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1 <br /> SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. <br /> Corporation <br /> [Service Provider's Complete Legal Name] <br /> By: <br /> Typed/Printed Name: <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 /> 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 -/w Bt-UEL- G-ZO&►P! LLC. <br /> Liability [Service Provider's Complete Legal Name] <br /> Company a Washington 1' -. iability company <br /> By: <br /> Type. • , ed Nal : Xen"t'aN M LA(l--kJ <br /> Managing M mbe <br /> Date: l0/?l/ ll <br /> Page 10 <br /> (Form Approved by City Attorney's Office January 7,2010) <br /> 11 <br />