Orange County NC Website
DocuSign Envelope ID:273B24CC-D965-44D0-A589-37C63CDFC6B6 <br /> WC 99 06 03 <br /> Worker's Compensation and Employer's Liability Policy Payment Schedule <br /> Policy Number: MWC0071930-02 <br /> Issued to: Family Centered Healthcare INC <br /> Effective Date: 11/17/2015 <br /> Month Payment <br /> 11/17/2015 $210.00 <br /> If you elect a payment plan,then you will be subject to installment fees for each payment ranging from$3-$10 depending on <br /> the state. If you elect electronic funds transfer,these fees will not apply. <br /> ©1991 National Council on Compensation Insurance. 6 of 6 <br />