ADD 1 ATT 4 RFP-11EAL-220 - Q8 Loss Runs.pdf

35363751 01/01/2022 - 01/01/2023 ATD PKG 0 $0 $0 $0 $0 $0 $0

35363751 01/01/2023 - 01/01/2024 ATD PKG 0 $0 $0 $0 $0 $0 $0

35363751 01/01/2024 - 01/01/2025 ATD PKG 0 $0 $0 $0 $0 $0 $0

35363751 01/01/2025 - 01/01/2026 ATD PKG 0 $0 $0 $0 $0 $0 $0

35363751 01/01/2026 - 01/01/2027 ATD PKG 0 $0 $0 $0 $0 $0 $0

35363751 01/01/2022 - 01/01/2023 MOD PROP 0 $0 $0 $0 $0 $0 $0

35363751 01/01/2023 - 01/01/2024 MOD PROP 0 $0 $0 $0 $0 $0 $0

35363751 01/01/2024 - 01/01/2025 MOD PROP 0 $0 $0 $0 $0 $0 $0

35363751 01/01/2025 - 01/01/2026 MOD PROP 2 $0 $541,175 $17,000 $558,175 $0 $558,175

35363751 01/01/2026 - 01/01/2027 MOD PROP 0 $0 $0 $0 $0 $0 $0

Totals: 2 $0 $541,175 $17,000 $558,175 $0 $558,175

CHUBB BUSINESS LOSS RUN

All dollar amounts displayed represent US dollars

Agency Name: GREGORY & APPEL INC Current As of Date: 07/07/2026 Insured Name: CONSOLIDATED CITY OF INDIANAPOLIS MARION COUNTY Number of Loss Years Requested: 5

Loss Run Summary:

Policy # Policy Term Policy Type No of

Claims/Occurrences Loss & Expense Reserves

Losses Paid Expenses Paid Losses & Expenses Paid

Recovery Total Incurred

- SEE IMPORTANT NOTICE FOLLOWING LOSS RUN DETAILS -

35363751 092025038473 000022

01/01/2025 - 01/01/2026

MOD PROP

Closed 05/13/2025 Indianapolis, IN

05/15/2025 12/17/2025

$0 $0

$121,690 $8,915

$0

$130,605 $0

$130,605 Claimant Name: Consolidated City Of Indianapolis Marion County Loss Description: Policy #35363751 Attach Timeout. There was an arson incident at Broad Ripple Park Community Center (SOV Location: 16-2). It caused damage to the building and contents.

Writing Company: FEDERAL INSURANCE COMPANY 35363751 092025038473 000022

01/01/2025 - 01/01/2026

MOD PROP

Closed 05/13/2025 Indianapolis, IN

05/15/2025 10/06/2025

$0 $0

$2,159 $0 $0

$2,159 $0

$2,159 Claimant Name: Consolidated City Of Indianapolis Marion County Loss Description: Policy #35363751 Attach Timeout. There was an arson incident at Broad Ripple Park Community Center (SOV Location: 16-2). It caused damage to the building and contents.

Writing Company: FEDERAL INSURANCE COMPANY 35363751 092025038473 000022

01/01/2025 - 01/01/2026

MOD PROP

Closed 05/13/2025 Indianapolis, IN

05/15/2025 10/06/2025

$0 $0

$30,836 $275

$0

$31,111 $0

$31,111 Claimant Name: Consolidated City Of Indianapolis Marion County Loss Description: Policy #35363751 Attach Timeout. There was an arson incident at Broad Ripple Park Community Center (SOV Location: 16-2). It caused damage to the building and contents.

Writing Company: FEDERAL INSURANCE COMPANY

CHUBB BUSINESS LOSS RUN

All dollar amounts displayed represent US dollars

Agency Name: GREGORY & APPEL INC Current As of Date: 07/07/2026 Insured Name: CONSOLIDATED CITY OF INDIANAPOLIS MARION COUNTY Number of Loss Years Requested: 5

Loss Run Detail:

Policy # Claim Reference # Claim/Occurrence # Claimant #

Policy Term Policy Type

Claim Status Claim Type (WC Only)

Loss Date Loss Location

Reported Date Close Date

Loss Reserve Expense Reserve

Losses Paid Expenses Paid Recovery

Losses and Expenses Paid Deductible Amount Total Incurred

35363751 092025039892 000024

01/01/2025 - 01/01/2026

MOD PROP

Closed 03/30/2025 Indianapolis, IN

05/20/2025 02/04/2026

$0 $0

$386,490 $7,811

$0

$394,301 $0

$394,301 Claimant Name: Consolidated City Of Indianapolis Marion County Loss Description: CAT 2528 - Shell Claim - Storm damage to buildings - Multiple Blanket Locations - See Statement of Values.

