) SIGNED by #NAME OF AUTHORISED ) REPRESENTATIVE# as authorised representative for #NAME OF ELIGIBLE ) CUSTOMER# in the presence of: ) ) ) ) Signature of witness ) ) ) ) By executing this agreement the signatory Name of witness (block letters) warrants that the signatory is duly authorised to ) execute this agreement on behalf of #NAME OF ELIGIBLE CUSTOMER# ) )
SIGNED by #NAME OF AUTHORISED REPRESENTATIVE# as authorised representative for #NAME OF ELIGIBLE CUSTOMER# in the presence of: Signature of witness Name of witness (block letters) ) ) ) ) ) ) ) ) ) ) ) ) ) ) By executing this agreement the signatory warrants that the signatory is duly authorised to execute this agreement on behalf of #NAME OF ELIGIBLE CUSTOMER#