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Contractor Section: <br /> JL�.Vr_� r_—s�"_Lc:��(�1�1 �� �_. � ' ----�.�_�% L. ' `'-� .' .. <br /> •J i.' <br /> ' `dencor \�ama �8usi�as� ���am�i URI fiumb�r <br /> � SE.`r�,� �� r L_ `_�� i - - <br /> — "il u. , _.�,.. <br /> Ste�a e;4';�asninc;on Contractor Liczns= Numoer. ; <br /> , �. C .1 �f.;•, <br /> �_1�,�,:; ��I _� L�✓ ����'11�. �-�1 !,L' � c> �Lt(L, , <br /> ��1�� <br /> ; -- — --�--- , <br /> Ven�+er hLailing Ador��ss ^it: S;•ate �i� <br /> - � � � <br /> _.:'.C�!s 8�t(; i,�-fZ--- JI:�_�__C��Lw�r -r- �ricl� .���r, , <br /> Phone Email <br /> � <br /> I. ihe Vendur, agree to rec_i��� the 8ac�water Prevenuon Device rebate cne=;o�ractiy ior tne <br /> ins?allalion at �he abov2 r=fersnced UfOaB(IY 5d�f955. B}'3Qf29il1�� '.0 fCCEIV= 1��2 fBfJ�IE?ChOCk <br /> d'•ec[ly, I agree io the tullowir,, <br /> 1 l"hz 8ach�vater r'rei�en,ion Davice rebeta amount .:i!i be der�cteri irom lrz �ina! �nvoc� <br /> ^ytV�f110:F1=properiy Ol'Jf1Pf i0f Ih8 i�Si�ll�!!O� 3i ih2 pfOpO�`V 3�d'@SS.iE�?fB�C_d BbOVB. i! - <br /> ii�� io'al c�5 or tne ;nslallauon is great=r tnan !he ceLa;� <br /> Z I .r.� Vendor, .m a 1�Vasn,notc� Siac2 li^snsed cnrn,racio� <br /> 3. The Ciry of Ev=reh�;-ill send a Federa' Form 1099 AiISC ;o r'�_. ;h: �ier,dc!. �vr Backwater <br /> Prev2ntior D�vir,e rebat= 08yments tolai!rg rncr� (h8i; SnCO CEi C]IO�dZ�;2cL F1fid S'a!I! <br /> report!he 52rie oaymerfs ;o tn= Interna' Revanue Sernce. <br /> � r o �' . . o ?t.i fi Cvn r� __ '—'__f <br /> I �c_epl the paymer.i ni tn_ Eack�vatar ?r��, �r:,n Dsv�ce r_b. c rom �h; Ci ; oi�. _r_�t p.nairg <br /> �ppie!�210`ih�ce;np�eted Backwatei Prever,Iio^ Davic_ re:^a'e p,c�.�ae ny tn= �"�ty cf Ever�, � <br /> 3/rr�►s' ' <br /> �i'-o-, ' % n , ,�� --: �� �� <br /> � ) � i <br /> �' � '� 'CG� `' 7`Z-�-L=�. _� ._ <br /> Sign�lure oi Con:ractor p3ie I <br /> ' I <br />