Document:

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                                                                   EXHIBIT 10.13

                              MANAGEMENT AGREEMENT

THIS AGREEMENT, entered into the 31st day of March, 2000 between Liberty Waste,
Inc., a Florida corporation ("Liberty") and EarthCare Company, a Delaware
corporation ("EarthCare").

         In consideration of the following mutual covenants, the parties agree
as follows:

         1.       RECITATIONS. Liberty and EarthCare desire to enter into an
                  agreement for EarthCare to furnish various management services
                  in exchange for a management fee. EarthCare has hired
                  executive personnel and invested in data processing assets in
                  anticipation of entering into this Agreement. EarthCare has
                  familiarized itself with the business of Liberty and has
                  consulted with various professionals and investment bankers
                  regarding the business of Liberty.

         2.       MANAGEMENT SERVICES. During the term of this Agreement,
                  EarthCare shall provide the following services for Liberty:

                  (a)      Accounting services;

                  (b)      Investment banking advisory services;

                  (c)      Information and data processing services;

                  (d)      Bid and bond advice;

                  (e)      Municipal contract assistance; and

                  (f)      Commercial banking services.

         3.       MANAGEMENT FEES. In exchange for the management services to be
                  furnished hereunder, Liberty shall pay EarthCare management
                  fees as follows:

                  (a)      $500,000 upon the execution of this Agreement; and

                  (b)      $75,000 per month, commencing April 15, 2000, for the
                           term of this Agreement.

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         4.       TERM. This Agreement shall be for a term commencing March 31,
                  2000 and ending on March 31, 2001, and shall be renewed
                  automatically for additional one - year terms unless
                  terminated by either party by giving not less than 60 days
                  written notice prior to the end of a term to the other party.

         5.       REPRESENTATIONS AND WARRANTIES OF LIBERTY.

                  (a)      Liberty is a corporation duly organized and legally
                           existing in good standing under the laws of the State
                           of Florida, and has all the requisite corporate power
                           and authority to carry on its business as now
                           conducted.

                  (b)      The execution, delivery and performance of this
                           Agreement by Liberty has been duly approved by its
                           Board of Directors, and no further corporate action
                           is necessary on the part of Liberty to consummate the
                           transactions contemplated by this Agreement, assuming
                           due execution of this Agreement by the Parties.

                  (c)      Liberty maintains in effect insurance covering its
                           assets and businesses and any liabilities relating
                           thereto in an amount believed adequate by Liberty,
                           and such insurance coverage shall be maintained by
                           Liberty.

                  (d)      Liberty possesses all licenses and other required
                           governmental or official approvals, permits or
                           authorizations, if any, the failure to possess which
                           would have a material adverse effect on the business,
                           financial condition or results of operations of
                           Liberty including, without limitation, all common
                           carrier rights, certificates of public need, waste
                           material transportation permits, trademarks and trade
                           names necessary to carry on its business as now being
                           conducted, without known conflict with valid
                           licenses, permits, trademarks and trade names of
                           others. All such licenses and permits are in full
                           force and effect, and no violations are or have been
                           recorded in respect to any thereof, and no proceeding
                           is pending, or to the knowledge of Liberty
                           threatened, to revoke, suspend or otherwise limit
                           such licenses or permits. All licenses and permits
                           will survive the closing of the transactions
                           contemplated by this Agreement.

                  (e)      No agent, broker, finder, representative or other
                           person or entity acting pursuant to authority of
                           Liberty will be entitled to any commission or

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                           finder's fee in connection with the origination,
                           negotiation, execution or performance of the
                           transactions contemplated under this Agreement.

                  (f)      This Agreement and all other agreements of Liberty
                           contemplated hereunder constitute valid and binding
                           obligations of Liberty, enforceable in accordance
                           with their respective terms. Neither the execution
                           and delivery of this Agreement (or any agreement
                           contemplated hereunder) nor the consummation of the
                           transactions contemplated hereby will: (i) conflict
                           with or violate any provision of the Articles of
                           Incorporation or By-Laws of Liberty; (ii) conflict
                           with or violate any decree, writ, injunction or order
                           of any court or administrative or other governmental
                           body which is applicable to, binding upon or
                           enforceable against Liberty; or (iii) result in any
                           breach of or default (or give rise to any right of
                           termination, cancellation or acceleration) under any
                           mortgage, contract, agreement, indenture, will, trust
                           or other instrument which is either binding upon or
                           enforceable against Liberty or its assets.

