Business Advice and Suitability Form

BUSINESS ADVICE AND SUITABILITY FORM

Parties and Contact Information

Client Name:    Business Name:

Advisor Name:    Advisor Firm:

Recitals

WHEREAS, Client desires to obtain business advisory services relating to strategic planning, organizational suitability, and financial and operational recommendations for the Client's business venture; and

WHEREAS, Advisor represents that Advisor possesses the necessary skill, experience and qualifications to render advisory services to the Client and is willing to provide such services subject to the terms set forth in this Agreement; and

WHEREAS, the parties wish to document the scope, fees, suitability assessment and other terms governing the provision of advisory services.

Scope of Work

Description of Services: The Advisor shall provide business advice and suitability analysis which may include market assessment, organizational recommendations, financial modeling, capital structure guidance, operational improvement plans, and recommendations for regulatory or compliance considerations as requested by the Client and agreed in writing.

Suitability Assessment

Industry:    Business Stage: Startup Growth Mature

Risk Tolerance: Low Moderate High    Time Horizon:

Payment Terms

Fee Amount:    Currency:

Flat fee Retainer Hourly Success fee

Late Fee:    Expenses: Advisor shall be reimbursed for pre-approved out-of-pocket expenses incurred in connection with the services upon submission of reasonable documentation.

Term and Termination

Term Start Date:    Term End Date:

Either party may terminate this Agreement for convenience upon written notice to the other party given at least prior to termination. The Advisor may terminate immediately for Client's material breach that is not cured within a commercially reasonable period following written notice. Termination does not relieve Client of its obligation to pay for services performed and expenses incurred through the effective date of termination.

Confidentiality

The parties acknowledge that, in connection with this engagement, each may receive confidential and proprietary information of the other. Each party agrees to maintain such information in strict confidence, to use it solely for the purposes of performing under this Agreement, and not to disclose it to any third party except as required by law or with the prior written consent of the disclosing party. Confidential information does not include information that is or becomes publicly available through no breach by the receiving party, or that is independently developed without use of the disclosing party's confidential information. Upon termination or upon request, the receiving party shall return or certify the destruction of confidential materials.

Conflicts; Disclosures

Representations and Acknowledgements

By signing below, Client represents and warrants that the information provided in this form is true, accurate and complete to the best of Client's knowledge and that Client has the authority to engage Advisor. Client acknowledges that Advisor's recommendations are advisory in nature, that Advisor is not providing legal or tax advice unless explicitly agreed in writing, and that final business decisions rest with Client.

Client consents to Advisor's collection and retention of business and financial information necessary to perform services. Client authorizes Advisor to rely upon the representations and data provided by Client and understands that omission or misstatement of facts may affect the suitability of Advisor's recommendations.

Governing Law; Entire Agreement

This Agreement shall be governed by and construed in accordance with the laws chosen by the parties: Jurisdiction: . Any dispute arising under this Agreement shall be resolved in the courts of that jurisdiction unless the parties mutually agree to alternative dispute resolution in writing.

This Agreement, including all attachments, schedules and any written engagement letters signed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings, negotiations and discussions, whether written or oral. Any amendment or modification must be in writing and signed by both parties.

Client Consent and Certification

By checking the boxes and signing, Client certifies that Client has read and understood the terms set forth herein, that the information supplied is complete and accurate, and that Client authorizes Advisor to provide the services described.

I certify that information provided is true and complete.

I understand Advisor's recommendations are advisory and not binding.

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