Insurance Company Name definition

Insurance Company Name. Contract Number: ______________________ Use the Special Requests section to provide additional insurance companies and contract numbers. Attach any required state replacement and/or 1035 exchange/transfer forms. State replacement forms may be required in certain states even if a replacement is not involved. ================================================================================================================================
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Insurance Company Name. Policy No.: Expiration Date:
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Insurance Company Name. Insurance Policy/Group Number: My child will require medication to be given during camp hours: Yes (fill out information below and sign below) No (skip information below and sign bottom of form) I, the undersigned, authorize and give permission to the Outdoor U to administer the following medication(s) to my child for the following period: From: / / To: / / month day year month day year Medication Route of administration? (Oral? Topical?) Dosage How many times per day? Time(s) of administration Require refrigeration?
Sample 1

Examples of Insurance Company Name in a sentence

  • Insurance Company Name: Insurer’s Address: City/State/Zip: Policy # or Self-ins.

  • Insurance Company Name After specifying a unique code for the company, you can also specify the full name of the insurance company.

  • Life Insurance (Company Name and Term or Whole Life)(Insured Life) Cash Value and Loan Balance, if any1.

  • PARENT/GUARDIAN INITIALS: Policy Holder’s Name Policy Holder’s Phone # Relation to Participant Insurance Company Name (IF KNOWN) Insurance Company Customer Service Phone # MEDICAL EMERGENCY PARENTAL PERMISSION I understand that my child must be healthy and reasonably fit in order to safely participate in this program’s activities.

  • Previous Insurance Company Name: Address: Phone #: ( )Contact: Years with Ins.

  • Co. Previous Insurance Company Name: Address: Phone #: ( )Contact: Years with Ins.

  • Mortgage Insurance (Choose one) HUD Private Mortgage Insurance Company Name Certificate No. FHA Case No. Premium Amt.

  • Insurance Company Name: (Not the insurance agency)Policy No: Dates of Coverage: ORApplicant is not required to have workers’ compensation liability coverage because: (check one) ( ) Applicant has no employees;( ) Applicant is self-insured (include a copy of your permit to self-insure);( ) Applicant has no employees who are covered by workers’ compensation; OR ( ) Certificate of Insurance is attached.

  • Student Medical Information:Family Physician: Physician Phone:Does the Student have health Insurance: Insurance Company Name: Does the Student Have any medical condition or allergies:If any, list here:List any medications Student required to bring to camp including strength: We, the UNDERSIGNED, HAVE FULLY READ, UNDERSTAND, AGREE TO, AND VOLUNTARILYSIGN THIS AGREEMENT, and agree that no oral representations, statements, or inducement apart from the foregoing written agreement have been made.

  • Name of Insurance Company Name of Insurance RepresentativePhone Number of Insurance Representative The Ocean County Library does not discriminate on the basis of handicapped status in the admission or access to, or treatment, or employment in its programs or activities.


