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HomeMy WebLinkAbout2025-560-E-Emergency Svc-Orange Grove Fire Department-Fire Department Service ContractRevised 01/24 1 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Orange Grove Fire Department Vendor Contact Person: Ricky Baker Phone: 843-251-5201 Address: 6800 Orange Grove Rd City Hillsborough State: NC Zip: 27278 Department: Emergency Services Amount: Budgeted Annually Purpose: Fire Department Service Contract Budget Code(s): 22750620-688000 Vendor # 50212 Vendor Status with NCSOS: n/a Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date 7/24/2025 End Date 7/24/2030 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement. This agreement is approved as to technical form and content . Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Orange Grove Fire Department has continued to provide fire protection and rescue services in absence of an active contract to necessitate the provision of public safety services. This agreement will be signed by the County Manager to be ratified at a date to be determined. Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 8/13/2025 8/12/2025 8/14/2025 9/2/2025 Revised 01/24 2 All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 1 STATE OF NORTH CAROLINA ORANGE COUNTY FIRE PROTECTION AND EMERGENCY SERVICES AGREEMENT THIS AGREEMENT (this “Agreement”), made and entered into this 24th day of July,2025 by and between Orange County, hereinafter referred to as the “County” and Orange Grove Volunteer Fire Department , hereinafter referred to as the “Fire Department”, referred to herein as “Party” and/or collectively as the “Parties”. WITNESSETH: 1. County created the Cane Creek Fire Protection District (the “District”) as a special tax district pursuant to Chapter 69 of the North Carolina General Statutes and desires to contract with Fire Department for fire protection and other services as set out herein. 2. Pursuant to §NCGS 69-25.4 the County agrees that it will cause to be assessed or levied a special tax of not more than Fifteen cents ($.15) per one-hundred dollar ($100) valuation of all real and personal property in the District unless otherwise limited or prohibited by law or a vote of the people, and will collect said tax as a part of the ad valorem taxes of Orange County; provided however, the amount levied annually shall be based on the needs projected in the budget estimate submitted by the Fire Department to the County as approved by the Orange County Board of Commissioners in its annual budget or as they may otherwise determine. 3. That a special or separate fund shall be maintained by the County for funds collected as a result of said special tax. 4. That from said special tax district the Board of County Commissioners will approve a Fire Protection District tax rate and Annual Budget for the Fire Department. The County agrees to remit quarterly payments by the 15th day of the first month of each quarter. The total quarterly payments to the fire department will equal the annual budget. 5. The Fire Department shall provide and furnish adequate fire protection services and shall provide the necessary equipment, personnel, and other resources as determined by the North Carolina Department of Insurance, Fire and Rescue Service Division, and the Insurance Service Office for all people and property located within the district. Fire Department currently has an insurance rating of Class 5/9E, and during the term of this Agreement will maintain at least a 9E insurance rating. The Fire Department will provide fire and rescue services free of charge to all people and individuals within the district (excluding non-public commercial transportation). Fire Department shall strive to maintain the current ISO rating of 5 /9E or look to achieve an ISO rating of 5 (or better). This section does not preclude the Fire Department from charging a pre-arranged nominal fee when standing by for special events. 6. That all funds paid to the Fire Department by the County shall be used exclusively by the Fire Department to provide fire protection services within the district (See Exhibit 1), and the Fire Department may also use said funds to provide Medical Responder and rescue services within the district, and to pay other legitimate fire, rescue, and Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 2 Medical Responder expenses are attributable to the services rendered within the District. This does not preclude mutual aid agreements. 7. The Fire Department may provide Medical Responder Services within the District. Medical Responder Services are defined as the provision of Basic Life Support treatment as needed until such time as more highly trained personnel arrive on scene. Such Medical Responder Services may be provided through mutual aid agreements or through third party contracts. 8. The Fire Department shall provide Hazardous Materials Response Services according to the North Carolina Department of Insurance North Carolina Fire Rescue Commission Haz-Mat 1 Responder level for all operational responses in the district. Hazardous Materials Response Services are defined as defensive actions necessary to protect life, property and the environment from the effects of the release. 9.The Fire Department shall provide Rescue Services to all people and individuals within the District. Rescue Services are defined as the removal, extrication, or freeing of individuals from vehicle confinement or danger. Fire Department shall maintain any current rescue certifications through the Rescue Association. Such Rescue Services may be provided through mutual aid agreements or through third party contracts. 10. Notwithstanding Section 6 above Fire Department may provide fire protection services outside the District subject to the following terms and conditions: A. That Fire Department is authorized to extend their primary insurance fire protection services in surrounding fire insurance districts to better serve the citizens by eliminating a class 10 area in the neighboring fire district. The fire department shall provide a notarized agreement between the fire departments submitted to the fire marshal for processing to the Board of County Commissioners. B. Fire Department shall not expend any funds or resources appropriated for the use of persons and individuals in the Cane Creek Fire District for the primary fire protection services outside the area of surrounding response districts. In the event any such expenditure occurs for primary fire protection outside of their insurance response to a neighboring district, the Fire Department shall immediately notify the County and Fire Department shall take corrective measures to rectify the expenditure and to ensure such expenditure shall not be repeated. This does not preclude fire departments in the county to expend funds toward a fire district in this county for the creation and use of a joint facility to be utilized for training in fire, rescue and other emergency services. 11. That Fire Department may enter into an agreement with surrounding Departments in which the Fire Department provides compensation to those surrounding Departments for their availability and service providing primary fire protection services in an Orange Rural Class 10 insurance response areas. Operational Scope and Mutual Aid Participation: The Fire Department shall respond to all emergency incidents within its designated response district and may also be dispatched to incidents in other jurisdictions under approved mutual aid agreements. Upon arrival at any incident, the Department shall operate within Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 3 the scope of its certified training, personnel capabilities, and standard operating procedures. If an incident exceeds the Department's certified capabilities, such as technical rescue, hazardous materials, structural collapse, or other specialized operations, the Department shall request or defer to qualified mutual aid resources. In such cases, the Department may provide scene support, personnel assistance, or logistical aid under the direction and supervision of the authority having jurisdiction over the specialized response. Participation by the Department or its personnel in such support roles shall not be construed as assuming command of, or delivering, specialized technical services beyond the Department's contractual, certified, or insured scope. Such participation shall be limited to activities consistent with the personnel's physical capabilities, documented training, and authorized operational directives. For the purposes of eligibility under the Federal Public Safety Officers' Benefits (PSOB) Program and North Carolina Line-of-Duty Death (LODD) benefits (pursuant to G.S. 143-166.2 et seq.), such participation shall be deemed an official duty, provided that: A. The personnel were officially dispatched or requested through recognized mutual aid protocols; B. The personnel acted under a defined command structure and did not self- deploy; C. The activities performed were within the individual's certified training or executed under the supervision of an agency qualified to manage the incident type. 12. In providing the services contemplated herein the Fire Department shall operate in compliance with all applicable State and local laws and regulations including but not limited to the North Carolina Fire Incident Reporting System (G.S. 58-79- 45, NC Administrative Code, §.0402). The Fire Department shall submit electronic incident reports on a quarterly basis to the Office of the North Carolina State Fire Marshal. The Fire Department further agrees to notify the Orange County Fire Marshal’s Office of the annual corporation meeting and provide a current list of its Board of Directors no later than 14 days after the by-laws declare new members take office. The Fire Department shall provide a copy of the certified personnel roster submitted to the N.C. State Firefighter Association to the Fire Marshal’s Office at the time of submission to the association. The fire department agrees to work with Emergency Management to resource type personnel, apparatus including pump and tank size, and specialized fire suppression equipment in Salamander or other software used by Emergency Services. The fire department shall immediately notify the Fire Marshal’s Office where there is a change in fire chief. The County shall have the right to inspect all books and accounts for the Fire Department at any time. Said inspection shall be conducted by the Orange County Fire Marshal and/or Orange County Finance Office and/or their designee. The following minimal performance standards are agreed upon by the County and the Fire Department and are a part of this contract: A. Response Time. Fire Department should have the goal of having a response time that exercises due diligence to responding to all emergencies when notified of the emergency. B. Personnel on Scene. Fire Department should have adopted standard operating guidelines that address the appropriate number of firefighters Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 4 needed on all types of fire calls. The National Incident Management System shall be used at all incidents to manage personnel. C. Training. Fire Department shall have the minimum standard training requirements set forth by the State of North Carolina and NC Department of Labor for providing fire and emergency services provided by the Fire Department. For purposes of this agreement emergency services includes both Medical Responder services, hazardous materials services, and rescue services. D. Fire Investigations. The Fire Department officer in charge at all fire scenes shall attempt to determine the cause and origin of every fire. When the officer in charge cannot determine the cause and origin of the fire, or if the cause is suspected to be of an incendiary nature, the officer in charge may request assistance from the Orange County Fire Marshal’s Office. E. Reports. Fire Department shall keep all records according to state law for retention. All State and county required reports and rosters shall be submitted by the applicable deadlines. F. Fire Hydrants. The Fire Department should report any malfunctions or damage to hydrants to the owner of the water distribution system. G. Emergency/Disaster Response. Fire Department shall follow the Orange County Emergency Operation Framework (EOF) Policy when responding to an emergency or disaster. H. State of Emergency. County requests that Fire Department, when available, assist with the following services, but not limited to, before, during, and following times of emergency/disaster: • Debris Clearance; • Traffic Control; • Alert and Warning; • Search and Rescue; • Evacuation Notification and Coordination; and • other life-saving and property protection measures as necessary. All operations shall be in accordance with the Orange County Emergency Operation Framework (EOF) Policy. 13. The Fire Department shall submit to an audit by a Certified Public Accountant, which will be paid for by the County, up to $8,500 per year, and shall be in conformity with General Accepted Accounting Principles. If an audit has already been performed by a certified entity, the Fire Department shall present the County with a copy of that audit. Such audit to be provided on or before December 31st of each year, and to be in conformity with the most recent audit policies of the County and the North Carolina Local Government Commission. Further, the fire department agrees to comply with County budgeting procedures including a mid-year financial statement and other procedures provided for by State Law and agree to submit budget estimates to the Board of Commissioners on the standard forms used by County departments. The Fire Department also agrees to use standard line items for accounting