Agency Information. Flatline Bristol Ltd, Registered office:000 Xxxxxxxxxxx Xxxx, Xxxxxxx, Xxxxxxx, XX0 0XX Tel: 0000 0000000 Email: xxxx@xxxxxxxxxxxxxx.xx.xx Registered in England no: 11614550 Members of: BALMA Client money protection: CM Protect Limited, Premiere House, 1st Floor, Elstree Way, Borehamwood, WD6 1JH. Redress scheme: Property Redress Scheme Premiere House, 1st Floor, Elstree Way, Borehamwood, WD6 1JH. Declaration I/We the Applicant(s), hereby confirm the acceptance of the Terms and Conditions set out above and the additional information provided below including those contained within our privacy policy. Signed: Print: for and on behalf of all Applicants IMPORTANT NOTE: The Landlord requires that all tenants provide a Guarantor.
Agency Information. Agency [Insert Agency name] Agency File Reference [Insert Agency file reference number] RFQ Reference [Insert Agency RFQ reference number] Agency Representative Name: [Insert contact name] Position: [Insert title] Address: [Insert address, including postcode] Email: [Insert email address] Contact number: [Insert contact number, including area code] RFQ and Proposed Order Details RFQ Release Date [insert date the RFQ is released] RFQ Closing Date [insert date and time the RFQ closes] Proposed Order Commencement Date [insert date the Services will commence] Proposed Order Term and/or Completion Date [insert the order term and/or completion date] Request For Quotation for Services Options to extend The Agency may extend the Contract for [insert time period] by providing written notice to the Service Provider prior to the Order Completion Date. Milestones [Insert proposed milestones for the delivery of the Services] Statement of Work Service Area [Insert which Service Category within a Service Area the Services required relate to (Financial/Corporate/Commercial)] Service Category [Insert the relevant Service Category that the services relate to] Service Sub-category [Insert the relevant Service Subcategory that the services relate to] Detailed Statement of Work [Insert a detailed description of the Services required and any Associated Outputs, including relevant background material and whether any licences/authorisations are required to provide the services and any reporting that may be required. A separate Statement of Work may be referenced and attached] Deliverables [include details of any deliverables required under a resulting Contract] Subcontractors [Select one of the following statements: The Service Provider may nominate subcontractors to provide some or all of the Services; or The Service Provider may not nominate subcontractors to provide some or all of the Services.] Location [Insert the required work location/site, or insert ‘Not Applicable’] Fees [Insert details of fee structure e.g. hourly/daily rates, fixed fee] Payment Terms [Select the relevant payment terms] [For Non-corporate Commonwealth entities: (a) five calendar days where the Agency and the Service Provider both have the capability to deliver and receive e Invoices through the Pan-European Public Procurement On-Line Framework and have agreed to use this method of invoicing; or (b) 20 calendar days] [For Agencies other than Non-corporate Commonwealth entities: [insert payment terms]] Tr...
Agency Information. How did you find out about Alternatives For Girls (Please be as specific as possible)? What personal, professional, experiential, or other skills and/or resources would you offer to AFG as an Intern? What do you expect from your internship experience? Have you been involved with an organization that serves girls and/or young women? If yes, in what capacity? References Please list the three references that you will give the reference forms to. Name Phone Name Phone Name Phone I understand that I need to meet with and attend New Intern Orientation training with the Volunteer Services Manager before I begin my internship or volunteer service. I also understand that I must comply with all of Alternatives For Girls’ requirements prior to and during my internship.
