ACKNOWLEDGEMENT RECEIPT

Date: __________________

This is to acknowledge receipt of a copy of FLI Health and Safety Guidelines Booklet. I hereby bind
myself to read, understand, and comply with the rules and regulations stated therein.

Further, I acknowledge that my compliance with the FLI Health and Safety Guidelines Booklet shall
serve as a condition of my continued employment with the Company,

This booklet remains a property of Federal Land, Inc. and shall be surrendered upon my separation
from the Company as part of my clearance and accountability.

________________________
(Signature over printed name)

Witnessed by:

_________________________
HR