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Contractor Section: <br />A+ Sewer Technologies <br />Vendor Name I Business Name / U81 Number <br />G03 OB9 164 <br />State of Washington Contractor License Number: <br />900 Meridian Ave E STE 19•193 Milton WA 98354 <br />Vendor Maiting Address City State Zip <br />(888) 213-7656 info@sewertechs.com <br />Phone <br />Email <br />I, the Vendor, agree lo receive the Bsckwater Prevention Device rebate check directly for the <br />installation at the above referenced property address. By agreeing to receive the rebate check <br />directly, I agree to Ihe following: <br />1. The Backwater Pievenlion Device rebale amount will he deducled 1rom the final invoice <br />given to lhe property owner for Ihe installation at the property address re(erenced above, if <br />Ihe lolat cost of the installation is greater than tho rebate. <br />2. I, the Vendor, am a Washington State licensed contractor. <br />3. The Cily of Everett wiil send a Federal Form 1099 MISC to me, the Vendor, for Backwaler <br />Prevention Device rebate paymenls totaling more lhan 5600 per calendar year, and �vill <br />report Ihe same paymenls to the Internal Revenue Service. <br />I accept Ihe payment of O�e Backwater Prevenlion Device rebate from the City of Everett pending <br />approval of the completed Backwater Prevenlion Device rebate package by Ihe Ciry of Everetl <br />W�II io�o�riy>����aerw.� <br />��nN� rn•W�R a•n..w. <br />• cmaJ-xa'iUuwc�cNicom.nUS <br />uam ](I150111 N 1�9P aSOT <br />Signature ol CoNracfor <br />1�12�2�15 <br />Date <br />