Service Provider Information

Service Provider Information

Entity Type Individual Person Corporation Limited Liability Company (LLC) Partnership Sole Proprietorship Trust Non-Profit Organization Government Entity

Select the type of entity

Full Legal Name

As it should appear on the document

Doing Business As (DBA)

Optional trade name

State of Formation Select state... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming District of Columbia

Where the entity was formed

Authorized Representative

Person authorized to sign

Representative Title

Title or position

Address

Street Address

City

State Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming District of Columbia

ZIP Code

Email Address

Phone Number

Client Information

Client Information

Entity Type Individual Person Corporation Limited Liability Company (LLC) Partnership Sole Proprietorship Trust Non-Profit Organization Government Entity

Select the type of entity

Full Legal Name

As it should appear on the document

Doing Business As (DBA)

Optional trade name

State of Formation Select state... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming District of Columbia

Where the entity was formed

Authorized Representative

Person authorized to sign

Representative Title

Title or position

Address

Street Address

City

State Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming District of Columbia

ZIP Code

Email Address

Phone Number

Quality & Standards

Quality Standards & Acceptance Criteria

Warranty/Guarantee Period Select... No Warranty 30 Days 60 Days 90 Days 6 Months 1 Year 2 Years

Warranty Scope & Coverage

Service Level Agreement (SLA) Terms

Response Time Commitment Select... Immediate Within 1 Hour Within 4 Hours Within 24 Hours Within 2 Business Days Within 5 Business Days

Number of Revision Rounds Included

Intellectual Property

Intellectual Property Ownership * Select... Client Owns All IP Service Provider Retains IP, Client Gets License Shared Ownership Work for Hire

When IP Transfers to Client Select... Upon Final Payment Upon Project Completion Upon Each Milestone Immediate

License Type (if provider retains IP) Select... Exclusive Non-Exclusive Limited Perpetual Term-Limited

Usage Restrictions or Limitations

Service Provider Can Use Work in Portfolio

Attribution/Credit Required

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