Thank you for your interest in partnering with AppraisalBridge

Size: px
Start display at page:

Download "Thank you for your interest in partnering with AppraisalBridge"

Transcription

1 Thank you for your interest in partnering with AppraisalBridge AppraisalBridge is a management agent for lenders, regulatory and enforcement agencies and other institutions that rely on real estate valuation services. Independent Contractors must agree to a contract relationship with AppraisalBridge to manage appraisal assignments available from our sourcing platform. Our web portal offers you convenient real-time access to all of your assignments. The technology allows for transactional updating, profile management, payment tracking and the opportunity to capture more business through positive quality and service performance. The following instructions and packet of documents will lead you through the application process for becoming approved as an Independent Contractor for AppraisalBridge. The packet includes the following: Independent Contractor Engagement Agreement - Please sign Contractor Application Form - Please complete and sign Self Identification Form - Please complete and sign (voluntarily) Lender Specific Addendums - Please sign if provided Please return each of the above listed and applicable documents and all requested attachments to AppraisalBridge. AppraisalBridge, LLC Attn: Fee Panel Management 200 NE Missouri Road, Suite 200 Lee s Summit, MO Or fax to Or to [email protected] If you have any questions, please contact AppraisalBridge at Page 1 of 12

2 Page 2 of 12 Independent Contractor Engagement Agreement This Agreement, and referenced forms and addendum, sets forth the terms and conditions under which you will perform your appraisal assignments and will be compensated for your services as performed on behalf of AppraisalBridge, LLC (AppraisalBridge ) a Missouri limited liability company in your capacity as Appraiser. Whenever the terms of we or our are used, reference is being made to AppraisalBridge and when the terms you or your are used, reference is being made to the Appraiser. Definitions - the following terms are defined as used herein this document: Appraiser shall mean licensed real estate appraisers who have established a service provider relationship with AppraisalBridge on an independent contracting basis, and who are not an employee or representative of AppraisalBridge. Lender shall mean the lender or institution indicated in the specific appraisal assignment to be identified by the appraiser as the Lender/Client on the appraisal report. Client shall mean the company that is engaging the appraiser (AppraisalBridge ). 1. Nature of Relationship: Appraiser is an independent contractor. This Agreement does not create or evidence an employer-employee, principal-agent, or joint venture relationship between Appraiser and AppraisalBridge and Appraiser is not, and shall not represent himself or herself, to be an employee of AppraisalBridge or the companies we represent. Approval for service by AppraisalBridge does not guarantee work. Contracts for appraisal assignments are given on a job-by-job basis. AppraisalBridge does not guarantee engagement as an independent contractor or offer guaranteed amount of compensation. 2. Deductions: As an independent contractor, Appraiser is solely responsible for all federal, state, and local tax requirements. 3. Expenses: Appraiser shall be responsible for all of Appraiser s own expenses, except for those that AppraisalBridge, in its sole discretion, agrees to pay, in advance, and confirmed in writing, on Appraiser s behalf. 4. Compensation: In consideration for the services to be performed as an independent contractor: a) Upon completion of each appraisal assignment, Appraiser shall be entitled to the contracted rate listed on the appraisal order form. Appraiser will not invoice AppraisalBridge clients directly. AppraisalBridge will process payment within 30 days of post review acceptance of all assignments. b) AppraisalBridge reserves the right from time to time to increase or decrease the amount of fees payable, upon 30 calendar days notice to Appraiser, at which time the fee will apply to all new assignments ordered 30 days after the notice and as reflected on current valuations engagement order. c) Appraiser agrees that appraisal product found to be unacceptable as first delivered and after review will not be processed for payment until all corrections, revisions or requests for clarification have been addressed in writing and cleared by AppraisalBridge quality assurance reviewer. If after correction or revision the appraisal is still deemed unreliable by a professional peer, part or the entire fee may be forfeited and grounds for termination of this Agreement. d) Appraiser agrees that any arrangement for compensation for appraisal services between Appraiser and AppraisalBridge is confidential in nature and should not be discussed with any third party without the express written consent of AppraisalBridge. 5. Insurance: Appraiser understands that AppraisalBridge recommends that, as an independent contractor, you maintain errors and omission insurance with a minimum of $250,000 liability coverage, automobile insurance with a minimum of $500,000 liability coverage, and that if you operate a business that employs associate appraisers, you should maintain worker s compensation insurance. These are recommendations only and are not required by AppraisalBridge for consideration of appraisal assignments.

3 Independent Contractor Engagement Agreement AppraisalBridge and Appraiser agree that: 1. Appraiser shall obtain and maintain all equipment necessary to develop and deliver appraisal product. Appraiser shall receive and transmit all assignments by an approved electronic delivery method. 2. In accordance with USPAP, appraisers have the right to refuse appraisal orders based upon complexity of the assignment and/or competencies required to complete the assignment. Refusal of any appraisal assignments will be communicated to AppraisalBridge in a timely manner and in accordance with the AppraisalBridge service standards included with each appraisal order form. 3. Product due dates will be provided with each assignment as listed on the appraisal order form and must be confirmed by Appraiser. 4. Appraiser understands and agrees that appraisals transmitted to AppraisalBridge, including all data, opinions, and information shown on said appraisals, are property of the Client exclusively and Appraiser has no interest therein. Appraiser will not provide a copy or summary of any appraisal delivered to Client, nor any excerpts there from, to any person, without Client s express written permission. 5. Contracts may be cancelled or terminated by either party (Appraiser or AppraisalBridge ) at any time. In the event that Appraiser s contract is cancelled or terminated with AppraisalBridge all payments thereafter made to Appraiser shall be made in accordance with the compensation agreement in effect at the time that the assignment is ordered with Appraiser. 6. Any disputes under this Agreement shall be litigated in the small claims court of the jurisdiction where the litigation is commended if the amount of the dispute is within the jurisdiction amount of said court. The losing party in any litigation based on this Agreement will pay the prevailing party s reasonable attorney s fees. Appraiser warrants to AppraisalBridge : 1. All information submitted by Appraiser to AppraisalBridge in providing appraisal services and in applying for approval as independent contractor is true and correct as of the date of submission, and are true and correct as of the effective date of this Agreement. 2. If Appraiser becomes aware of any information that may disqualify Appraiser from working as independent contractor of AppraisalBridge, Appraiser will notify AppraisalBridge of such information immediately. 3. All appraisals must meet USPAP, AppraisalBridge instructions from appraisal order form, Lender specific requirements, and conform to supplemental guidelines (Fannie Mae, FHLMC, and HUD). In addition all appraisals must meet AppraisalBridge quality and service standards, as included with each appraisal order form. 4. All appraisals completed by Appraiser will be delivered to AppraisalBridge on or before the due date on the assignment as confirmed by Appraiser. Completed appraisals will be delivered to AppraisalBridge via EDI (Electronic Data Interchange) and in first generation Adobe PDF format. In cases where Appraiser is experiencing technical difficulty, appraisals may be sent via overnight mail, as agreed upon beforehand, at Appraiser s own expense. 5. Appraiser understands that all appraisal reports completed for AppraisalBridge are subject to automated, desk and/or field review at the discretion of AppraisalBridge. Appraiser understands and agrees to provide written response within the designated timeframes to any identified deficiencies or requests for additional information. 7. Appraiser is licensed or certified as required in order to perform appraisals related to properties located in the states and corresponding counties to be identified by Appraiser through the AppraisalBridge online account setup function, and will provide to AppraisalBridge a copy of each such license and renewal thereof. Appraiser will maintain these licenses/certifications throughout the term of this Agreement, and will advise AppraisalBridge immediately of any investigation or proceeding relating to said license/certification. Appraiser will indemnify AppraisalBridge and its clients for any and all losses, damages, fines and/or costs, including reasonable attorney s fees, in connection with any failure by Appraiser to be properly licensed/certified. Page 3 of 12

