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BK 00027 PG Charles Parks October 24, 2014 Chairman Lee County Board of Commissioners 106 Hillcrest Dr. Sanford, NC 27331 Re: Renewal of Emergency Medical Services Agreement between AMISUB of North Carolina, Inc. d/b /a Central Carolina Hospital ( "Provider ") and County of Lee ( "County ") effective as of October 1, 2007 Dear Mr. Parks: This letter ( "Renewal ") will serve as written notice of the Hospital's desire to renew the Agreement referenced above subject to the modifications set forth below: 1. The Agreement shall renew for a period of seven (7) year(s) commencing on November 30, 2014, or on the day of execution ( "Renewal Term "). 2. County shall pay provider for provision of the Services. The amounts are described in Exhibit A attached hereto and incorporated herein by this reference (the "Services Fee "). The Services Fee shall be payable monthly on the 15' day of each month during the Term commencing as of October 1, 2014. Upon reasonable written request of the Provider, submitted to the Board together with reasonable supporting documentation, the Services Fee shall be increased from time to time during the Term by the Board to reflect increased costs to Provider in the event of a significant change in the Service's scope, such as an expansion of the county's census that necessitates increased staff coverage or the addition of a service or program for a different target population than that served by the Service. The Services Fee shall not be reduced or otherwise affected by any amounts collected from patients or third -party payers for emergency transportation and patient care. All other terms and conditions stated in the Agreement shall remain in effect throughout the Renewal Term. 4. To the extent there are any conflicts between the terms of this Renewal and the Agreement, the provisions of this Renewal shall prevail. Initials 0 Initials