Required Affirmations Sample Clauses

Required Affirmations. IF SUBMITTED ELECTRONICALLY:  I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Checking this box constitutes my electronic signature on the date of its submission. IF SUBMITTED BY U.S. MAIL: I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Dated: Signature: SETTLEMENT ADMINISTRATOR ADDRESS (where to send the completed form if submitting by mail): AAG TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. EXHIBIT 6 OPT-OUT FORM OPT-OUT FORM AAG TCPA Settlement Only use this Form if you want to request exclusion from (i.e., opt-out) of the proposed settlement class. For more information on the proposed settlement, please visit www.[xxx].com.
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Required Affirmations. IF SUBMITTED ELECTRONICALLY: 🞎 I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address], [City], [State] [Zip Code]. Checking this box constitutes my electronic signature on the date of its submission. Dated: Signature: • A Settlement with a $1,670,000 cash fund has been reached in a class action lawsuit claiming that Change Healthcare Resources, LLC, under the brand My Advocate, calling on behalf of Blue Cross Blue Shield of North Carolina (“Defendants”), sent prerecorded voice messages to wireless telephone numbers without consent of the recipients in violation of the Telephone Consumer Protection Act, 47 U.S.C. § 227. Defendants deny the allegations in the lawsuit and the Court has not decided who is right. • If you are a Settlement Class Member, your legal rights are affected whether you act or do not act. Read this notice carefully. DO NOTHING If you do nothing but have been identified in Defendants’ records and have received a mailed notice about the Settlement, you will automatically receive a payment from the Settlement Fund and will give up your right to bring your own lawsuit against Defendants about the claims in this case. If you do nothing but have not been identified in Defendants’ records or have not received a mailed notice about the Settlement, you will not receive a payment from the Settlement Fund and will give up your right to bring your own lawsuit against Defendants about the claims in this case. MAKE A CLAIM If you have not been identified in Defendants’ records or have not received a mailed notice about the Settlement, you may make a claim to receive a payment from the Settlement Fund. If you have been identified in Defendants’ records and have received a mailed notice about the Settlement, you will automatically receive a payment from the Settlement Fund without making a claim. EXCLUDE YOURSELF You may request to be excluded from the Settlement. If you do, you will not receive a payment from the Settlement Fund but will not give up your right to bring your own lawsuit against Defendants about the claims in this case. OBJECT Write to the Court if you do not like the...
Sample 1
Required Affirmations. Etna Township COUNTY: Licking CONTRACT NUMBER: 962FA-26DA4 CONTRACT PERIOD: January 1, 2023 through December 31, 2024 To be considered, the proposal must address every one of the elements. When these are not fully addressed, proposals will be considered non-responsive to the RFP and will not be evaluated further. Please ensure these affirmations are the first element of your firm’s proposal and indicate your firm’s agreement with the affirmation by checking the respective box for each affirmation.
Sample 1
Required Affirmations. IF SUBMITTED ELECTRONICALLY: 🞎 I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Checking this box constitutes my electronic signature on the date of its submission. IF SUBMITTED BY U.S. MAIL: I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Dated: Signature: Settlement Administrator Address (where to send the completed form if submitting by mail): Safe Streets TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. EXHIBIT 4 Publication notice Safe Streets TCPA Settlement Banner Advertisement 728 x 90 Online Display Banner Frame 1: Frame 2: Facebook Newsfeed Banner Instagram Newsfeed Banner EXHIBIT 5 Publication Notice Claim Form In the United States District Court for the Eastern District of North Carolina Jones, et. al. v. Safe Streets USA LLC, Case No. 5:19-cv-394
Sample 1

Related to Required Affirmations

  • Warranty Affirmations Assurances and Certifications 12 5.1 WARRANTY 12 5.2 General Affirmations 12 5.3 Federal Assurances 12 5.4 Federal Certifications 12 5.5 State Assurances 12 ARTICLE VI. Intellectual Property 13

  • CONTRACT AFFIRMATIONS Performing Agency certifies that, to the extent Contract Affirmations are incorporated into the Contract under the Signature Document, the Performing Agency has reviewed the Contract Affirmations and that Performing Agency is in compliance with all requirements.

  • AFFIRMATIONS, ASSURANCES AND CERTIFICATIONS 11 5.1 General Affirmations 11 5.2 Federal Assurances 11 5.3 Federal Certifications 11

  • WARRANTY, AFFIRMATIONS, ASSURANCES AND CERTIFICATIONS 12 5.1 WARRANTY 12 5.2 General Affirmations 13 5.3 Federal Assurances 13 5.4 Federal Certifications 13 5.5 State Assurances 13 ARTICLE VI. INTELLECTUAL PROPERTY 13 6.1 Ownership of Work Product 13 6.2 Grantee s Pre-Existing Works 14 6.3 THIRD PARTY IP 14 6.4 Agreements with Employees and Subcontractors 14 6.5 Delivery upon Termination or Expiration 15 6.6 SURVIVAL 15 6.7 System Agency Data 15 ARTICLE VII. PROPERTY 15

  • Required Consents No consent shall be required for any assignment except to the extent required by subsection (b)(i)(B) of this Section and, in addition:

  • Required Certifications A bidder who makes a false certification on the Bidder Certification of the Prequalification Classification and Work Capacity Form will be subject to forfeiture of his bid bond and/or disqualification from bidding on future work for a 90 day period, or both. The Contracting Officer will determine the imposition and the extent of such sanctions. A sworn statement shall be executed by the bidder or his agent on behalf of each person, firm, association, or corporation submitting a bid. The statement shall certify that the person, firm, association, or corporation has not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action to restrain free competitive bidding in connection with the proposal. The sworn statement shall be part of the bid or in the form of an affidavit and shall be sworn to before a person who is authorized by the laws of the State to administer oaths. The bids shall contain the identical sworn statement. For the purpose of this Section, affixing digital ID to the bid will be considered by the Department conditional evidence of signing before a person who is authorized by the laws of the Commonwealth to administer oaths. The original of the sworn statement shall be filed with the Department when the bid is submitted.

  • General Affirmations Grantee certifies that, to the extent affirmations are incorporated into the Grant Agreement, the Grantee has reviewed the affirmations and that Grantee is in compliance with all requirements.

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