date: 04/01/2020 oklahoma workers' compensation … · 2020-04-01 · date: 04/01/2020...

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLST Time: 08:13 CARRIER LISTING Page: 1 TYPE: INSUR CO Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address 1900 C 7710 INSURANCE COMPANY 1462 S ACADIA INSURANCE CO CORPORATION SERVICE COMPANY ATTN: TODD ESTES 10300 GREENBRIAR PLACE PO BOX 26350 OKLAHOMA CITY, OK 73159- OKLAHOMA CITY, OK 73126- 1877 C ACCEPTANCE INDEMNITY INS CO 1457 S ACCIDENT FUND GENERAL INSURANCE CO ATTN: MICHAEL BLINSON ATTN: JOE WROZEK 702 OBERLIN RD PO BOX 40790 RALEIGH, NC 27605- LANSING, MI 4890 - 1291 S ACCIDENT FUND INSURANCE CO OF AMERICA 1467 S ACCIDENT FUND NATIONAL INSURANCE CO ATTN: JOE WROZEK ATTN: JOE WROZEK PO BOX 40790 PO BOX 40790 LANSING, MI 4890 - LANSING, MI 4890 - 1588 S ACCIDENT INSURANCE CO INC 0251 C ACE AMERICAN INSURANCE CO C/O US ADMINISTRATOR CLAIMS NORTH AMERICA COMMERCIAL CLAIM OPERATIONS PO BOX 2005 PO BOX 5122 OAK RIDGE, TN 37831- SCRANTON, PA 18505- 0360 C ACE FIRE UNDERWRITERS INSURANCE CO 0526 C ACE PROPERTY & CASUALTY INSURANCE CO NORTH AMERICA COMMERCIAL CLAIMS OPERATIONS NORTH AMERICA COMMERCIAL CLAIMS OPERATIONS PO BOX 5122 PO BOX 5122 SCRANTON, PA 18505- SCRANTON, PA 18505- 0505 S ACIG INSURANCE CO 1876 S ADMIRAL INDEMNITY COMPANY ATTN: LINDSEY MICHAELS THE CORPORATION COMPANY - JUDY BEST 12222 MERIT DR STE 1660 1833 SOUTH MORGAN RD DALLAS, TX 75251- OKLAHOMA CITY, OK 72128- * Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Page 1: Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION … · 2020-04-01 · Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLST Time:

Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 1

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1900 C 7710 INSURANCE COMPANY 1462 S ACADIA INSURANCE COCORPORATION SERVICE COMPANY ATTN: TODD ESTES10300 GREENBRIAR PLACE PO BOX 26350OKLAHOMA CITY, OK 73159- OKLAHOMA CITY, OK 73126-

1877 C ACCEPTANCE INDEMNITY INS CO 1457 S ACCIDENT FUND GENERAL INSURANCE COATTN: MICHAEL BLINSON ATTN: JOE WROZEK702 OBERLIN RD PO BOX 40790RALEIGH, NC 27605- LANSING, MI 4890 -

1291 S ACCIDENT FUND INSURANCE CO OF AMERICA 1467 S ACCIDENT FUND NATIONAL INSURANCE COATTN: JOE WROZEK ATTN: JOE WROZEKPO BOX 40790 PO BOX 40790LANSING, MI 4890 - LANSING, MI 4890 -

1588 S ACCIDENT INSURANCE CO INC 0251 C ACE AMERICAN INSURANCE COC/O US ADMINISTRATOR CLAIMS NORTH AMERICA COMMERCIAL CLAIM OPERATIONSPO BOX 2005 PO BOX 5122OAK RIDGE, TN 37831- SCRANTON, PA 18505-

0360 C ACE FIRE UNDERWRITERS INSURANCE CO 0526 C ACE PROPERTY & CASUALTY INSURANCE CONORTH AMERICA COMMERCIAL CLAIMS OPERATIONS NORTH AMERICA COMMERCIAL CLAIMS OPERATIONSPO BOX 5122 PO BOX 5122SCRANTON, PA 18505- SCRANTON, PA 18505-

0505 S ACIG INSURANCE CO 1876 S ADMIRAL INDEMNITY COMPANYATTN: LINDSEY MICHAELS THE CORPORATION COMPANY - JUDY BEST12222 MERIT DR STE 1660 1833 SOUTH MORGAN RDDALLAS, TX 75251- OKLAHOMA CITY, OK 72128-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

Page 2: Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION … · 2020-04-01 · Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLST Time:

Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 2

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1427 C ADVANTAGE WORKERS COMPENSATION INSURANCE CO 0276 S AIG ASSURANCE COMPANY FKA CHARTIS CASUALTY COATTN: DAN STEPHENS C/O WILLIAM PERRINEPO BOX 571918 PO BOX 8301SALT LAKE CITY, UT 84157-1918 TULSA, OK 74101-8301

0475 S AIG PROP & CASUALTY CO FKA BIRMINGHAM FIRE INS CO 1694 C AIG PROPERTY CASUALTY COMPANYC/O WILLIAM PERRINE C/O WILLIAM PERRINEPO BOX 8301 PO BOX 8301TULSA, OK 74101-8301 TULSA, OK 74141-

0474 S AIU INSURANCE CO 0498 S ALASKA NATIONAL INSURANCE COC/O WILLIAM PERRINE 7001 JEWEL LAKE RDPO BOX 8301 ANCHORAGE, AK 99502-2825TULSA, OK 74101-8301

1268 S ALEA NORTH AMERICA INSURANCE CO 0304 S ALL AMERICA INSURANCE COCORPORATION SERVICE COMPANY C/O JAMES C FERGUSONATTN: CHELSEY MARTINE 941 E BRITTON RD10300 GREENBRIAR PL OKLAHOMA CITY, OK 73114-OKLAHOMA CITY, OK 73159-

1582 C ALLIANCE INDEMNITY CO 1583 C ALLIANZ GLOBAL RISKS US INSURANCE COPO BOX 1401 225 W WASHINGTON ST STE 2000MCPHERSON, KS 67460- CHICAGO, IL 60606-

1584 C ALLIED WORLD INSURANCE CO 1804 C ALLMERICA FINANCIAL ALLIANCE INS COATTN: PADMINI SHAH THE CORPORATION COMPANY - C/O JUDY BEST199 WATER STREET 24TH FL 1833 SOUTH MORGAN RDNEW YORK, NY 10038- OKLAHOMA CITY, OK 73128-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

Page 3: Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION … · 2020-04-01 · Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLST Time:

Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 3

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1578 C ALLMERICA FINANCIAL BENEFIT INSURANCE CO 1258 S AMERICA FIRST INSURANCE COTHE CORPORATION COMPANY - C/O JUDY BEST C/O AIMEE TREECE1833 S MORGAN RD 101 N ROBINSON AVE STE 1105OKLAHOMA CITY, OK 73128- OKLAHOMA CITY, OK 73102-

0256 S AMERICAN ALTERNATIVE INSURANCE CO 0243 S AMERICAN AUTOMOBILE INSURANCE COREGISTERD AGENT SOLUTIONS INC ATTN: WILLIAM PAN1406 TERRACE DRIVE PO BOX 740174TULSA, OK 74104-4626 ATLANTA, GA 30374-

1899 C AMERICAN BUILDERS INSURANCE CO 0275 S AMERICAN CASUALTY CO OF READING PAPO BOX 723099 ATTN: IRMA CLASSATLANTA, GA 31139- 151 NORTH FRANKLIN

CHICAGO, IL 60606-

1441 S AMERICAN COMPENSATION INSURANCE CO 1532 C AMERICAN COUNTRY INSURANCE COATTN: SUSAN PILON ATTN: PAUL ROMANOPO BOX 390327 953 AMERICAN LN 3RD FLMINNEAPOLIS, MN 55439- SCHAUMBURG, IL 60173-

0444 S AMERICAN ECONOMY INSURANCE CO 1662 AMERICAN FAMILY HOME INSURANCE COC/O AIMEE TREECE YORK RISK SERVICES GROUP101 N ROBINSON AVE STE 1105 ATTN: BRENDA MORENOOKLAHOMA CITY, OK 73102- PO BOX 619079

ROSEVILLE, CA 95661-

0346 S AMERICAN FIRE & CASUALTY CO 0503 S AMERICAN GUARANTEE & LIABILITY INSURANCE COC/O AIMEE TREECE C/O ZURICH CLAIMS101 N ROBINSON AVE STE 1105 ATTN: TANYA GROOVEROKLAHOMA CITY, OK 73102- PO BOX 968023

SCHAUMBURG, IL 60196-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 4

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1425 C AMERICAN HARDWARE MUTUAL INSURANCE CO 0473 S AMERICAN HOME ASSURANCE COC/O MOTORISTS INSURANCE GROUP C/O WILLIAM PERRINEATTN: JUDY PALAMARA PO BOX 8301471 E BROAD ST TULSA, OK 74101-8301COLUMBUS, OH 43215-

0271 S AMERICAN INSURANCE CO 1167 S AMERICAN INTERNATIONAL PACIFIC INSURANCE COATTN: WILLIAM PAN C/O WILLIAM PERRINEPO BOX 740174 PO BOX 8301ATLANTA, GA 30374- TULSA, OK 74101-8301

0312 S AMERICAN INTERSTATE INSURANCE CO 1884 C AMERICAN LIBERTY INSURANCE COATTN: KATHRYN SHIRLEY S & C CLAIMS - BETH MARTINEZ2301 HIGHWAY 190 WEST 7881 W CHARLESTON BLVDDERIDDER, LA 70634- LAS VEGAS, NV 89148-

0321 S AMERICAN MANUFACTURERS MUTUAL INSURANCE CO 1626 C AMERICAN MINING INSURANCE COC/O OKLAHOMA PROPERTY & CASUALTY INSURANCE G.A. C/O YORK RISK SERVICES GROUP2601 NW EXPY STE 330E 5501 LBJ FREEWAY STE 300OKLAHOMA CITY, OK 73112- DALLAS, TX 75240-

1660 AMERICAN MODERN HOME INSURANCE CO 1810 C AMERICAN MODERN PROPERTY & CASUALTY INS COYORK RISK SERVICES GROUP PO BOX 5323ATTN: BRENDA MORENO CINCINNATI, OH 45201-5323PO BOX 619079ROSEVILLE, CA 95661-

0504 S AMERICAN MOTORISTS INSURANCE CO 1533 C AMERICAN NATIONAL PROPERTY & CASUALTY COC/O OKLAHOMA PROPERTY & CASUALTY INSURANCE G.A. ATTN: RONALD KOCH2601 NW EXPY STE 330E 1949 E SUNSHINEOKLAHOMA CITY, OK 73112- SPRINGFIELD, MO 65899-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 5

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1197 S AMERICAN SAFETY CASUALTY INSURANCE CO 1796 C AMERICAN SELECT INSURANCE CO1845 THE EXCHANGE STE 200 BROADSPIRE SERVICES INCATLANTA, GA 30339- ATTN: DEBRA GLOVER

5901 COLLEGE BLVD STE 275OVERLAND PARK, KS 66211-

0468 S AMERICAN STATES INSURANCE CO 0506 S AMERICAN ZURICH INSURANCE COC/O AIMEE TREECE C/O ZURICH CLAIMS101 N ROBINSON AVE STE 1105 TANYA GROOVEROKLAHOMA CITY, OK 73102- PO BOX 968023

SCHAUMBURG, IL 60196-

1579 C AMERISURE INSURANCE CO 1200 C AMERISURE MUTUAL INSURANCE COPIERCE COUCH HENDRICKSON BAYSINGER AND GREEN LLP PIERCE COUCH HENDRICKSON BAYSINGER & GREEN LLPATTN TODD ESTES 1109 N FRANCIS AVE1109 N FRANCIS AVE OKLAHOMA CITY, OK 73106-6813OKLAHOMA CITY, OK 73106-6813

1630 C AMERISURE PARTNERS INSURANCE CO 1535 C AMEX ASSURANCE COC/O TODD ESTES PO BOX 190201109 N FRANCIS AVE GREEN BAY, WI 54307-OKLAHOMA CITY, OK 73106-6813

1758 C AMGUARD INSURANCE COMPANY 1476 S AMTRUST INSURANCE CO OF KS INCPO BOX A H ATTN: LISA JOHNSONWILKES BARRE, PA 74136-3849 PO BOX 94405

CLEVELAND, OH 44101-

1536 C ARCH INDEMNITY INSURANCE CO 1142 S ARCH INSURANCE COATTN: ED SCHENK ATTN: ED SCHENKHARBORSIDE 3, 210 HUDSON ST STE 300 HARBORSIDE 3, 210 HUDSON ST STE 300JERSEY CITY, NJ 07311- JERSEY CITY, NJ 07311-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 6

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0248 C ARGONAUT GREAT CENTRAL INSURANCE CO 0361 C ARGONAUT INSURANCE COC/O D CRAIG JOHNSTON D CRAIG JOHNSTON2101 N SANTA FE 2101 N SANTA FEEDMOND, OK 73003- EDMOND, OK 73003-

0362 C ARGONAUT MIDWEST INSURANCE CO 0363 C ARGONAUT SOUTHWEST INSURANCE COD CRAIG JOHNSTON D CRAIG JOHNSTON2101 N SANTA FE 2101 N SANTA FEEDMOND, OK 73003- EDMOND, OK 73003-

1801 C ASHMERE INSURANCE COMPANY 0244 S ASSOCIATED INDEMNITY CORPNEXT LEVEL ADMINISTRATORS LLC - KATHY FORTIER ATTN:WILLIAM PANPO BOX 1061 PO BOX 740174BRADENTON, FL 34206-1061 ATLANTA, GA 30374-

0337 C ASSOCIATION CASUALTY INSURANCE CO 1655 C ASSOCIATON INSURANCE COMPANYATTN: PAUL BONHAM PO BOX 72309910820 HARNEY STREET ATLANTA, GA 31139-0099OMAHA, NE 68154-

1538 C ATHENA ASSURANCE CO 1762 C ATLANTIC CASUALTY INSURANCE COMPANYATTN: MICHAEL DOODY PO BOX 8010385 WASHINGTON ST GOLDSBORO, NC 27533-ST PAUL, MN 55102-

1344 S ATLANTIC SPECIALTY INSURANCE CO 0286 C AUTOMOBILE INSURANCE CO OF HARTFORDATTN: CYNTHIA J VAN EYLL C/O CORPORATION SERVICE CO605 HWY 169 N STE 800 10300 GREENBRIAR PLACEPLYMOUTH, MN 55441- OKLAHOMA CITY, OK 73159-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 7

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1539 C AXIS INSURANCE CO 0250 C BANKERS STANDARD INSURANCE COATTN: BERTMAN BRAUD C/O ESIS11680 GREAT OAKS WAY STE 500 ATTN: CAROL GALLIMOREALPHARETTA, GA 30022- 225 E JOHN CARPENTER FWY STE 1300

IRVING, TX 75062-

1653 C BEARING MIDWEST CASUALTY CO 0514 S BENCHMARK INSURANCE COMIDWEST BUILDERS CASUALTY MUTUAL CO S & C CLAIMS SERVICE INC - EMILIE ZINK-WRIGHTELIZABETH LONG 3737 S ELIZABETH ST #1011100 WALNUT ST STE 3010 INDEPENDENCE, MO 64057-KANSAS CITY, MO 64106-

1596 S BERKLEY NATIONAL INSURANCE CO 1540 C BERKLEY REGIONAL INSURANCE COATTN: JAMES F BLONDIN ATTN: JAMES F BLONDIN1250 E DIEHL ROAD STE 200 1250 E DIEHL RD STE 200NAPIERVILLE, IL 60563- NAPERVILLE, IL 60563-

1795 C BERKSHIRE HATHAWAY DIRECT INSURANCE CO 1489 C BERKSHIRE HATHAWAY HOMESTATE INSURANCE CO (BHHIC)ATTN: DAVID DARO ATTN: NICOLE ALBRECHT1314 DOUGLAS ST STE 1400 PO BOX 881716OMAHA, NE 68102-1944 SAN FRANCISCO, CA 94188-

0516 S BITCO GENERAL INSURANCE COMPANY (FKA BITUMINOUS CA 1157 S BITCO NATIONAL INSURANCE COMPANY (FKA BITUMINOUS FATTN: KELLY GRAMMER ATTN: KELLY GRAMMERPO BOX 12936 PO BOX 12936OKLAHOMA CITY, OK 73157-2936 OKLAHOMA CITY, OK 73157-2936

0449 S BROTHERHOOD MUTUAL INSURANCE CO 1664 C BUILDERS MUTUAL INSURANCE COATTN: GARY ALDRIDGE PO BOX 150006PO BOX 2228 RALEIGH, NC 27624-FT WAYNE, IN 46801-2228

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 8

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0274 S CAMDEN FIRE INSURANCE ASSOCIATION 1460 S CAROLINA CASUALTY INSURANCE COATTN: JIM JORDAN ATTN: JOHN BURKE150 ROYALL ST 9301 INNOVATION DRIVE STE 200CANTON, MA 02021- MANASSAS, VA 20110-

1446 C CASTLEPOINT NATIONAL INSURANCE CO (FKA SUA INSURAN 0305 S CENTRAL MUTUAL INSURANCE COATTN: BILL HIPSELBERGER C/O JAMES C FERGUSON200 HUDSON ST STE 800 941 E BRITTON RDJERSEY CITY, NJ 07311-1104 OKLAHOMA CITY, OK 73114-

0524 S CENTRE INSURANCE CO 0261 C CHARTER OAK FIRE INSURANCE COC/O JAY MCATEE C/O CORPORATION SERVICE COPO BOX 50611 10300 GREENBRIAR PLACETULSA, OK 74150-0611 OKLAHOMA CITY, OK 73159-

1493 S CHARTIS PROPERTY & CASUALTY CO FKA AIG CASUALTY 1363 S CHEROKEE INSURANCE COC/O WILLIAM PERRINE ATTN: LAURA BOOTHPO BOX 8301 34200 MOUND RDTULSA, OK 74101- STERLING HEIGHTS, MI 48310-

1873 C CHIRON INSURANCE COMPANY 0525 C CHUBB INDEMNITY INSURANCE COC/O JAY MCATEE C/O MALCOLM SMITH1115 S CINCINATTI 5416 S YALE AVE STE 225TULSA, OK 74119- TULSA, OK 74135-

1541 C CHUBB NATIONAL INSURANCE 0338 S CHURCH MUTUAL INSURANCE COATTN: RONALD CALAVANO C/O JENNIFER LAABS15 MOUNTAIN VIEW RD PO BOX 342WARREN, NJ 70059- MERRILL, WI 54452-0342

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 9

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1865 S CIMARRON INSURANCE COMPANY INC 0325 S CINCINNATI CASUALTY COBRENTWOOD SERVICES - MARK SPARKS C/O ADVANCED CLAIM SERVICES LLC104 CONTINENTAL PL STE 200 ATTN: STACIA SMITHBRENTWOOD, TN 37027- PO BOX 721078

OKLAHOMA CITY, OK 73132-

1595 C CINCINNATI INDEMNITY CO 0326 S CINCINNATI INSURANCE COC/O ADVANCED CLAIM SERVICES LLC C/O ADVANCED CLAIM SERVICES LLCATTN: STACIA SMITH ATTN: STACIA SMITHPO BOX 721078 PO BOX 721078OKLAHOMA CITY, OK 73172- OKLAHOMA CITY, OK 73172-

1659 C CITIZENS INSURANCE CO OF AMERICA 1802 C CITY NATIONAL INSURANCE COMPANYTHE CORPRATION COMPANY - C/O JUDY BEST 1900 L DON DODSON DR1833 S MORGAN RD BEDFORD, TX 76021-OKLAHOMA CITY, OK 73128-

1847 S CLERMONT INSURANCE COMPANY 1853 C CM REGENT INSURANCE COMPANYTHE CORPORATION COMPANY - JUDY BEST ATTN JENNIFER LAABS1833 S MORGAN RD PO BOX 342OKLAHOMA CITY, OK 73128- MERRILL, WI 54452-

