Exhibit A - Master IDIQ Agreement No. 0000262.pdf

MASTER IDIQ AGREEMENT BETWEEN N3B

AND

SUBCONTRACTOR

PO 0000262– Off-site Analytical Laboratory Services — Master IDIQ Agreement Date _8_/9 /_2018_

Form 9096, Rev. 1, (06/21/18)

MASTER IDIQ AGREEMENT

BETWEEN

N3B

AGREEMENT NO. PO 0000262

THIS INDEFINITE DELIVERY, INDEFINITE QUANTY MASTER SERVICES AGREEMENT (“Agreement”) No 0000262 (together with the Attachments hereto) dated and effective as of February 1, 2019 (the “Effective Date”), is hereby made and entered into by and between Newport News Nuclear N3B-Los Alamos, LLC (N3B) (hereafter “Contractor”), having a place of business located at 600 6th Street, Los Alamos, NM 87544 and ______________ (hereinafter “Subcontractor”) having a place of business located at _________ (each a “Party” and collectively, the “Parties”).

WHEREAS, Contractor has entered into an agreement (the “Prime Agreement”) with the Department of Energy (the “Owner”) to manage and operate the Los Alamos Legacy Waste Cleanup (LLCC) Project (the “Project”);

WHEREAS, Contractor desires to subcontract for a Master IDIQ Agreement to support its performance of the Prime Agreement to Subcontractor; and

WHEREAS, Subcontractor desires to perform such subcontracted services for Contractor.

NOW THEREFORE, for and in consideration of the foregoing premises and mutual covenants and agreements contained herein, the Parties agree as follows:

1. SERVICES TO BE RENDERED

1.1 Subcontractor agrees to undertake the providing of Off-site Analytical Laboratory Services (“Services”) with the Project in accordance with the terms and conditions contained herein, as may be requested by Contractor in writing from time to time.

1.2 The Services to be performed and the schedule for performance for each task shall be described in one or more authorizations issued to Subcontractor by Contractor.

1.2 The ceiling value of this Agreement is [TBD]. No single order or combination of orders will exceed the ceiling value. Orders shall be placed on a IDIQ basis.

1.3 This is an indefinite-quantity indefinite-delivery subcontract for the supplies or services specified, and effective for the period stated, in Exhibit C or as otherwise specified in a Task Order/Work Authorization.

The quantities of supplies and services specified in Exhibit C are estimates only and are neither guaranteed order quantities nor purchased by this Agreement.

1.4 Except for any limitations on quantities in Exhibit C, there is no limit on the number of orders that may be issued. The Contractor may issue orders requiring delivery to multiple destinations or performance at multiple locations.

2. PAYMENTS FOR SERVICES

2.1 In consideration for providing those Services as specified in a Task Order/Work Authorization issued hereunder, Contractor shall pay Subcontractor pursuant to the rates and charges as set forth in each Task Order/Work Authorization Issued.

2.2 If Subcontractor is a US person (a US individual, corporation, partnership, trust, etc.), Subcontractor must provide to Contractor a completed and signed Form W-9, Request for Taxpayer Identification Number and Certification, or be subject to backup withholding as required by Federal law.

2.3 If Subcontractor is a foreign person (a foreign individual, corporation, partnership, trust, etc.), Subcontractor must provide to Contractor the appropriate Form W-8, or Form 8233 (for non-resident alien individuals providing independent personal services in the US), completed and signed, so Contractor can determine the proper withholding tax as required by Federal law.

2.4 Subcontractor shall be responsible for all reporting and payment obligations with respect to (i) Subcontractor’s personnel relating to worker’s compensation insurance, Social Security, state and federal unemployment insurance, medical-hospital insurance, salary continuation insurance, pension plan costs, and pro rata allowances for vacation and sick leave pay, as well as all other employee benefit programs and (ii) the payment of all sales and use taxes which are measured by the value of Services performed under this Agreement and the applicable Task Order/Work Authorization. Subcontractor shall, when requested by Contractor, furnish Contractor with evidence in a form and substance satisfactory to Contractor that Subcontractor has been paid amounts owed under this Agreement and that all liens and claims have been waived to the extent permitted by law.

