North Carolina Department of Insurance Wayne Goodwin, Commissioner Licensed Self-Insured Workers Compensation Individual

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1 North Carolina Department of Insurance Wayne Goodwin, Commissioner Licensed Self-Insured Workers Compensation Individual Financial Evaluation Division 1201 Mail Service Center Raleigh, NC (919) Fax: (919) As of: 4/2/2015 AAA Cooper Transportation P. O. Box 6827 Dothan, AL Baxter International, Inc. One Baxter Parkway Deerfield, IL ABF Freight System, Inc. P. O. Box Fort Smith, AR Blue Cross Blue Shield of North Carolina P. O. Box 2291 Durham, NC Adventist Health System Sunbelt Healthcare Corporation 900 Hope Way Altamonte Springs, FL Boddie-Noell Enterprises, Inc. P. O. Box 1908 Rocky Mount, NC Alex Lee, Inc. P. O. Box 800 Hickory, NC Butterball, LLC One Butterball Lane Garner, NC Altec Industries, Inc. 210 Inverness Center Drive Birmingham, AL CVS Health Corporation One CVS Drive Woonsocket, RI Asplundh Tree Expert Co. 708 Blair Mill Road Willow Grove, PA CaroMont Health, Inc. P.O. Box 1747 Gastonia, NC Averitt Express, Inc. P. O. Box 3166 Cookeville, TN Case Foods, Inc. P. O. Box 729 Troutman, NC BJ's Warehouse Club, Inc. 25 Research Dr. P.O. Box 5230 Westborough, MA Coats American, Inc Toringdon Way, Suite 301 Charlotte, NC Baker, Knapp & Tubbs, Inc. 444 Highland Drive Kohler, WI Columbia Forest Products, Inc Thorndike Road Greensboro, NC Page 1 of 6

2 Consolidated Diesel Company, Inc Norman Center Drive, Suite 1000 Minneapolis, MN Costco Wholesale Corporation 999 Lake Drive Issaquah, WA Cracker Barrel Old Country Store, Inc. P. O. Box 787 Lebanon, TN Cumberland County Hospital System Inc. P. O. Box 2000 Fayetteville, NC D. H. Griffin Wrecking Company, Inc. P O Box 7657 Greensboro, NC Dart Container Corporation of Georgia 500 Hogsback Road Mason, MI Davey Tree Expert Company 1500 N Mantua St Kent, OH Delhaize America LLC P. O. Box 1330 Salisbury, NC Dolgencorp, LLC. P. O. Box 1728 Goodlettsville, TN Duke Energy Corporation P. O. Box 1244 Charlotte, NC Duke University P. O. Box Durham, NC E. I. Du Pont De Nemours & Company 1007 Market St. D-8065 Wilmington, DE Engineered Controls International, LLC P. O. Box 247 Elon, NC Estes Express Lines, Inc. P. O. Box Richmond, VA Family Dollar Stores, Inc. P.O. Box 1017 Charlotte, NC FedEx Freight, Inc. P. O. Box 840 Harrison, AR FedEx Ground Package System, Inc. P. O. Box Pittsburgh, PA Federal Express Corporation 3620 Hacks Cross Road, Building B, 3rd Floor Memphis, TN First Citizens BancShares, Inc P. O. Box Raleigh, NC FirstHealth of the Carolinas, Inc. P. O. Box 3000 Pinehurst, NC Page 2 of 6

3 Flowers Foods, Inc Flowers Circle Thomasville, GA General Motors LLC P. O. Box 69 Southfield, MI Guilford Mills, Inc Telegraph Rd Southfield, MI Halifax Regional Medical Center, Inc. and Affiliates 250 Smith Church Road P.O. Box 1089 Roanoke Rapids, NC High Point Regional Health Care System P. O. Box HP-5 High Point, NC Hillcrest Foods, Inc. 50 Satellite Blvd. Ste. G Suwanee, GA Home Depot U.S.A., Inc. & Affiliates 2455 Paces Ferry Road, NW Building C, 20 th Floor Atlanta, GA Ingles Markets, Inc. P. O. Box 6676 Asheville, NC International Paper Company 6400 Poplar Ave. Memphis, TN Kimberly-Clark Corporation PO Box 349 Neenah, WI Knight Transportation, Inc W. Buckeye Rd. Phoenix, AZ Kroger Co. and Subsidiaries, The 3631 Peters Creek Road Roanoke, VA LA-Z-Boy Incorporated 1284 N. Telegraph Road Monroe, MI Louisiana-Pacific Corporation 805 SW Broadway, Portland, OR Lowe's Companies, Inc. P. O. Box 1000 Mooresville, NC M. B. Kahn Construction Company, Inc. P. O. Box 1179 Columbia, SC Macy's Retail Holdings, Inc. 7 West Seventh Street Cincinnati, OH Marriott International, Inc Fernwood Rd. Dept 52/ Bethesda, MD MasTec Incorporated 800 Douglas Road Coral Gables, FL Masco Corporation Van Born Road Taylor, MI Page 3 of 6

