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Five model sole agency contracts
An exclusive agency contract, that is, an exclusive agency contract, means that a manufacturer or owner only signs a contract with an agent, granting him the right to exclusively operate a product in a specific time and region. The following is a sample of the sole agency contract I collected. Welcome to learn from it.

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Model sole agency contract (1)

Supplier: _ _ _ _ _ _ _ Company (hereinafter referred to as Party A)

Agent: _ _ _ _ _ _ _ Company (hereinafter referred to as Party B)

2. Commodities and quantities

Party A designates Party B as the exclusive sales agent of _ _ _ _ _ _. Party B guarantees that the above-mentioned commodities will be sold at least _ _ _ _ _ _ _ _ _ _ _ (quantity or amount) during the agreement period.

3. Sales area

Limited to _ _ _ _ _ _ _ _ regions.

4. Confirmation of orders

The relevant quantity, price and delivery period of the agreed goods shall be confirmed one by one in the transaction. Please refer to Party A's sales confirmation for details.

5. Payment (choose the following methods)

(1) After the order is confirmed, Party B shall arrange to open an irrevocable letter of credit at sight in favor of Party A within the time specified in the relevant sales confirmation, and notify Party A immediately after the letter of credit is opened, so that Party A can prepare for shipment.

(2)_______________________________________;

(3)_______________________________________。

6. Commission

After receiving the payment, Party A will pay Party B a commission of% of the invoice value of each batch of goods.

7. Market situation report

Party B is obliged to send a detailed report to Party A every three months, reflecting the local market situation and consumer opinions. Party B shall also send samples of the same goods quoted by other suppliers and their prices, sales and advertising materials to Party A for reference at any time.

8. Advertising expenses

Party B shall bear all advertising expenses in the above areas during the agreement period. All advertisements must be approved by Party A in advance.

9. Term of validity of the agreement

This agreement shall be valid for _ _ _ _ _ years after being signed by both parties. From _ _ _ _ _ _, if one party fails to perform the terms of this agreement, the other party has the right to terminate this agreement.

10. Arbitration

All disputes arising from or related to this contract shall be settled by both parties through consultation. If negotiation fails, the case shall be submitted to China International Economic and Trade Arbitration Commission for arbitration in accordance with its arbitration rules. The arbitral award is final and binding on both parties.

1 1. Other clauses

(1) Party A shall not supply the agreed goods to other customers in the above areas, and shall transfer any direct inquiry to Party B. However, if any customer insists on direct transaction with Party A, Party A has the right to direct transaction. In the latter case, Party A shall send a sales confirmation to Party B, and reserve a commission of% of the net transaction value for Party B. ..

(2) If Party B fails to send at least _ _ _ _ _ _ _ _ copies to Party A,

(3) For the transaction between the two governments, Party A has the right to directly conclude the transaction under the authorization of its government without being bound by this agreement. Party B shall not interfere in this direct transaction, nor shall it demand compensation or commission.

(4) Other terms shall be subject to the formal sales confirmation signed by both parties.

This agreement is made in duplicate, with each party holding one copy.

Party A (supplier): _ _ _ _ _ _ _ _ _ Party B (agent): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Representative (signature): _ _ _ _ _ _ _ _ _ _ Representative (signature): _ _ _ _ _ _ _ _ _ _ _

Signed at _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.

Model sole agency contract (2)

Party A:

Party B:

Party A and Party B hold friendly consultations on the use and promotion cooperation of "_ _ series products of learning methods of educational curriculum coding" (note 1) and the use of _ _ series products of learning methods of educational curriculum coding by sponsoring enterprises, organizations and individuals. Party A agrees that Party B will act as an agent to carry out the series of products of _ _ _ educational course coding method, and both parties reach and agree to abide by the following terms.

1. Basic conditions for Party B to become an agent

Party B shall be a legally existing legal person or an individual with full capacity for civil rights and conduct, and be able to bear civil liabilities independently. Party B shall know and be familiar with Party A's agency system, service contents of "pp Education" products, specific business processes and other related information. Party A shall review and confirm the above contents of the distribution applicant and decide whether to grant Party B the agency qualification.

2. Rights and obligations of Party A

2. 1 Party A is responsible for the normal operation of _ _ series products of educational curriculum coding, and provides relevant technical support (such as software upgrade, error correction, online technical support, etc.). ) for the users developed by Party B, but excluding the contents for which Party B is responsible; Party A will upgrade and repair the faults caused by the quality problems of Party A's products for free.

2.2 Party A provides free training for Party B and its development users.

2.3 Party A is responsible for formulating relevant tariff standards and service standards.

2.4 Party A constantly improves the agency service system to facilitate and support Party B to carry out agency business.

2.5 Party A owns all the ownership of "_ _ series products of educational curriculum coding learning method".

3. Rights and obligations of Party B

3. 1 Party B shall provide customers with the contents and usage methods of "_ _ series products of educational curriculum coding learning method", provide customer service, be responsible for developing the market and customers by itself, and guarantee to provide good service to customers in the distribution business, and shall not damage the interests of customers and Party A and Party A's reputation by fraudulent, coercive and other improper means.

3.2 Party B promises not to develop customers below the retail price of Party A, not to engage in unfair competition with other agents, and not to engage in other activities that harm Party A's interests ... When Party B violates this obligation, Party A has the right to cancel Party B's agency qualification; At the same time, if Party B violates this obligation and causes losses to Party A, Party B shall bear the corresponding liability for compensation.

3.3 Party B shall fully understand and abide by the provisions of relevant agreements when applying for new users of "_ _ series products of educational curriculum coding learning methods", and fully understand and abide by the provisions of relevant terms of service when using other paid services.

3.4 Party B shall pay the fees for the selected services according to the then effective price standard set by Party A, and renew the fees for the expired users of the selected "_ _ series products of educational curriculum coding learning methods" in time. Party A has no obligation to notify in advance. The losses caused by Party B's failure to renew the fees for its expired users in time shall be borne by Party B..

3.5 Party B shall keep confidential the information clearly indicated by Party A as confidential information.

3.6 Party B can use the series products of educational curriculum coding learning method and the name of curriculum coding learning method to explore the market.

4. Payment/settlement terms/and agency level

The series of products (hereinafter referred to as the "system") provided by Party B on behalf of Party A are as follows:

Exclusive agent:

4. 1. Party B pays the exclusive agency fee of RMB (in words) to Party A, and Party B becomes the exclusive agent of all provinces, cities, counties and towns. Enjoy the exclusive agency in this area. Party A provides Party B with a series of products of _ _ _ educational course coding learning method independently developed by Party A, and Party B returns 30% of the sales amount to Party A. Within two months, Party A can unconditionally refund the agency fee to Party B at the request of Party B. Party B shall return the goods placed by Party A to Party A. (See Annex 1).

4.2. The agent can recruit dealers in the authorized area, or directly adopt chain operation. See Annex 4 for the list of ordered products.

4.3, can use the course coding learning method to open remedial classes, the company provides technology and platform, and the service is free.

4.4. If Party B adopts the course coding learning method to tutor students, Party A will provide Party B with all kinds of auxiliary services needed to start remedial classes, such as making study plans and providing stage papers.

4.5 Both parties shall abide by the intellectual property agreement (see Annex 2).

4.6 Party A provides services to Party B (see Annex 3).

4.7__ The series products of educational curriculum coding learning method are sold at the national unified price stipulated by the Head Office.

5. Liability for breach of contract

5. 1 If Party B violates relevant national policies and regulations, Party A has the right to terminate the contract, and Party B shall bear corresponding responsibilities.

5.2 In case of user disputes due to Party B's reasons (such as failure to provide services according to payment standards and service standards, untimely payment, etc.). ), which shall be the responsibility of Party B..

5.3 Party A shall be responsible for the losses caused to the users of "_ _ educational course coding learning method series products" due to Party A's technical reasons.

