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9 <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 Geo/Test Services,Inc. <br /> Signature: <br /> Name of Signer. Kevin Richardson <br /> Title of Signer: Business Development <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 /> Page 3 of 4 <br /> Standard Document Approved 4.22.14/Office of City Attorney 6 <br />