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29 <br />Attachment 1 <br />Addresses for Notice <br />Participant is required to provide information inthe Primary Contact fields below unless otherwise noted. <br />Pursuant to Section 22, Notifications will EHVHQWWRWKHFRQWDFWVEHORZFRQFHUQLQJWKLV$JUHHPHQWLQFOXGLQJ <br />WKHQHHGIRUDPHQGPHQWV1RWLILFDWLRQVZLOOnot be sent via facsimile; however, please feel free to provide this <br />information. <br />Participant Address for Notice <br />Primary Contact Alternate Contact <br />Not required <br />Name <br />Title <br />Organization <br />Address <br />City, State <br />Zip <br />Phone <br />Fax (not <br />required) <br />E-mail <br />NC HIEA Address for Notice <br />1&+,($Legal Contact for NotiFH 6$6Technical Contact for <br />Notice RQ Breaches <br />Mailing <br />Address <br />NC HIEA <br />Attn: Legal Team <br />4101 Mail Service Center <br />Raleigh, NC 27699-4101 <br />Not Applicable <br />Phone Phone: 919-754-6928 (919) 531-2700 <br />Email HIEALegal@NC.Gov HIESupport@SAS.com <br />Kim Woodward Kyle Ronn <br />EMS Operations Manager QA/QI Coordinator <br />Orange County EMS Orange County EMS <br />510 Meadowlands Drive 510 Meadowlands Drive <br />Hillsborough, NC 27278 Hillsborough, NC 27278 <br />(919) 245 - 6133 (919) 245 - 6124 <br />N/A N/A <br />kwoodward@orangecountync.gov kronn@orangecountync.gov <br />DocuSign Envelope ID: 47B4445A-C7CA-4D2E-9075-2AFD82F82DEC