Common use of Settlement Class Member Affirmation Clause in Contracts

Settlement Class Member Affirmation. I declare under penalty of perjury that the information supplied in this claim form is true and correct. I authorize the Settlement Administrator to contact me, using the contact information set forth above, to obtain any necessary supplemental information. By submitting this Claim Form, I certify that any documentation that I have submitted in support of my Claim consists of unaltered documents in my possession. □ Yes, I understand that my failure to check this box may render my Claim null and void. Please include your name in both the Signature and Printed Name fields below. Signature: Print Name: _________________________________ Date: involving ▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ LLP, Mondelēz Global LLC, and Chicago IVF you may be eligible for a CASH PAYMENT or other benefits under a class action settlement. A proposed settlement has been reached in a class action lawsuit concerning a Data Security Incident perpetrated against Defendant ▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ LLP (“BCLP”). On or about February 27, 2023, BCLP became aware of potential unauthorized access to certain systems and data within its information technology network (the “Data Security Incident”). BCLP investigated and determined that a threat actor had accessed certain files related to BCLP’s clients, including Defendant Mondelēz Global LLC (“Mondelēz”; and collectively with BCLP, “Defendants”) and Chicago IVF, that contained personally identifiable information and protected health information (“PII/PHI”). The Settlement would resolve a lawsuit in which Plaintiffs allege that the Data Security Incident exposed individuals’ PII/PHI, including some combination of names; marital statuses, Social Security numbers, addresses, dates of birth, genders, employee identification numbers, retirement and/or thrift plan information, and PHI. Defendants deny all claims of wrongdoing or liability that Plaintiffs, Settlement Class Members, or anyone else have asserted in this Litigation or may assert in the future based on the conduct alleged in the complaints. ▇▇▇▇▇▇▇▇ and BCLP maintain that they did nothing wrong. The Court has not decided who is right. Instead, the parties agreed to a compromise. The Settlement offers payments and credit monitoring services to members of the Settlement Class. Settlement Class Members can claim the following Settlement Benefits:

Settlement Class Member Affirmation. I declare under penalty of perjury that the information supplied in this claim form is true and correct. I authorize the Settlement Administrator to contact me, using the contact information set forth above, to obtain any necessary supplemental information. By submitting this Claim Form, I certify that any documentation that I have submitted in support of my Claim consists of unaltered documents in my possession. □ Yes, I understand that my failure to check this box may render my Claim null and void. Please include your name in both the Signature and Printed Name fields below. Signature: Print Name: _________________________________ Date: If your data was accessed in the 2020 Data Security Incident involving ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ & Co. and ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ LLPServices, Mondelēz Global LLCInc., and Chicago IVF you may be eligible for a CASH PAYMENT or other benefits under a class action settlement. A proposed settlement has been reached in a class action lawsuit concerning a Data Security Incident perpetrated against Defendant Defendants ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ Co. (“AJG”) and ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ LLP Services, Inc. (“BCLPGB,” and collectively with AJG, “Defendants”). On Between June 3, 2020 and September 26, 2020, an unknown party accessed or about February 27, 2023, BCLP became aware acquired data contained within certain segments of potential unauthorized access to certain systems and data within its information technology Defendants’ network during a criminal ransomware attack (the “Data Security Incident”). BCLP investigated and determined that a threat actor had accessed certain files related to BCLP’s clients, including Defendant Mondelēz Global LLC (“Mondelēz”; and collectively with BCLP, “Defendants”) and Chicago IVF, that contained personally identifiable information and protected health information (“PII/PHI”). The Settlement would resolve a lawsuit in which Plaintiffs allege that the Data Security Incident exposed individuals’ personal identifying information (“PII/”) and personal health information (“PHI”), including some combination of names; marital statuses, Social Security numbers and tax identification numbers; driver’s license, addresses, passport and other government identification numbers; dates of birth, genders, ; usernames and passwords; employee identification numbers; financial account and credit card information; and/or electronic signatures, retirement as well as medical treatment, claim, diagnosis, medication or other medical information; health insurance information; medical records or account numbers; and/or thrift plan biometric information, and PHI. Defendants deny all claims of wrongdoing or liability that Plaintiffs, Settlement Class Members, or anyone else have asserted in this Litigation or may assert in the future based on the conduct alleged in the complaints. ▇▇▇▇▇▇▇▇ and BCLP maintain that they did nothing wrong. The Court has not decided who is right. Instead, the parties agreed to a compromisecomplaint. The Settlement offers payments and credit financial account monitoring services to members of the Settlement Class. Settlement Class Members can claim the following Settlement Benefits: