As in effect
3/1/61 FORM 10K/A
--------------------
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D. C. 20549
--------------------
AMENDMENT TO APPLICATION OR REPORT
Filed Pursuant to Sections 12, 13, or 15(d) of THE SECURITIES
EXCHANGE ACT OF 1934
OLD REPUBLIC INTERNATIONAL CORPORATION
- ------------------------------------------------------------------------------
(Exact name of registrant as specified in charter)
AMENDMENT NO. 4
---------
The undersigned registrant hereby amends the following items, financial
statements, exhibits or other portions of its ANNUAL REPORT FOR 1996
on FORM 10-K as set forth in the pages attached hereto: (List all such
items, financial statements, exhibits other portions amended)
FORM 11-K
Pursuant to the requirements of the Securities Exchange Act of 1934, the
registrant has duly caused this amendment to be signed on its behalf by
the undersigned, thereunto duly authorized.
OLD REPUBLIC INTERNATIONAL CORPORATION
------------------------------------------
(Registrant)
Date: April 28, 1997 By: /s/ Paul D. Adams
-------------- ---------------------------------------
(Signature)
Paul Dennis Adams
Senior Vice President,
Chief Financial Officer
and Treasurer
Total Pages: 16
----------------
<PAGE>
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
----------
FORM 11-K
----------
ANNUAL REPORT
Pursant to Section 15(d) of the
Securities Exchange Act of 1934
For The Fiscal Year ended December 31, 1996
----------
GREAT WEST CASUALTY COMPANY
PROFIT SHARING PLAN
-----------
OLD REPUBLIC INTERNATIONAL CORPORATION
307 NORTH MICHIGAN AVENUE
CHICAGO, ILLINOIS 60601
<PAGE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
Index to Financial Statements
- -------------------------------------------------------------------------------
Page No.
--------
Report of Independent Accountants 1
Financial Statements:
Statements of Net Assets Available for Benefits at
December 31, 1996 and 1995 2
Statements of Changes in Net Assets Available for Benefits
for the Years Ended December 31, 1996 and 1995 3
Notes to Financial Statements 4-10
Supplemental Schedules Exhibit I-II
<PAGE>
REPORT OF INDEPENDENT ACCOUNTANTS
To the Administrative Committee of
Great West Casualty Company Profit Sharing Plan
We have audited the accompanying statements of net assets available for benefits
of Great West Casualty Company Profit Sharing Plan as of December 31, 1996 and
1995, and the related statements of changes in net assets available for benefits
for the years then ended. These financial statements are the responsibility of
the Plan's management. Our responsibility is to express an opinion on these
financial statements based on our audits.
We conducted our audits in accordance with generally accepted auditing
standards. Those standards require that we plan and perform the audit to obtain
reasonable assurance about whether the financial statements are free of material
misstatement. An audit includes examining, on a test basis, evidence supporting
the amounts and disclosures in the financial statements. An audit also includes
assessing the accounting principles used and significant estimates made by
management, as well as evaluating the overall financial statement presentation.
We believe that our audits provide a reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly, in
all material respects, the net assets available for benefits of the Plan as of
December 31, 1996 and 1995, and the changes in net assets available for benefits
for the years then ended in conformity with generally accepted accounting
principles.
Our audits were performed for the purpose of forming an opinion on the financial
statements taken as a whole. The supplemental schedules included in Exhibits I
and II are presented for the purpose of additional analysis and are not a
required part of the basic financial statements, but are supplementary
information required by the Department of Labor's Rules and Regulations of
Reporting and Disclosure under the Employee Retirement Income Security Act of
1974. The supplemental schedules have been subjected to the auditing procedures
applied in the audits of the basic financial statements and, in our opinion, are
fairly stated in all material respects in relation to the basic financial
statements taken as a whole.
/s/ Coopers & Lybrand L.L.P.
