Payment Category Form

Payment Category Form

This Payment Category Form ("Agreement") is made effective as of Date: by and between Client Name: (Client) and Service Provider Name: (Provider).

WHEREAS

WHEREAS, Client wishes to engage Provider to perform certain services and to establish the permissible category and structure for payments associated with those services; and

WHEREAS, Provider has represented that it has the expertise and capacity to provide the services and accept payments under the categories and terms set forth in this Agreement; and

WHEREAS, the parties desire to reduce to writing an agreed form of payment categorization and related terms to govern invoicing, remittance, and dispute resolution.

PARTIES AND CONTACT INFORMATION

SCOPE OF WORK

Provider shall perform the services described below. The parties agree that the payment categories and schedules below apply only to the tasks and deliverables expressly described herein unless otherwise mutually agreed in writing.

PAYMENT CATEGORY

Select the payment category(ies) that will govern invoicing and remittance for the Scope of Work:

PAYMENT TERMS

Payment Amount (if fixed): $ . If variable, provide basis for calculation in Payment Schedule below.

Accepted Payment Methods (check all that apply):

Late Payment: Amounts not received by the due date shall accrue interest at and a one-time administrative late fee of $ until paid. Provider may suspend performance for unpaid amounts that remain outstanding for more than days after written notice.

TERM AND TERMINATION

Term Commencement Date: . Term Expiration Date (if applicable): .

Either party may terminate this Agreement for convenience upon written notice of days to the other party. Termination for cause shall be permitted where a material breach is not cured within days after written notice specifying the breach. Upon termination, Client shall pay Provider for all work performed and reimbursable expenses incurred through the effective date of termination.

CONFIDENTIALITY

Each party shall maintain in confidence all non-public information disclosed by the other party that is designated as confidential or that reasonably should be understood to be confidential given the nature of the information ("Confidential Information"). Confidential Information does not include information that: (a) is or becomes publicly available other than through a breach of this Agreement; (b) was lawfully known to the recipient prior to disclosure; or (c) is rightfully received from a third party without restriction. The obligations in this section survive termination and remain in effect for three (3) years following disclosure, except that trade secrets remain protected for so long as such information qualifies as a trade secret under applicable law.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to its conflict of laws principles. The parties consent to the exclusive jurisdiction and venue of the courts located in that state for any dispute arising under this Agreement, except that either party may seek injunctive or other equitable relief in a court of competent jurisdiction to protect its confidential information or intellectual property.

ENTIRE AGREEMENT

This Agreement, including any attachments or exhibits executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings, negotiations and discussions, whether oral or written. No amendment or modification shall be effective unless in writing and signed by authorized representatives of both parties.

REPRESENTATIONS AND CERTIFICATIONS

Each party represents and warrants that it has the full power and authority to enter into this Agreement and to perform its obligations hereunder. The signer of this form certifies that the information provided regarding payment categories, remittance instructions, and contacts is true, complete, and accurate to the best of their knowledge, and acknowledges that any material misstatement may constitute a breach of this Agreement.

ADMINISTRATIVE DETAILS

By signing below, the undersigned representatives confirm that they are authorized to bind their respective parties to the terms of this Payment Category Form and accept the payment categories and terms described herein.

Sign Now