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AG 23-255 - KEYBANKRETURN TO: PW ADMIN EXT: 2700 ID #: q J 5-7 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / Deputy Director 2. ORIGINATING STAFF PERSON: Desiree Winkler EXT: 2700 3. DATE REQ. BY: 1 2/22/23 3. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION 0 CONTRACT AMENDMENT (AG#): TBD ID434% ❑ INTERLOCAL EI OTHER. Relocation Voucher Amendment 4. PROJECT NAME: CalVo/Hernandez Relocation Voucher 4 NAME OF CONTRACTOR: In -House Escrow ADDRESS: E-MAIL: SIGNATURE NAME: TELEPHONE: FAX: TITLE: 6. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL, EXP. 12/311 UBI #, , EXP. _/_/ 7. TERM: COMMENCEMENT DA COMPLETION DATE: 8. TOTAL COMPENSATION: $ 556.31 "(INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: S IS SALES TAX OWED: 13 YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED 8 PURCHASING: PLEASE CHARGE TO: 36610-26110 9. DOCUMENT / CONTRACT REVIEW ❑ PROJECT MANAGER DIVISION MANAGER DEPUTY DIRECTOR d DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) 11 LAW DEPT 10. COUNCIL APPROVAL (IF APPLICABLE) INITIAL / DATE REVIEWED INITIAL / DATE APPROVED DSW 12/8/23 KVA 12111/2023 SCHEDULED COMMITTEE DATE: SCHEDULED COUNCIL DATE: COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 11. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: N III DATE REC, D: N (� ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE (INCLUDE DEPT. SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.) INITIAL / DATE SIGNED AG# a 5 DATE SENT:_ a COMMENTS: EXECUTE " 1 " ORIGINALS ❑ FINANCE DEPARTMENT ❑ LAW DEPT ❑ SIGNATORY (MAYOR OR 1RIiCTOR ❑ CITY CLERK ❑ ASSIGNED AG.# ❑ SIGNED COPY RETURNED 1/2020 Amendment to original voucher Relocation Assistance Voucher 2 Agency Name: City of Federal Way 33325 81' Ave. S Federal Way, WA 98003 I hereby certify under penalty of perjury that the items and amounts listed herein are proper charges against the Agency. That the same or any part thereof has not been paid, and that I am authorized to sign for the claimant. I further certify that I am a citizen of the United States of America or am an alien lawfully present in the United States of America. Displaced Person(s) or Claimant (Name, address with zip + 4 to which payment will be sent) Javier Calvo & Maria Isabel Le6n Hernandez 31014 28ih Ave S Federal Way, WA 98003-5005 Signature (Blue ink) for each claimant X Date Javier Calvo X Maria Isabel Le6n Hernandez Project Title: City of Federal Way, Joint Operations & Maintenance Facility Parcel No.: 092104-9170 Displacee No.: 2 Displacee Name: Javier Calvo & Maria Isabel Le6n Hernandez Date Parcel Vacated: PENDING Replacement Housing Pa ments $ Amounts Price Differential — 90 da owner for amounts u2 to $31,000 $0.00 MIDP - Increased Mortgage Interest Payment $0.00 Incidentals — Other costs as the ageneX determines to be incidental to the purchase $556.31 Last Resort Housing — owner for amounts over $31,000 $0.00 Rental Supplement — 90 day tenants and certain others amounts up to $7,200 $0,00 Down Payment Assistance — 90 day tenants and certain others $0.00 Last Resort Housing — tenants amounts over $7,200 $0.00 Comments / other cicscribc): $0.00 Moving Expense Payments $ Amounts Self -Move / Schedule Payments — residential $0.00 Actual Expenses (Commercial Move/Actual Cost Self Move) — residential $0.00 Fixed Payment (in lieu of all other moving expenses) - Non -Residential I $0.00 Actual Costs / Self Move / Commercial - Non -Residential $0.00 Reestablishment Costs - Non -Residential $0.00 Personal Pro ert Only $0.00 Comments / Other (describe): $0.00 Deductions: _$0.00 TOTAL 4 $556.31 Invoice No.- Date: Amount: $ ACCOUNT CLASSIFICATION PARCEL JOB NUMBER WORK OP I ACCOUNT I CONTROL I OBJ SUB SECTION ORG. NO. NON -PART TOTALS DOLLARS WORK ORDER I GRP TOTAL 4$556.31 RELOCATION SPECIALIST: Paula Ferreira -Smith Pin. 'e,,1 bUD_. DATE:12/4/2023 project Manager, Margc 13ailev Marge R. Bailey DATE:12/8/2023 [, the undersigned, certify that the above information is correct, that the payment is necessary for the above relocation assistance, that it has been performed in accordance with prescribed procedures, and that this payment is not considered income or resources to a "DISPLACED PERSON" pursuant to Section 216 of Public Law 91-646 and RC W 8.26,115.: Z lr 8 1ZoZ Warrant Register No.: Voucher No.: AGE AUTHORIZATION: DATE EJ Walsh. Public Works Director. City of Federal Way LPA-537 Pa 4nnio TIlerreto, A C L S C 0 M P A N Y From: Marge Bailey, Project Manager Paula Ferreira -Smith, Senior Relocation Agent Date: December 8, 2023 Project Title: City of Federal Way, Joint Operations and Maintenance Facility Parcel No: 092104-9170 Displacee: Javier Calvo & Maria Isabel Leon Hernandez Displacee No.: 2 Subject: Replacement Housing— Mortgage Interest Differential, Incidental Expenses, & Purchase Price Differential Payment Recommendation —AMENDMENT NO. 1 This amendment No. 1 to the original "Replacement Housing" Recommendation is necessary to reflect the actual costs of the 4% buydown (or 4% points). The actual cost is $7,696.40. (see attached closing cost details). The original estimate of the 4% buydown from the mortgage lender was: $7,140.09. Therefore, the city shall pay the difference of: $556.31. Payment to be made through the closing escrow company for the replacement home. The undersigned has reviewed and approves this Amendment 1 to the Incidental Expenses and Mortgage Interest Differential, Replacement Housing Payment Recommendations to purchase the replacement home. City of Federal Way Ali Date: 023 EJ Walsh, P.E. Public Works Director Tierra ?fight cf ':Voy Sei ,ices Lrd LEI ��iB��P,I.irtln Niy East. Suite 203 • La_ey `,V_ishingto❑ 93516 . Phone_ 205 36-, 155r, . Closing Disclosure This form is a statement of final loan terms and closing costs. Compare this document with your Loan Estimate. Closing Information Transaction Information Loan Information Date Issued 12/07/2023 Borrower Javier Calvo Loan Term 11 yr. 1 mo. Closing Date 12/08/2023 31014 28th Ave S Purpose Purchase Disbursement Date 12/12/2023 Federal Way, WA 98003 Product Fixed Rate Settlement Agent In House Escrow Seller Donna Connor and John Dochnahl 37806 39th Ave S Loan Type ®Conventional El FHA File # 1-2887-JQ Auburn, WA 98001 ❑ VA ❑ Property 37806 39th Ave S Lender Sound Credit Union Loan ID # 20000009942 Auburn, WA 98001 MIC # Sale Price $577,200 Loan Terms Can this amount increase after closing? Loan Amount $192,410 NO Interest Rate 5.125 % NO Monthly Principal & Interest $1,899.27 See Projected Payments below for your Estimated Total Monthly Payment Prepayment Penalty NO Does the loan have these features? NO Balloon Payment I NO Payment Calculation Principal & Interest Mortgage Insurance Estimated Escrow Amount can increase over time Estimated Total Monthly Payment Estimated Taxes, Insurance & Assessments Amount can increase over time See page 4 for details Closing Costs Cash to Close Years 1-12 $1,899.27 0 653.01 $2,552.28 This estimate includes In escrow? ® Property Taxes YES $653.01 ® Homeowner's Insurance YES a month ❑ Other: See Escrow Account on page 4 for details. You must pay for other property costs separately. $9,759.91 Includes $4,217.15 in Loan Costs + $5,542.76 in Other Costs - $0 in Lender Credits. see page 2 for details. $363,569.94 Includes Closing Costs. See Calculating Cash to Close on page 3 for details. rc1 1 RSFF 1ASR rl n imr ni rl rKl IRF PArF 1 nF S • I nAN In fl7nnnnnnQQa7 Closing Cost Details Borrower -Paid I Seger -Paid Paid By • ' At Closing Before_Closing l At dosing Before Closing others A. Origination Charges $1,100.00 4% of Loan Amount (Points) to Sound Credit Union $7,696.40 Processing Fee to Sound Credit Union $1,100.00 Il B. Services Borrower Did Not Shop For $1,012.75 Appraisal Fee to Arivs $850.00 Credit Report Fee to Factual Data $62.25 Flood Certificate Fee to Core Logic $15.50 Tax Service Fee to Cenlar $85.00 C. Services Borrower Did Shop For $2,104.40 I Title— Document Delivery Fee to In —House Escrow $75.00 i Title— E—Recording Fee to In —House Escrow $11.00 Title— Notary Fee to In —House Escrow $150.00 Title —Settlement —Closing Fee to In —House Escrow $1,255.14 Title —Titlelnsur—Lender's toTicorTitle $613.26 D. TOTAL LOAN COSTS (Borrower -Paid) $4,217.15 Loan Costs Subtotals (A + B + C) $3,367.15 $850.00 E. Taxes and Other Government Fees $445.00 Recording Fees Deed: $210.00 Mortgage: $235.00 $445.00 F. Prepaids $2,485.71 Homeowner's Insurance Premium (12 mo.) to Allstate $1,937.91 Mortgage Insurance Premium ( mo.) Prepaid Interest ($27.39 per day from 12/12/23 to 1/1/24) $547.80 Property Taxes ( mo.) G. Initial Escrow Payment at Closing $2,612.05 Homeowner's Insurance $161.49 per month for 5 mo. $807.45 Mortgage Insurance per month for mo. Property Taxes $8.06 per month for 5 mo. $40.30 County Property Taxes $483.46 per month for 6 mo. $2,900.76 Aggregate Adjustment $-1,136.46 H. Other Commissions to eXp Realty $17,250.00 Commissions to Skyline Properties Inc $17,250.00 Title —Title lnsur—Owner's to Ticor Title i $1,639.39 i I. TOTAL OTHER COSTS (Borrower -Paid) $5,542.76 Other Costs Subtotals (E + F + G + H) I $5,542.76 I J. TOTAL CLOSING COSTS (Borrower -Paid) $9,759.91 Closing Costs Subtotals (D + 1) $8,909.91 $850.00 $36,139.39 $7,696.40 Lender Credits n iw;rr iAs,A (-1 nrimr ni ri n i IRF PGr;F ) nr C • I nAN In tt,)nnnnnnOQd7 Calculating Cash to Close Use this table to see what has changed from your Loan Estimate. Loan Estimate Final Did this change? Total Closing Costs (J) $17,880.00 $9,759.91 YES • See Total Loan Costs (D) and Total Other Costs (1) Closing Costs Paid Before Closing $0 -$850.00 YES • You paid these Closing Costs before closing Closing Costs Financed (Paid from your Loan Amount) $0 $0 NO Down Payment/Funds from Borrower $384,790.00 $384,790.00 NO Deposit -$25,653.00 -$5,000.00 YES • You decreased this payment. See Deposit in Section L. Funds for Borrower $0 $0 NO Seller Credits $0 $0 NO Adjustments and Other Credits $0 -$25,129.97 YES • See details in Sections K and L Cash to Close $377,017.00 $363,569.94 Use this table to see a summary of your transaction. BORROWER'S TRANSACTION K. Due from Borrower at Closing Sale Price of Property Sale Price of Any Personal Property Included in Sale Closing Costs Paid at Closing (J) Adjustments Adjustments for Items Paid by Seller in Advance City/Town Taxes to County Taxes 12/12/23 to 01/01/24 Assessments to Other 12/12/23 to 01/01/24 L Paid Already by or on Behalf of Borrower at Closing Deposit Loan Amount Existing Loan(s) Assumed or Taken Subject to Seller Credit Other Credits Other City of Federal Way other City of Federal Way Adjustments $586,430.27 $577,200.00 $8,909.91 SELLER'S TRANSACTION M. Due to Seller at Closing Sale Price of Property Sale Price of Any Personal Property Included in Sale Adjustments for Items Paid by Seller in Advance City/Town Taxes to $315.30 County Taxes 12/12/23 to 01/01/24 Assessments to $5.06 Other 12/12/23 to 01/01/24 $222,860.33 N. Due from Seller at Closing $5,000.00 Excess Deposit $192,410.00 Closing Costs Paid at Closing (J) Existing Loan(s) Assumed or Taken Subject to Payoff of First Mortgage Loan Payoff of Second Mortgage Loan $20,653.33 $4,797.00 Seller Credit Adjustments for Items Unpaid by Seller Adjustments for Items Unpaid by Seller City/Town Taxes to City/Town Taxes to County Taxes to County Taxes to Assessments to Assessments to $577,520.36 $577,200.00 $315.30 $5.06 $36,139.39 $36,139.39 CALCULATION CALCULATION Total Due from Borrower at Closing (K) $586,430.27 Total Due to Seller at Closing (M) $577,520.36 Total Paid Already by or on Behalf of Borrower at Closing (L)-$222,860.33 Total Due from Seller at Closing (N)-$36,139.39 Cash to Close ®From ❑ To Borrower $363,569.94 Cash ❑ From ®To Seller $541,380.97 n 1RrAA iassz rl rKINf; nirrl nri IRF par F: :t r1F S • I nArj In tt7nnnnnnQQd7 Additional Information About This Loan Assumption If you sell or transfer this property to another person, your lender ❑ will allow, under certain conditions, this person to assume this loan on the original terms. ® will not allow assumption of this loan on the original terms. Demand Feature Your loan ❑ has a demand feature, which permits your lender to require early repayment of the loan. You should review your note for details. ® does not have a demand feature. Late Payment If your payment is more than 15 days late, your lender will charge a late fee of 5% of the overdue monthly principal and interest payment. Negative Amortization (Increase in Loan Amount) Under your loan terms, you ❑ are scheduled to make monthly payments that do not pay all of the interest due that month. As a result; your loan amount will increase (negatively amortize), and your loan amount will likely become larger than your original loan amount. Increases in your loan amount lower the equity you have in this property. ❑ may have monthly payments that do not pay all of the interest due that month. If you do, your loan amount will increase (negatively amortize), and, as a result, your loan amount may become larger than your original loan amount. Increases in your loan amount lower the equity you have in this property. ® do not have a negative amortization feature. Partial Payments Your lender ❑ may accept payments that are less than the full amount due (partial payments) and apply them to your loan. ❑ may hold them in a separate account until you pay the rest of the payment, and then apply the full payment to your loan. ® does not accept any partial payments. If this loan is sold, your new lender may have a different policy. Security Interest You are granting a security interest in 37806 39th Ave 5, Auburn, WA 98001 You may lose this property if you do not make your payments or satisfy other obligations for this loan. Escrow Account For now, your loan ® will have an escrow account (also called an "impound" or "trust" account) to pay the property costs listed below. Without an escrow account, you would pay them directly, possibly in one or two large payments a year. Your lender may be liable for penalties and interest for failing to make a payment. Escrow Escrowed $7,836.12 Estimated total amount over year 1 for Property Costs your escrowed property costs: over Year 1 Hazard Insurance County Property Taxes Assessment Non -Escrowed Estimated total amount over year 1 for Property Costs your non -escrowed property costs: over Year 1 You may have other property costs. Initial Escrow $2,612.05 A cushion for the escrow account you Payment pay at closing. See Section G on page 2. Monthly Escrow $653.01 I The amount included in your total Payment monthly payment. ❑ will not have an escrow account because ❑ you declined it ❑ your lender does not offer one. You must directly pay your property costs, such as taxes and homeowner's insurance. Contact your lender to ask if your loan can have an escrow account. No Escrow Estimated Estimated total amount over year 1. You Property Costs must pay these costs directly, possibly over Year 1 in one or two large payments a year. Escrow Waiver Fee In the future, Your property costs may change and, as a result, your escrow pay- ment may change. You may be able to cancel your escrow account, but if you do, you must pay your property costs directly. If you fail to pay your property taxes, your state or local government may (1) impose fines and penalties or (2) place a tax lien on this property. If you fail to pay any of your property costs, your lender may (1) add the amounts to your loan balance, (2) add an escrow account to your loan, or (3) require you to pay for property insurance that the lender buys on your behalf, which likely would cost more and provide fewer benefits than what you could buy on your own. n 1StSFF iaSu ri ncimr, nitr-i n�i iRF Paf;F a nF F • i naN in s?nnnnnngaa,) Total of Payments. Total you will have paid after you make all payments of principal, interest, mortgage insurance, and loan costs, as scheduled Finance Charge. The dollar amount the loan will cost you. Amount Financed. The loan amount available after paying your upfront finance charge. Annual Percentage Rate (APR). Your costs over the loan term expressed as a rate. This is not your interest rate. Total Interest Percentage (TIP). The total amount of interest that you will pay over the loan term as a percentage of your loan amount. Name Address NMLS ID WA License ID Contact Contact NMLS ID Contact WA License ID Email Phone Appraisal If the property was appraised for your loan, your lender is required to $257,366.51 give you a copy at no additional cost at least 3 days before closing. If you have not yet received it, please contact your lender at the information listed below. $63,254.50 Contract Details See your note and security instrument for information about $189,347.06 • what happens if you fail to make your payments, • what is a default on the loan, • situations in which your lender can require early repayment of the loan, and 5.385% • the rules for making payments before they are due. Questions? If you have questions about the loan terms or costs on this form, use the contact information below. To get more information or make a complaint, contact the Consumer Financial Protection Bureau at www.consumerfinance.gov/mortgage-closing Lender Sound Credit Union 1331 Broadway Tacoma, WA 98402 691150 Jamie Alford 740600 jalford@soundcu.com 31.568% Liability after Foreclosure If your lender forecloses on this property and the foreclosure does not cover the amount of unpaid balance on this loan, ❑ state law may protect you from liability for the unpaid balance. If you refinance or take on any additional debt on this property, you may lose this protection and have to pay any debt remaining even after foreclosure. You may want to consult a lawyer for more information. ® state law does not protect you from liability for the unpaid balance. Refinance Refinancing this loan will depend on your future financial situation, the property value, and market conditions. You may not be able to refinance this loan. Tax Deductions If you borrow more than this property is worth, the interest on the loan amount above this property's fair market value is not deductible from your federal income taxes. You should consult a tax advisor for more information. Real Estate Broker(B) eXp Realty 2815 Elliott Ave Suite 100 Seattle, WA 98121 24540 Brett Bonner 27156 Real Estate Broker(S) Skyline Properties Inc 20415 72nd Ave S, suite 180 Kent, WA 98032 1979 Karen Mitchell 113753 brettbonner@brettbonner.coml findhomesinwa@gmail.com (253)383-2016 1(253)606-0578 1(206)551-3464 Settlement Agent In -House Escrow 1010 South 336th St, Suite 115 Federal Way, WA 98003 604-178-111 Justine Qualls 11259 tea mjusti ne@in houseescrow.c om (800)838-5667 Confirm Receipt By signing, you are only confirming that you have received this form. You do not have to accept this loan because you have signed or received this form. Javier Laivo Date ZX] 1 RSfr, 1ArR r'I (KINn nicri (KI IRF PArF S nr S • I nAN In ttJnnnnnnQQd,) Residential Mortgage Interest Rate Lock Agreement Pursuant to RCW 19.146.030(2)(a) and WAC 208-620-510(3) Calvo Loan#: 20000009942 MIN:100579600000031878 Date: November 1, 2023 The interest rate has been locked with Sound Credit Union. The cost, terms, and conditions of the interest rate lock are detailed below: 37806 39th Ave S Auburn Property Address City DETAILS: WA 98001 State Zip Interest Rate: 5.12 5 % Interest rate lock fee: $ 0 . 0 0 (If you do not charge for an interest rate lock, put $0 or N/A) Lock Date: 12 / 04 /2 0 2 3 Lock Days (#): 15 Lock -in Expiration Date: 12 / 18 / 2 02 3 (mm/dd/yyyy) (mm/dd/yyyy) Refund: Your interest rate lock fee ❑ is refundable or ® is not refundable. If refundable, see conditions below. Conditions for refund of the interest rate lock fee: DESCRIBE OTHER TERMS AND CONDITIONS OF THE INTEREST RATE LOCK: Loan Amount: $192 , 410.00 Loan Program: Conforming 15 Year Fixed DISCOUNT POINTS/CHARGES or CREDITS: ❑ 1 will pay a charge of $ ( points) for the interest rate I have chosen. This charge will increase my loan costs at closing. ❑ I will receive a credit of $ ( points) for the interest rate I have chosen. This credit will decrease my loan costs at closing. I/We understand and agree to the terms contained in this Interest Rate Lock Agreement. - BORROWER - Javier Calvo - DATE - Washington Department of Financial Institutions Interest Rate Lock Agreement Rev 9/3/2019 921 2792.296 Page I of I RETURN TO: PW ADMIN EXT: 2700 ID #: 4349 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PUBLIC WORKS / Deputy Director 2. ORIGINATING STAFF PERSON: Desiree Winkler EXT: 2700 3. DATE REQ. BY: 12/8/23 3. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL ® OTHER Relocation Voucher 4. PROJECT NAME: CalVO Relocation Voucher 5. NAME OF CONTRACTOR: Key Bank ADDRESS: TELEPHONE: E-MAIL: FAX: SIGNATURE NAME: TITLE: 6. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS CFW LICENSE # BL. EXP. 12/31/ UBI # EXP. 7. TERM: COMMENCEMENT DATE: COMPLETION DATE: 8. TOTAL COMPENSATION: $ 32,590.42 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED 0 PURCHASING: PLEASE CHARGE TO: R36610-26100 9. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED ❑ PROJECT MANAGER d DIVISION MANAGER 6 DEPUTY DIRECTOR DSW 12/5/23 DSW 1215/23 d DIRECTOR EJ Wahh -_== ❑ RISK MANAGEMENT (IF APPLICABLE) 8 LAW DEPT KVA 12/6/2023 10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE: SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: 11. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC' D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE (INCLUDE DEPT. SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.) INITIAL / DATE SIGNED ❑ FINANCE DEPARTMENT ❑ LAW DEPT ❑ SIGNATORY (MAYQ OR �DIRECTOR) ❑ CITY CLERK ❑ ASSIGNED AG # AG# 23-255 ❑ SIGNED COPY RETURNED DATE SENT: COMMENTS: EXECUTE " 1 " ORIGINALS 1/2u10 In -House Escrow, LLC 1010 S. 336'h Street, Suite 115 Federal Way, 66 98003 4.1 � (0) 425-589-0660 IN-HOUSE ESCROW www.i-304-6557 www.inhouseescrow.com WIRE TRANSFER REQUEST WE HEREBY REQUEST THAT THE APPLICABLE FUNDS ARE WIRE TRANSFERRED DIRECTLY TO OUR ACCOUNT. IF YOU HAVE ANY QUESTIONS REGARDING THIS MATTER PLEASE CALL (800) 838- 5667. OUR BANK: Key Bank 601 1081h Ave. Ste. 320 Bellevue, WA 98004 OUR ACCOUNT NAME: 1HE I Trust Account ACCOUNT NBR: 479681299448 BANK ROUTING NBR: 125000574 REFERENCE OUR ESCROW NO.: REFERENCE OUR BUYER NAME: REFERENCE THE SUBJECT PROPERTY: 1-2887-JQ Javier Calvo and Maria Isabel Leon Hernandez 37806 39th Avenue South, Auburn, WA 98001 *Please be advised these wire instructions will not change and we do not email wire instructions or requests to have funds wired. Always confirm wire instructions prior to initiating. *Our earnest money portal may NOT be used to submit buyer closing funds. Funds must be sent as a wire or cashier's check. Cashier's checks must be in our office at least one day before closing. *ACH transfers are not permitted and will be rejected. Sincerely, Justine Qualls In -House Escrow 1010 South 336th Street, Suite 115, Federal Way, WA 98003 Relocation Assistance Voucher 1 Agency Name: City of Federal Way 33325 81s Ave. S Federal Way, WA 98003 I hereby certify under penalty of perjury that the items and amounts listed herein are proper charges against the Agency. That the same or any part thereof has not been paid, and that I am authorized to sign for the claimant. 1 further certify that I am a citizen of the United States of America or am an alien lawfully present in the United States of America. Displaced Person(s) or Claimant Sig attire (Blue inky fart h claimant (Name, address with zip+4 to which payment will be sent) Javier Calvo & Maria Isabel Le6n Hernandez X 31014 28' Ave S Javier Ca Federal Way, WA 98003-5005 x W144 Maria Isabel Left Hernandez Project Title: City of Federal Way, Joint Operations & Maintenance Facility I Date Inc 2 Parcel No.: 092104-9170 Displacee No.: 2 Displacee Name: Javier Calvo & Maria Isabel Le6n Hernandez Date Parcel Vacated: PENDING Re lacement Housing Payments $ Amounts Price Differential - .90 day owner for amounts up to $31.000 $0.00 MIDP - Increased Mortgage Interest Payment MIDP$20.653.33 +4%%s down $7,140-09 _ $27.793.42 Incidentals $4,797.00 Last Resort Housing — owner for amounts over $31,000 $0.00 Rental Su p pleme:nt — 90 day tenants and certain others amounts up to $7,200 $0.00 Down Payment Assistance — 90 day tenants and certain others $0.00 Last Resort Housing_— tenants amounts over $7,200 $0.00 Comments / other (describe):_ $0.00 _ Moving Expense Payments Self -Move / Schedule Payments — residential $ Amounts $0.00 Actual Expenses. (Commercial Move/Actual Cost Self Move) — residential $0.00 Fixed Payment (in lieu of all other moving expenses) - Non -Residential $0.00 Actual Costs / Self Move / Commercial - Non -Residential $0.00 _ Reestablishment Costs - Non -Residential $0.00 Personal Propaily Only $0.00 Comments / Other (describe): $0.00 Deductions: :$0.00 TOTAL 4 $32,590.42 Invoice No.: Date: Amount: $ ACCOUNT CLASSIFICATION — JOB NUMBER i ACCOUNT CONTROL TOTALS PARCEL WORK ORDER GRP WORK OP I OBJ I SUB SECTION ORG. NO. NON -PART DOLLARS TOTAL 4$32 590.42 RELOCATION SPECIALIST: Paula Ferreira -Smith DATE:12/4/2023 Project Manager: Marge Bailey DATE:12/4/2023 I, ihc:nrdersign4 certify that the above information is correct, that the payment is necessary for the above relocation assistance, that it has been performed in accordance with prescribed procedures, and that this payment is not considcrcd income or resourocs to a "DISPLACED PERSON" pursuant to Section 216 of Public Law 91-646 and RCW 8.26.115.: Warrant Register No.: Voucher No.: AGENCY AUTHORIZATION- DATE EJ Walsh Public Works Director, City of Federal Wa LIIA-537 Rev. 612019 Relocation Assistance Voucher 1 Agency Name: City of Federal Way 33325 8'h Ave. S Federal Way, WA 98003 I hereby certify under penalty of perjury that the items and amounts listed herein are proper charges against the Agency. That the same or any part thereof has not been paid, and that I am authorized to sign for the claimant. I further certify that I am a citizen of the United States of America or am an alien lawfully present in the United States of America. Displaced Person(s) or Claimant (Name, address with zip +4 to which payment will be sent) Javier Calvo & Maria Isabel Le6n Hernandez 31014 28' Ave S Federal Way, WA 98003-5005 Signature (Blue ink) for each claimant X Date Javier Calvo X Maria Isabel Le6n Hernandez Project Title: City of Federal Way, Joint Operations & Maintenance Facility Parcel No.: 092104-9170 Displacee No.: 2 Displacee Name: Javier Calvo & Maria Isabel Le6n Hernandez Date Parcel Vacated: PENDING Replacement Housing Payments $ Amounts Price Differential — 90 day owner for amounts up to $31,000 $0.00 MIDP - Increased Mortgage Interest Payment MIDP$20,653.33 + 4% Buvdown $7,140.09) $27,793.42 Incidentals $4.797.00 Last Resort Housing — owner for amounts over $31 000 $0.00 Rental Supplement — 90 day tenants and certain others amounts up to $7.200 $0.00 Down Payment Assistance — 90 d4X tenants and certain others $0.00 Last Resort Housing — tenants amounts over $7 200 $0.00 Comments / other (describe): $0.00 Moving Expense Payments $ Amounts Self -Move / Schedule Payments — residential $0.00 Actual Expenses Commercial Move/Actual Cost Self Move) — residential $0.00 Fixed Payment in lieu of all other moving expenses) - Non -Residential $0.00 Actual Costs / Self Move / Commercial - Non -Residential $0.00 Reestablishment Costs - Non -Residential $0.00 Personal Property Only $0.00 Comments / Other (describe): $0.00 Deductions: _$0.00 TOTAL 4 $32,590.42 Invoice No.: Date: Amount: $ ACCOUNT CLASSIFICATION JOB NUMBER I ACCOUNT CONTROL TOTALS WORK ORDER I GRP I OBJ PARCEL WORK OP SUB SECTION ORG. NO. NON -PART DOLLARS $ TOTAL 4$32,590.42 RELOCATION SPECIALIST: Paula Ferreira -Smith DATE:12/1/2023 Project Manager: Marge Bailey DATE:12/l/2023 I, the undersigned, certify that the above information is correct, that the payment is necessary for the above relocation assistance, that it has been performed in accordance with prescribed procedures, and that this payment is not considered income or resources to a "DISPLACED PERSON" pursuant to Section 216 of Public Law 91-646 and RCW 8.26.115.: 1,y-- 12/1 /2023 Warrant Register No.: Voucher No.: A NCY AUTHORIZATION: DATE Ef Walsh Public Works Director, City of Federal Way LPA-537 Rev 6/2019 Ttlerret, A C L S C 0 M P A N Y To: \' EJ Walsh, P.E. Public Works Director From: Marge Bailey, Project Manager Paula Ferreira -Smith, Senior Relocation Agent Date: December 1, 2023 Project Title: City of Federal Way, Joint Operations & Maintenance Facility. Parcel No.: 092104-9170 Displacee: Javier Calvo & Maria Isabel Le6n Hernandez Displacee No.: 2 Subject: Replacement Housing - Mortgage Interest Differential, Incidental Expenses, & Purchase Price Differential Payment Recommendation Description of the Subiect: Javier Calvo and Maria, Isabel Leon Hernandez are residential displaced property owners, they have occupied the displacement site, with their 19-year-old son since 2018. Maria runs a janitorial housekeeping business, serving clientele in the King and Pierce County areas. Javier works for the Port Seattle at SeaTac Airport. Mr. Calvo indicated that he has health issues that prevent him from going up and down stairs, therefore the replacement home would need to be a one-story, single-family home, like the displacement site. The displacee made an offer to purchase a replacement home located at 37806 39' Avenue S, Auburn, WA 98001. The offer was accepted and is currently under contract with a scheduled closing date of December 8, 2023 or sooner. On October 26, 2023, a Decent, Safe, and Sanitary (DSS) Inspection was conducted at 37806 39' Avenue S, Auburn, WA 98001; the replacement dwelling meets DSS and City standards for qualified replacement housing. MIDP - Mortgage Interest Differential Payment The displacees currently have an outstanding principal balance in the amount of $199,155.51, with an existing remaining term of 133 months at an annual interest rate of 3.000% with a monthly mortgage payment of $1,761.98 (excluding taxes and insurance). The current market rate as of November 30, 2023, for $201,633 for Washington State varies from 6.5% to 7.25%. The displacee secured a loan in the amount of $201,633 with an annual percentage rate of 5.125%, and with a 4% buydown, for a monthly principal and interest mortgage housing cost of $1,775.38. The existing displacement site loan interest rates are not available in the current market. The lender stated that due to banking guidelines and compliance, the interest rate cannot be decreased any further; to decrease the monthly payment to match the existing payment, the displacee would need to increase the down payment. Applying the Mortgage Interest Differential Payment to the buy down of the mortgage balance will accomplish this. A Mortgage Interest Differential Payment calculation was completed based on the information from the displacement site mortgage and replacement site mortgage. The calculated amount is $27,793.42 which included an Increased Mortgage Interest Cost of $20,653.33 and 4% points of $7,140.09. Tierra Right of Way Services; Ltd. :Jla, nJ 6r:,1,:� 3685 Martin VVav East, Suite 203 Lacey, Alashington 98516 • Phone: 206,363,1556 E it nrnen:aI Flan r Purchase Price Differential Payment The replacement housing analysis did not include a purchase price differential. The comparable sales were listed at $549,950, which is below the subject appraised value of $575,000. The replacement home offer is for of $577,200. Per our calculation, the limit set by 24.401/24.402 is $0 (no replacement housing payment) and the additional funds are in addition to that amount. Incidental Expenses The displacee is eligible for reimbursement of certain other incidental purchase expenses required to purchase the replacement property. The reimbursable expenses may include costs for title search, recording fees, appraisal fees, loan origination fees, credit report, home inspection, and other approved costs. A loan estimate was issued on November 27, 2023, for the replacement residence. A review of the estimate determined that the displacee is eligible to receive $4,797 for incidental expenses towards the purchase of the replacement residence. It became necessary for the displacee (buyer) and seller to execute an Addendum/Amendment to Purchase and Sale Agreement. The terms of the Addendum/Amendment extended the closing date to on or before December 12, 2023, and increased the sale price by $2,200 to $577,200. The increase may cause a minimal increase in incidental expenses. When a new loan estimate or final HUD is available, a review of the incidental expenses will be completed. Any additional funds owed to the displacees will be requested at that time. The best comparable was listed at $549,950 which was below the appraised value of the displacement site at $575,000, therefore the displacee is not eligible for the additional purchase amount of $2,200. Housing of Last Resort, section 24.404(c)(1). Section 24.404 (c) : "Methods of providing comparable replacement housing. Agencies shall have broad latitude in implementing this subpart, but implementation shall be for reasonable cost, on a case -by -case basis unless an exception to case -by -case analysis is justified for an entire project.". Recommendation Based on the current mortgage market Rate and the additional funds necessary for the displacee to purchase a replacement home, I recommend the City of Federal Way approve an increase mortgage interest cost in the amount of $20,653.33 an additional amount to lower the interest rate from 6.234% to 5.125% in the amount of $7,140.09, $4,797.00 for estimated closing cost, for a total of $32,590.42, as reasonable and necessary to purchase a replacement home. Summary of Estimated Replacement Housinp- Cost Most Comparable List Price $549,950 Re lacement Dwelling Purchase Price $577,200 Remaining Term on Old Mort a e 133 months Length of New Mortgage 133 Months Old Mortgage Balance $199,155.51 New Mortgage Balance $201.633 Old Interest Rate 3.00% New Interest Rate 5.125% Estimated Closing Cost Pre -Closing Final Ineligible Closing Cost Homeowner's Insurance (12 months $1,200) $1,200.00 Property Taxes ($483.46 per month for 5 months) $2,417.00 Pre -Paid Interest ($28.70 per day for 1 days 5.125%) $29.00 Increased Mortgage Interest Differential from 5.125% to 3% $20,653.33 4% Points on Revised Mortgage Balance Prorated from $8,065.32) $7,140.09 Processing Fee $1,100.00 Appraisal Fee $850.00 Credit Report $62.00 Flood Certificate Fee $16.00 Tax Service Fee $85.00 Wire Fee $25.00 Recording Fees and Other Taxes Transfer Taxes $442.00 Title -Settlement -Closing Fee $1,571.00 Title -Insurance -Lender's $646.00 Home Inspection $0.00 Total Estimated Preliminary Eligible Closing Costs $32,590.42 , $3,646.00 Total Downpayment from Acquisition funds $351200.00 Total due at closing $384.790.42 Estimated New loan amount after eligible replacement housing payment 1 $192,409.58 Attached • Replacement Home PSA • Replacement Home PSA-Addendum adding sale price and closing date • Displacement Site Payoff Statement, dated 11/27/2023 • Initial Lender Re -Disclosure, dated 11/27/2023 ■ MIDP Calculation (FHWA-Traditional Buy Down Method) ■ Wire Instructions • Incidental Worksheet Preliminary Closing Cost • Down Payment Instruction ■ Decent, Safe and Sanitary Inspection (Professional Home Inspection -Attached) • Voucher No. 1 Replacement Housing Supplement (MIDP and Incidental Expenses) • Move Expense Agreement —Residential The undersigned has reviewed and approves the above Incidental Expenses and Mortgage Interest Differential, Replacement Housing Payment Recommendations to purchase the replacement home. City of Federal Way i��L_ Date: EJ alsh, P.E. Public Works Director 12/1 /2023 Price Differential Report Project Title: City of Federal Way, Joint Operations & Maintenance Facility Parcel No.: 092104-9170 Displaced Person(s): Javier Calvo and Maria Isabel Leon Hernandez Displacee No.: 2 Total Take — Typical Residential Acquisition 1. Price of Comparable (from Housing Comparison Worksheet). 2. Appraised Value of subject to be acquired. Include value of uneconomic remnant, or "building lot remainder," and/or damages as appropriate. 3. Maximum Price Differential (Subtract line 2 from line 1). Residential Carve Out 4. , Price of Comparable (from Housing Comparable Worksheet). 