Chicago, Illinois
April 7, 1997
<PAGE>
<TABLE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
STATEMENTS OF NET ASSETS AVAILABLE FOR BENEFITS
As of December 31, 1996 and 1995
- -------------------------------------------------------------------------------
December 31
--------------------------
1996 1995
---- ----
ASSETS
<S> <C> <C>
Investments, at fair value:
Old Republic International
Corporation (ORI) common stock $ 1,455,495 $ 1,134,322
Pooled Separate Accounts 6,378,180 3,714,023
Participant loans 289,115 193,232
Investment, at contract value:
CGLIC General Accounts 15,224,460 14,722,007
----------- -----------
Net assets available for benefits $23,347,250 $19,763,584
=========== ===========
</TABLE>
See accompanying Notes to Financial Statements
2
<PAGE>
<TABLE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
STATEMENTS OF CHANGES IN NET ASSETS AVAILABLE FOR PLAN BENEFITS
for the years ended December 31, 1996 and 1995
- ------------------------------------------------------------------------------
Years Ended December 31
---------------------------
1996 1995
---- ----
<S> <C> <C>
Additions to net assets attributable to:
Contributions:
Employer 1,767,190 $ 1,553,967
Employee 810,397 655,437
----------- -----------
2,577,587 2,209,404
----------- -----------
Investment Income:
Interest from CGLIC General Accounts 747,696 768,513
Dividends from Old Republic
International Common Stock 22,948 16,192
Net appreciation of Old Republic
International Common Stock 183,347 445,964
Net investment gain from Pooled
Separate Accounts 833,010 629,538
----------- -----------
1,787,001 1,860,207
----------- -----------
Other additions 18,108 19,576
----------- -----------
Total additions 4,382,696 4,089,187
Deductions from net assets attributed to:
Benefits paid to participants 793,795 682,433
Administrative expenses 2,766 2,087
Participant loans 2,469 8,302
----------- -----------
Net increase 3,583,666 3,396,365
Net assets available for benefits:
Beginning of year 19,763,584 16,367,219
----------- -----------
End of year $23,347,250 $19,763,584
=========== ===========
</TABLE>
See accompanying Notes to Financial Statements
3
<PAGE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
NOTES TO FINANCIAL STATEMENTS
- ------------------------------------------------------------------------------
NOTE 1 - DESCRIPTION OF PLAN
The following brief description of the Great West Casualty Company Profit
Sharing Plan (Plan) is provided for general information purposes only.
Participants should refer to the Plan agreement for a more complete description.
(a) General
The Plan is a defined contribution profit-sharing plan sponsored by Great West
Casualty Company (the Company), covering all eligible employees of that Company
as well as its affiliates, American General Agency, Central Data Services, Joe
Morten & Son,Inc., Midwest Insurance, Inc., Motor-Ways, Inc., and Truckmen
Underwriters Agency, Inc. It is subject to the provisions of the Employee
Retirement Income Security Act of 1974 (ERISA).
(b) Contributions and Participants Accounts
Participants may contribute 1% to 6% of their annual wages to the Plan. In 1996
and 1995, the Company made matching contributions to the Plan equal to 25% of
the employees' pre-tax contribution amount. Participants may elect to have their
contributions invested in any one or more of the ten separate investment funds
(CIGNA Guaranteed Long-Term Account, CIGNA Guaranteed Short-Term Account, CIGNA
Separate Account - Fidelity Advisor Balanced Account, CIGNA Separate Account -
Fidelity Advisor Growth Opportunities Account, CIGNA Separat Account - INVESCO
Total Return Account, CIGNA Separate Account - Neuberger & Berman Trust Account,
CIGNA Separate Account - PBHG Growth Account, CIGNA Separate Account - Janus
Worldwide Account, CIGNA Separate Account - Stock Market Index Account and ORI
Stock Account). The Company may also contribute an additional nonmatching amount
out of its current or accumulated profits, if any, as determined by the Company.
Each participant's account is credited with participant's contribution, and
allocation of (a) Company's contributions as described above, and (b) plan
earnings. Allocations are based on participant account balances as defined. The
benefit to which a participant is entitled is the benefit that can be provided
from the participant's account.
(c) Eligibility and Vesting
Under the terms of the Plan, an employee shall become eligible for inclusion in
the Plan upon reaching age 21 with completion of 1,000 hours of service during
the twelve month period beginning with date of hire. Minimum age for vesting
service is 18 years.
All employee and employer matching contributions are immediately 100% vested.
Participants become fully vested in the value of the discretionary contributions
after 7 years of credited service.
(d) Payment of Benefits
On termination of service, a participant may elect to leave funds in the Plan or
receive either a lump-sum payment or purchase of a single premium life annuity
contract. Net assets at December 31, 1996 and 1995, include funds totaling
$256,735 and $210,450, respectively, which represent the account balance of
retired and terminated participants who have elected to leave the funds in the
Plan upon retirement or termination.
4
<PAGE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
NOTES TO FINANCIAL STATEMENTS
- -------------------------------------------------------------------------------
NOTE 1 - DESCRIPTION OF PLAN, Continued
(e) Forfeitures
All forfeitures are segregated until the employee has attained a five year
break-in-service. At that time forfeitures are allocated pro-rata to each
participant account according to their respective earnings for that year. There
were unallocated assets of $409,520 and $311,526 at December 31, 1996 and 1995,
respectively related to these forfeitures.
(f) Loans
Participants may elect to borrow from the plan based upon specified conditions.
A participant may have only one outstanding loan at any time which must be for
at least $1,000. In no case shall the aggregate amount lent to a participant
exceed the lesser of the following: (a) $50,000 reduced by the excess of the
highest outstanding balance of loans from the plan during the one year period
ending on the date before the date of the loan to the participant; (b) 50% of
the participant's vested interest; or (c) 100% of the sum of the balances in the
participant's pre-tax contribution and matching contribution accounts.
(g) Administrative Expenses
The Company provides administrative support for the plan and pays for
administrative trustee fees.
NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
(a) Basis of Presentation
The accompanying financial statements have been prepared on the accrual basis.
Benefits are recorded when paid. The unit value of each account is determined at
the close of each business day.The preparation of financial statements in
conformity with generally accepted accounting principles requires management to
make estimates and assumptions that affect the reported amounts of assets and
liabilities and disclosure of contingent assets and liabilities at the date of
the financial statements and the reported amounts of revenues and expenses
during the reporting period. Actual results could differ from those estimates.
(b) Investments
Old Republic International Corporation stock is stated at the closing market
value on the last business day of the year.
The Plan presents in the statements of changes in net assets available for
benefits the net appreciation in the fair value of the Old Republic Stock
Account, which consists of the realized gains or losses and the unrealized
appreciation (depreciation) of this investment.
The Plan entered into a group annuity contract with Connecticut General Life
Insurance Company (CGLIC). CGLIC maintains contributions in a contract holder's
account and such contributions are allocated to separate investment funds
according to participant elections. The accounts are credited with earnings on
the underlying investments and charged for Plan benefits paid and deductions for
investment expenses, risk, profit and annual management fees charged by CGLIC.
The General Accounts are included in the financial statements at contract value
and the Separate Accounts are included in the financial statements at fair value
at December 31, 1996 and 1995 as reported to the Plan by CGLIC. Realized
investment gains and losses in the separate investment funds are recognized in
the year of sale.
