Laserfiche WebLink
<br />25724 <br /> <br />AMENDMENT NO. 3 (Continued) <br /> <br />This amendment shall become effective on the date stipulated above, <br />provided that (1) it is executed in duplicate; (2) payment of the <br />premium for the first month after the effective date is received by <br />Blue Cross and Blue Shield of Texas, Inc.: and (3) in the event of any <br />alteration of this amendment, such alteration is accepted in writinq <br />by Blue Cross and Blue Shield of Texas, Inc. <br /> <br />Blue Cross and Blue Shield <br />of Texas, Inc. <br /> <br />By: ~=l..(~f16e~ j <br />John Melton, president <br /> <br />I~~L Jl ;4mi( <br /> <br />Reqistrar <br /> <br />citv of Paris <br />Full or corporate Name <br /> <br />By: <br />Siqnature and Title <br /> <br />, d ,/ <br />, H <br />~. . '? . ',~/,<-. <br />'/'-->,1-~(.;;j))"""-:;7 _ <br />Date/ <br /> <br />':""'/./"; <br />./.:.., <br /> <br />/- ...." r <br />.1 v? <br />/ / ,~ 0 <br /> <br />Date <br /> <br />Form No. CBCBS-2-Amend.(9) <br />