Fermin Igelesias Metro Med Shockwave, Proex Diagnostics, Prime Orthopedics, Inc., ADDITIONAL CASE INFORMATION Prime Medical Resources, Inc., Meridian Rehab Care, Bright Rehab Solutions Case Number Injured Worker Employer Claims Administrator ADJ1801034 MELIZA GUERRERO ALLKAY ELECTRONICS INC AARIS INSURANCE ADJ9012098 GLORIA JUC ABAD FOAM INC ABAD FOAM INC ADJ9453683 ALBERTO ROMAN TRM MANUFACTURING INC ACCELERATED CLAIMS IRVINE ADJ7344112 ARMANDO CHAVEZ TRM MANUFACTURING INC ACCELERATED CLAIMS IRVINE ADJ7690413 FRANCISCO ROSAS PBC ACCELERATED CLAIMS IRVINE ADJ6636734 RAUL PENALOZA TRM MANUFACTURING INC ACCELERATED CLAIMS IRVINE ADJ8931085 ALEX COURSE APM TERMINALS ACCLAIM IRVINE ADJ8931085 ALEX COURSE LONG BEACH CONTAINER TERMINAL ACCLAIM IRVINE ADJ8931085 ALEX COURSE TOTAL TERMINALS INTERNATIONAL ACCLAIM IRVINE ADJ9142381 ELISEO SANCHEZ PARKER HANNIFIN ACCLAMATION 802108 SANTA CLARITA ADJ6933875 JAMES WILCOX PARKER HANNIFIN ACCLAMATION 802108 SANTA CLARITA ADJ7502401 JUAN ORTEGA DUENAS LAYNE CHRISTENSEN CO ACCLAMATION 802108 SANTA CLARITA ADJ877167 ROBERT GRIFFIN COUNTY OF LOS ANGELES/DWP ACCLAMATION 802108 SANTA CLARITA ADJ8617582 GRACIE SAENZ JG BOSWELL ACCLAMATION FRESNO ADJ1475111 JOSE SEPULVEDA CITY OF BAKERSFIELD ACCLAMATION FRESNO ADJ8162473 ONORIO SERRANO ESPARZA ENTERPRISES INC ACCLAMATION FRESNO ADJ3595330 RAMON RAMOS KERN RIDGE GROWERS ACCLAMATION FRESNO ADJ6683252 RUBEN GARCIA CITY OF CLOVIS ACCLAMATION FRESNO ADJ9146137 SOFIA LICEA SAN BERNARDINO SUPERIOR COURT ACCLAMATION SACRAMENTO ADJ9811501 YULIANI CAMACHO ORANGE COUNTY VECTOR CONTROL DISTRICT ACCLAMATION SACRAMENTO ADJ4544288 YU SHIH LIN COUNTY OF LOS ANGELES/DPSS ACCLAMATION SANTA CLARITA ADJ3241717 ABRAM SAUSEDO CMC FONTANA STEEL ACE ADJ3241717 ABRAM SAUSEDO RPS INC ACE ADJ2087933 ALEJANDRO HERNANDEZ SKY BLUE COLLECTION, INC. ACE ADJ1565054 ALFONSO GUIFARRO VALLEY SEAFOOD & POULTRY ACE ADJ1565054 ALFONSO GUIFARRO VALLEY SEAFOOD MARKET ACE ADJ1611037 ALICIA MORA ANDERSON BARROWS METALS CORP ACE ADJ485079 ALMA DUENAS APPLEBEES ACE ADJ4291303 ANDREA CASANOVA SELECT STAFFING ACE ADJ3847909 ARACELI RUIZ BIOSEAL MEDICAL PACKAGING CONCEPTS ACE ADJ1063829 DAVID VILLEGAS HIGHTOWER STAFFING, INC. ACE ADJ1859701 DOLORES DURAN REMEDY TEMP ACE ADJ1693368 FLORENTINO MENDOZA SUN PACIFIC SHIPPERS ACE ADJ252687 GLORIA REYES SELECT REMEDY PERSONNEL SERVICES ACE ADJ7281997 GRACIELA MORALES BIMBO BAKERIES ACE ADJ8817951 HUGO PADILLA VALLEY CREST LANDSCAPE MAINTENANCE ACE ADJ782627 ITALA GRIMALDI CLAREMONT CARE CENTER ACE ADJ3347034 JESUS NAREZ NORTHGATE GONZALEZ MARKET ACE ADJ7294880 JESUS SALES KOOSHAREM CORP ACE ADJ7294880 JESUS SALES KOOSHAREN CORPORATION DBA SELECT PERSONNEL ACE ADJ7294880 JESUS SALES SELECT STAFFING ACE ADJ7294880 JESUS SALES SUN SWEEPING SERVICE ACE ADJ4621341 JOSE ARVIZU RB SAN DIEGO ACE ADJ4358312 JOSEFINA GOMEZ GOLDEN RULE BINDERY ACE ADJ587612 JOSUE HERNANDEZ SRD ENGINEERING, INC. ACE ADJ2579724 JUAN SANDOVAL WALTCO TRUCK EQUIPMENT ACE ADJ2579724 JUAN SANDOVAL WALTCO TRUCK EQUIPMENT CO ACE ADJ153555 LIONEL SIMMS VARCO-BJ DRILLING SYSTEMS ACE ADJ3345688 MANUEL ESTRADA EXIM FABRIC ACE ADJ3367530 MARIA DIAZ AMERICAN BUILDING MAINTENANCE ACE ADJ2212654 MARIA IRENE SOLORZANO SONY PICTURES ENTERTEINMNET ACE ADJ3165324 MIGUEL CARRILLO ANDRADE TREMCO ACE ADJ2215105 REINA MORENO SELECT PERSONNEL SERVICES ACE ADJ4537801 ROSARIO SAIPHONG REMEDY TEMP ACE ADJ4537801 ROSARIO SAIPHONG SELECT STAFFING ACE ADJ1166445 SAUL JIMENEZ WATTS ANDERSON -- BARROWS ACE ADJ4135240 STEPHANIE HOANG PITNEY BOWES ACE ADJ4068165 VICKY GUZMAN SIGNET ARMORLITE ACE ADJ718384 VICTORIANO REYNA ARISE SCAFFOLDING & EQUIPMENT ACE ADJ1269610 DAVID LOPEZ MERVYN'S ACE AMERICAN ADJ2592379 OLIVIA RODRIGUEZ JACK IN THE BOX ACE AMERICAN INSURANCE COMPANY ADJ9115381 VERONICA GUTIERREZ SELCO DISTRIBUTOR INC ACE FIRE UNDERWRITERS INSURANCE CO ADJ7690413 FRANCISCO ROSAS PBC ACME ADMINISTRATORS TEMECULA ADJ8973605 JOSHUA NOWAK MOULTON NIGUEL WATER DISTRICT ACWA JPIA ROSEVILLE ADJ9163423 ALEXY RAFAEL CITY OF CARSON ADMINSURE ONTARIO ADJ2385052 CEFERINO NOYOLA CHAPARRA ADMINSURE ONTARIO ADJ7416522 EDWARD ROMAN CITY OF CARSON ADMINSURE ONTARIO ADJ7318708 FELIXBERTO BERDIN CITY OF BEVERLY HILLS ADMINSURE ONTARIO ADJ7527883 GERTIS BENEMIE POMONA VALLEY HOSPITAL ADMINSURE ONTARIO ADJ7128076 JAMES SMITH HEMET UNIFIED SCHOOL DISTRICT ADMINSURE ONTARIO ADJ8986391 JOEL HOLLEY CITY OF HOPE NATIONAL MEDICAL CENTER ADMINSURE ONTARIO ADJ8305742 MARIA HINTZ CITY OF PALM SPRINGS ADMINSURE ONTARIO ADJ3316438 MARIA JIMENEZ CITY OF HOPE NATIONAL MEDICAL CENTE ADMINSURE ONTARIO ADJ6581538 MARIA MARTINEZ CITY OF REDONDO BEACH ADMINSURE ONTARIO ADJ3391646 PATTIE GILKEY CITY OF MONTEBELLO ADMINSURE ONTARIO ADJ7384723 PERCY BOWEN HEMET UNIFIED SCHOOL DISTRICT ADMINSURE ONTARIO ADJ1730383 TED LOWE LACC DISTRICT ADMINSURE ONTARIO ADJ8895116 BENJAMIN CASTELLANOS ADVANCED MANAGEMENT ADVANCED MANAGEMENT INDUSPAC CALIFORNIA INC WESTERN FOAM PACKAGING ADJ8081723 BEATRIZ DELGADO ADVANTAGE ROCKLIN PRODUCT ADJ8068900 EDGAR CARRILLO IMPERIAL VALLEY CHEESE OF CALIFORNIA ADVANTAGE ROCKLIN ADJ7444554 JOSE CALDERON OLYMPUS ADVANTAGE ROCKLIN ADJ7331827 JULIO RODRIGUEZ CAZARES ICON HEALTH AND FITNESS ADVANTAGE ROCKLIN ADJ8700548 LUIS LOPEZ GENE BERG TRUCKS ADVANTAGE ROCKLIN ADJ8539035 MANUEL MORENO FACILITIES SUPPORT SERVICES ADVANTAGE ROCKLIN Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9312731 MANUELA CORADO CLINICA SAN MIGUEL PEDIATRIA ADVANTAGE ROCKLIN ADJ6860845 LAURA LOPEZ WHITE MEMORIAL MEDICAL CENTER ADVENTIST HEALTH ROSEVILLE ADJ844259 CARLOS LARA LOS ANGELES PHILHARMONIC ASSOC AIG ADJ6642488 FILIBERTO NOCHEBUENA GIBRALTAR PARTHERSHIP LP AIG ADJ6833254 JUAN HUERTA BEAR VALLEY FABRICATORS AIG ADJ6839836 ROSA HERNANDEZ EQUINOX HOLDINGS INC AIG ADJ6937656 SIMONA PERLERA SERVICON SYSTEMS AIG ADJ2764495 DAVID FLORES GLADSTONE RESTAURANT AIG AMERICAN INTL CLAIMS SERVICES ADJ1314284 LUCIO CAMACHO US BATTERIES AIG AMERICAN INTL CLAIMS SERVICES ADJ3028447 MARIBEL ALVAREZ AMERICAN INTERNATIONAL GROUP AIG AMERICAN INTL CLAIMS SERVICES ADJ3139599 SALVADOR SANDOVAL HACOR INC AIG AMERICAN INTL CLAIMS SERVICES ADJ7343030 ANDREA MOORE SERVICE EMPLOYEES INTERNATIONAL UNION AIG CLAIM SERVICES ADJ4555448 ERNESTO VALDEZ NORTHROP GRUMMAN AIG CLAIM SERVICES ADJ2511542 SERGIO VILLANUEVA R&I INDUSTRIES INC AIG CLAIM SERVICES ADJ3200219 SILVIA MEMIJE AB/T1 INC AIG CLAIM SERVICES ADJ8203335 ALFONSO LOPEZ DE WELL LOGISTICS LLC AIG CLAIMS ADJ8527094 EDWIN RAMIREZ DOUBLE VISION GLASS & MIRRORS AIG CLAIMS ADJ7282543 ERIKA RAMIREZ SPECTRUM ATHLETIC CLUB AIG CLAIMS ADJ2526028 JOSEFINA AVELINO JAM INDUSTRIES INC AIG CLAIMS ADJ9316165 SILVIA MERCADO SAMANO MAG INSTRUMENT AIG CLAIMS ADJ7169580 JESUS IBARRA AMPAM PARKS MECHANICAL INC AIG CLAIMS ADJ1542406 ALEJANDRO MENDOZA HESPERIA TRUSS AIG CLAIMS CONCORD ADJ1542406 ALEJANDRO MENDOZA HESPERIA TRUSS INC AIG CLAIMS CONCORD ADJ6693628 AMERICA TORRES VIRGIN AMERICANS INC AIG CLAIMS CONCORD ADJ6706565 APOLINAR MURILLO JPS SURFACE SOLUTIONS INC AIG CLAIMS CONCORD ADJ1884248 BLANCA HERNANDEZ OGDEN GROUND SERVICES AIG CLAIMS CONCORD ADJ4223314 CARLOS MARAVILLA IRISH CONSTRUCTION AIG CLAIMS CONCORD ADJ353822 DERRICK WINZER TRI WEST LTD AIG CLAIMS CONCORD ADJ353822 DERRICK WINZER TRI-WEST AIG CLAIMS CONCORD ADJ7112495 FRANCISCO AVALOS DESERT COMMERCIAL CONCRETE AIG CLAIMS CONCORD ADJ3272627 ISRAEL REYES NICKY'S FASHION AIG CLAIMS CONCORD ADJ1287548 JAVIER MORENO PERSONNEL PLUS INC AIG CLAIMS CONCORD ADJ1545982 JOHN BODNAR UNITED TECHNOLOGIES CORP. AIG CLAIMS CONCORD ADJ3882758 JORGE BARAJAS DPR CONSTRUCTION AIG CLAIMS CONCORD ADJ3882758 JORGE BARAJAS DPR CONSTRUCTION, INC AIG CLAIMS CONCORD ADJ318800 JOSE AYALA SOLIDEAL USA AIG CLAIMS CONCORD ADJ3984391 JOSE MORISCO TWF CONSTRUCTION AIG CLAIMS CONCORD ADJ3984391 JOSE MORISCO TWF CONSTUCTION. MC. AIG CLAIMS CONCORD ADJ7181314 JOSE ZETINA DESERT COMERCIAL CONCRETE AIG CLAIMS CONCORD ADJ3140206 LAURA GUERRA APRIA HEALTHCARE AIG CLAIMS CONCORD ADJ249754 LEOVIGILDA SOSA STAFFMARK COMPANY AIG CLAIMS CONCORD ADJ3431787 MARIA ELIZALDE RAFCO PRODUCTS BRICKFORM AIG CLAIMS CONCORD ADJ7617830 MARIA GUTIERREZ SPOTLESS DETAIL AIG CLAIMS CONCORD ADJ2136237 MARIA LEON PREFERRED PERSONNEL AIG CLAIMS CONCORD ADJ1025357 MARIAM SANCHEZ NEXCYCLE AIG CLAIMS CONCORD ADJ1346884 MARTHA RAMOS ST JUDE'S HOSP AIG CLAIMS CONCORD ADJ8536660 MILI AVILA PRIORITY BUILDING SERVICES LLC AIG CLAIMS CONCORD ADJ3396893 OMAR GUTIERREZ COMMODITY LOGISTICS WEST, INC. AIG CLAIMS CONCORD ADJ8537133 OSCAR GAMBOA THE CHEFS WAREHOUSE AIG CLAIMS CONCORD ADJ2808553 RAMON RODRIGUEZ CROWN DISPOSAL CO. AIG CLAIMS CONCORD ADJ3666217 SILVIA GARCIA CITI STAFF SOLUTIONS, INC. AIG CLAIMS CONCORD ADJ7475373 XIAOFANG WANG MONTEREY PARK CONVALESCENT HOSPITAL INC AIG CLAIMS CONCORD ADJ7135125 ABEL BACILIO RAD BUILDING DEVELOPMENT AIG CLAIMS COSTA MESA ADJ7469714 ABRAHAM NUNEZ PERSONNEL PLUS AIG CLAIMS COSTA MESA ADJ3241717 ABRAM SAUSEDO CMC FONTANA STEEL AIG CLAIMS COSTA MESA ADJ3241717 ABRAM SAUSEDO RPS INC AIG CLAIMS COSTA MESA ADJ7121997 ADAM CERVANTES COIN STAR AIG CLAIMS COSTA MESA ADJ1933902 ADAN RODRIGUEZ HANSEN STEEL SERVICES AIG CLAIMS COSTA MESA ADJ8212563 ADRIANA LIZARRAGA LYON TECHNOLOGIES AIG CLAIMS COSTA MESA ADJ7830322 ALBA NAJERA DIAMOND CONTRACT SERVICES AIG CLAIMS COSTA MESA ADJ8258677 ALBERTA PEREZ LUNA DIAMOND CONTRACT SERVICES INC AIG CLAIMS COSTA MESA ADJ7823462 ALEJANDRA GONZALEZ HOSPITAL STAFFING SOLUTIONS AIG CLAIMS COSTA MESA ADJ1934850 ALEJANDRA LOPEZ CARLTON CUNNINGHAM AIG CLAIMS COSTA MESA ADJ8954417 ALEJANDRO MEJIA CALIFORNIA DROP FORGE INC AIG CLAIMS COSTA MESA ADJ1542406 ALEJANDRO MENDOZA HESPERIA TRUSS AIG CLAIMS COSTA MESA ADJ1542406 ALEJANDRO MENDOZA HESPERIA TRUSS INC AIG CLAIMS COSTA MESA ADJ817041 ALEJANDRO MORENO J.C. PENNEY AIG CLAIMS COSTA MESA ADJ7469479 ALFONSO PONCE CRST LINCOLN SALES AIG CLAIMS COSTA MESA ADJ7338769 ALFREDO ANDRADE STAFFING SYSTEM CORP AIG CLAIMS COSTA MESA ADJ7683014 ALFREDO ANDRADE STAFFING SYSTEMS AIG CLAIMS COSTA MESA ADJ7943211 ALFREDO PULIDO ASBURY ENVIRONMENTAL SERVICES INC AIG CLAIMS COSTA MESA ADJ4536302 ALFREDO RODRIGUEZ AERO GROUND AIG CLAIMS COSTA MESA ADJ9974815 ALICIA FLORES PREMIER PERSONNEL AIG CLAIMS COSTA MESA ADJ5829459 ALICIA MORALES UFP TECHNOLOGIES AIG CLAIMS COSTA MESA ADJ5829459 ALICIA MORALES UFP TECHNOLOGIES INC AIG CLAIMS COSTA MESA ADJ2891588 ALVARO GONZALEZ FIRST CHOICE STAFFING, INC. AIG CLAIMS COSTA MESA ADJ3657936 ALVARO MIRAMONTES BRICKLEY ENVIRONMENTAL AIG CLAIMS COSTA MESA ADJ1839760 AMIE URIBE NEPTUNE FOODS AIG CLAIMS COSTA MESA ADJ6507378 AMY FISHER WEIGHT WATCHERS INTERNATIONAL AIG CLAIMS COSTA MESA ADJ7123171 ANA AVELENDA JC PENNY AIG CLAIMS COSTA MESA ADJ2620238 ANA MARINA PACHECO HUTCHINSON SEAL CORP AIG CLAIMS COSTA MESA ADJ8241427 ANA RUTH MEDINA ANTELOPE VALLEY CONVALESCENTP HOSP AND NURSING AIG CLAIMS COSTA MESA ADJ8241427 ANA RUTH MEDINA GERI CARE IV LLC ANTILOPE VALLEY CARE CENTER AIG CLAIMS COSTA MESA ADJ8050693 ANABEL VARGAS JCPENNEY COMPANY INC, AIG CLAIMS COSTA MESA ADJ7628617 ANADELIA MARTINEZ ALL CITY MANAGEMENT SERVICES AIG CLAIMS COSTA MESA ADJ8290966 ANGEL CASILLAS MATRIX DOCUMENT IMAGING AIG CLAIMS COSTA MESA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ759818 ANGELICA MIRELES MJO STAFFING AIG CLAIMS COSTA MESA ADJ8195701 ANGELICA TORRES ADVANCED MULSERVICE AIG CLAIMS COSTA MESA ADJ4549998 ANTHONY BRISSERUP FOUNDATION PILE, INC. AIG CLAIMS COSTA MESA ADJ6815901 ANTONIO BERNAL JR UNIVERSAL CONSTRUCTION INC AIG CLAIMS COSTA MESA ADJ7123985 ANTONIO ZUNIGA NATIONAL ACOOUNTS AIG CLAIMS COSTA MESA ADJ2110592 ARACELI GRANADOS STAFFMARK INC WEST AIG CLAIMS COSTA MESA ADJ3847909 ARACELI RUIZ BIOSEAL MEDICAL PACKAGING CONCEPTS AIG CLAIMS COSTA MESA ADJ7083825 ARIEL GONZALEZ TOBO CONSTRUCTION INC AIG CLAIMS COSTA MESA ADJ6917675 ARMANDO MORA J DURAN CONSTRUCTION AIG CLAIMS COSTA MESA ADJ6917675 ARMANDO MORA J DURAN CONSTRUCTION INCI AIG CLAIMS COSTA MESA ADJ6916600 ARNOLDO PEREZ PREFERRED PERSONNEL AIG CLAIMS COSTA MESA ADJ9526863 ARTURO CANUT SOSA GREEN TRUCKING, LLC AIG CLAIMS COSTA MESA ADJ9064163 ARTURO GARCIA REDT SERVICE AIG CLAIMS COSTA MESA ADJ7590937 AUBREY FLOWERS BENCHMARK STAFFING AIG CLAIMS COSTA MESA ADJ6956704 AUREA VELASQUEZ PREFERRED PERSONNEL AIG CLAIMS COSTA MESA ADJ2319495 AURELIO ESPINOZA WEBER METALS, INC. AIG CLAIMS COSTA MESA ADJ8643098 AURORA CURIEL CENTER FOR COMMUNITY & FAMILY SERVICES AIG CLAIMS COSTA MESA ADJ7839394 BARRIE BAUTISTA ALL SOURCE PLUMBING COMPANY AIG CLAIMS COSTA MESA ADJ4709408 BEATRICE MONJICA CAITAC GARMENT PROCESSING INC. AIG CLAIMS COSTA MESA ADJ7015862 BELISARIO GARCIA CAL HOSEMENS SAFETY AIG CLAIMS COSTA MESA ADJ6868657 BERTHA GOMEZ COURTESY STAFFING INC AIG CLAIMS COSTA MESA ADJ6903172 BLANCA CASTRO MBM AIG CLAIMS COSTA MESA ADJ6769497 BROCK DOHERTY LAKEVIEW PROFESSIONAL SERVICES AIG CLAIMS COSTA MESA ADJ7611345 CARLOS AGUILAR NORTHRUP GRUMMAN AIG CLAIMS COSTA MESA ADJ7492940 CARLOS LOPEZ MJO STAFFING AIG CLAIMS COSTA MESA ADJ9137507 CARLOS LOPEZ SO CAL CONCEPTS AIG CLAIMS COSTA MESA ADJ9137507 CARLOS LOPEZ SO CAL CONCEPTS INC AIG CLAIMS COSTA MESA ADJ4223314 CARLOS MARAVILLA IRISH CONSTRUCTION AIG CLAIMS COSTA MESA ADJ1115416 CARLOS MORALES SMITH BROTHERS GLASS AIG CLAIMS COSTA MESA ADJ4121924 CARLOS MORALES GUARDS MARK SECURITY AIG CLAIMS COSTA MESA ADJ2857817 CHARLES GARY LIDO COMMUNITIES AIG CLAIMS COSTA MESA ADJ6743544 CHARLES PARKER JB HUNT TRANSPORT AIG CLAIMS COSTA MESA ADJ6743544 CHARLES PARKER JB HUNT TRANSPORT INC AIG CLAIMS COSTA MESA ADJ7217472 CHRISTOPHER FORMENT SENERCHIA TRUCKING AIG CLAIMS COSTA MESA ADJ8014548 CHRISTOPHER TOWNSEND NORTHRUP GRUMMAN AIG CLAIMS COSTA MESA ADJ4674521 CIRILO VARELA SOUTH SHORE/COASTAL EMPLOYERS AIG CLAIMS COSTA MESA ADJ7065347 CLARENCE BROWN SUNRAY ENERGY AIG CLAIMS COSTA MESA ADJ603568 COLEE PITCHFORD TRIMAC AIG CLAIMS COSTA MESA ADJ8477467 CONCEPCION CRUZ ZUNIGA EMBEE INC AIG CLAIMS COSTA MESA ADJ3175937 CRISTOBAL REQUENA INTER PLAN WEST CONSTRUCTIONS AIG CLAIMS COSTA MESA ADJ9162064 CUAUHTEMOC GARCIA PDS TRUCKING INC AIG CLAIMS COSTA MESA ADJ7447673 DANY SERPAS SARES REGIS AIG CLAIMS COSTA MESA ADJ7527870 DARRYL YOUNG UFA EXPRESS AIG CLAIMS COSTA MESA ADJ7527870 DARRYL YOUNG UFA EXPRESS INC AIG CLAIMS COSTA MESA ADJ7342857 DAVID PADILLA CALIFORNIA LANDSCAPE AND DESIGN AIG CLAIMS COSTA MESA ADJ353822 DERRICK WINZER TRI WEST LTD AIG CLAIMS COSTA MESA ADJ353822 DERRICK WINZER TRI-WEST AIG CLAIMS COSTA MESA ADJ9062440 DIEGO ZAMUDIO WORKFORCE SOLUTIONS WFS LLC AIG CLAIMS COSTA MESA ADJ6701684 DOMINGO RODRIGUEZ PROGRESSIVE LOGISTICS SERVICES AIG CLAIMS COSTA MESA ADJ4255388 DONALD GREEN KEDREN HEADSTART AIG CLAIMS COSTA MESA ADJ8855222 EDGAR BERRA OLACHEA FRAMING BY SUPERIOR AIG CLAIMS COSTA MESA ADJ7858924 EDGARDO ALCANTARA AREVALO MCLANE FOOD SERVICE AIG CLAIMS COSTA MESA ADJ9146406 EDWARD KICHLINE FFE FROZEN FOODS EXPRESS AIG CLAIMS COSTA MESA ADJ7721309 ELFEGA SANCHEZ MJO STAFFING AIG CLAIMS COSTA MESA ADJ9172752 ELIZABETH MARTINEZ JONATHAN AND GEORGE SALON INC AIG CLAIMS COSTA MESA ADJ8447599 ELIZABETH ROQUE NONGSHIM HOLDINGS USA INCI AIG CLAIMS COSTA MESA ADJ7893171 ELIZABETH SERRATO RON WILSON AIG CLAIMS COSTA MESA ADJ7816245 EMILIO CONTRERAS AMERICAN INTEGRATED SERVICES INC AIG CLAIMS COSTA MESA ADJ7697382 ENRIQUE GONZALEZ AGI MARBLE CO AIG CLAIMS COSTA MESA ADJ7697382 ENRIQUE GONZALEZ STONEWARE TILE INC AIG CLAIMS COSTA MESA ADJ8902505 ESPERANZA BUSTOS CARLISLE INTERCONNECT TECHNOLOGIES AIG CLAIMS COSTA MESA ADJ1692003 EVA RAMIREZ PEDUS BUILDING SERVICES AIG CLAIMS COSTA MESA ADJ8641249 EVELYN JUAREZ THE WESTIN BONAVERNTURE HOTEL AIG CLAIMS COSTA MESA ADJ4052440 FAVIO ULATE WESTERN BUILDING PROFESSIONALS AIG CLAIMS COSTA MESA ADJ3428889 FERNANDO BRAVO PRIORITY STAFFING SERVICES AIG CLAIMS COSTA MESA ADJ8001116 FRANCISCO MORENO ERECTA RAK WEST INC AIG CLAIMS COSTA MESA ADJ6726437 FREDY ZANUNZINI GONSALEZ PAINTING CORP AIG CLAIMS COSTA MESA ADJ6726437 FREDY ZANUNZINI GONZALEZ PAINTING CORP AIG CLAIMS COSTA MESA ADJ9429784 GASPER RIOS HYDROCHEM INDUSTRIAL AIG CLAIMS COSTA MESA ADJ1898885 GERARDO AYALA NALCO CHEMICAL AIG CLAIMS COSTA MESA ADJ6670568 GERARDO AYALA NALCO CHEMICAL CO AIG CLAIMS COSTA MESA ADJ7361642 GERMAN GARCIA GUZMAN GARDEN AIG CLAIMS COSTA MESA ADJ7882378 GLADYS ALFARO DIAMOND CONTRACT SERVICES AIG CLAIMS COSTA MESA ADJ8937712 GLORIA SANTANA ISLAND HOSPITALITY MANAGEMENT INC AIG CLAIMS COSTA MESA ADJ6669650 GONZALO AROS QUALITY ASSOCIATES INC AIG CLAIMS COSTA MESA ADJ3530701 GRACIELA HERRERA STAFF MARK AIG CLAIMS COSTA MESA ADJ7510669 GUDELIO LEIVA BILTMORE METAL FABRICATORS AIG CLAIMS COSTA MESA ADJ3366656 GUMARO HERRERA STAFFMARK AIG CLAIMS COSTA MESA ADJ7536950 HARRY GEVSHENIAN CAST AND CREW ENTERTAINMENT SERVICES AIG CLAIMS COSTA MESA ADJ7536950 HARRY GEVSHENIAN ENTERTAINMENT PARTNERS EPSG AIG CLAIMS COSTA MESA ADJ7536950 HARRY GEVSHENIAN WARNER BROTHERS NETWORK AIG CLAIMS COSTA MESA ADJ8330154 HARRY LOW MOVIE MOVERS AIG CLAIMS COSTA MESA ADJ7719697 HILARIA MERCADO APS AERO PORT SERVICES AIG CLAIMS COSTA MESA ADJ7232084 HIRAM GOMEZ T A INDUSTRIES AIG CLAIMS COSTA MESA ADJ1841222 HOA HAGGARD BOEING AIG CLAIMS COSTA MESA ADJ8290787 HUGO HIGAREDA FUJI FOOD PRODUCTS AIG CLAIMS COSTA MESA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7740010 HUMBERTO VASQUEZ DAMERON ALLOY FOUNDRIES INC AIG CLAIMS COSTA MESA ADJ6677588 ILALEO MANU SWISSPORT AIG CLAIMS COSTA MESA ADJ6535830 ILENE DE ARCOS J C PENNEY AIG CLAIMS COSTA MESA ADJ2124657 IRMA BECERRA PACIFIC VIAL MANUFACTURING AIG CLAIMS COSTA MESA ADJ7936463 ISABEL CASTRO NIETO MJO STAFFING INC AIG CLAIMS COSTA MESA ADJ2665823 ISRAEL CASTRO FORCE FRAMING INC AIG CLAIMS COSTA MESA ADJ9469054 ISSAC DUMAS SODEXO AIG CLAIMS COSTA MESA ADJ6875143 JACK MELKONIAN ALLIED SYSTEMS AIG CLAIMS COSTA MESA ADJ2655695 JAIME VELAZQUEZ APRIA HEALTHCARE AIG CLAIMS COSTA MESA ADJ8371316 JAIRO LOZANO MISSION LANDSCAPE COMPANY AIG CLAIMS COSTA MESA ADJ6754572 JAMES WILLOUGHBY GRANT AME CHURCH AIG CLAIMS COSTA MESA ADJ6754572 JAMES WILLOUGHBY HILL ROCK CORPORATION AIG CLAIMS COSTA MESA ADJ1062010 JAVIER CASTREJON DIAZ CONSTRUCTION CO., INC. AIG CLAIMS COSTA MESA ADJ496895 JAVIER ONITVEROS PACIFIC OCEAN DYE DINISHING AIG CLAIMS COSTA MESA ADJ7555123 JAVIER SANTOS ROSALIO RICHLINE TEXTILE INC AIG CLAIMS COSTA MESA ADJ7472183 JEFF REESE NORTHROP GRUMMAN CORP AIG CLAIMS COSTA MESA ADJ7472183 JEFF REESE NORTHROP GRUMMAN CORPORATION AIG CLAIMS COSTA MESA ADJ7589929 JESUS CARRERA INDIGO CONSTRUCTION CORP AIG CLAIMS COSTA MESA ADJ7602179 JESUS MORENO CROWTHER PRENTISS CO AIG CLAIMS COSTA MESA ADJ9389087 JESUS PEREZ SFC AIG CLAIMS COSTA MESA ADJ7754586 JIAN LI FOODMART INTERNATIONAL CORP AIG CLAIMS COSTA MESA ADJ7325167 JOHN LAWLER R T CONSTRUCTION AIG CLAIMS COSTA MESA ADJ7367474 JOHN RUBIO DAN DAVIS ENTERPRISE INC AIG CLAIMS COSTA MESA ADJ6808521 JOHN TURANO GEM MOBILE TREATMENT SERVICES INC AIG CLAIMS COSTA MESA ADJ9231132 JOSE ACOSTA PACER CARTAGE INC AIG CLAIMS COSTA MESA ADJ9473023 JOSE ARAUJO TS EMPLOYMENT AIG CLAIMS COSTA MESA ADJ4475300 JOSE BAUTISTA STAFFMARK LLC AIG CLAIMS COSTA MESA ADJ7378456 JOSE DE JESUS JIMENEZ X3 MANAGEMENT SERVICE AIG CLAIMS COSTA MESA ADJ8396853 JOSE DELGADILLO LIFE STEPS FOUNDATION AIG CLAIMS COSTA MESA ADJ3727509 JOSE GARCIA WEBER METALS AIG CLAIMS COSTA MESA ADJ6778807 JOSE GARCIA SWEET OVATIONS LLC AIG CLAIMS COSTA MESA ADJ7112880 JOSE GUSTAVO CERVANTES HERNANDEZ INTERSTATE CLEANING CORPORATION AIG CLAIMS COSTA MESA ADJ9515122 JOSE HERNANDEZ BARRAGAN WASH DEPOT HOLDINGS AIG CLAIMS COSTA MESA ADJ3283523 JOSE LOPEZ SUBURBAN PLASTERING AIG CLAIMS COSTA MESA ADJ3283523 JOSE LOPEZ SUBURBAN PLASTERING/PROLINE PLASTER AIG CLAIMS COSTA MESA ADJ7325051 JOSE MACIAS AMERICAN TECHNOLOGIES INC AIG CLAIMS COSTA MESA ADJ7210005 JOSE MARTINEZ TK SAFEWAY AIG CLAIMS COSTA MESA ADJ8598563 JOSE MENDEZ TEAM NATION AIG CLAIMS COSTA MESA ADJ3984391 JOSE MORISCO TWF CONSTRUCTION AIG CLAIMS COSTA MESA ADJ3984391 JOSE MORISCO TWF CONSTUCTION. MC. AIG CLAIMS COSTA MESA ADJ7519769 JOSE RAMIREZ FABRLCATION CONCEPTS CORP AIG CLAIMS COSTA MESA ADJ7181314 JOSE ZETINA DESERT COMERCIAL CONCRETE AIG CLAIMS COSTA MESA ADJ8238163 JOSEMIGUEL POLI ENTERTAINMENT PARTNERS AIG CLAIMS COSTA MESA ADJ8101338 JUAN ALCARAZ ABCANA INDUSTRIES AIG CLAIMS COSTA MESA ADJ6956061 JUAN CAREAGA CENTURY TRUCK AIG CLAIMS COSTA MESA ADJ8241620 JUAN CEDENO INLAND WOODWORKS AIG CLAIMS COSTA MESA ADJ7904623 JUAN CERVANTES ULTIMATE REMOVAL INC AIG CLAIMS COSTA MESA ADJ7358796 JUAN DELGADO PADILLA CONSTRUCTION COMPANY AIG CLAIMS COSTA MESA ADJ7205564 JUAN LAREDO PARR LUMBER AIG CLAIMS COSTA MESA ADJ4498635 JUAN MACIAS MAYER ROOFING INC AIG CLAIMS COSTA MESA ADJ9505831 JUAN MANUEL MEDINA BURRTEC WASTE INDUSTRIES AIG CLAIMS COSTA MESA ADJ8786559 JUAN NUNEZ CASTRO MASTER HALCO AIG CLAIMS COSTA MESA ADJ8268080 JUAN PONCE DAVID DEVELOPEMENT AIG CLAIMS COSTA MESA ADJ4077636 JULIA LANGARICA PACER TECHNOLOGY AIG CLAIMS COSTA MESA ADJ7282529 KEVIN CHANG CRST INTERNATIONAL INC AIG CLAIMS COSTA MESA ADJ6489502 KIM BULLARD SELECT BUILD AIG CLAIMS COSTA MESA ADJ7537597 LAURA ANGULO SC STAFFING AIG CLAIMS COSTA MESA ADJ2924616 LAURA GALVAN PRIORITY BUSINESS SERVICES AIG CLAIMS COSTA MESA ADJ3508391 LAURA MAGANA MJO STAFFING AIG CLAIMS COSTA MESA ADJ6658108 LEANDRO DEL REAL CORTANT HOUSING L ECONOMIC AIG CLAIMS COSTA MESA ADJ9839722 LENIN DIEGO PARTNERSHIP STAFFING SOLUTION AIG CLAIMS COSTA MESA ADJ9097029 LESLEY DOAN PIZZA HUT AIG CLAIMS COSTA MESA ADJ6779359 LETICIA CASIMIRO CAITAC GARMENT PROCESSING INC AIG CLAIMS COSTA MESA ADJ6779359 LETICIA CASIMIRO CAITAL GARMET PROCESSING AIG CLAIMS COSTA MESA ADJ6465014 LI SHENG TAN ROLLINS NARROW FABRIC, INC. AIG CLAIMS COSTA MESA ADJ8762494 LIDIA OYUELA AMERICAN APPAREL INC AIG CLAIMS COSTA MESA ADJ6427151 LISA YESH OLYMPIC PARTNERS AIG CLAIMS COSTA MESA ADJ7994323 LORENZO GOMORA GAMBOL INDUSTRIES INC AIG CLAIMS COSTA MESA ADJ4310265 LORENZO RAMOS COMMUNITY RECYCLING RESOURCES AIG CLAIMS COSTA MESA ADJ7045703 LOYDA FERREIRA AMERICAN GENERAL FINANCIAL SVS AIG CLAIMS COSTA MESA ADJ230157 LUCAS ORTIZ PERSONNEL PLUS AIG CLAIMS COSTA MESA ADJ3962906 LUCY RUSHING SERVICE CRAFT AIG CLAIMS COSTA MESA ADJ8045453 LUIS FLORES AMERICAN THEATRICAL DRYWALL FRAMING INC AIG CLAIMS COSTA MESA ADJ8944030 LUIS FLORES LINCOLN AUTO SPA AIG CLAIMS COSTA MESA ADJ7034739 MAELINA GIBSON SH STAFFING LLC AIG CLAIMS COSTA MESA ADJ7665056 MANUEL CAMPOS MJO STAFFING AIG CLAIMS COSTA MESA ADJ6581116 MANUEL CHAVARIN GEM MOBILE TREATMENT SERVICES AIG CLAIMS COSTA MESA ADJ6893989 MANUEL HERRERA DISTRIBUIDORA MORAZAN INC AIG CLAIMS COSTA MESA ADJ9385481 MANUEL QUINONEZ CIERA STAFFING AIG CLAIMS COSTA MESA ADJ1262856 MANUEL RODRIGUEZ PARAGON TEXTILES, INC. AIG CLAIMS COSTA MESA ADJ7305323 MANUEL SALGADO GREAT BASIN ENVIRONMENTAL INC AIG CLAIMS COSTA MESA ADJ4107729 MARCELINO SOTO MCLANE FOODSERVICE DIST AIG CLAIMS COSTA MESA ADJ9086387 MARGARITA SERVIN SOUTHERN CALIFORNIA PIZZA DBA PIZZA HUT AIG CLAIMS COSTA MESA ADJ9510205 MARIA AVILA COMPASS GROUP USA AIG CLAIMS COSTA MESA ADJ3383577 MARIA DEL ROCIO FLORES INTERSTATE CLEANING CORP AIG CLAIMS COSTA MESA ADJ579246 MARIA FLORES BLUE COLLAR STAFFING SOLUTIONS INC AIG CLAIMS COSTA MESA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8768795 MARIA GARCIA RESIDENCE INN AIG CLAIMS COSTA MESA ADJ2492761 MARIA GOMEZ CONSOLIDATED FOUNDRIES AIG CLAIMS COSTA MESA ADJ4462473 MARIA GUEVARA ESSI WORLD SERVICES WEST AIG CLAIMS COSTA MESA ADJ8747618 MARIA LIZAOLA AAA PROPERTY SERVICES AAA ELECTRICAL COMMUNICATIONS AIG CLAIMS COSTA MESA ADJ7349704 MARIA LOMELI THE RIGHT CHOICE AIG CLAIMS COSTA MESA ADJ6619587 MARIA MORA WORKFORCE AIG CLAIMS COSTA MESA ADJ2561735 MARIA OROZCO CIS INTERNATIONAL HOLDINGS COR AIG CLAIMS COSTA MESA ADJ6731293 MARIA PADILLA PACIFIC PALMS HEALTHCARE AIG CLAIMS COSTA MESA ADJ7908304 MARIA REYES ANTELOPE VALLEY RETIREMENT AIG CLAIMS COSTA MESA ADJ8525613 MARIA VENTURA GOLDEN STATE CARE AIG CLAIMS COSTA MESA ADJ7129804 MARICARMEN MARTINEZ MJO STAFFING AIG CLAIMS COSTA MESA ADJ7129804 MARICARMEN MARTINEZ MJO STAFFING INC AIG CLAIMS COSTA MESA ADJ8859607 MARINA NAVARRO SILVERADOSENIOR LIVING MGMT AIG CLAIMS COSTA MESA ADJ7642000 MARK TABBERRNER TEAM SERVICES AIG CLAIMS COSTA MESA ADJ7380065 MARTHA MALDONADO LOPEZ GALLONI ENTERPRISES MEDICAL CORP AIG CLAIMS COSTA MESA ADJ7380065 MARTHA MALDONADO LOPEZ HELPMATES STAFFING SERV1CES AIG CLAIMS COSTA MESA ADJ7380065 MARTHA MALDONADO LOPEZ HELPMATES STAFFING SERVICES AIG CLAIMS COSTA MESA ADJ6500328 MARTHA NAVA FRESH AND EASY NEIGHBORHOOD AIG CLAIMS COSTA MESA ADJ8777338 MARTHA TORREZ KEDREN COMMUNITY HEALTH CENTER AIG CLAIMS COSTA MESA ADJ7734612 MARVIN HERNANDEZ BURRTEC WASTE GROUP INC AIG CLAIMS COSTA MESA ADJ3120280 MAURO JORGE MARTINEZ QUALITY INN AIG CLAIMS COSTA MESA ADJ1719591 MAXIMIANO RAMIREZ LIPPERT COMPONENTS/DBA ZIEMAN, INC. AIG CLAIMS COSTA MESA ADJ3638841 MAXIMIANO RAMIREZ LIPPERT COMPONENST, INC. AIG CLAIMS COSTA MESA ADJ7934932 MICHAEL OREFICE ENTERTAINMENT PARTNERS AIG CLAIMS COSTA MESA ADJ7934932 MICHAEL OREFICE FSI/FPS SERVICES INC. AIG CLAIMS COSTA MESA ADJ7934932 MICHAEL OREFICE NBC ULVERSAL AIG CLAIMS COSTA MESA ADJ1950800 MILTON GAMEZ SWISSPORT CARGO SERVICES AIG CLAIMS COSTA MESA ADJ707830 MIRIAM ESPINOLA ESTEY INTERNATIONAL, INC. AIG CLAIMS COSTA MESA ADJ7126328 MIYNOR AVILA PDS TRUCKING AIG CLAIMS COSTA MESA ADJ7126328 MIYNOR AVILA PDS TRUCKING INC AIG CLAIMS COSTA MESA ADJ4097432 MUHAMMED SAADIQ ROTATOR STAFFING SERVICE AIG CLAIMS COSTA MESA ADJ688551 NEFFITERRI HEARNES AERO PORT SERVICES, INC. AIG CLAIMS COSTA MESA ADJ8093070 NINFA ESTHELA ARANDA HACOR INC AIG CLAIMS COSTA MESA ADJ1373051 NORMA HEREDIA PREFERRED PERSONNEL AIG CLAIMS COSTA MESA ADJ7003914 OFELIA LARA FRANCO CVS AIG CLAIMS COSTA MESA ADJ3379024 OLGA ARIAS MISSION FOODS AIG CLAIMS COSTA MESA ADJ4348232 OLIVA RUEDAS FASHION MANIA AIG CLAIMS COSTA MESA ADJ7994100 ORALIA ALARCON ADVANCED SERVICES UNLIMITED AIG CLAIMS COSTA MESA OSCAR ROLANDO VALENCIANO AKA ANGEL ADJ8977064 LAKE LINDERO COUNTRY CLUB AIG CLAIMS COSTA MESA CAST ADJ798123 OSCAR VILLALOBO COIT SERVICES INC AIG CLAIMS COSTA MESA PATRICIA AKA GUADALUPE MEDINA AKA ADJ7915234 PREFERRED PERSONNEL AIG CLAIMS COSTA MESA MENDOZA PATRICIA AKA GUADALUPE MEDINA AKA ADJ7915234 PREFERRED PERSONNEL INC AIG CLAIMS COSTA MESA MENDOZA ADJ813420 PAUL WARD NORTHROP GRUMMAN AIG CLAIMS COSTA MESA ADJ644059 PAULA PEDROZA WORKFORCE OUTSOURCING AIG CLAIMS COSTA MESA ADJ7199319 PEDRO CABRERA CITISTAFF SOLUTIONS INC AIG CLAIMS COSTA MESA ADJ4601664 PEDRO GARCIA LAKEVIEW PROFESSIONAL SERVICES AIG CLAIMS COSTA MESA ADJ6751677 PEDRO HERNANDEZ FENCEWORKS AIG CLAIMS COSTA MESA ADJ6658842 RAMIRO CERVANTEZ STAFFMARK TRANSPORTATION AIG CLAIMS COSTA MESA ADJ7969556 RAMIRO MENDEZ MORLEY CONSTRUCTION AIG CLAIMS COSTA MESA ADJ2924671 RAMIRO MENDOZA ALFA LEISURE INC AIG CLAIMS COSTA MESA ADJ3953083 RAMON ARRENDONDO INNOVATIVE REAL ESTATE AIG CLAIMS COSTA MESA ADJ7994184 RAMON TERRAZAS CITISTAFF SOLUTIONS INC AIG CLAIMS COSTA MESA ADJ7718187 RANDALL MALONE CALISLE TIRE AND WHEEL COMPANY AIG CLAIMS COSTA MESA ADJ7360629 RAUL MONREAL QUEST CONSTRUCTION AIG CLAIMS COSTA MESA ADJ7798198 RAUL PALMA HOLLYWOOD BEAUTIFICATION AIG CLAIMS COSTA MESA ADJ8639651 RAUL TORRES MJO STAFFING AIG CLAIMS COSTA MESA ADJ3168012 RAYMOND POINTKOWSKI BROOKSTONE EQUIPMENT AIG CLAIMS COSTA MESA ADJ121045 RENE LEONOR PREFERRED PERSONELL AIG CLAIMS COSTA MESA ADJ9313936 RICARDO ANAYA BORBON, INC. AIG CLAIMS COSTA MESA ADJ7430539 RICARDO MENDOZA RELIABLE INTERIORS INC ACCEL AIG CLAIMS COSTA MESA ADJ1508707 ROBERTO MALDONADO QUALITY PLASTERING AIG CLAIMS COSTA MESA ADJ6561694 ROBERTO ROMAN PREFERRED PERSONNEL AIG CLAIMS COSTA MESA ADJ238483 ROBERTO SANCHEZ TUTOR SALIBA CORP AIG CLAIMS COSTA MESA ADJ7374939 ROBERTO TORRES PREFERRED PERSONNEL AIG CLAIMS COSTA MESA ADJ8424838 RODOLFO SANDOVAL JB VARGAS AIG CLAIMS COSTA MESA ADJ3019682 RODRIGO LUEVANOS ALFA LEISURE INC AIG CLAIMS COSTA MESA ADJ539384 RODRIGO MONTES EMC AIG CLAIMS COSTA MESA ADJ7141231 ROSA SANCHEZ SC STAFFING SOLUTIONS AIG CLAIMS COSTA MESA ADJ1270106 ROSARIO LOPEZ SPECTRUM CLUBS, INC AIG CLAIMS COSTA MESA ADJ8673077 RUBEN JUAREZ BERNADETTE MCKEON AIG CLAIMS COSTA MESA ADJ8488872 SALOMON CORTEZ AMERICAN HERITAGE LANDSCAPE AIG CLAIMS COSTA MESA ADJ7427379 SALVADOR HERNANDEZ ENTERTAINMENT PARTNERS AIG CLAIMS COSTA MESA ADJ4670574 SALVADOR OCHOA CBS PERSONNEL INC. AIG CLAIMS COSTA MESA ADJ4670574 SALVADOR OCHOA STAFF MARK TRANSPORTATION AIG CLAIMS COSTA MESA ADJ4670574 SALVADOR OCHOA STAFF MARK, INC. AIG CLAIMS COSTA MESA ADJ9474589 SANTA BARRERA DE PALMA TERRANCE SENIOR LIVING AIG CLAIMS COSTA MESA ADJ7079970 SENEN MEJIA PARK PLACE MHC LLC AIG CLAIMS COSTA MESA ADJ6550035 SHAROL LEWIS NORTHROP GRUMMAN AIG CLAIMS COSTA MESA ADJ6550035 SHAROL LEWIS NORTHROP GRUMMAN CORP AIG CLAIMS COSTA MESA ADJ7644113 SHIRLEY PARSON KEDREN HEAD START AIG CLAIMS COSTA MESA ADJ7939737 SILVIA ZELAYA ROYAL DENIM INC. AIG CLAIMS COSTA MESA ADJ9129032 SOCORRO CALLARI VALLEY VIEW GARDEN AIG CLAIMS COSTA MESA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7839858 SULEMA CASTANEDA MJO STAFFING AIG CLAIMS COSTA MESA ADJ7904917 SUZANNE SIBEL MJO STAFFING AIG CLAIMS COSTA MESA ADJ2419267 TEODORA PALOMINOS MJO STAFFING AIG CLAIMS COSTA MESA ADJ7654285 THET TUN SIMPLE STAFFING AIG CLAIMS COSTA MESA ADJ7623036 VALENTIN HUAPE ARROYO PERSONNEL PLUS INC AIG CLAIMS COSTA MESA ADJ8656502 VERONICA HERNANDEZ SNSI STAFFING LLC AIG CLAIMS COSTA MESA ADJ7129261 VERONICA RODRIGUEZ SWISS PORT USA AIG CLAIMS COSTA MESA ADJ7129261 VERONICA RODRIGUEZ SWISS PORT USA INC AIG CLAIMS COSTA MESA ADJ8272757 VICTOR AVILA ASSOCIATE PACIFIC CONSTRUCTOR AIG CLAIMS COSTA MESA ADJ6830921 VICTORIA REYES THE INDUSTRIAL LABOR MGM GROUP INC AIG CLAIMS COSTA MESA ADJ2725413 VICTORLINO BRICENO STERLING JEWELERS INC AIG CLAIMS COSTA MESA ADJ7493864 YENI CONTRERAS PERSONNEL PLUS INC AIG CLAIMS COSTA MESA ADJ6737660 DIANA ARREDONDO MJO STAFFING INC AIG CLAIMS PHOENIX ADJ6737660 DIANA ARREDONDO ROSS STORE AIG CLAIMS PHOENIX ADJ8181608 ELSA GUEVARA DE CARILLO PERSONNEL PLUS INC AIG CLAIMS PHOENIX ADJ3342882 JOSE TLATENCHI AIR GROUND MANPOWER CONSULTING AIG CLAIMS PHOENIX ADJ3342882 JOSE TLATENCHI MONARCH CONSULTING DBA PES PAYROLL AIG CLAIMS PHOENIX ADJ3342882 JOSE TLATENCHI RALLY MANAGEMENT SERVICES LLC AIG CLAIMS PHOENIX ADJ7365502 MARLON ENAMORADO CREATIVE COMMUNICATION TECHNOLOGIES AIG CLAIMS PHOENIX ADJ6797363 MARTIN MARTINEZ CORPORATE PERSONNEL NETWORK AIG CLAIMS PHOENIX ADJ7041182 STEVE CANON US AIRWAYS AIG CLAIMS PHOENIX ADJ9314116 AARON TREJO MANPOWER STAFFING AIG CLAIMS SAN DIEGO ADJ971607 ALEJANDRO MARTINEZ FIRST TEAM STAFFING GROUP AIG CLAIMS SAN DIEGO ADJ9160742 ALFREDO ZARAGOSA RECONSERVE OF CALIFORNIA AIG CLAIMS SAN DIEGO ADJ8887047 ANA TRUJILLO PERSONNEL PLUS AIG CLAIMS SAN DIEGO ADJ9461137 ANH BUI NORTHROP GRUMMAN AIG CLAIMS SAN DIEGO ADJ7628911 BARTOLO VEGA UNITED NATIONAL MAINTENANCE AIG CLAIMS SAN DIEGO ADJ7326044 BETIINA AUSTIN JB HUNT AIG CLAIMS SAN DIEGO ADJ7646328 CARLOS BUCIO CREATIVE COMMUNICATIONS TECH AIG CLAIMS SAN DIEGO ADJ8852243 CESAR CASTILLO MAUSER CORP AIG CLAIMS SAN DIEGO ADJ7381916 CESAR CHINCHILLA PERSONNEL PLUS AIG CLAIMS SAN DIEGO ADJ7169884 CRISTAL MUNOZ MJO STAFFTNG INC AIG CLAIMS SAN DIEGO ADJ6737660 DIANA ARREDONDO MJO STAFFING INC AIG CLAIMS SAN DIEGO ADJ6737660 DIANA ARREDONDO ROSS STORE AIG CLAIMS SAN DIEGO ADJ7213459 DUARDO CATANO PRECOR INC AIG CLAIMS SAN DIEGO ADJ8855222 EDGAR BERRA OLACHEA FRAMING BY SUPERIOR AIG CLAIMS SAN DIEGO ADJ9194526 EDUARDO RIVERA DAVIS DEVELOPMENT COMPANY AIG CLAIMS SAN DIEGO ADJ9121113 ENRIQUETA LICEA SODEXO AIG CLAIMS SAN DIEGO ADJ7797123 EVELIA MOSSO CITI STAFF SOLUTIONS INC AIG CLAIMS SAN DIEGO ADJ7599951 EVELIN MONGE MJO STAFFING AIG CLAIMS SAN DIEGO ADJ8117120 FRANK SIMMONS BALLY TOTAL FITNESS AIG CLAIMS SAN DIEGO ADJ9429784 GASPER RIOS HYDROCHEM INDUSTRIAL AIG CLAIMS SAN DIEGO ADJ7363295 GERARDO VALDEZ H PETER GUBER AIG CLAIMS SAN DIEGO ADJ9531400 GRACE LAFFERTY ADVANCED CLINICAL EMPLOYMENT STAFFING AIG CLAIMS SAN DIEGO ADJ9531400 GRACE LAFFERTY EMERALD HEALTH SERVICES AIG CLAIMS SAN DIEGO ADJ9531400 GRACE LAFFERTY HEALTHSOURCE GLOBAL STAFFING AIG CLAIMS SAN DIEGO ADJ9531400 GRACE LAFFERTY PROCARE ONE NURSES LLC AIG CLAIMS SAN DIEGO ADJ9531400 GRACE LAFFERTY US NURSING CORP AIG CLAIMS SAN DIEGO ADJ7622403 GUADALUPE MARTINEZ INTERCONTINENTAL ART INC AIG CLAIMS SAN DIEGO ADJ9440288 HILARIO AMPARO DOMINGUEZ ETIVISTA CONCRETE AIG CLAIMS SAN DIEGO ADJ6875143 JACK MELKONIAN ALLIED SYSTEMS AIG CLAIMS SAN DIEGO ADJ7371618 JACOB DOLAN TORRANCE REFINERY SAVAGE INDUSTRY AIG CLAIMS SAN DIEGO ADJ8985492 JAIME BELTRAN SOUTHERN FIBER OF LOS ANGELES AIG CLAIMS SAN DIEGO ADJ9236441 JAIME FLORES CHAMPION HOME BUILDERS INC AIG CLAIMS SAN DIEGO ADJ7487026 JASON PALMER IAP WORLD SERVICES AIG CLAIMS SAN DIEGO ADJ7472183 JEFF REESE NORTHROP GRUMMAN CORP AIG CLAIMS SAN DIEGO ADJ7472183 JEFF REESE NORTHROP GRUMMAN CORPORATION AIG CLAIMS SAN DIEGO ADJ9598454 JESUS BUENAVENTURA PLATINUM STAFFING AIG CLAIMS SAN DIEGO ADJ9328734 JESUS CORRAL LAX WHEEL REFINISHING INC AIG CLAIMS SAN DIEGO ADJ9328734 JESUS CORRAL PLATINUM STAFFING 6 AIG CLAIMS SAN DIEGO ADJ8472963 JESUS DEL RIO ACEVEDO DMSI STAFFING AIG CLAIMS SAN DIEGO ADJ6755349 JESUS GALAN STAFFMARK AIG CLAIMS SAN DIEGO ADJ3882758 JORGE BARAJAS DPR CONSTRUCTION AIG CLAIMS SAN DIEGO ADJ3882758 JORGE BARAJAS DPR CONSTRUCTION, INC AIG CLAIMS SAN DIEGO ADJ8088393 JOSE MARQUEZ SERTA MATTRESS INCORPORATED AIG CLAIMS SAN DIEGO ADJ4711417 JOSE ORTEGA MANAGING JOB OPPORTUNITY AIG CLAIMS SAN DIEGO ADJ8719150 JOSE RIVERA WEST COAST DRYWALL INC AIG CLAIMS SAN DIEGO ADJ4517148 JOSE TORTOLEDO SUNRISE PLAZA TRANSPORTATION CO AIG CLAIMS SAN DIEGO ADJ6961554 JOSE VARGAS PERSONNEL PLUS AIG CLAIMS SAN DIEGO ADJ8244426 JUAN GONZALEZ ALISO ELECTRIC AIG CLAIMS SAN DIEGO ADJ8989046 JUAN PEREZ ST GEORGE EMPLOYEE LEASING AIG CLAIMS SAN DIEGO ADJ6779359 LETICIA CASIMIRO CAITAC GARMENT PROCESSING INC AIG CLAIMS SAN DIEGO ADJ6779359 LETICIA CASIMIRO CAITAL GARMET PROCESSING AIG CLAIMS SAN DIEGO ADJ6762410 LETICIA HERNANDEZ MELLACE FAMILY AIG CLAIMS SAN DIEGO ADJ7665056 MANUEL CAMPOS MJO STAFFING AIG CLAIMS SAN DIEGO ADJ7198293 MARIA MORALES SELECT STAFFING AIG CLAIMS SAN DIEGO ADJ9590890 MARIA NAVARRO AEROFIT LLC AIG CLAIMS SAN DIEGO ADJ9016282 MARIA OROZCO ARDEN COMPANIES AIG CLAIMS SAN DIEGO ADJ8905439 MARIBEL LEMUS BURTEC AIG CLAIMS SAN DIEGO ADJ7129804 MARICARMEN MARTINEZ MJO STAFFING AIG CLAIMS SAN DIEGO ADJ7129804 MARICARMEN MARTINEZ MJO STAFFING INC AIG CLAIMS SAN DIEGO ADJ8529726 MIGUEL CUELLAR PICTURE PERFECT INSTALLATION AIG CLAIMS SAN DIEGO ADJ6968095 MIGUEL MUNOZ SME STEELS AIG CLAIMS SAN DIEGO ADJ7126328 MIYNOR AVILA PDS TRUCKING AIG CLAIMS SAN DIEGO ADJ7126328 MIYNOR AVILA PDS TRUCKING INC AIG CLAIMS SAN DIEGO ADJ9104083 MONSERRAT CABRERA ISS FACILITY SERVICES INC SAN DIEGO AIG CLAIMS SAN DIEGO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ1863845 NICOLAS PEREZ VICEROY AIG CLAIMS SAN DIEGO ADJ7500443 NORMA ALCANTARA READY PACK AIG CLAIMS SAN DIEGO ADJ8178918 OSCAR RAMIREZ BERTRAM PARTNERS INC AIG CLAIMS SAN DIEGO ADJ8178918 OSCAR RAMIREZ WATERMAN APARTMENTS AIG CLAIMS SAN DIEGO ADJ6836752 PATRICIA RODRIGUEZ PERSONEL PLUS AIG CLAIMS SAN DIEGO ADJ6836752 PATRICIA RODRIGUEZ PERSONNEL PLUS, INC. AIG CLAIMS SAN DIEGO ADJ7493812 PAUL KOSAKO MORGAN STANLEY REAL ESTATE INV AIG CLAIMS SAN DIEGO ADJ1820428 PEDRO ALVAREZ ACCREDITED CLEANIN SERVICES INC. AIG CLAIMS SAN DIEGO ADJ8193117 RAMON VASQUEZ FIRSTGROUP AMERICA AIG CLAIMS SAN DIEGO ADJ1757666 RAYMOND DAVIS MAMMOET WESTERN AIG CLAIMS SAN DIEGO ADJ1757666 RAYMOND DAVIS MAMMOET WESTERN INC AIG CLAIMS SAN DIEGO ADJ6767592 RODOLFO CHAVEZ SIMMONS MANUFACTURING CO AIG CLAIMS SAN DIEGO ADJ7101363 SAYED ISMAIL EMPIRE/CLS AIG CLAIMS SAN DIEGO ADJ1981654 SELVIN HERRERA CRAIG DOLLASE AIG CLAIMS SAN DIEGO ADJ8089029 SYLVA BEJJANI FUDDRUCKERS AIG CLAIMS SAN DIEGO ADJ7304830 TEODULO CARDOSO RAMIREZ EXPRESS SERVICE GROUP AIG CLAIMS SAN DIEGO ADJ7304830 TEODULO CARDOSO RAMIREZ OPTIMA STAFFING AIG CLAIMS SAN DIEGO ADJ7304830 TEODULO CARDOSO RAMIREZ PURETECK CORPORATION AIG CLAIMS SAN DIEGO ADJ8539705 TIMOTHY LEONARD NORTHROP GRUMMAN AIG CLAIMS SAN DIEGO ADJ8587862 WILLIE JOHNSON ANCON MARINE AIG CLAIMS SAN DIEGO ADJ7992986 ZAIDA KADRI PIZZA HUT OF SE KANSAS 502 AIG CLAIMS SAN DIEGO ADJ7937140 LOUIE AMADOR CHARTIS AIG CLAIMS SAN DIEGO ADJ7937140 LOUIE AMADOR HERCULES FORWARDING INC AIG CLAIMS SAN DIEGO ADJ2022709 JOSEPH FLORES DEFENSE SUPPORT SERVICES LLC AIG DOMESTIC CLAIMS INC ADJ5829459 ALICIA MORALES UFP TECHNOLOGIES AIG DOMESTIC CLAIMS, INC. ADJ5829459 ALICIA MORALES UFP TECHNOLOGIES INC AIG DOMESTIC CLAIMS, INC. ADJ4653966 JOHN LAKE COUNTY OF LOS ANGELES REGISTRAR RECORDER COUNTY CLERK AIMS ADJ4653966 JOHN LAKE LOS ANGELES COUNTY REGISTRAR RECORDER AIMS ADJ1475111 JOSE SEPULVEDA CITY OF BAKERSFIELD AIMS AIU INSURANCE COMPANY AMERICAN INTL GROUP CLAIMS ADJ3962906 LUCY RUSHING SERVICE CRAFT SERV ADJ2999844 ANA RIVERA PETERSON BROTHERS CONSTRUCTION ALASKA NATIONAL SEATTLE ADJ2715429 CLAUDIA BANUELOS BELL CONVALESCENT HOSPITAL ALASKA NATIONAL WALNUT CREEK ADJ2434272 EDUARDO BELMONTES CAPITAL DRYWALL ALASKA NATIONAL WALNUT CREEK ADJ6659341 EPIFANIA MINIKEL RAMONA'S CARE CENTER ALASKA NATIONAL WALNUT CREEK ADJ7087487 GONZALO NOEGERRATH PJ`S BUILDING MATERIALS ALASKA NATIONAL WALNUT CREEK ADJ6935989 GRACIELA GALLEGOS THE STANDARD HOTEL ALASKA NATIONAL WALNUT CREEK ADJ7557926 IVONNE HATTADY DECEASED MODERN PARKING INC ALASKA NATIONAL WALNUT CREEK ADJ6715517 JOSE GOMEZ VASQUEZ HI TECH SEATING PRODUCTS INC KUSTOM FIT ALASKA NATIONAL WALNUT CREEK ADJ6946169 JUAN NEGRETE CAPITAL DRYWALL ALASKA NATIONAL WALNUT CREEK ADJ6603058 RODOLFO HUANCA HOLYDAY MANOR CARE CENTER ALASKA NATIONAL WALNUT CREEK ADJ6893295 SONIA MCTAGGART BELLA VISTA CARE CENTER ALASKA NATIONAL WALNUT CREEK ADJ2989759 AMADO AGUILAR VONS GROCERY ALBERTSONS HOLDINGS FULLERTON ADJ7464368 DANIEL DESPER SAFEWAY ALBERTSONS HOLDINGS FULLERTON ADJ2839007 JOVITA ELSA VONS ALBERTSONS HOLDINGS FULLERTON ADJ6783304 JUAN MARTINEZ VONS COMPANIES INC ALBERTSONS HOLDINGS FULLERTON ADJ8653584 LINO GARCIA VONS COMPANIES ALBERTSONS HOLDINGS FULLERTON ADJ9284329 MAGDALENA ESTRADA THE VONS COMPANIES INC ALBERTSONS HOLDINGS FULLERTON ADJ9284329 MAGDALENA ESTRADA VONS ARCADIA ALBERTSONS HOLDINGS FULLERTON ADJ7969174 MARK IVEY THE VONS COMPANIES SAFEWAY CORPORATION ALBERTSONS HOLDINGS FULLERTON ADJ1421801 NAOMI CASTORENA VONS ALBERTSONS HOLDINGS FULLERTON ADJ7304500 SONYA WILSON VONS ALBERTSONS HOLDINGS FULLERTON ADJ7196669 VIRGILIO DUARTE SALVADOR VONS A SAFEWAY COMPANY INC ALBERTSONS HOLDINGS FULLERTON ADJ2989759 AMADO AGUILAR VONS GROCERY ALBERTSONS HOLDINGS PLEASANTON ADJ3050136 ANA MARIA ZENDEJAZ SAFEWAY ALBERTSONS HOLDINGS PLEASANTON ADJ3080124 REYNALDO MENDIOLA MYERS BUILDING SERVICE INC ALL AMERICAN RISK FRESNO ADJ1489539 AURA ESTRADA REMEDY INTELLIGENT STAFFING ALLIANZ RESOLUTION PETALUMA ADJ4679965 ELIZABETH MORENO DEUTSCH INDUSTRIAL PRODUCT ALLIANZ RESOLUTION PETALUMA ADJ8210703 LUZ LOPEZ EL POLLO LOCO ALLIANZ RESOLUTION PETALUMA ADJ8210703 LUZ LOPEZ WKS RESTAURANT CORP. ALLIANZ RESOLUTION PETALUMA ADJ8949526 ALFREDO ARGUETA LA BREA DINING CALIFORNIA ALLIANZ RESOLUTION RANCHO CORDOVA ADJ7245616 ANDRES LOPEZ SANTA ANA COUNTRY CLUB ALLIANZ RESOLUTION RANCHO CORDOVA ADJ7444833 ANGELINA ORTEGA PLAZA PET HOSPITAL ALLIANZ RESOLUTION RANCHO CORDOVA ADJ9466684 ANTONIO MARQUEZ SPECIFICATION SEALS CO ALLIANZ RESOLUTION RANCHO CORDOVA ADJ7344086 BEATRIZ CORPENO JOAN ROSENBERG ALLIANZ RESOLUTION RANCHO CORDOVA ADJ8164930 CECIL LOPEZ GALE BANK ENGINEERING ALLIANZ RESOLUTION RANCHO CORDOVA ADJ1490944 CECILIA RODRIGUEZ NORTON PACKAGING, INC. ALLIANZ RESOLUTION RANCHO CORDOVA ADJ8188578 ELIAS CONTRERAS EAGLE ROOFING PRODUCTS ALLIANZ RESOLUTION RANCHO CORDOVA ADJ3579993 ELIGIO CHAVEZ HMS VETERINARY DEVELOPMENT, INC. ALLIANZ RESOLUTION RANCHO CORDOVA ADJ8071404 FRANCISCO VALENZUELA FRANKEL FAMILU TRUST ALLIANZ RESOLUTION RANCHO CORDOVA ADJ6954867 HILDA CASTRO MEDWAY PLASTIC CORPORATION ALLIANZ RESOLUTION RANCHO CORDOVA ADJ9577732 JOSE MARTINEZ SLADE INDUSTRIAL LANDSCAPE ALLIANZ RESOLUTION RANCHO CORDOVA ADJ9577732 JOSE MARTINEZ SLADE INDUSTRIAL LASDSCAPE ALLIANZ RESOLUTION RANCHO CORDOVA ADJ1342888 JOSE PINEDO CLAIM JUMPER ALLIANZ RESOLUTION RANCHO CORDOVA ADJ1342888 JOSE PINEDO CREATIVE TEACHING PRESS INC. ALLIANZ RESOLUTION RANCHO CORDOVA ADJ8210703 LUZ LOPEZ EL POLLO LOCO ALLIANZ RESOLUTION RANCHO CORDOVA ADJ8210703 LUZ LOPEZ WKS RESTAURANT CORP. ALLIANZ RESOLUTION RANCHO CORDOVA ADJ7636678 NELIA ZAIDE LSA ASSOCIATES INC ALLIANZ RESOLUTION RANCHO CORDOVA ADJ9416812 NOEMY RODRIGUEZ LAWRENCE PERKINS ALLIANZ RESOLUTION RANCHO CORDOVA ADJ7772209 RAFAELA HERNANDEZ NEWPORT CENTER ANIMAL HOSPITAL ALLIANZ RESOLUTION RANCHO CORDOVA ADJ2029535 SUSAN BERSON DIEDRICH COFFEE, INC. ALLIANZ RESOLUTION RANCHO CORDOVA ADJ7388258 TIMOTEO TAUVALAAU ALUMINITE SOUTH ALLIANZ RESOLUTION RANCHO CORDOVA ADJ7451457 VICTOR OSUNA FRIENDS AMERICA ALLIANZ RESOLUTION RANCHO CORDOVA ADJ7451457 VICTOR OSUNA FRIENDS AMERICA INC ALLIANZ RESOLUTION RANCHO CORDOVA ADJ9020429 FRANCISCA ESTRADA ARGIL AND DALIT ARGIL ALLIED SACRAMENTO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ4107370 THOMAS MCCONNELL HELIX WATER DISTRICT ALTERNATIVE SERVICE CITRUS HEIGHTS ADJ4290239 ALAN VALDEZ INLAND COLD STORAGE AMERICAN CASUALTY ADJ9483491 ALFREDO ACTUAL DIRECT EXPRESS INC AMERICAN CASUALTY ADJ4474076 ALFREDO VILLEGAS TANIMURA AND ANTLE AMERICAN CASUALTY ADJ187589 DOMINGA ZARCO LEMONS CORPORATION AMERICAN CASUALTY ADJ653725 FRANK CATHRILL PERRIS UNIFIED SCHOOL DISTRICT AMERICAN CASUALTY ADJ653725 FRANK CATHRILL PERRIS UNION HIGH SCHOOL AMERICAN CASUALTY ADJ653725 FRANK CATHRILL PERRIS UNION HIGH SCHOOL DISTRICT AMERICAN CASUALTY ADJ1410196 ISABELITA PEREZ-SOTELO PREFERRED PERSONNEL AMERICAN CASUALTY ADJ2432118 JORGE MENDOZA MONICO ALLOYS AMERICAN CASUALTY ADJ4529793 MARIA PEREZ CARL KARCHER ENTERPRISES AMERICAN CASUALTY ADJ4529793 MARIA PEREZ CARL'S JR AMERICAN CASUALTY ADJ979400 RANDAL WILSON CARROWS RESTAURANT AMERICAN CASUALTY ADJ3282723 ULYSSES ESPINOZA EXPLORER COMPETITION PRODUCTS AMERICAN CASUALTY ADJ7155760 VICTOR QUEBRADO DRI COMPANIES AMERICAN CASUALTY ADJ8990489 ABEL CERVANTES GRIPLOCK SYSTEMS AMERICAN CLAIMS SAN DIEGO ADJ6960697 ABEL LEAL CAMILLE INC DBA DENNYS AMERICAN CLAIMS SAN DIEGO ADJ6960697 ABEL LEAL DENNYS AMERICAN CLAIMS SAN DIEGO ADJ7628617 ANADELIA MARTINEZ ALL CITY MANAGEMENT SERVICES AMERICAN CLAIMS SAN DIEGO ADJ7037636 ARTURO MORENO MSCZ INC DBA EARTHWIZE RECYCLING AMERICAN CLAIMS SAN DIEGO ADJ9234529 AURELIA LOPEZ BENITEZ MAC N FRY INC AMERICAN CLAIMS SAN DIEGO ADJ8290462 BEATRIZ OLIVAS RESTAURANT ADMINISTRATION AMERICAN CLAIMS SAN DIEGO ADJ7448085 BERTHA CANTORAL CONTINENTAL FOOD AMERICAN CLAIMS SAN DIEGO ADJ9505953 BLANCA LEAL EBS INC AMERICAN CLAIMS SAN DIEGO ADJ7619654 BYRON CABRERA CARPET DISTRUBUTORS CORP AMERICAN CLAIMS SAN DIEGO ADJ8036916 CARLOS GUERRERO AUTUMN MILLING CO AMERICAN CLAIMS SAN DIEGO ADJ7191477 CIPRIANO ARMENTA CALIFORNIA LANDSCAPE AMERICAN CLAIMS SAN DIEGO ADJ8969563 CLEOTILDE CORTEZ BURGER KING 696 AMERICAN CLAIMS SAN DIEGO ADJ8628574 CRISTINA ZAMORA MARTINEZ RELLIABLE RENOVATION INC AMERICAN CLAIMS SAN DIEGO ADJ9070540 DANIEL GUZMAN PRO WALL LATHE AND PLASTER AMERICAN CLAIMS SAN DIEGO ADJ9070540 DANIEL GUZMAN PRO WALL LATHE AND PLASTER INC AMERICAN CLAIMS SAN DIEGO ADJ2709568 DANIEL SIXTOS GENERAL BUILDING MAINTENANCE AMERICAN CLAIMS SAN DIEGO ADJ8342416 DONAJA ZAMORA PARKVIEW PROPERTY MANAGEMENT AMERICAN CLAIMS SAN DIEGO ADJ8342416 DONAJA ZAMORA PARKVIEW PROPERTY MANAGEMENT INC AMERICAN CLAIMS SAN DIEGO ADJ6878814 EDWARD CASTELLANOS PACIFIC TITAN INC AMERICAN CLAIMS SAN DIEGO ADJ9404813 ELVIRA JUAREZ WORLD VARIETY PRODUCE AMERICAN CLAIMS SAN DIEGO ADJ6975061 ENRIQUE DEHARO RHYLEY CONSTRUCTION AMERICAN CLAIMS SAN DIEGO ADJ7188907 ENRIQUE OSUNA FARMER BOYS RESTAURANT AMERICAN CLAIMS SAN DIEGO ADJ8162031 ERIKA PEREZ SANTA CLARITA CONCESSIONS AMERICAN CLAIMS SAN DIEGO ADJ9390968 ERNESTO PALOMINO COMPETITIVE ASPHALT COATING AMERICAN CLAIMS SAN DIEGO ADJ8674560 FRANCISCO CERVANTES WESTCO CONSTRUCTION CO INC AMERICAN CLAIMS SAN DIEGO ADJ7613834 FRANCISCO INIGUEZ EL PASEO INN LLC AMERICAN CLAIMS SAN DIEGO ADJ8858170 FRANCISCO MORENO INDIAN RIDGE COUNTRY CLUB AMERICAN CLAIMS SAN DIEGO ADJ7921356 FRANCISCO RODAS LOS ANGELES NEWS DISTRIBUTION AMERICAN CLAIMS SAN DIEGO ADJ7746299 FRANKLYN CHAVARRIA GARDNER POOL COMPANY AMERICAN CLAIMS SAN DIEGO ADJ8585680 GABRIEL CASTANEDA FIBER CARE BATHS INC AMERICAN CLAIMS SAN DIEGO ADJ7834671 GENOVEVA MACEDO MCDONALDS (22570) AMERICAN CLAIMS SAN DIEGO ADJ7348279 GEORGE OLIVERO GP WILCOXSON AMERICAN CLAIMS SAN DIEGO ADJ9770384 GERMAN TORRES BEAUMONT JUICE DBA PERRICONE JUICES AMERICAN CLAIMS SAN DIEGO ADJ7804867 GUILLERMO ESTRADA K J BECKS INC (MCDONALDS) AMERICAN CLAIMS SAN DIEGO ADJ7804867 GUILLERMO ESTRADA KJ BECKS INC MCDONALDS AMERICAN CLAIMS SAN DIEGO ADJ7804867 GUILLERMO ESTRADA TALLYRAND AMERICAN CLAIMS SAN DIEGO ADJ8069140 GUILLERMO SOLIS NUNEZ AG INC AMERICAN CLAIMS SAN DIEGO ADJ8677643 GUSTAVO VARGAS BAUTISTA BURGER KING AMERICAN CLAIMS SAN DIEGO ADJ9041987 HECTOR AGUILAR BARRIENTOS GOLDEN CONSTRUCTION DEVELOPMENT AMERICAN CLAIMS SAN DIEGO ADJ8151808 HECTOR CORREA BLUE POINT ELECTRIC INC AMERICAN CLAIMS SAN DIEGO ADJ7086110 HECTOR PEREZ ABBOTT TECHNOLOGIES INC AMERICAN CLAIMS SAN DIEGO ADJ9213086 HORTENCIA BERMUDEZ J AND S PAPER SOUTHERN LLC AMERICAN CLAIMS SAN DIEGO ADJ8831654 IRINEO PEREYRA MATSUNAGA LANDSCAPE MAINTENANCE AMERICAN CLAIMS SAN DIEGO ADJ9466225 IRVIN GONZALES PERRICONE JUICE AMERICAN CLAIMS SAN DIEGO ADJ7816710 JESUS CANCHOLA HALL MANAGEMENT CORP AMERICAN CLAIMS SAN DIEGO ADJ6679294 JESUS GALLARDO RICK HAMM CONSTRUCTION INC AMERICAN CLAIMS SAN DIEGO ADJ7391345 JESUS MENDEZ SWERTFEGERS EQUIPMENT INC AMERICAN CLAIMS SAN DIEGO ADJ7964922 JESUS PADILLA CAL SIN ENTERPRISES DBA EL POLLO LOCO AMERICAN CLAIMS SAN DIEGO ADJ6976274 JESUS ROJO BURGOS TRU FORM TOOL AND MANUFACTURING INDUSTRIES INC AMERICAN CLAIMS SAN DIEGO ADJ7720439 JOHN RIOS SCOTT HARRISON PLIMBING AND HEATING INC1 AMERICAN CLAIMS SAN DIEGO ADJ9530970 JORDY ARGUETA FARMERS BOYS RESTAURANT AMERICAN CLAIMS SAN DIEGO ADJ8077738 JORGE TORRES CAMACHO S INCORPORATED AMERICAN CLAIMS SAN DIEGO ADJ9158719 JOSE ARROYO R DEUTSCHMAN ASSOCIATES AMERICAN CLAIMS SAN DIEGO ADJ774506 JOSE FUENTES FAST TRACK PROJECT MANAGEMENT INC AMERICAN CLAIMS SAN DIEGO ADJ7875399 JOSE GONZALEZ COMMONWEALTH MANAGEMENT LLC AMERICAN CLAIMS SAN DIEGO ADJ7431034 JOSE MOLINAR GSL COMMUNICATIONS AMERICAN CLAIMS SAN DIEGO ADJ7783914 JOSE NUNEZ HIGH LIGHT ELECTRIC INC AMERICAN CLAIMS SAN DIEGO ADJ8190496 JOSE ZALDIVAR MASTER DISTRIBUTORS AMERICAN CLAIMS SAN DIEGO ADJ9282452 JUAN CALDERON RICK HAMM CONSTRUCTION INC AMERICAN CLAIMS SAN DIEGO ADJ10127376 JUAN OSORIO NAKASE BROTHERS AMERICAN CLAIMS SAN DIEGO ADJ8720764 JUAN PENA RED COW AMERICAN CLAIMS SAN DIEGO ADJ9088531 JUAN PLUMA CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION PSI AMERICAN CLAIMS SAN DIEGO ADJ9088531 JUAN PLUMA WOLF RESTAURANTS GROUP LP AMERICAN CLAIMS SAN DIEGO ADJ2332510 KATHRYN WOODLEY BURGER KING AMERICAN CLAIMS SAN DIEGO ADJ8042069 LEE LEWIS WILLIAM HOOSE AN INDIVIDUAL AMERICAN CLAIMS SAN DIEGO ADJ7760379 LEONARDO VARGAS R C I BUILDERS INC AMERICAN CLAIMS SAN DIEGO ADJ8522167 LUIS HERNANDEZ LIVING COLORS INC AMERICAN CLAIMS SAN DIEGO ADJ7660714 LUIS PEREZ CLARK ADAMS CO AMERICAN CLAIMS SAN DIEGO ADJ8668822 MARCELA GONZALEZ RESTAURANT ADMINISTRATION AMERICAN CLAIMS SAN DIEGO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8319284 MARIA DEL CARMEN LUVIANO BURGER KING 12986 AMERICAN CLAIMS SAN DIEGO ADJ7731148 MARIA ENRIQUEZ LINARES BURGER KING AMERICAN CLAIMS SAN DIEGO ADJ7457532 MARIA MEZA COLOUR CONCEPTS INC AMERICAN CLAIMS SAN DIEGO ADJ7037978 MARIA NAVARRETE BURGER KING AMERICAN CLAIMS SAN DIEGO ADJ7037978 MARIA NAVARRETE CALIFORNIA RESTAURANT MUTUAL BENEFI AMERICAN CLAIMS SAN DIEGO ADJ9186074 MARIA PEREZ METRO SERVICE AMERICAN CLAIMS SAN DIEGO ADJ8227117 MARIA ROSALES JACK IN THE BOX AMERICAN CLAIMS SAN DIEGO ADJ8222469 MARIA VILLA MCDONALDS AMERICAN CLAIMS SAN DIEGO ADJ8551768 MARIA VILLANUEVA TACO BELL NO 144 AMERICAN CLAIMS SAN DIEGO ADJ8795177 MARIANO MENDOZA LITE EXTRUSIONS MANUFACTURING AMERICAN CLAIMS SAN DIEGO ADJ7854147 MARIELA AVILA LMS GROUP INC DBA JACK IN THE BOX AMERICAN CLAIMS SAN DIEGO ADJ8017216 MARTHA SALAZAR PEREZ CONTRACTING LLC AMERICAN CLAIMS SAN DIEGO ADJ7585008 MARTIN ESTRADA C A M CONSTRUCTION INC AMERICAN CLAIMS SAN DIEGO ADJ6871988 MAXIMILIANO CASTRO CICON ENGINEERING AMERICAN CLAIMS SAN DIEGO ADJ7356657 MAXIMO MARCELO ARANDA TOOLING INC AMERICAN CLAIMS SAN DIEGO ADJ8110821 MIGUEL CABRERA MANGEN GROUP INC AMERICAN CLAIMS SAN DIEGO ADJ9428189 MIGUEL HERNANDEZ GLOBAL PET AMERICAN CLAIMS SAN DIEGO ADJ9428189 MIGUEL HERNANDEZ GLOBAL PET INC AMERICAN CLAIMS SAN DIEGO ADJ8358815 MIGUEL MAZARIEGO SHAMMA CONSTRUCTION AMERICAN CLAIMS SAN DIEGO ADJ7638069 MIZRAIN VEGA JACK IN THE BOX AMERICAN CLAIMS SAN DIEGO ADJ8580977 MONICA MARTINEZ KFC HBS FOOD SERVICES AMERICAN CLAIMS SAN DIEGO ADJ9011949 NICOLAS MARTINEZ QUICKEL PAVING AMERICAN CLAIMS SAN DIEGO ADJ8388883 NOEL SERPAS NUCOAT PAINTING AMERICAN CLAIMS SAN DIEGO ADJ8241535 NOEMI CONTRERAS FARMER BOYS AMERICAN CLAIMS SAN DIEGO ADJ6567960 OLGA CALDERON ENVISION FOODS AMERICAN CLAIMS SAN DIEGO ADJ7209181 OMAR RAMIREZ KR COMMERCIAL INTERIOR AMERICAN CLAIMS SAN DIEGO ADJ3803997 PEDRO GARCIA ANAPLEX AMERICAN CLAIMS SAN DIEGO ADJ3803997 PEDRO GARCIA ANAPLEX CORP AMERICAN CLAIMS SAN DIEGO ADJ1261552 PERFECTO BARRIOS GROUND MAINTENANCE SERVICES AMERICAN CLAIMS SAN DIEGO ADJ7075645 PERLA CAMPOS CHAPMAN CONVALESCENT HOSPITAL AMERICAN CLAIMS SAN DIEGO ADJ2450884 PRISCILLA CASTRO JACK IN THE BOX AMERICAN CLAIMS SAN DIEGO ADJ2450884 PRISCILLA CASTRO SYED IRFAN AHMAD INC DBA JACK IN THE BOX 3585 AMERICAN CLAIMS SAN DIEGO ADJ7838839 RAFAEL MACIAS CALLAGHAN CONCRETE CONSTRUCTION AMERICAN CLAIMS SAN DIEGO ADJ7303676 RAMIRO HURTADO WELD IT COMPANY AMERICAN CLAIMS SAN DIEGO ADJ6679351 RAMON CURIEL EFREN REYES POOL AND PLASTERING AMERICAN CLAIMS SAN DIEGO ADJ6679351 RAMON CURIEL EFREN REYES POOL PLASTERING AMERICAN CLAIMS SAN DIEGO ADJ7194150 RAQUEL VALENCIA MARIAS HOUSE CLEANING AMERICAN CLAIMS SAN DIEGO ADJ7679258 REINA BONILLA R&L NEWSPAPER DISTRIBUTORS INC AMERICAN CLAIMS SAN DIEGO ADJ7954830 RICARDO ARIAS AGUIRRE MANGEN GROUP AMERICAN CLAIMS SAN DIEGO ADJ7954830 RICARDO ARIAS AGUIRRE MANGEN GROUP DBA BURGER KING AMERICAN CLAIMS SAN DIEGO ADJ8937065 RICARDO CERVANTES STEELTECH REINFORCING INC. AMERICAN CLAIMS SAN DIEGO ADJ8234625 RODRIGO RUIZ WOOD RANCH AMERICAN CLAIMS SAN DIEGO ADJ7361140 ROSE SHAPIRO ZAHARONI INDUSTRIES AMERICAN CLAIMS SAN DIEGO ADJ7361140 ROSE SHAPIRO ZHARONI INDUSTRIES AMERICAN CLAIMS SAN DIEGO ADJ6673039 RUBEN MORALES STR AUTO REPAIR AND SERVICE INC AMERICAN CLAIMS SAN DIEGO ADJ7641695 RUFINO GONZALEZ JAMES HOOVER AND PEGGY HOOVER DBA HOOVER RANCH AMERICAN CLAIMS SAN DIEGO ADJ3869103 SALVADOR MANRIQUEZ PAGE PRINTING SERVICES AMERICAN CLAIMS SAN DIEGO ADJ7605385 SANDRA GONZALEZ JACK IN THE BOX AMERICAN CLAIMS SAN DIEGO ADJ7266301 SANDRA LUNA PREMIER HARVEST INC AMERICAN CLAIMS SAN DIEGO ADJ7466937 SECILIO AVILA ORANGE COUNTY PATIO AMERICAN CLAIMS SAN DIEGO ADJ9364317 SERGIO SILVA REYNOLDS DANIEL BUILDERS AMERICAN CLAIMS SAN DIEGO ADJ8896903 SILVERIO ROMANO EAST WEST FRANCHISE INVESTMENTS AMERICAN CLAIMS SAN DIEGO ADJ7810368 SILVIA GALEANA GRAFFIUS FOOD SERVICES INC AMERICAN CLAIMS SAN DIEGO ADJ7811929 SONIA LEMUS MCDONALDS AMERICAN CLAIMS SAN DIEGO ADJ7162202 STEVEN MARTINEZ JACK IN THE BOX AMERICAN CLAIMS SAN DIEGO ADJ7162202 STEVEN MARTINEZ JYM ENTERPRISES INC AMERICAN CLAIMS SAN DIEGO ADJ8045672 VANESSA RIVAS JACK IN THE BOX AMERICAN CLAIMS SAN DIEGO ADJ8600978 VERONICA SEVILLA MCDONALD S AMERICAN CLAIMS SAN DIEGO ADJ8270064 VICTORIA SANCHEZ CAM SERVICES AMERICAN CLAIMS SAN DIEGO ADJ6592866 WENDY LOPEZ LIGHT BULBS INC AMERICAN CLAIMS SAN DIEGO ADJ7179043 WILLIAM LIMON CALIFORNIA COACH AUTO BODY TOWING AMERICAN CLAIMS SAN DIEGO ADJ7715543 ZAYDA ELIAS CASA MARAVILLA 99 2000 SENIOR NUTRITION AMERICAN CLAIMS SAN DIEGO ADJ2840596 EDGARDO MARQUEZ CALIFORNIA DELUXE WINDOWS IND INC AMERICAN COMMERCIAL ADJ2434337 FREDDY PINEDA THUNDER FINISHING, INC AMERICAN COMMERCIAL ADJ2342692 GUARNELH ORELLANA ABREGO TRUE WORLD FOODS INC AMERICAN COMMERCIAL ADJ924389 MARIA LUISA CALDERON GOLDEN APPLEX COMPANY AMERICAN COMMERCIAL ADJ1016451 PAULA VELASQUEZ CASTLE INN AMERICAN COMMERCIAL ADJ1415384 SERGIO LEDESMA BENT MFG CO AMERICAN COMMERCIAL ADJ6467677 VICTORIA BAKER ANTHONY AND KATHERINE VIELE AMERICAN COMMERCIAL ADJ6467677 VICTORIA BAKER TOKA PROPERTIES AMERICAN COMMERCIAL ADJ1851698 ARMANDO CADENA R C WENDT PAINTING INC AMERICAN COMMERCIAL SAN DIEGO ADJ2042634 AUGUSTO MENDIZABAL PASCO SPECIALTY & MFG INC AMERICAN COMMERCIAL SAN DIEGO ADJ704658 DOLORES BELTRAN MARQUIS HOTEL/EDWARD KIM AMERICAN COMMERCIAL SAN DIEGO ADJ1516009 ELIZABETH EVANS PACIFIC AMBULANCE INC AMERICAN COMMERCIAL SAN DIEGO ADJ1104547 EMILIANO SEGURA PACIFIC TERRAIN LANDSCAPE AMERICAN COMMERCIAL SAN DIEGO ADJ4522208 ESPIRIDION CONTRERAS ROYAL CABINETS AMERICAN COMMERCIAL SAN DIEGO ADJ4510843 FRANCISCO HERRERA LOS ANGELES REGIONAL FOOD BANK AMERICAN COMMERCIAL SAN DIEGO ADJ1924185 GABRIEL TAPIA HERRON CONSTRUCTION INC AMERICAN COMMERCIAL SAN DIEGO ADJ1172060 GUTIERREZ TERESO NORCO INJECTION MOLDING INC. AMERICAN COMMERCIAL SAN DIEGO ADJ1407397 JOEL LOPEZ KITCHEN FABRICATORS, INC. AMERICAN COMMERCIAL SAN DIEGO ADJ1540196 JOSE RODRIGUEZ CLASSIC PARKING AMERICAN COMMERCIAL SAN DIEGO ADJ1540196 JOSE RODRIGUEZ CLASSIC PARKING INC AMERICAN COMMERCIAL SAN DIEGO ADJ618102 JOSE VICENTE MICHAEL NICHOLAS DESIGNS INC AMERICAN COMMERCIAL SAN DIEGO ADJ1289339 JUAN MARRUJO MARCO RENTALS, INC AMERICAN COMMERCIAL SAN DIEGO ADJ4436013 JUAN VALDIVIA LIBERTY GLASS AMERICAN COMMERCIAL SAN DIEGO ADJ443664 JUAN VERA ATHON, MERRELL/ARTIC AMERICAN COMMERCIAL SAN DIEGO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6438427 JUANA PEREZ PREMIER LABOR SERVICES AMERICAN COMMERCIAL SAN DIEGO ADJ1221969 KARINA ESPINOZA FOUR SEASONS GARMENTS, INC. AMERICAN COMMERCIAL SAN DIEGO ADJ481419 LIDIA SCOTT SHINODA DESIGN CENTER AMERICAN COMMERCIAL SAN DIEGO ADJ3903840 MANUEL GALLARDO SHELLEY AUTOMOTIVE LLC AMERICAN COMMERCIAL SAN DIEGO ADJ4298247 MARIA JIMENEZ SOLAR LINK INTERNATIONAL INC AMERICAN COMMERCIAL SAN DIEGO ADJ6690608 OSCAR GONZALEZ THOREAU JANITORIAL SERVICES AMERICAN COMMERCIAL SAN DIEGO ADJ1411779 PEDRO VEJAR BJ'S RENTALS AMERICAN COMMERCIAL SAN DIEGO ADJ1177394 REYNALDO GONZALEZ QUICKCRETE PRODUCTS AMERICAN COMMERCIAL SAN DIEGO ADJ1019269 ROSA CEJA HOLIDAY INN EXPRESS AND SUITES AMERICAN COMMERCIAL SAN DIEGO ADJ1521645 SILVESTRE LOPEZ TRUJILLO TORRES FARM LABOR CONTRACTOR AMERICAN COMMERCIAL SAN DIEGO ADJ2765440 VICTOR GAONA RDF EXPRESS AMERICAN COMMERCIAL SAN DIEGO ADJ6765235 ERNESTO MEDINA PACIFIC COAST MANAGEMENT AMERICAN COMMERCIAL SAN FRANCISCO ADJ7327538 JOSE ESTRADA EMPIRE BUILDING AND ENVIRONMENTAL SERVICES INC AMERICAN COMMERCIAL SAN FRANCISCO ADJ6429867 VIOLETA MARTINEZ ALCO METAL FAB AMERICAN COMMERCIAL SAN FRANCISCO ADJ7045703 LOYDA FERREIRA AMERICAN GENERAL FINANCIAL SVS AMERICAN GENERAL FINANCIAL SVS ADJ6664878 MARIA RODRIGUEZ PRIORITY STAFFING AMERICAN HOME ASSURANCE ADJ3810225 DIANNA SCOGGINS COMMODITY LOGISTICS WEST, INC. AMERICAN HOME ASSURANCE CO ADJ3810225 DIANNA SCOGGINS INGRAM MICRO AMERICAN HOME ASSURANCE CO ADJ3810225 DIANNA SCOGGINS INGRAN MICRO AMERICAN HOME ASSURANCE CO ADJ2029535 SUSAN BERSON DIEDRICH COFFEE, INC. AMERICAN INSURANCE ADJ4218832 JOSE CABRAL AMERON AMERON PASADENA ADJ8870246 JOSE VALLES AMERON AMERON PASADENA ADJ9079840 FRANCISCO DUARTE CAFE TU TANGO AMGUARD INS WILKES BARRE ADJ9738302 RAUL HERNANDEZ OROZCO VIKE INVESTMENTS INC DBA TABLETOP GRILL AMGUARD INS WILKES BARRE ADJ7137017 GUADALUPE HOLGUIN CONTRERAS AVALON AT CERRITOS AMTRUST ADJ9228398 MARIA ESCAMILLA FELIZA VELAZCO AMTRUST ADJ8567575 ALVARO MARTINEZ SWISSTEX AMTRUST CONCORD ADJ9203683 ALVARO MONZON TILE AND STONE AMTRUST CONCORD ADJ9665085 ARTURO LOMELI KAMRAN STAFFING AMTRUST CONCORD ADJ9665085 ARTURO LOMELI KAMRAN STAFFING INC AMTRUST CONCORD ADJ9538129 CARMEN CARRILLO STEVENSON RESTAURANT INC AKA BURGER KING AMTRUST CONCORD ADJ9237813 CELIA HERNANDEZ J AND R HOCK ENTERPRISES A FRANCHISE OF TACO BELL AMTRUST CONCORD ADJ9503478 DOLORES MARIA DELUNA ANGELA PRESCHOOL & KINDERGARTEN AMTRUST CONCORD ADJ9456012 FERNANDO GALINDO GLENDALE DODGE CHRYSLER JEEP AMTRUST CONCORD ADJ9132540 FRANCISCO A GARCIA PEREZ HILTON GARDEN INN AMTRUST CONCORD ADJ3132250 FRANCISCO ZAVALA INGARDIA BROS PRODUCE AMTRUST CONCORD ADJ8832614 GABRIELA RANGEL FRESH GRILL AMTRUST CONCORD ADJ7327528 GARY FEE CALIFORNIA MANUFACTURING ENGINEERING AMTRUST CONCORD ADJ9012098 GLORIA JUC ABAD FOAM INC AMTRUST CONCORD ADJ9316333 GRACIELA VERDIN LA MEXICANA FOOD PRODUCTS AMTRUST CONCORD ADJ8290825 GREGORIO BRITO NEW SEOUL BBQ BUFFET RESTAURANT AMTRUST CONCORD ADJ8563644 HECTOR VELA LET IT FLY LLC AMTRUST CONCORD ADJ9367188 IRMA GONZALEZ RYTAN AMTRUST CONCORD ADJ10453255 JORGE ARCO BALLINA LAKEVIEW FARMS AMTRUST CONCORD ADJ7852090 JOSE QUEVEDO EMPIRE FARM LABOR CONTRACTING INC AMTRUST CONCORD ADJ9305253 MACIEL BUSTOS ENVIROMENTAL CONCEPTS AMTRUST CONCORD ADJ9305253 MACIEL BUSTOS ENVIRONMENTAL CONCEPTS INC. AMTRUST CONCORD ADJ8668822 MARCELA GONZALEZ RESTAURANT ADMINISTRATION AMTRUST CONCORD ADJ9653587 MARCO CARRANZA RESOURCE EMYMENT SOLUTIONS AMTRUST CONCORD ADJ7532310 MARIA BONILLA BEST WESTERN RAFFLES INN AMTRUST CONCORD ADJ8981820 MARIA CERVANTES DIN TAI FUNG RESTAURANT INC. AMTRUST CONCORD ADJ9668465 MARIA CORTEZ NARAYAN PLASTIC CORP AMTRUST CONCORD ADJ8332829 MARIA RICO BEST WESTERN OC AIRPORT NORTH AMTRUST CONCORD ADJ9670790 MARIA SANDOVAL NORTHWEST PHARMANATURALS INC AMTRUST CONCORD ADJ8621835 MARIBEL SIERRA TACO BELL AMTRUST CONCORD ADJ9119421 OTONIEL MORALES ANTHONY LAUREN AND CO AMTRUST CONCORD ADJ8226862 SERGIO SERNA LITTLE DAVID PEST CONTROL AMTRUST CONCORD ADJ8490646 SILVIA ORTEGA POLLY S PIES AMTRUST CONCORD ADJ7277437 WEI YING ZHOU FORTUNE AVENUE FOODS INC AMTRUST CONCORD ADJ9232895 YOLANDA GONZALEZ ARECONT VISION AMTRUST CONCORD ADJ9570287 ANA RIOS GOOD FAMILY INC AMTRUST COVINA ADJ9612804 ARCELIA GUTIERREZ BERSHTEL ENTERPRISES AMTRUST COVINA ADJ9378166 JOSE AGUILAR UP LANDSCAPE MAINTENANCE AMTRUST COVINA ADJ205778 MICHAEL OGAZ UNIFIED WESTERN GROCERS AMTRUST COVINA ADJ7782079 MIGUEL HERNANDEZ KV MART COMPANY AMTRUST COVINA ADJ7706697 ALBERTO BALDERRAMA JAM INDUSTRIES AMTRUST IRVINE ADJ8216750 ALBERTO TERRONES PEARL CAR WASH LA JOLLA INC AMTRUST IRVINE ADJ6820674 ALFREDO HERNANDEZ BELL FOUNDRY COMPANY AMTRUST IRVINE ADJ6617697 ANTONIO RAMIREZ HAHM MOTORSPORTS AMTRUST IRVINE ADJ6617697 ANTONIO RAMIREZ HAMH ENTERPRISES AMTRUST IRVINE ADJ9262329 BALDEMAR GARCIA H MART GARDEN GROVE AMTRUST IRVINE ADJ9613149 CARLOS GONZALEZ TAMA TRADING CO INS AMTRUST IRVINE ADJ7624749 EDGAR SANCHEZ J A M INDUSTRIES AMTRUST IRVINE ADJ9399865 ELIZABETH DOMINGUEZ GREAT AMERICAN CHICKEN AMTRUST IRVINE ADJ9223600 ERENDIRA ARREOLA WENDYS AMTRUST IRVINE ADJ9373753 FELIX CUXUM SLATERS 50 50 AMTRUST IRVINE ADJ7772967 FLORENTINO GUDINO DC PAINTS INCORPORATED AMTRUST IRVINE ADJ3132250 FRANCISCO ZAVALA INGARDIA BROS PRODUCE AMTRUST IRVINE ADJ9614476 FRANCO RIPLEY WHOLESOME CHOICE MARKET AMTRUST IRVINE ADJ6687390 GABRIELA OCHOA RODRIGUEZ ACCUPRINT SERVICES INC AMTRUST IRVINE ADJ6687390 GABRIELA OCHOA RODRIGUEZ PERSONA 1 HR AMTRUST IRVINE ADJ7470286 GASTON ESCOBAR PROCARE TREE SERVICE INC AMTRUST IRVINE ADJ7605771 GILBERTO PENA MORALES THRIFTY TREE SERVICE AMTRUST IRVINE ADJ9158709 GLORIA SANTA CRUZ CALIFORNIA SUSHI TERIYAKI AMTRUST IRVINE ADJ8018202 JACQUELINE VASQUEZ SAMBA GROUP AMTRUST IRVINE ADJ8018202 JACQUELINE VASQUEZ SAMBA GROUP INC AMTRUST IRVINE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9507701 JAVIER MORALES HERNANDEZ INLAND LANDSCAPE MAINTENANCE AMTRUST IRVINE ADJ2660150 JESUS FLORES RODRIGUEZ ELITE LEATHER