Renovation contract Model Agreement on Housing [Article 5]

Article 1 Model House renovation contract Agreement

Employer (hereinafter referred to as Party A): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

After friendly negotiation, Party A decides to entrust Party B with the house decoration. 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.

I. Overview of the Project

1. Decorate the construction site:

2. House structure: living room with room type, with construction area of 100 m2.

3. Decoration construction content: See Annex I Decoration Construction Content Table for details.

4. Contracting method: _ _ _ _ _ _ (quantity contracting, contract settlement, partial contracting).

5. Duration: This project will start on _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.

Second, the project price and settlement agreement

1. Total project price: RMB _ _ _ _ _ _ _, in words (RMB): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.

2. The project payment method is as follows:

(1) The first time, the budget design was passed, and the date of signing the contract. Pay the deposit 10000 yuan, which will be deducted in the second payment.

(2) After signing the second contract, pay 50% of the total project cost before starting construction, totaling _ _ _ _ _ _ yuan.

(3) During the third construction, 40% of the total project cost will be paid according to half of the construction progress, totaling _ _ _ _ _ _ _ yuan.

(4) Pay 10% of the total project price on the day of the fourth completion acceptance, totaling _ _ _ _ _ _ _ yuan.

(5) The warranty period of this project is two years. After all the project funds are settled, Party A and Party B shall sign the project warranty, and the warranty period shall be calculated from the date of signing the completion acceptance.

Three. Material supply agreement

1. Materials supplied by Party A: See the quotation of decoration project in the contract 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.

3. The materials and equipment provided by Party B shall not be used if they do not meet the quality requirements or have different specifications. If it has been used, Party B shall be responsible for the losses caused to the project. If the materials and equipment provided by Party B are fake and shoddy goods, Party A shall be compensated twice the price of the materials and equipment.

Four. Project quality and acceptance agreement

1. This project implements DBJ 08–62–97 Technical Specification for Residential Building Decoration Engineering and DB 31/T30–1999 Acceptance Standard for Residential Decoration Engineering, as well as other local standards and quality evaluation acceptance standards formulated by the municipal construction administrative department.

2. This project is designed and constructed by Party A..

3. If the quality of materials and equipment provided by Party A is not up to standard, which will affect the project quality, the cost of rework shall be borne by Party A, and the construction period shall be postponed. In case of quality accident due to Party B, the rework cost shall be borne by Party B, and the construction period shall remain unchanged.

4. In the process of construction, when Party A puts forward design modification opinions and increases or decreases engineering projects, it should contact Party B in advance, and the engineering construction can only be carried out after mutual consent. The result affects the completion date, and both parties agree.

5. Both parties 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 will organize personnel to conduct the acceptance, and Party A will acknowledge 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.

6. Project completion: Party B shall notify Party A for acceptance three days in advance, and Party A shall organize acceptance within three days after receiving the notice. If Party A fails to organize the acceptance within the specified time, it shall notify Party B in time and set another acceptance date.

Five, safety production and fire prevention agreement

The construction drawings or practice instructions 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.

Other matters of intransitive verbs

1. Party A shall provide Party B with the construction drawings approved by the property management department, and make on-site disclosure to Party B before commencement. And provide Party B with necessary conditions such as water and electricity required for construction, and explain the matters needing attention in use. Do a good job in the construction of temporary use of public parts and the coordination of neighborhood relations.

2. Party B shall participate in the on-site disclosure of the construction drawings or instructions organized by Party A, organize the construction as required, complete the construction tasks with good quality and quantity on schedule, and solve all matters for which Party B is responsible, and Party B shall recognize its actions. Without the consent of Party A and the approval of the local housing management or property management department, the original building load-bearing structure, various equipment and pipelines shall not be dismantled and modified at will.

Seven. responsibility for breach of contract

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, it shall pay a penalty of RMB yuan for each day overdue.

2. If the completion of the project is delayed due to Party B's reasons, Party B shall pay _ _ _ _% of the payment made by Party A as liquidated damages for each day overdue.