6. Exemption clause

6. 1 If Party A's normal service and technical support are affected by force majeure or unexpected events, it shall not be regarded as Party A's breach of contract, and Party B agrees. "Force majeure" refers to unforeseeable, insurmountable and unavoidable objective events, such as wars, natural disasters and government bans. "Accident" refers to similar events, such as submarine optical cable being damaged by collision, and communication line or server failure beyond Party A's ability to prevent and foresee.

6.2 When Party A is maintaining the server of "_ _ Educational Curriculum Coding Learning Method Series Products", it sometimes needs to interrupt the service for a short time, or the access speed of the virtual host is slowed down due to accidental blocking of the Internet. Party B agrees that this is normal and does not belong to Party A's breach of contract.

7. Termination of contract

The Contract shall be dissolved under the following circumstances, and the party proposing to dissolve the Contract shall notify the other party in writing seven days in advance:

7. 1 Both parties reach an agreement to terminate this contract;

7.2 Upon the expiration of this contract, both parties fail to renew it;

7.3 If one party's qualification disappears, is revoked or enters bankruptcy or liquidation procedures, the other party has the right to terminate the contract, except for reorganization, renaming, division or merger with a third party;

7.4 If one party fails to perform or violate its obligations under this contract, and fails to perform its obligations or take remedial measures after a certain period of time is given by the other party, so that the expected benefits of the other party under this contract cannot be realized or it is unnecessary to continue to perform this contract, the other party has the right to terminate this contract;

7.5 If one party explicitly expresses non-performance of obligations or shows non-performance of obligations by actions, the other party may terminate the contract;

7.6 If it is impossible or unnecessary to continue the performance of the contract due to force majeure or unexpected events, both parties may request to terminate the contract.

After the termination of the contract, the rights and obligations of both parties under the contract are terminated, but the obligations that one party should perform before the termination of the contract still need to be performed. Unless the contract is terminated due to force majeure or unexpected events, the party causing the termination of the contract shall compensate the other party for the losses suffered due to the termination of the contract. 8. Appendix 8. 1 This Agreement is fully understood and recognized by both parties and supersedes all previous oral or written agreements. In the process of printing or filling in, Party B shall not change any terms of this contract at will without the written consent of Party A. After this agreement comes into effect with the signatures and seals of both parties, any changes shall be agreed upon by both parties through consultation and confirmed in writing.

8.2 Matters not covered in this contract shall be settled by both parties through consultation. If negotiation fails, the case shall be submitted to Shenyang Arbitration Commission for arbitration, and the arbitration fee shall be borne by the losing party. Disputes shall be settled in accordance with the relevant laws, regulations and industry practices of People's Republic of China (PRC).

8.3 This contract shall come into effect after being signed and sealed by the representatives of both parties, and shall be valid for one year. If both parties have no objection at the expiration of the contract, the contract will continue to be valid; If Party A formulates new contract terms during the renewal period, both parties shall sign a new contract.

8.4 This contract is made in duplicate, one for each party.

8.5 Additional pages can be attached for matters not covered by both parties, and the legal effect is equivalent to the first page.

Signature of Party A: Signature of Party B:

Party A's telephone number: Party B's telephone number:

Company address: Address:

Postal code:

Model sole agency contract (3)

Party A:

Party B:

According to the Contract Law of People's Republic of China (PRC) and other laws and regulations, Party A and Party B have reached an agreement on entrusting Party A to sell the products exclusively on the principle of equality, voluntariness and honesty, and signed this contract.

I. Acting as an agent to sell products

Party B entrusts Party A as the sole agent to sell the products as follows: specifications, models, technical performance, quality standards and uses;

Second, the agency mode.

Party B entrusts Party A as the exclusive agent to sell the above-mentioned products, and Party B promises not to entrust any third party (legal person, natural person or other organization) to sell the above-mentioned products, including not to set up a company, enterprise or other organization, team or group with others to sell the above-mentioned products.

