Laserfiche WebLink
i <br /> � <br /> � <br /> I <br /> I <br /> ! <br /> � <br /> Contractor Section: 1 <br /> --- --- .. . ---- - � <br /> �PLUMBING R SERVICE LLC/602 950 1 77 j <br /> i <br /> Vendor Name 1 Business Name/UBI Number I <br /> CJSPLI'59150D � <br /> State of Washingtnn Contractor License Number. � <br /> t <br /> 5;?8 218TH AVE NE _ GRANITE FALLS � WA 'J8252 j <br /> Vendor Mailing Address City State Zip j <br /> � <br /> 360-691�159 CJSPLUIJBINGRMSN.COM � <br /> _ � <br /> Phone Email � <br /> --- -- - - — -- ( <br /> I, the Vendor, agree to receive Ihe Backwater Prevention Device rebate check directly for the ! <br /> installation at the above referenced property address. Dy agreeing to receive thc rebate check � <br /> direclly, I agree to the following: � <br /> � <br /> 1. The Dackwater Prevention pevice rebate amounl will be deducted from the(inal invoice � <br /> given to ihe property owner tor lhe installation at the property address referencecl above, if � <br /> the total cost of the installation is greater than the rebale. � <br /> I <br /> 2. I, the Vendor, am a Washington State licensed contractor. � <br /> I <br /> 3. The City of L=veretl will send a Federal Form 1099 MISC lo me, the Vendor, for Backwater <br /> Prevention Device rebate paymenls totaling more Ihan$600 per calendar year, and wiil <br /> report the same paymenls to Ihe Inlernal Revenue Service. <br /> I accepl the payment of the Backwater Prevention Device rebale hom the City ot Everetl pending I <br /> approval of the compleled Backwater f'revention Device rebate package by the City oi Everett � <br /> � <br /> I <br /> 1 <br /> r� g .--�,-�� I <br /> SiynafuFcnf •on or Dale � <br /> I <br /> ----- - - -_. - -.. —_ -'-- —- ---- � <br /> -------_ . � <br /> i <br /> I <br /> � <br /> I <br /> i <br /> � <br />