CNG HA X HI CH NGHA VIT NAM

c lp T do Hnh phc
----------o0o--------a danh, ngy thng nm.

PH LC HP NG DCH V
S.................
-

Cn c theo HKT s........................................ k ngy.thng.nm.........

Cn c nhu cu thc t 2 bn...................................................................................................

Chng ti gm c:
BN THU/MUA/S DNG DCH V (Bn A):
CNG TY......................................................................................................................................
i din:.........................................................................................................................................
Chc v:.........................................................................................................................................
a ch: ..........................................................................................................................................
in thoi: ...........................................................Fax:...................................................................
M s thu:.....................................................................................................................................
S ti khon:...................................................................................................................................
BN CHO THU/BN/CUNG CP DCH V (Bn B):
CNG TY......................................................................................................................................
i din:.........................................................................................................................................
Chc v:.........................................................................................................................................
a ch: ..........................................................................................................................................
in thoi: ...........................................................Fax:...................................................................
M s thu:.....................................................................................................................................
S ti khon:...................................................................................................................................

Sau khi xem xt, tha thun hai bn i n thng nht k Ph lc hp ng dch v
s....... v i vi hp ng k s ........................... , ngy, thngnmc
th nh sau:
1 .....................................................................................................................................................
2 .....................................................................................................................................................
3 .....................................................................................................................................................
4 .....................................................................................................................................................
5. iu khon chung:
5.1 Quyn v ngha v ca mi bn c quy nh trong hp ng s:.......................................
5.2 Ph lc hp ng c lp thnh my bn, c ni dung & gi tr php l nh nhau, mi
bn gi ........
5.3 Ph lc ny l 1 phn khng th tch ri ca HDV s.....v c gi tr k t ngy k.......
I DIN BN A

I DIN BN B

GIM C

GIM C