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A G R E E M E N T
This Agreement is made by and between et3.com, Inc.
(referred to as "LICENSOR"), a corporation organized and existing
under the laws of Florida and having a principal place of business of at 236
N.E.3rd Street, Crystal River, Florida and
________________________________________ ("LICENSEE"), (a corporation
organized and existing under the laws of ______________ and having a principal
place of business at) (or individual residing at)
__________________________________________________________________________________
WHEREAS:
A. LICENSOR is the sole owner of all right, title, and interest
in and to: 1) US patent number 5,950,543;
2) foreign patent applications; 3)know how; 4)technology assignments; 5)
trade secrets; 6)common law logos trademarks and servicemarks; et3,et3.com
et3.com Inc, et3.org, et3.net;
7)copyrights; 8)marketing and business plans; 9)et3.com, et3.org,
et3.net domain names; and 10)associated databases; all relating to the
development of an Evacuated Tube Transport system (“ETT”), and LICENSOR has the
right to grant the rights transferred under this Agreement;
B. LICENSEE desires to review, use, co-develop, participate in,
underwrite sublicensees, promote, market, educate others about, manufacture,
make products relating to, sell, participate in products relating to or
otherwise make use of the ETT databases, technology, know-how, patents and
patent applications;
C. LICENSOR is
willing to grant such non-exclusive rights upon the terms and conditions set
forth in this Agreement;
NOW, THEREFORE, in consideration for the mutual covenants
and promises contained in this Agreement, the parties agree as follows:
1.
Definitions
a. The term
"TECHNOLOGY," as used in this Agreement, shall mean all know-how,
technical data, or other information of any kind regarding the design,
manufacture, operation, use, or sale of any Product or other device for use in
any field and incorporating or based on United States Patent No. 5,950,543
Evacuated Tube Transport (ETT herein) or foreign counterparts of this patent,
or of the applications leading to such patents, any other patents now or
hereafter owned or controlled by LICENSOR or based on any products currently
sold by LICENSOR, and any modification or improvements thereto made by LICENSOR
or LICENSEE.
b. The terms
"PROJECT" and "PRODUCT," as used in this Agreement, shall
mean any and all intellectual property, services or goods produced, used,
and/or sold or otherwise commercialized by LICENSEE or its sublicensees
resulting from the use of any portion of the TECHNOLOGY or based on any portion
of the TECHNOLOGY;
c. The term UNDERWRITER, as used in this
Agreement, shall refer to an existing LICENSEE or LICENSE applicant, acting to
sub-license the applicant under substantially identical license terms, and
governed by the rules of the et3.com handbook posted on www.et3.com.
d. The term PARTICIPANT, as used herein,
shall refer to a LICENSEE who engages in an ETT project.
2. Grant of Technology Rights
a. Subject
to the other terms and conditions set forth herein, LICENSOR hereby grants to
LICENSEE the non-exclusive worldwide right and license to: 1) access and
utilize all TECHNOLOGY ; 2) review and bid on ETT participation products; 3)
submit novel participation proposals; 4) as an independent contractor,
underwrite sub-licensees, according to substantially identical terms of this
Agreement, entitling royalty commissions (described herein); 5)vote on
products, their priority, and bid acceptance to the extent of participation
percentage; 6) receive bonus as winner of competitive sub-licensing contests
announced on contest database; 7)own stock in et3.com Inc.; and 8) trade
et3.com Inc. stock with other licensees on the et3.com Inc. exchange website at
www.et3.net.
b. The nonexclusive license extends
automatically to all TECHNOLOGY, business plans, marketing systems, projects,
know how, etc., that et3.com or its successor shall acquire, develop, pool or
license from others.
c. Notwithstanding the above, or anything else to the
contrary, all rights to the patents or intellectual property rights now
existing or to be obtained in the future, which are based on the TECHNOLOGY or
PROJECTS shall be the sole property of LICENSOR.
d. Within twenty (20) business days after the execution date
of this Agreement LICENSOR shall disclose to LICENSEE any and all technical
information and know-how then within the knowledge or possession of LICENSOR
which was not already disclosed to LICENSEE and which would be helpful to
LICENSEE in the manufacture, use or sale of the PROJECT or in otherwise
exploiting the subject matter of this Agreement.
