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<br />~~ INSURANCE
<br />GROUP
<br />~~ 30Q brie iris. Race
<br />.~.. Erie, Pq 16530
<br />{Ito saof cbse a binder €or Ciaissts-Made Pa3icb; Bus'sness Ca3as4ropite or Fidelity and
<br />TYPE OF ^ PRt>G PASS. AttTO. ~ GAfiA&E ^ PERSOt1iAL t3gB~i SYY ~ COP16tAERCiAi.tlAt3~iY
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<br />NAME: AND ADDRESS OF AGENGY AGENT'S Nt4.
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<br />CIERtt INSURANCE PROPERTY&CASUALTY COMPANY ^Preferred
<br />The Ballard Agenc
<br />IriC ^FLAGSHIPCfiYtNSURANCEGDMPANY ^Standard
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<br />P . O . Box 1 5 5 9 EFFECTtVE{TIMEj M '~~~ 1 1 20sittder tray not 6e in force
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<br />Hillsborough, NC 27278 y
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<br />EKPtRES {TIME} M:~ ;~-2o-A-g~r~t~-srma~a>}
<br /> Agent must merit Home O€-etce'~capY of this Binder to the Horne Office
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<br />NAME AND MAILING ADDRESS OF ENSURED ~SCRh`rsltoNOF€1PERAt~iE}NP°vT~ifCi.E{S'1-mcF Year;fi~a[ce&wmpleteVtTtnolF~ropertY
<br /> Public Officials Bond
<br />Orange County Board of Commissioners Charles Gary Humphreys
<br />P.O. Box 8181 Director of Finance
<br />Hillsborough, NC 27278
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<br />NAME OF POLtGY {Far[eity Personal Arrt[a ,Braadcs~ver HF', etc_} t~`~9R,t3E f g4P3LS d 3~Pa'#S
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<br />Public Officials Bond.
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<br />Y+ (If iiomePtofectpr,Nameororne ,also indicate ~L'ab. and.Mad_ F.aymartss below } Each GCC43t7eTiCB Limit $ ,GGO
<br />~ TYPE (tF iP#{.ytlttANCE IJaxn~e to Premises
<br />~ ~ PRE-USiSE:S/OPERATSi3N~ iNC_ PEi~St3f3AL & AL7ir'~2T 95iNG iN,tYStfil'' ~ieatecF to tRtsets $ ,000 firry~ePremis~
<br />~. DFRODt3CTS/COttllPt.E1'ED OPERATIONS 1~etlicai Expense Lim;t $ .000 lityOne Person
<br />~' ^ CONT€2AGTLiAL Pa~l~<,P,d~~t'~~3~.~~4 S ,000 ~
<br /> C!THE~2 {Specify Bel~srrrj Setter,~Aggrec,~te Lund ~ .000
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<br />LlilttED. PAY ~
<br />Ptntdut~sf~~~ttpletedOpEtatiens $ ,000
<br />~ Ag omit
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<br /> G'331EiT1461~ tlt~tTS OF Pt#[3TE GI30M f:f41[Et~i,E f~ch Petsan. lice ' t.
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<br /> ~GOt~IPREi-I~StVTE S DEDEACTiBLE t3t7Bi~Ydi4~1FSt2V $ ,4bOC} ca ,G00
<br />~ ~COLLISiON $ 'DEDUCTIBLE PRGPE#'r'tYt3~4MA{,E $ _,000
<br />~ ~ iv9fl3iCAL PRYMEN i S 4iVIED. E70=? j1C~j .rp ,4'e00 Each Person Cc3M8tNE33 s3NGi~ LIMft' {CSL} $ ,000
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<br />00i} Eax~ Purr $
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<br />~STATtFi'ORYt
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<br />Of~ cadt Accidestt
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<br />,~ ~S~ I StlPPL ONtidS.fi.iTJt]E3itNS.\
<br />lLMtlt~FtiSTS-BIYC?tdLY ~)`` $ ,OGO Eacdt Person $ ,OOO Eacra Atxaderrt COM&t1~EDS!lVCaLE tlMiY{GSt.7 ~ ,000
<br />~+4 ~It3NINS.~JND2=BINS. MQTURPSTS-{Bi} ~ ,GGO EacFr Petsen $ ,OGG Eaci~ Ac~dertt C~luietNED SttdGt~ tttdlE i (CSI.) S ,000
<br />~ {tF APPLIGA6LEl~D $ ,~ Eat A€xrii`.~ DcSuett~- ~
<br />~ ~ ST7AC°fED Q UNSTAC {Pfi~ Os'tLYj
<br /> ^ FIRST PARTY BENEFITS {PA ONLY] ~ Med ;000. g Lass t ,0 00 C]P~s'
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<br />Fca~eral ,tl0i~_ ~ Ace I C~h ,OS
<br />lik; ~f Exizaurdis~ry E?~te~#icat
<br /> PERSt3NAL IN3t3l:sY PROTEGTiOS~i $
<br /> ^ADDFTIONAL PIP (t+tY ONLY]
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<br /> ROAt.3 SERVICfc ~ OTHER Spe~S+ : RATE CLASS {A3AS, etc.)
<br />1l~ 'iptORKERS COMPENSATION - Speci;y State{s}:
<br />~ ^ EIPr{PLE3YERS LIABILITY - ~ Statidvcy Lir~ EYhec: $
<br />£~Tl`IER COVERAGESf COMMENTS:
<br />P ublic Officials Bond for Charles Gary Humphreys,Director of
<br />Finance Bond Limit - $250,000
<br />NAME AND ADDRESS OF: MORTGAGEE OP. LIcNNOLDER I CERTIFIGATE HOLDER IS ABOVE INSURED PRESENTLY A POLICYHOLDER?
<br /> ^ YES ~NO
<br /> iF YES, POLICY No.
<br />
<br /> ~gnature of Authored Agent Date
<br />E1G-6211'3101 {SF~©TI-IFJ~S31:1E)
<br />3
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