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IN WITNESS WHEREOF, COUNTY and PROVIDER, by their respective authorized agents, have <br />caused this Agreement and its Schedules to be executed, effective as of the date by which all parties <br />hereto have affixed their respective signatures, as indicated below. <br />Date Signed: <br />Date Signed: <br />Date Signed: //- a Y"-/`% <br />Date Signed: <br />FOR PROVIDER: <br />1" C'�C)v►c <br />Cs"ale vi+ <br />FOR COUNTY: <br />4UvAq-' Q".1 A"M <br />JOSEPH PARISI, County Executive <br />SCOTT MCDONELL, County Clerk <br />* [print name and title, below signature line of any person signing this document] <br />rev. 04/13 <br />