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771-0221
DEVELOPMENT SERVICES DEPARTMENT Expirationl.
Bond No 71610273
EARTH SUBSIDENCE AND LANDSLIDE HAZARD AREA (ESL€ -dA)
SITE RESTORATION
BONDING COIViPANY BOND
Edmonds Building Permit No, BLD2014-0942
Project Address 15701 75th Place West
Developer/caner Vats NI. Car 1 —
5
WHEREAS, Van M. Caryl hereinafter referred to as
"The Princispal", has applied to the City of Edmonds, hereinafter referred to as "The City", to
ite Restoratioxi- uth Subsidence
constructer T andslirlP TTa�ar Arca located at 15701 75th Place West
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, WESTERN SURETY 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 tide City for emergency repairs
undertaken TO stabilize the site, ulbllc
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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 13th day of January r 2015
WESTERN SURETY COMPANY
Bonding Company Jolin M. Brown
Attorney-i�,,-Fact
'orney
cer
Wabash Ave., 41st Floor
0 icer/Title 333 S. Wabad, �A,,
Chicago, IL 60604 / 605-336-0850
Address/Phone
71610273
Van M. Siarl
Developer/Owner/Principal
Print Name
15701 75th P1. W., Edmonds, WA 98026
Mailing Address
425-870-8084
Phone Number
1 -\building new folder 2010\es1ha\es1ha bonding corn pa ny,docx ESI-HARestoration Bond Form Page 203
Wil"AUT 1121
STATE DFILLINOIS
)
/ms.
County of COOK
On this 14th d ay of January _2015before me, the undersigned, o
Notary Public 1nand for the State ofILLINOIS ' duly commissioned and sworn, personally appeared
JOHN M BROWN to meknow hn6ethe
ATTORNEY wFACT _of WESTERN SURETY COMPANY the corporation
that executed the foregoing instrument,and acknowledged the said instrument t0bethe free and
voluntary act and deed ufsaid corporation, for the uses and purposes therein mentioned, and *noath
state that he was authorized to execute said instrument and that the seal affixed is the
corporate seal o[said corporation,
WITNESS n`yhand and official seal hereto affi d the day and year first above written.
THOMAS M. HESTER C—ILA"
OFFICIAL SEAL NOTARY PUBLIC }nand fordheState nf
Notary Public, State of Illinois
My Commission Expires �ow"�u=*o^��"/L
October 02, 2016
ILLINOIS,8a�dioQai,—__
STATE OF WASHINGTON)
}ss.
County of
On this
before me, the undersigned, o
Notary Public in and forthe State of Washington, duly commissioned and sworn, personally appeared
umeknow tobethe
the general
partnership that executed the foregoing instrument, and acknowledged the said instrument tobethe
free and voluntary act and deed of said partnership, for the uses and purposes therein mentioned, and
on oath state that ___A�4
was authorized toexecute said instrument.
WITNESS y rha I hereto affixed the ci�
of
o% NOTARY PUBLIC in and fc
Washington, Residing at., X
st
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ACKNOWLEDGMENT OF SURETY
STATE OF Illinois — (Attorney -in -Fact) Bond No. 71610273
COUNTY OF Cook ss
On this I'A 114- day of _J AN om, before me, a notary public in
and for said County, personally appeared JOHN M BROWN
to me personally known and being by me duly sworn, did say, that he/she is the Attorney -in -Fact of WESTERN SURETY
COMPANY, a corporation of Sioux Falls, South Dakota, created, organized and existing under and by virtue of the laws of the
State of South Dakota, that the said instrument was executed on behalf of the said corporation by authority of its Board of
Directors and that the said JOHN M BROWN
acknowledges said instrument to be the free act and deed of said corporation and that he/she has authority to sign said
instrument without affixing the corporate seal of said corporation.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal at
Chicago Illinois , the day and year last above written.
My con ssion expires
12 , t!
Form 106-9-2013
THOMAS M HESTER
OFFICIAL SEAL
,fit Notary Public, State of Illinois
9 `;,� My Commission Expires
l October 02, 2016
Western Surety Company
POWER OF ATTORNEY - CERTIFIED COPY
Bond No. 71610273
Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws
of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company"), does by these presents make,
constitute and appoint JOHN M BROWN
its true and lawful attorney(s)-in-fact, with full power and authority hereby conferred, to execute, acknowledge and deliver for and on its
behalf as Surety, bonds for:
Principal: Van M. Caryl
Obligee: City of Edmonds
Amount: $500,000.00
and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Senior Vice President, sealed with
the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said attorneys) -in -fact
may do within the above stated limitations. Said appointment is made under and by authority of the following bylaw of Western Surety
Company which remains in full force and effect.
"Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile."
All authority hereby conferred shall expire and terminate, without notice, unless used before midnight of January 13
2016 , but until such time shall be irrevocable and in full force and effect.
In Witness Whereof, Western Surety Company has caused these presents to be signed by its Vice President, Paul T. Bruflat, and its
corporate se j;tg. w -affixed 13th day of January 2015
WEST R SURE COMPANY
Paul T. ruflat, Vice President
9TQTrF°°z9rA
COUNT 7s,lijj � ss
On this 13th day of January in the year 2015 , before me, a notary public, personally appeared
Paul T. Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of
WESTERN SURETY COMPANY and acknowledged said instrument to be the voluntary act and dee f said co o at'on.
}4 4 4 4 44 4444444 4444 9 4 44444 +
8 S. PETRIK %
a SEAL NOTARY PUBLIC $ a otary Public - South Dakota
j�SOUTH DAKOTA l?
X44444444444444444444444 'f
My Commission Expires August 11, 2016
I the undersigned officer of Western Surety Company, a stock corporation of the State of South Dakota, do hereby certify that the
attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as
set forth in the Power of Attorney is now in force.
In testimony wherecf, I have hereunto set my hand and seal of Western Surety Company this 13th day of
January 2015
WEST R SURE COMPANY
Paul T. fruflat, Vice President
Form F5306-8-2012