SIGNATURES MUST BE NOTARIZED Sample Clauses

SIGNATURES MUST BE NOTARIZED. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document STATE OF CALIFORNIA ) COUNTY OF ) On , 2015, before me, personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document STATE OF CALIFORNIA ) COUNTY OF ) On , 2015, before me, personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) Exhibit A Property Description CLTA Preliminary Report Form Order Number: 0505-4987768 (Rev. 11/06) Page Number: 1 First American Title Company 00 Xxxxx Xxxx Xxxxxx Xxxxxx Xxxx, XX 00000 Order Number: 0505-4987768 () Escrow Officer: Xxxxxx Xxxxx Phone: (000)000-0000 Fax No.: (000)000-0000 E-Mail: xxxxxx@xxxxxxx.xxx E-Mail Loan Documents to: XxxxxxXxxxXXxxx@xxxxxxx.xxx Buyer: Property: Vacant Land Angels Camp, CA
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SIGNATURES MUST BE NOTARIZED. COMMUNITY HEALTH CENTERS OF CITY OF LOMPOC: THE CENTRAL COAST, INC.: By: By: Xxx Xxxxxx, City Manager Its By: ATTEST: Its Xxxxxx Xxxxxx, City Clerk APPROVED AS TO FORM: Xxxxxx X. Xxxxxxx, City Attorney -------------------' - ' ----. ----------. ---------------- -.-- -----,--- - --- - W OCEAN AVENUE IMPROVEMENT NOTES J<Sl!J..l:ity,IP,!CIUOIOl>P0!(NfW_fl!lllFl[CO,IN[C!l0fl. 0 0 : "ClJ>'llf'[ C(N'Cfl.O,,lf'o:;:lA>ll'.IAl'D"'ll.lCC>,iQrtJCTCU!'<NIDCUatlP,i I I Future Retail I: 13,150 xx X X I' Future Retail 6,600 sf cc,mwq,;.c:p.. oavi:P\0 COl,,\rACTlD!,.D.PO'Cf'IOFI.C+,Lroc:;;1Alj!)A<,'O tl:JJO!!f'tPfl<W.:-Ot.tF11'.l'0"1S>U:Ct.lMlHDA10tl. CC>l:ili01JCIOJRB MlPrO,CAl[,.c,..L! A>G!;l;..IIOAl'O,v.NN:IJl,,A!iOClf'O, LOMroc::.tNJl)Al'[).0., CCfflWUCICUl!'IJR,W,rro>CAl[CC<LWA>GllAIIDA>'OPlllll"8MN<DCICIO' lOMPOC&lAHOA00.00. CON':l>'UCTCUPOIW.PP[;C...:[fCMll'-',"3llMJOAOOM.AN- AADC!rrOf (C>l.f'OC;fAf!Mro«Jo. EXISTING COMMERCIAL =Ui = t.:i ,.'f\ !;<'01r.r;.,'Al'lC>/ffitl.DW J,!PAC10C"1;)0elaD1l
Sample 1
SIGNATURES MUST BE NOTARIZED. EXHIBIT C-1 TO GRANT DEED PROPERTY (Attach legal description of District Property to be conveyed to City)
Sample 1
SIGNATURES MUST BE NOTARIZED. Exhibit A PROPERTY Real property in the City of Desert Hot Springs, County of Riverside, State of California, described as follows: INSERT DESCRIPTION APN: 000-000-000 Exhibit B UNIT MIX, RENT AND OCCUPANCY RESTRICTIONS Restricted Unit Type Number of Required Restricted Units Maximum Initial Income Limit 1-Bedroom 2 XXX 3 VLI 6 LI 30% of AMI 40% of AMI 60% of AMI 2-Bedroom 3 XXX 10 VLI 13 LI 30% of AMI 40% of AMI 60% of AMI 3-Bedroom 3 XXX 8 VLI 13 LI 30% of AMI 40% of AMI 60% of AMI Total Restricted Units 61 Unrestricted (Manager’s Unit) 1 Total Units 62 AMI = Area Median Income XXX = Extremely Low-Income VLI = Very Low-Income LI = Low-Income Maximum Initial Income Limit = maximum income for a household to qualify for initial occupancy in the specified Restricted Unit. Exhibit C INSURANCE REQUIREMENTS Prior to issuance of building permits for the Project and throughout the term of this Agreement, Owner shall obtain and maintain, at Owner’s expense, the following policies of insurance.
