Please provide address so that we may keep you informed electrnnically nf filings in your

Size: px
Start display at page:

Download "Please provide address so that we may keep you informed electrnnically nf filings in your"

Transcription

1 Please provide address so that we may keep you informed electrnnically nf filings in your The petition of the above-named complainant, respectfully shows: 1. That the above-named,&&w 6Nh,&A&+ $kd/ (name of defendant), is a public utility engaged in the business of &&z% 17#'& fl%&//& (state the public utility business of 3/0 FHk?4/d G cl&a gr kt (their the defendant, Le. gas, electric telephone, etc.] at f~&il;/7 /wid744 &CY 3 57 address), in the State of West Virginia, and as such is subject to the provisions of Chapter 24 (or 24A) of the Code of West Virginia, 1931, as amended, and the provisions thereof applicable to said class of public utilities. 2. That the said defendant has violated the laws of the State of West Virginia, governing said public utility business, in the following particulars, to-wit: (a) mere state concisely the matters complained of.] 5-f-1 R1flfM [WK& sheet of paper DO NOT WRITE ON BACK OF PAGES - attach a

2 (b) Here state the remedy you seek 4- Wherefore, the complainant prays that the said defendant fi/?/&b?&&bd/ (defendant's name) be required to answer the charges herein above set out, and that, after due investigation, an order may be made commanding the said defendant to cease and desist from the wrongful conduct aforesaid, and for such other and further order as the Public Service Commission of West Virginia may deem necessary, reasonable and just in the premises. prayer may ask for the ascertainment of lawful rates of practices, and an order requiring the defendant to conform thereto.] Dated this d?d day of MJdKh & d~ ) (If you have an attorney, hisher name) Attorney's Address:, Attorney, if applicable. Subscribed and sworn before me this THIS FORM MUST BE NOTARIZED [If Complainant is signing out-of-state, please use verification F O NO. ~ 1s cxl 2 Tc no c-3 moa c,- 5,c IJzr Q 0 B.-""a w m PLEASE NOTE: -5 cn <? - I m mw It is extremely important to notify the PSC of any changes to youreo@##$ i&r&ion Tzxl W and to promptly retrieve Certified Mail upon notification of sucbz 5 rn oj= mcd

3 FARMERS & MECHANICS MUTUAL INSURANCE CO. OF WEST VIRGINIA Insuring West Virginians Since 1877 In the course of following up on this complaint, I have determined that this is a third party tow. The claimant-darrell Collins s 1998 Honda Civic was struck and later determined to be a total loss after our insured s daughter struck this vehicle on West Pea Ridge Rd near Huntington. The 1998 Honda Civic was towed from the scene at the request of the Cabell County Sheriff Department, who contact Thompson s Auto Service 1941 Seventh Ave Huntington, WV ( or ) The vehicle sat in storage for approximately 37 days until our adjustor completed the claim and had the vehicle moved to Copart Auto Salvage in Hurricane, WV. After the vehicle was sold at auction, we received the final invoice from Copart which included advance charges paid by Copart in the amount of $1, These charges were described in the Copart invoice as Tow service- $175.00, Storage- $ and First Tow into East End- $ The billing we received with the Copart invoice was from East End Body Shop Ferris Court, Huntington, WV ( ) and describes the charges as Towing $ (original tow bill& storage) and storage $ (our storage). The bill was written by Leanne Thompson. We believe this bill is exorbitant. W. D. Deke Walker Special Investigator Farmers & Mechanics Insurance Companies of WV P 0 Box 1917 Martinsburg, WV Ext Ext dwalker@fmiwv. com PO BOX , M A R T I N S B U R G, W V W / W F A X /

4 COPART AUTO AUCTIONS 2481 RT. 60 HURRICANE, WV PHONE (304) TfiJ ID# Date 9/15/08 Visit us at All Amounts are in USD FINAL INVOICE Copart Lot# WV - CHARLESTON Loss Date 6/08/08 Called In 8/05/08 P/U Cleared 8/05/08 Pickup Date 8/06/08 Original Title 8/21/08 Trans Title 8/22/08 Sale Document 9/03/08 Loss Type COLLISION Description 98 HOND CIVIC EX BLACK Vehicle ID# lhgej8249wl License#/ST Mileage 168,876 Pickup From EAST END AUTO BODY 3117 FERRIS COURT HUNTINGTON, WV (304) ADVANCE CHARGES PAID BY COPART TOW SERVICE.... STORAGE FIRST TOW IN TO EAST END..... TOTAL ADVANCE CHARGES... COPART SERVICE CHARGES POOLING CHARGE.... TOW IN TITLE PROCESSING..... SALES TAX.... TOTAL COPART SERVICE CHARGES TOTAL DUE COPART PROCEEDS FROM SALE... FAR2 CAP065 ' BRIAN CULP FARMERS & MECHANICS FIRE 25 ADMINISTRATIVE DR PO BOX 1917 MARTINSBURG, WV Claim# FC Policy# Loss Code Reference# Insured STEPHEN FLEMING Owner DARRELL L. COLLINS Zone SALVAGE CERTIFICATE CR *Bid Raised By Internet* NET DUE COPART SALE INFORMATION Lot# sale Date 9/11/08 Sale Amount Sold To SUTPHINS BODY SHOP BOX MCCOMAS ROAD SALT ROCK, WV (304) RES# Return Cert# CJ59098.O% Item# 1123 Payment From Buyer 9/15/08 09/18/ :lO PM Invoice Date 9/15/08 Invoice Amount USD

5 I I c I_-cI--c c ' 4 * 08/06/2008 at 04:32 PM BAST END BODY SHOP Federal m #: I, ROMANS 10:9, Ferris Court Huntington, WV (304) Fax: {304) UNREXATED PRIOR DAM&GE (Information Only) Written By: Leanne Thompson Adjuster: Job Number: Insured: Owner : ' Address : Day : Fax : Ins peat Loaation : Darrell Collins Claim #FC08108 Darre1.l Collins policy # Deductible; Date of Loss: (304) Type of Loss: (304) Point oe Impact: 12. Front i' EAST END BODY -SHOP! Business: (304) Ferris Court Huntington, WV ~ Insurance APPRAISAL Company :.I.,, Days to Repair i I VIN: 1998 HOND lhgej8249wl CIVIC EX 4-1.6L-FI Lie: 2D 4KW762 CPE BLACK WV Int: Prod Date: Odometer: 168,87 ~ Air Conditioning Rear Defogger Tilt Wheel Cruise Control Intermittent Wipers Body Side Moldings I Dual Mirrors Console/Storage Electric Glass Sunroof I Cle3.r Coat Paint Power Steering Power Brakes Power Windows Power Locks Power Mirrors I AM Radio FM Radio Stereo Driver Air Bag Pasgenger Air Bag Cloth Seats Bucket Seats Reclkne/Lounge seats Automatic Transmission Overdrive Full. Wheel Covers I I c L_I L_I LI NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT I# OTHER CHARGES 2# Towing 3# Storage I' _---_-_,,,,,,,,,,,,i,, Subtotals ==> :IO PM

6 t L 08/06/2008 at 04:32 PM HOND UN~EXATED PRXOR DAMAGE CIVIC. EX 4-1.6L-FI 2D CPE BLACK Int: Job Number: This report is an estimate only!!! The need of additional labor, materials &/OX parts may be discovered--upon further inspection. In 'all cases, the vehicle owner will be notified of any additional labor, materials &/or parts needed prior to continuing repairs.., 811 Parts Prices are Subject to Final Invoice... An authorization to repair must be signed by the vehicle owner prior to order of parts or start of repairs..s$any cancellations after parts have been ordered may possibly result in the charge of a restocking fee to the vehicle owner...!% Payment must be made in full ptior to release of vehicle, No exceptions to this policy without prior authorization by management of East End Body Shop inc... :L The insurance policy under which a claim is filed may include a deductible. In all cases in which a deductible is applicable, the vehicle owner is responsible for payment of that deductible to East End Body Shop inc. prior to release of vehicle. No exceptions to this.policy without: prior authorization by management of East End Body Shop inc.,, I-* 1; ALL REPAIRS COVERED BY LIMITED kfetime WARRANTY UNLESS OTHERWISE NOTED IN WRITING...SEE YOUR SHOP ESTINATOR FOR DETAILS.,. Any person who knowingly presenps a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison,! :lO PM

7 PUBLIC SERVICE COMMISSION OF WEST VIRGINIA CHARLESTON secl11208.wpd Entered by the PUBLIC SERVICE COMMISSION OF WEST VIRGINIA, in the City of Charleston on the 12* day of November CASE NO MC-FC FARMERS & MECHANICS MUTUAL INSURANCE CO. OF WEST VIRGINIA a corporation, Complainant, V. EAST END BODY SHOP Huntington, Cabell County, Defendant, COMMISSION ORDER OnNovember 12,2008, Farmers & Mechanics Mutual Insurance Co. of West Virginia filed a formal complaint, duly verified, against East End Body Shop. IT IS THEREFORE ORDERED that the Defendant be, and hereby is, required to satisfy the formal complaint or make answer thereto, in writing, within ten days of the service upon them by certified mail of a copy of the formal complaint and a copy of this order in accordance with the provisions of Rule 7 of the Rules of Practice and Procedure before this Commission, and after receipt thereof or default therein, the Commission will proceed to investigate the matters set forth in the formal complaint in such manner and by such means as may be deemed proper. A mediation request by the Defendant will not be considered if an answer has not been filed. IT IS FURTHER ORDERED that the Executive Secretary of the Commission, be, and hereby is, directed to serve a copy of the formal complaint upon the defendant, by delivering to them a copy of the formal complaint and a copy of this order by United States Certified Mail, return receipt requested. FOR THE COMMISSION: SSIjan s.wpd Public Service Commission of West Virginia Charleston

09/06/2013 at 01:16 PM File ID:

09/06/2013 at 01:16 PM File ID: For: AGGRESSIVE USA - Adjuster: DON MCANALLY APPRAISAL SERVICE Mcanally Appraisal Services LLC 145 W Main St. Azle, TX 76020 (817)444-8463 Fax: (817)444-9598 Written By: JAMELL BROWN Insured: UNK Claim

More information

dhfi4 utility business, in the following particulars, to-wit: Form No. 1 COMPLAINT State of West Virginia Public Service Commission Charleston

dhfi4 utility business, in the following particulars, to-wit: Form No. 1 COMPLAINT State of West Virginia Public Service Commission Charleston /,' J,," Form No. 1 COMPLAINT State of West Virginia Public Service Commission Charleston TYPE OR PRINT CLEARLY USING BLACK INK The petition of the above-named complainanf respectfully shows: 1. That the

More information

TILLEMAN MOTOR CO. You Win with Tilleman 4514 US Highway 2 W, Havre, MT Phone: (406) FAX: (406)

TILLEMAN MOTOR CO. You Win with Tilleman 4514 US Highway 2 W, Havre, MT Phone: (406) FAX: (406) TILLEMAN MOTOR CO You Win with Tilleman 4514 US Highway 2 W, Havre, MT 59501 Phone: (406) 395-6877 FAX: (406) 265-7875 Workfile ID: f846535b Written By: Doug Hollingshead Insured: Thompson, Colin Policy

More information

P&C Appraisal Services 2121 NATOMAS CROSSINGS DR SUITE # , SACRAMENTO, CA (916) Fax: (916)

P&C Appraisal Services 2121 NATOMAS CROSSINGS DR SUITE # , SACRAMENTO, CA (916) Fax: (916) This Estimate Was prepared By an Independent Appraiser and is Subject to Insurance Company Audit & Approval. Only The Vehicle Owner Can Authorize Repairs. Contact the Handling Adjuster for Confirmation

More information

Vehicle Condition Report

Vehicle Condition Report Vehicle Condition Report VIN: Lease No: FADP3F2XEL329873 5047968 ALL ITEMS OF DAMAGE FOR WHICH A CHARGE FOR EXCESSIVE WEAR OR DAMAGE WILL BE CLAIMED BY THE HOLDER MUST BE NOTED IN THE APPRAISAL. IF YOU

More information

Metromile Insurance Company

Metromile Insurance Company Days to Repair: 6 Metromile Insurance Company ALL SUPPLEMENTS REQUIRE PRIOR APPROVAL To file a supplement, please visit the following WEBSITE: WWW.SUPPLEMENTS.SNAPSHEET.ME For questions or assistance please

More information

UN-Priced Offers Due: Wednesday, April 25, 2018 at 10:00 a.m. Reverse Auction/Bid: Wednesday, May 9, 2018 starting at 10:30 a.m.

UN-Priced Offers Due: Wednesday, April 25, 2018 at 10:00 a.m. Reverse Auction/Bid: Wednesday, May 9, 2018 starting at 10:30 a.m. LAUDERDALE COUNTY BOARD OF SUPERVISERS 410 Constitution Ave, 11 th Floor Meridian, Mississippi 39301 601-482-9746 Main 601-482-9744 Fax BIDDERS INFORMATION PACKET BID NO: 3808 One (1) or more New Model

More information

Towns (tip of South Park

Towns (tip of South Park Towns (tip of South Park 2675 Brownsvifle Road, South Park, Pennsyfvania 15129 Phone.: (412) 831-7000 Fa#: (412) 831-0425 www.soittfijjarfi.tvvp.com Boarcf of Supervisors : David]. Buchewicz Walter C.

