Support Request Form

Support Request Form and Service Agreement

Client Name:    Service Provider Name:

Recitals

WHEREAS, Client requires technical support, maintenance, and related services for systems and software identified in requests submitted under this form; and

WHEREAS, Service Provider represents that it has the personnel, experience, and capability to provide such support on the terms set forth in this Support Request Form and Service Agreement; and

NOW, THEREFORE, Client and Service Provider agree that each individual support request submitted using this form will be governed by the terms below and by any mutually executed order or amendment referencing this form.

Requester Contact Information

Support Request Details

Internal Reference / Ticket #:    Requested Response By:

Scope of Work

The Service Provider shall perform diagnostic, remedial, and advisory services reasonably necessary to resolve the reported issue(s) described above. Services may include remote troubleshooting, on-site visits where agreed, configuration changes, patching, and testing. The parties acknowledge that any work outside the scope documented in the request or in a contemporaneous statement of work will require prior written approval and may incur additional charges.

Payment Terms

Client shall pay Service Provider for services performed in accordance with the rates and schedule below. Invoices are payable within the agreed payment period and will itemize services rendered and applicable taxes.

Late Payment Fee: Client agrees that unpaid amounts shall accrue interest at a rate of % per month (or the maximum allowed by law), and Service Provider may suspend services for accounts delinquent more than days after written notice.

Term and Termination

This Agreement shall commence on Start Date: and shall continue until End Date: unless earlier terminated in accordance with this section.

Either party may terminate this Agreement or any individual request for convenience upon providing written notice at least days prior to the effective termination date. Termination for cause may be effected immediately if a material breach is not cured within thirty (30) days of written notice specifying the breach.

Confidentiality

Each party acknowledges that in the course of performance it may receive Confidential Information of the other. "Confidential Information" means non-public information disclosed in any form that is designated confidential or that a reasonable person would understand to be confidential. Each party shall (a) use Confidential Information only for purposes of performing its obligations under this Agreement; (b) protect Confidential Information with at least the same degree of care it uses to protect its own confidential information; and (c) not disclose Confidential Information to any third party except to employees, agents, or subcontractors who require access for performance and who are bound to confidentiality obligations no less protective than those contained herein. Confidentiality obligations shall survive termination for a period of three (3) years, except with respect to trade secrets which shall remain protected for so long as they are trade secrets under applicable law.

Acknowledgement of Confidentiality (enter initials):

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 consent to the exclusive jurisdiction of the state and federal courts located in that state for resolution of disputes.

Entire Agreement

This Support Request Form and Service Agreement, together with any executed statements of work and accepted requests, constitute the entire agreement between the parties with respect to the subject matter and supersede all prior and contemporaneous agreements, understandings and representations, whether written or oral. Any amendment or modification must be in writing and signed by authorized representatives of both parties.

Miscellaneous Provisions

Liability limitations, insurance requirements, and intellectual property ownership shall be addressed in mutually executed statements of work or separate agreements. Each party warrants that it has the authority to enter into this Agreement and that performance will comply with applicable laws and regulations.

Attachments and additional documentation may be appended to this form and incorporated by reference when signed by both parties.

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