Laserfiche WebLink
Contractor Section: <br />Ilq- <br />Vendor Name / Business Name PUBI Numb r <br />State of Washington License Number: <br />�C1 Fractor <br />� <br />� y 67L1 YI .>.�J ?:(� I�0 <br />Vendor Mailing Address <br />City State Zip <br />2 ©n y q(9. � <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 />2. 1, the Vendor, am a Washington State licensed contractor. <br />3. 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 comuleled Backwater Prevention Device rebate package by the City of.Everetl <br />n lu a of Contractor Date <br />