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PAYMENT BOND <br />Bond No. 023219182 <br />The City of Everett has awarded toForma Construction Company(principal), a contract for the construction of the <br />project designated as Job Order Contracting for General Construction Services, Project No. 2021-022, in Everett, <br />Washington (Contract), and said Principal is required under the terms of that Contract to furnish a payment bond in accord <br />with Title 39.08 Revised Code of Washington (RCW) and (where applicable) 60.28 RCW. *Year 1 <br />The Principal, and Liberty Mutual Insurance Company (Surety), a corporation organized under the laws of the <br />State of Massachusetts and licensed to do business in the State of Washington as surety and named in the <br />current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff <br />Bureau of Accounts, U.S. Treasury Dept., are jointly and severally held and firmly bound to the City of Everett in the sum of <br />Three Million and No/100 US Dollars ($ 3,000,000.00 ) Total Contract <br />Amount, subject to the provisions herein. <br />This statutory payment bond shall become null and void, if and when the Principal, its heirs, executors, administrators, <br />successors, or assigns shall pay all persons in accordance with RCW Titles 39.08 and 39.12 including all workers, laborers, <br />mechanics, subcontractors, and material suppliers, and all persons who shall supply such contractor or subcontractor with <br />provisions and supplies for the carrying on of such work; and if such payment obligations have not been fulfilled, this bond <br />shall remain in full force and effect. <br />The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, <br />the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its <br />obligation on this bond, except as provided herein, and waives notice of any change, extension of time, alteration or <br />addition to the ter ms of the Contract or the work performed. The Surety agrees that modifications and changes to the <br />terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase <br />the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. <br />This bond may be executed in two (2) original counterparts, and shall be signed by the parties' duly authorized officers. <br />This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer <br />executing on behalf of the surety. <br />PRINCIPAL Forma Construction Company SURETY <br />Printed Name: <br />PR.TAN RTCH <br />Title: VICE PRESIDENT <br />y Mutual Insurance Company <br />tut) <br />Printed Name: Holli Albers <br />Title: Attorney -in -Fact <br />Name, address, and telephone number of local office/agent of Surety is: <br />Propel Insurance <br />1201 Pacific Ave., Suite 1000, Tacoma, WA 98402 <br />253-759-2200 <br />PAYMENT BOND APPROVED BY <br />CITY OF EVERETT, WASHINGTON <br />By: <br />ATTEST: <br />Cassie Franklin, Mayor Sharon Fuller, City Clerk <br />Date: <br />Date: <br />APPROVED AS TO FORM: <br />City Attorney <br />Date: <br />