Fill and Sign the Bartering Contract Form

Bartering Contract or Exchange Agreement 1. Name of Person or entity initiating barter offer (the Offeror ): ______________________________________________________________________ 2. Street Address or Post Office Box Number of Offeror: ______________________________________________________________________ 3. City, State and Zip Code __________________________________________________ 4. Phone: ________________Fax: ___________________Email: ___________________ 5. Name of Person or entity accepting barter offer (the Offeree ): ______________________________________________________________________ 6. Street Address or Post Office Box Number of Offeree: ______________________________________________________________________ 7. City, State and Zip Code of Offeree: ________________________________________ 8. Phone: ________________Fax: ___________________Email: ___________________ 9. Description of product and/or service that Offeror is offering: ______________________________________________________________________ 10. Condition of product: [ ] New [ ] Used A. Price: $_____________________ B. If services are being offered, is this a flat or hourly rate? [ ] Yes [ ] No C. If hourly rate, how many hours are being offered?_____________________ D. Applicable State Tax (to be paid separately): _______________________ 11. If a product or products are being offered, describe or identify the following: A. Manufacturer: _________________________ Year ______________ B. Delivery Method: ____________________________________________ C. Model #: ________________________________________________ D. Who will pay for delivery? ____________________ E, Serial #: _________________________________________________ 12. Monetary value of Offeror’s offer to Offeree for barter? $ _____________ 13. Does offer exceed the price of the item and/or service? [ ] Yes [ ] No If so, how will remainder be paid? _____________________________________ 14. Description of product or service that Offeror wishes to receive: ______________ _________________________________________________________________ A. Delivery Method: ____________________________________________ B. Who will pay for delivery? ____________________________________ * * * * * * * * * * * This Agreement is between ________________________________, Offeror, and _______________________________, Offeree, who jointly agree to be bound by the following terms and conditions when bartering products and/or services as outlined above. I. It is understood by both parties that completion and submission of this form by Offeree to Offeror represents the intent of Offeror and Offeree to enter into a legally binding contract. Upon acceptance of the product and/or service described above as the bid amount of Offeror, Offeree agrees to submit payment for the product and/or service via barter and other means ( e.g., check, money order or credit card), as agreed. Each party agrees to inform the other of all anticipated fees before commencement of any exchange of products and/or services. II. Each party attests that he or she is freely entering into this Agreement freely and will abide by its directives and requirements. III. Each party agrees to adhere to the price set by each as final. Each party attests that the pricing for product and/or service represents fair market value, to the best of their knowledge, within that industry. IV. Each party represents and warrants that the product and/or service being offered for barter can legally be sold by them and that their assigned agents or dealers and have full power to make this Agreement. Each party also represents and warrants that the product and/or service does not infringe upon any statutory copyright or upon any common law rights, proprietary rights or any other rights of another person or entity. V. Each party shall indemnify, defend and hold harmless the other, its officers, trustees, agents assigns, and employees, from and against any and all claims, demands, suits, losses, liabilities and costs, including attorneys’ fees, arising out of any alleged breach of the foregoing warranties or any alleged violation of copyright or other property rights. VI. Each party a grees to adhere to the delivery schedule as set by the parties. Each party a grees to deliver products and/or services in good condition. VII. Each party attests that all information included on this contract is true, to the best of their knowledge. VIII. If either p arty opts to terminate this barter agreement, the terminating party agrees to compensate the other party fairly for any products and/or services provided as of the date of the termination notice. IX. Any reference to a party includes that party's heirs, executors, administrators, successors and assigns, singular includes plural and masculine includes feminine. Witness our signatures effective the ______ day of _________________, 20_____. ________________________________ (Name of Offeror) ________________________________ (Signature of Offeror) ________________________________ (Name of Offeree) ________________________________ (Signature of Offeree) (Acknowledgment form may vary by state) STATE OF ______________ COUNTY OF _______________ Personally appeared before me, the undersigned authority in and for the said county and state, on this ____ day of _________, 20__, within my jurisdiction, the within named, _________________________ (Name of Offeror), who acknowledged that he/she executed the above and fore going instrument. ________________________ NOTARY PUBLIC My Commission expires: ______________________ STATE OF ______________ COUNTY OF _______________ Personally appeared before me, the undersigned authority in and for the said county and state, on this _____ day of _________________, 20_____, within my jurisdiction, the within named, ____________________________ (Name of Offeree) , who acknowledged that he/she executed the above and fore going instrument. NOTARY PUBLIC _______________________ My Commission expires: ______________________