Xxx Xxxxxxxx Bats Throws The content below should be filled out by a notary. State County I, , a Notary Public for said County and State, do hereby certify that personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my hand and official seal, this the day of , 20 [ SEAL ] Notary Public My commission expires It is strongly recommended that this form be notarized. Most hospitals require consent form to be notarized. 1086115_1 Send copy to Department Baseball chairman. Team manager shall retain original.
Xxxxxxxx Xxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 2 xxxxxxxx@xxxxxxxxxxxxxxx.xxx Purchase Order and Sales Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 3 2143616611 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 2 xxxxxxxxxxxxxxx.xxx Entity D/B/A's and Assumed Names You must confirm that you are responding to this solicitation under your legal entity name. Go now to your Supplier Profile in this eBid System and confirm that your profile reflects your "Legal Name" as it is listed on your W9. In this question, please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the Legal Name under which you respond to this solicitation unless you organize otherwise with TIPS after award. 5 No response Primary Address Primary Address 2 0000 Xxxx Xxxxx Xxx Primary Address City Primary Address City 7 Dallas Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 TX Primary Address Zip Primary Address Zip 75231 Search Words Identifying Vendor Please list all search words and phrases to be included in the TIPS database related to your entity. Do not list words which are not associated with the bid category/scope (See bid title for general scope). This will help users find you through the TIPS website search function. You may include product names, manufacturers, specialized services, and other words associated with the scope of this solicitation. Mechanical, plumbing, HVAC, boilers, pumps, hydronic accessories, fans, air handlers, Lochinvar, Xxxxxxxxx, suctions guides, triple duty valves, plug valves, Bell & Xxxxxxx, Taco, Paco, butterfly valves, expansion tank, diaphragm type expansion tank, energy, heat coils, air dirt separators, magnetic separation, chillers, Carrier, Trane, York, Aerco, Xxxxxx, LAARS, RayPak, Amtrol, cooling towers, BAC, Marley, Evapco, fan coil units Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
Xxxxxxx Xxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 2 xxxxxxxx@xxxxx.xxx Purchase Order and Sales Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 3 9728241762 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 2 4 xxx.xxxxx.xxx Entity D/B/A's and Assumed Names You must confirm that you are responding to this solicitation under your legal entity name. Go now to your Supplier Profile in this eBid System and confirm that your profile reflects your "Legal Name" as it is listed on your W9. In this question, please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the Legal Name under which you respond to this solicitation unless you organize otherwise with TIPS after award. 5 Connect Technology Group Primary Address Primary Address 6 0000 XxxXxxxxx Xx. Xxxxx 000 Primary Address City Primary Address City 7 Carrollton Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 TX Primary Address Zip Primary Address Zip 9 75007 Search Words Identifying Vendor Please list all search words and phrases to be included in the TIPS database related to your entity. Do not list words which are not associated with the bid category/scope (See bid title for general scope). This will help users find you through the TIPS website search function. You may include product names, manufacturers, specialized services, and other words associated with the scope of this solicitation.
Xxxxxx Xxxxxxxx SIGNED by the Premier of the State of Western Australia for and on behalf of the State in the presence of — XXXXX XXXXX.
