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3 <br /> SERVICE PROVIDER: Please fill in the spaces and <br /> sign in the box appropriate for your business entity. <br /> CITY OF EVERETT, <br /> Corporation <br /> WASHINGTON <br /> [Service Provider's Complete Legal Name] <br /> By: <br /> Ray Stephanson, Mayor <br /> Typed/Printed Name: <br /> Its: <br /> Date <br /> Date: <br /> ATTEST: <br /> Sharon Fuller, City Clerk <br /> Date <br /> APPROVED AS TO FORM: <br /> James D. Iles, City Attorney <br /> Date <br /> Page 2 <br /> 19 <br />