Laserfiche WebLink
29. Coordination of Benefits claims accounted for in the claims data and discount guarantees by a flag indicating <br />that a transaction utilized COB functionality within the RxCLAIM system. COB claims are excluded from <br />pricing guarantees, but are assessed an administrative fee if applicable. <br />RxBenefits - ESI will be able to support Client's custom/current Rx Plan Design. <br />G. EXECUTION BY CLIENT <br />Client hereby represents and warrants that the information contained in Section A of this Client Application <br />is true and correct in all respects and Client hereby agrees to the specific terms, conditions and financial arrangements <br />set out in Sections B, C and D of this Client Application. Client agrees that if any information in Section A changes, <br />Client will give Administrator prompt notice of such changes. Furthermore, Client understands that this Client <br />Application(Exhibit A is a part of the Administrative Services Agreement between Client and Administrator to which <br />it is attached and incorporated into by reference and that Client is bound by all terms and conditions of such <br />Administrative Services Agreement. <br />All capitalized terms used in this Client Application but not specifically defined herein shall have the <br />meanings given to such terms in the Administrative Services Agreement to which this Client Application is attached <br />and made a part of. <br />IN WITNESS WHEREOF, Client has caused this Client Application(—Exhibit 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 Al 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.�• pUt�TV�' <br />CLIENT: �� •��'G .. <br />Co <br />Attest: Jeffrey R. Smith, Clerk of <br />Circuit Court and Com troller Indian River Coun Board of Coq Co �* <br />By. <br />Deputy Clerk <br />P me ame: Joseph E. FleschTy,���\�P•'+• <br />Its: Chairman <br />Acknowledged, agreed to and accepted by: <br />ADMINISTRATOR: <br />Printe Name: <br />Its: .� <br />1 <br />NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY <br />AND CONSTITUTES TRADE SECRETS OF ESI AND RXBENEFITS <br />16 <br />