Laserfiche WebLink
Contractor Section: <br />CJ'S PLUMBING 8 SERVICF L LC / 602 �350 117 <br />Vendor Namo � Business Name ! UBI Number <br />CJSP�P59150D <br />State of Washington Contractor License Number: <br />5528 21BTH AVE NE GRANITE FALI S WA 98252 <br />Vendor Mailing Address City State Zip <br />360-691�5159 GJSPWM�ING�?MSN.COM <br />Phone Email <br />I, the Vendor, agree h receive the Backwater Prevenlion Device rebale check directly for the <br />installation at the above referenced property address. By agreeing lo receiue ihe rebale check <br />directly, I ac�ree to ihe follov.�ing: <br />1. The Bar.kwaler Prevention Device rebale amount will be deducted Irom the (inal invoice <br />given to the property ownei tor lhc inslallation at tlie property address referenced above, if <br />the total cosl of the inslailation is grealer than the rebate. <br />7. I, lhe Vendor, am a Washinglon Slale licensed contracror. <br />3 The Cily ol C-verett will send a Federal Form 1099 Iv11SC to me, the Vendar, (or Backwaler <br />Prevention Device rebale payments lotahng more than 5600 per calendar year, and �vdl <br />report the same paymenls to Ihe Internal Revenue Service <br />I accept the payment ot the Backwater Prevention Uevice rebate from the Cdy ot FvereU pending <br />approval of ihe c:ompleted Backwater Prevention Dr.vice rebate package by the City of L=verell <br />/ <br />���- L f 7G•_��,.� <br />t <br />Siynalure C�o raclor Date <br />