Expansion States. If Vendor agreed to extend its PEPPM bid pricing to other states via the State Selection Form, those extensions will continue through December 31, 2022 unless modified by an amendment to the State Selection Form. GSI4 use only: Xxx Xxxxxxxx Witness Print Names Above: GLWTR♙L S4SQ4LH♙WW♙ IWνLRNLDI♙νL 4WIν By Xxxx Xxxxxxx CSIU Executive Director Date: _gu _st 19,202 1_ __ Date: August19,2021 [signatures continued on following page] Vendor Name (if corporation) Xxxx Xxxxxxxx Corporate Secretary (or designee) Sr. VP of Finance and Administration Designee Title (If not Corporate Secretary) Print Names Above: HATCH, Inc. By Xxxxx Xxxxxx Corporate Presťdent (or designee) Desťgnee Title (If not Corporate President) Signature Date: 7/20/2021 _ Vendor Name (if unincorporated) Witness TitLe Print Names Above: Signature Date: _ By Owner Designee Title (If not Owner) Signature
Appears in 1 contract
Samples: www.peppm.org
Expansion States. If Vendor agreed to extend its PEPPM bid PEPPMbid pricing to other states via the State Selection Form, those extensions will continue through December 31, 2022 unless modified by an amendment to the State Selection Form. GSI4 use only: Xxx Xxxxxxxx Witness Print Names Above: GLWTR♙L S4SQ4LH♙WW♙ IWνLRNLDI♙νL 4WIν By Xxxx Xxxxxxx CSIU Executive Director Date: _gu _st 19,202 1_ __ Date: August19,2021 [signatures continued on following page] Vendor Name (if unincorporated) By Owner __ Designee Title (If not Owner) Witness Title Print Names Above: Signature Signature Date: _ ____ _ Date: --------------- Vendor Name (if corporation) Xxxx Xxxxxxxx Corporate Secretary (or designee) Sr. VP of Finance and Administration Designee By ___,,,2-.-,-a-'-�'-.�-��lfi��· Corporate President (or designee) Designẹe Title (If not Corporate Secretary) Print Names Above: HATCH, Inc. By Xxxxx Xxxxxx Corporate Presťdent (or designee) Desťgnee Designee Title (If not Corporate President) Signature Date: 7/20/2021 _ Vendor Name (if unincorporated) Witness TitLe Print Names Above: Signature Date: _ By Owner Designee Title (If not Owner) Signaturefi.C � !� „& .,.,>' ÅR.ORATS SSAL)
Appears in 1 contract
Samples: Vendor Agreement
Expansion States. If Vendor agreed to extend its PEPPM bid pricing to other states via the State Selection Form, those extensions will continue through December 31, 2022 unless modified by an amendment to the State Selection Form. GSI4 use only: Xxx Xxxxxxxx Witness Print Names Above: GLWTR♙L S4SQ4LH♙WW♙ IWνLRNLDI♙νL 4WIν By Xxxx Xxxxxxx CSIU Executive Director Date: _gu _st 19,202 1_ __ Date: August19,2021 [signatures continued on following page] Vendor Name (if corporation) Xxxx Xxxxxxxx Corporate Secretary (or designee) Sr. VP of Finance and Administration By Corporate President (or designee) Designee Title ({If not Corporate Secretary) Print Names Above: HATCH, Inc. By Xxxxx Xxxxxx Corporate Presťdent (or designee) Desťgnee Designee Title ({If not Corporate President) Print Names Above: Signature Signature (CORPORATE SEAL) Date: 7/20/2021 _ Date: Vendor Name (if unincorporated) Witness TitLe Print Names Above�e 1rv\ be\.. Sec,,01 "(.-� So \0·h0ns I LLC t By_ D Owner ___:e b : Signature Date: _ By Owner Designee Title (If not Owner) Signature�_Ot __;
Appears in 1 contract
Samples: Vendor Agreement
Expansion States. If Vendor agreed to extend its PEPPM bid pricing to other states via the State Selection Form, those extensions will continue through December 31, 2022 unless modified by an amendment to the State Selection Form. GSI4 use only: Xxx Xxxxxxxx Witness Print Names Above: GLWTR♙L S4SQ4LH♙WW♙ IWνLRNLDI♙νL 4WIν By Xxxx Xxxxxxx CSIU Executive Director Date: _gu _st 19,202 1_ __ Date: August19,2021 [signatures continued on following page] Vendor Name (if corporation) Xxxx Xxxxxxxx Corporate Secretary (or designee) Sr. VP of Finance and Administration Designee Title (If not Corporate Secretary) Print Names Above: HATCH(CORPORATE SEAL) Date: 7 - \ ci - 0\�\ By &cc}!f,,.EL ::&, Inc. By Xxxxx Xxxxxx \bN_ Corporate Presťdent President (or designee) Desťgnee Designee Title (If not Corporate President) Signature Date: 7/20/2021 _ _J-___._{-=Z'----=2 1 Vendor Name (if unincorporated) Witness TitLe Print Names Above: Signature Date: _ By Owner Designee Title (If not Owner) SignatureWitness Title Print Names Above:
Appears in 1 contract
Samples: Vendor Agreement