as requested by the County Finance Department. A. In the event that the audit reveals any reportable and/or material issue(s) with regard to compliance with generally accepted accounting principles, or any material weakness or significant deficiencies, the fire department shall provide a written statement to the county that contains an explanation of each issue and an action plan (with implementation timetable) for resolving each such issue, weakness and/or deficiency, Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 5 and shall provide periodic reports to the county on progress made in resolution of each issue, weakness and/or deficiency. If resolution of such issues, weakness or deficiencies requires professional advice on the part of that fire department’s (or county’s) auditor, the fire department shall bear the cost of such advice. B. Should the fire department fail to submit its audit report to the county within the above time period, the county will suspend all funds immediately until the audit is delivered as set forth above, except that the county’s Chief Financial Officer may grant a reasonable submittal extension if the department is unable to deliver the audit for reasons beyond the control of the fire department or the auditor. C. The fire department agrees that if its financial records are judged to be un-auditable for purposes of an audit or establishment of a budget by the county’s chief financial officer or the independent audit firm, or if a regular or special audit by a certified public accountant reveals competent evidence of reckless or willful financial mismanagement practices or intentional or criminal wrongdoing, the fire department’s Board of Directors will be notified by the county. At that time, the county and Board of Directors may jointly name a trustee who will assume responsibility for management and financial decision-making for the fire department until such time as the county and fire department’s Board of Directors agree that the fire department’s finances have been stabilized to the extent required to satisfy the financial management provisions of this contract. 14. The Fire Department shall comply with the County budgeting procedures, and shall submit annual budget estimates in accordance with established County budget timetables. A supporting letter of request for the proposed tax rate shall be signed by the Fire Department’s president upon approval of its Board of Directors. The County will provide the Fire Department with standard forms for budget submission and the Fire Department shall use such standard forms. 15. The Fire Department shall comply with the State of North Carolina purchasing procedures for local governments as identified in Attachment #1, as well as other procedures provided for by state law. 16. The Fire Department shall file with the County Fire Marshal a true copy of its Articles of Incorporation, Bylaws, and shall furnish any changes made thereto not less than thirty (30) days prior to their effective dates. Further, the Fire Department agrees to amend its Articles of Incorporation and Bylaws as necessary to meet all minimum legal requirements for a North Carolina nonprofit corporation, as required by the provisions of Chapter 55A of the General Statutes of North Carolina. Should Fire Department be notified that it has failed to meet all minimum legal requirements for a North Carolina nonprofit corporation and/or failed to maintain its federal, state, or local tax-exempt status the Fire Department shall, within thirty (30) days of such notification, begin taking appropriate steps to remedy said failure. Should said failure not be appropriately remedied within ninety (90) days after such notification the County may withhold special district tax revenues until such time as the Fire Department meets all minimum legal requirements of Chapter 55A of the General Statutes of North Carolina and/or until such time as the Fire Department’s tax-exempt status is restored. Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 6 17. In the event the Fire Department dissolves then the Fire Department shall deliver, release, and convey to the County all its equipment, cash, or other assets to be used by the County exclusively for the provision of fire protection services, rescue services, or Medical Responder services within the District. Any such dissolution shall comply with applicable laws of North Carolina. If Fire Department ceases to provide either fire protection services, rescue services, or Medical Responder services within the District Fire Department shall deliver, release, and convey to County all of its equipment, cash, or other assets used for those specific services the Fire Department has ceased to provide, to be used by the County exclusively for the provision of fire protection services, rescues services, or Medical Responder services within the District. Should the terms of this paragraph conflict with Fire Department’s Articles of Incorporation the Articles of Incorporation shall control. 18. The Fire Department agrees to hold harmless and indemnify the County from and against any and all liability and expenses including attorney fees, court costs and other costs incurred by the County caused by any act or omission of the Fire Department, its agents and employees. The Department shall purchase and maintain, during the term of this Agreement, and any extension hereof, at least the following insurance coverage: A. Comprehensive Automobile Liability Insurance with combined single limits of at least one million dollars ($1,000,000) per occurrence. Coverage shall be provided under a symbol “1”. Coverage shall apply, on an excess basis, for hired, borrowed and non-owned vehicles. Coverage shall apply, on a primary basis, for commandeered vehicles. Volunteers or employees shall be considered insureds and volunteers and employees shall have coverage in excess of their personal auto liability limits when they are using their vehicles on behalf of the Fire Department. Fellow member liability shall be provided. Auto pollution liability shall be included in the coverage. B. Auto physical damage shall be provided on an agreed value basis. Coverage shall be included for hire, borrowed or commandeered vehicles without a limit of liability. Coverage shall be provided to bring replacement vehicles up to the most current national standards, such as NFPA or DOT. C. Comprehensive General Liability Insurance with limits of at least one million dollars ($1,000,000) per occurrence and two million dollars ($2,000,000) aggregate. The aggregate shall apply per named insured and per insured location. The policy shall include the following coverage: Volunteers or employees as insureds, Medical Malpractice, Good Samaritan Liability Coverage, Intentional Acts Coverage for both bodily injury and or property damage, Fellow Member Liability, Non-owned Watercraft, Fire Damage Legal Liability with limits of one million dollars ($1,000,000), Pollution Liability arising out of emergency operations, training activities or equipment wash downs. D. Directors and Officers Liability Insurance with limits of at least one million dollars ($1,000,000) per occurrence with two million dollars ($2,000,000) aggregate. This policy shall include coverage for prior acts. The insured shall include current volunteers and employees, former volunteers and employees, and any people or organizations providing service to the Department under a mutual aid or similar agreement. Coverage shall Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 7 include civil rights type suits such as discrimination and sexual harassment; liability arising out of the administration of benefit plans for employees or volunteers and employment related practice suites. Coverage shall include claims made for future compensation and benefits lost from wrongful termination of an employee. E. Umbrella Liability Insurance with limits of at least one million dollars ($1,000,000) per occurrence and one million dollars ($1,000,000) aggregate. The umbrella policy shall provide excess coverage over the Auto Liability Policy, General Liability Policy, and the Employer’s Liability Section of the Workers’ Compensation Policy. Volunteers and employees shall be included as insureds. F. The Department shall maintain Property Insurance protecting against the risk of direct physical loss or damage. The policy covering the building shall be written on a Guaranteed Replacement Cost Basis, with coverage included for Building Ordinance, Flood, and Earthquake. Coverage shall include Commandeered Property in the amount of two-hundred fifty thousand dollars ($250,000). Contents coverage shall be provided on a replacement cost basis. Coinsurance penalties shall not apply. G. Portable Equipment Coverage shall be provided protecting against the risk of direct physical loss or damage, including electrical surges. Coverage shall be provided on a Guaranteed Replacement Cost Basis. H. The Automobile Liability Policy, General Liability Policy, Umbrella Liability Policy and Management Liability Policy shall name the County as an additional insured. The Department shall furnish the County with Certificates of Insurance showing the type of policy, limits of liability, name of insurance companies, policy numbers, effective dates and expiration dates of policies. I. Workers’ Compensation Insurance covering all volunteers and salaries firefighters meeting statutory limits in compliance with applicable State and Federal Laws. J. Each policy shall also contain a ten (10) day notice to the County in the event of cancellation or modification of any stipulated insurance coverage. 19. In connection with the performance of this Agreement, the Fire Department agrees not to discriminate against any employee, member, or applicant for employment or membership because of race, color, national origin, religion, creed, ethnicity, sex, sexual orientation, age, disability, political affiliation, and Vietnam-Era or disabled veteran status. Employees, members and applicants must be competent and capable to perform the requirements of the job. The Fire Department agrees to take all reasonable measures to ensure that applicants are employed, and that employees are treated appropriately, during their employment, without regard to their race, color, national origin, religion, creed, ethnicity, sex, sexual orientation, age, disability, political affiliation, and Vietnam-Era or disabled veteran status. 20. Term. This agreement is effective as of July 24, 2025 and shall continue for five years, Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 8 until June 30, 2030. Either party may terminate this agreement effective at the end of any fiscal year by giving the other party notice at least (1) year in advance of the end of the fiscal year that the agreement is to terminate . 21. This Agreement sets forth the entire understanding of the parties and supersedes any and all prior agreements, arrangements, and understandings related to the subject matter hereto. This Agreement may not be changed or terminated except in writing and as provided herein, and no notice shall be effective unless evidenced by a written instrument duly executed by the Party or Parties, hereto. 22. Any notice required under this Agreement will be in writing, addressed to the appropriate party at its address identified on the signature page of this Agreement and delivered either in person, by email, by facsimile, by registered or certified mail, or by commercial courier service. All notices shall be effective upon the date of receipt. 23. Any provision or part of this Agreement held to be void or unenforceable under any Laws or Regulations shall be deemed stricken and all remaining provisions shall continue to be valid and binding upon the Parties. The Parties agree that the Agreement shall be reformed to replace such stricken provision or part thereof with a valid and enforceable provision that comes as close as possible to expressing the intention of the stricken provision. 24. That this Agreement shall be binding upon and inure to the benefit of the parties and their respective successors, legal representatives and assigns, but this Agreement may not be assigned by either party without prior written consent of the other party, which may be withheld in the sole discretion of a party. 25. No act or failure to act by the County or the Fire Department shall constitute a waiver of any right or duty granted to the Parties by the terms of this Agreement. Nor shall any act or failure to act constitute any approval except as specifically agreed to in writing. 26. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Fire Department affirms that Fire Department is and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Fire Department certifies that Fire Department has not been identified and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Fire Department certifies that they have not been identified and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. 27. Fire Department shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal non-discrimination laws, policies, rules, and regulations and the Orange County Non- Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.) Any violation of the Orange County Non-Discrimination Policy is a breach of this Agreement and County may immediately terminate this Agreement without further Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 9 obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. 28. Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party; however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 10 IN WITNESS WHEREOF, the County has caused this instrument to be executed by the Chairperson of the Board of County Commissioners and attested by the Clerk to the Board of County Commissioners, and the Fire Department has caused this instrument to be signed in its corporate name by its President, attested by its Secretary, and its corporate seal hereto affixed, all by order of its Board of Directors. Acknowledged and agreed to the day and date first above recorded. ORANGE COUNTY FIRE DEPARTMENT BY: BY: Travis Myren, County Manager President Address: Address: Contact Person: Contact Person: ATTEST: ATTEST: Clerk Board of Commissioners Secretary (County Seal) (Corporate Seal) Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 6800 Orange Grove Road Hillsborough, NC 27278 Daniel SnipesTravis Myren 200 South Cameron St.Hillsborough, NC 27278 11 Attachment 1 Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 12 Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTR INSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 8/8/2025 (919) 755-1401 (919) 755-1125 19445 Orange Grove Vol Fire Co Inc 6800 Orange Grove Road Hillsborough, NC 27278 A 1,000,000 X VFNU-TR-0016261 7/22/2025 7/22/2026 1,000,000 5,000 1,000,000 10,000,000 10,000,000 1,000,000A X VFNU-CM-0016262 7/22/2025 7/22/2026 2,000,000A X VFNU-TR-0016261 7/22/2025 7/22/2026 4,000,000 Management Liability $1,000,000 "Each Wrongful Act" / $10,000,000 Aggregate. Orange County is included as Additional Insured per VGLNC1 - Who is an Insured "Blanket Additional Insureds" as required by contract. Orange County 300 W. Tryon Street Hillsborough, NC 27278 ORANGRO-01 LHALL VFIS of North Carolina4140 Parklake Avenue, Suite 520Raleigh, NC 27612 admin@vfisnc.com National Union Fire X X X X X X Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTR INSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 8/19/2025 (919) 755-1401 (919) 755-1125 19445 Orange Grove Vol Fire Co Inc 6800 Orange Grove Road Hillsborough, NC 27278 A 1,000,000 X VFNU-TR-0016261 7/22/2025 7/22/2026 1,000,000 5,000 1,000,000 10,000,000 10,000,000 1,000,000A X VFNU-CM-0016262 7/22/2025 7/22/2026 2,000,000A X VFNU-TR-0016261 7/22/2025 7/22/2026 4,000,000 Management Liability $1,000,000 "Each Wrongful Act" / $10,000,000 Aggregate. Prem 1/1-6800 Orange Grove Rd - Building $1,194,867 GRC / Contents $154,579 RC. Prem 1/2 6800 Orange Grove Rd - Building $33,746 GRC/ Contents $11,249 RC. Prem 2/1 - 6801 Rocky Ridge Rd - Building $94,119 GRC / Contents $8,325 RC. Prem 3/1 - 4725 Nicks Rd - Building $94,119 GRC / Contents $8,005 RC. Prem 3/2 - 4725 Nicks Rd - Building $15,000 GRC / Contents $10,000 RC. $2,500 Property Deductible. Portable Equiment - Guaranteed Replacement Cost / $500 Deductible. Commandeered Property - Full Replacement Cost. Orange County is included as Additional Insured per VGLNC1 - Who is an Insured "Blanket Additional Insureds" as required by contract. Orange County 300 W. Tryon Street Hillsborough, NC 27278 ORANGRO-01 LHALL VFIS of North Carolina4140 Parklake Avenue, Suite 520Raleigh, NC 27612 admin@vfisnc.com National Union Fire X X X X X X Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 ^HS^Named Insured:ORANGE GROVE VOLUNTEER FIRE COMPANY, INC Policy Number:VFNU-TR-0016261-05/000 Policy Period:From 07/22/2025 To 07/22/2026^HE^ ^FS^VPR100 (01/20) Page 2^FE^ PROPERTY COVERAGE PART DECLARATIONS Schedule of Property Coverage Premises #: 1 Item #: 1 Address:Occupancy: 6800 ORANGE GROVE RD HILLSBOROUGH, NC 27278 FIRE STATION Coverages Limit of Insurance Inflation Guard A.Real Property $1,194,867 4% B.Personal Property See Blanket Summary 4% C.Loss of Income 24 Months Actual Loss Sustained D.Extra Expense 24 Months Actual Loss Sustained Mine Subsidence Not Covered Coverage Details Valuation Method Coinsurance Real Property GRC Guaranteed Replacement Cost N/A Personal Property RC Replacement Cost N/A Deductible Details Policy Deductible 2,500 Per Occurrence Earthquake Deductible 67,472 Per Item Flood Deductible 1,000 Per Premises Mine Subsidence Deductible Per Premises Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 ^HS^Named Insured:ORANGE GROVE VOLUNTEER FIRE COMPANY, INC Policy Number:VFNU-TR-0016261-05/000 Policy Period:From 07/22/2025 To 07/22/2026^HE^ ^FS^VPR100 (01/20) Page 3^FE^ PROPERTY COVERAGE PART DECLARATIONS Schedule of Property Coverage Premises #: 1 Item #: 2 Address:Occupancy: 6800 ORANGE GROVE RD HILLSBOROUGH, NC 27278 GARAGE Coverages Limit of Insurance Inflation Guard A.Real Property $33,746 4% B.Personal Property See Blanket Summary 4% C.Loss of Income 24 Months Actual Loss Sustained D.Extra Expense 24 Months Actual Loss Sustained Mine Subsidence Not Covered Coverage Details Valuation Method Coinsurance Real Property GRC Guaranteed Replacement Cost N/A Personal Property RC Replacement Cost N/A Deductible Details Policy Deductible 2,500 Per Occurrence Earthquake Deductible 2,250 Per Item Flood Deductible 1,000 Per Premises Mine Subsidence Deductible Per Premises Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 ^HS^Named Insured:ORANGE GROVE VOLUNTEER FIRE COMPANY, INC Policy Number:VFNU-TR-0016261-05/000 Policy Period:From 07/22/2025 To 07/22/2026^HE^ ^FS^VPR100 (01/20) Page 4^FE^ PROPERTY COVERAGE PART DECLARATIONS Schedule of Property Coverage Premises #: 2 Item #: 1 Address:Occupancy: 6801 ROCKY RIDGE RD HILLSBOROUGH, NC 27278 FIRE STATION/GARAGE Coverages Limit of Insurance Inflation Guard A.Real Property $94,119 4% B.Personal Property See Blanket Summary 4% C.Loss of Income 24 Months Actual Loss Sustained D.Extra Expense 24 Months Actual Loss Sustained Mine Subsidence Not Covered Coverage Details Valuation Method Coinsurance Real Property GRC Guaranteed Replacement Cost N/A Personal Property RC Replacement Cost N/A Deductible Details Policy Deductible 2,500 Per Occurrence Earthquake Deductible 5,122 Per Item Flood Deductible 1,000 Per Premises Mine Subsidence Deductible Per Premises Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 ^HS^Named Insured:ORANGE GROVE VOLUNTEER FIRE COMPANY, INC Policy Number:VFNU-TR-0016261-05/000 Policy Period:From 07/22/2025 To 07/22/2026^HE^ ^FS^VPR100 (01/20) Page 5^FE^ PROPERTY COVERAGE PART DECLARATIONS Schedule of Property Coverage Premises #: 3 Item #: 1 Address:Occupancy: 4725 NICKS RD MEBANE, NC 27302 FIRE STATION/GARAGE Coverages Limit of Insurance Inflation Guard A.Real Property $94,119 4% B.Personal Property See Blanket Summary 4% C.Loss of Income 24 Months Actual Loss Sustained D.Extra Expense 24 Months Actual Loss Sustained Mine Subsidence Not Covered Coverage Details Valuation Method Coinsurance Real Property GRC Guaranteed Replacement Cost N/A Personal Property RC Replacement Cost N/A Deductible Details Policy Deductible 2,500 Per Occurrence Earthquake Deductible 5,106 Per Item Flood Deductible 1,000 Per Premises Mine Subsidence Deductible Per Premises Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 ^HS^Named Insured:ORANGE GROVE VOLUNTEER FIRE COMPANY, INC Policy Number:VFNU-TR-0016261-05/000 Policy Period:From 07/22/2025 To 07/22/2026^HE^ ^FS^VPR100 (01/20) Page 6^FE^ PROPERTY COVERAGE PART DECLARATIONS Schedule of Property Coverage Premises #: 3 Item #: 2 Address:Occupancy: 4725 NICKS RD MEBANE, NC 27302 OTHER Coverages Limit of Insurance Inflation Guard A.Real Property $15,000 4% B.Personal Property See Blanket Summary 4% C.Loss of Income 24 Months Actual Loss Sustained D.Extra Expense 24 Months Actual Loss Sustained Mine Subsidence Not Covered Coverage Details Valuation Method Coinsurance Real Property GRC Guaranteed Replacement Cost N/A Personal Property RC Replacement Cost N/A Deductible Details Policy Deductible 2,500 Per Occurrence Earthquake Deductible 1,250 Per Item Flood Deductible 1,000 Per Premises Mine Subsidence Deductible Per Premises Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 ^HS^Named Insured:ORANGE GROVE VOLUNTEER FIRE COMPANY, INC Policy Number:VFNU-TR-0016261-05/000 Policy Period:From 07/22/2025 To 07/22/2026^HE^ ^FS^VPR100 (01/20) Page 7^FE^ PROPERTY COVERAGE PART DECLARATIONS Blanket Summary The following limit applies to all coverages denoted above as “See Blanket Summary”. Coverage Limit of Insurance Personal Property $192,158 Money and Securities Coverage Limit of Insurance Money and Securities $50,000 Software Coverage Limit of Insurance Software $250,000 Property Forms See Schedule of Forms and Endorsements. Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 WORKERS'COMPENSATION CERTIFICATE OF COVERAGE ISSUED BY OR ON BEHALF OF THE VOLUNTEER SAFETY WORKERS'COMPENSATION FUND NAME AND ADDRESS OF FUND PARTICIPANT Orange Grove Volunteer Fire Company,Inc 6800 Orange Grove Rd Hillsborough,NC 27278 This company is a qualified self-insured in the state of North Carolina for its Workers' Compensation liabilities pursuant to all statutory requirements under section 97-93 of the North Carolina Workers'Compensation Act. CLIENT NUMBER:0277 COVERAGE PERIOD FROM:7/1/2025 TO 7/1/2026 EMPLOYER LIABILITY LIMITS:$100,000 Each Accident $500,000 Disease-Policy Limit $100,000 Disease-Each Employee AUTHORIZED AGENT: DATE:8/7/2025 Volunteer Safety Worker's Compensation Fund 300 GALLERIA OFFICE CENTRE,SUITE 200 SOUTHFIELD,MI 48034 AGENCY: Business Insurers of the Carolinas Inc 501 Eastowne Dr.St.250 Chapel Hill,NC 27514 Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28 VOLUNTEER SAFETY WORKERS’COMPENSATION FUND Docusign Envelope ID: CA1170BA-DF12-46AD-A715-3B43B21EAF28