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i <br /> I <br /> I <br /> Contractor Section: � <br /> - -- --- --_ _ - -- --- - _ _ __ _ — _ ---- - <br /> CJ'S PLUIdl11NG 6 SERVIGF LLC I 6�'_950 117 � <br /> Vendor Name / Business Name I UBI Number { <br /> c�sr�rss�eon � <br /> State oi Washington Contractor License Number: � <br /> � <br /> 5528 2181 H AVF NE GNANITE f ALLS WA 98?!i7 � <br /> ._—..__ . . . . _—. . ...-----��- _ - � <br /> Vendor Mading Address Cdy State Zip � <br /> 9fi0-G91•5159 CJSPI.UIdRMG��MSN COM , <br /> Phone Email + <br /> { <br /> _ _ _ — — -- i <br /> I, the Vendor, agree to receive Ihe Flar,kwater PreveMion Device rebate check directly for ihe <br /> mslallalion if��I1P. AIIOVP. !f?1P.fP.f1CP.fI �1ff1�11?fiy aCICIfP.SR I3Y:19fP.P.lf19�0 fP.CCIVB IFIP, fP.b3ie CFIE'CI( j <br /> directly, I agree to Uie following. <br /> i <br /> 1 The C3ackwaler Prevention Device re.bate amount will be deducted from Ihe final invoice � <br /> given to the property owner for the iristalla6on at the properly address rcicrenced above, il ; <br /> the total r,ost of the insfallalion is greater than the rebate. � <br /> 2. I, the Vendor, am a Washington State licensed conUactor <br /> 3. ihe Cily oi GvereU will send a Federal Forrn 1099 MISC to me, thc Vendor, tor Hackwater f <br /> P�evenlion Dr.vlce rebal? paymanls lotalmy more lhan$f00 per calendar ye�r, and wdl � <br /> repoA the same paymeNs to the Intemal Kevenue Service. I <br /> i <br /> I accept the payment o1 the f3ackwatr.�Prevention I)evice rel�ate trnm the Cily of[veretl pending I <br /> a{>pioval o(the completed dackwater Prevention Device reba�e packaye by Ihe Cily ol Fverell � <br /> ��-' __ <br /> '� -=� � - ------- �(�,-- 0 - �� , <br /> c �-1 <br /> j Signaliued-C ntradar Da�c <br /> I�— --- -- — — -_ _ ; <br /> i <br /> � <br /> i <br /> i <br />