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29. RxBenefits - ESI will be able to support Client's custom/current Rx Plan Design. F. EXECUTION BY CLIENT Client hereby represents and warrants that the information contained in Section A of this Client Application is true and correct in all respects and Client hereby agrees to the specific terms, conditions and financial arrangements set out in Sections B, C and D of this Client Application. Client agrees that if any information in Section A changes, Client will give Administrator prompt notice of such changes. Furthermore, Client understands that this Client Application Exhibit A is a part of the Administrative Services Agreement between Client and Administrator to which it is attached and incorporated into by reference and that Client is bound by all terms and conditions of such Administrative Services Agreement. All capitalized terms used in this Client Application but not specifically defined herein shall have the meanings given to such terms in the Administrative Services Agreement to which this Client Application is attached and made a part of. IN WITNESS WHEREOF, Client has caused this Client Application(Exhibit A to the Agreement) to be executed as of the Effective Date. In the event this Client Application is amended by the Parties after the Effective Date, the Parties may substitute such amended Client Application for the former Client Application, provided the Parties set forth the date from and after which such amended Client Application shall be effective (the "date" line at the bottom of the Administrator's acknowledgment signature block on an amended Client Application shall be such new effective date with respect to such amended Client Application). The Parties further agree that they will attach such amended Client Application to this Agreement and provide a copy of this Agreement with the amended Client Application (Exhibit A to Administrator and Client for their respective records. Any such amended Client Applicatiop an"bje signed by Client's authorized representative and acknowledged, agreed to, accepted and dated by Ad1�j�orized representative. ° �' ' s%•:, . CLIENT: ,f• *. Indian River County Board of CCo „ rs : *; Attest: Jeffrey R. Smith, Clerk of Circuit Court and Comptroller By: Prir Deputy Clerk S. Name: Joseph E. Fles Chairman Acknowledged, agreed to and accepted by: ADMINTRATOR: ` RxBen fi ,Inc. By Printed Name: Lauren Simmons Its: Sr. Director of Compliance & Legal Affairs NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY AND CONSTITUTES TRADE SECRETS OF ESI AND RXBENEFITS 17