EFTA00316431

EMPLOYMENT APPLICATION Position Applying fon 0 Full-lime O Part-Time O Sasonal SMTWIFSat. Hours Available: and/or its affiliate Ls an Equal Opportunity Employer. We consider applicant for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other legally protected status. NAME Sodal Security Number 1 An you at least 18 yen of age O Yes O No Pint Middle Last Present Street Address City State • Bp Previous Street Address City State Zp Phone Number Alternative Phone Number Are you a US. Gtizen or an you provide venticabon of your legal right to work in the United States O Yes O No Position Desired ci pa Tim, Date Amiable for Work Have you ever been employed by ? 0 Part Time O Yes C. No Position: • _Deter; ' List rums of Mends or relatives now employed b) Met/or its affiliate List offia machines you an operate Rndude WPM and Shorthand) List other equipment you can operate Do you have any special slalh or training related to the position sot;shrt EDUCATION Name of Institution City & State Circle Last Year Completed High School 9 10 11 12 College 1 2 3 4 Graduate School Degree received O Ye 0 No Other r lvaLITARY SERVICE BRANCH Rank Attained Date Entered Date of Cischarse EFTA00316431 EMPLOYMENT: Include all previous jobs starting with the present or most recent. May we contact your present employer? 0 Yes 0 No L Employer Petition Held & Duties AvICIISS Phone 140. Supervisor — Datm Employed Rale Fre= To: ng Pa Ending Reason foe Leming . - 2. Employer Position Held &Duties Adams PhomNo. Supervisor Data Employed • Pay Rate Pitt To: Stardsc Ending: Reason forEeaving 3. Employer Position Hdd &Duties; Address Phone No. Supervisor Dates Employed Pay Rate Prom: . To: Stanley Endlny Reason for Leaving Have you ever been convicted of a felony or a misdemeanor (other than minor traffic violations)? 0 Yes 0 No If pm, Please explain: PLEASE READ THIS STATEMENT CAREFULLY I agree to comply with all rules of this Company. I understand that any falsification or omission of information provided on this application or while inteniewing will be grounds for dismissal from employment, even if not discovered until after my separation from the Company. I authorize a thorough investigation to be made in conjunction with this application concerning my charade:, genera/ reputa Sonpersonal characteristics and mode of living. whichever maybe applicable. I understand this investigation may include pasonal interviews +rah third parties, such as family members, business asscciates,financial sources,friends,neighbon or others with whom lam acquainted. If len hired, Tape. that my employment and compensation can be terminated with or without G.useand with or without notice at any time, al tie option of theCompary or myself. (understand that no other representative of theCornpany other than thePresidentof N. A. Property, Inc. has the authcci ly to modify this agreement In any way, and that a ny such modification must be in a writing signed by both the Prudent and myself. I have read and affirm the above statement as my own. Signature Chit gr... I /13 EFTA00316432 U.S. Department of JuStIfe OkeNo UlSeijo InuarigmKm and Namslization Service Employment Eligibility Verification Please read instructions carefully before completing this form. The instructions must be available during completion of this form. ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work eligible individuals. Employers CANNOT specify which document(s) they will accept from an employee. The refusal to hire an individual because of a future expiration date may also constitute Illegal discrimination. Section 1. Employee Information and Verification. To be completed and signed by employee at the time employment begun. Print Name Last First Middle Initial Maiden Name Address IStrece Name end Numbed Apt • Date ol act, fmonrh/day•prarj City State Zip Code Social Security 0 I am aware that federal law provides for I attest. undo: moony of perjury. that I am (check one or the 1011Ovong) O A citizen or national of the United States imprisonment and/or fines for false statements or 0 A Lawful Permanent Resident (Allen ff A use of false documents in connection with the 0 An alien authorized to wok until / I completion of this form. (Alien 0 or Admission ff) Employee's Signature Date (mumble:by/year) Preparer and/or Translator Certification. (Toort completed end signed Section lhaeparedbyaperson *Mee Mon Me empinyet fl attest. under penalty Of perjury. that have assdred on /he complenon of knit ram end that Mine best of my knowledge the esformanon is true end correct. Preparees/Translator's Signature Pint Name AddreSS (Sneer Name and Artmeter. City. State. Zp Cede( Date (rnonthidaylyear) Section 2. Employer Review and Verification. To be completed and signed by employer. examine one document from lilt A OR examine one document from Ust B and one from list C, as aged on the reverse of ma form, and record the title, number and expiration date, art. of the documental List A OR List Et AND List C Document title' *.3 Issuing authority I'l .4 _ Document • E'i Cagayan Date (I any) —1—l— —1.—1 /— Document • Expiration Dote re any) —I—I— i'.ig'i% CERTIFICATION - I attest. under penalty of perjury. that I have examined the document(s) presented by the above-named employee. that the above-listed document(s) appear to be genuine and to relate to the employee named, that the employee began employment on (month/day/year) _1_1_ and that to the best of my knowledge the employee is eligible to work in the United States. (State employment agencies may omit the date the employee began employment.) Signature of Employer or Authorized Representative Print Name Title Rosiness or Organization Name Monist (Sure( Name and Number. City. SOM. Zsp SOW Date (month/Joy/Sad Section 3. Updating and Reverificatlon. To be completed and signed by employer A New Name (d oppecable) B. Date ol Attlee (monmicieneer) appfrobV) C. 11 employee's previous grant Cl work authorization has expired. pantie the edormati0n below for the document that establishes Gummi employment eligibility. Document Title Document .arratIon Date tif any}.__ 1 I attest, under penalty or ventaty. that to the best of my knowledge. 014 employee te eigiblv to work in the United States. and if the employee situated docum ent(s). the document()) I have examined appear to be genuine and to retie 10 Ike Int/MMUS Signature of Employer de Authorized Representative Date (Month/day/yead Form 1.9 INt. i1.714111fferit 2 EFTA00316433 LISTS OF ACCEPTABLE DOCUMENTS LIST A LIST LIST C Documents that Establish Both Documents that Establish Documents that Establish Identity and Employment Identity Employment Eligibility Eligibility OR AND 1. Driver's license or ID card 1. U.S. social security card issued 1. U.S. Passport (unexpired or issued by a state or outlying by the Social Security expired) possession of the United States Administration (other than a card provided it contains a stating it is not valid for photograph or information such as employment) 2. Certificate of U.S. Citizenship name, date of birth, gender, (INS Form N560 or N•561) height, eye color and address 2. Certification of Birth Abroad 3. Certificate Of Naturalization 2. ID card issued by federal, state issued by the Department of (INS Form N•550 or N•570) or local government agencies or State (Form FS.545 or Form entities, provided it contains a DS. 1350) photograph or information such as 4. Unexpired foreign passport, name, date of birth, gender, with 1- 551 stamp or attached height, eye color and address INS Form 1.94 indicating 3. Original or certified copy of a unexpired employment birth certificate issued by a state, 3. School ID card with a authorization county. municipal authority or photograph outlying possession of the United States bearing an official seal 5. Permanent Resident Card or 4. Voter's registration card Alien Registration Receipt Card with photograph INNS Form 5. U.S. Military card or draft record I-151 or 1-5511 6. Military dependent's ID card 4. Native American tribal document 6. Unexpired Temporary Resident Card (INS Form I-6891 7. U.S. Coast Guard Merchant Mariner Card 5. U.S. Citizen ID Card (INS Form 7. Unexpired Employment 8. Native American tribal document 1-1971 Authorization Card (INS Form I-688A) 9. Driver's license issued by a Canadian government authority 6. ID Card for use of Resident 8. Unexpired Reentry Permit (INS Citizen in the United States Form 1-327) For persons under age 18 who (INS Farm I-1791 are unable to present a document listed above: 9. Unexpired Refugee Travel Document IIN$ Form 1-5711 7. Unexpired employment 10. School record or report card authorization document issued by 10. Unexpired Employment the INS (other than those fared Authorization Document issued by undo List Al the INS which contains a 11. Clinic, doctor or hospital record photograph (INS Form /6888) 12. Day-care or nursery school record Illustrations of many of these documents appear in Part 8 of the Handbook for Employers (M-2741 faun 19 (Rev lOPleff line? EFTA00316434 The exceptions don't apply to supplemental wages Nonwago Incense If you have a largearnount of Form W-4 (2017) greater than 31.000.000. nonwage Income, such es interest or 6vIderets, cosider making estimated tax payments uskg Form Bask Instructions. If you anal exempt. complete 040.ES, Estimated Tax kr Individuals OthervAse Purpose. Complete Form W-4 so that your the Personal Allowances Worksheet below. The employer can wthhoki the correct federal income worksheets at page 2 further adjust your you may owe see Pal tax. Ilse hanponsion or tax from your pay. Consider 4 anew Form vAthholding allowances bawd on itemized annuity Income, see Pub. 505 to find out if you shoed W-4 each year and when your or financial deductions. certain credits, actustments to Income, &gust your withholding an Font W-4 orW-CP. 