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WEBSITE REDESIGN PROJECT PLANNING June 2020
Request for Proposal (RFP) For
Website Redevelopment
ISSUED BY THE
NEW YORK eHEALTH COLLABORATIVE
APPLICATION INFORMATION
CONTACT NAME NYeC
EMAIL ADDRESS [email protected]
SUBMISSION DEADLINE July 20, 2020
All correspondence and proposals should be submitted via email directly to the email address listed above and include ‘Website Redevelopment’ in the
subject line.
WEBSITE REDESIGN PROJECT PLANNING June 2020
I. STATEMENT OF PURPOSEThe New York eHealth Collaborative (NYeC) is seeking applications from experienced websitedevelopment firms for the redevelopment and restructuring of the New York eHealthCollaborative’s website, www.nyehealth.org. Applications should include how the firm plans to:
• Redevelop the website using recommendations from a supplied external website audit(to be supplied to potential applicants that submit a letter of intent and execute a Non-Disclosure Agreement; see “Section V. Mandatory Requirements” for furtherinformation)
• All work must be done in complete alignment with Americans with Disabilities Act (ADA)compliance requirements and must comply with New York State Enterprise IT Policy NYS-P08-005, Accessibility of Web-Based Information and Applications, as such policy may beamended, modified or superseded from time to time (NYS Enterprise IT Policy).
• Give high-level review and advisement on select top page content (homepage, about,programs, careers) to streamline messaging, as well as complete content migration ofblog posts and other content areas
• Include plugins or other functionality means for seamless integration of social media,forms, and photography/videography media
• Build a site that will be largely maintained and updated internally by NYeC staff
II. INTRODUCTION
NYeC is a non-profit organization, working in partnership with the New York State Departmentof Health to improve healthcare by collaboratively leading, connecting, and integrating HealthInformation Exchange (HIE) across the state.
NYeC is New York State’s designated entity who leads the advancement of the Statewide HealthInformation Network of New York (SHIN-NY), a network connecting healthcare professionalsstatewide. The SHIN-NY connects all of the regional health information organizations (RHIO),or Qualified Entities (QEs), which allow participating healthcare professionals, with patientconsent, to quickly access electronic health information and securely exchange data with anyother participant. Each QE operates its own network that aggregates data from electronic healthrecords (EHRs) from participating providers in their regions. They are interconnected through aSHIN-NY hub via the statewide patient record lookup (sPRL). The hub is an orchestration andsecurity appliance. Together, the QEs collect and exchange data from acute care hospitals in NewYork State, provider systems, individual providers, laboratories, public health departments andother data sources such health insurance payers.
WEBSITE REDESIGN PROJECT PLANNING June 2020
As the health data interoperability landscape continues to evolve there is an increasing need for innovation and collaboration in the market to allow data to be exchanged more effectively. To meet these needs, NYeC has developed a set of ambitious goals outlined in the SHIN-NY 2020 Roadmap, which outlines five strategies that together will allow NYeC to support the evolving health information exchange landscape. These strategies: ensuring a strong foundation for HIE within New York State, supporting stakeholder needs, enabling interoperability and innovation, promoting efficiency and affordability and collective advocacy, all support the need to understand the advances in interoperability and partnership that are being promoted nationally.
III. BACKGROUND INFORMATION
As the organization’s primary and most visible communications vehicle, www.nyehealth.org iskey to showcasing the value, utility, and success of the SHIN-NY. It serves to inform stakeholdersand the general public of our efforts to advance health information technology (HIT) and healthinformation exchange (HIE) policies and standards, as well as providing information aboutprovider assistance programs and opportunities offered by NYeC.
We are seeking an experienced website developer to redevelop, restructure, and redesign awebsite for NYeC that reflects a more dynamic, user-friendly, and engaging web experience thatallows NYeC to significantly improve the organization’s ability to educate stakeholders, articulatethe organization’s work, and highlight the value of the SHIN-NY.