3. Warranties and Representations of
LICENSOR
a. LICENSOR
warrants and represents that to the best of its knowledge it owns or has an
exclusive right to; 1) US patent number 5,950,543; 2) foreign patent applications; 3) know how; 4) technology
assignments; 5) trade secrets; 6) common law logos trademarks and servicemarks;
et3,et3.com et3.com Inc, et3.org, et3.net;
7) copyrights; 8) marketing and business plans; 9) et3.com, et3.org,
et3.net domain names; and 10) associated databases; and that it is free to
enter into this Agreement and that it has no knowledge of any suit, action, or
claim instituted or threatened by a third party against any of these
intellectual property rights.
b. LICENSEE
agrees that it will defend, indemnify and hold harmless LICENSOR, its
employees, officers and agents (the “indemnified parties”) from and against any
and all claims and causes of action of any nature made or lawsuits or other
proceedings filed or otherwise instituted against the indemnified parties
relating directly or indirectly to or arising from the manufacture and sale of
any ETT system or component that they may design, construct or apply. Licensee will assume responsibility for all
costs and expense related to such claims and lawsuits for which it shall
indemnify the indemnified parties, including, but not limited to, the payment
of all attorney’s fees and costs of litigation or other defense.
c.
LICENSEE will maintain any secret or
proprietary nature of all patent pending ETT
technologies, business plans, and materials that LICENSEE may receive from
or in behalf of et3.com Inc. LICENSEE will exercise all prudent measures to
protect any proprietary ETT technology from unlicensed dissemination. LICENSEE
will obtain a signed official et3.com non-disclosure Agreement (located at
www.et3.com) from any prospective licensee before presentation of any
proprietary ETT technology. LICENSEE
will make no copies whatsoever of any sales materials, or information in the
ETT databases. Any purchase of ETT
marketing materials must be made through et3.com or an approved vendor.
d.
A project PARTICIPANT is
subject to additional project participation terms as agreed to by majority of existing et3.com
Participants engaged in the project. A Participant shall not
conduct ETT related business with a non-licensee. All employees of a Participant must be et3.com Licensees if they
do any work relating to an ETT project.
Alternatively a licensee may hold additional open name licenses for
employee use.
e. Nothing
herein shall be construed as a warranty or representation by et3.com Inc. as to
the scope or validity of any patent application or a any patent or patents that
may be issued or be assigned. The ETT
system and TECHNOLOGY has not been built, tested or independently
evaluated. Licensee shall exercise due
diligence to verify the potential performance and cost of the ETT system.
4. Payments and Obligations
a. The license fee is $100.
Royalties are not included in the fee. The licensing fee is not
refundable. Use of the licensing fee
($100) is to fund et3.com Inc. general operating expenses; Fees do not cover the cost of any hard copy
materials or reports, other than what is used for this Agreement. All notices,
statements, and technology updates are posted on www.et3.com web site,
or sent to the licensees’ e-mail address. The licensee may request hard copies
from et3.com Inc. provided the added cost is paid in advance.
b. Royalties are 6% of the accepted project participation bid (more
or less as determined by majority vote of Participants and owners). The
royalties are to be submitted with any funded participation bid. Use of
royalties as follows: 50% is paid to the royalty distribution account, 5%
commission is paid to the Underwriter of
the licensee paying the royalty. Up to
5% may be used for any overhead resulting from royalty administration and
audit. The 40% remaining is gross profit, 10% of the gross profit (4% of the
total) is donated to the et3 foundation, a non-profit organization (see
www.et3.org). The balance (after any taxes owed) is paid to the owners of
et3.com according to share. The greater of actual Sales Price, or fair market
value of goods or services shall be used to calculate royalties due.
c. The Royalty Distribution Account is administered for the
exclusive benefit of ETT Participants.
