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SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <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 /> 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 ADS LLC <br /> Liability [Service Provider's Complete Legal Name] <br /> Company a incited li< ility company <br /> D w r <br /> By: <br /> Type /Prin Name:Joseph J. Goustin <br /> Assistant Treasurer <br /> Dat : A - 2_o2.1 <br /> Page 11 <br /> (Form Approved by City Attorney's Office January 7,2010,updated November 4,2020) <br />