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SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. <br /> Corporation • <br /> NIi dwe - eominim lull 01/1.s-Technolo oes,Inc. abw <br /> [Service Provider's Complete Legal Name] ►�10eCK IN X Wel-boor J//1-u1ct' <br /> By: fi <br /> Typed/Pri d Name: . <br /> Its: _ 1` !\' — <br /> Date: I/31 1-1 <br /> Partnership <br /> (general) [Service Provider's Complete Legal Name] <br /> a Washington general partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Partnership <br /> (limited) [Service Provider's Complete Legal Name] <br /> a Washington limited partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Sole <br /> Proprietorship Typed/Printed Name: <br /> Sole Proprietor: <br /> Date: <br /> Limited <br /> Liability [Service Provider's Complete Legal Name] <br /> Company a Washington limited liability company <br /> By: <br /> Typed/Printed Name: <br /> Managing Member <br /> Date: <br /> Page 12 <br /> Black Box 2017 <br />