CONTRACT FOR PURCHASE OF INTERMENT RIGHTS, CEMETERY SUPPLIES OR SERVICES Schedule A to By-law Cemetery operator License #

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The Corporation of the Municipality of Bayham 9344 Plank Road, Box 160 Straffordville, ON N0J 1Y0 Telephone: 519-866-5521 www.bayham.on.ca bayham@bayham.on.ca CONTRACT FOR PURCHASE OF INTERMENT RIGHTS, CEMETERY SUPPLIES OR SERVICES Schedule A to By-law 2016-057 Cemetery operator License # 3267732 2016 In Name and Address of Cemetery CONTRACT INFORMATION Contract Reference # Date of issue PURCHASER INFORMATION Name Address PC Telephone Email address Purchaser s relationship to the Recipient(s) RECIPIENT #1 INFORMATION Name Address Province Postal Code Telephone Email RECIPIENT #2 INFORMATION Name Address Province Postal Code Telephone Email This contract is between the Purchaser AND The Corporation of the Municipality of Bayham For cemetery Interment Rights, Supplies and/or Services for the recipient(s) as identified in this contract. To be made in DUPLICATE

Schedule A to B/L 2016-057 - 2 - The Purchaser (if different than the Recipient (s) represents being legally authorized or charged with the responsibility for the Recipient(s) cemetery Interment Rights and cemetery pre-paid supplies and services arrangements specified in this contract. This agreement will be enforceable to the benefit of and be binding upon the parties hereto and their respective heirs, heirs, executors, administrators, successors, and assigns. Interment Rights per regular lot may include no more than one full size traditional body interment, plus two (2) cremation interments, provided the first interment is in a vault. Alternatively, up to four (4) cremation interments only, may be made in a regular lot. No more than two (2) appropriately sized urns shall be placed in any single columbarium niche or in a designated 3 x 3 cremation lot. Cremation urns or containers may be used for burials in regular lots when used for cremation burials only. All cremated human remains interred in a regular 4 x10 lot on top of a full body casket in a vault shall be placed in a small flat six by six inch (6 x6 ) box type container with a depth of no more than four (4) inches to ensure at least two feet (2 ) of earth coverage over the cremation remains, at surrounding ground level. For each cremation interment on top of an existing body burial with a vault, permission forms must be completed, signed and on file with the Municipality, in advance. **The purchase price per regular lot, cremation lot or niche permits one interment only in the respective lot or niche. **Each additional interment in a regular lot, cremation lot or niche is subject to payment of an additional fee, as may be in place at time of such interment, and must be properly authorized in writing. ** Resale: Interment Rights may be resold to a third party, through the operator, subject to restrictions. The Purchaser agrees that in the event of resale of the said Internment Rights, this certificate shall be returned with the completed and signed Part 1 and Part 2 of the Interment Rights Resale Endorsement Form C, to the Cemetery Operator who, upon completion, approval and payment of any required fees, will issue a new certificate to the new Interment Rights holder. **( Examples of Care and Maintenance Fund contributions from purchase of interment rights: 1. The Purchase Price of $600.00 (six hundred dollars) per regular lot includes $300.00 to the Care and Maintenance Fund and allows one interment in the regular lot. 2. The purchase price of $300.00 (three hundred dollars) per cremation lot includes $150.00 to the Care and Maintenance Fund and allows one interment in the cremation lot.)

