Be A Health Navigator

Right to Represent Acknowledgement

I, Kelly Stewart, hereby acknowledge that I grant VIVA USA INC the exclusive right to represent me for the contract position of Health Navigator. This position is a contract assignment for the end-client Blue Cross Blue Shield of Tennessee within the AgileOne contingent worker program. In agreement to this, I agree not to allow another agency permission to submit my resume and credentials for consideration for the aforementioned position. I understand that if I were to allow representation from multiple agencies, I may be eliminated from consideration for this position. I also understand that the Vendor Management System utilised by BCBST requires the month and date of birth as well as the last 5 of the Social Security Number and have provided them below.

Signature of Candidate (Email Signature is Acceptable Electronically) Kelly Stewart

Printed Name

10398

Acceleration VMS Requisition #

11_/_26

Month and Date of Birth

36452

Last 5 of SSN

Date Signed: 12/07/2023

Time Stamp of Signature:

Zoho Sign Document ID: 2AD01028-WZUWEW9NEPBSYXNOLB1NX8A92-VP-7KSWUVHQ8DAILC

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