Addition of Territory Addendum USA

Table 2 & 3
PRODUCTS & TERRITORY

ecoSPIRITS Submission
Relationship Lead*
Title:*
Relationship Lead Email*
Please enter your email address to approve Brand Partner submission after checking details
Date of the Brand Partner Agreement

DayMonthYear
Please enter the date of the Brand Partner Agreement
Effective Date*

DayMonthYear
Please enter the start date for Year 1 licensing period
Products(s)*
Use the full Product name. If more than one Product, separate with a comma.
Territory (State)*
Licensed Operator(s)*
Licensed Operator's email address for invoicing*
example@example.com
Official Distributor(s)*
Please enter the FULL legal name of the official importer or distributor for this Brand Partner REGISTERED in your country. If self-distributing, please enter "Self Distribution"
Initial Term*
Please select the initial term agreed with the Brand Partner
Renewal Term*
Annual Territory Fee
Currency*
Currency of Choice
Amount*
Please type the Annual Territory Fee amount
BRAND PARTNER INFORMATION
Brand Partner Admin Info*

First NameLast Name
Brand Partner Admin Email*
example@example.com
Brand Partner Signatory Info*

First NameLast Name
Brand Partner Signatory Email*
example@example.com
Title*
Signed by a duly authorised representative of the Brand Partner
LICENSED OPERATOR BANK DETAILS

For ecoSPIRITS Representative
Beneficiary Name*
Beneficiary Account Number*
Swift Code*
Signed below by the duly authorised representatives of each Party:
For and on behalf of ecoSPIRITS:*

Clear

Table 1
BRAND PARTNER INFORMATION

To be completed by Brand Partner
Legal Name*
Please enter the FULL legal name of the Brand Partner company REGISTERED in your country
Registered Address*
Please provide FULL registered address of the Brand Partner company REGISTERED in your country
Business Registration No. / EIN No.*
Please provide registration number of the Brand Partner
Country of Formation*
Please select country of formation of the Brand Partner
By clicking here, I state that I am opting in for the Green Steps Forest Program with eS USA at .20 cents per 750ml equivalent. One tree will be planted for every two ecoTOTES' cycle completion.
Signed below by the duly authorised representatives of each Party:
For and on behalf of Brand Partner:*

Clear
Only the authorised signatory can sign the agreement
Should be Empty:

CONTRACT DETAILS