Dear Representative, Exhibit Levels & Recognition: incur additional fees - One 6ft table for your display

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1 1020 Locust Street, Suite M5 Philadelphia, PA T JEFF-CME ( ) T F jeffersoncpd@jefferson.edu CME.Jefferson.edu Dear Representative, 18th Annual Thomas Jefferson University Spine Fellows Alumni Symposium July 13-14, 2018 Newport, RI - The Hotel Viking Don t miss this Exhibit Opportunity - Register Today! On behalf of Sidney Kimmel Medical College at Thomas Jefferson University, and the Course Co-Directors, Alexander R. Vaccaro, MD, PhD and Jeffrey Rihn, MD, I would like to formally invite your company to exhibit at the 18 th Annual Thomas Jefferson University Spine Fellows Alumni Symposium on Friday, July 13, 2018 & Saturday, July 14, 2018 at the Viking Hotel in Newport, RI. We are pleased to offer a variety of exhibit opportunities which will provide you with access to personally share your product information directly with spine surgeons from across the country, all who have been trained at Thomas Jefferson University a recognized institution for excellence in orthopaedic science and technology. Exhibitors will have several opportunities to converse with attendees during breakfast, breaks, lunch, and evening reception and dinner. Exhibit Levels & Recognition: Gold Level Exhibitor - $6,000 1 st Choice Exhibit Booth location in Exhibit Area (first come, first serve basis) - Full page, color Ad in Exhibitor Directory - Acknowledgement via separate Conference Sign and a separate slide in the conference PowerPoint presentation running during all breaks - Acknowledgement posted online via a Virtual Exhibit Hall and ed to all participants before and after the conference. - Special name badge designation - Up to 6 company representatives may attend evening reception (subject to fees for additional representatives) - Basic electricity included. Advanced electrical requirements/setup may incur additional fees - Two 6ft tables for your display Silver Level Exhibitor - $3,500 - Acknowledgement Conference Sign and inclusion in conference PowerPoint presentation running during all breaks - Up to 2 company representatives may attend evening reception (subject to fees for additional representatives) - Basic electricity included. Advanced electrical requirements/setup may incur additional fees - One 6ft table for your display

2 For additional information regarding exhibiting or for additional course information, we ask that you review the attached sheets and visit the course activity webpage at: Exhibit fees can be mailed to my attention at Sidney Kimmel Medical College, Jefferson Alumni Hall, Office of CME, 1020 Locust Street - Suite M-5, Philadelphia, PA Our tax ID number is: Please make checks payable to: Thomas Jefferson University, Office of CME. Visa and MasterCard will also be accepted (AMEX is not accepted). We hope you will join us as an exhibitor for this exceptional program and important networking event, most appropriately deserving of your participation and support. Please feel free to contact me with any questions you may have. I can be reached by phone at or by fax at , or at Sincerely, Patti Shaughnessy Senior CME Planner Sidney Kimmel Medical College at Thomas Jefferson University 1020 Locust Street, Suite M-5 Philadelphia, PA (Phone) (Fax) *Please note that Sidney Kimmel Medical College at Thomas Jefferson Universityis not listed as a covered recipient on the CMS/Sunshine Act list. Questions about Jefferson s status may be directed to Dr. Cole, Assistant Dean for CME.

