New Account Opening




REFERENCES (All four references must be completed.)


The undersigned ("Customer") certifies that everything in this Form is true and complete.


Aqua Systems, Inc. ("Aqua Systems")

Re: Customer Certification and Letter of Assurance

acknowledges that Aqua Systems, directly and through its designated freight forwarders, provide us with products that may be subject to the export laws and regulations of the United States and other countries. We also acknowledge that, under these export laws and regulations, Aqua System’s delivery of some products to us may take place only after Aqua Systems has received certain written assurances from us.

Accordingly, we hereby acknowledge, represent and warrant that (i) we will comply with all applicable laws and regulations whenever we transfer, export or re-export products obtained from Aqua Systems; and (ii) as required, secure licensing for items, end uses, and end users controlled under US export regulations, and present any such license to Aqua Systems upon request. We specifically acknowledge receipt, and understanding, of the applicable U.S. Sanctions regulations, copies of which have been provided by Aqua Syastems. We further acknowledge and represent and warrant that we will not:

  • Transfer, export or re-export, directly or indirectly, any product(s) acquired from Aqua Systems to Cuba, Iran, North Korea, Sudan, Syria, or any nationals thereof, or to any other country subject to restriction under applicable laws and regulations. We also represent and warrant that we are not located in, under the control of, or a national resident of any such country.
  • Use the product(s) in any activity related to the development, production, use, or maintenance of Weapons of Mass Destruction, as defined by the U.S. Department of Commerce, including without limitation, uses related to nuclear, missile and/or chemical/biological development and/or production, nor will we transfer, export or re-export, directly or indirectly, to any party engaged in any such activity. We further understand that any activity relating, directly or indirectly, to the development of production of Weapons of Mass Destruction, is subject to prior U.S. export licensing requirements.
  • Transfer, export or re-export, directly or indirectly, to any party listed by the U.S. Government on the Office of Foreign Assets Control (“OFAC”) Specially Designated Nationals (“SDNs”) list, or identified under any applicable law as prohibited from receiving product(s). We also represent and warrant that we are not on, or under control of, any person or entity on any such list.
  • Request or make any regulatory certifications or applications on behalf of Aqua Systems.

If changes to this Letter of Assurance are necessary, we will contact Ali Asghar of Aqua Systems at:

Tel: 1-516-705-0786 ; or email: [email protected].