Eight, dispute handling methods

Any dispute arising from the execution of the contract between the two parties shall be settled through friendly negotiation. If negotiation fails, a lawsuit may be brought to the people's court.

Nine. Alteration and termination of the contract

After this contract is signed by both parties, both parties must strictly abide by it.

X this contract is made in duplicate, one for each party, with the same legal effect. The annex to the contract is an integral part of this contract.

Party A (signature): _ _ _ Tel: _ _ _ _

Party B (signature): _ _ _ Tel: _ _ _ _

Signing place: _ _ _ _ _ _

Date of Signing: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Article 2 Model House renovation contract Agreement

Party A (Employer): ID number:

Party B (contractor):

ID number:

This agreement is reached by both parties through consultation, and both parties shall abide by it. As follows:

I. Project:

1, three rooms (two rooms and one living room, hereinafter referred to as three rooms) shall be marked with corner lines, including heating and pipes (the living room shall be symmetrical), and plaster lines shall be marked around the roof to cover the doors and windows of the three rooms; The living room and bedroom are covered with laminated wood floors; Remove the original paint from all rooms, putty from the living room and bedroom, and paint with Nippon paint twice.

2. Put a crossbar at the doors and windows of the balcony, and make a shelf on it according to Party A's requirements (drawings); On the east side of the balcony, a multi-purpose cabinet (shoes below and bookcases above) and a hanging cabinet on the west side are used to cover the balcony, lay tiles and hang pvc boards.

3, bathroom, bathroom, kitchen tiles to the top, pvc board hanging on the roof; The kitchen floor was tiled and a stove was built.

4. The power supply circuit of the room should be properly adjusted according to the requirements of Party A, and there is a multi-purpose cabinet behind the living room door (shoes are placed below and clothes are hung on it).

5. If no details are involved, Party A shall put forward a plan and discuss it.

Second, the way of contracting:

Party A must ensure the materials needed during the renovation according to Party B's requirements (Party B shall notify Party A in advance), and Party B shall be responsible for the construction.

Third, the quality standard:

The construction quality shall meet the safety requirements, and the decoration quality shall not be lower than the decoration standard of the same building type, which shall be approved by both parties.

Fourth, the construction period:

Starting from _ _ _ _ _ _ _ _

Five, the project cost:

Materials are provided by Party A, and Party A only pays Party B five thousand six hundred yuan for decoration labor.

Terms of payment for intransitive verbs:

After the completion of the project, if Party A meets the above-mentioned construction projects and design requirements after acceptance, the decoration labor cost shall be paid in one lump sum within three days.

Seven, other issues:

The specific requirements of the renovation project shall be put forward by Party A and implemented by Party B. Matters not covered in this agreement shall be settled by both parties through consultation. This agreement shall come into effect as of the date of signature by both parties.

Eight. This agreement is made in duplicate, with each party holding one copy, all of which are equally authentic.

Party A: Party B:

Signature (seal): Signature (seal):

Year after year, month after month, year after year.

Article 3 Model House renovation contract Agreement

Client (Party A): Organizer (Party B):

Through friendly negotiation between Party A and Party B, Party A decides to entrust Party B to decorate the living room. In order to ensure the smooth progress of the project, this contract is hereby signed in accordance with relevant national laws and regulations for * * * * to abide by.

Article 1: Project Overview

1, project location:

2. Regarding the project contracting mode, both parties agree to adopt the following (1) contracting mode:

(1) Party B contracts all materials;

(2) Party B contracts some materials and Party A provides some materials.

(3) Party B undertakes the work and Party A undertakes all the materials. house decoration contract

3. Total price:

4. Start date, month and year

Article 2: Quality Requirements

1. The varieties, specifications and names of the main materials used in the project shall be approved by both parties.

2. The acceptance standard of this project shall be implemented with reference to the relevant provisions of the state.

3. In the process of construction, if Party A has special construction projects or special quality requirements, both parties shall sign a supplementary contract for the increased cost.

4. Party A shall be responsible for the product quality of all materials and equipment purchased by Party A, and Party B shall be responsible for the construction quality. ..

