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4 . <br /> SERVICE PROVIDER:Please fill in the spaces and sign in the box appropriate for your business <br /> entity. <br /> Corporation <br /> Full Legal Name -Krazan&Associ. es,Inc. <br /> iliwp,.#40" <br /> Signatur-. �� ii I 1— <br /> Name of Signer. e- - Xere, <br /> i <br /> Title;of Signer: o p it ons Manager <br /> Partnership <br /> Full Legal Name: <br /> Signature: ,Partner <br /> Name of Signer: <br /> Sole Proprietor <br /> Signature: ,Sole Proprietor <br /> Name: <br /> Limited Liability Company <br /> Full:Legal Name <br /> Signature: ,Managing Member <br /> Name of Signer: <br /> Page3of4 <br /> Standard Document Approved 11.26.13/Office of City Attorney 4 6 <br />