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<br />The undersigned acknowledges receipt of the infonnation contained herein prior to any purchase and approves <br />the proposed transaction on behalf of the plan without receiving, either directly or indirectly, any personal <br />compensation in connection with the purchase of policies under this Plan. <br /> <br />FOR CITY OF PARIS, PURCHASER: <br /> <br />ATTEST: <br /> <br />Title: Mayor, Eric S. Clifford <br /> <br />April 8. 1996 <br />(Date) <br /> <br />Mattie Cunningham, City Clerk <br /> <br />APPROVED AS TO FORM: <br /> <br />FOR HEAL THCARE BENEFITS, INC., CONTRACfOR: <br /> <br />T. K. Haynes, City Attorney <br /> <br />Roma Dixon <br />Vice-President - HealthCare Benefits, Inc. <br /> <br />(Date) <br /> <br />2 <br />