LIBERTY Dental Plan Attn: Client Services P.O. Box Santa Ana, CA Fax: (949)
|
|
|
- Virginia Marshall
- 5 years ago
- Views:
Transcription
1 LIBERTY Dental Plan Marketing Service Agreement for Agents/Brokers Thank you for your interest in promoting our dental plans. Please review the attached form and complete the requested information on page 4. Be sure to sign the agreement. Please attach the documents listed below and return to: LIBERTY Dental Plan Attn: Client Services P.O. Box Santa Ana, CA Fax: (949) Current Florida Insurance License Department of the Treasury Internal Revenue Service Form W-9 If you have any questions regarding this Agreement, please contact our Client Services Department at (888) Once we receive your executed agreement and supporting documents, you will receive notification of your LIBERTY Dental Plan assigned Agent/Broker number. This number is to be used on all documents you submit to LIBERTY Dental Plan. We look forward to working with you to bring access to quality dental benefits to your clients! LDP Marketing Service Agreement 1
2 LIBERTY Dental Plan of Florida, Inc. MARKETING SERVICE AGREEMENT THIS AGREEMENT is made and entered into by and between LIBERTY Dental Plan of Florida, Inc. (hereafter referred to as the Company) and the Agent/Broker indicated on the signature line of this agreement. The Company is a Florida corporation that operates a prepaid limited health services organization ( PLHSO ) offering prepaid dental plans and is licensed and regulated by the Florida Office of Insurance Regulation under the provisions of Part I, Chapter 636, Florida Statutes. The Agent/Broker is an independent contractor and not an employee of LIBERTY Dental Plan of Florida, Inc. The parties agree to the following: 1. The Agent/Broker will act as a marketing agent for the Company s products and services to groups and individuals within the Company s service area. The Agent/Broker will also provide reasonable group enrollment support, as needed to complete the marketing process. To the extent reasonably necessary to enable the Agent/Broker to perform his or her duties hereunder, the Agent/Broker shall be authorized to engage the services of any agents, solicitors, service representatives, or assistants that may be deemed proper. The Agent/Broker may further employ, engage, or retain the services of such other persons or corporations to aid or assist in the proper performance of his duties. The cost is to be borne solely by the Agent/Broker. 2. On all programs effected through the Agent/Broker, the Company will pay to the Agent/Broker as full compensation thereon, the commission percentages, provided in the commission schedule and which is part of this contract. 3. Any commissions accruing hereunder shall be payable in the month following the month of receipt of premium by the Company. In the event of a termination of coverage by the Company or by group or subscriber, the Agent/Broker shall refund paid commissions to the Company in the same proportion that the Company refunds subscriber s premiums to the terminated subscriber. 4. If any contract shall be terminated by either the Company or the contract-holder for any reason or cause, all rights to commissions that might otherwise have accrued hereunder on such contract shall cease. 5. No rights or interest arising hereunder shall be subject to assignment except with written consent of the Company, such consent not to be withheld unreasonably. Any indebtedness of the Agent/Broker to the Company arising at any time shall constitute a first lien upon any commissions or allowances due or to become due hereunder. 6. The Agent/Broker has no authority to alter or discharge any contract or to extend the time of premium payment or to waive or extend any contract provisions or conditions. The Agent/Broker has no authority to alter, amend, or change any promotional brochures without the prior written approval of the Company. All printed matter, applications and sales literature which the Company may furnish the Agent/Broker shall remain the property of the Company. 7. The Agent/Broker shall be responsible for all monies due to the Company for premiums paid on any contract and received by the Agent/Broker or by his appointees or employees. All such monies shall be promptly paid to the Company within five (5) days. Any failure of the Agent/Broker to pay said monies as provided herein or comply with any of the provisions hereof shall effect immediate termination of this LDP Marketing Service Agreement 2
