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Assets
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AMERICAN STATES INSURANCE COMPANY
FINANCIAL STATEMENT -DECEMBER 31, 2010
Cash and Bank Deposits ......................................... $ 95,576,031
*Bonds - U.S Government ..................................... 167,861,630
*Other Bonds ............................................................ 1,059,930,651
*Stocks ...................................................................... 599432,186
Real Estate .............................................................. 0
Agents' Balances or Uncollected Premiums........... 247,397,167
Accrued Interest and Rents ..................................... 12,304,131
Other Admitted Assets ............................................ 92.127.280
Total Admitted Assets
Liabilities
Unearned Premiums ................................................ $ 368,839,985
Reserve for Claims and Claims Expense ................. 830,202,910
Funds Held Under Reinsurance Treaties ................. 0
Reserve for Dividends to Policyholders .................. 71,239
Additional Statutory Reserve .................................. 0
Reserve for Commissions, Taxes and
Other Liabilities ................................................ 205.490.823
Total .............................................................. $1,404,604,957
Special Surplus Funds ................. $ 1,643,803
Capital Stock ............................... 5,000,000
Paid in Surplus ............................ 303,892,772
Unassigned Surplus ..................... 19,487,544
Surplus to Policyholders ............................... 330.024.119
Total Liabilities and Surplus ................................ 5t _73
* Bonds are stated at amortized or investment value; Stocks at Association Market Values.
The foregoing financial information is taken from American States Insurance Company's financial
statement filed with the state of Indiana Department of Insurance.
1, TIM MIKOLAJEWSKI, 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, 2010, 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 30th day of
March, 2011.
Vice-President
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INSURANCE DEPARTMENT
I, Michael Consedine, Acting Insurance Commissioner of the Commonwealth of Pennsylvania,
do hereby certify that the attached is a full, true and correct copy of the
Certificate of Authority, as of April 1, 2011, 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 4th day of April, 2011.
Michael Consedine
Acting Insurance Commissioner
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COMMONWEALTH OF PENNSYLVANIA
INSURANCE DEPARTMENT
CERTIFICATE OF AUTHORITY
IN WITNESS WHEREOF, I HAVE HEREUNTO SET MY
HAND AND AFFIXED MY OFFICIAL SEAL, THE
DATE AND YEAR FIRST ABOVE WRITTEN.
MICHAEL CONSEDINE
ACTING INSURANCE COMISSIONER
Casualty Effective Date: April 1, 2011
AMERICAN STATES INSURANCE COMPANY
NAIC NO. 19704
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)
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, 2012, IN ACCORDANCE WITH ITS CHARTER AND IN CONFORMITY
WITH THE LAWS OF SAID COMMONWEALTH OF PENNSYLVANIA.