Amendment 003 _ on RFP 19QA1024R0014.pdf

15C. DATE SIGNED

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE

2. AMENDMENT/MODIFICATION NO.

3. EFFECTIVE DATE

02 -20-2025

4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)

7. ADMINISTERED BY (If other than Item 6) CODE

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

FACILITY CODE

9A. AMENDMENT OF SOLICITATION NO.

19QA1024R0014

9B. DATED (SEE ITEM 11)

11- 19- 2024

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended, is not extended.

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

(a)By completing items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment your desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER

NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, X is required to sign this document and return 1 copies to the issuing office.

15A. NAME AND TITLE OF SIGNER (Type or print)

16C. DATE SIGNED

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

Vincent Fellone - Contracting Officer

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

The purpose of this amendment of solicitation is to:

1) Update the deadline from March 10, 2025 to be on or before 09:00 a.m. (local time) March 03, 2025.

2) Update Sections (B.3.2 - Bi-Weekly Retention Amounts), (B.6- GROUP LIFE INSURANCE RATES); and (B.7-ADMINISTRATIVE RETENTION AMOUNTS) (See continuation page of Block 14) on pages 2 to 6 and Update Section (J)(adding Claims reports, Detailed Census list for Health Insurance;

and Detailed Census list for Life Insurance (See continuation page of Block 14) on pages 7 to 26; and

3) Add Attachment No.1 - "Questions & Answers "

4) CERTIFICATION REGARDING COMPLIANCE WITH APPLICABLE FEDERAL ANTI-DISCRIMINATION LAW

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

PAGE OF PAGES

1 27

6. ISSUED BY CODE 19QA10

American Embassy Procurement section - GSO P.O Box 2399 Doha – Qatar

Phone: 974 -4496-6042 Fax: 974-4487-3318

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code) (X)

X

CODE

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

NSN 7540-01-152-8070

Previous edition unusable SENSITIVE BUT UNCLASSIFIED

2/20/2025

Solicitation No. 19QA1024R0014

Continuation page of Block 14 of SF-30:

Update Sections (B.3.2 - Bi-Weekly Retention Amounts), (B.6- GROUP LIFE INSURANCE RATES); and (B.7-ADMINISTRATIVE RETENTION AMOUNTS) - Pages 2 to 6

B.3. ADMINISTRATIVE RETENTION AMOUNTS

B.3.1 If the Contractor requests a price adjustment under B.4 below, the Contractor must present cost experience data that includes the retention amount. For purposes of any economic price adjustment, this retention amount is a fixed amount that is a part of the premium amounts in B.2. This retention amount will not be adjusted for any reason.

The retention amount is part of the premium and may include, but not be limited to, such costs as overhead and general and administrative costs. It will also include any profit. Essentially, it includes all costs except the actual portion of the premium intended to fund claims paid to the health care provider/claimant. B.3.2 sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

NOTE TO OFFEROR: Fill in the fixed bi-weekly retention amounts for each period of performance and for each category of premium. This fixed amount must be expressed in the currency in which the premium amount is proposed. The fixed retention amount shall

NOT be expressed in terms of a percentage of the premium.

B.3.2 Bi-Weekly Retention Amounts per separate premium paid per single Self employee, or

Employee’s Spouse, and Employees’ Dependent Child.

Period of

Performance Self Self plus One

Family (3 or more individual)

Base Period

First Option Year

Second Option Year

Third Option Year

Fourth Option Year

SENSITIVE BUT UNCLASSIFIED2

B.6. GROUP LIFE INSURANCE RATES

This is a fixed-price with economic-price- adjustment-requirements type contract under which the Government will issue firm-fixed price task orders. The fixed prices/premium rates in Qatari

Riyals per one thousand of salary to provide life insurance, accidental death and dismemberment and partial and total disability coverage are as follows:

B.6.1 Base Year of Contract

Biweekly Rates per Employee

Type of Insurance

Premium

(per 1,000 of

Salary)

Estimated

Payroll

(Biweekly in thousands)

Biweekly

Total

a. Basic Life QR 1,400

b. Accidental Death & Dismemberment QR 1,400

c. Partial & Total Disability Coverage QR 1,400

d. Funeral Benefit QR 1,400

e. Subtotal (a + b + c+ d)

f. Total Price for Base Year (e x 26)

SENSITIVE BUT UNCLASSIFIED3

B.6.2 First Option Year of Contract

Biweekly Rates per Employee

Type of Insurance

Premium

(per 1,000 of

Salary)

Estimated

Payroll

(Biweekly in thousands)

Biweekly

Total

g. Basic Life QR 1,400

h. Accidental Death & Dismemberment QR 1,400

i. Partial & Total Disability Coverage QR 1,400

j. Funeral Benefit QR 1,400

k. Subtotal (g + h + i+ j)

l. Total Price for First Option Year (k x 26)

B.6.3 Second Option Year of Contract

Biweekly Rates per Employee

Type of Insurance

Premium

(per 1,000 of

Salary)

Estimated

Payroll

(Biweekly in thousands)

Biweekly

Total

m. Basic Life QR 1,400

n. Accidental Death & Dismemberment QR 1,400

o. Partial & Total Disability Coverage QR 1,400

p. Funeral Benefit QR 1,400

q. Subtotal (m + n + o + p)

r. Total Price for Second Option Year (q x 26)

SENSITIVE BUT UNCLASSIFIED4

B.6.4 Third Option Year of Contract

Biweekly Rates per Employee

Type of Insurance

Premium

(per 1,000 of

Salary)

Estimated

Payroll

(Biweekly in thousands)

Biweekly

Total

s. Basic Life QR 1,400

t. Accidental Death & Dismemberment QR 1,400

u. Partial & Total Disability Coverage QR 1,400

v. Funeral Benefit QR 1,400

w. Subtotal (s + t + u + v)

x. Total Price for Third Option Year (w x 26)

B.6.5 Fourth Option Year of Contract

Biweekly Rates per Employee

Type of Insurance

Premium

(per 1,000 of

Salary)

Estimated

Payroll

(Biweekly in thousands)

Biweekly

Total

y. Basic Life QR 1,400

z. Accidental Death & Dismemberment QR 1,400

aa. Partial & Total Disability Coverage QR 1,400

bb. Funeral Benefit QR 1,400

cc. Subtotal (y + z + aa + bb)

dd. Total Price for Fourth Option Year (cc x 26)

B.6.6 Grand Total of Base plus All Option Years

Base Year Total

First Option Year Total

Second Option Year Total

Third Option Year Total

Fourth Option Year Total

Grand Total of Base plus All Option Years

SENSITIVE BUT UNCLASSIFIED5

B.7 ADMINISTRATIVE RETENTION AMOUNTS

B.7.1 If the Contractor requests a price adjustment under B.8 below, the Contractor must present cost experience data that includes the retention amount. For purposes of any economic price adjustment, this retention amount is a fixed amount that is a part of the premium amounts in B.6. This retention amount will not be adjusted for any reason.

The retention amount is part of the premium and may include, but not be limited to, such costs as overhead and general and administrative costs. It will also include any profit. Essentially, it includes all costs except the actual portion of the premium intended to fund claims paid to the claimant.

B.7.2 Sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

NOTE TO OFFEROR: Fill in the fixed retention amounts for each period of performance and for each category of premium. This fixed amount must be expressed in the currency in which the premium amount is proposed. The fixed retention amount shall NOT be expressed in terms of a percentage of the premium.

