funeral service contract - Guaranteed Funeral Deposits of Canada

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funeral service contract - Guaranteed Funeral Deposits of Canada
SAMPLE OUTLINE ONLY
SAMPLE OUTLINE ONLY
PREPAID CONTRACT – FUNDED BY Growth Funeral Plan GFP or Growth Funeral Plan Annuity GFPA™
Contract No.
Business Name (“the Provider”) Licence # ________
123 Establishment Address Here, Ontario DOI TRT (Phone)
[email protected]
www. businessname.com [optional]
Name:
(“Purchaser”)
Name:
(“Recipient”)
Address:
Address:
Address:
Address:
Telephone:
Birth date:
e-mail:
Birth place:
Relationship to Recipient:
This contract is between the Purchaser and the Provider (“the parties”) concerning funeral services and supplies and is
subject to the provisions of the Funeral, Burial and Cremation Services Act, 2002 (“the Act”).
SERVICES
Package Discount (if applicable)
Professional & Staff Services
Itemized Total (* services or supplies)
Co-ordinating activities, rites, ceremonies
Savings on package
Documentation – permits, forms, etc.
Package Price
Transport remains - initial ( _____ km)
Services and supplies not in package
Basic preparation of remains
Total Services and Supplies
(A)
Embalming of remains
Facilities for preparation/embalming/shelter
DISBURSEMENTS (Estimate including applicable taxes)
Staff services for visitation
Coroner’s fee
Facilities for visitation
Clergy honorarium
Staff services for ceremony
Organist
Facilities for ceremony
Notice __________ (one column, ___ lines)
Transport remains - additional ( _____ km)
Notice __________ (one column, ___ lines)
Vehicle ___________________________
Municipal fee for registration of death
Vehicle ___________________________
Other:
_________________________________
_________________________________
SUPPLIES (manufacturer, model, description)
Casket:
Total Disbursements (Tax included)
(C)
Total Services and Supplies
(A)
Other Services or Supplies
HST on Services and Supplies
(B)
Additional mileage ( _____ km x $ _____ )
Total Disbursements (Tax included)
(C)
Urn:
Outer burial container:
Total
(A + B + C)
Discount [Optional]
Amount to be Funded
Payment terms: This contract is to be funded through an insurance/annuity policy. The Purchaser has purchased or
agrees to purchase an insurance/annuity policy whereby the proceeds of the insurance/annuity policy are to be paid
directly or indirectly to the Provider. References to the insurance/annuity policy are contained in this contract, but the
insurance/annuity enrolment application itself contains the terms of payment, cancellation and refund for the
insurance/annuity policy purchased.
Additional Terms or Schedule of Payments: The parties agree to the additional terms:
Delivery time and location: The services or supplies contained in this contract will be delivered following the death of the
Recipient, in accordance with this contract and as agreed between the Provider and the Recipient’s legal representative.
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[Business prompt]: This paragraph should outline the terms that you offer regarding the payment of an at-need
outstanding balance. Your statement should indicate the rate of interest or financing charges and how they are to be
applied. Your statement must also include any other amounts to be charged for late or deficient payments or eligibility for
discounts for prompt payment. Failure to include this information may prevent you from collecting or charging such
amounts.]
Details of Insurance/Annuity Policy: The following insurance/annuity policy will be used to fund directly or indirectly the
cost of the services, supplies, disbursements and taxes set out in this contract.
 Growth Funeral Plan Annuity (GFPA™)
 Guaranteed Funeral Plan (GFP™)
Insurer Name: Assurant Life of Canada
Policy # (if known):___________
Insurer Address: P.O. Box 93040, 1111 Davis Drive, Newmarket, ON L3Y 8K3 1-800-663-8680
Administered by Guaranteed Funeral Deposits of Canada (Fraternal)
Phone #: 1-800-268-2466
If checked off, the following documents are attached to this contract:
 Copy of the insurance/annuity Certificate
 Copy of the Enrolment Form or other documents that confirm the purchase of the insurance/annuity Policy assigning
the proceeds of the Policy to the Provider.
Commissions: the Provider and/or _________________ [name of person(s) to receive the benefit] will receive
commissions, consideration or benefit from Assurant Life of Canada as a result of the Purchaser applying for or buying
insurance in connection with this contract.
[Business prompt: Commissions and Benefits for Recommendations to Third Party: the Provider and/or
_________________ [name of person to receive the benefit] will receive consideration or benefit from the following third
party suppliers for referrals or recommendations:
[Example:[name of person paying the benefit] (up to _____% or up to $____),
[name of person paying the benefit] (up to _____% or up to $____), …]
Fulfilling this contract and Excess Funds: At the time the services and supplies are provided, the price of the supplies
and services to be provided under this contract will be calculated based on the price list in effect at that time, and the
actual disbursements, if included in this contract and prepaid, and applicable taxes will be added.
If the insurance/annuity policy is paid in accordance with the terms of the insurance/annuity policy and this contract, the
proceeds or death benefit of the insurance/annuity policy payable directly or indirectly to the Provider will be applied to the
cost of the services, supplies, disbursements and applicable taxes.
Guarantee: If the proceeds of the insurance/annuity policy are less than the cost of the services, supplies, disbursements
and any applicable taxes, no further payment will be required.
Increases to taxes or fees imposed by the Federal, Provincial or Municipal Governments now or in the future may be
owing.
If the proceeds of the insurance/annuity contract are more than the cost of the services, supplies, disbursements and
applicable taxes, the excess amount will be paid to the person identified in the insurance/annuity policy.
If the application for insurance/annuity is denied or the insurance/annuity policy is cancelled, rescinded, or has lapsed, or
at the time of the recipient’s death the insurance/annuity policy is not paid in full or the Provider is no longer the assignee
of the proceeds of the policy or the Provider may no longer assign or designate the beneficiary of the policy, this contract
will be null and void.
Discount: If this contract includes a discount, the discount applies only at the time of prepayment. This contract will be
fulfilled as described above.
Substitution: the Provider will make reasonable efforts to obtain and provide the services and supplies agreed to in this
contract. If the Provider is unable to obtain and provide a service or supply, the Provider will provide a refund of the sum
of the initial amount paid for the supply or service and any income earned on the amount paid. The Provider will inform the
person entitled under this contract to cancel this contract, of the refund. This contract may be cancelled in accordance
with the terms of cancellation. If the Provider and the person entitled to cancel this contract agree, the Provider may
substitute a supply or service, which will be of comparable quality and value, and similar in style, design and construction
to, the supply or service that is unavailable. The substitution will be made at no increase in price.
Cancellation Rights: The Purchaser, or someone designated in this contract by the Purchaser, may cancel this contract
by providing notice of the cancellation in writing to the Provider.
If this contract meets all of the requirements of the Act and is cancelled within 30 days of the date of this contract and
before any services or supplies have been provided, premiums paid will be refunded to the Purchaser based on the terms
of the insurance/annuity contract and the law.
If this contract meets all of the requirements of the Act and is cancelled after 30 days of this contract date and before any
services or supplies have been provided, a refund to be paid, if any, may be available based on the terms of the
insurance/annuity policy and the law:
 Growth Funeral Plan Annuity (GFPA™): Cancellation of this contract does not cancel the Purchaser’s GFPA™
policy which can only be terminated by the provisions of the policy. If the policy is terminated after thirty (30) days
premiums paid plus accrued interest will be refunded to the Purchaser. A T-5 form may be forwarded to the
Purchaser as required by the Income Tax Act.
 Guaranteed Funeral Plan (GFP™): Cancellation of this contract does not cancel the Purchaser's GFP™ policy
which can only be terminated by the provisions of the Policy. If the policy is terminated after thirty (30) days the
premium on a single pay plan is refunded. For a time pay plan, the cash surrender value is paid as per the
provisions of the policy and may be less than the original premiums paid or nothing. A T-5 form may be forwarded
to the Purchaser as required by the Income Tax Act.
If this contract meets all of the requirements of the Act and is cancelled after some of the services or supplies have been
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provided as directed under the terms of this contract, the maximum refund required will be the amount to be paid out
under the terms of the insurance/annuity policy, and in some circumstances permitted by the Act, the Provider may retain
the value of the services and supplies that have been delivered.
If this contract fails to meet the requirements of ss.40(1) of the Act, the maximum refund required will be the amount to be
paid out under the terms of the insurance/annuity policy, and in some circumstances permitted by the Act, the Provider
may retain the value of the services and supplies that have been delivered.
The following individuals may cancel this contract and receive the refund, if the proceeds of the insurance/annuity policy
have been paid to the Provider.
1. Before the death of the Recipient, the Purchaser or a person designated in this contract by the Purchaser may cancel
this contract at any time and receive the refund, if any, under the terms of the insurance/annuity policy.
