EXHIBIT 10.1.3
Terms for User Agreement
Read first, then fill out User Agreement
Consumer Report User Agreement
Please read and complete this agreement and fax to Avert. If
you are dissatisfied for any reason, notify Avert in writing YOUR CUSTOMER
within 30 days of the date you signed this agreement. Your NUMBER IS
account will be closed and your $50.00 set-up fee (less -------------
charges for products and services ordered) will be refunded. ----------
BUSINESS INFORMATION (Address must be physical location of company)
Business Name (User)
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Address
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City State Zip Code
Main Contact Name
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First Last Title
Phone # Fax # E-mail
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Second Contact Name (if applicable)
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First LastT itle
Phone # Fax # E-mail
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Billing Contact (if different from main contact)
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First Last Title
Phone # Fax # E-mail
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1. Please describe your company's business.
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2. List approximate number of employees. _______
3. How long has your company been in business? ______
4. Is your company in:
Commercial
[______________]Industrial
[______________]Residential
[______________]Other (please explain) Building?
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5. Identify two principals (or owners) of your business, or if your company
stock is traded on a recognized stock exchange, please provide the symbol and
exchange.
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Name Title Phone
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Name Title Phone
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Symbol Exchange
6. Select One Account Option: (Check Appropriate box)
Basic Account
[______________]AVERTadvantage ($10/month)
[______________]AVERTadvantage Online($20/month)
7. If you intend to use reports containing information obtained from credit
bureaus, (i.e. Name Link, Instant Address Link, Credit Link, etc.) please
provide a copy of ONE of the following items listed below: (Check Appropriate
box)
[_______________]Sales Tax License
[_______________]Business license
[_______________]Articles of Incorporation
8. Select One Billing Option: (Check appropriate box)
[_______________]Bill $50.00 Set-up Fee to Credit Card (Net 30 days for all
other charges)
[_______________]Bill Any Charges from Avert to Credit Card on an Ongoing Basis
[_______________]Direct Deposit (Addendum Required)
[_______________]Net 30 Days Billing Option
9. If paying set-up fee and/or other charges by credit card, please complete the
following : (Visa, mastercard and American Express accepted)
Card Type _______________________________________
Credit Card Number ______________________________
Expiration Date _________________________________
Cardholder Name _________________________________
User certifies that the "Terms for Consumer Report User Agreement" have been
read and agrees to the terms as written.
x
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User Authorized Signature Title Date
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Avert, Inc. Authorized Signature Title Date
After reading through the terms and conditions,
return to the Avert User Agreement
TERMS FOR CONSUMER REPORT USER AGREEMENT
This agreement by and between Avert, Inc. and the company named on the
Consumer Report User Agreement Form (User) and/or its designated agent(s)
consists of the following understandings and conditions:
User certifies and agrees to:
Use the services of and the reports received from Avert in strict compliance
with all provisions of the Fair Credit Reporting Act (FCRA), Public Law 91-508
and the Americans with Disabilities Act (ADA 1990), and all other applicable
federal and state laws and regulations including federal and state equal
opportunity laws and regulations.
Review the Notice to Users of Consumer Reports: Obligations of Users under the
FCRA and perform legal obligations as set forth in said Notice.
Use the information provided by Avert for the User's exclusive use only, except
to disclose said information to the subject of the report, and for employment
purposes only, and only in accordance with applicable law.
Make a clear and conspicuous disclosure to the applicant or employee, in writing
and in a separate document, that a consumer report may be obtained for
employment purposes.
Make a clear and accurate disclosure to the applicant or employee if an
investigative consumer report (reference check) will be obtained, including a
statement informing the subject of the report that additional information is
available if requested. Obtain the proper written authorization from the
applicant or employee for any consumer report prior to requesting any report.
Provide proper notice to the applicant or employee, a copy of the report
obtained, and a Summary of Rights, as required by the FCRA, if an adverse
decision regarding employment is going to be made due to information in any
report obtained from Avert, Inc.
Ensure that reports will be requested only by User's designated representatives
and forbid employees from obtaining reports on themselves, associates or any
other person except in the exercise of their official duties.
Recognize that information is obtained and managed by fallible sources, and that
for the fee charged, Avert does not guarantee or insure the accuracy or the
depth of information provided.
Assume responsibility for the final verification of the applicant's identity.
Base employment decisions or any actions on the User's lawful policies and
procedures and recognize that Avert employees are not allowed to render any
legal opinions.
Recognize that once Avert, Inc. has delivered your customer number to the main
contact person listed on this agreement, that the security and dissemination of
this unique customer number is the responsibility of the person signing this
agreement. Avert will neither release information nor take orders for services
unless the customer number is provided.
Pay for services based on a statement system similar to ones used by telephone
companies. Terms are NET 30 days. Accounts in arrears will assume a finance
charge of 2% per month or the highest lawful rate, whichever is less. If an
account goes to collection, User agrees to pay all expenses, including
reasonable legal fees.
Provide credit information on User as may be requested by Avert, Inc. during the
course of this agreement.
Be aware that, if an account remains inactive for twelve consecutive months, it
may be closed and a new User Agreement may be required to reopen the account.
Acknowledge that a facsimile of this agreement is as valid as an original.
Recognize that in order to remain in compliance with laws and regulations
governing consumer reporting agencies Avert may make modifications to this
agreement from time to time. These modifications may be mailed to the User and
the User's use of Avert's services after the date specified in the communication
will be construed as your agreement and implied consent to these modifications.
Avert agrees to:
Comply with all applicable laws in the preparation and transmission of reports
as defined in 15 USC-1681 et seq, regulated by the Federal Trade Commission.
Follow reasonable quality assurance procedures to assure maximum possible
accuracy of information.
Re-verify at no cost any disputed report when either the User or the subject
makes a request in accordance with applicable law. Avert's response shall be
made in writing and delivered in a timely manner.
Maintain consumer report information and transaction details for a minimum of
two years. During an inquiry, the subject of the report has the right to learn
the name of the User ordering information and has the right to receive a copy of
the report ordered by the User when a lawful request is made to Avert.
Provide all information to the consumer as required by the Fair Credit Reporting
Act.
Maintain confidentiality of its data acquisition and verification methodology.
Avert may, at its sole discretion, terminate service to any User.
