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1 <br /> N '\WO r ks ACA ASSURED- »� <br /> ACA Assured"' Fee Agreement <br /> CLIENT NAME: City of Everett <br /> CLIENT CONTACT NAME: Marcy Hammer <br /> PHONE NUMBER: 425-257-7035 <br /> ADDRESS: 2930 Wetmore Avenue,Suite 5A, Everett,WA 98201 <br /> PRODUCT DESCRIPTION FEES <br /> ACA Audit Annual <br /> Representation during IRS examination covering the calendar <br /> ProtectionT'^ $295 <br /> year'during which Audit Protection fee is paid. <br /> +$110 for each additional FEIN <br /> ACA Audit ACA Audit Protection"" PLUS ACA compliance Assurance Advice Annual <br /> Protection+ including: (i) ACA liability assessment forecast; (ii) confirmation $995 <br /> Assurance of client reporting and compliance strategy; (iii) avoidance of <br /> +$110 for each additional FEIN <br /> Advicee" known audit triggers;and(iv)Assurance Advice report. <br /> PRODUCT FEES <br /> [SERVICE) <br /> TOTAL <br /> This Fee Agreement is governed by and subject to the Terms and Conditions noted below. <br /> El I have read and agree to the Terms and Conditions. <br /> Company Authorization: <br /> Signature Date <br /> Printed Name Title <br /> 9.22.15 <br /> 7 <br />