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KITTITAS COUNTY PUBLIC WORKS
<br />Local Agency Ray.ment Bond
<br />PUBLIC WORKS PAYMENUTBOND
<br />to [City of or County], WA
<br />Bond No.
<br />The ,_:-------_—__ County], Washington QCity or County]) has awarded to
<br />(Principal), a contract for the construction of the project designated as ,Project
<br />No. in [location], Washington (Contract), and said Principal is required under the terms of that Contract to furnish
<br />payment bond in accord with Tile 39.08 Revised Code of Washington (RCW) and (where applicable_w�.28 RCW_
<br />The Principal, and (Surety), a corporation organized under theIa .4 the Stag of
<br />and licensed to do business in the State of Washington as surety and named in the current ' t ,Su•ity V , Apanies Acceptable in
<br />Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts,. '� ? •.f; ,gip{ , are jointly and
<br />severally held and firmly bound to the [City or County], in the sum of + U5
<br />Dollars ($ ) Total Contract Amours subject to the provisions herein.
<br />This statutory payment bond shall become null and void, if and when the Prinits heirs, execut;;, ', ' -oistrators, successors, or
<br />assigns shall pay all persons in accordance with RCW 39.08, 39.12, and 80.2_*'. Wig all workers i'abo?brs, mechanics,
<br />subcontractors, and materialmen, and all person who shall supply suct; :-- - a` ;• r ro . b :;-'-se`nr � provisions and supplies for
<br />the carrying on of such work, and all taxes incurred on said Contra& ' ,oei,. TT .. 0 n _ RrV - Ad all taxes imposed on the
<br />Principal under Title 82 RCW; and if such payment obligations ha_ - ct t; iL '.I=d, t?1lS'i .•,1 'Iball remain in full force and effect.
<br />4
<br />The Surety for value received agrees that no change, e on .-it; -A* ' =uon or addltron to the terms of the Contract, the
<br />specifications accompanying the Contract, or to the wo 7 ry r;.j 1, u ,mr the Contract shall in anyway affect its obligation an
<br />this bond, and waives notice of any changes, extension or .irsraLurf , ddition to the terms of the Contractor the work
<br />performed_ The Surety agrees that modifications and chan6 I - p r } a ,ronditions of the Contract that increase the total
<br />amount to be paid the Principal shall automat]"IN increase- bf-i_ : ^ offt Surety on this bond and notice to Surety is not
<br />required for such increased obligation. S
<br />This bond may be executed in two (2) original caw'.. ;arty, 11 be signed by the parties' duly authorized officers. This bond will
<br />only be accepted if it is accompar�jc" i a fully ex .,, ' a¢d original power of attorney for the office executing on behalf of the surety.
<br />PRINCIPAL Y SURETY
<br />Principal' Signature Date Surety Signature
<br />Printed Name ' Date
<br />Title
<br />Printed Name
<br />Title
<br />Name, address, and telephone of local of icelagent of Surety Company is:
<br />Approved as to form:
<br />[City or County] Attorney, [City of or County]
<br />DOT Form 272-003A
<br />OW012
<br />Date
<br />Date
<br />Date
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