ACCEPTED BY. Accepted by: Ohio Department of Taxation Print Taxpayer Name Xxxxxxx X. XxXxxxx, Tax Commissioner Signature Name Title
ACCEPTED BY. Renter Congregation Xxxx Xxxxx Signature of Renter Signature of Xxxx Xxxxx Print Name Print Name Date Date INDIVIDUAL USE RENTAL APPLICATION Date of Event: Expected Number of Participants: Time of Event (5 Hour Maximum): From to Type of Event: Name of person making reservation: Name of Organization, if applicable: Address: Home Phone: Cell Phone: Email Address: Caterer will set up on: Food Purveyors: Food Purveyor’s contact and phone number: Caterer’s Insurance (if Caterer will be on-site): Florist:
ACCEPTED BY. THE BANK OF NEW YORK MELLON By: Name: Title: Address: APPENDIX I TO T-1 SUPPLEMENT [Names of Funds] [On AP’s Firm Letterhead] CERTIFICATE OF AUTHORIZED PERSONS (of Authorized Participant) The undersigned officer, who is not an Authorized Person, hereby certifies that (i) he/she is the duly elected and acting (title) of (the “Participant”), and (ii) that the following officers or employees (each, an “Authorized Person”) of the Participant are duly authorized to deliver oral or written instructions to The Bank of New York Mellon (“Transfer Agent”) pursuant to the Participant Agreement by and between the Participant, the Transfer Agent and the Distributor, and that the signatures appearing opposite their names are true and correct: The below shall be the Participant list of Authorized Persons: Name Title Signature Name Title Signature Name Title Signature Name Title Signature Name Title Signature Name Title Signature Name Title Signature This Certificate supersedes any prior certificate of Authorized Persons the Transfer Agent may have on file. Any updates to the above list of Authorized Persons will be provided by the Participant as changes occur. [seal] By: Title: Date:
Examples of ACCEPTED BY in a sentence
By: /s/ Fxxxx Xxxxxxxxx Name: Fxxxx Xxxxxxxxx Title: President and CEO ACCEPTED BY: IMAC HOLDINGS, INC., as Collateral Agent By: /s/ Jxxxxxx X.
More Definitions of ACCEPTED BY
ACCEPTED BY. SUBMITTED BY: RENOVIS, INC. OPTIONEE By: Name: Optionee Its: Address:
ACCEPTED BY. SUBMITTED BY LEAP WIRELESS INTERNATIONAL, HOLDER: INC. By:_________________________________ By:_________________________________ Print Name:__________________________ Print Name: Xxxxxxx X. Xxxxxxxxx Title:_______________________________ Address:_____________________________ ATTACHMENT A-4 LEAP WIRELESS INTERNATIONAL, INC. 2004 STOCK OPTION, RESTRICTED STOCK AND DEFERRED STOCK UNIT PLAN RESTRICTED STOCK AWARD GRANT NOTICE AND RESTRICTED STOCK AWARD AGREEMENT Leap Wireless International, Inc. (the "COMPANY"), pursuant to its 2004 Stock Option, Restricted Stock and Deferred Stock Unit Plan (the "PLAN"), hereby grants to the holder listed below ("HOLDER"), the right to purchase the number of shares of the Company's Common Stock set forth below (the "SHARES") at the purchase price set forth below. This Restricted Stock award is subject to all of the terms and conditions as set forth herein and in the Restricted Stock Award Agreement attached hereto as Exhibit A (the "RESTRICTED STOCK AGREEMENT") and the Plan, each of which are incorporated herein by reference. Unless otherwise defined herein, the terms defined in the Plan shall have the same defined meanings in this Grant Notice and the Restricted Stock Agreement. HOLDER: Xxxxxxx X. Xxxxxxxxx XXXXX DATE: ______________, 2005 PURCHASE PRICE PER SHARE: $0.0001 per share TOTAL NUMBER OF SHARES OF RESTRICTED STOCK: [__________] VESTING SCHEDULE: The Shares shall be released from the Company's Repurchase Option set forth in Section 3.1 of the Restricted Stock Agreement on the dates and in the percentages indicated in Exhibit B to this Grant Notice. By his or her signature and the Company's signature below, Holder agrees to be bound by the terms and conditions of the Plan, the Restricted Stock Agreement and this Grant Notice. Holder has reviewed the Restricted Stock Agreement, the Plan and this Grant Notice in their entirety, has had an opportunity to obtain the advice of counsel prior to executing this Grant Notice and fully understands all provisions of this Grant Notice, the Restricted Stock Agreement and the Plan. Holder hereby agrees to accept as binding, conclusive and final all decisions or interpretations of the Administrator of the Plan upon any questions arising under the Plan, this Grant Notice or the Restricted Stock Agreement. If Holder is married, his or her spouse has signed the Consent of Spouse attached to this Grant Notice as Exhibit C. LEAP WIRELESS INTERNATIONAL, HOLDER: INC. By: ________________...