CO AMTRUST IRVINE ADJ2660150 JESUS FLORES RODRIGUEZ ELITE LEATHER COMPANY AMTRUST IRVINE ADJ7303525 JOSE BAUTISTA D J KLEIN CONSTRUCTION AMTRUST IRVINE ADJ6819262 JOSE BENITEZ ARTISTIC DYERS INC AMTRUST IRVINE ADJ9822488 JOSE GONZALEZ ANDERCO CARPET COMP INC AMTRUST IRVINE ADJ7680016 JOSE PADILLA MOLDING PLUS INC AMTRUST IRVINE ADJ7852090 JOSE QUEVEDO EMPIRE FARM LABOR CONTRACTING INC AMTRUST IRVINE ADJ7873164 JOSE VILLEGAS GENEVA STAFFING AMTRUST IRVINE ADJ7181314 JOSE ZETINA DESERT COMERCIAL CONCRETE AMTRUST IRVINE ADJ8376908 JUVENAL RIOS CENTRAL AIR CONDITIONING INC AMTRUST IRVINE ADJ8371384 MARIA BONILLA LIFEHOUSE HOLDINGS LLC AMTRUST IRVINE ADJ9229639 MARIA CRESPO FIN CREATIVE CONCEPTS LLC AMTRUST IRVINE ADJ9229639 MARIA CRESPO MI RANCHITO VERACRUZANO AMTRUST IRVINE ADJ9338908 MARIA DE LOURDES LEON M&B RESTAURANT GRP JACK IN THE BOX AMTRUST IRVINE ADJ7622309 MARISELA JACOBO NEWSWAYS SERVICES INC AMTRUST IRVINE ADJ8489398 MARTIN MARTINEZ MARIPOSA LANDSCAPE AMTRUST IRVINE ADJ8489398 MARTIN MARTINEZ MARIPOSA LANDSCAPES AMTRUST IRVINE ADJ9693991 MATILDE TOSCANO SHIBRO AMTRUST IRVINE ADJ6962945 MIGUEL CAMPOS AMERICAN SECURITY PRODUCTS COMPANY AMTRUST IRVINE ADJ9711290 MIGUEL JIMENEZ GARCIA FB HOLDING COMPANY AMTRUST IRVINE ADJ9646999 MIGUEL LOPEZ MOTOR VILLAGE LA AMTRUST IRVINE ADJ6799657 MIRIAN DE JESUS SALAZAR ALPHA SOURCE AMTRUST IRVINE ADJ9522670 NESTOR DANIEL MORALES ALL GREEN INSULATION AMTRUST IRVINE ADJ6988854 QI YONG SHENG KROOUSA INC AMTRUST IRVINE ADJ9442114 RAMON HERNANDEZ ARCHITECTURAL ICI MILLWORK AMTRUST IRVINE ADJ7139060 RAUDEL VILLALOBOS ORANGE COUNTY NURSERY INC AMTRUST IRVINE ADJ9155945 RICARDO ORLANDO FABIE TILE AND MARBLE AMTRUST IRVINE ADJ9455826 SAUL VARGAS DUO MAX ENT AMTRUST IRVINE ADJ7037816 SERAFIN URIOSTEGUI DIVISION THREE CONSTRUCTION SERVICES INC AMTRUST IRVINE ADJ8090631 SONIA PALACIOS LIFEHOUSE HEALTH SERVICE COMMUNITY AMTRUST IRVINE ADJ8040244 UBALDO LOPEZ SP CARPET PROS INC AMTRUST IRVINE ADJ7133800 WENDY CARDONA TROPICAL FOODS INC AMTRUST IRVINE ADJ7526580 ESTEBAN ROMERO KYU RYONG JI DBA LA NEW YORK CAKE AND BAKERY AMTRUST NORTH AMERICA ADJ9559390 ELFEGA SELENE VERGARA SO CAL GARMENT AMTRUST NORTH AMERICA/TECHNOLOGY INSURANCE ADJ9205431 ALAN RICCIARDO RYDELL CHEVROLET AMTRUST SAN DIEGO ADJ6543939 ANGELICA TORRES WILMON CORPORATION DBA MILLERS PORGRESSIVE CARE AMTRUST SAN DIEGO ADJ6543939 ANGELICA TORRES WILMON CORPORATION DBA MILLEWS PROGRESSIVE CARE AMTRUST SAN DIEGO ADJ6692441 ANTONIO RAMIREZ HAHM MOTORSPORTS AMTRUST SAN DIEGO ADJ7630108 ARMANDO CORONA KAR CONSTRUCTION INC AMTRUST SAN DIEGO ADJ9482785 GENNY VERA H W ALL STARS INC DBA RADISSON SUITES HOTEL AMTRUST SAN DIEGO ADJ8840971 GUADALUPE MORALES SEVEN FORTY ONE COMPANY DBA IHOP AMTRUST SAN DIEGO ADJ9525312 ISRAEL ZEPAHUA SANCHEZ NAKORN GROUP INC AMTRUST SAN DIEGO ADJ6465219 JAMES LAWRENCE PROCAST PRODUCTS AMTRUST SAN DIEGO ADJ9701929 JOSE AVILA GOLDEN HAMMER AMTRUST SAN DIEGO ADJ7006348 JOSE GIL CIRILO TRIMCO FINISH AMTRUST SAN DIEGO ADJ9637910 JUAN BUSTOS ALS PLASTICS AMTRUST SAN DIEGO ADJ7570520 MARTHA BRAVO KARLTON RESIDENTIAL CARE AMTRUST SAN DIEGO ADJ8489398 MARTIN MARTINEZ MARIPOSA LANDSCAPE AMTRUST SAN DIEGO ADJ8489398 MARTIN MARTINEZ MARIPOSA LANDSCAPES AMTRUST SAN DIEGO ADJ281681 OFELIA VIRAY MURRIETA GARDENS AMTRUST SAN DIEGO ADJ8538805 ORLANDO FLORES MC STARLITE AMTRUST SAN DIEGO ADJ7023736 WILLIAM LIPSTRAW DOUBLE EAGLE TRANSPORTATION AMTRUST SAN DIEGO ADJ4413402 ERIKA RIOS UNIVERSAL PSYCHOLOGIST MEDICAL CTR ANTHONY ROHDAS INC ADJ9009842 SANTIAGO LAZALDE AOT GROUP USA LLC AOT GROUP USA LLC ADJ4707007 CARMEN HERNANDEZ TARSADIA HOTELS, INC. APPLIED RISK MANAGEMENT ADJ7844398 AMELIA MORENO FDS MANUFACTURING COMPANY INC APPLIED RISK OMAHA ADJ9134321 ARLIN NAJERA ORTEGA TACO BELL 004819 APPLIED RISK OMAHA ADJ7925569 ARMANDO RUEDA PRECISION ANODIZING PLATING INC APPLIED RISK OMAHA ADJ8122119 ARMANDO VILLALOBOS ESCOBAR 4MY2C INC APPLIED RISK OMAHA ADJ205269 CHRISTIAN JUAREZ PRICE BUILDERS APPLIED RISK OMAHA ADJ8246724 DEMETRIUS BERRY MAYFLOWER AFFORDABLE QUALITY MOVING APPLIED RISK OMAHA ADJ9312787 EDGAR GOMEZ RAMIREZ BOETHING TREELAND FARMS APPLIED RISK OMAHA ADJ7347661 EDGAR RAMIREZ PRECISION INTERIORS INC APPLIED RISK OMAHA ADJ7818663 EFREN RUEDA GENERAL PLATING CO APPLIED RISK OMAHA ADJ294172 ELVIA OREJEL 24/7 BUILDING MAINTENANCE APPLIED RISK OMAHA ADJ9030903 FRANCISCO MARTINEZ GOMEZ J AND R FLEET SERVICES APPLIED RISK OMAHA ADJ9030903 FRANCISCO MARTINEZ GOMEZ J AND R FLEET SERVICES INC APPLIED RISK OMAHA ADJ7507115 FRANCISCO RAMIREZ CARLOS MALLAND CARLOS MALLAND SSH FOR DECOCAL INC APPLIED RISK OMAHA ADJ3206994 FRANCISCO SANCHEZ CLEAN CLEAR THROUGH APPLIED RISK OMAHA ADJ8220829 GUILLERMO SOLORIO GL CONSTRUCTION AND DRYWALL APPLIED RISK OMAHA ADJ1743603 GUSTAVO VILLANUEVA CHIKATO BROS ICE CO APPLIED RISK OMAHA ADJ6514709 ISAIAS CASTILLO GRANT'S LANDSCAPE SERVICES APPLIED RISK OMAHA ADJ8282120 JAVIER TRUJILLO YANNETTY LANDSCAPE CO APPLIED RISK OMAHA ADJ8272268 JEFF KOTLYAR EMPIRE INTERNATIONAL APPLIED RISK OMAHA ADJ7828382 JESS FARMER BENZ SANITATION APPLIED RISK OMAHA ADJ7303525 JOSE BAUTISTA D J KLEIN CONSTRUCTION APPLIED RISK OMAHA ADJ7949120 JOSE LASCANO PARAISO LANDSCAPE APPLIED RISK OMAHA ADJ7208164 JOSE LOPEZ IN AND OUT REMOVAL APPLIED RISK OMAHA ADJ9927692 JOSE MORA RODRIGUEZ PRL GLASS SYSTEMS APPLIED RISK OMAHA ADJ9604575 JOSE OLVERA LAND MECHANICS APPLIED RISK OMAHA ADJ8290855 L C RILEY PATTEN ENERGY ENTERPRISE INC APPLIED RISK OMAHA ADJ8290855 L C RILEY PATTEN ENERGY ENTERPRISE INC APPLIED RISK OMAHA ADJ8425285 LEONOR IBARRA FAMILY NUTRITION CENTER APPLIED RISK OMAHA ADJ4052034 MARIA OJEDA AMERICAN LEISURE INDUSTRIES INC APPLIED RISK OMAHA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9441896 MARIA VILLICANA ALVA COASTAL BUILDING SERVICES APPLIED RISK OMAHA ADJ3839139 MARTIN CORONA WEST COAST METAL FINISHING APPLIED RISK OMAHA ADJ7592554 MIGUEL CALDERA ALVAREZ CONSTRUCTION CLEAN UP INC APPLIED RISK OMAHA ADJ8480022 MONICA LIAS SOFT GEL TECHNOLOGIES INC APPLIED RISK OMAHA ADJ6516151 NAZARIO FONSECA APPLIANCE DISTRIBUTION INC APPLIED RISK OMAHA ADJ2917893 NICHOLAS SORIA J & J JANITORIAL APPLIED RISK OMAHA ADJ2389836 NICOLAS CASILLAS CAMPESINO LANDSCAPE APPLIED RISK OMAHA ADJ7794913 OMAR HERRERA SHIEKH SHOES APPLIED RISK OMAHA ADJ8942565 OSCAR DIAZ CLASSIC DISTRIBUTIION BEVERAGE APPLIED RISK OMAHA ADJ7916292 PABLO ALEMAN FRONTERA CONSTRUCTION COMPANY APPLIED RISK OMAHA ADJ7928847 PATRICIA MORALES GOLDILOCKS APPLIED RISK OMAHA ADJ9625114 PEARL RANGEL PLS CHECK CASHERS OF CALIFORNIA INC APPLIED RISK OMAHA ADJ6591795 RAFAEL ARMENDARIZ FUSION DISPLAY AND DESIGN APPLIED RISK OMAHA ADJ8217336 RAFAEL MORALES AFFORDABLE QUALITY MOVING STORAGE APPLIED RISK OMAHA ADJ3988036 SANDRA CORDOVA BEST WESTERN LOS ALAMITOS APPLIED RISK OMAHA ADJ9186126 SONG TSI ROYAL CUSTOM DESIGNS LLC APPLIED RISK OMAHA ADJ8637742 VICENTE GOMEZ FAIRWEATHER ROOFING INC APPLIED RISK OMAHA ADJ7843750 VICTOR VARGAS WEST COAST METALS APPLIED RISK OMAHA ADJ7657890 WERNER ZACARIAS DERECK J TRABILEY DRYWALL INC APPLIED RISK OMAHA ADJ3682099 GARY CLARK LARS CONSTRUCTION/SOUTH PACIFIC APPLIED RISK SERVICES ADJ3079398 GREGORIO MACIEL FLORES CHERNISS TIRE WORLD APPLIED RISK SERVICES ADJ1726962 JUAN MENDOZA LITTLE SISTERS TRUCK WASH APPLIED RISK SERVICES INC ADJ7750270 REYNA CASTANEDA ARG RESOURCES LLC ARG RESOURCES LLC ADJ7140227 AMELIA ALVAREZ GC SERVICES ARGONAUT FRESNO ADJ2918943 CARLYN FERRELL AURORA BEHAVORIAL HEALTH CARE ARGONAUT FRESNO ADJ2918943 CARLYN FERRELL SIGNATURE HEALTH CARE DBA ARGONAUT FRESNO ADJ6513973 EDITH MORAN GLIDEWELL LABORATORIES ARGONAUT FRESNO ADJ398518 ESEQUIEL MORENO ROYAL TRUCK BODIES ARGONAUT FRESNO ADJ398518 ESEQUIEL MORENO ROYAL TRUCK BODIES INC ARGONAUT FRESNO ADJ1334680 GENARO VELASCO BICYCLE CASINO ARGONAUT FRESNO ADJ486683 JESUS HERNANDEZ PREFERRED FRAMING INC ARGONAUT FRESNO ADJ6548088 JOSE SANCHEZ BCBG MAXARIA GROUP INC ARGONAUT FRESNO ADJ6840630 JUAN GARCIA VILLA A1 RECYCLING ARGONAUT FRESNO ADJ7977960 JUAN ORTEGA JONES CLEANING CENTERS ARGONAUT FRESNO ADJ7156005 MARIA ARZATE FP STORES INC ARGONAUT FRESNO ADJ7150209 PEDRO REBOLLAR ROMANTIX INC ARGONAUT FRESNO ADJ4468391 VEDRAN BARBIC MURPHY INDUSTRIAL COATINGS ARGONAUT FRESNO ADJ8149217 RUBEN MORALES GOFORTH ENTERPRISES LLC ARGONAUT IRVINE ADJ1169131 MARIA REYNAGA PERFORMANCE FOOD ARROWOOD INDEMNITY COMPANY CHARLOTTE ADJ3322832 ALICIA AVILA INDEPENDENT STAFFING SOLUTIONS AS&G CLAIMS ADMINISTRATION INC ADJ3014531 PATRICK STREET INDEPENDENT STAFFING SOLUTIONS AS&G CLAIMS ADMINISTRATION INC ADJ7442036 HELIODORO COVARRUBIAS ASPLUNDH TREE EXPERT CO ASPLUNDH TREE EXPERT CO ADJ7496282 ALMER REYES UHAUL ASSURANCE CO OF AMERICA SACRAMENTO ADJ7920120 ANGEL VILLALPANDO ENRIQUE CRUZ MASONRY ATHENS ADMINISTRATORS CONCORD ADJ6541590 CHARLES SOWARDS YELLOW TRANSPORTATION ATHENS ADMINISTRATORS CONCORD ADJ9314303 CHRISTIAN MEDINA GLENDORA COUNTRY CLUB ATHENS ADMINISTRATORS CONCORD ADJ6779232 ERIKA ZUNIGA HOME INSTEAD SENIOR CARE ATHENS ADMINISTRATORS CONCORD ADJ6779232 ERIKA ZUNIGA HOMESTEAD SENIOR CARE ATHENS ADMINISTRATORS CONCORD ADJ7598119 ERMILO GARCIA TAPIA PACHECO BROTHERS INC ATHENS ADMINISTRATORS CONCORD ADJ7318708 FELIXBERTO BERDIN CITY OF BEVERLY HILLS ATHENS ADMINISTRATORS CONCORD ADJ6650778 FRANCISCO MORALES KADIMA SECURITY SERVICES ATHENS ADMINISTRATORS CONCORD ADJ6650778 FRANCISCO MORALES KADIMA SECURITY SVCS ATHENS ADMINISTRATORS CONCORD ADJ7405448 GARY CORNELL ABF FREIGHT SYSTEMS ATHENS ADMINISTRATORS CONCORD ADJ6870395 HILARIA URIARTE COHN RESTAURANT GROUP ATHENS ADMINISTRATORS CONCORD ADJ7796833 JACKELINE TRUJILLO DOWNEY REGIONAL MEDICAL CENTER ATHENS ADMINISTRATORS CONCORD ADJ7148379 JORGE MALDONADO SOTO BLACKHAWK PAINTING CO INC ATHENS ADMINISTRATORS CONCORD ADJ7493260 JORGE PACHECO RENT A BIN ATHENS ADMINISTRATORS CONCORD ADJ7330472 JOSE JIMENEZ ST JOHN OF GOD ATHENS ADMINISTRATORS CONCORD ADJ8452457 JOSE TELLEZ R D METAL FABRICATIONS INC ATHENS ADMINISTRATORS CONCORD ADJ8190496 JOSE ZALDIVAR MASTER DISTRIBUTORS ATHENS ADMINISTRATORS CONCORD ADJ8762494 LIDIA OYUELA AMERICAN APPAREL INC ATHENS ADMINISTRATORS CONCORD ADJ7523199 MARTIRES GARCIA TRI STAR MANUFACTURING INC ATHENS ADMINISTRATORS CONCORD ADJ6995348 NATALIO CANCHE SUPERIOR GROCERIES ATHENS ADMINISTRATORS CONCORD ADJ6995348 NATALIO CANCHE SUPERIOR GROCERS ATHENS ADMINISTRATORS CONCORD ADJ8126452 OLIVERIO CHAVEZ MEGA FARM LABOR SERVICES ATHENS ADMINISTRATORS CONCORD ADJ8168589 OLIVIA RIVERA VALLEY AG INC ATHENS ADMINISTRATORS CONCORD ADJ9297128 SERGIO TORRES EXTENDED CARE HOSPITAL ATHENS ADMINISTRATORS CONCORD ADJ9017652 TIRSO BARAGAN AMERICAN APPAREL ATHENS ADMINISTRATORS CONCORD ADJ9066084 VALENTIN PALAFOX AMERICAN APPAREL ATHENS ADMINISTRATORS CONCORD ADJ7491932 WALTER JOSE COLON THE FLOWER PARROT COMP ATHENS ADMINISTRATORS CONCORD ADJ7320300 ALVARO CORTES SLOVER BROS TRUCKING INC ATHENS ADMINISTRATORS ORANGE ADJ7822603 DOMINGO MELGAR AMERICAN APPAREL INC ATHENS ADMINISTRATORS ORANGE ADJ9432009 ELVIRA OLIVAS JUAN MUNOZ DBA FARM LABOR CONTRACTOR ATHENS ADMINISTRATORS ORANGE ADJ8374887 ENRIQUE CONTRERAS COOPER SERVICES ATHENS ADMINISTRATORS ORANGE ADJ7543859 GERARDO CALZADA BDS NATURAL PRODUCTS INC ATHENS ADMINISTRATORS ORANGE ADJ9214821 GUSTAVO FRAGA WEST COVINA ATHENS ADMINISTRATORS ORANGE ADJ7451573 JESUS LEON JUAN MUNOZ FARM LABOR CONTRACTOR ATHENS ADMINISTRATORS ORANGE ADJ8238029 JULIA PARRA AFFINITY MEDICAL TECHNOLOGIES ATHENS ADMINISTRATORS ORANGE ADJ7155233 MARTHA BANDA QPERFUMES ATHENS ADMINISTRATORS ORANGE ADJ8809133 MEI QING KUANG AMERICAN APPAREL USA LLC ATHENS ADMINISTRATORS ORANGE ADJ8467206 MELISSA DUARTE AUTUMN YEARS AT NEWPORT MESA ATHENS ADMINISTRATORS ORANGE ADJ7213401 MIGUEL PERALES TTS ENGINEERING INC ATHENS ADMINISTRATORS ORANGE ADJ7028491 ROSE LOPEZ PRESBYTERIAN COMMUNITY HOSPITAL ATHENS ADMINISTRATORS ORANGE ADJ2295547 SHIRLEY LEVASSEUR SORENSON CHILDRENS HOSPITAL ATHENS ADMINISTRATORS ORANGE ADJ9660288 MARCO BACAJOL XCVI LLC ATHENS ADMINISTRATORS SAN DIEGO ADJ3078452 DAVID ARCIGA POREX CORPORATION ATLANTIC MUTUAL INSURANCE CO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7008921 SEVERINO HUERTA B F OPERATIONS HOLDINGS AVIZENT ADJ6793755 ANA TINOCO DENNIS RESTAURANT NO 7020 AVIZENT 4530 EL DORADO HILLS ADJ8913319 CARLOS RUIZ STAFFMARK AVIZENT 4530 EL DORADO HILLS ADJ1581911 OSCAR ROJAS T SYSTEMS INTERNATIONAL AVIZENT 4530 EL DORADO HILLS ADJ8633451 WENDY KENNEDY WALMART AVIZENT 4530 EL DORADO HILLS ADJ7519937 BLANCA MONGE WALMART AVIZENT 4740 EL DORADO HILLS ADJ9462054 CLARA VINLOVE WALMART AVIZENT 4740 EL DORADO HILLS ADJ6498082 DAVID GUTIERREZ WAL MART AVIZENT 4740 EL DORADO HILLS ADJ4372663 ERIC SMITH WAL MART AVIZENT 4740 EL DORADO HILLS ADJ7088930 MANUEL MUNAR WALMART AVIZENT 4740 EL DORADO HILLS ADJ8903249 OSWALSO SOLIS STAFFMARK INC AVIZENT 4740 EL DORADO HILLS ADJ8932558 PAULINE GARCIA WAL MART STORES INC AVIZENT 4740 EL DORADO HILLS ADJ7968743 RICARDO GALVEZ TAYLOR DESK AVIZENT 4740 EL DORADO HILLS ADJ7155371 RICHARD YBARRA WAL MART AVIZENT 4740 EL DORADO HILLS ADJ7155371 RICHARD YBARRA WAL-MART AVIZENT 4740 EL DORADO HILLS ADJ7071359 ROBBY PHILLIPS WALMART STORES AVIZENT 4740 EL DORADO HILLS ADJ9025873 TAMMIE SCOTT WAL MART AVIZENT 4740 EL DORADO HILLS ADJ1572676 DONALD STEPHENS 7UP BOTTLING AVIZENT ANAHEIM ADJ7071193 MARINA QUIROZ BALDWIN PARK UNIFIED SCHOOL DISTRICT BALDWIN PARK UNIFIED SCHOOL DISTRICT ADJ7146881 DIANA SANTIBANEZ BANK OF AMERICA BANK OF AMERICA ADJ7153807 HILDA RAMIREZ BARFIELD ELEMENTARY BARFIELD ELEMENTARY ADJ7153807 HILDA RAMIREZ BARFIELD ELEMENTARY SCHOOL BARFIELD ELEMENTARY ADJ9212888 BERNABE CARRANZA BBSI YOUNGS COMERCIAL TRUCKING BARRETT BUSINESS SACRAMENTO ADJ9212888 BERNABE CARRANZA BBSI YOUNGS COMMERCIAL TRUCKING BARRETT BUSINESS SACRAMENTO ADJ1624762 EDWIN AUSTIN BARRETT BUSINESS SERVICES BARRETT BUSINESS SACRAMENTO ADJ9368736 ELVIRA GODINEZ BBSI & LIQUID GRAPHICS BARRETT BUSINESS SACRAMENTO ADJ9256001 FILIBERTO CASILLAS YOUNG`S COMMERCIAL TRANSFER INC BARRETT BUSINESS SACRAMENTO ADJ6694885 GABRIEL VILLA CRS COMMERCIAL BBSI SANTA ANA BARRETT BUSINESS SACRAMENTO ADJ8493547 JESUS LOPEZ FACILITIES SUPPORT SERVICES BARRETT BUSINESS SACRAMENTO ADJ7562275 JOSE ARANA POWER HOUSE ENTERTAINMENT BARRETT BUSINESS SACRAMENTO ADJ8887846 JOSE CUELLAR SAMAYOA DOMINOS PIZZA BARRETT BUSINESS SACRAMENTO ADJ9556932 JOSE IBARRA ADCRAFT BUSINESS MAIL BARRETT BUSINESS SACRAMENTO ADJ7365812 JOSE QUINTERO BARRETT BUSINESS SERV1CES BARRETT BUSINESS SACRAMENTO ADJ7365812 JOSE QUINTERO JIMS CARPET SERVICE BARRETT BUSINESS SACRAMENTO ADJ8527547 JOSE RIVERA BARRETT BUSINESS SERVICES BARRETT BUSINESS SACRAMENTO ADJ6998000 LETICIA POSADAS BARRETT BUSINESS SERVICES BARRETT BUSINESS SACRAMENTO ADJ7075921 LETICIA POSADAS BARRETT BUSINESS SERVICES BARRETT BUSINESS SACRAMENTO ADJ8539035 MANUEL MORENO FACILITIES SUPPORT SERVICES BARRETT BUSINESS SACRAMENTO ADJ9771539 MARCELA OSORIO ORTIZ SEAN`S EMBROIDERY BARRETT BUSINESS SACRAMENTO ADJ2269695 MARIA ISIDRA GOMEZ ORTEGA BARRETT BUSINESS SERVICES BARRETT BUSINESS SACRAMENTO ADJ2269695 MARIA ISIDRA GOMEZ ORTEGA INTEGRATED FOOD SERVICES BARRETT BUSINESS SACRAMENTO ADJ9862457 MARIA LEMUS BARRETT BUSINESS SERVICES INC BARRETT BUSINESS SACRAMENTO ADJ7079472 MARIA MARTINEZ GLEN PARK RETIREMENT HOME BARRETT BUSINESS SACRAMENTO ADJ8905439 MARIBEL LEMUS BURTEC BARRETT BUSINESS SACRAMENTO ADJ7945689 MARIBEL PEREZ ROMERO BARRETT BUSINESS SERVICES BARRETT BUSINESS SACRAMENTO ADJ7945689 MARIBEL PEREZ ROMERO BARRETT BUSINSS SERVICES BARRETT BUSINESS SACRAMENTO ADJ7883898 MIRIAM SOCORRO MORENO BARRETT BUSINESS SERVICE INC BARRETT BUSINESS SACRAMENTO ADJ9294601 MONICA SILVA PYRAMID FLOWERS BARRETT BUSINESS SACRAMENTO ADJ8948889 OSCAR RIVERA BRO PACK ENTERPRISES LLC BARRETT BUSINESS SACRAMENTO ADJ9396745 PABLO ROSALES ADAME LANDSCAPE BARRETT BUSINESS SACRAMENTO ADJ7486908 PEDLITO ROGACION RDM PROPERTY MANAGEMENT BARRETT BUSINESS SACRAMENTO ADJ9490912 PEDRO RUIZ DE LA ROSA BROTHERS CONSTRUCTION CO INC BARRETT BUSINESS SACRAMENTO ADJ9088218 RICHARD MONUGIAN SIGN RESOURCES BARRETT BUSINESS SACRAMENTO ADJ8015485 ROBERT MANERS BBSI BARRETT BUSINESS SACRAMENTO ADJ7608312 RUPANDE SHRIMANKAR AMERICAN LOGISTICS CO BARRETT BUSINESS SACRAMENTO ADJ7608312 RUPANDE SHRIMANKAR CABCO YELLOW INC BARRETT BUSINESS SACRAMENTO ADJ7608312 RUPANDE SHRIMANKAR CALIFORNIA YELLOW CAB BARRETT BUSINESS SACRAMENTO ADJ7608312 RUPANDE SHRIMANKAR BARRETT BUSINESS SERVICES BARRETT BUSINESS SACRAMENTO ADJ7373784 JOSE DURAN SEA SHEILD MARINE PRODUCTS INC BARRETT BUSINESS SACRAMENTO ADJ8032513 LUISA RICANO BBSI SAN BERNARDINO BARRETT BUSINESS SACRAMENTO ADJ7324336 NAZARIO MALDONADO T L FABRICATION BARRETT BUSINESS SACRAMENTO ADJ7883898 MIRIAM SOCORRO MORENO BARRETT BUSINESS SERVICE INC BARRETT BUSINESS SERVICE INC ADJ3461787 JOSE CARRANZA AGRILAND COMPANY BARRETT BUSINESS SERVICES ADJ7662603 SALVADOR GUZMAN BARRETT BUSSINESS SERVICES BARRETT BUSSINESS SERVICES ADJ7365651 JAVIER DE LA PAZ BBSI BBSI ADJ9212888 BERNABE CARRANZA BBSI YOUNGS COMERCIAL TRUCKING BBSI YOUNGS COMMERCIAL TRUCKING ADJ9212888 BERNABE CARRANZA BBSI YOUNGS COMMERCIAL TRUCKING BBSI YOUNGS COMMERCIAL TRUCKING ADJ2060359 JUAN VEGA L&S LIGHTING FIXTURE BEAVER FREMONT AMERICAN INS CO ADJ9468484 DAVID OSARIO K C RESTORATION INC BENCHMARK ONTARIO ADJ8518779 LUCILO HERNANDEZ PINNACLE PLASTERING BENCHMARK ONTARIO ADJ9334622 SILVANO OSUNA COMPASS SERVICES - BENCHMARK ONTARIO ADJ2850018 MARCO ARANDA BB CO INC BERKSHIRE HATHAWAY ADJ1746201 ROSA GASCA PREMIER BUILDING MAINTENANCE BERKSHIRE HATHAWAY HOME COMPANIES ADJ2285425 JOSE CORTEZ DE LA TORRE LANDSCAPE BERKSHIRE HATHAWAY HOMESTATE CO ADJ6726144 ABRAHAM GARCIA DAYS INN & SUITES BERKSHIRE HATHAWAY PASADENA ADJ9426250 ADRIANA VAZQUEZ RAMA FOOD MANUFACTURER BERKSHIRE HATHAWAY PASADENA ADJ9443928 ALEJANDRO HEREDIA VEGA BAKERS BURGERS INC BERKSHIRE HATHAWAY PASADENA ADJ7550594 ANGEL PIEDRA ARTHORMADE PLASTICS INC BERKSHIRE HATHAWAY PASADENA ADJ9526863 ARTURO CANUT SOSA GREEN TRUCKING, LLC BERKSHIRE HATHAWAY PASADENA ADJ7052147 ARTURO JIMENEZ SUNSET LANDSCAPE MAINTENANCE COMPANY BERKSHIRE HATHAWAY PASADENA ADJ459004 ARTURO ORTEGA WASHINGTON GARMENT DYEING BERKSHIRE HATHAWAY PASADENA ADJ9402788 BLANCA DE LA ROSA WGCI GARMENT WEST PROCESSING CENTER BERKSHIRE HATHAWAY PASADENA ADJ9472889 CARLOS CASTELLANOS MT SINAI MEMORIAL PARK BERKSHIRE HATHAWAY PASADENA ADJ2159227 CARLOS REYES CENTER POINTE CONTRACTORS BERKSHIRE HATHAWAY PASADENA ADJ9509276 DAVID BONILLA EMERALD CITY ASSISTED LIVING BERKSHIRE HATHAWAY PASADENA ADJ7435812 DEBBIE DEPRIEST GLEN IVY DAY SPA BERKSHIRE HATHAWAY PASADENA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7009372 DONACIANO FIERROS PEAR GARDEN PRODUCE BERKSHIRE HATHAWAY PASADENA ADJ8550015 EDUARDO MENDOZA SIGNRESOURCE BERKSHIRE HATHAWAY PASADENA ADJ6506316 EVERARDO OSEGUERA INTERNATIONAL WOOD PROCESSORS BERKSHIRE HATHAWAY PASADENA ADJ7215840 FRANCISCO CAMARILLO SUNSPORTS APPAREL BERKSHIRE HATHAWAY PASADENA ADJ9144436 FRANCISCO SALAZAR UDC CORPORATION BERKSHIRE HATHAWAY PASADENA ADJ6510977 FRANCISCO ZARAGOZA DEL MAR PLASTERING BERKSHIRE HATHAWAY PASADENA ADJ2434337 FREDDY PINEDA THUNDER FINISHING, INC BERKSHIRE HATHAWAY PASADENA ADJ6845555 GLORIA ALOMIA AAREN SCIENTIFIC INC BERKSHIRE HATHAWAY PASADENA ADJ6845555 GLORIA ALOMIA OPHTALMIC INOVATION INTERNATIONAL BERKSHIRE HATHAWAY PASADENA ADJ6845555 GLORIA ALOMIA PIZZA HUT BERKSHIRE HATHAWAY PASADENA ADJ648336 GLORIA RAMIREZ BAKERY EXPRESS OF SOUTHERN CALIFORN BERKSHIRE HATHAWAY PASADENA ADJ6501510 HERMINIO PEREZ PACHECO CREEL PRINTING OF CA, INC. BERKSHIRE HATHAWAY PASADENA ADJ3741362 HOLGA DIAZ MARQUEZ BODY SHOP BERKSHIRE HATHAWAY PASADENA ADJ295567 ISIDRO SAHAGUN CLS LANDSCAPE MGT BERKSHIRE HATHAWAY PASADENA ADJ2783303 JENNIFER MARTINEZ CRITICOM INTERNATIONAL BERKSHIRE HATHAWAY PASADENA ADJ4433811 JOSE DIAZ CALIVAS INC BERKSHIRE HATHAWAY PASADENA ADJ4169872 JOSE MEDRANO GARCIA ECONOMY TRUCK SERVICE INC BERKSHIRE HATHAWAY PASADENA ADJ547408 JOSE PRADO VILLA PARK LANDSCAPE BERKSHIRE HATHAWAY PASADENA ADJ7858650 JUAN CABRERA SO CAL FRAMING