INSURANCE CARRIER/SELF-INSURER LIST OF DESIGNATED CONTACTS

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1 State of New Jersey Department of Labor & Workforce Development Division of Workers Compensation INSURANCE CARRIER/SELF-INSURER LIST OF DESIGNATED CONTACTS P.L Chapter 96, effective October 1, 2008, applies to workers compensation insurance carriers and authorized self-insured employers. The law provides that: Every carrier and self-insured employer shall designate a contact person who is responsible for responding to issues concerning medical and temporary disability benefits where no claim petition has been filed or where a claim petition has not been answered. The full name, telephone number, address, address, and fax number of the contact person shall be submitted to the division. Any changes in information about the contact person shall be immediately submitted to the division as they occur. After an answer is filed with the division, the attorney of record for the respondent shall act as the contact person in the case. Failure to comply with the provisions of this section shall result in a fine of $2,500 for each day of noncompliance, payable to the Second Injury Fund. The Division has compiled the attached contact person listing from information submitted to us by workers compensation insurance carriers and authorized self-insurers. You can search for a particular company in this document by using the Find tool in Adobe Reader or by clicking on the embedded bookmarks. If you find an error with a particular entry in the attached list, please contact the following to verify our records: Joanne Allen tel: , fax: Carriers/self-insurers that have not yet designated a contact person as required by law must do so by downloading and completing the Insurance Carrier Contact form available on our website: Note: If you are a representative from a specific carrier/self-insurer who has already submitted an Insurance Carrier Contact Form to the Division but cannot locate your company in this listing, please contact us to verify that the form has been received by us. Thank you. Last revised: 12/22/2014

2 ABF FREIGHT SYSTEM, INC. RACHELLE PRATT, WC CLAIMS SPECIALIST ATTN: RISK MANAGEMENT, P.O. BOX 10048, FORT SMITH, AR TEL #: FAX #: ALLEN KING, MANAGER, WORKERS' COMP P.O. BOX FORT SMITH, AR TEL #: FAX #: ACCIDENT FUND GENERAL INSURANCE COMPANY JEAN KLUISZA, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE, LANSING, MI TEL #: FAX #: -- KAREN HOLTZ, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE LANSING, MI TEL #: FAX #: ACCIDENT FUND INSURANCE COMPANY OF AMERICA JEAN KLUISZA, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE, LANSING, MI TEL #: FAX #: -- KAREN HOLTZ, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE LANSING, MI TEL #: FAX #: ACCIDENT FUND NATIONAL INSURANCE COMPANY JEAN KLUISZA, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE, LANSING, MI TEL #: FAX #: -- KAREN HOLTZ, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE LANSING, MI TEL #: FAX #: ACE AMERICAN INSURANCE COMPANY PAM LLEWELLYN, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E, WILMINGTON DE TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 1

3 GUS GONNELLA, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E WILMINGTON DE TEL #: FAX #: ACE FIRE UNDERWRITERS INSURANCE COMPANY PAM LLEWELLYN, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E, WILMINGTON DE TEL #: FAX #: GUS GONNELLA, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E WILMINGTON DE TEL #: FAX #: ACE PROPERTY & CASUALTY INSURANCE COMPANY PAM LLEWELLYN, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E, WILMINGTON, DE TEL #: FAX #: GUS GONNELLA, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E WILMINGTON, DE TEL #: FAX #: ACIG INSURANCE COMPANY RON ARTHUR, VICE PRESIDENT - CLAIMS MANAGER MERIT DRIVE, SUITE 1660, DALLAS, TX TEL #: FAX #: SUSIE MCGEE, VICE PRESIDENT - CLAIMS MERIT DRIVE, SUITE 1660 DALLAS, TX TEL #: FAX #: ACME MARKETS, INC. JEAN MICHETTI, TEAM LEADER SPECIALTY RISK SERVICES (SRS), 150 SOUTH WARNER ROAD, KING OF PRUSSIA, PA TEL #: FAX #: CASSANDRA GOMEZ, OPERATIONS MANAGER SPECIALTY RISK SERVICES (SRS), 4245 MERIDIAN PARKWAY AURORA, IL TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 2

4 ADVANTAGE WORKERS COMPENSATION INSURANCE COMPANY TERESA J. MARECK, VICE PRESIDENT & GENERAL COUNSEL P.O. BOX , SALT LAKE CITY, UT TEL #: FAX #: GWEN E. CHURCH, ASSISTANT VICE PRESIDENT P.O. BOX SALT LAKE CITY, UT TEL #: FAX #: AIG PROPERTY CASUALTY COMPANY JANICE MOORE, ASST. VICE PRESIDENT CHARTIS, P.O. BOX 4050, ALPHARETTA, GA TEL #: FAX #: MELODY KENSEY, ADMINISTRATIVE ASSISTANT CHARTIS, P.O. BOX 4050 ALPHARETTA, GA TEL #: FAX #: ALCATEL-LUCENT USA INC SHERRY D BAKER, CLAIMS MANAGER 624 S.E. 29TH STREET, CAPE CORAL, FL TEL #: FAX #: SOPHIE CHEVILLET, DIRECTOR NA RISK MANAGEMENT 600 MOUNTAIN AVENUE, ROOM 7B-503 MURRAY HILL, NJ TEL #: FAX #: ALLAMERICA FINANCIAL ALLIANCE INSURANCE COMPANY CHERYL UNGAR, WC UNIT MANAGER P.O. BOX 15144, WORCESTER, MA TEL #: FAX #: PAULA ANDRADE, WC UNIT MANAGER P.O. BOX WORCESTER, MA TEL #: FAX #: ALLAMERICA FINANCIAL BENEFIT INSURANCE COMPANY CHERYL UNGAR, WC UNIT MANAGER P.O. BOX 15144, WORCESTER, MA TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 3

5 PAULA ANDRADE, WC UNIT MANAGER P.O. BOX WORCESTER, MA TEL #: FAX #: ALLIANCE NATIONAL INSURANCE COMPANY JOHN EAGEN, MANAGER 220 W. GERMANTOWN PIKE, PLYMOUTH MEETING, PA TEL #: FAX #: MARY BETH TORUNIAN, UNDERWRITER 220 W. GERMANTOWN PIKE PLYMOUTH MEETING, PA TEL #: FAX #: ALLIED EASTERN INDEMNITY COMPANY KELLI CHAPMAN, DIRECTOR OF CLAIMS 25 RACE AVENUE, LANCASTER PA TEL #: ext FAX #: TARA HOOPER, MANAGER OF REGIONAL CLAIMS 25 RACE AVENUE LANCASTER PA TEL #: ext FAX #: AMERICAN ALTERNATIVE INSURANCE COMPANY CHARLES KROH, VICE PRESIDENT 555 COLLEGE ROAD EAST, PRINCETON, NJ TEL #: FAX #: STEPHEN DIONISIO, VICE PRESIDENT 555 COLLEGE ROAD EAST PRINCETON, NJ TEL #: FAX #: AMERICAN AUTOMOBILE INSURANCE COMPANY THOMAS CUEL, SR. CLAIMS DIRECTOR GREAT OAKS WAY, SUITE 200, ALPHARETTA, GA TEL #: FAX #: JENNIFER FELCH, WORKERS' COMPENSATION SUPERVISOR GREAT OAKS WAY, SUITE 200 ALPHARETTA, GA TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 4

6 AMERICAN CASUALTY COMPANY OF READING PA DIANE WEBER, CLAIM MANAGER CNA, 401 PENN STREET, READING, PA TEL #: FAX #: ELIZABETH SIEKS, WC OPERATIONS ANALYSIS CONSULTING DIRECTOR CNA, 333 S. WABASH AVE., 39S CHICAGO, IL TEL #: FAX #: AMERICAN COMPENSATION INSURANCE COMPANY SUSAN PILON, MANAGER OF NATIONAL CLAIM QUALITY & COMPLIANCE P.O. BOX , MINNEAPOLIS, MN TEL #: FAX #: AMY HAWLEY, DIRECTOR OF OPERATIONS P.O. BOX MINNEAPOLIS, MN TEL #: FAX #: AMERICAN FIRE & CASUALTY INSURANCE COMAPNY TODD GANCARZ, UNIT LEADER 5062 BRITTONFIELD PARKWAY, E. SYRACUSE, NY TEL #: FAX #: KAREN PEINKOFER, UNIT LEADER 5062 BRITTONFIELD PARKWAY E. SYRACUSE, NY TEL #: FAX #: AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY BRIAN M. DOOLEY, ASST. VICE PRESIDENT 300 INTERPACE PARKWAY, MORRIS CORPORATE 1, BLDG. B/C, PARSIPPANY, NJ TEL #: FAX #: RONALD TANELLI, TEAM MANAGER 300 INTERPACE PARKWAY, MORRIS CORPORATE 1, BLDG. B/C PARSIPPANY, NJ TEL #: FAX #: AMERICAN HOME ASSURANCE COMPANY JANICE MOORE, ASSISTANT VICE PRESIDENT CHARTIS, P.O. BOX 9973, WILMINGTON, DE TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 5

