Five renovation contract 2022 model houses
House renovation contract 202 1 Model 1
I. Overview
1. The house decorated by Party A is legally inhabited. Party B is a civil decoration enterprise legal person approved by the administrative department for industry and commerce and the relevant departments of the Municipal Construction Committee.
2. Decoration construction site: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
3. House structure: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
4. Contents of decoration construction: See Annex 1 Table of Decoration Construction Contents for details.
5. Contracting method: _ _ _ (contracting, contracting, contracting).
6. Total price: RMB _ _ _ _ _ _ _ _, in words: _ _ _ _ _ _, in which: if the construction content is changed by mutual consent, the project payment for the changed part shall be calculated separately.
7. Construction period: from _ _ _ _ _ _ _ to _ _ _ _ _ _ _ _ _
Second, about the agreement of the material supply:
1. Materials provided by Party A: See Annex II "List of Materials and Equipment Provided by Party A" for details. The materials and equipment that Party A is responsible for purchasing and supplying for this project shall be qualified products that meet the design requirements, and shall be supplied to the site on time, and Party B shall go through the acceptance formalities. If there is any quality problem or specification difference in the materials and equipment supplied by Party A, Party B shall promptly raise it with Party A in written form. If Party A still says that it will be used, Party A shall bear the responsibility for the engineering losses. After the materials supplied by Party A arrive at the site, they shall be kept by Party B after passing the acceptance. Party B may charge a storage fee for the materials provided by Party A, and the rate shall be determined by both parties. Party B shall be responsible for compensating the losses caused by improper storage.
2. The decoration materials and equipment purchased by Party B from Party A shall be used for residential decoration agreed in this contract, and shall not be used for other purposes without Party A's consent ... If Party B violates this regulation, Party B shall compensate Party A at twice the price of the misappropriated materials and equipment.
Three. Agreement on project quality and acceptance:
1, this project implements the local standards and quality evaluation acceptance standards formulated by the municipal construction administrative department, such as dbj08-62-97 Technical Specification for Residential Building Decoration Engineering, db3 1/t30- 1999 Acceptance Standard for Residential Decoration.
2. The construction scheme of this project is designed by Party A..
3, project acceptance. Party A and Party B shall handle the acceptance formalities of concealed works and intermediate works in time. If Party A fails to attend the acceptance as scheduled, Party B shall organize personnel to carry out the acceptance, and Party A shall approve it. Thereafter, if Party A requests reinspection, Party B shall reinspect as required. If the reinspection is qualified, the expenses for reinspection and rework shall be borne by Party A, and the construction period shall be postponed.
4. Project completion: Party B shall notify Party A of the acceptance three days in advance, and Party A shall organize the acceptance within three days after receiving the notice, and go through the acceptance handover procedures (see the Annex "Project Quality Acceptance Sheet" for details). If Party A fails to organize the acceptance within the specified time, it shall notify Party B in time and set another acceptance date. If it passes the completion acceptance, Party A shall acknowledge the original completion date and bear Party B's storage expenses and other related expenses.
Four, about the project price and settlement agreement:
1. Payment method of project funds:
2. Project settlement:
3. The warranty period of the project is one year. Party A and Party B can sign the project warranty only after the project price is fully settled, and the warranty period starts from the date of signing the completion acceptance.
4. Receipts shall be issued for the capital exchanges between the two parties, and invoices shall be issued at the end of construction.
Verb (abbreviation for verb) Other matters
1. Party A's work: (1) Party A shall provide Party B with _ _ _ copies of construction drawings or practice instructions approved by the property management department one day before the start of construction, and make on-site disclosure to Party B. Empty all or part of the house and remove obstacles that affect the construction. Protective measures should be taken for furniture and furnishings stranded in houses that can only be partially vacated. Provide Party B with necessary conditions such as construction water and electricity, and explain matters needing attention. (2) Do a good job in the coordination of the temporary use of public parts in the construction and the influence on neighborhood relations. (3) If it is really necessary to dismantle or change the original building structure or design the pipeline, it shall be responsible for going through the corresponding examination and approval procedures at the local housing management department or property management department, and bear the relevant expenses.
2. Party B's work: (1) Participate in the on-site disclosure of construction drawings or instructions organized by Party A. (2) Appoint _ _ _ _ as the on-site representative of Party B to be responsible for the performance of the contract. Organize the construction as required, complete the construction task on time with good quality and quantity, and solve all matters that Party B is responsible for, and Party B shall recognize its behavior. If there is any personnel change, Party B shall promptly notify Party A in writing. (3) Without the consent of Party A and the approval of the local housing management or property management department, the original building load-bearing structure and all kinds of equipment and pipelines shall not be dismantled at will.
