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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 /> [Service Provider's Complete Legal Name] <br /> By: <br /> Typed/Printed Name: <br /> Its:Date: <br /> Partnership <br /> (general) [Service Provider's Complete Legal Name] <br /> a Washington general partnership <br /> By: __T _ <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: 5 <br /> Date: ,,",, � o. <br /> Limited ltlb . _ <br /> Liability [Service Provider's Complete Legal Name] # <br /> Company <br /> a Washington limited liability company '` : ' <br /> By: yididvrt <br /> Typed/ Name: AC U a C� .40 <br /> Managmber <br /> Date: ______ _ . ()-14i.h '3 / i 4rf <br /> ..,....,,,.,. ,, ,. .,,, 4 ," ' <br /> Page 11 <br /> (Form Approved by City Attorney's Office January 7,2010,updated November 21,2016) <br />