Certification for Induction Loop Certificate

CERTIFICATION FOR INDUCTION LOOP CERTIFICATE

Certificate Number:

WHEREAS

WHEREAS Client Name: (the "Client") desires the design, installation and certification of an induction loop (hearing loop) system at the Premises identified below;

WHEREAS Contractor Name: (the "Contractor") is duly experienced and qualified to install and test induction loop systems in accordance with applicable industry standards and accepted measurement procedures;

WHEREAS the Parties have agreed that the Contractor shall perform the Scope of Work described below and shall furnish a certification attesting that the installed induction loop system meets the specified performance criteria or, where it does not, shall list the deviations and remedial measures undertaken;

SITE AND SYSTEM IDENTIFICATION

Site / Premises Name:

Installation Date:    System Type:

SCOPE OF WORK

CERTIFICATION DETAILS & TEST RESULTS

Installer Company:

Coverage Area / Zones Tested:

Test Result: Pass Fail

PAYMENT TERMS

Late Fee / Interest on Overdue Amounts:

TERM AND TERMINATION

Agreement Start Date:    Agreement End Date (if applicable):

Either Party may terminate this Agreement for material breach by the other Party if the breaching Party fails to cure such breach within the specified notice period. Termination does not relieve the Client of the obligation to pay for work satisfactorily performed through the date of termination, subject to offsets for Contractor's uncured breaches.

CONFIDENTIALITY

Each Party shall maintain as confidential all proprietary technical and business information of the other Party disclosed in connection with this Agreement and shall not disclose such information to any third party except as required by law or to employees, agents, or subcontractors who have a need to know and who are bound by confidentiality obligations at least as restrictive as those set forth herein. Confidential information does not include information that is or becomes publicly available through no fault of the receiving Party or that is independently developed without use of the disclosing Party's confidential information.

GOVERNING LAW

This Agreement and any dispute arising out of or relating to this Agreement shall be governed by and construed in accordance with the laws of the State of without regard to its conflict of laws rules.

ENTIRE AGREEMENT

This document, together with any attachments and written change orders executed by the Parties, constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings and communications, whether written or oral. No amendment or modification shall be effective unless in writing and signed by both Parties.

CERTIFICATION

The undersigned, on behalf of the Contractor, certifies that the induction loop system described in this Certificate has been installed and tested in accordance with the Scope of Work and the referenced Test Standard. The undersigned further certifies that the Test Results and Measured Values reported above are true and correct to the best of the signatory's knowledge and that any known deviations have been documented and remedied or noted for future correction.

Name of Certifying Representative:    Title:

Signature (Installer Representative):    Date:

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