ACCEPTED AND AGREED TO BY. Reseller’s Full Legal Name BALLANTYNE STRONG, INC., BY AND ITS: NEC DISPLAY SOLUTIONS OF AMERICA, INC BY AND ITS: /s/ Jxxx Xxxxxxx 1-22-10 /s/ Jxx Xxxxxxxxx 1-22-10 Signature Date Signature Date Jxxx Xxxxxxx Jxx Xxxxxxxxx Printed Name Printed Name President & C.E.O. General Manager Title Title ADDENDUM “A” AUTHORIZED LOCATION(S) TO RESELLER AGREEMENT BETWEEN NEC DISPLAY SOLUTIONS OF AMERICA, INC. AND BALLANTYNE STRONG, INC. RESELLER’s Full Legal Name and d/b/a (if different from Legal Name) Legal Company Name: Contact: BALLANTYNE STRONG, INC. Kxxxx Xxxxxxxx D.B.A. Name: Title: Chief Financial Officer Bxxx To Address: Ship to Address: 4000 XxXxxxxx Xxxxxx 4000 XxXxxxxx Xxxxxx Bxxx To City: Ship to City Omaha Omaha Bxxx To State and Zip Ship to State and Zip Nebraska 68112 Nebraska 68112 Telephone: Email Address: Kxxxx.xxxxxxxx@xxx-xxx.xxx 402.453.4444 Fax Number: Sales Manager: Rxx Xxxxxxx, SVP 402.453.7238 A/P Contact and Phone # Service Manager: Gxxxxxx Xxxxxxx, VP Pxxxx Xxxxxx 402.453.4444 x377 Website URL: wxx.xxxxxxxxxx-xxxxx.xxx NEC-DS Sales Rep: Jxx Xxxxxxxxx, GM This Addendum is effective as of the date executed by NEC-DS, and supersedes any such addendum(a) previously executed by the parties. RESELLER: NEC DISPLAY SOLUTIONS OF AMERICA, INC. BALLANTYNE STRONG, INC. /s/ Jxx Xxxxxxxxx 1-22-10 RESELLER’s Full Legal Name Authorized Signature Date /s/ Jxxx X. Xxxxxxx 1-22-10 GM Digital Cinema Div Authorized Signature Date Title President and C.E.O. Title
ACCEPTED AND AGREED TO BY. “you” or “Customer” Signature Date NEITHER PARTY SHALL BE LIABLE FOR ANY CLAIM BROUGHT MORE THAN TWO YEARS AFTER THE CAUSE OF ACTION FOR SUCH CLAIM FIRST AROSE.
ACCEPTED AND AGREED TO BY. WACYPAA 15 WACYPAA 15 Xx. Xxxxxxx Xxxxx Xx. Xxxx Xxxxxxx Facilities Chairman Chair of the Western Area Signature: Signature: Date: Date: ALEXIS PARK RESORT ALEXIS PARK RESORT Xx. Xxxxxxx Xxxxxxx Xx. Xxx Xxxxx General Manager Sr. Sales Manager Signature: Signature: Date: Date:
ACCEPTED AND AGREED TO BY. Xxxxxx Xxxxx Vice Chair, Southern Nevada Anthropomorphic Events Date: [NAME] [POSITION]
ACCEPTED AND AGREED TO BY. LICENSEE: Licensee Name: (please print complete name of Licensee company) Signature: Print Signatory Name: Signatory Title: Date: ACCEPTED AND AGREED TO BY: GLOBALPLATFORM, INC. Signature: Name: Title: Date: Licensee Registration Form This Licensee Registration Form is to be completed by Licensee and attached to the accompanying Test Materials License Agreement between the undersigned Licensee and GlobalPlatform, Inc. Licensee Company Legal Name: Licensee Company existing under the laws of: Address of Licensee’s registered office: Licensee Contact Name: (for legal notices) Licensee Contact Email address (for legal notices): Licensee Contact Telephone Number: Licensee Contact Facsimile Number: Licensee Business Contact Name: Business Contact Email address: Business Contact Phone number: Business Contact Facsimile number: What products or services is Licensee providing or does Licensee plan to make available using the Licensed Works? Form Prepared By:
ACCEPTED AND AGREED TO BY. AUTHOR Signature of Author: DATE Print Name of Author: Print Name of Guardian if applicable Signature of Guardian Address of Author: Phone number of Author: E-Mail Address of Author: Title of Work: Pen name or pseudonym if applicable SSN/TAX ID: (U.S. authors only) ACCEPTED AND AGREED TO BY: DLITE PRESS By: DATE Title
ACCEPTED AND AGREED TO BY. AEP Span, a Division of VP Consolidated Holdings, Inc. Original Owner: Signature of Authorized Representative: Signature of Authorized Representative: _____________________________________ _____________________________________ Printed Name: _________________________ Printed Name: _________________________ Title: ________________________________ Title: ________________________________ Date: ________________________________ Date: ________________________________ Roofing Contractor: Co. Name: ___________________________ Signature: ___________________________ Printed Name: ________________________ Title: _______________________________
ACCEPTED AND AGREED TO BY. AEP Span, a Division of ASC Profiles Inc. Original Owner: Signature of Authorized Representative: Signature of Authorized Representative: _____________________________________ Printed Name: Printed Name: _________________________ Title: Title: ________________________________ Date: ________________________________ Date: ________________________________ Roofing Contractor: Co. Name: ___________________________ Signature: ___________________________ Printed Name: ________________________ Title: _______________________________
ACCEPTED AND AGREED TO BY. Name of Agent - Business Entity or Individual Name (please print) X Signature of Agent or Authorized Officer, if Bueiness Entity Date Name of Upline - Business Entity or Indiviudal Name (please print) Title X Signature of Upline or Authorized Officer, if Bueiness Entity Date Prosperity Life Group is a trade name representing various affiliates of the Prosperity Life Insurance Group, LLC, including the operating members listed above. Members not licensed in all states. Only SBLI USA Life Insurance Company, Inc. is licensed in New York. Each member is solely responsible for its financial condition and contractual obligations. APTCAAECW16 Page 1 of 1 7/2016 SBLI USA Life Insurance Company, Inc. S.USA Life Insurance Company, Inc. Shenandoah Life Insurance Company (Each the “Company”) Members of the Prosperity Life Group BENEFICIARY DESIGNATION This form is used to enable the Agent to designate a beneficiary to receive money due the Agent from the Company after the death of the Agent. Unless this form is completed and received by the Company prior to the Agent’s death, money due the Agent posthumously under the contract shall be paid in the following order of preference:
ACCEPTED AND AGREED TO BY. LICENSEE: Licensee Name: (please print complete name of Licensee company) Signature: Print Signatory Name: Signatory Title: Signatory Email: Date: ACCEPTED AND AGREED TO BY: GLOBALPLATFORM, INC. Signature: Name: Title: Date: Licensee Registration Form This Licensee Registration Form is to be completed by Licensee and attached to the accompanying Consulting Services License Agreement between the Licensee identifies below and GlobalPlatform, Inc. Licensee Company Legal Name: Licensee Company existing under the laws of: Address of Licensee’s registered office: Licensee Contact Name: (for legal notices) Licensee Contact Email address (for legal notices): Licensee Contact Telephone Number: Licensee Contact Facsimile Number: Licensee Business Contact Name: Business Contact Email address: Business Contact Phone number: Business Contact Facsimile number: Form Prepared By: (please print name and title) Date: Appendix A Consulting Rate Consulting Rate: 10%* of the amount charged by Licensee to perform GP-related Consulting Services.