                  (g)      Liberty has the full power, right and authority to
                           enter into and perform this Agreement without the
                           consent of any person, entity, or governmental
                           agency, and the consummation of the transactions
                           contemplated by this Agreement will not result in the
                           breach or termination of any provision of or
                           constitute a default under any lease, indenture,
                           mortgage, deed of trust or other agreement or
                           instrument or any order, decree, statute or
                           restriction to which Liberty is a party or by which
                           Liberty is bound or to which the outstanding shares
                           of stock of Liberty or any of the properties of
                           Liberty is subject.

                  (h)      No representation, statement or information made or
                           furnished by Liberty to EarthCare, including those
                           contained in this Agreement and the other information
                           and statements referred to herein, contains or shall
                           contain any untrue statement of any material fact.

         6. REPRESENTATIONS AND WARRANTIES OF EARTHCARE.

                  (a)      EarthCare is a corporation duly organized, validly
                           existing and in good standing under the laws of the
                           State of Delaware and has all the requisite corporate
                           power and authority to carry on its business as now
                           conducted and to consummate the transactions
                           contemplated by this

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                           Agreement.

                  (b)      The execution, delivery and performance of this
                           Agreement by EarthCare has been duly approved by its
                           Board of Directors, and no further corporate action
                           is necessary on the part of EarthCare to consummate
                           the transactions contemplated by this Agreement,
                           assuming due execution of this Agreement by the
                           Parties.

                  (c)      No agent, broker, finder, representative or other
                           person or entity acting pursuant to the authority of
                           EarthCare will be entitled to any commission or
                           finder's fee in connection with the origination,
                           negotiation, execution or performance of the
                           transactions contemplated under this Agreement.

                  (d)      This Agreement and all other agreements of EarthCare
                           contemplated hereunder constitute valid and binding
                           obligations of EarthCare, enforceable in accordance
                           with their respective terms. Neither the execution
                           and delivery of this Agreement (or any agreement
                           contemplated hereunder) nor the consummation of the
                           transactions contemplated hereby will: (i) conflict
                           with or violate any provision of the Articles of
                           Incorporation or By-Laws of EarthCare; (ii) conflict
                           with or violate any decree, writ, injunction or order
                           of any court or administrative or other governmental
                           body which is applicable to, binding upon or
                           enforceable against EarthCare; or (iii) result in any
                           breach of or default (or give rise to any right of
                           termination, cancellation or acceleration) under any
                           mortgage, contract, agreement, indenture, will, trust
                           or other instrument which is either binding upon or
                           enforceable against EarthCare or its assets.

                  (e)      EarthCare has the full power, right and authority to
                           enter into and perform this Agreement without the
                           consent of any person, entity, or governmental
                           agency, and the consummation of the transactions
                           contemplated by this Agreement will not result in the
                           breach or termination of any provision of or
                           constitute a default under any lease, indenture,
                           mortgage, deed of trust or other agreement or
                           instrument or any order, decree, statute or
                           restriction to which EarthCare is a party or by which
                           EarthCare is bound or to which the outstanding shares
                           of stock of EarthCare or any of the properties of
                           EarthCare is subject.

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                  (f)      No representation, statement or information made or
                           furnished by EarthCare to Liberty in this Agreement,
                           or in connection with the transactions contemplated
                           hereby contains, or shall contain any untrue
                           statement of any material fact or omits or shall omit
                           any material fact necessary to make the information
                           contained herein true.

         7.       MATERIAL CONTRACTS, ETC. In anticipation of the acquisition by
                  EarthCare of a significant minority interest in Liberty,
                  Liberty shall not, without the written consent of EarthCare,
                  issue or enter into any subscriptions, options, agreements or
                  other commitments in respect of the issuance, transfer, sale
                  or encumbrance of any shares of Liberty common stock, or enter
                  into any material transactions outside the ordinary course of
                  business.

         8.       INDEMNIFICATION BY LIBERTY.

                  (a)      Liberty shall indemnify and hold EarthCare harmless
                           from and against any and all damages, loss, cost,
                           deficiency, assessment, liability or other expense
                           (including reasonable attorney's fees, costs of court
                           and costs of litigation, if any) suffered, incurred
                           or paid by EarthCare as a result of:

                           (i)      The untruth, inaccuracy, breach or violation
                                    of any representation, warranty covenant or
                                    other obligation of Liberty set forth in or
                                    made in connection with this Agreement.

