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SERVICE PROVIDER: Please fill in the spaces and appropriate in the box a ro for <br /> signPP P <br /> your business entity. <br /> Corporation <br /> [Service Provider's Complete Legal Name] <br /> By: <br /> Typed/Printed Name: • <br /> Its: <br /> Date: <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 /> } <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:Limited <c7ot5 Fres4-.1 C.::,soi -,n5 LLC <br /> Liability [Service Provider's Complete Legal Name] <br /> Company a Washington limited liability company <br /> By: <br /> Typed/Printed Name: T v r 5 a 11.1+rnnj <br /> Managing Member <br /> Date: (-Z5 —to <br /> Page 11 <br /> (Form Approved by City Attorney's Office November 1,2009) <br />