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064-25 - Warren Edward Lumsden - Contract Addendums
Inslee, Best, Doezie & Ryder, P.S. 10900 NE 4th St., Suite 1500 Bellevue, WA 98004 Phone: 425-455-1234 Fax: 425-635-7720 SELLER DISCLOSURE STATEMENT IMPROVED PROPERTY SELLER: Warren Edward Lumsden © Commercial Brokers CBA Association V ALL RIGHTS RESERVED Form: 17 Seller Disclosure Statement - Improved Rev. 8/2021 Page 1 of 10 To be used in transfers of improved residential real property, including residential dwellings up to four units, new construction, dwellings in a residential common interest community not subject to a public offering statement, condominiums not subject to a public offering statement, certain timeshares, and manufactured and mobile homes. See RCW Chapter 64.06 for further information. INSTRUCTIONS TO THE SELLER Please complete the following form. Do not leave any spaces blank. If the question clearly does not apply to the property check "NA." If the answer is "yes" to any asterisked (*) item(s), please explain on attached sheets. Please refer to the line number(s) of the question(s) when you provide your explanation(s). For your protection you must date and initial each page of this disclosure statement and each attachment. Delivery of the disclosure statement must occur not later than five (5) business days, unless otherwise agreed, after mutual acceptance of a written purchase and sale agreement between Buyer and Seller. NOTICE TO THE BUYER THE FOLLOWING DISCLOSURES ARE MADE BY THE SELLER ABOUT THE CONDITION OF THE PROPERTY LOCATED AT 1333 Lloyd Parkway, CITY Port Orchard , COUNTY Kitsap ("THE PROPERTY") OR AS LEGALLY DESCRIBED ON THE ATTACHED EXHIBIT A. SELLER MAKES THE FOLLOWING DISCLOSURES OF EXISTING MATERIAL FACTS OR MATERIAL DEFECTS TO BUYER BASED ON SELLER'S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME SELLER COMPLETES THIS DISCLOSURE STATEMENT. UNLESS YOU AND SELLER OTHERWISE AGREE IN WRITING, YOU HAVE THREE (3) BUSINESS DAYS FROM THE DAY SELLER OR SELLER'S AGENT DELIVERS THIS DISCLOSURE STATEMENT TO YOU TO RESCIND THE AGREEMENT BY DELIVERING A SEPARATELY SIGNED WRITTEN STATEMENT OF RESCISSION TO SELLER OR SELLER'S AGENT. IF THE SELLER DOES NOT GIVE YOU A COMPLETED DISCLOSURE STATEMENT, THEN YOU MAY WAIVE THE RIGHT TO RESCIND PRIOR TO OR AFTER THE TIME YOU ENTER INTO A PURCHASE AND SALE AGREEMENT. THE FOLLOWING ARE DISCLOSURES MADE BY SELLER AND ARE NOT THE REPRESENTATIONS OF ANY REAL ESTATE LICENSEE OR OTHER PARTY. THIS INFORMATION IS FOR DISCLOSURE ONLY AND IS NOT INTENDED TO BE A PART OF ANY WRITTEN AGREEMENT BETWEEN BUYER AND SELLER. FOR A MORE COMPREHENSIVE EXAMINATION OF THE SPECIFIC CONDITION OF THIS PROPERTY YOU ARE ADVISED TO OBTAIN AND PAY FOR THE SERVICES OF QUALIFIED EXPERTS TO INSPECT THE PROPERTY, WHICH MAY INCLUDE, WITHOUT LIMITATION, ARCHITECTS, ENGINEERS, LAND SURVEYORS, PLUMBERS, ELECTRICIANS, ROOFERS, BUILDING INSPECTORS, ON -SITE WASTEWATER TREATMENT INSPECTORS, OR STRUCTURAL PEST INSPECTORS. THE PROSPECTIVE BUYER AND SELLER MAY WISH TO OBTAIN PROFESSIONAL ADVICE OR INSPECTIONS OF THE PROPERTY OR TO PROVIDE APPROPRIATE PROVISIONS IN A CONTRACT BETWEEN THEM WITH RESPECT TO ANY ADVICE, INSPECTION, DEFECTS OR WARRANTIES. Sellers / ❑ is not occupying the Property. I. SELLER'S DISCLOSURES: * If you answer "Yes" to a question with an asterisk (*), please explain your answer and attach documents, if available and not otherwise publicly recorded. If necessary, use an attached sheet. SELLER'S INITIALS { / DATE: �/� l ( �` ) SELLER'S INITIALS: DATE Inslee, Best, Doezie & Ryder, P.S. 10900 NE 4th St., Suite 1500 Bellevue, WA 98004 Phone: 425-455-1234 Fax: 425-635-7720 SELLER DISCLOSURE STATEMENT IMPROVED PROPERTY © Commercial Brokers CBA Association V ALL RIGHTS RESERVED Form: 17 Seller Disclosure Statement - Improved Rev. 8/2021 Page 2 of 10 1. TITLE YES NO DON'T N/A KNOW A. Do you have legal authority to sell the property? If no, please explain ................ ❑ ❑ ❑ *B. Is title to the property subject to any of the following? (1) First right of refusal.......................................................................................... ❑ ,E ❑ ❑ (2) Option.............................................................................................................. ❑ .$ ❑ ❑ (3) Lease or rental agreement.............................................................................. ❑ .E ❑ ❑ (4) Life estate?...................................................................................................... ❑ .( ❑ ❑ *C. Are there any encroachments, boundary agreements, or boundary disputes?... ❑ , ❑ ❑ *D. Is there a private road or easement agreement for access to the property?....... ❑ ,�' ❑ ❑ *E. Are there any rights -of -way, easements, or access limitations that may affect the Buyer's use of the property?................................................................ ❑ 21 ❑ ❑ *F. Are there any written agreements for joint maintenance of an easement or right-of-way?........................................................................................................ ❑ ,B- ❑ ❑ *G. Is there any study, survey project, or notice that would adversely affect the property?.............................................................................................................. ❑ ,P� ❑ ❑ *H. Are there any pending or existing assessments against the property'? ...............Li ❑ , ' ❑ ❑ I. Are there any zoning violations, nonconforming uses, or any unusual restrictions on the property that would affect future construction or ❑ remodeling?.......................................................................................................... ❑ El *J. Is there a boundary survey for the property?........................................................ .Ef, ❑ ❑ ❑ *K. Are there any covenants, conditions, or restrictions recorded against the property?.............................................................................................................. ❑ l- ❑ ❑ NOTICE TO BUYER: Covenants or deed restrictions based on race, creed, sexual orientation, or other protected class were voided by RCW 49.60.224 and are unenforceable. Washington law allows for the illegal language to be struck by bringing an action in superior court or by the free recording of a restrictive covenant modification document. Many county auditor websites provide a short form with instructions on this process. 2. WATER A. Household Water (1) The source of water for the property is: ptrivate or publicly owned water system ❑ Private well serving only the subject property * ❑ Other water system *If shared, are there any written agreements'?.............................................. *(2) Is there an easement (recorded or unrecorded) for access to and/or maintenance of the water source?.............................................................. *(3) Are there any problems or repairs needed'?................................................ ❑ ❑ .ef ❑ ❑ ❑ ❑ ) C SELLER'S INITIALS: DATE: r SELLER'S INITIALS: DATE: Inslee, Best, Doezie & Ryder, P.S. 10900 NE 4th St., Suite 1500 Bellevue, WA 98004 Phone: 425-455-1234 Fax: 425-635-7720 SELLER DISCLOSURE STATEMENT IMPROVED PROPERTY © Commercial Brokers �I CBA Association V ALL RIGHTS RESERVED Form: 17 Seller Disclosure Statement - Improved Rev. 8/2021 Page 3 of 10 (4) During your ownership, has the source provided an adequate year-round supply of potable water?.............................................................................. If no, please explain: *(5) Are there any water treatment systems for the property? ........................... If yes, are they: El Leased El Owned *(6) Are there any water rights for the property associated with its domestic water supply, such as a water right permit, certificate, or claim? ................. (a) If yes, has the water right permit, certificate, or claim been assigned, transferred, or changed?.............................................................................. *(b) If yes, has all or any portion of the water right not been used for five or more successive years?........................................................................... *(7) Are there any defects in the operation of the water system (e.g. pipes, tank, pump, etc.)?......................................................................................... B. Irrigation Water (1 ] Are there any irrigation water rights for the property, such as a water right permit, certificate, or claim?................................................................. *(a) If yes, has all or any portion of the water right not been used for five or more successive years?................................................................... *(b) If so, is the certificate available? (If yes, please attach a copy.).......... *(c) If so, has the water right permit, certificate, or claim been assigned, transferred, or changed?...................................................................... *(2) Does the property receive irrigation water from a ditch company, irrigation district, or other entity?.................................................................. If so, please identify the entity that supplies water to the property: C. Outdoor Sprinkler System (1) Is there an outdoor sprinkler system for the property? .............................. *(2) If yes, are there any defects in the system? ............................................. *(3) If yes, is the sprinkler system connected to irrigation water? ................... 3. SEWER/ON-SITE SEWAGE SYSTEM A. The property is served by: El Public sewer system n -site sewage system (including pipes, tanks, drainfields, and all other component parts) El Other disposal system Please describe: B. If public sewer system service is available to the property, is the house connected to the sewer main ..................................................... .............. If no, please explain: '/ . _ 1 6/,w'- 7" SELLER'S INITIALS: DATE: SELLER'S INITIALS: YES NO DON'T N/A KNOW El El El ❑ 2( ❑ El El p' ❑ ❑ El El El ❑ El ❑ ❑ O ❑ � ❑ ❑ El B ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Cl ❑ ❑ El ,�❑ ❑ ,�- ❑ ❑ ❑ El ,a'.' ❑ ❑ El /1' ❑ El ❑ .. ❑ El DATE: Inslee, Best, Doezie & Ryder, P.S. 10900 NE 4th St., Suite 1500 Bellevue, WA 98004 Phone: 425-455-1234 Fax: 425-635-7720 SELLER DISCLOSURE STATEMENT IMPROVED PROPERTY © Commercial Brokers ''I CI3� Association V ALL RIGHTS RESERVED Form: 17 Seller Disclosure Statement - Improved Rev. 8/2021 Page 4 of 10 *C. Is the property subject to any sewage system fees or charges in addition to those covered in your regularly billed