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sTATE OF NORTH CAROLINA DEPARTMENT OF STATE AUDITOR FIREMEN',~ AND RESCUE SQUAD WORKER'S PENSION FUND DIVISION ANNDAL CERTIFICATION OF FIREMEN General Statutes, Chapter 118-38, requires that all certified fire departments certify annually to the N. C. Firemen's Pension Fund a complete roster of its qualified firemen. The following certification along with a complete roster of all active firemen* as of June 30 of each year must be submitted to the N. C. Firemen's Penaion Fund, 300 N. Salisbur~ St., Raleigh, N. C. on or before Jul~ 31. Failure to Submit this Certification alon~ with a complete roster will result in the loss of the death benefit provided b~ the State. CERTIFICATION We, the Cabarrus County Board of Commissioners in our capacity as the governing (~oV~rning Body) body of the Col0 Water Fire Department, certify that we have examined and find that attached is a true and accurate list of all active firemenl of the Cold Water Fire Department, address 1825 Songwood Dr. County of Cabarrus , North Carolina. Concord. NC 28025 Signed Title Date For Fire Department Chief Onl~ ' , Chief of the Fire Department, certify the attached roster is a true and accurate llst of all eligible fire- men. (Eligible firemen are firemen who have met the required 36 hours of meetings and drills during the last calendar, year (July 1 - June 30). In addition~ the term "eligible firemen" shall mean those firemen who have joined the fire department within the calendar year and are in the process of completing the required 36 hours of meetings and drills.) Fire Chief g-~- ~ Date ROSTER MI~ST BE ATTACHED WIT~ NAMES IN ALPHABETICAL ORDER. *Firemen on authorized "Leave of Absence" are to be included on the roster. I,~enever a ne~ fireman is added to the roster during the year, his or her name should be for~rd to the Pension Fund Office iranediatel~.