Individual Self-Insurer ID Numbers (Board Assigned W Numbers) As of 07/01/21

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Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W549919 38th Floor Productions, Inc. 10/1/2006 1/1/2018 W301006 AAA Trucking Corporation 9/1/1971 9/1/1985 W549919 Aardvark Productions Inc 10/1/2006 W338503 ABA Transportation Holding Co., Inc 11/1/1992 12/15/2019 W499073 Abercrombie & Fitch, Inc. 11/1/1993 5/19/1998 W303754 ABEX Corporation 7/23/1975 3/1/1978 W329882 ABF Freight System Inc 9/2/1982 W413843 Abraham & Straus, Inc. 8/1/1994 8/25/1995 W302004 ACF Industries Incorporated 7/6/1914 9/1/1970 W440754 ACM Medical Laboratory, Inc. 1/1/2016 W338503 Acme Bus Corp. 1/1/2012 12/15/2019 W368005 Acustar, Inc. 5/11/1987 1/1/1993 W591192 Adalbert Cemetery 7/1/1989 W591507 ADAPEP (Drug Ed) Cath. School Office Drug Prgrm 4/16/1974 W570253 Ademco Distribution, Inc. 5/1/1994 4/1/2000 W303879 Adirondack Steel Casting Co, Inc. 1/2/1978 12/7/1983 W503007 Adler-Royal Business Machines Inc. 1/1/1972 5/31/1979 W303002 ADT Company Inc 10/27/1914 10/23/1987 W413843 Advertex Communications, Inc 2/1/1999 W683502 Aero Oil Company Inc. 7/1/1973 6/1/1997 W503007 Aero Service Corporation (DEL) 4/1/1971 6/14/1974 W568078 Agape Parents Fellowship, Inc. 8/1/2013 W372254 Ag-Chem, Inc. 10/1/1991 11/24/2003 W311757 AIL Systems, Inc. 9/1/1989 9/30/1997 W381255 Air Express International USA, Inc. 5/1/2005 5/1/2013 W304133 Airborne Express Inc 4/1/1993 12/30/2004 W307508 AL Tech Specialty Steel Corporation 8/2/1976 7/10/1997 W450134 Alamo Ambulance Service, Inc. 4/1/2006 6/1/2009 W591127 Albany Catholic Youth Association, Inc. Pyramid Life Center 9/30/2016 W591127 Albany Diocesan Cemeteries 3/31/2010 W591127 Albany Diocesan School Board 9/1/1978 W307250 Albany International Corporation 1/1/1995 1/1/2013 W667257 Albany Public Market, Inc. 9/20/1977 1/1/2004 W591127 Albany/Rensselaer Counties/First Street Center 9/1/1978 W308001 Alco Products Inc (DEL) 1/1/1965 10/1/1968 W309009 Alco Products Inc (NY) 12/30/1916 12/31/1964 W314009 Alcoa, Inc (nka Arconic Inc) 9/30/1914 7/1/2001 W476006 Alcor Envelope Company, Inc. 5/1/1999 6/30/2001 W338503 Alert Coach Lines, Inc. 1/1/2012 12/15/2019 W617005 Alexander Smith, Inc.(nka Mohaco Industries, Inc.) 7/13/1914 10/1/1954 W309504 Alistar Beverages Corporation dba Pepsi Cola Allied Beverages 9/1/1992 11/17/1998 W310007 All American Cables & Radio Inc (NY) 8/29/1928 10/1/1962 W591127 All Saints Catholic Academy 7/1/2009 W591127 All Saints Catholic Church 10/1/2009 W591374 All Saints Church 6/1/1976 12/31/2011 W591507 All Saints Church of Syracuse, NY 4/16/1974 W591192 All Saints Parish 7/1/1989 W591192 All Saints Parish 7/1/1989 W334759 AllData, LLC 9/1/2002 9/1/2005 W310502 Alleghany Corp 5/1/1978 12/31/1978 W312003 Allegheny Ludlum Industries, Inc 4/30/1947 8/2/1976 W311500 Allegheny Ludlum Industries, Inc. 4/30/1947 8/2/1976 W312250 Allegheny Power Service Corporation 1/1/1991 6/24/1996 W304380 Allens Inc 3/1/2007 9/15/2008 W558720 Allied Building Products Corporation 1/1/2005 1/2/2018 W413876 Allied Split Corporation 9/1/1980 9/16/1994 W629505 Almy Stores Inc. 8/1/1985 3/19/1987 W591192 Aloysius Regional School 7/1/1989 W313001 Alpha Portland Cement Co. 6/29/1914 9/1/1957 W382501 Amcast Industrial Corp 1/1/1977 1/31/1985 W315006 American Bakeries, Co. 12/29/1957 1/1/1966 W315501 American Brass Company, LP 5/1/1988 9/1/1990 W316004 American Can Co 7/6/1914 4/1/1983 W318000 American Centurion Life Assurance Company 9/30/2002 9/30/2005 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W317002 American Chicle Co. (NJ) 11/1/1929 10/3/1962 W317507 American Cyanamid Company nka Wyeth Holdings LLC 11/1/1988 7/1/1995 W318000 American Express Bank FSB 9/30/2007 9/30/2013 W319008 American Express Bank Ltd 9/20/1934 2/29/2008 W318000 American Express Business Finance Corp 9/30/2002 11/30/2004 W318000 American Express Centurion Services Corp 9/30/2002 9/30/2013 W318000 American Express Company 8/11/1914 9/30/2013 W318000 American Express Publishing Corporation 9/30/2002 9/30/2013 W318000 American Express Tax and Business Services Inc. 9/30/2002 9/30/2005 W318000 American Express Travel Related Services 1/1/1983 9/30/2013 W319503 American Freight System Inc 5/1/1978 9/22/1988 W320006 American Laundry Machinery 5/3/1920 9/1/1960 W321004 American Olean Tile Company Inc 1/1/1964 1/1/1971 W446256 American Parts System Inc. 1/1/1981 9/12/1985 W322507 American Sales Company Inc 1/1/1999 7/1/2003 W323000 American Standard Inc 8/12/1939 1/1/1972 W326003 American Sugar Refining Company of New York, The 1/8/1954 1/1/1982 W562250 AmeriMark Building Products Inc. 10/1/1997 12/31/1999 W318000 Ameriprise Financial Sevices, Inc. 9/30/2002 9/30/2005 W318000 Amex Card Services Company 9/30/2007 9/30/2013 W304505 AMOCO Chemical Company 1/1/1973 4/1/1999 W305007 Amoco Oil Company (Formerly Whale Oil Company) 4/3/1971 9/1/1971 W328504 AMPCO - Pittsburgh Corporation 6/1/1981 1/1/1986 W326003 Amstar Corporation 12/31/1919 1/1/1982 W327001 Anaconda Co The 1/7/1919 12/31/1981 W328009 Ancorp National Services Inc (DEL) 1/1/1960 2/10/1973 W591507 Annunciation Church 4/16/1974 W591192 Annunciation of the Blessed Virgin Mary Parish 7/1/1989 W303507 APA Transport Corporation 6/1/1974 11/1/1999 W548509 Aquatic Productions LLC 4/29/2020 W329007 Arcata Publications Group, Inc 1/1/1971 1/1/1984 W446256 Arco Publishing, Inc. 1/1/1985 11/27/1998 W683502 Argus Chemical Corporation 7/1/1973 6/9/1989 W476006 Arizona Chemical Company 1/1/1998 2/28/2007 W331755 Armor Kone Elevator Inc 5/1/1992 6/1/1995 W331508 Armour & Company (AZ) 10/1/1982 1/2/1983 W330005 Armour & Company (DE) 10/31/1962 10/1/1982 W331003 Armour & Company (IL) 9/24/1943 10/31/1960 W331508 Armour Food Company 1/2/1983 12/19/1983 W332258 Armstrong Industrial Specialties, Inc. (nka Interface Solutions, Inc.) 1/1/1996 7/1/1999 W332001 Armstrong World Industries, Inc. 1/1/1959 10/1/1999 W424634 Army Times Publishing Company 10/1/2000 12/1/2000 W361737 Arnold Foods Company, Inc. 12/1/1991 10/1/1997 W332506 Arnot Ogden Medical Center 1/1/1985 W558720 Arzee Acquisition LLC 9/1/2005 W333132 Ascension Health 2/1/2004 W333132 Ascension Health Alliance 2/1/2004 W591192 Ascension Parish 7/1/1989 W333199 Aspire of Western New York Inc 1/1/2005 W498505 Associated Lerner Shops of America 7/1/1975 1/1/1979 W538003 Associated Products Inc. 11/1/1977 12/19/1982 W334007 Associated Transport Inc. 12/1/1950 4/22/1976 W446256 Associates Commercial Corp. 2/27/1984 10/31/1989 W446256 Associates Financial Services Co., Inc. 1/1/1981 10/31/1989 W446256 Associates Financial Svce Co of NY 1/1/1981 10/31/1989 W591507 Assumption of the Blessed Virgin Mary 4/16/1974 W591192 Assumption Parish 7/1/1989 W325005 AT&T Communications of New York, Inc. 7/14/1914 11/19/2005 W325005 AT&T Communications, Inc. 1/1/1984 11/19/2005 W325005 AT&T Corporation 7/14/1914 11/19/2005 W325005 AT&T Resource Management Corp. 1/29/1931 11/19/2005 W669006 AT&T Technologies, Inc. 10/14/1966 1/1/1990 W368385 At-A-Glance, Inc. 2/16/1992 12/31/2000 W334502 Atlantic Richfield Co 1/1/1982 7/1/1986 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W568133 Atochem North America Inc 11/1/1979 6/16/1990 W549919 Atom Entertainment, Inc. 12/31/2006 12/31/2019 W347751 Auburn Technology, Inc. 5/15/1995 6/30/2006 W659007 Audlane Lumber Corporation 1/1/1966 6/4/1970 W591374 Augustinian Academy 6/1/1976 W315501 Aurubis Buffalo Inc 5/1/1988 11/8/2012 W651251 Autotronic Products Inc. 1/1/1979 9/1/1982 W334759 Autozone Development Corporation 9/1/2002 9/1/2005 W334759 Autozone Inc 9/1/2002 9/1/2005 W334759 Autozone Stores, Inc 9/1/2002 9/1/2005 W334759 Autozone Texas, LP 9/1/2002 9/1/2005 W334759 Autozoners, Inc 9/1/2002 9/1/2005 W595755 Aviation Sales & Management Co Inc. 3/24/1987 12/31/1991 W549919 Awesomeness, Inc. 11/10/2008 W341002 B. Specialty Apparel Co. 10/15/1981 3/12/1985 W548509 Backstreet Pictures LLC 3/3/2020 W667133 Baja Fresh Westlake Village, Inc. 9/15/2005 11/27/2006 W336002 Baker & Williams Inc 12/1/1957 9/30/1981 W559256 Baker Hall, Inc. dba Baker Victory Services 4/1/1992 4/20/2020 W559256 Baker Victory Healthcare Center 3/1/2009 4/20/2020 W336382 Ball Corporation 1/1/1985 W336382 Ball Metal Beverage Container Corp. 1/1/1996 W336382 Ball Plastic Container Corp. 1/1/1996 6/15/2010 W492003 Bargain Harold's USA Inc. 3/1/1986 6/26/1992 W662506 Barmat Construction Corp. 4/30/1978 5/1/1981 W558506 Barnett/Novo International Corp. 5/1/1973 7/14/1978 W499073 Bath & Body Works Brand Management, Inc. 7/12/2006 W499073 Bath & Body Works Direct, Inc. 1/1/2006 1/1/2010 W499073 Bath & Body Works, Inc. 11/1/1993 4/1/2006 W499073 Bath & Body Works, LLC 7/1/2006 W338503 Baumann & Sons Buses Inc. 1/1/2012 12/15/2019 W338503 Baumann Bus Company, Inc. 1/1/2014 12/15/2019 W340004 Bay Ridge Operations Co Inc 12/5/1917 4/1/1981 W647630 Bayway Refining Company 9/15/1995 2/1/1997 W417380 Beacon Network Services, Inc. 6/1/2012 W499073 BeautyAvenues, LLC 2/1/2006 W341259 Beech-Nut Nutrition Corporation 5/1/1994 9/10/1998 W557904 Beechwood, Inc. 1/1/2011 1/1/2012 W440754 Behavioral Health Network, Inc. d/b/a Rochester Mental Health Center 1/1/2012 W342000 Bell Telephone Laboratories 2/2/1925 2/15/1975 W446256 Belwyn-Mills Publishing Corp. 2/27/1984 3/22/1985 W342505 Bendix Corporation 10/1/1979 10/1/1983 W372254 Berliner & Marx, Inc 10/1/1983 5/24/1995 W341002 Berliner & Marx., Inc. 10/1/1983 5/24/1995 W549919 BET Services, Inc. 10/1/2006 W558720 Betco Block & Products Corporation 10/1/1993 8/8/1997 W343008 Bethlehem Steel Corporation (1963) 7/1/1963 8/30/1986 W343503 Bethlehem Steel Corporation (1988) 8/30/1988 5/7/2003 W343503 Bethlehem Steel Export Corporation 8/30/1988 5/7/2003 W557904 Beverwyck, Inc. 1/1/2011 1/1/2012 W650065 Beverwyck, Inc. 1/1/2016 W438006 BF Goodrich Co 7/1/1954 10/1/1982 W335509 BFI of Metro New York Inc 1/1/1995 5/1/1997 W344006 Bickford's Inc 1/1/1957 12/31/1970 W446256 Big A Auto Parts Inc. 1/1/1981 9/12/1985 W344253 Big V Supermarkets Inc (nka SRS North) 2/16/1994 7/14/2002 W548002 Binghamton Movers Inc. 1/1/1971 7/26/1985 W380257 Birds Eye Foods Inc 7/1/1982 7/1/2009 W591507 Bishop Grimes Jr./Sr. High School 3/31/2016 W591507 Bishop Ludden Jr./Sr. High School 4/16/1974 W591127 Bishop Maginn High School 9/1/1978 W600720 Bishop/Hobson Miller Paper Co. Inc. 7/1/1975 7/1/1977 W335756 BJ's Wholesale Club, Inc. 7/27/1997 W591192 Bl. Mother Teresa of Calcutta 7/1/1989 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591127 Black Catholic Apostolate, The 7/1/2010 W549919 Black Entertainment Television, Inc 10/1/2006 11/1/2017 W549919 Black Entertainment Television, LLC 3/31/2008 W346001 Blaw-Knox Company (NJ) 6/20/1945 12/31/1952 W346001 Blaw-Knox Company (DEL) 12/31/1952 7/6/1967 W595755 Blazer Truck Lines, Inc. 11/24/1989 2/28/1997 W591374 Blessed John XXII Newman Center 6/1/1976 W591127 Blessed Sacrament Church 9/1/1978 W591127 Blessed Sacrament Church 9/1/1978 W591507 Blessed Sacrament Church - Vestal 4/16/1974 W591507 Blessed Sacrament Church and School 4/16/1974 W591127 Blessed Sacrament Church Mohawk 9/1/1978 W591507 Blessed Sacrament Church of Eastwood 4/16/1974 W591192 Blessed Sacrament Parish 7/1/1989 W591192 Blessed Sacrament Parish 7/1/1989 W591192 Blessed Sacrament Parish 7/1/1989 W591192 Blessed Sacrament Roman Catholic Church 7/1/1989 W591192 Blessed Trinity Parish 7/1/1989 W446256 Blockbuster Music Retail Inc. 7/1/1995 10/26/1998 W446256 Blockbuster Videos Inc. 7/1/1995 10/1/1999 W548509 Bloom and Hedge Productions LLC 3/6/2020 W446256 Bloomcraft Inc. 1/1/1981 9/12/1985 W413843 Bloomingdale’s The Outlet Store, LLC. 10/1/2019 W413843 Bloomingdale's By Mail Ltd. 12/19/1994 7/31/2015 W413843 Bloomingdale's Merchandising, LLC 4/1/2005 W413843 Bloomingdale's The Outlet Store, Inc. 6/1/2010 10/1/2019 W413843 Bloomingdale's, LLC 8/1/1994 W413843 Bloomingdales.com, LLC 7/31/2015 W449508 Blue Jeans Corp. 3/1/1978 11/20/1981 W413843 Bluemercury, Inc. 8/1/2015 W347751 Bombardier Capital, Inc. 5/15/1995 6/30/2006 W347751 Bombardier Corporation (nka Bombardier Transportation (Global USA) 5/15/1995 6/30/2006 W347886 Bon Secours Charity Health System Medical Group PC 4/1/2017 W347886 Bon Secours Charity Health System, Inc. 4/1/2017 W421754 Bon Secours Charity Health System, Inc. 10/1/1998 5/19/2015 W421754 Bon Secours Community Hospital 10/1/1998 5/19/2015 W347886 Bon Secours Community Hospital Port Jervis 4/1/2017 W421754 Bon Secours Health System, Inc. (nka Bon Secours Mercy Health, Inc.) 10/1/1998 6/28/2018 W421754 Bon Secours New York Health System, Inc. 10/1/1998 6/28/2018 W558720 Bonsal American, Inc. 1/1/2005 W348007 Borden Inc (nka Hexion Inc) 1/1/1971 7/1/1997 W349005 BorgWarner Corp 1/1/1968 1/1/1974 W558506 Boss-Linco Lines Inc. 5/1/1973 7/14/1978 W350003 Boston and Albany Railroad 7/22/1914 4/3/1961 W351506 Bradlees, Inc. 7/10/1992 2/6/2001 W591507 Brady Faith Center, Inc. 4/16/1974 W351001 Branch Motor Express Company 10/1/1974 8/1/1983 W354005 Brewer-Titchener Corp (NY) (1968) (Default) 2/26/1968 6/30/1978 W353007 Brewer-Titchener Corp. (NY) (1918) 1/22/1918 2/25/1968 W354138 Briggs & Stratton Corporation 4/1/2016 9/1/2020 W354138 Briggs & Stratton Power Products Group LLC 4/1/2016 1/1/2017 W520852 Broadcort Capital Corp. 2/1/1994 1/9/2006 W380257 Brockport Cold Storage Company,Inc. 2/20/1991 9/30/1991 W354252 Brookdale Family Care Centers. Inc. 9/30/2000 W354252 Brookdale Hospital Center Hegeman Ave Housing Co Inc 11/13/1978 W354252 Brookdale Hospital Center Housing Co., Inc. 11/13/1978 11/1/2012 W354252 Brookdale Hospital Medical Center 11/13/1978 W354252 Brookdale Residence Housing Development Fund Corp., Co. 11/13/1978 W354948 Brooklyn Bureau of Community Service 5/1/1996 W326003 Brooklyn Cooperage Co. 7/6/1914 1/1/1982 W356000 Brooklyn Union Gas Co 7/6/1914 1/1/1945 W556500 Brooklyn Union Gas Company 7/1/2009 W488860 Brooklyn Union Gas Company KeySpan Energy Delivery of NY 9/30/2001 7/1/2009 W338503 Brookset Bus Corp. 1/1/2012 12/15/2019 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W662506 Brook-Vale Equities Inc. 4/30/1978 5/1/1981 W591374 Brothers of Christian Instruction 6/1/1978 W600720 Brown & Bigelow Inc. 1/1/1979 4/4/1980 W600944 Brown Jordan Co. 7/1/1978 12/12/1983 W356943 Browning-Ferris Industries of NY Inc 1/1/1983 5/1/1997 W453005 Buffalo Bills Inc 12/1/1974 6/30/1987 W358006 Buffalo Brake Beam Co 7/26/1919 7/1/1976 W559504 Buffalo China, Inc 7/1/1984 5/17/2011 W386007 Buffalo Containers Inc. 4/1/1970 12/31/1973 W403505 Buffalo Creek RR Company 2/9/1942 10/9/1972 W328504 Buffalo Forge Company 6/1/1981 7/26/1982 W538003 Buffalo Freezer Corp. (NY) 1/1/1971 8/8/1975 W492003 Builders Square, Inc. 8/1/1992 9/1/1997 W591127 Burke Community Service Corporation 3/31/2012 W361000 Burns Bros. 4/9/1919 6/1/1963 W361505 Burns International Sec Services 7/1/1974 8/14/1982 W361638 Bush Industries Inc 1/1/1989 W499073 Cacique, Inc. 11/1/1993 1/31/1998 W361828 Caldor Corporation, The 12/31/1996 1/22/1999 W519698 Caldor, Inc. (1987) 8/1/1987 10/28/1989 W361828 Caldor, Inc. (1991) 8/4/1991 10/21/1993 W558720 Callanan Industries, Inc. 10/1/1993 W386007 Calmar Inc. 4/1/1970 1/1/1972 W591507 Calvary - St Patrick Cemetery , NY 3/31/2010 W591127 Calvary Cemetery 9/1/1978 W591507 Calvary Cemetery - Utica 3/31/2010 W559504 Camden Wire Company 1/1/1985 4/1/1997 W591127 Camp Scully 9/1/1978 W591192 Camp Turner 7/1/1989 W363006 Canada Dry Corporation 4/1/1972 2/2/1982 W450944 Cancer and Blood Medical Services of New York, P.C. 7/1/2013 12/31/2013 W363253 Canron Fabrication Corp 11/1/1996 2/23/1998 W591192 Cantalician Center for Learning 7/1/1989 W591192 Cantalician Center for Learning, Inc. 7/1/1989 W591192 Cantalician Center Workshop 7/1/1989 W363501 Capital Credit Corp. 1/1/1979 12/14/1984 W557904 Capital Region Geriatric Center, Inc. 1/1/2011 1/1/2012 W650065 Capital Region Geriatric Center, Inc. 1/1/2016 W364004 Carborundum Company, The 10/1/1954 12/31/1980 W364251 Career Employment Services, Inc. 7/1/1994 7/1/1994 W364251 Career Horizons Government Services, Inc 7/1/1994 1/1/1998 W364251 Career Horizons Inc 7/1/1994 1/1/1998 W364517 Cargill Inc 6/1/1991 5/31/2007 W364517 Cargill Investor Services, Inc. 6/1/1991 9/1/2005 W574255 Carhart Photo 8/1/1988 1/1/1995 W364384 Carillon Nursing and Rehabilitation Center LLC 3/20/2005 W364509 Carolina Freight Carriers Corp 6/1/1974 12/31/1994 W368757 Carthage Specialty Paperboard Inc 4/1/1993 3/1/2014 W364525 Case Paper Co Inc 2/16/1996 8/1/1999 W591127 Cathedral of the Immaculate Conception 9/1/1978 W591507 Cathedral of the Immaculate Conception 4/16/1974 W591374 Cathoic Charities Watertown 6/1/1976 W591192 Catholic Academy of Niagara Falls 7/1/1989 W591192 Catholic Academy of the Holy Family 7/1/1989 W591192 Catholic Academy of West Buffalo 7/1/1989 W591127 Catholic Cemeteries Delaware-Otsego 9/1/1978 W591507 Catholic Cemeteries of Rome 4/16/1974 W591192 Catholic Cemeteries of the Roman Catholic Diocese of Buffalo, Inc 7/1/1989 W591507 Catholic Cemeteries of the Roman Catholic Diocese of Syracuse, Inc. 3/31/2010 W591127 Catholic Central High School 9/1/1978 W591374 Catholic Charitie Plattsburgh 6/1/1976 W591507 Catholic Charities - Accounting 7/1/1992 W591507 Catholic Charities - Lourdes Camp 7/1/1992 W591507 Catholic Charities - Utica/Rome 4/16/1974 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591374 Catholic Charities (Franklin County) 6/1/1976 W591374 Catholic Charities Abstinence Program 6/1/1976 W591127 Catholic Charities AIDS Services 8/4/2008 W591127 Catholic