sewer or on -site sewage system maintenance service?.................................................................................... D. If the property is connected to an on -site sewage system: *(1) Was a permit issued for its construction, and was it approved by the local health department or district following its construction'?............. (2) When was it last pumped? *(3) Are there any defects in the operation of the on -site sewage system?................................................................................................ (4) When was it last Inspected? /1aZ( By whom: M4 (5) For how many bedrooms was the on -site sewage system approved? bedrooms E. Are all plumbing fixtures, including laundry drain, connected to the sewer/on-site sewage system?...................................................................... If no, please explain: *F. Have there been any changes or repairs to the on -site sewage system?.......................................................................................................... G. Is the on -site sewage system, including the drainfield, located entirely within the boundaries of the property?........................................................... If no, please explain: *H. Does the on -site sewage system require monitoring and maintenance services more frequently than once a year'?.................................................. YES NO DON'T N/A KNOW ❑ X ❑ ❑ b ■ ❑ ❑ ❑ ■ ■ S ■_ ❑ 0 0 NOTICE: IF THIS RESIDENTIAL REAL PROPERTY DISCLOSURE IS BEING COMPLETED FOR NEW CONSTRUCTION WHICH HAS NEVER BEEN OCCUPIED, SELLER IS NOT REQUIRED TO COMPLETE THE QUESTIONS LISTED IN ITEM 4 (STRUCTURAL) OR ITEM 5 (SYSTEMS AND FIXTURES). 4. STRUCTURAL *A. Has the roof leaked within the last 5 years'?........................................ *B. Has the basement flooded or leaked'?................................................. *C. Have there been any conversions, additions or remodeling'?.............. *(1) If yes, were all building permits obtained'?.................................... *(2) If yes, were all final inspections obtained'?................................... D. Do you know the age of the house'?.................................................... If yes, year of original construction: /'2 *E. Has there been any settling, slippage, or sliding of the property or its improvements?.................................................................................... JSELLER'S INITIALS: : DATE/ I J SELLER'S INITIALS: ......❑ ❑ ❑ ....I...❑ 0 ❑ .~0' .......... ❑ Z ❑ ❑ ......... 0 0 0 ❑ ......... ❑ ............ ❑ ❑ ❑ ❑ X DATE: Inslee, Best, Doezie & Ryder, P.S. 10900 NE 4th St., Suite 1500 Bellevue, WA 98004 Phone: 425-455-1234 Fax: 425-635-7720 SELLER DISCLOSURE STATEMENT IMPROVED PROPERTY © Commercial Brokers Association V ALL RIGHTS RESERVED Form: 17 Seller Disclosure Statement - Improved Rev. 8/2021 Page 5 of 10 *F. Are there any defects with the following: (If yes, please check applicable items and explain) YES NO DON'T N/A KNOW El ❑ -7 El ❑ Foundations El Decks El Exterior Walls El Chimneys ❑ Interior Walls El Fire Alarms El Doors El Windows El Patio El Ceilings El Slab Floors El Driveways El Pools El Hot Tub ❑ Sauna El Sidewalks ❑ Outbuildings El Fireplaces El Garage Floors El Walkways El Siding El Wood Stoves El Elevators El Incline Elevators El Stairway Chair Lifts ❑ Wheelchair Lifts El Other *G. Was a structural pest or "whole house" inspection done? .......................... ❑ ,•� ❑ El If yes, when and by whom was the inspection completed? H. During your ownership, has the property had any wood destroying organism or pest infestation?....................................................................... ❑ El El I. Is the attic insulated?.................................................................................... ❑ ❑ ❑ J. Is the basement insulated?........................................................................... ❑ El El .E- 5. SYSTEMS AND FIXTURES *A. If any of the following systems or fixtures are included with the transfer, are there any defects? If yes, please explain: Electrical system, including wiring, switches, outlets, and service ......................El ❑ .1 ❑ El Plumbing system, including pipes, faucets, fixtures, and toilets ..........................El ❑ .E( 0 El Hotwater tank...................................................................................................... ❑ .E3" ❑ El Garbagedisposal................................................................................................. ❑ El 0 : I� Appliances........................................................................................................... ❑ .E'T ❑ ❑ Sumppump......................................................................................................... ❑ El El -E1 Heating and coolinggssystems............................................................................... ❑ ❑ ❑ Security system _YJ Owned El Leased................................................................. ❑ El ❑ El Other El El ❑ El *B. If any of the following fixtures or property is included with the transfer, are they leased? (If yes, please attach copy of lease.) Security System: ❑ ❑ El Tanks (type): ❑ ❑ ❑ SELLER'S INITIALS: DATE: ` "` 4��SELLERS INITIALS: DATE. Inslee, Best, Doezie & Ryder, P.S. © Commercial Brokers �� CBA V n AssRVED 10900 NE 4th St., Suite 1500 ALL RIGHTS RESERVED Bellevue, WA 98004 Phone: 425-455-1234 Seller Disclosure Statement Form: 17 - Fax: 425-635-7720 Improved Rev. 8/2021 Page 6 of 10 SELLER DISCLOSURE STATEMENT IMPROVED PROPERTY Satellite dish: ❑ �J` ❑ ❑ Other: ❑ ❑ ❑ ❑ YES NO DON'T N/A KNOW *C. Are any of the following kinds of wood burning appliances present at the property? (1) Woodstove?..........................................................................._............................ ❑ 2 ❑ ❑ (2) Fireplace insert?......................................................................................... ❑ 3" ❑ ❑ (3) Pellet stove?............................................................................................... ❑ J≥ ❑ ❑ (4) Fireplace?................................................................................................... ❑ ,[t" ❑ ❑ If yes, are all of the (1) woodstoves or (2) fireplace inserts certified by the U.S. Environmental Protection Agency as clean burning appliances to improve air quality and public health?................................................................ ❑ ❑ ❑ Li D. Is the property located within a city, county, or district or within a department of natural resources fire protection zone that provides fire protection services?............................................................................................................. ❑ ❑ ❑ E. Is the property equipped with carbon monoxide alarms? (Note: Pursuant to RCW 19.27.530, Seller must equip the residence with carbon monoxide . alarms as required by the state building code.) .................................................. ❑ ❑ ❑ F. Is the property equipped with smoke detection devices'? ......................................� ❑ ❑ ❑ (Note: Pursuant to RCW 43.44.110, if the property is not equipped with at least one smoke detection device, at least one must be provided by the seller.) G. Does the property currently have internet service? ❑ ❑ ❑ Provider: 6. HOMEOWNERS' ASSOCIATION/COMMON INTERESTS A. Is there a Homeowners' Association?................................................................... ❑ ❑ ❑ Name of Association and contact information for an officer, director, employee, or other authorized agent, if any, who may provide the association's financial statements, minutes, bylaws, fining policy, and other information that is not publicly available: B. Are there regular periodic assessments?.............................................................. ❑ ❑ ❑ -El $ per ❑ month ❑ year ❑ Other: *C. Are there any pending special assessments?...................................................... ❑ ❑ ❑ _n *D. Are there any shared "common areas" or any joint maintenance agreements (facilities such as walls, fences, landscaping, pools, tennis courts, walkways, or other areas co -owned in undivided interest with others)? ................................ ❑ ❑ ❑ —❑ 7. ENVIRONMENTAL SELLER'S INITIALS: - DATE. 7 a 7SELLER'S INITIALS: DATE: Inslee, Best, Doezie & Ryder, P.S. ©commercial Brokers CBA V 10900 NE 4th St., Suite 1500 ALL RIGHTS AssRVED RESERVED Bellevue, WA 98004 Phone: 425-455-1234 Form: 17 Seller Disclosure Statement - Fax: 425-635-7720 Improved Rev. 8/2021 Page 7 of 10 SELLER DISCLOSURE STATEMENT IMPROVED PROPERTY YES NO DON'T N/A KNOW *A. Have there been any flooding, standing water, or drainage problems on the ❑ El El property that affect the property or access to the property? .......................... *B. Does any part of the property contain fill dirt, waste, or other fill ❑ El ❑ material?............................................................................... *C. Is there any material damage to the property from fire, wind, floods, beach ❑ El ❑ movements, earthquake, expansive soils, or landslides? .............................. D. Are there any shorelines, wetlands, floodplains, or critical areas on the ❑ �"' El O property?.......................................................................................................... *E. Are there any substances, materials, or products in or on the property that may be environmental concerns, such as asbestos, formaldehyde, radon El gas, lead -based paint, fuel or chemical storage tanks, or contaminated ❑ El ❑ soilor water?.................................................................................................. *F. Has the property been used for commercial or industrial purposes? ............. ❑ ❑ ❑ *G. Is there any soil or groundwater contamination? ........................................... ❑ ❑ _-D El *H. Are there transmission poles or other electrical utility equipment installed, maintained, or buried on the property that do not provide utility service to the structures on the property?............................................................................ ❑ El El *I. Has the property been used as a legal or illegal dumping site? ...................... ❑ El ❑ *J. Has the property been used as an illegal drug manufacturing site? ............... ❑ Z' ❑ El *K. Are there any radio towers in the area that cause interference with cellular telephone reception?...................................................................................... ❑ , El Li 8. LEAD BASED PAINT (Applicable if the house was built before 1978) ...................... A. Presence of lead -based paint and/or lead -based paint hazards (check one below): El Known lead -based paint and/or lead -based paint hazards are present in the housing (explain). El Seller has no knowledge of lead -based paint and/or lead -based paint hazards in the housing. B. Records and reports available to the Seller (check one below): El Seller has provided the purchaser with all available records and reports pertaining to lead -based paint and/or lead -based paint hazards in the housing (list documents below). El Seller has no reports or records pertaining to lead -based paint and/or lead -based paint hazards in the housing. YES NO DON'T N/A KNOW 9. MANUFACTURED AND MOBILE HOMES If the property includes a manufactured or mobile home, *A. Did you make any alterations to the home? ............................................. ❑ ❑ ❑ ❑ If yes, please describe the alterations: SELLER'S INITIALS: DATE: �/ �1� SELLER'S INITIALS: DATE: Inslee, Best, Doezie & Ryder, P.S. © Commercial Brokers A CBA n 10900 NE 4th St., Suite 1500 ALL RIGHTS AssERESERVED V Bellevue, WA 98004 17 Phone: 425-455-1234 Form: Seller Disclosure Statement - - Fax: 425-635-7720 Improved Rev. 8/2021 Page 8 of 10 SELLER DISCLOSURE STATEMENT IMPROVED PROPERTY *B. Did any previous owner make any alterations to the home? ................... ❑ ❑ ❑ *C. If alterations were made, were permits or variances for these alterations obtained?................................................................................................. ❑ ❑ ❑ 10. FULL DISCLOSURE BY SELLERS A. Other conditions or defects: *Are there any other existing material defects affecting the property that a prospective buyer should know about? ❑ ❑ ❑ ]l B. Verification The foregoing answers and attached explanations (if any) are complete and correct to the best of Seller's knowledge and Seller has received a copy hereof. Seller agrees to defend, indemnify and hold real estate licensees harmless from and against any and all claims that the above information is inaccurate. Seller authorizes real estate licensees, if any, to deliver a copy of this disclosure statement to other real estate lice s all prospective buyers of pro rtk. Seller Da a Seller Date If the answer is "Yes" to any asterisked (*) items, please explain below (use additional sheets if necessary). Please refer to the line number(s) of the question(s). SELLER'S INITIALS: DATE: / '/9% SELLER'S INITIALS: DATE: Inslee, Best, Doezie & Ryder, P.S. 10900 NE 4th St., Suite 1500 Bellevue, WA 98004 Phone: 425-455-1234 Fax: 425-635-7720 SELLER DISCLOSURE STATEMENT IMPROVED PROPERTY II. NOTICES TO THE BUYER 1. SEX OFFENDER REGISTRATION © Commercial Brokers Association ALL RIGHTS RESERVED Form: 17 Seller Disclosure Statement - Improved Rev. 8/2021 Page 9 of 10 VC3A INFORMATION REGARDING REGISTERED SEX OFFENDERS MAY BE OBTAINED FROM LOCAL LAW ENFORCEMENT AGENCIES. THIS NOTICE IS INTENDED ONLY TO INFORM YOU OF WHERE TO OBTAIN THIS INFORMATION AND IS NOT AN INDICATION OF THE PRESENCE OF REGISTERED SEX OFFENDERS. 2. PROXIMITY TO FARMING/WORKING FOREST THIS NOTICE IS TO INFORM YOU THAT THE REAL PROPERTY YOU ARE CONSIDERING FOR PURCHASE MAY LIE IN CLOSE PROXIMITY TO A FARM OR WORKING FOREST. THE OPERATION OF A FARM OR WORKING FOREST INVOLVES USUAL AND CUSTOMARY AGRICULTURAL PRACTICES OR FOREST PRACTICES, WHICH ARE PROTECTED UNDER RCW 7.48.305, THE WASHINGTON RIGHT TO FARM ACT. OIL TANK INSURANCE THIS NOTICE IS TO INFORM YOU THAT IF THE REAL PROPERTY YOU ARE CONSIDERING FOR PURCHASE UTILIZES AN OIL TANK FOR HEATING PURPOSES, NO COST INSURANCE MAY BE AVAILABLE FROM THE POLLUTION LIABILITY INSURANCE AGENCY. III. BUYER'S ACKNOWLEDGEMENT 1. BUYER HEREBY ACKNOWLEDGES THAT: A. Buyer has a duty to pay diligent attention to any material defects that are known to Buyer or can be known to Buyer by utilizing diligent attention and observation. B. The disclosures set forth in this statement and in any amendments to this statement are made only by the Seller and not by any real estate licensee or other party. C. Buyer acknowledges that, pursuant to RCW 64.06.050 (2), real estate licensees are not liable for inaccurate information provided by Seller, except to the extent that real estate licensees know of such inaccurate information. D. This information is for disclosure only and is not intended to be a part of the written agreement between the Buyer and Seller. E. Buyer (which term includes all persons signing the "Buyer's acceptance" portion of this disclosure statement below) has received a copy of this Disclosure Statement (including attachments, if any) bearing Seller's signature(s). F. If the house was built prior to 1978, Buyer acknowledges receipt of the pamphlet Protect Your Family From Lead in Your Home. DISCLOSURES CONTAINED IN THIS DISCLOSURE STATEMENT ARE PROVIDED BY SELLER BASED ON SELLER'S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME SELLER COMPLETES THIS DISCLOSURE. UNLESS BUYER AND SELLER OTHERWISE AGREE IN WRITING, BUYER SHALL HAVE THREE (3) BUSINESS DAYS FROM THE DAY SELLER OR SELLER'S AGENT DELIVERS THIS DISCLOSURE STATEMENT TO RESCIND THE AGREEMENT BY DELIVERING A SEPARATELY SIGNED WRITTEN STATEMENT OF RESCISSION TO SELLER OR SELLER'S AGENT. YOU MAY WAIVE THE RIGHT TO RESCIND PRIOR TO OR AFTER THE TIME YOU ENTER INTO A SALE