INC BERKSHIRE HATHAWAY PASADENA ADJ9374046 JUAN LOPEZ AKER INTERNATIONAL BERKSHIRE HATHAWAY PASADENA ADJ7634967 JUAN MAGANA T REX TRUCK BERKSHIRE HATHAWAY PASADENA ADJ2060359 JUAN VEGA L&S LIGHTING FIXTURE BERKSHIRE HATHAWAY PASADENA ADJ2793090 JUANA SALAZAR CHILD DEVELOPEMENT CONSORTIUM BERKSHIRE HATHAWAY PASADENA ADJ9614870 LEONARDO DOMINGUEZ NORTH STAR DYE AND WASH BERKSHIRE HATHAWAY PASADENA ADJ3019315 LETICIA ESTRADA EGGOLOGY INC BERKSHIRE HATHAWAY PASADENA ADJ9219080 LIAN XIANG ZHAO GBT INC BERKSHIRE HATHAWAY PASADENA ADJ7146185 LUIS LEYVA TAB POOL SERVICES INC BERKSHIRE HATHAWAY PASADENA ADJ6713507 MARCELO RODRIGUEZ WARE DISPOSAL INC BERKSHIRE HATHAWAY PASADENA ADJ3312908 MARGARITO ALVAREZ ADVANCE BUILDING MAINTENANCE INC BERKSHIRE HATHAWAY PASADENA ADJ6800188 MARIA BETENCOURT MCKC ENTERPRISES INC DBA CAROUSEL CHILD CARE BERKSHIRE HATHAWAY PASADENA ADJ2412146 MARIA DAVILA ENCINO RETIREMENT HOTEL BERKSHIRE HATHAWAY PASADENA ADJ2412146 MARIA DAVILA ENCINO RETIREMENT HOTEL, LLC BERKSHIRE HATHAWAY PASADENA ADJ6453925 MARICELA MONTES TRISTAR BERKSHIRE HATHAWAY PASADENA ADJ2949920 MARINA SILVA PLAZA DE LA RAZA HEAD START INC BERKSHIRE HATHAWAY PASADENA ADJ7084115 MARIO LOPEZ PREMIER BUILDING MAINTENANCE BERKSHIRE HATHAWAY PASADENA ADJ7160917 MAXIMO CRUZ PACIFIC FABRIC FINISHING INC BERKSHIRE HATHAWAY PASADENA ADJ7160917 MAXIMO CRUZ PACIFIC FABRIC FINISHING INC DBA CHRIS STONE INC BERKSHIRE HATHAWAY PASADENA ADJ7090692 MIGUEL ROMO MEDI PEDI BEDDING BERKSHIRE HATHAWAY PASADENA ADJ2733507 NAURO CANALES LAKEVIEW CONCRETE BERKSHIRE HATHAWAY PASADENA ADJ6690608 OSCAR GONZALEZ THOREAU JANITORIAL SERVICES BERKSHIRE HATHAWAY PASADENA ADJ7090558 PEDRO VASQUEZ HUNTER LANDSCAPE INC BERKSHIRE HATHAWAY PASADENA ADJ6515964 QINGAN LI CHENWEI XING DBA HEBO WROUGHT IRON ENTERPRISE BERKSHIRE HATHAWAY PASADENA ADJ9187878 RACHQUEL NESBIT SHARP FRIEGHT SYSTEMS BERKSHIRE HATHAWAY PASADENA ADJ6616104 RAFAELA CASTILLO HOLIDAY INN BERKSHIRE HATHAWAY PASADENA ADJ9376969 RAUL ARJON GONZALEZ MIKE LOWRIE TRUCKING BERKSHIRE HATHAWAY PASADENA ADJ9088218 RICHARD MONUGIAN SIGN RESOURCES BERKSHIRE HATHAWAY PASADENA ADJ9416958 ROCIO HERNANDEZ COUNTY OF LOS ANGELES DEPARTMENT OF MENTAL HEALTH BERKSHIRE HATHAWAY PASADENA ADJ9416958 ROCIO HERNANDEZ MENTAL HEALTH AMERICA OF LOS ANGELES BERKSHIRE HATHAWAY PASADENA ADJ3681964 ROGELIO MORALES HARVEST LANDSCAPE ENTERPRISE BERKSHIRE HATHAWAY PASADENA ADJ6522989 RONNIE BLAKE CHARLES DREW UNIVERSITY OF MEDICINE AND SCIENCE BERKSHIRE HATHAWAY PASADENA ADJ7184934 ROSALEA PADILLA DEL RIO CONVALESCENT AND SANITOR BERKSHIRE HATHAWAY PASADENA ADJ3983719 ROSALIO PELAYO HIGH VALLEY LODGE BERKSHIRE HATHAWAY PASADENA ADJ9506085 ROXANA CARTAGENA EMERALD CITY ASSISTED LIVING BERKSHIRE HATHAWAY PASADENA ADJ6636656 SANTOS MORENO TOP SHELF FIXTURES BERKSHIRE HATHAWAY PASADENA ADJ7794922 SERGIO CERVANTES CALIFORNIA THREAD AND SUPPLY BERKSHIRE HATHAWAY PASADENA ADJ933029 SILVIA GARCIA ALLIED WEST PAPER CORP. BERKSHIRE HATHAWAY PASADENA ADJ9054287 SILVINO VALADEZ DUNHAM METAL PROCESSING BERKSHIRE HATHAWAY PASADENA ADJ1199001 STANLEY MATHEWS SYSTEMS INTEGRATED BERKSHIRE HATHAWAY PASADENA ADJ6818271 SUSAN COUCH GLEN IVY DAY SPA BERKSHIRE HATHAWAY PASADENA ADJ3626246 TERRY ALVARADO FARMERS BOYS RESTAURANT BERKSHIRE HATHAWAY PASADENA ADJ1527484 UBALDO FLORES VALUE MEATS INC BERKSHIRE HATHAWAY PASADENA ADJ774552 VICTOR GARCIA STREETS AHEAD, INC. BERKSHIRE HATHAWAY PASADENA ADJ7146291 VILMA AVALOS SPORTS CLUB EMBROIDERY BERKSHIRE HATHAWAY PASADENA ADJ6892575 VIRGINIA JANOVSKY SIERRA CYN HIGH SCHOOL FOUNDATION BERKSHIRE HATHAWAY PASADENA ADJ2159121 YESENIA TINOCO CCP POULTRY & MEAT CORP DBA H&M BERKSHIRE HATHAWAY PASADENA ADJ6955771 ANA MARIA DEL REAL PACIFIC ATHLETIC WEAR INC BERKSHIRE HATHAWAY SAN DIEGO ADJ9551814 ARTHUR CASTANEDA MAYFIELD SENIOR SCHOOL BERKSHIRE HATHAWAY SAN DIEGO ADJ2732930 CARLOS LOPEZ PACIFIC PRIDE SEAFOOD, INC. BERKSHIRE HATHAWAY SAN DIEGO ADJ7206942 CRISOFORO SILVA PRYOR PRODUCTS BERKSHIRE HATHAWAY SAN DIEGO ADJ7221847 DEBBIE KANG SOUTH BAY VOCATIONAL CENTER BERKSHIRE HATHAWAY SAN DIEGO ADJ9073093 EDGAR ALMANZAN CARRASCO AEON MANUFACTURING BERKSHIRE HATHAWAY SAN DIEGO ADJ3107792 EDGAR QUIJADA ORE-CAL CORP BERKSHIRE HATHAWAY SAN DIEGO ADJ8162031 ERIKA PEREZ SANTA CLARITA CONCESSIONS BERKSHIRE HATHAWAY SAN DIEGO ADJ6765235 ERNESTO MEDINA PACIFIC COAST MANAGEMENT BERKSHIRE HATHAWAY SAN DIEGO ADJ143695 ESTHER FLORES VM INTERNATIONAL BERKSHIRE HATHAWAY SAN DIEGO ADJ7148381 GILBERTO REGALADO FAIRWAY LANDSCAPE AND IRRIGATION BERKSHIRE HATHAWAY SAN DIEGO ADJ9215385 IRMA SALGADO K BELL BERKSHIRE HATHAWAY SAN DIEGO ADJ6551351 JESUS VERDUGO DEL MAR PLASTERING INC BERKSHIRE HATHAWAY SAN DIEGO ADJ2212188 JOSE CAMACHO ACACIA LANDSCAPE SERVICES BERKSHIRE HATHAWAY SAN DIEGO ADJ7425732 JOSE GARCIA LOCK RIDGE TOOL CO INC BERKSHIRE HATHAWAY SAN DIEGO ADJ7665194 JOSE GOMEZ V&V FARM LABOR CONTRACTORS BERKSHIRE HATHAWAY SAN DIEGO ADJ1540196 JOSE RODRIGUEZ CLASSIC PARKING BERKSHIRE HATHAWAY SAN DIEGO ADJ1540196 JOSE RODRIGUEZ CLASSIC PARKING INC BERKSHIRE HATHAWAY SAN DIEGO ADJ9144757 JUAN RUIZ SSP AMERICA BERKSHIRE HATHAWAY SAN DIEGO ADJ9144757 JUAN RUIZ SSP AMERICA, INC BERKSHIRE HATHAWAY SAN DIEGO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ4436013 JUAN VALDIVIA LIBERTY GLASS BERKSHIRE HATHAWAY SAN DIEGO ADJ8380225 LETICIA DANESTA ORTIZ GLOBAL BAKERIES BERKSHIRE HATHAWAY SAN DIEGO ADJ3019315 LETICIA ESTRADA EGGOLOGY INC BERKSHIRE HATHAWAY SAN DIEGO ADJ7449143 LORENA RODRIGUEZ EL CHOLO RESTAURANT BERKSHIRE HATHAWAY SAN DIEGO ADJ8268455 MARCO ANTONIO ESTRADA AMTREND CORPORATION BERKSHIRE HATHAWAY SAN DIEGO ADJ9113416 MARIA FLORES GMI BUILDING SERVICES BERKSHIRE HATHAWAY SAN DIEGO ADJ8395009 MARTHA ALDRETE ALLIANCE FOR HOUSING AND HEALING BERKSHIRE HATHAWAY SAN DIEGO ADJ9099888 MARTIN RAMIREZ LUCERO SF APPAREL BERKSHIRE HATHAWAY SAN DIEGO ADJ6450030 MARTIN VASOUEZ DE LA TORRE LANDSCAPE AND MAINTENANCE BERKSHIRE HATHAWAY SAN DIEGO ADJ6864990 MIGUEL MARTINEZ LA PRINTEX INDUSTRIES INC DBA TGI TEXTILE FIVE STAR BERKSHIRE HATHAWAY SAN DIEGO ADJ6498149 MIGUEL MEDRANO DAN`S LANDSCAPE SERVICES BERKSHIRE HATHAWAY SAN DIEGO ADJ6812838 MIGUEL NAVARRO COMMERCIAL SHEET METAL WORKS BERKSHIRE HATHAWAY SAN DIEGO ADJ8583602 PABLO GALICIA EMPI INC BERKSHIRE HATHAWAY SAN DIEGO ADJ6596617 PEDRO CHAVEZ SAN DIEGO POOLS BERKSHIRE HATHAWAY SAN DIEGO ADJ6560145 RAMON PORTILLO OAK MILLS INC BERKSHIRE HATHAWAY SAN DIEGO ADJ6469048 RICHARD NAVARRO RICHWELL STEEL CORP BERKSHIRE HATHAWAY SAN DIEGO ADJ6476838 RON MACKEY HELIX WHOLESALE BERKSHIRE HATHAWAY SAN DIEGO ADJ8226862 SERGIO SERNA LITTLE DAVID PEST CONTROL BERKSHIRE HATHAWAY SAN DIEGO ADJ8308144 SOCORRO COVARRUBIAS RC PALMER CONSTRUCTION BERKSHIRE HATHAWAY SAN DIEGO ADJ6752789 TERRY MUNSON LEE SCHEFFERS INC BERKSHIRE HATHAWAY SAN DIEGO ADJ7947015 VICKIE CHAMBERLIN RONALD MCDONALD HOUSE CHARITIES BERKSHIRE HATHAWAY SAN DIEGO ADJ7947015 VICKIE CHAMBERLIN RONALD MCDONALD HOUSE CHARITY BERKSHIRE HATHAWAY SAN DIEGO ADJ6429867 VIOLETA MARTINEZ ALCO METAL FAB BERKSHIRE HATHAWAY SAN DIEGO ADJ7086075 YOLANDA CURIEL SHIVA MANAGEMENT 1NC BERKSHIRE HATHAWAY SAN DIEGO ADJ9057853 ADALBERTO VALDIVIESO STAR LANDSCAPE AND MAINTENANCE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9426250 ADRIANA VAZQUEZ RAMA FOOD MANUFACTURER BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7382383 ALBERTO RODRIGUEZ GARDENLAND CENTER INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8373264 ALEJANDRA SANCHEZ TULA MARKET BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7680680 ALEJANDRO ALEGRIA VELAZQUEZ LEONARD ROOFING INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6595095 ALEJANDRO MONTIEL COINER NURSERY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8949526 ALFREDO ARGUETA LA BREA DINING CALIFORNIA BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7460022 ALICA HOBBS THERAPEUTIC LIVING CENTER FOR THE BLIND BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8401521 ALVARO SALDIVAR D AND H LANDSCAPING MAINTENANCE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7839188 ANA GABRIELA VARGAS FIRST TEAM REAL ESTATE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ402958 ANA LUNA RAINBOW SUBLYMATION INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ3411365 ANTONIO VALADEZ THE BEACH HOUSE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7113412 ARISTEO MARTINEZ LA CASA DEL CAMINO BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8831930 ARMANDO MENDOZA ADVANCED MEDICAL ANALYSIS INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7014015 ARMANDO SANCHEZ RICHARD I KORAL INC DBA JESSICAS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6547083 ARTURO ROCHA JIMS BURGER BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6547083 ARTURO ROCHA JIMS BURGERS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6974704 AURA RUANO ILUFA FORWARDING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6974771 AURA RUANO ILUFA FORWARDING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7701737 AURORA DOMINGUEZ EL PATIO RESTAURANT BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9606453 BERTHA BANDERAS MAREBLU MANUFACTURE INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9505953 BLANCA LEAL EBS INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9472889 CARLOS CASTELLANOS MT SINAI MEMORIAL PARK BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9507860 CARLOS CASTELLANOS PORTOS BAKERY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9030534 CELSO PALOS BAUMANN ENGINEERING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7191477 CIPRIANO ARMENTA CALIFORNIA LANDSCAPE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7076852 CRISTINA ALCALA CROWNE PLAZA LA HARBOR HOTEL BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8345328 DALILA SALAZAR LIQUID GRAPHICS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7842002 DAVID CANTORAN BARTWOOD CONSTRUCTION BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7286400 DIANA VALADEZ HOMETOWN BUFFET BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7183872 DIMAS GUTIERREZ PREMIUM BUILDING MAINTENANCE SERVICES BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6701422 DOMINGO LORENZO QUICK CRETE PRODUCTS CORP BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8609293 DORA CORDOVA GLOBAL BAKERIES BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8306193 EDGAR GARCIA SILVA S H CONTRACTORS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8737983 EFRAIN RAMIREZ ADVANCED LANDSCAPE 2000 INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6985334 ELIZABETH GARCIA FLEXCO INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ3715669 ELIZABETH JACKSON CHARLES R DREW UNIVERSITY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7269595 ERIDETH CRUZ LIQUID GRAPHICS INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7586856 ESPERANZA TINOCO LAGUNA BEACH INN BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6635470 FELIPE SILVA API KIRK CONTAINERS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9101249 FRANCISCA MONTES PIONEER THATRES BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7498325 FRANCISCO CARRILLO DELCA CORP BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9114573 FRANCISCO CASTILLO ADMIRAL FIRE PROADVANCO FIRE PROTECTION BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6798132 FRUCTOSO RODRIGUEZ LUVIANO SKY LUXURY CORP BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7545257 GUADALUPE CONTRERAS ASOCIACION NACIONAL PRO PERSONAS MAYORES BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9061825 HOWARD DAVIS B B PIPE AND TOOL COMPANY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7914263 IMELDA CRUZ PEREZ DEL RIO CONVALESENT BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8255355 IRMA ALCANTAR ACME AUTO HEADLINING COMPANY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ4414084 IRMA ARZOLA SHERWOOD MANAGEMENT COMPANY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6639659 ISMAEL GRANADOS ALL ABOUT LANDSCAPE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7253617 J GUADALUPE PEREZ WARE DISPOSAL INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7500877 JAVIER MIRELES GRANT CONSTRUCTION INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ1923203 JENNIFER MUNOZ HEALTH VIEW HOME HEALTH BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8472963 JESUS DEL RIO ACEVEDO DMSI STAFFING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6712412 JESUS MALDONADO JM PAN AMERICAN BANANAS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6551351 JESUS VERDUGO DEL MAR PLASTERING INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7041816 JOE GIL ARROYO PLUMBING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8774640 JOEL GOMEZ CARDENAS REPLANET PACIFIC INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7582225 JOSE ARCE TAPS FISH HOUSE AND BREWERY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8864903 JOSE CARMEN ROBLEDO CALIFORNIA TRUSSFRAME BERKSHIRE HATHAWAY SAN FRANCISCO ADJ4245193 JOSE CASTANEDA LOS ANGELES TIMES BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8530569 JOSE D HERNANDEZ MIKE LOWRIE TRUCKING BERKSHIRE HATHAWAY SAN FRANCISCO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7872987 JOSE DEL CID RELIABLE CABLE TV CONTRACTORS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8396853 JOSE DELGADILLO LIFE STEPS FOUNDATION BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7327538 JOSE ESTRADA EMPIRE BUILDING AND ENVIRONMENTAL SERVICES INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ1612949 JOSE GERMAN SUPER DYEING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7451983 JOSE MARQUEZ SANTIAGO STAUFFERS LANDSCAPE INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8179747 JOSE NORIEGA PACIFIC HANDY CUTTER BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9105321 JUAN MALDONADO EXPAK GROUND INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9105321 JUAN MALDONADO UNITY COURIER SERVICES BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9105321 JUAN MALDONADO UNITY COURIER SVCS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8323856 KARINE MARKOSSIAN ST MARYS ADULT HEALTHCARE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7104656 LETICIA ACEVEDO SAN DIEGUITO PRINTERS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9147355 LOUISE ARRAIGA TRANSWORLD SHIPPING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6935860 LUCIO GONZALEZ STEVEN ANTHONY INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7146185 LUIS LEYVA TAB POOL SERVICES INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7519892 LUIS SANCHEZ MURILLO CLOSET BY DESIGN BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8431366 MACARIO BOHORQUEZ TICE VALLEY LANDSCAPE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8634210 MANUEL CARRANZA MIKE LOWNE TRUCKING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8543275 MANUEL GONZALEZ PALM SPRINGS UNIFIED SCHOOL BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8543275 MANUEL GONZALEZ SEVEN LAKES HOME OWNERS ASSOCIATION BERKSHIRE HATHAWAY SAN FRANCISCO ADJ4115302 MANUEL JASSO HERNANDEZ GRANT PARKING CO BERKSHIRE HATHAWAY SAN FRANCISCO ADJ3413590 MANUELA ALMARAZ RIVERA SONIA SONY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ3413590 MANUELA ALMARAZ RIVERA XENON INVESTMENT BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9660288 MARCO BACAJOL XCVI LLC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7211296 MARCOS PINEDA JONATHAN LOUIS INTERNATIONAL LTD BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7117851 MARIA ARMENTA AMERICAN INTERNATIONAL INDUSTRIES BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6773375 MARIA CASTILLO CAPTEK SOFTGEL INTERNATIONAL BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6773375 MARIA CASTILLO CAPTEK SOFTGEL INTERNATIONAL INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6773375 MARIA CASTILLO CAPTEK SOFTGEL INTL BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7060862 MARIA DE LA CRUZ RAMADA PLAZA HOTEL ANAHEIM RESORT BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9056193 MARIA GARCIA EMPIRE BUILDING SERVICES BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8937067 MARIA TERESA HERNANDEZ BHARTI INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9173657 MARIA URZUA PAKNIQUE INTERNATIONAL INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6453925 MARICELA MONTES TRISTAR BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8213186 MARIO PALACIOS BOHNS PRINTING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8282022 MARTHA SANCHEZ DAYLIGHT ADULTH HEALTH CARE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6983690 MARTIN GONZALEZ WARE DISPOSAL BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6983690 MARTIN GONZALEZ WARE DISPOSAL CO INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ3504613 MARY AVALOS TIERRA DEL SOL FOUNDATION BERKSHIRE HATHAWAY SAN FRANCISCO ADJ9010459 MASHELA BENSON ALTA HOME CARE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6599326 MAXIMILIANO DUARTE SOCAL UNIFORM RENTAL BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7331681 MAXIMINO CONTRERAS GENLABS CORPORATION BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6812838 MIGUEL NAVARRO COMMERCIAL SHEET METAL WORKS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ2909564 MIGUEL NOLASCO THE ORIGINAL MOWBRAY'S TREE SERVICE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7704647 NANCY CONSTANZA RAMIREZ B W GOLDEN SAILS HOTEL BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8332585 NANCY MARQUEZ ROWE DEVELOPMENT MAGNOLIA APARTMENTS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7592293 OLAFUR BACHMANN DAVIS MEDICAL ELECTRONICS INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6602005 OMAR GONZALEZ EVER LLC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8694042 ORFANEL MARTINEZ YOSHI S GREEN SUPPLY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8301018 ORLANDO LOPEZ EL TORO MEAT SHOP 9921 BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8898383 OSMIN QUINTANILLA WEISS FAMILY PROPERTIES BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7265392 PAULA BOYD BAKERS BURGERS INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8992704 PEDRO SANCHEZ GREEN MEADOW GROWERS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6515964 QINGAN LI CHENWEI XING DBA HEBO WROUGHT IRON ENTERPRISE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7483709 RAFAEL MALDONADO ALLWEST PLASTICS INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8109272 RAUL LOPEZ CALIFORNIA FLORAL IMPORTS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8109465 RAUL LOPEZ BARON HR BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8109465 RAUL LOPEZ CALIFORNIA FLORA AND HOME BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8109465 RAUL LOPEZ CALIFORNIA FLORAL AND HOME BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7879974 REYNA HERNANDEZ INDEPENDENT BUILDING MAINTENANCE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7218516 ROBERT WEINLOOD JERRYS PLUMBING AND HEATING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8449979 ROBERTO RODRIGUEZ CLOSET WORLD BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8035493 ROGELIO MIRANDA HUNTER LANDSCAPE INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6858838 ROSALINO MENDOZA CREATIVE COMMUNICATIONS TECH INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ4337771 ROSARIO DE LA CRUZ U.S. GARMENTS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ4337771 ROSARIO DE LA CRUZ US GARMENTS INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7355167 RUBEN CHICA PACIFIC FABRIC FINISHING INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7532405 RUBEN GONZALEZ GREENLEAF ORGANIC PEST MANAGEMENT INCORPORATED BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7760003 SABINO MALDONADO MILLER WOOD WORKING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7818852 SALVADOR GARCIA STANLEY PEST CONTROL BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6997296 SALVADOR LUNA WARE DISPOSAL INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6816639 SANDRA BARRIOS RAYS WRAP INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ1415384 SERGIO LEDESMA BENT MFG CO BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8226862 SERGIO SERNA LITTLE DAVID PEST CONTROL BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7476809 SHAWNTE HAILEY NATIONAL COMMUNITY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8454517 SHERRY FEHLMAN DMSI INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8454517 SHERRY FEHLMAN DMSI STAFFING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8454517 SHERRY FEHLMAN MJO STAFFINGS SERVICE CORPORATE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ4150798 SILVIA GARCIA NATHA ASSOCIATES INC (RAMADA LIMITE BERKSHIRE HATHAWAY SAN FRANCISCO ADJ4150798 SILVIA GARCIA RAMADA LIMITED SAN DIEGO BERKSHIRE HATHAWAY SAN FRANCISCO ADJ933029 SILVIA GARCIA ALLIED WEST PAPER CORP. BERKSHIRE HATHAWAY SAN FRANCISCO ADJ3786169 SIXTO TAPIA HEROE'S RESTAURANT, INC. BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7304830 TEODULO CARDOSO RAMIREZ EXPRESS SERVICE GROUP BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7304830 TEODULO CARDOSO RAMIREZ OPTIMA STAFFING BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7304830 TEODULO CARDOSO RAMIREZ PURETECK CORPORATION BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7480053 TERESA TORRES CIPS MARKETING GROUP INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8564109 TERESITA RICE AUXILIARY RESDENTIAL CARE INC BERKSHIRE HATHAWAY SAN FRANCISCO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7094351 THYRA CONLEY GLOBAL PARATRANSIT INC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7230269 URBANO MARTINEZ QUICK CONCRETE PRODUCTS CORP BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7414844 VERONICA AKA ERICKA RENEE PEREZ AKA RIVAS HUICHOS BAKERY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ8656502 VERONICA HERNANDEZ SNSI STAFFING LLC BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7947015 VICKIE CHAMBERLIN RONALD MCDONALD HOUSE CHARITIES BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7947015 VICKIE CHAMBERLIN RONALD MCDONALD HOUSE CHARITY BERKSHIRE HATHAWAY SAN FRANCISCO ADJ2765440 VICTOR GAONA RDF EXPRESS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ6429867 VIOLETA MARTINEZ ALCO METAL FAB BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7084358 WILLIAM LARA LORI PRODUCTS BERKSHIRE HATHAWAY SAN FRANCISCO ADJ7208747 JAMES WHYTE BEST DEDICATED BEST DEDICATED ADJ7208747 JAMES WHYTE FURNITURE TRANSPORTATION SERVICE BEST DEDICATED ADJ9226707 MARINA AVOLEVAN AV HOSPITAL BETA HEALTHCARE GROUP ROSEVILLE ADJ8189247 MARLO WILLIAMSON WATTS HEALTHCARE CORP BETA HEALTHCARE GROUP ROSEVILLE ADJ7215225 FABIOLA VASQUEZ BIG SAVER FOODS BIG SAVER FOODS ADJ7827888 JIAN QIANG WU BLUE RIDGE HOME FASHIONS INC BLUE RIDGE HOME FASHIONS INC ADJ9313936 RICARDO ANAYA BORBON, INC. BORBON, INC. ADJ1019036 INGRID PAZ RALPH'S STORE BRADFORD BARTHEL LIEN UNIT ONTARIO ADJ9024458 LUIS PELAYO BRAMBLES INC BRAMBLES INC ADJ468323 AURORA PEREZ SHURFLO LLC BROADSPIRE ADJ6537862 EUSTACIO SOSA FIRST TRANSIT BROADSPIRE ADJ3882344 EVA GARCIA FAMILY DENTISTRY BROADSPIRE ADJ447349 JAMES BROWN GENERAL DYNAMICS BROADSPIRE ADJ6877959 JULIA ROMERO RALLY MANAGEMENT STAFFING BROADSPIRE ADJ7282166 MAYRA DIAZ SECURITAS SECURITY SVCS USA BROADSPIRE ADJ9653494 SANTIAGO GUTIERREZ E & C FASHION INC BROADSPIRE ADJ7517327 DAVID PERNELL FIRST TRANSIT BROADSPIRE 12586 FRESNO CLOSED ADJ7449376 GARY BELK FIRST TRANSIT BROADSPIRE 12586 FRESNO CLOSED ADJ1433114 ANTONIO RAMIREZ TRINITY BROADCASTING NETWORK BROADSPIRE 24016 FRESNO ADJ1433114 ANTONIO RAMIREZ TRINITY CHRISTIAN CENTER BROADSPIRE 24016 FRESNO ADJ1492803 BARBARA CHAPMAN OLSEN CHEVRON CORP BROADSPIRE 24016 FRESNO ADJ3693930 BULMARO BAHENA PARAMOUNT FARMS, INC. BROADSPIRE 24016 FRESNO ADJ7053320 CHARLES DALRYMPLE AMETEK AEROSPACE BROADSPIRE 24016 FRESNO ADJ2698884 CHRISTOPHER CLAVESILLA DASH TRANSPORTATION BROADSPIRE 24016 FRESNO ADJ4484771 CRUZ CERON STAFFMARK BROADSPIRE 24016 FRESNO ADJ4484771 CRUZ CERON STAFFMARK, INC. BROADSPIRE 24016 FRESNO ADJ1828958 EDVIN ORTIZ AMERICAN MEDICAL RESPONSE BROADSPIRE 24016 FRESNO ADJ2351091 ELIZABETH VILANUEVA STAFFMARK INC BROADSPIRE 24016 FRESNO ADJ7043481 ELSA FERNANDEZ MV TRANSPORTATION BROADSPIRE 24016 FRESNO ADJ7016206 ELSA OCHOA HI NIMBLE BROADSPIRE 24016 FRESNO ADJ7016206 ELSA OCHOA HI NIMBLE CORPORATION BROADSPIRE 24016 FRESNO ADJ7973420 EVELYN MARTINEZ WM BOLTHOUSE FARMS BROADSPIRE 24016 FRESNO ADJ2556205 JAMES NIX FED EX BROADSPIRE 24016 FRESNO ADJ7294171 JUAN DELGADILLO TESORO WEST COAST CO LLC BROADSPIRE 24016 FRESNO ADJ6538368 LUZ LEON CHEVRON BROADSPIRE 24016 FRESNO ADJ7483172 MARIA CARDENAS FEDEX GROUP PKG SYST INC BROADSPIRE 24016 FRESNO ADJ9411016 MARIA CISNEROS 99 CENTS ONLY STORES BROADSPIRE 24016 FRESNO ADJ8736612 MARIA GUADALUPE MEDINA PARAMOUNT CITRUS PACKING BROADSPIRE 24016 FRESNO ADJ8823205 MARIA MONTES PARAMOUNT FARMS INTERNATIONAL BROADSPIRE 24016 FRESNO ADJ7654268 MARIA NUNEZ MV TRANSPORTATION BROADSPIRE 24016 FRESNO ADJ8191986 MICHAEL BEN GRAVES MV TRANSPORTATION BROADSPIRE 24016 FRESNO ADJ7489308 ROSANDA WESTBROOKS THE SPORTS AUTHORITY BROADSPIRE 24016 FRESNO ADJ9591591 TOMAS SANTAMARIA JEAN MART BROADSPIRE 24016 FRESNO ADJ8681759 VILMA COCA PARAMOUNT FARM INTERNATIONAL BROADSPIRE 24016 FRESNO ADJ7171637 ABRAHAM ARANDA PACIFIC GEAR BROADSPIRE BREA ADJ7140227 AMELIA ALVAREZ GC SERVICES BROADSPIRE BREA ADJ7416496 ANTHONY LAVE CHARTER COMMUNICATIONS BROADSPIRE BREA ADJ7208348 ANTONIO DORANTES NATIONAL RETAIL TRANSPORTATION BROADSPIRE BREA ADJ2484549 CANDICE RAGSDALE SECURE PASSES SECURITY USA BROADSPIRE BREA ADJ4135328 CONSUELO GUERRA ABM BROADSPIRE BREA ADJ7609433 DENEANE RATCHFORD ADECCO USA INC BROADSPIRE BREA ADJ7678871 ELIA LOPEZ HUGOS FACTORY INC BROADSPIRE BREA ADJ3319538 ELVA LETICIA PEREZ 99 CENTS ONLY STORES BROADSPIRE BREA ADJ4575102 EVANGELINA SALAZAR NORCO RANCH BROADSPIRE BREA ADJ4575102 EVANGELINA SALAZAR NORCO RANCH INC BROADSPIRE BREA ADJ8004859 FRAGLIN RUIZ CLASSIC PARKING INC BROADSPIRE BREA ADJ653725 FRANK CATHRILL PERRIS UNIFIED SCHOOL DISTRICT BROADSPIRE BREA ADJ653725 FRANK CATHRILL PERRIS UNION HIGH SCHOOL BROADSPIRE BREA ADJ653725 FRANK CATHRILL PERRIS UNION HIGH SCHOOL DISTRICT BROADSPIRE BREA ADJ6687785 GEORGE CAMARGO BAXTER HEALTHCARE CORPORATION BROADSPIRE BREA ADJ8709905 GERSON REYES VASQUEZ WIN SOON DBA EPOCA BROADSPIRE BREA ADJ8709905 GERSON REYES VASQUEZ WIN SOON INC BROADSPIRE BREA ADJ2287368 HECTOR SALVADOR SECURITAS BROADSPIRE BREA ADJ8563644 HECTOR VELA LET IT FLY LLC BROADSPIRE BREA ADJ7007506 INGRID MAYEN ADECCO BROADSPIRE BREA ADJ6906051 IRMA OCHOA ALUMINUM PRECISION PRODUCTS BROADSPIRE BREA ADJ7814152 JORGE LLAMAS GONZALEZ GOLDEN WEST HOMES BROADSPIRE BREA ADJ7033643 LINDA COTE BOEING COMPANY BROADSPIRE BREA ADJ9100018 LIZBETH VILLAGOMEZ DE SALDANA 99 ONLY STORES BROADSPIRE BREA ADJ6766332 LUIS MALDONADO SECURITAS SECURITY SERVICES USA INC BROADSPIRE BREA ADJ8226791 LUIS MORALES RAMADA INN BROADSPIRE BREA ADJ9299264 LUPE ZARAGOZA ACCUPATHDIAGNOSTIC LABORATORIES INC DBA US LABS BROADSPIRE BREA ADJ7373663 MANUELA SANDOVAL CEC ENTERTAINMENT BROADSPIRE BREA ADJ2957631 MARGARITA HERNANDEZ SECURITAS SECURITY SERVICES BROADSPIRE BREA ADJ9411016 MARIA CISNEROS 99 CENTS ONLY STORES BROADSPIRE BREA ADJ7213015 MARIA ELENA PULIDO SECURITAS SECURITY SERVICES BROADSPIRE BREA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ4654376 MARIA GONZALEZ SOURCE ONE STAFFING BROADSPIRE BREA ADJ213370 MARIA KUHAKE SUNBRIDGE CARE & REHAB. BROADSPIRE BREA ADJ707031 MARIA MONDACA A.E.S.S., INC BROADSPIRE BREA ADJ707031 MARIA MONDACA REMEDY TEMPORARY BROADSPIRE BREA ADJ7863014 MARIA MORA HERNANDEZ 99 CENT STORES BROADSPIRE BREA ADJ2951251 MARIANA MADRIGAL 99 CENTS ONLY BROADSPIRE BREA ADJ8808544 MARTHA ALVAREZ 99 CENT ONLY STORE BROADSPIRE BREA ADJ7748882 MARTHA LOPEZ DAVITA INC BROADSPIRE BREA ADJ6943599 MAURA RODRIGUEZ AMERICAN TEXTILE MAINTENANCE BROADSPIRE BREA ADJ8663952 MEKICIA GILLETT UNIVERSITY OF SOUTHERN CALIFORNIA BROADSPIRE BREA ADJ7934932 MICHAEL OREFICE ENTERTAINMENT PARTNERS BROADSPIRE BREA ADJ7934932 MICHAEL OREFICE FSI/FPS SERVICES INC. BROADSPIRE BREA ADJ7934932 MICHAEL OREFICE NBC ULVERSAL BROADSPIRE BREA ADJ4664780 MIKE MEDINA ADECCO STAFFING BROADSPIRE BREA ADJ7303965 MINGQUAN GUO UNIVERSITY OF SOUTHERN CALIFORNIA BROADSPIRE BREA ADJ8613162 NAANA ASANTE RIVERSIDE COMMUNITY HOSPITAL BROADSPIRE BREA ADJ6530616 PROSERPINA TAPIA E AND M RANCH BROADSPIRE BREA ADJ9191959 RAMONA VENTURA CM LAUNDRY BROADSPIRE BREA ADJ7081387 ROBERT SALAZAR AJILON COMMUNICATIONS BROADSPIRE BREA ADJ6548923 ROSA SUAREZ ROYAL CARPET MILLS INC BROADSPIRE BREA ADJ3390153 ROSALBA ARZOLA ADECCO BROADSPIRE BREA ADJ7170449 SAMUEL VALENCIA ROYALTY CARPET MILLS BROADSPIRE BREA ADJ7427619 SHAFIQUL KHAN NOBILE HOUSE HOTELS BROADSPIRE BREA ADJ6536905 VALENTIN CASTANEDA HERNANDEZ ADECCO BROADSPIRE BREA ADJ6885803 VERONICA SANCHEZ SECURITAS USA INC BROADSPIRE BREA ADJ7423773 VICTORIA OLAN SUN BRIDGE CARE AND REHABILITATION BROADSPIRE BREA ADJ6769239 WILL BLACKWELL SECURITAS BROADSPIRE BREA ADJ9617815 XIOMARA SZABO PLAYA DEL REY REHAB BROADSPIRE BREA ADJ9614885 ROSA SALAS PRIDE INDUSTRIES BROADSPIRE CIGA FOLSOM ADJ3690098 ALBERT SNIDER OLYMPIC STAFFING BROADSPIRE CIGA GLENDALE CLOSED ADJ889037 BULMARO SERRANO SKECHERS USA INC BROADSPIRE CIGA GLENDALE CLOSED ADJ889037 BULMARO SERRANO SKETCHERS, USA BROADSPIRE CIGA GLENDALE CLOSED ADJ889037 BULMARO SERRANO TEAM ONE STAFFING BROADSPIRE CIGA GLENDALE CLOSED ADJ889037 BULMARO SERRANO TEAM ONE/SKETCHERS BROADSPIRE CIGA GLENDALE CLOSED ADJ3509612 LAWRENCE THOMPSON MAC ELECTRIC BROADSPIRE CIGA GLENDALE CLOSED ADJ3509612 LAWRENCE THOMPSON MAC ELECTRIC INC BROADSPIRE CIGA GLENDALE CLOSED ADJ1868683 LUIS ZARAGOSA TORRES FOREST RIVER INC BROADSPIRE CIGA GLENDALE CLOSED ADJ3449956 MARIA FERNANDEZ STAFFING SERVICES BROADSPIRE CIGA GLENDALE CLOSED ADJ449949 MARIA PADILLA MIRAMAR SHERATON HOTEL BROADSPIRE CIGA GLENDALE CLOSED ADJ1444958 MELVIN MARTINEZ PRESS ENTERPRISE BROADSPIRE CIGA GLENDALE CLOSED ADJ3794387 PETER SHERWOOD ISLAND CONSTRUCTION BROADSPIRE CIGA GLENDALE CLOSED ADJ3820772 RODIMIRO FIGUEROA MI RANCHO TORTILLA SHOP BROADSPIRE CIGA GLENDALE CLOSED ADJ397720 BRENDA CHAN SEES CANDY BROADSPIRE CONCORD ADJ397720 BRENDA CHAN SEE`S CANDY SHOPS INC BROADSPIRE CONCORD ADJ6490670 JORGE UBEDA VERTIS COUMMINCATIONS BROADSPIRE CONCORD ADJ9104083 MONSERRAT CABRERA ISS FACILITY SERVICES INC SAN DIEGO BROADSPIRE CONCORD ADJ4333427 ALAN KLINKER COCA COLA BOTTLING COMPANY BROADSPIRE SACRAMENTO ADJ7860628 CRISTINO MENDOZA IMPERIAL PARKING BROADSPIRE SACRAMENTO ADJ4575102 EVANGELINA SALAZAR NORCO RANCH BROADSPIRE SACRAMENTO ADJ4575102 EVANGELINA SALAZAR NORCO RANCH INC BROADSPIRE SACRAMENTO ADJ8932940 GABRIEL BENITEZ SOUTHERN PACPIZZA LLC DBA PIZZA HUT BROADSPIRE SACRAMENTO ADJ8932940 GABRIEL BENITEZ TARGET CORPORATION BROADSPIRE SACRAMENTO ADJ8290825 GREGORIO BRITO NEW SEOUL BBQ BUFFET RESTAURANT BROADSPIRE SACRAMENTO ADJ8556440 JOSE PEDRO BUENO NORMS RESTAURANTS BROADSPIRE SACRAMENTO ADJ7050145 LIGIA RODRIGUEZ PERRY ELLIS INTERNATIONAL BROADSPIRE SACRAMENTO ADJ7532310 MARIA BONILLA BEST WESTERN RAFFLES INN BROADSPIRE SACRAMENTO ADJ8328143 MARIA VARELA WYNDHAM DBA ROS ANNA INC BROADSPIRE SACRAMENTO ADJ8280227 MICAELA BAUTISTA PINAS NEWPORT TAFT HAMPTON INN SEAWORLD BROADSPIRE SACRAMENTO ADJ840726 NORMA VALLE SKILL MASTER BROADSPIRE SACRAMENTO ADJ7145906 ROBERTO RODRIGUEZ CH2MHILL BROADSPIRE SACRAMENTO ADJ7261977 SANTIAGO RAYA TALENT TREE CRYSTAL BROADSPIRE SACRAMENTO ADJ7261977 SANTIAGO RAYA TALENT TREE CRYSTAL INC BROADSPIRE SACRAMENTO ADJ9276030 STACEY DOMINGUEZ FOREVER 21 BROADSPIRE SACRAMENTO ADJ1792244 VICENTE ROSAS EARL SCHEIB BROADSPIRE SACRAMENTO ADJ1792244 VICENTE ROSAS EARL SCHEIB PAINT & BODY BROADSPIRE SACRAMENTO ADJ8336892 ZOILA CORTEZ ES RING MANAGEMENT CORP BROADSPIRE SACRAMENTO ADJ3732074 CARY BARNETT THE BOEING CO BROADSPIRE SERVICES ADJ6978484 FLAVIO PENA BROOKLYN THRIFT STORE BROOKLYN THRIFT STORE ADJ4016356 MARIA CAAMAL BUDGET MOTEL BUDGET MOTEL ADJ7728189 GRACIELA RAMOS BUFFETS INC BUFFETS INC ADJ7726434 GABRIEL RODRIGUEZ BUN BOY BUN BOY ADJ4676421 ROBERT BARRON AVL STAFFING CA SELF INSURED SECURITY FUND ESTATE MAINSTAY ADJ4676421 ROBERT BARRON CA SELF INSURED SECURITY FUND ESTATE MAINSTAY CA SELF INSURED SECURITY FUND ESTATE MAINSTAY ADJ2430419 HECTOR RODRIQUEZ ARCHIBALD TIMBER CALIF COMPENSATION & FIRE CO ADJ449949 MARIA PADILLA MIRAMAR SHERATON HOTEL CALIF COMPENSATION & FIRE CO ADJ3271853 ALFONSO SERNA TOWER STAFFING SOLUTIONS CALIF COMPENSATION & FIRE CO/BROADSPIRE ADJ3271853 ALFONSO SERNA TOWER TEMPS CALIF COMPENSATION & FIRE CO/BROADSPIRE ADJ367455 VICTORIA SARGENT DENNY'S/QLC MANAGEMENT CALIF COMPENSATION & FIRE CO/BROADSPIRE ADJ367455 VICTORIA SARGENT DONAHUE ENTERPRISES CALIF COMPENSATION & FIRE CO/BROADSPIRE CALIF COMPENSATION & FIRE CO/INTERCARE INSURANCE ADJ2119074 MARIA SEVELINA ORTIZ COMMAND PACKAGING SERVICES CALIF COMPENSATION & FIRE CO/TRISTAR CLAIMS ADJ4184537 VIVIAN LELCESONA BRASWELL HAMPTON MANOR MANAGEMENT CALIF COMPENSATION & FIRE CO/TRISTAR CLAIMS ADJ4184537 VIVIAN LELCESONA BRASWELL'S HAMPTON MANOR MANAGEMENT ADJ1891794 JUAN MORELOS TAG TOYS INC CALIFORNIA INDEMNITY INS CO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9206709 ABRAHAM TORRES METROPOLITAN AUTOMOTIVE WAREHOUSE CALIFORNIA INSURANCE COMPANY ADJ9156031 EUTIMIO MARTINEZ TW SERVICES CALIFORNIA INSURANCE COMPANY ADJ3839139 MARTIN CORONA WEST COAST METAL FINISHING CALIFORNIA INSURANCE COMPANY ADJ9850699 NORBERTO GARRIDO ROYAL CUSTOM DESIGNS LLC CALIFORNIA INSURANCE COMPANY ADJ8942565 OSCAR DIAZ CLASSIC DISTRIBUTIION BEVERAGE CALIFORNIA INSURANCE COMPANY ADJ10119960 URBANO GUADARRAMAA OCONNEL LANDSCAPE MAINTENANCE CALIFORNIA INSURANCE COMPANY ADJ4184537 VIVIAN LELCESONA BRASWELL HAMPTON MANOR CALIFORNIA INSURANCE GUARANTEE ASSN ADJ4184537 VIVIAN LELCESONA BRASWELL'S HAMPTON MANOR CALIFORNIA INSURANCE GUARANTEE ASSN ADJ7873579 JULIAN HURTADO VELA CALIFORNIA PIZZA KITCHEN INC CALIFORNIA PIZZA KITCHEN INC ADJ1323591 ANTHONY COUCH CITY OF LOS ANGELES CAMBRIDGE INT. SERVICES ADJ3116907 YOLANDA MARTINEZ CALSONICKANSEI NORTH AMERICA INC CAMBRIDGE INTEGRATED SERVICE ADJ764181 BELLVETT GARCIA COUNTY OF LOS ANGELES CAMBRIDGE INTEGRATED SERVICES ADJ2356638 ARMANDO AREVALO LEON TORO STONEWORKS, INC. CAMBRIDGE PASADENA CLOSED ADJ2181966 HOWARD MACK L.A. COUNTY/PUBLIC HEALTH PROGRAMS CAMBRIDGE PASADENA CLOSED ADJ1342888 JOSE PINEDO CLAIM JUMPER CAMBRIDGE PASADENA CLOSED ADJ1342888 JOSE PINEDO CREATIVE TEACHING PRESS INC. CAMBRIDGE PASADENA CLOSED ADJ4645734 MICHAEL CROUGH MCDONNELL DOUGLAG AIRCRAFT CAMBRIDGE PASADENA CLOSED ADJ6588458 RALPH ESPINOZA COUNTY OF ORANGE CAMBRIDGE PASADENA CLOSED ADJ877167 ROBERT GRIFFIN COUNTY OF LOS ANGELES/DWP CAMBRIDGE PASADENA CLOSED ADJ1893763 SHERA LLOYD SIZZLER CAMBRIDGE PASADENA CLOSED ADJ2295547 SHIRLEY LEVASSEUR SORENSON CHILDRENS HOSPITAL CAMBRIDGE PASADENA CLOSED ADJ2260315 ZINA CAMP LLOYD LOS ANGELES COUNTY PROBATION CAMBRIDGE PASADENA CLOSED ADJ6493455 RAUL GONZALEZ COMPASS GROUP USA DBA BON APPETIT CAMBRIDGE PORTLAND ADJ2914747 BENITO MATA DEDICATED TRANSPORTATION CAMBRIDGE SAN DIEGO CLOSED ADJ6643505 BERTA MARTINEZ CINTAS CORPORATION CAMBRIDGE SAN DIEGO CLOSED ADJ1621412 CARLOS ORREGO RESEDA AUTO & ELECTRIC CAMBRIDGE SAN DIEGO CLOSED ADJ3060574 CONSUELO AMADOR JIMWAY INC CAMBRIDGE SAN DIEGO CLOSED ADJ2138625 DANIEL HERNANDEZ THE EASTRIDGE GROUP CAMBRIDGE SAN DIEGO CLOSED ADJ2599566 EDNA LOPEZ OLD DOMINION FREIGHT LINE CAMBRIDGE SAN DIEGO CLOSED ADJ3642436 LUCRECIA BARAJAS ST JOHN CAMBRIDGE SAN DIEGO CLOSED ADJ1261773 MARGARITA SOTELO ST. JOHN CAMBRIDGE SAN DIEGO CLOSED ADJ3426967 SANDRA LANZA GCB COMMUNICATIOS, INC CAMBRIDGE SAN DIEGO CLOSED ADJ791804 SHAWN PETTUS PRESTIGE STAFFING SERVICES CAMBRIDGE SAN DIEGO CLOSED ADJ3988189 STEVE OROPEZA OLD DOMINION FREIGHT LINE CAMBRIDGE SAN DIEGO CLOSED ADJ3813888 ANGIE WARD TELETECH CANNON COCHRAN CONCORD ADJ7279492 ANTONIO OJEDA RED ROBIN GOURMET BURGERS CANNON COCHRAN CONCORD ADJ7188510 DANIEL GUERRA CORNERSTONE CANNON COCHRAN CONCORD ADJ6556935 GERARDO VASQUEZ RED ROBIN CANNON COCHRAN CONCORD ADJ7905927 JERONIMO VASQUEZ RUAN TRANSPORT CORPORATION CANNON COCHRAN CONCORD ADJ8843123 JOSE GALVAN CENTAL VALLEY MEAT CANNON COCHRAN CONCORD ADJ8843123 JOSE GALVAN CENTRAL VALLEY MEAT CANNON COCHRAN CONCORD ADJ8399117 JOSEFA LARA DRESICK FARMS INC CANNON COCHRAN CONCORD ADJ8324878 MARIA ELENA ORTIZ MILLENNIUM BILTMORE HOTEL CANNON COCHRAN CONCORD ADJ9424203 ALBERTO LAGUNAS HERNANDEZ PERFORMANCE BUILDING SERVICE CANNON COCHRAN IRVINE ADJ9275722 ALEJANDRO NAVA EL DORADO NATIONAL CANNON COCHRAN IRVINE ADJ8544005 BRENDA HERNANDEZ DMS SERVICE CANNON COCHRAN IRVINE ADJ1180504 DAVID GAXIOLA SCHER TIRE INC CANNON COCHRAN IRVINE ADJ7427611 EMILIO RAMOS FLYING J INC CANNON COCHRAN IRVINE ADJ8574575 EMY OLIVEROS CIRCLE FOODS CANNON COCHRAN IRVINE ADJ8033510 JOSE ORTEGA GREAT CIRCLE FAMILY FOODS CANNON COCHRAN IRVINE ADJ8108894 LUIS SANCHEZ GARCIA PERFORMANCE BUILDING SERVICES CANNON COCHRAN IRVINE ADJ9251078 MARIA MOLINA GREAT CIRCLE FAMILY FOODS LLC CANNON COCHRAN IRVINE ADJ6961470 MARIANA RANGEL IN N OUT BURGERS CANNON COCHRAN IRVINE ADJ7319072 MARIO FABELA STAFFMARK COMPANY CANNON COCHRAN IRVINE ADJ9356096 MONICA ALVARADO STAR FI SHERIES CANNON COCHRAN IRVINE ADJ8903249 OSWALSO SOLIS STAFFMARK INC CANNON COCHRAN IRVINE ADJ6957539 YESENIA GUTIERREZ PACIFIC BUILDING CARE INC CANNON COCHRAN IRVINE ADJ8062320 LORENA ALVAREZ ST JOHN KNITS CANNON COCHRAN IRVINE ADJ3813888 ANGIE WARD TELETECH CANYON COACH MGMT ADJ1410539 CARMEN BLANDON DISABLED AMERICAN VETERANS CARE WEST PEGASUS MODESTO ADJ1410539 CARMEN BLANDON DISABLED AMERICAN VETS CARE WEST PEGASUS MODESTO ADJ1410539 CARMEN BLANDON DISABLED VETERANS CHARITIES CARE WEST PEGASUS MODESTO ADJ8429816 FIDEL GUZMAN SUPERIOR STORE CARE WEST PEGASUS MODESTO ADJ7464339 JOSEFINA ZUNIGA SUPERIOR SUPER WHOLESALE CARE WEST PEGASUS MODESTO ADJ7308695 MARIA ZAMUDIO STAFF CHEX CARE WEST PEGASUS MODESTO ADJ6778282 ROSALBA HERNANDEZ SOLIS SUPERIOR SUPER WAREHOUSE CARE WEST PEGASUS MODESTO ADJ7833626 ANGELICA GARCIA PREFERRED PERSONNEL CARL WARREN TUSTIN ADJ9294286 ANTONIO CAUDILLO VESSEY AND COMPANY CARL WARREN TUSTIN ADJ7639963 CONNIE PARTIDA CARDENAS MARKET CARL WARREN TUSTIN ADJ772519 DAVID ROSALES VILLAGE NURSERIES CARL WARREN TUSTIN ADJ8603920 ENRIQUE PEREZ TORRES FARM LABOR CARL WARREN TUSTIN ADJ8075875 EULOGIO JAIMES PREFERRED PERSONNEL CARL WARREN TUSTIN ADJ7941897 EUSTAQUIO SANDOVAL CARDENAS MARKETS INC CARL WARREN TUSTIN ADJ731669 GLORIA VILLALTA MERCHANTS CARL WARREN TUSTIN ADJ8061003 IRMA ESPINOZA VALLARTA MARKET 8 CARL WARREN TUSTIN ADJ8524630 JEFFRY ESTRADA CORPORATE PERSONNEL NETWORK CARL WARREN TUSTIN ADJ8193220 JESUS PEREZ PREFERRED PERSONNEL CARL WARREN TUSTIN ADJ9128006 JORGE RICO CERDA CALIFORNIA AG SERVICES INC CARL WARREN TUSTIN ADJ9490630 JOSE LUIS M AVILA HERRERA SOURCE ONE STAFFING CARL WARREN TUSTIN ADJ9473724 JUAN RODRIGUEZ SUPER CENTER CONCEPTS INC DBA SUPERIOR GROCERS CARL WARREN TUSTIN ADJ7652471 KENNETH KOTTWITZ HERZOG CONTRACTING CORPORATION CARL WARREN TUSTIN ADJ7032950 LASHICA LOWE APC CORPORATION CARL WARREN TUSTIN ADJ8214251 MANUEL ORTEGA SERVICON SYSTEM CARL WARREN TUSTIN ADJ7906862 MARIA CAMACHO SERVICON SYSTEMS INC CARL WARREN TUSTIN ADJ1320892 MARIA GARCIA SERVI COM SYSTEM CARL WARREN TUSTIN ADJ6961470 MARIANA RANGEL IN N OUT BURGERS CARL WARREN TUSTIN Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8109803 MARICELA MEDINA CARDENAS CARL WARREN TUSTIN ADJ6624656 MELQUIADES RAMIREZ ROYAL COURT-ENSIGN GROUP CARL WARREN TUSTIN ADJ8894970 NORA CABRERA FALCON FARMS CARL WARREN TUSTIN PATRICIA AKA GUADALUPE MEDINA AKA ADJ7915234 PREFERRED PERSONNEL CARL WARREN TUSTIN MENDOZA PATRICIA AKA GUADALUPE MEDINA AKA ADJ7915234 PREFERRED PERSONNEL INC CARL WARREN TUSTIN MENDOZA ADJ4235345 RAUL REYES VILLAGE NURSERIES CARL WARREN TUSTIN ADJ4235345 RAUL REYES VILLAGE NURSERY CARL WARREN TUSTIN ADJ7419457 VICTORIA DE MORALEZ SERVICON SYSTEMS INC CARL WARREN TUSTIN ADJ7432791 INOCENSIO HURTADO MACARIOS TREE SERVICE CASTLEPOINT NATIONAL INS IRVINE ADJ8887846 JOSE CUELLAR SAMAYOA DOMINOS PIZZA CASTLEPOINT NATIONAL INS IRVINE ADJ401458 PATRICA URENDA HORIZON HOBBY CCMSI ADJ8837627 ERICA GALVAN CENTER CONCEPTS CENTER CONCEPTS ADJ4394971 MARCO RAMIREZ GLASSTONE, INC. CHARTIS ADJ7403630 NELSON URRUTIA GURIDO DORA SARIP OF SM CHARTIS COSTA MESA ADJ7507360 MANUEL ESTALA SC STAFFING SOLUTIONS CHARTIS INSURANCE ADJ9002519 RENE SOLIS CHEMCOR CHEMICAL CORPORATION CHEMCOR CHEMICAL CORPORATION ADJ6538368 LUZ LEON CHEVRON CHEVRON SAN RAMON ADJ6461713 CLARK HARDMAN CHICAGO CUBS BASEBALL CLUB CHICAGO CUBS BASEBALL CLUB ADJ9146133 ALMA ADAN DESIGN WEST TECHNOLOGIES CHUBB GROUP LOS ANGELES ADJ7940993 ANA RODRIGUEZ FOREVER 21 INCORPORATED CHUBB GROUP LOS ANGELES ADJ7940993 ANA RODRIGUEZ FOREVER 21 LOGISTICS CHUBB GROUP LOS ANGELES ADJ9557851 ASUNCION LOPEZ MAGNA FLOW CHUBB GROUP LOS ANGELES ADJ9271440 BERTA CASTANEDA SYNNEX CORP CHUBB GROUP LOS ANGELES ADJ2911407 CARITINA DOMINGUEZ OSI OPTOELECTRONICS, INC CHUBB GROUP LOS ANGELES ADJ9413858 CECILIA MELGARES ALGONIC PARTNERS CHUBB GROUP LOS ANGELES ADJ7764256 DELMI ARGUETA FOREVER 21 LOGISTICS LLC CHUBB GROUP LOS ANGELES ADJ9398135 EMMA MONTIEL UNITED PHARMA CHUBB GROUP LOS ANGELES ADJ8995731 EULOGIO ESPINOSA JR LA CARE HEALTH PLAN CHUBB GROUP LOS ANGELES ADJ6790122 FRANCISCO MARTINEZ HOLLYWOOD RENTALS CHUBB GROUP LOS ANGELES ADJ8310387 ISMAEL LUGARDO NAVA CAPTEK SOFTGEL INTERNATIONAL CHUBB GROUP LOS ANGELES ADJ7414250 JASMINE MCGOWAN AMERICAN HOME MORTGAGE INC CHUBB GROUP LOS ANGELES ADJ4588249 JENNIFER TURNER HANGER PROSTHETICS & ORTHOTICS CHUBB GROUP LOS ANGELES ADJ8842358 JOAQUIN LOPEZ BIGHORN GOLF CLUB CHUBB GROUP LOS ANGELES ADJ7570525 JOSE DEL CID RIVERA TAHQUITZ CREEK GOLF CHUBB GROUP LOS ANGELES ADJ6513972 JOSE MUNIZ QSC AUDIO PRODUCTS CHUBB GROUP LOS ANGELES ADJ8917011 JUAN ALVARADO GOGLANIAN BAKERIES CHUBB GROUP LOS ANGELES ADJ7393438 JUAN MARTINEZ DECRA ROOFING SYSTEMS INC CHUBB GROUP LOS ANGELES ADJ8266506 JUAN TABARES BALBOA WATER GROUPS INC CHUBB GROUP LOS ANGELES ADJ186059 JULIETA TOVES OPEN SOLUTIONS CHUBB GROUP LOS ANGELES ADJ9419883 LUIS HERNANDEZ ALTRO USA INC CHUBB GROUP LOS ANGELES ADJ1449428 LUZ MEZA SELECT PERSONNEL SERVICE CHUBB GROUP LOS ANGELES ADJ2391384 LUZ MEZA SELECT PERSONNEL SERVICE CHUBB GROUP LOS ANGELES ADJ7539463 MARIA TOVAR BALBOA WATER GROUP CHUBB GROUP LOS ANGELES ADJ6648325 MAXIMINO GONZALEZ ALEXANDER NAWROCKI CHUBB GROUP LOS ANGELES ADJ8894974 MICHAEL PLAYER RELIANCE STANDARD LIFE INSURANCE CHUBB GROUP LOS ANGELES ADJ9598260 PATRICIA MELGOZA AMERICAN INTERNATIONAL CHUBB GROUP LOS ANGELES ADJ9442114 RAMON HERNANDEZ ARCHITECTURAL ICI MILLWORK CHUBB GROUP LOS ANGELES ADJ6980500 RAUL ROMAN PINA GUCKENHEIMER ENTERPRISES INC CHUBB GROUP LOS ANGELES ADJ8048910 RICARDO CHILLON HYATT REGENCY CHUBB GROUP LOS ANGELES ADJ1508960 ROBERTO MARTINEZ ROBINSON RANCH CHUBB GROUP LOS ANGELES ADJ3718665 RON SABATINI GRIFFIN TECHNOLOGY INC CHUBB GROUP LOS ANGELES ADJ9661507 ROSA MELENDEZ LISA EDWARD CHUBB GROUP LOS ANGELES ADJ8308233 RUTH HAMMOND CLARK PHNSINC CHUBB GROUP LOS ANGELES ADJ9316352 RUTH USHER PURPLE COMMUNICATIONS CHUBB GROUP LOS ANGELES ADJ482724 SALVADOR CRUZ HAYWARD INDUSTRIES INC CHUBB GROUP LOS ANGELES ADJ9012359 SAMUEL CAMM SPACEX CHUBB GROUP LOS ANGELES ADJ7407658 VICTOR CRUZ SUMMER INFANT INC CHUBB GROUP LOS ANGELES ADJ7350981 DESIREE LEWIS CHUGACH MCKINLEY CHUGACH MCKINLEY ADJ6820667 JAVIER RODRIGUEZ ECHOS OF FAITH REVIVALS INC CHURCH MUTUAL MERRILL ADJ7361017 MARIA RAMIREZ PROSPECT MANOR CIGA ADJ8847421 ANTONIA SALGADO RAMIREZ SUPPORT SERVICES OF AMERICA CIGA GLENDALE ADJ1489539 AURA ESTRADA REMEDY INTELLIGENT STAFFING CIGA GLENDALE ADJ9060130 BEATRIZ RAMON SOCAL GARMENT LLC CIGA GLENDALE ADJ8845696 CIRINO JACOBO LOCKHART STAFFING SMART TEK AUTOMATED SERVICES CIGA GLENDALE ADJ8845696 CIRINO JACOBO VENTURA REGIONAL SANITATION DISTRICT CIGA GLENDALE ADJ8736942 DOLORES FLORES WARE STAFFING CIGA GLENDALE ADJ7358832 FERNANDO FLORES PACIFIC FORD CIGA GLENDALE ADJ9598454 JESUS BUENAVENTURA PLATINUM STAFFING CIGA GLENDALE ADJ7932700 JUAN SUAREZ KKW TRUCKING INC CIGA GLENDALE ADJ8494709 LORENA CAMPOS PAMA MANAGEMENT CIGA GLENDALE ADJ8717741 MARIA CASTRO CIGA GLENDALE ADJ9633295 MARTHA MARTINEZ TRI STATE STAFFING CIGA GLENDALE ADJ7875439 MERCEDES SILVA ORION DISTRIBUTION CORP CIGA GLENDALE ADJ8168589 OLIVIA RIVERA VALLEY AG INC CIGA GLENDALE ADJ9442114 RAMON HERNANDEZ ARCHITECTURAL ICI MILLWORK CIGA GLENDALE ADJ933029 SILVIA GARCIA ALLIED WEST PAPER CORP. CIGA GLENDALE ADJ8004771 MARTHA FUENTES TRI STATE STAFFING EMPLOYMENT CIGA GLENDALE ADJ968312 CARMEN PEREZ CARDENAS MARKETS INC CIGA INTERCARE ORANGE ADJ7054848 YVANGNA GARCIA WARESTAFF LLC CIGA INTERCARE ORANGE REDLANDS EMPLOYMENT SERVICES DBA ARROW STAFFING ADJ7558169 MARIA TOVAR DE MORALES CIGA TRISTAR RANCHO CORDOVA AGENCY ADJ9424034 MARIBEL RIVERA GALINDO BL TEE CIGA TRISTAR RANCHO CORDOVA ADJ158202 NANCY RASHADA LOS ANGELES COUNTY CIS/PRESIDIUM ADJ7764641 CESAR ROMO CITY OF BURBANK CITY OF BURBANK Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ2699988 DAVID ROSA CITY OF LONG BEACH CITY OF LONG BEACH ADJ3233170 MIRTHA ESTHER GUEVARA CITY OF LONG BEACH CITY OF LONG BEACH ADJ7750198 CARLOS MAYA CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ7750198 CARLOS MAYA CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ7023574 DEMETURIUS MATTHEWS CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ4267463 DONNA HARRIS CITY OF L.A. RECREATION & PARKS CITY OF LOS ANGELES ADJ8132420 FLORA STEWART CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ8132420 FLORA STEWART CITY OF LOS ANGELES COMMUNITY DEPT CITY OF LOS ANGELES ADJ8119871 FRANK DOMINGUEZ CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ8119871 FRANK DOMINGUEZ CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ685417 GARY HAYES CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ6513975 GLORIA JACKSON CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ9074771 GUSTAVO RAMIREZ CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ9074771 GUSTAVO RAMIREZ CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ8279851 JANA MARTINEZ CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ2058943 JOSE GARCIA CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ7349731 JOSEPH CAMPION CITY OF LOS ANGELES WASTE AND WATER CITY OF LOS ANGELES ADJ7562405 JOSEPH GIVENS CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ7562405 JOSEPH GIVENS CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ1733084 JUSTINA PAQUE CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ7839946 KRISSY HUFF CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ1327461 LEON MEDINA CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ7527722 LLOYD CANO CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ7527722 LLOYD CANO CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ8144317 MARGUERITA CHENIER CITY OF LOS ANGELES ANIMAL SERVICES SHELTER CITY OF LOS ANGELES ADJ964728 MARZETTE HENRY CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ8572548 PATRICIA STOUT CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ7892460 RAFAEL REZA CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ834383 RICHARD ROMAN CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ9419556 SALVADOR MIRANDA CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ8855340 SERENE CHEN PANG CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ6981175 TIMOTHY TURNER CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ7339000 ULRIC PATTILLO CITY OF LOS ANGELES CITY OF LOS ANGELES ADJ7349731 JOSEPH CAMPION CITY OF LOS ANGELES WASTE AND WATER CITY OF LOS ANGELES WASTE AND WATER ADJ8921595 GEFEI SUN CITY OF LOS ANGELES DEPT OF WATER AND POWER CITY OF LOS ANGELES DEPT OF WATER AND POWER ADJ834383 RICHARD ROMAN CITY OF LOS ANGELES CITY OF LOS ANGELES WORKERS' COMP SECTION ADJ2815948 DAVID CABRERA CITY OF RIVERSIDE CITY OF RIVERSIDE ADJ118647 ANJA FREEMAN SAN DIEGO FIRE DEPT CITY OF SAN DIEGO ADJ456236 MARGARITA RUIZ MERCURY DIE & CONTAINER CLAIM QUEST ADJ9076839 ARMANDO RAMIREZ ABM BUILDING VALUE CLAIMQUEST WALNUT ADJ9076839 ARMANDO RAMIREZ MERCHANTS BUILDING MAINTENANCE CLAIMQUEST WALNUT ADJ8091250 CAROLINE NGUYEN HOAG MEMORTAL HOSPITAL PRESBYTERIAN CLAIMQUEST WALNUT ADJ9020429 FRANCISCA ESTRADA ARGIL AND DALIT ARGIL CLAIMQUEST WALNUT ADJ7970405 GABRIEL ACEVES AMCOR SUNCLIPSE NORTH AMERICA CLAIMQUEST WALNUT ADJ7208747 JAMES WHYTE BEST DEDICATED CLAIMQUEST WALNUT ADJ7208747 JAMES WHYTE FURNITURE TRANSPORTATION SERVICE CLAIMQUEST WALNUT ADJ7037635 JOSE CEBALLOS GUARDS SYSTEMS INC CLAIMQUEST WALNUT ADJ8086987 MANUEL CONTRERAS MERCHANTS BUILDING MAINTENANCE CLAIMQUEST WALNUT ADJ2951251 MARIANA MADRIGAL 99 CENTS ONLY CLAIMQUEST WALNUT ADJ7697710 MARY OAXACA BRETT & KIMBERLY ENGSTROM CLAIMQUEST WALNUT ADJ7469621 OCTAVIO BENITO MERCHANTS BUILDING MAINTENANCE LLC CLAIMQUEST WALNUT ADJ940510 RAFAEL SANCHEZ PARCO INC CLAIMQUEST WALNUT ADJ6730877 RITA FIGUEROA KIRKWOOD OF ORANGE CLAIMQUEST WALNUT ADJ1923391 MIGUEL GOMEZ ROYAL ROOFING COMPANY CLAIMS ADMINISTRATION (INDEPENDING ADJ3283523 JOSE LOPEZ SUBURBAN PLASTERING CLAIMS CONSLUTANT ADJ3283523 JOSE LOPEZ SUBURBAN PLASTERING/PROLINE PLASTER CLAIMS CONSLUTANT ADJ889037 BULMARO SERRANO SKECHERS USA INC CLARENDON NATIONAL INSURANCE CO ADJ889037 BULMARO SERRANO SKETCHERS, USA CLARENDON NATIONAL INSURANCE CO ADJ889037 BULMARO SERRANO TEAM ONE STAFFING CLARENDON NATIONAL INSURANCE CO ADJ889037 BULMARO SERRANO TEAM ONE/SKETCHERS CLARENDON NATIONAL INSURANCE CO ADJ1506394 ROGELIO MENDOZA RELIANCE MAINTENANCE SERV.,INC. CLARENDON NATIONAL INSURANCE CO/INSERVE ADJ1506394 ROGELIO MENDOZA RELIANCE MAINTENANCE SERVICES INC CLARENDON NATIONAL INSURANCE CO/INSERVE CLARENDON NATIONAL INSURANCE CO/TARHEEL INSURANCE ADJ1506394 ROGELIO MENDOZA RELIANCE MAINTENANCE SERV.,INC. MANAGEMENT CO CLARENDON NATIONAL INSURANCE CO/TARHEEL INSURANCE ADJ1506394 ROGELIO MENDOZA RELIANCE MAINTENANCE SERVICES INC MANAGEMENT CO ADJ3142895 EDGAR MENDEZ CLOUGHERTY PACKING LLC/DOES 1 TO 50 CLOUGHERTY PACKING CO ADJ7949507 JOSE TOBAR CLOUGHERTY PACKING LLC CLOUGHERTY PACKING LOS ANGELES ADJ3143970 ROSAURA GARCIA CLOUGHERTY PACKING LOS ANGELES CLOUGHERTY PACKING LOS ANGELES ADJ3143970 ROSAURA GARCIA E.J. FOOD SERVICE, LLC CLOUGHERTY PACKING LOS ANGELES ADJ1029985 CESAR BURGOS HEINAMAN CONTRACT GLAZING CNA CASUALTY OF CALIFORNIA ADJ7215396 ANTONIO OCEGUEDA KITTRICH CORPORATION CNA CLAIMS PLUS ADJ8275517 MODESTO OSUNA CORESLAB INTERNATIONAL CNA CLAIMS PLUS ADJ9193211 ANDRES BARRAGAN H & D MOLDING CO CNA CLAIMS PLUS BREA ADJ9193211 ANDRES BARRAGAN WEST COAST METRIC INC CNA CLAIMS PLUS BREA ADJ7014569 ANGEL GOMEZ KING TACO CNA CLAIMS PLUS BREA ADJ7060280 AURELIA FLORES AVALON AUTO SUPPLY CNA CLAIMS PLUS BREA ADJ6966946 BERTA CLARA AVIS RENT A CAR SYSTEMS CNA CLAIMS PLUS BREA ADJ7424772 BERTHA GUTIERREZ MANRIYA INC DBA SUBWAY CNA CLAIMS PLUS BREA ADJ7440499 DAVID VARELA CLAIM JUMPER RESTAURANTS CNA CLAIMS PLUS BREA ADJ7711232 ELIAS VARELA PACIFIC WEST LANDSCAPING CO CNA CLAIMS PLUS BREA ADJ8425107 ELSA TRAN EXTRON ELECTRONICS CNA CLAIMS PLUS BREA ADJ7444867 EMELIA GOMEZ OHL CNA CLAIMS PLUS BREA ADJ7222856 ERIBERTO VERA ROSITAS BAKERY CNA CLAIMS PLUS BREA ADJ6632032 ERLINDA VASQUEZ ANGELUS PLAZA CNA CLAIMS PLUS BREA ADJ9147382 GREGORY SMITH SPEEDPRO IMAGING CNA CLAIMS PLUS BREA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6502942 HILDA RAMOS WINDHAM WORLD MARK TREDWEST CNA CLAIMS PLUS BREA ADJ6892121 IRENE AGUILERA SK TEXTILE INC CNA CLAIMS PLUS BREA ADJ6892121 IRENE AGUILERA SK TEXTILE INC. CNA CLAIMS PLUS BREA ADJ7352185 JEFFREY GAMMAGE DIAMOND COMICS DISTRIBUTORS CNA CLAIMS PLUS BREA ADJ8939819 JESUS OCHOA GREYSTAR MANAGEMENT SERVICES CNA CLAIMS PLUS BREA ADJ9506149 JOHNNY GUEVARA UNIVERSAL SECURITY PROTECTION CNA CLAIMS PLUS BREA ADJ6490670 JORGE UBEDA VERTIS COUMMINCATIONS CNA CLAIMS PLUS BREA ADJ7381508 JOSE ALVARADO KING TACO RESTAURANTS INC CNA CLAIMS PLUS BREA ADJ8888988 JUAN ARELLANO JAS SERVICE CORP CNA CLAIMS PLUS BREA ADJ6671578 JUAN CARLOS GRAJEDA MISSRY ASSOCIATES INC CNA CLAIMS PLUS BREA ADJ2840002 JUAN GARCIA CERVANTES AMERICAN AIRLESS CNA CLAIMS PLUS BREA ADJ2840002 JUAN GARCIA CERVANTES AMERICAN KENDA RUBBER INDUSTRIES CNA CLAIMS PLUS BREA ADJ7165592 LILIANA SOLTERO TREND OFFSET PRINTING CNA CLAIMS PLUS BREA ADJ10260191 MANUELA ALVARADO STANDARD TEXTILE CO INC CNA CLAIMS PLUS BREA ADJ8323324 MARCO GALVAN US AIR CONDITIONING DISTRIBUTORS CNA CLAIMS PLUS BREA ADJ9275501 MARGARITO RODRIGUEZ AMERICAN SECURITY PRODUCT CNA CLAIMS PLUS BREA ADJ3777043 MARIA BOJORQUEZ PACIFIC ASSEMBLY CORP CNA CLAIMS PLUS BREA ADJ707031 MARIA MONDACA A.E.S.S., INC CNA CLAIMS PLUS BREA ADJ707031 MARIA MONDACA REMEDY TEMPORARY CNA CLAIMS PLUS BREA ADJ9408736 MARIBEL MARTINEZ UNIVERSAL BUILDING MAINTENANCE CNA CLAIMS PLUS BREA ADJ6710027 MARTA ESPINDOLA PRETIUM PACKAGING CNA CLAIMS PLUS BREA ADJ6983690 MARTIN GONZALEZ WARE DISPOSAL CNA CLAIMS PLUS BREA ADJ6983690 MARTIN GONZALEZ WARE DISPOSAL CO INC CNA CLAIMS PLUS BREA ADJ9338638 MI MOON UNI CAPS CNA CLAIMS PLUS BREA ADJ7641955 MICHELLE DE LA ROSA SUBWAY CNA CLAIMS PLUS BREA ADJ707830 MIRIAM ESPINOLA ESTEY INTERNATIONAL, INC. CNA CLAIMS PLUS BREA ADJ8008023 NOELIA DAVILA SK TEXTILE CNA CLAIMS PLUS BREA ADJ8357479 QINGYUN LI HAWAIIAN GARDENS CASINO CNA CLAIMS PLUS BREA ADJ7605180 ROMAN HERNANDEZ ROLLINGS AUTOMOTIVE CNA CLAIMS PLUS BREA ADJ6619915 ROSARIO RODRIGUEZ HINES HORTICULTURE CNA CLAIMS PLUS BREA ADJ1221880 SALVADOR BARBA WEST CENTRAL PRODUCE CNA CLAIMS PLUS BREA ADJ2164228 SALVADOR JACOBO AMPAM PARKS MECHANICAL INC CNA CLAIMS PLUS BREA ADJ2164228 SALVADOR JACOBO PARKS MECHANICAL CONSTRUCTION CNA CLAIMS PLUS BREA ADJ7319289 SELVIN MENJIVAR KING TACO RESTAURANT CNA CLAIMS PLUS BREA ADJ7620723 SERGIO CONTRERAS WEST COAST INTERIORS INC CNA CLAIMS PLUS BREA ADJ8854860 ZAIDA MONTES AVIS RENT A CAR SYSTEM CNA CLAIMS PLUS BREA ADJ7517147 ZONIA REED BIXBY KNOLLS TOWERS CNA CLAIMS PLUS BREA ADJ7978856 DEANNDRA WORMACK UNIVERSAL PROTECTION SERVICE CNA CLAIMS PLUS BREA ADJ7217426 WALTER CERDERO USA SHADE FABRIC STRUCTURES INC CNA CLAIMS PLUS BREA ADJ8099270 CIPRIANO TORRES VALLARTA MARKET CNA CLAIMS PLUS PORTLAND ADJ7407740 ELIA GASTELUM AVIS RENT A CAR CNA CLAIMS PLUS PORTLAND ADJ7407855 ELIA GASTELUM AVIS RENT A CAR CNA CLAIMS PLUS PORTLAND ADJ6731352 FERNANDO BANALES MODULAR STRUCTURES CNA CLAIMS PLUS PORTLAND ADJ8368013 SELSA CEJA SK TEXTILE CNA CLAIMS PLUS PORTLAND ADJ7922178 DAVID GALVAN HINES NURSERIES INC CNA CLAIMS PLUS SAN FRANCISCO ADJ9254072 MONICA MEJIA HALL MANAGEMENT CNA CLAIMS PLUS SAN FRANCISCO ADJ2099525 CYNTHIA ANN MAHAN WORLDWIDE DREAMS CNA INSURANCE ADJ6539782 ANTHONY TRUJILLO RIVERSIDE REGIONAL COUNTY MEDICAL CENTER CNTY OF RIVERSIDE WORK COMP DIV ADJ2917863 BELINDA WINFIELD DEPT OF PUBLIC HEALTH / RIVERSIDE CNTY OF RIVERSIDE WORK COMP DIV ADJ8961609 CAMELIA SGARLATO RIVERSIDE REGIONAL MEDICAL CENTER CNTY OF RIVERSIDE WORK COMP DIV ADJ3156617 GLORIA PEREZ IHSS/PA CNTY OF RIVERSIDE WORK COMP DIV ADJ157260 WILLIAM MORROW COUNTY OF RIVERSIDE CNTY OF RIVERSIDE WORK COMP DIV ADJ157260 WILLIAM MORROW COUNTY OF RIVERSIDE - HUMAN RESOURC CNTY OF RIVERSIDE WORK COMP DIV ADJ7316042 MARIA VILLAGRANA COCA COLA COCA COLA

ADJ6796372 BRIAN DERAS COCA COLA BOTTLING COMPANY OF SOUTHERN CALIFORNIA COCA COLA BOTTLING COMPANY OF SOUTHERN CALIFORNIA ADJ7106048 SIJIFREDO OROZCO SUAREZ COCA COLA ENTERPRISE COCA COLA ENTERPRISE ADJ9531400 GRACE LAFFERTY ADVANCED CLINICAL EMPLOYMENT STAFFING COMMERCE AND INDUSTRY INSURANCE COMPANY ADJ9531400 GRACE LAFFERTY EMERALD HEALTH SERVICES COMMERCE AND INDUSTRY INSURANCE COMPANY ADJ9531400 GRACE LAFFERTY HEALTHSOURCE GLOBAL STAFFING COMMERCE AND INDUSTRY INSURANCE COMPANY ADJ9531400 GRACE LAFFERTY PROCARE ONE NURSES LLC COMMERCE AND INDUSTRY INSURANCE COMPANY ADJ9531400 GRACE LAFFERTY US NURSING CORP COMMERCE AND INDUSTRY INSURANCE COMPANY ADJ1550339 ANA RODRIGUEZ HILTON HOTEL COMP LINK INC ADJ8279511 JOSE ALMONACI API KIRK CONTAINERS COMP WEST INSURANCE COMPANY ADJ8413337 ABELARDO CARREON JONATHAN LOUIS INTERNATIONAL LTD COMPWEST NEWPORT BEACH ADJ7466789 ADRIANA GARCIA AUTOMAC PARKING 1NC COMPWEST NEWPORT BEACH ADJ7119397 ALEJANDRO NAVA PRADO LA DESSERTS INC COMPWEST NEWPORT BEACH ADJ6625573 ALMA URBINA VICTORY FOAM COMPWEST NEWPORT BEACH ADJ8229315 ANA GONZALEZ HUXTABLES KITCHEN COMPWEST NEWPORT BEACH ADJ7550594 ANGEL PIEDRA ARTHORMADE PLASTICS INC COMPWEST NEWPORT BEACH ADJ1655169 ANGEL SALAZAR CAVALIER COMPWEST NEWPORT BEACH ADJ6907122 ARTURO ROCHA ACROMIL CORP COMPWEST NEWPORT BEACH ADJ9613149 CARLOS GONZALEZ TAMA TRADING CO INS COMPWEST NEWPORT BEACH ADJ2251295 CLAUDIA FLORES MODERN WAY MARKET COMPWEST NEWPORT BEACH ADJ7234536 CURTIS MARKET JCM ENGINEERING COMPWEST NEWPORT BEACH ADJ8881931 DAVID BEASLEY FINANCIAL STATEMENT SERVICE INC COMPWEST NEWPORT BEACH ADJ9509276 DAVID BONILLA EMERALD CITY ASSISTED LIVING COMPWEST NEWPORT BEACH ADJ8279677 DELMY MIRANDA WAY OUT WEST COMPWEST NEWPORT BEACH ADJ2735622 DOUGLAS HARRINGTON REDLANDS AUTO CENTER COMPWEST NEWPORT BEACH ADJ7236423 ELISEO MENDOZA MUTUAL WHOLESALE LIQUOR INC COMPWEST NEWPORT BEACH ADJ691244 ERNESTO AGUAYO BEST LABEL COMPANY INC COMPWEST NEWPORT BEACH ADJ3588382 ERNESTO MARROQUIN HERRERA THE STINKING ROSE COMPWEST NEWPORT BEACH ADJ3588382 ERNESTO MARROQUIN HERRERA THE STINKING ROSE/STINK INC/LA COMPWEST NEWPORT BEACH ADJ6733579 EUGENIO RODRIGUEZ BAS RECYCLING INC COMPWEST NEWPORT BEACH ADJ7083618 FRANCISCO IBARRA ESPINOZA GAINERY CERAMICS NEWPORT TILE COMPWEST NEWPORT BEACH ADJ7083618 FRANCISCO IBARRA ESPINOZA GAINEY CERAMICS INC COMPWEST NEWPORT BEACH Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7619081 FRANCISCO OROZCO ALLOY DIE CASTING CO COMPWEST NEWPORT BEACH ADJ7023629 GEORGINA ALCARAZ MIN-E-CON COMPWEST NEWPORT BEACH ADJ6839368 GUSTAVO ESQUIVEL TOWNE INCL ALLPOINTS COMPWEST NEWPORT BEACH ADJ7283796 ISABEL GARCIA RD RUBBER TECHNOLOGY CORP COMPWEST NEWPORT BEACH ADJ6692488 ISMAEL ARIZAGA WESTERN PACIFIC STORAGE SOLUTIONS COMPWEST NEWPORT BEACH ADJ7829484 JAIRO PATINO RODRIGUEZ AMERICAN NATIONAL MANUFACTURING INC COMPWEST NEWPORT BEACH ADJ8972749 JAVIER PLASCENCIA ACE CLEARWATER ENTERPRISES COMPWEST NEWPORT BEACH ADJ7229389 JESUS PEREZ SPECIALTY MEATS COMPWEST NEWPORT BEACH ADJ7825684 JESUS PEREZ SPECIALTY MEATS COMPWEST NEWPORT BEACH ADJ7827888 JIAN QIANG WU BLUE RIDGE HOME FASHIONS INC COMPWEST NEWPORT BEACH ADJ7775072 JORGE MANJARREZ LONG BEACH SEAFOOD CO COMPWEST NEWPORT BEACH ADJ7775072 JORGE MANJARREZ LONG BEACH SEAFOOD COMPANY COMPWEST NEWPORT BEACH ADJ8077738 JORGE TORRES CAMACHO S INCORPORATED COMPWEST NEWPORT BEACH ADJ8164325 JOSE ORTIZ OFFICE MASTER COMPWEST NEWPORT BEACH ADJ1511230 JOSE QUEZADA WEST COAST SAMPLES COMPWEST NEWPORT BEACH ADJ7755681 JOSEPHINE RODRIGUEZ JUICE HARVEST EVOLUTION FRESH COMPWEST NEWPORT BEACH ADJ660045 JUAN LUNA WELK RESORT CENTER COMPWEST NEWPORT BEACH ADJ8094799 JUAN SORIA SKY MANUFACTURING COMPWEST NEWPORT BEACH ADJ1562155 JUAN ZARAGOZA ALLOY DIE CASTING COMPWEST NEWPORT BEACH ADJ6680320 JULIO NUNO WESTERN SUMMIT FLEXIBLE PACKAGING COMPWEST NEWPORT BEACH ADJ6754809 JUVENTINO HERNANDEZ KOLBE HONDA COMPWEST NEWPORT BEACH ADJ7704667 LEONARDO OSUNA GAINEY CERAMICS INC COMPWEST NEWPORT BEACH ADJ7277901 LETICIA RODRIGUEZ SPECTRUM HOTEL GROUP LLC DOUBLETREE HOTEL IRVINE COMPWEST NEWPORT BEACH ADJ7277901 LETICIA RODRIGUEZ SPECTRUM HOTEL GROUP LLC COMPWEST NEWPORT BEACH ADJ8842560 LILY LUGO DCG FULFILLMENT COMPWEST NEWPORT BEACH ADJ8842560 LILY LUGO GAR LABORATORIES COMPWEST NEWPORT BEACH ADJ8842560 LILY LUGO JC BLINDS MFG INC COMPWEST NEWPORT BEACH ADJ8842560 LILY LUGO NEWPORT THIN FILM LABORATORY INC COMPWEST NEWPORT BEACH