4 Maxwell Family Holding Company System P. O. Box Goldsboro, NC MeadWestvaco Corporation 501 South 5th Street Richmond, VA Meritor, Inc W. Maple Road Troy, MI Mission Health, Inc. 509 Biltmore Avenue Asheville, NC Moses H. Cone Memorial Hospital 1200 North Elm Street Greensboro, NC Mount Vernon Mills Chemicals, LLC 503 South Main Street Mauldin, SC NACCO Materials Handling Group, Inc Greenville Blvd.,NE Greenville, NC Nash Johnson & Sons Farms, Inc. 441 Sunset Blvd West Columbia, SC Nordstrom, Inc. P. O. Box Seattle, WA North Carolina Granite Corporation P. O. Box 151 Mount Airy, NC Novant Health, Inc. P. O. Box Winston-Salem, NC Old Dominion Freight Lines, Inc. 500 Old Dominion Way Thomasville, NC PB Enterprises of Claremont, Inc. P.O. Box 339 Claremont, NC PCC Airfoils, LLC Chagrin Blvd. Ste.290 Beachwood, OH PPG Industries, Inc, P. O. Box 2009 Allison Park, PA PSNC Energy Mail Code 056 Columbia, SC Parkdale Mills, Inc. P. O. Box 1787 Gastonia, NC Parker Hannifin Corporation 6035 Parkland Boulevard Cleveland, OH Piedmont Natural Gas Company P. O. Box Charlotte, NC Precor Incorporated nd Ave NE Woodinville, WA Page 4 of 6

5 Procter & Gamble Company 5299 Spring Grove Avenue Cincinnati, OH Progress Energy, Inc. P. O. Box 1551 Raleigh, NC QuikTrip Corporation P.O. Box 3475 Tulsa, OK Research Triangle Institute P. O. Box Research Triangle Park, NC Reynolds American, Inc. 401 North Main Street Winston-Salem, NC Roberts Company Acquisitions, LLC (The ) 133 Forlines Road Winterville, NC Rollins, Inc Piedmont Rd., NE Atlanta, GA Saint Joseph of the Pines, Inc. 100 Gossman Drive, Suite B Southern Pines, NC STM Industries, Inc P. O. Box 2228 Hickory, NC Saia Inc. P. O. Box A Station 1 Houma, LA Sherwin Williams Company 101 Prospect Avenue, NW Cleveland, OH Southeastern Freight Lines, Inc. P. O. Box 1691 Columbia, SC Terminix Service, Inc. P. O. Box 2627 Columbia, SC Textron, Inc Norman Center Dr, Ste. 400 Minneapolis, MN The Budd Group, Inc S. Stratford Road Winston-Salem, NC Tyson Foods, Inc. P. O. Box 2020 Springdale, AR VF Corporation P. O. Box Greensboro, NC Variety Wholesalers, Inc. P. O. Box 947 Henderson, NC Vertellus Specialties, Inc. 201 N. Illinois St. Suite 1800 Indianapolis, IN Virginia Electric & Power Company P. O. Box Richmond, VA Page 5 of 6

6 Vulcan Materials Company P. O. Box Birmingham, AL Waffle House, Inc. P. O. Box 6450 Norcross, GA Wake Forest University P. O. Box 7201 Winston-Salem, NC Wake Forest University Baptist Medical Center (formerly known as North Carolina Baptist Hospital, Inc.) Medical Center Blvd. Winston-Salem, NC WakeMed P. O. Box Raleigh, NC Wendys International, Inc W. Dublin-Granville Rd. Dublin, OH Western and Southern Life Insurance Company 400 Broadway Cincinnati, OH Weyerhaeuser Company P. O. Box 9777 MS:EC2-2B2 Federal Way, WA YRC Inc Roe Avenue Overland Park, KS Count: 107 Page 6 of 6

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