Sample 1
SIGNATURES MUST BE NOTARIZED. Exhibit A The land situated in the City of Pittsburg, County of Contra Costa, State of California and described as follows: A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of Contra Costa ) On before me, , Notary Public, , personally appeared, , who proved to me the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under penalty of perjury under the laws of the State of California that the foregoing paragraph is true and correct.
Sample 1
SIGNATURES MUST BE NOTARIZED. Attachment 1 (Attach legal description.) Exhibit C-Attachment 1 Exhibit D FORM OF REGULATORY AGREEMENT Recording requested by and when recorded mail to: Redevelopment Agency of the City of Milpitas 000 Xxxx Xxxxxxxx Xxxxxxxx, XX 00000 Attention: Executive Director EXEMPT FROM RECORDING FEES PER GOVERNMENT CODE §§6103, 27383 Space above this line for Recorder’s use. AFFORDABLE HOUSING REGULATORY AGREEMENT AND DECLARATION OF RESTRICTIVE COVENANTS by and between REDEVELOPMENT AGENCY OF THE CITY OF MILPITAS a public body, corporate and politic and INTEGRAL COMMUNITIES XxXXXXXXXX, LLC a California limited liability company dated as of , 2010 This Affordable Housing Regulatory Agreement and Declaration of Restrictive Covenants (this “Agreement”) is entered into effective as of , 2010 (“Effective Date”) by and between the Redevelopment Agency of the City of Milpitas, a public body, corporate and politic (the “Agency”) and Integral Communities XxXxxxxxxx, LLC, a California limited liability company (“Owner"). Agency and Owner are hereinafter collectively referred to as the “Parties.”
Sample 1
SIGNATURES MUST BE NOTARIZED. PROPERTY (Attach legal description.) Number of Restricted Units Building Number of moderate units Xxx 0/Xxxxxxxx 0 00 Xxx 0/Xxxxxxxx 0 00 Xxx 2/Building 2 25 Lot 4/Building 4 26 Lots 5 and 6/Buildings 5 and 6 31 Lots 7 and 8/Buildings 7 and 8 33 TOTAL 199 Attachment 3 to Form of Regulatory Agreement INSURANCE REQUIREMENTS Prior to issuance of building permits for the Project and throughout the term of this Agreement for as long as the residential components of the Project are operated as rental units and/or Owner owns such units (i.e., has not sold them to affordable households), Owner shall obtain and maintain, at Owner's expense, the following policies of insurance.
Sample 1
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SIGNATURES MUST BE NOTARIZED. I hereby declare under oath that the information provided above is true to the best of my knowledge and belief. Signature of Genealogist Date Name (Printed or Typed) Subscribed and Sworn on: My term expires:
Sample 1
SIGNATURES MUST BE NOTARIZED. EXHIBIT B Legal Description of Property 1587202.31
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Related to SIGNATURES MUST BE NOTARIZED

