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FOURTH AMENDMENT TO THE INTERLOCAL AGREEMENT BETWEEN THE PALM BEACH COUNTY HEALTH FACILITIES AUTHORITY AND INDIAN RIVER COUNTY WHEREAS, the Palm Beach County Health Facilities Authority (the "Authority") is a public body corporate, organized and existing under and by virtue of Chapter 154, Part III, Florida Statutes, and is a properly constituted Health Facilities Authority and a "public agency" and a"local agency" under Chapter 159, Part II, Florida Statutes; and WHEREAS, Indian River County (the "County") is a political subdivision of the State of Florida and a "public agency" and a "local agency" under Chapter 159, Part II, Florida Statutes; and WHEREAS, the Authority and the County have heretofore entered into an interlocal Agreement finally executed on November 27, 1996, as previously amended by (i) a First Amendment to the Interlocal Agreement executed by the County on November 24, 1998 and by the Authority on December 14, 1998, (ii) a Second Amendment to the Interlocal Agreement executed by the County and the Authority as of December 6, 2006, and (iii) a Third Amendment to the Interlocal Agreement executed by the County on October 19, 2010, and by the Authority on November 3, 2010 (collectively, the "Interlocal Agreement"); and WHEREAS, the Authority is considering the additional financing, through the issuance of its revenue bonds (the "Bonds") pursuant to Chapter 159, Part I1, Florida Statutes, of a project consisting of the financing or refinancing of costs of improvements and additions to five (5) health care facilities, three (3) of which are in the jurisdiction of the Authority and two (2) of which are in the jurisdiction of the County, and all of which are owned and operated by ACTS Retirement-Life Communities, Inc. ("ACTS"), a not-for-profit corporation determined to be tax- exempt under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended, and duly licensed by the Florida Department of Insurance pursuant to Chapter 651, Florida Statutes; and WHEREAS, it is deemed desirable by both the Authority and County that the Authority and the County enter into this Fourth Amendment to the Interlocal Agreement (this "Amendment") in order to assist ACTS by financing the said project constituting "health care facilities" under Chapter 159.27(16) of the Florida Statutes; and WHEREAS, the Authority and ACTS have determined that the provision of funds by,the Authority to ACTS will assist in the maintenance of the public health of the residents of the County and shall serve a public purpose by improving the health and living conditions and providing adequate medical care and health care facilities therein and will promote the most efficient and economical maintenance of health care facilities in a manner and pursuant to forms of governmental organization that will accord best with the geographic, economic, and population characteristics which influence the health care needs of Palm Beach County of the State of Florida ("Palm Beach County") and the County and the inhabitants thereof, and WHEREAS, the Authority finds that ACTS will be financially responsible and fully capable and willing to fulfil its obligations including the obligation to make the debt service i 85265353 1