2131 PINE ST 2022-05-04 - Laserfiche WebLink

i � � I i � Cnntractor Section: � — - -- — — � CJ'S PLUMBWG 8 S[RVICE:LLC/602950 1 t7 I Vendor Name/ Busines:� Name/ UBI Number ! i CJSPLP59150D I i i � State of Washington Contractor License Number: i ; � � 5528218TH AVE NE — GRA41Tf_fALLS VJA 98252 . ; Vendor Mailing Address City State Zip � � ' 360•69t•5159 CJSPLUPIBING��MSN.COM i Phone Email ; -- --- -- _ i i I. tne Vendor, agree to receive ihe BacMv2ter Prevention Device rebate check directly for the � instailahon at the above referenced property address By agreeing to receive the rebate check directly, I agree to the fo�lowing: I 1 The Backwater Prevention Device rebate amount will be deducted from the fnal invoice � 9iven to lhe proper,y or:ncr for the installation at the property address referenced above, if , the lolal cost of tne installatioo is grealer than the rebate. 2 I. the Vendor, am a Washington State licensed conlracror. � 3 1 he Ciry of Everett will send a Federal Form 1099 Po11SC to me, the Vendor, for Backwater f Prevention Device rebate payments totaling more lhan 5600 per calendar year, and will � report the sarne payrnents to the Internal Revenue Service. � i -- --- - — —---- - — • i I accept the payment of the E3ackwater Prevention Device rebate (rom �he City of Everett pending I i approval of the completed Backwater PrevenGon Device rebate package by the City of Everett ! i i �/� ; � Signature of Contractor ate ' i i - - — _ _ _ — -- - --- --__ _ .._ � �_ I I � I �