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C <br />3B. No Self Insurance Fund. <br />a. If Lessee does not maintain a self - insurance fund, please complete the following: <br />Lessee obtains funds to pay claims for which it has self - insured from the following sources: <br />b. The limitations on the amounts payable for claims from the above sources are as follows: <br />4. Authority. <br />a. The following entity or officer has authority to authorize payment for claim: <br />b. In the event the entity or officer named in the prior response denies payment of a claim, does the claimant have recourse to <br />another administrative officer, agency or the courts? <br />YES NO (circle one) <br />If yes, to whom does the claimant have recourse? <br />5. Certificates oflnsurance. <br />Attached hereto are copies of certificates of insurance with respect to policies maintained by Lessee. <br />IN WITNESS WHEREOF, Lessee has caused this Questionnaire to be executed as a supplement to the representations of Lessee in the <br />Agreement by its duly authorized officer. <br />ORANGE GROVE VOLUNTEER FIRE COMPANY, INC., <br />Lessee <br />By: <br />Name: Bill Waddell <br />Title: President <br />Date: <br />Telephone: 919- 454 -8089 <br />Facsimile: 919- 942 -5888 <br />Attachment <br />38 <br />5/16/ 2013: BQ- ESCfamtem.D0C /rev.01 /04.st1 <br />