Charities Care Coordination Services 9/1/1978 W591127 Catholic Charities Disability Services 9/1/1978 W591374 Catholic Charities Essex County RSVP 6/1/1976 W591374 Catholic Charities Foster Grandparent Program 6/1/1976 W591127 Catholic Charities Housing 9/1/1978 W591507 Catholic Charities of Broome County 4/16/1974 W591192 Catholic Charities of Buffalo, NY Inc. 7/1/1989 W591507 Catholic Charities of Chenango County 7/1/1993 W591127 Catholic Charities of Columbia & Greene Counties 9/1/1978 W591507 Catholic Charities of Cortland County 4/16/1974 W591127 Catholic Charities of Delaware, Ostego & Schoharie Counties 9/1/1978 W591127 Catholic Charities of Fulton and Montgomery Counties 9/1/1978 W591127 Catholic Charities of Herkimer County 9/1/1978 W591507 Catholic Charities of Oswego 4/16/1974 W591127 Catholic Charities of Schoharie County 9/1/1978 W591127 Catholic Charities of the Diocese of Albany 9/1/1978 W591127 Catholic Charities of the Diocese of Albany dba Catholic Charities of Saratoga, Warren & Washington Counties 9/1/1978 W591374 Catholic Charities of the Diocese of Ogdensburg 6/1/1976 W591507 Catholic Charities of the RCD of Syracuse dba Catholic Charities of Onondaga Co 7/1/1992 W591374 Catholic Charities Ogdensburg Regional Office 6/1/1976 W591374 Catholic Charities Seaway House 6/1/1976 W591127 Catholic Charities Senior & Caregiver Support Services 9/1/1978 W591127 Catholic Charities Transportation 9/1/1978 W591127 Catholic Charities Tri-County Services 9/1/1978 W591374 Catholic Community of Burke & Chateaugay 6/1/1976 W591374 Catholic Community of Constable, Westville & Trout River 6/1/1976 W591507 Catholic Community of St. Stephen & St Patrick 4/16/1974 W591507 Catholic School Diocese of Syracuse 4/16/1974 W591507 Catholic Schools of Broome County 4/16/1974 W646509 Cayuga Medical Center at Ithaca Inc 2/1/1994 W384754 CBR Development Company, Inc. 7/1/1979 6/30/1998 W446256 CBS Broadcasting Inc. 1/1/2001 W446256 CBS Consumer Products, Inc. 9/1/2010 W446256 CBS Corporate Services, Inc. 9/1/2008 W446256 CBS Films, Inc. 9/1/2008 W446256 CBS Interactive Media, Inc. 9/1/2008 W446256 CBS Interactive, Inc. 10/2/2008 W446256 CBS News, Inc. 9/1/2008 W446256 CBS Operations Inc. 7/31/1996 12/4/2019 W446256 CBS Outdoor Group Inc. 1/1/2001 6/1/2014 W446256 CBS Outdoor, Inc. 1/1/2001 6/1/2014 W446256 CBS Outernet, Inc. 9/1/2008 6/1/2014 W446256 CBS Radio East Inc. 4/13/2001 12/31/2003 W446256 CBS Radio Inc. 1/1/2001 12/31/2003 W446256 CBS Radio Media Corporation 1/1/2001 12/31/2003 W446256 CBS Radio Sales Company 12/30/2005 11/17/2017 W446256 CBS Radio Services Inc. 12/30/2005 11/17/2017 W446256 CBS Radio Stations Inc. 1/1/2001 12/31/2003 W446256 CBS Radio Technical Services Inc. 1/1/2001 12/31/2004 W446256 CBS Sports Inc. 12/30/2005 W446256 CBS Studios, Inc. 9/1/2008 W446256 CBS/CTS, Inc. 12/30/2005 W413132 CE Elevator Corp. 8/1/1994 1/1/1997 W434005 CeCorr, Inc. 1/1/1999 12/19/2005 W437750 Cengo Construction Corp. 5/30/1980 W437750 Central Distributors, Inc. 5/30/1980 W364608 Central General Hospital, Inc. nka Plainview Hospital 10/1/1984 2/17/1988 W361786 Central Hudson Gas & Electric Corporation 1/1/2013 W476006 Central Lewmar, LLC 9/1/2007 12/31/2009 W515506 Central Wholesalers, LLC 5/1/2017 1/1/2018 W591192 Cephas Attica Inc. 12/1/2007 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W364723 Cerock Wire & Cable Group, Inc. 1/1/1983 5/5/1984 W364533 Cerro Conduit Company 5/5/1984 5/29/1987 W364699 Cerro Wire & Cable Corp 1/1/1981 1/1/1983 W361786 CH Energy Group, Inc. 1/1/2013 W591507 Chadwick Residence, Inc. 4/16/1974 1/8/2018 W365134 Champion International Corporation 10/1/1990 6/20/2000 W365258 Champlain Valley Physicians Hospital Medical Center 2/16/1979 W591374 Chancery Building 6/1/1976 W591127 Chapel of the Assumption (Mission of Our Lady of Hope Hague) 9/1/1978 W365324 Charmer Industries Inc 12/1/1994 11/1/1998 W662506 Charro Trucking Corporation 4/30/1978 7/1/1981 W591507 Chenango County Catholic School 4/16/1974 W366009 Chicago Bridge & Iron Co 4/16/1937 12/22/1985 W366504 Chicago Market Enterprises Inc 8/1/1981 11/1/1985 W367130 Chicago Pneumatic Tool Co c/o Atlas Copco North America LLC 4/1/1990 4/1/1997 W367007 Chicago Pneumatic Tool Company 6/16/1949 9/1/1986 W367193 Child and Family Services Foundation 7/1/2014 W367193 Child and Family Services of Erie County 7/1/2014 W367254 Children's & Women's Health Inc 4/1/1989 4/1/1998 W367254 Children's Hospital of Buffalo 4/1/1983 4/1/1998 W367254 Children's Hospital of Buffalo Foundation 9/20/1990 4/1/1998 W463004 Childs Restaurant Division (nka Service Properties Trust) 4/1/1948 9/15/1950 W591192 Christ Our Hope 7/1/1989 W591507 Christ Our Hope at St Joseph Church 4/16/1974 W591127 Christ our Light Catholic Church 11/17/2009 W591507 Christ Our Light Church 4/16/1974 W591127 Christ the King Church 9/1/1978 W591507 Christ the King Church 4/16/1974 W591192 Christ the King Parish 7/1/1989 W591507 Christ the King Retreat House 2/1/1994 W591192 Christ the King Seminary 7/1/1989 W591507 Christopher Community, Inc 4/16/1974 W368005 Chrysler Credit Corporation 10/1/1978 1/1/1996 W368187 Chrysler Credit Corporation 10/1/1978 1/1/1996 W368005 Chrysler Motors Corporation 4/1/1961 12/31/1989 W368005 Chrysler Plastics Products Corp. 10/1/1978 10/29/1981 W368005 Chrysler Realty Corp. 10/1/1978 9/29/1979 W662506 Church Avenue Supermarket Inc. 4/30/1978 5/1/1981 W591374 Church of All Saints (The Catholic Community of Moriah) 6/1/1976 W591127 Church of our Lady of Hope 12/31/2009 W591127 Church of St. Joseph - Stuyvesant 12/31/2009 W591127 Church of the Annunciation 9/1/1978 W591374 Church of the Assumption 6/1/1976 W591374 Church of the Assumption 7/1/1976 W591507 Church of the Assumption Blessed Virgin Mary 4/16/1974 W591127 Church of the Assumption St. Paul 9/1/1978 W591127 Church of the Blessed Sacrament 9/1/1978 W591374 Church of the Holy Angels 6/1/1976 W591374 Church of the Holy Cross 6/1/1976 W591507 Church of the Holy Family 4/16/1974 W591507 Church of the Holy Family, The - Endwell 4/16/1974 W591374 Church of the Holy Name 6/1/1976 W591127 Church of the Holy Spirit - Gloversville 7/1/2009 W591507 Church of the Holy Trinity of Fulton 4/16/1974 W591374 Church of the Immaculate Conception 6/1/1976 W591507 Church of the Immaculate Conception 4/16/1974 W591507 Church of the Immaculate Conception 4/16/1974 W591507 Church of the Sacred Heart & St Mary 4/16/1974 W591374 Church of the Visitation, Norfolk 6/1/1976 5/1/2015 W448757 Circle International Group Inc 2/15/1991 12/31/2000 W448757 Circle International, Inc. 2/15/1991 12/31/2000 W372254 Citrus Bowl Inc. 10/15/1981 12/1/1986 W341002 Citrus Bowl, Inc. 10/15/1981 12/26/1984 W522759 Claims Adjusting & Processing Service Company 1/1/1997 11/30/1999 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W558720 Clemente Latham Concrete Corporation 10/1/1993 12/29/1995 W591507 Clerical Fund Society of the Roman Catholic Diocese of Syracuse 3/31/2013 W368500 Clermont Fruit Packers Inc 10/20/1976 3/23/1982 W369250 Cliffstar Corporation (by Refresco Beverages US ) 5/1/2004 8/17/2010 W440754 Clifton Springs Sanitarium Company, The 1/1/2016 W369508 Cluett Peabody & Company Inc 4/1/1983 1/1/1987 W421754 Coalition for Care 10/1/1998 6/28/2018 W369755 Coles Express Inc 8/1/1996 12/31/1996 W574255 Colorcraft Corp 8/1/1998 12/31/1990 W370506 Colorcraft Corporation 2/1/1986 8/1/1998 W379507 Colt Industries Operating Corp. 9/1/1975 12/20/1985 W591192 Columban Center 7/1/1989 W417885 Columbia Funds Distributor, Inc. 1/1/2004 8/1/2004 W417885 Columbia Management Advisors, Inc. 4/1/2003 8/1/2004 W370753 Columbia University in the City of New York, Trustees of 7/1/1992 W371009 Commercial Cable Co. of NY 7/22/1914 10/1/1962 W384820 Community Facilities, Inc. 9/1/2001 W650069 Community Hospice Foundation, The 1/1/2016 W650069 Community Hospice, Inc., The 1/1/2016 W591127 Community Maternity Services 9/1/1978 W591127 Community Maternity Services 9/1/1978 W372007 Comstock-Greenwood Inc. (NY) 10/1/1964 3/1/1969 W372254 ConAgra Foods Inc (nka Conagra Brands Inc) 10/1/1991 6/1/2005 W372254 ConAgra Foods Refrigerated Foods Co., Inc. 10/1/1981 11/28/2004 W341002 ConAgra Grocery Products 2/28/1963 2/26/2001 W372254 ConAgra Grocery Products Company 2/26/2001 12/31/2004 W372387 ConAgra Maple Leaf Milling Inc 3/1/1993 2/1/1999 W372502 Condec Corporation 2/1/1974 1/31/1986 W455000 Conrad International Hotels Corp. 9/14/1989 3/20/2001 W373005 Consolidated Edison Company of New York, Inc. 7/8/1914 W374003 Consolidated Freightways Corp of DEL 1/1/1965 10/1/1996 W591127 Consultation Center 9/1/1978 W375257 Container Corp. of America 2/1/1974 9/30/1986 W364251 Contemporary Graphics Group, Inc. 7/1/1994 1/1/1998 W574131 Continental Coffee Products Company 10/1/1993 7/1/1997 W517627 Convention Hotels Inc. 5/1/1978 3/2/1992 W568257 Con-Way Eastern Express Inc. (nka XPO CNW, Inc.) 1/1/1978 10/1/1990 W375937 Cooper Crouse-Hinds, LLC 1/1/2005 7/1/2008 W375398 Cooper Industries Inc 1/3/1983 1/1/2005 W375937 Cooper Industries, LLC 1/1/2005 7/1/2008 W375398 Cooper Power Systems, Inc. 10/1/1992 1/1/2005 W375937 Cooper Power Systems, LLC 1/1/2005 7/1/2008 W375937 Cooper Tools, Inc. 1/1/2005 7/1/2008 W375919 Cooper Turbocompressor, Inc. (nka Cameron Int'l Corp) 12/1/1990 1/1/2007 W375937 Cooper US, Inc. 1/1/2005 7/1/2008 W375505 Cooper-Jarrett, Inc 7/1/1933 1/1/1982 W376008 Cornell University 10/31/1928 W378251 Corning Hospital 7/1/1989 7/1/2009 W378004 Corning Incorporated 10/22/1925 8/15/1998 W591192 Coronation of the Blessed Virgin Mary Parish 7/1/1989 W517627 Corporate Food Services, Inc. 10/1/1992 3/27/1998 W517627 Corporate Food Services, Inc. 10/1/1992 3/27/1998 W591127 Corpus Christi Church Ushers 9/1/1978 W591192 Corpus Christi Parish 7/1/1989 W378442 Costco Wholesale Corporation 10/1/1996 W549919 Country Services Inc. 10/1/2006 W517627 Courtyard Management Corporation 4/20/1989 W421754 Covenant Corporation of Suffern, NY 10/1/1998 3/2/2000 W361737 CPC International Inc. c/o Unilever US Inc. 12/1/1991 12/1/1997 W378632 Crawford Furniture Mfg. Corp. 1/1/1992 1/1/2009 W558720 CRH Americas, Inc. 10/1/1993 W379259 Crouse Health Hospital, Inc. 2/17/1979 W379002 Crouse Hinds Company 10/14/1925 1/1/1983 W379507 Crucible Materials Corp. 7/1/1983 12/20/1985 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W379697 Crucible Materials Corporation 2/1/1989 12/20/1994 W548509 Crystalightning Productions LLC 1/31/2021 W446256 CSTV Networks, Inc. 9/1/2008 W341002 Culligan Dutchess Putman Water Cond 2/1/1977 7/2/1987 W379754 Culligan Dutchess-Putnam Water Conditioning, Inc 2/1/1977 7/2/1987 W379887 Cummins Emission Solutions, Inc. 3/31/2013 W379887 Cummins Mobility Services Inc. 3/31/2013 W379887 Cummins Northeast LLC 1/1/2016 1/1/2018 W379887 Cummins Power Generation, Inc. 2/1/1994 W379887 Cummins Power Systems, LLC 3/31/2013 1/1/2017 W379887 Cummins, Inc. 2/1/1994 W380323 Curtis Niagara, LLC 7/1/2005 11/3/2014 W380380 Curtis Screw Co., Inc. 7/1/1993 7/1/2005 W595755 Custom Food Management Service Inc. 3/1/1977 12/31/1978 W381008 Cyprus Mines Corp 7/1/1969 7/8/1979 W520852 Dacion Corp. 2/1/1994 8/1/2009 W368005 Daimler Chrysler Corporation 4/1/1961 4/1/1999 W477251 Danskin Inc. 10/1/1981 11/1/1983 W381255 Danzas Corporation 5/1/2005 5/1/2013 W548509 Dark Register Productions LLC 1/8/2020 W382006 Darling-Delaware Co Inc 7/20/1963 4/1/1979 W519698 David's Bridal, Inc. 1/1/2004 2/2/2006 W381131 DCH Auto Group (USA) Inc. 9/1/2006 11/1/2014 W381131 DCH Long Island Saturn, LLC 11/1/2008 11/1/2014 W381131 DCH Mamaroneck LLC 11/1/2008 11/1/2014 W381131 DCH Management Services Inc. 9/1/2006 11/1/2014 W381131 DCH Midland LLC 11/1/2008 11/1/2014 W381131 DCH NY Imports, LLC 11/1/2008 11/1/2014 W381131 DCH NY Motors LLC 11/1/2008 11/1/2014 W381131 DCH NY Team Member Services LLC 9/1/2006 11/1/2014 W591127 De Paul Management Group Corp. 1/1/2005 W591192 De Sales Catholic School 7/1/1989 W568078 Deaf Access Services, Inc. 7/1/2019 W382634 Dean Foods Vegetable Company 2/1/1995 9/24/1998 W595755 Delavan Industries, Inc. 3/1/1977 12/31/1991 W383004 Delaware & Hudson Railroad Corp. 6/11/1930 7/1/1968 W610505 Delaware County Dairies Inc. 1/1/1978 8/10/1987 W448252 Delhaize America Distribution, LLC 1/4/2015 W448252 Delhaize America Shared Services Group LLC (nka RBS) 3/31/2011 12/13/2016 W448252 Delhaize America Supply Chain Services, Inc. 1/1/2014 W448252 Delhaize America Transportation LLC 4/15/1990 W448252 Delhaize America, LLC 4/15/1990 W384630 Delphi Automotive Systems Human Resources LLC 1/1/2002 10/6/2009 W384630 Delphi Automotive Systems Services, LLC 1/1/2001 10/6/2009 W384630 Delphi Corporation 5/28/1999 10/6/2009 W591192 Delta Development of Western New York, Inc 7/1/1989 W384754 Denny's Inc 7/1/1979 6/30/1998 W384820 DePaul Adult Care Communities, Inc. 9/1/2001 W384820 DePaul Community Services, Inc. 9/1/2001 W384820 DePaul Group Inc 9/1/2001 W384820 DePaul Properties, Inc. 9/1/2001 W309504 Desormeau Vending Corporation 7/1/1994 11/17/1998 W499917 Detroit Red Wings, Inc. 10/4/1985 11/4/1990 W381255 DHL Airways, Inc. (nka Astar Air Cargo, Inc. ) 9/1/1991 5/14/2001 W381255 DHL Express (USA), Inc. 1/15/2001 5/1/2013 W381255 DHL Global Customer Solutions (USA), Inc. 1/15/2001 5/1/2013 W381255 DHL Information Services (Americas), Inc. 1/15/2001 5/1/2013 W381255 DHL Network Operations (USA), Inc. 1/1/2006 5/1/2013 W389001 Di Gorgio Corporation (1972) 1/1/1972 12/10/1981 W386007 Diamond Automation Inc. 4/1/1970 1/1/1972 W386007 Diamond International Corp 4/1/1970 1/1/1983 W386007 Diamond National Corporation 4/1/1970 1/1/1972 W591192 Diocesan Counseling Center for Clergy and Religious 7/1/1989 W591507 Diocese of Syracuse Saint Thomas Preparatory Seminary Fund, Inc. 3/31/2013 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W548509 Direct Productions LLC 4/4/2019 W480008 Direct Winters Transport Ltd. 10/1/1976 1/1/1983 W591192 Discalced Carmelite Monastery of St. Teresa of the Child Jesus 7/1/1989 W437008 Distech Systems, Inc. 10/1/2015 1/1/2016 W645501 Distribution System of America, Inc. 1/1/1979 4/1/1998 W591507 Divine Mercy Parish 4/16/1974 W591507 Divine Mercy Parish 4/16/1974 W591192 Divine Mercy Roman Catholic Parish 7/1/1989 W389753 Dolgen New York, LLC dba Dollar General Stores 5/15/2001 W558720 Dolomite Products Company, Inc. 1/1/2005 W390389 Dow Chemical Company The 10/1/1982 12/1/1997 W381255 DPWN Holdings (USA) Inc 9/1/1991 5/1/2013 W390504 Dresser Industries Inc 6/1/1977 11/1/1987 W499040 Drummond Glass Company 5/15/1996 7/1/2009 W549919 DW Studios LLC 12/31/2006 W480503 Dyno Nobel Inc 6/10/1985 7/1/2003 W391502 Eastern Co Frazer/Jones Div 7/1/1984 7/1/1986 W392005 Eastern Express Inc 11/23/1965 5/10/1977 W393003 Eastern Freightways Inc 12/3/1968 4/22/1976 W444004 Eastern Greyhound Lines Company 9/1/1986 3/19/1987 W394001 Eastern Railroad Association 3/13/1925 1/1/1979 W395008 Eastman Kodak Company (NJ) 9/5/1936 W395008 Eastman Kodak Stores, Inc. (NY) 6/11/1923 11/2/1968 W395008 Eastman Technology, Inc. 1/1/1986 1/1/1996 W397004 Ebinger Baking Co 7/3/1936 5/1/1966 W482889 Eczel Corporation 8/1/1985 5/6/1986 W650065 Eddy Licensed Home Care Agency, Inc 1/1/2016 W397251 Edison International Inc 1/5/1981 1/1/1987 W517627 Edition Management LLC 10/1/2020 W548509 EFH Productions LLC 2/5/2021 W488381 Eggo Company 4/1/1999 4/1/2000 W391007 EI du Pont de Nemours and Company 8/10/1914 6/1/2019 W549919 Elevate Productions Inc. 1/1/2010 W568078 Elmwood Health Center, Inc. 3/1/2006 W413876 Elton Leather Company 9/1/1980 9/16/1994 W398531 Emerson Power Transmission Corp 4/1/1994 7/1/2010 W399000 Empire City Subway Co 7/6/1914 12/12/1991 W557904 Empire Home Infusion Service, Inc. 1/1/2011 1/1/2012 W650065 Empire Home Infusion Service, Inc. 1/1/2016 W400006 Endicott Johnson Corp 1/1/1923 1/31/1982 W412001 Enjay Chemical Company (DEL) 7/1/1966 1/1/1973 W400253 Entergy Nuclear Operations Inc 5/31/2006 W591192 Epiphany of Our Lord 7/1/1989 W402002 Equitable Life Assur. Society of U.S. 7/12/1916 4/11/1944 W402507 Erie County Medical Center Corporation 3/31/2016 W576508 Erie Liquor Co. Inc. 10/1/1974 11/30/1977 W439756 ESCO Turbine Technologies – Syracuse Inc (nka Consolidated Precision Products) 12/1/1993 12/28/2012 W412001 Esso Chemical Company Inc. (DEL) 5/1/1963 1/1/1973 W410005 Esso Standard Oil Co c/o Exxon Corp 1/1/1949 1/1/1960 W410757 Estech Inc. 10/1/1981 10/5/1981 W591127 Evangelist - Catholic News Organization 9/1/1978 W411508 Evans Products Co 1/1/1979 10/15/1984 W627756 Evolution Fresh, Inc. 9/30/2013 W589501 Excell Partners Inc 5/1/2012 W417380 Excellus Acquisition, Inc. 6/1/2012 W417380 Excellus Health Plan, Inc. 12/31/1998 W417380 Excellus Ventures, Inc. 6/1/2012 W517627 Execustay, LLC 10/6/2000 5/1/2012 W520506 Export Carpenters Inc. 10/1/1977 8/24/1980 W499073 Express, Inc. 11/1/1993 5/1/1998 W499073 Express, LLC (1993) 11/1/1993 7/6/2007 W499073 Express, LLC (2005) 3/31/2005 7/6/2007 W562250 Exterior Systems Inc ( fka Norandex Inc.) 7/3/1997 8/31/2007 W412001 Exxon Corp 5/1/1950 7/1/1978 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W412001 Exxon Enterprises Inc. 8/1/1970 7/1/1978 W412001 Exxon International Inc. (DEL) 1/1/1952 8/17/1971 W412001 Exxon Research & Engineering Co. 8/1/1970 6/1/1976 W413504 Fabric Leather Corporation 12/16/1975 10/31/1988 W557417 Faconnable USA, Inc. 2/1/2001 2/26/2002 W517627 Fairfield FMC, LLC 10/1/1992 W413629 Falconer Glass Industries Inc 1/1/1981 1/1/1986 W565253 Family Care Services 4/1/2013 4/1/2014 W413665 Family Dollar Inc 6/1/2014 9/1/2017 W413665 Family Dollar Services, LLC 6/1/2014 9/1/2017 W413665 Family Dollar Stores of New York, Inc. 6/1/2014 9/1/2017 W446256 Famous Music Corporation 1/1/1981 12/31/2005 W517627 Farrell's Ice Cream Parlour Restaurants, Inc. 4/20/1989 10/1/1993 W570253 FBX Corporation 5/1/1994 4/1/2000 W413075 FCA US, LLC 4/1/1961 12/31/2004 W413751 Fedders Corp 6/17/1980 5/11/1982 W413785 Federal Express Corporation 1/15/1988 W413819 Federal Stamping, Inc. 10/1/1981 6/7/1985 W413843 Federated Corporate Services, Inc. 12/19/1994 1/1/2004 W413694 FedEx Freight Inc 7/1/2007 W586259 FedEx Ground Package System, Inc 12/1/1992 W413868 Felchar Manufacturing Corporation 7/1/2004 9/1/2019 W413876 Feuer Leather Corporation 9/1/1980 9/16/1994 W413876 Feuer Purchasing Corporation 2/15/1990 9/16/1994 W413132 FHE Services, Inc. 8/1/1994 1/1/1997 W417007 Fifth Avenue Coach Lines Inc 4/1/1921 11/5/1954 W389001 Filper Corp 1/1/1972 11/8/1981 W417000 Finch, Pruyn & Company, Inc. 7/27/1914 6/30/1963 W417257 Finch, Pruyn & Company, Inc. 7/1/1993 6/18/2007 W380257 Finger Lakes Packaging Co., Inc. 12/16/1986 10/9/1996 W417323 Finger Lakes Regional Health System, Inc. 1/31/2002 W570253 Fire Burglary Instruments, Inc. 5/1/1994 4/1/2000 W417505 First National Supermarkets Inc (1977) 1/1/1977 1/9/1987 W417752 First National Supermarkets Inc (1989) 4/1/1989 2/23/1997 W417885 FIS Securities, Inc. 4/1/1995 8/30/2002 W595755 FJ Boutell Driveaway Co., Inc. 12/31/1991 3/11/1997 W417885 Fleet Bank 4/1/1995 11/14/1997 W417885 Fleet Bank, National Association 5/1/1996 9/1/2000 W417885 Fleet Boston, LLC 4/1/1995 12/31/2000 W417885 Fleet Brokerage Securities, Inc. 4/1/1995 3/31/1998 W417885 Fleet Business Credit, LLC 1/4/2003 8/1/2004 W417885 Fleet Capital Corporation 4/1/1995 8/1/2004 W417885 Fleet Clearing Corporation 4/1/1995 10/30/1998 W417885 Fleet Community Development Corporation 1/1/1998 4/27/2001 W417885 Fleet Insurance Services, LLC 5/28/2002 8/1/2004 W417885 Fleet Investment Advisors, Inc. 4/1/1995 4/1/2003 W417885 Fleet Investment Services 4/1/1995 6/7/2002 W417885 Fleet Mortgage Corp. 4/1/1995 6/1/2001 W417885 Fleet National Bank 4/1/1995 8/1/2004 W417885 Fleet Precious Metals, Inc. 4/1/1995 8/1/2004 W417885 Fleet Securities, Inc. 4/1/1995 1/28/1998 W417885 Fleet Securities, Inc. (1998) 2/1/1998 8/1/2004 W417885 Fleet Specialist, Inc. 1/1/2002 8/1/2004 W417885 Fleet Venture Resources, Inc. 4/1/1995 12/31/1995 W417885 FleetBoston Financial Corporation (nka Bank of America) 4/1/1995 8/1/2004 W625008 Fleischmann Distilling Corp. (NY) 4/2/1934 12/31/1977 W418503 Flying J Inc 5/1/2002 7/1/2010 W418503 Flying J Transportation, LLC 5/1/2002 7/1/2010 W492508 FM Sales & Distribution, Inc. 1/1/2004 W419006 Food Fair Inc 7/1/1972 11/1/1978 W420004 Food Fair Stores of New York Inc. 8/30/1951 6/25/1967 W421002 Ford Motor Company 7/13/1914 W434005 Fort James Operating Company 2/1/2002 12/19/2005 W482889 Fort James Operating Company 4/30/1989 1/31/2002 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591192 Foundation of the Roman Catholic Diocese of Buffalo 9/30/2006 W591507 Foundation of the Roman Catholic Diocese of Syracuse 7/1/2016 W591507 Foundation of the Roman Catholic Diocese of Syracuse 7/1/2016 W591192 Fourteen Holy Helpers Parish 7/1/1989 W449508 FR Tripler & Co., Inc. 3/1/1978 11/20/1981 W421754 Frances Schervier Child Day Care & Learning Center 10/1/1998 1/1/2008 W421754 Frances Schervier Home & Hospital 10/1/1998 6/28/2018 W421754 Franciscan Health Partnership, Inc. 10/1/1998 3/2/2000 W650065 Franciscan Management Services, Inc. 1/1/2016 W605000 Frank GShattuck Co 1/1/1968 4/1/1976 W433254 Fred Koch Brewery 8/25/1992 4/1/1993 W538003 Freezer Queen Foods Inc. (DEL) 1/1/1971 6/9/1982 W588008 Frontier Communications of New York, Inc. 1/1/1977 10/1/1997 W588008 Frontier Communications of Sylvan Lake, Inc. 1/1/1977 10/1/1997 W588008 Frontier Corporation 8/1/1921 10/1/1997 W422380 Fulton Boiler Works, Inc. 11/1/1993 W591127 Fulton County CFCS 9/1/1978 W422570 Fulton Group NA, Inc. 7/1/2005 W422570 Fulton Heating Solutions, Inc. 7/1/2005 W422570 Fulton Service Solutions 1/1/2013 W422570 Fulton Steam Solutions 1/1/2013 W422570 Fulton Thermal Corp. 7/1/2005 W520852 Fund Asset Management, Inc. 2/1/1994 1/9/2006 W662506 Funnel Equities Corporation 4/30/1978 5/1/1981 W430003 Furniture Group America Inc. 6/1/1986 8/26/1986 W555502 G & G Sales & Services of Western New York, Inc. 7/1/1975 6/25/1988 W424006 GAF Corporation 10/31/1939 11/1/1982 W574131 Gaines Pet Foods Corporation 10/1/1993 7/1/1997 W662506 Galley Park Inc. 4/30/1978 5/1/1981 W549919 Game Trailers Corp. 1/1/2008 12/31/2019 W446256 Games Productions Inc. 7/1/1995 12/31/2005 W549919 Games Productions Inc. 10/1/2006 W600720 Gamma Packing Corp. 7/1/1975 4/4/1980 W424634 Gannett Government Media Corporation 10/1/2000 6/29/2015 W424634 Gannett Satellite Information Network, Inc. 10/1/2000 6/29/2015 W651251 Garlet Inc. 1/1/1979 1/1/1981 W424758 Garlock Inc (nka Garlock Sealing Technologies LLC) 4/26/1976 5/31/2002 W424873 Garrett Corp The 6/1/1976 1/1/1985 W424949 Gaynor News Co Inc 12/31/1978 8/25/1985 W372254 Geldermann, Inc. 10/1/1991 12/13/1994 W425003 General Abrasive Co. 1/1/1936 1/1/1970 W426001 General Cable Corporation 4/30/1928 3/1/1971 W427009 General Cigar Company Incorporated 5/17/1918 11/1/1937 W428007 General Crushed Stone Co 2/2/1928 5/1/1976 W429005 General Electric Co 7/6/1914 1/1/1960 W430003 General Mills Inc 6/1/1937 6/1/1993 W431001 General Motors Investment Management Corporation 6/20/1996 W431001 General Motors, LLC 5/9/1924 W431381 General Nutrition Corporation 9/1/1995 1/31/2010 W431381 General Nutrition Government Services, Inc. 6/1/1997 1/31/2010 W431381 General Nutrition, Inc. 6/1/1997 1/31/2010 W431753 General Signal Corporation 1/1/1990 4/1/1997 W432009 General Telephone Co of Upstate NY 7/12/1937 6/1/1961 W433007 Genesco, Inc. 7/9/1956 7/22/1986 W433254 Genesee Brewing Company, Inc. 8/25/1992 12/15/2000 W433254 Genesee Corporation 8/25/1992 10/10/2001 W433502 Genesee Hospital, The 1/1/1983 10/1/1996 W440754 Genesee Region Home Care Association Inc dba Lifetime Care 1/1/2020 W417380 Genesee Region Home Care Association Inc, 12/1/1995 10/1/2019 W440754 Genesee Region Home Care of Ontario County dba Home Care Plus 1/1/2020 W417380 Genesee Region Home Care of Ontario County, Inc. 12/1/1995 10/1/2019 W417380 Genesee Valley Group Health Association 12/1/1995 12/31/2017 W591192 Genesee Wyoming Catholic Central School 7/1/1989 W417323 Geneva General Hospital 1/31/2002 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W433759 Geneva General Hospital 7/1/1993 12/31/1998 W433759 Geneva Nursing Home II, Inc. 9/19/1996 12/31/1998 W417323 Geneva Nursing Home II, Inc. d/b/a Living Center at Geneva-North 1/31/2002 W417323 Geneva Nursing Home, Inc. d/b/a Living Center at Geneva-South 1/31/2002 W433759 Geneva Nursing Home, Inc. d/b/a Living Center at Geneva-South 7/1/1993 12/31/1998 W433759 Geneva Regional Health System Inc 7/1/1993 12/31/1998 W434005 Georgia-Pacific Corporation 5/1/1971 12/19/2005 W591192 Gerard Place LP 3/26/2004 10/29/2004 W517627 Gladieux Corporation 6/15/1985 10/1/1993 W437008 Gleason Sales (Americas) Corporation 10/1/2003 W437008 Gleason Works, The 1/22/1915 W437503 Glen & Mohawk Milk Association, Inc. 10/1/1975 6/26/1983 W557904 Glen at Hiland Meadows, Inc. 1/1/2011 1/1/2012 W650065 Glen at Hiland Meadows, Inc., The 1/1/2016 W557904 Glen Eddy, Inc. 1/1/2011 1/1/2012 W650065 Glen Eddy, Inc. 2/11/2016 W437636 Glens Falls Cement Co, Inc. 7/28/1996 4/16/1999 W548509 Glitter Pictures LLC. 8/9/2018 W413876 Glove Splits Inc. 9/1/1980 3/30/1988 W431001 GM Components Holdings, LLC 7/1/2009 W437750 Golub Corporation 5/30/1980 W437750 Golub Service Stations Inc. 5/30/1980 W421754 Good Samaritan Foundation for Better Health, Inc. 10/1/1998 5/19/2015 W347886 Good Samaritan Hospital of Suffern, NY 4/1/2017 W421754 Good Samaritan Hospital of Suffern, NY 10/1/1998 5/19/2015 W421754 Good Samaritan Services, Inc. 10/1/1998 3/2/2000 W591192 Good Shepherd Parish 7/1/1989 W438758 Gould Pumps Inc (DEL) 7/1/1985 1/1/1988 W438501 Goulds Pumps Inc 1/1/1981 7/1/1985 W439004 Grace Line Inc & Huron Stevedoring ( Defaulted) 1/5/1956 12/15/1967 W439509 Grand Union Company 8/1/1980 3/4/2001 W645501 Graphic Controls Corp. 1/1/1979 12/30/1986 W440002 Graybar Electric Co Inc 2/16/1926 1/1/1984 W440507 Great Atlantic & Pacific Tea Co, Inc. 1/15/1978 10/5/2015 W341002 Great Bear Spring Co. 12/1/1986 7/19/1987 W591507 Greater Utica Area Catholic School, The 3/31/1999 12/31/2016 W446256 Greeff Fabrics, Inc. 1/1/1981 9/12/1985 W441000 Green Bus Lines Inc 5/7/1939 7/1/1985 W442008 Green Fuel Economizer Co Inc 1/1/1967 9/1/1971 W600720 Greene, E. & Co., Inc. 7/1/1975 4/4/1980 W662506 Greenlawn Land Development Corp. 4/30/1978 5/1/1981 W662506 Greenlawn Plaza Corporation 4/30/1978 5/1/1981 W443006 Green-Wood Cemetery 10/29/1928 5/9/1969 W445001 Greif Bros Corporation 12/27/1940 10/26/1987 W573505 Greyhound Food Management Inc 4/1/1977 3/30/1981 W444004 Greyhound Lines Inc 8/1/1976 3/19/1987 W440754 GRHS Foundation, Inc. 1/1/2012 W633754 Griffith Oil, Inc. 7/20/1994 8/3/1998 W386007 Groveton Paper Company 4/1/1970 1/1/1983 W372254 Grower Service Corporation 10/1/1991 11/24/2003 W645501 Grumbacher, M. Inc. 1/1/1979 6/19/1985 W499073 Gryphon Development, Inc. 11/1/1993 10/31/2002 W446256 Guaranteed Parts Company Inc. 1/1/1981 7/31/1982 W591507 Guardian Angel Society 3/31/2013 W591507 Guardian Angel Society Syracuse 3/31/2013 W591374 Guggenheim Center Religious Programs 6/1/1976 W446256 Gulf & Western Manufacturing Co. 1/1/1981 9/12/1985 W565501 Gull Inc. 3/1/1974 6/30/1992 W446389 Gunlocke Company 9/1/1991 12/29/2002 W446389 Gunlocke Company L.L.C. 12/29/2002 7/1/2010 W446504 Hall's Motor Transit Co 5/18/1975 9/1/1985 W447007 Hanna Coal & Ore Corp 7/1/1943 12/30/1954 W448005 Hanna Furnace Corp The (NY) 6/13/1930 7/8/1983 W448252 Hannaford Bros. Co., LLC 4/15/1990 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W448633 Harden Furniture LLC 1/1/1993 7/17/2018 W599252 Harding, Williams, Dixie Corp. 7/1/1982 7/1/1984 W549919 Harmonix Music Systems, Inc. 10/1/2006 12/31/2010 W384754 Harold Butler Enterprises #714 Inc. 7/1/1979 6/30/1998 W449003 Harris Structural Steel Co Inc 5/18/1921 5/16/1980 W449508 Hart Schaffner & Marx 3/1/1978 9/28/1992 W557904 Hawthorne Ridge, Inc. 1/1/2011 1/1/2012 W650065 Hawthorne Ridge, Inc. 1/1/2016 W568078 Headway of Western New York, Inc. 1/31/2011 W450134 Health Quest Medical Practice, PC 1/1/2008 6/1/2009 W450134 Health Quest Systems Inc 4/1/2006 6/1/2009 W450134 HealthServe LLC 4/1/2006 6/1/2009 W450944 HealthStar Network Inc dba Stellaris Health Network 10/1/2002 12/31/2013 W446389 Hearth & Home Technologies Inc. 6/30/1994 7/1/2010 W451504 Hellenic Lines Ltd 7/1/1973 5/31/1980 W499073 Henri Bendel, Inc. 11/1/1993 2/3/2019 W446256 Her Majesty Industries Inc. 1/1/1981 9/12/1985 W452007 Hercules, Inc. 7/13/1914 12/1/2008 W557904 Heritage House Nursing Center, Inc. 1/1/2011 1/1/2012 W650065 Heritage House Nursing Center, Inc. 1/1/2016 W452254 Herr Foods Incorporated 8/15/1999 9/1/2014 W452502 Hickey-Freeman Co Inc 3/1/1978 4/1/2002 W449508 Hickey-Freeman Co., Inc. 3/1/1978 9/28/1992 W453252 Highland Community Development Corp. 7/1/1995 W453252 Highland Hospital of Rochester 4/1/1982 W453252 Highland Living Center Inc. 7/1/1995 W454003 Hills Supermarket Inc ( Defaulted) 2/1/1972 12/22/1975 W419006 Hills Supermarkets, Inc. 5/7/1977 11/1/1978 W662506 Hills Trumbull Corporation 4/30/1978 5/1/1981 W454888 Hillside Children's Center 9/1/2005 W454888 Hillside Children's Foundation 9/1/2005 W454888 Hillside Family of Agencies 9/1/2005 W454888 Hillside ICAP 9/1/2005 W454888 Hillside Services Solutions, Inc. 7/1/2008 W454888 Hillside Work Scholarship Connection, Inc. 9/1/2005 W455000 Hilton Inns, LLC (fka Hilton Inns, Inc.) 9/14/1989 1/1/2010 W455000 Hilton Worldwide, Inc. 1/1/1972 12/1/2011 W591127 Hispanic Outreach 9/1/1978 W446447 HJ Wilson Company, Inc. 9/1/1994 12/31/2000 W446389 HNI Corporation 6/30/1994 7/1/2010 W367254 Hodge Parking, Inc. 4/1/1984 4/1/1998 W458509 Holiday Corporation 4/27/1997 5/31/1999 W458509 Holiday Inns, Inc. 9/1/1989 4/27/1997 W453757 Hollingsworth & Vose Company 4/1/1989 5/15/2012 W591192 Holy Angels Parish 7/1/1989 W591192 Holy Apostles 7/1/1989 W591127 Holy Cross Cemetery 9/1/1978 W591127 Holy Cross Church 4/4/2011 W591127 Holy Cross Church 9/1/1978 W591127 Holy Cross Church - Albany 9/1/1978 10/1/2009 W591127 Holy Cross Church - Elizaville 9/1/1978 W591127 Holy Cross Church - Morris NY 4/4/2011 W591507 Holy Cross Church Dewitt 4/16/1974 W591507 Holy Cross Church Dewitt Dewitt 4/16/1974 W591127 Holy Cross Church School - Albany 9/1/1978 7/1/2009 W591192 Holy Cross Parish 7/1/1989 W591374 Holy Family Church 6/1/1976 W591507 Holy Family Church 4/16/1974 W591507 Holy Family Church - Fairmount 4/16/1974 W591127 Holy Family Church - Stottville 9/1/1978 12/31/2009 W591507 Holy Family Church - Vernon 4/16/1974 W591127 Holy Family Church & St. Mary's Cemetery 3/31/1993 W591192 Holy Family of Jesus, Mary & Joseph 7/1/1989 W591192 Holy Family of Jesus, Mary & Joseph 7/1/1989 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591127 Holy Family Parish 12/31/2006 W591192 Holy Family Parish 7/1/1989 W591192 Holy Family Parish 7/1/1989 W591192 Holy Family Parish 7/1/1989 W591127 Holy Family Parish of the Roman Catholic Community of Little Falls Inc 3/31/1993 W591374 Holy Family School 6/1/1976 W591374 Holy Family School 6/1/1976 W591374 Holy Ghost Academy 6/1/1976 W591127 Holy Infancy Church - Lake Luzerne 9/1/1978 7/1/2009 W591127 Holy Mother and Child 7/1/2009 W591374 Holy Name Church 6/1/1976 W591192 Holy Name of Mary Church 7/1/1989 W591127 Holy Spirit Church East Greenbush 9/1/1978 W591192 Holy Spirit Parish 7/1/1989 W591192 Holy Spirit Parish 7/1/1989 W591127 Holy Trinity Church 9/1/1978 W591507 Holy Trinity Church - Binghamton 4/16/1974 W591507 Holy Trinity Church - Fulton 4/16/1974 W591127 Holy Trinity Church - Schaghticoke 9/1/1978 9/30/2010 W591507 Holy Trinity Church - Utica 4/16/1974 W591127 Holy Trinity Church (was Church of the Resurrection) 9/1/1978 W591127 Holy Trinity Parish 9/1/1978 W591192 Holy Trinity Parish 7/1/1989 W591192 Holy Trinity Roman Catholic Church of Medina New York 7/1/1989 W557904 Home Aide Service of Eastern New York, Inc. Inc. 1/1/2011 1/1/2012 W650065 Home Aide Service of Eastern NY, Inc. 1/1/2016 W461008 Honeywell Inc 7/1/1961 4/1/2000 W461008 Honeywell Information Systems Inc. 10/1/1970 3/26/1987 W461008 Honeywell Mutual Protection Serv. 4/1/1973 1/1/1975 W461008 Honeywell-Measurex Corporation 1/1/1998 3/23/2000 W591192 Hope of Buffalo 7/1/1989 W413876 Horizon Leather Corporation 2/15/1990 9/16/1994 W462576 Hospital For Joint Diseases Orthopaedic Institute DBA NYU Langone Orthopedic Hospital 9/15/1995 1/1/2006 W517627 Host International Inc. 4/1/1983 10/1/1993 W517627 Host Marriott Corporation 5/1/1978 10/1/1993 W517627 Host Services of NY Inc. 4/1/1983 10/1/1993 W466502 Hotel Waldorf Astoria 10/1/1977 12/22/1980 W466007 Hotel Waldorf Astoria Corp (NY 1953) 1/1/1972 10/1/1977 W455000 Hotel Waldorf-Astoria Corp. (1960) 1/1/1972 12/1/1990 W455000 Hotels Statler Co., Inc. 2/1/1976 12/1/2011 W662381 House2Home Inc 8/1/1993 7/31/2002 W488829 Howe & Rusling, Inc. 9/15/1991 9/28/1992 W466882 Huck International Inc 9/1/1993 7/1/1999 W517627 Hudson Sheraton Corporation LLC 10/1/2020 W549919 Hudson Street Productions, Inc. 12/22/2007 W450134 Hudson Valley Ambulatory Medical Services PLLC 4/1/2006 6/1/2009 W450134 Hudson Valley Critical Care Physicians, PLLC 4/1/2006 6/1/2009 W450134 Hudson Valley Emergency Medicine, PLLC 4/1/2006 6/1/2009 W450134 Hudson Valley Home Care Inc. 7/31/2006 6/1/2009 W450134 Hudson Valley Newborn Physician Services, PLLC 4/1/2006 6/1/2009 W412001 Humble Oil & Refinig Co. (DEL) 1/1/1960 1/1/1973 W433759 Huntington Nursing Home, Inc. 7/1/1993 12/31/1998 W417323 Huntington Nursing Home, Inc. dba Huntington Living Center 1/31/2002 W341002 Hunt-Wesson, Inc. 12/1/1986 9/23/1993 W384820 Huther-Doyle Memorial Institute, Inc. 9/1/2001 10/31/2003 W472005 Hygrade Food Products Corp 12/26/1929 4/1/1969 W473508 IBM China/Hong Kong Corporation 2/1/1995 12/31/2010 W473508 IBM World Trade Corporation 2/1/1995 12/31/2010 W473508 IBM World Trade Europe/Middle East/Africa Corp. 2/1/1995 12/31/2010 W548509 Ice Cream Fridge LLC 4/4/2019 W472500 Ideal Corporation (DEL) 12/1/1973 6/30/1980 W419006 Idealco Incorporated 4/1/1977 11/1/1978 W318000 IDS Life Insurance Company of New York 9/30/2002 9/30/2005 W549919 IFilm Corp. 10/1/2006 8/31/2015 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W458509 IHG Management (Maryland), LLC 10/1/2006 9/30/2008 W591507 Immaculate Conception - Fayetteville 4/16/1974 W591127 Immaculate Conception - Haines Falls 9/1/1978 7/1/2009 W591127 Immaculate Conception Cemetery 9/1/1978 W591507 Immaculate Conception Church - Pompey 4/16/1974 W591127 Immaculate Conception Church Glenville 9/1/1978 W591127 Immaculate Conception Church Hoosick Falls 9/1/1978 W591127 Immaculate Conception Church New Lebanon 9/1/1978 W591507 Immaculate Conception Church-Greene 4/16/1974 W591127 Immaculate Conception of Corinth 9/1/1978 7/1/2009 W591192 Immaculate Conception Parish 7/1/1989 W591192 Immaculate Conception Parish 7/1/1989 W591192 Immaculate Conception Parish 7/1/1989 W591192 Immaculate Conception Parish 7/1/1989 W591192 Immaculate Conception School of Allegany County 7/1/1989 W591374 Immaculate Heart Central High School 6/1/1976 W591374 Immaculate Heart Central Primary & Intermediate School 6/1/1976 W591192 Immaculate Heart of Mary 7/1/1989 W591374 Immaculate Heart of Mary 6/1/1976 W591507 Immaculate Heart of Mary Church - Liverpool 4/16/1974 W591127 Immaculate Heart of Mary Parish 9/30/2005 W591127 Immaculate Heart of Mary Parish 9/30/2005 W440754 Independent Living for Seniors, Inc. 6/1/1997 W499073 Independent Production Services, Inc. 9/26/1997 12/31/2004 W591192 Infant of Prague Parish 7/1/1989 W627509 InfoLogix, Inc. 3/4/2011 W473003 Ingersoll-Rand Company 12/30/1927 1/1/1987 W458509 Intercontinental Hotels Group Resources, Inc. 4/30/2004 9/30/2008 W473508 International Business Machines Corporation 2/1/1995 12/31/2010 W474001 International Harvester Co 3/17/1966 5/1/1983 W475503 International Imaging Materials, Inc. 5/1/1995 4/1/1998 W476006 International Paper Company 12/28/1923 1/1/2017 W477251 International Playtex Inc 10/1/1981 12/12/1986 W556005 International Railway Company (NY) 12/28/1921 7/28/1947 W478002 International Terminal Operating Co 1/1/1956 6/15/1987 W417885 Interpay, Inc. 11/1/1998 4/1/2003 W479000 Interstate Brands Corp ( Defaulted) 1/1/1972 7/1/1984 W480008 Interstate Motor Freight System 7/1/1958 12/1/1983 W562250 InterWrap, Corp 11/1/2016 12/15/2020 W499073 Intimate Beauty Corporation 5/18/1995 8/21/2007 W499073 Intimate Brands Service Corporation 5/26/1995 10/31/2002 W499073 Intimate Brands, Inc. 5/16/1995 3/24/2002 W595755 Inventory Locator Service, Inc. 11/24/1989 12/7/1993 W332506 Ira Davenport Memorial Hospital, Inc. 4/1/2011 W481006 Iroquois Gas Corp 7/7/1915 7/15/1974 W549919 Jackass World LLC 12/22/2007 W591507 Jail Ministry of Onondaga County, Inc 10/12/2020 W482004 Jamaica Bus Tours Corporation 8/6/1977 7/13/1983 W482004 Jamaica Buses, Inc. 6/1/1955 7/1/1985 W557904 James A. Eddy Memorial Geriatric Center, Inc. 1/1/2011 1/1/2012 W650065 James A. Eddy Memorial Geriatric Center, The 1/1/2016 W379440 James River Corp of Nevada 1/1/1983 4/24/1988 W482756 James River II, Inc. 4/24/1988 12/28/1992 W483002 Jarka Corporation, The (DEL) 3/1/1949 5/4/1954 W470504 JB Hunt Transport, Inc 1/1/1990 8/1/1997 W483507 Jefferson Smurfit Corporation (US) 4/1/1991 11/1/2004 W627509 Jensen Tools & Supply, Inc. 7/1/2009 W485007 Jewel Companies Inc 10/1/1954 5/23/1981 W519888 JJ Newberry Co. 4/1/1975 1/1/1979 W446256 JL Productions Inc. 1/1/1981 12/18/1985 W419006 JM Fields, Inc. 4/1/1977 11/1/1978 W486005 Joanna Western Mills, Co. 1/20/1966 3/28/1987 W591192 John Eudes Center 7/1/1989 W341002 John Sexton & Co., Inc. 10/15/1981 12/5/1983 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W519383 John T Mather Memorial Hospital 1/1/2004 6/1/2010 W591127 John the Baptist Church Greenville 9/1/1978 W520001 John W. McGrath Corp 10/1/1955 4/29/1983 W52001 John W. McGrath Corp 10/1/1955 4/29/1983 W520506 John W. McGrath Corp 10/1/1977 4/29/1983 W591374 John XXIII College Community 8/9/1999 W449508 Johnny Carson Apparel Inc. 3/1/1978 1/31/1984 W487003 Jones & Laughlin Steel Corp ( Defaulted) 1/1/1960 1/1/1979 W487250 Jones Motor Co Inc 1/1/1979 11/22/1981 W487383 Jordan Marsh Company 7/1/1985 1/31/1987 W487441 Jordan Marsh Stores Corporation 1/31/1987 4/21/1988 W591127 Joseph's Church Troy 9/1/1978 W625008 Julius Wile Sons & Co., Inc. 1/1/1978 10/15/1982 W522502 Kalteux Oil Co., Inc. (DEL) 6/1/1968 1/1/1982 W413876 Karg Bros. Finishing Corp. 9/1/1980 9/16/1994 W413876 Karg Bros. Inc. 9/1/1980 9/16/1994 W446256 Katzenbazh & Warren Inc. 1/1/1981 9/12/1985 W446256 Kayser-Roth Corporation 1/1/1981 9/12/1985 W446256 Kayser-Roth Industries Inc. 1/1/1981 9/12/1985 W488381 Kellogg Company 4/1/1999 4/1/2000 W488381 Kellogg Sales Company 4/1/1999 4/1/2000 W488258 Kelsey-Hayes Co Utica Division 4/1/1977 4/1/1987 W683502 Kenite Corporation 7/1/1973 3/31/1975 W488639 Kennecott Corp. 12/31/1980 1/1/1987 W488571 Kentile Floors Inc ( Defaulted) 1/1/1987 1/1/1989 W488829 Key Bancshare of New York, Inc. 9/15/1991 6/30/1997 W488829 Key Bank Life Insurance, Ltd. 9/15/1991 6/30/1995 W488829 Key Bank USA, NA 9/15/1991 10/1/2004 W488829 Key Financial Services, Inc. 9/15/1991 3/31/1995 W488829 Key Investments Inc. 9/15/1991 5/14/1999 W488829 Key Mortgage Funding, Inc. 9/15/1991 6/1/1992 W488829 Key Services Corporation 9/15/1991 12/14/1998 W488829 Key Trust Company 9/15/1991 12/29/2000 W488829 KeyBank National Association 9/15/1991 6/30/2014 W488829 KeyCorp (1991) 9/15/1991 6/30/2014 W488829 KeyCorp Leasing Ltd. 9/15/1991 9/1/1997 W488829 KeyCorp Mortgage, Inc. 6/1/2002 3/31/1995 W488860 KeySpan Corporate Services, LLC 9/30/2001 7/1/2009 W556500 KeySpan Corporation 7/1/2009 W517569 KeySpan Corporation (1998) 5/28/1998 9/30/1999 W488860 KeySpan Corporation (2001) 9/30/2001 7/1/2009 W488860 KeySpan Electric Services, LLC 9/30/2001 7/1/2009 W488860 KeySpan Energy Development Corporation 9/30/2001 7/1/2009 W556500 KeySpan Energy Development Corporation 7/1/2009 W488860 KeySpan Energy Trading Services, LLC 9/30/2001 7/1/2009 W488860 KeySpan Engineering & Survey, Inc. 9/30/2001 7/1/2009 W488860 KeySpan Gas East Corporation 9/30/2001 7/1/2009 W556500 KeySpan Gas East Corporation 7/1/2009 W488860 KeySpan Generation, LLC 9/30/2001 7/1/2009 W488860 KeySpan MHK, Inc. 9/30/2001 7/1/2009 W556500 KeySpan MHK, Inc. 7/1/2009 W488860 Keyspan Ravenswood Services Corp 9/30/2001 7/1/2008 W488860 KeySpan Utility Services, LLC 9/30/2001 7/1/2009 W488860 KeySpan-Ravenwood, Inc. 9/30/2001 8/26/2008 W548509 Kick Five Productions, LLC 10/9/2020 W489009 Kimberly-Clark Corporation 5/1/1946 12/30/1971 W561757 Kimble Glass, Inc. 1/1/1993 12/31/1993 W489256 King Kullen Grocery Co Inc 4/1/1978 4/1/1987 W558720 King Paving Corporation 10/1/1993 12/31/2002 W558720 King Road Materials, Inc. 10/1/1993 12/31/2002 W446256 King World Corporation 1/1/2001 W446256 King World Productions, Inc. 1/1/2001 W489389 Kistner Concrete Products Inc 9/30/2003 W677009 Klearfold, LLC 1/1/2003 12/31/2003 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W489446 Klein Cutlery LLC 1/1/2012 7/1/2019 W449508 Kleinhans Co., Inc. (fka Ntn’l Clothing Co.of Rochester, Inc.) 3/1/1978 11/30/1991 W492003 KMart Apparel Fashions Corp. 7/1/1985 1/30/1991 W492003 Kmart Corporation ( Defaulted) 4/24/1934 3/19/2002 W576508 Knickerbocker Liquors Corporation 10/1/1974 11/30/1977 W576508 Knickerbocker Warehousing Corp. 10/1/1974 11/30/1977 W489884 Knight Transportation, Inc. 5/1/2008 7/1/2011 W491005 Koppers Co Inc 11/10/1944 5/1/1976 W591127 Korean Apostolate of the Diocese of Albany 9/1/1978 W491500 Krasdale Foods, Inc. 10/1/2000 W492508 L & JG Stickley Inc 1/1/1994 W499073 L Brands Direct Media Production, Inc. 8/1/2005 8/1/2018 W499073 L Brands Inc 11/1/1993 W499073 L Brands New York, Inc. 1/1/2009 1/1/2011 W499073 L Brands Service Company, LLC 11/1/1993 W499073 L Brands Store Design & Construction, Inc. 11/1/1993 W499073 La Senza, Inc. 1/1/2010 1/6/2019 W662506 Lake Grove Realty Corporation 4/30/1978 5/1/1981 W492755 Landis Plastics Inc 4/1/1994 2/5/2006 W499073 Lane Bryant, Inc. 11/1/1993 8/16/2001 W522502 Langie Fuel Service Inc. (NY) 6/1/1968 1/1/1982 W446256 Late Show, Inc., The 4/1/2015 W495006 Latouraine-Bickford Food Inc 1/1/1971 3/1/1973 W450944 Lawrence Center for Rehabilitation and Sports Medicine Corp 10/1/2002 12/31/2013 W450944 Lawrence Community Health Services, Inc. 10/1/2002 12/31/2013 W450944 Lawrence Hospital Center 10/1/2002 12/31/2013 W450944 Lawrence Medical Associates, PC 3/1/2009 12/31/2013 W496509 Lawyer's Cooperative Publishing, Co 1/1/1978 1/1/1991 W662506 LBRO Realty Corporation 4/30/1978 5/1/1981 W347751 Learjet, Inc. 5/15/1995 10/19/2003 W517601 Leasametric, Inc. 4/1/1988 6/23/1992 W607501 Lehman Brothers, Inc. 7/1/1993 9/30/2004 W498257 Lenox Hill Hospital 6/1/1979 7/1/2013 W498380 Leprino Foods Company 11/1/1981 W498380 Leprino Transportation Company 2/11/1998 11/3/2002 W499073 Lerner New York, Inc. 11/1/1993 11/27/2002 W498505 Lerner Stores Corporation 7/1/1975 1/1/1979 W499040 Libbey Glass Inc 10/10/1995 7/1/2009 W561757 Libbey Glass, Inc. 3/24/1987 6/24/1993 W499131 Life Savers Inc 1/1/1983 12/31/1984 W417380 Lifetime HealthCare, Inc. 12/1/1995 W417380 Lifetime Pharmacy, LLC 12/31/2009 10/1/2019 W499073 Limited Brands Store Operations, Inc. 5/16/1995 8/31/2005 W499073 Limited New York, Inc. (1993) 11/1/1993 12/31/2005 W499073 Limited Stores LLC 7/1/2006 8/3/2007 W499073 Limited Stores, Inc. 11/1/1993 7/1/2006 W499073 Limited Too, Inc. 11/1/1993 8/24/1999 W499503 Lincoln First Bank NA 12/31/1978 7/1/1984 W499503 Lincoln First Banks Inc 12/31/1978 7/1/1984 W499503 Lincoln First Commercial Corp. 12/31/1978 7/1/1984 W499750 Lipe-Rollway Corp 4/1/1981 4/1/1986 W499917 Little Ceasar Enterprises, Inc. 10/4/1985 11/4/1990 W499917 Little Ceasar International, Inc. 10/4/1985 11/4/1990 W503007 Litton Bionetics Inc. 8/1/1982 8/1/1984 W503007 Litton Business Systems Inc. 4/1/1971 8/1/1984 W503007 Litton Business Telephone Systems 8/1/1974 5/23/1984 W503007 Litton Educational Publishing Inc. 4/1/1971 4/4/1981 W503007 Litton Financial Services Corp. 8/1/1974 8/1/1984 W503007 Litton Industrial Products Inc. 4/1/1971 8/1/1984 W503007 Litton Industrial Systems Inc. (DEL) 4/1/1971 8/1/1984 W503007 Litton Industries Inc Etal 4/1/1971 8/1/1984 W503007 Litton Medical Products Inc. (DEL) 4/1/1971 11/2/1974 W384820 Living Opportunities of DePaul, Inc. 9/1/2001 W509004 Loblaw, Inc. 12/9/1951 5/22/1977 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W519698 Loehmann's Inc. 8/1/1987 9/19/1988 W510002 Lone Star Industries Inc 12/1/1936 4/1/1970 W511505 Long Island Lighting Company 1/1/1995 5/28/1998 W512008 Long Island Railroad Co 8/12/1954 8/14/1967 W419006 Longwood Distributors Inc. 4/1/1977 11/1/1978 W568078 Lothlorien Therapeutic Riding Center Inc 4/1/2020 W520746 Louis V. Gerstner Jr. Graduate School 4/16/2005 W591507 Lourdes Camp, Inc. 7/1/1992 W515506 Lowe's Home Centers, LLC 1/28/2000 W499008 LSI United Holding Corp. 7/1/1938 12/17/1951 W557904 LTC (Eddy), Inc. 1/1/2011 1/1/2012 W579007 LTV Steel Co Inc 5/29/1930 5/7/1986 W516132 Lucent Technologies Inc (nka Alcatel-Lucent USA Inc) 7/1/1997 7/1/2001 W595755 M & G Convoy, Inc. 3/1/1977 3/31/1994 W678759 M Wile & Co Inc 3/1/1978 4/1/2002 W449508 M Wile & Company, Inc. 3/1/1978 9/28/1992 W517254 Mack Trucks Inc 1/1/1976 7/1/1983 W413843 Macy's Backstage, Inc. 8/1/2015 W413843 Macy's Corporate Services, LLC 1/1/2004 W413843 Macy's East, Inc. 12/19/1994 1/28/2006 W413843 Macy's East, LLC 4/1/2005 8/28/2009 W413843 Macy's Home Store, LLC 4/1/2005 8/28/2009 W413843 Macy's Merchandising Corp. 3/10/2009 W413843 Macy's Merchandising Group, Inc. 4/1/2005 W413843 Macy's Retail Holdings, LLC 8/30/2005 W413843 Macy's Systems and Technology, Inc. 12/19/1994 W413843 Macy's, Inc. 8/1/1994 W413843 Macys.com, Inc. 1/1/1998 10/31/2015 W413843 Macys.com, LLC 10/31/2015 W446256 Madison Square Garden Associates, Inc. 7/1/1991 3/11/1995 W446256 Madison Square Garden Center, Inc. 7/1/1981 3/11/1995 W446256 Madison Square Garden Corp 1/1/1981 3/11/1995 W517387 Magna Powertrain USA Inc 9/29/2004 10/1/2007 W434005 Mail-Well Envelope Company, Inc. 4/1/1991 2/24/1994 W515506 Maintenance Supply Headquarters LP 1/1/2018 W517627 Manhattan Sheraton Corporation Manhattan Sheraton Corporation 10/1/2020 W557904 Marjorie Doyle Rockwell Center, Inc. 1/1/2011 1/1/2012 W650069 Marjorie Doyle Rockwell Center, Inc., The 1/1/2016 W341002 Market Forge Company 10/15/1981 1/30/1985 W517585 Marmon Corporation 1/1/1988 7/1/1993 W364756 Marmon Group Inc The 2/24/1976 1/1/1981 W517601 Marmon Industrial Corporation 4/1/1988 1/1/1999 W446256 Marquette Company 1/1/1981 4/27/1982 W517627 Marriott Claims Services Corporation 10/6/2000 W517627 Marriott Educational Services, Inc. 11/1/1981 3/27/1998 W517627 Marriott Family Restaurants Inc. 10/1/1978 10/1/1993 W517627 Marriott Fifth Avenue, LLC 10/1/2008 W517627 Marriott Hotel Management Company, LLC 10/1/2008 10/1/2008 W517627 Marriott Hotel Services, Inc. 10/1/1993 W517627 Marriott International Administrative Services, Inc. 1/1/1996 W517627 Marriott International Design & Construction Services, Inc. 10/1/2008 W517627 Marriott International Services, Inc. 7/1/1984 3/27/1998 W517627 Marriott International, Inc. 5/1/1978 W517627 Marriott Laundry Services, Inc. 10/1/1992 3/27/1998 W517627 Marriott Management Services Corp. 6/25/1986 3/27/1998 W517627 Marriott Ownership Resorts, Inc. 10/1/2008 10/1/2011 W517627 Marriott Rewards LLC 10/1/2020 W448252 Martin's Foods of South Burlington II, LLC 4/15/1990 W591192 Mary Immaculate Parish 7/1/1989 W591192 Mary of the Lake Parish 7/1/1989 W591192 Mary Queen of Angels Catholic School 7/1/1989 W591192 Mary Queen of Angels RC Church 7/1/1989 W517759 Mason & Dixon Lines Inc ( Defaulted) 1/1/1974 2/7/1984 W518005 Mason & Hanger Co. Inc. 5/21/1934 10/28/1939 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W476006 Masonite Corporation 1/1/1997 8/31/2001 W519003 Massena Terminal Railroad Co 9/30/1914 9/11/1987 W499073 Mast Logistics Services, Inc. 11/1/1993 4/1/2008 W499073 Mast Technology Services, Inc. 7/6/1999 W519250 Materials Liquidation Corporation (formerly known as Materials Research Corporation) 3/1/1992 4/1/1998 W519508 Matlack Inc 10/1/1975 10/1/1996 W645501 Matthew Bender & Co., Inc. 1/1/1979 4/1/1998 W448757 Max Gruenhut International, Inc. 2/15/1991 1/1/2001 W519698 May Department Stores Co (nka Macy’s Retail Holdings, Inc.) 2/1/1987 8/30/2005 W519698 May Department Stores International 1/1/2004 8/30/2005 W413843 May Department Stores International, Inc. 8/30/2005 12/31/2006 W519698 May Merchandising Corporation 2/1/1987 1/30/1988 W519714 Mayfair Supermarkets, Inc. 2/23/1997 11/4/2000 W600720 McCarthy, J.F. Corp. (NY) 7/1/1975 4/4/1980 W591127 McCloskey Community Service Corporation 6/30/2004 W519888 McCrory Corporation 4/1/1975 1/1/1979 W519946 McDonald's Restaurants of New York, Inc. 5/1/1994 1/1/1999 W520506 McGrath Services Corp. 10/1/1977 4/30/1983 W420509 McKesson Corporation 5/1/1981 7/1/1997 W520639 McLean Trucking Co. 5/1/1979 2/1/1986 W520696 McWane Inc dba Kennedy Valve Co 12/1/1988 W520605 Mead Corporation 6/1/1994 1/1/2003 W677009 Mead Corporation 1/1/2003 1/1/2003 W520712 Meadow Brook Dairy Company, Inc. 9/1/1993 11/28/1993 W453252 Meadows At Westfall, Inc. 1/1/2000 W677009 MeadWestvaco Consumer Packaging Group, LLC 1/1/2003 9/30/2010 W677009 MeadWestvaco Corporation (WestRock) 7/6/1914 10/1/2015 W677009 MeadWestvaco Packaging Systems, LLC 1/1/2003 10/1/2015 W417380 MedAmerica Insurance Company of New York 12/31/2009 W417380 MedAmerica, Inc. 6/1/2012 W650065 Memorial Hospital Albany, NY 1/1/2016 1/1/2020 W520746 Memorial Hospital for Cancer & Allied Diseases 4/16/2005 W557904 Memorial Hospital, Albany, NY 1/1/2011 1/1/2012 W520746 Memorial Sloan-Kettering Cancer Center 4/16/2005 W558720 Merchants Metals, Inc. 4/1/2007 W520852 Merrill Lynch & Co Inc 2/1/1994 8/1/2009 W520852 Merrill Lynch Business Financial Services, Inc 2/1/1994 8/1/2009 W520852 Merrill Lynch Capital Services, Inc. 2/1/1994 8/1/2009 W520852 Merrill Lynch Fiduciary Services 2/1/1994 1/9/2006 W520852 Merrill Lynch Futures, Inc. 2/1/1994 7/1/2001 W520852 Merrill Lynch Governmant Securities, Inc. 2/1/1994 8/1/2009 W520852 Merrill Lynch Hubbard, Inc. 2/1/1994 8/1/2009 W520852 Merrill Lynch Insurance Group, Inc. 2/1/1994 8/1/2009 W520852 Merrill Lynch Interfunding, Inc. 2/1/1994 1/9/2006 W520852 Merrill Lynch Investment Management, Inc. 2/1/1994 1/9/2006 W520852 Merrill Lynch Life Agency, Inc. 2/1/1994 8/1/2009 W520852 Merrill Lynch Money Markets, Inc. 2/1/1994 8/1/2009 W520852 Merrill Lynch Private Capital, Inc. 2/1/1994 1/9/2006 W520852 Merrill Lynch Professional Clearing Corp. 2/1/1994 8/1/2009 W520852 Merrill Lynch Specialists, Inc. 2/1/1994 1/9/2006 W520852 Merrill Lynch, Pierce, Fenner, & Smith, Inc. 2/1/1994 8/1/2009 W520829 Metropolitan Museum of Art 7/1/1994 W520506 Metropolitan News Company 10/1/1977 4/23/1983 W450134 Mid-Hudson Oncology Physician, PLLC 4/1/2006 6/1/2009 W450134 Mid-Hudson Radiation Therapists, Inc. 4/1/2006 6/1/2009 W520870 Mid-Hudson Valley Staffco LLC 7/1/2015 W520886 Migay Trucking Corp 12/31/1978 8/25/1985 W499073 MII Brand Import,LLC 11/1/1993 W415004 Millard Fillmore Hospital (1925) 6/29/1925 6/1/1988 W415509 Millard Fillmore Hospital (1991) 9/1/1991 4/1/1998 W420509 Millbrook Distribution Services Co. 7/1/1991 7/1/1997 W420509 Millbrook Distributors, Inc. 7/1/1991 7/1/1997 W591127 Mission of Our Lady of Hope 9/1/1978 W591374 Mission Project Service 4/21/2005 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W522759 Mobil Business Resources Corporation 1/1/1997 11/30/1999 W522502 Mobil Corp 3/15/1979 1/1/1982 W522759 Mobil Corporation (1997) 1/1/1997 11/30/1999 W522502 Mobil Oil Corp. 6/30/1934 1/1/1982 W524003 Mobil Oil Corporation 6/30/1934 1/1/1982 W522759 Mobil Oil Corporation (1997) 1/1/1997 11/30/1999 W522502 Mobil Pipe Line Co. (DEL) 5/1/1969 1/1/1982 W522502 Mobil Research & Development Corp. 6/1/1972 1/1/1982 W522502 Mobil Sales & Supply Corp. (DEL) 6/1/1972 1/1/1982 W522502 Mobil Shipping & Transportation Co. 6/1/1972 1/1/1982 W522502 Mobil South Inc. (DEL) 6/1/1972 1/1/1982 W386007 Mohawk Containers Inc. 4/1/1970 1/1/1983 W576508 Mohawk Valley Merchandisers Corp. 10/1/1974 11/30/1977 W559009 Monarch Brass & Copper Corp. 11/1/2001 2/8/2002 W591192 Monsignor Carr Institute 7/1/1989 W591192 Monsignor Martin High School Athletic Association 7/1/2004 W591127 Montgomery County CFCS 9/1/1978 W533004 Montgomery Ward & Co Inc 8/10/1933 8/15/1987 W534002 Morris Lew Demolition Co 4/1/1953 9/18/1973 W438501 Morris Pumps Inc. 4/1/1982 1/1/1984 