                           (ii)     The assertion against EarthCare of any
                                    liabilities or obligations of Liberty or any
                                    claim relating to the operations of
                                    Liberty's business; or

                           (iii)    The enforcement of EarthCare's right to
                                    indemnification under this Agreement.

                  (b)      EarthCare shall give written notice to Liberty of any
                           claim, action, suit or proceeding relating to the
                           indemnity herein provided by Liberty not later than
                           ten (10) days after EarthCare has received notice
                           thereof. Liberty shall have the right, at its option,
                           to compromise or defend, at its own expense and by
                           its own counsel (which counsel shall be reasonably
                           satisfactory to EarthCare), any such action, suit or
                           proceeding. EarthCare and Liberty agree to cooperate
                           in any such

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                           defense or settlement and to give each other full
                           access to all information relevant thereto.

                  (c)      Except as herein expressly provided, the remedies
                           provided in Paragraph 8 hereof shall be cumulative
                           and shall not preclude assertion by EarthCare or the
                           seeking of any other remedies available against
                           Liberty at law or in equity.

                  (d)      The indemnification shall not extend to damages or
                           costs caused by the willful or wrongful acts of
                           EarthCare, including, without limitation, violations
                           of federal, state or local laws.

         9.       INDEMNIFICATION BY EARTHCARE

                  (a)      EarthCare shall indemnify and hold Liberty harmless
                           from and against any and all damages, loss, cost,
                           deficiency, assessment, liability or other expense
                           (including reasonable attorney's fees, costs of court
                           and costs of litigation, if any) suffered, incurred
                           or paid by Liberty as a result of:

                           (i)      The untruth, inaccuracy, breach or violation
                                    of any representation, warranty, covenant or
                                    other obligation of EarthCare set forth in
                                    or made in connection with this Agreement.

                           (ii)     The assertion against Liberty of any
                                    liabilities or obligations of EarthCare or
                                    any claim relating to the operations of
                                    EarthCare's business; or

                           (iii)    The enforcement of Liberty's right to
                                    indemnification under this Agreement.

                  (b)      Liberty shall give written notice to EarthCare of any
                           claim, action, suit or proceeding relating to the
                           indemnity herein provided by EarthCare not later than
                           ten (10) days after Liberty has received notice
                           thereof. EarthCare shall have the right, at its
                           option, to compromise or defend, at its own expense
                           and by its own counsel (which counsel shall be
                           reasonably satisfactory to Liberty), any such action,
                           suit or proceeding. EarthCare and Liberty agree to
                           cooperate in any such defense or

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                           settlement and to give each other full access to all
                           information relevant thereto.

                  (c)      Except as herein expressly provided, the remedies
                           provided in Paragraph 9 hereof shall be cumulative
                           and shall not preclude assertion by Liberty or the
                           seeking of any other remedies available against
                           EarthCare at law or in equity.

                  (d)      The indemnification shall not extend to damages or
                           costs caused by the willful or wrongful acts of
                           Liberty, including, without limitation, violations of
                           federal, state or local laws.

         10.      WAIVER OR EXTENSION OF CONDITIONS. Liberty or EarthCare may
                  extend the time for or waive the performance of any of the
                  obligations of the other party, waive any inaccuracies in the
                  representations or warranties by the other party, or waive
                  compliance by the other party with any of the covenants or
                  conditions contained in this Agreement. Any such extension or
                  waiver shall be in writing and signed by the Liberty and
                  EarthCare. Any such extension or waiver shall not act as a
                  waiver or an extension of any other provisions of this
                  Agreement.

         11.      NOTICES. Any notice, request or other document shall be in
                  writing and sent by registered or certified mail, return
                  receipt requested, postage prepaid and addressed to the party
                  to be notified at the following addresses, or such other
                  address as such party may hereafter designate by written
                  notice to all parties, which notice shall be effective as of
                  the date of posting:

                           (a)      If to EarthCare:
                                    EarthCare Company
                                    14901 Quorum Drive
                                    Suite 200
                                    Dallas, TX 75240

                                    Copy to:

                                    Robert C. Gist, Esq.
                                    12809 Plum Hollow Drive
                                    Oklahoma City, OK 73142-5148

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                           (b)      If to Liberty

                                    Copy to:

         12.      GOVERNING LAW. This Agreement shall be governed by the laws of
                  the State of Texas.

         13.      SUCCESSORS AND ASSIGNS. This Agreement shall be binding upon
                  and inure to the benefit of the parties hereto and their
                  respective heirs, representatives, successors and assigns.

