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WWA" Risk Management Pools <br /> A" Workers Compensation <br /> Payment Plan Available: Workers' Compensation Pool Quoted on: 4/20/2020 <br /> County or Entity: LEE COUNTY <br /> Annual Payment Plan: <br /> $389,158 <br /> We appreciate your participation. To insure effective, efficient operation of your Pool we must <br /> receive payment in full no later than August 1st.A two percent late payment fee will be <br /> assessed on all amounts received after that date. <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: /p <br /> Signature i vvv <br /> Printed Name 4b4 i g Ce/'Lerit:V1 <br /> Print Title <br /> Date c— 4 X) <br /> This instrument has been pre-audited in the manner required by the Government Budget and Fiscal Control Act. <br /> Financial Officer: <br /> Signature (7,0c <br /> Date S S 011) -)S <br /> Please sign and return the accepted proposal by June 15th, 2020. <br /> NCACC 4/20/2020 <br />