Liability for breach of contract of intransitive verbs:
1. If the construction period is delayed or suspended due to Party A's reasons, Party A shall compensate Party B for the losses caused by suspension or slowdown, and Party A shall pay RMB to Party B for each day of suspension or slowdown; If Party A fails to make payment as agreed in the contract, Party A shall pay% of the overdue payment as penalty for each day overdue.
2. If the completion is delayed due to Party B's reasons, Party B shall pay _ _% of the project payment to Party A for each day overdue.
3. Without going through the relevant formalities, Party A forcibly requests Party B to dismantle and rebuild the original load-bearing structure of the building and the equipment and pipelines used by * * *, and Party A shall be responsible for the losses or accidents (including fines) caused thereby.
4. If Party B dismantles or changes the original building load-bearing structure or equipment pipeline, the losses or accidents (including fines) caused thereby shall be borne by Party B..
Seven. Dispute handling method:
1. In case of any dispute over the quality of the project, both parties may consult and mediate with the Family Decoration Committee of Shanghai Building Decoration Association on the basis of the text of this contract and the unified invoice issued by the construction enterprise, or apply to the district/county construction administrative department or the consumer association for mediation. 2. If the parties are unwilling to settle the dispute through negotiation or mediation, or if negotiation or mediation fails, they may apply to the Municipal Arbitration Commission for arbitration in accordance with this contract and bring a lawsuit to the people's court.
Eight. Modification and dissolution of the contract:
1. After both parties sign the contract (the contract signed in the tangible market must be witnessed by the seal of the market management department), both parties must strictly abide by it. If either party needs to change the contents of the contract, it shall sign a supplementary agreement after consultation. If it is necessary to terminate the contract, the party who proposes to terminate the contract shall do so in writing, pay liquidated damages at% of the total contract price, and go through the termination procedures.
2. In the process of construction, if either party proposes to terminate the contract, it shall submit it to the other party in writing. After both parties agree to go through liquidation procedures and conclude an agreement to terminate the contract, the contract shall be deemed to be terminated.
Nine. This contract was signed on _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Party A (signature): Party B (signature):
Authorized Agent: Legal Representative:
Address: Address:
Tel: Tel:
Postal code:
Date of signature: year month day.
House renovation contract 202 1 Template 2
Party A: Party B:
Party A will give Party B the vacant room at B 1602 in Building No.5, and the decoration materials will be calculated by both parties through consultation. The purchase cost of the house decoration materials is RMB 2,000,000.00 Yuan only, and the two parties reached the following agreement during the cooperation:
1. Party B began to decorate and purchase materials on, and it must be completed before.
2. Party B is responsible for the purchase and quality of decoration materials and the maintenance and replacement of materials during the warranty period. If the materials provided by Party B have quality problems, Party B shall bear all the responsibilities.
3. If the materials purchased by Party B are damaged during transportation, Party B shall be fully responsible.
4. Party B shall completely decorate and purchase materials in accordance with the European style provided by Party A. ..
5. After Party A moves in, Party A shall be responsible for any man-made problems caused by negligence.
6. Party B shall pay Party B RMB 2,000,000.00 Yuan as scheduled within days after the completion of decoration and material procurement.
7. Matters not mentioned above shall be settled by both parties through friendly negotiation. If negotiation fails, it shall be submitted to the relevant departments for arbitration.
8. This agreement is made in triplicate, each party holds one copy, which has the same legal effect. Both parties * * * shall take effect from the date of signature.
Party A (official seal): _ _ _ _ _ _
Party B (official seal): _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
House renovation contract 202 1 Template 3
Employer (Party A):
Contractor (Party B):
Party A has a set located in x B model 201; Now Party B is entrusted to decorate the carpentry part of the commodity house. Party A shall be responsible for the materials used in this project, and Party B shall carry out the construction according to Party A's drawings (attached drawings).
I. Project Name: Interior Decoration Woodworking Project
Second, the construction site: _
Three. Total cost of woodworking project: according to the price signed by Party A and Party B (with price list and construction acceptance).
4. Payment method: After the project is completely completed and accepted by the owner and the project leader of Party A, Party A will pay 90% of the project payment to Party B within 30 days, and the remaining 10% of the project payment will be the quality guarantee, and Party A will pay it to Party B after half a year.