2.5 Subcontractor shall render invoices monthly for Services performed during the previous calendar month.

All invoices shall reference this Agreement and, if applicable, the specific task number pertaining to the approved Task Order/Work Authorization. Payment terms will be net forty-five (45) days on all invoiced amounts. Contractor and Subcontractor shall promptly attempt to effect a resolution of any dispute concerning an invoice submitted by Subcontractor and Subcontractor shall provide Contractor with a corrected invoice or additional supporting documentation as necessary. Contractor may withhold payment of that portion of an invoice disputed by Contractor until the dispute has been resolved.

Notwithstanding anything to the contrary in this Agreement, Contractor shall pay Subcontractor the undisputed portion of any invoice only after Contractor receives corresponding payment from Owner.

2.6 Subcontractor agrees to submit invoices that align with the N3B accounting calendar which ends on Friday of each week for subcontractors. Invoices will be based on whole weeks of 4 weeks or 5 weeks closely aligned to the end of each calendar month. N3B will provide a billing calendar to the contractor each year, Subcontractor agrees to bill based on this billing calendar. Invoices will include a summary of charges by individual by week and the supporting details (timesheets, receipts, per diem and other allowable cost detail) by week.

2.7 N3B will provide accurate and timely billing to DOE based on information provided by the Subcontractor.

Therefore, Subcontractor will have a very rigid time reporting and expense reporting systems that provides information on a timely basis to support accurate billing to N3B. If an adjustment to a prior period invoice is required, the adjustment will be submitted on a separate invoice with all supporting details including an explanation of the differences from the weekly invoice information previously submitted.

Adjustments will be the exception and may require additional review time before the invoice is acceptable to N3B.

2.8 Subcontractor will submit weekly time reports by individual to N3B. Initially time reports are be submitted through one of two mechanisms provided by N3B. These time reports are submitted to the N3B manager no later than 10:00 a.m. local time every Monday. N3B provides either a paper time report or access to an electronic time reporting system. It is the intent of N3B to have all Subcontractor time reports submitted electronically, Subcontractor agrees to provide time reports as requested by N3B.

2.9 Invoices shall be submitted as follows:

accountspayable@em-la.doe.gov

3. RESPONSIBILITY FOR SERVICES

3.1 Subcontractor shall perform the Services in accordance with the highest degree of care, diligence, professional skill, practices and judgment that is exercised by recognized professionals in his/her/its field of expertise with respect to services of a similar nature, and Subcontractor shall be responsible for the professional quality, technical accuracy, and completeness of all Services furnished under this Agreement. Subcontractor warrants that such Services shall be free of error or omission, and shall conform to any requirements specified in the applicable Task Order/Work Authorization, and shall not result in or contribute to any infringement of any patent, copyright, trademark or other intellectual property right. In the event that Contractor determines that Subcontractor’s Services have failed to meet any of the above standards, Subcontractor agrees, upon written notice from Contractor, to correct the faulty portion of the Services and that it shall be responsible for all resulting damages and losses, regardless of whether resulting wholly or only partially there from, all at no cost to Contractor and all without prejudice to any other right or remedy. Subcontractor understands that Contractor will rely on the data, findings and recommendations obtained from the Subcontractor under this Agreement. Any and all tools, materials and instruments required to perform the Work shall be furnished by Subcontractor.

4. SAFETY

4.1 Subcontractor acknowledges that safety is of prime importance to Contractor and Owner, and Subcontractor shall cooperate with Contractor and Owner in efforts to prevent injuries to personal and to comply with all applicable safety rules and regulations.

2. INSURANCE

5.1 Subject to written variation by Contractor in an applicable Task Order/Work Authorization, Subcontractor shall effect and maintain during the performance of Services under a Task Order/Work Authorization the insurance coverage’s as identified in Exhibit J.

3. INDEMNITY

6.1 The indemnity clause found in Exhibit B - General Terms shall apply to this Agreement.

4. WAIVER OF CONSEQUENTIAL DAMAGES

7.1 Notwithstanding anything to the contrary in this Agreement or a Task Order/Work Authorization, Contractor shall in no event be liable, whether based on contract, tort, negligence, strict liability, delay, warranty, indemnity, error and omission, or otherwise, for any consequential, special, incidental, indirect, exemplary, punitive or multiple damages, or damages arising from or in connection with loss of use or loss of revenue or profit and Subcontractor hereby releases Contractor from any such liability.

mailto:accountspayable@em-la.doe.gov

5. CHANGES

8.1 Contractor may from time to time modify, extend, enlarge, reduce, shorten or terminate the Services and/or schedule under a Task Order/Work Authorization by written instructions to Subcontractor. In the event Contractor requires Subcontractor to perform additional Services, or make other modifications to the Services, Subcontractor’s compensation, the schedule and any other relevant terms and conditions of the relevant Task Order/Work Authorization shall be subject to mutual negotiation.

6. INDEPENDENT SUBCONTRACTOR

9.1 Subcontractor is an independent contractor. Neither Subcontractor, nor any of its employees, are or shall be deemed to be agents or employees of Contractor or Owner. Subcontractor has sole authority and responsibility to employ, discharge or otherwise control its employees.

7. CONFLICT OF INTEREST

10.1 Subcontractor represents that performance of the Services does not create any conflict of interest with Subcontractor’s other business undertakings, and Subcontractor agrees not to undertake any other assignment from any third party that might create an actual or apparent conflict of interest with performing the Services for Contractor.

8. COMPLIANCE WITH LAWS

11.1 The Services and Subcontractor’s performance thereof shall comply with all applicable Federal, State and local laws, rules, regulations, codes, etc.. In addition, Subcontractor shall comply with all work rules and restrictions established at or for the site of the Services by Contractor or Owner. Subcontractor agrees to indemnify, defend and hold the Indemnified Parties harmless from and against any and all Damages based on or arising out of, in whole or in part, from any violation or alleged violation of law or any noncompliance by Subcontractor under this Article 11, whether based on contract, tort, negligence, strict liability, delay, warranty, indemnity, error and omission, or otherwise.

9. OWNERSHIP OF DOCUMENTS / WARRANTY OF TITLE

12.1 All documents originally prepared by Subcontractor or its subcontractors in the performance of Services under a Task Order/Work Authorization and to be provided to Contractor are "works made for hire" for Contractor under the Copyright Act of 1976, as amended. Contractor shall acquire all right, title and interest in any such document, whether delivered to Contractor or not, and Subcontractor hereby assigns, and will cause each of its subcontractors to assign, to Contractor all right, title and interest in any such document and the copyright therein. Contractor shall have the unrestricted right to use and disclose such information in any manner and for any purpose without any further payment or compensation.

12.2 Subcontractor warrants and represents that any document furnished by Subcontractor or any of its subcontractors in the performance of Services under a Task Order/Work Authorization do not infringe any patent, copyright, trademark or other third party intellectual property rights. Subcontractor shall indemnify, defend and hold the Indemnified Parties harmless from and against any Damages arising out of or relating to any claim of infringement in connection with any document furnished by Subcontractor or its subcontractor in the performance of Services under a Task Order/Work Authorization, subject to applicable law, whether based on contract, tort, negligence, strict liability, delay, warranty, indemnity, error and omission, or otherwise.

10. TERMINATION/SUSPENSION

13.1 Contractor shall have the right (in its sole and absolute discretion) to terminate for its convenience this Agreement or any Task Order/Work Authorization prior to completion of the Services thereunder delivery of written notice to Subcontractor, or upon death or disability of Subcontractor or of any key person performing any Services under a Task Order/Work Authorization. Subcontractor shall stop all Services on the date specified in such notice. In any such event, Contractor shall pay Subcontractor all undisputed amounts due up to the effective date of termination.

13.2 Contractor shall have the right (in its sole and absolute discretion), at any time, to suspend for its convenience performance of all or any part of the Services by giving written notice to Subcontractor.

Subcontractor shall stop all Services on the date specified in such notice. Such suspension may continue for a total cumulative aggregate period of up to twelve (12) months after the effective date of suspension during which period Contractor may request, in writing, Subcontractor to resume performance of the Services. A suspension of Services by Contractor may be the basis for a change pursuant to Article 8.

11. CONFIDENTIALITY

14.1 Subcontractor shall preserve the confidentiality of all information provided by Contractor or Owner or developed or furnished by Subcontractor under this Agreement, and shall restrict the use thereof to those within its organization requiring such use in order to perform the Services. When required by Contractor, Subcontractor shall require its employees and subcontractors, if any, to enter into appropriate similar non-use and non-disclosure agreements. The above restrictions shall not apply with respect to: a) information which is or becomes generally available to the public other than as a result of violation of this Article 14;

b)written information disclosed to Subcontractor hereunder which was in Subcontractor’s possession prior to such disclosure and which was not acquired under an obligation of confidentiality directly or indirectly; c) information received by Subcontractor, from a third party, after the time of first disclosure hereunder and without any obligation of confidentiality directly or indirectly; or d) information which is required by appropriate legal authority to be disclosed (but only to the extent of such requirement).

