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COMMONWEALTH OF PENNSYLVANIA
INSURANCE DEPARTMENT
Harrisburg, PA
April 1, 2001
Whereas, the AMERICAN STATES INSURANCE COMPANY, located at Indianapolis, IN, has filed
in this Department a certified copy of its charter and a detailed statement of its Assets and Liabilities, and
otherwise complied with the requirements of Section 661 of the Act of Assembly of the Commonwealth of
Pennsylvania, entitled "An act relating to insurance; amending, revising and consolidating the Law &c.,"
approved the 17th day of May, A.D. 1921, as well as with the requirements of the laws of this Commonwealth
applicable to such company in doing business herein.
Now Therefore, I, M. Diane Koken~ Insurance Commissioner of the Commonwealth of Pennsylvania, do
hereby certify, in accordance with Section 1, of the Act of Assembly approved June 29, 1923 and known as act
No. 373 of the Laws of 1923, that the American States Insurance Company, of Indianapolis, IN, is duly
authorized to become and be accepted as sole surety on all bonds, undertakings and obligations required or
permitted by law or the ordinances, rules or regulations of any municipality, board, body, organization, or
public officer.
In Witness Whereof, I have hereunto set my hand and
affixed my official seal, the day and year first above written.
Insurance Commissioner
SAFECO
AMERICAN STATES INSURANCE COMPANY
FINANCIAL STATEMENT -- DECEMBER 31, 2000
Assets
Cash and Bank Deposits ...................................... $ (40,395,013)
*Bonds -- U.S. Government ................................. 160,218,018
*Other Bonds ......................................................... 959,840,153
*Stocks ................................................................... 395,408,109
Real Estate ............................................................ 20,979,960
Agents' Balances or Uncollected Premiums ........ 168,680,066
Accrued Interest and Rents .................................. 17,264,987
Other Admitted Assets ......................................... 12,515,232
Liabilities
Unearned Premiums ...............................................
Reserve for Claims and Claims Expense ................
Funds Held Under Reinsurance Treaties ................
Reserve for Dividends to Policyholders .................
Additional Statutory Reserve .................................
Reserve for Commissions, Taxes and
Other Liabilities ................................................
Total ...............................................................
Capital Stock ............................. $ 5,000,000
Paid in Surplus ........................... 537,757,201
Unassigned Surplus ................... (120,088,714)
$ 336,416,228
81 l,136,345
5,334
4,829,463
119,455,655
$ I, 271,843,025
Surplus to Policyholders .............................. 422,668,487
Total Admitted Assets ..................................$1,694,511,512
Total Liabilities and Surplus ............................... $1,694,511,512
* Bonds are stated at amortized or investment value; Stocks at Association Market Values. Securities
carried at $17,434,132 are deposited as required by law.
1, MICHAEL C. PETERS, senior vice president of American States Insurance Company, do hereby certify that the foregoing is a true, and correct
statement of the Assets and Liabilities of said Corporation, as of December 31, 2000, to the best of my knowledge and belief.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Corporation at Seattle, Washington, this 1st day of
March, 2001. ~
Senior Vice President
$-1262/ASI 3/01
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