Page 73 - 2021 MHA Start-up Guide

AGENCY1: NAME.
ADDRESS LINE 1
ADDRESS LINE 2
EMAIL
[Name:____________________________]
________________________:
[Address:___________________________________________________]

9. The terms and conditions set forth in this Agreement constitute all of the terms and conditions to which
the parties have agreed, and no other terms or conditions in the future shall be valid or binding on either party, unless
reduced to writing, executed by both parties, and attached to this Agreement as an amendment or a revision.

IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed in several counterparts,
each of which shall be deemed an original, as of the day and year first above set forth.

AGENCY1

________________________

By:________________________________ By:_____________________________________
Name: Date NAME: Date
Title: TITLE

MOBILE HEALTHCARE ASSOCIATION 7 1