Xxxx Xxxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 xxxx.xxxxxxxx@xxxxxxxxx.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 8177273799 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxx.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 6 000 Xxxx Xxxxxx Xxxxx 000, Xx00 Primary Address City Primary Address City 7 Fort Worth Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 Texas Primary Address Zip Primary Address Zip 9 76102 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. Construction, Facilities, Elevator, Maintenance, Contract, Estimates, Build out, TI, Tenant Improvement, Finish, Interior, Exterior, Metal, Roof, Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
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.
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.
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.
Xxxxx Xxxxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 xxxxxxxxxx@xxxxxxxxxxxxxxxxxxxxx.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 9566182360 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxxxxxxxxxxxxx.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 Telepro Communications Primary Address Primary Address 2 6 00000 X. Xxxxx Xx. Primary Address City Primary Address City 7 Mission Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 TX Primary Address Zip Primary Address Zip 9 78573 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. data, audio-visual, audio, visual, intercom, access control, security, cameras, surveillance, CCTV, fiber, fiber optics, network, WAP, wireless access points, telephone, switch, structured cabling, cable Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
Xxxxxxxx Xxxxxx Xxxxxxxx@xxx.xxx Xxx Xxxxxx Xxxxxx.Xxxxxx@xxx.xxx Xxx X. Xxxxxxx Xxx.Xxxxxxx@xxx.xxx Xxxx Xxxxx Xxxx.Xxxxx@xxx.xxx Xxxxxx Xxxxxx Xxxxxx.Xxxxxx@xxx.xxx Date: Subject: [●], 20[●] Equity Distribution Agreement – Placement Notice Gentlemen: Pursuant to the terms and subject to the conditions contained in the Equity Distribution Agreement by and between TELA Bio, Inc. (“Company”) and Xxxxx Xxxxxxx & Co. (“Agent”), dated November 13, 2023 (the “Agreement”), the Company hereby requests that Agent sell up to [●] shares of the Company’s common stock, par value $0.001 per share, at a minimum market price of $[●] per share. Sales should begin on the date of this Placement Notice and shall continue until [●] /[all shares are sold]. SCHEDULE 2 NOTICE PARTIES TELA Bio, Inc. Xxxxxx Xxxxxxx xxxxxxxx@xxxxxxx.xxx Xxxxxxx Xxxx xxxxx@xxxxxxx.xxx Xxxxx Xxxxxxx xxxxxxxx@xxxxxxx.xxx Xxxxx Xxxxxxx & Co. Xxxx X. Xxxxx Xxxx.Xxxxx@xxx.xxx Xxxxxx X. Xxxxxxxx Xxxxxx.Xxxxxxxx@xxx.xxx Xxx Xxxxxx Xxxxxx.Xxxxxx@xxx.xxx Xxx X. Xxxxxxx Xxx.Xxxxxxx@xxx.xxx Xxxx Xxxxx Xxxx.Xxxxx@xxx.xxx Xxxxxx Xxxxxx Xxxxxx.Xxxxxx@xxx.xxx SCHEDULE 3 FORM OF REPRESENTATION CERTIFICATE PURSUANT TO SECTION 3(q) OF THE AGREEMENT [●] Xxxxx Xxxxxxx & Co. 800 Nicollet Mall Minneapolis, MN 55402 Sir/Madam: The undersigned, the duly qualified and elected Chief Operating Officer and Chief Financial Officer of TELA Bio, Inc., a Delaware corporation (the “Company”), does hereby certify in such capacity and on behalf of the Company, pursuant to Section 3(q) of the Equity Distribution Agreement, dated November 13, 2023 (the “Equity Distribution Agreement”), between the Company and Xxxxx Xxxxxxx & Co., that to the best of the knowledge of the undersigned:
Xxxxxxxxx Xxxxx 19.1 Employees who lose time by reason of being required to attend Court or Coroner's inquest or to appear as witnesses, in cases in which the Company is involved, or subpoenaed by the Crown in such cases, will be paid for time so lost. If no time is lost, they will be paid for actual time held with a minimum of two hours at one and one-half times the hourly rate. Necessary actual expenses while away from the home terminal will be allowed when supported by receipts.
Xxxxxx 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 xxxxxx@xxxxxxxxxxxxxxxxx.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 3152473177 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxxxxxxxxx.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. NGU Sports LIghting, LLC Primary Address Primary Address 6 0000 XXX Xxxx, Xxxxx 000 Primary Address City Primary Address City 2 7 Palm Beach Gardens Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 FL Primary Address Zip Primary Address Zip 9 33410 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. LED lighting, LED Sports Lighting, LED Indoor lighting, LED Field lighting, Sports lighting, Field lighting, Colored lighting, Convention Center Lighting Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
