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<br /> <br /> <br />Page 11 <br />Davey Resource Group PSA 2022 <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br />your business entity. <br />Corporation <br />______________________________________ <br />[Service Provider’s Complete Legal Name] <br /> <br />By: __________________________________ <br />Typed/Printed Name: ____________________ <br />Its: __________________________________ <br />Date: ____________________ <br />Partnership <br />(general) <br /> <br />______________________________________ <br />[Service Provider’s Complete Legal Name] <br />a Washington general partnership <br /> <br />By: __________________________________ <br />Typed/Printed Name: ____________________ <br />General Partner <br />Date: ____________________ <br />Partnership <br />(limited) <br /> <br />______________________________________ <br />[Service Provider’s Complete Legal Name] <br />a Washington limited partnership <br /> <br />By: __________________________________ <br />Typed/Printed Name: ____________________ <br />General Partner <br />Date: ____________________ <br />Sole <br />Proprietorship <br /> <br />______________________________________ <br />Typed/Printed Name: <br /> <br />______________________________________ <br />Sole Proprietor: <br />Date: ____________________ <br />Limited <br />Liability <br />Company <br />______________________________________ <br />[Service Provider’s Complete Legal Name] <br />a Washington limited liability company <br /> <br />By: __________________________________ <br />Typed/Printed Name: ___________________ <br />Managing Member <br />Date: ____________________ <br />Amber Krebbers <br />Regional Operations Manager <br />12/02/2022 <br />Amber Krebbers