AG 15-003RETURN TO: Jeri -Lynn Clark EXT: x2401
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT./DIV:
2. ORIGINATING STAFF PERSON
CED /COMMUNITY SERVICES DEPARTMENT
JERI -LYNN CLARK EXT: x2401 3. DATE REQ. BY:
4. 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
x OTHER PROMISSORY NOTE
5. PROJECT NAME: BLOKZYL — PROMISSORY NOTE
6. NAME OF CONTRACTOR: JAMES & SANDRA BLOZYL
ADDRESS: 32820 20' AVE S #21, FEDERAL WAY WA 98003 TELEPHONE: (253) 344 -1247
E -MAIL: N/A FAX: N/A
SIGNATURE NAME: JAMES & SANDRA BLOKZYL TITLE HOMEOWNERS
7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE X ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS
8. TERM: COMMENCEMENT DATE: DECEMBER 15, 2014 COMPLETION DATE: DECEMBER 15 2019
9. TOTAL COMPENSATION $ 5,836.35 (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
❑ PURCHASING: PLEASE CHARGE TO: 119- 7300 - 996 - 594 -41 -410
10. DOCUMENT /CONTRACT REVIEW
❑ PROJECT MANAGER
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
❑ LAW
INITIAL / DATE REVIEWED
INITIAL / DATE APPROVED
11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE:
12. CONTRACT SIGNATURE ROUTING
• SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
• ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
l LAW DEPARTMENT / ,,¢ "Oil Z- 2 3
SIGNATORY (MAY.QR[o �tR`�E �lOIi) �� ,D
5D CITY CLERK
❑ ASSIGNED AG# AG#
❑ SIGNED COPY RETURNED DATE SENT: i L
COMMENTS:
11/9
CITY OF CITY HALL
Federal Way 33325 81 Way, 8003
y Federal Way, WA 98003 -6325
(253) 835-7000
www cityolfederahvay com
PROMISSORY NOTE
City of Federal Way Housing Repair Program (HRP)
LENDER: City of Federal Way, a Municipal corporation
33325 8thAvenue South
Federal Way, WA 98003
BORROWER: James & Sandra Blokzyl,
Homeowner(s)
EHRP RESIDENCE: 32820 20th Ave S #21
Federal Way, WA 98003
PRINCIPAL $5,836.35
AMOUNT:
LOAN DATE: December 15, 2014
DUE DATE: The earlier of "Default Date" or December 15, 2019
In consideration for the mutual undertakings and covenants contained in this Promissory
Note (the "Note "), Lender (also referred to hereinafter as the "City ") and Borrower agree as
follows:
1. Purpose for Loan. Borrower is eligible to participate in Lender's Emergency Housing
Repair Program ( "EHRP "), a program to assist eligible homeowners with emergency housing
problems that pose a combination of unforeseen circumstances that require immediate action to
protect the health and safety of its occupants or the neighborhood as a whole. The program is
funded by Community Development Block Grant funds that have been made available to the
City. Borrower's application for an Emergency Housing Repair Program loan has been
approved and the City is prepared to fund the loan upon Borrower's execution of this Promissory
Note.
2. Promise to Pay. For value received, on or before the Due Date, Borrower, including its
assigns and successors, promises to pay Lender in lawful money of the United States of America,
at Lender's principal place of business, or such other place as Lender may designate in writing
from time to time, the Principal Amount listed above and as shall have been advanced by Lender
to or on behalf of Borrower under this Note, plus interest (in the event of Default) as provided in
this Note.
3. Interest Rate. The unpaid Principal Amount shall bear interest at the rate of Zero Percent
(0 %) per annum (the "Effective Interest Rate ") unless or until a Default.
4. Payments. No payments will be required to be made on the Principal Amount unless or until
a Default occurs. In the event of Default, the entire unpaid balance of the Principal Amount as of
the date of Default shall immediately become due and payable and interest on the unpaid balance
shall commence to accrue at the "Default Interest Rate" on the date of Default.
PROMISSORY NOTE 10/2012
HOUSING REPAIR PROGRAM Page 1
CITY OF CITY HALL
33325 8th Avenue
Federal Way �� Federal Way, WA 98003 8003
6325
(253)$35 -7000
www ciryotfederalway com
5. Loan Account. All advances made to or on behalf of Borrower under this Note shall be
charged to a loan account in Borrower's name on Lender's books ( "Loan Account") and Lender
shall debit to Borrower's Loan Account the amount of each advance, and credit the amount of
each repayment made by Borrower or "Forgiveness of Debt" granted by Lender.
6. Forgiveness of Debt. Commencing upon the date on which the Lender issues the last
advance of funds to or on behalf of Borrower under this Note (the "Repayment Commencement
Date "), Borrower shall be entitled to receive, and Lender shall grant, forgiveness of Twenty
Percent (20 %) of the Principal Amount for each consecutive twelve -month period after the
Repayment Commencement Date (a "Repayment Year ") that Borrower actually occupies the
Residence identified above as Borrower's principal place of residence. If Borrower resides in
the Residence for five (5) Repayment Years, the entire Principal Amount shall be forgiven and
this Note shall be satisfied in full. If Borrower fails for any reason to live in the Residence for
five (5) Repayment Years, this Note shall be in Default as of the date upon which Borrower no
longer resides in the Residence. For purposes of calculating the amount of forgiveness, if any, to
which Borrower may be entitled for the Repayment Year in which Borrower vacates the
Residence, the amount of forgiveness to which Borrower would be entitled for that Repayment
Year shall be prorated for the number of days that Borrower actually occupied the Residence in
that Repayment Year.
