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y1��rr��1►:,iwa�•�►�.a rte` �'r' <br />111PG:0327 <br />NCACC Risk Management Pools <br />Association of CountyCommissioners Liability and Property Pool <br />JULY 1, 2016 to JULY 1, 2017 <br />Increased Automobile Liability Limit <br />Your application reflected your county or entity may need additional Auto Liability Limits; A <br />quotation for those limits is provided below: <br />County or Entity: Lee County <br />Quoted on: 5-9-16 <br />Effective Date: 7-1-16 <br />ANNUAL <br />INCREASED LIMIT CONTRIBUTION <br />$3,000,000 excess of $2,000,000 1 $23,845 <br />Please make a selection (X): <br />J` Accept Increased Auto Liability Limits <br />Declined Increased Auto Liability Limits <br />Accepted by: Signature: <br />Print Name:q",4 e 4 urn% <br />Print Title: 694tA <br />Date: <br />This instrument has been pre -audited in the manner required by the Government Budget and <br />Fiscal Control Act. <br />Financial Officer: Signature: <br />Print Name: `, �Sr,► G-• Date: U\ U l k A <br />