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WORKERS CONIPENSATION EXPERIENCE RATING
<br />/CC! • Risk Name: JOHNSON.DAVIS INC Risk ID: 097182.140
<br />Rattng Effoctive Date: 03/01/2016 Production Date: 11/13/2015 State: FLORIDA
<br />X{Ssilii?c:
<br />Ad( Cito.Los9'e's ": yl3nT1&st_'c ' :Act tide L(issbS'
<br />:' Aotl?rlilt
<br />oss s Lo§ses': o's''"os:
<br />6s os
<br />FL-A ,26 224,541 334,041 109,497
<br />161,082 60,200 3.15,935
<br />154,853
<br />FL-C •26 1,69 2,535 637
<br />0 60,200 0
<br />0
<br />FL-1) .26 22,67 33,845 11,169
<br />0 60,200 18,125
<br />18,125
<br />)
<br />0t,
<br />(E (C) {tji R'COt38
<br />i SD) EXpoo{orf
<br />(Cj E>tp Priln
<br />jr..) Act CxE:-
<br />(C3j,9Tlla l:i:y
<br />(II)"Act Int.:',':
<br />F'fljii"'•= .
<br />lLossos:(Df:)
<br />loSsok' :`,
<br />I ossos (1{ :�)?
<br />'' ; '- k
<br />i L.4sSPs
<br />A.(I)11oj
<br />s it osprik:;'• .
<br />.26-248,918
<br />370,421
<br />12.1,503
<br />169,219
<br />60,200
<br />� 295,041
<br />135,822
<br />...�,;_. .;..r.
<br />.._ f7r-..
<br />:,�.,� �=siilblitzttfc�valho,�y:>= �.>.:;.:Ralaillekxcessa:'.�����:�:r�-�-<.,�„tToafs'•-._'',,-_”
<br />_
<br />=M:i?`y ' - -
<br />_.
<br />(1 - A) + G
<br />(A)' (F)
<br />(J)
<br />Actual
<br />136,822
<br />J-
<br />244,399
<br />11,397
<br />421,618
<br />(E)
<br />c' (1- A) + G
<br />(A)' (C)
<br />Expected
<br />121,503
<br />244,399
<br />64,719
<br />430,621
<br />i A,;.,.:
<br />:.�,-
<br />- qR�� r :.;>.
<br />_ _ .i/Ir1ItCiAp;TMw;
<br />:_�:r�_ _ :4><'{i;(yfoii'.. •... .
<br />(J)1(K)
<br />Factors
<br />1.00
<br />.98
<br />REVISED RATING
<br />RATING REFLECTS A DECREASE OF 70% MEDICAL ONLY PRIMARY AND EXCESS LOSS
<br />DOLLARS WHERE ERA 13 APPLIED.
<br />RATING REVISED TO REFLECT APPROVED RATING VALUES
<br />O Copyrighi l l)[IM01b, At! fights reserved. This productis comprised of compilations and fnformallon w4ch aro tiro proprietary and oxciusive property of tho I:ational Cotmrg on
<br />Compensation Insurance; Ira. (NCCI). Nb further use, dfsseminallbn, sere, transfer, essigrmfenl of disposition of this product, ln%vholo Orin pad, may be made without the priorwriiten
<br />consent of NCCI. This product is furnished 'As Is"As availab!e-'Wlh a7 defects' and includes Information ava'lab:e at the bme of pub.calion only. NCCI ntaY,es no represonlations or
<br />warranties of any find relating to the product and hereby expressly dsclalms.any and a'I express, statutory, or Imp!ledwounnlies, Including the Implied warranty of merchantabydy, 6lness
<br />for a particular purpoto. -accuracy, comp!atoness, currentness, or correctness ofeny Information or product furnished hereunder. All responsib;bly for the use of and for any and all results
<br />derived of obtained through the use of the product are the end user's and NCCI sha+l'not have any liabiily thereto.
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