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' OCT 1 6 2019 <br /> D! <br /> ci <br /> SERVICE PROVIDER: Please fill in the spaces and sign in the box appr at <br /> your business entity. <br /> Corporation <br /> [Service Provider's Complete Legal Name] <br /> By: <br /> Typed/Printed Name: <br /> Its: <br /> Date: <br /> Partnership <br /> (general) [Service Provider's Complete Legal Name] <br /> a Washington general partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Partnership <br /> (limited) [Service Provider's Complete Legal Name] <br /> a Washington limited partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Sole <br /> Proprietorship Typed/Printed Name: <br /> Sole Proprietor: <br /> Date: <br /> Limited C/A/Swl.DA'l Ts, LL C <br /> Liability [Service Provider's Complete Legal Name] <br /> Company a Washington limited bility company <br /> B � � <br /> .: 'rinted Name: 4A4e. 4' �'SS <br /> anaging�mb�r C�EGG/r7r& OCE-- �,eES/,dEr/T <br /> Date: /0!//o/// <br /> Page 11 <br /> (Form Approved by City Attorney's Office January 7,2010,updated August 16,2019) <br />