This Agreement is made and shall be effective this ______________________ day of ___________________
20_____ between IUB AGENCY LLC. 7040 E. LAREDO ST. STE E, LAS VEGAS NV 89117 hereinafter
referred to as “IUB”, and _______________________________ hereinafter referred to as “Company”.
THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties hereto agree
I. IUB agrees:
a. To provide Company with Program materials and forms including: Customer agreements, Company rate
schedule, Remittance Register for transmittal of Customer agreements to IUB, and miscellaneous marketing
materials, if available, to assist in implementing the Program.
b. To maintain and administer the Program for the Company and to maintain a telephone contact line(s) for
Customers to obtain Program services.
c. To maintain a telephone line for Company to obtain assistance with ordering supplies; existing claims and/or
questions about the Program during normal business hours 8:30 am to 5:00 pm Monday through Friday (Pacific
d. To provide the Program at the prices identified on the Company Rate Schedule and Company Enrollment
forms attached hereto for each Program membership enrolled.
e. To ensure that all claims covered by the Program are processed and covered in accordance with the terms and
conditions of the Customer agreement and that payment is issued on all valid approved claims within a reason-
able time frame.
f. To provide Company with thirty (30) days notice of any changes in the Program or Customer agreement and
that no such change shall he retroactively effective as to any Program membership enrolled before the effective
date of the change.
g. To provide notification to Company upon receipt of any Program membership submitted that is incomplete
and/or that is not paid in full by the Company, Company must remedy the issue within seven (7) calendar days
of being notified or the Program membership will be rejected and any money rem