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k rJ <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 Materials Testing& Consulting,Inc: <br /> Signature: - Cibuttat•-• <br /> Name of Signer: Terri McCullough <br /> Title of Signer: President <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 /> • <br /> Signature: ,Managing Member <br /> Name of Signer: <br /> Page 3 of 3 <br /> Standard Document Approved X.X.1 3/Office of City Attorney 50 <br />