Document:

<PAGE>   1
                                                                    EXHIBIT 10.4

                               PROVIDER AGREEMENT

                                     PART I

THIS AGREEMENT is made the ________ day of _____________________________, 200__,
by and between ___________________________________________________________, with
its principle place of business at
________________________________________________________________, hereinafter
referred to as ""Provider, and Eye Care International, Inc. (ECI) with its
principle place of business at 1511 N. Westshore Blvd., Suite 925, Tampa,
Florida 33607.

RECITALS

WHEREAS, ECI markets a national vision plan Network consisting of, among others,
ophthalmologists providing ECI patient members with the highest quality of
ophthalmic services at reasonable prices; and WHEREAS, ECI and Provider desire
to enter into an agreement whereby ECI will refer to Provider ECI members and
participants located in the Providers geographical area; NOW THEREFORE, in
consideration of the mutual covenants contained herein, the parties agree as
follows:

DUTIES OF PROVIDER

1. Provider agrees to provide medical and surgical services and products (if
applicable) to all ECI members and participants (collectively called members) at
prices set forth below. ECI shall not serve as insurer, guarantor or underwriter
with respect to members' responsibility for payment for services or goods.

2. Provider understands that ECI may enter into agreements with patient groups
providing for third party payment of Providers fees. Provider agrees to bill the
member via either ECI or a designated payer for services (and products, if
applicable - see Part II) rendered to the member.

3. Provider is responsible for billing and collections. Provider shall charge
ECI non-Medicare patients 80% of the Medicare approved fees applicable to
Providers location. For procedures not usually covered by Medicare, ECI members
are to be charged 20% below your usual and customary fees. Medicare patients
should be billed in accordance with your usual billing practices.

QUALITY ASSURANCE

Provider agrees that he or she shall complete and return to ECI quality
assurance questionnaires which may be forwarded to the Provider by ECI.

LICENSES

Provider agrees to maintain all appropriate licenses required to conduct
business, including malpractice insurance of not less than one-million dollars,
and to otherwise conduct himself/herself in a manner consistent with the ethics
of the medical profession. If requested, Provider agrees to provide ECI with
proof of insurance coverage.

IDENTIFICATION OF PROVIDER AS PARTICIPATING IN THE ECI NETWORK

Provider hereby grants ECI the right to use his or her name, specialist
certifications, business ads and telephone number for purposes of informing the
ECI members (including sales efforts) and prospective members of the identities
of the participating providers and for otherwise carrying out the terms and
intents of this Agreement.

CONSIDERATION

PROVIDER WILL HAVE NO FINANCIAL OBLIGATION TO ECI.

TERM OF AGREEMENT

This Agreement shall be effective for a three (3) year period, commencing on the
date that this Agreement is signed by ECI. Unless terminated, this Agreement
shall be automatically renewed for successive yearly periods. This Agreement may
be terminated by either party immediately by reason of a material breach by the
non-terminating party.

<PAGE>   2

ENTIRE AGREEMENT

The Agreement contains the entire understanding between the parties.

AGREEMENT NOT EXCLUSIVE

Either party may enter into other similar agreements for performance of similar
services; except that the Provider agrees that during for so long as this
Agreement is in effect, and for a six (6) month period thereafter, he or she
shall not join a providers national network servicing an entity the same as or
similar to ECI; i.e., a non-insurance based national network of ophthalmologists
offering medical services based on a RBRVS fee schedule (or a comparable
schedule). Specifically excluded from the foregoing restrictions is any national
insurance carrier, HMO, PPO or substantially similar type plan.

CONFIDENTIALITY

Provider agrees not to divulge the compensation, fees, rates and charges subject
to this Agreement. Each party agrees on behalf of itself, its affiliates,
officers, agents and employees that it will not, directly or indirectly,
communicate, divulge or use for its own benefit, or for the benefit of any other
person, or legal entity, any information or data concerning marketing, finances,
methods, patients, contacts, operations, membership or any other information
acquired or learned through the other. This provision shall survive the
termination or expiration of this Agreement.

NOTICE

Any notice pertaining to the Agreement must be in writing, addressed to the
party to be notified, postage prepaid and registered or certified with return
receipt requested sent to the address of the respective parties herein set
forth.

GOVERNING LAW

THIS AGREEMENT IS MADE IN THE COUNTY OF PINELLAS, STATE OF FLORIDA, AND SHALL BE
CONSTRUED AND INTERPRETED IN ACCORDANCE WITH THE LAWS OF THE STATE OF FLORIDA.
IF ANY OF TERMS OF THIS AGREEMENT DIFFER OR CONFLICT WITH ANY FEDERAL OR LOCAL
LAWS, THE FEDERAL OR LOCAL LAWS SHALL PREVAIL AND THE CONFLICT PROVIDER
AUTOMATICALLY HEREIN SHOULD BE DEEMED STRICKEN.

FREE EYE EXAM PROGRAM: ECI members receive a certificate for one FREE EYE EXAM
per family membership each year (excludes exams for contact lenses). A condition
of this feature is that the initial prescription, if needed, must be filled at
the provider location performing the exam (if you dispense). All other family
members will pay the exam fee as provided for in this agreement. Please check
one of the options below:

         ____     Please include us in the participating provider list that
                  refers members to us for one free eye exam per family
                  membership in the ECI vision plan.

         ____     Please do not include me in the free eye exam program.

                                       2
<PAGE>   3

PROVIDERS AND LOCATIONS

Primary Office Location:
                        --------------------------------------------------------

Address:
        ------------------------------------------------------------------------

City:                                            State:            Zip:
     -------------------------------------------       -----------     ---------

Telephone                              Office Hours:
         ----------------------------               ----------------------------

List below all office locations, including zip codes that you would like listed
in our computer directory, and the names of all providers servicing your
practice for purposes of patient referrals.

         PROVIDERS NAME                     OFFICE LOCATION

-----------------------------       --------------------------------------------

-----------------------------       --------------------------------------------

(IF ADDITIONAL SPACE IS NEEDED, PLEASE LIST ON A SEPARATE SHEET OF PAPER AND
ATTACH TO THIS AGREEMENT.)

Complete all categories that apply to your office(s):
<TABLE>
<CAPTION>

I.  NUMBER OF              II.  SURGICAL PROCEDURES           III.  EXAMINATIONS/DISPENSING
    ---------                   -------------------                 -----------------------

                           YES NO                             YES NO
<S>                        <C>                                <C>
____ M.D' s                __ __ Cataract/Corneal/Glaucoma    __ __ Eyeglass Exams
____ O.D' s                __ __ Oculoplastics                __ __ Contact Lens Exams
____ Opticians             __ __ Pediatric Surgery            __ __ Dispense Eyeglasses
                           __ __ Retinal/Vitreal              __ __ Dispense Contact Lenses
                           __ __ RK/ALK Surgery
                           __ __ Excimer Laser

</TABLE>

PLEASE LIST LANGUAGES, OTHER THAN ENGLISH, THAT YOU AND/OR YOUR PROFESSIONAL
STAFF SPEAK.

         I SPEAK                MY STAFF SPEAKS           LEVEL OF FLUENCY
         -------                ---------------           ----------------

------------------------   -------------------------   ------------------------

------------------------   -------------------------   ------------------------

NOTE: IF YOU DISPENSE, PLEASE COMPLETE PART II OF THIS AGREEMENT; IF NOT,
PLEASE CHECK HERE                  .
                   ----------------

PLEASE BE SURE TO SIGN THIS AGREEMENT ON PAGE 4.

                                       3

<PAGE>   4

                                     PART II

ROVIDERS WHO DISPENSE EYE WEAR

1.    Pricing and dispensing fees shall be as listed on PRICE SCHEDULE 1, or
      your current sale price, if lower.

2.    Prices on contact lenses (disposables not included), non-prescription
      sunglasses, and all other sundry items shall be offered at a 20% discount
      off established retail.

3.    PROVIDER agrees that, except in the case of the Free Eye Exam program, it
      will release to Program Members their eyewear prescription resulting from
      an examination.

4.    PROVIDER will honor a 30-day unconditional guarantee to Program Members by
      refunding their money if for any reason they return their glasses or
      contacts within 30 days from the date of purchase. Exams are not included
      in the guarantee.

5.    PROVIDER shall warrant and guarantee the satisfaction of the products and
      services sold to ECI Members consistent with industry standards and other
      guarantees otherwise offered by PROVIDER.

SIGNATURE

I (the individual eye care/eye wear {if applicable} provider or authorized
company officer) hereby applies for membership.

Authorized by:                     Authorized by Eye Care International, Inc.

----------------------------       ----------------------------------------
Name and title (signature)             Name and title (signature)

----------------------------        ----------------------------------------
Print name                                      Acceptance Date

                                       4

<PAGE>   5

EYE CARE INTERNATIONAL, INC.

