Acknowledgement Esignature Form

ACKNOWLEDGEMENT E-SIGNATURE FORM

This Acknowledgement and E-Signature Consent (the Agreement) is entered into by and between Client Name: and Service Provider Name: (collectively, the Parties) effective as of Effective Date: .

RECITALS

WHEREAS, the Parties have entered into a separate agreement for the provision of services and related deliverables described below (the Underlying Agreement) with an effective date of ; and

WHEREAS, the Parties wish to confirm consent to receive notices and execute signatures electronically and to acknowledge certain business terms including scope, payment, and confidentiality; and

WHEREAS, the Parties desire that this Acknowledgement and related consents be binding and admissible in any proceeding as if such consents and acknowledgements were provided in original handwritten form.

SCOPE OF WORK

PAYMENT TERMS

Total Payment Amount:

Late Payment Fee: . All unpaid sums shall accrue interest at the stated rate or the maximum allowed by law, whichever is lower. Client shall also be responsible for reasonable collection costs and attorneys' fees incurred to collect overdue amounts.

TERM AND TERMINATION

Term Commencement Date: . Term Expiration Date: .

Either Party may terminate this Agreement for material breach if the breaching Party fails to cure such breach within days after receipt of written notice. Either Party may also terminate for convenience upon days' written notice to the other Party. Termination shall not relieve either Party of obligations that accrued prior to the effective date of termination.

CONFIDENTIALITY

"Confidential Information" means non-public information disclosed by one Party to the other, whether written, oral, electronic, or in any other form, that is designated as confidential or reasonably understood to be confidential. The receiving Party shall (i) hold Confidential Information in confidence using at least the same degree of care it uses to protect its own confidential information but no less than a reasonable standard of care, (ii) use Confidential Information solely to perform its obligations under this Agreement, and (iii) not disclose Confidential Information to any third party except to employees, consultants, or advisors who have a need to know and are bound by confidentiality obligations no less protective than those set forth herein. The obligations of confidentiality shall survive termination of this Agreement for a period of three (3) years, or longer to the extent required by applicable law or to protect trade secrets.

ELECTRONIC SIGNATURE CONSENT AND ACKNOWLEDGEMENT

By checking the boxes below and signing this form, the undersigned acknowledges and agrees that electronic delivery of notices and execution of signatures shall have the same legal effect as a handwritten signature, and that the Parties intend to be bound by electronic signatures.

I consent to receive notices, agreements, and related documents electronically.

I agree that my electronic signature is the legal equivalent of my manual signature.

Method of Electronic Signature (select all that apply): Typed name Drawn signature on device Electronic signature service

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to its conflicts of law principles. Any dispute arising under or relating to this Agreement shall be resolved in the courts located within that State, subject to applicable jurisdictional requirements.

ENTIRE AGREEMENT

This Agreement, together with the Underlying Agreement and any exhibits or attachments expressly incorporated herein, constitutes the entire agreement between the Parties with respect to the subject matter and supersedes all prior and contemporaneous agreements, understandings, negotiations and discussions, whether oral or written. Any amendment or modification to this Agreement must be in writing and signed by authorized representatives of both Parties.

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