ACCEPTED BY. Start Date: _ Business: E-mail: Mailing Address: City, State, ZIP: _ Payment must be assured by automatic bank debit or prewritten checks dated the last day of each month. ( ) I agree to pay with an automatic bank debit from my account on the last business day of each month for the following month of advertising. Door County Daily Xxxx.xxx Sales Representative: NONDISCRIMINATION POLICY: Nicolet Broadcasting, Inc. and its stations/websites do not discriminate in advertising contract on the basis of race or ethnicity. Any provision in any order or agreement for advertising or services that purports to discriminate on the basis of race, gender, even if handwritten, typed, or otherwise made a part of this particular contract, is hereby rejected. Nicolet broadcasting, Inc. is an equal opportunity employer. This is an annual agreement that can be cancelled at any time with payment of a rate adjustment based on actual number of ads run on the rate card in effect at the time of this agreement. The current rate card is on the opposite side of this agreement.
ACCEPTED BY. For and on behalf of For and on behalf of [ACCEPTING BANK] [BORROWER] ........................... ........................... Authorised signatory Authorised signatory Reverse of Xxxx For and on behalf of [BORROWER]
ACCEPTED BY. THE BANK OF NEW YORK MELLON, AS TRANSFER AGENT By: Name: Title: Address:
ACCEPTED BY. For the Applicant: For the Public Utilities Commission of Ohio: (Signature) (Signature) Name Title Chairman
ACCEPTED BY. Signature Name: Xxxxx Xxxxx Date: Print Name Title: Director of Food & Beverage Send all correspondence to: SMG/SAVOR Peoria Civic Center 000 XX Xxxxxxxxx Avenue Peoria, IL 61602 Attention: Xxxxx Xxxxx Tele: 000- 000-0000 Fax: 000-000-0000 E-mail xxxxxx@xxxxxxxxxxxxxxxxx.xxx Exhibit A Product/ Menu Schedule Vendor’s Location(s): Vendor Company Name: THE ITEMS LISTED BELOW, ONLY AFTER APPROVED IN WRITING BY SMG, MAY BE PLACED AND SOLD AT VENDOR’S LOCATION DURING THE EVENT. Vendor: Please list the complete name, description, portion size and price for all items to be sold at your vending area location. SMG will check for conflicts with sponsorship and pricing All signage and graphics must be approved or will be custom designed to SMG specifications. Vendor logos must be approved prior to placement. All stand décor and design must be approved by SMG Serving Containers to be approved by SMG and absolutely NO SYTROFOAM will be allowed in the Peoria Civic Center Effective 11-17-14 If additional pages are needed, please photocopy and attach. Product Name & Description SMG Approval Portion Size Selling Price 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Exhibit B Schedules DEADLINES DUE DATE Copy of Exhibit A Signed and dated copy of this Agreement Original Certificate of Insurance Proof of Worker’ Compensation Coverage Seller’s Permit Certification City License Information Health Permit Associated Charges SMG will make every reasonable attempt to furnish the necessary equipment. However, due to specifications of layout and design, some items may not be meet Vendors exact specifications. It is ultimately the Vendor’s responsibility to furnish equipment needed after reasonable efforts have been made by SMG/SAVOR. Operating Supplies Vendor is also responsible for all operating supplies necessary for operation of stand to include and not limited to chemicals, gloves, cleaning supplies, and disposable wares etc… Commission Calculation (Enter in Detail Below)