14.2 Contractor and Subcontractor agree that in the event of a breach of the confidentiality provisions in this Article 14, Contractor shall be entitled to equitable relief, including injunctive relief and specific performance, in addition to all other remedies available at law or in equity.

14.3 In the event the Parties have a separate confidentiality agreement, the more stringent provisions shall apply, notwithstanding Article 17.2.

12. TERM AND OPTIONS TO EXTEND

15.1 Unless otherwise specified, the term of this Agreement shall be February 1, 2019 to January 31, 2020 subject to earlier termination as herein provided. Any Services performed under an existing Task Order/Work Authorization after the expiration of this Agreement shall continue to be governed by the terms of this Agreement.

15.2 The Contractor retains the sole right to exercise the option(s) included in this Agreement. The inclusion of the option(s) does not represent a commitment, financial or otherwise, on the part of the Contractor to exercise any or all of the option(s) nor extend the Agreement beyond the end date specified by the Agreement or most current Agreement amendment. Lacking written notice by the Contractor, the option(s) will expire with the Agreement.

Contractor may exercise one or more of the following options by providing written notice to the Subcontractor prior to the most current Agreement end date:

Option Periods:

February 1, 2020 through January 31, 2021 February 1, 2021 through January 31, 2022 February 1, 2022 through April 28, 2023

13. LIENS

16.1 Subcontractor shall pay when due all labor and material bills, if any, arising from performance of the Services, keep the premises free from any liens, and indemnify, defend and hold the Indemnified Parties harmless from any Damages arising out of any liens or claims for payment, if any, arising from performance of the Services. Should any lien or notice of lien be filed by any person performing labor or furnishing material to the Subcontractor, Contractor shall have the option to (a) retain a sufficient sum to pay and discharge such obligation, or (b) pay and discharge such lien without regard to its validity and to collect from Subcontractor all costs including reasonable attorney’s fee for discharging such lien. In lieu of (a) or (b) above, the Subcontractor at its option may furnish an indemnity bond, approved by Contractor, at Subcontractor’s cost.

14. GENERAL

17.1 Contractor and Subcontractor each represent and warrant that this Agreement has been duly authorized, executed and delivered and constitute its binding agreement enforceable against it.

17.2 Subcontractor shall maintain true and correct records of all reimbursable costs (in accordance with generally accepted accounting principles applied on a consistent basis) pertaining to Subcontractor’s Services under this Agreement and all transactions related thereto, and shall retain all such records for a period of four (4) years from the date of their preparation, or such longer period as may be required by law. Contractor may from time to time make an audit of all records of Subcontractor in connection with the Services rendered under this Agreement. Contractor shall be permitted to make such audits for a period of four (4) years from the date of the preparation of the applicable records, or such longer period as may be required by law. Subcontractor shall assist Contractor in making the above audits. In the event an audit by Contractor results in disallowance of costs, any overpayment that has been made to Subcontractor will be immediately reimbursed by Subcontractor to Contractor.

17.3 This Agreement and Task Order/Work Authorization may not be assigned by Subcontractor in any way, including by operation of law, unless otherwise mutually agreed to in writing, and any such attempted non-authorized assignment shall be null and void and of no force or effect.

17.4 Notices shall be effective hereunder as follows only if in writing and addressed to the Party designated in this provision: (1) upon delivery, if delivered personally to the Party; (2) upon transmission, if transmitted to the facsimile number of the Party; and (3) two business days after posting by registered or overnight mail (postage prepaid). The acceptable addresses for each Party to whom notices are to be delivered are as follows:

CONTRACTOR: N3B

Attention: Matt Cockfield

600 6th Street

Los Alamos, NM 87544

Email: matt.cockfield@em-la.doe.gov

Phone: (505) 551-2867

SUBCONTRACTOR: TBD

17.5 All contract issues and matters of law will be adjudicated in accordance with the laws of the State of New Mexico, excluding any provisions or principals thereof which would require the application of the laws of a different jurisdiction, unless the Parties mutually agree in writing to apply the laws of a different jurisdiction. In the event a dispute arises between Contractor and Owner in connection with the Prime Agreement, Contractor shall have the right to implead Subcontractor into the dispute resolution proceeding and Subcontractor hereby consents and agrees to any such impleader.

17.6 The terms and conditions of this Agreement shall prevail, notwithstanding any variance with any document submitted by Subcontractor whether formally rejected by Client or not. This Agreement may be modified only by amendment when signed by each Party. In the event that any one or more of the provisions of this Agreement shall be found to be illegal or unenforceable, the remaining provisions of this Agreement shall remain in full force and effect, and such term or provision shall be deemed stricken only to the extent and in the jurisdictions necessary for compliance with applicable law. In such a case Contractor and Subcontractor shall meet in a good faith effort to amend this Agreement so that it will comply as nearly as is then legally possible with its original provisions.

17.7 Nothing in this Agreement shall be construed to give any rights or benefits to anyone other than Contractor or Subcontractor.

17.8 The headings in this Agreement are for convenience only, and shall not affect the interpretation hereof.

17.9 The provisions under the Articles for Responsibility for Services, Confidentiality, Limitation of Liability, Insurance, Waiver of Consequential Damages and Indemnity and any other provisions of this Agreement and/or Task Order/Work Authorization(s) providing for limitation of or protection against liabilities between the Parties hereto shall survive termination of this Agreement and/or completion of the Services hereunder.

17.10 This Agreement and any executed Task Order/Work Authorizations supersede all prior written and/or oral contracts and agreements that may have been made or entered into between Contractor and Subcontractor regarding the subject matter hereof, including but not limited to any and all proposals, oral or written, and all communications between the Parties relating to this Agreement or any Task Order/Work Authorization, and constitutes the entire agreement between the parties hereto with respect to the subject matter hereof. No amendment to this Agreement or any Task Order/Work Authorization shall be enforceable unless in writing and signed by both Parties hereto. Subcontractor shall have accepted this Agreement, provided that Subcontractor has received this Agreement and either a) received payment; or

b) started performance of the services.

18. FOREIGN NATIONALS

As used in this article, the term “Foreign National” is defined to be a person who was born outside the jurisdiction of the United States, is a citizen of a foreign nation and has not been naturalized under U.S.

law.)

18.1. The Subcontractor shall obtain the approval of Procurement Representative, in writing, prior to any visit to a DOE or Contractor Operated facility by any Foreign National in connection with work being performed under this Subcontract, in accordance with the requirements of DOE Order 142.3, Unclassified Foreign Visits and Assignments Program. Visits are normally for the purpose of technical discussions, orientation, observation of projects or equipment, training, Subcontract service work, including delivery of materials, or for courtesy purposes. The term visit also includes officially-sponsored attendance at a DOE or Contractor event offsite from DOE/SRR facility, but does not include offsite events and activities open to the general public. Subcontractor should be aware that required forms and documents necessary for approval of visits by Foreign Nationals should be submitted to the Contractor Procurement Representative at least four (4) to six (6) weeks prior to the visit, depending on the nationality of the individual and the areas to be visited. Forms can be obtained from the Procurement Representative.

18.2. In addition, the Subcontractor shall obtain the approval of the Contractor Procurement Representative, in writing, prior to the employment of, or participation by, any Foreign National in the performance of work under this Subcontract or any lower tier Subcontract at off-site locations. Such approvals will be processed in accordance with the requirements of DOE Order 142.3.

18.3. In the performance of offsite work, Foreign Nationals only incidentally involved with the Subcontract knowledge that their activities are associated with the Subcontract work, are exempt from the above provisions.

19. SECURITY AND SITE ACCESS, APPLICABLE FOR ONSITE WORK

19.1 All persons on the LLCC project site are required to have a DOE identification badge and a General Employee Training (GET) badge. These badges are required for access through the DOE security gate and must be worn, visible at all times while on DOE property.

19.2 There are no known radiological hazards on the LLCC site; therefore, no other badges or training are required at this time for general access to the LLCC site.

19.3 DOE identification Badge – Subcontractor employees will be photographed when they first report to work.

At the present time it takes approximately two weeks for the badge to be issued after the picture is taken.