B.7.2 Retention Amounts per Separate Premium Paid per Employee:

Period of

Performance Basic Life

Accidental

Death and

Dismemberment

Partial and Total

Disability Coverage Funeral

Benefit

Base Period

First Option Year

Second Option

Year

Third Option Year

Fourth Option

Year

SENSITIVE BUT UNCLASSIFIED6

Policy Period : March 22, 2022 to March 21, 2023

Claim Type Claim Amt (QAR) No. of Claimant No. of Claims Cash Claims 135,116.03 98 324 Direct Billing 4,117,273.00 409 3,414 Grand Total 4,252,389.03 507 3,738

IN / OP Claim Amt (QAR) No. of Claimant No. of Claims Ip 1,492,438.58 24 48 Op 2,759,950.45 421 3,690 Grand Total 4,252,389.03 445 3,738

Benefit Claim Amt (QAR) No. of Claimant No. of Claims Basic 3,111,122.08 375 2,960 Dental 463,145.06 186 519 Maternity 637,963.41 15 148 Optical 40,158.48 81 111 Grand Total 4,252,389.03 657 3,738

Top 10 Providers Claim Amt (QAR) No. of Claimant

No. of IP Claims

No. of OP Claims

United Healthcare Global - 910820 1,854,880.26 4 10 86 Al Ahli Hospital - 113716 256,032.33 44 7 194 Al-Emadi Hospital Wll - 113794 237,349.55 56 10 294 Doha Clinic - 113536 153,087.94 69 2 249 West Bay Medicare Center - Provider - 910670 112,297.28 35 1 242 Al Nasr Pharmacy - 910026 101,984.74 18 38 Turkish Hospital - 910508 93,701.95 17 3 46 Alfardan Medical With North Western Medicine - 910805 90,761.65 17 66 Dr Moopens Aster Hospital - 910561 64,506.08 30 1 122 Aster Medical Centre-Al Rafa Polyclinic- Muntazah - 910070 61,919.37 44 165

Top 10 Claimants Claim Amt (QAR) No. of Claimant No. of IP Claims

No. of OP Claims

Claimant 1 911,558 1 2 27 Claimant 2 535,239 1 8 75 Claimant 3 419,913 1 17 Claimant 4 113,788 1 43 Claimant 5 103,433 1 4 47 Claimant 6 59,261 1 41 Claimant 7 54,741 1 3 13 Claimant 8 37,164 1 1 17 Claimant 9 36,579 1 1 22 Claimant 10 30,581 1 3 25

Top 10 diagnosis Claim Amt (QAR) No. of Claimant No. of IP Claims

No. of OP Claims

Other Preterm Infant, 32 Or More Completed Weeks But Less Than 37 Completed Weeks - P07.33789,932.57 1 2 1 Leiomyoma Of Uterus, Unspecified - D25.9 409,413.08 2 11 Other Placental Disorders - O43.8 365,152.64 1 4 1 Other Low Birth Weight 1500 - 2499g - P07.13 79,018.61 1 1 Pulpitis - K04.0 70,525.10 35 58 Essential (Primary) Hypertension - I10 69,778.45 38 102 Type 2 Diabetes Mellitus Without Complication - E11.9 69,501.63 28 66 Dental Caries, Unspecified - K02.9 68,037.32 50 73 Acute Upper Respiratory Infection, Unspecified - J06.9 63,148.99 121 222 Old - Systemic Lupus Erythematosus - M32 62,214.69 1 14

Continuation page of Block 14 of SF-30:

Update Section (J) (adding Claims reports, Detailed Census list for Health Insurance; and Detailed Census list for Life Insurance (See continuation page of Block 14) on pages 7 to 26

CLAIM EXPERIENCE REPORT

Policy Period : March 22, 2024 to October 31, 2024

Note: the below data represents the claims processed up to October 31, 2024 only

Claim Type Claim Amt (QAR) No. of Claimant No. of Claims

Cash Claims 81,950.45 107 263

Direct Billing 3,197,043.63 459 3,074

Grand Total 3,278,994.08 566 3,337

IN / OP Claim Amt (QAR) No. of Claimant No. of Claims

Ip 420,135.25 26 39

Op 2,858,858.83 484 3,298

Grand Total 3,278,994.08 510 3,337

Benefit Claim Amt (QAR) No. of Claimant No. of Claims

Basic 2,812,928.15 433 2,764

Dental 299,807.25 164 394

Maternity 135,476.13 18 100

Optical 30,782.55 69 79

Grand Total 3,278,994.08 684 3,337

Top 10 Providers Claim Amt (QAR) No. of Claimant

No. of IP

Claims

No. of OP

Claims

Al-Emadi Hospital Wll - 113794 557,717.42 82 5 397

Doha Clinic - 113536 317,110.62 55 10 181

West Bay Medicare Center 236,921.57 36 2 206

Alfardan Medical With North Western Medicine 149,974.18 15 2 57

Aster Medical Centre-Al Rafa Polyclinic- Muntazah 149,845.30 65 150

Dr Moopens Aster Hospital - 910561 136,403.62 51 2 173

Sidra Medicine (Children) - 910945 129,113.84 15 4 39

Al Ahli Hospital - 113716 125,663.74 21 45

Syrian American Medical Center - 910205 88,720.95 10 1 46

International Medical Company - 113706 77,676.03 54 104

Top 10 Claimants Claim Amt (QAR) No. of Claimant No. of IP

Claims

No. of OP

Claims

Claimant 1 82,787 1 12

Claimant 2 74,804 1 2 28

Claimant 3 60,417 1 3 18

Claimant 4 57,402 1 3 37

Claimant 5 50,188 1 3

Claimant 6 48,746 1 1 9

Claimant 7 48,472 1 1 25

Claimant 8 44,812 1 1 19

Claimant 9 41,893 1 19

Claimant 10 40,100 1 2 23

Top 10 diagnosis Claim Amt (QAR) No. of Claimant No. of IP

Claims

No. of OP

Claims

Type 2 Diabetes Mellitus Without Complication - E11.9 120,352.65 39 76

Essential (Primary) Hypertension - I10 111,344.06 42 102

Hyperlipidaemia, Unspecified - E78.5 79,923.44 40 72

Dental Caries, Unspecified - K02.9 72,132.68 51 73

Acute Upper Respiratory Infection, Unspecified - J06.9 66,958.05 93 1 169

Iron Deficiency Anaemia, Unspecified - D50.9 61,935.00 26 46

Malocclusion, Unspecified - K07.4 54,165.00 18 67

Injury Of Extensor Muscle And Tendon Of Other Finger At Wrist And Hand Level - S66.350,188.30 1 3

Other And Unspecified Abdominal Pain - R10.4 46,366.41 16 23

Acute Bronchitis, Unspecified - J20.9 45,890.60 32 54

CLAIM EXPERIENCE REPORT

Policy Period : March 22, 2023 to March 21, 2024

Claim Type Claim Amt (QAR) No. of Claimant No. of Claims

Cash Claims 85,144.30 100 330

Direct Billing 4,746,733.64 460 4,185

Grand Total 4,831,877.94 560 4,515

IN / OP Claim Amt (QAR) No. of Claimant No. of Claims

Ip 554,939.46 35 59

Op 4,276,938.48 481 4,456

Grand Total 4,831,877.94 516 4,515

Benefit Claim Amt (QAR) No. of Claimant No. of Claims

Basic 4,207,358.86 434 3,782

Dental 431,839.72 194 496

Maternity 150,683.12 20 122

Optical 41,996.24 93 115

Grand Total 4,831,877.94 741 4,515

Top 10 Providers Claim Amt (QAR) No. of Claimant

No. of IP

Claims

No. of OP

Claims

Al-Emadi Hospital Wll - 113794 744,734.64 80 11 480

Al Ahli Hospital - 113716 298,395.99 35 5 90

Doha Clinic - 113536 277,681.12 70 6 206

Dr Moopens Aster Hospital - 910561 259,877.63 47 5 305

West Bay Medicare Center - Provider - 910670 228,919.74 43 4 221

Aster Medical Centre-Al Rafa Polyclinic- Muntazah - 910070 196,944.67 64 238

Alfardan Medical With North Western Medicine - 910805 166,971.67 17 3 76

Naseem Al Rabeeh Medical Centre - 114251 145,771.43 50 5 221

Al Nasr Pharmacy - 910026 140,670.25 17 28

Syrian American Medical Center - 910205 137,297.60 9 69

Top 10 Claimants Claim Amt (QAR) No. of Claimant No. of IP

Claims

No. of OP

Claims

Claimant 1 214,613 1 20

Claimant 2 166,657 1 3 31

Claimant 3 142,526 1 3 34

Claimant 4 81,089 1 1 45

Claimant 5 75,819 1 21

Claimant 6 71,609 1 1 43

Claimant 7 66,604 1 41

Claimant 8 62,398 1 33

Claimant 9 58,294 1 1 27

Claimant 10 58,172 1 7 29

Top 10 diagnosis Claim Amt (QAR) No. of Claimant No. of IP

Claims

No. of OP

Claims

Essential (Primary) Hypertension - I10 176,333.29 38 114

Acute Upper Respiratory Infection, Unspecified - J06.9 165,860.03 159 302

Type 2 Diabetes Mellitus Without Complication - E11.9 136,494.37 33 92

Systemic Lupus Erythematosus, Unspecified - M32.9 108,813.87 1 6

Chronic Sinusitis, Unspecified - J32.9 84,020.17 7 2 10

Dental Caries, Unspecified - K02.9 80,639.82 58 79

Other And Unspecified Abdominal Pain - R10.4 79,901.35 25 43

Vitamin D Deficiency, Unspecified - E55.9 77,768.85 50 81

Hyperlipidaemia, Unspecified - E78.5 76,966.91 38 74

Malocclusion, Unspecified - K07.4 74,952.66 19 71

1 of 1 9

SN Member Relation Gender DOB Marital Status Nationality 1 EMPLOYEE Male 20-Dec-74 Married India 2 EMPLOYEE Female 12-Feb-88 Married Canada 3 SON Male 4-Jun-17 Single Canada 4 DAUGHTER Female 9-Jun-19 Single Canada 5 HUSBAND Male 21-May-87 Married Canada 6 EMPLOYEE Male 22-Feb-68 Married Sudan 7 WIFE Female 3-Aug-72 Married Sudan 8 DAUGHTER Female 29-Aug-02 Single Sudan 9 DAUGHTER Female 4-Oct-05 Single Sudan 10 SON Male 27-Dec-00 Single Sudan 11 EMPLOYEE Male 1-Apr-99 Married Sudan 12 EMPLOYEE Male 22-Oct-89 Married Iraq 13 EMPLOYEE Female 8-Nov-67 Married Philippines 14 EMPLOYEE Female 25-May-84 Married Philippines 15 SON Male 3-Jun-19 Single Philippines 16 DAUGHTER Female 11-Feb-14 Single Philippines 17 HUSBAND Male 18-Dec-84 Married Philippines 18 EMPLOYEE Male 24-Feb-85 Married Pakistan 19 WIFE Female 8-Oct-84 Married Pakistan 20 DAUGHTER Female 24-Apr-19 Single Pakistan 21 SON Male 31-Mar-16 Single Pakistan 22 SON Male 30-Mar-12 Single Pakistan 23 EMPLOYEE Female 8-May-91 Married USA 24 EMPLOYEE Female 24-Jul-82 Married India 25 EMPLOYEE Female 22-Aug-78 Single Iraq 26 EMPLOYEE Male 3-Apr-79 Married Sri Lanka 27 EMPLOYEE Female 8-Aug-73 Married Algeria 28 DAUGHTER Female 17-Jul-03 Single Algeria 29 EMPLOYEE Male 10-Mar-79 Married Egypt 30 SON Male 18-Jun-19 Single Egypt 31 DAUGHTER Female 14-Aug-15 Single Egypt 32 DAUGHTER Female 20-Nov-13 Single Egypt 33 WIFE Female 1-Jun-88 Married Egypt 34 EMPLOYEE Male 7-Jun-67 Married Sri Lanka 35 EMPLOYEE Female 26-Feb-73 Married India 36 HUSBAND Male 18-Apr-66 Married India 37 EMPLOYEE Male 16-Apr-76 Married Philippines 38 DAUGHTER Female 28-Dec-14 Single Philippines 39 SON Male 7-Mar-07 Single Philippines 40 SON Male 20-Jul-04 Single Philippines 41 WIFE Female 9-Apr-73 Married Philippines 42 EMPLOYEE Male 9-Sep-74 Married Kenya 43 EMPLOYEE Female 5-Jun-88 Married Algeria 44 DAUGHTER Female 26-Jun-18 Single Algeria 10

BashirFT Cross-Out

45 SON Male 26-Feb-17 Single Algeria 46 HUSBAND Male 4-Mar-87 Married Algeria 47 EMPLOYEE Male 30-May-86 Married India 48 DAUGHTER Female 6-Aug-18 Single India 49 WIFE Female 20-Nov-91 Married India 50 EMPLOYEE Male 21-Nov-86 Married India 51 DAUGHTER Female 30-Nov-17 Single India 52 WIFE Female 29-Jun-95 Married India 53 DAUGHTER Female 18-Jul-21 Single India 54 EMPLOYEE Male 31-May-73 Married India 55 DAUGHTER Female 21-Nov-09 Single India 56 DAUGHTER Female 13-Apr-06 Single India 57 SON Male 9-May-04 Single India 58 WIFE Female 15-Mar-79 Married India 59 EMPLOYEE Male 24-Apr-87 Married India 60 WIFE Female 28-Dec-89 Married India 61 EMPLOYEE Male 31-Dec-82 Married Philippines 62 WIFE Female 11-Dec-79 Married Philippines 63 DAUGHTER Female 18-May-17 Single Philippines 64 SON Male 7-Jun-16 Single Philippines 65 SON Male 25-Jul-20 Single Philippines 66 EMPLOYEE Male 12-Mar-83 Single Pakistan 67 EMPLOYEE Male 23-Sep-66 Married India 68 EMPLOYEE Male 6-Jul-84 Single India 69 WIFE Female 1-Nov-89 Married India 70 SON Male 23-Jun-12 Single India 71 DAUGHTER Female 31-Mar-15 Single India 72 DAUGHTER Female 10-Oct-16 Single India 73 EMPLOYEE Male 24-Nov-82 Married Canada 74 WIFE Female 1-Mar-79 Married Canada 75 DAUGHTER Female 3-Jun-08 Single Canada 76 SON Male 4-Sep-17 Single Canada 77 EMPLOYEE Male 5-Feb-84 Married Pakistan 78 WIFE Female 23-Mar-85 Married Pakistan 79 DAUGHTER Female 20-Jun-20 Single Pakistan 80 SON Male 2-Oct-09 Single Pakistan 81 DAUGHTER Female 27-Aug-10 Single Pakistan 82 DAUGHTER Female 1-Jul-14 Single Pakistan 83 DAUGHTER Female 15-Apr-17 Single Pakistan 84 EMPLOYEE Male 4-Nov-86 Married India 85 WIFE Female 14-Nov-88 Married India 86 DAUGHTER Female 17-Apr-13 Single India 87 SON Male 28-Nov-18 Single India 88 EMPLOYEE Male 31-Aug-90 Single Pakistan 89 EMPLOYEE Male 10-Feb-91 Single Kenya 90 EMPLOYEE Male 29-Jul-92 Single Yemen 11

91 EMPLOYEE Male 1-Dec-92 Single India 92 EMPLOYEE Male 3-Oct-86 Married India 93 WIFE Female 6-Apr-89 Married India 94 SON Male 1-Oct-14 Single India 95 DAUGHTER Female 27-May-19 Single India 96 EMPLOYEE Male 30-Apr-91 Single Pakistan 97 EMPLOYEE Male 19-Feb-81 Single Tunisia 98 EMPLOYEE Female 21-Apr-83 Married Jordan 99 HUSBAND Male 24-Jul-72 Married Jordan

100 SON Male 6-Apr-19 Single Jordan 101 SON Male 2-Oct-14 Single Jordan 102 EMPLOYEE Male 1-Jan-73 Married Sudan 103 WIFE Female 27-Dec-80 Married Sudan 104 DAUGHTER Female 29-Sep-03 Single Sudan 105 DAUGHTER Female 1-Sep-06 Single Sudan 106 SON Male 29-Jun-11 Single Sudan 107 SON Male 4-Sep-14 Single Sudan 108 EMPLOYEE Male 17-Mar-90 Single Kenya 109 EMPLOYEE Male 26-May-83 Single Pakistan 110 WIFE Female 25-Aug-91 Married Pakistan 111 SON Male 8-Jan-12 Single Pakistan 112 SON Male 26-Jul-14 Single Pakistan 113 DAUGHTER Female 19-Feb-19 Single Pakistan 114 EMPLOYEE Male 30-Mar-73 Married Morocco 115 SON Male 24-Sep-12 Single USA 116 SON Male 30-Mar-07 Single USA 117 WIFE Female 23-Sep-67 Married Philippines 118 EMPLOYEE Male 22-Aug-77 Married Sudan 119 SON Male 28-Nov-18 Single Sudan 120 SON Male 8-Mar-11 Single Sudan 121 DAUGHTER Female 19-Oct-06 Single Sudan 122 WIFE Female 1-Jan-85 Married Sudan 123 EMPLOYEE Male 21-Jan-76 Married Yemen 124 SON Male 1-Jan-15 Single Yemen 125 DAUGHTER Female 31-Mar-10 Single Yemen 126 DAUGHTER Female 27-Jul-07 Single Yemen 127 WIFE Female 1-Aug-83 Married Yemen 128 DAUGHTER Female 8-Aug-21 Single Yemen 129 EMPLOYEE Male 26-Mar-72 Married Tunisia 130 SON Male 16-Nov-15 Single Tunisia 131 SON Male 3-Nov-13 Single Tunisia 132 WIFE Female 2-Mar-84 Married Tunisia 133 EMPLOYEE Male 18-Oct-69 Married India 134 DAUGHTER Female 12-Jun-06 Single India 135 SON Male 26-Feb-05 Single India 136 SON Male 30-Apr-02 Single India 12

