Frozen Semen Storage & Shipment FROZEN SEMEN STORAGE & SHIPMENT Owner / Agent InfoWho is submitting this form? Owner Agent Name First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneFaxEmail * If the Owner identified above is an entity other than an individual person, or if there are multiple owners for the frozen semen covered by this Agreement, the individual executing this Agreement warrants that he/she is legally authorized to act on behalf of the Owner or additional owners for the purposes of arranging breeding services, authorizing frozen semen shipments and entering into this Agreement.Equine InformationRegistered Name Breed Registry Registration Number Year Foaled HiddenSex Male Female * The owner wishes to engage MPEH to provide services with regard to frozen semen from the above horse or horses, collectively referred to as the "Horses" and each individually as "Horse."Services ProvidedConsent Needed(Required) By checking this box, owner wishes and MPEH agrees to provide the services below:Storage and distribution of frozen semen for domestic use.Payment Termsa) Services provided by MPEH will be billed at the rates published in effect at the time the services are provided. Fees are due for services provided regardless of the results of those services. MPEH reserves the right to revise the Fee Schedule at the beginning of each breeding season, and at any time upon notice from MPEH to the Owner for any frozen semen requiring special services or management b) Frozen semen storage is billed on a quarterly basis. You will be billed for the number of doses that are in inventory on the last day of the quarter. c) Invoices are due upon receipt. Any balance not paid within 30 days of the date of invoice will accrue interest. d) The failure of Owner to pay amounts due within 90 days of the date of invoice and failure of Owner to satisfy Owner's obligations to IVIPEH within five (5) days of notice from MPEH of Owner's default constitutes Owner's permission for MPEH to destroy any or all of Owner's semen in MPEH custody.Automatic CC Payment Consent * As a convenience for our valued customers, we offer an automatic payment method for frozen semen storage. This is our preferred method of payment. If you'd like to setup automatic credit card payments, please check the box. You will receive future receipts from MPEH at the email address you enter below.I agree to automatic payments via Credit CardCC Info / AuthorizationA deposit is required. Please call our office with your credit card information at (509) 928-6734Email Enter Email Confirm Email Signature for Auto Pay AuthorizationDate Month Day Year Shipment of Semena) For any semen stored at MPEH, it is the responsibility of the Owner to provide to MPEH the name and delivery address for any recipient to which semen is to be shipped, certify that the recipient has met its contractual and financial obligations to the Owner for breeding to the Horse, indicate the quantity of semen to be shipped and the requested shipment date. MPEH will make best efforts to meet shipment requests, but shall not be responsible for factors beyond its control, including but not limited to weather related delays, holidays, power failures, labor disputes and other impediments to shipment. Other than requiring the Owner's consent to semen shipments, MPEH has no duty to verify the eligibility of any recipient to receive the semen, the validity of the address provided, the recipient's ability to appropriately handle or store the semen or to use it for insemination, any limit on the number of mares a recipient may breed with the semen shipped, or enforcement of the recipient's obligation to destroy or return unused semen. b) In order for us to ship frozen semen upon request of the owner, frozen semen storage fees must be up to date and fees for shipping the semen must be paid in advance to MPEH by either the semen Owner or the recipient.Waiver of WarrantiesConsent Needed(Required) By checking this box, I agree to the below statement:Owner realizes that regardless of initial test results, there are many factors that can affect a horse's fertility at any given time, many out of control of either MPEH or the Owner, and that there is no guarantee that semen that meets or exceeds MPEH post-thaw quality standards will produce any particular conception rates. MPEH makes no guarantee or warranty as to the fertilizing capacity of any semen tested, stored or distributed under this agreement. Owner hereby waives any warranties with regard to quantity, quality, or viability of semen, including both express warranties and those implied by law, and SPECIFICALLY WAIVES ANY WARRANTIES WITH REGARD TO MERCHANTABILITY of the semen collected, processed and stored by.Assumption of Risk and waiver of Claimsa) Owner acknowledges that MPEH's insurance does not cover Owner's property interests in the semen stored pursuant to this Agreement and Owner assumes all risk of loss, damage, or injury in connection with services provided by MPEH and with the presence of Owner's property at MPEH. Owner acknowledges that Owner bears the sole responsibility to insure or to self insure against damage or loss to Owner's interests, including damage, destruction or loss of Owner's semen stored at MPEH not solely caused by the recklessness or willful behavior of MPEH. b) Owner assumes the risk of selling and shipping semen to third parties, including the inherent risks of infection of mares inseminated. Owner hereby waives all claims against MPEH, its owners, officers, employees and other agents (the "Released Parties") for any loss or damage suffered either by Owner or by third party mare owners, or any others with claims to or regarding any Horse and/or semen, and agrees to indemnify and hold the Released Parties harmless against any claims or damages, including but not limited to attorney's fees and the costs of defense against any such claims or damages. c) In the event that Owner's frozen semen stored at MPEH should be unintentionally thawed or otherwise lost or destroyed while in storage at MPEH due solely to the recklessness or willful behavior of MPEH, not including permitted destruction pursuant to Section 3(d) above, Owner agrees that the maximum monetary value of each straw of semen lost or destroyed shall be determined by the amount invoiced to the Owner by MPEH to collect and process the semen actually destroyed, not including the costs of storage incurred to store the semen from the date of production to the date of loss. In the event that the frozen semen lost or destroyed was not frozen by MPEH, the maximum monetary value of each breeding dose shall be $20.00. d) Owner agrees and acknowledges that MPEH shall not be liable for any interruption or any loss of business, incidental or consequential damages (including strict liability in tort) whether or not resulting from any action of MPEH hereunder.Term Lengtha) This Agreement shall be in force and effect for the duration of time there is semen belonging to Owner stored at MPEH, and continuing until all amounts due hereunder are paid in full, unless or until it is terminated or modified in writing by the mutual consent of the parties. b) Should Owner transfer any interest in any Horse during any period for which stored semen from the Horse is at MPEH, Owner will immediately notify MPEH of the transfer, and no further services will be provided by MPEH until any new owner or owners have executed a new agreement with MPEH, and until Owner has provided to MPEH a purchase and sale agreement, consent to retention of previously collected semen, or other evidence regarding whether the ownership of frozen semen in storage at MPEH has transferred to the new owner(s) as part of the transfer of the Horse or is retained by Owner. Transfer of ownership of the Horse and/or the frozen semen at MPEH notwithstanding, the Owner shall remain obligated to pay for all services provided, including storage of semen beyond the date of transfer of title, until any new owner enters into an agreement with MPEH.General TermsThis Agreement constitutes the entire agreement of the parties with regard to the subject matter addressed hereunder. Aside from revised Schedule of Fees as provided in Section 3(a) above, it may only be amended in writing signed by both parties. Notice required by this Agreement must be in writing and may be delivered either by hand, by U.S. Mail or by private delivery service to each party at the address provided in the preamble above or to such updated address as either shall provide the other from time to time, with a certified mail.Owner Name Owner Title Owner SignatureDate MM slash DD slash YYYY CAPTCHA Δ