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Contractor Section: <br />CJ S PLULi(3DJG 8 SERV��,CE LLC l6^u2 95U 117 <br />Vendor Name / f3usiness Name / U131 Numbe; <br />CJSPLP59150D <br />Slate of Washington Conlracbr License Number. <br />5520218TN AVE NE GRANRG fA'�,_lS lVA <br />Vendor fviailing Address City State <br />3fi0�69 t -5159 CJSPLVI�'01 NG �e �r15N.COtl <br />Phone Email <br />98252 <br />7_ip <br />I, the Vendor, agree to receive the Cackv:ater Prevention Device rebale cneck directly for the <br />insta'lahon al the above referenced propedy ac�dress By a�reeing to receive Ihe rebate check <br />�uectiy, I agree to lhe folloe+�ng <br />1 <br />2. <br />3 <br />Tne Backwater Prevention Dev�ce rebale amount wdl be deducted (rom the fmal invoice <br />given to Ihe prope�ty cwner `or u�e instauation at Ihe p�operty address referenced above, d <br />Ihe total cost of the u�s,a!IaUon is yreater than the rebate <br />1, the Vendor, am a Vdashington State licensed contracror <br />The Cdy of Everett �vill send a Fedcral Form 1099 A�iISC to mr,. the Vendor, for pack�va;er <br />PreveNion Dewce rebale payments totaling mom lhan $600 per caler.dar year, anA will <br />repor� lhe same paymenis to lhe Intemal Revenue Service <br />II accept the paymenl of the fia:kwater Prevention Device �ebate fwm lhe C�ty of [verett pendin� <br />� approval of the completed Dackwaler Prevention Device rebate package by the Cily o� Everelt <br />I <br />II � <br />,(�.� %� , <br />SignaWr of C trac r <br />� <br />Date <br />h <br />i <br />i <br />