Name of Firm. Supervisor: Address: Phone: City: Zip: Worker’s Disability Carrier: Policy No. Liability Insurance Carrier: Policy No. Job Title: Date Employment Begins: Ends: Hours to be worked: Mon Tue Wed Thu Fri Sat Sun Earliest Latest Avg. Hrs. Per Day*: Xxx Xxx. Per Week**: Starting Wage: *Cannot compute to more than ½ of the pupil’s FTE. **Work and school hours cannot exceed 48 hours per week for students under age 18 Unpaid Employment Information (Complete for in-district placements only) IMPORTANT: IN-DISTRICT placements MUST be directly related to one of the following: 🞏 State-Approved CTE work-based (Name of related CTE Program: ) PSN from above: 🞏 Postsecondary career and employment goals and objectives in the pupil’s transition service plan developed for special education services. A copy of the pupil’s transition services plan must be attached and relate directly to placement. Failure to do so will result in lost FTE. Position/Assignment: Supervisor: Beginning Date: Ending Date: This assignment is: (check one) 🞏 for the marking period 🞏 for the semester 🞏 for the school year Hours to be worked (must occur during scheduled classroom time): Mon Tue Wed Thu Fri Education Goals Education/Career Goal(s): List the education goals related to this placement that align with the student’s career pathway contained in the student’s educational development plan. For unpaid work-based experiences, specific, unduplicated skills must be listed for each 45 hours of placement. *Attach copy of the EDP or IEP.
Name of Firm. Address: Phone:
Name of Firm. Address: Phone: Contact person for matters concerning MBE/WBE compliance:
Examples of Name of Firm in a sentence
Name of Firm: Click here to enter text.Address: Click here to enter text.
Proposed Position: Name of Firm: Name of Staff: Profession: Date of Birth: Years with Firm: Nationality: Membership in Professional Societies: Detailed Tasks Assigned: Key Qualifications: [Give an outline of staff member’s experience and training most pertinent to tasks on assignment.
Name of Firm Address of Firm Contact Person Telephone # Fax #( ) ( ) Name or Contract No. # of Years / Term of Contract Type of Service Dollar Amt.
If a joint venture, appropriate officers of each company shall sign.) (Signature of Chief Executive Officer) (Typed Name and Title) (Type Name of Firm) Dated: APPENDIX B LETTER OF INTENT(Note: To be typed on Respondent's Letterhead.
Tender No. Name of Firm/ Company Year of Establishment Name of Owner/Authorized agent Office Address GST No. NTN.
More Definitions of Name of Firm
Name of Firm. Dated this: Day of Printed Name Title Signature
Name of Firm. Reg. Decision: NIPT No: Address: Represented by: Preamble N.G. University is a school of higher education that offers dual study programmes where theory combines with practice on an equal ratio in order to enable students to apply independently during their professional practice scientific knowledge and methods gained during theoretical studies. According to this concept, firms may qualify their personnel by enabling their theoretical qualification at the university, whereas the practical training is taken over by the firm itself. The purpose of the dual study programme is to establish stable and long-term contacts between the business enterprises and the students that would generate benefits for both parties. Business enterprises would benefit from qualified personnel that suit the business profile of the enterprise, whereas students would benefit from a stable employment according to their professional qualification.
Name of Firm. Street Address: Mailing Address: Telephone Number: Fax number: E-mail Address: Date Firm was Established: Is this firm a (check all that apply): Prime Contractor? [ ] Yes [ ] No Subcontractor? [ ] Yes [ ] No Identify specialty: Service Provider? [ ] Yes [ ] No Identify service: Material Supplier? [ ] Yes [ ] No Identify material: Manufacturer? [ ] Yes [ ] No Identify product: Certified DBE? [ ] Yes [ ] No If so, by whom? [ ] DOT&PF Certified Small Business [ ] Yes [ ] No If so, please include a copy of the SBA Certificate. Type of contracts/proposals bid by the firm: [ ] Highways [ ] Airports [ ] Mass Transit [ ] Other (specify) _ _ _ Firm’s gross annual receipts: [ ] < $500,000 [ ] $500,000 - $999,999 [ ] $1,000,000 - $4,999,999 [ ] $5,000,000 - $9,999,999 [ ] $10,000,000 - $16,999,999 [ ] > $17,000,000 Send this completed form to: City and Borough of Juneau Engineering Dept., Contract Administrator 000 Xxxxx Xxxxxx Xxxxxx Juneau, Alaska 99801 If you have any questions, please call (000) 000-0000. JNU AIRCRAFT RESCUE & FIREFIGHTING DBE GOALS - BIDDER REGISTRATION FORM STATION MODIFICATIONS 005420 - 7
Name of Firm. Tax Identification No.: 2 Address of Firm: DUNS No.:
Name of Firm. Signature: Print Name: Title: [END OF EXHIBIT “H”]
Name of Firm. ______________________Name of Firm: ____________________ Signature: _________________________ Signature: _______________________ Name: ____________________________Name: __________________________ Title: _____________________________ Title: ___________________________ Date: ____________________________ Date: ___________________________ INFORMATION FOR DETERMINING JOINT VENTURE ELIGIBILITY – PAGE 4 Date _________________________ State of _________________________ County of _________________________ AFFIDAVIT STATE OF FLORIDA ) COUNTY OF ) ) ss: The foregoing instrument was acknowledged before me by means of ☐ physical presence, or ☐ online notarization, this _____ day of ________________, 20__, by __________________________________ [NAME OF PERSON], as ______________________________________ [TYPE OF AUTHORITY,… e.g. officer, trustee, etc.)] for _____________________________[NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED]. ☐ Personally Known; OR ☐ Produced Identification. Type of identification produced _. [CHECK APPLICABLE BOX TO SATISFY IDENTIFICATION REQUIREMENT OF FLA. STAT. §117.05] __________________________________ Notary Public My Commission Expires: __________________________________ (Printed, typed or stamped commissioned name of Notary Public) ORANGE COUNTY, FLORIDA Procurement Division CONTRACT NO. Y23-155 SEWAGE HAULING This contract is not valid unless bilaterally executed. Subject to mutual agreement Orange County, Florida, hereby enters into a contract subject to the following:
Name of Firm. Begin: End: Supervisor: Phone: City Address: : State: Zip: