Employment Contract

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The option "Company" should be selected if the Employer is a company incorporated with Companies House. The option "Sole Trader" should be selected if the Employer is a sole trader (i.e. a self employed person). The option "Partnership" should be selected if the Employer is a partnership.



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The Parties/signatories to this Agreement are advised that signature of this document will have legal consequences. Where either Party is unsure or does not understand the legal obligations and responsibilities placed upon them under this Agreement, they are advised to seek legal advice before signing.

Employment Contract

1. Parties

A. Employer:

________ (Company number ________) whose registered office is at:

________

(hereafter "the Employer")

B. Employee:

________ of:

________

(hereafter "you")


2. Your Appointment

A. You will be employed by the Employer in accordance with the terms and conditions set out in this contract (the Contract).

B. Your employment with the Employer under the Contract will commence on ________ ("the Commencement Date").

C. Your period of continuous employment with the Employer commenced on ________. This period of continuous employment shall not be lost under the Contract. You shall continue to be treated as having commenced employment on ________ with the Employer.

D. Your continuing employment under the Contract is conditional upon you being permitted to work in the UK.

E. Your Employment under this agreement shall continue as a permanent agreement until it is properly terminated under the terms of this agreement or by operation of law.


3. Duties

A. You will be employed to undertake the following duties:

________

B. During your employment:

I. there may be occasions where you are required to carry out different or additional duties as a reasonable requirement of the Employer's business; and

II. you are required to comply with all policies, procedures and workplace rules provided by the Employer; and

III. you must carry out your duties with honesty, integrity and should carry out all reasonable tasks assigned to you by the Employer.


4. Probationary Period

A. Your appointment and general employment is not the subject of any probationary period.


5. Notice Period

A. The Contract may be terminated at any time by the Employer giving written notice to the Employee of no less than:

I. one WEEK where you have been continuously employed for more than one MONTH and up to two years;

II. one WEEK for each full year you have worked where you have been continuously employed between two years and up to twelve years;

III. twelve WEEKS where you have been continuously employed for twelve years or more;

B. The Contract may be terminated at any time by the Employee giving written notice to the Employer of no less than one WEEK.


6. Pay

A. The Employer will pay you:

£________ (________) per hour.

(your "Pay")

B. Your Pay shall be paid in weekly instalments (in arrears to cover the previous pay period) on: ________.

C. Your Pay shall be paid via: ________.

D. Your Pay shall be subject to any deductions as required by law.

E. Where, at any time during your employment, you owe any sums to the Employer, the Employer may deduct this amount from your Pay.


7. Place of Work and Mobility Clauses

A. There shall be an arrangement for you to work remotely and your normal Place of Work shall therefore be your home address of:

________ (your Remote Place of Work)

B. Notwithstanding the above, you may be required to perform your duties in such other place or places as the Employer may reasonably require from time to time.


8. Requirement to Work Outside of the UK

A. You shall not be required to work outside of the United Kingdom for a period of more than one MONTH during your employment.


9. Trial Period for Remote Working Arrangements

A. The arrangements for you to work remotely (as described in the section above which addresses your Place of Work) are exclusively subject to a trial period, the terms of which are defined below.

B. The first ________ MONTH of remote working following the Commencement Date of the Contract shall be subject to the trial period (the Trial Period).

C. The arrangement in place for you to work remotely may be terminated during the Trial Period in the event that it is considered by the Employer to no longer be appropriate.

D. In the event of a termination to the remote working arrangements during the trial period, your Place of Work shall thereafter be:

________ (your Formal Place of Work).

E. You will be given ________ WEEK notice of any termination to the remote working arrangements.

F. At the conclusion of the Trial Period you shall be informed of the outcome in writing. This could include, but is not limited to, any of one the following options:

I. confirmation that the remote working arrangements shall be appropriate for the remainder of your employment; or

II. a further extension to the Trial Period; or

III. a termination of the remote working arrangements altogether and a return to your Formal Place of Work.

G. The success of the Trial Period will be reviewed by:

________

H. Any appeal to the decision made in respect of the Trial Period must be made in writing within ________ WEEK of the decision. Any such appeal should be made to: ________.


10. Remote Working Arrangements - Employer's Right to Terminate after the Trial Period

A. The Employer reserves the right to terminate the arrangements put in place for you to work remotely at any time after the Trial Period should the arrangements no longer be deemed suitable and in line with its needs. In this instance, you shall receive ________ WEEK notice in writing that your Place of Work shall change to your Formal Place of Work.

B. The Employer shall also properly consider any written requests made by you to change your Place of Work to your Formal Place of Work.


11. Change to Your Home Address

A. You must notify us as soon as is reasonably practicable of any change to your home address.


12. Hours of Work

A. Your normal hours of work are ________ hours per WEEK. Your working pattern shall be as follows:

________

B. It is your responsibility to ensure that you take your allocated breaks.

C. The Employer may vary your hours of work or the pattern of your normal hours, where this is considered necessary for the purposes of the Employer's business. Any variation to your working hours shall be determined as follows:

________

D. Where the Employer considers it necessary, you may be asked to work additional hours (Overtime). You shall not be required to work above a total of 40 hours per WEEK for the purposes of any Overtime.

E. For Overtime you will be paid:

________

F. Any Overtime shall be determined, managed and arranged in the following manner:

________


13. Communication and Development During Remote Working

A. During your hours of remote work you must remain contactable wherever possible during your working hours in the following manner:

________

B. During your hours of remote work you shall report any issues regarding your work, or the arrangement generally in the following manner:

________

C. During your hours of remote work the standard of your work and the hours you work shall be reviewed in the following manner:

________

D. Whilst you are working remotely, you shall be offered the opportunities for training, development and progression in the following manner:

________


14. Holidays

A. You will be entitled to the following paid holiday per holiday year:

________

B. The holiday year runs for one calendar year from the Commencement Date each year.

C. Your statutory basic annual leave entitlement must be taken in the first instance, followed by your statutory annual leave entitlement. Any contractual annual leave entitlement must then be taken once your basic and statutory annual leave has been taken.

D. Your annual leave entitlement must be taken in the year in which it accrues.

E. Annual leave must be authorised in advance by the Employer. Requests should be made no less than ________ WEEK prior to the desired period of leave.

F. On termination of your employment you will be paid in lieu for any untaken statutory holiday entitlement in respect of the holiday period in which your employment terminates. Any holiday taken in excess of your accrued entitlement on termination shall be deducted from your final pay.


15. Sickness

A. If you are absent from work for any reason you must ensure that you notify the Employer of this in the following manner:

________

B. Wherever you are working remotely, you must report any sickness days using the following method:

________

C. In the event of absence from work due to illness or injury (and subject to your full compliance with the Employer's sickness procedures as referred to and described above), you shall be eligible for sick pay (Contractual Sick Pay) from the Employer. The terms of your eligibility to such additional sick is defined as follows:

I. Contractual Sick Pay shall mean payment of your salaried amount for any period absence of ________ WEEK per calendar year.

II. Payments of Contractual Sick Pay shall be inclusive of any Statutory Sick Pay properly owed to you at the time of sickness.

III. Your eligibility for Contractual Sick Pay shall remain at the sole discretion of the Employer.

D. The Employer may require you to attend a medical examination in order to manage your employment and to assess the proper administration of any Sick Pay. You agree to undertake such medical examinations as required.


16. Additional Paid Leave

A. During the course of your employment, you may be eligible for periods of paid leave in addition to those described above in the sections 'Sickness' and 'Holidays'. This could include, but is not limited to:

________

B. Your eligibility for additional paid leave shall be determined upon request and shall be subject to your fulfilment of any required statutory provisions and criteria.


17. Health and Safety for Remote Working

A. You shall permit the Employer to carry out all necessary health and safety risk assessments relevant to your health, safety and wellbeing whilst working remotely.

B. You shall be issued with health and safety policies and guidelines which shall be relevant to remote working arrangements. In signing this agreement, you undertake to comply with such policies and guidelines.


18. Disciplinary Procedure

A. The Employer has disciplinary rules and procedures which shall be applicable to you throughout the course of your Employment. Full details of the current procedure can be found in the Employer's disciplinary procedure, a copy of which shall be provided to you and you agree you shall read the same. The disciplinary procedures does not form part of the Contract and they may be amended and updated periodically. You shall be notified of any amendments and you agree to read these.

B. The Employer reserves the right to temporarily suspend you from your full duties, or from some of your duties in the event that any proper disciplinary investigation requires this. The terms and conditions of any suspension shall be provided to you in writing in the event that such a situation arises.

C. Where you seek to appeal any final disciplinary decision, you have the right to do so. Any appeal should be made following the process set out in the disciplinary procedure and should be made out to ________.


19. Grievance Procedure

A. In the event that you wish to raise a grievance, you should set this out in writing to ________ in accordance with the Employer's grievance procedure, which does not form part of the Contract. A copy of this shall be provided to you and you agree to read the same.

B. Where you seek to appeal any final grievance decision, you have the right to do so. Any appeal should be made following the process set out in the grievance procedure and should be made out to ________.


20. Pensions

A. The Employer is not required to auto-enrol you in its workplace pension scheme under the Pensions Act 2008. You may however elect to join the scheme. The details of this policy shall be provided to you separately in the form of: ________.


21. Expenses

A. The Employer will reimburse you with any general expenses incurred by you during Employment provided that these are reasonable and necessary for the purposes of your role. The authorisation of such expenses shall be determined in line with our procedure as set out in: ________.

B. It is also agreed that the Employer shall be responsible for the reimbursement of reasonable expenses arising directly out of remote work undertaken by you. Such reasonable expenses shall be defined as follows:

________


22. Equipment for Remote Working

You shall be provided with the following additional equipment to enable you to undertake your duties under the Remote Work Agreement:

A. Inventory of equipment:

________

B. You agree that you shall properly report any damage or theft of this above named equipment without delay.

C. All equipment provided to you by the Employer shall be returned to us at the conclusion of your employment.


23. Insurance

A. It is the responsibility of the Employer to hold a valid employer's liability insurance policy.

B. The Employer shall ensure that its employer's liability insurance shall cover you, the Employee, wherever you working remotely.

C.The Employee will be responsible for taking out proper insurance to cover the following equipment, and shall ensure that the policy remains valid as a condition of remote working arrangements:

________


24. Training

A. No training shall provided to you during your employment. You will not be required to attend any training at any stage as a requirement of your employment.


25. Other Benefits

A. Certain benefits may be made available to you by the Employer during your employment. The benefits which you may be eligible to receive are:

________

B. The benefits offered are subject to change. You shall be notified of any such changes.


26. Collective Agreements

A. The terms and conditions of your employment are affected by the following collective agreements which were made between the parties set out below:

________

B. Further details regarding the relevant collective agreements can be obtained from ________.


27. Confidential Information

A. During your employment, you will be provided with or exposed to confidential information.

B. Confidential information for the purposes of the Contract is defined as:

I. information which is provided to you directly or indirectly through your employment, giving rise to your duty of confidence as an employee; and

II. the information relates to the Employer's business which is either marked specifically as confidential information or is guarded as confidential information by the Employer; and

III. the information is not publicly available; and

IV. the information would, if used in an manner which has not been authorised by the Employer, be detrimental to the Employer's business.

C. You must at all times during your employment maintain the proper security of Confidential Information.

D. 825 85588 222 52 522 2822 555822 2255 2228222222 25 52 522 2822 52225 2255 2228222222 558 8222 2252825225 (82 522 22528), 58888282 522 822285222858 52225252822 22 522 22525 8258885558, 252528852822 25 85882288.

E. 225 252 582855282 22 522 52582, 252 2528888228 22 2588 8282822 52 222 2528222 252 52282222 2522 252822 522 252228225 58888285528 52525 8282822 288 22 252 5228222222 882528 882 2885 25 522 58888285528 85885 552 25222582 52858525 82 858.


28. Data Protection

A. It will be necessary for the Employer to collect and process personal information and/or data in relation to you during the course of your employment.

B. Any personal information and/or data in relation to you will only be collected and processed and/or transferred in accordance with the Employer's privacy statement (the Privacy Statement), which can be found at the following location: ________.

C. You must also ensure you comply with the data protection procedures and rules applicable to Employees as set out in the Employer's policy.


29. Data Protection and Confidentiality During Remote Working

A. During all periods of remote work, you shall ensure and maintain the proper security of Confidential Information and all data protection requirements in the following manner:

________


30. 8552228 22 252 82225582

B. 822 8552228 22 252 82225582 85588 82 25288525 22 225 82 8582822, 525 82 5882555282 8825 8.2 22 252 5228222222 882528 882 2885.


