Legal | airSlate SignNow

Florida commissary letter of a... Florida Department of Agriculture and Consumer Services Division of Food Safety COMMISSARY LETTER OF AGREEMENT ADAM H. PUTNAM COMMISSIONER 5K-4. 002 and 5K-4. 20 F*A. C. Phone 850 245-5520 This form is to be filled out and given to the FDACS inspector in the field and submitted as part of a mobile food establishment permit application or with a package ice plant self-vending permit application that requires a commissary. SECTION 1 MOBILE FOOD ESTABLISHMENT MFE INFORMATION Owner Name Phone Number include area code Owner Mailing Address Permit Number City Zip Code 4 optional County I hereby certify the provided information is correct and understand permit approval is contingent upon verification of an approved commissary. Signature owner of MFE Print Name owner of MFE Date SECTION 2 PRIMARY COMMISSARY INFORMATION Primary Commissary Name Commissary Address Primary Phone Number include area code Commissary License/Permit Number Primary E-Mail Address Licensed By check one Department of Business and Professional Regulation Department of Agriculture Consumer Services Wastewater Disposal of Municipal/Utility On-site Well Supplier Name Septic Tank System Other Water Supply of Primary Commissary Department of Health Package Plant I intend to provide the following activities at this commissary Dish or equipment washing Yes No Storing of food and dry goods room temperature Dumping wastewater Cold Storage of food including ice and drinks Receiving potable water Cooking and/or reheating food Washing the outside of the vehicle Three compartment sink Restroom facilities Other Describe below Describe other activities here Signing this document will allow FDACS Food Inspectors entry to my business during normal hours of operation for evaluation of facilities. Print Name of Person in Charge of Commissary Are additional commissaries used DACS-14223 Rev* 07/08 Page 1 of 2 Signature of Person in Charge of Commissary No If yes List additional commissaries on next page use as many pages needed* SECTION 3 ---ADDITIONAL COMMISSARIES Permit/Licensed Licensed By check one FDACS DOH DBPR. PUTNAM COMMISSIONER 5K-4. 002 and 5K-4. 20 F*A. C. Phone 850 245-5520 This form is to be filled out and given to the FDACS inspector in the field and submitted as part of a mobile food establishment permit application or with a package ice plant self-vending permit application that requires a commissary. SECTION 1 MOBILE FOOD ESTABLISHMENT MFE INFORMATION Owner Name Phone Number include area code Owner Mailing Address Permit Number City Zip Code 4 optional County I hereby certify the provided information is correct and understand permit approval is contingent upon verification of an approved commissary. SECTION 1 MOBILE FOOD ESTABLISHMENT MFE INFORMATION Owner Name Phone Number include area code Owner Mailing Address Permit Number City Zip Code 4 optional County I hereby certify the provided information is correct and understand permit approval is contingent upon verification of an approved commissary. Signature owner of MFE Print Name owner of MFE Date SECTION 2 PRIMARY COMMISSARY INFORMATION Primary Commissary Name Commissary Address Primary Phone Number include area code Commissary License/Permit Number Primary E-Mail Address Licensed By check one Department of Business and Professional Regulation Department of Agriculture Consumer Services Wastewater Disposal of Municipal/Utility On-site Well Supplier Name Septic Tank System Other Water Supply of Primary Commissary Department of Health Package Plant I intend to provide the following activities at this commissary Dish or equipment washing Yes No Storing of food and dry goods room temperature Dumping wastewater Cold Storage of food including ice and drinks Receiving potable water Cooking and/or reheating food Washing the outside of the vehicle Three compartment sink Restroom facilities Other Describe below Describe other activities here Signing this document will allow FDACS Food Inspectors entry to my business during normal hours of operation for evaluation of facilities.

Nwcg interagency training nomi... NWCG INTERAGENCY TRAINING NOMINATION AND AGREEMENT TO COLLECT FUNDS INSTRUCTIONS: Complete Part I. Complete PART II only if there are tuition charges for the training. Part I - TRAINING NOMINATION

This operating agreement hipaa... HIPAA BUSINESS ASSOCIATE ADDENDUM This Business Associate Addendum ('Addendum') is a part of the Contract dated between the Department of and , contract number . For purposes of this Addendum,

Iowa public health supervision... PUBLIC HEALTH SUPERVISION AGREEMENT Agreement Between: Supervising Dentist's Name: Work Address: Work Phone: E-mail: Dental Hygienist's Name: Work Address: Work Phone: E-mail: Years of Clinical Practice

Living quarters permit agreeme... Michigan.gov/lcc Business ID Request ID For MLCC use only Living Quarters Permit Agreement and Application Authorized by M. Complete form LCC-3619 Living Quarters Permit Agreement and Application 70. 00 Inspection fee Please submit with your signed application. The fees must be paid by check bank/postal money order made payable to State of Michigan/MLCC or by credit card using the attached Credit Card Authorization Form LC-3065.

