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OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 1 Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address 1462 S ACADIA INSURANCE CO 1457 S ACCIDENT FUND GENERAL INSURANCE CO ATTN: TODD ESTES C/O BROADSPIRE PO BOX 26350 ATTN: TINA LITWILLER OKLAHOMA CITY, OK 73126- 2200 NW 50 ST STE 200E OKLAHOMA CITY, OK 73112- Phone (1): (405)235-1611 Phone (1): (866)206-5851 CarrRep: DSA: [email protected] CarrRep: [email protected] InsComm: [email protected] DSA: [email protected] InsComm: [email protected] 1291 S ACCIDENT FUND INSURANCE CO OF AMERICA 1467 S ACCIDENT FUND NATIONAL INSURANCE CO C/O BROADSPIRE C/O BROADSPIRE ATTN: TINA LITWILLER ATTN: TINA LITWILLER 2200 NW 50 ST STE 200E 2200 NW 50 ST STE 200E OKLAHOMA CITY, OK 73112- OKLAHOMA CITY, OK 73112- Phone (1): (866)206-5851 Phone (1): (866)206-5851 CarrRep: [email protected] CarrRep: [email protected] DSA: [email protected] DSA: [email protected] InsComm: [email protected] InsComm: [email protected] 1588 S ACCIDENT INSURANCE CO INC 0251 C ACE AMERICAN INSURANCE CO PO BOX 2005 C/O ESIS OAK RIDGE, TN 37831- ATTN: CAROL GALLIMORE 225 E JOHN CARPENTER FWY STE 1300 Phone (1): (800)896-6884 IRVING, TX 75062- Phone (2): (866)984-3316 Phone (1): (302)476-7446 CarrRep: Phone (2): (972)465-7704 DSA: [email protected] InsComm: CarrRep: [email protected] DSA: [email protected] InsComm: [email protected] * Inv Flag 'S' indicates Service Company, 'C' indicates Corporate

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OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 1

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1462 S ACADIA INSURANCE CO 1457 S ACCIDENT FUND GENERAL INSURANCE CO

ATTN: TODD ESTES C/O BROADSPIRE

PO BOX 26350 ATTN: TINA LITWILLER

OKLAHOMA CITY, OK 73126- 2200 NW 50 ST STE 200E

OKLAHOMA CITY, OK 73112-

Phone (1): (405)235-1611

Phone (1): (866)206-5851

CarrRep:

DSA: [email protected] CarrRep: [email protected]

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

1291 S ACCIDENT FUND INSURANCE CO OF AMERICA 1467 S ACCIDENT FUND NATIONAL INSURANCE CO

C/O BROADSPIRE C/O BROADSPIRE

ATTN: TINA LITWILLER ATTN: TINA LITWILLER

2200 NW 50 ST STE 200E 2200 NW 50 ST STE 200E

OKLAHOMA CITY, OK 73112- OKLAHOMA CITY, OK 73112-

Phone (1): (866)206-5851 Phone (1): (866)206-5851

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1588 S ACCIDENT INSURANCE CO INC 0251 C ACE AMERICAN INSURANCE CO

PO BOX 2005 C/O ESIS

OAK RIDGE, TN 37831- ATTN: CAROL GALLIMORE

225 E JOHN CARPENTER FWY STE 1300

Phone (1): (800)896-6884 IRVING, TX 75062-

Phone (2): (866)984-3316

Phone (1): (302)476-7446

CarrRep: Phone (2): (972)465-7704

DSA: [email protected]

InsComm: CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 2

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0360 C ACE FIRE UNDERWRITERS INSURANCE CO 0526 C ACE PROPERTY & CASUALTY INSURANCE CO

C/O ESIS C/O ESIS

ATTN: CAROL GALLIMORE ATTN: CAROL GALLIMORE

225 E JOHN CARPENTER FWY STE 1300 225 E JOHN CARPENTER FWY STE 1300

IRVING, TX 75062- IRVING, TX 75062-

Phone (1): (302)476-7446 Phone (1): (302)476-7446

Phone (2): (972)465-7704 Phone (2): (972)465-7704

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0505 S ACIG INSURANCE CO 1427 C ADVANTAGE WORKERS COMPENSATION INSURANCE CO

ATTN: LINDSEY MICHAELS PO BOX 571918

12222 MERIT DR STE 1660 SALT LAKE CITY, UT 84157-

DALLAS, TX 75251-

Phone (1): (972)702-9004 CarrRep:

DSA: [email protected]

CarrRep: InsComm: [email protected]

DSA: [email protected]

InsComm: [email protected]

0474 S AIU INSURANCE CO 0498 S ALASKA NATIONAL INSURANCE CO

C/O WILLIAM PERRINE 7001 JEWEL LAKE RD

PO BOX 8301 ANCHORAGE, AK 99502-2825

TULSA, OK 74101-8301

Phone (1): (972)448-1711 CarrRep:

Phone (2): (918)382-1400 DSA: [email protected]

InsComm: [email protected]

CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 3

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1268 S ALEA NORTH AMERICA INSURANCE CO 0304 S ALL AMERICA INSURANCE CO

55 CAPITAL BLVD C/O C SCOTT BEUCH

ROCKY HILL, CT 06067- 2201 N CLASSEN

OKLAHOMA CITY, OK 73106-

Phone (1): (860)258-6512

Phone (1): (419)238-1010

CarrRep: Phone (2): (405)524-4333

DSA:

InsComm: [email protected] CarrRep:

DSA: [email protected]

InsComm: [email protected]

1582 C ALLIANCE INDEMNITY CO 1583 C ALLIANZ GLOBAL RISKS US INSURANCE CO

PO BOX 1401 225 W WASHINGTON ST STE 2000

MCPHERSON, KS 67460- CHICAGO, IL 60606-

Phone (1): (316)241-2200 Phone (1): (312)224-3300

CarrRep: CarrRep:

DSA: DSA:

InsComm: [email protected] InsComm: [email protected]

1584 C ALLIED WORLD REINSURANCE CO 1578 C ALLMERICA FINANCIAL BENEFIT INSURANCE CO

2 LIBERTY SQ STE 11 440 LINCOLN ST

BOSTON, MA 02109- WORCHESTER, MA 01653-

Phone (1): (857)288-6000 Phone (1): (508)855-2963

CarrRep: CarrRep:

DSA: DSA:

InsComm: [email protected] InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 4

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1258 S AMERICA FIRST INSURANCE CO 0256 S AMERICAN ALTERNATIVE INSURANCE CO

C/O AIMEE TREECE YORK RISK SERVICES GROUP

101 N ROBINSON AVE STE 1105 ATTN: BRENDA MORENO

OKLAHOMA CITY, OK 73102- PO BOX 619079

ROSEVILLE, CA 95661-

Phone (1): (617)654-4073

Phone (2): (405)879-0363 Phone (1): (609)275-2079

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

0243 S AMERICAN AUTOMOBILE INSURANCE CO 0275 S AMERICAN CASUALTY CO OF READING PA

ATTN: DENNIS MASON ATTN: ROBERT BILTZ

PO BOX 740174 PO BOX 8317

ATLANTA, GA 30374- CHICAGO, IL 60680-

Phone (1): (866)386-3932 Phone (1): (800)262-1113

Phone (2): (678)393-4006 Phone (2): (214)220-1557

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm:

1441 S AMERICAN COMPENSATION INSURANCE CO 1532 C AMERICAN COUNTRY INSURANCE CO

ATTN: SUSAN PILON ATTN: GINGER BALKE

PO BOX 390327 150 NW POINT BLVD STE 300

MINNEAPOLIS, MN 55439- ELK GROVE, IL 60007-1040

Phone (1): (800)789-2242 Phone (1): (847)700-8405

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 5

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0444 S AMERICAN ECONOMY INSURANCE CO 1662 AMERICAN FAMILY HOME INSURANCE CO

C/O AIMEE TREECE YORK RISK SERVICES GROUP

101 N ROBINSON AVE STE 1105 ATTN: BRENDA MORENO

OKLAHOMA CITY, OK 73102- PO BOX 619079

ROSEVILLE, CA 95661-

Phone (1): (617)654-4073

Phone (2): (405)879-0363 Phone (1): (609)275-2079

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm:

0346 S AMERICAN FIRE & CASUALTY CO 0503 S AMERICAN GUARANTEE & LIABILITY INSURANCE CO

C/O AIMEE TREECE C/O ZURICH CLAIMS

101 N ROBINSON AVE STE 1105 ATTN: JUDITH MANDELKY

OKLAHOMA CITY, OK 73102- PO BOX 968023

SCHAUMBURG, IL 60196-

Phone (1): (617)654-4073

Phone (2): (405)879-0363 Phone (1): (410)559-8519

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

1425 C AMERICAN HARDWARE MUTUAL INSURANCE CO 0473 S AMERICAN HOME ASSURANCE CO

C/O MOTORISTS INSURANCE GROUP C/O WILLIAM PERRINE

ATTN: JUDY PALAMARA PO BOX 8301

471 E BROAD ST TULSA, OK 74101-8301

COLUMBUS, OH 43215-

Phone (1): (972)448-1711

Phone (1): (614)225-8211 Phone (2): (918)382-1400

Phone (2): (412)858-1110

CarrRep: [email protected]

CarrRep: DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 6

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0271 S AMERICAN INSURANCE CO 1167 S AMERICAN INTERNATIONAL PACIFIC INSURANCE CO

PO BOX 740174 C/O WILLIAM PERRINE

ATLANTA, GA 30374- PO BOX 8301

TULSA, OK 74101-8301

Phone (1): (866)386-3932

Phone (2): (678)393-4006 Phone (1): (972)448-1711

Phone (2): (918)382-1400

CarrRep:

DSA: CarrRep: [email protected]

InsComm: DSA: [email protected]

InsComm:

0312 S AMERICAN INTERSTATE INSURANCE CO 0321 S AMERICAN MANUFACTURERS MUTUAL INSURANCE CO

ATTN: APRIL BURNS C/O OKLAHOMA PROPERTY & CASUALTY INSURANCE G.A.

2301 HIGHWAY 190W 2601 NW EXPY STE 330E

DERIDDER, LA 70634- OKLAHOMA CITY, OK 73112-

Phone (1): (337)460-3606 Phone (1): (847)320-7137

Phone (2): (337)460-3364 Phone (2): (405)843-5454

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA:

InsComm: [email protected] InsComm: [email protected]

1626 C AMERICAN MINING INSURANCE CO 1660 AMERICAN MODERN HOME INSURANCE CO

ATTN: DIANA YERA YORK RISK SERVICES GROUP

5512 S FOT APACHE RD STE 130 ATTN: BRENDA MORENO

LAS VEGAS, NV 89148- PO BOX 619079

ROSEVILLE, CA 95661-

Phone (1): (205)874-8229

Phone (2): (702)754-5802 Phone (1): (609)275-2079

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 7

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0504 S AMERICAN MOTORISTS INSURANCE CO 1533 C AMERICAN NATIONAL PROPERTY & CASUALTY CO

C/O OKLAHOMA PROPERTY & CASUALTY INSURANCE G.A. ATTN: JAMES CYBULSKI

2601 NW EXPY STE 330E 1949 E SUNSHINE

OKLAHOMA CITY, OK 73112- SPRINGFIELD, MO 65899-

Phone (1): (847)320-7137 Phone (1): (417)887-4990

Phone (2): (405)843-5454

CarrRep:

CarrRep: [email protected] DSA: [email protected]

DSA: InsComm: [email protected]

InsComm: [email protected]

1197 S AMERICAN SAFETY CASUALTY INSURANCE CO 1534 C AMERICAN SENTINEL INSURANCE

ATTN: TOM RUDD ATTN: RONALD THOMAS

100 GALLERIA PKWY SE STE 700 PO BOX 61140

ATLANTA, GA 30339- HARRISBURG, PA 17106-

Phone (1): (770)485-4423 Phone (1): (717)657-9671

Phone (2): (800)388-3647

CarrRep:

CarrRep: DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

0468 S AMERICAN STATES INSURANCE CO 0506 S AMERICAN ZURICH INSURANCE CO

C/O AIMEE TREECE C/O ZURICH CLAIMS

101 N ROBINSON AVE STE 1105 ATTN: JUDITH MANDELKY

OKLAHOMA CITY, OK 73102- PO BOX 968023

SCHAUMBURG, IL 60196-

Phone (1): (617)654-4073

Phone (2): (405)879-0363 Phone (1): (410)559-8547

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 8

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1579 C AMERISURE INSURANCE CO 1200 C AMERISURE MUTUAL INSURANCE CO

C/O TODD ESTES C/O TODD ESTES

PO BOX 26350 PO BOX 26350

OKLAHOMA CITY, OK 73106- OKLAHOMA CITY, OK 73106-

Phone (1): (405)235-1611 Phone (1): (800)325-1721

Phone (2): (405)235-1611

CarrRep: [email protected]

DSA: [email protected] CarrRep: [email protected]

InsComm: DSA: [email protected]

InsComm: [email protected]

1630 C AMERISURE PARTNERS INSURANCE CO 1535 C AMEX ASSURANCE CO

C/O TODD ESTES PO BOX 19020

PO BOX 26350 GREEN BAY, WI 54307-

OKLAHOMA CITY, OK 73106-

Phone (1): (920)431-4067

Phone (1): (405)235-1611

CarrRep:

CarrRep: [email protected] DSA:

DSA: [email protected] InsComm:

InsComm:

1476 S AMTRUST INSURANCE CO OF KS INC 1142 S ARCH INSURANCE CO

PO BOX 650767 ATTN: KAY RAGER

DALLAS, TX 75265- PO BOX 542033

OMAHA, NE 68154-

Phone (1): (214)360-8560

Phone (1): (877)688-2724

CarrRep: Phone (2): (877)688-2724

DSA:

InsComm: [email protected] CarrRep: [email protected]

DSA: [email protected]

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 9

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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 CO

C/O BRAD HOLLAR C/O BRADLEY HOLLAR

909 CEDAR LAKE BLVD 909 CEDAR LAKE BLVD

OKLAHOMA CITY, OK 73114- OKLAHOMA CITY, OK 73114-

Phone (1): (972)506-2406 Phone (1): (972)506-2411

Phone (2): (405)755-8100 Phone (2): (405)755-8100

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0362 C ARGONAUT MIDWEST INSURANCE CO 0363 C ARGONAUT SOUTHWEST INSURANCE CO

C/O BRADLEY HOLLAR C/O BRADLEY HOLLAR

909 CEDAR LAKE BLVD 909 CEDAR LAKE BLVD

OKLAHOMA CITY, OK 73114- OKLAHOMA CITY, OK 73114-

Phone (1): (972)506-2406 Phone (1): (972)506-2406

Phone (2): (405)755-8100 Phone (2): (405)755-8100

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1537 S ARROWOOD INDEMNITY CO 0244 S ASSOCIATED INDEMNITY CORP

C/O STEPHANIE MILNES ATTN: DENNIS MASON

CORPORATION SERVICE COMPANY PO BOX 740174

115 SW 89 ST ATLANTA, GA 30374-

OKLAHOMA CITY, OK 73139-8511

Phone (1): (866)386-3932

Phone (1): (704)522-2744 Phone (2): (678)393-4006

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 10

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0337 C ASSOCIATION CASUALTY INSURANCE CO 1655 C ASSOCIATON INSURANCE COMPANY

ATTN: PAUL BONHAM PO BOX 723099

PO BOX 9728 ATLANTA, GA 31139-0099

AUSTIN, TX 78766-9728

Phone (1): (678)309-4147

Phone (1): (512)345-7500

Phone (2): (800)877-4245 CarrRep: [email protected]

DSA:

CarrRep: InsComm:

DSA: [email protected]

InsComm: [email protected]

0508 S ASSURANCE CO OF AMERICA 1538 C ATHENA ASSURANCE CO

C/O ZURICH CLAIMS ATTN: MICHAEL DOODY

ATTN: JUDITH MANDELKY 385 WASHINGTON ST

PO BOX 968023 ST PAUL, MN 55102-

SCHAUMBURG, IL 60196-

Phone (1): (410)559-8547 CarrRep:

DSA:

CarrRep: [email protected] InsComm: [email protected]

DSA: [email protected]

InsComm: [email protected]

1344 S ATLANTIC SPECIALTY INSURANCE CO 0286 C AUTOMOBILE INSURANCE CO OF HARTFORD

ATTN: VIRGINIA MCCARTHY C/O CORPORATION SERVICE CO

150 ROYALL ST 115 SW 89 ST

CANTON, MA 02021- OKLAHOMA CITY, OK 73139-8511

Phone (1): (781)332-7000 Phone (1): (214)570-6764

Phone (2): (781)332-7191 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 11

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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 0512 S BANCINSURE INC

ATTN: BERTMAN BRAUD ATTN: NANCY ALLISON

11680 GREAT OAKS WAY STE 500 PO BOX 26104

ALPHARETTA, GA 30022- OKLAHOMA CITY, OK 73126-

Phone (2): (800)227-1700 Phone (1): (405)416-5190

Phone (2): (405)416-5190

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

0250 C BANKERS STANDARD INSURANCE CO 1653 C BEARING MIDWEST CASUALTY CO

C/O ESIS ATTN: MINDY YANCEY

ATTN: CAROL GALLIMORE 1100 WALNUT ST STE 3010

225 E JOHN CARPENTER FWY STE 1300 KANSAS CITY, MO 64106-

IRVING, TX 75062-

Phone (1): (816)474-7799

Phone (1): (302)476-7446

Phone (2): (972)465-7704 CarrRep: [email protected]

DSA: [email protected]

CarrRep: [email protected] InsComm: [email protected]

DSA: [email protected]

InsComm: [email protected]

0514 S BENCHMARK INSURANCE CO 1596 S BERKLEY NATIONAL INSURANCE CO

ATTN: SHEILA WEHRKAMP ATTN: STEVE RIEWER

775 PRAIRIE CENTER DR STE 420 11201 DOUGLASS AVE

EDEN PRAIRIE, MN 55344- URBANDALE, IA 50322-

Phone (1): (952)974-2200 Phone (1): (630)210-0406

Phone (2): (952)974-2200 Phone (2): (515)473-3137

CarrRep: [email protected] CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 12

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1540 C BERKLEY REGIONAL INSURANCE CO 1489 C BERKSHIRE HATHAWAY HOMESTATE INSURANCE CO (FKA COR

ATTN: STEVE RIEWER ATTN: NICOLE ALBRECHT

11201 DOUGLAS AVE PO BOX 881716

URBANDALE, IA 50322- SAN FRANCISCO, CA 94188-

Phone (1): (515)473-3137 Phone (1): (402)393-7255

Phone (2): (402)952-5121

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

0475 S BIRMINGHAM FIRE INSURANCE CO OF PENNSYLVANIA 0516 S BITUMINOUS CASUALTY CORP

C/O WILLIAM PERRINE ATTN: KELLY GRAMMER

PO BOX 8301 PO BOX 12936

TULSA, OK 74101-8301 OKLAHOMA CITY, OK 73157-2936

Phone (1): (972)448-1711 Phone (2): (405)767-2064

Phone (2): (918)382-1400

CarrRep:

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

1157 S BITUMINOUS FIRE & MARINE INSURANCE CO 0449 S BROTHERHOOD MUTUAL INSURANCE CO

ATTN: KELLY GRAMMER ATTN: GARY ALDRIDGE

PO BOX 12936 PO BOX 2228

OKLAHOMA CITY, OK 73157-2936 FT WAYNE, IN 46801-2228

Phone (2): (405)767-2064 Phone (1): (260)482-8668

Phone (2): (260)482-8668

CarrRep:

DSA: [email protected] CarrRep: [email protected]

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1664 C BUILDERS MUTUAL INSURANCE CO 0274 S CAMDEN FIRE INSURANCE ASSOCIATION

PO BOX 150006 ATTN: VIRGINIA MCCARTHY

RALEIGH, NC 27624- 150 ROYALL ST

CANTON, MA 02021-

Phone (1): (919)845-9382

Phone (1): (781)332-7000

CarrRep: [email protected] Phone (2): (781)332-7191

DSA:

InsComm: CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

0400 S CAPITAL CITY INSURANCE CO INC 1460 S CAROLINA CASUALTY INSURANCE CO

C/O QBE AMERICAS INC C/O BERKLEYNET UNDERWRITERS LLC

ATTN: JOSEPH MONTELEONE ATTN: JOHN BURKE

PO BOX 975 12701 MARBLESTONE DR STE 250

SUN PRAIRIE, WI 53590- WOODBRIDGE, VA 22192-

Phone (1): (608)825-5160 Phone (1): (866)915-4458

Phone (2): (803)612-7775 Phone (2): (866)915-4458

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

1446 C CASTLEPOINT NATIONAL INSURANCE CO (FKA SUA INSURAN 0305 S CENTRAL MUTUAL INSURANCE CO

ATTN: DEE KAPADIA C/O C SCOTT BEUCH

HARBORSIDE FINANCIAL CENTER 2201 N CLASSEN

800 PLAZA TWO OKLAHOMA CITY, OK 73106-

JERSEY CITY, NJ 07311-

Phone (1): (419)238-1010

Phone (1): (201)881-8329 Phone (2): (405)524-4333

Phone (2): (201)881-8329

CarrRep:

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm:

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

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0524 S CENTRE INSURANCE CO 0261 C CHARTER OAK FIRE INSURANCE CO

C/O JAY MCATEE C/O CORPORATION SERVICE CO

PO BOX 50611 115 SW 89 ST

TULSA, OK 74150-0611 OKLAHOMA CITY, OK 73139-8511

Phone (1): (212)859-2640 Phone (1): (214)570-6764

Phone (2): (918)633-8051 Phone (2): (405)636-4070

CarrRep: CarrRep: [email protected]

DSA: DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0276 S CHARTIS CASUALTY CO FKA AMERICAN INTERNATIONAL SOU 1493 S CHARTIS PROPERTY & CASUALTY CO FKA AIG CASUALTY

C/O WILLIAM PERRINE C/O WILLIAM PERRINE

PO BOX 8301 PO BOX 8301

TULSA, OK 74101-8301 TULSA, OK 74101-

Phone (1): (972)448-1711 Phone (1): (972)448-1711

Phone (2): (918)382-1400 Phone (2): (918)382-1400

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1363 S CHEROKEE INSURANCE CO 0525 C CHUBB INDEMNITY INSURANCE CO

ATTN: LAURA BOOTH C/O MALCOLM SMITH

34200 MOUND RD 5416 S YALE AVE STE 225

STERLING HEIGHTS, MI 48310- TULSA, OK 74135-

Phone (1): (800)201-0450 Phone (1): (214)754-0777

Phone (2): (800)201-0450 Phone (2): (918)392-2910

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1541 C CHUBB NATIONAL INSURANCE 0338 S CHURCH MUTUAL INSURANCE CO

ATTN: RONALD CALAVANO C/O DAVID A SEISER

15 MOUNTAIN VIEW RD PO BOX 342

WARREN, NJ 70059- MERRILL, WI 54452-0342

Phone (1): (908)903-2525 Phone (1): (715)539-4626

Phone (2): (715)539-4626

CarrRep:

DSA: CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

0325 S CINCINNATI CASUALTY CO 1595 C CINCINNATI INDEMNITY CO

C/O ADVANCED CLAIM SERVICES LLC C/O ADVANCED CLAIM SERVICES LLC

ATTN: STACIA SMITH ATTN: STACIA SMITH

PO BOX 721078 PO BOX 721078

OKLAHOMA CITY, OK 73132- OKLAHOMA CITY, OK 73172-

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm:

0326 S CINCINNATI INSURANCE CO 1659 CITIZENS INSURANCE CO OF AMERICA

C/O ADVANCED CLAIM SERVICES LLC ATTN: DOLORES NARDELLA

ATTN: STACIA SMITH 440 LINCOLN ST

PO BOX 721078 WORCESTER, MA 01653-0002

OKLAHOMA CITY, OK 73172-

Phone (1): (580)855-2996

Phone (2): (508)856-9297

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA:

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0530 S CLARENDON NATIONAL INSURANCE CO 1542 C COLONIAL AMERICAN CASUALTY & SURETY CO

C/O MIDLANDS CLAIM ADMINISTRATORS ATTN: COLLEEN ZITT

ATTN: CHARLES CALDWELL 1400 AMERICAN LN TOWER

PO BOX 22778 SCHAUMBURG, IL 60196-

OKLAHOMA CITY, OK 73123-

Phone (1): (847)413-5048

Phone (1): (212)790-9715

Phone (2): (405)840-0074 CarrRep:

