AGREEMENT SIGNATURE. TO: AMERICAN EXPRESS INTERNATIONAL (NZ), INC. The Entity named above (“You”)requests that American Express International (NZ) Inc provide the Corporate Payment products (“Accounts”) elected in this application. The undersigned officer has read the attached Terms and Conditions and agrees that on your behalf you will be bound by them and liable for charges in accordance with these Terms and Conditions. You authorise American Express International (NZ) Inc to contact your bankers or any other source, including but not limited to Credit Reporting Agencies to obtain any information American Express requires to establish the chosen Accounts. You agree that a microfilmed or other reproduction of this form may be produced by American Express as evidence of your request to open the chosen Account(s). The undersigned warrants to American Express that he/she is duly authorised by you to open the chosen Account(s) in the name of the above Entity. Title First Name Last Name Position Company Name (As per registered Company Name) Telephone Number Fax Number – – We need an email address to send the Company changes to the Terms and Conditions, servicing and marketing communications from American Express. Email Address (Mandatory) In order to comply with the Anti-Money Laundering and Countering Financing of Terrorism Act 2009 American Express International (NZ) Inc is required to gather identification information (including residential address and date of birth) on those individuals that are authorised to act on behalf of the customer, this includes the Authorised Signatory, Programme Administrator and the Decision Maker. We will not be able to process your application without this information. Decision Maker’s Address14 City Postcode Date of birth D D / M M / Y Y Company Decision Maker’s Signature14 ✘ Date D D / M M / Y Y Y Y
AGREEMENT SIGNATURE. Signed ................................................................. Date ................................. Name in block capitals:........................................... Xxxx authorised to sign for and on behalf of RSSB and Signed.................................................................. Date ................................. Name in block capitals: .......................................... Xxxx authorised to sign for and on behalf of [Contractor] SCHEDULE ONE Services The services shall be the work as fully described in the following documents: [Insert the document name of the Invitation document used and date] [Insert the document name of the Contractor’s proposal, reference and date; list all contract negotiation emails if not available in one document] SCHEUDLE TWO Agreement Price and Payment (Use this schedule when price is a FIRM FEE)
AGREEMENT SIGNATURE. This Agreement, including its applicable schedules, has been executed and takes effect on the date of last signature written below. Name of MSBase/MGBase centre (e.g. hospital or clinic): Centre Authority (Head of Department, or similar) Signature Date Name written in full Position MSBase Principal Investigator (Signs to acknowledge the Agreement): Signature Date Name written in full MGBase Principal Investigator (Signs to acknowledge the Agreement): Signature Date Name written in full The MSBase Foundation Ltd MSBase Foundation Director: Xxxxxx Xxxxxxxxxx
AGREEMENT SIGNATURE. TO: AMERICAN EXPRESS AUSTRALIA LIMITED The Entity named above (“You”)requests that American Express Australia Limited provide the Corporate Payment products (“Accounts”) elected in this application. The undersigned officer has read the attached Terms and Conditions and agrees that on your behalf you will be bound by them and liable for charges in accordance with these Terms and Conditions. You authorise American Express Australia Limited to contact your bankers or any other source, including but not limited to Credit Reporting Agencies to obtain any information American Express requires to establish the chosen Accounts. You agree that a microfilmed or other reproduction of this form may be produced by American Express as evidence of your request to open the chosen Account(s). The undersigned warrants to American Express that he/she is duly authorised by you to open the chosen Account(s) in the name of the above entity in his/ her capacity as (PLEASE TICK ONE): Director, if a Company, including where Company is a Trustee Partner, if a Partnership Chairperson, Secretary, or Treasurer if an Association/Co-operative Other (Please specify role): If the Company is a Trustee, the Trustee enters into this Agreement in its own right and as trustee of the Trust. Title First Name Last Name Position Company Name (As per registered ABN Company Name) Decision Maker’s Address14 City State Postcode Telephone Number Fax Number – – We need an email address to send the Company changes to the Terms and Conditions, servicing and marketing communications from American Express. Business Email Address (Mandatory) Decision Maker’s Signature14 ✘ Date D D / M M / Y Y Y Y
AGREEMENT SIGNATURE. This Agreement has been executed and takes effect on the date of last signature written below. Name of centre (e.g. hospital or clinic): Click or tap here to enter text. Centre Authority: Signature Date Name written in full Position MSBase Principal Investigator (Signs to acknowledge the Agreement): Signature Date Name written in full MGBase Principal Investigator – if applicable (Signs to acknowledge the Agreement): Signature Date Name written in full The MSBase Foundation Ltd MSBase Foundation Director: Xxxxxx Xxxxxxxxxx
AGREEMENT SIGNATURE. The agreement constitutes the entire agreement between the parties and supersedes all prior agreements, whether written or oral. The agreement shall become effective as the date it is fully executed by the parties hereto, provided that such execution occurs before the cut-off date. Until the effective date, no venue space arrangements herein are binding on Prairie du Chien Country Club. Each party here by represents to the other that the person(s) who sign this agreement below on its behalf is fully authorized to do so. Group Name: Date: Date: Date: Prairie du Chien Country Club Authorized Signature
AGREEMENT SIGNATURE. We have read and agree to abide by the sponsorship rules and regulations for 2023 NMA Colloquium stated in this agreement in their entirety. We have either completed above credit card information for the total sponsorship cost or have requested an invoice in ‘Payment Method’ dropdown. If invoice for payment requested, we are obligated to pay the invoice amount upon receipt of invoice per the net terms included in said invoice. Failure to do so shall result in an assessment of a late payment fee and may result in cancellation of the sponsorship purchase.
