Instructions

This Agreement is to be completed after CAT has quoted your circuit board, and you accept our quote contracting CAT to perform the work. No work will commence until this document is received. Please use CAT Job No. on our quote to you in the space indicated below. Please print this page, complete where required and fax to 281-271-8004.

I, the undersigned, in the capacity of an individual acting on my own or as an officer of the herein stated company, authorized by said company to execute legally binding agreements, by virtue of affixing my signature hereon, covenant with Circuit Applied Technology, its owner(s), heirs and assigns (hereinafter CAT), that the printed circuit board referenced by the CAT Job No. shown below, being contracted with CAT for the purpose of Reverse Engineering, is not the exclusive property of any other person or legal entity, is in the public domain, and/or the undersigned has written authorization from the owner of said property, which authorization is herein made part and parcel to this Agreement.

I, the undersigned, herewith agree to assume any and all liability that may arise in connection with the Reverse Engineering performed by CAT at the request of the undersigned, and further absolves CAT of any and all liability, holding CAT harmless in all situations and for all purposes, and will further defend CAT's involvement as herein stated in any and all litigation that may arise in connection with this contract and Agreement.

I, the undersigned, further state the full, complete and truthful purpose for which said printed circuit board is requested to be Reverse Engineered by CAT, and is stated as follows for the record:
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Absent information to the contrary, CAT, in relying upon this Agreement, has a belief in the honesty and integrity of the undersigned, and in good faith accepts and contracts with the undersigned to perform Reverse Engineering of said printed circuit board. Should the legal and rightful ownership of said printed circuit board be challenged in a competent court of law, CAT will cooperate as fully as practicable with all concerned parties. The party requesting CAT's participation in any legal proceedings bearing directly or indirectly upon the subject of this contract and Agreement will bear any and all expenses connected with and to the extent of CAT's participation in said legal proceedings.

_____________________________ Date CAT Job No. _____________________

________________________________________________ Signature ________________________________________________ Printed Name

Please check as applicable:
Agreement executed in my capacity as an individual.
Agreement executed in my capacity as an authorized officer of the following company:

Name ___________________________________________________

Address _________________________________________________

City __________________________ ST _______ Zip ____________