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DocuSign Envelope ID:91 F43AFA-8CB4-4861-887A-F304C7A6614B <br /> SCHEDULE OF OPERATIONS <br /> This Schedule of Operations forms a part of the policy effective on the inception date of the policy unless another date is <br /> indicated below: <br /> INSURER: HARTFORD FIRE INSURANCE COMPANY <br /> Company Code: 1 <br /> Policy Number: 22 WBC CN3905 Schedule Number: 01-32-03 <br /> Effective Date: 10/01/15 Effective hour is the same as stated on the Information Page of the policy. <br /> Named Insured and Location Address of operations covered by this schedule: <br /> NORTH CAROLINA PUBLIC HEALTH FOUNDATION <br /> 308 WEST MILL BROOK RD, STE F <br /> RALEIGH NC 27609 <br /> NAICS: <br /> FEIN: 470921425 UIN: SIC: NO. OF EMPL: <br /> 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating <br /> Plans. All information required below is subject to verification and change by audit. <br /> Premium Basis <br /> Classifications Total Estimated Rates Per Estimated <br /> Code Number and Annual $100 of Annual <br /> Description Remuneration Remuneration Premium <br /> 8810 764,000 .21 1,604 <br /> CLERICAL OFFICE EMPLOYEES NOC <br /> TOTAL CLASS PREMIUM 2,224 <br /> TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 2,224 <br /> EXPENSE CONSTANT (0900) 250 <br /> TERRORISM (9740) 885,600 .010 89 <br /> CATASTROPHE (9741) 885,600 .010 89 <br /> TOTAL ESTIMATED ANNUAL PREMIUM 2,652 <br /> Countersigned by <br /> Authorized Representative <br /> Form WC 99 00 05 (1) Printed in U.S.A. <br /> Process Date: 08/01/15 Policy Expiration Date: 10/01/16 <br />