Name of Facility. Facility Address: Surgical Specialty Number of procedures performed [year], by category Enhanced Medical Goods & Services Please provide a list and statement of revenues for all enhanced medical goods and services provided by your Facility.
Name of Facility. [⚫] Municipal Address [or description of Indigenous Lands (as defined in the LT1 RFP), if applicable]: [⚫] Connection Point and Circuit Designation: [⚫] Feeder Name or Upstream Transmission Station: [⚫] Description of Generation or Storage Technology: [⚫] Technology specific Exhibits applicable to the Facility: [Exhibit E-1 / Exhibit E-2] Indigenous Participation The Supplier [is/is not] an Indigenous Participation Supplier as of the Contract Date.
Name of Facility. Location: EIA Number: CEC ID: WREGIS ID: Certification Date: On-line Date: [For Pooled Facilities (for use only with Firm Product): All Product sold hereunder shall be from one or more of the [type of generation] facilities listed below: Name of Facility: [ ] Name of Facility: [ ] Location: EIA Number: CEC ID: WREGIS ID: Certification Date: On-line Date: (collectively, the “Pooled Facilities”) The Parties acknowledge and agree that the Project consists of the Pooled Facilities and Seller is permitted to utilize the Pooled Facilities in order to satisfy its obligations hereunder. The Parties further acknowledge and agree that, with respect to Section 3.1(a) of this Confirmation, Product shall solely be limited to the actual Product generated and delivered by the Pooled Facilities used to satisfy the Contract Quantity, and that Buyer is not entitled to any additional Product produced by the Pooled Facilities in the Project above and beyond the Contract Quantity. Each of the Pooled Facilities shall have been certified by the CEC as an RPS-eligible resource and Seller shall have obtained LORS Certification for each of the Pooled Facilities.]
Examples of Name of Facility in a sentence
Adjustments to Statement of Expenditures Name of Facility License No.Report for Year Ended* All except "Help Wanted".
The Product is: Renewable Energy Facility or Unit Specific; if so, complete the following: Name of Facility Location of Facility EIA number Online Date Renewable Energy Source specific; if so, state: Aggregator area specific.
Name of Facility: Facility Address: Surgical Specialty Number of procedures performed [year], by category Enhanced Medical Goods & Services Please provide a list and statement of revenues for all enhanced medical goods and services provided by your Facility.
Signature Signature Title Title Name of Facility Sworn to and subscribed before me, this the day of , 20 .
Signature (Purchaser) Signature (Seller) Title Title Name of Facility Sworn to and subscribed before me, this the day of , 20 .
More Definitions of Name of Facility
Name of Facility. Account #: Address: City/State/Zip Contact Person: Phone No.: Rep Name: Rep #: Medline Sales Order # PUMP SET PURCHASE AGREEMENT: [Customer] has agreed to purchase pump sets of the following manufacturer from Medline in accordance with the terms and conditions set forth below: Novartis Medline Xxxx The purchase price of the pump sets, Medline Reorder No. shall be $ per case and this price shall be firm for the first 12 months of the term of the agreement. Thereafter, Medline may increase said price by no more than 5% per year. If and to the extent Medline receives Enteral Feeding Pumps from the above manufacturer at no cost, Medline will provide such pumps to Customer at no cost. Customer acknowledges and agrees that any discount offered by Medline will be accurately reflected as a discount on its cost report and claims submitted. Further, it may be considered fraud to xxxx the Medicare or Medicaid program for items Customer receives at no cost. TERMS AND CONDITIONS
Name of Facility. Address of Facility: Signature: Print Name: Title: Date: DANCELY Signature: Print Name: Title: Date: Photograph, Video, and Image License Agreement This Agreement (the "Agreement") is by and between Xxxxx Xxxxxx, Inc., a Florida corporation ("Company") and Licensor.
Name of Facility. Mailing Address: City: State: Zip: Name of Director of Nursing (DON): (PLEASE PRINT) Signature of DON: Date: Phone Number: Email: Preceptor information Name of Preceptor Assigned: (PLEASE PRINT) Signature: Date: Phone Number: Email: Additional information The facility and Preceptor will be notified in writing of the student’s successful completion of the coursework. At which time the Preceptor will be sent the course objectives and they may begin their clinical rotation. The Nursing Department at Mohave Community College will implement a contractual agreement and submit it to the facility Director of Nursing for the appropriate signatures, if one has not already been established. Any questions should be addressed to Xxxxxx Xxxx, Nursing Programs Assistant. xxxxx@xxxxxx.xxx 000-000-0000
Name of Facility. Pueblo Police Dept Range Class Location: Pueblo , CO Hosting Agency: Pueblo Police Department Anticipated Number of Students: 20 Estimated length of class: 40.0 hour(s) $12,400.00 $12,400.00 Total Training Line 7- Supervising Patrol Critical Incidents Class Date: From 7/2/2018 to 6/28/2019 Description: This 16-hr course is designed to provide patrol supervisors with the information and tools needed to manage a critical incident prior to the arrival of SWAT. Legal issues, scene management and small team tactics can give the patrol supervisor tolls needed to manage a critical incident scene as well as respond to unfolding events prior to the arrival of SWAT.
Name of Facility. Address: City: State: Zip: Phone: DEGREE AND MEANS OF SUPERVISION: The supervising Physician shall provide supervision to the physician assistant to adequately serve the health care needs of the practice population and ensure that the patient’s health, safety, and welfare will not be adversely compromised. A physician assistant holding a temporary license may work only under 100% direct supervision. List the method of immediate consultation whenever the physician assistant is not under the direct supervision of the supervising physician: List the process and degree of onsite supervision: List the method of supervision when the supervising physician is on vacation: FREQUENCY AND MECHANISM OF CHART REVIEW: List the method for chart review and co-signatures of the supervising practitioner for supervision. Include the process for chart review and co-signatures required:
Name of Facility. Address of Facility: Business Phone#: Business Hours: Day(s) of the week when vendor will be using your restroom: Time of day the vendor will be using your restroom: The above named vendor has my permission to use my restroom facilities at the above stated facility. I agree to provide a functioning toilet, hand wash sink with hot and cold running water, soap, paper towels or hand blow dryer for the vendor to use. I understand the facilities need for use of my restroom facilities is to prevent foodborne illness to its patrons. I understand this agreement is between myself and Mr./Ms. , and that I shall notify the Department of Environmental Health, within 10 days of severance of this agreement, or when the above named individual has not used my restroom facilities for a period of 30 days. I declare the information above to be accurate and correct. Signature Date As an authorized representative of the Department, I am familiar with the above facility and have verified that it meets standards for a functioning restroom.
Name of Facility. Canterbury Health Facility Facility Address: 1720 Knowles Road Xxxxxx City, Alabama 36868 Legal Description: