<html><body dir="auto" role="textbox" aria-label="Message Body"><head><meta http-equiv="content-type" content="text/html; charset=us-ascii"></head><blockquote type="cite"><div dir="ltr"><meta http-equiv="content-type" content="text/html; charset=us-ascii"><div><blockquote type="cite"><div dir="ltr"><meta http-equiv="content-type" content="text/html; charset=us-ascii"><blockquote type="cite"><div dir="ltr"><meta http-equiv="content-type" content="text/html; charset=us-ascii"><div dir="ltr"><h1 style="-webkit-text-size-adjust: auto; margin: 0in 16.55pt 10.85pt 30.75pt; text-align: center; text-indent: -0.5pt; line-height: 17.1200008392334px; break-after: avoid; font-size: 12pt; font-family: "Times New Roman", serif; font-weight: normal; text-decoration: underline;"><span style="text-decoration: none;"></span><o:p></o:p></h1><p class="MsoNormal" style="-webkit-text-size-adjust: auto; margin: 0in 0in 21.8pt 9.6pt; line-height: 16.866666793823242px; font-size: 11pt; font-family: "Times New Roman", serif; text-align: justify; text-indent: 0.25pt;"><span style="font-size: 12pt; line-height: 18.399999618530273px;">I confirm that all the information given above is correct, and that the Business shown above agrees to pay Affiliated Blind of Louisiana for any and all Interpreting Services provided in accordance with said agreement.</span><o:p></o:p></p><p class="MsoNormal" style="-webkit-text-size-adjust: auto; margin: 0in 0in 14.3pt 46.3pt; line-height: 15.546667098999023px; font-size: 11pt; font-family: "Times New Roman", serif; text-indent: -0.5pt;"><span style="font-size: 10pt; line-height: 14.133332252502441px;">Signature</span></p></div></div></blockquote></div></blockquote></div></div></blockquote></body></html>