Specifically, the redeveloped website will reflect:• An improved user experience through a reorganized site architecture and overall design
functionality reflective of current industry best practices• High-level content overview with content migration• Alignment with objectives to increase awareness of NYeC and convert users looking for
more information• Follows and responds to recommendations and findings from supplied website audit
conducted in early 2020
IV. ELIGIBILITY CRITERIARequired skills and qualifications:
• A minimum three years’ experience in website development and design and;• Able to register in the Federal System for Award Management (SAM) prior to
commencement of work, if selected and;• Able to complete the New York State Vendor Responsibility Questionnaire and;
WEBSITE REDESIGN PROJECT PLANNING June 2020
• The selected vendor will be required to adhere to certain New York State grant contractand confidentiality requirements specific to the initiative. These requirements will beoutlined in the vendor contract.
Preferred skills and qualifications: • Previous experience with clients in the non-profit, healthcare and/or information
technology (IT) fields
V.MANDATORY REQUIRMENTS
NYeC is requiring applicants to submit a letter of intent (LOI) and a signed Non-DisclosureAgreement in order to receive the findings of the external website audit the organizationperformed in early 2020. The LOI template and Non-Disclosure Agreement can be found inAppendix A and B of this RFP. The completed LOI and NDA must be submitted [email protected] by July 6, 2020. After an internal review and approval ofthese documents, the applicant will receive the full external audit report, “NYeC Website PlanningAudit March 2020”. The submission of the completed LOI and Non-Disclosure Agreement aremandatory in order for the applicant’s proposal to be considered for review.
VI.SCOPE OF WORKApplicants should provide NYeC with a proposal that addresses all of the areas outlined in SectionVII. Contents of Proposal for a redeveloped website.
Specifically, the redeveloped website will reflect: • An improved user experience through a reorganized site architecture and overall design
functionality reflective of current industry best practices• High-level content overview with content migration• Alignment with objectives to increase awareness of NYeC and convert users looking for
more information• Follows and responds to recommendations and findings from the supplied website audit
conducted in early 2020
VII. CONTENTS OF PROPOSAL
The following section outlines the contents that should be included in proposals for the requested redeveloped website.
1. Applicant Overview and Qualifications:
WEBSITE REDESIGN PROJECT PLANNING June 2020
The proposal should provide a general overview of the applicant’s capabilities, resources, and experience. The ideal applicant will have at least three years website development and design experience, expert familiarity with current SEO best practices, and ADA and NYS Enterprise IT Policy compliance standards. Applicants should include a brief narrative that demonstrates the organizations clear understanding of the scope of website redesign and the redesign and redevelopment of this particular website. Additionally, the applicant must provide samples of website architecture projects to demonstrate background, experience, and expertise in the following areas:
o Website development and designo Current SEO best practiceso Current ADA and NYS Enterprise IT Policy compliance standards and best practiceso Developing websites using the WordPress content management systemo If applicable, experience with clients in the non-profit, healthcare and/or
information technology (IT) fields
2. Approach and Plan:The proposal should include a thorough, detailed approach and plan to redevelop the websiteusing recommendations from the NYeC-supplied external website audit, completed in early2020, with guidance on SEO, user experience, architecture/wireframes, and accessibility.
o The plan and approach should specifically address the key website redevelopmentinsights and recommendations detailed in the audit, including the need for: A re-envisioned site architecture based on data that reflects what users are
seeking, better engaging them and increasing conversions (e.g. campaignlanding page lead form fills, subscriptions to the NYeC eNewsletter, etc).
Development of content that allows users to identify themselves and,therefore, select a content-specific path (audience pathways) to addressNYeC’s three primary users: providers, stakeholders, and patients. Thiscontent should be simple, welcoming, and informational, giving NYeC theopportunity to lead with authority while seeming approachable.
Development of user-friendly content that engages users with simple,welcoming language that starts at a high-level and dives deeper intotechnical or industry-known terms as users become more familiar NYeC andthe SHIN-NY.
A refreshed sitemap and a true content refresh. Migrated content will needto be purposefully mapped out and updated.
o The plan and approach should focus on creating an improved user experience thatfollows best practices while aligning with organizational objectives to increaseengagement and conversions with target audiences, which include:
WEBSITE REDESIGN PROJECT PLANNING June 2020
Healthcare professionals and users of the Statewide Health InformationNetwork for New York (SHIN-NY) e.g. physicians, nurses, CIOs,administrators, and senior leaders at hospitals, health plans, clinics,Federally Qualified Health Centers (FQHCS), home care agencies, andcommunity-based organizations, among others.