Third, the exclusive agency period.

Party A's exclusive agency period is from, to. Within one year before the expiration of the sole agency term, Party A and Party B shall negotiate whether to extend the term of this contract. If it fails to postpone, Party A still has the right to sell the above products as an agent.

Four. Exclusive agency area

Party A's exclusive sales area is all regions in the world.

Verb (abbreviation for verb) transportation and transportation expenses

In general, Party B is responsible for transportation and bears the transportation expenses. Party B shall, in accordance with Party A's instructions, deliver the products to the designated place in a safe and timely manner with good quality and quantity, and deliver them to the consignee.

Capacity guarantee of intransitive verbs

Party B shall prepare sufficient inventory according to Party A's sales forecast to ensure production capacity, and ensure that Party A can book products at any time without affecting Party A's sales work and customers' production of goods.

The specific forecast time shall be determined by both parties through consultation.

Seven. Party A's sales

The supply price provided by Party B to Party A shall be determined by both parties through consultation. Party A's sales task is: Party A's sales volume is _ _ _ _ _ _ _ _ _ _.

Eight. intellectual property

Party B guarantees that the above products will not infringe other people's intellectual property rights such as patent rights, trademark rights, proprietary technology and trade secrets. If the intellectual property rights of others are infringed or sued by others, Party B shall be responsible and bear legal responsibilities.

Nine, customer service

Party B shall provide Party A with services such as supply, quality assurance and after-sales service as agreed in the contract. If there are any objections or complaints, Party B shall be responsible for handling them, and Party A shall cooperate to solve them.

Force majeure

Neither party shall be liable for failure or temporary failure to perform all or part of its obligations under this Agreement due to the following reasons: natural disasters, government procurement or prohibition, and any other events that both parties cannot foresee, control, avoid and overcome when signing this Contract.

However, the party affected by force majeure shall notify the other party of the incident as soon as possible, and attach the supporting materials.

XI。 responsibility for breach of contract

1. If the goods delivered by Party B do not meet the quality requirements and other requirements agreed in the contract, Party A has the right to refuse to accept them.

2. If the styles or materials of the products provided by Party B are obviously changed, Party A may return all the goods in this order, and Party B shall compensate Party B for all the business losses and goodwill losses suffered as a result.

3. If Party B terminates the contract in advance without authorization, it shall bear the losses of Party A's early cost and expected income.

4. When Party B bears the liability for breach of contract, it shall also bear the legal fees, attorney fees, notarization fees, guarantee fees, travel expenses and other rights protection expenses of Party A. ..

Twelve. Good faith clause

Party A and Party B shall perform this contract in good faith to ensure that the legitimate rights and interests of the other party are not infringed. If there are any unfinished matters, differences or disputes, they should be settled through friendly negotiation, and a supplementary agreement can be signed, which has the same legal effect as this contract.

Thirteen. Service of documents

The address, e-mail, fax number and contact person recorded by Party A and Party B in this Contract are true and accurate delivery addresses, and the documents will be deemed to have been delivered three days after one party mailed them to the above delivery place.

If one party changes its service address, it shall notify the other party in advance. If it cannot be delivered due to the change of address, the changing party shall bear the consequences.

Fourteen settlement of dispute

If negotiation fails, it may be submitted to the people's court of the plaintiff's domicile for trial.

Fifteen. Effective clause

This agreement is made in duplicate, one for each party.

This agreement shall come into force as of the date of signature or seal by both parties.

Party A: Party B:

Agent:

Address: Address:

Postal code:

Contact person: contact person:

Tel: Tel:

Fax: Fax:

Email: Email:

Year, month, sun, moon, sun.

Model sole agency contract (4)

Party A: _ _ _ _ _ _ _

Address: _ _ _ _ _ _

Tel: _ _ _ _ _ _

Fax: _ _ _ _ _ _

Party B: _ _ _ _ _ _

Address: _ _ _ _ _ _

Tel: _ _ _ _ _ _

Fax: _ _ _ _ _ _

2. Appointment

Party A appoints Party B as its sole agent to solicit orders for the goods listed in Article 3 from customers in the areas listed in Article 4, and Party B accepts the above appointment.

