CONTRACT NO. PB078AA Signature Page
CONTRACT NO. This Contract is entered into between the Florida Department of Environmental Protection (Department) and Contractor Name, Contractor Address (Contractor), a Insert Entity Type.
CONTRACT NO. This is the number assigned by the City of Tampa for the bid or proposal. • W.O.# If the report covers a work order number (W.O.#) for the contract, please indicate it in that space. • Contract Name. This is the name of the contract assigned by the City of Tampa for the bid or proposal. • Contractor Name. The name of your business. • Address. The physical address of your business. • Federal ID. A number assigned to a business for tax reporting purposes. • Phone. Telephone number to contact business. • Fax. Fax number for business. • Email. Provide email address for electronic correspondence. • Pay Period. Provide start and finish dates for pay period. (e.g. 05/01/13 – 05/31/13) • Payment Request/Invoice Number. Provide sequence number for payment requests. (ex. Payment one, write 1 in space, payment three, write 3 in space provided.) • City Department. The City of Tampa department to which the contract pertains. • Total Amount Requested for pay period. Provide all dollars you are expecting to receive for the pay period. • Total Contract Amount (including change orders). Provide expected total contract amount. This includes any change orders that may increase or decrease the original contract amount. • Signed/Name/Title/Date. This is your certification that the information provided on the form is accurate. • See attached documents. Check if you have provided any additional documentation relating to the payment data. Located at the bottom middle of the form. • Partial Payment. Check if the payment period is a partial payment, not a final payment. Located at the top right of the form. • Final Payment. Check of this period is the final payment period. Located at the top right of the form. The following instructions are for information of any and all subcontractors used for the pay period.
CONTRACT NO. This contract no. (the “Contract”) is made and entered into as of (the “Effective Date”) by and between: THE ISRAEL AIRPORTS AUTHORITY, incorporated by and under the Airports Authority Act 1977, and having its registered office at POB 0, Xxx Xxxxxx Airport (the “IAA”), and State of , registration number , having its registered office at (the (The IAA and the Supplier are each referred to as a “Party”, and collectively as the
CONTRACT NO. C25XXXXXX SIGNATURE PAGE
CONTRACT NO. 1029891 - Farmout Agreement Parties: Exxon Mobil Corporation and Spinnaker Exploration Oil Company Effective Date: May 30, 2003 Lands Covered: XX/0XX/0 Xxxx Xxxxxx Xxxxx 000, XXX-X 06168
CONTRACT NO. PROGRAM NAME Sheet 1 of ------------------------------------------------------------------------------------------------------ ECN CLASS -------------------------------------------------------------------------------------- --------------------------------- DATA ENTRY REQUIRED REASON FOR CHANGE ECP No. Requester TYPE I [ ] II [ ] RCD [ ] ----------------------------------------------------------------------------------------------------------------------------------- Doc [ ] Bom [ ] Part [ ] Routine Incorporate ----------------------------- ----------------------------------------- DATA ENTRY REQUIRED Customer Approval Date Urgent Changes by ----------------------------- ----------------------------------------- --------------------------------- Doc [ ] Bom [ ] Part [ ] Emergency ----------------------------------------------------------------------------------------------------------------------------------- Parts Disposition Codes -------------------------------------------------------- DOCUMENT(S) AFFECTED PART(S) AFFECTED 1. Use part as is (no action)
CONTRACT NO. THIS AGREEMENT, made and entered into effective as of the day of , 20 (the “Effective Date”), by and between the FAIRFAX COUNTY WATER AUTHORITY, hereinafter called “FW”, and
CONTRACT NO. 12PSX0313
CONTRACT NO. Contract Rate Index
