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5E@ <br /> } <br /> SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. <br /> Corporation <br /> r L t.,e " 5(.,.wt) rdvi_LiCkt ttLL- 1AcSc'GtG4(t(AA) <br /> [Service Provider's Complete Legal Name] <br /> 1 C. — 1 <br /> By: .(. <br /> Typed/P 'rated Name: C) ...1 cit v t' -l <br /> Its: Z-vtwtw t.sSt(4, .rk'. <br /> Date: Cs I G t`_7 <br /> I I <br /> Partnership I <br /> (general) [Service Provider's Complete Legal Name] <br /> a Washington general partnership <br /> By: <br /> Typed/Printed Name: 1 <br /> General Partner <br /> Date: 1. <br /> Partnership l <br /> (limiter [Service Provider's Complete Legal Name] 1 <br /> a Washington limited partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Sole <br /> ProprietorshipTyped/Printed Name: <br /> [ <br /> l <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 /> [ <br /> [ <br />