         14.      HEADINGS. The subject headings of the Sections of this
                  Agreement are included for purposes of convenience only and
                  shall not affect the constructions or interpretation of any of
                  its provisions.

         15.      COUNTERPARTS. This Agreement may be executed simultaneously in
                  two or more counterparts, each of which shall be deemed an
                  original and all of which together shall constitute but one
                  and the same instrument.

         16.      ARBITRATION.  Any controversy or claim arising out of, in
                  connection with, or relating to this Agreement or a breach
                  thereof shall be settled by binding arbitration in
                  Dallas, Texas. The arbitration panel shall be comprised of
                  three arbitrators. Each party shall appoint one arbitrator for
                  the panel and the two so appointed shall appoint a third. The
                  panel shall resolve the dispute within sixty (60) days of the
                  appointment of the panel and shall notify the parties of its
                  findings in writing. Each party agrees to bear its own costs
                  of arbitrators and to split equally the cost of the third
                  arbitrator.

         17.      ENTIRE AGREEMENT; MODIFICATION. This Agreement constitutes the
                  entire agreement and understanding between the parties, and
                  supersede any prior agreements and understandings relating to
                  the subject matter hereof. This Agreement may be modified or
                  amended only by a written instrument executed by all parties
                  hereto.

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         IN WITNESS WHEREOF the parties have executed this Agreement on the date
first above written.

Liberty Waste, Inc.

By:
   ---------------------------

EarthCare Company

By:
   ---------------------------

                                        9<PAGE>   1
                                                                   EXHIBIT 10.14

THIS DEBENTURE HAS NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS
AMENDED, AND IS TRANSFERABLE ONLY UPON THE CONDITIONS SPECIFIED IN THE DEBENTURE
AGREEMENT REFERRED TO HEREIN.

                                EARTHCARE COMPANY

                 10% Convertible Subordinated Debenture Due 2006

No. <<Note_>>                                                 <<Purchase_Price>>

         EARTHCARE COMPANY, a corporation duly organized and existing under the
laws of the State of Delaware (herein called the "Company") for value received,
hereby promises to pay to <<REGISTERED_OWNER>> or registered assigns, the
principal sum of <<Purchase_Price>> Dollars on October 31, 2006, and to pay
interest thereon quarterly on December 31, March 31, June 30, and September 30
(each an "Interest Payment Date"), in each year commencing on December 31, 1999,
at 10% per annum, from the date of issuance of this Debenture, or from the most
recent Interest Payment Date for which interest has been paid or duly provided
for on the Debentures, and upon prepayment or conversion hereof, as provided in
the Debenture Agreement, until the principal hereof is paid or made available
for payment. To the extent permitted by law, interest on any overdue payment of
principal or interest shall be payable quarterly at a rate equal to 18% per
annum. Interest will be computed on the basis of a 365-day year. The Company may
pay interest by issuing additional Debentures to the holder in aggregate
principal amount equal to interest due and payable on an Interest Payment Date
as provided in the Debenture Agreement.

         The interest so payable, and punctually paid or duly provided for, on
any Interest Payment Date will be paid to the person in whose name this
Debenture is registered. Payment of the principal of and interest on this
Debenture will be made at the offices or agencies of the Company maintained for
that purpose in Dallas, Texas and at any other office or agency maintained by
the Company for such purpose, in such coin or currency of the United States of
America as at the time of payment is legal tender for payment of public and
private debts; provided, however, that at the option of the Company payment of
interest may be made by check mailed to the address of the person entitled
thereto as such address shall appear in the Debenture register.

         This Debenture is one of a duly authorized issue of Debentures of the
Company (which term includes any successor corporation under the Debenture
Agreement hereinafter referred to) designated as its 10% Convertible
Subordinated Debentures due 2006 (the "Debentures"), limited in aggregate
principal amount of up to $15,000,000, issued pursuant to a Debenture Agreement
dated

                                Page 1 of 4 Pages

<PAGE>   2

as of October 19, 1999 (the "Debenture Agreement"), between the Company and the
purchasers of the Debentures. The terms of this Debenture include those stated
in the Debenture Agreement. Reference is hereby made to the Debenture Agreement
and all supplements thereto for a statement of the respective rights,
limitations of rights, duties and immunities thereunder of the Company, and the
holders of the Debentures and of the terms upon which the Debentures are, and
are to be, and delivered.

         In the event of conversion of this Debenture in part only, a new
Debenture or Debentures for the unpaid or unconverted principal portion hereof
will be issued in the name of the holder hereof upon the cancellation hereof.

         If an Event of Default shall occur and be continuing, the principal of
all the Debentures may be declared due and payable in the manner and with the
effect provided in the Debenture Agreement.

         The indebtedness evidenced by the Debentures is, to the extent provided
in the Debenture Agreement, subordinate and junior in right of payment to the
prior payment in full of all Senior Obligations, as defined in the Debenture
Agreement. Each holder of this Debenture, by accepting the same, agrees to and
shall be bound by such provisions of the Debenture Agreement.

         Subject to and upon compliance with the provisions of the Debenture
Agreement, the holder of this Debenture is entitled, at such holder's option, at
any time on or before the close of business on October 31, 2006, or, if earlier,
the close of business on the Business Day immediately preceding any Redemption
Date, or the date this Debenture is paid if later, to convert this Debenture (or
any portion of the principal amount hereof which is $1,000 or an integral
multiple thereof), at the principal amount hereof, or of such portion, into
newly issued, fully paid and nonassessable shares of Common Stock of the Company
at a Conversion Price equal to $11.50 aggregate principal amount of Debentures
for each share of Common Stock (or at the current adjusted Conversion Price if
an adjustment has been made as provided in the Debenture Agreement) by surrender
of this Debenture, duly endorsed or assigned to the Company or in blank and also
accompanied by the conversion notice hereon duly executed, to the Company at
such office or agency of the Company as may be designated by it for such purpose
in Dallas, Texas. Upon receipt of a duly endorsed Debenture and conversion
notice, the Company will cancel such Debenture, issue the requisite number of
shares of Common Stock into which such Debenture or portion thereof is
convertible in the name of the holder, or his designated assigns, and deliver
such shares to such holder or assigns along with interest accrued on the portion
of such Debenture so converted from the last Interest Payment Date to the
effective date of conversion, as provided in the Debenture Agreement. Subject to
the aforesaid requirement for payment, no payment or adjustment is to be made on
conversion for interest accrued hereon after the date of conversion or for
dividends on the Common Stock issued on conversion. No fractions of shares or
scrip representing fractions of shares will be issued on conversion, but

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instead of any fractional interest (calculated to the nearest 1/100th of a
share) the Company shall pay a cash adjustment as provided in the Debenture
Agreement. The Conversion Price is subject to adjustment as provided in the
Debenture Agreement. In addition, the Debenture Agreement provides that in case
of certain consolidations or mergers to which the Company is a party or the
transfer of all or substantially all of the assets of the Company, the Debenture
Agreement shall be amended, without the consent of any holders of Debentures, so
that this Debenture, if then outstanding, will be convertible thereafter, during
the period this Debenture shall be convertible as specified above, only into the
kind and amount of securities, cash, and other property receivable upon such
consolidation, merger, or transfer by a holder of the number of shares of Common
Stock of the Company into which this Debenture might have been converted
immediately prior to such consolidation, merger, or transfer (assuming such
holder of Common Stock failed to exercise any rights of election and received
per share the kind and amount received per share by a plurality of non-electing
shares). Adjustments in the Conversion Price of less than one percent of such
price will not be required, but any adjustment that would otherwise be required
to be made will be carried forward and taken into account in the computation of
any subsequent adjustment.

         The Debenture Agreement permits, with certain exceptions as therein
provided, the amendment thereof and the modification of the rights and
obligations of the Company and the rights of the holders under the Debenture
Agreement at any time by the Company with the consent of the holders of 66-2/3%
in aggregate principal amount of the Debentures at the time outstanding. The
Debenture Agreement also contains provisions permitting the holders of 66-2/3%
in aggregate principal amount of the Debentures at the time outstanding, on
behalf of the holders of all the Debentures, to waive compliance by the Company
with certain provisions of the Debenture Agreement and certain past defaults
under the Debenture Agreement and their consequences. Any such consent or waiver
by the holder of this Debenture shall be conclusive and binding upon such holder
and upon all future holders of this Debenture and of any Debenture issued upon
the registration of transfer hereof or in exchange herefor or in lieu hereof,
whether or not notation of such consent or waiver is made upon this Debenture.

