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In consideration of the payment of Premiums when due and subject to all of the terms of this Agreement, <br />Blue Cross Blue Shield of Florida, Inc. hereby agrees to provide each enrollee of Indian River County <br />Board of County Commissioners the benefits of this Agreement as set forth in the attached Evidence of <br />Coverage beginning on each enrollee's effective date. <br />The Group has selected the following plan and premium: PP02 RX1 @ $316.55 <br />The Group's Agreement is effective as of 10/1/2018. <br />IN WITNESS WHEREOF, the parties have executed this Agreement as of September 11, 201 <br />Blue Cross Blue Shield of Florida, Inc. Indian River County Board : Bmf ' my <br />(DBA Florida Blue) Commissioners D ' <br />(Signa (Signature) '''•••••." . <br />Name: Lynn Esposito Name: Peter D. O'Bryan <br />(Please Print or Type) (Please Print or Type) <br />Title: <br />Vice President, Sales Operations Title: Chairman <br />ApPRON/Fn n..ct TO FORM <br />AINU i -E -U. -.t. uurFIC,ENCY <br />BY .. <br />COUNTY ArTOHNEY <br />ATTEST: Jeffrey R. Smith, Clerk of Court <br />,,and Comptr ler <br />BY: <br />Deputy Clerk <br />12 <br />