Schedule A to B/L 2016-057 - 3-3. The Purchase Price of $1200.00 (twelve hundred dollars) per single columbarium niche includes $300.00 to the Care and Maintenance Fund and allows one interment in a single columbarium niche. Interment Rights to Regular / Cremation Lot or Columbarium Niche purchased: Location & Details Block Section Plot # Row Grave(s): No. of graves(s) Dimensions per lot Area of square feet. OR: Columbarium Niche Unit 1 or 2 Side A or B # The number of Regular Lot(s) / Cremation Lot(s) or columbarium niche purchased: at ($600 / $300 or $1200), each, equals, which includes ($ 150, $300 or $300) to the Care and Maintenance Fund. (Circle above as appropriate) Interment Rights Purchases: Amount HST Regular lot(s) Cremation lot(s) Columbarium Niche Services: Identification & marking of lot for burial Identification & marking of lot for marker placement Placement of up to four corner posts provided by interment rights holder Duplicate Interment Rights Certificate Transfer Duplicate Interment Rights Certificate Resale Endorsement Interment Permission Form No charge Municipal fee for opening & closing Cremation grave Municipal fee for opening & closing Columbarium Niche Fee for each additional interment in a regular or cremation lot or inurnment in a single columbarium niche (circle selection) Name plate & engraving plus cast shipping Extra copy of Cemetery By-law Booklet Purchase of two (2) or four(4) corner markers (circle choice) Ministry interment/inurnment fee N/C Other Total Contract Price $ Sub-Totals +

Schedule A to B/L 2016-057 - 4 - TERMS & CONDITIONS OF CONTRACT 1. THE FOLLOWING TRUSTING PROVISIONS ARE IN EFFECT: Per each regular Lot: Per each cremation lot: Per each columbarium niche: 40% of the Purchase price or $ 300, whichever is greater 40% of the Purchase price or $150, whichever is greater. 40% of the Purchase price or $300, whichever is greater. 2. CONTRIBUTION TO CARE AND MAINTENANCE FOR MARKER INSTALLATION: Flat marker 173 square inches or more: $ 50. Upright monument up to 4 feet in height or width $100. Upright monument more than 4 feet in height or width $200. 3. A CONTRACT FOR THE PURCHASE OF INTERMENT RIGHTS INCLUDES: In accordance with the cemetery By-law -116, the following restrictions on the exercising of interment rights and documents required are under the Interment Heading. If an interment rights holder desires to transfer an interment right, the rights holder shall give notice on the appropriate form Schedule E to the cemetery owner and return the original interment rights certificate. Upon full payment of all applicable fees, the cemetery owner shall issue a new interment rights certificate to the Transferee. For Contract Cancellation within thirty days of purchase, refer to the By-law heading Cancellation. In accordance with By-law -116, restrictions on the transfer of interment rights can be found under the Transfers, Repurchases & Third Party Sales heading. The resale of interment rights after 30 days by the purchaser or interment rights holder, as applicable, to a third party is now permitted. Please refer to Resales under the Transfers, Repurchases & Third Party ReSale heading. NOTE: ALL THIRD PARTY RESALES OF INTERMENT RIGHTS SHALL BE CARRIED OUT THROUGH THE CEMETERY OPERATOR. 4. CANCELLATION OF CONTRACT If the above Interment Rights have been paid for in full, have not been used, and the Interment Rights Certificate has not been issued, the Purchaser may, in writing to the owner, within thirty (30) days from the signing of the contract, cancel this contract and receive a full refund. If the above Interment Rights have been paid for in full, have not been used, and the Interment Rights Certificate has been issued, the Interment Rights Holder(s) may, in writing to the owner, within thirty (30) days from the signing of the contract, cancel this contract and receive a full refund. The Purchaser or Interment Rights Holder, as applicable, may in writing to the owner, within thirty (30) days from the signing of the contract, cancel pre-paid supplies and services, provided they are paid in full, and receive the refund.

