MUST BE COMPLETED. Has any applicant been insured for medical expenses under any policy or plan during the last 12 months, whether individual or group coverage?❑ Yes ❑ NoIf your response to the above question is yes, the following is required:1) Name of insured 2) A copy of any Certificates of Creditable Coverage from prior insurer or planNote:An individual must present satisfactory documentation to show the amount of creditable coverage and to calculate deductibles, coinsurance, limits, waiting periods, and/or exclusions.
MUST BE COMPLETED. Please post the signed amendment form to: Bank of IrelandGlobal Markets
MUST BE COMPLETED. If to the Contractor*: If to the Institution*: a t e w a y C o m m u n i t y C o l l e g e 2 h u r c h S t r e e t New Haven, CT 06510 A t t n : D e a n M a r k Kosinski, PH.D New Haven Public Schools 54 Meadow Street New Haven, CT 06519 Attn: Dr. Iline Tracey [Note: *Any party may change its Notice information in writing in accordance with this Section.]
MUST BE COMPLETED. BY THE OWNER OR OWNER’S AUTHORIZED AGENT (please print) SECCION 2: DEBE SER COMPLETADA POR EL DUENO O PROPIETARIO (favor de escribir en molde) Was unit built before 1978? □ Yes □ No Is this a HUD assisted unit: □ Yes □ No Name of Owner or Owner’s Authorized Agent: Nombre del Dueño o /Agente Autorizado: Name of Managing Company (if applicable): Nombre de la Compañía Encargada (si es aplicable): Mailing Address: Domicilio: Unit #: # de Unidad: City/Zip: Ciudad/Código Postal: Home Phone: Work or Daytime Phone: Teléfono: Número durante el día o del trabajo: Signature: Date: Firma: Fecha: By signing this form, the owner or owner’s agent and the tenant grant the contractor permission to enter the dwelling unit and to perform or install weatherization measures, minor home repair, and/or rehabilitation including but not limited to repair or replacement of doors and windows, caulking, door thresholds, water heater blankets and pipe wrap, insulation, setback thermostat, carbon monoxide detectors, mechanical ventilation, repair or replacement of inefficient or unsafe gas appliances (furnaces/stoves/water heaters), and additional measures to prevent the loss of heat and reduce the amount of energy consumption to the above-described unit, and agree to the following:
MUST BE COMPLETED. 1st 2nd 3rd 1st 2nd 3rd
MUST BE COMPLETED. This form is for:❑ Employee Only CoverageLate EnrollmentBeneficiary ChangeName Change❑ Life Insurance EnrollmentCoverage for DependentsAddress ChangeWaiver of CoverageNew EmployeeTermination (Initials: )❑ Change of StatusRemoval of Dependent(s)Participating Organization:Group ID Number:Full Legal Name: (Last, First, Middle)Citizenship:Are you a U.S. citizen or resident required to file a U.S. tax return? ❑ Yes ❑ No ❑ Male ❑ FemaleOccupation:Annual Salary: (Required if applying for a life amount based on 1x, 2x, or 3x salary)Requested Effective Date: / / (MM/DD/YYYY)Mailing Address:City:State/Country:Postal/Zip Code:Telephone:Country of Residence:At the time of this application, are any applicants currently located in the state of New York? (If yes, then the purchase of this plan is not available) ❑ Yes ❑ NoEmployee ID Number:Date of Birth: / / (MM/DD/YYYY)Height:Weight:
MUST BE COMPLETED. Consumer / Non-Corporate Farm Credit Agreement And Statement of Disclosure Mackenzie Cooperative Ltd. PO Box 190, Mackenzie BC V0J2C0 Phone: (250)997-3335 Fax: (250)997-4715 In consideration of the Co-op accepting your credit agreement, which forms part of this agreement, and opening an account in your name, you agree to the credit terms set out below:


  • ACCESS TO WORK District representatives shall at all times have access to the Work, wherever it is, in preparation or in progress. Contractor shall provide safe and proper facilities for such access.

  • Completion The Subcontractor will be required, unless otherwise stated under the terms of this Agreement, to complete the Services: (choose one) ☐ - By the Specific date of ______________________, 20____. ☐ - In accordance with industry standards. ☐ - Other: ________________________________________________________

  • Title to Work Title to Work, materials and equipment covered by an approved Application for Payment will pass to the Owner either by incorporation in construction or upon receipt of payment by the Contractor, whichever shall occur first;

  • Commissioning Functional testing and certification is complete. Forms and documentation which record the certification and performance of building systems, utility systems and equipment are fully executed and posted to the Princeton Collaborative System.

  • Inspection and Testing Each Constructing Entity shall cause inspection and testing of the Interconnection Facilities that it constructs in accordance with the provisions of this section. The Construction Parties acknowledge and agree that inspection and testing of facilities may be undertaken as facilities are completed and need not await completion of all of the facilities that a Constructing Entity is building.

  • Right to Work For purposes of federal immigration law, you will be required to provide to the Company documentary evidence of your identity and eligibility for employment in the United States. Such documentation must be provided to us within three (3) business days of your Start Date, or our employment relationship with you may be terminated.

  • Construction of the Improvements Borrower shall commence construction of the Improvements on or before the Construction Commencement Date, and shall prosecute the construction of the Improvements with diligence and continuity, in a good and workmanlike manner, and in accordance with sound building and engineering practices, all applicable Laws and governmental requirements, the Plans and the Loan Documents. Borrower shall not permit cessation of work for a period in excess of ten (10) consecutive days, except for Excusable Delays. Borrower shall complete construction of the Improvements free and clear of all liens (except liens created by the Loan Documents), and shall obtain a certificate of occupancy and all other permits, licenses and approvals from all applicable governmental authorities required for the occupancy, use and operation of the Improvements, in each case satisfactory to Administrative Agent, on or before the Completion Date. Borrower shall promptly after receiving knowledge of same, correct (a) any material defect in the Improvements, (b) any material departure from the Plans, Law or governmental requirements, or (c) any encroachment by any Improvements or structure on any building setback line, easement, property line or restricted area.

  • Condition of the Contractor’s Property or Equipment The Contractor shall make the Property and/or equipment available to the Judicial Council, pursuant to the terms and conditions set forth in this Agreement. The Contractor shall immediately remedy any problem with the Property’s physical plant or equipment that impairs or diminishes the quality of the Program. The Contractor shall ensure the appropriate hot water, heating, and ventilation is provided at the Property during the Program, inclusive in the prices set forth herein.

  • Approval of Plans and Specifications The Plans and Specifications will conform to the requirements and conditions set out by applicable law or any effective restrictive covenant, and to all governmental authorities which exercise jurisdiction over the Leased Premises or the construction thereon.