Stockholder Disclosure Certification Sample Clauses

Stockholder Disclosure Certification. Name of Business: ☐ I certify that the list below contains the names and home addresses of all stockholders holding 10% or more of the issued and outstanding stock of the undersigned. OR ☐ I certify that no one stockholder owns 10% or more of the issued and outstanding stock of the undersigned. Check the box that represents the type of business organization: ☐ Partnership ☐ Corporation ☐ Sole Proprietorship ☐ Limited Partnership ☐ Limited Liability Corporation ☐ Limited Liability Partnership ☐ Subchapter S Corporation Sign and notarize the form below, and, if necessary, complete the stockholder list below. Stockholders: Name: Stockholder Name Name: Stockholder Name Home Address: Home Address Home Address: Home Address Name: Stockholder Name Name: Stockholder Name Home Address: Home Address Home Address: Home Address Name: Stockholder Name Name: Stockholder Name Home Address: Home Address Home Address: Home Address Subscribed and sworn before me this day of _, 2 . (Notary Public) My Commission expires: _ (Affiant) (Print name & title of affiant) (Corporate Seal) PROPOSAL FORM 18: GENERAL TERMS AND CONDITIONS ACCEPTANCE FORM‌ Check one of the following responses to the General Terms and Conditions in this solicitation, including the Master Agreement: ☒ We take no exceptions/deviations to the general terms and conditions. (Note: If none are listed below, it is understood that no exceptions/deviations are taken.) ☐ We take the following exceptions/deviations to the general terms and conditions. All exceptions/deviations must be clearly explained. Reference the corresponding general terms and conditions that you are taking exceptions/deviations to. Clearly state if you are adding additions terms and conditions to the general terms and conditions. Provide details on your exceptions/deviations below: Click or tap here to enter text. (Note: Unacceptable exceptions shall remove your proposal from consideration for award. CCOG shall be the sole judge on the acceptance of exceptions/deviations and the decision shall be final.) PROPOSAL FORM 19: EQUALIS GROUP ADMINISTRATION AGREEMENT DECLARATION‌
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Stockholder Disclosure Certification. Name of Business: ☐ I certify that the list below contains the names and home addresses of all stockholders holding 10% or more of the issued and outstanding stock of the undersigned. OR ☐ I certify that no one stockholder owns 10% or more of the issued and outstanding stock of the undersigned. Check the box that represents the type of business organization: ☐ Partnership ☐ Corporation ☐ Sole Proprietorship ☐ Limited Partnership ☐ Limited Liability Corporation ☐ Limited Liability Partnership ☐ Subchapter S Corporation Sign and notarize the form below, and, if necessary, complete the stockholder list below. Stockholders: PROPOSAL FORM 17: GENERAL TERMS AND CONDITIONS ACCEPTANCE FORM Check one of the following responses to the General Terms and Conditions in this solicitation, including the Master Agreement: ☐ We take no exceptions/deviations to the general terms and conditions (Note: If none are listed below, it is understood that no exceptions/deviations are taken.) ☒ We take the following exceptions/deviations to the general terms and conditions. All exceptions/deviations must be clearly explained. Reference the corresponding general terms and conditions that you are taking exceptions/deviations to. Clearly state if you are adding additions terms and conditions to the general terms and conditions. Provide details on your exceptions/deviations below: Kyndryl has uploaded its exceptions/deviations to T&C in Supplemental Documents. (Note: Unacceptable exceptions shall remove your proposal from consideration for award. EQUALIS/CCOG shall be the sole judge on the acceptance of exceptions/deviations and the decision shall be final.) Contract Section Exception or Proposed Revision
Sample 1
Stockholder Disclosure Certification. PROPOSAL FORM 17: GENERAL TERMS AND CONDITIONS ACCEPTANCE FORM Check one of the following responses to the General Terms and Conditions in this solicitation, including the Master Agreement: ☒ We take no exceptions/deviations to the general terms and conditions (Note: If none are listed below, it is understood that no exceptions/deviations are taken.) ☐ We take the following exceptions/deviations to the general terms and conditions. All exceptions/deviations must be clearly explained. Reference the corresponding general terms and conditions that you are taking exceptions/deviations to. Clearly state if you are adding additions terms and conditions to the general terms and conditions. Provide details on your exceptions/deviations below: Click or tap here to enter text. (Note: Unacceptable exceptions shall remove your proposal from consideration for award. CCOG shall be the sole judge on the acceptance of exceptions/deviations and the decision shall be final.) PROPOSAL FORM 18: EQUALIS GROUP ADMINISTRATION AGREEMENT DECLARATION
Sample 1
Stockholder Disclosure Certification. Name of Business: □ I certify that the list below contains the names and home addresses of all stockholders holding 10% or more of the issued and outstanding stock of the undersigned. OR □ I certify that no one stockholder owns 10% or more of the issued and outstanding stock of the undersigned. Check the box that represents the type of business organization: □ Partnership □ Corporation □ Sole Proprietorship □ Limited Partnership □ Limited Liability Company □ Limited Liability Partnership □ Subchapter S Corporation Sign and notarize the form below, and, if necessary, complete the stockholder list below. Stockholders: Name: Stockholder Name Name: Stockholder Name Home Address: Home Address Home Address: 0000 Xxxx Xxxx Xxxxx, Xxxxxxxxxx, XX 00000 Name: Stockholder Name Name: Tech Data Corporation Home Address: Home Address Home Address: Home Address Name: Stockholder Name Home Address: Home Address Name: Stockholder Name Home Address: Home Address 1_1/_09/_20 22 02:29 (Affiant) Xxxxxxxxx Xxxxx, Director of Contracts and Corporate Counsel (Print name & title of affiant) MISSOURI ACKNOWLEDGEMENT RsMo. 486.750 State of Missouri )s County of St. Xxxxxxx )s On this 9th day of November , 2022 , before me, the undersigned xxxxxx, personallyappeared X personally known to me; Xxxxxxxxx Xxxxx provided to me through identification documents, which were ; proved to me on the oath oraffirmation of _, who is personally known to me and sated to me that (he)(she) personally knows the document signer and is unaffected by the document; proved to me on the oath or affirmation of _, whose identities have been proven to me through identification documents and who have stated to me that they personally know the document signer and are unaffected by the document; to be the person whose name is signed on the preceding or attached document, and acknowledged to me that (he) she signed it voluntarily for its stated purpose as Director of Contracts and Corporate Counsel for DLT Solutions, LLC Official Signature of Notary Public: Xxxxxx Xxxxxx 11/09/20 22 02:30 Online Notary Public. This notarial act involved the use of online audio/video (Corporate Seal) Proposal Form 17: General Terms and Conditions Acceptance Form Check one of the following responses to the General Terms and Conditions in this solicitation, including the Master Agreement: □ We take no exceptions/deviations to the general terms and conditions (Note: If none are listed below, it is understood that no exceptions/deviatio...
Sample 1
Stockholder Disclosure Certification. Name of Business ☐ I certify that the list below contains the names and home addresses of all stockholders holding 10% or more of the issued and outstanding stock of the undersigned. OR ☐ I certify that no one stockholder owns 10% or more of the issued and outstanding stock of the undersigned. Check the box that represents the type of business organization: ☐ Partnership ☐ Corporation ☐ Sole Proprietorship ☐ Limited Partnership ☐ Limited Liability Corporation ☐ Limited Liability Partnership ☐ Subchapter S Corporation Sign and notarize the form below, and, if necessary, complete the stockholder list below. Stockholders: Name: Name: Home Address: Home Address: Name: Name: Home Address: Home Address: Name: Name: Home Address: Home Address: (Affiant) (Print name & title of affiant) (Corporate Seal) Subscribed and sworn before me this day of , Year (Notary Public) My Commission expires: Attachment B INDIVIDUAL TRAINING SUB-AGREEMENT 22-FXXX-01 PERFORMANCE BASED
Sample 1

Related to Stockholder Disclosure Certification

  • Antitrust Certification Statements (Tex Government Code § 2155.005) By submission of this bid or proposal, the Bidder certifies that: I affirm under penalty of perjury of the laws of the State of Texas that: (1) I am duly authorized to execute this contract on my own behalf or on behalf of the company, corporation, firm, partnership or individual (Company) listed below; (2) In connection with this bid, neither I nor any representative of the Company has violated any provision of the Texas Free Enterprise and Antitrust Act, Tex. Bus. & Comm. Code Chapter 15; (3) In connection with this bid, neither I nor any representative of the Company has violated any federal antitrust law; (4) Neither I nor any representative of the Company has directly or indirectly communicated any of the contents of this bid to a competitor of the Company or any other company, corporation, firm, partnership or individual engaged in the same line of business as the Company.

  • REPORTS AND DISCLOSURE UNDER THE SECURITIES ACTS With a view to making available to the Investor the benefits of Rule 144 promulgated under the Securities Act or any other similar rule or regulation of the SEC that may at any time permit the Investor to sell securities of the Company to the public without registration (“Rule 144”), the Company agrees, at the Company’s sole expense, to:

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