© Copyright Envision Corporation. 2002. All rights reserved.

Protected by the copyright laws of the United States & Canada and by International treaties. IT IS
ILLEGAL AND STRICTLY PROHIBITED TO DISTRIBUTE, PUBLISH, OFFER FOR SALE, LICENSE OR SUBLICENSE, GIVE OR DISCLOSE TO ANY OTHER
PARTY, THIS PRODUCT IN HARD COPY OR DIGITAL FORM. ALL OFFENDERS WILL BE SUED IN A COURT OF LAW.
laws of the United States and Canada and by international treaties. IT IS ILLEGAL AND
© Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright

LICENSE OR SUBLICENSE, GIVE OR DISCLOSE TO ANY OTHER PARTY, THIS

AGREEMENT ON DISPUTED ACCOUNT
STRICTLY PROHIBITED TO DISTRIBUTE, PUBLISH, OFFER FOR SALE,

PRODUCT IN HARD COPY OR DIGITAL FORM. ALL OFFENDERS WILL

This Agreement on Disputed Account (the “Agreement”), is made and effective [EFFECTIVE DATE],

BETWEEN: [CLAIMANT NAME] (the "Claimant") a corporation organized and existing under
the laws of the [STATE/PROVINCE], with its head office located at:

AND: [DISPUTANT NAME] (the "Disputant") a corporation organized and existing

AUTOMATICALLY BE SUED IN A COURT OF LAW.

under the laws of the [STATE/PROVINCE], with its head office located at:

WHEREAS Claimant has a claim against Disputant on a disputed invoice dated [DATE] in the amount of
[AMOUNT];

IT IS AGREED AS FOLLOWS:

1. The Claimant will accept a lesser payment of [AMOUNT] in full settlement of its claim on the invoice.

2. If the Disputant does not pay the lesser payment in full to the Claimant within [NUMBER] days of
receipt back of an original copy of this agreement executed by both parties, the Claimant may sue the
Disputant for the full amount of its disputed invoice.

3. If the Claimant's claim on its disputed invoice is compromised pursuant to this agreement, the parties
mutually release each other from any and all claims and rights of action against each other, present
and future, arising in connection with their dispute over payment of the disputed invoice.

4. This agreement binds and benefits the parties and their respective heirs, executors, administrators,
personal representatives, successors and assigns.

Executed under seal in duplicate on [DATE].

Signed, Sealed and Delivered in the Presence of

NAME NAME

Authorized Signature Authorized Signature

Print Name and Title Print Name and Title

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