                                PRICE SCHEDULE 1

                           DISPENSING FEE (PER PAIR):
<TABLE>
----------------------------------------------------------------------------------------------------------------------
<S>                                             <C>         <C>                                               <C>
Single Vision.................................. $30.00      Cataract or other specialty lenses.................$50.00
Bifocal........................................  35.00      Frame only........................................  15.00
Trifocal.......................................  40.00      Lenses only.................1/2the regular dispensing fee
Progressive....................................  50.00
----------------------------------------------------------------------------------------------------------------------
</TABLE>

                            GLASS AND PLASTIC LENSES:
                       Edged and Assembled for ZYL frames
                               Sphere PL to +/-400
    Cylinder .025 to -400 (For higher powers add $1.00 per lens, per diopter)

<TABLE>
<CAPTION>
----------------------------------------------------------------------------------------------------------------------
                                               Per Pair                                                     Per Pair

<S>                                             <C>         <C>                                                  <C>
Single Vision...................................$19.95      Executive Bifocal....................................$39.95
Bifocal (25, 28, RD)............................ 34.95      Executive Trifocal....................................54.95
Trifocal (25, 28)............................... 46.95      Blended Bifocal.......................................52.95
Bifocal (35).................................... 39.95      Progressive.......................................... 73.95
Trifocal (8X35)................................. 54.95      Varilux...............................................85.95
----------------------------------------------------------------------------------------------------------------------
</TABLE>

                          ADDITIONAL CHARGES PER PAIR:
<TABLE>
<CAPTION>
----------------------------------------------------------------------------------------------------------------------
                                                     SINGLE VISION              BIFOCAL TRIFOCAL     PROGRESSIVE
----------------------------------------------------------------------------------------------------------------------
<S>                                                   <C>               <C>              <C>                <C>
Oversize 56 Eye Size and Over                         $ 7.00            $ 10.00          $ 10.00            $  --
FDA Hardening and Testing                               4.00               4.00             4.00             4.00
Prescribed Prism (.25 to 3.00)                          4.00               4.00             4.00             4.00
TINT:
Glass:  Rose 1 & 2                                      6.00               9.00            10.00               --
Green & Gray 2 & 3                                      6.00               9.00            10.00               --
Plastic:  all solid                                     7.00               7.00             7.00             7.00
Plastic:  single gradient                               9.00               9.00             9.00             9.00
Plastic:  double gradient                              11.00              11.00            11.00            11.00
UV 400                                                  9.00               9.00             9.00             9.00
Photochromic                                           11.00              19.00            24.00            24.00
Transitions                                            53.00              66.00            66.00            66.00
Factory Scratch Coat                                   12.00              14.00            14.00               --
Polycarbonate                                          14.00              18.00            33.00            40.00
Lite Style                                             25.00              29.00            44.00            51.00
Ultra Litestyle                                        33.00              37.00            52.00            59.00
High Index                                             40.00              48.00            48.00            48.00
Wire Mounting                                           4.00               4.00             4.00             4.00
Rimless Mounting                                        8.00               8.00             8.00             8.00
Edge & Mount Half Eye                                   7.00                 --               --               --
Polish Edges                                            8.00               8.00             8.00             8.00
Over 3.00 Add                                             --               9.00             9.00             9.00
Multi-Layered AR Coating                               29.95              29.95            29.95            29.95
Mirage 2000                                            32.95              32.95            32.95            32.95
</TABLE>

                                     FRAMES:

Charge current FRAMES or FRAME FAX price. If the frame is not listed in either
aforementioned periodicals, charge acquisition cost.

                                  OTHER ITEMS:

CONTACT LENSES (disposables not included), NON-PRESCRIPTION Sunglasses: give a
20% discount off your established retail price. ALL OTHER ITEMS NOT LISTED (i.e.
sundry items), give 30% off your established retail price.

NOTE: IF PROVIDER'S ACQUISITION COST OF FRAMES AND/OR LENSES IS HIGHER THAN THE
SCHEDULE, CHARGE THE ACQUISITION COST.

                                       5<PAGE>   1
                                                                    EXHIBIT 10.5

                         NATIONAL VISION SERVICES, INC.
                 (a subsidiary of Eye Care International, Inc.)

                               PROVIDER AGREEMENT

THIS AGREEMENT is made the _____ day of ______________________, 20__, by and
between ___________________________________________________, with its principal
place of business at
____________________________________________________________________________,
hereinafter referred to as "PROVIDER," and National Vision Services, Inc. (NVS),
a Florida Corporation, with its principal place of business at 1511 N. Westshore
Blvd., Suite 925, Tampa, Florida 33607.

