| Chubb Global Casualty |
| --- |
| State | Estimated Policy Premium ($) | Initial AARO Adjustment ($) | Total Estimated Written Premium ($) |
| Nebraska | 159 | 0 | 159 |
| Nevada | 264 | 0 | 264 |
| New Hampshire | 178 | 0 | 178 |
| New Jersey | 1,913 | 0 | 1,913 |
| New Mexico | 162 | 0 | 162 |
| New York | 47,752 | 0 | 47,752 |
| North Carolina | 1,735 | 0 | 1,735 |
| Ohio | 1,430 | 0 | 1,430 |
| Oklahoma | 544 | 0 | 544 |
| Oregon | 343 | 0 | 343 |
| Pennsylvania | 2,180 | 0 | 2,180 |
| Puerto Rico | 342 | 0 | 342 |
| Rhode Island | 181 | 0 | 181 |
| South Carolina | 436 | 0 | 436 |
| South Dakota | 75 | 0 | 75 |
| Tennessee | 489 | 0 | 489 |
| Texas | 5,301 | 0 | 5,301 |
| Utah | 390 | 0 | 390 |
| Vermont | 44 | 0 | 44 |
| Virginia | 1,524 | 0 | 1,524 |
| Washington | 875 | 0 | 875 |
| West Virginia | 851 | 0 | 851 |
| Wisconsin | 709 | 17 | 726 |
| Wyoming | 38 | 0 | 38 |
| TOTALS | 92,205 | 17 | 92,222 |

**Totals - All Policies**

| Policy Number(s) | Estimated Policy Premium ($) | Initial AARO Adjustment ($) | Total Estimated Written Premium ($) |
| --- | --- | --- | --- |
| HDQG7109490A | 79,681 | 17,072 | 96,753 |
| ISAH25157564 | 92,205 | 17 | 92,222 |
| TOTALS | 171,886 | 17,089 | 188,975 |

International Business Machines Corporation  
05/17/2018  
Initial Statement of Adjustment Page 16 of 36