Blackmon Mooring Contract

SIGNATURE FORM

The undersigned hereby proposes and agrees to furnish goods and/or services in strict compliance with the terms, specifications and conditions at the prices proposed within response unless noted in writing. The undersigned further certifies that he/she is an officer of the company and has authority to negotiate and bind the company named below. Prices are guaranteed: 120 days Company name Address City/State/Zip Telephone No. Fax No.

Email address Printed name

Blackmon Mooring Services, LTD / BMS CAT, Inc. 308 Arthur St. Fort Worth, TX 76107 24/7 Call Center: (877) 730-1948/ Corp Prog Director: (817) 810-5604 (817) 334-3501 [email protected] Cameron Blackmon

Position with company Authorized signature

Accepted by The Cooperative Purchasing Network: Term of contract

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Unless otherwise stated, all contracts are for a period of one (1) year with an option to renew annually for an additional four (4) years if agreed to by TCPN and the awarded vendor. Awarded vendor shall honor all administrative fees for any sales made based on a TCPN contract whether renewed or no

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Authorized Signature ';