3 agreement and a forfeiture of all rights of the Agent/Broker hereunder and all commissions and allowances to the Agent/Broker provided for herein. The Agent/Broker is not authorized to collect any funds on behalf of the Company; however, in the event the Agent/Broker collects such funds, the following provisions shall apply: a) All funds received by the solicitor firm for the account of the Company shall at all times be segregated from the assets of the solicitor firms and shall be promptly deposited to a trust account in a state or federal bank authorized to do business in this state and insured by an appropriate federal insuring agency. Promptly deposited means deposited no later than the business day following receipt by the solicitor firm. b) All funds received by the solicitor firm for the account of the Company shall be transmitted to the Company within five (5) business days. 8. This Agreement shall remain in effect until either party elects to terminate this agreement without cause by giving a written one hundred twenty (120) day notification. Notice of such termination shall be delivered in person, or by mail, certified, return receipt requested. This Agreement may be terminated immediately for causes that may be hazardous to the Plan or its Members. Causes for immediate termination include but are not limited to loss of Agent/Broker s license, fraud, embezzlement, and bankruptcy of Agent/Broker The Florida Office of Insurance Regulation may by order cause the plan to terminate this Agreement in accordance with Paragraph 8 pursuant to Section , Florida Statutes. In the event of termination for cause, all rights to fees and other forms of compensation shall cease, and no right to damages resulting from such termination shall arise. 9. All records, books, and papers of a management company, solicitor firm, and any provider or subcontractor providing services to the Company shall be open to inspection during normal business hours by the Florida Office of Insurance Regulation. The Agent/Broker shall preserve for a period of not less than five years, the books of account and other records required under the provisions of, and for the purposes of the Act. 10. The Plan shall have the right to reject applications for membership. The Plan is responsible to return premium in the event of such election. The Plan shall have the right to approve all marketing, membership, educational, and informational materials developed by the Agent/Broker before said materials are used in any manner whatsoever. 11. Both parties shall comply and shall cause their respective principal persons and employees to comply with all applicable provisions of the Florida Statutes and regulations relevant to the marketing and solicitation of prepaid limited health services organizations. The Agent/Broker, at all times, shall be licensed by the Department of Financial Services as a Health or Life and Health Agent and shall comply with the applicable provisions of the Florida Statutes, its amendments and all rules, regulations, and directive promulgated by the Department of Financial Services or the Office of Insurance Regulation. Should disciplinary proceedings occur against the Agent/Broker or against any principal persons or employees relating to any license issued to such person(s) by the Department of Financial Services, notice of such proceeding must be reported to the Company within five (5) days of the proceedings commencement. LDP Marketing Service Agreement 3
4 12. This Agreement constitutes the entire contract between the parties hereto. Any amendments to the Agreement shall be prepared in written form by the Company and delivered by mail to the Agent/Broker at his last known address. IN WITNESS THEREOF this agreement has been executed in duplicate by the undersigned parties to take effect on. LIBERTY Dental Plan of Florida, Inc. AGENT/BROKER (PLEASE PRINT) x SIGNATURE NAME NAME COMPANY NAME TITLE PAY TO THE ORDER OF ON COMMISSION CHECK DATE STREET ADDRESS CITY, STATE, ZIP FLORIDA INSURANCE LICENSE # TELEPHONE NUMBER FAX NUMBER SSN or TIN ADDRESS X SIGNATURE DATE LDP Marketing Service Agreement 4
5
BROKER AND BROKER S AGENT COMMISSION AGREEMENT
BROKER AND BROKER S AGENT COMMISSION AGREEMENT Universal Care BROKER AND BROKER S AGENT COMMISSION AGREEMENT This BROKER AND BROKER S AGENT COMMISSION AGREEMENT (this "Agreement") is made and entered
AGENT / BROKER INFORMATION
(FOR INTERNAL USE ONLY) (Please Print) BROKER NUMBER: BROKER REGION CODE: COMMISSION AGREEMENT DATE: AGENT / BROKER INFORMATION (ALL INFORMATION IS REQUIRED TO PROCESS COMMISSION PROPERLY) LICENSED AGENT
BROKER AGREEMENT. To become contracted with us, please include the following: The declaration page of your E&O insurance
BROKER AGREEMENT After you have your first piece of approved Health Net business to submit, you may mail the forms and application to Health Net s broker relations using the enclosed envelope. You ve made
(This Agreement supersedes all prior Agreements) AGREEMENT
(This Agreement supersedes all prior Agreements) AGREEMENT AGREEMENT, dated day of, 20, between International Transportation & Marine Agency, Inc., a corporation organized and existing under and by virtue
PRODUCER AGREEMENT R E C I T A L S
PRODUCER AGREEMENT This Producer Agreement (this "Agreement") is entered into by and between CAREINGTON International Corporation, a Texas corporation ("CAREINGTON"), and the undersigned ("Producer") and
BEGA Agreement (08/99) Brokerage Executive General Agent AGREEMENT
Brokerage Executive General Agent AGREEMENT BANNER LIFE INSURANCE COMPANY ROCKVILLE, MARYLAND Agreement of Brokerage Executive General Agent 1. APPOINTMENT Subject to the terms and conditions of this Agreement,
PRODUCER AGREEMENT. THIS AGREEMENT will be effective upon verification of Producer s credentials and the acceptance and appointment by Company.
PRODUCER AGREEMENT THIS PRODUCER AGREEMENT is made by and between Educators Mutual Insurance Association of Utah, its affiliates, and subsidiaries (hereinafter Company ), a Utah Company doing business
00396E (06-12) MGA - Associate Broker
00396E (06-12) MGA - Associate Broker Agreement Name of the Associate Broker Please Print Between and Desjardins Financial Security Life Assurance Company (Desjardins Financial Security) 1. Appointment
PRODUCER AGREEMENT. Hereinafter ("Producer"), in consideration of the mutual covenants and agreements herein contained, agree as follows:
PRODUCER AGREEMENT Hereinafter First Choice Insurance Intermediaries, Inc "FCII", a Florida company, having an office at 814 A1A North, Suite 206, Ponte Vedra Beach, FL 32082 and " Producer" having an
1. Name. First Middle Last
Please Check Appropriate Company 1 Liberty Bankers Life Insurance Company (LBL) 1 The Capitol Life Insurance Company (CLIC) 1 American Benefit Life Insurance Company (ABL) Application for Producer Contract
UNITEDHEALTHCARE INSURANCE COMPANY AGENT AGREEMENT
UNITEDHEALTHCARE INSURANCE COMPANY AGENT AGREEMENT This AGENT AGREEMENT (this Agreement ) is made and entered into this day of, 20, by and between UnitedHealthcare Insurance Company ( United ), on behalf
VILLAGE OF BEAR LAKE (Manistee County, Michigan) Resolution No. RESOLUTION TO AUTHORIZE ISSUANCE OF WATER SUPPLY SYSTEM REVENUE BONDS
VILLAGE OF BEAR LAKE (Manistee County, Michigan) Resolution No. RESOLUTION TO AUTHORIZE ISSUANCE OF WATER SUPPLY SYSTEM REVENUE BONDS Minutes of a special meeting of the Village Council of the Village
CUSTOMER AGREEMENT. To: Lek Securities Corporation
CUSTOMER AGREEMENT To: Lek Securities Corporation In consideration for you (the Broker ) opening or maintaining one or more accounts (the Account ) for the undersigned (the Customer ), the Customer agrees
MORTGAGE. This Mortgage is made this day of, Legal Description: Property Address:
Return To: FOLIO # MORTGAGE This Mortgage is made this day of, between ( Borrower ) residing at and, a ( Lender ), located at. In this Mortgage, the words I, me and mine mean the Borrower and the words
I N S U R A N C E UNDERWRITERS PRODUCER APPOINTMENT PACKAGE
I N S U R A N C E UNDERWRITERS PRODUCER APPOINTMENT PACKAGE UNDERWRITERS INSURANCE Appointment Packet CHECKLIST PACKET CONTENTS INCLUDE Windhaven Underwriters Producer Agreement Form Windhaven Underwriters
FINANCIAL INSTITUTION AGREEMENT
Banner Life Insurance Company 3275 Bennett Creek Avenue Frederick, Maryland 21704 (800) 638-8428 FINANCIAL INSTITUTION AGREEMENT 1. Subject to the terms and conditions of this Agreement, the undersigned
STG Indemnity Agreement
STG Indemnity Agreement INDEMNITY AGREEMENT 1 This indemnification is made and given by: referred to herein as "Indemnitor" (whether one or more) for the benefit of Stewart Title Guaranty Company and (individually
Banner Life Insurance Licensing Checklist
Banner Life Insurance Licensing Checklist Please complete the following contracting papers. Remember to sign in the required areas. The more complete the application, the sooner it will be approved. Agents
P.O. Box Las Vegas, NV /14/2011
02/14/2011 P.O. Box 15645 Las Vegas, NV 89114-5645 GEORGE FOGELSON LA DEPT OF WATER&POWER ACTIVE&RETIREE NONRISK 111 N HOPE STREET, ROOM 564 LOS ANGELES CA 90012 Dear GEORGE FOGELSON: Enclosed is a renewal
REGISTERED CONTRACTOR AGREEMENT
REGISTERED CONTRACTOR AGREEMENT THE RESTORATION COMPANY Technical Service Department. 2628 Pearl Road. Medina, OH 44256 RESTORATION SOLUTIONS FOR EVERY ROOF & WALL Phone: 800-551-7081. Fax: 800-382-1218
CONTRACT REQUEST FORM
CONTRACT REQUEST FORM PLEASE COMPLETELY FILL OUT ALL FIELDS AND INCLUDE A COPY OF YOUR INSURANCE LICENSE, E&O INSURANCE AND A VOIDED CHECK. Once you have completed the contract please return by Faxing
SECTION I. Appointment, Activities, Authority and Status of REPRESENTATIVE
CAPITAL FINANCIAL SERVICES, INC. REPRESENTATIVE'S AGREEMENT This Agreement is executed in duplicate between Capital Financial Services, Inc., a Wisconsin corporation (hereinafter "COMPANY"), and the Sales
CONTRACT AGREEMENT FOR PARKING AREA CONSTRUCTION. THIS AGREEMENT, made this day of, 2018,
CONTRACT AGREEMENT FOR PARKING AREA CONSTRUCTION THIS AGREEMENT, made this day of, 2018, signed between Nampa & Meridian Irrigation District, hereafter referred to as "NMID" and, of (address), hereinafter
DFI FUNDING BROKER AGREEMENT Fax to
DFI FUNDING BROKER AGREEMENT Fax to 916-848-3550 This Wholesale Broker Agreement (the Agreement ) is entered i n t o a s o f (the Effective Date ) between DFI Funding, Inc., a California corporation (
Producer Agreement DDWA Product means an Individual or Group dental benefits product offered by Delta Dental of Washington.
Producer Agreement This agreement, effective the day of is between DELTA DENTAL OF WASHINGTON, referred to as DDWA in this agreement, and, referred to as Producer in this agreement. In consideration of
ORDINANCE NO ISSUANCE AND SALE OF WATER SUPPLY SYSTEM BONDS, SERIES B TO THE MICHIGAN FINANCE AUTHORITY.
ORDINANCE NO. 11-16 ISSUANCE AND SALE OF WATER SUPPLY SYSTEM BONDS, SERIES 2011- B TO THE MICHIGAN FINANCE AUTHORITY. AN ORDINANCE AUTHORIZING THE ACQUISITION AND CONSTRUCTION OF EXTENSIONS AND IMPROVEMENTS
Wright National Flood Insurance Services, LLC th Avenue North, Suite 110 St. Petersburg, FL (hereinafter referred to as "WNFIS )
PARTIES TO THIS AGREEMENT V1116S Wright National Flood Insurance Services, LLC 801 94 th Avenue North, Suite 110 St. Petersburg, FL 33702 (hereinafter referred to as "WNFIS ) Producer Name: Address: City,
Standard Producer Commission Agreement
Standard Producer Commission Agreement Last Revised: November, 2008 Standard Producer Commission Agreement In this Section The components of this Standard Producer Commission Agreement are as follows:
Agent Appointment. Application / Contract
Agent Appointment Application / Contract Last Updated: 2.7.2017 AGENT APPOINTMENT APPLICATION/CONTRACT Please follow each of the steps below in order to assure efficient processing of your FirstCare Health
AGREEMENT made as of by and between Empire BlueCross BlueShield (Empire), with offices located at 11 West 42nd Street, New York, NY and
EMPIRE USE ONLY Rep Name: Rep Code: INSURANCE PRODUCER AGREEMENT AGREEMENT made as of by and between Empire BlueCross BlueShield (Empire), with offices located at 11 West 42nd Street, New York, NY 10036
Apollo Medical Holdings, Inc.
SECURITIES & EXCHANGE COMMISSION EDGAR FILING Apollo Medical Holdings, Inc. Form: 8-K Date Filed: 2017-02-13 Corporate Issuer CIK: 1083446 Copyright 2017, Issuer Direct Corporation. All Right Reserved.
Producer Appointment and Commission Agreement
A BETTER WAY TO TAKE CARE OF BUSINESS WASHINGTON REGION Producer Appointment and Commission Agreement This Agreement among Kaiser Foundation Health Plan of Washington ( KFHPWA ), Kaiser Foundation Health
BUSINESS REWARDS CREDIT CARD AGREEMENT (TO BE USED FOR CORPORATIONS, PARTNERSHIPS, LLCs, SERVICE ORGANIZATIONS OR OTHER BUSINESSES)
BUSINESS REWARDS CREDIT CARD AGREEMENT (TO BE USED FOR CORPORATIONS, PARTNERSHIPS, LLCs, SERVICE ORGANIZATIONS OR OTHER BUSINESSES) This AGREEMENT made and entered into this day of, 20, by and between
All ESD General Agents Charles R. Mankamyer, President of General Agents ESD Selling UA ProCare Medicare Supplements!
Memo To: From: Re: All ESD General Agents Charles R. Mankamyer, President of General Agents ESD Selling UA ProCare Medicare Supplements! Preserve your existing ESD client base as they transition to retirement
PROMISSORY NOTE A SECURED BY DEED OF TRUST (AUTHORITY)
.. PROMISSORY NOTE A SECURED BY DEED OF TRUST (AUTHORITY) $38,930,000 Principal Amount Santa Monica, California Dated: December 14, 2004 A. The REVELOPMENT AGENCY OF THE CITY OF SANTA MONICA (the "Borrower"),
FIXED RATE PROMISSORY NOTE (INTEREST-ONLY PAYMENTS)
FIXED RATE PROMISSORY NOTE (INTEREST-ONLY PAYMENTS) Loan Number: 2014A1234 : OCTOBER 29, 2014 $ 125,000.00 FOR VALUE RECEIVED, the undersigned ("") promises to pay to A&D MORTGAGE LLC, A FLORIDA LIMITED
AGENT APPLICATION AND AGREEMENT REQUIREMENTS (AGTCTRT)
Americo Financial Life and Annuity Insurance Company AGENT APPLICATION AND AGREEMENT REQUIREMENTS (AGTCTRT) Please check here if paperwork is for an Agency/Corporation Appointment Detailed below are all
NEW YORK NOVEMBER 11, Blank Rome Tax Update
NEW YORK NOVEMBER 11, 2015 Blank Rome Tax Update Tax Update The Accountant s Role in the Mergers and Acquisitions Process 11/11/2015 Blank Rome LLP Joseph T. Gulant Cory G. Jacobs Jeffrey M. Rosenfeld
Schedule 1 COLLATERAL ASSIGNMENT AGREEMENT
Schedule 1 COLLATERAL ASSIGNMENT AGREEMENT For use outside Quebec BY: [Insert name of the Policy Owner], [address] (the Policy Owner ) TO AND IN FAVOUR OF: INDUSTRIAL ALLIANCE INSURANCE AND FINANCIAL SERVICES
LETTER OF TRANSMITTAL
LETTER OF TRANSMITTAL To Tender Shares of Common Stock of Lightstone Value Plus Real Estate Investment Trust, Inc. Pursuant to the Offer to Purchase dated May 1, 2013 THE OFFER, PRORATION PERIOD AND WITHDRAWAL
NORTH OGDEN CITY, UTAH FINAL BOND RESOLUTION SALES TAX REVENUE REFUNDING BONDS, SERIES 2014 FEBRUARY 11, 2014 RESOLUTION NO.
