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._. <br /> �--- ----- - - ------ --- �- -� <br /> - -. ._ . .------- __-------- ----� <br /> '\ � <br /> i <br /> j• � <br /> /� Backwater Prevention Device Rebate Prugram � <br /> „ Rebate Submittal Checklist i <br /> � <br /> / <br /> ISubmit your rebale packet wdhin 90 days trom lhe dele the�nstallation is mspected and � <br /> � approved by the cdy. Use this checklist to make sure that it includes alt of the necessary I ! <br /> � matenals The items ind�cated �CONTRACTOR�wdi be provided to you by yaur contractoc I <br /> I 1 ; <br /> � — - — ---__._ <br /> - ------ - � - -----� � --- <br /> �; Your rebate packet must include the following: I <br /> ! [� Completed and signed Rebate Application Form (green) <br /> � � <br /> ❑ Comple;ed and signed IRS Form W9 'Request tor Taxpayer ldentification Number and <br /> � CerliGcalion" (white) <br /> [✓] Vendar Payment Option Form (purple) signed by you and the contractor IF you want the � <br /> rebate check sent to the contractor Otherwise, the rebate witl be sent to you <br /> I <br /> I , <br /> � [] Completed 8ackwater Prevention Devite Final Instaliation ChecAlist(CONTRACTORj • <br /> � , <br /> �� [✓] Itemited invoice for lhe work, showing contractor name, address, license number and the � <br /> detaile'd:coslc�of mstallation and matenals (CONTRACTOR] ! <br /> �,,.i' � <br /> � [j Map of your properly with location of the installed device�CONTRACTORj <br /> I <br /> � <br /> When the packet is complete, mail or dehver il to City of Everett, Atln BWPD Robate <br /> Program. 3200 Cedar StreeL Everett, WA 98201 <br /> i <br /> i <br /> I <br /> I 1 <br /> � <br /> I � <br /> I <br /> _.... _ . . .._. ._ .....__. _ _... _._ .. _ -. -_.• . .. - ---__ -- -._. ..-'- ' _._.I <br />