7. Default. Upon the occurrence of any of the following events ( "Events of Default "), Lender,
at its option, and without notice to Borrower, may declare the entire unpaid Principal Amount to
be immediately due and payable:
a. The Borrower no longer occupies the Residence as Borrower's primary residence;
b. The Borrower sells the Residence or conveys the Residence in lieu foreclosure, or forfeits
the Residence in foreclosure, bankruptcy or other insolvency proceeding;
c. The Borrower makes, or is deemed to have made, any materially incorrect, false,
fraudulent or misleading representation, warranty or certificate to the Lender or makes, or is
deemed to have made, any materially incorrect, false, fraudulent, or misleading representation in
any statement or application to Lender in connection with Lender's consideration of Borrower's
EHRP application;
d. The Borrower is enjoined, restrained or in any way prevented by court order from
continuing to reside in the Residence;
e. Formal charges are filed against the Borrower under any federal, state or municipal
statute, law or ordinance for which forfeiture of the Residence is a potential penalty, or the
Residence is in fact so seized or forfeited;
f. The Borrower fails to maintain the Residence, commits waste upon the Residence
property or allows the Residence or Residence property to become a nuisance;
g. The Borrower (1) makes an assignment for the benefit of creditors, (2) consents to the
appointment of a custodian, receiver or trustee for itself or for a substantial part of its assets or
(3) commences, consents to the commencement or continuation of, or has commenced upon it,
voluntarily or involuntarily, any proceeding under any bankruptcy, insolvency or similar laws of
any jurisdiction; or,
h. The Borrower dies.
PROMISSORY NOTE 10/2012
HOUSING REPAIR PROGRAM Page 2
CITY OF
,�,�...., Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253)835 -7000
www cdyot%derahvay com
The term "Default Date" shall mean the date on which an Event of Default has occurred or the
date Borrower is no longer entitled to cure the Event of Default under the terms of this Note.
8. Default Interest Rate. Upon the occurrence of any Event of Default, the unpaid Principal
Amount balance shall bear interest at the per annum interest rate for judgments provided by
Washington law until the Note is satisfied in full.
9. Default Remedies. Upon the occurrence of any Event of Default, Lender shall have and
may exercise any one or more of the rights and remedies available under the law.
10. Application of Payments. All payments received on this Note shall first be applied against
accrued and unpaid interest and "Costs and Fees" owed to Lender under this Note, and the
balance against unpaid Principal Amount. Borrower expressly assumes all risks of loss or delay
in the delivery of any payments made by mail, and no course of conduct or dealing shall affect
Borrower's assumption of these risks.
11. Costs and Fees. Borrower agrees to pay all of Lender's costs incurred in the collection,
modification, review, monitoring, or termination of this Note, including actual attorney fees and
those incurred in any foreclosure, bankruptcy, or other similar insolvency proceeding.
12. No Waiver. Acceptance by Lender of any payment in an amount less than the amount then
due shall be deemed an acceptance on account only, and Lender's acceptance of any such partial
payment shall not constitute a waiver of Lender's right to receive the entire amount due.
13. Consent. Borrower hereby jointly and severally (i) waives presentment for payment,
demand, notice of non - payment, notice of protest or protest of this Note, (ii) waives Lender's
diligence in collection or bringing suit, and (iii) waives consent to any and all extensions of time,
renewals, waivers or modifications as may be granted by Lender with respect to payment or any
other provisions of this Note. The liability of the Borrower under this Note shall be absolute and
unconditional, without regard to the liability of any other party.
14. Governing Law and Venue. This Note shall be interpreted, construed and governed by, and
in accordance with, the laws of the State of Washington. Venue for any action commenced by
Borrower or Lender to interpret or enforce this Note shall be in the Superior Court of the State of
Washington, For King County, at the Maleng Regional Justice Center, Kent, Washington.
15. Entire Agreement. Except as otherwise expressly provided in this Note constitutes the
entire agreement of the Borrower and the Lender relating to its subject matter.
ORAL AGREEMENTS OR ORAL COMMITMENTS TO LOAN MONEY, EXTEND
CREDIT, OR TO FORBEAR FROM ENFORCING REPAYMENT OF A DEBT ARE
NOT ENFORCEABLE UNDER WASHINGTON LAW.
PROMISSORY NOTE 10/2012
HOUSING REPAIR PROGRAM Page 3
Federal Wa
00 . y
Agreed to and accepted by:
LENDER:
CITY OF FEDERAL WAY
ovev
Ji , Mayor
A OVED AS FORM:
P :
XV
City Atto , Amy Jo Pearsall
BORR¢ R(S):�
Sl re - James Blokzyl
Printed Name
STATE OF WASHINGTON )
ss.
COUNTY OF )
ATTEST:
I►�l �I
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
oww cityoffederalway com
I i 'y" PH TIM �601 ww
.0 , . I - 66"-�
Printed Name
o me known to be the
On this day personally appeared before me, �G ,
individual described in and who executed the foregoing instrument, and on oath swore that he /she /they
executed the foregoing instrument as his/her /their free and voluntary act and deed for the uses and
purposes therein mentioned.
GIVEN my hand and official seal this da of 20 /V
`�.XI— �(NN coq r���/ Notary's signature
Notary's printed name 1r1
, Notary Public in an for the State of Washington.
u • - �' = My commission expires L- b 6 y
O =
4.20.1�?Az
,sit, OP WAS \;� "0
PROMISSORY NOTE 10/2012
HOUSING REPAIR PROGRAM Page 4