2016 IRS Section 6055/6056 Reporting Enrollment Form

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1 2016 IRS Section 6055/6056 Reporting Enrollment Form Enrollment Instructions: Please note: You must have a PPI-administered medical plan with an effective date on or before 9/1/2016 in order to enroll in 2016 IRS Section 6055/6056 Reporting with PPI/NavigateHCR. 1. Review all provisions, disclaimers and terms, and then complete/sign this enrollment form. 2. Prepare payment for all annual fees. Make checks payable to PPI Benefit Solutions (not ACSA, BIEBT, or NavigateHCR). Include ACA Services as a note on the check. Write your PPI Employer Number or Company Name on the check (if it is different than what is printed on the check). Do not include fulfillment costs (print/mail and options), which will be billed later, once fulfillment is complete. ACH/wire transfer instructions are available upon request. 3. Submit your completed enrollment form and payment for all annual fees to PPI IRS Section 6055/6056 Reporting Services will commence once PPI has received a completed and signed copy of this enrollment form plus payment in full for all annual fees. MAIL TO: Attn. ACA Services PPI Benefit Solutions 10 Research Pkwy. Ste. 200 Wallingford, CT Do not send payment for 2016 IRS Section 6055/6056 Reporting Services in the same envelope as your regular, PPI monthly invoiced payment. If preferred, your enrollment form may be faxed or ed under separate cover: clientservices@ppibenefits.com with ACA Services Enrollment Form in the subject line Fax: (203) ; ATTN: ACA Services PPI Enrollment Instructions

2 Employer Information Company Name: FEIN: Do you operate multiple companies? Yes No If yes, how many FEINS will be included in your PPI/NavigateHCR 2016 IRS Section 6055/6056 Reporting? Company Address: Company Phone: Company Fax: Primary Employer Contact (contact receiving all notices and reports): *This contact has permission to access secure information within the NavigateHCR Compass Portal: X Yes No Name: Title: Phone: Secondary Employer Contact: *This contact has permission to access secure information within the NavigateHCR Compass Portal: Yes No Name: Title: Phone: Broker Contact: *This contact has permission to access secure information within the NavigateHCR Compass Portal: Yes No Name: Company Name: Phone: Benefits Administration Contact: *This contact has permission to access secure information within the NavigateHCR Compass Portal: Yes No Name: Karen Greco Company Name: PPI Benefit Solutions Phone: (203) greco.karen@ppibenefits.com Page 1

3 Q Pricing Effective for 2016 IRS Section 6055/6056 Reporting enrollments completed 10/1/2016 through 10/31/2016. Enrollment is considered complete when PPI has received a completed and signed copy of this enrollment form plus payment in full for all annual fees. After 10/31/2016, enrollment is closed. Please note: You must have a PPI-administered medical plan with an effective date on or before 9/1/2016 in order to enroll in 2016 IRS Section 6055/6056 Reporting with PPI/NavigateHCR. All annual fees are due to PPI at the time of enrollment. Fulfillment costs (print/mail and options) will be billed later, once fulfillment is complete. Contract Effective Date: 1/1/2016 Service Fees Election Payment Due Tracker for IRS Reporting Includes implementation, report consulting, quarterly data collection, code calculations, PDF copies and filing of Forms 1094-C and 1095-C to the IRS Additional FEINs <500 Forms 1095: $5,000 annual >500 Forms 1095: $7,000 annual (covers 1 FEIN; additional fees apply for additional FEINs) $1,200 annual (per additional FEIN) Yes No Upon enrollment Yes No Upon enrollment Fulfillment of Form 1095-C Optional Print/mail: $4/form $0.50/form Yes Yes No No Billed later, once fulfillment is complete ACA Helpline Optional $1,250 annual Yes No Upon enrollment Important Notes: The above pricing is effective 10/1/2016 to 10/31/2016. All fees are non-refundable. In the event that a client terminates with PPI, annual fees will not be returned. NavigateHCR will continue to provide service, but all involvement by PPI will be discontinued. ACA Compliance Services are configured and updated at the client s direction. The client is responsible for all compliance requirements, including ACA reporting. PPI provides access to ACA tracking tools and information, which may be used by the client to assist with reporting and compliance needs. However, neither PPI, Businessolver, nor NavigateHCR is responsible for ensuring the accuracy, completeness, or final compliance of the client with respect to Employer Shared Responsibility Final Regulations (79 FR 8543) or other applicable laws and regulations. The employer is always advised to consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to its specific circumstances. Charges and fees will apply for all 12 months of a single calendar/reporting year, regardless of actual implementation date. Page 2

4 Application Agreement/Signature WE,THE UNDERSIGNED CLIENT, OR BROKER ON BEHALF OF THE CLIENT, AND FIRST PACIFIC EXCHANGE SHALL DEFEND, INDEMNIFY, AND HOLD THE OTHER PARTY AND ITS OFFICERS, DIRECTORS, EMPLOYEES, REPRESENTATIVES, AGENTS, SUCCESSORS AND ASSIGNS HARMLESS AGAINST ANY AND ALL CLAIMS, DEMANDS, LOSSES, ACTIONS, CAUSES OF ACTION, DAMAGES, JUDGMENTS, FINES, FEES (INCLUDING REASONABLE ATTORNEY S FEES), PENALTIES, SETTLEMENTS, AND ANY AND ALL OTHER SUMS OF MONEY RESULTING FROM OR IN CONNECTION WITH ANY BREACH OF THIS AGREEMENT BY THE INDEMNIFYING PARTY OR THE INDEMNIFYING PARTY S EMPLOYEES OR AGENTS, UNLESS SUCH ACTIONS ARISE OUT OF THE WILLFUL ACT OR NEGLIGENCE OF THE OTHER PARTY. IN ADDITION TO THE INDEMNIFICATION SET FORTH ABOVE, FIRST PACIFIC EXCHANGE SHALL HOLD HARMLESS CLIENT, ITS AFFILIATES, SUBSIDIARIES, SUCCESSORS, ASSIGNS, AGENTS, OFFICERS, DIRECTORS, REPRESENTATIVES, AND EMPLOYEES, FROM AND AGAINST ANY LIABILITY, CLAIMS, ACTIONS, DAMAGES OR LOSSES, FOR INJURY, INCLUDING DEATH, TO ANY PERSON OR DAMAGE TO ANY PROPERTY OR PROPERTY RIGHT ARISING OUT OF OR IN CONNECTION WITH FIRST PACIFIC EXCHANGE S PROVISION OF THE SERVICES (COLLECTIVELY, A LOSS ) SO LONG AS THE LOSS DID NOT RESULT FROM THE GROSS NEGLIGENCE OR INTENTIONAL MISCONDUCT OF CLIENT OR THE BREACH OF THIS AGREEMENT BY CLIENT. This Agreement shall commence on the Date of Signature and shall continue in effect for one (1) year (the Initial Term ). Upon expiration of the Initial Term, and on each annual anniversary thereafter, this Agreement shall be automatically renewed for an additional one-year period unless either party gives notice of non-renewal to the other party at least thirty (30) days prior to the expiration of the then current term. We, the undersigned Client, or broker on behalf of the Client, affirm the accuracy of this application and acknowledge this application can be relied upon for the preparation and compliance of the Affordable Care Act. Subject to the Client s timely payments and adherence to these terms and conditions, upon enrollment First Pacific Exchange grants Client permission to use and distribute only to its employees, First Pacific Exchange s materials, pamphlets, brochures, s and/or other compliance documents ( Compliance Materials ) sent by first Pacific Exchange to client pursuant to this Agreement. On behalf of employer, you covenant and agree that the client will keep in confidence, and prevent the disclosure of any and all Compliance Materials sent by First Pacific Exchange to client, to any person or persons outside its organization. Client shall take safeguards to ensure that any employees or other persons authorized to receive First Pacific Exchange s materials, also comply with this Agreement and do not disseminate said materials to persons outside the organization, other than for personal use. Client shall be jointly and severely liable for the breach of this Agreement by any employee or agent receiving the Compliance Material. Such information is considered proprietary, confidential information that is subject to protection of intellectual property laws, including without limitation, copyright. Thus, it is imperative that this Agreement is strictly adhered to and First Pacific Exchange s proprietary information is not disseminated to third parties who have not paid for the materials and information. Client agrees that the materials, pamphlets, brochures, s and/or other compliance documents subject to this Agreement are unique, unusual and extraordinary in nature such that it has peculiar value, the loss of which cannot be reasonably or adequately compensated in damages in an action at law. Therefore, in addition to any other rights or remedies which the First Pacific Exchange may possess, First Pacific Exchange shall be entitled to injunctive and other equitable relief to prevent or remedy a breach of this Agreement by client or any of its employees or agents. Date: Signature: Name of Client: Title: NHCR Representative: Title: Page 3

5 Privacy Policy This privacy policy (the Privacy Policy ) discloses the information gathering and dissemination practices for NavigateHCR.com. We will notify you of changes by posting the new policy on this website. Review our Privacy Policy regularly so that you can stay informed of current practices, as they may change in the future. By using our services or submitting information, you are accepting the practices described in this Privacy Policy. Your assent to these practices is essential for us to provide our services. Similarly, we need you to provide accurate personal information so that you can be contacted and use our website and related services. You can opt-out and decide not to provide the requested personal information. However, by doing so, we will not be able to contact you and you will not be able to use our website or services. The personal information we collect includes name, address, password, telephone number, fax number, and date of birth. We automatically collect certain information from visitors to, and members of, the site, such as Internet addresses, browser type, Internet Service Provider (ISP), referring and exit page, operating system, timestamps, and clickstream data. We also track and analyze non-identifying and aggregate usage and volume statistical information from our visitors and customers. This information is logged to help diagnose technical problems, and to administer our site so that we can constantly improve the quality of the services we provide. We do not respond to your browser s do not track signals or other mechanisms for indicating your preference regarding the collection personally identifiable information. Also, we do not permit third parties to collect personally identifiable information about your online activities when you use our website. Anything you send us, post on our site, or use with our service, such as s or voice recordings, or if other users or third parties send us anything about your activities or postings, we will collect such information into a file specific to you. We use information in the file that we maintain for you, and other information that we obtain from your use of the services, to resolve disputes, troubleshoot problems, and enforce our agreements. We take measures to prevent the loss, misuse, and alteration of your information. We carefully limit access to the database in which your personal information is stored. Additionally, we share and transfer your personal information only in the ways set forth in this privacy policy. We cannot ensure that all of your private communications and other personally identifiable information will never be disclosed in ways not otherwise described in this Privacy Policy. For example, we may be forced to disclose information to the government or third parties under certain circumstances, or third parties may unlawfully intercept or access transmissions or private communications. We can (and you authorize us to) disclose any information about you to law enforcement or other government officials as we, in our sole discretion, believe necessary or appropriate in connection with an investigation of fraud, intellectual property infringements, or other activity that is illegal or may expose us to legal liability. Contact us at the address below if you want us to change or delete any information that we have about you. We will respond to your request to access, update, or delete your information within ten (10) business days. Before we are able to provide you with any information, correct any inaccuracies, or delete any information, however, we may ask you to verify your identity. This website is owned and operated by: First Pacific Exchange, Inc Rancho Bernardo Road, Suite 270 San Diego, CA This privacy policy is effective as of September 25, navigatehcr.com Rancho Bernardo Rd. Suite 270 San Diego, CA Page 4

6 Terms of Use IMPORTANT - READ THESE TERMS OF USE. THIS AGREEMENT CONTAINS DISCLAIMERS OF WARRANTIES, LIMITATIONS OF LIABILITY, AN EXCLUSIVE REMEDY, THE REQUIREMENT TO ARBITRATE ANY AND ALL CLAIMS. THESE PROVISIONS FORM AN ESSENTIAL BASIS OF OUR AGREEMENT. First Pacific Exchange, Inc. ( First Pacific Exchange ), provides web-based services for managing a company s federal health care reform compliance obligations ( Services ) on the NavigateHCR website at NavigateHCR.com (the Site ). By consenting to these Terms of Use you ( You ) agree to be bound by the terms of this Terms of Use Agreement ( TOU ), as well as the NavigateHCR Privacy Policy are located on all pages of website (Footer) and in the account setup, both of which are incorporated herein by reference. You may not use this Site if you are not of legal age to form a binding contract with First Pacific Exchange. First Pacific Exchange reserves the right to update and change, from time to time, this TOU and all documents incorporated by reference. You can find the most recent version of this TOU located on all pages of website (Footer) and in the account setup and at NavigateHCR.com/TOU. First Pacific Exchange will post a notice on its home page that the TOU or Privacy Policy has changed. Use of the Site after such changes constitutes acceptance of such changes. In the event of substantive changes to the TOU or Account Setup, you will be required to affirmatively assent to the new terms, and you may also be notified by . If any modification is unacceptable, your only recourse is not to use our Services and Site. 1. Use of the Site. First Pacific Exchange grants You the right to use this Site and Service as expressly provided for in this TOU. You may not use this Site for any purpose that is unlawful or prohibited by this TOU, or cause damage on or through this Site. You agree not to use any automated means, including, without limitation, agents, robots, scripts, or spiders, to access, monitor, or copy any part of this Site, except those automated means that First Pacific Exchange has expressly approved in writing in advance. You promise that none of your communications with or through the Site will violate any applicable local, state, national, or international law. 2. You agree to pay the fees (the Fees ) indicated on the NavigateHCR Account Setup, which is incorporated herein by reference. Payment is due in advance for each Billing Interval. Fees are not refundable and will not be prorated. We reserve the right to change the Fees from time to time, and will notify you in advance of any change. Time is of the essence with respect to payment. Your use of the Site or Service may be paused or terminated because of late payment. 3. First Pacific Exchange Intellectual Property. Our Site and all of its contents (collectively, the Intellectual Property ), are protected by copyright, trademark and other laws of the United States, as well as international conventions and the laws of other countries. The Intellectual Property is owned or controlled by First Pacific Exchange or the party credited as the provider of the intellectual property. No portion of this Site may be reproduced, duplicated, copied, sold, or otherwise exploited for any commercial purpose that is not expressly permitted by First Pacific Exchange. You must keep intact all copyright, trademark, and other notices, including any contained in your personal copies. Except as otherwise provided in this TOU, you may not reproduce or allow others to reproduce your personal copies of downloaded materials, nor may you make them available electronically without our express written consent. You may not save or archive a significant portion of the material appearing on the Site. You may not attempt to alter or modify the content posted on the Site. Except as expressly set forth in this TOU, you may not copy, download, display, distribute, publish, enter into a database, perform, modify, create derivative works, transmit, post, decompile, reverse engineer, disassemble or in any way exploit any of our Intellectual Property or the Site itself. 4. Confidentiality 4.1. For the purpose of this Agreement, Confidential Information shall be deemed to navigatehcr.com Rancho Bernardo Rd. Suite 270 San Diego, CA Page 5

7 include all information and materials that: (a) if in written format is marked as confidential, or (b) if disclosed verbally is noted as confidential at time of disclosure, or (c) in the absence of either (a) or (b) is information which a reasonable party would deem to be non-public information and confidential Confidential Information shall include without limitation: all information provided on or through the Site and our Service; data that you input; and materials, pamphlets, brochures, s, and other compliance materials (the Compliance Materials ) sent by First Pacific Exchange to You or Your employees You acknowledge and agree that First Pacific Exchange s Confidential Information derives value from the fact that it is not generally known and used by others in the highly competitive industry in which First Pacific Exchange competes Each party acknowledges that it is receiving Confidential Information in confidence and will use, publish, copy, and disclose Confidential Information only as provided for in this Agreement. You acknowledge that you will only use the Confidential Information to fulfill your federal health care reform compliance obligations and that you will use best efforts to prevent unauthorized disclosure of the Confidential Information to any third party The obligation of confidentiality shall not apply to any particular portion of Confidential Information which: (a) was in the public domain when access to it was first granted; (b) entered the public domain through no fault of the receiving party subsequent to receipt; (c) was in the receiving party s possession free of any obligation of confidence at the time of the disclosure; (d) was rightfully communicated by a third party to the receiving party free of any obligation of confidence subsequent to the time of the disclosing party s communication thereof to receiving party; (e) was developed by the receiving party independently of and without knowledge or reference to any Confidential Information; (f) is approved for release by written authorization from the disclosing party; or (g) is required to be disclosed pursuant to any statute, law, rule or regulation of any governmental authority or pursuant to any order of any court of competent jurisdiction, but in any case, the receiving party will immediately notify the disclosing party before disclosure and given a reasonable opportunity to obtain a protective order or other form of protection Other than as expressly provided for herein, in no event shall you be deemed by virtue hereof to have acquired any right or interest by license or otherwise, in or to First Pacific Exchange s Confidential Information All originals and any copies of the Confidential Information remain the property of the disclosing party. Copyright and other proprietary notices shall be reproduced, if any, in the same form that they appear on all the materials provided, on all copies of the Confidential Information. Originals and copies of all Confidential Information shall be returned or destroyed upon request. 5. Rules of Conduct. When accessing the Site or using the Service, you agree to obey the law and to respect the privacy rights of the individuals whose personal information the Site or Service processes. You agree not to upload, download, display, perform, transmit, or otherwise distribute any information or content in violation of any third party s rights. You agree to be solely responsible for any violations of any relevant laws and for any infringements of third party rights caused by anything you provide or transmit, or that is provided or transmitted using your account. The burden of proving that something does not violate any laws or third party rights rests solely with you. You may never use, allow, enable others to use, or condone use of our Site to: 5.1. violate any laws, regulations, judicial or governmental order, treaties, or our rights or the rights of any other person, firm, or enterprise; navigatehcr.com Rancho Bernardo Rd. Suite 270 San Diego, CA Page 6

8 5.2. engage in conduct that is or could be considered libelous, defamatory, indecent, vulgar, obscene, pornographic, sexually explicit, sexually suggestive, racially, culturally or ethnically offensive, harmful, harassing, intimidating, threatening, hateful, objectionable, discriminatory, or abusive; 5.3. impersonate any other person, firm, or enterprise or any of our or their employees and agents; 5.4. use the Site for posting, distributing, or otherwise using malicious or unauthorized code, (e.g., viruses, time bombs, cancel bots, worms, Trojan horses, spyware) or other potentially harmful material or information or in any way interrupt, damage, interfere with, destroy, or limit the functionality of any computer software or hardware or communication equipment, including