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DocuSign Envelope U. 465DCC77-DCEA-4CA9-8641-2BDF97F2755B EXHIBITK Subdivision Participation and Release Fonn Will vour subdivision or special district be signing the settlement participation form for the CVS Settlement at this time? [ X] Yes [] No Governmental Entity: Mayfield village I State: OH Authorized Signatory: Brenda T. Bodnar. Mayor and Stephen Schutt President of Council Address l: 6622 Wilson Mill s Road Address 2 - City, City, State, Zip: Mayfield Village, Ohio 44143 Phone: 440-461-221() Email: do Diane Wol amuth Director of Administration dwolmamuthc-)mayfieldvillage.com The governmental entity identified above ("Governmental Entity'), in order to obtain and in consideration for the benefits provided to the Governmental Entity pursuant to the Settlement Agreement dated December 9, 2022 ("CVS Settlement'), and acting through the undersigned authorized official, hereby elects to participate in the CVS Settlement, release all Released Claims against all Released Entities, and agrees as follows. 1. The Governmental Entity is aware of and has reviewed the CVS Settlement, understands that all terms in this Participation and Release Form have the meanings defined therein, and agrees that by executing this Participation and Release Form, the Governmental Entity elects to participate in the CVS Settlement and become a Participating Subdivision as provided therein. The Governmental Entity shall promptly, and in any event no later than 14 days after the Reference Date and prior to the filing of the Consent Judgment, dismiss with prejudice any Released Claims that it has filed. With respect to any Released Claims pending in In re National Prescription Opiate Litigation, MDL No. 2804, the Governmental Entity authorizes the Plaintiffs' Executive Committee to execute and file on behalf of the Governmental Entity a Stipulation of Dismissal with Prejudice substantially in the form found at IiRp.s:/lnatiotialopioidsettlement.com. I The Governmental Entity agrees to the terns ofthe CVS Settlement pertaining to Participating Subdivisions as defined therein. 4. By agreeing to the terms of the CVS Settlement and becoming a Releasor, the Governmental Entity is entitled to the benefits provided therein, including, if applicable, monetary payments beginning after the Effective Date. 5. The Governmental Entity agrees to use any monies it receives through the CVS Settlement solely for the purposes provided therein.