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<br /> I •
<br /> . CAPITOL INDEMNITY CORPORATION
<br /> . - BALANCE SHEET
<br /> I December 31,2011
<br /> Admitted Assets 2011
<br /> Cash and invested assets: - •
<br /> I Bonds 5214,021289
<br /> Common stocks 135.323578
<br /> Cash,cash equivalents and short-tents investments 16.569.613
<br /> Other invested assets 6.564.992
<br /> Total cash and invested assets 372,479,472•
<br /> IInvestment income due and accrued 2.108,836
<br /> Uncollected premiums and agents'balances in course oCcollection 11,924,922
<br /> Deferred premi ,agents'balances and installments booked but deferred and not yet due 10,746.634
<br /> urs
<br /> Amounts recoverable from reinsurers 708,397
<br /> Other amen=receivable under reinsurance contracts 29,769
<br /> Current federal and foreign income tax recoverable and interest thereon 1,397,333
<br /> Net deferred tax asset 6.071,496
<br /> I Electronic data processing equipment and software
<br /> Receivables from parent,subsidiaries and affiliates 2.982,477
<br /> • Other admitted assets 153.829
<br /> Total admitted assets 409,436,197
<br /> Liabilities and Surplus as Regards Policyholders
<br /> Liabilities:
<br /> •
<br /> Losses - 1118,819,607
<br /> I Reinsurance payable on paid losses and loss adjustment expenses
<br /> 9.313,200
<br /> Loss adjustment expenses 18,926,149
<br /> Cot mdssiots payable,contingent commissions and other similar charges 741,890
<br /> Other expenses(excluding taxes,licenses and fees) 6.606,503
<br /> Taxes,licenses and fees(exclud rag federal and foreign income taxes) 505527
<br /> Unearned premiums 48.043,355
<br /> Dividends declared and unpaid to policyholders 110,817
<br /> Ceded reinsurance premiums payable(net of ceding commissions) (815,171)
<br /> I Funds held by company under reinsurance treaties 18,419
<br /> Amounts withheld or retained by company for account of others 8,701,954
<br /> Remittances and items not allocated 3,016,417
<br /> . Provision for reinsurance 44,000
<br /> Payable to parent,subsidiaries and a0liates 4,035,928 '
<br /> I - Other liabilities
<br /> Total liabilities 225.228,916
<br /> Surplus as regards policyholders:
<br /> Common capital stock 4.201,416
<br /> Gross paid in and contributed surplus 62,621,510
<br /> nas
<br /> Usigned funds(surplus) 117,384,355
<br /> Surplus as regards policyholders 184,207,281
<br /> Total liabilities and capital and surplus 409,436.197
<br /> 1,David Pauly,CEO and President of Capitol Indemnity Corporation do hereby certify that to the best of my knowledge and belief,the
<br /> foregoing is a full and true statutory Statement of Admitted Assets and Liabilities,Capital and Surplus of the Operation at December 31,
<br /> 2011,prepared in conformity with the accounting practices prescribed by the Insurance Department of the State of Wisconsin. IN
<br /> WITNESS WHEREOF,I have set my hand and affixed the seal of the Corporation at Middleton,Wisconsin. •
<br /> - �
<br /> David Pauly +a��Nlrreg
<br /> CEO 6 President "....e.Y. a
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<br /> . Sa,ti��
<br /> S.J 'SE ALE t O yz
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