3/31/2008 INSURER REPORT SBWC # 20582 20622 20764 13246 13214 13240 13235 10253 10221 13034 10002 13193 13176 21753 20315 10193 12089 10066 21715 21130 13202 13202 10295 21774 13244 21464 10034 21596 13245 13117 13117 13122 13122 13122 10012 10006 10007 12090 10262 10009 10011 10011 10013 10013 10015 10016 10016 13030 10146 13021 10018 10018 10018 10019 20459 12044 20496 13007 13124 13223 10254 10244 12077 12022 10106 13167 13167 13167 13167 21621 13210 13183 13183 Insurance Carriers/Self-Insureds/Group Funds A G RHODES NURSING HOME AAA COOPER TRANSPORATION ABF FREIGHT SYSTEM INC ACCIDENT FUND GENERAL INSURANCE COMPANY ACCIDENT FUND INSURANCE COMPANY OF AMERICA ACCIDENT FUND NATIONAL INSURANCE COMPANY ACCIDENT INSURANCE COMPANY ACE AMERICAN INSURANCE COMPANY ACE FIRE UNDERWRITERS ACE INDEMNITY INSURANCE COMPANY ACE PROPERTY & CASUALTY ACIG INSURANCE COMPANY ADVANTAGE WORKERS COMPENSATION INSURANCE CO ADVENTIST HEALTH SYSTEM / SUNBELT HEALTHCARE CORP AGL RESOURCES INC AIG CASUALTY (FKA BIRMINGHAM FIRE OF PA) AIG NATIONAL INSURANCE COMPANY AIU INSURANCE COMPANY ALBANY INTERNATIONAL CORP ALBANY, CITY OF ALEA NORTH AMERICA (MULTI-TPA) ALEA NORTH AMERICA (MULTI-TPA) ALL AMERICA INSURANCE COMPANY ALLENS INC ALLIED PROPERTY & CASUALTY INSURANCE COMPANY ALLIED SYSTEMS LTD ALLMERICA FINANCIAL BENEFIT ALPHARETTA, CITY OF AMCO INSURANCE COMPANY AMCOMP ASSURANCE (MULTI-TPA) AMCOMP ASSURANCE (MULTI-TPA) AMERICAN ALTERNATIVE INSURANCE (MULTI-TPA) AMERICAN ALTERNATIVE INSURANCE (MULTI-TPA) AMERICAN ALTERNATIVE INSURANCE (MULTI-TPA) AMERICAN AND FOREIGN INSURANCE COMPANY AMERICAN AUTOMOBILE INSURANCE COMPANY AMERICAN CASUALTY COMPANY OF READING PA AMERICAN CENTRAL INSURANCE COMPANY AMERICAN ECONOMY INSURANCE COMPANY AMERICAN EMPLOYERS INSURANCE COMPANY AMERICAN FIRE AND CASUALTY CO (MUTI-TPA) AMERICAN FIRE AND CASUALTY CO (MUTI-TPA) AMERICAN GUARANTY & LIABILITY (MULTI-TPA) AMERICAN GUARANTY & LIABILITY (MULTI-TPA) AMERICAN INSURANCE COMPANY AMERICAN INSURANCE COMPANY (THE) (MULTI-TPA) AMERICAN INSURANCE COMPANY (THE) (MULTI-TPA) AMERICAN INTERNATIONAL AMERICAN INTERNATIONAL SOUTH AMERICAN INTERSTATE INSURANCE COMPANY AMERICAN MANUFACTURING MUTUAL INS (MULTI-TPA) AMERICAN MANUFACTURING MUTUAL INS (MULTI-TPA) AMERICAN MANUFACTURING MUTUAL INS (MULTI-TPA) AMERICAN MOTORISTS INSURANCE COMPANY AMERICAN NATIONAL RED CROSS AMERICAN PROTECTION INSURANCE AMERICAN PROTEINS INC AMERICAN RESOURCES INSRUANCE COMPANY AMERICAN RISK FUNDING AMERICAN SAFETY CASUALTY INSRUANCE AMERICAN STATES INSURANCE COMPANY AMERICAN STATES INSURANCE OF TEXAS AMERICAN ZURICH INSURANCE COMPANY AMERISURE INSURANCE COMPANY AMERISURE MUTUAL INSURANCE AMGUARD INSURANCE COMPANY (MULTI-TPA) AMGUARD INSURANCE COMPANY (MULTI-TPA) AMGUARD INSURANCE COMPANY (MULTI-TPA) AMGUARD INSURANCE COMPANY (MULTI-TPA) ANHEUSER-BUSCH COMPANY ANSUR AMERICAN INSURANCE COMPANY ARCH INSURANCE COMPANY (MULTI-TPA) ARCH INSURANCE COMPANY (MULTI-TPA) Address Line 1 3715 NORTHSIDE PARKWAY PO BOX 6827 PO BOX 10048 232 SOUTH CAPITOL AVENUE 232 SOUTH CAPITOL AVENUE 131 DUTCHMAN BLVD 436 WALNUT STREET 436 WALNUT STREET PO BOX 41484 436 WALNUT STREET 12222 MERIT DRIVE PO BOX 571918 602 COURTLAND STREET DBA ATLANTA GAS LIGHT 175 WATER STREET 175 WATER STREET 175 WATER STREET PO BOX 1907 PO BOX 447 55 CAPITAL BLVD 800 SOUTH WASHINGTON STREET 305 EAST MAIN STREET 1100 LOCUST STREET 160 CLAIRMONT AVE EMBASSY ROW 600 2 SOUTH MAIN STREET 1100 LOCUST STREET 701 US HIGHWAY 1 Address Line 2 BLDG 400 STE 205 SUITE 1660 SUITE 330 PO BOX 4569 LOC 1462 18TH FLOOR 18TH FLOOR 18TH FLOOR DEPT 3030 SUITE 410 6600 PEACHTREE-DUNWOODY RD DEPT 3030 SUITE 200 City/State/Zip ATLANTA GA 30327 DOTHAN AL 36302 FORT SMITH AR 72917 LANSING MI 48933 LANSING MI 48933 IRMO SC 29063 PHILADELPHIA PA 19105 PHILADELPHIA PA 19105 PHILADELPHIA PA 19101 PHILADELPHIA PA 19105 DALLAS TX 75251 SALT LAKE CITY UT 84157-1918 ORLANDO FL 328804 ATLANTA GA 30302 NEW YORK NY 10038 NEW YORK NY 10038 NEW YORK NY 10038 ALBANY NY 12201 ALBANY GA 31702 ROCKY HILL CT 06067 VAN WERT OH 45891 SIOAM SPRINGS AR 72761 DES MOINES IA 50391-1100 DECATUR GA 30030 ATLANTA GA 30328 ALPHARETTA GA 30201 DES MOINES IA 50391-1100 N PALM BEACH FL 33408 555 COLLEGE ROAD EAST PRINCETON NJ 08543 9300 ARROWPOINT BLVD 777 SAN MARIN DRIVE 333 S WABASH AVENUE ONE BEACON STREET C/O LICENSING T-18 ONE BEACON STREET 9450 SEWARD RD CHARLOTTE NC 28273 NOVATO CA 94998 CHICAGO IL 60604 BOSTON MA 02108 SEATTLE WA 98185 BOSTON MA 02108 FAIRFIELD OH 45014 CNA CENTER 28TH FLOOR SAFECO PLAZA 1400 AMERICAN LANTE SCHAUMBURG IL 60196-1023 777 SAN MARIN DRIVE NOVATO CA 94998 175 WATER STREET 175 WATER STREET 2301 HIGHWAY 190 WEST ONE KEMPER DRIVE B-7 ONE KEMPER DRIVE B-7 2025 EAST STREET NW ONE KEMPER DRIVE B-7 4705 LELAND DRIVE PO BOX 91149 12222 MERIT DRIVE 8145 THE EXCHANGE C/O LICENSING T-18 C/O LICENSING T-18 1400 AMERICAN LANE 26777 HALSTED ROAD 26777 HALSTED ROAD PO BOX 1368 2600 S SEVENTH STREET #203LL ONE MUTUAL AVE 300 1ST STAMFORD PLACE 18TH FLOOR 18TH FLOOR 9TH FLOOR SUITE 1660 SAFECO PLAZA SAFECO PLAZA 5TH FLOOR NEW YORK NY 10038 NEW YORK NY 10038 DERIDDER LA 70634 LONG GROVE IL 60049-0001 LONG GROVE IL 60049-0001 WASHINGTON, DC 20006 LONG GROVE IL 60049-0001 CUMMING GA 30041 MOBILE AL 36691 DALLAS TX 75251 ATLANTA GA 30339 SEATTLE WA 98185 SEATTLE WA 98185 SCHAUMBURG IL 60196 FARMINGTON HILLS MI 48331-3586 FARMINGTON HILLS MI 48331-3586 WILKES BARRE PA 18703 ST LOUIS MO 63127 FRANKENMUTH MI 48787 STAMFORD CT 06902 Telephone CLAIMS HANDLING 404 949 3830 STOWE ASSOCIATES 334 793 2284 CRAWFORD & COMPANY 479 785 6218 ABF FREIGHT RISK MANAGEMENT ACCIDENT FUND CLAIMS DEPT. 800 395 2366 ACCIDENT FUND CLAIMS DEPT. 800 395 2366 ACCIDENT FUND CLAIMS DEPT. ACCIDENT INSURANCE CO CLAIMS 215 640 1272 ESIS INC 215 640 1272 ESIS INC 215 640 1272 ESIS INC 215 640 1272 ESIS INC 800 563 6051 NOVAPRO RISK SOLUTIONS LP 888 595 8750 GALLAGHER BASSETT SERVICES 407 200 4894 ADVENTIST HEALTH RISK MANAGEMENT 404 584 3782 AGL COMPANY RISK MANAGEMENT 212 458 7043 AMERICAN INTERNATIONAL GROUP 212 458 7043 AMERICAN INTERNATIONAL GROUP 212 458 7043 AMERICAN INTERNATIONAL GROUP 518 447 6492 GALLAGHER BASSETT SERVICES 912 431 2107 UNISOURCE ADMINISTRATORS 877 775 8637 GALLAGHER BASSETT SERVICES CHUBB GROUP 800 736 7000 CENTRAL INSURANCE RISK MGMT 479 524 6431 ALLENS INC RISK MANAGEMENT 800 228 6700 ALLIED CLAIMS ADMINISTRATION INC 404 687 5905 BROADSPIRE SERVICES 770 943 6696 ALLMERICA FINANCIAL BENEFIT CLAIMS 404 982 0102 AMTRUST SOUTH/COVENANT 800 228 6700 AMCO INSURANCE RISK MANGT 800 226 1898 AMCOMP ASSURANCE RISK MGMT AMCOMP ASSURANCE RISK MGMT 800 305 4954 CRAWFORD & COMPANY AMTRUST SOUTH/COVENANT RISK MANAGEMENT SERVICES 704 522 3521 UNISUN INSURANCE 800 227 1700 FIREMAN'S FUND INSURANCE 312 822 4314 CNA CLAIMS PLUS 973 630 6601 ONEBEACON INSURANCE 206 675 3609 SAFECO INSURANCE 974 630 6601 ONEBEACON INSURANCE 800 843 6446 OHIO CASUALTY CLAIMS DIVISION OHIO CASUALTY CLAIMS DIVISION 847 605 6587 ZURICH NORTH AMERICA CLAIMS DIV. ZURICH NORTH AMERICA CLAIMS DIV. 800 277 1700 AMERICAN INTERNATIONAL GROUP FIREMAN'S FUND INSURANCE FIREMAN'S FUND INSURANCE 212 458 7043 AMERICAN INTERNATIONAL GROUP 212 458 7043 AMERICAN INTERNATIONAL GROUP 800 256 9052 AMERISAFE RISK SERVICES 847 320 5580 KEMPER INSURANCE CRAWFORD & COMPANY CRAWFORD & COMPANY 847 320 5580 KEMPER INSURANCE 202 303 7843 CAMBRIDGE 847 320 5580 CRAWFORD & COMPANY 770 886 2250 UNISOURCE ADMINISTRATORS 800 711 4413 AMTRUST SOUTH/COVENANT 800 563 6051 RSKCO RISK ENTERPRISE MANAGEMENT 206675 3609 SAFECO INSURANCE 206 675 3609 SAFECO INSURANCE 847 605 6587 ZURICH NORTH AMERICA CLAIMS DIV. 800 257 1900 AMERISURE INSURANCE CLAIMS 800 257 1900 AMERISURE INSURANCE CLAIMS 800 673 2465 AMGROUP INSRUANCE GROUP GUARD INSURANCE GROUP GUARD INSURANCE GROUP GUARD INSURANCE GROUP 314 577 3576 HELMSMAN MANAGEMENT SERVICES 800 234 1133 FRANKENMUTH FINANCIAL GROUP CLAIMS 877 258 7475 CNA CLAIMSPLUS GALLAGHER BASSETT SERVICES UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 SUITE 217 100 GLENRIDGE PT PARKWAY PO BOX 10048 232 SOUTH CAPITOL AVENUE 232 SOUTH CAPITOL AVENUE 232 SOUTH CAPITOL AVENUE 3440 BLUE SPRINGS ROAD 500 COLONIAL CENTER PARKWAY 500 COLONIAL CENTER PARKWAY 500 COLONIAL CENTER PARKWAY 500 COLONIAL CENTER PARKWAY 1100 HAMMOND DRIVE 100 CRESCENT CENTRE PARKWAY 602 COURTLAND STREET PO BOX 4569 PO BOX 2158 PO BOX 2158 PO BOX 2158 100 CRESCENT CENTRE PARKWAY 3740 DAVINCI COURT 100 CRESCENT CENTRE PARKWAY 3445 PEACHTREE ROAD NE 800 SOUTH WASHINGTON STREET PO BOX 250 1100 LOCUST STREET 655 ENGINEERING DRIVE EMBASSY ROW 600 PO BOX 740042 100 LUCUST STREET 1000 PARKWOOD CIRCLE 13120 BALLANTYNE CORPORATE PLACE 100 GLENRIDGE PT PARKWAY PO BOX 740042 PO BOX 105206 5950 LIVE OAK PARKWAY 11475 GREAT OAKS WAY 2435 COMMERCE AVENUE 5901-B PEACHTREE-DUNWOODY ROAD 2055 SUGARLOAF CIRCLE 5901-B PEACHTREE-DUNWOODY ROAD PO BOX 399 PO BOX 29621 3003 SUMMIT BLVD 4010 BOYSCOUT BLVD PO BOX 2158 11475 GREAT OAKS WAY PO BOX 740174 PO BOX 2158 PO BOX 2158 808 HWY 190 WEST PO BOX 926240 1601 SW 80TH TERRACE 5620 GLENRIDGE DRIVE NE PO BOX 926240 809 GLEN EAGLE COURT 5620 GLENRIDGE DRIVE NE 3740 DAVINCI COURT 11330 LAKEFIELD DRIVE PO BOX 105497 PO BOX 105026 2055 SUGARLOAF CIRCLE 2055 SUGARLOAF CIRCLE 3003 SUMMIT BLVD 3237 SATELLITE BLVD 3237 SATELLITE BLVD PO BOX 1368 620 MOOREFIELD DRIVE 5973 EDENFIELD DRIVE 102 WEST PENNSYLVANIA AVE 3901 PREMIER NORTH DRIVE 129 FREDERICK 2435 COMMERCE AVENUE 100 CRESCENT CENTRE PARKWAY ADDRESS LINE 2 2951 FLOWERS ROAD, SOUTH SUITE 203 SUITE 200 SUITE 200 SUITE 200 SUITE 200 SUITE 410A-120 SUITE 600 SUITE 330 LOC 1470 SUITE 600 SUITE 100 SUITE 600 2 LIVE OAK CENTER #900 SUITE 200 6600 PEACHTREE-DUNWOODY RD SUITE 100 SUITE 100 1140 HAMMOND DR SUITE 200 ROYAL CENTRE THREE BLDG 2200 SATELLITE SAFECO PLAZA SUITE 600 ROYAL CENTRE THREE SSUITE 210 SUITE 100 BLDG 11 STE 100 1140 HAMMOND DR #J-2075 SAFECO PLAZA SAFECO PLAZA BLDG 300 SUITE 400 SUITE 400 SUITE 209 SUITE 206 BLDG 2200 SATELLITE PLACE SUITE 600 CITY STATE ZIP ATLANTA GA 30341 ATLANTA GA 30302 FORT SMITH AR 72917-0048 LANSING MI 48933 LANSING MI 48933 LANSING MI 48933 KENNESAW GA 30144 ROSWELL GA 30076 ROSWELL GA 30076 ROSWELL GA 30076 ROSWELL GA 30076 ATLANTA GA 30328 TUCKER GA 30084 ORLANDO FL 32804 ATLANTA GA 30302 ALPHARETTA GA 30023 ALPHARETTA GA 30023 ALPHARETTA GA 30034 TUCKER GA 30084 NORCROSS GA 30092 TUCKER GA 30084 ATLANTA GA 30326 VAN WERT OH 45891 SILOAM SPRINGS AR 72761 DES MOINES IA 50391 NORCROSS GA 30092 ATLANTA GA 30328 ATLANTA GA 30374-0042 DES MOINES IA 50391 ATLANTA GA 30339 CHARLOTTE NC 28277 ATLANTA GA 30302 ATLANTA GA 30374 ATLANTA GA 30328 NORCROSS GA 30093 ALPHARETTA GA 30374 DULUTH GA 30096 ATLANTA GA 30328 DULUTH GA 30097 ATLANTA GA 30328 HOLLY SPRINGS GA 30142 RALEIGH NC 27607 ATLANTA GA 30319 TAMPA FL 33607 ALPHARETTA GA 30023 ALPHARETTA GA 30374 ATLANTA GA 30374 ALPHARETTA GA 30023-2158 ALPHARETTA GA 30023-2158 DERIDDER LA 70634-6006 NORCROSS GA 30010 PLANTATION FL 33324 ATLANTA GA 30342 NORCROSS GA 30010 TOWSON MD 21286 ATLANTA GA 30342 NORCROSS GA 30092 DULUTH GA 30097 ATLANTA GA 30348 ATLANTA GA 30328 DULUTH GA 30097 DULUTH GA 30097 ATLANTA GA 30319 DULUTH GA 30096 DULUTH GA 30096 WILKES-BARRE PA 18703-1368 RICHMOND VA 23236-3692 ACWORTH GA 30101 TOWSON MD 21204 TAMPA FL 33618 BRUNSWICK GA 31520 DULUTH GA 30096 TUCKER GA 30084 TELEPHONE 770 451 6222 800 249 9243 800 961 9744 800 395 2366 800 395 2366 800 395 2366 678 921 4314 800 685 7361 800 685 7361 800 685 7361 800 685 7361 678 731 9091 800 354 6494 407 200 4894 404 584 3782 800 448 9707 800 448 9707 800 448 9707 800 354 6494 877 638 7876 800 354 6496 404 266 4855 800 736 7000 800 234 2553 800 985 7078 800 450 0692 770 943 6696 678 258 8000 800 532 1436 800 992 1072 800 249 9243 678 258 8000 800 347 1128 770 849 0242 800 227 1700 800 282 7084 800 203 9600 678 417 3654 800 203 9600 877 933 2666 800 366 6446 800 241 7570 800 448 9707 800 227 1700 678 393 4550 800 448 9707 800 448 9707 800 256 3462 678 969 7337 425 391 8763 404 847 4007 678 969 7337 410 847 6395 404 847 4007 877 638 7876 678 258 8000 800 283 2318 800 347 1128 678 417 3654 678 417 3654 800 241 7570 800 230 9338 770 813 3300 800 282 6218 800 234 1133 800 354 6494 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 13183 21371 21644 10081 10081 10026 10026 10026 12039 12039 12039 21476 10027 13115 13173 10144 10252 20505 10215 10215 10215 21257 21534 20313 20485 20314 10268 10268 10268 13154 13232 21676 12010 10030 21652 21545 21348 13074 20309 10269 13071 20529 21760 21209 13077 20537 20608 20918 21186 21654 10032 10033 21729 21651 20620 20541 21746 13179 10031 21649 20394 40008 21517 21413 21427 21716 13234 21762 10036 13099 21297 13048 21139 Insurance Carriers/Self-Insureds/Group Funds ARCH INSURANCE COMPANY (MULTI-TPA) ARCHBOLD MEDICAL CENTER ARCHER-DANIELS-MIDLAND COMPANY ARGONAUT GREAT CENTRAL (MULTI-TPA) ARGONAUT GREAT CENTRAL (MULTI-TPA) ARGONAUT INSURANCE COMPANY (MULTI-TPA) ARGONAUT INSURANCE COMPANY (MULTI-TPA) ARGONAUT INSURANCE COMPANY (MULTI-TPA) ARGONAUT-MIDWEST INSURANCE CO (MULTI-TPA) ARGONAUT-MIDWEST INSURANCE CO (MULTI-TPA) ARGONAUT-MIDWEST INSURANCE CO (MULTI-TPA) ASPLUNDH TREE EXPERT COMPANY ASSOCIATED INDEMNITY COPORATION ASSOCIATED INDUSTRIES INSURANCE COMPANY ASSOCIATION CASUALTY ASSOCIATION INSURANCE COMPANY ASSURANCE COMPANY OF AMERICA ATCO RUBBER PRODUCTS ATHENA ASSURANCE COMPANY (MULTI-TPA) ATHENA ASSURANCE COMPANY (MULTI-TPA) ATHENA ASSURANCE COMPANY (MULTI-TPA) ATHENS REGIONAL MEDICAL CENTER ATHENS-CLARKE COUNTY GOVERNMENT ATLANTA BOARD OF EDUCATION ATLANTA HOUSING AUTHORITY ATLANTA, CITY OF ATLANTIC INSURANCE COMPANY (MULTI-TPA) ATLANTIC INSURANCE COMPANY (MULTI-TPA) ATLANTIC INSURANCE COMPANY (MULTI-TPA) ATLANTIC SPECIALTY INSURANCE COMPANY ATLANTIC STATES INSURANCE COMPANY AUGUSTA-RICHMOND COUNTY BOARD OF COMMISSIONERS AUTOMOBILE INSURANCE CO OF HARTFORD CT AUTO-OWNERS INSURANCE COMPANY AUTOZONE INC AVERITT EXPRESS INC BALDWIN COUNTY BOARD OF COMMISSIONERS BANCINSURE INC BANK SOUTH BANKERS STANDARD FIRE AND MARINE BANKERS STANDARD INSURANCE COMPANY BARTOW COUNTY BOARD OF EDUCATION BEAULIEU GROUP LLC BELLSOUTH TELECOMMUNICATION INC BENCHMARK INSURANCE COMPANY BENTON-GEORGIA INC. BERRY COLLEGE INC BIBB COUNTY BOARD OF COMMISIONERS BIBB COUNTY BOARD OF EDUCATION BIG LOTS STORES INC BITUMINOUS CASUALTY CORPORATION BITUMINOUS FIRE & MARINE INSURANCE COMPANY BJ'S WHOLESALE CLUB INC BLACK & DECKER CORPORATION BLOSSMAN COMPANIES BLUE BIRD BODY COMPANY BREMEN BOWDEN INVESTMENT COMPANY INC BRIDGEFIELD CASUALTY BROTHERHOOD MUTUAL INSURANCE COMPANY BROWN INDUSTRIES INC BRUNSWICK, CITY OF BUILDERS INSURANCE GROUP BURLEN CORPORATION C T HARRIS CAGLE'S INC & SUBSIDIARIES CALDWELL TANKS ALLIANCE INC CALIFORNIA INSURANCE COMPANY CAMDEN COUNTY BOARD OF COMMISSIONERS CAMDEN FIRE INSURANCE ASSOCIATION CANAL INSURANCE COMPANY CANDLER HOSPITAL INC CAPITAL CITY INSURANCE CASCADE CORPORATION Address Line 1 Address Line 2 PO BOX 1018 PO BOX 1470 3625 N SHERIDAN ROAD 10101 REUNION PLACE 10101 REUNION PLACE SUITE 500 Telephone THOMASVILLE GA 31799 DECATUR IL 62525 PEORIA IL 61633-0001 229 228 8041 717 424 5233 877 769 5953 SAN ANTONIO TX 78216 800 470 7958 SAN ANTONIO TX 78216 800 470 7958 708 BLAIR MILL ROAD WILLOW GROVE PA 19090 215 784 1456 PO BOX 812319 4370 PEACHTREE ROAD NE 2410 PACES FERRY ROAD 1400 AMERICAN LANE 7101 ATCO DRIVE 385 WASHINGTON STREET BOCA RATON FL 33481 ATLANTA GA 30319 ATLANTA GA 30339 SCHAUMBERG IL 60196 FORT WORTH TX 76118 ST PAUL MN 55102 800 866 1600 800 282 0480 800 883 9305 847 605 6587 817 595 2894 800 328 2189 ATHENS GA 30606 ATHENS GA 30603 ATLANTA GA 30303 ATLANTA GA 30303 ATLANTA GA 30303 HARTFORD CT 06183 706 475 3357 706 613 3101 404 827 8169 404 892 4700 404 330 6400 860 954 5660 BOSTON MA 02108 MARIETTA PA 17547 AUGUSTA GA 30911 HARTFORD CT 06183 LANSING MI 48909-8160 MEMPHIS TN 38103 COOKEVILLE TN 38502 MILLEDGEVILLE GA 31061 OKLAHOMA CITY OK 73126-0104 CHARLOTTE NC 28255 PHILADELPHIA PA 19105 PHILADELPHIA PA 19105 DULUTH GA 30096 DALTON GA 30722-2128 ATLANTA GA 30375 OVELAND PARK KS 66202 DOUGLASVILLE GA 30133 MOUNT BERRY GA 30149-0129 MACON GA 31201 MACON GA 31208 COLUMBUS OH 43228 ROCK ISLAND IL 61201 ROCK ISLAND IL 61201 NATICK MA 01760 TOWSON MD 21286 OCEAN SPRINGS MS 39566-1110 FORT VALLEY, GA 31030 BOWDON GA 30108 LAKELAND FL 33802 FORT WAYNE IL 46801 DALTON GA 30722-2128 BRUNSWICK GA 31521 ATLANTA GA 31139 TIFTON GA 31793 SANDERSVILLE GA 31082 ATLANTA GA 30318 NEWNAN GA 30263 OMAHA NE 68154 WOODBINE GA 31569 BOSTON MA 02108 DULUTH GA 30096 SAVANNAH GA 31405 COLUMBIA SC 29221 FAIRVIEW OR 97024 973 630 6601 1199 PRINCE AVE PO BOX 1868 130 TRINITY AVE 230 JOHN WESLEY DOBBS AVE 68 MITCHELL STREET SW ONE TOWER SQUARE 1 BEACON STREET 1195 RIVER ROAD CITY/COUNTY BUILDING ONE TOWER SQUARE PO BOX 30660 123 SOUTH FRONT STREET PO BOX 3166 121 N WILKENSON STREET PO BOX 26104 C/O NATIONSBANK 436 WALNUT STREET 436 WALNUT STREET C/O SIA PO BOX 1248 675 W PEACHTREE ST 6405 METCALF AVENUE PO BOX 838 PO BOX 490129 601 MULBERRY STREET PO BOX 6157 FKA CONSOLIDATED STORES 329 18TH STREET 329 18TH STREET ONE MERCER ROAD 701 EAST JOPPA ROAD PO BOX 1110 402 BLUE BIRD BLVD 141 COMMERCE STREET PO BOX 988 6400 BROTHERHOOD WAY PO BOX 1103 PO BOX 550 PO BOX 723099 PO BOX 168 9411 DEEPSTEP ROAD 2000 HILLS AVE NW 57 EAST BROAD STREET 10805 OLD MILL ROAD 200 EAST 4TH STREET ONE BEACON STREET PO BOX 4086 5353 REYNOLDS STREET PO BOX 212157 2201 NE 201ST AVENUE SUITE 500 City/State/Zip SUITE 300 SUITE 8100 POB XO 302 ROOM 217 100 NORTH TRYON ST 3473 SATELLITE BLVD # 310 N MAIL CODE 17H54 SUITE 400 SOUTH ROOM 412 300 PHILLIPI ROAD PO BOX 937 PO BOX 2227 706 772 5984 860 954 5660 800 346 0346 901 495 7244 800 251 6730 912 453 8404 800 221 1825 215 640 1272 215 640 1272 770 344 0070 705 272 4511 404 927 1612 913 722 0622 770 942 8180 706 236 2265 478 621 6022 478 779 3527 614 278 6807 800 475 4477 800 475 4477 508 651 6158 405 270 2819 228 872 8916 478 822 2001 770 258 3315 800 282 7648 800 333 3735 706 277 8964 912 267 5500 678 309 4044 229 382 4100 478 552 5070 404 355 2820 770 253 3232 912 576 5660 617 725 9322 678 259 2779 912 819 8972 888 717 6827 503 669 6708 CLAIMS HANDLING GAB ROBINS NORTH AMERICA ALLIED CLAIMS ADMINISTRATION INC GALLAGHER BASSETT SERVICES ARGONAUT INSURANCE GROUP ARGONAUT INSURANCE GROUP BROADSPIRE SERVICES ARGONAUT INSURANCE GROUP ARGONAUT INSURANCE GROUP ARGONAUT INSURANCE GROUP ARGONAUT INSURANCE GROUP CRAWFORD & COMPANY BROADSPIRE SERVICES FIREMAN'S FUND INSURANCE ASSOCIATED INDUSTRIES CLAIMS ASSOCIATION CASUALTY CLAIMS BUILDERS INSURANCE GROUP ZURICH NORTH AMERICA CLAIMS DIV. COLLINS & COMPANY TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES GEORGIA ADMINISTRATIVE SERVICES ATHENS-CLARKE CTY RISK MANAGEMENT ATLANTA BOARD OF ED RISK MGMT ATLANTA HOUSING AUTH RISK MGMT NOVAPRO RISK SOLUTIONS LP TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES ONEBEACON INSURANCE SOUTHERN INSURANCE COMPANY OF VA GEORGIA ADMINISTRATIVE SERVICES TRAVELERS COMPANIES AUTO-OWNERS INSURANCE CLAIMS GALLAGHER BASSETT SERVICES AVERITT EXPRESS RISK MANAGEMENT BALDWIN COUNTY RISK MANAGEMENT CRAWFORD & COMPANY CRAWFORD & COMPANY ESIS INC ESIS INC SELF-INSURANCE ADMINISTRATORS INC BEAULIEU GROUP RISK MANAGEMENT SEDGWICK CMS AMTRUST SOUTH/COVENANT AMTRUST SOUTH/COVENANT KEY RISK MANAGEMENT SERVICES BIBB COUNTY RISK MANAGEMENT BIBB COUNTY BD P ED & ORP SEDGWICK CMS BITUMINOUS CASUALTY CO CLAIMS BITUMINOUS CASUALTY CO CLAIMS GALLAGHER BASSETT SERVICES SPECIALTY RISK SERVICES UNDERWRITERS SAFETY & CLAIMS UNDERWRITERS SAFETY & CLAIMS AMTRUST SOUTH/COVENANT SUMMIT CONSULTING BROTHERHOOD MUTUAL INS CLAIMS AMTRUST SOUTH/COVENANT UNDERWRITERS SAFETY & CLAIMS BUILDERS INSURANCE GROUP CLAIMS AMTRUST SOUTH/COVENANT UNDERWRITERS SAFETY & CLAIMS AMERICAN PROFESSIONAL RISK RISK MANAGEMENT SERVICES CALIFORNIA INSURANCE AMTRUST SOUTH/COVENANT MONTGOMERY INSURANCE CO UNISOURCE ADMINISTRATORS UNDERWRITERS SAFETY & CLAIMS SOUTHEASTERN CLAIMS SERVICES INC KEY RISK MANAGEMENT SERVICES UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 220 NORWOOD PARK SOUTH PO BOX 674869 100 CRESCENT CENTRE PARKWAY 3000 OLD ALABAMA ROAD 3625 NORTH SHERIDAN ROAD PO BOX 5065 3000 OLD ALABAMA ROAD PO BOX 152007 PO BOX 152007 3000 OLD ALABAMA ROAD 100 GLENRIDGE PT PARKWAY 655 ENGINEERING DRIVE 11475 GREAT OAKS WAY PO BOX 310719 4370 PEACHTREE ROAD NE 2410 PACES FERRY ROAD 3003 SUMMIT BLVD PO BOX 723783 CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE 1775 SPECTRUM DRIVE PO BOX 1868 130 TRINITY AVENUE 230 JOHN WESLEY DOBBS AVE NE 1100 HAMMOND DRIVE CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE 5901-B PEACHTREE-DUNWOODY ROAD 3237 SATELLITE BLVD 1775 SPECTRUM DRIVE 3632 QUEEN PALM DRIVE PO BOX 100044 100 CRESCENT CENTRE PARKWAY PO BOX 3166 PO BOX 1599 100 GLENRIDGE PT PARKWAY 100 GLENRIDGE PT PARKWAY 500 COLONIAL CENTER PARKWAY 500 COLONIAL CENTER PARKWAY 3473 SATELLITE BLVD PO BOX 1248 1117 PERIMETER CENTER WEST PO BOX 740042 PO BOX 740042 PO BOX 2670 601 MULBERRY STREET PO BOX 6157 1117 PERIMETER CENTER WEST 3700 CRESTWOOD PARKWAY 3700 CRESTWOOD PARKWAY 100 CRESCENT CENTRE PARKWAY PO BOX 305104 5105 PAULSEN STREET PO BOX 465537 PO BOX 740042 340 JESSE JEWEL PARKWAY 6400 BROTHERHOOD WAY PO BOX 740042 5105 PAULSEN STREET 2410 PACES FERRY ROAD PO BOX 740042 5105 PAULSEN STREET 1255 MCFARLAND 400 DRIVE 9100 MARKSFIELD ROAD 10805 OLD MILL ROAD PO BOX 740042 3555 KOGER BLVD 3740 DAVINCI COURT 5105 PAULSEN STREET 6501 PEAK ROAD PO BOX 2670 ADDRESS LINE 2 SUITE 600 SUITE 119-301 SUITE 119-301 SUITE 119-301 SUITE 100 SUITE 100 ROYAL CENTRE THREE SUITE 300 SUITE 100 SUITE 410A-120 SUITE 300 SUITE 100 SUITE 600 SUITE 100 SUITE 100 SUITE 200 SUITE 200 SUITE 310 NORTH SUITE E500 ROOM 412 SUITE E500 SUITE 650 SUITE 650 SUITE 600 SUITE 241B SUITE 250 PO BOX 2227 SUITE 241B SUITE 300 SUITE 241B SUITE 100 SUITE 241B BUILDING 1200 CITY STATE ZIP NORWOOD MA 02062-4634 MARIETTA GA 30006 TUCKER GA 30084 ALPHARETTA GA 30022 PEORIA IL 61633-9801 ATLANTA GA 30302 ALPHARETTA GA 30022 IRVING TX 75015 IRVING TX 75015 ALPHARETTA GA 30022 ATLANTA GA 30302-5065 NORCROSS GA 30092 ALPHARETTA GA 30374 BOCA RATON FL 33421 ATLANTA GA 30319 ATLANTA GA 30339 ATLANTA GA 30319 ATLANTA GA 31139 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 LAWRENCEVILLE GA 30043 ATHENS GA 30613 ATLANTA GA 30303 ATLANTA GA 30303 ATLANTA GA 30328 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 ATLANTA GA 30328 DULUTH GA 30096 LAWRENCEVILLE GA 30043 TAMPA FL 33619 DULUTH GA 30096 TUCKER GA 30084 COOKEVILLE TN 38502 MILLEDGEVILLE GA 31059-1599 ATLANTA GA 30302 ATLANTA GA 30302 ROSWELLGA 30076 ROSWELL GA 30076 DULUTH GA 30096 DALTON GA 30722 ATLANTA GA 30338 ATLANTA GA 30374 ATLANTA GA 30374-0042 ALPHARETTA GA 30023 MACON GA 31201 MACON GA 31201 ATLANTA GA 30338 DULUTH GA 30096 DULUTH GA 30096 TUCKER GA 30084 NASHVILLE TN 37230 SAVANNAH GA 31405 LAWRENCEVILLE GA 30042 ATLANTA GA 30374-0042 GAINESVILLE GA 30501 FORT WAYNE IN 46801 ATLANTA GA 30374-0042 SAVANNAH GA 31405 ATLANTA GA 30339 ATLANTA GA 30374-0042 SAVANNAH GA 31405 ALPHARETTA GA 30004 LOUISVILLE KY 40222 OMAHA NE 68154 ATLANTA GA 30374-0042 DULUTH GA 30096 NORCROSS GA 30092 SAVANNAH GA 31405 MACON GA 31210 ALPHARETTA GA 20023 TELEPHONE 770 818 1517 800 354 6494 877 589 6846 866 572 7586 800 678 6766 800 249 9243 800 866 1600 800 252 9641 800 883 9305 800 241 7570 770 434 9222 800 238 6214 800 241 9245 800 387 8734 800 421 0710 706 713 3101 404 827 8256 404 817 7465 678 731 9091 800 238 6214 800 241 9245 800 387 8734 800 203 9600 800 277 7442 800 421 0710 800 387 8734 770 931 7766 800 354 6494 800 251 6730 912 453 8404 800 249 9243 800 249 9243 800 685 7361 800 685 7361 770 344 0070 706 275 4451 800 932 4464 678 258 8000 678 258 8000 800 366 1511 478 621 6022 478 779 3527 800 932 4464 800 822 2905 800 822 2905 800 354 6494 8005410139 800 928 9096 888 245 4722 678 258 8000 800 971 2667 800 333 3735 678 258 8000 800 928 9096 800 883 9305 678 258 8000 800 928 9096 800 372 5402 678 258 8000 800 762 5573 877 638 7876 800 928 9096 800 471 2103 800 366 1511 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 21775 20621 21624 21533 10040 10267 21081 13171 10272 10272 10272 20470 20561 20884 21738 21295 21129 20443 13250 20607 21504 13075 13195 10297 13014 13060 10195 10043 12094 21159 21069 20527 21487 20345 21066 21038 20514 21425 20347 20577 13181 21505 10114 20566 13221 21529 20323 20550 13127 10010 20954 20958 21094 13194 10248 10046 13131 13165 13000 30001 21393 10048 30006 20523 10051 10052 21016 13225 13225 21508 20401 21694 21273 Insurance Carriers/Self-Insureds/Group Funds CATERSVILLE, CITY OF CATHOLIC ARCHDIOCESE OF ATLANTA CATOOSA COUNTY BOARD OF EDUCATION CENTRAL GEORGIA HEALTH SYSTEM CENTRAL MUTUAL INSURANCE COMPANY CENTURY INDEMNITY COMPANY CERTAINTEED CORPORATION CGU INSURANCE CHARTER OAK FIRE INSURANCE CO (MULTI-TPA) CHARTER OAK FIRE INSURANCE CO (MULTI-TPA) CHARTER OAK FIRE INSURANCE CO (MULTI-TPA) CHATHAM AREA TRANSIT AUTHORITY CHATHAM COUNTY CHATHAM COUNTY BOARD OF EDUCATION CHEMICAL PRODUCTS CORPORATION CHEROKEE BRICK & TILE COMPANY CHEROKEE COUNTY BOARD OF COMMISSIONERS CHEROKEE COUNTY BOARD OF EDUCATION CHEROKEE INSURANCE COMPANY CHEVRON USA INC CHILDRENS HEALCARE OF ATLANTA CHUBB INDEMNITY INSURANCE COMPANY CHUBB NATIONAL INSURANCE COMPANY CHURCH MUTUAL INSURANCE COMPANY CINCINNATI CASUALTY COMPANY CINCINNATI INDEMNITY COMPANY CINCINNATI INSURANCE COMPANY (THE) CITIZENS INSURANCE OF AMERICA CLARENDON NATIONAL INSURANCE CLAYTON COUNTY BOARD OF COMMISSIONERS CLAYTON COUNTY BOARD OF EDUCATION CLAYTON COUNTY WATER AUTHORITY COACHMEN RECREATIONAL VEHICLE COATS & CLARK INC COBB COUNTY BOARD OF COMMISSIONERS COBB COUNTY SCHOOL SYSTEM COCA-COLA COMPANY COCO-COLA ENTERPRISES COLLEGE PARK, CITY OF COLLIS FOOD INC COLONIAL AMERICAN CASUALTY & SURETY COMPANY COLONIAL GROUP INC COLONIAL PENN FRAN INSURANCE COMPANY COLONIAL PIPELINE COMPANY COLORADO CASUALTY INSURANCE COMPANY COLQUITT COUNTY BOARD OF EDUCATION COLQUITT REGIONAL MEDICAL CENTER COLUMBIA COUNTY BOARD OF EDUCATION COLUMBIA MUTUAL INSURANCE COLUMBIA NATIONAL INSURANCE COMPANY COLUMBUS FOUNDRIES INC COLUMBUS REGIONAL HEALTHCARE COLUMBUS WATER WORKS COMBINED SPECIALTY INSURANCE COMPANY COMMERCE & INDUSTRY INSURANCE COMMERCIAL UNION COMMERCIAL UNION MIDWEST INSURANCE COMPANION COMMERICAL INSURANCE COMPANION PROPERTY & CASUALTY COMPTRUST AGC OF GEORGIA CONAGRA FOODS INC AND SUBSIDIARIES CONNECTICUT INDEMNITY COMPANY CONSTRUCTIONS SUPPLIERS ASSOCIATION SI FUND CONTIGROUP COMPANIES INC CONTINENTAL CASUALTY COMPANY CONTINENTAL INSURANCE COMPANY CONTINENTAL TIRE NORTH AMERICA CONTINENTAL WESTERN INSURANCE CO (MULTI-TPA) CONTINENTAL WESTERN INSURANCE CO (MULTI-TPA) COOPER TIRE & RUBBER COOPER US INC COSTCO WHOLESALE CORPORATION COTTRELL INC Address Line 1 1 NORTH ERWIN STREET 680 WEST PEACHTREE ST NW PO BOX 130 DBA MACON-BIBB HOSPITAL AUTHORITY PO BOX 41484 PO BOX 41484 750 E SWEDESFORD ROAD ONE BEACON STREET ONE TOWER SQUARE 900 EAST GREENWICH STREET PO BOX 9292 PO BOX 9966 PO BOX 2470 PO BOX 4567 90 NORTH STREET 110 ACADEMY STREET 34200 MOUND ROAD PO BOX 6022 FKA EGLESTON/SCOTTISH RITE 15 MOUNTAIN VIEW ROAD 15 MOUNTAIN VIEW ROAD 3000 SCHUSTER LANE 6200 SOUTH GILMORE ROAD 6200 SOUTH GILMORE ROAD PO BOX 145496 EMBASSY ROW 600 7 TIMES SQUARE RISK MANAGEMENT 1058 FIFTH AVENUE 1611 LAKE HARBIN ROAD PO BOX 3300 3430 TORINGDON WAY #301 PO BOX 649 PO BOX 1088 ONE COCA-COLA PLAZA 2500 WINDY HILL RIDGE PARKWAY PO BOX F FKA MARKETPLACE HOLDINGS 1400 AMERICAN LANE PO BOX 576 PO BOX 1979 1185 SANCTUARY PARKWAY 10700 E GEDDES AVENUE PO BOX 2708 PO BOX 40 PO BOX 10 2102 WHITE GATE DRIVE 2102 WHITE GATE DRIVE PO BOX 4201 707 CENTER STREET PO BOX 1600 175 WEST JACKSON 175 WATER STREET ONE BEACON STREET ONE BEACON STREET PO BOX 1100165 PO BOX 100165 PO BOX 675829 ONE CONAGRA DRIVE 1-220 9300 ARROWPOINT BLVD 1850 LAKE PARK DRIVE 277 PARK AVENUE 333 S WABASH AVENUE 333 S WABASH AVENUE 1800 CONTINENTAL BLVD 1121 DOUGLAS 701 LIMA AVENUE FKA COOPER INDUSTRIES 999 LAKE DRIVE 2125 CANDLER ROAD Address Line 2 691 CHERRY ST STE 600 12 EAST BAY STREET SUITE 310 6001 BOLLINGER CANYON ROAD 1600 TULIE CIRCLE PO BOX 145496 PO BOX 145496 6600 PEACHTREE DUNWOODY ROAD 36 & 37TH FLOOR 112 SMITH STREET 701 CHEROKEE BLVD #D SUITE 300 SUITE 1100 18TH FLOOR 51 CLEMSON ROAD SUITE 200 CNA CENTER 28TH FLOOR CNA CENTER 28TH FLOOR PO BOX 4446 City/State/Zip CARTERSVILLE GA 30120 ATLANTA GA 30309 RINGOLD GA 30736 MACON GA 31201 PHILADELPHIA PA 19101 PHILADELPHIA PA 19101 VALLEY FORGE PA 19482-1979 BOSTON MA 02108 HARTFORD CT 06183 Telephone 770 387 5672 404 885 7227 706 965 2297 478 633 6999 215 640 1272 215 640 1272 610 341 7383 617 725 9322 860 954 5660 SAVANNAH GA 31401 SAVANNAH GA 31412 SAVANNAH GA 31402 CARTERSVILLE GA 30120 MACON GA 31208 CANTON GA 30014 CANTON GA 30114 STERLING HEIGHTS MI 48310 SAN RAMON CA 94583-0722 ATLANTA GA 30329 WARREN NJ 07061 WARREN NJ 07061 MERRILL WI 54452 CINCINNATI OH 45250 CINCINNATI OH 45014 CINCINNATI OH 45252 ATLANTA GA 30328 NEW YORK NY 10036 JONESBORO GA 30236-3299 JONESBORO GA 30236-3299 MORROW GA 30260 ELKHART IN 46515 CHARLOTTE NC 28277 MARIETTA GA 30061 MARIETTA GA 30061 ATLANTA GA 30313 ATLANTA GA 30339 COLLEGE PARK GA 30337 CHATTANOOGA TN 37405 SCHAUMBURG IL 60196 SAVANNAH GA 31402-0576 VALLEY FORGE PA 19482-1979 ALPHARETTA GA 30004 ENGLEWOOD CO 80112 MOULTRIE GA 31776 MOULTRIE GA 31776 APPLING GA 30802 COLUMBIA MO 65202 COLUMBIA MO 65202 COLUMBUS GA 31914 COLUMBUS GA 31901 COLUMBUS GA 31902 CHICAGO IL 60604 NEW YORK NY 10038 BOSTON MA 02108 BOSTON MA 02108 COLUMBIA SC 29229 COLUMBIA SC 29202 MARIETTA GA 30006 OMAHA, NE 68102 CHARLOTTE NC 28273 SMYRNA GA 30080 NEW YORK NY 10172 CHICAGO IL 60604 CHICAGO IL 60604 CHARLOTTE NC 28273 URBANDALE IA 50322 N/A 912 944 4757 912 201 5272 770 382 2144 478 781 6800 770 479 0406 770 479 1871 800 201 0450 925 842 8164 404 785 7826 908 903 5156 908 903 5156 800 826 0006 800 635 7521 800 635 7521 800 635 7521 770 943 6696 800 797 2526 770 477 3590 FINDLAY OH 45840 HOUSTON TX 77210 ISSAQUAH WA 98027 GAINESVILLE GA 30507 419 427 4779 713 209 8791 425 313 8547 770 532 7251 770 961 2130 574 262 0123 704 329 5260 770 528 2564 770 426 3489 404 676 1254 770 989 3042 770 767 1537 423 756 8839 847 605 6587 912 443 6569 610 650 2000 678 762 2231 800 840 2242 912 985 1550 229 890 3482 770 541 0650 800 877 3579 800 877 3579 706 596 2222 706 571 6309 706 649 3400 800 209 6206 212 458 7043 617 725 9322 617 725 9322 800 845 2724 800 845 2724 402 595 5361 704 522 3043 678 213 2164 212 207 5222 312 822 4314 312 822 4314 704 583 8190 CLAIMS HANDLING USIS CLAIMS MANAGEMENT SERVICES CLAIMS MANAGEMENT SERVICES INNOVATIVE CLAIMS MANAGEMENT CENTRAL INSURANCE RISK MGMT ESIS INC ESIS INC CGU INSURANCE CLAIMS TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES CHATHAM AREA TRANSIT RISK MGMT UNDERWRITERS SAFETY & CLAIMS UNDERWRITERS SAFETY & CLAIMS KEY RISK MANAGEMENT SERVICES CHEROKEE BRICK & TILE RISK MGMT AMTRUST SOUTH/COVENANT AMTRUST SOUTH/COVENANT CHEROKEE INSURANCE CLAIMS CRAWFORD & COMPANY UNDERWRITERS SAFETY & CLAIMS CHUBB GROUP CHUBB GROUP CHURCH MUTUAL CINCINNATI INSURANCE CINCINNATI INSURANCE CINCINNATI INSURANCE CITIZENS INSURANCE SPECIALTY RISK SERVICES GEORGIA ADMINISTRATIVE SERVICES GEORGIA ADMINISTRATIVE SERVICES AMTRUST SOUTH/COVENANT ALTERNATIVE SERVICE CONCEPTS RSKCO AMTRUST SOUTH/COVENANT COBB COUNTY SCHOOLS RISK MGMT TRAVELERS COMPANIES SEDGWICK CMS GATES MDONALD & COMPANY TENCO SERVICES ZURICH UNISOURCE ADMINISTRATORS GAB ROBINS NORTH AMERICA ATTENTA MONTGOMERY INSURANCE CO COLQUITT COUNTY BOE RISK MGMT COLQUITT REGIONAL RISK MANAGEMENT UNDERWRITERS SAFETY & CLAIMS COLUMBIA INSURANCE GROUP COLUMBIA INSURANCE GROUP BROADSPIRE SERVICES AMTRUST SOUTH/COVENANT COLUMBUS WATER WORKS RISK MGMT TIG CLAIMS CENTER AMERICAN INTERNATIONAL GROUP CGU CGU INSURANCE CLAIMS COMPANION GROUP COMPANION GROUP AFFINITY SERVICE GROUP SEDGWICK CMS UNISUN INSURANCE ATTENTA ESIS INC CNA CLAIMSPLUS CNA CLAIMSPLUS CAMBRIDGE INTEGRATED SERVICES UNION STANDARD INSURANCE GROUP CUSTARD INSURANCE CROCKETT ADJUSTMENT SERVICES CAMBRIDGE INTEGRATED SERVICES SEDGWICK CMS SELF-INSURANCE ADMINISTRATORS INC UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 PO BOX 616648 PO BOX 1447 PO BOX 1447 PO BOX 2378 800 SOUTH WASHINGTON STREET 500 COLONIAL CENTER PARKWAY 120 NORTH 9TH STREEET 3555 KOGER BLVD CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE 900 EAST GREENWICH STREET 5105 PAULSEN STREET 5105 PAULSEN STREET PO BOX 2670 PO BOX 4567 PO BOX 740042 PO BOX 740042 34200 MOUND ROAD 100 GLENRIDGE PT PARKWAY 5105 PAULSEN STREET 3445 PEACHTREE ROAD NE 3445 PEACHTREE ROAD NE PO BOX 342 PO BOX 920338 PO BOX 921338 PO BOX 920338 EMBASSY ROW 600 PO BOX 60000 1775 SPECTRUM DRIVE 1775 SPECTRUM DRIVE PO BOX 740042 PO BOX 221558 PO BOX 105497 PO BOX 740042 PO BOX 1088 CALLER SERVICES 1818 PO BOX 958422 3550 ENGINEERING DRIVE 8735 DUNWOODY PLACE 3003 SUMMIT BLVD PO BOX 19559 3039 PREMIER PARKWAY ONE INDEPENDENT PLAZA 4600 PARK ROAD PO BOX 2798 PO BOX 40 PO BOX 465537 2295 PARKLAKE DRIVE 2295 PARKLAKE DRIVE PO BOX 923240 PO BOX 740042 PO BOX 1600 PO BOX 152867 PO BOX 2158 3555 KOGER BLVD 3555 KOGER BLVD PO BOX 100165 PO BOX 100165 1940 THE EXCHANGE 1117 PERIMETER CENTER WEST 5950 LIVE OAK PARKWAY 5605 GLENRIDGE DR 500 COLONIAL CENTER PARKWAY 2435 COMMERCE AVENUE 2435 COMMERCE AVENUE 2644 SOUTH SHERWOOD FOREST BLVD 122 W. CARPENTER FREEWAY PO BOX 81888 PO BOX 1009 9950 PRINCESS PALM AVENUE 1117 PERIMETER CENTER WEST 3473 SATELLITE BLVD ADDRESS LINE 2 360 MARKET PLACE 360 MARKET PLACE SUITE 200 SUITE 241B SUITE 241B SUITE 100 SUITE 241B 2 LIVE OAK CENTER #900 2 LIVE OAK CENTER #900 3000 SCHUSTER LANE 6600 PEACHTREE-DUNWOODY RD SUITE 100 SUITE 100 SUITE 175 SUITE 300 SUITE 900 SUITE 100 SUITE 500 SUITE 100 SUITE 100 SUITE 200 SUITE 500 SUITE 200 SUITE 300 SUITE 200 BLDG 2200 SATELLITE PLACE BLDG 2200 SATELLITE PLACE SUITE 1200 SUITE 350 SUITE 100 SUITE 500 SUITE 310 NORTH CITY STATE ZIP ORLANDO FL 32861-6648 ROSWELL GA 30077-1447 ROSWELL GA 30077-1447 FORT VALLEY GA 31030-2278 VAN WERT OH 45891 ROSWELL GA 30076 RICHMOND IN 47374 DULUTH GA 30096 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 SAVANNAH GA 31401 SAVANNAH GA 31401 SAVANNAH GA 31405 ALPHARETTA GA 30023 MACON GA 31208 ATLANTA GA 30374-0042 ATLANTA GA 30374-0042 STERLING HEIGHTS MI 48310 ATLANTA GA 30302 SAVANNAH GA 31405 ATLANTA 30326-1276 ATLANTA GA 30326-1276 MERRILL WI 54452 NORCROSS GA 30010-0338 NORCROSS GA 30010-0338 NORCROSS GA 30010-0338 ATLANTA GA 30328 ATLANTA GA 30325 LAWRENCEVILLE GA 30043 LAWRENCEVILLE GA 30043 ATLANTA GA 30374-0042 LOUISVILLE KY 40252 ATLANTA GA 30348 ATLANTA GA 30374-0042 MARIETTA GA 30061-1088 ALPHARETTA GA 30023-1818 LAKE MARY FL 32795-8422 NORCROSS GA 30092 ATLANTA GA 30350 ATLANTA GA 30319 SARASOTA FL 34276 DULUTH GA 30097 BIRMINGHAM AL 35209 CHARLOTTE NC 28209 MOULTRIE GA 31776 MOULTRIE GA 31776 LAWRENCEVILLE GA 30042 ATLANTA GA 30345 ATLANTA GA 30345 NORCROSS GA 30010 ATLANTA GA 30374-0042 COLUMBUS GA 31902 IRVING TX 75015 ALPHARETTA GA 30023 DULUTH GA 30096 DULUTH GA 30096 COLUMBIA SC 29202-3165 COLUMBIA SC 29202-3165 ATLANTA GA 30339 ATLANTA GA 30338 NORCROSS GA 30093 ATLANTA GA 30342 ROSWELL GA 30076 DULUTH GA 30096 DULUTH GA 30096 BATON ROUGE LA 70816-4492 IRVING TX 75039 ATLANTA GA 30366 LITTLE ROCK AR 72203 TAMPA FL 33619 ATLANTA GA 30338 DULUTH GA 30096 TELEPHONE 800 444 9098 770 998 7411 770 998 7411 478 825 3607 800 736 7000 800 685 7361 765 983 6244 800 762 5573 800 238 6214 800 241 9245 800 387 8734 N/A 800 928 9096 800 928 9096 800 366 1511 800 277 2745 678 258 8000 678 258 8000 800 201 0450 800 249 9243 800 928 9096 404 266 4855 404 266 4855 800 826 0006 770 662 8753 770 662 8753 770 662 8753 770 943 6696 800 445 9058 800 421 0710 800 421 0710 678 258 8000 800 289 1060 800 283 2318 678 258 8000 770 426 3357 800 238 6214 800 548 1373 770 810 1051 770 518 1935 800 241 7570 877 638 7876 770 457 9555 800 277 7500 800 334 0078 912 985 1550 229 890 3482 888 245 4722 800 767 4080 800 767 4080 678 969 7337 678 258 8000 706 649 3400 800 448 9707 800 762 5573 800 762 5573 800 845 2724 800 845 2724 800 233 2436 770 901 3185 770 849 0242 800 685 7361 800 282 7084 800 282 7084 800 444 0049 800 457 3390 501 614 6000 800 303 4437 770 901 3185 770 344 0070 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 20603 21755 20552 21368 21532 21360 20446 13037 10294 21021 13109 21370 13178 13228 21355 20610 20617 20298 20722 20499 21410 21175 20538 13177 13243 13243 10198 20854 20302 20405 21367 20365 20553 20301 21328 21609 20366 21538 21558 13249 13168 13168 13168 13168 13162 20371 21395 21552 13072 10017 13152 21416 20379 10196 10189 10189 10241 10059 21383 13188 13189 13190 13191 21617 21572 21620 13082 13082 13082 13180 12023 13091 13128 Insurance Carriers/Self-Insureds/Group Funds COVINGTON, CITY OF COWETA COUNTY BOARD OF COMMISSIONERS COWETA COUNTY BOARD OF EDUCATION CRACKER BARREL COUNTRY STORE CRAWFORD & COMPANY INC CRIDER INCORPORATED CRISP COUNTY BOARD OF EDUCATION CRUM & FORSTER INDEMNITY CUMIS INSURANCE SOCIETY INC CW MATTHEWS CONTRACTING CO INC CYPRESS INSURANCE COMPANY D L LEE & SON INC DAIMLER CHRYSLER INSRUANCE COMPANY DALLAS NATIONAL INSURANCE COMPANY DALTON, CITY OF DART CONTAINER CORPORATION DECATUR, CITY OF DEKALB COUNTY DEKALB COUNTY BOARD OF EDUCATION DEKALB FARMERS MARKET DEKALB REGIONAL HEALTHCARE SYSTEM DELHAIZE AMERICA INC DELTA AIRLINE DELTA FIRE & CASUALTY INSURANCE DEPOSITORS INSURANCE COMPANY (MULTI-TPA) DEPOSITORS INSURANCE COMPANY (MULTI-TPA) DISCOVER PROPERTY & CASUALTY DIXIE GROUP AND SUBSIDIARIES DOLLAR GENERAL CORPORATION DOUGHERTY COUNTY BOARD OF COMMISSIONERS DOUGHERTY COUNTY SCHOOL SYSTEM DOUGLAS COUNTY BOARD OF COMMISSIONERS DOUGLAS COUNTY SCHOOLS DOUGLAS, CITY OF DSM CHEMICALS DULUTH, CITY OF E I DUPONT NEMOURS & COMPANY E.R. SNELL CONTRACTORS EAST POINT, CITY OF EASTERN ALLIANCE INSURANCE COMPANY EASTGUARD INSURANCE COMPANY (MULTI-TPA) EASTGUARD INSURANCE COMPANY (MULTI-TPA) EASTGUARD INSURANCE COMPANY (MULTI-TPA) EASTGUARD INSURANCE COMPANY (MULTI-TPA) ECONOMY FIRE & CASUALTY ELBERTA CRATE & BOX COMPANY ELBERTON GRANITE ASSOCIATION ELBERTON, CITY OF ELECTRIC INSURANCE COMPANY EMC PROPERTY & CASUALTY COMPANY EMCASCO INSURANCE COMPANY EMERSON ELECTRIC EMORY UNIVERSITY EMPLOYERS FIRE INSURANCE CO (THE) EMPLOYERS INSURANCE OF WAUSAU (MULTI-TPA) EMPLOYERS INSURANCE OF WAUSAU (MULTI-TPA) EMPLOYERS MUTUAL CASUALTY COMPANY EMPLOYERS REINSURANCE CORPORATION ENCOMPASS GROUP LLC ENCOMPASS HOME & AUTO INSURANCE ENCOMPASS INDEPENDENT INSURANCE COMPANY ENCOMPASS INSURANCE COMPANY OF AMERICA ENCOMPASS PROERTY & CASUALTY EQUITY GROUP GEORGIA DIVISION ESTES EXPRESS LINES EVANS GRADING COMPANY INC EVEREST NATIONAL INSURANCE CO (MULTI-TPA) EVEREST NATIONAL INSURANCE CO (MULTI-TPA) EVEREST NATIONAL INSURANCE CO (MULTI-TPA) EVEREST SECURITY INSURANCE COMPANY EXCELSIOR INSURANCE COMPANY EXECUTIVE RISK INDEMNITY INC. FAIRFIELD INSURANCE COMPANY Address Line 1 PO BOX 1527 22 EAST BROAD STREET PO DRAWER 280 PO BOX 787 5620 GLENRIDGE DRIVE NE PO BOX 398 PO BOX 729 305 MADISON AVENUE 5910 MINERAL POINT ROAD PO DRAWER 970 9290 WEST DODGE ROAD PO BOX 206 POB 5169 14160 DALLAS PARKWAY PO BOX 1205 500 HOGSBACK ROAD 509 NORTH MCDONOUGH STREET 1300 COMMERCE DRIVE 3770 NORTH DECATUR ROAD FKA YOUR FAVORITE MARKETS DBA DEKALB MEDICAL CENTER DBA FOOD LION HARTSFIELD-JACKSON INTERNATIONAL 4370 PEACHTREE ROAD NE 1100 LOCUST STREET 1100 LOCUST STREET 385 WASHINGTON STREET 2208 SOUTH HAMILTON STREET PO BOX 1729 225 PINE AVE 601 FLINT AVE 8700 HOSPITAL DRIVE PO BOX 1077 PO BOX 470 PO BOX 2451 3578 WEST LAWRENCEVILLE ST 1007 MARKET STREET 2092 SCENIC HIGHWAY 2777 EAST POINT STREET PO BOX 83777 PO BOX 1368 385 WASHINGTON STREET PO BOX 760 PO BOX 640 PO BOX 746 75 SAM FONZO DRIVE PO BOX 712 PO BOX 712 800 WEST FLORISSANT AVE 1364 CLIFTON ROAD NE ONE BEACON STREET 175 BERKELEY STREET PO BOX 712 5200 METCALF AVENUE 615 MACON ROAD CNA CENTER 28TH FLOOR CNA CENTER 28TH FLOOR CNA CENTER 28TH FLOOR CNA CENTER 28TH FLOOR FKA CAGLE FOODS JV LLC PO BOX 25612 4045 ROCKMART ROAD 477 MARTINSVILLE ROAD 2580 WESTSIDE PARKWAY 62 MAPLE AVE 15 MOUNTAIN VIEW ROAD 695 EAST MAIN STREET Address Line 2 SUITE 300 SUITE 500 300 E PONCE DE LEON AVE 2701 N DECATUR ROAD PO BOX 1330 PO BOX 20706 DEPT 858 DEPT 3030 DEPT 3030 100 MISSION RIDGE ROOM D-8065 ROOM HB53 333 SOUTH WABASH 333 SOUTH WABASH 333 SOUTH WABASH 333 SOUTH WABASH 300 BARR HARBOR DR #600 PO BOX 400 PO BOX 830 PO BOX 1620 City/State/Zip COVINGTON GA 30298 NEWNAN GA 30263 NEWNAN GA 30264 LEBANON TN 37088 ATLANTA GA 30342 STILLMORE GA 30464 CORDELE GA 31015 MORRISTOWN NJ 07962 MADISON WI 53705 MARIETTA GA 30061 ALPHARETTA NE 68114-3363 ALMA GA 31510 SOUTHFIELD MN 48086 DALLAS TX 75274 DALTON GA 30720 MASON MI 48854 DECATUR GA 30031 DECATUR GA 30030 DECATUR GA 30032 DECATUR GA 30030 DECATUR GA 30033 SALISBURY NC 28145 ATLANTA GA 30320 ATLANTA GA 30319 DES MOINES IA 50391-1100 DES MOINES IA 50391-1100 ST PAUL MN 55102 DALTON GA 30721 GOODLETSVILLE TN 37072 ALBANY GA 31703 ALBANY GA 31701 DOUGLASVILLE, GA 30134 DOUGLASVILLE GA 30134 DOUGLAS GA 31533 AUGUSTA GA 30903 DULUTH GA 30136 WILMINGTON DE 19898 SNELLVILLE GA 30078 EAST POINT GA 30344 LANCASTER PA 17608-3777 WILKES BARRE PA 18703 Telephone 770 786 5324 770 254 2604 770 254 2800 615 443 4444 404 847 4061 912 562 9180 912 276 3400 800 690 5520 800 356 2644 770 422 7520 770 410 3666 912 632 4406 800 782 9164 800 533 0457 706 278 6006 800 248 0457 770 370 4102 404 371 4791 404 296 2000 404 377 6400 404 501 5810 704 633 8250 404 677 7475 800 282 0480 800 228 6700 800 228 6700 800 328 2189 706 876 5804 615 855 5133 912 431 2121 912 431 1808 770 949 2000 770 920 4021 912 384 3302 706 849 6250 770 476 3434 302 773 6473 770 985 0600 404 765 1000 888 654 7100 800 673 2465 ST PAUL MN 55102 BAINBRIDGE GA 39818 ELBERTON GA 30635 ELBERTON GA 30345 BEVERLY MA 01915 DES MOINES IA 50306 DES MOINES IA 50306 ST LOUIS MO 63136 ATLANTA GA 30322 BOSTON MA 02108 BOSTON MA 02116 800 356 4098 229 246 2266 706 283 2551 706 283 5321 800 227 2757 800 247 2128 800 247 2128 314 553 1918 404 686 7941 973 630 6601 800 344 0198 DES MOINES IA 50306 OVERLAND PARK KS 66202 MCDONOUGH GA 30253 CHICAGO IL 60604 CHICAGO IL 60604 CHICAGO IL 60604 CHICAGO IL 60604 W CONSHOHOCKE PA 19380 RICHMOND VA 23260 SILVER CREEK GA 30173 LIBERTY CORNER NJ 07938-0830 800 247 2128 800 256 6931 770 957 3981 312 822 4314 312 822 4314 312 822 4314 312 822 4314 610 668 6710 804 353 1900 706 235 1117 800 438 4375 ALPHARETTA GA 30009 KEENE NH 03431 WARREN NJ 07061 STAMFORD CT 06904 800 546 7742 800 826 6189 908 903 5156 800 431 9994 CLAIMS HANDLING SELF-INSURANCE ADMINISTRATORS INC AMTRUST SOUTH/COVENANT CLAIMS MANAGEMENT SERVICES GALLAGHER BASSETT SERVICES CRAWFORD & COMPANY UNDERWRITERS SAFETY & CLAIMS CLAIMS MANAGEMENT SERVICES CRUM & FORSTER CLAIMS CUMIS INSURANCE CLAIMS C W MATTHEWS RISK MGMT BERKSHIRE HATHAWAY D L LEE & SON INC RISK MGMT TIG CLAIMS CENTER COLLINS AND COMPANY COLLINS & COMPANY DART CONTAINER CORP RISK MGMT PMA INSURANCE GROUP DEKALB COUNTY RISK MANAGEMENT DEKALB COUNTY BOE RISK MGMT DEKALB FARMERS MARKET RISK MGMT AMTRUST SOUTH/COVENANT DELHAIZE AMERICA RISK MGMT ESIS INC BANKERS FIDELITY CLAIMS NATIONWIDE PROPERTY & CASUALTY DEPOSITORS INSURANCE CLAIMS TRAVELERS COMPANIES AMERICAN PROFESSIONAL RISK DOLLAR GENERAL UNDERWRITERS SAFETY & CLAIMS DOUGHERTY COUNTY BOE RISK MGMT AFFINITY SERVICE GROUP SELF-INSURANCE ADMINISTRATORS INC AMERICAN PROFESSIONAL RISK DSM CHEMICALS RISK MANAGEMENT AMTRUST SOUTH/COVENANT BROADSPIRE SERVICES HELMSMAN MANAGEMENT SERVICES AMTRUST SOUTH/COVENANT EASTERN ALLIANCE INSURANCE CLAIMS GUARD INSURANCE GROUP GUARD INSURANCE GROUP GUARD INSURANCE GROUP GUARD INSURANCE GROUP ECONOMY FIRE & CASUALTY CLAIMS UNDERWRITERS SAFETY & CLAIMS ELBERTON GRANITE ASSN RISK MGMT AMTRUST SOUTH/COVENANT SEDGWICK CMS EMPLOYERS MUTUAL CASUALTY CLAIMS EMPLOYERS MUTUAL CASUALTY CLAIMS SEDGWICK CMS AMTRUST SOUTH/COVENANT ONEBEACON INSURANCE EMPLOYERS INSURANCE OF WAUSAU CLAIMS WAUSAU BUSINESS INSURANCE CLAIMS EMPLOYERS MUTUAL CASUALTY CLAIMS GALLAGHER BASSETT SERVICES AMTRUST SOUTH/COVENANT CNA CLAIMSPLUS CNA CLAIMSPLUS CNA CLAIMSPLUS CNA CLAIMSPLUS SEDGWICK CMS GALLAGHER BASSETT SERVICES COLLINS & COMPANY F. A. RICHARD (FARA) F. A. RICHARD (FARA) GALLAGHER BASSETT SERVICES EVEREST NATIONAL MONTGOMERY INSURANCE CO CHUBB GROUP CANNON COCHRAN MANAGEMENT UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 3473 SATELLITE BLVD PO BOX 740042 PO BOX 1447 2915 PREMIERE PARKWAY 100 GLENRIDGE PT PARKWAY 5105 PAULSEN STREET PO BOX 1447 PO BOX 958426 5910 MINERAL POINT ROAD PO DRAWER 970 1725 WINDWARD COUNCOURSE PO BOX 206 PO BOX 152867 207 KING STREET 555 RIVER STREET 500 HOGSBACK ROAD 2100 RIVEREDGE PARKWAY 1300 COMMERCIAL DRIVE, 5TH FLOOR 3770 NORTH DECATUR ROAD 3000 EAST PONCE DE LEON AVE PO BOX 740042 PO BOX 1330 500 COLONIAL CENTER PARKWAY 4370 PEACHTREE ROAD NE PO BOX 147061 1100 LOCUST STREET CALLER SERVICES 1818 1255 MCFARLAND 400 DRIVE 100 MISSION RIDGE DRIVE 5105 PAULSEN STREET PO BOX 1470 PO BOX 675829 3473 SATELLITE BLVD 1255 MCFARLAND 400 DRIVE PO BOX 2451 PO BOX 740042 655 ENGINEERING DRIVE PO BOX 300 PO BOX 740042 PO BOX 83777 102 WEST PENNSYLVANIA AVE 5973 EDENFIELD DRIVE 5973 MOOREFIELD DRIVE 620 MOOREFIELD DRIVE 100 CRESCENT CENTRE PARKWAY PO BOX 37969 PO BOX 640 PO BOX 740042 PO BOX 15065 PO BOX 1568 PO BOX 1568 2000 CENTER POINT DRIVE PO BOX 740042 5901-B PEACHTREE-DUNWOODY ROAD PO BOX 945290 925 NORTH POINT PARKWAY PO BOX 1568 555 MARRIOTT DRIVE PO BOX 740042 2435 COMMERCE AVENUE 2435 COMMERCE AVENUE 2435 COMMERCE AVENUE 2435 COMMERCE AVENUE 1117 PERIMETER CENTER WEST 100 CRESCENT CENTRE PARKWAY 555 RIVER STREET 3913 RIVARIDGE COURT 7000 EXECUTIVE CENETER DRIVE 100 CRESCENT CENTRE PARKWAY 477 MARTINSVILLE ROAD 4600 PARK ROAD 3445 PEACHTREE ROAD NE 3235 SATELLITE BLVD ADDRESS LINE 2 SUITE 310 NORTH 360 MARKET PLACE SUITE 350 SUITE 200 SUITE 241B SUITE 200 SUITE J SUITE 1250 SUITE 200 SUITE 241B SUITE 310 NORTH SUITE 200 SUITE 206 SUITE 209 SUITE 209 SUITE 1000 SUITE 2350 SUITE 300 SUITE 650 BLDG 2200 SATELLITE PLACE BLDG 2200 SATELLITE PLACE BLDG 2200 SATELLITE PLACE BLDG 2200 SATELLITE PLACE SUITE 500 SUITE 600 SUITE 320 SUITE 600 SUITE 500 2 LIVE OAK CENTER #900 BLDG 400 SUITE 300 CITY STATE ZIP DULUTH GA 30096 ATLANTA GA 30374-0042 ROSWELL GA 30077-1447 DULUTH GA 30097 ATLANTA GA 30302 SAVANNAH GA 31405 ROSWELL GA 30077 LAKE MARY FL 32795 MADISON WI 53705 MARIETTA GA 30061 ALPHARETTA GA 30005 ALMA GA 31510 IRVING TX 75015 DALTON GA 30721 CHATTANOOGA TN 37405 MASON, mi 48854 ATLANTA GA 30328 DECATUR GA 30030 DECATUR GA 30032 DECATUR GA 30030 ATLANTA GA 30374-0042 SALISBURY NC 28145-2527 ROSWELL GA 30076 ATLANTA GA 30319 GAINESVILLE FL 32614 DES MOINES IA 50391 ALPHARETTA GA 30023 ALPHARETTA GA 30004 GOODLETTSVILLE TN 37072 SAVANNAH GA 31405 ALBANY GA 31703 MARIETTA GA 30006 DULUTH GA 30096 ALPHARETTA GA 30004 AUGUSTA GA 30903 ATLANTA GA 30374-0042 NORCROSS GA 30092 BRENTWOOD TN 37027 ATLANTA GA 30374-0042 LANCASTER PA 17608 TOWSON MD 21204 ACWORTH GA 30101 WILKES-BARRE PA 18703-1368 WILKES-BARRE PA 18703-1368 TUCKER GA 30084 TALLAHASSEE, FL 32315 ELBERTON GA 30635 ATLANTA GA 30374-0042 ALBANY NY 12212 BIRMINGHAM AL 35201-1568 BIRMINGHAM AL 35201-1568 COLUMBIA SC 29210 ATLANTA GA 30374-0042 ATLANTA GA 30328 MAITLAND FL 32794 ALPHARETTA GA 30005 BIRMINGHAM AL 35201-1568 NASHVILLE TN 37214 ATLANTA GA 30374-0042 DULUTH GA 30096 DULUTH GA 30096 DULUTH GA 30096 DULUTH GA 30096 ATLANTA GA 30338 TUCKER GA 30084 CHATTANOOGA TN 37405 MARIETTA GA 30062 BRENTWOOD TN 37037 TUCKER GA 30084 LIBERTY CORNER NJ 07938 CHARLOTTE NC 28209 ATLANTA GA 30326 DULUTH GA 30096 TELEPHONE 770 344 0070 678 258 8000 770 998 7411 770 280 2500 800 249 9243 800 928 9096 770 998 7411 800 423 3060 800 356 2644 770 422 7520 877 742 2322 912 632 4406 888 805 9184 800 884 1535 800 884 1535 800 248 0457 800 222 4524 404 371 4791 678 676 0234 404 371 3912 678 258 8000 704 633 8250 800 685 7361 800 241 1439 800 985 7078 800 238 6214 770 752 0122 615 855 5110 800 928 9096 229 431 1808 678 298 1914 770 344 0070 770 752 0122 706 849 6250 678 258 8000 800 450 0692 800 523 6906 678 258 8000 888 654 7100 800 228 0721 706 283 2551 678 258 8000 800 434 8331 800 239 1407 800 239 1407 800 426 2885 678 258 8000 800 203 9600 800 943 1113 800 239 1407 800 288 9843 678 258 8000 770 901 385 800 354 6494 800 884 1535 877 605 3272 800 675 2771 800 354 6494 800 438 4375 404 266 4855 888 674 2524 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 13009 13009 13009 13142 20516 21361 13153 21433 10062 21630 10064 10064 12059 13130 20535 21705 21345 13146 10257 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10299 10197 10197 21022 12041 10067 12029 50002 13066 13066 13066 10292 21125 21196 13229 13174 13174 10259 10259 21002 21598 20600 21472 21578 20380 20393 21559 13164 21756 21574 20599 21172 21227 30017 Insurance Carriers/Self-Insureds/Group Funds FARMINGTON CASUALTY COMPANY (MULTI-TPA) FARMINGTON CASUALTY COMPANY (MULTI-TPA) FARMINGTON CASUALTY COMPANY (MULTI-TPA) FARMLAND MUTUAL FAYETTE COUNTY BOARD OF EDUCATION FAYETTE COUNTY BOARD OF COMMISSIONERS FCCI INSURANCE COMPANY FEDERAL EXPRESS FEDERAL INSURANCE COMPANY FEDERATED DEPARTMENT STORES INC FEDERATED MUTUAL INSURANCE CO (MULTI-TPA) FEDERATED MUTUAL INSURANCE CO (MULTI-TPA) FEDERATED RURAL ELECTRIC INSURANCE EXCHANGE FEDERATED SERVICE INSRUANCE COMPANY FEDEX FREIGHT EAST INC FEDEX GROUND PACKAGE SYSTEM FENNER DUNLOP (ATLANTA) INC FFVA MUTUAL INSURANCE FIDELITY & DEPOSIT COMPANY OF MARYLAND FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO (MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO(MULTI-TPA) FIDELITY & GUARANTY INSURANCE CO(MULTI-TPA) FIDELITY & GUARANTY UNDERWRITERS (MULTI-TPA) FIDELITY & GUARANTY UNDERWRITERS (MULTI-TPA) FIELDALE FARMS CORPORATION FIRE & CASUALTY INSURANCE COMPANY OF CONNECTICUT FIREMAN'S FUND INSURANCE COMPANY FIREMAN'S FUND INSURANCE COMPANY OF GEORGIA FIREMAN'S FUND INSURANCE COMPANY OF GEORGIA FIRST LIBERTY INSURANCE CORPORATION (MULTI-TPA) FIRST LIBERTY INSURANCE CORPORATION (MULTI-TPA) FIRST LIBERTY INSURANCE CORPORATION (MULTI-TPA) FIRST NATIONAL INSURANCE COMPANY OF AMERICA FLEETWOOD HOMES OF GEORGIA FLEXSTEEL INDUSTRIES INC FLORIDA HOSPITALITY MUTUAL INSURANCE COMPANY FLORISTS' INSURANCE COMPANY (MULTI-TPA) FLORISTS' INSURANCE COMPANY (MULTI-TPA) FLORISTS MUTUAL INSURANCE CO (MULTI-TPA) FLORISTS MUTUAL INSURANCE CO (MULTI-TPA) FLOWERS FOODS FLOYD COUNTY BOARD OF COMMISIONERS FLOYD COUNTY BOARD OF EDUCATION FLOYD HEALTHCARE MANAGEMENT INC. FLYING J INC FORD MOTOR COMPANY FOREST PARK, CITY OF FORSYTH COUNTY BOARD OF EDUCATION FRANKENMUTH MUTUAL INSURANCE FRANKLIN ALUMINUM COMPANY INC FUEUDENBERG-NOK FULTON COUNTY FULTON COUNTY BOARD OF EDUCATION FULTON-DEKALB HOSPITAL AUTHORITY GA EDUCATION WORKERS' COMP[ TRUST FUND Address Line 1 ONE TOWER SQUARE Address Line 2 City/State/Zip HARTFORD CT 06183 1100 LOCUST STREET 210 STONEWELL AVENUE 140 STONEWALL AVENUE 6300 UNIVERSITY PARKWAY 3620 HACKS CROSS ROAD 15 MOUNTAIN VIEW ROAD 7 WEST SEVENTH STREET 121 EAST PARK SQUARE DEPT 3030 DES MOINES IA 50391 FAYETTEVILLE GA 30214 FAYETTEVILLE GA 30214 SARASOTA FL 34240 MEMPHIS TN 38125 WARREN NJ 07061 CINCINNATI OH 45202 OWATONNA MN 55060 PO BOX 15147 121 E PARK SQUARE FKA AMERICAN FREIGHTWAY PO BOX 5459 FKA GA DUCK & CORDAGE MILL PO BOX 948239 1400 AMERICAN LANE BLG B 3RD FLOOR POB 840 21 LAREDO DRIVE LENEXA KS 66285-5147 OWANTONNA MN 55060 HARRISON AR 72602 AKRON OH 44334-0459 SCOTTDALE GA 30079 MAITLAND FL 32794 SCHAUMBURG IL 60196 385 WASHINGTON STREET ST PAUL MN 55102 385 WASHINGTON STREET ST PAUL MN 55102 PO BOX 558 9300 ARROWPOINT BLVD 777 SAN MARIN DRIVE 777 SAN MARIN DRIVE 777 SAN MARIN DRIVE 175 BERKELEY STREET BALDWIN GA 30511 CHARLOTTE NC 28273 NOVATO CA 94998 NOVATO CA 94998 NOVATO CA 94998 BOSTON MA 02116 C/O LICENSING T-18 PO BOX 767 PO BOX 877 9485 REGENCY SQUARE BLVD #1 HORTICULTURAL LANE SUITE 415 PO BOX 428 SEATTLE WA 98185 ALMA GA 31510 DUBIQUE IA 52004 JACKSONVILLE FL 32225 EDWARDSVILLE IL 62025 #1 HORTICULTURAL LANE PO BOX 428 EDWARDSVILLE IL 62025 1919 FLOWERS CIRCLE PO BOX 946 600 RIVERSIDE PARKWAY NE 304 TURNER MCCALL BLVD 1104 COUNTRY HILL DRIVE NORWOOD BLDG RM 203 745 FOREST PARKWAY 1129 DAHLONEGA HIGHWAY 1 MUTUAL AVENUE 266 MARY JOHNSON ROAD 100 COMMERCIAL STREET SUITE 5021 786 CLEVELAND AVE SW 80 JESSE HILL JR DRIVE 1940 THE EXCHANGE SAFECO PLAZA 19540 ALLEN ROAD 1ST FLOOR NORTH 141 PRYOR STREET BOX 208 SUITE 200 THOMASVILLE GA 31757 ROME GA 30162 ROME GA 30161-2938 ROME GA 30162 OGDEN UT 84403 MELVINDALE MI 48122 FOREST PARK GA 30050 CUMMING GA 30066 FRANKENMUTH MI 48787 FRANKLIN GA 30217 MANCHESTER NH 03101 ATLATNA GA 30303 ATLANTA GA 30315 ATLANTA GA 30303-3801 ATLANTA GA 30339 Telephone CLAIMS HANDLING 860 954 5660 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 800 228 6700 NATIONWIDE GROUP 770 460 3535 SELF-INSURANCE ADMINISTRATORS INC 404 461 6041 UNDERWRITERS SAFETY & CLAIMS 800 226 3224 FCCI SERVICES 901 434 4557 SELECTIVE INSURANCE 908 903 5156 CHUBB GROUP 513 579 7853 FEDERATED DEPT STORES RISK MGMT 800 533 0472 FEDERATED MUTUAL CLAIMS FEDERATED MUTUAL CLAIMS 800 356 8360 BROADSPIRE SERVICES 800 533 0472 FEDERATED MUTUAL CLAIMS 870 741 9000 FEDEX EAST RISK MANAGEMENT 330 665 8512 SEDGWICK CMS 404 297 3080 CLAIMS MANAGEMENT SERVICES 321 214 5350 FFVA MUTUAL CLAIMS 847 605 6587 ZURICH NORTH AMERICA CLAIMS DIV. CRAWFORD & COMPANY DISCOVER RE MANAGERES INC AMERICAN INTERNATIONAL GROUP BROADSPIRE SERVICES BROADSPIRE SERVICES CAMBRIDGE INTEGRATED SERVICES CANNON COCHRAN MANAGEMENT ESIS INC FRANK GATES SERVICE COMPANY GAB ROBINS NORTH AMERICA GALLAGHER BASSETT SERVICES GALLAGHER BASSETT SERVICES GATES MCDONALD HELMSMAN MANAGEMENT SERVICES SEDGWICK CMS SEDGWICK CMS SPECIALTY RISK SERVICES SPECIALTY RISK SERVICES TIG CLAIMS CENTER 800 328 2189 TRAVELERS COMPANIES USIS 800 328 2189 SPECIALTY RISK SERVICES BROADSPIRE SERVICES 706 778 5100 FIELDALE FARMS RISK MANAGEMENT 704 522 3043 UNISUN INSURANCE 800 227 1700 FIREMAN'S FUND INSURANCE 800 227 1700 FIREMAN'S FUND INSURANCE 800 227 1700 FIREMAN'S FUND INSURANCE 800 344 0197 LIBERTY MUTUAL CLAIMS LIBERTY MUTUAL CLAIMS LIBERTY MUTUAL CLAIMS 206 675 3609 SAFECO INSURANCE BROADSPIRE SERVICES 563 556 7734 FLEXSTEEL INDUSTRIES RISK MGMT 800 329 4340 USIS 800 851 7740 CRAWFORD & COMPANY HORTICA 800 851 7740 CRAWFORD & COMPANY HORTICA 229 227 2311 UNDERWRITERS SAFETY & CLAIMS 706 291 5157 HEWITT COLEMAN ASSOCIATES 706 236 1824 AMTRUST SOUTH/COVENANT 706 509 6079 AMTRUST SOUTH/COVENANT 801 624 1757 GALLAGHER BASSETT SERVICES 313 390 3014 FORD MOTOR CLAIMS OFFICE 404 366 4720 SELF-INSURANCE ADMINISTRATORS INC 770 887 2461 CLAIMS MANAGEMENT SERVICES 800 243 1133 FRANKENMUTH FINANCIAL GROUP CLAIMS 770 254 2604 CMI OCTGON 603 628 7375 SPECIALTY RISK SERVICES 404 730 6749 FULTON COUNTY RISK MANAGEMENT CLAIMS MANAGEMENT SERVICES 404 616 1953 FULTON DEKALB HOSP RISK MGMT 678 292 1912 AFFINITY SERVICE GROUP UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 3632 QUEEN PALM DRIVE CALLER SERVICES 1818 3097 SATELLITE BLVD 1100 LOCUST STREET 3473 SATELLITE BLVD 5105 PAULSEN STREET 3175 SATELLITE BLVD 69290 PROFESSIONAL PARKWAY E 3445 PEACHTREE ROAD NE 7 WEST SEVENTH STREET 20 PERIMETER SUMMIT BLVD NE 4301 ANCHOR PLAZA PARKWAY PO BOX 41 4301 ANCHOR PLAZA PARKWAY PO BOX 840 1117 PERIMETER CENTER WEST PO BOX 1447 PO BOX 945927 3003 SUMMIT BLVD 100 GLENRIDGE PT PARKWAY 5 BATTERSON PARK PO BOX 3030 655 ENGINEERING DRIVE 9502 WILLIAMSBURG PLACE 1100 PARK CENTRAL BLVD 3235 SATELLITE BLVD 500 COLONIAL CENTER PARKWAY 701 INTERNATIONAL PARKWAY 3039 PREMIER PARKWAY 2600 MCCORMICK DRIVE #110 601 VESTAVIA PARKWAY PO BOX 945150 3901 PREMIER NORTH DRIVE 1117 PERIMETER CENTER WEST PO BOX 958422 828 ROYAL PARKWAY PO BOX 60000 PO BOX 152867 CALLER SERVICES 1818 PO BOX 616648 10735 DAVID TAYLOR DRIVE 100 GLENRIDGE PT PARKWAY PO BOX 558 5950 LIVE OAK PARKWAY 11475 GREAT OAKS WAY 11475 GREAT OAKS WAY PO BOX 740174 3235 SATELLITE BLVD 3901 PREMIER NORTH DRIVE PO BOX 300 2055 SUGARLOAF CIRCLE PO BOX 926240 PO BOX 1067 PO BOX 616648 100 GLENRIDGE PT PARKWAY 5840-A SOUTH SEMORAN BLVD 100 GLENRIDGE PT PARKWAY 5840-A SOUTH SEMORAN BLVD 5105 PAULSEN STREET PO BOX 244 PO BOX 940042 PO BOX 740042 100 CRESCENT CENTRE PARKWAY 175 GREENWOOD INDUSTRIAL PARKWAY 3473 SATELLITE BLVD PO BOX 1447 129 FREDERICK GWINNETT COMMERCE PO BOX 60000 141 PRYOR STREET PO BOX 1447 PO BOX 26208 PO BOX 675829 ADDRESS LINE 2 DEPT 3010 SUITE 310 NORTH SUITE 241B SUITE 200 2 LIVE OAK CENTER #900 SUITE 1900 SUITE 350 SUITE 250 SUITE 500 360 MARKET PLACE SUITE 100 SUITE 200 SUITE 200 SUITE 1100 BLDG 400 SUITE 300 SUITE 200 SUITE 175 SUITE 900 ONE PRESTIGE PLACE SUITE 251 SUITE E500 SUITE 200 SUITE 400 SUITE 100 SUITE 200 ROYAL CENTRE THREE ROYAL CENTRE THREE BLDG 400 SUITE 600 SAFECO PLAZA INDUSTRIAL BLVD SUITE 100 SUITE 100 SUITE 241B SUITE 600 SUITE 310 NORTH 360 MARKET PLACE 2700 CRESTWOOD PKWY #620 SUITE 5021 360 MARKET PLACE CITY STATE ZIP TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 DES MOINES IA 50391-3010 DULUTH GA 30096 SAVANNAH GA 31405 DULUTH GA 30096 SARASOTA FL 34240 ATLANTA GA 30326 CINCINNATI OH 45202 ATLANTA GA 30319-1416 TAMPA FL 33634 GAINESVILLE GA 30503 TAMPA FL 33634 HARRISON AR 72602-0840 ATLANTA 30338 ROSWELL GA 30077-1447 MAITLAND FL 32794-5927 ATLANTA GA 30319 ATLANTA GA 30302-5065 FARMINGTON CT 06032 ALPHARETTA GA 30023 NORCROSS GA 30092 LOUISVILLE KY 40222 POMPANO BEACH FL 33064 DULUTH GA 30096 ROSWELL GA 30076 LAKE MARY FL 32746 DULUTH GA 30097 CLEARWATER FL 33759 BIRMINGHAM AL 35216 MAITLAND FL 32794 TAMPA FL 33618 ATLANTA GA 30338 LAKE MARY FL 32795 NASHVILLE TN 37230 ATLANTA GA 30325 IRVING TX 75015 ALPHARETTA GA 30023 ORLANDO FL 32861-6648 CHARLOTTE NC 28262 ATLANTA GA BALDWIN GA 30511 NORCROSS GA 30093 ALPHARETTA GA 30374 ALPHARETTA GA 30374 ATLANTA GA 30374 DULUTH GA 30096 TAMPA FL 33624 BRENTWOOD TN 37024 DULUTH GA 30097-4074 NORCROSS GA 30010-6240 DUBLIN GA 31040 ORLANDO FL 32861-6648 ATLANTA GA 30302-5065 ORLANDO FL 32822 ATLANTA GA 30302-5065 ORLANDO FL 32822 SAVANNAH GA 31405 KINGSTON SPRINGS TN 37082 ATLANTA GA 30374-0042 ATLANTA GA 30374-0042 TUCKER GA 30084 MCDONOUGH GA 30253 DULUTH GA 30097 ROSWELL GA 30077-1447 BRUNSWICK GA 31520 DULUTH GA 30096 ATLANTA GA 30325 ATLANTA GA 30303 ROSWELL GA 30077-1447 ATLANTA GA 30355-3801 MARIETTA GA 30006 TELEPHONE 800 387 8734 800 238 6214 800 241 9245 806 698 3737 770 344 0070 800 928 9096 800 805 3737 800 741 1136 404 266 4855 513 579 7528 800 241 4945 800 237 8292 404 992 3845 800 237 8292 870 741 9000 770 901 3185 770 998 7411 800 226 0666 800 241 7570 800 238 6214 877 300 6187 404 497 6300 706 778 5100 770 849 0242 800 227 4700 800 227-1700 800 213 4903 800 282 6218 678 417 3654 678 969 7337 478 272 6911 800 444 9098 800 249 9243 407 249 1866 800 249 9243 407 249 1866 800 928 9096 866 265 4256 678 258 8000 678 258 8000 800 354 6494 770 305 7241 770 344 0070 770 998 7411 800 234 1133 678 621 1351 800 445 9058 404 730 6749 770 998 7411 404 616 1953 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 40010 40010 21665 30007 10070 10213 10058 10073 20385 30003 30004 10075 20388 30011 30008 30029 30014 30033 30023 40003 30046 21453 10261 10077 21516 20554 21386 20595 10277 10079 12006 12062 12062 12007 12075 10080 10192 20398 20789 12072 10298 10298 10082 12078 20555 30020 12046 21053 10246 21135 21070 21076 21418 20466 21097 10086 21031 13020 12051 12018 13057 20389 10089 10089 10089 10089 10089 10089 10089 10044 10044 10044 10044 Insurance Carriers/Self-Insureds/Group Funds GA RESTAURANT MUTUAL CAPTIVE (MULTI-TPA) GA RESTAURANT MUTUAL CAPTIVE (MULTI-TPA) GANNETT COMPANY INC GEMC WORKERS COMPENSATION SI FUND GENERAL ACCIDENT INSURANCE CO OF AMERICA GENERAL ACCIDENT INSURANCE COMPANY GENERAL CASUALTY COMPANY OF WISCONSIN GENERAL INSURANCE COMPANY OF AMERICA GENERAL MOTORS CORPORATION GEORGIA ASSOCIATION OF COUNTY COMMISSIONERS GEORGIA AUTOMOBILE DEALERS ASSOCIATION SI FUND GEORGIA CASUALTY & SURETY GEORGIA CRATE & BASKET COMPANY GEORGIA HOSPITAL ASSOCIATION WCSIF GEORGIA MUNICIPAL ASSOCIATION GEORGIA NURSING HOME WCSIGF GEORGIA OILMEN'S ASSOCIATION WCSIF GEORGIA OPERATOR'S WCSIF GEORGIA SCHOOL BOARD ASSOCIATION WCSIGF GEORGIA TIMBER HARVESTERS MUTUAL CAPTIVE INS CO GEORGIA WHOLESALE & RETAIL WCSIGF GFF HOLDING CO. GLENS FALLS INSURANCE COMPANY (THE) GLOBE INDEMNITY COMPANY GLYNN COUNTY BOARD OF COMMISIONERS GLYNN COUNTY SCHOOLS GOLDEN PANTRY FOOD STORES INC GOODY PRODUCTS GRANGE MUTUAL CASUALTY COMPANY GRANITE STATE INSURANCE COMPANY GRAPHIC ARTS MUTUAL INSURANCE COMPANY GRAY INSURANCE COMPANY (THE) (MULTI-TPA) GRAY INSURANCE COMPANY (THE) (MULTI-TPA) GREAT AMERICAN ALLIANCE INSURANCE GREAT AMERICAN ASSURANCE COMPANY GREAT AMERICAN INSURANCE COMPANY GREAT AMERICAN INSURANCE COMPANY OF NY GREAT ATLANTIC & PACIFIC TEA COMPANY GREAT DANE LIMITED PARTNERSHIP GREAT NORTHERN INSURANCE COMPANY GREAT WEST CASUALTY COMPANY (MULTI-TPA) GREAT WEST CASUALTY COMPANY (MULTI-TPA) GREATER NEW YORK MUTUAL INSURANCE CO GREENWICH INSURANCE COMPANY GRIFFIN-SPALDING SCHOOLS GTMA/AYSA GUARANTEE INSURANCE COMPANY GUARDIAN AUTOMOTIVE CORP GUIDEONE MUTUAL INSURANCE COMPANY GULFSTREAM AEROSPACE CORPORATION GWINNETT COUNTY BOARD OF COMMISSIONERS GWINNETT COUNTY PUBLIC SCHOOLS GWINNETT HEALTH SYSTEM HALL COUNTY BOARD OF EDUCATION HAMILTON HEALTH CARE SYSTEM HANOVER INSURANCE COMPANY HAPEVILLE, CITY OF HARBOR SPECIALTY INSURANCE COMPANY HARCO NATIONAL INSURANCE COMPANY HARLEYSVILLE MUTUAL INSURANCE HARLEYSVILLE-ATLANTIC INSURANCE HARRISON POULTRY INC HARTFORD ACCIDENT & INDEMNITY (MULTI-TPA) HARTFORD ACCIDENT & INDEMNITY (MULTI-TPA) HARTFORD ACCIDENT & INDEMNITY (MULTI-TPA) HARTFORD ACCIDENT & INDEMNITY (MULTI-TPA) HARTFORD ACCIDENT & INDEMNITY (MULTI-TPA) HARTFORD ACCIDENT & INDEMNITY (MULTI-TPA) HARTFORD ACCIDENT & INDEMNITY (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) Address Line 1 PO BOX 160226 7950 JONES BRANCH DRIVE PO BOX 1707 ONE BEACON STREET ONE BEACON STREET ONE GENERAL DRIVE C/0 LICENSING T-18 PO BOX 69 ACCG-GSIWCF GADA 4370 PEACHTREE ROAD NE PO BOX 46 1675 TERRELL MILL ROAD 201 PRYOR STREET SW C/O THE SANFORD COMPANY 1775 SPECTRUM DRIVE PO BOX 9000 5120 SUGARLOAF PARKWAY PO BOX 13603 GOLDEN ISLES UNDERWRITERS 1404 ORCHARD HILL ROAD CNA CENTER 28TH FLOOR 9300 ARROWPOINT BLVD 1725 REYNOLDS STREET PO BOX 1677 1150 WALL STREET 29 EAST STEPHENSON STREET 650 SOUTH FRONT STREET 175 WATER STREET 180 GENESSEE STREET 3601 NORTH 1-10 SERVICE RD WEST (AMERICAN ALLIANCE) 49 EAST FOURTH STREET 49 EAST FOURTH STREET FORMER AMERICAN NAT'L FIRE 2 PARAGON DRIVE PO BOX 67 15 MOUNTAIN VIEW ROAD 1100 WEST 29TH ST 200 MADISON AVE 70 SEAVIEW AVENUE 216 SOUTH SIXTH STREET 50 HURT PLAZA 401 E LAS OLAS BLVD #1540 2300 HARMON ROAD 1111 ASHWORTH ROAD PO BOX 2206 75 LANGLEY DRIVE 53 GWINNETT DRIVE 100 MEDICAL CENTER BLVD 711 GREEN ST PO BOX 1168 EMBASSY ROW 600 PO BOX 82311 7 TIMES SQUARE 2850 WEST GOLF ROAD 355 MAPLE AVENUE 355 MAPLE AVENUE PO BOX 550 HARTFORD PLAZA HARTFORD PLAZA Address Line 2 SAFECO PLAZA 3169 HOLCOMB BRIDGE RD #400 4000 CUMBERLAND PKWY BLDG 900-A 4025 VINEVILLE AVENUE SUITE 100 25 BULL STREET PO BOX 2487 333 SOUTH WABASH 18TH FLOOR 49 EAST 4TH STREET #400 SOUTH SUITE 400 SOUTH SUITE 400 SOUTH 49 EAST 4TH STREET #400 SOUTH SUITE 985 684 WINDER HWY BUILDING C SUITE 100 6600 PEACHTREE-DUNWOODY RD 36 & 37TH FLOOR City/State/Zip SAVANNAH GA 31411 MCLEAN VA 22107 TUCKER GA 30085 BOSTON MA 02108 BOSTON MA 02108 SUN PRAIRIE WI 55359 SEATTLE WA 98185 SOUTHFIELD MI 48037 NORCROSS GA 30091 ATLANTA GA 30339-4575 ATLANTA GA 30329 THOMASVILLE GA 31799 MARIETTA GA 30067 ATLANTA GA 30303 MACON GA 31210 LAWRENCEVILLE GA 30043 CLEARWATER FL 33758 LAWRENCEVILLE GA 30243 SAVANNAH GA 31401 NORCROSS GA 30091 LAGRANGE GA 30240 CHICAGO IL 60604 CHARLOTTE NC 28273 BRUNSWICK GA 31520 BRUNSWICK GA 31520 BOGART GA 30622 FREEPORT IL 61032 COLUMBUS OH 43206 NEW YORK NY 10038 NEW HARTFORD NY 13413 METAIRIE LA 70002-7045 CINCINNATI OH 45202 CINCINNATI OH 45202 CINCINNATI OH 45202 CINCINNATI OH 45202 MONTVALE NJ 07645 SAVANNAH GA 31402 WARREN NJ 07061 S. SIOUX CITY NE 68776 NEW YORK NY 10016 STAMFORD CT 06902 GRIFFIN GA 30233 ATLANTA GA 30303 FT LAUDERDALE FL 33301 AUBURN HILLS MI 48326 W DES MOINES IA 50265 SAVANNAH GA 31402 LAWRENCEVILLE GA 30245 LAWRENCEVILLE GA 30045 LAWRENCEVILLE GA 30045 GAINESVILLE GA 30505-0298 DALTON GA 30722-2128 ATLANTA GA 30328 HAPEVILLE GA 30354 NEW YORK NY 10036 ROLLING MEADOW IL 60008 HARLEYSVILLE PA 19438 HARLEYSVILLE PA 19438 BETHLEHEM GA 30620 HARTFORD CT 06115 HARTFORD CT 06115 Telephone CLAIMS HANDLING 912 927 0005 UNDERWRITERS SAFETY & CLAIMS UNDERWRITERS SAFETY & CLAIMS 703 854 6925 AMERICAN INTERNATIONAL GROUP 770 270 6950 GEMC 617 725 9322 MONTGOMERY INSURANCE CO 617 725 6000 MONTGOMERY INSURANCE CO 800 362 5448 CRAWFORD & COMPANY 206 675 3609 SAFECO INSURANCE 866 299 2613 SEDGWICK CMS 678 225 4245 ACCG STOWE ASSOCIATES 800 282 0480 GEORGIA CASUALTY & SURETY CLAIMS 229 226 2541 GEORGIA CRATE & BASKET RISK MGMT 770 240 4500 ALLIED CLAIMS ADMINISTRATION INC 888 488 4462 GEORGIA MUNICIPAL ASSOCIATION 478 741 8770 SANFORD COMPANY (THE) 800 421 0710 GEORGIA ADMINISTRATIVE SERVICES GALLAGHER BASSETT SERVICES UNDERWRITERS SAFETY & CLAIMS 888 540 6980 OLD SOUTHE INSURANCE COMPANY 770 242 7001 UNISOURCE ADMINISTRATORS 706 882 8801 SEDGWICK CMS 312 822 4314 CNA CLAIMPLUS 704 522 3043 UNISUN INSURANCE 912 554 7170 ALTERNATIVE SERVICE CONCEPTS 912 267 4100 UNDERWRITERS SAFETY & CLAIMS 706 549 4945 AMTRUST SOUTH/COVENANT 815 266 8835 TRAVELERS COMPANIES 800 422 0550 GRANGE MUTUAL INSURANCE CLAIMS 212 458 7043 AMERICAN INTERNATIONAL GROUP 800 274 1914 GRAPHIC ARTS MUTUAL CLAIMS 504 888 7790 GRAY INSURANCE CRAWFORD & COMPANY 513 287 8166 GREAT AMERICAN ALLIANCE CLAIMS 513 287 8166 GREAT AMERICAN ALLIANCE CLAIMS 513 287 8166 GREAT AMERICAN ALLIANCE CLAIMS 513 287 8166 GREAT AMERICAN ALLIANCE CLAIMS 201 571 4114 CRAWFORD & COMPANY 912 644 2636 GALLAGHER BASSETT SERVICES 908 903 5156 CHUBB GROUP 800 328 2189 GREAT WEST CASUALTY CUSTARD INSURANCE 212 683 9700 INDEPENDENT ADJUSTERS 800 622 7311 ECS CLAIMS ADMINISTRATORS 770 229 3700 AMTRUST SOUTH/COVENANT GEORGIA ADMINISTRATIVE SERVICES 800 948 2651 GUARANTEE INSURANCE 248 340 2161 ESIS INC 877 448 4331 GUIDEONE INSURANCE 912 965 3020 UNDERWRITERS SAFETY & CLAIMS 770 822 7850 GWINNETT COUNTY BOC RISK MGMT 770 513 6855 CLAIMS MANAGEMENT SERVICES 678 442 4164 IONIC RISK MANAGEMENT 770 534 1080 SELF-INSURANCE ADMINISTRATORS INC 706 283 2551 COLLINS & COMPANY 770 943 6696 HANOVER INSURANCE 404 669 2115 SELF-INSURANCE ADMINISTRATORS INC 800 797 2526 GEORGIA INSOLVENCY POOL 800 448 4642 BROADSPIRE SERVICES 800 523 6344 HARLEYSVILLE GROUP CLAIMS 800 523 6355 HARLEYSVILLE GROUP CLAIMS 770 867 7511 UNDERWRITERS SAFETY & CLAIMS 860 547 7823 HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD AURORA MED ONLY CLAIMS SPECIALTY RISK SERVICES SPECIALTY RISK SERVICES GALLAGHER BASSETT SERVICES SEDGWICK CMS 860 547 7823 HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD SOUTHEAST WC CLAIMS CENTER GALLAGHER BASSETT SERVICES FRANK GATES SERVICE COMPANY UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 PO BOX 465537 5105 PAULSEN STREET PO BOX 2158 PO BOX 1707 3555 KOGER BLVD 3555 KOGER BLVD 100 GLENRIDGE PT PARKWAY 2055 SUGARLOAF CIRCLE PO BOX 69 3169 HOLCOMB BRIDGE ROAD 2951 FLOWERS ROAD SOUTH PO BOX 105480 PO BOX 465537 PO BOX 674869 4025 VINEVILLE AVENUE 1775 SPECTRUM DRIVE 2915 PREMIERE PARKWAY PO BOX 465537 PO BOX 491540 PO BOX 4088 1117 PERIMETER CENTER WEST 2435 COMMERCE AVENUE 5950 LIVE OAK PARKWAY 1725 REYNOLDS STREET PO BOX 465537 PO BOX 740042 CALLER SERVICES 1818 2755 DIEHL ROAD PO BOX 2158 41 PERIMETER CENTER EAST NE PO BOX 6202 100 GLENRIDGE PT PARKWAY PO BOX 5432 PO BOX 5432 PO BOX 5432 49TH STREET 100 GLENRIDGE PT PARKWAY 100 CRESCENT CENTRE PARKWAY 3445 PEACHTREE ROAD NE 1100 W 29TH STREET PO BOX 30030 2130 TUCKER INDUSTRIAL ROAD 3525 PIEDMONT ROAD #300 PO BOX 740042 1775 SPECTRUM DRIVE 1061 521 CORPORATE CENTER DRIVE 500 COLONIAL CENTER PARKWAY 2305 W PARK PLACE 5105 PAULSEN STREET 75 LANGLEY DRIVE PO BOX 1447 PO BOX 2340 3473 SATELLITE BLVD 555 RIVER STREET 6600 PEACHTREE-DUNWOODY RD 3473 SATELLITE BLVD 2177 FLINTSTONE DRIVE #R 655 ENGINEERING DRIVE PO BOX 140996 PO BOX 140996 PO BOX 465537 50 GLENLAKE PARKWAY 200 COLONIAL CENTER PARKWAY 4245 MERIDIAN PARKWAY 828 ROYAL OAK PARKWAY 50 GLENLAKE PARKWAY 100 CRESCENT CENTRE PARKWAY 1117 PERIMETER CENTER WEST 50 GLENLAKE PARKWAY 200 COLONIAL CENTER PARKWAY 100 CRESCENT CENTRE PARKWAY 701 INTERNATIONAL PARKWAY ADDRESS LINE 2 SUITE 241B SUITE 100 SAFECO PLAZA SUITE 400 SUITE 217 SUITE 100 SUITE 350 SUITE 500 BLDG 2200 SATELLITE PLACE SUITE 200 SUITE 302 SUITE 300 SUITE 100 SUITE 100 SUITE 600 2 LIVE OAK CENTER #900 BLDG 7 SUITE 300 SUITE 100 SUITE 140 SUITE 200 SUITE A SUITE 241B 684 WINDER HWY 360 MARKET PLACE SUITE 310 NORTH SUITE 310 NORTH SUITE 200 SUITE 500 SUITE 200 SUITE 330 SUITE 600 SUITE E500 SUITE 500 SUITE 600 SUITE 175 CITY STATE ZIP LAWRENCEVILLE GA 30042 SAVANNAH GA 31405 ALPHARETTA GA 30023-2158 TUCKER GA 30085 DULUTH GA 30096 DULUTH GA 30096 ATLANTA GA 30302-5065 DULUTH GA 30097-4074 SOUTHFIELD MI 48037 NORCROSS GA 30071 ATLANTA GA 30341 ATLANTA GA 30348 THOMASVILLE GA 31799 MARIETTA GA 30006 TELEPHONE 888 245 4722 800 928 9096 800 448 9707 770 270 6950 800 762 5573 800 762 5573 800 249 9243 678 417 3654 800 489 4646 678 225 4245 770 451 6222 800 241 1433 800 841 0001 MACON GA 31210 LAWRENCEVILLE GA 30042 DULUTH GA 30097 LAWRENCEVILLE GA 30042 LAWRENCEVILLE GA 30049 DULUTH GA 30095 ATLANTA GA 30338 DULUTH GA 30096 NORCROSS GA 30093 BRUNSWICK GA 31520 LAWRENCEVILLE GA 30042 ATLANTA GA 30374-0042 ALPHARETTA GA 30023-1818 WARRENVILLE IL 60555 ALPHARETTA GA 30023-2158 ATLANTA GA 30346-1903 METAIRIE LA 70009 ATLANTA GA 30302-5065 CINCINNATI OH 45202 CINCINNATI OH 45202 CINCINNATI OH 45202 CINCINNATI OH 45202 ATLANTA GA 30302 TUCKER GA 30084 ATLANTA GA 30326-1276 S SOUIX CITY NE 68776-0277 SAVANNAH GA 31410 TUCKER GA 30084 ATLANTA GA 30305 ATLANTA GA 30374-0042 LAWRENCEVILLE GA 30043 FORT MILL SC 29715 ROSWELL GA 30076 STONE MOUNTAIN GA 30087 SAVANNAH GA 31405 LAWRENCEVILLE GA 30045 ROSWELL GA 30077-1447 STOCKBRIDGE GA 30281 DULUTH GA 30096 CHATTANOOGA TN 37405 ATLANTA GA 30328 DULUTH GA 30096 TUCKER GA 30084 NORCROSS GA 30092 NASHVILLE TN 37214 NASHVILLE TN 37214 LAWRENCEVILLE GA 30042 ATLANTA GA 30328 LAKE MARY FL 32746 AURORA IL 60504 NASHVILLE TN 37214 ATLANTA GA 30328 TUCKER GA 30084 ATLANTA GA 30338 ATLANTA GA 30328 LAKE MARY FL 32746 TUCKER GA 30084 LAKE MARY FL 32746 478 741 8770 770 280 2500 888 245 4722 770 277 1462 770 901 3185 770 849 0242 800 322 1276 888 245 4722 678 258 8000 800 238 6214 800 935 5300 800 448 9707 770 481 7500 504 888 7790 800 249 9243 877 589 6846 877 589 6846 877 589 6846 877 589 6846 800 249 9243 800 354 6494 404 266 4855 800 228 8602 912 887 2120 800 838 9853 404 504 6290 678 258 8000 800 421 0710 800 948 2651 800 685 7361 770 469 6006 800 928 9096 770 822 7850 770 998 7411 678 610 5581 770 344 0070 800 884 1535 770 344 0070 770 621 9835 800 450 0692 888 549 9876 888 549 9876 888 245 4722 877 673 9222 800 824 1732 630 692 8225 800 541 0129 678 338 4171 800 354 6494 800 932 4464 877 673 9222 800 824 1732 800 354 6494 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 10044 10044 13094 13094 13094 13094 13094 13094 12045 12045 12045 12045 12045 12045 12092 12092 12092 12092 12092 12092 12092 12037 12037 12037 12037 12037 12037 12037 10123 10123 10123 10123 10123 10123 10123 10123 40012 21779 20580 20404 21426 20533 20937 21612 20565 20419 21286 20312 21046 20362 20407 21354 21281 21001 21182 20461 13231 12071 10203 21344 10093 10094 13089 20359 20642 21514 21321 21143 21474 20412 21719 21714 20571 Insurance Carriers/Self-Insureds/Group Funds HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD CASUALTY INSURANCE CO (MULTI-TPA) HARTFORD FIRE INSURANCE CO (MULTI-TPA) HARTFORD FIRE INSURANCE CO (MULTI-TPA) HARTFORD FIRE INSURANCE CO (MULTI-TPA) HARTFORD FIRE INSURANCE CO (MULTI-TPA) HARTFORD FIRE INSURANCE CO (MULTI-TPA) HARTFORD FIRE INSURANCE CO (MULTI-TPA) HARTFORD INS CO OF THE MIDWEST (MULTI-TPA) HARTFORD INS CO OF THE MIDWEST (MULTI-TPA) HARTFORD INS CO OF THE MIDWEST ( MULTI-TPA) HARTFORD INS CO OF THE MIDWEST (MULTI-TPA) HARTFORD INS CO OF THE MIDWEST (MULTI-TPA) HARTFORD INS CO OF THE MIDWEST (MULTI-TPA) HARTFORD INS CO OF THE MIDWEST (MULTI-TPA) HARTFORD INS CO OF THE SOUTHEAST (MULTI-TPA) HARTFORD INS CO OF THE SOUTHEAST (MULTI-TPA) HARTFORD INS CO OF THE SOUTHEAST (MULTI-TPA) HARTFORD INS CO OF THE SOUTHEAST (MULTI-TPA) HARTFORD INS CO OF THE SOUTHEAST (MULTI-TPA) HARTFORD INS CO OF THE SOUTHEAST (MULTI-TPA) HARTFORD INSURANCE COMPANY OF THE SOUTHEAST HARTFORD UNDERWRITERS INSURANCE (MULTI-TPA) HARTFORD UNDERWRITERS INSURANCE (MULTI-TPA) HARTFORD UNDERWRITERS INSURANCE (MULTI-TPA) HARTFORD UNDERWRITERS INSURANCE (MULTI-TPA) HARTFORD UNDERWRITERS INSURANCE (MULTI-TPA) HARTFORD UNDERWRITERS INSURANCE (MULTI-TPA) HARTFORD UNDERWRITERS INSURANCE (MULTI-TPA) HARTFORD UNDERWRITERS INSURANCE (MULTI-TPA) HEALTHCARE MUTUAL CAPTIVE INSURANCE HEARTLAND EXPRESS INC HENRY COUNTY BOARD OF EDUCATION HERCULES INCORPORATED HERSCHEND FAMILY ENTERTAINMENT HILLCREST FOODS INC HILTON HOTELS CORP. HNI CORPORATION HORMEL FOODS HORTON HOMES INC HOSPITAL AUTHORITY OF HOUSTON COUNTY HOSPITAL AUTHORITY OF RANDOLPH COUNTY HOSPITAL AUTHORITY OF VALDOSTA/LOWNDES CO HOUSTON COUNTY BOARD OF COMMISSIONERS HOUSTON COUNTY BOARD OF EDUCATION HOWARD SHEPPARD INC HUTCHESON MEDICAL CENTER INC HYATT CORPORATION IDA CASON CALLAWAY FOUNDATION IKON OFFICE SOLUTIONS INC IMPERIAL CASUALTY AND INDEMNITY COMPANY INDEMNITY INSURANCE COMPANY OF NORTH AMERICA INDIANA LUMBERMENS MUTUAL INGLES MARKETS INC INSURANCE COMPANY OF NORTH AMERICA INSURANCE COMPANY OF STATE OF PENNSYLVANIA INSURANCE COMPANY OF THE WEST INTERFACE INC INTERNATIONAL PAPER COMPANY INTERSTATE PAPER LLC J & J INDUSTRIES INC JESUP, CITY OF JOHN WIELAND HOMES AND NEIGHBORHOODS JOHNS MANVILLE COPORATION JONES COMPANY (THE) ENGINEERED FABRICS F/K/A K&F INDUSTRIES KELLEY MANUFACTURING Address Line 1 Address Line 2 HARTFORD PLAZA HARTFORD CT 06115 HARTFORD PLAZA HARTFORD CT 06183 HARTFORD PLAZA HARTFORD CT 06115 HARTFORD PLAZA HARTFORD PLAZA 1775 SPECTRUM DRIVE 2777 HEARTLAND DRIVE 396 TOMLINSON STREET 1313 NORTH MARKET STREET FKA SILVER DOLLAR CITY 50 SATELLITE BLVD 9336 CIVIC CENTER DRIVE FKA HON INDUSTRIES 1 HORMEL PLACE PO BOX 4410 1601 WATSON BLVD 109 RANDOLPH ST 2501 N PATTERSON STREET 200 CARL VINSON PARKWAY 1211 WASHINGTON STREET PO BOX 797 100 GROSS CRESCENT CIRCLE 200 WEST MADISON PO BOX 963 70 VALLEY STREAM PARKWAY 8000 WARREN PARKWAY 436 WALNUT STREET 3600 WOODVIEW TRACE PO BOX 6676 436 WALNUT STREET 175 WATER STREET PO BOX 85563 1503 ORCHARD HILL ROAD 6400 POPLAR AVENUE 2366 INTERSTATE PAPER ROAD PO BOX 1287 PO BOX 427 1950 SULLIVAN ROAD PO BOX 5108 PO BOX 2149 669 GOODYEAR STREET PO DRAWER 1467 City/State/Zip HARTFORD CT 06115 HARTFORD CT 06115 SUITE 100 RESEARCH CENTER 2800 W 76 COUNTRY BLVD SUITE G 414 EAST THIRD STREET PO BOX 1727 SUITE 300 18TH FLOOR LAWRENCEVILLE GA 30043 CORALVILLE IA 52241 MCDONOUGH GA 30253 WILMINGTON DE 19808 BRANSON MO 65616 SUWANEE GA 30024 BEVERLY HILLS CA 90210 MUSCATINE IA 52761 AUSTIN MN 55912 EATONTON GA 31024 WARNER ROBINS GA 31094 CUTHBERT GA 39840 VALDOSTA GA 31603 WARNER ROBINS GA 31088 PEWRRY GAS 31069 SANDERSVILLE GA 31082 FT OGLETHORPE GA 30742 CHICAGO IL 60606 PINE MOUNTAIN GA 31822 MALVERN PA 19355 FRISCO TX 75034 PHILADELPHIA PA 19105 INDIANAPOLIS IN 46254 ASHEVILLE NC 28816 PHILADELPHIA PA 19105 NEW YORK NY 10038 SAN DIEGO CA 92186 LAGRANGE GA 30240 MEMPHIS TN 38197 RICEBORO GA 31323 DALTON GA 30721 JESUP GA 31545 ATLANTA GA 30337 DENVER CO 80217 WAYCROSS GA 31502 ROCKMART GA 30153 TIFTON GA 31793 Telephone 860 547 7823 860 547 7823 860 547 7823 860 547 7823 860 547 3530 912 927 0005 319 545 2507 770 957 6601 302 995 3480 417 336 7081 770 932 1137 312 780 5509 563 264 7588 507 437 5491 706 485 8506 478 542 7826 229 732 2181 229 259 4104 912 542 2115 912 987 1929 478 552 5127 706 858 2645 312 750 8266 770 663 5159 610 408 7147 215 640 1272 800 428 1441 828 669 2941 215 640 1272 212 458 7043 800 877 1111 706 812 6403 901 419 3938 912 884 3371 706 278 4454 912 427 1313 770 703 2245 303 978 4937 706 213 0060 770 684 7855 229 382 9393 CLAIMS HANDLING SEDGWICK CMS SPECIALTY RISK SERVICES HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD AURORA WC CLAIMXCHANGE SPECIALTY RISK SERVICES SPECIALTY RISK SERVICES GALLAGHER BASSETT SERVICES HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD SOUTHEAST WC CLAIMS CENTER SEDGWICK CMS GALLAGHER BASSETT SERVICES SPECIALTY RISK SERVICES FRANK GATES SERVICE COMPANY HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD AURORA MED ONLY CLAIMS SPECIALTY RISK SERVICES SPECIALTY RISK SERVICES FRANK GATES SERVICE COMPANY GALLAGHER BASSETT SERVICES HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD AURORA MED ONLY CLAIMS SPECIALTY RISK SERVICES SPECIALTY RISK SERVICES GALLAGHER BASSETT SERVICES SEDGWICK CMS HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD AURORA MED ONLY CLAIMS SPECIALTY RISK SERVICES SPECIALTY RISK SERVICES GAB ROBINS NORTH AMERICA GALLAGHER BASSETT SERVICES SEDGWICK CMS GEORGIA ADMINISTRATIVE SERVICES GALLAGHER BASSETT SERVICES SELF-INSURANCE ADMINISTRATORS INC SPECIALTY RISK SERVICES CLAIMS MANAGEMENT SERVICES AMTRUST SOUTH/COVENANT GALLAGHER BASSETT SERVICES GALLAGHER BASSETT SERVICES ZURICH UNDERWRITERS SAFETY & CLAIMS UNISOURCE ADMINISTRATORS AMTRUST SOUTH/COVENANT AMTRUST SOUTH/COVENANT MOZLEY FINLAYSON & LOGGINS LLP SELF-INSURANCE ADMINISTRATORS INC UNDERWRITERS SAFETY & CLAIMS COLLINS & COMPANY GALLAGHER BASSETT SERVICES AMTRUST SOUTH/COVENANT HELMSMAN MANAGEMENT SERVICES IMPERIAL CASUALTY ESIS INC INDIANA LUMBERMENS SCHAFFER COMPANIES LTD ESIS INC AMERICAN INTERNATIONAL GROUP UNISOURCE ADMINISTRATORS GATES MDONALD & COMPANY SEDGWICK CMS INTERSTATE PAPER RISK MANAGEMENT COLLINS & COMPANY JESUP CITY RISK MANAGEMENT CLAIMS MANAGEMENT SERVICES ESIS INC AMTRUST SOUTH/COVENANT K & F INDUSTRIES RISK MANAGEMENT SELF-INSURANCE ADMINISTRATORS INC UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 1117 PERIMETER CENTER WEST 828 ROYAL OAK PARKWAY 200 COLONIAL CENTER PARKWAY 50 GLENLAKE PARKWAY 4245 MERIDIAN PARKWAY 828 ROYAL PARKWAY 50 GLENLAKE PARKWAY 2990 BRANDYWINE ROAD 200 COLONIAL CENTER PARKWAY 50 GLENLAKE PARKWAY 1117 PERIMETER CENTER WEST 100 CRESCENT CENTRE PARKWAY 828 ROYAL PARKWAY 701 INTERNATIONAL PARKWAY 200 COLONIAL CENTER PARKWAY 50 GLENLAKE PARKWAY 4245 MERIDIAN PARKWAY 828 ROYAL OAK PARKWAY 50 GLENLAKE PARKWAY 701 INTERNATIONAL PARKWAY 2990 BRANDYWINE ROAD 50 GLENLAKE PARKWAY 4245 MERIDIAN PARKWAY 828 ROYAL OAK PARKWAY 50 GLENLAKE PARKWAY 2990 BRANDYWINE ROAD 1117 PERIMETER CENTER WEST 200 COLONIAL CENTER PARKWAY 200 COLONIAL CENTER PARKWAY 50 GLENLAKE PARKWAY 4245 MERIDIAN PARKWAY 828 ROYAL OAK PARKWAY 50 GLENLAKE PARKWAY 3039 PREMIERE PARKWAY 2990 BRANDYWINE ROAD 1117 PERIMETER CENTER WEST 1775 SPECTRUM DRIVE 100 CRESCENT CENTRE PARKWAY 3473 SATELLITE BLVD PO BOX 60000 PO BOX 1447 PO BOX 740042 100 CRESCENT CENTRE PARKWAY 100 CRESCENT CENTRE PARKWAY 3003 SUMMIT BLVD 5105 PAULSEN STREET 3740 DAVINCI COURT PO BOX 740042 PO BOX 740042 ONE PREMIER PLAZA #900 3473 SATELLITE BLVD 5105 PAULSEN STREET 555 RIVER STREET 100 CRESCENT CENTRE PARKWAY PO BOX 740042 3901 PREMIER NORTH DRIVE 800 WARREN PARKWAY 500 COLONIAL CENTER PARKWAY 3600 WOODVIEW TRACE PO BOX 550549 500 COLONIAL CENTER PARKWAY PO BOX 2158 3740 DAVINCI COURT 3550 ENGINEERING DRIVE 1117 PERIMETER CENTER WEST 2366 INTERSTATE PAPER ROAD 555 RIVER STREET PO BOX 427 PO BOX 1447 500 COLONIAL CENTER PARKWAY PO BOX 740042 669 GOODYEAR STREET 3473 SATELLITE BLVD ADDRESS LINE 2 SUITE E500 SUITE 200 SUITE 500 SUITE 200 SUITE 330 SUITE 100 SUITE 500 SUITE E500 SUITE 600 SUITE 200 SUITE 175 SUITE 500 SUISTE 200 SUITE 330 SUITE 175 SUITE 100 SUITE 200 SUITE 330 SUITE 100 SUITE 500E SUITE 500 SUITE 500 SUITE 200 SUITE 330 SUITE 900 SUITE 100 SUITE 500E SUITE 100 SUITE 600 SUITE 310 NORTH 360 MARKET PLACE SUITE 600 SUITE 600 SUITE 241B SUITE 100 5605 GLENRIDGE DRIVE SUITE 310 NORTH SUITE 241B SUITE 600 SUITE 300 SUITE 200 SUITE 200 SUITE 100 SUITE 175 SUITE 500 360 MARKET PLACE SUITE 200 SUITE 310 NORTH CITY STATE ZIP ATLANTA GA 30338 NASHVILLE TN 37214 LAKE MARY FL 32746 ATLANTA GA 30328 AURORA IL 60504 NASHVILLE TN 37214 ATLANTA GA 30328 ATLANTA GA 30341 LAKE MARY FL 32746 ATLANTA GA 30328 ATLANTA GA 30338 TUCKER GA 30084 NASHVILLE TN 37230 LAKE MARY FL 32746 LAKE MARY FL 32746 ATLANTA GA 30328 AURORA IL 60504 NASHVILLE TN 37214 ATLANTA GA 30328 LAKE MARY FL 32746 ATLANTA GA 30341 ATLANTA GA 30328 AURORA IL 60504 NASHVILLE TN 37214 ATLANTA GA 30328 ATLANTA GA 30341 ATLANTA GA 30338 LAKE MARY FL 32746 LAKE MARY FL 32746 ATLANTA GA 30328 AURORA IL 60504 NASHVILLE TN 37214 ATLANTA GA 30328 DULUTH GA 30097 ATLANTA GA 30341 ATLANTA GA 30338 LAWRENCEVILLE GA 30043 TUCKER GA 30084 DULUTH GA 30096 ATLANTA GA 30325 ROSWELL GA 30077-1447 ATLANTA GA 30374-0042 TUCKER GA 30084 TUCKER GA 30084 ATLANTA GA 30319 SAVANNAH GA 31405 NORCROSS GA 30092 ATLANTA GA 30374-0042 ATLANTA GA 30374-0042 ATLANTA GA 30342 DULUTH GA 30096 SAVANNAH GA 31405 CHATTANOOGA TN 37405 TUCKER GA 30084 ATLANTA GA 30374-0042 TAMPA GA 33618 FRISCO TX 75034 ROSWELL GA 30076 INDIANAPOLIS IN 46268 GASTONIA NC 28055 ROSWELL GA 30076 ALPHARETTA GA 30023-2158 NORCROSS GA 30092 NORCROSS GA 30092 ATLANTA GA 30338 RICEBORO GA 31323 CHATTANOOGA TN 37405 JESUP GA 31545 ROSWELL GA 30077-1447 ROSWELL GA 30076 ATLANTA GA 30374-0042 ROCKMART GA 30153 DULUTH GA 30096 TELEPHONE 800 932 4464 800 824 1732 877 673 9222 630 692 8225 800 541 0129 678 338 4171 770 458 6494 800 354 6494 800 824 1732 877 673 9222 630 692 8225 800 541 0139 678 338 4171 407 333 0100 770 458 6494 877 673 9222 630 692 8225 800 541 0139 678 338 4171 770 458 6494 770 901 3185 800 824 1732 800 824 1732 877 673 9222 630 692 8225 800 541 0139 678 338 4171 800 616 6446 770 458 65494 770 901 3185 800 421 0710 800 354 6496 770 344 0070 800 445 9058 770 998 7411 678 258 8000 800 354 6494 800 354 6496 800 241 7570 800 928 9096 877 638 7876 678 258 8000 678 258 8000 404 256 0700 770 344 0070 800 928 9096 800 884 1535 800 354 6494 678 258 8000 800 282 6218 888 339 5736 800 685 7361 800 428 1441 877 263 1480 800 685 7361 800 448 9707 877 638 7876 770 810 1051 770 901 3185 912 884 3371 800 884 1535 912 427 1313 770 998 7411 800 685 7361 678 258 8000 770 684 7855 770 344 0070 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 20944 13155 21051 20567 20737 21461 21752 21704 21709 21512 21763 21511 10219 21340 21550 13182 10097 10097 10097 10098 10098 12085 10128 13220 13059 21365 21547 21333 10101 12005 20430 21389 10140 13139 21415 21490 21610 20809 10258 21379 20487 21764 20606 21530 21759 21737 13084 13215 21446 21675 13148 21525 10172 10172 10172 20502 10104 13208 21536 20410 13054 13054 13233 13241 13219 20299 10088 21020 20448 21103 21701 12081 10042 Insurance Carriers/Self-Insureds/Group Funds KELLOGG CO AND SUBSIDIARIES KEY RISK INSURANCE COMPANY KIMBERLY CLARK CORPORATION KING & PRINCES SEAFOOD KLEEN-TEX INDUSTRIES INCORPORATED KLLM TRANSPORT SERVICES INC KNIGHT TRANSPORTATION KROGER COMPANY (THE) LABOR READY SOUTHEAST INC LAGRANGE, CITY OF LAGRANGE, CITY OF LAGRANGE-TROUP COUNTY HOSPITAL LANCER INSURANCE LANGDALE INDUSTRIES LAWRENCEVILLE, CITY OF LIBERTY INSURANCE CORPORATION (MULTI-TPA) LIBERTY MUTUAL FIRE INSURANCE COMPANY (MULTI-TPA) LIBERTY MUTUAL FIRE INSURANCE COMPANY (MULTI-TPA) LIBERTY MUTUAL FIRE INSURANCE COMPANY (MULTI-TPA) LIBERTY MUTUAL INSURANCE COMPANY (MULTI-TPA) LIBERTY MUTUAL INSURANCE COMPANY (MULTI-TPA) LIBERTY MUTUAL INSURANCE COMPANY (MULTI-TPA) LINCOLN GENERAL INSURANCE COMPANY LION INSURANCE COMPANY LM INSURANCE COMPANY LOUISIANA PACIFIC CORPORATION LOW TEMP INDUSTRIES LOWES HOME CENTERS INC LUMBERMENS MUTUAL CASUALTY LUMBERMENS UNDERWRITING ALLIANCE MACON, CITY OF MACON/BIBB WATER/SEWERAGE MAG MUTUAL INSURANCE COMPANY MANUFACTURERS ALLIANCE MARIETTA CITY SERVICES MAR-JAC POULTRY INC MARRIOTT INTERNATIONAL INC MARTA MASSACHUSETTS BAY INSURANCE COMPANY MAY DEPARTMENT STORES MB KAHN CONSTRUCTION MCG HEALTH INC MCLANE COMPANY M-D BUILDING PRODUCTS INC MEADOWS REGIONAL MEDICAL CENTER MEADWESTVACO MEDICAL ASSURANCE MEMIC INDEMNITY COMPANY MEMORIAL HEALTH UNIVERSITY MEDICAL MERCER UNIVERSITY (THE CORPORATION OF) MERIDIAN SECURITY INSURANCE COMPANY METALPLATE GALVANIZING METLIFE INSURANCE OF CONNECTICUT (MULTI-TPA) METLIFE INSURANCE OF CONNECTICUT (MULTI-TPA) METLIFE INSURANCE OF CONNECTICUT (MULTI-TPA) MICROMERITICS INSTRUMENT CORPORATION MIDWEST EMPLOYERS CASUALTY MIDWESTERN INDEMNITY COMPANY MILLEDGEVILLE, CITY OF MILTON J WOOD COMPANY MITSUI SUMITOMO INS CO OF AMERICA (MULTI-TPA) MITSUI SUMITOMO INS CO OF AMERICA (MULTI-TPA) MITSUI SUMITOMO INSURANCE USA INC MITSUI SUMITOMO INSURANCE USA INC MONROE GUARANTY INSURANCE COMPANY MONROE, CITY OF MONUMENTAL GENERAL CASUALTY MOUNT VERNON MILLS MURRAY COUNTY BOARD OF EDUCATION MUSCOGEE COUNTY SCHOOL DISTRICT NASH JOHNSON & SONS FARMS INC NATIONAL AMERICAN INSURANCE COMPANY NATIONAL FARMERS UNION STANDARD Address Line 1 FKA KEEBLER 7900 MCCLOUD ROAD 1414 W LARSEN ROAD 1 KING & PRINCE BLVD 1516 ORCHARD HILL ROAD PO BOX 6098 5601 WEST BUCKEYE 1014 VINE STREET 1015 A STREET PO BOX 430 200 RIDLEY AVE DBA WEST GEORGIA HEALTH SYSTEM 370 WEST PARK AVENUE PO BOX 1088 PO BOX 2200 Address Line 2 ONE KELLOGG SQUARE PO BOX 349 PO BOX 2910 1514 VERNON ROAD City/State/Zip BATTLE CREEK MI 49017 GREENSBORO NC 27409 NEENAH WI 5495700349 BRUNSWICK GA 31520 LAGRANGE GA 30240 JACKSON MS 39288 PHOENIX AZ 85043 CINCINNATI OH 45202 TACOMA WA 98401 LAGRANGE GA 30240 LAGRANGE GA 30240 LAGRANGE GA 30240 LONG BEACH NY 11561 VALDOSTA GA 31603 ATLANTA GA 30246 Telephone 269 660 7494 800 366 1511 920 721 2894 912 265 5155 800 241 2323 601 933 4942 602 606 6218 770 496 7497 800 610 8920 706 883 2000 706 883 2010 706 845 3139 516 431 4441 229 333 2551 770 963 2414 175 BERKELEY STREET 18TH FLOOR BOSTON MA 02116 617 654 4180 175 BERKELEY STREET 18TH FLOOR BOSTON MA 02116 617 654 4180 YORK PA 17402 HOLIDAY FL 34691 BOSTON MA 02116 PORTLAND OR 97205-3303 JONESBORO GA 30237 MOORESVILLE NC 28115 LONG GROVE IL 60049-0001 BOCA RATON FL 33431 MACON GA 31202 MACON GA 31298 ATLANTA GA 30092 BLUE BELL PA 19422 MARIETTA GA 30061 GAINESVILLE GA 30503 WASHINGTON DC 20058 ATLANTA GA 30324 ATLANTA GA 30328 ST LOUIS MO 63101 COLUMBIA SC 29202 AUGUSTA GA 30912 TEMPLE TX 76503-6115 OKLAHOMA CITY OK 73125 MACON GA 30475 GLEN ALLEN VA 23060 BIRMINGHAM AL 35209 PORTLAND ME 04104 SAVANNAH GA 31403-3089 MACON GA 31207-0001 INDIANAPOLIS IN 46208 BIRMINGHAM AL 35201 HARTFORD CT 06183 800 876 3350 727 938 5562 800 344 0197 503 821 5289 770 478 88803 704 758 3055 847 320 5580 800 327 0630 912 751 7447 912 741 9152 800 282 4882 800 222 2749 770 429 4342 770 531 5000 301 380 4450 404 848 5220 770 943 6696 314 342 65225 803 227 1290 706 721 9289 254 771 7428 800 348 4070 912 538 5898 804 327 8008 800 282 6242 NORCORSS GA 30093 CHESTERFIELD MO 63017 LOVELAND OH 45140 MILLEDGEVILLE GA 31059 JACKSONVILLE FL 32226 WARREN NJ 07059 770 662 3620 877 975 2667 800 436 9600 912 453 5725 904 353 5527 800 388 1802 WARREN NJ 07059 WARREN NJ 07059 SARASOTA FL 34240 MONROE GA 30655 BALTIMORE MD 21201 MAULDIN SC 29662 CHATSWORTH GA 30705 COLUMBUS GA 31904-3086 LEESVILLE SC 29070 CHANDLER OK 74834 AURORA CO 80014 800 226 3224 770 267 7536 800 233 4624 864 688 7100 770 695 4531 706 748 2380 803 532 4488 800 332 2210 800 347 1961 PO BOX 3709 2739 US HIGHWAY 19 NORTH 175 BERKELEY STREET 805 SW BROADWAY PO BOX 795 PO BOX 1000 1 KEMPER DRIVE 1905 NW CORPORATE BLVD PO BOX 247 792 SECOND ST 3525 PIEDMONT ROAD 380 SENTRY PARKWAY 205 LAWRENCE ST PO BOX 1017 MARRIOTT DRIVE 2424 PIEDMONT ROAD EMBASSY ROW 600 611 OLIVE STREET PO BOX 1179 1120 15TH STREET BA 3237 4747 MCLANE PARKWAY PO BOX 25188 PO BOX 1048 11013 W BROAD STREET 100 BROOKWOOD PLACE PO BOX 11409 PO BOX 23089 1400 COLEMAN AVENUE 2955 N MERIDIAN STREET PO BOX 966 ONE TOWER SQUARE ONE MICROMERITICS DRIVE 14755 NORTH OUTER FORTY DRIVE 6281 TRI-RIDGE BLVD 115-119 EAST HANCOCK STREET FKA MJW CONSOLIDATED 15 INDEPENDENCE BLVD 15 INDEPENDENCE BLVD 15 INDEPENDENCE BLVD 6300 UNIVERSITY PARKWAY 227 S BROAD STRET 520 PARK AVENUE PO BOX 100 PO BOX 40 5661 LORENZO ROAD PO BOX 3628 1010 MANVEL AVENUE 11900 EAST CORNELL AVENUE SUITE 600 SUITE 700 BLDG 8 SUITE 600 DEPT 52/924.36 6600 PEACHTREE DUNWOODY ROAD PO BOX 6115 SUITE 500 SUITE 300 3805 FAYE ROAD 912 350 8447 478 301 2810 800 777 7324 205 595 4700 860 954 5660 CLAIMS HANDLING GALLAGHER BASSETT SERVICES KEY RISK MANAGEMENT SERVICES KIMBERLY CLARK CORP RISK MGMT UNDERWRITERS SAFETY & CLAIMS UNDERWRITERS SAFETY & CLAIMS ATTENTA BALDWIN & LYONS SEDGWICK CMS ESIS INC TRAVELERS COMPANIES AMTRUST SOUTH/COVENANT ALLIED CLAIMS ADMINISTRATION INC LANCER INSURANCE COMPANY LANGDALE INDUSTRIES RISK MGMT SELF-INSURANCE ADMINISTRATORS INC LIBERTY MUTUAL INSURANCE GROUP LIBERTY MUTUAL INSURANCE GROUP LIBERTY MUTUAL INSURANCE GROUP LIBERTY MUTUAL INSURANCE GROUP LIBERTY MUTUAL INSURANCE GROUP LIBERTY MUTUAL INSURANCE GROUP LIBERTY MUTUAL INSURANCE GROUP GALLAGHER BASSETT SERVICES PACKARD CLAIMS ADMINISTRATION LIBERTY MUTUAL INSURANCE GROUP SEDGWICK CMS AMTRUST SOUTH/COVENANT SPECIALTY RISK SERVICES KEMPER INSURANCE CAMBRIDGE INTEGRATED SERVICES UNDERWRITERS SAFETY & CLAIMS ALTERNATIVE SERVICE CONCEPTS UNISOURCE ADMINISTRATORS PMA INSURANCE GROUP AMTRUST SOUTH/COVENANT AMTRUST SOUTH/COVENANT MARRIOTT CLAIMS SERVICES MARTA RISK MANAGEMENT MASSACHUSETTS BAY WEBB CARLOCK COPELAND ETAL HEWITT COLEMAN ASSOCIATES AMTRUST SOUTH/COVENANT AMERICAN INTERNATIONAL GROUP CLAIMS & RISK SERVICES INC CORE ADMINISTRATIVE SERVICES SEDGWICK CMS MEDICAL ASSURANCE CLAIMS CANNON COCHRAN MANAGEMENT UNDERWRITERS SAFETY & CLAIMS CORE ADMINISTRATIVE SERVICES STATE AUTOMOBILE MUTUAL COMP MANAGEMENT TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES UNISOURCE ADMINISTRATORS ATTENTA MONTGOMERY INSURANCE CO CITY OF MILLEDGEVILLE RISK MGMT GEORGIA ADMINISTRATIVE SERVICES MITSUI SUMITO MARINE CLAIMS MITSUI SUMITO MARINE CLAIMS MITSUI SUMITO MARINE CLAIMS MITSUI SUMITO MARINE CLAIMS FCCI SERVICES AMTRUST SOUTH/COVENANT GALLAGHER BASSETT SERVICES CLAIMS MANAGEMENT SERVICES COLLINS & COMPANY MUSCOGEE COUNTY SCHOOL RISK MGMT KEY RISK MANAGEMENT SERVICES NATIONAL AMERICAN INS CLAIMS GAB ROBINS NORTH AMERICA UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 2915 PREMIERE PARKWAY PO BOX 2670 2300 WINCHESTER ROAD 5105 PAULSEN STREET PO BOX 465537 5605 GLENRIDGE DR 1099 MERIDIAN STREET 1117 PERIMETER CENTER WEST 500 COLONIAL CENTER PARKWAY 3632 QUEEN PALM DRIVE PO BOX 740042 PO BOX 674869 370 WEST PARK AVENUE PO BOX 1088 3473 SATELLITE BLVD PO BOX 31204 PO BOX 300 PO BOX 31204 PO BOX 926240 PO BOX 300 PO BOX 31204 PO BOX 31204 601 VESTAVIA PARKWAY 2739 US HIGHWAY 19 NORTH 3235 SATELLITE BLVD 1117 PERIMETER CENTER WEST PO BOX 740042 10735 DAVID TAYLOR DRIVE PO BOX 926240 1100 PARK CENTRAL BLVD 5105 PAULSEN STREET PO BOX 2966 3740 DAVINCI COURT 2100 RIVEREDGE PARKWAY PO BOX 740042 PO BOX 740042 360 INTERSTATE NORTH PARKWAY 2424 PEIDMONT ROAD NE EMBASSY ROW 600 2600 MARQUIS 2 TOWER PO BOX 5500 PO BOX 740042 PO BOX 2158 PO BOX 21450 PO BOX 90 1117 PERIMETER CENTER WEST 1576 EAST SCARLET OAKS CT 3235 SATELLITE BLVD 5105 PAULSEN STREET PO BOX 90 2955 M MERIDIAN STREET 2180 SATELLITE BLVD CALLER SERVICES 1818 3097 SATELLILTE BLVD 3632 QUEEN PALM DRIVE 3740 DAVINCI COURT ONE PREMIER PLAZA #300 4600 PARK ROAD PO BOX 1599 1775 SPECTRUM DRIVE 14 PIEDMONT CENTER #415 312 ELM STREET 14 PIEDMONT CENTER #415 14 PIEDMONT CENTER #415 3175 SATELLITE BLVD PO BOX 740042 100 CRESCENT CENTRE PARKWAY PO BOX 1447 555 RIVER STREET PO BOX 2427 PO BOX 2670 1010 MANVEL AVENUE 3039 PREMIERE PARKWAY ADDRESS LINE 2 SUITE 350 PO BOX 2007 SUITE 241B SUITE 300 SUITE 500 SUITE 200 SUITE 310 NORTH SUITE 251 SUITE 500 BLDG 400 SUITE 600 SUITE 500 SUITE 400 SUITE 1100 SUITE 241B SUITE 100 SUITE 1250 SUITE 630 6600 PEACHTREE-DUNWOODY RD 285 PEACHTREE SUITE 500 BLDG 400 SUITE 300 SUITE 241B SUITE 400 SUITE 100 5605 GLENRIDGE DRIVE SUITE 500 3535 PIEDMONT ROAD SUITE 1250 3535 PIEDMONT ROAD 3535 PIEDMONT ROAD SUITE 600 360 MARKET PLACE SUITE 900 CITY STATE ZIP DULUTH GA 30097 ALPHARETTA GA 30023 NEENAH WI 54957 SAVANNAH GA 31405 LAWRENCEVILLE GA 30042 ATLANTA GA 30342 INDIANAPOLIS, IN 46204 ATLANTA GA 30338 ROSWELL GA 30076 TAMPA FL 33619 ATLANTA GA 30374-0042 MARIETTA GA 30006 LONG BEACH NY 11561 VALDOSTA GA 31603 DULUTH GA 30096 TAMPA FL 33631-3204 BRENTWOOD TN 37024 TAMPA FL 33631-3204 NORCROSS GA 30010 BRENTWOOD TN 37024 TAMPA FL 33631-3204 TAMPA FL 33631-3204 BIRMINGHAM AL 35216 HOLIDAY FL 34691 DULUTH GA 30096 ATLANTA GA 30338 ATLANTA GA 30374-0042 CHARLOTTE NC 28262 NORCROSS GA 30010 POMPANO BEACH FL 33064 SAVANNAH GA 31405 RICHMOND HILL GA 31324 NORCROSS GA 30092 ATLANTA GA 30328 ATLANTA GA 30374-0042 ATLANTA GA 30374 ATLANTA GA 30339 ATLANTA GA 30324 ATLANTA GA 30328 ATLANTA GA 30343 GREENVILLE SC 29606 ATLANTA GA 30374-0042 ALPHARETTA GA 30023-2158 OKLAHOMA CITY OK 73156 MACON GA 31202-0090 ATLANTA GA 30338 TERRE HAUTE IN 47802 DULUTH GA 30096 SAVANNAH GA 31405 MACON GA 31202--0090 INDIANAPOLIS IN 46208 DULUTH GA 30097 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 NORCROSS GA 30092 ATLANTA GA 30342 CHARLOTTE NC 28209 MILLEDGEVILLE GA 31059-1599 LAWRENCEVILLE GA 30043 ATLANTA GA 30305 CINCINNATI OH 45202-2749 ATLANTA GA 30305 ATLANTA GA 30305 DULUTH GA 30096 ATLANTA GA 30374 TUCKER GA 30084 ROSWELL GA 30077-1447 CHATTANOOGA TN 37405 COLUMBUS GA 31902 ALPHARETTA GA 30023 CHANDLER OK 74834 DULUTH GA 30097 TELEPHONE 770 280 2500 800 366 1511 800 722 9005 800 928 9096 888 245 4722 404 847 1614 800 644 5501 770 901 3185 800 6857361 800 387 8734 678 258 8000 770 818 1517 516 431 4441 229 333 2551 770 344 0070 800 282 6218 800 523 6906 800 282 6218 800 523 6906 800 282-6218 800 282 6218 866 605 8601 866 605 8601 800 213 4903 770 901 3185 678 258 8000 877 300 6187 877 295 0011 800 928 9096 912 727 5224 877 638 7876 800 222 4524 678 258 8000 678 258 8000 770 226 9827 404 848 4521 770 943 6696* 404 522 8220 800 421 9139 678 258 8000 800 448 9707 405 751 0943 888 741 2673 770 901 385 888 685 3999 888 674 2524 800 928 9096 888 741 2673 800 777 7324 770 281 8997 800 238 6214 800 241 9245 800 387 8734 877 638 7876 800 476 2541 800 334 0078 912 453 9496 800 421 0710 800 805 3737 404 242 6100 800 354 6494 770 998 7411 800 884 1535 770 324 5661 800 366 1511 800 332 2210 770 457 9555 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 10115 12088 13184 13184 13047 10117 10118 13143 12021 10119 13015 13045 21000 20601 12040 12040 12040 13101 21643 21679 13169 13169 13169 13169 20591 13001 12026 21388 10126 10209 21259 12093 21062 13032 12058 13028 13197 13199 13196 21468 20814 13004 21717 10130 10132 20457 21553 21327 10029 10134 13248 13198 12074 12009 13138 10291 10136 21292 10137 10138 10138 10138 21237 21622 21728 20454 13141 13226 21712 21567 21449 10266 12054 Insurance Carriers/Self-Insureds/Group Funds NATIONAL FIRE INSURANCE COMPANY OF HARTFORD NATIONAL INDEMNITY COMPANY NATIONAL INTERSTATE INSURANCE CO (MULTI-TPA) NATIONAL INTERSTATE INSURANCE CO (MULTI-TPA) NATIONAL LIABILITY & FIRE INSURANCE NATIONAL SURETY COPORATION NATIONAL UNION FIRE INSURANCE COMPANY NATIONWIDE AGRIBUSINESS NATIONWIDE MUTUAL FIRE INSURANCE COMPANY NATIONWIDE MUTUAL INSURANCE COMPANY NATIONWIDE PROPERTY & CASUALTY INSURANCE CO NETHERLANDS INSURANCE COMPANY NEWTON COUNTY BOARD OF COMMISSIONERS NEWTON COUNTY BOARD OF EDUCATION NIPPONKOA INSUANCE CO LTD (US BRANCH) (MULTI-TPA) NIPPONKOA INSUANCE CO LTD (US BRANCH) (MULTI-TPA) NIPPONKOA INSUANCE CO LTD (US BRANCH) (MULTI-TPA) NLC MUTUAL INSURANCE COMPANY NORDSON CORPORATION NORDSTROM INC NORGUARD INSURANCE COMPANY (MULTI-TPA) NORGUARD INSURANCE COMPANY (MULTI-TPA) NORGUARD INSURANCE COMPANY (MULTI-TPA) NORGUARD INSURANCE COMPANY (MULTI-TPA) NORMAN W. FRIES INC NORTH AMERICAN SPECIALTY INSURANCE NORTHBROOK INDEMNITY INSURANCE COMPANY NORTHEAST GEORGIA HEALTH SYSTEM NORTHERN ASSURANCE COMPANY OF AMERICA NORTHERN INSURANCE COMPANY OF NEW YORK NORTHSIDE HEALTH SERVICES OHIO FARMERS INSURANCE COMPANY OLD DOMINION FRIEGHT LINE INC OLD DOMINION INSURANCE COMPANY OLD REPUBLIC GENERAL INSURANCE CORPORATION OLD REPUBLIC UNION INSURANCE COMPANY ONEBEACON AMERICAN INSURANCE COMPANY ONEBEACON INSURANCE COMPANY ONEBEACON MIDWEST INSURANCE COMPANY OWENS CORNING OWENS ILLINOIS INC OWNERS INSRUANCE COMPANY OXFORD CONSTRUCTION COMPANY PACIFIC EMPLOYERS INSURANCE COMPANY PACIFIC INDEMNITY COMPANY PARKER HANNIFIN CORPORATION PATTERSON PUMP COPMANY PCC AIRFOILS INC PEERLESS INDEMNITY INSURANCE COMPANY PEERLESS INSURANCE COMPANY PEGASUS INSURANCE COMPANY INC PENNSYLVANIA GENERAL INSRUANCE COMPANY PENNSYLVANIA LUMBERMENS MUTUAL INSURANCE PENNSYLVANIA MANUFACTURERS ASSN INS CO. PENNSYLVANIA MANUFACTURERS INDEMNITY PENNSYLVANIA MILLERS INSURANCE PENNSYLVANIA NATIONAL MUTUAL CASUALTY PHOEBE PUTNEY HEALTH SYSTEM INC PHOENIX ASSURANCE COMPANY OF NEW YORK PHOENIX INSURANCE COMPANY (MULTI-TPA) PHOENIX INSURANCE COMPANY (MULTI-TPA) PHOENIX INSURANCE COMPANY (MULTI-TPA) PIEDMONT HEALTHCARE PIGGLY WIGGLY CAROLINA COMPANY PILOT TRAVEL CENTERS PPG INDUSTRIES INC PREFERRED PROFESSIONAL INSURANCE COMPANY PREMIER GROUP INSURANCE COMPANY PRESBYTERIAN HOMES OF GEORGIA PRINTPACK INC PROCTOR & GAMBLE CO. PROTECTIVE INSURANCE PROVIDIAN AUTO & HOME INSURANCE COMPANY Address Line 1 333 S WABASH AVENUE 3024 HARNEY STREET 3250 INTERSTATE DRIVE 3024 HARNEY STREET 777 SAN MARIN DRIVE 175 WATER STREET 1100 LOCUST STREET ONE NATIONWIDE PLAZA ONE NATIONWIDE PLAZA ONE NATIONWIDE PLAZA 62 MAPLE AVE 1113 USHER STREET 3187 NEWTON DRIVE NE ONE TOWER SQUARE Address Line 2 CNA CENTER 28TH FLOOR 18TH FLOOR DEPT 3030 1301 PENNSYLVANIA AVE SW 555 JACKSON STREET PO BOX 21865 PO BOX 1368 SUITE 550 BDA CLAXTON POULTRY 650 ELM STREET 385 WASHINGTON STREET 743 SPRING ST NE ONE BEACON STREET 1400 AMERICAN LANE 1000 JOHNSON-FERRY ROAD NE ONE PARK CIRCLE 500 OLD DOMINION WAY 4601 TOUCHTON ROAD EAST 307 N MICHIGAN AVENUE 307 N MICHIGAN AVENUE ONE BEACON STREET ONE BEACON STREET ONE BEACON STREET ONE OWENS CORNING PARKWAY O-I PLAZA PO BOX 30660 3200 PALMYRA ROAD 436 WALNUT STREET 15 MOUNTAIN VIEW ROAD 6035 PARKLAND BLVD PO BOX 790 1400 POPE DRIVE FORMERLY ATLAS ASSURANCE 62 MAPLE AVE 200 EXECUTIVE WAY ONE BEACON STREET 170 S INDEPENDENCE MALL WEST 380 SENTRY PARKWAY 380 SENTRY PARKWAY 72 N FRANKLIN STREET PO BOX 2361 417 THRID AVE 9300 ARROWPOINT BLVD ONE TOWER SQUARE PO BOX 428 1968 PEACHTREE ROAD NW 176 CROGAHN SPUR ROAD 5508 LONAS ROAD 4325 ROSANNA DR 11605 MIRACLE HILLS DRIVE 100 VINE STREET 2000 E WEST CONNECTOR 4335 WENDELL DRIVE 5299 SPRING GROVE AVENUE 1099 N MERIDIAN 2000 WESTWOOD DRIVE MC509A PO BOX 5001 SUITE 3400 ONE MICHAEL OWENS WAY 3333 WARRENVILLE RD 4TH FL SUITE 210 CURTIS CENTER SUITE 301 PO BOX 10146 BUILDING C SUITE 200 City/State/Zip CHICAGO IL 60604 OMAHA NE 68131 RICHFIELD OH 44286 OMAHA NE 68131 NOVATO CA 94998 NEW YORK NY 10038 DES MOINES IA 50391 COLUMBUS OH 43215 COLUMBUS OH 43216 COLUMBUS OH 43215 KEENE NH 03431 COVINGTON GA 30014 COVINGTON GA 30209 HARTFORD CT 06183 WASHINGTON, DC 20004 AMHERST OH 44001 SEATTLE WA 98111 WILKES BARRE PA 18703 CLAXTON GA 30417 MANCHESTER NH 03101 ST PAUL MN 55102 GAINESVILLE GA 30501 BOSTON MA 02108 SCHAUMBURG IL 60196 ATLANTA GA 30342 WESTFIELD CENTER OH 44251 THOMASVILLE NC 27360 JACKSONVILLE FL 32245-6000 CHICAGO IL 60601 CHICAGO IL 60601 BOSTON MA 02108-3100 BOSTON MA 02108-3100 BOSTON MA 02108-3100 TOLEDO OH 43659 PERRYSBURG OH 43551-2999 LANSING MI 48909-8160 ALBANY GA 31707 PHILADELPHIA PA 19105 WARREN NJ 07061 CLEVELAND OH 44124 TOCCOA GA 30577 DOUGLAS GA 31535 LISLE IL 60532 KEENE NH 03431 PONTE VEDRA BCH FL 32082 BOSTON MA 02108-3100 PHILADELPHIA PA 19106 BLUE BELL PA 19422 BLUE BELL PA 19422 WILKES BARRE PA 18773 HARRISBURG PA 17105 ALBANY GA 31707 CHARLOTTE NC 28273 HARTFORD CT 06183 ATLANTA GA 30309 CHARLESTON SC 29407 KNOXVILLE TN 37939 ALLISON PARK PA 15101 OMAHA NE 68154 MURFREESBORO TN 37130 AUSTELL GA 30106 ATLANTA GA 30336 CINCINNATI OH 45217 INDIANAPOLIS IN 46204 ST LOUIS MO 63146 Telephone CLAIMS HANDLING 312 822 4314 CNA CLAIMPLUS 800 356 5750 BERKSHIRE HATHAWAY 800 929 1500 COLLINS AND COMPANY COLLINS AND COMPANY 800 356 5750 BERKSHIRE HATHAWAY 800 227 1700 FIREMAN'S FUND INSURANCE 212 458 7043 AMERICAN INTERNATIONAL GROUP 800 228 6700 NATIONWIDE GROUP 614 249 0702 NATIONWIDE INSURANCE 614 249 0702 NATIONWIDE INSURANCE 614 249 0702 NATIONWIDE INSURANCE 800 826 6189 MONTGOMERY INSURANCE CO 706 787 1330 SELF-INSURANCE ADMINISTRATORS INC 706 787 1330 SELF-INSURANCE ADMINISTRATORS INC 860 547 7823 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 202 626 3110 NLC MUTUAL INSURANCE CLAIMS 800 321 2881 CLAIMS MANAGEMENT SERVICES 206 303 4417 NORDSTROM INC RISK MANAGEMENT 800 673 2465 GUARD INSURANCE GROUP GUARD INSURANCE GROUP GUARD INSURANCE GROUP GUARD INSURANCE GROUP 912 739 3181 UNDERWRITERS SAFETY & CLAIMS 800 542 9200 CRAWFORD & COMPANY 800 356 4098 TRAVELERS COMPANIES 770 535 3561 UNISOURCE ADMINISTRATORS 973 630 6601 ONEBEACON INSURANCE 847 605 6587 ZURICH NORTH AMERICA CLAIMS DIV. 404 851 8490 CLAIMS MANAGEMENT SERVICES 800 243 0210 WESTFIELD INSURANCE GROUP 336 889 5000 CAMBRIDGE INTEGRATED SERVICES 904 380 7265 OLD DOMINION 800 621 0365 OLD REPUBLIC INSURANCE 800 621 0365 OLD REPUBLIC INSURANCE 973 630 6601 ONEBEACON INSURANCE 973 630 6601 ONEBEACON INSURANCE 973 630 6601 ONEBEACON INSURANCE 419 248 8640 GALLAGHER BASSETT SERVICES 567 336 2064 GALLAGHER BASSETT SERVICES 800 346 0346 AUTO-OWNERS INSURANCE CLAIMS 229 883 3232 AMTRUST SOUTH/COVENANT 215 640 1272 ESIS INC 908 903 5156 CHUBB GROUP 216 896 2417 UNDERWRITERS SAFETY & CLAIMS 706 2997 2847 AMTRUST SOUTH/COVENANT 912 3834 6633 UNDERWRITERS SAFETY & CLAIMS 800 826 6189 MONTGOMERY INSURANCE CO 800 826 6189 MONTGOMERY INSURANCE CO PEGASUS INSURANCE 973 630 6601 ONEBEACON INSURANCE 800 752 1895 TENCO SERVICES 800 222 2749 PMA GROUP 800 222 2749 PMA INSURANCE GROUP 800 233 8347 COLLINS AND COMPANY 800 388 4754 CRAWFORD & COMPANY 229 312 2401 PMA INSURANCE GROUP 704 522 3043 UNISUN INSURANCE 860 954 5660 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 404 605 3614 PIEDMONT MEDICAL RISK MGMT 843 554 9880 COMPANION GROUP 865 588 7488 PILOT CORPORATION RISK MGMT 412 492 5428 SENTRY CLAIMS SERVICE 800 441 7742 PREFERRED PROFESSIONAL CAMBRIDGE INTEGRATED SERVICES 770 819 7004 SELF-INSURANCE ADMINISTRATORS INC 404 460 7356 FRANK GATES SERVICE COMPANY 513 627 7571 CAMBRIDGE INTEGRATED SERVICES 800 644 5501 CRAWFORD & COMPANY PROVIDIAN AUTO & HOME UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 2435 COMMERCE AVENUE 1725 WINDWARD COUNCOURSE PO BOX 723783 2014 RIVERSIDE DRIVE 1725 WINDWARD COUNCOURSE 11475 GREAT OAKS WAY PO BOX 2158 1100 LOCUST STREET 2170 SATELLITE BLVD 2170 SATELLITE BLVD PO BOX 147061 4600 PARK ROAD 3473 SATELLITE BLVD 3473 SATELLITE BLVD CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE 1301 PENNSYLVANIA AVE NW PO BOX 1447 PO BOX 12865 620 MOOREFIELD DRIVE 5973 EDENFIELD DRIVE 102 WEST PENNSYLVANIA AVE 620 MOOREFIELD DRIVE 5105 PAULSEN STREET 655 ENGINEERING DRIVE CALLER SERVICES 1818 PO BOX 19559 5901-B PEACHTREE-DUNWOODY ROAD 4010 BOYSCOUT BLVD PO BOX 1447 3505 KOGER BLVD PO BOX 1238 PO BOX 4828 PO BOX 789 307 N MICHIGAN AVE 5901-B PEACHTREE-DUNWOODY ROAD 5901-B PEACHTREE-DUNWOODY ROAD 3901-B PEACHTREE-DUNWOODY ROAD 100 CRESCENT CENTRE PARKWAY 475 KILVERT STREET PO BOX 100044 PO BOX 740042 500 COLONIAL CENTER PARKWAY 3445 PEACHTREE ROAD NE 5105 PAULSEN STREET PO BOX 740042 5105 PAULSEN STREET 4600 PARK ROAD 4600 PARK ROAD ONE INDEPENDENCE PLAZA 5901-B PEACHTREE-DUNWOODY ROAD 8735 DUNWOODY PLACE 2100 RIVEREDGE PARKWAY 2100 RIVEREDGE PARKWAY PO BOX 723783 100 GLENRIDGE PT PARKWAY 2100 RIVEREDGE PARKWAY 5950 LIVE OAK PARKWAY 3632 QUEEN PALM DIRVE CALLER SERVICES 1818 3097 SATELLITE BLVD 1968 PEACHTREE ROAD NW PO BOX 100159 PO BOX 10146 PO BOX 26363 11605 MIRACLE HILLS DRIVE 9950 PRINCESS PALM AVE 3473 SATELLITE BLVD 4751 BEST ROAD 3725 BERKELEY LAKE ROAD 100 GLENRIDGE PT PARKWAY 20 MOORES ROAD ADDRESS LINE 2 BLDG 2200 SATELLITE PLACE SUITE 200 SUITE A SUITE 200 ROYAL CENTRE THREE DEPT 3010 SUITE 208 SUITE 208 SUITE 500 SUITE 310 NORTH SUITE 310 NORTH SUITE 550 360 MARKET PLACE SUITE 209 SUITE 206 SUITE 209 SUITE 241B SUITE 600 360 MARKET PLACE SUITE 275 SUITE 600 SUITE 105 SUITE 200 2 LIVE OAK CENTER #900 SUITE 241B SUITE 241B SUITE 500 SUITE 500 SUITE 520 SUITE 3 SUITE 1250 SUITE 1250 SUITE 100 SUITE 1250 SUITE 200 SUITE 200 SUITE 100 SUITE 310 NORTH SUITE 100 SUITE 100 CITY STATE ZIP DULUTH GA 30096 ALPHARETTA GA 30005 ATLANTA GA 311339 MACON GA 31201 ALPHARETTA GA 30005 ALPHARETTA GA 30374 ALPHARETTA GA 30023-2158 DES MOINES IA 50391-3010 DULUTH GA 30097 DULUTH GA 30097 GAINESVILLE FL 32614 CHARLOTTE NC 28209 DULUTH GA 30096 DULUTH GA 30096 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 WASHINGTON DC 20004 ROSWELL GA 30077-1447 SEATTLE WA 98111 WILKES-BARRE PA 18703-1368 ACWORTH GA 30101 TOWSON MD 21204 RICHMOND VA 23236-3692 SAVANNAH GA 31405 NORCROSS GA 30092 ALPHARETTA GA 30023 SARASOTA FL 34276 ATLANTA GA 30305 TAMPA FL 33607 ROSWELL GA 30077-1447 DULUTH GA 30096 MANGO FL 33550 SYRACUSE NY 13221-4828 GREENSBURG PA 15601 CHICAGO IL 60601 ATLANTA GA 30328 ATLANTA GA 30328 ATLANTA GA 30328 TUCKER GA 30084 WARWICK RI 02886 DULUTH GA 30096 ATLANTA GA 30374-0042 ROSWELL GA 30076 ATLANTA GA 30326-1276 SAVANNAH GA 31405 ATLANTA GA 30374-0042 SAVANNAH GA 31405 CHARLOTTE NC 28209 CHARLOTTE NC 28209 BIRMINGHAM AL 35209 ATLANTA GA 30328 ATLANTA GA 30350 ATLANTA GA 30328 ATLANTA GA 30328 ATLANTA GA 30328 ATLANTA GA 30302 ATLANTA GA 30328 NORCROSS GA 30093 TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 ATLANTA GA 30309 COLUMBIA SC 29202-3159 KNOXVILLE TN 37939 RICHMOND VA 23260-6363 OMAHA NE 68154 TAMPA FL 33619 DULUTH GA 30096 ATLANTA GA 30337 DULUTH GA 30096 ATLANTA GA 30342 FRAZER PA 19355 TELEPHONE 800 282 7084 877 212 3816 770 434 9222 800 370 8484 800 227 1700 800 448 9707 806 698 3737 770 279 5504 770 279 5504 800 985 7078 800 334 0078 770 344 0070 770 344 0070 800 238 6214 800 241 9245 800 387 8734 202 626 3110 770 998 7411 877 275 7475 800 928 9096 800 238 6214 877 638 7876 770 998 7411 800 685 4604 813 612 5236 724 600 7523 800 621 0365 800 203 9600 800 203 9706 800 203 9600 800 354 6494 401 739 7111 770 931 7766 678 258 8000 800 685 7361 404 266 4855 800 928 9096 678 258 8000 800 928 9096 800 334 0078 800 334 0078 888 258 4412 800 203 9600 800 621 1313 770 988 3393 800 222 4524 800 222 4524 800 249 9243 800 222 4524 770 849 0242 800 387 8734 800 238 6214 800 241 9245 404 605 3614 800 845 2724 800 562 6210 800 338 2487 800 441 7742 800 303 4437 770 344 0070 404 762 8800 800 235 1134 404 497 6545 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 10142 21706 20350 21772 21745 13119 10055 21771 13031 20920 13086 21671 20524 21757 13227 20602 20862 30043 21441 21773 20520 10226 10147 10264 21656 21500 20546 20945 10274 13092 10148 13187 13187 13187 13187 13187 13187 13121 21296 20468 10153 13096 10240 10240 10240 13042 12097 13069 13097 13218 13218 13218 13218 13218 13218 10255 21084 21744 21645 21266 21276 21758 20596 21539 21494 13200 20478 40009 21497 20428 30012 40014 20858 Insurance Carriers/Self-Insureds/Group Funds PUBLIC SERVICE MUTUAL INSRUANCE COMPANY QUIKTRIP CORPORATION RACETRAC PETROLEUM INC RAYONIER INC RECONSERVE INCORPORATED REDLAND INSURANCE COMPANY REGENT INSURANCE COMPANY REGIONS FINANCIAL CORPORATION REPUBLIC-FRANKLIN INSURANCE COMPANY RICHMOND COUNTY BOARD OF EDUCATION RISCORP NATIONAL INSURANCE RIVERDALE, CITY OF RMC INDUSTRIES ROBERTS CONTRCTING INC ROCHDALE INSURANCE COMPANY ROCKDALE COUNTY BOARD OF EDUCATION ROLLINS INC ROOFING & SHEET METAL ASSOCIATION WCSIGF ROPER COPORATION ROSEBURG FOREST PRODUCTS ROSWELL, CITY OF ROYAL & SUNALLIANCE INSURANCE COMPANY ROYAL INDEMNITY COMPANY ROYAL INSURANCE COMPANY OF AMERICA RTM INC RUBY TUESDAY INC RYAN'S FAMILY STEAKHOUSE/FIRE MOUNTAIN RYDER SYSTEM INC SAFECO INSURANCE COMPANY OF AMERICA SAFECO INSURANCE COMPANY OF ILLINOIS SAFEGUARD INSURANCE COMPANY SAFETY FIRST INSURANCE (MULTI-TPA) SAFETY FIRST INSURANCE (MULTI-TPA) SAFETY FIRST INSURANCE (MULTI-TPA) SAFETY FIRST INSURANCE (MULTI-TPA) SAFETY FIRST INSURANCE (MULTI-TPA) SAFETY FIRST INSURANCE (MULTI-TPA) SAFETY NATIONAL CASUALTY SATILLA HEALTH SERVICES SAVANNAH, CITY OF SECURITY INSURANCE COMPANY OF HARTFORD SECURITY NATIONAL INSURANCE SELECT INSURANCE COMPANY (MULTI-TPA) SELECT INSURANCE COMPANY (MULTI-TPA) SELECT INSURANCE COMPANY (MULTI-TPA) SELECTIVE INSURANCE COMPANY OF SOUTH CAROLINA SELECTIVE INSURANCE COMPANY OF THE SOUTHEAST SELECTIVE INSURANCE OF AMERICA SELECTIVE WAY INSURANCE SENTINEL INSURANCE COMPANY (MULTI-TPA) SENTINEL INSURANCE COMPANY (MULTI-TPA) SENTINEL INSURANCE COMPANY (MULTI-TPA) SENTINEL INSURANCE COMPANY (MULTI-TPA) SENTINEL INSURANCE COMPANY (MULTI-TPA) SENTINEL INSURANCE COMPANY (MULTI-TPA) SENTRY SELECT INSURANCE COMPANY SHAW INDUSTRIES INC SHEPHERD CONSTRUCTION COMPANY INC SHEPHERD MEDICAL CENTER SHERWIN-WILLIAMS COMPANY (THE) SHONEY'S INCE SIMMONS FOODS INC SIZEMORE INCORPORATED SKF USA INC SMURFIT STONE CONTAINER SOMPO JAPAN INSURANCE OF AMERICA SOUTH CAROLINA ELECTRIC & GAS SOUTHEAST EMPLOYERS MUTUAL SOUTHEAST GEORGIA HEALTH SYSTEM SOUTHEASTERN FREIGHT LINE SOUTHEASTERN LUMBER MANUFACTURERS' WCSIF SOUTHEASTERN U.S. INSURANCE INC. SOUTHERN COMPANY Address Line 1 ONE PARK AVENUE PO BOX 3475 300 TECHNOLOGY COURT 50 NORTH LAURA STREET FKA SCOPE INDUSTRIES 6263 N SCOTTSDALE ROAD ONE GENERAL DRIVE 417 NORTH 20TH STREET 180 GENESEE STREET 864 BROAD ST PO BOX 25700 6690 CHURCH STREET 840 GESSNER ROAD PO BOX 699 59 MAIDEN LANE 954 NORTH MAIN STREET 2170 PIEDMONT RD NE PO BOX 90519 PO BOX 1408 PO BOX 1088 38 HILL STREET PO BOX 19809 9300 ARROWPOINT BLVD 9300 ARROWPOINT BLVD 5995 BARFIELD ROAD 150 WEST CHURCH STREET PO BOX 100 POB 020816UE C/O LICENSING T-18 C/O LICENSING T-18 9300 ARROWPOINT BLVD 2043 WOODLAND PARKWAY Address Line 2 2811 WILSHIRE BLVD #410 2ND FLOOR #208 SUITE 1400 6TH FLOOR SAFECO PLAZA SAFECO PLAZA City/State/Zip NEW YORK NY 10016 TULSA OK 74101 SMYRNA GA 30082 JACKSONVILLE FL 32202 SANTA MONICA CA 90401 SCATTSDALE AZ 85250 SUN PRAIRIE WI 55359 BIRMINGHAM AL 35203 NEW HARTFORD NY 13413 AUGUSTA GA 30901 CHARLOTTE NC 28229 RIVERDALE GA 30274 HOUSTON TX 77024 COMER GA 30629 NEW YORK NY 10038 CONYERS GA 30012 ATLANTA GA 30324 EAST POINT GA 30344 LAFAYETTE GA 30728 ROSEBURG OR 97470 ROSWELL GA 30075 CHARLOTTE NC 28219 CHARLOTTE NC 28273 CHARLOTTE NC 28273 ATLANTA GA 30328 MARYVILLE TN 37801 GREER SC 29652 MIAMI FL 33102 SEATTLE WA 98185 SEATTLE WA 98185 CHARLOTTE NC 28273 ST LOUIS MO 63146 Telephone 888 663 7275 918 615 7763 770 431 7600 904 357 9114 310 458 1574 800 243 1782 800 362 5448 205 944 1300 800 274 1914 706 826 1010 800 200 2667 770 242 6100 713 722 6071 706 318 5552 770 860 4255 404 888 2260 404 766 1632 706 277 2770 541 679 2742 770 594 6450 866 227 1500 704 522 3043 704 522 3042 404 705 1296 865 379 5910 864 879 1000 305 500 4404 206 675 3609 206 675 3609 704 522 3043 888 372 7515 2043 WOODLAND PARKWAY 410 DARLING AVE PO BOX 1027 9300 ARROWPOINT BLVD PO BOX 650665 ONE TOWER SQUARE ST LOUIS MO 63146 WAYCROSS GA 31501 SAVANNAH GA 31402 CHARLOTTE NC 28273 DALLAS TX 75265 HARTFORD CT 06183 888 995 5300 912 338 6499 912 651 7798 704 522 3043 888 291 8298 860 954 5660 40 WANTAGE AVENUE 40 WANTAGE AVENUE 40 WANTAGE AVENUE 40 WANTAGE AVENUE HARTFORD PLAZA BRANCHVILLE NJ 07890 BRANCHVILLE NJ 07890 BRANCHVILLE NJ 07890 BRANCHVILLE NJ 07890 HARTFORD CT 06115 800 777 9656 800 777 9656 800 777 9656 800 777 9656 860 547 7823 1800 NORTH POINT DRIVE PO DRAWER 2128 PO BOX 8088 STATION F 2020 PEACHTREE ROAD NW 101 PROSPECT AVE NW 1727 ELM HILL PIKE STE B-1 601 NORTH HICO STREET 2116 WALTON WAY 1111 ADAMS AVENUE SIX CITY PLACE DRIVE TWO WORLD FINANCIAL CENTER DBA SCANNA CORPORATION 1775 SPECTRUM DRIVE 2415 PARKWOOD DRIVE PO BOX 1691 671 FOREST PARKWAY 1908 CLIFF VALLEY WAY NE 30 IVAN ALLEN JR BLVD NW 225 LIBERTY ST 43RD FLOOR 1426 MAIN ST MAIL CODE 056 SUITE 100 SUITE 100 BIN SC 1404 STEVENS POINT WI 54481 DALTON GA 30722-2128 ATLANTA GA 31106-0088 ATLANTA GA 30309-1402 CLEVELAND OH 44112 NASHVILLE TN 37210 SILOAM SPRINGS AR 72761 AUGUSTA GA 30904 NORRISTOWN PA 19403 CREVE COEUR MO 63141 NEW YORK NY 10281 COLUMBIA SC 29201 LAWRENCEVILLE GA 30043 BRUNSWICK GA 31520 COLUMBIA SC 29202 FOREST PARK GA 30050 ATLANTA GA 30329 ATLANTA GA 30308 800 739 3344 706 275 4351 404 325 9350 404 350 7343 216 566 3095 615 231 2072 479 524 8151 706 736 1456 610 630 2737 314 746 1313 800 444 6870 803 217 9908 800 421 0710 912 466 5599 803 939 3301 404 361 1437 404 842 7100 404 506 0703 CLAIMS HANDLING AMERICAN PROFESSIONAL RISK QUIKTRIP CORP RISK MANAGEMENT GALLAGHER BASSETT SERVICES ESIS INC GALLAGHER BASSETT SERVICES ACCEPTANCE INSURANCE CRAWFORD & COMPANY CROCKETT ADJUSTMENT SERVICES REPUBLIC-FRANKLIN INSURANCE GROUP RICHMOND COUNTY RISK MANAGEMENT RISCORP NATIONAL INSURANCE AMTRUST SOUTH/COVENANT TRAVELERS COMPANIES UNDERWRITERS SAFETY & CLAIMS AMTRUST SOUTH/COVENANT CLAIMS MANAGEMENT SERVICES GALLAGHER BASSETT SERVICES AMERICAN PROFESSIONAL RISK COLLINS & COMPANY CANNON COCHRAN MANAGEMENT AMTRUST SOUTH/COVENANT ROYAL & SUNALLIANCE ROYAL INDEMNITY UNISUN INSURANCE SPECIALTY RISK SERVICES SEDGWICK CMS SPECIALTY RISK SERVICES RYDER SYSTEMS RISK MANAGEMENT SAFECO INSURANCE SAFECO INSURANCE UNISUN INSURANCE SAFETY FIRST CLAIMS MATRIX ABSENCE CAMBRIDGE INTEGRATED SERVICES SPECIALTY RISK SERVICES GALLAGHER BASSETT SERVICES BROADSPIRE SERVICES SAFETY NATIONAL AMTRUST SOUTH/COVENANT SEDGWICK CMS CAMBRIDGE INTEGRATED SERVICES SECURITY NATIONAL INSURANCE TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES SELECTIVE INSURANCE SELECTIVE INSURANCE SELECTIVE INSURANCE SELECTIVE INSURANCE HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD AURORA MED ONLY CLAIMS SPECIALTY RISK SERVICES SPECIALTY RISK SERVICES GALLAGHER BASSETT SERVICES SENTRY CLAIMS SERVICE GALLAGHER BASSETT SERVICES HELMSMAN MANAGEMENT SERVICES ALLIED CLAIMS ADMINISTRATION INC GALLAGHER BASSETT SERVICES BROADSPIRE SERVICES S. B. HOWARD & CO AMTRUST SOUTH/COVENANT BROADSPIRE SERVICES CRAWFORD & COMPANY BROADSPIRE SERVICES COMPANION GROUP GEORGIA ADMINISTRATIVE SERVICES AMTRUST SOUTH/COVENANT ZURICH ROYAL & SUNALLIANCE COMMON SENSE CLAIMS SOUTHERN COMPANY RISK MGMT UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 1255 MCFARLAND 400 DRIVE PO BOX 3475 100 CRESCENT CENTRE PARKWAY 500 COLONIAL CENTER PARKWAY 100 CRESCENT CENTRE PARKWAY PO BOX 4017 100 GLENRIDGE PT PARKWAY 1500 RIVERFRONT DRIVE 41 PERIMETER CENTER EAST NE 864 BROAD STREET PO BOX 25700 PO BOX 740042 CALLER SERVICES 1818 5105 PAULSEN STREET PO BOX 740042 PO BOX 1447 100 CRESCENT CENTRE PARKWAY 1255 MCFARLAND 400 DRIVE 555 RIVER STREET 3235 SATELLITE BLVD PO BOX 740042 PO BOX 19809 5950 LIVE OAK PARKWAY 5950 LIVE OAK PARKWAY PO BOX 60000 PO BOX 958422 PO BOX 4076 PO BOX 2370 2055 SUGARLOAF CIRCLE 2055 SUGARLOAF CIRCLE 5950 LIVE OAK PARKWAY 2043 WOODLAND PARKWAY PO BOX 3449 1775 THE EXCHANGE PO BOX 60000 100 CRESCENT CENTRE PARKWAY 655 ENGINEERING DRIVE 2043 WOODLAND PARKWAY PO BOX 740042 1117 PERIMETER CENTER WEST PO BOX 1238 10000 N CENTRAL EXPRESSWAY CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE 3426 TORINGTON WAY 3426 TORINGTON WAY 3426 TORINGTON WAY 3426 TORINGTON WAY 200 COLONIAL CENTER PARKWAY 50 GLENLAKE PARKWAY 4245 MERIDIAN PARKWAY 828 ROYAL OAK PARKWAY 50 GLENLAKE PARKWAY 2990 BRANDYWINE ROAD PO BOX 26363 2915 PREMIERE PARKWAY 3235 SATELLITE BLVD PO BOX 674869 100 CRESCENT CENTRE PARKWAY 655 ENGINEERING DRIVE PO BOX 1627 PO BOX 740042 1216 DULANEY WOODS ROAD 100 GLENRIDGE PT PARKWAY PO BOX 5065 PO BOX 100159 1775 SPECTRUM DRIVE PO BOX 740042 3003 SUMMIT BLVD PO BOX 105536 1908 CLIFF VALLEY WAY NE 241 RALPH MCGIL BLVD ADDRESS LINE 2 SUITE 600 SUITE 200 SUITE 600 SUITE 100 SUITE 1200 SUITE 300 2ND FLOOR #208 SUITE 241B 360 MARKET PLACE SUITE 600 BLDG 400 SUITE 300 SUITE 200 SUITE 200 SAFECO PLAZA SUITE 200 SUITE 360 SUITE 600 SUITE 200 SUITE E500 PO BOX 650665 SUITE 200 SUITE 200 SUITE 200 SUITE 200 SUITE 500 SUITE 200 SUSITE 330 SUITE 100 SUITE 350 SUITE 400 SUITE 600 SUITE 200 2501 N 4TH PLACE SUITE 100 SUITE 100 SUITE 200 CITY STATE ZIP ALPHARETTA GA 30004 TULSA OK 94101-3475 TUCKER GA 30084 ROSWELL GA 30076 TUCKER GA 30084 COUNCIL BLUFFS IA 51502 ATLANTA GA 30342 LITTLE ROCK AR 72202 ATLANTA GA 30346-1903 AUGUSTA GA 30901 CHARLOTTE NC 28229-5700 ATLANTA GA 30374-0042 ALPHARETTA GA 30023-1818 SAVANNAH GA 31405 ATLANTA GA 30374 ROSWELL GA 30077-1447 TUCKER GA 30084 ALPHARETTA GA 30004 CHATTANOOGA TN 37405 DULUTH GA 30096 ATLANTA GA 30374-0042 CHARLOTTE NC 28219 NORCROSS GA 30093 NORCROSS GA 30093 ATLANTA GA 30325 LAKE MARY FL 32795-8422 MURFREESBORO TN 37133 ALPHARETTA GA 30023 DULUTH GA 30097 DULUTH GA 30097 NORCROSS GA 30093 ST LOUIS MO 63146 PLANT CITY FL 33563 ATLANTA GA 30339 ATLANTA GA 30325 TUCKER GA 30084 NORCROSS GA 30092 ST LOUIS MO 63146 ATLANTA GA 30374-0042 ATLANTA GA 30338 MANGO FL 33550 DALLAS TX 75265-0665 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 333619 CHARLOTTE NC 28277 CHARLOTTE NC 28277 CHARLOTTE NC 28277 CHARLOTTE NC 28277 LAKE MARY FL 32746 ATLANTA GA 30328 AURORA IL 60504 NASHVILLE TN 37214 ATLANTA GA 30328 ATLANTA GA 30341 RICHMOND VA 23260-6363 DULUTH GA 30097 DULUTH GA 30096 MARIETTA GA 30006 TUCKER GA 30084 NORCORSS GA 30092 ROGERS AR 72756 ATLANTA GA 30374-0042 COCKEYSVILLE MD 21030 ATLANTA GA 30302 ATLANTA GA 30302 COLUMBIA SC 29202-3159 LAWRENCEVILLE GA 30043 ATLANTA GA 30374-0042 ATLANTA GA 30319 ATLANTA GA 30328 ATLANTA GA 30329 ATLANTA GA 30302 TELEPHONE 770 752 0122 918 615 7754 800 354 6494 800 685 7361 800 354 6494 712 329 3616 404 497 6545 800 224 3104 800 477 1903 706 826 1010 678 258 8000 800 238 6214 800 928 9096 770 998 7411 800 354-6494 770 752 0122 800 884 1535 888 674 2524 678 258 8000 770 849 0242 800 445 9058 800 548 1373 800 707 8893 800 695 0359 678 417 3654 678 417 3654 770 849 0242 888 372 7512 888 878 0005 800 862 4252 800 445 9058 800 354 6494 800 450 0692 678 258 8000 770 901 3185 800 303 4437 888 291 8298 800 238 6214 800 762 5573 800 387 8734 800 688 9656 800 688 9656 800 688 9656 800 688 9656 800 824 1732 877 673 9222 630 692 8225 800 541 0139 678 338 4171 770 458 6494 800 338 2487 770 280 2501 770 818 1517 800 354 6494 800 450 0692 479 636 0198 678 258 8000 410 666 7550 800 249 9243 866 572 7586 800 845 2724 800 421 0710 678 258 8000 800 241 7570 888 590 9487 404 560 2881 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 10243 10224 12053 13230 21042 13063 21543 12099 21117 13185 13185 20870 20987 20338 10287 10287 10287 10149 10149 10149 12055 12055 12055 10200 10200 10200 10150 10150 10150 13206 13206 13206 10216 21569 13053 10159 10163 10164 20788 21114 13238 21473 20572 13186 21721 21568 21535 13224 21585 21387 21463 20492 21685 21429 21557 12003 13211 13239 12091 13237 10170 10171 10001 10001 10001 12016 12016 12016 13064 13064 13064 12017 12017 Insurance Carriers/Self-Insureds/Group Funds SOUTHERN FIRE & CASUALTY COMPANY SOUTHERN GUARANTY INSURANCE COMPANY SOUTHERN GUARANTY INSURANCE COMPANY OF GA SOUTHERN INSURANCE COMPANY OF VIERGINIA SOUTHERN MILLS INC. SOUTHERN MUTUAL CHURCH INSURANCE COMPANY SOUTHERN PAN SERVICES SOUTHERN PILOT INSRUANCE COMPANY SOUTHERN REGIONAL HEALTH SYSTEM SOUTHERN STATES INSURANCE EXCHANGE (MULTI-TPA) SOUTHERN STATES INSURANCE EXCHANGE (MULTI-TPA) SOUTHWIRE COMPANY SPARTA, CITY OF ST FRANCIS HOSPITAL ST PAUL FIRE & CASUALTY INSURANCE CO (MULTI-TPA) ST PAUL FIRE & CASUALTY INSURANCE CO (MULTI-TPA) ST PAUL FIRE & CASUALTY INSURANCE CO (MULTI-TPA) ST PAUL FIRE & MARINE INSURANCE CO (MULTI-TPA) ST PAUL FIRE & MARINE INSURANCE CO (MULTI-TPA) ST PAUL FIRE & MARINE INSURANCE CO (MULTI-TPA) ST PAUL GUARDIAN INSURANCE COMPANY (MULTI-TPA) ST PAUL GUARDIAN INSURANCE COMPANY (MULTI-TPA) ST PAUL GUARDIAN INSURANCE COMPANY (MULTI-TPA) ST PAUL MEDICAL LIABILITY (MULTI-TPA) ST PAUL MEDICAL LIABILITY (MULTI-TPA) ST PAUL MEDICAL LIABILITY (MULTI-TPA) ST PAUL MERCURY INSURANCE COMPANY (MULTI-TPA) ST PAUL MERCURY INSURANCE COMPANY (MULTI-TPA) ST PAUL MERCURY INSURANCE COMPANY (MULTI-TPA) ST PAUL PROTECTIVE INSURANCE (MULTI-TPA) ST PAUL PROTECTIVE INSURANCE (MULTI-TPA) ST PAUL PROTECTIVE INSURANCE (MULTI-TPA) STANDARD FIRE INSURANCE COMPANY STANLEY WORKS & SUBSIDIARIES STAR INSURANCE STATE AUTO PROPERTY AND CASUALTY STATE AUTOMOBILE MUTUAL INSURANCE STATE FARM FIRE & CASUALTY COMPANY STATE OF GEORGIA STONE CONTAINER CORP STONEBRIDGE CASUALTY INSURANCE COMPANY SUD-CHEMIE INC & SUBSIDIARIES SUTHERLANDS FOODSERVICE T.H.E. INSURANCE COMPANY TALON EQUITIES INC TANNER HEALTH SERVICES TARGET CORPORATION TECHNOLOGY INSURANCE COMPANY TERMINIX SERVICE INC TEXTRON INC THERMAL CERAMICS INC THOMASVILLE, CITY OF THREE SPRINGS INC TIP TOP POULTRY INC TM POLYFILM INC TOKIO MARINE & FIRE INSURANCE COMPANY TOKIO MARINE & NICHIDO FIRE INSURANCE TOWER INSURANCE COMPANY OF NEW YORK TRANS PACIFIC INSURANCE COMPANY TRANSGUARD INSURANCE COMPANY OF AMERICA INC TRANSPORT INSURANCE COMPANY TRANSPORTATION INSURANCE COMPANY TRAVELERS CASUALTY & SURETY CO (MULTI-TPA) TRAVELERS CASUALTY & SURETY CO (MULTI-TPA) TRAVELERS CASUALTY & SURETY CO (MULTI-TPA) TRAVELERS CASUALTY & SURETY OF AMERICA (MULTI-TPA) TRAVELERS CASUALTY & SURETY OF AMERICA (MULTI-TPA) TRAVELERS CASUALTY & SURETY OF AMERICA (MULTI-TPA) TRAVELERS CASUALTY CO OF CONNECTICUT (MULTI-TPA) TRAVELERS CASUALTY CO OF CONNECTICUT (MULTI-TPA) TRAVELERS CASUALTY CO OF CONNECTICUT (MULTI-TPA) TRAVELERS CASUALTY INS CO OF ILLINOIS (MULTI-TPA) TRAVELERS CASUALTY INS CO OF ILLINOIS (MULTI-TPA) Address Line 1 ONE GENERAL DRIVE ONE GENERAL DRIVE ONE GENERAL DRIVE 3237 SATELLITE BLVD 6501 MALL BLVD PO BOX 9346 2385 LITHONIA INDUSTRIAL BLVD ONE GENERAL DRIVE 11 UPPER RIVERDALE ROAD SW PO BOX 26234 Address Line 2 SUITE 300 PO BOX 289 City/State/Zip SUN PRAIRIE WI 53596 SUN PRAIRIE WI 53596 SUN PRAIRIE WI 53596 DULUTH GA 30096 UNION CITY GA 30291 COLUMBIA SC 29290 LITHONIA GA 30058 SUN PRAIRIE WI 53596 RIVERDALE GA 32074-2600 RICHMOND VA 34360 ONE SOUTHWIRE DRIVE PO BOX H 380 MARKET PLACE 385 WASHINGTON STREET CARROLLTON GA 30119 SPARTA GA 31087 ROSWELL GA 30077 ST PAUL MN 55102 385 WASHINGTON STREET ST PAUL MN 55102 385 WASHINGTON STREET ST PAUL MN 55102 385 WASHINGTON STREET ST PAUL MN 55102 385 WASHINGTON STREET ST PAUL MN 55102 385 WASHINGTON STREET ST PAUL MN 55102 ONE TOWER SQUARE 1000 STANLEY DRIVE 26255 AMERICAN DRIVE 518 EAST BROAD STREET 518 EAST BROAD STREET ONE STATE FARM PLAZA CAPITOL HILL STATION 8182 MARYLAND AVE 520 PARK AVENUE DBA UNITED CATALYST PO BOX 786 10451 GULF BLVD. 8024 FAIR OAKS COURT 802 DIXIE STREET 1000 NICOLLET MALL 59 MAIDEN LANE 3618 FERNANDINA ROAD AON RISK CONSULTANTS PO BOX 923 PO BOX 1540 247 CHATEAU DRIVE PO BOX 6338 503 GIL HARBIN INDUSTRIAL BLVD 230 PARK AVE 230 PARK AVENUE 120 BROADWAY 230 PARK AVENUE 700 OAKMONT LANE 4100 HARRY HINES BLVD CNA CENTER 28TH FLOOR ONE TOWER SQUARE HARTFORD CT 06183 NEW BRITAIN CT 06053 SOUTHFIELD MN 48034-6112 COLUMBUS OH 43215 COLUMBUS OH 43215 BLOOMINGTON, IL 61710 ATLANTA GA 30334 ST LOUIS MO 63105 BALTIMORE MD 21044 LOUISVILLE KY 40232 FOREST PARK GA 30298 TREASURE ISLAND FL 33706 JONESBORO GA 30236-3299 CARROLLTON GA 30117 MINNEAPOLIS MN 55403 NEW YORK NY 10038 COLUMBIA SC 29210 MINNEAPOLIS MN 55437 AUGUSTA GA 30903 THOMASVILE GA 31799 HUNTSVILLE AL 35801 MARIETTA GA 30065 VALDOSTA GA 31601 NEW YORK NY 10169 NEW YORK NY 10169 NEW YORK NY 10271 NEW YORK NY 10169 WESTMONT IL 60559 DALLAS TX 75219 CHICAGO IL 60604 HARTFORD CT 06183 PO BOX 38198 PO BOX 32370 MAIL STOP TPN 1300 6TH FLOOR 8300 NORMAN CTR DR #400 1131 EAGLETREE LANE 31ST FLOOR 333 SOUTH WABASH ONE TOWER SQUARE HARTFORD CT 06183 ONE TOWER SQUARE HARTFORD CT 06183 ONE TOWER SQUARE HARTFORD CT 06183 Telephone CLAIMS HANDLING 800 362 5448 CRAWFORD & COMPANY 800 362 5448 CRAWFORD & COMPANY 800 362 5448 CRAWFORD & COMPANY SOUTHERN INSURANCE COMPANY 770 969 1000 AMTRUST SOUTH/COVENANT 800 922 5332 SOUTHEASTERN CLAIMS SERVICES INC 678 301 2400 AMTRUST SOUTH/COVENANT 404 497 6545 CRAWFORD & COMPANY 770 991 8394 AMTRUST SOUTH/COVENANT 877 243 6677 SOUTHERN STATES CRAWFORD & COMPANY 770 832 4730 SOUTHWIRE RISK MANAGEMENT 706 444 5753 CITY OF SPARTA RISK MANAGEMENT 706 596 4140 CLAIMS MANAGEMENT SERVICES 800 328 2189 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 800 328 2189 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 800 328 2189 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 800 328 2189 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 800 328 2189 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 800 328 2189 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 860 954 5660 TRAVELERS COMPANIES 860 827 3872 SPECIALTY RISK SERVICES 800 482 2726 ASSOCIATION SELF-INSURANCE SERVICES 800 444 9950 STATE AUTO 800 444 9950 STATE AUTO 309 766 5249 STATE FARM 404 463 1499 KEY RISK MANAGEMENT SERVICES 314 746 1313 CRAWFORD & COMPANY 800 233 4624 GALLAGHER BASSETT SERVICES 502 634 7200 CLAIMS MANAGEMENT SERVICES 404 366 8550 SAVELL & WILLIAMS 800 438 7740 CRAWFORD & COMPANY 770 471 8089 UNISOURCE ADMINISTRATORS 770 838 8845 CLAIMS MANAGEMENT SERVICES 612 761 1154 SEDGWICK CMS AMTRUST SOUTH/COVENANT 803 772 1783 HEWITT COLEMAN ASSOCIATES 952 656 8260 BROADSPIRE SERVICES 706 796 4287 UNDERWRITERS SAFETY & CLAIMS 912 228 7673 CITY OF THOMASVILLE RISK MGMT 256 880 3339 GALLAGHER BASSETT SERVICES 770 973 8070 CLAIMS MANAGEMENT SERVICES 229 247 7734 UNDERWRITERS SAFETY & CLAIMS 212 297 6986 TOKIO MARINE MANAGEMENT 212 297 6062 TOKIO MARINE MANAGEMENT 212 655 2018 GALLAGHER BASSETT SERVICES 212 297 6986 TOKIO MARINE MANAGEMENT TRANSGUARD INSURANCE 800 527 5412 TRANSPORT INSURANCE 312 822 4314 CNA CLAIMPLUS 860 954 5660 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 860 954 5660 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 860 954 5660 TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES 860 954 5660 TRAVELERS COMPANIES TRAVELERS COMPANIES UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 100 GLENRIDGE PT PARKWAY 100 GLENRIDGE PT PARKWAY 100 GLENRIDGE PT PARKWAY 3237 SATELLITE BLVD PO BOX 740042 PO BOX 27180 PO BOX 740042 100 GLENRIDGE PT PARKWAY PO BOX 740042 6606 WEST BROAD STREET PO BOX 2172 ONE SOUTHWIRE DRIVE PO BOX H PO BOX 1447 CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE CALLER SERVICES 1818 2097 SATELLITE BLVD 3236 QUEEN PALM DRIVE CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE 3632 QUEEN PALM DRIVE 3097 SATELLITE BLVD CALLER SERVICES 1818 CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE CALLER SERVICES 1818 PO BOX 60000 2500 FAIRLANE DRIVE PO BOX 7183 PO BOX 7183 11350 JOHNS CREEK PARKWAY C/O DOAS 100 GLENRIDGE PT PARKWAY 601 VESTAVIA PARKWAY PO BOX 1447 THE EQUITABLE BLDG PO BOX 14409 3740 DAVINCI COURT PO BOX 1447 PO BOX 958422 PO BOX 740042 PO BOX 5500 655 ENGINEERING DRIVE 5105 PAULSEN STREET PO BOX 1540 100 CRESCENT CENTRE PARKWAY PO BOX 1447 5105 PAULSEN STREET ONE RAVINIA DRIVE ONE RAVINIA DRIVE 100 CRESCENT CENTRE PARKWAY ONE RAVINIA DRIVE 700 OAKMONT LANE 4100 HARRY HINES BLVD 2435 COMMERCE AVENUE CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE 3632 QUEEN PALM DRIVE CALLER SERVICES 1818 3097 SATELLITE BLVD CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE 3097 SATELLITE BLVD CALLER SERVICES 1818 ADDRESS LINE 2 SUITE 100 SUITE 100 SUITE 100 SUITE 300 SUITE 100 360 MARKET PLACE SUITE 100 PO BOX 38198 SUITE 100 SUITE 251 360 MARKET PLACE SUITE 1500 SUITE 100 360 MARKET PLACE SUITE 200 SUITE 241B SUITE 600 360 MARKET PLACE SUITE 241B SUITE 1130 SUITE 1130 SUITE 600 SUITE 1130 BLDG 2200 SATELLITE BLVD CITY STATE ZIP ATLANTA GA 30342 ATLANTA GA 30342 ATLANTA GA 30342 DULUTH GA 30096 ATLANTA GA 30374-0042 MACON GA 31221 ATLANTA GA 30374-0042 ATLANTA GA 30342 ATLATNA GA 30374-0042 RICHMOND VA 23230 VALDOSTA GA 31603 CARROLLTON GA 30119 SPARTA GA 31087 ROSWELL GA 30077-1447 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 TAMPA FL 33619 DULUTH GA 30096 ALPHARETTA GA 30023 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 ALPHARETTA GA 30023 ATLANTA GA 30325 MONTGOMERY AL 36116 INDIANAPOLIS IN 46208 INDIANAPOLIS IN 46208 DULUTH GA 30098 ATLANTA GA 30334 ATLANTA GA 30302 BIRMINGHAM AL 35216 ROSWELL GA 30077-1447 ATLANTA GA 30303 SAVANNAH GA 31406 NORCROSS GA 30092 ROSWELL GA 30077-1447 LAKE MARY FL 32795-8422 ATLANTA GA 30374 GREENVILLE SC 29606 NORCROSS GA 30092 SAVANNAH GA 31405 THOMASVILLE GA 31799 TUCKER GA 30084 ROSWELL GA 30077-1447 SAVANNAH GA 31405 ATLANTA GA 30346 ATLANTA GA 30346 TUCKER GA 30084 ATLANTA GA 30346 WESTMONT IL 60559 DALLAS TX 75219 DULUTH GA 20096 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33691 TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 DULUTH GA 30096 ALPHARETTA GA 30023 TELEPHONE 404 497 6545 404 497 6545 800 277 7442 678 258 8000 800 471 2103 678 258 8000 404 497 6545 678 258 8000 877 243 6677 229 242 0523 770 832 4730 706 444 5753 770 998 7411 800 238 6214 800 241 9245 800 387 8734 800 238 6214 800 241 9245 800 387 8734 800 238 6214 800 241 9245 800 387 8734 800 238 6214 800 241 9245 800 387 8734 800 387 8734 800 241 9245 800 238 6214 800 238 6214 800 241 9245 800 387 8734 800 238 6214 800 445 9058 800 536 7702 800 777 7374 800 777 7324 800 816 2449 404 656-4772 800 249 9243 800 354 6494 770 998 7411 404 521 1282 866 527 7586 877 638 7876 770 998 7411 800 548 1373 678 258 8000 800 421 9139 800 450 0692 800 928 9096 912 228 7673 800 354 6496 770 998 7411 800 928 9096 800 354 6494 800 359 5928 800 474 2526 800 828 7084 800 238 6214 800 241 9245 800 387 8734 800 387 8734 800 238 6214 800 241 9245 800 238 6214 800 241 9245 800 387 8734 800 241 9245 800 238 6214 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 12017 13065 13065 13065 10218 10218 10218 10162 10162 10162 10060 10060 10060 50003 50003 50003 13039 13039 13039 21599 10237 13095 21595 10174 13157 13213 10175 10175 10175 10175 10175 10175 10175 10175 21101 13166 13166 13102 13217 20756 40015 10177 10177 10177 10177 10177 10177 10177 10177 10177 10177 10177 10177 10178 10179 21241 21688 13133 13135 20501 10180 13132 20503 13019 10181 13025 21725 10235 13222 12063 20507 21119 21629 Insurance Carriers/Self-Insureds/Group Funds TRAVELERS CASUALTY INS CO OF ILLINOIS (MULTI-TPA) TRAVELERS COMMERCIAL INSURANCE CO (MULTI-TPA) TRAVELERS COMMERCIAL INSURANCE CO (MULTI-TPA) TRAVELERS COMMERCIAL INSURANCE CO (MULTI-TPA) TRAVELERS INDEMNITY (MULTI-TPA) TRAVELERS INDEMNITY (MULTI-TPA) TRAVELERS INDEMNITY (MULTI-TPA) TRAVELERS INDEMNITY CO OF AMERICA (MULTI-TPA) TRAVELERS INDEMNITY CO OF AMERICA (MULTI-TPA) TRAVELERS INDEMNITY CO OF AMERICA (MULTI-TPA) TRAVELERS INDEMNITY CO OF CT (MULTI-TPA) TRAVELERS INDEMNITY CO OF CT (MULTI-TPA) TRAVELERS INDEMNITY CO OF CT (MULTI-TPA) TRAVELERS INSURANCE (SUBSTITUTE) (MULTI-TPA) TRAVELERS INSURANCE (SUBSTITUTE) (MULTI-TPA) TRAVELERS INSURANCE (SUBSTITUTE) (MULTI-TPA) TRAVELERS PROPERTY CASUALTY-AMERICA (MULTI-TPA) TRAVELERS PROPERTY CASUALTY-AMERICA (MULTI-TPA) TRAVELERS PROPERTY CASUALTY-AMERICA (MULTI-TPA) TRC STAFFING SERVICES INC TRINITY UNIVERSAL INSURANCE COMPANY TRINITY UNIVERSAL OF KANSAS TROUP COUNTY BOARD OF EDUCATION TRUCK INSURANCE EXCHANGE TRUMBULLL INSURANCE COMPANY TRUSTGUARD INSURANCE COMPANY TWIN CITY FIRE INSURANCE COMPANY (MULTI-TPA) TWIN CITY FIRE INSURANCE COMPANY (MULTI-TPA) TWIN CITY FIRE INSURANCE COMPANY (MULTI-TPA) TWIN CITY FIRE INSURANCE COMPANY (MULTI-TPA) TWIN CITY FIRE INSURANCE COMPANY (MULTI-TPA) TWIN CITY FIRE INSURANCE COMPANY (MULTI-TPA) TWIN CITY FIRE INSURANCE COMPANY (MULTI-TPA) TWIN CITY FIRE INSURANCE COMPANY (MULTI-TPA) TYSON FOODS INCORPORATED U.S. SPECIALTY INSURANCE COMPANY (MULTI-TPA) U.S. SPECIALTY INSURANCE COMPANY (MULTI-TPA) ULICO CASUALTY COMPANY UNION INSURANCE COMPANY UNITED AIRLINES INC UNITED BUSINESS INSURANCE CO (A MUTUAL CAPTIVE) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIDELITY & GUARANTY (MULTI-TPA) UNITED STATES FIRE INSURANCE COMPANY UNIVERSAL UNDERWRITERS UNIVERSITY HOSPITAL USF HOLLAND USF&G BUSINESS INSURANCE COMPANY USF&G INSURANCE COMPANY OF WISCONSIN USX CORPORATION UTICA MUTUAL INSURANCE COMPANY UTICA NATIONAL ASSURANCE COMPANY VALDOSTA, CITY OF VALIANT INSURANCE COMPANY VALLEY FORGE INSURANCE COMPANY VANLINER INSURANCE COMPANY VARIETY WHOLESALERS VIGILANT INSURANCE COMPANY VININGS INSURANCE COMPANY VIRGINIA SURETY VULCAN MATERIALS COMPANY WAFFLE HOUSE INC WAGGONERS TRUCKING (THE) Address Line 1 Address Line 2 City/State/Zip Telephone ONE TOWER SQUARE HARTFORD CT 06183 860 954 5660 ONE TOWER SQUARE HARTFORD CT 06183 860 954 5660 ONE TOWER SQUARE HARTFORD CT 06183 800 954 5660 ONE TOWER SQUARE HARTFORD CT 06183 860 954 5660 ONE TOWER SQUARE HARTFORD CT 06183 860 954 5660 ONE TOWER SQUARE HARTFORD CT 06183 860 954 5660 ATLANTA GA 30338 DALLAS TX 75265 DALLAS TX 75265 LAGRANGE GA 30241 LOS ANGELES CA 90051 HARTFORD CT 06115 COLUMBUS OH 63206-2085 HARTFORD CT 06183 770 392 1411 800 777 2249 800 777 2249 706 883 1545 323 923 3395 860 547 7823 800 422 0550 860 954 5660 100 ASHFORD CENTER NORTH PO BOX 655028 PO BOX 655028 PO BOX 1228 PO BOX 2478 HARTFORD PLAZA 650 SOUTH FRONT STREET HARTFORD PLAZA SUITE 500 TERMINAL ANNEX 2210 OAKLAWN 13403 NORTHWEST FREEWAY SPRINGDALE AR 72762 HOUSTON TX 77040 479 290 4278 713 996 1115 1625 EYE STREET NW PO BOX 152180 PO BOX 66100 350 FRANKLIN ROAD 3835 WASHINGTON STREET WASHINGTON DC 20006 IRVING TX 75015 CHICAGO IL 60666-0100 MARIETTA GA 30067 ST PAUL MN 55102 800 431 5425 800 444 0049 847 700 7504 678 766 8242 800 690 5520 305 MADISON AVENUE 7045 COLLEGE BLVD 1350 WALTON WAY C/O YRC WORLDWIDE 385 WASHINGTON STREET 385 WASHINGTON STREET 600 GRANT STREET 180 GENESEE STREET 180 GENESEE STREET 216 E CENTRAL AVENUE 1400 AMERICAN LANE 28TH FLOOR ONE PREMIER DRIVE PO BOX 947 15 MOUNTAIN VIEW ROAD 2410 PACES FERRY ROAD 1000 N MILWAUKEE AVENUE PO BOX 385014 PO BOX 6450 1131 HWY 101 SOUTH SUITE 330 10990 ROE AVENUE ROOM 2544 333 SOUTH WABASH SUITE 300 MORRISTOWN NJ 07962 OVERLAND PARK KS 66211 AUGUSTA GA 30901 OVERLAND PARK KS 66211 ST PAUL MN 55102 ST PAUL MN 55102 PITTSBURG PA 15219 NEW HARTFORD NY 13413 NEW HARTFORD NY 13413 VALDOSTA GA 31603 SCHAUMBURG IL 60196 CHICAGO IL 60604 ST LOUIS MO 63026 HENDERSON NC 27536 WARREN NJ 07061 ATLANTA GA 30339 GLENVIEW IL 60025 BIRMINGHAM AL 35238-5014 NORCROSS GA 30091 GREER SC 29651 800 690 5520 800 821 7803 706 774 5693 913 266 6574 800 328 2189 800 328 2189 412 433 6613 800 274 1914 800 274 1914 912 259 3544 847 605 6587 678 473 3644 800 325 3619 252 430 2188 908 903 5156 800 883 9305 312 381 9528 205 298 3074 770 729 5917 864 877 2651 CLAIMS HANDLING TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES ESIS INC TRINITY UNIVERSAL INSURANCE TRINITY UNIVERSAL INSURANCE COLLINS & COMPANY TRUCK INSURANCE HARTFORD SOUTHEAST WC CLAIMS CENTER GRANGE MUTUAL INSURANCE CLAIMS HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD SOUTHEAST WC CLAIMS CENTER HARTFORD AURORA MED ONLY CLAIMS SPECIALTY RISK SERVICES SPECIALTY RISK SERVICES GAB ROBINS NORTH AMERICA GALLAGHER BASSETT SERVICES SEDGWICK CMS TYSON FOODS RISK MANAGEMENT CRAWFORD & COMPANY GALLAGHER BASSETT SERVICES ULICO INSURANCE UNION STANDARD INSURANCE GROUP GALLAGHER BASSETT SERVICES UNITED BUSINESS INSURANCE BROADSPIRE SERVICES TRAVELERS COMPANIES DISCOVER RE MANAGERS FRANK GATES SERVICE COMPANY GAB ROBINS NORTH AMERICA GALLAGHER BASSETT SERVICES GALLAGHER BASSETT SERVICES PMA GROUP RISK MANAGEMENT SERVICES SPECIALTY RISK SERVICES SPECIALTY RISK SERVICES SPECIALTY RISK SERVICES CRUM & FORSTER CLAIMS ZURICH NORTH AMERICA CLAIMS DIV. UNDERWRITERS SAFETY & CLAIMS TRAVELERS COMPANIES TRAVELERS COMPANIES TRAVELERS COMPANIES USX CORPORATION RISK MANAGEMENT UTICA INATIONAL CLAIMS UTICA NATIONAL AMTRUST SOUTH/COVENANT ZURICH NORTH AMERICA CLAIMS DIV. CNA CLAIMPLUS GEORGIA ADMINISTRATIVE SERVICES HEWITT COLEMAN ASSOCIATES CHUBB GROUP BUILDERS INSURANCE GROUP GALLAGHER BASSETT SERVICES VULCAN MATERIALS RISK MANAGEMENT BRENTWOOD SERVICES WAGGONERS TRUCKING RISK MGMT UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 3632 QUEEN PALM DRIVE 3632 QUEEN PALM DRIVE CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE CALLER SERVICES 1818 3097 SATELLITE BLVD CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE CALLER SERVICES 1818 3097 SATELLITE BLVD 3632 QUEEN PALM DRIVE PO BOX 100007 PO BOX 650665 10000 N CENTRAL EXPRESSWAY 555 RIVER STREET PO BOX 190 50 GLENLAKE PARKWAY PO BOX 1575 200 COLONIAL CENTER PARKWAY 50 GLENLAKE PARKWAY 4245 MERIDIAN PARKWAY 828 ROYAL OAK PARKWAY 50 GLENLAKE PARKWAY 3039 PREMIERE PARKWAY 2990 BRANDYWINE ROAD 1117 PERIMETER CENTER WEST PO BOX 3428 5620 GLENRIDGE DRIVE NE 100 CRESCENT CENTRE PARKWAY 2955 HARTLEY ROAD 122 W. CARPENTER FREEWAY 100 CRESCENT CENTRE PARKWAY 350 FRANKLIN ROAD PO BOX 5065 CALLER SERVICES 1818 5 BATTERSON PARK 701 INTERNATIONAL PARKWAY 3039 PREMIERE PARKWAY 601 VESTAVIA PARKWAY 1551 SAWGRASS CORPORATE PKWY 2359 PERIMETER POINTE PARKWAY 9100 MARKSFIELD ROAD 605 CRESCENT EXECUTIVE COURT 50 GLENLAKE PARKWAY 828 ROYAL PARKWAY PO BOX 958426 600 GALLERIA PARKWAY SE 5105 PAULSEN STREET CALLER SERVICES 1818 CALLER SERVICES 1818 CALLER SERVICES 1818 600 GRANT STREET 41 PERIMETER CENTER EAST NE 41 PERIMETER CENTER EAST NE PO BOX 740042 3033 SUMMIT BLVD 2435 COMMERCE AVENUE 1775 SPECTRUM DRIVE PO BOX 5500 3445 PEACHTREE ROAD NE 2410 PACES FERRY ROAD 100 CRESCENT CENTRE PARKWAY PO BOX 385014 PO BOX 1125 1131 HWY 101 SOUTH ADDRESS LINE 2 PO BOX 650665 SUITE 500 SUITE 200 SUITE 900 SUITE 100 SUITE 500E SUITE 600 SUITE 104 SUITE 350 SUITE 600 SUITE 330 SUITE 175 SUITE 900 SUITE 251 SUITE 220 SUITE 250 BLDG 3 2ND FLOOR SUITE 330 SUITE 200 SUITE 990 SUITE 241B ROOM 2544 SUITE 300 SUITE 300 BLDG 2200 SATELLITE PLACE 2 LIVE OAK CENTER #900 SUITE 300 SUITE 600 CITY STATE ZIP TAMPA FL 33619 TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 ALPHARETTA GA 30023 DULUTH GA 30096 TAMPA FL 33619 ROSWELL GA 30077 DALLAS TX 75265-0665 DALLAS TX 75265-0665 CHATTANOOGA TN 37405 NORTH AURORA IL 60542 ATLANTA GA 30328 WARRENVILLE IL 60555 LAKE MARY FL 32746 ATLANTA GA 30328 AURORA IL 60504 NASHVILLE TN 37214 ATLANTA GA 30328 DULUTH GA 30097 ATLANTA GA 30341 ATLANTA GA 30338 OXFORD AL 36203 ATLANTA GA 30342 TUCKER GA 30084 JACKSONVILLE FL 32257 IRVING TX 75039 TUCKER GA 30084 MARIETTA GA 30067 ATLANTA GA 30302-5065 ALPHARETTA GA 30023 FARMINGTON CT 06030 LAKE MARY FL 32746 DULUTH GA 30097 BIRMINGHAM AL 35216 SUNRISE FL 33323 CHARLOTTE NC 28208 LOUISVILLE KY 40222 LAKE MARY FL 32746 ATLANTA GA 30328 NASHVILLE TN 37214 LAKE MARY FL 32795 ATLANTA GA 30339-5994 SAVANNAH GA 31405 ALPHARETTA GA 30023-1818 ALPHARETTA GA 30023 ALPHARETTA GA 30023 PITTSBURGH PA 14219 ATLANTA GA 30346-1903 ATLANTA GA 30346-1903 ATLANTA GA 30374-0042 ATLANTA GA 30319 DULUTH GA 30096 LAWRENCEVILLE GA 30043 GREENVILLE SC 29606 ATLANTA GA 30326 ATLANTA GA 30339 TUCKER GA 30084 BIRMINGHAM AL 35238 BRENTWOOD TN 37024 GREER SC 29650 TELEPHONE 800 387 8734 800 387 8734 800 238 6214 800 241 9245 800 387 8734 800 238 6214 800 241 9245 800 238 6214 800 241 9245 800 387 8734 800 238 6214 800 241 9245 800 387 8734 800 238 6214 800 241 9245 800 387 8734 800 238 6214 800 241 9245 800 387 8734 678 795 4506 888 291 8298 888 291 8298 800 884 1535 800 357 3204 800 935 5300 800 824 1732 800 824 1732 800 824 1732 800 841 0139 800 541 0139 800 616 6446 770 458 6494 770 901 3185 256 831 4381 404 847 4007 904 880 4757 800 444 0049 800 354 6494 678 766 8242 404 497 6253 800 238 6214 866 657 2827 800 423 3060 800 433 8842 800 928 9096 800 238 6214 800 238 6214 800 238 6214 412 433 6613 800 477 1914 800 477 1914 678 258 8000 800 241 7570 800 282 7084 800 421 0710 800 421 9139 404 266 4127 800 883-9305 800 354 6494 205 298 3001 800 524 0604 800 462 0602 Consult the Enforcement Division for Claims Handling Information 3/31/2008 INSURER REPORT SBWC # 21661 21735 20349 21357 10095 10095 13116 13116 12036 20451 21206 21626 20548 10275 12084 13044 20509 13204 20726 21353 21754 13120 20889 13236 13081 13081 13081 13081 20551 21601 13056 10143 10187 13017 50001 50001 Insurance Carriers/Self-Insureds/Group Funds WALKER COUNTY BOARD OF EDUCATION WALTON COUNTY BOARD OF EDUCATION WAREHOUSE HOME FURNISHINGS INC WARNER ROBINS, CITY OF WAUSAU BUSINESS INSURANCE (MULTI-TPA) WAUSAU BUSINESS INSURANCE (MULTI-TPA) WAUSAU GENERAL INSURANCE (MULTI-TPA) WAUSAU GENERAL INSURANCE (MULTI-TPA) WAUSAU UNDERWRITER INSURANCE COMPANY WAYCROSS, CITY OF WELLINGTON LEISURE PRODUCTS WELLSTAR HEALTH SYSTEM WENDY'S INTERNATIONAL WEST AMERICAN INSURANCE COMPANY WESTFIELD INSURANCE COMPANY WESTFIELD NATIONAL INSURANCE COMPANY WESTPOINT STEVENS INC WESTPORT INSURANCE CORPORATION WEYERHAEUSER COMPANY WHITFIELD COUNTY BOARD OF EDUCATION WILD ADVENTURES VALDOSTA LLC WILLIAMSBURG NATIONAL INSURANCE WINN-DIXIE STORES INC WORK FIRST CASUALTY COMPANY XL SPECIALTY INSURANCE (MULTI-TPA) XL SPECIALTY INSURANCE (MULTI-TPA) XL SPECIALTY INSURANCE (MULTI-TPA) XL SPECIALTY INSURANCE (MULTI-TPA) YELLOW TRANSPORTATION YKK CORPORATION YORK INSURANCE COMPANY ZENITH INSURANCE COMPANY ZURICH AMERICAN INSURANCE COMPANY ZURICH AMERICAN INSURANCE COMPANY OF ILLINOIS ZURICH/AMERICAN GUARANTEE (MULTI-TPA) ZURICH/AMERICAN GUARANTEE (MULTI-TPA) Address Line 1 PO BOX 29 115 OAK STREET PO BOX 1140 PO BOX 1488 175 BERKELEY STREET Address Line 2 City/State/Zip LAFAYETTE GA 30728 MONROE GA 30655 DUBLIN GA 31040 WARNER ROBINS GA 31099 BOSTON MA 02116 Telephone 423 638 1240 770 267 6544 478 275 6188 912 929 1129 617 654 4180 175 BERKELEY STREET BOSTON MA 02116 800 344 0198 175 BERKELEY STREET PO DRAWER 99 200 IMPERIAL MILL ROAD 805 SANDY PLAINS ROAD 4288 W DUBLIN-GRANVILLE 9450 SEWARD ROAD PO BOX 5001 PO BOX 5001 PO BOX 71 5200 METCALF AVENUE PO BOX 9777 PO BOX 2167 3766 OLD CLYATTVILLE ROAD 12641 EAST 166TH STREET 505 EDGEWOOD CT 3411 SILVERSIDE ROAD 70 SEAVIEW AVENUE BOSTON MA 02116 WAYCROSS GA 31502 EATONTON GA 31029 MARIETTA GA 30066 DUBLIN OH 43017 FAIRFIELD OH 45014 WESTFIELD CENTER OH 45201 WESTFIELD CENTER OH 44251 WEST POINT GA 31833 OVERLAND PARK KS 66202 FEDERAL WAY WA 98063 DALTON GA 30720 VALDOSTA GA 31601 CERRITOS CA 90703 JACKSONVILLE FL 32254 WILMINGTON DE 19810 STAMFORD CT 06902 800 344 0198 912 287 2914 706 485 2181 770 792 7541 614 764 8452 800 843 6446 800 243 0210 800 243 0210 706 645 4672 800 255 6931 253 924 7591 706 278 8070 229 219 7111 800 482 2726 904 783 5303 FKA YELLOW FREIGHT 4234 OCMULGEE EAST BLVD 88 BOYD AVENUE 21255 CALIFA STREET 1400 AMERICAN LANE 1400 AMERICAN LANE 1400 AMERICAN LANE PO BOX 256 ONE PARK CIRCLE ONE PARK CIRCLE WORKERS COMP EC2-2B2 BARBARD BLDG STE 101 POB 7270 OVERLAND PARK KS 66207 MACON GA 31217 E PROVIDENCE RI 02901 WOODLAND HILLS CA 91367 SCHAUMBURG IL 60196-1023 SCHAUMBURG IL 60196 SCHAUMBURG IL 60196 800 622 7311 913 696 6120 478 744 6272 800 556 3825 800 200 2667 847 605 6587 847 605 6587 847 605 6591 CLAIMS HANDLING CLAIMS MANAGEMENT SERVICES SELF-INSURANCE ADMINISTRATORS INC UNDERWRITERS SAFETY & CLAIMS UNDERWRITERS SAFETY & CLAIMS WAUSAU BUSINESS INSURANCE CLAIMS WAUSAU BUSINESS INSURANCE CLAIMS WAUSAU INSURANCE GROUP WAUSAU INSURANCE GROUP WAUSAU BUSINESS INSURANCE CLAIMS CRAWFORD & COMPANY SELF-INSURANCE ADMINISTRATORS INC CLAIMS MANAGEMENT SERVICES GALLAGHER BASSETT SERVICES OHIO CASUALTY CLAIMS DIVISION WESTFIELD INSURANCE GROUP WESTFIELD INSURANCE GROUP TRAVELERS COMPANIES GALLAGHER BASSETT SERVICES WEYERHAEUSER/IMPACK RISK MGMT UNDERWRITERS SAFETY & CLAIMS AMTRUST SOUTH/COVENANT ASSOCIATION SELF-INSURANCE SERVICES SEDGWICK CMS SPECIALTY RISK SERVICES ECS CLAIM ADMINISTRATORS SEDGWICK CMS GALLAGHER BASSETT SERVICES GAB ROBINS NORTH AMERICA GALLAGHER BASSETT SERVICES GEORGIA ADMINISTRATIVE SERVICES PROVIDENCE WASHINGTON INSURANCE ZENITH INSURANCE ZURICH NORTH AMERICA CLAIMS DIV. ZURICH NORTH AMERICA CLAIMS DIV. ESIS INC CAMBRIDGE INTEGRATED SERVICES UNLAWFUL TO EDIT OR ALTER THIS REPORT.; ADDRESS LINE 1 PO BOX 1447 3473 SATELLITE BLVD PO BOX 465537 5105 PAULSEN STREET PO BOX 105067 PO BOX 945290 925 NORTHPOINT PARKWAY PO BOX 945290 925 NORTH POINT PARKWAY 100 GLENRIDGE PT PARKWAY 3473 SATELLITE BLVD PO BOX 1447 100 CRESCENT CENTRE PARKWAY PO BOX 29621 3505 KOGER BLVD 3503 KOGER BLVD CALLER SERVICES 1818 555 MARRIOTT DRIVE PO BOX 688 PO BOX 465537 PO BOX 740042 2500 FAIRLANE DRIVE 8649 BAYPINE ROAD PO BOX 305104 3525 PIEDMONT ROAD #300 1117 PERIMETER CENTER WEST 100 CRESCENT CENTRE PARKWAY 950 22ND STREET PO BOX 292109 1775 SPECTRUM DRIVE 88 BOYD AVE 900 W TRADE STREET 3033 SUMMIT BLVD 3003 SUMMIT BLVD 500 COLONIAL CENTER PARKWAY 1100 PARK CENTRAL BLVD ADDRESS LINE 2 360 MARKET PLACE SUITE 310 NORTH SUITE 241B SUITE 300 SUITE 300 SUITE 100 SUITE 310 NORTH 360 MARKET PLACE SUITE 600 SUITE 275 SUITE 275 SUITE 650 SUITE 100 BLDG 7 SUITE 300 BUILDING 7; SUITE 300 SUITE 500 SUITE 600 SUITE 680 SUITE 100 SUITE 200 SUITE 1100 CITY STATE ZIP ROSWELL GA 30077-1447 DULUTH GA 30096 LAWRENCEVILLE GA 30042 SAVANNAH GA 31405 ATLANTA GA 30348 MAITLAND FL 32794 ALPHARETTA GA 30005 MAITLAND FL 32794 ALPHARETTA GA 30005 ATLANTA GA 30302 DULUTH GA 30096 ROSWELL GA 30077-1447 TUCKER GA 30084 RALIEGH NC 26707 DULUTH GA 30096 DULUTH GA 30096 ALPHARETTA GA 30023-1818 NASHVILLE TN 37214 NEW BERN NC 28563-0688 LAWRENCEVILLE GA 30042 ATLANTA GA 30374-0042 MONTGOMERY AL 36116 JACKSONVILLE FL 32256 NASHVILLE TN 37230 ATLANTA GA 30305 ATLANTA GA 30338 TUCKER GA 30084 BIRMINGHAM AL 35203 NASHVILLE TN 37229-2109 LAWRENCEVILLE GA 30043 E PROVIDENCE RI 02914 CHARLOTTE NC 28202 ATLANTA GA 30329 ATLANTA GA 30319 ROSWELL GA 30076 POMPANO BEACH FL 33064 TELEPHONE 770 998 7411 770 344 0070 888 245 4722 800 928 9096 770 569 4889 770 569 4889 800 249 2551 770 344 0070 770 998 7411 800 354 6494 888 701 8727 800 685 4604 800 685 4604 800 238 6214 800 288 9843 800 633 1642 888 245 4722 678 258 8000 800 536 7702 904 419 5315 800 541 0139 800 354 6494 800 288 9843 800 421 0710 800 556 3825 800 200 2667 800 241 7570 800 241 7570 Consult the Enforcement Division for Claims Handling Information
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