More information

State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION Division of Insurance 1511 Pontiac Avenue Cranston, RI 02920

State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION Division of Insurance 1511 Pontiac Avenue Cranston, RI 02920 State of Rhode Island and Providence Plantations DEPARTMENT OF BUSINESS REGULATION Division of Insurance 1511 Pontiac Avenue Cranston, RI 02920 INSURANCE REGULATION 77 PRE-INSPECTION OF PRIVATE PASSENGER

More information

GARAGE AND AUTO DEALERS APPLICATION

GARAGE AND AUTO DEALERS APPLICATION GARAGE AND AUTO DEALERS APPLICATION Proposed Effective Date: Producer: Name Proposed Expiration Date: Address Phone # Applicant Name and Mailing Address: Contact & Email: Individual Partnership Corporation

More information

United Equitable Insurance Company

United Equitable Insurance Company United Equitable Insurance Company PHONE: 800-831-8330 CLAIMS FACSIMILE: 847-583-9011 CLAIMS AFFIDAVIT OF VEHICLE THEFT NOTE: All thefts must be reported to the police. If there is no report on file, we

More information

ROAD PUBLIC SERVICE DISTRICT

ROAD PUBLIC SERVICE DISTRICT 1 RIVER ROAD PUBLIC SERVICE DISTRICT Post Office Box 2484 Westover, WV 26502 (304) 983-8810 November 5,2008 West Virginia Public Service Commission Attn.: Sandra Squire, Executive Secretary 201 Brooks

More information

GARAGE APPLICATION. APPLICANT INFORMATION Policy Period Requested: From / / To / / County State Zip Code Phone ( )

GARAGE APPLICATION. APPLICANT INFORMATION Policy Period Requested: From / / To / / County State Zip Code Phone ( ) GARAGE APPLICATION APPLICANT INFORMATION Policy Period Requested: From / / To / / Business Trade Name Mailing Address City County State Zip Code Phone ( ) Years this business entity has been in operation?

More information

Request for Quotation

Request for Quotation City Hall 501-3 rd Ave., Box 190 Fernie, BC V0B 1M0 www.fernie.ca Request for Quotation PICK UP TRUCK Issue Date: December 13, 2016 Quotations marked Quotation will be received at the City of Fernie, City

More information

Rural Based Business License Application

Rural Based Business License Application New Applications All forms must be filled out completely, including mailing and business addresses and all available phone/fax/email information. Currently we do not accept applications by mail. $35.00

More information

GARAGE AND AUTO DEALERS APPLICATION

GARAGE AND AUTO DEALERS APPLICATION GARAGE AND AUTO DEALERS APPLICATION Proposed Effective Date: Producer: Name Proposed Expiration Date: Address Phone # Applicant Name and Mailing Address: Contact & Email: Individual Partnership Corporation

More information

SAMPLE. CarHistory Report & PPSR Certificate Report generated on 30/06/2016 QUICK SUMMARY REPORT ID SAMPLE VIN. Year (first retail date) 2009

SAMPLE. CarHistory Report & PPSR Certificate Report generated on 30/06/2016 QUICK SUMMARY REPORT ID SAMPLE VIN. Year (first retail date) 2009 CarHistory Report & PPSR Certificate Report generated on 30/06/2016 REPORT ID 4512671 VIN Make Model Variant/series Body Transmission QUICK SUMMARY MAZDA CX-9 LUXURY- Year (first retail date) 2009 Colour

More information

INVITATION TO BID PURCHASING DEPARTMENT P.O. BOX NORTH ASHLEY ST. VALDOSTA, GEORGIA #LC

INVITATION TO BID PURCHASING DEPARTMENT P.O. BOX NORTH ASHLEY ST. VALDOSTA, GEORGIA #LC INVITATION TO BID PURCHASING DEPARTMENT P.O. BOX 1349 327 NORTH ASHLEY ST. VALDOSTA, GEORGIA 31601 #LC-2018-7004 FOR: 3 New Model Half Ton Trucks for Public Works OPENING DATE: March 9, 2018 TIME: 10:00

More information

Property/Casualty Insurance Renewal Survey

Property/Casualty Insurance Renewal Survey P.O. Box 5670 Cortland, NY 13045 Phone (800) 822-3747 Fax: (607) 756-5051 Email: applications@ mcneilandcompany.com GENERAL INFORMATION Date of survey: Renewal Date: Date proposal needed: Legal Name of

More information

Garage Application. Security Financial Insurance a member of Landmark Insurance Group E. Belleview Ave #550 Englewood, CO Ph.

Garage Application. Security Financial Insurance a member of Landmark Insurance Group E. Belleview Ave #550 Englewood, CO Ph. Security Financial Insurance a member of Landmark Insurance Group 6501 E. Belleview Ave #550 Englewood, CO 80111 Ph. 720-922-7376 Garage Application ALL QUESTIONS MUST BE ANSWERED IN FULL, SIGNED AND DATED

More information

3. Are you involved in any additional business operations other than what is described above: Yes No If yes, describe:

3. Are you involved in any additional business operations other than what is described above: Yes No If yes, describe: GARAGE APPLICATION APPLICANT INFORMATION Policy Period Requested: From / / To / / Business Trade Name Mailing Address City County State Zip Code Phone ( ) Years this business entity has been in operation?

More information

AUTO DEALER APPLICATION GARAGE

AUTO DEALER APPLICATION GARAGE AUTO DEALER APPLICATION GARAGE Phone: 888-376-9633 ext 2029 Fax: 866-914-6753 essubmissions@appund.com I. GENERAL INFORMATION Effective Date: FEIN # : 1. Your Name: Phone No.: (dba): 2. Mailing Address:

More information

Loss/Collision Damage Waiver HOW TO FILE A CLAIM

Loss/Collision Damage Waiver HOW TO FILE A CLAIM Loss/Collision Damage Waiver HOW TO FILE A CLAIM 1. Complete all items on the attached claim form. 2. Attach the following documents (as applicable): Copy of rental car agreement Copy of police report

More information

Navigators Insurance Company Real Estate Professionals Errors and Omissions Insurance Application

Navigators Insurance Company Real Estate Professionals Errors and Omissions Insurance Application Navigators Insurance Company Real Estate Professionals Errors and Omissions Insurance Application NOTICE: This is an application for a Claims-made policy. Coverage for prior acts and claims made after

More information

REGISTRATION FORM. NAME: or Business: ADDRESS: CITY: STATE: ZIP: HOME PHONE: CELL PHONE: TODAYS DATE:

REGISTRATION FORM. NAME: or Business: ADDRESS: CITY: STATE: ZIP: HOME PHONE: CELL PHONE:   TODAYS DATE: REGISTRATION FORM NAME: or Business: ADDRESS: CITY: STATE: ZIP: HOME PHONE: CELL PHONE: EMAIL: TODAYS DATE: I, have read and understand the rules and regulations set forth by Acme Auto Auction Inc as stated

More information

SEVEN (7), 2017 OR NEWER GASOLINE POWERED, 1 TON 4x4 CREW CAB LONG BED PICKUP TRUCKS For the Boone County Public Works Department

SEVEN (7), 2017 OR NEWER GASOLINE POWERED, 1 TON 4x4 CREW CAB LONG BED PICKUP TRUCKS For the Boone County Public Works Department Boone County, Kentucky INVITATION FOR BID # 082417PW SEVEN (7), 2017 OR NEWER GASOLINE POWERED, 1 TON 4x4 CREW CAB LONG BED PICKUP TRUCKS For the Boone County Public Works Department ACCEPTANCE DATE: Prior

More information

GARAGE LIABILITY APPLICATION

GARAGE LIABILITY APPLICATION Date: GARAGE LIABILITY APPLICATION Agency: Phone: Producer: Fax: Please include the following with all applications: Current MVR s for all drivers Complete Vehicle & Equipment Schedule 1. General Information

More information

BID # Ambulance E450 Van Chassis

BID # Ambulance E450 Van Chassis INVITATION FOR BID BID #1011 - Ambulance E450 Van Chassis St. Charles County Ambulance District ST. CHARLES COUNTY AMBULANCE DISTRICT (Herein referred to as District ) 4169 OLD MILL PARKWAY ST. PETERS,

More information

Used Auto and Motorhome Dealer Application

Used Auto and Motorhome Dealer Application Used Auto and Motorhome Dealer Application COLUMBIA INSURANCE COMPANY NATIONAL INDEMNITY COMPANY NATIONAL FIRE & MARINE INSURANCE COMPANY NATIONAL LIABILITY & FIRE INSURANCE COMPANY NATIONAL INDEMNITY

More information

Researching an Automobile. What should I look for?

Researching an Automobile. What should I look for? Researching an Automobile What should I look for? Transportation Part of everyone s life 15 20% of an individual s budget Automobile is the 2 nd most expensive purchase, only after a home Family Economics

More information

LOUISIANA DEPARTMENT OF INSURANCE STATEMENT OF COMPLIANCE POLICY FORM / RATE / ADVERTISING FILING

LOUISIANA DEPARTMENT OF INSURANCE STATEMENT OF COMPLIANCE POLICY FORM / RATE / ADVERTISING FILING LOUISIANA DEPARTMENT OF INSURANCE STATEMENT OF COMPLIANCE POLICY FORM / RATE / ADVERTISING FILING Insurer Name: Product Code: P0302-010000 NAIC #: Company Tracking #: Policy Holder Type: Filing Submission

More information

CNA COMMERCIAL LINES Workfile ID: b34b24d0. Supplement of Record 1 with Summary. Owner: Pools By Blue Haven, Inc. Job Number:

CNA COMMERCIAL LINES Workfile ID: b34b24d0. Supplement of Record 1 with Summary. Owner: Pools By Blue Haven, Inc. Job Number: CNA COMMERCIAL LINES Workfile ID: b34b24d0 ***ASI Estimate Audit*** 2123 EastView Parkway Conyers, GA 30013 Phone: (800) 647-3626, FAX:(800) 952-5371 Written By: David Savino Adjuster: BOHON, READ, (610)

More information

TITLE DEPARTMENT OF BUSINESS REGULATION

TITLE DEPARTMENT OF BUSINESS REGULATION 230-RICR-20-40-2 TITLE 230 - DEPARTMENT OF BUSINESS REGULATION CHAPTER 20 - INSURANCE SUBCHAPTER 40 - CLAIMS PART 2 - Unfair Property/Casualty Claims Settlement Practices 2.1 Authority This Part is adopted

More information

City of Portsmouth Portsmouth, New Hampshire Public Works Department INVITATION TO BID

City of Portsmouth Portsmouth, New Hampshire Public Works Department INVITATION TO BID City of Portsmouth Portsmouth, New Hampshire Public Works Department INVITATION TO BID Sealed bid proposals, plainly marked "WATER DEPARTMENT 2 WD ½ TON PICK UP TRUCK Bid #40-07 on the outside of the envelope,

More information

GARAGE APPLICATION. APPLICANT INFORMATION Policy Period Requested: From / / To / / Business Trade Name. Mailing Address City

GARAGE APPLICATION. APPLICANT INFORMATION Policy Period Requested: From / / To / / Business Trade Name. Mailing Address City GARAGE APPLICATION APPLICANT INFORMATION Policy Period Requested: From / / To / / Business Trade Name Mailing Address City County State Zip Code Phone ( ) Years this business entity has been in operation?

More information

TOP LIMO N.Y, INC. 835 Remsen Ave, Brooklyn, NY Tel: (800) , Fax: (347)

TOP LIMO N.Y, INC. 835 Remsen Ave, Brooklyn, NY Tel: (800) , Fax: (347) TOP LIMO N.Y, INC. 835 Remsen Ave, Brooklyn, NY. 11236. Tel: (800) 776-3413, Fax: (347) 627-9030 www.toplimony.com e-mail: info@toplimony.com Year: Make: Model: Body Type: Vehicle VIN #: Length of Conversion:

More information

GARAGE APPLICATION. Locations where you conduct Garage Operations: Do these locations belong to your business entity? Yes No

GARAGE APPLICATION. Locations where you conduct Garage Operations: Do these locations belong to your business entity? Yes No GARAGE APPLICATION Agent Information Clear Form General Agency: Agent Name: Phone Number: Retail Agency: Agent Name: Phone Number: Applicant Information Applicant s Name: Mailing Address: City: County

More information

A summary of the vehicle to be purchased: Department Type of Vehicle Quantity Planning Department Half Ton Regular Cab 4x4 Pick-Up Truck 2

A summary of the vehicle to be purchased: Department Type of Vehicle Quantity Planning Department Half Ton Regular Cab 4x4 Pick-Up Truck 2 City of Cartersville P.O. Box 1390 1 North Erwin Street Cartersville, GA 30120 DATE: October 5, 2017 TO: FROM: RE: Automobile Dealers Fleet Sales Personnel Tom Rhinehart, Finance Director Vehicle Bids

More information

CITY OF GALESBURG. PURCHASING 55 West Tompkins Street Galesburg, IL Phone: 309/ INVITATION FOR BIDS

CITY OF GALESBURG. PURCHASING 55 West Tompkins Street Galesburg, IL Phone: 309/ INVITATION FOR BIDS CITY OF GALESBURG PURCHASING 55 West Tompkins Street Galesburg, IL 61401 Phone: 309/345-3678 INVITATION FOR BIDS For the purchase of one new one-ton heavy duty pickup truck with tow/haul package for the

More information

ID Theft Insurance HOW TO FILE A CLAIM

ID Theft Insurance HOW TO FILE A CLAIM ID Theft Insurance HOW TO FILE A CLAIM 1. Complete all items on the attached claim form. 2. Attach the following documents (as applicable): The completed claim form Copy of all correspondence, police reports,

More information

RECEIPT OF THE APPLICATION DOES NOT GUARANTEE ELIGIBLITY FOR A LOAN

RECEIPT OF THE APPLICATION DOES NOT GUARANTEE ELIGIBLITY FOR A LOAN IRON WORKERS DISTRICT COUNCIL OF SOUTHERN OHIO & VICINITY ANNUITY TRUST Dear Annuity Loan Applicant: The following information is needed to process your request for a loan. Please fully complete and return

More information

GREAT AMERICAN ASSURANCE COMPANY Real Estate Professional Liability Insurance Application

GREAT AMERICAN ASSURANCE COMPANY Real Estate Professional Liability Insurance Application GREAT AMERICAN ASSURANCE COMPANY Real Estate Professional Liability Insurance Application NOTICE: This is an application for a Claims-Made policy. Coverage for prior acts and claims made after termination

More information

Used Auto and Motorhome Dealer Application

Used Auto and Motorhome Dealer Application Used Auto and Motorhome Dealer Application COLUMBIA INSURANCE COMPANY NATIONAL INDEMNITY COMPANY NATIONAL FIRE & MARINE INSURANCE COMPANY NATIONAL LIABILITY & FIRE INSURANCE COMPANY NATIONAL INDEMNITY

More information

RECEIPT OF THE APPLICATION DOES NOT GUARANTEE ELIGIBLITY FOR A LOAN

RECEIPT OF THE APPLICATION DOES NOT GUARANTEE ELIGIBLITY FOR A LOAN IRON WORKERS DISTRICT COUNCIL OF SOUTHERN OHIO & VICINITY ANNUITY TRUST Dear Annuity Loan Applicant: The following information is needed to process your request for a loan. Please fully complete and return

More information

ONE CENT AUTO REPAIR & SALES

ONE CENT AUTO REPAIR & SALES Congratulations on your recent used car purchase from ONE CENT AUTO REPAIR & SALES! To give our valued clients some peace of mind, we offer this limited warranty on select vehicles, at no additional charge,

More information

NEW HAMPSHIRE PERSONAL AUTO APPLICATION

NEW HAMPSHIRE PERSONAL AUTO APPLICATION AGENCY NEW HAMPSHIRE PERSONAL AUTO APPLICATION APPLICANT'S NAME AND MAILING ADDRESS (Include county & ZIP+4) TELEPHONE NUMBER (MM/DD/YYYY) CONTACT NAME: PHONE (A/C, No, Ext): FAX (A/C, No): E-MAIL ADDRESS:

More information

GENERAL INFORMATION. Lift Kit (suspension) Installation/Sales

GENERAL INFORMATION. Lift Kit (suspension) Installation/Sales Automobile Service s Application COLUMBIA INSURANCE COMPANY NATIONAL INDEMNITY COMPANY NATIONAL FIRE & MARINE INSURANCE COMPANY NATIONAL LIABILITY & FIRE INSURANCE COMPANY NATIONAL INDEMNITY COMPANY OF

More information

Salt Lake City Area Office 8722 S. Harrison St. Sandy, UT P.O. Box 4439 Sandy, UT Fax

Salt Lake City Area Office 8722 S. Harrison St. Sandy, UT P.O. Box 4439 Sandy, UT Fax Salt Lake City Area Office 8722 S. Harrison St. Sandy, UT 84070 P.O. Box 4439 Sandy, UT 84091 800-257-5590 Fax 800-478-9880 Chicago Office 303 W. Madison Street Suite 2075 Chicago, IL 60606 800-456-4576

More information

Child Care Complete Application

Child Care Complete Application Markel Insurance Company P.O. Box 440549, Kennesaw, GA 30160 Telephone: (678) 290-2100 Fax: (678) 290-2200 Email applications to: newsub@markelcorp.com Website: markelinsurance.com Child Care Complete

More information

Automobile Liability Insurance Commercial Vehicles (U.S.A.) Proposal Form

Automobile Liability Insurance Commercial Vehicles (U.S.A.) Proposal Form Automobile Liability Insurance Commercial Vehicles (U.S.A.) Proposal Form INSURED: DBA: Physical Address: Mailing Address: ICC Docket MC: Type of Carrier: DESIRED COVERAGE Auto Liability DOT: Common Private

More information

INVITATION TO BID VEHICLE MAINTENANCE AND REPAIRS FOR COUNTY EMS AND FLEET VEHICLES BID #

INVITATION TO BID VEHICLE MAINTENANCE AND REPAIRS FOR COUNTY EMS AND FLEET VEHICLES BID # INVITATION TO BID VEHICLE MAINTENANCE AND REPAIRS FOR COUNTY EMS AND FLEET VEHICLES BID #2016-06 Issued By: Baker County Board of County Commissioners 55 N. 3 rd St. Macclenny, FL 32063 (904) 259-3613

More information

OCCUPATIONAL TAX CERTIFICATE

OCCUPATIONAL TAX CERTIFICATE TYPE: NEW BUSINESS (date) CLOSED (date) RENEWAL (date) AMENDED (specify change) BUSINESS TYPE: SOLE OWNERSHIP CORPORATION PARTNERSHIP HOME OCCUPATION OTHER (specify) BUSINESS INFORMATION: BUSINESS NAME:

More information

Identify the letter of the choice that best completes the statement or answers the question.

Identify the letter of the choice that best completes the statement or answers the question. Chapter 16 - Practice Questions Multiple Choice Identify the letter of the choice that best completes the statement or answers the question. 1) Because of the effect of escaping CFCs on the earth's atmosphere,

More information

Excess Baggage Protection Baggage Delay

Excess Baggage Protection Baggage Delay CHUBB Excess Baggage Protection Baggage Delay HOW TO FILE A CLAIM 1. Complete all items on the attached claim form. 2. Attach the following documents: Copy of payment or denial from common carrier (e.g.,

More information

Request for Quotation

Request for Quotation City Hall 501-3 rd Ave., Box 190 Fernie, BC V0B 1M0 www.fernie.ca Request for Quotation MECHANICAL SWEEPER Issue Date: March 1, 2017 Quotations marked RFQ will be received at the City of Fernie, City Hall,

More information

HOME INSPECTOR. Application Form and Resume. Contact Name: Agency Name: Address: Address: Agency Code:

HOME INSPECTOR. Application Form and Resume. Contact Name: Agency Name: Address:  Address: Agency Code: HOME INSPECTOR Application Form and Resume Contact Name: Agency Name: Address: Phone: Email Address: Agency Code: Fax: PO BOX 3867, Bellevue, WA 98009 P: 800.562.8095 I F: 425.453.8696 submissions@gogus.com

More information

NORTH CAROLINA PERSONAL AUTO APPLICATION

NORTH CAROLINA PERSONAL AUTO APPLICATION NORTH CAROLINA PERSONAL AUTO APPLICATION (MM/DD/YYYY) AGENCY APPLICANT'S NAME AND MAILING ADDRESS (Include county & ZIP+4) TELEPHONE NUMBER FIRE DIST CONTACT NAME: PHONE (A/C, No, Ext): FAX (A/C, No):

More information

Deductible Reimbursement Proof of Loss Claim #:

Deductible Reimbursement Proof of Loss Claim #: Deductible Reimbursement Proof of Loss Claim #: Please be advised that this is a generic claim form and may refer to several types of coverages. This does not imply or suggest that your policy contains

More information

Understanding the Claims Handling Process

Understanding the Claims Handling Process Understanding the Claims Handling Process About This Brochure This brochure was designed to answer frequently asked questions about the claim handling process. If you have other questions or would like

More information

University of Massachusetts Lowell. BID REQUEST 2012 FORD CLUB WAGON Bid Number # CL12-EP-0025

University of Massachusetts Lowell. BID REQUEST 2012 FORD CLUB WAGON Bid Number # CL12-EP-0025 University of Massachusetts Lowell BID REQUEST 2012 FORD CLUB WAGON Bid Number # CL12-EP-0025 Introduction The University of Massachusetts Lowell (UMASS LOWELL) invites bids for a 2012 OR CURRENT FORD

More information

Real Estate Professional Errors & Omissions Insurance Application

Real Estate Professional Errors & Omissions Insurance Application Real Estate Professional Errors & Omissions Insurance Application NOTICE: This is an application for a "Claims-Made" policy. Coverage for prior acts and claims made after termination of this policy may

More information

GARAGE APPLICATION ****LOSS RUNS REQUIRED ON GARAGE RISKS WITH 8 (EIGHT) OR MORE EMPLOYEES****

GARAGE APPLICATION ****LOSS RUNS REQUIRED ON GARAGE RISKS WITH 8 (EIGHT) OR MORE EMPLOYEES**** GARAGE APPLICATION General Information Effective Date:: FEIN # : 1. Your Name Phone No. (dba) 2. Mailing Address 3. Your Web site address 4. Location #1 Address 5. Location #2 Address Is there work done

More information

GENERAL INSURANCE TERMS AND CONDITIONS AND ADDITIONAL DAMAGE WAIVERS

GENERAL INSURANCE TERMS AND CONDITIONS AND ADDITIONAL DAMAGE WAIVERS GENERAL INSURANCE TERMS AND CONDITIONS AND ADDITIONAL DAMAGE WAIVERS Our company SNL, a French company with capital of 585.000, whose headquarters is located Zone Loueurs - Aéroport Pôle Caraïbes 97139

More information

INVITATION FOR BIDS FOR A PURCHASE OF 9 VEHICLES TO BE USED BY MONROE COMMUNITY MENTAL HEALTH AUTHORITY

INVITATION FOR BIDS FOR A PURCHASE OF 9 VEHICLES TO BE USED BY MONROE COMMUNITY MENTAL HEALTH AUTHORITY INVITATION FOR BIDS FOR A PURCHASE OF 9 VEHICLES TO BE USED BY MONROE COMMUNITY BID # 12-16-0001 BID DUE DATE: JANUARY 13, 2017 BID DUE TIME: 3:00 P.M. Invitation for Bids Notice is hereby given that the

More information

Navigators Insurance Company Real Estate Professionals Errors and Omissions Insurance Application

Navigators Insurance Company Real Estate Professionals Errors and Omissions Insurance Application Navigators Insurance Company Real Estate Professionals Errors and Omissions Insurance Application NOTICE: This is an application for a Claims-made policy. Coverage for prior acts and claims made after

More information

commercial credit application

commercial credit application commercial credit application IRBY ELECTRICAL DISTRIBUTOR Please complete the following application in its entirety to ensure prompt processing of the account setup. You are welcome to email the final

More information

VEHBIDZ BUYER TERMS AND CONDITIONS Last updated on: February 8, 2010

VEHBIDZ BUYER TERMS AND CONDITIONS Last updated on: February 8, 2010 VEHBIDZ BUYER TERMS AND CONDITIONS Last updated on: February 8, 2010 As a registered buyer ("Buyer") through VEHBIDZ ( VEHBIDZ ) you agree to be bound by the following Buyer Terms and Conditions. VEHBIDZ

More information

Statewide Auto Auction 1756 North Broad St Meriden, CT P: F:

Statewide Auto Auction 1756 North Broad St Meriden, CT P: F: Application/Agreement Supplement Statewide Dealer #: Legal Name of Business Trade Name of Business Street: City: State: Zip: Phone: Fax: Dealership email: Dealer License Plate #: Owner Name: Owner Cell:

More information

AUTO DEALER APPLICATION

AUTO DEALER APPLICATION General Information Effective Date: FEIN # : 1. Your Name Phone No. (dba) 2. Mailing Address 3. Your Web site address 4. Location #1 Address 5. Location #2 Address Is there work done elsewhere? i.e.; Roadside?

