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10, Exhibit D of the Agreement shall be amended by deleting the language that is in stFikeou <br />and inserting the language that is in bold, as follows: <br />Activate shall provide the following additional services as part of Activate Services: <br />[Please note that South Bend may incur lab fees and other nominal charges for some of <br />the below services.] <br />a. Adult vaccinations (limited) <br />b. Occupational health services <br />c. DOT exams <br />duo <br />d. Drugileehel-testing,7�)Y <br />e. Pre -employment physical exams <br />f. Pre -employment drug screenings <br />11. The Amendment shall be effective January 1, 2019 ("Effective Date"). <br />12. In all other respects, the Parties agree that the terms and provisions of the Agreement <br />remain unchanged and that the changes set forth in this Amendment shall be incorporated <br />into the remaining terms and provisions of the Agreement as though set forth in full therein. <br />Intending to be legally bound, by execution of this Amendment the Parties indicate <br />their acceptance of the terms hereof, <br />City of South Bend Indiana <br />Activate Healthcare, LLC <br />Name: Debra Geihsler <br />Title: Principal and Co -Founder <br />Date: Date: 11/6/18 <br />