SETTLEMENT AGREEMENT BETWEEN
THE UNITED STATES OF AMERICA AND
ASSOCIATED FOOT & ANKLE CENTERS OF NORTHERN VIRGINIA, PC

U.S. DEPARTMENT OF JUSTICE DJ # 202-79-281

BACKGROUND

1. The parties (“Parties”) to this Settlement Agreement (“Agreement”) are the United States of America (“United States”) and Associated Foot & Ankle Centers of Northern Virginia, PC (“AFAC”), a podiatry practice with locations in Stafford and Lake Ridge, Virginia.
2. This matter was initiated by a complaint filed with the United States against AFAC, alleging violations of title III of the Americans with Disabilities Act of 1990, as amended (the “ADA”), 42 U.S.C. §§ 12181-12189, and its implementing regulation, 28 C.F.R. Part 36. Specifically, Complainant K.B. (the “Complainant”), who is deaf, alleged that AFAC personnel failed to provide sign language interpretive services during multiple medical appointments, including pre- and post-surgery and provided an individual who is not a qualified interpreter during other medical appointments. Complainant further alleges that a qualified interpreter was necessary in order to ensure effective communication.
3. Complainant K.B. is deaf and uses sign language as her primary means of communication. K.B. needed the services of a podiatrist, including foot surgery.

INVESTIGATION AND FINDINGS

4. The United States Attorney for the Eastern District of Virginia (“U.S. Attorney’s Office”) is authorized under 42 U.S.C.§ 12188 and 28 C.F.R. Part 36, Subpart E, to investigate the allegations of the complaint in this matter to determine AFAC’s compliance with title III of the ADA. The U.S. Attorney’s Office has the authority to, where appropriate, negotiate and secure voluntary compliance agreements, and to bring civil actions enforcing title III of the ADA should it fail to secure voluntary compliance.
5. Complainant is deaf and as such is an individual with a “disability” within the meaning of the ADA. 42 U.S. C. § 12102; 28 C.F.R. § 36.104.
6. AFAC is a professional corporation which operates a podiatry practice that is licensed by the Commonwealth of Virginia. AFAC is a “public accommodation” within the meaning of title III of the ADA. 42 U.S.C. § 12181(7)(F); 28 C.F.R. § 36.104.
7. The ADA prohibits discrimination on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of a public accommodation. 42 U.S.C. § 12182(a); 28 C.F.R. § 36.201(a).
8. On the basis of its investigation, the U.S. Attorney’s Office determined that AFAC denied K.B. appropriate auxiliary aids and services necessary for effective communication during multiple medical appointments in violation of 42 U.S.C. § 12182(b)(2)(A)(iii); 28 C.F.R. § 36.303.
9. AFAC fully cooperated with the United States Attorney’s Office’s investigation in this matter. This Agreement is neither an admission of liability by AFAC nor a concession by the United States that its claims are not well founded. By entering into this Agreement, AFAC does not admit the allegations in paragraphs 2 and 8, above, or to any violation of law, liability, fault, misconduct or wrongdoing in connection with those allegations. The Parties have determined that the complaint filed with the United States can be resolved without litigation and have agreed to the terms of this Agreement.

DEFINITIONS

10. The term “auxiliary aids and services” includes qualified interpreters on-site or through video remote interpreting (VRI) services; notetakers; real-time computer-aided transcription services; written materials; exchange of written notes; telephone handset amplifiers; assistive listening devices; assistive listening systems; telephones compatible with hearing aids; closed caption decoders; open and closed captioning, including real-time captioning; voice, text, and video-based telecommunications products and systems, including text telephones (TTYs), videophones, and captioned telephones, or equally effective telecommunications devices; videotext displays; accessible electronic and information technology; or other effective methods of making aurally delivered information available to individuals who are deaf or hard of hearing. 28 C.F.R. § 36.303(b)(1).
11. The term “AFAC Personnel” means any person working for AFAC, whether as an officer, agent, employee, volunteer, or independent contractor, including, without limitation, nurses, doctors, therapists, technicians, physician’s or nurse’s assistants, nurse practitioners, office managers, administrative assistants, secretaries, receptionists, and other clerical staff.
12. The term “qualified interpreter” means an interpreter who, via a video remote interpreting (VRI) service or an on-site appearance, is able to interpret effectively, accurately, and impartially, both receptively and expressively, using any necessary specialized vocabulary. Qualified interpreters include, for example, sign language interpreters, oral transliterators, and cued-language transliterators. 28 C.F.R. § 36.104.
13. The term “Patient” shall be broadly construed to include any individual who is seeking or receiving the goods, services, facilities, privileges, advantages, or accommodations of AFAC.
14. The term “Companion” means a person who is deaf or hard of hearing and is a family member, friend, or associate of an individual seeking access to, or participating in, the goods, services, facilities, privileges, advantages, or accommodations of a public accommodation, who, along with such individual, is an appropriate person with whom the public accommodation should communicate. 28 C.F.R. § 36.303(c)(1)(i).
15. “Patient medical files, records or charts” means the medical files and related records for an individual patient, including both the paper and electronic records.

