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Backwater Prevention Device Reba�e P am <br /> � �ebate Submittal Chec�Clist � ����� <br /> � <br /> �C�V � <br /> � � �o�� <br /> Submit your rebate packet within 90 days from the date the installation is inspecte a d�� �,� <br /> �ppraved by the city. Use this checklist to make sure that it includes all of the necessary <br /> n�aterials. The items indicafied [CONTRACTOR]will be provided to you by y�ur contractar. <br /> . Your rebate packet must include the following: <br /> �..�=Completed and signed Rebate Application Form (green) <br /> �ompleted and signed IRS Form W-9 "Request for Taxpay�r ldentification Nurnber and <br /> Certification" (white) <br /> ❑ Vendor Paymenf Option Fo�-m (purple) signed by you and the eontractor IF yau want the <br /> rebate check sen##o fhe contractor. Otherwise, the rebate will be senf ta yau. <br /> [� Completed Backwater Prevention Device Final Instaliation Checklist [CONTRA�TOR] ' <br /> � Itemized invoice for the work, shflwing contractor name, address, license number and the <br /> detailed costs of installation and materials [CONTRACTOR]. <br /> � Map of your property with location of the installed device [CONTRACTOR] <br /> When the packet is complete, mail or deliver it to: City of Everett, Attn: BWPD Rebate <br /> Program, 3200 Cedar Streefi, Everett, WA 98201. <br /> � <br /> � <br /> � <br /> i <br /> , <br /> � <br />