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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 />Environmental Science Associates <br />[Service Provider's Complete Legal Name] <br />By:w 6`" 7'."` <br />Typed/Printed Name: Susan Cunningham <br />Its: Program Manager <br />Date: 0312n2 <br />Partnership <br />(general) <br />[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) <br />[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 <br />Typed/Printed Name: <br />Sole Proprietor: <br />Date: <br />Limited <br />Liability <br />Company <br />[Service Provider's Complete Legal Name] <br />a Washington limited liability company <br />By: <br />Typed/Printed Name: <br />Managing Member <br />Date: <br />Page 11 <br />(Form Approved by City Attorney's Office January 7, 2010, updated January 6, 2022) <br />