Main Contact. The Convener will serve as the main contact. Union County Commissioner Xxxx Xxxxxxxx is the main contact, with Xxxxx Xxxxxxx, County Planning Director, assisting in this effort.
Main Contact. This is the person who should be contacted with questions regarding the agency (only 1 name is necessary). Name: Phone: Email: Fax: Appointed Agent: 220 licensed agent who will be appointed by Avatar (only 1 is necessary). Name: Phone: Email: License Number: (Include a copy of the 220 License) Additional Usernames Requested: any other CSR or Agent who will be quoting and would like their own login information (there is no limit to how many users you can have, but only 1 is necessary). Name: Phone: Email: Name: Phone: Email: Name: Phone: Email: Name: Phone: Email: PRODUCER AGREEMENT This Producer Agreement, hereinafter referred to as “Agreement” is made this day of , 20 by and between: Producer Name License Number Producer Address Telephone No. Facsimile No. E-Mail Herein after referred to as “Producer” and Avatar Property & Casualty Insurance Company, which has their Administrative offices at 0000 X. Xxxxxxxxxx Xxx. Tampa, FL 33602 and are hereinafter referred to as “Company”. In consideration of the foregoing and the mutual covenants and promises contained herein, the parties agree as follows:
Main Contact. The following individual will be the main representative of Institution for purposes of this Agreement, providing guidance and direction in operational and service matters: Name: Company: Street Address: City: State: Post Code: Country: Phone: Fax: Email: Technical Contact. The following individual will be the representative of the Institution for general technical matters and information. Name: Company: Street Address: City: State: Post Code: Country: Phone: Fax:
Main Contact. Name: ...........................................................................................................................................................................................
Main Contact. Admin. User □ User □ Phone: Fax: Email Address: Other Contact: Admin. User □ User □ Phone: Fax: Email Address: Other Contact: Admin. User □ User □ Phone: Fax: Email Address: Certification Describe the specific purpose(s) for which credit will be used: Subscriber certifies that it is not a(n): Attorney (other than those whose sole purpose is to use credit information for rental purposes), Bail Bond company ; Credit Repair company (including credit counseling and credit clinics) ; Check Cashing company; Dating service; Genealogical research firm; Investigative company (including private investigators or detective agencies); Financial counseling; massage services; Insurance claim service; News Agency or Journalist; Law Enforcement; pawnshop; asset or children location service; tattoo service. Subscriber certifies that it is the END USER and WILL NOT resell reports under any circumstances. Signature I certify that the information above is true and accurate. I further certify that I am authorized to sign on behalf of the company. Subscriber’s Name: Title: Signature: Date: FCRA Requirements Federal Fair Credit Reporting Act (as amended by the Consumer Credit Reporting Reform Act of 1996) Although the FCRA primarily regulates the operations of consumer credit reporting agencies, it also affects you as a user of information. We suggest that you and your employees become familiar with the following sections in particular: § 604. Permissible Purposes of Reports § 607. Compliance Procedures § 615. Requirement on users of consumer reports § 616. Civil liability for willful noncompliance § 617. Civil liability for negligent noncompliance § 619. Obtaining information under false pretenses § 621. Administrative Enforcement § 623. Responsibilities of Furnishers of Information to Consumer Reporting Agencies § 628. Disposal of Records Each of these sections is of direct consequence to users who obtain reports on consumers. As directed by the law, credit reports may be issued only if they are to be used for extending credit, review or collection of an account, employment purposes, underwriting insurance or in connection with some other legitimate business transaction such as in investment, partnership, etc. It is imperative that you identify each request for a report to be used for employment purposes when such report is ordered. Additional state laws may also impact your usage of reports for employment purposes. We strongly endorse the letter and spirit of the Federal Fair ...
Main Contact. Claire CIO XXX@XxxxxxXx.xxx The Main Contact is the Customer contact for onboarding, who receives the confirmation that the order has been processed (which includes the confirmed Start Date). If current contact is inaccurate, please correct here: Main Contact corrected name: Main Contact corrected email: Technical Administrator: Xxxx SysAdmin Xxxx@XxxxxxXx.xxx The Technical Administrator is the main contact for technical and system related communications. If current contact is inaccurate, please correct here: Technical Administrator corrected name: Technical Administrator corrected email: Please provide a Financial Contact - The Financial Contact acts as the main Customer contact for finance related communication including invoicing. Customer Financial Contact name: Alex Accountant Customer Financial Contact email: Xxxx@XxxxxxXx.xxx 5. CUSTOMER LOCATION Customer has provided the following primary access location: Sample Co. 000 Xxxxx Xxxxxx Xxxxxxxx, XX 00000
Main Contact. Anika Therapeutics: Name: Xxxxx Xxxxxxx Title: Vice President - Operations Telephone: 000-000-0000 FAX: 000-000-0000 e-mail: xxxxxxxx@xxxxxxxxxxxxxxxxx.xxx CERTAIN CONFIDENTIAL PORTIONS OF THIS EXHIBIT WERE OMITTED AND REPLACED WITH “[***]”. A COMPLETE VERSION OF THIS EXHIBIT HAS BEEN FILED SEPARATELY WITH THE SECRETARY OF THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO AN APPLICATION REQUESTING CONFIDENTIAL TREATMENT UNDER RULE 24b-2 OF THE SECURITIES EXCHANGE ACT OF 1934.