W535009 Morse Chain Company 1/1/1966 12/31/1967 W535884 Morton International, Inc. (nka Autoliv ASP Inc) 7/1/1989 3/31/1997 W535751 Morton Thiokol Inc 3/31/1981 7/1/1989 W591127 Most Holy Redeemer Cemetery 9/1/1978 W591507 Most Holy Rosary Church 4/16/1974 W591507 Most Holy Rosary Church (Maine, NY) 4/16/1974 W591507 Most Holy Rosary School 4/16/1974 W591192 Most Precious Blood Roman Catholic Church Corp. 7/1/1989 W341002 Mother's Cookie Company 10/15/1981 2/8/1985 W535504 Motor Freight Express Inc 1/1/1973 12/1/1982 W333132 Mount St. Mary's Hospital of Niagara Falls 2/1/2004 7/1/2015 W548002 Moving Services Consultants Inc. 1/1/1971 7/26/1985 W596878 MRC Bearings, Inc. 1/1/1987 1/1/1988 W517627 MRO Roast Beef of Long Island, Inc. 3/15/1979 4/14/1990 W549919 MTV Networks Global Services Inc. 10/1/2006 W446256 MTVi Group, Inc. 12/21/1999 12/31/2005 W424634 Multimedia Entertainment, Inc. 10/1/2000 6/29/2015 W595755 Murray Recon, Inc. 1/1/1985 12/31/1995 W568078 Museum of Disability History 3/1/2006 W677009 MW Custom Papers, LLC 1/1/2003 10/1/2015 W538003 Nabisco, Inc. 4/1/1921 5/1/2001 W539001 Nassau Metals Corporation 1/23/1935 7/1/2001 W540009 National Can Corp 1/1/1972 1/1/1982 W318000 National Express Company, Inc. 9/30/2002 9/30/2013 W541007 National Food Management Service 1/1/1962 10/27/1972 W541254 National Fuel Gas Company 12/31/1978 W541254 National Fuel Gas Distribution Corp 7/15/1974 W541254 National Fuel Gas Supply Corp. 7/15/1974 W556500 National Grid Corporate Services, LLC 7/1/2009 11/5/2012 W556500 National Grid Electric Services, LLC 7/1/2009 W556500 National Grid Energy Trading Services LLC 7/1/2009 W556500 National Grid Engineering & Survey Inc. 7/1/2009 W556500 National Grid Generation LLC 7/1/2009 W556500 National Grid USA 1/1/2004 W556500 National Grid USA Service Company, Inc. 7/1/2009 W556500 National Grid Utility Services LLC 7/1/2009 11/5/2012 W542005 National Gypsum Co. 1/1/1936 1/1/1971 W627509 National Manufacturing Sales Co. 7/1/2006 W591127 Nativity of Blessed Virgin Mary 9/1/1978 12/31/2009 W591192 Nativity of Our Lord Parish 7/1/1989 W591192 Nativity of the Blessed Virgin Mary 7/1/1989 W549919 Neopets, Inc. 10/1/2006 8/31/2015 W548002 Neptune Furniture Inc. 1/1/1971 7/26/1985 W548002 Neptune Furniture Westbury Corp. 1/1/1971 7/26/1985 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W545008 Neptune Meter Co 8/31/1935 10/1/1972 W548002 Neptune Supermart Inc. 1/1/1971 7/26/1985 W548002 Neptune Thru-Container Corp. 1/1/1971 7/26/1985 W548002 Neptune World Wide Moving Inc 1/1/1971 7/26/1985 W548509 Netflix Animation LLC 1/1/2019 W548509 Netflix Backstage LLC 4/4/2019 W548509 Netflix Entertainment LLC 4/4/2019 W548509 Netflix India Originals, LLC 6/27/2019 W548509 Netflix IO Productions, LLC 6/27/2019 W548509 Netflix Japan Originals, LLC 6/27/2019 W548509 Netflix Originais, LLC 6/27/2019 W548509 Netflix Productions LLC 1/1/2019 W548509 Netflix Studios LLC 1/30/2019 W548509 Netflix Worldwide Entertainment LLC 9/30/2019 W548509 Netflix, Inc. 7/1/2018 W549919 New 38th Floor Productions, Inc. 12/22/2007 W645501 New American Library Co., Inc. 1/1/1979 12/28/1983 W549919 New Country Services, Inc. 12/22/2007 W549919 New Creative Mix, Inc. 12/22/2007 W549257 New Era Cap Co, Inc. 12/1/1993 12/1/2019 W549919 New Games Productions, Inc. 12/22/2007 W549919 New International Mix Inc. 12/22/2007 W549919 New Nickelodeon Animation Studios Inc. 12/31/2011 W549919 New Not Before 10AM Productions, Inc. 12/22/2007 W549919 New Open Door Productions, Inc. 12/22/2007 W565253 New Partners, Inc. 10/18/1999 W549919 New Pop Culture Productions, Inc. 12/22/2007 W368005 New Process Gear Corp. 1/1/1980 9/30/1984 W549638 New Process Gear, Inc. 9/29/2004 10/1/2007 W549919 New Remote Productions, Inc. 12/22/2007 W549885 New Venture Gear Inc 4/1/1990 12/31/2004 W549885 New Venture Gear of New York LLC 1/1/1999 12/31/2004 W549885 New Venture Gear Operating Company 1/1/1999 12/31/2004 W554885 New York & Presbyterian Hospital 12/31/1997 3/31/1999 W549976 New York Black Car Operators' Injury Comp Fund, Inc. 1/20/2007 W550008 New York Central Railroad ( Defaulted) 7/22/1914 3/9/1960 W550271 New York Downtown Hospital 11/27/1997 12/1/2009 W389001 New York Fruit Auction Corp 1/1/1972 8/1/1972 W552509 New York News Inc 12/31/1978 3/20/1991 W554000 New York University (1972) 4/1/1972 10/15/1998 W554192 New York University (2015) 9/1/2015 W440754 Newark Wayne Community Hospital Foundation, Inc. 1/1/2012 W440754 Newark Wayne Community Hospital, Inc. 10/1/1996 W554380 Newark-Wayne Community Hospital 1/31/1992 10/1/1996 W554752 Newsday Inc 1/1/1977 1/1/1979 W645501 Newsday, Inc. 1/1/1977 4/1/1998 W549752 Newsweek Inc 1/1/1982 1/1/1999 W548509 NF Voices LLC 6/29/2020 W488829 Niagara Asset Corporation 6/1/1992 3/10/1999 W591192 Niagara Catholic High School 12/31/1991 W555122 Niagara Falls Memorial Medical Center 4/1/1980 4/30/1999 W557003 Niagara Junction Railway Co. (NY) 10/7/1948 1/11/1971 W556500 Niagara Mohawk Holdings, Inc. 7/1/2009 W556500 Niagara Mohawk Power Corporation dba National Grid 1/1/2004 W557318 Niagara Recycling Inc 9/1/1995 5/1/1997 W557169 Niagara Specialty Metals Inc 7/1/2001 9/13/2002 W538003 Niagara Trading Company Inc. 11/1/1977 8/26/1978 W549919 Nickelodeon Animation Studios, Inc. 12/22/2007 W446256 Nickelodeon Magazine Inc. 7/1/1995 12/31/2005 W549919 Nickelodeon Magazines Inc. 10/1/2006 W537005 NL Industries Inc 7/13/1914 8/1/1993 W562250 Norandex Distribution, Inc. 1/1/2007 8/31/2007 W450944 Norcorp Inc. 10/1/2002 12/31/2013 W557417 Nordstrom, Inc. 1/1/1995 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591374 North Country Catholic, The 6/1/1976 W591127 North Country Ministry, Inc. 3/1/2008 W440754 North Park Nursing Home, Inc. 1/1/2016 W417380 North Star Home Health Management, Inc. 6/1/2012 7/18/2016 W557904 Northeast Health Foundation, Inc. 1/1/2011 1/1/2012 W650065 Northeast Health Foundation, Inc., The 1/1/2016 W557904 Northeast Health Inc 1/1/2011 1/1/2012 W591192 Northern Chautauqua Catholic School 7/1/1989 W450134 Northern Dutchess Hospital 4/1/2006 6/1/2009 W450134 Northern Dutchess Residential Healthcare Facility, Inc. 4/1/2006 6/1/2009 W591507 Northern Regional Catholic Schools 4/16/1974 W450944 Northern Westchester Hospital Association 10/1/2002 12/31/2013 W450944 Northern Westchester Hospital Auxiliary 10/1/2002 12/31/2013 W450944 Northern Westchester Hospital Center Foundation 10/1/2002 12/31/2013 W450944 Northern Westchester Oncology Management Associates, Inc. 10/1/2002 12/31/2013 W450944 Northern Westchester Realty Holding Corp 10/1/2002 12/31/2013 W450944 Northern Westchester Surgical Services, PC 1/12/2011 12/31/2013 W548509 Northstar Pictures LLC 11/15/2019 W651251 Norwalk-Turbo, Inc. 1/1/1979 12/9/1982 W549919 Not Before 10am Productions Inc. 10/1/2006 W591192 Notre Dame Academy 5/23/2006 W591374 Notre Dame Church 6/1/1976 W591374 Notre Dame Church - Ogdensburg 6/1/1976 W591192 Notre Dame Educational Foundation 7/1/1989 W591507 Notre Dame Elementary School 3/31/1999 12/31/2016 W591507 Notre Dame Jr./Sr. High School (1974-2016) 4/16/1974 12/31/2016 W591507 Notre Dame Jr/Sr High School 1/1/2017 W591127 Notre Dame Visitation Church 9/1/1978 W591127 Notre Dame/ Bishop Gibbons School 9/1/1978 W558506 Novo Airfreight Corporation 5/1/1973 7/14/1978 W558506 Novo Corporation ( Defaulted) 5/1/1973 7/14/1978 W676001 Numanco Inc. 1/1/1986 12/1/1989 W450944 NWHC Health Management Services Inc. 10/1/2002 12/31/2013 W450944 NWHC Staff Housing Corp 10/1/2002 12/31/2013 W591127 NYS Labor Religion Coalition 9/1/1978 W537500 NYSARC Inc Chautauqua County Chapter 12/1/1994 1/1/2008 W537633 NYSARC Inc Chautauqua County Chapter dba The Resource Center 1/1/2008 W537880 NYU Langone Hospitals 1/1/1998 W562250 O/C Tanks Corporation 9/1/1989 1/1/1995 W542005 Oakfield Gypsum Products Corporation 3/31/1928 9/12/1938 W558605 O-AT-KA Milk Products Cooperative Inc 12/1/1995 5/1/2017 W558696 Occidental Chemical Corporation 1/1/1990 12/1/1998 W562250 OCV Fabrics US, Inc. 10/31/2007 W347504 OfficeMax Contract, Inc. 4/1/1995 1/1/2005 W347504 OfficeMax Incorporated 1/1/1984 1/1/2005 W591374 Ogdensburg Catholic Central School 6/1/1976 W560759 OH Properties Inc 2/11/2019 W558720 Oldcastle APG Northeast, Inc. 1/1/2005 W558720 Oldcastle Buildingenvelope, Inc. 1/1/2005 W558720 Oldcastle Infrastructure, Inc 1/1/2005 W558720 Oldcastle Payroll, Inc. 1/1/2017 W558720 Oldcastle Services, Inc. 1/1/2009 W555502 Olean Market Incorporated 9/27/1978 12/28/1980 W559009 Olin Corporation 6/23/1923 7/1/2006 W499917 Olympia Arenas, Inc 10/4/1985 11/4/1990 W446256 On Broadband Networks, LLC 9/1/2008 W559504 Oneida Ltd 2/1/1979 5/17/2011 W433254 Ontario Foods, Inc. 8/25/1992 7/28/2001 W549919 Open Door Productions Inc. 10/1/2006 W560502 Orange and Rockland Utilities, Inc. 1/1/1979 W560759 Oswego Hospital 4/1/1991 W591127 Our Lady Help of Christians Cemetery 9/1/1978 W591192 Our Lady Help of Christians Parish 7/1/1989 W591127 Our Lady of Angels Cemetery 9/1/1978 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591192 Our Lady of Bistrica Parish-dba Our Lady of the Sacred Heart of Jesus 7/1/1989 W591192 Our Lady of Black Rock 7/1/1989 W591192 Our Lady of Charity 7/1/1989 W591192 Our Lady of Czestochowa Parish 7/1/1989 W591192 Our Lady of Czestochowa Parish 7/1/1989 W591127 Our Lady of Fatima Church 9/1/1978 W591507 OUR LADY OF GOOD COUNSEL CHURCH 4/16/1974 W591507 Our Lady of Good Counsel Church - Endicott 4/16/1974 W591127 Our Lady of Grace Church 9/1/1978 W591127 Our Lady of Hope 9/1/1978 W591192 Our Lady of Hope 7/1/1989 W591507 Our Lady of Hope Church of Syracuse, NY (fka St. James' Church Syracuse) 4/16/1974 W591192 Our Lady of Loreto Parish 7/1/1989 W591507 Our Lady of Lourdes - Utica 4/16/1974 W591374 Our Lady of Lourdes Church - Schroon Lake 6/1/1976 W591507 Our Lady of Lourdes Church - Syracuse 4/16/1974 10/7/2017 W591507 Our Lady of Lourdes Church - Windsor 4/16/1974 W561500 Our Lady of Lourdes Memorial Hospital 7/1/1981 W591127 Our Lady of Mercy Church - Colonie 9/1/1978 11/17/2009 W650065 Our Lady of Mercy Life Center 1/1/2016 W591192 Our Lady of Mercy Roman Catholic Parish 7/1/1989 W591127 Our Lady of Mount Carmel 9/1/1978 4/13/2009 W591127 Our Lady of Mount Carmel Church 9/1/1978 W591192 Our Lady of Mount Carmel Parish 7/1/1989 W591507 Our Lady of Peace Cemetery 2/1/2004 W591507 Our Lady of Peace Church - Syracuse 4/16/1974 W591192 Our Lady of Peace Parish 7/1/1989 W591192 Our Lady of Peace Roman Catholic Parish of Salamanca, NY 7/1/1989 W333132 Our Lady of Peace, Inc. 2/1/2004 W591507 Our Lady of Perpetual Help 4/16/1974 W591192 Our Lady of Perpetual Help Parish 7/1/1989 W591507 Our Lady of Pompei Church of Syracuse 4/16/1974 W591507 Our Lady of Pompei Church of Syracuse 4/16/1974 W591192 Our Lady of Pompeii Parish 7/1/1989 W591507 Our Lady of Sorrows Church 4/16/1974 W591192 Our Lady of the Angels Parish 7/1/1989 W591127 Our Lady of the Annunciation Church 9/1/1978 W591127 Our Lady of the Assumption Church 9/1/1978 W591192 Our Lady of the Lake Parish 7/1/1989 W591507 Our Lady of the Rosary 4/16/1974 W591507 Our Lady of the Rosary Church 4/16/1974 W591374 Our Lady of the Sacred Heart Church - Watertown 6/1/1976 W591192 Our Lady of the Sacred Heart Parish 7/1/1989 W591127 Our Lady of the Snow Church 9/1/2009 W591127 Our Lady of the Snow Parish 9/1/2009 W591374 Our Lady of Victory Church - Plattsburgh 6/1/1976 W591127 Our Lady of Victory Church & Early Childhood Program 9/1/1978 W559256 Our Lady of Victory Homes of Charity 4/1/1992 4/20/2020 W561633 Our Lady of Victory Hospital of Lackawanna 7/1/1991 7/1/2000 W591192 Our Lady of Victory National Shrine 7/1/1989 W591127 Our Lady Queen of Peace 7/1/2010 W591127 Our Lady, Queen of Apostles Church 9/1/1978 W591192 Our Mother of Good Counsel Parish 7/1/1989 W591507 Over the Rainbow Daycare 7/1/2009 W548509 Overshadow Productions LLC 10/22/2019 W562250 Owens Corning 9/1/1989 W562250 Owens Corning (2006) 10/31/2006 W562250 Owens Corning Franchising, LLC 1/1/2007 W562250 Owens Corning Insulating Systems, LLC 1/1/2007 W562250 Owens Corning Sales, LLC 1/1/2007 W561757 Owens-Brockway Glass Container, Inc. 1/1/1993 10/1/2019 W561757 Owens-Brockway Packaging Inc. 7/1/1989 1/1/1993 W561757 Owens-Illinois General Inc. 3/24/1987 2/19/1993 W561757 Owens-Illinois Glass Container, Inc. 3/24/1987 1/1/1989 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W562508 Owens-Illinois Inc (1977) 9/1/1977 3/24/1987 W561757 Owens-Illinois, Inc. (1987) (nka O-I Glass, Inc.) 3/24/1987 10/1/2019 W492003 Pace Membership Warehouse, Inc. 8/1/1992 1/14/1994 W564504 Pacific Intermountain Express Co 9/1/1973 7/11/1983 W413876 Pan American Tanning Corp. 9/1/1980 9/16/1994 W565006 Papec Machine Co, 11/1/1950 11/1/1970 W446256 Paramount Communications Realty Corp. 1/1/1981 10/10/2000 W549919 Paramount Pictures Corp. 12/31/2006 W446256 Paramount Pictures Corporation 1/1/1981 12/31/2005 W446256 Paramount Productions Service Corporation 6/1/1992 10/10/2000 W591127 Parish of Mater Christi 10/1/2009 W591127 Parish of our Lady of Hope 12/31/2009 W591127 Parish of our Lady of Hope - Copake Falls 12/31/2009 W591127 Parish of Our Lady of the Valley 7/1/2009 W591127 Parish of St. John the Evangelist and St. Joseph, The 3/31/2007 W591127 Parish of St. Joseph the Worker 7/1/2009 W591127 Parish of the Holy Trinity 7/1/2009 W591127 Parish of the Holy Trinity - Hudson 7/1/2009 W591374 Parish of the Visitation and St. Raymond, The 5/1/2015 W440754 Park Ridge Child Care Center, Inc. 1/1/2016 W565634 Park Ridge Hospital Inc 5/1/1982 11/1/1985 W440754 Park Ridge Housing Development Fund Company, Inc. 1/1/2016 W440754 Park Ridge Housing, Inc. 1/1/2016 4/23/2018 W565576 Park Ridge Nursing Home Inc 5/1/1982 11/1/1985 W440754 Park Ridge Nursing Home, Inc. 1/1/2016 W440754 Park Way Commons Housing Development Fund Company, Inc. 1/1/2016 W565501 Parker Hannifin Corporation 3/1/1974 W565501 Parker Hannifin Customer Support, Inc. 10/1/1998 6/30/2008 W440754 Parma Housing Development Fund Corporation 1/1/2016 W440754 Parma Senior Housing Associates, LP 1/1/2016 W440754 Parma Senior Housing, LLC 1/1/2016 W565253 Partners in Care, Inc. 1/1/1994 10/18/1999 W634000 Pathmark Stores, Inc. 9/15/1976 5/1/2000 W565691 Pathmark Stores, Inc. 2/1/2001 10/6/2015 W519698 Patless Shoesource, Inc. 2/1/1987 4/1/1996 W565758 Patterson Dental Co. 10/1/1981 4/27/1985 W446256 PCI'S Holdings Corporation 7/1/1995 1/1/1996 W420509 PCS Health Systems, Inc. 7/1/1991 11/21/1994 W418503 PDG, Inc. 5/1/2002 7/1/2010 W477251 Pennaco Hosiery Incorporated 10/1/1981 11/1/1982 W566004 Penn-Dixie Industries Inc 3/1/1964 10/5/1981 W568000 Pennsylvania Railroad 5/3/1916 2/1/1968 W541254 Penn-York Energy Corporation 12/31/1978 7/13/2000 W568078 People Community Housing Development Corporation 3/1/2006 W568078 People Home Health Care Services - Certified, Inc. 3/1/2006 W568078 People Home Health Care Services - Licensed, Inc. 3/1/2006 W568078 People Inc. Finger Lakes 1/1/2013 W568078 People Inc. Foundation 3/1/2006 W568078 People, Inc. 3/1/2006 W569255 Pfaltzgraff Company 1/1/1994 10/10/1995 W569255 Pfaltzgraff Outlet Company 1/1/1994 10/10/1995 W450944 Phelps Child Care Center Inc. 5/21/2003 11/1/2003 W450944 Phelps Memorial Hospital Association 10/1/2002 12/31/2013 W569137 Phelps Memorial Hospital Association 1/1/2014 1/1/2016 W557789 Philips Electronics North America Corporation 4/1/1990 9/30/2002 W450134 Physicians Network, PC 4/1/2006 6/1/2009 W596258 PIE Nationwide, Inc 8/1/1973 2/1/1987 W570253 Pittway Corporation 5/1/1994 4/1/2000 W548509 Pivot Pictures LLC 7/22/2019 W634000 Plainbridge, Inc. 10/26/1993 5/1/2000 W570501 Ponderosa, Inc. 7/1/1979 7/1/1984 W417885 Poorman-Douglas Corporation 1/1/1998 3/2/2001 W549919 Pop Culture Productions Inc. 10/1/2006 W549919 Pop Toons, Inc. 1/1/2008 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591507 Pope John Paul XXIII Roman Catholic Church 4/16/1974 W450944 Post Development Corp. 10/1/2002 12/31/2013 W571004 Post Houses, Inc. 4/1/1977 3/30/1981 W548002 Poughkeepsie Movers Incorporated 1/1/1971 12/8/1980 W572507 Powell & Minnock Brick Works ( Defaulted) 4/1/1973 2/28/1994 W563001 PPG Industries, Inc 5/1/1926 7/1/1985 W517502 PR Mallory & Co, Inc. 1/1/1973 2/27/1979 W440754 PRCD, Inc. 1/1/2016 W361828 Premier Service Programs, Inc. 8/4/1991 8/1/1992 W446256 Prentice-Hall Inc. 1/1/1985 11/27/1998 W446256 Prentice-Hall International Inc. 1/1/1985 11/27/1998 W446256 Prentice-Hall Media Inc. 1/1/1985 8/25/1985 W446256 Prentice-Hall Professional Software, Inc. 1/1/1985 11/27/1998 W572622 Presbyterian Hospital in the City of New York 4/7/1977 12/31/1997 W572754 Preston Trucking Company Inc (1975) (Deafulted) 10/1/1975 3/1/1986 W572887 Preston Trucking Company, Inc. (1990) c/o YRC Worldwide 3/1/1990 7/15/1998 W440754 PRH, Inc. 1/1/2016 W437750 Price Chopper Operating Co., Inc. 5/30/1980 W572945 Price Company, The 6/1/1993 9/3/2001 W591127 Prison Families of Albany 9/1/1978 W558092 Procter & Gamble Pharmaceuticals Inc 6/8/1982 10/30/2009 W573000 Proctor & Gamble Manufacturing Company 1/7/1929 9/4/1991 W335756 ProFoods Restaurant Supply, LLC 9/1/2004 2/1/2007 W448252 Progressive Distributors Inc. 4/15/1990 1/3/2015 W591507 Project Joseph aka Dignity Works 2/13/2018 W548509 Proxy Productions, LLC 7/1/2019 W450134 Putnam Hospital Center 4/1/2006 6/1/2009 W591127 Pyramid Life Center Paradox 9/1/1978 W574131 Quaker Oats Company 10/1/1993 7/1/1997 W574255 Qualex, Inc 8/1/1988 1/1/1995 W591192 Queen of Angels 7/1/1989 W591192 Queen of Heaven Parish 7/1/1989 W591192 