Service Certification Form

SERVICE CERTIFICATION FORM

RECITALS (WHEREAS)

WHEREAS: Client Name: and Service Provider Name: (each a "Party" and collectively the "Parties");

WHEREAS: On or about Agreement Date: the Parties entered into a service agreement pursuant to which Service Provider agreed to perform certain services described below;

WHEREAS: Service Provider has performed, or will perform, the services set forth herein and seeks formal certification by Client that such services have been completed in accordance with the applicable agreement and industry standards.

SCOPE OF WORK

PAYMENT TERMS

Payment Amount: . Payment shall be due within days of receipt of invoice unless otherwise stated below.

Late Payment: Unpaid amounts shall accrue interest at the lesser of (a) or (b) the maximum rate permitted by law, and Client shall be responsible for all collection costs, including reasonable attorneys' fees and expenses.

Taxes: Taxes included in amount. If unchecked, Client is responsible for applicable taxes and obligations unless exempt.

TERM AND TERMINATION

Term Commencement Date: . Termination Date (if any): .

Either Party may terminate for cause upon material breach that remains uncured for days following written notice. Termination for convenience requires days' prior written notice and payment for services performed through the effective termination date, subject to any set-off rights expressly set forth in the underlying agreement.

CONFIDENTIALITY

Each Party shall maintain in confidence all proprietary and non-public information disclosed by the other Party in connection with the services ("Confidential Information") and shall not disclose such information except to those employees, contractors, or agents who have a need to know and who are bound by confidentiality obligations no less protective than those herein. Confidential Information does not include information that is or becomes public through no breach by the receiving Party; is rightfully received from a third party without obligation of confidentiality; or is independently developed without use of the disclosing Party's Confidential Information. The obligations of confidentiality shall survive termination of this Certification for a period of years. Remedies for breach shall include specific performance or injunctive relief in addition to other available remedies.

GOVERNING LAW

This Certification and any dispute arising under or relating to it shall be governed by the laws of the State of without regard to conflicts of law principles. Venue for any action shall be in the courts located within the chosen jurisdiction unless otherwise mutually agreed in writing.

ENTIRE AGREEMENT

This Service Certification, together with any incorporated attachments or referenced agreement, constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all prior and contemporaneous understandings, proposals, and communications, whether oral or written. No amendment shall be effective unless in writing and signed by authorized representatives of both Parties.

SERVICE CERTIFICATION DETAILS

Service Period Start: End: .

Certification: The undersigned certifies that the services described above were performed in accordance with the terms of the referenced agreement, in a professional manner and in conformity with applicable standards. By checking the boxes below, the undersigned indicates acceptance of services and authorizes payment in accordance with the Payment Terms specified herein.

Services performed in accordance with contract requirements.

Deliverables accepted by Client.

AUTHORIZED REPRESENTATIVES

Sign Now