4 Independent Contractor Engagement Agreement 8. Appraiser will complete all field assignments in person and will not allow assignments to be completed by, or assigned to, appraisers that are not approved by AppraisalBridge, or to trainees without notification, and prior to approval by AppraisalBridge. 9. By accepting an assignment, Appraiser acknowledges that he/she has the knowledge and the experience to complete the assignment competently and is familiar with all significant market factors in the geographic areas identified by Appraiser as their coverage area. 10. Appraiser s use of electronic communications to transmit appraisals is secure; only Appraiser knows the password required to transmit appraisals and only Appraiser has the access required to electronically transmit an appraisal with an electronic signature. Appraiser also warrants to AppraisalBridge the following confidentiality requirements: 1. Definitions: As used herein, the term Customer Information shall mean any nonpublic personal information about the customers and consumers (as those terms are defined in Title V of the Gramm- Leach-Bliley Act and the privacy regulations adopted hereunder) of AppraisalBridge. Service Provider shall mean the party accepting below as Appraiser who hereafter may be providing any goods or services to AppraisalBridge clients. 2. The privacy regulations and information security guidelines issued by the federal financial regulators pursuant to the Title V of the Gramm-Leach-Bliley Act ( GLBA ) went into effect on July 1, Pursuant to those regulations and guidelines, covered financial institutions and service providers with access to confidential data are required to ensure that all service providers and marketing partners who have access to customer information provide for confidentiality and security of such information. To facilitate our ability to demonstrate compliance with the privacy requirements of GLBA, we ask that you agree to the following which will apply to all data provided to you by AppraisalBridge or Lenders. 3. Service Provider hereby agrees that, except as may be reasonably necessary in the ordinary course of business to carry out the activities to be performed by Service Provider under its agreement(s) with AppraisalBridge clients or as may be required by law or legal process; it will not disclose any Customer Information to any third party other than affiliates of Service Provider or Client engaging Appraiser. 4. Service Provider hereby agrees that it will not use any Customer Information other than to carry out the purposes for which such Customer Information was disclosed by Client unless such other use is (a) expressly permitted by a written agreement executed by Client, or (b) required by law or legal process. 5. Service Provider agrees to take all reasonable measures, including without limitation such measures as it takes to safeguard its own confidential information, to ensure the security and confidentiality of all Customer Information, to protect against anticipated threats or hazards to the security or integrity of such Customer Information and to protect against unauthorized access to or use of such Customer Information. 6. Throughout the term of this Agreement, Service Provider shall implement and maintain appropriate safeguards, as that term is used in 314.4(d) of the FTC Safeguard Rule, 16 C.F.R. 314 (the FTC Rule ) for all customer information as that term is defined in 314.2(b) of the FTC Rule, owned by Client and delivered to the Service Provider pursuant to this agreement. 7. Service Provider shall promptly notify Client engaging appraiser in writing of each instance of (i) unauthorized access to or use of that Customer Information that could result in substantial harm or inconvenience to a customer of AppraisalBridge client or (ii) unauthorized disclosure, misuse, alteration, destruction or other compromise of that Customer Information. 8. Service Provider shall indemnify and defend AppraisalBridge client for security breaches, violations of the GLBA caused by Service Provider s and hold harmless negligence and loss or material alteration of Customer Information. Page 4 of 12

5 Independent Contractor Engagement Agreement All warranties made as of the effective date of this Agreement and shall survive any termination of this Agreement. Termination of Agreement: Either party, upon 30 calendar days written notice, or immediately with cause, may terminate this Agreement. All written notices are to be sent certified or via overnight mail to the address listed on page one of the Contractor Application Form. Indemnification: Appraiser will indemnify and hold harmless AppraisalBridge, LLC, a Missouri corporation for any liability arising out of negligent work, for not abiding by the rest of this agreement, on use of available web forms, Appraiser s software, or for the release of any appraisals without permission from AppraisalBridge, and that Appraiser is liable for payment of any legal fees, claims, damages, losses and liabilities resulting from Appraiser s negligence or non-performance of the duties and obligations identified herein. Non-Compete Clause: During the term of this Agreement, Appraiser will not solicit work from any businesses introduced to Appraiser by virtue of the relationship with AppraisalBridge or AppraisalBridge clients. This includes referencing your relationship with AppraisalBridge or AppraisalBridge clients and/or offering to complete appraisal assignments directly for the institution rather than through AppraisalBridge. This non-compete clause will continue in full force for a period of twelve (12) months following written termination of this Agreement by either party. I have read and fully understand the Independent Contractor Engagement Agreement and promise to comply with all terms and conditions outlined herein under which you are requiring of me to perform and complete appraisal assignments. This Agreement, and referenced forms and addendum constitutes the entire Agreement between Appraiser, AppraisalBridge and its clients. This agreement supersedes any and all prior Agreements and/or discussions. Appraiser Signature Printed Name and Title Date AppraisalBridge Signature Mark H Maschger, President Date Page 5 of 12

6 Contractor Application Form Appraiser must hold a current State License or Certification for real estate appraisal issued by a state organization or a state-regulated agency whose criteria for licensing meets current minimum criteria issued by industry qualification boards. Appraiser must understand secondary market guidelines, including those of FNMA, FHLMC, and HUD, and be able to competently apply these guidelines as well as any more stringent guidelines established by AppraisalBridge or its customers. Appraiser must not be prohibited from performing valuation work by any state licensing agency, nor misrepresent any information in this application or other supporting documentation contributing toward Applicant s approval. AppraisalBridge uses the following documentation criteria in approving Applicants for our Approved Panel. The documentation criteria are subject to change without notice. Complete this Contractor Application. Provide a copy of the current State License or Certification for any state in which Appraiser has registered and desires to perform appraisal assignments. Complete and attach W-9 Form Contractor Information Applicant Name SSN - - Firm Name Phone ( ) Business Address Fax ( ) City County State Zip Type of License: Years Post License Experience Conventional Yes No FHA Yes No Relocation (ERC) Yes No REO Yes No Special property appraisal experience: Have you or has your firm ever been involved in a lawsuit either pending or resolved? Yes No (If yes, please attach letter of explanation) Have you ever been disciplined by a state appraisal licensing agency or professional organization? Yes No (If yes, please attach letter of explanation) Have you ever been disciplined or sanctioned by HUD? Yes No Are you listed on HUD s Lender Select Roster? Yes No Do you carry Errors and Omissions Insurance? Yes No (If Yes, attach copy of certificate) Have you ever had a claim filed against your Errors and Omissions Insurance? Yes No Please provide your Professional Membership Sponsoring Organization: Designation: Other Qualifications: Professional References: Name Title Phone ( Name Title Phone ( Name Title Phone ( ) ) ) I hereby authorize AppraisalBridge to check my references and to verify any of the provided data. I understand that if approved by AppraisalBridge, I will be contacted and provided an account login and password for online selfconfiguration of my account profile. Applicant Signature Date Page 6 of 12

7 Contractor Application Form - Continued The application may be completed in its entirety (pages one and two below), or Appraiser may complete page one and also attach a current résumé that includes all employment for the prior five years, plus a listing of professional education classes taken for licensing or continuing education within the last two years. The résumé should note what percentage of time was devoted to the appraisal of real property for each employment period. Applicant Name SSN - - Firm Name Phone ( ) Business Address Fax ( ) City County State Zip Page 7 of 12

8 Self Identification Form It is the policy of AppraisalBridge to provide equal employment opportunity for everyone, including Independent Contractors, and to abide by all relevant EEO/AA laws, federal, state or local. Including Title VII of the Civil rights Act of 1964 Executive Order as amended. (38USC2012) Section 402 of the Vietnam Era Readjustment Assistance Act of 1974, Section 503 of the Rehabilitation Act of 1973, and their implementing regulations. AppraisalBridge is required by its regulators/investors to provide the information requested below. The information on this form will be provided to HUD, but will be maintained separately from other portions of this Independent Contractor / Service Provider Approval Packet. Completing this form is VOLUNTARY. Refusal to provide the requested information will not subject Appraiser to any adverse treatment. The information will be kept confidential and used only in accordance with federal law. Please complete and return this form directly to our Fee Panel Management. Thank you for your cooperation. Printed Name: _ Appraiser Approval Number: City: State: Zip: Please check the appropriate box(s): I decline to answer. I understand that my decision to not provide this voluntary information has no bearing on my approval or how appraisers are selected by AppraisalBridge for valuations assignment. African American Native Americans: including American Indians, American Eskimos, American Aleuts and Native Hawaiians Hispanic Americans: from any Latin American country in South America, Central America or the Caribbean. Asian-Pacific Americans: from Japan, China, Okinawa, the Philippines, Vietnam, Korea, Samoa, Guam, Northern Marinas, Laos, Cambodia, Taiwan and the U.S. Trust Territories of the Pacific. Asian Indian Americans: from India, Pakistan and Bangladesh. Women Owned Business Concern: a concern that is at least fifty-one percent (51%) owned, or is a publicly owned business where the combined total of all classes of stock is owned by a woman or women who are U.S. citizens and who also control and operate the business. Control in this context shall mean exercising power to make policy decisions and operate shall mean being actively involved in the day-to-day management. AppraisalBridge is fully committed to the policy and guidelines of the Community Reinvestment Act, Federal Fair Housing Act, and Equal Credit Opportunity Act and adheres to Non-Discrimination practices in the valuation process. AppraisalBridge does not support or encourage discrimination or like practices of any form. I understand that any omission or misrepresentation of material fact in this application may result in non approval. I acknowledge that AppraisalBridge, at their sole discretion and for any reason, has the option of not accepting my application or changing my status at any time. I hereby authorize AppraisalBridge to make any investigation of my background deemed necessary and to release copies of my application packet, (application, resume and license) to their clients upon request. Applicant Signature Date Page 8 of 12

9 Page 9 of 12

10 Page 10 of 12

11 Page 11 of 12

12 Page 12 of 12

Advanced AMC, Inc. Appraiser Services Agreement (Independent Contractor Agreement)

Advanced AMC, Inc. Appraiser Services Agreement (Independent Contractor Agreement) Advanced AMC, Inc.. Appraiser Services Agreement (Independent Contractor Agreement) This Appraiser Services Agreement ( Agreement ) shall be effective as of the Effective Date by and between Advanced AMC,

More information

Are you a Table Funding Partner? Are you a Correspondent?

Are you a Table Funding Partner? Are you a Correspondent? Thank you for joining RenasantConnect s appraisal ordering service for Table Funding Partners and Correspondent Lenders. Renasant Bank and SettlementOne Valuation are pleased to present you with tailored

More information

AGREEMENT. Solicitor Without Per Diem Compensation

AGREEMENT. Solicitor Without Per Diem Compensation Solicitor Without Per Diem Compensation AGREEMENT Products underwritten by: American General Life Insurance Company Houston, Texas The United States Life Insurance Company in the City of New York New York,

More information

Louisiana State University System

Louisiana State University System PM-36: Attachment 4 Business Associate Contract Addendum On this day of, 20, the undersigned, [Name of Covered Entity] ("Covered Entity") and [Name of Business Associate] ("Business Associate") have entered

More information

CLS Investments, LLC Instructions for the Solicitor Application and Agreement

CLS Investments, LLC Instructions for the Solicitor Application and Agreement CLS Investments, LLC Instructions for the Solicitor Application and Agreement Please complete all fields on page 1 of the Solicitor Application and Agreement. Some general guidelines are set forth below.

More information

Recitals. NOW, THEREFORE, the parties hereto agree as follows: Agreement

Recitals. NOW, THEREFORE, the parties hereto agree as follows: Agreement THIS INDEPENDENT CONTRACTOR SERVICES AGREEMENT (this Agreement ) is made this day of, 20 (the Effective Date ), regardless of the date of execution, by and between Sierra Field Services, Inc., a Nevada

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT Please complete the following and return signed via Fax: 919-785-1205 via Mail: Aesthetic & Reconstructive Plastic Surgery, PLLC 2304 Wesvill Court Suite 360 Raleigh, NC 27607

More information

Covered California. Terms and Conditions of Use

Covered California. Terms and Conditions of Use Terms and Conditions of Use Contents: Purpose Of This Agreement Privacy Policy Modification Of This Agreement Permission To Act On Your Behalf How We Identify You Registration Additional Terms For Products

More information

HIPAA BUSINESS ASSOCIATE AGREEMENT

HIPAA BUSINESS ASSOCIATE AGREEMENT HIPAA BUSINESS ASSOCIATE AGREEMENT This Agreement, dated as of, 2015 ("Agreement"), by and between, on its own behalf and on behalf of all entities controlling, under common control with or controlled

More information

BENCHMARK MEDICAL LLC, BUSINESS ASSOCIATE AGREEMENT

BENCHMARK MEDICAL LLC, BUSINESS ASSOCIATE AGREEMENT BENCHMARK MEDICAL LLC, BUSINESS ASSOCIATE AGREEMENT This BUSINESS ASSOCIATE AGREEMENT ( Agreement ) dated as of the signature below, (the Effective Date ), is entered into by and between the signing organization

More information

EPS EFT Enrollment Authorization Agreement

EPS EFT Enrollment Authorization Agreement EPS EFT Enrollment Authorization Agreement Optum is improving service to you by replacing paper checks and Explanation of Benefits (EOBs) with the Optum EPS solution. Get a head start by enrolling today!

More information

Valuation Management Group strives to assist all appraisers who are looking to maximize their time efficiency and quality.

Valuation Management Group strives to assist all appraisers who are looking to maximize their time efficiency and quality. Dear Appraiser: We are delighted that you are joining our team at Valuation Management Group. Our goal is to improve the appraisal process for our clients and appraisers to ensure appraiser independence.

More information

BROKER AGREEMENT. NOW THEREFORE, in consideration of promises, covenants and agreements hereinafter contain, the parties agree as follows:

BROKER AGREEMENT. NOW THEREFORE, in consideration of promises, covenants and agreements hereinafter contain, the parties agree as follows: THIS AGREEMENT is entered into in the State of California this day of 2006, between Crestline Funding Corporation, hereinafter referred to as Crestline Funding, and, hereinafter referred to as Broker.

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT THIS BUSINESS ASSOCIATE AGREEMENT (this Agreement ) is made effective as of the day of 2014 (the Effective Date ), by and between Sarasota County Public Hospital District,

More information

SUB-PRODUCER AGREEMENT (Alfa Insurance Agent)

SUB-PRODUCER AGREEMENT (Alfa Insurance Agent) www.neagencies.com 6467 Main Street, Suite 104 Williamsville, NY 14221 phone: (800) 333-0980 fax: (716) 954-0219 SUB-PRODUCER AGREEMENT (Alfa Insurance Agent) Northeast Agencies, Inc. ( NEA ), a New York

More information

PROFESSIONAL/CONSULTING SERVICES AGREEMENT

PROFESSIONAL/CONSULTING SERVICES AGREEMENT This SERVICES AGREEMENT ( Agreement ) is entered into by and between the undersigned, ( Contractor ), (Social Security Number or Federal I.D. No.), located at and Texas Southern University ( TSU ), an

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT THIS BUSINESS ASSOCIATE AGREEMENT (the AGREEMENT ) is entered into this (the "Effective Date"), between Delta Dental of Tennessee ( Covered Entity ) and ( Business Associate

More information

HSHS BUSINESS ASSOCIATE AGREEMENT BACKGROUND AND RECITALS

HSHS BUSINESS ASSOCIATE AGREEMENT BACKGROUND AND RECITALS HSHS BUSINESS ASSOCIATE AGREEMENT This HIPAA Business Associate Agreement, ( Agreement ) is entered into on the date(s) set forth below by and between Hospital Sisters Health System on its own behalf and

More information

INDEPENDENT CONTRACTOR AGREEMENT

INDEPENDENT CONTRACTOR AGREEMENT INDEPENDENT CONTRACTOR AGREEMENT This Agreement, made this day of, between, Florida Rock Stars Inc. hereinafter referred to as "Company", located at 205 N Flagler Ave, Homestead FL 33030 and hereinafter

More information

4. ACCESS TO THE SITE

4. ACCESS TO THE SITE Service Agreement for Mortgage Lenders & Appraisers for compliance with the Appraisal Independence regulation included in the Dodd-Frank Wall Street Reform and Consumer Protection Act. This Service Agreement

More information

ADDENDUM 5 - BUSINESS ASSOCIATE AGREEMENT

ADDENDUM 5 - BUSINESS ASSOCIATE AGREEMENT ADDENDUM 5 - BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (the BAA ) is effective as of (the Effective Date ) and is entered into by and between, with an address of (the Covered Entity

More information

In the Agreement, "we", us" and "our" refer to Computerisms. "you" or "your" refers to the Client.

In the Agreement, we, us and our refer to Computerisms. you or your refers to the Client. Web Hosting Agreement! This Agreement covers the terms and conditions under which Computerisms provides web-hosting services to the agreeing party. As an organization or individual applying for web-hosting

More information

Health Plan Select, Inc. Business Associate Privacy Addendum To The Service Agreement

Health Plan Select, Inc. Business Associate Privacy Addendum To The Service Agreement This (hereinafter referred to as Addendum ) by and between Athens Area Health Plan Select, Inc. (hereinafter referred to as HPS ) a Covered Entity under HIPAA, and INSERT ORG NAME (hereinafter referred

More information

CATHOLIC SOCIAL SERVICES BUSINESS ASSOCIATE AGREEMENT

CATHOLIC SOCIAL SERVICES BUSINESS ASSOCIATE AGREEMENT CATHOLIC SOCIAL SERVICES BUSINESS ASSOCIATE AGREEMENT THIS BUSINESS ASSOCIATE AGREEMENT (Agreement) is made this day of, 20, between the Catholic Social Services ( CSS ), whose business address is 3710

More information

First Source Capital Mortgage, Inc.

First Source Capital Mortgage, Inc. First Source Capital Mortgage, Inc. Please submit the following items along with your application package to expedite your approval process. If you have any questions or need additional information please

More information

3. DUTIES: The following duties shall be required of Agent: No minimum production level set

3. DUTIES: The following duties shall be required of Agent: No minimum production level set Business Finance Agent Agreement This Agreement is between The Business Finance Store ("Company") a division of FinanceMark Inc. a Nevada Corporation and you, referred to as Agent from this point forth.

