Common use of Check if Required Clause in Contracts

Check if Required. If checked, the Supplemental State Terms and attached hereto as Exhibit "G" are hereby incorporated by reference into this DPA in their entirety. If checked, XXX and Provider agree to the additional terms or modifications set forth in Exhibit "H". (Optional) Document Ref: K9ZQZ-EZEZK-8KSFY-SHKWX Page 1 of 25

Check if Required. If checked, the Supplemental State Terms and attached hereto as Exhibit "G" are hereby incorporated by reference into this DPA in their entirety. If checked, XXX and Provider agree to the additional terms or modifications set forth in Exhibit "H". (Optional) Document Ref: K9ZQZG6EGS-EZEZK-8KSFYYZAWT-SHKWX LDC5T-KSSN4 Page 1 of 25

Check if Required. If checked, the Supplemental State Terms and attached hereto as Exhibit "“G" ” are hereby incorporated by reference into this DPA in their entirety. If checked, XXX and Provider agree to the additional terms or modifications set forth in Exhibit "“H"”. (Optional) Document Ref: K9ZQZ-EZEZK-8KSFY-SHKWX Page 1 of 25)

Check if Required. YES: If checked, the Supplemental State Terms and attached hereto as Exhibit "“G" ” are hereby incorporated by reference into this DPA in their entirety. NO: If checked, XXX and Provider agree to the additional terms or modifications set forth in Exhibit "“H". (Optional) Document Ref: K9ZQZ-EZEZK-8KSFY-SHKWX Page 1 of 25”.

Check if Required. If checked, the Supplemental State Terms and attached hereto as Exhibit "G" are hereby incorporated by reference into this DPA in their entirety. If checked, XXX and Provider agree to the additional terms or modifications set forth in Exhibit "H". (Optional) Document Ref: K9ZQZ3TLO3-EZEZK-8KSFYKXUB8-SHKWX DDZTJ-GLPKA Page 1 of 25