Business Supplier Profile Form

BUSINESS SUPPLIER PROFILE FORM

Supplier and Contracting Parties

Purchasing Entity Name:

Supplier Legal Name:

Effective Date:

WHEREAS (Recitals)

WHEREAS, the Purchasing Entity requires certain goods and/or services in the ordinary course of its business, and desires to identify and onboard a qualified supplier;

WHEREAS, the Supplier represents that it is duly organized, authorized and capable of providing the goods and/or services described herein and meeting the regulatory, insurance and financial requirements set forth by the Purchasing Entity;

WHEREAS, the parties desire to document supplier profile information and record certain commercial and contractual terms to facilitate procurement, payment and compliance;

Supplier Contact and Identification

Corporation LLC Partnership Individual/Sole Proprietor Other

Scope of Work / Products & Services

Payment Terms

Typical Contract Amount (if fixed):

Late Payment Fee:   Payment Terms (net):   Currency:

Banking and Remittance

Insurance & Compliance

Does the Supplier maintain commercial liability insurance at the limits required by the Purchasing Entity? Yes No

Term and Termination

Contract Start Date:   Contract End Date:

Either party may terminate for convenience upon days' written notice. Termination for cause is permitted for material breach where the breaching party fails to cure within days following written notice.

Confidentiality

The parties acknowledge that in the course of performance they may exchange Confidential Information. Each party shall: (a) maintain Confidential Information in strict confidence; (b) use Confidential Information solely for performance or administration of obligations under this profile and any subsequent purchase orders; and (c) not disclose Confidential Information to any third party except as permitted in writing or required by law. Confidential Information does not include information which is publicly available through no breach by the receiving party or which is rightfully obtained from a third party without restriction.

Governing Law and Entire Agreement

This profile and any resulting agreement shall be governed by the laws of: , without regard to conflict of law principles. This document, together with any referenced purchase orders, constitutes the entire agreement between the parties with respect to the subject matter and supersedes prior understandings, negotiations and representations, whether written or oral.

Acknowledgments & Certifications

By signing below, Supplier certifies that all information provided herein is true, accurate and complete; Supplier shall promptly notify Purchasing Entity of any material changes. Supplier further certifies that it will comply with applicable laws, safety standards and any specific client requirements provided in writing.

Additional Notes

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