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SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. <br /> Corporation <br /> [Service Provider's CompleteAl <br /> Legal Na e] <br /> By: %� " <br /> Typed/Printed Name: 01,1`,,4 Ikr.s€,LikolvAw1 <br /> Its: r' %.1 emvt <br /> Date: 1 1 7 1 1 1 1 <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 /> ♦ 4 L <br /> By: <br /> Typed/Printed Name: <br /> Managing Member <br /> Date: <br /> Page 10 <br /> (Form Approved by City Attorney's Office January 7,2010,updated June 15,2014) <br />