Writing Company: FEDERAL INSURANCE COMPANY

CHUBB BUSINESS LOSS RUN

All dollar amounts displayed represent US dollars

Agency Name: GREGORY & APPEL INC Current As of Date: 07/07/2026 Insured Name: CONSOLIDATED CITY OF INDIANAPOLIS MARION COUNTY Number of Loss Years Requested: 5

Loss Run Detail:

Policy # Claim Reference # Claim/Occurrence # Claimant #

Policy Term Policy Type

Claim Status Claim Type (WC Only)

Loss Date Loss Location

Reported Date Close Date

Loss Reserve Expense Reserve

Losses Paid Expenses Paid Recovery

Losses and Expenses Paid Deductible Amount Total Incurred

- IMPORTANT NOTICE -

THE INFORMATION CONTAINED HEREIN IS PROVIDED “AS IS” AND HAS NOT BEEN AUDITED OR REVIEWED. WE MAKE NO REPRESENTATION AS TO THE ACCURACY OF THIS INFORMATION. THIS INFORMATION IS NOT INTENDED TO AND SHOULD NOT BE RELIED ON TO COMPLY WITH ANY STATUTE, REGULATION OR OTHER LEGAL OR REGULATORY REQUIREMENT. WE RESERVE THE

RIGHT IN OUR DISCRETION TO WITHHOLD SPECIFIC LOSS INFORMATION.

THE WORKERS COMPENSATION CLAIMS SHOWN ON THIS LOSS RUN DO NOT INCLUDE CLAIMS IN THE FOLLOWING STATES: ALASKA, HAWAII, IDAHO, MAINE, MONTANA, NEVEDA, NEW MEXICO, AND OREGON. IF YOU ARE A CHUBB INSURANCE AGENT, PLEASE CONTACT YOUR UNDERWRITER FOR LOSS INFORMATION IN THESE STATES. IF YOU ARE A CHUBB INSURED, PLEASE CONTACT YOUR

INSURANCE AGENT FOR GUIDANCE ON GETTING LOSS INFORMATION IN THESE STATES.

BY RECEIVING THIS INFORMATION, RECIPIENT ACKNOWLEDGES AND AGREES THAT: 1.) WE ARE PROVIDING THIS INFORMATION BASED ON RECIPIENT'S EXPRESS REPRESENTATION THAT RECIPIENT IS REQUESTING SUCH INFORMATION ON BEHALF OF AND/OR WITH THE CONSENT OF RECIPIENT'S CUSTOMER; 2.) RECIPIENT WILL USE THIS INFORMATION ONLY FOR ITS OWN INTERNAL PURPOSES OR FOR SUCH PURPOSES AUTHORIZED BY RECIPIENT'S CUSTOMER; 3.) SUCH INFORMATION IS CONFIDENTIAL AND PROPRIETARY AND MAY BE SUBJECT TO PRIVACY LAWS, REGULATIONS OR OTHER LEGAL REQUIREMENT; 4.) RECIPIENT AGREES TO

PROTECT AND SAFEGUARD THE INFORMATION FROM UNAUTHORIZED USE OR DISCLOSURE.

RHODE ISLAND INSUREDS: IN ACCORDANCE WITH SECTION 27-29-17.5 OF CHAPTER 27-29 OF THE GENERAL LAWS OF RHODE ISLAND, ADDITIONAL INFORMATION ON LOSS RESERVES MAY BE AVAILABLE UPON REQUEST OF THE FIRST NAMED INSURED OR SUCH

INSURED'S AUTHORIZED AGENT OR BROKER.

FOR QUESTIONS REGARDING THE CONTENT OF THIS CHUBB LOSS RUN REPORT, PLEASE CONTACT YOUR CHUBB OFFICE.

Loss Run Header Section:

Agency Name - The name of the current agent or broker associated with the policy.

Current as of Date - This is the date for which the data is valid.

Insured Name - The named insured as stated on the policy of insurance.

Number of Loss Years Requested – This is the 3, 5, 7 or 10 year historical range with the timeframe determined by the most recent policy effective date listed.

Policy Summary:

Policy Number - The number which uniquely identifies a policy for an insured.

Policy Term - The Effective and Expiration Dates for the Policy Term.

Policy Type - The type of policy issued by the company.

Number of Claims/Occurrences - The number of Claims/Occurrences for each Policy Number, Term and Type.

Loss and Expense Reserves - The sum of the outstanding Loss and Expense Reserves for each Policy Number, Term and Type. "*" will be displayed for open Specialty claims.