5. Appraised Value of land and improvements (dwelling, well, garage, etc.) to be acquired contributing to the residential use of the subject. For lots larger than typical, only include square footage typical of the subject area. 6. Amount of damages to the residential portion of the remaining property from DV, (do not include if lot is larger than typical). 7. Carve out residential value of subject (Add lines 5 and 6). 8. Maximum Price Differential (Subtract lines 7 from line 4). $549,950 $575,000 -($25,050) $0.00 $N/A $N/A $N/A $N/A $N/A Remarks: Purchase Price Differential Report is $0.00 because there are comparable available in the market listed under or similar to the displacement site value of $575,000. Prepared By: Paula Ferreira -Smith, RW-RAC Reviewed: Marge Bailey Date: 9/20/2023 Pciutn._ �ssuisinio�_ Agency pproval: E1 Walsh, P.E. Amount: $0.00 Date: 44 114A,-- 12/1 /2023 Actual Pr/ce Differential Computation (complete after above approval received) 9. Purchase Price of Replacement Dwelling or Price of Comparable (lesser amount) 10. Residential value of acquired dwelling/site. Include inducements such as administrative settlements, free salvage, etc. 11. Subtract line 10 from line 9. $549,950 $575,000 -($25,050) 12. Maximum Price Differential (line 3 or 8). $0.00 13. Price Differential Payment (lesser of lines 11 or 12). $0.00 Remarks: Prepared By: Paula Ferreira -Smith, RW-RAC Reviewed: Date: 12/1/2023 T c�.W.�n,_ VrsStFLQ,1J1.l�_ Ar ncv Ap roval: Amount: $ Date: 12/1 /2023 LPA-54 Rev 5/2022 Relocation Entitlement Instructions lvown TO: In -House Escrow, LLC 1010 S. 336' Street, Suite 115, Federal Way, WA 98003 Key Bank-Acct Name: IHE 1 Trust Account 601 108' Ave. Ste. 320, Bellevue, WA 98004 Attn: Justine Qualls Telephone No.: (425) 589-0660 Fax No.: (800) 304-6557 DATE: December 1, 2023 Assistance Agency Information: Attn: Desiree Winkler City of Federal Way 33325 8' Ave. S, Federal Way, WA 98003 Project Title: City of Federal Way, Joint Operations & Maintenance Facility Parcel No.: 092104-9170 Displacee No.: 2 Escrow No: 1-28887-JQ The City of Federal Way (City) has determined that Javier Calvo & Maria Isabel Le6n Hernandez (Displacee) is entitled to the sum of $32,590.42 under the Relocation Assistance Program for the purchase of the property located at 37806 39' Avenue South, Auburn, WA 98001. The City has advised that this amount will be placed in escrow on or before December 12, 2023. The City and the Displacee mutually agree and instruct that the funds be handled as stated below: 1. The sum of $20,653.33 (MIDP) to be applied toward the down payment only to reduce the amount of principal owed, and $11,937.09 ($4,797 Incidentals, and $7,140.09 Points (4%), to cover eligible closing costs, but NOT to be applied to prepaid taxes and insurance. 2. Upon receiving this letter, please send an estimated closing statement to the relocation specialist listed below showing the amount of the down payment from the City. Upon closing, mail a copy of the recorded instruments and a certified copy of the final closing statement to: Paula. Ferreira r�7i tierra-row.com, copied to baordon.rt tierra-row.com, and mbailey@tierrL- row.com. Said closing statement must include, at a minimum: (1) Funds received from the City (2) The closing date of the escrow (3) Endorsement by purchaser to the effect that the statement has been approved (3) Certification by the closing officer that the statement is true and correct In the event that you are unable to perform, as instructed herein prior to December 5, 2023, please return all City funds, less your escrow cancellation charge, if any, with your letter of explanation to the City at the address shown above. Paula Ferreira -Smith Right of Way Agent Tierra Right of Way Services, Ltd 8685 Martin Way E., #203, Lacey, WA 98516 pgula.ferreira cr tierra-row.com (206) 677-8256 Mobile LPA-516 Rev.6/2019 Displacee: Ls� Signature: Javier Calvo Signature: Date: Maria Isabel LeonHernandez LPA-S l6 Rev U2016 Authentisign to: Form 21 ©Copyright 2023 Residential PSA RESIDENTIAL PURCHASE AND SALE AGREEMENT Northwest Multiple Listing Service Rev. 7/23 ALL RIGHTS RESERVED Page 1 of 6 Specific Terms 1. Date: October 28, 2023 MLS No.: 2072712 Offer Expiration Date: 10/29/2023 2. Buyer: Javier Calvo Maria Isabel Leon Hernandez A married couple Buyer Buyer Status 3. Seller: Donna L Conner Seller Seller 4. Property: Legal Description attached as Exhibit A. Tax Parcel No(s).: 3750605364 3750605442 37806 39th Avenue S Auburn King WA 98001 _ Address City County State Zip 5. Included Items: ® stove(s)/range(s); ® refrigerator(s); ® washer(s); ® dryer(s); M dishwasher(s); M microwave(s); ❑ fireplace insert(s); ❑ wood stove(s); ❑ satellite dish; ❑ security system; ❑ hot tub; ❑ attached camera(s); ❑ attached speaker(s); ❑ attached TV(s); ❑ generator; ❑ 6. Purchase Price: $ 575,000.00 Five Hundred Seventy -Five Thousand U.S. Dollars 7. Earnest Money: $ 5,000.00 U.S. Dollars; Delivery Date 3 days after mutual acceptance To be held by ❑ Buyer Brokerage Firm; ® Closing Agent; ❑ In the form of a Promissory Note (included as an Addendum) 8. Default: (check only one) ® Forfeiture of Earnest Money; ❑ Seller's Election of Remedies 9. Title Insurance Company: Ticor 10. Closing Agent: in-house Escrow Justine Qualls Company Individual (optional) 11. Closing Date: 11/30/2023 or sooner Possession Date: ❑ on Closing; ® Other 1 day after closing. 12. Services of Closing Agent for Payment of Utilities: ® Requested (attach NWMLS Form 22K); ❑ Waived 13. Charges/Assessments Levied Before but Due After Closing: ❑ assumed by Buyer; ® prepaid in full by Seller at Closing 14. Seller Citizenship (FIRPTA): Seller ❑ is; M is not a foreign person for purposes of U.S. income taxation 15. Information Verification Period: ❑ Expires days after mutual acceptance; KI Satisfied/Waived 16. Agency Disclosure: Buyer represented by: KI Buyer Broker; ❑ Buyer/Listing Broker (dual agent); ❑ unrepresented Seller represented by: KI Listing Broker; ❑ Listing/Buyer Broker (dual agent); ❑ unrepresented 17. Buyer Brokerage Firm Compensation: % 3 ; KI Pay as Offered or ❑ Other— See Addendum $ or % Amount Offered in Listing 18. Addenda: 22A(Financing) 22D(Optional Clauses) 22SKC(King Septic) 22T(Title Contingency) 22Q(Pending Sale) 35W(Inspection Waiver) r5igna[ure Date 10/28/2023 Buyer Signature Date Buyer Address City, State, Zip Buyer Phone No. Fax No- javierlealvo@gmaii.com Buyer E-mail Address eXp Realty 5939 Buyer Brokerage Firm MLS Office No. Brett Bonner 6166 Buyer Broker (Print) MLS LAG No_ (888)317-5197 (253)606-0578 Firm Phone No. Broker Phone No. Firm Fax No. 1+J4�tHA L ��h2p 10/29/2023 Teller Signature Date Seller Signature Date Seller Address City, State, Zip Seller Phone No. Fax No. Seller E-mail Address Skyline Properties, Inc. 3353 Listing Brokerage Firm Karen Mitchell MLS Office No. 96988 Listing Broker (Print) (253)520-3780 (206)551-3464 MLS LAG No. (253)520-3785 Firm Phone No. Broker Phone No. Firm Fax No. wa.contracts@exprealty.com skyline@skylineproperties.com Firm Document E-mail Address Firm Document E-mail Address brettbonner@brettbonner.com findhomesinwa@gmail.com Buyer Broker E-mail Address Listing Broker E-mail Address 27156 24540 113753 1979 Buyer Broker DOL License No. Firm DOL License No. Listing Broker DOL License No. Firm DOL License No. Decent, Safe, and Sanitary (DSS) Replacement Dwelling Inspection Report Project Title: City of Federal Way, Joint Operations & Maintenance Facility Parcel No.: 092104-9170 Displaced Person(s) Javier Calvo & Maria Isabel Leon Hernandez Displacee No.: 2 Address of Replacement Dwelling: 37806 39th Avenue S, Auburn, WA 98001 Replacement Housing Inspection Dwelling Type Number Oft7ccupants _ ® Single Family ❑ Apt. ❑ RV Adult Male I Adult Female I Child Malc Child Female ❑ Duplex ❑ Mobile Home ❑ Other 2 I 1 �_ 0 0 Total Sq Ft. No. Rooms No. Bedrooms Type of Water Su ply* Purchase Price/Monthly 1.520 8 3 ❑ Private Well (9 City Community Well Rent: $575,000 Yes I No 1 Yes I No 1. Structurally Sound I + ❑ d. Proper connection to potable hot & cold x ❑ 2. Safe and Adequate Electrical System ® ❑ water 3. Weather Tight ❑ e. Range (stove) space with utility connections ® ❑ 4. Adequate Heating (turn on furnace) ❑ f. Refrigerator space with utility connections ® ❑ 5. Safe Ingress and Egress ® ❑ 11. Bathroom(s) j G. In Good Repair ® ❑ a. Separate room properly lighted and ®I ❑ 7. Adequate Number of Rooms ® ❑ ventilated 8. Barriers to Handicapped (if applicable) P/q ❑ ❑ b. Fully functional sink (basin) ® ❑ 9. If 3 or more stories, does each story have 2 exits0 . ❑ ❑ c. Privacy for users ® ❑ from a common corridor 'Y/A d. Fully functional flush toilet ® ❑ 10. Kitchen e. Fully functional bathtub or shower stall X1 ❑ a. Separate room or area for kitchen use m ❑ f. Plumbing in good working order for water ® ❑ b. Sink in good working order R] ❑ supply and sewage system c. Proper connection to sewage system ® ❑ 12. Dwelling meets applicable housing and (] ❑ occupancy codes in project file) *Note: if community well, indicate when last water test was done under "Remarks" or if private well, attach a copy of the Health Department water test results to report. 