FORM OF COMPANY REPRESENTATIVE NOTICE
120 Adelaide Street West
Suite 1600
Toronto, Ontario M5H 1T1
T 416-967-7474
F 416-967-1947
www.ieso.ca
contract.management@ieso.ca
IESOCM-FORM-005A(2011-10)
SUBMIT BY E-MAIL (PDF WITH SIGNATURE) TO
contract.management@ieso.ca
Pursuant to Section [No.] of the Contract, the Supplier is hereby submitting this completed Form of Company Representative Notice to the Buyer.
Capitalized terms not defined herein have the meanings ascribed thereto in the Contract.
ADDING OR REPLACING THE COMPANY REPRESENTATIVE
The Authorized Signatory below is either a signatory of the Contract, a person authorized to receive Notices, or the Company
Representative. No other forms are required.
The Authorized Signatory below is neither a signatory of the Contract, a person authorized to receive Notices, nor the Company
Representative. A Form of Certificate of Incumbency (IESOCM-FORM-18A/Corporation or IESOCM-FORM-18B/General Partner)
must be submitted with this form.
Date
Legal Name of Supplier
Name of Contract Facility
Location of Contract Facility
Municipality
Contract Title
(the “Contract”)
Contract Date
ADD
THE CURRENT COMPANY REPRESENTATIVE WILL BE REMOVED WHEN A NEW COMPANY REPRESENTATIVE IS APPOINTED.
Name of
Company Representative
Title
Mailing Address
Including Postal Code
Telephone
Direct Line
(
)
Fax
Direct Line
(
)
E-Mail Address
AUTHORIZED SIGNATORY
By:
Date:
[Name]
[Title]
[Legal Name of Supplier]
FORM OF COMPANY REPRESENTATIVE NOTICE
IESOCM-FORM-005A(2011-10)
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