3. Acting commodity

_________。

4. Agency area

Only _ _ _ _ _ _ _

5. Minimum business volume

Party B agrees that within the validity period of this agreement, the order value of the above-mentioned goods solicited from customers in the above-mentioned agency area shall not be less than _ _ _ _ _ _ _ _ _ _ _ _.

6. Price and payment

The price of each transaction is determined by Party B and the buyer through negotiation, and finally confirmed by Party A. ..

Payment shall be made by confirmed and irrevocable letter of credit opened by the buyer in favor of Party A. The letter of credit must reach Party A 15 days before the date of shipment.

7. Exclusive agency

Based on the exclusive agency right granted by this agreement, Party A shall not directly or indirectly sell or export the goods listed in Article 3 to _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.

8. Business report

In order to make Party A fully understand the current market situation, Party B promises to provide Party A with market reports at least once a quarter or at any time when necessary, including changes in local laws and regulations related to the import and sale of goods under this agreement, the development trend of the local market and the buyer's opinions on the quality, packaging and price of goods provided by Party A under this agreement. Party B also promises to provide Party A with quotations and advertising materials of similar goods from other suppliers.

9. Advertising and expenses

Party B shall bear all expenses for advertising the goods sold by the agent in Singapore within the validity period of this agreement, and submit the audio-visual materials used for advertising to Party A for prior approval.

10. Commission

For the orders directly obtained by Party B and accepted by Party A, Party A shall pay Party B a commission of 5% of the net invoice price. The commission will not be paid until Party A receives the full payment for each order.

1 1. Transactions between government departments

The transactions reached between the government departments of Party A and Party B are not restricted by the terms of this agreement, and the amount of such transactions shall not be included in the minimum business volume stipulated in Article 5.

12. Industrial property rights

During the validity of this agreement, Party B may use the trademark owned by Party A for the purpose of selling washing machines, and acknowledge that any patent trademark, copyright or other industrial property rights used or contained in _ _ _ _ _ _ _ are exclusive to Party A. Once any infringement is discovered, Party B shall immediately notify Party A and assist Party A to take measures to protect Party A's rights and interests.

13. terms of the agreement

This agreement shall come into effect after being formally signed by both parties. The validity period is _ _ _ _ _ _ _ _ _ _ _ _ years, and the validity period is _ _ _ _ _ _ _ _ years. Unless otherwise notified, this agreement will be extended for _ _ _ _ _ months after its expiration.

14. Termination of the Agreement

During the validity of this agreement, if one party is found to have violated the terms of the agreement, the other party has the right to terminate the agreement.

15. Force Majeure

If one party is unable or temporarily unable to perform this Agreement in whole or in part due to flood, fire, earthquake, drought, war or other unforeseeable, uncontrollable, inevitable and insurmountable events, the other party shall not be liable. However, the party affected by the force majeure event shall notify the other party of the event as soon as possible, and send the force majeure event certificate issued by the relevant organization to the other party within 15 days after the force majeure event.

16 arbitration

All disputes arising from the performance of this Agreement shall be settled through friendly negotiation. If no settlement can be reached through negotiation, the dispute shall be submitted to China International Economic and Trade Arbitration Commission (Beijing) for arbitration in accordance with its arbitration rules. The arbitral award is final and binding on both parties.

