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C. FIRE.~,IEN'$ PENSION FUND <br /> <br /> DIVISION <br /> DI~PART~4ENT OF STATE'. ADD~TOR <br /> <br /> ANNUAL CERTIFICATION OF FtRE~N <br /> <br /> General Statutes, Chapter 118-23, requires that all certified fire departments certify <br /> annually to the N. C. Firemen~s Pension Fund a complete roster of its qualified firemen. <br /> <br /> The following certification along with a complete roster of all active firemen* as of <br /> June 30 of each year must be submitted to the N. C. Firemen's Pension Fund, 116 W, Jones <br /> St., Raleigh, N. C. on or before July 31. Failure to submit this certification along <br /> with a complete roster will result in the loss of the death benefit provided by the State. <br /> <br /> CERTIFICATION <br /> <br /> We, the Caba~rus Board of Commissioners in our capacity as the governing <br /> (Governing Body) <br /> body of the Cold Water Fire Department, certify that we have examined <br />and find that attached is a true and accurate list of all active firemen* of the <br /> Cold Water Fire Department, address P.O. box 81? County of <br /> C~h~us , North Carolina. Concord 28025 <br /> <br /> Signed <br /> <br /> Title <br /> <br /> Date <br /> <br /> For Fire Department Chief Only <br /> <br />I, Ned R. Blackwe!der , Chief of the Cold Water Fire <br />Department, certify the attached roster is a true and accurate llst of all eligible fire- <br />men. (Eligible firemen are firemen who have met the required 36 hours of meetings and <br />drills during the last calendar year (July 1 - June 30). In addition, the term "eligible ' <br />firemen" shall mean those firemen who have joined the fire departm&nt'within the calendar <br />year and are in the process of completing the required 36 hours of meetings and drills.) <br /> <br />ROSTER MUST BE ATTACHED WITH NAI{ES IN ALPIIABETICAL ORDER. <br /> <br />*Firemen on authorized "Leave of Absence" are to be included on thd roster. <br /> <br /> <br />