<table class="MsoTableGrid" border="1" cellspacing="0" cellpadding="0" width="708" style="width: 531.15pt; margin-left: -33.95pt; border: none;">
 <tbody><tr style="mso-yfti-irow:0;mso-yfti-firstrow:yes;height:31.85pt">
  <td width="70" style="width:52.85pt;border:solid windowtext 1.0pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:31.85pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">Fecha<o:p></o:p></span></b></p>
  </td>
  <td width="70" style="width:52.85pt;border:solid windowtext 1.0pt;border-left:
  none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:31.85pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">Peso actual</span></b></p><p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">(kg)</span></b></p><p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif"><o:p></o:p></span></b></p>
  </td>
  <td width="96" style="width:72.0pt;border:solid windowtext 1.0pt;border-left:
  none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:31.85pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">Alimento a
  ofrecer</span></b></p><p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">(Marca)</span></b></p><p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif"><o:p></o:p></span></b></p>
  </td>
  <td width="93" style="width:69.7pt;border:solid windowtext 1.0pt;border-left:
  none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:31.85pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">Alimento a ofrecer</span></b></p><p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">(gr)</span></b></p><p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif"><o:p></o:p></span></b></p>
  </td>
  <td width="145" style="width:108.6pt;border:solid windowtext 1.0pt;border-left:
  none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:31.85pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">Peso a
  perder semanalmente</span></b></p><p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">(%)</span></b></p><p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif"><o:p></o:p></span></b></p>
  </td>
  <td width="85" style="width:63.55pt;border:solid windowtext 1.0pt;border-left:
  none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:31.85pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">Peso perdido<o:p></o:p></span></b></p>
  </td>
  <td width="149" style="width:111.6pt;border:solid windowtext 1.0pt;border-left:
  none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:31.85pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">Observaciones<o:p></o:p></span></b></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:1;height:15.55pt">
  <td width="70" style="width:52.85pt;border:solid windowtext 1.0pt;border-top:
  none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="70" style="width:52.85pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="96" style="width:72.0pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="93" style="width:69.7pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="145" style="width:108.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="85" style="width:63.55pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="149" style="width:111.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:2;height:15.55pt">
  <td width="70" style="width:52.85pt;border:solid windowtext 1.0pt;border-top:
  none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="70" style="width:52.85pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="96" style="width:72.0pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="93" style="width:69.7pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="145" style="width:108.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="85" style="width:63.55pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="149" style="width:111.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:3;height:15.55pt">
  <td width="70" style="width:52.85pt;border:solid windowtext 1.0pt;border-top:
  none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="70" style="width:52.85pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="96" style="width:72.0pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="93" style="width:69.7pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="145" style="width:108.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="85" style="width:63.55pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="149" style="width:111.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:4;height:15.55pt">
  <td width="70" style="width:52.85pt;border:solid windowtext 1.0pt;border-top:
  none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="70" style="width:52.85pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="96" style="width:72.0pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="93" style="width:69.7pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="145" style="width:108.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="85" style="width:63.55pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="149" style="width:111.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:5;height:15.55pt">
  <td width="70" style="width:52.85pt;border:solid windowtext 1.0pt;border-top:
  none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="70" style="width:52.85pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="96" style="width:72.0pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="93" style="width:69.7pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="145" style="width:108.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="85" style="width:63.55pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="149" style="width:111.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:6;height:15.55pt">
  <td width="70" style="width:52.85pt;border:solid windowtext 1.0pt;border-top:
  none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="70" style="width:52.85pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="96" style="width:72.0pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="93" style="width:69.7pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="145" style="width:108.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="85" style="width:63.55pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="149" style="width:111.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow:7;mso-yfti-lastrow:yes;height:15.55pt">
  <td width="70" style="width:52.85pt;border:solid windowtext 1.0pt;border-top:
  none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
  padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="70" style="width:52.85pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="96" style="width:72.0pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="93" style="width:69.7pt;border-top:none;border-left:none;border-bottom:
  solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;mso-border-top-alt:
  solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="145" style="width:108.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="85" style="width:63.55pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
  <td width="149" style="width:111.6pt;border-top:none;border-left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:15.55pt">
  <p class="MsoNormal" align="center" style="margin-bottom:0cm;margin-bottom:.0001pt;
  text-align:center;line-height:normal"><b><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,sans-serif">&nbsp;</span></b></p>
  </td>
 </tr>
</tbody></table>