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I, Michael Consedine, 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, 2012, 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 I ITH day of April, 2012.
Michael ''Consedine
Insurance Commissioner
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COMMONWEALTH OF PENNSYLVANIA
INSURANCE DEPARTMENT
CERTIFICATE OF AUTHORITY
Casualty Effective Date: April 1, 2012
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, 2013, IN ACCORDANCE WITH ITS CHARTER AND IN CONFORMITY
WITH THE LAWS OF SAID COMMONWEALTH OF PENNSYLVANIA.
IN WITNESS WHEREOF, I HAVE HEREUNTO SET MY
HAND AND AFFIXED MY OFFICIAL SEAL, THE
DATE AND YEAR FIRST ABOVE WRITTEN.
MICHAEL CONSEDINE
INSURANCE COMISSIONER
'0 SAFECO INSURANCE COMPANY OF AMERICA
Mutlua - FINANCIAL STATEMENT - DECEMBER 31, 2011
SURETY
Assets Liabilities
Cash and Bank Deposits ..................................... $ 142,401,794 Unearned Premiums.............................................. $ 765,946,552
*Bonds - U.S Government ................................. 213,904,445 Reserve for Claims and Claims Expense............... 1,673,156,676
Funds Held Under Reinsurance Treaties ............... 0
*Other Bonds ........................................................ 2,065,056,385
Reserve for Dividends to Policyholders ................ 209,734
*Stocks .................................................................. 542,053,558 Additional Statutory Reserve ................................ 0
Real Estate .......................................................... 0 Reserve for Commissions, Taxes and
Agents' Balances Or Uncollected Premiums....... 519,959,131 Other Liabilities .............................................. 544.037.508
Accrued Interest and Rents ................................. 26,688,776 Total............................................................ 2,983,350,470
Other Admitted A#sets ........................................ 344.092.016 Special Surplus Funds ... ... ...... $ 20,576,030
Capital Stock ............................... 5,000,000
Paid in Surplus ............................ 580,930,179
Unassigned Surplus ..................... 264,299,426
Total Admitted Assets ................................. 53_R54.156aM Surplus to Policyholders ............................. 870.805.635
Total Liabilities and Surplus .............................. 3 R54 156,105
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a `"o o * Bonds are stated at amortized or investment value; Stocks at Association Market Values.
o :1853 - The foregoing financial information is taken from Safeco Insurance Company's financial statement filed
0dy?rwith the state of Washington Department of Insurance.
I, TIM MIKOLAJEWSKI, Assistant Secretary of Safeco Insurance Company of America, do hereby certify that the foregoing is a true, and
correct statement of the Assets and Liabilities of said Corporation, as of December 31, 2011, 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 5th day of
April, 2012.
Assistant Secretary
S-1262SA/a 4/12