'Mahon changes. or two.earners/nxitiple jobs situations. Two earners or multiple jobs.11you tan a Exemption from withholding. II you are exempt. Complete all worksheets that apps.. Ho ever, you working spouse or more than me jOb. Nun) the complete only fines 1.2.3,4.3nd 7 and sign the may claim fewer for zero) allowances. For regular total number of allowances you ale eraUS to claim form to vadat. n. You Son for 2017 expires wages, withholding must be based on allowances on all lobs usng worksheets from on& one Form February 15.2018. See Pub. , Tax Wertholdng you claimed and may not be a Dal amount or vi-4. Your w:thhold.ag usually wis be most accurate when el allowances are claimed on tee Form W.s and Estimated Tax. Percentage of wages. for the highest payng job and :aro alcwances are Note: II another person can dam you as a dependent Head of household. Genomay. you can claim head claimed on the others. See Pub 505 for octets. on Ns Or her lax return, you Can't clam exemption of househed ng status on your tax retum only if Nonresident alien, II you are a nonresdent alien, see from withholding if you, total income exceeds 21,050 You are UnnianiC4 and pay more than 50% of the Nalco 1392. Supplemental Form W-4 instructions tor and include, mire than 5350 ol unearned :mom, (for oasts of keeping up 0 home for yourself and your Nonresident Aliens, before correlating alis example, interest and dvidends). dependent(s) or other .qualify:re indrAdvals. See &captions. An engto may be able to claim Pub. 601, Exe mason 5. Standard Deduction, and howyour Form W.4 takes Check your withholding. After exemption from wit mg even if the employee is Filing Information, for Information. effect, use Pub. 505 to see the Whaunt you are a dependant, il the employee: Tex credits. You can take Protected tax credits into having withheldcompares to your preeleted total tax account In !goring your 1.10Wable number of Sot 2017. Se* Pub. 5.•speaelly itwur earnings • Is age es welder. withhold atokrxxes. Credits for aid or dependent exceed 5130.000 (Singe) or • Is Win& or care expenses and the Child tax credit may be claimed Future developments. Information about any future 'AIN the Persona: Allowances Worksheet below. developments affecting Form W.4 (such as • WI claim adjustments to income; tax credits: or See Pub. 505 for nformation on converting your other legislation enacted after we release le mll be Posted Iternad asuman'', on Ns or her tax tram. erodes Into withholding allowance& at mvw.ara.gcrelw4. Personal Allowances Worksheet (Keep for your records.) A Enter "1" for yourself if no one else can claim you as a dependent A { • You're single and have only one job; or B Enter "1" if: • You're married, have only one job, and your spouse doesn't work; or • Your wages from a second job or your spouse's wages (or the total of both) are $1,500 or less. C Enter "1" for your spouse. But, you may choose to enter --O." if you are married and have either a working spouse or more than one job. (Entering *-0-- may help you avoid having too little tax withheld ) C D Enter number of dependents (other than your spouse or yourself) you will claim on your tax return 0 E Enter "1' if you will file as head of household on your tax return (see conditions under Head of household above) . E F Enter "1" If you have at least $2,000 of child or dependent care expenses for which you plan to claim a credit . . F (Note: Do not include child support payments. See Pub. 503, Child and Dependent Care Expenses, for details.) G Child Tax Credit cncluding additional child tax credit). See Pub. 972. Child Tax Credit, for more information. • II your total income will be less than $70,000 ($100,000 if married), enter "2" for each eligible child; then less "1" if you have two to four eligible children or less "2' if you have five or more eligible ctildren. • If your total income wal be between $70,000 and $84,000 ($100,000 and $119,000 if married), enter -1- for each ellgtle chid. G H Add linos A through 0 and enter total here. (Note: This may bo afferent from the number of exemptions you claim on your tax robin.) * H • If you plan to itemize or claim adjustments to Income and want to reduce your withholding, see the Deductions For accuracy. and Adjustments Worksheet on page 2. complete all • If you ere single and have more than one job or are married and you and your spouse both work and the combined worksheets earnings from all lobs exceed $50,000 ($20,000 if married), see the Two-Earners/Multiple Jobs Worksheet on page 2 that apply. to avoid having too tittle tax withheld. • II neither of the above situations applies, atop hero and enter the number from line H on line 5 of Form IN-4 below. Separate hero and give Form W-4 to your employer. Keep the top part for your records. Fenn W-4 Employee's Withholding Allowance Certificate OMB N0.1645-0074 ofeeetnstro el the UMW( Internet pane Sete li. Whether you are entitled to claim a certain number of allowances or exemption from withholding is subject to review by the WS. Your employer may be required to send a copy of this form to the IRS. 2017 1 Your first an ad middle Initial last name 2 Vow social security number Home address ( umber and street or rural route) 3 O Slop O Maned O Married, but withhold at riper Stele nate. Note: IlmaMed. NA leg* separated, or spouse is a norresiderl alitncheck to 'Sip' box. City or town, state, and DP code 4 If your last name differs from that shown on your social security card, chock here. You must call 1.900.772.1213 fora replacement card. IP O 5 Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) 5 6 Additional amount, if any, you want withheld from each paycheck 8 $ 7 I claim exemption from withholding for 2017, and I certify that I meet both of the following conditions for exemption. • Last year I had a right to a refund of all federal income tax withheld because I had no tax liability, and • This year I expect a refund of all federal Income tax withheld because I expect to have no tax liability If you meet both conditions, write "Exempt" here * I 71 Under penalties of perjury. I declare that I have examined this certificate and, to the best of my knowledge and belief, it Is true, correct, and complete. Employee's signature (This form is not valid unless you sign it.) ► Date ► 8 Employees name and address (Employer. Complete lines 8 and 10 only if sending to the IRS.) 9 Offas coda Options) 10 Employer kleaticalion number (OM For Privacy Act and Paperwork Reduction Act Notice, see page 2. Cat. No. 102200 Fonts W-4 (2017) EFTA00316435 Form W-4 12017) Page 2 Deductions and Adjustments Worksheet Note: Use this worksheet only If you plan to itemize deductions or claim certain credits or adjustments to income. 1 Enter an estimate of ycer2017 ?remind deduction These incbie (edifying home mortgage interest, chantable contributions, state and local taxes. medal expenses in excess of 10%d your income, and miscellaneous deducUons. For 2017, you may have to reduce your itemized aducCons if your income is over $313,800 and you're married ling jointly or you're a obifying widowlert $287,650 if you're head of householot $261,500 it you're single, not head d hettselice and not a qualifyng Mdow(er) or $156,900 II you're married ling separately. See Pub. 505 for dela I $ S12,700 If married filing jointly or qualifying widower) 2 Enter: { $9,350 If head of household 2 $ $6,350 if single or married filing separately 3 Subtract line 2 from One 1. II zero or less, enter "-0-" 3 $ 4 Enter an estimate of your 2017 adjustments to income and any additional standard deduction (see Pub. 505) 4 $ 5 Add lines 3 and 4 and enter the total. (Include any amount for credits from the Converting Credits to Withholding Allowances for 2017 Form W-4 worksheet in Pub. 505.) 5 S 6 Enter an estimate of your 2017 nonwage income (such as dividends or interest) 6 $ 7 Subtract line 6 from line 5. If zero or less, enter "-0-' 7 $ 8 Divide the amount on line 7 by $4,050 and enter the result here. Drop any fraction 8 9 Enter the number from the Personal Allowances Worksheet, line H, page 1 9 10 Add lines 8 and 9 and enter the total here. If you plan to use the Two-Eamers/Multiple Jobs Worksheet, also enter this total on line 1 below. Otherwise, stop here and enter this total on Form W-4, fine 5, page 1 10 Two-Earners/Multiple Jobs Worksheet (See Two earners or multiple jobs on page 1.) Note: Use this worksheet only if the instructions under line H on page 1 direct you here. 1 Enter the number from line H, page 1(or from Me 10 above if you used the Deductions and Adjustments Worksheet) 1 2 Find the number In Table 1 below that applies to the LOWEST paying job and enter it here. However, if you are married filing jointly and wages from the highest paying job are $65,000 a less, do not enter more than sr 2 3 If line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result hero (if zero, enter "-0-") and on Form W-4, fine 5, page 1, Do not use the rest of this worksheet 3 Note: If line 1 is less than line 2, enter *-0-" on Form W-4, line 5, page 1. Complete lines 4 through 9 below to figure the additional withholding amount necessary to avoid a year-end tax bill. 4 Enter the number from line 2 of this worksheet 4 5 Enter the number from line 1 of this worksheet 5 6 Subtract line 5 from line 4 6 7 And the amount in Table 2 below that applies to the HIGHEST paying job and enter it here . . . . 7 $ 8 Multiply line 7 by line 6 and enter the result here. This Is the additional annual withholding needed . . 8 $ 9 Divide line B by the number of pay periods remaining in 2017. For example. divide by 25 if you are paid every two weeks and you complete this form on a date in January when there are 25 pay periods remaining in 2017. Enter the result here and on Form W-4, line 6, page 1. This is the additional amount to be withheld from each paycheck 9 $ Table 1 Table 2 Married Filing Jointly All Others Married Filing Jointly All Others If wages from LOWEST Enter on a wages from LOWEST Enter on a wages from HIGHEST Enter on If wages from HIGHEST Enter on Ps/0900 be— Met above paying jab are— line 2 about paying job are— line? above paying fob are— Erie? above SO • $7,000 0 SO - 38,000 0 So - 575000 $610 SO • 336,000 $610 7,001 • 14003 1 8.031 - 16= 1 75,001 • 135,000 1,010 38,001 - 85,000 1,010 14,001 - 22.030 2 18,001 - 26.000 2 135,001 • 205,000 1.130 85,001 • 185.000 1.13O 22.031 - 27,000 3 26,001 - 34,000 3 205001 - 360300 1,340 185,001 - 480303 1340 27.001 • MOO 4 34,001 - 44,000 4 360,001 • 405.000 1,420 400,001 and over 1.600 35001 - 44,000 5 44.001 - 70,000 5 405,001 and over 1.600 44,001 - 55,000 6 70,001 - 85,000 6 55.801 • 65,000 7 85,001 - 110,000 7 65,001 - 75000 8 110001 - 125,000 8 75001 • 80000 9 125001 • 140000 9 80,001 - 95000 10 140.031 and over ID 91,001 - 115,000 11 113,001 • 130.000 12 130,001 - 140.000 13 140.001 • 130.000 14 150,001 and over 15 Primo/Ad and Paperwork ReductionAd Negev. We ask kr en Worm eon on Ws tom You are not required to provide the inforrnahon requested on • form that is 10 Cam 0ul se Interne/ Firrecue laws of the UnitedStates. Internal Revenue Code seders subject to the Paperwork Reduction Act unless the form displays a weld OM 34028SZ and 6109 and Mrr rely:rations requireyea he provide this Inhormaumg yore enlyieyee control number. Books or records relating toe form or Its instructions must be uses h to detente sour Waal mcome tax vat/sold:4 Fare to provide wooed/ retained as long as their contents may become material n the administration of completed Mtn mil result r your berg unto) as a sin M person who claims no wthhoicing any Internal Revenue Law. Generally. lax returns and return inkanation ate shthswees; preys:rig frauctlera mayfraece may sailed you to penises. Routine uses d confidential, as re:pared by Code section 6103. this isthrmatial incitte givrg it to the Depalment 01Justke bore and criminal Stylists t0 The average time and expenses required to complete and fit this am wil vary cities. states. be OeMc10l Columba. and U.S. cannicermearem and possessions lee use is depending on individual circumstance,. For estimeted averages, see the administering their tie Imes and to the Department of Health and Kann Sevicos br use n instructions for your income tax return. the Natanal Ornate, of New Hires Wo may also declass this information to other countries under a lax 8,1.SY, to fader& and sate agonies booboo federal nontax amnai laws. or to If you have suggestions for making this form simpler, we woad be happy to hoer !criers law mimeo-nen! Lid intelligence agencies to combat terrorism. Iron you. See the instructions for your Income tax return EFTA00316436 CONFIDENTIALITY AGREEMENT In order to induce NES, LW ("NES") to consider the undersigned for employment or engagement as an independent contractor to provide services, including, without limitation, services with respect to NES, Jeffrey Epstein ("Epstein") and any of the Epstein Companies (as hereinafter defined) and real property directly and indirectly owned or occupied by NES, Epstein or any of the Epstein Companies (the "Properties"), and in consideration of any employment or engagement that the undersigned may obtain with NES, Epstein or any of the Epstein Companies, whether with respect to the Properties or otherwise, and any compensation or other remuneration to be hereafter paid to the undersigned in connection therewith, the undersigned, (hereinafter sometimes referred to as the Applicant"), acknowledges that the Applicant has been informed of the Applicant's obligations hereunder and that such obligations are a condition to the consideration by NES, Epstein or any of the Epstein Companies of the Applicant's employment or engagement, and to any employment or engagement that the Applicant may obtain, and the Applicant hereby agrees as follows: Section 1. Term of Employment; Termination. In the event that the Applicant is hereafter employed or engaged as an independent contractor by NES, Epstein or any of the Epstein Companies, the Applicant agrees and understands that nothing in this Agreement shall confer any right on the Applicant with respect to the grant or continuation of the Applicant's employment or engagement as an independent contractor. The Applicant further agrees and understands that, in the event that the Applicant is employed or engaged as an independent contractor, any breach of this Agreement by the Applicant will result, in addition to any and all other remedies which may then be available to NES, Epstein or any of the Epstein Companies, as the case may be, in the Applicant's immediate termination. Section 2. Confidentiality Obligations of the Applicant. 2.1 Definition of Confidential Information. (a) For purposes of this Agreement, the term "Confidential Information" shall mean any "Business Information" (as hereinafter defined) and any "Personal Information" (as hereinafter defined) about any of: (i) the Properties or any other real property owned or occupied directly or indirectly by any of NES, Epstein or any of the Epstein Companies; (ii) NES, (iii) Epstein; (iv) any and all corporations, limited liability companies, trusts, limited partnerships, general partnerships or other entities with which Epstein is affiliated ("Epstein Companies"); (v) any of the members, managers, directors, officers, shareholders, limited partners, general partners, trustees, beneficiaries, employees, contractors or agents of NES, Epstein or any of the Epstein Companies; (vi) any person residing at, visiting or staying for any duration at any of the Properties; and (vii) any personal associate, business associate or client of any of the persons described in the above clauses (ii) through (vi), inclusive; previously or hereafter gathered or learned by the Applicant directly or indirectly during the course of the any interactions between