Verification Form Template

Verification Form Template

Effective Date:

Client Name:    Client Contact:

Verifier Name:    Verifier Contact:

Recitals

WHEREAS, Client has requested that Verifier perform verification services relating to specified records, background elements, or documentation identified in this Agreement; and

WHEREAS, Verifier represents that it has the necessary expertise, personnel, and authority to conduct the requested verification in a professional and commercially reasonable manner; and

WHEREAS, the parties desire to set forth the terms and conditions under which Verifier will provide verification services to Client.

Scope of Work

Verification Details

Subject of Verification:

Identity Employment Education Background Other

Payment Terms

Payments are due in accordance with the Payment Schedule. Late payments shall accrue the Late Fee above, and Client shall be responsible for any collection costs and reasonable attorneys' fees incurred by Verifier to collect overdue amounts.

Term and Termination

Term Commencement Date:    Term End Date:

Either party may terminate this Agreement for convenience upon providing the required notice. Termination shall not relieve Client of payment obligations for services performed and costs incurred prior to the effective date of termination.

Confidentiality

Each party acknowledges that during the course of performance it may receive Confidential Information of the other party. "Confidential Information" means non-public information disclosed in any form. Each party shall (a) use Confidential Information solely for the purposes of performing under this Agreement; (b) limit disclosure to employees, agents, or subcontractors with a need to know; and (c) use at least the same degree of care to protect Confidential Information as it uses for its own confidential information, but in no event less than reasonable care.

Confidential Information does not include information that: (i) is or becomes publicly available without breach; (ii) was rightfully in the receiving party's possession before receipt; (iii) is independently developed without use of Confidential Information; or (iv) is required to be disclosed by law, provided the disclosing party is given prompt notice and, where permitted, an opportunity to seek protective measures.

Acknowledgement of Confidentiality: I acknowledge and agree to maintain confidentiality as defined above.

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 provisions. The parties submit to the exclusive jurisdiction of the courts located therein for any dispute arising out of this Agreement.

Representations and Warranties

Verifier represents that: (a) it will perform services in a professional and workmanlike manner consistent with industry standards; (b) it shall comply with applicable laws and regulations in performing the verification; and (c) it will maintain appropriate processes to protect Confidential Information.

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, or representations, whether written or oral. Any amendment or modification shall be effective only if in writing and signed by both parties.

Certifications

By signing below, each signatory certifies that they are authorized to execute this Agreement on behalf of the party they represent, that the information provided in this Verification Form is true and correct to the best of their knowledge, and that they agree to be bound by the terms set forth herein.

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