1, the undersigned, have inspected the replacement dwelling at the address shown above. The inspection was made to determine if the dwelling qualifies the Displacee to receive a replacement housing payment. Photograph(s) of the replacement dwelling is attached hereto. TO THE BEST OF MY KNOWLEDGE AND BELIEF, this dwelling [Z MEETS ❑ DOES NOT MEET the Agency's standards for qualified replacement housing. 1Remarks1R -- - - — Relocation Specialist: Paula Ferreira -Smith C) Date Displaced Person's Disclaimer Statement I understand the requirements for replacement housing and certify to the best of my knowledge that the above property meets said requirements. I further understand that the statements, finding, decisions and conclusions appearing in the foregoing are made solely for the purposes of detennining my eligibility for payments Ibr replacement housing mid are not intended to Inc, nor do they constitute, warrants or guarantees by the Agency that said replacement dwelling is free from defects. The DSS inspection does not take the place of a professional hone inspection. . -J�evi s - _. - 10 Dispkced Person: Javier Calvo & Maria Isabel Le6n Hernandez bate LPA-525 Rev. 612019 Washington State Ai Department of Transportation P P DSS Ins ection Re lacement HomAlmokk e Project Title: Parcel No.: 092104917007 City of Federal Way, Operation & Maintenance Facility Displaced Person(s): Displacee No.: 2 Javier Calvo and Maria Isabel Leon Hernandez Displacement Address: 31014 28`h Ave S, Federal Way 98003 Inspection Date:10/26/2023 Replacement Address: 37806 3911 Avenue S, Auburn, WA 98001 Present: Javier Calvo & Maria Isabel Le6n Hernandez, Listing Agent, Karen Mitchell, Buyer's Agent Brett Bonner �• __� _fir Single Family/2 car ti= -- garage The driveway toward garage. Calvo Hernandez indicated that they would install drainage to diver water getting in the garage. Front Door/Entrance with wide hand railing. Noted to Calvo Hernandez. 1\ Livi YRoom Dining Room/Off Entrance r Dinin Area/Kitchen Area idW Washington State DSS Inspection W� Departmentns Replacement Home of Transportation P A a Cat - o Kitchen with Dishwasher/double sink Refrigerator/microwave/recommended cleaning the microwave vent i Side/by side refrigerator Electric Stove I 9� i Main Bathroom Sink/Main Bathroom i906hl w, Washington State DSS Inspection Replacement Home Department of Transportation p 1� Shower/Main Bathroom Bathroom/Master Bedroom/Noted to Calvo Hernandez that shower door open the wrong way i Under Sink/Bathroom/Master Bedroom Pending new photo/Shower head was lose. Calvo Hernandez to replace after occupancy- F3 Sink/Bathroom/Master Bedroom Adw w�Washington State DSS Inspection Replacement Home Department of Transportation P P ss A - _-_._ Security System Thermostat - E J i Hot Water heather and Washer and Dryer located in the garage. Electric Water Heather The water heater read 120 degrees. Noted to Calvo Hernandez. who indicated that theywould lower Lem erature -` Pending photo. Garage access to the house has three high steps with not railing. Calvo Hernandez indicated that they would repair J at move in [m�ve- w Electricalin. Box in the garage w, Washington Stye DSS Inspection Replacement Home ns Re Department of Transportation P P House is on aseptic system with an electric pump. r Septic pump connected via extension cord. Noted to property owner by Professional Inspector, Real Estate Agent, and Relocation Agent. Calvo Hernandez said they will do electrical repair at move - in CITY OF L Federal Way August 31, 2023 Javier Calvo & Maria Isabel Le6n Hernandez 31014 281h Ave S Federal Way, WA 98003 CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 vlvlw cityoffederalway. com Relocation Assistance Program General Notice of Relocation Rights Project Title: City of Federal Way, Joint Operations and Maintenance Facility Parcel Number: 092104-9170 Displacee No.: 2 Dear Javier Calvo & Maria Isabel Le6n Hernandez: This notice is to inform you that the property you are occupying at 31014 28th Ave S, Federal Way, is scheduled to be purchased by the City of Federal Way (City) for the construction of a new Operations and Maintenance Facility in the Steel Lake proximity. If the property is acquired as planned, it will be necessary for you to move. Persons displaced as a result of this project may be entitled to certain relocation assistance as generally described in this letter and in the Relocation Assistance Program Brochure, which has been provided to you with this letter. The actual law and legal regulations governing relocation assistance are contained in the United States Code, 42 USC 4601 et seq., Public Law 91-646, the implementing regulations found in the Code of Federal Regulations, 49 CFR Part 24, the Revised Code of Washington, RCW 8.26, and the implementing regulations of the Washington Administrative Code, WAC 468-100. Oualification Requirements In order to qualify to receive relocation entitlements, you must be in occupancy of the property prior to the date the City acquires the property. If you move before the offer, you may lose your eligibility to receive relocation entitlements. Please contact your relocation specialist prior to moving in order to avoid any loss of entitlements. If you are required to move, you will receive a Notice of Relocation Eligibility, Entitlements, & 90-Day Assurance that will explain your relocation entitlements in detail. This letter will inform you of the location of at least one comparable dwelling that is currently available as well as advise you of other relocation assistance that you are entitled to receive. Any person who is an alien not lawfully present in the United States is ineligible for relocation Name: Javier Calvo and Maria Hernandez LPA-504 Date: 8/31/2023 Rev. 6/2019 Page 1 advisory services and relocation payments, unless such ineligibility would result in exceptional and extremely unusual hardship to a qualifying spouse, parent, or child as defined in WAC 468- 100-208. Relocation Assistance Entitlementsmay include {documentation is required on all cIaims): • Replacement Housing Payment • Direct Moving Expenses up to a maximum of 50 miles for moving personal property. • Advisory Services which include housing referrals, and help in filing payment claims, transportation to look at replacement housing, and other necessary assistance to ease your inconvenience. A complete list of relocation entitlements for which you may be eligible can be found in WAC 468-100-301(4); WAC 468-100-301(7) (a through g) and (k through r); WAC 468-100-303; WAC 468-100-306. Occupancy of Property When appropriate, you will receive a Notice of Relocation Eligibility, Entitlements & 90-Day Assurance providing you with the earliest date that you could be required to vacate the property. Right to Appeal RELOCATION APPEAL PROCESS Reconsideration of a City Decision and Right to Appeal Any aggrieved person may file a written appeal with the City of Federal Way in any case in which the person believes that the City has failed to properly consider the person's eligibility for, or the amount of, a payment required for relocation assistance under Chapter 12 of the Washington State Department of Transportation Right of Way Manual, or a relocation payment required under WAC 468-100-010. A person must file a written appeal with the City within sixty (60) calendar days of receipt of the City's written determination of eligibility or entitlement. This written appeal should be addressed to: EJ Walsh Public Works Director, City of Federal Way 33325 8th Ave S Federal Way, WA 98003 Appeals must be in writing. The City will consider a written appeal regardless of form. The appeal letter shall include the following: • The City's project name. Name: Javier Calvo and Maria Hemandez LPA-504 Date: 8/31/2023 Rev. 6/2019 Page 2 • The Project Parcel number or the Tax Parcel number of the real property involved. • Date of the relocation notice that is being appealed. • Name of the aggrieved person(s). ■ A statement of issues/concerns. • An explanation of what the aggrieved person is claiming: all facts, reasons, and any supporting evidence as to the nature of the grievance or why the aggrieved person is otherwise aggrieved. • The relief requested. ■ The signature, current address and telephone number of the aggrieved person or the person's authorized representative. Any aggrieved person has a right to be represented by legal counsel or other representative in connection with his or her appeal, but solely at the person's own expense. The City looks forward to assisting you in any way it can. Please sign on the line provided below to acknowledge receipt of this letter. Please feel free to contact your relocation specialist with any questions you may have. Sincerely, Paula Ferreira -Smith, RW-RAC Relocation Agent/Specialist, Tierra Right of Way Services, Ltd. 8685 Martin Way E., Suite 203 Lacey, WA 98516 Mobile: 206.677.8256 1800.887.0847 Paula.Ferreira a,tierra-row.com Enclosure: Relocation Assistance Program Brochure Acknowledgment of receipt of General Notice letter Signature: Date: Javier Calvo Signature: Date: Maria Isabel Le6n Hernandez Name: Javier Calvo and Maria Hernandez LPA-504 Date: 8/3 l /2023 Rev. 6/2019 Page 3 USPS TRACIWG # 9590 9402 8198 3030 9688 05 United States Postal Service First -Class Mall Postage & Fees Paid LISPS - Permit No. G-10 • Sander.Please print your name, address, and ZIP+sa In ft box' Tierra Right of Way Services, Ltd. Paula Ferreira -Smith 8685 Martin Way E., Suite 203 Lacey, WA 98516 V� * Complete items 1, 2, and 3. * Print your name and address on the reverse so that we can return the card to you. r Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Javier Calvo & Maria Isabel Leon Hernandez 31014 28th Ave S Federal Way, WA 98003 A. Sig�tature 13 Agent X .'�]�: ❑ Addressee B. Received by (Printed Name) C. Date of Delivery D. Is delivery address different from item 1? 0 Yes If YES, enter delivery address below: 0 No II I ��� I I I I II I��I IIII III I� II I I I II Service Type 13 ❑ Adult Signature ❑ Priority Mail Express® ❑ Registered Mail- �II3. 0 Adult Signature Restricted Delivery 0Regi5i.::.,tlMail Restricted, RCertif(ed Mail® Dc L:� 9590 9402 8198 3030 9688 05 ❑ Certified Mail Restricted Delivery io Signature Confirmation'" ❑ Collect on Delivery ❑ Signature Confirmation 2. Article Number (Transfer from service Mel) ❑ Collect on Delivery Restricted Delivery Restricted Delivery lured Mail 7022 3330 0901 1223 6809 ; fired Mail Restricted Delivery Ps Form 3811, July 2020 PSN 7590-02-000-9053 Domestic Return Receipt Lawfully Present in the United States Certification Project Title: City of Federal Way, Joint Operations and Maintenance Parcel No.: 92104-9170 Facility Property Displaced Person(s): Calvo and Maria Isabel Leon Hernandez Displacee No.: 2 Federal law requires certification of residency status. Please fill out the appropriate category below with your occupancy status in the United States. Your signature constitutes certification. RESIDENTIAL 1) 1 certify that I am: 9 a citizen or national of the United States ❑ an alien lawfully present in the United States 2) 1 certify that there are persons in my household, and that are citizens or nationals of the United States and are aliens lawfully present in the United States. NON-RESIDENTIAL Unincorporated Business/Farm/Nonprofit Organization 1) 1 certify that I am: ❑ a citizen or national of the United States ❑ an alien lawfully present in the United States 2) 1 certify that there are owners in the organization, and that are citizens or nationals of the United States and are aliens lawfully present in the United States. 3) 1 certify that the United States. (corporation) is authorized to conduct business in Incorporated Business/Farm/Nonprofft Organization I certify that _ United States. (corporation) is authorized to conduct business in the PERSONAL PROPERTY ONLY (PPO) I certify that I am: ❑ a citizen or national of the United States ❑ an alien lawfully present in the United States By signature below, I am certifying that the information provided is complete and accurate. Signatur " Date Javier Calvo & Maria Isabel Leon Hernandez LPA-547 Rev. 11/21 A C L S C O M P A N Y September 22nd, 2023 Javier Calvo & Maria Isabel Le6n Hernandez 31014 28th Ave S Federal Way, WA 98003 Relocation Assistance Program Notice of Relocation Eligibility, Entitlements, & 90-Day Assurance Project Title: City of Federal Way, Joint Operations & Maintenance Facility Parcel Number: 092104-9170 Displacee No.: 2 Dear Javier Calvo and Maria Isabel Leon Hernandez: On September 22"d, 2023, the City of Federal Way (City) offered to purchase your property located at 31014 28th Ave S, Federal Way. According to the information you provided, you have occupied the above property since 2018. Relocation Notice of Eligibility You are eligible to receive relocation assistance in accordance with the United States Code, 42 USC 4601 et seq., Public Law 91-646, the implementing regulations found in the Code of Federal Regulations, 49 CFR Part 24, the Revised Code of Washington, RCW 8.26, and the implementing regulations of the Washington Administrative Code, WAC 468-100. The purpose of this letter is to advise you of the relocation services and entitlements that may be available to you in accordance with the state and federal laws and regulations cited above. 90-Day Assurance You are not required to relocate immediately. You will not be required to vacate the property before December 15th, 2023, which is at least 90 days from the date you receive this letter. Tierra Right of `Nay Services, I-td ,_ S 86n5 Martin VA/ay East. Suite 203 • Lacey, bVashington P3513 • Phone: 206.363 1556 Toll Free: 000.387-O847 • Ai,.vr.=.tierra-ro ;,com Replacement Housing Payment -Price Differential Entitlement As an owner occupant of 90 or more days, you may be entitled to a Price Differential Payment. This payment is based upon the difference between the acquisition price of your home and the amount necessary to purchase a comparable replacement property currently available on the market. Listed below are comparable property(s) currently available for purchase: Address Asking Price 1. 2227 SW 342"1 Street Federal Way, WA 98023 $549,950 2. 3920 SW 316 Street Federal Way, WA 98023 $575,000 3. 1720 57`h Avenue NE Tacoma, WA 98422 $575.000 Comparable number 1 is considered to be the most similar to the subject property. Based on the asking price of comparable number 1, your maximum price differential is $0.00. This amount is the maximum that the City can pay to reduce the purchase price of your replacement property. The comparable is listed at $549,950, which is below the appraised value of your property, $575,000. If you decide not to purchase a replacement property and elect to rent instead, you may be eligible for a rental assistance payment. Please contact your relocation specialist if you would like to have a rent supplement amount calculated. Incidental Purchase Expenses You may be reimbursed for certain other incidental purchase expenses required to purchase your replacement property. Reimbursable expenses may include costs for title search, recording fees, appraisal fees, loan origination fees, credit report, home inspection, and other approved costs. Payment of costs is based upon several factors including the amount of your present mortgage and the cost of the comparable used to compute the Replacement Housing Payment -Price Differential Entitlement. The estimated amount of these reimbursable costs can be determined once you have received a preliminary closing statement for the purchase of your replacement property. In addition, a home inspection is encouraged; the cost of the home inspection will be fully reimbursed by the City. It is highly recommended that you make your offer to purchase a replacement property subject to a home inspection as well as a Decent, Safe, and Sanitary (DSS) inspection. Mortgage Interest Differential Payment (MIDP) If you have a 180-day bona fide mortgage, you may be eligible to receive payment for increased mortgage interest costs if the interest rate on your new mortgage is greater than the interest of your present mortgage. The exact amount of the interest differential will be determined once you have obtained a loan commitment for the purchase of your replacement property. Please contact your relocation specialist as soon as you begin looking for a loan. Moving Entitlement You may select a commercial move, an actual cost move, or a self -move schedule payment for moving your personal property. If you elect to contract with a commercial mover, the City will reimburse your actual moving expenses based on paid receipts. The City can also pay your mover LPA-507 2 Rev. 12/2021 directly upon request. Payment for a commercial move is limited to a maximum of 50 miles. If you elect to complete an actual cost move, you will be reimbursed for labor and equipment used to move your property. You will need to supply supporting documentation, such as paid receipts or invoices to your relocation specialist. If you elect to complete a self -move with a schedule payment, you will be paid based on the number of eligible rooms. It has been determined that you have 76 eligible rooms, which entitles you to a moving payment of $23,300 to move your personal property including all building materials throughout the property, the "L" shape chicken coop, the 8 feet by 13 feet shed, the landscaping bricks, and tiles. Once you decide how you wish to move, you will need to sign a Move Expense Agreement. The appraisal report provided an estimated replacement cost from $12,000 to $14,000, including labor and materials, for the larger 12 feet by 16 feet by 10 feet tall storage shed. If you replace the larger shed at your replacement residence, you are eligible to receive reimbursement up to $14,000 for the replacement of the storage shed, including labor, material, and installation. To receive the reimbursement, you will need to supply supporting documentation, such as paid receipts or invoices to your relocation specialist. Advisory Assistance Your relocation specialist will be available to answer any questions about your relocation entitlements. You will be provided with assistance in completing claim forms. If you request, transportation will be provided so you