Legal Acknowledgment of Service

Legal Acknowledgment of Service

This Legal Acknowledgment of Service (the "Acknowledgment") is entered into by and between Acknowledging Party: whose address for receipt of notices is , and Serving Party: whose business address is . The parties are collectively referred to as the "Parties."

RECITALS

WHEREAS, Serving Party asserts that it effected service of process upon the person or entity identified below in accordance with applicable rules governing service; and

WHEREAS, Acknowledging Party desires to document the facts, manner and date of such service for the record and to permit the Parties and any tribunal of competent jurisdiction to rely upon the representations contained herein; and

WHEREAS, the Parties intend that this Acknowledgment constitute a written record of service and a certification of service-related facts for the limited purposes set forth below.

NOW, THEREFORE, in consideration of the mutual covenants and promises contained herein, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows:

1. ACKNOWLEDGMENT OF SERVICE

Serving Party certifies that service was made on the following date: at approximately at the location: .

Name and relationship of person served (if applicable): ; Description of person served (e.g., age, appearance): .

Documents served (title and number of pages):

2. METHOD OF SERVICE

The method of service was (check all that apply):

Personal delivery Substituted service Certified or registered mail Posting Other (specify)

3. CERTIFICATION OF SERVING PARTY

Serving Party hereby certifies under penalty of perjury under the laws of the applicable jurisdiction that the facts set forth in this Acknowledgment are true and correct to the best of Serving Party's knowledge, information and belief. Serving Party further certifies that all steps required for the method of service selected were completed in conformity with governing procedural rules.

Name of person who performed service: ; Process server identification number or badge (if applicable): .

4. REPRESENTATIONS, WARRANTIES AND INDEMNITY

Each Party represents and warrants that it has the full power and authority to enter into this Acknowledgment and to perform its obligations hereunder. Serving Party agrees to indemnify and hold harmless Acknowledging Party from and against any claims, liabilities, losses or expenses arising from any material misstatement, omission, or failure to comply with applicable service requirements by Serving Party or the person performing service under Serving Party's direction.

5. NOTICES

All notices, requests, demands and other communications required or permitted hereunder shall be given in writing and delivered to the addresses set forth below or to such other address as a Party may designate by written notice:

6. AMENDMENT; WAIVER; COUNTERPARTS

This Acknowledgment may be amended only by a written instrument signed by both Parties. No failure or delay by any Party in exercising any right under this Acknowledgment shall operate as a waiver of that right. This Acknowledgment may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument.

7. GOVERNING LAW

This Acknowledgment shall be governed by and construed in accordance with the laws of the state or jurisdiction where the service was effected, without regard to conflict of laws principles.

8. ENTIRE AGREEMENT

This Acknowledgment constitutes the entire agreement of the Parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals, representations and understandings, whether written or oral, relating to such subject matter.

9. SEVERABILITY

If any provision of this Acknowledgment is held to be invalid or unenforceable by a court of competent jurisdiction, the remaining provisions shall remain in full force and effect and shall be construed so as to best effectuate the original intent of the Parties.

10. EXECUTION

This Acknowledgment is effective as of the later of the dates on which the Parties sign below.

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