         No reference herein to the Debenture Agreement and no provision of this
Debenture or of the Debenture Agreement shall alter or impair the obligation of
the Company, which is absolute and unconditional, to pay the principal of and
interest on this Debenture at the times, places and rate, and in the coin or
currency, herein prescribed or to convert this Debenture as provided in the
Debenture Agreement.

         As provided in the Debenture Agreement and subject to certain
limitations therein set forth, the transfer of this Debenture is registrable in
the Debenture register, upon surrender of this Debenture for registration of
transfer at the offices or agencies of the Company in Dallas, Texas duly
endorsed by, or accompanied by a written instrument of transfer in substantially
the form

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<PAGE>   4

accompanying this Debenture duly executed by, the holder hereof or his attorney
duly authorized in writing, and thereupon one or more new Debentures, of
authorized denominations and for the same aggregate principal amount, will be
issued to the designated transferee or transferees.

         As provided in the Debenture Agreement and subject to certain
limitations therein set forth, the Debentures are exchangeable for a like
aggregate principal amount of Debentures of a different authorized denomination,
as requested by the holder surrendering the same.

         Prior to due presentment of this Debenture for registration of
transfer, the Company, and any agent of the Company may treat the person in
whose name this Debenture is registered as the owner hereof for all purposes,
whether or not this Debenture be overdue, and neither the Company, nor any such

agent shall be affected by notice to the contrary.

         All terms used in this Debenture which are defined in the Debenture
Agreement shall have the meanings assigned to them in the Debenture Agreement.
The Company will furnish to any Debentureholder of record upon written request
without charge a copy of the Debenture Agreement. Requests may be made to:
EarthCare Company, 14901 Quorum Drive, Suite 200, Dallas, Texas 75240.

         IN WITNESS WHEREOF, EarthCare Company has caused this instrument to be
executed in its corporate name.

Dated:  November 5, 1999

                                           EARTHCARE COMPANY

                                           By:
                                              ------------------------------
                                           Name:
                                                ----------------------------
                                           Title:
                                                 ---------------------------

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<PAGE>   5

                                 ASSIGNMENT FORM

         If you the holder want to assign this 10% Subordinated Convertible
Debenture, fill in the form below and have your signature guaranteed:

         I or we assign and transfer this 10% Subordinated Convertible Debenture
to:

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

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

--------------------------------------------------------------
                  (Print or type name, address and zip code and
                  social security or tax ID number of assignee)

and irrevocably appoint __________________________, agent to transfer this 10%
Convertible Subordinated Debenture on the books of the Company. The agent may
substitute another to act for him.

Dated:______________________         Signed:________________________

<PAGE>   6
'

                           Form of Conversion Notice.

                                CONVERSION NOTICE

         The undersigned holder of this Debenture hereby irrevocably exercises
the option to convert this Debenture, or any portion hereof (which is $1,000 or
an integral multiple thereof) below designated, into shares of Common Stock in
accordance with the terms of the Debenture Agreement referred to in this
Debenture, and directs that such shares, together with a check in payment for
any fractional share and any Debentures representing any unconverted principal
amount hereof, be delivered to and be registered in the name of the undersigned
unless a different name has been indicated below. If shares of Common Stock or
Debentures are to be registered in the name of a Person other than the
undersigned, the undersigned will pay all transfer taxes payable with respect
thereto.

Dated:
      -----------------
                                          ------------------------------
                                                     Signature

If shares or Registered Debentures        If only a portion of the Debentures
are to be registered in the name of a     is to be converted, please indicate:
Person other than the holder, please
print such Person's name and
address:

-------------------------                 1. Principal Amount to be converted:
         Name                                U.S. $__________

-------------------------                 2. Amount and denomination of
         Address                             Registered Debentures representing
                                             unconverted principal amount to be
                                             issued:

                                             Amount:  $__________

-------------------------                    Denominations:
Social Security or other
Taxpayer Identification                      $__________
Number, if any                               ($1,000 or an integral multiple
                                             thereof)

                                            [Signature Guaranteed]
-------------------------

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