Agreed by the parties



______________________
Signed by ________:


______________________
Date

______________________
Signed by ________
for and on behalf of ________


______________________
Date

See your document
in progress

The Parties/signatories to this Agreement are advised that signature of this document will have legal consequences. Where either Party is unsure or does not understand the legal obligations and responsibilities placed upon them under this Agreement, they are advised to seek legal advice before signing.

Employment Contract

1. Parties

A. Employer:

________ (Company number ________) whose registered office is at:

________

(hereafter "the Employer")

B. Employee:

________ of:

________

(hereafter "you")


2. Your Appointment

A. You will be employed by the Employer in accordance with the terms and conditions set out in this contract (the Contract).

B. Your employment with the Employer under the Contract will commence on ________ ("the Commencement Date").

C. Your period of continuous employment with the Employer commenced on ________. This period of continuous employment shall not be lost under the Contract. You shall continue to be treated as having commenced employment on ________ with the Employer.

D. Your continuing employment under the Contract is conditional upon you being permitted to work in the UK.

E. Your Employment under this agreement shall continue as a permanent agreement until it is properly terminated under the terms of this agreement or by operation of law.


3. Duties

A. You will be employed to undertake the following duties:

________

B. During your employment:

I. there may be occasions where you are required to carry out different or additional duties as a reasonable requirement of the Employer's business; and

II. you are required to comply with all policies, procedures and workplace rules provided by the Employer; and

III. you must carry out your duties with honesty, integrity and should carry out all reasonable tasks assigned to you by the Employer.


4. Probationary Period

A. Your appointment and general employment is not the subject of any probationary period.


5. Notice Period

A. The Contract may be terminated at any time by the Employer giving written notice to the Employee of no less than:

I. one WEEK where you have been continuously employed for more than one MONTH and up to two years;

II. one WEEK for each full year you have worked where you have been continuously employed between two years and up to twelve years;

III. twelve WEEKS where you have been continuously employed for twelve years or more;

B. The Contract may be terminated at any time by the Employee giving written notice to the Employer of no less than one WEEK.


6. Pay

A. The Employer will pay you:

£________ (________) per hour.

(your "Pay")

B. Your Pay shall be paid in weekly instalments (in arrears to cover the previous pay period) on: ________.

C. Your Pay shall be paid via: ________.

D. Your Pay shall be subject to any deductions as required by law.

E. Where, at any time during your employment, you owe any sums to the Employer, the Employer may deduct this amount from your Pay.


7. Place of Work and Mobility Clauses

A. There shall be an arrangement for you to work remotely and your normal Place of Work shall therefore be your home address of:

________ (your Remote Place of Work)

B. Notwithstanding the above, you may be required to perform your duties in such other place or places as the Employer may reasonably require from time to time.


8. Requirement to Work Outside of the UK

A. You shall not be required to work outside of the United Kingdom for a period of more than one MONTH during your employment.


9. Trial Period for Remote Working Arrangements

A. The arrangements for you to work remotely (as described in the section above which addresses your Place of Work) are exclusively subject to a trial period, the terms of which are defined below.

B. The first ________ MONTH of remote working following the Commencement Date of the Contract shall be subject to the trial period (the Trial Period).

C. The arrangement in place for you to work remotely may be terminated during the Trial Period in the event that it is considered by the Employer to no longer be appropriate.

D. In the event of a termination to the remote working arrangements during the trial period, your Place of Work shall thereafter be:

________ (your Formal Place of Work).

E. You will be given ________ WEEK notice of any termination to the remote working arrangements.

F. At the conclusion of the Trial Period you shall be informed of the outcome in writing. This could include, but is not limited to, any of one the following options:

I. confirmation that the remote working arrangements shall be appropriate for the remainder of your employment; or

II. a further extension to the Trial Period; or

III. a termination of the remote working arrangements altogether and a return to your Formal Place of Work.

G. The success of the Trial Period will be reviewed by:

________

H. Any appeal to the decision made in respect of the Trial Period must be made in writing within ________ WEEK of the decision. Any such appeal should be made to: ________.


10. Remote Working Arrangements - Employer's Right to Terminate after the Trial Period

A. The Employer reserves the right to terminate the arrangements put in place for you to work remotely at any time after the Trial Period should the arrangements no longer be deemed suitable and in line with its needs. In this instance, you shall receive ________ WEEK notice in writing that your Place of Work shall change to your Formal Place of Work.

