Xxxxxxxx, P E., P.S./City Engineer / / Date ( ) - Phone CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER CERTIFICATION: Pursuant to Section VI. B. and VI. C. of the Agreement, the undersigned Chief Executive Officer and Chief Fiscal Officer of the Recipient, as both are designated in Appendix B of the Agreement, hereby request the Director to disburse financial assistance moneys made available to Project in Appendix C of the Agreement (inclusive of any amendment thereto) to the payee as identified below in the amount so indicated which amount equals the product of the Disbursement Ratio and the dollar value of the attached cost documentation which was properly billed to the Recipient in exclusive connection with the performance of the Project. The undersigned further certify that:
Xxxxxxxxx Xxxx Xxxx Certificate of Trust shall be effective upon filing.
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.
xxx/XxxxxxXxxx If You need authorization when the Administrator’s office is closed, You may obtain prior authorization by visiting xxx.XxXxxxxxxxxxXxxx000.xxx/XxxxxxXxxx any time. Failure to obtain prior authorization may result in non-payment. California: Warrantech Consumer Product Services, Inc. (License No. SA-1) is the Service Contract Administrator and AMT Warranty Corp. (License No. SA-42) is the Obligor for this Service Contract. WHAT IS COVERED – Food Loss (for refrigerator and/or freezer Covered Products) and Laundry/Cleaning Services (for washer and/or dryer Covered Products) coverages are NOT available to residents of California. CANCELLATION: is amended as follows: This Service Contract may be canceled by the Service Contract holder for any reason, including, but not limited to, the Device covered under this Service Contract being sold, lost, stolen or destroyed. If You decide to cancel Your Service Contract, and Your cancellation notice is received by the Administrator within thirty (30) days for a home electronic, or within sixty (60) days for all other covered products, of the date You received the Service re Contract, and You have made no Claims against the Service Contract, You will be refunded the full Service Contract price paid by You; or if You have made Claims against the Service Contract or Your Service Contract is canceled by written notice after thirty (30) days for a home electronic, or after sixty (60) days for all other covered products, from the date You received this Service Contract, You will be refunded a prorated amount of the Service Contract price paid by You, less any Claims paid. Connecticut: This Service Contract is an agreement between the Obligor/Provider, AMT Warranty Corp., 00 Xxxxxx Xxxx, 00xx Xxxxx, Xxx Xxxx, XX 00000, (866) 327- 5818 and You. In the event of a dispute with Administrator, You may contact The State of Connecticut, Insurance Department, P.O. Box 816, Hartford, CT 06142-0816, Attn: Consumer Affairs. The written complaint must contain a description of the dispute, the purchase or lease price of the Product, the cost of repair of the Product and a copy of the warranty Service Contract. CANCELLATION is amended as follows: This Service Contract may be cancelled by the Service Contract Holder if the Device covered under this Service Contract is returned, sold, lost, stolen or destroyed. GUARANTY is amended as follows: If We fail to pay or to deliver service on a claim within sixty (60) days after proof of loss has been filed, or in the event You cancel this Service Agreement and We fail to issue any applicable refund within sixty (60) days after cancellation, file a claim against the insurer, Wesco Insurance Company at 00 Xxxxxx Xxxx, 00xx Xxxxx, Xxx Xxxx, XX 00000, by calling 0-000-000-0000. Florida: This Service Contract is between the Provider, Technology Insurance Company, Inc. (License No. 03605) and You, the purchaser. The rates charged to You for this Service Contract are not subject to regulation by the Florida Office of Insurance Regulation. CANCELLATION: is amended as follows: You may cancel Your Service Contract at any time by informing the Administrator, WCPS of Florida, Inc. (License No. 80202) of Your cancellation request. In the event the Service Contract is canceled by You, return of the premium shall be based upon one hundred (100%) percent of the unearned pro rata premium less any Claims that have been paid or less the cost of repairs made on Your behalf. In the event the Service Contract is canceled by the Administrator or Provider, return of the premium shall be based upon one hundred (100%) percent of the unearned pro rata premium less any Claims that have been paid or less the cost of repairs made on Your behalf. Georgia: EXCLUSIONS – Only unauthorized product repairs, modifications or alterations performed after the effective date of the Service Contract are excluded. The "Pre-Existing Condition:" definition is deleted and replaced with: conditions that were caused by You or known by You prior to purchasing this Service Contract. CANCELLATION is amended as follows: In no event will any claims incurred or paid be deducted from any refund. The Provider may only cancel this Service Contract for fraud by You, material misrepresentation by You, or nonpayment by You. The lienholder may only cancel this Contract for non-payment if they hold a power of attorney. Illinois: Covered items must be in place and in good operating condition on the effective date of coverage and become inoperative due to defects in materials or workmanship after the effective date of this Service Contract This Service Contract does not cover failures resulting from normal wear and tear.
Xxxx Xxxxxxxxx Secondary Contact Title Secondary Contact Title CEO Secondary Contact Email Please enter a valid email address that will definitely reach the Secondary Contact. Xxxx.Xxxxxxxxx@xxxxxxxxxxxxx.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. 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. Xxxx Xxxxxx Administration Fee Contact Email Please enter a valid email address that will definitely reach the Administration Fee Contact. 9 Xxxx.xxxxxx@xxxxxxxxxxxxx.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 4327413101
Xxxxxxxx, Xx (Xxxxxxx Xxxxxxxx).
Xxxxxxxxx, X Xxxxxxx Chairman & CEO Barangay Bagumbayan Paracale, Camarines Norte Tel No. 0000-000-0000/000-0000 Email: xxxxxxxxx_xxxx@xxxxx.xxx November 4, 2008 November 3, 2033 Paracale, Camarines Norte Gold, Copper 173.9329 MPSA 273-2008-V Orophil Stonecraft, Inc. Xx. 0 Xxxxxxx Xxxx Xxx Xxxxxx, Xxxxxx Xxxx November 26, 2008 November 25, 2033 Baao, Camarines Sur Perlite 141.1418 MPSA 279-2009-V Xxxxxxxx X. Xxxxx, Et. Al. c/o Xx. Xxxxxxxx X. Abaño Xxxxx Xxxxxxx Xxxxx Xxxxxx & Xxxxxxx Law Offices Suite 1515 Tektite East Tower Phil Exchange Center Building Exchange Road, Ortigas Center Pasay City Tel No. (000) 000-0000 0000-000-0000 April 8, 2009 April 7, 2034 Bula, Camarines Sur Gypsum 171.6511 MINERAL AGREEMENT NUMBER CONTRACTOR DATE GRANTED DATE EXPIRY LOCATION MINERAL COMMODITY AREA (Has.) MPSA 297-2009-V Guo Long Mining Corp. Xxx Xxxx President Xxxx Xxxxxxxx, Paracale Camarines Norte November 16, 2009 November 15, 2034 Xxxx Xxxxxxxxxx, Camarines Norte Gold, Iron, etc 595.6522 MPSA 306-2009-V Pargum Consolidated Corporation Xxxxxx X. Xxxxxx President 7th Floor, Corporate Business Center 000 Xxxxx Xx Xxxxx xxxxxx Xxxxxx Xxxxxx Xxxxxx Xxxx Tel No.: 000-00-00 000-00-00 Fax No.: 000-00-00 000-00-00 December 23, 2009 December 22, 2034 Xxxx Xxxxxxxxxx, and Paracale, Camarines Norte Gold, etc. 476.6808 MPSA 329-2010-V Filminera Resources Corp March 23, 2010 March 22, 2035 Aroroy, Masbate Gold,etc 584.2034 MPSA 334-2010-V East Environ, Incorporated Xxxxxxxx X. Tolentino Unit J Primrose Building Rose Avenue, Xxxxx Village Las Piñas City May 27, 2010 May 27, 2035 Baao, Camarines Sur Perlite 62.1904 MPSA 300-2009-V Yinlu Bicol Mining Corporation Xxx Xxxx President Xxxx Xxxxxxxx, Paracale Camarines Norte November 24, 2009 November 23, 2034 Paracale & Xxxx Xxxxxxxxxx, Camarines Norte Iron, gold, etc. 663.0746 MINERAL AGREEMENT NUMBER CONTRACTOR DATE GRANTED DATE EXPIRY LOCATION MINERAL COMMODITY AREA (Has.) MPSA 308-2009-V MPSA UNDER REVIEW BY THE DENR Heirs of Xxxxxxx Xxxxxxxx: XXXX. XXXXXXXX X. XXXXX Suite 2104 B, East Tower Philippine Stock Exchange Center Bldg. Eschange Road, Ortigas Center Pasig City XXXXXXX X. XXXXXXXX Unit 2002 B, West Park Alder Condominium Northgate Filinvest Corporate City, Alabang Muntinlupa City XXXXXXX X. XXXXXXXX 0-X Xxxxx Xxxxxx, San Antonio San Francisco Del Monte Quezon City NOTE : MPSA UNDER REVIEW BY THE OSEC December 18, 2009 December 17, 2034 Xxxx Xxxxxxxxxx, Camarines Norte Iron, gold, etc. 153.7478
Xxxxxxx, P E./Project Manager / / Date ( ) - Phone CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER CERTIFICATION: Pursuant to Section VI. B. and VI. C. of the Agreement, the undersigned Chief Executive Officer and Chief Fiscal Officer of the Recipient, as both are designated in Appendix B of the Agreement, hereby request the Director to disburse financial assistance moneys made available to Project in Appendix C of the Agreement (inclusive of any amendment thereto) to the payee as identified below in the amount so indicated which amount equals the product of the Disbursement Ratio and the dollar value of the attached cost documentation which was properly billed to the Recipient in exclusive connection with the performance of the Project. The undersigned further certify that:
Xxxxxxxx, X X. Xxxxxx, as Trustee .................. 00 Xxxxx Xxxxxx, Xxxxxx, Xxxxxxxxxxxxx 00000
Xxxxxxxxx, Xx Xxxxxxx X. Xxxxxxxxx, Xx., Chief Executive Officer