EQUITABLE RELIEF

A. Prohibition of Discrimination

16. AFAC shall provide appropriate auxiliary aids and services, including qualified interpreters, where such aids and services are necessary to ensure effective communication with Patients and Companions who are deaf or hard of hearing. Pursuant to 42 U.S.C. § 12182(a), AFAC shall also provide Patients and Companions, who are deaf or hard of hearing, with the full and equal enjoyment of its services, privileges, facilities, advantages, and accommodations as required by this Agreement and the ADA.
17. AFAC shall not deny equal services, accommodations, or other opportunities to any individual because of the known relationship of that person with someone who is deaf or hard of hearing. See 42 U.S.C. § 12182(b)(1)(E).
18. AFAC shall not retaliate against or coerce in any way any person who made, or is making, a complaint according to the provisions of this Agreement or exercised, or is exercising, his or her rights under this Agreement or the ADA. See 42 U.S.C. § 12203.

B. Effective Communication

19. Pursuant to 42 U.S.C. § 12182(b)(2)(A)(iii), AFAC will provide to Patients and Companions, who are deaf or hard of hearing, any appropriate auxiliary aids and services that are necessary for effective communication after making the assessment described in paragraphs 20 & 21 of this Agreement. Appropriate auxiliary aids and services will be provided as soon as practicable (without compromising patient care). AFAC will advise Patients and Companions who require auxiliary aids or services that these are available throughout the patient’s treatment at the podiatry practice.
20. The determination of appropriate auxiliary aids and services, and the timing, duration, and frequency with which they will be provided, must be made at the time an appointment is scheduled for the Patient or on the arrival of the Patient or Companion at the Practice, whichever is earlier. The determination of appropriate auxiliary aids or services, and the timing, duration, and frequency with which they will be provided, will be made by an AFAC physician in consultation with the person with a disability. The assessment made by the AFAC physician will take into account all relevant facts and circumstances, including, for example, the individual’s communication skills and knowledge, and the nature and complexity of the communication at issue. AFAC shall use the Communication Assessment Form that is attached to this Agreement as Exhibit A in performing the communication assessment. AFAC shall ensure that a completed Communication Assessment Form is obtained from each individual patient or companion who agrees to complete the Form. AFAC shall provide assistance in completing the Form at the Patient’s or Companion’s request. After being completed, the Form(s) shall be maintained in the patient’s medical chart, whether kept in paper or electronic form. If a patient identifies a companion who is not presently at AFAC but is expected at AFAC during the patient’s course of treatment, AFAC Personnel shall provide the patient with the contact information of the AFAC Personnel who can assist the companion in completing a Deaf or Hard of Hearing Communication Request Form in advance of arriving at AFAC and with the contact information of AFAC Personnel who can assist the Companion in completing the Form at AFAC (if the Form is not completed in advance). If at any point during a patient’s course of treatment, a companion identifies himself or herself as deaf or hard of hearing, AFAC shall promptly provide him/her with the Form, if it has not done so already.
21. The determination of which appropriate auxiliary aids and services are necessary, and the timing, duration, and frequency with which they will be provided, must be made at the time AFAC learns that a deaf or hard of hearing Patient will be using its services or on the arrival of the deaf or hard of hearing Patient or Companion at AFAC, whichever is earlier. AFAC Personnel will perform an assessment (see paragraph 20) as part of each initial inpatient assessment and document the results in the Patient’s electronic medical chart. In the event that communication is not effective, AFAC Personnel will reassess which appropriate auxiliary aids and services are necessary, in consultation with the person with a disability, where possible, and provide such aid or service based on the reassessment.
22. The patient’s medical chart shall be conspicuously labeled (such as with a sticker, indicator, or label on the cover) to alert AFAC Personnel to the fact that the Patient and/or Companion is deaf or hard of hearing. The chart shall indicate the mode of communication requested by and provided to the Patient and/or Companion.
23. If a Patient or a Companion has an ongoing relationship with AFAC, with respect to each of these subsequent visits, AFAC will continue to provide the appropriate auxiliary aids or services to the Patient or Companion without requiring a request for the appropriate auxiliary aids or services by the Patient or Companion for each visit. AFAC will keep appropriate records that reflect the ongoing provision of auxiliary aids and services to Patients and Companions, such as notations in a Patient’s medical charts.
24. If a Patient and/or Companion does not request auxiliary aids or services, but AFAC has reason to believe that such person would benefit from auxiliary aids or services, AFAC will specifically inform the Patient and/or Companion that auxiliary aids and services are available free of charge.
25. AFAC will maintain a log in which requests for qualified interpreters on site or through video remote services will be documented. The log will indicate the time and date the request was made, the name of the Patient or Companion who is deaf or hard of hearing, the time and date of the scheduled appointment (if a scheduled appointment was made), the nature of the auxiliary aid or service provided, and the time and date the appropriate auxiliary aid or service was provided. If no auxiliary aid or service was provided, the log shall contain a statement why the auxiliary aid and service was not provided. The log should include the AFAC personnel who conducted the assessment and made the determination. Such logs will be maintained for the entire duration of the Agreement, and will be incorporated into the semi-annual Compliance Reports to the United States Attorney’s Office.
26. All appropriate auxiliary aids and services required by this Agreement will be provided free of charge to the deaf or hard of hearing Patient and/or Companion.
27. AFAC will take appropriate steps to ensure that all AFAC Personnel are made aware of a Patient or Companion’s disability and auxiliary aid and services needed so that effective communication with such person will be achieved. These steps will include designating this information in the electronic medical record.

C. Qualified Interpreters

28. Depending on the complexity and nature of the communication, a qualified interpreter may be necessary to ensure effective means of communication for patients and visitors. When an interpreter is needed, AFAC shall provide qualified sign language interpreters to Patients and Companions who are deaf or hard of hearing and whose primary means of communication is sign language, and qualified oral interpreters to such Patients and Companions who rely primarily on lip reading as necessary for effective communication. Examples of circumstances when the communication may be sufficiently lengthy or complex so as to require an interpreter include the following:
1. Discussing a patient’s symptoms and medical condition, medications, and medical history;
2. Explaining medical conditions, treatment options, tests, medications, surgery and other procedures;
3. Providing a diagnosis and recommendation for treatment;
4. Communicating with a patient during treatment, including physical and occupational therapies, testing procedures, and during physician’s rounds;
5. Obtaining informed consent for treatment;
6. Providing instructions for medications, pre- and post-surgery instructions, post-treatment activities and follow-up, treatments; and
7. Discussing powers of attorney, living wills and/or complex billing and insurance matters.
29. Within thirty (30) days of the effective date of this Agreement, AFAC will establish and maintain a list of qualified interpreters or interpreter agencies that employ or arrange the services of qualified interpreters to ensure that qualified interpreter services are available. AFAC will establish internal procedures for ordering interpreting services that is consistent with the interpreter or interpreter agencies’ procedures. At a minimum, all of AFAC’s requests for interpreters, including the time and date, will be confirmed in writing at the time of the request. Further, AFAC will consider an order for interpreting services to be complete only after receiving written confirmation from the interpreting service that an interpreter will be provided at the time and date requested. AFAC will file a copy of all written correspondence with interpreting services in the patient’s medical chart. Additionally, for the duration of this Agreement, AFAC will file a copy of its written correspondence with interpreters and interpreting agencies in the Auxiliary Aid and Service Log discussed in paragraph 25.
30. Within thirty (30) days of the effective date of this Agreement, AFAC will submit to the United States Attorney’s Office its list of sign language interpreter providers and a copy of its contract(s) with one or more sign language interpreter or sign language interpreter agency.
31. VRI can provide immediate, effective access to interpreting services in a variety of situations including emergencies and unplanned incidents. When using VRI services, AFAC shall ensure that it provides: (1) Real-time, full-motion video and audio over a dedicated high-speed, wide-bandwidth video connection or wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication; (2) A sharply delineated image that is large enough to display the interpreter’s face, arms, hands, and fingers, and the participating individual’s face, arms, hands, and fingers, regardless of his or her body position; (3) A clear, audible transmission of voices; and (4) Adequate training to users of the technology and other involved individuals so that they may quickly and efficiently set up and operate the VRI. 28 C.F.R. § 36.303(f). VRI shall not be used when it is not effective due, for example, to a patient’s limited ability to move his or her head, hands or arms; vision or cognitive issues; or significant pain; or due to space limitations in the room. If, based on the circumstances, VRI is not providing effective communication after it has been provided or is not available due to circumstances outside of AFAC’s control, VRI shall not be used as a substitute for an on-site interpreter, and an on-site interpreter shall be provided promptly.
32. AFAC will not rely on an adult friend or family member of the individual with a disability to interpret except in an emergency involving an imminent threat to the safety of an individual or the public where there is no interpreter available; or where the individual with a disability specifically requests that the adult friend or family member interpret, the accompanying adult agrees to provide such assistance, and reliance on that adult for such assistance is appropriate under the circumstances. AFAC will not rely on a minor child or a patient to interpret except in an emergency involving an imminent threat to the safety of an individual or the public where there is no interpreter available.
33. If a patient and/or companion indicates to AFAC Personnel that he or she wants an interpreter after failing to request one on the Deaf or Hard of Hearing Communication Request Form, AFAC Personnel shall provide the Patient or Companion with a new Deaf or Hard of Hearing Communication Request Form. AFAC Personnel shall then comply with the requirements of paragraphs 20 and 23 as if the patient or companion had originally requested an interpreter. Both the original Deaf or Hard of Hearing Communication Request Form and the new one shall be kept in the patient’s medical chart.

D. Notice to Community

34. Within thirty (30) days of the entry of this Agreement, AFAC shall post and maintain signs of conspicuous size and print at all AFAC waiting areas, examination rooms and wherever a Patient’s Bill of Rights is required by law to be posted. Such signs shall be to the following effect:

Sign language and oral interpreters, TTYs, and other auxiliary aids and services are available free of charge to people who are deaf or hard of hearing. For assistance, please contact any AFAC Personnel or the Information Office at _____________(voice/TTY), room ______.

These signs will include the international symbols for “interpreters." Additionally, AFAC will provide a notice containing the language found above to each patient when they check in for appointments.

35. Website. AFAC will include on its website the policy statement described in Paragraph 34, above.

E. Notice to AFAC Personnel and Physicians

36. AFAC shall send an internal memorandum to its personnel that includes a policy statement regarding the AFAC’s policy for effective communication with persons who are deaf or hard of hearing. This policy statement shall include, but is not limited to, language to the following effect:

If you recognize or have any reason to believe that a Patient or a relative, close friend, or Companion of a Patient is deaf or hard of hearing, you must advise the person that appropriate auxiliary aids and services, such as sign language and oral interpreters, video remote interpreting services, TTYs, note takers, written materials, telephone handset amplifiers, assistive listening devices and systems, telephones compatible with hearing aids, televisions with captioning or closed caption decoders, and open and closed captioning of most programs, will be provided free of charge when appropriate. If you are the responsible health care provider, you must ensure that such aids and services are provided when appropriate.

AFAC will circulate this memorandum within thirty (30) days of the Effective Date of this Agreement to all AFAC Personnel and both employed and affiliated physicians, and to all new AFAC Personnel and newly employed or affiliated physicians upon their affiliation or employment with AFAC.