5
<PAGE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
NOTES TO FINANCIAL STATEMENTS
- -------------------------------------------------------------------------------
NOTE 3 - ASSETS GREATER THAN 5% OF PLAN ASSETS
Investments that represent 5% or more of the plan assets are as follows:
<TABLE>
December 31,
---------------------------
1996 1995
<S> <C> <C>
CIGNA Guaranteed Long Term $15,017,842 $14,538,432
CIGNA Stock Market Index 1,469,253 595,975
Fidelity Growth Opportunity 2,785,498 2,146,541
Old Republic International Stock 1,455,495 1,134,322
</TABLE>
NOTE 4 - FEDERAL INCOME TAXES
The Plan has received an Internal Revenue Service Determination Letter dated
March 20, 1995, which states that it qualifies under the provisions of Section
501(a) of the Internal Revenue Code (IRC). The Plan's Committee Members believe
that the Plan is designed and is currently being operated in compliance with the
applicable requirements of the IRC.
NOTE 5 - TERMINATIONS
Although it has not expressed any intent to do so, the Company has the right
under the Plan to discontinue its contributions at any time and to terminate the
Plan subject to the provisions of ERISA. In the event of plan termination,
participants will become 100 percent vested in their accounts.
6
<PAGE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
NOTES TO FINANCIAL STATEMENTS
- -------------------------------------------------------------------------------
NOTE 6 - ALLOCATION OF NET ASSETS AVAILABLE FOR BENEFITS AND CHANGES IN
NET ASSETS AVAILABLE FOR BENEFITS
Ten separate investments funds are maintained under the Plan for the benefit of
participants. The allocation of changes in net assets available to the separate
investments funds is as follows:
<TABLE>
As of December 31, 1996
-----------------------
Guaranteed Guaranteed Stock Growth Old
Long-Term Short-Term Market Balanced Opportunity Republic
Combined Account Account Index Account Account Stock
<S> <C> <C> <C> <C> <C> <C> <C>
Investments, at fair value:
Old Republic International
Corp. (ORI) common stock $1,455,495 - - - - - $1,455,495
Pooled Separate Accounts 6,378,180 - - $1,469,253 $1,108,574 $2,785,498 -
Participant Loans 289,115 - - - - - -
Investments, at contract value:
CGLIC General Accounts 15,224,460 $15,017,842 $206,618 - - - -
-----------------------------------------------------------------------------------------------
Net assets available
for benefits $23,347,250 $15,017,842 $206,618 $1,469,253 $1,108,574 $2,785,498 $1,455,495
===============================================================================================
</TABLE>
<TABLE>
As of December 31, 1996
-----------------------
Invesco Neub & Parti-
Total Berman PBHG Janus cipant
Return Guardian Growth Worldwide Loans
<S> <C> <C> <C> <C> <C>
Investments, at fair value:
Old Republic International
Corp. (ORI) common stock - - - - -
Pooled Separate Accounts $48,170 $179,515 $385,742 $401,428 -
Participant Loans - - - - $289,115
Investments, at contract value:
CGLIC General Accounts - - - - -
-----------------------------------------------------------
Net assets available
for benefits $48,170 $179,515 $385,742 $401,428 $289,115
===========================================================
</TABLE>
<TABLE>
As of December 31, 1995
-----------------------
Guaranteed Guaranteed Stock Growth Old
Long-Term Short-Term Market Balanced 0pportunity Republic
Combined Account Account Index Account Account Stock
<S> <C> <C> <C> <C> <C> <C> <C>
Investments, at fair value:
Old Republic International
Corp. (ORI) common stock $1,134,322 - - - - - $1,134,322