Cash disbursements shall be paid to the Participant upon 30 days of
written or e-mail request. Cash disbursement shall not be made more than once
per year unless for amounts greater than $1000. A Licensee may elect to receive
stock (if available) instead of royalty distribution, provided any applicable
laws and regulations concerning such stock offering are satisfied by the
Participant. Participation percentage is diluted as additional participation is
accepted.
d. A submitted PROJECT plan gains priority
by vote of the Participants. PROJECTS
are ranked and votes weighted according to the relative percentage of
participation. If a PROJECT plan
achieves majority Participant and owner approval, it is eligible for
capitalization with et3.com Inc. stock issue (if available); or funding by
licensees. Bidding for portions of the
approved and capitalized project shall commence. PROJECTS shall start when a licensee bid is accepted by majority
of the Project PARTICIPANTS and owner vote, subject to availability of funds,
holdback, inspection and audit. A funded project is owned jointly by funding
participants in the project according to the proportional value of their
contributions. A new PARTICIPANT
receives participation percentage according to the value of contributed goods
or services as voted appropriate by existing PARTICIPANTS and owners.
e. Stock representing ownership of et3.com Inc.
is not publicly traded. SEC regulations prevent the transfer of non-registered
stock to third parties. All outstanding
shares of et3.com Inc. are private placement or compensatory shares and are
restricted as such.
f. These fees as described herein shall be due and payable for
as long as LICENSEE or any associated, affiliates, or related entities shall be
involved in the commercialization of PROJECTS or TECHNOLOGY or for as long as
permitted by law.
g. Project Participant covenants that it will, in good faith
commit itself to a thorough vigorous, and diligent program of exploiting the
TECHNOLOGY and/or PROJECTS hereof in accordance with the best business customs
of the applicable industry or industries, so that full utilization of the
PROJECTS will result.
h. LICENSEE agrees that it will pay interest to LICENSOR on
any and all amounts that are at any time overdue to LICENSOR at the rate of
average Florida Bank prime rate times 1.25 from the date when payments are due
and payable to the date of receipt of actual payment by LICENSOR.
i. All monies payable hereunder shall be paid in United States
Dollars at such location in the United States of America as LICENSOR may from
time to time designate.
5. Records and Reports
LICENSOR shall
maintain an ETT technology database, a project database, a PARTICIPANT
database, accounts database, and a LICENSEE database, on a server accessible by
a LICENSEE at www.et3.net. The serial
number from a US dollar bill is the ID number for access, submit ½ retain ½. LICENSEE shall keep full, clear and accurate
computer records with respect to project participation subject to royalty or
fee under this Agreement. LICENSEE
shall update their ETT database at least weekly. et3.com, or its authorized agent, shall have the right to examine
and audit such records with reasonable notice during normal business hours, as
reasonably required to ensure LICENSOR’s rights.
In case
LICENSOR does not accept the statements of sales performed by LICENSEE and the
parties cannot reach an agreement within thirty (30) days after LICENSOR's
notification of disagreement, LICENSOR is authorized to have audited by a
certified public accountant bound by professional secrecy the documents
relevant for computing the fee. This
auditor shall have the right to inspect all books and records of LICENSEE
directly related to the PROJECTS it is manufacturing or offers for sale. The auditing costs shall be borne by
LICENSOR unless the auditing proves the failure of LICENSEE to provide LICENSOR
with correct statement of sales performed.
In the latter case LICENSEE shall pay the costs of the auditing if the
statement of sales is in error in excess of five percent (5%) of the amounts
due to LICENSOR. LICENSEE shall make
prompt adjustment to compensate for any errors or omissions discovered by such
audit. If records do go uncontested for
two years, et3.com shall have no further right to contest such report, unless
fraud is proven. All records shall be
kept in English; in a secure, mainstream computer format, as shall be agreeable
to 75% vote of Participants.
