Material Information Request Form

MATERIAL INFORMATION REQUEST FORM

RECITALS

WHEREAS Requesting Party: seeks detailed technical data, safety documentation and, where applicable, physical samples of certain materials for evaluation, testing and regulatory assessment;

WHEREAS Responding Party: is the owner, manufacturer, distributor or authorized provider of such materials and is capable of supplying the requested information under the terms set forth herein;

WHEREAS the parties desire to document the specific materials requested, the scope of information to be produced, payment and delivery terms, confidentiality protections and governing law applicable to the exchange.

REQUEST SUMMARY

Request ID:    Date of Request:    Project / PO No.:

SCOPE OF WORK

MATERIALS TO BE PROVIDED

List up to three material items. Attach additional sheets if necessary.

REQUIRED DOCUMENTATION

  Safety Data Sheet (SDS) / MSDS

  Certificate of Analysis (COA)

  Batch / Test Reports

  Technical Data Sheet (TDS)

  Regulatory Compliance Documents (REACH, RoHS, etc.)

PURPOSE OF REQUEST

Response Deadline:    Requested Method of Delivery:

CONTACT INFORMATION

PAYMENT TERMS

Fees for samples or data:

Late fee for overdue invoices:    Currency:

Shipping and handling responsibility: Requesting Party    Responding Party   

TERM AND TERMINATION

Effective Start Date:    Term End Date:

Either party may terminate this request for convenience upon written notice delivered at least days prior to termination. Termination does not relieve the parties of obligations accrued prior to termination, including payment for services rendered and return of confidential materials.

CONFIDENTIALITY

All information, data, reports and samples disclosed in response to this request that are designated in writing as confidential or that a reasonable person would understand to be confidential shall be treated as Confidential Information. The recipient shall (i) use Confidential Information solely for the purposes set forth in this form; (ii) restrict disclosure to its employees, agents or contractors who have a need to know and who are bound by confidentiality obligations no less protective than those herein; and (iii) take reasonable measures to protect Confidential Information from unauthorized disclosure. Confidentiality obligations shall survive termination for a period of years, unless otherwise agreed in writing.

Exceptions: Confidential Information does not include information that is or becomes publicly known other than by breach, is independently developed, or is rightfully received from a third party without restriction.

GOVERNING LAW; LIMITATION OF LIABILITY

This request and any dispute arising out of or in connection with it shall be governed by and construed in accordance with the laws of the state of , without regard to conflict of law principles. Neither party shall be liable to the other for consequential, incidental, special or punitive damages arising from performance or non-performance under this request, except for liability arising from willful misconduct or gross negligence.

REPRESENTATIONS; CERTIFICATIONS

The Responding Party represents and warrants that, to the best of its knowledge, the information and documents provided in response to this request are true, accurate and complete as of their date, and that any samples supplied will be representative of the described material. The Requesting Party acknowledges that it will rely on its own testing before using the materials and that Responding Party makes no other warranties beyond those expressly stated.

ENTIRE AGREEMENT

This Material Information Request Form, together with any attachments or additional written agreements executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter herein and supersedes all prior negotiations, representations and agreements, whether written or oral. Any amendments must be in writing and signed by authorized representatives of both parties.

ADDITIONAL TERMS

ACKNOWLEDGMENT

By signing below, each party certifies that the individual signing has authority to bind the respective party and that the information provided in this form is accurate to the best of the signer's knowledge. The parties agree to comply with the terms set forth above in good faith.

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