Facility user account agreemen... FACILITY USER ACCOUNT AGREEMENT Please print clearly Section 1: Internet Data Submission (IDS) User Account Information (all information is required) 1. FACILITY NAME: 2. AHCA NUMBER: 3. NAME OF IDS

Sunadvantage pre authorized de... SunAdvantage Pre-authorized debit (PAD) agreement Category: Business TM To use PAD you must agree to all the terms of this authorization. By signing below as payor, you agree to the following: Sun

Wire transfer agreement form WIRE TRANSFER AGREEMENT Customer This agreement between the Bank named above and the Customer and its authorized agents hereafter Customer governs origination and receipt of wire transfers on behalf of the Customer. Customer s obligations shall not be excused in these circumstances. The Bank shall reject any transfer request or incoming wire transfer which does not conform to the limitations security procedures and/or other requirements set forth in this agreement such as availability of funds on deposit. 7 Rejection of the Bank s Transfer Request If the Bank receives notice that a wire transfer transmitted by the Bank has been rejected the Bank shall notify the Customer of such rejection including the reason given for rejection by telephone electronic message or U.S. mail. The Bank will have no further obligation to transmit the rejected wire transfer if it complied with this agreement with respect to the original transfer request. NOTE If Customer has enrolled in a service providing for submitting wire transfer requests online or electronically collectively Online Wire Requests then Customer will transmit transfer requests in accordance with the applicable Online Wire Requests service agreement and the security procedures for Online Wire Requests shall be Customer s access credentials and the submitter s actual access to the Online Wire Request system. If the Online Wire Request system is unavailable however then the option checked below will be used as backup for offline wire transfer requests. At the time the Bank executes a wire transfer or internal transfer the Customer agrees to pay the Bank with available funds on deposit for the amount of the wire plus the current Wire Transfer Fee as listed in the Bank s fee schedule. If the Customer fails to pay in accordance with this agreement the Bank shall be entitled to request cancellation of the transfer or to undertake any other legal means to collect the amount of the transfer if unable to cancel including exercise of right of offset as detailed in the Bank s Deposit Agreement. If the Customer fails to pay in accordance with this agreement the Bank shall be entitled to request cancellation of the transfer or to undertake any other legal means to collect the amount of the transfer if unable to cancel including exercise of right of offset as detailed in the Bank s Deposit Agreement. 6 Errors and Rejections by Bank If a wire transfer request indicates an intermediary bank or a beneficiary s bank inconsistently by name and identifying number execution of the request might be based solely upon the number even if the number identifies a bank different from the named bank or a person who is not a bank. Any termination shall not affect any obligations occurring prior to termination. 10 Authorization The Customer represents and warrants that the accounts listed below are owned entirely by the within-named Customer and are hereby authorized to be charged as instructed by the Customer for wire transfers and related fees The Customer hereby authorizes the following individuals as agents for purposes of authorizing wire transfer requests on behalf of the Customer. These agents shall remain authorized until the Customer notifies the Bank in writing of revocation of any agent s authorization. Other individuals can be authorized only by adding them to this agreement or by completion of a new agreement with the Bank. If Customer does not have a deposit account at Bank then Customer a hereby waives any right to a jury trial and agrees that any such claim or controversy shall be decided in a trial to a state or federal judge sitting without a jury in the state and county where Bank is headquartered or in the county of the physical Bank branch at which Customer requested the transfer and b hereby waives the right to litigate such claim or controversy in a class action as a class member or class representative. This agreement supersedes any prior agreements between the Bank and the Customer on the subject matter hereof and shall also be binding upon the Customer s heirs representatives and successors. In the event of any inconsistency between this agreement and the Deposit Agreement with respect to wire transfers this agreement shall govern. If any part of this agreement is invalid illegal or unenforceable the remaining provisions shall remain in effect.

Revenue sharing agreement temp... REVENUE SHARING AGREEMENT This REVENUE SHARING AGREEMENT (this 'Agreement'), dated as of December 31, 2011 (the 'Effective Date') is entered into by and among Deutsche Bank AG,

Installment agreement form acc... INSTALLMENT AGREEMENT FORM (ACCIDENT / DEFAULT IN PAYMENT SUSPENSIONS ONLY) SUSPENDED DRIVER'S PERSONAL INFORMATION (Please Print): Last Name First Name City Middle Initial State Suffix (Jr., Sr.,

