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EXHIBIT 1C <br />DATA REQUIREMENTS <br />PARS will provide the Services under this Agreement contingent upon receiving the <br />following information. Agency is solely responsible for ensuring that all information and <br />documentation provided to PARS is true, correct, and authorized: <br />1.Executed Legal Documents: <br />(A)Certified Resolutions <br />(B)Adoption Agreement to the Public Agencies Post-Retirement Health Care Plan <br />and Trust <br />(C)Trustee Investment Forms <br />2.Contribution – completed Contribution Transmittal Form signed by the Plan <br />Administrator (or authorized Designee) which contains the following information: <br />(A)Agency name <br />(B)Contribution amount <br />(C)Contribution date <br />(D)Contribution method (Check, ACH, Wire) <br />3.Reimbursement/Distribution – completed Payment Reimbursement/Distribution Form <br />signed by the Plan Administrator (or authorized Designee) which contains the <br />following information: <br />(A)Agency name <br />(B)Payment reimbursement/distribution amount <br />(C)Applicable statement date <br />(D)Copy of applicable premium, claim, statement, warrant, and/or administrative <br />expense evidencing payment <br />(E)Signed certification of reimbursement/distribution from the Plan Administrator <br />(or authorized Designee) <br />4.Other information pertinent to the Services as reasonably requested by PARS and <br />Actuarial Provider. <br />Page 7 <br /> <br />