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i1, <br /> SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. <br /> Corporation 4 c n ff(H4/i , -zwees <br /> [Service Pr vider's Complete Legal Name] <br /> By: • l id 4 <br /> TYP ed/P ' ted N e: /&V `67, �E/S <br /> ' <br /> Its: (PVCW � ��i /T� <br /> Date: 4447/0 <br /> Partnership <br /> (general) [Service Provider's Complete Legal Name] <br /> a Washington general partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Partnership <br /> (limited) [Service Provider's Complete Legal Name] <br /> a Washington limited partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Sole <br /> Proprietorship Typed/Printed Name: <br /> Sole Proprietor: <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 10 <br /> (Form Approved by City Attorney's Office January 7,2010,updated June 15,2014) <br /> 77 <br />