REQUESTED BY. AUTHORIZED SIGNER'S NAME AUTHORIZED SIGNATURE:___________________________________________________________ PHONE NUMBER:___________________________________________________________________ FROM ACCOUNT # _________________________ TO ACCOUNT #__________________________ REQUESTED TRANSACTION TYPE REQUEST DOLLAR AMOUNT $_________________________________ PRINCIPAL INCREASE (ADVANCE) $_________________________________ PRINCIPAL PAYMENT (ONLY) $_________________________________ INTEREST PAYMENT (ONLY) $_________________________________ PRINCIPAL AND INTEREST (PAYMENT) $_________________________________ OTHER INSTRUCTIONS:_____________________________________________________________ ________________________________________________________________________________ All representations and warranties of Borrower stated in the Loan and Security Agreement are true, correct and complete in all material respects as of the date of the telephone request for an Advance confirmed by this Borrowing Certificate; provided, however, that those representations and warranties expressly referring to another date shall be true, correct and complete in all material respects as of such date. BANK USE ONLY

REQUESTED BY. AUTHORIZED SIGNER'S NAME AUTHORIZED SIGNATURE:_____________________________________________________ PHONE NUMBER:___________________________________________________________________ FROM ACCOUNT #_________________________ TO ACCOUNT#_______________________ REQUESTED TRANSACTION TYPE REQUEST DOLLAR AMOUNT -------------------------- --------------------- PRINCIPAL INCREASE (ADVANCE) $_____________________________________ PRINCIPAL PAYMENT (ONLY) $_____________________________________ INTEREST PAYMENT (ONLY) $_____________________________________ PRINCIPAL AND INTEREST (PAYMENT) $_____________________________________ OTHER INSTRUCTIONS:_______________________________________________________ __________________________________________________________________________ All representations and warranties of Borrower stated in the Loan Agreement are true, correct and complete in all material respects as of the date of the telephone request for and Advance confirmed by this Borrowing Certificate; provided, however, that those representations and warranties expressly referring to another date shall be true, correct and complete in all material respects as of such date. =============================================================================== ------------------------------------------------------------------------------- BANK USE ONLY: TELEPHONE REQUEST: ----------------- The following person is authorized to request the loan payment transfer/loan advance on the advance designated account and is known to me. ____________________________________ ______________________________________ Authorized Requester Phone # ____________________________________ ______________________________________ Received by (Bank) Phone # ___________________________________ Authorized Signature (Bank) ------------------------------------------------------------------------------- EXHIBIT D BORROWING BASE CERTIFICATE COLLATERAL SCHEDULE (FOREIGN A/R LINE OF CREDIT) ------------------------------------------------------------------------- Borrower: LTX Corporation . Lender: Silicon Valley Bank LTX Park at University Drive 0000 Xxxxxx Xxxxx Xxxxxxxx, Xxxxxxxxxxxxx 00000 Xxxxx Xxxxx, XX 00000 Commitment Amount: $5,000,000.00 ------------------------------------------------------------------------- FOREIGN ACCOUNTS RECEIVABLE FROM EXPORT ACTIVITIES

Examples of REQUESTED BY in a sentence

APPENDIX B – ABILITIES FORM Employee Group: Requested By: WSIB Claim: Yes No WSIB Claim Number: To the Employee: The purpose for this form is to provide the Board with information to assess whether you are able to perform the essential duties of your position, and understand your restrictions and/or limitations to assess workplace accommodation if necessary.
APPENDIX B – ABILITIES FORM‌ Employee Group: Requested By: WSIB Claim: Yes No WSIB Claim Number: To the Employee: The purpose for this form is to provide the Board with information to assess whether you are able to perform the essential duties of your position, and understand your restrictions and/or limitations to assess workplace accommodation if necessary.
Test Result Summary: Testing Item Remark:mg/kg = Milligram Per Kilogram = ppm ND = Not Detected Tests Conducted (As Requested By The Applicant) (B)RoHS Requirement:Restricted SubstancesThe Above Limits Were Quoted From 2002/95/EC And Amendment 2005/618/EC For Homogeneous Material.
Tests Conducted (As Requested By The Applicant) (B)RoHS Requirement:Restricted SubstancesThe Above Limits Were Quoted From 2002/95/EC And Amendment 2005/618/EC For Homogeneous Material.
Test Result Summary: Testing Item Remark:mg/kg = Milligram Per Kilogram = ppmmg/kg With 50cm2 = Milligram Per Kilogram With 50 Square Centimeter ND = Not DetectedN=Negative Tests Conducted (As Requested By The Applicant) (B)RoHS Requirement:Restricted SubstancesThe Above Limits Were Quoted From 2002/95/EC And Amendment 2005/618/EC For Homogeneous Material.

More Definitions of REQUESTED BY

REQUESTED BY. ACCEPTED BY: Signed: Signed: FOR PAYROLL RECORD PURPOSES Date Employee Shift Worked Shift Worked For Original Return APPROVED BY: Department Supervisor: JOB SECURITY It is agreed that all existing articles, letters of agreement and previous correspondence relative to Job Security shall be deemed to be superseded by this article.

