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7 <br /> SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. <br /> Corporation <br /> �''�1,� '!r►yr !Y «r a r c► <br /> [Service Prov'er's Complete Le�_al Dame] <br /> 1 <br /> • B _ ( ` `1 <br /> Type. Printed Name: Q \ 4 re,ct <br /> Its: - r• : <br /> Mgt <br /> Date: z 'LG <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 <br /> Liability [Service Provider's Complete Legal Name] <br /> Company a Washington limited liability company <br /> By: <br /> Typed/Printed Name: <br /> Managing Member <br /> Date: <br /> Page 10 <br /> (Form Approved by City Attorney's Office January 7,2010,updated June 7,2012) <br /> 57 <br />