6. Patent Prosecution and Third-Party
Infringement
a. LICENSOR, at its own expense, may prosecute any
domestic or foreign patent application that may relate to ETT or be assigned to
et3.com, and any continuations, divisions, continuations in part, substitutes,
and reissues, of such patent application or any patent thereon, at its own
expense, until all applicable patents issue or any patent application finally
becomes abandoned. LICENSOR shall also
pay any maintenance fees which are due on any patent that may issue. If for any reason et3.com shall intend to
abandon any patent, it shall notify LICENSEES at least two months in advance of
abandonment so LICENSEES may have opportunity to prosecute the patent, in such
case et3.com shall cooperate to any degree required, at LICENSEE’S
expense. If LICENSEE acts and is
successful all reasonable prosecution expenses shall be deducted from any
royalties due.
b. Should
LICENSOR or LICENSEE become aware of any infringement or alleged infringement
of any patents covering any portion of the TECHNOLOGY, that party shall immediately
notify the other party in writing of the name and address of alleged infringer,
the alleged acts of infringement, and any available evidence of infringement.
LICENSOR and LICENSEE agree to work jointly (on a best effort basis) to prevent
any infringement. LICENSOR shall bear
the expense of any action and shall be entitled to all recovery. If LICENSOR does not act, one or more
LICENSEES may take action. If
LICENSEE(S) take action the cost shall be borne by LICENSEE(S) and recovery
shall be split among LICENSEE(S) according to their involvement in the
recovery, subject to any owed royalties.
c. If, at any time during the term of this Agreement, LICENSOR
or LICENSEE shall be unable to uphold the validity of any LETTERS PATENTS or
other intellectual property rights against any alleged infringer, LICENSEE
shall not have a damage claim or a claim for refund or reimbursement against
LICENSOR.
7. Term and Termination
a. With
respect to the rights granted herein, this Agreement shall commence upon the
executing hereof and, shall extend in perpetuity to both parties or their
successors unless terminated sooner for any reason under the terms of this
Agreement, or until superseded by an Agreement amenable to both parties.
b. This Agreement may be terminated for:
i) Default:
If a LICENSEE fails to make payment on or before the date due under this
Agreement, or if LICENSEE makes any other default under or breach of this Agreement,
et3.com shall have right to terminate the Agreement upon three months written
notice of intent to terminate, specifying
such failure, breach or default to LICENSEE.
If LICENSEE fails to make payment or otherwise cure the breach, et3.com
may send written notice of termination, and this Agreement shall terminate one
month from said notice date.
ii) Bankruptcy,
receivership, or assignment for the benefit of creditors of LICENSEE shall
result in the immediate termination of this Agreement, without prejudice to any
rights et3.com may have.
c. Subsequent to the termination of this Agreement, LICENSEE
agrees that it will not engage in the use, sale, or other commercialization of
the TECHNOLOGY and that it will not manufacture the PROJECTS or PRODUCTS. Notwithstanding the foregoing, LICENSEE may,
for up to ninety (90) days after the effective date of such termination, sell
all PRODUCTS or PROJECTS which may be in inventory and not sold; provided,
however, LICENSEE provides any reports and payments required by Section 5 of
this Agreement.
d. If this Agreement is thus terminated,
all non-disclosure clauses, and assignments, remain in effect unless release is
made by et3.com in writing.
e. Upon termination of this Agreement, for any reason, nothing
herein shall be construed to release either party of any obligation which
matured prior to the effective date of such termination or which may continue
beyond such termination, and any unpaid payments under this Agreement shall
become immediately due and payable to LICENSOR.
8. Taxes, Governmental Approvals and
Liability
a. LICENSEE
shall be solely responsible for the payment and discharge of any taxes, duties,
or withholdings relating to any transaction of LICENSEE in connection with the
manufacture, use, sale, lease, or other commercialization of the TECHNOLOGY or
the PROJECTS, if done by LICENSEE.