NORTH OGDEN CITY, UTAH FINAL BOND RESOLUTION SALES TAX REVENUE REFUNDING BONDS, SERIES 2014 FEBRUARY 11, 2014 RESOLUTION NO. A RESOLUTION AUTHORIZING $2,550,000 SALES TAX REVENUE REFUNDING BONDS, SERIES
DEED OF TRUST AND ASSIGNMENT OF RENTS SAN FRANCISCO POLICE IN THE COMMUNITY LOAN PROGRAM (PIC)
Free Recording Requested Pursuant to Government Code Section 27383 When recorded, mail to: Mayor's Office of Housing AND Community Development of the City and County of San Francisco One South Van Ness
Refunded Bonds ), originally issued in the amount of Three Million Two Hundred Fifty
ORDINANCE NO. 18-2004 An Ordinance concerning the refunding by the Town of Plainfield, Indiana, of its Waterworks Revenue Bonds of 1996; authorizing the issuance of waterworks refunding revenue bonds for
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C FORM 8-K
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 8-K CURRENT REPORT Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 Date of Report (Date of earliest event
Membership Application & Indemnity Agreement
Massachusetts Care Self-Insurance Group, Inc. Workers Compensation Membership Application & Indemnity Agreement P.O. Box 859222-9222 / Braintree, MA 02185 / 781-843-0005 / 800-790-8877 v 6-2015 Massachusetts
NGL Contracting Checklist
NGL Contracting Checklist Please submit the following information and documents to SMS when licensing with NGL: Completed and Signed Contracting Agreement Completed and Signed NGL Advance Selection form
WHOLESALE BROKER AGREEMENT. THIS WHOLESALE BROKER AGREEMENT (this Agreement ) dated as of the
WHOLESALE BROKER AGREEMENT THIS WHOLESALE BROKER AGREEMENT (this Agreement ) dated as of the day of,, by and among the entities indicated on Schedule A attached hereto and incorporated herein by reference
SEVENTH AMENDED AND RESTATED SECURED PROMISSORY NOTE. (For Revolving Line of Credit, Advances and Guaranteed Obligations)
[Execution Copy] SEVENTH AMENDED AND RESTATED SECURED PROMISSORY NOTE (For Revolving Line of Credit, Advances and Guaranteed Obligations) (Up to) $4,500,000 July 30, 2012 Los Angeles, California $1,400,445
FIXTURING/INSTALLATION AGREEMENT
Dept Index Contract No. Requisition No. FIXTURING/INSTALLATION AGREEMENT This FIXTURING/INSTALLATION AGREEMENT by and between THE UNIVERSITY OF NORTH FLORIDA BOARD OF TRUSTEES, a public body corporate
REVOLVING CREDIT MORTGAGE
REVOLVING CREDIT MORTGAGE WHEN RECORDED, MAIL TO: 1 2 3 PARCEL ID NUMBER: 4 SPACE ABOVE THIS LINE FOR RECORDER'S USE THIS MORTGAGE CONTAINS A DUE-ON-SALE PROVISION AND SECURES INDEBTEDNESS UNDER A CREDIT
OneAmerica Producer Contracting
OneAmerica Producer Contracting Use the checklist on the next page as a reference. Proper completion and submission of the necessary forms will help expedite the processing of your appointment. After completing
CITADEL PROPERTY MANAGEMENT GROUP, INC. MANAGEMENT SERVICES CONTRACT
CITADEL PROPERTY MANAGEMENT GROUP, INC. MANAGEMENT SERVICES CONTRACT This agreement (the Agreement ) is made and entered into this day of, 201 by and between the association known as (the Association ),
Interconnection of Electric Generators
Interconnection of Electric Generators (GENERATING CAPACITY OF NOT MORE THAN 25 KILOWATTS) Public Utility #1 of Ferry County Republic Washington November 15, 2007 Table of Contents Chapter 1 Purpose and
DEED OF TRUST AND ASSIGNMENT OF RENTS FIRST RESPONDERS DOWNPAYMENT ASSISTANCE LOAN PROGRAM (FRDALP)
Free Recording Requested Pursuant to Government Code Section 27383 When recorded, mail to: Mayor's Office of Housing and Community Development of the City and County of San Francisco 1 South Van Ness Avenue,
MANAGING GENERAL REPRESENTATIVE AGREEMENT
MANAGING GENERAL REPRESENTATIVE AGREEMENT IN CONSIDERATION OF THE MUTUAL PROMISES CONTAINED HEREIN, AMERIPLAN CORPORATION, PLANO, TEXAS (hereinafter referred to as (the Company ) AND THE PERSON SIGNING
ESCROW AGREEMENT. (a) $4,208, to purchase an equivalent principal amount of federal securities as identified in Exhibit A attached hereto;
ESCROW AGREEMENT THIS ESCROW AGREEMENT, made and entered into by and between the Plainview Elgin Sanitary District, Minnesota (the "Issuer"), and Northland Trust Services, Inc., in Minneapolis, Minnesota
HULL & COMPANY, INC. DBA: Hull & Company MacDuff E&S Insurance Brokers PRODUCER AGREEMENT
HULL & COMPANY, INC. DBA: Hull & Company MacDuff E&S Insurance Brokers PRODUCER AGREEMENT THIS PRODUCER AGREEMENT (this Agreement ), dated as of, 20, is made and entered into by and between Hull & Company,
The following preamble and resolution were offered by Commissioner and supported by Commissioner :
RESOLUTION AUTHORIZING ALLEGAN COUNTY SEWAGE DISPOSAL SYSTEM NO. 18 (KALAMAZOO LAKE SEWER AND WATER AUTHORITY 2012 IMPROVEMENTS) BONDS (GENERAL OBLIGATION LIMITED TAX) Minutes of a meeting of the Board
3. Producer agrees that any materials furnished by Pro General shall always remain the property of Pro General and shall be returned upon demand.
