Consent Disclosure Sample Clauses

Consent Disclosure. Per a separate form, additional consent will be requested to permit SIU to share student record information with UoR.
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Consent Disclosure. Where (a) an Applicant for this contract provided false particulars to the prejudice of the Insurer or knowingly misrepresents or fails to disclose any fact in any part of this application required to be stated therein; or (b) the Insured contravenes a term of the contract or commits a fraud; or (c) the Insured willfully makes false statement(s) in respect to a claim, the claim will become invalid and the Insured rights to recover are forfeited. The Applicant(s) have reviewed all parts and attachments of this application and acknowledge that all information is true, correct and understand that this application of insurance is based on the truth and completeness of this information. Any and all individual that have provided personal information in this document and otherwise may in the future provide further personal information. Some of this personal information may include, but is not limited to credit information and claims history. I/we authorize the broker or insurance company to collect, use and disclose any of this personal information, subject to the law and to the brok er or insurance company’s policy regarding personal information, for the purposes of communication, assessing the application for insurance underwriting, evaluating claims, detecting and preventing fraud, and analyzing business results. Any and all individuals whose personal information is contained in this document have authorized that and agree to the above. I/we hereby apply for insurance in the selected amount indicated on the application. I/we have voluntarily elected to purchase the insurance available through TOWERS REALTY GROUP LTD.. I/we have read the Coverage Summary on pages 3 to 4 of this agreement and understand that the insurance applied for under the Master Policy underwritten by XN Financial does have SPECIAL LIMITATIONS AND EXCLUSIONS. PRINT NAME: PRINT NAME: SIGNATURE: SIGNATURE: DATE: DATE: FOR ALL QUESTIONS ABOUT YOUR INSURANCE COVERAGE: PLEASE CALL 1 83 BFL CANADA Insu 3 351 6825 or email xxxxxxxxxxxxxx@xxxxxxxxx.xx rance Services Inc – ask for Tenant Program specialist TOWERS REALTY GROUP LTD. and their staff are not an Insurance Agent Please do not address questions regarding the insurance to the Manager/Landlord. Beneficiary Coverage Summary attached to Group Policy 4-449-1-0029‌ CERTIFICATE PERIOD: This insurance is effective 12:01am Standard time on the first day of insured move in date and after the first payment of premium unless otherwise stated. This ins...

Related to Consent Disclosure

  • LEAD PAINT DISCLOSURE (a) Lead Warning Statement. Housing built before 1978 may contain lead based paint. Lead from paint, paint chips, and dust can pose health hazards if not taken care of properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre 1978 housing, landlords must disclose the presence of known lead based paint and lead based paint hazards in the dwelling.

  • NEPOTISM DISCLOSURE A. In this section the term “relative” means:

  • Data Disclosure Under Minnesota Statute § 270C.65, Subdivision 3 and other applicable law, the Contractor consents to disclosure of its social security number, federal employer tax identification number, and/or Minnesota tax identification number, already provided to the State, to federal and state agencies and state personnel involved in the payment of state obligations. These identification numbers may be used in the enforcement of federal and state laws which could result in action requiring the Contractor to file state tax returns, pay delinquent state tax liabilities, if any, or pay other state liabilities.

  • Continuing Disclosure The Creditor may be required to provide you with regular statements. The statements will give you information about your account. Statements will be provided every six months if required. What Could Happen if You Fail to Meet Your Commitments: Security interestThe Creditor has an interest in the property listed below to secure performance of your obligations under the contract, or the payment of money payable under the contract, or both. If you fail to meet your commitments under the contract, including by granting a security interest over this property to another person, then to the extent of the security interest, the Creditor may be entitled to repossess and sell this property. If the sale of the property does not cover the whole of your liability to the Creditor, you will remain liable for the shortfall.Make: Model: Year: Registration No.: _ Chassis / Serial No.: Vin No: Colour: _ Default Interest Charges and Default FeesIn the event of a default in payment and while the default continues you must pay the Default Interest Charges. In the event of a breach of the contract or on the enforcement of the contract, the Default Fees specified below are payable. Your credit contract allows the Creditor to vary these fees and charges. Default Interest ChargesDefault interest is calculated at the rate of % per annum plus the annual interest rate referred to in the “Interest” section above. If you fail to make any payment (whether interest or otherwise) on the due date, you must, upon demand by the Creditor, pay the Creditor default interest on the overdue amount from the due date until the date that the Creditor receives full payment of that overdue amount. Default Fees $ dishonour fee, in respect of each payment which is dishonoured, or for which an automatic payment fails. The fee is payable and will be debited to your account at the time the relevant payment was due. $ late payment fee, in respect of each payment which is not made on its due date and remains outstanding for seven days after its due date. The fee is payable and will be debited to your account seven days after the due date for payment. $ repossession action fee, in respect of the Creditor commencing repossession of the Goods. The fee is payable and will be debited to your account at the time such repossession is commenced. $ post repossession fee. The fee is payable and will be debited to your account after realisation of the Goods or abandonment of realisation.An early repayment recovery amount as described in the “Full Prepayment” section below may be payable by you on the enforcement of the contract on demand by the Creditor. The method for calculating the early repayment recovery amount is further described in the General Conditions (Consumer).Costs incurred by the Creditor in connection with the enforcement of, taking advice on or taking any action pursuant to the contract, or otherwise in connection with the contract, are payable by you on demand by the Creditor on a full indemnity basis.

