Laserfiche WebLink
Contractor Section: <br />6 41r-04: i l- CL`t ' <br />Vender Name 1 Busine s Name I UBI Number <br />State of Washington Contractor License Number: <br />Vendor Mailing Address city :hate Zip <br />Phone Email <br />I, the Vendor, agree to receive the Backwater 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 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 installation at the property address referenced above, if <br />the total cost of the installation is greater than the rebate. <br />3. <br />I, the Vendor, am a Washington State licensed contractor. <br />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 $600 per calendar year, and will <br />report the same payments to the Internal Revenue Service. <br />I accept the payment of the Backwater Prevention Device rebate from the City of Everett pending <br />approval of the completed Backwater Prevention Device rebate package by the City of Everett <br />Signature of contractor Da e <br />