User Modification Request Form

USER MODIFICATION REQUEST AND AMENDMENT AGREEMENT

This User Modification Request and Amendment Agreement (the Agreement) is entered into by and between Client Name: and Service Provider Name: (each a Party and collectively the Parties), with the modifications described herein to be effective as of .

WHEREAS

WHEREAS, the Parties previously entered into a services agreement governing user accounts, access rights, and related support obligations (the Original Agreement); and

WHEREAS, Client requires a modification to an existing user account, access level, or configuration, and the Parties wish to document the scope, costs, schedule, and terms applicable to that modification as an amendment to the Original Agreement.

NOW, THEREFORE, in consideration of the mutual covenants set forth below, and other good and valuable consideration, the Parties agree as follows:

SCOPE OF WORK

MODIFICATION DETAILS

User ID:    Username:    Current Role:

Requested Role/Access:    Priority:

PAYMENT TERMS

Modification Fee Amount: $    Currency:

One-time payment due within days of invoice.

Recurring (describe frequency):

Late payment fee: . Interest shall accrue from the due date at the rate specified above.

TERM AND TERMINATION

Term Start:    Term End:

Either Party may terminate this modification upon written notice to the other Party. Notice period (days): . Termination for cause shall be immediate where the other Party materially breaches its obligations and fails to cure within the notice period.

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 ("Confidential Information"). Confidential Information includes user credentials, security configurations, personally identifiable information and business processes. The receiving Party shall (a) use Confidential Information solely to perform its obligations under this Agreement, (b) restrict disclosure to employees, contractors or agents who have a need to know and are bound to confidentiality obligations at least as protective as those herein, and (c) take reasonable measures to protect the confidentiality of such information.

Exceptions: Confidential Information does not include information that (i) is or becomes publicly available other than through a breach of this Agreement, (ii) was known to the receiving Party without restriction prior to disclosure, (iii) is rightfully received from a third party without restriction, or (iv) is independently developed without use of the disclosing Party's Confidential Information. If disclosure is compelled by law, the receiving Party shall provide prompt notice and cooperate with the disclosing Party to seek protective relief.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to its conflicts of law principles. The Parties consent to exclusive jurisdiction of the courts located in that State for resolution of disputes arising under this Agreement.

ENTIRE AGREEMENT

This Agreement constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals and communications, whether written or oral, relating to such subject matter. Except as expressly modified herein, all terms and obligations of the Original Agreement remain in full force and effect.

ADDITIONAL PROVISIONS

Remedies: The Parties acknowledge that breach of confidentiality or unauthorized access may cause irreparable harm for which monetary damages may be inadequate; the non-breaching Party shall be entitled to injunctive relief in addition to any other remedies at law or in equity.

Requestor certifies that the information provided herein is accurate and that the requested modification is authorized by the requestor's organization. (Check to certify)

Sign Now