DRAFT NEW AGREEMENT -4- h. Number of days inpatient i. Number of days outpatient j- Date released as outpatient k. Ship transportation and subsistence costs ]. Aircraft costs m. Total costs n. Date vessel left to return patient to home island 0. Verification of above by signature of the Marshall Islands District Director of Health Services and review by Headquarters TTPI p. 5. Date claim paid in full by TIPI It is agreed and understood that the TTPI will indemnify and hold harmless the DOE/PASO, its contractors and employees from any and al] liability (including third party liability) for any cause whatsoever arising out of implementation of this Agreement and resulting in injury, loss, or damage to a patient, person accompanying the patient or any other person; provided, however, that this indemnification provision shall not apply to the extent that such liability, injury, loss, or damage shail have resulted from the fault or negligence of the DOE/PASO, its contractors, or employees.