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332 <br /> p/9 <br /> N. C. FIREMEN'S PENSION FUND <br /> DIVISION <br /> DEPARTMENT OF STATE AUDITOR <br /> 116 REST JONES STREET <br /> RALEIGH,N. C.27611 <br /> ANNUAL CERTIFICATION OF FIREMEN <br /> General Statutes, Chapter 118-23, requires that all certified fire departments certify <br /> annually to the N. C. Firemen's Pension Fund a complete roster of its qualified firemen. <br /> The following certification along with a complete roster of all active firemen* as of <br /> June 30 of each year must be submitted to the N. C. Firemen's Pension Fund, 116 W. Jones <br /> St., Raleigh, N. C. on or before July 31. Failure to submit this certification along <br /> with a complete roster will result in the loss of the death benefit provided by the State. <br /> CERTIFICATION <br /> We, the Orange County Board of Commissioners in our capacity as the governing <br /> (Governing Body) <br /> body of the Chapel Hill Fire Department Fire Department, certify that we have examined <br /> and find that attached is a true and accurate list of all active firemen* of the <br /> Chapel Hill Fire Department, address County of <br /> Carolina. <br /> Signed <br /> Title Chair, Orange County Board of Commissioner <br /> Date <br /> For Fire Department Chief Only <br /> I, 4'C IA.2112.170-- 00-44A-tert , Chief of the i Fire <br /> Department, certify he attac d roster is a true and accurate st of all eligible fire- <br /> men. (Eligible firemen are firemen who have met the required 36 hours of meetings and <br /> drills during the last calendar year (July 1 - June 30). In addition, the term "eligible <br /> firemen" shall mean those firemen who have joined the fire department within the calendar <br /> year and are in the process of completing the required 36 hours of meetings and drills.) <br /> AI, <br /> AK& <br /> — do r, •Ch"ef <br /> Date <br /> ROSTER MUST BE ATTACHED WITH NAMES IN ALPHABETICAL ORDER. <br /> Firemen on authorized "Leave of Absence" are to be included on the roster. <br />