1542 C COLONIAL AMERICAN CASUALTY & SURETY CO 1543 C COLUMBIA MUTUAL INSURANCE COC/O ZURICH CLAIMS ATTN: PAUL BONHAMATTN: TANYA GROOVER 10820 HARNEY STREETPO BOX 968023 OMAHA, NE 68154-SCHAUMBURG, IL 60196-

1319 S COLUMBIA NATIONAL INSURANCE CO 1602 C COLUMBUS INSURANCE COATTN: PAUL BONHAM C/O GALLAGHER BASSETT SERV - ANN TERRY10820 HARNEY STREET 14000 QUAIL SPRINGS PKWY STE 3000OMAHA, NE 68154- OKLAHOMA CITY, OK 73134-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 10

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0476 S COMMERCE & INDUSTRY INSURANCE CO 0627 S COMPSOURCE MUTUAL INS CO (FKA COMPSOURCE OKLAHOMA)C/O WILLIAM PERRINE ATTN: NENA MCDANIELPO BOX 8301 PO BOX 53505TULSA, OK 74101-8301 OKLAHOMA CITY, OK 73152-3505

0246 S CONTINENTAL CASUALTY CO 1544 S CONTINENTAL INDEMNITY COATTN: IRMA CLASS ATTN: ROBERT STAFFORD151 NORTH FRANKLIN PO BOX 3804CHICAGO, IL 60606- OMAHA, NE 68103-

0247 S CONTINENTAL INSURANCE CO 1438 C CONTINENTAL NATIONAL INDEMNITY COATTN: IRMA CLASS ATTN: SHANNON CASEY151 NORTH FRANKLIN PO BOX 3804CHICAGO, IL 60606- OMAHA, NE 68103-

1256 S CONTINENTAL WESTERN INSURANCE CO 1891 C COREPOINTE INSURANCE COMPANYATTN: TODD ESTES ATTN: LISA JOHNSONPO BOX 26350 PO BOX 94405OKLAHOMA CITY, OK 73126- CLEVELAND, OH 44101-

1800 C COUNTRY MUTUAL INSURANCE COMPANY 1897 C CRESTBROOK INSURANCE COMPANYPO BOX 2100 ATTN: BRIAN NELSONBLOOMINGTON, IL 61701-2100 1100 LOCUST ST STE 3010

DES MOINES, IA 50391-3010

1141 S CRUM & FORSTER INDEMNITY CO 0537 C CUMIS INSURANCE SOCIETY INCC/O MIKE HICKS ATTN: DOAK SOMMERS2400 LAKESIDE BLVD STE 200 PO BOX 1221RICHARDSON, TX 75082- MADISON, WI 53701-1221

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 11

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1850 C CYPRESS INSURANCE COMPANY 0489 C DAIMLERCHRYSLER INSURANCE COATTN: NICOLE ALBRECHT 27777 INSTER RD CIMS 405-17-00PO BOX 881716 FARMINGTON HILLS, MI 48333-SAN FRANCISCO, CA 94188-

1349 S DAKOTA TRUCK UNDERWRITERS 1235 S DIAMOND INSURANCE COATTN: ROBERT HOLLAN C/O GALLAGHER BASSETT SERVICESPO BOX 89310 ATTN: CARLA TATESIOUX FALLS, SD 57109-9310 6303 WATERFORD BLVD STE 120

OKLAHOMA CITY, OK 73118-

1546 C DIAMOND STATE INSURANCE CO 1175 C DISCOVER PROPERTY & CASUALTY INSURANCE COATTN: JAMES JARVIE C/O CORPORATION SERVICE CO3 BALA PLZ STE 300E 10300 GREENBRIAR PLBALA CYNWYD, PA 19004- OKLAHOMA CITY, OK 73159-

1767 C EASTGUARD INS CO 0450 C ELECTRIC INSURANCE COPO BOX A H C/O SEDGWICK CMSWILKES BARRE, PA 18703-0020 PO BOX 14017

LEXINGTON, KY 40512-

1152 S EMC INSURANCE CO 1819 S EMC PROPERTY AND CASUALTY COMPANYWALKER, FERGUSON & FERGUSON - JON DEROUEN JR WALKER, FERGUSON & FERGUSON - JON DEROUEN, JR941 E BRITTON RD 941 E BRITTON RDOKLAHOMA CITY, OK 73114- OKLAHOMA CITY, OK 73114-

0487 S EMCASCO INSURANCE CO 1867 S EMPIRE FIRE AND MARINE INSURANCE COWALKER, FERGUSON & FERGUSON - JON DEROUEN JR ZURICH CLAIMS941 E BRITTON RD ATTN: TANYA GROOVEROKLAHOMA CITY, OK 73114- PO BOX 968023

SCHAUMBURG, IL 60196-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 12

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1285 C EMPLOYERS ASSURANCE CO (FKA AMCOMP ASSURANCE) 1855 C EMPLOYERS COMPENSATION INS COATTN: KELLY SPINA ATTN: KELLY SPINA2550 PASEO VERDE PARKWAY STE 100 2550 PASEO VERDE PARKWAY STE 100HENDERSON, NV 89074- HENDERSON, NV 89074-

1159 S EMPLOYERS FIRE INSURANCE 1856 C EMPLOYERS INSURANCE CO OF NEVADAATTN: VIRGINIA MCCARTHY ATTN: KELLY SPINA150 ROYALL ST 2550 PASEO VERDE PARKWAY STE 100CANTON, MA 02021- HENDERSON, NV 89074-

0429 S EMPLOYERS INSURANCE CO OF WAUSAU 0488 S EMPLOYERS MUTUAL CASUALTY COC/O AIMEE TREECE WALKER, FERGUSON & FERGUSON - JON DEROUEN JR101 N ROBINSON AVE STE 1105 941 E BRITTON RDOKLAHOMA CITY, OK 73102- OKLAHOMA CITY, OK 73114-

1820 S EMPLOYERS NATIONAL INSURANCE COMPANY 1786 C EMPLOYERS PREFERRED INSURANCE COCHRISTENSEN LAW GROUP PLLC - CLAY CHRISTENSEN ATTN: KELLY SPINA3401 NW 63RD ST ST 600 2550 PASEO VERDE PARKWAY STE 100OKLAHOMA CITY, OK 73116- HENDERSON, NV 89074-

1281 S ESSENTIA INSURANCE CO FKA AMERICAN CENTRAL 1805 C EVEREST DENALI INSURANCE COATTN: VIRGINIA MCCARTHY ATTN: KEITH BARBAROSH150 ROYALL ST 477 MARTINSVILLE ROADCANTON, MA 02021- LIBERTY CORNER, NJ 07938-

1334 C EVEREST NATIONAL INSURANCE CO 1809 C EVEREST PREMIER INSURANCE COMPANYC/O KEITH BARBAROSH ATTN: KEITH BARBAROSH477 MARTINSVILLE ROAD 477 MARTINSVILLE ROADLIBERTY CORNER, NJ 07938- LIBERTY CORNER, NJ 07938-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1249 C EXECUTIVE RISK INDEMNITY INC 1609 C EXPLORER INSURANCE COC/O MALCOLM SMITH PO BOX 855635416 S YALE AVE STE 225 SAN DIEGO, CA 92186-TULSA, OK 74105-

1803 C EXPLORER INSURANCE COMPANY 1215 S FAIRFIELD INSURANCE COATTN: KEVIN M PRIOR 120 LONG RIDGE RD15025 INNOVATION DR STAMFORD, CT 06902-SAN DIEGO, CA 92128-3409

0241 S FARMERS ALLIANCE MUTUAL INSURANCE CO 0544 C FARMERS INSURANCE EXCHANGEC/O CYNTHIA LUCAS ATTN: LAURA DAVISPO BOX 1401 15700 LONG VISTA DRIVEMCPHERSON, KS 67460-1401 AUSTIN, TX 78728-

0287 C FARMINGTON CASUALTY CO 0452 S FARMLAND MUTUAL INSURANCE COC/O CORPORATION SERVICE CO ATTN: BRIAN NELSON10300 GREENBRIAR PLACE 1100 LOCUST ST STE 3010OKLAHOMA CITY, OK 73159- DES MOINES, IA 50391-3010

1812 S FCCI INSURANCE COMPANY 0545 C FEDERAL INSURANCE COREGISTERED AGENT SOLUTIONS INC C/O MALCOLM SMITHATTN: RICARDO OROZCO 5416 S YALE AVE STE 2251406 TERRACE DRIVE TULSA, OK 74135-TULSA, OK 74104-

0397 S FEDERATED MUTUAL INSURANCE CO 1832 C FEDERATED RESERVE INSURANCE COATTN: ADRIAN JOHNSON ATTN: ADRIAN JOHNSONPO BOX 486 PO BOX 486OWATONNA, MN 55060- OWATONNA, MN 55060-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0546 S FEDERATED RURAL ELECTRIC INSURANCE EXCHANGE 0547 S FEDERATED SERVICE INSURANCE COC/O CHRISTINA JOHNSON ATTN: ADRIAN JOHNSONPO BOX 15147 PO BOX 486LENEXA, KS 66285-5147 OWATONNA, MN 55060-

0390 S FIDELITY & DEPOSIT CO OF MD 1204 C FIDELITY & GUARANTY INSURANCE COC/O ZURICH CLAIMS C/O CORPORATION SERVICE COATTN: TANYA GROOVER 10300 GREENBRIAR PLACEPO BOX 968023 OKLAHOMA CITY, OK 73159-SCHAUMBURG, IL 60196-

0548 C FIDELITY & GUARANTY INSURANCE UNDERWRITERS 1828 S FIRE INSURANCE EXCHANGEC/O CORPORATION SERVICE CO C/O TAMMY LEE10300 GREENBRIAR PLACE PO BOX 108843OKLAHOMA CITY, OK 73159- OKLAHOMA CITY, OK 73101-8843

0272 S FIREMANS FUND INSURANCE CO 1551 C FIREMENS INSURANCE CO OF WASHINGTON DCATTN: GREG RUSH ATTN: WILLIAM AMBROSE1 PROGRESS POINTE PKWY PO BOX 61038OFALLON, MO 63368- RICHMOND, VA 22361-

