Business Entry Form

BUSINESS ENTRY FORM

RECITALS

WHEREAS, Applicant Business: is a business seeking entry and limited operations at the premises managed by Host Entity: ;

WHEREAS, Applicant requires access for the purpose of conducting the activities described below and Host is willing to permit such access on the terms and conditions set forth in this Business Entry Form (the "Agreement").

APPLICANT INFORMATION

Sole Proprietor    LLC    Corporation    Partnership    Other:

PROPOSED ENTRY DETAILS

Proposed Entry Date:    Location on Premises:

INSURANCE AND PERMITS

Liability Insurance Carrier:    Policy Number:

Coverage Limits:

SCOPE OF WORK

The Applicant shall perform the work described below in a professional manner and in accordance with all applicable laws, regulations, and Host site rules:

PAYMENT TERMS

Fees for access and associated services shall be as follows. Applicant agrees to pay Host the amounts in accordance with this Payment Terms section.

Late fee:    Billing Contact / Invoice Address:

TERM AND TERMINATION

Term Commencement Date:    Term End Date:

Either party may terminate this Agreement for material breach that remains uncured after notice and the opportunity to cure as provided below. Required notice period prior to termination for convenience: days.

Material breach includes, without limitation, failure to maintain required insurance, failure to obtain required permits, or failure to pay amounts when due. Termination does not relieve either party of obligations accrued prior to termination, including payment for services rendered and indemnity obligations.

CONFIDENTIALITY

Definition: "Confidential Information" means non-public business, technical, financial and other proprietary information disclosed by one party to the other in connection with this Agreement, whether disclosed in writing, orally, or by inspection.

Obligations: The receiving party shall (i) protect Confidential Information with at least the same degree of care it uses to protect its own confidential information but no less than reasonable care, (ii) limit disclosure to employees, agents or contractors who have a need to know and who are bound by confidentiality obligations, and (iii) use Confidential Information only for performance under this Agreement.

Exclusions: Confidential Information does not include information that is or becomes publicly available through no breach, was known prior to receipt, is rightfully received from a third party without restriction, or is independently developed.

Duration of confidentiality obligations: years from the date of disclosure, except for trade secrets, which shall be protected for so long as they remain trade secrets under applicable law.

INSURANCE, INDEMNITY, AND COMPLIANCE

Insurance: Applicant shall maintain insurance as specified above and provide certificates evidencing coverage upon request. Host may require additional insured status where reasonably necessary to protect Host's interests.

Indemnity: Applicant shall defend, indemnify and hold harmless Host and its directors, officers, employees and agents from and against any claims, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of or resulting from Applicant's acts or omissions in connection with this Agreement, except to the extent caused by Host's gross negligence or willful misconduct.

Compliance: Applicant warrants that it will comply with all applicable federal, state and local laws, ordinances, codes and regulations while on Host premises and will obtain all necessary permits and licenses prior to commencement of work.

GOVERNING LAW; DISPUTE RESOLUTION

Governing Law State:    This Agreement shall be governed by and construed in accordance with the laws of the state specified above without regard to conflicts of law principles. The parties agree that venue for any action arising out of this Agreement shall lie in the state and federal courts located within that state.

ENTIRE AGREEMENT

This Agreement, including all attachments and documents incorporated by reference, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous understandings and agreements, whether written or oral. No amendment shall be effective unless in writing signed by authorized representatives of both parties.

CERTIFICATIONS AND AUTHORIZATIONS

By signing below, Applicant certifies that the information provided in this Business Entry Form is true and correct, that Applicant is authorized to enter into this Agreement, and that Applicant will maintain all required insurance, permits and licenses during the Term. Host's signature constitutes authorization for Applicant to enter the premises subject to the terms herein.

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