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SERVICE PROVIDER: Please fill in the spaces and sign in the hox appropriate for <br /> your business entity. <br /> Corporation 11 <br /> MWN KrbQfCckS, ` . <br /> [Service P ovider's Complete Legal Name] <br /> By: AZ- <br /> �A"/"_ <br /> Typed rinted Name: Ior{G 6. 4" <br /> Its: ljc.S1. Ae.i-1b ! c c. 1-Aa-,--0 1e-' <br /> Date: 22_ St F 2171(o <br /> Partnership <br /> (general) [Service Provider's Complete Legal Name] <br /> a Washington general partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Partnership <br /> (limited) [Service Provider's Complete Legal Name] <br /> a Washington limited partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Sole <br /> Proprietorship Typed/Printed Name: <br /> Sole Proprietor: <br /> Date: <br /> Limited <br /> Liability [Service Provider's Complete Legal Name] <br /> Company a Washington limited liability company <br /> By: <br /> Typed/Printed Name: <br /> Managing Member <br /> Date: <br /> Page 11 <br /> (Form Approved by City Attorney's Office January 7,2010, updated June 15, 2014) <br />