5. Construction period: from March 25th, 2000 to April 25th, 2000 ***3 1 day. If Party A changes the design scheme or Party A's materials cannot arrive on time, the construction period will be postponed.
Warranty of intransitive verbs: the warranty period is half a year, which belongs to Party B's construction quality problem and Party B needs warranty. All expenses (including materials) arising from the warranty shall be borne by Party B or deducted from the quality guarantee fund by Party A; If the cost exceeds the quality deposit, Party A has the right to deduct it from other project funds of Party B.. (In case of man-made damage or natural disasters, it is not covered by the warranty).
Seven, responsibility:
(1). Before entering the site for construction, Party B shall check the integrity of the wall structure, basically accept the completion of the previous working procedure, and make acceptance handover. Check and accept the quantity and quality of materials received from Party A, and Party B shall be responsible for the shortage and damage after acceptance. In addition, if Party B's personnel are found to have embezzled Party A's materials, once confirmed, they will be punished with one penalty and ten penalties.
(2) Without the consent of Party A, Party B shall not change the construction scheme, otherwise, Party B shall be responsible for the economic losses caused.
(3) During the construction, Party B shall pay attention to fire control and work-related injury safety, and carry out the construction in strict accordance with Party A's construction guidelines. During the construction period, Party B shall be responsible for the unexpected losses and work-related injuries caused by Party B..
(4) If the project is not completed on schedule due to Party B's reasons, 5% of the total project price will be deducted every day according to the number of days of delay.
Eight. This contract is made in duplicate, one for each party. It will take effect after being signed by both parties, and will be automatically terminated after all projects are settled.
Party A:
Party B:
Date of signing:
Date of signing:
House renovation contract 202 1 Template 4
Employer: (hereinafter referred to as Party A)
Renovation contract model
Address:
Entrusted agent:
Contact telephone number:
Contractor: (hereinafter referred to as Party B)
Address:
Entrusted agent:
Contact telephone number:
Risk warning:
The main purpose of signing the renovation contract is to clarify the responsibilities. Renovation contract is a binding certificate of the quality of home improvement, a guarantee to avoid home improvement disputes, and an important "weapon" for owners to safeguard their legitimate rights and interests.
Therefore, when concluding a contract, it is suggested that the employer clearly stipulate the general situation of the project, liability for breach of contract and jurisdiction according to the actual situation, so as to reduce the risk of contract performance, ensure the smooth performance of the contract and protect its legitimate and reasonable interests as much as possible.
According to the Contract Law of People's Republic of China (PRC), Regulations on Decoration Engineering Contracts and relevant laws and regulations, Party A and Party B decide to entrust Party B to carry out house decoration through friendly negotiation. In order to protect the legitimate rights and interests of both parties, combined with the specific conditions of this project, the two parties reached the following agreement for common compliance.
Article 1 General situation of the project
1. 1 project name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Location: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
1.2 project content (with engineering design drawings and text description and project budget)
Decoration content is subject to drawings and budget. Any increase or decrease in actual construction shall be agreed by both parties and confirmed in writing, and settled according to the facts.
Risk warning:
When the decoration company or foreman quotes, because the owner will pay more attention to the single price, he often ignores the process description, especially what materials, specifications, grades and due explanations are used. An owner told his personal experience: I didn't know anything at that time. The quotation given by the decoration company and the foreman only uses vague words, such as: large core board for cabinet and frame, solid wood wrapping, cement, interface agent, gypsum board covering, etc. All these are traps.
1.3 mode of contract: it is _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
Class A is contractors and contractors; Class B refers to non-material contracting.
1.4 According to the design drawings, the contents of the project budget and the contracting method.
Both parties confirm that the contract amount is _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
The design fee is _ _ _ _ _ _ _ _ _ Yuan, and amount in words is (RMB) _ _ _ _ _ _ _ _ _ _ _.
1.5 construction period: according to the national construction decoration project construction period quota, both parties agree.
Construction started on _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
1.6 In case of the following circumstances, the construction period shall be postponed accordingly.
1.6. 1 According to the provisions of the construction preparation, the construction site cannot be provided, the power line cannot be connected, and obstacles cannot be removed, which affects the construction in the field.
1.6.2 major facilities that are not within the coefficient range are changed, and the provision of engineering data is not allowed to change the design scheme or affect the progress due to the inability to construct.
