PLEASE INITIAL BELOW. EXPLANATION: An “exclusive right to sell” listing means that if you, the OWNER of the PROPERTY, find a buyer for your house, or if another broker finds a buyer, you must pay the agreed commission to the present broker. An “exclusive agency” listing means that if you, the OWNER of the PROPERTY, find a buyer, you will not have to pay a commission to the broker. However, if another broker finds a buyer, you will owe a commission to both the selling broker and your present broker. PARTIES SIGNATURE OWNER Date: OWNER Date: LISTING BROKER (Auth. Rep) Date: LISTING AGENT The “EFFECTIVE DATE” of this Agreement shall be latest date entered alongside the parties’ signatures Date:
PLEASE INITIAL BELOW. EXPLANATION: An “exclusive right to rent” listing means that if you, the LANDLORD of the PROPERTY, find a tenant for your house, or if another broker finds a tenant, you must pay the agreed commission to the present broker. An “exclusive agency” listing means that if you, the LANDLORD of the PROPERTY, find a tenant, you will not have to pay a commission to the broker. However, if another broker finds a buyer, you will owe a commission to both the selling broker and your present broker. PARTIES SIGNATURE LANDLORD Date: _ LANDLORD Date: _ LISTING BROKER (Auth. Rep) Date: _ LISTING AGENT _ Date: The “EFFECTIVE DATE” of this Agreement shall be latest date entered alongside the parties’ signatures
PLEASE INITIAL BELOW. I am physically fit and able to proceed in a fitness program with Xxxx Xxxx Fitness, LLC. I understand that the exercise and any weight training I am about to engage in can be dangerous if I do not consult with my personal physician prior to engagement. I am aware that the usual risks, hazards and dangers of personal injury, death and/or disability and loss (collectively “damages”), necessarily increase when myself or others use heavy weights and weight training machinery while engaging in such activity. I understand that these risks, hazards and dangers are further increased when other persons, whether or not of the same level of experience or skill, are present at the same time and using the same facilities. I also understand the importance of keeping my trainer informed of any existing or future health concerns. I have specified my package of choice and preferred weekly training days/times or I have specified that I will schedule individual sessions at the specified rate. I declare that I have read and agreed with the Xxxx Xxxx Fitness, LLC policies regarding payment and cancellations. Having read the policies, I understand that my package and/or individual sessions are non- transferrable and that all packages expire. Sessions are not refundable and a 48-hours advanced notice is required to cancel or reschedule all sessions. I have read, initialed, and signed this Client Agreement with full knowledge of its significance. I further state that I am at least 18 years of age and competent to sign this Client Agreement. Signature: Print Name: Date: Birthdate: Contact Email: Cell Phone: Address: City / State / Zip
PLEASE INITIAL BELOW. It is mutually agreed that the following terms and conditions shall govern the entire transaction and that said terms and conditions shall constitute the entire agreement and contract between the parties.
PLEASE INITIAL BELOW. 7% DISCOUNT: To receive a 7.00% discount off the annual rental amount, you will be required to pay in full the Annual Rental amount postmarked no later than December 15, 2012. Any contracts received after this date will void DISCOUNT being APPLIED toward slip rental and could result in the loss of current or preferred slip.
PLEASE INITIAL BELOW. I authorize Club Pet to transport my pet to a veterinary office if determined necessary by kennel management. I agree to be responsible for all costs and charges associated with this reasonable treatment and authorize Club Pet to use the credit card on file for payment of any medical charges at the time services are provided. By signing below, I acknowledge that I have read and agree to all items listed above.