DSA: [email protected]

CarrRep: InsComm: [email protected]

DSA: [email protected]

InsComm: [email protected]

1543 C COLUMBIA MUTUAL INSURANCE CO 1319 S COLUMBIA NATIONAL INSURANCE CO

ATTN: ROGER BALLARD ATTN: PAUL BONHAM

PO BOX 618 PO BOX 618

COLUMBIA, MO 66205- COLUMBIA, MO 65205-0618

Phone (1): (573)474-6193 Phone (1): (800)877-3579

Phone (2): (800)877-4245

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

1602 C COLUMBUS INSURANCE CO 0476 S COMMERCE & INDUSTRY INSURANCE CO

C/O CONNIE WOLFE C/O WILLIAM PERRINE

3030 NW EXPY STE 500 PO BOX 8301

OKLAHOMA CITY, OK 73112-5399 TULSA, OK 74101-8301

Phone (1): (972)448-1711

CarrRep: Phone (2): (918)382-1400

DSA:

InsComm: CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1567 C COMPANION COMMERCIAL INSURANCE CO 1571 S COMPANION PROPERTY & CASUALTY INSURANCE CO

ATTN: DUNCAN MCINTOSH ATTN: THERESA A SPATHAROS

51 CLEMSON RD I 20 AT ALPINE RD AA 270

COLUMBIA, SC 29229- COLUMBIA, SC 29219-

Phone (2): (803)264-3552 Phone (1): (803)735-0672

Phone (2): (803)264-3504

CarrRep:

DSA: [email protected] CarrRep:

InsComm: DSA: [email protected]

InsComm:

0627 S COMPSOURCE OKLAHOMA 0246 S CONTINENTAL CASUALTY CO

ATTN: TAMMY LOTT ATTN: ROBERT BILTZ

PO BOX 53505 PO BOX 8317

OKLAHOMA CITY, OK 73152-3505 CHICAGO, IL 60680-

Phone (1): (405)232-7663 Phone (1): (800)262-1113

Phone (2): (214)220-1557

CarrRep: [email protected]

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: CNAOKLAHOMASTATEFILING'[email protected]

InsComm:

1544 S CONTINENTAL INDEMNITY CO 0247 S CONTINENTAL INSURANCE CO

ATTN: SHANNON CASEY ATTN: ROBERT BILTZ

PO BOX 3804 PO BOX 8317

OMAHA, NE 68103- CHICAGO, IL 60680-

Phone (2): (877)234-4420 Phone (1): (800)262-1113

Phone (2): (214)220-1557

CarrRep: [email protected]

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: CNAOKLAHOMASTATEFILING'[email protected]

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1438 C CONTINENTAL NATIONAL INDEMNITY CO 1256 S CONTINENTAL WESTERN INSURANCE CO

ATTN: SHANNON CASEY ATTN: TODD ESTES

PO BOX 3804 PO BOX 26350

OMAHA, NE 68103- OKLAHOMA CITY, OK 73126-

Phone (1): (877)234-4420 Phone (1): (405)235-1611

CarrRep: [email protected] CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

1141 S CRUM & FORSTER INDEMNITY CO 0537 C CUMIS INSURANCE SOCIETY INC

C/O MIKE HICKS ATTN: DOAK SOMMERS

6404 INTERNATIONAL PKWY STE 1000 PO BOX 1221

PLANO, TX 75093- MADISON, WI 53701-1221

Phone (2): (972)380-3167 Phone (1): (608)231-8474

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA:

InsComm: [email protected] InsComm: [email protected]

0489 C DAIMLERCHRYSLER INSURANCE CO 1349 S DAKOTA TRUCK UNDERWRITERS

27777 INSTER RD CIMS 405-17-00 ATTN: ROBERT HOLLAN

FARMINGTON HILLS, MI 48333- PO BOX 89310

SIOUX FALLS, SD 57109-9310

Phone (1): (405)235-1425

Phone (1): (605)362-5672

CarrRep:

DSA: CarrRep:

InsComm: DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1545 C DEERFIELD INSURANCE CO 1235 S DIAMOND INSURANCE CO

C/O SHAND MORAHAN & CO C/O GALLAGHER BASSETT SERVICES

ATTN: J WILLIAMS ATTN: CARLA TATE

10 PKWY N 6303 WATERFORD BLVD STE 120

DEERFIELD, IL 60015-2526 OKLAHOMA CITY, OK 73118-

Phone (1): (847)572-6000 Phone (1): (847)230-1331

Phone (2): (405)843-8658

CarrRep: [email protected]

DSA: [email protected] CarrRep: [email protected]

InsComm: DSA: [email protected]

InsComm: [email protected]

1546 C DIAMOND STATE INSURANCE CO 1175 C DISCOVER PROPERTY & CASUALTY INSURANCE CO

ATTN: BRIAN RILEY C/O DISCOVERY MANAGERS LTD

3 BALA PLZ STE 300E ATTN: AGNES MORALES

BALA CYNWYD, PA 19004- 5 BATTERSON PARK

FARMINGTON, CT 06032-

Phone (1): (610)664-1500

Phone (1): (860)284-2653

CarrRep: Phone (2): (860)284-2808

DSA: [email protected]

InsComm: [email protected] CarrRep: [email protected]

DSA: [email protected]

InsComm:

0450 C ELECTRIC INSURANCE CO 0487 S EMCASCO INSURANCE CO

C/O SEDGWICK CMS ATTN: CHARLENE BENNETT

1 CORPORATE PLAZA 5104 260 WASHINGTON ST PO BOX 1739

ALBANY, NY 12212- WICHITA, KS 67201-1739

Phone (1): (800)836-5426 Phone (2): (316)352-5716

Phone (2): (800)434-8331

CarrRep:

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm:

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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) 1159 S EMPLOYERS FIRE INSURANCE

C/O CORPORATION SERVICE CO ATTN: VIRGINIA MCCARTHY

115 SW 89 ST 150 ROYALL ST

OKLAHOMA CITY, OK 73139- CANTON, MA 02021-

Phone (1): (775)327-2700 Phone (1): (781)332-7000

Phone (2): (781)332-7191

CarrRep: [email protected]

DSA: [email protected] CarrRep: [email protected]

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

0429 S EMPLOYERS INSURANCE CO OF WAUSAU 0488 S EMPLOYERS MUTUAL CASUALTY CO

C/O AIMEE TREECE ATTN: CHARLENE BENNETT

101 N ROBINSON AVE STE 1105 PO BOX 1739

OKLAHOMA CITY, OK 73102- WICHITA, KS 67201-1739

Phone (1): (617)654-4073 Phone (2): (316)352-5716

Phone (2): (405)879-0363

CarrRep:

CarrRep: DSA: [email protected]

DSA: [email protected] InsComm:

InsComm:

1281 S ESSENTIA INSURANCE CO FKA AMERICAN CENTRAL 1334 C EVEREST NATIONAL INSURANCE CO

ATTN: VIRGINIA MCCARTHY C/O TOM CAREY

150 ROYALL ST PO BOX 830

CANTON, MA 02021- LIBERTY CORNER, NJ 07938-0830

Phone (1): (781)332-7000 Phone (2): (908)604-3344

Phone (2): (781)332-7191

CarrRep:

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm:

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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 CO

C/O MALCOLM SMITH PO BOX 85563

5416 S YALE AVE STE 225 SAN DIEGO, CA 92186-

TULSA, OK 74105-

Phone (1): (858)350-2400

Phone (1): (214)754-0777

Phone (2): (918)392-2910 CarrRep:

DSA:

CarrRep: [email protected] InsComm:

DSA: [email protected]

InsComm: [email protected]

1215 S FAIRFIELD INSURANCE CO 1548 C FAIRMONT PREMIER INSURANCE CO

120 LONG RIDGE RD ATTN: LUCI PALAZZOLO

STAMFORD, CT 06902- 250 COMMERCIAL ST STE 5000

MANCHESTER, NH 31001-

Phone (1): (203)328-6466

Phone (1): (603)656-2233

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

1549 C FAIRMONT SPECIALTY INSURANCE CO 0241 S FARMERS ALLIANCE MUTUAL INSURANCE CO

ATTN: LUCI PALAZZOLO PO BOX 1401

250 COMMERCIAL ST STE 5000 MCPHERSON, KS 67460-1401

MANCHESTER, NH 31001-

Phone (1): (603)656-2233 CarrRep:

DSA:

CarrRep: InsComm: [email protected]

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0544 S FARMERS INSURANCE EXCHANGE 0287 C FARMINGTON CASUALTY CO

C/O TAMMY LEE C/O CORPORATION SERVICE CO

PO BOX 108843 115 SW 89 ST

OKLAHOMA CITY, OK 73101-8843 OKLAHOMA CITY, OK 73139-8511

Phone (1): (512)533-8361 Phone (1): (214)570-6764

Phone (2): (512)533-8388 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0452 S FARMLAND MUTUAL INSURANCE CO 0545 C FEDERAL INSURANCE CO

ATTN: SHARON BELL C/O MALCOLM SMITH

1100 LOCUST ST STE 3010 5416 S YALE AVE STE 225

DES MOINES, IA 50391-3010 TULSA, OK 74135-

Phone (1): (515)508-3472 Phone (1): (214)754-0777

Phone (2): (800)228-6700 Phone (2): (918)392-2910

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0397 S FEDERATED MUTUAL INSURANCE CO 0546 S FEDERATED RURAL ELECTRIC INSURANCE EXCHANGE

ATTN: ADRIAN JOHNSON C/O CHRISTINA SPOTSER

PO BOX 1548 PO BOX 15147

HURST, TX 76053- LENEXA, KS 66285-5147

Phone (1): (817)545-1500 Phone (1): (800)356-8360

Phone (2): (817)545-1500 Phone (2): (ext) -122

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0547 S FEDERATED SERVICE INSURANCE CO 0390 S FIDELITY & DEPOSIT CO OF MD

ATTN: ADRIAN JOHNSON C/O ZURICH CLAIMS

PO BOX 1548 ATTN: JUDITH MANDELKY

HURST, TX 76053- PO BOX 968023

SCHAUMBURG, IL 60196-

Phone (1): (817)545-1500

Phone (2): (817)545-1500 Phone (1): (410)559-8519

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1204 C FIDELITY & GUARANTY INSURANCE CO 0548 C FIDELITY & GUARANTY INSURANCE UNDERWRITERS

C/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO

115 SW 89 ST 115 SW 89 ST

OKLAHOMA CITY, OK 73139- OKLAHOMA CITY, OK 73139-8511

Phone (1): (214)570-6764 Phone (1): (214)570-6764

Phone (2): (405)636-4070 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1550 C FIDELITY NATIONAL PROPERTY & CASUALTY INSURANCE CO 0272 S FIREMANS FUND INSURANCE CO

ATTN: JOHN GIORGIANNI ATTN: GREG RUSH

601 RIVERSIDE AVE BLDG 5 STE 200 1 PROGRESS POINTE PKWY

JACKSONVILLE, FL 32204- OFALLON, MO 63368-

Phone (1): (904)997-7312 Phone (1): (866)386-3932

Phone (2): (678)393-4006

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1551 C FIREMENS INSURANCE CO OF WASHINGTON DC 0550 S FIRST LIBERTY INSURANCE CORP

ATTN: WILLIAM AMBROSE C/O AIMEE TREECE

PO BOX 61038 101 N ROBINSON AVE STE 1105

RICHMOND, VA 22361- OKLAHOMA CITY, OK 73102-

Phone (1): (804)285-2700 Phone (1): (617)654-4073

Phone (2): (405)879-0363

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm:

0434 S FIRST NATIONAL INSURANCE CO OF AMERICA 1372 C FIRSTCOMP INSURANCE CO

C/O AIMEE TREECE ATTN: KATHLEEN STURGEON

101 N ROBINSON AVE STE 1105 10 PARKWAY N

OKLAHOMA CITY, OK 73102- DEERFIELD, IL 60015-

Phone (1): (617)654-4073 Phone (1): (402)926-0099

Phone (2): (405)879-0363 Phone (2): (847)572-6387

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

0402 S FLORISTS MUTUAL INSURANCE CO 1637 S FOREMOST INSURANCE CO GRAND RAPIDS MICHIGAN

C/O JOHN OLDFIELD JR C/O TAMMY LEE

4808 N CLASSEN BLVD PO BOX 108843

OKLAHOMA CITY, OK 73118- OKLAHOMA CITY, OK 73101-

Phone (1): (618)655-1802 Phone (1): (888)327-6335

Phone (2): (512)533-8388

CarrRep: [email protected]

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 25

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1636 S FOREMOST PROPERTY & CASUALTY INSURANCE 1638 S FOREMOST SIGNATURE INSURANCE COMPANY

C/O TAMMY LEE C/O TAMMY LEE

PO BOX 108843 PO BOX 108843

OKLAHOMA CITY, OK 73101- OKLAHOMA CITY, OK 73101-

Phone (1): (888)327-6335 Phone (1): (888)327-6335

Phone (2): (512)533-8388 Phone (2): (512)533-8388

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: InsComm:

1618 C FRANK WINSTON CRUM INSURANCE INC 1439 S FRANKENMUTH MUTUAL INSURANCE CO

158 LOOKOUT PL STE 201 ATTN: MIKE PORTER

MAITLAND, FL 32751- 2200 NW 50 ST STE 200E

OKLAHOMA CITY, OK 73112-

CarrRep: Phone (1): (800)234-4433

DSA: Phone (2): (800)321-1866

InsComm:

CarrRep:

DSA:

InsComm: [email protected]

1270 C FREESTONE INSURANCE CO (FKA DALLAS FIRE & DALLAS N 1479 C GATEWAY INSURANCE CO

PIERCE COUCH HENDRICKSON BAYSINGER & GREEN LLP ATTN: SERENA LINTKER

ATTN: TODD ESTES PO BOX 20038

PO BOX 26350 ST LOUIS, MO 63144-

OKLAHOMA CITY, OK 73126-0350

Phone (1): (314)373-3333

Phone (1): (972)233-0178

Phone (2): (405)235-1611 CarrRep: [email protected]

DSA: [email protected]

CarrRep: [email protected] InsComm: [email protected]

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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

0555 S GENERAL CASUALTY CO OF WISCONSIN 0435 S GENERAL INSURANCE CO OF AMERICA

C/O QBE AMERICAS INC C/O AIMEE TREECE

ATTN: JOSEPH MONTELEONE 101 N ROBINSON AVE STE 1105

PO BOX 975 OKLAHOMA CITY, OK 73102-

SUN PRAIRIE, WI 53590-

Phone (1): (617)654-4073

Phone (1): (800)362-5448 Phone (2): (405)879-0363

Phone (2): (803)612-7775

CarrRep:

CarrRep: DSA: [email protected]

DSA: [email protected] InsComm:

InsComm:

1552 C GENESIS INSURANCE CO 0281 S GEORGIA CASUALTY & SURETY CO

120 LONG RIDGE RD ATTN: PAUL BONHAM

STAMFORD, CT 06902- 11138 STATE BRIDGE RD

ALPHARETTA, GA 30022-

Phone (1): (203)328-6466

Phone (2): (800)877-4245

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

1553 C GERLING AMERICA INSURANCE CO 0557 C GRAIN DEALERS MUTUAL INSURANCE CO

161 N CLARK ST C/O SCOTT CANNON

CHICAGO, IL 60601- 9175 S YALE AVE STE 300

TULSA, OK 74137-

Phone (1): (312)456-6798

Phone (1): (800)436-2005

CarrRep: Phone (2): (918)935-3999

DSA:

InsComm: [email protected] CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0477 S GRANITE STATE INSURANCE CO 1661 GRAPHIC ARTS MUTUAL INSURANCE CO

C/O WILLIAM PERRINE ATTN: MARTHA DUMONT

PO BOX 8301 180 GENESEE ST

TULSA, OK 74101-8301 NEW HARTFORD, NY 13413-2200

Phone (1): (972)448-1711 Phone (1): (315)734-2868

Phone (2): (918)382-1400

CarrRep: [email protected]

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm:

InsComm: [email protected]

1554 C GRAY CASUALTY & SURETY CO 0339 S GRAY INSURANCE CO

ATTN: ROBERT HUGHES C/O DAVID MANGUNO

PO BOX 6202 5601 NW 72

METAIRE, LA 70009- OKLAHOMA CITY, OK 73132-5903

Phone (1): (504)888-7790 Phone (1): (504)888-7790

Phone (2): (405)773-8551

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

1364 S GREAT AMERICAN ALLIANCE INSURANCE CO 1356 S GREAT AMERICAN ASSURANCE CO

ATTN: PATRICIA HAIDLE ATTN: PATRICIA HAIGLE

PO BOX 1445 PO BOX 1445

ALPHARETTA, GA 30009- ALPHARETTA, GA 30009-

Phone (1): (770)225-4597 Phone (1): (770)225-4597

Phone (2): (770)225-4597 Phone (2): (770)225-4597

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1353 S GREAT AMERICAN INSURANCE CO OF NEW YORK 1431 C GREAT DIVIDE INSURANCE CO

ATTN: PATRICIA HAIGLE ATTN: CLAIMS DEPT

PO BOX 1445 7233 E BUTHERUS DR

ALPHARETTA, GA 30009-1445 SCOTTSDALE, AZ 85260-

Phone (1): (770)225-4597 Phone (1): (480)951-0905

Phone (2): (770)225-4597

CarrRep:

CarrRep: DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm:

1597 C GREAT MIDWEST INSURANCE CO 0558 C GREAT NORTHERN INSURANCE CO

800 GESSNER RD STE 600 C/O MALCOLM SMITH

HOUSTON, TX 77024- 5416 S YALE AVE STE 225

TULSA, OK 74135-

Phone (1): (713)935-4800

Phone (1): (214)754-0777

CarrRep: [email protected] Phone (2): (918)392-2910

DSA:

InsComm: CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

0345 S GREAT WEST CASUALTY CO 1556 GREATER NEW YORK MUTUAL INSURANCE CO

ATTN: DALE SEGUIN ATTN: LILLIAN LENT

1100 W 29 ST 200 MADISON AVE

S SIOUX CITY, NE 68776-3130 NEW YORK, NY 10016-

Phone (1): (800)228-8602 Phone (1): (212)683-9700

Phone (2): (800)228-8602

CarrRep:

CarrRep: DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1168 S GREENWICH INSURANCE CO 0942 S GUARANTEE INSURANCE CO

ATTN: SARAH MIMS C/O LISA BALMER

505 EAGLEVIEW BLVD STE 100 PO BOX 6550

EXTON, PA 19341- CHESTERFIELD, MO 63006-

Phone (1): (203)964-5200 Phone (2): (888)237-2027

Phone (2): (610)968-2970

CarrRep:

CarrRep: DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm:

1429 S GUIDEONE ELITE INSURANCE CO 0391 S GUIDEONE MUTUAL INSURANCE CO

ATTN: TRINA OLAONE ATTN: TRINA OLOANE

PO BOX 14543 PO BOX 14543

DES MOINES, IA 50306- DES MOINES, IA 50306-

Phone (1): (888)748-4326 Phone (1): (888)748-4326

Phone (2): (888)748-4326 Phone (2): (888)748-4326

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm:

0418 C HANOVER AMERICAN INSURANCE CO 0419 C HANOVER INSURANCE CO

C/O MICHAEL MANCILLAS C/O MICHAEL MANCILLAS

5801 N BROADWAY EXT STE 303 5801 N BROADWAY EXT STE 303

OKLAHOMA CITY, OK 73118- OKLAHOMA CITY, OK 73118-

Phone (1): (800)628-0250 Phone (1): (800)628-0250

Phone (2): (405)840-1404 Phone (2): (405)840-1404

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1196 S HARBOR SPECIALTY INSURANCE CO 0307 S HARCO NATIONAL INSURANCE

C/O MIDLANDS CLAIM ADMINISTRATORS C/O REBECCA CULLINS

ATTN: D NEWMAN 1300 S MERIDIAN STE 323

PO BOX 238808 OKLAHOMA CITY, OK 73108-

OKLAHOMA CITY, OK 73123-8808

Phone (1): (800)890-8975

Phone (1): (212)790-9715 Phone (2): (ext)222-

CarrRep: CarrRep:

DSA: [email protected] DSA:

InsComm: [email protected] InsComm: [email protected]

0562 S HARLEYSVILLE INSURANCE CO 0398 S HARLEYSVILLE MUTUAL INSURANCE CO

355 MAPLE AVE 355 MAPLE AVE

HARLEYSVILLE, PA 19438- HARLEYSVILLE, PA 19438-

Phone (1): (215)256-5830 Phone (1): (888)549-9876

Phone (2): (215)256-5830

CarrRep:

CarrRep: DSA:

DSA: InsComm: [email protected]

InsComm:

0262 S HARTFORD ACCIDENT & INDEMNITY CO 0263 S HARTFORD CASUALTY INSURANCE CO

ATTN: KATE LECHTENBERG ATTN: KATE LECHTENBERG

PO BOX 14474 PO BOX 14474

LEXINGTON, KY 40512- LEXINGTON, KY 40512-

Phone (1): (860)519-1479 Phone (1): (860)519-1479

Phone (2): (281)877-3413 Phone (2): (281)877-3413

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0264 S HARTFORD FIRE INSURANCE CO 1591 S HARTFORD INSURANCE CO OF ILLINOIS

ATTN: KATE LECHTENBERG ATTN: KATE LECHTENBERG

PO BOX 14474 PO BOX 14474

LEXINGTON, KY 40512- LEXINGTON, KY 40512-

Phone (1): (860)519-1479 Phone (1): (860)519-1479

Phone (2): (281)877-3413 Phone (2): (281)877-3413

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm:

0265 S HARTFORD INSURANCE CO OF THE MIDWEST 1650 S HARTFORD SACRAMENTO INSURANCE CO

ATTN: KATE LECHTENBERG ATTN: KATE LECHTENBERG

PO BOX 14474 PO BOX 14474

LEXINGTON, KY 40512- LEXINGTON, KY 40512-

Phone (1): (860)519-1479 Phone (1): (860)519-1479

Phone (2): (281)877-3413

CarrRep: [email protected]

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm:

InsComm:

0266 S HARTFORD UNDERWRITERS INSURANCE CO 1603 C HDI GERLING AMERICA INSURANCE CO

ATTN: KATE LECHTENBERG 161 N CLARK ST

PO BOX 14474 CHICAGO, IL 60601-

LEXINGTON, KY 40512-

Phone (1): (860)519-1479 CarrRep:

Phone (2): (281)877-3413 DSA:

InsComm:

CarrRep: [email protected]

DSA: [email protected]

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1558 HOUSING AUTHORITY PROPERTY INSURANCE A MUTUAL CO 0284 S HOUSTON GENERAL INSURANCE CO

ATTN: SARAH RODRIGUEZ ATTN: VIRGINIA MCCARTHY

PO BOX 189 150 ROYALL ST

CHESHIRE, CT 06410- CANTON, MA 02021-

Phone (1): (203)272-8220 Phone (1): (781)332-7000

Phone (2): (781)332-7191

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

1313 C HUDSON INSURANCE CO (TRIBES ONLY) 0478 S ILLINOIS NATIONAL INSURANCE CO

100 WILLIAM ST FL 5 C/O WILLIAM PERRINE

NEW YORK, NY 10038-5044 PO BOX 8301

TULSA, OK 74101-8301

Phone (1): (212)978-2800

Phone (1): (972)448-1711

CarrRep: [email protected] Phone (2): (918)382-1400

DSA:

InsComm: [email protected] CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

1617 C IMPERIUM INSURANCE CO 0412 C INDEMNITY INSURANCE CO OF NORTH AMERICA

800 GESSNER RD STE 600 C/O ESIS

HOUSTON, TX 77024- ATTN: CAROL GALLIMORE

225 E JOHN CARPENTER FWY STE 1300

IRVING, TX 75062-

CarrRep:

DSA: Phone (1): (302)476-7446

InsComm: Phone (2): (972)465-7704

CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 33

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1559 INDEMNITY NATIONAL INSURANCE CO 0278 C INDIANA LUMBERMENS MUTUAL

