Trading Partner Information. Name: Uniform assigned name (UAN) or quasi-UAN if an e-form trial lien claimant (if applicable): EAMS reference number (ERN) if applicable: Mailing address: City: State: 5-digit ZIP code: Physical address (if different than mailing address): City: State: ZIP code: The trading partner’s ERN will be used as the trading partner’s unique identifier. Trading partner category (check all that apply): Claims administrator office Representative office (attorney office or non-attorney representative office) Lien claimant (unrepresented) Third party filer Other:
Trading Partner Information. Name: The formal name of the trading partner. A trading partner can be one office or one entity. For example, a claims administrator with multiple offices can request each office become a trading partner (by submitting trading partner agreements for each office) or the entity can be the trading partner on behalf of all its offices. EAMS reference number (ERN): Uniquely assigned number for entity registered in EAMS. If the trading partner does not have or know its ERN, DWC will assign one and inform the trading partner of the same by email to the primary administrator. Claims administrators and representative offices should locate their ERNs using the UAN online lookup tool. Uniform assigned name (UAN): The formal UAN created for claims administrators and representatives by the DWC. Claims administrators are insurance carriers who self-administer claims, third party administrators, and self-insured self-administered employers. Representatives are attorney and non-attorney representatives. Mailing address: The mailing address used to receive deliveries via the U.S. Postal Service for the trading partner. Physical address: Trading partner’s physical address. Leave field blank if this address is the same as the mailing address. City: The city portion of the street address of the trading partner. State: The two-character standard state abbreviation of the state portion of the street address of the trading partner. ZIP code: The five-position ZIP code of the mailing address of the trading partner. Trading partner type:
Trading Partner Information. (a) Notwithstanding any provision in this Agreement to the contrary, each party acknowledges and agrees that its right to receive GDSN Data from another GDSN Participant, and its right to disseminate, disclose or provide GDSN Data to another GDSN Participant, may be subject to contractual limitations or restrictions imposed on such GDSN Data by a Source Trading Partner (“Source Trading Partner Data Restrictions”). Subject to the terms of subsection (b) of this Paragraph 5, each party agrees to use GDSN Data solely for the purpose of participating in the GDSN and not to disseminate, disclose, provide or use such GDSN Data in contravention of this Agreement or applicable Source Trading Partner Data Restrictions of which such party has knowledge. The failure of one party to provide another party with access to GDSN Data shall not constitute a breach of this Agreement if the provision of such GDSN Data would violate such Source Trading Partner Data Restrictions.
Trading Partner Information. (a) Notwithstanding any provision in this Agreement to the contrary, each party acknowledges and agrees that its right to receive Trading Partner Data from another GDSN participant, and its right to disseminate Trading Partner Data to another GDSN participant (including, without limitation, GS1 GDSN, another Data Pool or another Trading Partner), may be subject to contractual limitations imposed on such Trading Partner Data by a Trading Partner (“Trading Partner Data Restrictions”). Each party agrees to use Trading Partner Data solely for the purpose of participating in the GDSN and not disclose or use such Trading Partner Data in contravention of this Agreement or applicable Trading Partner Data Restrictions of which such party has knowledge. The failure of one party to provide another party with access to Trading Partner Data shall not constitute a breach of this Agreement if the provision of such Trading Partner Data would violate such Trading Partner’s Trading Partner Data Restrictions.
Trading Partner Information. Dun & Bradstreet (D&B) #: (If none, provide explanation) * Federal Taxpayer ID # (TIN): (N/A for non-U.S. Firms) * Company Name: * Address: * City: * State/Postal Code: * Country: * Phone: * Fax: (If none, provide explanation) * Email address: (If none, provide explanation) * POC Name: Do you do business under any other name(s) or Dun & Bradstreet #s? Yes No If yes, please list (use separate sheet of paper if necessary): .
