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DOT Form 272-003A EF <br />12/2019 <br />PUBLIC WORKS PAYMENT BOND <br />to City of Everett, WA <br />Bond No. _________ <br />The City of Everett, Washington, has awarded to _______________________________________ (Principal), <br />a Contract for the construction of the project designated as 2025 PAVEMENT MAINTENANCE OVERLAY, <br />Project No. 3830, in Everett, Washington (Contract), and said Principal is required under the terms of that <br />Contract to furnish a payment bond in accord with Title 39.08 Revised Code of Washington (RCW) and (where <br />applicable) 60.28 RCW. <br />The Principal and ______________________________________ (Surety), a corporation organized under the <br />laws of the State of ______________________ and licensed to do business in the State of Washington as <br />surety and named in the current list of Surety Companies Acceptable in Federal Bonds as published in the <br />Federal Register by the Audit Staff Bureau of Accounts, U.S. Treasury Dept., are jointly and severally held and <br />firmly bound to _________________________________, in the sum of <br />_____________________________________________________________________________ US Dollars <br />($_______________________________) Total Contract Amount, subject to the provisions herein. <br />This statutory payment bond shall become null and void, if and when the Principal, its heirs, executors, <br />administrators, successors, or assigns shall pay all persons in accordance with RCW Titles 60.28, 39.08, and <br />39.12 including all workers, laborers, mechanics, subcontractors, lower tier subcontractors, and material <br />suppliers, and all persons who shall supply such contractor or subcontractor with provisions and supplies for <br />the carrying on of such work, and all taxes incurred on said Contract under Title 50 and 51 RCW and all taxes <br />imposed on the Principal under Title 82 RCW; and if such payment obligations have not been fulfilled, this <br />bond shall remain in full force and effect. <br />The Surety agrees to indemnify, defend, and protect the City of Everett against any claim of direct or indirect <br />loss resulting from the failure of the Principal, its heirs, executors, administrators, successors, or assigns, (or <br />the subcontractors or lower tier subcontractors of the Principal) to pay all laborers, mechanics, subcontractors, <br />lower tier subcontractors materialpersons, and all persons who shall supply such contractor or subcontractors <br />with provisions and supplies for the carrying on of such work. <br />The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of <br />the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract <br />shall in any way affect its obligation on this bond, except as provided herein, and waives notice of any change, <br />extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees <br />that modifications and changes to the terms and conditions of the Contract that increase the total amount to <br />be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety <br />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 <br />officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney <br />for the officer executing on behalf of the surety. <br />The Surety agrees to be bound by the laws of the state of Washington and subjected to the jurisdiction of the <br />state of Washington. <br />PRINCIPAL SURETY <br />______________________________________ <br />Principal Signature Date Surety Signature Date <br />Printed Name Printed Name <br />Title Title <br />Local office/agent of Surety Company: <br />Name _________________________________ Telephone _________________________________ <br />Address ____________________________________________________________________________ <br />STANDARD BOND FORM <br />OFFICE OF THE CITY ATTORNEY <br />APPROVED AS TO FORM <br />APPROVED AS TO CITY CHARTER § 4.1