7 MELODY KENSEY, ADMINISTRATIVE ASSISTANT CHARTIS, P.O. BOX 9973 WILMINGTON, DE TEL #: FAX #: AMERICAN INSURANCE COMPANY THOMAS CUEL, SR. CLAIMS DIRECTOR GREAT OAKS WAY, SUITE 200, ALPHARETTA GA TEL #: FAX #: JENNIFER FELCH, WORKERS' COMPENSATION SUPERVISOR GREAT OAKS WAY, SUITE 200 ALPHARETTA, GA TEL #: FAX #: AMERICAN ZURICH INSURANCE COMPANY BRIAN M. DOOLEY, ASST. VICE PRESIDENT 300 INTERPACE PARKWAY, MORRIS CORPORATE 1, BLDG. B/C, PARSIPPANY, NJ TEL #: FAX #: RONALD TANELLI, TEAM MANAGER 300 INTERPACE PARKWAY, MORRIS CORPORATE 1, BLDG. B/C PARSIPPANY, NJ TEL #: FAX #: AMERIHEALTH CASUALTY INSURANCE COMPANY TERRY SMITH, MANAGER OF NJ OPERATIONS 8000 MIDLANTIC DRIVE, SUITE 410N, MT. LAUREL, NJ TEL #: FAX #: MARK MORRONE, SENIOR CLAIMS REPRESENTATIVE 8000 MIDLANTIC DRIVE, SUITE 410N MT. LAUREL, NJ TEL #: FAX #: AMERISURE INSURANCE COMPANY LAURA PIERMAN, CLAIMS MANAGER HALSTED, FARMINGTON HILLS, MI TEL #: ext FAX #: MICHAEL HEARSCH, CLAIMS SUPERVISOR HALSTED FARMINGTON HILLS, MI TEL #: ext FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 6

8 AMERISURE MUTUAL INSURANCE COMPANY LAURA PIERMAN, CLAIMS MANAGER HALSTED, FARMINGTON HILLS, MI TEL #: ext FAX #: MICHAEL HEARSCH, CLAIMS SUPERVISOR HALSTED FARMINGTON HILLS, MI TEL #: ext FAX #: AMERITRUST INSURANCE CORPORATION LINDA FEATHERNGILL, WC CLAIMS SUPERVISOR P.O. BOX 5086, SOUTHFIELD, MI TEL #: FAX #: RANDY LESTER, CLAIMS MANAGER P.O. BOX 5086 SOUTHFIELD, MI TEL #: FAX #: AMGUARD INSURANCE COMPANY HUGH SPIEGELMAN, CLAIMS SUPERVISOR GUARD INSURANCE GROUP, P.O. BOX 1368, WILKES BARRE, PA TEL #: FAX #: DIANA DUDA MONGO, STAFF ATTORNEY GUARD INSURANCE GROUP, 110 SOUTH JEFFERSON ROAD WHIPPANY, NJ TEL #: FAX #: AMSTED INDUSTRIES, INC. ROB GOULD, HUMAN RESOURCES MANAGER 1100 WEST FRONT STREET, FLORENCE, NJ TEL #: FAX #: JOHN GEANEY, ATTORNEY 8000 MIDLANTIC DRIVE, SUITE 300S MT. LAUREL, NJ TEL #: FAX #: ARCH INSURANCE COMPANY CHASE W DEITS, CPCU, ARM, AIC 1125 SANCTUARY PKWY, SUITE 200, ALPHARETTA, GA TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 7

9 PAUL MILOSCIA, VP, CLAIMS ONE LIBERTY PLAZA, 53RD FLOOR NEW YORK, NY TEL #: FAX #: ARGONAUT INSURANCE COMPANY MARILYN BRANDS, VP OF WORKERS' COMPENSATION CLAIMS 100 MARINE PARKWAY, REDWOOD CITY, CA TEL #: FAX #: MELINDA SEILER, REGIONAL CLAIMS DIRECTOR 8325 N. ALLEN RD., SUITE B PEORIA, IL TEL #: FAX #: ARGONAUT-MIDWEST INSURANCE COMPANY MARILYN BRANDS, VP OF WORKERS' COMPENSATION CLAIMS 100 MARINE PARKWAY, REDWOOD CITY, CA TEL #: FAX #: MELINDA SEILER, REGIONAL CLAIMS DIRECTOR 8325 N. ALLEN RD., SUITE B PEORIA, IL TEL #: FAX #: AT&T CORPORATION JULIE DUNCAN, CLAIMS SUPERVISOR 350 LINDEN OAKS, ROCHESTER, NY TEL #: FAX #: MARIANNE PEIKHAM, CLAIMS SUPERVISOR 350 LINDEN OAKS ROCHESTER, NY TEL #: FAX #: ATLANTIC HEALTH SYSTEMS INC & SUBS LORI WILLIAMS, ESQ., ATTORNEY 475 SOUTH STREET, P.O. BOX 1905, MORRISTOWN NJ TEL #: FAX #: STEPHEN T FANNON 8000 MIIDLANTIC DR, STE 300, LAUREL CORPORATE CENTER MT LAUREL NJ TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 8

10 ATLANTIC STATES CAST IRON PIPE CO. ELIZABETH KUNIGUS, WORKERS' COMP. ADMINISTRATOR 183 SITGREAVES STREET, PHILLIPSBURG, NJ TEL #: ext. 276 FAX #: HEATHER KNIGHTEN, ACCOUNTANT 2900 HWY. 280, SUITE 300 BIRMINGHAM, AL TEL #: FAX #: ATLANTICARE REGIONAL MEDICAL CENTER TRUDY MANDIA, RN,CCM,CWCP, SR. MANAGER, WC DEPARTMENT 2500 ENGLISH CREEK AVENUE, ATLANTICARE HEALTH PARK BLDG. 600, EGG HARBOR TOWNSHIP, NJ TEL #: FAX #: PAT BITZER, W.C. SPECIALIST 2500 ENGLISH CREEK AVENUE, ATLANTICARE HEALTH PARK, BLDG. 600 EGG HARBOR TOWNSHIP, NJ TEL #: FAX #: BANCROFT NEUROHEALTH, INC. TONY DIBARTOLLO, V.P. HUMAN RESOURCES 800 NO. KINGS HWY., SUITE 305, CHERRY HILL, NJ TEL #: ext FAX #: MICHAEL SALERNO, ADMINISTRATOR 330 MILLTOWN ROAD, SUITE E-11 EAST BRUNSWICK, NJ TEL #: FAX #: BANKERS STANDARD INSURANCE COMPANY PAM LLEWELLYN, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E, WILMINGTON, DE TEL #: FAX #: GUS GONNELLA, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E WILMINGTON, DE TEL #: FAX #: BARNABAS HEALTH INC DAVID A. MEBANE, ESQ., SR. V.P. FOR LEGAL AFFAIRS - CHIEF LEGAL OFFICER 95 OLD SHORT HILLS ROAD, WEST ORANGE, NJ TEL #: FAX #: CARYL RUSSO, SR. VICE PRESIDENT, CORPORATE CARE KIMBALL MEDICAL CENTER, 600 RIVER AVENUE LAKEWOOD, NJ TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 9

11 BATH & BODY WORKS, INC. INNAH DULAY, CASE MANAGEMENT CONSULTANT 4 LIMITED PARKWAY, REYNOLDSBURG, OH TEL #: FAX #: SUSAN MANOS, SUPERVISOR CASE MANAGEMENT 4 LIMITED PARKWAY REYNOLDSBURG, OH TEL #: FAX #: BERGEN REGIONAL MEDICAL CENTER VIKI ABRAMS, CLAIMS EXAMINER QUALCARE, P.O. BOX 309, PISCATAWAY, NJ TEL #: FAX #: PRIMO SISCO, BENEFITS COORDINATOR BERGEN REGIONAL MEDICAL CENTER, 230 EAST RIDGEWOOD AVENUE PARAMUS, NJ TEL #: FAX #: BERKLEY NATIONAL INSURANCE COMPANY ROBERT BUEHLER, ASSISTANT SECRETARY 215 SHUMAN BLVD., SUITE 200, NAPERVILLE, IL TEL #: FAX #: PATRICIA PETERS, REGULATORY ADMINISTRATOR 215 SHUMAN BLVD., SUITE 200 NAPERVILLE, IL TEL #: FAX #: BERKLEY REGIONAL INSURANCE COMPANY JOHN THELAN, ASSISTANT SECRETARY DOUGLAS AVENUE, URBANDALE, IA TEL #: FAX #: GREG KENDRICK, LEGAL ASSISTANT DOUGLAS AVENUE URBANDALE, IA TEL #: FAX #: BERKSHIRE HATHAWAY HOMESTATE INSURANCE CO (FMLY CORNHUSKERS CASUALTY) KATHLEEN KOESTER-HOLT, CLAIMS SUPERVISOR BERKSHIRE HATHAWAY HOMESTATE INSURANCE COMPANY, P.O. BOX , SAN FRANCISCO, CA TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 10

12 NICOLE ALBRECHT, CLAIMS MANAGER BERKSHIRE HATHAWAY HOMESTATE INSURANCE COMPANY, P.O. BOX SAN FRANCISCO, CA TEL #: FAX #: BEST FOODS/CPC MICHELL LARGMANN, FINANCIAL ANALYST UNILEVER U.S. INC., 700 SYLVAN AVENUE, ENGLEWOOD CLIFFS, NJ TEL #: FAX #: -- SAM MALIK, ASSOCIATE FINANCE MANAGER UNILEVER U.S. INC., 700 SYLVAN AVENUE ENGLEWOOD CLIFFS, NJ TEL #: FAX #: -- BON SECOURS HEALTH SYSTEM INC. & SUBS KIM STEHLE, SR. CLAIM REPRESENTATIVE GALLAGHER BASSETT SERVICES, 3300 VICKERY ROAD, NORTH SYRACUSE, NY TEL #: FAX #: -- MARY BETH FITZGERALD, BRANCH MANAGER GALLAGHER BASSETT SERVICES, 3300 VICKERY ROAD NORTH SYRACUSE, NY TEL #: FAX #: -- BROTHERHOOD MUTUAL INSURANCE COMPANY DEBBIE BENZINGER, SR. MANAGER, WC CLAIMS 6400 BROTHERHOOD WAY, P.O. BOX 2227, FORT WAYNE, NJ TEL #: FAX #: DAVID ROESENER, REGULATORY AND COMPLIANCE DIRECTOR 6400 BROTHERHOOD WAY, P.O. BOX 2227 FORT WAYNE, NJ TEL #: FAX #: CAMDEN, RC DIOCESE OF PATRICIA NAPIER, SR. WC CLAIMS SUPERVISOR P.O. BOX 500, SOMERS POINT, NJ TEL #: ext FAX #: LINDA DEROUIN, LITIGATED SUPERVISOR P.O. BOX 500 SOMERS POINT, NJ TEL #: ext FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 11

13 CAPE REGIONAL MEDICAL CENTER MICHAEL MORLEY, V.P. RISK MANAGEMENT 2 SONE HARBOR BLVD., CAPE MAY COURT HOUSE, NJ TEL #: FAX #: PATRICIA NAPIER, SENIOR CLAIMS ANALYST SCIBAL INSURANCE GROUP, P.O. BOX 500 SOMERS POINT, NJ TEL #: FAX #: -- CAROLINA CASUALTY INSURANCE COMPANY LORI ZOBLER, DIRECTOR OF CLAIMS 2445 KUSER RD, STE 201, HAMILTON NJ TEL #: FAX #: JOHN BURKE, SR VP AND CHIEF CLAIMS OFFICER BERKLEYNET UNDERWRITERS LLC, MARBLESTONE DRIVE, SUITE 250 WOODBRIDGE VA TEL #: FAX #: CASTLEPOINT INSURANCE COMPANY LAURA DANIELS, WC SUPERVISOR 225 BROADHOLLOW ROAD, SUITE 410E, MELVILLE, NY TEL #: FAX #: DEBORAH KREMER, WC SUPERVISOR 225 BROADHOLLOW ROAD, SUITE 410E MELVILLE, NY TEL #: FAX #: CASTLEPOINT NATIONAL INSURANCE COMPANY TIM KARAGJIOZI, SR. HOME OFFICE CLAIM ANALYST 3 HUNTINGTON QUAD, SUITE 2015, MELVILLE, NY TEL #: FAX #: PHILIP KOZELETZ, ASST. VICE PRESIDENT, BRANCH CLAIM MANAGER 3 HUNTINGTON QUAD, SUITE 2015 MELVILLE, NY TEL #: FAX #: CBS BROADCASTING INC STEPHANIE GROSSBERG, DIRECTOR - RISK MANAGEMENT 51 W. 52ND STREET, NEW YORK, NY TEL #: FAX #: DAVID RICHARDSON, VICE PRESIDENT - CLAIMS ONE UNION PLAZA NEW LONDON, CT TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 12