Schedule A to B/L 2016-057 - 5-5. RESALE OF INTERMENT RIGHTS AFTER 30 DAY COOLING-OFF PERIOD & PRICE Unless the interment rights have been exercised the Purchaser or Interment Rights Holder, as applicable, retains the right to re-sell the interment rights. A Purchaser or an Interment Rights Holder cannot re-sell their Interment Rights for more than the current value on the cemetery price list. The current cost for the cemetery operator to complete and provide a new Interment Rights Certificate upon resale is listed on the Cemetery Tariff/Fee Schedule. 6. SUBDIVISION OF INTERMENT RIGHTS No Purchaser or Interment Rights Holder(s) may sub-divide and sell or transfer a portion of an Interment Rights. 7. MEMORIALIZATION The purchase of a lot permits placement of a maximum of one (1) upright monument only on a traditional full body interment, plus up to two (2) cremations or on a lot with up to 4 cremations only, subject to approved by-laws. Care and Maintenance Fund Contribution for Marker and Monument Installation: In accordance with the FBCSA and Ontario Regulation 30/11, the following contributions will be made to the Care and Maintenance Fund for every installation of a marker or monument: (a) In the case of a flat marker measuring less than 1,116.3 sq. cm. (173 sq. in.) $0.00 (b) In the case of a flat marker measuring over 1,116.3 sq. cm. (173 sq. in.) $50.00 (c) In the case of an upright monument measuring 1.22 m. (4 ft.) or less in height or length, including the base $100.00 (d) In case of an upright monument measuring more than 1.22m. (4 ft.) either in height or length, including the base $200.00. Only the Memorial plaque included with the purchase of the Niche are permitted as found under the Columbarium heading. Interment Rights Holder(s) request to remove memorialization: A marker, monument, or memorialization purchased and/or installed by anyone other than the Rights Holder(s) may be removed by the cemetery representative on the written request of the Rights Holder(s). 8. PAYMENT TERMS Payment in full is required at time of purchase. Full payment must be made before any burial or memorialization can take place. An Interment Rights Certificate will not be issued until the Interment Right(s) and Care and Maintenance portions have been paid in full. An Interment Rights Certificate(s) will be issued within 14 days of full payment and signing of the contract by the operator. 9. CAUSES BEYOND THE CEMETERY OPERATOR S CONTROL The cemetery operator cannot be responsible if unable/prevented from carrying out this contract due to causes beyond its control.

Schedule A to B/L 2016-057 - 6 - Privacy Policy Personal Information: The Purchaser acknowledges and provides consent to permit the Corporation of the Municipality of Bayham to collect, use and disclose your personal information in accordance with the requirements under the FBCSA and Ontario Regulation 30/11 for information within the municipal owned cemeteries public register. The Purchaser also understands that the Corporation of the Municipality of Bayham does not rent or sell personal information to third party organizations. Consumer Information Guide and cemetery price list: By initialing below, the purchaser acknowledges receiving a copy of the Ontario Government s Consumer information Guide (where made available by the Registrar) and the cemetery price list at the time of entering into this contract. { } I hereby acknowledge I have been offered and/or received a copy of the Ontario Government s Consumer Information Guide and the Cemetery Price List. I have reviewed the Contract s terms and conditions and hereby confirm that the Interment Rights, as specified in this contract are complete and correct. I direct the operator to proceed with the sale of the Interment Right(s), as identified in the contract in accordance with the cemetery by-laws which are now or at any time hereafter in force. { } I hereby acknowledge I have received and reviewed a copy of the cemetery s by-laws. The Terms and Conditions set out in this contract expire within 30 days unless executed by the purchaser and the operator. The contract date set out below is the date on which this contract is accepted by the operator. { } I acknowledge having received a copy of this contract, and assume full responsibility for payment of the total contract amount to the operator in accordance with the contract s terms and conditions. It is agreed between the parties that this contract and the operation of the cemetery, including restrictions on Interment Rights, is subject to the Cemetery By-laws of the Municipality of Bayham and the Purchaser hereby acknowledges receipt of a copy of the current By-laws and that the Terms & Conditions of Contract above, have been read and understood. Total Contract Price $ (from page 3) Ordered by: Signature (Purchaser Name) Payment by cheque #: received on Accepted on behalf of the Operator by: Name Cemetery Operator / Representative: Signature Contact: Email: Telephone #: