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Contra_ctor Section: <br />CJ'S PLUh1BiNG P. SERVICE L�C / 602 950 1' 7 <br />Vendor Name / Business Name / UBI Number <br />CJSPLPS915CD <br />Slate of UJashington Contractor License �umber <br />5528 218TH AVF NF- <br />Vendor Mailing Adtlress <br />36u � Eiil1-5159 <br />Phone <br />GHA�CITF FALLS WA <br />- City <br />GJSPL�t+�9iNG�fdSN COt.-7 <br />Email <br />38252 <br />State 2ip �, <br />I, lhe Vendor agree t� receive the Backwater Preven:ion Device rebate check direr.tly for the <br />installalion a� the above referenced property address By agreeing to receie�c the rebate check <br />directly, I agree to the following: <br />1 The Back�vater Prevention Device rebate amo�nt v�ill t�e deducled from the f�nal invoice <br />given to tne proper;y ormer for the inst211ation al th= property address ro(erenced above, if <br />the total cosl of the installation is greater than the rebate. <br />Z. I, the Vendor, am a WashingMn Stalc licensed confrar.ror. <br />3. The Gdy af Everetl will send a Federal Form 1099 MISC to me, the Vendor. for Back�vater <br />Prevenlion Device rebate paymenls totaling n�ore than 5600 per calenc�ar year, and wiil <br />report the same payments to the IMernal Revenue Service <br />I accept the ;�ayment o( the Backwaler Prevention Device ret�ate from the C ty of Everett prnding <br />approval o( the compteted Ciack�vater Prevenlion Device rebate package by the Cdy of Fveretl <br />���Q�� ���y _ , (� � <br />Signaturc of Conl�actor Datc� <br />