Equipment Request Form

EQUIPMENT REQUEST FORM & SUPPLY AGREEMENT

Request Summary

Request ID:

Equipment Requested

Complete one or more line items below. Provide model, manufacturer, and any required accessories or consumables.

Purchase Rental/Lease Other

Agreement Recitals

WHEREAS, Requesting Party has identified the need for the equipment described herein to support its business operations and has submitted this request to procure or lease such equipment;

WHEREAS, Supplier represents that it is authorized to supply, deliver, and, if applicable, install and maintain the requested equipment in accordance with the terms set forth in this Agreement;

NOW, THEREFORE, in consideration of the mutual covenants and promises contained in this document and other good and valuable consideration, the parties agree as follows.

Scope of Work

Supplier shall supply the equipment described in the Equipment Requested section and shall perform any agreed services including delivery, installation, configuration, testing, and commissioning as specified. Supplier shall supply all labor, parts, materials, and documentation required to make the equipment operational to the Requesting Party's reasonable specifications. Any deviation from the scope must be approved in writing by both parties prior to performance.

Payment Terms

Requesting Party agrees to pay Supplier the amounts invoiced for equipment and services in accordance with the schedule below. All amounts are due in United States dollars unless otherwise stated. Supplier shall provide itemized invoices that reference this Request ID.

Late fee: on outstanding balances, compounded monthly, plus reasonable collection costs. Taxes: Requesting Party is responsible for applicable taxes unless Supplier provides a valid exemption certificate.

Term and Termination

This Agreement commences on the Start Date and continues until the End Date or until all obligations are fulfilled, unless earlier terminated as provided herein. Either party may terminate this Agreement for convenience upon written notice to the other party delivered at least the number of days specified below. Either party may terminate for material breach if the breach remains uncured for thirty (30) days after written notice.

Upon termination for any reason, Requesting Party shall return all equipment in accordance with Supplier's reasonable return instructions. Outstanding amounts for equipment delivered and services performed prior to termination shall become immediately due and payable. Supplier may withhold final deliverables until payment is made in full.

Confidentiality

"Confidential Information" means non-public information disclosed by one party to the other related to pricing, technical specifications, business processes, or other proprietary matters. Each party shall (a) maintain confidentiality with at least the same degree of care it uses to protect its own confidential information, but no less than reasonable care; (b) use Confidential Information solely to perform obligations under this Agreement; and (c) not disclose Confidential Information to third parties except to affiliates, advisors, or contractors who have a need to know and who are bound by confidentiality obligations no less protective than those herein. Confidential Information does not include information that is or becomes public through no wrongful act of the receiving party, is rightfully known prior to disclosure, or is independently developed without use of the disclosing party's Confidential Information.

Warranties and Liability

Supplier warrants that equipment delivered will materially conform to the manufacturer's specifications and be free from defects in materials and workmanship for a period set forth in the invoice or manufacturer's warranty. EXCEPT FOR THE FOREGOING EXPRESS WARRANTY, SUPPLIER DISCLAIMS ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, INCLUDING MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. IN NO EVENT SHALL EITHER PARTY BE LIABLE FOR INDIRECT, INCIDENTAL, SPECIAL, OR CONSEQUENTIAL DAMAGES, AND EACH PARTY'S AGGREGATE LIABILITY ARISING OUT OF OR RELATED TO THIS AGREEMENT SHALL NOT EXCEED THE TOTAL AMOUNTS PAID OR PAYABLE BY REQUESTING PARTY TO SUPPLIER UNDER THIS AGREEMENT IN THE TWELVE (12) MONTHS PRECEDING THE CLAIM.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the state specified below, without regard to conflict of laws principles. The parties submit to the exclusive jurisdiction of the state and federal courts located in that state for any dispute arising out of or related to this Agreement.

Entire Agreement

This document, together with any purchase orders or change orders executed by both parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements, proposals, negotiations, and communications, whether written or oral. Any amendment must be made in writing and signed by authorized representatives of both parties.

Approvals

By submitting this Equipment Request Form and signing below, Requesting Party and Supplier each represent and warrant that they are authorized to enter into this Agreement, that the information provided is true and complete to the best of their knowledge, and that they will comply with the terms set forth herein.

Sign Now