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Of INSURANCE DEPARTMENT
1
I, Joel Ario, Insurance Commissioner of the Commonwealth of Pennsylvania, do hereby certify
that the attached is a full, true and correct copy of the Annual Statement for the year ending
March 31, 2010, of AMERICAN STATES INSURANCE COMPANY as the same
appears of record and remains on file with this Department.
In Witness Whereof, I have hereunto set my hand
and caused my official seal to be affixed this
2nd day of April, 2009.
0044 Q4;40-7
Joel Ario
Insurance Commissioner
Li
Mubetuayl.
AMERICAN STATES INSURANCE COMPANY
FINANCIAL STATEMBNT - DECEMBER 31,2M
Assets
Cash and Bank Deposits ......................................... $ 186,777,106
*Bonds - U.S Govemment ...................................... 91,648,279
*Other Bonds ...............................................................1,336,729,735
*Stocks ...................................................................... 48,257,848
Real Estate .......................
0
Agents' Balances or Uncollected Premiums.......... 254,003,861
Accrued Interest and Rants .................................... 19,632,694
Other Admitted Assets ........................................... 14087JM
Total Ad mkW Assets ---.----.----.----.. h
Lsibma
Unsarned A+emimm ............................................... $ 383,835,113
Reserve for Claims and Claims Expense .............. 908,411,569
Fbnds Held Under Reinsurance Treaties .............. 10,019
Reserve for Dividends to Policyholders ................ 1,246,506
Additional Statutory Reserve ................................. _
Reserve for Comnsissions, Taxes and
Other Liabilities ............................................... 242372.531
Total.--•----•----•----•----•--- --N. S1X5$M,738
Special Surplus Roade ............. $12.654,151
Capital Stock ............................. $5,000,000
Paid in Surplus .......................... 557,757,202
Unassigned Surplus .................... (34.162.768)
Surphss to Po l yboMers ---.---•-----.-. 541.24SSW
Total LialMdes said Surplus--------------- M cs
* Bonds are stated of amortized or investmant value; Stocks stAssociation Market V dues.
Securities carried at $64,221,088 are deposited as required by law.
1, TIM MQKOLAJEWSIU, Vice-President of American States Insurance Company, do hereby certify that the foregoing is a true, and
correct statement of the Assets and Liabilities o f said Corporation, as of December 31, 2008, to the best of my knowledge and bolicE
IN VMNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Corporation at Seattle, Washington, this 1st day of
March, 2009.
Vice-president
S-7 262ASUe 300
COMMONWEALTH OF PENNSYLVANIA
INSURANCE DEPARTMENT
CERTIFICATE OF AUTHORITY
Casualty
AMERICAN STATES INSURANCE COMPANY
NAIC NO. 19704
IN WITNESS WHEREOF, I HAVE HEREUNTO SET MY HAND AND
AFFIXED MY OFFICIAL SEAL, THE DATE AND YEAR FIRST ABOVE
WRITTEN.
JOEL ARIO
INSURANCE COMMISSIONER
HAS COMPLIED WITH THE REQUIREMENTS OF THE LAWS OF THE COMMONWEALTH OF
PENNSYLVANIA RELATING TO ADMISSION IN SAID COMMONWEALTH FOR THE PURPOSE OF
TRANSACTING INSURANCE BUSINESS IN PENNSYLVANIA AND THAT THE ABOVE NAMED
COMPANY IS HEREBY AUTHORIZED TO TRANSACT THE BUSINESS OF:
Accident and Health 40 P.S. s 382(c)(2)
Boiler and Machinery 40 P.S. s 382(c)(5)
Elevator 40 P.S. s 382(c)(9)
Glass 40 P.S. s 382(c)(3)
Livestock 40 P.S. s 382(c)(10)
Ocean Marine 40 P.S. s 382(b)(3)
Personal Property Floater 40 P. S. s 382(c)(13)
Water Damage 40 P.S. s 382(c)(8)
Effective Date: April 01, 2009
Auto Liability 40 P.S. s 382(c)(11)
Burglary and Theft 40 P.S. s 382(c)(6)
Fidelity and Surety 40 P.S. s 382(c)(1)
Inland Marine and Physical Damage 40 P.S. s 382(b)(2)
Mine and Machinery 40 P. S. s 382(c)(12)
Other Liability 40 P.S. s 382(c)(4)
Property and Allied Lines 40 P.S. s 382(b)(1)
Workers Compensation 40 P.S. s 382(c)(14)
FOR THE YEAR ENDING MARCH 31, 2010, IN ACCORDANCE WITH ITS CHARTER AND
IN CONFORMITY WITH THE LAWS OF SAID COMMONWEALTH OF PENNSYLVANIA.
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