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<br />The undersigned acknowledges receipt of the information contained herein prior to any purchase and <br />approves the proposed transaction on behalf of the plan without receiving, either directly or indirectly, any <br />personal compensation in connection with the purchase of policies under this Plan. <br /> <br />FOR CITY OF PARIS, PURCHASER: <br /> <br />P.Z~ <br /> <br />Title: r,;.....- 0 ~; "".~ <br /> <br />t"y, r <br />(Date) <br /> <br />FOR HEALTHCARE BENEFITS, INC., CONTRACTOR: <br /> <br /> <br /> <br />1/16/95 <br /> <br />, <br />:'" <br /> <br />ackie Hamilton <br />Vice President - HealthCare Benefits, Inc. <br /> <br />(Date) <br /> <br />,I; <br /> <br />2 <br /> <br />'I I <br />;. _,I <br />, "II <br />