22-84131503-ITB Commercial Automobile Insurance Attachment J Historical Loss Experience Report.pdf

ITB No. 22-84131503-ITB Commercial Automobile Insurance

Attachment J Loss Experience Report

A loss experience report dated July 20, 2022 is provided on the following pages.

STATE OF FLORIDA

4050 ESPLANDE WAY

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Summary Sorted by Policy Type PC-LE02-E

Claims Valued as of Wednesday, July 20, 2022

Policy Type Carrier Policy Number Effective Date

Expiration Date

Claims Reported

Claims Open

Loss Reserve

Expense Reserve

Paid Losses

Paid Expenses Recoveries

Total Incurred

Auto AAIC GPPAAU4050065-00 10/20/2017 10/20/2018 27 0 0 0 43,224 1,191 (15,597) 28,818

AAIC GPPAAU4050065-01 10/20/2018 10/20/2019 24 0 0 0 35,943 154 (18,995) 17,102

AAIC GPPAAU4050065-02 10/20/2019 10/20/2020 18 1 40,000 10,000 48,832 157 (30,320) 68,669

NUFIC GPNUAU0024153-00 10/20/2020 10/20/2021 39 1 90,000 0 114,696 1,212 (27,992) 177,917

NUFIC GPNUAU0024153-01 10/20/2021 10/20/2022 25 1 0 0 59,862 0 (19,736) 40,126

Auto Totals: 133 3 130,000 10,000 302,558 2,715 (112,640) 332,632

Grand Totals: 133 3 130,000 10,000 302,558 2,715 (112,640) 332,632

AAIC American Alternative Insurance Corporation

NUFIC National Union Fire Insurance Company of Pittsburgh, Pa.

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless approved by the Officer of the Company.

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPNUAU0024153-00

10/20/2020 10/20/2021

NUFIC

AUTO LIABILITY

10/29/2020 10/29/2020 FLAU20101056 11/09/2020 0 0 0 0 0 0

FOL: Claimant vehicle making a left turn across three lanes of traffic, second veh let CV go. IV traveling in opposite direction struck CV.

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP5JC251062 INSURED DRIVER: Bridget Davisdon

01/15/2021 01/21/2021 FLAU21010750 01/29/2021 0 0 1,476 0 0 1,476

Insured vehicle backing struck parked claimant vehicle

ACCIDENT LOCATION: Lake City, FL

AUTO: 2018 DODGE GRAND CARAVAN SE (Class: 7398) VIN: 2C4RDGBG8JR311908 INSURED DRIVER: Sheila Rahimpour

02/08/2021 02/09/2021 FLAU21020348 06/29/2021 0 0 3,721 0 0 3,721

Insured vehicle went through stop sign and struck claimant vehicle

ACCIDENT LOCATION: Auburndale, FL

AUTO: 2016 FORD E-SERIES BUS (Class: 5892) VIN: 1FDEE3FL5GDC23496 INSURED DRIVER: Joseph Davis

02/21/2021 05/10/2021 FLAU21050503 05/21/2021 0 0 0 0 0 0

Insured stopped vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP2JY304959 INSURED DRIVER: Mona Steagald

03/25/2021 04/06/2021 FLAU21040240 05/24/2021 0 0 3,517 323 (247) 3,593

Insured vehicle backing struck claimant vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC251091 INSURED DRIVER: Laura Anne Howard

06/22/2021 06/24/2021 FLAU21060900 08/02/2021 0 0 0 0 0 0

Claimant turning from side road, pulled in to path of insured.

ACCIDENT LOCATION: Ocala, FL

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPNUAU0024153-00

10/20/2020 10/20/2021

NUFIC

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP6JC250499 INSURED DRIVER: Andrea Fowler

07/20/2021 08/05/2021 FLAU21080270 08/12/2021 0 0 0 0 0 0

Insured vehicle struck claimant vehicle turning into their lane

ACCIDENT LOCATION: Clearwater, FL

AUTO: 2017 FORD FUSION 4 (Class: 7398) VIN: 3FA6P0G70HR236173 INSURED DRIVER: Lacey Anne Tatro

07/30/2021 08/02/2021 FLAU21080075 12/07/2021 0 0 0 0 0 0

Stopped insured vehicle struck by claimant vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2012 FORD FOCUS (Class: 7398) VIN: 1FAHP3F27CL106365 INSURED DRIVER: Sheila Chevron-Brown

08/20/2021 08/24/2021 FLAU21080848 09/14/2021 0 0 0 0 0 0

Insured vehicle struck in rear by other vehicle while making a right hand turn

ACCIDENT LOCATION: Fort Pierce, FL

AUTO: 2013 FORD FUSION (Class: 7398) VIN: 3FA6P0G71DR138537 INSURED DRIVER: Stephen Gosnell

08/24/2021 09/13/2021 FLAU21090655 09/20/2021 0 0 0 0 0 0

Claimant vehicle backing out of parking space and struck Insured vehicle

ACCIDENT LOCATION: Vero Beach, FL

AUTO: 2016 FORD TAURUS SE (Class: 7398) VIN: 1FAHP2D86GG100413 INSURED DRIVER: Edward Arens Jr 10/12/2021 10/12/2021 FLAU21100391 Open 90,000 0 12,660 676 0 103,336

Insured vehicle rear-ended claimant vehicle.

ACCIDENT LOCATION: Fort Myers, FL

AUTO: 2019 CHEVY IMPALA (Class: 7398) VIN: 2G11X56S31K9144503 INSURED DRIVER: Mark Edward Moore

AUTO PHYSICAL DAMAGE

10/29/2020 10/30/2020 FLAU20101056 11/11/2020 0 0 11,101 0 0 11,101

FOL: Claimant vehicle making a left turn across three lanes of traffic, second veh let CV go. IV traveling in opposite direction struck CV.

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP5JC251062 INSURED DRIVER: Bridget Davisdon

11/10/2020 12/15/2020 FLAU20120627 12/23/2020 0 0 945 214 0 1,159

Unknown struck insured vehicle while parked and unattended

ACCIDENT LOCATION: Hernando, FL

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPNUAU0024153-00

10/20/2020 10/20/2021

NUFIC

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP0JC251034 INSURED DRIVER: Joseph Lamendola

12/16/2020 12/23/2020 FLAU20120961 01/12/2021 0 0 1,432 0 0 1,432

Insured vehicle vandalized and catalytic converter stolen

ACCIDENT LOCATION: Marianna, FL

AUTO: 2020 TOYOTA SIENNA 8 PASSENGER VAN (Class: 7398) VIN: 5TDKZ3DC2LS028419

12/28/2020 02/04/2021 FLAU21020222 02/26/2021 0 0 752 0 0 752

Glass damage to insured vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2019 FORD FLEX (Class: 7398) VIN: 2FMGK5B88KBA17893

01/15/2021 01/21/2021 FLAU21010750 01/29/2021 0 0 813 0 0 813

Insured vehicle backing struck parked claimant vehicle

ACCIDENT LOCATION: Lake City, FL

AUTO: 2018 DODGE GRAND CARAVAN SE (Class: 7398) VIN: 2C4RDGBG8JR311908 INSURED DRIVER: Sheila Rahimpour

02/08/2021 02/09/2021 FLAU21020348 03/05/2021 0 0 0 0 0 0

Insured vehicle went through stop sign and struck claimant vehicle

ACCIDENT LOCATION: Auburndale, FL

AUTO: 2016 FORD E-SERIES BUS (Class: 5892) VIN: 1FDEE3FL5GDC23496 INSURED DRIVER: Joseph Davis

02/21/2021 05/10/2021 FLAU21050503 05/26/2021 0 0 1,208 0 (1,208) 0

Insured stopped vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP2JY304959 INSURED DRIVER: Mona Steagald

02/22/2021 03/02/2021 FLAU21030188 04/06/2021 0 0 1,121 0 0 1,121

Comp / Glass Loss

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP1JY305472 INSURED DRIVER: Lana Johnson

02/26/2021 03/03/2021 FLAU21030205 03/15/2021 0 0 1,962 0 0 1,962

Insured vehicle struck deer

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2021 TOYOTA RAV 4 HYBRID LE AWD SE (Class: 7398) VIN: 4T3L6RFVXMU017277 INSURED DRIVER: Alison Leung

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPNUAU0024153-00

10/20/2020 10/20/2021

NUFIC

02/28/2021 03/02/2021 FLAU21030182 03/08/2021 0 0 7,530 0 0 7,530

Insured vehicle struck by claimant vehicle in intersection

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP7JC247286 INSURED DRIVER: Diane Kendall

03/25/2021 04/06/2021 FLAU21040240 04/13/2021 0 0 2,798 0 0 2,798

Insured vehicle backing struck claimant vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC251091 INSURED DRIVER: Laura Anne Howard

04/13/2021 04/15/2021 FLAU21040628 04/20/2021 0 0 945 0 0 945

Insured vehicle struck a raccoon

ACCIDENT LOCATION: Frostproof, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC248849 INSURED DRIVER: Apryl Rittman

04/23/2021 04/28/2021 FLAU21041160 05/06/2021 0 0 853 0 0 853

Insured vehicle struck parked insured vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 DODGE GRAND CARAVAN SE (Class: 7398) VIN: 2C4RDGBG1JR310342 INSURED DRIVER: Verena Vencil

04/23/2021 04/28/2021 FLAU21041160 05/05/2021 0 0 0 0 0 0

Insured vehicle struck parked insured vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 DODGE GRAND CARAVAN SE (Class: 7398) VIN: 2C4RDGBG8JR311908 INSURED DRIVER: Verena Vencil

05/03/2021 08/10/2021 FLAU21080380 11/10/2021 0 0 0 0 0 0

Rock cracked glass on Insured vehicle

ACCIDENT LOCATION: Wildwood, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3APXJC247198

05/10/2021 05/14/2021 FLAU21050656 08/24/2021 0 0 0 0 0 0

Glass damage to insured vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2015 GOSHEN COACH SERVICE (Class: 21499) VIN: 1FDEE3FS3FDA35047

05/28/2021 06/24/2021 FLAU21060902 09/13/2021 0 0 520 0 0 520

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPNUAU0024153-00

10/20/2020 10/20/2021

NUFIC

Comp / Glass Loss

ACCIDENT LOCATION: Ocoee, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP7JC248857

06/22/2021 06/24/2021 FLAU21060900 07/12/2021 0 0 1,319 0 0 1,319

Claimant turning from side road, pulled in to path of insured.

