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Confidentiality Agreement Template 3


Confidentiality Agreement Template 3
Confidentiality Agreement Template 3
i³ IP Component Integration Request Form
IP Integration Request Form and Mutual NDA.doc Rev. 121108
ISO Share:\Procedures\
By completing this form, you and your organization are agreeing to the Mutual Non-Disclosure Agreement attached
below. Please fill the form out as completely as possible to speed up the integration process. Once the information
has been reviewed, we will contact you to provide you with further details regarding the integration.
Filled Out On (Date)
Contact Information of Integration Requisitioner
First and Last Name
Phone Number
Email Address
Information about the IP Component
Manufacturer’s Name
Model Name
Part Number
Please answer to the best of your knowledge: Yes / No
Does the Component support RTSP/RTP Media Transmission
Does the Component support HTTP Device Control API
Does the Component support UPnP or mDNS/ZeroConf
Please attach all available documentation to this form Yes / No
Does the Component have Manual or Specifications Document
Does the Component have Programming SDK/Documentation
Does the Component have HTTP/CGI API Document
Contact at IP Component Manufacturer (if available)
First and Last Name
Phone Number
Email Address
Information on IP Component Demo**
Shipped to i3 On (Date)
Number of Items Shipped
Return Address
(On project completion, i3 will ship all
received demo items to this address)
Canadian shipping address:
Attention: Olga Skelly
i³ International Inc.
780 Birchmount Road, Unit 16, Scarborough,
Ontario, Canada, M1K 5H4
US shipping address:
Attention: Olga Skelly
i3DVR C/O N.G. Jensen Inc.
RMA WHSE
181 Cooper Avenue Ste 100,
Tonawanda, NY 14150
Submit by Email
Print Form
Confidentiality Agreement Template 3
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