This Installment Agreement (the “Agreement”) is hereby entered into by and between: ___________________________________, of legal age, _______________ citizen, single/married, with address at __________________________________, hereinafter referred to as the “FIRST PARTY”; -and- ________________________, a corporation organized and existing under and by virtue of the laws of the Republic of the Philippines, with principal office at ____________________________, represented by its duly authorized ____________________________, and hereinafter referred to as the “SECOND PARTY”. Each a “Party”, and collectively, the “Parties”.
WITNESSETH THAT: WHEREAS, the SECOND PARTY is engaged in the
WHEREAS, the FIRST PARTY desires to avail the services of the SECOND PARTY, the details of which is attached in this agreement (ANNEX “A”), including the price and terms of service;
WHEREAS, the parties desire to enter into an agreement whereby the FIRST PARTY shall avail of the procedure through installment and shall pay the SECOND PARTY the sum of the deficiency through a payment plan according to the terms and conditions herein set forth.
NOW THEREFORE, for and in consideration of the foregoing premises, and the following covenants, the PARTIES hereby agree as follows:
1. Deficiency Acknowledgment - The FIRST PARTY agrees and acknowledges that it owes the SECOND PARTY an amount of money equal to the deficiency as defined above. Nothing in this Payment Agreement is a waiver of any amounts owed and in the event of any breach of this Agreement by the FIRST PARTY, the SECOND PARTY’s rights to the Deficiency shall not be limited.
2. Payment Plan - The PARTIES hereby agree to the payment plan as described hereunder. The FIRST PARTY agrees to make the payments to the SECOND PARTY associated with the dates as listed on the following Payment Plan:
(insert table)
3. Method of Payment - Payments shall be made to the SECOND PARTY in accordance with the Payment Plan via cash or visa/master card credit card.
4. Release and Indemnification - In consideration for agreeing to this Payment Agreement, the SECOND PARTY hereby releases any claims against the FIRST PARTY related to the Deficiency as of the date of this Agreement. However, nothing in this Agreement is meant to release the FIRST PARTY from its obligation to pay the Deficiency according to the Payment Plan herein set forth or limit the rights of the SECOND PARTY in collecting said Deficiency. 5. Acceleration upon Breach - In the event that the FIRST PARTY fails to make any payments in accordance with the Payment Plan, upon reaching ten (10) days after the failure to make any such prescribed payment, the full amount of the Deficiency shall come immediately due and payable.
6. No Modification Unless in Writing - No modification of this Agreement shall be valid unless in
writing and agreed upon by both Parties.
7. Forfeiture – The treatment shall be available within the timeframe as provided in the attachment as aforementioned. The FIRST PARTY understands that failure to avail of the treatment within the time period or validity date shall mean the forfeiture of the remaining sessions, if any.
8. The payment for the treatment are non-refundable and non-convertible and the services are non- transferrable.
IN WITNESS WHEREOF, the parties have hereunto set their hands and affixed their signatures this ___ day of September, 2019 in the City of _____________________, Philippines.
(First Party) (Second Party)
By:
Operations Manager
Signed in the presence of:
________________________________ ________________________________ (Signature over printed name) (Signature over printed name)
ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES)
CITY OF __________________)
BEFORE ME, a Notary Public for and in the above jurisdiction, this ______________ personally appeared: Name Valid Government Issued ID Date/Place Issued or Validity Date
who have satisfactorily proven to me their identity upon presentment of their respective competent evidence of identity, who acknowledged before me to be the same persons who executed the foregoing Memorandum of Agreement and further acknowledged to me that the same is their own free and voluntary act and deed and as well as of the corporations and/or juridical entities they represent, as indicated above, with full authority to sign in such capacity.
This Installment Agreement consists of three (3) pages including this page where the Acknowledgment is written and signed by the party together with his instrumental witnesses on each and every page thereto.
WITNESS MY HAND, this ____ day ________________ in the City of _____________________.