More information

Lenders Axis LLC Working Capital Sales Agent Agreement Lenders Axis Sales Agent Agreement V 2.0

Lenders Axis LLC Working Capital Sales Agent Agreement Lenders Axis Sales Agent Agreement V 2.0 Lenders Axis LLC Working Capital Sales Agent Agreement Lenders Axis Sales Agent Agreement V 2.0 This Sales Agent Agreement (the Agreement ) is made and effective as of this the day of 13 by and between

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (the Agreement ), is made effective as of the sign up date on the login information page of the CarePICS.com website, by and between CarePICS,

More information

GENERAL AGENT AGREEMENT

GENERAL AGENT AGREEMENT Complete Wellness Solutions, Inc. 6338 Constitution Drive Fort Wayne, Indiana 46804 GENERAL AGENT AGREEMENT This Agreement is made by and between Complete Wellness Solutions, Inc. (the Company ) and (the

More information

INDEPENDENT CONTRACTOR AGREEMENT (ICA)

INDEPENDENT CONTRACTOR AGREEMENT (ICA) INDEPENDENT CONTRACTOR AGREEMENT (ICA) (This agreement is not a construction contract within the meaning of Civil Code section 2783, and is not an agreement for the provision of construction services within

More information

NetSuite Customer ID: _

NetSuite Customer ID: _ NetSuite Customer ID: _ Online Commission Agreement This Web Sales Commission Agreement (hereinafter Agreement ) is made by and agreed to between Therapon Skin Health, Limited Partnership (TSH) and (hereafter

More information

UNIVERSITY PHYSICIANS OF BROOKLYN HIPAA BUSINESS ASSOCIATE AGREEMENT CONTRACT NO(S):

UNIVERSITY PHYSICIANS OF BROOKLYN HIPAA BUSINESS ASSOCIATE AGREEMENT CONTRACT NO(S): UNIVERSITY PHYSICIANS OF BROOKLYN HIPAA BUSINESS ASSOCIATE AGREEMENT CONTRACT NO(S): THIS AGREEMENT is made by and between UNIVERSITY PHYSICIANS OF BROOKLYN, INC., located at 450 Clarkson Ave., Brooklyn,

More information

Online Account Management Broker s User Guide

Online Account Management Broker s User Guide Online Account Management Broker s User Guide TABLE OF CONTENTS BROKER SINGLE SIGN-ON ACTIVATION ------------------------------------------------------------------- 3 BROKER SINGLE SIGN-ON REQUEST FORM

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT COLUMBIA AGREEMENT BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ( Agreement ) is entered into as of ( Effective Date ) by and between The Trustees of Columbia University in the City of

More information

SOLICITOR APPLICATION

SOLICITOR APPLICATION Date: / / SOLICITOR APPLICATION General Information Name: Birth Date: / / Office Address: City: State: Zip: E-mail address: Business phone: ( ) - Fax number: ( ) - Assistant s Name: Registered Investment

More information

TERMS OF BUSINESS AGREEMENT

TERMS OF BUSINESS AGREEMENT TERMS OF BUSINESS AGREEMENT 2525 E Camelback Rd, Suite 800 As used in this Agreement, The Keating Group, Inc. (tkg) shall refer to any business unit or entity that may be affiliated through common ownership

More information

AGREEMENT BETWEEN COUNTY AND CONTRACTOR FOR GOODS AND SERVICES. THIS AGREEMENT, effective this 20th day of April in the year, 2015, between:

AGREEMENT BETWEEN COUNTY AND CONTRACTOR FOR GOODS AND SERVICES. THIS AGREEMENT, effective this 20th day of April in the year, 2015, between: AGREEMENT BETWEEN COUNTY AND CONTRACTOR FOR GOODS AND SERVICES THIS AGREEMENT, effective this 20th day of April in the year, 2015, between: MARTIN COUNTY BOARD OF COUNTY COMMISSIONERS, a political subdivision

More information

EmoeHost agrees to provide to Client the Services agreed upon between EmoeHost and Client as selected by Client at www.emoehostmaine.com.

EmoeHost agrees to provide to Client the Services agreed upon between EmoeHost and Client as selected by Client at www.emoehostmaine.com. EmoeHost Service Agreement 1. Site Services EmoeHost agrees to provide to Client the Services agreed upon between EmoeHost and Client as selected by Client at www.emoehostmaine.com. 2. Payment & Invoicing

More information

Reverse Mortgage Specialist

Reverse Mortgage Specialist ADVISOR/LENDER APPLICANT ASSISTANCE AGREEMENT This ADVISOR/LENDER APPLICANT ASSISTANCE AGREEMENT (the Agreement ) is made this day of, 200_ by and between Oaktree Funding Corporation, a California Corporation

More information

Rediff Hosting Business Associate Agreement

Rediff Hosting Business Associate Agreement Rediff Hosting Business Associate Agreement THIS REDIFF HOSTING BUSINESS ASSOCIATE AGREEMENT (the "Agreement") shall constitute binding terms between REDIFF.COM INDIA LIMITED, a Company incorporated under

More information

EDI TRADING PARTNER AGREEMENT BETWEEN DIRECT SUBMITTER AND WELLPOINT, INC.

EDI TRADING PARTNER AGREEMENT BETWEEN DIRECT SUBMITTER AND WELLPOINT, INC. EDI TRADING PARTNER AGREEMENT BETWEEN DIRECT SUBMITTER AND WELLPOINT, INC. This EDI Trading Partner Agreement, ( Agreement ) is entered into by and between Hoschton Medical, PC ( Direct Submitter or Trading

More information

AGREEMENT FOR ACCESS TO PROTECTED HEALTH INFORMATION BETWEEN WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND

AGREEMENT FOR ACCESS TO PROTECTED HEALTH INFORMATION BETWEEN WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND AGREEMENT FOR ACCESS TO PROTECTED HEALTH INFORMATION BETWEEN WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND THIS AGREEMENT for Access to Protected Health Information ( PHI ) ( Agreement ) is entered

More information

INVESTMENT ADVISER REPRESENTATIVE AGREEMENT

INVESTMENT ADVISER REPRESENTATIVE AGREEMENT INVESTMENT ADVISER REPRESENTATIVE AGREEMENT This investment adviser representative agreement ( Agreement ), made as of, 20, is between Partners for Prosperity, Inc., a Nevada corporation, with the principal

More information

BUSINESS ASSOCIATE AND DATA USE AGREEMENT NAME OF COVERED ENTITY: COVERED ENTITY FEIN/TAX ID: COVERED ENTITY ADDRESS:

BUSINESS ASSOCIATE AND DATA USE AGREEMENT NAME OF COVERED ENTITY: COVERED ENTITY FEIN/TAX ID: COVERED ENTITY ADDRESS: BUSINESS ASSOCIATE AND DATA USE AGREEMENT NAME OF COVERED ENTITY: COVERED ENTITY FEIN/TAX ID: COVERED ENTITY ADDRESS:, City State Zip This Business Associate and Data Use Agreement ( Agreement ) is effective

More information

ELKHART COUNTY BOARD OF REALTORS AND MULTIPLE LISTING SERVICE OF ELKHART COUNTY INC. VIRTUAL OFFICE WEBSITE (VOW) LICENSE AGREEMENT

