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<br /> <br /> <br /> <br /> <br />EXHIBIT C: Adopting Employer/Plan Administrator Authorized Representatives <br /> <br />Name: Signature: Title: Date: <br />Name: Signature: Title: Date: <br />Name: Signature: Title: Date: <br />Name: Signature: Title: Date: <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Continuation and/or Retiree Billing 14 <br />Administrative Agreement (public sector) <br /> <br />