Housing Replenishment Request Form

Housing Replenishment Request Form

REQUEST IDENTIFICATION

Request ID:   Date of Request:

Requesting Party Name:

RECITALS

WHEREAS, the Requesting Party operates or manages the residential property identified above and requires replenishment of supplies, fixtures, or consumables necessary to maintain habitability and tenant services; and

WHEREAS, the Supplier or Housing Provider has represented that it is able to supply the requested items and perform delivery, inventory replacement, or installation services in accordance with the terms set forth in this Request and any resulting agreement; and

WHEREAS, both parties desire to document the scope, payment, timing, and confidentiality obligations related to this replenishment to ensure continuity of housing services.

SCOPE OF WORK

ITEMIZED REPLENISHMENT

List each item, quantity, unit price (if known), and any special delivery or installation notes. Add additional rows if necessary.

PAYMENT TERMS

Total Estimated Amount:

Late Payment Fee:

Billing Contact Name:

Billing Contact Email/Phone:

TERM AND TERMINATION

Effective Start Date:   Intended Completion / End Date:

Either party may terminate this replenishment request or resulting supply agreement for material breach or failure to perform after written notice and a cure period of days.

Termination for convenience requires a written notice of days and payment for work completed through the effective termination date.

CONFIDENTIALITY

Both parties acknowledge that during the performance of replenishment services they may receive confidential information regarding tenants, operations, pricing, or security procedures. Each party agrees to:

1. Hold such information in strict confidence and not disclose it except as required by law or as necessary to perform obligations under this Request;
2. Limit disclosure to employees or subcontractors with a strict need to know and who are bound by equivalent confidentiality obligations; and
3. Return or destroy confidential materials upon completion of the replenishment services or upon written request of the disclosing party.

GOVERNING LAW

This Request and any resulting agreement shall be governed by and construed in accordance with the laws of the state where the property is located. The parties submit to the exclusive jurisdiction of the state and federal courts located within that state for any dispute arising under this Request.

ENTIRE AGREEMENT

This Request, including its recitals, scope, itemized attachments, and any written approvals by authorized signatories, constitutes the entire agreement between the parties with respect to the subject matter herein and supersedes all prior negotiations, representations, or agreements, whether written or oral. No amendment shall be effective unless in writing and signed by authorized representatives of both parties.

APPROVALS / CONTACTS

ACKNOWLEDGMENT

By signing below, the parties acknowledge that they have read, understand, and agree to the terms of this Housing Replenishment Request Form. The parties further confirm that the information provided is true and that signatories have authority to bind their respective organizations.

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