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KiTTITAS COUNTY PUBLIC WORKS <br />to [City of <br />Local Agency Payment Bond <br />PUBLIC WORKS PAYMENT BOND <br />Bond No. <br />or <br />County], WA <br />The [City of or County], Washington ([City or County]) has awarded to <br />(Principal), a contract for the construction of the project designated as ,Project No. <br />in [location], Washington (Contract), and said Principal is required under the terms of that Contract to furnish a <br />payment bond in accord with Title 39.08 Revised Code of Washington (RCW) and (where applica1 D.28 RCW. <br />The Principal, and (Surety), a corporation organized under the of the ernpanies <br />of <br />and licensed to do business in the State of Washington as surety and named in the curve of 'Su Acceptable in <br />Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts, Tr ept., jointly and <br />severally held and firmly bound to the [City or County], in the sum of US <br />Dollars ($ ) Total Contract Amount, subject to the provisions herein. <br />This statutory payment bond shall become null and void, if and when the Pri'ts heirs, executors�l trators, successors, or <br />assigns shall pay all persons in accordance with RCW 39.08, 39.12, anIN <br />ng all worker pborers, mechanics, <br />subcontractors, and materialmen, and all person who shall supply sf o rrtra NLh provisions and supplies for <br />the carrying on of such work, and all taxes incurred on said Cont n50 a and all taxes imposed on the <br />Principal under Title 82 RCW; and if such payment obligation§ noIt?+�, Yhia shall remain in full force and effect. <br />The Surety for value received agrees that no change, e <br />specifications accompanying the Contract, or to the wo <br />this bond, and waives notice of any changes, extension C <br />performed. The Surety agrees that modifications and cha <br />amount to be paid the Principal shall automrlcrea <br />required for such increased obligation. <br />This bond may be executed in two_(2) original <br />only be accepted if it is accompa Ouli <br />PRINC[PAL <br />Principal Sign <br />Printed Name <br />Title <br />gyration or addition to the terms of the Contract, the <br />nd �r the Contract shall in anyway affect its obligation on <br />ddition to the terms of the Contract or the work <br />x conditions of the Contract that increase the total <br />of the Surety on this bond and notice to Surety is not <br />mal[ be signed by the parties' duly authorized officers. This bond will <br />id original power of attorney for the office executing on behalf of the surety. <br />SURETY <br />Date Surety Signature <br />Date Printed Name <br />Title <br />Name, address, and telephone of local officelagent of Surety Company is: <br />Approved as to form: <br />[City or County] Attorney, [City of or County] <br />DOT Form 272-003A <br />08/2012 <br />Date <br />Date <br />Date <br />