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Contractor Section: <br /> JeWer �r' i2�jrl.�.t � LLC " (� D2 � 3S �g� <br /> Vendor Name/Business Name/ UBI umber <br /> SeweY- � 1- �11 l.¢ vv� S <br /> State of Washington Contractor License Number: <br /> ��Z�x �-4�15 ��1nn��c� � INA- �g a�(o <br /> Vendor Mailing Address Ciry State Zip <br /> 2plo 8�D �'(�}� 8 'iu��eC�S�,wer-Friendlv,c�am <br /> Phone Email <br /> I, the Vendor, egree to recelde the Backwater Prevention Devlce rebate check directly for the <br /> installation at the above referenced properiy address. By agreeing to receive the rebate check <br /> directly,I agree to the following: <br /> ' 1. The Backwater Prevention Device rebate amount will be deducted from the final invoice <br /> given to the property owner for the instailation at the property address referenced above, if <br /> the total cost of the installation is greater than the rebate. <br /> 2. I, the Vendor, am a Washington State licensed contractor. <br /> 3. The City of Everett will send a Federal form 1099 MISC to me, the Vendor,for Backwater <br /> Prevention Device rebate payments totaling more than 5600 per calendar year, and will <br /> report the same paymenls to the Internal Revenue Service. <br /> I accept lhe payment of the Backwater Preventfon Device rebate from the City of Everett pending <br /> approval ot the completed Backwater Prevention Device rebate package by the City of Everetl <br /> '�%�� �>4��'� �� <br /> Signature o!Contractor Date <br /> � <br />