georgia state board of workers' compensation insurer and claim

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SBWC # Insurer Name Address Email

10114 WILMINGTON

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20582 ATLANTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20622 DOTHAN

FL 32716

Phone:

SBWC # Insurer Name Address Email

20764 FORT SMITH

FORT SMITH AR 72917

Phone:

SBWC # Insurer Name Address Email

13246 LANSING

LANSING MI 48901

Phone:

BRUNSWICK GA 31520

Phone:

SBWC # Insurer Name Address Email

13214 LANSING

LANSING MI 48901

888-888-8136 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

A G RHODES HOME INC 3715 NORTHSIDE PKWY,

BLDG 400 STE 305

GA 30327 BCHANDLER@BAUGUESSMGMT.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

Georgia State Board of Workers' Compensation

Insurer and Claim Offices by Name

21ST CENTURY PREMIER INS CO FKA

COLONIAL PENN FRAN INS CO

21ST CENTURY PLAZA, 3

BEAVER VALLEY ROAD

DE 19803

ACCIDENT FUND INSURANCE 20-3058200 129 FREDERICK DR GINNYS@ACCIDENTFUND.COM

912-264-0988 Ext.

800-395-2366 Ext. 1702

ACCIDENT FUND GENERAL INSURANCE

COMPANY

MI 48933 JUDY2T@ACCIDENTFUND.COM

ACCIDENT FUND CLAIMS

DEPT

38-3207001 200 N GRAND AVE STEPHENW@ACCIDENTFUND.COM

800-961-9744 Ext.

ABF FREIGHT SYSTEM INC. AR 72917 STANMCD@ARKBEST.COM

ABF FREIGHT SYSTEM INC 71-0249444 P O BOX 10048 LYNETTEBW@ARKBEST.COM

800-315-6090 Ext.

AAA COOPER TRANSPORTATION AL 36302 ASCOTT@AAACOOPER.COM

NORTH AMERICAN RISK

SERVICES INC

13-3901415 P O BOX 166002 ALTAMONTE

SPRINGS

MAILROOM@NARIK.COM

ACCIDENT FUND CLAIMS

DEPT

38-3207001 200 N GRAND AVE STEPHENW@ACCIDENTFUND.COM

ACCIDENT FUND INSURANCE CO OF AMERICA MI 48933 JUDY2T@ACCIDENTFUND.COM

Phone:

BRUNSWICK GA 31520

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13240 LANSING

LANSING MI 48901

Phone:

BRUNSWICK GA 31520

Phone:

SBWC # Insurer Name Address Email

13235 IRMO

KENNESAW GA 30144

Phone:

SBWC # Insurer Name Address Email

10253 PHILADELPHIA

LITTLE ROCK AZ 72231

Phone:

BIRMINGHAM AL 35209

Phone:

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

LOUISVILLE KY 40222

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

CINCINNATI OH 45224

Phone:

MAITLAND FL 32751

ACCIDENT FUND INSURANCE 20-3058200 129 FREDERICK DR GINNYS@ACCIDENTFUND.COM

912-264-0988 Ext.

800-395-2366 Ext. 1702

ACCIDENT FUND NATIONAL INSURANCE

COMPANY

MI 48933 JUDY2T@ACCIDENTFUND.COM

ACCIDENT FUND CLAIMS

DEPT

38-3207001 200 N GRAND AVE STEPHENW@ACCIDENTFUND.COM

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

ACCIDENT FUND INSURANCE 20-3058200 129 FREDERICK DR GINNYS@ACCIDENTFUND.COM

912-264-0988 Ext.

800-395-2366 Ext. 1702

BROADSPIRE INC 36-3917295 P O BOX 926240 ATLANTA@CHOOSEBROADSPIRE.COM

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

800-277-7500 Ext. 29106

ALTERNATIVE SERVICE

CONCEPTS LLC

43-1954328 P O BOX 15550 JAMES.CHANCELLOR@ASCRISK.COM

800-669-0437 Ext. 108

ACE AMERICAN INS CO 436 WALNUT STREET, PA 19106 MARILEE.BRABSON@ACEGROUP.COM

800-896-6884 Ext. 8459

US ADMINISTRATOR CLAIMS 26-3357762 3440 BLUE SPRINGS ROAD HMOSS@USADMINCLAIMS.COM

ACCIDENT INSURANCE COMPANY SC 29063 MICHAEL.HUNTER@ACCINSCO.COM

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

800-235-1134 Ext. 5

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

BROADSPIRE SERVICES INC. 36-3917295 9502 WILLIAMSBURG TOM.WEBER@CHOOSEBROADSPIRE.COM

800-742-4248 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

678-969-7337 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

ALPHARETTA GA 30005

Phone:

TAMPA FL 33612

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

FT MILL SC 29716

Phone:

CLEARWATER FL 33758

Phone:

FORT MILL SC 29715

Phone:

TAMPA FL 33618

Phone:

ATLANTA GA 30328

800-473-9009 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

800-288-9843 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 KRISTY_SANDS@GBTPA.COM

800-685-7361 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

770-352-2978 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR GEORGIAWCBOARD@TRAVELERS.COM

866-814-1740 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 KIM_BUCHANAN@GBTPA.COM

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE JULIE_MCCOY-LINCOLN@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

800-282-6218 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 607 JULIE_MCCOY-LINCOLN@GBTPA.COM

803-547-8036 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30338

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

LAKE MARY FL 32746

Phone:

ALPHARETTA GA 30005

Phone:

SAVANNAH GA 31405

Phone:

PARSIPPANY NJ 07054

Phone:

SBWC # Insurer Name Address Email

10221 PHILADELPHIA

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ROSWELL GA 30076

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

770-353-4591 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SEDGWICK CMS BELLSOUTH

DISABILITY

36-2685608 1200 ASHWOOD PARKWAY TOBIN.BECKERMANN@SEDGWICKCMS.COM

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

800-347-4494 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

ACE FIRE UNDERWRITERS 436 WALNUT STREET,

WB04G

PA 19106 MARILEE.BRABSON@ACEGROUP.COM

912-355-8989 Ext.

YORK CLAIMS SERVICE INC 13-1963636 99 CHERRY HILL ROAD STEPHANIE.MARSHALL@YORKRSG.COMM

877-927-2255 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

800-541-0139 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

CT

SCOTT.WESTMAN@SRSCONNECT.COM

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

800-235-1134 Ext. 5

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

Phone:

DULUTH GA 30097

Phone:

ORLANDO FL 32878

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

13034 PHILADELPHIA

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

SYRACAUSE NY 13202

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

615-824-5095 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

800-843-8999 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

800-685-7361 Ext.

800-685-7361 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

800-235-1134 Ext. 5

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

ACE INDEMNITY INSURANCE CO PA 19106 MARILEE.BRABSON@ACEGROUP.COM

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

SBWC # Insurer Name Address Email

10002 PHILADELPHIA

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

SYRACAUSE NY 13202

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13193 DALLAS,

TAMPA FL 33602

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13176 SALT LAKE CITY

TUCKER GA 30084

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21753 ORLANDO

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

ACE PROPERTY & CASUALTY 436 WALNUT STREET,

WB04G

PA 19106 MARILEE.BRABSON@ACEGROUP.COM

ACIG INSURANCE COMPANY 12222 MERIT DRIVE,

SUITE 1660

TX 75251 ACIGREGULATORY@ACIG.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

407-562-3632 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

ADVENTIST HEALTH SYSTEM SUNBELT

HEALTHCARE CORP

602 COURTLAND ST, STE

330

FL 32804 NANCEE.ROSEN@AHSS.ORG

800-354-6494 Ext. 201

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY JTHOMAS@SYNERGYINSURANCE.NET

866-710-0908 Ext.

ADVANTAGE WORKERS COMPENSATION

INSURANCE COMPANY

UT 84157 CLAIMS@ADVANTAGEWC.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

678-731-9091 Ext. 252

NOVAPRO RISK 36-4550659 101 E KENNEDY BLVD KROGERS@NOVAPRORISK.COM

800-426-5990 Ext.

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE TKATER@NOVAPRORISK.COM

ORLANDO FL 32804

Phone:

SBWC # Insurer Name Address Email

20315 ATLANTA

ATLANTA GA 30302

Phone:

SBWC # Insurer Name Address Email

30047 COMMERCE

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

10066 NEW YORK

ALPHARETTA GA 30023

SBWC # Insurer Name Address Email

21130 ALBANY

JOHNS CREEK GA 30097

SBWC # Insurer Name Address Email

21715 ALBANY

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13202 ROCKY HILL

ATLANTA GA 30326

Phone:

GLEN ALLEN VA 23058

Phone:

TUCKER GA 30084

407-200-4894 Ext.

ADVENTIST HEALTH

SYSTEM RISK MANAGEMENT

59-2170012 602 COURTLAND STREET NANCEE.SMITH@AHSS.ORG

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

ALBANY CITY OF GA 31702 JCLARK@ALBANY.GA.US

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

AIU INSURANCE COMPANY 175 WATER STREET,

18TH FLOOR

NY 10038 ALGAWCFR@AIG.COM

CEDWARDS@GEORGIA-ADMIN.COM

800-421-0710 Ext.

AGRI TRUST OF GA GA 30529

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE

404-584-3782 Ext.

AGL RESOURCES INC. DBA ATLANTA GAS

LIGHT

GA 30302 KEMERSON@AGLRESOURCES.COM

AGL RISK MANAGEMENT 58-2210952 P O BOX 4569 KEMERSON@AGLRESOURCES.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

404-266-4855 Ext.

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE MARCIA_MORGAN@CORVEL.COM

800-906-4461 Ext.

ALEA NORTH AMERICA INSURANCE COMPANY CT 06067 ARLEEN.SIMMONS@ALEAGROUP.COM

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE KPILZ@CHUBB.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

ALBANY INTERNATIONAL CORP NY 12201 ANITA.GERACE@ALBINT.COM

Phone:

SBWC # Insurer Name Address Email

10295 VAN WERT

VAN WERT OH 45891

Phone:

SBWC # Insurer Name Address Email

13275 LANCASTER

LANCASTER PA 17608

Phone:

SBWC # Insurer Name Address Email

13244 COLUMBUS

GAINESVILLE FL 32614

Phone:

SBWC # Insurer Name Address Email

21464 ATLANTA

ALPHARETTA GA 30023

Phone:

SBWC # Insurer Name Address Email

13293 WORCESTER

WORCESTER MA 01653

Phone:

SBWC # Insurer Name Address Email

21596 ALPHARETTA

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

13245 COLUMBUS

GAINESVILLE FL 32614

Phone:

SBWC # Insurer Name Address Email

800-354-6494 Ext. 201

ALLIED SYSTEMS LTD 2302 PARKLAKE DR,

BUILDING 15 SUITE 600

GA 30378 JOHN.BLOUNT@ALLIEDHOLDINGS.COM

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 FERRANT@NATIONWIDE.COM

800-985-7078 Ext.

ALLIED PROPERTY AND CASUALTY INSURANCE

COMPANY

ONE NATIONWIDE

PLAZA, 3-13-401

OH 43215 KINGJ4@NATIONWIDE.COM

ALLIED EASTERN

INDEMNITY COMPANY

26-0026993 P O BOX 83777 RIRONS@EAINS.COM

888-654-7100 Ext.

ALLIED EASTERN INDEMNITY COMPANY PA 17608 RIRONS@EAINS.COM

CENTRAL INSURANCE 34-4202560 800 SOUTH WASHINGTON CLININGER@CENTRAL-INSURANCE.COM

800-736-7000 Ext. 2380

ALL AMERICA INSURANCE CO OH 45891 PWOIROL@CENTRAL-INSURANCE.COM

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 FERRANT@NATIONWIDE.COM

800-985-7078 Ext.

AMCO INSURANCE COMPANY ONE NATIONWIDE

PLAZA, 3-13-401

OH 43215 KINGJ4@NATIONWIDE.COM

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

ALPHARETTA CITY OF GA 30009 DNELSON@ALPHARETA.GA.US

HANOVER INSURANCE

COMPANY

13-5129825 440 LINCOLN STREET EBESHAI@HANOVER.COM

800-628-0250 Ext.

ALLMERICA FINANCIAL BENEFIT INSURANCE

COMPANY

MA 01653 EBESHAI@HANOVER.COM

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

800-448-9707 Ext.

13122 PRINCETON

ATLANTA GA 30319

Phone:

TUCKER GA 30084

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10006 NOVATO

ATLANTA GA 30374

Phone:

ALPHARETTA GA 30022

Phone:

SBWC # Insurer Name Address Email

10007 CHICAGO

ATLANTA GA 30339

Phone:

POMPANO BEACH FL 33064

Phone:

DULUTH GA 30096

Phone:

CHICAGO IL 60604

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

IRVING TX 75039

Phone:

678-393-4584 Ext.

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174 KLOCKE@FFIC.COM

678-393-4550 Ext.

FIREMAN'S FUND

INSURANCE CO

94-1610280 11475 GREAT OAKS WAY JUDY.OWEN@AFFIC.COM

AMERICAN AUTOMOBILE INSURANCE

COMPANY

CA 94998 LMNUSON@FFIC.COM

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

800-450-0692 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

AMERICAN ALTERNATIVE INSURANCE

CORPORPATION

NJ 08543 CKROH@MUNICHREAMERICAN.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

312-822-2331 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

877-241-6121 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

800-283-2318 Ext. 3574

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH GASTATEICNUMBERS@CNA.COM

800-862-4252 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

AMERICAN CASUALTY COMPANY OF READING

PENNSYLVANIA

333 S WABASH AVENUE,

28 SOUTH

IL 60604 DEBRA.RETEL@CNA.COM

CAMBRIDGE INTEGRATED 23-2731565 1775 THE EXCHANGE DAVID.HAYS@CAMBRIDGE-NA.COM

GALLAGHER BASSET 36-3365500 222 W LAS COLINAS BLVD TERRY_TARTER@GBTPA.COM

800-787-6750 Ext.

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13271 BLOOMINGTON

MAITLAND FL 32751

Phone:

SBWC # Insurer Name Address Email

10262 SEATTLE

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13255 MADISON

SCHOFIELD WI 55476

Phone:

SBWC # Insurer Name Address Email

10011 FAIRFIELD

CHARLOTTE NC 28277

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

770-901-3121 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

800-871-6670 Ext.

866-246-0259 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

AMERICAN FIRE & CASUALTY COMPANY OH 45014 CORPORATESECRETARY@LIBERTYMUTUAL.COM

800-692-6326 Ext. 41237

AMERICAN FAMILY INSURANCE COMPANY WI 53783 CGILB@AMFAM.COM

AMERICAN FAMILY

INSURANCE COMPANY

CLAIMS

39-1835307 P O BOX 530 SLODHOLZ@AMFAM.COM

678-417-3654 Ext.

AMERICAN ECONOMY INS CO CO LICENSING T-18,

SAFECO PLAZA

WA 98185 CORPORATESECRETARY@LIBERTYMUTUAL.COM

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE MARPOO@SAFECO.COM

866-291-0194 Ext.

AMERICAN COMPENSATION INSURANCE

COMPANY

MN 55437 MARSHALL.LIN@RTWI.COM

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 CHRISTINE.JONES@MONTGOMERY-INS.COM

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

10013 SCHAUMBURG

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

CLEARWATER FL 33758

Phone:

TAMPA FL 33622

Phone:

BIRMINGHAM AL 35266

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

FT MILL SC 29716

Phone:

800-473-9009 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 KRISTY_SANDS@GBTPA.COM

404-851-3207 Ext.

AMERICAN GUARANTEE

AND LIABILITY COMPANY

36-6071400 1900 SUMMIT TOWER CHRIS.CALLOWAY@ZURICHNA.COM

404-851-3207 Ext.

AMERICAN GUARANTEE & LIABILITY

INSURANCE COMPANY

IL 60196 TIM.GRAHAM@ZURICHNA.COM

AMERICAN GUARANTEE

AND LIABILITY COMPANY

36-6071400 1001 SUMMIT BLVD CHRIS.CALLOWAY@ZURICHNA.COM

AMERICAN FIRE &

CASUALTY COMPANY

59-141790 13830 BALLANTYNE CORP

800-334-0197 Ext.

800-334-0078 Ext. 214

WARNER.MARSHALL@LIBERTYMUTUAL.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY CHRIS_ROCK@GBTPA.COM

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2600 MCCORMICK DR #110 CANDICE_BUCHANAN@GBTPA.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE JULIE_MCCOY-LINCOLN@GBTPA.COM

866-814-1740 Ext. 201

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SCHAUMBERG IL 60666

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

10015 NEW YORK

NORCROSS GA 30071

Phone:

BIRMINGHAM AL 35209

Phone:

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

CINCINNATI OH 45224

Phone:

MAITLAND FL 32751

Phone:

ALPHARETTA GA 30023

Phone:

OKLAHOMA CITY OK 73123

AMERICAN HOME ASSURANCE COMPANY 175 WATER STREET,

18TH FLOOR

NY 10038 ALGAWCFR@AIG.COM

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

ZURICH NORTH AMERICA 36-3839542 P.O. BOX 2769 USZ_GA_WC_CLAIM_NOTICES@ZURICHNA.COM

404-851-3208 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

800-235-1134 Ext. 5

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

678-969-7337 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BROADSPIRE INC 36-3917295 P O BOX 926240 ATLANTA@CHOOSEBROADSPIRE.COM

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

800-277-7500 Ext. 29106

ALTERNATIVE SERVICE

CONCEPTS LLC DBA ASC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

678-447-0200 Ext. 302

CLAIMETRICS 20-1604010 PO BOX 22478 LAUREN.TOPPINS@CLAIMETRICS.COM

866-291-0194 Ext.

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

800-448-9707 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.EXCHANGING.COM

800-235-1134 Ext. 5

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

Phone:

ALPHARETTA GA 30005

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

ORLANDO FL 32878

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

EDI USE ONLY 01 72756 JUDY PIERCE

Phone:

NASHVILLE TN 37214

Phone:

LEXINGTON KY 40512

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

985-624-6739 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

770-352-2978 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

877-241-6121 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

405-728-5544 Ext. 2326

800-347-4494 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

241-922-0638 Ext.

SEDGWICK WALMART HD 71-0738006 EDI USE ONLY

479-621-2900 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

ATLANTA.GA@SEDGWICKCMS.COM

678-628-1318 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext. 35832

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 DANIELLE.MINNIEHAN@SRSCONNECT.COM

Phone:

SBWC # Insurer Name Address Email

10016 NOVATO

ATLANTA GA 30374

Phone:

ALPHARETTA GA 30022

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

13021 DERIDDER

DERIDDER LA 70634

Phone:

LAWRENCEVILLE GA 30045

Phone:

SBWC # Insurer Name Address Email

13296 BIRMINGHAM

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20459 WASHINGTON

RICHMOND VA 23285

Phone:

SBWC # Insurer Name Address Email

20496 CUMMING

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174 KLOCKE@FFIC.COM

678-393-4550 Ext.

FIREMAN'S FUND

INSURANCE CO

94-1610280 11475 GREAT OAKS WAY JUDY.OWEN@AFFIC.COM

AMERICAN INSURANCE COMPANY CA 94998 ESAYERS@FFIC.COM

605 CRESCENT EXECUTIVE

COURT

800-541-0139 Ext.

770-339-9878 Ext.

AMERISAFE RISK SERVICES

INC

58-1181498 2301 HWY 190 WEST GASTATEBOARD@AMERISAFE.COM

800-256-3462 Ext.

AMERISAFE RISK SERVICES

INC

72-1274075 555 OLD NORCROSS RD JBISTOK@AMERISAFE.COM

AMERICAN INTERSTATE INSURANCE COMPANY LA 70634 PMCCRANEY@AMERISAFE.COM

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

678-393-4584 Ext.

AMERICAN PROTEINS INC GA 30041 ANN.MILFORD@AMPROT.COM

SEDGWICK CMS 36-2685608 1800 BAYBERRY COURT PATRICIA.CARROWIANO@SEDGWICKCMS.COM

804-673-5400 Ext.

AMERICAN NATIONAL RED CROSS 2025 E. STREET NW, 3RD

FLOOR, NW3-144A

DC 20006 WOLDETSADIKM@USA.REDCROSS.ORG

-- Ext.

AMERICAN MINING INSURANCE COMPANY INC AL 35266 MCARNEY@AMERICANMINING.COM

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD ATLANTA.GA@US.CRAWCO.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

678-447-0200 Ext. 302

13007 MOBILE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13124 DALLAS

ATLANTA GA 30348

Phone:

SBWC # Insurer Name Address Email

13223 ATLANTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10254 SEATTLE

DULUTH GA 30097

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10244 SEATTLE

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

12077 SCHAUMBURG

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

678-258-8000 Ext.

AMERICAN RESOURCES INS CO AL 36695 MBRADY@ARIC.CC

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

AMERICAN STATES INSURANCE COMPANY SAFECO PLAZA, 1001

4TH AVENUE

WA 98185 CORPORATESECRETARY@LIBERTYMUTUAL.COM

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

AMERICAN SAFETY CASUALTY INSURANCE 100 GALLERIA

PARKWAY SE, SUITE 700

GA 30339 TRUDD@AMSAFETY.COM

800-283-2318 Ext.

AMERICAN RISK FUNDING 12222 MERIT DRIVE,

SUITE 1660

TX 75251

CNA CLAIMS PLUS - P O BOX 105497

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE MARPOO@SAFECO.COM

678-417-3654 Ext.

AMERICAN STATES INSURANCE COMPANY OF

TEXAS

SAFECO PLAZA, 1001

4TH AVENUE

WA 98154 CORPORATESECRETARY@LIBERTYMUTUAL.COM

TRAVELERS CASUALTY &

SURETY COMPANY OF

AMERICA

06-0907370 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

TRAVELERS CASUALTY &

SURETY COMPANY OF

AMERICA

06-0907370 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE MARPOO@SAFECO.COM

678-417-3654 Ext.

404-851-3207 Ext.

AMERICAN ZURICH

INSURANCE COMPANY

36-3141762 1001 SUMMIT BLVVD CHRIS.CALLOWAY@ZURICHNA.COM

AMERICAN ZURICH INSURANCE COMPANY IL 60196 USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

AMERICAN ZURICH

INSURANCE COMPANY

36-3141762 1900 SUMMIT TOWER CHRIS.CALLOWAY@ZURICHNA.COM

Phone:

TAMPA FL 33630

Phone:

ATLANTA GA 30319

Phone:

POMPANO BEACH FL 33064

Phone:

MAITLAND FL 32751

Phone:

UNIONTOWN OH 44685

Phone:

ALPHARETTA GA 30005

Phone:

DUBUQUE IA 52004

Phone:

WHITESBURG GA 30185

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

BIRMINGHAM AL 35266

Phone:

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BROADSPIRE CLAIMS 36-3917295 CALL BOX 30539 KRISTIN.CANNELL@CHOOSEBROADSPIRE.COM

800-258-1811 Ext.

404-851-3207 Ext.

CHESTERFIELD SERVICES 34-1709723 3520 FOREST LAKE DRIVE ITALO.GROSSI@TPA4TSA.COM

330-896-4311 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

866-291-0194 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

CREATIVE RISK SOLUTIONS 20-0989430 P O BOX 9207 NLYMAN@YOURCLAIMS.COM

770-577-9657 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

877-241-6121 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

770-352-2978 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 KRISTY_SANDS@GBTPA.COM

800-473-9009 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY CHRIS_ROCK@GBTPA.COM

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

800-354-6494 Ext. 201

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

FT MILL SC 29716

Phone:

CLEARWATER FL 33758

Phone:

WILMINGTON NC 28404

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

TAMPA FL 33602

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

COLUMBIA SC 29210

Phone:

ATLANTA GA 30338

Phone:

JACKSONVILLE FL 32256

Phone:

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

800-896-3079 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE JULIE_MCCOY-LINCOLN@GBTPA.COM

866-814-1740 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 KIM_BUCHANAN@GBTPA.COM

678-731-9091 Ext. 252

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

NOVAPRO RISK 36-4550659 101 E KENNEDY BLVD KROGERS@NOVAPRORISK.COM

800-426-5990 Ext.

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE TKATER@NOVAPRORISK.COM

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE EDICOORDINATOR@MATRIXCOS.COM

888-878-0005 Ext.

SEDGWICK CMS 36-2685608 8649 BAYPINE ROAD MARILYN.SANDERS@SEDGWICKCMS.COM

888-784-3470 Ext.

800-426-2885 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE JCONNOR@SEDGWICKCMS.COM

LAKE MARY FL 32746

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

FT SMITH AR 72919

Phone:

TAMPA FL 33610

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

12022 FARMINGTON

HILLSDULUTH GA 30097

Phone:

DULUTH GA 30097

Phone:

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD GASTATEBOARDINBOX@SEDGWICKCMS.COM

678-338-4171 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-548-1373 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 FIANA WAY MWHITE@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

AMERISURE INSURANCE COMPANY MI 48331 CORPLEGAL@AMERISURE.COM

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

888-329-6259 Ext.

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

800-842-5612 Ext. 4611

800-230-9338 Ext.

AMERISURE MUTUAL 38-0829210 2160 SATELLITE BLVD CPUZA@AMERISURE.COM

770-813-3302 Ext.

AMERISURE INSURANCE

COMPANY

38-1869912 2160 SATELLITE BLVD KSWAN@AMERISURE.COM

SBWC # Insurer Name Address Email

10106 FARMINGTON

HILLSDULUTH GA 30097

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13167 WILKES-BARRE

WILKES-BARRE PA 18703

Phone:

ALPHARARETTA GA 30009

Phone:

WILKES-BARRE PA 18703

Phone:

WILKES-BARRE PA 18703

Phone:

TOWSON MD 21204

Phone:

SBWC # Insurer Name Address Email

13095 DALLAS

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13210 FRANKENMUTH

FRANKENMUTH MI 48787

Phone:

FRANKENMUTH MI 48787

Phone:

SBWC # Insurer Name Address Email

13183 STAMFORD

SAVANNAH GA 31405

AMERISURE MUTUAL 38-0829210 2160 SATELLITE BLVD CPUZA@AMERISURE.COM

770-813-3302 Ext.

AMERISURE INSURANCE

COMPANY

38-1869912 2160 SATELLITE BLVD KSWAN@AMERISURE.COM

800-230-9338 Ext.

AMERISURE MUTUAL INSURANCE COMPANY MI 48331 CORPLEGAL@AMERISURE.COM

800-673-2465 Ext. 8302

GUARD INSURANCE GROUP - P O Box 1368 CLAIMS3@GUARD.COM

678-581-0589 Ext.

GUARD INSURANCE GROUP 23-2240322 102 WEST PENNSYLVANIA

AVE

CLAIMS3@GUARD.COM

800-673-2465 Ext. 8110

GUARD INSURANCE GROUP 23-2240322 P O BOX A - H CLAIMS3@GUARD.COM

800-673-2465 Ext. 8110

AMGUARD 23-2240321 P O Box 1368 CLAIMS3@GUARD.COM

800-673-2465 Ext. 8110

AMGUARD INSURANCE

COMPANY

23-2240321 294 SOUTH MAIN STREET BDIAMOND@GUARD.COM

AMGUARD INSURANCE COMPANY PA 18703 ESOLA@GUARD.COM

ANSUR AMERICA INSURANCE COMPANY MI 48787 JOHN.BENSON@FMINS.COM

ANSUR AMERICA

INSURANCE COMPANY

38-3467437 ONE MUTUAL AVENUE SUZANNE.COWAN@FMINS.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

AMTRUST INSURANCE COMPANY OF KANSAS

INC

TX 75265 KFAIRRIS@AMTRUSTGROUP.COM

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

MREVELLE@ASG-ADJ.COM

ARCH INSURANCE COMPANY 300 1ST STAMFORD

PLACE, 5TH FLOOR

CT 06902 JROEHRICH@ARCHINSURANCE.COM

800-234-1133 Ext.

FRANKENMUTH MUTUAL

INSURANCE COMPANY

38-0555290 ONE MUTUAL AVE. SUZANNE.COWAN@FMINS.COM

800-234-1122 Ext.

Phone:

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

DULUTH GA 30096

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

PARSIPPANY NJ 07054

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

21371 THOMASVILLE

MARIETTA GA 30006

Phone:

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA CMULLINS@AVIZENTRISK.COM

800-277-7500 Ext. 20104

800-580-6912 Ext.

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

800-283-2318 Ext. 3574

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

866-246-0259 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 9 CAMPUS DRIVE ATLANTAR@GABROBINS.COM

800-422-4436 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY BETH.RODEE@SRSCONNECT.COM

770-901-3124 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

ALLIED CLAIMS

ADMINISTRATION INC

58-1962415 P O BOX 674869 WILCOXB@MCNEARY.COM

800-476-7601 Ext.

ARCHBOLD MEDICAL CENTER INC GA 31799 JKING@ARCHBOLD.ORG

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

678-338-4171 Ext.

SBWC # Insurer Name Address Email

21644 DECATUR

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

10081 SAN ANTONIO

ALPHARETTA GA 30022

Phone:

SBWC # Insurer Name Address Email

10026 SAN ANTONIO

ALPHARETTA GA 30022

Phone:

IRVING TX 75015

Phone:

CHICAGO IL 60606

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

12039 SAN ANTONIO

ALPHARETTA GA 30022

Phone:

IRVING TX 75015

Phone:

CHICAGO IL 60606

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

10147 CHARLOTTE

ARGONAUT GREAT

CENTRAL INSURANCE

37-0301640 3000 OLD ALABAMA ROAD CWILLIAMS@ARGOGROUPUS.COM

770-754-0424 Ext.

ARGONAUT GREAT CENTRAL 10101 REUNION PLACE,

SUTIE 500

TX 78216 MSMITH@ARGOGROUPUS.COM

866-246-0259 Ext.

ARCHER DANIELS MIDLAND COMPANY IL 62525 MICHAEL.SCOTT@ADM.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

ARGONAUT INSURANCE

COMPANY

94-1390273 255 W WASHINGTON CSURENS@ARGOGROUPUS.COM

800-678-6766 Ext.

ARGONAUT INSURANCE 94-1390273 P O BOX 152007 CSTEVENS@ARGOGROUPUS.COM

800-678-6766 Ext.

ARGONAUT GREAT

CENTRAL INSURANCE

37-0301640 3000 OLD ALABAMA ROAD CWILLIAMS@ARGOGROUPUS.COM

770-754-0424 Ext.

ARGONAUT INSURANCE COMPANY 10101 REUNION PLACE,

SUITE 500

TX 78216 MSMITH@ARGOGROUPUS.COM

ARGONAUT GREAT

CENTRAL INSURANCE

37-0301640 3000 OLD ALABAMA ROAD CWILLIAMS@ARGOGROUPUS.COM

770-754-0424 Ext.

ARGONAUT MIDWEST INS CO 10101 REUNION PLACE,

SUITE 500

TX 78216 MSMITH@ARGOGROUPUS.COM

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

ARGONAUT MIDWEST

INSURANCE COMPANY

36-2489372 275 W WASHINGTON CSTEVENS@ARGOGROUP.COM

800-678-6766 Ext.

ARGONAUT INSURANCE 94-1390273 P O BOX 152007 CSTEVENS@ARGOGROUPUS.COM

800-678-6766 Ext.

ARROWOOD INDEMNITY COMPANY NC 28273 LLINDA.PETTIGREW@ARROWPOINTCAP.COM

CHARLOTTE NC 28273

Phone:

SBWC # Insurer Name Address Email

21476 WILLOW GROVE

TAMPA FL 33618

Phone:

SBWC # Insurer Name Address Email

10027 NOVATO

ATLANTA GA 30374

Phone:

ALPHARETTA GA 30022

Phone:

SBWC # Insurer Name Address Email

13115 BOCA RATON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13173 AUSTIN

ATLANTA GA 30319

Phone:

COLUMBIA MO 65205

Phone:

SBWC # Insurer Name Address Email

10144 ATLANTA

ATLANTA GA 30339

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

ASPLUNDH TREE EXPERT CO 708 BLAIR MILL ROAD,

RISK MGMT 3RD FLOOR

PA 19090 DRIGGS@ASPLUNDH.COM

800-523-6235 Ext. 3

ARROWOOD INDEMNITY

COMPANY

13-5358230 3600 ARCO CORPORATE

DRIVE

DEBBIE.SCHILLER@ARROWPOINTCAP.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

ASSOCIATED INDUSTRIES INSURANCE

COMPANY INC

FL 33481 JSCHUESSLER@AMTRUSTGROUP.COM

678-393-4550 Ext.

FIREMAN'S FUND

INSURANCE CO

94-1610280 11475 GREAT OAKS WAY JUDY.OWEN@AFFIC.COM

678-393-4584 Ext.

ASSOCIATED INDEMNITY CORP CA 94998 LMUNSON@FFIC.COM

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174 KLOCKE@FFIC.COM

573-474-6193 Ext.

ASSOCIATION CASUALTY 74-1958653 4370 PEACHTREE ROAD NE RPITTMAN@COLINSGRP.COM

404-442-1174 Ext.

ASSOCIATION CASUALTY

INSURANCE CO

74-1958653 P O BOX 618 FSHORE@COLINSGRP.COM

ASSOCIATION CASUALTY INSURANCE

COMPANY

3420 EXECUTIVE

CENTER DRIVE, #200

TX 78731 FSHORE@COLINSGRP.COM

JTHOMAS@SYNERGYINSURANCE.NET

866-710-0908 Ext.

800-883-9305 Ext.

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY

ASSOCIATION INSURANCE COMPANY GA 30339 LMCMURRAY@BLDRS.COM

BUILDERS INSURANCE 58-2453325 P O BOX 723099 CLAIMSFORM@BLDRS.COM

10252 SCHAUMBURG

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20505 FORT WORTH

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

10215 ST PAUL

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21534 ATHENS

ATHENS GA 30603

Phone:

SBWC # Insurer Name Address Email

21257 ATHENS

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

20314 ATLANTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20485 ATLANTA

ASSURANCE COMPANY OF

AMERICA

13-6081895 3003 SUMMIT BLVD CHRIS.CALLOWAY@ZURICHNA.COM

404-851-3207 Ext.

ASSURANCE COMPANY OF

AMERICA

13-6081895 1900 SUMMIT TOWER CHRIS.CALLOWAY@ZURICHNA.COM

ASSURANCE COMPANY OF AMERICA IL 60196 TIM.GRAHAM@ZURICHNA.COM

COLLINS & COMPANY 62-0882150 555 RIVER STREET AGRIME@COLLINSANDCO.COM

800-884-1535 Ext.

ATCO RUBBER PRODUCTS INC TX 76118 BLIGHTSEY@ATCOFLEX.COM

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

404-851-3207 Ext.

706-613-3101 Ext.

ATHENS CLARKE CTY GOVT GA 30603

ATHENS CLARKE CTY GOVT 58-1911146 P O BOX 1868

888-487-3492 Ext.

ATHENA ASSURANCE

COMPANY

41-1435765 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

ATHENA ASSURANCE CO MN 55102 CURBANIA@TRAVELERS.COM

ATHENA ASSURANCE

COMPANY

41-1435765 BLDG V STE 200 DBRYSON@TRAVELERS.COM

ATLANTA HOUSING AUTHORITY GA 30303 STEPHANIE.STEPHENS@ATLANTAHOUSING.ORG

TKATER@NOVAPRORISK.COM

678-731-9091 Ext. 252

ATLANTA CITY OF 68 MITCHELL STREET

SW, SUITE 9100

GA 30303

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE

800-421-0710 Ext.

ATHENS REGIONAL MEDICAL CENTER GA 30606 TERRIASH@ARMC.ORG

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GEORGIA-ADMIN.COM

ATLANTA GA 30303

Phone:

SBWC # Insurer Name Address Email

20313 ATLANTA

ATLANTA GA 30303

Phone:

SBWC # Insurer Name Address Email

13154 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

13232 MARIETTA

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

21676 AUGUSTA

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

10030 LANSING

DULUTH GA 30096

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

12010 HARTFORD

TAMPA FL 33610

ATLANTIC SPECIALTY INS CO MA 02108 SHOLLAND@ONEBEACON.COM

ATLANTA PUBLIC SCHOOLS - 130 TRINITY AVENUE HBTURNER@ATLANTA.K12.GA.US

404-802-2335 Ext.

ATLANTA PUBLIC SCHOOLS GA 30303

ATLANTA HOUSING

AUTHORITY

- 230 JOHN WESLEY DOBBS

AVE NE

404-817-7465 Ext.

AUGUSTA RICHMOND COUNTY BOARD

COMMISSIONERS

CITY/COUNTY

BUILDING, ROOM 217

GA 30911 JBLACKSTONE@AUGUSTAGA.GO

800-277-7442 Ext. 1336

ATLANTIC STATES INSURANCE COMPANY 1195 RIVER ROAD, PO

BOX 302

PA 17547 CYGREENYA@DONEGALGROUP.COM

SOUTHERN INSURANCE 54-0386765 3237 SATELLITE BLVD MIKEGORE@DONEGALGROUP.COM

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 DDAVENPORT@ONEBEACON.COM

800-203-9600 Ext. 9706

800-238-6214 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

AUTO OWNERS INSURANCE

CO

38-0315280 P O BOX 100044 GEORGIAWORKCOMP.CLM@AOINS.COM

770-931-7766 Ext. 201

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

AUTO-OWNERS INSURANCE CO MI 48909 AOHOCLAIMS@AOINS.NET

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GEORGIA-ADMIN.COM

800-421-0710 Ext.

AUTOMOBILE INSURANCE COMPANY OF

HARTFORD CT

CT 06183 KDAVIS@TRAVELERS.COM

AUTOMOBILE INS CO OF

HARTFORD CT

06-0848755 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21545 COOKEVILLE

COOKEVILLE TN 38502

Phone:

SBWC # Insurer Name Address Email

21348 MILLEDGEVILLE

MILLEDGEVILLE GA 31059

Phone:

SBWC # Insurer Name Address Email

13074 OKLAHOMA CITY

ATLANTA GA 30319

Phone:

GLEN ALLEN VA 23058

Phone:

CHARLESTON SC 29416

Phone:

FRISCO TX 75034

Phone:

SBWC # Insurer Name Address Email

13299 ST PETERSBURG

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10269 PHILADELPHIA

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

800-906-4461 Ext.

931-525-5384 Ext.

AVERITT EXPRESS INC TN 38502 DMCDOWELL@AVERITTEXPRESS.COM

AVERITT EXPRESS INC 62-0755421 P O BOX 3166 LMAYBERRY@AVERITTEXPRESS.COM

888-329-6259 Ext.

AUTOMOBILE INSURANCE

COMPANY OF HARTFORD CT

06-0848755 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

CORVEL CORPORATION 95-3382819 4820 LAKE BROOK DRIVE

#150

MARCIA_MORGAN@CORVEL.COM

866-424-2480 Ext.

CORVEL ENTERPRISES 42-1704550 P O BOX 81029 GLENN_MARTIN@CORVEL.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BANCINSURE INC OK 73126 BBAILEY@BANCINSURE.COM

912-453-8404 Ext.

BALDWIN CO BOARD OF COMMISSIONERS GA 31061 BOBBY@BOBBYBROWNINSURANCE.COM

BALDWIN COUNTY RISK - P O BOX 1599 BOBBY@BOBBYBROWNINSURANCE.COM

BANKERS INSURANCE COMPANY FL 33716 COMPLIANCE@BANKERSINSURANCE.COM

IMPERIAL CASUALTY

INDEMNITY COMPANY

47-0412734 P O BOX 2009 SUPPORT@IMPERIALCASUALTY.COM

888-339-5736 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

BANKERS STANDARD FIRE AND MARINE

COMPANY

436 WALNUT STREET,

WB04

PA 19106 MARILEE.BRABSON@ACEGROUP.COM

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE TKATER@NOVAPRORISK.COM

678-731-9091 Ext. 252

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13071 PHILADELPHIA

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

20529 DULUTH

GRAYSON GA 30017

Phone:

SBWC # Insurer Name Address Email

21760 DALTON

DALTON GA 30722

Phone:

SBWC # Insurer Name Address Email

21209 DALLAS

NORCROSS GA 30010

Phone:

JACKSONVILLE FL 32256

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30338

678-338-4171 Ext.

BANKERS STANDARD INSURANCE COMPANY 436 WALNUT STREET,

WB04G

PA 19106 MARILEE.BRABSON@ACEGROUP.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

BARTOW COUNTY BOE 3473 SATELLITE BLVD,

STE 310 NORTH

GA 30096

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

KELLYW@MAIL.COREMRG.COM

770-962-3627 Ext.

SEDGWICK CMS BELLSOUTH

DISABILITY

36-2685608 1200 ASHWOOD PARKWAY TOBIN.BECKERMANN@SEDGWICKCMS.COM

888-784-3470 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

ATLANTA@CHOOSEBROADSPIRE.COM

678-969-7337 Ext.

SEDGWICK CMS 36-2685608 8649 BAYPINE ROAD MARILYN.SANDERS@SEDGWICKCMS.COM

BROADSPIRE INC 36-3917295 P O BOX 926240

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

BELLSOUTH TELECOMMUNICATIONS INC fka

BELLSOUTH CORPORATION

ONE AT&T PLAZA, 208 S

AKARD ROOM 2731

TX 75202 JD949H@ATT.COM

706-275-4451 Ext. 5406

BEAULIEU GROUP LLC GA 30722 BETH.RANDOLPH@BEAULIEUGROUP.COM

BEAULIEU GROUP LLC 58-2272636 PO BOX 1248 BETH.RANDOLPH@BEAULIEUGROUP.COM

Phone:

SBWC # Insurer Name Address Email

13077 OVERLAND PARK

JOHNS CREEK GA 30097

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20537 DOUGLASVILLE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13290 NAPERVILLE

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13298 NAPERVILLE

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

20608 MOUNT BERRY

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

21186 MACON

MACON GA 31201

Phone:

SBWC # Insurer Name Address Email

21654 COLUMBUS

BENCHMARK INSURANCE CO 6405 METCALF AVENUE,

SUITE 400

KS 66202 JSPAIN@BENCHMARKINSCO.COM

770-353-4591 Ext.

678-258-8000 Ext.

BENTON-GEORGIA INC GA 30133 MMCM@BENTON-GEORGIA.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

866-246-0259 Ext.

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

478-779-3527 Ext.

BIBB COUNTY BOARD OF EDUCATION GA 31208 KBENTLEY@BIBB.K12.GA.US

BIBB COUNTY BD P ED & - P O BOX 6157 KBENTLEY@BIBB.K12.GA.US

336-668-9050 Ext. 7539

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 GHENEHAN@KEYRISK.COM

BERRY COLLEGE INC GA 30149 BERB@BERRY.EDU

KEY RISK MANAGEMENT

SERVICES LLC

56-1800954 3655 NORTH POINT PKWY JDUGGINS@KEYRISK.COM

800-366-1511 Ext. 7732

BERKLEY REGIONAL INSURANCE COMPANY 215 SHURMAN BLVD,

SUITE 200

IL 60563 LLARSEN@BUPLLC.COM

800-366-1511 Ext. 7732

BERKLEY NATIONAL INSURANCE COMPANY 215 SHUMAN BLVD,

SUITE 200

IL 60563 LLARSEN@BUPLLC.COM

KEY RISK MANAGEMENT

SERVICES LLC

56-1800954 3655 NORTH POINT PKWY JDUGGINS@KEYRISK.COM

BIG LOTS STORES INC FKA CONSOLIDATED

STORES CORP

OH 43228 SHARONEVANS@BIGLOTS.COM

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

10032 ROCK ISLAND

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

10033 ROCK ISLAND

DULUTH GA 30096

Phone:

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

21729 WESTBOROUGH

JACKSONVILLE FL 32256

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

20541 FORT VALLEY

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21746 BOWDON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13179 LAKELAND

800-822-2905 Ext.

BITUMINOUS FIRE & MARINE

INS CO

36-6054328 3700 CRESTWOOD

PARKWAY

ROLSON@BITUMINOUSINSURANCE.COM

800-822-2905 Ext.

BITUMINOUS FIRE & MARINE INSURANCE CO IL 61201 BRAINEY@BITUMINOUSINSURANCE.COM

BITUMINOUS CASUALTY 36-0810360 3700 CRESTWOOD

PARKWAY

ROLSON@BITUMINOUSINSURANCE.COM

800-822-2905 Ext.

BITUMINOUS CASUALTY CORP IL 61201 BRAINEY@BITUMINOUSINSURANCE.COM

BITUMINOUS CASUALTY 36-0810360 3700 CRESTWOOD

PARKWAY

ROLSON@BITUMINOUSINSURANCE.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

678-258-8000 Ext.

BREMEN BOWDON INVESTMENT COMPANY GA 30108 DEBBRADY@ATT.NET

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

800-224-9524 Ext.

BLUE BIRD BODY COMPANY GA 31010 MIKE.MCCURDY@BLUE-BIRD.COM

888-784-3470 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

BJ'S WHOLESALE CLUB INC 25 RESEARCH DRIVE, P

O BOX 5230

MA 01581 MCHAFE@BJS.COM

SEDGWICK CMS 36-2685608 8649 BAYPINE ROAD MARILYN.SANDERS@SEDGWICKCMS.COM

BRIDGEFIELD CASUALTY INSURANCE

COMPANY

FL 38802 BOB.LARAMORE@SUMMITHOLDINGS.COM

CHARLOTTE NC 28277

Phone:

GAINESVILLE GA 30501

Phone:

SBWC # Insurer Name Address Email

13286 BOSTON

GAINESVILLE GA 30501

Phone:

SBWC # Insurer Name Address Email

21888 WAUWATOSA

CHARLESTON SC 29416

Phone:

SBWC # Insurer Name Address Email

10031 FORT WAYNE

FORT WAYNE IN 46801

Phone:

SBWC # Insurer Name Address Email

21649 DALTON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20394 BRUNSWICK

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

40008 ATLANTA

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

BROTHERHOOD MUTUAL INSURANCE

COMPANY

IN 46801 DROESENER@BROTHERHOODMUTUAL.CO

GLENN_MARTIN@CORVEL.COM

866-434-2480 Ext.

BRIGGS AND STRATTON CORPORATION WI 53222

PARKER SERVICES 39-1956269 P O BOX 81029

800-971-2667 Ext.

BRIDGEFIELD EMPLOYERS INSURANCE

COMPANY

MA 02116 BOB.LARAMORE@SUMMITHHOLDINGS.COM

SUMMIT CONSULTING INC. 59-1683711 340 JESSE JEWELL

PARKWAY SE

STACEY.FEWOX@SUMMITHOLDINGS.COM

800-334-0078 Ext.

SUMMIT CONSULTING INC. 59-1683711 340 JESSE JEWELL

PARKWAY SE

STACEY.FEWOX@SUMMITHOLDINGS.COM

800-971-2667 Ext.

BRIDGEFIELD CASUALTY

INSURANCE COMPANY

59-3269531 1380 BALLANTYNE CORP

PLACE

WARNER.MARSHALL@LIBERTYMUTUAL.COM

BUILDERS INSURANCE 58-2453325 P O BOX 723099 CLAIMSFORM@BLDRS.COM

800-883-9305 Ext.

BUILDERS INSURANCE A MUTUAL CAPTIVE 2410 PACES FERRY

ROAD, SUITE 300

GA 30339 CEDWARDS@BLDRS.COM

912-355-8989 Ext.

BRUNSWICK CITY OF GA 31521 GRIFFINC@SBWC.GA.GOV

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

BROWN INDUSTRIES INC GA 30722 TIM.HOLT@BROWNIND.COM

BROTHERHOOD MUTUAL

INSURANCE COMPANLY

35-0198580 P O BOX 2227 GALDRIDGE@BROTHERHOODMUTUAL.COM

800-333-3735 Ext.

13261 RALEIGH

RALEIGH NC 27624

Phone:

SBWC # Insurer Name Address Email

21517 TIFTON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21427 ATLANTA

ALPHARETTA GA 30004

Phone:

SBWC # Insurer Name Address Email

13234 OMAHA

OMAHA NE 68103

Phone:

SBWC # Insurer Name Address Email

21762 WOODBINE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

10036 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

13099 GREENVILLE

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

21297 SAVANNAH

SAVANNAH GA 31401

Phone:

877-234-4424 Ext.

CALIFORNIA INSURANCE COMPANY NE 68103 SWILLNERD@AUW.COM

CALIFORNIA INSURANCE

COMPANY

94-1627528 P O BOX 3804 NALBRECHT@AUW.COM

770-752-0122 Ext.

CAGLES INC & SUBSIDIARY GA 30318 LWAITE@CAGLESINC.COM

AMERICAN PROFESSIONAL

RISK

58-1872616 1255 MCFARLAND 400 CLAIMS@AMPRISK.COM

678-258-8000 Ext.

BURLEN CORPORATION GA 31793 LISAS@BURLEN.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

800-809-4861 Ext.

BUILDERS MUTUAL INSURANCE COMPANY NC 27606 JVISINTINE@BMICO.COM

AEGIS ADMINISTRATIVE

SERVICES INC

56-1749798 P O BOX 150006 SGAY@BMICO.COM

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST ANNF@USCKY.COM

CANDLER HOSPITAL INC GA 31405 MILLSA@SJCHS.ORG

678-447-0200 Ext. 302

CANAL INSURANCE CO. SC 29602

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

DDAVENPORT@ONEBEACON.COM

800-203-9600 Ext. 9706

ONEBEACON INSURANCE 23-1502700 P O BOX 9155

CAMDEN FIRE INSURANCE ASSOCIATION MA 02021 SHOLLAND@ONEBEACON.COM

678-258-8000 Ext.

CAMDEN COUNTY BOARD OF COMMISSIONERS GA 31569 SBOWICK@CO.CAMDEN.GA.US

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

912-355-8929 Ext. 224

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

13048 COLUMBIA

759507 MACON GA 31221

Phone:

SBWC # Insurer Name Address Email

13078 WOODBRIDGE

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

21775 CARTERSVILLE

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

21139 FAIRVIEW

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

12098 CHICAGO

MOBILE AL 36695

Phone:

MAITLAND FL 32751

Phone:

CHICAGO IL 60606

Phone:

SBWC # Insurer Name Address Email

20621 SMYRNA

COLUMBIA SC 29202

CASCADE CORPORATION OR 97024 SUSAN.WRIGHT@CASCORP.COM

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 SAM.BOONE@USIS-TPA.COM

800-444-9098 Ext. 214

CARTERSVILLE CITY OF GA 30120 DPORTA@CITYOFCARTERSVILLE.ORG

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 GHENEHAN@KEYRISK.COM

336-668-9050 Ext. 7539

CAROLINA CASUALTY INS 12701 MARBLESTONE

DRIVE, SUITE 250

VA 22192 JBURKE@BERKLEYNET.COM

800-471-2103 Ext.

CAPITAL CITY INS SC 29221 WWALTON@NPIC.COM

SOUTHEASTERN CLAIMS

SERVICES INC

57-0851047 P O BOX 27180 WMURRAY@SOUTHEASTERNCLAIMS.COM

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

912-355-8989 Ext.

866-450-8608 Ext.

SUA INSURANCE CO 23-2182777 2222 S RIVERSIDE PLAZA NFLORES@SUAINSURANCE.COM

888-782-4672 Ext.

CASTLEPOINT NATIONAL

INSURANCE COMPANY

23-2182777 1111 HILLCREST ROAD EWALLS@TWRGRP.COM

800-711-4405 Ext.

SUA INSURANCE CLAIMS 23-2182777 101 SOUTHHALL LANE,

SUITE 365

JBEASON@SUAINSURANCE.COM

CASTLEPOINT NATIONAL INSURANCE

COMPANY FKA SUA INS CO

222 SOUTH RIVERSIDE

PLAZA, SUITE 1600

IL 60606 ROREN@TWRGRP.COM

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 GHENEHAN@KEYRISK.COM

336-668-9050 Ext. 7539

CATHOLIC ARCHDIOCESE OF ATLANTA GA 30080 LGALLAGHER@ARCHATL.COM

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 WCMAIL@COMPANIONGROUP.COM

Phone:

SBWC # Insurer Name Address Email

21624 RINGOLD

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

21368 LEBANON

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

21533 MACON

GLEN ALLEN VA 23058

Phone:

CHARLESTON SC 29416

Phone:

SBWC # Insurer Name Address Email

10040 VAN WERT

VAN WERT OH 45891

Phone:

SBWC # Insurer Name Address Email

10267 PHILADELPHIA

ROSWELL GA 30076

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

21081 VALLEY FORGE

RICHMOND IN 47374

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

CBOCS INC F/K/A CRACKER BARREL COUNTRY

STORE

PO BOX 787, HARTMAN

DRIVE

TN 37088 RBEHNKE@CRACKERBARREL.COM

WCMAIL@COMPANIONGROUP.COM

800-845-2724 Ext. 43582

CATOOSA COUNTY BOARD OF EDUCATION GA 30736

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159

800-845-2724 Ext. 43582

COMPANION THIRD PARTY

ADMINISTRATORS LLC

CENTRAL MUTUAL INSURANCE COMPANY OH 45891 PWOIROL@CENTRAL-INSURANCE.COM

866-434-2480 Ext.

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE MARCIA_MORGAN@CORVEL.COM

800-906-4461 Ext.

CORVEL ENTERPRISES 42-1704550 P O BOX 81029 GLENN_MARTIN@CORVEL.COM

CENTRAL GA HEALTH SYSTEM fka MACON BIBB

HOSP AUTHORITY

777 HEMLOCK STREET,

MSC#135

GA 31201 HODGE.SUSAN@MCCG.ORG

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-685-7361 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

CENTURY INDEMNITY COMPANY PA 19106 PAUL.NEAFSEY@ACEGROUP.COM

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

CENTRAL INSURANCE 34-4202560 800 SOUTH WASHINGTON CLININGER@CENTRAL-INSURANCE.COM

800-736-7000 Ext. 2380

CERTAINTEED CORPORATION PA 19482 MEGHAN.GILLIN@SAINT-GOBAIN.CO

ESIS INC. - 120 NORTH 9TH STREET GAFORMS@ESIS.COM

800-541-0139 Ext.

Phone:

SBWC # Insurer Name Address Email

10272 HARTFORD

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

10146 NEW YORK

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

ALPHARETTA GA 30023

Phone:

OKLAHOMA CITY OK 73123

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33612

Phone:

TAMPA FL 33610

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

765-983-6244 Ext.

BROADSPIRE INC 36-3917295 P O BOX 926240 ATLANTA@CHOOSEBROADSPIRE.COM

678-969-7337 Ext.

CHARTIS CASUALTY COMPANY 175 WATER STREET,

18TH FLOOR

NY 10038 SMEETA.TECK@CHARTISINSURANCE.COM

888-329-6259 Ext.

CHARTER OAK FIRE INS CO 06-0291290 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

CHARTER OAK FIRE INSURANCE COMPANY CT 06183 KDAVIS@TRAVELERS.COM

CHARTER OAK FIRE INS CO 06-0291290 BLDG V STE 200 DBRYSON@TRAVELERS.COM

CLAIMETRICS 20-1604010 PO BOX 22478 LAUREN.TOPPINS@CLAIMETRICS.COM

405-728-5544 Ext. 2326

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-448-9707 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

800-685-7361 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR

DR #200

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

770-352-2978 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR GEORGIAWCBOARD@TRAVELERS.COM

770-934-3414 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

TAMPA FL 33602

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

LEXINGTON KY 40512

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10193 NEW YORK

ALPHARETTA GA 30023

Phone:

TAMPA FL 33610

Phone:

ATLANTA GA 30338

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

20561 SAVANNAH

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21738 CARTERSVILLE

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

20443 CANTON

800-426-5990 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

NOVAPRO RISK 36-4550659 101 E KENNEDY BLVD KROGERS@NOVAPRORISK.COM

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

800-541-0139 Ext. 35832

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 DANIELLE.MINNIEHAN@SRSCONNECT.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR

DR #200

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

800-448-9707 Ext.

CHARTIS PROPERTY CASUALTY COMPANY 175 WATER STREET,

18TH FLOOR

NY 10038 ALGAWCFR@AIG.COM

CHEMICAL PRODUCTS CORP GA 30120 DPICKARD@CPC-US.COM

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 GHENEHAN@KEYRISK.COM

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

CHATHAM COUNTY BOC P O BOX 9297, 12 E BAY GA 31412 CMVOELKE@CHATHAMCOUNTY.ORG

CHEROKEE COUNTY BD OF ED GA 30114 JULIE.LITTLE@CHEROKEE.K12.GA.US

336-668-9050 Ext. 7539

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21129 CANTON

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

13250 STERLING

HEIGHTSSTERLING

HEIGHTS

MI 48310

Phone:

SBWC # Insurer Name Address Email

20607 SAN RAMON

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21504 ATLANTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13075 WARREN

ATLANTA GA 30326

Phone:

GLEN ALLEN VA 23058

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

CHEROKEE COUNTY BOARD OF

COMMISSIONER

GA 30114 MMCGUIRE@CHEROKEEGA.COM

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 GHENEHAN@KEYRISK.COM

678-258-8000 Ext.

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CHEVRON USA INC PO BOX 6022, 6001

BOLLINGER CANYON

ROAD

CA 94583 KELLY.GEORGE@CHEVRON.COM

800-201-0450 Ext. 3436

CHEROKEE INSURANCE COMPANY MI 48310 MMITTLESTAT@CHEROKEEINSURANCE.COM

CHEROKEE INSURANCE CO 38-3464294 34200 MOUND ROAD MMROHN@CHEROKEEINSURANCE.COM

336-668-9050 Ext. 7539

404-266-4855 Ext.

CORVEL CORPORATION 95-3382819 4820 LAKE BROOK DRIVE

#150

MARCIA_MORGAN@CORVEL.COM

866-424-2480 Ext.

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE KPILZ@CHUBB.COM

CHUBB INDEMNITY INSURANCE COMPANY NJ 07061 PREMIUMTAXGROUP@CHUBB.COM

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

CHILDRENS HEALTHCARE OF ATL (EGLESTON/SCOTTISH

RITE), 1600 TULIE

CIRCLE NE

GA 30329 DARLENE.ALMEIDA@CHOA.ORG

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13195 WARREN

ATLANTA GA 30326

Phone:

GLEN ALLEN VA 23058

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10297 MERRILL

MERRILL WI 54452

Phone:

SBWC # Insurer Name Address Email

13014 CINCINNATI

NORCROSS GA 30010

Phone:

SBWC # Insurer Name Address Email

13060 CINCINNATI

NORCROSS GA 30010

Phone:

SBWC # Insurer Name Address Email

10195 CINCINNATI

NORCROSS GA 30010

TAMPA FL 33610

CHUBB NATIONAL INSURANCE COMPANY NJ 07061 PREMIUMTAXGROUP@CHUBB.COM

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

770-901-3121 Ext.

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

CORVEL CORPORATION 95-3382819 4820 LAKE BROOK DRIVE

#150

MARCIA_MORGAN@CORVEL.COM

866-424-2480 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE KPILZ@CHUBB.COM

404-266-4855 Ext.

CINCINNATI INSURANCE

COMPANY

31-0542366 P O BOX 920338 MIKE_THOMAS@CINFIN.COM

770-662-8753 Ext.

CINCINNATI CASUALTY CO 6200 S. GILMORE RD., P

O BOX 145496

OH 45250 MARK_WELSH@CINFIN.COM

800-554-2642 Ext. 2

CHURCH MUTUAL 39-0712210 3000 SCHUSTER LANE DSEISER@CHURCHMUTUAL.COM

CHURCH MUTUAL INSURANCE COMPANY WI 54452 DSEISER@CHURCHMUTUAL.COM

TRAVELERS COMMERCIAL

CASUALTY COMPANY

95-3634110 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

CINCINNATI INSURANCE

COMPANY

31-0542366 P O BOX 920338 MIKE_THOMAS@CINFIN.COM

CINCINNATI INS CO THE OH 45250 MARK_WELSH@CINFIN.COM

CINCINNATI INSURANCE

COMPANY

31-0542366 P O BOX 920338 MIKE_THOMAS@CINFIN.COM

770-662-8753 Ext.

CINCINNATI INDEMNITY COMPANY OH 45250 MARK_WELSH@CINFIN.COM

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

10043 WORCESTER

WORCESTER MA 01653

Phone:

SBWC # Insurer Name Address Email

12094 NEW YORK

ATLANTA GA 30366

FL 32716

Phone:

SBWC # Insurer Name Address Email

21159 JONESBORO

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21069 JONESBORO

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

20527 MORROW

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

21487 ELKHART

MANDEVILLE LA 70471

TRAVELERS COMMERCIAL

CASUALTY COMPANY

10401 HIGHLAND MANOR

DRIVE

888-329-6259 Ext.

CLARENDON NATIONAL INS 466 LEXINGTON AVE,

19TH FLOOR

NY 10017 DNG@CLARENDON-INS.COM

HANOVER INSURANCE

COMPANY

13-5129825 440 LINCOLN STREET EBESHAI@HANOVER.COM

800-628-0250 Ext.

CITIZENS INSURANCE COMPANY OF AMERICA MA 01653 DAXMURPHY@HANOVER.COM

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GEORGIA-ADMIN.COM

800-421-0710 Ext.

CLAYTON COUNTY PUBLIC SCHOOLS GA 30236 BMILLER@CLAYTON.K12.GA.US

CEDWARDS@GEORGIA-ADMIN.COM

800-421-0710 Ext.

CLAYTON COUNTY BOARD OF COMMISSIONERS RISK MANAGEMENT, 112

SMITH STREET

GA 30236

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE

800-315-6090 Ext.

ADJUSTMENT SERVICES INC. 58-1623664 P O BOX 81306 SHARON@ADJUSTMENTSERVICES.COM

NORTH AMERICAN RISK

SERVICES INC

13-3901415 P O BOX 166002 ALTAMONTE

SPRINGS

MAILROOM@NARIK.COM

COACHMEN RECREATIONAL VEHICLE IN 46515 LBARKER@ALLAMERICANGROUPINC.COM

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

888-888-8136 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

CLAYTON COUNTY WATER AUTHORITY GA 30260 MMIRZAIEE@CCWA.US

Phone:

BRENTWOOD TN 37027

Phone:

SBWC # Insurer Name Address Email

20345 CHARLOTTE

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21066 MARIETTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21038 MARIETTA

MARIETTA GA 30061

Phone:

SBWC # Insurer Name Address Email

20514 ATLANTA

ALPHARETTA GA 30005

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

20347 COLLEGE PARK

POMPANO BEACH FL 33064

Phone:

SBWC # Insurer Name Address Email

13181 SCHAUMBURG

ATLANTA GA 30319

Phone:

985-624-6739 Ext.

F A RICHARD (FARA) 72-0837383 7000 EXECUTIVE CENTER

DRIVE

GEORGIA.NOTICES@FARA.COM

800-675-2771 Ext. 225

678-258-8000 Ext.

COBB COUNTY BD OF COMMISS GA 30061 TONY.HAGLER@COBBCOUNTY.ORG

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

800-450-0692 Ext.

COATS NORTH AMERICA FKA COATS & CLARK

INC

3430 TORINGDON WAY,

SUITE 301

NC 28277 SCOTT.WILLIS@COATS.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

770-352-2978 Ext.

COCA COLA COMPANY ONE COCA-COLA

PLAZA, MAIL STOP NAT

GA 30313 SHGREEN@NA.KO.COM

770-426-3357 Ext.

COBB COUNTY SCHOOL SYSTEM GA 30061 SANDRA.ELLIOTT@COBBK12.ORG

COBB COUNTY SCHOOLS

RISK M

58-6000214 P O BOX 1088 SANDRA.ELLIOTT@COBBK12.ORG

COLONIAL AMERICAN CASUALTY & SURETY

COMPANY

IL 60196 USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

ASSURANCE COMPANY OF

AMERICA

13-6081895 3003 SUMMIT BLVD CHRIS.CALLOWAY@ZURICHNA.COM

877-295-0011 Ext.

COLLEGE PARK CITY OF GA 30337 DBAKER@COLLEGPARKGA.COM

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

404-851-3207 Ext.

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21505 SAVANNAH

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

13221 BOSTON

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21529 MOULTRIE

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

20323 MOULTRIE

MOULTRIE GA 31768

Phone:

SBWC # Insurer Name Address Email

20550 APPLING

LAWRENCEVILLE GA 30042

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

ZURICH NA ATL CLAIMS 36-4233459 3003 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

COLONIAL AMERICAN

CASUALTY AND SURETY

52-1096670 1900 SUMMIT TOWER CHRIS.CALLOWAY@ZURICHNA.COM

404-851-3207 Ext.

COLONIAL AMERICAN

CASUALTY AND SURETY

52-1096670 3003 SUMMIT BLVD CHRIS.CALLOWAY@ZURICHNA.COM

404-851-3207 Ext.

COLORADO CASUALTY INSURANCE COMPANY MA 02116 CORPORATESECRETARY@LIBERTYMUTUAL.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

678-447-0200 Ext. 302

COLONIAL GROUP INC GA 31402 DDEASON@COLONIALGROUPINC.COM

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST ANNF@USCKY.COM

800-928-9096 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST ANNF@USCKY.COM

912-355-8929 Ext. 224

COLQUITT CTY BD OF ED GA 31776 MKEY@COLQUITT.K12.GA.US

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 CHRISTINE.JONES@MONTGOMERY-INS.COM

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

COLUMBIA COUNTY BD OF ED GA 30802

COLQUITT REGIONAL

MEDICAL CENTER

58-0607088 3131 SOUTH MAIN STREET DSPRUNGER@COLQUITTREGIONAL.COM

229-890-3482 Ext.

COLQUITT REGIONAL MEDICAL CENTER GA 31768 DSPRUNGER@COLQUITTREGIONAL.COM

Phone:

SBWC # Insurer Name Address Email

13127 COLUMBIA

ATLANTA GA 30345

Phone:

SBWC # Insurer Name Address Email

10010 COLUMBIA

ATLANTA GA 30345

Phone:

COLUMBIA MO 65205

Phone:

SBWC # Insurer Name Address Email

20958 COLUMBUS

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

21094 COLUMBUS

COLUMBUS GA 31902

Phone:

SBWC # Insurer Name Address Email

10248 NEW YORK

POMPANO BEACH FL 33064

Phone:

ALPHARETTA GA 30023

Phone:

OKLAHOMA CITY OK 73123

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

800-224-9524 Ext.

800-767-4080 Ext.

COLUMBIA NATIONAL INS 47-0685688 P O BOX 618 FSHORE@COLINSGRP.COM

573-474-6193 Ext.

COLUMBIA NATIONAL INSURANCE COMPANY MO 65205 FSHORE@COLINSGRP.COM

COLUMBIA INSURANCE

GROUP

43-0926456 2295 PARKLAKE DR FSHORE@COLINSGRP.COM

800-767-4080 Ext.

COLUMBIA MUTUAL MO 65202 FSHORE@COLINSGRP.COM

COLUMBIA INSURANCE

GROUP

43-0926456 2295 PARKLAKE DR FSHORE@COLINSGRP.COM

706-649-3436 Ext.

COLUMBUS WATER WORKS GA 31902 PCRAIGHEAD@CWWGA.ORG

COLUMBUS WATER WORKS 58-6001931 P O BOX 1600 PCRAIGHEAD@CWWGA.ORG

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

COLUMBUS REGIONAL HEALTHCARE SYSTEM

INC

GA 31901 WAYNE.JOINER@CRHS.NET

800-685-7361 Ext.

CLAIMETRICS 20-1604010 PO BOX 22478 LAUREN.TOPPINS@CLAIMETRICS.COM

405-728-5544 Ext. 2326

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-448-9707 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

COMMERCE AND INDUSTRY INS 175 WATER STREET,

18TH FLOOR

NY 10038 ALGAWCFR@AIG.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

LEXINGTON KY 40512

Phone:

NASHVILLE TN 37214

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13165 COLUMBIA

COLUMBIA SC 29202

Phone:

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

13000 COLUMBIA

COLUMBIA SC 29202

Phone:

COLUMBIA SC 29202

Phone:

FRANKLIN TN 37067

Phone:

SBWC # Insurer Name Address Email

40016 ATLANTA

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

21393 OMAHA

COLUMBIA SC 29210

800-541-0139 Ext. 35832

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 DANIELLE.MINNIEHAN@SRSCONNECT.COM

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

800-845-2724 Ext.

COMPANION PROPERTY &

CASUALTY

57-0768836 P O BOX 100165 WCMAIL@COMPANIONGROUP.COM

877-379-7389 Ext.

COMPANION COMMERCIAL INS SC 29202 CURTIS.STEWART@COMPANIONGROUP.COM

COMPANION COMMERCIAL

INS

58-2292212 P O BOX 100165 WCMAIL@COMPANIONGROUP.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

AFFINITY SERVICE GROUP 58-2438483 1940 THE EXCHANGE GDORSEY@AFFINITYSERVICEGROUP.COM

800-233-2436 Ext. 1897

COMPTRUST AGC MUTUAL CAPTIVE

INSURANCE CO

1940 THE EXCHANGE,

SUITE 200

GA 30339 BCOREY@AFFINITYSERVICEGROUP.COM

KM@JOHNSTONANDASSOC.COM

800-304-5035 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

800-845-2724 Ext.

COMPANION PROPERTY &

CASUALTY

57-0768836 P O BOX 100165 WCMAIL@COMPANIONGROUP.COM

877-379-7389 Ext.

COMPANION PROPERTY & CASUALTY SC 29202 CURTIS.STEWART@COMPANIONGROUP.COM

COMPANION COMMERCIAL

INS

58-2292212 P O BOX 100165 WCMAIL@COMPANIONGROUP.COM

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE BHANNA@SEDGWICKCMS.COM

CONAGRA FOODS INC AND SUBSIDIARIES NE 68102 JEFF.REGLER@CONAGRAFOOD.COM

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

30006 TYRONE

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

10051 CHICAGO

ATLANTA GA 30319

Phone:

ATLANTA GA 30339

Phone:

POMPANO BEACH FL 33064

Phone:

DULUTH GA 30096

Phone:

CHICAGO IL 60604

Phone:

DUBUQUE IA 52004

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GEORGIA-ADMIN.COM

800-421-0710 Ext.

CONSTRUCTION SUPPLIERS 120 HANDLEY ROAD,

SUITE 610

GA 30290 DIANEROUNTREE@GOCSA.COM

241-922-0638 Ext.

800-426-9218 Ext. 12131

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

312-822-2331 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

800-283-2318 Ext. 3574

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH GASTATEICNUMBERS@CNA.COM

800-862-4252 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CAMBRIDGE INTEGRATED 23-2731565 1775 THE EXCHANGE DAVID.HAYS@CAMBRIDGE-NA.COM

CONTINENTAL CASUALTY CO 333 S WABASH AVENUE,

28 SOUTH

IL 60604 GASTATEICNUMBERS@CNA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

877-241-6121 Ext.

COTTINGHAM AND BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

888-329-6259 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

ALPHARETTA GA 30005

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

20523 NEW YORK

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

10052 CHICAGO

POMPANO BEACH FL 33064

Phone:

DULUTH GA 30096

Phone:

ALPHARETTA GA 30005

Phone:

CHICAGO IL 60604

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21016 FORT MILL

POMPANO BEACH FL 33064

Phone:

SBWC # Insurer Name Address Email

13225 URBANDALE

IRVING TX 75039

Phone:

SBWC # Insurer Name Address Email

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

CONTINENTAL GRAIN F/K/A CONTIGROUP

COMPANIES INC

NY 10172 STEVE.CARLSSON@CONTI.COM

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

800-238-6214 Ext.

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH GASTATEICNUMBERS@CNA.COM

312-822-2331 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-283-2318 Ext. 3574

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

770-352-2978 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

CONTINENTAL INSURANCE CO 333 S WABASH AVENUE,

28 SOUTH

IL 60604 DEBRA.RETEL@CNA.COM

UNION STANDARD 47-0547953 122 W CARPENTER

FREEWAY

SRICHARDSON@USIC.COM

CONTINENTAL WESTERN INS CO IA 50322 SGEILS@USIC.COM

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

CONTINENTAL TIRE THE AMERICAS LLC FKA

CONTINENTAL TIRE NORTH

SC 29707 RICK.LEDSINGER@CONTI-NA.COM

800-444-0049 Ext.

13295 OMAHA

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21694 ISSAQUAH

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

20603 COVINGTON

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21755 NEWNAN

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20552 NEWNAN

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

21532 ATLANTA

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21360 STILLMORE

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

13037 MORRISTOWN

LAKE MARY FL 32795

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD GASTATEBOARDINBOX@SEDGWICKCMS.COM

800-548-1373 Ext.

COSTCO WHOLESALE CORPORATION WA 98027 ALOONAM@COSTCO.COM

CORNHUSKER CASUALTY

COMPANY

- 1725 WINDWARD

CONCOURSE

NWILSON@BHHC.COM

877-212-3816 Ext. 253

CORNHUSKER CASUALTY COMPANY 3333 FARNAM STREET,

SUITE 300

NE 68131 NWILSON@BHHC.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

COWETA COUNTY BOC GA 30263

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

800-224-9524 Ext.

COVINGTON CITY OF GA 30015 NHARVILLE@CITYOFCOVINGTON.ORG

-- Ext.

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD ATLANTA.GA@US.CRAWCO.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

CRAWFORD & COMPANY INC GA 30319 JOE_CAPORASO@US.CRAWCO.COM

WCMAIL@COMPANIONGROUP.COM

800-845-2724 Ext. 43582

COWETA COUNTY SCHOOL SYS BD OF ED GA 30264

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159

UNITED STATES FIRE

INSURANCE COMPANY

13-5459190 1064 GREENWOOD BLVD DENVER_CHEEK@CFINS.COM

CRUM & FORSTER INDEMNITY COMPANY NJ 07962 GEORGE_ROBERTS@CFINS.COM

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

912-355-8989 Ext.

CRIDER INCORPORATED GA 30464 MHARRELL@CRIDERINC.COM

Phone:

SBWC # Insurer Name Address Email

21021 MARIETTA

MARIETTA GA 30061

Phone:

SBWC # Insurer Name Address Email

13109 OMAHA

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21370 ALMA

ALMA GA 31510

Phone:

SBWC # Insurer Name Address Email

13265 SIOUX FALLS

ATLANTA GA 30302

Phone:

SBWC # Insurer Name Address Email

13228 DALLAS

DALTON GA 30722

Phone:

SBWC # Insurer Name Address Email

21355 DALTON

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

21789 MASON

MASON MI 48854

Phone:

SBWC # Insurer Name Address Email

20610 MASON

UNITED STATES FIRE

INSURANCE COMPANY

800-423-3060 Ext. 6301

CYPRESS INSURANCE COMPANY 3333 FRNAM STREET,

SUITE 300

NE 68131 DALTMAN@BHHC.COM

770-422-7520 Ext.

CW MATTHEWS CONTRACTING CO INC GA 30061 SFRAM@CWMATTHEWS.COM

C W MATTHEWS

CONTRACTING CO.

58-0652729 P O DRAWER 970 LORIT@CWMATTHEWS.COM

DALLAS NATIONAL INSURANCE COMPANY 14160 DALLAS

PARKWAY, SUITE 500

TX 75254 JOSEB@ASPENADMININC.COM

404-300-1250 Ext.

DAKOTA TRUCK UNDERWRITERS SD 30319 ROB.HOLLAN@RASCOMPANIES.COM

CRAWFORD & COMPANY 58-0506554 P O BOX 5056 SHARI_BRANSON@US.CRAWCO.COM

800-673-9339 Ext.

D L LEE & SON INC GA 31510 JERRY.LEE@DLLEE.COM

D L LEE & SON INC - P O BOX 206 JERRY.LEE@DLLEE.COM

800-884-1535 Ext.

DALTON CITY OF GA 30720 CCAIN@COLLINSANDCO.COM

COLLINS & COMPANY 62-0882150 555 RIVER STREET AGRIME@COLLINSANDCO.COM

COLLINS & COMPANY 62-0882150 P O BOX 6429 AGRIME@COLLINSANDCO.COM

706-277-1253 Ext.

DART CONTAINER CORPORATION OF GEORGIA MI 48854 CHERYL.KLEBBA@DART.BIZ

800-545-3278 Ext. 2548

DART CONTAINER CORP OF CALIFORNIA MI 48854 CHERYL_KLEBBA@DART.BIZ

DART CONTAINER CORP 38-2482823 500 HOGSBACK ROAD CHERYL_KLEBBA@DART.BIZ

CYPRESS INSURANCE 95-6042929 1725 WINDWARD

CONCOURSE

CBARNES@BHHC.COM

877-212-3816 Ext. 230

MASON MI 48854

Phone:

SBWC # Insurer Name Address Email

20617 DECATUR

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20298 DECATUR

DECATUR GA 30030

Phone:

SBWC # Insurer Name Address Email

20722 STONE

MOUNTAINSTONE MOUNTAIN GA 30083

Phone:

SBWC # Insurer Name Address Email

20499 DECATUR

DECATUR GA 30030

Phone:

SBWC # Insurer Name Address Email

21410 DECATUR

BRENTWOOD TN 37024

Phone:

SBWC # Insurer Name Address Email

21175 PORTLAND

SALISBURY NC 28145

Phone:

SBWC # Insurer Name Address Email

800-545-3278 Ext. 2548

DART CONTAINER CORPORATION OF GEORGIA

DART CONTAINER CORP 38-2482823 500 HOGSBACK ROAD CHERYL_KLEBBA@DART.BIZ

404-371-4791 Ext.

DEKALB COUNTY BOARD OF COMMISSIONERS 1300 COMMERCE DRIVE,

4TH FLOOR

GA 30030 WDLAWTON@CO.DEKALB.GA.US

DEKALB COUNTY RISK

MANAGEMENT

58-6000814 1300 COMMERCE DRIVE WDLAWTON@DEKALBCOUNTYGA.GOV

770-677-3423 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

DECATUR CITY OF GA 30031 BIEN.NGUYEN@DECATURGA.COM

PMA INS GROUP 23-1642962 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

DEKALB REGIONAL HEALTHCARE SYSTEM INC

DBA DEKALB MEDICAL

GA 30033 DAWN.MANNING@DEKALBMEDICAL.ORG

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 MICHELLE.BYRD@BWOOD.COM

404-371-3912 Ext. 3915

DEKALB FARMERS MARKET(YOUR) GA 30030 HR@DEKALBFARMERSMARKET.COM

DEKALB FARMERS

MARKET(YOUR)

58-1332242 3000 E PONCE DE LEON ASHARMA@DEKALBFARMERSMARKET.COM

678-676-0401 Ext.

DEKALB COUNTY BOARD OF EDUCATION GA 30083 MICHAEL_S_FLORIO@FC.DEKALB.K12.GA.US

DEKALB COUNTY BOARD OF

EDUCATION

58-6000227 1701 MOUNTAIN

INDUSTRIAL BLVD

704-633-8250 Ext.

DELHAIZE AMERICA LLC ME 04104 LIROBERTS@HANNAFORD.COM

DELHAIZE RISK

MANAGEMENT

56-0660192 P O BOX 1330 RPBACK@FOODLION.COM

800-524-0604 Ext.

20538 ATLANTA

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

13177 ATLANTA

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13243 DES MOINES

DES MOINES IA 50391

Phone:

GAINESVILLE FL 32614

Phone:

SBWC # Insurer Name Address Email

13281 BALA CYNWYD

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10198 ST PAUL

NORCROSS GA 30071

Phone:

NORCROSS GA 30071

Phone:

SAVANNAH GA 31405

Phone:

LAKE MARY FL 32746

Phone:

BIRMINGHAM AL 35209

ATLANTA GA 30319

DELTA AIR LINES HARTSFIELD-JACKSON

INT'L, P O BOX 20706

DEPT 858

GA 30320 GRETCHEN.A.VANPARYS@DELTA.COM

800-985-7078 Ext.

DEPOSITORS INSURANCE

COMPANY

42-1207150 1100 LOCUST STREET PORTERK@NATIONWIDE.COM

800-532-1436 Ext. 3340

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 FERRANT@NATIONWIDE.COM

DEPOSITORS INSURANCE COMPANY IA 50391

GEORGIA CASUALTY &

SURETY

58-0537066 4370 PEACHTREE ROAD NE FSHORE@COLINSGRP.COM

800-877-3579 Ext.

DELTA FIRE & CASUALTY INS GA 30319 KSLONINA@ATLAM.COM

DISCOVER PROPERTY & CASUALTY MN 55102 CURBANIA@TRAVELERS.COM

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

DIAMOND STATE INSURANCE COMPANY THREE BALA PLAZA

EAST, SUITE 300

PA 19004 GSEGELKEN@UAI-GROUP.COM

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

AVIZENT 31-4359765 701 INTERNATIONAL

PARKWAY

TWELDON@AVIZENTRISK.COM

800-755-1441 Ext.

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

MREVELLE@ASG-ADJ.COM

800-580-6912 Ext.

678-447-0200 Ext. 302

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

ATLANTA@CHOOSEBROADSPIRE.COMBROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

678-447-0200 Ext. 302

ALTERNATIVE SERVICE

CONCEPTS LLC DBA ASC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

Phone:

POMPANO BEACH FL 33064

Phone:

MAITLAND FL 32751

Phone:

DUBUQUE IA 52004

Phone:

ALPHARETTA GA 30005

Phone:

FT SMITH AR 72919

Phone:

FRANKLIN TN 37067

Phone:

CHARLOTTE NC 28226

Phone:

TAMPA FL 33610

Phone:

ORLANDO FL 32814

Phone:

ROSWELL GA 30076

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37229

Phone:

866-291-0194 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

877-295-0011 Ext.

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

DISCOVER PROPERTY &

CASUALTY INS CO

36-2999370 1000 WINWARD GEORGIA.WC.BOARD@TRAVELERS.COM

800-238-6214 Ext.

DISCOVER PROPERTY &

CASUALTY INSURANCE

COMPANY

36-2999370 1000 FIANA WAY MJWHITE@TRAVELERS.COM

877-241-6121 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

-- Ext.

ESIS 95-2008390 500 COLONIAL CENTER

PARKWAY

MARK.IRWIN@ESIS.COM

678-795-4500 Ext.

DISCOVER PROPERTY &

CASUALTY INSURANCE

COMPANY

36-2999370 2420 LAKEMONT AVENUE

888-329-6259 Ext.

DISCOVER PROPERTY &

CASUALTY INSURANCE

COMPANY

36-2999370 11440 CARMEL COMMONS

BLVD

MWLANE@TRAVELERS.COM

800-759-6194 Ext.

DISCOVER PROPERTY &

CASUALTY INSURANCE

COMPANY

36-2999370 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

800-842-5612 Ext. 4611

DISCOVER PROPERTY &

CASUALTY INSURANCE

COMPANY

36-2999370 6640 CAROTHERS LCRAFT@TRAVELERS.COM

615-660-6258 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

800-288-9843 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

TAMPA FL 33631

Phone:

WILMINGTON NC 28404

Phone:

OWING MILLS MD 21117

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

866-428-0283 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE EDICOORDINATOR@MATRIXCOS.COM

800-896-3079 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

866-654-4001 Ext.

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 HEATHER.STANFORD@LIBERTYMUTUAL.COM

800-282-6218 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

800-347-4494 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

RICHMOND VA 23260

Phone:

ATLANTA GA 30328

Phone:

LEXINGTON KY 40512

Phone:

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

20854 DALTON

ALPHARETTA GA 30004

Phone:

SBWC # Insurer Name Address Email

20302 GOODLETSVILLE

GOODLETTSVILLE TN 37070

Phone:

SBWC # Insurer Name Address Email

13287 MARIETTA

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

20405 ALBANY

SAVANNAH GA 31405

Phone:

800-541-0139 Ext. 35832

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 SAM.BOONE@USIS-TPA.COM

800-444-9098 Ext. 214

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 DANIELLE.MINNIEHAN@SRSCONNECT.COM

800-822-4469 Ext.

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 WCCLAIMSEAST@SENTRY.COM

800-338-2487 Ext. 4616

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

770-752-0122 Ext.

DIXIE GROUP & SUBSIDIARIES GA 30721 DEREK.DAVIS@DIXIEGROUP.COM

AMERICAN PROFESSIONAL

RISK

58-1872616 1255 MCFARLAND 400 CLAIMS@AMPRISK.COM

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

DOUGHERTY COUNTY BOC GA 31703

DONEGAL INSURANCE - 3097 SATELLITE BLVD MIKEGORE@DONEGALGROUP.COM

800-277-7442 Ext.

DONEGAL MUTUAL INSURANCE COMPANY PA 17547 WAYNESMITH@DONEGALGROUP.COM

800-871-6670 Ext.

RISK ENTERPRISES

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

800-871-6670 Ext.

615-855-5110 Ext.

DOLLAR GENERAL CORPORATION TN 37070 JSTUTSMA@DOLLARGENERAL.COM

DOLLAR GENERAL

CORPORATION

61-0502302 100 MISSION RIDGE DRIVE JSTUTSMA@DOLLARGENERAL.COM

SBWC # Insurer Name Address Email

21367 ALBANY

BRENTWOOD TN 37024

Phone:

SBWC # Insurer Name Address Email

20301 DOUGLAS

ALPHARETTA GA 30004

Phone:

SBWC # Insurer Name Address Email

20365 DOUGLASVILLE

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

20553 DOUGLASVILLE

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21328 AUGUSTA

AUGUSTA GA 30903

Phone:

SBWC # Insurer Name Address Email

21609 DULUTH

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20366 WILMINGTON

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21538 SNELLVILLE

800-524-0604 Ext.

DOUGHERTY COUNTY SCHOOL SYSTEM GA 31701 K.HENDERSON@DOCOSCHOOLS.ORG

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 MICHELLE.BYRD@BWOOD.COM

706-849-6250 Ext.

DSM CHEMICALS NORTH AMERICA INC GA 30903 LINDA.GRIFFITH@DSM.COM

DSM CHEMICALS RISK

MANAGEMENT

58-0942142 P O BOX 2451 LINDA.GRIFFITH@DSM.COM

800-224-9524 Ext.

DOUGLAS COUNTY SCHOOLS GA 30134 KAY_TURNER@DOUGLAS.K12.GA.US

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

800-233-2436 Ext. 1897

BROADSPIRE INC 36-3917295 P O BOX 926240 ATLANTA@CHOOSEBROADSPIRE.COM

678-969-7337 Ext.

E I DUPONT NEMOURS & COMPANY 1007 MARKET STREET,

ROOM D-8065

DE 19898 CAROL.A.CARR@USA.DUPONT.COM

678-258-8000 Ext.

DULUTH CITY OF GA 30096 EJOHNSON@DULUTHGA.NET

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

DOUGLAS COUNTY BOC GA 30134

AFFINITY SERVICE GROUP 58-2438483 1940 THE EXCHANGE GDORSEY@AFFINITYSERVICEGROUP.COM

CLAIMS@AMPRISK.COM

770-752-0122 Ext.

DOUGLAS CITY OF GA 31533

AMERICAN PROFESSIONAL

RISK

58-1872616 1255 MCFARLAND 400

E R SNELL CONTRACTOR INC GA 30078 RGOODWIN@ERSNELL.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21558 EAST POINT

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13276 LANCASTER

LANCASTER PA 17608

Phone:

SBWC # Insurer Name Address Email

13249 LANCASTER

LANCASTER PA 17608

Phone:

SBWC # Insurer Name Address Email

13168 WILKES-BARRE

WILKES-BARRE PA 18703

Phone:

ALPHARETTA GA 30009

Phone:

WILKES-BARRE PA 18703

Phone:

TOWSON MD 21204

Phone:

SBWC # Insurer Name Address Email

21552 ELBERTON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13072 BEVERLY

888-654-7100 Ext.

EASTERN ADVANTAGE ASSURANCE COMPANY PA 17608 RIRONS@EAINS.COM

EASTERN ADVANTAGE

ASSURANCE COMPANY

65-1316719 P O BOX 83777 RIRONS@EAINS.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

EAST POINT CITY OF GA 30344

800-532-7706 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

ELBERTON CITY OF GA 30345

GUARD INSURANCE GROUP 23-2240322 102 WEST PENNSYLVANIA

AVE

CLAIMS3@GUARD.COM

800-673-2465 Ext. 8302

800-673-2465 Ext. 8110

EASTGUARD INSURANCE

COMPANY

01-0125870 294 S MAIN STREET BDIAMOND@GUARD.COM

800-673-2465 Ext. 8110

GUARD INSURANCE GROUP 23-2240322 P O BOX A - H CLAIMS3@GUARD.COM

800-673-2465 Ext. 8110

EASTGUARD INSURANCE COMPANY PA 18703 ESOLA@GUARD.COM

AMGUARD 23-2240321 P O Box 1368 CLAIMS3@GUARD.COM

888-654-7100 Ext.

EASTERN ALLIANCE INSURANCE CO PA 17608 RIRONS@EAINS.COM

EASTERN ALLIANCE 23-2900463 P O BOX 83777 KCHAPMAN@EAINS.COM

ELECTRIC INSURANCE COMPANY MA 01915 STEPHEN.PALENSCAR@ELECTRICINSURANCE.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

ALBANY NY 12212

Phone:

SBWC # Insurer Name Address Email

10017 DES MOINES

BIRMINGHAM AL 35201

Phone:

SBWC # Insurer Name Address Email

13152 DES MOINES

BIRMINGHAM AL 35201

Phone:

SBWC # Insurer Name Address Email

20379 ATLANTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13117 RENO

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

10196 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

10189 BOSTON

CHARLOTTE NC 28277

Phone:

TAMPA FL 33618

Phone:

SBWC # Insurer Name Address Email

10241 DES MOINES

EMORY UNIVERSITY 1364 CLIFTON RD NE,

ROOM HB53

GA 30322 LUCRECIA.WALKER@EMORYHEALTHCARE.ORG

EMPLOYERS MUTUAL

CASUALTY COMPANY

42-0234980 P O BOX 1568 TERRY.L.HARDESTY@EMCINS.COM

800-239-1407 Ext. 301

EMCASCO INSURANCE COMPANY IA 50306 KEVIN.J.HOVICK@EMCINS.COM

TERRY.L.HARDESTY@EMCINS.COM

800-239-1407 Ext. 301

EMC PROPERTY & CASUALTY COMPANY IA 50306

EMPLOYERS MUTUAL

CASUALTY COMPANY

42-0234980 P O BOX 1568

800-434-8331 Ext.

STEPHEN.PALENSCAR@ELECTRICINSURANCE.COM

SEDGWICK CMS 36-2685608 PO BOX 15065 PNICKEL@EDGE.ELECTRICINSURANCE.COM

704-759-2580 Ext.

EMPLOYERS INS CO OF

WAUSAU

39-0264050 3901 PREMIER NORTH DR CHARLES.HUNNELL@LIBERTYMUTUAL.COM

813-264-6588 Ext.

EMPLOYERS INSURANCE CO OF WAUSAU MA 02116 CORPORATESECRETARY@LIBERTYMUTUAL.COM

EMPLOYERS INS CO OF

WAUSAU

39-0264050 P O BOX 49000 CHARLES.HUNNELL@LIBERTYMUTUAL.COM

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 DDAVENPORT@ONEBEACON.COM

800-203-9600 Ext. 9706

EMPLOYERS FIRE INS CO THE MA 02021 SHOLLAND@ONEBEACON.COM

EMPLOYERS ASSURANCE

COMPANY

61-0477370 14120 BALLANTYNE

CORPORATE PL

EASTIMAGING@EMPLOYERS.COM

800-992-1072 Ext.

EMPLOYERS ASSURANCE COMPANY NV 89521 REGULATORY@EMPLOYERS.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

EMPLOYERS MUTUAL CASUALTY CO IA 50306 KEVIN.J.HOVICK@EMCINS.COM

BIRMINGHAM AL 35201

Phone:

SBWC # Insurer Name Address Email

13126 RENO

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13188 CHICAGO,

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13189 CHICAGO,

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13190 CHICAGO,

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13191 CHICAGO,

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

21617

KNOXVILLE TN 37919

Phone:

SBWC # Insurer Name Address Email

21572 RICHMOND

TUCKER GA 30084

ENCOMPASS INDEPENDENT INS. CO. CNA CENTER-28TH

FLOOR, 333 SO. WABASH

IL 60604 NEFIA.DORITY@CNA.COM

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

800-283-2318 Ext. 3574

ENCOMPASS HOME AND AUTO INS. CNA CENTER-28TH

FLOOR, 333 SO. WABASH

IL 60604 NEIFIA.DORITY@CNA.COM

EMPLOYERS ASSURANCE

COMPANY

61-0477370 14120 BALLANTYNE

CORPORATE PL

EASTIMAGING@EMPLOYERS.COM

800-992-1072 Ext.

EMPLOYERS PREFERRED INSURANCE

COMPANY

NV 89521 REGULATORY@EMPLOYERS.COM

EMPLOYERS MUTUAL

CASUALTY COMPANY

42-0234980 P O BOX 1568 TERRY.L.HARDESTY@EMCINS.COM

800-239-1407 Ext. 301

865-583-8342 Ext.

JESSICA.FARNSCHLADER@KEYSTONEFOODS.COM

SEDGWICK CMS 36-2685608 1111 NORTHSHORE DRIVE KENNETH.CAMPBELL@SEDGWICKCMS.COM

EQUITY GROUP GA DIV fka CAGLE FOODS JV

LLC

300 BARR HARBOR

DRIVE, SUITE 600

WEST

CONSHOHOCKEN

PA 19428

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

800-283-2318 Ext. 3574

ENCOMPASS PROPERTY & CASUALTY CNA CENTER-28TH

FLOOR, 333 SO WABASH

IL 60604 NEIFIA.DORITY@CNA.COM

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

800-283-2318 Ext. 3574

ENCOMPASS INS.CO. OF AMERICA CNA CENTER-28TH

FLOOR, 333 SO. WABASH

IL 60604 NEIFIA.DORITY@CNA.COM

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

800-283-2318 Ext. 3574

ESTES EXPRESS LINES VA 23260 LSIBLEY@ESTES-EXPRESS.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

21620 ROME

DALTON GA 30722

Phone:

SBWC # Insurer Name Address Email

13082 LIBERTY CORNER

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ALPHARETTA GA 30009

Phone:

MANDEVILLE LA 70471

Phone:

BRENTWOOD TN 37027

Phone:

TUCKER GA 30084

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

EVEREST NATIONAL INSURANCE CO 477 MARTINSVILLE RD.,

PO BOX 830

NJ 07938 LORRAINE.DAY@EVERESTRE.COM

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

706-277-1253 Ext.

EVANS GRADING CO. INC 3225 ALABAMA HWY,

P.O. BOX 2160

GA 30164 EVANSCONST1@COMCAST.NET

COLLINS & COMPANY 62-0882150 P O BOX 6429 AGRIME@COLLINSANDCO.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

100 CRESCENT CENTRE

PARKWAY

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

800-843-8999 Ext.

F A RICHARD (FARA) 72-0837383 7000 EXECUTIVE CENTER

DRIVE

GEORGIA.NOTICES@FARA.COM

800-675-2771 Ext. 225

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

678-942-2330 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.EXCHANGING.COM

800-235-1134 Ext. 5

EVEREST NATIONAL

INSURANCE COMPANY

22-2660372 P O BOX 1620 CHIP.CRAZE@ESICINSURANCE.COM

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

Phone:

SARASOTA FL 34230

Phone:

NASHVILLE TN 37214

Phone:

LEXINGTON KY 40512

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13180 ALPHARETTA

LIBERTY CORNER NJ 07938

Phone:

BRENTWOOD TN 37027

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

12023 KEENE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13091 WARREN

ATLANTA GA 30326

Phone:

ATLANTA GA 30326

Phone:

EVEREST SECURITY INSURANCE 925 NORTH POINT

PARKWAY, SUITE 400

GA 30005 CHIP.CRAZE@ESICINSURANCE.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext. 35832

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 DANIELLE.MINNIEHAN@SRSCONNECT.COM

800-595-2255 Ext.

PBOA (PROFESSIONAL

BUSINESS OWNERS ASSN

65-0923856 P O BOX 49468 AWARD@PBOA.COM

866-246-0259 Ext.

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE KPILZ@CHUBB.COM

404-266-4855 Ext.

EXECUTIVE RISK INDEMNITY INC NJ 07061 PREMIUMTAXGROUP@CHUBB.COM

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 CHRISTINE.JONES@MONTGOMERY-INS.COM

EXCELSIOR INSURANCE CO NH 03431 CORPORATESECRETARY@LIBERTYMUTUAL.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

800-675-2771 Ext. 225

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

EVEREST NATIONAL

INSURANCE

22-2660372 477 MARTINSVILLE ROAD ELENA.BITNER@EVERESTRE.COM

800-438-4375 Ext.

F A RICHARD (FARA) 72-0837383 7000 EXECUTIVE CENTER

DRIVE

GEORGIA.NOTICES@FARA.COM

EXECUTIVE RISK 13-2912259 2 LIVE OAK CENTER SUITE

900

KPILZ@CHUBB.COM

404-266-4127 Ext.

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13128 STAMFORD

MAITLAND FL 32751

Phone:

SBWC # Insurer Name Address Email

10214 MANCHESTER

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

MANCHESTER NH 03101

Phone:

SBWC # Insurer Name Address Email

10230 MANCHESTER

ATLANTA GA 30348

Phone:

SBWC # Insurer Name Address Email

13009 HARTFORD

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13142 DES MOINES

FAIRMONT PREMIER INSURANCE COMPANY 250 COMMERCIAL

STREET, SUITE 5000

NH 03101 BRENDA_VAN_HIRTUM@TRG.COM

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

866-291-0194 Ext.

FAIRFIELD INSURANCE COMPANY CT 06904 DSPRAGUE@GENRE.COM

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

FARMINGTON CASUALTY

COMPANY

06-1067463 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

FARMINGTON CASUALTY

COMPANY

06-1067463 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

FARMINGTON CASUALTY COMPANY CT 06183 KDAVIS@TRAVELERS.COM

CNA CLAIMS PLUS - P O BOX 105497

800-283-2318 Ext.

FAIRMONT SPECIALTY INSURANCE COMPANY 250 COMMERCIAL

STREET, SUITE 5000

NH 03101 BRENDA_VAN_HIRTUN@TRG.COM

TIG WORK COMP CLAIMS - 250 COMMERCIAL STREET BRENDA_VAN_HIRTUM@TRG.COM

888-805-9184 Ext.

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

FARMLAND MUTUAL INSURANCE COMPANY 1100 LOCUST STREET,

DEPT 0301

IA 50391 LARSENS@NATIONWIDE.COM

888-329-6259 Ext.

DES MOINES IA 50391

Phone:

SBWC # Insurer Name Address Email

21361 FAYETTEVILLE

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

20516 FAYETTEVILLE

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13153 SARASOTA

SARASOTA FL 34232

Phone:

SARASOTA FL 34240

Phone:

SBWC # Insurer Name Address Email

21433 MEMPHIS

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

10062 WARREN

ATLANTA GA 30319

Phone:

ATLANTA GA 30326

Phone:

DULUTH GA 30097

Phone:

PARSIPPANY NJ 07054

Phone:

FCCI INSURANCE COMPANY FL 34240 COMPLIANCEDEPT@FCCI-GROUP.COM

XCALIBRE RISK SERVICES 26-4197853 4370 PEACHTREE ROAD NE JMARSHBURN@ATLAM.COM

404-266-5749 Ext.

FAYETTE COUNTY BOARD OF EDUCATION GA 30214 ELLIS.REANEE@FCBOE.ORG

AFFINITY SERVICE GROUP 58-2438483 1940 THE EXCHANGE GDORSEY@AFFINITYSERVICEGROUP.COM

800-233-2436 Ext. 1897

FAYETTE COUNTY BOARD OF COMMISSIONERS GA 30214 LSMITH@FAYETTECOUNTYGA.GOV

NATIONWIDE AGRIBUSINESS 42-1015537 1100 LOCUST ST. NEWCLAIM@NATIONWIDE.COM

800-532-1436 Ext. 4344

1100 LOCUST STREET,

DEPT 0301

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

FEDERAL INSURANCE COMPANY NJ 07061 PREMIUMTAXGROUP@CHUBB.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

FEDERAL EXPRESS CORPORATION 3620 HACKS CROSS

ROAD, BLG B, 3RD

TN 38125 JGSTEGALL@FEDEX.COM

800-226-3243 Ext. 5729

FCCI SERVICES 59-1968027 P O BOX 58004 FCCICLAIMSEDI@FCCI-GROUP.COM

800-226-3243 Ext. 5729

FCCI SERVICES INC 59-1968027 6300 UNIVERSITY FCCICLAIMSEDI@FCCI-GROUP.COM

800-422-4436 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 9 CAMPUS DRIVE ATLANTAR@GABROBINS.COM

404-266-4127 Ext.

FEDERAL INSURANCE

COMPANY

13-1963496 2 LIVE OAK CNTR #900 KPILZ@CHUBB.COM

DULUTH GA 33622

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

CLEARWATER FL 33758

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10064 OWATONNA

TAMPA FL 33634

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

12059 LENEXA

ATLANTA GA 30302

Phone:

GAINESVILLE GA 30503

Phone:

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PKWY LASKYM@GABROBINS.COM

770-823-0997 Ext. 230

FEDERATED MUTUAL INS CO MN 55060 TLHANEY@FEDINS.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 KIM_BUCHANAN@GBTPA.COM

800-226-8002 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

404-992-3845 Ext.

SHARI_BRANSON@US.CRAWCO.COM

404-300-1250 Ext.

CRAWFORD & COMPANY 58-0506554 P O BOX 41 GREG_HODSON@US.CRAWCO.COM

CRAWFORD & COMPANY 58-0506554 P O BOX 5056

FEDERATED RURAL ELECTRIC INSURANCE

EXCHANGE

KS 66285

FEDERATED MUTUAL

INSURANCE COMPANY

- 20 PERIMETER SUMMIT

BLVD NE

800-241-4945 Ext.

FEDERATED MUTUAL

INSURANCE COMPANY

41-0417460 P O BOX 31716 CLVOLLENWEIDER@FEDINS.COM

800-237-8292 Ext. 8253

SBWC # Insurer Name Address Email

13130 OWATONNA

TAMPA FL 33634

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

20535 HARRISON

800-237-8292 Ext. 8253

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

FEDERATED SERVICE INSURANCE COMPANY MN 55060 ACKELLY@FEDINS.COM

FEDERATED MUTUAL

INSURANCE COMPANY

41-0417460 P O BOX 31716 CLVOLLENWEIDER@FEDINS.COM

615-493-5802 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

407-562-3632 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

FEDEX FREIGHT EAST INC fka AMERICAN

FREIGHTWAYS

AR 72602

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

HARRISON AR 72602

Phone:

SBWC # Insurer Name Address Email

21705 PITTSBURGH

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13146 MAITLAND

MAITLAND FL 32751

Phone:

SBWC # Insurer Name Address Email

13229 JACKSONVILLE

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

10299 ST PAUL

NORCROSS GA 30071

SAVANNAH GA 31405

Phone:

LAKE MARY FL 32746

Phone:

BIRMINGHAM AL 35209

Phone:

TAMPA FL 33630

Phone:

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

LOUISVILLE KY 40222

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

FEDEX GROUND PACKAGE SYSTEM INC WORKERS

COMPENSATION

SECTION, P O BOX

535859

PA 15253 THOMAS.DITTOE@FEDEX.COM

FEDEX EAST 71-0562003 P O BOX 840 BETTY.REYNOLDS@FEDEX.COM

870-741-9000 Ext.

FEDEX FREIGHT EAST INC fka AMERICAN

FREIGHTWAYS

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

MREVELLE@ASG-ADJ.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

FIDELITY & GUARANTY INSURANCE CO MN 55102 CURBANIA@TRAVELERS.COM

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 SAM.BOONE@USIS-TPA.COM

800-444-9098 Ext. 214

FHM INSURANCE COMPANY FKA FLORIDA

HOSPITALITY MUTUAL INS CO

4601 TOUCHTON ROAD

EAST, SUITE 3150

BUILDING 300

FL 32246 COO@FHMIC.COM

800-346-4825 Ext.

FFVA MUTUAL CLAIMS 59-6828087 800 TRAFALGAR COURT SHALAGH.MAXWELL@FFVA.COM

FFVA MUTUAL FL 32794 ALAN.HAIR@FFVA.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BROADSPIRE SERVICES INC. 36-3917295 9502 WILLIAMSBURG TOM.WEBER@CHOOSEBROADSPIRE.COM

BROADSPIRE INC 36-3917295 P O BOX 926240 ATLANTA@CHOOSEBROADSPIRE.COM

678-969-7337 Ext.

BROADSPIRE CLAIMS 36-3917295 CALL BOX 30539 KRISTIN.CANNELL@CHOOSEBROADSPIRE.COM

800-258-1811 Ext.

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

800-580-6912 Ext.

AVIZENT 31-4359765 701 INTERNATIONAL

PARKWAY

TWELDON@AVIZENTRISK.COM

800-755-1441 Ext.

Phone:

POMPANO BEACH FL 33064

Phone:

MAITLAND FL 32751

Phone:

DUBUQUE IA 52004

Phone:

FARMINGTON CT 06032

Phone:

ROSWELL GA 30076

Phone:

ROSWELL GA 30076

Phone:

ALPHARETTA GA 30005

Phone:

FT SMITH AR 72919

Phone:

CHARLOTTE NC 28226

Phone:

FRANKLIN TN 37067

Phone:

ORLANDO FL 32814

Phone:

TAMPA FL 33610

Phone:

ORLANDO FL 32814

Phone:

FRANKLIN TN 37067

Phone:

TAMPA FL 33610

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

800-742-4248 Ext.

800-842-5612 Ext. 4611

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

43-1091525 1000 FIANA WAY MJWHITE@TRAVELERS.COM

678-795-4500 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

DISCOVER RE MANAGERS 06-1288492 5 BATTERSON PARK EDOUGLAS@DISCOVER-RE.COM

866-657-2827 Ext.