REQUESTED BY. Report To: Job Location: Date Required: Start Time: HOURS 5 X 8s ( ) 4 X 10s ( ) 6 X 10s ( ) Other ******************************** Day Shift Night Shift ******************************** Approximate Duration Days Weeks Plus Months Plus Orientation Time: Trade Journeyman Apprentice Year Steamfitter/Pipefitter Plumber Sprinklerfitter Basic Welder F3/4 Stainless/Chrome Welder 6/5 Refrigeration Mechanic Instrument Mechanic Gasfitter Pipefitter/Rigger Fiberglass Conditions of Employment are: Industrial Contract: Rate: Commercial Contract: Rate: “Strict Adherence to Contractor Safety Policy & Rules” Special Requirements: Notes: Welder Classification - Legend □ Welder □ SS Stick (F5) □ Inconel Stick (F43) □ Chrome Stick (F4) □ Carbon Stick (F4) □ B Welder (F3/F4) □ SS Tig (F6) □ Inconel Tig/Stick (f43/F43) □ Chrome Tig Stick (F6/F4) □ Carbon Tig/Stick (F6/F4) □ CWB Flux-cored □ SS Stick Overlay (F5) □ Inconel Stick Overlay (F43) □ Other - Specify □ SS Chrome Tig Stick (F6/5) Name: (First Name) (Initial) (Last Name) Street Address: Apt. No.: P.O. Box: City/Town: Province: Postal Code: Home Phone: ( ) Other Phone: ( ) S.I.N: Hospitalization No.: Net Tax Claim Code: ( ) Other Phone: ( ) Home Phone: Address: Name:

REQUESTED BY. EMAIL: CONTACT PERSON: PHONE: ADDRESS: CITY: STATE: ZIP: COPY OF INSURANCE RECEIVED: INITIAL: Date of Event: Time of Event: From: AM/PM To: AM/PM Complex(es) Needed: Rental Charge per Tournament: $ This Agreement entered into this day of , 20 , by and between (hereinafter referred to as “Renter”), who is duly authorized to act herein, and the City of Shreveport, Public Assembly and Recreation (hereinafter referred to as “City” or “SPAR”), herein represented by its Director who is duly authorized to act herein.

REQUESTED BY. Incident Supervisor: Incident Position: (print/sign legibly) Contact Phone: Date: Approved By: Contractor/CRWB: Date: Team IC, Deputy IC or OSC: (print/sign legibly) Contact Phone: Date: EXHIBIT IV - SAMPLE INVOICE FORM Company Name: Invoice # Company Remittance Address: Date: Agreement #: Addressee: Attn: Address: Description Quantity Unit Price Extension Incident Name: Incident Number: $ $ $ $ $ $ 0 $ 0 $ 0 $ 0 $ 0 TOTAL DUE $ $ 0 0 $ 0 $ 0

REQUESTED BY. [NAME], Senior Facilities Analyst Office of Real Estate and Facilities Management Judicial Council of California 0000 Xxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxxx, XX 00000-0000 [PHONE NUMBER] DATE: Invoices Associated with this Work Authorization If your firm is selected, please make sure you send all invoices to the following email address: Judicial Xxxxxxx_Xxxxxxxxxxxxx_Xxxxxxx@xxx.xx.xxx In addition, please include the information listed below on a cover sheet with all invoices submitted. Invoices will not be approved without this information. Date: [ENTER DATE] Project Name: Proposed Main Facility – Add Site Name Contractor’s Proposal [AGREEMENT NO.] Judicial Council PO Number: (Determined after contract award.) Contractor’s Invoice Number: Project Manager/Contact Person: Original Firm Fixed Fee (FFF) Amount from Contractor’s Proposal: Approved Amendments (please itemize): $0.00 - Amendment 1 $0.00 - Amendment 2 $0.00 Total FFF Amount including all amendments: $0.00 Number of Invoices Submitted to Date: 00 Total Amount Billed to Date $0.00 Amount Included in Current Invoice $0.00 Total Amount Remaining After Current Invoice Please remit payment to: $0.00 Contractor’s Company Name Attention (name of contact for account related issues) Address,City, State Zip Phone, Fax END OF EXHIBIT D EXHIBIT E STANDARD AGREEMENT COVERSHEET – WORK ORDER JUDICIAL COUNCIL OF CALIFORNIA STANDARD AGREEMENT COVERSHEET WORK ORDER NUMBER [#] FEDERAL EMPLOYER ID [#]

REQUESTED BY. Faculty Member (print) Signature Date Approved By: AUH Signature Date Xxxx Signature Date Xxxxxxx Signature Date

REQUESTED BY. RECEIVED BY: TAX AMOUNT 0.00 DATE: FREIGHT TOTAL AMOUNT 0.00 INSTRUCTIONS TO SUPPLIERS:

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