This producer s agreement (the Agreement ) made this day of, 20 by and between Pro General Insurance Solutions, Inc. (hereinafter called Pro General ) and DBA, an insurance agency, (hereinafter called
SECURITY/LIEN AGREEMENT INSTALLATION OF REQUIRED IMPROVEMENTS
Return recorded copy to: Broward County Highway Construction & Engineering Division 1 North University Drive, Suite 300B Plantation, FL 33324-2038 Document prepared by: NOTICE: PURCHASERS, GRANTEES, HEIRS,
G E O R G I A P O R T S A U T H O R I T Y I N S U R A N C E R E Q U I R E M E N T S
Page 11 of 17 G E O R G I A P O R T S A U T H O R I T Y I N S U R A N C E R E Q U I R E M E N T S The contractor shall provide certificates of insurance in a form acceptable to the Georgia Ports Authority
THIS LOCKBOX AND ACCOUNT CONTROL AGREEMENT (this Agreement ) is made as of, 200_, by and among ( Depositor ), ( Bank ) and ( Lender ).
FORM 18A.2 LOCKBOX AND ACCOUNT CONTROL AGREEMENT THIS LOCKBOX AND ACCOUNT CONTROL AGREEMENT (this Agreement ) is made as of, 200_, by and among _ ( Depositor ), ( Bank ) and ( Lender ). R E C I T A L S
US Assure Insurance Services of Florida, Inc.
US Assure Insurance Services of Florida, Inc. PRODUCER AGREEMENT THIS AGREEMENT is made and entered into as of the date hereof ( the Effective date ), by and between US Assure Insurance Services of Florida,
DEED OF TRUST WITH REQUEST FOR NOTICE
RECORDING REQUESTED BY: When Recorded Mail Document To: APN: SPACE ABOVE THIS LINE IS FOR RECORDER S USE DEED OF TRUST WITH REQUEST FOR NOTICE HIS DEED OF TRUST is made this day of among the Trustor, (herein
SILKROLL INC. CROWD SAFE. (Crowdfunding Simple Agreement for Future Equity)
THIS INSTRUMENT HAS BEEN ISSUED PURSUANT TO SECTION 4(A)(6) OF THE SECURITIES ACT OF 1933, AS AMENDED (THE SECURITIES ACT ), AND NEITHER IT NOR ANY SECURITIES ISSUABLE PURSUANT HERETO HAVE BEEN REGISTERED
a. Article(s) Goods and/or services described on the face of the Purchase Order
TERMS AND CONDITIONS LIBERTY MUTUAL STANDARD TERMS AND CONDITIONS V. 5.0 1. DEFINITIONS a. Article(s) Goods and/or services described on the face of the Purchase Order b. Customer Liberty Mutual Insurance
NEW JOBS TRAINING AGREEMENT PART I
NEW JOBS TRAINING AGREEMENT PART I 1. College means Community College,,, Michigan. Notices, requests, or other communications directed to the College under this Agreement shall be addressed as follows:
AGREEMENT BETWEEN THE COUNTY OF ORANGE AND THE COUNTY OF MONO
Attachment A - Agreement Page of AGREEMENT BETWEEN THE COUNTY OF ORANGE AND THE COUNTY OF MONO 0 THIS AGREEMENT, entered into this First day of October, which date is enumerated for purposes of reference
Expanded Market Programs
Expanded Market Programs Empowering you to say Yes more often! Ivantage and NEA are affiliates of Allstate, who offer Exclusive Agents access to additional products for risks outside of Allstate s market
JAPAN INTERNATIONAL COOPERATION AGENCY. General Terms and Conditions for Japanese ODA Loans
JAPAN INTERNATIONAL COOPERATION AGENCY General Terms and Conditions for Japanese ODA Loans April 2012 General Terms and Conditions for Japanese ODA Loans Table of Contents Article Number Heading Page Article
CONVERTIBLE NOTE AGREEMENT
CONVERTIBLE NOTE AGREEMENT This Agreement by and between Example LLC, duly organized and existing under the laws of the State of LLC State and note issuer, "Note Holder". W I T N E S S E T H: WHEREAS,
BETWEEN name. address. AND name (hereinafter called the Subcontractor ) address
AGREEMENT BETWEEN CONTRACTOR AND SUBCONTRACTOR CONTRACTOR S COPY SUBCONTRACT NO. Alberta Standard Construction Subcontract THIS AGREEMENT made this day of, A.D. 20 BETWEEN name (hereinafter called the
I N V I T A T I O N T O B I D BID #33-16 RECONSTRUCTION OF RETAINING WALL
FINANCE DEPARTMENT I N V I T A T I O N T O B I D GREGORY N. L HEUREUX Finance Director KRISTIE BRADBURY Deputy Finance Director COLLEEN C. SELBERG Purchasing Agent BID #33-16 RECONSTRUCTION OF RETAINING
MARGIN AGREEMENT. KEEP A COPY FOR YOUR RECORDS. This is a copy of your Margin Agreement with Pershing LLC ( Pershing ).
MARGIN AGREEMENT KEEP A COPY FOR YOUR RECORDS. This is a copy of your Margin Agreement with Pershing LLC ( Pershing ). TO: Pershing LLC In consideration of your accepting and carrying for the undersigned
FleetPride, Inc. Standard Terms and Conditions of Purchase
FleetPride, Inc. 1. Terms of Agreement: The following terms and conditions of sale (these Standard Terms and Conditions ) contain general provisions applicable to all FleetPride, Inc. ( FleetPride ) supply
Council of the City of York, Pa. Session 2013 Resolution No. INTRODUCED BY: Michael Ray Helfrich DATE: February 5, 2013
Council of the City of York, Pa. Session 2013 Resolution No. INTRODUCED BY: Michael Ray Helfrich DATE: February 5, 2013 A RESOLUTION AUTHORIZING A BORROWING IN ANTICIPATION OF CURRENT TAXES AND REVENUES,
ORDINANCE NO Act 94 shall mean Act 94, Public Acts of Michigan, 1933, as amended.
ORDINANCE NO. 247 AN ORDINANCE TO PROVIDE FOR THE ACQUISITION, CONSTRUCTION AND EQUIPPING OF IMPROVEMENTS TO THE WATER SUPPLY SYSTEM OF THE VILLAGE OF BARAGA; TO PROVIDE FOR THE ISSUANCE AND SALE OF REVENUE
REVOLUTION LIGHTING TECHNOLOGIES, INC. (Exact name of registrant as specified in its charter)
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 8-K CURRENT REPORT Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 Date of Report (Date of earliest event
Mason County PUD No. 1. Net Energy Metering Interconnection Agreement
Mason County PUD No. 1 Net Energy Metering Interconnection Agreement Customer Owned Fuel Cell, Solar, Wind, Biogas, Combined Heat and Power or Hydropower Electric Generating Facilities of 100 Kilowatts
LOAN AGREEMENT. Québec Only. AMONG: INDUSTRIAL ALLIANCE INSURANCE AND FINANCIAL SERVICES INC. (the Lender )
LOAN AGREEMENT Québec Only AMONG: INDUSTRIAL ALLIANCE INSURANCE AND FINANCIAL SERVICES INC. (the Lender ) AND: AND: AND: AND: (the Borrower ) (the Borrower ) (the Guarantor ) (the Guarantor ) (referred
PROPERTY MANAGEMENT AGREEMENT
-Cover start- PROPERTY MANAGEMENT AGREEMENT This property management agreement is intended for real estate owners to execute with those managing their property for rental purposes. Download this property
contract STANDARD PROVISIONS - COMMERCIAL PRODUCTION CONTRACT
contract STANDARD PROVISIONS - COMMERCIAL PRODUCTION CONTRACT 1. Ownership All right, title and interest in and to the commercials and/or advertisements, all negatives, prints, soundtracks and other elements
INTERMEDIARY AGREEMENT. between. Universal Healthcare Services (Pty) Ltd (Reg. No: 2008/005871/07) and. Reg. Number / Identity Number:
INTERMEDIARY AGREEMENT between Universal Healthcare Services (Pty) Ltd (Reg. No: 2008/005871/07) and Reg. Number / Identity Number: For office use only Date processed by Universal Healthcare Services:...
BACKGROUND. To induce Creditor to extend the Loan, Creditor has required the execution of this Agreement by Debtor.
SECURITY AGREEMENT THIS SECURITY AGREEMENT (this Agreement ) is made this day of March, 2015, by Manny Green ( Debtor ) in favor of Downright Good Investments, LLC ( Creditor ). BACKGROUND Creditor has
THIRTIETH SUPPLEMENTAL RESOLUTION TO THE MASTER RESOLUTION AUTHORIZING THE ISSUANCE, SALE, AND DELIVERY OF BOARD OF REGENTS OF THE UNIVERSITY OF
THIRTIETH SUPPLEMENTAL RESOLUTION TO THE MASTER RESOLUTION AUTHORIZING THE ISSUANCE, SALE, AND DELIVERY OF BOARD OF REGENTS OF THE UNIVERSITY OF TEXAS SYSTEM REVENUE FINANCING SYSTEM BONDS, AND APPROVING
This Agreement is made as of the day of, 20 ; between Neighborhood Health Plan Inc. ( NHP ),
Brokerage Agreement This Agreement is made as of the day of, 20 ; between Neighborhood Health Plan Inc. ( NHP ), a Massachusetts health maintenance organization ( HMO ) and ( Broker ), as follows: WHEREAS,
Hull & Company, LLC Tampa Bay Branch PRODUCER AGREEMENT
Hull & Company, LLC Tampa Bay Branch PRODUCER AGREEMENT THIS PRODUCER AGREEMENT (this Agreement ), dated as of, 20, is made and entered into by and between Hull & Company, LLC, a Florida corporation (
Southern California Edison Revised Cal. PUC Sheet No E Rosemead, California (U 338-E) Cancelling Revised Cal. PUC Sheet No.
