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Insurance Premium Tax (Ipt) Collection Program - Delinquent - Louisiana Municipal Advisory & Technical Services Bureau Page 2

PAYMENT AGREEMENT

LaMATS agrees to provide the participant with a complete and professional

accomplishment of the scope of work. For this service, the participant agrees to pay

LaMATS postage and ten percent (10%) of delinquent taxes and penalties received by

the participant under this contract.

The participant and LaMATS will establish a

mutually agreeable payment schedule. If no collections are made under this contract,

no fees are due by the participant.

All services provided by LaMATS will be performed by The Palmer Group, which is

under contract with LaMATS.

HOLD HARMLESS

The participant will hold harmless and indemnify LaMATS, its agents, officers and

employees, against all suits, claims or causes of action that may arise out of or result

from any allegations of any error, omission, or fault or negligent act of the participant, its

agents, officers of employees, relating in any way to collections services as provided in

this contract. LaMATS will hold harmless and indemnify the participant, its agents,

officers, and employees, against all suits, claims, or causes of action that may arise out

of or result from any allegations of any error, omission, fault or negligent act of LaMATS,

its officers or employees, relating in any way to collections services as provided in this

contract. “Indemnity” as used herein shall extend to any and all awards of damages

against the indemnitee, its agents, officers and employees, as well as reimbursement of

all cost of defense, to include attorney’s fee.

The terms of this agreement are mutually acceptable and our authorized signatures are

affixed hereto.

__________ of ____________________

By: ______________________________

________________________________

(title)

Louisiana Municipal Advisory & Technical Services Bureau

By: ______________________________

Tom Ed McHugh

Executive Director, LMA

Louisiana Municipal Advisory & Technical Services Bureau

700 North 10

Street, Suite 460, P.O. Box 4327, Baton Rouge, LA 70821-4327

800.996.9573/Fax 225.336.5262

Email Address:

ipt@lamats.net

Web Address:

Insurance Premium Tax (Ipt) Collection Program - Delinquent - Louisiana Municipal Advisory & Technical Services Bureau Page 2