Please Check Applicable Box Sample Clauses

The "Please Check Applicable Box" clause serves to prompt parties to indicate their selection or agreement by marking the relevant option within a contract or form. In practice, this clause is often presented alongside a list of choices, such as payment methods, service levels, or specific terms, where the party must check the box that applies to their situation. This mechanism ensures that the parties clearly communicate their preferences or decisions, thereby reducing ambiguity and helping to prevent disputes over which terms were agreed upon.
Please Check Applicable Box. ¨ I am purchasing ____________ shares of the Company’s common stock at a price of $11.50 per share, reflecting the fact that selling commissions and dealer manager fees will not be payable in connection with such purchase, as a participant in the Company’s directed share program.
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Please Check Applicable Box. 🞏 A publically held corporation; therefore, this reporting requirement is not applicable. 🗷 Is not owned or operated by anyone who has been convicted of a felony. 🞏 Is owned or operated by the following individual(s) who has/have been convicted of a felony KPMG LLP (KPMG or firm) has not been convicted of a crime. To the best of our knowledge, no current partner, principal or employee of the firm has been charged with or convicted of a crime relating to the firm’s business or provision of services to clients. ⮚ If the 3rd box is checked, a detailed explanation of the names and convictions must be attached. Which best describes your company’s position in the distribution channel: Manufacturer Direct Certified education/government reseller Authorized Distributor Manufacturer marketing through reseller Value-added reseller Other: Services Provider Processing Information Provide company contact information for the following: Sales Reports / Accounts Payable Contact Person: ▇▇▇▇▇▇▇ ▇▇▇▇ Title: Manager Contracts, West Region Company: _KPMG LLP Address: ▇▇▇ ▇. ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇: ▇▇▇▇▇▇▇▇▇▇ Zip: 90071 Phone: _ +▇▇▇ ▇▇▇ ▇▇▇▇ Email: ▇▇▇▇▇@▇▇▇▇.▇▇▇ Purchase Orders Contact Person: ▇▇▇▇▇▇▇ ▇▇▇▇ Title: Manager Contracts, West Region Company: _KPMG LLP Address: ▇▇▇ ▇. ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇: ▇▇▇▇▇▇▇▇▇▇ Zip: 90071 Phone: _ +▇▇▇ ▇▇▇ ▇▇▇▇ Email: ▇▇▇▇▇@▇▇▇▇.▇▇▇ Sales and Marketing Contact Person: _▇▇▇▇▇ ▇▇▇▇▇▇▇ Title: _Managing Director, KPMG Healthcare and Government Solutions Company: _KPMG LLP Address: ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇: ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇: ▇▇▇▇▇▇▇▇▇▇ Zip: 95814 Phone: _+▇ ▇▇▇ ▇▇▇ ▇▇▇▇ _ Email: _▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇ In addition to the current typical unit pricing furnished herein, the Vendor agrees to offer all future product introductions at prices that are proportionate to Contract Pricing. If answer is no, attach a statement detailing how pricing for NCPA participants would be calculated for future product introductions. 🗷 Yes 🞏 No Pricing submitted includes the required NCPA administrative fee. The NCPA fee is calculated based on the invoice price to the customer. 🗷 Yes 🞏 No Vendor will provide additional discounts for purchase of a guaranteed quantity. 🗷 Yes 🞏 No Tab 4 – Vendor Profile Please provide the following information about your company: Company’s official registered name. Brief history of your company, including the year it was established. KPMG International and its network of Member Firms (...
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Please Check Applicable Box. (If the 3rd box is checked, a detailed explanation of the names and convictions must be attached):
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Please Check Applicable Box. (If the 3rd box is checked, a detailed explanation of the names and convictions must be attached): X A publicly held corporation; therefore, this reporting requirement is not applicable. Is not owned or operated by anyone who has been convicted of a felony. Is owned or operated by the following individual(s) who has/have been convicted of a felony Which best describes your company’s position in the distribution channel: Manufacturer Direct Certified education/government reseller X Authorized Distributor Manufacturer marketing through reseller Email ▇▇▇▇▇▇▇▇▇@▇▇▇▇▇.▇▇▇ In addition to the current typical unit pricing furnished herein, the Vendor agrees to offer all future product introductions at prices that are proportionate to Contract Pricing. If answer is no, attach a statement detailing how pricing for NCPA participants would be calculated for future product introductions. Yes No Pricing submitted includes the required NCPA administrative fee. The NCPA fee is calculated based on the invoice price to the customer. Yes No List any other cooperative or state contracts currently held or in the process of securing. Please provide the following information about your company: • Company’s official registered name. D&H Distributing Company • Brief history of your company, including the year it was established. D&H Distributing, founded in 1918, has delivered innovation and excellence over the last 105 years as a leader in the North American distribution market, supporting many technology-led industries. Through its powerful culture of trust, as well as its combined private and employee ownership structure, D&H has delivered record-setting growth.
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Please Check Applicable Box. (If the 3rd box is checked, a detailed explanation of the names and convictions must be attached): Is not owned or operated by anyone who has been convicted of a felony. Is owned or operated by the following individual(s) who has/have been convicted of a felony Which best describes your company’s position in the distribution channel: Manufacturer Direct Certified education/government reseller Authorized Distributor Manufacturer marketing through reseller Contact Person Title Company Address City/State/Zip Phone Email ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Contract Specialist Sitmatic ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇ Fullerton, CA, 92833 (▇▇▇) ▇▇▇-▇▇▇▇ ▇▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇.▇▇▇ In addition to the current typical unit pricing furnished herein, the Vendor agrees to offer all future product introductions at prices that are proportionate to Contract Pricing. If answer is no, attach a statement detailing how pricing for NCPA participants would be calculated for future product introductions. Yes No Pricing submitted includes the required NCPA administrative fee. The NCPA fee is calculated based on the invoice price to the customer. Yes No List any other cooperative or state contracts currently held or in the process of securing. North Carolina State Contract 51% 6/2023 $80,000 South Carolina State Contract 51% 12/2024 $30,000 Pennsylvania State Contract 50% 4/2024 $30,000
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Please Check Applicable Box. (If the 3rd box is checked, a detailed explanation of the names and convictions must be attached): x A publicly held corporation; therefore, this reporting requirement is not applicable. Is not owned or operated by anyone who has been convicted of a felony. Is owned or operated by the following individual(s) who has/have been convicted of a felony x Which best describes your company’s position in the distribution channel: Manufacturer Direct Certified education/government reseller Authorized Distributor Manufacturer marketing through reseller Value-added reseller Other: Contact Person Title Company Address City/State/Zip Phone Email ▇▇▇▇ ▇▇▇▇▇▇▇ Administrator MyVRSpot, LLC PO Box 272266 Fort ▇▇▇▇▇▇▇, CO 80527 888-237-6740 x1002 ▇▇▇▇@▇▇▇▇▇▇▇▇.▇▇▇ In addition to the current typical unit pricing furnished herein, the Vendor agrees to offer all future product introductions at prices that are proportionate to Contract Pricing. If answer is no, attach a statement detailing how pricing for NCPA participants would be calculated for future product introductions. Yes No Pricing submitted includes the required NCPA administrative fee. The NCPA fee is calculated based on the invoice price to the customer. Yes No List any other cooperative or state contracts currently held or in the process of securing. Please provide the following information about your company: - Company’s official registered name. o MyVRSpot, LLC - Company’s Dun & Bradstreet (D&B) number.
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Please Check Applicable Box. (If the 3rd box is checked, a detailed explanation of the names and convictions must be attached): A publicly held corporation; therefore, this reporting requirement is not applicable. Is not owned or operated by anyone who has been convicted of a felony. Is owned or operated by the following individual(s) who has/have been convicted of a felony Which best describes your company’s position in the distribution channel: Manufacturer Direct Certified education/government reseller Authorized Distributor Manufacturer marketing through reseller Value-added reseller Other: Contact Person Title Company Address City/State/Zip Phone Email ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Contract Specialist Sitmatic ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇ Fullerton, CA, 92833 (▇▇▇) ▇▇▇-▇▇▇▇ ▇▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇.▇▇▇ In addition to the current typical unit pricing furnished herein, the Vendor agrees to offer all future product introductions at prices that are proportionate to Contract Pricing. If answer is no, attach a statement detailing how pricing for NCPA participants would be calculated for future product introductions.
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