Southern California Edison Revised Cal. PUC Sheet No. 59895-E Rosemead, California (U 338-E) Cancelling Revised Cal. PUC Sheet No. 57290-E GENERATING FACILITY INTERCONNECTION AGREEMENT (Non-Exporting)
LETTER OF TRANSMITTAL. To Surrender Common Units and Preferred Units (each, a Unit ) of MUZAK HOLDINGS LLC
LETTER OF TRANSMITTAL To Surrender Common Units and Preferred Units (each, a Unit ) of MUZAK HOLDINGS LLC THIS FORM SHOULD BE COMPLETED, SIGNED AND RETURNED TO THE ADDRESS SET FORTH BELOW. DELIVERY OF
INDEPENDENT CONTRACTOR AGREEMENT
INDEPENDENT CONTRACTOR AGREEMENT This Agreement is made on this day of, 20, between Coordinated Capital Securities, Inc. ("Company") and ( RR ). Section 1: Appointment 1.1 The Company hereby appoints the
SPONSORED RESEARCH AGREEMENT
SPONSORED RESEARCH AGREEMENT (Collaborative Research - Jointly Owned Intellectual Property - Short Form) This Sponsored Research Agreement (the "Agreement") is made between The University of Texas, ("University"),
DEED OF TRUST. a resident of the Commonwealth of Virginia, whose full residence or business address is. , and
"THIS DEED OF TRUST SHALL NOT WITHOUT THE CONSENT OF THE SECURED PARTY HEREUNDER BE SUBORDINATED UPON THE REFINANCING OF ANY PRIOR MORTGAGE." Return To: Tax Map Reference #: Prepared by: RPC/Parcel ID
Sunlife Financial Contracting Instructions
Sunlife Financial Contracting Instructions Some of these forms will be used for some situations and not for others. Please follow the instructions below that pertain to your situation, and remember, required
SUBCONTRACT CONSTRUCTION AGREEMENT
SUBCONTRACT CONSTRUCTION AGREEMENT THIS SUBCONTRACT CONSTRUCTION AGREEMENT, made and executed this day of, 20, by and between SHERWOOD CONSTRUCTION, INC (hereinafter referred to as "Contractor"), and (hereinafter
ASHI DIAMONDS, LLC. 18 EAST 48TH STREET, 14TH FLOOR NEW YORK, N.Y ((212) ~ FAX (212) ~ ((800) 622-ASHI
ASHI DIAMONDS, LLC. 18 EAST 48TH STREET, 14TH FLOOR NEW YORK, N.Y. 10017 ((212) 319-8291 ~ FAX (212) 319-4341 ~ ((800) 622-ASHI S E C U R I T Y A G R E E M E N T This Purchase Money Security Interest Agreement
REQUEST FOR PROPOSAL TO PROVIDE UNCLAIMED PROPERTY SECURITIES CUSTODY SERVICES TO THE STATE OF NEW HAMPSHIRE
Catherine A. Provencher STATE TREASURER THE STATE OF NEW HAMPSHIRE STATE TREASURY 25 CAPITOL STREET, ROOM 121 CONCORD, NH 03301 (603) 271-2621 FAX (603) 271-3922 EMAIL: cprovencher@treasury.state.nh.us
*Audio Video Design-Build Group Cypress, CA
EXHIBIT A Page 1 of 1 BID NO. 311 AUDIO VISUAL EQUIPMENT AND INSTALLATION IRVINE VALLEY COLLEGE MARCH 30, 2015 CONTRACTORS AMOUNT *Audio Video Design-Build Group Cypress, CA Digital Networks Group, Inc.
BROKERAGE AGREEMENT. This Brokerage Agreement (the Agreement ) is made and entered into by and between
BROKERAGE AGREEMENT This Brokerage Agreement (the Agreement ) is made and entered into by and between Broker Name & Address: (the Broker ) and P. E. Brokerage 105 Montgomery Ave PO Box 249 Montgomeryville,
THE PROVISION OF CRACK SEAL MATERIAL 2017/2018 NOTICE TO BIDDERS. This entire Bid Package, which includes the following:
THE PROVISION OF CRACK SEAL MATERIAL 2017/2018 NOTICE TO BIDDERS This entire Bid Package, which includes the following: Notice Inviting Bids, Bid Proposal Forms, and County of Inyo Standard Contract No.
ALABAMA TAS PROVIDER EQUIPMENT AGREEMENT
ALABAMA TAS PROVIDER EQUIPMENT AGREEMENT FOR INTERNAL USE ONLY Agreement Number: ALDAYC-00- Provider ID: Effective Date: This Agreement is made by and between Conduent State & Local Solutions, Inc. a New