Reconsideration If We did not attempt to consult with Your Provider who recommended the Covered Service before making an adverse determination, the Provider may request reconsideration by the same clinical peer reviewer who made the adverse determination or a designated clinical peer reviewer if the original clinical peer reviewer is unavailable. For Preauthorization and concurrent reviews, the reconsideration will take place within one (1) business day of the request for reconsideration. If the adverse determination is upheld, a notice of adverse determination will be given to You and Your Provider, by telephone and in writing.
Appeal (1) An appeal against a decision of the Court of First Instance may be brought before the Court of Appeal by any party which has been unsuccessful, in whole or in part, in its submissions, within two months of the date of the notification of the decision.
Civil Action except where a joint Union-Employer Committee considers that there has been flagrant or wilful negligence on the part of an employee, the Employer agrees not to seek indemnity against an employee whose actions result in a judgement against the Employer. The Employer agrees to pay any judgement against an employee arising out of the performance of his/her duties. The Employer also agrees to pay any legal costs incurred in the proceedings including those of the employee.
Hearing The grievance shall be heard by a single arbitrator and both parties may be represented by such person or persons as they may choose and designate, and the parties shall have the right to a hearing at which time both parties will have the opportunity to submit evidence, offer testimony, and make oral or written arguments relating to the issues before the arbitrator. The proceeding before the arbitrator shall be a hearing denovo.
Initiation written request. To initiate the review, the claimant, within 60 days after receiving the Bank’s notice of denial, must file with the Bank a written request for review.
Appeals a. Should the filer be dissatisfied with the Formal Dispute determination, a written appeal may be filed with the Chief Procurement Officer, by mail or email, using the following contact information: Chief Procurement Officer Procurement Services A Division of the Office of General Services 00xx Xxxxx, Xxxxxxx Xxxxx Xxxxxx Xxxxx Xxxxx Xxxxxx, XX 00000 Email: xxxxxxxx.xxxxxxxx@xxx.xx.xxx Subject line: Appeal – Attn: Chief Procurement Officer
Preliminaries Where prices are submitted by the contractor or nominated/selected sub contractor during the progress of the works in respect of contract instructions or in regard to a claim under the terms of the contract and notwithstanding the fact that such prices may be used in an interim payment certificate, there is to be no presumption of acceptance. Should the principal agent wish to accept any such prices prior to the issue of the final certificate, it will be in writing. Clause 31.9 is amended as follows: Payment shall be subject to the Employer giving the Contractor a Tax Invoice for the amount due. The Employer undertakes to ensure compliance with the administrative requirements of Sections 20 (2) and 21 (4) of the Value Added Tax Act (Act 89 of 1991). The Contractor agrees to the adoption of the self invoicing procedures and undertakes not to issue any tax invoices, debit or credit notes in respect of any transaction included in the Tax Invoices issued by the Employer. The above clauses shall constitute a written agreement between the parties as required in terms of the Value Added Tax Act (Act 89 of 1991).' 30 F: ……….… V: ….……… T: ….……... Item Adjustment to the contract value (Clause 32). 31 F: ……….… V: ….……… T: ….……... Item Recovery of expense and loss (Clause 33). 32 F: ……….… V: ….……… T: ….……... Item Final account and final payment (Clause 34). 33 F: ……….… V: ….……… T: ….……... Item Payment to other parties (Clause 35). 34 F: ……….… V: ….……… T: ….……... Item Carried to Collection R Section 1 Bill No. 1 Preliminaries R CANCELLATION Cancellation by Employer - Contractor's default (Clause 36). 35 F: ……….… V: ….……… T: ….……... Item Cancellation by Employer - Loss and damage (Clause 37). 36 F: ……….… V: ….……… T: ….……... Item Cancellation by Contractor - Employer's default (Clause 38). 37 F: ……….… V: ….……… T: ….……... Item Cancellation - Cessation of the works (Clause 39). 38 F: ……….… V: ….……… T: ….……... Item DISPUTE Dispute Settlement (Clause 40) 39 F: ……….… V: ….……… T: ….……... Item SUBSTITUTE PROVISIONS State Clauses (Clause 41) 40 F: ……….… V: ….……… T: ….……... Item CONTRACT VARIABLES The Schedule: Pre-Tender information (Clause 42). 41 F: ……….… V: ….……… T: ….……... Item Carried to Collection Section 1 Bill No. 1 Preliminaries