Legal Proponent Identification Annex

LEGAL PROPONENT IDENTIFICATION ANNEX

This Legal Proponent Identification Annex (the Annex) is executed as of Effective Date: by and between Proponent Name: and Contracting Party Name: .

RECITALS

WHEREAS, the Proponent provides the identification and organizational information required by the Contracting Party to evaluate legal status, authority to contract, and financial responsibility; and

WHEREAS, the Contracting Party requires a written annex containing verified identification data, authorized representative details, and supporting documentation descriptors; and

WHEREAS, the parties intend that this Annex become an integral part of their underlying agreement and that the information provided herein shall be relied upon by the Contracting Party;

NOW THEREFORE, in consideration of the mutual covenants contained in the Agreement and for other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the parties agree as follows:

1. IDENTIFICATION OF PROPONENT

Individual    Corporation    LLC    Partnership    Other

2. AUTHORIZED REPRESENTATIVE

3. ATTACHMENTS AND SUPPORTING DOCUMENTS

The Proponent certifies that the following documents are provided with or will be provided to the Contracting Party as indicated below (check all that apply):

Articles of Incorporation/Organization    Certificate of Good Standing    Government-issued ID of Authorized Representative

Power of Attorney or Board Resolution authorizing execution    Financial Statements    Other (describe below)

4. REPRESENTATIONS AND WARRANTIES

The Proponent represents and warrants to the Contracting Party that: (a) the information provided in this Annex and any attachments is true, complete and accurate in all material respects; (b) the Proponent is validly existing and in good standing under the laws of the jurisdiction identified above and has all requisite corporate, partnership or organizational power and authority to execute and deliver this Annex and to perform its obligations under the Agreement; (c) execution, delivery and performance of this Annex have been duly authorized by all necessary action; and (d) the individual signing below on behalf of the Proponent is authorized to bind the Proponent and possesses any required corporate or partner approvals to do so.

5. USE AND LIMITATION OF INFORMATION

The Contracting Party shall use the identification information and supporting documents for verification, regulatory compliance, and contract administration purposes only. The Contracting Party will maintain commercially reasonable safeguards to protect such information. The Proponent acknowledges that information provided that is false or materially misleading shall constitute a material breach of the Agreement and this Annex.

6. NOTICES

Notices under this Annex shall be sent to the addresses below. Delivery to these addresses shall constitute effective notice under the Agreement.

7. AMENDMENT; WAIVER

This Annex may be amended only by a written instrument signed by both parties. No waiver of any provision of this Annex shall be effective unless in writing and signed by the party against whom enforcement is sought. The waiver of any breach shall not constitute a waiver of any subsequent breach.

8. GOVERNING LAW

This Annex shall be governed by and construed in accordance with the laws of the jurisdiction specified in the Agreement, without regard to conflicts of law principles. The parties submit to the exclusive jurisdiction of the courts specified in the Agreement for resolution of disputes arising under this Annex.

9. ENTIRE AGREEMENT; SEVERABILITY

This Annex, together with the Agreement and any referenced attachments, constitutes the entire understanding between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, whether written or oral. If any provision of this Annex is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

10. COUNTERPARTS

This Annex may be executed in two or more counterparts, each of which shall be deemed an original and all of which shall constitute one and the same instrument. Signatures transmitted by facsimile, electronic image, or other electronic means shall be effective as originals.

CERTIFICATION

The undersigned certifies under penalty of law that the information contained in this Annex and any attachments is true, correct and complete to the best of the signatory's knowledge and that the signatory is authorized to execute this Annex on behalf of the Proponent.

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