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_ _._ . - - - ----- - _ _ __ _ ._ _-� -- _ <br /> � <br /> ; <br /> i <br /> ! <br /> I <br /> ! Contractor Section: <br /> i <br /> ; A+SewerTech�ologies I <br /> Vendor Name/Business Name/UBI Number <br /> 603 089 164 � <br /> j State uf Washington Contraaor License Number: i <br /> i <br /> � <br /> 900 Meridian Ave E STE 19-193 Milton WA 98354 <br /> Vendor Malling Address City State Zip � <br /> ; (888)213-7656 info@sewertechs.com <br /> � Phone Email <br /> ' I,the Vendor,agree to rece(ve the Backwetor Prevendon Device rebffie chedc dlrecily for U�e � <br /> i InaYalletlon at ihe above referenced property addresa.By agreeMg Oo receive the rebate check <br /> ' di;eetty, I ngree to the fallowing� <br /> 1. Tha 8ackwater Prevantion Device rebate amount will be deducted hom the filk�l invoice <br /> given to the property ownor for the inatelletion et the property eddress raferer.ced above, if I <br /> ttie total cost of the instelletion is greatei thnn the rebate. � <br /> I 2. I,the Vendor,am a Washington State licensed contrador. i <br /> 3. The City of Everett wlll send a Foderal Form 1089 MISC to me,fhe Vendor,for Backwater <br /> PrevenHon Device rabate payments totaling more tha�3600 par colendar year,and wlll � <br /> I report the same payments to the Internal Revenue Service. <br /> I � <br /> I accept tha peyment of the Backwoter Pravenl�en Dovicc rebete from tha City of Everett pending I <br /> approval of Ihe compleled Backwater Prevention Device rebate package by lhe City of Everett <br /> � <br /> i I <br /> i i ncury.w.abw�� <br /> � Walt :..a�.�...,�. <br /> �.�.�.. <br /> , �P� 2- zc- � � <br /> . u.s1e11C}.OmON�al40 _ <br /> 'i SignaWre of Contractor Date <br /> i ---- <br /> � <br /> I <br />