CORPORATE PERFORMANCE GRAPH (CPG) Order Form

Basic Service $549 per graph
$649 with custom peer group
Graphs with S&P Data $949 per graph
$1049 with custom peer group
Quarterly Service
(Includes annual & 3 quarterly reports)		 $699 per graph
$799 per graph
Graphs with S&P Data
(Includes annual & 3 quarterly reports) 		$1149 per graph
$1249 per graph
 
Items with an * are required fields for form submission.
*Company Name:
*Select the Broad Market Index to be used in your graph:
(All S&P 500 companies must use the S&P 500 Index)
*Select the Peer Group Index to be used in your graph:
 
*Your company's fiscal year end:
*Performance report needed by:
*Delivery:
*How did you hear about this service?
*Name:
Title:
*Company:
*Address:
 
*City:
*State: *Zip:
*Telephone:
Fax:
*Authorized Purchasing Signature:
  *Date:
For more information, please contact Jo Ann Crowder, Manager of Compliance Services:
Phone 804.278.6702
Fax 804.358.1857
jcrowder@hemscott.com

DISCLAIMERS For purposes of the performance graph which is the subject of this order, the Customer has selected the overall market performance indicator and the industry index or peer comparison required by item 402(1) of SEC Regulation S-K and the Customer is solely responsible for same. Hemscott, LLC believes its methodology used in creating the performance graph is appropriate and reliable. A detailed copy of the methodology is available in advance upon request and is also delivered with each ordered graph. Any order of the corporate performance graph indicates Customer's acceptance of the Hemscott methodology. Data on the relevant companies utilized by Hemscott in development of the performance graph is derived from the Hemscott database, consisting of both current and historical financial data on approximately 10,000 companies. Hemscott bases its data input, used in the performance graph, on sources believed by it to be reliable. However, Hemscott does not represent, warrant or guarantee either the accuracy or the timeliness of the data, or the compliance of the graph with the requirements of Item 402(1) of SEC Regulation S-K, and it shall have no liability of any kind whatsoever to Customer, or to any other party with respect to such matters. THERE ARE NO EXPRESS OR IMPLIED WARRANTIES OF ANY KIND WITH RESPECT TO THE PERFORMANCE GRAPH.

"S&P" is a registered trademark of McGraw-Hill, Inc. Hemscott, Inc. is an authorized licensee of the S&P total return index data for both the S&P broad market indices and the S&P industry group indices, which may be used in the Corporate Performance Graph. Licensee's relationship with S&P is that S&P grants permission to Licensee to use and refer to certain trademarks and tradenames of S&P and to disseminate data derived from the S&P Indices, which are determined, composed, and calculated by S&P without regard to the Corporate Performance Graph product. S&P does not guarantee the accuracy and/or the completeness of the S&P Indices or any data therein. S&P makes no warranty, expressed or implied, as to results to be obtained by Licensee, owners of the product or any other person or entity from the use of the S&P Indices or any data included therein in connection with the rights licensed hereunder or for any other use. S&P makes no express or implied warranties, and hereby expressly disclaims all warranties of merchantability or fitness for a particular purpose or use with respect to the S&P indices or any data included therein. Without limiting any of the foregoing, in no event shall S&P have any liability for any special, punitive, indirect or consequential damages (including lost profits), even if notified of the possibility of such damages.

Payment for the product, ordered by this submission of this order form by Purchaser, is due within thirty (30) days of the date of Hemscott's invoice for same. If payment is not timely made, the Purchaser shall be liable for all collection costs incurred by Hemscott, including, without limitation, all reasonable attorney's fees and court costs.