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TRAVELERS CASUALTY AND SURETY COMPANY OT AMERICA
<br />HARTFORD, CT, 06183
<br />ATTORNEY -M -FACT SUSTOICATION
<br />PRBNCFPAL'S ACKNOWLEDGIRENT--Tf A CORPORATION
<br />State ofbtow York. County of )es..
<br />On this day of 120 , before nee personally appeared ,
<br />to tits krun m, who, being by me duly &worn, deposes and says! That he/she rendes in the City of -
<br />tkar.he/shalsOro of - ,rile
<br />corporation described in and which executed the Lvilhin Instrument; that helsho knows the seal of said anporatlon; that the real affixed to said instrument is such corporals
<br />seal; that it was in affixed by order a(dw Bond of Directors of said corporation, and dam bdshe signed Idulla r Anne thereto by like order.
<br />Slate of New York, County of
<br />BRINCII-AL'S ACITNOWLEDGhIENT—FF INDIVIDUAL OR FUNI
<br />) 32.
<br />Do this day or ,20 , beforo Ase personally appeared to we
<br />knmm to be (the indiyidual)(ueo ofplc Ann of ) described in and who execaded the within
<br />Instrument, and hdsbe thereupon duly acknowledged to Are that bdsho executed the sense (as the act and dead of said f na).
<br />SURETY C011FPANY'S ACKNOWLEDGMENT
<br />StatoafNaw Yark,Counlyaf NaSSBU ) H.
<br />On Ibis 4th dayof October „2096,befoeo me personal�lyv avpvpeared RI1R SROIBianO , to
<br />me known, who, being by me duly swum, did depose and say; That he/she resider in the KIII County of Nes5au, NY
<br />that he/sho it Altamcydn•Fact of TRAVELERS CASUAI;TY AND SURETY COiIWANY OF AMEWCA, the corporation described in sad which "cooled the within
<br />insWment; that hclakc knaves the corporate seal of said Company; shat the seal affixed to said Instrument Is such corporate seal; and th a he/she signed said Instrument as
<br />Almmey4o-Fact by audwrily of the Board of Dircclors of said Company; and afRant did NRher depose and say that the Sopes9ntendent of Insurance of Ole Slain of New Yosk
<br />has, pursuant to Chapter 892 ordm Leers of the Slate of Naw York for the year 1939, constituting chapter 25 of the Consolidating Laws of Ike Slats of New York as $a
<br />Insurance Law as =ended, Issued to 71tAVELERS CASUALTY AND SURETY C04NU-ANY OF AALERFCA hisAter certificate Ilial said Company Is qualified Io
<br />become and be nucaplod As snotty, or guaeanlor on all bonds, undertakings, mcognlaanees, guaranties, and other obh inns Michel or permitted by law; slid that such
<br />codlReatahas not boon revoked.
<br />olaryPublia
<br />Sembilan carried at $7,605,638 In the above stalament are doposiled with public Ruth Billion, a9 Required by law
<br />23B-26
<br />TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA DONNAMARIE A KI&SANE
<br />Hartford, Connacdoul
<br />06103 Notary
<br />Pubtie, State of New York
<br />FINANCIAL STATEMENT AS OF DECEMBER 31, 2015 No. 011<16297783
<br />Qualified In
<br />AS FILED WITH THE INSURANCE DEPT. OF nils ssA E OF NEW YORK
<br />CommlSBtltln EstpErea March 3, 2099
<br />TresNeSM rch 3, 2
<br />CAPITAL STOCK
<br />$ 6,450,000
<br />ASSETS
<br />_-....._ LIABILITIES 8 SURPLUS
<br />_......w.....
<br />GSH AND INVESTED CASH
<br />S .54,880,881
<br />UNEARNED PREMIUMS
<br />4 052,633,454
<br />BOND@
<br />3,500,572,595
<br />LOSSES
<br />734,725,171
<br />STOCKa
<br />245,581,191
<br />L00SADNJSTMENTOPENSES
<br />270,400,[00
<br />INVESTMENT INCOME DUE! AND ACCRUED
<br />43,505,720
<br />COMMISSIONS
<br />36194B,81A
<br />OTHER INVESTED ASSETS
<br />3,850,575
<br />TAXES. LICENSES AND FEES
<br />11,051,717
<br />PREMIUM BALANCES
<br />200,490,013
<br />OTHER EXPENSES
<br />35,486,897
<br />NET DEFERREO TAX ASSET
<br />03,751,105
<br />CURRENT FEDERAL AND FOREIGN INCOME TAXES
<br />16,158,520
<br />REINSURANCE RECOVERABLE
<br />22,53205
<br />RRMdTTANCES AND ITPMB NOT ALLOCATED
<br />4,201
<br />OECURBIYES LENDING RE INVESTED COLLATERAL ASSETS 11,772,178
<br />AMOUNTSVVIUMBLOI RETAINED BY COMPANY FOR
<br />OTHERS 33,044,553
<br />RECEIVABLES FROM PARENT, SUSIRCIARIBS AND AFF9,IATES 29,659,482
<br />RETROFCTNE REINSURANCE RESERVE ASSUMED
<br />890,144
<br />OTHERASSETS
<br />5,605,597
<br />POLICYHOLDER DIVIDENDS
<br />8,01501181
<br />PROVISION FOR REINSURANCE
<br />3,834,804
<br />ADVANCE PREMIUM
<br />1,572,035
<br />PAYABLE FOR SECURITIES
<br />11.11 ,000
<br />.
<br />PAYABLE FOR SECURITIES LENDING
<br />51,772,170
<br />CEDED REOJSURANCA NET PREMIUMS PAYABLE
<br />25,0.78,325
<br />'
<br />ESCHEAT UA3IU` Y
<br />084,427
<br />OTHER ACCRUED EXPENSES AND LIABILITIES
<br />1�
<br />TOTAL LIABILITIES
<br />81.1
<br />CAPITAL STOCK
<br />S 6,480,009
<br />PND IN SURPLUS
<br />403.507,700
<br />OUIER SURPLUS
<br />1600 312 0x5
<br />TOTAL SURPLUS TO POLICYHOLDERS
<br />SS 2�d4978
<br />TOTAL ASSETS
<br />5 4184aN,709
<br />TOTALLiABILITIESaSURPLUS
<br />S_d,T��1-f 760_
<br />Sembilan carried at $7,605,638 In the above stalament are doposiled with public Ruth Billion, a9 Required by law
<br />23B-26
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