1740 S FIRST INSURANCE COMPANY OF OKLAHOMA (FICO) 0550 S FIRST LIBERTY INSURANCE CORPC/O CHRISTENSEN LAW GROUP - CLAY CHRISTENSEN C/O AIMEE TREECE3401 NW 63RD ST STE 600 101 N ROBINSON AVE STE 1105OKLAHOMA CITY, OK 73116- OKLAHOMA CITY, OK 73102-

0434 S FIRST NATIONAL INSURANCE CO OF AMERICA 1852 C FIRST TEXAS INSURANCE SERVICES LCC/O AIMEE TREECE 700 HIGHLANDER BLVD STE 350101 N ROBINSON AVE STE 1105 ARLINGTON, TX 76015-OKLAHOMA CITY, OK 73102-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1372 C FIRSTCOMP INSURANCE CO 0402 S FLORISTS MUTUAL INSURANCE COADELSON,TESTAN,BRUNDO,NOVELL & JIMENEZ- L FORMAN C/O AMY KRYST3700 N CLASSEN BLVD STE 102 PO BOX 8032OKLAHOMA CITY, OK 73118- STEVENS POINT, WI 54481-

1637 C FOREMOST INSURANCE CO GRAND RAPIDS MICHIGAN 1636 S FOREMOST PROPERTY & CASUALTY INSURANCEC/O LAURA DAVIS C/O LAURA DAVIS15700 LONG VISTA DRIVE 15700 LONG VISTA DRIVEAUSTIN, TX 78728- AUSTIN, TX 78728-

1638 S FOREMOST SIGNATURE INSURANCE COMPANY 1618 C FRANK WINSTON CRUM INSURANCE INCC/O TAMMY LEE C/O JAMES M CARRPO BOX 108843 100 S MISSOURI AVEOKLAHOMA CITY, OK 73101- CLEARWATER, FL 33756-

1439 S FRANKENMUTH MUTUAL INSURANCE CO 1479 C GATEWAY INSURANCE COATTN: MIKE PORTER 150 NW POINT BLVD 3RD FL2200 NW 50 ST STE 200E ELK GROVE VILLAGE, IL 60007-OKLAHOMA CITY, OK 73112-

0555 S GENERAL CASUALTY CO OF WISCONSIN 0435 S GENERAL INSURANCE CO OF AMERICAC/O SEDGWICK CMS C/O AIMEE TREECEATTN: KAMMI CORONADO 101 N ROBINSON AVE STE 1105PO BOX 975 OKLAHOMA CITY, OK 73102-SUN PRAIRIE, WI 53590-

1552 C GENESIS INSURANCE CO 0281 S GEORGIA CASUALTY & SURETY CO120 LONG RIDGE RD ATTN: PAUL BONHAMSTAMFORD, CT 06902- 10820 HARNEY STREET

OMAHA, NE 68154-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1553 C GERLING AMERICA INSURANCE CO 1838 S GOODVILLE MUTUAL CASUALTY CO161 N CLARK ST C/O MICHAEL S ZIMMERMANCHICAGO, IL 60601- 625 W MAIN ST PO BOX 489

NEW HOLLAND, PA 17557-

0557 C GRAIN DEALERS MUTUAL INSURANCE CO 0477 S GRANITE STATE INSURANCE COC/O BRUCE R FOX C/O WILLIAM PERRINE4601 TOUCHTON ROAD EAST, SUITE 3400 PO BOX 8301JACKSONVILLE, FL 32246- TULSA, OK 74101-8301

1661 GRAPHIC ARTS MUTUAL INSURANCE CO 1554 C GRAY CASUALTY & SURETY COATTN: MARTHA DUMONT ATTN: ROBERT HUGHES180 GENESEE ST PO BOX 6202NEW HARTFORD, NY 13413-2200 METAIRE, LA 70009-

1364 S GREAT AMERICAN ALLIANCE INSURANCE CO 1356 S GREAT AMERICAN ASSURANCE COATTN: MLADEN DOBROSAVLDEVIC ATTN: MLADEN DOBROSAVLDEVIC3211 INTERNET BLVD STE 350 3211 INTERNET BLVD STE 350FRISCO, TX 75034- FRISCO, TX 75034-

1353 S GREAT AMERICAN INSURANCE CO OF NEW YORK 1811 S GREAT AMERICAN SECURITY INSURANCE COMPANYATTN: MLADEN DOBROSAVLDEVIC MLADEN DOBROSAVLDEVIC3211 INTERNET BLVD STE 350 3211 INTERNET BLVD STE 350FRISCO, TX 75034- FRISCO, TX 75034-

1555 C GREAT AMERICAN SPIRIT INSURANCE CO 1431 C GREAT DIVIDE INSURANCE COATTN: MLADEN DOBROSAVLDEVIC ATTN: CLAIMS DEPT3211 INTERNET BLVD STE 350 7233 E BUTHERUS DRFRISCO, TX 75034- SCOTTSDALE, AZ 85260-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1597 C GREAT MIDWEST INSURANCE CO 0558 C GREAT NORTHERN INSURANCE COCBCS INC - AMY DRISCOLL C/O MALCOLM SMITH800 MAIN STREET 5416 S YALE AVE STE 225DUBUQUE, IA 52001- TULSA, OK 74135-

0345 S GREAT WEST CASUALTY CO 1556 GREATER NEW YORK MUTUAL INSURANCE COATTN: ASHLEY JAACKS ATTN: LILLIAN LENTPO BOX 94 200 MADISON AVESOUTH SIOUX CITY, NE 68776- NEW YORK, NY 10016-

1168 S GREENWICH INSURANCE CO 1429 S GUIDEONE ELITE INSURANCE COATTN: SARAH MIMS ATTN: TRINA OLAONE505 EAGLEVIEW BLVD STE 100 PO BOX 14543EXTON, PA 19341- DES MOINES, IA 50306-

0391 S GUIDEONE MUTUAL INSURANCE CO 1822 C GUIDEONE SPECIALTY MUTUAL INS COATTN: TRINA OLOANE 1111 ASHWORTH ROADPO BOX 14543 WEST DES MOINES, IA 50265-3538DES MOINES, IA 50306-

0418 C HANOVER AMERICAN INSURANCE CO 0419 C HANOVER INSURANCE COTHE CORPORATION COMPANY - C/O JUDY BEST THE CORPORATION COMPANY - C/O JUDY BEST1833 S MORGAN RD 1833 SOUTH MORGAN RDOKLAHOMA CITY, OK 73128- OKLAHOMA CITY, OK 73128-

1196 S HARBOR SPECIALTY INSURANCE CO 0307 S HARCO NATIONAL INSURANCEC/O MIDLANDS CLAIM ADMINISTRATORS THE CORPORATION COMPANYATTN: D NEWMAN 1833 SOUTH MORGAN RDPO BOX 238808 OKLAHOMA CITY, OK 73128-OKLAHOMA CITY, OK 73123-8808

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0562 S HARLEYSVILLE INSURANCE CO 0398 S HARLEYSVILLE MUTUAL INSURANCE CO355 MAPLE AVE 355 MAPLE AVEHARLEYSVILLE, PA 19438- HARLEYSVILLE, PA 19438-

0262 S HARTFORD ACCIDENT & INDEMNITY CO 0263 S HARTFORD CASUALTY INSURANCE COC/O THE CORPORATION COMPANY C/O THE CORPORATION COMPANY1833 S MORGAN RD 1833 S MORGAN RDOKLAHOMA CITY, OK 73128- OKLAHOMA CITY, OK 73128-

0264 S HARTFORD FIRE INSURANCE CO 1807 S HARTFORD INS CO OF THE SOUTHEASTC/O THE CORPORATION COMPANY C/O THE CORPORATION COMPANY1833 S MORGAN RD 1833 S MORGAN RDOKLAHOMA CITY, OK 73128- OKLAHOMA CITY, OK 73128-

1591 S HARTFORD INSURANCE CO OF ILLINOIS 0265 S HARTFORD INSURANCE CO OF THE MIDWESTC/O THE CORPORATION COMPANY C/O THE CORPORATION COMPANY1833 S MORGAN RD 1833 S MORGAN RDOKLAHOMA CITY, OK 73128- OKLAHOMA CITY, OK 73128-

1650 S HARTFORD SACRAMENTO INSURANCE CO 0266 S HARTFORD UNDERWRITERS INSURANCE COC/O THE CORPORATION COMPANY C/O THE CORPORATION COMPANY1833 S MORGAN RD 1833 S MORGAN RDOKLAHOMA CITY, OK 73128- OKLAHOMA CITY, OK 73128-

1603 C HDI GLOBAL INS CO FKA HDI GERLING AMERICA INSURANC 1896 S HERC HOLDINGS INC (OWN RISK)161 N CLARK ST FLOOR 48 BROADSPIRE SERVICES INC - HEATHER THEKANCHICAGO, IL 60601- 1391 NW 136TH AVE

SUNRISE, FL 33323-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1859 C HORIZON MIDWEST CASUALTY COMPANY 1558 HOUSING AUTHORITY PROPERTY INSURANCE A MUTUAL COMIDWEST BUILDERS CASUALTY MUTUAL CO - ELIZABETH LO ATTN: SARAH RODRIGUEZ1100 WALNUT ST STE 3010 PO BOX 189KANSAS CITY, MO 64106- CHESHIRE, CT 06410-

1823 C HOUSING SPECIALTY INSURANCE COMPANY INC 0284 S HOUSTON GENERAL INSURANCE COC/O EDMUND JOSEPH MALASPINA ATTN: VIRGINIA MCCARTHY189 COMMERCE COURT 150 ROYALL STCHESHIRE, CT 06410- CANTON, MA 02021-

1313 C HUDSON INSURANCE CO (TRIBES ONLY) 0478 S ILLINOIS NATIONAL INSURANCE CO100 WILLIAM ST FL 5 C/O WILLIAM PERRINENEW YORK, NY 10038-5044 PO BOX 8301

TULSA, OK 74101-8301

1617 C IMPERIUM INSURANCE CO 0412 C INDEMNITY INSURANCE CO OF NORTH AMERICACBCS INC - AMY DRISCOLL NORTH AMERICA COMMERCIAL CLAIM OPERATIONS800 MAIN ST PO BOX 5122DUBUQUE, IA 52001- SCRANTON, PA 18505-

1559 INDEMNITY NATIONAL INSURANCE CO 0278 C INDIANA LUMBERMENS MUTUALATTN: MATTHEW TUCKER 2005 MARKET ST STE 12004800 OLD KINGSTON PIKE PHILADELPHIA, PA 19103-7008KNOXVILLE, TN 37919-

0421 C INDUSTRIAL UNDERWRITERS 0252 C INSURANCE CO OF NORTH AMERICAC/O ESIS C/O ESISATTN: CAROL GALLIMORE ATTN: CAROL GALLIMORE225 E JOHN CARPENTER FWY STE 1300 225 E JOHN CARPENTER FWY STE 1300IRVING, TX 75062- IRVING, TX 75062-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0479 S INSURANCE CO OF THE STATE OF PENN 1165 S INSURANCE CO OF THE WESTC/O WILLIAM PERRINE C/O BARNUM & CLINTON PLLC - CATHY C BARNUMPO BOX 8301 1011 24TH AVE NWTULSA, OK 74101-8301 NORMAN, OK 73069-

1875 C INTREPID DIRECT INSURANCE 1841 S INTREPID INSURANCE COMPANYC/O JOHN BURKE C/O JAMES F BLONDIN9301 INNOVATION DRIVE STE 200 1250 E DIEHL ROAD STE 200MANASSAS, VA 20110- NAPERVILLE, IL 60563-

1894 C KEY RISK INSURANCE COMPANY 1848 C KS TRUCKERS RISK MGMT GROUP7823 NATIONAL SERVICE RD 13955 MEADOW CIRCLEGREENSBORO, NC 27409- LEAWOOD, KS 66224-

1768 C KYLE EDWARDS AUTO GROUP INC 1408 S LEXINGTON INSURANCE COPO BOX 386 C/O WILLIAM PERRINECHECOTAH, OK 74426-0386 PO BOX 8301

TULSA, OK 74101-8301

0570 S LIBERTY INSURANCE CORP 1629 C LIBERTY LIFE ASSURANCE CO OF BOSTONC/O AIMEE TREECE C/O AIMEE TREECE101 N ROBINSON AVE STE 1105 101 N ROBINSON AVE STE 1105OKLAHOMA CITY, OK 73102- OKLAHOMA CITY, OK 73102-

0571 S LIBERTY MUTUAL FIRE INSURANCE 0572 S LIBERTY MUTUAL INSURANCE COC/O AIMEE TREECE C/O AIMEE TREECE101 N ROBINSON AVE STE 1105 101 N ROBINSON AVE STE 1105OKLAHOMA CITY, OK 73102- OKLAHOMA CITY, OK 73102-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1414 C LINCOLN GENERAL INSURANCE CO 1627 C LION INSURANCE COATTN: KAREN GROFF ATTN: DUSTIN CLARKPO BOX 3709 2739 US HWY 19YORK, PA 17402- HOLIDAY, FL 34691-

1397 S LM INSURANCE CORP 1564 C LUBA CASUALTY INSURANCE COMPANYC/O AIMEE TREECE CAPITOL DOCUMENT SERVICES INC101 N ROBINSON AVE STE 1105 1833 S MORGAN RDOKLAHOMA CITY, OK 73102- OKLAHOMA CITY, OK 73128-

1878 S LUBA INDEMNITY INSURANCE COMPANY 0573 S LUMBERMENS UNDERWRITING ALLIANCEC/O CAPITOL DOCUMENT SERVICE INC ATTN: JAMES POIRIER1833 S MORGAN RD PO BOX 3061OKLAHOMA CITY, OK 73128- BOCA RATON, FL 33431-3061

1589 S MADISON INSURANCE CO 1815 C MAG MUTUAL INSURANCE COMPANYUS ADMINISTRATOR CLAIMS - CORD FARRIS THE CORPORATION COMPANY - JUDY BESTPO BOX 2005 1833 SOUTH MORGAN ROADOAK RIDGE, TN 37831- OKLAHOMA CITY, OK 73128-

1365 S MANUFACTURERS ALLIANCE INSURANCE CO 1814 C MARKEL AMERICAN INSURANCE COMPANYC/O GALLAGHER BASSETT SERVICES INC ATTN: CHRISTY C TOWNESATTN: STACY GOBLE 4521 HIGHWOODS PARKWAY14000 QUAIL SPRINGS PARKWAY SUITE 3000 GLEN ALLEN, VA 23060-OKLAHOMA CITY, OK 73134-

0407 S MARKEL INSURANCE CO 0420 C MASSACHUSETTS BAY INSURANCE COATTN: CHRISTY C TOWNES THE CORPORATION COMPANY - C/O JUDY BEST4521 HIGHWOODS PARKWYA 1833 S MORGAN RDGLEN ALLEN, VA 23060- OKLAHOMA CITY, OK 73128-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1501 C MEDICAL ASSURANCE CO 0575 S MEDMARC CASUALTY INSURANCE COATTN: JEFFREY MANGET ATTN: KAREN M MURPHYPO BOX 590009 14280 PARK MEADOW DR STE 300BIRMINGHAM, AL 35259-0009 CHANTILLY, VA 20151-2219

1886 C MEMIC CASUALTY COMPANY 1450 C MEMIC INDEMNITY COATTN: EILEEN FONGEMIE ATTN: EILEEN FONGEMIEPO BOX 11409 PO BOX 11409PORTLAND, ME 04104- PORTLAND, ME 04104-

1502 C MENDOTA INSURANCE CO 1464 S MERIDIAN SECURITY INSURANCE COATTN: ANTOINETTE CALLOWAY ATTN: SUSAN PILONPO BOX 64586 PO BOX 390327ST PAUL, MN 55164-0586 MINNEAPOLIS, MN 55439-

0453 C MICHIGAN MILLERS MUTUAL INSURANCE CO 0578 S MID CENTURY INSURANCE COC/O LEGALINC CORPORATE SERVICES INC - PATTIE SCLI C/O TAMMY LEE624 S DENVER AVE STE 300A PO BOX 108843TULSA, OK 74119- OKLAHOMA CITY, OK 73101-8843

0579 S MIDDLESEX INSURANCE CO 1818 C MIDSOUTH MUTUAL INSURANCE COMPANYATTN: MARY SWENSON ATTN: BONNIE MOSERPO BOX 8032 PO BOX 1125STEVENS POINT, WI 54481- BRENTWOOD, TN 37027-

1481 C MIDWEST BUILDERS CASUALTY MUTUAL CO 0581 S MIDWEST EMPLOYERS CASUALTY COELIZABETH LONG C/O MIKAL SOLTYS1100 WALNUT ST STE 3010 14755 N OUTER FORTY DR STE 300KANSAS CITY, MO 64106- CHESTERFIELD, MO 63017-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1864 C MIDWEST FAMILY ADVANTAGE INS COMPANY 1862 C MIDWEST FAMILY MUTUAL INS COMPANYATTN: KRISTIE VAN PELT ATTN: KRISTI VAN PELT4401 WESTOWN VAN PELT 4401 WESTWON PKWY STE 305WEST DES MOINES, IA 50266- WES DES MOINES, IA 50266-

1448 C MIDWEST INSURANCE CO 1504 S MILFORD INSURANCE CO FKA MILWAUKEE CASUALTY INSURAJOANNA CADLE C/O LISA JOHNSON300 S BRADFORDTON RD PO BOX 94405SPRINGFIELD, IL 62711- CLEVELAND, OH 44101-

1600 C MILWAUKEE CASUALTY INSURANCE CO (UNITRIN ) 1417 C MITSUI SUMITOMO INSURANCE CO OF AMERICAROY DYKES 560 LEXINGTON AVEPO BOX 650771 NEW YORK, NY 10022-DALLAS, TX 75265-

1418 C MITSUI SUMITOMO INSURANCE USA INC 1817 C MONROE GUARANTY INSURANCE COMPANY560 LEXINGTON AVE REGISTERED AGENT SOLUTIONS INC - RICARDO OROZCONEW YORK, NY 10022- 1406 TERRACE DRIVE

TULSA, OK 74104-

1632 C MONTGOMERY INSURANCE CO 1892 C MOTORISTS MUTUAL INSURANCE COMPANYC/O AIMEE TREECE 471 E BROAD ST101 N ROBINSON AVE STE 1105 COLUMBUS, OH 43215-3861OKLAHOMA CITY, OK 73102-

0427 C NATIONAL AMERICAN INSURANCE CO 1849 C NATIONAL BUILDERS INSURANCE COMPANYATTN: RICHARD EVANS PO BOX 723099PO DRAWER 38 ATLANTA, GA 31139-0099CHANDLER, OK 74834-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1592 C NATIONAL CASUALTY CO 0583 S NATIONAL FARMERS UNION PROPERTY & CASUALTY COATTN: BRIAN NELSON C/O ONE BEACON NATIONAL WORK COMP CENTER1100 LOCUST ST DEPT 3010 5 TECHNOLOGY DRDES MOINES, IA 50391- MILFORD, MA 01757-

0459 S NATIONAL FIRE INSURANCE CO OF HARTFORD 0282 S NATIONAL INDEMNITY COATTN: IRMA CLASS J MICHAEL GOTTSCHALK151 NORTH FRANKLIN 1314 DOUGLAS ST STE 1400CHICAGO, IL 60606- OMAHA, NE 68102-

1245 S NATIONAL INTERSTATE INSURANCE CO 0283 S NATIONAL LIABILITY FIRE & CASUALTYATTN: ALVIN B. TURNER JR. J MICHAEL GOTTSCHALK3250 INTERSTATE DR 1314 DOUGLAS ST STE 1400RICHFIELD, OH 44286-0549 OMAHA, NE 68102-5

0392 S NATIONAL SURETY CORP 1889 C NATIONAL TRUST INS COC/O FIREMENS FUND INSURANCE REGISTERED AGENT SOLUTIONS - RICARDO OROZCOPO BOX 74014 1406 TERRACE DRIVEATLANTA, GA 30374-0174 TULSA, OK 74104-

