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Contractor Section: <br />Ver.dor Mailing Address City State Zip <br />Z3 <br />Pt*me Email <br />I, the Vendor, agree to receive the Backwater Prevention Device rebate check diredly for Uie <br />insfallation at the above referenced property 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 ihe final invoice <br />g'iven to the property owner for the installation at the properry address re(erenced above, if <br />the total cost of the installation is greater ihan 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 10 me, the Vendor, tor Backwater <br />Prevention Device rebate payments totaling more than 5600 per calendar year, and will <br />report the same payments to the Internal Revenue Service <br />I accept Ihe payment of the Backwater Prevenlion Device rebate from the City of Evereft pending <br />approvai of the compieled Backwater Prevention Device re6ate package by Ihe City of EvereH <br />�2,—�S <br />Sig Gre of Contractor �� <br />� <br />