  • Counterpart Signatures For the purpose of facilitating the recordation of this Agreement as herein provided and for other purposes, this Agreement may be executed simultaneously in any number of counterparts, each of which counterparts shall be deemed to be an original, and such counterparts shall constitute but one and the same instrument.

  • Counterpart Signature This Agreement may be signed in counterpart, and the signed copies will, when attached, constitute an original Agreement.

  • AUTHORIZING SIGNATURES (cont I. Office of the Assistant Secretary of Defense (Energy, Installations, and Environment) DALSIMER.ALLYN. Digitally signed by XXXXXXXX.XXXXX.XXX.1284843602 DN: c=US, o=U.S. Government, ou=DoD, XXX.1284843602 ou=PKI, ou=OTHER, cn=DALSIMER.XXXXX.XXX.1284843602 Date: 2016.08.11 11:15:51 -04'00' Xxxxxx X. Xxxxxxxx Date Director, DoD Natural Resources Program 8‐26‐16

  • AUTHORIZING SIGNATURES The following authorizing signatures are attached: U.S. DEPARTMENT OF THE INTERIOR A. Bureau of Land Management B. U.S. Fish and Wildlife Service C. U.S. Geological Survey

  • COUNTERPARTS: SIGNATURES This Deposit Agreement may be executed in any number of counterparts, each of which shall be deemed an original and all of those counterparts shall constitute one and the same instrument. Copies of this Deposit Agreement shall be filed with the Depositary and the Custodians and shall be open to inspection by any Owner or Holder during regular business hours. Any manual signature on this Deposit Agreement that is faxed, scanned or photocopied, and any electronic signature valid under the Electronic Signatures in Global and National Commerce Act, 15 U.S.C. § 7001, et. seq., shall for all purposes have the same validity, legal effect and admissibility in evidence as an original manual signature, and the parties hereby waive any objection to the contrary.

  • AGREEMENT SIGNATURES By signing below, both parties agree to the terms and conditions of this Agreement. Please acknowledge acceptance of this document and terms by returning a signed copy within seven (7) days of issuing. If a signed copy is not returned within seven (7) days and you are attending service, Fighting Chance will deem this to be acceptance of the document. If signed by Xxx XxxXxxxxxxX: Signature of Participant: Date: If signed by Person Responsible: I confirm that this Agreement has been explained to the individual receiving the services and that they agree to the terms. I further confirm that I have authority to sign on their behalf. Signature of Person Responsible: Date: SignaĒure on behalf of FighĒing Chance: Signature of Person(s) responsible: Date: Name: Appendix 1 Key Contact Details Participant’s Name Participant’s Email Participant’s Phone Participant’s Address Person(s) responsible’s Name Person(s) responsible Relationship to Participant Person(s) responsible’s Email Person(s) responsible’s Phone Support Coordinator (where applicable) Support Coordinator’s Name Support Coordinator’s Email Support Coordinator’s Phone Shared Living/Supported Accommodation/Group Home (if applicable) House Manager’s Name House Manager’s Email House Manager’s Phone Additional Contacts (if applicable) Role Contact’s Name Contact’s Email Contact’s Phone Appendix 2 NDIS Claiming Preferences Fighting Chance supports NDIS participants who are NDIA-Managed, Self-Managed or Plan Managed. To invoice and bill you correctly, it is important you keep us updated with your plan management preferences, and let us know ongoing if your status changes. For the purposes of services delivered by Fighting Chance, your NDIS plan is: (please tick) ☐ NDIA-MANAGED You understand that Fighting Chance will claim directly through the NDIA portal if your funding for Fighting Chance is NDIA-managed, so you will not receive any direct request for payment from us. To ensure that you do not get a text from the NDIA to approve each claim weekly, endorse Fighting Chance as a ‘My Provider’ for automatic payment processing. Instructions can be found at xxxxxxxxxxxxx.xxx.xx/xxxx/ or you can contact the Fighting Chance My Provider Endorsement Helpdesk on (00) 0000 0000 or xxxxxxxxxxxxxxx@xxxxxxxxxxxxx.xxx.xx ☐ (Optional) Please supply me, by email, with monthly Statements of Account to: ☐ SELF-MANAGED ☐ I am self-managed and would like to be invoiced for services once a week. Please email invoices to: Please see Appendix 3 for Self-Management Payment Options. ☐ PLAN-MANAGED Please send invoices to my plan manager: Plan management organisatio Contact Name Email Address Phone number ☐ OTHER FUNDING (eg. self-funded, iCare or other insurance funding) Please email invoices to: Appendix 3 Self-Managed Payment Options Participants who are self-managed have a number of payment options with Fighting Chance: ☐ DIRECT DEPOSIT (preferred option) Payment of Fighting Chance invoices can be made by Electronic Funds Transfer (EFT) through your bank. Fighting Chance’s bank account details are as follows: Bank: Commonwealth Bank of Australia Account Name: Fighting Chance Australia Ltd BSB: 062-438 Account Number: 00000000 To ensure all payments are correctly allocated to your account, please include the full invoice number in the reference field. ☐ CREDIT CARD Payments can be made by credit card by clicking the ‘pay by credit card’ link included on the invoice. Please note that a service fee for this option will be imposed. ☐ PAYPAL Payment of your invoices can also be made via our PayPal account. To make payment via PayPal, please access the following link: xxxxx://xxxxxx.xx/FightingChanceAus?locale.x=en_AU To ensure your payment is correctly allocated, please enter the full invoice number in the reference field. Appendix 4 Non Face to Face Time Breakdown - Jigsaw Standard Non Face-to-Face Supports Delivered to every Jigsaw Participant daily, weekly, annually Writing the Board (i.e. preparing and writing up each person’s individualised program for the following day). Reviewing Trainee records/journal notes/medical or other key information to be able to best support the person during their day. Parent/Guardian/Carer Updates, i.e. emails, phone calls. Pre- and post-shift sta briefings. Zone setup (setting up workstations, boxes, visuals and group training areas) Resource development to support each Trainee to progress towards their employment goals (adapting training resources, creating visual aids and cheat sheets, etc). Research/Coordination to implement support strategies (disability, behavioural and learning strategies). Family reviews and the development of training plans (planning, delivery and follow up). Planning social events and extra curricular training (e.g. TAFE). Standard NDIS Annual Support Review Letter. Standard Ǫuarterly Reports - Upon Request. Complex Non Face-to-Face Supports - Delivered to Jigsaw Participants with High Intensity Support Needs (in addition to supports outlined in Standard) Allied health meetings, phone calls, correspondence. Specialist/additional sta training (internal or external), i.e. BSP implementation training. Creation of additional/detailed social stories/visuals. Data collection requested by behaviour therapists. Incident follow up or crisis meetings (seperate to regular family updates or regular allied health meetings). Development/review/discussion of medication forms/transfer plans/mealtime assistance plans etc. Detailed and regular sta training on individual complex behaviour/medical/transfer/mealtime support plans. Extended daily pre-brief and debrief. Additional Non Face-to-Face Supports - billed separately upon request Detailed NDIS Review Letters One-o engagement or training with Allied Health. Detailed Ǫuarterly Reports.

