-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, N8oYhhmHxYTIRACVqbGxR1sjTuX73YwA64Ke4bcfwP2eTpBiWvbsbxAHqQ0EeSfQ P5DW8F37G6r4M/IZqFzS9A== 0001209191-09-027018.txt : 20090515 0001209191-09-027018.hdr.sgml : 20090515 20090515193004 ACCESSION NUMBER: 0001209191-09-027018 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20090513 FILED AS OF DATE: 20090515 DATE AS OF CHANGE: 20090515 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rumbolz Michael D CENTRAL INDEX KEY: 0001313332 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33245 FILM NUMBER: 09835102 MAIL ADDRESS: STREET 1: 3201 WEST COUNTY ROAD 42, SUITE 106 CITY: BURNSVILLE STATE: MN ZIP: 55306 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Employers Holdings, Inc. CENTRAL INDEX KEY: 0001379041 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 043850065 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10375 PROFESSIONAL CIRCLE CITY: RENO STATE: NV ZIP: 89521 BUSINESS PHONE: 775-327-2936 MAIL ADDRESS: STREET 1: 10375 PROFESSIONAL CIRCLE CITY: RENO STATE: NV ZIP: 89521 4 1 doc4.xml FORM 4 SUBMISSION X0303 4 2009-05-13 0 0001379041 Employers Holdings, Inc. EIG 0001313332 Rumbolz Michael D 10375 PROFESSIONAL CIRCLE RENO NV 89521 1 0 0 0 Common Stock, par value $0.01 2009-05-13 4 P 0 1000 10.00 A 9593 D Common Stock, par value $0.01 2009-05-13 4 P 0 200 9.92 A 9793 D Common Stock, par value $0.01 2009-05-13 4 P 0 300 9.94 A 10093 D /s/ Lenard T. Ormsby, attorney in fact 2009-05-15 EX-24.4_287055 2 poa.txt POA DOCUMENT POWER OF ATTORNEY I, Michael D. Rumbolz, hereby constitute and appoint Lenard T. Ormsby as my true and lawful attorney-in-fact and agent, with full power of substitution and resubstitution for me and in my name, place and stead, in any and all capacities, to sign any or all required filings or amendments to such filings with the Securities and Exchange Commission (the "SEC") with respect to my reporting obligations under Section 16 of the Securities Exchange Act of 1934, as amended, for EIG Mutual Holding Company (to be renamed Employers Holdings, Inc.) and to file the same with the SEC, granting unto said attorney-in-fact and agents, and each of them, full power and authority to do and perform each and every act and thing necessary or appropriate to be done with respect to such filings in the premises, as fully to all intents and purposes as he might or could do in person, hereby ratifying and confirming all that said attorney-in-fact and agents, or any of them, or their or his substitute or substitutes, may lawfully do or cause to be done by virtue thereof. This power of attorney shall continue in effect until specifically terminated in writing by me. /s/ Michael D. Rumbolz Name: Michael D. Rumbolz STATE OF NEVADA COUNTY OF CLARK The foregoing instrument was acknowledged before me this 26th day of January, 2007 by Michael D. Rumbolz, who is personally known to me or who has produced US passport as identification. /s/ Bonnie S. Pond Signature of person taking acknowledgment Bonnie S. Pond Name typed, printed, or stamped Notary Public Title or rank 94-2025-1 Serial number (if applicable) -----END PRIVACY-ENHANCED MESSAGE-----