Certification Regarding Public Access to Compensation Information Sample Clauses

Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. Provide compensation information here: Certificate Of Completion Envelope Id: 92441102150F468FBA21A3808FA4EECC Status: Sent Subject: New $2,602,223.00; HHS001019500016; Fort Bend County; DSHS/LIDS - IMM/COVID-19 Source Envelope: Document Pages: 67 Signatures: 0 Envelope Originator: Certificate Pages: 2 Initials: 0 Texas Health and Human Services Commission AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) 0000 X. 00xx Xx. Austin, TX 78756 XXX_XxxxXxxx@xxxx.xxxxx.xx.xx IP Address: 167.137.1.16 Record Tracking Status: Original 4/16/2021 7:16:40 PM Holder: Texas Health and Human Services Commission XXX_XxxxXxxx@xxxx.xxxxx.xx.xx Location: DocuSign Signer Events Signature Timestamp X.X. Xxxxxx Xxxxxx.Xxxxx@xxxxxxxxxxxxxxxx.xxx County Judge Fort Bend County Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Xxxx Marker Xxxxxx.Xxxxxx@xxxx.xxxxx.xx.xx Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Xxxxx Xxx xxxxx.xxx@xxx.xxxxx.xxx Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Xxxx Xxxxx Xxxx.Xxxxx@xxx.xxxxx.xxx Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Xxxxxxxx Xxxx Xxxxxxxx.Xxxx@xxxx.xxxxx.xxx Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Sent: 4/16/2021 7:37:09 PM In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp CMS Inbox xxxxxxxxxxxx@xxxx.xxxxx.xxx Se...
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Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If Yes, where can this information be found? If No, you must provide the names and total compensation of the top five highly compensated officers. Example: Xxxx Xxxx:500000;Xxxx Xxxx:50000;Xxxx Xxxx:400000;Xxxx Xxxxx:300000;Xxxxx Xxx:300000 Identify contact persons for FFATA Correspondence FFATA Contact Person #1 Name Email Telephone Xxxx Xxx xxxx@xx.xxxxxx.xx.xx (000) 000-0000 FFATA Contact Person #2 Name Email Telephone Xxxxx Xxxxxx-Xxxxxxxx xxxxxxx-xxxxxxxx@xx.xxxxxx.xx.xx (000) 000-0000 As the authorized representative of the Organization, I hereby certify that the statements made by me in this certification form are true, complete and correct to the best of my knowledge. E-Signature Date
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Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. For example: Xxxx Xxxx:500000;Xxxx Xxxx:50000;Xxxx Xxxx:400000;Xxxx Xxxxx:300000; Xxxxx Xxx:300000
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Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. Provide compensation information here: Certificate Of Completion Envelope Id: 86B0F66FDDA44FC3847020C72BF74588 Status: Sent Subject: Amending $1,361,266; HHS000059600001 Xxxxxxx County A-1; DSHS/CMS Source Envelope: Document Pages: 15 Signatures: 0 Envelope Originator: Certificate Pages: 3 Initials: 0 Texas Health and Human Services Commission AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) 0000 X. 00xx Xx.
