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� � Backwater Prevention Oevice Rebate Program <br /> Rebate Submittal Checklist <br /> Submil your rebate paekel withln 90 days from Ihe Cale Ihe Installation is inspeded and <br /> approved by the city.Uce this checWisl to make sure that it indudes ell o(the neoessery <br /> melerials.TTe items Indicated(CONTRACTOR]will bo provided ro yau by your dontrador. <br /> Your rebate packet must lnciude the(ollowing: <br /> �Compleled and signed Rebate Application Fortn(preen) <br /> �Completed end signed IRS Fortn W9"Request for Taxpayer ldentifiqllon Number and <br /> CeAification"(white) <br /> �/enda Paymenl Optlon Form(purple)slgned by you and the contraGor�you wanl Ihe <br /> rebale check sent to the contractor.Olhenvise,fhe rebetewill be sent lo yau. <br /> (�Compl9led 6adcwaler Prevention Device Fnal Inst211atio�Chedcfist jCONTRACTORJ <br /> �-Itemized involoe for the work,'showing wnlraetor name,address,Ileense number and the <br /> delalled cos�of Insfallalion and materials�CONTRACTOR�. <br /> �]`-Mep of your properly wilh laratlon 01 the Installed devlce�CANTRACTOR� <br /> When Iha pecket is camplete,mefl or deliver il t0:City of Eveiatl,Attn:BWPD Rebate <br /> . Program,32t70 Cedar Sheel,Everetl,WA 9B2a1. <br />