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TO: North Carolina Commissioner of Insurance <br /> Department of Insurance <br /> Raleigh, North Carolina 27611 <br /> CERTIFICATION OF THE FIRE DEPARTMENT <br /> BY ITS GOVERNING BODY <br /> WHEREAS, G. S. 118-23 requires certification to the North Carolina <br /> Commissioner of Insurance as to firemen and fire departments in compliance with <br /> minimum conditions precedent to the eligibility of firemen and volunteer firemen <br /> for benefits under the North Carolina Firemen's Pension Fund Act, the undersigned <br /> certifies to the North Carolina Commissioner of Insurance that: <br /> (1) Caldwell ,North Carolina, is a Municipality ( ), . <br /> County Fire District ; or Sanitar District <br /> fire department which operates fire apparatus and equipment ofathehvalue ofbf1Yefide <br /> thousand dollars ($5,000.00) or more, and said fire department holds drills and <br /> meetings not less than four hours monthly; <br /> (2) The persons names on the attached roster are regular and/or volunteer <br /> firemen fire <br /> all drills and meetings of)saiidvfire and <br /> departmenteinn attend at least <br /> year, each calendar <br /> of (3) This certification was duly'approved and adopted by the governing body <br /> day of North Carolina at a meeting held on the <br /> ward'a copy a same_to the NoF and'Carolina Corrsnissionerwof Insurance to execute an or- <br /> WITNESS my hand and seal, this the <br /> _.�,. day of , 19� <br /> ea. o Governing Bo.y - it e------"'—""--. <br /> (SEAL) <br /> NORTH CAROLINA <br /> Orange COUNTY <br /> I' a notary public of said county, do hereby <br /> certify that -- <br /> me and, being first u y sworn, acknowledgedithatrtheaforegoing certificationewas eduly <br /> adopted by the governing body of <br /> the execution of the foregoing certification on e f a of North and acknowledged <br /> WITNESS my hand and official seal, this the <br /> 19 day of <br /> My commission expires: <br /> W 'R' PU; C <br />