COMMONWEALTH OF VIRGINIA VIRGINIA WORKERS' COMPENSATION COMMISSION RICHMOND VA 232 PARENTAL GUARANTEE , a corporation organized under the laws of the State / Commonwealth of , with its principal office located at , on account of its financial interest in its subsidiaries or , a wholly-owned subsidiary corporation of , and in consideration of the benefits to it accruing, does hereby guarantee prompt and full payment of all liability of the said arising under and by virtue of the Virginia Workers' Compensation Act. This Guarantee ensures to the benefit of and may be enforced by any and all employees of the said having a claim against it under said Act. IN WITNESS WHEREOF, the said has caused this instrument to be signed by its duly authorized officer and its corporate seal to be hereunto affixed and attested by its Secretary, this day of , . (SEAL) By: ATTEST: Secretary VWC Form No. SI22 (rev. 08/1/15) American LegalNet, Inc. www.FormsWorkFlow.com