More Definitions of Insurance Company Name

Insurance Company Name. Address: Member I.D.: Other Source: 3. Patient/legal guardian’s monthly resources: Salary $ Social Security $ Cash/Welfare Payment $ Family Contribution $ Income from Savings Accounts, CDs, etc. $ Other $ Total $
Sample 1
Insurance Company Name. Xxxx Xxxxxx Title: VP, Investments UGI UTILITIES, INC. This Agreement is hereby accepted and agreed to as of the date hereof. NOTE PURCHASE AGREEMENT SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY By xx Xxxxx Xxx Name: Senior Portfolio Manager UGI UTILITIES, INC. NOTE PURCHASE AGREEMENT This Agreement is hereby accepted and agreed to as of the date hereof. STATE FARM LIFE INSURANCE COMPANY By: ____________________________________ Name: Xxxxxxx X. Xxxx Title: Investment Professional By: ____________________________________ Name: Xxxxxxxx X. Xxxxx Title: Investment Professional STATE FARM LIFE AND ACCIDENT ASSURANCE COMPANY By: ____________________________________ Name: Xxxxxxx X. Xxxx Title: Investment Professional By: ____________________________________ Name: Xxxxxxxx X. Xxxxx Title: Investment Professional STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY By: ____________________________________ Name: Xxxxxxx X. Xxxx Title: Investment Professional By: ____________________________________ Name: Xxxxxxxx X. Xxxxx Title: Investment Professional DocuSign Envelope ID: C765D0D1-4E45-43F8-ABB5-97543367EADB UGI UTILITIES, INC. NOTE PURCHASE AGREEMENT This Agreement is hereby accepted and agreed to as of the date hereof. STATE FARM FIRE AND CASUALTY COMPANY By: ____________________________________ Name: Xxxxxxx X. Xxxx Title: Investment Professional By: ____________________________________ Name: Xxxxxxxx X. Xxxxx Title: Investment Professional STATE FARM INSURANCE COMPANIES EMPLOYEE RETIREMENT TRUST By: ____________________________________ Name: Xxxxxxx X. Xxxx Title: Authorized Signer By: ____________________________________ Name: Xxxxxxxx X. Xxxxx Title: Authorized Signer DocuSign Envelope ID: C765D0D1-4E45-43F8-ABB5-97543367EADB
Sample 1
Insurance Company Name. Contract Number: ______________________ Use the Special Requests section to provide additional insurance companies and contract numbers. Attach any required state replacement and/or 1035 exchange/transfer forms. State replacement forms may be required in certain states even if a replacement is not involved. ================================================================================================================================ Investment Options (total must equal 100%) -------------------------------------------------------------------------------------------------------------------------------- Name Code Pct Name Code Pct -------------------------------------------------------------------------------------------------------------------------------- AIM Capital Appreciation Portfolio KC % PIMCO VIT Real Return Portfolio - Adm Class PR % American Funds Global Growth Fund - Class 2 Shares IL % PIMCO VIT Total Return Portfolio PM % American Funds Growth Fund - Class 2 Shares IG % Pioneer Fund Portfolio UP % American Funds Growth-Income Fund - Class 2 Shares II % Pioneer Mid Cap Value Portfolio FW % Capital Appreciation Fund (Janus) US % Pioneer Strategic Income Portfolio HP % Citistreet Diversified Bond Fund - Class I OB % Xxxxxx VT Small Cap Value Fund - Class IB Shares OP % Citistreet International Stock Fund - Class I OI % Salomon Brothers Variable All Cap Fund - Class I AD % Citistreet Large Company Stock Fund - Class I OC % Salomon Brothers Variable Investors Fund - C2 % Class I Citistreet Small Company Stock Fund - Class I OE % SB Adjustable Rate Income Portfolio BI % Delaware VIP REIT Series AQ % Xxxxx Xxxxxx Aggressive Growth Portfolio SG % Delaware VIP Small Cap Value Series AP % Xxxxx Xxxxxx Appreciation Portfolio 1N % Dreyfus VIF Appreciation Portfolio DP % Xxxxx Xxxxxx High Income Portfolio HH % Dreyfus VIF Developing Leaders Portfolio DS % Xxxxx Xxxxxx Large Cap Growth Portfolio AB % Equity Income Portfolio (Fidelity) 4F % Xxxxx Xxxxxx Small Cap Growth Opportunities C9 % Portfolio Equity Index Portfolio - Class II GF % Social Awareness Stock Portfolio (Xxxxx Xxxxxx) SA % Fidelity VIP Contrafund(R)Portfolio-Service Class 2 FT % Strategic Equity Portfolio (Fidelity) HA % Fidelity VIP Mid Cap Portfolio - Service Class 2 D1 % Style Focus Series: Small Cap Growth Portfolio FY % Franklin Mutual Shares Securities Fund - Class 2 R2 % Style Focus Series: Small Cap Value Portfolio F0 % Janus Aspen Series Mid Cap Growth Portfolio - JA % Xxxxxxxxx Dev...
Sample 1

Related to Insurance Company Name

  • Insurance Company The Transferee is an insurance company whose primary and predominant business activity is the writing of insurance or the reinsuring of risks underwritten by insurance companies and which is subject to supervision by the insurance commissioner or a similar official or agency of a state, U.S. territory or the District of Columbia.

  • Insurance Companies means the companies with whom the Insurance Policies are held.