Queen of Martyrs Parish 7/1/1989 W511000 Queens Borough Gas & Electric Co. 10/19/1914 3/1/1929 W574388 Queens Borough Public Library 7/1/1995 W417885 Quick & Reilly, Inc. 2/1/1998 8/1/2004 W417885 Quick & Reilly/Fleet Securities, Inc. 2/1/1998 8/1/2004 W574756 QuickChek Corporation (nka Murphy USA) 5/21/2014 5/1/2021 W575005 Quinn Freight Lines Inc 3/1/1966 1/1/1978 W517627 Quornden Inc. 4/20/1989 3/27/1998 W687750 Rabbi Isaac Elchanan Theological Seminary 7/1/2011 W548509 RAD Productions LLC 4/8/2019 W381255 Radix Group International, Inc. 5/1/2005 5/1/2013 W576003 Railway Express Agency (nka REA Express, Inc.) ( Defaulted) 3/25/1929 7/1/1961 W576250 Ralston Purina Company (nka Nestle' Purina PetCare Co) 9/30/1981 10/1/1995 W596258 Ranger Nationwide Inc. 1/1/1984 1/1/1986 W576508 Rapid-American Corp. 11/1/1973 1/1/1979 W576755 Raymond Corporation 5/1/1992 W576755 Raymond Transportation Corporation 6/15/2002 W446256 Raymor-Moreddi Incorporated 1/1/1981 10/22/1982 W388003 RE Dietz Company 12/21/1915 7/31/1986 W446256 Reality Check Productions Inc. 7/1/1995 12/31/2005 W446256 Regents Publishing Co. Inc. 1/1/1987 11/27/1998 W591127 Re-Igniting Our Faith Foundation Inc 8/8/2017 W446256 Remote Productions Inc. 7/1/1995 12/31/2005 W549919 Remote Productions Inc. 10/1/2006 W517627 Renaissance Hotel Management Company, LLC 10/1/2008 W517627 Renaissance Hotel Operating Company 10/1/2008 W517627 Residence Inn by Marriott, LLC 10/1/1992 W384820 Resources Management, Inc. 9/1/2001 W443501 Restaura Inc 6/1/1988 1/27/1999 W446256 Reston Publishing Co., Inc. 1/1/1985 11/27/1998 W591127 Resurrection Church of Germantown 9/1/1978 1/1/2009 W591192 Resurrection Parish 7/1/1989 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591192 Resurrection RC Church Society of Batavia New York 7/1/1989 W499073 Retail Brokerage Solutions, LLC 7/1/2004 W499073 Retail Store Operations, Inc. 1/1/2006 W581003 Revere Copper & Brass, Inc. 12/31/1931 12/1/1984 W581003 Revere Copper Products Inc. 6/30/1980 12/1/1984 W574131 Richardson Foods Corporation 10/1/1993 7/1/1997 W584254 Riegal Products Corp 11/1/1987 4/30/1989 W584502 Riegel Textile Corporation 7/1/1982 10/1/1985 W413876 Riesdorph Tanning Co. Inc. 9/1/1980 4/30/1982 W558720 Ritangela Construction Corp. 10/1/1997 4/30/2001 W517627 Ritz-Carlton Hotel Company, LLC 10/1/2008 W568078 Rivershore, Inc. 1/1/2015 10/5/2016 W446256 Riverside Broadcasting Co., Inc. 7/1/1995 7/2/1997 W450134 Riverside Diversified Services, Inc. 4/1/2006 6/1/2009 W450134 Riverside Medical Practice, PLLC 4/1/2006 6/1/2009 W450134 Riverside Physical & Occupational Therapy Speech Path 4/1/2006 6/1/2009 W586002 Roadway Express Inc c/o YRC Worldwide 1/1/1957 7/1/1996 W499073 Roamans, Inc. 11/1/1993 8/1/1994 W586507 Robintech, Inc. 11/1/1977 9/2/1982 W522502 Robison. E. Inc. (NY) 6/1/1969 1/1/1982 W440754 Rochester General Health System 10/1/1996 W440754 Rochester General Hospital 10/1/1996 W587257 Rochester General Hospital 4/1/1982 10/1/1996 W440754 Rochester General Hudson Housing, Inc. 1/1/2012 W440754 Rochester General Long Term Care, Inc. d/b/a Hill Haven Nursing Home 10/1/1996 W587505 Rochester Institute of Technology 11/1/1981 W587448 Rochester Instrument Systems Inc 1/1/1999 9/5/2000 W517601 Rochester Instruments Systems, Inc. 4/1/1988 12/31/1998 W440754 Rochester Regional Health 10/1/1996 W440754 Rochester Regional Health Foundation Inc. 1/1/2012 W440754 Rochester Regional Health Home Infusion Pharmacy, LLC 1/1/2020 W597629 Rochester St Mary's Hospital of the Sisters of Charity 7/1/1981 1/1/2000 W440754 Rochester St. Mary’s Residence Facility, The, LLC 1/1/2016 W591002 Rockefeller University, The 10/25/1928 W321509 Roll International Corporation (nka the Wonderful Company) 9/15/1991 12/1/1994 W499750 Rollway Bearing International 4/1/1981 4/1/1986 W591259 Roman Catholic Archdiocese of NY 4/15/1976 9/1/1978 W591127 Roman Catholic Community of All Saints on the Hudson 7/1/2011 W591374 Roman Catholic Community of Brownville and Dexter 6/1/1976 W591127 Roman Catholic Diocese of Albany 9/1/1978 W591192 Roman Catholic Diocese of Buffalo 7/1/1989 W591374 Roman Catholic Diocese of Ogdensburg 6/1/1976 W591507 Roman Catholic Diocese of Syracuse 4/16/1974 W591507 Roman Catholic Diocese of Syracuse, NY - Diocesan High Schools 4/16/1974 W591507 Rome Catholic High School 4/16/1974 W446256 Ronkonkoma Wall Paper Corporation 1/1/1981 5/4/1985 W446256 Roosevelt Raceway Inc. 1/1/1981 7/12/1984 W662126 Rosco Tools Incorporated 10/1/1979 8/1/1985 W591192 Rose of Lima Parish 7/1/1989 W592133 Rosina Food Products, Inc 10/1/2006 W592257 Roswell Park Cancer Institute Corporation 1/31/2002 W503007 Royal Business Machines Inc. 8/1/1976 5/31/1979 W595755 RPD Incorporated 1/1/1985 6/15/1987 W390256 RR Donnelley & Sons Co 3/1/1982 7/1/2007 W593008 Rubel Corp. 12/23/1926 4/10/1931 W594006 Russell Burdsall & Ward Bolt & Nut 9/19/1919 7/1/1971 W503007 Rust Engineering Company 4/1/1971 7/18/1972 W503007 Rust Furnace Company (DEL) 4/1/1971 7/18/1972 W596258 Ryder - PIE Nationwide Inc. 8/1/1973 2/1/1987 W595755 Ryder Airline Services, Inc. 11/24/1989 12/7/1993 W595755 Ryder Automotive Operations, Inc. 12/31/1991 9/30/1997 W595755 Ryder Aviall, Inc. 12/31/1991 12/7/1993 W595755 Ryder Driver Leasing Inc. 1/1/1985 12/31/2003 W595755 Ryder Freight Management, Inc. 1/1/1985 12/31/1986 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W595755 Ryder Freight System Inc. 1/1/1985 12/28/1988 W595755 Ryder Integrated Logistics, Inc. 1/1/1985 5/1/2008 W595881 Ryder Integrated Logistics, Inc. 12/1/2014 W595755 Ryder International Freight & Custom Service 1/12/1987 5/8/1989 W595881 Ryder Last Mile Inc 8/1/2019 W595755 Ryder Student Transportation Service, Inc. 11/24/1989 9/14/1999 W595755 Ryder System, Inc. 3/1/1977 5/1/2008 W596258 Ryder Transportation Services,Inc. 8/1/1973 1/1/1986 W595755 Ryder Truck Rental, Inc. 3/1/1977 5/1/2008 W595881 Ryder Truck Rental, Inc. 12/1/2014 W595881 Ryder Vehicle Sales, LLC 12/1/2014 W595755 Ryder/ATE, Inc. 11/24/1989 9/14/1999 W517627 Rye Amusement Parks Incorporated 11/1/1981 12/31/1982 W595755 S & B Brokerage Corporation 3/24/1987 12/31/1987 W591507 Sacred Heart Basilica 4/16/1974 W591374 Sacred Heart Cemetery 6/1/1976 W591507 SACRED HEART CEMETERY 3/31/2010 W591127 Sacred Heart Church 9/1/1978 7/1/2009 W591374 Sacred Heart Church 6/1/1976 W591127 Sacred Heart Church - Berlin 9/1/1978 9/1/2009 W591507 Sacred Heart Church - Cicero 4/16/1974 W591127 Sacred Heart Church - Gloversville 9/1/1978 7/1/2009 W591374 Sacred Heart Church (Edwards) 6/1/1976 W591127 Sacred Heart Church 3rd Ave 9/1/1978 W591127 Sacred Heart Church Cairo 9/1/1978 W591127 Sacred Heart Church Castleton 9/1/1978 W591127 Sacred Heart Church Lake George 9/1/1978 W591127 Sacred Heart Church Margaretville 9/1/1978 W591127 Sacred Heart Church Sidney 9/1/1978 W591127 Sacred Heart Church Stamford 9/1/1978 W591127 Sacred Heart Church Troy 9/1/1978 W591127 Sacred Heart- Immaculate Conception Church 7/1/2009 W591374 Sacred Heart of Jesus Church (Crown Point) 6/1/1976 W591127 Sacred Heart of Jesus Church Albany 9/1/1978 W591192 Sacred Heart of Jesus Parish 7/1/1989 W591192 Sacred Heart Parish 7/1/1989 W591127 Sacred Heart School Troy 10/1/2010 W599252 Saga Corporation 7/1/1982 6/25/1986 W599252 Saga Dining Halls Incorporated 7/1/1982 6/27/1983 W517627 Saga Education Food Service, Inc. 6/27/1983 3/27/1998 W517627 Saga Health Care Dietary Management Svcs, Inc. 6/27/1983 3/27/1998 W557862 Saint-Gobain Abrasives, Inc. 4/1/1992 W557862 Saint-Gobain Advanced Ceramics Corporation 6/1/1996 1/2/2011 W557862 Saint-Gobain Ceramics & Plastics, Inc. 4/1/1992 W557862 Saint-Gobain Performance Plastics Corporation (1993) 3/1/1993 12/31/1999 W557862 Saint-Gobain Performance Plastics Corporation (2000) 1/1/2000 W591127 Saints Cyril and Method Cemetery 9/1/1978 W591374 Saints Peter & Paul Church (Fish Creek) 6/1/1976 W599500 Salada Foods Inc 1/1/1981 1/1/1986 W600001 Salvation Army, The 3/23/1931 4/1/1987 W557904 Samaritan Child Care Center Inc. 1/1/2011 1/1/2012 W650065 Samaritan Child Care Center Inc. 1/1/2016 W421754 Samaritan Home Care Services 10/1/1998 5/31/2003 W557904 Samaritan Hospital of Troy, NY 1/1/2011 1/1/2012 W650065 Samaritan Hospital of Troy, NY 1/1/2016 W466759 Samaritan Medical Center 9/11/1990 1/1/2020 W600258 Samaritan-Keep Nursing Home, Inc. 10/1/1994 1/1/2020 W448252 Sampson Supermarkets Inc. 4/15/1990 12/30/1995 W341002 Sanna Incorporated 10/15/1981 4/24/1984 W503007 Saphier, Lerner, Schindler, Envir. 4/1/1973 5/1/1977 W591127 Saratoga Central Catholic HS 9/1/1978 W591127 Saratoga/Warren/Washington Cos. CFCS 9/1/1978 W651046 Satellite Agency WMMS Inc. 4/1/1999 1/21/2002 W600720 Saxon Adhesive Products Inc. 7/1/1975 8/1/1975 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W600720 Saxon Business Products Inc. 7/1/1975 4/4/1980 W600720 Saxon Industries Inc (NY) 7/1/1975 5/10/1982 W361737 SB Thomas, Inc. 12/1/1991 10/1/1997 W591127 Schenectady County CFCS 9/1/1978 W576508 Schenley Affiliated Brands Corp. 10/1/1974 1/1/1979 W576508 Schenley Industries Incorporated 10/1/1974 1/1/1979 W421754 Schervier Housing Development Fund Corp. 10/1/1998 6/28/2018 W421754 Schervier Nutrition Services, Inc. 10/1/1998 1/1/2008 W600894 Schoeller Technical Papers, Inc. 1/1/1984 3/21/1986 W591127 Schoharie County CFCS 9/1/1978 W354252 Schulman & Schachne Institute for Nursing & Rehabil 11/13/1978 W596860 SCI Technology Inc (nka Sanmina Corp) 1/1/1990 12/1/1994 W600944 Scott Graphics Incorporated 7/1/1978 12/4/1978 W600944 Scott Paper Company (nka Kimberly-Clark Corporation) 7/1/1978 7/1/1996 W601009 Sealright Co, Inc. (DEL) 1/1/1965 12/31/1982 W603005 Sears Industries Inc 1/1/1937 3/15/1973 W604003 Sears Roebuck and Company (NY) 8/13/1929 9/1/1986 W380257 Seasonal Employers, Inc. 2/20/1991 7/1/2009 W446256 Selig Manufacturing Company, Inc. 1/1/1981 9/12/1985 W541254 Seneca Resources Corp 12/31/1978 7/1/1995 W557904 Senior Care Connection, Inc. 1/1/2011 1/1/2012 W650065 Senior Care Connection, Inc. dba Eddy Senior Care 1/1/2016 W356976 Sentry Safe, Inc. 7/1/2006 10/1/2016 W517627 Service Systems Corporation 8/14/1987 3/27/1998 W591374 Seton Academy 7/1/2006 W591374 Seton Catholic Central 5/1/1986 W650065 Seton Health at Schuyler Ridge Residential Healthcare 1/1/2016 W333132 Seton Health at Schuyler Ridge Residential Healthcare Corp. 2/1/2004 10/1/2011 W650065 Seton Health Foundation, Inc. 1/1/2016 1/1/2019 W333132 Seton Health System, Inc. 2/1/2004 10/1/2011 W650065 Seton Health System, Inc. 1/1/2016 1/1/2019 W492508 Seventh Brook Properties LLC 12/1/2003 W602007 Sheffield Farms Company, Inc. 12/23/1914 12/31/1941 W608004 Shell Oil Company (Del) 10/1/1949 4/1/1997 W609002 Shenango Incorporated 10/1/1977 8/30/1982 W328504 Shepard-Niles Crane & Hoist Corp. 1/1/1985 1/1/1986 W610000 Sheraton Corp of America (DEL) 7/1/1969 11/1/1970 W866669 Sherburne-Earlville CSD 7/1/1993 7/1/1994 W611503 Sherwin-Williams Automotive Finishes Corp. 1/1/1996 12/31/2009 W611503 Sherwin-Williams Company 11/1/1991 W548509 Shields Productions LLC 1/1/2019 W413868 Shop Vac Corporation 7/1/2004 8/1/2019 W610505 Shopwell, Inc. 1/1/1978 10/5/2015 W476006 Shorewood Packaging Corp. 3/26/2004 12/31/2011 W446256 Showtime Marketing, Inc. 9/1/2008 W446256 Showtime Networks, Inc. 7/1/1995 W446256 Showtime Satellite Networks Retail Sales & Marketing Inc. 7/1/1995 10/10/2000 W591192 Shrine of the Infant Jesus 7/1/1989 W417380 Sibley Nursing Personnel Service, Inc. 1/1/2006 12/31/2014 W612501 Silent Hoist & Crane Co. 1/1/1977 10/18/1984 W613004 Simkins Industries Inc 4/1/1965 7/1/1983 W446256 Simmons Casket Corporation 1/1/1981 8/27/1982 W446256 Simmons Juvenile Products Co. Inc. 1/1/1981 9/12/1985 W446256 Simmons U.S.A. Corporation 1/1/1981 9/12/1985 W446256 Simmons Universal Corporation 1/1/1981 9/12/1985 W446256 Simon & Schuster Digital Sales, Inc. 1/1/2017 W446256 Simon & Schuster Inc. 1/1/1981 W614002 Sinclair Refining Company 8/31/1920 10/1/1966 W615009 Singer Company 1/19/1949 2/1/1970 W616007 Singer Sewing Machine Co 7/16/1914 2/1/1970 W627756 Siren Retail Corporation 1/29/2018 W616502 Sisters of Charity Hosp of Buffalo 7/1/1979 7/1/1998 W591374 Sisters of St. Joseph Motherhouse 6/1/1976 W458509 Six Continents Hotels, Inc. 9/1/1989 9/30/2008 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W548509 Sketchy Animation LLC 1/1/2019 W596878 SKF USA, Inc. 1/1/1980 W381255 Sky Courier, Inc. 1/1/2006 5/1/2013 W520746 Sloan Kettering Institute for Cancer Research 4/16/2005 W454888 Snell Farm Children's Center 9/1/2005 W446256 SNI/SI Networks, LLC 9/1/2008 W616882 Snyder Tank Corporation 6/1/1994 6/1/1998 W549919 Social Project, Inc. 11/1/2008 11/1/2017 W591127 Society for the Propagation of the Faith 9/1/1998 W617500 Society of the New York Hospital, The 11/1/1991 12/31/1997 W417323 Soldiers & Sailors Memorial Hospital of Yates County, Inc. 1/31/2002 W617757 Sonoco Products Company 11/1/1996 10/1/2003 W413009 South Bay Corp 2/12/1936 4/30/1962 W618003 South Brooklyn Railway Co 7/6/1914 6/1/1940 W591192 South Buffalo Catholic School 5/23/2006 W549919 South Park Digital Studios, LLC 1/1/2010 W568078 Southeast Community Work Center, Inc 10/1/2016 W591192 Southern Tier Catholic School 7/1/1989 W380257 Southland Frozen Foods, Inc. 2/20/1991 9/30/1991 W591192 Southtowns Catholic School 7/1/1989 W558720 Spancrete Northeast, Inc. 10/1/1993 12/31/1997 W595755 Specialized Transportation Co. Inc. 3/24/1987 6/15/1987 W619753 Spector Freight Systems Inc 8/25/1974 1/1/1978 W619506 Spector Industries Inc 1/1/1978 12/31/1980 W619886 Spector Red Ball, Inc. 12/30/1980 5/7/1982 W621007 Sperry Rand Corp (Remington) 7/1/1955 1/4/1960 W621007 Sperry Rand Corporation Remington Rand Division 7/1/1955 1/31/1962 W591507 Spiritual Renewal Center 3/12/1990 W622005 Spode, Inc. 7/1/1968 2/4/1972 W446256 SportsLine.Com 12/30/2005 12/31/2006 W517627 Springhill SMC, LLC 4/1/2010 W559009 Squibb, E.R. & Sons, Inc. 1/1/1966 7/1/1967 W591192 SS. Brendan & Jude Parish 7/1/1989 W591192 SS. Joachim & Anne 7/1/1989 W591192 SS. Peter & Paul Parish 7/1/1989 W591192 SS. STS Peter & Paul Parish 7/1/1989 W591507 St Francis de Sales Church 4/16/1974 W591507 St Margaret's School 4/16/1974 W591507 St Mary's Academy 4/16/1974 W591507 St Mary's School 4/16/1974 W591507 St Rose of Lima School 4/16/1974 W591507 St Vincent De Paul Parish Center 4/16/1974 W591507 St Vincent De Paul Parish Center 4/16/1974 W591127 St. Adalbert's Church Schenectady 9/1/1978 W591192 St. Adalbert's Response to Love Center 7/1/1989 W591192 St. Adalbert's Response to Love Center, Inc. 7/1/1989 W591507 St. Agatha's Church 4/16/1974 W591127 St. Agnes' Cemetery 9/1/1978 W591374 St. Agnes Church 6/1/1976 W591507 St. Agnes' Church - Brewerton 4/16/1974 W591374 St. Alexander's Church 6/1/1976 W591192 St. Aloysius Gonzaga Parish 7/1/1989 W591192 St. Aloysius Parish 7/1/1989 W591374 St. Alphonsus & Holy Name of Jesus Church 6/1/1976 12/31/2011 W591374 St. Alphonsus Church Cemetery Association 6/1/1976 W591127 St. Alphonsus Church Glens Falls 9/1/1978 8/1/2010 W591507 St. Ambrose Church - Endicott 4/16/1974 W591127 St. Ambrose Church Latham 9/1/1978 W591127 St. Ambrose School Latham 9/1/1978 W591192 St. Amelia Parish 7/1/1989 W591374 St. Andre Bessette Roman Catholic Parish 6/1/1976 W591192 St. Andrew Kim Roman Catholic Church 7/1/1989 W591192 St. Andrew Parish 7/1/1989 W591192 St. Andrew Polish Roman Catholic Church Society 7/1/1989 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591192 St. Andrew R C Church 7/1/1989 W591374 St. Andrew's Church 6/1/1976 W591374 St. Andrew's Church 6/1/1976 W591507 St. Ann, Mother of Mary Church 4/16/1974 W591127 St. Annas Church - Summit 9/1/1978 6/28/2009 W591507 St. Ann's Catholic Church DBA Church of the Holy Trinity 4/16/1974 W591127 St. Ann's Church 9/1/1978 W591374 St. Ann's Church 6/1/1976 W591507 St. Ann's Church - Manlius 4/16/1974 W591374 St. Ann's Church - Mooers Forks 6/1/1976 W591507 St. Ann's Church - Syracuse 4/16/1974 W591374 St. Ann's Church (Wells) 6/1/1976 W591127 St. Anthony & Joseph Church Herkimer 9/1/1978 W591192 St. Anthony Church RC Church Cemetary 7/1/1989 W347886 St. Anthony Community Hospital, Warwick, NY 4/1/2017 W421754 St. Anthony Community Hospital, Warwick, NY 10/1/1998 5/19/2015 W591507 St. Anthony of Padua Church 4/16/1974 W591127 St. Anthony of Padua Church Troy 9/1/1978 W591374 St. Anthony of Padue Parish of Inlet & Raquette Lake 6/1/1976 W591192 St. Anthony Parish 7/1/1989 W591127 St. Anthony's Cemetery 9/1/1978 W591127 St. Anthony's Church 9/1/1978 W591192 St. Anthony's Church 7/1/1989 W591507 St. Anthony's Church 4/16/1974 W591507 St. Anthony's Church 4/16/1974 W591507 St. Anthony's Church - Cortland 3/31/1999 W591374 St. Anthony's Church - Padua Oratory 6/1/1976 W591374 St. Anthonys Church - Watertown 6/1/1976 12/31/2011 W591127 St. Anthony's Church Schenectady 9/1/1978 W591192 St. Anthony's RC Church 7/1/1989 W591507 St. Anthonys -St. Agnes Church - Utica 4/16/1974 W591507 St. Augustine Church RC Church of Baldwinsville 4/16/1974 W591192 St. Augustine Parish 7/1/1989 W591374 St. Augustine's Chuch 6/1/1976 W591374 St. Augustine's Chuch 5/1/1986 W591374 St. Augustine's Chuch - Peru 6/1/1976 W591127 St. Augustine's Church Troy 9/1/1978 W596845 St. Barnabas Community Enterprises, Inc. 1/1/2003 W596845 St. Barnabas Community Health Plan, Inc. 1/1/2003 4/26/2010 W596845 St. Barnabas Hospital 1/1/2003 W596845 St. Barnabas Nursing Home, Inc. 1/1/2003 11/4/2016 W591507 St. Bartholomew Church 4/16/1974 W591374 St. Bartholomews's Church - Old Forge 6/1/1976 