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2018-015A1
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2018-015A1
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Last modified
12/21/2020 11:37:35 AM
Creation date
5/9/2018 1:10:52 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
01/23/2018
Control Number
2018-015A1
Agenda Item Number
12.D.1.
Entity Name
RxBenefits
Subject
Administrative Services Agreement for Prescription Benefits
Alternate Name
Health Insurance Drug Benefits
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IN WITNESS WHEREOF, Client has caused this Client Application xhibit A to the Agreement) to be <br />executed as of the Effective Date. In the event this Client Application is amended by the Parties after the Effective <br />Date, the Parties may substitute such amended Client Application for the former Client Application, provided the <br />Parties set forth the date from and after which such amended Client Application shall be effective (the "date" line at <br />the bottom of the Administrator's acknowledgment signature block on an amended Client Application shall be such <br />new effective date with respect to such amended Client Application). The Parties further agree that they will attach <br />such amended Client Application to this Agreement and provide a copy of this Agreement with the amended Client <br />Application (Exhibit A) to Administrator and Client for their respective records. Any such amended Client <br />Application must be signed by Client's authorized representative and acknowledged, agreed to, accepted and dated by <br />Administrator's authorized representative. <br />CLIENT: ••�.��,t l C . .............� ••� <br />ATTEST: Jeffrey R. Smith, Indian r oun Board o unty Comity, ionk • `�1 ;N: <br />Okm <br />Clerk of Court <br />and C roller By: e <br />BY: <br />Printed Name: peter n n 1 >3nyan .•:9yQL • O SOP <br />`Q <br />Dep ty Clerk Its: Chairman <br />• �'••q�OUNr; E: <br />Cle`•. <br />BCC Approved: January 23, 2018 <br />Acknowledged, agreed to and accepted by: <br />ADMINISTRATOR: <br />RxBenefps,Inc. <br />By: AW4-191wml�-o <br />Printed Name: Lauren Simmons <br />Its: Director of Compliance and Legal Affairs <br />APPROVED AS TO FORM <br />AND LEGAL SUFE - IENCY <br />S� / <br />DYLAN! REINGOLD <br />COUNTY ATTORNEY <br />NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY <br />AND CONSTITUTES TRADE SECRETS OF ESI AND RXBENEFITS <br />32 <br />
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