ELKHART COUNTY BOARD OF REALTORS AND MULTIPLE LISTING SERVICE OF ELKHART COUNTY INC. VIRTUAL OFFICE WEBSITE (VOW) LICENSE AGREEMENT ELKHART COUNTY BOARD OF REALTORS AND MULTIPLE LISTING SERVICE OF ELKHART COUNTY INC. VIRTUAL OFFICE WEBSITE (VOW) LICENSE AGREEMENT This License Agreement (the Agreement) is made and entered into between

More information

Expanded Market Programs

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

More information

GSG APPRAISAL MANAGEMENT, LLC INDEPENDENT FEE APPRAISER APPLICATION

GSG APPRAISAL MANAGEMENT, LLC INDEPENDENT FEE APPRAISER APPLICATION GSG APPRAISAL MANAGEMENT, LLC INDEPENDENT FEE APPRAISER APPLICATION Thank you for your interested in joining the GSG Appraisal Management (GSG AMC) residential appraisal panel. In order to be considered

More information

WellDyneRxWEST Customer (TPA, Broker, Consultant, Group Health Plan, and other).

WellDyneRxWEST Customer (TPA, Broker, Consultant, Group Health Plan, and other). WellDyneRxWEST Customer (TPA, Broker, Consultant, Group Health Plan, and other). RE: HIPAA Business Associate Agreement Effective 4/14/04 Business Associate: WellDyneRxWEST, Inc., a Colorado Corporation

More information

Domain Registration Agreement

Domain Registration Agreement Domain Registration Agreement IF YOU ACCEPT THIS AGREEMENT WITHOUT READING IT IN ITS ENTIRETY YOU ARE STILL BOUND BY THIS AGREEMENT IN ITS ENTIRETY 1. AGREEMENT. In this Registration Agreement ("Agreement")

More information

PRODUCER AGREEMENT. Hereinafter ("Producer"), in consideration of the mutual covenants and agreements herein contained, agree as follows:

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

More information

Acquia Certification Program Agreement

Acquia Certification Program Agreement BY CLICKING THE ACCEPT BUTTON ON THE PROGRAM TERMS ACCEPTANCE PAGE OF ANY ACQUIA CERTIFICATION PROGRAM EXAM, YOU ACCEPT AND AGREE TO BE BOUND BY THIS ACQUIA CERTIFICATION PROGRAM AGREEMENT, INCLUDING ANY

More information

Everest/WFGIA New Agent Contracting Set Up Sheet

Everest/WFGIA New Agent Contracting Set Up Sheet Everest/WFGIA New Agent Contracting Set Up Sheet WFG Code # Agent s Name: Address: Apt./Suite No.: Phone Number: E-Mail Address: Checklist: Completed Producer History Sheet (9511) Contract (3357) signed

More information

Registration Agreement

Registration Agreement Registration Agreement In order to complete the registration process you must read and agree to be bound by all terms and conditions herein. TERMS AND CONDITIONS 1.Definitions "You" and "your" refers to

More information

MISSOURI HIGHWAYS AND TRANSPORTATION COMMISSION ELECTRONIC SIGNATURE AGREEMENT

MISSOURI HIGHWAYS AND TRANSPORTATION COMMISSION ELECTRONIC SIGNATURE AGREEMENT CCO Form: DE06 Approved: 02/14 (AR) Revised: Modified: MISSOURI HIGHWAYS AND TRANSPORTATION COMMISSION ELECTRONIC SIGNATURE AGREEMENT THIS AGREEMENT is entered into by the Missouri Highways and Transportation

More information

SERVICE AGREEMENT FOR FULL REIMBURSEMENT MANAGEMENT

SERVICE AGREEMENT FOR FULL REIMBURSEMENT MANAGEMENT SERVICE AGREEMENT FOR FULL REIMBURSEMENT MANAGEMENT This Service Agreement is entered into by and between the New Hampshire Alcohol and Other Drug Service Providers Association, a New Hampshire non-profit

More information

Processing Done Right

Processing Done Right Processing Done Right 818.510.3560 818.304.7141 fax [email protected] www.processingdoneright.net 25346 Lacebark Drive Murrieta, CA 92563 MORTGAGE LOAN PROCESSING AGREEMENT This agreement is made

More information

Web Site Development Agreement

Web Site Development Agreement Web Site Development Agreement 1. Parties; Effective Date. This Web Site Development Agreement ( Agreement ) is between Plug-N-Run, its affiliates, (including but not limited to USA Financial, USA Financial

More information

AON HEWITT DEFINED CONTRIBUTION NEXUS PARTICIPATION AGREEMENT

AON HEWITT DEFINED CONTRIBUTION NEXUS PARTICIPATION AGREEMENT AON HEWITT DEFINED CONTRIBUTION NEXUS PARTICIPATION AGREEMENT Participation Agreement (this Agreement ) made as of the day of, 20, by and among Hewitt Financial Services LLC ( HFS ) and ( Fund Manager

More information

South Coast Air Quality Management District

South Coast Air Quality Management District South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765 4178 (909) 396 2000 www.aqmd.gov Business Information Request Dear SCAQMD Contractor/Supplier: South Coast Air Quality

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT 1. The terms and conditions of this document entitled Business Associate Agreement ( Business Associate Agreement ), shall be attached to and incorporated by reference in the

More information

CUSTOMER LIST PURCHASE AGREEMENT BY AND BETWEEN RICHARD PENNER SELLER. and S&W SEED COMPANY BUYER

CUSTOMER LIST PURCHASE AGREEMENT BY AND BETWEEN RICHARD PENNER SELLER. and S&W SEED COMPANY BUYER EXHIBIT 10.1 CUSTOMER LIST PURCHASE AGREEMENT BY AND BETWEEN RICHARD PENNER as SELLER and S&W SEED COMPANY as BUYER CUSTOMER LIST PURCHASE AGREEMENT THIS CUSTOMER LIST PURCHASE AGREEMENT ( Agreement )

More information

.uk Registration Agreement

.uk Registration Agreement 1/6.uk Registration Agreement In order that a party may hold a valid.co.uk or.org.uk domain name registration, Tucows Inc. requires that all registrants adhere to certain terms and conditions. As an organization

More information

INDEPENDENT CONTRACTOR AGREEMENT

INDEPENDENT CONTRACTOR AGREEMENT INDEPENDENT CONTRACTOR AGREEMENT This Independent Contractor Agreement ("Agreement") is made and effective this day of, 20. BETWEEN: (the "Independent Contractor"), a company organized and existing under

More information

FACILITIES USE AGREEMENT

FACILITIES USE AGREEMENT FACILITIES USE AGREEMENT Effective Date: Sponsor: Sponsor Address: Facility: THIS FACILITIES USE AGREEMENT ( Agreement ) is effective as of the Effective Date set forth above, by and between Temple University

