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ADMINISTRATIVE SERVICES AGREEMENT <br /> This Administrative Services Agreement("Agreement")between United HealthCare Services,Inc. ("United"in this <br /> Agreement) and Orange County ("Customer" in this Agreement) is effective January 1, 2014 ("Effective Date"). <br /> This Agreement covers the services United is providing to Customer, either directly or in conjunction with one of <br /> United's affiliates,for use with Customer's Self-Funded employee benefit plan. <br /> United HealthCare Services,Inc. identifies this arrangement as Contract No.: 743058 <br /> By signing below,each party agrees to the terms of this Agreement. <br /> United HealthCare Services,Inc. Orange County <br /> 185 Asylum Street 200 South Cameron Street <br /> Hartford,CT 06103-3408 Hillsborough,)?r27278..7 <br /> By: By: <br /> r <br /> Authorized Signature Authorized Signatur "J <br /> ✓ y <br /> Print Name: � JT�n Print Name: C'I k?i' �'5 �J �`�� C's 61 r <br /> �y <br /> Print Title: } (n�Q,1 LeC C1r1Qr( . Print Title: (�p�K!:!J Aa-* ,A-A-c.Y' <br /> Date: aa I"1 Date: 1, I <br /> This instrument has been pre-audited in the <br /> manner required by the Local Government <br /> /7 Budget and FiVA, l C roI Act <br /> Clarence G.Grier,Assistant Co. Manager& ASA 4Q 2013 Rev <br /> CFO <br />