Supplier Qualification Form

SUPPLIER QUALIFICATION FORM

RECITALS

WHEREAS, Company seeks to evaluate and qualify suppliers to provide goods and/or services in accordance with Company's procurement standards and requirements; and

WHEREAS, Supplier desires to be considered as an approved supplier and represents that Supplier has the capacity, experience and resources necessary to furnish the goods and/or services described in this form; and

WHEREAS, the parties wish to document Supplier's qualifications and certain business terms to govern the relationship pending execution of any purchase orders or formal agreement;

SUPPLIER IDENTIFICATION

BUSINESS PROFILE

Business Structure:

CAPABILITIES, CERTIFICATIONS, AND INSURANCE

REFERENCES

SCOPE OF WORK

The Supplier represents its ability to provide the following goods and/or services to Company. Describe the scope, primary deliverables, and performance standards. Include lead times, typical order minimums, and any exclusions.

PAYMENT TERMS

Company and Supplier hereby agree to the following payment terms as a condition of qualification. These terms apply to purchase orders issued under this qualification unless superseded by a separate written agreement.

TERM AND TERMINATION

This qualification and any resulting purchase orders shall commence on the Start Date and continue until the End Date, unless earlier terminated in accordance with this section.

Either party may terminate for material breach if the breaching party fails to cure the breach within the notice period specified above. Termination shall not relieve either party of obligations accrued prior to termination.

CONFIDENTIALITY

"Confidential Information" means non-public information disclosed by one party to the other that is identified as confidential or that reasonably should be understood to be confidential. The receiving party shall: (a) protect Confidential Information with at least the same degree of care it uses to protect its own confidential information, (b) use Confidential Information only to perform obligations under this qualification or related purchase orders, and (c) not disclose Confidential Information to third parties except to the extent necessary for performance and subject to confidentiality obligations. Exceptions include information that is or becomes publicly known without breach, was known prior to disclosure, or is independently developed.

WARRANTIES AND COMPLIANCE

Supplier warrants that all goods and services supplied will conform to the agreed specifications, be free from material defects, and comply with applicable laws, regulations, and industry standards. Supplier shall maintain all licenses and insurance required by law and provide certificates upon request.

GOVERNING LAW

This Qualification Form and any purchase orders or agreements arising from it shall be governed by and construed in accordance with the laws of the state indicated by Company below, without regard to conflict of law principles.

ENTIRE AGREEMENT

This Supplier Qualification Form, together with any incorporated purchase orders and certificates of insurance or other attachments, constitutes the entire agreement between the parties concerning supplier qualification and supersedes prior understandings. Any amendments must be in writing and signed by authorized representatives of both parties.

CERTIFICATION

By signing below, Supplier certifies that the information provided herein is true, complete and accurate to the best of Supplier's knowledge and that Supplier will promptly notify Company in writing of any material changes. Supplier acknowledges that falsification of this form may result in disqualification or termination.

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