AGREEMENT. SELLER'S INITIALS: DATE: SELLER'S INITIALS: DATE Inslee, Best, Doezie & Ryder, P.S. 10900 NE 4th St., Suite 1500 Bellevue, WA 98004 Phone: 425-455-1234 Fax: 425-635-7720 SELLER DISCLOSURE STATEMENT IMPROVED PROPERTY © Commercial Brokers ACBA Association ALL RIGHTS RESERVED Form: 17 Seller Disclosure Statement - Improved Rev. 8/2021 Page 10 of 10 BUYER HEREBY ACKNOWLEDGES RECEIPT OF A COPY OF THIS DISCLOSURE STATEMENT AND ACKNOWLEDGES THAT THE DISCLOSURES MADE HEREIN ARE THOSE OF THE SELLER ONLY, AND NOT OF ANY REAL ESTATE LICENSEE OR OTHER PARTY. Buyer Date Buyer 2. BUYER'S WAIVER OF RIGHT TO REVOKE OFFER Buyer has read and reviewed the Seller's responses to this Seller Disclosure Statement. Buyer approves this statement and waives Buyer's right to revoke Buyer's offer based on this disclosure. Date Buyer Date 3. BUYER'S WAIVER OF RIGHT TO RECEIVE COMPLETED SELLER DISCLOSURE STATEMENT Buyer has been advised of Buyer's right to receive a completed Seller Disclosure Statement. Buyer waives that right. However, if the answer to any of the questions in the section entitled "Environmental" would be "yes," Buyer may not waive the receipt of the "Environmental" section of the Seller Disclosure Statement. Uate Buyer SELLER'S INITIALS: DATE: 7 /SELLER'S INITIALS: Date DATE Inslee, Best, Doezie & Ryder, P.S. © commerAssociation cial Brokers �I•CBA V 10900 NE 4th St., Suite 1500 ALL RIGHTS RESERVED Bellevue, WA 98004 Phone: 425-455-1234 Form:UA Utility Addendum Fax: 425-635-7720 Rev. 7/2020 Page 1 of 2 UTILITY CHARGES ADDENDUM CBA Text Disclaimer: Text deleted by licensee indicated by strike. New text inserted by licensee indicated by small capital letters. The following is part of the Purchase and Sale Agreement with Reference Date July 23 , 20 25 between City of Port Orchard ("Buyer") and Warren Edward Lumsden ("Seller") regarding the sale of property located at 1333 Lloyd Parkway , Port Orchard , WA 98367 (the "Property"). Pursuant to RCW 60.80, Buyer and Seller request the Closing Agent to administer the disbursement of closing funds necessary to satisfy unpaid utility charges affecting the Property. The names and addresses of all utilities providing service to the Property and having lien rights are as follows: Water District: ame Name Sewer District: e-mail or website (optional) City, State, Zip Irrigation District 1V. Name e-mail orwebsite (optional) City, State, Zip Garbage: (-i//Y] lforpo _ t .cery;crc /1/f CRr'r,i Air) Name e-mail orwebsite (optional) Address Lor Antoele!r, Chi- 90oSy -10tc City. State, Zip INITIALS: Buy Date I /2 Seller , f Date C Buyer Date Seller Date Inslee, Best, Doezie & Ryder, P.S. 10900 NE 4th St., Suite 1500 Bellevue, WA 98004 Phone: 425-455-1234 Fax: 425-635-7720 UTILITY CHARGES ADDENDUM (CONTINUED) Electricity: Pv9 r I 50pn d hrr V Name e-mail or website (optional) PO 13ox `'/269 Address 8rl/{ vvr, W74 `/9'00 9 — 92 6cf City, State, Zip - Gas: CA igz _dr LVaicra. j 601 c Name e-mail or website (optional) PO Box 51�o Address I3;srnarck N D Sso6-S6ao City, State, Zip Special District(s): i4 c+cq,,idTnt P h t (local improvement districts Name or utility local improvement) e-mail orwebsite (optional) © Commercial Brokers CBA Association V ALL RIGHTS RESERVED Form: UA Utility Addendum Rev. 7/2020 Page 2 of 2 IF THE ABOVE INFORMATION HAS NOT BEEN FILLED IN AT THE TIME OF MUTUAL ACCEPTANCE OF THIS AGREEMENT, THEN (1) WITHIN DAYS (5 DAYS IF NOT FILLED IN) OF MUTUAL ACCEPTANCE OF THIS AGREEMENT, SELLER SHALL PROVIDE THE LISTING BROKER, SELLING BROKER, OR CLOSING AGENT WITH THE NAMES AND ADDRESSES OF ALL UTILITY PROVIDERS HAVING LIEN RIGHTS AFFECTING THE PROPERTY AND (2) BUYER AND SELLER AUTHORIZE LISTING BROKER, SELLING BROKER OR CLOSING AGENT TO INSERT INTO THIS ADDENDUM THE NAMES AND ADDRESSES OF THE UTILITY PROVIDERS IDENTIFIED BY SELLER. SELLER ACKNOWLEDGES THAT THIS ADDENDUM DOES NOT RELIEVE SELLER OF ITS OBLIGATION TO PAY UTILITY CHARGES, BILLED OR UNBILLED OR EVIDENCED BY A RECORDED LIEN OR NOT. THE PARTIES UNDERSTAND THAT NEITHER LISTING BROKER NOR SELLING BROKER IS RESPONSIBLE FOR PAYING UTILITY CHARGES OR FOR INSURING THAT THEY ARE PAID BY ANY OTHER PERSON. INITIALS: Buy Date -7 Seller Dale t/C Buyer Date Seller Date Inslee, Best, Doezie & Ryder, P.S. © Commercial Brokers �I CBA n 10900 NE 4th St., Suite 1500 ALL RIGHTS RESERVED AssRVociatED V Bellevue, WA 98004 Phone: 425-455-1234 Form: 22E FIRPTA Certificate ertifcate Fax: 425-635-7720 Rev. 7/2020 Page 1 of 2 CERTIFICATION UNDER THE FOREIGN INVESTMENT IN REAL PROPERTY TAX ACT ("FIRPTA") Section 1445 of the U.S. Internal Revenue Code, The Foreign Investment in Real Property Tax Act ("FIRPTA") provides that a buyer of a U.S. real property interest must withhold tax if the Seller is a foreign person, unless an exception in the Act applies. The following information is intended to help the Buyer and Closing Agent determine if tax withholding is required. Note: The above law applies to foreign corporations, partnerships, trusts, estates and other foreign entities, as well as to foreign individuals. If the Seller is a corporation, partnership, trust, estate or other entity, the terms "I" and "my" as used below means the corporation or other entity. A "real property interest" includes full or part ownership of land and/or improvements thereon; leaseholds; options to acquire any of the foregoing; and an interest in foreign corporations, partnerships, trusts or other entities holding U.S. real estate. SELLER CERTIFICATION. Seller hereby certifies the following: PROPERTY. I am the Seller of real property: ® at 1333 Lloyd Parkway Port Orchard, (address) (city) Washington; or ❑ (if no street address) legally described on the attached. CITIZENSHIP STATUS. I ❑ AM ® AM NOT a non-resident alien (or a foreign corporation, foreign partnership, foreign trust, foreign estate or other foreign business entity) for purposes of U.S. income taxation. TAXPAYER I.D. NUMBER. My U.S. taxpayer identification number (e.g. social security number) is: S/4-ya-917 ADDRESS. My home address is: /i2/(, b, 27 5T Al.I/J. if P71 6t& NAR&9 Under penalties of perjury, I declare that I have examined this Certification and to the best of my knowledge and belief it is true, correct and complete. I understand that this Certification may be disclosed to the Internal Revenue Service and that any false statement I have made here could be punished by fine, imprisonment, or both. 7 TE SELLER DATE SELLER DATE Inslee, Best, Doezie & Ryder, P.S. © Commercial Brokers �I CBA n 10900 NE 4th St., Suite 1500 ALL RIGHTS RESERVED AssRVociatED V Bellevue, WA 98004 Formi 22E Phone: 425-455-1234 FIRPTA Certificate Fax: 425-635-7720 Rev. 7/2020 Page 2 of 2 CERTIFICATION UNDER THE FOREIGN INVESTMENT IN REAL PROPERTY TAX ACT ("FIRPTA") BUYER CERTIFICATION (Fill this in only if the Seller is a non-resident alien). NOTE: If the Seller is a non-resident alien, and has not obtained a release from the Internal Revenue Service, then the closing agent must withhold 15% of the amount realized from the sale and pay it to the IRS, unless Buyer certifies that one of the statements below are correct: ❑ Amount Realized is $300,000 or Less, and Family Residence. I certify that the total price that I am to pay for the property, including liabilities assumed and all other consideration to the Seller, does not exceed $300,000; AND I certify that I or a member of my family* have definite plans to reside on the property for at least 50% of the time that the property is used by any person during each of the first two twelve month periods following the date of this sale. If applicable, there is no withholding and corresponding tax payment to the IRS. ❑ Amount Realized is More than $300,000 but does not exceed $1,000,000, and Family Residence. I certify that the total price that I am to pay for the property, including liabilities assumed and all other consideration to the Seller, exceeds $300,000 but does not exceed $1,000,000; AND I certify that I or a member of my family* have definite plans to reside on the property for at least 50% of the time that the property is used by any person during each of the first two twelve month periods following the date of this sale. If applicable, closing agent must withhold 10% of the amount realized from sale and pay it to the IRS. * (Defined in 11 U.S.C. 267(c)(4). It includes brothers, sisters, spouse, ancestors and lineal descendants). Under penalties of perjury, I declare that I have examined this Certification and to the best of my knowledge and belief both statements are true, correct and complete. I understand that this Certification may be disclosed to the Internal Revenue Service and that any false statement I have made here could be punished by fine, imprisonme both. BUYER DATE BUYER DATE Inslee, Best, Doezie & Ryder, P.S. © Commercial Brokers 10900 NE 4th St., Suite 1500 AssEVED VC Bellevue, WA 98004 ALL RIGHTS RESERRVED Phone: 425-455-1234 Form: PS_AS Assignment and Assumption Fax: 425-635-7720 Rev. 7/2020 Page 1 of 5 ASSIGNMENT AND ASSUMPTION AGREEMENT This has been prepared for submission to your attorney for review and approval prior to signing. No representation is made by licensee as to its sufficiency or tax consequences This Assignment and Assumption Agreement (the "Assignment") is made the day of , 20 25 , between Warren Edward Lumsden ("Assignor") and City of Port Orchard, a Washington municipal corporation ("Assignee") who are parties to a Purchase and Sale Agreement with a Reference Date of July 23 , 20 25 (the "Purchase Agreement") for real property located at or a business opportunity commonly known as 1333 Lloyd Parkway, Port Orchard, WA 98367 (the "Property"). 1. Assigned Property. Pursuant to the terms of the Purchase Agreement, Assignor grants, assigns, sells, transfers, sets over and delivers to Assignee all of Assignor's right, title and interest in and to the following personal property (collectively the "Assigned Property") and Assignee accepts such assignment: A. Leases. Each of the leases of real or personal property identified in Exhibit A to this Assignment; B. Contracts. All contracts or agreements of any nature, (including without limitation design contracts, construction contracts, purchase orders, utility contracts, water and sewer service contracts, maintenance contracts, warranties, and soils reports), identified in Exhibit B to this Assignment; and LC) Intangible Property. All intangible property now or hereafter existing with respect to the Pr perry (Including without limitation: all rights -of -way fights of ingress or egress or other interests In)on, or to, any land, highway, street. road, or avenue, open or