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t3Al � Sales Representative S0 L U T 1 0 N S ;AAG Account 1 Site Number Document Shredding Service Frequency Additional Pick Up Description 4x Per Waste Container Size Additional Pick Up Fee Medium Price/Container/Pick Up Additional Container Charge NA OSHA Compliance Number of Employees Mock Compliance Walkthrough ®1-10 ❑11-50 ❑51-100 ❑100+ ❑Yes p No Type of Office ❑Medical ❑Dental Other Charge/Location Scheduling of training and walk-through are the responsibility of the customer,one per year $599 Per Year(only upon request of customer) unless otherwise specified Waste Planning Solid Waste Consulting Additional Notes Medical Waste Management Plan Formation #of Locations Estimated Hours Needed For Planning Total Charge ❑Submissions to Regulatory Agencies Hazardous Waste 4x Per Pick Up Fee NA Price I Container Size NA By signing below i affirm that I am authorized,the authorized officer or agent of the Customer and have the authority to bind the Customer to this Agreement.The Customer hereby agrees to be bound to the terms and conditions that appear on the second page hereof and comply with Waste Stream Solutions'Waste Acceptance Policy,both of what are integral parts of this Agreement. Contract Effective Date Customer Initials Customer Date Name(print) Title z i 9/3 Tatl k / Waste Strea olutions Agent Date Name(pant) Title 02/18/2013 Aldo Gonzalez Regional Accounts Manager Waste Stream solutions reserve the right to deal solely with the customer and not with any third party agents of the customer for all purposes relating to this agreement. Customer represents and warrants to Waste Stream Solutions that it is the medical waste generator and is acting for its own account and not to avoid liquidated damages, in the amount set forth herin for Customer's breach of representation and warranty. PO Box 1015 Claremont,CA 91711-Phone:800-550-0559