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PAYROLL DEDUCTION
$5,000 GUARANTEE
KEUKA GUARANTEE OF SATISFACTION


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$5,000 GUARANTEE

Keuka Café® Footwear is engineered for safety, style, comfort and durability at an affordable price. Designed to protect workers on slippery surfaces, Keuka Café® Footwear is the brand of choice for restaurants, hotels, supermarkets, factories and industrial areas throughout the U.S. & Canada.

WHAT IS THE KEUKA CAFÉ® FOOTWEAR CONFIDENCE GUARANTEE?

We are so confident that our Keuka Café® slip-resistant footwear product line will help reduce slips and falls in your workplace, we will pledge to pay up to $5,000 towards direct medical expenses paid by you (Company) for injuries sustained from slips and fall accidents by any of your Company employees wearing a pair of Keuka Café® footwear purchased through a payroll deduction plan or through a 100% subsidized company purchase.

With the average cost of a lost-time slip, trip and fall accident being $28,000 (National Safety Council statistic), it’s worth it to any company to develop a slip-resistant footwear program.

CONFIDENCE GUARANTEE Guidelines

1.    The employee must have been wearing a pair of Keuka Café® footwear purchased through a payroll deduction program or a 100% subsidized company program within 6 months of the accident date.

2.    Exclusions from this offer include: accidents sustained due to objects on the floor, icy surfaces, coolers areas, freezers areas, in subzero areas, or in climatic controlled areas.

3.    Maximum claim: limited to the lesser of either $5,000 or the completed claim amount.

4.    Maximum reimbursement during the calendar year is 10% of the company’s net purchase of the Keuka Café® footwear for the calendar year in which the accident occurs.

5.    Keuka Footwear, Inc. reserves the right to require written certification by the employee and/or the manager confirming any of the above conditions on the form(s) provided, by Keuka Footwear, Inc.

6.    If the Company is more than sixty (60) days delinquent in its payment of any Keuka Footwear, Inc. invoices, this CONFIDENCE GUARANTEE may be canceled at anytime.

7.    Keuka Footwear, Inc. reimbursements via the CONFIDENCE GUARANTEE are for direct medical expenses only. Claims other than direct medical expenses will not be considered for payment including but not limited to expenses due to lost time at work.

8.    The limited warranty is only effective for slips and falls that occur on the floor at the Company's workplace.

9.   Stairs are expressly excluded from any coverage in any form within the context of the warranty.

10.ShoeGuard™ is a shoe covering and does not possess the same fit characteristics as Keuka Cafe® footwear. Therefore, ShoeGuard™ is excluded from the warranty.


CONFIDENCE GUARANTEE CLAIM PROCEDURE

No reimbursement amount shall be paid to the CONFIDENCE GUARANTEE Participating Company for any accident, which is not reported in writing to Keuka Footwear, Inc. within twenty-one (21) days of the date of the accident.

CANCELLATION OF CONFIDENCE GUARANTEE

This CONFIDENCE GUARANTEE shall automatically terminate upon the termination of the Employee Payroll Deduction Plan or the 100% company subsidized program with Keuka Footwear, Inc.

CONFIDENCE GUARANTEE REIMBURSEMENT PROCEDURES

When a location Manager informs your Corporate Risk/Safety Manager that an employee has incurred a slip and fall accident wearing Keuka Café® Slip-resistant footwear, the following process needs to be followed:

1.    The footwear must have been purchased within six (6) months through a payroll deduction plan or 100% company subsidized program.
2.    The Corporate Safety/Risk Manager should forward a copy of an accident report to the facility manager where the accident occurred.
3.    The accident report should be completed, signed and notarized by the facility manager and then forwarded back to the Corporate Safety/Risk Manager.
4.    The Corporate Safety/Risk Manager must send the accident report to Keuka Footwear, Inc. within twenty-one (21) days of the incident. Please send these forms to:

Keuka Footwear, Inc.
PO Box 693
Penn Yan, NY 14527
Attn: Michael O’Brien

Upon review, Keuka Footwear, Inc. will reimburse your company the lesser of either $5000 or the completed claim amount for direct medical expenses only, not to exceed 10% of the Company’s net purchases for the year, after you forward us a copy of the claim closure from your insurance carrier or any other proof that you paid direct medical expenses for this claim.

LIMITED WARRANTY
Subject to the definitions, terms and conditions set forth below, Keuka Footwear, Inc. hereby agrees to pay the CONFIDENCE GUARANTEE participating company the direct medical expenses paid by the CONFIDENCE GUARANTEE participating company, provided the claim is for injuries sustained by the employee as a result of a slip and fall accident while the employee is wearing Keuka Café® slip-resistant shoes.  The Keuka Café® footwear needs to be purchased via a Keuka Footwear, Inc. payroll deduction plan or a 100% company subsidized program within a six-month period prior to the accident.

DEFINITIONS:
A.    A “CONFIDENCE GUARANTEE Participating Company” is a company having an employee payroll deduction plan or a 100% subsidized program with Keuka Footwear, Inc. in effect on the date the company applies for reimbursement from Keuka Footwear, Inc.

B.    The “reimbursable amount” is the amount of the claim paid by the CONFIDENCE GUARANTEE Participation Company to its employee for direct medical expenses only for injuries sustained by its employee or $5,000 whichever is less (not to exceed 10% of the Company’s net purchases for the year in which the accident occurs).

TERMS AND CONDITIONS

A.    No reimbursable amount shall be paid by Keuka Footwear, Inc. to the CONFIDENCE GUARANTEE Participating Company if such reimbursable amount would cause the total reimbursable amounts paid to the CONFIDENCE GUARANTEE Participating Company during the Calendar year to exceed ten percent (10%) of the CONFIDENCE GUARANTEE Participating Company’s net purchases of Keuka Footwear, Inc. Slip-resistant shoes during the calendar year.

B.    No reimbursable amount shall be paid by Keuka Footwear, Inc. to the CONFIDENCE GUARANTEE Participating Company if the accident occurred due to tripping on an object on the floor, icy surface, cooler areas, freezer areas, in subzero area, or in any other climatic controlled areas.  Keuka Footwear, Inc. reimbursements via the CONFIDENCE GUARANTEE are for direct medical expenses only. Claims other than direct medical expenses will not be considered for payment including but not limited to expenses due to lost time at work. This limited warranty is only valid for slips and falls that occur on the floor at the Company's workplace. Stairs are expressly excluded from any coverage in any form within the context of the warranty.

C.    This limited warranty may be canceled by Keuka Footwear, Inc. at any time if the CONFIDENCE GUARANTEE Participating Company is more than Sixty (60) days delinquent in its payment of any Keuka Footwear, Inc. invoice.

D.    No reimbursable amount shall be paid to the CONFIDENCE GUARANTEE Participating Company for any accident, which is not reported in writing to Keuka Footwear, Inc. within twenty-one (21) days of the date of the accident.  Keuka Footwear, Inc. reserves the right to condition payment of such reimbursable amount to the CONFIDENCE GUARANTEE Participating Company upon receipt of written certification by the injured employee or the manager as to the facts and circumstances of such accident.

E.    CONFIDENCE GUARANTEE is applicable to accidents occurring on or after June 1, 2005.

GOVERNING LAW
This Limited Warranty is governed by the Laws of the State of New York.