ACCIDENT LOCATION: Ocala, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP6JC250499 INSURED DRIVER: Andrea Fowler

07/05/2021 07/07/2021 FLAU21070229 07/12/2021 0 0 481 0 0 481

Insured vehicle backing struck claimant property

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2012 TOYOTA TACOMA SERVICE (Class: 01499) VIN: 3TMMU4FNXCM046873 INSURED DRIVER: Barry Walton

07/20/2021 08/05/2021 FLAU21080270 09/30/2021 0 0 20,795 0 (20,795) 0

Insured vehicle struck claimant vehicle turning into their lane

ACCIDENT LOCATION: Clearwater, FL

AUTO: 2017 FORD FUSION 4 (Class: 7398) VIN: 3FA6P0G70HR236173 INSURED DRIVER: Lacey Anne Tatro

07/30/2021 08/02/2021 FLAU21080075 10/19/2021 0 0 6,060 0 0 6,060

Stopped insured vehicle struck by claimant vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2012 FORD FOCUS (Class: 7398) VIN: 1FAHP3F27CL106365 INSURED DRIVER: Sheila Chevron-Brown

08/20/2021 08/24/2021 FLAU21080848 09/29/2021 0 0 0 0 0 0

Insured vehicle struck in rear by other vehicle while making a right hand turn

ACCIDENT LOCATION: Fort Pierce, FL

AUTO: 2013 FORD FUSION (Class: 7398) VIN: 3FA6P0G71DR138537 INSURED DRIVER: Stephen Gosnell

08/20/2021 09/28/2021 FLAU21080848 09/29/2021 0 0 2,573 0 (2,449) 124

Insured vehicle struck in rear by other vehicle while making a right hand turn

ACCIDENT LOCATION: Fort Pierce, FL

AUTO: 2017 FORD FUSION (Class: 7398) VIN: 3FA6P0G70HR108175 INSURED DRIVER: Stephen Gosnell

08/24/2021 08/27/2021 FLAU21090655 09/20/2021 0 0 945 0 (929) 15

Claimant vehicle backing out of parking space and struck Insured vehicle

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPNUAU0024153-00

10/20/2020 10/20/2021

NUFIC

ACCIDENT LOCATION: Vero Beach, FL

AUTO: 2016 FORD TAURUS SE (Class: 7398) VIN: 1FAHP2D86GG100413 INSURED DRIVER: Edward Arens Jr

08/30/2021 09/07/2021 FLAU21090353 11/03/2021 0 0 0 0 0 0

Glass damage to Insured vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3APXJC247136

09/07/2021 09/17/2021 FLAU21090910 11/03/2021 0 0 1,517 0 0 1,517

Comp / Glass Loss

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC248849

10/11/2021 10/12/2021 FLAU21100467 10/20/2021 0 0 1,365 0 0 1,365

Glass damage to insured vehicle

ACCIDENT LOCATION: Ocala, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP6JC250499 INSURED DRIVER: Andrea Fowler

10/12/2021 10/12/2021 FLAU21100391 03/16/2022 0 0 25,610 0 (2,363) 23,247

Insured vehicle rear-ended claimant vehicle.

ACCIDENT LOCATION: Fort Myers, FL

AUTO: 2019 CHEVY IMPALA (Class: 7398) VIN: 2G11X56S31K9144503 INSURED DRIVER: Mark Edward Moore

10/14/2021 10/15/2021 FLAU21100624 12/08/2021 0 0 676 0 0 676

comp/Glass damage to insured vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP6JC248753 INSURED DRIVER: Jonesha Bean

NO FAULT

07/20/2021 08/13/2021 FLAU21080521 01/18/2022 0 0 0 0 0 0

The insured vehicle struck claimant vehicle while claimant was turning left into their lane.

ACCIDENT LOCATION: Clearwater, FL

GPNUAU0024153-00 Totals: 90,000 0 114,696 1,212 (27,992) 177,917

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPNUAU0024153-01

10/20/2021 10/20/2022

NUFIC

AUTO LIABILITY

10/21/2021 10/25/2021 FLAU21100926 11/01/2021 0 0 0 0 0 0

Other vehicle rear-ended insured vehicle

ACCIDENT LOCATION: Winter Haven, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP0JC247291 INSURED DRIVER: Amanda Sanchez

10/23/2021 10/27/2021 FLAU21101067 11/08/2021 0 0 0 0 0 0

Stopped insured vehicle rear ended by claimant vehicle at light

ACCIDENT LOCATION: Tallahassee, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP2JY304105 INSURED DRIVER: Joanna Segarra

10/26/2021 10/29/2021 FLAU21110026 11/03/2021 0 0 0 0 0 0

Insured vehicle rear ended by claimant vehicle in heavy traffice

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP4JY300136 INSURED DRIVER: Lucas Suazo

02/01/2022 02/03/2022 FLAU22020144 02/16/2022 0 0 0 0 0 0

Insured vehicle was stopped and rear ended by claimant vehicle 002 and impact pushed insured vehicle into the rear of claimant vehicle 003

ACCIDENT LOCATION: Plant City, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC251091 INSURED DRIVER: Laura Howard

02/26/2022 03/01/2022 FLAU22030089 03/14/2022 0 0 0 0 0 0

Insured vehicle responding, and backed into carport at scene

ACCIDENT LOCATION: Winter Park, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC249855

03/15/2022 03/23/2022 FLAU22031034 04/07/2022 0 0 0 0 0 0

Insured vehicle struck claimant vehicle.

ACCIDENT LOCATION: Tallahassee, FL

AUTO: 2016 NISSAN FRONTIER SERVICE (Class: 01499) VIN: 1N6BD0CT5GN750331 INSURED DRIVER: James Nicolas

AUTO PHYSICAL DAMAGE

10/21/2021 10/25/2021 FLAU21100926 11/01/2021 0 0 11,812 0 (9,668) 2,144

Other vehicle rear-ended insured vehicle

ACCIDENT LOCATION: Winter Haven, FL

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPNUAU0024153-01

10/20/2021 10/20/2022

NUFIC

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP0JC247291 INSURED DRIVER: Amanda Sanchez

10/23/2021 10/27/2021 FLAU21101067 11/08/2021 0 0 0 0 0 0

Stopped insured vehicle rear ended by claimant vehicle at light

ACCIDENT LOCATION: Tallahassee, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP2JY304105 INSURED DRIVER: Joanna Segarra

11/08/2021 01/06/2022 FLAU22010292 01/26/2022 0 0 1,116 0 0 1,116

Insured vehicle struck curb

ACCIDENT LOCATION: Kissimmee, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3APXJC249226 INSURED DRIVER: Porsche Fletcher

11/16/2021 02/14/2022 FLAU22020573 02/22/2022 0 0 373 0 0 373

Insured vehicle struck deer

ACCIDENT LOCATION: Fort Meade, FL

AUTO: 2020 FORD SUPER CREW (Class: 01499) VIN: 1FTFW1E53LKD06248 INSURED DRIVER: Aaron Medley

11/17/2021 11/19/2021 FLAU21110807 03/03/2022 0 0 0 0 0 0

Insured vehicle glass damage

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2020 FORD TRANSIT 350 WAGON (Class: 5882) VIN: 1FBAX2Y82LKA04974

12/03/2021 12/08/2021 FLAU21120387 02/11/2022 0 0 8,133 0 0 8,133

Insured vehicle rear ended by claimant vehicle

ACCIDENT LOCATION: West Palm Beach, FL

AUTO: 2018 MERCEDES E 300 (Class: 7398) VIN: WDDZF4JB7JA482934 INSURED DRIVER: John Kelly

12/20/2021 12/23/2021 FLAU21120938 12/30/2021 0 0 466 0 0 466

Insured vehicle backing struck sidewalk

ACCIDENT LOCATION: Marianna, FL

AUTO: 2020 TOYOTA SIENNA 8 PASSENGER VAN (Class: 7398) VIN: 5TDKZ3DC2LS028419

01/13/2022 01/13/2022 FLAU22010597 04/27/2022 0 0 461 0 0 461

Comp / Glass Loss

ACCIDENT LOCATION: Orlando, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP7JC247286 INSURED DRIVER: Jangel Cubero

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPNUAU0024153-01

10/20/2021 10/20/2022

NUFIC

02/01/2022 02/03/2022 FLAU22020144 02/23/2022 0 0 18,753 0 (10,068) 8,686

Insured vehicle was stopped and rear ended by claimant vehicle 002 and impact pushed insured vehicle into the rear of claimant vehicle 003

ACCIDENT LOCATION: Plant City, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC251091 INSURED DRIVER: Laura Howard

02/26/2022 02/26/2022 FLAU22030089 04/11/2022 0 0 1,765 0 0 1,765

Insured vehicle responding, and backed into carport at scene

ACCIDENT LOCATION: Winter Park, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC249855

03/04/2022 03/08/2022 FLAU22030353 05/23/2022 0 0 0 0 0 0

Glass damage to insured vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP2JY304105

03/15/2022 03/16/2022 FLAU22030760 03/29/2022 0 0 505 0 0 505

Insured vehicle damaged by unsecured pallet that flew off claimant vehicle

ACCIDENT LOCATION: Citra, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP5JY302929 INSURED DRIVER: Richard Arens

03/15/2022 03/23/2022 FLAU22031034 04/01/2022 0 0 10,244 0 0 10,244

Insured vehicle struck claimant vehicle.

ACCIDENT LOCATION: Tallahassee, FL

AUTO: 2016 NISSAN FRONTIER SERVICE (Class: 01499) VIN: 1N6BD0CT5GN750331 INSURED DRIVER: James Nicolas

03/21/2022 03/23/2022 FLAU22031035 03/31/2022 0 0 474 0 0 474

Glass damage to insured vehicle.

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC247459

03/24/2022 04/08/2022 FLAU22040359 05/02/2022 0 0 3,271 0 0 3,271

Insured vehicle damaged when gate blew closed on insured vehicle

ACCIDENT LOCATION: Lakeland, FL

AUTO: 2016 FORD E-SERIES BUS (Class: 5892) VIN: 1FDEE3FL5GDC23496

03/30/2022 03/31/2022 FLAU22031352 04/11/2022 0 0 0 0 0 0

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Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPNUAU0024153-01

10/20/2021 10/20/2022

NUFIC

Insured vehicle vandalized

ACCIDENT LOCATION: Wildwood, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP2JY304959

04/08/2022 04/12/2022 FLAU22040426 04/15/2022 0 0 676 0 0 676

comp/Glass damage to Insured vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP9JC250920

04/22/2022 05/12/2022 FLAU22050484 05/23/2022 0 0 1,354 0 0 1,354

Insured vehicle struck by golf cart

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2011 FORD ESCAPE (Class: 7398) VIN: 1FMCU9DG2BKC12284

06/10/2022 06/15/2022 FLAU22060685 06/24/2022 0 0 461 0 0 461

Glass damage to insured vehicle

ACCIDENT LOCATION: Lakeland, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP9JC250450 INSURED DRIVER: Alleyn Tanner GPNUAU0024153-01 Totals: 0 0 59,862 0 (19,736) 40,126

GPPAAU4050065-00

10/20/2017 10/20/2018

AAIC

AUTO LIABILITY

11/01/2017 11/08/2017 FLAU217110580 04/19/2018 0 0 2,000 1,060 0 3,060

INSURED VEHICLE TURNING LEFT, CLAIMANT VEHICLE TURNING RIGHT

AND THE VEHICLES IMPACTED

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2017 FORD SUPER DUTY E450 (Class: 21499) VIN: 1FDFE4FS9HDC31975

04/12/2018 04/13/2018 FLAU218040910 05/16/2018 0 0 1,391 131 0 1,522

WHILE BACKING, THE INSURED VEHICLE STRUCK THE CLAIMANT'S

VEHICLE

ACCIDENT LOCATION: JACKSONVILLE, FL

AUTO: 2016 GMC YUKON DENALI (Class: 7398) VIN: 1GKS1CKJGR337755 INSURED DRIVER: WILLIAM L MOON SR

07/24/2018 07/30/2018 FLAU18071288 08/06/2018 0 0 1,264 0 0 1,264

Insured backing out of parking space and struck parked vehicle.

ACCIDENT LOCATION: St Petersburg, FL

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

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Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPPAAU4050065-00

10/20/2017 10/20/2018

AAIC

AUTO: 2012 FORD FUSION (Class: 7398) VIN: 3FAHP0GA6CR418893 INSURED DRIVER: Willengy W Ramos

07/29/2018 08/07/2018 FLAU18080315 09/07/2018 0 0 506 0 0 506

The insured backed into the claimant vehicle while parking

ACCIDENT LOCATION: Titusville, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC251091 INSURED DRIVER: Victoria Entz

09/07/2018 09/10/2018 FLAU18090398 10/01/2018 0 0 0 0 0 0

Insured vehicle, while traveling on main roadway, was struck by claimant vehicle who failed to yield right of way at a stop sign.

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC247459 INSURED DRIVER: Margaritta Karen Fisher- Gordon

09/10/2018 09/13/2018 FLAU18090601 09/21/2018 0 0 0 0 0 0

Clmt veh rear-ended insd veh

ACCIDENT LOCATION: Ocala, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP2JY304105 INSURED DRIVER: Benjamin Bums

09/13/2018 09/13/2018 FLAU18090596 10/02/2018 0 0 0 0 0 0

The insured's vehicle was struck by the claimant's vehicle as the claimant attempted to change lanes.

ACCIDENT LOCATION: Lakeland, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP7JC247272 INSURED DRIVER: Alicia Siska

AUTO PHYSICAL DAMAGE

11/01/2017 11/08/2017 FLAU217110580 11/28/2017 0 0 1,099 0 0 1,099

INSURED VEHICLE TURNING LEFT, CLAIMANT VEHICLE TURNING RIGHT

AND THE VEHICLES IMPACTED

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2017 FORD SUPER DUTY E450 (Class: 21499) VIN: 1FDFE4FS9HDC31975

04/12/2018 04/13/2018 FLAU218040910 04/23/2018 0 0 0 0 0 0

WHILE BACKING, THE INSURED VEHICLE STRUCK THE CLAIMANT'S

VEHICLE

ACCIDENT LOCATION: JACKSONVILLE, FL

AUTO: 2016 GMC YUKON DENALI (Class: 7398) VIN: 1GKS1CKJGR337755 INSURED DRIVER: WILLIAM L MOON SR

05/16/2018 06/20/2018 FLAU218061050 06/22/2018 0 0 2,107 0 0 2,107

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

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Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPPAAU4050065-00

10/20/2017 10/20/2018

AAIC

DAMAGED FOUND ON INSD VEH

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2013 TOYOTA SIENNA (Class: 7398) VIN: 5TDZK3DC7DS326145

06/01/2018 06/08/2018 FLAU218060564 07/17/2018 0 0 6,501 0 0 6,501

INSD VEH STOLEN, VEH RECOVERED WITH DAMAGE

ACCIDENT LOCATION: FORT MYERS, FL

AUTO: 2007 FORD ECONOLINE E250 SERVICE (Class: 01499) VIN: 1FTNE24W27DA11649

07/29/2018 08/07/2018 FLAU18080315 08/22/2018 0 0 87 0 0 87

The insured backed into the claimant vehicle while parking

ACCIDENT LOCATION: Titusville, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC251091 INSURED DRIVER: Victoria Entz

08/14/2018 08/16/2018 FLAU18080725 09/04/2018 0 0 584 0 0 584

Insd veh damaged

ACCIDENT LOCATION: Fort Meade, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP7JC247286 INSURED DRIVER: Diane Kendall

08/16/2018 08/16/2018 FLAU18080757 11/19/2018 0 0 309 0 (309) 0

insured vehicle damaged

ACCIDENT LOCATION: Tallahassee, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP0JC247291 INSURED DRIVER: katrina Boodhan

08/20/2018 08/21/2018 FLAU18080884 08/27/2018 0 0 64 0 0 64

Glass damage to Insd veh

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2014 FORD EXPORER (Class: 7398) VIN: 1FM5K8B87EGA92011 INSURED DRIVER: Sara Oliver

08/27/2018 08/27/2018 FLAU18081154 08/31/2018 0 0 365 0 0 365

Insd veh damaged

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2011 GMC SIERRA SERVICE (Class: 01499) VIN: 1GT12ZC84BF142324

08/29/2018 08/30/2018 FLAU18090023 09/17/2018 0 0 1,268 0 0 1,268

Parked insd veh damaged by clmt veh

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

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Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPPAAU4050065-00

10/20/2017 10/20/2018

AAIC

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 GMC TERRAIN (Class: 7398) VIN: GKALMEV1JL208582 INSURED DRIVER: Tim Parenton

09/07/2018 09/10/2018 FLAU18090398 09/14/2018 0 0 6,962 0 0 6,962

Insured vehicle, while traveling on main roadway, was struck by claimant vehicle who failed to yield right of way at a stop sign.

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC247459 INSURED DRIVER: Margaritta Karen Fisher- Gordon

09/10/2018 09/13/2018 FLAU18090601 09/20/2018 0 0 2,381 0 (233) 2,147

Clmt veh rear-ended insd veh

ACCIDENT LOCATION: Ocala, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP2JY304105 INSURED DRIVER: Benjamin Bums

09/13/2018 09/13/2018 FLAU18090596 09/20/2018 0 0 6,452 0 (6,452) 0

The insured's vehicle was struck by the claimant's vehicle as the claimant attempted to change lanes.

ACCIDENT LOCATION: Lakeland, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP7JC247272 INSURED DRIVER: Alicia Siska

09/15/2018 10/03/2018 FLAU18100284 04/19/2019 0 0 0 0 0 0

Insd veh damaged

ACCIDENT LOCATION: Tallahassee, FL

AUTO: 2015 GOSHEN COACH SERVICE (Class: 21499) VIN: 1FDEE3FS3FDA35047

09/30/2018 10/02/2018 FLAU18100168 10/12/2018 0 0 396 0 0 396

Insd veh damaged running over rubber from blown tire of clmt veh

ACCIDENT LOCATION: Macon, GA

AUTO: 2018 MAZDA M3S GT A (Class: 7398) VIN: 3MZBN1W36JM187581 INSURED DRIVER: Matthew Driscoll

10/01/2018 10/17/2018 FLAU18101105 11/21/2018 0 0 380 0 0 380

Insd veh damaged turning around in parking lot

ACCIDENT LOCATION: Rockledge, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP5JC249229 INSURED DRIVER: Rickey McConn

10/04/2018 10/10/2018 FLAU18100610 12/19/2018 0 0 507 0 0 507

Insd veh damaged

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

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Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPPAAU4050065-00

10/20/2017 10/20/2018

AAIC

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC251091 INSURED DRIVER: Victoria Entz

10/08/2018 10/11/2018 FLAU18100578 10/19/2018 0 0 0 0 0 0

Insd veh vandalized by unknowns

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP0JY303552 INSURED DRIVER: Jason Burdick

10/18/2018 10/25/2018 FLAU18101208 10/31/2018 0 0 8,603 0 (8,603) 0

I/V & C/V collided at intersection

ACCIDENT LOCATION: Tallahassee, FL

AUTO: 2014 TOYOTA PRIUS (Class: 7398) VIN: JTDKDTB3XE1081385 INSURED DRIVER: Shonda Jackson

NO FAULT

09/07/2018 10/15/2018 FLAU18100672 10/18/2018 0 0 0 0 0 0

Insured vehicle, while traveling on main roadway, was struck by claimant vehicle who failed to yield right of way at a stop sign.

ACCIDENT LOCATION: TALLAHASSEE, FL

GPPAAU4050065-00 Totals: 0 0 43,224 1,191 (15,597) 28,818

GPPAAU4050065-01

10/20/2018 10/20/2019

AAIC

AUTO LIABILITY

04/23/2019 04/24/2019 FLAU19041010 05/06/2019 0 0 0 0 0 0

The insured vehicle was rear ended by claimant vehicle one and pushed into claimant vehicle two.

ACCIDENT LOCATION: Orlando, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3APXJC250800 INSURED DRIVER: Sherman George

07/23/2019 07/25/2019 FLAU19071336 08/27/2019 0 0 0 0 0 0

Insured parked vehicle struck by claimant vehicle

ACCIDENT LOCATION: Wildwood, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3APXJC247198

08/19/2019 08/21/2019 FLAU19080851 08/30/2019 0 0 1,476 154 0 1,631

Insured vehicle backing struck parked claimant vehicle

ACCIDENT LOCATION: Crystal River, FL

AUTO: 2011 GMC SIERRA SERVICE (Class: 01499) VIN: 1GT12ZC84BF142324 INSURED DRIVER: Ashley Dawdy

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

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SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPPAAU4050065-01

10/20/2018 10/20/2019

AAIC

AUTO PHYSICAL DAMAGE

10/29/2018 10/29/2018 FLAU18101363 11/02/2018 0 0 1,274 0 0 1,274

Insd vehicle vandalized in parking lot

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 DODGE GRAND CARAVAN SE (Class: 7398) VIN: 2C4RDGBG1JR310342

11/24/2018 11/26/2018 FLAU18111063 01/15/2019 0 0 571 0 0 571

Glass damage to Insd veh

ACCIDENT LOCATION: Merritt Island, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC248690 INSURED DRIVER: Corrin Casper

12/14/2018 02/06/2019 FLAU19020243 05/08/2019 0 0 560 0 0 560

Insd veh damaged

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP5JY302929 INSURED DRIVER: Andrea Rhodes

12/15/2018 01/02/2019 FLAU19010073 01/18/2019 0 0 610 0 0 610

Glass cracked on I/V

ACCIDENT LOCATION: Gainesville, FL

AUTO: 2016 FORD F-150 SERVICE (Class: 01499) VIN: 1FTEW1EG2GKD82434 INSURED DRIVER: Charles Cobb

12/24/2018 12/27/2018 FLAU18120935 01/28/2019 0 0 564 0 0 564

Gravel rock from road damaged glass on I/V

ACCIDENT LOCATION: Ocala, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP7JC248857 INSURED DRIVER: LaTrina Wallace

