Certification Statement for Insurers and Rating Organizations. The use of territories as a factor in rating by the above-named (insurer or rating organization) has been reviewed within the previous 3 years; and Use of the territories on file, or as set forth in this filing, are actuarially justified. I understand that the Maryland Insurance Administration will rely on this certification, and if it is determined that this certification is materially false or incorrect, the insurer may be subject to administrative action, including appropriate penalties. Certification Statement for Insurers Adopting the Certification Statement of a Rating Organization. _____________(insurer) is a member of or subscriber to _________________ (rating organization), a licensed rating organization, and has authorized the Commissioner to accept filings from ______________ (rating organization) on its behalf or has filed to adopt _______________ (rating organization's) filings. ________________(insurer) has filed no deviations relating to territory from the automobile rate filings submitted by ____________(rating organization). _____________ (rating organization) has filed with the Commissioner the certification statement required by Insurance Article, §11-216 or 11-319, Annotated Code of Maryland, and COMAR 31.07.03.03. ____________________(insurer) hereby adopts the statements made in the certification statement.