RECITALS

WHEREAS, NVS is affiliated with Eye Care International, Inc. ("ECI"), a
non-insurance based discount network, which provides its Program Members with
various services in the eye care industry; and

WHEREAS, PROVIDER has agreed to participate in the various ECI programs
(hereinafter collectively called the "Program"), which give Program Members,
among other things, the right to purchase eyewear at the prices set forth on
PRICE SCHEDULE 1; and

WHEREAS, NVS and PROVIDER desire to enter into an agreement whereby NVS will
direct patients to approved PROVIDER eye care centers;

NOW THEREFORE, in consideration of the mutual covenants contained herein, the
parties agree as follows:

DUTIES OF PROVIDER

1.    PROVIDER agrees to sell its products and services to all Program Members
      and any additional groups validated by ECI at pricing and dispensing fees
      listed on PRICE SCHEDULE 1, or your current ?sale? price, if lower.

2.    PROVIDER will give a 20% discount off established retail prices on contact
      lenses (disposables not included), non-prescription sunglasses, and other
      items offered at retail.

3.    PROVIDER examinations and contact lens fitting fees may be charged
      according to the PROVIDER'S usual and customary fee structure. PROVIDER'S
      current usual and customary fee is the following:

                  For a standard exam:               $________________________
                  For a standard contact lens exam:  $________________________
                  For a contact lens fitting:        $________________________

4.    PROVIDER understands neither NVS or ECI is an insurance or a third party
      payor. PROVIDER is responsible for all billings and collections resulting
      from the sale of its products and services, except as herein specifically
      provided to the contrary.

5.    PROVIDER understands that, notwithstanding Paragraph 4 above, ECI may,
      from time to time, enter into agreements with patient groups, which
      agreements provide for third party payment of PROVIDER'S fees. With
      respect to such agreements, upon being notified of same by NVS, PROVIDER
      agrees to bill either NVS or ECI's designated administrator (at NVS's
      election) for services rendered to the individual Program Member. It is
      understood that payment will be forwarded to the PROVIDER by either NVS or
      said third party administrator, as the case may be, within five (5) days
      of receipt.

6.    PROVIDER understands he/she is NOT RESPONSIBLE TO PAY ANY FEE TO NVS or
      ECI, with respect to the joining of the NVS networks or with respect to
      any Program Member directed to PROVIDER by NVS.

7.    FREE EYE EXAM PROGRAM: Provider agrees to participate in the ECI eye exam
      program. Under this program, provider will perform, without charge, one
      refraction per family membership per year. Exams for contact lenses are
      specifically excluded from this program. The standard NVS price schedule
      shall be used for prescriptions filled as a result of this examination.
      All other family members receiving an eye exam will be charged providers
      usual and customary fee.

                                   Page 1 of 5

<PAGE>   2

8.    PROVIDER agrees to maintain and keep current his/her appropriate licenses
      required to conduct business, including malpractice insurance of not less
      than one million dollars. If requested by NVS, PROVIDER agrees to name ECI
      and/or such other sponsor of the Program as may be identified by ECI, as
      an additional named insured provided that if the cost of same exceeds $50,
      NVS agrees to pay such sum over and above said $50.

9.    PROVIDER will provide all Program Members with the same office hours,
      services, and products as that of non-members.

10.   PROVIDER agrees that, with respect to a Program Member, when referral to
      an ophthalmologist is indicated, PROVIDER will direct the patient to the
      ECI toll-free number (800-ELITE-36), and will not otherwise refer the
      patient to a non-ECI ophthalmologist.

11.   PROVIDER agrees all participating eye care centers will release to Program
      Members eyewear prescriptions resulting from an examination at his/her
      office to include the following:

                  a)       Provider location number
                  b)       Doctor's name, address, and telephone number
                  c)       Member's prescription

12.   PROVIDER agrees Program Member is not obligated to use PROVIDER as the
      examining doctor and agrees to fill the Program Member's prescription
      regardless of where the Program Member's eyes have been examined. Any
      remakes or redos due to incorrect outside prescriptions are the
      responsibility of, and may be charged to the Program Member.

13.   PROVIDER agrees to honor the ELITE card or any other card authorized by
      NVS through the renewal date indicated on the membership card. All
      immediate family members are entitled to full privileges of the card for
      unlimited use during the year.