our Service or Site; 5.5. gain unauthorized use of our Site, other users accounts, names, log-in or password information, personally identifiable information, or use the Site or Service in any manner that violates or is inconsistent with the provisions or spirit of this TOU; 5.6. violate or attempt to violate any security features of the Site or Service; 5.7. attempt to modify, reverse-engineer, decompile, disassemble, or otherwise reduce or attempt to reduce to a human-perceivable form any of the source code that we use in providing the Site or Service; 5.8. modify, disrupt, impair, alter, or interfere with the use, features, functions, operation or maintenance of our Site or Service, or the rights, use, and enjoyment of our Site or Service by any other person, firm, or enterprise; 5.9. advocate or encourage conduct that could constitute a criminal offense, give rise to civil liability, or otherwise violate any applicable local, state, national, or foreign law or regulation. First Pacific Exchange intends to cooperate fully with any law enforcement officials or agencies in the investigation of any violation of this TOU or of any applicable laws. Any violation of system or network security may subject you to civil and criminal liability. 6. Representations and Warranties. You represent that: 1) the information provided by You when registering is up-to-date, and materially accurate; 2) you are responsible for maintaining and promptly updating Your account information with First Pacific Exchange for accuracy and completeness and keeping such information (and any passwords) secure against unauthorized access; 3) You are solely responsible for all account activity; 4) You are a user and not a reseller of the Service; 5) You have full right and authority to enter into this Agreement and to perform all of Your obligations hereunder; 6) execution and performance of this Agreement will not breach any agreement between You and a third party; 7) Your use of the Site and Service will comply with all applicable law, including without limitation laws that apply to privacy and data collection; 8) Your use of the Site and Service will not cause First Pacific Exchange to violate any law or infringe any third party right; 9) You have adequate consent from each individual whose personal information You input into the Site or Service to use the personal information as contemplated by this Agreement; and 10) the provisions of this Agreement are binding upon and enforceable against You except as may be limited by applicable United States bankruptcy laws and other laws affecting creditors rights. 7. Disclaimer of Warranties. FIRST PACIFIC EXCHANGE DOES NOT GUARANTEE THE ACCURACY OF INFORMATION FOUND ON THE SITE OR THROUGH THE SERVICES. USE OF THE SITE, THE SERVICES AND ANY DATA ACCESSED WHILE USING THE SITE OR THE SERVICES IS AT YOUR SOLE RISK. THE SITE, THE SERVICES AND ALL CONTENTS OF EACH ARE PROVIDED ON AN AS IS AND AS AVAILABLE BASIS. navigatehcr.com Rancho Bernardo Rd. Suite 270 San Diego, CA Page 7

9 FIRST PACIFIC EXCHANGE DOES NOT WARRANT THAT THE SITE OR SERVICES WILL MEET ANY REQUIREMENTS OR NEEDS YOU MAY HAVE, OR THAT THE SITE OR SERVICES WILL OPERATE ERROR FREE, OR IN AN UNINTERRUPTED FASHION, OR THAT ANY DEFECTS OR ERRORS IN THE SITE OR SERVICES WILL BE CORRECTED, OR THAT THE SITE OR SERVICES ARE COMPATIBLE WITH ANY PARTICULAR PLATFORM. FIRST PACIFIC EXCHANGE IS NOT OBLIGATED TO PROVIDE ANY UPDATES TO THE SITE OR SERVICES. FIRST PACIFIC EXCHANGE DOES NOT WARRANT OR MAKE ANY REPRESENTATIONS REGARDING THE MATERIALS ON THIS SITE OR SERVICES IN TERMS OF THEIR TIMELINESS, CORRECTNESS, ACCURACY, RELIABILITY, OR OTHERWISE. WHILE FIRST PACIFIC EXCHANGE MAKES REASONABLE EFFORTS TO PROVIDE ACCURATE AND TIMELY INFORMATION ON THE SITE, YOU SHOULD NOT ASSUME THAT THE INFORMATION PROVIDED IS ALWAYS UP TO DATE OR THAT THE SITE CONTAINS ALL THE RELEVANT INFORMATION. FIRST PACIFIC EXCHANGE UNDERTAKES NO OBLIGATION TO VERIFY OR MAINTAIN THE CURRENCY OF SUCH INFORMATION. FIRST PACIFIC EXCHANGE DOES NOT REPRESENT THAT THE SITE, THE SERVICES OR ANY DATA ACCESSED WHILE USING THE SITE OR THE SERVICES IS APPROPRIATE OR AVAILABLE FOR USE OUTSIDE THE UNITED STATES. FIRST PACIFIC EXCHANGE EXPRESSLY DISCLAIMS ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, RELATING TO THE SITE, THE SERVICES AND ANY DATA ACCESSED WHILE USING THE SITE OR THE SERVICES, OR THE ACCURACY, TIMELINESS, COMPLETENESS, OR ADEQUACY OF THE SITE, THE SERVICES, AND ANY DATA ACCESSED WHILE USING THE SITE OR THE SERVICES, INCLUDING THE IMPLIED WARRANTIES OF TITLE, MERCHANTABILITY, SATISFACTORY QUALITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT. 8. Limitation of Liability. FIRST PACIFIC EXCHANGE IS NOT LIABLE TO YOU FOR CLAIMS OR LIABILITIES OF ANY KIND, INCLUDING WITHOUT LIMITATION, FOR ANY INDIRECT, INCIDENTAL, CONSEQUENTIAL OR ANY OTHER DAMAGES ARISING OUT OF OR RELATED TO THE USE OF THE SITE OR SERVICES BY YOU OR BY THIRD PARTIES OR ARISING OUT OF OR RELATED TO ANY THIRD-PARTY SOFTWARE, ANY DATA ACCESSED WHILE USING THE SITE OR SERVICES, YOUR USE OR INABILITY TO USE OR ACCESS THE SITE OR SERVICES, WHETHER SUCH DAMAGE CLAIMS ARE BROUGHT UNDER ANY THEORY OF LAW OR EQUITY EVEN IF YOU HAVE ADVISED FIRST PACIFIC EXCHANGE IN ADVANCE OF THE POSSIBILITY OF SUCH DAMAGE, INCLUDING, WITHOUT LIMITATION, DAMAGES FOR LOSS OF BUSINESS PROFITS, INJURY TO PERSON OR PROPERTY, BUSINESS INTERRUPTION, LOSS OF BUSINESS OR PERSONAL INFORMATION. IF, NOTWITHSTANDING THE LIMITATIONS OF LIABILITY SET FORTH ABOVE, FIRST PACIFIC EXCHANGE IS FOUND LIABLE UNDER ANY THEORY, FIRST PACIFIC EXCHANGE S LIABILITY UNDER THIS AGREEMENT OR OTHERWISE WITH RESPECT TO THE SITE AND THE SERVICES AND YOUR EXCLUSIVE REMEDY WILL BE LIMITED TO MONEY DAMAGES NOT TO EXCEED THE AMOUNT YOU PAID IN FEES DURING THE MONTH IN WHICH THE LIABILITY FIRST AROSE. SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF CERTAIN WARRANTIES OR THE LIMITATION OR EXCLUSION OF LIABILITY FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES AS SET FORTH ABOVE. ACCORDINGLY, SOME OF THE LIMITATIONS SET FORTH ABOVE MAY NOT APPLY TO YOU. IN SUCH CASE, THE TERMS OF SEVERABILITY (BELOW) WILL APPLY. 9. Indemnification. You will defend, indemnify, and hold First Pacific Exchange harmless from any claim or demand, including attorneys fees and costs, made by any third party in arising under or related to your use of the Service or Site, your violation of any terms of this TOU, your violation of applicable laws, or your violation of any rights of another person or entity. The party that first learns of the duty to indemnify shall promptly notify the other. First Pacific Exchange shall be entitled, at its own expense, and upon reasonable notice to You, to participate in the defense. Participation in the defense shall not waive or reduce any of navigatehcr.com Rancho Bernardo Rd. Suite 270 San Diego, CA Page 8

10 Your obligations to indemnify or hold First Pacific Exchange harmless. You shall not settle any claim without First Pacific Exchange s prior written consent. You shall also indemnify First Pacific Exchange from any and all attorneys fees and other costs incurred by First Pacific Exchange in responding to, investigating, or enforcing its rights relative to a claim. In the context of this section only, the term First Pacific Exchange shall include officers, directors, employees, corporate affiliates, subsidiaries, agents, attorneys, and subcontractors. 10. Arbitration YOU UNDERSTAND AND AGREE THAT ALL CLAIMS, DISPUTES, OR CONTROVERSIES BETWEEN YOU AND FIRST PACIFIC EXCHANGE, ITS PARENTS, AFFILIATES, SUBSIDIARIES, OR RELATED COMPANIES, INCLUDING, WITHOUT LIMITATION, TORT AND CONTRACT CLAIMS, CLAIMS BASED UPON ANY FEDERAL, STATE, OR LOCAL STATUTE, LAW, ORDER, ORDINANCE, OR REGULATION, AND THE ISSUE OF ARBITRABILITY, SHALL BE RESOLVED BY THE FINAL AND BINDING ARBITRATION PROCEDURES SET BELOW. THE PARTIES ACKNOWLEDGE AND AGREE THAT ANY SUCH CLAIMS SHALL BE BROUGHT SOLELY IN THE PARTY S INDIVIDUAL CAPACITY, AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS, REPRESENTATIVE PROCEEDING, OR PRIVATE ATTORNEY GENERAL CAPACITY. THE PARTIES FURTHER AGREE THAT THE ARBITRATOR MAY NOT CONSOLIDATE MORE THAN ONE PERSON S CLAIMS, AND MAY NOT OTHERWISE PRESIDE OVER ANY FORM OF A REPRESENTATIVE OR CLASS PROCEEDING. THE PARTIES VOLUNTARILY AND KNOWINGLY WAIVE ANY RIGHT THEY HAVE TO A JURY TRIAL. ANY CONTROVERSY CONCERNING WHETHER A DISPUTE IS ARBITRABLE SHALL BE DETERMINED BY THE ARBITRATOR AND NOT BY THE COURT. JUDGMENT UPON ANY AWARD RENDERED BY THE ARBITRATOR MAY BE ENTERED BY A CALIFORNIA STATE OR FEDER- AL COURT HAVING JURISDICTION THEREOF. THIS ARBITRATION CONTRACT IS MADE PURSUANT TO A TRANSACTION IN INTERSTATE COMMERCE AND ITS INTERPRETATION, APPLICATION, ENFORCEMENT AND PROCEEDINGS HEREUNDER SHALL BE GOVERNED BY THE FEDERAL ARBITRATION ACT ( FAA ). The following procedures shall apply: Any party that intends to make a claim shall first notify the opposing party in writing of such intention and shall describe in such notice, with reasonable particularity, the nature and basis of such claim, and the total amount of the claim. Within thirty (30) days of receipt of such notice, the party receiving notice of a claim shall provide a written response which, with reasonable particularity, sets forth its position concerning the claim. If the parties are unable to resolve the dispute arising from the claim by good faith negotiations to be conducted within the thirty (30)-day period following the written response, either of them may initiate binding arbitration pursuant to the terms and conditions set forth below In the event a party elects to proceed with binding arbitration, it shall provide written notice thereof to the other party by registered or certified mail. The arbitration shall be conducted by Judicate West, and shall be conducted using the then current Judicate West commercial rules and regulations (except as varied by this agreement). The arbitration shall take place in San Diego County, California, but may proceed telephonically in the event the total amount of the claim does not exceed $2,500 U.S. dollars (if the claimant so chooses) Separate and apart from the agreement to arbitrate set forth above, the parties hereby independently waive any right to bring or participate in any class action in any way related to, or arising from, this agreement. 11. Miscellaneous Complete Agreement. This TOU, the NavigateHCR Account Setup, and Privacy Policy constitute the entire understanding between First Pacific Exchange and you respecting use of the Site and the Services, superseding all prior agreements between you and First Pacific Exchange. If there is any conflict between the terms this TOU and those in the Privacy Policy, the navigatehcr.com Rancho Bernardo Rd. Suite 270 San Diego, CA Page 9

11 terms of this TOU will control, except to the extent that the Privacy Policy imposes additional restrictions and liabilities on your actions Governing Law; Jurisdiction; Attorney s Fees. This Site (excluding linked sites) is controlled by us from our office in California, United States of America. Although use of the Services from outside the United States is strictly prohibited, the Site can be accessed worldwide. As each of these jurisdictions has laws and regulations that may differ from those of California, by accessing this Site or purchasing, subscribing, or otherwise using the Services, you and First Pacific Exchange agree that the laws of California (expect for conflicts of laws principles) will apply to all matters relating to use of this Site. If for any reason, the Arbitration provision required above is deemed inapplicable or unenforceable, exclusive jurisdiction must lie with the courts of California in the county of San Diego for all disputes, actions, or proceedings arising out of or relating to your use of the Site. In any dispute that arises out of the relationship of First Pacific Exchange and you, including tort claims, the prevailing party will be entitled to attorneys fees and costs English Language Controls. This English-language TOU is First Pacific Exchange s official agreement with users of this Site. In case of any inconsistency between this English-language TOU and its translation into another language, this English-language document controls Severability. If a provision of this TOU is held to be illegal, invalid, or unenforceable, then: 1) it must be deemed amended to achieve as nearly as possible the same economic effect as the original provision, and 2) the legality, validity and enforceability of the remaining provisions of this TOU must not be affected or impaired Waiver. No failure or delay on the part of First Pacific Exchange in exercising any right, power, or remedy under this TOU may operate as a waiver, nor may any single or partial exercise of any such right, power, or remedy preclude any other or further exercise of such right, power, or remedy, or the exercise of any other right, power, or remedy under this TOU. navigatehcr.com Rancho Bernardo Rd. Suite 270 San Diego, CA Page 10

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