Occupational License Permit

OCCUPATIONAL LICENSE PERMIT

This Occupational License Permit ("Permit") is issued on the date set forth below pursuant to the authority of the Issuing Authority and subject to the terms and conditions contained herein.

WHEREAS

WHEREAS, Issuing Authority: has the power to grant occupational licenses and regulate the conduct of regulated occupations within its jurisdiction; and

WHEREAS, Licensee: seeks authorization to engage in the occupation described below and has submitted the required application, attestations, and fees; and

WHEREAS, Issuing Authority deems it appropriate to grant a permit subject to the conditions set forth in this Permit to protect public health, safety, and welfare.

APPLICANT INFORMATION

SCOPE OF WORK

The Licensee is authorized to perform the occupational activities described below, subject to the terms, conditions, and limitations of this Permit:

PAYMENT TERMS

License Fee Amount: $

Late Payment Fee: percent of the unpaid balance per month, or the maximum permitted by applicable law, whichever is less. Failure to pay fees when due constitutes a material breach and may result in suspension or revocation.

TERM AND TERMINATION

Term Commencement Date: . Term Expiration Date: .

Either party may terminate this Permit for cause upon written notice to the other party if the other party materially breaches any provision and fails to cure within days following receipt of written notice. Issuing Authority may immediately suspend or revoke the Permit without prior notice where necessary to protect public health or safety.

CONFIDENTIALITY

Except as required by applicable law, the parties shall keep confidential all non-public business information disclosed in connection with this Permit. Confidential information does not include information that: (a) is or becomes publicly available through no fault of the recipient; (b) is already known to the recipient at the time of disclosure; or (c) is independently developed without use of the disclosing party's confidential information. The recipient shall use the same degree of care to protect confidential information as it uses to protect its own confidential information, but in no event less than reasonable care.

COMPLIANCE; INSURANCE; INDEMNIFICATION

The Licensee shall comply with all applicable laws, regulations, codes and ordinances in performance of the authorized activities. Prior to commencement, Licensee shall provide proof of insurance as required by Issuing Authority and maintain such insurance during the term. Licensee shall indemnify, defend, and hold harmless Issuing Authority, its officers, agents, and employees from and against all claims, liabilities, losses, damages, and expenses arising out of Licensee's performance under this Permit, except to the extent caused by the gross negligence or willful misconduct of Issuing Authority.

GOVERNING LAW

This Permit shall be governed by and construed in accordance with the laws of the jurisdiction of the Issuing Authority. Any legal action arising out of or relating to this Permit shall be brought in the courts of that jurisdiction.

ENTIRE AGREEMENT

This Permit, together with any attachments, exhibits, and any written amendments executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior understandings, negotiations, and agreements, whether written or oral.

ADMINISTRATIVE / PERMIT INFORMATION

Special Conditions or Limitations:

ACKNOWLEDGMENTS

By signing below, the parties certify that the information provided is true and correct to the best of their knowledge, that the Licensee will perform only the activities authorized by this Permit, and that the Licensee understands that violation of any material term may result in suspension or revocation.

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