5. If Party A hires a project supervisor, it shall notify Party B before the project starts, so as to facilitate the work connection.

Article 3: Material supply

1. Party B shall clearly price the materials used in this contract in strict accordance with the relevant national price regulations. The materials provided by Party A shall be used in the decoration project specified in this contract, and shall not be used for other purposes without Party A's consent ... If Party B uses them for other purposes, Party B shall compensate Party A at double the price of the misappropriated materials.

2. If the materials and equipment provided by Party B do not meet the quality requirements or have different specifications, they shall be prohibited from being used. If it has been used, all losses caused to the project shall be borne by Party B. ..

3. The materials and equipment that Party A is responsible for purchasing and supplying shall be qualified products that meet the design requirements, and shall be supplied to the site on time. Delayed arrival, postponed construction period and delayed punishment. Pay Party B 10% of the total materials provided by Party A as the management fee. After the materials are accepted by Party B, Party B shall be responsible for keeping them, and Party B shall be responsible for compensating the losses caused by improper keeping.

Article 4: Method of Payment

1. After the contract is signed, Party A shall pay 30% of the project cost; The remaining 70% will be settled by Party A after the project is completed and accepted.

Party A's failure to pay on time is a breach of contract, and Party B has the right to stop the construction. If the project price is not settled after acceptance, it shall not be delivered for use.

2. If there is any increase or decrease in the project or need to be changed during the construction, both parties shall sign a supplementary contract, and Party B shall be responsible for the construction change order and notify the person in charge of the construction site. Increase or decrease the project price and settle on the spot.

3. If Party A fails to prepay the project price within the time limit stipulated in this contract, Party A shall pay 1% of the unpaid project price to Party B for each day overdue.

Article 5: Liability for breach of contract

After the contract comes into effect, during the performance of the contract, the party that terminates the contract without authorization shall pay the other party 5% of the total contract amount as liquidated damages. If the actual loss caused to the other party by the unauthorized termination of the contract exceeds the liquidated damages, it shall be compensated.

Article 6: Entry into force of the contract

1. This contract and its annexes shall be sealed by both parties and come into force after being signed. Matters not covered shall be settled by both parties through consultation.

2. The supplementary contract has the same legal effect as this contract.

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

Party A (Owner): Party B:

Bank account number: Bank account number:

Date of signature: year month day.

Article 4 Model House renovation contract Agreement

Owner (hereinafter referred to as Party A): _ _ _ _ _ Tel: _ _ _ _ _ _ _

Construction Team (hereinafter referred to as Party B): _ _ _ _ _ _ _

Tel: _ _ _ _ _ _

ID number and copy

Project: bedroom decoration

After many friendly consultations between Party A and Party B, Party A decided to entrust the right to decorate the living room to Party B. In order to ensure the smooth progress of the project, this contract (including its annexes and all supplementary contracts) is specially signed in accordance with relevant national laws and regulations for * * * to abide by.

I. Overview of the Project

1, project address:

2. Room specifications: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Room specifications: _ _ _ _ _ _ _ _ _ _ _ _ Room specifications

Total: square meters of construction area;

3. Construction content: For details, please refer to Annex (1) Detailed Drawing of Home Decoration Construction Project and House Type Construction Drawing.

4. Entrustment method:

Second, the project price

Labor cost for clearing packages: _ _ _ Yuan, in words:

Three. terms of payment

1, the construction team enters the site, and the living expenses are paid in advance: _ _ _ _ _.

2, plumber completed, salary _ _ _ _ _ yuan.

3, after the completion of carpentry, pay _ _ _ _ yuan,

4. The bricklayer shall pay RMB _ _ _ _ _ yuan after completion.

5, the project is completed, pay _ _ _ _ _ yuan,

6. In the process of project construction, if there is any increase or decrease of the project or need to be changed, the increase or decrease of the project price shall be settled after the completion of the increase or decrease of the project through consultation between Party A and Party B. ..

7. The project quality warranty is in Jin Yuan, which shall be paid after 1 year from the date of completion.

8. If all the acceptance items meet Party A's acceptance standards and are satisfactory when the project is completed, Party A will pay Party B an additional project award fund.

