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021 <br />N a R T x C ,� R o z z N A NCACC Risk Management Poots <br />Associ, -moN OF C00,NTY CO3,TmISST0 I its Liability and Property <br />Payment Plan Available: Liability & Property Pool Quoted on: 411212011 <br />County or Entity: - LEE COUNTY <br />Annual Payment Plan: (due on or before August 1, 2011) s_ — sr— <br />$325,515 <br />I understand that changes made to the exposures subsequent to submission of the <br />renewal application may result in changes to the Estimated Contribution: <br />Accepted by: <br />Signature <br />Printed Name <br />• Print Title <br />Date <br />This instrument has been pre- audited in the manner required by the Government Budget and Fiscal Control <br />Act. <br />Financial Officer: <br />Signature <br />Date <br />• <br />NCACC 4/12/2011 <br />