Business Balance Document

BUSINESS BALANCE DOCUMENT

Business Name:    Counterparty Name:

RECITALS

WHEREAS, Business Name has provided goods and/or services to Counterparty Name under one or more agreements and invoices identified by Invoice Reference: ; and

WHEREAS, the parties wish to record the current balance, agree payment terms for resolution of outstanding amounts, and memorialize mutual acknowledgements regarding the account balance as of As Of Date: .

NOW, THEREFORE, in consideration of the mutual covenants set forth below, the parties agree as follows.

SCOPE OF WORK

BALANCE SUMMARY

The parties acknowledge the account activity and balances as follows:

ITEMIZED TRANSACTIONS

Enter key transactions supporting the balance. If additional transactions exist, attach an addendum signed by both parties.

PAYMENT TERMS

The parties agree that the Current Balance set forth above shall be satisfied according to the following terms.

If any scheduled payment is not received within the period specified in the schedule, late fees and interest will accrue as provided above. Failure to cure a payment default within the notice period set forth in Section Term and Termination will constitute an event of default, entitling the non-defaulting party to exercise remedies including acceleration, collection costs, and attorney's fees.

TERM AND TERMINATION

Termination for cause may be effected immediately upon material breach that remains uncured after the notice period. Termination does not relieve the obligor of accrued payment obligations, and upon termination all unpaid amounts become immediately due and payable unless otherwise agreed in writing.

CONFIDENTIALITY

Each party shall treat as confidential all non-public information delivered by the other party in connection with the account and this document, including but not limited to financial records, pricing, and business terms ("Confidential Information"). Confidential Information shall not be disclosed to third parties except to the extent required by law or to a party's legal or financial advisors on a need-to-know basis and who are bound by confidentiality obligations. Obligations under this section survive termination or expiration of this document for a period of three (3) years.

GOVERNING LAW

This Business Balance Document shall be governed by and construed in accordance with the laws of the State: without regard to its conflict of laws principles. Venue for disputes shall be in the state or federal courts located in the same state unless the parties agree otherwise in writing.

ENTIRE AGREEMENT

This document, together with any attachments or addenda signed by both parties, constitutes the entire agreement between the parties concerning the subject matter hereof and supersedes all prior understandings, agreements, negotiations and discussions, whether oral or written. No amendment or modification is binding unless made in writing and signed by both parties.

NOTICES

CERTIFICATION AND ACKNOWLEDGMENT

Each party represents and warrants that the individual executing this document on its behalf is authorized to bind the party, that the financial information and balances set forth are true and correct to the best of the signing party's knowledge, and that acceptance of this document constitutes a binding agreement to the payment, confidentiality and other obligations set forth herein. The parties further acknowledge that this document may be used to support collection efforts and is intended to create a binding contractual obligation.

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