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�cantractmr �ecfiion: <br />� Ve�dr� <br />State of <br />1��� 1 Business �lame / UBE ��it�umber � <br />�°��'������`�°'` � �� � � � � <br />�tast�ington Car�firactar Licer,se Number: ''�� � � <br />��_ ,����,�'���. �'t� ��.:�sY`�r�� r} �v <br />Vendor� Mai(ing Address <br />..�. <br />v����� .P��'�� �` <br />Phone Email <br />Gify �State <br />I, th� V�ndor, �gree to receive� the Backwater�Preventi�n`aevice r�t�ate check direeily fpr fhe � <br />installation af �he above referenced property address. By agreeing to receive the rebate check <br />directly, I agree to the following: <br />1. Th�= Backu,�ater Pr�v�n�ion C�evice xeL��te arnou�t wili be deducied from the final inv�ice����� <br />�� giv��n tc� the'proper�y �ov�ner f�r ft�� ir����61a�i�n �t th� p€op�r�y address r�f�r�r�ced ��i�ve, �';if <br />ti�e total co�t af th� insf�llatian is greater than fhe r�b�te. <br />2. 1, tr�e Vendar, am a l�V�shingtan State licensed contractc�r, <br />�� 3. Th�; �i�� �f Everett �vill� send a�ed�ral F�cm 1 Q99 MISC t� me,� the Ven�a�r,`fior Ba�kw�t�r <br />��I�r�ven�ion D�vice re�i�ate p�ymen�� tot�ling m�are fihan �fit��} {��r�ca(endar ��ar, ar�d�wi(I �� <br />report the s�me payments to ih� Interna[ Revenue Service. <br />f accept the p�yment of t��e S�ckwaker�Pre�enfian E3r�vi�� ��bate fram�the �ity Qf �uerett pendirtg <br />�pproval c�f the cr�mpleted Backwat�r Pr�vention Device rebate pack�g� by the City of Everett <br />,w �. ��.., _ _ _ . <br />� �.., <br />; .��� <br />.. <br />�.� �' �; -� ; <br />; ��� ��..._.- __ <br />� � �..��._ <br />x �`� ' -a� �v _ - - � <br />Signatui�e of��ontracfior <br />� � <br />�-� � ���� � <br />Date <br />