Miscellaneous Portability Request

MISCELLANEOUS PORTABILITY REQUEST

Request Identification

Recitals

WHEREAS, Requestor Name: is the current account holder or authorized representative of the asset(s) identified in this request; and

WHEREAS, Provider Name: is the intended recipient of the portability action and has agreed to accept such portability subject to the terms set forth in this Request; and

WHEREAS, the parties desire to document the requested scope, payment, timing and legal terms under which the portability will be executed and to obtain required authorizations for the transfer of information and services.

Request Details and Authorizations

Requested Portability Date: — Requested Effective Date (if different):

Scope of Work

The Provider shall perform the portability functions described below in accordance with the schedule and technical specifications agreed by the parties. The Provider's responsibilities will include coordination with the Current Provider, verification of entitlement, data transfer, provisioning and post-transfer validation.

Payment Terms

In consideration for the portability services, Requestor shall pay Provider the fees set forth below. Fees are due according to the agreed schedule; late payments shall accrue additional charges as set forth.

Late Fee: — Late Payment Flat Fee (if applicable):

Term and Termination

This Request is effective as of the Start Date below and will remain in effect until the End Date below or until terminated in accordance with the termination provisions set forth herein.

Start Date: — End Date:

Confidentiality

Each party acknowledges that during performance of this Request it may receive or have access to Confidential Information (as defined below) of the other party. Each party agrees to hold such Confidential Information in strict confidence, to use it only for the purposes of executing this portability request, and to disclose it only to those employees, contractors or agents who have a legitimate need to know and who are bound to confidentiality obligations no less protective than those contained herein.

"Confidential Information" includes non‑public business information, technical specifications, customer data, account credentials, and any other information designated as confidential or which, by its nature, should reasonably be considered confidential. Confidential Information does not include information that is or becomes publicly available without breach of this Request, or information rightfully received from a third party without confidentiality obligations.

Acknowledgement of Confidentiality Obligations:

Representations, Warranties and Liability

Each party represents and warrants that it has the full corporate or individual authority to enter into this Request and to perform its obligations. The Requestor represents that it is authorized to request portability and to authorize transfer of the assets listed. Except as expressly provided herein, neither party makes any other warranties, and liability is limited to direct damages up to the amount paid for the portability services, except in cases of gross negligence or willful misconduct.

Governing Law and Dispute Resolution

This Request shall be governed by and construed in accordance with the laws of the jurisdiction entered below. Any dispute arising out of or relating to this Request shall be resolved by binding arbitration or litigation as selected by the prevailing party; exclusive venue and jurisdiction shall be in the courts of the governing jurisdiction to the extent litigation is pursued.

Entire Agreement

This Request, including any attachments and statements of work incorporated by reference, constitutes the entire agreement between the parties with respect to portability and supersedes all prior and contemporaneous agreements, understandings and communications, whether written or oral, relating to the subject matter hereof. No modification is effective unless in writing and signed by authorized representatives of both parties.

Attachments and Supporting Documents

Certifications and Acknowledgements

By signing below, Requestor certifies that the information provided in this Miscellaneous Portability Request is true and accurate to the best of its knowledge, that it is authorized to request the portability described, and that it accepts the terms and fees set forth herein. Provider acknowledges receipt of the Request and acceptance of the terms when signing below.

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