zilongwang/ReadingBank huggingface dataset:
METROPOLITAN EAST REGION – SCHOOL NAMES SHS SS All Hallows’ School Balmoral SHS Bay View SS SS Berrinba East SS Birkdale South SS Birkdale SS Bayside SHS Bulimba SS Buranda SS Burrowes SS – Springwood Camp Hill SS Cannon Hill SS College Carina SS SHS Chatswood Hills SS Cleveland District SHS SS Coolnwynpin SS Coorparoo SS Crestmead SS Daisy Hill SS Dunwich SS Dutton Park SS SS Eight Mile Plains SS – Greenslopes SS Groves Christian College Gumdale SS Harris Fields SS Hilliard SS SHS SS SS Kingston State College SS Reserve SS Loganlea SHS Lota SS Mabel Park SHS Mabel Park SS MacGregor SS Mackenzie SS SS Manly SS Manly West SS SHS SS Marsden SHS Marsden SS SS Mary Immaculate Primary School Mayfield SS Morningside SS SS Mount Gravatt East SS SHS SS Murarrie SS Norman Park SS Ormiston SS Our Lady of Our Lady’s College SS Rochedale SHS Rochedale South SS Rochedale SS SS San Sisto College Seven Hills SS SS Somerville House Springwood Central SS Springwood Road SS Springwood SHS St Agnes’ School St Anthony’s School St Bernard’s School St Catherine’s School St Edward the St Elizabeth’s School St Ita’s Primary School St James College St James Primary School St Joachim’s School St John Vianney’s School ’s School St Laurence’s College St Luke’s School ’s School St Mary MacKillop Primary School St ’s School St Peter’s School St Rita’s School ’ School Star of the Sts Peter & Paul’s School Thornlands SS Tingalpa SS Upper SS Point SHS Woods SS West SS Wellers Hill SS Point SHS SS College Wishart SS SS North SS SHS SS Wynnum SHS Wynnum SS Wynnum West SS Yarranlea SS
Risk Management All Queensland School Sport events require a risk management process to be performed prior to the event commencing. This process is the responsibility of the teachers involved with the activity. Principals and teachers should be aware that there are in effect three risk assessment areas as identified by the Department: Curriculum Activity Risk Assessment (CARA) for the particular sport – Completed by the Team Coach Representative Sports Event - Team Manager – Completed by Team Manager Representative Sport Event – Convenor – Completed by Convenor Risk Management: Representative Sports Event The following table summarises the risk management process and who has the associated responsibilities Event Level Risk assessment prepared by Risk assessment approved by Location of Approved Documentation District Trials District Convenor – usually teachers Chair of the District Sport Management Committee School of the District Sport Committee Chair School Team Manager - usually teachers Principal from the school of the teacher official Teacher’s school School Team Coach - usually teachers Principal from the school of the teacher official Teacher’s school Regional Trials Regional Convenor – usually teachers Sport Officer Sport Office District Team Manager - usually teachers Chair of the District Sport Management Committee Teacher’s school District Team Coach - usually teachers Chair of the District Sport Management Committee Teacher’s school State Championships State Convenor – usually teachers Sport Officer Sport Office Regional Team Manager - usually teachers Sport Officer Teacher’s school Regional Team Coach - usually teachers Sport Officer Teacher’s school hosted Interstate & International events Convenor – usually teachers Sport Unit Sport Unit Team Manager - usually teachers Sport Unit Teacher’s school Team Coach - usually teachers Sport Unit Teacher’s school Other Interstate & International events Team Manager - usually teachers Sport Unit Teacher’s school Team Coach - usually teachers Sport Unit Teacher’s school
FORM: LETTER OF INTENT 42th Call for Projects: Agri-Food Sector III SECTION I : GENERAL INFORMATION I.1 Project Title I.2 Principal Applicant First name: Last name: Organization: Function: Postal address: Telephone: Email address: Signature of the Principal Applicant: PRIQ (Public Research Institute in Quebec) Authorized Official First name: Last name: Email address: Signature or initials I.3 Co-applicants (if more than 3, please add information in appendix) 1.3.1 Large enterprises/SME Name Enterprise Title Coordinates 1. Telephone: Email: 2. Telephone: Email: 3. Telephone: Email: Public Research Institute in Quebec (PRIQ) Co-applicant’s name PRIQ Title Coordinates 1. Telephone: Email: 2. Telephone: Email: 3. Telephone: Email: SECTION II: DESCRIPTION OF THE PROPOSED PROJECT (maximum 3000 characters)
(You may refer to pages 5 to 7 of the Applicant’s Guide, Research Program 2018-2019) SECTION IV : PROJECT’S COLLABORATIVE ASPECT (maximum 1500 characters) (Justify the role of every participant) SECTION V: ASSESSMENT OF THE PROJECT’S TRL AT STARTING POINT 1- AIMED FINAL APPLICATION (product – service – bioprocess)
Sl. No Name Name of father/husband Nationality Occupation with address of place of work (at the time of filing application. Phone/ mobile no. if available Post held in the Association Relationship with other Member(s) of the Exe. Council/Governing body Address for Correspondence 1 2 3 4 5 6 7 8
Rule 62(3) Form 23 Notice of intention to adduce evidence (insert front sheet) NOTICE OF INTENTION TO ADDUCE EVIDENCE Criminal Procedure Act 1921 s 134(1) TO THE DIRECTOR OF PUBLIC PROSECUTIONS Response In response to the order dated …………………of Justice ..............................................., the defendant (name of defendant) ……………………………………………………… intends to introduce at the trial evidence of the following kind: Date: (signed) ………………………………………….………… Solicitor for the defendant/Defendant (delete whichever is inapplicable)
MISSOURI DEPARTMENT OF TRANSPORTATION DESIGNATION NOTICE FAMILY AND MEDICAL LEAVE ACT (FMLA) LEAVE Employee’s Name: Home Address: Home Phone Number: Job Title: District/Division/Office: Date: Dear We have reviewed your request for leave under the FMLA and any supporting documentation you have provided. We received your most recent information on . You have requested leave under the FMLA for: the birth of your child the placement (adoption or foster care) of a child with you your serious health condition the care of your spouse/child/parent with a serious health condition the qualifying exigency arising out of the fact that your spouse/child/parent is a member of the Armed Forces on covered active duty or call to covered active duty status the care of an injured/ill servicemember for whom you are the spouse/child/parent/next of kin We have approved your request for FMLA leave. The approved FMLA leave is only for absences related to the reason indicated above. If leave is taken on an intermittent basis you will be required to indicate if an absence is related to your FMLA qualifying event, or if you are requesting leave for another reason, so the department will know how to designate leave. You have anticipated, and we have approved, absences during the following dates: (expected start date) through (expected date of return to work) . You are entitled to 12 26 workweeks of leave under the FMLA. Your approved leave may end sooner than the dates listed above if your qualifying event no longer exists (conditions improve), or if you have exhausted your entitlement during the current 12-month period. The FMLA requires that you notify us as soon as practicable if dates of scheduled leave change or are extended, or were initially unknown. If it becomes necessary to request additional time away from work you should do so in writing. (Please see page 2 for additional information about your FMLA leave.) Additional information is needed to determine if your FMLA leave request can be approved. (Please see additional attached page(s) detailing the information needed.) Your FMLA leave request is not approved. The FMLA does not apply to your leave request. You have exhausted your FMLA leave entitlement in the applicable 12-month period.
CE04 Dams/Water Retaining Structures Irrigation & Flood Control Systems Construction of water retaining structure such as dams, reservoirs, aqueducts, treatment plants, pipe laying works etc. Earth work/dredging in canal, river and offshore. CE05 Offshore Works Offshore construction works including related works. CE06 Tunnelling and underpinning Tunnelling and underpinning works. CE07 Railways Tracks Installation of railway tracks, distressing of rails and tracks. CE08 Oil and Gas Pipe Lines Installation, maintenance and repair of oil and gas pipelines. CE09 Sewerage Works Water Supply Sewerage pipelines, disposal works, sewerage treatment works and allied works. Installation, maintenance and repair of water supply pipelines, pumping stations, tube wells, water treatment works etc. CE10 General Civil Engineering Works Slope Protection System Concrete Repairs Soil Investigation and Stabilization Landscaping & Horticulture Reclamation Works and Waterproofing General Buildings and Maintenance General civil engineering works, including earthworks, sub-soil drainage, etc. Slope protection works. Reinforcement of structures by way of pressure grouting, guniting, etc. Services include sampling, investigation and testing services to determine soil classifications, strength and composition. Also includes soil stabilization works such as micro piling, ground anchoring, sand drains and ground grouting. Provision of Landscaping services including tree planting, turfing, horticulture etc. Reclamation works. Water proofing of basement, roofs and walls. All types of repair/maintenance of civil engineering works. Construction related civil engineering works including allied electrical and mechanical works. Asphalt Road, P.C.C streets, pavements including culverts. BC01 Prefabricated Buildings and Steel Framed Buildings and Industrial Plants Construction of buildings and industrial plants using prefabricated components and systems. Construction of steel framed buildings and industrial plants. Airports Terminal buildings, Satellite buildings, cargo terminals, air traffic control towers, contact piers, passenger loading bridges.
REQUEST FOR DISTRIBUTION FROM THE TRUST, ‘[TRUST NAME]’ Name, position, telephone number and email address of person making request Name of trust Type of trust instrument (‘trust instrument’) Date of trust instrument Extract of relevant trust instrument Date and terms of sanction altering trust instrument (if any) Capital at end of previous financial year Accrued income at end of previous financial year Detailed explanation of purpose for which distribution is sought (having regard to trust terms per [trust instrument OR (if relevant) sanction]), including- Requested date for distribution Amount sought Period through which expenditure to be made [Insert] [Insert] [Insert] [Insert] [Insert] [Insert] [Insert] [Insert] [Insert]
Rule 107 Form 23A Notice of discontinuance of action, cross action or third party action NOTICE OF DISCONTINUANCE OF ACTION, CROSS ACTION OR THIRD PARTY ACTION The (role of party) (name) hereby wholly discontinues his/her/its/their (delete whichever is inapplicable) action/cross action/third party action (delete whichever is inapplicable) against the (role of party) (name). Date: Signed by (name) (role of party)/(role of party’s) solicitor (delete whichever is inapplicable) (If the Court has ordered that the action proceed to trial, pursuant to rule 107(3) consent of all of the other parties to the discontinuance is required) CONSENT OF THE OTHER PARTIES Date: Signed by (name) (role of party)/(role of party’s) solicitor (delete whichever is inapplicable)
PERSON SPECIFICATION Criteria Essential Desirable How to be assessed Qualifications, knowledge & experience GCSE Mathematics and English or equivalent qualifcations Secretarial training to RSA/NVQ Level II including ability to audio type Demonstrable experience of using Microsoft Office including and spreadsheets and mail merge Experience of working in a complex and changing environment Administrative experience in a health care setting Training as a medical secretary Experience of working as a medical secretary Experience of transcribing from audio Planning & organising Demonstrable experience of organising and prioritising own work Proven track record of applying attention to detail to maintain accuracy Problem solving & initiative Demonstrable ability to work independently to solve a range of problems relating to administrative processes. Proven ability to use initiative to source information regarding administrative procedures. Proven organisation skills. Management & teamwork Demonstrable ability to work; independently, as part of a large team and under supervision to ensure that deadlines and quality standards are maintained Communicating & influencing Excellent communication and interpersonal skills to include telephone, email and face to face. Proven experience of seeking and clarifying information and providing assistance where necessary Ability to adapt communication with deaf people (deaf awareness training given) Other skills & behaviours To be courteous to all contacts both internal and external. To be aware of diversity policies and practice Special requirements
Form 23A NOTICE OF OBJECTION TO PRE-TRIAL SPECIAL HEARING Magistrates Court of South Australia Evidence Act 1929 Section 12AB Court Use Date Filed: Registry File No Address Street Telephone Facsimile City/Town/Suburb State Postcode Email Address Respondent Name DOB Surname Given name/s dd/mm/yyyy Address Street Telephone ID Number City/Town/Suburb State Postcode Email Address Applicant Name DOB Surname Given name/s dd/mm/yyyy Address Street Telephone ID Number City/Town/Suburb State Postcode Email Address Grounds of Objection: Date Respondent’s signature Hearing date Registry Date Address Time am/pm Telephone Facsimile Email Address Date MAGISTRATES COURT IMPORTANT NOTICE TO THE RESPONDENT The respondent must file this notice in the Court within 14 days of being served with the application for a pre-trial special hearing
b For existing units undergoing expansion Sl. Name (s) of the Product (s) Annual Installed capacity prior to expansion Actual production during last year/ from the date of commercial production till date (if any) Remarks Quantity Value(in Rs) Quantity Value(in Rs) 12 Raw Materials : a For New unit Sl No Name/s of the raw materials Annual requirement Quantity Value(in Rs) b For existing units undergoing expansion Sl No Name/s of the raw materials Annual requirement prior to expansion Annual requirement after expansion Quantity Value(in Rs) Quantity Value(in Rs) 13 of finished product(s) : a For New unit Sl No Name/s of the Product(s) Product(s) sold during last year/ from the date of commercial production Remarks
(Signature of Applicant) (Name in Block Letters) _______________________ (Designation of the Signatory) _______________________ Place: _________________ Date: _______________ List of Enclosures:- 1. ______________________ 5. ______________________ 2. ______________________ 6. ______________________ 3. ______________________ 7. ______________________ 4. ______________________ 8. ______________________
FORM NS NAMED SUBCONTRACTORS Proposer Name: __________________________________________________ Subcontractor name/ contact Address of head office Telephone/facsimile address Percentage of proposed contract price For two most recent contracts, list reference, telephone number, and E-mail address Contract 1 Contract 2
UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF NEW YORK In re: 2013 COLONIAL LLC, Debtor. ) ) ) ) ) ) Case No. 16-22715-RDD Chapter 11 ORDER PURSUANT TO RULE 2004 OF THE FEDERAL RULES OF BANKRUPTCY PROCEDURE AUTHORIZING EXAMINATION OF _____________ AND PRODUCTION OF DOCUMENTS Upon the application, dated ___________ (the “Application”), of _____________ (the “Movant”) for an order pursuant to Fed. R. Bankr. P. 2004 directing the production of documents by and oral examination of _____________ [,by _____________ and/or any other employee of ____________ most knowledgeable about _____________ (the “Rule 2004 Topics”); and, after due deliberation, the Court having concluded that the Movant has established sufficient cause for the relief granted herein; and no additional notice being required except as specified herein; now, therefore, it is hereby ORDERED that: The Movant is authorized, pursuant to Fed. R. Bankr. P. 2004, to conduct an oral examination of ______________ [, by _______________, or such other employee of _____________ who is most knowledgeable regarding the Rule 2004 Topics. The Movant is authorized, pursuant to Fed. R. Bankr. P. 9016, to issue subpoenas for the production of documents relevant to the Rule 2004 Topics and attendance for the foregoing examination (each, a "Rule 2004 Subpoena"). ______________ shall produce the documents (including electronically stored information) in its possession, custody or control referenced in the Rule 2004 Subpoena not later
Drug: __ 0 – No Alcohol: __ 1 – Yes Tobacco: __ 3 - Unknown Using Tobacco Product: __ *Discharge Reason: ___ ___ 1 - Completed Episode of Care – no substance abuse 2 - Completed Episode of Care – some substance use (some impairment) 6 - Non-compliant with agency’s rules 7 - Left before completing treatment (involuntary) 8 - Incarcerated 9 – Died 10 – Completed Non-TX services (TASC/Interv./Prev.) 11 – Did not complete Non-TX services (TASC/Interv./Prev.) 13 - Referred outside of agency – episode of care completed 14 - Referred outside of agency – episode of care not completed 15 - Left before completing treatment (voluntary) Page 6C – 15 *End Date: ___ ___ / ___ ___ / ___ ___ ___ ___ Page 6C – 15 REFERRAL: ___ ___ 1 - Individual (Self-Referral) 14 - Other Court Order/Recognized Legal Entity 2 - Substance Abuse Care Provider 16 - SINS/FINS 3 - Mental Health Care Provider 17 - Addictions Receiving Facilities 4 - Juvenile Justice (JARF’s) 18 - Outreach Program 5 - Health Unit 19 - DCF/ADM (no longer used) 6 - School (Education) 20 - 7 - Employer/Employee 21 - Assistance Program 22 - Physician/Doctor 8 - Other Social Service/Health/ 23 - Law Enforcement Community Ref 24 - Family Safety Foster Care 9 - TASC (Assessment Centers) 25 - Family Safety Protective Services 10 - Probation/Parole/Controlled 99 - None of the Above Release Authority 11 - DUI/DWI 12 – Pretrial 13 - Prison/Jail Page 6C - 15 *ZIP CODE: ___ ___ ___ ___ ___ US Postal Zip code for this client’s residence Page 6C – 16 PROVIDER INFORMATION: Page 6C - 16 *Veteran status ____ 0 – No 1 – Yes 2 – Unknown Page 6C - 16 *Contract Number 1 - __ __ __ __ __ Page 6C - 16 Contract Number 2 - __ __ __ __ __ Page 6C - 17 Contract Number 3 - __ __ __ __ __ Page 6C - 17
*MHDiagnosis ____ 0 – No 1 – Yes Page 6C - 17 Social connectedness: ___ ___ 01 – No attendance in the past month 04 – 8 – 15 times in past month 02 – 1-3 times in past month 05 – 16-30 times in past month 03 – 4-7 times in past month 06 – Some attendance in past month, frequency unknown Page 6C - 18 school attendance: ___ 1 – Suspended 2 – Expelled 3 – Suspended and Expelled 4 – Not Applicable Page 6C - 18 Signature: Date: //
Using Tobacco Product: __ *CHILD INVOLVED IN PREVENTION: ___ 0 – No, 1 – Yes Page 6B -13 BIRTH OUTCOME: ___ ___ 1 – Live birth (drug present) 5 – Pregnancy terminated 2 – Live birth (drug not present) 6 – Not yet ivered (transfers only) 3 – Still birth 7 – Unknown Birth Outcome 4 - Miscarrige 8 – N/A (non-pregnant only) Page 6B – 14 *friends use: 0 - No 1 - Yes 3 – Unknown Page 6B – 14 *Mother drug free: 0 - No 1 - Yes 3 – Unknown 4 – N/A (non-pregnant only) Page 6B – 14 *arrest (0-9): Page 6B – 14 *DISCHARGE REASON: 1 - Completed Episode of Care – no substance abuse 2 - Completed Episode of Care – some substance use (some impairment) 6 - Non-compliant with agency’s rules 7 - Left before completing treatment (involuntary) 8 - Incarcerated 9 – Died 10 – Completed Non-TX services (TASC/Interv./Prev.) 11 – Did not complete Non-TX services (TASC/Interv./Prev.) 13 - Referred outside of agency – episode of care completed 14 - Referred outside of agency – episode of care not completed 15 - Left before completing treatment (voluntary) 16 – Administrative Discharge (Agency initiated) 17 – Agency Closed with no Referral 99 – Administrative Discharge (No Services Provided – SAMH generated only) Page 6B – 14 * status at discharge 10 - Active military, overseas Not in Work Force: 20 - Active military, 81 - Homemaker 30 - Full Time 82 – Student 31 – Unpaid Family Worker 83 – Retired 40 - Part Time 84 - Disabled 50 - Leave of Absence 85 – Inmate (Jail, Prison, Psych. Institution, etc.) 60 – Retired 86 – Not Authorized to work 70 - Terminated (unemployed) Page 6B – 17 *future use: Page 6B – 17
contact last name: Page 6B – 25 contact address 1: Page 6B – 26 contact address 2: Page 6B – 26 : Page 6B – 26 : Page 6B – 26 contact zip code: Page 6B – 26 contact phone: Page 6B – 26 other first name: Page 6B – 26 Other last name: Page 6B – 26 other address 1: Page 6B – 27 other address 2: Page 6B – 27 other city: Page 6B – 27 other state: Page 6B – 27 other zip code: Page 6B – 27 other phone: Page 6B – 27 PROVIDER INFORMATION: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Page 6B – 27 *Contract Number 1 - __ __ __ __ __ Page 6B – 27 Contract Number 2 - __ __ __ __ __ Page 6B – 28 Contract Number 3 - __ __ __ __ __ Page 6B – 28 Social Connectedness: ___ ___ 01 – No attendance in the past month 04 – 8 – 15 times in past month 02 – 1-3 times in past month 05 – 16-30 times in past month 03 – 4-7 times in past month 06 – Some attendance in past month, frequency unknown Page 6B – 28 school attendance: ___ 1 – Suspended 2 – Expelled 3 – Suspended and Expelled 4 – Not Applicable Page 6B - 28 Signature: Date: //
*INVOLVED IN CHILD WELFARE: ___ 0 – No 1 – Yes 3 – N/A Page 6A - 10 *RESIDENTIAL STATUS: 01 - Independent Living-alone 10 – Hospital 02 - Independent Living-with Relatives 11 - Nursing Home 03 - Independent Living –with Non-Relatives 12 - Supported Housing 04 - Dependent Living-with Relatives 13 - Correctional Facility 05 - Dependent Living-with Non-Relatives 14 - DJJ Facility 06 - Assisted Living Facility (ALF) 15 – Crisis Residence 07 - Foster Care/Home 16 – Children Residential Treatment Facility 08 - Group Home 17 – Limited Mental Health Licensed ALF 09 – Homeless 99 - Not Available or Unknown Page 6A - 10 *MARITAL STATUS: 1 – Single 5 - Separated 2 – Married 6 - Unreported 3 – Widowed 7 - Registered Domestic Partner 4 – Divorced 8 - Legally Separated Page 6A - 11 *SUBSTANCE PROBLEM *** (New drug list)*** Primary: Secondary: Tertiary: Page 6A - 11 *Frequency of use (Month prior to evaluation) Primary: ___ 1 - No past month use 4 - 3 to 6 times per week Secondary: ___ 2 - 1 to 3 times in past month 5 - Daily Tertiary: ___ 3 - 1 to 2 times per week Page 6A - 13 *USUAL ROUTE OF ADMINISTRATION Primary: 1 – Oral 4 – Injection Secondary: 2 – Smoking 5 – Other Tertiary: 3 – Inhalation Page 6A - 14 *AGE OF FIRST DRUG OR ALCOHOL USE Primary: Secondary: Tertiary: Page 6A - 14 *CHILD INVOLVED IN PREVENTION: ___ 0 – No, 1 – Yes Page 6A - 15
Required Reviews and Approvals NIH RAC # Approval Date FDA IND # Approval Date Required Attachments PI CV Responses to Appendix M I – MVI submitted to NIH RAC Recombinant or Synthetic Nucleic Acid Gene Name Gene Source(s) (Genus, Species, Strain) Function of Insert/Protein Expressed Regulatory Elements in the Construct (i.e. promoters, enhancers, polyA, replication origins, terminators) 1. 2. 3. Vector Description Vector Type Plasmid Viral Naked DNA or RNA Other: Specify Vector Administration Route IV IM IP Other: Specify Vector Source Genus, species N/A, not plasmid or viral Name of Vector Provide Technical Name Provide reference or source OR N/A, not commercially available Vector Characteristics Replicating Replication defective Integrating Oncolytic
Check all that apply Latency potential Other: Specify Host Target Cells Type of Gene Transfer In vivo Ex vivo Biological Risk Assessment and Safety Precautions Biological Safety Level Indicate the highest BSL applied in the experiment BSL 1 BSL 2 BSL 2+ Location(s) and PPE Building name / Room number Description of Work (Surgery, treatment, prep, patient care, other) Patient Isolation PPE Check all that apply 1. Standard Contact Droplet Aerosol single glove double glove surgical mask respirators* goggles/safety glasses Face shield lab coat disposable lab coat/gown Other: 2. Standard Contact Droplet Aerosol single glove double glove surgical mask respirators* goggles/safety glasses Face shield lab coat disposable lab coat/gown Other: * The use of respirators requires medical evaluation and fit test prior to use. Specific Location Features Will there be any additional specifications for work locations N/A room ventilation room signage Other:
Name of student Assign. No. Grade indicators awarded to grade descriptors Grading decisions agreed Yes/No Feedback and Recommendations to Assessor: To include evaluative commentary/feedback/recommendations on the following: assessment decision and quality of feedback justifying decision, grading judgement and quality of feedback justifying grade given, quality of feedback to learner with guidance to facilitate development/improvement of future work. Action required 1. 2. 3. 1. 2. 3. 1. 2. 3. 1. 2. 3. 1. 2. 3. 1. 2. 3. Action plan Date for Date
Form S17 WARRANT OF APPREHENSION (BREACH OF BOND) Magistrates Court of South Australia Sentencing Act 2017 Section 113(1)(a)(ii) Court Use Date Filed: Registry File No Address Street Telephone Facsimile City/Town/Suburb State Postcode Email Address Originating Document Type: Date substantiated on oath: Informant: Defendant Name DOB Surname Given name/s dd/mm/yyyy Address Street Telephone Licence Number City/Town/Suburb State Postcode Email Address Particulars of Breach of Bond Date of breach: Breach location: Breach: Reason for issue of warrant: Date warrant issued: To the Commissioner of Police for the State of South Australia and each member of the police force for the State You are directed to apprehend the defendant and, subject to any endorsement below, bring the defendant before the Court not later than the next working day after the day of the defendant’s arrest to be dealt with according to law. MAGISTRATE / REGISTRAR / JUSTICE OF THE PEACE Endorsement (Pursuant to section 5(2) of the Bail Act 1985) Variable 1 The defendant may not be released on bail. Variable 2 At the discretion of a member of the police force who is of, or above, the rank of Sergeant or who is in charge of a police station, the defendant may be released on bail. Variable 3 Person or class of persons authorised/required to release the defendant on bail following arrest: MAGISTRATE / REGISTRAR / JUSTICE OF THE PEACE
Form S22Y APPLICATION FOR ENFORCEMENT OF A BREACH OF AN INTENSIVE CORRECTION ORDER Youth Court of South Australia Sentencing Act 2017 Section 116 Court Use Date Filed: Registry File No Address Street City/Town/Suburb State Postcode Telephone Facsimile Email Address DX Applicant Full Name Address Street City/Town/Suburb State Postcode Telephone Facsimile Email Address Particulars of Youth Full Name DOB Address Street City/Town/Suburb State Postcode Telephone Facsimile Email Address Details of Application The youth entered into an Intensive Correction Order (a true copy of which is attached hereto) at the Youth Court on the day of 20 . AND it is alleged that the youth failed to observe the conditions of that Intensive Correction Order, in that the youth has: AND the applicant now asks that the youth be brought before the probative court at the time and place listed below to answer the allegation and cause why he/she should not be further dealt with according to law. AND the applicant now asks that a warrant be issued for the youth’s arrest. I, the undersigned applicant, make oath and swear the contents of this application to be true and correct to the best of my knowledge and belief. Date Applicant Taken and sworn before me this day of 20 , at in the State of South Australia. Date Justice of the Peace/Proclaimed Police Officer Hearing details Registry Date Address Time am/pm Telephone Facsimile Email Address
Rule 44(1) Form SA16 Originating application for delivery of passport ORIGINATING APPLICATION FOR DELIVERY OF PASSPORT Independent Commissioner Against Corruption Act 2012 Sch 2 cl 18 TO THE DEFENDANT (name) of (address). The plaintiff (name of plaintiff) the Independent Commissioner Against Corruption the Deputy Commissioner an examiner appointed by the Independent Commissioner Against Corruption (delete whichever is inapplicable) applies for the relief set out in this application. Action required A Judge will hear this application, or make orders for the conduct of the proceeding, at the time and place stated below. If you or your lawyer do not attend, the Judge may make orders in your absence. You must file a Notice of Address for Service (form 16 or 17 in the General Supplementary Rules) in the Registry before attending Court or taking any other steps in the proceeding. If you do not have a solicitor, you may attend personally at a Registry to do this. A list of the Registry addresses may be obtained through the website of the Courts Administration Authority () or by telephoning the Registry of the Court (8204 0289). The application will be heard before Justice……… in the Supreme Court at 1 Gouger Street, Adelaide on …………. at ……….. or so soon afterwards as the business of the Court allows. The courtroom in which the application will be heard will be published: on the Courts Administration Authority website the day before; in the Advertiser on the day; and on the notice board at the Courts Building.
Rule 14(2A) Form SA1D Application for confirmation of surveillance authority APPLICATION FOR CONFIRMATION OF SURVEILLANCE AUTHORITY Surveillance Devices Act 2016 s 22 Applicant’s name (in full): Name of investigating agency to which applicant belongs: Applicant’s rank/position: Application 1. I apply for confirmation of a surveillance device (emergency) authority under section 22 of the Surveillance Devices Act 2016 for the purposes of the investigation of a matter by— South Australia Police The Independent Commissioner Against Corruption An Australian Crime Commission (delete whichever is inapplicable) 2. The surveillance device to which the authority relates is: (provide details of surveillance device) 3. I apply for confirmation of the authority on the following grounds: (set out grounds) 4. The grounds for the confirmation are verified in my accompanying affidavit. 5. In addition, I apply for a warrant under section 22 of the Surveillance Devices Act 2016. (delete if inapplicable)
Endorsements Application made pursuant to section 24 of the Serious and Organised Crime (Unexplained Wealth) Act 2009 and rule 59 of the District Court Special Applications Rules 2014. You will be notified separately of the time and place of the hearing of the application. Date: Signed by (name) Defendant/Solicitor for the defendant (delete whichever is inapplicable) Note— 1. Section 24(2) of the Serious and Organised Crime (Unexplained Wealth) Act 2009 requires the grounds of objection to be stated fully and in detail in the notice of objection
learners to complete programmes should satellite centre close accompanying application SAT4. Record-keeping SAT4.1 Adequate recording systems are in place at satellite centres to comply with CIPS requirements, to track learner progress and achievement. Learner progress and achievement records SAT5. Quality Assurance SAT5.1 Management recognises quality assurance responsibility relating to satellite centres Staff member with responsibility for QA across all centres Time allowed for QA activity across all centres SAT5.2 Satellite centre has policies and practices equivalent to those at main centre, which protect the quality of provision for the learner. Satellite centre’s own policies, if not the same as main centre’s Course structure, delivery, review etc mirror that of main centre SAT5.3 Main centre has procedures for reviewing processes and performance of satellite centres at regular intervals Review arrangements Schedule of management visits to satellite centres Please keep a copy of the completed application form for your own records, and email a copy to , or Liz Luck (CIPS Networks Administrator) – or post to Liz Luck Networks Administrator CIPS Easton House Easton on the Hill Stamford Lincolnshire PE9 3NZ
STATE OF Substance Abuse and Mental Health CLIENT SPECIFIC SERVICE EVENT FORM Client’s Name:___________________________________________________________ ( * Mandatory Fields) (Reference: Chapter 7, DCF Pam 155-2) 1 *Client SSN: __ - - __ Page 9-6 2. *Contractor ID: - If your agency is the subcontracted provider from Managing Entity, put the Managing Entity’s ID here. Page 9-6 3. *Service Date: __ __/ __ __/200__ Month Day Year Page 9-6 4. *Start Time: __ (HHMM) Page 9-7 5. *: __ __ Page 9-7 – 9-21 6. *Program Type: ___ 1 - Mental Health 2 - Substance Abuse Page 9-21 7. *Provider ID: - __ __ __ __ __ __ Page 9-21 8. *Setting: __ __ Page 9-21 9. *: __ __ Page 9-23 10. Procedure Code: __ __ __ __ __ (HIPAA Approved Procedures Codes only) Page 9-23 11. *Site Identifier: __ __ Page 9-24 12. Client ID: __ __ __ __ __ __ __ __ __ __ Page 9-24 13. *Provider Type: __ __ 01 - Counselors by subtype 09 - Physician/Osteopath by subtype 02 - Marriage & Family Therapist 10 – Psychosocial 03 - Therapist 11 - Rehabilitation 04 – Neuropsychologist 12 - Specialist 05 - Psychoanalyst by subtype 13 - School Psychologist 06 - Psychologist by subtype 14 - Social Worker 07 - Nursing service related 15 - Sociologist provider by type/subtype 16 - Other 08 - Physician assistant and advanced practice nursing providers by type/subtype Page 9-24
Does the contract stipulate that any data necessary to substantiate the approval of the maintenance programme should be provided for the operator’s agreement and the CAA upon request? Yes No N/A Comments: Where the collection of data and initial assessment of the effectiveness of the Maintenance Programme is made by the sub-contracted Continuing Airworthiness Management Organisation, are the required actions endorsed by the operator? Yes No N/A Comments: Does the MME specify the participation of the operator in reliability meetings with the sub-contracted Continuing Airworthiness Management Organisation? Yes No N/A Comments: Do the procedures state that any variations to the Maintenance Programme must have the agreement of the operator and the operator has to apply for any variations outside of the scope allowed by the operator in the approved Maintenance Programme? Yes No N/A Comments: Where the Continuing Airworthiness Management Organisation plans and defines what maintenance is to be performed, do the procedures adequately specify the operator’s involvement? Refer to CAP 02 paragraph 31, Appendix A Item A6 for examples. Yes No N/A Comments: Does the operator’s quality system monitor the adequacy of the sub-contracted Continuing Airworthiness Management Organisation’s arrangements for compliance with the contract and CAR OPS 1/3 Subpart M? Yes No N/A Comments: Has the operator specified the maintenance data, together with the responsibility for providing the data, for the purpose of the contract? Yes No N/A Comments: Does the operator ensure that maintenance data including revisions are readily available to both the operator’s maintenance management personnel and the Continuing Airworthiness Management Organisation who may be required to access such data? Yes No N/A Comments:
Appendix A - Sponsorship Privileges The table below shows the privileges for each type of sponsorship. Privileges Sponsorship Platinum Gold Silver Bronze Delegate Bag Complimentary prime location single exhibition space) at IWAF/2 (1,2 and 13-16) and Day 1 of A39 (#1 – 3) ✓ ONLY FOR IWAF/2 Sponsor's logo and hyper link on the ICAO event website ✓ ✓ ✓ Up to three single sheets of printed promotional material (8½×11 inch or A4) inserted into the delegate bags or folder ✓ ✓ 1 sheet ✓ Recognition by the event moderator during the opening and closing ceremonies ✓ ✓ ✓ ✓ ✓ Prime visibility in the Program of the sponsor’s name, logo and company’s products/services ✓ ✓ ✓ ✓ ✓ Display of sponsor's logo in the venue areas ✓ ✓ ✓ ✓ Sponsor’s name and logo on the Event auditorium screen ✓ ✓ ✓ ✓ ✓ Invitation to the hospitality event with sponsor name and logo on the Event auditorium screen ✓ ✓ ✓ ✓ Display of sponsor’s logo during the event being sponsored ✓ ✓ ✓ ✓ Free delegate or exhibitor passes and folder or delegate bag. Please note that only 2 exhibitor passes will be issued for day 1 of A39. 6* 4* 3* 2* 2*
Appendix B – Exhibitors Services Services Included Not Included Comments At ICAO Carpeting the Event exhibition space(s) ✓ Exhibition areas are carpeted. The ICAO building is air conditioned. Electricity supply (one outlet per single space) with an extension cable and a multi-socket power bar ✓ 110V for a maximum of 15 ampere. Unlimited wireless Internet connection ✓ 24-hour security of public areas ✓ Special security measures will be in place. ICAO is not, however, responsible for any loss or damage of property in the exhibition areas. Exhibitor’s logo, contact, URL and description of the company’s products/services in the program directory ✓ Free delegate or exhibitor passes and folder or delegate bag ✓ Two free pass each single Event exhibition space. Only applicable for IWAF/2. Note for the Assembly 39th Session: only Workshop Zone passes will be issued. Invitation to sponsored, coffee breaks, lunches and cocktail receptions ✓ Only for exhibitors holding delegate or exhibitor passes. Daily cleaning of public areas ✓ Official Service Providers Appointed by ICAO Materials handling, advance warehouse storage, rental of extra furniture, chairs, tables, graphic banners, electrical accessories, transformers ✓ Should be arranged through the ICAO appointed official exhibition services provider. Transportation and customs services ✓ Should be arranged through the ICAO appointed official customs broker. Audio visual equipment, laptops, TV, DVD players, ✓ Should be arranged through the ICAO appointed official audio visual supplier. Exhibition Booth Construction Exhibition booth that are 4’x6’, 4’x8’,6’x8’ or 8’x8’ ✓ Must use the services of GES (Official service provider) for any additional requirements. Appendix C – Floor plan IWAF/2 Only – 26 September 2016 Appendix D – Floor plan A39 – 27 September to 5 October 2016
DOW UNIVERSITY OF HEALTH SCIENCES DEPARTMENT OF RESEARCH Application Form for Summer Short Courses 2018 A) PERSONAL INFORMATION: Name of Applicant: [Please fill in BLOCK letters] S/o, D/o, W/o: Date of Birth: Address: Please Affix Photograph here Tel No (Residential): Cell No: Email Address: C.N.I.C #: B) EDUCATION BACKGROUND: Academic Record Name & Place of Institute Passing Year Marks Obtained % / Div. Matric / O level / Equivalent Inter Science / A level / Equivalent Graduation Degree Name: Postgraduate Degree Name: Others Degree Name:
WAC 480-93-188 GAS LEAK SURVEYS S U N/A N/C 480-93-180(1) gas leak surveys using a gas detection instrument covering areas listed in 480-93-188(1)(a-e) Gas detection instruments tested for accuracy/intervals (Mfct rec or monthly not to exceed 45 days) 480-93-188(2) Surveys conducted according to the minimum frequencies outlined under 480-93-188(3)(a-d) Surveys conducted under the following circumstances outlined under 480-93-188(4)(a-e) Survey records must be kept for a minimum of five years and contain information required under 480-93-188(5)(a-f) Self audits as necessary, but not to exceed three years between audits and meet the criteria outlined under 480-93-188(6)(a-e) Comments: PIPELINE MARKERS PROCEDURES S U N/A N/C 480-93-180(1) Placement of markers - railroad, road, irrigation and drainage ditch crossings… 480-93-124 (1) Placement of markers - Separation/Other locations… 480-93-124 (2) & 192.707 Installed at each end of bridges or other spans / Inspected 1/YR (15 Months) 480-93-124 (3) Markers reported missing or damaged replaced within 45 days? 480-93-124(4) Surveys of pipeline markers – Not to exceed 5/YR Records 10/Yrs minimum 480-93-124(5) Maintain maps, drawings or other records indicating class locations and other areas where pipeline markers are required 480-93-124(6) Comments: SUBPART - M TRANSMISSION RECORD KEEPING PROCEDURES S U N/A N/C 480-93-180(1) / 192.605 (b) Records must be maintained… .709 (a) Repairs to the pipe – life of system (b) Repairs to “other than pipe” – 5 years (c) Operation (Sub L) and Maintenance (Sub M) patrols, surveys, tests – 5 years or until next one
7) If appropriate, was this individual’s outstanding service or innovation documented using measurements or surveys? If so, please describe the measurement and the result. 8) 50-word (or less) citation for the certificate: GROUP & INDIVIDAL AWARD NOMINEE DETAILS – add as many lines as necessary Nominee Name Nominee Title Nominee Grade Employee Number Employee Type – USDH, EFM, LE Staff, PSC, etc. Percentage of Award for Each Nominee (must total 100%) FOR INTERNAL USE ONLY ICASS Working Group Awards Committee Approvals 9) award amount: $_________ Approved 10) ICASS Service Center Awards Committee Co-Chair Signature: Name: Signature:
