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NORTH CAROLINA <br />WORKERS COMPENSATION INSURANCE <br />EXPERIENCE RATING <br />Page <br />COMBO GROUP ID:6801607 <br />CARRIER:37354 BUILDERS MUTUAL INSURANCE COMPANY <br />RATING DATE: 09/01/25 to 09/01/26 <br />POLICY: WCP109295901 <br />3 <br />Policy Period:09/01/23 to 09/01/24 Carrier 37354 Policy WCP109295900 <br />Actual Primary <br />Claim Number <br />or #claims <br />Class <br />Code <br />Inj Open = <br />Typ Closed = 1 <br />Incurred <br />Losses <br />Actual <br />Losses <br />Class <br />Exp. <br />Loss <br />Code Payroll Rate <br />Expected <br />Losses <br />D <br />Ratio <br />Primary <br />Expected <br />Losses <br />8810 1,352,460 .03 406 .45 183 <br />POLICY TOTALS:31,804 25,500 1,952,750 8,763 2,910 <br />Release Date:04/12/25 <br />Docusign Envelope ID: 44C13555-A1DE-83DE-8008-D9A38861DC35