DECLARATION AND SIGNATURES. The submission of this Application does not obligate us to issue, or the Applicant to purchase, a policy. The Applicant will be advised if the Application for coverage is accepted. The Applicant hereby authorizes us to make any investigation and inquiry in connection with this Application that we deem necessary. The undersigned, acting on behalf of all Applicants, declare that to the best of their knowledge and belief, after reasonable inquiry, the statements set forth in this Application and in any attachments or other documents submitted with the Application are true and complete and no material facts have been withheld. A material fact is one in which the knowledge or ignorance of it would naturally and reasonably influence the judgment of an insurer in making the contract at all, in estimating the degree or character of the risk, in fixing the rate of premium, or would otherwise be deemed material under applicable law. The undersigned agree that the information provided in this Application and any material submitted herewith are the representations of all the Applicants and the basis for issuance of the insurance policy should a policy providing the requested coverage be issued, and that we will have relied on all such materials in issuing any such policy. The undersigned further agree that the Application and any material submitted herewith shall be considered attached to and a part of the policy. Any material submitted with the Application shall be maintained on file (either electronically or paper) with us. The undersigned hereby acknowledge they are aware that:
DECLARATION AND SIGNATURES. I/We hereby apply for Shares in RE:CM Global Fund Limited ( the Fund ) as specified above and confirm that I/we agree with the terms of this Subscription Agreement, including the attached Notes, and to be bound by the Offering Memorandum dated 31 August 2010. I/We confirm that I am/we are 18 years of age or over, aware of the risks involved in investing in the Fund, and not a Prohibited Person (as defined in the Offering Memorandum) and am/are not acquiring Shares on behalf of, or for the benefit of, a Prohibited Person nor do I/we intend selling or transferring any Shares which I/we may purchase to any person who is a Prohibited Person. I/We confirm that I was/we were not in the United States at the time any Shares were offered to me/us or when I/we executed this Agreement, and I/we confirm that I/we are not US Persons, as defined hereto. I/We confirm that I am/we are not resident in the Island of Guernsey, Herm or Alderney and am/are not acquiring Shares on behalf of, or for the benefit of, a person who is resident in those Islands nor do I/we intend selling or transferring any Shares which I/we may purchase to any person who is a resident of the islands of Guernsey, Herm or Alderney. I/We agree to provide these confirmations to the Fund at such times as the Fund may request, and to provide on request such certifications, documents or other evidence as the Fund may reasonably require to substantiate such representations. I/We agree to notify the Fund immediately if I/we become aware that any of the confirmations are no longer accurate and complete in all respects and agree immediately either to sell or to tender to the Fund for redemption a sufficient number of Shares to allow the confirmation to be made. I/We having received and considered a copy of the Offering Memorandum and any Supplemental Memoranda hereby confirm that this subscription is based solely on the Offering Memorandum and any Supplemental Memoranda for the Fund current at the date of this subscription and the material contracts therein referred together (where applicable) with the most recent audited annual report of the Fund and that I/we are not relying on any representations made by other third parties. I/We confirm that we have completed either Section 1, 2 or 3 in relation to Prevention of Money Laundering and Terrorist Financing. The Administrator, the Manager and the Fund are each hereby authorised and instructed to accept and execute any instructions in respect of the Shares to wh...
DECLARATION AND SIGNATURES. I have read and fully understand the foregoing Contract of Employment and I agree to abide by the terms of the contract and further warrant that all statements and representations which I have made to the Institute in application for this appointment are true and correct. Signed: ______________________________ Date: _________________________ Employee Signed: _____________________________ Date: _________________________
DECLARATION AND SIGNATURES. I am authorised to sign this Agreement on behalf of Arcare Pty Ltd SIGNATURE PRINT NAME AND TITLE Address: Date I am authorised to sign this Agreement as the nominated employee bargaining representative on behalf of the New South Wales Nurses and Midwives’ Association/ Australian Nursing and Midwifery Federation NSW Branch SIGNATURE PRINT NAME AND TITLE Address: Date I am authorised to sign this Agreement as the nominated employee bargaining representative on behalf of XXX New South Wales Branch SIGNATURE PRINT NAME AND TITLE Address:
DECLARATION AND SIGNATURES. All Directors, Partners, Officers and Authorised Person must agree and sign below. I/We confirm that I/we have not been declined service by any other NZX Firm or been declared bankrupt. I/We confirm that the particulars supplied in the Agreement are correct. The person identified as the Authorised Person is authorised to operate the account on my/our behalf.
DECLARATION AND SIGNATURES. In consideration of the hire fee described in clause 2(D), the Village Hall agrees to permit the Hirer to use the premises (defined as the whole hall including the car park) for the purpose described in clause 2(A) for the period(s) described in clauses 2(B) and 2(C). The details inserted in clause 1 and the answers to the questions in clauses 2 and 3 are terms of this agreement. Signing this Hiring Agreement means that you also commit to clauses 5 and 6, covering all hiring conditions, any additional special conditions and the ‘Important Information for Hirers’. These documents are provided separately. As witness the hands of the parties hereto: Signed by the booking secretary or delegate, on behalf of the Village Hall’s Management Committee
DECLARATION AND SIGNATURES. In consideration of the hire fee described in clause 2(D), the Village Hall agrees to permit the Hirer to use the premises (defined as the whole hall including the car park) for the purpose described in clause 2(A) for the period(s) described in clauses 2(B) and 2(C). The details inserted in clause 1 and the answers to the questions in clauses 2 and 3 are terms of this agreement. Signing this Hiring Agreement means that you also commit to clauses 5 and 6, covering all hiring conditions, any additional special conditions and the ‘Important Information for Hirers’. These documents are provided separately. As witness the hands of the parties hereto: Signed by the booking secretary or delegate, on behalf of the Village Hall’s Management Committee Signed by the person named at 1 above duly authorised, on behalf of any organisation named at 1 above, where applicable
DECLARATION AND SIGNATURES. I am authorised to sign this Agreement on behalf of FRESH HOPE CARE SIGNATURE PRINT NAME AND TITLE Address: Date: I am authorised to sign this Agreement as a nominated employee bargaining representative SIGNATURE PRINT NAME AND TITLE Address: Date: I am authorised to sign this Agreement as the nominated employee bargaining representative on behalf of the New South Wales Nurses and Midwives’ Association/ Australian Nursing and Midwifery Federation NSW Branch SIGNATURE PRINT NAME AND TITLE Address: Date: I am authorised to sign this Agreement as the nominated employee bargaining representative on behalf of the Health Services Union NSW Branch SIGNATURE PRINT NAME AND TITLE Address: Date SCHEDULE 1 – PAY RATE Classification Stream Current rate 1 Nov 2021 1 Nov 2022 Assistant in Nursing (without Certificate III qualification) 1st year 22.25 23.82 24.47 2nd year 23.18 24.77 25.45 Thereafter (experienced without Cert III) 24.41 25.08 25.77 Assistant in Nursing (with Certificate III qualification) 1st Year (with Cert III) 23.67 24.50 25.17 Thereafter (with Cert III) 24.41 25.08 25.77 Team Leader 25.41 26.11 26.83 Enrolled Nurse (without medication qualification) 1st year 26.75 27.49 28.24 2nd year 27.33 28.08 28.85 3rd year 27.91 28.68 29.47 4th year 28.50 29.28 30.09 Thereafter 29.11 29.91 30.73 Enrolled Nurse Level a 28.78 29.57 30.38 Level b – 1st year 29.38 30.19 31.02 Level b – 2nd year 30.02 30.85 31.69 Level b – 3rd year 31.46 32.33 33.21 Registered Nurse 1st year 33.60 34.52 35.47 2nd year 35.65 36.63 37.64 3rd year 37.82 38.86 39.93 4th year 40.14 41.24 42.38 Thereafter 42.59 43.76 44.96 Clinical Nurse Specialist 44.31 45.53 46.78 Clinical Nurse Educator 44.31 45.53 46.78 Nurse Educator 1st year 47.22 48.52 49.85 2nd year 48.54 49.87 51.25 3rd year 49.75 51.12 52.52 4th year 52.35 53.79 55.27 Senior Nurse Educator 1st year 53.60 55.07 56.59 2nd year 54.70 56.20 57.75 3rd year 56.54 58.09 59.69 Clinical Nurse Consultant 52.35 53.79 55.27 Nursing Unit Manager Level 1 - 1st year 47.22 48.52 49.85 Level 1 - 2nd year 48.54 49.87 51.25 Level 2 49.75 51.12 52.52 Level 3 51.06 52.46 53.91 Classification Stream Current rate 1 Nov 2021 1 Nov 2022 Deputy Director of Nursing < 20 beds 49.54 50.90 52.30 20 – 75 beds 50.82 52.22 53.65 75 – 100 beds 51.99 53.42 54.89 100 – 150 beds 53.08 54.54 56.04 150 – 200 beds 54.70 56.20 57.75 Director of Nursing < 25 beds 55.39 56.91 58.48 25 – 50 beds 58.65 60.26 61.92 50 – 75 beds 59.90 61.55 63.24 75 – 100 beds 61.16 62.84 64....
DECLARATION AND SIGNATURES. Terms that apply to this document. This direct debit/direct credit request is governed by the terms of the direct debit/direct credit service agreement set out below. This request remains in force until you revoke it. Before signing this document. Before signing this document fill in and cross out any blank spaces. If there’s more than one signatory authorised to operate your Account, each required signatory must sign this document. Don’t sign this document if there’s anything you don’t understand. What you agree to by signing this document. By signing this document: • you confirm that at least one of the Account holders is a borrower under the Facility. • you request and authorise us to debit and/or credit your Account, through the Bulk Electronic Clearing System, with any amounts due and/or requested under the Facility. • you request and authorise us to debit the Account with an amount required to pay off the total amount or part of it owing from time to time under the Facility. • you confirm that all information you’ve given us is complete, correct and not misleading. Signature of Bank Account Holder 1 Signature of Bank Account Holder 2 ✗ ✗ Signatory’s full name (please print) Signatory’s full name (please print) Date (dd/mm/yyyy) Date (dd/mm/yyyy) / / / / DIRECT DEBIT/DIRECT CREDIT SERVICE AGREEMENT This agreement sets out the terms on which we accept and act under a direct debit or direct credit request you give us to debit and/or credit amounts in connection with the Facility from a specified account of yours under the direct debit system. We’ll only draw money out of, or deposit money into, your Account in accordance with the terms of your direct debit/direct credit request. Changes we can make. We can: • change our direct debit/direct credit procedures • change the terms of your direct debit/direct credit request • cancel your direct debit/direct credit request We’ll notify you in writing of changes as soon as reasonably possible unless the change is unfavourable to you in which case we’ll give you 30 days’ notice. However, we don’t have to give you notice (or we can give you shorter notice) if it’s reasonable to manage a material and immediate risk. Changes you can make. By contacting us and quoting your Facility account number, you can ask us to: • change the terms of your direct debit/direct credit request • defer a payment to be made under your direct debit request • stop a payment under your direct debit request • cancel your direct debit/dire...
DECLARATION AND SIGNATURES. All Applicants and Authorised Person must agree and sign below. I/We confirm that I/we have not been declined service by any other NZX Firm or been declared bankrupt.I/We confirm that the particulars supplied in the Schedule are correct and that I/we have read and understood this Agreement and agree to comply with it.The person identified as the additional Authorised Person has read, understood and agrees to comply with this Agreement and is authorised to operate the account on my/our behalf.I/We acknowledge that I/we have read the risk disclosures relevant to this account as set out in Part B of this agreement.Where a person is signing as an Attorney, an original certified copy of the Power of Attorney must be provided. The Attorney hereby certifies that they have not been given notice revoking the Power of Attorney (POA).By signing below and returning Part A of this Agreement to Xxxxxxxx Xxxxx Partners (“SSP”), I/we agree to the provision to me/us by SSP of sharebroking and ancillary services on the Terms and Conditions set out in Part B of this Agreement, the Appendices hereto and agree to abide by those Terms and Conditions. Name of First Applicant/POA: Signature: Date: Name of Second Applicant/POA: Signature: Date: Name of Authorised Person: Signature: Date: SSP agrees to provide to the Account Holder(s) named above, sharebroking and ancillary services on the Terms and Conditions set out in Part B of this Agreement, the Appendices hereto and agrees to abide by those Terms and Conditions. SSP Authorised Name: SSP Authorised Signatory: Date: Xxxxxxxx Xxxxx Partners will retain the original copy of this Client Agreement.Please contact us on (00) 000 0000 or xxxxxx@xxxxxxxx.xx.xx if you require a copy for your records.