AGREEMENT SIGNATURE. I agree that initial assessment and guidance concerning the course has been provided, this included information about the course, its entry requirements, the implications of the choice of course, its suitability and the support which is available to students. I agree that I have read this document and the information given on this application is correct to the best of my knowledge. I agree that this information can be used to process my data for any purposes connected with my studies or my health and safety whilst on the premises or for any other contractual requirements and in particular to the disclosure of all the data on this form or otherwise collected about me to the ESFA for the purposes noted above in the Privacy Statement. Student Signature Date Once completed please return the form to: Xxxxxxxxxxxxx@xxxx.xx.xx HSDC, The MIS Enrolment Team, South Downs Campus, College Road, Waterlooville, PO7 8AA
AGREEMENT SIGNATURE. TO: AMERICAN EXPRESS AUSTRALIA LIMITED The Entity named above (“You”) requests that American Express Australia Limited provide the Corporate Payment products (“Accounts”) elected in this application. The undersigned officer has read the attached Terms and Conditions and agrees that on your behalf you will be bound by them and liable for charges in accordance with these Terms and Conditions. You authorise American Express Australia Limited to contact your bankers or any other source, including but not limited to Credit Reporting Agencies to obtain any information American Express requires to establish the chosen Accounts. You agree that a microfilmed or other reproduction of this form may be produced by American Express as evidence of your request to open the chosen Account(s). The undersigned warrants to American Express that he/she is duly authorised by you to open the chosen Account(s) in the name of the above entity in his/her capacity as (PLEASE TICK ONE): Director, if a Company, including where Company is a Trustee Partner, if a Partnership Chairperson, Secretary, or Treasurer if an Association/Co-operative Other (Please specify role): If the Company is a Trustee, the Trustee enters into this Agreement in its own right and as trustee of the Trust. Full Name Position Company Name (maximum 40 characters) (As per registered ABN Entity Name) Decision Maker’s Address12 City State Postcode Telephone Number – We need an email address to send the Company changes to the Terms and Conditions, servicing and marketing communications from American Express. Business Email Address Before you submit this form, check that you have provided true and correct information. It is an offence under the Anti-Money Laundering and Counter-Terrorism Financing Xxx 0000 to knowingly provide false, incomplete or misleading information. Decision Maker’s Signature12 ✘ Date D D / M M / Y Y Y Y State Postcode We need an email address to send the Company changes to the Terms and Conditions, servicing and marketing communications from American Express. Business Email Address I would like to enrol for BTA Reports YES NO Spend Comparison Report DHTML Airline Usage Report DHTML Trip Requisition Analysis DHTML Traveller Analysis Report DHTML Customer Reference Analysis DHTML Top 10 Air Routings Report DHTML Do you have an existing @ Work User ID? YES NO If Yes, please provide your User ID If No, please provide your day and month of birth. You will be prompted to enter this as authentication ...
AGREEMENT SIGNATURE. TO: AMERICAN EXPRESS AUSTRALIA LIMITED The Entity named above (“You”) requests that American Express Australia Limited provide the Corporate Payment products (“Accounts”) elected in this application. The undersigned officer has read the attached Terms and Conditions and agrees that on your behalf you will be bound by them and liable for charges in accordance with these Terms and Conditions. You authorise American Express Australia Limited to contact your bankers or any other source, including but not limited to Credit Reporting Agencies to obtain any information American Express requires to establish the chosen Accounts. You agree that a microfilmed or other reproduction of this form may be produced by American Express as evidence of your request to open the chosen Account(s). The undersigned warrants to American Express that he/she is duly authorised by you to open the chosen Account(s) in the name of the above entity in his/her capacity as (PLEASE TICK ONE): Director, if a Company, including where Company is a Trustee Partner, if a Partnership Chairperson, Secretary, or Treasurer if an Association/Co-operative Other (Please specify role): If the Company is a Trustee, the Trustee enters into this Agreement in its own right and as trustee of the Trust. I would like to enrol for BTA Reports YES NO Spend Comparison Report DHTML Airline Usage Report DHTML Trip Requisition Analysis DHTML Traveller Analysis Report DHTML Customer Reference Analysis DHTML Top 10 Air Routings Report DHTML Do you have an existing @ Work User ID ? YES NO If Yes, please provide your User ID Title First Name Last Name Position Company Name (maximum 40 characters) (As per registered ABN Entity Name) Decision Maker’s Address14 City State Postcode Telephone Number – Fax Number – We need an email address to send the Company changes to the Terms and Conditions, servicing and marketing communications from American Express. Business Email Address
