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UnitedHealthcW <br />A UnitedHealth Group Company <br />CITY OF SANTA ANA <br />RENEWAL AGREEMENT <br />Contract Period: <br />Flexible Spending Account Plan Services: <br />Annual Renewal <br />Record-keeping & Claims Administration <br />Annual Report Form 5500 <br />Plan Amendments <br />Annual Account Statements <br />Sent to employer for distribution <br />CITY OF SANTA ANA <br />January 1 through December 31, 2011 <br />$750 <br />$3.75 per participant per month <br />$150 per filing <br />$100 per amendment <br />No charge <br />Accepted By: 0., 1-d a,,,, <br />Signature - as an authorized party of the Employer <br />Print Name: p? V d etl wI <br />?c <br />Title: 0C,(V\CA U It, t"_ <br />Date: SEP 15 2010 <br />Sign and return to attention of Donna Labisch by September 1 2010 <br />5 <br />UHC BENEFIT SERVICES <br />250 N. PA "PRICK BOULEVARD <br />SUITE 125 <br />BROOKFIELD, W1 53045-5876 <br />MAILING ADDRESS <br />P.O. Box 2490 <br />BROOKFIELD, WI 53008-2490 <br />262 789.8181 <br />800 236.8187 <br />FAx 262 879.0720 <br />EXHIBIT A.