Indiana Vision Serv/Former VSPPLEASE ATTACH TO YOUR CONTRACT
REVISION TO CONTRACT
APPROVED, AS TO
FORM
THAT CERTAIN CONTRACT entered into between INDIANA VISION SERVICES, INC.,
hereinafter called VSP, and CITY OF CARMEL (12013661), hereinafter called Group, is hereby
revised.
EXCEPT as specifically revised herein, said contract shall remain in full force and effect.
IT IS HEREBY AGREED that effective JULY 1, 2001, contract shall be revised as follows:
TERM AND CANCELLATION (Signature Page, First Paragraph):
This contract shall be effective commencing MAY 1, 2001 for an Initial Term of TWENTY
THREE (23) months, and continuing thereafter until terminated by either party giving the other
sixty (60) days prior written notice.
COSTS UNDER THE PLAN
PREPAYMENT FEES (Page 11, First Paragraph):
Payments by contract holder to VSP for services and materials provided hereunder during the
Initial Term of the contract shall be as follows:
$ 6.28 per month for each eligible employee without dependents
$ 9.58 per month for each eligible employee with one eligible dependent
$17.18 per month for each eligible employee with two or more eligible dependents
Said rates shall be guaranteed for a period of TWENTY THREE (23) months through
MARCH 31, 2003.
CITY OF CARMEL
By see attached sj_gnature page
Title
Date
MID-ATLANTIC VISION SERVICE
PLAN, INC. ~
By ~
Title Executive Vice President
Date JULY 6, 2001
CITY OF CARMEL, INDIANA
By and through its Board of Public Works and Safety
~ard, Presiding Officer
Date
Date
Date
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