More information

PATROL VEHICLES FOR THE MACON COUNTY SHERIFF S OFFICE

PATROL VEHICLES FOR THE MACON COUNTY SHERIFF S OFFICE REQUEST FOR BIDS AND PROPOSALS BID REQUEST NO. 4310-07 PATROL VEHICLES FOR THE MACON COUNTY SHERIFF S OFFICE ISSUE DATE: SEPTEMBER 5, 2018 BID OPENING DATE: SEPTEMBER 14, 2018 4:00 P.M. ISSUED BY: MACON

More information

Company Type: Corporation LLC Partnership Individual Joint Venture If Joint Venture, please describe: Additional Named Insured s (if any)

Company Type: Corporation LLC Partnership Individual Joint Venture If Joint Venture, please describe: Additional Named Insured s (if any) CONTRACTOR S POLLUTION LIABILITY APPLICATION SECTION 1 APPLICANT INFORMATION Applicant (Full Legal Name): Physical Address of Applicant: Mailing Address of Applicant: City: State: Zip Code: Established:

More information

Application for Rental Autos & Trucks Short Term

Application for Rental Autos & Trucks Short Term Application for Rental Autos & Trucks Short Term (Hour, Day or Week) National Fire & Marine Insurance Company National Indemnity Company of the South National Liability & Fire Insurance Company Policy

More information

Date of survey: Renewal Date: Date proposal needed: Legal Name of Organization: (Include all organizations that are to be included as insureds)

Date of survey: Renewal Date: Date proposal needed: Legal Name of Organization: (Include all organizations that are to be included as insureds) ARCHERY RANGES APPLICATION P.O. Box 5670 Cortland, NY 13045 Phone: (800) 822-3747 Fax: (607) 756-5051 Email: applications@ mcneilandcompany.com GENERAL INFORMATION Date of survey: Renewal Date: Date proposal

More information

A copy has been served upon all parties of record.

A copy has been served upon all parties of record. EO. Box 655 2650~-Q65~ rnlsolomon@frontier.com Michael L. Solomon April 2,2014 Ms. Ingrid Ferrell, Executive Secretary PUBLIC SERVICE COMMISSION P. 0. Box 812 Charleston, WTI 25323 RE: Case No.: 14-0238-MC-FC

More information

BUSINESS INSURANCE APPLICATION

BUSINESS INSURANCE APPLICATION General Business Information: P.O. Box 4389 - Davidson, NC 28036 (P) 800-287-7127 (F) 704-895-0230 info@acna.us www.aciginsurance.com BUSINESS INSURANCE APPLICATION 1. Business Name: 2. Business Type:

More information

INVITATION TO BID COMMERCIAL FLOORING CONTRACTORS

INVITATION TO BID COMMERCIAL FLOORING CONTRACTORS FACILITIES COORDINATOR 800 Church Street, Suite B60, Waycross, GA 31501 Phone: 912 287 4480 Cell: 912 281 9964 Fax: 912 287 4482 Email: sbaxley@warecounty.com INVITATION TO BID COMMERCIAL FLOORING CONTRACTORS

More information

HOME INSPECTORS PROFESSIONAL LIABILITY INSURANCE APPLICATION THIS INSURANCE, IF ISSUED, WILL BE ON A CLAIMS-MADE AND REPORTED BASIS.

HOME INSPECTORS PROFESSIONAL LIABILITY INSURANCE APPLICATION THIS INSURANCE, IF ISSUED, WILL BE ON A CLAIMS-MADE AND REPORTED BASIS. 800 Oak Ridge Turnpike, Suite A-1000 Oak Ridge, Tennessee 37830 HOME INSPECTORS PROFESSIONAL LIABILITY INSURANCE APPLICATION THIS INSURANCE, IF ISSUED, WILL BE ON A CLAIMS-MADE AND REPORTED BASIS. NOTICE:

More information

THE HARTFORD PROFESSIONAL LIABILITY INSURANCE POLICY SM THIRD PARTY ADMINISTRATORS SUPPLEMENTAL APPLICATION

THE HARTFORD PROFESSIONAL LIABILITY INSURANCE POLICY SM THIRD PARTY ADMINISTRATORS SUPPLEMENTAL APPLICATION THE HARTFORD PROFESSIONAL LIABILITY INSURANCE POLICY SM THIRD PARTY ADMINISTRATORS SUPPLEMENTAL APPLICATION This is a supplement to an application for a CLAIMS MADE and REPORTED Policy. It is to be used

More information

Name Relationship/Interest Address City, State, Zip

Name Relationship/Interest Address City, State, Zip USLI.COM 888-523-5545 Catering Plus Liquor Liability Warranty Application Banquet Halls, Bartending Services, Caterers, Concessionaires YOU CAN OBTAIN A QUOTE BY PROVIDING THE INFORMATION IN SECTION I

More information

BIDDER REGISTRATION PACKET FOR HIGHWAY 51 CLASSIC CAR AUCTION

BIDDER REGISTRATION PACKET FOR HIGHWAY 51 CLASSIC CAR AUCTION BIDDER REGISTRATION PACKET FOR HIGHWAY 51 CLASSIC CAR AUCTION IN ORDER TO BID AT THE HIGHWAY 51 CLASSIC CAR AUCTION, PLEASE PROVIDE THE FOLLOWING... 1) SIGNED HIGHWAY 51 AUCTION REGISTRATION & BIDDER AGREEMENT

More information

ADVANCE MOTORS LLC BUYER TERMS AND CONDITIONS Last updated on: Feb 26, 2018

ADVANCE MOTORS LLC BUYER TERMS AND CONDITIONS Last updated on: Feb 26, 2018 ADVANCE MOTORS LLC BUYER TERMS AND CONDITIONS Last updated on: Feb 26, 2018 As a registered buyer ("Buyer") with Advance Motors LLC ("Company") you agree to be bound by the following Buyer Terms and Conditions.

More information

Lost Instrument Bond Application PRINCIPAL INFORMATION

Lost Instrument Bond Application PRINCIPAL INFORMATION 801 S Figueroa Street, Suite 700 Los Angeles, CA 90017 USA Tel: 310-649-0990 Lost Instrument Bond Application A PRINCIPAL INFORMATION FIRST NAME/ MIDDLE NAME/ LAST NAME (AS IT SHOULD APPEAR ON THE BOND)

More information

REAL ESTATE APPRAISERS PROFESSIONAL LIABILITY APPLICATION - RENEWAL AMERICAN ACADEMY OF STATE CERTIFIED APPRAISERS, A RISK PURCHASING GROUP

REAL ESTATE APPRAISERS PROFESSIONAL LIABILITY APPLICATION - RENEWAL AMERICAN ACADEMY OF STATE CERTIFIED APPRAISERS, A RISK PURCHASING GROUP Lexington Insurance Company Administrative Offices: 100 Summer Street, Boston, Massachusetts 02110 SEND APPLICATIONS AND INQUIRIES TO: 1438-F West Main Street, Ephrata, PA 17522-1345 800.640.7601; 717.721.3500;

More information

Policy Term From: To. Medical Payments

Policy Term From: To. Medical Payments Truck Application COLUMBIA INSURANCE COMPANY NATIONAL FIRE & MARINE INSURANCE COMPANY NATIONAL INDEMNITY COMPANY NATIONAL INDEMNITY COMPANY OF MID-AMERICA NATIONAL INDEMNITY COMPANY OF THE SOUTH NATIONAL

More information

THE HARTFORD PROFESSIONAL LIABILITY INSURANCE POLICY SM TRUSTEE SUPPLEMENTAL APPLICATION

THE HARTFORD PROFESSIONAL LIABILITY INSURANCE POLICY SM TRUSTEE SUPPLEMENTAL APPLICATION THE HARTFORD PROFESSIONAL LIABILITY INSURANCE POLICY SM TRUSTEE SUPPLEMENTAL APPLICATION This is a supplement to an application for a CLAIMS MADE and REPORTED Policy. It is to be used solely in conjunction

More information

Greenwich Insurance Company REAL ESTATE PROFESSIONAL ERRORS AND OMISSIONS INSURANCE RENEWAL APPLICATION

Greenwich Insurance Company REAL ESTATE PROFESSIONAL ERRORS AND OMISSIONS INSURANCE RENEWAL APPLICATION REAL ESTATE PROFESSIONAL ERRORS AND OMISSIONS INSURANCE RENEWAL APPLICATION te: Failure to submit a completed application in a timely manner could jeopardize your prior acts coverage. Named Insured: Policy.:

More information

Auctions In Motion General Policies

Auctions In Motion General Policies Auctions In Motion General Policies All customers should become knowledgeable of our policies. The Auction reserves the right to change the policies as needed. Lack of knowledge of policy requirements

More information

THE MTA IS ACCEPTING INFORMAL BIDS FOR THE SALE OF 27 SURPLUS STORAGE CONTAINERS.

THE MTA IS ACCEPTING INFORMAL BIDS FOR THE SALE OF 27 SURPLUS STORAGE CONTAINERS. LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY PROCUREMENT DEPARTMENT ONE GATEWAY PLAZA LOS ANGELES, CALIFORNIA 90012-2932 TEL. (213) 922-1092 REQUEST FOR BID BID NO. O51209-S THIS IS NOT AN

More information

Recreational Vehicle Rental Agreement Class B Lexington Grand Touring RV

Recreational Vehicle Rental Agreement Class B Lexington Grand Touring RV Recreational Vehicle Rental Agreement Class B Lexington Grand Touring RV Important Disclosures: Responsibility for Damage or Loss; Reporting to Police By signing this agreement you understand and agree

More information

Navigators Insurance Company Real Estate Professionals Errors and Omissions Insurance Application

Navigators Insurance Company Real Estate Professionals Errors and Omissions Insurance Application Navigators Insurance Company Real Estate Professionals Errors and Omissions Insurance Application NOTICE: This is an application for a Claims-made policy. Coverage for prior acts and claims made after

More information

ARKANSAS SENATE 90th General Assembly - Regular Session, 2015 Amendment Form

ARKANSAS SENATE 90th General Assembly - Regular Session, 2015 Amendment Form ARKANSAS SENATE 90th General Assembly - Regular Session, 2015 Amendment Form Subtitle of Senate Bill No. 800 TO ENSURE THE SAFETY, RELIABILITY, COST-EFFECTIVENESS OF TRANSPORTATION NETWORK COMPANY SERVICES;

More information

GARAGE APPLICATION. Locations where you conduct Garage Operations: Do these locations belong to your business entity? Yes No Loc.

GARAGE APPLICATION. Locations where you conduct Garage Operations: Do these locations belong to your business entity? Yes No Loc. GARAGE APPLICATION Agent Information General Agency: Agent Name: Phone Number: Retail Agency: Agent Name: Phone Number: Applicant Information Applicant s Name: Mailing Address: City: County: State: Zip:

More information

Subject: Solicitation for Purchase a Project Vehicle for the IFES Kenya Program

Subject: Solicitation for Purchase a Project Vehicle for the IFES Kenya Program Date: August 22, 2016 Ref.: Addendum No. 1 - RFQ/16/121 Subject: Solicitation for Purchase a Project Vehicle for the IFES Kenya Program The International Foundation for Electoral Systems (IFES), invites

More information

Watershed Educational Campaign Project

Watershed Educational Campaign Project Request for Proposal 40686 Watershed Educational Campaign Project For Grand River Dam Authority PROPOSALS TO BE SUBMITTED TO: Grand River Dam Authority Central Purchasing Unit 226 West Dwain Willis Avenue

More information

Business License Application (January 1 December 31)

Business License Application (January 1 December 31) 4035 WALNUT CIRCLE / P.O. BOX 99 OAKWOOD GA 30566 770-534-2365 Business License Application (January 1 December 31) Date: Please check one: [ ] Mail (if mailed, please add and $1.25 for postage) [ ] Pick-up

More information

WRIGHT CITY R-II SCHOOL DISTRICT REQUEST FOR PROPOSAL Wright City West Elementary School Teacher Desks and Chairs June 27, 2018

WRIGHT CITY R-II SCHOOL DISTRICT REQUEST FOR PROPOSAL Wright City West Elementary School Teacher Desks and Chairs June 27, 2018 I. GENERAL CONDITIONS WRIGHT CITY R-II SCHOOL DISTRICT REQUEST FOR PROPOSAL Wright City West Elementary School Teacher Desks and Chairs June 27, 2018 The Wright City R-II School District (hereafter District

More information

Workforce Management Consulting Services

Workforce Management Consulting Services Request for Proposal #40604 Workforce Management Consulting Services For Grand River Dam Authority PROPOSALS TO BE SUBMITTED TO: Grand River Dam Authority Central Purchasing Unit 226 West Dwain Willis

More information

GASOLINE POWERED, ¾ TON 4X4 EXTENDED CAB WITH LONG BOX PICK-UP TRUCK For the Boone County Parks & Recreation Department

GASOLINE POWERED, ¾ TON 4X4 EXTENDED CAB WITH LONG BOX PICK-UP TRUCK For the Boone County Parks & Recreation Department Boone County, Kentucky INVITATION FOR BID #012216PKS GASOLINE POWERED, ¾ TON 4X4 EXTENDED CAB WITH LONG BOX PICK-UP TRUCK For the Boone County Parks & Recreation Department ACCEPTANCE DATE: Prior to 2:00

More information

Auto Dealers Application

Auto Dealers Application Auto Dealers Application APPLICANT INFORMATION Proposed Policy Term: From: To: Address: Phone: Contact Location Address: 1. Home Phone: 2. Web Address: 3. Form of Business: Individual Partnership Corporation

More information

APPLICATION FOR GARAGE POLICY

APPLICATION FOR GARAGE POLICY APPLICATION FOR GARAGE POLICY Business Trade Name: Mailing Address: Policy Period Desired: From Insured: County: State: Zip Code: Phone ( ) - Internet Address (If any): Years in Business: City: Years Sales/Repair

More information