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SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. <br /> Corporation <br /> 1142R I a 111-61S <br /> [Service P • idem .lete Legal Name] <br /> AW <br /> By: <br /> Typed/Pri /-. Name: (j 7f 114 C:74r—C -7Z <br /> Its: i ' ;ga, , . c7_ <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 <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 July 23,2018) <br />