Business Drain Request Form

Business Drain Request Form and Service Agreement

Parties and Effective Date

This Business Drain Request Form and Service Agreement ("Agreement") is entered into effective as of between:

Client Name:

Service Provider Name:

WHEREAS

WHEREAS, Client operates the business at the location identified in this form and requires professional drain inspection, cleaning, maintenance, repair, and related services (collectively, "Drain Services"); and

WHEREAS, Provider represents that it possesses the necessary licenses, equipment and personnel to perform Drain Services in a safe, timely and workmanlike manner and agrees to perform the Drain Services subject to the terms and conditions of this Agreement.

Business Drain Request Details

Emergency (requires immediate response)    ASAP    Schedule for a specific date

Client certifies that Client has the authority to authorize Provider to perform Drain Services at the Service Location. Client will provide safe and reasonable access, available utilities, and any permits required by applicable law.

Scope of Work

Payment Terms

Total Estimated Fee: $

Payment Due Days:    Late Fee:

Client will pay Provider for additional work not described in the Scope of Work only upon written authorization. All payments are non-refundable except as expressly provided herein.

Term and Termination

Term Commencement Date:    Term Expiration Date:

Either party may terminate this Agreement for convenience upon days' prior written notice. Provider may suspend services immediately upon Client's failure to pay undisputed amounts when due. Termination will not relieve Client of obligation to pay for services performed through the effective date of termination.

Confidentiality

Each party shall hold in confidence and not disclose to third parties any non-public business, technical or financial information received from the other party and designated as confidential or which, under the circumstances, ought reasonably to be treated as confidential. Confidential information shall not include information that is or becomes generally available to the public through no fault of the receiving party, is rightfully received from a third party without restriction, or is independently developed without use of the disclosing party's confidential information.

Permits, Compliance and Safety

Provider shall comply with all applicable laws, codes and regulations and shall obtain and maintain any licenses or permits required to perform the Drain Services. Client shall obtain any property owner permissions required for Provider to access the Service Location, unless otherwise agreed in writing.

Permit on File with Client:    Provider to obtain permits:

Liability and Insurance

Provider shall maintain commercial general liability insurance and, where applicable, workers' compensation insurance. Provider's liability to Client for any claim arising out of or in connection with this Agreement shall be limited to direct damages not to exceed the greater of the fees paid by Client for the specific work giving rise to the claim or $10,000, except for damages resulting from Provider's gross negligence or willful misconduct.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to its conflict of laws principles.

Entire Agreement; Amendments

This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals and understandings, whether written or oral. Any amendment must be in writing and signed by authorized representatives of both parties.

Acknowledgement and Certifications

By signing below, Client requests the Drain Services described herein and certifies that all information provided on this form is true and correct. Client authorizes Provider to perform the described work subject to the terms of this Agreement and certifies that Client has the authority to bind the business at the Service Location.

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