AGREEMENT

This Agreement is executed by and between:

AVENTUS MEDICAL CARE, INC., a corporation duly organized

and existing under Philippine Laws, with principal offices at Room 301
3rd Floor, Comfoods Building, Sen. Gil Puyat Avenue, Cor. Chino Roces
St., Makati City herein represented by its Manager-Operations,
DWIGHT ANDY YUTANKIN, and hereinafter referred to as the
“AVENTUS”;

- And -

(Name of company), a corporation organized and existing

under the Philippine Laws, with principal offices at the (Principal
address of the company), herein represented by its (Designation of
authorized signatory), (NAME OF AUTHORIZED SIGNATORY), and
hereinafter referred to as “COMPANY”.

-And-

Intellicare, the company’s HMO provider, a corporation

organized and existing under the Philippine Laws, with principal offices
at the 4th Floor Feliza Building V.A Rufino St. Legaspi Village Makati
City, herein represented by its Assistant Vice President APE Section-
Account Management Dept. ROLANDO F. SAN JUAN JR., and
hereinafter referred to as “Intellicare”.

WITNESSETH

WHEREAS, AVENTUS is engaged in the business of providing medical, dental and health services;

WHEREAS, the COMPANY desires to engage the services of AVENTUS to conduct specimen
collection to its employees at its premises;

WHEREAS, AVENTUS has offered and the COMPANY has accepted the services of AVENTUS to
conduct specimen collection to its employees under the terms and conditions hereinafter stipulated;

NOW, THEREFORE, for and in consideration of the foregoing, the mutual covenants, agreements
and stipulations hereinafter set forth, the parties hereto agree as follows.

1. The COMPANY shall provide AVENTUS with a temporary clinic site within the COMPANY’s
premises at (address of the company and its specific floor number if there’s any), wherein the
specimen collection shall be conducted. The COMPANY shall ensure the privacy of the clinic site
for the conduct of the specimen collection.

2. AVENTUS shall conduct specimen collection to the COMPANY’s employees at the clinic site on
(date) from (time schedule).

3. For and in consideration of the services rendered under this Agreement, the HMO provider of
(company name) shall pay AVENTUS the following fees:

a. Remote Collection Application Fee- 500 per site(valid for 14 calendar days only)

4. The HMO PROVIDER OF THE COMPANY shall pay the fees under Section 3 here of within thirty
(30) days from receipt of the Statement of Account issued by AVENTUS. Failure to pay within the
said thirty (30) day period shall entitle AVENTUS to impose interest on any unpaid amount at the
rate of twelve percent (12%) per annum until fully paid.

5. AVENTUS shall conduct the specimen collection only to COMPANY employees who are able to
present their HEALTHCARD OR ANY VALID ID, or is included in the list of employees to be
submitted by the COMPANY to AVENTUS through their HMO provider.

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 6. The COMPANY hereby warrants that the conduct of the specimen collection on its employees
under this Agreement is in accordance with the COMPANY’s existing laws, rules and regulations,
and guidelines issued by the Department of Labor and Employment. The COMPANY shall hold
AVENTUS free and harmless from any claim, liability or penalty arising from the COMPANY’s
breach of this warranty.

7. AVENTUS shall deliver to the COMPANY the results of the specimen collection within twenty (20)
working days from the last day of the specimen collection was conducted. The COMPANY hereby
warrants that it has secured the necessary consent from its employees to conduct the specimen
collection and to receive the results of the latter procedures.

8. Both parties shall comply with all applicable laws and regulations.

IN WITNESS WHEREOF, both parties have executed this Agreement on the _____day of
________, 2019 at ___________________, Philippines.

AVENTUS MEDICAL CARE, INC. (NAME OF COMPANY) INTELLICARE

DWIGHT ANDY YUTANKIN (NAME OF AUTHORIZED SIGNATORY) ROLANDO SAN JUAN JR.
Manager-Operation (Position) Assistant Vice President
APE Section - Account
Management Department

REPUBLIC OF THE PHILIPPINES)

CITY/MUNICIPALITY OF ______) SS.

ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in the (Province/City/Municipality) of _____________ this
__date__ personally appeared.

Name CTC/Passport No./SSS No. Issued on/at

1. (NAME OF AUTHORIZED SIGNATORY) ______________________ ________________________

2. Mr. Rolando San Juan Jr. 33-6609521-9 ________________________
3. Mr. Dwight Andy Yutankin 34-1133676-8 ________________________

known to me and to me known to be the same person who executed the foregoing instrument
for and in behalf of said corporation, and (he/she) acknowledged to me that the same is the free and
voluntary corporate act and deed of the companies they represent for uses and purposes therein set
forth.

This Instrument consists of only two (2) pages, including this page in which this
Acknowledgement is written, duly signed by both parties and his instrumental witnesses on each and
every page hereof.

WITNESS MY HAND AND SEAL this _____________ at _____________, Philippines.

NOTARY PUBLIC

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of ______;

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