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This Agreement will be effective on _ , 20_(which is the Effective Date of the Agreement). <br /> ATTEST: <br /> By <br /> [CORPORATE SEAL] [CORPORATE SEAL] <br /> Address for giving notices <br /> License No. <br /> Agent for service of process <br /> (If CONTRACTOR is a corporation, attached <br /> evidence of authority to sign). <br /> 08/12 00500-6 11-4179 <br />