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1 <br /> 32 <br /> NORTH CAROLINA Page 1 <br /> WORKERS COMPENSATION INSURANCE <br /> EXPERIENCE RATING <br /> COMBO GROUP ID: 6801607 RATING DATE: 09/01/25 to 09/01/26 <br /> COVERAGE GROUP ID: 27818530 8M SOLAR LLC <br /> COVERAGE GROUP ID: 28448160 8M SOLAR LLC WRAP UP <br /> COVERAGE GROUP ID: 29686500 8M SOLAR LLC WRAP UP <br /> Policy Actual Actual Expected <br /> Effective Incurred Primary Expected Primary <br /> Date Policy Number Losses Losses Losses Losses <br /> Coverage Group ID 27818530 8M SOLAR LLC <br /> 03/23/21 XWS2262898897 0 0 482 170 <br /> 09/01/21 BNUWC0154977 0 0 6,265 2,077 <br /> 09/01/22 BNUWC0157689 0 0 6,411 2,133 <br /> 09/01/23 WCP109295900 31,804 25,500 8,763 2,910 <br /> Coverage Group ID 28448160 8M SOLAR LLC WRAP UP <br /> 09/19/22 WC761932900 0 0 299 102 <br /> EXPERIENCE TOTALS: A= 31,804 B= 25,500 C= 22,220 D= 7,392 <br /> Actual Excess Losses E = ( A - B ) = 6,304 <br /> Expected Excess Losses F = ( C - D ) = 14,828 <br /> Weighting Value G = .16 <br /> Ballast Value H = 52,440 <br /> Experience Mod Formula Actual Calculation <br /> B + H + ( E x G ) + (( 1 - G ) x F) 77,940 + 1,009 + 12,456 <br /> D + H + ( F x G ) + (( 1 - G ) x F) 59,832 + 2,372 + 12,456 <br /> Experience Modification 1.22 <br /> Expected Losses (thousands) I = 22.220 <br /> Weighted Test Ratio J = 1.87 <br /> ARAP Surcharge Formula Actual Calculation <br /> 1 + ( 0.08 ) x I x ( J - 1 ) 1.25 1 + 1.778 x .838 <br /> ( I + 3 ) ^ 0.5 5.022 <br /> Assigned Risk Adjustment Program (ARAP) Surcharge, If Applicable 1.30 <br /> Release Date: 04/12/25 <br />