LICENSOR is solely responsible for any and all taxes, fees, etc. levied
by the authorities because of being the inventor of the patented TECHNOLOGY,
because of the receipt of any and all payment by third parties to LICENSOR
because of the licensed TECHNOLOGY including but not limited to the fees
payable under this Agreement.
b. LICENSEE
shall, at its own expense, be responsible for applying for and obtaining any
approvals, authorizations, or validations relative to this Agreement under the appropriate
national laws or otherwise, including authorization for the remittances
hereunder from the appropriate governmental authorities.
c. LICENSEE
shall be responsible for all PRODUCT liability and PRODUCT warranty for any
PRODUCTS manufactured by or for LICENSEE under this Agreement and shall insure
this risk accordingly. LICENSEE further
indemnifies LICENSOR for any and all claims brought against LICENSOR of which
the cause of action was set by any act of LICENSEE related to any PRODUCTS
covered by this Agreement.
9. Independence of the Parties
This Agreement shall not constitute the designation of
either party as the representative or agent of the other, nor shall either
party by this Agreement have the right or authority to make any promise,
guarantee, warranty, or representation, or to assume, create, or incur any
liability or other obligation of any kind, express or implied, against or in
the name of, or on behalf of, the other, except as described herein.
10. Assignment
a. LICENSOR shall not have the right to assign or otherwise
transfer this Agreement and the rights herein, including rights acquired by
LICENSOR herein, to receive payments, to any third party, without the prior
written consent of LICENSEE which consent shall not be unreasonably
withheld. Such assignment or transfer
shall not be deemed effective unless such assignee or transferee has agreed in
writing to be bound by the terms and provisions of this Agreement.
b. Any improvement that LICENSEE shall make to ETT
technologies before, during or after the term of this Agreement shall be
assigned to et3.com Inc. for $1, plus any previously agreed upon participation
percentage value disclosed herein. This
shall include without limitation, patent applications, patents, computer
software, copyrights, know-how or licenses acquired, that relate to ETT
participation. The assignment shall be
exclusive with respect to ETT usage of the IP; the licensee shall retain rights
to any non-ETT uses of the intellectual property that they develop.
c.
LICENSEE shall have the
right to underwrite other entities as sublicenses under identical terms of this
Agreement. LICENSEE shall remain bound to pay fees as per Section 4. of this
Agreement. LICENSEE shall, provide a
license Agreement properly executed by the prospective sub-licensee to
LICENSOR. If a SUBLICENSEE shall
terminate as a LICENSEE for any reason without a named successor, any SUBLICENSEES
subject to the terminating LICENSEE who underwrote the terminating SUBLICENSE
shall be subject to the LICENSEE who underwrote the terminating
SUBLICENSE. The underwriting LICENSEE
has no power to limit or restrict a SUBLICENSEE with additional SUBLICENSE
terms. An organization may hold
multiple SUBLICENSES in open name for employees and/or subsidiaries and/or
related entities. The 5% royalty
commission paid on open name licenses is paid to the underwriter of the entity
holding the open name license generating the royalty.
d. LICENSEE may file for additional patents or intellectual
property rights on behalf of LICENSOR and in LICENSOR's name at its own expense
in any country it so desires.
11. Notices
a. All
notices, demands, and other communications under this Agreement shall be in
written English, and shall be sent by first class certified mail, return
receipt requested, postage prepaid, to the concerned party at the address
listed on this application. Any notice shall be considered made on the day
deposited in the mail. General notices to all licensees are to be posted on the
website accessible through www.et3.com.