ATTN: MATTHEW TUCKER 8888 KEYSTONE CROSSING STE 250

4800 OLD KINGSTON PIKE INDIANAPOLIS, IN 46240-

KNOXVILLE, TN 37919-

Phone (1): (317)875-3710

Phone (1): (865)934-4360

CarrRep:

CarrRep: DSA:

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

0421 C INDUSTRIAL UNDERWRITERS 0252 C INSURANCE CO OF NORTH AMERICA

C/O ESIS C/O ESIS

ATTN: CAROL GALLIMORE ATTN: CAROL GALLIMORE

225 E JOHN CARPENTER FWY STE 1300 225 E JOHN CARPENTER FWY STE 1300

IRVING, TX 75062- IRVING, TX 75062-

Phone (1): (302)476-7446 Phone (1): (302)476-7446

Phone (2): (972)465-7704 Phone (2): (972)465-7704

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0479 S INSURANCE CO OF THE STATE OF PENN 1165 S INSURANCE CO OF THE WEST

C/O WILLIAM PERRINE ATTN: GINA SKOLASKI

PO BOX 8301 PO BOX 85563

TULSA, OK 74101-8301 SAN DIEGO, CA 92186-

Phone (1): (972)448-1711 Phone (1): (800)877-1111

Phone (2): (918)382-1400 Phone (2): (800)877-1111

CarrRep: [email protected] CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1408 S LEXINGTON INSURANCE CO 0570 S LIBERTY INSURANCE CORP

C/O WILLIAM PERRINE C/O AIMEE TREECE

PO BOX 8301 101 N ROBINSON AVE STE 1105

TULSA, OK 74101-8301 OKLAHOMA CITY, OK 73102-

Phone (1): (972)448-1711 Phone (1): (617)654-4073

Phone (2): (918)382-1400 Phone (2): (405)879-0363

CarrRep: [email protected] CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm:

1629 C LIBERTY LIFE ASSURANCE CO OF BOSTON 0571 S LIBERTY MUTUAL FIRE INSURANCE

C/O AIMEE TREECE C/O AIMEE TREECE

101 N ROBINSON AVE STE 1105 101 N ROBINSON AVE STE 1105

OKLAHOMA CITY, OK 73102- OKLAHOMA CITY, OK 73102-

Phone (1): (617)654-4073 Phone (1): (617)654-4073

Phone (2): (405)879-0363 Phone (2): (405)879-0363

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: InsComm:

0572 S LIBERTY MUTUAL INSURANCE CO 1414 C LINCOLN GENERAL INSURANCE CO

C/O AIMEE TREECE ATTN: KAREN GROFF

101 N ROBINSON AVE STE 1105 PO BOX 3709

OKLAHOMA CITY, OK 73102- YORK, PA 17402-

Phone (1): (617)654-4073

Phone (2): (405)879-0363 CarrRep:

DSA: [email protected]

CarrRep: InsComm: [email protected]

DSA: [email protected]

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1627 C LION INSURANCE CO 1397 S LM INSURANCE CORP

ATTN: DUSTIN CLARK C/O AIMEE TREECE

2739 US HWY 19 101 N ROBINSON AVE STE 1105

HOLIDAY, FL 34691- OKLAHOMA CITY, OK 73102-

Phone (1): (727)938-5562 Phone (1): (617)654-4073

Phone (2): (405)879-0363

CarrRep:

DSA: CarrRep:

InsComm: DSA: [email protected]

InsComm:

0573 S LUMBERMENS UNDERWRITING ALLIANCE 1589 S MADISON INSURANCE CO

ATTN: SUE LITCHY PO BOX 2005

PO BOX 3061 OAK RIDGE, TN 37831-

BOCA RATON, FL 33431-3061

Phone (1): (800)896-6884

Phone (1): (800)327-0630 Phone (2): (866)984-3316

Phone (2): (877)214-1173

CarrRep:

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm:

InsComm: [email protected]

1365 S MANUFACTURERS ALLIANCE INSURANCE CO 0407 S MARKEL INSURANCE CO

C/O GALLAGHER BASSETT SERVICES INC C/O SHAND MORAHAN & CO

ATTN: EDWARD WIEWEL ATTN: J WILLIAMS

6303 WATERFORD BLVD STE 120 10 PARKWAY N

OKLAHOMA CITY, OK 73118- DEERFIELD, IL 60015-

Phone (1): (800)222-2749 Phone (1): (847)572-6000

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0254 S MARYLAND CASUALTY CO 0255 S MARYLAND INSURANCE CO

C/O ZURICH CLAIMS C/O ZURICH CLAIMS

ATTN: JUDITH MANDELKY ATTN: JUDITH MANDELKY

PO BOX 968023 PO BOX 968023

SCHAUMBURG, IL 60196- SCHAUMBURG, IL 60196-

Phone (1): (410)559-8519 Phone (1): (410)338-9155

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0420 C MASSACHUSETTS BAY INSURANCE CO 1501 C MEDICAL ASSURANCE CO

C/O MICHAEL MANCILLAS ATTN: JEFFREY MANGET

5801 N BROADWAY STE 303 PO BOX 590009

OKLAHOMA CITY, OK 73118- BIRMINGHAM, AL 35259-0009

Phone (1): (800)628-0250 Phone (1): (205)877-4442

Phone (2): (405)840-1404

CarrRep:

CarrRep: DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

0575 S MEDMARC CASUALTY INSURANCE CO 1450 C MEMIC INDEMNITY CO

C/O GALLAGHER BASSETT ATTN: KAREN SCHWARTZ

6303 WATERFORD BLVD STE 120 PO BOX 11409

OKLAHOMA CITY, OK 73118- PORTLAND, ME 04104-

Phone (1): (318)473-2572 Phone (1): (207)791-3350

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1502 C MENDOTA INSURANCE CO 1464 S MERIDIAN SECURITY INSURANCE CO

ATTN: NEIL STEFFL ATTN: SUSAN PILON

PO BOX 64586 PO BOX 390327

ST PAUL, MN 55164-0586 MINNEAPOLIS, MN 55439-0327

Phone (1): (651)468-2991 Phone (2): (317)931-7742

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0453 C MICHIGAN MILLERS MUTUAL INSURANCE CO 0578 S MID CENTURY INSURANCE CO

C/O STEPHEN STRATTON C/O TAMMY LEE

4101 PERIMETER CENTER DR STE 110 PO BOX 108843

OKLAHOMA CITY, OK 73112- OKLAHOMA CITY, OK 73101-8843

Phone (1): (517)482-6211 Phone (1): (512)533-8361

Phone (2): (405)943-8319 Phone (2): (512)533-8388

CarrRep: [email protected] CarrRep: [email protected]

DSA: DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0579 S MIDDLESEX INSURANCE CO 1481 C MIDWEST BUILDERS CASUALTY MUTUAL CO

ATTN: MARY SWENSON ATTN: MINDY YANCEY

PO BOX 8032 1100 WALNUT ST STE 3010

STEVENS POINT, WI 54481- KANSAS CITY, MO 64106-

Phone (1): (715)346-9052 Phone (1): (816)474-7799

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 38

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0581 S MIDWEST EMPLOYERS CASUALTY CO 1448 C MIDWEST INSURANCE CO

C/O MIKAL SOLTYS ATTN: JOE DONOVAN

14755 N OUTER FORTY DR STE 300 PO BOX 13369

CHESTERFIELD, MO 63017- SPRINGFIELD, IL 62791-

Phone (1): (636)449-7000 Phone (1): (217)862-1417

Phone (2): (217)862-1417

CarrRep:

DSA: [email protected] CarrRep: [email protected]

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

1600 C MILWAUKEE CASUALTY INSURANCE CO (AMTRUST) 1417 C MITSUI SUMITOMO INSURANCE CO OF AMERICA

PO BOX 650767 560 LEXINGTON AVE

DALLAS, TX 75265- NEW YORK, NY 10022-

Phone (1): (214)360-8560

CarrRep:

CarrRep: DSA:

DSA: InsComm: [email protected]

InsComm:

1418 C MITSUI SUMITOMO INSURANCE USA INC 1632 C MONTGOMERY INSURANCE CO

560 LEXINGTON AVE C/O AIMEE TREECE

NEW YORK, NY 10022- 101 N ROBINSON AVE STE 1105

OKLAHOMA CITY, OK 73102-

CarrRep: Phone (2): (405)879-0363

DSA:

InsComm: [email protected] CarrRep:

DSA: [email protected]

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 39

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0427 C NATIONAL AMERICAN INSURANCE CO 1592 C NATIONAL CASUALTY CO

ATTN: RICHARD EVANS ATTN: SHARON BELL

PO DRAWER 38 1100 LOCUST ST DEPT 3010

CHANDLER, OK 74834- DES MOINES, IA 50391-

Phone (1): (800)332-2210 Phone (1): (800)228-6700

Phone (2): (515)508-3429

CarrRep: [email protected]

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm:

0583 S NATIONAL FARMERS UNION PROPERTY & CASUALTY CO 0459 S NATIONAL FIRE INSURANCE CO OF HARTFORD

C/O ONE BEACON NATIONAL WORK COMP CENTER ATTN: ROBERT BILTZ

5 TECHNOLOGY DR PO BOX 8317

MILFORD, MA 01757- CHICAGO, IL 60680-

Phone (1): (816)391-2384 Phone (1): (800)262-1113

Phone (2): (800)224-4416 Phone (2): (214)220-1557

CarrRep: CarrRep:

DSA: DSA: [email protected]

InsComm: [email protected] InsComm:

0282 S NATIONAL INDEMNITY CO 1245 S NATIONAL INTERSTATE INSURANCE CO

C/O BRIAN SNOVER ATTN: JULIE MCGRAW

100 FIRST STAMFORD PL 3250 INTERSTATE DR

STAMFORD, CT 06902-6745 RICHFIELD, OH 44286-0549

Phone (1): (402)536-3000 Phone (1): (800)929-1500

Phone (2): (203)363-5200

CarrRep:

CarrRep: DSA: [email protected]

DSA: InsComm: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0283 S NATIONAL LIABILITY FIRE & CASUALTY 0585 S NATIONAL STANDARD INSURANCE CO

C/O BRIAN SNOVER C/O ZURICH CLAIMS

100 FIRST STAMFORD PL ATTN: JUDITH MANDELKY

STAMFORD, CT 06902-6745 PO BOX 968023

SCHAUMBURG, IL 60196-

Phone (1): (402)536-3000

Phone (1): (410)559-8519

CarrRep:

DSA: CarrRep: [email protected]

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

0392 S NATIONAL SURETY CORP 0480 S NATIONAL UNION FIRE INSURANCE CO

C/O FIREMENS FUND INSURANCE C/O WILLIAM PERRINE

PO BOX 74014 PO BOX 8301

ATLANTA, GA 30374-0174 TULSA, OK 74101-8301

Phone (1): (410)560-4697 Phone (1): (972)448-1710

Phone (2): (800)282-6351 Phone (2): (918)382-1400

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0257 C NATIONWIDE AGRIBUSINESS INSURANCE CO 0586 C NATIONWIDE INSURANCE CO OF AMERICA

ATTN: SHARON BELL C/O THE CORPORATION COMPANY

1100 LOCUST ST STE 3010 1833 S MORGAN RD

DES MOINES, IA 50391-3010 OKLAHOMA CITY, OK 73128-

Phone (1): (515)508-3108 Phone (1): (614)249-7111

Phone (2): (515)508-3429

CarrRep: [email protected]

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm:

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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 CO

C/O THE CORPORATION COMPANY ATTN: AIMEE TREECE

1833 S MORGAN RD 101 N ROBINSON AVE STE 1105

OKLAHOMA CITY, OK 73128- OKLAHOMA CITY, OK 73102-

Phone (1): (614)249-7111 Phone (1): (617)654-4073

Phone (2): (405)879-0363

CarrRep: [email protected]

DSA: [email protected] CarrRep:

InsComm: DSA: [email protected]

InsComm:

0481 S NEW HAMPSHIRE INDEMNITY CO 0482 S NEW HAMPSHIRE INSURANCE CO

C/O WILLIAM PERRINE C/O WILLIAM PERRINE

PO BOX 8301 PO BOX 8301

TULSA, OK 74101-8301 TULSA, OK 74101-8301

Phone (1): (972)448-1711 Phone (1): (972)448-1711

Phone (2): (918)382-1400 Phone (2): (918)382-1400

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1505 C NEW YORK MARINE & GENERAL INSURANCE CO 1403 C NIPPONKOA INSURANCE CO LTD