Pooled Separate Accounts 3,714,023 - - $ 595,975 $ 971,507 $2,146,541 -
Participant Loans 193,232 - - - - - -
Investments, at contract value:
CGLIC General Accounts $14,722,007 $14,538,432 $183,575 - - - -
-----------------------------------------------------------------------------------------------
Net assets available
for benefits $19,763,584 $14,538,432 $183,575 $ 595,975 $ 971,507 $2,146,541 $1,134,322
===============================================================================================
</TABLE>
<TABLE>
As of December 31, 1995
-----------------------
Invesco Neub & Parti-
Total Berman PBHG Janus cipant
Return Guardian Growth Worldwide Loans
<S> <C> <C> <C> <C> <C>
Investments, at fair value:
Old Republic International
Corp. (ORI) common stock - - - - -
Pooled Separate Accounts - - - - -
Participant Loans - - - - $193,232
Investments, at contract value:
CGLIC General Accounts - - - - -
-----------------------------------------------------------
Net assets available
for benefits - - - - $193,232
===========================================================
</TABLE>
7
<PAGE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
NOTES TO FINANCIAL STATEMENTS
- -------------------------------------------------------------------------------
NOTE 6 - ALLOCATION OF NET ASSETS AVAILABLE FOR BENEFITS AND CHANGES IN
NET ASSETS AVAILABLE FOR BENEFITS
The allocation of changes in net assets available to the separate investment
funds is as follows:
<TABLE>
For the year ended December 31, 1996
------------------------------------
Guaranteed Guaranteed Stock Growth Old Invesco
Long-Term Short-Term Market Balanced Opportunity Republic Total
Combined Account Account Index Account Account Stock Return
<S> <C> <C> <C> <C> <C> <C> <C> <C>
Contributions:
Employer $ 1,767,190 $ 833,425 $ 11,875 $ 124,126 $ 247,179 $ 407,786 $ 141,831 $ 154
Employee 810,397 287,422 9,463 106,194 117,566 221,473 63,841 616
----------- ----------- ---------- ---------- ----------- --------- ---------- --------
2,577,587 1,120,847 21,338 230,320 364,745 629,259 205,672 770
----------- ----------- ---------- ---------- ----------- --------- ---------- --------
Investment Income:
Interest 747,696 738,503 9,193 - - - - -
Dividends 22,948 - - - - - 22,948 -
Net appreciation of
investments 183,347 - - - - - 183,347 -
Net investment gain (loss)
from Separate Accounts 833,010 - - 230,639 100,057 498,575 - 1,485
----------- ----------- --------- --------- ----------- --------- ---------- --------
1,787,001 738,503 9,193 230,639 100,057 498,575 206,295 1,485
Other additions 18,108 (236) 172 3,161 4,113 7,888 2,735 2
----------- ----------- --------- --------- ----------- --------- ---------- --------
Total additions 4,382,696 1,859,114 30,703 464,120 468,915 1,135,722 414,702 2,257
Deductions from net assets
attributed to:
Benefits paid
to participants 793,795 517,330 2,175 58,045 63,297 113,614 39,334 -
Administrative expenses 2,766 592 29 154 271 320 1,398 -
Participant loans 2,469 21,402 4,246 18,402 9,103 19,168 26,439 (22)
Transfers between funds - 840,380 1,210 (485,759) 259,177 363,663 26,358 (45,891)
----------- ----------- ---------- ---------- ----------- --------- ----------- ---------
Net increase (decrease) 3,583,666 479,410 23,043 873,278 137,067 638,957 321,173 48,170
----------- ----------- ---------- ---------- ----------- --------- ----------- ---------
Net assets available
for plan benefits:
Beginning of year 19,763,584 14,538,432 183,575 595,975 971,507 2,146,541 1,134,322 -
----------- ----------- ---------- ---------- ----------- ---------- ----------- ---------
End of year $23,347,250 $15,017,842 $ 206,618 $1,469,253 $ 1,108,574 $2,785,498 $ 1,455,495 $ 48,170
=========== =========== ========== ========== =========== ========== =========== =========
</TABLE>
<TABLE>
For the year ended December 31, 1996
------------------------------------
Neub & Parti-
Berman PBHG Janus cipant
Guardian Growth Worldwide Loans
<S> <C> <C> <C> <C>
Contributions:
Employer $ 97 $ 301 $ 416 -
Employee 390 1,768 1,664 -
-------- -------- -------- --------
487 2,069 2,080 -
-------- -------- -------- --------
Investment Income:
Interest - - - -
Dividends - - - -
Net appreciation of
investments - - - -
Net investment gain (loss)
from Separate Accounts 6,070 (11,381) 7,565 -
-------- -------- -------- --------
6,070 (11,381) 7,565 -
Other additions 11 88 174 -
-------- -------- -------- --------
Total additions 6,568 (9,224) 9,819 -
Deductions from net assets
attributed to:
Benefits paid
to participants - - - -
Administrative expenses - - 2 -
Participant loans (59) (209) (118) (95,883)
Transfers between funds (172,888) (394,757) (391,493) -
-------- -------- --------- --------
Net increase (decrease) 179,515 385,742 401,428 95,883
-------- -------- --------- --------
Net assets available
for plan benefits:
Beginning of year - - - 193,232
-------- -------- --------- --------
End of year $179,515 $385,742 $ 401,428 $289,115
======== ======== ========= ========
</TABLE>
<TABLE>
For the year ended December 31, 1995
------------------------------------
Guaranteed Guaranteed Growth Stock Old Parti-
Long-Term Short-Term Balanced Opportunity Market Republic cipant
Combined Account Account Account Account Index Stock Loans
<S> <C> <C> <C> <C> <C> <C> <C> <C>
Contributions:
Employer $ 1,553,967 $ 1,471,130 $ 991 $ 22,625 $ 31,838 $ 7,631 $ 19,752 -
Employee 655,437 257,417 3,776 100,281 174,836 50,287 68,840 -
----------- ----------- ---------- ---------- ----------- --------- ---------- --------
2,209,404 1,728,547 4,767 122,906 206,674 57,918 88,592 -
----------- ----------- ---------- ---------- ----------- --------- ---------- --------
Investment Income:
Interest 768,513 759,985 8,528 - - - - -
Dividends 16,192 - - - - - 16,192 -
Net appreciation of
investments 445,964 - - - - - 445,964 -
Net investment gain
from Separate Accounts 629,538 - - 98,772 441,543 89,223 - -
----------- ----------- ---------- ---------- ----------- --------- ---------- --------
1,860,207 759,985 8,528 98,772 441,543 89,223 462,156 -
Other additions 19,576 3,078 121 3,990 7,133 2,624 2,630 -
Total additions 4,089,187 2,491,610 13,416 225,668 655,350 149,765 553,378 -
Deductions from net assets
attributed to:
Benefits paid
to participants 682,433 597,710 12,274 16,944 21,007 8,121 26,377 -
Administrative expenses 2,087 423 30 104 107 48 1,375 -
Participant loans 8,302 1,089 1,279 (9,004) (13,903) (9,834) 18,305 20,370
Transfers between funds - (633,019) (2,211) 97,559 291,104 308,478 (61,911) -
----------- ----------- ---------- ---------- ----------- --------- ----------- --------
Net increase (decrease) 3,396,365 1,259,369 (2,378) 315,183 939,243 459,908 445,410 (20,370)
----------- ----------- ---------- ---------- ----------- --------- ----------- --------
Net assets available
for plan benefits:
Beginning of year 16,367,219 13,279,063 185,953 656,324 1,207,298 136,067 688,912 213,602
----------- ----------- ---------- ---------- ----------- --------- ----------- --------
End of year $19,763,584 $14,538,432 $ 183,575 $ 971,507 $ 2,146,541 $ 595,975 $ 1,134,322 $193,232
=========== =========== ========== ========== =========== ========= =========== ========
</TABLE>
<PAGE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