Payments, statements, and other communications may be sent by regular
mail, or electronic means to the following destinations:
For LICENSOR:
P.O. Box 1423, Crystal River, Florida 34423,
Telephone: (352) 795-5415
E-Mail: et3@fx2.com
For LICENSEE:
(mailing address)_________________________________________________________
(e-mail)________________________________________________________________
(licensee will pay mailing fees if e-mail address is not
provided)
The
parties hereto may give written notice of change of address, and, after such
notice has been received, any notice of request shall thereafter be given to
such party at the changed address.
b. In the future, electronic notice,
signature, and receipt confirmation methods may advance to the point of
satisfying legal notification requirements at lower cost than first class
certified mail. If new notification
standards are adopted, licensee shall conform. If licensee fails to conform, licensee must pay, the cost of
certified mail notification, and any time value attributed to postal delays.
12. Jurisdiction; Governing Law
a. In
the event of any dispute,
controversy or claim between the parties arising out of or in connection with
this Agreement (or related or subsequent agreements or amendments thereto), in
particular (but not limited) as to its conclusion, existence, validity,
interpretation, performance or non-performance, breach, termination, the
assessment of damages including claims in tort, whether arising before or after
the termination of the Agreement, the parties shall make a good faith effort to
negotiate a settlement. If not settled,
the dispute shall be referred to and finally determined by three arbitrators
appointed in accordance with the rules of arbitration of the American
Arbitration Association in New York, New York.
The arbitrator’s award shall be non-appealable and enforceable in any
court of competent jurisdiction. The
arbitral proceeding shall be conducted in the English language.
b. This
Agreement shall be governed by, and construed in accordance with, the laws of
the State of Florida, except that the Federal Laws of the United States of
America shall apply to questions regarding the validity or infringement or
enforceability of United States Federal Patent and Trademark rights relating in
any way to this Agreement or the subject matter of this Agreement.
c. Any action related to this Agreement
shall be brought in Citrus County, Florida or in
any such other state and/or jurisdiction as LICENSOR shall transfer said
action.
13. Attorney Fees
In the event there is a default
under this Agreement and it becomes necessary for any party to employ the
services of an attorney, either to enforce or terminate this Agreement, with or
without arbitration, the losing party or parties to the controversy arising out
of the default shall pay to the successful party or parties reasonable
attorneys fees and, in addition, such costs and expenses as are incurred in
enforcing or in terminating this Agreement.
14. Identification of TECHNOLOGY and PRODUCTS
a. LICENSEE
agrees to mark the following with a patent number, (or United States or foreign
patent number) in conformity with the patent laws and practice of the
respective country:
1. all PRODUCTS
which are made, used, sold, leased, or otherwise disposed of;
2. all
packaging of all PRODUCTS, and
3. all brochures,
manuals, and documents describing the PRODUCTS which are to be used, sold, or
distributed.
b. Unless
otherwise directed by LICENSOR, LICENSEE shall state in a manner acceptable to LICENSOR
and approved by LICENSOR, in a prominent position on all materials and things
specified in sub-Section 14a above, that the TECHNOLOGY is utilized and the
PRODUCTS are manufactured and sold by LICENSEE under license from LICENSOR.
15. General Provisions
a. The
parties hereto have read this Agreement and agree to be bound by all its terms.
The parties further agree that this Agreement shall constitute the complete and
exclusive statement of the Agreement between them and supersedes all proposals,
oral or written, and all other communications between them relating to the
TECHNOLOGY and PRODUCTS, including but not limited to the inventions,
technology, and know-how, which are the subject matter of this Agreement.
b. No
agreement changing, modifying, amending, extending, superseding, discharging,
or terminating this Agreement or any provisions hereof shall be valid unless it
is in writing and is dated and signed by duly authorized representatives of the
party or parties to be charged.
c. The
provisions of this Agreement are severable, and in the event that any provisions
of this Agreement shall be held to be invalid, illegal, or unenforceable, the
validity, legality, and enforceability of the remaining provisions shall not in
any way be affected or impaired thereby.