Key Stakeholder Populations e.g. healthcare industry associations, state andlocal government agencies, elected officials, and policy makers
General public (including patients/consumers) and the mediao The plan must include a project management outline, including planned project
management tools, approach, and requirements of NYeC during buildo The plan must include:
A variety of page templates to showcase content in a multitude of ways,including storytelling, infographic/fact sharing, etc.
SEO integration with the website back-end including staff training onbuilding content in an optimal SEO environment
Approach to ensuring the website is in compliance with the Americans withDisabilities Act and meets NYS Enterprise IT Policy compliance standards
o Applicants must include a plan for providing quality assurance outline and contentmanagement strategy (CMS) training to up to five NYeC staff on front-end sitefunctionality, a testing phase for content population, quality assurance period, bugfixes, and as needed post-launch corrections for a period of 30 business days
3. Cost:The proposal must include a detailed budget for complete website redevelopment andredesign, including hourly rate and estimated hours of time. This should also include anypotential additional plug-in or integration purchases/costs. List of plugins or other functionalitymeans required for seamless integration of social media, forms, and photography/videographymedia
VIII. APPLICATION PROCESS AND TIMELINE
Proposals will be evaluated by a selection committee. Proposals that do not address all thecriteria below may not be evaluated by NYeC.
Proposal submissions are due July 20, 2020. Organizations may only contact NYeC using the email address [email protected] for all matters concerning this RFP.
WEBSITE REDESIGN PROJECT PLANNING June 2020
If you have questions about the application, please submit those questions to the designated mailbox noted on the cover page of the RFP by June 26, 2020 by 12 p.m. EST and NYeC will post all questions received and answers to those questions by July 1, 2020 by 5 p.m. EST to https://www.nyehealth.org/resources/rfps/.
NYeC reserves the right to amend or cancel this RFP at any time prior to a signed contract. NYeC is not responsible for any costs incurred in the preparation of a response to this RFP.
Please submit your application in Microsoft Word format using font size 12 with a maximum of 10 pages. Samples of previous work may be included in addition to the 10 pages, though may not exceed three examples. All valid applications must include all sections identified in the evaluation criteria.
Item Due Date RFP Release June 18, 2020 Deadline to submit Questions to NYeC June 26, 2020 by 5 p.m. EST Q&A Document posted July 1, 2020 by 5 p.m. EST Last day to submit Letter of Intent and NDA July 6, 2020 by 5 p.m. EST Proposal due July 20, 2020 by 5 p.m. EST
IX. EVALUATION CRITERIA
All proposals are to address and be evaluated upon the following criteria (10-page maximumproposal length) as it relates to Section VI. Contents of Proposal.
A. Website Redevelopment Project Plan – 50 points
B. Expertise and Unique Qualifications to lead redesign – 30 points: Samples of websitearchitecture projects to demonstrate previous experience are not included in themaximum page count of 10 pages.
C. Cost – 20 points:
APPENDIX A: Letter of Intent
__________________________________
Name of Potential Applicant
On behalf of the above-named potential applicant for the Website Redevelopment RFP, the undersigned hereby attests and represents as follows:
1. I have reviewed the Website Redevelopment RFP and provided the attached information (i.e. resume) to demonstrate that the above-named potential applicant meets all of the eligibility requirements listed in RFP as noted in Section V. Mandatory Requirements; and
2. I have reviewed and signed the “Mutual Non-Disclosure Agreement” on behalf of the above-named potential applicant; and
3. I understand and acknowledge that Confidential Information as defined in the “Mutual Non-Disclosure Agreement” includes, but is not limited to, NYeC Website Planning Audit March 2020, which will be provided by NYeC to the above-named potential applicant; and
4. I have the authority to make such attestation on behalf of the above-named potential applicant.
Signature: ______________________________________
Name: ______________________________________
Title: ______________________________________
Date: ______________________________________
Appendix B
MUTUAL NON-DISCLOSURE AGREEMENT This Mutual Non-disclosure Agreement (“Agreement”) is made and entered into as of this ___ day of [MONTH], 2020 by and between New York eHealth, Collaborative Inc., a New York not-for-profit corporation , having its principal place of business at 99 Washington Avenue, Suite 1750, Albany, New York 12210, and _____________________, a _____________ having its principal place of business at ________________________________ .
WHEREAS, both parties are interested or involved in the evaluation of a potential transaction or similar exchange being discussed or negotiated by and between them (the “Transaction”); and
WHEREAS, in connection with the Transaction, either party (the “Disclosing Party”) has disclosed or may disclose, and the other party (the “Recipient”) may have access to or otherwise come in contact with, confidential or proprietary information of or concerning Disclosing Party (the “Confidential Information,” as further defined in paragraph 1).
NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto agree as follows:
1. CONFIDENTIAL INFORMATION
a. Definition. Confidential Information means all information, whether in written, oral, visual, magnetic, electronic or any other form, furnished prior to or after the date hereof by or on behalf of Disclosing Party or its trustees, members, managers, directors, officers, partners, associates, affiliates, employees, agents or representatives (collectively, “Representatives”) to Recipient or Recipient’s Representatives, and all reports, analyses, compilations, studies and other materials prepared by Recipient (in whatever form maintained, whether documentary, computer storage or otherwise) containing, reflecting or based upon, in whole or in part, any such Confidential Information. Confidential Information includes, without limitation, with respect to Disclosing Party and any entities Disclosing Party controls, manages or owns, in whole or in part: (a) financial information, business models, pricing and margin formulae, business line or customer profitability, promotion plans, sales and marketing plans, financing and capital plans, plans for existing business lines, future business and marketing plans, and customer lists; (b) all information related to company structure, owners, management, employees, assets, income and expenses including, without limitation, business, corporate, and operations; (c) know-how, techniques,
methods, information tools, software development, trade secrets, technology, potential products, potential business operations, technical information, inventions, product design information, and all other intellectual property information or data; and (d) all information, that, if released to unauthorized persons, could be detrimental to the business interests of Disclosing Party, its customers or clients. Mingling Confidential Information with information of Recipient shall not affect the confidential nature or ownership of the Confidential Information.
b. Exceptions. The term “Confidential Information” does not include information which Recipient can document: (i) is or becomes generally available to and known by the public other than as a result of a disclosure by Recipient, its Representatives, anyone to whom Recipient or any of its Representatives transmits any Confidential Information in violation of this Agreement or any third party in violation of Disclosing Party’s rights; or (ii) is or becomes known or available to Recipient on a non-confidential basis from a source (other than Disclosing Party or one of its Representatives) who acquired the Confidential Information in a lawful manner without any violation of Disclosing Party’s rights and who is not prohibited from transmitting the information to Recipient or its Representatives by a contractual, legal or fiduciary obligation or otherwise in violation of Disclosing Party’s rights. For the purposes of this paragraph 1(b), Confidential Information shall only be deemed to be generally available to and known by the public if: (a) more than certain individual features or components of such Confidential Information are or become known to the public; and (b) such Confidential Information is contained in documents, materials or disclosures of general circulation and generally accessible to the public.
2. REPRESENTATIVES. Recipient may disclose Confidential Information to Recipient’s Representatives who are approved in advance by Disclosing Party and only if and to the extent that such Representatives reasonably need to know the Confidential Information to assist Recipient with the Transaction. Recipient shall inform such Representatives of the confidential nature of the Confidential Information and the terms of this Agreement and such Representatives shall agree in writing to be bound by this Agreement, including the restrictions on disclosure set forth herein. Recipient shall be responsible for any actions by its Representatives which are not in accordance with these provisions.
3. PERMITTED USE. Recipient and its permitted Representatives will review and use Confidential Information solely as necessary to proceed with the Transaction and for no other purpose.
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4. OBLIGATIONS OF RECIPIENT.
a. Handling. Recipient shall, and shall cause each permitted Representative to: (i) regard and preserve as confidential all Confidential Information which may be obtained from any source as a result of this Agreement; (ii) treat Confidential Information with the same degree of care with which it treats its own confidential information, and in no case less than a reasonable degree of care; (iii) not alter, decompile, disassemble, reverse engineer, or otherwise modify any Confidential Information; (iv) not remove any copyright notice, trademark notice, and/or other proprietary legend or indication of confidentiality set forth on or contained in any of the Confidential Information; (v) not, without Disclosing Party’s prior written consent, disclose or make available to any person, firm or other entity, reproduce or transmit, or use (directly or indirectly) for its own benefit or the benefit of others, any such Confidential Information in whole or in part; and (vi) promptly advise Disclosing Party in writing of any unauthorized use or disclosure of Confidential Information of which Recipient becomes aware and shall provide reasonable assistance to Disclosing Party to stop such unauthorized use or disclosure.
b. Related Facts. Without Disclosing Party’s prior written consent, Recipient will not disclose to any third party, other than its permitted Representatives pursuant to paragraph 2, (i) that this Agreement exists, that the Confidential Information has been made available to Recipient, or that Recipient has inspected any portion of the Confidential Information, (ii) that any discussions or negotiations are taking place concerning any possible Transaction between Recipient and Disclosing Party, including the status thereof or the termination or discussions or negotiations, or (iii) any of the terms, conditions or other facts with respect to any possible Transaction.
c. Communications with Employees. Recipient agrees that neither it nor any of its Representatives will initiate or cause to be initiated any communications with any employee of Disclosing Party concerning the Confidential Information or any facts or information referred to in subparagraph b above or any information relating to a possible Transaction, without Disclosing Party’s prior written consent.
5. LEGALLY COMPELLED DISCLOSURE. If Recipient or any of its Representatives are legally required (by oral questions, interrogatories, requests for information or documents, subpoena, civil investigative demand or similar process) to disclose any Confidential Information or any facts or information referred to in paragraph 4b above or any information relating to a possible Transaction or such person’s opinion, judgment, view or recommendation concerning Disclosing Party or any of its Representatives as developed from the Confidential Information, Recipient will promptly notify Disclosing Party of such requirement so that Disclosing
Party may seek to avoid or minimize the required disclosure and/or to obtain an appropriate protective order or other appropriate relief to ensure that any information so disclosed is maintained in confidence to the maximum extent possible by the agency or other person receiving the disclosure, or, in the discretion of Disclosing Party, to waive compliance with the provisions of this Agreement. Recipient will use its reasonable efforts to cooperate with Disclosing Party or otherwise to avoid or minimize the required disclosure and/or to obtain such protective order or other relief. If, in the absence of a protective order or the receipt of a waiver hereunder, Recipient or any Representative is compelled to disclose the Confidential Information or else stand liable for contempt or suffer other sanction, censure or penalty, Recipient will disclose only so much of the Confidential Information to the party compelling disclosure as Recipient believes in good faith on the basis of advice of counsel is required by law. Recipient shall give Disclosing Party prior notice of the Confidential Information Recipient believes Recipient or its Representative is required to disclose.
6. RETURN. Upon request of Disclosing Party at any time, and in any event upon termination of the Transaction or in the event that the Transaction is not consummated, Recipient shall return to Disclosing Party all originals as well as copies of all Confidential Information and any tangible material containing, prepared on the basis of, or reflecting, in whole or in part, any such Confidential Information, or reflecting Recipient’s or its Representatives’ review of, or interest in, a Transaction including, without limitation, all reports, analyses, compilations, studies (in whatever form maintained, whether documentary, computer storage or otherwise) that are in Recipient’s or its Representatives’ possession or control; provided, that Recipient may, upon prior written approval of Disclosing Party, destroy certain Confidential Information in lieu of its delivery to Disclosing Party. Notwithstanding the delivery or destruction of Confidential Information, Recipient will continue to be bound by its obligations of confidentiality and other obligations as required hereunder. Thereafter, Recipient shall not reveal, publish, use or disclose to anyone else, directly or indirectly, any Confidential Information, or permit or assist, by acquiescence or otherwise, anyone else to reveal, publish, use or disclose, directly or indirectly, any such Confidential Information. Recipient shall certify in writing to Disclosing Party that all such Confidential Information has been returned or destroyed, as the case may be, in accordance with this paragraph.
7. DISCLAIMER. Recipient acknowledges that neither Disclosing Party nor its Representatives make any representation or warranty as to the reliability, accuracy or completeness of the Confidential Information. Neither Disclosing Party nor its Representatives shall be liable to Recipient or any of its Representatives in any manner whatsoever in connection with any decisions, obligations,
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costs or expenses incurred, changes in business practices, plans, organization, products, services, or otherwise, based on Recipient’s decision to use or rely on any Confidential Information provided hereunder.
