20130523144217897.pdf/tic �c�0
CITY,� � r O F; �; D M O N D S� DAVE EARLING
I
T v MAYOR
121 5th AVENUE NORTH • EDMONDS, WA 98020 • (425) 771.0220 • FAX (425) 771-0221
www.edmondswa.gov Date Posted
DEVELOPMENT SERVICES DEPARTMENT Expiration
Bond No 1092216
EARTH SUBSIDENCE AND LANDSLIDE HAZARD AREA (ESLHA)
SITE RESTORATION
BONDING COMPANY BOND
Edmonds Building Permit No. 13 l -QC) -O I 0 "-N 33
Project Address
Developer/Owr
WHEREAS, Theresa Neal , hereinafter referred to as
"The Principal", has applied to the City of Edmonds, hereinafter referred to as "The City", to
construct Deck Repairs located at 16116 72nd Ave W, Edmonds WA 98026
within City limits.
WHEREAS, as required by City Ordinance #3632, this form will certify that this Surety has
a bond for the above referenced project. This bond is established for restoration and/or other
repairs or stabilization measures, as required by Edmonds Community Development Code
Chapter 19.10.050A.
NOW, THEREFORE, the undersigned Principal and bonding company, Lexon Insurance Company
a corporation authorized to transact surety business in the State of Washington, hereinafter
referred to as "The Surety", agree and bind themselves, their heirs, executors, administrators
and assigns, unto the City in the sum of $ 50, 000.00 , lawful money of the United States,
according to the following terms and conditions:
1) The total sum indicated will be withheld by this Surety from disbursements, to any
entity other than the City of Edmonds or its designee. Only written authorization from the City
shall cause release of the Bond.
2) If the Principal does not complete all repairs and/or restorations within 24 hours of
service of written notice, then the Surety shall, upon demand by the City remit to the City
within ten (10) days of receipt of said demand, the amount of this Bond or such lesser amount
as may be specified in the demand, so that the repairs can be installed or completed
immediately to City standards. Such funds shall also be paid to the City for emergency repairs
undertaken to stabilize the site, public improvements, or utilities and/or adjacent structures,
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where it is impossible or impractical to provide the 24 hour notice to correct. The Surety shall
not be liable to the owner for disbursement of said funds to the City of Edmonds or on its
behalf.
3) In the event the Principal fails to complete any of the above repairs or restoration within
the time period specified by the City, its employees and agents shall have the right at their sole
election to enter onto said property for the purpose of completing the repairs. This provision
shall not be construed as creating an obligation on the part of the City or its representatives to
complete such repairs or restorations.
4) In the event any lawsuit is instituted by the City, the Principal or the Surety to enforce
the terms of this Bond or to determine the rights of any party hereunder, the prevailing party in
such litigation shall be entitled to recover from the losing party its costs, including reasonable
attorneys' fees, incurred as a result of such lawsuit.
5) This bond shall remain in full force and effect until occupancy approval on the structure
is granted by the City Building Official.
DATED this 23rd day of may
Lexon Insurance C?mpany
Bonding Company
Cameron Huntsucker, Attorney -in -Fact
Officer/Title
co Integrity Surety LLC 206-546-1397
17544 Midvale Ave N #300, Seattle WA 98133
Address/Phone
1092216
T.9001HEM
2013
Developer/Owner/Principal
Theresa Neal
Print Name
16116 72nd Ave W, Edmonds WA 98026
Mailing Address
-- 'W V
Phone Number
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STATE OF WASHINGTON)
) ss.
County of King )
On this 23rd day of May 2013 , before me, the undersigned, a
Notary Public in and for the State of Washington, duly commissioned and sworn, personally appeared
Cameron Huntsucker to me know to be the
Attorney -in -Fact of Lexon Insurance Company the corporation
that executed the foregoing instrument, and acknowledged the said instrument to be the free and
voluntary act and deed of said corporation, for the uses and purposes therein mentioned, and on oath
state that he was authorized to execute said instrument and that the seal affixed is the
corporate seal of said corporation.
1111111„
W'5+ °y hand and official seal he
® ' �0 ARY
PUBOGio
os 26
the day and year first above written.
00 PUBLIC in and for the State of
shington, Residing at Seattle WA
OF 0�`�•�® DEVELOPER/OWNER ACKNOWLEDGEMENT
STATE OF WASHINGTON)
) ss.
County of King )
On this 23rd day of May 2013 , before me, the undersigned, a
Notary Public in and for the State of Washington, duly commissioned and sworn, personally appeared
Theresa Neal
Owner
to me know to be the
of Subject Property
the general
partnership that executed the foregoing instrument, and acknowledged the said instrument to be the
free and voluntary act and deed of said partnership, for the uses and purposes therein mentioned, and
on oath state that she
was authorized to execute said instrument.
WITNESS my hand and official seal hereto a
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POWER OF ATTORNEY
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KNOW ALL MEN BYTHESE PRESENTS, that LEKUN|0SUHANCE COMPANY, aTexas Corporation, with its principal office in
Louisville, Kentucky, does hereby constitute and appoint: Kara Skinner,C8DleCOD Huntsucker * * * * * * * * * * * * * * * * *
its true and lawful Attorney(s)-In-Fact to make, exeoute, seal and deliver for, and on its behalf as nurety, any and all bonds, undertakings or
other writings obligatory in nature of bond.
This authority is made under and by the authority of a resolution which was passed by the Board of Directors of LE8ON
INSURANCE COMPANY onthe 1st day ofJuly, 2O03aefollows:
Resolved, that the President odthe Company is hereby authorized ioappoint and empower any representative ofthe Company or
other person orpersons aa/01nrney-|n'Facttuexecute onbehalf ofthe Company ap�bon�s~��do�ak�qa�md' ~nontmu�nfi y
orNhorxvhhngsob|ig�oryinnature Wabond not toexceed $ ' 000 ~—^~^~00 ~'`~^^~'`~'~^ -- ----
dollars, which the Company might execute through its duly elected officers, and affix the seal of the Company thereto. Any said execution of
auohdooumontsbyanAUomey-|n'Fao shall be as binding upon the Company as if they had been duly executed and acknowledged by the
regularly elected officers ofthe Company. Any A8om*y'|n-Fact, so appointed, may be removed for good cause and the authority aogranted
may berevoked aaspecified inthe Power ofAttorney.
Heeo|ved, that the signature o(the President and the aeu| ofthe Company maybe affixed by facsimile on any power ofattorney
granted, and the signature of the Assistant Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such
power and any such power orcertificate bearing such facsimile signature and seal shall bevalid and binding on the Company. Any such
power so executed and sealed and certificate so executed and sealed ehe||, with respect to any bond of undertaking to which it is attached,
continue tobovalid and binding onthe Company.
IN WITNESS THEREOF, LEXON INSURANCE COMPANY has caused this instrument to be signed by its Prooident, and its
Corporate Seal to be affixed this 21at day of September, 2009,
LEXON|NSUHANCE COMPANY
d: TEXAS
MPANY BY
David E. Campbell
President
ACKNOWLEDGEMENT
On this 21e1day ofSeptember, 2009. before m*. personally came David E.Campbell Vo mo knmwn, who being duly sworn, did
depose and say that he is the President of LEXON INSURANCE COMPANY, the corporation described in and which executed the above
instrument; that he executed said instrument on behalf ofthe corporation byauthority nf his office under the By-laws of said corporation,
"OFFIC.IAL SEAL"
MAURE EN K. AYE
Notary Piablic, State of Illinois
My Commission Exph-es 09/21/13 \.Maureen K. Aye
CERTIFICATE Notary Public
|. the undersigned, Assistant Secretary ofLEXONINSURANCE COMPANY, ATexas Insurance Company, DOHEREBY CERTIFY
that the original Power cdAttorney dwhich the foregoing iaatrue and correct oopy, is in full hoom and effect and has not been revoked and
the resolutions auset forth are now inforce.
Signed and Sealed at Woodridge, Illinois this Day of 20 � �
_
rEXAS
X* INSURANCE
COMPANY
Philip
Assistant Secretary
"WARNINGperson who knowingly and with intent to defraud any insurance company or other person, files an application for insurance
statement mclaim containing any materially false information, or conceals for the purpose of misleading, information concerning any factmmori'
al thereto, commits a fraudulent insurance act, which is a crime and Subjects Such person to criminal and civil penalties."