12/27/2018 12/27/2018 FLAU18120956 02/01/2019 0 0 809 0 (564) 245

Insured vehicle struck by rock

ACCIDENT LOCATION: Kissimmee, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP5JC251062 INSURED DRIVER: Gerald Poke

12/28/2018 01/07/2019 FLAU19010241 01/18/2019 0 0 64 0 0 64

Insured vehicle damaged by rock

ACCIDENT LOCATION: Tallahassee, FL

AUTO: 2018 DODGE GRAND CARAVAN SE (Class: 7398) VIN: 2C4RDGBG8JR311908

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

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Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPPAAU4050065-01

10/20/2018 10/20/2019

AAIC

01/17/2019 01/21/2019 FLAU19010801 03/22/2019 0 0 468 0 0 468

Insd veh damaged

ACCIDENT LOCATION: Tallahassee, FL

AUTO: 2016 FORD TRANSIT T-350 SERVICE (Class: 01499) VIN: 1FBZX2CM1GKB57343

01/28/2019 01/30/2019 FLAU19011285 02/08/2019 0 0 0 0 0 0

Insd veh ran over object in road damaging vehicle.

ACCIDENT LOCATION: Homosassa, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP6JC248722 INSURED DRIVER: Cindy Harrell

04/10/2019 04/11/2019 FLAU19040531 04/22/2019 0 0 77 0 0 77

Insd veh struck clmt property

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP9JC250450 INSURED DRIVER: David Martine

04/23/2019 04/24/2019 FLAU19041010 05/03/2019 0 0 19,350 0 (18,431) 918

The insured vehicle was rear ended by claimant vehicle one and pushed into claimant vehicle two.

ACCIDENT LOCATION: Orlando, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3APXJC250800 INSURED DRIVER: Sherman George

05/17/2019 05/17/2019 FLAU19050718 05/29/2019 0 0 0 0 0 0

Insd veh rear ended by clmt veh at intersection

ACCIDENT LOCATION: Orlando, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC249855

07/09/2019 07/11/2019 FLAU19070501 09/09/2019 0 0 584 0 0 584

Insd veh damaged

ACCIDENT LOCATION: Mount Dora, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3APXJC249226 INSURED DRIVER: Porsche Fletcher

07/12/2019 07/12/2019 FLAU19070543 08/08/2019 0 0 584 0 0 584

Insured vehicle damaged

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP9JC250450 INSURED DRIVER: David Martine

07/23/2019 07/25/2019 FLAU19071336 08/20/2019 0 0 247 0 0 247

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

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Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPPAAU4050065-01

10/20/2018 10/20/2019

AAIC

Insured parked vehicle struck by claimant vehicle

ACCIDENT LOCATION: Wildwood, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3APXJC247198

07/26/2019 07/30/2019 FLAU19071302 08/14/2019 0 0 4,208 0 0 4,208

Insured vehicle backing struck concrete pole

ACCIDENT LOCATION: Fort Lauderdale, FL

AUTO: 2016 FORD EXPLORER (Class: 7398) VIN: 1FM5K8B85GGB97570 INSURED DRIVER: George Borges

08/07/2019 08/19/2019 FLAU19080761 08/23/2019 0 0 564 0 0 564

Insured vehicle parked and struck by claimant vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN SENTRA (Class: 7398) VIN: 3N1AB7AP2JY304105

08/15/2019 08/19/2019 FLAU19080742 10/02/2019 0 0 27 0 0 27

Insured vehicle rear ended by claimant vehicle at intersection

ACCIDENT LOCATION: Orlando, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC248690 INSURED DRIVER: Jaime Drake

09/10/2019 10/16/2019 FLAU19100649 10/22/2019 0 0 599 0 0 599

Damage to insured vehicle of unknown origin

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2019 DODGE CARAVAN (Class: 7398) VIN: 2C4RDGBG3KR665000 INSURED DRIVER: Scott Weinman

09/29/2019 10/01/2019 FLAU19100054 10/17/2019 0 0 529 0 0 529

Insured vehicle damaged

ACCIDENT LOCATION: Mount Dora, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3APXJC249226

10/03/2019 10/03/2019 FLAU19100199 10/11/2019 0 0 2,780 0 0 2,780

Insured damaged after striking raccoon

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP0JC247291 INSURED DRIVER: Alexandra Calhoun GPPAAU4050065-01 Totals: 0 0 35,943 154 (18,995) 17,102

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

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Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPPAAU4050065-02

10/20/2019 10/20/2020

AAIC

AUTO LIABILITY

12/06/2019 12/12/2019 FLAU19120530 01/07/2020 0 0 0 0 0 0

Other vehicle struck insured vehicle at intersection

ACCIDENT LOCATION: Vero Beach, FL

AUTO: 2014 FORD FUSION (Class: 7398) VIN: 1FA6POH72E5406434 INSURED DRIVER: Ryan Butler

12/19/2019 02/12/2020 FLAU20020423 02/14/2020 0 0 0 0 0 0

Stopped insured vehicle was rear ended by claimant vehicle#1 and pushed into claimant vehicle#2

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2017 TOYOTA CAMRY LE/XLE/SE/XSE (Class: 7398) VIN: 4T1BF1FK7HU442263 INSURED DRIVER: Jaron Ray Fairman

02/10/2020 03/04/2020 FLAU20030160 03/18/2020 0 0 2,864 0 0 2,864

Insured vehicle opening door struck claimant vehicle

ACCIDENT LOCATION: Fort Pierce, FL

AUTO: 2016 FORD TAURUS SE (Class: 7398) VIN: 1FAHP2D86GG100413 INSURED DRIVER: Edward Arens Jr

03/18/2020 03/19/2020 FLAU20030664 06/08/2020 0 0 1,725 0 0 1,725

Insured vehicle backed into claimant vehicle

ACCIDENT LOCATION: Inverness, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP0JC251034 INSURED DRIVER: Joseph Lamendola 05/01/2020 05/05/2020 FLAU20050128 Open 40,000 10,000 1,784 157 0 51,941

The insured improperly merged into a lane where the claimant was proceeding with the right-of-way and sideswiped the passenger side rear of the claimant vehicle.

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC249208 INSURED DRIVER: Shanique Frederick

AUTO PHYSICAL DAMAGE

12/06/2019 12/12/2019 FLAU19120530 01/10/2020 0 0 10,926 0 (10,926) 0

Other vehicle struck insured vehicle at intersection

ACCIDENT LOCATION: Vero Beach, FL

AUTO: 2014 FORD FUSION (Class: 7398) VIN: 1FA6POH72E5406434 INSURED DRIVER: Ryan Butler

12/09/2019 12/10/2019 FLAU19120413 01/03/2020 0 0 683 0 0 683

comp/glass damage

ACCIDENT LOCATION: TALLAHASSEE, FL

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPPAAU4050065-02

10/20/2019 10/20/2020

AAIC

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC249208 INSURED DRIVER: Shanique Frederick

12/19/2019 02/12/2020 FLAU20020423 05/08/2020 0 0 18,657 0 (16,575) 2,082

Stopped insured vehicle was rear ended by claimant vehicle#1 and pushed into claimant vehicle#2

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2017 TOYOTA CAMRY LE/XLE/SE/XSE (Class: 7398) VIN: 4T1BF1FK7HU442263 INSURED DRIVER: Jaron Ray Fairman

01/21/2020 01/24/2020 FLAU20011863 01/28/2020 0 0 819 0 0 819

Insured vehicle damaged hitting a pot hole

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3APXJC249100 INSURED DRIVER: Melissa Creeger

02/10/2020 03/04/2020 FLAU20030160 03/17/2020 0 0 0 0 0 0

Insured vehicle opening door struck claimant vehicle

ACCIDENT LOCATION: Fort Pierce, FL

AUTO: 2016 FORD TAURUS SE (Class: 7398) VIN: 1FAHP2D86GG100413 INSURED DRIVER: Edward Arens Jr

03/02/2020 03/04/2020 FLAU20030156 03/31/2020 0 0 403 0 0 403

Insured vehicle struck curb

ACCIDENT LOCATION: Lakeland, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP7JC247286 INSURED DRIVER: Diane Kendall

03/15/2020 03/17/2020 FLAU20030613 03/18/2020 0 0 769 0 0 769

Insured vehicle went into ditch at clients home

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP7JC248857 INSURED DRIVER: Patricia Ireland

03/18/2020 03/19/2020 FLAU20030664 03/25/2020 0 0 0 0 0 0

Insured vehicle backed into claimant vehicle

ACCIDENT LOCATION: Inverness, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP0JC251034 INSURED DRIVER: Joseph Lamendola

04/03/2020 04/06/2020 FLAU20040193 04/30/2020 0 0 3,009 0 (2,819) 190

Wood from other vehicle struck insured vehicle

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP1JC251091 INSURED DRIVER: Brooke Schmeiser

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless

TALLAHASSEE, FL 32399-0950

SUITE 360

Glatfelter Underwriting Services Customer Summary Loss Experience

Including 5 Years of History from claim registration and policy inception

C73827

Customer Detail Sorted By Policy & Coverage Type PC-LE09-E Claims Valued as of Wednesday, July 20, 2022

Policy Number Effective Date Expiration Date Carrier

Coverage __Loss Date ____Description of Accident/Loss

Loss Reported Date Claim Number Closed Date Loss Reserve

Expense Reserve Paid Losses

Paid Expenses Recoveries Total Incurred

GPPAAU4050065-02

10/20/2019 10/20/2020

AAIC

04/10/2020 04/13/2020 FLAU20040326 04/17/2020 0 0 4,973 0 0 4,973

Insured vehicle struck claimant property

ACCIDENT LOCATION: Cocoa, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC248902 INSURED DRIVER: Nicole Steinle

05/01/2020 05/05/2020 FLAU20050128 05/08/2020 0 0 1,410 0 0 1,410

The insured improperly merged into a lane where the claimant was proceeding with the right-of-way and sideswiped the passenger side rear of the claimant vehicle.

ACCIDENT LOCATION: TALLAHASSEE, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP8JC249208 INSURED DRIVER: Shanique Frederick

09/11/2020 09/14/2020 FLAU20090536 09/17/2020 0 0 809 0 0 809

Insured vehicle struck claimant property

ACCIDENT LOCATION: Orlando, FL

AUTO: 2018 NISSAN ALTIMA (Class: 7398) VIN: 1N4AL3AP5JC251062 INSURED DRIVER: Gerald Poke

NO FAULT

12/06/2019 12/16/2019 FLAU19120693 01/06/2020 0 0 0 0 0 0

Other vehicle struck insured vehicle at intersection

ACCIDENT LOCATION: Vero Beach, FL

GPPAAU4050065-02 Totals: 40,000 10,000 48,832 157 (30,320) 68,669

Grand Totals: 130,000 10,000 302,558 2,715 (112,640) 332,632

AAIC American Alternative Insurance Corporation

NUFIC National Union Fire Insurance Company of Pittsburgh, Pa.

NOTE: This report contains proprietary and confidential information that should only be disclosed to internal associates, the agent of record or to the first name insured listed above unless