1870 S NATIONAL UNION FIRE INS CO OF PITTSBURGH PA 0480 S NATIONAL UNION FIRE INSURANCE COC/O WILLIAM PERRINE C/O WILLIAM PERRINEPO BOX 8301 PO BOX 8301TULSA, OK 74101-8301 TULSA, OK 74101-8301

0257 C NATIONWIDE AGRIBUSINESS INSURANCE CO 0586 C NATIONWIDE INSURANCE CO OF AMERICAATTN: BRIAN NELSON ATTN: BRIAN NELSON1100 LOCUST ST STE 3010 1100 LOCUST ST DEPT 3010DES MOINES, IA 50391-3010 DES MOINES, IA 50391-3010

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0367 C NATIONWIDE MUTUAL INSURANCE CO 1359 S NETHERLANDS INSURANCE COC/O CORPORATION SERVICE COMPANY ATTN: AIMEE TREECE10300 GREENBRIAR PLACE 101 N ROBINSON AVE STE 1105OKLAHOMA CITY, OK 73159-7653 OKLAHOMA CITY, OK 73102-

0481 S NEW HAMPSHIRE INDEMNITY CO 0482 S NEW HAMPSHIRE INSURANCE COC/O WILLIAM PERRINE C/O WILLIAM PERRINEPO BOX 8301 PO BOX 8301TULSA, OK 74101-8301 TULSA, OK 74101-8301

1505 C NEW YORK MARINE & GENERAL INSURANCE CO 1757 C NORGUARD INSURANCE COC/O CCMSI PO BOX A HATTN: LASHAWNA SEARS WILKES BARRE, PA 18703-00201501 NORTH UNIVERSITY AVE SUITE 767LITTLE ROCK, AR 72207-

1858 C NORMANDY INSURANCE COMPANY 1508 C NORTH AMERICAN ELITE INSURANCE COATTN: JOSE BELTRAN ATTN: EDWARD STYS800 FAIRWAY DR SUITE 160 650 ELM STDEERFIELD BEECH, FL 33441-1828 MANCHESTER, NH 03103-

0590 S NORTH AMERICAN SPECIALTY INSURANCE CO 1605 C NORTH DAKOTA WORKFORCE SAFETY & INSURANCE (NLC)C/O GALLAGHER BASSETT PO BOX 5585ATTN: CARLA TATE BISMARCK, ND 58506-558514000 QUAIL SPRINGS PKWY #3000OKLAHOMA CITY, OK 73134-

1509 S NORTH POINTE INSURANCE CO 0591 S NORTH RIVER INSURANCE COC/O SEDGWICK CMS C/O MIKE HICKSATTN: KAMMI CORONADO 2400 LAKESIDE BLVD STE 200PO BOX 975 RICHARDSON, TX 75082-4341SUN PRAIRIE, WI 53950-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0442 S NORTHERN ASSURANCE CO 1510 C NORTHLAND CASUALTY COATTN: VIRGINIA MCCARTHY ATTN: MICHAEL DOODY150 ROYALL ST PO BOX 64816CANTON, MA 02021- ST PAUL, MN 55164-

1511 C NORTHLAND INSURANCE CO 0593 C NORTHWESTERN PACIFIC INDEMNITY COATTN: MICHAEL DOODY C/O MALCOLM SMITHPO BOX 64816 5416 S YALE AVE STE 225ST PAUL, MN 55164- TULSA, OK 74105-

1488 C NOVA CASUALTY CO 1872 C NUTMEG INSURANCE COMPANYTHE CORPORATION COMPANY - C/O JUDY BEST C/O THE CORPORATION COMPANY - JUDY BEST1833 SOUTH MORGAN RD 1833 S MORGAN RDOKLAHOMA CITY, OK 73128- OKLAHOMA CITY, OK 73128-

1827 C O & M TB LLC 1658 C OAK RIVER INSURANCE COMPANY (ORIC)O & M TB LLC BERKSHIRE HATHAWAY HOMESTATE COMPANIES (BHHC)6533 N CLASSEN BLVD ATTN: NICOLE ALBRECHTOKLAHOMA CITY, OK 73116-7309 P O BOX 881716

SAN FRANCISCO, CA 94188-

1791 C OBI AMERICA INSURNCE COMPANY 1641 S OBI NATIONAL INSURANCE CO605 HWY 169 N STE 800 605 HWY 169 N STE 800PLYMOUTH, MN 55441- PLYMOUTH, MN 55441-

1512 C OCCIDENTAL FIRE & CASUALTY OF NORTH CAROLINA 0347 S OHIO CASUALTY INSURANCE COATTN: MICHAEL BLINSON C/O AIMEE TREECE702 OBERLIN ROAD 101 N ROBINSON AVE STE 1105RALEIGH, NC 27605- OKLAHOMA CITY, OK 73102-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1585 S OHIO FARMERS INSURANCE CO 1426 C OHIO SECURITY INSURANCE COC/O BROADSPIRE SERVICES INC ATTN: AIMEE J TREECEATTN: DEBRA GLOVER 101 N ROBINSON STE 11055901 COLLEGE BLVD STE 275 OKC, OK 02116-OVERLAND PARK, KS 66211-

1465 C OLD GLORY INSURANCE CO 1382 C OLD REPUBLIC GENERAL INSURANCE CORPTHE CORPORATION COMPANY C/O PRENTICE HALL CORP1833 SOUTH MORGAN ROAD 10300 GREENBRIAR PLACEOKLAHOMA CITY, OK 73128- OKLAHOMA CITY, OK 73159-7653

0425 C OLD REPUBLIC INSURANCE CO 1423 S ONE BEACON AMERICA INSURANCE COC/O PRENTICE HALL CORP ATTN: JIM JORDAN10300 GREENBRIAR PLACE 150 ROYALL STOKLAHOMA CITY, OK 73159-7653 CANTON, MA 02021-

0441 S ONE BEACON INSURANCE CO (FKA CGU INSURANCE) 0253 C PACIFIC EMPLOYERS INSURANCE COATTN: JIM JORDAN C/O ESIS150 ROYALL ST ATTN: CAROL GALLIMORECANTON, MA 02021- 225 E JOHN CARPENTER FWY STE 1300

IRVING, TX 75062-

0596 C PACIFIC INDEMNITY CO 1419 S PEERLESS INDEMNITY INSURANCE COC/O MALCOLM SMITH C/O AIMEE TREECE5416 S YALE AVE STE 225 101 N ROBINSON AVE STE 1105TULSA, OK 74135- OKLAHOMA CITY, OK 73102-

1346 S PEERLESS INSURANCE CO 1840 C PENN MILLERS INS COC/O AIMEE TREECE C/O TRACY VALICHKA101 N ROBINSON AVE STE 1105 PO BOX POKLAHOMA CITY, OK 73102- WILKES-BARRE, PA 18773-0016

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0446 S PENNSYLVANIA INS CO FKA PENNSYLVANIA GENERAL INS C 1156 S PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE CATTN: PETER GUNN C/O GALLAGHER BASSETT SERVICES INCPO BOX 3646 ATTN: STACY KARBSOMAHA, NE 68103-0646 14000 QUAIL SPRINGS PKWAY STE 3000

OKLAHOMA CITY, OK 73134-

1389 S PENNSYLVANIA MANUFACTURERS INDEMNITY CO 0438 C PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COC/O GALLAGHER BASSETT SERVICES INC C/O CYNTHIA REINHARTATTN: STACY KARBS PO BOX 23611400 QUAIL SPRINGS PKWY STE 3000 HARRISBURG, PA 17105-OKLAHOMA CITY, OK 73134-

0490 S PETROLEUM CASUALTY CO 0599 S PHARMACISTS MUTUAL INS COC/O EXXON MOBIL RISK MANAGEMENT INC C/O JAY MCATEEC/O ANDREW KIYFES 1115 S CINCINNATI3225 GALLOWS RD TULSA, OK 74119-FAIRFAX, VA 22037-

0288 C PHOENIX INSURANCE CO 1513 C PLATTE RIVER INSURANCE COC/O CORPORATION SERVICE CO ATTN: JOSH DENO10300 GREENBRIAR PLACE PO BOX 5900OKLAHOMA CITY, OK 73159- MADISON, WI 53705-

1432 S PRAETORIAN INSURANCE CO 1893 C PREFERRED EMPLOYERS INS COC/O SEDGWICK CMS 8300 BISSONNET STE 610ATTN: KAMMI CORONADO HOUSTON, TX 77074-PO BOX 975SUN PRAIRIE, WI 53590-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1447 C PREFERRED PROFESSIONAL INSURANCE CO 1890 C PROASSURANCE INDEMNITY COMPANY INC11605 MIRACLE HILLS DR STE 200 100 BROOKWOOD PL STE 500OMAHA, NE 68154- BIRMINGHAM, AL 35209-6832

1669 C PROFESSIONAL INSURANCE 1654 C PROPERTY & CASUALTY INSURANCE COMPANY OF HARTFORD1122 N WALTON BLVD C/O THE CORPORATION COMPANYBENTONVILLE, AR 72712- 1833 S MORGAN RD

OKLAHOMA CITY, OK 73128-

1831 C PROSELECT INSURANCE COMPANY 0465 S PROTECTIVE INSURANCE COANNE SEGGERMAN ATTN: DAVID GHESQUIEREONE FINANCIAL CENTER 13TH FL PO BOX 7099BOSTON, MA 02111- INDIANAPOLIS, IN 46207-7099

1857 C PROTUCKET INSURANCE COMPANY 1594 S QBE INSURANCE CORPATTN: ALBERT B MILLER C/O SEDGWICK CMS3501 CONCORD RD STE 120 ATTN: KAMMI CORONADOYORK, PA 17402- PO BOX 975

SUN PRAIRIE, WI 53590-

1771 RED ROCK INSURANCE COMPANY 0605 S REDLANDS INSURANCE COC/O DEMCY WILSON C/O SEDGWICK CMS13431 N BROADWAY STE 101A ATTN: KAMMI CORONADOOKLAHOMA CITY, OK 73114- PO BOX 975

SUN PRAIRIE, WI 53590-

1744 C REDWOOD FIRE AND CASUALTY INSURANCE COMPANY 0606 S REGENT INSURANCE COATTN: NICOLE ALBRECHT C/O SEDGWICK CMSPO BOX 881716 ATTN: KAMMI CORONADOSAN FRANCISCO, CA 94188- PO BOX 975

