REPUBLIC OF THE PHILIPPINES )

) S.S.

RELEASE, WAIVER AND

QUITCLAIM with UNDERTAKING

I, ____________________, of legal age, and with residential address at

_______________________________________________________, currently engaged as
_____________ of _________________ (the “Company”), do hereby manifest and declare that:

1. I am an independent contractor providing services for the Company by virtue of a

Service Agreement.

2. I am performing my duties on my own accord, without any force, coercion or

compulsion from the Company.

3. As part of my duties, I perform tasks that will require me to do field work or work
outside the premises of the Company.

4. I am aware and, I understand and acknowledge all the health risks involved in
relation to the performance of my tasks with the Company during the COVID-19 pandemic.

5. I assume all the risks, known and unknown, in any way connected with my work
during the pandemic, including the possibility of contracting COVID-19 personally or
transmitting it to others.

6. I likewise accept full responsibility for any liability, injury, loss, damage or death,
whether on myself or on others, in any way or manner connected with my Service
Agreement with the Company.

7. I acknowledge that the Company has informed and educated me about the
dangers and risks of COVID-19 and how to prevent from contracting it.

8. Likewise, the Company has also taken steps and measures in preventing its
independent contractors from contracting COVID-19 by providing all the necessary
equipment, vitamins and supplements, and other sanitary items, as recommended by the
government.

9. I hereby release, remise, waive, and forever discharge the Company, its affiliates,
subsidiaries, assigns, successors, stockholders, officers, directors, agents and/or its
employees from any and all action, whether civil, criminal, administrative, labor or
otherwise, or from any claim of any kind or character on of my engagement, or in
connection with or arising out of my Service Agreement with the Company during the
pandemic including the possibility of contracting COVID 19 personally or transmitting it to
others.

10. I hereby undertake to keep the details of this Release Waiver and Quitclaim with
Undertaking confidential from any and all third parties, and undertake that I will NOT do
or perform any act or make any statement that may be prejudicial to the Company, its
affiliates, subsidiaries, assigns, successors, stockholders, officers, directors, agents and/or
its employees.

11. Finally, I have read this document entitled Release Waiver and Quitclaim with
Undertaking, and fully understood every word of it and its meaning and have affixed my
signature hereunder voluntarily and freely with the full and complete knowledge of the
meaning and intent of this document and of my rights under existing laws.
 I hereunto set my hand this ________________, 2020, ____________.

____________________________
(INDEPENDENT CONTRACTOR)

Signed in the presence of:

_____________________

SUBSCRIBED AND SWORN to before me this _____day of _________ 2020 at __________ City,
affiant appeared exhibiting her ____________________________ as proof of identity.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020.