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<br />BlueCross BlueShield <br />of North Dakota <br /> <br />+.v <br /> <br />An Independent Licensee ot the <br />Blue Cross & Blue Shield Association <br /> <br />4510 13th Avenue SOW. <br />Fargo. North Dakota 58121-0001 <br /> <br />ro.:» <br />c:::o <br />c:::o <br />-'= <br />c:;) 0 <br />C'":) J> <br />--I en <br />en ;:xJ <br />N Om <br />~ 00 <br /> m <br />::D J>- <br />c:< <br />::3 om <br /> _0 <br />CO -t <br />0 <br />(.ù ;:xJ <br />CJ1 <br /> <br />~"'Y:C" <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />." :-.: <br />" ~: <br />. ':~ <br /> <br />ATTN: MIKE MONTPLAISIR <br />CASS COUNTY PERSONNEL <br />PO BOX 2806 <br />FARGO ND 58108-2806 <br /> <br />111111111111111111111111111111111111111111111111111111111I1111 <br /> <br />NOTICE OF ANNUAL MEETING <br />Please take notice that the Annual Meeting of Members of Noridian Mutual Insurance Company is scheduled <br />to take place at 9 a.m. on December 3, 2004, at the Blue Cross Blue Shield of North Dakota Home Office, <br />4510 13th Avenue SW, Fargo, NO, for the purposes of electing members to the Board of Directors of the <br />Company and considering such other business as may properly come before the meeting. <br /> <br />You can cast a ballot or assign a proxy either by mail or online at www.BCBSND.com. For instructions on how <br />to complete a ballot or proxy, see the reverse side of this form. <br /> <br />(Please note that you cannot cast a ballot and assign a proxy. Doing so will cancel your vote.) <br /> <br />SIGN ONL V ONE SIDE OF THIS CARD <br /> <br />Detach along perforation <br /> <br />- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- <br /> <br />FORMS MUST BE RECEIVED BY NOVEMBER 29, 2004 <br /> <br />I, the undersigned Voting Member of Noridian Mutual Insurance Company, hereby appoint <br />Mark Sanford, Dennis Elbert, and Jane Bissel, and each of them, with power of substitution, <br />as my proxy to attend and vote on my behalf at the Annual Meeting of Members of the Company <br />to be held on December 3, 2004, or any adjournment thereof, upon the following matters: <br /> <br />(1) Election of Directors; <br />(2) On such other business as may properly come before the members. <br /> <br />User Key 6558028827 <br /> <br />ATTN: MIKE MONTPLAISIR <br />CASS COUNTY PERSONNEL <br />PO BOX 2806 <br />FARGO ND 58108-2806 <br /> <br />day of <br /> <br />,2004 <br /> <br />Dated and signed this <br /> <br />MS3540A_O2 <br /> <br />6427 <br /> <br />Signature of Voting Member (SIGN ONL Y ONE SIDE) <br /> <br /> <br />"m,o..""" <br />