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2018-2019 PCT RENEWAL SCHEDULE PROPERTY -,5cep C.mrit® ',41177---.,.)*" ''`� a r3 Montana Association of Counties i " SINcE 19.6°;-_ _ Property' Cccsuci1 ty Trust 4-,: .,-,„, ,,,,-1*,,� ACKNOWLEDGEMENT FORM 2018-2019 PCT RENEWAL SCHEDULED PROPERTY ip-' rr+-, County, in conjunction with their agent, has reviewed the four schedules(Buildings, Vehicles, Heavy Equipment and Other Equipment) and have made the necessary updates, deletions and additions. Furthermore, we understand that: (1) Coverage may be denied if the property in question is not properly scheduled or f f on file with MACo PCT. (2) The renewal premium is calculated off the scheduled values, so it's important to thoroughly review the items and values. (3) If a scheduled item lacks a value, the County has not paid premium for that property; thus, the item is insured for liability only even if the Liability Only option states "No". (4) Changes to any of the four schedules should be done through the online Portal in a timely fashion. I hereby certify that I am an authorized agent to sign on behalf of this County. Car-1 Kir'`5e.L, w,rIni5Siov, C-I/1a:1. r'- Authorized Name (Printed) Title 1-14- ISe A/t ized- i/re pate Agent Signature Date PLEASE FILL OUT THIS FORM IN ITS ENTIRETY AND THEN SUBMIT BACK TO MACo. YOU MAY SUBMIT THE FORM VIA MAIL, EMAIL OR FAX.