Sample 1See All (8)
Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. For example: Xxxx Xxxx:500000;Xxxx Xxxx:50000;Xxxx Xxxx:400000;Xxxx Xxxxx:300000; Xxxxx Xxx:300000 Provide compensation information here: Health and Human Services (HHS) Uniform Terms and Conditions - Governmental Entity Version 3.0 Published and Effective - March 1, 2020 Responsible Office: Chief Counsel Table of Contents
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Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If Yes, where can this information be found? If No, you must provide the names and total compensation of the top five highly compensated officers. Example: Xxxx Xxxx:500000;Xxxx Xxxx:50000;Xxxx Xxxx:400000;Xxxx Xxxxx:300000;Xxxxx Xxx:300000 Draft Identify contact persons for FFATA Correspondence FFATA Contact Person #1 Name Email Telephone Xxxxx Xxxxxx xxxxxx@xx.xxxxx.xx.xx (000) 000-0000 FFATA Contact Person #2 Name Email Telephone Xxxxx Xxxxxxx xxxxxx@xx.xxxxx.xx.xx (000) 000-0000 As the authorized representative of the Organization, I hereby certify that the statements made by me in this certification form are true, complete and correct to the best of my knowledge. E-Signature Date Xxxx Xxxxx 08/20/2014 DEPARTMENT OF STATE HEALTH SERVICES Contract 2015-001100 Amendment Summary The Department of State Health Services (DSHS) and Comal County Health Department (Contractor) agree to amend Contract 2015-001100 in accordance with this Amendment 01: Public Health Emergency Preparedness (PHEP) Amendment effective date: 09/01/2014 Purpose for the amendment: Draft This amendment will change set dates to open dates as detailed in the FY15 Hazards Contractual Requirements Schedule and remove two contractual requirements. Change No: 01 Statement of Work Current: 5. Update the Texas Public Health Jurisdictional Risk Assessment Tool (TxPHRAT) by September 30, 2014; Revised: 5. Update the Texas Public Health Jurisdictional Risk Assessment Tool (TxPHRAT) within an established timeframe designated by DSHS pending release of the tool;
Sample 1See All (4)
Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. For example: Xxxx Xxxx:500000;Xxxx Xxxx:50000;Xxxx Xxxx:400000;Xxxx Xxxxx:300000; Xxxxx Xxx:300000 Provide compensation information here: DocuSign Envelope ID: 7E16DFEF-8D5D-4F17-A65C-E7630F71D691 REQUEST DOCUMENT XXXXX Contract Change Request Requestor 00000242250 - Xxxxx,Xxxxxxxx Requisition ID 0000069171 Document ID ADH0000000000000000068495 Document Owner 00000242250 - Xxxxx,Xxxxxxxx Contract change request header Agency lead contact for contract changes 00000256514 - Xxxxxx,Xxxxxx Xxxxxxx Desired amendment effective date March 25, 2019 Amendment contract number 537-18-0187-00001 Request amendment description Contract Description: The contractor provides activities in their service area in support of the Public Health Emergency Preparedness Cooperative Agreement from the Centers for Disease Control and Prevention and further Strategic National Stockpile program to comply with the Public Health Emergency Preparedness Cooperative Agreements Capabilities-based approach. The Cities Readiness Initiative requirements support the Medical Countermeasure Dispensing, Medical Material Management and Distribution capabilities, and supports medical countermeasure distribution and dispensing for all-hazards events. Contractor Name: Fort Bend County (located in Richmond,, TX) Purpose of Amendment: Amendment #2 (Renewal)-The purpose of the amendment is revise current language to the SOW and to renew the contract by adding funding for an additional year through June 30, 2020 to continue the activities for the Public Health Emergency Preparedness Cooperative Agreement for their service area. **This is a $0.00 requisition using FY19 chart field to start the XXXXX contract collaboration process with PCS. This contract crosses fiscal years. Once the FY20 organizational budget is loaded, additional requisitions will be entered to encumber the FY20 funds for the contract. ** ...
Sample 1See All (4)
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Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. Provide compensation information here: DATA USE AGREEMENT BETWEEN THE TEXAS HEALTH AND HUMAN SERVICES ENTERPRISE AND FORT BEND COUNTY (“CONTRACTOR”) This Data Use Agreement (“DUA”), effective as of the date signed below (“Effective Date”), is entered into by and between the Texas Health and Human Services Enterprise agency DSHS, (“HHS”), and Fort Bend County, a political subdivision of the State of Texas (“CONTRACTOR”), and incorporated into the terms of HHS Contract No., in Xxxxxx County, Texas (the "Base Contract").
Sample 1See All (4)
Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. For example: Xxxx Xxxx:500,000; Xxxx Xxxx:50,000; Xxxx Xxxx:400,000; Xxxxx Xxx:30,0000 As the duly authorized representative (Xxxxxx) of the Contractor, I hereby certify that the statements made by me in this certification form are true, complete and correct to the best of my knowledge. Printed Name of Authorized Representative Signature of Authorized Representative
Sample 1
Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. For example: Xxxx Xxxx:500000;Xxxx Xxxx:50000;Xxxx Xxxx:400000;Xxxx Xxxxx:300000; Xxxxx Xxx:300000 Provide compensation information here: REVIEW AND CERTIFICATION OF SOLICITATION, AND ROUTING REQUEST OF PROPOSED CONTRACT New Contract Number Amendment Number Emergency (See Texas Government Code (TGC) Ch. 418; §2155.137 and Texas Administrative Code (TAC) §20.41) New Work Order Number Amendment Number
Sample 1
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