House sitter agreement form TERMINATION OF AGREEMENT 18. 1 to give the house sitter at least 7 days notice of an early termination 18. HOUSE SITTING BOND Cross out if there is not going to be a bond A bond of. must be paid by the house sitter to the homeowner s nominated agent on or before the signing of this agreement. 16. 1 assign the whole or part of the house sitter s interest under this Agreement or 16. 2 sub-let the residential premises without the homeowner s prior written permission or 16. ADDITIONAL TERMS Additional terms and conditions may be added here homeowner and house sitter to initial each additional term. N.B. If any form of rent is to apply then State tenancy laws may be applicable thereby affecting this Agreement. TERM The term of this Agreement begins at. am/pm on. /. /. and ends at. am/pm on. /. /. CONTINUATION At the end of this term the house sitter may continue to occupy the premises under the same terms of this Agreement ONLY if notified by the homeowner. 1 an inadvertent lockout situation or 14. 2 loss of keys by the house sitter or 14. 3 any other situation where spare keys may be required. omission by any person the house sitter allows on the residential premises who breaks any terms of the Agreement. 3 have or permit a boarder or lodger whether or not paying rent or board or other occupation fees. TELEPHONES state as at the start of the Agreement and the house sitter shall make good all reconnection charges arising from any action of the house sitter. 1 the damage was not caused as a result of a breach of this Agreement by the house sitter and 12. 2 the house sitter gives the homeowner or contact a reasonable opportunity to make the repairs and trades-person named in this Agreement make the repairs and 12. at. BETWEEN HOMEOWNER Name/s Address AND HOUSE SITTER Other people who will ordinarily live at the premises PETS Belonging to the homeowner Type of pet/s eg German Shepherd Persian Budgerigar. Description No person/s or pet/s other than those listed above are permitted to live at the premises during the term of this Agreement. 1993 - 2013 The House Sitters www. housesitters. com*au PREMISES The homeowner gives the house sitter a license to occupy the premises rent free at and the following parking space and storeroom This is not a lease and the parties agree that the house sitter is granted only a license to occupy and has no legal interest in the premises whatsoever. HOMEOWNER S NOMINATED BOND AGENT Cross out if there is not going to be a bond TRADESPERSON/S see Urgent Repairs clause 12 13. VETERINARIAN clause 7. CONTACT PERSON/S see clause 6 9 11 12 14 19. 1. 1 a copy of this agreement at or before the time the agreement is signed and PAYMENT OF COUNCIL RATES LAND TAX AND OTHER CHARGES 2. 1 Council rates and 2. 2 land taxes and 2. 3 the accounts referred to in Clause 3 and 2. 4 all charges under any Act for the residential premises. 3 The house sitter agrees to reimburse the homeowner 3. 1 for electricity and 3. 2 for gas where applicable and 3.

Roomer landlord form ROOMER/LANDLORD AGREEMENT This form applies if a roomer is living with a homeowner or a member of the homeowner s immediate family and sharing a kitchen and/or bathroom with the homeowner. Landlord - Roomer Disputes Although the Off-Campus Housing Office will not get directly involved in disputes the staff can offer information to both parties and can make referrals for you for mediation or other services/support. The roomer cannot interfere with the landlord s reasonable enjoyment of the property. The common areas that may be used by the Roomer e.g. bathroom kitchen hall are TERMS OF RENTAL Use Option 1 for a fixed rental period with a specific end date. Does the roomer have a friend who is a local contact in case of emergency Entry of Their Room Specify under what circumstances the landlord will enter the roomer s room In case of fire or other emergency If they go away for the weekend and leave a window open Regular cleaning Both parties must be respectful of each other s right to privacy. The designated parking area is LAUNDRY G No laundry facilities G Use of washer and dryer restrictions if any HOUSE RULES AGREEMENTS e.g. noise pets smoking overnight guests use of kitchen Additional rules agreements to be listed and signed on Page 3 comprising part of this license THIS AGREEMENT SIGNED ON THE DAY OF 20 Landlord Roomer I HEREBY ACKNOWLEDGE RECEIPT OF A FULLY EXECUTED ORIGINAL COPY OF THIS AGREEMENT THIS DAY OF 20. If vehicle shuffling is necessary will the roomer and landlord have access to each other s car keys Smoking and Pets Specify whether or not smoking is allowed. In which rooms Outside only Are pets allowed Name Address and Phone Number of Your Student The landlord should be provided with the roomer s full name home address and telephone number as the University cannot release personal information should they need to be contacted at a later date or in the event of an emergency. The Tenant Protection Act does not apply to such an agreement which is a license not a lease. BETWEEN THE LICENSOR HEREINAFTER CALLED THE LANDLORD AND THE LICENSEE AGREEMENT The Landlord agrees to rent to the Roomer and the Roomer agrees to rent from the Landlord accommodations at the following address USE OF ACCOMMODATION The Roomer agrees to use the rented accommodations as a residential dwelling and for no other purpose and to abide by the covenants rules and regulations of this agreement. The rent will be per week / month circle one until date. CONTENTS OF ROOM S BEING RENTED Description of room s and location within the premises are as follows e.g. middle bedroom 2nd floor north side In this room items owned by the landlord are LANDLORD S RESPONSIBILITY The landlord is responsible for providing and maintaining the rented premises in a good state of repair to comply with all applicable health and safety standards. Heat must be maintained at 21degrees Celsius in all occupied areas. ROOMER S RESPONSIBILITY The roomer is responsible for ordinary cleanliness of the rented premises and for the repair of damages incurred by the roomer or their guests.

Legal forms

Browse over 85,000 state-specific fillable forms for all your business and personal needs. Customize legal forms using advanced airSlate SignNow tools.

Showing results for:

Get legally binding signatures now!