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855, __....._.... �......•.v,a .Ktta:.1'�11 YrS1A 4%'0'4MII:fY01M1AYYY"' -.. - • r• GeneScreen 26M Sa•rrinu,us F"'Y..Yuitt- /11 Adhiv. 7;- %ax 75207 21.1 611.5152 S00 I),V:I T!'ST I':IS 21-16.14-.1.122 AGREEMENT TO PROVIDE' SPECIh1EN COLLECTION FACILITY This agreement for specimen collection services is made and entered into by and between GeneScreen, Inc., n Delaware corporation having its principal place of business at 2600 Slemmons Fwy, Suite 133, Dallas, TX 75207 ( "GeneScreen "), and (-PROVIDER.-) 1A'ITNESSI'sTII: WHEREAS, GeneScreen wishes to arrange for specimen collection services to provide for the taking of blood and /or tissue specimens from parties for use in genetic testing; and WHEREAS, the PROVIDER is willing to provide a facility to accommodate GeneScreen's requirements; NOW, THEREFORE, in consideration of the mutual undertakings and agreements hereinafter set forth, the PROVIDER and GeneScreen agree as follows: I. LOCATION. PROVIDER agrees to provide space for [lie drawing of blood specimens for parentage testing at the following site: II. SCHEDULE FOR SPECIMEN COLLECTION. GeneScreen and the PROVIDER agree to work together to establish a mutually agreeable schedule for specimen collection. III. INDEMNIFICATION. GeneScreen ' agrees to hold the PROVIDER and all its employees harmless of any legal liability incurred as a result of sample collection on the premises above - named. GeneScreen assumes all legal liability for the subsequent identification, testing, and reporting of genetic information. 1V. CONFIDENTIALITY OF INFORMATION. PROVIDER agrees to keep confidential the identities of any and all parties appearing for specimen collection and to refrain from disclosing the identities of said parties by any means whatsoever. GeneScreen agrees to waive the provisions of this paragraph should PROVIDER'S employees be required to serve as witness to the specimen collection or should the Court require disclosure. V. SUFFICIENCY OF AGREEMENT /MODIFICATION. It is hereby agreed by and between the parties hereto that all provisions of this agreement are contained in this written Agreement. It is further agreed that all amendments or modifications to this Agreement shall be in writing on a document requiring the signatures of both parties hereto. Vl. TERMINATION. This agreement commences upon the date signed hereinbelow and shall terminate upon a thirty (30) day written notice of cancellation given by either party to the other for any reason, with or without cause. EXHIBIT A