1.6.3 During the construction process, if the power and water supply are cut off, the normal construction will be affected.
1.6.4 The supervision visa of the person in charge of Party A's site is not timely, which affects the construction of next working procedure.
1.6.5 The delay of Party A's material supply affects the construction.
1.6.6 Failure to allocate advance payment, project progress payment or price difference of purchased materials as stipulated in the contract affects the construction.
1.6.7 The construction period is delayed due to force majeure factors such as government actions and natural disasters.
Article 2 Project supervision
If the project is supervised, Party A and the supervision company shall separately sign (project supervision contract) and notify Party B of the name, unit, contact information and responsibilities of the supervision engineer.
Article 3 Obligations of Party A
3. 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
In the process of construction; Party A shall send the person in charge of the site to _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
3.2 The bearing structure of the original building shall not be demolished. If it is necessary to dismantle or change the non-load-bearing structure or equipment pipeline of the original building, go through the corresponding examination and approval procedures with the relevant departments.
3.3 Do a good job of timely supply, and make up the shortage of materials immediately.
3.4 The project completion acceptance shall be the responsibility of the supervisor who participates in the project quality and construction progress.
Article 4 Obligations of Party B
4. 1 During the construction, strictly implement the safety construction operation specifications, fire prevention regulations, construction specifications and quality standards, and complete the project on time with good quality and quantity.
4.2 Ensure the cleanliness of the construction site. Strictly implement the provisions of _ _ _ _ _ _ _ _ _ _
Article 5 Engineering changes
If it is necessary to change the project or construction method, both parties shall reach a consensus through consultation, determine a written change agreement, and adjust the related project cost and construction period.
Risk warning:
In order to protect the reasonable interests of the employer, the acceptance procedures for concealed works and intermediate works should be clearly stipulated in the contract.
Renovation contract shall stipulate that after the completion of the project, the contractor shall notify the employer for acceptance, and the employer shall organize the acceptance within a reasonable time and go through the acceptance handover procedures. If the Employer fails to organize the acceptance within the specified time, it shall promptly notify the Contractor to arrange another acceptance time. If the Employer finds that it does not meet the quality standards during acceptance, it may require the Contractor to compensate or rework.
Article 6 Project acceptance
6. 1 Concealed works: Party A shall send the technical director to inspect the concealed works with Party B for 24 hours, and sign an opinion after acceptance, which shall be kept by Party B as the basis for completion acceptance and repair.
6.2 After the project is completed, Party B shall notify Party A for acceptance. After receiving the acceptance notice, Party A shall organize the acceptance and fill in the acceptance form within two days. If it is not paid within the time limit, it will be deemed as qualified, and the handover procedures will be handled after the project payment is settled.
Risk warning:
In the process of decoration, it is easy to add or subtract items, such as making more cabinets and changing several meters of water circuits. These are all due when you finish. So what should the unit price of these items be? If the construction has already started, then the design may have the final say. Therefore, if possible, you can make a copy of the original complete quotation of the decoration company to avoid the decoration company stealing columns and changing prices when signing contracts or adding or subtracting projects.
Also note that when you finally settle the expenses, the increased or decreased expenses you should pay should be signed by you before the project construction. If you don't sign for it, you don't have to pay the corresponding fee.
Article 7 Method of payment for project funds
7. 1 On the date of signing the contract for the first time, Party A shall pay _ _ _ _% of the total contract amount, namely _ _ _ _ _ _ _ _.
7.2 When the second time is _ _ _ _% of the project progress, Party A shall pay _ _ _ _% of the total contract amount, namely _ _ _ _ _.
7.3 When the project progress reaches ` _ _ _% for the third time, Party A shall pay _ _ _ _% of the total contract amount, namely _ _ _ _ _ _ _ _ _.
7.4 After the acceptance of the project, Party B puts forward the project settlement proposal to Party A, and sends relevant materials to Party A. If Party A has no objection within three days after receiving the materials, it will be deemed as agreement. Both parties shall fill in the project settlement list and pay the balance within seven days.
Article 8 Liability for breach of contract
8. 1 If the construction period is delayed or suspended due to Party A's reasons, Party A shall compensate Party B for the losses caused by suspension or slowdown, and Party A shall pay RMB to Party B for each day of suspension; If Party A fails to make payment as agreed in the contract, Party A shall pay RMB as liquidated damages for each day overdue.
8.2 If the completion is overdue due to Party B's reasons, Party B shall pay% of the project payment to Party A for each day overdue.
Article 9 guarantee
9. 1 The warranty period of this project is one year, counting from the date of acceptance and signature by both parties.
9.2 Party B shall provide lifelong maintenance service, and Party A shall be responsible for the maintenance expenses outside the warranty period.
9.3 Losses caused by man-made damage and external factors, quality reasons of materials specified or provided by Party A, natural disasters and force majeure are not covered by the warranty.
Article 10 Dispute settlement methods
In case of any dispute during the execution of this agreement, both parties may apply to the Economic Contract Arbitration Committee for arbitration or bring a lawsuit directly to the court.
Eleventh specific provisions of other projects
1 1. 1 The garbage generated by the project construction shall be transported out of the construction site by Party B and transported to the designated place, and the garbage cleaning fee shall be borne by Party A (this fee is not included in the project price).
1 1.2 The final accounts of project completion shall be subject to the calculation of actual quantities.
1 1.3 The increase or decrease of items shall be negotiated by both parties, subject to the visas of both parties.
1 1.4 The construction drawings or descriptions provided by Party A and the construction site shall meet the requirements of fire prevention and accident prevention, mainly including the smoothness and qualification of electrical lines, gas pipelines, tap water and other pipelines. During the construction period, Party B shall take necessary safety protection and fire control measures to ensure the safety of operators and nearby residents, and prevent accidents such as pipeline blockage, water leakage, power failure and damage to houses and articles of nearby residents. In case of the above situation, it shall be the responsibility of Party A, and Party A shall be responsible for and compensate; Where Party B is responsible, Party B shall be responsible for repair and compensation.
Article 12 Supplementary Provisions
This contract shall come into effect after being signed by both parties.
12.2 The direct appraisal contract between Party A and Party B was concluded on _ _ _ _ _ _ _ _.
12.3 this contract will automatically terminate after the project is completed, accepted, paid and settled.
12.4 this contract is based on the principle of voluntary visa, and the contract text can be submitted to the relevant visa department of the city (district) where it is located for visa, so as to protect the legitimate rights and interests of both parties to the contract.
12.5 Other annexes to the contract.
Attachment 1: decoration project budget
Attachment 2: Design Drawings of Decoration Engineering
Annex III: Decoration Engineering Change Order
Attachment 4: Decoration Project Acceptance Sheet
Annex V: Project Settlement Table
Appendix 6: Project Warranty
Employer (seal): Contractor (seal):
Authorized Agent: Authorized Agent:
Signature time: Signature time:
House renovation contract 202 1 Template 5
(hereinafter referred to as Party A)
(hereinafter referred to as Party B)
In order to create a better sales environment for Party B, both parties have reached the following agreement through consultation on the principles of voluntariness, equality and mutual benefit:
1. From the date of signing this agreement, Party A shall be responsible for providing Party B with the overall design and decoration of the store. Decoration contents include:
Design, manufacture and installation of door billboards;
Design, manufacture and installation of product image wall;
Design, manufacture and installation of product display racks;
The formula and painting of the main color in the shop;
Design, manufacture and install hanging flags on the roofs of shops;
Party A shall provide Party B with a set of models, four sets of work clothes and various certificates and product descriptions free of charge.
2. Party B shall pay Party A a renovation deposit of RMB _ _ _ _ _ _ _ _ _ Yuan only from the date of signing this agreement.
3. Within one year from the date of signing the agreement, Party B shall not engage in other brands or products that conflict with Party A, otherwise Party B's decoration deposit will be deducted.
4. After a year of cooperation between Party A and Party B, Party B can well maintain Party A's product image, and there is no breach of contract. Party A will refund Party B the decoration deposit in full (in the form of floor cash).
5. This agreement is made in triplicate, with Party A holding 2 copies and Party B holding/kloc-0 copies. ..
6. The modification of this agreement shall be settled by both parties through consultation.
7. This Agreement shall come into effect as of the date when both parties affix their seals, and shall be terminated on _ _ _ _ _ _.
Party A: _ _ _ _ _ _ _ _ _ _ _ Party B: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Office address: _ _ _ _ _ _ _ _ _ _ _ Office address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Bank of deposit: _ _ _ _ _ _ Bank of deposit: _ _ _ _ _ _ _ _
Account number: _ _ _ _ _ _ _ _ _ _ _ _ Account number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Postal code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
Phone number: _ _ _ _ _ _ _ _ _ Phone number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Fax: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Representative (signature): _ _ _ _ Representative (signature): _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
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