Business One Page Application

Business One Page Application

Applicant Name:     Doing Business As (DBA):

Company Name:     Effective Date:

RECITALS

WHEREAS, Applicant is engaged in the business described below and seeks to establish a commercial relationship with Company for the provision of goods and/or services; and

WHEREAS, Company provides commercial services and/or products and is willing to consider Applicant's request subject to the terms set forth in this application and any subsequent agreement; and

WHEREAS, the parties intend for this One Page Application, together with any accepted terms, to form the basis for a binding General Business Agreement upon execution by authorized representatives of both parties.

BUSINESS INFORMATION

Sole Proprietor    Partnership    LLC    Corporation    Other:

SCOPE OF WORK

The parties agree that Applicant seeks the following goods and/or services from Company and that Company may provide the following scope of work if accepted:

PAYMENT TERMS

Payment Amount:     Payment Schedule:

Late Fee: on outstanding balances; interest shall accrue from the due date until paid in full. Applicant agrees to reimburse Company for all reasonable collection costs, including attorney fees, if action is necessary to collect overdue amounts.

TERM AND TERMINATION

Term Commencement Date:     Termination Date (if any):

Either party may terminate any resulting agreement for convenience upon written notice to the other party delivered at least days prior to the intended termination date. Termination for cause may be immediate where a party materially breaches obligations and fails to cure within 15 days after written notice.

CONFIDENTIALITY

Each party (the "Receiving Party") shall keep confidential all non-public, proprietary, or business information disclosed by the other party (the "Disclosing Party") and shall not use or disclose such Confidential Information except as necessary to perform obligations under any resulting agreement. Confidential Information does not include information that (a) is or becomes public other than by breach; (b) is known to the Receiving Party prior to disclosure as demonstrated by written records; (c) is independently developed by the Receiving Party; or (d) is required to be disclosed by law, provided the Disclosing Party is given prompt notice and an opportunity to seek protective measures.

Applicant acknowledges and agrees to maintain reasonable safeguards to protect Company's Confidential Information and to return or destroy such Confidential Information upon Company's written request.

Acknowledgement of Confidentiality: Applicant acknowledges and agrees to the confidentiality provisions above.

GOVERNING LAW

This application, and any agreement arising from it, shall be governed by and construed in accordance with the laws of the State of without regard to conflict of law principles.

ENTIRE AGREEMENT

This One Page Application, together with any accepted written terms executed by authorized representatives of both parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior negotiations, proposals, representations, or agreements, whether written or oral. Any amendment or modification must be in writing and signed by both parties.

AUTHORIZATION AND CERTIFICATION

Applicant certifies that all information supplied in this application is true, complete, and correct to the best of Applicant's knowledge. Applicant authorizes Company to verify information provided, including obtaining credit, banking, or background information necessary to evaluate Applicant's request. Applicant agrees to promptly notify Company of any material changes to the information herein.

ADDITIONAL INFORMATION

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