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Contractor Section: <br /> A+Sewer TecPnologics <br /> Vondor Name/Dusiness Narne I UBI Number <br /> 603 089 164 <br /> State of Washington ConVactor License Numbar: <br /> 900 Meridian Ave E STE 19-193 Milton WA 98354 <br /> Vendor A9ailing Address City State Zip <br /> �888) 213-7656 info@sewertechs.com <br /> Phone Emeil <br /> I,the Vendor, agree to receive t�e Backwater Prevention Device rebate check directly for Ihe <br /> instelletion at the above referenced property address. 8y agreeing to receive the rebate check <br /> directly. I agrea to the followin�: <br /> i. The Backwater Prevention Device rebate amount will be detlucted from the final invoice <br /> given to ihe property owner for the installation at the property address referenced above, i( <br /> the lotel cost of tha installation is greater than ihe rebale. <br /> 2. I,the Vendor,am a Washington State Iicensed conlractor. <br /> 3. The City of[verett will send a Federal Form 1099 MISC ro me, the Vendor, for Backwater <br /> Prevention Device rebate payments totaling more than �60D per calendar year, and will <br /> repo�t thc samo paymonts to the Internel Revenue Service. <br /> I accept the payment of tho Backwaler Prevention Device rebate from the City of Everett pendinp <br /> approval of the complotod Bockwater Preventbn pevice rebate package by fhe City of Everetl <br /> �'py.ryaw.a��v��� <br /> UValt .��,�::-�.mm;..� � �s ��s <br /> We AI�M��Cf�T)1 dlV <br /> SignatureotContractor �J D e <br />