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DocuSign Envelope ID:A4C366A3-F5D9-473B-9218-AF49BCCA02E0 <br /> NO, R T I-r C h a o r. I N A NCACC Risk Management Pools <br /> 1 AssociATION OF COUNTY UNTY COMMISSIONERS Woi,kel"s Conlpensat<ion <br /> Limits and Experience Modification <br /> Participant ORANGE COUNTY <br /> Certificate Number WC-OR-067-14 <br /> Contract period July 1, 2014 to July 1, 2015 <br /> Effective Time 12:01 A.M., Eastern Daylight Time <br /> Coverage A Workers' Compensation Statutory <br /> Coverage B Employers' Liability $2,000,000 <br /> Coverage C Other States Statutory <br /> Coverage Type Standard <br /> Deductible/Retention $150,000 <br /> ( Aggregate: $0 <br /> Experience Mod <br /> 2014-2015 0.59 <br /> ( <br /> NCACC Workers' Compensation Limits Document Issued <br /> Edition 7/1/2014 6/26/2014 <br />