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DocuSign Envelope ID: EA6C45CD-7691-43D8-B939-A4300A7DD233 <br /> IIWledical IIII"" iii IIII <br /> iii iii <br /> IIIC .. III .. iii .. hint Care Adrniinistratiuri <br /> All claims for Dependent Care Assistance reimbursements shall be submitted by the participants to <br /> Flores in accordance with the instructions. Flores shall pay Dependent Care Assistance claims in <br /> accordance with instructions provided to participants during enrollment. Flores shall not make any <br /> Dependent Care Assistance claims payment to a participant if the amount of the Dependent Care <br /> Assistance claim exceeds the balance credited on the participant's balance in the Company <br /> Account. <br /> 5. Forfeitures. If at the end of a Plan Year there is any forfeiture of balances in <br /> participants' accounts, the Company shall instruct Flores as to how the forfeited balances are to be <br /> applied, provided that such application is in accordance with the Plan's governing instruments.These <br /> balances will be returned to the Company at the end of the Claims Run Out period net of any unpaid <br /> administration fees. <br /> 6. Plan Administration. As Plan Administrator, it will be the Company's responsibility to <br /> collect data in preferred method, determine employee contribution limits, have participants make <br /> payroll deduction elections, transmit election data, Company monies as requested, and deliver <br /> reimbursement checks from Flores to the participants (if required). <br /> 7. Fees and Compensation. The Company agrees to compensate Flores for the setup <br /> charges upon installation of the Plan. Fees for annual plan administration will be billed on a monthly <br /> basis based on the"Current Balance Report". Upon termination of the Administration Agreement,the <br /> Company will be responsible for the administration fees billed for the Claims run-out period. Attached is <br /> a copy of the Professional Fees and Acceptance Agreement which are included as part of this <br /> agreement. <br /> 8. Authority. The Company represents herein that the Company is the plan administrator <br /> for the Plan and is as such duly authorized to act for the Plan and to engage agents in this capacity to <br /> assist in the performance of administrative duties. Flores will not become a fiduciary or a party to the <br /> Plan by this Agreement, and will assume only those responsibilities described in this Agreement. The <br /> Company understands that Flores does not contract to provide tax or legal advice, and that any <br /> responsibility for the preparation, adequacy or validity of any legal documents affecting this Plan will be <br /> vested in the attorney retained by the Company or the Plan. <br /> ORANGE COUNTY 15 Mores <br />