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Home My WebLink AboutCAG2024-237 - Original - Soos Creek Water and Sewer District - East Hill North Community Park Water Installation - 05/20/2024 FOR CITY OF KENT OFFICIAL USE ONLY Sup/Mgr: Agreement Routing Form Dir Asst: • For Approvals,Signatures and Records Management Dir/Dep: sz KENT This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms. eL W A S H I N G T O N (Print on pink or cherry colored paper) (optional) Originator: Department: KateLynn Jennings for Terry Jungman Parks, Recreation &Community Services Date Sent: Date Required: > 5/6/2024 5/13/2024 O QAuthorized to Sign: Date of Council Approval: QDirector or Designee Mayor N/A Budqet Account Number: Grant?[--]Yes F71No P21067.64920.530 Budget?V]Yes[7]No Type: N/A Vendor Name: Category: Soos Creek Water and Sewer District Other Vendor Numb el Sub-Category: 34327 Original C East Hill North Community Park-Application and Agreement for Water Installation Project Name: E i O Project Details: C C O E Agreement Am $27,638.48 Basis for Selection of Contractor: Other *Memo to Mayor must be attached Start Date: May 2024 Termination Date: Q Local Business?7 Yes r7No* If meets requirements per KCC3.70.100,pleosecomplete"VendorPurchase-Locol Exceptions"form onCityspace. Business License Verification:DYes Dn-Process PlExempt(KCC 5.01.045) Notice required prior to disclosure? Contract Number: r7Yes17No CAG2024-237 Comments: CM GJ H •> i GJ 3 DC +, Date Received by City Attorney: 5/13/24 ca Im Date Routed to the Mayor's Office: 5/20/24 V1 Date Routed to the City Clerk's Office: 5/20/24 adccW22373_1_20 Visit Documents.KentWA.gov to obtain copies of all agreements rev.200821 SOOS CREEK WA TER AND SEWER DISTRICT APPLICATIONAND AGREEMENT FOR METER INSTALLATION The undersigned hereby makes application to Soos Creek Water and Sewer District for a connection with the water system of Soos Creek Water and Sewer District to the property line of the property described as follows: SFR ❑ Commercial ❑d Residential ❑ Backflow. Yes Parcel No: 102205 9011 Property Owner City of Kent Phone Number 253-856-5112 Mailing address 220 Fourth Ave S Kent WA 98032 Property Address 13525 SE 216th St Kent 98042 Legal Description Lot Block East Hill North Community Park Notes Premise isolation unless otherwise approved by SC. Permit Fee: $200.00 If the meter or angle-stop size changes,there Meter size:2 Inch 15" Lay Length Cost: $1 005.48 will be a meter upgrade fee of$650.00 It is the Service Installation:Long/Short $6,000.00 owner's responsibility to verify the existing angle-stop and requirements for connection. General Facilities Charges(non-refundable) $7,694.40 Initial: Latecomer/Special Connection# ff.x Local Facility Charge $12,813.00 ff.x Backflow Device Required Yes $100.00 SPUFacility Charge: $7,720.00 ROW: Other: TOTAL DUE. $27,638.48 The above is payment for a complete installation of such connection,including all pipes,fittings,meter box and meter appropriate to the connection. By signing this Application and Agreement as a condition to connection to the District's water system,the Property Owner agrees to comply with the terms and conditions of all applicable District resolutions and policies regarding the provision of water service,including,but not limited to payment of all rates and charges in accordance with the District's schedule of rates and charges. Upon completion of the installation,the Property Owner understands and agrees that it will commence paying the minimum water rate charged by the District,regardless of actual consumption. The Property Owner hereby acknowledges that the District retains all ownership to the meter and materials installed by the District in accordance herewith. Owner hereby grants to the District a license to enter onto Owner's property any equipment reasonably necessary to remove,maintain, repair and replace the water meter and appurtenances. This Agreement and Permit shall expire 150 days from the date hereof,unless delay has occurred due to action of the District. Upon renewal following expiration,the application acknowledges and agrees that it will pay the then-current General Facilities Area Charges and all other then-current charges related to the new Application,with credit being given only for the amount ofpayment made pursuant to this Application. MONTHL Y SER VICE CHARGE Billing for water service shall be rendered in accordance with Resolution No.3408-C. Application Date 3/28/2024 Expires 8/25/2024 Signature Date: 05/20/2024 Account Number Type: DE Dept Date Installed. Meter size Receipt No. By: Work Order Ready Meter#: ID# BillingBackflow Y/N: Data by: Radio ID# BF checked: Street Light Code: Inventory Tap Number. 24240 DE Dept Note: Signature: Terry Jun a (May a,zoza 10:35 PDT) Signature: Kent Parks(May 8,2021 Email: tjungman@kentwa.gov Email: parkscontracts@kentwa.gov Signature: 8rc�C&= efz Brian Levenhagen(May 13,20 09:04 PDT) Email: bjlevenhagen@kentwa.gov PPD-SoosCreekWater-EHN Permit Final Audit Report 2024-05-13 Created: 2024-05-06 By: KateLynn Jennings(kjennings@kentwa.gov) Status: Signed Transaction ID: CBJCHBCAABAAtiyaeMhCo9zZUPW7keaV4hMs8SDc4y6m "PPD-SoosCreekWater-EHN Permit" History Document created by KateLynn Jennings (kjennings@kentwa.gov) 2024-05-06-7:51:23 PM GMT Document emailed to Terry Jungman (tjungman@kentwa.gov)for signature 2024-05-07-0:53:25 AM GMT Email viewed by Terry Jungman (tjungman@kentwa.gov) 2024-05-08-5:35:06 PM GMT 1 Document e-signed by Terry Jungman (tjungman@kentwa.gov) Signature Date:2024-05-08-5:35:29 PM GMT-Time Source:server Document emailed to Kent Parks (parkscontracts@kentwa.gov)for signature 2024-05-08-5:35:30 PM GMT Email viewed by Kent Parks (parkscontracts@kentwa.gov) 2024-05-09-0:23:48 AM GMT E1 Document e-signed by Kent Parks (parkscontracts@kentwa.gov) Signature Date:2024-05-09-0:24:24 AM GMT-Time Source:server Document emailed to bjlevenhagen@kentwa.gov for signature 2024-05-09-0:24:26 AM GMT Email viewed by bjlevenhagen@kentwa.gov 2024-05-09-4:10:53 PM GMT Signer bjlevenhagen@kentwa.gov entered name at signing as Brian Levenhagen 2024-05-13-4:04:24 PM GMT E1 Document e-signed by Brian Levenhagen (bjlevenhagen@kentwa.gov) Signature Date:2024-05-13-4:04:26 PM GMT-Time Source:server Powered by r � Adobe T Acrobat Sign Agreement completed. 2024-05-13-4:04:26 PM GMT POWL-md by Adobe KENT Acrobat Sign