Contact Information 1. The contact information of the Programme Operator is as specified in this programme agreement.
CONTRACT INFORMATION 1. The State of Arkansas may not contract with another party:
LICENSE HOLDER CONTACT INFORMATION This noƟce is being provided for informaƟon purposes. It does not create an obligaƟon for you to use the broker’s services. Please acknowledge receipt of this noƟce below and retain a copy for your records. Davidson Bogel Real Estate, LLC 9004427 xxxx@xx0xx.xxx 214-526-3626 Licensed Broker /Broker Firm Name or Primary Assumed Business Name License No. Email Phone Xxxxxxx Xxxxxx Xxxxx XX 598526 xxxxxx@xx0xx.xxx 214-526-3626 Designated Broker of Firm License No. Email Phone Xxxxxxxxxxx Xxxx Xxxxxx 672133 xxxxxxx@xx0xx.xxx 214-526-3626 Licensed Supervisor of Sales Agent/ Associate License No. Email Phone N/A N/A N/A N/A Sales Agent/Associate’s Name License No. Email Phone Buyer/Tenant/Seller/Landlord Initials Date Regulated by the Texas Real Estate Commission InformaƟon available at xxx.xxxx.xxxxx.xxx
Emergency Contact Information Resident must complete and provide to University an emergency contact information form provided by University Housing before Resident will be allowed to move into the Residence Facility.
Product Information Contractor shall provide the following information for all goods provided pursuant to this Agreement: manufacturer’s name, product code number, and pack size.
Project Information Except for confidential information designated by the City as information not to be shared, Consultant agrees to share Project information with, and to fully cooperate with, those corporations, firms, contractors, public utilities, governmental entities, and persons involved in or associated with the Project. No information, news, or press releases related to the Project, whether made to representatives of newspapers, magazines, or television and radio stations, shall be made without the written authorization of the City’s Project Manager.
Client Information (2) Protected Health Information in any form including without limitation, Electronic Protected Health Information or Unsecured Protected Health Information (herein “PHI”);
Service Information Pages Verizon shall include all VarTec NXX codes associated with the geographic areas to which each directory pertains, to the extent it does so for Verizon’s own NXX codes, in any lists of such codes that are contained in the general reference portion of each directory. VarTec’s NXX codes shall appear in such lists in the same manner as Verizon’s NXX information. In addition, when VarTec is authorized to, and is offering, local service to Customers located within the geographic area covered by a specific directory, at VarTec’s request, Verizon shall include, at no charge, in the “Customer Guide” or comparable section of the applicable alphabetical directories, VarTec’s critical contact information for VarTec’s installation, repair and Customer service, as provided by VarTec. Such critical contact information shall appear alphabetically by local exchange carrier and in accordance with Verizon’s generally applicable policies. VarTec shall be responsible for providing the necessary information to Verizon by the applicable close date for each affected directory.
Alert Information As Alerts delivered via SMS, email and push notifications are not encrypted, we will never include your passcode or full account number. You acknowledge and agree that Alerts may not be encrypted and may include your name and some information about your accounts, and anyone with access to your Alerts will be able to view the contents of these messages.
Service Information Service Visit Date Mode of service Face-to face, telephone, etc. Responsibility for payment Used to exclude federal govt., WCB, etc. Main and secondary diagnoses ICD10-CA codes Main and other interventions and attributes CCI procedure codes and attributes Type of Anesthetic Identifies the type used for interventions (general, spinal, local, etc.) Provider types NACRS code assigned to provider type (MD, Dentist, RN, etc.) Doctor name and identifier Physician specific information Admit via Ambulance Used if a Client is brought to the service delivery site by ambulance Institution from and institution to Used when a Client is transferred from or to another acute care facility Visit disposition Discharged, admitted, left without being seen, etc. Schedule “D” Appendix 2 Additional Elements Required for Data Management (XXX) Client Identifying Information Province Client‟s Home Province AB, BC, SK, MB, NL, PE, NS, NB, QC, ON, NT, YT, NU, US, OC (Other Country), NR (Unsp. Non-resident) Service Information Facility Code AHS provided code that indicates service being provided. Facility Fee Dollar value of service being provided Alberta Health Physician Fee Billing Code Alberta Health Physician Service Fee code that further defines facility code Regional standard format and submission method remains as is via excel file and email. NOTE: Submission method may be adjusted in accordance with security standards of AHS. Schedule “D” Appendix 3