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� <br />� <br />Backwater Prevention Device Rebate Program <br />Rebate Submittal Checklist <br />Submit your rebale packet within 90 days from Ihe date the instailation is inspected and <br />approved by the cily. Use this checklist to make sure that it includes all o( the r�ecessary <br />materiais. The items indicated (CONTRACTOR] will be provided lo you by your contrar,tor. <br />Your rebate packet must include the following: <br />Completed and signed Rebate Appiication Form (green) <br />�'Compleled and signed IRS Form W-9 "Request for Taxpayer ldentificatici Number and <br />Cerlification" (white) <br />0 Vendor Payment Option Form (purpie) signed by you and the contractor IF you want the <br />, rebate cher!c sent to the contractor. Othenvise, the rebate v�iil be senl to you. <br />�Compieted Backwater Prevention Device Final inslallation Checklist [CONTRACTOR] <br />�lemized invoice for the work, showing contractor name, address, license number and the <br />detailed cosis of installation and materials [CONTRACTOR�. <br />[�Map of your property with localion of the inslalled device [CONTRACTOR] <br />When the packel is wmplele, mail or deliver it to: City of Everetl, Attn: BWPD Rebate <br />Progre�n, 3200 Cedar Streel, Everett, WA 9�201. <br />