14 CBS CORPORATION STEPHANIE GROSSBERG, DIRECTOR - RISK MANAGEMENT 51 W. 52ND STREET, NEW YORK, NY TEL #: FAX #: EUGENE J. MELLEVOLD, VICE PRESIDENT 51 W. 52ND STREET NEW YORK, NY TEL #: FAX #: CBS OUTDOOR GROUP INC STEPHANIE GROSSBERG, DIRECTOR, RISK MANAGEMENT 51 W. 52ND STREET, NEW YORK, NY TEL #: FAX #: DAVE RICHARDSON, VP - CLAIMS MURPHY AND BEANE, ONE UNION PLAZA NEW LONDON, CT TEL #: ext. 240 FAX #: CBS OUTDOOR INC STEPHANIE GROSSBERG, DIRECTOR - RISK MANAGEMENT 51 W. 52ND STREET, NEW YORK, NY TEL #: FAX #: DAVID RICHARDSON, VICE PRESIDENT - CLAIMS ONE UNION PLAZA NEW LONDON, CT TEL #: FAX #: CECORR INC TIM B STARKS, SR. WC MANAGER 133 PEACHTREE STREET, NE, ATLANTA, GA TEL #: FAX #: LIZ WYNACHT, MANAGER - WC 1333 PEACHTREE STREET, NE ATLANTA, GA TEL #: FAX #: -- CHARTER OAK FIRE INSURANCE COMPANY MARGARET MUIR-O'CONNOR, FIELD PRODUCT LINE MANAGER TRAVELERS INSURANCE COMPANIES, INC., 445 SOUTH STREET, MORRISTOWN, NJ TEL #: FAX #: TROY TICE, DIRECTOR OF OPERATIONS TRAVELERS INSURANCE COMPANIES, INC., 445 SOUTH STREET MORRISTOWN, NJ TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 13

15 CHEROKEE INSURANCE COMPANY SCOTT PHILLIPS, CLAIM REPRESENTATIVE P.O. BOX 159, WARREN, MI TEL #: ext FAX #: LAURA BOOTH, CLAIM REPRESENTATIVE P.O. BOX 159 WARREN, MI TEL #: ext FAX #: CHUBB INDEMNITY INSURANCE COMPANY ANDY HERBERT, CLAIMS SUPERVISOR 15 MOUNTAIN VIEW ROAD, P.O. BOX 1616, WARREN, NJ TEL #: FAX #: CRAIG FARINA, CLAIMS MANAGER 15 MOUNTAIN VIEW ROAD, P.O. BOX 1616 WARREN, NJ TEL #: FAX #: CHURCH MUTUAL INSURANCE COMPANY DAVID A SEISER, CLAIM MANAGER, WC P.O. BOX 342, MERRILL, WI TEL #: FAX #: TEENA NOVOTNY, CLAIMS SUPERVISOR, WC P.O. BOX 342 MERRILL, WI TEL #: FAX #: CINCINNATI CASUALTY COMPANY DEREK NEHIL, UNIT MANAGER YORK RISK SERVICES GROUP, P.O. BOX , COLUMBUS, OH TEL #: FAX #: TONI POSTELL, SUPERINTENDENT P.O. BOX CINCINNATI, OH TEL #: FAX #: CINCINNATI INDEMNITY COMPANY DEREK NEHIL, UNIT MANAGER YORK RISK SERVICES GROUP, P.O. BOX , COLUMBUS, OH TEL #: FAX #: TONI POSTELL, SUPERINTENDENT P.O. BOX CINCINNATI, OH TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 14

16 CINCINNATI INSURANCE COMPANY DEREK NEHIL, UNIT MANAGER YORK RISK SERVICES GROUP, P.O. BOX , COLUMBUS, OH TEL #: FAX #: TONI POSTELL, SUPERINTENDENT CINCINNATI INSURANCE COMPANY, P.O. BOX CINCINNATI, OH TEL #: FAX #: CITIZENS INSURANCE COMPANY OF AMERICA DANIEL GERMAIN, UNIT MANAGER HANOVER INSURANCE, 440 LINCOLN STREET, WORCESTER, MA TEL #: FAX #: MOLLY FLANAGAN, AVP WORK COMP HANOVER INSURANCE, 440 LINCOLN STREET WORCESTER, MA TEL #: FAX #: COLONIAL CONCRETE CO & SUBS KAREN SAYRE, ADMINISTRATIVE ASST. P.O. BOX 68, NEWTON, NJ TEL #: FAX #: APRIL GRANGER, CLAIMS REPRESENTATIVE P.O. BOX 68 NEWTON, NJ TEL #: FAX #: COMMERCE & INDUSTRY INSURANCE COMPANY JANICE MOORE, ASSISTANT VICE PRESIDENT CHARTIS, P.O. BOX 9973, WILMINGTON, DE TEL #: FAX #: MELODY KENSEY, ADMINISTRATIVE ASSISTANT CHARTIS, P.O. BOX 9973 WILMINGTON, DE TEL #: FAX #: COMPANION PROPERTY & CASUALTY INSURANCE COMPANY TERRY SMITH, MANAGER OF NJ OPERATIONS 8000 MIDLANTIC DRIVE, SUITE 410N, MT. LAUREL, NJ TEL #: FAX #: MARK MORRONE, SENIOR CLAIMS REPRESENTATIVE 8000 MIDLANTIC DRIVE, SUITE 410N MT. LAUREL, NJ TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 15

17 CONAGRA FOODS INC AND SUBS BRENDA MCGOWEN, SR. FINANCIAL ANALYST CONAGRA FOODS, INC., ONE CONAGRA DRIVE, 1-220, OMAHA, NE TEL #: FAX #: EMILY JONES, FINANCIAL ANALYST CONAGRA FOODS, INC., ONE CONAGRA DRIVE OMAHA, NE TEL #: FAX #: CONTINENTAL CASUALTY COMPANY (CNA) DIANE WEBER, CLAIM MANAGER CNA, 401 PENN STREET, READING, PA TEL #: FAX #: ELIZABETH SIEKS, WC OPERATIONS ANALYSIS CONSULTING DIRECTOR CNA, 333 S. WABASH AVE., 39S CHICAGO, IL TEL #: FAX #: CONTINENTAL INDEMNITY COMPANY ERIC KENNEDY, UNIT SUPERVISOR P.O. BOX 3804, OMAHA, NE TEL #: FAX #: PETER GUNN, CLAIMS MANAGER P.O. BOX 3804 OMAHA, NE TEL #: FAX #: CONTINENTAL INSURANCE COMPANY DIANE WEBER, CLAIM MANAGER CNA, 401 PENN STREET, READING, PA TEL #: FAX #: ELIZABETH SIEKS, WC OPERATIONS ANALYSIS CONSULTING DIRECTOR CNA, 333 S. WABASH AVE., 39S CHICAGO IL TEL #: FAX #: CONTINENTAL INSURANCE COMPANY OF NEW JERSEY DIANE WEBER, CLAIM MANAGER CNA, 401 PENN STREET, READING, PA TEL #: FAX #: ELIZABETH SIEKS, WC OPERATIONS ANALYSIS CONSULTING DIRECTOR CNA, 333 S. WABASH AVE., 30S CHICAGO, IL TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 16

18 COOPER HOSPITAL/UNIVERSITY MEDICAL CENTER MARYANN MIKULICH, BENEFITS SPECIALIST COOPER UNIVERSITY HOSPITAL, 3 COOPER PLAZA, SUITE 500, CAMDEN, NJ TEL #: FAX #: KATHLEEN VONDER HAYDEN, ADMIN. DIRECTOR OF HUMAN RESOURCES COOPER UNIVERSITY HOSPITAL, 3 COOPER PLAZA, SUITE 500 CAMDEN, NJ TEL #: FAX #: COSTCO WHOLESALE CORPORATION EDWARD W FRITSCH, CLAIMS SUPERVISOR SCMS, P.O. BOX 14517, LEXINGTON, KY TEL #: FAX #: MICKEY PINEIRO, WORKERS' COMP MANAGER SCMS, P.O. BOX LEXINGTON, KY TEL #: FAX #: CUMBERLAND INSURANCE COMPANY KEN MAILLEY, CLAIMS MANAGER 633 SHILO PIKE, P.O. BOX 556, BRIDGETON, NJ TEL #: FAX #: NICOLE BANO, OPERATIONS MANAGER 633 SHILO PIKE, P.O. BOX 556 BRIDGETON, NJ TEL #: FAX #: CVS/CAREMARK CORPORATION LISA HOUDE, WC EXAMINER ONE CVS DRIVE, WOUNSOCKET, RI TEL #: ext FAX #: JOCELYN RUSHEY, WC MANAGER ONE CVS DRIVE WOUNSOCKET, RI TEL #: ext FAX #: DAVIDS BRIDAL INC MARGARET MUIR-O'CONNOR, WC FIELD PRODUCT LINE MANAGER P.O. BOX 1900, MORRISTOWN, NJ TEL #: FAX #: None provided INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 17