Contractor is attempting to shorten this turn-around time. Subcontractor employees and visitors who do not have a DOE badge may be escorted onto the LLCC site by Subcontractor employees who are properly badged. Each escort is allowed to escort up to three unbadged individuals at one time. The individuals being escorted must remain within the escort person’s field of view at all times.

19.4 There is no charge for issuing DOE Badges. However, since unauthorized possession of a DOE identification badge is a serious security issue, the Subcontractor will be assessed an administrative fee of $250.00 for each DOE identification badge which is not returned at the completion of the Subcontractor’s task or upon Subcontractor employee termination.

19.5 GET and Site Access Badging - When Subcontractor employees first report to work at the LLCC site they will be required, in addition to being photographed for the DOE identification badge, to attend a site orientation lecture, followed by a computerized test (approximately two (2) hours in total). After attending the orientation lecture and successfully completion of the test, the Subcontractor employee will be issued a GET and Site Access badge. This badge attests that the Subcontractor employee has received the basic safety and security training required for access to the site. Unlike the identification badge, the GET badge is transportable between subcontractors on the LLCC site and is valid for two years from the date of issue. Subcontractor employees must retake the orientation lecture and test prior to the expiration date of their badge or if their badge is rescinded for safety/security violations. A certificate of completion of GET is also provided to the Subcontractor employees. If the GET badge is lost, this certificate may be used as evidenced of GET certification pending issuance of a new badge.

20. FAIR OPPORTUNITY PROCEDURES

20.1 The Contractor will give all subcontractors that were awarded a similar subcontract a fair opportunity to be considered for each task order, except as otherwise provided in Section (20.5) of this clause.

20.2 When giving subcontractors a fair opportunity the Contractor may consider technical approach, past performance, management approach, personnel experience, and cost/price factors. However, the Contractor might not consider all of those factors together.

20.3 The Contractor 's objective is to keep task order selection procedures simple and inexpensive for all parties to the subcontract. Thus, as a general rule, the Contractor will consider subcontractors based on

(1) information already in its files, (2) price quotations, and (3) past performance under prior orders. The Contractor reserves the right to use more formal procedures when it considers them to be necessary.

20.4 After it selects a subcontractor for a task order, the Contractor may discuss the details of task plans and procedures and negotiate prices with the subcontractor before issuing the task order. If the Procurement Representative is not satisfied with the progress or outcome of those discussions or negotiations, the Contractor may reconsider its task order selection decision and then select a different subcontractor.

20.5 The Contractor shall give every awardee a fair opportunity to be considered for a delivery-order or task-order exceeding $10,000 unless one of the following exceptions applies:

20.5.1 The Contractor need for the supplies or services is so urgent that providing a fair opportunity would result in unacceptable delays.

20.5.2 Only one awardee is capable of providing the supplies or services required at the level of quality required because the supplies or services ordered are unique or highly specialized.

20.5.3 The order must be issued on a sole-source basis in the interest of economy and efficiency because it is a logical follow-on to an order already issued under the subcontract.

20.5.4 The Owner, a policy, or a regulation expressly authorizes or requires that the purchase be made from a specified source.

20.5.5 Contractor may, at its discretion, set aside orders for any of the small business concerns identified in FAR 19.000(a)(3).

21. EXHIBITS AND ATTACHMENTS

21.1 The following Exhibits, Attachments, and Forms which are attached hereto are subcontract documents and incorporated by this reference into this Agreement as if fully set forth herein.

Exhibit B: General Conditions

Exhibit C: Schedule of Quantities and Pricing

Exhibit D: Statement of Work & Technical Specifications

Exhibit F: Environmental Safety & Health Requirements

Exhibit G: Physical Security Low Risk Security Requirements

Exhibit H: Quality Assurance Requirements

Exhibit I: Attachment A – Subcontractor Transmittal Status Sheet

Exhibit I: Attachment B – Offsite Analytical Lab Scope Subcontractor Submittal Request

Exhibit J: Insurance

Attachment 6 to Exhibit D: Chain of Custody/Analysis Request

IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly executed by their duly authorized representatives, effective as of the day and year first above mentioned.

SUBCONTRACTOR:

By:

Name:

Title:

Date:

CONTRACTOR: N3B

By:

Name:

Title:

Date: