Representative Email Address definition

Representative Email Address. Enter the email address. PLEASE PRINT CLEARLY. This should be a business email address. This email address will be entered as part of your Submitter file profile. This email address will be used to contact someone from your company concerning the electronic file submission or allow you to submit HIPAA electronic claims.
Sample 1Sample 2Sample 3
Representative Email Address. Enter the email address. PLEASE PRINT CLEARLY. This should be a business email address. This email address will be entered as part of your Submitter file profile. This email address will be used to send a confirmation to acknowledge the processing of the EDI AGREEMENT and confirm your submitter profile has been updated to allow you to send TEST NCPDP D.0 or 1.2 claims.
Sample 1

Examples of Representative Email Address in a sentence

  • Vendor’s Name/Company Name: Address, City, State, and Zip Code: Phone Number: Fax Number: Printed Name and Title of Authorized Representative: Email Address: Signature of Authorized Representative: Date: Federal Tax ID # NORTHSIDE INDEPENDENT SCHOOL DISTRICT PURCHASING GENERAL TERMS AND CONDITIONS‌ The following terms and conditions are incorporated into this RFP and incorporated into any formal written agreement between NISD and the successful Proposer(s).

  • From:Company Name Website Representative Email Address Complete Address City State Zip Telephone Number Fax NumberE-VERIFY AFFIDAVIT Pursuant to O.C.G.A. § 13-10-91, a public employer shall not enter into a contract for the performance of services unless the contractor registers and participates in the federal work authorization program.

  • VENDOR/CONTRACTOR Name/Company Name: Address, City, State, and Zip Code: Phone Number: Fax Number: Printed Name of Authorized Representative: Email Address: Signature of Authorized Representative: Date: VII.

  • Company Name and Address of Bidder: Signature of Bidder Date Printed Name and Title of Representative: Email Address: EIN#: IMPORTANT: This bid analysis form is the only pricing format acceptable.

  • Tenderer Name & Signature Designation Address Tel No. Fax No Cell No. & Name (Representative) Email Address GST No. NTN No. Seal SCM – Supply Chain Management(RUPEES ONE HUNDRED NON-JUDICIAL STAMP PAPER) Distract.

  • Tenderer Name & Signature Designation Address Tel No. Fax No Cell No. & Name (Representative) Email Address GST No. NTN No. Seal SCM – Supply Chain Management(RUPEES ONE HUNDRED NON-JUDICIAL STAMP PAPER) Manager SCM LHE, SCM DepartmentPakistan Intentional Airlines PIA Lahore.

  • Contractor’s Name/Company Name: Address, City, State, and Zip Code: Phone Number: Fax Number: Printed Name and Title of Authorized Representative: Email Address: Signature of Authorized Representative: Date: Complete the Small Business Program participation plan form and submit the Exhibit at the time set forth in the RFP.

  • Authorized Representative Email Address: Insert the email address of the contractor’s authorized representative.

  • Name of Member: Name of Representative Completing this Form on Behalf of Member: Mailing Address of Representative: Email Address of Representative: Draft Standard to which this Election Form relates: A.

  • Name of Participant: Name of Representative Completing this Form on Behalf of Participant: Mailing Address of Representative: Email Address of Representative: Draft Standard and RFP (if any) to which this Form relates: A.

Related to Representative Email Address

  • Email Address means a current valid email address.

  • Notification Email Address means the email address (if any) designated by Customer, via the user interface of the Processor Services or such other means provided by Google, to receive certain notifications from Google relating to these Data Processing Terms.

  • IP Address means a unique number on the Internet of a network card or controller that identifies a device and is visible by all other devices on the Internet.

  • Electronic mail address means a destination, commonly expressed as a string of characters, consisting of a unique user name or mailbox (commonly referred to as the “local part” of the address) and a reference to an internet domain (commonly referred to as the “domain part” of the address), whether or not displayed, to which electronic mail can be sent or delivered.

  • Residential address means the physical location where the student’s parents, legal guardians, persons having legal, lawful control of the student under order of a court, or persons standing in loco parentis reside. A student may use the residential address of a legal guardian, person having legal, lawful control of the student under order of a court, or person standing in loco parentis only if the student resides at the same residential address and if the guardianship or other legal authority is not granted solely for educational needs or school attendance purposes.

  • Class Member Address Search means the Administrator’s investigation and search for current Class Member mailing addresses using all reasonably available sources, methods and means including, but not limited to, the National Change of Address database, skip traces, and direct contact by the Administrator with Class Members.

  • Home Address , in relation to a person, means—

  • representative office means any of- fice of a foreign bank which is located in any state and is not a Federal branch, Federal agency, State branch, State agency, or commercial lending company subsidiary.

  • Notice Address means with respect to the following entities:

  • Last known address means the address the Tax Administrator has at the time a document is originally sent by certified mail, or any address the Tax Administrator can ascertain using reasonable means such as the use of a change of address service offered by the postal service or an authorized delivery service under Section5703.056 of the ORC.

  • Billing address means the location indicated in the books and records of the taxpayer as the primary mailing address relating to a customer’s account as of the time of the transaction as kept in good faith in the normal course of business and not for tax avoidance purposes.

  • Sevicer Loan Address Zip Code: Rem Term: Occp Code: Appr Value: Note Date: Ceiling Lien City: Purpose: Prod Code: Curr CLTV: Prin Maturity Cr. Cr. 3561419 CA 300 14 $279,200.00 09/01/2000 2.00 45 356141900000000 11898 Crescent Drive 01 298 1 $349,000.00 06/01/2000 18.00 2 Grass Valley 95945 2 5.99 90 $34,471.39 06/01/2025 $34,900 716 3550802 CA 180 14 $252,700.00 09/02/2000 3.00 45 355080200000000 45 Cleo Court 01 178 1 $320,000.00 06/02/2000 18.00 2 Novato 94947 1 5.99 94 $46,472.83 06/02/2015 $48,000 753 3540894 CA 300 14 $204,000.00 12/02/2000 4.88 48 354089400000000 236 Center Avenue 01 298 1 $255,000.00 06/02/2000 18.00 2 Pacheco 94553 2 8.5 90 $24,348.15 06/02/2025 $25,000 636 3536787 CA 180 14 $144,000.00 09/02/2000 4.50 42 353678700000000 18714 Bainbury Street 02 178 1 $180,000.00 06/02/2000 18.00 2 Santa Clarita 91351 1 5.99 93 $21,525.92 06/02/2015 $22,500 659 3536734 CO 300 14 $112,408.00 09/02/2000 1.75 42 353673400000000 2065 Hooker Street 02 298 1 $165,000.00 06/02/2000 18.00 2 Denver 80211 2 5.99 80 $19,285.14 06/02/2025 $19,500 628 3551343 GA 180 09 $162,500.00 2.75 49 355134300000000 5097 Faversham Hil Drive 01 178 1 $203,185.00 06/02/2000 18.00 2 Suwanee 30024 1 12.25 100 $40,600.00 06/02/2015 $40,600 730 3538853 MA 180 14 $150,000.00 12/02/2000 4.00 45 353885300000000 21 Elaine Avenue 02 178 1 $200,000.00 06/02/2000 18.00 2 Peabody 01960 1 8.5 95 $39,508.76 06/02/2015 $40,000 641 3539868 FL 181 14 $78,068.00 12/02/2000 3.25 27 353986800000000 8527 Irving Road 02 179 1 $98,000.00 06/02/2000 18.00 2 Fort Myers 33912 1 8.5 93 $12,500.00 07/01/2015 $12,500 682 3535290 NJ 180 14 $336,000.00 12/02/2000 3.50 44 353529000000000 801 Westend Place 01 178 1 $420,000.00 06/02/2000 24.00 2 Cranford 07016 3 8.5 95 $63,000.00 06/02/2015 $63,000 687 3543538 WA 180 14 $320,000.00 09/02/2000 2.75 41 354353800000000 6957 N W Illich Road 01 178 1 $400,000.00 06/02/2000 18.00 2 Silverdale 98383 1 5.99 95 $22,007.38 06/02/2015 $60,000 814 3548385 NJ 300 14 $215,000.00 09/07/2000 2.25 42 354838500000000 2 Algonquin Terrace 02 298 1 $320,000.00 06/02/2000 18.00 2 Millstone 07726 2 5.99 75 $24,973.39 06/02/2025 $25,000 630 3551546 GA 180 09 $420,000.00 09/02/2000 3.75 44 355154600000000 1360 Creek Ridge Creek 01 178 1 $525,000.00 06/02/2000 18.00 2 Alpharetta 30005 1 5.99 95 $78,750.00 06/02/2015 $78,750 736 Page 187 of 318

  • Mailing Address City: State: Zip: Email Address: Is this your first GSA Sale?: Yes No _ (mark appropriate one) Telemarketing Phone Call (Auction House) GSA Fleet E-Mail Auction House Social Media GSA Auctions Website (xxxxxxxxxxx.xxx) Auction House Email Blast Newspaper Ad GSA Fleet Website (XxxxXxxxxxxx.xxx.xxx) Friend/ Relative Other (please specify)

  • Master Street Address Guide or "MSAG" is a database of street names and house number ranges within their associated communities defining particular geographic areas and their associated ESNs to enable proper routing of 911 calls. "Meet Point" is a point of Interconnection between two (2) networks, designated by two (2) Telecommunications Carriers, at which one Carrier's responsibility for service begins and the other Carrier's responsibility ends.

  • Email address of record means the designated email

  • Service address means the service address of a member or the body corporate in terms of rule 4; and

  • Street Address means, with respect to a physical location, the street name and number, city, state, and (if not the United States) country, and the postal code, if any, that is required for delivery of mail to the location. If, by reason of rural location or otherwise, a street name and number, city, or town does not exist, "street address" shall mean an appropriate description fixing as nearly as possible the actual physical location, but, for all locations in the United States, the county or parish and, if any, the rural free delivery route and the United States postal code shall be included.

  • Proof of address/business address means a document less than 3 months old containing residential address that is a utility bill, bank statement, rates account or tax invoice.

  • Authorized Address means (1) any Officially Designated address to which redemption proceeds may be sent, (2) any address designated in writing (not to include Electronic Transmission) by the Shareholder of Record and received by the Insured at least one (1) day prior to the effective date of such designation, or (3) any address designated by voice over the telephone or by Electronic Transmission by the Shareholder of Record at least 15 days prior to the effective date of such designation.

  • Undeliverable address means an address to which the postal service or an authorized delivery service under Section5703.056 of the ORC is not able to deliver an assessment of the Tax Administrator, except when the reason for non-delivery is because the addressee fails to acknowledge or accept the assessment.

  • Business address means a single address of a governmental agency designated for the public to contact an employee or officer of the governmental agency.

  • supply address means the premises to which gas was, is or may be supplied under a contract.

  • Delivery Address means the address stated on the Order.

  • electronic address means any number or address used for the purposes of sending or receiving notices, documents or information by electronic means;

  • Contact Name Date: Address: Phone: City: State: Zip Code: Email:

  • Notice Addresses Landlord: Tenant: