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COMMONWEALTH OF PENNSYLVANIA
INSURANCE DEPARTMENT
Harrisburg, PA April 1, 2012
Whereas, the SELECTIVE INSURANCE COMPANY OF AMERICA, located at Branchville, N.J.,
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. 1911, as well as with the requirements of the laws of this Commonwealth
applicable to such company in doing business herein.
Now Therefore, I, Michael Conseoine, 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 I aws of 1923, that the Selective Insurance Company of America,
of Branchville, N. J., is duly authorized to become and be accepted as sole surety on all bonds, undertakings
and obligations required or permitted b? 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
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11514 9`5C1
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Selective Insurance Company of America
40 r Wantagt Avenue
S E LE Cj1 I I B
Branchville, New Jersey 07890
973-948-3000
STATEMENT OF FINANCIAL CONDITION
I hereby certify that the following inf 'on is contained in the Annual Statement of Selective Insurance Company of
America ("SICA") to the New Jersey of Banking and Insurance as of December 31, 2011:
Bonds
Preferred stocks at convention
Common stocks at convention values
Subsidiary common stock at
convention values
Short-term investments
Mortgage loans on real estate
(including collateral loans)
Other invested assets
Interest and dividends due or accrued
Premiums receivable
Other admitted assets
M LIAR i MS AND SURPLUS (in thousands)
S 1,637,544 Reserve for losses and loss expenses $1,275,472
0 Reserve for unearned premiums 375,856
Provision for unauthorized
107,231 reinsurance 577
Commissions payable and
0 contingent commissions 21,199
72,139 Other accrued expenses 20,039
38,131 Other liabilities 200.275
102,916 Total liabilities 1,893,418
17,410
295,614 Surplus as regards policyholders 507.390
129.823
Total liabilities and surplus as
Total admitted assets $ a"" regards policyholders $ L49=
1 further certify that the following is at?ue and exact excerpt from Article VII, Section I of the By-Laws of SICA, which is
still valid and existing.
The Chairman of the Board, sident, Chief Executive Officer, any Executive Vice President,
any Senior Vice President or y Corporate Secretary may, from time to time, appoint attorneys
in fact, and agents to and for d on behalf of the Corporation and they may give such appointee
such authority, as his/her c 'ficate of authority may prescribe, to sign with the Corporation's
name and seal with the Corl ion's seal, bonds, recognizances, contracts of indemnity and
other writings obligatory in a nature of a bond, recognizance or conditional undertaking, and
any of said Officers may, at any time, remove any such appointee and revoke the power and
authority given him/her. ,
IN WITNESS WHEREOF, I hereunto!subscribe my name and
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Michael H. Lanza i 1?t-At- S
SICA Corporate Secretar _ 1925
STATE OF NEW JERSEY : +°rr J EL ''
:ss. Branchville
COUNTY OF SUSSEX
On this day of Aa ` 2012, bere me, the undersigned officer, personally appeared Michael H. Lanza, who
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acknowledged himself to be the Corp4 to Secretary of SICA, and that be, as such Corporate Secretary, be
to do, executed the foregoing instrument for the purposes therein by signing the name of the coy . K/
himself as Corporate Secretary. Q'
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