Business Supplier Inclusion Form

Business Supplier Inclusion Form

Recitals

WHEREAS, Company Name: seeks to maintain a roster of qualified suppliers for goods and services necessary to its operations; and

WHEREAS, Supplier Name: represents that it is available and qualified to provide the goods or services described in the Scope of Work below pursuant to the terms set forth in this Business Supplier Inclusion Form (the "Agreement"); and

WHEREAS, the parties desire to document the material commercial, compliance and administrative terms by which Supplier will be included as an approved supplier.

Supplier Information

Corporation   LLC   Partnership   Sole proprietorship   Other:

Scope of Work

Describe the goods and/or services Supplier is approved to provide. This description establishes the initial scope for supplier inclusion; specific purchase orders, statements of work or change orders will govern particular engagements.

Payment Terms

Supplier will invoice Company in accordance with the agreed schedule. Company will pay undisputed invoices in accordance with the following terms:

Late payments will incur interest or fees as set forth below:

Payment Method: ACH   Wire transfer   Check  

Supplier acknowledges responsibility for accuracy of banking information and accepts that Company is not liable for misdirected funds resulting from inaccurate information provided by Supplier.

Term and Termination

Inclusion is effective as of Effective Date: and will continue until End Date: unless earlier terminated in accordance with this section.

Either party may terminate this inclusion for convenience upon providing Notice Period (days): days' written notice to the other party. Company may also immediately suspend or remove Supplier from the approved roster for material breach, failure to maintain required insurance or compliance, or for reasons of safety or regulatory noncompliance.

Confidentiality

Supplier and Company each agree that information designated as confidential or which reasonably should be understood to be confidential will be protected from unauthorized disclosure and used only for purposes of performance under this Agreement. Confidential information excludes information that is or becomes publicly available other than by breach, is rightfully received from a third party without restriction, or is independently developed without use of the other party's confidential information.

Insurance and Compliance

Supplier shall, at its expense, maintain insurance coverages customary and sufficient for the risks associated with the services or goods provided, and shall provide certificates of insurance upon request. Supplier certifies that it complies with all applicable laws, regulations and licensing requirements necessary for performance.

Supplier certifies that it is authorized to conduct business and is in compliance with all applicable workplace, tax and employment laws in jurisdictions where services are performed.

Warranties and Representations

Supplier represents and warrants that all goods and services supplied will conform to the specifications, be free from defects and be performed in a professional and workmanlike manner. Supplier further warrants that it has all rights, licenses and permits required to perform and deliver the goods and services.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State/Province specified here: without regard to choice-of-law principles.

Entire Agreement

This Business Supplier Inclusion Form, together with any referenced purchase orders, statements of work and attachments, constitutes the entire agreement between Company and Supplier relating to the subject matter hereof and supersedes all prior offers, negotiations and agreements, whether written or oral. Any modification must be in writing and signed by authorized representatives of both parties.

Certifications and Acknowledgments

By signing below, Supplier certifies that the information provided in this form is true, complete and accurate to the best of Supplier's knowledge; Supplier agrees to notify Company promptly of any material changes to the information provided.

Supplier acknowledges that inclusion on Company's supplier roster is not a guarantee of work or purchase volume, and that individual engagements will be governed by separate purchasing documents.

Attachments

Indicate which documents are provided with this submission:

Tax or identification documentation   Certificate of insurance   Business license or professional license   Other:

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