INSURANCE DISCLOSURE. I am aware that my local Pop Warner organization carries group accident insurance which is considered secondary or excess for medical purposes to any and all valid insurance I possess is considered primary insurance. Furthermore, I agree to notify in writing my head coach and local Pop Warner organization of any medical claim as a result of participation in Xxx Xxxxxx as soon as reasonably possible. I understand that any registration fee paid does not constitute a direct premium for insurance and that a deductible(s) may apply.
INSURANCE DISCLOSURE. The attached terms and conditions contain provisions related to liability and indemnification, and should be carefully considered by the interconnection customer. The interconnection customer is not required to obtain general liability insurance coverage as a precondition for interconnection approval; however, the interconnection customer is advised to consider obtaining appropriate insurance coverage to cover the interconnection customer’s potential liability under this agreement.
INSURANCE DISCLOSURE. The attached terms and conditions contain provisions related to liability and indemnification, and should be carefully considered by the interconnection customer. The interconnection customer shall carry general liability insurance coverage, such as, but not limited to, homeowner's insurance. Whenever possible, the interconnection customer shall name the EDC as an additional insured on its homeowner's insurance policy, or similar policy covering general liability.
INSURANCE DISCLOSURE. The obligations of the provider under this Agreement are covered by a policy of insurance issued by MIC Property and Casualty Insurance Corporation, Executive/Administrative Offices: 000 Xxxxxxxx Xxxxxxxxxx, Xxxxx 000, Xxxxxxxxxx, XX 00000. In the event the provider does not pay any CLAIM or make any refund or consideration due, including the return of any unearned provider fee, within thirty (30) days after proof of loss has been filed or the provider ceases to do business or goes bankrupt, YOU may apply directly to MIC Property and Casualty Insurance Corporation for the protection afforded by this Agreement at 0-000-000-0000, Monday through Friday, 8:00 a.m. to 5:00 p.m. local time.
INSURANCE DISCLOSURE. The obligations of the provider under this Agreement are covered by a policy of insurance issued by MIC Property and Casualty Insurance Corporation, Executive/Administrative Offices: 000 Xxxxxxxx Xxxxxxxxxx, Xxxxx 000, Xxxxxxxxxx, XX 00000. In the event the provider does not pay any CLAIM or make any refund or consideration due, including the return of any unearned provider fee, within thirty (30) days after proof of loss has been filed or the provider ceases to do business or goes bankrupt, YOU may apply directly to MIC Property and Casualty Insurance Corporation for the protection afforded by this Agreement at 0-000-000-0000. State Disclosure The following is provided in accordance with RSA 415-C:6(h) of the New Hampshire Revised Statutes. In the event you do not receive satisfaction under this contract, you may contact the New Hampshire Insurance Department at the following address and telephone number: New Hampshire Insurance Department 00 Xxxxx Xxxxx Xxxxxx Concord, NH 03301 Telephone number (000) 000-0000 New Mexico Exception Language
INSURANCE DISCLOSURE. The attached terms and conditions contain provisions related to liability and indemnification, and should be carefully considered by the interconnection customer. The interconnection customer is not required to obtain general liability insurance coverage as a precondition for interconnection approval; however, the interconnection customer is advised to consider obtaining appropriate insurance coverage to cover the interconnection customer’s potential liability under this agreement. Customer Signature I hereby certify that: 1) I have read and understand the terms and conditions which are attached hereto by reference and are a part of this Agreement; 2) I hereby agree to comply with the attached terms and conditions; and 3) to the best of my knowledge, all of the information provided in this application request form is complete and true. I consent to permit the PSC and interconnecting utility to exchange information regarding the generating system to which this application applies. Interconnection Customer Signature: __________________________________ Title: Date:____________________ …………………………………………………………………………………………………… Conditional Agreement to Interconnect Small Generator Facility Receipt of the application fee is acknowledged and, by its signature below, the EDC has determined the interconnection request is complete. Interconnection of the small generator facility is conditionally approved contingent upon the attached terms and conditions of this Agreement the return of the attached Certificate of Completion duly executed, verification of electrical inspection and successful witness test or EDC waiver thereof. EDC Signature: ____________ Date: Printed Name:___________________________Title:___________________________ Terms and Conditions for Interconnection Construction of the Small Generator Facility. The Interconnection Customer may proceed to construct (including operational testing not to exceed 2 hours) the Small Generator Facility once the Conditional Agreement to Interconnect a Small Generator Facility on the preceding page has been signed by the EDC.
INSURANCE DISCLOSURE. Attorney does maintain errors and omissions insurance coverage applicable to the services rendered.
INSURANCE DISCLOSURE. Within 30 days after the date of this Agreement Dime shall prepare and deliver to Washington Mutual a schedule setting forth the following information as of a date not more than 15 days prior to such date of delivery: a true and complete list and a brief description (including name of insurer, agent, coverage and expiration date) of all insurance policies in force with respect to the business and assets of Dime and its Subsidiaries (other than insurance policies under which Dime or any Subsidiary thereof is named as a loss payee, insured or additional insured as a result of its position as a secured lender on specific loans and mortgage insurance policies on specific loans).
INSURANCE DISCLOSURE. Attorney meets the criteria for errors and omissions (malpractice) coverage set forth in Business and Professions Code Section 6147. Attorney does not meet any of the criteria for errors and omissions (malpractice) coverage set forth in Business and Professions Code Section 6147.
INSURANCE DISCLOSURE. The attached terms and conditions contain provisions related to liability and indemnification, and should be carefully considered by the interconnection Member. The interconnection Member shall carry general liability insurance coverage, such as, but not limited to, homeowner's insurance. Whenever possible, the interconnection Member shall name the Cooperative as an additional insured on its homeowner's insurance policy, or similar policy covering general liability. Member Signature Memberr Signature: Title: Date: I hereby certify that: (1) I have read and understand the terms and conditions which are attached hereto by reference; (2) I hereby agree to comply with the attached terms and conditions; and (3) to the best of my knowledge, all of the information provided in this application request form is complete and true.