  • Company Name Address: Attention: Tel: Fax: Email: If sent to Cornell: For all correspondence except payments - Center for Technology Licensing at Cornell University Attention: Executive Director 000 Xxxx Xxxx Xxxx, Xxxxx 000 Xxxxxx, XX 00000 FAX: 000-000-0000 TEL: 000-000-0000 EMAIL: xxx-xxxxxxxxx@xxxxxxx.xxx For all payments - If sent by mail: Center for Technology Licensing at Cornell University XX Xxx 0000 Xxxxxx, XX 00000-0000 If remitted by electronic payments via ACH or Fed Wire: Receiving bank name: Xxxxxxxx Trust Co. Bank account no.: 0111000065 Bank routing (ABA) no.: 000000000 SWIFT code: Bank account name: XXXXXX00 Cornell University Bank ACH format code: Not required Bank address: X.X. 000, Xxxxxx, XX 00000 Additional information: Reference D-5062 Agreement No.: <to be filled> An email copy of the transaction receipt shall be sent to xxx-xxxxxxxxx@xxxxxxx.xxx. Licensee is responsible for all bank charges of wire transfer of funds for payments. The bank charges shall not be deducted from the total amount due to Cornell.

  • Captive insurance company means a pure captive insurance company, association captive insurance company, captive reinsurance company, sponsored captive insurance company, special purpose captive insurance company, or industrial insured captive insurance company formed or licensed under this chapter. For purposes of this chapter, a branch captive insurance company must be a pure captive insurance company with respect to operations in this State, unless otherwise permitted by the director.

  • Title Insurance Company as defined in Section 5.1(l).

  • Association captive insurance company means a company that insures risks of the member organizations of the association and their affiliated companies.

  • Specified Insurance Company means any Entity that is an insurance company (or the holding company of an insurance company) that issues, or is obligated to make payments with respect to, a Cash Value Insurance Contract or an Annuity Contract.

  • Sponsored captive insurance company means a captive insurance company:

  • Insurance premium finance company means a person engaged in the business of

  • Life insurance means insurance coverage on human lives including benefits of endowment and annuities, and may include benefits in the event of death or dismemberment by accident and benefits for disability income and unless otherwise specifically excluded, includes individually issued annuities.

  • life insurance business means the business of providing or undertaking to provide policy benefits under life policies;

  • Life Insurance Policy has the meaning given in Section 6.10.

  • Pure captive insurance company means a company that

  • Insurance Commissioner means the Insurance Commissioner

  • Insurance group means the persons that comprise an insurance holding company system.

  • Mortgage Insurance means insurance protecting Lender against the nonpayment of, or default on, the Loan.

  • In-Orbit Insurance means, with respect to any Satellite (or, if the entire Satellite is not owned by the Issuer or any Restricted Subsidiary, as the case may be, the portion of the Satellite it owns or for which it has risk of loss), insurance (subject to a right of co-insurance in an amount up to $150.0 million) or other contractual arrangement providing for coverage against the risk of loss of or damage to such Satellite (or portion, as applicable) attaching upon the expiration of the launch insurance therefor (or, if launch insurance is not procured, upon the initial completion of in-orbit testing) and attaching, during the commercial in-orbit service of such Satellite (or portion, as applicable), upon the expiration of the immediately preceding corresponding policy or other contractual arrangement, as the case may be, subject to the terms and conditions set forth in this Indenture.

  • Blanket insurance policy means a group policy covering a defined class of

  • Finance Company means any Finance Company or other lender with whom You have agreed a Loan or credit agreement through the Supplying Outlet.

  • group insurance means insurance, other than creditor’s group insurance and family insurance, whereby the lives of a number of persons are insured severally under a single contract between an insurer and an employer or other person; (“assurance collective”)

  • R&W Insurance Policy means the representations and warranties insurance policy issued to Buyer in connection with the transactions contemplated hereby.

  • Ocean marine insurance means insurance against loss of or damage to:

  • Service Company means any entity employed by the Custodian or the Distributor, including the transfer agent for the Fund(s), to perform various administrative duties of either the Custodian or the Distributor. In any case where there is no Service Company, the duties assigned hereunder to the Service Company will be performed by the Distributor (if any) or by an entity that has a contract to perform management or investment advisory services for the Fund(s).

  • Owners Corporation means the Owners’ corporation of the Lot and the Development incorporated and registered under the Building Management Ordinance (Cap.344);

  • Day care center means any child day care facility other than a family day care home, and includes infant centers, preschools, extended day care facilities and school age child care centers.

  • policy of life insurance means any instrument by which the payment of money is assured on death (except death by accident only) or the happening of any contingency dependent on human life, or any instrument evidencing a contract which is subject to payment of premiums for a term dependent on human life;