Business Application Form

BUSINESS APPLICATION FORM

RECITALS

WHEREAS, Applicant Name: (the "Applicant") submits this Business Application Form to request acceptance as a vendor, supplier, or business partner of Company Name: .

WHEREAS, the Company requires information and certain contractual commitments from the Applicant in order to evaluate the Applicant's qualifications and to define the scope of any subsequent engagement; and

WHEREAS, upon acceptance of this application, the parties intend that the terms stated herein and any attachments will govern the business relationship between Applicant and Company.

BUSINESS INFORMATION

Corporation LLC Partnership Sole Proprietor Other:

OWNERSHIP / PRINCIPALS

SCOPE OF WORK

Describe the goods or services Applicant seeks to provide to the Company. Include deliverables, performance standards, and any milestone schedule.

PAYMENT TERMS

Compensation Amount: $ (amount per invoice or unit)

Payment Schedule: . Payments will be made in accordance with invoices rendered and subject to the Company's invoice approval process.

Late Payment: A late fee of on unpaid balances, or the maximum lawful rate if lower, will accrue on overdue amounts.

TERM AND TERMINATION

Effective Start Date: . Term shall continue until Effective End Date: unless earlier terminated under the provisions below.

Termination for Convenience: Either party may terminate this engagement for convenience upon written notice delivered days prior to the effective termination date. Termination for Cause: Either party may terminate immediately upon material breach by the other if such breach remains uncured for days after written notice.

CONFIDENTIALITY

The parties acknowledge that in the course of performance they may receive Confidential Information. "Confidential Information" means nonpublic business, technical, or financial information disclosed in any form. Each party shall: (a) hold Confidential Information in strict confidence; (b) not disclose it to any third party except as necessary for performance and subject to confidentiality obligations; and (c) use it only to perform obligations under this agreement. The obligations do not apply to information that is public, known prior to disclosure, independently developed, or lawfully required to be disclosed by valid legal process (provided the disclosing party is given prompt notice to seek protective measures).

GOVERNING LAW; COMPLIANCE

This application, and any subsequent agreement arising from acceptance of this application, shall be governed by and construed in accordance with the laws of the jurisdiction specified by Company: without regard to choice-of-law principles. Applicant agrees to comply with all applicable laws, ordinances and regulations in performing under any engagement.

REPRESENTATIONS, WARRANTIES, AND CERTIFICATIONS

Applicant represents and warrants that: (a) all information provided in this application is true, complete, and accurate; (b) Applicant has full authority to enter into agreements and perform the requested services; and (c) there are no pending judgments or insolvency proceedings that would materially impair Applicant's ability to perform.

Applicant authorizes Company to verify any representations and to obtain credit or background reports as necessary to evaluate this application. Applicant further certifies that it will maintain insurance required for performance and will provide certificates upon request.

ENTIRE AGREEMENT; AMENDMENT

This Business Application Form, together with any schedules, attachments, and any subsequent agreement executed by the parties, constitutes the entire agreement between Applicant and Company with respect to the subject matter and supersedes all prior negotiations and understandings. Any amendment must be in writing and signed by authorized representatives of both parties.

DECLARATION AND AUTHORIZATION

By signing below, Applicant certifies under penalty of perjury that the information provided in this application is true and complete to the best of Applicant's knowledge, and that Applicant is authorized to bind the entity identified herein. Applicant consents to the collection and use of business and personal data for purposes of evaluating this application.

Applicant authorizes Company to obtain trade references and to contact banks, suppliers, and other parties to verify Applicant's financial condition and performance history. Applicant will promptly notify Company in writing of any material change to the information supplied.

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