Project Bridge Request Form

PROJECT BRIDGE REQUEST FORM

RECITALS

THIS PROJECT BRIDGE REQUEST FORM AND AGREEMENT (the "Agreement") is entered into as of by and between Requester Name: and Bridge Provider Name: .

WHEREAS, Requester requires short-term bridging of funds, resources or services to maintain continuity of Project: ;

WHEREAS, Provider has the capacity and willingness to provide such bridge on the terms set forth in this Agreement; and WHEREAS, the parties intend that the provision of the bridge shall be temporary and subject to repayment, replacement or remediation in accordance with the terms below.

PROJECT DETAILS

Short-term operational bridge    Funding bridge (cash)    Services or resource bridge

SCOPE OF WORK

The Provider will deliver the following bridge services or resources. The description below shall govern the Provider's obligations and is incorporated into this Agreement.

PAYMENT TERMS

Payment obligation, schedule and remedies for late payment are as follows. All monetary amounts are in United States Dollars unless otherwise specified.

TERM AND TERMINATION

This Agreement commences on Start Date and continues until End Date unless earlier terminated under this section. Unless otherwise agreed, termination shall not relieve Requester of obligations to repay any outstanding bridge amounts.

CONFIDENTIALITY

Each party (the "Receiving Party") shall maintain in strict confidence all non-public, proprietary or commercially sensitive information disclosed by the other party (the "Disclosing Party") in connection with the Project and the provision of the bridge ("Confidential Information"). Confidential Information excludes information that (i) is or becomes public through no breach of this Agreement by the Receiving Party, (ii) was known to the Receiving Party prior to disclosure without an obligation of confidentiality, (iii) is rightfully received by the Receiving Party from a third party without restriction, or (iv) is independently developed by the Receiving Party without use of the Disclosing Party's Confidential Information.

The Receiving Party shall use Confidential Information solely for exercising rights and performing obligations under this Agreement, shall restrict disclosure to those employees or agents with a need to know, and shall implement commercially reasonable safeguards to protect Confidential Information.

Yes, treat all disclosed materials as Confidential

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to conflict of law principles. The parties submit to the exclusive jurisdiction of the courts located in that State for disputes arising out of or in connection with this Agreement.

ENTIRE AGREEMENT

This Agreement, including any schedules, exhibits and the Requester's representations and documentation delivered in connection with the request, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals, representations and communications, whether oral or written. Any amendment must be in writing and signed by authorized representatives of both parties.

ADDITIONAL REPRESENTATIONS

Requester represents and warrants that all information provided in this form is true, complete and accurate to the best of Requester's knowledge, and that Requester is authorized to enter into this Agreement and to request the bridge. Provider represents that it has the authority to provide the bridge on the terms stated herein.

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