PLEASE INITIAL BELOW. EXPLANATION: An “exclusive right to rent” listing means that if you, the LANDLORD of the PROPERTY, find a tenant for your house, or if another broker finds a tenant, you must pay the agreed commission to the present broker. An “exclusive agency” listing means that if you, the LANDLORD of the PROPERTY, find a tenant, you will not have to pay a commission to the broker. However, if another broker finds a buyer, you will owe a commission to both the renting broker and your present broker. PARTIES SIGNATURE LANDLORD _ LANDLORD _ LISTING BROKER (Auth. Rep) _ LISTING AGENT Date: Date: Date: Date: The “EFFECTIVE DATE” of this Agreement shall be latest date entered alongside the parties’ signatures
PLEASE INITIAL BELOW. This Agreement is for ongoing primary care and is NOT a medical insurance agreement. I do NOT have an emergent medical problem at this time. In the event of a medical emergency, I agree to call 911 first. I do NOT expect the practice to file or fight any third party insurance claims on my behalf. I do NOT expect the practice to prescribe chronic controlled substances on my behalf. (These include commonly abused opioid medications, benzodiazepines, and stimulants.) In the event I have a complaint about the Practice, I will first notify the Practice directly. This Agreement (without a “wrap around” compliant insurance policy) does not meet the individual insurance requirement of the Affordable Care Act. I am enrolling (myself and my family if applicable) in the practice voluntarily. I may receive a copy of this document upon request. This Agreement is non-transferable. APPENDIX 1 - Periodic & Enrollment Fees This Agreement is for ongoing primary care. This is Agreement is NOT HEALTH INSURANCE and is NOT A HEALTH MAINTENANCE ORGANIZATION. The Patient may need to use the care of specialists, emergency rooms, and urgent care centers that are outside the scope of this Agreement. The Nurse Practitioner within the Practice will make an appropriate determination about the scope of primary care services offered by the Nurse Practitioner. Examples of common conditions we treat, procedures we perform, and medications we prescribe are listed on our website and are subject to change. Fee Schedule Enrollment Fee: This is charged when the Patient enrolls with the Practice and is nonrefundable. This fee is subject to change. If a patient discontinues membership and wishes to re-enroll in the practice we reserve the right to decline re-enrollment or to require that the re-enrollment fee reflect an amount equivalent to the months of absent payments when dis-enrolled from the Practice. Your Enrollment fee is: Individual- $100. Family- $300 College Student- $60 Small Business $75 Re-enrollment Fee: Requests to restart memberships are subject to approval and availability. If accepted, a minimum re-enrollment fee of $200 per person will apply before service can be restarted. Monthly Periodic Fee: (billed at the beginning of the service period) – This fee is for ongoing primary care services. There is a 3% administration fee added to your monthly membership each month for credit card users and a 1% administration fee added to ACH account members. Scheduled in person visits per ye...
PLEASE INITIAL BELOW. Dings or scratches to walls, wallpaper, cabinets, trim, old paint, stain or wallpaper lines not 100% covered by new countertops. Damage to existing plumbing, faucets, and disposals due to age, corrosion and/ or tear out. The saving of tile splashes or sinks for reuse. They often are damaged. Mirrors broken during demolition or installation process. The working condition of appliances which were removed for installation of tops or damaged during removal or repositioning of appliances during demolition or installation. During installation, our crews will often cut into the sheetrock to get the best fir for the new countertops.
PLEASE INITIAL BELOW. I authorize MHS Boarding/ Daycare to transport my pet to either my designated veterinary office, to Cheshire Animal Hospital, or to the veterinary clinic designated by my pet’s veterinarian or Cheshire Animal Hospital as providing on-call emergency services. I agree to be responsible for all costs and charges associated with this reasonable treatment, including transportation, and authorize MHS Boarding/ Daycare to use the credit card on file for payment of any medical charges at the time services are provided. By signing below, I acknowledge that I have read and agree to items 1 – 13 above. Owner Name(s): Address: City, State, Zip Home phone: Cell phone: Email: I give permission for the Boarding and Daycare staff to use my puppy’s image in photos, on MHS Facebook and on the MHS website. MHS Daycare & Boarding Contract (Rev. 02/2017) Page PAGE 1 of NUMPAGES 3 000 Xxxx Xxxxxxx Xxxx Xxxxxxx, XX 00000
