<?xml version="1.0" encoding="utf-8"?>
<BatchDataSet SchemaVersion="1.0" Year="2013" ReportingState="NJ" SubmissionType="LLOYDS">
  <Insurer>
    <NAICNumber>NAICNumb1</NAICNumber>
    <Name>Name1</Name>
    <Contact>
      <FirstName>FirstName1</FirstName>
      <MiddleName>MiddleName1</MiddleName>
      <LastName>LastName1</LastName>
      <NameSuffix>NameSuffix1</NameSuffix>
      <EmailAddress>test@noreply.com</EmailAddress>
      <ContactAddress>
        <Address>Address1</Address>
        <Address2>Address21</Address2>
        <City>City1</City>
        <StateCode>AL</StateCode>
        <PostalCode>12345</PostalCode>
        <CountryCode>USA</CountryCode>
      </ContactAddress>
      <PhoneNumber>8503831011</PhoneNumber>
      <Fax>8503831015</Fax>
    </Contact>
  </Insurer>
  <Brokerages>
    <Brokerage Xml_BrokerageID="1">
      <SLANumber>SLAN1</SLANumber>
      <LicenseNumber>LicenseNu1</LicenseNumber>
      <Name>Name1</Name>
      <Policies>
        <Policy Xml_PolicyID="1">
          <PolicyType>B</PolicyType>
          <UMR>B1234ABCDEFGHIJKL</UMR>
          <EffectiveDate>1900-01-01</EffectiveDate>
          <ExpirationDate>1900-01-01</ExpirationDate>
          <PolicyHolder>Policy Holder</PolicyHolder>
          <Transactions>
            <Transaction Xml_TransactionID="1">
              <SLATransactionNumber>S0001-00-00001</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="2">
              <SLATransactionNumber>S0001-00-00002</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="3">
              <SLATransactionNumber>S0001-00-00003</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
          </Transactions>
        </Policy>
        <Policy Xml_PolicyID="2">
          <PolicyType>B</PolicyType>
          <UMR>B1234ABCDEFGHIJKL</UMR>
          <EffectiveDate>1900-01-01</EffectiveDate>
          <ExpirationDate>1900-01-01</ExpirationDate>
          <PolicyHolder>Policy Holder</PolicyHolder>
          <Transactions>
            <Transaction Xml_TransactionID="4">
              <SLATransactionNumber>S0001-00-00004</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="5">
              <SLATransactionNumber>S0001-00-00005</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="6">
              <SLATransactionNumber>S0001-00-00006</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
          </Transactions>
        </Policy>
      </Policies>
    </Brokerage>
    <Brokerage Xml_BrokerageID="2">
      <SLANumber>SLAN2</SLANumber>
      <LicenseNumber>LicenseNu2</LicenseNumber>
      <Name>Name2</Name>
      <Policies>
        <Policy Xml_PolicyID="4">
          <PolicyType>B</PolicyType>
          <UMR>B1234ABCDEFGHIJKL</UMR>
          <EffectiveDate>1900-01-01</EffectiveDate>
          <ExpirationDate>1900-01-01</ExpirationDate>
          <PolicyHolder>Policy Holder</PolicyHolder>
          <Transactions>
            <Transaction Xml_TransactionID="10">
              <SLATransactionNumber>S0001-00-00010</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="11">
              <SLATransactionNumber>S0001-00-00011</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="12">
              <SLATransactionNumber>S0001-00-00012</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
          </Transactions>
        </Policy>
        <Policy Xml_PolicyID="5">
          <PolicyType>B</PolicyType>
          <UMR>B1234ABCDEFGHIJKL</UMR>
          <EffectiveDate>1900-01-01</EffectiveDate>
          <ExpirationDate>1900-01-01</ExpirationDate>
          <PolicyHolder>Policy Holder</PolicyHolder>
          <Transactions>
            <Transaction Xml_TransactionID="20">
              <SLATransactionNumber>S0001-00-00020</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="21">
              <SLATransactionNumber>S0001-00-00021</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="22">
              <SLATransactionNumber>S0001-00-00022</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
          </Transactions>
        </Policy>
      </Policies>
    </Brokerage>
    <Brokerage Xml_BrokerageID="3">
      <SLANumber>SLAN3</SLANumber>
      <LicenseNumber>LicenseNu3</LicenseNumber>
      <Name>Name3</Name>
      <Policies>
        <Policy Xml_PolicyID="7">
          <PolicyType>B</PolicyType>
          <UMR>B1234ABCDEFGHIJKL</UMR>
          <EffectiveDate>1900-01-01</EffectiveDate>
          <ExpirationDate>1900-01-01</ExpirationDate>
          <PolicyHolder>Policy Holder</PolicyHolder>
          <Transactions>
            <Transaction Xml_TransactionID="30">
              <SLATransactionNumber>S0001-00-00030</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="31">
              <SLATransactionNumber>S0001-00-00031</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="32">
              <SLATransactionNumber>S0001-00-00032</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
          </Transactions>
        </Policy>
        <Policy Xml_PolicyID="8">
          <PolicyType>B</PolicyType>