F. Training

37. AFAC will provide mandatory ADA training for all AFAC personnel who might interact with deaf or hard of hearing Patients or Companions within thirty (30) days of the effective date of this Agreement, and will be conducted annually thereafter. Such training will be sufficient in duration and content to train the individual in:
1. the various degrees of hearing impairment, language, and cultural diversity in the deaf community;
2. identification of communication needs of persons who are deaf or hard of hearing;
3. recommended and required charting procedures governing requests for auxiliary aids and services;
4. types of auxiliary aids and services available at AFAC and how to secure them in a timely manner;
5. the proper use and role of qualified interpreters;
6. criteria to be used in order to select an interpreter who is qualified;
7. the proper use and role of video remote interpreting services;
8. making and receiving calls through TTYs and the relay service; and
9. any other applicable requirements of this Agreement.
38. AFAC will hire an independent agency or group to conduct the initial trainings described in paragraph 37 of this Agreement. The trainer shall be subject to the approval of the U.S. Attorney’s Office. For the required annual trainings thereafter, AFAC may conduct the trainings without the assistance of an independent group, but must sufficiently update and/or create training materials in order to ensure the trainings include any new developments to the ADA and its requirements. AFAC may also videotape the initial trainings for annual trainings as long as AFAC also ensures that it supplements such training with any new developments to the ADA and its requirements.
39. All employees who receive incoming telephone calls from the public will receive special instructions by AFAC on using TTYs or relay services to make, receive, and transfer telephone calls. Such training must be provided within 60 days of the effective date of this Agreement and will be conducted annually thereafter.
40. AFAC will provide the training specified above in paragraphs 37-39 to new employees within thirty (30) days after the commencement of their services for AFAC.
41. AFAC will maintain in electronic form for the duration of this Agreement, confirmation of training conducted pursuant to paragraphs 37-40 of this Agreement, which will include the names and respective job titles of the attendees, as well as the date and time of the training session.

G. Reporting, Monitoring, and Violations

42. Within sixty (60) days of the effective date of this Agreement, AFAC will provide the United States with a copy of all training materials used to train its staff, training attendance sheets required in Paragraph 41, above, and photographs of the notices posted in its offices pursuant to this Agreement.
43. Beginning six months after the Effective Date of this Agreement and every six months thereafter for the entire duration of the Agreement, AFAC will provide a written report (“Compliance Report”) to the U.S. Attorney’s Office regarding the status of its compliance with this Agreement. The Compliance Report will include data relevant to the Agreement, including but not limited to:
1. the Auxiliary Aid and Service Log described in paragraph 25; and
2. the number of complaints received by AFAC from deaf and hard of hearing Patients and Companions regarding auxiliary aids and services and/or effective communication, and the resolution of such complaints including any supporting documents.

AFAC will maintain records to document the information contained in the Compliance Reports and will make them available, upon request, to the U.S. Attorney’s Office.

44. During the term of this Agreement, AFAC will notify the U.S. Attorney’s Office if any person files a lawsuit, complaint or formal charge with a state or federal agency, alleging that AFAC failed to provide auxiliary aids and services to deaf or hard of hearing Patients or Companions or otherwise failed to provide effective communication with such Patients or Companions. Such notification must be provided in writing via certified mail within twenty (20) days of the date AFAC received notice of the allegation and will include, at a minimum, the nature of the allegation, the name of the person making the allegation, and any documentation possessed by AFAC relevant to the allegation. AFAC will reference this provision of the Agreement in the notification to the U.S. Attorney's Office.

H. Compensatory Relief for Complainants and Release

45. Within ten (10) days after receiving the complainant's signed release (a blank release form is at Exhibit B), AFAC will send a check in the amount of fourteen thousand ($14,000) dollars made out to Complainant K.B. This check is to compensate the Complainant pursuant to 42 U.S.C. § 12188(b)(2)(B), for the effects of the alleged discrimination suffered as described in paragraph 2. The check shall be mailed to:

Financial Litigation Unit
United States Attorney's Office for
Eastern District of Virginia
101 W. Main Street #8000
Norfolk, VA 23510

A copy of the check shall be sent to:

Steven Gordon
Assistant United States Attorney
2100 Jamieson Avenue
Alexandria, VA 22314

I. Payment of Civil Penalty to the United States

46. Within ten (10) days of the Effective Date of this Agreement, the AFAC will pay to the United States of America the sum of one thousand ($1,000.00) dollars pursuant to 42 U.S.C. §12188(b)(2)(C). The check shall be mailed to:

Financial Litigation Unit
United States Attorney's Office for
Eastern District of Virginia
101 W. Main Street #8000
Norfolk, VA 23510

A copy of the check shall be sent to:

Steven Gordon
Assistant United States Attorney
2100 Jamieson Avenue
Alexandria, VA 22314

J. Enforcement and Miscellaneous

47. This Agreement will be in effect for three (3) years from the Effective Date.
48. This Agreement does not affect AFAC's continuing responsibility to comply with all applicable aspects of title III of the ADA.
49. A copy of this document or any information contained in it will be made available to any person by AFAC or the United States on request.
50. In consideration of the terms of this Agreement as set forth above, the Attorney General agrees to refrain from undertaking further investigation or from filing a civil suit under title III of the ADA related to the allegations in paragraph 2, except as provided in paragraph 51. Nothing contained in this Agreement is intended or shall be construed as a waiver by the United States of any right to institute proceedings against AFAC for violations of any statutes, regulations, or rules administered by the United States or to prevent or limit the right of the United States to obtain relief under the ADA.
51. The United States may review compliance with this Agreement at any time and can enforce this Agreement if the United States believes that it or any requirement thereof has been violated by instituting a civil action in the U.S. District Court. If the United States believes that this Agreement or any portion of it has been violated, it will raise its claim(s) in writing with AFAC, and the parties will attempt to resolve the concern(s) in good faith. The United States will allow AFAC thirty days from the date it notifies AFAC of any breach of this Agreement to cure said breach, prior to instituting any court action to enforce the ADA or the terms of the Agreement.
52. This Agreement and the attachments hereto constitute the entire agreement between the parties on the matters raised herein, and no other statement, promise, or agreement, either written or oral, made by either party or agents of either party, that is not contained in this written agreement, shall be enforceable. This Agreement is limited to the facts set forth herein and does not purport to remedy any other potential violations of the ADA or any other federal law.
53. This Agreement is final and binding on the parties, including all principals, agents, executors, administrators, representatives, successors in interest, beneficiaries, assigns, heirs and legal representatives thereof. Each party has a duty to so inform any such successor in interest.
54. Failure by any party to seek enforcement of this Agreement pursuant to its terms with respect to any instance or provision shall not be construed as a waiver to such enforcement with regard to other instances or provisions.
55. The signer of this document, in a representative capacity for AFAC, represents that he or she is authorized to bind AFAC to this Agreement.
56. The effective date of this Settlement Agreement is the date of the last signature below.
57. This Agreement may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same Agreement. Electronically transmitted signatures shall constitute acceptable, binding signatures for purposes of this Agreement.

Exhibit A

ATTACHMENT A: COMMUNICATION ASSESSMENT FORM

____________________am/pm Date/Time
_______________________ Name of Person with Disability	_______________________ Patient's Name (if not person with disability)
Nature of Disability:	Relationship to Patient:
__Deaf	__Self
__ Hard of Hearing	__ Family Member
__ Speech Disability	__Friend / Companion
__ Other: ______________	__ Other: ______________

Do you want a professional sign language or oral interpreter for your visit?

__No. I do not use sign language and do not use interpreters to lip read.
__No. I prefer to have family members/ friends help with communication.
__No. I do not feel an interpreter is necessary or do not want one for this visit.
__Yes. Choose one (free of charge):

__American Sign Language (ASL) interpreter
__Pidgin Signed English (PSE) interpreter
__Signed English interpreter
__Oral interpreter
__Other. Explain: _____________________________

Which of these would be helpful for you for effective communication? (free of charge)

__TTY/TDD (text telephone)

__Assistive listening device (sound amplifier)
__Qualified note-takers

__Writing back and forth
__CART: Computer-assisted Real Time Transcription Service
__Other. Explain: _________________________________________

We ask this information so we can communicate with you effectively. All communication aids and services are provided FREE OF CHARGE. If you need further assistance, please ask a member of our office staff.

Any questions? Please call our office, ______________(voice), ______________ (TTY), or visit us during normal business hours.

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Exhibit B

RELEASE OF ADA CLAIMS

For and in consideration of the acceptance of relief offered to me by Associated Foot & Ankle Centers of Northern Virginia (“AFAC”) pursuant to a Settlement Agreement between the United States and AFAC: I, _________________, release and discharge AFAC from all legal and equitable claims under, arising out of, or related to the complaint described in paragraph 2 of the Settlement Agreement between the United States and AFAC concerning AFAC's failure to provide effective communication in violation of the Americans with Disabilities Act.

This Release will be considered null and void in the event that AFAC fails to send a check in the amount specified in the Settlement Agreement within ten (10) days of receipt of this signed Release.

I HAVE READ THIS RELEASE AND UNDERSTAND THE CONTENTS THEREOF AND I EXECUTE THIS RELEASE OF MY OWN FREE WILL.

Signed this _______ day of ____________, 2014.