Signature Authorization. The parties have duly executed and agreed to be bound by this Agreement as evidenced by the signatures of their authorized representatives affixed hereto above. Each party represents and warrants to the other that the signatory identified beneath its name herein has full authority to execute this Agreement on its behalf.
Signature Authorization. Employer represents that the information on this application is true and accurate to the best of its knowledge. Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and shall also be subject to a civil penalty not to exceed $5,000 and the stated value for the claim for each such violation. By signing below, Employer and Capital District Physicians’ Healthcare Network, Inc. hereby agree to the Terms and Conditions attached hereto and incorporated herein. Capital District Physicians’ Healthcare Network, Inc., by: Signature: Date Print name: Employer, by: Signature: Date Print name: Print title: Broker’s signature: Date Print name: Account Rep’s signature: Date Print name:
Signature Authorization. The person signing this Agreement on behalf of Contractor hereby warrants that he/she is an agent of Contractor and is duly authorized to enter into this Agreement on behalf of Contractor.
Signature Authorization. The Customer Signatories appearing below are duly authorized officers or agents of the Customer. The Customer shall deliver to the Custodian a duly executed Secretary's Certificate in the form of Exhibit F hereto, or such other evidence of such authorization as the Custodian may reasonably require, whether by way of a certified resolution or otherwise.
Signature Authorization. This Agreement may be executed in counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. Signatures received by PDF file or other electronic format are agreed to be acceptable as original signatures. By signing the below, the Account Xxxxxx and Xxxxx agree to the terms of this Agreement. Name Title Signature Date Name Xxxxxxxx Xxxxxx Title Chief Executive Officer Signature Date 05/06/2021
Signature Authorization. If you are doing business as a corporation or in a name other than your own name, we need to have this information on file.
Signature Authorization. This Agreement may be executed in counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. Signatures received by PDF file or other electronic format are agreed to be acceptable as original signatures.
Signature Authorization pdf Yes - No Yes - No 2 Yes - No
Signature Authorization. If I choose to sign this form electronically, I agree that my electronic signature is a legally binding equivalent to my handwritten signature on a paper form. Print name Title Signature Date Complete and sign FTB 1052A PC, Electronic Wage Garnishment Agreement, and email it to:
Signature Authorization. Contractor’s signatory is duly authorized to enter into the Agreement, and the execution and performance of this Agreement will not violate:
A. any provision of any charter document of the Contractor; or
B. any statute or any judgment, decree, order, regulation, or rule of any court or governmental authority applicable to Contractor; or
