2127 RAINIER AVE 2022-05-11 - Laserfiche WebLink

Contractor Section: Vendor Narne I Busine�s Name / Uel Number _ H I - l `— a.Z-.��- -� �' � �" _ Slate of Wasliington Contractor License Number: �� LrdLL�_�_� • ti'�-1�'.:i-� �� _G� Vendor Mailing Address Ciiy State Zip Phone Email I, ihe Vendor, agree to receiv� the Back�vater Prevention Device rebate check direclly tor the inslallation al the above referenced property address. By agreeing to receive ihe rebale check direcHy, I agree to the foliov�ing: 1. The Backwater Prevention Device rebate amount v�ill be deducled from the final invoice given lo the property owner for the installation at the propetty address referenced ahove, if the lotal cost of the instailalion is grealer than lhe rehate. 2. I, the Vendor, am a Washington State lice,�sed contractor. 3. The Ciry of Everett will send a Pederel Fonn 1099 MISC to me, the Vendor, for Backwater Prevention Device rebate paymenls totaling more than $600 per calendar year, and �vill report ihe same paymenis to the Intemal Revenue Service. I accepl the p3yment of the Backwaler P�eve�ition Devico rebate fran the Ciry of Everett prnding approval of the completed [iackwater Prevention Device rebale package by lhe City of Evereti �� .;�_. �� - Signature of Contractor _��_�� Date