W591192 St. Benedict Parish 7/1/1989 W591192 St. Bernadette Parish 7/1/1989 W591192 St. Bernard Parish 7/1/1989 W591192 St. Bernard Parish 7/1/1989 W440754 St. Bernard’s Housing Development Fund Company, Inc. 1/1/2016 10/5/2016 W591507 St. Bernard's Church 4/16/1974 W591127 St. Bernard's Church - Cohoes 9/1/1978 11/6/2009 W591374 St. Bernard's Church - Lyon Mountain 6/1/1976 W591374 St. Bernard's Church - Saranac Lake 6/1/1976 W440754 St. Bernard's II, Inc. 1/1/2016 10/5/2016 W591192 St. Bonaventure Parish 7/1/1989 W591192 St. Brendan on the Lake 7/1/1989 W591374 St. Brendan's Church 6/1/1976 W591374 St. Brendan's Church - Keene 6/1/1976 W591127 St. Bridget's Church - Copake Falls 9/1/1978 12/31/2009 W591507 St. Brigid - St. Joseph Church 4/16/1974 W591192 St. Brigid Parish 7/1/1989 W591192 St. Casimir Parish 7/1/1989 W591127 St. Casimir's Church - Amsterdam 9/1/1978 5/3/2009 W591127 St. Catherine of Siena, Church & School 9/1/1978 10/1/2009 W591127 St. Catherine's Center for Children 9/1/1978 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591127 St. Catherine's Center For Children 9/1/1978 W591127 St. Cecilia's Church 9/1/1978 W591374 St. Cecilia's Church 6/1/1976 W591507 St. Charles Borromeo Church 4/16/1974 W591192 St. Christopher Roman Catholic Church Society 7/1/1989 W591127 St. Clare's Church 9/1/1978 W591127 St. Clement's Church 9/1/1978 W591127 St. Clement's Regional Catholic School 9/1/1978 W591192 St. Columba - Brigid Parish 7/1/1989 W591507 St. Cyril & Methodius Slovak RC Church of Binghamton 4/16/1974 W591374 St. Cyril's Church 6/1/1976 W591507 St. Daniel's Church 4/16/1974 W591192 St. Dominic 7/1/1989 W591374 St. Edmund's Church - Ellenburg 6/1/1976 W591127 St. Edward the Confessor Church 9/1/1978 W591507 St. Elizabeth Ann Seton Church 4/16/1974 W591192 St. Elizabeth Ann Seton Parish 7/1/1989 W591374 St. Elizabeth Church 6/1/1976 W596852 St. Elizabeth Medical Center 1/1/2012 12/31/2017 W591192 St. Elizabeth Roman Catholic Church 7/1/1989 W591374 St. Elizabeth Seton Church 6/1/1976 W347886 St. Francis Center at the Knolls, Inc. 4/1/2017 W421754 St. Francis Center at the Knolls, Inc. 10/1/1998 5/19/2015 W591127 St. Francis de Sales Church & Calvary Cemetery 9/1/1978 W591127 St. Francis de Sales Regional Catholic School 9/1/1978 W591127 St. Francis DeSales - Loudonville 9/1/1978 11/17/2009 W591127 St. Francis DeSales - Troy 9/1/1978 2/2/2009 W591192 St. Francis of Assis Church 7/1/1989 W591127 St. Francis of Assisi Church 10/18/1996 W591127 St. Francis of Assisi Church 9/1/1978 W591374 St. Francis of Assisi Church 6/1/1976 W591507 St. Francis of Assisi Church 4/16/1974 W591507 St. Francis of Assisi Church 7/1/1993 W591507 St. Francis of Assisi Church - Binghamon 4/16/1974 W591507 St. Francis of Assisi Church - Bridgeport 4/16/1974 W591192 St. Francis of Assisi Church Parish 7/1/1989 W591192 St. Francis of Assisi Parish 7/1/1989 W591374 St. Francis Solanus Church - Harrisville 6/1/1976 W591507 St. Francis Xavier Church 4/16/1974 W591192 St. Gabriel Parish 7/1/1989 W591127 St. Gabriel the Archangel Church 9/1/1978 W591192 St. George RC Church 7/1/1989 W591374 St. George's Church 6/1/1976 W591192 St. Gregory the Great Parish 7/1/1989 W591374 St. Hedwig's Church (Houseville) 6/1/1976 W591507 St. Helena's Church 4/16/1974 W591507 St. Helena's Church - Sherrill 4/16/1974 W591374 St. Helen's Church (Chasm Falls) 6/1/1976 W591127 St. Henry's Church 9/1/1978 W591374 St. Henry's Church 6/1/1976 W591374 St. Henry's Church (Long Lake) 6/1/1976 W591374 St. Hubert's Church Star Lake 6/1/1976 W591192 St. Hyacinth's Church School 7/1/1989 W591127 St. Isaac Jogues Church 9/1/1978 W591127 St. Isaac Jogues Parish 12/31/2009 W591192 St. Isidore 7/1/1989 W591127 St. James' Church 9/1/1978 W591374 St. James' Church 6/1/1976 W591507 St. James' Church 4/16/1974 W591127 St. James' Church - Fort Plain 9/1/1978 7/1/2010 W591374 St. James' Church - Gouverneur 6/1/1976 W591507 St. James Church - Johnson City 4/16/1974 W591127 St. James Church Chatham 9/1/1978 W591374 St. James Major Church 6/1/1976 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591374 St. James Minor Church 6/1/1976 W591192 St. James Roman Catholic Church Society 7/1/1989 W591374 St. James School 6/1/1976 W591127 St. Jean Baptiste Cemetery 9/1/1978 W591507 St. Joan of Arc - Processed through Diocese 7/1/1992 W591127 St. Joan of Arc Church 9/1/1978 W591192 St. Joan of Arc R.C. Church 7/1/1989 W597009 St. Joe Minerals Corporation 1/11/1927 9/18/1987 W591374 St. John Bosco Church 6/1/1976 W591374 St. John Church - Port Leyden 6/1/1976 W591192 St. John de LaSalle Parish 7/1/1989 W591192 St. John Gualbert Parish 7/1/1989 W591374 St. John in the Wilderness Catholic Church 6/1/1976 W591192 St. John Kanty Parish 7/1/1989 W591192 St. John Neumann 7/1/1989 W591192 St. John Paul II 7/1/1989 W591192 St. John RC Church 7/1/1989 W591507 St. John the Baptist 4/16/1974 W591507 St. John the Baptist - Rome 4/16/1974 W591127 St. John the Baptist Church 9/1/1978 W591127 St. John the Baptist Church 9/1/1978 W591374 St. John the Baptist Church 6/1/1976 W591127 St. John the Baptist Church - Amsterdam 9/1/1978 2/25/2009 W591374 St. John the Baptist Church - Madrid 6/1/1976 W591127 St. John the Baptist Church - Schenectady 9/1/1978 6/25/2009 W591374 St. John the Baptist Church RCC - Plattsburgh 6/1/1976 W591127 St. John the Baptist Church Walton 9/1/1978 W591192 St. John the Baptist Parish 7/1/1989 W591192 St. John the Baptist Parish 7/1/1989 W591192 St. John the Baptist Parish 7/1/1989 W591192 St. John the Baptist Parish 7/1/1989 W591192 St. John the Baptist Parish 7/1/1989 W591507 St. John the Evangelist - Binghamton 4/16/1974 W591507 St. John the Evangelist - New Hartford 4/16/1974 W591374 St. John the Evangelist Church 6/1/1976 W591507 St. John the Evangelist Church - Bainbridge 4/16/1974 W591374 St. John the Evangelist Church - Clayton 6/1/1976 W591127 St. John the Evangelist Church & St. Joseph & Holy Sepulchre Cemetery 9/1/1978 W591127 St. John the Evangelist Church Schenectady Schenectady 12308 9/1/1978 W591127 St. John the Evangelist School 9/1/1978 W591127 St. John Vianney 7/17/2007 12/31/2009 W591192 St. John Vianney Parish 7/1/1989 W591192 St. John XXIII 7/1/1989 W591127 St. John's Cemetery 9/1/1978 W591507 St. John's Cemetery 4/16/1974 W591192 St. John's Church 7/1/1973 W591374 St. John's Church 6/1/1976 W591507 St. John's Church 4/16/1974 W591507 St. John's Church - Camden 4/16/1974 W591507 St. John's Church - North Bay 4/16/1974 W591507 St. Joseph - St Patrick Church (Utica) 4/16/1974 W591127 St. Joseph / St. Michael / Our Lady of Mt Carmel Church 9/1/1978 W591192 St. Joseph Cathedral 7/1/1989 W591507 St. Joseph Church 4/16/1974 W591507 St. Joseph Church 4/16/1974 W591507 St. Joseph Church 4/16/1974 W591507 St. Joseph Church - Lee Center 4/16/1974 W591507 St. Joseph Church - Liverpool 4/16/1974 W591192 St. Joseph R.C. Church 7/1/1989 W591192 St. Joseph RC Church 7/1/1989 W591192 St. Joseph Regional School 9/30/2018 W591192 St. Joseph Roman Catholic Church Society Inc 7/1/1989 W591192 St. Joseph University Parish 7/1/1989 W591192 St. Josephat Parish 7/1/1989 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591127 St. Joseph's Church 9/1/1978 W591374 St. Joseph's Church 6/1/1976 W591374 St. Joseph's Church 6/1/1976 W591507 St. Joseph's Church - Camillus 4/16/1974 W591127 St. Joseph's Church - Cohoes 9/1/1978 2/25/2009 W591507 St. Joseph's Church - Deposit 4/16/1974 W591507 St. Joseph's Church - Endicott 4/16/1974 W591374 St. Joseph's Church - Evan Mills 6/1/1976 W591127 St. Josephs Church - Greenfield Center 9/1/1978 W591507 St. Josephs Church - Lafayette 4/16/1974 W591507 St. Joseph's Church - Oswego 4/16/1974 W591507 St. Joseph's Church - Oxford 4/16/1974 W591127 St. Joseph's Church - Richfield Springs 9/1/1978 7/1/2009 W591127 St. Joseph's Church - Schoharie 9/1/1978 7/1/2009 W591127 St. Joseph's Church - West Winfield 9/1/1978 7/1/2009 W591374 St. Joseph's Church & Cemetary 6/1/1976 W591127 St. Joseph's Church & Cemetery 9/1/1978 W591374 St. Joseph's Church (Bombay) 6/1/1976 W591374 St. Joseph's Church (Owl's Head) 6/1/1976 W591374 St. Joseph's Church (Treadwells Mills) 6/1/1976 W591127 St. Joseph's Church Broadalbin 9/1/1978 W591374 St. Joseph's Church Dannemora 6/1/1976 W591127 St. Joseph's Church Dolgeville 9/1/1978 W591127 St. Joseph's Church Greenfield Center 9/1/1978 W591127 St. Joseph's Church Greenwich 9/1/1978 W591374 St. Joseph's Church Schroon Lake 6/1/1976 W591127 St. Joseph's Church Scotia 9/1/1978 W591127 St. Joseph's Church Worcester 9/1/1978 W596944 St. Joseph's Health System, Inc. 1/1/2000 1/23/2012 W591374 St. Joseph's Home Ogdensburg 6/1/1976 W596944 St. Joseph's Hospital 1/1/2000 W487508 St. Joseph's Hospital Health Center 1/1/1979 12/31/2015 W650065 St. Joseph's Hospital Health Center 1/1/2016 W650065 St. Joseph's Medical, P.C. 1/1/2016 W650065 St. Joseph's Physician Health, P.C. 1/1/2016 W591192 St. Joseph's Roman Catholic Church Society 7/1/1989 W591374 St. Joseph's School 6/1/1976 W591192 St. Jude Parish 7/1/1989 W591192 St. Jude the Apostle 7/1/1989 W591127 St. Jude the Apostle Church 9/1/1978 W591127 St. Jude the Apostle School e 9/1/1978 W591374 St. Jude's Church 6/1/1976 W591127 St. Kateri Tekakwitha (was Our Lady of Fatima Church) 9/1/1978 W591127 St. Kateri Tekakwitha School (was St. Helen's School) 9/1/1978 W591192 St. Katharine Drexel 7/1/1989 W591374 St. Lawrence Church Massena 6/1/1976 W591192 St. Lawrence Parish 7/1/1989 W591374 St. Lawrence's Church (North Lawrence) 6/1/1976 W591507 St. Leo Church 4/16/1974 W591192 St. Leo the Great Parish 7/1/1989 W591507 St. Leo's Church - Tully 4/16/1974 W591374 St. Louis of France Church (Sciota) 6/1/1976 W591192 St. Louis Parish 7/1/1989 W591127 St. Lucy/St. Bernadette Church 9/1/1978 W591507 St. Lucy's Church 4/16/1974 W591127 St. Luke's Catholic Church 9/1/1978 W516256 St. Luke's Hospital Center 8/15/1978 11/1/1979 W597256 St. Luke's Memorial Hospital Center 1/1/1991 1/1/2000 W597504 St. Luke's-Roosevelt Hospital Center 11/1/1979 12/29/1983 W597538 St. Luke's-Roosevelt Hospital Center 12/29/1993 12/29/1997 W591127 St. Madeleine Sophie School 9/1/1978 W591127 St. Madeleine Sophie's Church Schenectady 9/1/1978 W591507 St. Malachy's Church 4/16/1974 W591127 St. Margaret Mary Church 9/1/1978 10/1/2009 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591192 St. Margaret Parish 7/1/1989 W591507 St. Margarets Church - Homer 4/16/1974 W591507 St. Margaret's Church - Mattydale 4/16/1974 W591374 St. Margaret's Church (Wilmington) 6/1/1976 W591507 St. Marianne Cope Parish 4/16/1974 W591192 St. Mark Parish 7/1/1989 W591192 St. Mark Parish 7/1/1989 W591192 St. Mark Parish 7/1/1989 W591507 St. Mark's Church - Utica 4/16/1974 W591192 St. Martha Parish 7/1/1989 W591192 St. Martin de Porres Parish 7/1/2020 W591192 St. Martin of Tours Parish 7/1/1989 W591374 St. Martin's Church 6/1/1976 W591507 St. Mary Church - Hamilton 4/16/1974 W591192 St. Mary of Lourdes Parish 7/1/1989 W591507 St. Mary of Mt. Carmel/Blessed Sacrament Church 4/16/1974 W591192 St. Mary of the Angels Parish 7/1/1989 W591507 St. Mary of the Assumption 4/16/1974 W591507 St. Mary of The Assumption 4/16/1974 W591127 St. Mary of the Assumption Church 9/1/1978 W591192 St. Mary of the Assumption Parish 7/1/1989 W591507 St. Mary of the Assumption-Minoa 4/16/1974 W591192 St. Mary of the Cataract Parish 7/1/1989 W591192 St. Mary Parish Arcade 7/1/1989 W591192 St. Mary Parish Canaseraga 7/1/1989 W591192 St. Mary Parish Cattaraugus 7/1/1989 W591192 St. Mary R.C. Church 7/1/1989 W591374 St. Mary's & St. Joseph's Church of Massena 1/1/2006 W591127 St. Mary's / St. Alphonsus Regional Catholic School 9/1/1978 W591127 St. Mary's / St.Paul's Church 9/1/1978 W591374 St. Mary's Cathedral Ogdensburg 6/1/1976 W591127 St. Mary's Cemetery 9/1/1978 W591507 St. Mary's Cemetery 4/16/1974 W591507 St. Mary's Cemetery Association 4/16/1974 W591127 St. Mary's Cemetery of Troy 9/1/1978 W591127 St. Mary's Church 9/1/1978 W591127 St. Mary's Church 9/1/1978 W591192 St. Mary's Church 7/1/1989 W591374 St. Mary's Church 1/1/2017 W591374 St. Mary's Church 6/1/1976 12/31/2011 W591374 St. Mary's Church 6/1/1976 W591374 St. Mary's Church 6/1/1976 W591374 St. Mary's Church 6/1/1976 W591374 St. Mary's Church 6/1/1976 W591374 St. Mary's Church 6/1/1976 W591374 St. Mary's Church 6/1/1976 W591507 St. Mary's Church - Baldwinsville 4/16/1974 W591507 St. Mary's Church - Clinton 4/16/1974 W591374 St. Mary's Church - Constableville 6/1/1976 W591507 St. Mary's Church - Cortland 4/16/1974 W591127 St. Marys Church - Coxsackie 9/1/1978 W591127 St. Mary's Church - Hudson 9/1/1978 7/1/2009 W591374 St. Mary's Church - Indian Lake 6/1/1976 W591507 St. Mary's Church - Kirkwood 4/16/1974 W591374 St. Mary's Church - Lowville 6/1/1976 W591507 St. Mary's Church - Oswego 4/16/1974 W591507 St. Mary's Church - Rome 4/16/1974 W591127 St. Marys Church - Schenectady 9/1/1978 6/28/2009 W591374 St. Mary's Church - Ticonderoga 6/1/1976 12/31/2011 W591127 St. Marys Church - Troy 9/1/1978 6/30/2010 W591374 St. Mary's Church - Waddington 6/1/1976 W591127 St. Mary's Church & Mt. Calvary Cemetery 9/1/1978 W591127 St. Mary's Church Amsterdam 9/1/1978 W591507 St. Mary's Church- Baldwinsville 4/16/1974 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591127 St. Mary's Church Ballston Spa 9/1/1978 W591127 St. Mary's Church Cooperstown 9/1/1978 W591127 St. Mary's Church Coxsackie 9/1/1978 W591127 St. Mary's Church Glens Falls 9/1/1978 W591127 St. Mary's Church of Clinton Heights 9/1/1978 W591507 St. Mary's Church of Our Lady of Czestochowa 4/16/1974 W591507 St. Mary's Church Rome 4/16/1974 W591127 St. Mary's Church/Our Lady of Mt. Carmel Cemetery 9/1/1978 W591374 St. Mary's Copenhagen 6/1/1976 W591127 St. Mary's Crescent Church 9/1/1978 W597561 St. Mary's Healthcare 10/1/1986 7/1/2020 W597751 St. Mary's Hospital of Troy 7/1/1981 1/1/1995 W591127 St. Mary's Institute Amsterdam 9/1/1978 W591374 St. Mary's Nativity Church - Constableville 6/1/1976 W591127 St. Mary's of Mt. Carmel 9/1/1978 7/1/2009 W591374 St. Mary's of the Fort 6/1/1976 W591507 St. Mary's of the Lake Church 4/16/1974 W591374 St. Mary's of the Lake Church - Plattsburgh 6/1/1976 W591192 St. Marys RC Church 7/1/1989 W591192 St. Marys RC Church Society 7/1/1989 W591127 St. Mary's Roman Catholic Church - Galway 9/1/1978 W591192 St. Mary's Roman Catholic Church Society 7/1/1989 W591127 St. Mary's School Ballston Spa 9/1/1978 W591127 St. Matthew's Church 9/1/1978 W591507 St. Matthew's Church - East Syracuse 4/16/1974 W591192 St. Maximilian Kolbe Parish 7/1/1989 W591192 St. Michael Parish 7/1/1989 W591127 St. Michael the Archangel Church 9/1/1978 W591127 St. Michael the Archangel Church 9/1/1978 W591507 St. Michael's Church 4/16/1974 W591127 St. Michael's Church Cohoes 9/1/1978 W591374 St. Michael's Oratory 6/1/1976 W591192 St. of Padua Parish 7/1/1989 W591192 St. Padre Pio Parish 7/1/1989 W591507 St. Patrick Church 4/16/1974 W591507 St. Patrick Church - Jordan 4/16/1974 W591507 St. Patrick Mission 4/16/1974 W591192 St. Patrick Parish 7/1/1989 W591192 St. Patrick Parish 7/1/1989 W591127 St. Patrick's Catholic Church 9/1/1978 W591127 St. Patrick's Cemetery 9/1/1978 W591374 St. Patrick's Church 6/1/1976 W591374 St. Patrick's Church 6/1/1976 W591374 St. Patrick's Church 6/1/1976 W591507 St. Patrick's Church 4/16/1974 W591127 St. Patrick's Church - Athens 9/1/1978 W591507 St. Patrick's Church - Binghamton 4/16/1974 W591374 St. Patricks Church - Brasher Falls 6/1/1976 W591374 St. Patricks Church - Rouses Point 6/1/1976 W591507 St. Patrick's Church - Syracuse 4/16/1974 W591507 St. Patricks Church - Taberg 4/16/1974 W591127 St. Patrick's Church - Troy 9/1/1978 7/1/2010 W591507 St. Patrick's Church - Truxton 4/16/1974 W591374 St. Patrick's Church - Watertown 6/1/1976 W591192 St. Patrick's Church Belfast 7/1/1989 W591127 St. Patrick's Church Cambridge 9/1/1978 W591127 St. Patrick's Church Cambridge 9/1/1978 W591127 St. Patrick's Church Catskill 9/1/1978 W591374 St. Patrick's Oratory (West Peru) 5/1/1986 W591507 St. Patrick's RC Church 4/16/1974 W591507 St. Patrick's School - Oneida 4/16/1974 W591127 St. Paul the Apostle - Troy 9/1/1978 5/31/2009 W591127 St. Paul the Apostle Church Hancock 9/1/1978 W591127 St. Paul the Apostle's Church Schenectady 9/1/1978 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591374 St. Paul's Church 6/1/1976 W591374 St. Paul's Church 6/1/1976 W591374 St. Paul's Church 6/1/1976 W591507 St. Paul's Church - Norwich 4/16/1974 W591507 St. Paul's Church - Oswego 4/16/1974 W591507 St. Paul's Church - Rome 4/16/1974 W591507 St. Paul's Church - Whitesboro 4/16/1974 W591507 St. Paul's Church (Binghamton) 4/16/1974 W591374 St. Paul's Church (Blue Mountain Lake) 6/1/1976 W591192 St. Paul's School & Roman Catholic Church Society 7/1/1989 W591374 St. Peter and Paul Church 6/1/1976 W591127 St. Peter and St. Paul Church 9/1/1978 7/1/2010 W591507 St. Peter Church 4/16/1974 W591192 St. Peter Claver Youth Program, Inc. 7/1/1989 W591192 St. Peter R C Church St. Peters School 7/1/1989 W591507 St. Peter's Cemetery 4/16/1974 W591127 St. Peter's Church 9/1/1978 W591374 St. Peter's Church 6/1/1976 W591374 St. Peter's Church 6/1/1976 W591374 St. Peter's Church 6/1/1976 W591507 St. Peter's Church 4/16/1974 W591507 St. Peter's Church 4/16/1974 W591374 St. Peter's Church - Lowville 6/1/1976 W591127 St. Peter's Church - Troy 9/1/1978 5/31/2009 W591507 St. Peter's Church - Utica 4/16/1974 W591127 St. Peter's Church Saratoga Springs 9/1/1978 W650065 St. Peter's Health Partners 1/1/2016 