2008/04/30 Council Agenda Packet

0 303 General Administration Bldg., P.O. Box 41008, Olympia, WA 98504-1008 Coonerative member contact information: Contact Person (To whom contract documents and related communications are to be mailed or faxed). Cooperative Member Name: City of Everett Contact Name: Clark Langstraat Address: 3200 Cedar Street City, St. Zip Everett, WA, 98201 Phone Number. 425-257-8901 Federal Id #: $3,000,001 FAX Number: 425-258-8864 Email Address: clangstraa@ci.everett.wa us Two -Year Membership Fee Schedule Note: Ed-tures below are net of debt service and inter -tuna transters Annual expenditures Annual expenditures of Two -Year of more than less than Membership Fee $0.00 $3,000,000 $400 $3,000,001 $7,500,000 $1,000 $7,500,001 $30,000,000 $2,000 $30,000,001 $68,000,000 $4,000 $90,000,001 $150,000,000 $8,000 $150,000,001 and over $10,000 The undersigned has read, understands and agrees to the terms and conditions of this agreement and this Authorized Signatory for the Cooperative member attests that the expenditure level initialed in the Membership Fee Schedule above is true and correct. Cooperative member Authorized Signature: Applicant must provide an authorized signature. Name: Title: Ray Stephanson, Mayor Address (if not the same as above): 2930 Wetmore, Everett, WA, 98201 Date Signed: APPROVED AS TO FORM: ATTEST: Anderson Hunter Law Firm, P.S. Sharon Marks By: City Clerk Interimy CitAttorney __... Date: FOR OSP USE ONLY (Completed by OSP, this page will be returned to you in executed copy) Approved as to form: , AAG Date: 07/18/07 (signature on file) OSP has assigned you Co-op member number, Please provide this number when ordering from contracts or communicating with OSP. OSP AUTHORIZED SIGNATURE Name Title Date 3 of 3