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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 /> Ge_ 1 <br /> c�'I'e Services __Loc. <br /> [Service Provider's Complete Legal Name] <br /> By: <br /> Typed/Printed Name: KevwL Nick wc{5ort. <br /> Its: Preside/4- <br /> Date: <br /> /l- <br /> Date: I ill 10611' <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 /> (Form Approved by City Attorney's Office January 7,2010,updated November 21,2016) <br />