19 DCH AUTO GROUP INC & SUBS JOHN BRUTHER, CFO 955 ROUTE 9 NORTH, SOUTH AMBOY, NJ TEL #: FAX #: GENE HALLENBECK, VP OF HUMAN RESOURCES 955 ROUTE 9 NORTH SOUTH AMBOY, NJ TEL #: FAX #: DELHAIZE AMERICA LLC ROD BACK, CLAIMS MANAGER P.O. BOX 2527, SALISBURY, NC TEL #: FAX #: JAN PINION, LITIGATION SPECIALIST P.O. BOX 2527 SALISBURY, NC TEL #: FAX #: DOLGENCORP, INC. DAVID STEFFES, SR.ANALYST 100 MISSION RIDGE, GOODLETTSVILLE, TN TEL #: FAX #: CHAD DAVIS, ACCOUNT EXECUTIVE 5000 BRADENTON AVENUE DUBLIN OH TEL #: FAX #: E.I. DUPONT DE NEMOURS & COMPANY BRUCE D PEIFFER, TEAM MANAGER BROADSPIRE, A CRAWFORD COMPANY, CONNELL CORPORATE CTR. III, 3 OAK WAY, P.O. BOX 608 BERKELEY HEIGHTS, NJ TEL #: FAX #: CAROLE A CARR, TREASURY SPECIALIST E.I. SUPONT DE NEMOURS AND CO., 1007 MARKET STREET, D8065 WILMINGTON, DE TEL #: FAX #: EASTERN ADVANTAGE ASSURANCE COMPANY KELLI CHAPMAN, DIRECTOR OF CLAIMS 25 RACE AVENUE, LANCASTER, PA TEL #: ext FAX #: TARA HOOPER, MANAGER OF REGIONAL CLAIMS 25 RACE AVENUE LANCASTER, PA TEL #: ext FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 18

20 EASTERN ALLIANCE INSURANCE COMPANY KELLI CHAPMAN, DIRECTOR OF CLAIMS EASTERN ALLIANCE INSURANCE GROUP, 25 RACE AVENUE, LANCASTER, PA TEL #: ext FAX #: TARA HOOPER, MANAGER OF REGIONAL CLAIMS EASTERN ALLIANCE INSURANCE GROUP, 25 RACE AVENUE LANCASTER, PA TEL #: ext FAX #: EASTGUARD INSURANCE COMPANY HUGH SPIEGELMAN, CLAIMS SUPERVISOR GUARD INSURANCE GROUP, P.O. BOX 1368, WILKES BARRE, PA TEL #: FAX #: DIANA DUDA MONGO, STAFF ATTORNEY GUARD INSURANCE GROUP, 110 SOUTH JEFFERSON ROAD WHIPPANY, NJ TEL #: FAX #: ELECTRIC INSURANCE COMPANY PAT NICKEL, ADJUSTER GE WC REGIONALSERVICE CENTER, 1 CORPORATE PLAZA, SUITE 104, 260 WASHINGTON STREET EXT. ALBANY, NY TEL #: FAX #: JULIE KIELY, SPECIAL LITIGATION MANAGER 75 SAM FONZO DRIVE BEVERLY, MA TEL #: FAX #: EMPLOYERS MUTUAL CASUALTY COMPANY JAMES N ZEIGLER, BRANCH CLAIMS MANAGER 1610 MEDICAL DRIVE, SUITE 205, POTTSTOWN, PA TEL #: FAX #: CATHY BROWN, CLAIMS SUPERVISOR 1610 MEDICAL DRIVE, SUITE 205 POTTSTOWN, PA TEL #: FAX #: EMPLOYERS PREFERRED INSURANCE CO DAVID MACY, MANAGER, CLAIMS 412 E. PARKCENTER BLVD., SUITE 320, BOISE, ID TEL #: FAX #: KATHRYN WHETSONE, VP, REGIONAL CLAIMS 851 TRAFALGAR COURT, SUITE 400E MAITLAND, FL TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 19

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