137 WIFE Female 28-Sep-75 Married India 138 EMPLOYEE Female 12-Jul-61 Married USA 139 SON Male 8-Feb-03 Single USA 140 EMPLOYEE Male 10-May-68 Married India 141 DAUGHTER Female 22-Aug-06 Single India 142 WIFE Female 19-Dec-70 Married India 143 EMPLOYEE Female 9-Dec-96 Married India 144 EMPLOYEE Female 26-Oct-65 Married Algeria 145 HUSBAND Male 27-Jun-56 Married Algeria 146 EMPLOYEE Male 20-May-76 Married India 147 SON Male 23-Jan-11 Single India 148 SON Male 27-Mar-06 Single India 149 SON Male 1-Oct-02 Single India 150 WIFE Female 30-Jan-85 Married India 151 EMPLOYEE Male 15-Mar-79 Married Jordan 152 SON Male 16-Jun-19 Single Jordan 153 SON Male 16-Jun-19 Single Jordan 154 WIFE Female 13-May-85 Married Jordan 155 EMPLOYEE Male 10-Jun-68 Married Sudan 156 SON Male 6-Dec-05 Single Sudan 157 SON Male 18-Nov-03 Single Sudan 158 SON Male 4-Oct-00 Single Sudan 159 WIFE Female 5-Jun-76 Married Sudan 160 EMPLOYEE Male 24-Feb-68 Married Bangladesh 161 DAUGHTER Female 23-Feb-11 Single Bangladesh 162 SON Male 3-Jun-07 Single Bangladesh 163 DAUGHTER Female 27-Oct-02 Single Bangladesh 164 WIFE Female 2-Jul-79 Married Bangladesh 165 EMPLOYEE Male 10-May-66 Married India 166 DAUGHTER Female 24-Feb-08 Single India 167 DAUGHTER Female 27-Jan-99 Single India 168 WIFE Female 11-Mar-74 Married India 169 EMPLOYEE Male 7-Dec-64 Married Philippines 170 DAUGHTER Female 27-Jun-02 Single Philippines 171 WIFE Female 26-May-67 Married Philippines 172 EMPLOYEE Male 27-Jul-60 Married Sudan 173 DAUGHTER Female 24-Sep-17 Single Sudan 174 DAUGHTER Female 16-Nov-13 Single Sudan 175 SON Male 1-Nov-08 Single Sudan 176 DAUGHTER Female 3-Aug-07 Single Sudan 177 SON Male 11-Sep-04 Single Sudan 178 WIFE Female 5-Jan-80 Married Sudan 179 EMPLOYEE Male 21-Jan-61 Married India 180 DAUGHTER Female 3-Oct-99 Single India 181 SON Male 13-Jun-98 Single India 182 WIFE Female 30-May-69 Married India 13

183 EMPLOYEE Male 26-May-68 Married India 184 DAUGHTER Female 17-Sep-05 Single India 185 SON Male 8-Jun-03 Single India 186 WIFE Female 28-May-69 Married India 187 EMPLOYEE Male 1-Jul-74 Married India 188 DAUGHTER Female 28-Feb-14 Single India 189 EMPLOYEE Male 1-Oct-75 Married India 190 DAUGHTER Female 10-Oct-08 Single India 191 EMPLOYEE Male 12-Apr-78 Married Yemen 192 SON Male 7-Jun-16 Single Yemen 193 DAUGHTER Female 5-Apr-12 Single Yemen 194 DAUGHTER Female 19-Mar-10 Single Yemen 195 WIFE Female 1-Jan-85 Married Yemen 196 DAUGHTER Female 12-Jun-21 Single Yemen 197 EMPLOYEE Male 11-Jun-63 Married Sudan 198 SON Male 27-Apr-09 Single Sudan 199 SON Male 25-Jul-04 Single Sudan 200 DAUGHTER Female 25-Jul-04 Single Sudan 201 WIFE Female 16-Oct-79 Married Sudan 202 EMPLOYEE Male 25-Sep-70 Married India 203 SON Male 14-Jun-09 Single India 204 SON Male 30-Dec-02 Single India 205 WIFE Female 5-Apr-76 Married India 206 EMPLOYEE Male 10-Jan-73 Married Sudan 207 DAUGHTER Female 21-Sep-11 Single Sudan 208 SON Male 21-Sep-11 Single Sudan 209 EMPLOYEE Male 4-Nov-67 Married Sudan 210 SON Male 5-Dec-08 Single Sudan 211 SON Male 6-Sep-05 Single Sudan 212 DAUGHTER Female 31-Aug-03 Single Sudan 213 WIFE Female 1-Jan-65 Married Sudan 214 EMPLOYEE Male 28-Mar-71 Married India 215 WIFE Female 10-Jan-79 Married India 216 EMPLOYEE Male 12-Apr-77 Married India 217 DAUGHTER Female 8-Oct-09 Single India 218 WIFE Female 21-Jun-81 Married India 219 EMPLOYEE Male 9-Aug-77 Married Philippines 220 SON Male 14-Feb-16 Single Philippines 221 DAUGHTER Female 27-May-13 Single Philippines 222 WIFE Female 14-Jan-77 Married Philippines 223 EMPLOYEE Male 15-Dec-63 Married Algeria 224 DAUGHTER Female 11-Jul-05 Single Algeria 225 DAUGHTER Female 28-Dec-03 Single Algeria 226 DAUGHTER Female 7-Nov-00 Single Algeria 227 WIFE Female 22-Mar-74 Married Algeria 228 EMPLOYEE Female 28-Jul-71 Married Philippines 14

229 EMPLOYEE Female 12-Nov-77 Married India 230 DAUGHTER Female 16-Oct-06 Single India 231 HUSBAND Male 28-Apr-77 Married India 232 EMPLOYEE Male 2-Mar-69 Married Pakistan 233 DAUGHTER Female 22-Oct-08 Single Pakistan 234 SON Male 18-Oct-05 Single Pakistan 235 SON Male 9-Jun-00 Single Pakistan 236 WIFE Female 1-Jan-75 Married Pakistan 237 EMPLOYEE Male 10-Mar-72 Married Philippines 238 SON Male 25-Jul-17 Single Philippines 239 DAUGHTER Female 29-Sep-02 Single Philippines 240 WIFE Female 16-Dec-73 Married Philippines 241 EMPLOYEE Male 1-Apr-72 Married Philippines 242 SON Male 24-Nov-07 Single Philippines 243 SON Male 12-Jan-05 Single Philippines 244 WIFE Female 12-Nov-74 Married Philippines 245 EMPLOYEE Male 6-Jul-67 Married Philippines 246 WIFE Female 25-Dec-81 Married Philippines 247 EMPLOYEE Male 26-Oct-77 Married Philippines 248 SON Male 13-Dec-12 Single Philippines 249 SON Male 26-Nov-07 Single Philippines 250 WIFE Female 25-Feb-81 Married Philippines 251 EMPLOYEE Female 15-Feb-86 Married Lebanon 252 DAUGHTER Female 29-May-17 Single Canada 253 DAUGHTER Female 4-Apr-14 Single USA 254 HUSBAND Male 2-May-84 Married Lebanon 255 EMPLOYEE Female 6-Jun-77 Married Sudan 256 EMPLOYEE Male 16-Nov-83 Married India 257 SON Male 27-Mar-17 Single India 258 DAUGHTER Female 11-Jul-12 Single India 259 WIFE Female 14-Sep-92 Married India 260 EMPLOYEE Male 1-Mar-86 Married India 261 WIFE Female 11-May-93 Married India 262 EMPLOYEE Male 10-Nov-80 Married Philippines 263 SON Male 17-Aug-15 Single Philippines 264 SON Male 27-Jan-10 Single Philippines 265 SON Male 19-Jun-07 Single Philippines 266 WIFE Female 7-Feb-80 Married Philippines 267 EMPLOYEE Male 1-Apr-81 Married Egypt 268 SON Male 9-Mar-17 Single Egypt 269 SON Male 4-May-14 Single Egypt 270 SON Male 1-Mar-12 Single Egypt 271 WIFE Female 28-Mar-84 Married Egypt 272 EMPLOYEE Male 20-Apr-78 Married Egypt 273 SON Male 23-Nov-08 Single Egypt 274 WIFE Female 25-Jun-79 Married Egypt 15