Losses Paid - The indemnity paid for each Policy Number, Term and Type. This excludes the Net Salvage/Subrogation and reimbursable deductible amounts actually received.

Expenses Paid - The sum of the defense and LAE expenses paid for each Policy Number, Term and Type. This excludes the Net Salvage/Subrogation and reimbursable deductible amounts actually received.

Losses and Expenses Paid - The sum of Losses Paid and Expenses Paid for each Policy Number, Term and Type. This excludes the Net

Salvage/Subrogation and reimbursable deductible amounts actually received.

Recovery - The sum of the Salvage/Subrogation Recovery including expenses paid or received for each Policy Number, Term and Type.

Total Incurred - The sum of the Losses and Expenses Paid including Recovery for each Policy Number, Term and Type. "*" will be displayed for open

Specialty claims.

Totals:

Number of Claims/Occurrences - The number of Claims/Occurrences for all Policy Numbers, Terms and Types in the Summary Section.

Loss and Expense Reserves - The sum of the outstanding Loss and Expense Reserves for all of the Policy Numbers, Terms and Types in the

Summary Section. This does not include Specialty claims.

CHUBB BUSINESS LOSS RUN

Losses Paid - The sum of Losses Paid for all of the Policy Numbers, Terms and Types in the Summary Section. This excludes the Net

Salvage/Subrogation and reimbursable deductible amounts actually received.

Expenses Paid - The sum of Expenses Paid for all of the Policy Numbers, Terms and Types in the Summary Section. This excludes the Net

Salvage/Subrogation and reimbursable deductible amounts actually received.

Losses and Expenses Paid - The sum of Losses Paid and Expenses Paid for all of the Policy Numbers, Terms and Types in the Summary Section.

This excludes the Net Salvage/Subrogation and reimbursable deductible amounts actually received.

Recovery - The sum of the Salvage/Subrogation Recovery including expenses paid or received for all of the Policy Numbers, Term and Types in the

Summary Section.

Total Incurred - The sum of the Losses and Expenses Paid including Recovery for all the Policy Numbers, Term and Types in the Summary Section.

"*" will be displayed for open Specialty claims.

* – In the Loss and Expense Reserves column: This information is not disclosed.

TPA - Denotes claims/occurrences processed by a third party administrator (TPA). Can reflect full or partial term TPA. Actual numbers do not include claims/occurrences processed by TPA's.

Loss Run Details:

Policy # - The number which uniquely identifies a policy for an insured.

Claim Reference # - A unique identifier for a Chubb claim.

Claim/Occurrence # - The unique number for an occurrence of claim associated with a policy. This is used in conjunction with the policy number to identify a claim. It is sequential within a policy number.

Claimant # - The unique number associated with Claimant Name.

Policy Term - The Effective and Expiration Dates for the Policy Term.

Policy Type - The type of policy issued by the company.

Claim Status - The status of a claim as of the Current as of Date. An 'RO' next to the status indicates a Report Only Claim.

Claim Type (WC Only) - The type(s) of loss associated with a coverage on a claim. Only applicable for WC claims.

Loss Location - The City and State where the loss occurred.

Loss Date - The date on which the loss occurred.

Reported Date - The date on which the loss was reported.

Close Date - The date the claim was closed.

Loss Reserve - The sum of the outstanding Loss Reserve for the Claim/Occurrence in the Detail Section. "*" will be displayed for Specialty claims.

Expense Reserve - The sum of the outstanding Expense Reserve for the Claim/Occurrence in the Detail Section. "*" will be displayed for Specialty claims.

Losses Paid – The indemnity paid for the Claim/Occurrence in the Detail Section. This excludes the Net Salvage/Subrogation and reimbursable deductible amounts actually received.

Expenses Paid - The sum of the defense and LAE expenses paid for the Claim/Occurrence in the Detail Section. This excludes the Net

Salvage/Subrogation and reimbursable deductible amounts actually received.

Losses and Expenses Paid – The sum of Losses and Expenses Paid for the Claim/Occurrence in the Detail Section. This excludes the Net

Salvage/Subrogation and reimbursable deductible amounts actually received.

Recovery - The sum of the Salvage/Subrogation Recovery including expenses paid or received for the Claim/Occurrence in the Detail Section.

Total Incurred - The sum of the Losses and Expenses Paid including Recovery for the Claim/Occurrence in the Detail Section.

Claimant Name - The name(s) of the claimant associated with the Claim/Occurrence.

Deductible Amount – Actual deductible recovery, if any, applied to the Claim/Occurrence.

Loss Description - A synopsis of the loss as entered by the claim examiner.

* – In the Loss and Expense Reserve column: This information is not disclosed.

All dollar amounts displayed represent US dollars.