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171 <br />SERVICE PROVIDER: Please fill ire the spaces and sigir in the boy- appropriate for <br />your business <br />end47. <br />Corporation <br />[Service Provider's Complete Legal Name] <br />By: <br />Typed/Printed Name: <br />Its: <br />Date: <br />Pa_f•trr.easfiip <br />(8erter-al) <br />[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 />(Hinited) <br />[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 />Proprietors"'F <br />Typed/Printed Name: <br />Sole Proprietor: <br />Date: <br />Limited <br />���E,�.� ���c�� �� ��t ��r Ll— C - <br />Liability <br />[Service Provider's Complete Legal Name] <br />Corrtparty <br />a Washington limited liability company <br />By:'"- <br />TypedlPrinted Name: 5 ST s • Q W N'%Z-'Z-' <br />Managing Me mber <br />Date: `7 17N 1 t5 <br />r r <br />_. ^iL _ �V!_'.(` v1Ll. <br />155 <br />