Fourth, design.

1. If Party A has drawings, it shall provide Party B with a set of drawings and be responsible for disclosure;

2. If Party A has no drawings, it shall clearly explain the requirements to Party B, and Party B shall draw a sketch for Party A's approval before construction.

Verb (abbreviation of verb) material

1. Party B shall provide Party A with a list of materials to be purchased three days in advance, and Party A shall timely purchase materials for the construction team within four days. Both parties shall bear their respective responsibilities for the delay in construction period and economic losses.

2. All building materials provided by Party A shall be kept by Party B after acceptance, and shall not be used for other purposes without Party A's consent; If Party B uses it for other purposes or keeps it improperly, it shall compensate Party A at twice the actual price of the materials.

3. Without the consent of Party A, Party B shall not purchase materials by itself; If it has been purchased, Party A has the right to refuse to use it unconditionally and refuse to pay for the materials.

4. If Party B needs to purchase some materials, Party B shall purchase them at the building materials supply point designated by Party A and issue an official invoice.

5. Party B shall check and accept the quality of building materials purchased by Party A, and raise quality problems with Party A in time, and have the right to refuse to use them. If Party A insists on using it, it shall request Party B in writing and bear the losses caused by the quality of the materials.

6. Party B shall assist Party A to receive the goods and check the accuracy of the quantity and accessories.

7. Party B shall properly keep the materials and prohibit other personnel from entering the site.

8. Without Party A's permission, Party B shall not take any building materials out of the house. If such a phenomenon is found, it will be deducted from the labor cost by doubling the material price.

Six, time limit for a project and project quality inspection and acceptance

1, the construction period is _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

2. During the construction period, Party B's daily working hours are: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

3, engineering quality inspection and acceptance

A, the basis of engineering quality evaluation and acceptance criteria:

(1) Construction drawings, practices and design changes;

② Code for Construction of Residential Decoration Engineering

(3) Quality Acceptance Standard for Urban Family Room Decoration Project

B. Process acceptance items: foundation reconstruction project, water and electricity line reconstruction project (before closing), waterproof project (before tile laying), ceiling project (before plasterboard coating), door and window project, joinery project and wall coating project;

C. Acceptance items confirmed by both parties; Unqualified items should be rectified within a time limit and accepted separately until they are qualified.

Seven, material processing

Party A's materials are delivered to the downstairs where the project is located, and any construction personnel of Party B shall carry them unconditionally.

Eight, garbage removal

1, garbage bagging;

2. Garbage should be cleaned up every day;

3. The garbage shall be transported by Party B to the garbage dump designated by the property. 、

Nine. Labor force management

1. Party B shall provide Party A with copies of ID cards of all construction personnel before the commencement of construction;

2. Without Party A's permission, off-site construction personnel shall not spend the night at the site;

3. Party B's temporary residence permit in Changsha is complete, and relevant losses caused by incomplete documents shall be borne by Party B;

4. Without the consent of Party A, Party B shall not change the construction personnel at will;

5. Without the consent of Party A, Party B shall not stop work or go slow under any circumstances.

X. Construction machinery and tools

Party B shall bring its own tools needed for construction, and ensure the safety and good usability of the tools, and the maintenance expenses of the tools shall be borne by Party B..

XI. On-site management

1, open flame is strictly prohibited at the site;

2, paint materials must be placed separately from other materials.

Twelve. maintain

1. Quality problems caused by Party B's construction,

Party B shall maintain it free of charge within two years.

2. For general maintenance, Party B shall carry out maintenance within three days after Party A notifies Party B, and for special cases (water and electricity problems), Party B must arrive within 24 hours to carry out maintenance.

3. If Party B fails to complete the maintenance in time as agreed in the contract, Party A can arrange other construction teams to carry out the maintenance work, and the labor costs incurred will be deducted from the project warranty fund.

Thirteen. Annex to the contract

1, details of construction contents, items and expenses.

