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DocuSign Envelope D. 465DCC77-DCEA-4CA9-8641-2BDF97F2755B <br />Exhibit K <br />,Subdivision and Special District Settlement Participation Form <br />Governmental Entity: Mayfield village I State: OH <br />Authorized Si , ,,atory : Brenda T. Bodnar, Mayor and Stephen Schutt, President of Council <br />Address L 6622 Wilson Mills Road <br />Address 2: <br />City, State, Zip: Mayfield Villa e, Ohio 44143 <br />Phone: <br />Email do Dianeth Director of Administration dwolizamuthPmayfieldvillaize.com <br />The governmental entity identified above ("Governmental Entity"), in order to obtain and in <br />consideration for the benefits provided to the Governmental Entity pursuant to the Agreement <br />dated November 22, 2022 ("Teva Settlement"), and acting through the undersigned authorized <br />official, hereby elects to participate in the Teva Settlement, release all Released Claims against all <br />Released Entities, and agrees as follows. <br />1. The Governmental Entity is aware of and has reviewed the Teva Settlement, understands that <br />all terms in this Election and Release have the meanings defined therein, and agrees that by <br />this Election, the Governmental Entity elects to participate in the Teva Settlement as provided <br />therein. <br />2. Following the execution of this Settlement Participation Form, the Governmental Entity shall <br />comply with Section 111.13 of the Teva Settlement regarding Cessation of Litigation Activities. <br />3. The Governmental Entity shall, within 14 days ofthe Reference Date and prior to the filing of <br />the Consent Judgment, file a request to dismiss with prejudice any Released Claims that it has <br />filed. With respect to any Released Claims pending in In re National Prescription Opiate <br />Litigation, MDL No. 2804, the Governmental Entity authorizes the Plaintiffs' Executive <br />Committee to execute and file on behalf of the Governmental Entity a Stipulation of Dismissal <br />With Prejudice substantially in the form found at hltps:iinalionaloi2ioidsettlemenl.com. <br />4. The Governmental Entity agrees to the terms of the Teva Settlement pertaining to <br />Subdivisions as defined therein. <br />5. By agreeing to the ten -ns of the Teva Settlement and becoming a Releasor, the Governmental <br />Entity is entitled to the benefits provided therein, including, if applicable, monetary payments <br />beginning after the Effective Date. <br />6. The Governmental Entity agrees to use any monies it receives through the Teva Settlement <br />solely for the purposes provided therein. <br />7. The Governmental Entity submits to the jurisdiction of the court in the Governmental Entity's <br />state where the Consent Judgment is filed for purposes limited to that court's role as provided <br />in, and for resolving disputes to the extent provided in, the Teva Settlement. <br />