275 EMPLOYEE Male 30-Jan-63 Married Philippines 276 EMPLOYEE Male 15-Apr-82 Married Egypt 277 DAUGHTER Female 1-Jan-17 Single Egypt 278 SON Male 18-Jul-11 Single Egypt 279 WIFE Female 13-Nov-85 Married Egypt 280 EMPLOYEE Female 1-Aug-80 Single Egypt 281 EMPLOYEE Male 17-Oct-85 Single India 282 SON Male 21-Feb-16 Single India 283 WIFE Female 26-Jan-91 Married India 284 EMPLOYEE Male 30-Aug-85 Married Jordan 285 DAUGHTER Female 30-Jan-20 Single Jordan 286 DAUGHTER Female 13-Dec-14 Single Jordan 287 DAUGHTER Female 10-Mar-13 Single Jordan 288 WIFE Female 2-Mar-89 Married Jordan 289 EMPLOYEE Male 1-Jan-75 Single Sudan 290 EMPLOYEE Male 14-Sep-73 Married Philippines 291 DAUGHTER Female 23-Mar-14 Single Philippines 292 SON Male 2-Dec-06 Single Philippines 293 WIFE Female 13-Jul-79 Married Philippines 294 EMPLOYEE Male 12-May-87 Single Eritrea 295 EMPLOYEE Female 19-Feb-82 Married India 296 EMPLOYEE Male 2-Jul-62 Married Egypt 297 DAUGHTER Female 26-Mar-99 Single Egypt 298 WIFE Female 28-Nov-58 Married Egypt 299 EMPLOYEE Male 3-May-82 Married India 300 SON Male 25-Nov-19 Single India 301 SON Male 20-Jun-17 Single India 302 DAUGHTER Female 13-Jan-13 Single India 303 DAUGHTER Female 2-Oct-10 Single India 304 WIFE Female 26-Mar-90 Married India 305 EMPLOYEE Female 1-Jan-91 Single Syria 306 EMPLOYEE Male 24-Apr-88 Single India 307 DAUGHTER Female 12-Nov-19 Single India 308 WIFE Female 5-Aug-94 Married India 309 EMPLOYEE Female 7-Dec-82 Married Tunisia 310 DAUGHTER Female 13-Jul-18 Single Tunisia 311 SON Male 24-Nov-15 Single Egypt 312 EMPLOYEE Female 18-May-85 Married Egypt 313 SON Male 1-Dec-19 Single Egypt 314 DAUGHTER Female 25-Feb-17 Single Egypt 315 HUSBAND Male 7-Jan-86 Married Egypt 316 EMPLOYEE Female 8-Oct-83 Married Trinidad and Tobago 317 DAUGHTER Female 15-Feb-17 Single Trinidad and Tobago 318 DAUGHTER Female 19-Aug-14 Single Trinidad and Tobago 319 HUSBAND Male 23-Dec-84 Married Trinidad and Tobago 320 EMPLOYEE Female 26-Dec-79 Married Philippines 16

321 DAUGHTER Female 23-Aug-12 Single Philippines 322 HUSBAND Male 10-Sep-76 Married Philippines 323 EMPLOYEE Female 1-Apr-68 Married India 324 HUSBAND Male 30-Mar-60 Married India 325 EMPLOYEE Male 6-Jul-79 Married Philippines 326 WIFE Female 28-Apr-85 Married Philippines 327 EMPLOYEE Male 26-Jun-67 Married Sudan 328 SON Male 14-Jun-10 Single Sudan 329 SON Male 22-Aug-08 Single Sudan 330 SON Male 1-Sep-07 Single Sudan 331 SON Male 2-Jun-06 Single Sudan 332 SON Male 21-Oct-02 Single Sudan 333 SON Male 3-Oct-01 Single Sudan 334 WIFE Female 1-Jan-78 Married Sudan 335 EMPLOYEE Male 1-Jan-69 Married Sudan 336 EMPLOYEE Female 13-May-88 Married Sudan 337 HUSBAND Male 2-Oct-82 Married Sudan 338 EMPLOYEE Female 5-Aug-87 Married Algeria 339 EMPLOYEE Male 27-Oct-86 Married Pakistan 340 DAUGHTER Female 25-Nov-16 Single Pakistan 341 SON Male 19-Jul-13 Single Pakistan 342 WIFE Female 11-Apr-90 Married Pakistan 343 EMPLOYEE Male 25-Jul-84 Married Chile 344 WIFE Female 4-Dec-83 Married Chile 345 SON Male 20-Sep-05 Single Chile 346 SON Male 25-Jan-17 Single Chile 347 EMPLOYEE Male 26-Aug-78 Married India 348 WIFE Female 26-Apr-81 Married India 349 HUSBAND Male 1-Jan-51 Married Lebanon 350 EMPLOYEE Female 25-Dec-53 Married USA 351 HUSBAND Male 14-Nov-61 Married USA 352 EMPLOYEE Male 11-Jan-87 Married USA 353 EMPLOYEE Male 23-Aug-90 Married India 354 WIFE Female 10-Sep-86 Married Philippines 355 DAUGHTER Female 20-Nov-20 Single Philippines 356 EMPLOYEE Male 23-Jul-80 Married Philippines 357 WIFE Female 25-Dec-86 Married Philippines 358 SON Male 28-Aug-14 Single Philippines 359 WIFE Female 15-Nov-72 Married Sudan 360 SON Male 28-Mar-03 Single Sudan 361 SON Male 7-Apr-22 Single India 362 WIFE Female 24-Sep-65 Married India 363 EMPLOYEE Female 24-Jul-86 Married Pakistan 364 EMPLOYEE Male 25-Nov-79 Married Jordan 365 DAUGHTER Female 6-Jun-22 Single India 366 SON Male 20-May-10 Single Sudan 17

367 SON Male 11-Dec-04 Single Sudan 368 EMPLOYEE Male 31-Dec-67 Single Philippines 369 WIFE Female 15-Oct-81 Married Philippines 370 SON Male 16-Jul-06 Single Philippines 371 SON Male 7-Oct-09 Single Philippines 372 EMPLOYEE Male 27-Feb-85 Married Morocco 373 EMPLOYEE Female 6-Apr-69 Married Philippines 374 WIFE Female 13-Oct-86 Married Morocco 375 SON Male 24-Oct-19 Single Morocco 376 SON Male 24-Feb-14 Single Morocco 377 SON Male 8-Sep-22 Single Lebanon 378 EMPLOYEE Male 25-Nov-78 Single Tunisia 379 EMPLOYEE Female 21-Mar-82 Single Sudan 380 EMPLOYEE Female 30-Oct-86 Single Uganda 381 EMPLOYEE Male 21-May-90 Single Uganda 382 EMPLOYEE Male 14-Jun-86 Single India 383 EMPLOYEE Female 17-Feb-88 Married Jordan 384 HUSBAND Male 29-Nov-82 Married Jordan 385 EMPLOYEE Male 15-Dec-82 Single Pakistan 386 EMPLOYEE Male 14-Sep-85 Single Pakistan 387 EMPLOYEE Female 31-May-92 Married India 388 EMPLOYEE Male 6-Dec-89 Single Pakistan 389 DAUGHTER Female 23-Sep-22 Single India 390 DAUGHTER Female 12-Feb-09 Single Philippines 391 DAUGHTER Female 1-Mar-06 Single Philippines 392 EMPLOYEE Male 3-Dec-87 Single India 393 DAUGHTER Female 29-Aug-22 Single India 394 WIFE Female 21-Jun-91 Married India 395 DAUGHTER Female 3-Feb-15 Single India 396 SON Male 1-Feb-21 Single India 397 DAUGHTER Female 11-Apr-09 Single Pakistan 398 DAUGHTER Female 12-Dec-10 Single Pakistan 399 EMPLOYEE Male 26-Mar-84 Single Uganda 400 EMPLOYEE Male 23-Jan-74 Single Jordan 401 EMPLOYEE Male 8-May-85 Single India 402 HUSBAND Male 1-Jan-83 Married Pakistan 403 SON Male 2-Nov-22 Single Morocco 404 EMPLOYEE Female 20-Mar-87 Single Algeria 405 EMPLOYEE Female 16-Nov-88 Single Tunisia 406 EMPLOYEE Female 21-Apr-87 Single India 407 EMPLOYEE Male 19-Aug-79 Single India 408 SON Male 8-Oct-22 Single India 409 EMPLOYEE Male 24-Nov-91 Single Jordan 410 EMPLOYEE Male 9-Oct-81 Single Pakistan 411 SON Male 22-May-14 Single Uganda 412 DAUGHTER Female 17-Jul-16 Single Uganda 18