B. The Employer shall also properly consider any written requests made by you to change your Place of Work to your Formal Place of Work.


11. Change to Your Home Address

A. You must notify us as soon as is reasonably practicable of any change to your home address.


12. Hours of Work

A. Your normal hours of work are ________ hours per WEEK. Your working pattern shall be as follows:

________

B. It is your responsibility to ensure that you take your allocated breaks.

C. The Employer may vary your hours of work or the pattern of your normal hours, where this is considered necessary for the purposes of the Employer's business. Any variation to your working hours shall be determined as follows:

________

D. Where the Employer considers it necessary, you may be asked to work additional hours (Overtime). You shall not be required to work above a total of 40 hours per WEEK for the purposes of any Overtime.

E. For Overtime you will be paid:

________

F. Any Overtime shall be determined, managed and arranged in the following manner:

________


13. Communication and Development During Remote Working

A. During your hours of remote work you must remain contactable wherever possible during your working hours in the following manner:

________

B. During your hours of remote work you shall report any issues regarding your work, or the arrangement generally in the following manner:

________

C. During your hours of remote work the standard of your work and the hours you work shall be reviewed in the following manner:

________

D. Whilst you are working remotely, you shall be offered the opportunities for training, development and progression in the following manner:

________


14. Holidays

A. You will be entitled to the following paid holiday per holiday year:

________

B. The holiday year runs for one calendar year from the Commencement Date each year.

C. Your statutory basic annual leave entitlement must be taken in the first instance, followed by your statutory annual leave entitlement. Any contractual annual leave entitlement must then be taken once your basic and statutory annual leave has been taken.

D. Your annual leave entitlement must be taken in the year in which it accrues.

E. Annual leave must be authorised in advance by the Employer. Requests should be made no less than ________ WEEK prior to the desired period of leave.

F. On termination of your employment you will be paid in lieu for any untaken statutory holiday entitlement in respect of the holiday period in which your employment terminates. Any holiday taken in excess of your accrued entitlement on termination shall be deducted from your final pay.


15. Sickness

A. If you are absent from work for any reason you must ensure that you notify the Employer of this in the following manner:

________

B. Wherever you are working remotely, you must report any sickness days using the following method:

________

C. In the event of absence from work due to illness or injury (and subject to your full compliance with the Employer's sickness procedures as referred to and described above), you shall be eligible for sick pay (Contractual Sick Pay) from the Employer. The terms of your eligibility to such additional sick is defined as follows:

I. Contractual Sick Pay shall mean payment of your salaried amount for any period absence of ________ WEEK per calendar year.

II. Payments of Contractual Sick Pay shall be inclusive of any Statutory Sick Pay properly owed to you at the time of sickness.

III. Your eligibility for Contractual Sick Pay shall remain at the sole discretion of the Employer.

D. The Employer may require you to attend a medical examination in order to manage your employment and to assess the proper administration of any Sick Pay. You agree to undertake such medical examinations as required.


16. Additional Paid Leave

A. During the course of your employment, you may be eligible for periods of paid leave in addition to those described above in the sections 'Sickness' and 'Holidays'. This could include, but is not limited to:

________

B. Your eligibility for additional paid leave shall be determined upon request and shall be subject to your fulfilment of any required statutory provisions and criteria.


17. Health and Safety for Remote Working

A. You shall permit the Employer to carry out all necessary health and safety risk assessments relevant to your health, safety and wellbeing whilst working remotely.

B. You shall be issued with health and safety policies and guidelines which shall be relevant to remote working arrangements. In signing this agreement, you undertake to comply with such policies and guidelines.


18. Disciplinary Procedure

A. The Employer has disciplinary rules and procedures which shall be applicable to you throughout the course of your Employment. Full details of the current procedure can be found in the Employer's disciplinary procedure, a copy of which shall be provided to you and you agree you shall read the same. The disciplinary procedures does not form part of the Contract and they may be amended and updated periodically. You shall be notified of any amendments and you agree to read these.

B. The Employer reserves the right to temporarily suspend you from your full duties, or from some of your duties in the event that any proper disciplinary investigation requires this. The terms and conditions of any suspension shall be provided to you in writing in the event that such a situation arises.