8. OWNERSHIP. Confidential Information shall be deemed the sole property of Disclosing Party, who hereby reserves all right, title and interest in and to the Confidential Information. Recipient shall not hold itself out as having any ownership rights with respect thereto or any other rights therein. Any and all goodwill associated with any such rights shall inure directly and exclusively to the benefit of Disclosing Party. It is hereby expressly understood, agreed and acknowledged that neither this Agreement, nor any disclosure of information under it, will be construed as creating, conveying, transferring, granting or conferring upon Recipient, any rights, license or authority in or to any Confidential Information.
9. INDEMNIFICATION. Recipient agrees to indemnify and hold Disclosing Party and each of its Representatives harmless from and against any loss, cost, liability, damage and expense (including reasonable attorneys’ fees) suffered or incurred by Disclosing Party, or any of its Representatives, arising out of, or in connection with, any breach by Recipient or Recipient’s Representatives under this Agreement or any unauthorized use or disclosure of the Confidential Information by Recipient or by any of Recipient’s Representatives.
10. REMEDIES. Recipient acknowledges that the Confidential Information disclosed and/or made available to Recipient hereunder is valuable to Disclosing Party and that any threatened or actual breach of this Agreement would cause irreparable injury to Disclosing Party (and/or clients of Disclosing Party) for which monetary damages would be inadequate. Accordingly, in the event of a breach or threatened breach of this Agreement, Disclosing Party shall be entitled to seek equitable relief, including without limitation, injunction and specific performance. Recipient hereby waives any requirements for security or posting of any bond in connection with such relief. No specification in this Agreement of any particular remedy shall be construed as a waiver or prohibition of any other remedies in the event of a breach or threatened breach of this Agreement.
11. GENERAL.
a. No Obligation. Each of Disclosing Party and Recipient agrees that, unless and until a definitive written agreement between them with respect to a Transaction has been executed and delivered, neither Disclosing Party nor Recipient will be under any legal obligation of any kind to complete a Transaction. This Agreement imposes no obligation on Disclosing Party to disclose any Confidential Information.
b. Assignment. This Agreement shall be binding upon and inure to the benefit of the parties hereto and their respective successors and assigns. Recipient may not assign this Agreement or any of its rights or obligations hereunder, by operation of law or otherwise, without the prior written approval of Disclosing Party, which approval may be granted or withheld in Disclosing Party’s sole discretion. Any purported assignment without such prior written consent shall be void and of no effect.
c. Enforcement. If any provision of this Agreement is held to be invalid or unenforceable by a court of competent jurisdiction, such holding shall not affect the validity or enforceability of any other provisions of this Agreement, which shall remain in full force and effect, and the provisions so held invalid or unenforceable shall be deemed modified so as to give such provisions the maximum effect permitted by applicable law.
d. Waiver. It is understood and agreed that no failure or delay by either party hereto in exercising any right, power or privilege hereunder shall operate as a waiver thereof, nor shall any single or partial exercise thereof preclude any other or further exercise thereof or the exercise of any right, power or privilege hereunder. This Agreement constitutes the entire agreement between Disclosing Party and Recipient, and supersedes all prior agreements and understandings, whether oral or written, relating to the subject matter hereof.
e. Amendment. This Agreement may not be amended, modified, waived or released except by a separate writing by the parties hereto.
f. Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed to be an original, but all of which shall constitute the same agreement.
g. Governing Law; Jurisdiction. This Agreement shall be governed in all respects by the substantive laws of the State of New York without regard for conflict of law principles. Both parties hereby irrevocably submit to personal jurisdiction in any action brought in any court, federal or state, within the Borough of Manhattan, City of New York, State of New York having subject matter jurisdiction arising under this Agreement, and waives, to the fullest extent permitted by law, the defenses of lack of personal jurisdiction, inconvenient forum, and improper venue to the maintenance of any action. Each party hereby authorizes and accepts service of process sufficient for personal jurisdiction in any action against it as is contemplated by this paragraph by certified or registered mail, return receipt requested, to its address as set forth above. Each party hereby waives its right to a trial by jury.
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IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as of the date first above written.
____________________________________________ New York eHealth Collaborative Valerie Grey, Executive Director ____________________________________________ [SIGNATURE] ____________________________________________ [PRINT INDIVIDUAL NAME AND TITLE] ____________________________________________ [Print Name of the Company]
