REQUIRO SCIENTIA LLC FIFTH THIRD BANK = PALM BEACH, FL 33480 63-9171/670 12/27/16 PAY TO THE ORDER OF___Blue Cross Blue Shield ss $H**4,998.59 Phe eee e Renee aERARERRREE HEN EEEE AAO RS OH OOCONEN ENED One It R red Ninety-Ei Blue Cross Blue Shield PO Box 538660 Atlanta, GA 30353-8660 EFTA00272755

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CREDIT ACCT OF NAMED PAYEE} ENDORSEMENT GUARANTEED BY BB&T CHARLOTTE NC EFTA00272756