Xxx Xxxxxxxx Bats Throws The content below should be filled out by a notary. State County I, , a Notary Public for said County and State, do hereby certify that personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my hand and official seal, this the day of , 20 [ SEAL ] Notary Public My commission expires It is strongly recommended that this form be notarized. Most hospitals require consent form to be notarized. 1086115_1 Send copy to Department Baseball chairman. Team manager shall retain original.
Xxxx Xxxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 xxxx@xxxxxxxxxxxxxx.xxx Purchase Order and Sales Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 3 9375934574 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxxxxxx.xxx Entity D/B/A's and Assumed Names You must confirm that you are responding to this solicitation under your legal entity name. Go now to your Supplier Profile in this eBid System and confirm that your profile reflects your "Legal Name" as it is listed on your W9. In this question, please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the Legal Name under which you respond to this solicitation unless you organize otherwise with TIPS after award. 5 Xxx'x Roofing Inc. Primary Address Primary Address 6 000 X. Xxxxxxxx Xxx. Primary Address City Primary Address City 7 Bellefontaine Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 Ohio Primary Address Zip Primary Address Zip 9 43311 Search Words Identifying Vendor Please list all search words and phrases to be included in the TIPS database related to your entity. Do not list words which are not associated with the bid category/scope (See bid title for general scope). This will help users find you through the TIPS website search function. You may include product names, manufacturers, specialized services, and other words associated with the scope of this solicitation. Duro-Last, shingles, Xxxxx Corning, Certainteed, GAF, single ply Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
xx/xxxxxxx xxxx The posted results will contain the information of the apparent bidders, and all bids are under review until final award of the purchase order. Quantities herein are only estimates and may increase or decrease dependent upon the needs of the Commission. Operator shall be paid at the unit price bid for actual services performed. The Commission reserves the right to reject any or all bids and award contracts as it determines to be in the best interest of the Commission.
xxx-xx.xxx.xx) If the Parties do not agree on an Adjudicator the Adjudicator will be appointed by the Arbitration Foundation of Southern Africa (AFSA).
Xxxx Xxxxxxxxx Secondary Contact Title Secondary Contact Title 3 COO Secondary Contact Email Please enter a valid email address that will definitely reach the Secondary Contact. xxxxx@xxxxxxxxxxx.xxx Secondary Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). Please provide the accurate and current phone number where the individual who will be secondarily responsible for all TIPS matters and inquiries for the duration of the contract can be reached directly. 5 0000000000 Secondary Contact Fax Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). No response Secondary Contact Mobile Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 1 No response Administration Fee Contact Name Please identify the individual who will be responsible for all payment, accounting, and other matters related to Vendor's TIPS Administration Fee due to TIPS for the duration of the contract. 8 Xxxxx Xxxxxxx Administration Fee Contact Email Please enter a valid email address that will definitely reach the Administration Fee Contact. 1 xx@xxxxxxxxxxx.xxx Administration Fee Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 0 3157264186
xxx/xxxxxxxxx At the end of this document is a list of United States Code citations for the FCRA. Other information about user duties is also available at the Bureau’s website. Users must consult the relevant provisions of the FCRA for details about their obligations under the FCRA. The first section of this summary sets forth the responsibilities imposed by the FCRA on all users of consumer reports. The subsequent sections discuss the duties of users of reports that contain specific types of information, or that are used for certain purposes, and the legal consequences of violations. If you are a furnisher of information to a consumer reporting agency (CRA), you have additional obligations and will receive a separate notice from the CRA describing your duties as a furnisher.
Xxxxxx Xxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 2 xxxxxx@xxxxxxxxxxxxxxxxx.xxx Purchase Order and Sales Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 3 3152473177 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxxxxxxxxx.xxx Entity D/B/A's and Assumed Names You must confirm that you are responding to this solicitation under your legal entity name. Go now to your Supplier Profile in this eBid System and confirm that your profile reflects your "Legal Name" as it is listed on your W9. In this question, please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the Legal Name under which you respond to this solicitation unless you organize otherwise with TIPS after award. NGU Sports LIghting, LLC Primary Address Primary Address 6 0000 XXX Xxxx, Xxxxx 000 Primary Address City Primary Address City 2 7 Palm Beach Gardens Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 FL Primary Address Zip Primary Address Zip 9 33410 Search Words Identifying Vendor Please list all search words and phrases to be included in the TIPS database related to your entity. Do not list words which are not associated with the bid category/scope (See bid title for general scope). This will help users find you through the TIPS website search function. You may include product names, manufacturers, specialized services, and other words associated with the scope of this solicitation. LED lighting, LED Sports Lighting, LED Indoor lighting, LED Field lighting, Sports lighting, Field lighting, Colored lighting, Convention Center Lighting Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
Xxxxx Xxxxxxxx Admin Fee Contact Email Admin Fee Contact Email 1 9 xxxxxxx@xx-xxxxxxxxxx.xxx Admin Fee Contact Phone Enter 10 digit phone number. (No dashes or extensions) Example: 8668398477 0 4098423737 Purchase Order Contact Name Purchase Order Contact Name. This person is responsible for receiving Purchase Orders from TIPS. Xxxxxx Xxxxxx Purchase Order Contact Email Purchase Order Contact Email 2 xxxxxxx@xx-xxxxxxxxxx.xxx Purchase Order Contact Phone Enter 10 digit phone number. (No dashes or extensions) Example: 8668398477 3 4098423737 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxxxxxxxxxx.xxx Entity D/B/A's and Assumed Names Please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the legal name under which you responded to this solicitation unless you organize otherwise with TIPS after award. 5 Industrial & Commercial Mechanical, LLC Primary Address Primary Address 2 6 0000 Xxxxxxxx Xxxxxx Primary Address City Primary Address City 7 Beaumont Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 TX Primary Address Zip Primary Address Zip 9 77705 Search Words: Please list search words to be posted in the TIPS database about your company that TIPS website users might search. Words may be product names, manufacturers, or other words associated with the category of award. YOU MAY NOT LIST NON-CATEGORY ITEMS. (Limit 500 words) (Format: product, paper, construction, manufacturer name, etc.) 3 A/C, Air conditioning, heating, ductwork, sheet metal, refrigeration, cooler, freezer, ventilation, HVAC, HVAC/R Do you want TIPS Members to be able to spend Federal grant funds with you if awarded? Is it your intent to be able to sell to our members regardless of the fund source, whether it be local, state or federal? Most of our members receive Federal Government grants or other funding and they make up a significant portion of their budgets. The Members need to know if your company is willing to sell to them when they spend federal budget funds on their purchase. There are attributes that follow that include provisions from the federal regulations in 2 CFR part 200, etc. Your answers will determine if your award will be designated as eligible for TIPS Members to utilize federal funds with your company. Do you want TIPS Members to be able to spend Federal funds, at the Member's discretion, with you? Yes Yes - No Certification of Residency - The vendor's ultimate parent company or majority owner:
Xxxxxxx Xxxxxx LIMITED (a company registered in England and Wales with registered number 2104188), whose registered office is at 00 Xxx Xxxxxx, London EC4M 7EN (“Xxxxxxx Xxxxxx”);
Xxxxxxxx Xxxxx The Company is in compliance, in all material respects, with all applicable provisions of the Xxxxxxxx-Xxxxx Act of 2002 and the rules and regulations promulgated thereunder.