14.   PROVIDER agrees to honor a 30-day unconditional guarantee given by ECI to
      Program Members by refunding their money if for any reason they return
      their glasses or contacts within 30 days from the date of purchase. Exams
      are not included in the guarantee.

15.   PROVIDER agrees to the use of his/her name or the name of his/her
      practice, as well as his/her address and telephone number in any locator
      service, promotional campaign, or directly as it relates to the Program.

16.   PROVIDER warrants and guarantees the satisfaction of the products and
      services to ECI and the valued Program Members. Said guarantee shall be
      consistent with industry standards and shall extend to guarantees
      currently being offered or offered in the future by PROVIDER.

CONFIDENTIALITY: NON-COMPETITION

1.    PROVIDER agrees that during the term of this Agreement, and for a period
      of two (2) years thereafter, PROVIDER will not permit the use by itself,
      or others, and will not disclose to any person, firm, or corporation, any
      technical or proprietary information obtained relating to the operation of
      NVS or ECI, without the express written consent of both NVS and ECI.

2.    PROVIDER agrees not to approach, pursue, or engage in business activity
      with any individual, group, corporation, or other entity brought to
      PROVIDER through NVS or ECI.

HOLD HARMLESS

      PROVIDER agrees to indemnify, defend and hold ECI and any other sponsor
      (private label) of the Program harmless from any and all claims, disputes,
      liability, or causes of action arising out of the subject of this
      Agreement occurring as a result of vision care services provided to
      Program Members.

                                   Page 2 of 5

<PAGE>   3

TERM: TERMINATION

      This Agreement shall remain in full force and effect for an initial term
      of one (1) year unless either party terminates it with cause. Thereafter,
      this Agreement shall automatically renew for the same term unless either
      party gives the other ninety (90) days written notice of its intentions
      not to renew prior to an otherwise scheduled renewal date.

GOVERNING LAW

      THIS AGREEMENT IS MADE IN THE COUNTY OF PINELLAS, STATE OF FLORIDA, AND
      SHALL BE CONSTRUED AND INTERPRETED IN ACCORDANCE WITH THE LAWS OF THE
      STATE OF FLORIDA. IF ANY OF TERMS OF THIS AGREEMENT DIFFER OR CONFLICT
      WITH ANY FEDERAL, STATE OR LOCAL LAWS, THE FEDERAL, STATE OR LOCAL LAW
      SHALL PREVAIL AND THE CONFLICTING PROVISION SHALL AUTOMATICALLY BE DEEMED
      STRICKEN.

NOTICE

      Any notice of correspondence required or necessary under this Agreement
      shall be directed by U.S. Mail, certified or registered, postage paid, to
      the addresses set out in this Agreement or as may be designated from time
      to time.

ENTIRE AGREEMENT: MODIFICATION

      This Agreement contains the prior understanding of the parties hereto and
      supersedes any and all prior written or oral agreements between the
      parties. This Agreement shall not be modified except by an agreement in
      writing executed by the parties.

PROVISIONS BINDING

      This Agreement shall be binding upon and inure to the benefit of the
      parties hereto, their successors, and assigns.

      List all languages, other than English, that you and/your professional
      staff speak.

         I SPEAK              MY STAFF SPEAKS               LEVEL OF FLUENCY
---------------------         -------------------------     ----------------

---------------------         -------------------------     ----------------

PROVIDERS AND LOCATIONS

List below all office locations, including zip codes, that you would like in our
computer directory, and the names of all providers servicing your practice for
purposes of patient referrals.

         PROVIDERS NAME                     OFFICE LOCATION

-----------------------------      -------------------------------------------

-----------------------------      -------------------------------------------

(If additional space is needed, please list on a separate sheet of paper and
attach to this Agreement.)

Please check all categories, which apply to your office(s):

____  Optician   ____  Eyeglass Examinations      ____  Dispense Eyeglasses
____  O.D.       ____  Contact Lens Examinations  ____  Dispense Contact Lenses
____  M.D.

                                   Page 3 of 5

<PAGE>   4

Name of Business_______________________________________________________________

Address _______________________________________________________________________

City _____________________________________ State _____________ Zip ____________

Telephone __________________________ Office Hours _____________________________

I (the undersigned individual eye care provider or authorized company officer)
hereby apply for membership with National Vision Services, Inc. and further
agree to abide by the rules and regulations of this Agreement.

Authorized by:                    Authorized by National Vision Services, Inc.

