Owner’s Name. (In the event accreditation is granted, the entity that owns and operates the Facility) Owner’s Main Business Address: Owner’s Representative Name & Title: (Should be the person for day-to-day contact and does not need to be the signee of the Agreement.) Private (non-governmental) Facility? Yes No Governmental Facility? Yes No Federal Tax ID: Facility and the Intersocietal Accreditation Commission, Inc. (IAC) agree as follows: Application Category Facility requests accreditation in the category(-ies) indicated below (check all that apply): Extracranial Cerebrovascular Testing Intracranial Cerebrovascular Testing Peripheral Arterial Testing Peripheral Venous Testing Visceral Vascular Testing Screening Superficial Venous Treatment and Management Adult Transthoracic Echocardiography Adult Transesophageal Echocardiography Adult Stress Echocardiography Pediatric Transthoracic Echocardiography Pediatric Transesophageal Echocardiography Fetal Echocardiography Nuclear Cardiology, Myocardial Perfusion Imaging Nuclear Cardiology, Equilibrium Radionuclide Angiography Nuclear Cardiology, Other Cardiovascular PET Oncologic Imaging Neurologic Imaging Cardiac Imaging Other PET Imaging General Nuclear Medicine Body MRI (Chest [non-cardiac], abdomen, pelvis) Breast Only MRI Cardiovascular MRI Musculoskeletal MRI Neurological MRI Magnetic Resonance Angiography (MRA) (must apply in Neurological, Cardiovascular or Body) COMPUTED TOMOGRAPHY (CT) (including Dental CT using Cone Beam Technology) Coronary Calcium Scoring CT Coronary CT Angiography Neurological CT (Brain, Acute Stroke Brain, Spine) Maxillofacial CT (Sinus, Temporal Bone, Facial Bone, Orbits, Mandibular) Body CT (Soft Tissue Neck, Chest [non-coronary], Abdomen, Pelvis, Extremity) Vascular CTA [Neurovascular (including carotids), Chest (non-coronary), Abdomen, Pelvis, Peripheral/Extremity] Low Dose CT (LDCT) lung cancer screening (required accreditation in the testing area of Body CT) Dental CT Carotid Stenting Procedures Testing and Ablation Device Implantation (Facilities may apply for accreditation in Device Implantation only) Chronic Lead Extraction (Option is only available, in addition to Device Implantation, when also applying for Testing and Ablation) Left Atrial Appendage Occlusion (LAAO) Adult Diagnostic Catheterization Percutaneous Coronary Intervention (PCI) Valve Interventions Structural Heart Interventions Complex Adult Congenital Heart Disease (ACHD) Pediatric Cardi...
Owner’s Name. Internet Y/N The type of listing agreement (e.g., exclusive right to sell, exclusive agency, etc.) may not be displayed. 713 Participants shall not modify or manipulate information relating to other participants’ listings. MLS Participants may augment their IDX display of MLS data with applicable property information from other sources to appear on the same webpage or display, clearly separated by the data supplied by the MLS. The source(s) of the information must be clearly identified in the immediate proximity to such data. This requirement does not restrict the format of MLS data display or display of fewer than all of the available listings or fewer authorized fields. A Participant who so modifies, augments, or references the Listing Participant’s data shall be solely responsible for the accuracy of any additions or modified data and shall indemnify and hold harmless the MLS, the Listing Participant, and the property owner from any liability arising from such modifications or additions. (NAR MANDATE 18.2.11)
Owner’s Name. No later than 120 days following the effective date of this First Amendment, Servicer shall utilize the name designated by Owner in all written and verbal communications with the Mortgagor in servicing the Mortgage Loans (“Private Label Servicing”).
10. The following Section 9.01 (ix) shall be added to the LSA:
Owner’s Name. PITCH No.............................................. DATE.....................................
Owner’s Name. St. Xxxxx River Water Management District
a. Description of goods or services provided: Currently providing courier services for statewide transportation of water samples
b. Date Services Completed: 2009 – present
c. Contact Person: Xxxxxxx Xxxxx, Laboratory Manager Address: 0000 Xxxx Xxxxxx | Palatka, FL 32177 Telephone Number: (386) 329‑4301 Email address: xxxxxx@xxxxxx.xxx
Owner’s Name. (hereinafter referred to as the ‘Owner’ which expression shall unless repugnant to the context or meaning thereof, include its successors, administrators and assigns) having awarded to M/s ...
