Form code 05/04/02/__
TO JSC Nordea Bank
ACCEPTANCE REPORT
on Materials and/or Works
Herewith __________________________________________________________________________________________
full or short company name, name, surname and patronymics of an individual entrepreneur
________________________________________________________ (hereinafter referred to as the Customer), concluded with JSC Nordea Bank (hereinafter referred to as the Bank) Agreement on service of Clients of JSC Nordea Bank using Systems "Bank - Client/Windows" and "Bank - Client/Internet" No. ________ dated " _____" ________________, 20__ (hereinafter referred to as the Agreement), has drawn up this Report of the following:
The Bank delivered and the Customer received:
software distributive of the customer part of the System "Bank - Client" and technical documentation to the System (at installation of the System version "Bank - Client/Windows");
a sealed envelope containing registration information of the customer for generation of the keys for the following Customer employees (in case of installation of System «Bank-Client/Internet») (surname, name, patronymics in full):
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________a key data medium (certified USB – token data medium);
a CD with drivers for the certified USB – token data medium - ____p.
a license for using software product CryproPro CSP 3.0 – ____ item.
the Bank public key, and key cards, reserved for the following Customer employees (in case of installation of System «Bank-
Client/Windows») (surname, name, patronymics in full):
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________The Bank has performed and the Customer has accepted the following works:
Standard installation of "Bank - Client/Windows" System software is made.
Non-standard installation of "Bank - Client/Windows" System software is made.
Staff training and the work with system with the in-built help is shown.
Test works performed - check of a connection with Bank’s server.
The Software was provided for the “Bank-Client” with change of the cryptographic protection;
The USB – token expertise was performed; USB – token was formatted; USB – token was withdrawn
Other: ______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
The Customer has no claims to the Bank in respect to the composition and quality of works and/or materials accepted.
The present Report shall form an integral part of the Agreement.
The date of the Report presentation to the Bank: "______" _____________________ 20__ .
________________________________________________________________________________
position, surname, name, patronymics of the Client representative
acting on the grounds of ________________________________________________________
____________________________________________________ Signature: ___________________________ Stamp here
Bank notes:
Date of Acceptance report acceptance: "____" ________________, 20___ . Subsidiary office: __________________________
Signature of the Bank authorized officer: _______________________ / ____________________________/
signature Surname, name, patronymics
