NITSUKO AMERICA
TELECOM DIVISION NITSUKO
APPLICATION FOR
DISTRIBUTORSHIP AGREEMENT
January 12, 1994
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Nitsuko America
4 Forest Parkway
Shelton, CT 06484
Gentlemen:
Acting on my behalf of such corporation or partnership as I may hereinafter
specify and as you may approve, I hereby apply for a Nitsuko America Telecom
Division (hereinafter "Nitsuko") Distributorship Agreement. In support of this
Application, I have completed the Questionnaire which follows and, in addition,
I will furnish such information pertaining to my qualifications or
qualifications of the distributorship company before action is taken on this
Application.
I understand that if this Application is acted upon favorably by Nitsuko, the
parties to such Distributorship will be Nitsuko and either I or such corporation
or partnership, and that Nitsuko will name in such Distributorship Agreement
those individuals, including me, upon whose participation in the operations
and/or ownership of the proposed distributorship Nitsuko will be relying in
entering into the Distributorship Agreement.
In making this Application, I acknowledge and agree that:
(1) This Application and Questionnaire have been supplied to me by Nitsuko as a
convenience to me and that is acceptance by Nitsuko for consideration shall be
without any obligation whatsoever on the part of Nitsuko or any of its
representatives.
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(2) No one other than the President or Vice-President of Nitsuko has the
authority to approve this Application for a Nitsuko Distributorship Agreement
for any distributorship area. That such approval, if given, will be solely in
the form of a written Distributorship Agreement; and that any action taken, any
expenditures made, or commitments assumed, by me by anyone to be associated with
me in the proposed distributorship, or by the proposed distributorship itself,
prior to receipt by me of such written Distributorship Agreement shall be at my
or their sole risk and responsibility without any liability or obligation
whatsoever on the part of Nitsuko or any of its representatives.
(3)No representative or employee of Nitsuko, or any other person, has the
authority or power to approve or effect in any manner whatsoever any change in
or modification of the terms of this Application.
(4) Prior to receipt by me or the entity on behalf of which I am acting of
any executed
Nitsuko Distributorship Agreement, I acknowledge that neither I nor it will be
entitled to rely upon any representation or statement made to me or anyone else
acting for such entity by any representative or employee of Nitsuko, or any
person whatsoever.
(5) Any material misrepresentation, whether intentional or unintentional,
in the information
submitted by me in connection with this Application or in the Questionnaire,
shall be grounds upon which Nitsuko may immediately terminate any
Distributorship Agreement executed by Nitsuko with me or the distributorship
designated by me.
Very truly yours,
/12 Jan 94
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Signature / Date
APPROVED
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Paul J. Shimko
Vice-President-Sales
