Signature Title. Agency/Organization Date
Signature Title. Annexes: A copy of an extract from a commercial register which certifies that the undersigned is a duly authorized legal representative of the Company and/or has the power to represent the Company through a personal identification document such as a copy of valid ID. VOTING INSTRUCTIONS □ FOR □ AGAINST the approval of the Composition with Creditors proposal no. 4/2020 formulated by Goldoni S.p.A. Date Signature (Stamp and signature)*
Signature Title. Deputy Director of the Department for Preventive Care, according to credentials Date……………………….. List of attachments: Appendix 1 – Protocol Appendix 2 – Financial assistance Appendix 3 – Bank details Appendix 4 – copy of Local Ethics Committee Approval, copy of SÚKL notification Šablona dvoustranné smlouvy mezi zdrav. zařízením a CRO SMLOUVA O NEINTERVENČNÍM KLINICKÉM HODNOCENÍ Tato smlouva (xxxx xxx „smlouva“) nabývá platnosti a účinnosti dnem uveřejnění v registru smluv („datum účinnosti”). A je uzavírána mezi těmito stranami: MAPI Life Science UK Limited, společnost zřízená a působící podle zákonů Spojeného království, se sídlem Concept House, 0 Xxxxxxxxxxx Xxxx, Xxxxxxxxx Xxxx, Xxxxxxxxx, Xxxxxxxxx, XX00 0XX Velká Británie, DIČ GB 193 9420 80, kterou zastupuje Xxxxx Xxxxxx Xxxx, Global Head, Operations Support Management, zplnomocněná k jednání pro účely této smlouvy, (xxxx „CRO”), která jedná jménem společnosti XXXXX PHARMA S.A.S., (xxxx xxx „Xxxxx“ nebo „zadavatel studie”), a Nemocnice Na Bulovce, se sídlem na adrese Xxxxxxxx 00/0, 000 00, Xxxxx-Xxxxx, kterou zastupuje MUDr. Xxxxx Xxxxxxxx, MBA, náměstkyně pro vědu, výzkum, grantové činnosti a rozvoj, dle pověření, (xxxx „zdravotnické zařízení“ nebo „pracoviště studie”), uvedené strany budou xxxx x xxxx smlouvě označovány jednotlivě jako „(smluvní) strana“ a společně jako „(smluvní) strany”.
Signature Title. Note: A stated child care policy may include services and/or benefits for employees and their families, including infants through school-age child care centers or family day care homes, before and after school programs, day camps, services for ill children, children with special needs, family leave and more. Please refer to the attached instructions for definitions. Please check ALL items on the form that apply to your business concern. PART ONE YES NO DOES YOUR BUSINESS HAVE A STATED CHILD CARE POLICY? H 0 If YES, please attach a copy PART TWO DOES YOUR BUSINESS PROVIDE CHILD CARE ASSISTANCE? I 0 If YES, Please check which form/s ofassistance Level I Assistance Subsidized company child care center D D Subsidized network ofchild care homes 0 0 Child care reimbursement in addition to other benefits M D Child care reimbursement in a flexible benefit package 0 □ Paid parental leave • M □ Purchase of spaces for employees in community child care Program/s (center or homes) D □ Level II Assistance Salary set-aside/flexible spending account funded with . employee salary dollars/Section 125 K Q Child Care referral services M 0 Parenting Seminars D 0 Counseling on work/family issues M D Start-up of a self-supporting center D D Start-up contributions to a Cbonsortium centerO D D Level III Assistance Flexible work hours H 0 Flex-place/work-at-home 0 D Permanent part-time job/job sharing H 0 Work-at-home following maternity leave 0 D Unpaid parental leave M 0 Donation to enhance child care program D D Other (Describe) I have read and completed the “Child Care Declaration Statement” and verify that the information provided is true and cprrect. Name and Title ' " ’ —• Date S-^-03 City Departments: Please return a copy of this form to: 000 Xxxxx Xxxxxx Xxxxxx, #0000, Xxx Xxxxxxx, XX 00000 EXHIBIT E DMJM Design/Xxxx+Xxxxxxxx Design Agreement AECOM Highlights Introduction IMPORTANT NOTE You cannot enroll in the depen dent care spending account unless you have dependents who qualify. The dependent care spending account allows you to pay for cer tain child care and other depen-. dent care services that are neces sary for you to work or, if you are married, for both you and your spouse to work. Your contributions cannot exceed the lesser of ' ® $5,000 • $2,500 if you are married, filing ' separate tax returns • $5,000 if you are a single head of household . • Your earned income or, if less, your spouse's earned income There are additional limitations if your minor child or...
Signature Title s/ XXXXX X. XXXXXXXXXX President, Chief Executive Officer and Director ------------------------------------------------ (Principal Executive Officer and Sole Director) (Xxxxx X. XxXxxxxxxx) /s/ XXXX X. XXXXXXXX Executive Vice President and Chief Financial ------------------------------------------------ Officer (Xxxx X. Xxxxxxxx) (Principal Financial Officer) /s/ XXXXX X. XXXXX Senior Vice President and Chief Accounting Officer ------------------------------------------------ (Principal Accounting Officer) (Xxxxx X. Xxxxx) CERTIFICATIONS I, Xxxxx X. XxXxxxxxxx, certify that:
Signature Title s/ XXXXXXX X. XXXXX Chief Executive Officer, Chairman and Director - -------------------------- (Principal Executive Officer) Xxxxxxx X. Xxxxx /s/ R. XXXXX XXXXXX Vice Chairman, Vice President and Director - --------------------------
Signature Title. E.P.E. ‘Fundació Mies van der Xxxx’ Date Name Xxx. Xxxx Xxxxx Signature Title Director
Signature Title. SCHEDULE 1 – SPECIFICATIONS
Signature Title. President & CEO Note: If there are any discrepancies in the name or address shown above, please make the appropriate corrections on this form. EXHIBIT A 2003 INCENTIVE AWARD PLAN EMPLOYEE STOCK OPTION AGREEMENT THIS EXHIBIT A to the Incentive Award Agreement attached hereto (the terms of which are hereby incorporated by reference and made a part of this Exhibit A, and together with this Exhibit A are referred to hereafter as the “Agreement”) sets forth additional terms and conditions by which Micrel Incorporated, a California corporation, hereinafter referred to as the “Company,” grants a stock option award to Employee of the Company, or a Subsidiary of the Company, identified on the Incentive Award Agreement and hereinafter referred to as “Optionee.”
Signature Title. Title: ------------------------------------------------------------------------------- Exhibit B ACCREDITED INVESTOR QUESTIONNAIRE The undersigned is an "Accredited Investor," based upon the following (check all that apply):