Fourteen dispute over a contract

1. In case of any dispute, Party A and Party B shall settle it through negotiation first.

2. If negotiation fails, a lawsuit can be brought to the court where the dispute is located.

Fifteen. Other instructions and requirements:

1. The pipeline to be concealed shall be concealed after Party A's acceptance, and Party A shall be provided with the as-built drawings of indoor water and electricity pipelines before the completion acceptance.

2. In addition to the above decoration requirements, if there is any extra work, both parties shall negotiate separately, and the construction cost shall not be higher than the average level of the same kind.

3. This project is a package settlement, and Party A only provides materials. Construction tools and other equipment shall be provided by Party B's construction contractor.

4. Party B's construction unit must ensure the construction quality. Found that the construction quality problems, the construction unit shall promptly correct. If quality problems are found during the completion acceptance, the construction unit shall immediately rectify them, and Party A has the right to refuse to pay the labor costs before Party A's rectification requirements are met.

5. Party B appoints (name) as the on-site representative of Party B to be responsible for the performance of the contract, organize the construction according to the requirements of the contract, and complete the construction task on time with good quality and quantity.

6, the construction personnel to civilized construction, barbaric construction is prohibited. 、

7. The construction unit is responsible for cleaning up the construction waste to the designated place in time. After the construction, the construction personnel are responsible for clearing the construction waste at the site, and can leave the site immediately after the completion.

8. Party B shall strengthen the safety education on fire prevention and theft prevention for on-site construction personnel. Construction personnel are not allowed to violate the law and discipline at the construction site, and the consequences will be at their own risk if problems arise.

9. Supplementary provisions

① This contract is signed by Party A and Party B in duplicate, with each party holding one copy. This contract shall come into effect after being signed (sealed) by both parties.

(2) after the signing of this contract, the project shall not be subcontracted.

(3) After the project is completed, the contract will be automatically terminated.

(4) The annexes to this contract are an integral part of this contract and have the same legal effect as this contract.

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

Signature: _ _ _ _ _ Signature: _ _ _ _

Date of signing: _ _ _ Date of signing: _ _ _ _

Article 5 Model House renovation contract Agreement

Entrusting party (Party A): _ _ _ _ _ _ Commitment party (Party B): _ _ _ _ _ _ _ _

Project: _ _ _ _ _ _ _ _ _ _ _ _ _ _ Project: _ _ _ _ _ _ _ _ _ _ _ _ _

Through friendly negotiation between Party A and Party B, Party A decides to entrust Party B to decorate the living room. In order to ensure the smooth progress of the project, in accordance with relevant national laws and regulations, this contract (including its annexes and all supplementary contracts) is hereby signed for * * * to abide by.

Article 1: Project Overview

1. Project address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

2. Construction content: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

3. Entrustment method: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

5. Project Commencement Date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

6. Project completion date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Total days of the project: _ _ _ _ _ _

Article 2: Project Price

Project Price (amount in words) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Article 3: Warranty Period

The warranty period is _ _ months from the date of project completion and acceptance by Party A. ..

Article 4: Liability for breach of contract

1. After the contract comes into effect, during the performance of the contract, the party that terminates the contract without authorization shall pay the other party 5% of the total contract amount as liquidated damages. If the actual loss caused to the other party by the unauthorized termination of the contract exceeds the liquidated damages, it shall be compensated.

2. During the warranty period, Party B shall guarantee to provide on-site service within 24 hours after Party A notifies the maintenance by telephone or in writing. In case of breach of contract, Party B shall pay a penalty of 5% of the total contract amount.

Article 5: Settlement of disputes

1. In case of any dispute during the performance of this contract, both parties shall settle it through negotiation without affecting the project progress.

2. If both parties are unwilling to solve the problem through negotiation or mediation, or negotiation or mediation fails, they can bring a lawsuit to Wuchang District People's Court according to this contract.

Article 6: Entry into force of the contract

1. This contract shall come into effect after being sealed by both parties.

2. Party A and Party B each hold one copy of this contract.

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

Domicile address: _ _ _ _ _ _ Business address: _ _ _ _ _ _ _ _

Postal Code: _ _ _ _ _ _ Postal Code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _