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44Backwater Prevention Device Rebate Program <br />Rebate Submittal Checklist <br />Submit your rebate packet within 90 days from the date the instaliation is inspected and <br />approved by the city. Use this checklist to make sure that it include:; all of the necessary <br />materials. The items indicated [CONTRACTOR] will be provided to you by your contractor. <br />Your rebate packet must include the following: <br />X Completed and signed Rebate Application Form (green) <br />[ZQ Completed and signed IRS Form W-9 "Request for Taxpayer Identificat. 1 Number and <br />Certification" (white) <br />❑ Vendor Payment Option Form (purple) signed by you and the contractor IF you want the <br />rebate check sent to the contractor. Otherwise, the rebate will be sent tr you. <br />M Completed Backwater Prevention Device Final Installation Checklist [CONTRACTOR] <br />[j Itemized invoice for the work, showing contractor name, address, license numter and the <br />detailed costs of installation and materials [CONTRACTOR[. <br />M Map of your property with location of the installed device [CONTRACTOR] <br />When the packet is complete, mail or deliver it to City of Everett, Attn: BWPD Rebate <br />Program, 3200 Cedar Street, Everett, WA 98201. <br />