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COMBO GROUP ID:6801607 <br />NORTH CAROLINA <br />WORKERS COMPENSATION INSURANCE <br />EXPERIENCE RATING <br />COVERAGE GROUP ID: 28448160 8M SOLAR LLC WRAP UP <br />CARRIER:37354 BUILDERS MUTUAL INSURANCE COMPANY <br />Page 4 <br />RATING DATE: 09/01/25 to 09/01/26 <br />POLICY: WCP109295901 <br />Policy Period: 09/19/22 to 05/01/23 Carrier 17965 Policy WC761932900 <br />Claim Number Class Inj Open = 0 <br />Actual <br />Incurred <br />Primary <br />or #claims Code Typ Closed = 1 Losses <br />Actual <br />Losses <br />Class <br />Code Payroll <br />Exp. <br />Loss <br />Rate <br />Expected D <br />Primary <br />Expected <br />Losses Ratio Losses <br />5190 34,766 .86 299 .34 102 <br />POLICY TOTALS:0 이 34,766 299 102 <br />Release Date:04/12/25 <br />Docusign Envelope ID: 44C13555-A1DE-83DE-8008-D9A38861DC35