Payment Agreement. The agreement between you and Barracudas begins at the point where a payment is made, whether in part or full, and is when these booking conditions apply from. This agreement is with you, as the person who made the booking, and you are responsible for ensuring any parent/carer relating to this booking are aware of, and accept, these booking conditions.
Payment Agreement. The Landowner hereby agrees to repay the Assessment Amount according to the Repayment Schedule attached hereto as Exhibit B, with annual payment coupons provided by the County Treasurer. It is generally the intent of the parties that the Landowner will repay the Assessment Amount over the course of five years with an interest rate of five percent (5%) with said payment to be made in two, semi-annual installments each year. Payments will be applied first to interest and then to the outstanding Assessment Amount. This section is an express covenant within the meaning of IC 32-29-1-2 acknowledging that, in addition to the mortgage created by this agreement, Landowner will also be personally liable for repayment as described herein. If more than one Landowner has signed this Agreement, Landowner obligations are joint and several. County may proceed against any, all or, none of the Landowners at its discretion, in order to enforce its rights under this Agreement. Absent a written agreement to the contrary, transfer of the Real Estate securing this Payment Agreement shall not relieve Landowner of Landowner’s obligations under this Agreement.
Payment Agreement. If the Borrower does not have an Account with any Federal Reserve Bank, the Borrower hereby agrees to the provisions of the Correspondent Credit and Payment Agreement, currently an ancillary agreement appended to the Circular (Exhibit 1 to the Circular’s Appendix 5), and designates ________________________________________ (Name of Agent/Correspondent) as “Correspondent” under that agreement. Authorized Individuals: The following individuals are permitted to provide instructions, pledge PPPLF Collateral to and request Advances from the Reserve Bank under the PPPLF on behalf of the Borrower. Name Title, Telephone and Email A Borrower that has not previously established access to the Discount Window by executing a standard Letter of Agreement to the Circular must enclose with this PPPLF Letter of Agreement a certified copy of the Authorizing Resolutions for Borrowers containing the titles of those persons authorized to request Advances from and to pledge PPPLF Collateral under the PPPLF. Notices: Any notices required under the PPPLF Agreement shall be directed as follows: If to the Borrower: If to the Reserve Bank: List department(s) and address(es) List department(s) and address(es) _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ Executed this ___ day of ______, 2020. _____________________________________________ Full Legal Name of Borrower By: _________________________________________ Signature(s) of individual(s) authorized to sign documents on behalf of the Borrower as provided in the Authorizing Resolution1 ______________________________________________ Name(s) ______________________________________________ Title(s) ______________________________________________ Telephone ______________________________________________ E-mail ______________________________________________ Routing Transit Number (RTN) of Borrower For Correspondents for Borrowers who do not have an Account with a Federal Reserve Bank: For th...
Payment Agreement. In consideration for certain project costs incurred by Contractor under this Agreement, Center shall compensate Contractor pursuant to the terms of the Payment Agreement, which is attached hereto as Attachment “C” and incorporated herein by this reference (the “Start-Up Payment Agreement”).
Payment Agreement. LESSEE further agrees to pay to the City on demand any and all sums, which may be due to the City for all required fees listed in this Lease Agreement, amenities/services listed in attachments, and special accommodations or materials as may be requested by LESSEE and approved by the City. All dues must be paid by a check, cash, money order or cashier’s check. Credit cards (only Visa and Master Card) are accepted only at our City Hall location.
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Payment Agreement. 1. As a courtesy to our clients, HCCC submits charges to contracted insurance plans. We are obligated to collect client responsibility amounts such as co-payment, co-insurance, deductible, and any non-covered services at the time of service. Sometimes, exact coverage cannot be determined until the insurance company receives the claim. Any overpayment will be applied as a credit to my account. If you prefer a refund, please contact the billing department for that request and to confirm mailing address to issue the refund.
Payment Agreement. I understand and agree that payment is due at the time services are rendered and that health, dental and accident insurance policies are an arrangement between my insurance carrier and myself. I understand that this office will prepare any necessary dental reports and dental forms to assist me in making collection from my insurance company, and that any amount authorized to be paid directly to this office will be credited to my account on receipt. However, I clearly understand and agree that all services rendered to me are charged directly to me and that I am personally responsible for payment, regardless of insurance. If the patient is a minor, I am the parent and/or guardian of said patient and agree that I am responsible for all services rendered to the patient herein. I understand that if I suspend or terminate any care and treatment to me or any person referred to in the previous sentence any fees for professional services rendered will be immediately due and payable. Signature: (If Patient is a minor, Parent or Guardian must sign here and complete section below) Date: RESPONSIBLE PARTY Sex: M or F SIN DOB Street _( City ) Province ( ) Postal Code (Dr/Mr/Mrs/Miss) First Middle Last Jr/Sr Home Phone Work Phone Employer METHOD OF PAYMENT How will you pay for today’s visit? Cash Bank Check MasterCard Visa Card Other Charge Card Authorization By signing hereunder, I authorize Lakeside Dental to bill my charge card account should any balance for services rendered that remain outstanding for more than (60) sixty days. If the account information given expires or is otherwise discontinued, I agree to give Lakeside Dental information as to an alternate charge account, which may be used. My account is as follows: Visa MasterCard Interac Card # Exp Date Signature Date PATIENT CONSENT FORM FOR COLLECTION, USE AND DISCLOSURE OF PERSONAL INFORMATION Privacy of your personal information is an important part of our office, just as providing you with quality dental care. We understand the importance of protecting your personal information and we are committed to collecting, using and disclosing your personal information responsibly. We also try to be as open and as transparent as possible about the way we handle your personal information. It is VERY important to us to provide this service to all of our patients. In this dental office, the dental centre manager acts as the privacy information officer. All team members who have come in contact with your personal informa...
Payment Agreement. (a) By requesting us to establish a payment agreement, you have consented to us to using, disclosing and recording your details, including the account or PayID details you have provided to us, and the details of the payment agreement in the Mandate Management Service operated by NPP Australia Limited as a payment agreement creation request.
Payment Agreement. Payment is due upon receipt and becomes delinquent on the 1st day of the following month. Facility reserves the right to assess a delinquency charge calculated daily beginning on the 1st day of the month following the date of the xxxx, at the rate of 1% per month until payment is received by the facility, on amounts not paid to facility by the due date. Patient shall promptly pay to facility all delinquency charges. Facility reserves the right to assess a fee of $25.00 for any check that is returned to facility. Unless waived in writing by the facility, all payments shall be applied first to delinquency charges and returned check charges, if any. Minimum monthly payment policies will apply.