413 WIFE Female 1-Jan-84 Married Pakistan 414 WIFE Female 4-Dec-88 Married Pakistan 415 DAUGHTER Female 14-Jan-19 Single Pakistan 416 DAUGHTER Female 10-Sep-21 Single Pakistan 417 DAUGHTER Female 16-Mar-23 Single Egypt 418 WIFE Female 29-Oct-92 Married India 419 DAUGHTER Female 17-Feb-13 Single India 420 SON Male 1-Aug-17 Single India 421 HUSBAND Male 28-Jan-87 Married Algeria 422 DAUGHTER Female 25-Sep-19 Single Algeria 423 DAUGHTER Female 10-Apr-17 Single Algeria 424 EMPLOYEE Male 10-Oct-87 Married Tunisia 425 WIFE Female 23-Sep-87 Married Tunisia 426 DAUGHTER Female 17-May-19 Single Tunisia 427 EMPLOYEE Male 1-Jun-87 Single Canada 428 WIFE Female 13-Sep-89 Married Pakistan 429 SON Male 25-Apr-17 Single Pakistan 430 SON Male 1-Sep-18 Single Pakistan 431 EMPLOYEE Female 1-Nov-83 Single Uganda 432 WIFE Female 9-Mar-91 Married Uganda 433 DAUGHTER Female 4-May-17 Single Uganda 434 DAUGHTER Female 9-Nov-19 Single Uganda 435 EMPLOYEE Male 27-Feb-85 Married India 436 WIFE Female 21-Aug-89 Married India 437 DAUGHTER Female 22-Nov-11 Single India 438 SON Male 22-Nov-11 Single India 439 SON Male 5-Dec-18 Single India 440 WIFE Female 10-May-85 Married Pakistan 441 DAUGHTER Female 10-May-12 Single Pakistan 442 DAUGHTER Female 21-Jul-09 Single Pakistan 443 DAUGHTER Female 26-Jun-08 Single Pakistan 444 EMPLOYEE Male 8-Feb-87 Single India 445 EMPLOYEE Male 20-Dec-76 Married Egypt 446 EMPLOYEE Male 15-Sep-85 Single USA 447 EMPLOYEE Male 28-May-87 Single Uruguay 448 EMPLOYEE Male 10-Nov-84 Single Tunisia 449 WIFE Female 23-Oct-94 Married India 450 SON Male 5-Aug-16 Single India 451 WIFE Female 7-Jul-93 Married India 452 DAUGHTER Female 26-Oct-19 Single India 453 SON Male 9-Feb-16 Single India 454 WIFE Female 5-Sep-91 Married Pakistan 455 SON Male 24-Feb-20 Single Pakistan 456 SON Male 14-Apr-22 Single Pakistan 457 EMPLOYEE Female 10-Jan-83 Married Kazakhstan 458 WIFE Female 18-May-88 Married India 19

459 DAUGHTER Female 5-Jun-13 Single India 460 SON Male 14-Jun-19 Single India 461 WIFE Female 28-Oct-87 Married Uruguay 462 SON Male 5-Feb-21 Single Uruguay 463 DAUGHTER Female 12-Dec-22 Single Uruguay 464 EMPLOYEE Male 9-Oct-91 Single Lebanon 465 EMPLOYEE Male 16-Apr-81 Single Uganda 466 EMPLOYEE Male 12-Mar-86 Single Pakistan 467 WIFE Female 20-Apr-93 Married India 468 SON Male 1-Sep-14 Single India 469 DAUGHTER Female 24-Dec-18 Single India 470 DAUGHTER Female 22-Mar-12 Single Sudan 471 SON Male 11-Jun-07 Single Sudan 472 SON Male 15-Jul-10 Single Sudan 473 HUSBAND Male 1-Jan-73 Married Sudan 474 EMPLOYEE Male 14-Apr-87 Married Jordan 475 WIFE Female 7-Sep-94 Married Jordan 476 SON Male 1-Aug-08 Single Kazakhstan 477 DAUGHTER Female 7-Jul-12 Single Kazakhstan 478 EMPLOYEE Male 27-Mar-94 Single Sudan 479 EMPLOYEE Female 21-Sep-86 Single Sudan 480 EMPLOYEE Male 22-Apr-81 Single Philippines 481 WIFE Female 15-Sep-82 Married Sri Lanka 482 WIFE Female 29-May-81 Married Tunisia 483 SON Male 23-Sep-09 Single Tunisia 484 DAUGHTER Female 7-Jun-11 Single Tunisia 485 SON Male 26-Dec-15 Single Tunisia 486 WIFE Female 24-Dec-93 Married USA 487 SON Male 18-Jan-14 Single USA 488 DAUGHTER Female 15-Jun-16 Single USA 489 SON Male 3-Aug-19 Single USA 490 SON Male 22-Mar-06 Single Uganda 491 WIFE Female 22-Dec-78 Married Tunisia 492 SON Male 28-May-11 Single Tunisia 493 SON Male 14-Dec-12 Single Tunisia 494 HUSBAND Male 21-Nov-85 Married Sudan 495 SON Male 2-Oct-16 Single Sudan 496 SON Male 6-Nov-14 Single Sudan 497 SON Male 2-Mar-20 Single Sudan 498 SON Male 20-Jul-23 Single Canada 499 EMPLOYEE Male 11-Sep-82 Single Philippines 500 EMPLOYEE Male 29-Oct-86 Single India 501 WIFE Female 8-Jan-86 Married Pakistan 502 SON Male 17-Aug-11 Single Pakistan 503 SON Male 13-Dec-13 Single Pakistan 504 SON Male 14-Oct-16 Single Pakistan 20

505 HUSBAND Male 4-Dec-92 Married India 506 EMPLOYEE Male 10-Jan-87 Single India 507 EMPLOYEE Female 14-Nov-92 Married Cameroon 508 EMPLOYEE Male 23-Mar-78 Married Sudan 509 DAUGHTER Female 20-Jan-09 Single Uganda 510 EMPLOYEE Female 27-Jan-84 Married USA 511 EMPLOYEE Male 22-Feb-92 Single Pakistan 512 EMPLOYEE Male 2-Oct-93 Single Pakistan 513 EMPLOYEE Male 19-Apr-81 Single Pakistan 514 WIFE Female 2-Sep-81 Married Philippines 515 SON Male 17-Sep-11 Single Philippines 516 DAUGHTER Female 14-Apr-20 Single Philippines 517 DAUGHTER Female 19-Apr-22 Single Philippines 518 WIFE Female 1-Jan-03 Married Sudan 519 HUSBAND Male 30-Aug-84 Married USA 520 SON Male 11-Sep-14 Single USA 521 DAUGHTER Female 9-Jan-19 Single USA 522 EMPLOYEE Male 1-Sep-91 Single Uganda 523 DAUGHTER Female 4-Jan-24 Single Uganda 524 WIFE Female 29-Aug-91 Married Pakistan 525 SON Male 10-Oct-18 Single Pakistan 526 WIFE Female 10-Nov-89 Married India 527 SON Male 22-Feb-19 Single India 528 SON Male 18-Sep-20 Single India 529 DAUGHTER Female 11-Mar-24 Single India 530 SON Male 9-Jan-24 Single Jordan 531 EMPLOYEE Male 28-Nov-82 Married Pakistan 532 EMPLOYEE Female 28-Oct-86 Married Sudan 533 EMPLOYEE Male 2-Jan-68 Married Sudan 534 WIFE Female 3-Sep-90 Married India 535 DAUGHTER Female 5-Jan-17 Single India 536 DAUGHTER Female 31-Aug-14 Single India 537 HUSBAND Male 23-Sep-89 Married Cameroon 538 WIFE Female 25-Oct-98 Married Eritrea 539 WIFE Female 15-Feb-94 Married Pakistan 540 SON Male 13-Nov-18 Single Pakistan 541 WIFE Female 10-Jun-84 Married Sudan 542 DAUGHTER Female 19-Nov-19 Single Kenya 543 WIFE Female 15-Mar-91 Married India 544 DAUGHTER Female 29-Sep-22 Single India 545 EMPLOYEE Male 2-May-86 Married Pakistan 546 WIFE Female 20-Apr-94 Married Pakistan 547 WIFE Female 15-Oct-85 Married Pakistan 548 SON Male 16-Jul-11 Single Pakistan 549 SON Male 24-Aug-19 Single Pakistan 550 DAUGHTER Female 30-Apr-15 Single Pakistan 21

551 DAUGHTER Female 15-Feb-11 Single Sudan 552 WIFE Female 26-Oct-86 Married Pakistan 553 DAUGHTER Female 20-Sep-13 Single Pakistan 554 SON Male 2-Jul-16 Single Pakistan 555 DAUGHTER Female 13-May-24 Single Canada 556 EMPLOYEE Male 18-Oct-93 Single India 557 WIFE Female 2-Jul-94 Married Pakistan 558 DAUGHTER Female 3-Jul-23 Single Pakistan 559 EMPLOYEE Male 31-Mar-88 Married Tunisia 560 EMPLOYEE Male 5-Apr-81 Married Sudan 561 WIFE Female 16-Jan-68 Married Sudan 562 SON Male 9-Dec-03 Single Sudan 563 SON Male 27-May-09 Single Sudan 564 DAUGHTER Female 15-Jul-24 Single Jordan 565 SON Male 15-Oct-22 Single Sudan 566 DAUGHTER Female 27-Dec-10 Single Sudan 567 DAUGHTER Female 14-Sep-13 Single Sudan 568 WIFE Female 29-Jul-92 Married Pakistan 569 WIFE Female 1-Apr-94 Married Kenya 570 EMPLOYEE Female 26-Oct-87 Single Bangladesh 571 SON Male 29-Aug-24 Single Pakistan 572 EMPLOYEE Female 4-Feb-73 Single Canada 573 EMPLOYEE Female 6-Jun-88 Single Uganda 574 EMPLOYEE Male 7-May-84 Single Pakistan 575 EMPLOYEE Male 31-Jan-94 Single Uganda 576 WIFE Female 15-Feb-87 Married Pakistan 577 SON Male 17-Apr-17 Single Pakistan 578 DAUGHTER Female 30-Mar-19 Single Pakistan 579 DAUGHTER Female 10-Oct-21 Single Sudan 580 DAUGHTER Female 28-May-14 Single Sudan 581 DAUGHTER Female 6-Apr-18 Single Sudan 582 SON Male 30-Jul-11 Single Sudan 583 SON Male 26-Jun-14 Single Pakistan 584 SON Male 20-Jun-18 Single Pakistan 585 SON Male 8-Aug-16 Single Pakistan 586 WIFE Female 12-Jan-88 Married Pakistan 587 WIFE Female 1-May-88 Married Sudan 588 HUSBAND Male 3-Apr-85 Married Tunisia 589 SON Male 12-Mar-19 Single Tunisia 590 DAUGHTER Female 26-Sep-16 Single Tunisia 591 WIFE Female 24-Nov-83 Married Uganda 592 EMPLOYEE Female 25-Sep-96 Single Lebanon 593 EMPLOYEE Male 15-Aug-90 Married Jordan 594 DAUGHTER Female 26-Sep-24 Single Sri Lanka 595 WIFE Female 2-Dec-98 Married Jordan

SN Gender DOB Marital Status Nationality

Basic Rate

(QAR)

1 Female 12-Feb-88 Married Canada QAR 123,950 2 Male 22-Feb-68 Married Sudan QAR 131,241 3 Male 1-Apr-99 Married Sudan QAR 162,423 4 Male 22-Oct-89 Married Iraq QAR 193,659 5 Female 8-Nov-67 Married Philippines QAR 373,998 6 Female 25-May-84 Married Philippines QAR 137,139 7 Male 24-Feb-85 Married Pakistan QAR 107,963 8 Female 8-May-91 Married United States of America QAR 190,023 9 Female 24-Jul-82 Married India QAR 420,551

10 Female 22-Aug-78 Single Iraq QAR 181,165 11 Male 3-Apr-79 Married Sri Lanka QAR 141,173 12 Female 8-Aug-73 Married Algeria QAR 121,458 13 Male 10-Mar-79 Married Egypt QAR 121,458 14 Male 7-Jun-67 Married Sri Lanka QAR 145,833 15 Female 26-Feb-73 Married India QAR 137,139 16 Male 16-Apr-76 Married Philippines QAR 187,412 17 Male 9-Sep-74 Married Kenya QAR 318,606 18 Female 5-Jun-88 Married Algeria QAR 218,649 19 Male 30-May-86 Married India QAR 162,423 20 Male 21-Nov-86 Married India QAR 269,198 21 Male 31-May-73 Married India QAR 80,973 22 Male 24-Apr-87 Married India QAR 91,144 23 Male 31-Dec-82 Married Philippines QAR 342,832 24 Male 12-Mar-83 Single Pakistan QAR 301,278 25 Male 23-Sep-66 Married India QAR 363,609 26 Male 6-Jul-84 Single India QAR 270,112 27 Male 24-Nov-82 Married Canada QAR 353,220 28 Male 5-Feb-84 Married Pakistan QAR 131,241 29 Male 4-Nov-86 Married India QAR 332,443 30 Male 31-Aug-90 Single Pakistan QAR 369,579 31 Male 10-Feb-91 Single Kenya QAR 150,861 32 Male 29-Jul-92 Single Yemen QAR 168,670 33 Male 1-Dec-92 Single India QAR 197,940 34 Male 3-Oct-86 Married India QAR 363,609 35 Male 30-Apr-91 Single Pakistan QAR 156,176 36 Male 19-Feb-81 Single Tunisia QAR 112,934 37 Female 21-Apr-83 Married Jordan QAR 121,002 38 Male 1-Jan-73 Married Sudan QAR 165,947 39 Male 17-Mar-90 Single Kenya QAR 382,322 40 Male 26-May-83 Single Pakistan QAR 212,401 41 Male 30-Mar-73 Married Morocco QAR 162,423 42 Male 22-Aug-77 Married Sudan QAR 120,305 43 Male 21-Jan-76 Married Yemen QAR 353,220 44 Male 26-Mar-72 Married Tunisia QAR 407,808 45 Male 18-Oct-69 Married India QAR 123,950

46 Female 12-Jul-61 Married USA QAR 137,139 47 Male 10-May-68 Married India QAR 199,907 48 Female 9-Dec-96 Married India QAR 224,896 49 Female 26-Oct-65 Married Algeria QAR 193,659 50 Male 20-May-76 Married India QAR 121,458 51 Male 15-Mar-79 Married Jordan QAR 221,693 52 Male 10-Jun-68 Married Sudan QAR 363,609 53 Male 24-Feb-68 Married Bangladesh QAR 218,649 54 Male 10-May-66 Married India QAR 353,220 55 Male 7-Dec-64 Married Philippines QAR 199,907 56 Male 27-Jul-60 Married Sudan QAR 353,220 57 Male 21-Jan-61 Married India QAR 112,934 58 Male 26-May-68 Married India QAR 131,241 59 Male 1-Jul-74 Married India QAR 149,928 60 Male 1-Oct-75 Married India QAR 269,198 61 Male 12-Apr-78 Married Yemen QAR 162,423 62 Male 11-Jun-63 Married Sudan QAR 125,719 63 Male 25-Sep-70 Married India QAR 290,889 64 Male 10-Jan-73 Married Sudan QAR 87,721 65 Male 4-Nov-67 Married Sudan QAR 94,789 66 Male 28-Mar-71 Married India QAR 91,095 67 Male 12-Apr-77 Married India QAR 140,805 68 Male 9-Aug-77 Married Philippines QAR 212,401 69 Male 15-Dec-63 Married Algeria QAR 162,423 70 Female 28-Jul-71 Married Philippines QAR 331,349 71 Female 12-Nov-77 Married India QAR 187,412 72 Male 2-Mar-69 Married Pakistan QAR 123,255 73 Male 10-Mar-72 Married Philippines QAR 43,749 74 Male 1-Apr-72 Married Philippines QAR 87,721 75 Male 6-Jul-67 Married Philippines QAR 112,934 76 Male 26-Oct-77 Married Philippines QAR 84,347 77 Female 15-Feb-86 Married Lebanon QAR 176,003 78 Female 6-Jun-77 Married Sudan QAR 121,002 79 Male 16-Nov-83 Married India QAR 168,670 80 Male 1-Mar-86 Married India QAR 91,144 81 Male 10-Nov-80 Married Philippines QAR 130,748 82 Male 1-Apr-81 Married Egypt QAR 84,347 83 Male 20-Apr-78 Married Egypt QAR 249,335 84 Male 30-Jan-63 Married Philippines QAR 162,423 85 Male 15-Apr-82 Married Egypt QAR 156,176 86 Female 1-Aug-80 Single Egypt QAR 80,973 87 Male 17-Oct-85 Single India QAR 116,968 88 Male 30-Aug-85 Married Jordan QAR 87,721 89 Male 1-Jan-75 Single Sudan QAR 109,370 90 Male 14-Sep-73 Married Philippines QAR 120,691 91 Male 12-May-87 Single Eritrea QAR 205,858 92 Female 19-Feb-82 Married India QAR 87,721 93 Male 2-Jul-62 Married Egypt QAR 145,833

94 Male 3-May-82 Married India QAR 125,036 95 Female 1-Jan-91 Single Syria QAR 174,918 96 Male 24-Apr-88 Single India QAR 190,023 97 Female 7-Dec-82 Married Tunisia QAR 121,002 98 Female 18-May-85 Married Egypt QAR 129,070 99 Female 8-Oct-83 Married Trinidad and Tobago QAR 120,691

100 Female 26-Dec-79 Married Philippines QAR 130,748 101 Female 1-Apr-68 Married India QAR 301,278 102 Male 6-Jul-79 Married Philippines QAR 165,947 103 Male 26-Jun-67 Married Sudan QAR 229,610 104 Male 1-Jan-69 Married Sudan QAR 253,363 105 Female 13-May-88 Married Sudan QAR 237,528 106 Female 5-Aug-87 Married Algeria QAR 344,092 107 Male 27-Oct-86 Married Pakistan QAR 120,691 108 Male 25-Jul-84 Married Chile QAR 344,092 109 Male 26-Aug-78 Married India QAR 87,721 110 Female 25-Dec-53 Married USA QAR 331,349 111 Male 11-Jan-87 Married USA QAR 116,968 112 Male 23-Aug-90 Married India QAR 280,500 113 Male 23-Jul-80 Married Philippines QAR 155,890 114 Female 24-Jul-86 Married Pakistan QAR 183,736 115 Male 25-Nov-79 Married Jordan QAR 187,412 116 Male 31-Dec-67 Single Philippines QAR 87,721 117 Male 27-Feb-85 Married Morocco QAR 150,861 118 Female 6-Apr-69 Married Philippines QAR 181,165 119 Male 25-Nov-78 Single Tunisia QAR 94,468 120 Female 21-Mar-82 Single Sudan QAR 84,347 121 Female 30-Oct-86 Single Uganda QAR 356,835 122 Male 21-May-90 Single Uganda QAR 229,610 123 Male 14-Jun-86 Single India QAR 193,659 124 Female 17-Feb-88 Married Jordan QAR 109,370 125 Male 15-Dec-82 Single Pakistan QAR 181,165 126 Male 14-Sep-85 Single Pakistan QAR 125,036 127 Female 31-May-92 Married India QAR 155,890 128 Male 6-Dec-89 Single Pakistan QAR 290,889 129 Male 3-Dec-87 Single India QAR 221,693 130 Male 26-Mar-84 Single Uganda QAR 109,370 131 Male 23-Jan-74 Single Jordan QAR 104,590 132 Male 8-May-85 Single India QAR 104,590 133 Female 20-Mar-87 Single Algeria QAR 190,023 134 Female 16-Nov-88 Single Tunisia QAR 181,165 135 Female 21-Apr-87 Single India QAR 237,528 136 Male 19-Aug-79 Single India QAR 193,659 137 Male 24-Nov-91 Single Jordan QAR 120,305 138 Male 9-Oct-81 Single Pakistan QAR 95,816 139 Male 10-Oct-87 Married Tunisia QAR 322,055 140 Male 1-Jun-87 Single Canada QAR 104,590 141 Female 1-Nov-83 Single Uganda QAR 213,775

142 Male 27-Feb-85 Married India QAR 280,500 143 Male 8-Feb-87 Single India QAR 197,940 144 Male 20-Dec-76 Married Egypt QAR 130,748 145 Male 15-Sep-85 Single USA QAR 205,858 146 Male 28-May-87 Single Uruguay QAR 311,666 147 Male 10-Nov-84 Single Tunisia QAR 92,725 148 Female 10-Jan-83 Married Kazakhstan QAR 160,918 149 Male 9-Oct-91 Single Lebanon QAR 116,968 150 Male 16-Apr-81 Single Uganda QAR 206,154 151 Male 12-Mar-86 Single Pakistan QAR 160,918 152 Male 14-Apr-87 Married Jordan QAR 156,176 153 Male 27-Mar-94 Single Sudan QAR 369,579 154 Female 21-Sep-86 Single Sudan QAR 100,831 155 Male 22-Apr-81 Single Philippines QAR 162,423 156 Male 11-Sep-82 Single Philippines QAR 89,634 157 Male 29-Oct-86 Single India QAR 105,724 158 Male 10-Jan-87 Single India QAR 145,207 159 Female 14-Nov-92 Married Cameroon QAR 145,207 160 Male 23-Mar-78 Married Sudan QAR 97,842 161 Female 27-Jan-84 Married USA QAR 120,691 162 Male 22-Feb-92 Single Pakistan QAR 193,659 163 Male 2-Oct-93 Single Pakistan QAR 91,144 164 Male 19-Apr-81 Single Pakistan QAR 162,423 165 Male 1-Sep-91 Single Uganda QAR 187,412 166 Male 28-Nov-82 Married Pakistan QAR 125,719 167 Female 28-Oct-86 Married Sudan QAR 229,610 168 Male 2-Jan-68 Married Sudan QAR 301,278 169 Male 2-May-86 Married Pakistan QAR 353,220 170 Male 18-Oct-93 Single India QAR 269,198 171 Male 31-Mar-88 Married Tunisia QAR 178,146 172 Male 5-Apr-81 Married Sudan QAR 369,579 173 Female 26-Oct-87 Single Bangladesh QAR 94,468 174 Female 4-Feb-73 Single Canada QAR 280,500 175 Female 6-Jun-88 Single Uganda QAR 87,498 176 Male 7-May-84 Single Pakistan QAR 130,748 177 Male 31-Jan-94 Single Uganda QAR 120,691 178 Female 25-Sep-96 Single Lebanon QAR 87,498 179 Male 15-Aug-90 Married Jordan QAR 259,698

Solicitation No. 19QA1024R0014 _ Health & Life Insurance _ Doha

CERTIFICATION REGARDING COMPLIANCE WITH APPLICABLE FEDERAL ANTI-DISCRIMINATION LAW

All Department of State contractors must certify that they do not operate any programs promoting DEI that violate any applicable anti-discrimination laws and agree that such certification is material for purposes of the government’s payment decision and therefore subject to the False Claims Act. See 31 U.S.C. 3729(b)(4).

DIRECTIONS FOR CONTRACTORS and/or OFFERORS

1.Read the entire certification provided below.

2.After you have read the provisions, please check the appropriate boxes.

3.Upon completion of Step 2, fill out the representation below.