ESIS 95-2008390 500 COLONIAL CENTER

PARKWAY

MARK.IRWIN@ESIS.COM

877-241-6121 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

877-295-0011 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

866-291-0194 Ext.

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 6640 CAROTHERS LCRAFT@TRAVELERS.COM

615-660-6258 Ext.

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 2420 LAKEMONT AVENUE PYOAKUM@TRAVELERS.COM

470-388-2587 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 2420 LAKEMONT AVENUE PYOAKUM@TRAVELERS.COM

407-388-2587 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

800-759-6194 Ext. 3298

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 6640 CAROTHERS LCRAFT@TRAVELERS.COM

615-660-6258 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 11440 CARMEL COMMONS

BLVD

MWLANE@TRAVELERS.COM

Phone:

CHARLOTTE NC 28226

Phone:

FT SMITH AR 72919

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

CLEARWATER FL 33758

Phone:

TAMPA FL 33622

Phone:

BIRMINGHAM AL 35266

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

MAITLAND FL 32794

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

10401 HIGHLAND MANOR

DRIVE

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2600 MCCORMICK DR #110 CANDICE_BUCHANAN@GBTPA.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

800-288-9843 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 1000 FIANA WAY MJWHITE@TRAVELERS.COM

800-842-5612 Ext. 4611

888-329-6259 Ext.

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 11440 CARMEL COMMONS

BLVD

MWLANE@TRAVELERS.COM

800-759-6194 Ext. 3298

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

407-916-8580 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GATES MCDONALD 31-4187660 P O BOX 945150

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY CHRIS_ROCK@GBTPA.COM

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

Phone:

TAMPA FL 33631

Phone:

WILMINGTON NC 28404

Phone:

OWING MILLS MD 21117

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

ATLANTA GA 30338

Phone:

LAKE MARY FL 32746

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

CHARLOTTE NC 28217

Phone:

RICHMOND VA 23260

Phone:

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 HEATHER.STANFORD@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

800-532-7706 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

888-888-8136 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE EDICOORDINATOR@MATRIXCOS.COM

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

866-654-4001 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

800-896-3079 Ext.

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEGWICKCMS.COM

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD GASTATEBOARDINBOX@SEDGWICKCMS.COM

800-548-1373 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 WCCLAIMSEAST@SENTRY.COM

800-338-2487 Ext. 4616

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

LEXINGTON KY 40512

Phone:

ATLANTA GA 30328

Phone:

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

10257 SCHAUMBURG

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

10197 ST PAUL

NORCROSS GA 30071

Phone:

SAVANNAH GA 31405

Phone:

LAKE MARY FL 32746

Phone:

BIRMINGHAM AL 35209

ATLANTA GA 30319

Phone:

POMPANO BEACH FL 33064

Phone:

MAITLAND FL 32751

FIDELITY AND DEPOSIT CO OF MARYLAND IL 60196 TIM.GRAHAM@ZURICHNA.COM

FIDELITY AND DEPOSIT

COMPANY OF MARYLAND

13-3046577 3003 SUMMIT BLVD CHRIS.CALLOWAY@ZURICHNA.COM

800-444-9098 Ext. 214

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 SAM.BOONE@USIS-TPA.COM

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 DANIELLE.MINNIEHAN@SRSCONNECT.COM

800-541-0139 Ext. 35832

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

AVIZENT 31-4359765 701 INTERNATIONAL

PARKWAY

TWELDON@AVIZENTRISK.COM

800-755-1441 Ext.

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

MREVELLE@ASG-ADJ.COM

800-580-6912 Ext.

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

678-447-0200 Ext. 302

FIDELITY AND GUARANTY UNDERWRITERS

INSURANCE

MN 55102 CURBANIA@TRAVELERS.COM

404-851-3207 Ext.

ZURICH SERVICES CORP 36-3839542 3003 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

FIDELITY AND DEPOSIT

COMPANY OF MARYLAND

13-3046577 1900 SUMMIT TOWER CHRIS.CALLOWAY@ZURICHNA.COM

404-851-3207 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

877-295-0011 Ext.

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

ALPHARETTA GA 30005

Phone:

FT SMITH AR 72919

Phone:

CHARLOTTE NC 28226

Phone:

ORLANDO FL 32814

Phone:

FRANKLIN TN 37067

Phone:

TAMPA FL 33610

Phone:

CHARLOTTE NC 28226

Phone:

FT SMITH AR 72919

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

877-241-6121 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

866-291-0194 Ext.

800-759-6194 Ext. 3298

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 1000 FIANA WAY MJWHITE@TRAVELERS.COM

800-842-5612 Ext. 4611

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 11440 CARMEL COMMONS

BLVD

MWLANE@TRAVELERS.COM

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

52-0616768 6640 CAROTHERS LCRAFT@TRAVELERS.COM

615-660-6258 Ext.

407-388-2587 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 11440 CARMEL COMMONS

BLVD

MWLANE@TRAVELERS.COM

800-759-6194 Ext. 3298

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 2420 LAKEMONT AVENUE PYOAKUM@TRAVELERS.COM

800-238-6214 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

43-1091525 1000 FIANA WAY MJWHITE@TRAVELERS.COM

800-842-5612 Ext. 4611

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

TAMPA FL 33631

Phone:

WILMINGTON NC 28404

Phone:

OWING MILLS MD 21117

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-843-8999 Ext.

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

888-888-8136 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE EDICOORDINATOR@MATRIXCOS.COM

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

866-654-4001 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

800-282-6218 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

800-896-3079 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 HEATHER.STANFORD@LIBERTYMUTUAL.COM

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

CHARLOTTE NC 28217

Phone:

RICHMOND VA 23260

Phone:

ATLANTA GA 30328

Phone:

227968 CHARLOTTE NC 28262

Phone:

LEXINGTON KY 40512

Phone:

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

21022 BALDWIN

BALDWIN GA 30511

Phone:

SBWC # Insurer Name Address Email

10067 NOVATO

ATLANTA GA 30374

Phone:

ALPHARETTA GA 30022

Phone:

SBWC # Insurer Name Address Email

12029 NOVATO

ATLANTA GA 30374

Phone:

SBWC # Insurer Name Address Email

13066 BOSTON

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 10735 DAVID TAYLOR JENNIFER.REEVE@SRSCONNECT.COM

800-822-4469 Ext.

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 WCCLAIMSEAST@SENTRY.COM

800-338-2487 Ext. 4616

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

678-393-4584 Ext.

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174 KLOCKE@FFIC.COM

678-393-4550 Ext.

FIREMAN'S FUND

INSURANCE CO

94-1610280 11475 GREAT OAKS WAY JUDY.OWEN@AFFIC.COM

FIREMAN'S FUND INS CO CA 94998 ESAYERS@FFIC.COM

FIELDALE FARMS

CORPORATION

58-1119934 P O BOX 558 SHELIACANTRELL@FIELDALE.COM

706-778-5100 Ext.

FIELDALE FARMS CORPORATION GA 30511 TOMHENSLEY@FIELDALE.COM

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 SAM.BOONE@USIS-TPA.COM

800-444-9098 Ext. 214

877-300-6187 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 DANIELLE.MINNIEHAN@SRSCONNECT.COM

800-541-0139 Ext. 35832

FIRST LIBERTY INSURANCE

CORPORATION

04-3058503 P O BOX 49000 CMC550CHARLOTE2@LIBERTYMUTUAL.COM

800-532-7706 Ext.

FIRST LIBERTY INSURANCE

CORPORATION

04-3058503 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

FIRST LIBERTY INSURANCE CORPORATION MA 02116 CORPORATESECRETARY@LIBERTYMUTUAL.COM

KLOCKE@FFIC.COM

678-393-4550 Ext.

FIREMAN'S FUND INSURANCE CO OF GEORGIA CA 94998

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

SBWC # Insurer Name Address Email

10292 SEATTLE

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

21196 DUBUQUE

DUBUQUE IA 52004

Phone:

SBWC # Insurer Name Address Email

20932 BIRMINGHAM

JACKSONVILLE FL 32207

Phone:

SBWC # Insurer Name Address Email

13174 EDWARDSVILLE

ATLANTA GA 30319

Phone:

LAWRENCEVILLE GA 30045

Phone:

ATLANTA GA 30319

Phone:

ORLANDO FL 32822

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

800-532-7706 Ext.

LIBERTY INSURANCE

CORPORATION

03-0316876 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

FIRST LIBERTY INSURANCE

CORPORATION

877-241-6121 Ext.

FLEXSTEEL INDUSTRIES INC IA 52004 CBRENN@FLEXSTEEL.COM

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE MARPOO@SAFECO.COM

678-417-3654 Ext.

FIRST NATIONAL INSURANCE COMPANY OF

AMERICA

SAFECO PLAZA, 1901

FOURTH AVENUE

WA 98154 CORPORATESCRETARY@LIBERTYMUTUAL.COM

800-282-6218 Ext.

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

LIBERTY MUTUAL FIRE

INSURANCE

04-1924000 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

-- Ext.

HORTICA - 5840A SOUTH SEMORAN

BLVD

BKEMP@HORTICA-INSURANCE.COM

CRAWFORD & COMPANY 58-0506554 160-3130 SUGARLOAF

PARKWAY

SHARI_BRANSON@CRAWCO.COM

678-377-5654 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD ATLANTA.GA@US.CRAWCO.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

FLORISTS INSURANCE COMPANY IL 62025 LTUCKER@HORTICA-INSURANCE.COM

866-293-5353 Ext. 114

FLORIDA ROCK INDUSTRIES INC AL 35242 HERRINGTONB@VMCMAIL.COM

BROADSPIRE 36-3917295 1965 BEACHWAY ROAD JENNIFER_JACOBS@CHOOSEBROADSPIRE.COM

Phone:

SBWC # Insurer Name Address Email

10259 EDWARDSVILLE

ATLANTA GA 30319

Phone:

LAWRENCEVILLE GA 30045

Phone:

ATLANTA GA 30319

ORLANDO FL 32822

Phone:

SBWC # Insurer Name Address Email

21002 THOMASVILLE

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21598 ROME

GREENVILLE SC 29607

Phone:

SBWC # Insurer Name Address Email

20600 ROME

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21472 ROME

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20380 DEARBORN

DEARBORN MI 48121

Phone:

SBWC # Insurer Name Address Email

5840A SOUTH SEMORAN

BLVD

800-566-5458 Ext.

FLORISTS MUTUAL INSURANCE COMPANY IL 62025 LTUCKER@HORTICA-INSURANCE.COM

800-421-9139 Ext. 859

FLOYD COUNTY BOARD OF COMMISSIONERS GA 30162 JOHNSONL@FLOYDCOUNTYGA.ORG

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 8500 RHURLEY@HEWITTCOLEMAN.COM

800-224-9524 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

FLOWERS FOODS INC GA 31792 MICHAEL_EGAN@FLOCORP.COM

HORTICA - 5840A SOUTH SEMORAN

BLVD

BKEMP@HORTICA-INSURANCE.COM

800-566-5458 Ext.

678-377-5654 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD ATLANTA.GA@US.CRAWCO.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CRAWFORD & COMPANY 58-0506554 160-3130 SUGARLOAF

PARKWAY

SHARI_BRANSON@CRAWCO.COM

313-206-4709 Ext.

FORD MOTOR COMPANY MI 48121 RWOOD4@FORD.COM

FORD MOTOR CLAIMS 38-0549190 P O BOX 607 MEVAN189@FORD.COM

678-258-8000 Ext.

FLOYD HEALTHCARE MANAGEMENT INC GA 30162 RSHEERIN@FLOYD.ORG

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

FLOYD COUNTY BOARD OF EDUCATION GA 30161 CKESSLER@FLOYDBOE.NET

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

20393 FOREST PARK

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21559 CUMMING

BRENTWOOD TN 37024

Phone:

SBWC # Insurer Name Address Email

13259 CLEARWATER

TAMPA FL 33630

Phone:

SBWC # Insurer Name Address Email

13164 FRANKENMUTH

FRANKENMUTH MI 48787

Phone:

FRANKENMUTH MI 48787

Phone:

SBWC # Insurer Name Address Email

21756 FRANKLIN

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

21574 MANCHESTER

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

20599 ATLANTA

ATLANTA GA 30303

Phone:

800-224-9524 Ext.

FOREST PARK CITY OF GA 30051 JPARKER@FORESTPARKGA.ORG

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

ANSUR AMERICA

INSURANCE COMPANY

38-3467437 ONE MUTUAL AVENUE SUZANNE.COWAN@FMINS.COM

800-234-1133 Ext.

FRANKENMUTH MUTUAL

INSURANCE COMPANY

38-0555290 ONE MUTUAL AVE. SUZANNE.COWAN@FMINS.COM

FRANKENMUTH MUTUAL INS. MI 48787 JOHN.BENSON@FMINS.COM

800-258-1811 Ext.

FRANK WINSTON CRUM INSURANCE INC FL 33756 BRIGITTEB@FWCRUMINSURANCE.COM

BROADSPIRE CLAIMS 36-3917295 CALL BOX 30539 KRISTIN.CANNELL@CHOOSEBROADSPIRE.COM

800-524-0604 Ext.

FORSYTH COUNTY BOARD OF EDUCATION GA 30040 DJONES@FORSYTH.K12.GA.US

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 MICHELLE.BYRD@BWOOD.COM

FULTON COUNTY 58-6001729 141 PRYOR ST VALARIE.HOWARD@FULTONCOUNTYGA.GOV

404-730-6749 Ext.

FULTON COUNTY 141 PRYOR STREET, 5070-

A

GA 30303 VALARIE.HOWARD@FULTONCOUNTYGA.GOV

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

770-352-2978 Ext.

FREUDENBERG-NOK GENERAL PARTNERSHIP 100 COMMERCIAL ST

1ST FL NORTH, FIRST

FLOOR NORTH

NH 03101 ALEXA.SCHLIEKER@FNACC.COM

800-932-4464 Ext.

FRANKLIN ALUMINUM CO INC GA 30217 DBIRCH@JACPROD.COM

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-234-1122 Ext.

SBWC # Insurer Name Address Email

21172 COLLEGE PARK

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

30003 NORCROSS

NORCROSS GA 30071

Phone:

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

30004 ATLANTA

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

20388 THOMASVILLE

THOMASVILLE GA 31799

Phone:

SBWC # Insurer Name Address Email

30017 ATLANTA

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

30008 ATLANTA

ATLANTA GA 30303

Phone:

SBWC # Insurer Name Address Email

30029 CONYERS

MACON GA 31210

866-646-8516 Ext. 245

GA AUTO DEALERS ASSOC SI GA 30339 LISAP@GADA.COM

GA AUTO DEALERS (GADA)

CLAIMS

58-1493566 2060 POWERS FERRY ROAD

SE

LISAP@GADA.COM

678-447-0200 Ext. 302

ACCG 58-1044477 3169 HOLCOMB BRIDGE

ROAD

JSMITH@ACCG.ORG

678-225-4241 Ext.

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

GA ASSOCIATION COUNTY COM ACCG-GSIWCF, 3169

HOLCOMB BRIDGE

ROAD STE 400

GA 30071

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 WCMAIL@COMPANIONGROUP.COM

800-845-2724 Ext. 43582

FULTON COUNTY BOARD OF EDUCATION GA 30349 ROUNSAVILLE@FULTON.K12.GA.US

GA NURSING HOME GROUP C/O TIS OF GA, 2281

MORRISON ROAD SW

GA 30094 CDOWNS@TISINS.COM

GA MUNICIPAL 58-1740980 201 PRYOR STREET SW KCLARK@GMANET.COM

888-488-4462 Ext. 124

GA MUNICIPAL ASSOCIATION GA 30303 GVANLEUVEN@GMANET.COM

GDORSEY@AFFINITYSERVICEGROUP.COM

800-233-2436 Ext. 1897

GA EDUCATION WC TRUST FUND 1940 THE EXCHANGE,

STE 200

GA 30339

AFFINITY SERVICE GROUP 58-2438483 1940 THE EXCHANGE

800-841-0001 Ext.

GA CRATE & BASKET COMPANY INC GA 31799 ELLIS@GACRATE.COM

GA CRATE & BASKET CO 58-0255590 PO BOX 46 LILLIAN@GACRATE.COM

SANFORD COMPANY 02-0634255 4025 VINEVILLE AVE JMERRITT@SANFORDCOMPANY.ORG

Phone:

SBWC # Insurer Name Address Email

30014 LAWRENCEVILLE

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

30033 CLEARWATER

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

30023 LAWRENCEVILLE

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21665 MCLEAN

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13264 ST LOUIS

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

10213 BOSTON

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

10058 SUN PRAIRIE

ATLANTA GA 31145

GA SCHOOL BOARD ASSOC GA 30243

888-888-8136 Ext.

PMA INS GROUP 23-1642962 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

770-677-3423 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

GA OPERATORS SELF INSURED FUND C/O ARTHUR J

GALLAGHER, P O BOX

9000

FL 33758 RANDI_WATSON@AJG.COM

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GEORGIA-ADMIN.COM

800-421-0710 Ext.

GA OILMEN'S ASSSOCIATION GA 30043

800-281-9761 Ext.

800-762-5573 Ext.

GENERAL ACCIDENT INSURANCE CO MA 02108

MONTGOMERY INSURANCE - 3555 KOGER BLVD.

770-813-0997 Ext. 230

GATEWAY INSURANCE COMPANY MO 63144 LWARD@GICAUTO.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-352-2978 Ext.

GANNETT COMPANY INC VA 22107 KHARRIS@GANNETT.COM

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-224-9524 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

GENERAL CASUALTY

COMPANY OF WISCONSIN

39-0301590 P O BOX 450409 SHARON.STARKS@US.QBE.COM

GENERAL CASUALTY CO OF WISCONSIN WI 55359 SHEILA.MCGRAW@GENERALCASUALTY.COM

Phone:

SBWC # Insurer Name Address Email

10073 SEATTLE

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

10075 COLUMBIA

ATLANTA GA 30319

Phone:

COLUMBIA MO 65205

Phone:

SBWC # Insurer Name Address Email

30007 TUCKER

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

30011 MARIETTA

MARIETTA GA 30006

Phone:

SBWC # Insurer Name Address Email

20788 ATLANTA

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21453 LAGRANGE

BRENTWOOD TN 37027

Phone:

SBWC # Insurer Name Address Email

800-877-3579 Ext.

GEORGIA CASUALTY &

SURETY

58-0537066 2102 WHITE GATE DR FSHORE@COLINSGRP.COM

573-474-6193 Ext.

GEORGIA CASUALTY & SURETY MO 65205 FSHORE@COLINSGRP.COM

GEORGIA CASUALTY &

SURETY

58-0537066 4370 PEACHTREE ROAD NE FSHORE@COLINSGRP.COM

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE MARPOO@SAFECO.COM

678-417-3654 Ext.

GENERAL INSURANCE COMPANY OF AMERICA 1001 FOURTH AVENUE,

SAFECO PLAZA

WA 98154 CORPORATESECRETARY@LIBERTYMUTUAL.COM

GENERAL CASUALTY

COMPANY OF WISCONSIN

770-493-1931 Ext.

GFF HOLDING CO GA 30240 GFFBETH@BELLSOUTH.NET

GA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GAADMINSVCS.COM

770-963-7732 Ext.

GEORGIA STATE OF CAPITOL HILL STATION,

P O BOX 38198

GA 30334 RISKMANAGEMENT@DOAS.GA.GOV

800-476-7601 Ext.

ALLIED CLAIMS

ADMINISTRATION INC

58-1962415 P O BOX 674869 WILCOXB@MCNEARY.COM

GEORGIA HOSPITAL ASSOCIATION WC FUND GA 30067 WILCOXB@MCNEARY.COM

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GEORGIA-ADMIN.COM

800-421-0710 Ext.

GEORGIA EMC WORKERS COMP FUND GA 30085 RICHARD.WEST@GEORGIAEMC.COM

BRENTWOOD SERVICES 62-1482047 1602 KNOX COURT JOHN.SMITHERMAN@BWOOD.COM

800-524-0604 Ext.

21787 GROVETOWN

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21516 BRUNSWICK

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

20554 BRUNSWICK

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21386 BOGART

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21227 ATLANTA

BRENTWOOD TN 37024

Phone:

SBWC # Insurer Name Address Email

10277 COLUMBUS

WARRENVILLE IL 60555

Phone:

COLUMBUS OH 43216

Phone:

SBWC # Insurer Name Address Email

10079 NEW YORK

NORCROSS GA 30071

Phone:

ALPHARETTA GA 30023

Phone:

800-224-9524 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

GLYNN COUNTY BOARD OF EDUCATION GA 31520

678-447-0200 Ext. 302

GLYNN COUNTY BOARD OF COMMISSIONERS GA 31520 GCOOLIDGE@GLYNNCOUNTY-GA.GOV

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

GIW INDUSTRIES INC GA 30813 GFOGUS@GIWINDUSTRIES.COM

800-935-5300 Ext. 254

GRANGE MUTUAL

CASUALTY COMPANY

31-4192970 P O BOX 182306 LVANCAMP@IMICO.COM

800-348-1741 Ext. 8407

GRANGE MUTUAL CASUALTY CO OH 43206 COLEMANL@GRANGEINSURANCE.COM

GRANGE MUTUAL 31-4192970 27755 DIEHL ROAD WIZAJ@GRANGEINSURANCE.COM

800-524-0604 Ext.

GRADY HOSPITAL FKA FULTON DEKALB HOSP

AUTHOR

80 JESSE HILL JR DR,

BOX 26208

GA 30303 CHUGHES@GMH.EDU

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 MICHELLE.BYRD@BWOOD.COM

678-258-8000 Ext.

GOLDEN PANTRY FOOD STORES INC GA 30622 DBGRIFFITH@GOLDENPANTRY.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

800-448-9707 Ext.

678-447-0200 Ext. 302

GRANITE STATE INSURANCE CO 175 WATER STREET,

18TH FLOOR

NY 10038 ALGAWCFR@AIG.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

SBWC # Insurer Name Address Email

12006 NEW HARTFORD

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

12062 METAIRIE

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

12007 CINCINNATI

CINCINNATI OH 45202

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

ALPHARETTA GA 30099

Phone:

SBWC # Insurer Name Address Email

12075 CINCINNATI

CINCINNATI OH 45202

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD ATLANTA.GA@US.CRAWCO.COM

-- Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

GRAY INSURANCE COMPANY (THE) LA 70002 MTAYLOR@GRAYINSCO.COM

GRAPHIC ARTS MUTUAL

INSURANCE CO

13-5274760 1040 CROWN POINT

PARKWAY

WORKERSCOMPMAIL@UTICANATIONAL.COM

800-477-1914 Ext.

GRAPHIC ARTS MUT INS CO NY 13413 WORKERSCOMPMAIL@UTICANATIONAL.COM

770-225-3538 Ext. 360

STRATEGIC COMP SERVICES 72-1331800 P O BOX 1445 BSMITH@STRATEGICCOMP.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

GREAT AMERICAN 31-0501234 P O BOX 5432 BSMITH@STRATEGICCOMP.COM

877-589-6846 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

GREAT AMERICAN ALLIANCE INS. 49 EAST FOURTH

STREET, 4400 SOUTH

OH 45202 TPEDOTO@GAIC.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

877-589-6846 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

770-901-3121 Ext.

GREAT AMERICAN ASSURANCE COMP OH 45202 TPEDOTO@GAIC.COM

GREAT AMERICAN 31-0501234 P O BOX 5432 BSMITH@STRATEGICCOMP.COM

ALPHARETTA GA 30099

Phone:

SBWC # Insurer Name Address Email

10080 CINCINNATI

MAITLAND FL 32751

Phone:

CINCINNATI OH 45202

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10080 CINCINNATI

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

ALPHARETTA GA 30099

SBWC # Insurer Name Address Email

10192 CINCINNATI

CINCINNATI OH 45202

Phone:

ALPHARETTA GA 30099

Phone:

SBWC # Insurer Name Address Email

13216 SCOTTSDALE

IRVING TX 75039

Phone:

SBWC # Insurer Name Address Email

12072 WARREN

ATLANTA GA 30326

Phone:

STRATEGIC COMP SERVICES 72-1331800 P O BOX 1445 BSMITH@STRATEGICCOMP.COM

770-225-3538 Ext. 360

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

GREAT AMERICAN INS CO 49 EAST FOURTH

STREET, SUITE 400

OH 45202 TPEDOTO@GAIC.COM

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

770-901-3121 Ext.

GREAT AMERICAN 31-0501234 P O BOX 5432 BSMITH@STRATEGICCOMP.COM

877-589-6846 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

866-291-0194 Ext.

GREAT AMERICAN INS CO 49 EAST FOURTH

STREET, SUITE 400

OH 45202 TPEDOTO@GAIC.COM

GREAT NORTHERN INSURANCE COMPANY NJ 07061 PREMIUMTAXGROUP@CHUBB.COM

800-449-2024 Ext. 8952

GREAT DIVIDE INSURANCE COMPANY AZ 85260 PLAMBERT@BERKLEYSUM.COM

BERKLEY SPECIALTY

UNDERWRITING

45-0397186 122 WEST CARPENTER

FREEWAY #300

JICLARK@BERKLEYSUM.COM

770-225-3538 Ext. 360

BSMITH@STRATEGICCOMP.COM

877-589-6846 Ext.

STRATEGIC COMP SERVICES 72-1331800 P O BOX 1445 BSMITH@STRATEGICCOMP.COM

GREAT AMERICAN INS CO OF NY 49 EAST FOURTH OH 45202

GREAT AMERICAN 31-0501234 P O BOX 5432

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

STRATEGIC COMP SERVICES 72-1331800 P O BOX 1445 BSMITH@STRATEGICCOMP.COM

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE KPILZ@CHUBB.COM

404-266-4855 Ext.

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30326

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10298 SOUTH SIOUX

CITYSOUTH SIOUX

CITY

NE 68776

Phone:

SBWC # Insurer Name Address Email

10082 NEW YORK

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

12078 EXTON

ATLANTA GA 30319

Phone:

ATLANTA GA 30339

Phone:

POMPANO BEACH FL 33064

Phone:

ATLANTA GA 30305

Phone:

BIRMINGHAM AL 35209

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

GREAT WEST CASUALTY

COPANY

47-6024508 P O BOX 277 WCCLAIMS@GWCCNET.COM

800-228-8602 Ext. 7208

GREAT WEST CASUALTY COMPANY NE 68776 WCCLAIMS@GWCCNET.COM

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

866-246-0259 Ext.

GREAT NORTHERN

INSURANCE

41-0729473 2 LIVE OAK CENTER SUITE

900

KPULZ@CHUBB.COM

404-266-4127 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

404-504-6290 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

ECS CLAIM - 3525 PIEDMONT RD #300

800-450-0692 Ext.

CAMBRIDGE INTEGRATED 23-2731565 1775 THE EXCHANGE DAVID.HAYS@CAMBRIDGE-NA.COM

800-862-4252 Ext.

GREENWICH INSURANCE COMPANY PA 19341 ANTHONY.EVANS@XLGROUP.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-838-9853 Ext.

GREATER NEW YORK MUTUAL INS. CO NY 10016 PMCGOVERN@GNY.COM

INDEPENDENT ADJUSTERS

INC.

58-1075455 2130 TUCKER INDUSTRIAL

RD

CLAIMS@IAICLAIMS.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 1 METROPLEX DRIVE ATLANTAR@GABROBINS.COM

800-587-3773 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

ATLANTA GA 30338

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

20555 GRIFFIN

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

30020 ATLANTA

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

12046 FT LAUDERDALE

LAKE MARY FL 32746

Phone:

FORT

LAUDERDALE

FL 33301

Phone:

SBWC # Insurer Name Address Email

21053 AUBURN HILLS

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

10246 WEST DES

STONE MOUNTAIN GA 30087

Phone:

SBWC # Insurer Name Address Email

21135 SAVANNAH

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

615-493-5802 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

654-703-8038 Ext.

GUARANTEE INSURANCE 22-2222789 1000 PRIMERA BLVD ALEPORE@GUARANTEEINS.COM

800-948-2651 Ext. 1306

GUARANTEE INSURANCE 22-2222789 401 EAST LAS OLAS BLVD ALEPORE@GUARANTEEINS.COM

GUARANTEE INSURANCE CO 401 EAST LAS OLAS

BLVD, SUITE 1540

FL 33301 KDAVIS@GUARANTEEINS.COM

CEDWARDS@GEORGIA-ADMIN.COM

800-421-0710 Ext.

GTMA/AYSA 50 HURT PLAZA, SUITE GA 30303

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE

50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

GRIFFIN SPALDING BOARD OF EDUCATION GA 30223

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE

GULFSTREAM AEROSPACE CORP DBA GENERAL

DYNAMICS

500 GULFSTREAM ROAD,

MAIL STATION B-06

GA 31407 TOM.RAMEE@GULFSTREAM.COM

KTORAIN@GUIDEONE.COM

800-659-1232 Ext. 6337

GUIDEONE MUTUAL INSURANCE COMPANY IA 50265

GUIDEONE MUTUAL

INSURANCE CO

42-0645088 2305 W PARK PLACE

800-685-7361 Ext.

GUARDIAN AUTOMOTIVE CORPORATION MI 48326 CLUMPKIN@GUARDIAN.COM

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21780 LAWRENCEVILLE

227948 LAWRENCEVILLE GA 30045

Phone:

SBWC # Insurer Name Address Email

21076 LAWRENCEVILLE

995259 CHARLOTTE NC 28247

Phone:

SBWC # Insurer Name Address Email

21418 LAWRENCEVILLE

228131 LAWRENCEVILLE GA 30046

Phone:

SBWC # Insurer Name Address Email

20466 GAINESVILLE

GRAYSON GA 30017

Phone:

SBWC # Insurer Name Address Email

21097 DALTON

928653 ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10086 WORCESTER

WORCESTER MA 01653

912-355-8929 Ext. 224

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST ANNF@USCKY.COM

HALL COUNTY BOARD OF EDUCATION 711 GREEN STREET,

SUITE 100

GA 30501 PAM.CRAVERO@HALLCO.ORG

GWINNETT HEALTH SYSTEM 58-2135755 100 MEDICAL CENTER RMILLER@GWINNETTMEDICALCENTER.ORG

678-312-4164 Ext.

GWINNETT HEALTH SYSTEM 100 MEDICAL CENTER

BLVD, SUITE 100

GA 30046 VGRIFFIN@GWINNETTMEDICALCENTER.ORG

BRENTWOOD SERVICES

ADMINISTRATORS INC

62-1482047 P O BOX 471127 JEAN.HIGH@BWOOD.COM

800-524-0604 Ext.

GWINNETT COUNTY PUBLIC SCHOOLS 53 GWINNETT DRIVE,

BUILDING A

GA 30045 BOB_TAYLOR@GWINNETT.K12.GA.US

770-822-7850 Ext.

GWINNETT COUNTY BOARD OF

COMMISSIONERS

GA 30045 BILL.SWIGER@GWINNETTCOUNTY.COM

GWINNETT COUNTY BD OF

COM

- 75 LANGLEY DRIVE

HANOVER INSURANCE CO MA 01653 DAWMURPHY@HANOVER.COM

HANOVER INSURANCE

COMPANY

13-5129825 440 LINCOLN STREET EBESHAI@HANOVER.COM

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

HAMILTON HEALTH CARE SYSTEM INC GA 30722 JHOPKINS@HHCS.ORG

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969 KELLYW@MAIL.COREMRG.COM

770-962-3627 Ext.

Phone:

SBWC # Insurer Name Address Email

21031 HAPEVILLE

227674 ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13020 NEW YORK

ATLANTA GA 30366

Phone:

ATLANTA GA 30339

Phone:

FL 32716

Phone:

SBWC # Insurer Name Address Email

12051 ROLLING

MEADOW

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13057 HARLEYSVILLE

227475 HARLEYSVILLE PA 19438

Phone:

SBWC # Insurer Name Address Email

13285 HARLEYSVILLE

1004829 HARLEYSVILLE PA 19438

Phone:

SBWC # Insurer Name Address Email

12018 HARLEYSVILLE

227475 HARLEYSVILLE PA 19438

Phone:

SBWC # Insurer Name Address Email

13284 HARLEYSVILLE

1004829 HARLEYSVILLE PA 19438

HAPEVILLE CITY OF GA 30354 ASHEPARD@HAPEVILLE.ORG

SELF-INSURANCE

ADMINISTRATORS (SIA)

58-1870166 4370 PEACHTREE ROAD NE JMARSHBURN@ATLAM.COM

800-628-0250 Ext.

800-450-0692 Ext.

HARCO NATIONAL INSURANCE COMPANY IL 60008 KCOOK@IAT-HARCO.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-315-6090 Ext.

800-883-9305 Ext.

NORTH AMERICAN RISK

SERVICES INC

13-3901415 P O BOX 166002 ALTAMONTE

SPRINGS

MAILROOM@NARIK.COM

ADJUSTMENT SERVICES INC. 58-1623664 P O BOX 81306 SHARON@ADJUSTMENTSERVICES.COM

800-772-8427 Ext.

BUILDERS INSURANCE 58-2453325 P O BOX 723099 CLAIMSFORM@BLDRS.COM

HARBOR SPECIALTY INS 7 TIMES SQUARE, 36 & 37

FLOOR

NY 10036 JSVOBODA@CLARENDON-INS.COM

404-266-5749 Ext.

HARLEYSVILLE PREFERRED INSURANCE

COMPANY

PA 19438 DBOND@HARLEYSVILLEGROUP.COM

HARLEYSVILLE GROUP - P O BOX 244 DHURT@HARLEYSVILLEGROUP.COM

888-549-9876 Ext. 1217

HARLEYSVILLE MUTUAL INSURANCE PA 19438 LHANSON@HARLEYSVILLEGROUP.COM

HARLEYSVILLE ATLANTIC 23-0902325 P O BOX 244 LHANSON@HARLEYSVILLEGROUP.COM

888-549-9826 Ext. 5003

HARLEYSVILLE INSURANCE COMPANY PA 19438 LHANSON@HARLEYSVILLEGROUP.COM

HARLEYSVILLE GROUP - P O BOX 244 DHURT@HARLEYSVILLEGROUP.COM

888-549-9876 Ext. 1217

HARLEYSVILLE ATLANTIC INSURANCE PA 19438 LHANSON@HARLEYSVILLEGROUP.COM

HARLEYSVILLE ATLANTIC 23-0902325 P O BOX 244 LHANSON@HARLEYSVILLEGROUP.COM

Phone:

SBWC # Insurer Name Address Email

13283 HARLEYSVILLE

1004829 HARLEYSVILLE PA 19438

Phone:

SBWC # Insurer Name Address Email

20389 BETHLEHEM

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

10089 HARTFORD

ATLANTA GA 30319

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

888-549-9826 Ext. 5003

800-450-0692 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

HARTFORD ACCIDENT & INDEMNITY CT 06115 PAULA.SOBOLESKI@THEHARTFORD.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

800-224-9524 Ext.