the Applicant, on the one hand, and any of NES, Epstein and/or any of the Epstein Companies, or any representatives of NES, Epstein or any of the Epstein Companies, on the other hand, including, without limitation, during the course of Applicant's application for employment or engagement by NES, Epstein or any of the Epstein Companies and/or in connection with any employment or engagement of the Applicant by NES, Epstein or any of the Epstein Companies. EFTA00316437 (b) For purposes of this Agreement, the term "Business Information" shall mean information of any type which is commonly considered of a confidential nature and includes, but is not limited to, any information (whether in oral, written, photographic, electronic or other recorded form) regarding the existence, identities, contact information, and business records of; the business plans of; mechanized or nonmechanized systems of accounting of; IT related systems or information of; methods of doing business of; vendor information (including, without limitation, existence, identities, contact information, records, fees, and disbursements of, and services and materials provided by, any and all vendors, contractors, consultants, and professional advisors) of; confidential business lists and other proprietary data of; assets of; investment strategies, transactions, records, procedures and history of; financial records of; the skills, business activities, compensation and financial net worth of; and any other information of a similar nature about; any of the persons or entities set forth in Section 2.1(a) (the "Classified Parties"). (c) For purposes of this Agreement, the term "Personal Information" shall mean information of any type which is commonly considered of a personal nature and includes, but is not limited to, information (whether in oral, written, photographic, electronic or other recorded form) regarding the identities of; contact information of; personal characteristics of; physical descriptions of; non-business activities of; IT systems and information of; personal assets of; personal records of; personal plans of; personal lifestyles of; relationships of; friends of; relatives of; individuals who associate with or who are invited to associate with; and any other information of a similar nature about; any of the Classified Parties; and shall also include, without limitation, the appearance and exterior and interior layout of, any and all improvements on, and furniture, furnishings, and other items of personal property contained anywhere in or on, any of the Properties or any other real property directly or indirectly owned or occupied by NES, Epstein or any of the Epstein Companies. 2.2 Confidential Information Shall Not Be Discussed. At all times hereafter, the Applicant will hold in the strictest confidence and will not, directly or indirectly, use, communicate, publicize, lecture upon, publish or in any manner disclose any Confidential Information, unless NES has expressly authorized in writing such use, communication, publicizing, lecturing, publication, or disclosure. The Applicant hereby assigns to NES any and all rights the Applicant may have or acquire in any Confidential Information and acknowledges that all Confidential Information shall be the sole and exclusive property of NES. The Applicant further agrees and acknowledges that under this Agreement, the Applicant is obligated to use the Applicant's best efforts to ensure that no Confidential Information is used, communicated, publicized, lectured upon, published or disclosed by any persons employed or engaged by the Applicant or under the Applicant's supervision or control. To the extent that the Applicant has any doubts, either now or in the future, as to whether information the Applicant possesses is Confidential Information as defined herein, the Applicant will contact NES, for written clarification and approval before divulging or using such information in any manner whatsoever. 2.3 Third Party Information Shall Not Be Disclosed. The Applicant understands that the Applicant may receive Confidential Information from third parties, as well as from NES. The Applicant acknowledges and agrees that Confidential Information which the Applicant receives from third parties is to be treated in the same manner as Confidential Information received from NES and that all of the Applicant's obligations hereunder apply to all Confidential EFTA00316438 Information received, regardless of its source. 2.4 Return of Documents. Upon demand by NES, and upon the expiration or termination of any employment or engagement as an independent contractor of the Applicant by NES, regardless of the reason or basis, if any, for such expiration or termination, the Applicant will deliver to NES any and all documents, written materials, notes, drawings, photographs, specifications and any other materials of any type or nature whatsoever (whether in written, photographic, electronic or other recorded form) which the Applicant has in the Applicant's possession or control, and all drafts, copies and electronic file copies of all or any part thereof, which may constitute, include, reflect or disclose any Confidential Information. Section 3. Review of Agreement. The Applicant acknowledges that the Applicant has read this Agreement, and that the Applicant has had the opportunity to review it and consult about it with the Applicant's own counsel if the Applicant so desires, before signing it. Section 4. Conflicts. 4.1 Avoidance of Conflict of Interest. If the Applicant is or subsequently becomes employed by NES, Epstein or any of the Epstein Companies (rather than being engaged as an independent contractor), the Applicant agrees that during the term of any such employment, so long as the Applicant is employed on a full-time basis, the Applicant will not, without the express written consent of NES, engage in any employment with any third party, or engage in any other business activity that would in any way conflict with the performance of the Applicant's duties of employment. 4.2 No Conflicting Obligations. The Applicant warrants and represents that the Applicant has not heretofore violated any provisions of this Agreement and that the Applicant has not entered into, or made, and agrees that the Applicant will not enter into or make, any written or oral agreement, undertaking, promise, or representation that conflicts with or violates the provisions of this Agreement or otherwise impairs the Applicant's ability to strictly perform the Applicant's obligations under this Agreement or to fully comply with the provisions of this Agreement. The Applicant further warrants and represents that the Applicant is not subject to any subpoena, injunction, decree, writ or order of any court or other authority or to any other duty or responsibility, legal or otherwise, which conflicts with the provisions of this Agreement or otherwise impairs the Applicant's ability to strictly perform the Applicant's obligations under this Agreement or to fully comply with the provisions of this Agreement. The Applicant shall immediately inform NES should the Applicant subsequently become subject to any such subpoena, injunction, decree, writ, order, duty or responsibility. Section 5. Remedies. 5.1 Equitable Relief. The Applicant acknowledges that the Confidential Information constitutes unique and confidential information of NES and the Classified Parties and in the event of a breach or a threatened breach of this Agreement, NES and any affected Classified Parties, will be irreparably harmed and there will be no adequate remedy at law. Therefore, in 3 EFTA00316439 addition to any and all other rights and remedies NES and any such Classified Parties may have, NES and such Classified Parties shall be entitled to injunctive or other equitable relief in the event of a breach or threatened breach hereof and the Applicant hereby waives any right to assert as a defense that there is an adequate remedy at law. 5.2 Liquidated Damages. In addition to any and all other rights, remedies or damages available at law or in equity, the Applicant agrees that if any court of competent jurisdiction finds that the Applicant has breached any of the provisions of this Agreement, the Applicant will pay NES or any affected Classified Party the sum of One Hundred Thousand ($100,000.00) Dollars, as liquidated damages and not as a penalty. The Applicant recognizes and understands that it would be difficult or impossible to calculate the actual amount of damages resulting from such a breach, and acknowledges that the sum of One Hundred Thousand ($100,000.00) Dollars would be reasonable under the circumstances. Section 6. General Provisions. 6.1 Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of New York applicable to contracts executed, delivered and to be fully performed in such jurisdiction, without giving effect to the principles of conflicts of law. 6.2 Severability. If one or more of the provisions of this Agreement are deemed invalid or unenforceable by law, then the remaining provisions hereof will continue in full force and effect, without regard to the invalid or unenforceable provision or provisions hereof, as the provisions of this agreement are intended to be and shall be deemed severable. 6.3 Survival. The provisions of this Agreement shall continue in full force and effect, regardless of whether the Applicant is ultimately employed or engaged by NES, Epstein or any of the Epstein Companies, and if the Applicant is so employed or engaged, the provisions hereof shall survive the expiration or termination of any such employment or engagement of the Applicant, regardless of the reason or basis, if any, for such expiration or termination. 6.4 Binding Effect. This Agreement and all of the provisions hereof shall inure to the benefit of, and be enforceable by, NES, and its successors and assigns, and shall be binding upon the Applicant and the Applicant's heirs, personal representatives, successors and assigns. This Agreement is intended for the benefit of and to be enforceable by NES and by the Classified Parties as third-party beneficiaries of this Agreement. 6.5 Waiver. No waiver of any provision of this Agreement shall be valid unless expressly given in writing, signed by the party against whom such waiver is sought to be enforced, and specifying the specific instance and the specific purpose for which such waiver is given. Each such waiver, if any, shall be effective only for the specific instance and for the specific purpose for which it is given. No waiver by NES or any Classified Party of any breach of this Agreement shall be a waiver of any preceding or succeeding breach. No waiver by NES or any Classified Party of any right under this Agreement shall be construed as a waiver of any other right. Neither NES nor any Classified Party shall be required to give notice to enforce strict adherence to all of the terms and 4 EFTA00316440 provisions of this Agreement. 6.6 Headings. The headings contained herein are for convenience only and shall not control or effect in any way the meaning or interpretation of the provisions hereof. 6.7 Entire Agreement. This Agreement sets forth the entire agreement and understanding between NES and the Applicant relating to the subject matter hereof and supersedes and merges all prior discussions between them relating to the subject matter hereof. No modification of, or amendment to, this Agreement will be effective unless in writing signed by the party to be charged therewith. If the Applicant is hereafter employed or engaged by NES, Epstein or any of the Epstein Companies, any subsequent change or changes in the Applicant's duties, salary or other remuneration will not affect the validity or scope of this Agreement. Signed: Print Name: Date: Address: 5 EFTA00316441 New York Member Enrollment Form - OHI UnitedHealthcar6 MAILING ADDRESS: P. O. Box 7085. Bridgeport CT 06601 • 1-800-444-6222 • wwwoxfordhealth.com Oxford A. Group Information (To be completed by the employe ) Please print neatly using Mack or blue ballpoint pen • ALL DATES MUST St MM/DD/YYYY Group Number Group Name Plan CSP !Billing Group Date of Hire Effective Date Occupation O On Leave of Absence O Retired COBRA/Young Adult/SC Gasifying Event Date Employer Signature Date Event / / X / / O Union Employee O Disabled B. Applicant Details (To be completed by the employee) Employee/Subscriber Spouse Child Child Social Security Number: Last Name: First Name, Middle Initial: Date of Birth: (MWDD/YYYY) / / / / / / / / Gender and Disabity Status: (Check appropriate boxes.) OM OF / 0 Disabled OM OF / O Disabled OM O F / O Disabled OM OF / O Disabled Primary Care Physician (PCP) ID Number: PCP Name: (If an coistais patient of PCP, check "Yes".) O Yes O yes 0 Yes O Yes Check all that apply: O Domestic Penner O Full-time Student O Full4ime Student O Young Adult O Young Adult Prior Carrier Carrier: (List coverage prior to this.) Poky Number: From Date I / I / / I I I O Same for all Thm date:: / / / / / / / / C. 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WA new] mopesnwan • filnhlir *A ettga mewed Employee's/Young Adult's Address (Apt #) Employee's/Young Adult's Signature Date City State Zip X / / EFTA00316442 NES, LLC January 10, 2018 Presentation - Inforce R Renewal OXFORD HEALTH PLANS BENEFITS 'Open Access' EPO PLAN Freedom Network - Platinum IltNetWOrk Maximum Benefits Unlimited Deductible (individual / Family) NM Coinsurance 100% Out of Pockel Maximum (Individual / Fernity) 32.500/15.000 Including Deductible UCR NM Office 'Nits • (PCP / Si/eel/ant) $20 I $40 Cense Preventive Cate 100% Pay and Lab Semites X-Ray: S90/ Latr 100: Erneteetcy Room Visit $200 Coon Waived it Admitted/ Hospital Serwats $400_00Ple.DeLiernissten Outpatient Facility $300 Coact Menial Healthcamt • Inpatient Sonsces S400.00MILDOLMIMILMOn Mental Healthcare Outpatient Sernces $40 Coon Prescription Drugs (Network Only Irv:heated) $50.dedittiblethraMtS301$601Geneciclush) Mall Otte Ones 2.5x Basic Cat for 90 Oat Suntan Ancillary Benefits (Vision. 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Ded. / Max. Prev. Svcs. Basic Svcs. off' Co pay. Svcs. Max. Ben. Max. Ben. CURRENT PRODUCT(S) Option 9; Passive PPO 2000 iDependent Children Dependent Children 100% I 80% 50% None I $50 / $2,000 350 / $2.00001H Only Only_ PROPOSED RENEWING PRODUCT(S) Option 9; Passive PPO 2000 100% 80% 50% Dependent Children Dependent Children None $50 / $2,000 350 / $2.000 Only Only ALTERNATE PRODUCT(S) Option 10; DMO Copay 41 Per SchedulePer Schedulefer Schedule None I $5 Noce/None N/A N/A / N/A Option 2; DMO 100% 80% I 50% None $5 None / None N/A N/A / WA Option 7; Consumer Directed DentalFund 100% None I None None I None - None - Option 3; Freedom-of-Choice: PPO 100% 90% 60960 None $5 None / None L N/A N/A / N/A Max Option 4; PPO Max 1500 100% 80% I 5696- None J None 350 / 31,500 None $50/ $1.500 Option 5; Active PPO 100% 80% 50% None None $50 / $1,500 None $50/ $1,000 Option 8: Freedom of Choice; PPO 100% 90% i 60% None None / None N/A N/A / N/A 1500 I $5 Option 6: Passive PPO 1500 100% 80% 50% None None $50/$1,500 None 350/$1,500 Option 9: Passive PPO 2000 100% 80% I 50% None None $50 / $2,000 None $50 / 32.000 Proposal Type: Renewal Group name: NES. DX Quote ID: 13752926 aetna® PSUID: 81115562 Effective Date: 02/01/18 to 02/01/19 Proposal Generated On: 11/29/2017 00:12 EFTA00316446 Pave 8