This Agreement on Disputed Account (the “Agreement”), is made and effective [EFFECTIVE DATE],
BETWEEN: [YOUR COMPANY NAME] (the "Claimant") a corporation organized and existing under the laws of the [State/Province] of [STATE/PROVINCE], with its head office located at:
[YOUR COMPLETE ADDRESS]
AND: [DISPUTANT NAME] (the "Disputant") a corporation organized and existing under the laws of the [State/Province] of [STATE/PROVINCE], with its head office located at:
Whereas Claimant has a claim against Disputant on a disputed invoice dated [DATE] in the amount of [AMOUNT];
It is agreed as follows:
The Claimant will accept a lesser payment of [AMOUNT] in full settlement of its claim on the invoice.
If the Disputant does not pay the lesser payment in full to the Claimant within [NUMBER] days of receipt back of an original copy of this agreement executed by both parties, the Claimant may sue the Disputant for the full amount of its disputed invoice.
If the Claimant's claim on its disputed invoice is compromised pursuant to this agreement, the parties mutually release each other from any and all claims and rights of action against each other, present and future, arising in connection with their dispute over payment of the disputed invoice.
This agreement binds and benefits the parties and their respective heirs, executors, administrators, personal representatives, successors and assigns.
Executed under seal in duplicate on [DATE].
Signed, Sealed and Delivered in the Presence of:
Authorized Signature Authorized Signature
Print Name and Title Print Name and Title