N.J. Workers’ Compensation Carriers, Self-Insureds Contact Information

                               

New Jersey workers’ compensation law provides that every carrier and self-insured employer shall designate a contact person who is responsible for responding to issues concerning medical and temporary disability benefits where no claim petition has been filed or where a claim petition has not been answered.

Here are those contacts.

If you find an error with a particular entry in the attached list, please contact the following to verify our records: Melpomene Kotsines at OSCF@dol.nj.gov or 609-292-0165.

Carriers/self-insurers that have not yet designated a contact person as required by law must do so completing and submitting the Insurance Carrier Contac: nj.gov/labor/insurancecarriercontactform

All WorkersCompensation.com New Jersey content is brought to you by Horizon Casualty Services, Inc.

ABF FREIGHT SYSTEM, INC.

RACHELLE PRATT, WC CLAIMS SPECIALIST
ATTN: RISK MANAGEMENT
P.O. BOX 10048 FORT SMITH, AR 72917
Tel: 479 785 6233 Fax: 479 785 6396 Email: rpratt@arkbest.com

ALLEN KING, MANAGER, WORKERS' COMP
P.O. BOX 10048 FORT SMITH, AR 72917
Tel: 479 785 6218 Fax: 479 785 6396 Email: aking@arkbest.com

ACADIA INSURANCE COMPANY

KIMBERLY MOORE, WC CLAIMS MANAGER BERKLEY MID-ATLANTIC GROUP
4820 LAKE BROOK DRIVE SUITE 300
Tel: 804 237 5189 Fax: 877 684 5484 Email: kmoore@wrbmag.com

KAROLINE SANDS, COUNSEL ACADIA INSURANCE COMPANY
ONE ACADIA COMMONS
WESTBROOK, ME 04092
Tel: 207 228 1932 Fax: 207 771 8090 Email: karoline.sands@acadia-ins.com

ACCEPTANCE INDEMNITY INSURANCE COMPANY

CASSANDRA GOMEZ, MANAGER CLAIM SERVICES
ACCEPTANCE INDEMNITY INSURANCE COMPANY
215 SHULMAN BLVD. SUITE 400
Tel: 630 864 3450 Fax: 630 864 3305 Email: cassandra.gomez@iatinsurance.com

MICHAEL BLINSON, SVP CORPORATE SECRETARY
HARCO NATIONAL INSURANCE COMPANY
702 OBERLIN ROAD RALEIGH NC 27605
Tel: 919 831 8176 Fax: 919 831 8160 Email: mikeblinson@iatinsurance.com

ACCIDENT FUND GENERAL INSURANCE COMPANY

JOE WROZEK, COMPLIANCE SPECIALIST AF GROUP
200 N. GRAND AVENUE LANSING, MI 48901
Tel: 517 708 5277 Fax: 517 316 2706 Email: cccompliance@afhi.com

NELLIE OSOWSKI, COMPLIANCE SPECIALIST AF GROUP
15200 W. SMALL RD. NEW BERLIN WI 53151
Tel: 262 787 7818 Fax: 262 787 7819 Email: cccompliance@afhi.com

ACCREDITED SURETY & CASUALTY COMPANY INC

CHRIS BARTHOLET, SR CLAIMS MANAGER
4798 NEW BROAD STREET SUITE 200 ORLANDO FL 32814
Tel: 407 629 2131 Fax: 407 629 4553 Email: claims.department@accredited-inc.com

BRENDA FERRELL, CLAIMS MANAGER
4798 NEW BROAD STREET SUITE 200 ORLANDO FL 32814
Tel: 407 629 2131 Fax: 407 629 4553 Email: claims.department@accredited-inc.com

ACE AMERICAN INSURANCE COMPANY

CHANDRA WINTERS, MANAGER,DISABILITY COMP PROGRAM CSAA INSURANCE GROUP
3055 OAK ROAD WALNUT CREEK CA 94597
Tel: 925 279 4158 Fax: 877 813 3551 Email: chandra.wilson@csaa.com

ACE FIRE UNDERWRITERS INSURANCE COMPANY

TOM EASON, AVP WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
1 BEAVER VALLEY ROAD WILMINGTON DE 19803
Tel: 302 476 7824 Fax: 302 476 7858 Email: thomas.eason@chubb.com

DAVID KROLL, AVP WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA
CLAIMS P.O. BOX 5118 SCRANTON PA 19803
Tel: 818 428 3753 Fax: 818 428 3588 Email: david.kroll@chubb.com

ACE PROPERTY & CASUALTY INSURANCE COMPANY

TOM EASON, AVP WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS 1 BEAVER VALLEY ROAD WILMINGTON, DE 19803
Tel: 302 476 7824 Fax: 302 476 7858 Email: thomas.eason@chubb.com

DAVID KROLL, AVP WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
P.O. BOX 5118 SCRANTON PA 18505
Tel: 818 428 3753 Fax: 818 428 3588 Email: david.kroll@chubb.com

ACIG INSURANCE COMPANY

PHIL OGLESBY, CLAIMS MANAGER ACIG INSURANCE COMPANY
2600 NORTH CENTRAL EXPRESSWAY SUITE 800
Tel: 972 702 9004 Fax: 972 687 0602 Email: claimsnotices@acig.com

RENE PINSON, VICE PRESIDENT - CLAIMS ACIG INSURANCE COMPANY
2600 NORTH CENTRAL EXPRESSWAY SUITE 800
Tel: 972 702 9004 Fax: 972 687 0602 Email: claimsnotices@acig.com

ADMIRAL INSURANCE COMPANY

JANET SHEMANSKE, ASSISTANT SECRETARY ADMIRAL INSURANCE COMPAY C/O W.R. BERKLEY E & S CENTER
7233 E. BUTHERUS DRIVE
Tel: 480 922 4045 Fax: 480 281 0791 Email: nic_regulatory@nautilus-ins.com

TREA MIHALOVICH, REGULATORY ANALYST ADMIRAL INSURANCE COMPANY C/O W. R. BERKLEY E & S CENTER
7233 E. BUTHERUS DRIVE
Tel: 480 509 6627 Fax: 480 477 1554 Email: nic_regulatory@nautilus-ins.com

AIG CLAIMS INC

LAURA MOREN, TECHNICAL HOME OFFICE DIRECTOR AIG
222 SW COLUMBIA STREET 10TH FLOOR
Tel: 503 417 8320 Fax: 877 304 4360 Email: LAURA.MOREN@AIG.COM

AIG CLAIMS SERVICES WAWA UNIT

LAURA MOREN, TECHNICAL HOME OFFICE AIG
222 SW COLUMBIA STREET 10TH FLOOR
Tel: 503 417 8320 Fax: 877 304 4360 Email: Laura.Moren@aig.com

AIG PROPERTY CASUALTY COMPANY

JANICE MOORE, ASST. VICE PRESIDENT P O BOX 25991
SHAWNEE MISSION KS 66225
Tel: 302 765 1635 Fax: 302 765 1806 Email: Janicem.moore@aig.com

AIU INSURANCE COMPANY

LAURA MOREN, TECHNICAL HOME OFFICE DIRECTOR AIG
222 SW COLUMBIA STREET 10TH FLOOR
Tel: 503 417 8320 Fax: 877 304 4360 Email: Laura.Moren@aig.com

ALAMANCE INSURANCE COMPANY

JOHN MAHONEY, CHIEF CLAIM OFFICER ALAMANCE INSURANCE COMPANY
185 ASYLUM STREET 7TH FLOOR
Tel: 860 756 7771 Fax: 860 723 8230 Email: jwmahoney@ifgcompanies.com

JEFFREY ROBERTS, DIRECTOR, HO CLAIM ALAMANCE INSURANCE COMPANY
185 ASYLUM STREET 7TH FLOOR
Tel: 860 723 8217 Fax: 860 723 8230 Email: jwroberts@ifgcompanies.com

ALEA NORTH AMERICA INSURANCE COMPANY

SUSANNE MAZZONE, VICE PRESIDENT, COMPLIANCE
55 CAPITAL BLVD.
ROCKY HILL, CT 06067
Tel: 860 258 6508 Fax: 860 258 6725 Email: susanne.mazzone@aleagroup.com

SUZANNE FETTER, SR. VP, HEAD OF CLAIMS
55 CAPITAL BLVD.
ROCKY HILL, CT 06067
Tel: 860 258 6512 Fax: 860 258 6725 Email: suzanne.fetter@aleagroup.com

ALL AMERICA INSURANCE COMPANY

JAMIE WIECHART, CLAIMS MANAGER ALL AMERICA INSURANCE COMPANY
800 S. WASHINGTON STREET
VAN WERT OH 45891
Tel: 800 786 9169 Fax: 800 736 7026 Email: jwiechart@central-insurance.com

KIM BUTLER, CLAIM REP ALL AMERICAN INSURANCE COMPANY
800 S. WASHINGTON STREET
VAN WERT OH 45891
Tel: 800 736 7000 Fax: 800 736 7026 Email: kbutler@central-insurance.com

ALLIANZ GLOBAL RISKS US INSURANCE COMPANY

MIKE DAVIES, CLAIM MANAGER
P.O. BOX 7782
BURBANK, CA 91510
Tel: 818 260 7212 Fax: 818 260 7218 Email: mdavies@aic-allianz.com

CRAIG FREY, ASST. VICE PRESIDENT
P.O. BOX 7782
BURBANK, CA 91510
Tel: 818 260 7152 Fax: 818 260 7218 Email: cfrey@aic-allianz.com

ALLIED EASTERN INDEMNITY COMPANY

ROBERT ALCOCK, SUPERVISOR OF REGIONAL CLAIMS ALLIED EASTERN INDEMNITY COMPANY
25 RACE AVENUE
LANCASTER PA 17603
Tel: 855 533 3444 ext: 1624 Fax: 717 481 7170 Email: ralcock@eains.com

TARA HOOPER, DIRECTOR OF REGIONAL CLAIMS ALLIED EASTERN INDEMNITY COMPANY
25 RACE AVENUE
LANCASTER PA 17603
Tel: 855 533 3444 ext: 1645 Fax: 717 481 8214 Email: thooper@eains.com

ALLMERICA FINANCIAL ALLIANCE INSURANCE COMPANY

KRISTY CARAHER, UNIT MANAGER WC THE HANOVER INSURANCE GROUP
PO BOX 15144
440 LINCOLN STREET
Tel: 315 453 4361 Fax: 508 635 8809 Email: kcaraher@hanover.com

LAURA THORSEN, UNIT MANAGER WC THE HANOVER INSURANCE GROUP
PO BOX 15144
440 LINCOLN STREET
Tel: 508 855 5279 Fax: 508 635 8809 Email: WCStateforms@hanover.com

ALLMERICA FINANCIAL BENEFIT INSURANCE COMPANY

KRISTY CARAHER, UNIT MANAGER WC THE HANOVER INSURANCE GROUP
PO BOX 15144
440 LINCOLN STREET
Tel: 315 453 4361 Fax: 508 635 8809 Email: kcaraher@hanover.com

LAURA THORSEN, UNIT MANAGER WC THE HANOVER INSURANCE GROUP
PO BOX 15144
440 LINCOLN STREET
Tel: 508 855 5279 Fax: 508 635 8809 Email: WCStateforms@hanover.com

AMERICAN ALTERNATIVE INSURANCE COMPANY

CHARLES KROH, VICE PRESIDENT
555 COLLEGE ROAD EAST
PRINCETON, NJ 08543
Tel: 609 243 4846 Fax: 609 243 4558 Email: ckroh@munichreamerica.com

STEPHEN DIONISIO, VICE PRESIDENT
555 COLLEGE ROAD EAST
PRINCETON, NJ 08543
Tel: 609 243 4514 Fax: 609 243 4558 Email: sdionisio@munichreamerica.com

AMERICAN AUTOMOBILE INSURANCE COMPANY

STEPHEN LANGSTAFF, WC CLAIMS TEAM LEAD ALLIANZ GLOBAL CORPORATE & SPECIALTY
P.O. BOX 970
HOUSTON TX 77009
Address: Tel: 713 877 5580 Fax: 916 415 2597 Email: stephen.langstaff@agcs.allianz.com

LETITIA TIGUE, CLAIMS COMPLIANCE SPECIALIST ALLIANZ GLOBAL CORPORATE & SPECIALIST
P.O. BOX 970
HOUSTON TX 77009
Tel: 952 486 5259 Fax: 888 340 6679 Email: letitia.tigue@agcs.allianz.com

AMERICAN CASUALTY COMPANY OF READING PA

KEVIN ZACCHIA, ASSISTANT VICE PRESIDENT
5786 WIDEWATERS
DEWITT NY 13214
Tel: 315 431 6752 Fax: 714 256 7905 Email: Kevin.Zacchia@cna.com

TAMMY SOWERS, WORKERS' COMPENSATION CLAIM MANAGER
ONE MERIDIAN BOULEVARD
WYOMISSING PA 19610
Tel: 610 320 4410 Fax: 877 371 5122 Email: Tammy.Sowers@cna.com

AMERICAN COMPENSATION INSURANCE COMPANY

SUSAN PILON, WC CLAIM MANAGER STATE AUTO INSURANCE COMPANIES
P.O. BOX 182617
COLUMBUS OH 43218
Tel: 952 897 5543 Fax: 800 563 3364 Email: susan.pilon@libertymutual.com

MICHAEL SCHNEIDER, CLAIMS TEAM MANAGER STATE AUTO INSURANCE COMPANIES
P.O. BOX 182617
COLUMBUS OH 43218
Tel: 952 893 3774 Fax: 800 563 3364 Email: michael.schneider@libertymutual.com

AMERICAN EUROPEAN INSURANCE COMPANY

DEE GRAULICH, WC CLAIM REPRESENTATIVE
309 FELLOWSHIP ROAD SUITE 300
MT. LAUREL NJ 08054
Tel: 856 235 8890 ext: 271 Fax: 856 778 8290 Email: fgraulich@merchantsgroup.com

BILL WOLFE, CLAIMS MANAGER
309 FELLOWSHIP ROAD SUITE 300
MT. LAUREL NJ 08054
Tel: 856 235 8890 ext: 270 Fax: 856 778 8290 Email: wwolfe@merchantsgroup.com

AMERICAN FIRE & CASUALTY INSURANCE COMAPNY

TODD GANCARZ, UNIT LEADER
5062 BRITTONFIELD PARKWAY E.
SYRACUSE, NY 13057
Tel: 315 431 6131 Fax: 800 526 0681 Email: todd.gancarz@peerless-ins.com

KAREN PEINKOFER, UNIT LEADER
5062 BRITTONFIELD PARKWAY E.
SYRACUSE, NY 13057
Tel: 315 431 6322 Fax: 800 526 0681 Email: Karen.Peinkofer@peerless-ins.com

AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY

BRIAN M. DOOLEY, ASST. VICE PRESIDENT AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY
300 INTERPACE PARKWAY
Tel: 973 394 5281 Fax: 973 394 5262 Email: brian.dooley@zurichna.com

AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY

KENNETH NIGRO, ASSISTANT VICE PRESIDENT AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY
300 INTERPACE PARKWAY
Tel: 973 394 5241 Fax: 973 394 5262 Email: KENNETH.NIGRO@ZURICHNA.COM

BETH BLANCHARD, TEAM MANAGER AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY
1299 ZURICH WAY
Tel: 617 570 8827 Fax: 973 394 5262 Email: elizabeth.blanchard@zurichna.com

AMERICAN HOME ASSURANCE COMPANY

LAURA MOREN, TECHNICAL HOME OFFICE DIRECTOR AIG
222 SW COLUMBIA STREET 10TH FLOOR
Tel: 503 417 8320 Fax: 877 304 4360 Email: LAURA.MOREN@AIG.COM

AMERICAN INSURANCE COMPANY

JASON FREDRICK, CLAIMS MANAGER AMERICAN INSURANCE COMPANY
1 PROGRESS POINT PARKWAY, SUITE 2
O'FALLON MO 63368
Tel: 314 817 2806 Fax: 888 887 6381 Email: jason.fredrick@agcs.allianz.com

SARA MAREK, WORKERS' COMPENSATION SUPERVISOR AMERICAN INSURANCE COMPANY
1 PROGRESS POINT PARKWAY, SUITE 2
OFALLON MO 63368
Tel: 314 513 1014 Fax: 314 552 7406 Email: sara.marek@agcs.allianz.com

AMERICAN ZURICH INSURANCE COMPANY

KENNETH NIGRO, ASSISTANT VICE PRESIDENT AMERICAN ZURICH INSURANCE COMPANY
300 INTERPACE PARKWAY MORRIS CORP #1, BLDG B/C
Tel: 973 394 5241 Fax: 973 394 5262 Email: kenneth.nigro@zurichna.com

AMERICAN ZURICH INSURANCE COMPANY

BRIAN M. DOOLEY, ASST. VICE PRESIDENT AMERICAN ZURICH INSURANCE COMPANY
300 INTERPACE PARKWAY MORRIS CORP #1, BLDG. B/C
Tel: 973 394 5281 Fax: 973 394 5262 Email: brian.dooley@zurichna.com

BETH BLANCHARD, TEAM MANAGER AMERICAN ZURICH INSURANCE COMPANY
1299 ZURICH WAY
SCHAUMBURG IL 06019
Tel: 617 570 8827 Fax: 973 394 5262 Email: elizabeth.blanchard@zurichna.com

AMERICAS INSURANCE COMPANY

ANNE MISSETT, CHIEF OPERATING OFFICER AMERICAS INSURANCE COMPANY
400 POYDRAS STREET SUITE 1150
Tel: 504 353 4151 Fax: 504 523 0084 Email: Anne.Missett@Americas-Insurance.com

MARK NEWMAN, COMPLIANCE COORDINATOR AMERICAS INSURANCE COMPANY
400 POYDRAS STREET SUITE 1150
Tel: 504 353 4167 Fax: 504 323 0084 Email: Mark.Newman@Americas-Insurance.com

AMERISURE INSURANCE COMPANY

RACHEL FRASSETTO, UNIT MANAGER
26777 HALSTED ROAD
FARMINGTON HILLS, MI 48331
Tel: 248 442 6644 Fax: 248 615 8602 Email: Rfrassetto@amerisure.com

KIMBERLY VAUGHN, AVP, CLAIMS
26777 HALSTEAD ROAD
FARMINGTON HILLS, MI 48331
Tel: 248 615 8341 Fax: 248 615 8602 Email: kvaughn@amerisure.com

AMERISURE MUTUAL INSURANCE COMPANY

RACHEL FRASSETTO, UNIT MANAGER
26777 HALSTED ROAD
FARMINGTON HILLS, MI 48331
Tel: 248 442 6642 Fax: 248 615 8602 Email: Rfrassetto@amerisure.com

KIMBERLY VAUGHN, AVP, CLAIMS
26777 HALSTED ROAD
FARMINGTON HILLS, MI 48331
Tel: 248 615 8341 Fax: 248 615 8602 Email: kvaughn@amerisure.com

AMERITRUST INSURANCE CORPORATION

LINDA FEATHERNGILL, WC CLAIMS SUPERVISOR
P.O. BOX 5086 SOUTHFIELD, MI 48086
Tel: 248 204 8149 Fax: 248 692 0432 Email: Linda.Featherngill@Meadowbrook.com

RANDY LESTER, CLAIMS MANAGER
P.O. BOX 5086 SOUTHFIELD, MI 48086
Tel: 248 204 8563 Fax: 248 281 5370 Email: Randy.Lester@Meadowbrook.com

AMGUARD INSURANCE COMPANY

ZACHARY PLESCIA, PARALEGAL AMGUARD INSURANCE COMPANY
P.O. BOX 1368
WILKES-BARRE PA 18703
Tel: 800 673 2465 Fax: 570 825 2065 Email: zachary.plescia@guard.com

AMTRUST INSURANCE COMPANY

MELISSA KOVACSY, DIRECTOR AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 609 936 3003 Fax: 678 258 8395 Email: melissa.kovacsy@amtrustgroup.com

SUSAN GOLDMAN, SENIOR MANAGER AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 732 276 4879 Fax: 678 258 8395 Email: susan.goldman@amtrustgroup.com

ARCH INSURANCE COMPANY

PAUL BERKOWITZ, WORKERS' COMPENSATION DIRECTOR ARCH INSURANCE COMPANY
210 HUDSON STREET SUITE 300
Tel: 201 743 4571 Fax: 866 266 3630 Email: pbekowitz@archinsurance.com

MARIO BRACUTI, SVP WORKERS COMPENSATION ARCH INSURANCE COMPANY
210 HUDSON STREET SUITE 300
Tel: 201 743 4773 Fax: 866 266 3660 Email: mbracuti@archinsurance.com

ARGONAUT GREAT CENTRAL INSURANCE COMPANY

MARILYN BRANDS, VP OF WORKERS' COMPENSATION CLAIMS
REDWOOD CITY, CA 94605
Tel: 650 508 5403 Fax: 309 690 3920 Email: mbrands@argogroupus.com

MELINDA SEILER, REGIONAL CLAIMS DIRECTOR
8325 N. ALLEN RD., SUITE B
PEORIA, IL 61615
Tel: 309 690 3901 Fax: 309 690 3920 Email: mseiler@argogroupus.com

ARGONAUT INSURANCE COMPANY

MARILYN BRANDS, VP OF WORKERS' COMPENSATION CLAIMS
100 MARINE PARKWAY
REDWOOD CITY, CA 94605
Tel: 650 508 5403 Fax: 309 690 3920 Email: mbrands@argogroupus.com

MELINDA SEILER, REGIONAL CLAIMS DIRECTOR
8325 N. ALLEN RD., SUITE B
PEORIA, IL 61615
Tel: 309 690 3901 Fax: 309 690 3920 Email: mseiler@argogroupus.com

ARGONAUT-MIDWEST INSURANCE COMPANY

MARILYN BRANDS, VP OF WORKERS' COMPENSATION CLAIMS
100 MARINE PARKWAY
REDWOOD CITY, CA 94605
Tel: 650 508 5403 Fax: 309 690 3920 Email: mbrands@argogroupus.com

MELINDA SEILER, REGIONAL CLAIMS DIRECTOR
8325 N. ALLEN RD., SUITE B
PEORIA, IL 61615
Tel: 309 690 3901 Fax: 309 690 3920 Email: mseiler@argogroupus.com

ARI INSURANCE COMPANY

MELISSA KOVACSY, DIRECTOR AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 609 936 3003 Fax: 678 258 8395 Email: melissa.kovacsy@amtrustgroup.com

SUSAN GOLDMAN, SENIOR MANAGER AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 732 276 4879 Fax: 678 258 8395 Email: susan.goldman@amtrustgroup.com

ATLANTA INTERNATIONAL INSURANCE COMPANY

PETER J JACOBUS, PRESIDENT
7230 MCGINNIS FERRY ROAD SUITE 200
SUWANEE, GA 30024
678 512 2333 Fax: 678 512 2490 Email: Peter_Jacobus@aon.com

JANICE EARWOOD, ADMINISTRATIVE SERVICES MANAGER
7230 MCGINNIS FERRY ROAD SUITE 200
SUWANEE, GA 30024
Tel: 678 512 2335 Fax: 678 512 2490 Email: Janice_Earwood@aon.com

ATLANTIC EMPLOYERS INSURANCE COMPANY

TOM EASON, AVP, WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
1 BEAVER VALLEY ROAD
WILMINGTON, DE 19803
Tel: 302 476 7824 Fax: 302 476 7858 Email: thomas.easton@chubb.com

DAVID KROLL, AVP, WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
P.O. BOX 5118
SCRANTON PA 18505
Tel: 818 428 3753 Fax: 818 428 3588 Email: david.kroll@chubb.com

ATLANTIC HEALTH SYSTEMS INC & SUBS

ASHLEY MCENROE, ESQ, ATTORNEY
475 SOUTH STREET
P.O. BOX 1905
MORRISTOWN NJ 07962
Tel: 973 660 3552 Fax: 973 360 0540 Email: Ashley.mcenroe@atlantichealth.org

8000 MIIDLANTIC DR, STE 300
LAUREL CORPORATE CENTER
MT LAUREL NJ 08054
Tel: 856 914 2065 Fax: 856 439 3168 Email: sfanon@capehart.com

ATLANTIC SPECIALTY INSURANCE COMPANY

CINDY VAN EYLL, VP OF WC CLAIMS OBI AMERICA INSURANCE COMPANY
605 NORTH AMERICA HIGHWAY 169 SUITE 800
Tel: 952 852 0828 Fax: 866 639 0437 Email: cvaneyll@IntactInsurance.com

CHRIS BAER, CLAIMS SUPERVISOR OBI AMERICA INSURANCE COMPANY
188 INVERNESSS DRIVE WEST, SUITE 600
ENGLEWOOD CO 80112
Tel: 781 332 8708 Fax: 866 387 9623 Email: cbaer@IntactInsurance.com

ATLANTICARE REGIONAL MEDICAL CENTER

BRITTANY PATTERSON, CORPORATE DIRECTOR, INTEGRATED DISABILITY AIRPORT COMMERCE CENTER
6550 DELILAH ROAD SUITE 210B
Tel: 609 677 6019 Fax: 609 272 6344 Email: BLPATTERSON@atlanticare.org

ADINA LAFFERTY, WORKERS' COMPENSATION SPECIALIST AIRPORT COMMERCE CENTER
6550 DELILAH ROAD SUITE 210B
Tel: 609 407 2382 Fax: 609 272 6344 Email: ABLAFFERTY@atlanticare.org

AUTOMOBILE INSURANCE CO. OF HARTFORD CT

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC.
P.O. BOX 4614 BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 786 5568 Email: haledort@travelers.com

TROY TICE, DIRECTOR OF OPERATIONS THE TRAVELERS COMPANIES INC.
445 SOUTH STREET MORRISTOWN, NJ 07960
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

AXA INSURANCE COMPANY

ANTHONY HAMPTON, REGIONAL CLAIMS OPERATIONS LEAD AXA XL
P.O. BOX 211547 DALLAS TX 75211
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum.axaxl.co

JOHN CONROY, ASST VP, SR. CLAIMS SPECIALIST AXA XL
505 EAGLEVIEW BOULEVARD 4TH FLOOR
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum.axaxl.co

BANCROFT NEUROHEALTH, INC.

TONY DIBARTOLLO, V.P. HUMAN RESOURCES
800 NO. KINGS HWY., SUITE 305
CHERRY HILL, NJ 08034
Tel: 856 667 7397 ext: 1195 Fax: 856 348 1219 Email: Tdibartolo@bnh.org

MICHAEL SALERNO, ADMINISTRATOR
330 MILLTOWN ROAD, SUITE E-11
EAST BRUNSWICK, NJ 08816
Tel: 732 613 1600 Fax: 732 613 9328 Email: Mikesal226@aoc.com

BANKERS STANDARD INSURANCE COMPANY

TOM EASON, AVP WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
1 BEAVER VALLEY ROAD
WILMINGTON, DE 19803
Tel: 302 476 7824 Fax: 302 476 7858 Email: thomas.eason@chubb.com

DAVID KROLL, AVP WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
P.O. BOX 5118
SCRANTON PA 18505
Tel: 818 428 3753 Fax: 818 428 3588 Email: david.kroll@chubb.com

BARNABAS HEALTH INC

DAVID A. MEBANE, ESQ., SR. V.P. FOR LEGAL AFFAIRS - CHIEF LEGAL OFFICER
95 OLD SHORT HILLS ROAD
WEST ORANGE, NJ 07052
Tel: 973 322 4042 Fax: 973 322 4040 Email: dmebane@barnabashealth.org

CARYL RUSSO, SR. VICE PRESIDENT, CORPORATE CARE KIMBALL MEDICAL CENTER
600 RIVER AVENUE
LAKEWOOD, NJ 08701
Tel: 732 557 7074 Fax: 732 557 7165 Email: crusso@barnabashealth.org

BENCHMARK INSURANCE COMPANY

ROBERT ROTH, COMPLIANCE MANAGER BENCHMARK INSURANCE COMPANY
150 LAKE STREET WEST
WAYZATA MN 55391
Tel: 952 974 2200 Fax: 952 974 2222 Email: compliance@trcancorp.com

BERKLEY CASUALTY COMPANY

TAMMY ANSELL, QUALITY & TRAINING MANAGER BERKLEY CASUALTY COMPANY
P.O. BOX 660847 BIRMINGHAM AL 35266
Tel: 205 874 8204 Fax: 205 870 3245 Email: tansell@berkindcomp.com

PETER GELSINGER, REGIONAL RESOLUTION MANAGER BERKLEY CASUALTY COMPANY
P.O. BOX 660847 BIRMINGHAM AL 35266
Tel: 205 874 8241 Fax: 205 870 3245 Email: pgelsginger@berkindcomp.com

BERKLEY NATIONAL INSURANCE COMPANY

ROBERT BUEHLER, ASSISTANT SECRETARY
215 SHUMAN BLVD., SUITE 200
NAPERVILLE, IL 60563
Tel: 630 210 0359 Fax: 630 210 0377 Email: rbuehler@wrberkley.com

PATRICIA PETERS, REGULATORY ADMINISTRATOR
215 SHUMAN BLVD., SUITE 200
NAPERVILLE, IL 60563
Tel: 630 210 0359 Fax: 630 210 0377 Email: ppeters@wrberkley.com

BERKLEY REGIONAL INSURANCE COMPANY

MELISSA RIEFENHAUSER, COMPLIANCE COORDINATOR W.R. BERKLEY CO
2445 KUSER ROAD SUITE 201
Tel: 609 584 4575 Fax: 609 588 5770 Email: mriefenhauser@wrberkley.com

SUZANNE SCELZA, VICE PRESIDENT, REGULATORY COMPLIANCE W.R. BERKLEY CO
1445 KUSER ROAD SUITE 201
Tel: 609 689 6648 Fax: 609 588 5770 Email: sscelza@wrberkley.com

BERKSHIRE HATHAWAY HOMESTATE INSURANCE CO (FMLY CORNHUSKERS CASUALTY)

JACOB MILLER, MANAGER BERKSHIRE HATHAWAY HOMESTATE COMPANIES
P.O. BOX 881716
SAN FRANCISCO CA 94188
Tel: 402 952 5176 Fax: 415 675 5469 Email: jamiller@bhhc.com

NICOLE ALBRECHT, ASSISTANT DIRECTOR BERKSHIRE HATHAWAY HOMESTATE COMPANIES
P.O. BOX 881716
SAN FRANCISCO CA 94188
Tel: 800 661 6029 Fax: 415 675 5469 Email: nalbrecht@bhhc.com

BITCO GENERAL INSURANCE CO

CHRISTIAN O'BRIAN, HOME OFFICE CLAIMS ADMINISTRATOR BITCO GENERAL INSURANCE CO. 3700 MARKET SQUARE CIRCLE
DAVENPORT IA 52807
Tel: 563 232 0261 Fax: 844 505 7271 Email: christian.obrian@bitco.com

BITCO NATIONAL INSURANCE CO

CHRISTIAN O'BRIAN, HOME OFFICE CLAIMS ADMINISTRATOR BITCO NATIONAL INSURANCE COMPANY
3700 MARKET SQUARE CIRCLE
DAVENPORT IA 52807
Tel: 563 232 0261 Fax: 844 505 7271 Email: christian.obrian@bitco.com

BJ'S WHOLESALE CLUB, INC.

JOHN WEISERT, DIRECTOR OF RISK AND INSURANCE BJ'S WHOLESALE CLUB INC
25 RESEARCH DRIVE
WESTBORO MA 01581
Tel: 774 512 6433 Fax: 774 512 6422 Email: jweisert@bjs.com

STEPHANIE TWOHIG, CLAIMS MANAGER BJ'S WHOLESALE CLUB INC
25 RESEARCH DRIVE
WESTBORO MA 01581
Tel: 774 512 6397 Fax: 508 986 7184 Email: stwohig@bjs.com

BLACKBOARD INSURANCE COMPANY

MORGAN SMITH, WORKERS' COMPENSATION RESOLUTION LEAD BLACKBOARD INSURANCE COMPANY
120 BROADWAY 17TH FLOOR
Tel: 347 640 2811 Fax: 609 919 0646 Email: morgan.smith@blackboardinsurance.com

LOUIS MANGER, CHIEF RESOLUTION OFFICER BLACKBOARD INSURANCE COMPANY
120 BROADWAY 17TH FLOOR
Tel: 347 453 4352 Fax: 609 919 0646 Email: louis.manger@blackboardinsurance.com

BLOOMINGTON COMPENSATION INSURANCE COMPANY

SUSAN PILON, WC CLAIM MANAGER STATE AUTO INSURANCE COMPANIES
P.O. BOX 182617
COLUMBUS OH 43218
Tel: 952 897 5543 Fax: 800 563 3364 Email: susan.pilon@libertymutual.com

MICHAEL SCHNEIDER, CLAIMS TEAM MANAGER STATE AUTO INSURANCE COMPANIES
P.O. BOX 182617
COLUMBUS OH 43218
Tel: 952 893 3774 Fax: 800 563 3364 Email: michael.schneider@libertymutual.com

BROTHERHOOD MUTUAL INSURANCE COMPANY

GARY ALDRIDGE, MANAGER - CLAIMS BROTHERHOOD MUTUAL INSURANCE COMPANY
6400 BROTHERHOOD WAY
FORT WAYNE IN 46825
Tel: 260 481 5626 Fax: 800 284 9579 Email: galdridge@brotherhoodmutual.com

MANDY MUNCIE, MANAGER-CLAIMS BROTHERHOOD MUTUAL INSURANCE COMPANY
6400 BROTHERHOOD WAY
PO BOX 2227
Tel: 260 481 5387 Fax: 800 284 9579 Email: mmuncie@brotherhoodmutual.com

CALIFORNIA INSURANCE COMPANY

ROBERT STAFFORD, VICE PRESIDENT OF FINANCE CALIFORNIA INSURANCE COMPANY
P.O. BOX 3646
OMAHA NE 68103
Tel: 402 827 3424 ext: 4094 Fax: 402 827 3432 Email: rstafford@auw.com

JEFF SILVER, SECRETARY CALIFORNIA INSURANCE COMPANY

P.O. BOX 3646
OMAHA NE 68103
Tel: 402 827 3424 Fax: 402 827 3432 Email: jeffreysilver@silver-law.net

CAMDEN, RC DIOCESE OF

PATRICIA NAPIER, ACCT MGR QUAL-LYNX
100 DECADON DRIVE
EGG HARBOR TWP NJ 08234
Tel: 609 833 2183 ext: Fax: 609 601 3172 Email: tnapier@qual-lynx.com

HOLLY CONN, LITIGATION SUPERVISOR QUAL-LYNX
100 DECADON DRIVE
EGG HARBOR TWP NJ 08234
Tel: 609 833 2224 ext: Fax: 609 601 3172 Email: hconn@qual-lynx.com

CAPE REGIONAL MEDICAL CENTER

MICHAEL MORLEY, V.P. RISK MANAGEMENT
2 SONE HARBOR BLVD.
CAPE MAY COURT HOUSE, NJ 08210
Tel: 609 463 2273 Fax: 609 465 9391 Email: mmorley@caperegional.com

PATRICIA NAPIER, SENIOR CLAIMS ANALYST SCIBAL INSURANCE GROUP
P.O. BOX 500
SOMERS POINT, NJ 08244
Tel: 609 653 8400 Fax: Email: pnapier@scibal.com

CAPITOL INDEMNITY CORPORATION

DAVID REGELE, HEAD OF CONTINOUS CLAIMS IMPROVEMENT
1600 ASPEN COMMONS SUITE
300 MIDDLETON WI 53562
Tel: 608 829 4869 Fax: 608 829 7411 Email: dregele@capspecialty.com

MICHELLE BEDARD, SR. CLAIMS REPORTING & COMPLIANCE SPECIALIST
1600 ASPEN COMMONS SUITE 300
MIDDLETON WI 53562
Tel: 860 494 4938 Fax: 608 829 7411 Email: mbedard@capspecialty.com

CAROLINA CASUALTY INSURANCE COMPANY

BRENT FOURNIER, CLAIMS MANAGER
9301 INNOVATION DRIVE SUITE 200
MANASSAS VA 20110
Tel: 571 298 0972 Fax: 855 395 2518 Email: bfournier@berkeleynet.com

HANNAH HANSON, CLAIMS OPERATIONS SPECIALIST BERKLEY NET UNDERWRITERS
9301 INNOVATIONS DRIVE SUITE 200
Tel: 571 778 6602 Fax: 855 395 2518 Email: hhanson@berkleynet.com

CASTLEPOINT NATIONAL INSURANCE COMPANY

TIM KARAGJIOZI, SR. HOME OFFICE CLAIM ANALYST
3 HUNTINGTON QUAD, SUITE 2015
MELVILLE, NY 11747
Tel: 631 465 1440 Fax: 631 532 1815 Email: tkaragjiozi@twrgrp.com

PHILIP KOZELETZ, ASST. VICE PRESIDENT, BRANCH CLAIM MANAGER
3 HUNTINGTON QUAD, SUITE 2015
MELVILLE, NY 11747
Tel: 631 465 1385 Fax: 888 291 6262 Email: pkozeletz@twrgrp.com

CBS BROADCASTING INC

STEPHANIE GROSSBERG, DIRECTOR - RISK MANAGEMENT
51 W. 52ND STREET NEW YORK, NY 10019
Tel: 212 975 8971 Fax: 212 597 4163 Email: stephanie.grossberg@cbs.com

DAVID RICHARDSON, VICE PRESIDENT - CLAIMS ONE UNION PLAZA
NEW LONDON, CT 06320
Tel: 860 447 0048 Fax: 860 442 0076 Email: drichardson@murphybeane.com

CBS OUTDOOR GROUP INC

STEPHANIE GROSSBERG, DIRECTOR, RISK MANAGEMENT
51 W. 52ND STREET NEW YORK, NY 10019
Tel: 212 975 8971 Fax: 212 597 4163 Email: stephanie.grossberg@cbs.com

DAVE RICHARDSON, VP - CLAIMS MURPHY AND BEANE
ONE UNION PLAZA
NEW LONDON, CT 06320
Tel: 860 447 0048 ext: 240 Fax: 860 442 0076 Email: DRICHARDSON@MURPHYBEANE.COM

CBS OUTDOOR INC

STEPHANIE GROSSBERG, DIRECTOR - RISK MANAGEMENT
51 W. 52ND STREET NEW YORK, NY 10019
Tel: 212 975 8971 Fax: 212 597 4163 Email: stephanie.grossberg@cbs.com

DAVID RICHARDSON, VICE PRESIDENT - CLAIMS
ONE UNION PLAZA
NEW LONDON, CT 06320
860 447 0048 Fax: 860 442 0076 Email: drichardson@murphybeane.com

CEDAR INSURANCE COMPANY

LORI POWERS, VP CEDAR INSURANCE COMPANY
628 HEBRON AVENUE SUITE 106
Tel: 860 368 2004 Fax: 860 368 2010 Email: lori.powers@siriusgroup.com

ANDREW ROTH, SR. VP CEDAR INSURANCE COMPANY
628 HEBRON AVENUE SUITE 106
Tel: 860 368 2005 Fax: 860 368 2010 Email: andrew.roth@siriusgroup.com

CENTRAL MUTUAL INSURANCE COMPANY

JAMIE WIECHERT, CLAIMS MANAGER CENTRAL MUTUAL INSURANCE COMPANY
800 S. WASHINGTON STREET
VAN WERT OH 45891
Tel: 800 786 9169 Fax: 800 736 7026 Email: jwiechart@central-insurance.com

KIM BUTLER, CLAIM REP. CENTRAL MUTUAL INSURANCE COMPANY
800 S. WASHINGTON STREET
VAN WERT, OH 45891
Tel: 800 736 7000 Fax: 800 736 7026 Email: kbutler@central-insurance.com

CENTURY INDEMNITY COMPANY

TOM EASON, AVP, WORKERS COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
1 BEAVER VALLEY ROAD
WILMINGTON, DE 19803
Tel: 302 476 7824 Fax: 302 476 7858 Email: Thomas.Eason@chubb.com

DAVID KROLL, AVP, WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
P.O. BOX 5118
SCRANTON PA 18505
Tel: 818 428 3753 Fax: 818 428 3588 Email: david.kroll@chubb.com

CHARTER OAK FIRE INSURANCE COMPANY

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC.
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TROY TICE, DIRECTOR OF OPERATIONS THE TRAVELERS COMPANIES, INC

445 SOUTH STREET
MORRISTOWN, NJ 07960
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

CHEROKEE INSURANCE COMPANY

MARJAN PALJUSAJ, CLAIM REPRESENTATIVE CHEROKEE INSURANCE COMPANY
P.O. BOX 159
WARREN, MI 48090
Tel: 800 201 0450 ext: 3440 Fax: Email: mpaljusaj@cherokeeinsurance.com

ROBYN CUSUMANO, ACCOUNTANT CHEROKEE INSURANCE COMPANY
P.O. BOX 159
WARREN, MI 48090
Tel: 800 201 0450 ext: 3411 Fax: Email: tax@cherokeeinsurance.com

CHUBB INDEMNITY INSURANCE COMPANY

LEVERETT STOCKING III, VP, CLAIM LEADER, NORTHEAST WORKERS' COMPENSATION CHUBB NORTH AMERICA CLAIMS
555 LONG WHARF DRIVE
NEW HAVEN CT 06511
Tel: 203 782 4082 Fax: 203 782 4126 Email: lstocking@chubb.com

MICHELLE LOPA, AVP, CLAIM MANAGER
150 ALLEN ROAD SUITE 101
BASKING RIDGE NJ 07920
Tel: 908 605 3058 Fax: 908 860 4706 Email: mlopa@chubb.com

CHUBB INSURANCE COMPANY OF NEW JERSEY

LEVERETT STOCKING III, VP, CLAIM LEADER, NORTHEAST WORKERS' COMPENSATION CHUBB NORTH AMERICA CLAIMS
555 LONG WHARF DRIVE
NEW HAVEN CT 06511
Tel: 203 782 4082 Fax: 203 782 4126 Email: lstocking@chubb.com

MICHELLE LOPA, AVP, CLAIM MANAGER CHUBB NORTH AMERICA CLAIMS
150 ALLEN ROAD
BASKING RIDGE NJ 07920
Tel: 908 605 3058 Fax: 908 860 4706 Email: mlopa@chubb.com

CHUBB NATIONAL INSURANCE COMPANY

LEVERETT STOCKING III, V.P. CLAIM LEADER,NORTHEAST WORKERS' COMPENSATION CHUBB NORTH AMERICA CLAIMS
555 LONG WHARF DRIVE
NEW HAVEN CT 06511
Tel: 203 782 4082 Fax: 203 782 4126 Email: lstocking@chubb.com
MICHELLE LOPA, AVP, CLAIM MANAGER CHUBB NORTH AMERICA CLAIMS
150 ALLEN ROAD SUITE 101
Tel: 908 605 3058 Fax: 908 860 4706 Email: mlopa@chubb.com

CHURCH MUTUAL INSURANCE COMPANY

HARRIET GAITHER, CLAIMS MANAGER CHURCH MUTUAL INSURANCE COMPANY S.I.
P.O. BOX 342 MERRILL WI 54452
Tel: 715 539 2306 Fax: 715 539 4651 Email: hgaither@cmregent.com

JENNIFER LAABS, CLAIMS MANAGER CHURCH MUTUAL INSURANCE COMPANY S.I.
P.O. BOX 342 MERRILL WI 54452
Tel: 715 539 5850 Fax: 715 539 4651 Email: jlaabs@churchmutual.com

CINCINNATI CASUALTY COMPANY

LINDSEY GUSTAVSON, ASSOCIATE MANAGER-WORKERS' COMPENSATION CLAIMS CINCINNATI INSURANCE COMPANIES
P.O.BOX 145496
CINCINNATI OH 45250
Tel: 513 371 7546 Fax: 513 371 7030 Email: Lindsey_Gustavson@cinfin.com

JESSICA ELSASS, ASSISTANT MANAGER- WORKERS' COMPENSATION CLAIMS CINCINNATI INSURANCE COMPANIES
P.O. BOX 145496
CINCINNATI OH 45250
Tel: 513 603 5664 Fax: 513 603 5002 Email: WCClaims@cinfin.com

CINCINNATI INDEMNITY COMPANY

LINDSEY GUSTAVSON, ASSOCIATE MANAGER - WORKERS' COMPENSATION CLAIMS CINCINNATI INSURANCE COMPANIES
P.O. BOX 145496
CINCINNATI OH 45250
Tel: 513 371 7546 Fax: 513 371 7030 Email: Lindsey_Gustavson@cinfin.com

JESSICA ELSASS, ASSISTANT MANAGER - WORKERS' COMPENSATION CLAIMS CINCINNATI INSURANCE COMPANIES
P.O. BOX 145496
CINCINNATI OH 45250
Tel: 513 603 5664 Fax: 513 603 5002 Email: WCClaims@cinfin.com

CINCINNATI INSURANCE COMPANY

LINDSEY GUSTAVSON, ASSOCIATE MANAGER - WORKERS' COMPENSATION CLAIMS CINCINNATI INSURANCE COMPANIES
P.O. BOX 145496
CINCINNATI OH 45250
Tel: 513 371 7546 Fax: 513 371 7030 Email: Lindsey_Gustavson@cinfin.com Name: JESSICA ELSASS, ASSISTANT MANAGER - WORKERS' COMPENSATION CLAIMS CINCINNATI INSURANCE COMPANIES
P.O. BOX 145496
CINCINNATI OH 45250
Tel: 513 603 5664 Fax: 513 603 5002 Email: WCClaims@cinfin.com

CITIZENS INSURANCE COMPANY OF AMERICA

KRISTY CARAHER, UNIT MANAGER WC THE HANOVER INSURANCE GROUP
PO BOX 15144 440
LINCOLN STREET
Tel: 315 453 4361 Fax: 508 635 8809 Email: kcaraher@hanover.com

LAURA THORSEN, UNIT MANAGER WC THE HANOVER INSURANCE GROUP
PO BOX 15144 440
LINCOLN STREET
Tel: 508 855 5279 Fax: 508 635 8809 Email: WCStateforms@hanover.com

CLARENDON NATIONAL INSURANCE COMPANY

DAVID CALANDRO, REGIONAL CLAIMS MANAGER ENTAR US
150 2ND AVENUE NORTH 3RD FLOOR
Tel: 727 217 2964 Fax: 727 576 3627 Email: david.calandro@enstargroup.com

SANDRA CORLEY, CLAIMS MANAGER ENSTAR US
P.O. BOX 100239
COLUMBIA SC 29223
Tel: 803 462 7441 Fax: 803 310 7320 Email: sandra.corley@enstargroup.com

CLEAR SPRING PROPERTY AND CASUALTY COMPANY

BRIAN FISCHER, VICE PRESIDENT CLEAR SPRING PROPERTY AND CASUALTY COMPANY
1 NORTH FEDERAL HIGHWAY, SUITE 400
Tel: 561 609 6220 Fax: Email: brian.fischer@clearspringinsurance.com

SCOTT HANFLING, EXECUTIVE VICE PRESIDENT AND CHIEF LEGAL OFFICER CLEAR SPRING PROPERTY AND CASUALTY COMPANY
227 WEST MONROTE
Tel: 312 837 3680 Fax: Email: scott.hanfling@clearspringinsurance.com

COLONIAL AMERICAN CASUALTY & SURETY COMPANY

KENNETH NIGRO, ASSISTANT VICE PRESIDENT COLONIAL AMERICAN CASUALTY & SURETY COMPANY
300 INTERPACE PARKWAY
Tel: 973 394 5241 Fax: 973 394 5262 Email: kenneth.nigro@zurichna.com

COLONIAL AMERICAN CASUALTY & SURETY COMPANY

BRIAN M. DOOLEY, ASSISTANT VICE PRESIDENT COLONIAL AMERICAN CASUALTY & SURETY COMPANY
300 INTERPLACE PKWY
Tel: 973 394 5281 Fax: 973 394 5262 Email: brian.dooley@zurichna.com

ANTHONY DALESSANDRO, TEAM MANAGER COLONIAL AMERICAN CASUALTY & SURETY COMPANY
300 INTERPACE PARKWAY
Tel: 973 394 5219 Fax: 973 394 5262 Email: anthony.dalessandro@zurichna.com

COLONIAL CONCRETE CO & SUBS

KAREN SAYRE, ADMINISTRATIVE ASST.
P.O. BOX 68
NEWTON, NJ 07860
Tel: 973 940 1851 Fax: 973 940 1852 Email: ksayre@risksolutions.com

APRIL GRANGER, CLAIMS REPRESENTATIVE
P.O. BOX 68
NEWTON, NJ 07860
Tel: 973 940 1851 Fax: 973 940 1852 Email: agranger@risksolutions.com

COMMERCE & INDUSTRY INSURANCE COMPANY

LAUREN MOREN, TECHNICAL HOME OFFICE DIRECTOR AIG
222 SW COLUMBIA STREET 10TH FLOOR
Tel: 503 417 8320 Fax: 877 304 4360 Email: laura.moren@aig.com

CONAGRA FOODS INC AND SUBS

EMILY JONES, FINANCIAL ANALYST CONAGRA BRANDS, INC.
ELEVEN CONAGRA DRIVE 11-200
OMAHA, NE 68102
Tel: 402 240 5964 Fax: 402 917 9509 Email: emily.jones@conagra.com

SCOTT SOLBERG, DIRECTOR, FINANCE CONAGRA BRANDS, INC.
ELEVEN CONAGRA DRIVE 11-200
OMAHA, NE 68102
Tel: 402 240 4574 Fax: 402 930 3340 Email: scott.solberg2@conagra.com

CONTINENTAL CASUALTY COMPANY (CNA)

KEVIN ZACCHIA, ASSISTANT VICE PRESIDENT
5786 WIDEWATERS
DEWITT NY 13214
Tel: 315 431 6752 Fax: 714 256 7905 Email: Kevin.Zacchia@cna.com

TAMMY SOWERS, WORKERS' COMPENSATION CLAIM MANAGER
ONE MERIDIAN BOULEVARD
WYOMISSING PA 19610
Tel: 610 320 4410 Fax: 877 371 5122 Email: Tammy.Sowers@cna.com

CONTINENTAL INDEMNITY COMPANY

JEFFREY A SILVER, SECRETARY CONTINENTAL INDEMNITY COMPANY
P.O. BOX 3646
OMAHA NE 68154
Tel: 402 827 3424 Fax: 402 827 3432 Email: jeffreysilver@silver-law.net

ROBERT STAFFORD, VICE PRESIDENT OF FINANCE CONTINENTAL INDEMNITY COMPANY
P.O. BOX 3646
OMAHA NE 68154
Tel: 402 827 3424 ext: 4094 Fax: 402 827 3432 Email: rstafford@auw.com

CONTINENTAL INSURANCE COMPANY

KEVIN ZACCHIA, ASSISTANT VICE PRESIDENT
5786 WIDEWATERS
DEWITT NY 13214
Tel: 315 431 6752 Fax: 714 431 6894 Email: Kevin.Zacchia@cna.com

TAMMY SOWERS, WORKERS' COMPENSATION CLAIM MANAGER
ONE MERIDIAN BOULEVARD
WYOMISSING PA 19610
Tel: 610 320 4410 Fax: 877 371 5122 Email: Tammy.Sowers@cna.com

CONTINENTAL INSURANCE COMPANY OF NEW JERSEY

KEVIN ZACCHIA, ASSISTANT VICE PRESIDENT - WORKERS' COMPENSATION CLAIM CNA
5786 WIDEWATERS PKWY 3RD FLOOR
Tel: 315 431 6752 Fax: 312 260 6985 Email: kevin.zacchia@cna.com

TAMMY SOWERS, CLAIMS MANAGER CNA ONE MERIDIAN BOULEVARD
WYOMISSING PA 19610
Tel: 610 320 4410 Fax: 877 371 5122 Email: tammy.sowers@cna.com

CONTINENTAL WESTERN INSURANCE COMPANY

KIMBERLY MOORE, WC CLAIMS MANAGER BERKLEY MID-ATLANTIC GROUP (BMAG)
4820 LAKE BROOK DRIVE SUITE 300
Tel: 804 237 5189 Fax: Email: kmoore@wrbmag.com

KAROLINE SANDS, COUNSEL ACADIA INSURANCE COMPANY
1 ACADIA COMMONS
WESTBROOK ME 04092
Tel: 207 228 1932 Fax: 207 771 8090 Email: karoline.sands@acadia-ins.com

COOPER HOSPITAL/UNIVERSITY MEDICAL CENTER

MARYANN MIKULICH, BENEFITS SPECIALIST COOPER UNIVERSITY HOSPITAL
3 COOPER PLAZA, SUITE 500
CAMDEN, NJ 08103
Tel: 856 342 2375 Fax: 856 968 8519 Email: mikulich-maryann@cooperhealth.edu

KATHLEEN VONDER HAYDEN, ADMIN. DIRECTOR OF HUMAN RESOURCES COOPER UNIVERSITY HOSPITAL
3 COOPER PLAZA, SUITE 500
CAMDEN, NJ 08103
Tel: 856 342 3057 Fax: 856 968 8519 Email: vonderhayden-k@cooperhealth.edu

COSTCO WHOLESALE CORPORATION

EDWARD W FRITSCH, CLAIMS SUPERVISOR SCMS
P.O. BOX 14517
LEXINGTON, KY 40512
Tel: 215 231 3804 Fax: 215 231 3800 Email: njmotions@sedgwickcms.com

MICKEY PINEIRO, WORKERS' COMP MANAGER SCMS
P.O. BOX 14517
LEXINGTON, KY 40512
Tel: 215 231 3908 Fax: 215 231 3800 Email: njmotions@sedgwickcms.com

COUNTRYWAY INSURANCE COMPANY

DAVID P JEWELL, DIRECTOR OF CLAIMS COUNTRYWAY INSURANCE COMPANY
P.O. BOX 27552
RICHMOND VA 23261
Tel: 800 828 6862 ext: 45249 Fax: 804 290 1581 Email: djewell@countryway.com

GABRIELLE PROCTOR, LITIGATION AND CASUALTY CLAIMS SUPERVISOR COUNTRYWAY INSURANCE COMPANY
P.O. BOX 27552
RICHMOND VA 23261
Tel: 800 828 6862 ext: 45237 Fax: 804 290 1581 Email: gproctor@countryway.com

CRUM & FORSTER INDEMNITY COMPANY

MARLENE COBAR, WC MANAGER CRUM & FORSTER INDEMNITY COMPANY
P.O. BOX 14139
LEXINGTON KY 40512
Tel: 973 490 6076 Fax: 877 622 6911 Email: marlene.cobar@cfins.com

DIANE PARRISH, AVP WC CLAIMS CRUM & FORSTER INDEMNITY COMPANY
P.O. BOX 14139
LEXINGTON KY 40512
Tel: 973 490 6992 Fax: 877 622 6911 Email: diane.parrish@cfins.com

CRUM & FORSTER INSURANCE COMPANY

MARLENE COBAR, WC MANAGER CRUM & FORSTER INSURANCE COMPANY
P.O. BOX 14139
LEXINGTON KY 40512
Tel: 973 490 6076 Fax: 877 622 6911 Email: marlene.cobar@cfins.com

DIANE PARRISH, CRUM & FORSTER INSURANCE COMPANY
P.O. BOX 14139
LEXINGTON KY 40512
Tel: 973 490 6992 Fax: 877 622 6911 Email: diane.parrish@cfins.com

CUMBERLAND INSURANCE COMPANY

KEN MAILLEY, CLAIMS MANAGER
633 SHILO PIKE P.O. BOX 556
BRIDGETON, NJ 08302
Tel: 856 451 4050 Fax: 856 455 8468 Email: kmailley@cumberlandgroup.com

NICOLE BANO, OPERATIONS MANAGER
633 SHILO PIKE P.O. BOX 556
BRIDGETON, NJ 08302
Tel: 856 451 4050 Fax: 856 455 8468 Email: NBano@cumberlandgroup.com

CVS/HEALTH CORPORATION

JACQUELINE LYNCH, CLAIMS SUPERVISOR SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
PO BOX 14152
LEXINGTON KY 40512
Tel: 973 515 6415 ext: Fax: 859 264 4061 Email: jacqueline.lynch@sedgwickcms.com

TALAL SAADE, CVS CLAIMS OPERATIONS MANAGER SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
PO BOX 14152
LEXINGTON KY 40512
Tel: 714 572 4822 ext: Fax: 501 251 2686 Email: talal.saade@sedgwickcms.com

DAKOTA TRUCK UNDERWRITERS

REBECCA DAVIS, VP CLAIMS RISK ADMINISTRATION SERVICES, INC.
P.O. BOX 89310
SIOUX FALLS SD 57109
Address: Tel: 605 361 4142 Fax: 605 361 4121 Email: rebecca.davis@rascompanies.com

MANDI REDMAN, CLAIMS SUPERVISOR RISK ADMINISTRATION SERVICES
P.O. BOX 89310
SIOUX FALLS SD 57109
Tel: 605 361 4142 Fax: 605 361 4121 Email: mandi.redman@rascompanies.com

DIAMOND STATE INSURANCE COMPANY

DAVID ELLIOT, VICE PRESIDENT
3 BALA PLAZA - EAST BALA
CYNWYD, PA 19004
Tel: 610 538 2525 Fax: 610 660 8885 Email: DELLIOT@GLOBAL-INDEMNITY.COM

MARGARET MCMANUS, MANAGER
2 BALA PLAZA - EAST BALA
CYNWYD, PA 19004
Tel: 610 660 6872 Fax: 610 660 8885 Email: MMCMANUS@GLOBAL-INDEMNITY.COM

DISCOVER PROPERTY & CASUALTY INSURANCE COMPANY

AGNES MORALES, OPERATIONS ANALYST - CLAIMS DISCOVER RE
5 BATTERSON PARK
FARMINGTON, CT 06032
Tel: 860 284 2808 Fax: 860 677 4352 Email: Amorales@Discover-Re.com

GWEN NEAL, OPERATIONS ANALYST - CLAIMS DISCOVER RE
5 BATTERSON PARK
FARMINGTON, CT 06032
Tel: 860 284 2808 Fax: 860 677 4352 Email: Gneal2@Travelers.com

EASTERN ADVANTAGE ASSURANCE COMPANY

ROBERT ALCOCK, SUPERVISOR OF REGIONAL CLAIMS EASTERN ADVANTAGE ASSURANCE COMPANY
25 RACE AVENUE
LANCASTER, PA 17603
Tel: 855 533 3444 Fax: 717 481 7170 Email: ralcock@eains.com

TARA HOOPER, DIRECTOR OF REGIONAL CLAIMS EASTERN ADVANTAGE ASSURANCE COMPANY
25 RACE AVENUE
LANCASTER, PA 17603
Tel: 855 533 3444 ext: 1645 Fax: 717 481 8214 Email: thooper@eains.com

EASTERN ALLIANCE INSURANCE COMPANY

ROBERT ALCOCK, SUPERVISOR OF REGIONAL CLAIMS EASTERN ALLIANCE INSURANCE COMPANY
25 RACE AVENUE
LANCASTER PA 17603
Tel: 855 533 3444 ext: 1624 Fax: 717 481 8214 Email: ralcock@eains.com

TARA HOOPER, DIRECTOR OF REGIONAL CLAIMS EASTERN ALLIANCE INSURANCE GROUP
25 RACE AVENUE
LANCASTER, PA 17603
Tel: 855 533 3444 ext: 1645 Fax: 717 481 8214 Email: thooper@eains.com

EASTGUARD INSURANCE COMPANY

ZACHARY PLESCIA, PARALEGAL EASTGUARD INSURANCE COMPANY
P.O. BOX 1368
WILKES-BARRE PA 18703
Tel: 800 673 2465 Fax: 570 825 2065 Email: zachary.plescia@guard.com

ELECTRIC INSURANCE COMPANY

PAT NICKEL, ADJUSTER GE WC REGIONALSERVICE CENTER
1 CORPORATE PLAZA, SUITE 104
260 WASHINGTON STREET EXT.
Tel: 518 218 2207 Fax: 978 232 1907 Email: Pat.Nickel@electricinsurance.com

JULIE KIELY, SPECIAL LITIGATION MANAGER
75 SAM FONZO DRIVE
BEVERLY, MA 01915
Tel: 978 524 5291 Fax: 978 236 5291 Email: julie.kiely@electricinsurance.com

EMC PROPERTY AND CASUALTY COMPANY

ROBERT E FRANCHETTI, WORKERS COMPENSATION SUPERVISOR EMC INSURANCE COMPANY P.O. BOX 297
POTTSTOWN PA 19464
Tel: 610 427 6200 Fax: 888 992 0216 Email: robert.e.franchetti@emcins.com

ANDY W TYLER, CLAIMS MANAGER EMC INSURANCE COMPANY
P.O. BOX 297
POTTSTOWN PA 19464
Tel: 610 427 6200 Fax: 888 992 0216 Email: andy.w.tyler@emcins.com

EMCASCO INSURANCE COMPANY

ROBERT E FRANCHETTI, WORKERS COMPENSATION SUPERVISOR EMC INSURANCE COMPANY
P.O. BOX 297
POTTSTOWN PA 19464
Tel: 610 427 6200 Fax: 888 992 0216 Email: robert.e.franchetti@emcins.com

ANDY W TYLER, CLAIMS MANAGER EMC INSURANCE COMPANY
P.O. BOX 297
POTTSTOWN PA 19464
Tel: 610 427 6200 Fax: 888 992 0216 Email: andy.w.tyler@emcins.com

EMPLOYERS ASSURANCE COMPANY

LAURA NOEL, CLAIMS UNIT LEADER EMPLOYERS ASSURANCE COMPANY
2550 PASEO VERDE PKWY, SUITE 100
LAS VEGAS NV 89074
Tel: 702 671 7146 Fax: 702 671 7755 Email: inoel@employers.com

KELLY SPINA, CLAIM DIRECTOR EMPLOYERS ASSURANCE COMPANY

LAS VEGAS NV 89074
Tel: 702 671 7271 Fax: 702 671 7735 Email: kspina@employers.com

EMPLOYERS COMPENSATION INSURANCE COMPANY

LAURA NOEL, CLAIMS UNIT LEADER EMPLOYERS COMPENSATION INSURANCE COMPANY
2550 PASEO VERDE PKWY, SUITE 100
LAS VEGAS NV 89074
Tel: 702 671 7146 Fax: 702 671 7755 Email: inoel@employers.com

KELLY SPINA JR, CLAIM DIRECTOR EMPLOYERS COMPENSATION INSURANCE COMPANY
2550 PASEO VERDE PKWY, SUITE 100
LAS VEGAS NV 89074
Tel: 702 671 7271 Fax: 702 671 7735 Email: kspina@employers.com

EMPLOYERS MUTUAL CASUALTY COMPANY

ROBERT E FRANCHETTI, WORKERS COMPENSATION SUPERVISOR EMC INSURANCE COMPANY
P.O. BOX 297
POTTSTOWN, PA 19464
Tel: 610 427 6203 Fax: 888 992 0216 Email: robert.e.franchetti@emcins.com

ANDY W TYLER, CLAIMS MANAGER EMC INSURANCE COMPANY
P.O. BOX 297 POTTSTOWN, PA 19464
Tel: 610 427 6200 Fax: 888 992 0216 Email: andy.w.tyler@emcins.com

EMPLOYERS PREFERRED INSURANCE CO

LAURA NOEL, CLAIMS UNIT LEADER EMPLOYERS PREFERRED INSURANCE COMPANY
2550 PASEO VERDE PKWY, SUTIE 100
LAS VEGAS NV 89074
Tel: 702 671 7146 Fax: 702 671 7755 Email: inoel@employers.com

KELLY SPINA, CLAIM DIRECTOR EMPLOYERS PREFERRED INSURANCE COMPANY
2550 PASEO VERDE PKWY, SUITE 100
LAS VEGAS NV 89074
Tel: 702 671 7271 Fax: 702 674 7735 Email: kspina@employers.com

EVEREST NATIONAL INSURANCE COMPANY

KEITH BARBAROSH, DIRECTOR, REGULATORY COMPLIANCE
477 MARTINSVILLE ROAD
LIBERTY CORNER, NJ 07938
Tel: 908 604 7289 Fax: 908 604 3525 Email: keith.barbarosh@everestre.com

TOM CAREY, CLAIM DIRECTOR
477 MARTINSVILLE ROAD
LIBERTY CORNER, NJ 07938
Tel: 908 604 3344 Fax: 908 604 3525 Email: tom.carey@everestre.com

EXCELSIOR INSURANCE COMPANY

KERRYANNE HOLLISS, SENIOR CLAIMS MANAGER LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 648 7987 Fax: 603 427 2667

JASON HACKLING, DIRECTOR COMPLEX WORKERS COMPENSATION LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 548 6912 Fax: 603 427 2665 Email: Jason.Hackling@LIbertyMutual.com

EXECUTIVE RISK INDEMNITY INC

LEVERETT STOCKING III, VP CLAIM LEADER, NORTHEAST WORKERS' COMPENSATION CHUBB NORTH AMERICA CLAIMS
555 LONG WHARF DRIVE
NEW HAVEN CT 06511
Tel: 203 782 4082 Fax: 203 782 4126 Email: lstocking@chubb.com

MICHELLE LOPA, AVP, CLAIMS MANAGER CHUBB NORTH AMERICA CLAIMS
150 ALLEN ROAD SUITE 101
Tel: 908 605 3058 Fax: 908 860 4706 Email: mlopa@chubb.com

EXPLORER INSURANCE COMPANY

CONNOR MCNULTY, CLAIMS MANAGER EXPLORER INSURANCE COMPANY
15025 INNOVATION DRIVE
P.O. BOX 509039
Tel: 484 654 1919 Fax: 858 369 7706 Email: cmcnulty@icwgroup.com

JUSTIN TARSI, CLAIMS SPECIALIST EXPLORER INSURANCE COMPANY
15025 INNOVATION DRIVE
P.O. BOX 509039
Tel: 484 654 1902 Fax: Email: jtarsi@icwgroup.com

FALLS LAKE NATIONAL INSURANCE CO

BAKARI WATKINS, VICE PRESIDENT - CLAIMS FALLS LAKE NATIONAL INSURANCE COMPANY
P.O. BOX 97308
RALEIGH NC 27624
Tel: 866 459 1349 Fax: 888 629 5821 Email: bakara.watkins@fallslakeins.com

JEANNETTE JOHNIAN, AVP WC CLAIMS FALLS LAKE NATIONAL INSURANCE COMPANY
P.O. BOX 97308
RALEIGH NC 27624
Tel: 866 459 1349 Fax: 888 629 5821 Email: Jeannette.Johnian@fallslakeins.com

FARM FAMILY CASUALTY INSURANCE COMPANY

JULIE LAVIN, WC CLAIM MANAGER
344 ROUTE 9W
GLENMONT, NY 12077
Tel: 518 431 5530 Fax: 518 533 4569 Email: Julile_Lavin@FarmFamily.com

ALICIA HOGAN, HOME OFFICE EXAMINER - WC
344 ROUTE 9W
GLENMONT, NY 12077
Tel: 518 431 5255 Fax: 518 391 7698 Email: alicia_hogan@farmfamily.com

FARMERS INSURANCE COMMPANY OF FLEMINGTON

SUSAN HORVATH, ACCOUNTING ASSOCIATE FARMERS INSURANCE COMPANY OF FLEMINGTON
23 ROYAL ROAD SUITE 100
Tel: 800 842 5032 ext: 601 Fax: 908 782 6899 Email: shorvath@farmersofflemington.com

CONNY BOETTCHER, EXECUTIVE SECRETARY FARMERS INSURANCE COMPANY OF FLEMINGTON
23 ROYAL ROAD SUITE 100
Tel: 800 842 5032 ext: 106 Fax: 908 782 6899 Email: cboettcher@farmersofflemington.com

FARMERS INSURANCE EXCHANGE

MATTHEW BLUM, WORKERS' COMPENSATION CLAIMS MANAGER FARMERS INSURANCE COMPANY
24000 N FARMERS WAY
PHOENIX AZ 85085
Tel: 602 635 5512 Fax: 877 217 1389 Email: matthew.blum@farmersinsurance.com

LAUREN ROLATER, WORKERS' COMPENSATION COMPLIANCE LIAISON FARMERS INSURANCE COMPANY
15700 LONG VISTA DRIVE
AUSTIN TX 78728
Tel: 512 533 8789 Fax: 512 533 8398 Email: lauren.rolater@farmersinsurance.com

FARMERS MUTUAL FIRE INSURANCE COMPANY OF SALEM COUNTY

MELISSA KUCHTYAK, ADMINISTRATIVE SECRETARY
330 FELLOWSHIP ROAD SUITE 200
MT. LAUREL, NJ 08054
Tel: 856 727 3015 Fax: 856 727 3186 Email: Melissa_Kuchtyak@pmagroup.com

JIM JORDAN, AVP CLAIMS 330 FELLOWSHIP ROAD SUITE 200
MT. LAUREL, NJ 08054
Tel: 856 727 3039 Fax: 856 727 3186 Email: jim_jordan@pmagroup.com

FARMINGTON CASUALTY COMPANY

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC.
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TROY TICE, DIRECTOR OF OPERATIONS THE TRAVELERS COMPANIES INC
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travellers.com

FEDERAL EXPRESS CORP.

THOMAS CONSTANCE, CLAIMS SUPERVISOR
P.O. BOX 37726
PHILADELPHIA, PA 19101
Tel: 215 231 3846 Fax: 215 231 3899 Email: njmotions@sedgwickcms.com

MICKEY PINEIRO, WC CLAIMS MANAGER
P.O. BOX 37726
PHILADELPHIA, PA 19101
Tel: 215 231 3908 Fax: 215 231 3899 Email: njmotions@sedgwickcms.com

FEDERAL INSURANCE COMPANY

ANDY HERBERG, CLAIMS SUPERVISOR
15 MOUNTAIN VIEW ROAD
P.O. BOX 1616
WARREN, NJ 07059
Tel: 908 903 5551 Fax: 908 903 5537 Email: asherbert@chubb.com

FEDERAL INSURANCE COMPANY

CARRIE TAGGART III, AVP CLAIM OPERATIONS CHUBB INSURANCE A/K/A FEDERAL INSURANCE COMPANY
2155 W. PINNACLE PEAK ROAD
Tel: 623 580 2409 Fax: Email: carrie.taggart@chubb.com

SARAH O CONNELL, QUALITY AND DATA MANAGER CHUBB INSURANCE A/K/A FEDERAL INSURANCE COMPANY
2155 W. PINNACLE PEAK ROAD
Tel: 623 580 2377 Fax: Email: soconnell@chubb.com

FEDERATED MUTUAL INSURANCE COMPANY

TODD FORBES, REGIONAL CLAIMS MANAGER 9785 CROSSPOINT BLVD SUITE 100
INDIANAPOLIS IN 46256
Tel: 317 595 4580 Fax: 317 849 2236 Email: mtforbes@fedins.com

LYDIA DRILLING, HO CLAIMS MANAGER - WC 121 EAST PARK SQUARE
OWATONNA MN 55060
Tel: 507 444 6752 Fax: 507 455 5738 Email: lsdrilling@fedins.com

FEDERATED RESERVE INSURANCE COMPANY

TODD FORBES, REGIONAL CLAIMS MANAGER
9785 CROSSPOINT BLVD. SUITE
100 INDIANAPOLIS IN 46256
Tel: 317 595 4580 Fax: 317 849 2236 Email: mtforbes@fedins.com

LYDIA DRILLING, HO CLAIMS MANAGER - WC 121 EAST PARK SQUARE
OWATONNA MN 55060
Tel: 507 444 6752 Fax: 507 455 5738 Email: lsdrilling@fedins.com

FEDERATED RURAL ELECTRIC INSURANCE EXCHANGE

CHRISTINA JOHNSON, WORKERS COMPENSATION CLAIMS MGR FEDERATED RURAL ELECTRIC INSURANCE EXCHANGE
P.O. BOX 15147
Tel: 800 356 8360 Fax: 913 541 2822 Email: cjohnson@federatedrural.com

MICHELLE MULLER, SR. CLAIMS SERVICE REP FEDERATED RURAL ELECTRIC INSURANCE
P.O. BOX 15147
LENEXA KS 66285
Tel: 800 356 8360 Fax: 913 541 2817 Email: mrm@federatedrural.com

FEDEX GROUND PACKAGE SYSTEM, INC.

LEIGH FERRON, MANAGER, WORKERS' COMPENSATION FEDEX GROUND PACKAGE SYSTEM, INC.
1000 FEDEX DRIVE
MOON TOWNSHIP, PA 15108
Tel: 412 859 7240 Fax: 412 747 8320 Email: leigh.ferron@fedex.com

LAURA DETWILER, WORKERS' COMPENSATION ADMINISTRATOR FEDEX GROUND PACKAGE SYSTEM, INC.
1000 FEDEX DRIVE
MOON TOWNSHIP PA 15108
Tel: 412 747 8321 Fax: 412 747 8320 Email: laura.detwiler@fedex.com

FIDELITY & GUARANTY INSURANCE COMPANY

AGNES MORALES, OPERATIONS ANALYST,CLAIM THE TRAVELERS COMPANIES INC/NATIONAL ACCOUNTS UNBUNDLED
ONE TOWER SQUARE
Tel: 860 954 8462 Fax: Email: amorale3@travelers.com

GWEN NEAL, OPERATIONS ANALYST,CLAIM THE TRAVELERS COMPANIES INC/NATIONAL ACCOUNTS UNBUNDLED
ONE TOWER SQURE
Tel: 860 954 8865 Fax: Email: gneal2@travelers.com

FIDELITY & GUARANTY INSURANCE UNDERWRITERS

AGNES MORALES, OPERATIONS ANALYST - CLAIMS THE TRAVELERS COMPANIES INC/NATIONAL ACCOUNTS UNBRIDLED
ONE TOWER SQUARE
Tel: 860 954 8462 Fax: Email: amorale3@travelers.com

GWEN NEAL, OPERATIONS ANALYST - CLAIMS THE TRAVELERS COMPANIES INC/NATIONAL ACCOUNTS UNBRIDLED
ONE TOWER SQUARE
Tel: 860 954 8865 Fax: Email: gneal2@travelers.com

FIRE INSURANCE EXCHANGE

GRAHAM CADWALLADER, TEAM LEADER - WORKERS' COMPENSATION
P.O. BOX 108843
OKLAHOMA CITY, OK 73101
Tel: 630 907 4340 Fax: 630 907 2428 Email: graham.cadwallader@hpcs.com

MIKE MCCABE, CLAIMS MANAGER - WORKERS' COMPENSATION
P.O. BOX 108843
OKLAHOMA CITY, OK 73101
Tel: 630 907 4335 Fax: 630 907 2428 Email: michael.mccabe@hpcs.com

FIREMANS FUND INDEMNITY CORPORATION

STEPHEN LANGSTAFF, WC CLAIMS TEAM LEAD ALLIANZ GLOBAL CORPORATE & SECURITY
P.O. BOX 970
O'FALLEN MO 63366
Tel: 713 877 5580 Fax: 916 415 2597 Email: stephen.langstaff@agcs.allianz.com

LETITIA TIGUE, CLAIMS COMPLIANCE SPECIALIST ALLIANZ GLOBAL CORPORATE & SPECIALTY
P.O. BOX 970
OFALLEN MO 63366
Tel: 952 486 5259 Fax: 888 340 6679 Email: letitia.tigue@agcs.allianz.com

FIREMANS FUND INSURANCE COMPANY

STEPHEN LANGSTAFF, WC CLAIMS TEAM LEAD ALLIANZ GLOBAL CORPORATE & SPECIALTY P.O. BOX 970
O'FALLON MO 63366
Tel: 713 877 5580 Fax: 916 415 2597 Email: stephen.langstaff@agcs.allianz.com

SARA MAREK, WORKERS' COMPENSATION SUPERVISOR
1 PROGRESS POINT PARKWAY, ST. 2
OFALLON MO 63368
Tel: 314 513 1014 Fax: 314 552 7406 Email: sara.marek@agcs.allianz.com

FIREMENS INSURANCE COMPANY OF WASHINGTON DC

KIMBERLY MOORE, WC CLAIMS MANAGER BERKELY MID-ATLANTIC GROUP
4820 LAKE BROOK DRIVE, SUITE 300
GLEN ALLEN, VA 23060
Tel: 804 237 5189 Fax: Email: kmoore@wrbmag.com

KAROLINE SANDS, COUNSEL ACADIA INSURANCE COMPANY
1 ACADIA COMMONS
WESTBROOK ME 04092
Tel: 207 228 1932 Fax: 207 771 8090 Email: karoline.sands@acadia-ins.com

FIRST DAKOTA INDEMNITY COMPANY

REBECCA DAVIS, VP CLAIMS RISK ADMINISTRATION SERVICES INC
P.O. BOX 89310
SIOUX FALLS SD 57109
Tel: 605 361 4142 Fax: 605 361 4121 Email: rebecca.davis@rascompanies.com

MANDI REDMAN, CLAIMS SUPERVISOR RISK ADMINISTRATION SERVICES, INC
P.O. BOX 89310
SIOUX FALLS SD 57109
Tel: 605 361 4142 Fax: 605 361 4121 Email: mandi.redman@rascompanies.com

FIRST FINANCIAL INSURANCE COMPANY

JOHN MAHONEY, CHIEF CLAIM OFFICER FIRST FINANCIAL INSURANCE CORPORATION
185 ASYLUM STREET 7TH FLOOR
Tel: 860 756 7771 Fax: 860 723 8230 Email: jwmahoney@igfcompanies.com

JEFFREY ROBERTS, DIRECTOR - HO CLAIMS FIRST FINANCIALINSURANCE CORPORATION
185 ASYLUM STREET 7TH FLOOR
Tel: 860 723 8217 Fax: 860 723 8230 Email: jwroberts@ifgcompanies.com

FIRST LIBERTY INSURANCE COMPANY

KERRYANNE HOLLINS, SENIOR CLAIMS MANAGER LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 648 7987 Fax: 603 427 2667 Email: Kerryanne.Hollins@LibertyMutual.com

JASON HACKLING, DIRECTOR COMPLEX WORKERS COMPENSATION LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 548 6912 Fax: 603 427 2665 Email: Jason.Hackling@LibertyMutual.com

FIRST NONPROFIT INSURANCE COMPANY

MELISSA KOVACSY, DIRECTOR AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 609 936 3003 Fax: Email: melissa.kovacsy@amtrustgroup.com

SUSAN GOLDMAN, MANAGER AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 732 276 4879 Fax: 678 258 8395 Email: susan.goldman@amtrustgroup.com

FIRSTENERGY CORP & SUBS

TIM LARKIN, CLAIMS TEAM LEADER SEDGEWICK CLAIMS MANAGEMENT SERVICES, INC.
EXECUTIVE PLAZA II
11350 MCCORMICK ROAD SUITE 800
Tel: 410 527 7628 Fax: Email: timothy.larkin@sedgwickcms.com

RISSA GOLDSTEIN, CLAIMS EXAMINER SEDGEWICK CLAIMS MANAGEMENT SERVICES, INC. EXECUTIVE PLAZA II
11350 MCCORMICK ROAD SUITE 800
Tel: 410 773 4215 Fax: Email: rissa.goldstein@sedgwickcms.com

FIRSTENERGY CORPORATION & SUBS

ROBERT MACHION, ASSISTANT VP OF CLAIMS SEDGWICK (TPA)
1801 MARKET STREET
PHILADELPHIA PA 19103
Tel: 215 231 3849 Fax: 215 231 3800 Email: Robert.Machion@sedgwick.com

WILLIAM REEDER, TEAM LEAD SEDGWICK (TPA)
1801 MARKET STREET
PHILADELPHIA PA 19103
Tel: 215 231 3934 Fax: 215 231 3800 Email: William.Reeder@sedgwick.com

FIRSTLINE NATIONAL INSURANCE COMPANY

RICHARD HUGHES, CLAIM SUPERVISOR
200 NORTH MAIN STREET
BEL AIR, MD 21014
Tel: 410 838 4000 Fax: 410 638 8707 Email: richard_hughes@harfordmutual.com

DEBORAH BETTEN, CLAIM SUPERINTENDENT
200 NORTH MAIN STREET BEL AIR, MD 21014
Tel: 410 838 4000 Fax: 410 638 6206 Email: deborah_betten@harfordmutual.com

FITCHBURG MUTUAL INSURANCE COMPANY

JOSEPH B. HASWELL, ASST. DIV. MANAGER, CASUALTY CLAIMS
222 AMES STREET
DEDHAM, MA 02026
Tel: 781 326 4010 Fax: 781 329 1818 Email: jhaswell@ndgroup.com

ALAN T. CONSOLETTI, SUPERVISOR, CASUALTY CLAIMS
222 AMES STREET
DEDHAM, MA 02026
Tel: 781 326 4010 Fax: 781 329 1818 Email: aconsoletti@ndgroup.com

FLORISTS MUTUAL INSURANCE COMPANY

JOAN KLOPF, CLAIMS MANAGER FLORISTS MUTUAL INSURANCE COMPANY
TWO TECHNOLOGY PARK DRIVE
WESTFORD MA 01886
Tel: 978 392 7152 Fax: 978 392 7137 Email: joan.klopf@sentry.com

MATT STOSS, DIRECTOR - CLAIMS FIELD FLORISTS MUTUAL INSURANCE COMPANY
1025 BOULDERS PARKWAY SUITE 200
Tel: 804 323 4550 Fax: 800 999 4642 Email: matt.stoss@sentry.com

FMI INSURANCE COMPANY
DALE MARTIN, CO-VICE PRESIDENT - CLAIMS
P.O. BOX 400
BRANCHVILLE, NJ 07862
Tel: 973 948 8808 Fax: 973 948 7190 Email: djmartin@fmiweb.com

MELINDA RUSSO, CLAIMS ADJUSTER
P.O. BOX 400
BRANCHVILLE, NJ 07826
Tel: 973 948 8865 Fax: 973 948 7190 Email: mhawkins@fmiweb.com

FRANK WINSTON CRUM INSURANCE INC
KELLY KURI, CLAIMS MANAGER FRANK WINSTON CRUM INSURANCE COMPANY
100 S. MISSOURI AVENUE
CLEARWATER, FL 33756
727 799 1150 Fax: 727 450 7911 Email: KellyK@FWCrumInsurance.com

BRIGITTE BECKER, VICE PRESIDENT-CLAIMS
100 S. MISSOURI AVENUE
CLEARWATER, FL 33756
Tel: 727 799 1150 Fax: 727 450 7911 Email: brigitteb@fwcruminsurance.com

FRANKENMUTH MUTUAL INSURANCE COMPANY

KRISTIN OTT, WORKERS COMPENSATION SUPERVISOR FRANKENMUTH MUTUAL INSURANCE COMPANY
1 MUTUAL AVENUE
FRANKENMUTH, MI 48787
Tel: 800 234 4433 ext: 2914 Fax: 989 652 6231 Email: kristin.ott@fmins.com

CHRISTOPHER ZOOK, WC/PIP/AUTO CLAIMS MANAGER FRANKENMUTH MUTUAL INSURANCE COMPANY
1 MUTUAL AVENUE
FRANKENMUTH, MI 48787
Tel: 800 234 4433 ext: 2846 Fax: 989 652 6231 Email: christopher.zook@fmins.com

FRANKLIN MUTUAL INSURANCE COMPANY

DALE MARTIN, CO-VICE PRESIDENT - CLAIMS
P.O. BOX 400
BRANCHVILLE, NJ 07826
Tel: 973 948 8808 Fax: 973 948 7190 Email: djmartin@fmiweb.com

MELINDA RUSSO, CLAIMS ADJUSTER
P.O. BOX 400
BRANCHVILLE, NJ 07826
Tel: 973 948 8865 Fax: 973 948 7190 Email: mhawkins@fmiweb.com

GANNETT SATELLITE INFO. NETWORK

KIM HARRIS, RISK MANAGEMENT COORDINATOR GANNETT CO., INC.
7950 JONES BRANCH DRIVE
MCLEAN, VA 22107
Tel: 703 854 6015 Fax: 703 854 2047

GENERAL CASUALTY COMPANY OF WISCONSIN

DAN RUFENACHT, VP-WORKERS COMPENSATION CLAIMS QBE AMERICAS, INC
ONE QBE WAY
SUN PRAIRIE WI 53596
Tel: 916 505 6113 Fax: Email: daniel.rufenacht@us.qbe.com

DAVE PALMER, LEAD CLAIMS COMPLIANCE ANALYST QBE AMERICAS, INC
ONE QBE WAY
SUN PRAIRIE WI 53596
Tel: 608 825 5767 Fax: Email: david.palmer@us.qbe.com

GENERAL SECURITY NATIONAL INSURANCE COMPANY

DENNIS HELEWA, VICE PRESIDENT, CLAIMS
199 WATER STREET SUITE 2100
NEW YORK, NY 10038
Tel: 212 884 9675 Fax: 212 363 3130 Email: dhelewa@scor.com

RICHARD GERRITY, VICE PRESIDENT, CLAIMS
199 WATER STREET SUITE 2100
NEW YORK, NY 10038
Tel: 212 884 9605 Fax: 212 363 3130 Email: rgerrity@scor.com

GENERAL STAR NATIONAL INSURANCE COMPANY

LETITIA BOICE, ASST. VICE PRESIDENT
695 E. MAIN STREET STAMFORD, CT 06901
Tel: 203 328 5646 Fax: 203 328 6150 Email: letitia.boice@gumc.com

PATRICIA VILLEGAS, ASST. VICE PRESIDENT
695 E. MAIN STREET STAMFORD, CT 06901
Tel: 203 328 6079 Fax: 203 328 6150 Email: patricia.villegas@generalstar.com

GENESIS INSURANCE COMPANY

MOLLY DUNN, ASSISTANT VICE PRESIDENT GENESIS INSURANCE COMPANY
120 LONG RIDGE ROAD ATTN: REGULATORY UNIT 3W
Tel: 203 328 5677 Fax: 203 328 5895 Email: molly.dunn@gumc.com

GERRESHEIMER GLASS INC

SUSAN H TINNON, VICE PRESIDENT, HUMAN RESOURCES GERRESHEIMER GLASS, INC.
537 CRYSTAL AVENUE
VINELAND, NJ 08360
Tel: 856 896 6260 Email: s.tinnon@gerresheimer.com

PETER MARTURANO, CLAIMS MANAGER CORVEL CORP.
1000 MADISON AVE, STE 205
NORRISTOWN PA 19403
Tel: 484 831 3332 Fax: 866 392 2565 Email: peter_marturano@corvel.com

GLENCAR INSURANCE COMPANY

KEVIN STINEMAN, CHIEF CLAIMS OFFICER GLENCAR INSURANCE COMPANY
500 PARK BLVD SUITE 825
602 793 1076 Fax: 630 735 2341 Email: Kevin.Stineman@hannover-re.com

FRANK EVANS, SENIOR CLAIMS MANAGER GLENCAR INSURANCE COMPANY
500 PARK BLVD SUITE 825
Tel: 805 217 6917 Fax: 630 735 2341 Email: frank.evans@hannover-re.com

GRANITE STATE INSURANCE COMPANY

LAURA MOREN, TECHNICAL HOME OFFICE DIRECTOR AIG
222 SW COLUMBIA STREET 10TH FLOOR
Tel: 503 417 8320 Fax: 877 304 4360 Email: LAURA.MOREN@AIG.COM

GRAPHIC ARTS MUTUAL INSURANCE COMPANY

IAN FISHER, SUPERVISOR GRAPHIC ARTS MUTUAL INSURANCE COMPANY
P.O. BOX 6610 UTICA NY 13504
Tel: 516 479 5240 Fax: 888 538 2018 Email: ian.fisher@uticanational.com

STEPHEN WILLIAMSON, WC CLAIMS MANAGER GRAPHIC ARTS MUTUAL INSURANCE COMPANY
P.O. BOX 6610
UTICA NY 13504
Tel: 315 734 2462 Fax: 888 538 2018 Email: stephen.williamson@uticanational.com

GRAY INSURANCE COMPANY
ANDY CONDREY, CLAIMS MANAGER THE GRAY INSURANCE COMPANY
P.O. BOX 6202
METAIRIE LA 70009
Tel: 504 457 3826 Fax: 504 587 5658 Email: acondrey@grayinsco.com

LARRY G MILLER, VICE PRESIDENT - CLAIMS THE GRAY INSURANCE COMPANY
P.O. BOX 6202
METAIRIE LA 70009
Tel: 504 754 6685 Fax: 504 887 5658 Email: lmiller@grayinsco.com

GREAT AMERICAN ALLIANCE INSURANCE COMPANY

MICHELE BUCEK, SR CLAIMS MANAGER GREAT AMERICAN INSURANCE GROUP (STRATEGIC COMP)
P.O. BOX 4080 Address:
Tel: 770 280 0786 Fax: 732 576 6157 Email: GAICMSMail@stategiccomp.com

KARA WILLIAMS, CLAIMS MANAGER GREAT AMERICAN INSURANCE GROUP
P.O. BOX 4081
CLINTON IA 52733
Tel: 213 220 8205 Fax: 732 576 8205 Email: alternativemarketscliams@gaig.com

GREAT AMERICAN ASSURANCE COMPANY

MICHELE BUCEK, SR. CLAIMS MANAGER GREAT AMERICAN INSURANCE GROUP (STRATEGIC COMP DIVISION)
P.O. BOX 4080
Tel: 770 280 0786 Fax: 732 576 6157 Email: GAICMSMail@stategiccomp.com

KARA WILLIAMS, CLAIMS MANAGER GREAT AMERICAN INSURANCE GROUP
P.O. BOX 4081
CLINTON IA 52733
Tel: 213 220 8205 Fax: 732 576 6013 Email: alternativemarketsclaims@gaig.com

GREAT AMERICAN INSURANCE COMMPANY OF NEW YORK

MICHELE BUCEK, SR CLAIMS MANAGER GREAT AMERICAN INSURANCE GROUP (STRATEGIC COMP DIVISION)
P.O. BOX 4080
Tel: 770 280 0786 Fax: 732 576 6157 Email: GAICMSMail@strategiccomp.com

KARA WILLIAMS, CLAIMS MANAGER GREAT AMERICAN INSURANCE GROUP
P.O. BOX 4081
CLINTON IA 52733
Tel: 213 220 8205 Fax: 732 576 6013 Email: alternativemarketsclaims@gaig.com

GREAT AMERICAN INSURANCE COMPANY

MICHELE BUCEK, SR. CLAIMS MANAGER GREAT AMERICAN INSURANCE GROUP (STRATEGIC COMP)
P.O. BOX 4080
Tel: 770 280 0786 Fax: 732 576 6157 Email: GAICMSMail@strategiccomp.com

KARA WILLIAMS, CLAIMS MANAGER GREAT AMERICAN INSURANCE GROUP
P.O. BOX 4081
CLINTON IA 45273
Tel: 213 220 8205 Fax: 732 576 4081 Email: alternativemarketsclaims@gaig.com

GREAT AMERICAN SPIRIT INSURANCE COMPANY

MICHELE BUCEK, SR CLAIMS MANAGER GREAT AMERICAN INSURANCE GROUP (STRATEGIC COMP DIVISION)
P.O. BOX 4080
Tel: 770 280 0786 Fax: 732 576 6157 Email: GAICMSMail@strategiccomp@com

KARA WILLIAMS, CLAIMS MANAGER GREAT AMERICAN INSURANCE GROUP
P.O. BOX 4081
CLINTON IA 52733
 Tel: 213 220 8205 Fax: 732 576 6013 Email: alternativemarketsclaims@gaig.com

GREAT DIVIDE INSURANCE COMPAY

ALAA ZUAITER, AVP WC BERKLEY ENVIRONMENTAL
600 E. LAS COLINAS BLVD., SUITE
1344 IRVING, TX 75039 Address: Tel: 972 819 8890 Fax: 866 360 1718 Email: AZuaiter@berkleyenvironmental.com

TAMMY ANSELL, QUALITY & TRAINING MANAGER BERKLEY CASUALTY COMPANY
ONE METROPLEX DRIVE SUITE 500
Tel: 205 874 8204 Fax: 205 870 3245 Email: tansell@berkindcomp.com

GREAT NORTHERN INSURANCE COMPANY

LEVERETT STOCKING III, VP, CLAIM LEADER, NORTHEAST WORKERS' COMPENSATION CHUBB NORTH AMERICA CLAIMS
555 LONG WHARF DRIVE
NEW HAVEN CT 06511
Tel: 203 782 4082 Fax: 203 782 4126 Email: lstocking@chubb.com

MICHELLE LOPA, AVP, CLAIMS MANAGER CHUBB NORTH AMERICA CLAIMS
150 ALLEN ROAD SUITE 101
Tel: 908 605 3058 Fax: 908 860 4706 Email: mlopa@cubb.com

GREAT WEST CASUALTY COMPANY

DALE SEGUIN, VICE PRESIDENT, WC CLAIMS GREAT WEST CASUALTY COMPANY
P.O. BOX 94
SOUTH SIOUX CITY, NE 68776
Tel: 800 228 8602 Fax: 800 833 1851 Email: d.sequin@gwccnet.com

JAMMIE LYNN, SR SUPERVISOR WORKERS COMPENSATION CLAIMS GREAT WEST CASUALTY COMPANY
P.O. BOX 94
SOUTH SIOUX CITY, NE 68776
Tel: 800 228 8602 Fax: 800 833 1851 Email: j.lynn@gwccnet.com

GREATER NEW YORK MUTUAL INSURANCE COMPANY

JAMES M PRIMAMORE, VP CLAIMS GREATER NEW YORK MUTUAL INSURANCE CO
333 THORNALL STREET 9TH FLOOR
Tel: 732 238 6300 ext: 284 Fax: 732 238 0355 Email: jprimamore@gny.com

SUSAN CICCOLELLA, CLAIMS EXAMINER GREATER NEW YORK MUTUAL INSURANCE CO.
333 THORNALL STREET 9TH FLOOR
732 238 6300 ext: 288 Fax: 732 238 0355 Email: sciccolella@gny.com

GREENWICH INSURANCE COMPANY

ANTHONY HAMPTON, REGIONAL CLAIMS OPERAITONS LEAD AXA XL
P.O. BOX 211547
DALLAS TX 75211
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum@axaxl.co

JOHN CONROY, ASST VP, SR CLAIMS SPECIALIST AXA XL
505 EAGLEVIEW BOULEVARD 4TH FLOOR
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum@axaxl.co

GUIDEONE ELITE INSURANCE COMPANY

JOE PITTS, CLAIMS DIRECTOR GUIDEONE INSURANCE
1111 ASHWORTH ROAD
WEST DES MOINES IA 50265
Tel: 515 267 5140 Fax: Email: JPitts@guideone.com

LISA GLIDDEN, BUSINESS UNIT MANAGER GUIDEONE INSURANCE
1111 ASHWORTH ROAD WEST DES MOINES IA 50265
Tel: 515 267 6621 Fax: Email: LGlidden@guideone.com

GUIDEONE MUTUAL INSURANCE COMPANY

LINDA WILSON, WC SUPERVISOR
1025 ASHWORTH ROAD
WEST DES MOINES, IA 50265
Tel: 515 267 5662 Fax: 800 676 4457 Email: lwilson@guideone.com

LEIGH HOLLIS, WC ADJUSTER
1025 ASHWORTH ROAD
WEST DES MOINES, IA 50265
Tel: 515 267 5508 Fax: 800 676 4457 Email: lhollis@guideone.com

HARCO NATIONAL INSURANCE COMPANY

CASSANDRA GOMEZ, MANAGER CLAIM SERVICES
215 SHULMAN BLVD SUITE
400 NAPERVILLE FL 60563
Tel: 630 864 3450 Fax: 630 864 3305 Email: cassandra.gomez@iatinsurance.com

MICHAEL BLINSON, SVP CORPORATE SECRETARY
702 OBERLIN ROAD
RALEIGH NC 27605
Tel: 919 831 8176 Fax: 919 831 8160 Email: mike.blinson@oatomsiramce

HARFORD MUTUAL INSURANCE COMPANY

BRYAN YEKSTAT, WORKERS' COMPENSATION CLAIMS SUPERVISOR
200 NORTH MAIN STREET
BEL AIR, MD 21014
Tel: 410 838 4000 Fax: Email: byekstat@hm1842.com

HARLEYSVILLE INSURANCE COMPANY

MELISSA TRIMMER, WC CLAIMS MANAGER HARLEYSVILLE INSURANCE COMPANY
PO BOX 182079
COLUMBUS OH 43218
Tel: 614 568 6513 Fax: 877 907 8531 Email: MTRIMMER@NATIONWIDE.COM

ANGELA DORAN, WC CONSULTANT HARLEYSVILLE INSURANCE COMPANY
PO BOX 182079
COLUMBUS OH 43218
Tel: 614 677 8613 Fax: Email: dorana1@nationwide.com

HARLEYSVILLE INSURANCE COMPANY OF NEW JERSEY

MELISSA TRIMMER, WC CLAIMS MANAGER HARLEYSVILLE INSURANCE COMPANY OF NEW JERSEY
PO BOX 182079
Tel: 614 568 6513 Fax: 877 907 8531 Email: MTRIMMER@NATIONWIDE.COM

ANGELA DORAN, WC CONSULTANT HARLEYSVILLE INSURANCE COMPANY OF NEW JERSEY
PO BOX 182079
Tel: 614 677 8613 Fax: Email: dorana1@nationwide.com

HARLEYSVILLE PREFERRED INSURANCE COMPANY

MELISSA TRIMMER, WC CLAIMS MANAGER HARLEYSVILLE PREFERRED INSURANCE COMPANY
PO BOX 182079
COLUMBUS NY 43218
Tel: 614 568 6513 Fax: 877 907 8531 Email: MTRIMMER@NATIONWIDE.COM

ANGELA DORAN, WC CONSULTANT HARLEYSVILLE PREFERRED INSURANCE COMPANY
PO BOX 182079
COLUMBUS OH 43218
Tel: 614 677 8613 Fax: Email: dorana1@nationwide.com

HARLEYSVILLE WORCESTER INSURANCE COMPANY

MELISSA TRIMMER, WC CLAIMS MANAGER HARLEYSVILLE WORCESTER INSURANCE COMPANY PO BOX 182079
COLUMBUS OH 43218
Tel: 614 568 6513 Fax: 877 907 8531 Email: MTRIMME@NATIONWIDE.COM

ANGELA DORAN, WC CONSULTANT HARLEYSVILLE WORCESTER INSURANCE COMPANY
P.O. BOX 182079
COLUMBUS OH 43218
Tel: 614 677 8613 Fax: Email: dorana1@nationwide.com

HARTFORD ACCIDENT & INDEMNITY COMPANY

CHRIS TURNER, CLAIM MANAGER
200 COLONIAL CENTER PKWY
LAKE MARY FL 32746 Address: Tel: 407 562 3665 Fax: Email: Chris.Turner@thehartford.com

VANESSA MORGAN, CLAIM MANAGER THE HARTFORD
300 SOUTH STATE STREET
SYRACUSE NY 13202
Tel: 315 385 5249 Fax: Email: Vanessa.Morgan@thehartford.com

HARTFORD CASUALTY INSURANCE COMPANY

CHRIS TURNER, CLAIM MANAGER THE HARTFORD
200 COLONIAL CENTER PKWY
LAKE MARY FL 32746
Tel: 407 562 3665 Fax: Email: Chris.Turner@thehartford.com

VANESSA MORGAN, CLAIM MANAGER THE HARTFORD
300 SOUTH STATE STREET
SYRACUSE NY 13202
Tel: 315 385 5249 Fax: Email: Vanessa.Morgan@thehartford.com

HARTFORD FIRE INSURANCE COMPANY

CHRIS TURNER, CLAIM MANAGER THE HARTFORD
200 COLONIAL CENTER PKWY
LAKE MARY FL 32746
Tel: 407 562 3665 Fax: Email: Chris.Turner@thehartford.com

VANESSA MORGAN, CLAIM MANAGER THE HARTFORD
300 SOUTH STATE STREET
SYRACUSE NY 13202
Tel: 315 385 5249 Fax: Email: Vanessa.Morgan@thehartford.com

HARTFORD INSURANCE COMPANY OF THE MIDWEST

CHRIS TURNER, CLAIM MANAGER THE HARTFORD
200 COLONIAL CENTER PKWY
LAKE MARY FL 32746
Tel: 407 562 3665 Fax: 4 Email: Chris.Turner@thehartford.com

VANESSA MORGAN, CLAIM MANAGER THE HARTFORD
300 SOUTH STATE STREET
SYRACUSE NY 13202
Tel: 315 385 5249 Fax: Email: Vanessa.Morgan@thehartford.com

HARTFORD UNDERWRITERS INSURANCE COMPANY

CHRIS TURNER, CLAIM MANAGER THE HARTFORD
200 COLONIAL CENTER PKWY
LAKE MARY FL 32746
Tel: 407 562 3665 Fax: Email: Chris.Turner@thehartford.com

VANESSA MORGAN, CLAIM MANAGER THE HARTFORD
300 SOUTH STATE STREET
SYRACUSE NY 13202
Tel: 315 385 5249 Fax: Email: Vanessa.Morgan@thehartford.com

HDI GLOBAL AMERICA INSURANCE CO

JOHN THOMPSON, V.P. CLAIMS
700 NORTH BRAND BLVD., SUITE 600
GLENDALE, CA 91203
Tel: 818 662 4360 Fax: 818 637 6015 Email: john.thompson@hdi-gerling.com

MARK ACKERMAN, CHIEF CLAIMS OFFICER
161 N. CLARK STREET CHICAGO, IL 60601
Tel: 312 456 6760 Fax: 312 924 0901 Email: mark.ackerman@hdi-gerling.com

HEREFORD INSURANCE COMPANY

JOHN ENG, WC CLAIMS MANAGER HEREFORD INSURANCE COMPANY
36-01 43RD AVENUE
LONG ISLAND CITY NY 11101
Tel: 718 361 9191 Fax: 718 937 5918 Email: jeng@herefordinsurance.com

RANDOLPH MONTANEZ, WC CLAIMS SUPERVISOR HEREFORD INSURANCE COMPANY
36-01 43RD AVENUE
LONG ISLAND CITY NY 11101
Tel: 718 361 9191 Fax: 718 937 5918 Email: rmontanez@herefordinsurance.com

HERR FOOD, INC.

MARK BENNETT, VP CLAIMS SERVICES
39 N. DUKE STREET
LANCASTER, PA 17601
Tel: 717 397 9600 Fax: 717 735 6951 Email: mbennett@murrayins.com

LINDA KOPF, MANAGER, LICENSING AND COMPLIANCE
39 N. DUKE STREET
LANCASTER, PA 17601
Tel: 717 397 9600 Fax: 717 735 6929 Email: lkopf@murrayins.com

HIGH POINT PREFERRED INSURANCE COMPANY

DAMMIE COURTNEY, HUMAN RESOURCE SPECIALIST
331 NEWMAN SPRINGS ROAD
RED BANK, NJ 07701
Tel: 732 978 6086 Fax: 732 978 6080 Email: dcourtney@highpointins.com

LAURIE MULLINS, HUMAN RESOURCE PROJECT MANAGER
331 NEWMAN SPRINGS ROAD
RED BANK, NJ 07701
Tel: 732 978 6085 Fax: 732 978 6080 Email: lmullins@highpointins.com

HIGHLANDS INSURANCE COMPANY

MARCIE CURCURITO, CLAIM TECHNICAL SPECIALIST
BOX 6396
LAWRENCEVILLE, NJ 08648
Tel: 609 895 3206 Fax: 609 883 9434 Email: marcella.curcurito@highlandsinsurance.com

VERNON WHITE, DIRECTOR OF CLAIMS
BOX 6396
LAWRENCEVILLE, NJ 08648
Tel: 609 895 3005 Fax: 609 883 9434 Email: vernon.white@highlandsinsurance.com

HIGHMARK CASUALTY INSURANCE COMPANY

LANCE VAUGHAN, TECHNICAL COORDINATOR, CLAIMS BRICKSTREET INSURANCE COMPANY
400 QUARRIER STREET
CHARLESTON WV 25301
Tel: 304 941 1000 Fax: 304 941 1294 Email: lance.vaughan@brickstreet.com

ROBERT MARTI, MANAGER, CLAIMS BRICKSTREET INSURANCE COMPANY
400 QUARRIER STREET
CHARLESTON WV 25301
Tel: 304 941 1000 Fax: 304 941 1294 Email: robert.marti@brickstreet.com

HIGHVIEW NATIONAL INSURANCE COMPANY

ESTEE LOWY, CHIEF OPERATING OFFICER HIGHVIEW NATIONAL INSURANCE COMPANY
1 ALPINE COURT SUITE 102
Tel: 845 363 0500 Fax: Email: estee@highviewins.com

JOSEPH SETTON, UNDERWRITING MANAGER HIGHVIEW NATIONAL INSURANCE COMPANY
1 ALPINE COURT SUITE 102
Tel: 845 363 0500 Fax: Email: jsetton@highviewins.com

HOLY REDEEMER HEALTH SYSTEM AND AFFILIATES

DARLENE PETERSON, WC MANAGER
2166 S. 12TH STREET
ALLENTOWN, PA 18103
Tel: 610 969 0162 Fax: 610 969 0252 Email: Darlene.Peterson@lvh.com

BONNIE KEELAR, WC MANAGER
2166 S. 12TH STREET ALLENTOWN, PA 18103
Tel: 610 969 0245 Fax: 610 969 0252 Email: Bonnie.Keelar@lvh.com

HOMESITE INSURANCE COMPANY

LUZANNA MARANGONI, HR GENERALIST
99 BEDFORD STREET
BOSTON, MA 02111
Tel: 617 832 1322 Fax: 866 399 5521 Email: LMarangoni@homesite.com

HOUSING AUTHORITY PROPERTY INSURANCE

LISE HOLIDAY, RESEARCH & COMPLIANCE ANALYST
189 COMMERCE COURT CHESHIRE, CT 06410
Address: Tel: 203 272 8220 Fax: 203 271 2265 Email: LHoliday@housingcenter.com

AMY GALVIN, FIANCIAL COMPLIANCE & PLANNING MANAGER
189 COMMERCE COURT
CHESHIRE, CT 06410
Tel: 203 272 8220 Fax: 203 271 2265 Email: LHoliday@housingcenter.com

HUDSON INSURANCE COMPANY

GREG EDWARDS, CLAIM UNIT MANAGER HUDSON INSURANCE GROUP
100 WILLIAM STREET
NEW YORK NY 10038
Tel: 212 978 2868 Fax: 646 216 3786 Email: gedwards@hudsoninsgroup.com

MICHAEL LOCONSOLO, CLAIMS OPERATIONS MANAGER HUDSON INSURANCE GROUP
100 WILLIAM STREET
NEW YORK NY 10038
212 918 9978 Fax: 646 216 3786 Email: mloconsolo@hudsoninsgroup.com

ILLINOIS INSURANCE COMPANY

JEFF SILVER, SECRETARY ILLINOIS INSURANCE COMPANY
P.O. BOX 3646
OMAHA NE 68154
Tel: 402 827 3424 Fax: 402 827 3432 Email: jeffreysilver@silver-law.net

ROBERT L STAFFORD, VICE PRESIDENT OF FINANCE ILLINOIS INSURANCE COMPANY
P.O. BOX 3646
OMAHA NE 68154
Tel: 402 827 3424 ext: 4094 Fax: 402 827 3432 Email: rstafford@auw.com

ILLINOIS NATIONAL INSURANCE COMPANY

LAURA MOREN, TECHNICAL HOME OFFICE DIRECTOR AIG
222 SW COLUMBIA STREET 10TH FLOOR
Tel: 503 417 8320 Fax: 877 304 4360 Email: Laura.Moren@aig.com

INDEMNITY INSURANCE COMPANY OF NORTH AMERICA

TOM EASON, AVP WORKERS' COMPENSATION CHUBB NORTH AMERICA CLAIMS
1 BEAVER VALLEY ROAD
WILMINGTON, DE 19803
Tel: 302 476 7824 Fax: 302 476 7858 Email: thomas.eason@chubb.com

DAVID KROLL, AVP WORKERS' COMPENSATION CHUBB NORTH AMERICA CLAIMS
P.O. BOX 5118
SCRANTON PA 18505
Tel: 818 428 3753 Fax: 818 428 3588 Email: david.kroll@chubb.com

INDIANA INSURANCE COMPANY

KERRYANNE HOLLISS, SENIOR CLAIMS MANAGER LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 648 7987 Fax: 603 427 2667 Email: Kerryanne.Holliss@LibertyMutual.com

JASON HACKLING, DIRECTOR COMPLEX WORKERS' COMPENSATION LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 648 7987 Fax: 603 427 2665 Email: Jason.Hackling@LibertyMutual.com

INSURANCE COMPANY OF GREATER NEW YORK

JAMES M PRIMAMORE, VP CLAIMS INSURANCE COMPANY OF GREATER NEW YORK
333 THORNALL STREET 9TH FLOOR
Tel: 732 238 6300 Fax: 732 238 0355 Email: jprimamore@gny.com

SUSAN CICCOLELLA, CLAIMS EXAMINER GREATER NEW YORK INSURANCE
333 THORNALL STREET 9TH FLOOR
Tel: 732 238 6300 ext: 288 Fax: 732 238 0355 Email: jprimamore@gny.com

INSURANCE COMPANY OF NORTH AMERICA

TOM EASON, AVP, WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
1 BEAVER VALLEY ROAD
WILMINGTON DE 19803
Tel: 302 476 7824 Fax: 302 476 7858 Email: Thomas.Eason@chubb.com

DAVID KROLL, AVP, WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
P.O. BOX 5118
SCRANTON PA 18505
Tel: 818 428 3753 Fax: 818 428 3588 Email: david.kroll@chubb.com

INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

LAURA MOREN, TECHNICAL HOMEOFFICE DIRECTOR AIG
222 SW COLUMBIA STREET 10TH FLOOR
Tel: 503 417 8320 Fax: 877 304 4360 Email: Laura.Moren@aig.com

INSURANCE COMPANY OF THE WEST

CONNOR MCNULTY, CLAIMS MANAGER ICW GROUP
15025 INNOVATION DRIVE
P.O. BOX 509039
Tel: 484 654 1919 Fax: 858 369 7706 Email: cmcnulty@icwgroup.com

JUSTIN TARSI, CLAIMS SPECIALIST ICW GROUP
15025 INNOVATION DRIVE
P.O. BOX 509039
Tel: 484 654 1902 Fax: 858 369 7706 Email: jtarsi@icwgroup.com

KING WORLD CORPORATION

STEPHANIE GROSSBERG, DIRECTOR - RISK MANAGEMENT
51 W. 52ND STREET
NEW YORK, NY 10019
Tel: 212 975 8971 Fax: 212 597 4163 Email: stephanie.grossberg@cbs.com

DAVID RICHARDSON, VICE PRESIDENT - CLAIMS ONE UNION PLAZA
NEW LONDON, CT 06320
Tel: 860 447 0048 Fax: 860 442 0076 Email: drichardson@murphybeane.com

LANCER INDEMNITY COMPANY

KIRT VOVOU, ASSISTANT VICE PRESIDENT CLAIMS LANCER INDEMNITY COMPANY
370 WEST PARK AVENUE
LONG BEACH NY 11561
Tel: 516 825 2800 Fax: 516 825 1947 Email: kvovou@lancerinsurance.com

SEAN METZGER, DIVISION MANAGER LANCER INDEMNITY COMPANY
370 WEST PARK AVENUE
LONG BEACH NY 11561
Tel: 516 825 2800 Fax: 516 825 1947 Email: smetzger@lancerinsurance.com

LANCER INSURANCE COMPANY

MARY GEISWELLER, STATE COMPLIANCE ASST. LANCER INSURANCE COMPANY
370 W. PARK AVENUE
LONG BEACH NY 11561
Tel: 516 431 4441 Fax: 516 889 5111 Email: mgeisweller@lancerinsurance.com

SUZANNE MASTROIANNI, ASSISTANT VP LANCER INSURANCE COMPANY
370 W. PARK AVENUE
LONG BEACH NY 11561
Tel: 516 431 4441 Fax: 516 889 5111 Email: smastroianni@lancerinsurance.com

LIBERTY INSURANCE CORPORATION

KELLYANNE HOLLISS, SENIOR CLAIMS MANAGER LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 648 7987 Fax: 603 427 2667 Email: Kerryanne.Holliss@LibertyMutual.com

JASON HACKLING, DIRECTOR COMPLEX WORKERS COMPENSATION LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 548 6912 Fax: 603 427 2665 Email: Jason.Hackling@LibertyMutual.com

LIBERTY MUTUAL FIRE INSURANCE CO.

KERRYANNE HOLLISS, SENIOR CLAIMS MANAGER LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 648 7987 Fax: 603 427 2667 Email: Kerryanne.Holliss@LibertyMutual.com

JASON HACKLING, DIRECTOR COMPLEX WORKERS COMPENSATION LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 548 6912 Fax: 603 427 2665 Email: Jason.Hackling@LibertyMutual.com

LIBERTY MUTUAL INSURANCE CO.

ANTHONY LEON, CASE MANAGER LIBERTY MUTUAL INSURANCE COMPANY
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 548 6926 Fax: 603 427 2676 Email: anthony.leon@libertymutual.com

LION INSURANCE COMPANY

KAREN BETZ, DIRECTOR OF WORKERS' COMPENSATION PACKARD CLAIMS ADMINISTRATION
P.O. BOX 1549
TARPON SPRINGS FL 34688
Tel: 727 682 1072 Fax: 727 202 9945 Email: kbetz@packardclaims.com

LM INSURANCE CORPORATION

CHRISTOPHER NIESMERTELNY, CLAIMS MANAGER
3 BECKER FARM ROAD
ROSELAND NJ 07068
Tel: 800 900 4875 ext: 2094 Fax: 800 449 2567 Email: christopher.niesmertelny@libertymutual.com

JASON D HACKLING, DIRECTOR OF COMPLEX WC CLAIMS
3 BECKER FARM ROAD
ROSELAND NJ 07068
Tel: 800 900 4875 ext: 2206 Fax: 800 449 2567 Email: jason.hackling@libertymutual.com

LOWES HOME CENTERS INC

KELLY YEAGER, WC CLAIMS HANDLER 150 S. WARNER ROAD SUITE 300
P.O. BOX 61512
Tel: 610 386 7744 Fax: 610 386 7763 Email: Kelly.Yeager@srsconnect.com

MECHELLE COLBY, WC CLAIMS HANDLER
303 LIPPINCOTT DRIVE SUITE 200
P.O. BOX 779
Tel: 856 355 4484 Fax: 860 756 8427 Email: Mechelle.Colby@srsconnect.com

MACY'S INC AND SUBSIDIARIES

SUSAN RUSSELL, WORKERS' COMPENSATION MANAGER MACY'S INC., AND SUBSIDIARIES
7 WEST 7TH STREET
CINCINNATI OH 45202
Tel: 513 579 7249 ext: Fax: Email: susan.russell@macys.com

GEOFF MANUEL, WORKERS' COMPENSATION MANAGER MACYS INC., AND SUBSIDIARIES
7 WEST 7TH STREET
CINCINNATI OH 45202
Tel: 513 579 7734 Fax: Email: geoffrey.manuel@macys.com

MAINE EMPLOYERS MUTUAL INSURANCE CO

MATTHEW HARMON, ASST V.P., MIC CLAIM DEPT.
1750 ELM ST., #500
MANCHESTER, NH 03104
Tel: 603 314 0612 Fax: 603 314 0630 Email: mharmon@memic.com

STACEY FOOTE, UNIT MANAGER
1750 ELM ST., #500 MANCHESTER, NH 03104
Tel: 603 314 0615 Fax: 603 314 0630 Email: sfoote@memic.com

MANUFACTURERS ALLIANCE INSURANCE COMPANY

ERIC REINER, ASST VICE PRESIDENT - EASTERN REGION CLAIMS PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE CO.
380 SENTRY PARKWAY
Tel: 443 690 8960 Fax: 484 530 7899 Email: Eric_Reiner@pmagroup.com

REGINA SIMON, CLAIM MANAGER - EASTERN REGION CLAIMS PENNSYLVANIA MANUFACTURERS ASSOCIATION INS CO.
TWO CHATHAM CENTER
Tel: 412 338 1224 Fax: 412 338 1216 Email: Regina_Simon@pmagroup.com

MARKEL INSURANCE COMPANY

KAREN DWYER, CLAIMS MANAGER MARKEL SERVICE, INCORPORATED
P.O. BOX 3188
OMAHA, NE 68103
Tel: 888 500 3344 Fax: 877 444 6806 Email: kdwyer@firstcomp.com

KIM SHOTKOSKI, SENIOR REGULATORY COMPLIANCE SPECIALIST MARKEL SERVICE, INCORPORATED
P.O. BOX 3188 OMAHA, NE 68103
Tel: 888 500 3344 Fax: 877 444 6806 Email: kshotkoski@firstcomp.com

MARRIOTT CLAIMS SERVICES CORP.

KAREN ROBINSON, CLAIMS UNIT MANAGER MARRIOTT CLAIM SERVICES INC.
9737 WASHINGTONIAN BLVD. SUITE 201
Tel: 301 380 0371 Fax: 301 644 8230 Email: Karen.Robinson@marriot.com

FAITH FRITZ, SENIOR MANAGER CLAIMS OPS. MARRIOTT CLAIM SERVICES INC.
9737 WASHINGTONIAN BLVD. SUITE 201
Tel: 301 380 0375 Fax: 301 644 8230 Email: Faith.Fritz@marriott.com

MARRIOTT INTERNATIONAL, INC.

KAREN ROBINSON, CLAIMS UNIT MANAGER MARRIOTT CLAIM SERVICES
540 GAITHER RD SUITE 600
Tel: 301 380 0371 Fax: 301 644 8230 Email: karen.robinson@marriott.com

FAITH FRITZ, SENIOR MANAGER CLAIMS OPERATIONS MARRIOTT CLAIM SERVICES
540 GAITHER RD SUITE 600
Tel: 301 380 0375 Fax: 301 644 8230 Email: faith.fritz@marriott.com

MASSACHUSETTS BAY INSURANCE COMPANY

KRISTY CARAHER, UNIT MANAGER WC THE HANOVER INSURANCE GROUP
PO BOX 15144
440 LINCOLN STREET
Tel: 315 453 4361 Fax: 508 635 8809 Email: kcaraher@hanover.com

LAURA THORSEN, UNIT MANAGR WC THE HANOVER INSURANCE GROUP
PO BOX 15144
440 LINCOLN STREET
Tel: 508 855 5279 Fax: 508 635 8809 Email: WCStateforms.hanover.com

MCWANE INC

MELANIE WILLIAMSON, VP & TREASURER MCWANE, INC.
2900 HIGHWAY 280, SUITE 300
BIRMINGHAM AL 35223
Tel: 205 414 3118 Fax: 205 414 3170 Email: melanie.williamson@mcwane.com

BONITA FLIPPO, AVP-RISK MANAGEMENT MCWANE, INC.
2900 HIGHWAY 280, SUITE 300
BIRMINGHAM AL 35223
Tel: 205 414 3110 Fax: 205 414 3170 Email: bonita.flippo@mcwane.com

MEMIC INDEMNITY COMPANY

GABE FOELDES, CLAIM TEAM MANAGER
MEMIC INDEMNITY COMPANY
1200 HARBOR BLVD. 10TH FLOOR
Tel: 201 643 170 Fax: 201 791 3334 Email: gfoeldes@memic.com

KAREN BELEY, CLAIM SPECIALIST IV MEMIC INDEMNITY COMPANY
1200 HARBOR BLVD 10TH FLOOR
Tel: 201 643 1704 Fax: 201 791 3334 Email: kbeley@memic.com

MEMORIAL SLOAN KETTERING CANCER CENTER

MAGDALENE NEGRON, MANAGER, FMLA/DISABILITY
533 THIRD AVENUE, 5TH FLOOR
NEW YORK, NY 10017
Tel: 646 227 3638 Fax: 212 557 1249 Email: negronm@mskcc.org

DONYSA VACHARASANEE, DISABILITY SPECIALIST
633 THIRD AVENUE, 5TH FLOOR
NEW YORK, NY 10017
Tel: 646 227 3289 Fax: 212 557 1249 Email: vacarad@mskcc.org

MERCER INSURANCE COMPANY OF NEW JERSEY INC

KEVIN MELCHERT, CLAIM SUPERVISOR UNITED FIRE GROUP
P.O. BOX 73909
CEDAR RAPIDS IA 52407
Tel: 319 399 5803 Fax: 888 514 9190 Email: kmelchert@unitedfiregroup.com

DEB ZANAR, SR. CLAIM REPRESENTATIVE UNITED FIRE GROUP
P.O. BOX 73909 CEDAR RAPIDS IA 52407
Tel: 319 247 6141 Fax: 888 514 9190 Email: dzanar@unitedfiregroup.com

MERCHANTS MUTUAL INSURANCE COMPANY

DEE GRAULICH, CLAIM REPRESENTATIVE
309 FELLOWSHIP ROAD SUITE 300
MT. LAUREL NJ 08054
Tel: 865 235 8890 ext: 271 Fax: 856 778 8290 Email: fgraulich@merchantsgroup.com

BILL WOLFE, CLAIM MANAGER
309 FELLOWSHIP ROAD SUITE 300
MT. LAUREL NJ 08054
Tel: 856 235 8890 ext: 270 Fax: 856 778 8290 Email: wwolfe@merchantsgroup.com

MERCHANTS PREFERRED INSURANCE COMPANY

MARALEE L DENZ, WC SUPERVISOR MERCHANTS INSURANCE GROUP
250 MAIN STREET
BUFFALO NY 14202
Tel: 716 849 3029 Fax: 716 849 3379 Email: MDenz@merchantsgroup.com

JONATHAN PERKINS, CLAIMS MANAGER MERCHANTS INSURANCE GROUP
250 MAIN STREET
BUFFALO NY 14202
Tel: 716 849 3250 Fax: 716 849 3379 Email: JPerkins@merchantsgroup.com

MERCK & COMPANY, INC.

ERIC JUSTICE, WC TEAM LEADER
100 DMV DRIVE
KING OF PRUSSIA PA 19406
Tel: 800 551 0271 Fax: 860 947 3907 Email: eric.justice@srsconnect.com

NANCY HOFAKER, ACCOUNT MANAGEMENT DIRECTOR
303 LIPPINCOTT CENTER SUITE 200
MANTOR NJ 08053
Tel: 856 797 6533 Fax: 860 756 8426 Email: nancy.hofacker@srsconnect.com

MERIDIAN SECURITY INSURANCE COMPANY

SUSAN PILON, WC CLAIM MANAGER STATE AUTO INSURANCE COMPANIES
P.O. BOX 182617
COLUMBUS OH 43218
Tel: 952 897 5543 Fax: 800 563 3364 Email: susan.pilon@libertymutual.com

MICHAEL SCHNEIDER, CLAIMS TEAM MANAGER STATE AUTO INSURANCE COMPANIES
P.O. BOX 182617
COLUMBUS OH 43218
Tel: 952 893 3774 Fax: 800 563 3364 Email: michael.schneider@libertymutual.com

METUCHEN, RC DIOCESE OF

JACQUELINE GLAKIN, INSURANCE MANAGER
146 METLARS LANE DIOCESE OF METUCHEN
PISCATAWAY NJ 08854
Tel: 732 562 1990 Fax: 732 562 2464 Email: jglackin@diometuchen.org

ERIC DILL, HUMAN RESOURCES DIRECTOR
146 METLARS LANE
PPISCATAWAY NJ 07059
Tel: 732 562 2465 Fax: 732 562 2464 Email: edill@metuchen.org

MIC PROPERTY & CASUALTY INSURANCE CORPORATION

SHANNA ADAMS, LICENSING SUPERVISOR
300 GALLERIA OFFICENTRE, SUITE 200
SOUTHFIELD, MI 48034
Tel: 248 263 6922 Fax: 248 263 6915 Email: shanna.adams@gmacts.com

MID CENTURY INSURANCE COMPANY

MATTHEW BLUM, WORKERS' COMPENSATION CLAIMS MANAGER FARMERS INSURANCE COMPANY
24000 N FARMERS WAY
PHOENIX AZ 85085
Tel: 602 635 5512 Fax: 877 217 1389 Email: matthew.blum@farmersinsurance.com

LAUREN ROLATER, WORKERS' COMPENSATION COMPLIANCE LIAISON FARMERS INSURANCE COMPANY
15700 LONG VISTA DRIVE
AUSTIN TX 78728
Tel: 512 533 8789 Fax: 512 533 8398 Email: lauren.rolater@farmersinsurance.com

MIDDLESEX INSURANCE COMPANY
JOAN KLOPF, CLAIMS MANAGER MIDDLESEX INSURANCE COMPANY
TWO TECHNOLOGY PARK DRIVE
WESTFORD MA 01886
Tel: 978 392 7152 Fax: 978 392 7137 Email: joan.klopf@sentry.com

KARRI ERBES, CLAIMS MANAGER MIDDLESEX INSURANCE COMPANY
1501 NORTH POINT DRIVE
STEVENS POINT, WI 54481
Tel: 715 346 9311 Fax: 715 346 9708 Email: karri.erbes@sentry.com

MIDWEST EMPLOYERS CASUALTY COMPANY

BRENT FOURNIER, CLAIMS MANAGER BERKLEY NET UNDERWRITERS
9301 INNOVATION DRIVE SUITE 200
Tel: 571 298 0972 Fax: 855 395 2518 Email: bfournier@berkleynet.com

HANNAH HANSON, CLAIMS OPERATIONS SPECIALIST BERKLEY NET UNDERWRITERS
9301 INNOVATION DRIVE SUITE 200
Tel: 571 778 6602 Fax: 855 395 2518 Email: hhanson@berkleynet.com

MILFORD CASUALTY INSURANCE COMPANY

MELISSA KOVACSY, DIRECTOR AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 609 936 3003 Fax: 678 258 8395 Email: melissa.kovacsy@amtrustgroup.com

SUSAN GOLDMAN, SENIOR MANAGER AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 732 276 4879 Fax: 678 258 8395 Email: susan.goldman@amtrustgroup.com

MITSUI SUMITOMO INSURANCE COMPANY OF AMERICA

ROBERT MIKITA, WC CLAIMS MANAGER MITSUI SUMITOMO MARINE MANAGEMENT
15 INDEPENDENCE WAY
WARREN NJ 07059
Tel: 908 604 2911 Fax: 419 730 4930 Email: RMikita@msigusa.com

KAREN HAYES, SR WC CLAIMS SPECIALIST MITSUI SUMITOMO MARINE MANAGEMENT
15 INDEPENDENCE WAY
WARREN NJ 07059
Tel: 908 604 2941 Fax: 419 730 4930 Email: KHayes@msigusa.com

MITSUI SUMITOMO INSURANCE USA INC

ROBERT MIKITA, WC CLAIMS MANAGER MITSUI SUMITOMO MARINE MANAGEMENT
15 INDEPENDENCE BLVD.
WARREN NJ 07059
Tel: 908 604 2911 Fax: 419 730 4930 Email: RMikita@msigusa.com

KAREN HAYES, SR WC CLAIMS MANAGER MITSUI SUMITOMO MARINE MANAGEMENT
15 INDEPENDENCE BLVD
WARREN NJ 07059
Tel: 908 604 2941 Fax: 419 730 4930 Email: KHayes@msigusa.com

MONMOUTH OCEAN HOSPITAL SERVICES CORP

JACQUELINE A LYNCH, CLAIMS MANAGER
PO BOX 309
PISCATAWAY NJ 08854
Tel: 732 562 7872 Fax: 732 465 7355 Email: jlynch@qualcareinc.com

KAREN JOSKO, SUPERVISOR OF WORKERS' COMPENSATIOIN
PO BOX 309
PISCATAWAY NJ 08854
Address: Tel: 732 465 7346 Fax: 732 465 7355 Email: kjosko@qualcareinc.com

MORRIS COUNTY MUNICIPAL JOINT INSURANCE FUND

ALICE H LIHOU, VICE PRESIDENT QUAL-LYNX
100 DECADON DRIVE
EGG HARBOR TOWNSHIP NJ 08234
Tel: 609 653 8400 ext: 2063 Fax: 609 653 2928 Email: alihou@qual-lynx.com

GEMMA ARMENIA, UNIT MANAGER QUAL-LYNX
100 DECADON DRIVE
EGG HARBOR TOWNSHIP NJ 08234
Tel: 609 653 8400 ext: 2063 Fax: 609 601 3181 Email: garmenia@qual-lynx.com

MOTORS INSURANCE CORPORATION

SHANNA ADAMS, LICENSING SUPERVISOR
300 GALLERIA OFFICENTRE, SUITE
200 SOUTHFIELD, MI 48034
Tel: 248 263 6922 Fax: 248 263 6915
Email: shanna.adams@gmacts.com

NATIONAL FIRE INSURANCE OF HARTFORD

KEVIN ZACCHIA, ASSISTANT VICE PRESIDENT
5786 WIDEWATERS
DEWITT NY 13214
Tel: 315 431 6752 Fax: 714 256 7905 Email: Kevin.Zacchia@cna.com

TAMMY SOWERS, WORKERS' COMPENSATION CLAIM MANAGER
ONE MERIDIAN BOULEVARD
WYOMISSING PA 19610
Tel: 610 320 4410 Fax: 877 371 5122 Email: Tammy.Sowers@cna.com

NATIONAL INTERSTATE INSURANCE COMPANY

DAN RUSSO, COMPLIANCE MANAGER
3250 INTERSTATE DRIVE
RICHFIELD, OH 44286
Tel: 800 929 1500 ext: 1544 Fax: 330 659 8909 Email: daniel.russo@natl.com

ANDY ISAKOFF, CLAIMS MANAGER
3250 INTERSTATE DRIVE
RICHFIELD, OH 44286
Tel: 800 929 1500 ext: 1117 Fax: 330 659 8909 Email: andy.isakoff@natl.com

NATIONAL INTERSTATE INSURANCE COMPANY OF HAWAII

ANDY ISAKOFF, CLAIMS MANAGER 3250 INTERSTATE DRIVE
RICHFIELD, OH 44286
Tel: 800 929 1500 ext: 1117 Fax: 330 659 8909 Email: andy.isakoff@natl.com

BRAD SCOFIELD, VICE PRESIDENT OF CLAIMS
3250 INTERSTATE DRIVE
RICHFIELD, OH 44286
Tel: 800 929 1500 ext: 1110 Fax: 330 659 8909 Email: brad.scofield@natl.com

NATIONAL SPECIALTY INSURANCE COMPANY

DIANNA CORDOVA, SENIOR COMPLIANCE ANALYST
1900 L. DON DODSON DRIVE
BEDFORD TX 76021
Tel: 800 877 4567 Fax: 877 295 3081 Email: WorkComp@StateNational.com

MONICA MCKENZIE, COMPLIANCE MANAGER
1900 L. DON DODSON DRIVE
BEDFORD, TX 76021
Address: Tel: 800 877 4567 Fax: 877 295 3081 Email: WorkComp@StateNational.com

NATIONAL SURETY CORPORATION

STEPHEN LANGSTAFF, WC CLAIMS TEAM LEAD ALLIANZ GLOBAL CORPORATE & SECURITY
P.O. BOX 970
O'FALLON MO 6366
Tel: 713 877 5580 Fax: 916 415 2597 Email: stephen.langstaff@agcs.allianz.com

LETITIA TIGUE, CLAIMS COMPLIANCE SPECIALIST ALLIANZ GLOBAL CORPORATE & SECURITY
P.O. BOX 970
OFALLON MO 63366
Tel: 952 486 5259 Fax: 888 340 6679 Email: letitia.tigue@agcs.allianz.com

NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PENNSYLVANIA

LAURA MOREN, TECHNICAL HOME OFFICE DIRECTOR AIG
222 SW COLUMBIA STREET 10TH FLOOR
Tel: 503 417 8320 Fax: 877 304 4360 Email: Laura.Moren@aig.com

NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PENNSYLVANIA

JANICE M. MOORE, ASST. VICE PRESIDENT
P O BOX 25991
SHAWNEE MISSION KS 66225
Tel: 302 765 1635 Fax: 320 765 1806 Email: Janicem.moore@aig.com

NATIONWIDE AGRIBUSINESS INSURANCE COMPANY

MELISSA TRIMMER, WC CLAIM MANAGER NATIONWIDE AGRIBUSINESS INSURANCE COMPANY
P.O. BOX 182079
COLUMBUS OH 43218
Tel: 614 568 6513 Fax: Email: mtrimmer@nationwide.com

ANGELA DORAN, WC CONSULTANT NATIONWIDE AGRIBUSINESS INSURANCE COMPANY
P.O. BOX 182079
COLUMBUS OH 43218
Tel: 614 677 8613 Fax: Email: dorana1@nationwide.com

NATIONWIDE MUTUAL FIRE INSURANCE COMPANY

MELISSA TRIMMER, WC CLAIM MANAGER NATIONWIDE MUTUAL FIRE INSURANCE COMPANY
PO BOX 182079
Tel: 614 568 6513 Fax: 877 907 8531 Email: mtrimme@nationwide.com

ANGELA DORAN, WC CONSULTANT NATIONWIDE MUTUAL FIRE INSURANCE COMPANY
P.O. BOX 182079
COLUMBUS OH 43218
Tel: 614 677 8613 Fax: Email: dorana1@nationwide.com

NATIONWIDE MUTUAL INSURANCE COMPANY

MELISSA TRIMMER, WC CLAIMS MANAGER NATIONWIDE MUTUAL INSURANCE COMPANY
PO BOX 182079
COLUMBUS OH 43218
Tel: 614 568 6513 Fax: 877 907 8531 Email: mtrimme@NATIONWIDE.COM

ANGELA DORAN, WC CONSULTANT NATIONWIDE MUTUAL INSURANCE COMPANY
P.O. BOX 182079
COLUMBUS OH 43218
Tel: 614 677 8613 Fax: Email: dorana1@nationwide.com

NETHERLANDS INSURANCE COMPANY

TODD GANCARZ, UNIT LEADER
5062 BRITTONFIELD PARKWAY EAST
SYRACUSE NY 13057
Tel: 315 431 6131 Fax: 800 526 0681 Email: todd.gancarz@peerless-ins.com

KAREN PEINKOFER, UNIT LEADER 5062 BRITTONFRIELD PARKWAY
EAST SYRACUSE NY 13057
Tel: 315 431 6322 Fax: 800 526 0681 Email: karen.peinkofer@peerless-ins.com

NEW HAMPSHIRE INSURANCE COMPANY

LAURA MOREN, TECHNICAL HOME OFFICE DIRECTOR AIG
222SW COLUMBIA STREET 10TH FLOOR
Tel: 503 417 8320 Fax: 877 304 4360 Email: Laura.Moren@aig.com

NEW JERSEY CASUALTY INSURANCE COMPANY

FRANK PERPIGLIA, DIRECTOR, WC CLAIMS NJM INSURANCE COMPANY
301 SULLIVAN WAY WEST
TRENTON, NJ 08628
Tel: 609 883 1300 Fax: 609 882 0838 Email: FPerpiglia@NJM.com

JAMIE SONSINI, DIRECTOR, WC CLAIMS NEW JERSEY CASUALTY INSURANCE COMPANY NJM INSURANCE COMPANY
301 SULLIVAN WAY
Tel: 609 883 1300 Fax: 609 882 0838 Email: JSonsini@NJM.com

NEW JERSEY INDEMNITY INSURANCE COMPANY

FRANK PERPIGLIA, DIRECTOR, WC CLAIMS NEW JERSEY INDEMNITY INSURANCE COMPANY NJM INSURANCE COMPANY
301 SULLIVAN WAY
Tel: 609 883 1300 Fax: 609 882 0838 Email: FPerpiglia@NJM.com

JAMIE SONSINI, DIRECTOR, WC CLAIMS NEW JERSEY INDEMNITY INSURANCE COMPANY NJM INSURANCE COMPANY
301 SULLIVAN WAY
Tel: 609 883 1300 Fax: 609 882 0838 Email: JSonsini@NJM.com

NEW JERSEY MANUFACTURERS INSURANCE COMPANY

FRANK PERPIGLIA, DIRECTOR, WC CLAIMS NEW JERSEY MANUFACTURERS INSURANCE COMPANY NJM INSURANCE COMPANY
Tel: 609 883 1300 Fax: 609 882 0838 Email: FPerpiglia@NJM.com

JAMIE SONSINI, DIRECTOR, WC CLAIMS NEW JERSEY MANUFACTURERS INSURANCE COMPANY NJM INSURANCE COMPANY
Tel: 609 883 1300 Fax: 609 882 0838 Email: JSonsini@NJM.com

NEW JERSEY RE-INSURANCE COMPANY

FRANK PERPIGLIA, DIRECTOR, WC CLAIMS NEW JERSEY RE-INSURANCE COMPANY NJM INSURANCE COMPANY
301 SULLIVAN WAY
Tel: 609 883 1300 Fax: 609 882 0838 Email: FPerpiglia@NJM.com

JAMIE SONSINI, NEW JERSEY RE-INSURANCE COMPANY NEW JERSEY RE-INSURANCE COMPANY NJM INSURANCE COMPANY
301 SULLIVAN WAY
Tel: 609 883 1300 Fax: 609 882 0838 Email: JSonsini@NJM.com

NEW YORK MARINE AND GENERAL INSURANCE COMPANY

SHERRON DAVENPORT, AVP, REGULATORY REPORTING
412 MT. KEMBLE AVENUE SUITE 300C
MORRISTOWN NJ 07960
Tel: 973 532 1728 Fax: 855 200 1158 Email: sdavenport@coactionspecialty.com

DANIEL NIEVES, SR. REGULATORY ANALYST
412 MT. KEMBLE AVENUE SUITE 300C
MORRISTOWN NJ 07960
Tel: 973 532 1775 Fax: 855 200 1158 Email: dnieves@coactionspecialty.com

NEWARK, RC ARCHDIOCESE OF

DONNA WROBEL, ASSISTANT DIRECTOR
171 CLIFTON AVENUE
NEWARK, NJ 07104
Address: Tel: 973 497 4044 Fax: 973 497 4313 Email: wrobeldo@rcan.org

JOSEPH FRANK, EXECUTIVE DIRECTOR
171 CLIFTON AVENUE
NEWARK, NJ 07104
Tel: 973 497 4041 Fax: 973 497 4313 Email: frankjoe@rcan.org

NORDSTROM, INC.

SIMONETTA LEVEQUE, WORKERS COMPENSATION SUPERVISOR
P.O. BOX 21865 SEATTLE WA 98111
Address: Tel: 206 303 2501 Fax: 206 303 2789 Email: simonetta.leveque@nordstrom.com

STEVE TOLAN, DIRECTOR OF WORKERS' COMPENSATION
P.O. BOX 21865
SEATTLE WA 98111
Tel: 714 513 4766 Fax: 206 303 2789 Email: steve.tolan@nordstrom.com

NORGUARD INSURANCE COMPANY

ZACHARY PLESCIA, PARALEGAL NORGUARD INSURANCE COMPANY
P.O. BOX 1368
WILKES-BARRE PA 18703
Tel: 800 673 2465 Fax: 570 825 2065 Email: zachary.plescia@guard.com

NORMANDY INSURANCE COMPANY

JOSE BELTRAN, CLAIMS MANAGER
800 FAIRWAY DRIVE SUITE 160
DEERFIELD FL 33441
Tel: 954 617 6265 Fax: 954 666 6047 Email: jbeltran@normandyins.com

CAITLIN PARROTT, BUSINESS ANALYST
800 FAIRWAY DRIVE SUITE
160 DEERFIELD BEACH FL 33441
Tel: 954 617 6265 Fax: 954 666 6047 Email: cparrott@normandyins.com

NORTH POINTE INSURANCE COMPANY

DAN RUFENACHT, VP. WORKERS COMPENSATION CLAIMS QBE AMERICAS, INC.
ONE QBE WAY
SUN PRAIRIE, WI 53596
Tel: 916 505 6113 Fax: 866 251 5389 Email: daniel.rufenacht@us.qbe.com

DAVE PALMER, LEAD CLAIMS COMPLIANCE ANALYST QBE AMERICAS, INC
ONE QBE WAY
SUN PRAIRIE WI 53596
Tel: 608 825 5767 Fax: 866 251 5389 Email: david.palmer@us.qbe.com

NORTH RIVER INSURANCE COMPANY

MARLENE COBAR, WC MANAGER NORTH RIVER INSURANCE COMPANY
P.O. BOX 14139
LEXINGTON KY 40512
Tel: 973 490 6076 Fax: 877 622 6911 Email: marlene.cobar@cfins.com

DIANE PARRISH, AVP WC CLAIMS NORTH RIVER INSURANCE COMPANY
P.O. BOX 14139
LEXINGTON KY 40512
Tel: 973 490 6992 Fax: 877 622 6911 Email: diane.parrish@cfins.com

NOVA CASUALTY COMPANY

MARK ROBICHAUD, WC PROGRAM CLAIM MANAGER HANOVER PROGRAMS
7 WATERSIDE CROSSING SUITE 100
Tel: 860 683 9885 Fax: 860 683 5000 Email: mrobichaud@hanoverprograms.com

JANICE LOMBARDI, SR. ADMINISTRATIVE ASSISTANT HANOVER PROGRAMS
7 WATERSIDE CROSSING SUITE 100
Tel: 860 683 5019 Fax: 860 683 5000 Email: jlombardi@hanoverprograms.com

OAK RIVER INSURANCE COMPANY

JACOB MILLER, MANAGER OAK RIVER INSURANCE COMPANY
P.O. BOX 881716
SAN RANCISCO CA 94188
Tel: 402 952 5156 Fax: 415 675 5469 Email: jamiller@bhhc.com

NICOLE ALBRECHT, ASSISTANT DIRECTOR OAK RIVER INSURANCE COMPANY
P.O. BOX 881716
SAN FRANCISCO CA 94188
Tel: 800 661 6029 Fax: 415 675 5469 Email: nalbrecht@bhhc.com

OBI AMERICA INSURANCE COMPANY

CINDY VAN EYLL, VP OF WC CLAIMS OBI AMERICA INSURANCE COMPANY
601 CARLSON PKWY, SUITE 600
MINNETONKA MN 55305
Tel: 952 852 0828 Fax: 866 639 0437 Email: cvaneyll@IntactInsurance.com

CHRIS BAER, CLAIMS SUPERVISOR OBI AMERICA INSURANCE COMPANY
188 INVERNESS DRIVE WEST, SUITE 600
ENGLEWOOD CO 80112 Address: Tel: 781 332 8708 Fax: 866 387 9623 Email: cbaer@IntactInsurance.com

OBI NATIONAL INSURANCE CO

CINDY VAN EYLL, VP OF WC CLAIMS OBI NATIONAL INSURANCE COMPANY
605 NORTH HIGHWAY 169 SUITE 800
Tel: 952 852 0828 Fax: 866 639 0437 Email: cvaneyll@IntactInsurance.com

CHRIS BAER, CLAIMS SUPERVISOR OBI AMERICA INSURANCE COMPANY
188 INVERNESS DRIVE WEST, SUITE 600
ENGLEWOOD CO 80112
Tel: 781 332 8708 Fax: 866 387 9623 Email: cbaer@IntactInsurance.com

OCCIDENTAL FIRE & CASUALTY COMPANY OF NORTH CAROLINA

CASSANDRA GOMEZ, MANAGER CLAIM SERVICES OCCIDENTAL FIRE & CASUALTY COMPANY
215 SHULMAN BLVD. SUITE 400
Tel: 630 864 3450 Fax: 630 864 3305 Email: cassandra.gomez@iatinsurance.com

MICHAEL BLINSON, SVP CORPORATE SECRETARY HARCO NATIONAL INSURANCE COMPANY
702 OBERLIN ROAD
RALEIGH NC 27605
Tel: 919 831 8176 Fax: 919 831 8160 Email: mike.blinson@iatinsurance.com

OHIO CASUALTY INSURANCE COMPANY

KERRYANNE HOLLISS, SENIOR CLAIMS MANAGER LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 648 7987 Fax: 603 427 2667 Email: Kerryanne.Holliss@LibertyMutual.com

JASON HACKLING, DIRECTOR COMPLEX WORKERS COMPENSATION LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 548 6912 Fax: 603 427 2665 Email: Jason.Hackling@LibertyMutual.com

OHIO FARMERS INSURANCE COMPANY

MONICA CASTRO, SR. WORKERS COMPENSATION CLAIMS REPRESENTATIVE
P.O. BOX 5005
WESTFIELD CENTER OH 44251
Tel: 330 887 0794 Fax: 330 887 4681
Email: MonicaCastro@WestfieldGrp.com

OHIO FARMERS INSURANCE COMPANY

MONICA CASTRO, WC CLAIM SPECIALIST OHIO FARMERS INSURANCE COMPANY
P.O. BOX 5005
WESTFIELD CENTER OH 44251
Tel: 330 887 0794 Fax: 330 887 4681 Email: monicacastro@westfieldgrp.com

JAMES GREENWALD, WORKERS COMPENSATION COMPLEX CLAIMS LEADER
P.O. BOX 5005
WESTFIELD CENTER OH 44251
Tel: 717 581 6878 Fax: 330 887 4681 Email: JamesGreenwald@WestfieldGrp.com

JOSHUA DIXON, WORKERS COMP COMPLEX CLAIMS LEADER OHIO FARMERS INSURANCE COMPANY
P.O. BOX 5005
WESTFIELD CENTER OH 44251
Tel: 717 581 6856 Fax: 330 887 4681 Email: joshuadixon@westfieldgrp.com

OHIO SECURITY INSURANCE COMPANY

KERRYANNE HOLLISS, SENIOR CLAIMS MANAGER LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Address: Tel: 973 648 7987 Fax: 603 427 2667 Email: Kerryanne.Holliss@LibertyMutual.com

JASON HACKLING, DIRECTOR COMPLEX WORKERS COMPENSATION LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 548 6912 Fax: 603 427 2665 Email: Jason.Hackling@LibertyMutual.com

OLD REPUBLIC GENERAL INSURANCE COMPANY

DEBORAH J MATTHEWS, VICE PRESIDENT, REGULATORY COMPLIANCE SERVICES OLD REPUBLIC INTERNATIONAL
307 N. MICHIGAN AVENUE, 17TH FLOOR
CHICAGO, IL 60601
Tel: 312 762 4530 Fax: 312 762 4950 Email: dmatthews@oldrepublic.com

OLD REPUBLIC INSURANCE COMPANY

KRISTINA MARADA, AVP CLAIM COMPLIANCE OLD REPUBLIC RISK MANAGEMENT
445 S. MOORLAND ROAD
BROOKFIELD WI 53005
Tel: 262 797 3400 Fax: 262 979 0486 Email: cclaims@orrm.com

J. ERIC STROKA, VICE PRESIDENT OLD REPUBLIC INSURANCE COMPANY
PO BOX 1019
YOUNGWOOD PA 15697
Tel: 724 834 5000 Fax: 724 834 8204 Email: claims@orinsco.com

PACIFIC EMPLOYERS INSURANCE COMPANY

TOM EASON, AVP, WORKERS' COMPENSATION CHUBB NORTH AMERICA CLAIMS
1 BEAVER VALLEY ROAD
WILMINGTON DE 19803
Tel: 302 476 7824 Fax: 302 476 7858 Email: Thomas.Eason@chubb.com

DAVID KROLL, AVP, WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
P.O. BOX 5118
SCRANTON PA 18505
Tel: OM 428 3753 Fax: 818 428 3588 Email: david.kroll@chubb.com

PACIFIC INDEMNITY COMPANY

LEVERETT STOCKING III, VP, CLAIM LEADER, NORTHEAST WORKERS' COMPENSATION CHUBB NORTH AMERICA CLAIMS
555 LONG WHARF DRVIE
NEW HAVEN CT 06511
Tel: 203 782 4082 Fax: 203 782 4126 Email: lstocking@chubb.com

MICHELLE LOPA, AVP, CLAIM MANAGER CHUBB NORTH AMERICA CLAIMS
150 ALLEN ROAD SUITE 101
Tel: 908 605 3058 Fax: 908 860 4706 Email: mlopa@chubb.com

PACIFIC PIONEER INSURANCE COMPANY

PING CHEN, TREASURER 6363 KATELLA AVENUE
CYPRESS, CA 90630
Tel: 714 228 7800 Fax: 714 228 7932 Email: pingc@pacpioneer.com

LANA CHAN, CONTROLLER PACIFIC PIONEER INSURANCE COMPANY
6363 KATELLA AVENUE
CYPRESS, CA 90630
Tel: 714 228 7800 Fax: 714 228 7930 Email: lchan@ucageneral.com

PARK NATIONAL INSURANCE COMPANY

MELISSA KOVACSY, DIRECTOR AMTRUST FINANCIAL SERVICES INC.
116 VILLAGE BOULEVARD SUITE 303
Tel: 609 936 3003 Fax: 678 258 8395 Email: melissa.kovacsy@amtrustgroup.com

SUSAN GOLDMAN, SENIOR MANAGER AMTRUST FINANCIAL SERVICES, INC
116 VILLAGE BOULEVARD SUITE 303
Tel: 732 276 4879 Fax: 678 258 8392 Email: susan.goldman@amtrustgroup.com

PARKER HANNIFIN CORPORATION

GARY LIMONCELLI, CLAIMS ADJUSTER
850 FULTON STREET, SUITE 3
FARMINGDALE, NY 11735
Tel: 516 750 1323 Fax: 516 283 0282 Email: gll@naiclaimsconsulting.com

TERRY BANASZAK, ACCOUNT EXECUTIVE
1700 EASTPOINT PARKWAY
LOUISVILLE, KY 40223 Address: Tel: 502 244 1343 Fax: 502 426 9185 Email: terryb@uscky.com

PATERSON, RC DIOCESE OF

PATRICIA NAPIER, SR WC CLAIMS SUPERVISOR
P.O. BOX 500
SOMERS POINT, NJ 08244
Tel: 800 367 0138 ext: 2046 Fax: 609 926 8038 Email: tnapier@sciadvantage.com

LINDA DEROUIN, LITIGATED SUPERVISOR
P.O. BOX 500
SOMERS POINT, NJ 08244
Tel: 800 367 0138 ext: 2058 Fax: 609 926 8038 Email: lderouin@sciadvantage.com

PEERLESS INDEMNITY INSURANCE COMPANY

TODD GANCARZ, UNIT LEADER
5062 BRITTONFIELD PARKWAY
EAST SYRACUSE NY 13057
Tel: 301 431 6131 Fax: 800 526 0681 Email: todd.gancarz@peerless-ins.com

KAREN PEINKOFER, UNIT LEADER
5062 BRITTONFIELD PARKWAY EAST
SYRACUSE NY 13057
Tel: 315 431 6322 Fax: 800 526 0681 Email: karen.peinkofer@peerless-ins.com

PENN MILLERS INSURANCE COMPANY

MARCY MARRA, WORKERS' COMP CLAIM SPECIALIST PENN MILLERS INSURANCE CO.
72 NORTH FRANKLIN STREET
PO BOX P
Tel: 570 200 1344 Fax: 570 822 2165 Email: mmarra@chubbagribusiness.com

MATTHEW G MINOR, ATTORNEY SWEET PASQUARELLI, PC
17A JOYCE KILMER AVENUE NORTH
P.O. BOX 674
Tel: 732 249 7180 Fax: 732 249 7705 Email: mminor@sweetpasquarelli.com

PENNSYLVANIA INSURANCE COMPANY

CHRISTINE PICA, CLAIMS MANAGER A.G. RISK MANAGEMENT
3 BATTERYMARCH PARK
QUINCY MA 02169
Tel: 857 403 1886 Fax: 866 399 7701 Email: cpica@agrminc.com

TRACY WALNISTA, CLAIMS SUPERVISOR A.G. RISK MANAGEMENT
3 BATTERYMARCH PARK
QUINCY MA 02169
Tel: 857 403 4989 Fax: 866 535 5142 Email: twalnista@agrminc.com

PENNSYLVANIA LUMBERMENS MUTUAL INSURANCE COMPANY

JOE DONNELLY, HR MANAGER PENNSYLVANIA LUMBERMENS MUTUAL INSURANCE COMPANY
2005 MARKET STREET
Tel: 267 825 9346 Fax: 215 625 9097 Email: Jdonnelly@plmins.com

DONNA SCARDELLI, HR GENERALIST PENNSYLVANIA LUMBERMENS MUTUAL INSURANCE COMPANY
2005 MARKET STREET
Tel: 267 825 9346 Fax: 215 625 9097 Email: dscardelli@plmins.com

PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE COMPANY

ANGELA FLOYD-MURPHY, CLAIMS MANAGER PENNSYLVANIA MANUFACTURERS ASSOCATION INS CO
330 FELLOWSHIP ROAD
Tel: 856 727 3004 Fax: 856 727 3144 Email: Angela_Floyd-Murphy@pmagroup.com

ERIC REINER, ASST VICE PRESIDENT- NORTHEAST REGION CLAIMS PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE
380 SENTRY PARKWAY
Tel: 443 690 8960 Fax: 484 530 7899 Email: Eric_Reiner@pmagroup.com

PENNSYLVANIA MANUFACTURERS INDEMNITY COMPANY

REGINA SIMON, CLAIM MANAGER - EASTERN REGION CLAIMS PENNSYLVANIA MANUFACTURERS INDEMNITY COMPANY
TWO CHATHAM CENTER
Tel: 412 338 1224 Fax: 412 338 1216 Email: Regina_Simon@pmagroup.com

ERIC REINER, ASST VICE PRESIDENT - EASTERN REGION CLAIMS PENNSYLVANIA MANUFACTURERS INDEMNITY COMPANY
380 SENTRY PARKWAY
Tel: 443 690 8960 Fax: 484 530 7899 Email: Eric_Reiner@pmagroup.com

PENNSYLVANIA NATIONAL MUTUAL CASUALTY COMPANY

NICOLE CARRUTH, WC TEAM LEADER
P.O. BOX 3880
HARRISBURG, PA 17105
Tel: 800 942 9715 ext: 3555 Fax: 877 942 9715 Email: ncarruth@pnat.com

DARLENE FLEISHER, WC TEAM LEADER
P.O. BOX 3880
HARRISBURG, PA 17105
Tel: 800 942 9715 ext: 3572 Fax: 877 942 9715 Email: dfleisher@pnat.com

PETROLEUM CASUALTY COMPANY

LAURIE MCCOY, CLAIM SUPERVISOR EXXONMOBIL RISK MANAGEMENT
22777 SPRINGWOODS VILLAGE PARKWAY EMRM/PCC LOC. 105
Tel: 832 624 6693 Fax: 281 298 8394 Email: laurie.h.mccoy@exxonmobile.com

ROBERT BOYER, R05EGIONAL TEAM LEADER - CLAIMS EXXONMOBIL RISK MANAGEMENT
22777 SPRINGWOODS VILLAGE PARKWAY EMRM/PCC LOC.
Tel: 832 625 7693 Fax: 281 298 8394 Email: robert.f.boyer@exxonmobil.com

PHARMACISTS MUTUAL INSURANCE COMPANY

KATHLEEN ZILLES, CLAIMS SUPERVISOR TRISTAR RISK MANAGEMENT
833 CHESTNUT STREET, SUITE 720
PHILADELPHIA, PA 19107
Tel: 814 790 4148 Fax: 215 592 5067 Email: Kathleen.Zilles@tristargroup.net

DANA BRENNAN, CLAIMS SUPERVISOR TRISTAR RISK MANAGEMENT
833 CHESTNUT STREET, SUITE 720
PHILADELPHIA, PA 19107
Tel: 215 592 5141 Fax: 215 592 5067 Email: Dana.Brennen@tristargroup.net

PHOENIX INSURANCE COMPANY

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TROY TICE, DIRECTOR OF OPERATIONS THE TRAVELERS COMPANIES, INC.
445 SOUTH STREET
MORRISTOWN, NJ 07960
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

PLATTE RIVER INSURANCE COMPANY

DAVID REGELE, HEAD OF CONTINUOUS CLAIMS IMPROVEMENT 1600 ASPEN COMMONS SUITE 300
MIDDLETON WI 53562
Tel: 608 829 4869 Fax: 608 829 7411 Email: dregele@capspecialty.com

MICHELLE BEDARD, SR CLAIMS REPORTING & COMPLIANCE SPECIALIST
1600 ASPEN COMMONS SUITE 300
MIDDLETON WI 53562
Tel: 860 494 4938 Fax: 608 829 7411 Email: mbedard@capspecialty.com

PRAETORIAN INSURANCE COMPANY

DANIELLE DOUGHERTY, WC PROJECT UNDERWRITER GREENSLATE
61 MAIN STREET
NEW YORK NY 13753
Tel: 201 206 1099 ext: 167 Fax: Email: wcclaims@gslate.com

PRAETORIAN INSURANCE COMPANY

DAN RUFENACHT, VP- WORKERS COMPENSATION CLAIMS QBE AMERICAS INC
ONE QBE WAY
SUN PRAIRIE, WI 53596
Tel: 916 505 6113 Fax: 866 251 5389 Email: daniel.rufenacht@us.qbe.com

KRISTIN PHRANER, WC ASSISTANT GREENSLATE
61 MAIN STREET
NEW YORK NY 13753
Tel: 212 206 1099 ext: 165 Fax: Email: wcclaims@gslate.com

PREFERRED PROFESSIONAL INSURANCE COMPANY

NICHOLE OLSON, DATABASE SPECIALIST PREFERRED PROFESSIONAL INSURANCE COMPANY
11605 MIRACLE HILLS DRIVE SUITE 200
Tel: 517 886 8330 Fax: 517 327 2535 Email: nolson@coverys.com

PRINCETON INSURANCE COMPANY

PHYLLIS GODFREY, WC CLAIM SUPERVISOR PRINCETON INSURANCE
P.O. BOX 5322
PRINCETON NJ 08543
Tel: 609 452 9404 ext: 135478 Fax: 609 951 5844 Email: Phyllis.godfrey@princetoninsurance.com

PRINCETON UNIVERSITY

LISA ZIMMARO, ESQ., RISK & INSURANCE MANAGER
P.O. BOX 35 2 NEW SOUTH BLDG.
PRINCETON, NJ 08544
Tel: 609 258 3349 Fax: 609 258 3448 Email: lzimmaro@princeton.edu

MEGAN ADAMS, ESQ., ASST. TREASURER
P.O. BOX 35 2 NEW SOUTH BLDG.
PRINCETON NJ 08544
Tel: 609 258 2169 Fax: 609 258 3448 Email: adamsm@princeton.edu

PROCTER & GAMBLE DISTRIBUTING CO.

DENISE MCCLANAHAN, SR. CLAIMS ADJUSTER 5299 SPRING GROVE AVENUE
CINCINNATI, OH 45217
Tel: 800 235 1134 ext: 2 Fax: 513 627 5314 Email: denise.mcclanahan@cambridge-na.com

CARRIE BOWLING, ADMINISTRATOR
5299 SPRING GROVE AVENUE
CINCINATTI, OH 45217
Tel: 513 627 7571 Fax: 866 554 0470 Email: bowling.ca@pg.com

PROCTER & GAMBLE MANUFACTURING CO.

DENISE MCCLANAHAN, SENIOR CLAIMS MANAGER
5299 SPRING GROVE AVENUE
CINCINNITI, OH 45217
Tel: 800 235 1134 ext: 2 Fax: 513 627 5314 Email: denise.mcclanahan@cambridge.com

CARRIE BOWLING, ADMINISTRATOR
5299 SPRING GROVE AVENUE
CINCINNATI, OH 45217
Tel: 513 627 7571 Fax: 866 554 0470 Email: bowling.ca@pg.com

PROPERTY & CASUALTY COMPANY OF HARTFORD

CHRIS TURNER, CLAIM MANAGER THE HARTFORD
200 COLONIAL CENTER PKWY
LAKE MARY FL 32746
Tel: 407 562 3665 Fax: Email: Chris.Turner@thehartford.com

VANESSA MORGAN, CLAIM MANAGER THE HARTFORD
300 SOUTH STATE STREET
SYRACUSE NY 13202
Tel: 315 385 5249 Fax: Email: Vanessa.Morgan@thehartford.com

PROTECTIVE INSURANCE COMPANY

LEA LUNDQUIST, VICE PRESIDENT OF WORKERS' COMPENSATION
P.O. BOX 7099
INDIANAPOLIS IN 46207
Tel: 317 429 2688 Fax: 317 429 2669 Email: NOtice@protectiveinsurance.com

STACY DELEE, CLAIMS COMPLIANCE COUNSEL
P.O. BOX 7099
INDIANAPOLIS IN 46207
Tel: 317 452 7350 Fax: 317 429 2623 Email: SDeLee@ProtectiveInsurance.com

PROVIDENCE WASHINGTON INSURANCE COMPANY

DAVID CALANDRO, REGIONAL CLAIM MANAGER ENSTAR US
150 2ND AVENUE NORTH 3RD FLOOR
Tel: 727 217 2964 Fax: 727 576 3627 Email: david.calandro@enstargroup.com

SANDRA CORLEY, CLAIMS MANAGER ENSTAR US
P.O. BOX 100239
COLUMBIA SC 29223
Tel: 803 462 7441 Fax: 803 310 7320 Email: sandra.corley@enstargroup.com

PSEG POWER LLC AND SUBSIDIARIES

MELISSA KUCHTYAK, ADMINISTRATIVE SECRETARY PMA COMPANIES
330 FELLOWSHIP ROAD SUITE 200
Tel: 856 727 3015 Fax: 856 727 3186 Email: melissa_kuchtyak@pmagroup.com

JIM JORDAN, A.V.P. CLAIMS PMA COMPANIES
330 FELLOWSHIP ROAD SUITE 200
Tel: 856 727 3039 Fax: 856 727 3186 Email: jim_jordan@pmagroup.com

PSEG SERVICES CORPORATION

MELISSA KUCHTYAK, ADMINISTRATIVE SECRETARY
330 FELLOWSHIP ROAD SUITE 200
MT. LAUREL NJ 08054
Tel: 856 727 3015 Fax: 856 727 3186 Email: melissa_kuchtyak@pmagroup.com

JIM JORDAN, A.V.P. CLAIMS
330 FELLOWSHIP ROAD SUITE 200
MT. LAUREL NJ 08054
Tel: 856 727 3039 Fax: 846 727 3186 Email: jim_jordan@pmagroup.com

PUBLIC SERVICE ELECTRIC & GAS CO.

MELLISA KUCHTYAK, ADMINISTRATIVE SECRETARY
330 FELLOWSHIP ROAD SUITE 200
MT. LAUREL NJ 08084
Tel: 856 727 3015 Fax: 856 727 3186 Email: melissa_kuchtyak@pmagroup.com

JIM JORDAN, A.V.P. CLAIMS
330 FELLOWSHIP ROAD SUITE 200
MT. LAUREL NJ 08084
Tel: 856 727 3039 Fax: 856 727 3186 Email: jim_jordan@pmagroup.com

PUBLIC SERVICE INSURANCE COMPANY

NORMAN ROTHSTEIN, AVP WORKERS COMPENSTATION CLAIMS
ONE PARK AVENUE
NEW YORK CITY NY 10016
Tel: 212 591 9321 ext: 9321 Fax: 212 591 9644 Email: nrothstein@mcarta.com

MICHELE WOODSON, MANAGER
ONE PARK AVENUE
NEW YORK CITY NY 10016
Tel: 212 591 9320 Fax: 212 591 9644 Email: mwoodson@mcarta.com

QBE INSURANCE CORPORATION

DAN RUFENACHT, VP, WORKERS COMPENSATION CLAIMS QBE AMERICAS, INC.
ONE QBE WAY
SUN PRAIRIE, WI 53596
Tel: 916 505 6113 Fax: 866 251 5389 Email: daniel.rufenacht@us.qbe.com

DAVE PALMER, LEAD CLAIMS COMPLIANCE ANALYST QBE AMERICAS, INC.
ONE QBE WAY
SUN PRAIRIE WI 53596
Tel: 608 825 5767 Fax: 866 251 5389 Email: david.palmer@us.qbe.com

BRUCE CARLINO, HEAD OF CLAIMS, SPECIALTY
88 PINE STREET WALL STREET PLAZA
NEW YORK, NY 10005
Tel: 212 422 1212 Fax: 212 422 1313 Email: bcarlino@qbeamericas.com

QUINCY MUTUAL FIRE INSURANCE COMPANY

SUSAN HAMMER, VICE PRESIDENT OF CLAIMS
P.O. BOX 68
NEWTON NJ 07860
Tel: 973 940 1851 Fax: 973 940 1852 Email: shammer@risksolutions.com

ANN MARIE KENDALL, ASSISTANT VICE PRESIDENT OF CLAIMS
57 WASHINGTON ST.
QUINCY MA 02169
Tel: 617 770 5154 Fax: 800 899 7790 Email: akendall@quincymutual.com

RALPH CLAYTON & SONS AND AFFILIATES

LOIS M. KAPP, MANAGER RALPH CLAYTON & SONS
1355 CAMPUS PARKWAY
NEPTUNE NJ 07753
Tel: 732 751 7668 Fax: 732 751 7619 Email: LKapp@claytonsonline.com

MARY MCCONNELL, ADMINISTRATIVE SECRETARY RALPH CLAYTON & SONS
1355 CAMPUS PARKWAY
NEPTUNE NJ 07753
Address: Tel: 732 751 7654 Fax: 732 751 7619 Email: MMcConnell@claytonsonline.com

RAMPART INSURANCE COMPANY

TERRI R WEAVER, SECRETARY RAMPART INSURANCE COMPANY
1880 JFK BOULEVARD SUITE 801
Tel: 267 238 0725 Fax: 215 655 1888 Email: tweaver@armourrisk.com

J M DORAN, PRESIDENT RAMPART INSURANCE COMPANY
1880 JFK BOULEVARD SUITE 801
Tel: 267 238 0733 Fax: 215 655 1888 Email: mdoran@armourrisk.com

REDWOOD FIRE AND CASUALTY INSURANCE CO

JACOB MILLER, MANAGER REDWOOD FIRE AND CASUALTY INSURANCE COMPANY
P.O. BOX 881716
Tel: 402 952 5176 Fax: 415 675 5469 Email: jamiller@bhhc.com

NICOLE ALBRECHT, ASSISTANT DIRECTOR REDWOOD FIRE AND CASUALTY INSURANCE COMPANY
P.O. BOX 881716
Tel: 800 661 6029 Fax: 415 675 5469 Email: nalbrecht@bhhc.com

REGENT INSURANCE COMPANY

DAN RUFENACHT, VP-WORKERS COMPENATION CLAIMS QBE AMERICAS, INC.
ONE QBE WAY
SUN PRAIRIE WI 53596
Tel: 916 505 6113 Fax: Email: daniel.rufenacht@us.qbe.com

DAVE PALMER, LEAD CLAIMS COMPLIANCE QBE AMERICAS, INC.
ONE QBE WAY
Tel: 608 825 5767 Fax: Email: david.palmer@us.qbe.com

REPUBLIC-FRANKLIN INSURANCE COMPANY

IAN FISHER, SUPERVISOR REPUBLIC-FRANKLIN INSURANCE COMPANY
P.O. BOX 6610
UTICA NY 13504
Tel: 516 479 5240 Fax: 888 538 2018 Email: ian.fisher@uticanational.com

STEPHEN WILLIAMSON, WC CLAIMS MANAGER REPUBLIC-FRANKLIN INSURANCE COMPANY
P.O. BOX 6610
UTICA NY 13504
Tel: 315 734 2462 Fax: 888 538 2018 Email: stephen.williamson@uticanational.com

REPWEST INSURANCE COMPANY

RICHARD JAMISON, MANAGER, WORKERS COMP CLAIMS
2721 N. CENTRAL AVENUE
PHOENIX AZ 85004
Tel: 833 228 0632 ext: 544502 Fax: 000 000 0000 Email: RAJamison@Repwest.com

RESIDENCE INN BY MARRIOTT, INC.

FAITH FRITZ, CLAIMS MANAGER MARROTT CLAIMS SERVICES - DC
9737 WASHINGTONIAN BLVD., SUITE 201
GAITHERSBURG, MD 20878
Tel: 301 380 0375 Fax: 301 644 8230 Email: Faith.Fritz@Marriott.com

ELIZABETH M. TOTH, SENIOR DIRECTOR MARRIOTT CLAIMS SERVICES - DC
9737 WASHINGTONIAN BLVD., SUITE 201
GAITHERSBURG, MD 20878
Tel: 301 380 0341 Fax: 301 644 8230 Email: Beth.Toth@Marriott.com

RIVERPORT INSURANCE COMPANY

BRENT FOURNIER, CLAIMS MANAGER BERKLEY NET UNDERWRITERS
9301 INNOVATION DRIVE SUITE 200
Tel: 571 298 0972 Fax: 855 395 2518 Email: bfournier@berkeleynet.com

HANNAH HANSON, CLAIMS OPERATIONS SPECIALIST BERKLEY NET UNDERWRITERS
9301 INNOVATION DRIVE SUITE 200
Tel: 571 778 6602 Fax: 855 395 2518 Email: hhanson@berkelynet.com

RLI INSURANCE COMPANY

CHRISTINA D. PAGE, CLAIM MANAGER 9025 N. LINDBERG DRIVE
PEORIA, IL 61615
Tel: 770 754 0100 ext: 2315 Fax: 866 692 6796 Email: Christina.Page@rlicorp.com

ROBERT WOOD JOHNSON UNIV. HOSPITAL

JESSICA BAKALCHUK, SENIOR CLAIMS ADJUSTER
P.O. BOX 309
PISCATAWAY, NJ 08855
Tel: 732 465 7320 Fax: 732 465 7355 Email: JBakalchuk@qualcareinc.com

JUDI BARANOWITZ, BENEFITS MANAGER
181 SOMERSET STREET
NEW BRUNSWICK, NJ 08901
Tel: 732 937 8811 Fax: 732 937 8774 Email: Judi.Baranowitz@rwjuh.edu

ROCHDALE INSURANCE COMPANY

MELISSA KOVACSY, DIRECTOR AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 609 936 3003 Fax: 678 258 8395 Email: melissa.kovacsy@amtrustgroup.com

SUSAN GOLDMAN, SENIOR MANAGER AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 732 276 4879 Fax: 678 258 8395 Email: susan.goldman@amtrustgroup.com

ROCKWOOD CASUALTY INSURANCE COMPANY

JACK TIPTON, VP CLAIMS ROCKWOOD CASUALTY INSURANCE COMPANY
654 MAIN STREET
ROCKWOOD PA 15557
Tel: 223 322 0681 Fax: 814 926 4070 Email: rick.tipton@rockwoodcasualty.com

JILL PECK, CLAIMS MANAGER ROCKWOOD CASUALTY INSURANCE COMPANY
654 MAIN STREET
ROCKWOOD PA 15557
Tel: 814 233 7116 Fax: 814 926 4070 Email: jill.peck@rockwoodcasualty.com

SAFECO INSURANCE COMPANY OF AMERICA

DEB GORNEY, CLAIMS ANALYST
P.O. BOX 515097
LOS ANGELES CA 90051
Tel: 720 497 9427 Fax: 888 268 8840 Email: DEBGOR@safeco.com

ERIC BARR, CLAIMS UNIT MANAGER
120 VANTIS #130 ALISO
VIEJO CA 92656
Tel: 949 860 6080 Fax: 888 268 8840 Email: ERIBAR@safeco.com

SAFETY FIRST INSURANCE COMPANY

DANA BAILEY, AVP CLAIMS COMPLIANCE SAFETY FIRST INSURANCE COMPANY
1832 SCHUETZ ROAD
ST. LOUIS MO 63146
Tel: 314 266 1006 Fax: 314 995 3897 Email: dana.bailey@safetynational.com

BECKY BRYANT, CORPORATE COMPLIANCE ANALYST SAFETY FIRST INSURANCE COMPANY
1832 SCHUETZ ROAD
ST. LOUIS MO 63146
Tel: 314 696 5783 Fax: 314 995 3897 Email: becky.bryant@safetynational.com

SAFETY NATIONAL CASUALTY CORPORATION

DANA BAILEY, AVP CLAIMS COMPLIANCE SAFETY NATIONAL CASUALTY CORPORATION
1832 SCHUETZ ROAD
ST. LOUIS MO 63146
Tel: 314 266 1006 Fax: 314 995 3897 Email: dana.bailey@safetynational.com

BECKY BRYANT, CORPORATE COMPLIANCE ANALYST SAFETY NATIONAL CASUALTY CORPORATION
1832 SCHUETZ ROAD
ST. LOUIS MO 63146
Tel: 314 696 5783 Fax: 314 995 3897 Email: becky.bryant@safetynational.com

SAMSUNG FIRE & MARINE INSURANCE CO LTD

THOMAS A. TROCCHIA, FILING & BUREAU REPORTING MANAGER
85 CHALLENGER ROAD, 6TH FLOOR
RIDGEFIELD PARK, NJ 07660
Tel: 201 807 6724 Fax: 201 229 6015 Email: trocchia.thomas@samsung.com

STEPHANIE KELLY, CGL CLAIMS MANAGER 85 CHALLENGER ROAD, 6TH FLOOR
RIDGEFIELD PARK, NJ 07660
Tel: 201 229 6008 Fax: 201 229 6015 Email: st.kelly@samsung.com

SELECTIVE CASUALTY INSURANCE COMPANY

LORIE WATERS, REGIONAL CLAIM MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 501 2830 Fax: 877 233 1353 Email: lorie.waters@selective.com

JOHN WINKLER, WC MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 916 1791 Fax: 877 233 1353 Email: john.winkler@selective.com

SELECTIVE FIRE & CASUALTY INSURANCE COMPANY

LORIE WATERS, REGIONAL CLAIM MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 501 2830 Fax: 877 233 1353 Email: lorie.waters@selective.com Name: JOHN WINKLER, WC MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742 Address: Tel: 704 916 1791 Fax: 877 233 1353 Email: john.winkler@selective.com

SELECTIVE INSURANCE CO OF NEW ENGLAND

LORIE WATERS, REGIONAL CLAIM MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 501 2830 Fax: 877 233 1353 Email: lorie.waters@selective.com

JOHN WINKLER, WC MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 916 1791 Fax: 877 233 1353 Email: john.winkler@selective.com

SELECTIVE INSURANCE COMPANY OF AMERICA

LORIE WATERS, REGIONAL CLAIM MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 501 2830 Fax: 877 233 1353 Email: lorie.waters@selective.com

JOHN WINKLER, WC MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 916 1791 Fax: 877 233 1353 Email: john.winkler@selective.com

SELECTIVE INSURANCE COMPANY OF NEW YORK

LORIE WATERS, REGIONAL CLAIMS MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 501 2830 Fax: 877 233 1353 Email: lorie.waters@selective.com

JOHN WINKLER, WC MANAGER SELECTIVE INSURANCE OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 916 1791 Fax: 877 233 1353 Email: john.winkler@selective.com

SELECTIVE INSURANCE COMPANY OF SOUTH CAROLINA

LORIE WATERS, REGIONAL CLAIM MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 501 2830 Fax: 877 233 1353 Email: lorie.waters@selective.com

JOHN WINKLER, WC MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 916 1791 Fax: 877 233 1353 Email: john.winkler@selective.com

SELECTIVE INSURANCE COMPANY OF THE SOUTHEAST

LORIE WATERS, REGIONAL CLAIM MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 501 2830 Fax: 877 233 1353 Email: lorie.waters@selective.com

JOHN WINKLER, WC MANAGER SELECTIVE INSUIRANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 916 1791 Fax: 877 233 1353 Email: john.winkler@selective.com

SELECTIVE WAY INSURANCE COMPANY

LORIE WATERS, REGIONAL CLAIM MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 501 2830 Fax: 877 233 1353 Email: lorie.waters@selective.com

JOHN WINKLER, WC MANAGER SELECTIVE INSURANCE COMPANY OF AMERICA
P.O. BOX 7252
LONDON KY 40742
Tel: 704 916 1791 Fax: 877 233 1353 Email: john.winkler@selective.com

SENTINEL INSURANCE COMPANY LTD

CHRIS TURNER, CLAIM MANAGER THE HARTFORD
200 COLONIAL CENTER PKWY
LAKE MARY FL 32746
Tel: 407 562 3665 Fax: Email: Chris.Turner@thehartford.com

VANESSA MORGAN, CLAIM MANAGER THE HARTFORD
300 SOUTH STATE STREET
SYRACUSE NY 13202
Tel: 315 585 5249 Fax: Email: Vanessa.Morgan@thehartford.com

SENTRY CASUALTY COMPANY

JOAN KLOPF, CLAIMS MANAGER SENTRY CASUALTY COMPANY
TWO TECHNOLOGY PARK DRIVE
WESTFORD, MA 01886
Tel: 978 392 7152 Fax: 978 392 7137 Email: joan.klopf@sentry.com

KARRI ERBES, CLAIMS MANAGER SENTRY CASUALTY COMPANY
1501 NORTH POINT DRIVE
STEVENS POINT, WI 54481
Tel: 715 346 9311 Fax: 715 346 9708 Email: karri.erbes@sentry.com

SENTRY INSURANCE COMPANY

JOAN KLOPF, CLAIMS MANAGER TWO TECHNOLOGY PARK DRIVE
WESTFORD MA 01886
Tel: 978 392 7152 Fax: 978 392 7137 Email: joan.klopf@sentry.com

KARRI ERBES, CLAIMS MANAGER
1501 NORTH POINT DRIVE
STEVEN POINT WI 54481
Tel: 715 346 9311 Fax: 715 346 9708 Email: karry.erbes@sentry.com

SENTRY SELECT INSURANCE COMPANY

JOAN KLOPF, CLAIMS MANAGER SENTRY SELECT INSURANCE COMPANY TWO TECHNOLOGY PARK DRIVE
WESTFORD MA 01866
Address: Tel: 978 392 7152 Fax: 978 392 7137 Email: joan.klopf@sentry.com

KARRI ERBES, CLAIMS MANAGER SENTRY SELECT INSURANCE COMPANY
1501 NORTH POINT DRIVE
STEVENS POINT WI 54481
Tel: 715 346 9311 Fax: 715 346 9708 Email: karri.erbes@sentry.com

SERVICE AMERICAN INDEMNITY COMPANY

TERRY ELIASEN, VICE PRESIDENT - CLAIMS SERVICE AMERICAN INDEMNITY COMPANY
6907 N. CAPITAL OF TEXAS HIGHWAY
AUSTIN TX 78731
Address: Tel: 512 637 3166 Fax: Email: terry.eliasen@servicelloyds.com

KIMOTHY DIXON, QUALTIY REVIEW AND COMPLIANCE SUPERVISOR SERVICE AMERICAN INDEMNITY COMPANY
6907 N. CAPTIAL OF TEXAS HIGHWAY
AUSTIN TX 78731 Address: Tel: 512 637 3717 Fax: Email: kimothy.dixon@servicelloyds.com

SHERWIN-WILLIAMS CO.

ANTHONY J COLANGELO, MANAGER
101 PROSPECT AVENUE N.W.
CLEVELAND OH 44115
Tel: 216 566 3095 Fax: 216 566 1745 Email: ajcolangelo@sherwin.com

MATT FLYNN, ANALYST & SAFETY
101 PROSPECT AVENUE N.W.
CLEVELAND OH 44115
Tel: 216 566 3717 Fax: 216 830 0661 Email: matt.g.flynn@sherwin.com

SHORE MEMORIAL HOSPITAL

KATHLEEN T NUNZI, BENEFITS ADMINISTRATOR
SHORE ROAD & NEW YORK AVENUE
SOMERS POINT NJ 08244
Tel: 609 653 4533 Fax: 609 601 6354 Email: knunzi@shorememorial.com

MICHAEL SALERNO, ADMINISTRATOR
330 MILLTOWN ROAD SUITE E-11
EAST BRUNSWICK NJ 08816
Tel: 732 613 1600 Fax: 732 613 9328 Email: mikesal226@aol.com

SIMON & SCHUSTER, INC.

STEPHANIE GROSSBERG, DIRECTOR-RISK MANAGEMENT
51 W. 52ND STREET
NEW YORK NY 10019
Address: Tel: 212 975 8971 Fax: 212 597 4163 Email: stephanie.grossberg@cbs.com

DAVID RICHARDSON, VICE PRESIDENT CLAIMS
ONE UNION PLAZA
NEW LONDON CT 06320
Address: Tel: 860 447 0048 Fax: 860 442 0076 Email: drichardson@murphybeane.com

SOMPO JAPAN INSURANCE COMPANY OF AMERICA

MIKE SPRAGUE, ASSISTANT MANAGER OF CLAIMS
2 WORLD FINANCIAL CENTER 43RD FL.
225 LIBERTY STREET
NEW YORK NY 10281
Address: Tel: 212 416 1336 Fax: 212 416 1283 Email: msprague@sompo-japan-us.com

SANDRA BARRETT, TEAM MANAGER
100 PASSAIC AVENUE SUITE 104
FAIRFIELD NJ 07004 Address: Tel: 973 439 6734 Fax: 973 227 5746 Email: sandra.barrett@choosebroadspire.com

ST. PAUL FIRE & MARINE INSURANCE COMPANY

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES INC.
P.O. BOX 4614
BUFFALO NY 14240 Address: Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TROY TICE, DIRECTOR OF OPERATIONS THE TRAVELERS COMPANIES INC.
445 SOUTH STREET
MORRISTOWN, NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

ST. PAUL MERCURY INSURANCE COMPANY

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES INC.
P.O. BOX 4614
BUFFALO NY 14240
Address: Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TROY TICE, DIRECTOR OF OPERATIONS THE TRAVELERS COMPANIES
445 SOUTH STREET
MORRISTOWN, NJ 07960
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

ST. PAUL PROTECTIVE INSURANCE COMPANY

TROY TICE, DIRECTOR THE TRAVELERS COMPANIES INC.
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC.
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

ST. PETERS UNIVERSITY HOSPITAL

DIANE SPECTOR, MANAGER-EMPLOYER HEALTH SERVICES
254 EASTON AVENUE
NEW BRUNSWICK NJ 08901
Address: Tel: 732 745 8600 ext: 8907 Fax: 732 220 8564 Email: dspector@saintpetersuh.com

JANET HUNTER-WILSON, DIRECTOR COMPENSATION & BENEFITS
254 EASTON AVENUE
NEW BRUNSWICK NJ 08901
Address: Tel: 732 745 8600 Fax: 732 220 8046 Email: jhunter@saintpetersuh.com

STANDARD FIRE INSURANCE COMPANY

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES INC.
P.O. BOX 4614
BUFFALO NY 14240
Address: Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TROY TICE, DIRECTOR OF OPERATIONS THE TRAVELERS COMPANIES INC.
445 SOUTH STREET
MORRISTOWN, NJ 07960
Tel: 973 631 3063 Fax: 877 786 5568 Email: ttice@travelers.com

STAR INSURANCE COMPANY

JOSEPH SGRO, VICE PRESIDENT OF CLAIMS MEADOWBROOK INC
26255 AMERICAN DRIVE
SOUTHFIELD MI 48034
Tel: 248 358 1100 Fax: 855 858 8187 Email: joseph.sgro@ameritrustgroup.com

TEMEKA HICKS, CLAIMS SUPERVISOR MEADOWBROOK INC
26255 AMERICAN DRIVE
SOUTHFIELD MI 48034
Tel: 248 358 1100 Fax: 855 858 8187 Email: temeka.hicks@ameritrustgroup.com

STAR SPECIALTY INSURANCE COMPANY

ADILLIA BANNIS, MANAGER
399 PARK AVENUE FLOOR 3
NEW YORK CITY NY 10022
Tel: 855 782 7725 Fax: 646 786 3950 Email: WCClaims@starrcompanies.com

CHIBUTAUZO EZE, CLAIMS ADMIN SUPPORT SPECIALIST
399 PARK AVENUE FLOOR 3
NEW YORK CITY NY 10022
Tel: 855 782 7725 Fax: 646 786 3950 Email: WCClaims@starrcompanies.com

STARNET INSURANCE COMPANY

BRENT FOURNIER, CLAIMS MANAGER BERKLEY NET UNDERWRITERS
9301 INNOVATION DRIVE SUITE 200
Tel: 571 298 0972 Fax: 855 395 2518 Email: bfournier@berkleynet.com

HANNAH HANSON, CLAIMS OPERATIONS SPECIALIST BERKLEY NET UNDERWRITERS
9301 INNOVATION DRIVE SUITE 200
Tel: 571 778 6602 Fax: 855 395 2518 Email: hhanson@berkleynet.com

STARR INDEMNITY AND LIABILITY COMPANY

DONNA BUKER, VP WC CLAIMS STARR INDEMNITY & LIABILITY COMPANY
1601 MARKET STREET, SUITE 1800
PHILADELPHIA PA 19103
Address: Tel: 215 399 2905 Fax: Email: donna.buker@starrcompanies.com

MIRIAM ELLIOTT, AVP WC CLAIMS STARR INDEMNITY & LIABILITY COMPANY
399 PARK AVENUE
NEW YORK CITY NY 10022
Tel: 646 227 6563 Fax: Email: miriam.elliott@starrcompanies.com

STARSTONE NATIONAL INSURANCE CO

ASHLEY TOTH, WC CLAIMS AUDITOR CORE SPECIALTY INSURANCE
201 E. FIFTH STREET SUITE 1200
Address: Tel: 732 428 6431 Fax: 513 599 7501 Email: ashley.toth@corespecialty.com

STATE AUTO PROPERTY & CASUALTY INSURANCE CO

SUSAN PILON, WC CLAIM MANAGER STATE AUTO INSURANCE COMPANIES
P.O. BOX 182617
COLUMBUS OH 43218
Tel: 952 893 3774 Fax: 800 563 3364 Email: susan.pilon@libertymutual.com

MICHAEL SCHNEIDER, CLAIMS TEAM MANAGER STATE AUTO INSURANCE COMPANIES
P.O. BOX 182617
COLUMBUS OH 43218
Tel: 952 893 3774 Fax: 800 563 3364 Email: michael.schneider@libertymutual.com

STATE AUTOMOBILE MUTUAL INSURANCE CO

SUSAN PILON, WC CLAIM MANAGER STATE AUTO INSURANCE COMPANIES
P.O. BOX 182617
COLUMBUS OH 43218
Tel: 952 897 5543 Fax: 800 563 3364 Email: susan.pilon@libertymutual.com

MICHAEL SCHNEIDER, CLAIMS TEAM MANAGER STATE AUTO MUTUAL INSURANCE COMPANIES
COLUMBUS OH 43218
Tel: 952 893 3774 Fax: 800 563 3364 Email: michael.schneider@libertymutual.com

STATE FARM FIRE & CASUALTY COMPANY

ANTHONY LEEPER, CLAIM TEAM MANAGER
1 STATE FARM DR
CONCORDVILLE PA 19339
Tel: 610 358 7683 Fax: 610 358 8528 Email: anthony.leeper.g2vy@statefarm.com

JOHN BURLING, CLAIM TEAM MANAGER
1 STATE FARM DR
CONCORDVILLE PA 19339
Tel: 610 358 7292 Fax: 610 358 8528 Email: john.burling.c87n@statefarm.com

STATE NATIONAL INSURANCE COMPANY INC

DIANNA CORDOVA, SENIOR COMPLIANCE ANALYST NATIONAL SPECIALTY INSURANCE COMPANY
1900 L. DON DODSON DRIVE
BEDFORD, TX 76021
Tel: 800 877 4567 Fax: 877 295 3081 Email: WorkComp@StateNational.com

MONICA MCKENZIE, COMPLIANCE MANAGER NATIONAL SPECIALTY INSURANCE COMPANY
1900 L DON DODSON DRIVE
BEDFORD, TX 76021
Tel: 800 877 4567 Fax: 877 290 3081 Email: WorkComp@StateNational.com

STONINGTON INSURANCE COMPANY

DAN RUFENACHT, VP-WORKERS' COMPENSATION CLAIMS QBE AMERICAS, INC
ONE QBE WAY
SUN PRAIRIE WI 53596
Tel: 916 505 6113 Fax: Email: daniel.rufenacht@us.qbe.com

DAVE PALMER, LEAD CLAIMS COMPLIANCE ANALYST QBE AMERICAS, INC.
ONE QBE WAY
SUN PRAIRIE WI 53596
Tel: 608 825 5767 Fax: Email: david.palmer@us.qbe.com

STRATHMORE INSURANCE COMPANY

JAMES M PRIMAMORE, VP CLAIMS STRATHMORE INSURANCE CO
333 THORNALL STREET 9TH FLOOR
Tel: 732 238 6300 ext: 284 Fax: 732 238 0355 Email: jprimamore@gny.com

SUSAN CICCOLELLA, CLAIMS EXAMINER STRATHMORE INSURANCE CO
333 THORNALL STREET 9TH FLOOR
Tel: 732 238 6300 ext: 288 Fax: 732 238 0355 Email: sciccolella@gny.com

SUEZ WATER NEW JERSEY INC

PAUL SOKOL, DIRECTOR - INSURANCE 200 OLD HOOK ROAD
HARRINGTON PARK, NJ 07640
Tel: 201 767 2898 Fax: 201 767 2839 Email: Paul.Sokol@Unitedwater.com

SUTTON NATIONAL INSURANCE

RICK PATTAVINA, VP OF CLAIMS SUTTON NATIONAL INSURANCE
1855 GRIFFIN ROAD SUITE B-390
Tel: 888 846 4238 Fax: 305 397 2138 Email: rpattavina@suttonnational.com

SYNERGY INSURANCE COMPANY

JENNIFER STELIKA, SYNERGY CLAIMS MANAGEMENT COMPANY
P.O. BOX 332
30 EAST STATE STREET
SHARON PA 16146
Tel: 724 704 7066 Fax: 724 704 7061 Email: jstelika@synergyinsurance.com

REBECCA KERR, CLAIMS DEPARTMENT TEAM LEAD SYNERGY CLAIMS MANAGEMENT COMPANY
P.O. BOX 332
30 EAST STATE STREET
Tel: 724 704 7038 Fax: 727 704 7061 Email: rkerr@synergyinsurance.com

T H E INSURANCE COMPANY

STEVEN CANNON, CLAIM MANAGER
2540 ROUTE 130
CRANBURY NJ 08512
Tel: 609 495 0312 Fax: 609 495 9048 Email: steven.cannon@REMLTD.com

STEPANIE JAMES, CLAIM SUPERVISORQ
2540 ROUTE 130
CRANBURY NJ 08512
Tel: 570 420 8247 Fax: 570 420 3248 Email: stephanie.james@REMLTD.com

TARGET CORPORATION

MARCIA OSBORN, CLAIMS TEAM LEAD SEDGWICK
P.O. BOX 14491
LEXINGTON, KY 40512
Tel: 410 773 4258 Fax: 410 773 4221 Email: Marcia.Osborn@Sedgwickcms.com

JANET COHEN, CLAIMS TEAM LEAD - ASST. SEDGWICK
P.O. BOX 14491
LEXINGTON, KY 40512
Tel: 410 773 4258 Fax: 410 773 4221
Janet.Cohen@Sedgwickcms.com

TECHNOLOGY INSURANCE COMPANY INC

MELISSA KOVACSY, DIRECTOR AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 609 936 3003 Fax: 678 258 8395 Email: melissa.kovacsy@amtrustgroup.com

SUSAN GOLDMAN, SENIOR MANAGER AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 732 276 4879 Fax: 678 258 8395 Email: susan.goldman@amtrustgroup.com

THE HANOVER AMERICA INSURANCE COMPANY

KERRI HOLLENKAMP, UNIT MANAGER, WC THE HANOVER INSURANCE GROUP
PO BOX 15144 440
LINCOLN STREET
Tel: 508 855 9314 Fax: 508 926 5660 Email: khollenkamp@hanover.com

MAUREEN OCONNOR, UNIT MANAGER, WC THE HANOVER INSURANCE GROUP
PO BOX 15144
440 LINCOLN STREET
Tel: 508 855 5184 Fax: 508 926 1952 Email: ma1oconnor@hanover.com

THE HANOVER INSURANCE COMPANY

KERRI HOLLENKAMP, UNIT MANAGER, WC THE HANOVER INSURANCE GROUP
PO BOX 15144 440
LINCOLN STREET
Tel: 508 855 9314 Fax: 508 926 5660 Email: khollenkamp@hanover.com

MAUREEN OCONNOR, UNIT MANAGER, WC THE HANOVER INSURANCE GROUP
PO BOX 15144
440 LINCOLN STREET
Tel: 508 855 5184 Fax: 508 926 1952 Email: ma1oconnor@hanover.com

THE PIE INSURANCE COMPANY

JOEL TOKIN, MANAGER, CLAIMS - WORKERS' COMPENSATION THE PIE INSURANCE COMPANY
1755 BLAKE STREET 5TH FLOOR
Tel: 202 991 8818 Fax: Email: joel.tokin@pieinsurance.com

NICHOLAS RHYDE, TEAM LEAD, CLAIMS-WORKERS COMPENSATION THE PIE INSURANCE COMPANY
1755 BLAKE STREET 5TH FLOOR
Tel: 720 743 2434 Fax: Email: nicholas.rhyde@pieinsurance.com

TIG INSURANCE COMPANY

STEVE ADAMS, VICE PRESIDENT, CLAIMS THE ZENITH
21255 CALIFA STREET
WOODLAND HILLS CA 91367
Tel: 619 207 9785 Fax: 818 710 1860 Email: sadams@thezenith.com

SUSAN EDDY, SUPERVISOR, CLAIMS THE ZENITH
3 PARK PLACE
DUBLIN CA 94568
Tel: 925 872 0592 Fax: 925 463 1864 Email: seddy@thezenith.com

TNUS INSURANCE COMPANY

ROBERT C. HUBBUCH, SENIOR MANAGER
230 PARK AVENUE
NEW YORK, NY 10169
Tel: 212 297 6942 Fax: 212 297 6692 Email: robert.hubbuch@tokiom.com

TYESHA LOWE, WC CLAIMS SUPERVISOR
230 PARK AVENUE
NEW YORK, NY 01069
Tel: 212 297 6606 Fax: 212 297 6692 Email: tyesha.lowe@tokiom.com

TOKIO MARINE AMERICA INSURANCE CO

ROBERT C. HUBBUCH, SENIOR MANAGER
230 PARK AVENUE
NEW YORK, NY 10169
Tel: 212 297 6942 Fax: 212 297 6692 Email: robert.hubbuch@tokiom.com

TYESHA LOWE, WC CLAIMS SUPERVISOR
230 PARK AVENUE
NEW YORK, NY 10169
Tel: 212 297 6606 Fax: 212 297 6692 Email: tyesha.lowe@tokiom.com

TOWNEPLACE MANAGEMENT CORPORATION

FAITH FRITZ, CLAIMS MANAGER 9737
WASHINGTONIAN BLVD., SUITE 201
GAITHERSBURG, MD 20878
Tel: 301 380 0375 Fax: 301 644 8230 Email: Faith.Fritz@Marriott.com

ELIZABETH TOTH, SENIOR DIRECTOR MARRIOTT CLAIMS SERVICES - DC
9737 WASHINGTONIAN BLVD., SUITE 201
GAITHERSBURG, MD 20878
Tel: 301 380 0341 Fax: 301 644 8230 Email: Beth.Toth@Marriott.com

TRANS PACIFIC INSURANCE COMPANY

ROBERT C. HUBBUCH, SENIOR MANAGER
230 PARK AVENUE
NEW YORK, NY 10169
Tel: 212 297 6942 Fax: 212 297 6692 Email: robert.hubbuch@tokiom.com

TYESHA LOWE, WC CLAIMS SUPERVISOR
230 PARK AVENUE
NEW YORK, NY 10169
Tel: 212 297 6606 Fax: 212 297 6692 Email: tyesha.lowe@tokiom.com

TRANSGUARD INSURANCE COMPANY OF AMERICA INC

CASSANDRA GOMEZ, MANAGER, WC/OCAC IAT/TRANSGUARD INSURANCE COMPANY
215 SHUMAN BLVD. #400
Tel: 630 864 3450 Fax: 630 864 3305 Email: cassandra.gomez@iatinsurance.com

DAVID JIMENEZ, AVP CLAIMS IAT/TRANSGUARD INSURANCE COMPANY
215 SHUMAN BLVD #400
Tel: 630 864 3525 Fax: 630 864 3344 Email: david.jimenz@iatinsurance.com

TRANSPORT INSURANCE COMPANY

JOHN FISCHER, ASST. TREASURER
2 CENTRAL SQUARE
CAMBRIDGE. MA 02139
Tel: 617 234 3801 Fax: 617 234 3899
Email: john.fischer@cavellamerica.com

FRANK GERACE, ACCOUNTING/REGULATORY FILINGS
2 CENTRAL SQUARE
CAMBRIDGE, MA 02139
Tel: 617 234 3804 Fax: 617 234 3899 Email: frank.gerace@cavellamerica.com

TRANSPORTATION INSURANCE COMPANY

KEVIN ZACCHIA, ASSISTANT VICE PRESIDENT
5786 WIDEWATERS
DEWITT NY 13214
Tel: 315 431 6752 Fax: 714 256 7905 Email: Kevin.Zacchia@cna.com

TAMMY SOWERS, WORKERS' COMPENSATION CLAIM MANAGER
MERIDIAN BOULEVARD
WYOMISSING PA 19610
Tel: 610 320 4410 Fax: 877 371 5122 Email: Tammy.Somers@cna.com

TRAVELERS CASUALTY & SURETY COMPANY

TROY TICE, DIRECTOR THE TRAVLERS COMPANIES, INC.
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TRAVELERS CASUALTY & SURETY COMPANY OF AMERICA

TROY TICE, DIRECTOR THE TRAVELERS COMPANIES INC.
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES INC
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TRAVELERS CASUALTY COMPANY OF CONNECTICUT

TROY TICE, DIRECTOR THE TRAVELERS COMPANIES, INC
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC.
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA

TROY TICE, DIRECTOR THE TRAVELERS COMPANIES, INC.
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TRAVELERS COMMERCIAL CASUALTY COMPANY

TROY TICE, DIRECTOR THE TRAVELERS COMPANIES INC.
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES INC.
P.O. BOX 4614
BUFFALO NY 14240
Address: Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TRAVELERS CONSTITUTION STATE INSURANCE COMPANY

TROY TICE, DIRECTOR THE TRAVELERS COMPANIES, INC.
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC.
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TRAVELERS IMDEMNITY COMPANY

TROY TICE, DIRECTOR THE TRAVELERS COMPANIES, INC.
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC.
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TRAVELERS INDEMNITY COMPANY OF AMERICA

MARGARET MUIR-O'CONNOR, FIELD PRODUCT LINE MANAGER
445 SOUTH STREET
MORRISTOWN, NJ 07960
Tel: 973 631 3063 Fax: 877 786 5568 Email: MMUIROCO@travelers.com

TROY TICE, DIRECTOR OF OPERATIONS 445 SOUTH STREET
MORRISTOWN, NJ 07960
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

TRAVELERS INDEMNITY COMPANY OF CONNECTICUT

TROY TICE, DIRECTOR THE TRAVELERS COMPANIES, INC.
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC.
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

TROY TICE, DIRECTOR THE TRAVELERS COMPANIES, INC.
445 SOUTH STREET
MORRISTOWN NJ 07950
Tel: 973 631 3099 Fax: 877 786 5568 Email: ttice@travelers.com

HELAINE ALEDORT, 2ND VP THE TRAVELERS COMPANIES, INC.
P.O. BOX 4614
BUFFALO NY 14240
Tel: 631 577 7203 Fax: 877 889 8376 Email: haledort@travelers.com

TRENTON, RC DIOCESE OF

JOSEPH BIANCHI, SPHR, DIRECTOR OF ADMINISTRATIVE SERVICES
701 LAWRENCEVILLE ROAD
TRENTON, NJ 08638
Tel: 609 406 7400 Fax: 609 406 7450 Email: jbianc@dioceseoftrenton.org

ANGELINA CANNADY, ADMINISTRATIVE ASSISTANT
701 LAWRENCEVILLE ROAD
TRENTON, NJ 08638
Tel: 609 406 7400 Fax: 609 406 7450 Email: acanna@dioceseoftrenton.org

TRI-STATE INSURANCE CO OF MINNESOTA

MELISSA RIEFENHAUSER, COMPLIANCE COORDINATOR W R BERKLEY
2445 KUSER ROAD SUITE 201
Tel: 609 584 4575 Fax: 609 588 5770 Email: mriefenhauser@wrberkley.com

SUZANNE SCELZA, VICE PRESIDENT, REGULATORY COMPLIANCE W R BERKLEY
2445 KUSER ROAD SUITE 201
Tel: 609 689 6648 Fax: Email: sscelza@wrberkley.com

TRINITAS REGIONAL MEDICAL

PATRICIA THIEL, DIRECTOR
225 WILLIAMSON STREET
ELIZABETH, NJ 07202
Tel: 908 994 5378 Fax: 908 994 5623 Email: pthiel@trinitas.org

RHONDA HARTLEY, R.N. 225 WILLIAMSON STREET
ELIZABETH, NJ 07202
Tel: 908 994 5726 Fax: 908 994 5623 Email: rhartley@trinitas.org

TRUCK INSURANCE EXCHANGE

MATTHEW BLUM, WORKERS' COMPENSATION CLAIMS MANAGER FARMERS INSURANCE COMPANY
24000 N FARMERS WAY
PHOENIX AZ 85085
Tel: 602 635 5512 Fax: 877 217 1389 Email: matthew.blum@farmersinsurance.com

LAUREN ROLATER, WORKERS' COMPENSATION COMPLIANCE LIAISON FARMERS INSURANCE COMPANY
15700 LONG VISTA DRIVE
AUSTIN TX 78728
Tel: 512 533 8789 Fax: 512 533 8398 Email: lauren.rolater@farmersinsurance.com

TRUMBULL INSURANCE COMPANY

CHRIS TURNER, CLAIM MANAGER THE HARTFORD
200 COLONIAL CENTER PKWY
LAKE MARY FL 32746
Tel: 407 562 3665 Fax: 8376 Email: Chris.Turner@thehartford.com

VANESSA MORGAN, CLAIM MANAGER THE HARTFORD
300 SOUTH STATE STREET
SYRACUSE NY 13202
Tel: 315 385 5249 Fax: Email: Vanessa.Morgan@thehartford.com

TWIN CITY FIRE INSURANCE COMPANY

CHRIS TURNER, CLAIM MANAGER - THE HARTFORD
200 COLONIAL CENTER PKWY
LAKE MARY FL 32746
Tel: 407 562 3665 Fax: Email: Chris.Turner@thehartford.com

VANESSA MORGAN, CLAIM MANAGER THE HARTFORD
300 SOUTH STATE STREET
Tel: 315 385 5249 Fax: Email: Vanessa.Morgan@thehartford.com

UNION INSURANCE COMPANY

KIMBERLY MOORE, WC CLAIMS MANAGER BERKLEY MID-ATLANTIC GROUP
4820 LAKE BROOK DRIVE SUITE 300
Tel: 804 237 5189 Fax: Email: kmoore@wrbmag.com

KAROLINE SANDS, COUNSEL ACADIA INSURANCE GROUP
ONE ACADIA COMMONS
WESTBROOK ME 04092
Tel: 207 228 1932 Fax: Email: karoline.sands@acadia-ins.com

UNITED STATES FIRE INSURANCE CO

MARLENE COBAR, WC MANAGER UNITED STATES FIRE INSURANCE CO.
P.O. BOX 14139
LEXINGTON KY 40512
Tel: 973 490 6076 Fax: 877 622 6911 Email: marlene.cobar@cfins.com

DIANE PARRISH, AVP, WORKERS COMPENSATION CLAIMS UNITED STATES FIRE INSURANCE CO.
P.O. BOX 14139
LEXINGTON KY 40512
Tel: 973 490 6992 Fax: 877 622 6911 Email: diane.parrish@cfins.com

UNITRIN AUTO & HOME INSURANCE COMPANY

PATRICK GILLSON, REGIONAL CLAIM MANAGER
5784 WIDEWATERS PARKWAY
DEWITT, NY 13214
Tel: 315 449 8680 Fax: 315 449 5770 Email: pgillson@wkemper.com

ROSE PARNELL, TECHNICAL CLAIM MANAGER
5784 WIDEWATERS PARKWAY
DEWITT, NY 13214 Address: Tel: 315 449 8922 Fax: 315 449 5770 Email: rparnell@ekemper.com

UNITRIN PREFERRED INSURANCE COMPANY

PATRICK GILLSON, REGIONAL CLAIM MANAGER
5784 WIDEWATERS PARKWAY DEWITT, NY 13214
Tel: 315 449 8680 Fax: 315 449 5770 Email: pgillson@ekemper.com

ROSE PARNELL, TECHNICAL CLAIM MANAGER
5784 WIDEWATERS PARKWAY
DEWITT, NY 13214
Tel: 315 449 8922 Fax: 315 449 5770 Email: rparnell@ekemper.com

UNIVERSAL UNDERWRITERS INSURANCE COMPANY

BRIAN M. DOOLEY, ASST. VICE PRESIDENT UNIVERSAL UNDERWRITERS INSURANCE COMPANY
300 INTERPACE PARKWAY, MORRIS CORP. #1 B/C
Tel: 973 394 5281 Fax: 973 394 5262 Email: brian.dooley@Zurichna.com

UNIVERSAL UNDERWRITERS INSURANCE COMPANY

KENNETH NIGRO, ASSISTANT VICE PRESIDENT UNIVERSAL UNDERWRITERS INSURANCE COMPANY
300 INTERPACE PARKWAY BUILDING B/C
Tel: 973 394 5241 Fax: 973 394 5262 Email: kenneth.nigro@zurichna.com

BETH BLANCHARD, TEAM MANAGER UNIVERSAL UNDERWRITERS INSURANCE COMPANY
1299 ZURICH WAY
SCHAUMBURG IL 60196
Tel: 617 570 8827 Fax: 973 394 5262 Email: elizabeth.blanchard@zurichna.com

UTICA MUTUAL INSURANCE COMPANY

IAN FISHER, SUPERVISOR UTICA MUTUAL INSURANCE COMPANY
P.O. BOX 6610
UTICA NY 13504
Tel: 516 479 5240 Fax: 888 538 2018 Email: ian.fisher@uticanational.com

STEPHEN WILLIAMSON, WC CLAIMS MANAGER UTICA MUTUAL INSURANCE COMPANY
P.O. BOX 6610
UTICA NY 13504
Tel: 315 734 2462 Fax: 888 538 2018 Email: stephen.williamson@uticanational.com

UTICA NATIONAL ASSURANCE COMPANY

IAN FISHER, SUPERVISOR UTICA NATIONAL INSURANCE COMPANY
P.O. BOX 6610
UTICA NY 13504
Tel: 516 479 5240 Fax: 888 538 2018 Email: ian.fisher@uticanational.com

STEPHEN WILLIAMSON, WC CLAIMS MANAGER UTICA NATIONAL ASSURANCE COMPANY
P.O. BOX 6610
UTICA NY 13504
Tel: 315 734 2462 Fax: 888 538 2018 Email: stephen.williamson@uticanationa.com

VALLEY FORGE INSURANCE COMPANY

KEVIN ZACCHIA, ASSISTANT VICE PRESIDENT
5786 WIDEWATERS
DEWITT NY 13214
Tel: 315 431 6752 Fax: 714 256 7905 Email: Kevin.Zacchia@cna.com

TAMMY SOWERS, WORKERS' COMPENSATION CLAIM MANAGER
ONE MERIDIAN BOULEVARD
WYOMISSING PA 19610
Tel: 610 320 4410 Fax: 877 371 5122 Email: Tammy.Sowers@cna.com

VALLEY HOME CARE INC

PEG MEYERSBURG, DIRECTOR, EMPLOYEE HEALTH SERVICE
15 ESSEX ROAD
PARAMUS, NJ 07652
Tel: 201 291 6436 Fax: 201 291 6125 Email: pmeyers@valleyhealth.com

MARION KARRAN, MANAGER, EMPLOYEE HEALTH SERVICE
15 ESSEX ROAD
PARAMUS, NJ 07652
Tel: 201 291 6436 Fax: 201 291 6125 Email: mkarran@valleyhealth.com

VALLEY PHYSICIANS SERVICES INC

KAREN SOSNOWSKI, DIRECTOR, TOTAL REWARDS & HR TECHNOLOGY
223 NORTH VAN DIEN AVENUE
RIDGEWOOD, NJ 07450
Tel: 201 291 6336 Fax: 201 291 6290 Email: ksosnow@valleyhealth.com

BARBARA SCHULTZ, DIRECTOR EMPLOYEE HEALTH & WELLNESS
223 NORTH VAN DIEN AVENUE
RIDGEWOOD, NJ 07450
Tel: 201 291 6436 Fax: 201 291 6437 Email: bschult@valleyhealth.com

VANLINER INSURANCE COMPANY

COLLEEN SHEPHERD, CLAIMS DIRECTOR ONE PREMIER DRIVE
ST. LOUIS, MO 63026
Tel: 800 325 3619 ext: 3682 Fax: 636 326 0403 Email: colleen.shepherd@vanliner.com

STEVE WINBORN, VICE PRESIDENT OF OPERATIONS ONE PREMIER DRIVE
ST. LOUIS, MO 63026
Tel: 800 325 3619 ext: 3854 Fax: 636 326 0403 Email: steve.winborn@vanliner.com

VIGILANT INSURANCE COMPANY

LEVERETT STOCKING III, VP, CLAIM LEADER, NORTHEAST WORKERS' COMPENSATION CHUBB NORTH AMERICA CLAIMS
555 LONG WHARF DRIVE
NEW HAVEN CT 06511
Tel: 203 782 4082 Fax: 203 782 4126 Email: lstocking@chubb.com

MICHELLE LOPA, AVP, CLAIM MANAGER CHUBB NORTH AMERICA CLAIMS
150 ALLEN ROAD SUITE 101
Tel: 90M 605 3058 Fax: 908 860 4706 Email: mlopa@chubb.com

VIRTUA HEALTH, INC. & SUBS.

KELLY SOBON, WC ADMINISTRATOR VIRTUA HEALTH
1200 HOWARD BLVD, STE 200
MT LAUREL NJ 08054
Tel: 856 761 3857 Fax: 856 762 2782 Email: ksobon@virtua.org

PATRICIA NAPIER, WC MANAGER QUAL-LYNX 100 DECADON DRIVE
EGG HARBOR TWP NJ 08234
Tel: 800 367 0138 ext: 2046 Fax: 856 926 8038 Email: tnapier@qual-lynx.com

WCF NATIONAL INS COMPANY (FKA ADVANTAGE WC INSURANCE COMPANY)

DAN STEPHENS, VICE PRESIDENT, MULTI-STATE CLAIMS WCF NATIONAL INSURANCE COMPANY(FKA ADVANTAGE WC INSURANCE COMPANY)
P.O. BOX 571918
Tel: 208 957 6705 Fax: 866 346 3289 Email: dstephens@wcf.com

TAMERA FOWLER, DIRECTOR, COMPLIANCE WCF NATIONAL INSURANCE COMPANY(FKA ADVANTAGE WC INSURANCE COMPANY)
P.O. BOX 571918 Address: Tel: 385 743 3014 Fax: 866 346 3289 Email: tfowler@wcf.com

WCF SELECT INSURANCE COMPANY FKA ASSOCIATED INDEMNITY CORPORATION

DAN STEPHENS, VP MULTI-STATE CLAIMS WCF SELECT INSURANCE COMPANY
P.O. BOX 571918
SALT LAKE CITY UT 84157
Tel: 208 957 6705 Fax: 866 346 3289 Email: dstephens@wcf.com

TAMERA FOWLER, DIRECTOR, COMPLIANCE WCF SELECT INSURANCE COMPANY
P.O. BOX 57198
SALT LAKE CITY UT 8415
Tel: 385 743 3014 Fax: 866 346 3289 Email: tfowler@wcf.com

WEGMANS FOOD MARKETS, INC.

ANNETTE DELAHOOKE, WC ANALYST
P.O. BOX 30844 ROCHESTER, NY 14603
Tel: 585 429 3276 Fax: 585 429 3312 Email: annette.delahooke@wegmans.com

CATHY L DAVIES, WCIDB SUPERVISOR
P.O. BOX 30844 ROCHESTER, NY 14603
Tel: 585 429 3860 Fax: 585 429 3312 Email: cathy.davies@wegmans.com

WESCO INSURANCE COMPANY

MELISSA KOVACSY, DIRECTOR AMTRUST FIANCIAL
116 VILLAGE BOULEVARD SUITE
303 Address: Tel: 609 936 3003 Fax: 678 258 8395 Email: melissa.kovacsy@amtrustgroup.com

SUSAN GOLDMAN, SENIOR MANAGER AMTRUST FINANCIAL
116 VILLAGE BOULEVARD SUITE 303
Tel: 732 276 4879 Fax: 678 258 8395 Email: susan.goldman@amtrustgroup.com

WEST AMERICAN INSURANCE COMPANY

KERRYANN HOLLISS, SENIOR CLAIMS MANAGER LIBERTY MUTUAL
P.O. BOX 4836
SYRACUSE NY 13221
Tel: 973 648 7987 Fax: 603 427 2667 Email: Kerryanne.Holliss@LibertyMutual.com

JASON HACKLING, DIRECTOR COMPLEX WORKERS COMPENSATION LIBERTY MUTUAL
P.O. BOX 4836 SYRACUSE NY 13221
Tel: 973 548 6912 Fax: 603 427 2665 Email: Jason.Hackling@LIbertyMutual.com

WEST BEND MUTUAL INSURANCE COMPANY

DAVE NETTUM, AVP - CLAIMS WEST BEND MUTUAL INSURANCE COMPANY
1900 S. 18TH AVENUE
WEST BEND WI 53095
Tel: 262 309 6650 Fax: 262 335 7054 Email: dnettum@wbmi.com

MELINDA SEILER, CLAIMS DIRECTOR WEST BEND MUTUAL INSURANCE COMPANY
1900 S. 18TH AVENUE WEST BEND WI 53095
Tel: 262 365 2150 Fax: 262 335 7054 Email: mseiler@wbmi.com

WESTCHESTER FIRE INSURANCE COMPANY

TOM EASON, AVP, WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICA CLAIMS
1 BEAVER VALLEY ROAD
WILMINGTON, DE 19803
Tel: 302 476 7824 Fax: 302 476 7858 Email: Thomas.Eason@chubb.com

DAVID KROLL, AVP, WORKERS' COMPENSATION CLAIMS CHUBB NORTH AMERICAL CLAIMS
P.O. BOX 5118
SCRANTON PA 18505
Tel: 818 428 3753 Fax: 818 428 3588 Email: david.kroll@chubb.com

WHITE CASTLE SYSTEM, INC.

SAMANTHA WALGATE, SPECIALTY RISK SERVICES 303 LIPPINCOTT CENTER SUITE 303
MARLTON NJ 08053
Tel: 800 630 0746 ext: 54486 Fax: 860 293 0778 Email: samantha.walgate@srsconnect.com

WILLIAM SELIGA, DIRECTOR-RISK MANAGEMENT
555 WEST GOODALE STREET
COLUMBUS OH 43215
Tel: 614 559 2700 Fax: 614 559 2757 Email: seligab@whitecastle.com

WORK FIRST CASUALTY COMPANY

DEBBIE NOWAK, VP - CLAIMS WORK FIRST CASUALTY COMPANY
2636 BIEHN STREET KLAMATH
FALLS OR 97601
Tel: 541 882 1090 Fax: 541 882 1090 Email: dnowak@workfirstcasualty.com

STEPHANIE CAMPBELL, VP - COMPLIANCE WORK FIRST CASUALTY COMPANY
110 EAST 6600 S #260
Tel: 302 477 1710 Fax: 302 477 1710 Email: skorab@workfirstcasualty.com

XL INSURANCE AMERICA, INC.

ANTHONY HAMPTON, REGIONAL CLAIMS OPERATIONS LEAD AXA XL
P.O. BOX 211547
DALLAS TX 75211
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum@axaxl.co

JOHN CONROY, ASST VP, SR. CLAIMS SPECIALIST AXA XL
505 EAGLEVIEW BOULEVARD 4TH FLOOR
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum@axaxl.co

XL INSURANCE COMPANY OF NEW YORK, INC.

ANTHONY HAMPTON, REIGONAL CLAIMS OPERATIONS LEAD AXA XL
P.O. BOX 211547
DALLAS TX 75211
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum@axaxl.co

JOHN CONROY, ASST. VP, SR. CLAIMS SPECIALIST AXA XL
505 EAGLEVIEW BOULEVARD 4TH FLOOR
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum@axaxl.co

XL REINSURANCE AMERICA INC

ANTHONY HAMPTON, REGIONAL CLAIMS OPERATIONS LEAD AXA XL
P.O. BOX 211547
DALLAS TX 19341
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum@axaxl.co

JOHN CONROY, ASST VP, SR. CLAIMS SPECIALIST AXA XL
505 EAGLEVIEW BOULEVARD 4TH FLOOR
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum@axaxl.co

XL SPECIALTY INSURANCE COMPANY

ANTHONY HAMPTON, REGIONAL CLAIMS OPERATIONS LEAD AXA XL
P.O. BOX 211547
DALLAS TX 75211
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4documentum@axaxl.co

JOHN CONROY, ASST VP, SR. CLAIMS SPECIALIST AXA XL
505 EAGLEVIEW BOULEVARD 4TH FLOOR
Tel: 877 720 8844 Fax: 877 896 4562 Email: xlclaims.general.emailbox4dcoumentum@axaxl.co

ZENITH INSURANCE COMPANY Name: KIM FLATFORD, VICE PRESIDENT - CLAIMS ZENITH INSURANCE COMPANY
P.O. BOX 1558
SARASOTA FL 34230
Tel: 704 567 7452 Fax: 800 364 0443 Email: kflatford@thezenith.com

KELLY BARKER, CLAIMS SUPERVISOR ZENITH INSURANCE COMPANY
P.O. BOX 1558
SARASOTA FL 34230
Tel: 484 622 2921 Fax: 484 622 6916 Email: kbarker@thezenith.com

ZNAT INSURANCE COMPANY

KIM FLATFORD, VICE PRESIDENT ZENITH INSURANCE COMPANY
P.O. BOX 1558
Tel: 800 440 5020 Fax: 800 364 0443 Email: kflatford@thezenith.com

KELLY BARKER, CLAIM MANAGER ZENITH INSURANCE COMPANY
P.O. BOX 1558 SARASOTA FL 34230
Tel: 800 440 5020 Fax: 800 364 0443 Email: KBarker@theZenith.com

ZURICH AMERICAN INSURANCE COMPANY

BRIAN M. DOOLEY, ASST. VICE PRESIDENT ZURICH AMERICAN INSURANCE COMPANY
300 INTERPACE PARKWAY MORRIS CORP. #1, BLDG. B/C
Tel: 973 394 5281 Fax: 973 394 5262 Email: brian.dooley@Zurichna.com

ZURICH AMERICAN INSURANCE COMPANY

KENNETH NIGRO, ASSISTANT VICE PRESIDENT ZURICH AMERICAN INSURANCE COMPANY
300 INTERPACE PARKWAY BUILDING B/C
Tel: 973 394 5241 Fax: 973 394 5262 Email: kenneth.nigro@zurichna.com

BETH BLANCHARD, TEAM MANAGER ZURICH AMERICAN INSURANCE COMPANY
1299 ZURICH WAY
SCHAUMBURG IL 60196
Tel: 617 570 8827 Fax: 973 394 5262 Email: elizabeth.blanchard@zurichna.com