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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 /> (1/124k) <br /> 1/1,,4, ) �S S. PC5 (e!c <br /> [ ervice Pr. ':: r .lete Legal Name] t /V <br /> 4111111,-5.74.0 <br /> By: <br /> Type. 'ri -d ame:v r.FF/Ll <br /> Its: t cYONJ ,14 f4>)i-Bc'L_ <br /> Date: /.2-/3 / <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 />