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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 /> IcOAS Idt>e <br /> [Se ice Provider's Complete Legal Name] • <br /> B•: __ <br /> Typed/Printed Name: F'�/� 1ff <br /> Its: /lLZ n>r2S7d,0i- <br /> Date: ,i✓z'G' ��j I(ot 71) <br /> 17 <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 11 <br /> (Follii Approved by City Attorney's Office January 7,2010,updated June 15,2014) <br /> 12 <br />