          <UMR>B1234ABCDEFGHIJKL</UMR>
          <EffectiveDate>1900-01-01</EffectiveDate>
          <ExpirationDate>1900-01-01</ExpirationDate>
          <PolicyHolder>Policy Holder</PolicyHolder>
          <Transactions>
            <Transaction Xml_TransactionID="40">
              <SLATransactionNumber>S0001-00-00040</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="41">
              <SLATransactionNumber>S0001-00-00041</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
            <Transaction Xml_TransactionID="42">
              <SLATransactionNumber>S0001-00-00042</SLATransactionNumber>
              <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
              <EffectiveDateTo>1900-01-01</EffectiveDateTo>
              <Premium>-999999.99</Premium>
              <LPSONumber>64555</LPSONumber>
              <LPSODate>1900-01-01</LPSODate>
            </Transaction>
          </Transactions>
        </Policy>
      </Policies>
    </Brokerage>
  </Brokerages>
  <IPC>
    <SelfInsurers>
      <SelfInsurer Xml_SelfInsurerID="1">
        <CompanyName>CompanyName1</CompanyName>
        <FirstName>ContactFirstName</FirstName>
        <LastName>ContactLastName</LastName>
        <SLANumber>S0001</SLANumber>
        <EmailAddress>test@noreply.com</EmailAddress>
        <ContactAddress>
          <Address>Address1</Address>
          <Address2>Address21</Address2>
          <City>City1</City>
          <StateCode>AL</StateCode>
          <PostalCode>12345</PostalCode>
          <CountryCode>USA</CountryCode>
        </ContactAddress>
        <PhoneNumber>8503831011</PhoneNumber>
        <Fax>8503831015</Fax>
        <Policies>
          <Policy Xml_PolicyID="10">
            <PolicyType>B</PolicyType>
            <UMR>B1234ABCDEFGHIJKL</UMR>
            <EffectiveDate>1900-01-01</EffectiveDate>
            <ExpirationDate>1900-01-01</ExpirationDate>
            <PolicyHolder>Policy Holder</PolicyHolder>
            <Transactions>
              <Transaction Xml_TransactionID="50">
                <SLATransactionNumber>S0001-00-00050</SLATransactionNumber>
                <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
                <EffectiveDateTo>1900-01-01</EffectiveDateTo>
                <Premium>-999999.99</Premium>
                <LPSONumber>64555</LPSONumber>
                <LPSODate>1900-01-01</LPSODate>
              </Transaction>
              <Transaction Xml_TransactionID="51">
                <SLATransactionNumber>S0001-00-00051</SLATransactionNumber>
                <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
                <EffectiveDateTo>1900-01-01</EffectiveDateTo>
                <Premium>-999999.99</Premium>
                <LPSONumber>64555</LPSONumber>
                <LPSODate>1900-01-01</LPSODate>
              </Transaction>
              <Transaction Xml_TransactionID="52">
                <SLATransactionNumber>S0001-00-00042</SLATransactionNumber>
                <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
                <EffectiveDateTo>1900-01-01</EffectiveDateTo>
                <Premium>-999999.99</Premium>
                <LPSONumber>64555</LPSONumber>
                <LPSODate>1900-01-01</LPSODate>
              </Transaction>
            </Transactions>
          </Policy>
          <Policy Xml_PolicyID="11">
            <PolicyType>B</PolicyType>
            <UMR>B1234ABCDEFGHIJKL</UMR>
            <EffectiveDate>1900-01-01</EffectiveDate>
            <ExpirationDate>1900-01-01</ExpirationDate>
            <PolicyHolder>Policy Holder</PolicyHolder>
            <Transactions>
              <Transaction Xml_TransactionID="60">
                <SLATransactionNumber>S0001-00-00050</SLATransactionNumber>
                <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
                <EffectiveDateTo>1900-01-01</EffectiveDateTo>
                <Premium>-999999.99</Premium>
                <LPSONumber>64555</LPSONumber>
                <LPSODate>1900-01-01</LPSODate>
              </Transaction>
              <Transaction Xml_TransactionID="61">
                <SLATransactionNumber>S0001-00-00051</SLATransactionNumber>
                <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
                <EffectiveDateTo>1900-01-01</EffectiveDateTo>
                <Premium>-999999.99</Premium>
                <LPSONumber>64555</LPSONumber>
                <LPSODate>1900-01-01</LPSODate>
              </Transaction>
              <Transaction Xml_TransactionID="62">
                <SLATransactionNumber>S0001-00-00042</SLATransactionNumber>
                <EffectiveDateFrom>1900-01-01</EffectiveDateFrom>
                <EffectiveDateTo>1900-01-01</EffectiveDateTo>
                <Premium>-999999.99</Premium>
                <LPSONumber>64555</LPSONumber>
                <LPSODate>1900-01-01</LPSODate>
              </Transaction>
            </Transactions>
          </Policy>
        </Policies>
      </SelfInsurer>
    </SelfInsurers>
  </IPC>
</BatchDataSet>