RFP EXCEPTIONS Add any additional line items for exceptions as necessary and reference any explanatory attachments within the line item to which it refers. RFP Section # or Form, Page # Exception Describe the nature of the Exception Explanation of Why This is an Issue for You Your Proposed Alternative to Meet the Needs of the City 1 2 3 4 5
FORM 3: ACCEPTANCE OF TERMS AND CONDITIONS It is the intent of the City to contract with a private supplier. All supplier representations, whether verbal, graphical or written, will be relied on by the City in the evaluation of the responses to this Request for Proposal. This reliance on the Supplier’s represented expertise is to be considered as incorporated into any, and all, formal Agreements between the parties. PRINT THE WORDS "NO EXCEPTIONS" HERE _________________ IF THERE ARE NO EXCEPTIONS TAKEN TO ANY OF THE TERMS, CONDITIONS, OR SPECIFICATIONS OF THESE REQUEST FOR PROPOSAL DOCUMENTS. IF THERE ARE EXCEPTIONS TAKEN TO ANY OF THESE TERMS, CONDITIONS, OR SPECIFICATIONS OF THESE REQUEST FOR PROPOSAL DOCUMENTS, THEY MUST BE CLEARLY STATED IN THE TABLE BELOW (“RFP EXCEPTIONS”) AND RETURNED WITH YOUR PROPOSAL IN THE APPROPRIATE SECTION. IF YOU PROVIDED A SAMPLE COPY OF YOUR CONTRACT(S) YOU STILL NEED TO IDENTIFY IN THIS DOCUMENT (“RFP EXCEPTIONS”) ANY AND ALL EXCEPTIONS YOU HAVE TO THE TERMS AND CONDITIONS. Firm or Individual Title Telephone Email Address PRINT NAME AND TITLE ______________________________________________________________________ AUTHORIZED SIGNATURE ______________________________________________________________________ DATE _______________________________________________________ _______ OTHER NOTES:
Three (3) copies of the application form, when complete, together with three (3) copies of a Curriculum Vitae (if desired) must be returned to:- The Human Resources Department, Mayo County Council, Áras an Chontae, Castlebar, Co. Mayo, not later than 12 noon on Friday, 1st July, 2016. 1. NAME IN FULL: (BLOCK LETTERS) 2. HOME ADDRESS: ……………………………………………………………… ……………………………………………………………… ……………………………………………………………… 3. PPS NO. 4. PRESENT ADDRESS: (IF DIFFERENT FROM ABOVE) ……………………………………………………………… ……………………………………………………………… ……………………………………………………………… 5. TELEPHONE NUMBER/S: HOME: ……………………………………………… MOBILE: ……………………………………………… 6. E-MAIL ADDRESS 7. ARE YOU IN GOOD HEALTH AND FREE FROM ANY PHYSICAL CONDITION THAT WOULD AFFECT YOUR ABILITY TO PERFORM THE DUTIES OF BEACH LIFEGUARD? YES NO IF NOT, PLEASE GIVE BRIEF DETAILS OF THE CONDITION: ……………………………………………………………… ……………………………………………………………… ……………………………………………………………… 8. WHAT IS YOUR CURRENT OCCUPATION? 9. IF OFFERED EMPLOYMENT AS BEACH LIFEGUARD, WHAT DATE WOULD YOU BE AVAILABLE TO TAKE UP FULL-TIME DUTY? ………………………………………………………………
Three (3) copies of the application form, when complete, together with three (3) copies of a Curriculum Vitae (if desired) must be returned to:- The Human Resources Department, Mayo County Council, Áras an Chontae, Castlebar, Co. Mayo, not later than 4.00p.m. on Friday, 16th February, 2018. 1. NAME IN FULL: (BLOCK LETTERS) 2. HOME ADDRESS: ……………………………………………………………… ……………………………………………………………… ……………………………………………………………… 3. PPS NO. 4. PRESENT ADDRESS: (IF DIFFERENT FROM ABOVE) ……………………………………………………………… ……………………………………………………………… ……………………………………………………………… 5. TELEPHONE NUMBER/S: HOME: ……………………………………………… MOBILE: ……………………………………………… 6. E-MAIL ADDRESS 7. ARE YOU IN GOOD HEALTH AND FREE FROM ANY PHYSICAL CONDITION THAT WOULD AFFECT YOUR ABILITY TO PERFORM THE DUTIES OF BEACH LIFEGUARD? YES NO IF NOT, PLEASE GIVE BRIEF DETAILS OF THE CONDITION: ……………………………………………………………… ……………………………………………………………… ……………………………………………………………… 8. WHAT IS YOUR CURRENT OCCUPATION? 9. IF OFFERED EMPLOYMENT AS BEACH LIFEGUARD, WHAT DATE WOULD YOU BE AVAILABLE TO TAKE UP FULL-TIME DUTY? ………………………………………………………………
THIRD LEVEL EDUCATION: Degree, Diplomas, etc. Grade Obtained (e.g. Pass; 2.2; 2.1;1; etc) Please list each subject taken in Final Exam University, College or Examining Authority Year in which Degree / Qualification was obtained OTHER QUALIFICATIONS: Name of Course Description of Course Content Date(s) Course Provider Page 4 of 8 EMPLOYMENT RECORD (Commencing with most recent Employment) DATES NAME & ADDRESS OF EMPLOYER TITLE OF POST HELD, DESCRIPTION OF DUTIES, ETC. IN FROM TO
OCCUPATION: OCCUPATION ADDRESS: EMPLOYER: _______________________________________________ _______________________________________________ _______________________________________________ Page 1 of 8 ARE YOU AVAILABLE DURING YOUR NORMAL WORKING HOURS: (See Clause 12 of Terms of Engagement of Retained Firefighter) Yes No (Please tick appropriate box) DISTANCE FROM FIRE STATION TO: Residential Address: Occupational Address: ___________ km/ Miles (Delete as appropriate) ___________ km/ Miles (Delete as appropriate) Details of previous Fire Brigade Service (if any): Rank in Fire Service: ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________
THIRD LEVEL EDUCATION: Degree, Diplomas, etc. Grade Obtained (e.g. Pass; 2.2; 2.1;1; etc) Please list each subject taken in Final Exam University, College or Examining Authority Year in which Degree / Qualification was obtained OTHER QUALIFICATIONS: Name of Course Description of Course Content Date(s) Course Provider Page 4 of 8 EMPLOYMENT RECORD (Commencing with most recent Employment) DATES NAME & ADDRESS OF EMPLOYER TITLE OF POST HELD, DESCRIPTION OF DUTIES, ETC. IN FROM TO