2016-541-E HR - Gallagher Benefit Services for consulting services

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DocuSign Envelope ID:7B0EAFC2-08FE-4D8D-8809-FC9B16F772B3 E`y -- Arthur J. Gallagher& Co. BUSINESS WITHOUT BARRIERS" • Gallagher is not a trustee of the Plan(s)and is neither the Plan Administrator of the Plan(s),a fiduciary of the Plan(s), nor an employer which has employees in the Plan(s). Gallagher shall not exercise discretionary authority or control with respect to plan management, the disposition of plan assets or plan administration. • Gallagher's liability to Client, or any party claiming by or through Client,on account of or relating to the provision of services to Client during the period of the relationship between Gallagher and Client shall not exceed $20 million in the aggregate. Without limiting the foregoing, Gallagher shall only be liable for actual damages incurred by Client, and shall not be liable for any indirect, consequential or punitive damages. For Employers and Plan Sponsors Subject to ERISA: This Disclosure Statement is being given to the Client (1)to make sure Client knows about Gallagher's and Gallagher affiliates' income before purchasing the insurance product and(2)for plans subject to ERISA,to comply with the disclosure, acknowledgment and approval requirement of Prohibited Transaction Class Exemption No. 84-244, which protects both Client and Gallagher5. Disclosure must be made to an independent plan fiduciary for the ERISA Plan(s), and Client acknowledges and confirms that this is a reasonable transaction in the best interest of participants in its ERISA Plan(s). For more information on Gallagher's compensation arrangements, please visit www.ajg.com/compensation. In the event a Client wishes to register a formal complaint regarding compensation Gallagher receives,please send an email to Compensation Complaints @ajg.com or send a letter to: AVC Compliance Officer,do Internal Audit Department,Arthur J. Gallagher&Co.,Two Pierce Place,Itasca,IL 60143. Thank you for your business and continued confidence in the services Gallagher provides to you and your employees. We sincerely appreciate the opportunity to serve Orange County, North Carolina. Please let us know if you have any questions regarding this information or would like more detail. GALLAGHER BENEFIT SERVICES,INC. DocuSigned by: By: GVt0SfblA, 2mE2AFr`511194B1._- Name: Wes Grigston Title: Area Vice President Date: 08/22/2016 Accepted by:INSERT FULL LEGAL CLIENT NAME DocuSigned by: By: bv't,lit.A 1561446644o B-1-998B-269P91481- Name: Brenda Bartholomew Title: HR Director Date: Which allows an exemption from a prohibited transaction under Section 408(a)of the Employee Retirement Income Security Act of 1974 (ERISA). 5 In making these disclosures,no position is taken,nor is one to be inferred,regarding the use of assets of a plan subject to ERISA to purchase such insurance. Gallagher Client Coverage Acknowledgment 05302014 02016 GALLAGHER BENEFIT SERVICES,INC. ARTHUR J.GALLAGHER&CO.I AJG.COM