2. Before the death of the Recipient, but after the death of the Purchaser, the Recipient or the Recipient’s personal
representative or a person designated in this contract by the Purchaser may cancel this contract at any time, and the
Recipient is entitled to receive the refund, if any, under the terms of the insurance/annuity policy.
3. After the death of the Recipient, the Recipient’s personal representative or a person designated in this contract by the
Purchaser may cancel this contract at any time prior to it being fully performed, and the Recipient is entitled to receive
the refund.
If this contract is cancelled and the refund proceeds of the insurance/annuity policy have not been paid to the Provider, a
refund, if any, will be paid out in based on the terms of the insurance/annuity policy and the law. A T-5 form may be
forwarded to the Purchaser as required by the Income Tax Act.
Cancellation of this contract does not cancel the insurance/annuity policy which can only be terminated by the provisions
of the policy. If this contract is cancelled, the insurance/annuity policy may be assigned to another Provider, or a named
beneficiary, under the terms of the insurance/annuity policy.
[Business prompt: This contract should outline the terms should one or more items be cancelled at the time of need, i.e.
a package of services was originally purchased, but now one or more services or supplies are being cancelled. Does this
mean the entire contract must be cancelled or may just that one item be cancelled? How will the value of the cancelled
item be calculated?]
[Business prompt: Cancellation – include here any additional cancellation policies you may have at your establishment
in addition to FBCSA]
[Business prompt: If a business is going to store supplies, it must include the relevant FBCSA requirements and
disclosures in the body of this contract or in an appendix.]
[Business prompt: If a business sells a customized supply, it must include the relevant FBCSA requirements and
disclosures in the body of this contract or in an appendix.]
Warranties: the Provider warrants that it will provide the services agreed to in this contract to the best of its abilities. The
warranties granted in connection with the supplies provided as part of this contract are the express written warranties, if
any, extended by the manufacturer of such supplies, and as required by Ontario consumer protection legislation.
[Business prompt: Include any additional warranties the operator may extend.]
[Business prompt: Additional terms and conditions concerning: Privacy, Warranties, Failure to Pay, any additional
business policies or disclosures.]
Purchaser’s Declarations and Acknowledgements:
Initial
____
Legal authority: The Purchaser declares that he/she is legally authorized to make, or charged with the
responsibility for, the arrangements contained in this contract.
____
Consumer Information Guide and business price list: The Purchaser acknowledges having received copies of
the business price list and the Consumer Information Guide prepared by the Board Of Funeral Services and the
Ontario Government.
____
Embalming: The Purchaser authorizes the body to be embalmed.
____
Disbursements/Third party supplier(s): The Purchaser acknowledges and agrees that the Provider will be
acting on behalf of, and only as agent for, the Purchaser in obtaining the services from a third party supplier. The
Purchaser acknowledges that unless other arrangements are made with the Provider, the Purchaser will be liable
to pay the supplier directly for the supplies or services and agrees to save the Provider harmless from any claims
by the third party supplier for payment.
____
Possession of Cremated Remains and Refundable Deposit: By initialing, the Purchaser authorizes the
Provider to take possession of the cremated remains of the recipient. The Purchaser agrees to pay a refundable
deposit of $350 to the Provider. The Provider will retain the cremated remains for one year from the date of
cremation. If the cremated remains are not claimed within one year, the Provider may inter the cremated remains
in a cemetery, including in a common lot for which the cemetery is the interment rights holder, and the Provider
may retain the deposit referred to in this section. If the cremated remains are claimed before they are interred, the
operator will refund any deposit paid.
____
Acknowledgement of prepayment: By initialing, the Purchaser acknowledges that once the beneficiary’s rights
to proceeds of the insurance/annuity policy are assigned to the Provider, money is considered, for the purposes
of section 38 of the Act, to have been paid under this contract for the provision of the services and supplies in an
amount equal to the amount of the proceeds under the insurance/annuity policy that will be paid directly or
indirectly to the Provider.
Initial
Business Name is operated by [Operator name], which is controlled by [controlling person].
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Licensee (name and license #)
For [operator name]
Negotiated by (name and #) if different from above
For [operator name]
____
Initial
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Date
SAMPLE OUTLINE ONLY
Purchaser (print & sign)
Date
Date
Purchaser (print & sign)
Contract: The purchaser acknowledges having received a copy of this contract.
Date

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