Contractor Name. Mailing Address: City: State: Zip Code: Business Phone: ( ) - Fax: ( ) - Home Phone: ( ) - E-mail: Contractor Sole Proprietor: Yes No Social Security Number (SSN) or Employer Identification Number (EIN) Contractor must provide a W9 Are you a former employee of the District? Yes No If yes, date last worked Are you related to any employee(s) of the District? Yes No If yes, please identify the individual(s) Are you a California resident? Yes No
Contractor Name. Address: Address: City: , State: Zip:
Contractor Name. Oaks Vendor ID: Mailing Address: LPA signature LPA Name: Oaks Vendor ID: Mailing Address:
Examples of Contractor Name in a sentence
The box for Prime Contractor Name that follows four lines down should be removed.
Contractor hereby attests that its federal work authorization user identification number and date of authorization are as follows: Federal Work Authorization User Identification Number Date of Authorization Name of Contractor Name of Project Houston County School District Name of Public EmployerI hereby declare under penalty of perjury that the foregoing is true and correct.
Correspondence or claims relating to this bond should be sent to the surety at the following address: Contractor Name of Surety (SEAL) By: Attorney-in-Fact NOTE: Signatures of those executing for the surety must be properly acknowledged.
Technical data delivered or otherwise furnished to the Government with limit rights shall be marked as follows:Limited RightsContract No: Contractor Name: Contractor Address:The Government’s rights to use, modify, reproduce, release, perform, display, or disclose these tec data are restricted by paragraph (b)(2) of CI Clause 14, Rights in Technical Data and Computer Soft Noncommercial Items, contained in the contract identified above.
Computer software delivered or otherwise furnished to the Government w restricted rights shall be marked with the following legend:Restricted RightsContract No: Contractor Name: Contractor Address:The Government's rights to use, modify, reproduce, release, perform, display, or disclose this com software are restricted by paragraph (b)(4) of CI Clause 14, Rights in Technical Data and Computer Software: Noncommercial Items, contained in the contract identified above.
More Definitions of Contractor Name
Contractor Name. Mailing Address: City: State: Zip Code: Telephone (Daytime): (Evening): Fax Number: E-Mail Address: FINAL ELECTRIC INSPECTION AND INTERCONNECTION CUSTOMER SIGNATURE The Small Generator Facility is complete and has been approved by the local electric inspector having jurisdiction. A signed copy of the electric inspector’s form indicating final approval is attached. The Interconnection Customer acknowledges that it shall not operate the Small Generator Facility until receipt of the final acceptance and approval by the EDC as provided below. Signed: Date (Signature of interconnection customer) Printed Name: _ Check if copy of signed electric inspection form is attached ………………………………………………………………………………………………………….. ACCEPTANCE AND FINAL APPROVAL FOR INTERCONNECTION (for EDC use only) The interconnection agreement is approved and the Small Generator Facility is approved for interconnected operation upon the signing and return of this Certificate of Completion by EDC: Electric Distribution Company waives Witness Test? (Initial) Yes ( ) No ( ) If not waived, date of successful Witness Test: Passed: (Initial) ( _) EDC Signature: Date:
Contractor Name. The Regents of the University of California UCLA Public Health and Community Dentistry Non-Employee Name: N/A Work Order No.: PH-004438-W1 County Master Agreement No.: PH-004438 GENERAL INFORMATION: The Contractor referenced above has entered into a Master Agreement with the County of Los Angeles to provide certain services to the County. The County requires your signature on this Contractor Non-Employee Acknowledgement and Confidentiality Agreement.
Contractor Name. [TBD] Contractor’s Federal Employer Identification Number (FEIN #): Authorized Signature: Print Name: Title: Date: Sworn to (or affirmed) and subscribed before me on this day of by (Signature of Notary) Check One: ☐Personally Known
Contractor Name. Mailing Address: City: State: Zip Code: Telephone (Daytime): (Evening): Fax Number: E-Mail Address: FINAL ELECTRIC INSPECTION AND INTERCONNECTION CUSTOMER SIGNATURE The Small Generator Facility is complete and has been approved by the local electric inspector having jurisdiction. A signed copy of the electric inspector’s form indicating final approval is attached. The Interconnection Customer acknowledges that it shall not operate the Small Generator Facility until receipt of the final acceptance and approval by the EDC as provided below. Signed: Date (Signature of interconnection customer) Printed Name: Check if copy of signed electric inspection form is attached …………………………………………………………………………………………………………..
Contractor Name. [TBD] Contractor’s Federal Employer Identification Number (FEIN #): Authorized Signature: Print Name: Title: Date: Sworn to (or affirmed) and subscribed before me on this day of 2018 by (Signature of Notary) Check One: Personally Known Produced the following ID AFFIDAVIT OF BEST PRICING Regarding the Contract between [TBD] (the “Contractor”) And State of Florida, Department of Management Services Contract No.: DMS-17/18-030 Effective [TBD] Pursuant to subsection 11.38 (Best Pricing Clause) of the Contract, the undersigned Contractor hereby attests that the Contractor is in compliance with the Best-Pricing clause in the Contract.
Contractor Name. Ameritas Life Insurance Corp. Contractor’s Federal Employer Identification Number (FEIN #): Authorized Signature: 00-0000000 Print Name: Xxxxx X. Xxxxx Title: Date: Senior Vice President 8/31/2022 | 1:57 PM CDT AFFIDAVIT OF WARRANTY OF SECURITY Regarding the Contract between Ameritas Life Insurance Corp. (the “Contractor”) And State of Florida, Department of Management Services Contract No.: DMS-21/22-027C Effective on Effective Date of Contract Pursuant to section 4.2.4, of the Contract, the undersigned Contractor hereby attests that Contractor is in compliance with the Warranty of Security clause in the Contract. Contractor Name: Ameritas Life Insurance Corp. Contractor’s Federal Employer Identification Number (FEIN #): Authorized Signature: Print Name: 00-0000000 Xxxxx X. Xxxxx Title: Senior Vice President Date: 8/31/2022 | 1:57 PM CDT AFFIDAVIT OF NO OFFSHORING Regarding the Contract between Ameritas Life Insurance Corp. (the “Contractor”) And State of Florida, Department of Management Services Contract No.: DMS-21/22-027C Effective on Effective Date of Contract Pursuant to section 4.2.5, of the Contract, the undersigned Contractor hereby attests that the Contractor and covered entities do not utilize offshore Subcontractors in the performance of this Contract and is in compliance with the Subcontractor clause in the Contract. Contractor Name: Ameritas Life Insurance Corp. Contractor’s Federal Employer Identification Number (FEIN #): Authorized Signature: Print Name: Title: 00-0000000 Xxxxx X. Xxxxx Senior Vice President Date: 8/31/2022 | 1:57 PM CDT ATTACHMENT 2: ADMINISTRATIVE REQUIREMENTS The Contractor shall comply with and provide Services in accordance with the following Administrative Requirements (which have been designated “AR” numbers). The Contractor agrees to provide documentation evidencing compliance with these ARs. Should Contractor become aware at any time that they are not in compliance with any AR, the Contractor will notify the Department’s Contract Manager immediately in writing. The Contractor will also provide a corrective action plan (CAP) as needed detailing the steps Contractor will take to either become in compliance with the AR and/or avoid future non-compliance.
Contractor Name. Contractor Address: City: State: Zip: Phone Number: Email Address: Washington State UBI No: Federal ID No: Now therefore, the College and Contractor mutually agree as follows: Scope of Work What is the contractor going to do? Be precise and specific. Include hours (to, from, and total), if applicable.