C. Where you seek to appeal any final disciplinary decision, you have the right to do so. Any appeal should be made following the process set out in the disciplinary procedure and should be made out to ________.


19. Grievance Procedure

A. In the event that you wish to raise a grievance, you should set this out in writing to ________ in accordance with the Employer's grievance procedure, which does not form part of the Contract. A copy of this shall be provided to you and you agree to read the same.

B. Where you seek to appeal any final grievance decision, you have the right to do so. Any appeal should be made following the process set out in the grievance procedure and should be made out to ________.


20. Pensions

A. The Employer is not required to auto-enrol you in its workplace pension scheme under the Pensions Act 2008. You may however elect to join the scheme. The details of this policy shall be provided to you separately in the form of: ________.


21. Expenses

A. The Employer will reimburse you with any general expenses incurred by you during Employment provided that these are reasonable and necessary for the purposes of your role. The authorisation of such expenses shall be determined in line with our procedure as set out in: ________.

B. It is also agreed that the Employer shall be responsible for the reimbursement of reasonable expenses arising directly out of remote work undertaken by you. Such reasonable expenses shall be defined as follows:

________


22. Equipment for Remote Working

You shall be provided with the following additional equipment to enable you to undertake your duties under the Remote Work Agreement:

A. Inventory of equipment:

________

B. You agree that you shall properly report any damage or theft of this above named equipment without delay.

C. All equipment provided to you by the Employer shall be returned to us at the conclusion of your employment.


23. Insurance

A. It is the responsibility of the Employer to hold a valid employer's liability insurance policy.

B. The Employer shall ensure that its employer's liability insurance shall cover you, the Employee, wherever you working remotely.

C.The Employee will be responsible for taking out proper insurance to cover the following equipment, and shall ensure that the policy remains valid as a condition of remote working arrangements:

________


24. Training

A. No training shall provided to you during your employment. You will not be required to attend any training at any stage as a requirement of your employment.


25. Other Benefits

A. Certain benefits may be made available to you by the Employer during your employment. The benefits which you may be eligible to receive are:

________

B. The benefits offered are subject to change. You shall be notified of any such changes.


26. Collective Agreements

A. The terms and conditions of your employment are affected by the following collective agreements which were made between the parties set out below:

________

B. Further details regarding the relevant collective agreements can be obtained from ________.


27. Confidential Information

A. During your employment, you will be provided with or exposed to confidential information.

B. Confidential information for the purposes of the Contract is defined as:

I. information which is provided to you directly or indirectly through your employment, giving rise to your duty of confidence as an employee; and

II. the information relates to the Employer's business which is either marked specifically as confidential information or is guarded as confidential information by the Employer; and

III. the information is not publicly available; and

IV. the information would, if used in an manner which has not been authorised by the Employer, be detrimental to the Employer's business.

C. You must at all times during your employment maintain the proper security of Confidential Information.

D. 825 85588 222 52 522 2822 555822 2255 2228222222 25 52 522 2822 52225 2255 2228222222 558 8222 2252825225 (82 522 22528), 58888282 522 822285222858 52225252822 22 522 22525 8258885558, 252528852822 25 85882288.

E. 225 252 582855282 22 522 52582, 252 2528888228 22 2588 8282822 52 222 2528222 252 52282222 2522 252822 522 252228225 58888285528 52525 8282822 288 22 252 5228222222 882528 882 2885 25 522 58888285528 85885 552 25222582 52858525 82 858.


28. Data Protection

A. It will be necessary for the Employer to collect and process personal information and/or data in relation to you during the course of your employment.

B. Any personal information and/or data in relation to you will only be collected and processed and/or transferred in accordance with the Employer's privacy statement (the Privacy Statement), which can be found at the following location: ________.

C. You must also ensure you comply with the data protection procedures and rules applicable to Employees as set out in the Employer's policy.


29. Data Protection and Confidentiality During Remote Working

A. During all periods of remote work, you shall ensure and maintain the proper security of Confidential Information and all data protection requirements in the following manner:

________


30. 8552228 22 252 82225582

B. 822 8552228 22 252 82225582 85588 82 25288525 22 225 82 8582822, 525 82 5882555282 8825 8.2 22 252 5228222222 882528 882 2885.


Agreed by the parties



______________________
Signed by ________:


______________________
Date

______________________
Signed by ________
for and on behalf of ________


______________________
Date