Common use of DECLARATION Clause in Contracts

DECLARATION. I hereby make application for the premises set out in this form for the day and the times specified in this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals or groups using the premises in association with this application shall comply with these Conditions. If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf of the corporation or incorporated association. In making this application, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policy.

DECLARATION. I hereby make application Do you authorise Property360 to issue and deliver payment instructions to your Banker for collection against your Bank account on condition that the premises set out sum of such payment instruction will never exceed your obligation as agreed in your contract/agreement? This method will commence effective (date) and will continue monthly thereafter until your obligation has ended or the authority and mandate is terminated by yourself giving us notice of not less than one month. In the event that the payment day falls on a Sunday or recognised South African public holiday, the payment day will automatically be the very next ordinary business day. Payment instructions due in December may be debited against my account on the last working day of the month. If there are insufficient funds in the nominated account to meet the obligation we are entitled to track your account and re-present the instructions for payment as soon as sufficient funds are available in your account. This authority and mandate may be cancelled by you however, such cancellation will not cancel the Agreement. You shall not be entitled to any refund of amounts which we may have withdrawn while this form for Authority was in force, if such amounts were legally owing to us. The authority and mandate may be ceded or assigned to a third party only if the day Agreement is also ceded or assigned to the third party. Please note that the reference that will appear on your bank statement will be Prop360. We will confirm your authority and mandate in writing prior to processing the times specified in this formdebit order against your account. I acknowledge that Do you understand and accept what I have read the Xxxxxxx Xxxxx Council Terms and Conditions to you? (yes/no) If you have any questions or complaints, please contact Property360 on xxxx@xxxxxxxx000.xx.xx Dated at on this day of Hire and Emergency Evacuation Procedure. I undertake 20 AS WITNESS FOR AND ON BEHALF OF PROPERTY360 (PTY) LTD By who warrants that he/she is duly authorised thereto AS WITNESS FOR AND ON BEHALF OF AGENCY/AGENT By who warrants that he/she is duly authorised thereto AGENCY INFORMATION SHEET AND BANK DEBIT ORDER INSTRUCTION CRM NO (Property360 Use Only) AGENCY BRANCH BRANCH CONTACT NO BRANCH EMAIL PRINCIPAL NAME PRINCIPAL CELL NO PRINCIPAL EMAIL FFC NO VAT NO LEAD CC EMAIL ACCOUNTS EMAIL DATA SOURCE DEBIT ORDER NAME OF ACCOUNT BANK ACCOUNT NO ACCOUNT TYPE BRANCH BRANCH CODE CONTRACT NO DEBIT AMOUNT COMMENCEMENT DATE ADDRESS LINE 1 ADDRESS LINE 2 POSTAL CODE ABBREVIATED NAME AS REGISTERED WITH BANK PROP360 Take up our Home Loan service offer from our Mortgage Origination department Send Property360 your signed Offer to be bound by and comply with these documents in every respect and I further undertake Purchase to be responsible for ensuring that all individuals or groups using the premises in association with this application shall comply with these Conditions. If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application process on behalf of the corporation or incorporated association. In making this applicationyour client and on registration, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) your agency will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy receive 0.10% of the personal information held by usregistered amount back in credits to further feature other listings to give them maximum exposure and convert to leads and sales. The way Would you like to try it out? If so, please tick the following and our consultant, Xxxxxxxxx Xxxxxxxx will be in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policytouch immediately.

DECLARATION. ❖ I hereby make application for am aware that participation in a retreat and ceremonies with the premises set out Inner Shift Institute involves the use of Psilocybin. ❖ I understand that taking these plants may involve emotional, psychological, and physical reactions, and I agree to take part and abide by the Terms and Conditions in this form for document and any other instructions given orally or in writing. ❖ I declare that I am choosing to participate of my own free will and have not been coerced into participating in a retreat or session by the day organisers or by any other person. The decision to participate is mine alone, and is based on my own personal assessment of the effects, the exclusion criteria, the potential risks and benefits, the focus of the ceremonies, and the times specified team of The Inner Shift Institute. ❖ The Team of The Inner Shift Institute has explained to me what to expect from the retreat or session and how it is intended to proceed. I am aware that I can ask questions about the ceremonies at any time and can change my mind about participating at any time before the ceremonies begin during the retreat. ❖ I agree to answer all questions honestly during the screening process, and understand that I must complete all medical questionnaires and respond to all follow up questions in order to participate in a retreat. I agree to provide all relevant information regarding my medical history, mental and physical health, and any other information that may serve to protect my health during this process. ❖ I have made the confidential disclosures requested by the Organiser and these are honest and accurate regarding my needs and condition(s). I understand that these will be kept in the strictest confidence. I reiterate my understanding of this by signing this form. ❖ I acknowledge accept full responsibility for participating in a retreat and in ceremonies with The Inner Shift Institute. ❖ I understand and agree that I have read can be excluded from participation in a retreat or ceremony at the Xxxxxxx Xxxxx Council Terms discretion of the facilitator. TERMS AND CONDITIONS This agreement is between Consciousness Rising Org VOG (the Organiser of The Inner Shift Institute Retreats and Conditions Ceremonies) and You (the Participant). The Inner Shift Institute operates under the umbrella of Hire Consciousness Rising as a subsidiary entity. The present terms and Emergency Evacuation Procedureconditions are subject to the law applicable in the Netherlands. I undertake to be bound by and comply with these documents in every respect and I further undertake to Consciousness Rising Org will not be responsible for ensuring that all individuals or groups using any change on the premises in association with this application shall comply with these Conditions. If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf of the corporation or incorporated association. In making this application, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions needed by the rules and they have current licences/certificates regulations approved by the Government, Parliament or Health Authorities. All the terms and current Public Liability Insurance cover. I declare that the information provided by me in this application is true and correct and I consent conditions can suffer changes due to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy situation of the personal information held by uscountry regarding the pandemic COVID-19. The way in which By booking a Retreat with Consciousness Rising you agree to all of the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policy.following items listed:

DECLARATION. I hereby make application for I/We acknowledge receipt of a copy of the premises Client Agreement and Fee Agreement and confirm that its content has been explained to me/us. I/We accept that the Client Agreement will become effective from the date I/We sign this document. I/ We consent to the processing and storage of personal information and to the issue of marketing material. One signed copy to be retained by the Client/Customer(s). One signed copy to be retained by GSI Wealth Management Ltd. Please sign to confirm receipt of this document and to confirm your relationship requirements: Sign to confirm Family Client: Client 1 Client 2 Signed: Signed: Print: Print: Date: Date: Advice Only Client: Client 1 Client 2 Signed: Signed: Print: Print: Date: Date: GSI Wealth Management Adviser: Signed: Print: Date: Order Execution Policy Introduction FCA rules require us to give you these details on our Order Execution Policy and we shall consider that you have consented to this Policy unless you object. We will notify you of any material changes to our order execution arrangements or execution policy. If you provide us with specific instructions regarding an order we will act in accordance with those instructions. Please note this may prevent us from taking the steps set out in this form Policy to obtain the best possible result in respect of the elements covered by those instructions. Our Policy The general rule is that we must take all appropriate steps to obtain, when executing orders, the best possible result for clients. In order of priority, we consider price, costs, speed, likelihood of execution and settlement, size, nature or any other consideration relevant to the day execution of an order when placing an order. We will only override the price and the times specified in cost factors mentioned if this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake is likely to be bound by and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals or groups using the premises in association with this application shall comply with these Conditions. If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf of the corporation or incorporated associationyour interests. In making practice this application, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming means that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) we will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance place agreed orders with the Local Government Act 2009 so that we can assess and finalise your applicationagreed provider as soon as possible. GenerallyIn addition, we will not disclose also take into consideration; • Your client categorisation and how this affects you • The nature and characteristics of your personal information outside of Council unless transaction • Where your transaction can be directed and • Any specific instructions you give us, whether received on an individual basis or as a general instruction to be applied to all your transactions Where we are required place your business The specific providers will always be described in our letters to do so by lawyou. When you complete your application or we receive your instruction to invest this, or unless you have given us your will be considered as express consent to undertake the order. Orders will be placed with: • Fund managers, Insurers, WRAP providers and other product providers including firms regulated by the Financial Conduct Authority • Outside of a regulated market, such disclosureas specialist unregulated investments Please note that this is not an exhaustive list but comprises those execution venues on which we place significant reliance. For further information about how we manage your personal information please see our Information Privacy Policy.GSI Wealth Management Ltd & GSI Xxxxx and Trusts LLP is registered in England at the following address: 0 Xxxxxxxxx Xxxxx, Xxxxxx’x Way, Xxxxxxxxx, Xxxx, TN16 1BT and reachable at +00 (0)0000 000000 or xxxxxxxxxxxxxxxxx@xxxxxxxx.xx.xx GSI Wealth Management Ltd is authorised and regulated by the Financial

DECLARATION. I I/We the undersigned in my/our capacity as an authorised representative of the Applicant hereby make application apply for the premises set out extension of credit facilities from Duxbury Transmission Equipment cc trading as Duxbury Networking (the supplier). The following information is submitted as basis for your consideration of my/our application. • I/We hereby certify that the foregoing details are true and correct in this form for the day each and the times specified in this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to notify the SUPPLIER in writing of any change or details shown above including change of ownership, name and address. • By entering into this Agreement you acknowledge and agree that we may provide any registered credit bureau with any details provided by you in your application; and/or details of the conduct of your credit account; and/or details of the transfer of our rights as a credit provider under this Agreement to another person; • I/We consent to Duxbury collecting our Personal information and where lawful and reasonable, from public sources for credit, fraud and compliance purposes • I/We warrant that the Directors/Partners/Proprietor have never been insolvent or associated with any business failure. • I/WE DO HEREBY ACCEPT THE TERMS AND CONDITIONS OF CONTRACT AS SET OUT ABOVE HEREOF WHICH CONDITIONS I ACKNOWLEDGE HAVING READ AND UNDERSTOOD, AND AGREE WILL BE APPLICABLE TO ALL CONTRACTS FOR THE PURCHASE OF GOODS FROM THE SUPPLIER. • I/We acknowledge that should credit facilities be responsible for ensuring that all individuals or groups using the premises in association with granted as a result of this application shall comply with these Conditions. If that they may be withdrawn (and/or altered) by the application SUPPLIER at any time without prior notice, and that the decision of whether or not to grant credit facilities to the PURCHASER is made by a corporation or incorporated association, at the person signing the form must occupy a position that is legally entitled to make an application on behalf sole discretion of the corporation or incorporated associationSUPPLIER. In making this applicationThe credit facilities granted by the SUPPLIER will be advised in writing. • Duxbury agrees and confirms to respect your privacy and will take reasonable measure to protect it. • I/We the undersigned do hereby authorise the Manager of a Recognised Financial Institution to furnish a Director, I confirm all Credit Manager, Administration Manager of DUXBURY TRANSMISSION EQUIPMENT CC with any information provided is true and correct and I am 18. By signing to assist them in accessing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy credit worthiness of the personal information held by usapplicant and/or its sureties. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld)DATE: …………………………………………………… COMPANY STAMP:…………………………………………………. We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess SIGNATURES Authorized signatory Authorized signatory Signature Signature Name and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policy.Title Name and Title Date Date

DECLARATION. I hereby make application for desire to participate, at my own risk, in the premises set out activity described above. I have been informed and fully realize that there are inherent risks and dangers associated with this activity and that injury could result from my participation. However, I knowingly and willingly wish to participate in this form for the day and the times specified in this formactivity. I acknowledge represent that I have read the Xxxxxxx Xxxxx Council Terms will take all safety precautions necessary thereto, assuming sole and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to be responsible full personal responsibility for ensuring that all individuals reasonably foreseeable safety requirements are met to my personal satisfaction prior to my active participation in such activity. I state that I am in good health, physically fit to engage in this activity, and have no known medical condition which could jeopardize my safety during such participation or groups using be aggravated by such participation. As a condition precedent to my being permitted to engage or participate in such activity, I personally hereby forever release, acquit, discharge, indemnify and hold harmless the premises in association with this application shall comply with these Conditions. If the application is made by a corporation or incorporated associationUnited States, the person signing State of North Carolina and their agents, officers, and employees, from any and all causes of action, including personal injury, illness, death, and property damage, costs, charges, claims, demands and liabilities of whatever kind, name or nature in any manner arising out of or in connection with my participation in the form must occupy a position indicated activity. I understand and agree that I may be held liable for any damage or loss to the United States or the State of North Carolina Government that is legally entitled to make an application on behalf caused by my negligence, willful misconduct, or fraud while participating in this activity. Date and Signature of Participant Printed Name of Participant If Participant is under 18 years of age: Signature of Parent or Legal Guardian Printed Name of Parent or Legal Guardian NSSC Match Entry (PRINT) LAST NAME FIRST NAME MI STREET ADDRESS CITY STATE ZIP CODE NRA NUMBER DATE OF BIRTH EMAIL ADDRESS BUTNER, NC DATE LOCATION SIGNATURE OF COMPETITOR CATEGORY (CIRCLE ONE) NAT’L MATCH CS CLASSIFICATION RIFLE MID RANGE CLASSIFICATION RIFLE LONG RANGE CLASSIFICATION RIFLE UNCLASSIFIED SERVICE UNCLASSIFIED ANY/IRON UNCLASSIFIED ANY/IRON HIGH MASTER MATCH HIGH MASTER ANY/ANY HIGH MASTER ANY/ANY MASTER TACTICAL MASTER SERVICE MASTER SERVICE EXPERT EXPERT PALMA EXPERT PALMA SHARPSHOOTER SHARPSHOOTER F/TR SHARPSHOOTER F/TR MARKSMAN MARKSMAN F/O MARKSMAN F/O SENIOR CIVILIAN POLICE RESERVE SERVICE WOMAN NAT’L GUARD JUNIOR CIRCLE CLASS AND RIFLE FOR THE MATCH COURSE OF FIRE NORTH STATE SHOOTING CLUB, INC GENERAL RELEASE OF LIABILITY FORM Data Required by the Privacy Act of 1974 Prescribing Directive: 10 USC 2733, 28 USC 3012, AR 27-20 Authority: Title 10, USC 3012. Principle Purpose: To release the United States Government, Department of the corporation Army, NC National Guard, Camp Butner and their agents and employees from any and all liability arising from or incorporated associationincident to participation in sporting events involving the North State Shooting Club on Camp Xxxxxx. In making this applicationMandatory or volunteer Disclosure and Effect on Individual Not Providing Information: Voluntary; however, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 not provided, participation in such sporting events may be denied. Date Date of Birth Last Name First Name MI Address City State Zip Code E-mail Address Phone Number NRA Number Emergency Point of Contact (QldName) (Print) Phone Number (Area Code). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policy.

