AGREEMENT SIGNATURE. TO: AMERICAN EXPRESS INTERNATIONAL (NZ), INC. The Entity named above (“You”)requests that American Express International (NZ) Inc provide the Corporate Payment products (“Accounts”) elected in this application. The undersigned officer has read the attached Terms and Conditions and agrees that on your behalf you will be bound by them and liable for charges in accordance with these Terms and Conditions. You authorise American Express International (NZ) Inc to contact your bankers or any other source, including but not limited to Credit Reporting Agencies to obtain any information American Express requires to establish the chosen Accounts. You agree that a microfilmed or other reproduction of this form may be produced by American Express as evidence of your request to open the chosen Account(s). The undersigned warrants to American Express that he/she is duly authorised by you to open the chosen Account(s) in the name of the above Entity. Title First Name Last Name Position Company Name (As per registered Company Name) Telephone Number Fax Number – – We need an email address to send the Company changes to the Terms and Conditions, servicing and marketing communications from American Express. Email Address (Mandatory) In order to comply with the Anti-Money Laundering and Countering Financing of Terrorism Act 2009 American Express International (NZ) Inc is required to gather identification information (including residential address and date of birth) on those individuals that are authorised to act on behalf of the customer, this includes the Authorised Signatory, Programme Administrator and the Decision Maker. We will not be able to process your application without this information. Decision Maker’s Address14 City Postcode Date of birth D D / M M / Y Y Company Decision Maker’s Signature14 ✘ Date D D / M M / Y Y Y Y
AGREEMENT SIGNATURE. This Agreement, including its applicable schedules, has been executed and takes effect on the date of last signature written below. Name of MSBase/MGBase centre (e.g. hospital or clinic): Centre Authority (Head of Department, or similar) Signature Date Name written in full Position MSBase Principal Investigator (Signs to acknowledge the Agreement): Signature Date Name written in full MGBase Principal Investigator (Signs to acknowledge the Agreement): Signature Date Name written in full The MSBase Foundation Ltd MSBase Foundation Director: Xxxxxx Xxxxxxxxxx
AGREEMENT SIGNATURE. Signed ................................................................. Date ................................. Name in block capitals:........................................... Xxxx authorised to sign for and on behalf of RSSB and Signed.................................................................. Date ................................. Name in block capitals: .......................................... Xxxx authorised to sign for and on behalf of [Contractor] SCHEDULE ONE Services The services shall be the work as fully described in the following documents: [Insert the document name of the Invitation document used and date] [Insert the document name of the Contractor’s proposal, reference and date; list all contract negotiation emails if not available in one document] SCHEDULE TWO Agreement Price and Payment
AGREEMENT SIGNATURE. The undersigned hereby declare that they have read the foregoing Agreement and any and all other materials submitted in connection with the same, and agree to abide by the requirements therein. Name: Title: Name: Title: Contractor Rome City School District Date: Date: EXHIBIT “A” 2021-2022 Rate School Transportation: Price per bus run $ Excess hourly rate $ After School Transportation: Price per bus run $ Extracurricular Activity Transportation: Price per bus run $ BOCES Occupational Education Transportation: Price per trip $ Supported Learning Runs: Price per bus run $ Pre-Kindergarten Runs: Price per bus run $ Bus Monitors and/or Bus Aides Price per hour $ Name: Title: Name: Title: Contractor Rome City School District Date: Date: EXHIBIT “B” 2021-2022 Rate CPI 2022-2023 Rate School Transportation: Price per bus run Excess hourly rate After School Transportation: Price per bus run Extracurricular Activity Transportation: Price per bus run BOCES Occupational Education Transportation: Price per trip Supported Learning Runs: Price per bus run Pre-Kindergarten Runs: Price per bus run Bus Monitors and/or Bus Aides Price per hour Name: Title: Name: Title: Contractor Rome City School District Date: Date: EXHIBIT “C” 2022-2023 Rate CPI 2023-2024 Rate School Transportation: Price per bus run Excess hourly rate After School Transportation: Price per bus run Extracurricular Activity Transportation: Price per bus run BOCES Occupational Education Transportation: Price per trip Supported Learning Runs: Price per bus run Pre-Kindergarten Runs: Price per bus run Bus Monitors and/or Bus Aides Price per hour Name: Title: Name: Title: Contractor Rome City School District Date: Date: ATTACHMENT #2 PROGRAM SITES, 2019-20 BUS ROUTES, AND SCHOOL DISTRICT APPROVAL OF DRIVERS ATTACHMENT #3
AGREEMENT SIGNATURE. This Agreement may be executed in counterparts, each of which will be deemed an original, and both of which taken together will constitute one and the same document. Electronically transmitted signatures will be deemed originals for all purposes relating to the agreement.