--------------------------------  ---------------------------------------------
Name and title (signature)                 Name and title (signature)

--------------------------------  ---------------------------------------------
Print name                                          Acceptance Date

                                   Page 4 of 5

<PAGE>   5

                            NATIONAL VISION SERVICES

                 (A SUBSIDIARY OF EYE CARE INTERNATIONAL, INC.)

                                PRICE SCHEDULE 1

                           DISPENSING FEE (PER PAIR):
<TABLE>
-----------------------------------------------------------------------------------------------------------------------
<S>                                           <C>         <C>                                                <C>
Single Vision.................................$30.00      Cataract or other specialty lenses.................$50.00
Bifocal......................................  35.00      Frame only........................................  15.00
Trifocal.....................................  40.00      Lenses only.................1/2the regular dispensing fee
Progressive..................................  50.00
-----------------------------------------------------------------------------------------------------------------------
</TABLE>

                            GLASS AND PLASTIC LENSES:
                       Edged and Assembled for ZYL frames
                               Sphere PL to +/-400
    Cylinder .025 to -400 (For higher powers add $1.00 per lens, per diopter)
<TABLE>
<CAPTION>
------------------------------------------------------------------------------------------------------------------------
                                             Per Pair                                                      Per Pair
------------------------------------------------------------------------------------------------------------------------
<S>                                        <C>             <C>                                             <C>
Single Vision............................. $ 19.95         Executive Bifocal.............................. $ 39.95
Bifocal (25, 28, RD)......................   34.95         Executive Trifocal.............................   54.95
Trifocal (25, 28).........................   46.95         Blended Bifocal................................   52.95
Bifocal (35)..............................   39.95         Progressive....................................   73.95
Trifocal (8X35)...........................   54.95         Varilux........................................   85.95
------------------------------------------------------------------------------------------------------------------------
</TABLE>

                          ADDITIONAL CHARGES PER PAIR:
<TABLE>
<CAPTION>

-------------------------------------------------------------------------------------------------------------------------
                                              SINGLE VISION           BIFOCAL           TRIFOCAL     PROGRESSIVE
-------------------------------------------------------------------------------------------------------------------------
<S>                                                 <C>               <C>               <C>           <C>
Oversize 56 Eye Size and Over                       $ 7.00            $ 10.00           $ 10.00       $     --
FDA Hardening and Testing                             4.00               4.00              4.00           4.00
Prescribed Prism (.25 to 3.00)                        4.00               4.00              4.00           4.00
TINT:

Glass:  Rose 1 & 2                                    6.00               9.00             10.00             --
Green & Gray 2 & 3                                    6.00               9.00             10.00             --
Plastic:  all solid                                   7.00               7.00              7.00           7.00

Plastic: single gradient                              9.00               9.00              9.00           9.00
Plastic: double gradient                             11.00              11.00             11.00          11.00
UV 400                                                9.00               9.00              9.00           9.00
Photochromic                                         11.00              19.00             24.00          24.00
Transitions                                          53.00              66.00             66.00          66.00
Factory Scratch Coat                                 12.00              14.00             14.00             --
Polycarbonate                                        14.00              18.00             33.00          40.00
Lite Style                                           25.00              29.00             44.00
  51.00
Ultra Litestyle                                      33.00              37.00             52.00          59.00
High Index                                           40.00              48.00             48.00          48.00
Wire Mounting                                         4.00               4.00              4.00           4.00
Rimless Mounting                                      8.00               8.00              8.00           8.00
Edge & Mount Half Eye                                 7.00                 --                --             --
Polish Edges                                          8.00               8.00              8.00           8.00
Over 3.00 Add                                           --               9.00              9.00           9.00
Multi-Layered AR Coating                             29.95              29.95             29.95          29.95
Mirage 2000                                          32.95              32.95             32.95          32.95

</TABLE>

                                     FRAMES:

Charge current FRAMES or FRAME FAX price. If the frame is not listed in either
aforementioned periodicals, charge acquisition cost.

                                  OTHER ITEMS:

CONTACT LENSES (disposables not included), NON-PRESCRIPTION Sunglasses: give a
20% discount off your established retail price. ALL OTHER ITEMS NOT LISTED (i.e.
sundry items), give 30% off your established retail price. NOTE: IF PROVIDER'S
ACQUISITION COST OF FRAMES AND/OR LENSES IS HIGHER THAN THE SCHEDULE, CHARGE THE
ACQUISITION COST.

                                  Page 5 of 5

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