Fill and Sign the Transition Agreement by and between the Registrant and Secgov Form

ACKNOWLEDGMENT FORM FOR CONSULTANTS/INDEPENDENT CONTRACTORS I acknowledge that I am not an employee of [Company] or its parent or any affiliate, but have the following status. (Check appropriate box): I am an employee of: I am a consultant/independent contractor to: I am a self-employed consultant/independent contractor. I understand that I am not an employee of the Company and it is not responsible for paying my salary and withholding appropriate taxes, or paying Social Security, Workers’ Compensation, state disability, and unemployment, or for providing any benefits on my behalf or on behalf of my spouse or dependents, including those that may be legally required. Such obligations are the responsibility of the agency/consulting firm by which I am employed, or if self-employed, my own obligations.I also expressly acknowledge and agree that because I am not an employee of the Company, I am not entitled or eligible to participate in any of the Company’s employee benefits programs (nor are my spouse or any dependents). I hereby waive all rights to such benefits, including any right to file a claim for any employee benefits under the Employee Retirement Income Security Act, applicable state or local law, or under any company policy, practice, procedure, or program.I understand and agree that should I ever apply for or be formally offered and accept employment with the Company, I would become eligible to participate in the Company’s employee benefits programs at that time, in accordance with the terms of each plan and company policies, practices, procedures, and programs.Name: Date: Please Read This Acknowledgment Form Carefully Before Signing.Signature: Company Representative: Date: