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� Backwater Prevention Device Rebate Program <br /> a Rebate �ubmittal Checklist <br /> Submi!your rebate packet wilhin 90�iays from the date th� installation is inspected and <br /> approved by lhe city. Use thi::checklist to make sure that it includes all of the necessary <br /> materials.The items indicate�i(CON'iRACTOR�will be provided to you by your contraclor. <br /> Your rebate packet must Include the tollowing: <br /> IIV7Completed and signed Rebate Ap��lication Form (green) <br /> V� <br /> �ompleted and s'gned IRS Form W-9"Requesl for Taxpayer ldentification Number and <br /> Certification"(white) <br /> �Vendor Payment Option Form (purple)signed by you end the conlractor IF you wanl the <br /> rebate check sent to the contractor. Othervvise,the rebate will bE�sent to you. <br /> � Completed Back�vater Prevention Device Final Installation Checklist[CONTRACTORJ <br /> �� Itemized invoice for the work, showing contractor name, address, license number and the <br /> detailed costs oi installation and meterials�CONTRACI JR]. <br /> �, Map of your propeAy with location of the installed device[CONTRACTOR) <br /> When the packet is complete, mail or deliver it to: City of Everett,Attn: BWPD Rebate <br /> Program, 3200 Cedar Streel, Everett,WA 9tl201. <br />