ATTN: THOMAS IACOPELLI 14 WALL ST 8TH FL

59 MAIDEN LN NEW YORK, NY 10005-

NEW YORK, NY 10038-

Phone (1): (212)551-0645 CarrRep:

DSA:

CarrRep: InsComm: [email protected]

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1508 C NORTH AMERICAN ELITE INSURANCE CO 0590 S NORTH AMERICAN SPECIALTY INSURANCE CO

ATTN: EDWARD STYS C/O GALLAGHER BASSETT

650 ELM ST ATTN: SHIRLEY BIZAL

MANCHESTER, NH 03103- 6303 WATERFORD BLVD STE 120

OKLAHOMA CITY, OK 73118-

Phone (1): (603)644-6600

Phone (1): (603)644-6600

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

1605 C NORTH DAKOTA WORKFORCE SAFETY & INSURANCE (NLC) 1509 S NORTH POINTE INSURANCE CO

PO BOX 5585 C/O QBE AMERICAS INC

BISMARCK, ND 58506-5585 ATTN: JOSEPH MONTELEONE

PO BOX 975

SUN PRAIRIE, WI 53950-

CarrRep:

DSA: Phone (1): (800)362-5448

InsComm: Phone (2): (803)612-7775

CarrRep:

DSA: [email protected]

InsComm:

0591 S NORTH RIVER INSURANCE CO 0442 S NORTHERN ASSURANCE CO

C/O MIKE HICKS ATTN: VIRGINIA MCCARTHY

6404 INTERNATIONAL PKWY STE 1000 150 ROYALL ST

PLANO, TX 75093- CANTON, MA 02021-

Phone (2): (972)380-3167 Phone (1): (781)332-7000

Phone (2): (781)332-7191

CarrRep:

DSA: [email protected] CarrRep: [email protected]

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0592 S NORTHERN INSURANCE CO OF NEW YORK 1510 C NORTHLAND CASUALTY CO

C/O ZURICH CLAIMS ATTN: MICHAEL DOODY

ATTN: JUDITH MANDELKY PO BOX 64816

PO BOX 968023 ST PAUL, MN 55164-

SCHAUMBURG, IL 60196-

Phone (1): (860)277-3966

Phone (1): (410)559-8519

CarrRep:

CarrRep: [email protected] DSA:

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

1511 C NORTHLAND INSURANCE CO 0593 C NORTHWESTERN PACIFIC INDEMNITY CO

ATTN: MICHAEL DOODY C/O MALCOLM SMITH

PO BOX 64816 5416 S YALE AVE STE 225

ST PAUL, MN 55164- TULSA, OK 74105-

Phone (1): (860)277-3966 Phone (1): (214)754-0777

Phone (2): (918)392-2910

CarrRep:

DSA: CarrRep: [email protected]

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

1488 C NOVA CASUALTY CO 1658 C OAK RIVER INSURANCE COMPANY (ORIC)

ATTN: KATHLEEN CAREY ATTN: NICOLE ALBRECHT

5 WATERSIDE XING STE 204A PO BOX 881716

WINDSOR, CT 06095- OMAHA, NE 68131-

Phone (1): (860)683-9892 Phone (1): (402)393-7255

Phone (2): (402)952-5121

CarrRep: [email protected]

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 44

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1641 S OBI NATIONAL INSURANCE CO 1512 C OCCIDENTAL FIRE & CASUALTY OF NORTH CAROLINA

ATTN: VIRGINIA MCCARTHY ATTN: KEVIN HAMM

150 ROYALL ST PO BOX 10800

CANTON, MA 02021- RALEIGH, NC 27605-

Phone (1): (919)833-1600

CarrRep: [email protected]

DSA: [email protected] CarrRep:

InsComm: DSA: [email protected]

InsComm: [email protected]

0347 S OHIO CASUALTY INSURANCE CO 1585 S OHIO FARMERS INSURANCE CO

C/O AIMEE TREECE C/O BROADSPIRE SERVICES INC

101 N ROBINSON AVE STE 1105 ATTN: DEBRA GLOVER

OKLAHOMA CITY, OK 73102- 5901 COLLEGE BLVD STE 275

OVERLAND PARK, KS 66211-

Phone (1): (617)654-4073

Phone (2): (405)879-0363 Phone (1): (330)887-0101

Phone (2): (913)663-7521

CarrRep:

DSA: [email protected] CarrRep:

InsComm: DSA: [email protected]

InsComm: [email protected]

1426 C OHIO SECURITY INSURANCE CO 1465 C OLD GLORY INSURANCE CO

ATTN: JOANNE CONNOLLY ATTN: BOB HENDERSON

9450 SEWARD RD PO BOX 6456

FAIRFIELD, OH 45014- TYLER, TX 75711-

Phone (2): (903)509-4929

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 45

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1382 C OLD REPUBLIC GENERAL INSURANCE CORP 0425 C OLD REPUBLIC INSURANCE CO

C/O PRENTICE HALL CORP C/O PRENTICE HALL CORP

115 SW 89 115 SW 89

OKLAHOMA CITY, OK 73139-8511 OKLAHOMA CITY, OK 73139-

Phone (1): (262)796-4858 Phone (1): (262)796-4858

CarrRep: [email protected] CarrRep: [email protected]

DSA: DSA:

InsComm: [email protected] InsComm: [email protected]

1423 S ONE BEACON AMERICA INSURANCE CO 0441 S ONE BEACON INSURANCE CO (FKA CGU INSURANCE)

ATTN: VIRGINIA MCCARTHY ATTN: VIRGINIA MCCARTHY

150 ROYALL ST 150 ROYALL ST

CANTON, MA 02021- CANTON, MA 02021-

Phone (1): (781)332-7000 Phone (1): (781)332-7000

Phone (2): (781)332-7191 Phone (2): (781)332-7191

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0253 C PACIFIC EMPLOYERS INSURANCE CO 0596 C PACIFIC INDEMNITY CO

C/O ESIS C/O MALCOLM SMITH

ATTN: CAROL GALLIMORE 5416 S YALE AVE STE 225

225 E JOHN CARPENTER FWY STE 1300 TULSA, OK 74135-

IRVING, TX 75062-

Phone (1): (214)754-0777

Phone (1): (302)476-7446 Phone (2): (918)392-2910

Phone (2): (972)465-7704

CarrRep: [email protected]

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 46

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1419 S PEERLESS INDEMNITY INSURANCE CO 1346 S PEERLESS INSURANCE CO

C/O AIMEE TREECE C/O AIMEE TREECE

101 N ROBINSON AVE STE 1105 101 N ROBINSON AVE STE 1105

OKLAHOMA CITY, OK 73102- OKLAHOMA CITY, OK 73102-

Phone (1): (617)654-4073 Phone (1): (617)654-4073

Phone (2): (405)879-0363 Phone (2): (405)879-0363

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: InsComm:

0446 S PENNSYLVANIA GENERAL INSURANCE CO (FKA GENERAL ACC 1156 S PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE C

ATTN: VIRGINIA MCCARTHY C/O GALLAGHER BASSETT SERVICES INC

150 ROYALL ST ATTN: EDWARD WIEWEL

CANTON, MA 02021- 6303 WATERFORD BLVD STE 120

OKLAHOMA CITY, OK 73118-

Phone (1): (781)332-7000

Phone (2): (781)332-7191 Phone (1): (800)222-2749

CarrRep: [email protected] CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1389 S PENNSYLVANIA MANUFACTURERS INDEMNITY CO 0438 C PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE CO

C/O GALLAGHER BASSETT SERVICES INC C/O RANDOLPH STROUP

ATTN: EDWARD WIEWEL PO BOX 2361

6303 WATERFORD BLVD STE 120 HARRISBURG, PA 17105-

OKLAHOMA CITY, OK 73118-

Phone (1): (800)222-2749 CarrRep: [email protected]

DSA: [email protected]

CarrRep: InsComm: [email protected]

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 47

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0490 S PETROLEUM CASUALTY CO 0599 S PHARMACISTS MUTUAL CO

C/O EXXON MOBIL RISK MANAGEMENT INC C/O JAY MCATEE

C/O ANDREW KIYFES 1115 S CINCINNATI

3225 GALLOWS RD TULSA, OK 74119-

FAIRFAX, VA 22037-

Phone (1): (800)247-5930

Phone (1): (713)680-7148 Phone (2): (515)295-2461

Phone (2): (703)846-2347

CarrRep:

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

0288 C PHOENIX INSURANCE CO 1513 C PLATTE RIVER INSURANCE CO

C/O CORPORATION SERVICE CO ATTN: JOSH DENO

115 SW 89 ST PO BOX 5900

OKLAHOMA CITY, OK 73139-8511 MADISON, WI 53705-

Phone (1): (214)570-6764 Phone (1): (608)829-6904

Phone (2): (405)636-4070

CarrRep:

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

1432 S PRAETORIAN INSURANCE CO 1447 C PREFERRED PROFESSIONAL INSURANCE CO

C/O QBE AMERICAS INC 11605 MIRACLE HILLS DR STE 200

ATTN: JOSEPH MONTELEONE OMAHA, NE 68154-

PO BOX 975

SUN PRAIRIE, WI 53590-

CarrRep:

Phone (1): (800)362-5448 DSA:

Phone (2): (803)612-7775 InsComm: [email protected]

CarrRep:

DSA: [email protected]

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1654 C PROPERTY & CASUALTY INSURANCE COMPANY OF HARTFORD 0465 S PROTECTIVE INSURANCE CO

HARTFORD PLAZA ATTN: DAVID GHESQUIERE

HARTFORD, CT 06115- 111 CONGRESSIONAL BLVD

CARMEL, IN 46032-

CarrRep: Phone (1): (317)636-9800

DSA: Phone (2): (317)429-2638

InsComm:

CarrRep:

DSA: [email protected]

InsComm: [email protected]

1514 C PROVIDENCE WASHINGTON INSURANCE CO 1594 S QBE INSURANCE CORP

ATTN: DONALD WOELLNER C/O QBE AMERICAS INC

475 KILVERT ST STE 330 ATTN: JOSEPH MONTELEONE

WARWICK, RI 02886- PO BOX 975

SUN PRAIRIE, WI 53590-

Phone (1): (401)453-7132

Phone (1): (800)362-5448

CarrRep: Phone (2): (803)612-7775

DSA: [email protected]

InsComm: [email protected] CarrRep:

DSA: [email protected]

InsComm:

1515 C QUANTA INDEMNITY CO 0605 S REDLANDS INSURANCE CO

ATTN: ROSE CHIERCHIO C/O SHERESA POTTORF

48 WALL ST 14 FLOOR PO BOX 975

NEW YORK, NY 10005- SUN PRAIRIE, WI 53590-

Phone (1): (212)373-1838 Phone (1): (800)362-5448

Phone (2): (972)664-7088

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0606 S REGENT INSURANCE CO 1162 C REPUBLIC FIRE & CASUALTY INSURANCE CO

C/O QBE AMERICAS INC PO BOX 809076

ATTN: JOSEPH MONTELEONE DALLAS, TX 75380-

PO BOX 975

SUN PRAIRIE, WI 53590- Phone (1): (972)788-6719

Phone (1): (800)362-5448 CarrRep: [email protected]

Phone (2): (803)612-7775 DSA: [email protected]

InsComm: [email protected]

CarrRep:

DSA: [email protected]

InsComm:

1163 C REPUBLIC UNDERWRITERS INSURANCE CO 0330 S REPUBLIC WESTERN INSURANCE CO

PO BOX 809076 C/O BARBARA DECOSTA

DALLAS, TX 75380- 2721 N CENTRAL AVE

PHOENIX, AZ 85004-

Phone (1): (972)788-6719

Phone (1): (602)263-6757

CarrRep: [email protected]

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA:

InsComm: [email protected]

1517 C RIVERPORT INSURANCE CO 1635 C RLI INSURANCE COMPANY

ATTN: MELISSA JAQUES RLI INSURANCE COMPANY

PO BOX 948 PO BOX 3736

MINNEAPOLIS, MN 55440- PEORIA, IL 61612-3736

Phone (1): (612)766-3244 Phone (1): (309)692-1000

Phone (2): (309)689-2047

CarrRep:

DSA: [email protected] CarrRep: PHILIP RAIMER

InsComm: [email protected] DSA:

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1518 C ROCKWOOD CASUALTY INSURANCE CO 1519 C RURAL COMMUNITY INSURANCE CO

654 MAIN ST 3501 THURSTON AVE

ROCKWOOD, PA 15557- ANOKA, MN 55303-

Phone (1): (814)926-4661 Phone (1): (763)323-2155

CarrRep: CarrRep: [email protected]

DSA: DSA:

InsComm: InsComm:

0436 S SAFECO INSURANCE CO OF AMERICA 1325 C SAFETY FIRST INSURANCE CO

C/O AIMEE TREECE 1832 SCHUETZ RD

101 N ROBINSON AVE STE 1105 ST LOUIS, MO 63146-

OKLAHOMA CITY, OK 73102-

Phone (1): (888)372-7512

Phone (1): (617)654-4073 Phone (2): (314)995-5300

Phone (2): (405)879-0363

CarrRep:

CarrRep: DSA:

DSA: [email protected] InsComm: [email protected]

InsComm:

1155 C SAFETY NATIONAL CASUALTY CORP 1257 C SAGAMORE INSURANCE CO

ATTN: JIM GODFREY C/O D WADE CHRISTENSEN

1832 SCHUETZ RD 210 PARK AVE STE 2900

ST LOUIS, MO 63146- OKLAHOMA CITY, OK 73102-

Phone (2): (314)995-6300 Phone (1): (317)429-2634

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1631 C SAMSUNG FIRE & MARINE INSURANCE CO LTD USB 1381 S SEABRIGHT INSURANCE CO

85 CHALLENGER RD FL 6 ATTN: DAVID CALANDRO

RIDGEFIELD PARK, NJ 07660-2112 7901 4 ST N STE 203

ST PETERSBURG, FL 33702-

Phone (1): (201)229-6013

Phone (1): (206)269-8961

CarrRep: DANIEL LEE Phone (2): (727)217-2964

DSA:

InsComm: CarrRep:

DSA: [email protected]

InsComm:

1613 C SECURA INSURANCE CO 1598 C SECURITY NATIONAL INSURANCE CO (AMTRUST)

PO BOX 819 ATTN: ROY DYKES

APPLETON, WI 54912- PO BOX 650767

DALLAS, TX 75265-

Phone (1): (920)830-4246

Phone (2): (877)207-3119

CarrRep:

DSA: CarrRep:

InsComm: DSA: [email protected]

InsComm:

0372 C SELECT INSURANCE CO 1520 C SENECA INSURANCE CO

C/O CORPORATION SERVICE CO ATTN: VINCENT MAIDA

115 SW 89 ST 160 WATER ST

OKLAHOMA CITY, OK 73139-8511 NEW YORK, NY 10038-

Phone (1): (214)570-6764 Phone (1): (212)344-3000

Phone (2): (405)636-4070

CarrRep:

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 52

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1434 S SENTINEL INSURANCE CO LTD 1494 C SENTRY CASUALTY CO

ATTN: KATE LECHTENBERG ATTN: MARY SWENSON

PO BOX 14474 PO BOX 8032

LEXINGTON, KY 40512- STEVENS POINT, WI 54481-

Phone (1): (860)519-1479 Phone (2): (715)346-9052

Phone (2): (281)877-3413

CarrRep: [email protected]

CarrRep: [email protected] DSA: [email protected]

DSA: [email protected] InsComm: [email protected]

InsComm:

0355 C SENTRY INSURANCE A MUTUAL CO 1166 C SENTRY SELECT INSURANCE CO

ATTN: MARY SWENSON ATTN: MARY SWENSON

PO BOX 8032 PO BOX 8032

STEVENS POINT, WI 54481-- STEVENS POINT, WI 54481-

Phone (1): (800)739-3344 Phone (1): (800)739-3344

Phone (2): (715)346-9052 Phone (2): (ext)905-2

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1521 C SERVICE INSURANCE CO 1483 C SFM MUTUAL INSURANCE CO

ATTN: MYRA CRONIN ATTN: MARGE LANTZ

PO BOX 9729 3500 AMERICAN BLVD STE 700

BRADENTON, FL 34206- BLOOMINGTON, MN 55431-

Phone (1): (800)780-8423 Phone (1): (952)838-4222

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0469 S SOMPO JAPAN INSURANCE CO OF AMERICA 1164 C SOUTHERN INSURANCE CO

ATTN: CAREY ARMISTREAD PO BOX 809076

11405 COMMUNITY HOUSE RD STE 600 DALLAS, TX 75380-9076

CHARLOTTE, NC 28277-

Phone (1): (972)788-6719

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1161 C SOUTHERN UNDERWRITERS INSURANCE CO 1475 C SPARTA INSURANCE CO

PO BOX 809076 ATTN: JOHN MINDEK

DALLAS, TX 75380- 185 ASYLUM ST CITYPLACE II

HARTFORD, CT 06103-

Phone (1): (972)788-6719

Phone (1): (860)275-6506

CarrRep: [email protected] Phone (2): (860)275-6506

DSA: [email protected]

InsComm: [email protected] CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

0623 C ST PAUL FIRE & MARINE INSURANCE CO 0414 C ST PAUL GUARDIAN INSURANCE CO

C/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO

115 SW 89 ST 115 SW 89 ST

OKLAHOMA CITY, OK 73139-8511 OKLAHOMA CITY, OK 73139-8511

Phone (1): (214)570-6764 Phone (1): (214)570-6764

Phone (2): (405)636-4070 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1522 C ST PAUL MEDICAL LIABILITY INSURANCE CO 0415 C ST PAUL MERCURY INSURANCE CO

C/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO

115 SW 89 ST 115 SW 89 ST

OKLAHOMA CITY, OK 73139-8511 OKLAHOMA CITY, OK 73139-8511

Phone (1): (214)570-6764 Phone (1): (214)570-6764

Phone (2): (405)636-4070 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1523 C ST PAUL PROTECTIVE INSURANCE CO 0410 C STANDARD FIRE INSURANCE

C/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO

115 SW 89 ST 115 SW 89 ST

OKLAHOMA CITY, OK 73139-8511 OKLAHOMA CITY, OK 73139-8511

Phone (1): (214)570-6764 Phone (1): (214)570-6764

Phone (2): (405)636-4070 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0416 S STAR INSURANCE CO 1461 C STARNET INSURANCE CO

C/O JAMES AUSTIN C/O BERKLEY NET UNDERWRITERS LLC

PO BOX 219559 ATTN: JOHN BURKE

KANSAS CITY, MO 64141-9559 12701 MARBLESTONE DR STE 250

WOODBRIDGE, VA 22192-

Phone (1): (248)358-1100

Phone (2): (913)266-5287 Phone (1): (703)586-6304

Phone (2): (866)915-4458

CarrRep:

DSA: [email protected] CarrRep: [email protected]

InsComm: DSA: [email protected]

InsComm: [email protected]

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

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

1524 C STARR INDEMNITY & LIABILITY CO 0625 S STATE AUTO PROPERTY & CASUALTY INSURANCE CO

399 PARK AVE 8TH FL ATTN: SUSAN PILON

NEW YORK, NY 10022- PO BOX 390327

MINNEAPOLIS, MN 55439-0327

CarrRep: Phone (2): (317)931-7742

DSA: [email protected]

InsComm: [email protected] CarrRep:

DSA: [email protected]

InsComm: [email protected]

0626 S STATE AUTOMOBILE MUTUAL INSURANCE CO 0315 S STATE FARM FIRE & CASUALTY CO

ATTN: SUSAN PILON ATTN: PAUL SLATER

PO BOX 390327 12222 STATE FARM BLVD

MINNEAPOLIS, MN 55439-0327 TULSA, OK 74146-

Phone (2): (800)789-2242 Phone (2): (918)641-2919

CarrRep: CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1471 S STONETRUST COMMERCIAL INSURANCE CO 1525 C STONINGTON INSURANCE CO

ATTN: DAVE LORINO ATTN: PETE HERNANDEZ

5615 CORPORATE BLVD STE 700 7701 LAS COLINAS RDG

BATON ROUGE, LA 70808-2557 IRVING, TX 75063-

Phone (1): (225)923-1050 Phone (1): (214)493-4280

Phone (2): (225)201-8011

CarrRep:

CarrRep: DSA:

DSA: [email protected] InsComm: [email protected]

InsComm:

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

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1619 S SUNZ INSURANCE CO 1242 C TECHNOLOGY INSURANCE CO (AMTRUST)

ATTN: DOUGLAS ALSOP PO BOX 650767

7405 N TAMIAMI TRL DALLAS, TX 75265-

SARASOTA, FL 34243-

Phone (1): (212)220-7120

CarrRep: CarrRep:

DSA: [email protected] DSA:

InsComm: InsComm: [email protected]

1260 C THE INSURANCE CO 0631 C TIG INSURANCE CO

ATTN: PAULETTE DAVIS C/O LARRY TAYLOR

10451 GULF BLVD 406 S BOULDER STE 410

TREASURE ISLAND, FL 33706-4814 TULSA, OK 74103-

Phone (1): (800)237-3355 Phone (1): (972)952-8000

Phone (2): (918)582-4446

CarrRep: [email protected]

DSA: [email protected] CarrRep: [email protected]

InsComm: [email protected] DSA:

InsComm: [email protected]

0331 S TOKIO MARINE AMERICA INS CO 1459 C TOWER INSURANCE CO OF NEW YORK

ATTN: KATHY STEPHENS ATTN: DEE KAPADIA

1 RAVINIA DR STE 1130 HARBORSIDE FINANCIAL CENTER

ATLANTA, GA 30346- 800 PLAZA TWO

NEW JERSEY, NJ 07311-

Phone (1): (212)297-6902

Phone (2): (800)359-5728 Phone (1): (201)881-8329

Phone (2): (201)881-8329

CarrRep: [email protected]

DSA: [email protected] CarrRep: [email protected]

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

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

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1573 C TOWER NATIONAL INSURANCE CO 1586 C TOYOTA MOTOR INSURANCE CO

ATTN: DEE KAPADIA 19001 S WESTERN AVE NF 23

HARBORSIDE FINANCIAL CENTER TORRANCE, CA 90509-

800 PLAZA TWO

NEW JERSEY, NJ 07311-1104 Phone (1): (310)468-8044

Phone (1): (201)881-8329 CarrRep:

Phone (2): (201)881-8329 DSA:

InsComm: [email protected]

CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

1498 S TRANS PACIFIC INSURANCE CO (NEW ID) 1240 C TRANSGUARD INSURANCE CO OF AMERICA INC

ATTN: SAL ETERNO C/O CORPORATION SERVICE CO

230 PARK AVE 115 SW 89 ST

NEW YORK, NY 10169-0001 OKLAHOMA CITY, OK 73139-8511

Phone (1): (212)297-6902 Phone (1): (800)796-2480

Phone (2): (630)570-3505

CarrRep: [email protected]

DSA: [email protected] CarrRep: [email protected]

InsComm: [email protected] DSA: [email protected]

InsComm: [email protected]

0463 S TRANSPORTATION INSURANCE CO 0289 C TRAVCO

ATTN: ROBERT BILTZ C/O CORPORATION SERVICE CO

PO BOX 8317 115 SW 89 ST

CHICAGO, IL 60680- OKLAHOMA CITY, OK 73139-8511

Phone (1): (800)262-1113 Phone (1): (214)570-6764

Phone (2): (214)220-1557 Phone (2): (405)636-4070

CarrRep: CarrRep: [email protected]

DSA: CNAOKLAHOMASTATEFILING'[email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

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

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0290 C TRAVELERS CASUALTY & SURETY CO 0291 C TRAVELERS CASUALTY & SURETY OF AMERICA

C/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO

115 SW 89 ST 115 SW 89 ST

OKLAHOMA CITY, OK 73139-8511 OKLAHOMA CITY, OK 73139-8511

Phone (1): (214)570-6764 Phone (1): (214)570-6764

Phone (2): (405)636-4070 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0293 C TRAVELERS CASUALTY CO OF CONNECTICUT 0292 C TRAVELERS CASUALTY INSURANCE CO OF AMERICA

C/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO

115 SW 89 ST 115 SW 89 ST

OKLAHOMA CITY, OK 73139-8511 OKLAHOMA CITY, OK 73139-8511

Phone (1): (214)570-6764 Phone (1): (214)570-6764

Phone (2): (405)636-4070 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0294 C TRAVELERS COMMERCIAL INSURANCE CO 0295 C TRAVELERS HOME & MARINE INSURANCE CO

C/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO

115 SW 89 ST 115 SW 89 ST

OKLAHOMA CITY, OK 73139-8511 OKLAHOMA CITY, OK 73139-8511

Phone (1): (214)570-6764 Phone (1): (214)570-6764

Phone (2): (405)636-4070 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 59

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0296 C TRAVELERS INDEMNITY CO 0297 C TRAVELERS INDEMNITY CO OF AMERICA

C/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO

115 SW 89 ST 115 SW 89 ST

OKLAHOMA CITY, OK 73139-8511 OKLAHOMA CITY, OK 73139-8511

Phone (1): (214)570-6764 Phone (1): (214)570-6764

Phone (2): (405)636-4070 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0298 C TRAVELERS INDEMNITY CO OF CONNECTICUT 0300 C TRAVELERS INDEMNITY CO OF MISSOURI

C/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO

115 SW 89 ST 115 SW 89 ST

OKLAHOMA CITY, OK 73139-8511 OKLAHOMA CITY, OK 73139-8511

Phone (1): (214)570-6764 Phone (1): (214)570-6764

Phone (2): (405)636-4070 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

0301 C TRAVELERS INSURANCE CO 0299 C TRAVELERS PROPERTY & CASUALTY CO OF AMERICA

C/O CORPORATION SERVICE CO C/O CORPORATION SERVICE CO

115 SW 89 ST 115 SW 89 ST

OKLAHOMA CITY, OK 73139-8511 OKLAHOMA CITY, OK 73139-8511

Phone (1): (214)570-6764 Phone (1): (214)570-6764

Phone (2): (405)636-4070 Phone (2): (405)636-4070

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1643 C TRI STATE INSURANCE COMPANY OF MINNESOTA 1324 S TRIANGLE INSURANCE CO

PO BOX 1594 ATTN: MELANIE PRENTICE

DES MOINES, IA 50306- PO BOX 1719

LITTLE ROCK, AR 72203-

CarrRep: CAROLYN CHAMBERS Phone (2): (800)648-4642

DSA:

InsComm: CarrRep:

DSA: [email protected]

InsComm: [email protected]

0635 S TRUCK INSURANCE EXCHANGE 1621 S TRUMBULL INSURANCE CO

C/O TAMMY LEE ATTN: KATE LECHTENBERG

PO BOX 108843 PO BOX 14474

OKLAHOMA CITY, OK 73101-8843 LEXINGTON, KY 40512-

Phone (1): (512)533-8361 Phone (1): (860)519-1479

Phone (2): (512)533-8388 Phone (2): (281)877-3413

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: InsComm:

0268 S TWIN CITY FIRE INSURANCE 0309 S UNION INSURANCE CO

ATTN: KATE LECHTENBERG ATTN: SUZANNE RICHARDSON

PO BOX 14474 PO BOX 152180

LEXINGTON, KY 40512- IRVING, TX 75015-

Phone (1): (860)519-1479 Phone (1): (800)444-0049

Phone (2): (281)877-3413 Phone (2): (972)719-2866

CarrRep: [email protected] CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1587 C UNITED NATIONAL SPECIALTY INSURANCE CO 0483 C UNITED STATES FIDELITY & GUARANTY CO

3 BALA PLAZA E STE 300 C/O CORPORATION SERVICE CO

BALA CYNWYD, PA 19004- 115 SW 89 ST

OKLAHOMA CITY, OK 73139-8511

Phone (1): (610)664-1500

Phone (1): (214)570-6764

CarrRep: Phone (2): (405)636-4070

DSA:

InsComm: [email protected] CarrRep: [email protected]

DSA: [email protected]

InsComm:

0640 S UNITED STATES FIRE INSURANCE CO 1428 C UNITED WISCONSIN INSURANCE CO

ATTN: MIKE HICKS 15200 W SMALL RD

6404 INTERNATIONAL PKWY STE 1000 NEW BERLIN, WI 53151-

PLANO, TX 75093-

Phone (1): (262)787-7700

Phone (2): (972)380-3167

CarrRep: [email protected]

CarrRep: DSA:

DSA: [email protected] InsComm: [email protected]

InsComm: [email protected]

1527 C UNIVERSAL CASUALTY CO 0323 S UNIVERSAL UNDERWRITERS INSURANCE CO

150 NW POINT BLVD C/O ZURICH CLAIMS

ELK GROVE VILLAGE, IL 60007- ATTN: JUDITH MANDELKY

PO BOX 968023

Phone (1): (847)700-8774 SCHAUMBURG, IL 60196-

CarrRep: Phone (1): (410)559-8519

DSA:

InsComm: CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1413 C US SPECIALTY INSURANCE CO 0426 C UTICA MUTUAL INSURANCE CO

13403 NW FRWY ATTN: LARRY HOCUTT

HOUSTON, TX 77040- PO BOX 5310

BINGHAMTON, NY 13902-

Phone (1): (713)462-3700

Phone (1): (315)734-2302

CarrRep: Phone (2): (972)677-6719

DSA:

InsComm: [email protected] CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

1606 C UTICA NATIONAL ASSURANCE CO 0641 S VALIANT INSURANCE CO

180 GENESEE ST C/O ZURICH CLAIMS

NEW HARTFORD, NY 13413- ATTN: JUDITH MANDELKY

PO BOX 968023

Phone (1): (315)734-2868 SCHAUMBURG, IL 60196-

CarrRep: Phone (1): (410)559-8519

DSA:

InsComm: CarrRep: [email protected]

DSA: [email protected]

InsComm: [email protected]

0464 S VALLEY FORGE INSURANCE CO 0396 S VANLINER INSURANCE CO

ATTN: ROBERT BILTZ C/O TODD ESTES

PO BOX 8317 PO BOX 26350

CHICAGO, IL 60680- OKLAHOMA CITY, OK 73126-

Phone (1): (800)262-1113 Phone (1): (636)349-3900

Phone (2): (214)220-1557

CarrRep:

CarrRep: DSA: [email protected]

DSA: CNAOKLAHOMASTATEFILING'[email protected] InsComm: [email protected]

InsComm:

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0642 C VIGILANT INSURANCE CO 0644 C VIRGINIA SURETY CO

C/O MALCOLM SMITH C/O JEFF DASOVICH

5416 S YALE AVE STE 225 11914 N PENN AVE STE B4

TULSA, OK 74135- OKLAHOMA CITY, OK 73120-

Phone (1): (214)754-0777 Phone (1): (312)381-9523

Phone (2): (918)392-2910 Phone (2): (405)755-1661

CarrRep: [email protected] CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1528 C WASHINGTON INTERNATIONAL INSURANCE CO 0645 S WAUSAU BUSINESS INSURANCE CO

ATTN: EDWARD STYS C/O AIMEE TREECE

475 N MARTINGDALE RD 101 N ROBINSON AVE STE 1105

SCHAUMBURG, IL 60173- OKLAHOMA CITY, OK 73102-

Phone (1): (603)644-6600 Phone (1): (617)654-4073

Phone (2): (405)879-0363

CarrRep:

DSA: [email protected] CarrRep:

InsComm: [email protected] DSA: [email protected]

InsComm:

0431 S WAUSAU UNDERWRITERS INSURANCE CO 1529 C WESCO INSURANCE CO (AMTRUST)

C/O AIMEE TREECE ATTN: ROY DYKES

101 N ROBINSON AVE STE 1105 PO BOX 650767

OKLAHOMA CITY, OK 73102- DALLAS, TX 75265-

Phone (1): (617)654-4073 Phone (1): (214)360-8560

Phone (2): (405)879-0363 Phone (2): (214)360-8560

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

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Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0348 S WEST AMERICAN INSURANCE CO 0428 C WESTCHESTER FIRE INSURANCE

C/O AIMEE TREECE C/O ESIS

101 N ROBINSON AVE STE 1105 ATTN: CAROL GALLIMORE

OKLAHOMA CITY, OK 73102- 225 E JOHN CARPENTER FWY STE 1300

IRVING, TX 75062-

Phone (1): (617)654-4073

Phone (2): (405)879-0363 Phone (1): (302)476-7446

Phone (2): (972)465-7704

CarrRep:

DSA: [email protected] CarrRep: [email protected]

InsComm: DSA: [email protected]

InsComm: [email protected]

1530 C WESTERN AGRICULTURAL INSURANCE CO 1566 C WESTERN NATIONAL ASSURANCE CO

ATTN: JANICE SEWRIGHT PO BOX 1463

5400 UNIVERSITY AVE MINNEAPOLIS, MN 55440-

W DES MOINES, IA 50266-

Phone (2): (952)921-5602

Phone (1): (515)225-5400

CarrRep:

CarrRep: DSA:

DSA: [email protected] InsComm:

InsComm: [email protected]

1422 S WESTFIELD INSURANCE CO 1217 S WESTPORT INSURANCE CORP (NEW) (FKA ERC)

C/O BROADSPIRE SERVICES INC ATTN: EARL CARTWRIGHT

ATTN: DEBRA GLOVER 5200 METCALF AVE

5901 COLLEGE BLVD STE 275 OVERLAND PARK, KS 66201-

OVERLAND PARK, KS 66211-

Phone (1): (913)676-5200

Phone (2): (913)663-7521 Phone (2): (913)676-5200

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 65

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

1451 S WORK FIRST CASUALTY CO 1640 C WORLDWIDE UNDERWRITERS INSURANCE CO

C/O BROADSPIRE SERVICES INC C/O AIMEE TREECE

ATTN: ANGELA STEIN 101 N ROBINSON AVE STE 1105

PO BOX 14342 OKLAHOMA CITY, OK 73102-

LEXINGTON, KY 40512-4342

Phone (2): (913)663-7515 CarrRep:

DSA: [email protected]

CarrRep: InsComm:

DSA: [email protected]

InsComm: [email protected]

1531 S XL INSURANCE AMERICA INC 1169 S XL SPECIALTY INSURANCE CO

ATTN: SARAH MIMS ATTN: SARAH MIMS

505 EAGLEVIEW BLVD STE 100 505 EAGLEVIEW BLVD STE 100

EXTON, PA 19341- EXTON, PA 19341-

Phone (1): (203)964-5200 Phone (1): (203)964-5200

Phone (2): (610)968-2970 Phone (2): (610)968-2970

CarrRep: CarrRep:

DSA: [email protected] DSA: [email protected]

InsComm: InsComm:

0313 S ZENITH INSURANCE CO 1645 C ZNAT INSURANCE CO

C/O STEVE BUNTING C/O STEVE BUNTING

15 W 6 ST STE 1212 15 W 6 ST STE 1212

TULSA, OK 74119-5406 TULSA, OK 74119-

Phone (1): (800)841-3987

Phone (2): (918)592-7030 CarrRep:

DSA:

CarrRep: InsComm:

DSA: [email protected]

InsComm: [email protected]

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

OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS

Date: 08/04/2014 CARRIER LISTING WITH EMAIL ADDRESSES Page: 66

Time: 12:35 TYPE: INSUR CO Rpt ID: CARLST-EMAIL

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

0649 S ZURICH AMERICAN INSURANCE CO 1420 S ZURICH AMERICAN INSURANCE CO OF IL

C/O ZURICH CLAIMS C/O ZURICH CLAIMS

ATTN: JUDITH MANDELKY ATTN: JUDITH MANDELKY

PO BOX 968023 PO BOX 968023

SCHAUMBURG, IL 60196- SCHAUMBURG, IL 60196-

Phone (1): (410)559-8519 Phone (1): (410)559-8519

CarrRep: [email protected] CarrRep: [email protected]

DSA: [email protected] DSA: [email protected]

InsComm: [email protected] InsComm: [email protected]

1574 S ZURICH NORTH AMERICAN INSURANCE CO

C/O ZURICH CLAIMS

ATTN: JUDITH MANDELKY

PO BOX 968023

SCHAUMBURG, IL 60196-

Phone (1): (410)559-8519

CarrRep: [email protected]

DSA: [email protected]

InsComm:

Records printed: 393

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