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� - _... __ __ _.. . - -- - — - - <br /> � <br /> I <br /> Contractor Section: <br /> , <br /> ; A+SewerTechnologies <br /> � Vendor Name I Business Name I UBI NumGer <br /> 603 089 164 <br /> State ot Nlashington Contractor License Number: <br /> 900 Meridian Ave E STE 19-193 Milton WA 98354 <br /> Vendor Mailing Address Ciry State Zip <br /> (888) 213-7656 info@sewertechs.com <br /> Phone Email <br /> � <br /> i <br /> I,the Vendor,agree to receive the Backwaler Prevention Device rebate check diredly for the j <br /> installation at the abova referenced property addresa. By agreeing to receive the rebate check � 1 <br /> directly, I agree to the following: � <br /> 1. The Backweler Prevenlion Device rebate amount will be deducted fram the final invoice I <br /> given lo the property owner for Ihe installation at the ptoperty address referenced above, if ' <br /> 1he total cosl of the installalion is greater ihan the rebate. <br /> � 2. I,the Vendor,am a Washinglon State licensed contractor. � <br /> i <br /> ; 3. The City of Everetl will send a Federal Form 1099 MISC to me, the Vendor,for Backwater <br /> ' Prevenlion Device rebete payments totaling mora than$600 per calendar year,and will <br /> report the same paymenls to Ihe Internal Revenue Service. <br /> � <br /> �� i atcept the payment of the Backwatar Prevention Device rebale from the Ciy ot Everett pending <br /> ' approval of lhe completed Backwaler Preuenlion Deviee rebate packaga by the City of Everett I <br /> i • <br /> i <br /> � ' <br /> i <br /> � Walt �..,,��..., <br /> �mW._..v. <br /> .�.....,.�.,.,..M i/i2/zois <br /> �� <br /> ' I�M].114 n1.111)9 H M�� <br /> � <br /> � Signature of Cantreclor Date <br /> I <br /> I <br />