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CoMract�r Section: <br />Vendor Name 1 eusiness tJame / UBI Number <br />�� <br />Sfate ofVJashington Contractor lloanse Numher: <br />��� t � ��r s�-u v�. m« e9�r� �v�� t,,,� 9�'a � t3 <br />Vendor Mailing Address City State Zip <br />-aiZ � <br />. , , <br />Email <br />I, the Vendor, agree to teceNe the Bedcwffier Prevention Device rebate chetlt dkectly for the <br />InstalWtion at the e6ove referenced propeAy address. By egreeing to reCelve the reDate cl►9dc <br />dlrectly, I ag�ee to the follownig: <br />i• <br />1. The Badcwater Preventlon Device rebala amount will be deduded from 1he fmal irnoice <br />given lo the �xnperty owner for the Installatlat et the property addreas referenoad ebove, If <br />Me total cost oi the instslletion is greater than the rebate. <br />2. I, Ihe Vendor, em a Washington Shate ficensed conVecto►. <br />3. 7he Cily of Everelt wili send a Federal Fotm 1099 MISC to me, the VerKlor, for Bodcwater <br />Prevenlbn Devioe rebale paymenfa totatlng more fhan E600 per calendar year, and will <br />report the same payments to tlie Intemal Revenue Servfce. <br />I ecoept ihe paymenl of the Badcwater Ptevanlion Device rebate from tlre Cify of Everett pending <br />approval oi the completed Backwater Prevenfion Devioe rebate package by Ihe Clry of Everett <br />� <br />Sign trador <br />G��2-it� <br />Date <br />