  • SELLER’S RADON DISCLOSURE Pursuant to the Montana Code Annotated §75-3-606, to the extent the property is habitable:

  • LEAD-BASED PAINT DISCLOSURE If the Property was constructed prior to 1978, Sublessee acknowledges receipt of the form entitled “LEAD-BASED PAINT DISCLOSURE” which contains disclosure of information on lead-based paint and/or lead-based paint hazards.

  • MEGAN’S LAW DISCLOSURE Pursuant to the provisions of Title 46, Chapter 23, Part 5 of the Montana Code Annotated, certain individuals are required to register their address with the local law enforcement offices agencies as part of Montana’s Sexual and Violent Offender Registration Act. In some communities, law enforcement offices will make the information concerning registered offenders available to the public. If you desire further information please contact the local County Sheriff’s office, the Montana Department of Justice, in Helena, Montana, and/or the probation officers assigned to the area.

  • Confidentiality and Safeguarding of University Records; Press Releases; Public Information Under this Agreement, Contractor may (1) create, (2) receive from or on behalf of University, or (3) have access to, records or record systems (collectively, University Records). Among other things, University Records may contain social security numbers, credit card numbers, or data protected or made confidential or sensitive by Applicable Laws. [Option (Include if University Records are subject to FERPA.): Additional mandatory confidentiality and security compliance requirements with respect to University Records subject to the Family Educational Rights and Privacy Act, 20 United States Code (USC) §1232g (FERPA) are addressed in Section 12.41.] [Option (Include if University is a HIPAA Covered Entity and University Records are subject to HIPAA.): Additional mandatory confidentiality and security compliance requirements with respect to University Records subject to the Health Insurance Portability and Accountability Act and 45 Code of Federal Regulations (CFR) Part 160 and subparts A and E of Part 164 (collectively, HIPAA) are addressed in Section 12.26.] Contractor represents, warrants, and agrees that it will: (1) hold University Records in strict confidence and will not use or disclose University Records except as (a) permitted or required by this Agreement, (b) required by Applicable Laws, or (c) otherwise authorized by University in writing; (2) safeguard University Records according to reasonable administrative, physical and technical standards (such as standards established by the National Institute of Standards and Technology and the Center for Internet Security [Option (Include if Section 12.39 related to Payment Card Industry Data Security Standards is not include in this Agreement.):, as well as the Payment Card Industry Data Security Standards]) that are no less rigorous than the standards by which Contractor protects its own confidential information; (3) continually monitor its operations and take any action necessary to assure that University Records are safeguarded and the confidentiality of University Records is maintained in accordance with all Applicable Laws and the terms of this Agreement; and (4) comply with University Rules regarding access to and use of University’s computer systems, including UTS165 at xxxx://xxx.xxxxxxxx.xxx/board-of-regents/policy-library/policies/uts165-information-resources-use-and-security-policy. At the request of University, Contractor agrees to provide University with a written summary of the procedures Contractor uses to safeguard and maintain the confidentiality of University Records.

  • Slavery Era Disclosure Contractor shall comply with San Francisco Administrative Code Chapter 12Y, San Francisco Slavery Era Disclosure Ordinance, including but not limited to Contractor’s affirmative duty to research and disclose evidence of Contractor, its parent or subsidiary entity, or its Predecessor Company’s Participation in the Slave Trade or receipt of Profits from the Slave Trade. Contractor is subject to the enforcement and penalty provisions in Chapter 12Y.

  • Radon Gas Disclosure Radon is a naturally occurring radioactive gas that, when it has accumulated in a building in sufficient quantities, may present health risks to persons who are exposed to it over time. Levels of radon that exceed federal and state guidelines have been found in buildings in Florida. Additional information regarding radon and radon testing may be obtained from your county public health unit.

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