Client Intake Profile

CLIENT INTAKE PROFILE

Client Details

Entity Type: Individual Corporation LLC Partnership

Business / Project Information

Engagement Agreement Recitals

WHEREAS, Client Name: seeks to engage Service Provider: to perform professional services as described below;

WHEREAS, the parties desire to set forth the scope, terms and conditions of the engagement in writing so that each party's duties and obligations are clear and enforceable;

WHEREAS, the effective date of this engagement is .

Scope of Work

Describe the services to be provided. Provide sufficient detail to define deliverables, milestones, and exclusions.

Payment Terms

Total Fee (or estimated fee): $

Late Fee and Interest: Unpaid amounts shall accrue interest at and a service charge of for delinquent invoices.

Term and Termination

Term Commencement: . Anticipated Completion: .

Either party may terminate this engagement for convenience upon written notice delivered at least days prior to the effective termination date. Termination for cause may be immediate where a material breach is not cured within a reasonable period after written notice.

Confidentiality

Each party agrees to maintain in strict confidence all Confidential Information disclosed by the other party in connection with this engagement. Confidential Information excludes information that is (a) generally known to the public other than through breach of this Agreement, (b) already in the receiving party's possession prior to disclosure as demonstrated by written records, or (c) independently developed without use of the disclosing party's Confidential Information. The receiving party shall use Confidential Information only for the purpose of performing obligations under this engagement and shall not disclose it to any third party except to employees, contractors, or advisors who have a need to know and are bound by comparable confidentiality obligations.

Governing Law; Entire Agreement

Governing Law: This Agreement and any dispute arising out of or relating to it shall be governed by the substantive laws of the state identified by the Service Provider, exclusive of its choice-of-law rules. Specify governing state if different:

Entire Agreement: This intake profile together with any attached statements of work, schedules, or exhibits constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior and contemporaneous agreements, representations, and understandings. Any modification must be made in writing and signed by both parties.

Administrative Information & Certifications

Documents Provided (check all that apply): Government ID copy Tax Identification form Executed contract Other

Certification: By signing below, Client certifies that the information provided herein is true and accurate to the best of Client's knowledge. Client authorizes Service Provider to verify any information provided, including performing reasonable background checks where permitted by law. Client acknowledges that submission of false information may constitute grounds for termination and may subject Client to liability.

Acceptance: The undersigned represent that they are authorized to execute this Intake Profile and Agreement on behalf of the respective parties and that acceptance below constitutes a binding agreement subject to the terms contained herein.

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