HARRISON POULTRY INC GA 30620 GFINCH@HARRISONPOULTRY.COM

888-549-9826 Ext. 5003

HARLEYSVILLE WORCESTER INSURANCE

COMPANY

PA 19438 LHANSON@HARLEYSVILLEGROUP.COM

HARLEYSVILLE GROUP - P O BOX 244 DHURT@HARLEYSVILLEGROUP.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

SYRACAUSE NY 13202

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10044 HARTFORD

ATLANTA GA 30319

Phone:

MAITLAND FL 32751

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

SUNRISE FL 33323

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

800-450-0692 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

HARTFORD CASUALTY INSURANCE COMPANY CT 06155 PAULA.SOBOLESK@THEHARTFORD.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-541-0139 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-685-7361 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

COTTINGHAM AND BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

877-241-6121 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

FRANKLIN TN 37067

Phone:

SYRACAUSE NY 13202

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

831038 HARTFORD CT 06115

Phone:

ATLANTA GA 30328

407-562-3632 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

KM@JOHNSTONANDASSOC.COM

800-304-5035 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

860-547-7936 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY BETH.RODEE@SRSCONNECT.COM

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 HARTFORD PLAZA PAUL.HAYWARD@THEHARTFORD.COM

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-932-4464 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

12045 HARTFORD

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

MAITLAND FL 32751

Phone:

WHITESBURG GA 30185

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

SUNRISE FL 33323

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

770-901-3124 Ext.

866-291-0194 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

HARTFORD FIRE INS CO CT 06115 PAULA.SOBOLESKI@THEHARTFORD.COM

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

985-624-6739 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

770-577-9657 Ext.

CREATIVE RISK SOLUTIONS 20-0989430 P O BOX 9207 NLYMAN@YOURCLAIMS.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

LAKE MARY FL 32746

Phone:

FRANKLIN TN 37067

Phone:

SYRACAUSE NY 13202

Phone:

ATLANTA GA 30328

Phone:

COLUMBIA SC 29210

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

LAKE MARY FL 32795

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE JCONNOR@SEDGWICKCMS.COM

800-426-2885 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

407-562-3632 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

KM@JOHNSTONANDASSOC.COM

800-304-5035 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 958424 MARI.NOONAN@SRSCONNECT.COM

877-300-6187 Ext. 1012

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-822-4469 Ext.

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

12037 HARTFORD

ATLANTA GA 30319

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

407-562-3632 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

800-541-0139 Ext.

605 CRESCENT EXECUTIVE

COURT

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-889-6764 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-450-0692 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

HARTFORD INSURANCE CO OF THE SOUTHEAST CT 06155 PAULA.SOBOLESKI@THEHARTFORD.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

Phone:

SYRACAUSE NY 13202

Phone:

COLUMBIA SC 29210

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

12092 HARTFORD

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

DUBUQUE IA 52004

Phone:

DUBUQUE IA 52004

Phone:

WHITESBURG GA 30185

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

407-562-3632 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD UNDERWRITERS

INS CO

200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

800-541-0139 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE JCONNOR@SEDGWICKCMS.COM

800-426-2885 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

770-577-9657 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

COTTINGHAM AND BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

877-241-6121 Ext.

CREATIVE RISK SOLUTIONS 20-0989430 P O BOX 9207 NLYMAN@YOURCLAIMS.COM

800-450-0692 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

877-241-6121 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

800-277-7500 Ext. 29106

HARTFORD INSURANCE COMPANY OF

MIDWEST

CT 06155 PAULA.SOBOLESKI@THEHARTFORD.COM

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

Phone:

DULUTH GA 30097

Phone:

PARSIPPANY NJ 07054

Phone:

TUCKER GA 30084

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

SYRACRUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

866-246-0259 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-422-4436 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 9 CAMPUS DRIVE ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

985-624-6739 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD INS CO MIDWEST 06-1008026 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD INC CO MIDWEST 06-1008026 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10123 HARTFORD

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

BRENTWOOD TN 37027

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

615-824-5095 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-822-4469 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

877-241-6121 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

HARTFORD UNDERWRITERS INS CT 06155 PAULA.SOBOLESKI@THEHARTFORD.COM

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-675-2771 Ext. 225

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

F A RICHARD (FARA) 72-0837383 7000 EXECUTIVE CENTER

DRIVE

GEORGIA.NOTICES@FARA.COM

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

Phone:

COLUMBIA SC 29210

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-889-6764 Ext. 201

800-426-2885 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE JCONNOR@SEDGWICKCMS.COM

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

ALPHARETTA GA 30005

Phone:

954444 TAMPA FL 33610

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

40012 LAWRENCEVILLE

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21779 N LIBERTY

TUCKER GA 30084

Phone:

SBWC # Insurer Name Email

20580 MCDONOUGH

GRAYSON GA 30017

Phone:

SBWC # Insurer Name Address Email

21426 BRANSON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20533 SUWANEE

JOHNS CREEK GA 30097

615-824-5095 Ext.

407-562-3632 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

800-238-6214 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

678-258-8000 Ext.

HERSCHEND FAMILY ENTERTAINMENT FKA

SILVER DOLLAR CITY

MO 65616 BETHERIDGE@HFECORP.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

770-962-3627 Ext.

Address

HENRY COUNTY BOARD OF EDUCATION GA 30253 DIANNA.WARE@HENRY.K12.GA.US

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969 KELLYW@MAIL.COREMRG.COM

800-354-6494 Ext. 201

HEARTLAND EXPRESS INC IA 52317 GKING@HEARTLANDEXPRESS.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-421-0710 Ext.

HEALTHCARE MUTUAL CAPTIVE GA 30043 CEDWARDS@GAADMINSVCS.COM

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GEORGIA-ADMIN.COM

HILLCREST FOODS INC 50 SATELLITE BLVD,

SUITE G

GA 30024 UHNGNTHR@BELLSOUTH.NET

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

Phone:

SBWC # Insurer Name Address Email

21612 MUSCATINE

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20565 AUSTIN

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20312 CUTHBERT

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21046 VALDOSTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20362 WARNER ROBINS

GREENVILLE SC 29607

Phone:

SBWC # Insurer Name Address Email

20407 PERRY

GRAYSON GA 30017

Phone:

SBWC # Insurer Name Address Email

ZURICH NA ATL CLAIMS 36-4233459 3003 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

HORMEL FOODS MN 55912 ENCARDENAS@HORMEL.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

HNI CORPORATION/HON INDUSTRIES IA 52761 HUDDLESTONM@HNICORP.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

678-258-8000 Ext.

RHURLEY@HEWITTCOLEMAN.COM

800-421-9139 Ext. 859

HOUSTON COUNTY BOARD OF

COMMISSIONERS

GA 31088

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 8500

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

HOSPITAL AUTHORITY OF

VALDOSTA/LOWNDES

2501 N PATTERSON

STREET, P.O. BOX 1727

GA 31603 CHARLES.EIDSON@SGMC.ORG

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

HOSPITAL AUTHORITY OF RANDOLPH COUNTY GA 39840 KPETERSE@PPMH.ORG

ZURICH SERVICES CORP 36-3839542 3003 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

770-962-3627 Ext.

HOUSTON COUNTY BOARD OF EDUCATION GA 31069

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969 KELLYW@MAIL.COREMRG.COM

21286 WARNER ROBINS

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21354 SANDERSVILLE

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21001 CHICAGO

MIRAMAR FL 33027

Phone:

SBWC # Insurer Name Address Email

21182 PINE MOUNTAIN

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

12071 PHILADELPHIA

NORCROSS GA 30010

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ALPHARETTA GA 30005

Phone:

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

HOWARD SHEPPARD INC GA 31082 ANDY@HOWARDSHEPPARD.COM

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST ANNF@USCKY.COM

912-355-8929 Ext. 224

HOUSTON HOSPITALS INC dba HOSP AUTHOR

OF HOUSTON CO

GA 31099 MFOWLER@HHC.ORG

ATLANTA@CHOOSEBROADSPIRE.COM

678-969-7337 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

BROADSPIRE INC 36-3917295 P O BOX 926240

INDEMNITY INSURANCE COMPANY OF NORTH

AMERICA

PA 19105 MARILEE.BRABSON@ACEGROUP.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

IDA CASON CALLAWAY FOUNDATION GA 31822 SLIPP@CALLAWAYGARDENS.COM

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 KRISTY_SANDS@GBTPA.COM

800-473-9009 Ext.

HYATT HOTELS CORPORATION 71 SOUTH WACKER

DRIVE, 17TH FLOOR

IL 60606 MADISON.WOMERSLEY@HYATT.COM

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

770-352-2978 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

800-235-1134 Ext. 5

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

TAMPA FL 33612

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

TUCKER GA 30084

Phone:

CLEARWATER FL 33758

Phone:

TAMPA FL 33622

Phone:

BIRMINGHAM AL 35266

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

FT MILL SC 29716

Phone:

CLEARWATER FL 33758

Phone:

TAMPA FL 33618

Phone:

TAMPA FL 33631

Phone:

ATLANTA GA 30328

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 KRISTY_SANDS@GBTPA.COM

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-934-3414 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR GEORGIAWCBOARD@TRAVELERS.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY CHRIS_ROCK@GBTPA.COM

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2600 MCCORMICK DR #110 CANDICE_BUCHANAN@GBTPA.COM

800-473-9009 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 HEATHER.STANFORD@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE JULIE_MCCOY-LINCOLN@GBTPA.COM

866-814-1740 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 KIM_BUCHANAN@GBTPA.COM

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

LAKE MARY FL 32746

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

986169 PARSIPPANY NJ 07054

Phone:

SBWC # Insurer Name Address Email

21344 ASHEVILLE

941165 ASHEVILLE NC 28816

Phone:

SBWC # Insurer Name Address Email

10093 PHILADELPHIA

ROSWELL GA 30076

Phone:

DULUTH GA 30097

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD GASTATEBOARDINBOX@SEDGWICKCMS.COM

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST ANNF@USCKY.COM

912-355-8929 Ext. 224

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

770-901-3121 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

800-548-1373 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-822-4469 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

INSURANCE COMPANY OF NORTH AMERICA 436 WALNUT STREET,

WB04G

PA 19106 MARILEE.BRABSON@ACEGROUP.COM

828-669-2941 Ext. 426

INGLES MARKETS INC NC 28816 AEUBANK@INGLES-MARKETS.COM

INGLES MARKETS 56-0846267 P O BOX 6676 AEUBANK@INGLES-MARKETS.COM

877-927-2255 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

912-355-8989 Ext.

YORK CLAIMS SERVICE INC 13-1963636 99 CHERRY HILL ROAD STEPHANIE.MARSHALL@YORKRSG.COMM

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10094 NEW YORK

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ALPHARETTA GA 30023

Phone:

OKLAHOMA CITY OK 73123

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33612

Phone:

FT SMITH AR 72919

Phone:

ROSWELL GA 30076

GAB ROBINS NORTH

AMERICA INC

770-813-0997 Ext. 230

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

INSURANCE COMPANY OF STATE OF PA 175 WATER STREET,

18TH FLOOR

NY 10038 ALGAWCFR@AIG.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

770-934-3414 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 1000 FIANA WAY MJWHITE@TRAVELERS.COM

800-842-5612 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR GEORGIAWCBOARD@TRAVELERS.COM

770-352-2978 Ext.

CLAIMETRICS 20-1604010 PO BOX 22478 LAUREN.TOPPINS@CLAIMETRICS.COM

405-728-5544 Ext. 2326

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-448-9707 Ext.

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

800-235-1134 Ext. 5

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

CLEARWATER FL 33758

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

LEXINGTON KY 40512

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13089 SAN DIEGO

678-731-9091 Ext. 252

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 KIM_BUCHANAN@GBTPA.COM

800-226-8002 Ext.

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE TKATER@NOVAPRORISK.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

800-685-7361 Ext.

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 DANIELLE.MINNIEHAN@SRSCONNECT.COM

800-541-0139 Ext. 35832

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

ATLANTA.GA@SEDGWICKCMS.COM

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

INSURANCE COMPANY OF THE WEST CA 92130 JDODKIN@ICWGROUP.COM

800-238-6214 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

TAMPA FL 33602

Phone:

SBWC # Insurer Name Address Email

20359 LAGRANGE

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

SBWC # Insurer Name Address Email

20642 MEMPHIS

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

21514 RICEBORO

228221 RICEBORO GA 31323

Phone:

SBWC # Insurer Name Address Email

21321 DALTON

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

21143 JESUP

227978 JESUP GA 31545

Phone:

SBWC # Insurer Name Address Email

21474 ATLANTA

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

20412 DENVER

INTERNATIONAL PAPER CO 6400 POPLAR AVENUE,

TOWER III, 4-110

TN 38197 PENNY.HUMPHREY@IPAPER.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

INTERFACE INC GA 30240 TED.ROUNTREE@INTERFACEFLOR.COM

NOVAPRO RISK 36-4550659 101 E KENNEDY BLVD KROGERS@NOVAPRORISK.COM

800-426-5990 Ext.

912-427-1313 Ext.

JESUP CITY OF GA 31545

JESUP CITY OF - P O BOX 427

800-884-1535 Ext.

J & J INDUSTRIES INC GA 30721 JULIE.NOLES@JJ-INVISION.COM

COLLINS & COMPANY 62-0882150 555 RIVER STREET AGRIME@COLLINSANDCO.COM

912-884-3371 Ext. 238

INTERSTATE PAPER LLC GA 31323 MIKE_MCGOWAN@INTERSTATEPAPER.COM

INTERSTATE PAPER LLC 54-1876547 2366 INTERSTATE PAPER

ROAD

SHARON_TERRY@INTERSTATEPAPER.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

JOHNS MANVILLE CO 80202 LOONAMMA@JM.COM

800-845-2724 Ext. 43582

JOHN WIELAND HOMES AND NEIGHBORHOODS

INC.

GA 30337 MARK.WHYTE@JWHOMES.COM

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 WCMAIL@COMPANIONGROUP.COM

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

21719 WAYCROSS

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20571 TIFTON

GRAYSON GA 30017

Phone:

SBWC # Insurer Name Address Email

20944 BATTLE CREEK

GLEN ALLEN VA 23058

Phone:

CHARLESTON SC 29416

Phone:

SBWC # Insurer Name Address Email

13155 GREENSBORO

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

21051 NEENAH

NEEAH WI 54957

Phone:

SBWC # Insurer Name Address Email

21461 JACKSON

JACKSON MS 39218

Phone:

SBWC # Insurer Name Address Email

21752 PHOENIX

BIRMINGHAM AL 35209

770-962-3627 Ext.

KELLEY MANUFACTURING COMPANY GA 31793 JTOMBERLIN@KELLEYMFG.COM

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969 KELLYW@MAIL.COREMRG.COM

678-258-8000 Ext.

JONES COMPANY (THE) GA 31502 HSIRMANS@FLASHFOODS.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

800-685-7361 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

-- Ext.

KIMBERLY-CLARK

CORPORATION

39-0394230 2300 WINCHESTER RD

KIMBERLY CLARK CORPORATION 2300 WINCHESTER

ROAD, PO BOX 2007

WI 54957 JANICE.FELTZ@KCC.COM

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 GHENEHAN@KEYRISK.COM

336-668-9050 Ext. 7539

KEY RISK INSURANCE CO 7900 MCCLOUD ROAD,

SUITE 300

NC 27409 TELBERT@KEYRISK.COM

800-906-4461 Ext.

CORVEL ENTERPRISES 42-1704550 P O BOX 81029 GLENN_MARTIN@CORVEL.COM

866-434-2480 Ext.

KELLOGG CO AND SUBSIDIARIES fka KEEBLER MI 49017 TRACY.LOZA@KELLOGG.COM

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE MARCIA_MORGAN@CORVEL.COM

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

KNIGHT TRANSPORTATION INC AZ 85043 TODDC@KNIGHTTRANS.COM

601-933-4942 Ext.

KLLM TRANSPORT SERVICES LLC MS 39218 JLUM@KLLM.COM

KLLM TRANSPORT SERVICES 64-0577750 135 RIVERVIEW DRIVE JLUM@KLLM.COM

Phone:

SBWC # Insurer Name Address Email

13267 WEST TRENTON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21704 ATLANTA

DULUTH GA 30096

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

21709 TACOMA

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

21763 LAGRANGE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21340 VALDOSTA

763045 VALDOSTA GA 31603

Phone:

SBWC # Insurer Name Address Email

21550 LAWRENCEVILLE

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20507 BIRMINGHAM

BIRMINGHAM AL 35238

Phone:

KROGER COMPANY (THE) GA 30345 BILL.GREEN@KROGER.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

KODIAK INSURANCE COMPANY NJ 08628 CPOPP@HERMITAGEINS.COM

AVIZENT fka FRANK GATES

SERVICE CO

800-277-7500 Ext. 29106

LANGDALE INDUSTRIES 58-1688919 P O BOX 1088 BBARRETT@LANGDALEINDUSTRIES.COM

229-333-2551 Ext.

LANGDALE COMPANY (THE) GA 31603 BBARRETT@LANGDALEINDUSTRIES.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

LAGRANGE CITY OF GA 30240 MKELSEY@LAGRANGEGA.ORG

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

LABOR READY INC 1015 A STREET, P O BOX

2910

WA 98401 AARENCIBIA@TRUEBLUEINC.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

ATLANTA.GA@SEDGWICKCMS.COM

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

LEGACY VULCAN

MATERIALS CO

63-0366371 P O BOX 385014 REEDB@VMCMAIL.COM

800-474-4082 Ext.

LEGACY VULCAN F/K/A VULCAN MATERIALS

COMPANY

AL 35242 HERRINGTONB@VMCMAIL.COM

XCALIBRE RISK SERVICES 26-4197853 4370 PEACHTREE ROAD NE JMARSHBURN@ATLAM.COM

404-266-5749 Ext.

LAWRENCEVILLE CITY OF GA 30046 TRACY.TULLIS@LAWRENCEVILLEGAWEB.ORG

SBWC # Insurer Name Address Email

13182 BOSTON

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

SBWC # Insurer Name Address Email

10097 BOSTON

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

SBWC # Insurer Name Address Email

10098 BOSTON

TAMPA FL 33618

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

LIBERTY INSURANCE CORPORATION MA 02116 CORPORATESECRETARY@LIBERTYMUTUAL.COM

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

LIBERTY MUTUAL FIRE INS CO MA 02116 CORPORATESECRETARY@LIBERTYMUTUAL.COM

800-282-6218 Ext.

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-532-7706 Ext.

LIBERTY INSURANCE

CORPORATION

03-0316876 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

LIBERTY INSURANCE

CORPORATION

03-0316876 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

800-532-7706 Ext.

LIBERTY MUTUAL INS CO MA 02117 CORPORATESECRETARY@LIBERTYMUTUAL.COM

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

LM INSURANCE

CORPORATION

04-3058504 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

800-282-6218 Ext.

LIBERTY MUTUAL FIRE

INSURANCE

04-1924000 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

800-532-7706 Ext.

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-532-7706 Ext.

LIBERTY MUTUAL FIRE

INSURANCE

04-1924000 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

SBWC # Insurer Name Address Email

13220 HOLIDAY

HOLIDAY FL 34691

Phone:

SBWC # Insurer Name Address Email

13059 BOSTON

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

800-532-7706 Ext.

HELMSMAN MANAGEMENT

SERVICES

LM INSURANCE CO MA 02116 CORPORATESECRETARY@LIBERTYMUTUAL.COM

PACKARD CLAIMS

ADMINISTRATION INC.

03-0567602 2739 US HIGHWAY 19 DOCUMENTS@PACKARDCLAIMS.COM

727-682-1072 Ext. 5552

LION INSURANCE COMPANY 2739 US HIGHWAY 19

NORTH, SUITE 600

FL 34691 GBEAN@LIONINSURANCECOMPANY.COM

800-282-6218 Ext.

LM INSURANCE

CORPORATION

04-3058504 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

800-532-7706 Ext.

LIBERTY INSURANCE

CORPORATION

03-0316876 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

LM INSURANCE

CORPORATION

04-3058504 P O BOX 31204

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

800-532-7706 Ext.

LIBERTY INSURANCE

CORPORATION

03-0316876 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

866-246-0259 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21547 JONESBORO

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21333 MOORESVILLE

ATLANTA GA 30338

Phone:

LAKE MARY FL 32746

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

12005 BOCA RATON

BOCA RATON FL 33431

Phone:

SBWC # Insurer Name Address Email

21530 OKLAHOMA CITY

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20430 MACON

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21389 MACON

ORLANDO FL 32861

Phone:

800-532-7706 Ext.

800-282-6218 Ext.

LM INSURANCE

CORPORATION

04-3058504 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

LUMBERMENS UNDERWRITING ALLIANCE FL 33431 GA@INS-LUA.COM

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD GASTATEBOARDINBOX@SEDGWICKCMS.COM

800-548-1373 Ext.

LOWES HOME CENTERS INC NC 28115 TIA.L.SCHWEIKERT@LOWES.COM

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

678-258-8000 Ext.

LOW TEMP INDUSTRIES GA 30237 RPRIEGEL@LOWTEMPIND.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

800-444-9098 Ext. 214

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 SAM.BOONE@USIS-TPA.COM

MACON/BIBB WATER/SEWERAGE GA 31298

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

MACON CITY OF 700 POPLAR STREET,

3RD FLOOR

GA 31201 KAREN.PENNYCUFF@MACON.GA.US

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD ATLANTA.GA@US.CRAWCO.COM

-- Ext.

M-D BUILDING PRODUCTS INC OK 73118 MCKINNEK@MDTEAM.COM

LUMBERMENS

UNDERWRITING ALLIANCE

CLAIMS

43-0799570 1905 NW CORPORATE LYNNCLAIMS@INS-LUA.COM

800-327-0515 Ext. 227

SBWC # Insurer Name Address Email

21630 CINCINNATI

CINCINNATI OH 45202

Phone:

SBWC # Insurer Name Address Email

10140 ATLANTA

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

13139 BLUE BELL

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

21490 GAINESVILLE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21415 MARIETTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20577 CHATTANOOGA

DALTON GA 30722

Phone:

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

PMA INS GROUP 23-1642962 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

770-677-3423 Ext.

MANUFACTURERS

ALLIANCE INSURANCE

23-2086596 500 NORTHPARK TOWN

CENTER

ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

MANUFACTURERS ALLIANCE INSURANCE

COMPANY

PA 19422 STEPHEN_GARTNER@PMAGROUP.COM

678-447-0200 Ext. 302

MAG MUTUAL INSURANCE COMPANY 3525 PIEDMONT ROAD,

BLDG 8-600

GA 30305 BPITTS@MAGMUTUAL.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

866-908-2395 Ext.

MACYS INC F/K/A FEDERATED DEPARTMENT

STORES INC

OH 45202 TIM.SCHWIRTZ@MACYS.COM

MACY'S F/K/A FEDERATED

DEPART STORE CLAIMS

13-3324058 7 WEST SEVENTH STREET BILL.KRONER@MACYS.COM

423-265-0541 Ext.

COLLINS & COMPANY 62-0882150 P O BOX 6429 AGRIME@COLLINSANDCO.COM

706-277-1253 Ext.

COLLINS & COMPANY 62-0882150 555 RIVER ST SBIBLE@COLLINSANDCO.COM

MARKETPLACE HOLDINGS fka COLLIS FOODS

INC

701 CHEROKEE BLVD,

SUITE 100

TN 37405 GTROBINSON@BELLSOUTH.NET

50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

MARIETTA CITY OF AND BOARD OF LIGHTS &

WATER

GA 30061

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE

678-258-8000 Ext.

MAR-JAC POULTRY INC GA 30503 MDMOHAMED@MARJACPOULTRY.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

21610 BETHESDA

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

20809 ATLANTA

ATLANTA GA 30324

Phone:

SBWC # Insurer Name Address Email

10103 SCHAUMBURG

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

SCHAUMBERG IL 60666

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

10258 WORCESTER

WORCESTER MA 01653

Phone:

SBWC # Insurer Name Address Email

21878 CORAL GABLES

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

20487 COLUMBIA

GREENVILLE SC 29607

Phone:

SBWC # Insurer Name Email

21764 AUGUSTA

404-851-3207 Ext.

MARYLAND CASUALTY

COMPANY

52-0403120 1900 SUMMIT TOWER CHRIS.CALLOWAY@ZURICHNA.COM

404-851-3207 Ext.

MARYLAND CASUALTY COMPANY IL 60196 TIM.GRAHAM@ZURICHNA.COM

MARYLAND CASUALTY

COMPANY

52-0403120 3003 SUMMIT BLVD CHRIS.CALLOWAY@ZURICHNA.COM

404-848-4521 Ext.

MARTA RISK MANAGEMENT,

2424 PIEDMONT ROAD

GA 30324 LMURPHY@ITSMARTA.COM

MARTA 58-0964286 RISK MANAGEMENT WCDISABILITY@ITSMARTA.COM

MARRIOTT CLAIMS SERVICE 52-2055918 320 INTERSTATE NORTH

PKWY

JERRY.WOOD@MARRIOTT.COM

800-825-2467 Ext.

MARRIOTT INTERNATIONAL INC 10400 FERNWOOD ROD,

DEPT 51/924.36

MD 20817 STEVE.HUY@MARRIOTT.COM

MB KAHN CONSTRUCTION SC 29202 JGORSAGE@MBKAHN.COM

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

MASTEC NORTH AMERICA INC FL 33134 ANDRES.LLOP@MASTEC.COM

HANOVER INSURANCE

COMPANY

13-5129825 440 LINCOLN STREET EBESHAI@HANOVER.COM

800-628-0250 Ext.

MASSACHUSETTS BAY INS CO MA 01653 DAWMURPHY@HANOVER.COM

404-851-3208 Ext.

ZURICH SERVICES CORP 36-3839542 3003 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

ZURICH NORTH AMERICA 36-3839542 P.O. BOX 2769 USZ_GA_WC_CLAIM_NOTICES@ZURICHNA.COM

Address

MCG HEALTH INC 1120 15TH STREET, (CJ

2332)

GA 30912 LMITCHUM@MCG.EDU

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 8500 RHURLEY@HEWITTCOLEMAN.COM

800-421-9139 Ext. 859

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20606 TEMPLE

ALPHARETTA GA 30023

Phone:

SBWC # Insurer Name Address Email

21759 VIDALIA

MACON GA 31202

Phone:

SBWC # Insurer Name Address Email

21737 RICHMOND

COLUMBIA SC 29210

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

13215 PORTLAND

MAITLAND FL 32751

Phone:

MANCHESTER NH 03104

Phone:

SBWC # Insurer Name Address Email

21446 SAVANNAH

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21675 MACON

888-741-2673 Ext.

CORE RISK MANAGEMENT

SERVICES

58-2314468 P O BOX 90 CONNIEW@COREMRG.COM

MEADOWS REGIONAL MEDICAL CENTER INC GA 30475 SHENDRIX@MEADOWSREGIONAL.ORG

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

800-448-9707 Ext.

MCLANE COMPANY INC 4747 MCLANE

PARKWAY, PO BOX 6115

TX 76503 MELANIE.BENNETT@MCLANECO.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

1120 15TH STREET, (CJ

2332)

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST ANNF@USCKY.COM

912-355-8929 Ext. 224

MEMORIAL HEALTH INC GA 31403 RAHNELL@MEMORIALHEALTH.COM

866-291-0194 Ext.

MEMIC INDEMNITY 02-0515329 1750 ELM STREET MHARMON@MEMIC.COM

800-660-1306 Ext. 612

MEMIC INDEMNITY COMPANY ME 04104 KSCHWARTZ@MEMIC.COM

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

800-426-2885 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

MEADWESTVACO VA 23219 KSB13@MEADWESTVACO.COM

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE JCONNOR@SEDGWICKCMS.COM

MERCER UNIVERSITY (THE CORPORATION OF) GA 31207 SMITH_CS@MERCER.EDU

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

912-355-8989 Ext.

MACON GA 31202

Phone:

SBWC # Insurer Name Address Email

13148 INDIANAPOLIS

GLEN ALLEN VA 23058

Phone:

INDIANAPOLIS IN 46206

Phone:

INDIANAPOLIS IN 46206

Phone:

SBWC # Insurer Name Address Email

21525 BIRMINGHAM

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10172 BLOOMFIELD

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13274 LANSING

ATLANTA GA 30319

Phone:

SARASOTA FL 34233

Phone:

LANSING MI 48917

Phone:

SBWC # Insurer Name Address Email

20502 NORCROSS

NORCROSS GA 30071

Phone:

800-777-7324 Ext.

MERIDIAN SECURITY

INSURANCE

35-1135866 P O BOX 7183 GLORIA-JEANNE.WILSON@STATEAUTO.COM

800-777-7324 Ext.

STATE AUTOMOBILE 31-4316080 2955 N MERIDIAN STREET GLORIA-JEANNE.WILSON@STATEAUTO.COM

800-906-4461 Ext.

MERIDIAN SECURITY INSURANCE CO IN 46208 MIKE.HOLMES@STATEAUTO.COM

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE MARCIA_MORGAN@CORVEL.COM

888-741-2673 Ext.

CORE RISK MANAGEMENT

SERVICES

58-2314468 P O BOX 90 CONNIEW@COREMRG.COM

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD ATLANTA.GA@US.CRAWCO.COM

-- Ext.

MICHIGAN COMMERCIAL

INSURANCE MUTUAL

38-3497412 4161 CLARK ROAD WRODRIGUEZ@MCIM.COM

MICHIGAN COMMERCIAL INSURANCE MUTUAL MI 48917 ESCHOBERT@MCIM.COM

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

METLIFE INSURANCE OF CONNECTICUT FKA

TRAVELERS INSURANCE CO

CT 06002 KDAVIS@TRAVELERS.COM

770-677-3423 Ext.

METALPLATE GALVANIZING AL 35201 MGREEN@METALPLATE.COM

PMA INS GROUP 23-1642962 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

678-447-0200 Ext. 302

MICROMERITICS INSTRUMENT CORPORATION GA 30093 JOANNE.MOCNY@MICROMERITIC.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

800-262-4743 Ext.

MICHIGAN COMMERCIAL

INSURANCE MUTUAL

38-3497412 1044 EASTBURY DRIVE WRODRIGUEZ@MCIM.COM

800-262-4743 Ext.

NASHVILLE TN 37214

Phone:

SBWC # Insurer Name Address Email

10222 STEVENS POINT

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

13292 KANSAS CITY

POMPANO BEACH FL 33064

Phone:

SBWC # Insurer Name Address Email

10104 CHESTERFIELD

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

TUCKER GA 30084

Phone:

AUBRUNDALE FL 33823

Phone:

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

13208 LOVELAND

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 WCCLAIMSEAST@SENTRY.COM

800-739-3344 Ext. 9063

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 WCCLAIMSEAST@SENTRY.COM

800-338-2487 Ext. 4616

MIDDLESEX INSURANCE COMPANY WI 54481 TOM.HERZOG@SENTRY.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 2501 MCGAVOCK PIKE SHARON.PROSSER@ASCRISK.COM

800-322-1276 Ext. 382

800-282-2460 Ext.

HERITAGE CONSULTANTS 59-2305659 209 PALMETTO STREET GGIST@FLORIDATPA.COM

800-354-6494 Ext. 201

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

MIDWEST EMPLOYERS CASUALTY 14755 NORTH OUTER

FORTY DR., SUITE 300

MO 63017 LALOISI@MWECC.COM

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

MIDWEST BUILDERS CASUALTY MUTUAL

COMPANY

1100 WALNUT STREET,

SUITE 3010

MO 64106 JCROWLEY@MWBC.COM

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 CHRISTINE.JONES@MONTGOMERY-INS.COM

MIDWESTERN INDEMNITY COMPANY OH 45140 CORPORATESECRETARY@LIBERTYMUTUA.COM

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 GHENEHAN@KEYRISK.COM

336-668-9050 Ext. 7539

21536 MILLEDGEVILLE

MILLEDGEVILLE GA 31059

Phone:

SBWC # Insurer Name Address Email

20410 JACKSONVILLE

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

13054 WARREN

ATLANTA GA 30305

Phone:

CINCINNATI OH 45202

Phone:

SBWC # Insurer Name Address Email

13233 WARREN

ATLANTA GA 30305

Phone:

SBWC # Insurer Name Address Email

20299 MONROE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13219 SARASOTA

SARASOTA FL 34232

Phone:

SARASOTA FL 34240

Phone:

SBWC # Insurer Name Address Email

21020 MAULDIN

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

21103 COLUMBUS

800-421-0710 Ext.

MILTON J WOOD COMPANY (MJW

CONSOLIDATED)

FL 32226 MWOOD@MJWOOD.COM

GA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GAADMINSVCS.COM

478-453-9496 Ext.

MILLEDGEVILLE CITY OF GA 31059 BOBBY@BBROWNINSURANCE.COM

MILLEDGEVILLE CITY OF 58-1467285 P O BOX 1599 BOBBY@BBROWNINSURANCE.COM

50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

MONROE CITY OF GA 30655

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE

MITSUI SUMITO MARINE 13-3429270 14 PIEDMONT CNT #415 PEASTERWOOD@MSIGUSA.COM

877-365-2299 Ext.

MITSUI SUMITOMO INSURANCE USA INC NJ 07059 BCURTIS@MSIGUSA.COM

MITSUI SUMITOMO MARINE

MANAGEMENT (USA) INC

22-3818012 312 ELM STREET

-- Ext.

877-365-2299 Ext.

MITSUI SUMITOMO INS. CO. OF AM NJ 07059 BCURTIS@MSIGUSA.COM

MITSUI SUMITO MARINE 13-3429270 14 PIEDMONT CNT #415 PEASTERWOOD@MSIGUSA.COM

MUSCOGEE COUNTY SCHOOL DISTRICT GA 31904 DNWALKER@MCSDGA.NET

800-845-2724 Ext. 43582

MOUNT VERNON MILLS SC 29662 GARYW@MVMILLS.COM

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 WCMAIL@COMPANIONGROUP.COM

800-226-3243 Ext. 5729

FCCI SERVICES INC 59-1968027 6300 UNIVERSITY FCCICLAIMSEDI@FCCI-GROUP.COM

800-226-3243 Ext. 5729

MONROE GUARANTY INSURANCE COMP FL 34240 COMPLIANCEDEPT@FCCI-GROUP.COM

FCCI SERVICES 59-1968027 P O BOX 58004 FCCICLAIMSEDI@FCCI-GROUP.COM

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21701 LAVONIA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

12081 CHANDLER

CHANDLER OK 74834

Phone:

SBWC # Insurer Name Address Email

10115 CHICAGO

DULUTH GA 30096

Phone:

CHICAGO IL 60604

Phone:

DUBUQUE IA 52004

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

12088 OMAHA

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13184 RICHFIELD

DALTON GA 30722

Phone:

CHATTANOOGA TN 37405

Phone:

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

800-224-9524 Ext.

312-822-2331 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

877-241-6121 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

800-283-2318 Ext. 3574

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH GASTATEICNUMBERS@CNA.COM

NATIONAL FIRE INS COMPANY OF HARTFORD 3333 S WABASH AVENUE,

28 SOUTH

IL 60604 GASTATEICNUMBERS@CNA.COM

LMCGREGOR@NAICO.COM

800-332-2210 Ext.

NATIONAL AMERICAN INSURANCE COMPANY OK 74834

NATIONAL AMERICAN INS 47-0247300 1010 MANVEL AVENUE

888-888-8136 Ext.

NASH JOHNSON & SONS FARMS INC GA 30553 DEB.WHITLEY@HOUSEOFRAEFORD.COM

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

423-265-0541 Ext.

COLLINS & COMPANY 62-0882150 P O BOX 6429 AGRIME@COLLINSANDCO.COM

706-277-1253 Ext.

COLLINS & COMPANY 62-0882150 555 RIVER ST SBIBLE@COLLINSANDCO.COM

NATIONAL INTERSTATE INSURANCE COMPANY OH 44286 KATHY.JUHASZ@NATL.COM

CYPRESS INSURANCE 95-6042929 1725 WINDWARD

CONCOURSE

CBARNES@BHHC.COM

877-212-3816 Ext. 230

NATIONAL INDEMNITY COMPANY NE 68131 LRRU@NATIONALINDEMNITY.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

ATLANTA GA 31139

Phone:

SBWC # Insurer Name Address Email

13047 OMAHA

MONTGOMERY AL 36123

Phone:

SBWC # Insurer Name Address Email

10117 NOVATO

ATLANTA GA 30374

Phone:

ALPHARETTA GA 30022

Phone:

SBWC # Insurer Name Address Email

13061 SARASOTA

SARASOTA FL 34232

Phone:

SARASOTA FL 34240

Phone:

SBWC # Insurer Name Address Email

10118 NEW YORK

NORCROSS GA 30071

Phone:

BIRMINGHAM AL 35209

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ALPHARETTA GA 30023

Phone:

ROSWELL GA 30076

COLLINS AND COMPANY 62-0882150 P O BOX 723783 ATLANTA@COLLINSANDCO.COM

770-434-9222 Ext.

NATIONAL TRUST INSURANCE COMPANY FL 34240 COMPLIANCEDEPT@FCCI-GROUP.COM

FCCI SERVICES 59-1968027 P O BOX 58004 FCCICLAIMSEDI@FCCI-GROUP.COM

678-393-4584 Ext.

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174 KLOCKE@FFIC.COM

678-393-4550 Ext.

FIREMAN'S FUND

INSURANCE CO

94-1610280 11475 GREAT OAKS WAY JUDY.OWEN@AFFIC.COM

NATIONAL SURETY CORPORATION CA 94998 LMUNSON@FFIC.COM

ASSOCIATED INSURANCE

ADMINISTRATORS

63-1103582 P O BOX 230848 CDAIL@ACAWORKCOMP.COM

800-388-6268 Ext.

NATIONAL LIABILITY & FIRE INSURANCE

COMPANY

NE 68131 STRPTGA@NATIONALINDEMNITY.COM

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

800-448-9707 Ext.

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

800-235-1134 Ext. 5

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

800-277-7500 Ext. 29106

678-447-0200 Ext. 302

NATIONAL UNION FIRE INSURANCE COMPANY

OF PITTSBURGH PA

175 WATER STREET,

18TH FLOOR

NY 10038 ALGAWCFR@AIG.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

800-226-3243 Ext. 5729

FCCI SERVICES INC 59-1968027 6300 UNIVERSITY FCCICLAIMSEDI@FCCI-GROUP.COM

800-226-3243 Ext. 5729

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

Phone:

MANDEVILLE LA 70471

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13143 DES MOINES

DES MOINES IA 50391

Phone:

SBWC # Insurer Name Address Email

12021 COLUMBUS

GAINESVILLE FL 32614

Phone:

SBWC # Insurer Name Address Email

10119 COLUMBUS

GAINESVILLE FL 32614

Phone:

SBWC # Insurer Name Address Email

13015 COLUMBUS

GAINESVILLE FL 32614

Phone:

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

ATLANTA.GA@SEDGWICKCMS.COM

678-628-1318 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 FERRANT@NATIONWIDE.COM

800-985-7078 Ext.

NATIONWIDE MUTUAL INS CO ONE NATIONWIDE

PLAZA, 3-13-401

OH 43215 KINGJ4@NATIONWIDE.COM

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 FERRANT@NATIONWIDE.COM

800-985-7078 Ext.

NATIONWIDE MUTUAL FIRE INS CO OH 43215 KINGJ4@NATIONWIDE.COM

NATIONWIDE AGRIBUSINESS 42-1015537 1100 LOCUST ST. NEWCLAIM@NATIONWIDE.COM

800-532-1436 Ext. 4344

NATIONWIDE AGRIBUSINESS 1100 LOCUST ST., DEPT

3030

IA 50391 NEWCLAIM@NATIONWIDE.COM

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

800-985-7078 Ext.

NATIONWIDE PROPERTY AND CASUALTY

INSURANCE CO

OH 43215 KINGJ4@NATIONWIDE.COM

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 FERRANT@NATIONWIDE.COM

SBWC # Insurer Name Address Email

13045 KEENE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

10122 NEW YORK

NORCROSS GA 30071

Phone:

BIRMINGHAM AL 35209

Phone:

SBWC # Insurer Name Address Email

10122 NEW YORK

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

MAITLAND FL 32751

Phone:

ALPHARETTA GA 30023

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33612

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

678-447-0200 Ext. 302

NEW HAMPSHIRE INSURANCE CO 175 WATER STREET,

18TH FLOOR

NY 10038 ALGAWCFR@AIG.COM

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 CHRISTINE.JONES@MONTGOMERY-INS.COM

NETHERLANDS INS CO NH 03431 CORPORATESECRETARY@LIBERTYMUTUAL.COM

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

866-291-0194 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

800-235-1134 Ext. 5

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

800-277-7500 Ext. 20104

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

NEW HAMPSHIRE INSURANCE CO 175 WATER STREET,

18TH FLOOR

NY 10038 ALGAWCFR@AIG.COM

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA CMULLINS@AVIZENTRISK.COM

770-352-2978 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR GEORGIAWCBOARD@TRAVELERS.COM

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

CHARTIS CLAIMS 13-2925174 P O BOX 1821 ALGAWCFR@AIG.COM

800-448-9707 Ext.

Phone:

FT SMITH AR 72919

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

CLEARWATER FL 33758

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

877-241-6121 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 1000 FIANA WAY MJWHITE@TRAVELERS.COM

800-842-5612 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

770-934-3414 Ext.

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-473-9009 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 KRISTY_SANDS@GBTPA.COM

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 HEATHER.STANFORD@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

800-532-7706 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 KIM_BUCHANAN@GBTPA.COM

800-226-8002 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

LEXINGTON KY 40512

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13294 NEW YORK

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

20601 COVINGTON

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

12040 HARTFORD

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

ATLANTA.GA@SEDGWICKCMS.COM

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-282-6218 Ext.

NEWTON COUNTY BOARD OF EDUCATION GA 30015 WILLIAMS.SHERRI@NEWTON.K12.GA.US

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

NEW YORK MARINE & GENERAL INSURANCE

COMPANY

919 3RD AVENUE, 10TH

FLOOR

NY 10022 CMCAULEY@PROSIGHTSPECIALTY.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 DANIELLE.MINNIEHAN@SRSCONNECT.COM

800-541-0139 Ext. 35832

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

NIPPONKOA INSURANCE

COMPANY LIMITED (U S

BRANCH)

98-0032627 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

NIPPONKOA INSURANCE

COMPANY LIMITED (U S

BRANCH)

98-0032627 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

NIPPONKOA INS CO LTD (US BRANCH) CT 06183

XCALIBRE RISK SERVICES 26-4197853 4370 PEACHTREE ROAD NE JMARSHBURN@ATLAM.COM

404-266-5749 Ext.

Phone:

SBWC # Insurer Name Address Email

13101 WASHINGTON

WASHINGTON DC 20004

Phone:

SBWC # Insurer Name Address Email

21643 AMHERST

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

21679 SEATTLE

SANTA ANA CA 92799

Phone:

SBWC # Insurer Name Address Email

13169 WILKES-BARRE

WILKES-BARRE PA 18703

Phone:

WILKES-BARRE PA 18703

Phone:

TOWSON MD 21204

Phone:

SBWC # Insurer Name Address Email

20591 CLAXTON

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

13001 MANCHESTER

ATLANTA GA 30319

Phone:

FT MILL SC 29716

NORDSON CORPORATION OH 44001 MDOYLE@NORDSON.COM

NLC Mutual Insurance Company 52-1479893 1301 PENNSYLVANIA AVE GERGEN@NLCMUTUAL.COM

202-626-3162 Ext.

NLC MUTUAL INSURANCE COMPANY 1301 PENNSYLVANIA

AVENUE NW, #550

DC 20004 MMCCORD@NLCMUTUAL.COM

888-329-6259 Ext.

NIPPONKOA INSURANCE

COMPANY LIMITED (U S

BRANCH)

800-673-2465 Ext. 8110

GUARD INSURANCE GROUP 23-2240322 P O BOX A - H CLAIMS3@GUARD.COM

800-673-2465 Ext. 8110

NORGUARD INSURANCE COMPANY PA 18703 ESOLA@GUARD.COM

AMGUARD 23-2240321 P O Box 1368 CLAIMS3@GUARD.COM

877-275-7475 Ext.

NORDSTROM INC WA 98111 DEBBIE.BORDEAUX@NORDSTROM.COM

NORDSTROM 91-0515058 P O BOX 25799 STEVE.TOLAN@NORDSTROM.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE JULIE_MCCOY-LINCOLN@GBTPA.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

NORTH AMERICAN SPECIALTY INSURANCE NH 03101 MARILYN_WRIGHT@SWISSRE.COM

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

NORMAN W. FRIES INC dba CLAXTON POULTRY GA 30417 BOB_GUNNELS@CLAXTONPOULTRY.COM

800-673-2465 Ext. 8302

GUARD INSURANCE GROUP 23-2240322 102 WEST PENNSYLVANIA

AVE

CLAIMS3@GUARD.COM

Phone:

SBWC # Insurer Name Address Email

10125 MORRISTOWN

LAKE MARY FL 32795

Phone:

SBWC # Insurer Name Address Email

12026 NORTHBROOK

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21388 GAINESVILLE

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

10126 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

10209 SCHAMBURG

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

SCHAUMBERG IL 60666

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21259 ATLANTA

GALLAGHER BASSETT

SERVICES INC

866-814-1740 Ext. 201

NORTHERN ASSURANCE COMPANY OF

AMERICA

MA 02081 SHOLLAND@ONEBEACON.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

678-447-0200 Ext. 302

NORTHEAST GEORGIA HEALTH SYSTEM INC GA 30501 CYNTHIA.TABUE@NGHS.COM

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

NORTHBROOK INDEMNITY INSURANCE CO IL 60062

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

800-423-3060 Ext. 6301

UNITED STATES FIRE

INSURANCE COMPANY

13-5459190 1064 GREENWOOD BLVD DENVER_CHEEK@CFINS.COM

NORTH RIVER INSURANCE COMPANY NJ 07962 GEORGE_ROBERTS@CFINS.COM

NORTHSIDE HEALTH SERVICES INC GA 30342 SUSAN.SOMMERS@NORTHSIDE.COM

404-851-3208 Ext.

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

ZURICH NORTH AMERICA 36-3839542 P.O. BOX 2769 USZ_GA_WC_CLAIM_NOTICES@ZURICHNA.COM

404-851-3601 Ext.

NORTHERN INSURANCE

COMPANY OF NEW YORK

13-5283360 1900 SUMMIT TOWER CHRIS.CALLOWAY@ZURICHNA.COM

404-851-3207 Ext.

NORTHERN INSURANCE COMPANY OF NEW

YORK

IL 60196 TIM.GRAHAM@ZURICHNA.COM

NORTHERN INSURANCE

COMPANY OF NEW YORK

13-5283360 3003 SUMMIT BLVD CHRIS.CALLOWAY@ZURICHNA.COM

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 DDAVENPORT@ONEBEACON.COM

800-203-9600 Ext. 9706

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13288 BUFFALO

TUCKER GA 30084

Phone:

ATLANTA GA 30328

Phone:

PARSIPPANY NJ 07054

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

10212 FAIRFIELD

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

12093 WESTFIELD

CENTERDULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13147 FAIRFIELD

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21062 THOMASVILLE

POMPANO BEACH FL 33064

Phone:

SBWC # Insurer Name Address Email

OHIO CASUALTY INS CO OH 45014 CORPORATESECRETARY@LIBERTYMUTUAL.COM

YORK CLAIMS SERVICE INC 13-1963636 1117 PERIMETER CENTER

WEST

GEORGE.NAJIM@YORKCLAIMS.COM

678-225-2284 Ext.

888-888-8136 Ext.

YORK CLAIMS SERVICE INC 13-1963636 99 CHERRY HILL ROAD STEPHANIE.MARSHALL@YORKRSG.COMM

877-927-2255 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

NOVA CASUALTY COMPANY 726 EXCHANGE STREET,

STE 1020

NY 14210 MSTARSKI@AIXGROUP.COM

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

877-295-0011 Ext.

OLD DOMINION FREIGHT LINE INC NC 27360 KATRENA.PARKER@OLDFL.COM

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 CHRISTINE.JONES@MONTGOMERY-INS.COM

800-334-0078 Ext. 214

OHIO SECURITY INSURANCE CO OH 45014 CORPORATESECRETARY@LIBERTYMUTUAL.COM

WESTFIELD INSURANCE

GROUP

34-6516838 3505 KROGER BLVD MARKKWIATKOWSKI@WESTFIELDGRP.COM

800-685-4604 Ext. 222

OHIO FARMERS INSURANCE CO OH 44251 DONBRATTON@WESTFIELDGRP.COM

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 CHRISTINE.JONES@MONTGOMERY-INS.COM

13032 JACKSONVILLE

SYRACUSE NY 13212

Phone:

SBWC # Insurer Name Address Email

12058 GREENSBURG

ATLANTA GA 30319

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

10129 GREENSBURG

ALPHARETTA GA 30005

Phone:

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

MAITLAND FL 32751

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30356

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-450-0692 Ext.

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 KRISTY_SANDS@GBTPA.COM

800-473-9009 Ext.

OLD REPUBLIC GENERAL INSURANCE

CORPORATION

PA 15601 E.STROKA@ORINSCO.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

315-434-1450 Ext.

OLD DOMINION INSURANCE

COMPANY

59-2070420 P O BOX 4828 KILLGOREK@MSAGROUP.COM

OLD DOMINION INS CO 4601 TOUCHTON ROAD

EAST, SUITE 3400

FL 32245 FOXB@MSAGROUP.COM

866-291-0194 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

800-235-1134 Ext. 5

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

800-247-2656 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

OLD REPUBLIC INSURANCE COMPANY PA 15601 J.ROBINSON@ORINSCO.COM

BERKLEY RISK

ADMINISTRATORS

22-2235730 3655 NORTH POINT

PARKWAY

TGARRISON@BERKLEYRISK.COM

678-942-7300 Ext.

CUSTARD INSURANCE

ADJUSTERS

- P O BOX 888385 MADKINS@CUSTARD.COM

CORVEL 42-1704550 2905 PREMIER PARKWAY SHERRE_KAHRS@CORVEL.COM

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

BIRMINGHAM AL 35266

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

LAKE MARY FL 32746

Phone:

SAVANNAH GA 31405

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 KRISTY_SANDS@GBTPA.COM

800-473-9009 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

770-551-2070 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

ATLANTA.GA@SEDGWICKCMS.COM

678-628-1318 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY CHRIS_ROCK@GBTPA.COM

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-541-0139 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

770-901-3121 Ext.

Phone:

SBWC # Insurer Name Address Email

13028 CHICAGO

TUCKER GA 30084

Phone:

CHICAGO IL 60601

Phone:

SBWC # Insurer Name Address Email

13197 CANTON

DULUTH GA 30096

Phone:

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

13199 CANTON

DULUTH GA 30096

Phone:

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

13131 CANTON

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13196 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

21468 TOLEDO

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

800-354-6494 Ext. 201

OLD REPUBLIC UNION

INSURANCE

36-3765116 307 N MICHIGAN AVE

800-621-0365 Ext.

OLD REPUBLIC UNION INS IL 60601 ORIACCOUNTING@OLDREPUBLIC.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

912-355-8989 Ext.

ONEBEACON MIDWEST INS CO FKA

COMMERICAL UNION MIDWEST INS

MA 02021

MONTGOMERY INSURANCE - 3555 KOGER BLVD.

DDAVENPORT@ONEBEACON.COM

800-203-9600 Ext. 9706

800-762-5573 Ext.

ONEBEACON INSURANCE 23-1502700 P O BOX 9155

ONEBEACON INSURANCE CO. MA 02021 SHOLLAND@ONEBEACON.COM

MONTGOMERY INSURANCE - 3555 KOGER BLVD.

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 DDAVENPORT@ONEBEACON.COM

800-203-9600 Ext. 9706

MONTGOMERY INSURANCE - 3555 KOGER BLVD.

800-762-5573 Ext.

ONEBEACON AMERICAN INS CO MA 02021 SHOLLAND@ONEBEACON.COM

800-354-6494 Ext. 201

OWENS CORNING ONE OWENS CORNING

PARKWAY, 2G

OH 43659 CAROL.OSINSKI@OWENSCORNING.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 DDAVENPORT@ONEBEACON.COM

800-203-9600 Ext. 9706

ONEBEACON MIDWEST INS. CO. MA 02021 SHOLLAND@ONEBEACON.COM

800-762-5573 Ext.

20814 PERRYSBURG

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13004 LANSING

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

21717 ALBANY

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

10130 PHILADELPHIA

LITTLE ROCK AZ 72231

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10132 WARREN

ATLANTA GA 30326

Phone:

TUCKER GA 30084

Phone:

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

OWENS ILLINOIS INC ONE O-I PLAZA, ONE

MICHAEL OWENS WAY

OH 43551 THAD.FRANKLIN@O-I.COM

800-685-7361 Ext.

ALTERNATIVE SERVICE

CONCEPTS LLC

43-1954328 P O BOX 15550 JAMES.CHANCELLOR@ASCRISK.COM

800-669-0437 Ext. 108

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

PACIFIC EMPLOYERS INSURANCE COMPANY 436 WALNUT STREET,

WB04G

PA 19106 MARILEE.BRABSON@ACEGROUP.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

OXFORD CONSTRUCTION COMPANY GA 31707 KMILLER@OXFORDCONSTRUCTION.COM

AUTO OWNERS INSURANCE

CO

38-0315280 P O BOX 100044 GEORGIAWORKCOMP.CLM@AOINS.COM

770-931-7766 Ext. 201

OWNERS INSURANCE COMPANY MI 48917 FISHER.BRUCE@AOINS.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE KPILZ@CHUBB.COM

404-266-4855 Ext.

PACIFIC INDEMNITY COMPANY NJ 07061 PREMIUMTAXGROUP@CHUBB.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

615-824-5095 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

DULUTH GA 30097

Phone:

ATLANTA GA 30326

Phone:

ATLANTA GA 30326

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20457 CLEVELAND

SAVANNAH GA 31405

Phone: 912-355-8989 Ext.

SBWC # Insurer Name Email

10247 STEVENS POINT

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

21553 TOCCOA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21327 DOUGLAS

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

10029 WARRENVILLE

CHARLOTTE NC 28277

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 WCCLAIMSEAST@SENTRY.COM

800-338-2487 Ext. 4616

PATRIOT GENERAL INSURANCE COMPANY WI 54481 TOM.HERZOG@SENTRY.COM

Address

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

PARKER HANNIFIN CORP OH 44124 CGROSS@PARKER.COM

770-901-3121 Ext.

PACIFIC INDEMNITY

INSURANCE

95-1078160 2 LIVE OAK CENTER SUITE

900

KPILZ@CHUBB.COM

404-266-4127 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

866-246-0259 Ext.

PACIFIC INDEMNITY 95-1078160 3445 PEACHTREE RD KPILZ@CHUBB.COM

404-266-4127 Ext.

PEERLESS INDEMNITY INSURANCE COMPANY 27201 BELLA VISTA

PARKWAY, SUITE 130

IL 60555 CORPORATESECRETARY@LIBERTYMUTUAL.COM

912-355-8929 Ext. 224

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

912-355-8989 Ext.

PCC AIRFOILS INC GA 31535 JOHN.HALLISEY@PCCDOUGLAS.COM

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST ANNF@USCKY.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

PATTERSON PUMP COMPANY GA 30577 SHARBIN@PATTERSONPUMPS.COM

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 WCCLAIMSEAST@SENTRY.COM

800-739-3344 Ext. 9063

CHRISTINE.JONES@MONTGOMERY-INS.COMMONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130

Phone:

SBWC # Insurer Name Address Email

10134 KEENE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

10291 WILKES BARRE

ATLANTA GA 31139

Phone:

SBWC # Insurer Name Address Email

13280 BALA CYNWYD

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13198 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

12074 PHILADELPHIA

ATLANTA GA 30350

Phone:

SBWC # Insurer Name Address Email

12009 BLUE BELL

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13138 BLUE BELL

PENN STAR INSURANCE THREE BALA PLAZA

EAST, SUITE 300

PA 19004 GSEGELKEN@UAI-GROUP.COM

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

770-434-9222 Ext.

PENN MILLERS INSURANCE PA 18773 MMARRA@PENNMILLERS.COM

COLLINS AND COMPANY 62-0882150 P O BOX 723783 ATLANTA@COLLINSANDCO.COM

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 CHRISTINE.JONES@MONTGOMERY-INS.COM

PEERLESS INSURANCE CO NH 03431 CORPORATESECRETARY@LIBERTYMUTUAL.COM

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

888-888-8136 Ext.

PENNSYLVANIA MANUFACTURERS ASSN INS CO PA 19422 STEPHEN_GARTNER@PMAGROUP.COM

PENNSYLVANIA

MANUFACTURERS

INDEMNITY

23-1642962 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

800-621-1313 Ext.

PENNSYLVANIA LUMBERMENS MUTUAL

INSURANCE CO

ONE COMMERCE

SQUARE, 2005 MARKET

ST, STE 1200

PA 19103 HJAMISON@PLMINS.COM

TENCO SERVICES 62-0449213 8735 DUNWOODY PL BSHARPE@TENCO.COM

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 DDAVENPORT@ONEBEACON.COM

800-203-9600 Ext. 9706

PENNSYLVANIA GENERAL INS CO MA 02028 SHOLLAND@ONEBEACON.COM

800-347-4494 Ext.

PENNSYLVANIA MANUFACTURERS INDEMNITY

CO

PA 19422 STEPHEN_GARTNER@PMAGROUP.COM

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10136 HARRISBURG

ATLANTA GA 30319

Phone:

GREENSBORO NC 27405

Phone:

SBWC # Insurer Name Address Email

10285 HOUSTON

FAIRFAX VA 22037

Phone:

SBWC # Insurer Name Address Email

13257 ALGONA

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

SBWC # Insurer Name Address Email

21292 ALBANY

OWING MILLS MD 21117

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

SBWC # Insurer Name Address Email

10138 HARTFORD

DULUTH GA 30097

888-975-2667 Ext.

EXXON MOBIL RISK

MANAGEMENT INC.

76-0006056 3225 GALLOWS ROAD MONICA.A.PARATONE@EXXONMOBILE.COM

PETROLEUM CASUALTY COMPANY TX 77253 BARBARA.L.HOOPER@EXXONMOBIL.COM

PENNSYLVANIA NATIONAL

MUTUAL CASUALTY

23-0961349 1703 E WENDOUR AVENUE

800-877-7366 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

PENNSYLVANIA NAT MUT CAS PA 17105 DAUSTIN@PNAT.COM

888-888-8136 Ext.

PENNSYLVANIA

MANUFACTURERS

INDEMNITY

23-1642962 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

866-654-4001 Ext.

MATRIX ABSENCE 77-0493584 11221 N 28TH DRIVE EDICOORDINATOR@MATRIXCOS.COM

800-866-2301 Ext.

PHOEBE PUTNEY HEALTH SYSTEM INC GA 31707 DWALKER@PPMH.ORG

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

PHARMACISTS MUTUAL INSURANCE CO 808 HIGHWAY 18 WEST,

PO BOX 370

IA 50511 LISA.MOLSBERRY@PHMIC.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

PHOENIX INSURANCE COMPANY CT 06183 KDAVIS@TRAVELERS.COM

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

CHARLOTTE NC 28226

Phone:

SBWC # Insurer Name Address Email

21237 ATLANTA

ATLANTA GA 30309

Phone:

SBWC # Insurer Name Address Email

21622 CHARLESTON

CHARLOTTE NC 28226

Phone:

SBWC # Insurer Name Address Email

21728 KNOXVILLE

KNOXVILLE TN 37939

Phone:

SBWC # Insurer Name Address Email

20454 ALLISON PARK

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

13251 NEW YORK

ATLANTA GA 30366

Phone:

SBWC # Insurer Name Address Email

13141 OMAHA

PIEDMONT MEDICAL 58-1503902 1968 PEACHTREE RD NW CATHERINE.SWEELEY@PIEDMONT.ORG

404-605-3614 Ext.

PIEDMONT HEALTHCARE GA 30309 CATHERINE.SWEELEY@PIEDMONT.ORG

PHOENIX INSURANCE

COMPANY

06-0303275 11440 CARMEL COMMONS

BLVD

CMHARRIS1@TRAVELERS.COM

800-759-6194 Ext. 3298

800-238-6214 Ext.

PHOENIX INSURANCE

COMPANY

06-0303275 BUILDING V SUITE 200 DBRYSON@TRAVELERS.COM

888-487-3492 Ext.

866-246-0259 Ext.

PHOENIX INSURANCE

COMPANY

06-0303275 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-338-2487 Ext. 4616

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 WCCLAIMSEAST@SENTRY.COM

800-739-3344 Ext. 9063

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 WCCLAIMSEAST@SENTRY.COM

PPG INDUSTRIES INC 4325 ROSANNA DRIVE,

BLDG C

PA 15101 CGRECO@PPG.COM

PILOT CORPORATION 34-1953155 P O BOX 10146 CONNIE.PARKS@PILOTTRAVELCENTERS.COM

800-562-6210 Ext.

PILOT TRAVEL CENTERS LLC TN 37939 DON.GRAHAM@PILOTTRAVELCENTERS.COM

CONSTITUTION STATE

SERVICES LLC

06-1501229 11440 CARMEL COMMONS

BLVD

BBIFARO@TRAVELERS.COM

800-759-6194 Ext. 3353

PIGGLY WIGGLY CAROLINA COMPANY INC 176 CROGHAN SPUR

ROAD, STE 301

SC 29407 DOLLYDROZE@THEPIG.NET

PREFERRED PROFESSIONAL INS CO 11605 MIRACLE HILLS

DRIVE, SUITE 200

NE 68154 COMPLIANCE@PPICINS.COM

800-772-8427 Ext.

PRAETORIAN INSURANCE CO NY 10005 MBLAKE@PFGI.COM

ADJUSTMENT SERVICES INC. 58-1623664 P O BOX 81306 SHARON@ADJUSTMENTSERVICES.COM

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

MANDEVILLE LA 70471

Phone:

BRENTWOOD TN 37027

Phone:

SBWC # Insurer Name Address Email

13226 MURFREESBORO

POMPANO BEACH FL 33064

Phone:

SBWC # Insurer Name Address Email

21712 AUSTELL

ATLANTA GA 30366

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21567 ATLANTA

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13084 BIRMINGHAM

227414 ATLANTA GA 30350

Phone:

SBWC # Insurer Name Address Email

21449 CINCINNATI

CINCINNATI OH 45224

PREMIER GROUP INSURANCE COMPANY TN 37130 DHESTER@PREMIERGROUPINS.COM

F A RICHARD (FARA) 72-0837383 7000 EXECUTIVE CENTER

DRIVE

GEORGIA.NOTICES@FARA.COM

800-675-2771 Ext. 225

-- Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD ATLANTA.GA@US.CRAWCO.COM

11605 MIRACLE HILLS

DRIVE, SUITE 200

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

PRINTPACK INC GA 30339 DKENNY@PRINTPACK.COM

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

404-266-5749 Ext.

ADJUSTMENT SERVICES INC. 58-1623664 P O BOX 81306 SHARON@ADJUSTMENTSERVICES.COM

800-772-8427 Ext.

SELF-INSURANCE

ADMINISTRATORS (SIA)

58-1870166 4370 PEACHTREE ROAD NE JMARSHBURN@ATLAM.COM

PRESBYTERIAN HOMES OF GEORGIA INC GA 30106 GHARDY@PHGAINC.ORG

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

PROCTER & GAMBLE CO 5299 SPRING GROVE

AVENUE, BOX 209

OH 45217 BOWLING.CA@PG.COM

800-621-1313 Ext.

PROASSURANCE INDEMNITY COMPANY INC SUITE 500, 100

BROOKWOOD PLACE

AL 35209 LGOODWIN@PROASSURANCE.COM

TENCO SERVICES 62-0449213 8735 DUNWOODY PL BSHARPE@TENCO.COM

Phone:

SBWC # Insurer Name Address Email

13094 HARTFORD

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

Phone:

NASHVILLE TN 37214

Phone:

SBWC # Insurer Name Address Email

13094 HARTFORD

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

PROPERTY & CASUALTY INSURANCE COMPANY

OF HARTFORD

CT 06155

800-235-1134 Ext. 5

615-824-5095 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

PROPERTY & CASUALTY INSURANCE COMPANY

OF HARTFORD

CT 06155

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW

Phone:

SBWC # Insurer Name Address Email

10266 INDIANAPOLIS

GLEN ALLEN VA 23058

Phone:

INDIANAPOLIS IN 46207

Phone:

SBWC # Insurer Name Address Email

12054 ST. LOUIS

227399 FRAZER PA 19355

Phone:

SBWC # Insurer Name Address Email

10142 NEW YORK

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

10042 DENVER

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

21706 TULSA

228406 TULSA OK 74101

Phone:

SBWC # Insurer Name Address Email

20350 ATLANTA

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21772 JACKSONVILLE

ROSWELL GA 30076

800-644-5501 Ext. 6573

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE MARCIA_MORGAN@CORVEL.COM

800-906-4461 Ext.

PROTECTIVE INSURANCE 35-6021485 PO BOX 7099 GEORGIACLAIMNOTIFICATIONS@PROTECTIVEINSURANC

E.COM

PROTECTIVE INSURANCE CO IN 46204 GEORGIACLAIMNOTIFICATIONS@PROTECTIVEINSURA

NCE.COM

407-562-3632 Ext.

QUIKTRIP CORPORATION 73-0675375 P O BOX 3475 SPHIPPS@QUIKTRIP.COM

918-615-7754 Ext.

QUIKTRIP CORPORATION OK 74101 JDYE@QUIKTRIP.COM

ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

QUANTA INDEMNITY COMPANY FKA NATIONAL

FARMERS UNION STANDARD

1125 17TH STREET,

SUITE 600

CO 80202

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

MREVELLE@ASG-ADJ.COM

800-580-6912 Ext.

PUBLIC SERVICE MUTUAL INSURANCE CO NY 10016 NROTHSTEIN@MCCARTA.COM

-- Ext.

PROVIDIAN AUTO & HOME MO 63146

PROVIDIAN AUTO & HOME - 20 MOORES ROAD

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

RAYONIER INC 1301 RIVERPLACE BLVD,

SUITE 2300

FL 32207 MICHAEL.FOUNTAIN@RAYONIER.COM

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

RACETRAC PETROLEUM INC 3225 CUMBERLAND

BLVD, SUITE 100

GA 30339 LWILLIAMS@RACETRAC.COM

Phone:

SBWC # Insurer Name Address Email

10055 SUN PRAIRIE

ATLANTA GA 31145

Phone:

SBWC # Insurer Name Address Email

21771 BIRMINGHAM

BIRMINGHAM AL 35209

Phone:

SBWC # Insurer Name Address Email

13031 NEW HARTFORD

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

20920 AUGUSTA

AUGUSTA GA 30901

Phone:

SBWC # Insurer Name Address Email

21671 RIVERDALE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13269 MINNEAPOLIS

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13227 CLEVELAND

REGIONS FINANCIAL CORPORATION 1900 5TH AVENUE

NORTH, ALBH10901B

AL 35203 SUZY.BRADEN@REGIONS.COM

SHARON.STARKS@US.QBE.COM

770-493-1931 Ext.

GENERAL CASUALTY

COMPANY OF WISCONSIN

39-0301590 P O BOX 450409

REGENT INSURANCE CO WI 53596 REGULATORYCOMPLIANCE@GENERALCASUALTY.CO

M

800-685-7361 Ext.

RIVERDALE CITY OF GA 30274 ASMITH@RIVERDALEGA.GOV

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

706-826-1010 Ext.

RICHMOND COUNTY BD OF ED 864 BROAD ST, 2ND

FLOOR #208

GA 30901 WILLIJU@BOE.RICHMOND.K12.GA.US

RICHMOND COUNTY BD OF 58-6000310 864 BROAD ST LABBRC1@BOE.RICHMOND.K12.GA.US

770-510-4100 Ext.

REPUBLIC FRANKLIN INSURANCE COMPANY NY 13413 WORKERSCOMPMAIL@UTICANATIONAL.COM

REPUBLIC-FRANKLIN

INSURANCE COMPANY

31-4290270 1040 CROWN POINT

PARKWAY

WORKERSCOMPMAIL@UTICANATIONAL.COM

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

ROCHDALE INSURANCE COMPANY 5800 LOMBARDO

CENTER, STE 200

OH 44131 CATHY.MAXIN@AMTRUSTGROUP.COM

800-366-1511 Ext. 7732

RIVERPORT INSURANCE COMPANY 222 SOUTH NINTH

STREET, SUITE 1300

MN 55402 EGERBER@RIVERPORTINSURANCE.COM

KEY RISK MANAGEMENT

SERVICES LLC

56-1800954 3655 NORTH POINT PKWY JDUGGINS@KEYRISK.COM

678-258-8000 Ext.

JOHNS CREEK GA 30097

Phone:

BIRMINGHAM AL 35209

Phone:

MANDEVILLE LA 70471

Phone:

FRANKLIN TN 37067

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

20602 CONYERS

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

20862 ATLANTA

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

21441 LAFAYETTE

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

21773 ROSEBURG

MAITLAND FL 32751

Phone:

SBWC # Insurer Name Address Email

20520 ROSWELL

ATLANTA GA 30328

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

800-277-7500 Ext. 29106

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

ROLLINS INC GA 30324 KNAGY@ROLLINSCORP.COM

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-845-2724 Ext. 43582

ROCKDALE COUNTY BOARD OF EDUCATION GA 30012 BBONTRAGER@ROCKDALE.K12.GA.US

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 WCMAIL@COMPANIONGROUP.COM

800-304-5035 Ext.

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY JTHOMAS@SYNERGYINSURANCE.NET

866-710-0908 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

KM@JOHNSTONANDASSOC.COM

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

ROSWELL CITY OF GA 30075

866-291-0194 Ext.

ROSEBURG FOREST PRODUCTS COMPANY OR 97470 LISAF@RFPCO.COM

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

800-884-1535 Ext.

ROPER CORPORATION GA 30728 BETH.NARMORE@GE.COM

COLLINS & COMPANY 62-0882150 555 RIVER STREET AGRIME@COLLINSANDCO.COM

Phone:

SBWC # Insurer Name Address Email

10226 CHARLOTTE

CHARLOTTE NC 28219

Phone:

SBWC # Insurer Name Address Email

21656 ATLANTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

21500 MARYVILLE

TUCKER GA 30084

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20945 ALPHARETTA

227900 ALPHARETTA GA 30023

Phone:

SBWC # Insurer Name Address Email

10274 SEATTLE

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13092 HOFFMAN

ESTATES

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13187 ST LOUIS

NORCROSS GA 30010

Phone:

ROYAL & SUNALLIANCE INS.

CO

- P O BOX 19809

866-227-1500 Ext.

ROYAL & SUNALLIANCE INSURANCE CO NC 28219

PMA MANAGEMENT

CORPORATION

888-888-8136 Ext.

800-695-0359 Ext.

RYDER SYSTEM INC GA 30023 GPITZ@RYDER.COM

RYDER SYSTEM INC 59-2305021 P O BOX 2370 DEBBIE.L.BREISACHER@RYDER.COM

770-901-3124 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY BETH.RODEE@SRSCONNECT.COM

RUBY TUESDAY INC TN 37801 MBARRETT@RUBYTUESDAY.COM

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY BETH.RODEE@SRSCONNECT.COM

770-901-3124 Ext.

RTM LLC 1155 PERIMETER

CENTER WEST, SUITE

GA 30338 JENNIFER.SMITH@WENDYSARBYS.COM

678-969-7337 Ext.

SAFETY FIRST INSURANCE MO 63146 TIM.STANGER@SAFETYNATIONAL.COM

BROADSPIRE INC 36-3917295 P O BOX 926240 ATLANTA@CHOOSEBROADSPIRE.COM

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE MARPOO@SAFECO.COM

678-417-3654 Ext.

SAFECO INSURANCE OF ILLINOIS 2800 HIGGINS ROAD,

SUITE 1000

IL 60169 CORPORATESECRETARY@LIBERTYMUTUAL.COM

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE MARPOO@SAFECO.COM

678-417-3654 Ext.

SAFECO INSURANCE COMPANY OF AMERICA SAFECO PLAZA, 1001

FOURTH AVENUE

WA 98154 CORPORATESECRETARY@LIBERTYMUTUAL.COM

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ROSWELL GA 30076

Phone:

TUCKER GA 30084

Phone:

OWING MILLS MD 21117

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

762600 ST LOUIS MO 63146

Phone:

ATLANTA GA 30338

LAKE MARY FL 32746

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

419-847-6323 Ext.

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE EDICOORDINATOR@MATRIXCOS.COM

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

866-654-4001 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

800-235-1134 Ext. 5

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.EXCHANGING.COM

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

800-548-1373 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

770-901-3121 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD GASTATEBOARDINBOX@SEDGWICKCMS.COM

888-878-0005 Ext.

SAFETY NATIONAL

CASUALTY CORPORATION

43-0727872 2043 WOODLAND JENNIFER.HOLMES@SNCC.COM

888-995-5300 Ext. 29506

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

13121 ST LOUIS

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ROSWELL GA 30076

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

ST LOUIS MO 63146

Phone:

ATLANTA GA 30338

Phone:

LAKE MARY FL 32746

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

21885 HOUMA

800-235-1134 Ext. 5

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.EXCHANGING.COM

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

419-847-6323 Ext.

SAFETY NATIONAL CASUALTY CORPORATION MO 63146 TIM.STANGER@SAFETYNATIONAL.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD GASTATEBOARDINBOX@SEDGWICKCMS.COM

800-548-1373 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

888-995-5300 Ext. 29506

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

SAFETY NATIONAL

CASUALTY CORPORATION

43-0727872 2043 WOODLAND JENNIFER.HOLMES@SNCC.COM

866-246-0259 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE EDICOORDINATOR@MATRIXCOS.COM

800-866-2301 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

SAIA MOTOR FREIGHT LINE LLC LA 70363 JFERGUSON@SAIA.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21296 WAYCROSS

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20468 SAVANNAH

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20884 SAVANNAH

COLUMBIA SC 29202

Phone:

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

13253 SEATTLE

SEATTLE WA 98101

Phone:

SBWC # Insurer Name Address Email

13096 DALLAS

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

10240 HARTFORD

ALPHARETTA GA 30052

Phone:

TAMPA FL 33610

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

SATILLA HEALTH SERVICES HUMAN RESOURCES, 410

DARLING AVE

GA 31501 DAVIDP@SATILLA.ORG

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

SEABRIGHT INSURANCE

CLAIMS

43-1436329 1501 4TH AVENUE MICHELLE.WELCH@SBIC.COM

813-315-8449 Ext.

SEABRIGHT INSURANCE COMPANY 1501 4TH AVENUE, SUITE

2600

WA 98101 DEBBIE.SUBRATTIE@SBIC.COM

800-845-2724 Ext.

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 WCMAIL@COMPANIONGROUP.COM

800-845-2724 Ext. 43582

SAVANNAH-CHATHAM COUNTY BOARD OF

EDUCATION

GA 31401 ROB.GORDON@SAVANNAH.CHATHAM.K12.GA.US

COMPANION COMMERCIAL

INS

58-2292212 P O BOX 100165 WCMAIL@COMPANIONGROUP.COM

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

SAVANNAH CITY OF GA 31402 SMITCHELL@SAVANNAHGA.GOV

800-238-6214 Ext.

SELECT INSURANCE 75-6013697 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

SELECT INSURANCE CO CT 06183 KDAVIS@TRAVELERS.COM

SELECT INSURANCE 75-6013697 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

678-258-8000 Ext.

SECURITY NATIONAL INSURANCE TX 75265 KFAIRRIS@AMTRUSTGROUP.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

Phone:

SBWC # Insurer Name Address Email

13069 BRANCHVILLE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

12097 BRANCHVILLE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13042 BRANCHVILLE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13097 BRANCHVILLE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

12032 NEW YORK

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

13218 HARTFORD

ATLANTA GA 30319

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

SELECTIVE INSURANCE

COMPANY OF AMERICA

22-1272390 3426 TORINGDON WAY GAIL.BLEVINS@SELECTIVE.COM

800-688-9656 Ext. 1772

SELECTIVE INSURANCE CO OF AMERICA NJ 07890 KATE.IMPARATO@SELECTIVE.COM

888-329-6259 Ext.

SENECA INSURANCE COMPANY INC 160 WATER STREET,

16TH FLOOR

NY 10038 LNOIA@SENECAINSURANCE.COM

800-688-9656 Ext. 1772

JENNIFER.LOMAURO@SELECTIVE.COMSELECTIVE INSURANCE

COMPANY

22-1272390 3426 TORINGDON WAY

SELECTIVE WAY INSURANCE NJ 07890 KATE.IMPARATO@SELECTIVE.COM

SELECTIVE INSURANCE

COMPANY OF AMERICA

22-1272390 3426 TORINGDON WAY GAIL.BLEVINS@SELECTIVE.COM

800-688-9656 Ext. 1772

SELECTIVE INSURANCE COMPANY OF SOUTH

CAROLINA

NJ 07890 KATE.IMPARATO@SELECTIVE.COM

SELECTIVE INSURANCE

COMPANY OF AMERICA

22-1272390 3426 TORINGDON WAY GAIL.BLEVINS@SELECTIVE.COM

800-688-9656 Ext. 1772

SELECTIVE INSURANCE CO OF THE SOUTHEAST NJ 07890 KATE.IMPARATO@SELECTIVE.COM

800-685-7361 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

SENTINEL INSURANCE COMPANY LTD CT 06155 PAULA.SOBOLESKI@THEHARTFORD.COM

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

800-224-9524 Ext.

TUCKER GA 30084

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

866-246-0259 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

407-562-3640 Ext.

SENTINEL INS CO 06-1552103 200 COLONIAL CENTER

PKWY

LARRY.EMORY@THEHARTFORD.COM

404-562-3640 Ext.

SENTINEL INS CO 06-1552103 300 SOUTH STATE ST LARRY.EMORY@THEHARTFORD.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

407-562-3632 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13247 STEVENS POINT

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

10087 STEVENS POINT

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

10255 STEVENS POINT

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

13268 MONTEREY

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

SENTRY INSURANCE COMPANY WI 54481 TOM.HERZOG@SENTRY.COM

800-338-2487 Ext. 4616

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 WCCLAIMSEAST@SENTRY.COM

800-739-3344 Ext. 9063

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 WCCLAIMSEAST@SENTRY.COM

SENTRY CASUALTY COMPANY WI 54481 TOM.HERZOG@SENTRY.COM

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

800-450-0692 Ext.

SEQUOIA INSURANCE COMPANY CA 93940 RP4544@SEQUOIAINS.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-338-2487 Ext. 4616

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 WCCLAIMSEAST@SENTRY.COM

800-739-3344 Ext. 9063

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 WCCLAIMSEAST@SENTRY.COM

SENTRY SELECT INSURANCE COMPANY WI 54481 GA.WC.CLAIMS@SENTRY.COM

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 WCCLAIMSEAST@SENTRY.COM

800-739-3344 Ext. 9063

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 WCCLAIMSEAST@SENTRY.COM

800-338-2487 Ext. 4616

21084 DALTON

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

21645 ATLANTA

MARIETTA GA 30006

Phone:

SBWC # Insurer Name Address Email

21744 ATLANTA

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21266 CLEVELAND

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

13256 DERIDDER

DERIDDER LA 70634

Phone:

LAWRENCEVILLE GA 30045

Phone:

SBWC # Insurer Name Address Email

21758 SILOAM SPRINGS

ROGERS AR 72756

Phone:

SBWC # Insurer Name Address Email

21786 WILMINGTON

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

800-354-6494 Ext. 201

SHERWIN-WILLIAMS CO THE OH 44115 AJCOLANGELO@SHERWIN.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

770-963-7732 Ext.

SHEPHERD CONSTRUCTION COMPANY INC P O BOX 8088, STATION F GA 31106 SSTEVE@SHEPCONST.COM

GA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GAADMINSVCS.COM

ALLIED CLAIMS

ADMINISTRATION INC

58-1962415 P O BOX 674869 WILCOXB@MCNEARY.COM

800-476-7601 Ext.

SHEPHERD CENTER INC GA 30309 BETSY_FOX@SHEPHERD.ORG

866-246-0259 Ext.

SHAW INDUSTRIES INC GA 30722 BRENDA.RATCLIFF@SHAWINC.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

SIMPSON LUMBER COMPANY LLC NC 28412 GBALLAR@SIMPSON.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

479-636-0198 Ext.

SIMMONS FOODS INC AR 72761 GLBRYANT@SIMFOODS.COM

S.B. HOWARD & CO. - P O BOX 1627 LESSADAVIS@MYNEWROADS.COM

800-256-3462 Ext.

AMERISAFE RISK SERVICES

INC

72-1274075 555 OLD NORCROSS RD JBISTOK@AMERISAFE.COM

770-339-9878 Ext.

SILVER OAK CASUALTY INC LA 70634 PMCCRANEY@AMERISAFE.COM

AMERISAFE RISK SERVICES

INC

58-1181498 2301 HWY 190 WEST GASTATEBOARD@AMERISAFE.COM

866-246-0259 Ext.

20596 AUGUSTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21539 LANDSALE

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13200 NEW YORK,

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20478 CAYCE

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

21497 BRUNSWICK

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20428 COLUMBIA

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20858 ATLANTA

ATLANTA GA 30308

Phone:

SBWC # Insurer Name Address Email

10243 SUN PRAIRIE,

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

SOMPO JAPAN INS OF AMERICA TWO WORLD

FINANCIAL CTR, 225

LIBERTY STREET 43RD

FL

NY 10281 MSPRAGUE@SOMPO-JAPAN-US.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

SKF USA INC PA 19446 LINDA.K.GUNSALLUS@SKF.COM

678-258-8000 Ext.

SIZEMORE INC GA 30904 MKOTTYAN@SIZEMOREINC.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

SOUTHERN COMPANY 30 IVAN ALLEN JR BLVD

NW, BIN SC 1404

GA 30308 CLWHATLE@SOUTHERNCO.COM

866-246-0259 Ext.

SOUTHEASTERN FREIGHT LINE SC 29202 RCONNOR@SEFL.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

678-258-8000 Ext.

SOUTHEAST GEORGIA HEALTH SYS. GA 31520 PEBRI@SGHS.ORG

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

800-845-2724 Ext. 43582

SOUTH CAROLINA ELECTRIC & GAS 220 OPERATION WAY,

MAIL CODE C105

SC 29033 JMELLETTE@SCANA.COM

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 WCMAIL@COMPANIONGROUP.COM

SOUTHERN FIRE & CAS CO WI 53596 REGULATORYCOMPLIANCE@GENERALCASUALTY.CO

M

SOUTHERN COMPANY

SERVICES

58-0690070 241 RALPH MCGILL BLVD CHHUNT@SOUTHERNCO.COM

404-506-2881 Ext.

ATLANTA GA 31145

Phone:

SBWC # Insurer Name Address Email

12053 SUN PRAIRIE

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

10224 SUN PRAIRIE

ATLANTA GA 31145

Phone:

SBWC # Insurer Name Address Email

13272 DALLAS

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13230 DULUTH

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

21042 UNION CITY

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

13063 COLUMBIACOLUMBIA SC 29202

Phone:

COLUMBIA SC 29202

Phone:

770-493-1931 Ext.

SOUTHERN GUARANTY INS. CO. WI 53596 REGULATORYCOMPLIANCE@GENERALCASUALTY.CO

M

GENERAL CASUALTY

COMPANY OF WISCONSIN

39-0301590 P O BOX 450409 SHARON.STARKS@US.QBE.COM

800-450-0692 Ext.

SOUTHERN GUARANTY INS CO OF GA WI 53596 REGULATORYCOMPLIANCE@GENERALCASUALTY.CO

M

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

GENERAL CASUALTY

COMPANY OF WISCONSIN

39-0301590 P O BOX 450409 SHARON.STARKS@US.QBE.COM

770-493-1931 Ext.

SOUTHERN MUTUAL CHURCH SC 29290 RBATES@SMCINS.COM

678-447-0200 Ext. 302

SOUTHERN MILLS INC GA 30291 J.HARRIS@TENCATE.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

800-277-7442 Ext. 1336

SOUTHERN INSURANCE

COMPANY OF VIRGINIA

54-0386765 3237 SATELLITE BLVD MIKEGORE@DONEGALGROUP.COM

SOUTHERN INSURANCE COMPANY OF VIRGINIA 3097 SATELLITE BLVD,

SUITE 250

GA 30096 WAYNESMITH@DONEGALGROUP.COM

770-813-0997 Ext. 230

SOUTHERN INSURANCE COMPANY TX 75240 DORIS.BROOKS@REPUBLICGROUP.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

800-845-2724 Ext. 43582

COMPANION COMMERCIAL

INS

58-2292212 P O BOX 100165 WCMAIL@COMPANIONGROUP.COM

800-845-2724 Ext.

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 WCMAIL@COMPANIONGROUP.COM

SBWC # Insurer Name Address Email

13277 ATHENS

ATHENS GA 30604

Phone:

SBWC # Insurer Name Address Email

12099 SUN PRAIRIE

ATLANTA GA 31145

Phone:

SBWC # Insurer Name Address Email

21117 RIVERDALE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13185 RICHMOND

VALDOSTA GA 31603

Phone:

RICHMOND VA 23230

Phone:

SBWC # Insurer Name Address Email

10236 MACON

MACON GA 31202

Phone:

SBWC # Insurer Name Address Email

20870 CARROLLTON

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13260 HARTFORD

DUBUQUE IA 52004

Phone:

TUCKER GA 30084

678-258-8000 Ext.

SOUTHERN REGIONAL HEALTH SYSTEM INC GA 32074 JANA.WARREN@SOUTHERNREGIONAL.ORG

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

770-493-1931 Ext.

SOUTHERN PILOT INSURANCE COMPANY WI 53596 REGULATORYCOMPLIANCE@GENERALCASUALTY.CO

M

GENERAL CASUALTY

COMPANY OF WISCONSIN

39-0301590 P O BOX 450409 SHARON.STARKS@US.QBE.COM

800-226-1919 Ext. 211

SOUTHERN MUTUAL INSURANCE COMPANY GA 30606 DAND@SOUTHERNMUTUAL.COM

SOUTHERN MUTUAL

INSURANCE

58-0439230 P O BOX 7009 MARTYW@SOUTHERNMUTUAL.COM

SPARTA INSURANCE COMPANY (THE) CITY PLACE II, 185

ASYLUM STREET

CT 06103 JMINDEK@SPARTAINSURANCE.COM

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

SOUTHWIRE CO GA 30119 CAROL_BUCHANAN@SOUTHWIRE.COM

SOUTHERN TRUST INS CO 58-1025758 P O BOX 250 SSHIFLETT@STINS.COM

800-476-5566 Ext.

SOUTHERN TRUST INSURANCE COMPANY GA 31202 KMOORE@STINS.COM

YOLANDA.WRIGHT@SSCOOP.COM

877-243-6677 Ext. 1421

229-242-0523 Ext.

SOUTHERN STATES INS

EXCHANGE

54-6048396 6606 WEST BROAD STREET

SOUTHERN STATES INSURANCE EXCHANGE VA 23260 GRADY.WATERS@SSCOOP.COM

CRAWFORD & COMPANY 58-0506554 P O BOX 2172 CECIL_ROBERSON@CRAWCO.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

877-241-6121 Ext.

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20338 COLUMBUS

BRENTWOOD TN 37024

Phone:

CHARLOTTE NC 28247

Phone:

SBWC # Insurer Name Address Email

21391 SAVANNAH

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

10287 ST PAUL

ROSWELL GA 30076

Phone:

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10149 ST PAUL

TUCKER GA 30084

Phone:

ST JOSEPHS HOSPITAL INC (SAVANNAH) GA 31405 MILLSA@SJCHS.ORG

800-524-0604 Ext.

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 MICHELLE.BYRD@BWOOD.COM

800-524-0604 Ext.

BRENTWOOD SERVICES

ADMINISTRATORS INC

62-1482047 P O BOX 471127 JEAN.HIGH@BWOOD.COM

ST FRANCIS HOSPITAL INC GA 31908 LANDRUMD@SFHGA.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

100 CRESCENT CENTRE

PARKWAY

800-354-6494 Ext. 201

ST PAUL FIRE & MARINE

INSURANCE COMPANY

41-0406690 10401 HIGHLAND MANOR

ROAD

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

888-329-6259 Ext.

ST PAUL FIRE & CASUALTY

INSURANCE COMPANY

41-1419276 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

ST PAUL FIRE & CASUALTY

INSURANCE COMPANY

41-1419276 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

ST PAUL FIRE & CASUALTY INSURANCE

COMPANY

MN 55102 CURBANIA@TRAVELERS.COM

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST ANNF@USCKY.COM

912-355-8929 Ext. 224

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

ST PAUL FIRE & MARINE INSURANCE COMPANY MN 55102 CURBANIA@TRAVELERS.COM

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

12055 ST PAUL

ALPHARETTA GA 30005

Phone:

ORLANDO FL 32814

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10200 ST PAUL

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10150 ST PAUL

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13206 ST. PAUL

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

800-238-6214 Ext.

ST PAUL GUARDIAN INS CO 41-0963301 2420 LAKEMONT AVE PYOAKUM@TRAVELERS.COM

407-388-2587 Ext.

ST PAUL GUARDIAN INSURANCE COMPANY MN 55102 CURBANIA@TRAVELERS.COM

ST PAUL GUARDIAN INS CO 41-0963301 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

ST PAUL FIRE & MARINE

INSURANCE COMPANY

41-0406690 10401 HIGHLAND MANOR

ROAD

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

ST PAUL FIRE & MARINE

INSURANCE COMPANY

41-0406690 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

ST PAUL MERCURY

INSURANCE COMPANY

41-0881659 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

ST PAUL MERCURY

INSURANCE COMPANY

41-0881659 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

ST PAUL MERCURY INSURANCE COMPANY 385 WASHINGTON ST,

MC 502L

MN 55102 CURBANIA@TRAVELERS.COM

888-329-6259 Ext.

ST PAUL MEDICAL

LIABILITY INSURANCE

41-1435766 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

ST PAUL MEDICAL

LIABILITY INSURANCE

41-1435766 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

ST PAUL MEDICAL LIABILITY INSURANCE

COMPANY

MN 55102 CURBANIA@TRAVELERS.COM

ST PAUL GUARDIAN INS CO 41-0963301 10401 HIGHLAND MANOR DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

800-238-6214 Ext.

ST PAUL PROTECTIVE

INSURANCE COMPANY

36-2542404 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

ST PAUL PROTECTIVE INSURANCE COMPANY MN 55102 CURBANIA@TRAVELERS.COM

ST PAUL PROTECTIVE

INSURANCE COMPANY

36-2542404 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

Phone:

SBWC # Insurer Name Address Email

10216 HARTFORD

ALHPARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13053 SOUTHFIELD

SARASOTA FL 34232

Phone:

SBWC # Insurer Name Address Email

13252 WOODBRIDGE

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

10159 INDIANAPOLIS

GLEN ALLEN VA 23058

Phone:

INDIANAPOLIS IN 46206

Phone:

SBWC # Insurer Name Address Email

10163 INDIANAPOLIS

GLEN ALLEN VA 23058

Phone:

INDIANAPOLIS IN 46206

Phone:

SBWC # Insurer Name Address Email

10164 BLOOMINGTON

DULUTH GA 30098

MEADOWBROOK INC 38-1798156 P O BOX 50608 LKULL@MEADOWBROOK.COM

800-741-7244 Ext.

STAR INSURANCE COMPANY MI 48034 KFREEMAN@MEADOWBROOK.COM

800-238-6214 Ext.

STANDARD FIRE INSURANCE

COMPANY

06-6033509 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

STANDARD FIRE INSURANCE COMPANY CT 06183 KDAVIS@TRAVELERS.COM

STANDARD FIRE INSURANCE

COMPANY

06-6033509 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

ST PAUL PROTECTIVE

INSURANCE COMPANY

10401 HIGHLAND MANOR

DRIVE

888-329-6259 Ext.

STATE AUTOMOBILE MUTUAL INS IN 46206 GLORIA-JEANNE.WILSON@STATEAUTO.COM

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE MARCIA_MORGAN@CORVEL.COM

800-777-7324 Ext.

STATE AUTOMOBILE 31-4316080 2955 N MERIDIAN STREET GLORIA-JEANNE.WILSON@STATEAUTO.COM

800-906-4461 Ext.

STATE AUTO PROPERTY & CASUALTY INS. CO IN 46208 MIKE.HOLMES@STATEAUTO.COM

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE MARCIA_MORGAN@CORVEL.COM

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 GHENEHAN@KEYRISK.COM

336-668-9050 Ext. 7539

STARNET INSURANCE COMPANY 12701 MARBLESTONE

DRIVE, SUITE 250

VT 22192 JBURKE@BERKLEYNET.COM

STATE FARM FIRE & CAS CO IL 61710 HOME.ACCT-STAR-

STATEFILING.430O00@STATEFARM.COM

STATE FARM FIRE & CAS CO 37-0533080 11350 JOHNS CREEK

PARKWAY

GASC.CLMS-WC.057N27@STATEFARM.COM

800-906-4461 Ext.

STATE AUTOMOBILE 31-4316080 2955 N MERIDIAN STREET GLORIA-JEANNE.WILSON@STATEAUTO.COM

800-777-7324 Ext.

Phone:

SBWC # Insurer Name Address Email

13291 BEDFORD

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13238 BALTIMORE

BIRMINGHAM AL 35266

Phone:

SBWC # Insurer Name Address Email

21473 LOUISVILLE

LOUISVILLE KY 40210

Phone:

SBWC # Insurer Name Address Email

13282 ST PETERSBURG

GLEN ALLEN VA 23058

Phone:

CHARLESTON SC 29416

Phone:

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

13297 CHARLOTTE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13186 TREASURE

ISLANDATLANTA GA 30302

Phone:

STONEBRIDGE CASUALTY INSURANCE

COMPANY

MD 21044 PLATCHFORD@AEGONUSA.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY CHRIS_ROCK@GBTPA.COM

770-813-0997 Ext. 230

STATE NATIONAL INSURANCE COMPANY INC TX 76021 DVANSANFORD@STATENATIONAL.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

800-816-2449 Ext.

866-434-2480 Ext.

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 SAM.BOONE@USIS-TPA.COM

800-444-9098 Ext. 214

CORVEL CORPORATION 95-3382819 4820 LAKE BROOK DRIVE

#150

MARCIA_MORGAN@CORVEL.COM

-- Ext.

CORVEL ENTERPRISES 42-1704550 P O BOX 81029 GLENN_MARTIN@CORVEL.COM

SUNZ INSURANCE COMPANY 100 2ND AVENUE

NORTH, STE 300

FL 33701 GDISTEFANO@SUNZINSURANCE.COM

502-634-7390 Ext.

SUD-CHEMIE INC KY 40210 RICHARD.POE@SUD-CHEMIE.COM

SUD-CHEMIE INC 61-0536101 1600 W HILL STREET RICHARD.POE@SUD-CHEMIE.COM

800-762-3486 Ext.

CRAWFORD & COMPANY 58-0506554 P O BOX 5056 SHARI_BRANSON@US.CRAWCO.COM

404-300-1250 Ext.

T H E INSURANCE COMPANY FL 33706 KPRATT@THEINSCO.COM

866-710-0908 Ext.

SYNERGY INSURANCE COMPANY 3440 TORINGDON WAY,

STE 300

NC 28277 SGRANT@SYNERGYINSURANCE.NET

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY JTHOMAS@SYNERGYINSURANCE.NET

SBWC # Insurer Name Address Email

21568 CARROLLTON

CHARLOTTE NC 28247

Phone:

SBWC # Insurer Name Address Email

21535 MINNEAPOLIS

LAKE MARY FL 32746

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

13224 CLEVELAND

JOHNS CREEK GA 30097

Phone:

BIRMINGHAM AL 35209

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

MANDEVILLE LA 70471

Phone:

FRANKLIN TN 37067

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21585 COLUMBIA

GREENVILLE SC 29607

Phone:

TARGET CORPORATION 1000 NICOLLET MALL,

TPN 1300

MN 55403 CARLA.LAVERE@TARGET.COM

800-524-0604 Ext.

TANNER HEALTH SERVICES GA 30117 SFOX@TANNER.ORG

BRENTWOOD SERVICES

ADMINISTRATORS INC

62-1482047 P O BOX 471127 JEAN.HIGH@BWOOD.COM

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.XCHANGING.COM

800-235-1134 Ext. 5

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

800-277-7500 Ext. 29106

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

TECHNOLOGY INSURANCE COMPANY 5800 LOMBARDO

CENTER, STE #200

OH 44131 CATHY.MAXIN@AMTRUSTGROUP.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD GASTATEBOARDINBOX@SEDGWICKCMS.COM

800-548-1373 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 8500 RHURLEY@HEWITTCOLEMAN.COM

800-421-9139 Ext. 859

TERMINIX SERVICE INC SC 29210 BCRAFT@TRUSTTERMINIX.COM

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY JTHOMAS@SYNERGYINSURANCE.NET

866-710-0908 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

KM@JOHNSTONANDASSOC.COM

800-304-5035 Ext.

SBWC # Insurer Name Address Email

21387 MINNEAPOLIS

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21463 AUGUSTA

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

20492 THOMASVILLE

THOMASVILLE GA 31799

Phone:

SBWC # Insurer Name Address Email

10167 MANCHESTER

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

SBWC # Insurer Name Address Email

21429 MARIETTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21557 VALDOSTA

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

13289 NEW YORK

THERMAL CERAMICS INC GA 30903 JERRY.CABE@THERMALCERAMICS.COM

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

TEXTRON INC C/O AON, 8300 NORMAN

CENTER DRIVE, SUITE

MN 55437 NANCY.PEARSON@AON.COM

TIP TOP POULTRY INC GA 30065 DAVID.JOHNSON@TIPTOPPOULTRY.COM

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

TIG INSURANCE COMPANY 250 COMMERICAL

STREET, SUITE 5000

NH 03101 BRENDA_VAN_HIRTUM@TRG.COM

912-228-7673 Ext.

THOMASVILLE CITY OF GA 31799

THOMASVILLE CITY OF - P O BOX 1540

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

TNUS INSURANCE COMPANY NY 10169 AGENCIES.REGULATORY@TOKIOM.COM

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST ANNF@USCKY.COM

912-355-8929 Ext. 224

TM POLYFILM INC GA 31601 VICKIR@TMPOLYFILM.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

ATLANTA GA 30346

Phone:

SBWC # Insurer Name Address Email

12003 NEW YORK

TUCKER GA 30084

Phone:

HARTFORD CT 06115

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

12003 NEW YORK

LAKE MARY FL 32746

Phone:

HARTFORD CT 06103

Phone:

ATLANTA GA 30346

Phone:

SBWC # Insurer Name Address Email

13159 MANCHESTER

MANCHESTER NH 03101

Phone:

SBWC # Insurer Name Address Email

13239 NEW YORK

TUCKER GA 30084

Phone:

MAITLAND FL 32751

Phone:

TOKIO MARINE & NICHIDO FIRE INSURANCE

COMPANY

NY 10169 ANGELIQUE.COOPER@TOKIOM.COM

770-481-3227 Ext.

TOKIO MARINE

MANAGEMENT

13-2871816 ONE RAVINIA DRIVE KERRI.CROSBY@TOKIOM.COM

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 225 ASYLUM STREET SEBSTIANO.BORDONARO@SRSCONNECT.COM

TOKIO MARINE & NICHIDO FIRE INSURANCE

COMPANY

NY 10169 ANGELIQUE.COOPER@TOKIOM.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 HARTFORD PLAZA PAUL.HAYWARD@THEHARTFORD.COM

860-547-7936 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

866-450-8608 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

SUA INSURANCE CLAIMS 23-2182777 101 SOUTHHALL LANE,

SUITE 365

JBEASON@SUAINSURANCE.COM

TOWER INSURANCE CO OF NEW YORK 120 BROADWAY, 31ST

FLOOR

NY 10271 ROREN@TWRGRP.COM

800-805-9184 Ext.

TORUS NATIONAL INSURANCE COMPANY FKA

TIG INDEMNITY COMPANY

250 COMMERCIAL

STREET, SUITE 5000

NH 03101 BRENDA_VAN_HIRTUM@TRG.COM

TIG WORK COMP CLAIMS - 250 COMMERCIAL STREET BRENDA_VAN_HIRTUM@TRG.COM

800-551-0271 Ext.

TOKIO MARINE

MANAGEMENT

13-2871816 ONE RAVINIA DRIVE KERRI.CROSBY@TOKIOM.COM

770-481-3227 Ext.

CHICAGO IL 60606

Phone:

MOBILE AL 36695

Phone:

PARSIPPANY NJ 07054

Phone:

TALLAHASSEE FL 32302

Phone:

SBWC # Insurer Name Address Email

13273 NEW YORK

MAITLAND FL 32751

Phone:

CHICAGO IL 60606

Phone:

ATLANTA GA 30339

Phone:

MAITLAND FL 32794

Phone:

FT LAUDERDALE FL 33309

Phone:

MOBILE AL 36695

Phone:

SBWC # Insurer Name Address Email

12091 NEW YORK

TUCKER GA 30084

Phone:

ATLANTA GA 30346

Phone:

SBWC # Insurer Name Address Email

13237 WESTMONT

WESTMONT IL 60559

SUA INSURANCE CO 23-2182777 2222 S RIVERSIDE PLAZA NFLORES@SUAINSURANCE.COM

888-782-4672 Ext.

888-782-4672 Ext.

TOWER NATIONAL

INSURANCE COMPANY

23-2182777 2780 BERT ADAM RD ROREN@TWRGRP.COM

212-655-7330 Ext.

SUA INSURANCE CLAIMS 23-2182777 101 SOUTHHALL LANE,

SUITE 365

JBEASON@SUAINSURANCE.COM

866-450-8608 Ext.

SUA INSURANCE CO 23-2182777 2222 S RIVERSIDE PLAZA NFLORES@SUAINSURANCE.COM

TOWER NATIONAL INSURANCE COMPANY 120 BROADWAY, 31ST

FLOOR

NY 10271 ROREN@TWRGRP.COM

866-456-5630 Ext.

YORK CLAIMS SERVICE INC 13-1963636 P O BOX 10609 STEPHANIE.MARSHALL@YORKRSG.COM

877-927-2255 Ext.

TOWER INSURANCE

COMPANY OF NEW YORK

13-3548249 1111 HILLCREST ROAD EWELLS@TWRGRP.COM

800-711-4405 Ext.

YORK CLAIMS SERVICE INC 13-1963636 99 CHERRY HILL ROAD STEPHANIE.MARSHALL@YORKRSG.COMM

TRANSGUARD 36-3529298 700 OAKMONT LANE CHRISTY.SKALLAS@TRANSGUARD.COM

TRANSGUARD INSURANCE COMPANY OF

AMERICA INC

IL 60559 TRANSGUARD.COMPLIANCE@TRANSGUARD.COM

TOKIO MARINE

MANAGEMENT

13-2871816 ONE RAVINIA DRIVE KERRI.CROSBY@TOKIOM.COM

770-481-3227 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

TRANS PACIFIC INS CO NY 10169 ANGELIQUE.COOPER@TOKIOM.COM

800-711-4405 Ext.

TOWER NATIONAL

INSURANCE COMPANY

04-2811570 1111 HILLCREST ROAD EWELLS@TWRGRP.COM

877-490-0049 Ext.

TOWER NATIONAL

INSURANCE COMPANY

04-2811570 101 SOUTHHALL LANE RWEST@TWRGRP.COM

877-490-0049 Ext.

TOWER NATIONAL

INSURANCE COMPANY

04-2811570 500 W CYPRESS CREEK EFITZGERALD@TWRGRP.COM

Phone:

SBWC # Insurer Name Address Email

10170 DALLAS

DALLAS TX 75219

Phone:

SBWC # Insurer Name Address Email

10171 CHICAGO

ATLANTA GA 30319

Phone:

DULUTH GA 30096

Phone:

CHICAGO IL 60604

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

10001 HARTFORD

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

12016 HARTFORD

ALPHARETTA GA 30005

Phone:

800-474-2526 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

800-283-2318 Ext. 3574

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH GASTATEICNUMBERS@CNA.COM

312-822-2331 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

TRANSPORTATION INSURANCE COMPANY 333 S WASBASH AVENUE,

28 SOUTH

IL 60604 DEBRA.RETEL@CANA.COM

214-526-3876 Ext.

TRANSPORT INSURANCE CO TX 75219

TRANSPORT INSURANCE CO - 4100 HARRY HINES BLVD

800-238-6214 Ext.

TRAVELERS CASUALTY & SURETY OF AMERICA CT 06183 KDAVIS@TRAVELERS.COM

TRAVELERS CASUALTY &

SURETY COMPANY OF

AMERICA

06-0907370 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS CASUALTY &

SURETY COMPANY

06-6033504 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

TRAVELERS CASUALTY & SURETY COMPANY CT 06183 KDAVIS@TRAVELERS.COM

TRAVELERS CASUALTY &

SURETY COMPANY

06-6033504 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13207 HARTFORD,

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13064 HARTFORD

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

12017 HARTFORD

TUCKER GA 30084

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

TRAVELERS CASUALTY &

SURETY COMPANY OF

AMERICA

06-0907370 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

800-238-6214 Ext.

TRAVELERS CASUALTY CO

OF CT

06-1286266 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

TRAVELERS CASUALTY

COMPANY OF CONNECTICUT

06-1286266 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

TRAVELERS CASUALTY COMPANY OF

CONNECTICUT

CT 06183 KDAVIS@TRAVELERS.COM

TRAVELERS CASUALTY

INSURANCE COMPANY OF

AMERICA

06-0876835 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

888-329-6259 Ext.

TRAVELERS CASUALTY

INSURANCE COMPANY OF

AMERICA

06-0876835 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS CASUALTY COMPANY OF

AMERICA

CT 06183 KDAVIS@TRAVELERS.COM

TRAVELERS CASUALTY &

SURETY COMPANY

06-6033504 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

TRAVELERS CASUALTY

INSURANCE COMPANY OF

AMERICA

06-0876835 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

800-354-6494 Ext. 201

TRAVELERS CASUALTY

INSURANCE COMPANY OF

AMERICA

06-0876835 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS CASUALTY INS CO OF AMERICA CT 06183 KDAVIS@TRAVELERS.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13158 HARTFORD

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13065 HARTFORD

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10218 HARTFORD

ALPHARETTA GA 30005

Phone:

ORLANDO FL 32814

Phone:

TAMPA FL 33610

Phone:

FT SMITH AR 72919

Phone:

CHARLOTTE NC 28226

Phone:

888-329-6259 Ext.

