LEGAL NOTICES
THE WALSH COUNTY PRESS - WEDNESDAY, MAY I3, 2020
Page 9
11452
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
Hartford Steam Boiler Inspection
Insurance Company
In the state of Connecticut
Total Assets 1572350084
Total Liabilities 980268310
Aggregate write-ins for
special surplus fund 0
Common Capital Stock 10000000
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds , 0
Surplus notes 0
Gross paid in and
contributed surplus 343016174
Unassigned funds (surplus) 239065600
Total Capital and Surplus 592081774
Total Liabilities, Capital
and surplus . 1572350084
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 574553
Total Direct Losses
Incurred 48424
Total Accident and Health Direct
Premiums Earned 0
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company In this office.
IN TESTIMONY WHEREOF, I have hereunto
setmyhandandaffixed the seal ofthis office at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed In this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of the State
regarding the business of insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021.
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
10885
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
Key Risk Insurance Company.
In the state of Iowa
Total Assets 53466632
Total Liabilities 19907499
Aggregate write-ins for
special surplus fund 0
Common Capital Stock 4500000
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds 0
Surplus notes 0
Gross paid in and
contributed surplus 20750000
Unassigned funds (surplus) 8309133
Total Capital and Surplus 33559133
Total Liabilities, Capital
and surplus 53466632
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 0
Total Direct Losses
Incurred 0
Total Accident and Health Direct
Premiums Earned 0
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, I have hereunto
setmyhandmdaffixedthesealofthisofficeat
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of the State
regarding the business of Insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby cert'rfy that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021 .
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
35246
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
Illinois Insurance Company
In the state of Iowa
Total Assets 72880894
Total Liabilities 36355484
Aggregate write-ins for
special surplus fund 0
Common Capital Stock 3420000
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds 0
Surplus notes 0
Gross paid in and
contributed surplus 4030000
Unassigned funds (surplus) 29075410
Total Capital and Surplus 36525410
Total Liabilities, Capital
and surplus . 72880894
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 0
Total Direct Losses
Incurred 0
Total Accident and Health Direct
Premiums Earned 0
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, I have hereunto
set my hand and affixed the seal of thisofficeat
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of the State
regarding the business of insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021 .
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
13722
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
KnightBrook Insurance Company
In the state of Delaware
Total Assets 176555288
Total Liabilities 75100749
Aggregate write-ins for
special surplus fund 0
Common Capital Stock 4218200
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds 0
Surplus notes 0
Gross paid in and
contributed surplus 114331396
Unassigned funds (surplus) -17095057
Total Capital and Surplus 101454539
Total Liabilities, Capital
and surplus 176555288
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 21 50
Total Direct Losses
Incurred 1 5
Total Accident and Health Direct
Premiums Earned 0
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA .
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, I have hereunto
setmyhandandaffixedtl'iesealofthisoffioeat
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of the State
regarding the business of insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021.
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
2:019 INSURANCE ABSTRACTS S 2019 INSURANCE ABSTRACTS S 2019 INSURANCE
ABSTRACTS
35408
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
lmperium Insurance Company
In the state of Texas
Total Assets 496272312
Total Liabilities 304684031
Aggregate write-ins for
special surplus fund 0
Common Capital Stock 4200000
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds 0
Surplus notes 0
Gross paid in and
contributed surplus 224068856
Unassigned funds (surplus) -36680575
Total Capital and Surplus 191588281
Total Liabilities, Capital
and surplus 496272312
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 367470
Total Direct Losses
Incurred 5815
Total Accident and Health Direct
Premiums Earned 0
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract -of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, I have hereunto
setmyhandandaffixedmesealofmisofficeat
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of the State
regarding the business of insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021 . ,
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
20621
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
Lamorak Insurance Company
In the state of Pennsylvania
Total Assets 26414024
Total Liabilities 360299
Aggregate write-ins for
special surplus fund 0
Common Capital Stock 6000000
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds 0
Surplus notes 0
Gross paid in and
contributed surplus 94455935
Unassigned funds (surplus) -7440221
Total Capital and Surplus 93015714
Total Liabilities, Capital
and surplus 93376013
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 0
Total Direct Losses
Incurred 0
Total Accident and Health Direct
Premiums Earned 0
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, I have hereunto
setmyhandandaffixedthesealofthisofficeat
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, (2019 conformable to the
requirements of the laws of the State
regarding the business of insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021 .
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
Call tlle Walsla
43575
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
Indemnity Insurance Company of North
America
In the state of Pennsylvania
Total Assets 337596866
Total Liabilities 179739545
Aggregate write-ins for
special surplus fund 0
Common Capital Stock 4501500
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds 0
Surplus notes 0
Gross paid in and
contributed surplus 42250750
Unassigned funds (surplus) 111105071
Total Capital and Surplus 157857321
Total Liabilities, Capital
and surplus 337596866
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 69789575
Total Direct Losses
Incurred 33484493
Total Accident and Health Direct
Premiums Earned ‘
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, have hereunto
setmyhandandaffixedthesealofthisofficeat
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of the State
regarding the business of insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021 .
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
‘ (SEAL).
0
-- JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
38148
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
Lancer Indemnity Company
In the state of New York
Total Assets 20833804
Total Liabilities 8525928
Aggregate write-ins for
special surplus fund -5304372
Common Capital Stock 4000000
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds 0
Surplus notes 0
Gross paid in and
contributed surplus 2800000
Unassigned funds (surplus) 10812248
Total Capital and Surplus 12307876
Total Liabilities, Capital
and surplus 20833804.
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 0
Total Direct Losses
Incurred 0
Total Accident and Health Direct
Premiums Earned 0
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, I have hereunto
set my hand and affixed the seal ofthis office at
Bismarck, the first day_of,May, AD. 2020
(SEAL). _
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of the State
regarding the business of insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021 .
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
18468
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
Indemnity National Insurance Company
In the state of Illinois
Total Assets 169254544
Total Liabilities 93915866
Aggregate write-ins for
special surplus fund 0
Common Capital Stock 3000000
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds 0
Surplus notes 0
Gross paid in and
contributed surplus 70145502
Unassigned funds (surplus) 2193176
Total Capital and Surplus 75338678
Total Liabilities, Capital
and surplus 169254544
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 64664
Total Direct Losses
Incurred 9700
Total Accident and Health Direct
Premiums Earned 0
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, have hereunto
setmyhandandaffixedthesealofthisofficeat
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of the State
regarding the business of insurance
and ,
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021 .
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance _ . ~ . a.
(May 6, 13, 27, 2020)
42404
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
Liberty Insurance Corporation
In the state of Illinois
Total Assets 238135772
Total Liabilities 8309478
Aggregate write—ins for
special surplus fund 0
Common Capital Stock 3500000
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds 0
Surplus notes 0
Gross paid in and
~ contributed surplus 156162500
Unassigned funds (surplus) 70163795
Total Capital and Surplus 229826295
Total Liabilities, Capital
and surplus 238135773
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 2883787
Total Direct Losses
Incurred 2023348
Total Accident and Health Direct
Premiums Earned 0
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, have hereunto
setmy handandaffixed the seal ofthisoffice at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of the State
regarding the business of insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021.
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
Ctolllaty Press at 284—6333 today
16116
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
JM Specialty Insurance Company
In the state of Wisconsin
Total Assets 15567567
Total Liabilities 14405
Aggregate write-ins for
special surplus fund 0
Common Capital Stock 3500000
Preferred Capital Stock 0
Aggregate write-ins for
other than special surplus funds 0
Surplus notes 0
Gross paid in and
contributed surplus 12725565
Unassigned funds (surplus) -672402
Total Capital and Surplus 15553163
Total Liabilities, Capital
and surplus 15567568
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 0
Total Direct Losses
Incurred 0
Total Accident and Health Direct
Premiums Earned 0
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, I have hereunto
set my hand and affixed the seal ofthis office at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of‘ the State
regarding the business of insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021 .
IN TESTIMONY WHEREOF, I have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
23085
ABSTRACT OF STATEMENT
FOR THE YEAR ENDING
DECEMBER 31, 2019
of the
Liberty Mutual Fire Insurance Company
In the state of Wisconsin
Total Assets 7032602683
Total Liabilities 5206633485
Aggregate write-ins for
special surplus fund 5242951
Common Capital Stock 10000000
Preferred Capital Stock 10
Aggregate write-ins for
other than special surplus funds 1250000
Surplus notes 0
Gross paid in and
contributed surplus 509999990
Unassigned funds (surplus) 1299476247
Total Capital and Surplus 1825969198
Total Liabilities, Capital
and surplus 7032602683
NORTH DAKOTA BUSINESS ONLY
FOR THE YEAR 2019
Total Direct Premiums
Earned 4319347
Total Direct Losses
Incurred 5661042
Total Accident and Health Direct
Premiums Earned c
Total Accident and Health Direct
Losses Incurred 0
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
I, Jon Godfread, Commissioner of
Insurance of the State of North Dakota,
do hereby certify that the foregoing is a
true Abstract of Statement, as officially
filed by the Company in this office.
IN TESTIMONY WHEREOF, have hereunto
set my hand and affixed the seal of this office at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
STATE OF NORTH DAKOTA
OFFICE OF THE COMMISSIONER
OF INSURANCE
COMPANY’S CERTIFICATE OF
AUTHORITY
WHEREAS, the above corporation duly
organized under the laws of its state or
country of domicile, has filed in this office
a sworn statement exhibiting its condition
and business for the year ending
December 31, 2019 conformable to the
requirements of the laws of the State
regarding the business of insurance
and
WHEREAS, the said company has filed in
this office a duly certified copy of its charter
with certificate of organization in
compliance with the requirements of
insurance law aforesaid,
NOW THEREFORE, I, JON GODFREAD,
Commissioner of Insurance of the State of
North Dakota, pursuant to the provisions of
said laws, do hereby certify that the above
named company is fully empowered
through its authorized agents and
representatives, to transact its appropriated
business of authorized insurance in the state
according to the laws thereof, until the 30th
day of April, AD. 2021 .
IN TESTIMONY WHEREOF, have
hereunto set my hand and affixed the seal at
Bismarck, the first day of May, AD. 2020
(SEAL).
JON GODFREAD
Commissioner of Insurance
(May 6, 13, 27, 2020)
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