Trade Request Form

TRADE REQUEST FORM

Administrative Information

Request ID:    Date Submitted:

Goods Services Mixed/Other

Parties

Contact Person (Requesting Party):    Phone/Email:

Contact Person (Counterparty):    Phone/Email:

Recitals

WHEREAS, Requesting Party named above desires to initiate a trade of goods or services under the terms set forth herein and is authorized to request such trade on behalf of its organization; and

WHEREAS, Counterparty named above is capable of supplying the requested goods or performing the requested services and agrees to evaluate and, if accepted, perform the trade in accordance with the Scope of Work and Payment Terms set forth below; and

WHEREAS, the parties intend for this Trade Request Form together with any accepted attachments to constitute the Agreement governing the specific trade described herein.

Scope of Work / Trade Description

Payment Terms

Total Estimated Amount:

Late Payment Fee:    Minimum Late Fee:

Term and Termination

Effective Start Date:    Anticipated Completion / End Date:

Either party may terminate for convenience upon days' prior written notice. Termination for material breach is permitted immediately upon written notice where the breach remains uncured for days after receipt of written notice.

Confidentiality

Each party shall keep confidential all non-public information disclosed by the other party that is designated as confidential or that reasonably should be understood to be confidential given the nature of the information and the circumstances of disclosure ("Confidential Information"). Confidential Information shall not include information that is publicly available, rightfully received from a third party without restriction, or independently developed without use of the other party's Confidential Information.

The receiving party shall use Confidential Information solely for the purpose of performing obligations under this Trade Request Form and shall not disclose such information except to employees, contractors, or agents who need to know and who are bound to confidentiality obligations at least as protective as those stated herein.

Representations and Warranties; Liability

Each party represents that it has full authority to enter into and perform this Trade Request Form and that performance will not violate any agreement or applicable law. EXCEPT AS EXPRESSLY SET FORTH HEREIN, EACH PARTY DISCLAIMS ALL OTHER WARRANTIES, EXPRESS OR IMPLIED.

Except for claims arising from willful misconduct or gross negligence, neither party's aggregate liability for any claim arising out of or related to this Trade Request Form shall exceed the total amount paid or payable under the specific trade giving rise to the claim.

Governing Law; Entire Agreement

This Trade Request Form shall be governed by and construed in accordance with the laws of the State of without regard to choice-of-law principles.

This Trade Request Form, together with any attachments or accepted purchase orders or confirmations incorporated herein, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior and contemporaneous agreements, proposals, and communications, whether written or oral.

Acceptance and Authorization

By signing below, the signatory affirms that they are authorized to bind the respective party and that the party accepts the terms of this Trade Request Form for the specific trade described herein. Acceptance may be evidenced by signature, written confirmation, or an authorized purchase order referencing this request.

Acknowledgement: I affirm that the information provided is accurate and complete to the best of my knowledge.

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