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5 <br /> SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. <br /> • <br /> Corporation r <br /> ra-C 1)f 7 S nem eiti /'oteg <br /> [Service Provi is Complije Legal Name] <br /> By: -OIL AlLa (art tiV-_ .•,y <br /> Ty. d/Printei, ame: f AM,V <br /> Its <br /> Date: , <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 /> • <br /> Date: <br /> Partnership <br /> (limited) [Service Provider's Complete Legal Name] <br /> a Washington limited partnership <br /> • <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 /> • <br /> By: <br /> Typed/Printed Name: <br /> Managing Member <br /> Date: <br /> • <br /> • <br /> • <br /> Page 10 <br /> (Form Approved by City Attorney's Office January 7,2010) <br /> 23 <br />