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Surety - Cash Surety Deposit Maintenance Assurance DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT Page 1 of 2 | Published: 2/1/2018 CASH SURETY DEPOSIT - MAINTENANCE ASSURANCE APPLICANT Name and Mailing Address (please print clearly) Name: Address 1: Address 2: Phone Number: Project No./Permit No. Project Name / Cash Surety Deposit Site Location $ The City of Renton (the “CITY”), hereby acknowledges receipt from the above-named APPLICANT, who has paid the cash surety deposit amount noted above. The APPLICANT hereby authorizes that the sum referenced above be kept on deposit with the City of Renton Finance Department for the purpose of guaranteeing that the above-referenced project will be maintained in accordance with the __________________________________________________________________ (“AGREEMENT”) for the project. THE CONDITION OF OBLIGATION is that: 1. Until written release of this obligation by the CITY, this cash financial guarantee may not be terminated or cancelled by the APPLICANT for any reason. 2. The obligations of the APPLICANT shall not be discharged or affected by any amendment of the engineering plans used for construction of the project. 3. Upon failure of the APPLICANT to perform any of the terms of the AGREEMENT, the CITY may use the funds to complete the work and pay outstanding fees and other amounts. The APPLICANT shall have no duty or right to evaluate the correctness or appropriateness of the CITY’S determination that requirements have not been satisfactorily completed. Any unexpended funds shall be returned to the above-named APPLICANT upon completion, to the CITY’S sole satisfaction, of the terms of the AGREEMENT. 4. The APPLICANT’S obligation to perform the work or pay fees and other amounts is not limited to the amount of this cash surety deposit. It is the APPLICANT’S responsibility to notify the CITY of any change in address, telephone number or change of ownership of the property. It is the APPLICANT’S responsibility to arrange for replacement of any/all financial guarantees prior to any change of ownership. APPLICANT: (Print Name) (Signature) (Date) Page 2 of 2 | Published: 2/1/2018 CASH SURETY DEPOSIT - MAINTENANCE ASSURANCE (CONT’D) Project No./Permit No. Project Name / (Choose One) INDIVIDUAL ACKNOWLEDGEMENT: State of Washington, County of King: I certify that I know or have seen satisfactory evidence that _________________________________________ (APPLICANT) signed this instrument and acknowledges it to be his/her free and voluntary act for the uses and purposes mentioned in this instrument. CORPORATE/LLC ACKNOWLEDGEMENT: State of Washington, County of King: I certify that I know or have satisfactory evidence that _____________________ is the _____________________ of _________________________, a Washington limited liability company/corporation (APPLICANT), and acknowledged this instrument to be the free and voluntary act and deed of said limited liability company/corporation, for the uses and purposes therein mentioned, and on oath stated that he/she was authorized to execute this instrument on behalf of said limited liability company/corporation. (Notary Seal or Stamp) Dated: Signature: Printed Name: My appointment expires: Received for the City of Renton By: (Print Name) (Signature) (Date)