AGREEMENT SIGNATURE. TO: AMERICAN EXPRESS AUSTRALIA LIMITED The Entity named above (“You”)requests that American Express Australia Limited provide the Corporate Payment products (“Accounts”) elected in this application. The undersigned officer has read the attached Terms and Conditions and agrees that on your behalf you will be bound by them and liable for charges in accordance with these Terms and Conditions. You authorise American Express Australia Limited to contact your bankers or any other source, including but not limited to Credit Reporting Agencies to obtain any information American Express requires to establish the chosen Accounts. You agree that a microfilmed or other reproduction of this form may be produced by American Express as evidence of your request to open the chosen Account(s). The undersigned warrants to American Express that he/she is duly authorised by you to open the chosen Account(s) in the name of the above entity in his/her capacity as (PLEASE TICK ONE): Director, if a Company, including where Company is a Trustee Partner, if a Partnership Chairperson, Secretary, or Treasurer if an Association/Co-operative Other (Please specify role): If the Company is a Trustee, the Trustee enters into this Agreement in its own right and as trustee of the Trust. Title First Name Last Name Position Company Name (As per registered ABN Entity Name) Decision Maker’s Address14 City State Postcode Telephone Number Fax Number – –
AGREEMENT SIGNATURE. This Agreement has been executed and takes effect on the date of last signature written below. It has been drawn up in two (2) identical copies of which the parties have received one each. Name of centre (e.g. hospital or clinic): Click or tap here to enter text. Centre Authority: Signature Date Name written in full Position MSBase Principal Investigator (Signs to acknowledge the Agreement): Signature Date Click or tap here to enter text. Name written in full MGBase Principal Investigator – if applicable (Signs to acknowledge the Agreement): Signature Date Click or tap here to enter text. Name written in full The MSBase Foundation Ltd MSBase Foundation Director: Xxxxxx Butzkueven
AGREEMENT SIGNATURE. TO: AMERICAN EXPRESS AUSTRALIA LIMITED The Entity named above (“You”) requests that American Express Australia Limited provide the Corporate Payment products (“Accounts”) elected in this application. The undersigned officer has read the attached Terms and Conditions and agrees that on your behalf you will be bound by them and liable for charges in accordance with these Terms and Conditions. You authorise American Express Australia Limited to contact your bankers or any other source, including but not limited to Credit Reporting Agencies to obtain any information American Express requires to establish the chosen Accounts. You agree that a microfilmed or other reproduction of this form may be produced by American Express as evidence of your request to open the chosen Account(s). The undersigned warrants to American Express that he/she is duly authorised by you to open the chosen Account(s) in the name of the above entity in his/her capacity as (PLEASE TICK ONE): Director, if a Company, including where Company is a Trustee Partner, if a Partnership Chairperson, Secretary, or Treasurer if an Association/Co-operative Other (Please specify role): If the Company is a Trustee, the Trustee enters into this Agreement in its own right and as trustee of the Trust. I would like to enrol for BTA Reports YES NO Spend Comparison Report DHTML Airline Usage Report DHTML Trip Requisition Analysis DHTML Traveller Analysis Report DHTML Customer Reference Analysis DHTML Top 10 Air Routings Report DHTML Do you have an existing @ Work User ID ? YES NO If Yes, please provide your User ID Title First Name Last Name Position Company Name (maximum 40 characters) (As per registered ABN Entity Name) Decision Maker’s Address14 City State Postcode Telephone Number – Fax Number – We need an email address to send the Company changes to the Terms and Conditions, servicing and marketing communications from American Express. Business Email Address
AGREEMENT SIGNATURE. The agreement constitutes the entire agreement between the parties and supersedes all prior agreements, whether written or oral. The agreement shall become effective as the date it is fully executed by the parties hereto, provided that such execution occurs before the cut-off date. Until the effective date, no venue space arrangements herein are binding on Prairie du Chien Country Club. Each party here by represents to the other that the person(s) who sign this agreement below on its behalf is fully authorized to do so. Group Name: Date: Date: Date: Prairie du Chien Country Club Authorized Signature
AGREEMENT SIGNATURE. We have read and agree to abide by the sponsorship terms and conditions for Heart Rhythm 2024 stated in this agreement in their entirety. We have either completed payment for the total sponsorship cost or have requested an invoice in ‘Payment Method’ dropdown. If invoice for payment requested, we are obligated to pay the invoice amount upon receipt of invoice per the net terms included in said invoice. Failure to do so shall result in an assessment of a late payment fee and may result in cancellation of the sponsorship purchase.
