Authorized Signature Date. Please complete this “Agreement for Use” and return it with your security deposit to: Woodlands Camp 0000 Xxx Xxxx Xxxxx Xxxx Cleveland, GA 30528 Office Use Only:
Authorized Signature Date. Specifications
Authorized Signature Date. Name as it appears on Card Credit Card # Visa Master Disc AMX Expiration Date (mm/yy) Security Code Phone Card Billing Address City State Zip
Authorized Signature Date. Return completed Dukane Service Center Request Form with your security deposit and shipping purchase order to the Dukane Ultrasonic Service Center. Requesting company or organization must be a reqgistered Dukane IAS customer.
Authorized Signature Date. TITLE: ----------------------- WITNESSES: XXXXXX COUNTY - ECONOMIC DEVELOPM£ HOR/ \ ;$ 4\2 . ) J ; t /;. 01·.5 AUTHORIZED SIGNATURE Date TITLE: C,Jy._ 1, ,..:,) EXHIBIT"A" B CREATION GRANT PROGRAM (JCP) GUIDELINES Xxxxxx County Economic Development Authority c/o County Manager's Xxxxxx 000 X.Xxxxxx Xxxxxx, Room 103 Wauchula, FL 33873 Voice (000) 000-0000 Fax (000) 000-0000 GUIDELINES OF THE XXXXXX COUNTY ECONOMIC DEVELOPMENT AUTHORITY (INDEPENDENT BOARD) JOB CREATION GRANT PROGRAM (JCP) I. PURPOSE
Authorized Signature Date. Printed Name Title 1 For frequently asked questions concerning Oklahoma Sales Tax Permit, see xxxx://xxx.xxx.xx.xxx/faq/faqbussales.html 2 For frequently asked questions concerning workers’ compensation insurance, see xxxx://xxx.xx.xxx/oid/faqs.html#c221 xxxx://xxx.xxx.xx.xxx/ xxxx://xxx.xxx.xx.xxx/faq/faqbussales.html xxxx://xxx.xx.xxx/oid/faqs.html#c221 ATTACHMENT G PAST USAGE DATA SW192 Construction Equipment Spend Fiscal Year 2016-Oklahoma Oklahoma: Total Political subdivisions and Higher Ed: $31,316,444.74 Oklahoma: Total State Agencies: $3,316,444.74 Oklahoma: Total Non-Affiliates: $29,358.02 Nebraska Annual State Spend: $2,429,298.00 Florida Annual State Spend: $3,538,452.00 Annual Political Subdivision Spend: $950,000. South Dakota Estimated Volume: $35,000,000.00 Attachment D-3 Past Performance Verification Supplier is to have this filled out by 3 separate government contract clients and returned with their response to the solicitation. Failure to submit this for 3 clients will result in your response not being considered. (pass/fail) Date: Name: (Name and title) Phone: Fax: Subject: Past Performance Survey of: (Name of Vendor requesting verification) The State of Oklahoma is collecting past performance information on prospective vendors. The information will be used to assist the State in the selection of vendors for NASPO ValuePoint OK-SW-192 Construction Equipment. Rate each of the criteria on a scale of 1 to 5. Please rate each of the criteria to the best of your knowledge. If you do not have sufficient knowledge of past performance in a particular area, leave it blank.
Authorized Signature Date. For office use only Child’s start date: PAD start date: $50 registration fee ½ first month ½ first month
Authorized Signature Date. 8. Report of Mold Assessment Results. Following the visual inspection and additional sampling (if conducted), CLIENT will be provided with a Mold Assessment Report identifying: Types and levels of molds read in samples along with sample locations; a description of each type of mold discovered; and a summary of findings. If all identified “red flag” areas are sampled, Mold Remediation Strategies will be provided. These strategies will identify remediation activities based on current published guidelines.
Authorized Signature Date. Please attach a voided check or deposit slip and return this form to the Payroll Department.
Authorized Signature Date. Instructions A certification of origin that is the basis for a claim for preferential tariff treatment under this Agreement shall include the following elements:
