**ZURICH-AMERICAN INSURANCE GROUP**

231 N. MARTINGALE ROAD
SCHAUMBURG, IL 60196

**POLICY INFORMATION**

* **INSURANCE COMPANY:** ZURICH INSURANCE
* **PRODUCTS & COMMISSION:** JOSEPH J. HIGGINS

**STANDARD PREMIUM**

* **YES:** $8,493,299 AP S
    * **COMMISSION %:** 6%
    * **TOTAL:** $533,427
* **NO:** $7,483 AP S
    * **TOTAL:** $0
* **TOTAL:** $8,493,482 AP S
    * **TOTAL:** $0

**SUBTOTAL:**

* **TOTAL:** $8,493,482 AP S
    * **TOTAL:** $0

**A/P:** $95,782
    * **TOTAL:** $0

**A/P:** $6,973.

**TOTAL EARNED PREMIUM**
* **DEPOSIT PREMIUM:** $0
* **ADDITIONAL DUE:** $0
* **REFUND DUE:** $0
* **INSURED:** $0

**AGENT COPY**

**MM 009847**