  • COUNTERPARTS; FACSIMILE/E-SIGNATURES This Settlement Agreement may be executed in counterparts and by facsimile or e- signatures, each of which shall be deemed an original, and all of which, when taken together, shall constitute one and the same document.

  • Preparer’s Signature The person completing the DBE commitment form on behalf of the consultant’s firm must sign their name.

  • COUNTERPARTS; FACSIMILE AND SIGNATURES This Settlement Agreement may be executed in counterparts and by facsimile or pdf signature, each of which shall be deemed an original, and all of which, when taken together, shall constitute one and the same document.

  • Signatures/Counterparts The parties expressly agree that this Amendment may be executed in one or more counterparts and expressly agree that such execution may occur by manual signature on a physically delivered copy of this Amendment, by a manual signature on a copy of this Amendment transmitted by facsimile transmission, by a manual signature on a copy of this Amendment transmitted as an imaged document attached to an email, or by “Electronic Signature”, which is hereby defined to mean inserting an image, representation or symbol of a signature into an electronic copy of this Amendment by electronic, digital or other technological methods. Each counterpart executed in accordance with the foregoing shall be deemed an original, with all such counterparts together constituting one and the same instrument. The exchange of executed counterparts of this Amendment or of executed signature pages to counterparts of this Amendment, in either case by facsimile transmission or as an imaged document attached to an email transmission, shall constitute effective execution and delivery of this Amendment and may be used for all purposes in lieu of a manually executed and physically delivered copy of this Amendment.

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