W650069 St. Peter's Health Partners Medical Associates, P.C. 1/1/2016 W650065 St. Peter's Hospital Foundation, Inc. 1/1/2016 W650069 St. Peter's Hospital of the City of Albany 1/1/2016 W591374 St. Peter's Parish (Church of the Sacred Heart) 6/1/1976 W591127 St. Peter's Roman Catholic Church of Delhi 9/1/1978 W591374 St. Philip and James Church - Lisbon 6/1/1976 W591374 St. Philip Neri Church - Westport 6/1/1976 W591374 St. Philip of Jesus Church 6/1/1976 W591192 St. Philip the Apostle Parish 7/1/1989 W591192 St. Philomena Parish 7/1/1989 W591127 St. Pius X Church 9/1/1978 W591192 St. Pius X Parish 7/1/1989 W591192 St. Pius X R.C. Church 7/1/1989 W591192 St. Raphael RC Parish 7/1/1989 W591374 St. Raphael's Church - Heuvelton 6/1/1976 W591374 St. Raymond's Church - Norfolk 6/1/1976 5/1/2015 W591374 St. Regis Indian Mission 6/1/1976 W610000 St. Regis Paper Company (NY) 8/10/1929 11/1/1952 W591127 St. Rita/Sacred Heart Church - Cohoes 9/1/1978 2/25/2009 W591374 St. Rita's Church (Deferiet) 6/1/1976 W591507 St. Rose of Lima Church 4/16/1974 W591192 St. Stanislaus Parish 7/1/1989 W591507 St. Stephen the King Church 4/16/1974 W591374 St. Stephen's Cemetery, Inc. 6/1/1976 W591374 St. Stephen's Cemetery, Inc. 6/1/1976 W591127 St. Stephen's Church 9/1/1978 W591374 St. Stephen's Church 6/1/1976 W591507 St. Stephen's Church 4/16/1974 W591192 St. Stephen's R C Church 7/1/1989 W591127 St. Teresa of Avila - Albany 9/1/1978 10/1/2009 W591192 St. Teresa of Avila Parish 7/1/1989 W591507 St. Teresa of the Infant Jesus Church 4/16/1974 W591192 St. Teresa Parish 7/1/1989 W591127 St. Theresa of the Child Jesus Church Windham 9/1/1978 W591374 St. Therese Church 6/1/1976 W591507 St. Thomas Aquinas Church 4/16/1974 W591507 St. Thomas Aquinas Fund, Inc. 3/31/2014 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591192 St. Thomas Aquinas Parish 7/1/1989 W591507 St. Thomas Church Roman Catholic Church - New Hartford 4/16/1974 W591374 St. Thomas More Campus Parish 6/1/1976 W591507 St. Thomas More Foundation 7/1/1974 W591507 St. Thomas More Foundation, Inc. 7/1/1994 W591127 St. Thomas the Apostle Church 9/1/1978 W591127 St. Thomas the Apostle Church 9/1/1978 W591127 St. Thomas the Apostle School Delmar 9/1/1978 W591192 St. Timothy Roman Catholic Church 7/1/1989 W591192 St. Vincent de Paul 7/1/1989 W591374 St. Vincent de Paul 1/1/2017 W591127 St. Vincent de Paul Church 9/1/1978 W591374 St. Vincent de Paul Church 6/1/1976 1/2/2021 W591507 St. Vincent de Paul Church - Syracuse 4/16/1974 W591507 St. Vincent de Paul Church (Vestal) 4/16/1974 W591507 St. Vincent de Paul Church Day Care 4/16/1974 W591507 St. Vincent de Paul Church Furniture & Clothing 4/16/1974 12/31/2011 W591127 St. Vincent de Paul's Church 9/1/1978 W591374 St. Vincent De Paul's Church (Rosiere) 6/1/1976 W591374 St. Vincent of Paul's Church 6/1/1976 W591192 St. Vincents RC Church of North Evans 7/1/1989 W591192 St. Vincent's RC Church Society 7/1/1989 W591192 St. Vincent's RC Church Society 7/1/1989 W591507 St. Vincent's RC Church Society 4/16/1974 W591127 St. William's Church 9/1/1978 2/25/2009 W591374 St. William's Church (Raquette Lake) 6/1/1976 W591192 St.Michael's RC Church School 7/1/1989 W625008 Standard Brands Inc 12/13/1929 12/31/1982 W600720 Standard Packing Corporation 7/1/1975 12/31/1978 W626758 Standard Products Company 10/1/1984 6/1/2010 W627004 Standard T Chemical Co 5/1/1963 11/10/1982 W627509 Stanley Access Technologies LLC 5/30/2006 W627509 Stanley Black & Decker, Inc. 4/18/1994 W627509 Stanley Bostitch, Inc. 4/18/1994 7/1/1999 W627509 Stanley Convergent Security Solutions, Inc. 1/16/2007 W367193 Stanley G. Falk School 7/1/2014 W627509 Stanley Home Automation Inc. 4/18/1994 7/1/1998 W627509 Stanley Magic-Door, Inc. 10/23/1995 12/31/1997 W627509 Stanley Mechanic Tools, Inc. 4/18/1994 12/31/1997 W627509 Stanley Security Solutions, Inc. 2/23/2003 W627509 Stanley Storage Systems, Inc. 4/18/1994 12/31/1997 W413876 Star Leather Company Incorporated 9/1/1980 10/31/1984 W628002 Star Supermarkets Inc ( Defaulted) 1/1/1960 12/4/1982 W627756 Starbucks Corporation 10/1/2002 W517627 Starwood Hotels & Resorts Worldwide LLC 10/1/2020 W629133 Staten Island University Hospital 10/1/1990 2/1/1992 W522759 Station Operators Inc. 1/1/1997 11/30/1999 W538003 Stella D'Oro Biscuit Co., Inc. 1/4/1994 5/1/2001 W413843 Stern's Department Stores, Inc. 8/1/1994 7/20/2001 W630750 Stewart's Marketing Corp 1/1/1992 1/1/2001 W630883 Stewart's Processing Corp 1/1/1992 1/1/2001 W630503 Stewart's Shops Corp 1/1/1992 W454888 Stillwater Children's Center, Inc 7/9/2015 W629505 Stop & Shop Companies, Inc. 8/1/1980 7/1/2003 W548509 Storybuilders LLC 1/10/2019 W503007 Stouffer Management Food Service 1/1/1972 3/5/1973 W503007 Stouffer Restaurant & Inn Corp. 4/1/1971 3/5/1973 W633507 Stroehmann Bakeries, Inc. (nka Bimbo Bakeries USA) 1/1/1990 1/2/1996 W499073 Structure, Inc. 11/1/1993 1/1/2002 W549919 Studio 3 Partners LLC 4/15/2008 12/31/2010 W633754 Sugar Creek Corporation (nka Superior Plus US Holdings) 7/20/1994 8/3/1998 W633754 Sugar Creek Stores, Inc. 7/20/1994 8/3/1998 W548509 Sugar Shack Pictures LLC 6/14/2019 W595755 Summit Industries, Inc. 12/31/1991 1/1/1994 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W591127 Sunnyside Day Care Center 9/1/1986 W557904 Sunnyview Hospital and Rehabilitation Center 1/1/2011 1/1/2012 W650069 Sunnyview Hospital and Rehabilitation Center 1/1/2016 W557904 Sunnyview Hospital and Rehabilitation Center Foundation, Inc. 1/1/2011 1/1/2012 W634000 Supermarkets General Holdings Corp 9/15/1976 5/1/2000 W417885 Suretrade, Inc. 2/1/1998 4/4/2001 W636005 Surface Transit Inc 6/21/1949 4/30/1962 W638001 Surface Transporation Company of NY 11/11/1927 6/21/1949 W503007 Sweda International Incorporated 8/1/1976 8/1/1984 W638191 Swift & Co. 10/1/1981 4/1/1985 W638225 Swift Leasing Co., LLC 12/31/2005 W638225 Swift Transportation Co. LLC 12/31/2005 W638225 Swift Transportation Co. of Arizona, LLC 12/31/2005 W638225 Swift Transportation Services, LLC 12/31/2005 W341002 Swift-Eckrich. Inc. 10/1/1981 11/28/2004 W638506 Sybron Corp 1/1/1975 1/1/1984 W638639 SYDA Foundation 2/1/1990 5/1/1995 W446256 Symons Corporation 1/1/1981 9/8/1983 W422570 Synex Controls 1/1/2013 9/1/2016 W591507 Syracuse Catholic Sun 4/16/1974 W499040 Syracuse China Company 10/10/1995 7/1/2009 W548002 Syracuse Movers Incorporated 1/1/1971 7/26/1985 W639504 Syracuse University 6/30/1979 W639504 Syracuse University Press, Inc. 6/30/1979 7/1/2010 W639504 Syracuse University Theatre Corp. 6/30/1979 7/1/1984 W646004 Szelagowski, A. & Son, Inc. 12/21/1960 7/1/1974 W458004 T Hogan & Sons Inc 9/24/1919 9/26/1968 W519722 T Marzetti Company 2/1/1995 12/31/2009 W555502 TA Buscaglia, Inc. 7/1/1975 11/1/2000 W382253 Target Corporate Services, Inc. 1/1/2011 2/1/2018 W382253 Target Corporation 6/1/1996 2/1/2018 W382253 Target Enterprise, Inc. 2/1/2015 2/1/2018 W382253 Target General Merchandise, Inc. 1/1/2011 2/1/2018 W382253 Target Sourcing Services Corporation 2/1/1999 5/25/2010 W476006 Taussig's Graphic Supply, Inc. 1/1/1998 1/31/2000 W633507 Taystee Baking Company, Inc. 1/1/1990 12/16/1995 W627756 Teavana Corporation 11/11/2013 W424634 TEGNA, Inc (fka Gannett Co., Inc) 10/1/2000 6/29/2015 W651046 Terrific Services / E.S. Inc. 4/1/1999 1/21/2002 W642757 Tessy Medical Products LLC 8/10/2020 W642757 Tessy Plastics Corp 6/1/2013 W643001 Textron, Inc. 3/4/1956 6/28/1964 W667133 THD Coffee CO., Inc. 9/15/2005 9/30/2006 W667133 THD Group 9/15/2005 9/30/2006 W391007 The Chemours Company FC, LLC 2/1/2015 7/1/2015 W591507 The Churches of St. Mary's/St. Bernadette's 4/16/1974 W591192 The Nativity Miguel Middle School of Buffalo 12/31/2012 W591192 The Trustees of the Catholic Society of St. Mary's Church 7/1/1989 W548509 Thimble Pea Productions LLC 3/25/2019 W644009 Thompson-Starrett Co, Inc. 2/1/1929 4/24/1935 W446256 Thonet Industries Incorporated 1/1/1981 9/12/1985 W558720 Tilcon New York Inc. 10/1/1997 W645758 Time-DC, Inc. 10/1/1980 5/1/1982 W645501 Times Mirror Company, The 1/1/1979 4/1/1998 W645501 Times Mirror Magazines, Inc. 1/1/1979 4/1/1998 W476006 TIN, Inc. 4/1/2012 1/1/2013 W646004 Tobin Packing Co Inc 6/24/1960 7/1/1974 W591507 Toomey Residential & Community Services Corp 3/31/2011 W555502 Tops Markets, Inc. 7/1/1975 7/1/2003 W555502 Tops, Inc. 7/1/1975 11/1/2000 W647630 Tosco Corporation 9/15/1995 2/1/1997 W565501 Total Filtration Services Inc 8/1/2018 W458509 Town Park Hotel Corporation 4/27/1997 4/30/2004 W517601 Trans Union Credit Information Company 4/1/1988 1/1/1999 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W648752 TransAmerica Airlines, Inc. 8/4/1977 4/1/1987 W648000 TransAmerican Freight Lines Inc 5/1/1957 10/10/1975 W591507 Transfiguration Church - Rome 4/16/1974 W591507 Transfiguration Church - Syracuse 4/16/1974 W591127 Transfiguration Parish 9/30/2010 W318000 Travel Impressions, Ltd. 9/30/2007 9/30/2013 W557417 Treasure & Bond, LLC 6/15/2011 9/2/2013 W650006 Trico Products Corporation 1/9/1922 10/31/1995 W591374 Trinity Catholic School 6/1/1976 W591374 Trinity Catholic School Cafeteria 6/1/1976 W650065 Trinity Health Corporation 1/1/2016 W341002 Tropicana Products Sales Inc. 12/1/1986 4/8/1988 W595755 Truckstops Corp. of America 3/1/1977 4/2/1984 W591507 Trust for Father Champlins Guardian Angels Society 3/31/2013 W650501 Turbodyne Corp 1/1/1973 1/4/1981 W650980 UCO Electronics, Inc. 11/18/1982 1/1/1986 W651079 UCO Optics Inc 11/15/1982 7/1/1983 W558720 Ulster Paving Company, Inc. 10/1/1993 8/8/1997 W548509 Ungrown Productions, LLC 7/9/2019 W629257 Unifrax Corporation 1/1/1987 10/30/1996 W651160 Unifrax I, LLC 10/30/1996 1/1/2020 W596845 Union Community Health Center, Inc 1/1/2003 8/15/2006 W651251 Union Corp The 1/1/1979 11/15/1982 W651632 Union KOL-FLO Corp 11/15/1982 1/29/1985 W652002 Union News Company 4/19/1921 12/31/1959 W434005 Unisource Worldwide, Inc. 4/1/2001 11/3/2002 W653000 United Air Lines Inc. 1/1/1972 3/31/2013 W653506 United Airlines, Inc. 4/1/2013 W654008 United Brands Co 11/10/1919 11/1/1972 W653506 United Ground Express, Inc. 8/1/2019 W655500 United Hospital Medical Center 10/1/1996 4/25/2000 W440754 United Memorial Medical Center 1/1/2016 W656003 United States Gypsum Co 6/6/1924 2/1/1963 W659007 United States Steel 6/27/1925 5/15/2002 W659007 United States Steel Corporation 1/1/1953 5/15/2002 W662001 United States Trucking Corp 3/8/1920 1/1/1984 W662027 United Structures, Inc. 7/1/2001 1/26/2004 W591127 United Tenants of Albany 9/1/1978 W386007 Unites States Playing Card Co. 4/1/1970 3/30/1979 W440754 Unity Aging Services, Inc. 1/1/2016 W440754 Unity Health System 1/1/2016 W440754 Unity Health System Foundation 1/1/2016 1/1/2017 W440754 Unity Hospital of Rochester, The 1/1/2016 W440754 Unity Housing Development Fund Corporation 1/1/2016 W440754 Unity Senior Housing Associates, LP 1/1/2016 W440754 Unity Senior Housing Corp 1/1/2016 W589501 University of Rochester 7/1/1979 W589006 University of Rochester (1928) 9/29/1928 7/1/1962 W662068 Upstate Niagara Cooperative, Inc 4/8/1991 5/19/2019 W417380 Upstate Professional Liability Corporation 6/1/2012 5/16/2016 W627756 Urban Coffee Opportunities, LLC 10/1/2002 10/21/2010 W651046 US Management WC Inc 4/1/1999 1/21/2002 W595755 US Packing & Shipping Company 3/24/1987 12/31/1987 W424634 USA Weekend, Inc. 10/1/2000 12/30/2002 W640387 USF Holland Inc (nka USF Holland LLC) c/o YRC Worldwide 2/1/1996 3/1/2006 W577506 USF Red Star, Inc.c/o YRC Worldwide 11/1/1993 5/6/2005 W659007 USX Corporation 1/1/1966 7/3/2001 W591507 Utica Area Catholic Schools 4/16/1974 W591507 Utica-Rome Catholic Charities 4/16/1974 W541254 Utility Constructors,Inc 9/1/1991 5/24/1995 W450134 Vassar Brothers Hospital 4/1/2006 6/1/2009 W553002 Verizon New York, Inc. 7/6/1914 12/31/2008 W662126 Vermont American Corporation 10/1/1979 8/1/1985 W549919 Viacom 18 US, Inc. 12/22/2007 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W549919 Viacom Global Services Inc. 10/1/2006 W446256 Viacom International Inc. 1/1/1995 7/31/1996 W549919 Viacom International Services Inc. 10/1/2006 W446256 Viacom MGS Services Inc. 7/1/1995 12/31/1996 W446256 Viacom Services, Inc. 1/1/2001 12/31/2004 W549919 Viacom, Inc. 10/1/2006 W446256 ViacomCBS, Inc. 1/1/1981 W499073 Victoria's Secret Catalogue, Inc. 11/1/1993 5/1/1998 W499073 Victoria's Secret Direct Brand Management, LLC 2/3/2007 W499073 Victoria's Secret Direct New York, LLC (1993) 11/1/1993 12/31/2006 W499073 Victoria's Secret Direct New York, LLC (2010) 1/1/2010 8/1/2018 W499073 Victoria's Secret Stores Brand Management.LLC 6/1/2005 W499073 Victoria's Secret Stores LLC 7/21/2005 W499073 Victoria's Secret Stores, Inc. 11/1/1993 7/21/2005 W347886 Villa Frances at the Knolls, Inc. 4/1/2017 W421754 Villa Frances at the Knolls, Inc. 10/1/1998 5/19/2015 W650065 Villa Mary Immaculate dba St. Peter's Nursing & Rehabilitation Center 1/1/2016 W565253 Visiting Nurse Service of New York 1/1/1994 W565253 Visiting Nurse Service of New York Home Care 1/1/1994 W565253 Visiting Nurse Service of New York Hospice Care 5/1/2003 W555502 VIX, Inc. 7/1/1984 6/25/1988 W565253 VNS Choice 10/1/2001 W565253 VNS Choice Community Care 9/1/2003 6/30/2018 W565253 VNS Continuing Care Development Corporation 10/1/2001 4/1/2003 W565253 VNS Group Health Home Care 10/1/2000 7/23/2008 W499073 VS Service Company, LLC 12/31/2008 W446256 W Shanhouse Sons, Inc 1/1/1981 9/12/1985 W591374 Wadhams Hall, Inc 6/1/1976 W440507 Waldbaum, Inc. (1988) 2/1/1989 10/5/2015 W662506 Waldbaum, Inc. 4/30/1978 5/1/1981 W492003 Walden Book Company, Inc. 7/1/1985 2/1/1995 W449508 Wallach's Inc. 3/1/1978 11/30/1991 W663504 Wal-Mart Associates, Inc. 11/1/2009 W342505 Warner & Swasey Company 10/1/1980 10/1/1983 W899003 Warner-Lambert Company 10/3/1962 7/7/1988 W398259 Washington Mills Electro Minerals Corporation 5/1/1987 6/1/2020 W591127 Waterford Central School Waterford (St Mary's) 9/1/1978 W591374 Watertown Catechetical Board 6/1/1976 W612501 WEA Enterprises Co. Inc. 4/1/1977 10/18/1984 W548002 Webster Rental Corporation 1/1/1971 7/26/1985 W665509 Wegmans Food Markets, Inc. 4/30/1996 W376008 Weill Cornell Medical College of Cornell University 10/31/1928 W667257 Weis Markets, Inc. 9/20/1977 1/1/2004 W666002 Welbilt Corporation 6/1/1955 4/20/1969 W667000 Welbilt Corporation (MICH) 7/19/1969 10/8/1975 W667133 Wendy's International, LLC 9/15/2005 W667133 Wendy's Old Fashioned Hamburgers of New York, LLC 9/15/2005 W667133 Wendy's Restaurants of New York, LLC 6/6/2011 W668008 Westchester Street Transportation 12/17/1956 4/30/1962 W503007 Western Geophycical Co. of America 1/1/1972 8/1/1984 W671508 Western Regional Off Track Betting Corporation 6/1/2019 W673008 Western Union Data Services Co., Inc. 9/1/1970 12/2/1979 W674006 Western Union Realty Corp (DEL) 9/1/1970 8/5/1975 W675003 Western Union Telegraph Co. The (nka New Valley LLC) 8/31/1914 3/1/1985 W676001 Westinghouse Broadcasting & Cable 1/1/1986 12/1/1989 W676001 Westinghouse Electric Corp 1/17/1939 1/1/1998 W677009 Westvaco Corporation 7/6/1914 12/31/2002 W645501 WETM-TV Incorporated 2/24/1981 6/19/1986 W677504 Weyerhaeuser Company 1/1/1978 8/23/2009 W677504 Weyerhaeuser NR Company 1/1/2009 8/23/2009 W520852 WFC Air, Inc. 2/1/1994 8/1/2009 W514004 WH Loomis Talc Corp. (NY) 12/31/1929 1/1/1954 W678254 White Castle System, Inc. 3/1/1992 W450944 White Plains Foundation Inc. 10/1/2002 12/31/2013 Individual Self-Insurer ID Numbers (Board Assigned W Numbers) as of 07/01/21

Qualification Termination Insurer ID# Organization Name Date Date W450944 White Plains Hospital Medical Center 10/1/2002 12/31/2013 W389001 White Rose Food Corp (fka Met Food Corp) 1/1/1972 12/10/1981 W521009 White Rose Food Corp. 1/1/1972 6/27/1986 W389506 White Rose Frozen Foods, Inc. 8/1/1992 4/1/1998 W389506 White Rose, Inc. 1/1/1972 1/1/2009 W449508 Wicks & Greenman Inc. 3/1/1978 8/1/1982 W620009 William Spencer & Son Corp 10/17/1931 11/1/1971 W681506 Wilson & Company Inc (DEL) 1/31/1973 6/1/1975 W555502 Wilson Farms, Inc. 7/1/1984 11/1/2000 W682009 Wilson-Sinclair Co. 4/1/1970 1/31/1973 W384820 Winship Community Residences, Inc. 9/1/2001 W421754 Winslow Therapeutic Riding Center, Inc. 10/1/1998 3/2/2000 W683502 Witco Corporation (nka LANXESS Solutions US Inc) 7/1/1973 6/1/1997 W683502 Witco Inter-American Corporation 7/1/1973 12/31/1979 W683502 Witco International Sales Corp. 7/1/1973 9/24/1989 W683502 Witco Investment Corporation 1/19/1983 6/9/1989 W683502 Witgo Oil and Gas Corporation 1/19/1983 12/1/1987 W446256 WNYT Inc. 7/1/1995 9/30/1996 W499073 Womanco Service Corporation 5/26/1995 10/31/2002 W367254 Women's & Children's Health Research Foundation 4/1/1984 4/1/1998 W367254 Women's & Children's Services Corp. 4/1/1985 4/1/1998 W450134 Women's Health Physician of the Hudson Valley, PLLC 4/1/2006 6/1/2009 W440754 Woodland Village, Inc. 1/1/2016 4/23/2018 W576508 World T & I Corporation 10/1/1974 1/1/1979 W684005 Worthington CEI Inc 1/1/1972 1/1/1974 W686000 Worthington Corp 11/27/1967 10/1/1972 W685002 Worthington Corporation 3/20/1937 11/27/1967 W687008 Worthington Turbine International 4/1/1970 1/1/1973 W662258 WPIX, Inc. 12/31/1978 7/1/1991 W662381 WSTM-TV Incorporated 2/24/1981 6/19/1986 W687503 Xerox Corporation 4/1/1976 1/1/1998 W549919 Xfire, Inc. 10/1/2006 8/2/2010 W446389 XLM Company 6/30/1994 5/31/1998 W688006 Yellow Transportation, Inc. c/o YRC Worldwide 1/1/1970 10/1/2008 W687750 Yeshiva University 7/1/2011 W687750 Yeshiva University High Schools 7/1/2011 W364517 Youngs, Inc. 4/4/1991 6/1/1991 W548509 Youthful Productions LLC 7/22/2019 W420509 Zee Services, Inc. 7/1/1994 7/1/1997