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`. 1 <br />�Backwater Prevention Device Rebate Program <br />Rebate Submittal Checklist <br />Submit your rebate packet within 90 days from thc data lhe installation is inspected and <br />approved by the ciry. Use lhis checklist to make sure that it includes all of the necessary <br />malerials. The items Indicated jCONTRACTOR] will be provided to you by your contractor. <br />Your rebate packet must include the following: <br />�Completed and signed Re6ate Application Form (green) <br />' <br />1 <br />1 <br />i <br />. : r :'''': �. . . <br />�Completed and signed IRS Form W-9 "Request fo� . axpayer ldentificaUon Number and <br />Certification" (�•rhite) <br />� Vendor Payment Option Form (purple) signed by you and the contractor IF you want the <br />reb�te check sent to the contractor. Othenvise, the rebate tivill be sent to 9ou. ' , <br />� Completed Backwater Prevention Device Final Installation Checkhst (COtJTRACTORj .' ; <br />�temlzed invoice for tfie �vork, shovding contr2ctor name, address, license number and tf�e ' <br />d tailed costs oi installation and materials (CONTRACTORj. <br />L Map o( your property �vith location of the Installed device jCONTRACTORj <br />1Nnen the packet is complete, mail or deliver it lo: Clly o( Everett, Attn BWPD R2bete ' <br />Program, 32(�0 Cedar Street, Everett, VJA 98201. <br />, r. `. <br />. . <br />_ , � <br />� � ,'' <br />::�.. <br />, �� - <br />;.� � - , <br />, 7_ <br />. <br />� <br />r;' <br />;.. <br />� ; <br />1 �_I <br />� <br />