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• <br /> I <br /> • <br /> SERVICE PROVIDER: Please fill in the spaces and <br /> • <br /> sign in the box jipr'opriate. or your business entity. <br /> CITY OF EVERETT, Corporation <br /> WASH NGTON 'e. As5cc r ri 5 ( t�� <br /> [Service Provider's Complete Legal Name] <br /> By: pV �0 <br /> Ray Stephanson,Mayor Typed/l ed Name: je.w h i Ce- <br /> Its: VlC2 eres.d-&. <br /> Date: <br /> Date <br /> • Partnership <br /> ATTEST: (general) <br /> [Service Provider's Complete Legal Name] <br /> a Washington general partnership <br /> Sharon Fuller,City Clerk <br /> By: <br /> Typed/Printed Name: <br /> Date General Partner • <br /> Date: <br /> • <br /> Partnership <br /> APPROVED AS TO FORM: <br /> (limited) [Service Provider's Complete Legal Name] <br /> • <br /> a Washington limited partnership <br /> James D.Iles,City Attorney <br /> • By: <br /> Typed/Printed Name: <br /> Date General Partner <br /> Date; <br /> Sole • <br /> • <br /> Proprietorship Typed/Printed Name: <br /> Sole Proprietor: <br /> • <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 l <br /> (Form Approved by City Attorey's Office January 1,2010,updated June 7,2012) <br /> • <br />