d. Failure
of any of the parties hereto to enforce any of the provisions of this Agreement
or any rights with respect thereto or to exercise any election provided for
therein, shall in no way be considered a waiver of such provisions, rights, or
election or in any way to affect the validity of this Agreement. No term or provision hereof shall be deemed
waived and no breach excused, unless such waiver or consent shall be in writing
and signed by the party claimed to have waived or consented. The failure by any of the parties hereto to
enforce any of said provisions, rights, or elections shall not preclude or
prejudice other provisions, rights, or elections which it may have under this
Agreement. Any consent by any party to,
or waiver of, a breach by the other, whether express or implied, shall not
constitute a consent or waiver of, or excuse for any other, different or
subsequent breach. All remedies herein
conferred upon any party shall be cumulative and no one shall be exclusive of
any other remedy conferred herein by law or equity.
e. Time
is of the essence in the performance of each and every obligation and covenant
imposed by this Agreement.
f. This
Agreement shall be binding not only upon the parties hereto, but also upon
without limitations thereto, their assignees, successors, heirs, devices,
divisions, subsidiaries, officers, directors and employees.
g. There
shall be no liability on either party on account of any loss, damage, or delay
occasioned or caused by strikes, riots, fires, insurrection or the elements,
embargoes, failure of carriers, acts of God or of the public enemy, compliance
with any law, regulation or other governmental order, or any other causes
beyond the control of either party, whether or not similar to the foregoing.
h. Except
as provided elsewhere in this Agreement, all of the legal, accounting, and
other miscellaneous expenses incurred in connection with this Agreement and the
performance of the various provisions of this Agreement shall be paid by the
party who incurred the expense.
i. All
covenants, agreements, representations, and warranties made herein in writing
in connection with this transaction shall survive after the closing date.
j. Headings
used in this Agreement are for reference purposes only and shall not be deemed
a part of this Agreement.
k. In any action for breach of this Agreement or for any other
cause of which neither party shall be liable to the other party for any
indirect or consequential damages; provided, however, that this provision shall
not be deemed to limit in any way LICENSEE's duty to indemnify LICENSOR for
claims brought by third parties as set forth in Section 6 of this Agreement.
l. Neither
party shall commit any act or take any action, which frustrates or hampers the
rights of the other parties under this Agreement. Each party shall act in good
faith and engage in fair dealings when taking action under or relating to this
Agreement.
m. In
case of any mistake in this Agreement, including any error, ambiguity,
illegality, contradiction, or omission, this Agreement shall be interpreted as
if such mistake were rectified in a manner which implements the intent of the
parties as nearly as possible and effects substantial fairness, considering all
pertinent circumstances.
n. Upon signing this Agreement with blue
ink, the parties agree that they have carefully read this Agreement and have
consulted or have had opportunity to consult counsel.
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be duly executed as of _____________.
Applicant:
Signature: ________________________________________Date:
____________________________________
Name ____________________________________________________EIN or
SSN _______________________________
Day Phone: __________________________ Home Phone:
___________________________
Mailing Address:
____________________________________________________________________________________________
City __________________________________________________State
________________ Zip_______________-______________
e-mail Address:
_________________________________________________________
Date of birth MM/DD/YY: ____________________________ List in
public licensee database ?
Yes No
(Type, or print in blue permanent ink. Attach: $100 Fee (check only), copy of official photo ID and
Social Security Card, R-hand 1/2 of portrait side of US one dollar bill,)
Underwriter:
Signature:_______________________________________________________Date:____________________________________
Name ____________________________________________________________Lic#
_______________________________
(Attach relevant
application(s) or copy of license(s), Type, or print in blue permanent ink)
SPONSOR SHOULD RECORD SN FOR THEIR RECORDS
CHECK ALL DATA;
INCOMPLETE OR UNVERIFIABLE APPLICATIONS MAY BE REJECTED WITHOUT NOTICE
Accepted by:
_____________________________________________________Date:______________________________________________________
Daryl Oster, CEO
et3.com