Party A (signature): _ _ _ _ Party B (signature): _ _ _ _ _ _

Model sole agency contract (5)

Party A: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Postal code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Legal Representative: _ _ _ _ _ _ _ _ _ _ _ _

Tel: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Fax: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

(hereinafter referred to as Party A)

Party B: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Postal code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Legal Representative: _ _ _ _ _ _ _ _ _ _ _ _

Tel: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Fax: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

(hereinafter referred to as Party B)

Party A and Party B enter into this contract through friendly negotiation in accordance with China and software-related laws and on the principle of good faith and mutual benefit. Both parties declare that they have understood and recognized all the contents of this contract, agree to assume their respective rights and obligations, and strictly implement the following contents of this contract:

1. Party A authorizes Party B to be the general agent of _ _ _ _ _ _ _ _.

Two. Rights and obligations of Party A:

1. Party A guarantees that all products provided to Party B are authentic, and enjoys the exclusive agency right in the region where Party B is located, that is, _ _ _ _ _ _ _ _, and shall not directly sell the subject matter of this contract to customers in the region where Party B is located.

2. Party A shall inform Party B of the launch of new products in time, and Party A is obliged to provide Party B with technical support, information and materials related to product sales in time to facilitate Party B's sales and publicity work, and Party B shall actively and closely cooperate with the sales work.

3. Party A shall keep the sales, market, inventory and other information provided by Party B strictly confidential and shall not disclose it to a third party.

Each batch of goods should be decided by both parties through consultation. The first order quantity shall not be less than RMB 10,000 (after discount).

Three. Rights and obligations of Party B:

1. Party B shall actively promote Party A's products and cooperate with Party A to do corresponding marketing activities to facilitate sales promotion.

2. If the product is found to have quality problems, it shall notify Party A in writing to replace it within three days. (Man-made damages caused by Party B, such as scratches and fractures, are not within the scope of replacement by Party A).

3. Party B shall keep the product price and agency regulations provided by Party A strictly confidential and shall not disclose them to a third party. However, if Party A commits fraud, that is, the price sold to Party B is higher than that of other agents, then Party B is not bound by the provisions of the preceding paragraph.

4. Party B guarantees that it will not commit any infringement on Party A's products, nor will it infringe the copyright and trademark rights of products. In the process of sales, once others are found to have infringed copyright, they shall promptly notify Party A and provide assistance.

5. Party B can supply goods to its subordinate dealers or specialty stores by itself.

Four. Liability for breach of contract:

1. If Party B's breach of contract causes losses to Party A's reputation and economy, Party A has the right to immediately cancel its qualification as a special dealer, and Party B shall pay Party A RMB as liquidated damages.

2. If Party A increases the agency in the agency area of Party B, or directly conducts sales or price fraud, Party A shall pay Party B RMB as penalty.

Verb (abbreviation for verb) sales policy:

1. Party B sells all products of Party A, and the price that Party A sells to Party B is _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. See the attached table for the retail price.

2. Settlement method: payment to delivery.

Intransitive verb delivery method:

1. Party A will deliver the goods within three days after receiving the payment from Party B. ..

2. Railway: Party A is responsible for transporting the products required by Party B to the station in Party B's city by railway, and Party B is responsible for picking up the goods from the station.

3. Highway: Party A is responsible for transporting the products required by Party B to the freight company in Party B's city through the highway transportation company, and Party B is responsible for picking up the goods from the freight company.

4. Party B shall inspect the goods immediately after receiving them, and notify Party A in writing within three days if there are any problems. If Party A fails to receive Party B's notice within three days, it shall be deemed that the quantity and variety of this batch of goods are checked correctly with Party A's outbound order.

5. The transportation expenses shall be borne by Party A, but the transportation expenses when the goods are transferred shall be borne by Party B..

Seven. Other matters:

1. This agreement is made in duplicate, one for each party, and shall come into force after being signed and sealed by both parties.

2. The faxed copy of this agreement is valid.

3. The validity period of this Agreement is _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.

Attachment: Retail Price List. (omitted)

Party A: _ _ _ _ _ _ _ _ _ _ _ Party B: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Seal: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Representative signature: _ _ _ _ _ _ _ _ _ _ _ Representative signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Date: _ _ _ _ _ _ _ _ _ _ _ _ Date: _ _ _ _ _ _ _ _ _ Date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.

Location: _ _ _ _ _ _ _ _ _ _ _ _ Location: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

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