may inspect replacement housing. Information concerning other available government programs such as Section 8 housing, unemployment benefits, food stamps, etc. will be provided upon request. Clairnins Your Entitlement You must notify your relocation specialist of the date you intend to move and sign a Move Expense Agreement. Once you have vacated the property completely you will need to schedule a vacate inspection with your relocation specialist. Once it has been verified that all personal property has been moved, your relocation specialist will prepare a claim, secure the appropriate signatures, and submit the claim for processing and payment. In the event that all personal property is not removed, appropriate action will be taken by the City and you will be responsible for the cost associated with removing any personal property left at the displacement site. This cost will be deducted from your moving claim/payment. Prior to processing claims for relocation entitlements, the Internal Revenue Service (IRS) requires the City to obtain your correct taxpayer identification number (TIN) or social security number (SSN). The City is required by the IRS to obtain a completed W-9 form from anyone to whom a payment is made. This is necessary even though relocation payments are considered non-taxable. Please let your relocation specialist know if you have already completed the form. If you need advice on how to complete the form, please contact an IRS office, accountant, or legal consultant. In order to be entitled to your replacement housing payment you must purchase (or rent) and occupy a DSS property within one year from the later of: (1) The date the City makes final payment for the acquisition of your property, (2) The date the LP A-507 3 Rev.12/2021 full amount of Just Compensation is deposited in the court, or (3) The date you move from your present property. You have 18 months after that same date to claim any relocation entitlement. Prior to signing a rental or purchase agreement for your replacement property, please contact your relocation specialist for an inspection of the property. This inspection will ensure that the property meets DSS requirements outlined in the Relocation Assistance Program Brochure previously provided to you. The inspection must be completed before any replacement housing payment can be made. Occupancy of Property Occupancy of the property beyond the date that the City takes possession of the property will not be possible. Right to Appeal RELOCATION APPEAL PROCESS Reconsideration of a City Decision and Right to Appeal Any aggrieved person may file a written appeal with the City of Federal Way in any case in which the person believes that the City has failed to properly consider the person's eligibility for, or the amount of, a payment required for relocation assistance under Chapter 12 of the Washington State Department of Transportation Right of Way Manual, or a relocation payment required under WAC 468-100-010. A person must file a written appeal with the City within sixty (60) calendar days of receipt of the City's written determination of eligibility or entitlement. This written appeal should be addressed to: EJ Walsh Public Works Director, City of Federal Way 33325 8th Ave. S. Federal Way, WA 98003 Appeals must be in writing. The City will consider a written appeal regardless of form. The appeal letter shall include the following: • The City's project name • The Project Parcel number or the Tax Parcel number of the real property involved ■ Date of the relocation notice that is being appealed + Name of the aggrieved person(s) + A statement of issues/concerns + An explanation of what the aggrieved person is claiming: all facts, reasons, and any supporting evidence as to the nature of the grievance or why the aggrieved person is otherwise aggrieved • The relief requested LPA-507 4 Rev.12/2021 The signature, current address and telephone number of the aggrieved person or the person's authorized representative As previously stated, the purpose of this letter is to provide specific information on the calculation and claiming of your relocation entitlements. Please sign on the line provided below to acknowledge receipt of this letter. Please feel free to contact your relocation specialist with any questions you may have. Sincerely, Paula Ferreira -Smith Right of Way Agent Tierra Right of Way Services, Ltd 8685 Martin Way E., #203 Lacey, WA 98516 pau la. ferrei ra• ii �t ierra-ro%%.coin (206) 677-8256 Mobile Acknowledgment of receipt of Notice of Eligibility letter '3 f/'If Signature:�GCI� Date: Z3 Javier Calvo i Signature: Bate: 22- Z Maria Isabel Le6n Hernandez LP A-507 Rev_ 12/2021 Form W-9 (Rev October 2018) OeWr*nt of the Tmomry Inx.Yrlll Rmmue Seiner Request for Taxpayer Identification Number and Certification ► Go to wwmirs.glIvlFwmWNB for instructions and the latest information. 1 "N.1me[m :horn on your income `talxreturn) Name is rcprmsd on tfua fora. do not lea" thts lino blank , 2 Business name/disregarded entity, name, if dMercnt from abovo 3 Check appropriate box for federal tax classification of the person whose name Is entered on line 1 Chock only one of the following seven boxes 2 llIndividual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ TrusVestale single -member LLC Give Form to the requester. Do not send to the IRS. 4 Exemptions (codes apply only to certain entities, not individuals. see vrstmctlons on page 3) Exempt payee code Of any) ❑ Limited liability company Enter the tax classification (C=C corporation, S-S corporation, P=Partnorship) to Note. Check the appeoptud* box in the tint: aoovo for the lax 0assilicanon M the •angte.nemiw ovmn Da not check Exemption from FATCA reporting LLC if the LLC Is cla wWO as a sngle member LLC llul r9 daegvded feom the owncq unless the ownee 01 Iho LLC a code (if airy) another LLC that s Art d�sroga dod flan pre owner for U S fe4ciAl lax purposm Othawnsa, a 9rigln-mrmbe[ LLC M111 is disregarded from the owner should Check the appropriate box for the tax dassdication of its owrrer. Other (see wiv ucltems) ► rhw• m �•m m..var u,rsa r. u sr 5 Address (number, street and --rrapt. or suite no.) Sao instruction Regies[nra Ma" and address topnondi I'1 % 1' V C 6 Cny. state and ZIP code 4. DE. x rti , ` 17 Lrsl account nunlberlsl he,* Iopbo'wg Enter your TIN in the appropriate box The TIN provided must match the name given on line 1 to avoid [ Social seventy spar _ backup withholding For individuals, this is generally your social security number (SSN) However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, later For other 0 _ entitles, it is your employer Identification number (EIN) If you do not have a number, see How to get a TIN, later. or Note: If the account is In more than one name, see the instructions for line 1 Also see What Name and I Employer rdnnWicabgn number Number To Give the Requester for guidelines on whose number to enter I I 7 I I I I r LM Certification Under penalties of perjury. I certify that. 1 The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding oecaua-, (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all rnNresl or dividends, or (c) the IRS has notified mo that I am no longer subject to backup withholding; and 3 1 am a U S citizen or other U S. person (defined below); and 4. The FATCA code(s) entered on this form (it any) indicating that I am exempt from FATCA reporting is correcL Certifieatlon Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have faded to report all interest and dividends on your tax return For real estate transactions, item 2 does not apply For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contnbubons to an individual retirement arrangement (IRA), and general[y payments other than interest and dividends. you are not required to sign the certification, but you must provide your correct TIN See the msUW*7 for Pan 11, later j � Jlyrl signature of Here uzuperson ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted Future developments- For the latest Information about developments related to Form W-9 and its Instructions, such as legislation enacted after they were published, go to www.irs gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who Is required to rile an information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social secunty number (SSN), individual taxpayer Identification number O[TIN), adoption taxpayer rderitdef ati07i uuinoer (ATIN), or employer idunDticatioll number (EIN), to report on an information ralum the amount paid to you, or other amount rmponaille on aft Intomialrnn return Exampl05 of Inf nmlalion realms include, but are not limited to, the following • Form 1099-INT (interest earned or paid) Date I- JI 1;9- Id -I-) I:)-S- • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of Income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan Interest). 1098-T (tuition) • Form 1099-C (canceled debt) • Form I M-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U S person (including a resident alien►, to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding See What is backup withholding, later. Cal No. 10231% Form W-V iRev. 1G-201 B)