Research Scholarly Affairs Committee Faculty Research Award Program 2011-2012 RSAC Bridging Support Awards External Award Supplements.

 

al Project Supplemental Application: GVPCCC 1 R ENEWAL P ROJECT SUPPLEMENTAL A PPLICATION 2010 al Project Supplemental Application: GVPCCC 2 1: Sponsor and Project Information.

 

New Project Supplemental Application 2010 Instructions: Please type responses and submit application electronically. The default for narrative sections is 11pt, Arial.

 

FORMCHECKBOX Week FORMCHECKBOX Month FORMCHECKBOX Hour FORMCHECKBOX Day FORMCHECKBOX Week FORMCHECKBOX Month FORMCHECKBOX Hour FORMCHECKBOX Day.

 

OTHER Applicable in Colorado It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting.

 

FORMCHECKBOX Real Estate Dev Property FORMCHECKBOX Land Leased to Others FORMCHECKBOX Vacant Land FORMCHECKBOX Real Estate Dev Property.

 

b. FORMCHECKBOX For Profit FORMCHECKBOX Not For Profit c. FORMCHECKBOX Buildings or premises owned or leased FORMCHECKBOX No buildings or premises owned or leased except for office.

 

FORMCHECKBOX Offer home warranty plans FORMCHECKBOX Home inspections FORMCHECKBOX Assume contractual responsibility for armed security services off duty.

 

TYPE OF RENTAL Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application.

 

Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty.

 

OTHER Applicable in Colorado It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting.

 

FORMCHECKBOX Offer home warranty plans FORMCHECKBOX Home inspections FORMCHECKBOX Assume contractual responsibility for armed security services off duty.

 

FORMCHECKBOX Week FORMCHECKBOX Month FORMCHECKBOX Hour FORMCHECKBOX Day FORMCHECKBOX Week FORMCHECKBOX Month FORMCHECKBOX Hour FORMCHECKBOX Day.

 

LOSS INFORMATION Applicable in Arkansas, Louisiana, and West Virginia Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit.

 

FORMCHECKBOX FORMCHECKBOX Pulls FORMCHECKBOX Water Exposures Will there be individual exhibitors, booths, vendors at the event FORMCHECKBOX Yes FORMCHECKBOX No If “Yes”,.

 

FORMCHECKBOX Tavern FORMCHECKBOX Sports Bar FORMCHECKBOX Nightclub FORMCHECKBOX Restaurant FORMCHECKBOX Tavern FORMCHECKBOX Sports Bar FORMCHECKBOX Nightclub FORMCHECKBOX Restaurant.

 

If yes, describe type of equipment and annual rental receipts: FORMCHECKBOX Yes FORMCHECKBOX No Any mobile equipment leased to others FORMCHECKBOX Yes FORMCHECKBOX No Any roofing.

 

OTHER Have you ever been involved in any construction defect claims FORMCHECKBOX Yes FORMCHECKBOX No If you use subs, are certificates of insurance obtained from subcontractors.

 

Applicable in Colorado It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud.

 

FORMCHECKBOX Boarded Up FORMCHECKBOX Alarmed FORMCHECKBOX Boarded Up FORMCHECKBOX Alarmed FORMCHECKBOX Locked and Secured FORMCHECKBOX Boarded Up FORMCHECKBOX Alarmed FORMCHECKBOX.

 

Do you provide any of the following services FORMCHECKBOX Body Piercing FORMCHECKBOX Body Wax FORMCHECKBOX Body Wraps FORMCHECKBOX Chemical Peels FORMCHECKBOX Electrolysis.

 

Do you provide any of the following services FORMCHECKBOX Body Piercing FORMCHECKBOX Body Wax FORMCHECKBOX Body Wraps FORMCHECKBOX Chemical Peels FORMCHECKBOX Electrolysis.

 

Applicable in Colorado It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud.

 

ELIGIBILITY CHECKLIST If answer is “Yes” to any of the following, the operation is not eligible Is Waste collected FORMCHECKBOX Yes FORMCHECKBOX No Is there an incineration facility FORMCHECKBOX Yes FORMCHECKBOX.

 

LOSS INFORMATION Applicable in Arkansas, Louisiana, and West Virginia Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit.

 

ELIGIBILITY CHECKLIST If answer is “Yes” to any of the following, the operation is not eligible Is Waste collected FORMCHECKBOX Yes FORMCHECKBOX No Is there an incineration facility FORMCHECKBOX Yes FORMCHECKBOX.

 

BUILDING INFORMATION.

 

Work for the military FORMCHECKBOX Yes FORMCHECKBOX No Adult Oriented Web Sites FORMCHECKBOX Yes FORMCHECKBOX No Website Hosting FORMCHECKBOX Yes FORMCHECKBOX No Hardware Manufacturing FORMCHECKBOX.

 

FORMCHECKBOX FR RECREATIONAL FACILITIES.

 

CHILDREN Enter the maximum number of children on the premises, in each age group on the highest attendance date within the year:.

 

b. FORMCHECKBOX For Profit FORMCHECKBOX Not For Profit c. FORMCHECKBOX Buildings or premises owned or leased FORMCHECKBOX No buildings or premises owned or leased except for office.

 

To the candidate:This optional form asks for some information already solicited in the Common Application. The information submitted on this form is for the use ofthe Pomona-Pitzer.