ACCEPTED BY. The Indiana State Library By: Representative Date Printed Name Title Executive Committee of Evergreen Indiana By: Executive Committee Chair’s Signature Date Chair’s Printed Name Executive Committee Secretary’s Signature Date Secretary’s Printed Name Entity Library Name By: Board President’s Signature Date Board President’s Printed Name Director’s Signature Date Director’s Printed Name The Evergreen Indiana Code of Ethics I acknowledge that I have an obligation to the Evergreen Indiana Project and to ensure that each of our library employees complies with this Code of Ethics: • I shall not violate the privacy and confidentiality of information entrusted to me or to which I may gain access, including a patron’s private information or reading records. A patron’s personal information, history, or records will not be provided to anyone without legal authorization. Further, I agree to take appropriate action in regard to any illegal or unethical practices that come to my attention. • I shall not use knowledge of a confidential nature to further my personal interests or for personal gain for myself or others. • I have an obligation to the Evergreen Indiana project to use equipment and software only for the purposes intended. • I shall keep my personal skills and knowledge up-to-date and insure that proper expertise is available to the public as needed. • I will share my knowledge by participating in Evergreen Indiana Committees; I will recommend policies and procedures to improve service delivery in accordance with the participation agreement. • I shall accept full responsibility for the work I perform. • I shall cooperate with other Evergreen Indiana members, treating them with honesty and respect. • I will avoid conflict of interest and insure that the appropriate Indiana State Library management is aware of potential conflicts. • I will not exploit the weakness of a computer system for personal gain or personal satisfaction for myself or others. • I will take all steps necessary to ensure that persons working on the Evergreen Indiana project on behalf of the Library will sign an agreement similar to this one which will be retained and made available if requested by Evergreen Indiana. Director’s Signature Date Director’s Printed Name Library Name Evergreen Indiana Payment Program This document will explain the cash and check payment program for Evergreen Indiana. The goal of the Evergreen Indiana Payment Program is to allow all Evergreen Indiana libraries to ac...
ACCEPTED BY. ("General Electric Company") ("Xxxxxxx.xxx") By: /s/ Xxxx Xxxxxxxxxx By: /s/ Xxxxx X. Xxxx ---------------------------- ---------------------------- Name: Xxxx Xxxxxxxxxx Name: Xxxxx X. Xxxx ------------------- ------------------- Title: Mgr, Technology Title: President & CEO ------------------------- ------------------------- EXHIBIT A SOFTWARE LICENSE ----------------
ACCEPTED BY. Battery Express, Inc. ---------------------------------------------- RESELLER's Full Legal Name iGo Corp ---------------------------------------------- D/B/A (if Applicable) A Corporation ---------------------------------------------- (Corporation, Partnership, Sole Proprietorship) of the State of ______________________________ /s/ X. Xxxxx ---------------------------------------------- Authorized Signature Xxxxxx X. Xxxxx Xx. ---------------------------------------------- Typed or Printed Name VP Sales & Marketing ---------------------------------------------- Title
ACCEPTED BY. Deposit returned / destroyed Date......................
ACCEPTED BY. The Parties have analyzed the subject change request in accordance with the authorized Change Control process to determine the effect that the implementation of the requested change will have on the Contract and related costs, if any. The Parties: (i) mutually approve the analyzed change request, as evidenced by the Parties’ signatures below; (ii) incorporate the resultant Change Order and its attachments, if any, into the Contract; and (iii) declare the Change Order effective as of the last date of signature. The approved Change Order alters only that portion of the Contract and related costs, if any, to which it expressly relates; and it does not otherwise affect the terms and conditions of the Contract. ________________________________ (Contractor): By: Date: _________________________ Printed Name: _____________________, or delegate Delegate Name: Title: Contractor Project Manager Delegate Title:
ACCEPTED BY. Executive Director, Xxxxxxx Xxxxxx Arlington Community Services Board 07/16/2024 | 02:45:25 EDT Date Executive Director, Xxxx Xxxxxxxx Alexandria Community Services Board 07/15/2024 | 16:01:22 PDT Date Executive Director, Xxxxxxxx Xxxxxx Loudoun Community Services Board 07/16/2024 | 01:22:25 PDT Date Executive Director, Bachman, Xxxxxxx Xxxxxx Xxxxxxx Community Services Board 07/16/2024 | 10:56:52 EDT Date Executive Director, Xxxxx Xxxxxxxxxx Fairfax-Falls Church Community Services Board 07/17/2024 | 09:29:47 EDT Date Docusign Envelope ID: DCFC78AB-9B0C-43FA-B3B6-4FFFBFF0F22F FFCCSB RTDS PROGRAMMING REGIONAL BED REFERRAL APPLICATION Complete the below Referral Form and attach the following reports and information:
ACCEPTED BY. Applied CIM Technologies, Inc. - a Minnesota Corporation 00000 - 00xx Xxxxxx Xxxxx Xxxxxxxxxxx, XX 00000 Signed: By: Title: Date: * All prices are subject to change without notice. 00000 - 00xx Xxxxxx Xxxxx Fax: 000-000-0000 Xxxxxxxxxxx, XX 00000 Website: xxx.xxxxxxxx.xxx
ACCEPTED BY. By: ------------------------------ Its: ------------------------------ [CORPORATE SEAL]
ACCEPTED BY. By: ------------------------------------- NAME: User Dated: ----------------------------------- By: ------------------------------------- World Commerce Online-Floraplex, Inc.
ACCEPTED BY. Canadian Western Trust Company 0000 Xxxxxxx Xxxxx, Xxxxx 000, Xxxxxxxxxxx, XX X0X 0X0 TO BE COMPLETED BY THE ANNUITANT: CURRENT SPOUSAL STATUS:
