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d DELTA DENTAL <br />Delta Dental of Washington <br />Dental Care Service Contract <br />Amendment <br />Contract Number <br />2021-01-00389-RC <br />Amendment # <br />1 <br />Contract Effective Date <br />1/1/2021 <br />Amendment Effective Date <br />5/1/2022 <br />Group Number(s): <br />00389 <br />Group Name <br />City of Everett <br />WHEREAS, Group and Delta Dental of Washington (DDWA) entered into a Contract for Dental Care Services as <br />indicated above, and <br />WHEREAS, Group and DDWA wish to amend their Contract to add Conflict of Interest provision, and <br />WHEREAS, Group and Delta Dental of Washington agree to amend the Contract as indicated with this <br />Amendment, NOW THEREFORE, <br />Effective 5/1/2022, the following provision is being added to the Dental Care Service Contract: <br />Conflict of Interest <br />Delta Dental declares that no conflict of interest with the City exists, nor do they have an <br />affiliation with or involvement in any organization or entity which may pose a financial or non- <br />financial conflict of interest with the City. <br />Except to the extent that the Contract and any prior Amendments are modified by this Amendment, they shall <br />remain in full force and effect and, together with this Amendment be the full Contract between the parties. <br />Accepted By: Accepted By: <br />City of Everett Delta Dental of Washington <br />2930 Wetmore Avenue, Floor 6 Post Office Box 75983 <br />Everett, WA 98201-4067 Seattle, WA 98175-0983 <br />Signed: Signed: <br />Title: <br />Date: <br />Title: Vice President <br />Underwriting and Actuarial <br />Date: May 24, 2022 <br />2021-01-00389-A1 <br />