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The franchiser ______________________, and the franchisee ____________________, as set forth in their franchise agreement on the ____________ day of _____________ 20 __, and as witnessed by __________________, have agreed to the following additional terms and conditions:
Franchisee agrees that under any circumstance ______ (he or she) is in no way licensed to act on behalf of the franchiser or its agents at any time. Franchisee agrees to act separately and in way obligate the franchiser into any contracts, responsibilities, or any act to bind franchises or franchiser or its agents implied or expressly at any time.
*** If Required By State Law ***
This Section for Notary:
State of _________
County of ________ [COUNTY]
On [DATE] before me, [NAME OF NOTARY], notary, personally appeared [NAME OF PERSON(S) INVOLVED], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal.
My commission expires: _____