Supporting Documentation · Mar 26, 2024
99-24 Exhibit to Temporary Extension Agreement.pdf
00d0dba76ba6d3d1d7a63a33656ba8a40ca72823740f177df05bad83d7b1ada0Indexed text · page 186
Show all pagesFIRST INDEMNITY FIRST INDEMNITY OF OF AMERICA INSURANCE COMPANY AMERICA INSURANCE COMPANY 2740 Route 2740 Route 10 10 West, West, Suite Suite 205, Morris Plains, 205, Morris Plains, N.J. N.J. 07950 07950 STATEMENT OF STATEMENT FINANCIAL CONDITION OF FINANCIAL CONDITION ASAS OF DECEMBER 31, OF DECEMBER 2017 31, 2017 Assets: Assets: Bonds Bonds $$ 1,175,648 1,175,645 Preferred && Common Preferred Common Stocks Stocks 7,445,188 7,445,188 Mortgage Loans Mortgage Loans 120,000 120,000 Real Estate Real Estate 1,066,243 1,066,243 Cash and Cash and Short Short Term Investruents Tenn Investments
1,066,243 Cash and Cash and Short Short Term Investruents Tenn Investments 1,314,787 1,314,787 Investment Income Investment incarme Due Due and and Accrued Accrued 20,576 20,576 Premiums in Premiums in the Course of the Course Collection {Under of Collection 90 Days) (Under 90 Days) 258,211 258,211 Reinsurance Recoverable Reinsurance Recoverable onon Loss and LAE loss and Payments ~E Payments 82,415 82,415 Deferred Tax Deferred Tax Asset Asset 381,188 381,188 Other Assets Other Assets 79,848 79,848 Total Admitted Assets Total Admitted Assets
79,848 Total Admitted Assets Total Admitted Assets $ 11,944,101 11,944,101 Liabilities and liabilities Surplus: and surplus: Reserve for Reserve Loss amd for Loss Loss Adjustment amd Loss Expenses Adjustment E>:penses 2,171,169 2,171.169 Other Expenses Other Expenses 250,441 250,441 Taxes Taxes Licenses and Fees licenses and Fees 72,118 77,118 Federal Income Federal Income Tax Payable Tax Payable 31,000 31,000 Unearned Premium Unearned Premium ’ 2,113,536 2,113,536 Amounts Withheld or Amounts Withheld Retained for or Retained Gthers for Others
mounts Withheld Retained for or Retained Gthers for Others 21,664 21,664 Ceded Reinsurance Balances Ceded Reinsurance Balances Payable Payable 155,322 155,322 Liabilitiy for Uabi!itiy Unauthorized Reinsurers for Unauthorized Reinsurers bt ees- —————— Tota! Liabititfes Total Liabilities 4,820,250 4,820,250 Capital Capital && Surplus: Surplus: Common Stock, Common Paid Up Stock, Paid Up 2,500,000 2,500,000 Paid in Paid in and and Contributed Contributed Surplus Surplus 1,480,945 1,480,945 Unassigned Surplus Unaslgned Surplus ) 3,142,906 3,142,906 Surplus as Surplus as Regards Regards to to Pollcyholders Policyholders
3,142,906 Surplus as Surplus as Regards Regards to to Pollcyholders Policyholders 7,123,851 7,123,851 Total Liabilities Total Liabilities and and Surplus Surplus $$ 11,944,101 11,944,101 1, Glenn I, Glenn A. Runne, Chief A. Runne, Financial Officer Chief Financial Officer of of First First Indemnity Indemnity ofof America Insurance Company, America Insurance Company, do hereby certify do hereby that the certify that the foregoing statement foregoing statement isis a a correct correct exhibit of the exhibit of assets and the assets and surplus surplus of the said of the said company, company, on the 31st on the 31st day day of December, 2017,
on the 31st day day of December, 2017, of December, 2017, according according toto the best information, the best information, knowledge, knowledge, andand belief, belief, .4a&n o R~ neveryera, ete Glenn A.A Runne Glenn Rutine . Chilef Officer Financial Officer Chleffim:mcial NED State of New State of New Jersey) Jersey) County of County of Morris) 55% Morris) SS» Subscribed and Subscribed and sworn to, before sworn to, before me, me, aa Notary Notary Public Public of the State of the State of of New Jersayinin the New Jersey the Township of Morris Township of Morris Plains, Plains, this 31st this 31st day of December, day of December, 2017. 2017.
1st this 31st day of December, day of December, 2017. 2017. of ~~hr£ I &/;ekJ) NAY Fed i oN ad SEA“2 J, I RA wed fe 3 Kathleen Fachesto a pt RoE My Commission My Commission Expires March Expires March 16, 16, 2020 2020 Shel, wd inns hI XE it Peart Jo Elz
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