DECLARATION. I hereby make the undersigned agree: to utilise any funding from Exmouth Town Council solely in connection with the activity described in this application form. If for any reason the funding is unused it will be repaid at the end of the three-year grant period to keep the appropriate officer of the Council informed of any proposed changes to the activity, the organisation’s manager or changes in contact details to recognise Exmouth Council in any and all literature related to the activity. to provide the Council with information which will enable the Council to monitor achievement of the stated outcomes. I understand that, if successful in my application, my organisation will be required to provide a report for the premises set out in this form for the day and the times specified in this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals or groups using the premises in association with this application shall comply with these ConditionsAnnual Town Meeting. If the activity which this application relates to involves children, young people or vulnerable adults, I confirm that the appropriate CRB checks will have been obtained for all volunteers, staff and management committee members in direct contact with children, young people or vulnerable adults by the date that the funding of the project is due to commence. The application form must be signed by the chairperson of the organisation or someone in a similar position. This should not be the same person as the Main Contact in Section 1. Title: First name(s): Surname: Position within the organisation: Home/business address: Postcode Phone Email Declaration The Council will take your signature on this form as confirmation that you understand the obligations under the Data Protection Act 2018 and the Freedom of Information Act 2000 and that you accept that the Council will not be liable for any loss or damage to you in fulfilment of our obligations under the relevant law. Signature: Position D ate: Application checklist: Please check that you have enclosed A copy of audited accounts and annual report Bank statements covering the last three months A copy of your organisation’s Constitution (if applicable) A copy of your organisation’s Terms of Reference or Articles of Association (If applicable) A copy of the certificates of employer insurance (if applicable) A copy of the public liability insurance A copy of certificates building/contents insurance (if applicable) If your service/activity involves children, young people or vulnerable adults, you are required to verify that DBS checks will have been made by a corporation or incorporated association, the person date that the grant is due to commence by signing the form must occupy a position above Declaration. You are also required to submit the following policies for your organisation: Child Protection Policy and Vulnerable Adult Policy If you have any additional information that is legally entitled you would like to make an application on behalf of the corporation or incorporated association. In making add to this application, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in please attach it to this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policyform.

DECLARATION. I hereby make application / WE confirm having read and understood the work requirements, terms & conditions and all relevant information regarding the tender Notification No - HLL/AFT/PUR/O&M OF B&WP/2020-23 dated 26-08-2020 and agree to abide by all without any deviation from what are stated above and contained therein in the Tender Notification. Place: SIGNATURE Date: Name & Address Seal (in case of society / Organization/Firm) Schedule - F HLL LIFECARE LIMITED (A Government of India Enterprise) AKKULAM PLANT, SREEKARIYAM P.O., THIRUVANANTHAPURAM-695017 HLL/AFT/PUR/O&M OF B&WP/2020-23 26.08.2020 INDEMINITY CLAUSE If the tenderer fails to execute the work as per the requirements mentioned in the Service Order or violates or infringes the existing rates as agreed to as mentioned in the Service Order, the tenderer shall and will indemnify the company against all loses or damages whatsoever to be incurred or sustained including the legal cost or expenses incurred by the company by reason of non-execution of work at agreed Schedules, Operating Procedures and terms & conditions specified in the Tender Document and Service Order. The company will initiate legal action if the tenderer fails to execute the work as per the requirements specified in the tender document and Service Order for the premises set out actual loss suffered. Responsiveness of the Bid shall be at the discretion of HLL. The tenderer shall have no right to change the conditions stipulated in the Tender Document & Service Order. Bid pronounced Non Responsive by HLL shall be summarily rejected. The decision of HLL will be final and no correspondence of this form for the day and the times specified in this formshall be entertained. I acknowledge that I We have read and understood the Xxxxxxx Xxxxx Council Terms above conditions and Conditions agree to abide by the same. PLACE: NAME AND SIGNATURE OF THE APPLICANT DATE: (WITH OFFICE SEAL) Schedule - G HLL LIFECARE LIMITED (A Government of Hire and Emergency Evacuation Procedure. India Enterprise) AKKULAM PLANT, SREEKARIYAM P.O., THIRUVANANTHAPURAM-695017 HLL/AFT/PUR/O&M OF B&WP/2020-23 26.08.2020 DECLARATION I undertake / We am/are fully aware of the statutory obligations to be bound by complied with respect to this offer and comply with these documents in every respect and I further undertake on awarding the work to me/us, I/We will be responsible for ensuring that all individuals or groups using the premises statutory/legal aspects like Labour, cGMP etc. I/We have also fully understood the nature of work and costs involved. The rates quoted by me/us in association with this application shall comply with these Conditionsbid is all inclusive and in case work is awarded, during the period of contract I/We will not claim any upward revision in the rate. If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf SIGNATURE: (Seal of the corporation Tenderer) NAME & ADDRESS OF TENDERER HLL LIFECARE LIMITED (A Government of India Enterprise) AKKULAM PLANT, SREEKARIYAM P.O., THIRUVANANTHAPURAM-695017 Email: xxxxxxxxxxxx@xxxxxxxxxxx.xxx Website: xxx.xxxxxxxxxxx.xxx PH: +00 000 0000000, 0000000 FAX: +00 000 0000000 PRICE BID OPERATION & MAINTENANCE CONTRACT FOR BOILER & WATER PLANT (TENDER NO- HLL/AFT/PUR/O&M OF B&WP/2020-23 Dtd 26/08/2020) AT AKKULAM FACTORY Schedule - H HLL LIFECARE LIMITED (A Government of India Enterprise) AKKULAM PLANT, SREEKARIYAM P.O., THIRUVANANTHAPURAM-695017 HLL/AFT/PUR/O&M OF B&WP/2020-23 26.08.2020 PRICE BID SCHEDULE Name & Address of the Tenderer : ……… …………………………………. ……… …………………………………. ……… …………………………………. ……… …………………………………. The Tenderer shall quote his/her/its competitive rate for engaging labours for carrying out the work mentioned in the tender. The tenderer should essentially understand the Tender conditions and other requirements specified in the Technical Bid. The rate shall include Minimum Wage - including employee contribution of PF & ESI, Other Charges Including Employer’s PF & ESI contributions, accident insurance coverage charges, Bonus, Supervision /Service charges, Goods Service Tax (GST), Income Tax & Other Charges, if applicable and any other payments as per EPF, ESI, Bonus Acts etc or incorporated association. In making this applicationRules applicable, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event rates prevalent. Wage calculation sheets shall also be attached with Price Bid. The tenderer shall submit Electronic Challan cum Return (food vendorsECR) for the previous wage month along with a copy of Challan which bears the bank acknowledgement, amusement ride businesseswhile submission of monthly bills. The ECR shall contain the details of labourers / workmen employed at HLL Lifecare Limited, hire companies etcAkkulam duly highlighted with marker pen". Tenderer shall submit the xxxx on monthly basis and the xxxx shall be prepared based on actual deployment (Attendance) will comply with all requirements of personnel. Separate Xxxx shall be submitted for Ash Removal (Monthly), Quarterly and terms and conditions and they have current licences/certificates and current Public Liability Insurance coverAnnual Maintenance. I declare that the information provided by me in this application is true and correct and I consent Fee & Levies to the making statutory bodies to be paid for the operation of enquiries and exchange Boiler will be borne by HLL. Monthly Xxxx shall be submitted before 5th of information with authorities of any Local, State/Territory or Commonwealth department every month to the officer in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance charge along with the Local Government Act 2009 so that we can assess attendance statement. HLL/AFT/PUR/O&M OF B&WP/2020-23 26.08.2020 PRICE BID FORM OPERATION & MAINTENANCE CONTRACT FOR BOILER & WATER PLANT I MAN POWER COST SL No (A) Description (B) No.of Persons / Day (C) Cost of Manpwer / Day (D) Service Charge / Day (E) Total Manpower Cost / Day (F=C X D) Total Service Charges / Day (G=C X E) Total Cost per Day (H=F+G) I.A Operator 9 I.B TOTAL COST PER MONTH (31 DAYS) I.C TOTAL COST / YEAR (12 MONTHS) II MONTHLY/QUARTERLY/YEARLY MAINTENANCE COST SL No (A) Description (B) No.of Maintenance / Year (C) Cost / Maintenance (D) Total Cost (E = C X D) II.A Ash Removal from Chimney Hood (Twice in a month Basis) 24 Nos II.B Fire Tube Cleaning [Boiler No- 1 & 2] 6 Nos II.C Annual Maintenance Cost [Boiler No- 1 & 2] 2 Nos II.D TOTAL MAINTENANCE COST / YEAR (II.A + II.B + II.C) III SUB TOTAL (II.D + I.C ) V GRAND TOTAL/ANNUM (III + IV) * Service Charges shall remain constant during the entire contract period even if any revision to the existing statutory rates and finalise your applicationany extension to contract. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy PolicyBREAK UP OF COSTING FOR BOILER & WATER PLANTOPERATOR SL No (A) Description (B) Amount per Month per Person (Rs.) (C) I OPERATOR I.A Wages including DA / Day (Shift Duty) I.B Add ESI @ 3.25% I.C Add EPF @ 13.00% I.D Add Bonus @ 8.33%

DECLARATION. I hereby make the undersigned agree: to utilise any funding from Exmouth Town Council solely in connection with the activity described in this application form. If for any reason the funding is unused it will be repaid at the end of the three-year grant period to keep the appropriate officer of the Council informed of any proposed changes to the activity, the organisation’s manager or changes in contact details to recognise Exmouth Council in any and all literature related to the activity. to provide the Council with information which will enable the Council to monitor achievement of the stated outcomes. I understand that, if successful in my application, my organisation will be required to provide a report for the premises set out in this form for the day and the times specified in this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals or groups using the premises in association with this application shall comply with these ConditionsAnnual Town Meeting. If the activity which this application relates to involves children, young people or vulnerable adults, I confirm that the appropriate CRB checks will have been obtained for all volunteers, staff and management committee members in direct contact with children, young people or vulnerable adults by the date that the funding of the project is due to commence. The application form must be signed by the chairperson of the organisation or someone in a similar position. This should not be the same person as the Main Contact in Section 1. Title: First name(s): Surname: Position within the organisation: Home/business address: Postcode Phone Email Declaration The Council will take your signature on this form as confirmation that you understand the obligations under the Data Protection Act 2018 and the Freedom of Information Act 2000 and that you accept that the Council will not be liable for any loss or damage to you in fulfilment of our obligations under the relevant law. Signature: Position D ate: Application checklist: Please check that you have enclosed A copy of audited accounts and annual report Bank statements covering the last three months A copy of your organisation’s Constitution (if applicable) A copy of your organisation’s Terms of Reference or Articles of Association (If applicable) A copy of the certificates of employer insurance (if applicable) A copy of the public liability insurance A copy of certificates building/contents insurance (if applicable) If your service/activity involves children, young people or vulnerable adults, you are required to verify that CRB checks will have been made by a corporation or incorporated association, the person date that the grant is due to commence by signing the form must occupy a position above Declaration. You are also required to submit the following policies for your organisation: Child Protection Policy and Vulnerable Adult Policy If you have any additional information that is legally entitled you would like to make an application on behalf of the corporation or incorporated association. In making add to this application, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in please attach it to this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policyform.

DECLARATION.  I / We hereby make application declare that the particulars given above are correct and complete and no blanks have been left. If the transaction is delayed or not effected at all for the premises set out in this form for the day and the times specified in this formreason of incomplete or incorrect information I / we would not hold Clincher Advisory Services Pvt Ltd responsible.  I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I / We undertake to be bound by revoke the instruction for NEFT in the event of the business relationship expiring and comply with these documents or being ‘terminated’ and further hereby specifically authorize Clincher Advisory Services Pvt Ltd, to do so, for me and on my behalf, in every respect case the revocation communication is not received from me within seven days of expiry and or being termination of relationship.  I / We further undertake to refund, at any time, any excess amount whether demanded by Clincher Advisory Services Pvt Ltd or not, which has been credited to my account [due to any reason] by Clincher Advisory Services Pvt Ltd, in excess of (i) the amount due to me, or (ii) in excess of amount for which I gave mandate, and or (iii) Any other payment.  I / We agree that the payment will be responsible endeavored to be credited starting from the date of next payment cycle and unless the Mandate is revoked by me/us issuance of relevant credit instruction for ensuring electronic payment from Clincher Advisory Services Pvt Ltd into the aforesaid account will be valid discharge to Clincher Advisory Services Pvt Ltd for having paid (i) the amount due to me, or (ii) in excess of amount for which I gave mandate, and or (iii) Any other payment.  I / We further confirm that all individuals we understand this mode as a method of payment introduced by Reserve Bank of India, which provides us an option to receive the amount and or groups using to collect our payments by electronic payment mode directly through my/our bank accounts.  I / We further confirm that I/we understand, Clincher Advisory Services Pvt Ltd, shall make electronic payment to my account by issuing the premises in association Payment instruction electronically through its banker to the Clearing Authority and the Clearing Authority would ensure credit to my/our specified bank account provided hereinabove.  I / We further undertake to inform Clincher Advisory Services Pvt Ltd with an advance notice of 6 weeks, to withdraw from this application shall comply with these Conditionsmode of electronic payment. If the application is made by a corporation or incorporated association I / We further confirm that Clincher Advisory Services Pvt Ltd will have, at its sole discretion, the person signing right to return back to the form must occupy a position that is legally entitled option of paying to make an application me/us by way of cheque if there are more than 2 consecutive failures in remittances for no fault on behalf the side of Clincher Advisory Services Pvt Ltd.  After Clincher Advisory Services Pvt Ltd issuing the corporation Payment instruction electronically through its banker, for whatever reasons, if I/we do not get the credit to my/our account, then same shall neither constitute the default in (i) Payment of amount requested by me, or incorporated association. In making this application(ii) Payment of amount due to me/us, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that or (iii) Any other payment by Clincher Advisory Services Pvt Ltd nor constitute default of any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, Stateagreement/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by MOU/ Claim/Refund/Other contract with me/us. The way  I/ We do hereby give my assent that Clincher Advisory Services Pvt Ltd or its associate companies can use my phone number / email address to notify me about new services, promotional program, and promotional offers or in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policyformations.

DECLARATION. The Declaration is to be agreed and signed by the applicant, who will be the User requiring access to the information for his/her own research needs, and by an appropriate officer (in the Research & Contracts Office, or equivalent) from the organisation from which they will be accessing the UK Data Service Secure Lab. Where there is a research team, each member of the team will need to be an ONS Accredited Researcher/ ESRC Accredited Researcher whose research Purpose has been approved. By signing this Declaration, I, the User, confirm that:  I hereby make application for have read, understood and agreed to the premises set out in this form for the day End user licence agreement available at xxxx://xxxxxxxxxxxxx.xx.xx/media/455131/cd137-enduserlicence.pdf and the times Accredited Researcher Declaration  I have read, understood and agreed to the UK Data Service Licence Compliance Policy available at xxxx://xxxxxxxxxxxxx.xx.xx/media/311391/CD142-LicenceCompliancePolicy.pdf  the accuracy of any information I provide to support my application  I have read and understand the conditions specified in this form. Agreement  I acknowledge that will abide by any other requirements communicated to me by the University relating to the use of potentially disclosive/Personal Information  I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals or groups using the premises in association with this application shall comply with these Conditions. If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf of the corporation or incorporated association. In making this application, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements of the policies and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. operating procedures presented to me in the training session I declare that the Personal Information provided to me shall be kept secure and confidential according to the terms of this Agreement. I understand that:  The University may hold and process information provided submitted by me in this my Accredited Researcher application is true for validation and correct statistical purposes, and for the purposes of the management of the service and may also pass such information to other parties such as data owners and data depositors.  The University reserves the right to scrutinise any analytical outputs, products or publications for disclosure control purposes before publication.  I consent may be liable to criminal prosecution under the Statistics and Registration Service Act 2007 if I disclose Personal Information without the written authority of the ONS.  I and my organisation may be liable to the making Penalties outlined in the UK Data Service Licence Compliance Policy if I disclose Personal Information without the written authority of enquiries and exchange the University.  My lawful use of Personal Information is only for the purposes of statistical research that will serve the public good.  Any information with authorities accessed through the UK Data Service Secure Lab will only be used for the purpose stated in the project application.  I am required to bring directly to the attention of any Local, State/Territory or Commonwealth department in regards to the University any matters relevant or events that may affect my obligations under this declaration.  I am authorised to this applicationaccess Personal Information only when I receive from the University a written confirmation, and only until the end date in that written confirmation. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects User’s signature User’s full name and manages personal information title Organisational address Date I, as organisational signatory, confirm that the User is attached to my organisation and understand that said organisation could be liable to the penalties outlined in the course UK Data Service Licence Compliance Policy in the event of performing its activities, functions and dutiesa breach of this Agreement by the User. We respect the privacy Organisational signature Name of organisational signatory Position of organisational signatory (must be an authorised signatory of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qldorganisation). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policy.

DECLARATION. 4.1 I hereby make application for the premises set out declare that: ⮚ The information given in this application form for is complete and correct. ⮚ I authorise the day Woolyungah Indigenous Centre, University of Wollongong to obtain information from and give information to other organisations, details about myself relevant to the times specified administration of the ITAS program. ⮚ I will notify the Woolyungah Indigenous Centre, University of Wollongong in writing of any changes to the information supplied on this formapplication form within seven (7) days of the change occurring. I acknowledge that I (insert name) have read and understand the Xxxxxxx Xxxxx Council Terms above declaration and Conditions of Hire and Emergency Evacuation Procedure. I undertake hereby agree to be bound by and comply with these documents in every respect and I further undertake it. Signature: Date: (dd/mm/yyyy) / / Note: any queries from students or tutors concerning provisions of, or payment for services described on this form should be made to be the ITAS Coordinator at the Woolyungah Indigenous Centre, University of Wollongong. Woolyungah Indigenous Centre is the University's Centre responsible for ensuring that all individuals or groups using Indigenous student recruitment, access and support ITAS – Indigenous Tutorial Assistance Scheme General Conditions of Agreement General Definitions These general conditions apply to the premises in association with services conducted for the Woolyungah Indigenous Centre (WIC) under Indigenous Tutorial Assistance Scheme (ITAS). On signing this application shall comply with these Conditions. If the application is made by a corporation or incorporated associationGeneral Condition of Agreement document, the person signatory becomes eligible as a tutor with the University of Wollongong (UoW) to provide tutorial services relating to the those agreements from the date of the approval of the agreement until the end of the current calendar year. Tutorial services involve the provision of: ⮚ Tutorial assistance for the student under ITAS, and/or ⮚ Educational assessment of students. Provision of Service I shall provide services set down under the ITAS Tutor Retainer Agreement form and shall: Not provide services before signing this form and not before receiving a ‘Letter of Approval’; Provide the form must occupy a position that is legally entitled to make an application WIC with evidence of my qualifications; Provide proof of identification; Only provide services on behalf of the corporation or incorporated associationWIC while the student(s) remain(s) to the best of their knowledge eligible for ITAS. In making this application, providing tutorial services I confirm all information shall: Provide a program of tuition which develops the students’ skills but which shall not include completing assignments of course work set by the University of Wollongong. Provide the Centre with a written outline of the proposed work program within two weeks of the commencement of tuition. Suspend tuition and notify the Centre when a student is absent from arranged sessions on two consecutive occasions. Submit an ITAS Student Progress Report when requested and agree that the Report may be made available to the ITAS applicant. I understand that the Centre may check the following informati provided is true to it with: Educational institutions – to verify professional qualifications and correct and also to ensure that I am 18not the students’ regular class or subject teacher. By signing Referees to verify written references. Employers to verify work history. Other persons or bodies to verify an experience and/or suitability claimed. Students and/or teachers to ensure acceptability as a tutor. As the Declaration you tutor I understand that: This is a contract for services with the WIC providing tutorial services as an employee of the UoW; Payment will not be made for services which are confirming that any third party contractor operating outside the period of contract stipulated in the Letter of Approval or which are in excess of the agreed number of hours per week; The ITAS Claim Form is to be signed by the student(s) on each occasion of tuition; Payment for tutorial services will be at the rate set out in the Letter of Approval; In the event of a claim for a session where a student(s) was unexpectedly absent, payment may be made for a maximum of one (food vendors, amusement ride businesses, hire companies etc1) hour at the agreed hourly rate; Payment of my service will comply with all requirements be made when the WIC receives my completed ITAS Claim Form which includes the signature of the student(s) involved in each session; I shall not disclose or retain or make public any information or material required or produced during my service without the written approval of the WIC. Varying or extending this agreement shall not be legally binding unless in writing and terms signed by both parties (WIC and conditions and they have current licences/certificates and current Public Liability Insurance coverthe tutor); I am required to cease or vary work upon written notice from the WIC. I declare understand that the information provided by me in this application is true and correct and I consent to the making request for termination or variation of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policymy ITAS contract may occur at anytime.

DECLARATION. I hereby make application for the premises set out in this form for the day and the times specified in this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals or groups using the premises in association with this application shall comply with these Conditions. If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf of the corporation or incorporated association. In making this application, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory Print Name: Position: (if company or Commonwealth department in regards to any matters relevant to this application. Applicant organisation) Signature: DateDated: Print Name: Position: (if company or organisation) Applicant Signature: DateDated: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Information Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages Statement Your personal information in has been collected for the course purpose of performing its activities, functions and dutiesassessing your Application for Approval. We respect The collection of your information is authorised under the privacy of the Local Government Act 2009. You are providing personal information held by uswhich will be used for the purpose of delivering services and carrying out Council business. The way in which the council manages Your personal information is governed by handled in accordance with the Information Privacy Act 2009 (Qld)and will be accessed by persons who have been authorised to do so. We are collecting your personal Your information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required be given to do so by law, any other person or agency unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy PolicyCouncil permission or the disclosure is required by law.

DECLARATION. I  I/We the undersigned in my/our capacity as an authorised representative of the Applicant hereby make application apply for the premises set out extension of credit facilities from Duxbury Transmission Equipment cc trading as Duxbury Networking (the supplier). The following information is submitted as basis for your consideration of my/our application.  I/We hereby certify that the foregoing details are true and correct in this form for the day each and the times specified in this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to notify the SUPPLIER in writing of any change or details shown above including change of ownership, name and address.  By entering into this Agreement you acknowledge and agree that we may provide any registered credit bureau with any details provided by you in your application; and/or details of the conduct of your credit account; and/or details of the transfer of our rights as a credit provider under this Agreement to another person;  I/We consent to Duxbury collecting our Personal information and where lawful and reasonable, from public sources for credit, fraud and compliance purposes  I/We warrant that the Directors/Partners/Proprietor have never been insolvent or associated with any business failure.  I/WE DO HEREBY ACCEPT THE TERMS AND CONDITIONS OF CONTRACT AS SET OUT ABOVE HEREOF WHICH CONDITIONS I ACKNOWLEDGE HAVING READ AND UNDERSTOOD, AND AGREE WILL BE APPLICABLE TO ALL CONTRACTS FOR THE PURCHASE OF GOODS FROM THE SUPPLIER.  I/We acknowledge that should credit facilities be responsible for ensuring that all individuals or groups using the premises in association with granted as a result of this application shall comply with these Conditions. If that they may be withdrawn (and/or altered) by the application SUPPLIER at any time without prior notice, and that the decision of whether or not to grant credit facilities to the PURCHASER is made by a corporation or incorporated association, at the person signing the form must occupy a position that is legally entitled to make an application on behalf sole discretion of the corporation or incorporated associationSUPPLIER. In making this applicationThe credit facilities granted by the SUPPLIER will be advised in writing.  Duxbury agrees and confirms to respect your privacy and will take reasonable measure to protect it.  I/We the undersigned do hereby authorise the Manager of a Recognised Financial Institution to furnish a Director, I confirm all Credit Manager, Administration Manager of DUXBURY TRANSMISSION EQUIPMENT CC with any information provided is true and correct and I am 18. By signing to assist them in accessing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy credit worthiness of the personal information held by usapplicant and/or its sureties. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld)DATE: …………………………………………………… COMPANY STAMP:…………………………………………………. We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess SIGNATURES Authorized signatory Authorized signatory Signature Signature Name and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policy.Title Name and Title Date Date

DECLARATION. Pursuant to 28 U.S.C. § 1746, I hereby make application for declare under penalty of perjury under the premises set out laws of the United States that (i) all the information provided in this form for the day and the times specified in this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals or groups using the premises in association with this application shall comply with these Conditions. If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf of the corporation or incorporated association. In making this application, I confirm all information provided Plaintiff Fact Sheet is true and correct to the best of my knowledge; (ii) that I have supplied all the documents requested in Section VII above to the extent that such documents are in my possession, custody, or control, or in the possession, custody, or control of my lawyers; and (iii) that I am 18have supplied the authorizations attached to this declaration. By signing Date: Signature: Printed Name: Location: Exhibit A AUTHORIZATION FOR RELEASE OF INSURANCE RECORDS To: Name Address City, State and Zip Code This will authorize you to furnish copies of all forms regarding insurance claims applications and benefits and all medical, health, hospital, physicians, nursing or allied health professional reports, records, notes or invoices and bills, which may be in your possession. Name of Insured whose date of birth is and whose social security number is: You are authorized to release the Declaration above records to the following representatives of defendants in the above-entitled matter, who have agreed to pay reasonable charges made by you to supply copies of such records. Litigation Management Inc., Name of Representative Third Party Record Requestor Representative Xxxxxxxx (e.g., attorney, records requestor, agent, etc.) PO Box 241370 Street Address Cleveland, OH 44124 City, State and Zip Code This authorization does not authorize you to disclose anything other than documents and records to anyone. This authorization shall be considered as continuing in nature and is to be given fuli force and effect to release information of any of the foregoing learned or determined after the date hereof, if is expressly understood by the undersigned and you are confirming that any third party contractor operating at authorized to accept a copy or photocopy of this authorization with the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licencessame validity as through the original had been presented to you. Name/certificates and current Public Liability Insurance coverSignature Date Exhibit B MEDICARE AUTHORIZATION FORM **ALL SECTIONS REQUIRED** SECTION A: BENEFICIARY INFORMATION Enter beneficiary name as it appears on Medicare card. I declare that the information provided by me in this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print First Name: Position: (if company or organisation) Applicant Signature: Date: Print Middle Name: PositionLast Name: Date of Birth (if company or organisationmm/dd/yyyy) Xxxxxxx Xxxxx Council – Privacy Collection NoticeMedicare Identification Number: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policy.Address: City: State: Zip code:

DECLARATION. I i 1. I/We hereby make application for declare that the premises set out in this form for the day and the times specified in this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals or groups using the premises in association with this application shall comply with these Conditions. If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf of the corporation or incorporated association. In making this application, I confirm all information provided is details furnished above are true and correct to the best of my/our Account Opening Form knowledge and I am 18belief and I/We undertake to inform you of any changes therein immediately. By signing In case any of the Declaration you above information is found to be false or untrue or misleading or misrepresent I/We am/are confirming aware that I/We held liable for it. 2. I/We undertake to provide all the disclosures as required under SEBI (Prohibition of Xxxxxxx Xxxxxxx) Regulations, 2015, Prevention of Money-Laundering Act, 2002 as amended from time to time or any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licencesother Act/certificates and current Public Liability Insurance coverRegulations. I 3. I/We hereby declare that the information provided amount given/to be given by me in this application is true and correct and I consent me/us to the making Portfolio Manager for investing on my/our behalf is derived through legitimate sources and is not held or designed for the purpose of enquiries and exchange of information with authorities contraventions of any Localact, Staterules, regulations or any status or legislation including Prevention of Money – Laundering Act, 2002 or any other applicable laws or any notifications, directions issued by any Government statutory authority from time to time. 4. I/Territory We hereby request you to treat the proceeds of the Demand Draft/Xxxxxx’s Cheque/Third Party Cheque or Commonwealth department funds/securities transfer, if any, as proceed from my/our behalf. I/We agree to indemnify PRP Edge Wealth Advisors Private Limited PMS in regards the event of any claim/loss by PRP Edge Wealth Advisors Private Limited due to any matters relevant to this applicationthis. Applicant SignatureDeclaration from NRI Client (in case applicable): I/We confirm that I am/We are Non-Resident Indian Nationality/Origin and I/We hereby confirm that the funds or subscription have been remitted from abroad through normal banking channels or from funds in my/our Non-Resident External/Ordinary Account/FCNR Account. Place: ✍ Date: Print NameSignature of Clients/ (all) Authorized Signatory (ies) FOR OFFICE USE ONLY Introducer/Distributor Details: PositionMr./ Ms./ M/s. Signature & Seal ✍ Address: Account Opening Form PORTFOLIO MANAGEMENT SERVICES AGREEMENT BETWEEN PRP EDGE WEALTH ADVISORS PVT LTD. AND Client’s Name Page 12 of 53 _. Account Opening Form DISCRETIONARY / NON-DISCRETIONARY PORTFOLIO MANAGEMENT AGREEMENT i This Discretionary / Non-Discretionary Portfolio Management Agreement (if company hereinafter referred to as “the Agreement”) is made at on this day of , 20 by and between PRP Edge Wealth Advisors Pvt Ltd. (PRP), a Private Limited Company incorporated under the Companies Act, 1956 and having its registered office at 000, 0xx Xxxxx, Xxxx Xxxx Xxxxxx, Xxxxxxxx Xxxx, Xxxxxx - 00-00, Xxxxxxxx - 000000, Xxxxxxx, Xxxxx and principal place of business at 000, 0xx Xxxxx, Xxxx Xxxx Xxxxxx, Xxxxxxxx Xxxx, Xxxxxx - 00-00, Xxxxxxxx - 000000, Xxxxxxx, Xxxxx (hereinafter referred to as "the Portfolio Manager" or organisation“the Company” which expression shall include, unless repugnant to or inconsistent with the subject or context thereof, its successors and assigns) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policy.ONE PART; AND

DECLARATION. I hereby make application for declare that I am resident of India; my age is more than 18 years as on date. I am legally qualified to do any Business or Agreement or Declaration in India. I am neither convicted under any criminal law nor is any litigation pending against me. I have read and understood all the premises set out terms and conditions given in this form for the day and the times specified in this application form. I acknowledge also confirm that I know my sponsor and have read full faith in him / her. My sponsor has explained me all the Xxxxxxx Xxxxx Council details about the company (including Company Profile, Products and Services of the Company, Suncity Solar Compensation Plan and Company Policies) in my vernacular language and I have confirmed by receiving One Time Password (OTP) only after understanding all the Terms and Conditions Conditions. The Personal details mentioned above are true and provided and approved by me. In case some information is not available as of Hire and Emergency Evacuation Procedurenow, I assure to update the same later. I undertake am buying the goods or services after being satisfied thoroughly with the contents and claims thereof and here by indemnify “Company” and its “Directors” and “employees” harmless of any claims what so ever arising out of any actions overt and covert attributed to be bound by and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals me or groups using the premises in association with this application shall comply with these Conditionsmy team members. If the application is made by As a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf of the corporation or incorporated association. In making this applicationsponsor (Referral above), I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I hereby declare that the Applicant(s) is known to me. I take responsibility for the fact that the Applicant(s) has applied for the Solar Advisor/Distributorship of Shree Chandramangal Suncity Marketing Private Limited only after he / she has read & understood all the Terms & Conditions. I have explained him / her all the details about the company (including Company Profile, Products and Services of the Company, Suncity Solar Compensation Plan and Company Policies) in his / her vernacular language. I reconfirm that all the information provided and declaration given by me in this application is true the applicant are true. I recommend that Shree Chandramangal Suncity Marketing Private Limited may accept the Application of the Applicant(s) for Solar Advisor/Distributorship of its Products and correct Services I along with the applicant hereby also declare and I consent committed to maintain the making decorum of enquiries and exchange of information with authorities the company. In case the company management feel any abusive language malpractices false commitment, unreasonable appearances or violation of any Localrules and regulation let by the company. In such case the company reserves the sole right to take the disciplinary action which includes Suspension/Blocking/Freeze/Termination of this E- Contract Agreement as direct selling agreement and company shall have the right to file appropriate civil and criminal proceedings against me as the case may be. IN TOKEN OF HIS/HER AGREEING TO AND ACCEPTING ALL PROVISIONS OF THIS CONTRACT AGREEMENT SET HEREIN ABOVE, StateHE/Territory or Commonwealth department in regards to any matters relevant to this applicationSHE IS CLICKING ON THE “I AGREE” BUTTON GIVEN HEREIN. Applicant Signature: Date: Print I AGREE& ACCEPT Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course S/O Shri Resident of performing its activities, functions and dutiesBank A/C No/_ IFSC Code Pin Code State PA NO._ AANDHAR NO. We respect the privacy _ Name of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policy.Bank & Branch AGREE ACCEPT & NODAL OFFICER M/S_ ADDRESS

DECLARATION. I hereby make the undersigned agree: to utilise any funding from Exmouth Town Council solely in connection with the activity described in this application form. If for any reason the funding is unused it will be repaid at the end of the three-year grant period to keep the appropriate officer of the Council informed of any proposed changes to the activity, the organisation’s manager or changes in contact details to recognise Exmouth Council in any and all literature related to the activity. to provide the Council with information which will enable the Council to monitor achievement of the stated outcomes. I understand that, if successful in my application, my organisation will be required to provide a report for the premises set out in this form for the day and the times specified in this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals or groups using the premises in association with this application shall comply with these ConditionsAnnual Town Meeting. If the activity which this application relates to involves children, young people or vulnerable adults, I confirm that the appropriate CRB checks will have been obtained for all volunteers, staff and management committee members in direct contact with children, young people or vulnerable adults by the date that the funding of the project is due to commence. The application form must be signed by the chairperson of the organisation or someone in a similar position. This should not be the same person as the Main Contact in Section 1. Title: First name(s): Surname: Position within the organisation: Home/business address: Postcode Phone Email Declaration The Council will take your signature on this form as confirmation that you understand the obligations under the Data Protection Xxx 0000 and the Freedom of Information Xxx 0000 and that you accept that the Council will not be liable for any loss or damage to you in fulfilment of our obligations under the relevant law. Signature: Position Date: Application checklist: Please check that you have enclosed A copy of audited accounts and annual report Bank statements covering the last three months A copy of your organisation’s Constitution (if applicable) A copy of your organisation’s Terms of Reference or Articles of Association (If applicable) A copy of the certificates of employer insurance (if applicable) A copy of the public liability insurance A copy of certificates building/contents insurance (if applicable) If your service/activity involves children, young people or vulnerable adults, you are required to verify that CRB checks will have been made by a corporation or incorporated association, the person date that the grant is due to commence by signing the form must occupy a position above Declaration. You are also required to submit the following policies for your organisation: Child Protection Policy and Vulnerable Adult Policy If you have any additional information that is legally entitled you would like to make an application on behalf of the corporation or incorporated association. In making add to this application, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that the information provided by me in please attach it to this application is true and correct and I consent to the making of enquiries and exchange of information with authorities of any Local, State/Territory or Commonwealth department in regards to any matters relevant to this application. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policyform.

DECLARATION. I/ we hereby declare that I/we have made myself/our selves thoroughly conversant with the local conditions regarding all materials such as stones,murum,sand etc and labour on which I/we have based my /our rates for this Work. The specification ,lead & lift for this work have been carefully studied and understood by me before submitting the tender. I/we undertake to use only the best material approved by the Engineer- in- charge or his duly representative before starting the work and to abide by his decision. I/We shall maintain /rectify the entire work as per as per standard specification of P.W.D (Red Book ) and X.X.X X and .H specification as soon as damage occurs up to the expiry defect liability period without putting forth any reasons. I hereby make application for the premises set out in this form for the day and the times specified in this form. I acknowledge that I have read the Xxxxxxx Xxxxx Council Terms and Conditions of Hire and Emergency Evacuation Procedure. I undertake to be bound by pay the labourers engaged on the work as per Maharashtra Contract Labour (Regulation and comply with these documents in every respect and I further undertake to be responsible for ensuring that all individuals Abolition rule 1971) or groups using the premises in association with this application shall comply with these Conditions. If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf of the corporation or incorporated association. In making this application, I confirm all information provided is true and correct and I am 18. By signing the Declaration you are confirming that any third party contractor operating at the event (food vendors, amusement ride businesses, hire companies etc) will comply with all requirements and terms and conditions and they have current licences/certificates and current Public Liability Insurance cover. I declare that rate revised by the information provided by me in this application is true and correct and I consent Competent Authority time to time applicable to the making zone concerned. CONTRACTOR'S SIGNATURE. FORM - 1 LIST OF MACHINERY AVAILABLE WITH TENDERER WHICH WILL BE USED ON THIS WORK Sr. No. Name of enquiries and exchange Equipment No. of information Unit Kind of Make Capacity Age of machinery Present Conditions Present location with authorities name & address of any Local, State/Territory or Commonwealth department in regards organisation where machinery under use at present Whether machinery is hypothecated to any matters relevant to division / Bank or other institution etc. Remarks NAME OF TENDERER :- NAME OF WORK;- Construction of POLICE STATION BUILDING AND RESIDENTIAL QUARTERS AT AROLI TALUKA MOUDA DIST NAGPUR Notes :- The above machineries are readily available with me / us for use on this applicationwork Contractors :- Name :- Address :- FORM - 2 LIST OF TECHNICAL PERSONNEL OF THE TENDERER LIKELY TO BE APPOINTED ON THIS WORK NAME OF TENDERER :- NAME OF WORK;- Construction of POLICE STATION BUILDING AND RESIDENTIAL QUARTERS AT AROLI TALUKA MOUDA DIST NAGPUR Sr. Applicant Signature: Date: Print Name: Position: (if company or organisation) Applicant Signature: Date: Print Name: Position: (if company or organisation) Xxxxxxx Xxxxx Council – Privacy Collection Notice: Xxxxxxx Xxxxx Council collects and manages personal information in the course No. Designation Name Qualification Professional Experience of performing its activities, functions and duties. We respect the privacy of the personal information held by us. The way in which the council manages personal information is governed by the Information Privacy Act 2009 (Qld). We are collecting your personal information in accordance with the Local Government Act 2009 so that we can assess and finalise your application. Generally, we will not disclose your personal information outside of Council unless we are required to do so by law, or unless you have given us your consent to such disclosure. For further information about how we manage your personal information please see our Information Privacy Policy.work carried out Remarks