Financial/Insurance. The Contractor must insure the risk of the Contract based upon the Contractor’s ability (size and financial reserves included) to survive a series of adverse experiences, including withholding of payment by the Division, or imposition of liquidated damages by the Division.
Financial/Insurance. 2.1.1 Return or reimburse NCT9-1-1 any 9-1-1 funds used in noncompliance with applicable laws and/or rules within 60 days after the discovery of noncompliance and notice to the Public Agency of such noncompliance, unless an alternative repayment plan is approved, in writing, by both parties.
Financial/Insurance. 1. I understand that I am responsible for all charges incurred and that services must be paid in full at the time of visit unless other arrangements have been made in advance. If for any reason my insurance does not pay for these services, I understand that I am responsible for all charges. Should my account be referred to an attorney or collection agency for collection, the undersigned shall pay the attorney fees and collection expenses. (Initial)
2. By my signature below, I hereby certify that the information given on the Intake Form is correct. I give permission for Xxxx Xxxxxx to provide information concerning my diagnosis, treatment or prognosis as may be requested by an insurance company or attorney. The insurance company is instructed to pay Xxxx Xxxxxx directly for all professional services rendered on my behalf. This instrument is an assignment of my rights to the extent of the fees for services and in cases of attorney representation, directs the attorney to withhold from settlement, judgment or verdict, such sums as my be necessary to pay these fees. All sums paid under the assignment are to be credited directly to my account. A photocopy of this assignment may serve as the original.
3. Co-pays are due at the end of each session.
Financial/Insurance a) Provide information regarding your financial status, including but not limited to:
1) 10K’s and 10Q’s equivalent information for not less than the previous 3 years.
2) Other financial reports for not less than the previous 3 years.
3) Audited Financial Statements of the offeror (not parent or holding company) including all footnotes and disclosures for not less than the previous 3 years.
4) Material changes in business operations (i.e. whether your firm has been involved in any bankruptcy proceedings, mergers, or acquisitions) for not less than the previous 3 years.
5) Outstanding financial arrangements (i.e. corporate guarantees, affiliations, partnerships or joint ventures). 6) Intent, source and methods of financing operation expenses.
b) Provide a description of your firm’s comprehensive liability, property damage, bodily injury, liquor liability, auto liability, and workers compensation insurance coverage, and note the ability to name the City of Xxxxxxxxx as an additional insured on each such policy.
Financial/Insurance. I understand that I am responsible for all charges incurred and that services must be paid in full at the time of visit unless other arrangements have been made in advance. If for any reason my insurance does not pay for these services, I understand that I am responsible for all charges. Should my account be referred to an attorney or collection agency for collection, the undersigned shall pay the attorney fees and collection expenses. ___ (Initial)
Financial/Insurance. Insurance provided by the Consultant Three (3) years audited financial statements
