COMPANY NAME The Members may change the name of the Company or operate under different names, provided a majority of the Members agree and the name complies with Section 00-00-000 of the Act.
Print Name Designation ...................................
CONTRACT NAME The name of this contract is Prepaid Mental Health Plan - Four Corners Community Behavioral Health Inc.
Project Name Register ASIC
Full Name Position: ................................................ Position: ................................................ Date: ..................................................... Date: .....................................................
Account Name The Grant will be paid in instalments by the Commonwealth in accordance with the agreed Milestones, and compliance by the Grantee with its obligations under this Agreement.
FULL NAME OF AGREEMENT The full name of this Agreement is the PDL NPDL/PFLG Slot Charter Agreement ("Agreement").
Name and address of the contractor concessionaire X. X. Xxxxxx & Sons Ltd (appointed to Lot 0) 000 Xxxxxxxxx Xxxx Barnsley S70 1UG Country United Kingdom NUTS code UKE - Yorkshire and the Humber Internet address xxxxx://xxx.xxxxxxxxxxxxxxx.xx.xx/ The contractor/concessionaire is an SME Yes
Name of Xxxxx(s) 2. The named person's role in the firm, and
Contractor Name Business License #: Address: City, State, Zip Code: Telephone: Facsimile: Email: * If you are an independent contractor you are required to obtain a business license with the City of Thousand Oaks. Contractor certifies under penalty of perjury that Contractor is a Sole Proprietor Corporation Limited Liability Company Partnership Nonprofit Corporation Other [describe: ]