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DocuSign Envelope ID:456CB831-89E2-409B-8715-A71C362353A4 <br /> O. -et .t•ky <br /> N 0 R T Ii r C A R 0 I. 1 N A NCACC Risk Management Pools <br /> ASSOCIATION OF COUNTY COMMISSIONERS Liability and Property <br /> 1 <br /> 1 <br /> SECTION VIII <br /> ENVIRONMENTAL IMPAIRMENT LIABILITY COVERAGE <br /> CONTRACT DECLARATIONS <br /> Participant SENIOR CARE OF ORANGE COUNTY, INC. <br /> Contract Number LP-SE-525-16 <br /> Contract Period July 1,2016 to July 1,2017 <br /> Effective Time 12:01 A.M., Eastern Daylight Time <br /> Amount of Coverage $250,000 aggregate for the entire Contract Period. <br /> This coverage is written on a claims made basis. <br /> Pool Sponsored by North Carolina Association of County Commissioners <br /> 215 North Dawson Street <br /> Raleigh, North Carolina 27603 <br /> Pool Adminstered by North Carolina Association of County Commissioners <br /> 215 North Dawson Street <br /> Raleigh,North Carolina 27603 <br /> Claims Administrator Sedgwick Claims Management Services, Inc. <br /> 5260 Parkway Plaza Boulevard, Suite 190 <br /> Charlotte, North Carolina 28217 <br /> ( <br /> NCACC AMP Environmental Impairment Liability Declarations Page Issued <br /> Edition 7/1/2016 6/27/2016 <br />