3 Conference Location: Exhibit Location/ Times: Exhibit Levels & Recognition: Exhibit Set & Breakdown Times: The Hotel Viking 1 Bellevue Avenue Newport, RI (p) The following preliminary times are dedicated exhibit times where food and beverage will be served. Times will be confirmed the week prior to the conference: Friday, July 13, 2018 (Preliminary Agenda - Subject to Change) 7:00AM 7:45AM Registration, Continental Breakfast & Exhibits 10:30AM 10:45AM AM Break & Exhibits 12:45PM 1:15PM Lunch & Case Presentations 6:00PM 9:00PM Evening Group Dinner Saturday, July 14, 2018 (Preliminary Agenda - Subject to Change) 7:30AM 8:10AM Registration, Continental Breakfast & Exhibits 10:45AM 11:00AM AM Break & Exhibits 11:30AM 11:45AM Lunch & Lecture Exhibitor Registration: Representatives may begin exhibiting at 6:45AM on Friday, July 13, 2018 (Subject to change). All exhibits must be tabletop or portable in nature. See shipping info below. Please notify Patti Shaughnessy of shipments by at or by phone at Gold Level Exhibitor - $6,000 1 st Choice Exhibit Booth location in Exhibit Area (first come, first serve basis) - Full page, color Ad in Exhibitor Directory o Specifications: PDF format, letter size (8.5 by 11), no bleed, preferably with a border. Deadline to submit: Friday, July 6, Acknowledgement via separate Conference Sign and a separate slide in the conference PowerPoint presentation running during all breaks - Acknowledgement posted online via a Virtual Exhibit Hall and ed to all participants before and after the conference. - Special name badge designation - Up to 6 company representatives may attend evening reception (subject to fees for additional representatives) - Basic electricity included. Advanced electrical requirements/setup may incur additional fees - Two 6ft tables for your display Silver Level Exhibitor - $3,500 - Acknowledgement Conference Sign and inclusion in conference PowerPoint presentation running during all breaks - Up to 2 company representatives may attend evening reception (subject to fees for additional representatives) - Basic electricity included. Advanced electrical requirements/setup may incur additional fees - One 6ft table for your display Exhibit Set-up can begin on Friday, July 13, 2018 at 6:45AM (Subject to change) Exhibit breakdown must be completed by 3:00PM on Saturday, July 14, 2018

4 Electrical Needs & Shipping Information: Accommodations: Payment: Exhibitor Rules: Electrical services are included in the exhibit fee. Advanced electrical requirements/setup may incur additional fees. Each company is responsible for communicating their electrical needs to Patti Shaughnessy via to. Please notify Patti Shaughnessy prior to shipping: Shipments will be accepted at the Hotel Viking 2 days prior to conference, no earlier than Wednesday, July 11, Be sure to label them accordingly. Name of Company and On-site Contact/Representative The Hotel Viking 1 Bellevue Avenue Newport, RI Hold for 18th Annual Spine Fellows, July 13-14, 2018 Box of The Hotel Viking does not accept any liability for equipment, goods, displays, or other materials which arrive unmarked or fail to arrive at the conference location. Each exhibiting company is responsible for insuring its property for loss or damage. Please note that all company representatives are solely responsible for coordinating return shipping at the conclusion of the conference with loading dock representatives. Information regarding overnight accommodations can be found: Please note that room block availability is limited. Once our room blocks are sold out we are not able to add additional rooms at a discounted rate. Please contact Patti Shaughnessy if you need additional assistance. Please make check payable to: Thomas Jefferson University, Office of CME Mail to: SKMC Office of CME 1020 Locust Street, Suite M-5 Philadelphia, PA *Visa and MasterCard are also accepted. AMEX is not accepted. Payment in full is required with registration. If paying with company check, Credit Card information will be required to hold space. (Credit Card will be charged on July 13th if another payment method is not received) All exhibits must be tabletop or portable in nature. Exhibitor activities are restricted to the allocated space at the conference. Distribution of educational/promotional materials by exhibitors is limited to their booth space in the exhibit area. It is not permitted anywhere else in the hall, in conference meeting space, or at the entrances to the conference meeting space. Exhibits are intended for informational purposes, products should not be sold on site. Photography by exhibitors that includes pictures of the overall conference and/or its attendees is prohibited. The purpose of the exhibit is to further the education of meeting attendees through product and service displays and demonstrations. Exhibitor personnel may observe, but must refrain from any participation or recording of any scientific sessions on that company s behalf. The conference is not responsible for the security of exhibitors materials. We suggest that exhibitors leave nothing of value (e.g., laptop computer,

5 audio visual equipment, etc.) unattended at any time in the exhibit hall. Cancellation by the Conference Organizers In the event that the Conference would have to be cancelled, the organizers are not responsible for any airfare, hotel, and/or other costs incurred by exhibitors. Sunshine Act The Parties acknowledge and agree that Exhibiting Company may be subject to Section 6002 of the Affordable Care Act, which added Section 1128G to the Social Security Act, and its implementing regulations codified in 42 CFR 402 & 403 (collectively the Sunshine Act ). Release of Liability Required by the Hotel Viking Exhibiting companies are solely responsible for collecting any information about actions within their exhibit space that constitutes a payment or transfer of value to a Covered Recipient that is required to be reported under the Sunshine Act. A separate Release of Liability will be sent for signature/approval. Exhibitors will not be permitted to exhibit without a signed release. Please note the following information: Exhibitor shall be fully responsible to pay for any and all damages to property owned by the Hotel Viking, its owners or managers which results from any act or omission of Exhibitor. Exhibitor agrees to defend, indemnify and hold harmless the Hotel Viking, its owner s, manager s, officers or directors, agents, employees subsidiaries and affiliates from any damages or charges resulting from direct or arising from or out of the Exhibitor s use of the property, other than caused by negligence of the Hotel Viking. Exhibitor s liability shall include all losses, costs, damages, or expenses arising from or out of or by reason of any accident or bodily injury or other occurrences to any person or persons including the exhibitor, its agents, employees, and business invitees which arise from or out of Exhibitor s occupancy and/or use of the exhibiting premises, Hotel Viking or any part thereof. The Exhibitor understands that the Hotel Viking does not maintain insurance covering the Exhibitor s property and that is the sole responsibility of the Exhibitor to obtain such insurance. Should your company require any other needs regarding your exhibit, please contact Patti Shaughnessy by phone at or via at.

6 1020 Locust Street, Suite M5 Philadelphia, PA T JEFF-CME ( ) T F jeffersoncpd@jefferson.edu CME.Jefferson.edu EXHIBITOR CREDIT CARD PAYMENT FORM 18th Annual Thomas Jefferson Spine Fellows Alumni Symposium July 13-14, 2018 Newport, Rhode Island Exhibit Fee: Indicate your level of exhibit: Gold Level $6,000 Silver Level $3,500 Payment is due on or before July 13, 2018 Company Name: Company Representative (to contact with questions): Phone Number: Address: I hereby authorized use of my: American Express is NOT accepted Account Number: Visa MasterCard American Express Amount $ Expiration Date: Cardholder s Name: Signature: Credit Card Billing Address: (include City, State and Zip) Address: A copy of the receipt will be sent upon processing Fax You may fax your application with Credit Card payment to Send completed form to patricia.shaughnessy@jefferson.edu ONLINE EXHIBITOR REGISTRATION MUST ALSO BE COMPLETED TO COMPLETE VISIT

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8 18th Annual Thomas Jefferson University Spine Fellows Alumni Symposium Newport, Rhode Island GROUP DINNER RSVP Please return by: Friday, June 29, 2018 A group clambake dinner is scheduled to take place on Friday, June 13, 2018 from 6:00PM 9:00PM in the on the Courtyard of the Hotel Viking. Please use the space provided below to identify the company representatives that will be attending this dinner Gold Level Exhibitors are allowed up to 6 representatives and Silver Level Exhibitors are allowed up to 2 representatives Company Name: Representative #1: Representative #2: Representative #3: Representative #4: Representative #5: Representative #6: (Gold and Silver Level) (Gold and Silver Level) (Gold Level) (Gold Level) (Gold Level) (Gold Level) Additional Representatives*: *Additional guest(s)/representatives will require a fee to attend. Please see the fee structure noted below. Indicate how many guests at each level you will bring and the total to be charged to your credit card. Before or on June 1, 2018 After June 2, 2018 Adults 18+: x $ = Adults 18+: x $ = Guests 17 & younger: x $75.00 = Total: Guests 17 & younger: x $75.00 = Total: Please forward the completed form along with payment (if applicable) to the Office of CME using one of the following options: Fax/ Payment: You may fax this form with credit card payment to or to I hereby authorized use of my: Visa Mastercard American Express Amount $ Account Number: Cardholder s Name: Billing Address: Expiration Date: Signature: Please contact Patti Shaughnessy at the Office of CME with any questions either by phone at or at

9 18th Annual Thomas Jefferson University Spine Fellows Alumni Symposium Newport, Rhode Island ADDITIONAL ONSITE REPRESENTATIVE REGISTRATION FORM Please return by: Friday, June 29, 2018 Gold Level Exhibitors are allowed up to 6 representatives and Silver Level Exhibitors are allowed up to 2 representatives. If you wish to add additional representatives please add their names below: Company Name: Additional Representative #1: Additional Representative #2: Additional Representative #3: Additional Representative #4: Number of Additional Representatives Cost Per Representative $175 per person Total: Please forward the completed form along with payment to the Office of CME using one of the following options: Fax/ You may fax this form with credit card payment to or to Payment: I hereby authorized use of my: Visa Mastercard American Express Amount $ Account Number: Expiration Date: Cardholder s Name: Billing Address: Signature: Please contact Patti Shaughnessy at the Office of CME with any questions either by phone at or at