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1 = <br /> SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. <br /> Corporation ! <br /> �lC✓� A f`c� �� l d G le 11 <br /> [Serv <br /> ice Provider's Complete Legal Name] <br /> Typ&d/Printe�d jame: c F c S, le;slow 1 <br /> Its: /1�� v 1 i t5 c�s1�r <br /> Date: Dom.'/ 13, Z01S' <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 11 <br /> Brown and Caldwell PSA 2015 <br /> 136 <br />