Fill and Sign the Purchaser Form

Bailment Contract between Owner of Equipment (Bailor) and Prospective Purchaser (Bailee) in Order to Allow Prospective Purchaser to Test Property This Bailment Agreement made on the ____________________________ (date) , between _________________________________________ (Name of Bailee) of ______ ________________________________________________________________________ ___________________________________ (street address, city, county, state, zip code) , referred to herein as Bailee , and _______________________________________ (Name of Bailor) , a corporation organized and existing under the laws of the state of ______________, with its principal office located at _____________________________ ________________________________________________________________________ (street address, city, county, state, zip code) , referred to herein as Bailor . Whereas, Bailor owns the Equipment described in Exhibit A attached hereto (the Equipment ), which has the value and is in the condition described in Exhibit A ; and Whereas, Bailee is interested in obtaining Equipment for purposes of testing; and Whereas, Bailor, subject to the provisions of this Agreement, is willing to bail Equipment to Bailee for testing; and Whereas, Bailee , in accordance with the terms of this Agreement, is willing to accept Equipment under such bailment. Now, therefore, for and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. Property to be Bailed Bailor shall bail to Bailee the Equipment , which shall be delivered to Bailee at Bailee’s expense. 2. Term of Bailment; Title This Agreement, unless extended in a writing signed by both parties, shall expire on ________________________________ (date) , and the Equipment shall be returned to Bailor within _______ (number) days afterward in the same condition as received, normal wear and tear excepted. Legal title to the equipment shall at all times during the term remain in Bailor . 3. Responsibility for Bailed Equipment A. Bailee shall be solely responsible for the Equipment until it is returned to Bailor and shall take all reasonable precautions to protect the equipment. Bailee shall advise Bailor promptly of any loss of or damage to the Equipment from any cause whatsoever, excepting normal wear and tear. B. Bailee shall pay to Bailor the reasonable costs of repairing any part of Equipment that is damaged, but which can be repaired in an economical manner. 4. Notices Any notice provided for or concerning this Agreement shall be in writing and shall be deemed sufficiently given when sent by certified or registered mail if sent to the respective address of each party as set forth at the beginning of this Agreement. The address of either party may be changed by giving written notice of such change to the other party. Notices may also be given in any other manner agreed on by the parties. 5. No Waiver The failure of either party to this Agreement to insist upon the performance of any of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as subsequently waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. 6. Governing Law This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of _____________________. 7. Mandatory Arbitration Any dispute under this Agreement shall be required to be resolved by binding arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party shall select one arbitrator and both arbitrators shall then select a third. The third arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by the rules of the American Arbitration Association then in force and effect. 8. Entire Agreement This Agreement shall constitute the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this Agreement shall not be binding upon either party except to the extent incorporated in this Agreement. 9. Modification of Agreement Any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if placed in writing and signed by each party or an authorized representative of each party. 10. Assignment of Rights The rights of each party under this Agreement are personal to that party and may not be assigned or transferred to any other person, firm, corporation, or other entity without the prior, express, and written consent of the other party. WITNESS our signatures as of the day and date first above stated. _________________________________ (Name of Bailor) By: _______________________________ ______________________________ (P rinted or typed name) ______________________________ ___________________________________ (P rinted name & signature of Bailee) (Name and Office in Corporation)