Agency Information. Please complete and return 2 copies for participation in the COMPANY's Mass Marketing Programs. AGENCY Name: Address: County Telephone No. ( ) Fax No. ( ) e-mail address: (circle one below) Partnership Sole Proprietor Corporation or LLC Date Established: Federal ID #: PRESENT PRINCIPALS/SHAREHOLDERS Years Name Title E-Mail Experience @ @ @ @ Number of Licensed Agents/Producers: Total Premium Volume: Premium Mix Personal Lines %Commercial Lines % TOP PREMIUM VOLUME COMPANIES Carrier Branch Office 3 Yr. Loss Ratio MGAs Program 3 Yr. Loss Ratio TERMS AND CONDITIONS
Agency Information. Each Borrower and the Guarantor shall make available the Chief Executive Officer, the President, the Chief Financial Officer, and/or any other appropriate officer of such Borrower or Guarantor, as applicable, to participate in discussions with Lender and provide information with respect to the following: (i) a projection of the obligations of such Borrower in connection with (A) repurchase obligations to Agencies and (B) amounts that may have been required to be deposited or entitled to be withdrawn from the Agency Collateral Account (the “Agency Obligations”), (ii) a projection of the impact the Agency Obligations may have on the operations of such Borrower, including but not limited to, the net impact on liquidity, statements of income, retained earnings and cash flows, (iii) the projected date of resolution of the Agency Obligations, and (iv) such other information as may be reasonably requested by the Lender, including information related to Subservicer’s financial condition, in all cases to the extent such Borrower is not prohibited from disclosing such information
Agency Information. Each Borrower shall make available the President, Chief Financial Officer and any other applicable officers of such Borrower to participate in discussions with Lender and provide information with respect to the following: (i) a projection of the obligations of such Borrower in connection with (A) all Agency Obligations and (B) amounts that may have been required to be deposited or withdrawn from any Collateral Account with any Agency (the “Collateral Account Activity”), (ii) a projection of the impact the Agency Obligations may have on the operations of Borrower, including but not limited to, the net impact on liquidity, statements of income, retained earnings and cash flows, (iii) the projected date of resolution of the Agency Obligations, and (iv) such other information as may be reasonably requested by the Lender, including information related to Subservicer’s financial condition, in all cases to the extent Borrower is not prohibited from disclosing such information.
Agency Information. Upon reasonable notice during normal business hours, the Borrower shall make available the Chief Executive Officer, the President, the Chief Financial Officer, any Executive Vice President or the Treasurer of the Borrower to participate in discussions with Xxxxxx and provide information with respect to the following: (i) a projection of the obligations of the Borrower in connection with (A) repurchase obligations to Agencies and (B) amounts that may have been required to be deposited or withdrawn from the related Agency Collateral Account (the “Agency Obligations”), (ii) a projection of the impact the Agency Obligations may have on the operations of the Borrower, including but not limited to, the net impact on liquidity, statements of income, retained earnings and cash flows,
Agency Information. Upon reasonable notice during normal business hours, the Borrower shall make available the Chief Executive Officer, the President, the Chief Financial Officer, any Executive Vice President or the Treasurer of the Borrower to participate in discussions with Xxxxxx and provide information with respect to the following: (i) a projection of the obligations of the Borrower in connection with (A) repurchase obligations to Agencies and (B) amounts that may have been required to be deposited or withdrawn from the related Agency Collateral Account (the “Agency Obligations”), (ii) a projection of the impact the Agency Obligations may have on the operations of the Borrower, including but not limited to, the net impact on liquidity, statements of income, retained earnings and cash flows, (iii) the projected date of resolution of the Agency Obligations, and (iv) such other information as may be reasonably requested by the Lender, in all cases to the extent the Borrower is not prohibited from disclosing such information.
Agency Information. Agency Authorized Recipient (Agency Name) Government Agency Applicant Type Yes No Physical Address Originating Agency Identifier (ORI) City State ZIP Code Outsourcing Is your agency outsourcing any functions that may allow contractor access to Criminal History Record Information (CHRI)? Examples of outsourcing include, but are not limited to, performing information technology (IT) services, storage and/or destruction of criminal history record results, making fitness recommendations for employment or Licensing and obtaining missing dispositions. If yes, provide contractor name, phone and email address below. Yes No Noncriminal Agency Coordinator (NAC) Authorized Personnel's Full Name and Title (Individual authorized to request and receive Criminal History Record Information (CHRI) on behalf of the agency. Phone Number FAX Number NAC's Email Address Local Agency Security Officer (LASO) Authorized Personnel's Full Name and Title (This individual is the primary Information Security contact between the Agency, the Bureau and Office of Technology Services (OTS)) Phone Number FAX Number LASO's Email Address A request for ACCESS AND RECEIPT OF CRIMINAL HISTORY RECORD INFORMATION The Agency listed on page 1 shall be hereinafter referred to as the "Agency."
Agency Information. FEDERAL PROGRAM AGENCY AGENCY IDENTIFIER: AGENCY LOCATION CODE (ALC): ACH FORMAT: CCD+ CTX CTP ADDRESS: CONTACT PERSON NAME: TELEPHONE NUMBER: ( ) ADDITIONAL INFORMATION: PAYEE/COMPANY INFORMATION NAME SSN NO. OR TAXPAYER ID NO. ADDRESS CONTACT PERSON NAME: TELEPHONE NUMBER: ( ) FINANCIAL INSTITUTION INFORMATION NAME: ADDRESS:
