South Carolina Workers’ Compensation Commission SELF-INSURANCE DIVISION 1333 Main Street, Suite 500 P.O. BOX 1715 Columbia, SC 29202-1715 (803) 737-5706 CORPORATE GUARANTY KNOW ALL MEN BY THESE PRESENTS, that we, of the State of (PARENT), a corporation existing under and by virtue of the laws , do hereby guarantee payment by the (SUBSIDIARY) of the compensation provided for under the compensation provisions of the Workmen’s Compensation and Occupational Disease Acts of the State of South Carolina in the event that said (SUBSIDIARY) shall not pay or cause to be paid direct to its employees the compensation due or that may become due under Acts, that the undersigned (PARENT) covenants and agrees that it will pay all such employees of the (SUBSIDIARY) such compensation, including a reasonable attorney’s fee incurred by said employee in any action brought on this agreement, with the express agreement and understanding as a condition of precedent to the execution and acceptance of this agreement, that it is for the benefit of unknown and unnamed employees of the said (SUBSIDIARY) and that said employees are hereby empowered to maintain direct action on this agreement or guaranty, and that the said does hereby recognize this agreement as a direct financial guarantee to said employees, provided further that (PARENT) (PARENT) shall have a right to cancel and terminate this agreement at any time upon giving the South Carolina Workers’ Compensation Commission and the (SUBSIDIARY) at least sixty days written notice of its desire so to do; such cancellation, however, not to affect its liability as to any compensation for injuries occurring prior to ten days after the date of the cancellation specified in such notice. This agreement shall be effective as of the Signed, sealed and delivered this day of day of , , . . By: Title: Attest: (CORPORATE SEAL) WCC Form # 7A 7A CORPORATE GUARANTY American LegalNet, Inc. www.FormsWorkFlow.com