NOTES TO FINANCIAL STATEMENTS
- -------------------------------------------------------------------------------
NOTE 6 - ALLOCATION OF NET ASSETS AVAILABLE FOR BENEFITS AND CHANGES IN
NET ASSETS AVAILABLE FOR BENEFITS, Continued
The fund unit values at December 31, 1996 are summarized as follows:
<TABLE>
Per Unit
Units Value
----- -----
<S> <C> <C>
Guaranteed Long-term Account 252,932.45 $52.44
Guaranteed Short-term Account 4,703.56 43.93
Stock Market Index 40,159.35 36.59
Balanced Account 49,258.98 22.51
Growth Opportunity Account 57,727.88 48.25
Old Republic Stock 54,411.03 26.75
Invesco Total Return 1,760.65 27.36
Neuberger & Berman Guardian 11,090.29 16.19
PBHG Growth 14,739.64 26.17
Janus Worldwide 11,224.71 35.76
</TABLE>
10
<PAGE>
Exhibit I
<TABLE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
SUPPLEMENTAL SCHEDULE
As of December 31, 1996
- -------------------------------------------------------------------------------
Item 27a: Schedule of Assets Held for Investment Purposes
Contract/
Identity Historical Current
of Party Description Cost Value
- -------- ----------- ----------- -----------
<S> <C> <C> <C>
CGLIC Guaranteed long-term $15,017,842 $15,017,842
CGLIC Guaranteed short-term 206,618 206,618
CGLIC Stock market index 1,212,760 1,469,253
CGLIC Fidelity Advisor Balanced account 956,358 1,108,574
CGLIC Fidelity Advisor Growth opportunity 2,046,352 2,785,498
CGLIC Old Republic stock 925,266 1,455,495
CGLIC INVESCO Total Return 47,250 48,170
CGLIC Neuberger & Berman Guardian 173,445 179,515
CGLIC PBHG Growth 396,840 385,742
CGLIC Janus Worldwide 393,524 401,428
CGLIC Loans to participants 0 289,115
</TABLE>
<PAGE>
Exhibit II
<TABLE>
GREAT WEST CASUALTY COMPANY PROFIT SHARING PLAN
SUPPLEMENTAL SCHEDULE
- ------------------------------------------------------------------------------
Item 27d: Schedule of Reportable Transactions
for the year ended December 31, 1996
(a) Identity (b) Description of Assets (c) Purchase (d) Selling (g) Cost of (h) Current value (i) Net gain
of party Price Price of asset of assets on or loss
involved transaction date
<S> <C> <C> <C> <C> <C> <C>
CGLIC Purchase of units in $1,386,311 Not $1,386,311 $1,386,311 $0
Guaranteed long-term Applicable
CGLIC Sales of units in Not $1,909,951 $1,909,951 $1,909,951 $0
Guaranteed long-term Applicable
CGLIC Purchases of units in $1,031,316 Not $1,031,316 $1,031,316 $0
CIGNA Stock market index Applicable
CGLIC Sales of units in Not $ 387,997 $ 326,926 $ 387,997 $61,071
CIGNA Stock market index Applicable
CGLIC Purchases of units in $1,258,156 Not $1,258,156 $1,258,156 $0
Fidelity Advisor Growth Applicable
CGLIC Sales of units in Not $1,109,984 $ 847,062 $1,109,984 $262,922
Fidelity Advisor Growth Applicable
</TABLE>
<PAGE>
SIGNATURES
----------
Pursuant to the requirements of the Securities Exchange Act of 1934, the Plan
Committe has duly caused this annual report to be signed on behalf of the
undersigned, thereunto duly authorized.
GREAT WEST PROFIT SHARING PLAN, Registrant
By, /s/ Allen J. Johnson
---------------------------------------
Allen J. Johnson, Plan Committee
By, /s/ Fredric J. Frey
---------------------------------------
Fredric J. Frey, Plan Committee
By, /s/ Michael P. Krehbiel
---------------------------------------
Michael P. Krehbiel, Plan Committee
By, /s/ R. Scott Rager
---------------------------------------
R. Scott Rager, Plan Committee
By, /s/ Gaylen L. TenHulzen
---------------------------------------
Gaylen L. TenHulzen, Plan Committee
By, /s/ Scott A. Wilson
---------------------------------------
Scott A. Wilson, Plan Committee
Dated: March 28, 1997
