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� Backwater Prevention Device Rebate �n��nnl� <br /> Rebate Submittal Checklist � (� <br /> V L�� <br /> �0� 14 1014 <br /> Submit your rebale packet within 90 days from the date the installation is inspecte tl W� j{S <br /> approved by ths city. Use this checklist to make sura lhat it includes ail of ihe nece.ssary <br /> materials. The items indicated[CONTRACTOR]will be provided to you by your contractor. <br /> Your rebate packet must include the following: <br /> �Completed and signed Rebate Application Form (green) <br /> [�ompleted and signed IRS Form'W-9"Request for Taxpayer ldentification Number and <br /> Certification"(avhite) <br /> ❑ Vendor Payment Option Form (purple)signed by you and the contractor IF you want the <br /> rebate check senl to the contractor. Otherwise,the rebale wiil be sent to you, <br /> �Completed Backwater Prevention Device Final Installation Checklist[CONTRACTOR] <br /> e Itemized invoice for the work, showing cnntractor name, address, license nurriber and the <br /> detailed cosls of installation and materials[CONTRACTOR]. <br /> � Map of your propeAy with location of the installed device[CONTRACTOR] <br /> When the packet is complete, mail or deliver it to: City of Everelt, Attn: BWPD Rebate <br /> Program, 3200 Cedar Street, Everett,WA 98201. <br />