Criteria to Settle the Impacted Claim Sample Clauses

Criteria to Settle the Impacted Claim. The parties agree that the following information is true and correct. Claimant Criteria to Settle Date of Birth and Age of Claimant "Claimant Dob" Claimant is "Age" years of age. Gender " Select Male/Female" Life Expectancy of Claimant "Claimant Total Years" years pursuant to the tables provided by the Social Security Administration. Claimant is expected to live an additional "Additional Life Exp." years. ("Additional Life Exp." x 12 months = "LE Months" months) ("Additional Life Exp." x 52 weeks = "LE Weeks" weeks) Marital Status "Select Married/Single" Dependents "0" Other Benefits The Claimant is receiving social security "Please Select" benefits in the amount of $0.00 per month. "The Claimant is not receiving social security or any other benefits." CLAIM 1 Claim Number "CLAIM 1" Date of "Select II/OD" "Doi/Dom" Description of "Please Select" "CAUSE" Nature and Extent of Condition and Disability "EFFECT ON IW" Date Claim Received by Department "Date Received" Date of Claim Allowance Claim was allowed by Department order dated "Date Of Allowance Order".
Sample 1
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Related to Criteria to Settle the Impacted Claim

  • Objections to Settlement 7.7.1 Only Participating Class Members may object to the class action components of the Settlement and/or this Agreement, including contesting the fairness of the Settlement, and/or amounts requested for the Class Counsel Fees Payment, Class Counsel Litigation Expenses Payment and/or Class Representative Service Payment.

  • Notice to Settlement Class Members 5.1 The Parties agree that the following Notice Program provides reasonable notice to the Settlement Class.

  • Delay Claim Must Be In Writing Any claim to extend the Contract Time and Material Completion and Occupancy Date must be in writing, must set forth in detail the basis for the claim and the number of days of delay claimed, must be correlated with the approved Overall Project Schedule, must be executed by the Contractor and delivered to the Design Professional and the Owner, and must be reviewed and an appropriate time assessed by the Design Professional.

  • Submitting False Claims The full text of San Francisco Administrative Code Chapter 21, Section 21.35, including the enforcement and penalty provisions, is incorporated into this Agreement. Pursuant to San Francisco Administrative Code §21.35, any contractor or subcontractor who submits a false claim shall be liable to the City for the statutory penalties set forth in that section. A contractor or subcontractor will be deemed to have submitted a false claim to the City if the contractor or subcontractor: (a) knowingly presents or causes to be presented to an officer or employee of the City a false claim or request for payment or approval;

  • Payments to Settlement Class Members (a) Defendant shall pay into the Escrow Account the amount of the Settlement Fund ($1,000,000.00), specified in Paragraph 1.33 of this Agreement, within sixty (60) days after Final Approval.

  • BUY AMERICA REQUIREMENT (Applies only to Federally Funded Highway and Transit Projects) With respect to products purchased by Customer for use in federally funded highway projects, Contractor shall comply with all federal procurement laws and regulations with respect to such projects, including the Buy American provisions set forth in 23 U.S.C. Section 313, 23 C.F.R. Section 635.410, as amended, and the Steel and Iron Preference provisions of Texas Transportation Code Section 223.045, to the extent applicable. Contractor agrees to provide all certifications required by Customer regarding such programs. With respect to products purchased by Customer for use in federally funded transit projects, Contractor shall comply with all federal procurement laws and regulations with respect to such projects, including the Buy American provisions set forth in 49 U.S.C. Section 5323(j)(1), 49 C.F.R. Sections 661.6 or 661.12, to the extent applicable. Contractor agrees to provide all certifications required by Customer regarding such programs.

  • Liability Calculation Method Per Claim Unless subject to a fixed dollar copayment, the calculation of Member liability on claims for Out-of-Area Covered Health Care Services processed through the BlueCard Program will be based on the lower of the provider’s billed charges or the negotiated price made available to Blue Shield by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s health care provider contracts. The negotiated price made available to Blue Shield by the Host Blue may be represented by one of the following:

  • ODUF Pack Rejection 6.4.1 Image Access will notify BellSouth within one (1) business day of rejected packs (via the mutually agreed medium). Packs could be rejected because of pack sequencing discrepancies or a critical edit failure on the Pack Header or Pack Trailer records (e.g., out-of-balance condition on grand totals, invalid data populated). Standard ATIS EMI error codes will be used. Image Access will not be required to return the actual rejected data to BellSouth. Rejected packs will be corrected and retransmitted to Image Access by BellSouth.

  • Invoicing for Charges Against the Judicial Council’s Master Account A. The Contractor shall establish a Master Account for the Judicial Council’s charges provided for under the exhibits of this Agreement.

  • Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions (a) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

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