proposed, in, on, or across, in front of, abutting or adjoining the Property; all rights to utilities serving the Property; all drawings, plans, specifications and other architectural or engineering work product; all governmental permits, certificates, licenses, authorizations and approvals; all rights, claims, causes of action, and warranties under contracts with contractors, engineers, architects, consultants or other parties associated with the Property; all utility, security and other deposits and reserve accounts made as security for the fulfillment of any of Assignor's obligations; any name of or telephone numbers for the Property; any related trademarks, service marks or trade dress; and guaranties, warranties or other assurances of performance received), identified in Exhibit C to this Assignment. 2. Assumption. Assignee assumes all of the obligations imposed on the Assignor by the Assigned Property that accrue or arise on or after the Effective Date of this Agreement. 3. Indemnification. Assignor agrees to indemnify, defend and hold Assignee harmless from and against any and all claims, demands, liabilities, costs and expenses, including reasonable attorneys' fees, occurring by reason of Assignor's breach of any provisions of the leases identified in Exhibit A or contracts or agreements identified in Exhibit B that occurred prior to the Effective Date. Assignee agrees to indemnify, defend and hold Assignor harmless from and against any and all claims, demands, liabilities, costs and expenses, including reasonable attorneys' fees, occurring by reason of Assignee's breach of any provisions of the leased real or personal property identified in Exhibit A or contracts or agreements identified in Exhibit B that occur on or after the Effective Date. 4. Effective Date. The term "Effective Date" as used in this Assignment means: a) in the event the Property consists of real property, the date that the deed conveying title to the Property from Assignor to Assignee is recorded in the official records of the County recorder's office or, b) in the event the Property consists only of a business opportunity, the date on which ownership of the business is legally transferred from Assignor to Assignee. 5. Further Assurances. Assignor and Assignee shall, on the written request of the other party, execute, acknowledge and deliver fu her documents an assurances and perform further acts that the other party i� INITIALS: ASSIGNOR DATE: A t(/,ASSIG DATE: ASSIGNOR DATE: ASSIGNEE DATE: Inslee, Best, Doezie & Ryder, P.S. © Commercial Brokers 10900 NE 4th St., Suite 1500 ALL RIGHTS RESERVED Association VD UCgA Bellevue, WA 98004 Form: PS AS Phone: 425-455-1234 Assignment and Assumption Fax: 425-635-7720 Rev. 7/2020 Page 2 of 5 ASSIGNMENT AND ASSUMPTION AGREEMENT (CONTINUED) reasonably requests in order to perform all of the obligations of this Assignment. 6. Counterparts. This Assignment may be signed in one or more counterparts, each of which shall be deemed an original and all of which shall constitute one and the same agreement. 7. Successors and Assigns. This Assignment shall be binding upon and inure to the benefit of the parties to this Assignment, their successors in interest and assigns. 8. Governing Law. This Assignment shall be governed by, construed and enforced in accordance with the laws of the State of Washington, and venue of any suit shall be in the county in which the Property is located. 9. Attorneys' Fees. If Assignor or Assignee sues to enforce this Assignment or obtain a declaration of either of their rights under this Assignment, the prevailing party in any such proceeding shall be entitled to recover its reasonable attorneys' fees and costs incurred in the proceeding (including those incurred in any bankruptcy proceeding or appeal). In the event of trial, the amount of the attorneys' fees shall be as fixed by the court. ASSIGNOR Assignor's Name By: Authorized Signature/Title ASSIGNEE Assignee's Name By: Authorized Signature/Title Date Date Assignor's Name By: Authorized Signature/Title Date Assignee's Name Date By: Authorized Signature/Title INITIALS: ASSIGNOR DATE: ASS! E DATE: [ a� ASSIGNOR DATE: ASSIGNEE DATE: Inslee, Best, Doezie & Ryder, P.S. © Commercial Brokers �t•CBA n 10900 NE 4th St., Suite 1500 ALL RIGHTS AssERESERVED V Bellevue, WA 98004 Form: PS AS Phone: 425-455-1234 Assignment and Assumption Fax: 425-635-7720 Rev. 7/2020 Page 3 of 5 ASSIGNMENT AND ASSUMPTION AGREEMENT (CONTINUED) EXHIBIT A (Leases) INITIALS: ASSIGNOR DATE: � � V '` ASSEGN DATE: l l ASSIGNOR DATE: ASSIGNEE DATE: Inslee, Best, Doezie & Ryder, P.S. © Commercial Brokers CBA ALL RIGHTS RESERVED 10900 NE 4th St., Suite 1500 AssEVED V Bellevue, WA 98004 Form: PS Phone: 425-455-1234 Assignment and Assumption Fax: 425-635-7720 Rev. 7/2020 Page 4 of 5 ASSIGNMENT AND ASSUMPTION AGREEMENT (CONTINUED) EXHIBIT B (Contracts) INITIALS: ASSIGNOR DATE: ASSIGN DATE: ASSIGNOR DATE: ASSIGNEE DATE: Inslee, Best, Doezie & Ryder, P.S. © Commercial Brokers I CBA Ass 10900 NE 4th St., Suite 1500 ALL RIGHTS RESERVED V Bellevue, WA 98004 Form: PS AS Phone: 425-455-1234 Assignment and Assumption Fax: 425-635-7720 Rev. 7/2020 Page 5 of 5 ASSIGNMENT AND ASSUMPTION AGREEMENT (CONTINUED) EXHIBIT C (Intangible Property) INITIALS: ASSIGNOR DATE: -ASSIGN DATE: I /i ASSIGNOR DATE: ASSIGNEE DATE: