Material Request Form

MATERIAL REQUEST FORM

Request Header

Request Number:     Date Submitted:

Phone:     Email:

Recitals

WHEREAS, Requesting Party: seeks to procure certain materials for use in its operations or project described above; and

WHEREAS, Supplying Party: is willing to supply such materials subject to the terms and conditions set forth in this request and any subsequent purchase order or agreement; and

WHEREAS, the parties desire to document the requested materials, delivery expectations, payment provisions, and confidentiality obligations in a manner that may form the basis for purchase authorization.

Scope of Materials Requested

Provide a concise description of the materials, specifications, acceptable substitutions, and any required delivery sequencing. Use the itemized list below for line-item details and quantities.

Itemized Material List

Instructions: Enter each line item with quantity, unit, unit price and any lead time. Total estimated value will be calculated for approval.

Additional Items (attach extra sheet if necessary)

Payment Terms

The following payment provisions apply to materials ordered pursuant to this request and any resulting purchase order or invoice.

Late Payment: A late fee of % per month or a flat fee of $ (whichever is greater) will accrue on past-due invoices, calculated from the invoice due date until paid in full. Parties may agree to alternative invoicing terms in writing.

Term and Termination

This Material Request is effective as of Start Date: and will remain in effect until End Date: , unless earlier terminated as set forth below.

Either party may terminate this request or any resulting purchase order for cause upon written notice if the other party materially breaches and fails to cure within days after receipt of written notice. Termination for convenience by Requesting Party requires days prior written notice and agreement on compensation for materials procured and reasonable restocking or cancellation fees.

Confidentiality

Each party acknowledges that in the performance of obligations related to this request it may receive or access Confidential Information of the other party. "Confidential Information" means non-public information disclosed in any form that is identified as confidential or which, under the circumstances of disclosure, ought reasonably to be treated as confidential. Each party shall (a) use Confidential Information solely for the purposes of fulfilling obligations under this request, (b) restrict disclosure to employees, subcontractors, and advisors who have a need to know and who are bound by confidentiality obligations at least as protective as those herein, and (c) not disclose Confidential Information to third parties without prior written consent, except as required by law. Confidentiality obligations shall survive termination of this request for a period of three (3) years.

Representations and Warranties

The Supplying Party represents that all materials supplied will conform to the specifications stated herein, will be free from defects in material and workmanship at the time of delivery, and will comply with applicable laws and industry standards. The Requesting Party represents that it has the authority to submit this request and to approve procurement in accordance with its internal policies.

Governing Law; Dispute Resolution

This request and any resulting purchase order shall be governed by the laws of the State of , without regard to its conflicts of law principles. The parties shall attempt in good faith to resolve any disputes arising out of or relating to this request through negotiation. If unresolved, disputes shall be resolved by the courts located in the county where Requesting Party's principal place of business is located.

Entire Agreement

This Material Request, together with any attached specifications and any subsequently executed purchase order that expressly references this request, constitutes the entire agreement between the parties with respect to the subject matter herein and supersedes all prior negotiations, proposals, or agreements, whether written or oral. Any modification to this request must be in writing and signed by authorized representatives of both parties.

Acknowledgments and Certifications

By signing below, each party certifies that it has the authority to enter into the obligations set forth in this request, that the information provided is true and accurate to the best of its knowledge, and that it will abide by the terms, payment obligations, and confidentiality provisions herein.

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