Common use of REFERENCED CONTRACT PROVISIONS Clause in Contracts

REFERENCED CONTRACT PROVISIONS. 2 3 “Term: July 1, 2017 through June 30, 2019 through June 30, 2024 4 Period One means the period from July 1, 20172019 through June 30, 2020 Period Two means the period from July 1, 2020 through June 30, 2021 5 Period Three means the period from July 1, 2021 through June 30, 20182022 6 Period TwoFour means the period from July1, 2018July 1, 2022 through June 30, 7 20192023 Period Five means the period from July 1, 2023 through June 30, 2024 9 Aggregate Maximum Obligation: 10 Period One Aggregate Maximum Obligation: $ 11,133,043913,726 11 Period Two Aggregate Maximum Obligation: 11,522,699 12 12,330,706 Period Three Aggregate Maximum Obligation: 12,762,281 13 Period Four Aggregate Maximum Obligation: 14,572,507 14 Period Five Aggregate Maximum Obligation: 14,951,877 15 TOTAL AGGREGATE MAXIMUM OBLIGATION: $22,655,742 $ 66,531,097” 16 Basis for Reimbursement: Fee for Service 17 18 Payment Method: Monthly in Arrears 19 20 Notices to COUNTY and CONTRACTOR: COUNTY: County Exhibit A of Orange Health Care Agency 23 the Contract Services 24 000 Xxxx 0xx Xxxxxx, Xxxxx 000 25 Santa Ana, CA 92701-4637 «LC_NAME» «CONTACT» 2 CONTRACTOR: «LC_DBA» «ADDRESS» 5 «CITY_STATE_ZIP» «CONTACT_EMAIL» 7 // 8 // 9 // 10 // // 11 // 12 // 13 // // 14 15 16 17 18 19 20 21 22 24

REFERENCED CONTRACT PROVISIONS. 2 3 “Term: July 1, 2017 through June 30December 31, 2019 through June 30, 2024 2020 4 Period One means the period from July 1, 20172019 2017 through June 30December 31, 2020 2017 5 Period Two means the period from July January 1, 2020 2018 through June 30December 31, 2021 5 2018 6 Period Three means the period from July January 1, 2021 2019 through June 30December 31, 20182022 6 2019 7 Period TwoFour Four means the period from July1, 2018July January 1, 2022 2020 through June 30December 31, 7 20192023 Period Five means the period from July 1, 2023 through June 30, 2024 9 2020 8 10 Aggregate Maximum Obligation: 10 $4,098,000 11 Period One Aggregate Maximum Obligation: $ 11,133,043913,726 11 $500,700 12 Period Two Aggregate Maximum Obligation: 11,522,699 12 12,330,706 991,500 13 Period Three Aggregate Maximum Obligation: 12,762,281 13 1,302,900 14 Period Four Aggregate Maximum Obligation: 14,572,507 14 Period Five Aggregate Maximum Obligation: 14,951,877 1,302,900 15 TOTAL AGGREGATE MAXIMUM OBLIGATION: $22,655,742 $ 66,531,097” 4,098,000 16 17 Basis for Reimbursement: Fee for Service 17 18 Payment Method: Monthly in Arrears 19 20 21 CONTRACTOR DUNS Number: «DUNS_NUMBER» 23 CONTRACTOR TAX ID Number: «TAX_ID» 24 25 Notices to COUNTY and CONTRACTOR: 26 27 COUNTY: County Exhibit A of Orange 28 Health Care Agency 23 the 29 Contract Services 24 30 000 Xxxx 0xx Xxxxxx, Xxxxx 000 25 Santa Ana00 Xxxxx Xxx, CA 92701XX 00000-4637 0000 «LC_NAMECONTRACTOR_NAME_» «CONTACTCONTRACTOR_ADDRESS» 2 33 CONTRACTOR: «LC_DBACONTRACTOR_ZIP» 34 35 «ADDRESS» 5 CONTRACTOR_CITY», «CITY_STATE_ZIP» «CONTACT_EMAIL» 7 CONTRACTOR_STATE», 36 // 8 37 // 9 // 10 // // 11 // 12 // 13 // // 14 15 16 17 18 19 20 21 22 244 OF 34

REFERENCED CONTRACT PROVISIONS. 2 3 “Term: July January 1, 2017 2014 through June 30, 2019 through June 30, 2024 2017 4 5 Period One means the period from July January 1, 20172019 2014 through June 30, 2020 2014 6 Period Two means the period from July 1, 2020 2014 through June 30, 2021 5 2015 7 Period Three means the period from July 1, 2021 2015 through June 30, 20182022 6 2016 8 Period TwoFour means the period from July1, 2018July 1, 2022 through June 30, 7 20192023 Period Five Four means the period from July 1, 2023 2016 through June 30, 2024 2017 9 Aggregate 11 Maximum Obligation: 10 $27,580,000 12 13 Period One Aggregate Maximum Obligation: $ 11,133,043913,726 11 3,560,000 14 Period Two Aggregate Maximum Obligation: 11,522,699 12 12,330,706 7,770,000 15 Period Three Aggregate Maximum Obligation: 12,762,281 13 8,000,000 16 Period Four Aggregate Maximum Obligation: 14,572,507 14 Period Five Aggregate Maximum Obligation: 14,951,877 15 8,250,000 17 TOTAL AGGREGATE MAXIMUM OBLIGATION: $22,655,742 $ 66,531,097” 16 27,580,000 18 19 Basis for Reimbursement: Fee for Service 17 18 Payment Method: Monthly in Arrears 19 Actual Cost Reimbursement 20 22 23 Notices to COUNTY and CONTRACTOR: 24 25 COUNTY: County Exhibit A of Orange 26 Health Care Agency 23 the 27 Contract Services 24 Development and Management 28 000 Xxxx 0xx Xxxxxx, Xxxxx 000 25 Santa Ana00 Xxxxx Xxx, XX 00000-0000 31 CONTRACTOR: MedImpact Healthcare Solutions, Inc. 32 00000 Xxxxxx Xxxxxx, Stop 5 33 San Diego, CA 9270100000-4637 «LC_NAME» «CONTACT» 2 CONTRACTOR0000 34 Contact person: «LC_DBA» «ADDRESS» 5 «CITY_STATE_ZIP» «CONTACT_EMAIL» 7 // 8 // 9 // 10 // // 11 // 12 // 13 // // 14 15 16 17 18 19 20 21 22 24Xxxxxxxxx Xxxx, CEO 35 Contact e-mail: XXxxx@XxxXxxxxx.xxx 36 Contact phone: (000) 000-0000 37 //

REFERENCED CONTRACT PROVISIONS. 2 3 “Term: July January 1, 2017 2014 through June 30, 2019 through June 30, 2024 2017 4 5 Period One means the period from July January 1, 20172019 2014 through June 30, 2020 2014 6 Period Two means the period from July 1, 2020 2014 through June 30, 2021 5 2015 7 Period Three means the period from July 1, 2021 2015 through June 30, 20182022 6 2016 8 Period TwoFour means the period from July1, 2018July 1, 2022 through June 30, 7 20192023 Period Five Four means the period from July 1, 2023 2016 through June 30, 2024 2017 9 Aggregate 11 Maximum Obligation: 10 $27,580,00030,520,000 12 13 Period One Aggregate Maximum Obligation: $ 11,133,043913,726 11 3,560,0006,500,000 14 Period Two Aggregate Maximum Obligation: 11,522,699 12 12,330,706 7,770,000 15 Period Three Aggregate Maximum Obligation: 12,762,281 13 8,000,000 16 Period Four Aggregate Maximum Obligation: 14,572,507 14 Period Five Aggregate Maximum Obligation: 14,951,877 15 8,250,000 17 TOTAL AGGREGATE MAXIMUM OBLIGATION: $22,655,742 $ 66,531,097” 16 27,580,00030,520,000 18 19 Basis for Reimbursement: Fee for Service 17 18 Payment Method: Monthly in Arrears 19 Actual Cost Reimbursement 20 21 22 23 Notices to COUNTY and CONTRACTOR: 24 25 COUNTY: County Exhibit A of Orange 26 Health Care Agency 23 the 27 Contract Services 24 Development and Management 28 000 Xxxx 0xx Xxxxxx, Xxxxx 000 25 Santa Ana00 Xxxxx Xxx, XX 00000-0000 31 CONTRACTOR: MedImpact Healthcare Systems, Inc. 32 00000 Xxxxxx Xxxxxx, Stop 5 33 San Diego, CA 9270100000-4637 «LC_NAME» «CONTACT» 2 CONTRACTOR0000 34 Contact person: «LC_DBA» «ADDRESS» 5 «CITY_STATE_ZIP» «CONTACT_EMAIL» 7 // 8 // 9 // 10 // // 11 // 12 // 13 // // 14 15 16 17 18 19 20 21 22 24Xxxxxxxxx Xxxx, CEO 35 Contact e-mail: XXxxx@XxxXxxxxx.xxx 36 Contact phone: (000) 000-0000 37 //

