Xxxxxxx Xxxx CareFirst BlueChoice’s Service Area is a clearly defined geographic area in which CareFirst BlueChoice has arranged for the provision of health care services to be generally available and readily accessible to Members. CareFirst BlueChoice will provide the Member with a specific description of the Service Area at the time of enrollment. The Service Area is as follows: the District of Columbia; the state of Maryland; in the Commonwealth of Virginia, the cities of Alexandria and Fairfax, Arlington County, the town of Vienna and the areas of Fairfax and Xxxxxx Xxxxxxxx Counties in Virginia lying east of Route 123. SAMPLE If a Member temporarily lives out of the Service Area (for example, if a Dependent goes to college in another state), the Member may be able to take advantage of the CareFirst BlueChoice Away From Home Program. This Program may allow a Member who resides out of the Service Area for an extended period of time to utilize the benefits of an affiliated Blue Cross and Blue Shield HMO. This Program is not coordination of benefits. A Member who takes advantage of the Away From Home Program will be subject to the rules, regulations and plan benefits of the affiliated Blue Cross and Blue Shield HMO. If the Member makes a permanent move, he/she does not have to wait until the Annual Open Enrollment Period to change plans. Please call 000-000-0000 or visit xxx.xxxx.xxx for more information on the Away from Home Program. CareFirst BlueChoice, Inc. 000 Xxxxx Xxxxxx, XX Xxxxxxxxxx, XX 00000 000-000-0000 An independent licensee of the Blue Cross and Blue Shield Association ATTACHMENT A BENEFIT DETERMINATIONS AND APPEALS AMENDMENT This attachment contains certain terms that have a specific meaning as used herein. These terms are capitalized and defined in Section A below, and/or in the Individual Enrollment Agreement to which this document is attached. These procedures replace all prior procedures issued by CareFirst BlueChoice, which afford CareFirst BlueChoice Members recourse pertaining to denials and reductions of claims for benefits by CareFirst BlueChoice. These procedures only apply to claims for benefits. Notification required by these procedures will only be sent when a Member requests a benefit or files a claim in accordance with CareFirst BlueChoice procedures. An authorized representative may act on behalf of the Member in pursuing a benefit claim or appeal of an Adverse Benefit Determination. CareFirst BlueChoice may require reasonable proof to determine whether an individual has been properly authorized to act on behalf of a Member. In the case of a claim involving Urgent/Emergent Care, a Health Care Provider with knowledge of a Member's medical condition is permitted to act as the authorized representative. SAMPLE
Xxxxxxxx Xxxx Xxxxx, all sons of Late Xxxxx Xxx Xxxxx (13) Xxxxxx Xxxxxx, wife of Late Xxxxx Xxx Xxxxx and (14) Xxx Xxxxxxxxxx Xxxxxx, son of Late Xxxxxxxxx Xxxxxx, who has been represented by his lawfully constituted attorney Sri Xxxxxxxxx Xxxx Xxxxxxxx, son of Late Xxxxxx Xxxxxxx Xxxxxxxx, by way of a Deed of Sale in Bengali language (kobala) dated 03rd June 2016 registered in the office of the District Sub-Registrar-III, North 24 Parganas and recorded in Book-I, Volume No. 1519-2016, at Pages 23140 to 23177, being No. 151901072 for the year 2016, sold, conveyed and transferred in favour of Smt. Xxxxxxx Xxxx Xxxxxxxx, wife of Sri Xxxxxxxxx Xxxx Xxxxxxxx, ALL THAT (1) piece and parcel of Sali (agricultural) land measuring 12 (twelve) decimal, more or less, comprised in R.S./L.R. Dag No. 105, recorded under L.R. Khatian Nos. 291, 684, 247, 1696, 300, 1981, 175, 277, 1294 and 1383 and (2) piece and parcel of Sali (agricultural) land measuring 0.88 (zero point eight eight) decimal, more or less, equivalent to 383.64 (three hundred and eighty three point six four) square feet, more or less [out of total land measuring 08 (eight) decimal, more or less], being part of R.S./L.R. Dag No. 101, recorded in L.R. Khatian No. 1811, both aggregating to land measuring 12.88 (twelve point eight eight) decimal, more or less, Mouza Paschim Icchapur, X.X. No. 29, Xx.Xx. No. 202, Police Station Barasat, within the limits of Xxxx No. 34 of Barasat Municipality, Sub-Registration District Kadambagachi, District North 24 Parganas (hereinafter referred as “Lakshmi’s First Land”).
Xxxxxx Xxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 Xxxxxx.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 8163653200 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. Xxxxx Midwest LP Primary Address Primary Address 0000 X XX Xxxxxxx 00 Primary Address City Primary Address City 7 Kansas City Primary Address State Primary Address State (2 Digit Abbreviation) 8 MO Primary Address Zip Primary Address Zip 9 64129 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. Roof, Roofing, Membrane Roofing, Sheet Metal, Metal Panels, Siding, Flashing, Glazing, Thermal Moisture control, metal Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
Xxxxxx, Xx Xxxxxxx X.
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 xxxxx@xxxxxxxxx-xxxxxxxxxxxx.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 8175046801 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxx-xxxxxxxxxxxx.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 M&R Roofing and Construction Company, LLC Primary Address Primary Address 2 6 000 Xxxxxxx Xxxxx Primary Address City Primary Address City 7 Weatherford Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 TX Primary Address Zip Primary Address Zip 9 76087 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.
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 xxxxxx@xxxxxxxxxxxx.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 9142339990 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxxxx.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 No response Primary Address Primary Address 6 00 Xxxxxxx Xxxxxx, Ste. 2B Primary Address City Primary Address City 7 Xxxxxxxx Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 NY Primary Address Zip Primary Address Zip 9 10528 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. Construction, contractor, builder, general construction, site work, site development, utilities, procurement, cooperative, alternative, coop, building trades, mechanical, electrical, plumbing, sprinkler, consultant, commercial, educational, higher education, k-12, college, SUNY, municipal, state, public, housing, county, police, fire department, library, city, village, town, design, carpentry, demolition, estimating, FEMA, bridge, highway, pre- construction, labor and materials, finishes, doors, windows, flooring, security, athletic facilities, pre-fabrication, flooring, government, turf fields 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”);