AGREEMENT

KNOWN ALL MEN BY THESE PRESENTS:

FAST DELI SERV, INC. a corporation organized under

Philippine laws, with principal office address, at 315 CMI
Building, Commonwealth Avenue, Tandang Sora, Quezon
City,represented by Februel Pacia, and hereinafter
referred o as CREDITOR

________________________________________________________,
Filipino, of legal age and a resident of

_______________________________________________________

________________________________________________,
hereinafter referred to as “DEBTOR”

-WITNESSETH-

WHEREAS, an accident occurred in which the DEBTOR,

while riding a Motorcycle Vehicle, collided with a person,
named__________________________________________________
_______, and the latter incurred medical expenses

Whereas, BOTH PARTIES agree and recognize that the

total amount of expenses incurred by the injured
employee due to the DEBTOR’s negligence amounted to
__________________________________________________. (PHP
_______________.00).

Whereas, the CREDITOR shouldered the expenses on

behalf of the DEBTOR

Whereas, the DEBTOR is desirous and willing to pay

back the total amount of
________________________________________. (PHP
________________.00) in installments to the CREDITOR,
either in cash and/or salary deductions

Whereas, the DEBTOR agrees that the amount of

______________________, shall be deducted from his salary

Whereas, the DEBTOR commits that he shall not resign

until he has fully paid all the aforementioned monetary
amount

WHEREAS the DEBTOR agrees that he shall still be liable

for the amount even if his services with the CREDITOR is
terminated

That in case of failure or refusal on the part of the

DEBTOR to pay the amount, the CREDITOR shall have
the right to use this Contract as proof of his monetary
liabilities to the CREDITOR before the proper courts.
 That the DEBTOR agrees that in case he fails to pay, or
make due with the total payments, the latter shall
become immediately due and demandable without the
prior need for a demand.

IN WITNESS WHEREOF, the parties have hereunto set

their hands at the place and on the date first stated above.

______________________ ______________________________
Creditor Debtor

SIGNED IN THE PRESENCE OF:

________________________ _______________________________

WITNESSES:

______________________ _____________________

ACKNOWLEDGMENT

Before me, a Notary public for _______________________________ and

the Province of __________________, personally appeared the following:

Name Proof of Identity

both known to me and to me known to be the same persons who

executed the foregoing AGREEMENT TO PAY, and they acknowledged to
me that the same was executed by them freely and voluntarily.
This instrument consists of ______ pages including this page on
acknowledgment.

WITNESS MY HAND AND SEAL on the day and place above

written.

Doc. No. _______

Page No. ________
Book No. _______
Series of 2018:
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