REFERENCED CONTRACT PROVISIONS. 2 3 “Term: July 1, 2017 through June 30, 2019 through June 30, 2024 2020 4 Period One means the period from July 1, 20172019 2017 through June 30, 2020 2018 5 Period Two means the period from July 1, 2020 2018 through June 30, 2021 5 2019 6 Period Three means the period from July 1, 2021 2019 through June 30, 20182022 6 Period TwoFour means the period from July1, 2018July 1, 2022 through June 30, 2020 7 20192023 Period Five means the period from July 1, 2023 through June 30, 2024 9 Aggregate 8 Maximum Obligation: 10 $1,500,000 9 Period One Aggregate Maximum Obligation: $ 11,133,043913,726 11 500,000 10 Period Two Aggregate Maximum Obligation: 11,522,699 12 12,330,706 500,000 11 Period Three Aggregate Maximum Obligation: 12,762,281 13 Period Four Aggregate Maximum Obligation: 14,572,507 14 Period Five Aggregate Maximum Obligation: 14,951,877 15 500,000 12 TOTAL AGGREGATE MAXIMUM OBLIGATION: $22,655,742 $ 66,531,097” 16 1,500,000 14 Basis for Reimbursement: Fee for Service 17 18 Actual Cost 15 Payment Method: Monthly Payment in Arrears 16 17 CONTRACTOR DUNS Number: 00-000-0000 18 19 CONTRACTOR TAX ID Number: 00-0000000 20 21 Notices to COUNTY and CONTRACTOR: 22 23 COUNTY: County Exhibit A of Orange 24 Health Care Agency 23 the 25 Contract Services 24 Development and Management 00 000 Xxxx 0xx Xxxxxx, Xxxxx 000 25 27 Santa Ana, CA 92701-4637 «LC_NAME» «CONTACT» 2 29 CONTRACTOR: «LC_DBA» «ADDRESS» 5 «CITY_STATE_ZIP» «CONTACT_EMAIL» 7 AHMC Anaheim Regional Medical Center LP 00 0000 X. Xx Xxxxx Ave. 31 Anaheim, CA 92801 32 Attn: Mr. Xxxxxxx Xxxxxx, CEO 33 Xxxxxxx.Xxxxxx@xxxxxxxxxx.xxx 34 // 8 35 // 9 36 // 10 // // 11 // 12 // 13 // // 14 15 16 17 18 19 20 21 22 2437 //

REFERENCED CONTRACT PROVISIONS. 2 3 “4 Term: July 1, 2017 20132016 through June 30, 20162019 2019 through June 30, 2024 4 2018 017 2018 2017 016 6 Period One means the period from July 1, 20172019 through June 30, 2020 20132 7 Period Two means the period from July 1, 2020 through June 30, 2021 5 2014 8 Period Three means the period from July 1, 2021 2015 9 10 Aggregate Maximum Obligation: 11 through June 30, 20182022 6 Period TwoFour means the period from July1, 2018July 1, 2022 20142 through June 30, 7 20192023 Period Five means the period from July 1, 2023 2015 through June 30, 2024 9 Aggregate Maximum Obligation: 10 2016 12 Period One Aggregate Maximum Obligation: $ 11,133,043913,726 11 46,500 13 Period Two Aggregate Maximum Obligation: 11,522,699 12 12,330,706 $46,500 14 Period Three Aggregate Maximum Obligation: 12,762,281 13 Period Four Aggregate Maximum Obligation: 14,572,507 14 Period Five Aggregate Maximum Obligation: 14,951,877 $46,500 15 TOTAL AGGREGATE MAXIMUM OBLIGATION: $22,655,742 $ 66,531,097” 139,500 16 17 Basis for Reimbursement: Fee for Service 17 18 19 Payment Method: Monthly in Fee for ServiceMonthly In Arrears 19 20 CONTRACTOR DUNS Number: «DUNS» 22 CONTRACTOR TAX ID Number: «TAX_ID» 24 26 Notices to COUNTY and CONTRACTOR: 27 28 COUNTY: 29 30 31 32 33 34 CONTRACTOR: 35 36 37 County Exhibit A of Orange Health Care Agency 23 the Contract Services 24 Development and ManagementServices 000 Xxxx 0xx Xxxxxx, Xxxxx 000 25 Santa AnaXxxxx Xxx, CA 92701XX 00000-4637 «LC_NAME0000 Xxxxxxxxx Xxxxxx, R.N., MFA«LC_NAME» «CONTACT000 Xxxxxx Xxxxxx, Xxx. #X«XXXXXXX» 2 CONTRACTOR: «LC_DBAXxxxxxx Xxxxx, XX 92663«CITYSTATEZIP» «ADDRESS» 5 «CITY_STATE_ZIP» «CONTACT_EMAIL» 7 // 8 // 9 // 10 // // 11 // 12 // 13 // // 14 15 16 17 18 19 20 21 22 24Xxxxxx0000@xxxxx.xxx«EMAIL»