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i <br /> SERVICE PROVIDER: Please fill in the spaces and <br /> sign in the box appropriate for your business entity. <br /> CITY OF EVERETT, CorporationwliS*cc. " <br /> c <br /> WASHINGTON c.ozr\—L.1 c- c.n omrr+v r.1 T k S'.nv tc.E.s eV W AS t.'.i t.46-11- c"--3 <br /> [Service Provider's' Complete Legal Name] <br /> ., iP'J k <br /> Ray Ste ry'. on,M: or Typed/Printed Name: VJ, ,..�?.....;c.E: <br /> 6 <br /> (ce, Its: . 1?. Anscc.1D Z1 . <br /> 11441- <br /> VDate: I Z-1. I-z,211- <br /> Date <br /> fA <br /> ST: <br /> Ar <br /> (general) <br /> / / [Service Provider's Complete Legal Name] <br /> C a Washington general partnership <br /> Sharon Fuller,City Clerk <br /> / By: <br /> c11 / r1 /4- Typed/Printed Name: <br /> Date General Partner <br /> Date: <br /> APPROVED AS TO FORM: Partnership <br /> (limited) [Service Provider's Complete Legal Name] <br /> a Washington limited partnership <br /> James D.Iles,City Attorney <br /> P// By: <br /> Typed/Printed Name: <br /> Date / 91/9– General Partner <br /> Date: <br /> Sole <br /> Proprietorship <br /> 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 /> By: <br /> Typed/Printed Name: <br /> Managing Member <br /> Date: <br /> Page 7 <br /> (Form Approved by City Attorney's Office January 1,2010,updated November 21,2016) <br />