More information

ii. sold, licensed, transferred or assigned to no other party for a period of thirty (30) days;

ii. sold, licensed, transferred or assigned to no other party for a period of thirty (30) days; Tymax Media Vendor Operating Agreement Tymax Media Vendor Operating Agreement (the "Agreement") is made and entered into by and between Tymax Media ("Tymax Media," us or "we"), and you, ("you" or "Vendor")

More information

HIPAA BUSINESS ASSOCIATE AGREEMENT

HIPAA BUSINESS ASSOCIATE AGREEMENT HIPAA BUSINESS ASSOCIATE AGREEMENT This Agreement ( Agreement ) is entered into by and between Wittman Enterprises, LLC ( Business Associate ) and City of Coronado Fire Department ( Covered Entity ). RECITALS

More information

ENOM, INC. REGISTRATION AGREEMENT

ENOM, INC. REGISTRATION AGREEMENT ENOM, INC. REGISTRATION AGREEMENT This Registration Agreement ("Agreement") sets forth the terms and conditions of your use of enom, Inc.'s ("enom") domain name registration services to register an Internet

More information

PsyBar, LLC 6600 France Avenue South, Suite 640 Edina, MN 55435 Telephone: (952) 285-9000 Facsimile: (952) 848-1798

PsyBar, LLC 6600 France Avenue South, Suite 640 Edina, MN 55435 Telephone: (952) 285-9000 Facsimile: (952) 848-1798 PsyBar, LLC 6600 France Avenue South, Suite 640 Edina, MN 55435 Telephone: (952) 285-9000 Facsimile: (952) 848-1798 Updated 12/8/15 PSYBAR, L. L. C. INDEPENDENT CONTRACTOR AGREEMENT PsyBar attempts to

More information

MEMORANDUM OF UNDERSTANDING Between COMPANY And MISSOURI STATE UNIVERSITY

MEMORANDUM OF UNDERSTANDING Between COMPANY And MISSOURI STATE UNIVERSITY MEMORANDUM OF UNDERSTANDING Between COMPANY And MISSOURI STATE UNIVERSITY THIS MEMORANDUM OF UNDERSTANDING (hereinafter referred to as MOU) is by and between COMPANY, LOCATION AND TYPE OF COMPANY (hereinafter

More information

BUSINESS ON-LINE BANKING AGREEMENT

BUSINESS ON-LINE BANKING AGREEMENT BUSINESS ON-LINE BANKING AGREEMENT THIS BUSINESS ON-LINE BANKING AGREEMENT (this Agreement ) is for Business On-Line Banking Services provided by First National Bank of Northern California, ( Bank or we

More information

BUSINESS ASSOCIATE ADDENDUM

BUSINESS ASSOCIATE ADDENDUM BUSINESS ASSOCIATE ADDENDUM This Business Associate Addendum ( Addendum ) is entered into this day of 2014. Perry Memorial Hospital ( Covered Entity ) and [ABC Company] ( Business Associate ) referred

More information

STATE OF NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES BUSINESS ASSOCIATE ADDENDUM

STATE OF NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES BUSINESS ASSOCIATE ADDENDUM STATE OF NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES BUSINESS ASSOCIATE ADDENDUM BETWEEN The Division of Health Care Financing and Policy Herein after referred to as the Covered Entity and (Enter Business

More information

AGREEMENT AND TERMS OF USE

AGREEMENT AND TERMS OF USE AGREEMENT AND TERMS OF USE The website located at www.100womeninhedgefunds.org and the services of 100 Women in Hedge Funds ( 100WHF ) available thereon (collectively, the Site ), together with the networking

More information

ELECTRONIC FILER AGREEMENT [REVISED JANUARY 1, 2014]

ELECTRONIC FILER AGREEMENT [REVISED JANUARY 1, 2014] This Electronic Filer Agreement ( Agreement ) is made by and between the DII Industries, LLC Asbestos PI Trust ( Trust ), P.O. Box 821628, Dallas, Texas 75382, and the law firm of, with offices at ( Law

More information

BUSINESS ASSOCIATE ADDENDUM

BUSINESS ASSOCIATE ADDENDUM BUSINESS ASSOCIATE ADDENDUM This BA Agreement, effective as of the effective date of the Terms of Use, adds to and is made part of the Terms of Use by and between Business Associate and Covered Entity.

More information

HOMEOWNERS LIMITED REPRESENTATIVE SERVICE AGREEMENT With SERVICE FIRST INSURANCE GROUP LLC. Of CYPRESS PROPERTY & CASUALTY INSURANCE COMPANY

HOMEOWNERS LIMITED REPRESENTATIVE SERVICE AGREEMENT With SERVICE FIRST INSURANCE GROUP LLC. Of CYPRESS PROPERTY & CASUALTY INSURANCE COMPANY HOMEOWNERS LIMITED REPRESENTATIVE SERVICE AGREEMENT With SERVICE FIRST INSURANCE GROUP LLC. Of CYPRESS PROPERTY & CASUALTY INSURANCE COMPANY This Agreement is made and entered into effective as of October

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT THIS BUSINESS ASSOCIATE AGREEMENT ( Agreement ) by and between OUR LADY OF LOURDES HEALTH CARE SERVICES, INC., hereinafter referred to as Covered Entity, and hereinafter referred

More information

CITY OF SHERWOOD Independent Contractor Agreement (for Personal Services or for Public Works under $25,000)

CITY OF SHERWOOD Independent Contractor Agreement (for Personal Services or for Public Works under $25,000) CITY OF SHERWOOD Independent Contractor Agreement (for Personal Services or for Public Works under $25,000) Dated: Parties: City of Sherwood ( CITY ) 20 NW Washington Street Sherwood, Oregon 97140 And

More information

HIPAA BUSINESS ASSOCIATE AGREEMENT

HIPAA BUSINESS ASSOCIATE AGREEMENT HIPAA BUSINESS ASSOCIATE AGREEMENT This HIPAA Business Associate Agreement and is made between BEST Life and Health Insurance Company ( BEST Life ) and ( Business Associate ). RECITALS WHEREAS, the U.S.

More information

CONSULTING SERVICES and CONTRACT LABOR AGREEMENT

CONSULTING SERVICES and CONTRACT LABOR AGREEMENT CONSULTING SERVICES and CONTRACT LABOR AGREEMENT This Consulting Services and Contract Labor Agreement ( Agreement ) is made and entered into as of the day of, 20 (the Effective Date ) by and between Volkswagen

More information

State of New Jersey New Jersey Public Broadcasting System New Jersey Network Standard Terms and Conditions

State of New Jersey New Jersey Public Broadcasting System New Jersey Network Standard Terms and Conditions 1. STANDARD TERMS AND CONDITIONS APPLICABLE TO THE CONTRACT: Unless the bidder is specifically instructed otherwise in the Request for Proposals (RFP), the following terms and conditions shall apply to

More information

GDS Data Systems, Inc. Terms & Conditions for GDS Network Services (GDS Connect / GDS Insight / GDS Cloud)

GDS Data Systems, Inc. Terms & Conditions for GDS Network Services (GDS Connect / GDS Insight / GDS Cloud) GDS Data Systems, Inc. Terms & Conditions for GDS Network Services (GDS Connect / GDS Insight / GDS Cloud) This Agreement establishes the Terms and Conditions that shall govern the sale of Services or

More information

SAMPLE BUSINESS ASSOCIATE AGREEMENT

SAMPLE BUSINESS ASSOCIATE AGREEMENT SAMPLE BUSINESS ASSOCIATE AGREEMENT THIS AGREEMENT IS TO BE USED ONLY AS A SAMPLE IN DEVELOPING YOUR OWN BUSINESS ASSOCIATE AGREEMENT. ANYONE USING THIS DOCUMENT AS GUIDANCE SHOULD DO SO ONLY IN CONSULT

More information

Tulane University. Tulane University Business Associates Agreement SCOPE OF POLICY STATEMENT OF POLICY IMPLEMENTATION OF POLICY

Tulane University. Tulane University Business Associates Agreement SCOPE OF POLICY STATEMENT OF POLICY IMPLEMENTATION OF POLICY Tulane University DEPARTMENT: General Counsel s POLICY DESCRIPTION: Business Associates Office -- HIPAA Agreement PAGE: 1 of 1 APPROVED: April 1, 2003 REVISED: November 29, 2004, December 1, 2008, October

More information

LIBERTY BANK ONLINE BILL PAYMENT ( BILL PAYMENT SERVICE ).

LIBERTY BANK ONLINE BILL PAYMENT ( BILL PAYMENT SERVICE ). LIBERTY BANK ONLINE BILL PAYMENT ( BILL PAYMENT SERVICE ). 1. USING THE BILL PAYMENT SERVICE As used in this Agreement, the term Payee means the person or entity to whom you wish a bill payment to be directed;

More information

Axosoft Software as a Service Agreement

Axosoft Software as a Service Agreement Axosoft Software as a Service Agreement IMPORTANT PLEASE READ CAREFULLY: BY CREATING AN ACCOUNT OR BY UTILIZING THE AXOSOFT SERVICE YOU AGREE TO BE BOUND BY THESE TERMS AND CONDITIONS. This software as

More information

TEXAS ASSOCIATION OF REALTORS INDEPENDENT CONTRACTOR AGREEMENT FOR SALES ASSOCIATE. Robyn Jones Homes, LLC

TEXAS ASSOCIATION OF REALTORS INDEPENDENT CONTRACTOR AGREEMENT FOR SALES ASSOCIATE. Robyn Jones Homes, LLC 1 TEXAS ASSOCIATION OF REALTORS INDEPENDENT CONTRACTOR AGREEMENT FOR SALES ASSOCIATE USE OF THIS FORM BY PERSONS WHO ARE NOT MEMBERS OF THE TEXAS ASSOCIATION OF REALTORS IS NOT AUTHORIZED Texas Association

More information

Insurance Producer Agreement

Insurance Producer Agreement Insurance Producer Agreement Section 1 - Producer s Authority The Producer shall periodically submit risks to the Company for its consideration as authorized by the Company. These risks shall be located

More information

These TERMS AND CONDICTIONS (this Agreement ) are agreed to between InfluencersAtWork,

These TERMS AND CONDICTIONS (this Agreement ) are agreed to between InfluencersAtWork, TERMS AND CONDITIONS INFLUENCERS AT WORK These TERMS AND CONDICTIONS (this Agreement ) are agreed to between InfluencersAtWork, Ltd. ( InfluencerAtWork ) and you, or if you represent a company or other

More information

ELECTRONIC FILER AGREEMENT

ELECTRONIC FILER AGREEMENT ELECTRONIC FILER AGREEMENT This Electronic Filer Agreement (the Agreement) is made by and among the Celotex Asbestos Settlement Trust (the Celotex Trust), and, after assignment as hereinafter provided,

More information

ONLINE CREDIT REPORTING S SUITE SOLUTIONS MEMBERSHIP GUIDELINES

ONLINE CREDIT REPORTING S SUITE SOLUTIONS MEMBERSHIP GUIDELINES ONLINE CREDIT REPORTING S SUITE SOLUTIONS MEMBERSHIP GUIDELINES The following procedures are needed to establish your account in order to download three bureau credit reports into your bankruptcy software.

More information

Real Estate Salesman Agreement (Independent Contractor)

Real Estate Salesman Agreement (Independent Contractor) Real Estate Salesman Agreement (Independent Contractor) This Packet Includes: 1. General Information 2. Instructions and Checklist 3. Real Estate Salesman Agreement (Independent Contractor ) 1 General

More information

INDEPENDENT CONTRACTOR AGREEMENT (Between Broker and Licensee)

INDEPENDENT CONTRACTOR AGREEMENT (Between Broker and Licensee) INDEPENDENT CONTRACTOR AGREEMENT (Between Broker and Licensee) This Independent Contractor Agreement ( Agreement ), is made between Realtyka LLC ( Broker ), operating under the assumed name Real and (

More information

AGREEMENT FOR INVESTMENT CONSULTING SERVICES AND MARIN COUNTY EMPLOYEES RETIREMENT ASSOCIATION

AGREEMENT FOR INVESTMENT CONSULTING SERVICES AND MARIN COUNTY EMPLOYEES RETIREMENT ASSOCIATION AGREEMENT FOR INVESTMENT CONSULTING SERVICES AND MARIN COUNTY EMPLOYEES RETIREMENT ASSOCIATION This Agreement for Investment Consulting Services (hereinafter referred to as the Agreement ) is made and

More information

BUSINESS ASSOCIATE AGREEMENT

BUSINESS ASSOCIATE AGREEMENT BUSINESS ASSOCIATE AGREEMENT THIS BUSINESS ASSOCIATE AGREEMENT is made and entered into as of the day of, 2013 ( Effective Date ), by and between [Physician Practice] on behalf of itself and each of its

More information

Insurance Producer Agreement

Insurance Producer Agreement Insurance Producer Agreement THIS AGREEMENT ( Agreement ) is made and entered into on this day of. (the Effective Date ), by and between KPS Health Plans (hereinafter referred to as KPS ), a duly licensed

More information

University Healthcare Physicians Compliance and Privacy Policy

University Healthcare Physicians Compliance and Privacy Policy Page 1 of 11 POLICY University Healthcare Physicians (UHP) will enter into business associate agreements in compliance with the provisions of the Health Insurance Portability and Accountability Act of

More information