Official Use Only. No Personal Use The Contract is only for official use by Authorized Users. Use of the Contract for personal or private purposes is strictly prohibited.
Official Use Only. Sales Person Code Account Liability Code Corporate Type Worldwide CIF Bill Fee Control Account Name Existing Corporate ID Name of Company Liability Billing Common Anniversary Payment mode Membership Miles Postcode Fax No. Mailing Details: (for remittance advice & other MIS reports) Recipient Name Position Office Address Telephone No. Cardmember Merchant Company Amex Travel Travellers Cheques BTA The Acount Development Manager American Express Global Corporate Payments Dunning AMEX Relationship Other Remarks Approve by
Official Use Only. Credit Card Entered in Rec Trac by: Date: Date: Signature: Exp. Date: Credit Card #: Automatic Credit Card Billing (automatic monthly charge on credit card) Automatic Payment Plan: I agree to make my monthly payment, as stated above, under this contract, by: o Visa o MasterCard o Discover
Official Use Only. Unit Processing Instructions
Official Use Only. □ Age manager Age group………………………………. □Official □Duty roster □ Opt-Out
Official Use Only. The person named below as "Depositor" is herewith depositing, or has previously deposited with the County of San Diego the sum of $ for the initial review (Scoping) of the following application being filed with the County: Said deposit and any subsequent deposits are made on behalf of the person, corporation or partnership named below as the "Financially Responsible Party". With reference to said application and deposits, Depositor and Financially Responsible Party hereby acknowledge and agree as follows:
Official Use Only. By: Approving Authority (Signature) (Print Name)
Official Use Only. Student ID#: Signature of Accepting Official from The Art Institute of New York City: Title of Accepting Official: I hereby certify that I have complied with all state and accreditation statues and rules during the enrollment of this student. Admissions Officer: Date:
Official Use Only. Department Recommendations: Approved Denied Additional Costs Department Initials DPW (if applicable) Fire Dept. (if applicable) Police Dept. (if applicable) If recommendation is denied, please attach a brief explanation OFFICIAL USE ONLY Date Received Council Action: (Approved / Disapproved) Date of Council Action: Insurance Received (if applicable) Outdoor Dining Application #: Department: List Department Name Here Department Approval YES NO DPW Fire Police Department Cost Estimate: If applicable Estimate based on: Fillable table – type your response here: If Application not Approved, Provide Reason Here: Fillable table – type your response here: Submitted By: Name / Title Date Submitted Appendices OUTDOOR DINING INSPECTION YES Item to verify NO Corrective action Extension cords plugged into approved electrical boxes? Do not use unless cords plugged direct TEMPORARY STRUCTURE SETUP AND DAILY CHECKLIST (tent and membrane structures) YES Item to Verify NO Corrective Action Is structure at least 20 feet from any property lines? Do not occupy or use structure. Structure needs to be relocated a minimum of 20 feet from any property lines. Is structure within 20 feet of any building? Do not occupy or use structure. Structure needs to be relocated a minimum of 20 feet from any building. Is structure within 20 feet of another structure? Evaluate all structures within 20 feet of each other as a single structure meeting all applicable requirements. Is structure within 20 feet of parking? Restrict parking or relocate structure at least 20 feet from parking. Is structure within 20 feet of any internal combustion engines? Do not use internal combustion engine until relocated at least 20 feet from structure. Are "No Smoking" signs posted inside and outside? Do not occupy or use structure unless no smoking signs are posted and enforced. Inspection performed by: Date:
Official Use Only. Added to List Storage Charge Posted Initials (Post a Scheduled charge on the 2018 reservation with an arrival date of 11/01/17)