SUN PRAIRIE, WI 53590-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1162 C REPUBLIC FIRE & CASUALTY INSURANCE CO 1163 C REPUBLIC UNDERWRITERS INSURANCE COATTN: EBONY UPSHAW ATTN: EBONY UPSHAWPO BOX 809076 PO BOX 809076DALLAS, TX 75380- DALLAS, TX 75380-

0330 S REPUBLIC WESTERN INSURANCE CO 1895 C REPWEST INSURANCE COMPANYC/O BARBARA DECOSTA 6690 BETA DRIVE2721 N CENTRAL AVE CLEVELAND, OH 44143-2359PHOENIX, AZ 85004-

1517 C RIVERPORT INSURANCE CO 1635 C RLI INSURANCE COMPANYATTN: JAMES F BLONDIN 9025 N LINDBERGH DR1250 E DIEHL ROAD SUITE 200 PEORIA, IL 61615-1499NAPERVILLE, IL 60563-

1518 C ROCKWOOD CASUALTY INSURANCE CO 1519 C RURAL COMMUNITY INSURANCE CO654 MAIN ST ATTN: DEBORAH LARSONROCKWOOD, PA 15557- 3501 THURSTON AVE

ANOKA, MN 55303-

1789 S RURAL TRUST INSURANCE CO 0436 S SAFECO INSURANCE CO OF AMERICA6301 IVY LN STE 506 C/O AIMEE TREECEGREENBELT, MD 20770-6338 101 N ROBINSON AVE STE 1105

OKLAHOMA CITY, OK 73102-

1325 C SAFETY FIRST INSURANCE CO 1155 C SAFETY NATIONAL CASUALTY CORPTHE CORPORATION COMPANY THE CORPORATION COMPANY1833 MORGAN ROAD 1833 SOUTH MORGAN RDOKLAHOMA CITY, OK 73128- OKLAHOMA CITY, OK 73128-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1257 C SAGAMORE INSURANCE CO 1631 C SAMSUNG FIRE & MARINE INSURANCE CO LTD USBC/O DAVID GHESQUIERE 85 CHALLENGER RD FL 6PO BOX 7099 RIDGEFIELD PARK, NJ 07660-2112INDIANAPOLIS, IN 46207-7099

1381 S SEABRIGHT INSURANCE CO 1826 C SEABRIGHT INSURANCE CO (CLEARSPRING)ATTN: JOHN MALONEY ATTN: JOHN MALONEY227 WEST MONROE STE 3950 227 WEST MONROE STE 3950CHICAGO, IL 60606- CHICAGO, IL 60606-

1613 C SECURA INSURANCE CO 1598 C SECURITY NATIONAL INSURANCE CO (AMTRUST)PO BOX 819 CO/ LISA JOHNSONAPPLETON, WI 54912- PO BOX 94405

CLEVELAND, OH 44101-

1737 C SEDGWICK INSURANCE CO 0372 C SELECT INSURANCE COSEDGWICK INSURANCE CO C/O CORPORATION SERVICE COPO BOX 14567 10300 GREENBRIAR PLACELEXINGTON, KY 40512- OKLAHOMA CITY, OK 73159-

1434 S SENTINEL INSURANCE CO LTD 1494 C SENTRY CASUALTY COTHE CORPORATION COMPANY - JUDY BEST ATTN: AMY KRYST1833 SOUTH MORGAN RD PO BOX 8032OKLAHOMA CITY, OK 73128- STEVENS POINT, WI 54481-

0355 C SENTRY INSURANCE A MUTUAL CO 1166 C SENTRY SELECT INSURANCE COATTN: AMY KRYST ATTN: AMY KRYSTPO BOX 8032 PO BOX 8032STEVENS POINT, WI 54481-- STEVENS POINT, WI 54481-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1577 C SEQUOIA INSURANCE CO 1885 C SERVICE AMERICAN INDEMNITY COMPANYPO BOX 15030 BROADSPIRE SERVICES INC - GODFREY LECOINTELAS VEGAS, NV 89114- PO BOX 14342

LEXINGTON, KY 40512-

1521 C SERVICE INSURANCE CO 1883 C SERVOCE AMERICAN INDEMNITY COMPANYATTN: BROOKE SHIRAZI BROADSPIRE SERVICES INC - GODFREY LECOINTE4730 STATE ROAD 64 E PO BOX 14342BRADENTON, FL 34208- LEXINGTON, KY 40512-

1483 C SFM MUTUAL INSURANCE CO 1742 C SILVER OAK CASUALTY INCATTN: BRIAN R BENT C/O KATHRYN H SHIRLEYPO BOX 9416 2301 HWY 190 WMINNEAPOLIS, MN 55440- DERIDDER, LA 70634-

0469 S SOMPO AMERICA FIRE & MARINE INS CO 1871 S SOMPO AMERICA INSURANCE COMPANYATTN: CAREY ARMISTREAD GALLAGHER BASSETT - STACY KARBS11405 COMMUNITY HOUSE RD STE 600 14000 QUAIL SPRINGS PKWY STE 3000CHARLOTTE, NC 28277- OKLAHOMA CITY, OK 73134-

1164 C SOUTHERN INSURANCE CO 1161 C SOUTHERN UNDERWRITERS INSURANCE COPO BOX 809076 ATTN: EBONY UPSHAWDALLAS, TX 75380-9076 PO BOX 809076

DALLAS, TX 75380-9076

1475 C SPARTA INSURANCE CO 0623 C ST PAUL FIRE & MARINE INSURANCE COATTN: JOHN MINDEK C/O CORPORATION SERVICE CO5 BATTERSON PARK RD FL 3 10300 GREENBRIAR PLACEFARMINGTON, CT 06032-2501 OKLAHOMA CITY, OK 73159-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0414 C ST PAUL GUARDIAN INSURANCE CO 1522 C ST PAUL MEDICAL LIABILITY INSURANCE COC/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO10300 GREENBRIAR PLACE 10300 GREENBRIAR PLACEOKLAHOMA CITY, OK 73159- OKLAHOMA CITY, OK 73159-

0415 C ST PAUL MERCURY INSURANCE CO 1523 C ST PAUL PROTECTIVE INSURANCE COC/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO10300 GREENBRIAR PLACE 10300 GREENBRIAR PLACEOKLAHOMA CITY, OK 73159- OKLAHOMA CITY, OK 73159-

0410 C STANDARD FIRE INSURANCE 0416 S STAR INSURANCE COC/O CORPORATION SERVICE CO C/O JAMES AUSTIN10300 GREENBRIAR PLACE PO BOX 219559OKLAHOMA CITY, OK 73159- KANSAS CITY, MO 64141-9559

1461 C STARNET INSURANCE CO 1524 C STARR INDEMNITY & LIABILITY COC/O JOHN BURKE 399 PARK AVE 3RD FL9301 INNOVATION DR STE 200 NEW YORK, NY 10022-MANASSAS, VA 20110-

1888 C STARR SPECIALTY INSURANCE CO 1682 C STARSTONE INS HOLDINGS FKA TORUS NATL INS CO399 PARK AVE 3RD FL C/O ENSTAR US - DAVID J CALANDRONEW YORK, NY 10022- 150 2ND AVENUE NORTH 3RD FL

ST PETERSBURG, FL 33701-

1879 S STARSTONE NATIONAL INSURANCE COMPANY 0625 S STATE AUTO PROPERTY & CASUALTY INSURANCE COENSTAR US - DAVID J CALANDRO ATTN: SUSAN PILON150 2ND AVE NORTH 3RD FL PO BOX 390327ST PETERSBURG, FL 33704-1 MINNEAPOLIS, MN 55439-0327

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0626 S STATE AUTOMOBILE MUTUAL INSURANCE CO 0315 S STATE FARM FIRE AND CASUALTY COATTN: SUSAN PILON C/O CORPORATION SERVICE COMPANYPO BOX 390327 10300 GREENBRIAR PLACEMINNEAPOLIS, MN 55439-0327 OKLAHOMA CITY, OK 73159-7653

1843 C STATE FARM MUTUAL AUTOMOBILE INS CO 1352 S STATE NATIONAL INSURANCE COSEDGWICK CMS ATTN: JEANNIE ALMAGUERPO BOX 14015 1900 L DON DODSON DRLEXINGTON, KY 40512-4015 BEDFORD, TX 76021-

1868 S STEADFAST INSURANCE COMPANY 1753 C STILLWATER PROPERTY AND CASUALTY INSURANCE COZURICH CLAIMS ATTN: MARK DAVEYATTN: TANYA GROOVER PO BOX 45126PO BOX 968023 JACKSONVILLE, FL 32232-SCHAUMBURG, IL 60196-

1471 S STONETRUST COMMERCIAL INSURANCE CO 1525 C STONINGTON INSURANCE COATTN: ANGELA SANDERS C/O SEDGWICK CMS5615 CORPORATE BLVD STE 700 ATTN: LISA ZIMMERMANBATON ROUGE, LA 70808-2557 PO BOX 975

SUN PRAIRIE, WI 53590-

1619 S SUNZ INSURANCE CO 1242 C TECHNOLOGY INSURANCE CO (AMTRUST)C/O NEXT LEVEL ADMIN LLC - LISA WAGNER ATTN: LISA JOHNSON1301 6TH AVE W 2ND FLOOR PO BOX 94405BRADENTON, FL 34205- CLEVELAND, OH 44101-

0339 S THE GRAY INSURANCE CO 1260 C THE INSURANCE COC/O FLOYD SIBLEY ATTN: LIN DOLENPO BOX 6202 10451 GULF BLVDMETAIRIE, LA 70009-6202 TREASURE ISLAND, FL 33706-4814

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1572 TNUS INSURANCE CO 0331 S TOKIO MARINE AMERICA INS COATTN: KATHY STEPHENS ATTN: KATHY STEPHENSPO BOX 483 PO BOX 483JERSEY CITY, NJ 07303- JERSEY CITY, NJ 07303-

1459 C TOWER INSURANCE CO OF NEW YORK 1573 C TOWER NATIONAL INSURANCE COATTN: BILL HIPSELBERGER ATTN: BILL HIPSELBERGER200 HUDSON ST STE 800 200 HUDSON ST STE 800JERSEY CITY, NJ 07311-1104 JERSEY CITY, NJ 07311-1104

1586 C TOYOTA MOTOR INSURANCE CO 1498 S TRANS PACIFIC INSURANCE CO (NEW ID)19001 S WESTERN AVE NF 23 ATTN: KATHY STEPHENSTORRANCE, CA 90509- PO BOX 483

JERSEY CITY, NJ 07310-

1240 C TRANSGUARD INSURANCE CO OF AMERICA INC 0463 S TRANSPORTATION INSURANCE COC/O CORPORATION SERVICE CO ATTN: IRMA CLASS10300 GREENBRIAR PLACE 151 NORTH FRANKLINOKLAHOMA CITY, OK 73159- CHICAGO, IL 60606-

0289 C TRAVCO 0290 C TRAVELERS CASUALTY & SURETY COC/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO10300 GREENBRIAR PLACE 10300 GREENBRIAR PLACEOKLAHOMA CITY, OK 73159- OKLAHOMA CITY, OK 73159-7653

0291 C TRAVELERS CASUALTY & SURETY OF AMERICA 0293 C TRAVELERS CASUALTY CO OF CONNECTICUTC/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO10300 GREENBRIAR PLACE 10300 GREENBRIAR PLACEOKLAHOMA CITY, OK 73159-7653 OKLAHOMA CITY, OK 73159-7653

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0292 C TRAVELERS CASUALTY INSURANCE CO OF AMERICA 0294 C TRAVELERS COMMERCIAL INSURANCE COC/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO10300 GREENBRIAR PLACE 10300 GREENBRIAR PLACEOKLAHOMA CITY, OK 73159-7653 OKLAHOMA CITY, OK 73159-7653

0295 C TRAVELERS HOME & MARINE INSURANCE CO 0296 C TRAVELERS INDEMNITY COC/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO10300 GREENBRIAR PLACE 10300 GREENBRIAR PLACEOKLAHOMA CITY, OK 73159-7653 OKLAHOMA CITY, OK 73159-7653

0297 C TRAVELERS INDEMNITY CO OF AMERICA 0298 C TRAVELERS INDEMNITY CO OF CONNECTICUTC/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO10300 GREENBRIAR PLACE 10300 GREENBRIAR PLACEOKLAHOMA CITY, OK 73159-7653 OKLAHOMA CITY, OK 73159-7653

0300 C TRAVELERS INDEMNITY CO OF MISSOURI 0301 C TRAVELERS INSURANCE COC/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO10300 GREENBRIAR PLACE 10300 GREENBRIAR PLACEOKLAHOMA CITY, OK 73159-7653 OKLAHOMA CITY, OK 73159-7653

0299 C TRAVELERS PROPERTY & CASUALTY CO OF AMERICA 1643 C TRI STATE INSURANCE COMPANY OF MINNESOTAC/O CORPORATION SERVICE CO ATTN: JAMES F BLONDIN10300 GREENBRIAR PLACE 1250 E DIEHL ROAD, SUITE 200OKLAHOMA CITY, OK 73159-7653 NAPERVILLE, IL 60563-

1324 S TRIANGLE INSURANCE CO 1729 S TRIUMPHE CASUALTY COMPANYATTN: ALLEN WILLIAMS C/O COMMERCIAL INSURANCE SERVICESPO BOX 1719 PO BOX 25928LITTLE ROCK, AR 72203- OKLAHOMA CITY, OK 73125-0928

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 37

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0635 S TRUCK INSURANCE EXCHANGE 1621 S TRUMBULL INSURANCE COC/O TAMMY LEE C/O THE CORPORATION COMPANYPO BOX 108843 1833 S MORGAN RDOKLAHOMA CITY, OK 73101-8843 OKLAHOMA CITY, OK 73128-

0268 S TWIN CITY FIRE INSURANCE CO 0309 S UNION INSURANCE COTHE CORPORATION COMPANY ATTN: SUZANNE RICHARDSON1833 S MORGAN RD PO BOX 152180OKLAHOMA CITY, OK 73128- IRVING, TX 75015-

1797 C UNION INSURANCE COMPANY OF PROVIDENCE 0483 C UNITED STATES FIDELITY & GUARANTY COWALKER, FERGUSON & FERGUSON - JON DEROUEN JR C/O CORPORATION SERVICE CO941 E BRITTON RD 10300 GREENBRIAR PLACEOKLAHOMA CITY, OK 73114- OKLAHOMA CITY, OK 73159-

0640 S UNITED STATES FIRE INSURANCE CO 1428 C UNITED WISCONSIN INSURANCE COATTN: MIKE HICKS ATTN: JOE WROZEK2400 LAKESIDE BLVD STE 200 PO BOX 40790RICHARDSON, TX 75082- LANSING, MI 48901-

0323 S UNIVERSAL UNDERWRITERS INSURANCE CO 1866 S UNIVERSAL UNDERWRITERS OF TEXAS INS COC/O ZURICH CLAIMS ZURICH CLAIMSATTN: TANYA GROOVER ATTN: TANYA GROOVERPO BOX 968023 PO BOX 968023SCHAUMBURG, IL 60196- SCHAUMBURG, IL 60196-

1799 C US FIRE INS CO 1413 C US SPECIALTY INSURANCE CO305 MADISON AVENUE ATTN: TOM ROONEYMORRISWTOWN, NJ 07960- 13403 NW FRWY

HOUSTON, TX 77040-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 38

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0426 C UTICA MUTUAL INSURANCE CO 1606 C UTICA NATIONAL ASSURANCE COATTN: LOUISA S RUFFINE C/O LOUISA S RUFFINEPO BOX 530 PO BOX 530UTICA, NY 13503- UTICA, NY 13503-

0464 S VALLEY FORGE INSURANCE CO 0396 S VANLINER INSURANCE COATTN: IRMA CLASS ATTN: ALVIN B TURNER JR151 NORTH FRANKLIN 3250 INTERSTATE INSURANCE COMPANYCHICAGO, IL 60606- RICHFIELD, OH 44286-

1743 C VANTAPRO SPECIALTY INSURANCE COMPANY 0642 C VIGILANT INSURANCE COC/O MARLENE MOURAD C/O MALCOLM SMITH1690 NEW BRITAIN AVE STE 101 5416 S YALE AVE STE 225FARMINGTON, CT 06032- TULSA, OK 74135-

0644 C VIRGINIA SURETY CO 0645 S WAUSAU BUSINESS INSURANCE COC/O JEFF DASOVICH C/O AIMEE TREECE11914 N PENN AVE STE B4 101 N ROBINSON AVE STE 1105OKLAHOMA CITY, OK 73120- OKLAHOMA CITY, OK 73102-

0431 S WAUSAU UNDERWRITERS INSURANCE CO 1529 C WESCO INSURANCE CO (AMTRUST)C/O AIMEE TREECE ATTN: LISA JOHNSON101 N ROBINSON AVE STE 1105 PO BOX 94405OKLAHOMA CITY, OK 73102- CLEVELAND, OH 44101-

0348 S WEST AMERICAN INSURANCE CO 1839 C WEST BEND MUTUAL INSURANCE COMPANYC/O AIMEE TREECE ATTN CHRIS ZWYGART101 N ROBINSON AVE STE 1105 1900 S 18TH AVEOKLAHOMA CITY, OK 73102- WEST BEND, WI 53095-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 39

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

0428 C WESTCHESTER FIRE INSURANCE 1759 C WESTCO INSURANCEC/O ESIS WESTCO INSURANCEATTN: CAROL GALLIMORE 420 MAPLE225 E JOHN CARPENTER FWY STE 1300 YUKON, OK 73099-IRVING, TX 75062-

1530 C WESTERN AGRICULTURAL INSURANCE CO 1566 C WESTERN NATIONAL ASSURANCE COATTN: CONNIE T DRESEN PO BOX 14635400 UNIVERSITY AVE MINNEAPOLIS, MN 55440-WEST DES MOINES, IA 50266-

1422 S WESTFIELD INSURANCE CO 1824 S WESTFIELD NATIONAL INS COC/O BROADSPIRE SERVICES INC C/O BROADSPIRE SERVICES INCATTN: DEBRA GLOVER ATTN DEBRA GLOVER5901 COLLEGE BLVD STE 275 5901 COLLEGE BLVD STE 275OVERLAND PARK, KS 66211- OVERLAND PARK, KS 66211-

1451 S WORK FIRST CASUALTY CO 1792 C WORKERS FIRST COMPENSATION FUNDC/O BROADSPIRE SERVICES INC 4314 EAGLE POINT PARKWAYATTN: ANGELA STEIN BIRMINGHAM, AL 35242-PO BOX 14342LEXINGTON, KY 40512-4342

1640 C WORLDWIDE UNDERWRITERS INSURANCE CO 1531 S XL INSURANCE AMERICA INCC/O AIMEE TREECE ATTN: BEKKI COLLINS101 N ROBINSON AVE STE 1105 725 S FIGUEROA STOKLAHOMA CITY, OK 73102- LOS ANGLES, CA 90017-

1169 S XL SPECIALTY INSURANCE CO 0313 S ZENITH INSURANCE COATTN: BEKKI COLLINS C/O BURNS ANDERSON JURY & BRENNER LP725 S FIGUEROA ST PO BOX 26300LOS ANGELES, CA 90017- AUSTIN, TX 78755-

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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Date: 04/01/2020 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLSTTime: 08:13 CARRIER LISTING Page: 40

TYPE: INSUR CO

Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address

1645 C ZNAT INSURANCE CO 0649 S ZURICH AMERICAN INSURANCE COC/O BURNS ANDERSON JURY AND BRENNER LLP C/O ZURICH CLAIMSPO BOX 26300 ATTN: TANYA GROOVERAUSTIN, TX 78755- PO BOX 968023

SCHAUMBURG, IL 60196-

1420 S ZURICH AMERICAN INSURANCE CO OF ILC/O ZURICH CLAIMSATTN: TONYA GROOVERPO BOX 968023SCHAUMBURG, IL 60196-

Records printed: 469

* Inv Flag 'S' indicates Service Company, 'C' indicates Corporate