TRAVELERS COMMERCIAL

CASUALTY COMPANY

95-3634110 1000 WINDWARD

CONCOURSE

GEORGIA.WC.BOARD@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS COMMERCIAL CASUALTY CO FKA

TRAVELERS INDEMNITY CO

CT 06183 KDAVIS@TRAVELERS.COM

TRAVELERS COMMERCIAL

CASUALTY COMPANY

95-3634110 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 2420 LAKEMONT AVENUE PYOAKUM@TRAVELERS.COM

407-388-2587 Ext.

TRAVELERS INDEMNITY COMPANY CT 06183 KDAVIS@TRAVELERS.COM

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

888-329-6259 Ext.

TRAVELERS COMMERCIAL

INS CO

06-1286268 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS COMMERCIAL

INS CO

06-1286268 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

TRAVELERS COMMERCIAL INSURANCE

COMPANY

CT 06183 KDAVIS@TRAVELERS.COM

TRAVELERS COMMERCIAL

INS CO

06-1286268 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

800-842-5612 Ext. 4611

TRAVELERS INDEMNITY

COPMANY

06-0566050 11440 CARMEL COMMONS

BLVD

CMHARRI1@TRAVELERS.COM

800-759-6194 Ext. 3298

TRAVELERS INDEMNITY

COMPANY

06-0566050 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 FIANA WAY MWHITE@TRAVELERS.COM

SBWC # Insurer Name Address Email

10162 HARTFORD

ALPHARETTA GA 30005

Phone:

ORLANDO FL 32814

Phone:

FRANKLIN TN 37067

Phone:

CHARLOTTE NC 28226

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10060 HARTFORD

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13039 HARTFORD

ALPHARETTA GA 30005

Phone:

FRANKLIN TN 37067

Phone:

-- Ext.

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 6640 CAROTHERS LCRAFT@TRAVELERS.COM

615-660-6258 Ext.

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-759-6194 Ext.

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 2420 LAKEMONT AVENUE PYOAKUM@TRAVELERS.COM

TRAVELERS INDEMNITY COMPANY OF

AMERICA

CT 06183 KDAVIS@TRAVELERS.COM

TRAVELERS PROPERTY CASUALTY COMPANY

OF AMERICA

CT 06183 KDAVIS@TRAVELERS.COM

TRAVELERS PROPERTY

CASUALTY COMPANY OF

AMERICA

36-2719165 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR

DR #200

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

TRAVELERS INDEMNITY COMPANY OF

CONNECTICUT

CT 06183 KDAVIS@TRAVELERS.COM

888-329-6259 Ext.

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 11440 CARMEL COMMONS

BLVD

CMHARRI1@TRAVELERS.COM

800-759-6194 Ext. 3298

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

800-238-6214 Ext.

TRAVELERS PROPERTY

CASUALTY COMPANY OF

AMERICA

36-2719165 6640 CAROTHERS LNEELEY@TRAVELERS.COM

800-342-4062 Ext.

TAMPA FL 33610

Phone:

ORLANDO FL 32814

Phone:

SBWC # Insurer Name Address Email

21599 ATLANTA

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

10237 DALLAS

DALLAS TX 75265

Phone:

SBWC # Insurer Name Address Email

21595 LAGRANGE

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

10174 LOS ANGELES

ALBANY GA 31708

Phone:

ATLANTA GA 30319

Phone:

TAMPA FL 33618

Phone:

SBWC # Insurer Name Address Email

13157 HARTFORD

ATLANTA GA 30319

Phone:

ROSWELL GA 30076

888-291-8298 Ext. 8667

TRINITY UNIVERSAL INS CO TX 75265 CHAAG@UNITRIN.COM

TRINITY UNIVERSAL

INSURANCE COMPANY OF

KANSAS INC

75-1413993 P O BOX 650665 ASHANNON@UNITRIN.COM

866-246-0259 Ext.

TRC STAFFING SERVICES INC GA 30346 CAROLYN.FAIREY@TRCSTAFFING.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

407-388-2587 Ext.

TRAVELERS PROPERTY

CASUALTY COMPANY OF

AMERICA

36-2719165 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

TRAVELERS PROPERTY

CAUSLATY COMPANY OF

AMERICA

36-2719165 2420 LAKEMONT AVENUE PYOAKUM@TRAVELERS.COM

TRUMBULL INSURANCE COMPANY ONE HARTFORD

INSURANCE, HARTFORD

PLAZA

CT 06115 PAULA.SOBOLESKI@THEHARTFORD.COM

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

ATLANTA.GA@US.CRAWCO.COM

-- Ext.

CRAWFORD & COMPANY 58-0506554 P O BOX 71465

229-436-3376 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD

TRUCK INSURANCE EXCHANGE CA 90010 BURT_GARAVAGLIA@FARMERSINSURANCE.COM

AGRIME@COLLINSANDCO.COM

800-884-1535 Ext.

TROUP COUNTY BOARD OF ED GA 30241

COLLINS & COMPANY 62-0882150 555 RIVER STREET

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

Phone:

DULUTH GA 30097

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-685-7361 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-932-4464 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

800-822-4469 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13213 COLUMBUS

WARRENVILLE IL 60555

Phone:

COLUMBUS OH 43216

Phone:

SBWC # Insurer Name Address Email

10175 HARTFORD

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

MAITLAND FL 32751

Phone:

DUBUQUE IA 52004

Phone:

WHITESBURG GA 30185

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

SUNRISE FL 33323

Phone:

800-348-1741 Ext. 8407

GRANGE MUTUAL 31-4192970 27755 DIEHL ROAD WIZAJ@GRANGEINSURANCE.COM

800-935-5300 Ext. 254

GRANGE MUTUAL

CASUALTY COMPANY

31-4192970 P O BOX 182306 LVANCAMP@IMICO.COM

TRUSTGARD INSURANCE COMPANY OH 43218 COLEMANL@GRANGEINSURANCE.COM

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

CREATIVE RISK SOLUTIONS 20-0989430 P O BOX 9207 NLYMAN@YOURCLAIMS.COM

770-577-9657 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

877-241-6121 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

866-291-0194 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

800-277-7500 Ext. 20104

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

TWIN CITY FIRE INSURANCE COMPANY CT 06115 PAULA.SOBOLESKI@THEHARTFORD.COM

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA CMULLINS@AVIZENTRISK.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-354-6494 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

FRANKLIN TN 37067

Phone:

SYRACAUSE NY 13202

Phone:

DULUTH GA 30096

Phone:

COLUMBIA SC 29210

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE JCONNOR@SEDGWICKCMS.COM

800-426-2885 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

ATLANTA.GA@SEDGWICKCMS.COM

407-562-3632 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

KM@JOHNSTONANDASSOC.COM

800-304-5035 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

SBWC # Insurer Name Address Email

21101 SPRINGDALE

OXFORD AL 36203

Phone:

SBWC # Insurer Name Address Email

13166 HOUSTON

ATLANTA GA 30302

Phone:

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

13102 WASHINGTON

ATLANTA GA 30302

Phone:

ATLANTA GA 30319

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13217 IRVING

IRVING TX 75039

Phone:

SBWC # Insurer Name Address Email

20756 CHICAGO

SUNRISE FL 33323

800-541-0139 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

678-338-4171 Ext.

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

ULLICO CASUALTY COMPANY DC 20006 MGROOME@ULLICO.COM

800-354-6494 Ext. 201

CRAWFORD & COMPANY 58-0506554 P O BOX 5056 SHARI_BRANSON@US.CRAWCO.COM

404-300-1250 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

U.S. SPECIALTY INSURANCE COMPANY TX 77040 CMCDANIEL@HCC.COM

TYSON FOODS INC 71-0225165 1520 MCPHERSON STREET TERESA.CROSSON@TYSON.COM

256-831-4381 Ext.

TYSON FOODS INCORPORATED AR 72762 CONNIE.DOWNUM@TYSON.COM

TWIN CITY FIRE INS CO 06-0732738 300 SOUTH STATE STREET LARRY.EMORY@THEHARTFORD.COM

UNITED AIRLINES INC IL 60666 JOHN.SMOLK@UNITED.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-444-0049 Ext.

UNION STANDARD 47-0547953 122 W CARPENTER

FREEWAY

SRICHARDSON@USIC.COM

UNION INSURANCE COMPANY TX 75015

866-246-0259 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD ATLANTA.GA@US.CRAWCO.COM

-- Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

CRAWFORD & COMPANY 58-0506554 P O BOX 5056 SHARI_BRANSON@US.CRAWCO.COM

404-300-1250 Ext.

Phone:

SBWC # Insurer Name Address Email

40015 MARIETTA

MARIETTA GA 30067

Phone:

SBWC # Insurer Name Address Email

13278 BALA CYNWYD

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13279 BALA CYNWYD

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10177 ST PAUL

NORCROSS GA 30071

Phone:

SAVANNAH GA 31405

Phone:

LAKE MARY FL 32746

Phone:

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

POMPANO BEACH FL 33064

Phone:

MAITLAND FL 32751

800-889-6764 Ext. 201

UNITED STATES FIDELITY & GUARANTY

COMPANY

MN 55102 CURBANIA@TRAVELERS.COM

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

UNITED NATONAL CASUALTY INSURANCE

COMPANY

THREE BALA PLAZA

EAST, SUITE 300

PA 19004 GSEGELKON@UAI-GROUP.COM

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-347-4494 Ext.

UNITED NATIONAL SPECIALTY INSURANCE THE THREE BALA PLAZA

EAST, SUITE 300

PA 19004 GEORGELKEM@UAI-GROUP.COM

UNITED BUSINESS

INSURANCE COMPANY

02-0608690 350 FRANKLIN ROAD DSILER@UNITED-BUSINESS.US

678-766-8242 Ext. 204

UNITED BUSINESS INSURANCE COMPANY A

MUTUAL CAPTIVE

350 FRANKNLIN ROAD,

STE 330

GA 30067 BANDERSON@UNITED-BUSINESS.US

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA CMULLINS@AVIZENTRISK.COM

800-277-7500 Ext. 20104

AVIZENT 31-4359765 701 INTERNATIONAL

PARKWAY

TWELDON@AVIZENTRISK.COM

800-755-1441 Ext.

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

MREVELLE@ASG-ADJ.COM

800-580-6912 Ext.

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

678-447-0200 Ext. 302

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

WILMINGTON NC 28404

Phone:

OWING MILLS MD 21117

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-288-9843 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

877-241-6121 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

866-291-0194 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

RAYMOND.EVANS@LIBERTYMUTUAL.COM

813-264-6588 Ext.

LIBERTY MUTUAL INS CO 04-1543470 P O BOX 31204

800-532-7706 Ext.

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 HEATHER.STANFORD@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 CMC555TAMPA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 CMC550CHARLOTTE2@LIBERTYMUTUAL.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

800-896-3079 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

RICHMOND VA 23260

Phone:

ATLANTA GA 30328

Phone:

LEXINGTON KY 40512

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

800-871-6670 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE EDICOORDINATOR@MATRIXCOS.COM

866-654-4001 Ext.

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 DANIELLE.MINNIEHAN@SRSCONNECT.COM

800-541-0139 Ext. 35832

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 WCCLAIMSEAST@SENTRY.COM

800-338-2487 Ext. 4616

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-932-4464 Ext.

RISK ENTERPRISES

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

800-871-6670 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

ORLANDO FL 32861

Phone:

ALPHARETTA GA 30005

Phone:

ORLANDO FL 32814

Phone:

FT SMITH AR 72919

Phone:

FRANKLIN TN 37067

Phone:

CHARLOTTE NC 28226

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13263 NEW BERLIN

NEW BERLINE WI 53151

Phone:

SBWC # Insurer Name Address Email

10179 ORLANDO

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

21241 AUGUSTA

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

10178 MORRISTOWN

ROSWELL GA 30076

Phone:

407-388-2587 Ext.

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 1000 FIANA WAY MJWHITE@TRAVELERS.COM

800-842-5612 Ext. 4611

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 2420 LAKEMONT AVENUE PYOAKUM@TRAVELERS.COM

800-238-6214 Ext.

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 SAM.BOONE@USIS-TPA.COM

800-444-9098 Ext. 214

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

UNIVERSITY HEALTH INC GA 30901 JSEWELL@UH.ORG

UNIVERSAL UNDERWRITERS - 600 GALLERIA PKY. USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

800-433-8842 Ext.

UNIVERSAL UNDERWRITERS INSURANCE

COMPANY

1900 SUMMIT TOWER

BOULEVARD, SUITE 600

FL 32810 USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

UNITED WISCONSIN

INSURANCE COMPANLY

39-0941450 15200 WEST SMALL ROAD STEPHEN.BURTON@UNITEDHEARTLAND.BIZ

800-258-2667 Ext. 7704

UNITED WISCONSIN INSURANCE COMPANY WI 53151 JUDY2T@ACCIDENTFUND.COM

800-759-6194 Ext. 3298

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 10401 HIGHLAND MANOR

DRIVE

DBRYSON@TRAVELERS.COM

888-329-6259 Ext.

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 6640 CAROTHERS LNEELEY@TRAVELERS.COM

800-342-4064 Ext.

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 11440 CARMEL COMMONS

BLVD

CMHARRIS1@TRAVELERS.COM

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-685-7361 Ext.

US FIRE INSURANCE COMPANY NJ 07962 GEORGE_ROBERTS@CFINS.COM

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

LAKE MARY FL 32795

Phone:

SBWC # Insurer Name Address Email

21688 OVERLAND PARK

NASHVILLE TN 37229

Phone:

SBWC # Insurer Name Address Email

13134 ST PAUL

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

10180 UTICA

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

13132 NEW HARTFORD

ATLANTA GA 30338

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

20503 VALDOSTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

10181 CHICAGO

ATLANTA GA 30319

Phone:

DULUTH GA 30096

Phone:

USF&G FAMILY INSURANCE CO MN 55102

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

800-288-9843 Ext. 201

USF HOLLAND INC FKA YRC WORLDWIDE 10990 ROE AVENUE, MS

A305

KS 66211 GLENDA.HARTL@YRCW.COM

UNITED STATES FIRE

INSURANCE COMPANY

13-5459190 1064 GREENWOOD BLVD DENVER_CHEEK@CFINS.COM

800-423-3060 Ext. 6301

VALDOSTA CITY OF GA 31601

UTICA NATIONAL

ASSURANCE CO

16-1486064 1040 CROWNE POINTE WORKERSCOMPMAIL@UTICANATIONAL.COM

770-510-4100 Ext.

UTICA MUTUAL INSURANCE

CO

15-0476880 1040 CROWN POINTE

PARKWAY, STE 450

WORKERSCOMPMAIL@UTICANATIONAL.COM

800-477-1914 Ext.

UTICA NATIONAL ASSURANCE CO NY 13413 WORKERSCOMPMAIL@UTICANATIONAL.COM

800-477-1914 Ext.

UTICA MUTUAL INSURANCE

CO

15-0476880 1040 CROWN POINTE

PARKWAY, STE 450

WORKERSCOMPMAIL@UTICANATIONAL.COM

UTICA MUTUAL INSURANCE CO NY 13504 WORKERSCOMPMAIL@UTICANATIONAL.COM

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

800-238-6214 Ext.

800-283-2318 Ext. 3574

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE GASTATEICNUMBERS@CNA.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

VALLEY FORGE INSURANCE CO 333 S WABASH AVENUE,

28 SOUTH

IL 60604 DEBRA.RETEL@CNA.COM

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

CHICAGO IL 60604

Phone:

SBWC # Insurer Name Address Email

13025 FENTON

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21725 HENDERSON

GREENVILLE SC 29607

Phone:

GREENVILLE SC 29606

Phone:

SBWC # Insurer Name Address Email

10235 WARREN

ATLANTA GA 30326

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30326

Phone:

SBWC # Insurer Name Address Email

13222 ATLANTA

ATLANTA GA 30339

Phone:

CHARLOTTE NC 28277

Phone:

800-421-0710 Ext.

VANLINER INSURANCE CO MO 63026 NICHOLAS_KOHL@VANLINER.COM

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GEORGIA-ADMIN.COM

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH GASTATEICNUMBERS@CNA.COM

312-822-2331 Ext.

866-246-0259 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 MARY.DAGOSTINO@SRSCONNECT.COM

770-901-3121 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE KPILZ@CHUBB.COM

404-266-4855 Ext.

VIGILANT INSURANCE COMPANY NJ 07061 PREMIUMTAXGROUP@CHUBB.COM

800-421-9139 Ext. 859

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 6528 CHOLLAND@HEWITTCOLEMAN.COM

864-240-5851 Ext.

VARIETY WHOLESALERS INC NC 27536 GTB@VWSTORES.COM

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 8500 RHURLEY@HEWITTCOLEMAN.COM

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY JTHOMAS@SYNERGYINSURANCE.NET

866-710-0908 Ext.

BUILDERS INSURANCE 58-2453325 P O BOX 723099 CLAIMSFORM@BLDRS.COM

800-883-9305 Ext.

VININGS INSURANCE COMPANY 2410 PACES FERRY

ROAD, SUITE 300

GA 30339 CEDWARDS@BLDRS.COM

VIGILANT INSURANCE

COMPANY

13-1963495 2 LIVE OAK CENTER #900 KPILZ@CHUBB.COM

404-266-4127 Ext.

SBWC # Insurer Name Address Email

12063 GLENVIEW

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

20481 ATLANTA

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21119 NORCROSS

BRENTWOOD TN 37024

Phone:

SBWC # Insurer Name Address Email

21629 GREER

GREER SC 29651

Phone:

SBWC # Insurer Name Address Email

21876 BENTONVILLE

DULUTH GA 30096

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

21661 LAFAYETTE

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

21735 MONROE

GRAYSON GA 30017

Phone:

VISITING NURSE HEALTH SYSTEM INC 5775 GLENRIDGE DRIVE,

E200

GA 30328 PATTI.ASKEW@VNHS.ROG

800-354-6494 Ext. 201

VIRGINIA SURETY CO INC IL 60025 WAYNE_BALIGA@AON.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

ATLANTA.GA@SEDGWICKCMS.COM

WAL MART ASSOCIATES INC 702 SW 8TH STREET, MS

0695

AR 72716

WAGGONERS TRUCKING 81-0290880 1131 HWY. 101 SOUTH RCOMPTON@WAGGONERSTRUCKING.COM

800-462-0602 Ext.

WAGGONERS TRUCKING THE SC 29651 RCOMPTON@WAGGONERSTRUCKING.COM

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 MICHELLE.BYRD@BWOOD.COM

800-524-0604 Ext.

WAFFLE HOUSE INC GA 30091 ELIZABETHBAILEY@WAFFLEHOUSE.COM

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GEORGIA-ADMIN.COM

800-421-0710 Ext.

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969 KELLYW@MAIL.COREMRG.COM

770-962-3627 Ext.

WALTON COUNTY BOARD OF EDUCATION GA 30655

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 WCMAIL@COMPANIONGROUP.COM

800-845-2724 Ext. 43582

WALKER COUNTY BOARD OF EDUCATION GA 30728

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

800-625-6588 Ext.

SBWC # Insurer Name Address Email

20349 DUBLIN

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21357 WARNER ROBINS

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21788 ALBANY

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

10095 BOSTON

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13116 BOSTON

CHARLOTTE NC 28277

Phone:

TAMPA FL 33618

Phone:

SBWC # Insurer Name Address Email

12036 BOSTON

CHARLOTTE NC 28277

Phone:

TAMPA FL 33618

WARNER ROBINS CITY OF GA 31099

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

800-224-9524 Ext.

WAREHOUSE HOME FURNISHINGS

DISTRIBUTORS INC

GA 31040 BHAGGARD@FARMERSFURNITURE.COM

WAUSAU GENERAL INSURANCE COMPANY MA 02116 CORPORATESECRETARY@LIBERTYMUTUAL.COM

WAUSAU BUSINESS

INSURANCE COMPANY

36-3522250 P O BOX 49000 CMC125ATLANTA@LIBERTYMUTUAL.COM

800-282-6218 Ext.

WAUSAU BUSINESS

INSURANCE COMPANY

36-3522250 3901 PREMIER NORTH RAYMOND.EVANS@LIBERTYMUTUAL.COM

800-282-6218 Ext.

WAUSAU BUSINESS INSURANCE COMPANY MA 02116 CORPORATESECRETARY@LIBERTYMUTUAL.COM

800-233-2436 Ext. 1897

WATER GAS & LIGHT COMMISSION OF ALBANY GA 31702 TTUCKER@WGL.ALBANYGA.ORG

AFFINITY SERVICE GROUP 58-2438483 1940 THE EXCHANGE GDORSEY@AFFINITYSERVICEGROUP.COM

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

WAUSAU UNDERWRITERS

INS GO

39-1341459 3901 PREMIER NORTH DR CHARLES.HUNNELL@LIBERTYMUTUAL.COM

WAUSAU UNDERWRITERS

INS CO

39-1341459 P O BOX 49000 JONATHAN.DAVIS@LIBERTYMUTUAL.COM

704-759-2580 Ext.

WAUSAU UNDERWRITER INSURANCE COMPANY MA 02116 CORPORATESECRETARY@LIBERTYMUTUAL.COM

813-264-6588 Ext.

CMC125ATLANTA@LIBERTYMUTUAL.COM

704-759-2580 Ext.

WAUSAU GENERAL

INSURANCE COMPANY

36-2753986 3901 PREMIER NORTH DR CHARLES.HUNNELL@LIBERTYMUTUAL.COM

WAUSAU GEN INS CO 36-2753986 P O BOX 49000

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

20451 WAYCROSS

GLEN ALLEN VA 23058

Phone:

CHARLESTON SC 29416

Phone:

SBWC # Insurer Name Address Email

21767 NEW YORK

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

21626 MARIETTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20548

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13242 CLEVELAND

JOHNS CREEK GA 30097

Phone:

BIRMINGHAM AL 35209

Phone:

MANDEVILLE LA 70471

Phone:

FRANKLIN TN 37067

Phone:

WAYCROSS CITY OF GA 31502 EGRIFFIN@WAYCROSSGA.COM

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE MARCIA_MORGAN@CORVEL.COM

800-943-1113 Ext. 454

WAUSAU UNDERWRITERS

INS GO

813-264-6588 Ext.

WAUSAU UNDERWRITERS

INSURANCE

39-1341459 P O BOX 49000 CMC125ATLANTA@LIBERTYMUTUAL.COM

WENDYS INTERNATIONAL INC 1155 PERIMETER

CENTER WEST, 6TH

GA 30328 JENNIFER.SMITH@WENDYSARBYS.COM

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

WELLSTAR HEALTH SYSTEM 140 LACY STREET, SUITE GA 30060 SAM.STOREY@WELLSTAR.ORG

800-685-7361 Ext.

WAYNE FARMS LLC NY 10172 STEVE.CARLSSON@CONTI.COM

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

800-906-4461 Ext.

CORVEL ENTERPRISES 42-1704550 P O BOX 81029 GLENN_MARTIN@CORVEL.COM

866-434-2480 Ext.

800-304-5035 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

KM@JOHNSTONANDASSOC.COM

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

800-277-7500 Ext. 29106

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE 50STATENOTICES@AMTRUSTGROUP.COM

678-258-8000 Ext.

WESCO INSURANCE COMPANY 5800 LOMBARDO

CENTER, STE 200

OH 44131 CATHY.MAXIN@AMTRUSTGROUP.COM

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

678-338-4171 Ext.

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

10275 FAIRFIELD

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21511 LAGRANGE

MARIETTA GA 30006

Phone:

SBWC # Insurer Name Address Email

12084 WESTFIELD

CENTERDULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13044 WESTFIELD

CENTER

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13204 OVERLAND PARK

NASHVILLE TN 37229

Phone:

FT MILL SC 29716

Phone:

SBWC # Insurer Name Address Email

20726 FEDERAL WAY

NASHVILLE TN 37214

Phone:

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY JTHOMAS@SYNERGYINSURANCE.NET

866-710-0908 Ext.

WESTFIELD INSURANCE

GROUP

34-6516838 3505 KROGER BLVD MARKKWIATKOWSKI@WESTFIELDGRP.COM

800-685-4604 Ext. 222

WESTFIELD NATIONAL INSURANCE COMPANY OH 44251 DONBRATTON@WESTFIELDGRP.COM

WESTFIELD INSURANCE

GROUP

34-6516838 3505 KROGER BLVD MARKKWIATKOWSKI@WESTFIELDGRP.COM

800-685-4604 Ext. 222

WESTFIELD INSURANCE COMPANY OH 44251 DONBRATTON@WESTFIELDGRP.COM

ALLIED CLAIMS

ADMINISTRATION INC

58-1962415 P O BOX 674869 WILCOXB@MCNEARY.COM

800-476-7601 Ext.

WEST GEORGIA MEDICAL CENTER INC FKA

LAGRANGE-TROUP CTY HOSP

GA 30240 HODGEK@WGHEALTH.ORG

800-334-0078 Ext. 214

WEST AMERICAN INSURANCE COMPANY OH 45014 CORPORATESECRETARY@LIBERTYMUTUAL.COM

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 CHRISTINE.JONES@MONTGOMERY-INS.COM

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

WEYERHAEUSER COMPANY P O BOX 9777, CH 3K33 WA 98063 BETSIE.DOUST@WEYERHAEUSER.COM

866-814-1740 Ext. 201

GALE_LESIEUR@GBTPA.COM

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE JULIE_MCCOY-LINCOLN@GBTPA.COM

WESTPORT INSURANCE CORP KS 66202

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109

SBWC # Insurer Name Address Email

21353 DALTON

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

13120 SOUTHFIELD

SARASOTA FL 34232

Phone:

SBWC # Insurer Name Address Email

20889 JACKSONVILLE

JACKSONVILLE FL 32256

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

13236 WILMINGTON

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13270 EXTON

NORCROSS GA 30071

Phone:

TAMPA FL 33630

Phone:

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

TUCKER GA 30084

800-224-9524 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF LAWRENCEVILLE@USCKY.COM

WHITFIELD CO BOARD OF ED GA 30720

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

WORK FIRST CASUALTY COMPANY 3411 SILVERSIDE RD,

BARNARD BLDG STE 101

DE 19810 SLONG@WORKFIRSTCASUALTY.COM

888-784-3470 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

WINN-DIXIE STORES INC FL 32254 DALEBITTER@WIN-DIXIE.COM

SEDGWICK CMS 36-2685608 8649 BAYPINE ROAD MARILYN.SANDERS@SEDGWICKCMS.COM

MEADOWBROOK INC 38-1798156 P O BOX 50608 LKULL@MEADOWBROOK.COM

800-741-7244 Ext.

WILLIAMSBURG NATIONAL INSURANCE

COMPANY

MN 48034 KFREEMAN@MEADOWBROOK.COM

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 KRISTY_SANDS@GBTPA.COM

800-473-9009 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

BROADSPIRE INC 36-3917295 P O BOX 926240 ATLANTA@CHOOSEBROADSPIRE.COM

678-969-7337 Ext.

BROADSPIRE CLAIMS 36-3917295 CALL BOX 30539 KRISTIN.CANNELL@CHOOSEBROADSPIRE.COM

800-258-1811 Ext.

678-447-0200 Ext. 302

XL INSURANCE AMERICA INC PA 19341 ANTHONY.EVANS@XLGROUP.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

13081 EXTON

NORCROSS GA 30071

Phone:

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

ATLANTA GA 30339

Phone:

POMPANO BEACH FL 33064

Phone:

TAMPA FL 33619

Phone:

DULUTH GA 30097

Phone:

BIRMINGHAM AL 35209

Phone:

PARSIPPANY NJ 07054

Phone:

TUCKER GA 30084

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE SUE.LORANCE@ASCRISK.COM

678-447-0200 Ext. 302

XL SPECIALTY INSURANCE COMPANY PA 19341 ANTHONY.EVANS@XLGROUP.COM

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

100 CRESCENT CENTRE

PARKWAY

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

800-422-4436 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

GAB ROBINS NORTH

AMERICA INC

13-2747054 9 CAMPUS DRIVE ATLANTAR@GABROBINS.COM

800-587-3773 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 1 METROPLEX DRIVE ATLANTAR@GABROBINS.COM

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 9950 PRINCESS PALM

AVENUE

JANET.CHORZELESKI@CAMBRIDGE-NA.COM

800-303-4437 Ext.

800-862-4252 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

CAMBRIDGE INTEGRATED 23-2731565 1775 THE EXCHANGE DAVID.HAYS@CAMBRIDGE-NA.COM

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

DULUTH GA 30097

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

21601 MACON

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

13056 E PROVIDENCE

E. PROVIDENCE RI 02914

Phone:

SBWC # Insurer Name Address Email

10143 WOODLAND

HILLSCHARLOTTE NC 28202

Phone:

SBWC # Insurer Name Address Email

800-354-6494 Ext. 201

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

ATLANTA.GA@SEDGWICKCMS.COM

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

ZENITH INSURANCE

COMPANY

95-1651549 900 W TRADE STREET CLAIMSLEGALNC@THEZENITH.COM

800-200-2667 Ext.

ZENITH INSURANCE CO CA 91367 AALPAY@THEZENITH.COM

800-556-3825 Ext.

YORK INSURANCE COMPANY RI 02901 NANCY.RESENDE@PROVWASH.COM

PROVIDENCE WASHINGTON - 88 BOYD AVENUE AMY.WATTS@PROVWASH.COM

800-421-0710 Ext.

YKK CORPORATION OF AMERICA GA 31217 JIMMYJOYNER@YKK-USA.COM

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE CEDWARDS@GEORGIA-ADMIN.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

800-541-0139 Ext.

10187 SCHAUMBURG

TAMPA FL 33630

Phone:

ATLANTA GA 30319

Phone:

LOUISVILLE KY 40222

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

MAITLAND FL 32751

Phone:

UNIONTOWN OH 44685

Phone:

ALPHARETTA GA 30005

Phone:

DUBUQUE IA 52004

Phone:

WHITESBURG GA 30185

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

800-235-1134 Ext. 5

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR SHEIMAN@CCMSI.COM

866-291-0194 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

ARTGOULD@US.XCHANGING.COM

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD NICOLE.DEWITT@US.EXCHANGING.COM

800-742-4248 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT BRIAN.WALSH@US.XCHANGING.COM

419-847-6323 Ext.

ATLANTA@CHOOSEBROADSPIRE.COM

800-450-0692 Ext.

BROADSPIRE SERVICES INC. 36-3917295 9502 WILLIAMSBURG TOM.WEBER@CHOOSEBROADSPIRE.COM

800-258-1811 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

ZURICH AMERICAN INSURANCE COMPANY IL 60196 USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

BROADSPIRE CLAIMS 36-3917295 CALL BOX 30539 KRISTIN.CANNELL@CHOOSEBROADSPIRE.COM

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY ATLANTAR@GABROBINS.COM

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

GEORGIA.NOTICES@FARA.COM

985-624-6739 Ext.

CREATIVE RISK SOLUTIONS 20-0989430 P O BOX 9207 NLYMAN@YOURCLAIMS.COM

770-577-9657 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY GAFORMS@ESIS.COM

877-241-6121 Ext.

COTTINGHAM AND BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 DUNMACHT@CBCSCLAIMS.COM

330-896-4311 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

GEORGIAWCBOARD@TRAVELERS.COM

770-352-2978 Ext.

CHESTERFIELD SERVICES 34-1709723 3520 FOREST LAKE DRIVE ITALO.GROSSI@TPA4TSA.COM

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

GB-ATLANTA_NORTH-MAIL@GBTPA.COM

800-473-9009 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 GALE_LESIEUR@GBTPA.COM

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 KRISTY_SANDS@GBTPA.COM

Phone:

TAMPA FL 33622

Phone:

BIRMINGHAM AL 35266

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

FT MILL SC 29716

Phone:

CLEARWATER FL 33758

Phone:

LAKE MARY FL 32746

Phone:

WILMINGTON NC 28404

Phone:

OWING MILLS MD 21117

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

TAMPA FL 33602

Phone:

ATLANTA GA 30328

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 KEITH_LEAHY@GBTPA.COM

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

ANDREA_HUMPHRIES@GBTPA.COM

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY CHRIS_ROCK@GBTPA.COM

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

100 CRESCENT CENTRE

PARKWAY

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 WILLIAM_KIMBROUGH@GBTPA.COM

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

866-654-4001 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

407-562-3632 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

800-896-3079 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

SOUTHEASTCLAIMCENTER.WCEDM@THEHARTFORD.COM

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE JULIE_MCCOY-LINCOLN@GBTPA.COM

866-814-1740 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 KIM_BUCHANAN@GBTPA.COM

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY GB-ATLANTA_NORTH-MAIL@GBTPA.COM

866-246-0259 Ext.

800-426-5990 Ext.

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE TKATER@NOVAPRORISK.COM

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 GEORGIAWORKERSCOMPENSATION@MATRIXCOS.COM

888-878-0005 Ext.

NOVAPRO RISK 36-4550659 101 E KENNEDY BLVD KROGERS@NOVAPRORISK.COM

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE EDICOORDINATOR@MATRIXCOS.COM

800-866-2301 Ext.

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

JACKSONVILLE FL 32256

Phone:

COLUMBIA SC 29210

Phone:

CHARLOTTE NC 28217

Phone:

LEWISVILLE TX 75067

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SAVANNAH GA 31405

Phone:

ORLANDO FL 32810

Phone:

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE JANICE.GUIDRY@REMLTD.COM

800-347-4494 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD ADOLPHUS_DRAIN@PMAGROUP.COM

888-888-8136 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR JANET.GREER@REMLTD.COM

678-731-9091 Ext. 252

404-851-3207 Ext.

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

ONE LAKE VIEW TAMMY.WILLIAMS@SRSCONNECT.COM

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY MARY.DAGOSTINO@SRSCONNECT.COM

ZURICH NA ATL CLAIMS 36-4233459 1900 SUMMIT TOWER USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

ZURICH NA ATL CLAIMS 36-4233459 3003 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

ZURICH AMERICAN

INSURANCE OF ILLINOIS

36-2781080 1900 SUMMIT TOWER USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET ANNF@USCKY.COM

912-355-8989 Ext.

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

SCOTT.WESTMAN@SRSCONNECT.COM

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592

972-906-8599 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP APULLEN@SEDGWICKCMS.COM

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

MYRA.NORMAN@SEDGWICKCMS.COM

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 750 STATE HWY 121 STEVEN.KEEFER@SEDGWICKCMS.COM

888-784-3470 Ext.

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE BHANNA@SEDGWICKCMS.COM

800-426-9218 Ext. 12131

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

ATLANTA.GA@SEDGWICKCMS.COM

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 8649 BAYPINE ROAD MARILYN.SANDERS@SEDGWICKCMS.COM

SBWC # Insurer Name Address Email

13017 SCHAUMBURG

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

Phone: 404-851-3207 Ext.

ZURICH AMERICAN

INSURANCE OF ILLINOIS

36-2781080 1900 SUMMIT TOWER USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

ZURICH NA ATL CLAIMS 36-4233459 1900 SUMMIT TOWER USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

ZURICH AMERICAN

INSURANCE COMPANY OF

ILLINOIS

36-2781080 3003 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA DMCCLOSKEY@AVIZENTRISK.COM

800-277-7500 Ext. 29106

ZURICH AMERICAN INSURANCE COMPANY OF

IL

IL 60196 USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

404-851-3207 Ext.

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD USZ.GA.WC.CLAIM.NOTICES@ZURICHNA.COM

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