ADJ8842560 LILY LUGO STAFF CHEX COMPWEST NEWPORT BEACH ADJ8842560 LILY LUGO TRADEMARK COSMETICS COMPWEST NEWPORT BEACH ADJ7739058 LLURY MONTERROSO CNETURY PLASTICS INC COMPWEST NEWPORT BEACH ADJ6888372 LUIS RODRIGUEZ GA SYSTEMS INC COMPWEST NEWPORT BEACH ADJ7474221 MARCOS MARTINEZ BON APPETIT COMPWEST NEWPORT BEACH ADJ7211296 MARCOS PINEDA JONATHAN LOUIS INTERNATIONAL LTD COMPWEST NEWPORT BEACH ADJ8297619 MARIA BATRES GAINEY CERAMICS COMPWEST NEWPORT BEACH ADJ6806699 MARIA CASTILLO KI`S RESTAURANT BARRY & CATHERINE HOL COMPWEST NEWPORT BEACH ADJ7879448 MARIA FABIAN VENTURA ANWRIGHT CORPORATION COMPWEST NEWPORT BEACH ADJ8115340 MARIA MOLINA JIF-PARK MANUFACTURING COMPWEST NEWPORT BEACH ADJ6718482 MARIA PADILLA RICHARDSONS RV CENTER INC COMPWEST NEWPORT BEACH ADJ7227340 MARIA SANDOVAL QUICKSORT COMPWEST NEWPORT BEACH ADJ7713178 MARIA URENA RAINBOW ACRES NATURAL FOODS NO 3 COMPWEST NEWPORT BEACH ADJ1182120 MARIA VILLAREAL DENCO ENTERPRISES (DBA DENNY'S) COMPWEST NEWPORT BEACH ADJ1182120 MARIA VILLAREAL DENCO ENTERPRISES DBA DENNYS COMPWEST NEWPORT BEACH ADJ8241773 MARTHA JIMENEZ GRINGO VENTURES DBA DOS GRINGOS COMPWEST NEWPORT BEACH ADJ6988408 MARTIN BADILLO DOOR & HARDWARE INSTALLERS INC COMPWEST NEWPORT BEACH ADJ7093830 MAXIMIANO MEDINA ALLOY DIE CASTING CO COMPWEST NEWPORT BEACH ADJ6859445 MILTON MERCADO ALPINE VILLAGE COMPWEST NEWPORT BEACH ADJ7558335 MIRA JUNG KEATING DENTAL ARTS COMPWEST NEWPORT BEACH ADJ8233355 OMAR JIMENEZ CALIFORNIA CREATIVE FOODS COMPWEST NEWPORT BEACH ADJ7863400 PEDRO PEREZ CLIFTON CAFETERIA COMPWEST NEWPORT BEACH ADJ8647490 RAFAEL GUTIERREZ FOAM MOLDERS AND SPECIALTIES COMPWEST NEWPORT BEACH ADJ2547234 RAUL GUARDADO CLUB CARIBE CASINO DBA S & S GAMING COMPWEST NEWPORT BEACH ADJ1333954 RINA BONILLA HUNTLEY HOUSE HOTEL COMPWEST NEWPORT BEACH ADJ7159536 RODOLFO HERNANDEZ RUIZ MEXICAN FOODS COMPWEST NEWPORT BEACH ADJ7159536 RODOLFO HERNANDEZ RUIZ MEXICAN FOODS INC COMPWEST NEWPORT BEACH ADJ9506085 ROXANA CARTAGENA EMERALD CITY ASSISTED LIVING COMPWEST NEWPORT BEACH ADJ7162403 RUBEN GODINEZ R L JONES SAN DIEGO INC COMPWEST NEWPORT BEACH ADJ7162403 RUBEN GODINEZ RL JONES COURTHOUSE BROKERS COMPWEST NEWPORT BEACH ADJ334361 SOMER BERMUDEZ CALIFORNIA BOX INC COMPWEST NEWPORT BEACH ADJ8227232 URIEL AGUILAR FLIGHT LINE PRODUCTS INC COMPWEST NEWPORT BEACH ADJ6987245 VICTOR BACARO FLAIR CLEANERS INC COMPWEST NEWPORT BEACH ADJ7367265 VIOLA TREVINO DOUBLETREE HOTEL COMPWEST NEWPORT BEACH ADJ6876250 YOUNG JANG EXPRESS MAINTENANCE COI INCE COMPWEST NEWPORT BEACH ADJ6876250 YOUNG JANG EXPRESS MAINTENANCE COMPANY INC COMPWEST NEWPORT BEACH ADJ6432822 ZENAIDA SOSA SANTA ANA COMFORT SUITES COMPWEST NEWPORT BEACH ADJ8413337 ABELARDO CARREON JONATHAN LOUIS INTERNATIONAL LTD COMPWEST SAN FRANCISCO ADJ7390485 CARLOS MUNOZ CHARLES JACOBSEN, INC COMPWEST SAN FRANCISCO ADJ6818271 SUSAN COUCH GLEN IVY DAY SPA COMPWEST SAN FRANCISCO ADJ9622844 SUSANA ISLAS ABKCO ENTERPRISES COMPWEST SAN FRANCISCO ADJ8175156 NELSON GONZALEZ CONAM MANAGEMENT CORP CONAM MANAGEMENT CORP ADJ7371212 MICHAEL CARTER CIRCLE K CONSTITUTION DIAMOND BAR ADJ7129720 LAURA BAHMAN SCOLL AND ASSOCIATES CONSTITUTION SAINT PAUL ADJ6710405 CARLOS PAREDES PEP BOYS AUTO CONSTITUTION WALNUT CREEK ADJ7663145 JULIE HUANG CATHAY BANK CONSTITUTION WALNUT CREEK ADJ9746989 NORMA BARAJAS NORTHRIDGE MILLS HOLDINGS CONSTITUTION WALNUT CREEK ADJ9108292 EDUARDO ANGEL CORP29 CORP29 ADJ1919573 PETER MCINTYRE CORRECTIONAL DIVISION 101 CORRECTIONAL DIVISION 101 ADJ7479839 MARITZA VALIENTE DEL TACO CORVEL ADJ7226715 JOSE BAUTISTA EL MARIACHI RESTAURANT CORVEL ADJ7776766 ABELARDO MORALES EVANGELINA NICOLAS CORVEL CHINO ADJ7339311 ALEJANDRA NAJERA JEAN BRUTON CORVEL CHINO ADJ9463078 ALFONSO MIRA KEYES MOTORS CORVEL CHINO ADJ8794680 ANGELA ANTOLIN CENTINELA MEDICAL CENTER CORVEL CHINO ADJ8124527 ANNA LIZA VELEZ CENTINELA HOSPITAL CORVEL CHINO ADJ6930963 ARTHUR GARCIA SAN BERNARDINO COUNTY SUPERINTENDENT OF SCHOOL CORVEL CHINO ADJ7590240 CECILIA LABAYEN HUSTLER EL DORADO ENTERPRISES CORVEL CHINO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ3848218 CYNTHIA GONZALEZ LOS ANGELES COUNTY CORVEL CHINO ADJ8484539 DIANNE MILLER COMPTON UNIFIED CORVEL CHINO ADJ8518624 ELVIA CRUZ DEL TACO REST SERVICES CORVEL CHINO ADJ9011913 FERNANDO GODINEZ VICTORIA PUBLIC GOLF CORVEL CHINO ADJ9011913 FERNANDO GODINEZ VICTORIA PUBLIC GOLF COURSE DBA CORVEL CHINO ADJ9389365 FONDA CADE LYNWOOD UNIFIED SCHOOL DISTRICT CORVEL CHINO ADJ9343975 GLORIANE DIAZ CENTINEL HOSPITAL MEDICAL CENTER CORVEL CHINO ADJ7394820 GUSTAVO CORDOBA V SIONJ LLC CORVEL CHINO ADJ9155924 HERLINDO MORALES LANDRYS CORVEL CHINO ADJ8239943 IRENE MURRAY LA COUNTY OFFICE OF EDUCATION CORVEL CHINO ADJ9060656 IVONNE PETERSON EMERITUS SENIOR LIVING CORVEL CHINO ADJ8579230 JERRY AVILA TOYOTA THOUSAND OAKS CORVEL CHINO ADJ9103504 JORGE CAMARENA LA HYUNDAI AT LAX CORVEL CHINO ADJ8082146 JORGE HERNANDEZ MVD GROUP CORVEL CHINO ADJ8398670 JOSE OJEDA DIVERSIFIED TRANSPORTATION LLC CORVEL CHINO ADJ7610207 JOSE SERRATOS KELLOGG/KEEBLER FOODS CORVEL CHINO ADJ7198625 LILLIAN MONTALVO POMONA UNIFIED SCHOOL DISTRICT CORVEL CHINO ADJ1406622 LOA GRIFFITH MONTEBELLO UNIFIED SCHOOL DISTRICT CORVEL CHINO ADJ7079490 LORENA RIVAS POMONA UNIFIED SCHOOL DISTRICT CORVEL CHINO ADJ8345427 LUZ ZUNIGA FAMSA CORVEL CHINO ADJ4327983 MARGARITA ALBERTS MORENO VALLEY UNIFIED SCHOOL DIST CORVEL CHINO ADJ7967420 MARGARITA FLORES COUNTRY OAKS CORVEL CHINO ADJ6832124 MARIA AQUINO DEL TACO RESTAURANT CORVEL CHINO ADJ7054409 MARIA GUZMAN FEDEX SMART POST CORVEL CHINO ADJ7945689 MARIBEL PEREZ ROMERO BARRETT BUSINESS SERVICES CORVEL CHINO ADJ7945689 MARIBEL PEREZ ROMERO BARRETT BUSINSS SERVICES CORVEL CHINO ADJ7907897 MARTHA ARREOLA LYNWOOD UNIFIED SCHOOL DISTRICT CORVEL CHINO ADJ7907897 MARTHA ARREOLA LYNWOOD USD CORVEL CHINO ADJ2923270 MARY TISCARENO LA COUNTY OFFICE OF EDUCATION CORVEL CHINO ADJ7206795 MAYA LANE LOS ANGELES COUNTY OFFICE OF EDUCATION CORVEL CHINO ADJ7548480 NANCY CAMACHO FRANK TNAG CORVEL CHINO ADJ8835954 RICARDO LOPEZ LEXUS OF VALENCIA CORVEL CHINO ADJ8954761 ROBIN RASK SAN BERNARDINO COUNTY SUPERINTENDANT OF SCHOOLS CORVEL CHINO ADJ7483176 SAI DASYAM PRIME HEALTHCARE SERVICES CORVEL CHINO ADJ7599412 SERBANDO GONZALEZ BED BATH AND BEYOND CORVEL CHINO ADJ9146137 SOFIA LICEA SAN BERNARDINO SUPERIOR COURT CORVEL CHINO ADJ7486437 STEVE TARATULA CITY OF MONTEBELLO CORVEL CHINO ADJ7905824 ZACCHEUS COOPER PASADENA UNIFIED SCHOOL DISTRICT CORVEL CHINO ADJ8119360 MARIA LOMELI DEL TACO CORVEL CHINO ADJ7935011 VERA MENDEZ CORVEL CHINO CORVEL CHINO ADJ7935011 VERA MENDEZ HUNTINGTON BEACH HOSPITAL CORVEL CHINO ADJ9212888 BERNABE CARRANZA BBSI YOUNGS COMERCIAL TRUCKING CORVEL OXNARD ADJ9212888 BERNABE CARRANZA BBSI YOUNGS COMMERCIAL TRUCKING CORVEL OXNARD ADJ3129533 JAMES COCHRAN VENTURA COUNTY SHERIFFS DEPT CORVEL OXNARD ADJ9294601 MONICA SILVA PYRAMID FLOWERS CORVEL OXNARD ADJ8423063 BLADIMIR MEDINA WEST COAST SCAFFOLD CORVEL SACRAMENTO ADJ9066751 CONSTANZA MEDINA VARGAS BARRETT BUSINESS SERVICES CORVEL SACRAMENTO ADJ4504396 DAVID GONZALEZ BARAZINI PAVE STONE, INC. CORVEL SACRAMENTO ADJ9596324 DEANNA AGUILAR BANK OF AMERICA CORVEL SACRAMENTO ADJ9368736 ELVIRA GODINEZ BBSI & LIQUID GRAPHICS CORVEL SACRAMENTO ADJ3820898 HECTOR PEREZ GARZA BBSI/A&S SECURITY CORVEL SACRAMENTO ADJ1442601 INOCENCIO VAZQUEZ BARRETT BUSINESS SERVICES CORVEL SACRAMENTO ADJ1442601 INOCENCIO VAZQUEZ NATIONAL DYEING CO.,INC. CORVEL SACRAMENTO ADJ170456 ISIDRO TORRES AA-1 SERVICES CORVEL SACRAMENTO ADJ7365651 JAVIER DE LA PAZ BBSI CORVEL SACRAMENTO ADJ7210911 JORDAN WARREN CONDA LEE SMITH CORVEL SACRAMENTO ADJ8612811 JOSE MORFIN BBSI SANTA ANA CORVEL SACRAMENTO ADJ7365812 JOSE QUINTERO BARRETT BUSINESS SERV1CES CORVEL SACRAMENTO ADJ7365812 JOSE QUINTERO JIMS CARPET SERVICE CORVEL SACRAMENTO ADJ9519549 JUAN MAYEN MENDEZ THE MENS WAREHOUSE CORVEL SACRAMENTO ADJ8545979 JUAN MUNOZ RODRIGUEZ LANDRYS RESTAURANT INC CORVEL SACRAMENTO ADJ7872007 JULIO FALCON BJS RENTALS INC CORVEL SACRAMENTO ADJ9402671 LUIS MONTERROSO H AND R BLOCK TAX AND BUSINESS SERVICES INC CORVEL SACRAMENTO ADJ7079472 MARIA MARTINEZ GLEN PARK RETIREMENT HOME CORVEL SACRAMENTO ADJ9389653 MERA FIELDS BANK OF AMERICA CORVEL SACRAMENTO ADJ7175279 NICHOLAS TORRES APPLE VALLEY CONSTRUCTION CO CORVEL SACRAMENTO ADJ9852538 ROSA MENDEZ SELECT STAFFING AGENCY CORVEL SACRAMENTO ADJ6939272 RUBEN MEDINA CK TRANSPORT CORVEL SACRAMENTO ADJ7662603 SALVADOR GUZMAN BARRETT BUSSINESS SERVICES CORVEL SACRAMENTO ADJ7673597 SANDRA BRAVO GAP INC CORVEL SACRAMENTO ADJ9567439 TELESIA MCLEAN TRAVELODGE CORVEL SACRAMENTO ADJ8622068 VICTOR LEMUS BBSI CAMARILLO CORVEL SACRAMENTO ADJ7705446 CARMEN SUAREZ FACILITY SERVICES PARTNERS INC CORVEL SAN DIEGO ADJ7594421 CATHERINE EVANS CAPISTRANO UNIFIED SCHOOL DISCTRICT CORVEL SAN DIEGO ADJ8094974 CELIA RODRIGUEZ SUPER MEX RESTAURANTS INC CORVEL SAN DIEGO ADJ9363220 DAMING YANG WANGS GOLDEN ENTERPRISES INC CORVEL SAN DIEGO ADJ7211998 DEAN TRUONG GUARANTY CHEVROLET INC CORVEL SAN DIEGO ADJ9229363 DULCE MARTINEZ GUTIERREZ JINNY ENTERPRISES INC CORVEL SAN DIEGO ADJ8050150 HERNEL SEBASTIAN SIERRA MAZDA OF MONROVIA CORVEL SAN DIEGO ADJ7160049 JAMES MATA TIMMONS VOLKSWAGEN CORVEL SAN DIEGO ADJ9310107 JUAN DE JESUS ORTIZ J & V PROPERTIES CORVEL SAN DIEGO ADJ3845497 MOISES GARCIA EASTER MUNICIPAL WATER DIST CORVEL SAN DIEGO ADJ1205679 SALVADOR OCHOA GOODWILL INDUSTRIES CORVEL SAN DIEGO ADJ9374341 SIXTO BRITO KS TEXTILE INC CORVEL SAN DIEGO ADJ8960946 VINCENT MORENO SELMAN CHEVROLET CORVEL SAN DIEGO ADJ7083611 WENDOLIN CUEVAS BAJA FRESH CORVEL SAN DIEGO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9050022 MARIA FLORES PACKERS SANITATION SERVICES INC COTTINGHAM BUTLER RIALTO ADJ9050022 MARIA FLORES RUSSAKS CURED AND SMOKED PRODUCTS COTTINGHAM BUTLER RIALTO ADJ7770636 ALMA GUTIERREZ COUNTY OF KERN KMC COUNTY OF KERN ADJ9404951 MARIA MARTHA GONZALEZ KERN MEDICAL CENTER COUNTY OF KERN ADJ7398717 KARLENE BAUERLEIN COUNTY OF LA CHILD SUPPORT SERVICES COUNTY OF LA CHILD SUPPORT SERVICES ADJ7398717 KARLENE BAUERLEIN COUNTY OF LOS ANGELES COUNTY OF LA CHILD SUPPORT SERVICES ADJ6702693 CRISTINA HERNANDEZ COUNTY OF LOS ANGELES COUNTY OF LOS ANGELES ADJ9014138 FRANK BARRAGAN COUNTY OF LOS ANGELES COUNTY OF LOS ANGELES ADJ7796707 LAURA MCDOWELL COUNTY OF LOS ANGELES COUNTY OF LOS ANGELES ADJ7382511 SUE WANG COUNTY OF LOS ANGELES COUNTY OF LOS ANGELES ADJ7874608 ALEJANDRO GONZALEZ COUNTY OF LOS ANGELES SHERIFFS DEPT COUNTY OF LOS ANGELES SHERIFFS DEPT ADJ6789089 HAZEL JACKSON COUNTY OF LOS ANGELES USC MEDICAL CENTER COUNTY OF LOS ANGELES USC MEDICAL CENTER COUNTY OF LOS ANGELES/CAMBRIDGE INTEGRATED SERVICES ADJ431091 FRANCES HOLLAND L.A. COUNTY HARBOR UCLA MEDICAL CTR GROUP ADJ157260 WILLIAM MORROW COUNTY OF RIVERSIDE COUNTY OF RIVERSIDE - HUMAN RESOURC ADJ157260 WILLIAM MORROW COUNTY OF RIVERSIDE - HUMAN RESOURC COUNTY OF RIVERSIDE - HUMAN RESOURC ADJ6772685 BRUCE SCOTT SAN BERNARDINO COUNTY COUNTY OF SAN BERNARDINO ADJ3267466 CHRIS FREDERICK COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ9030733 CRYSTAL TAYLOR THOMAS COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ9030733 CRYSTAL TAYLOR THOMAS SAN BERNARDINO COUNTY PROBATION COUNTY OF SAN BERNARDINO ADJ7183368 EMMELYN UALAT AGUIRRE ARROWHEAD REGIONAL MEDICAL CENTER COUNTY OF SAN BERNARDINO ADJ9081488 IDA TYLER MURDOCK COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ7942543 MARIA BAUTISTA COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ6868654 MARK PIRAINO SAN BERNARDINO COUNTY COUNTY OF SAN BERNARDINO ADJ8640753 ROSALIND BROWN COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ8640753 ROSALIND BROWN COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ9428346 SANDRA CHAN GEORGE COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ9215380 SHARON BODDIE COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ3794323 WANDA HARRIS COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ6874487 WENDY EVERETT COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ6874487 WENDY EVERETT COUNTY OF SAN BERNARDINO COUNTY OF SAN BERNARDINO ADJ2059983 JOEL LIFSCHULTZ COUNTY OF SAN DIEGO COUNTY OF SAN DIEGO ADJ2160840 LUPE ARBALLO COUNTY OF SAN DIEGO COUNTY OF SAN DIEGO ADJ2160840 LUPE ARBALLO SAN DIEGO COUNTY COUNTY OF SAN DIEGO ADJ7439640 SUSAN HEARD SAN DIEGO COUNTY COUNTY OF SAN DIEGO ADJ6868657 BERTHA GOMEZ COURTESY STAFFING INC COURTESY STAFFING INC ADJ6721998 LOURDES BARON CONSTRUCTION PROTECTIVE SERVICES CPS SECURITY SOLUTIONS GARDENA ADJ1870162 DONALD HOGG L.A. CO./PARKS & RECREATION CRAWFORD AND CO ADJ3950633 FLORENCE YOUNG COUNTY OF LOS ANGELES CRAWFORD AND CO ADJ3424099 HERBERT HEITMEYER LOS ANGELES COUNTY FIRE DEPT CRAWFORD AND CO ADJ4524318 ESTEBAN MARTINEZ DISTRIBUTION ALTERNATIVES CRAWFORD COLTON ADJ9554934 ISELA VILLAGRANA CROTHALL LAUNDRY SERVICES CROTHALL LAUNDRY SERVICES ADJ2228978 GUILLERMO CORNEJO MARINA LANDSCAPE INC. CRUM & FORSTER ADJ3004670 JAIME VELASCO PARKING CONCEPTS INC CRUM & FORSTER ADJ3274011 SOCORRO MORENO FOASBERG LAUNDRY & CLEANERS CRUM & FORSTER ADJ4405879 PABLO RANGEL ISLANDS RESTAURANTS CRUM & FOSTER ADJ8613037 ALEJANDRO CEJA VALENCIA NASCO GOURMET FOOD CRUM FORSTER ORANGE ADJ2760824 ALICIA MORENO PARRA NONG SHIM FOODS INC CRUM FORSTER ORANGE ADJ8451238 ALVARO BERNARDINO LOPEZ MISSION COMMUNITY HOSPITAL CRUM FORSTER ORANGE ADJ8583336 ANGEL FERNANDEZ EL TORITO GRILL CRUM FORSTER ORANGE ADJ7004395 BEATRIZ QUIROZ BODEGA LATINA CORPORATION CRUM FORSTER ORANGE ADJ7004395 BEATRIZ QUIROZ EL SUPER CRUM FORSTER ORANGE ADJ7345630 BILLY LANGFORD EL MONTE RENTS INC CRUM FORSTER ORANGE ADJ7623050 CASSANDRA LOPEZ OPI PRODUCTS INC CRUM FORSTER ORANGE ADJ7914660 EDDE RIVERA OUTSOURCE FLEET SERVICES INC CRUM FORSTER ORANGE ADJ570866 ELIAS REYES GONZALEZ AMERICUS LOGISTICS CRUM FORSTER ORANGE ADJ1924774 ESPERANZA MIRANDA DELTA DESIGN CRUM FORSTER ORANGE ADJ1167832 FELICITAS RETAMOZO JT CONTRACTORS CRUM FORSTER ORANGE ADJ7495828 FILIMON SUAREZ GOOD YEAR RUBBER CRUM FORSTER ORANGE ADJ9311525 FRANCISCO CASAS RM HQ LLC DBA EL TORITO CRUM FORSTER ORANGE ADJ8290153 FRANCISCO RIOS BAKERSFIELD COLD AND DRY STORAGE CRUM FORSTER ORANGE ADJ8192041 HECTOR PEREZ BESTWAY SUPERMARKET CRUM FORSTER ORANGE ADJ8681965 HERON GALVAN RM HOLDING ACAPULCO RESTAURANT CRUM FORSTER ORANGE ADJ8715724 HONG MEI LU THE BICYCLE CASINO LP CRUM FORSTER ORANGE ADJ8853308 HUMBERTO ARUAJO CONTINENTAL PROCESSORS CRUM FORSTER ORANGE ADJ8897195 ISIDORE OTERO LAKEVIEW PONTIAC CRUM FORSTER ORANGE ADJ8705157 JESSICA HAI GONG THE BICYCLE CASINO LP CRUM FORSTER ORANGE ADJ8190440 JOSE MANZANO SUPERMERCADO BESTWAY 5 CRUM FORSTER ORANGE ADJ9378968 JOSE RAMIREZ ZAGAL BM HQ DBA ACAPULCO RESTAURANT CRUM FORSTER ORANGE ADJ7714906 JOSUE SANCHEZ MAUSER CORP CRUM FORSTER ORANGE ADJ8944186 JUANA SAENZ ROBERT MICHAEL LTD CRUM FORSTER ORANGE ADJ7351308 LESLIE KELLY RAMONA VNA HOSPICE CRUM FORSTER ORANGE ADJ2630420 LIDIA RAMOS PELICAN PRODUCTS CRUM FORSTER ORANGE ADJ2396700 LUCIO CABRERA GARMENT PROCESSING CORP. CRUM FORSTER ORANGE ADJ7658654 LUZ PEREZ GOODWILL SERVING THE PEOPLE OF SOUTHERN LA COUNTY CRUM FORSTER ORANGE ADJ8539035 MANUEL MORENO FACILITIES SUPPORT SERVICES CRUM FORSTER ORANGE ADJ7939484 MARGARITA APREZA RUBIOS FRESH MEXICAN GRILL CRUM FORSTER ORANGE ADJ7611645 MARIA ARGUELLES MICRO SOLUTIONS ENTERPRISES CRUM FORSTER ORANGE ADJ8371384 MARIA BONILLA LIFEHOUSE HOLDINGS LLC CRUM FORSTER ORANGE ADJ8093902 MARIA DIAZ OPARC CRUM FORSTER ORANGE ADJ8221143 MARIA GONZALES PACIFIC LINE CLEAN UP INC CRUM FORSTER ORANGE ADJ7955284 MARIA LOPEZ CARLS JR DBA FRIENDLY FRANCHISE CORPORATION CRUM FORSTER ORANGE ADJ7809705 MARIA REYES TREND TECHNOLOGIES LLC CRUM FORSTER ORANGE ADJ8988991 MARIA VALLE FRIENDLY FRANCHISES CORP DFG RESTAURANTS CRUM FORSTER ORANGE ADJ8096701 MARISOL HERNANDEZ CAREMORE MEDICAL GROUP CRUM FORSTER ORANGE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8380002 MAY LAM HOLLYWOOD PARK CASINO CRUM FORSTER ORANGE ADJ7183604 MIGUEL MEJIA FORBES INDUSTRIES CRUM FORSTER ORANGE ADJ7762893 MISAEL MEJIA EL SUPER SUPERMARKETS CRUM FORSTER ORANGE ADJ7919471 RAFAEL JUAREZ COAST PLAZA DOCTORS HOSPITAL CRUM FORSTER ORANGE ADJ2924671 RAMIRO MENDOZA ALFA LEISURE INC CRUM FORSTER ORANGE ADJ7705531 REMEDIO CING GOODWILL CRUM FORSTER ORANGE ADJ9089311 ROBERTO MAYORGA TROON GOLF CRUM FORSTER ORANGE ADJ8300925 ROGELIO BAUTISTA THE BICYCLE CASINO CRUM FORSTER ORANGE ADJ6651695 SYLVIA REVELES COMMERCE ENERGY GROUP INC CRUM FORSTER ORANGE ADJ2834096 TERESA CARDONA SABERT CORP CRUM FORSTER ORANGE ADJ8053637 TOMASA REYES FACILITIES SUPPORT SERVICES INC CRUM FORSTER ORANGE ADJ7676892 VANESSA ARRANDA EL SUPER CRUM FORSTER ORANGE ADJ8818617 VERONICA BENITEZ GOODNITE INN MANAGEMENT CRUM FORSTER ORANGE ADJ6724082 VICTORINA ROSAS MOBILE MODULAR MANAGEMENT CORP CRUM FORSTER ORANGE ADJ6724082 VICTORINA ROSAS MOBILE MODULAR MANAGEMENT MCGRATH RENTCORP CRUM FORSTER ORANGE ADJ7565978 ZHIJI SHI WELL LUCK CO INC CRUM FORSTER ORANGE ADJ1764426 BASILIO LLAMAS AVILA PARKING CONCEPTS, INC. CRUM FORSTER RICHARDSON ADJ4224601 CATALINA RODRIGUEZ PROCOURIER CRUM FORSTER RICHARDSON ADJ2630420 LIDIA RAMOS PELICAN PRODUCTS CRUM FORSTER RICHARDSON ADJ6647828 MAXIMILIANO ROSALES TOP PRIORITY COURIERS INC CRUM FORSTER RICHARDSON ADJ1798046 MELISSA SAZO DON ROBERTS JEWELERS CRUM FORSTER RICHARDSON ADJ6836621 NORA ESPARZA MILITARY DELI AND BAKERY SERVICES INC CRUM FORSTER RICHARDSON ADJ9083448 RATHANA YANN BRE PROPERTIES INC CRUM FORSTER RICHARDSON ADJ1818212 RUBEN SOUZA PRO COURIER CRUM FORSTER RICHARDSON ADJ6916623 JOSE MEDRANO AKA ESTRADA SOUTH COAST FOODS COMPANY INC CYPRESS INSURANCE COMPANY ADJ9623427 LUCAS VILLEDA DEKEL ASSOC INC DEKEL ASSOC INC ADJ9623427 LUCAS VILLEDA DEKEL ASSOCIATES INC DEKEL ASSOC INC ADJ9520056 URVANO MARES VEGA DENNIS F BULOW PAINTING DENNIS F BULOW PAINTING ADJ6958748 MARIA ESPINO DENNY`S INC DENNY`S INC ADJ6958748 MARIA ESPINO NAGI INC DENNY`S INC ADJ7684348 MAGDAELENA GONZALEZ DEPARTMENT OF SOCIAL SERVICES DEPARTMENT OF SOCIAL SERVICES ADJ958847 AIDA DELGADILLO DEPT OF SOCIAL SERVICES DEPT OF SOCIAL SERVICES ADJ958847 AIDA DELGADILLO DEPT. OF SOCIAL SERVICES DEPT OF SOCIAL SERVICES ADJ7079287 SILVANO SAUCEDA DESERT CONCEPTS LANDSCAPE DESERT CONCEPTS LANDSCAPE ADJ9414019 JORGE LUIS GONZALEZ DIESEL DYNAMICS INC DIESEL DYNAMICS INC ADJ1410539 CARMEN BLANDON DISABLED AMERICAN VETERANS DISABLED VETERANS CHARITIES ADJ1410539 CARMEN BLANDON DISABLED AMERICAN VETS DISABLED VETERANS CHARITIES ADJ1410539 CARMEN BLANDON DISABLED VETERANS CHARITIES DISABLED VETERANS CHARITIES ADJ3732603 CARMEN VITELA DISNEYLAND DISNEY ANAHEIM ADJ7794060 ELVIRA RIVERA DISNEYLAND DISNEY ANAHEIM ADJ7676174 JOSE SERRATO DISNEYLAND HOTEL DISNEY ANAHEIM ADJ1610169 MARIA ORTEGA DISNEYLAND DISNEY ANAHEIM ADJ7877448 MELANY MICHELLE CASTRO DISNEYLAND DISNEY ANAHEIM ADJ7878444 MELANY MICHELLE CASTRO DISNEYLAND DISNEY ANAHEIM ADJ7302709 ROCHELLE STEPHENS DISNEYLAND DISNEY ANAHEIM ADJ7302709 ROCHELLE STEPHENS DISNEYLAND RESORT DISNEY ANAHEIM ADJ7483602 ROSA SEGURA DISNEYLAND RESORT DISNEY ANAHEIM ADJ9256283 TERESA RODARTE WALT DISNEY PARKS & RESORTS U.S. INC. DISNEY ANAHEIM ADJ1610169 MARIA ORTEGA DISNEYLAND DISNEY WORLDWIDE SERVICES ADJ7877448 MELANY MICHELLE CASTRO DISNEYLAND DISNEYLAND ADJ7302709 ROCHELLE STEPHENS DISNEYLAND DISNEYLAND RESORT ADJ7302709 ROCHELLE STEPHENS DISNEYLAND RESORT DISNEYLAND RESORT ADJ7483602 ROSA SEGURA DISNEYLAND RESORT DISNEYLAND RESORT ADJ1507336 JESUS CHAVEZ DOUGLAS E BARNHART DOUGLAS E BARNHART ADJ1507336 JESUS CHAVEZ DOUGLAS E BARNHART INC DOUGLAS E BARNHART ADJ7912855 DANIEL RODRIGUEZ DSC LOGISTICS DSC LOGISTICS ADJ7904834 GARRETT TATSUMI DWP LOS ANGELES DWP LOS ANGELES ADJ7904834 GARRETT TATSUMI DWP LOS ANGELES DWP LOS ANGELES ADJ8921595 GEFEI SUN CITY OF LOS ANGELES DEPT OF WATER AND POWER DWP LOS ANGELES ADJ7151234 OSCAR MARROQUIN DEPARTMENT OF WATER & POWER DWP LOS ANGELES ADJ7600898 DAVID RODRIGUEZ DYNAFLEX PRODUCTS DYNAFLEX PRODUCTS ADJ3547497 ARTEMIO LOPEZ DIE CAST PRODUCTS EAGLE INSURANCE COMPANIES ADJ9801124 LIDIA MONTES ECLIPSE RECREATIONAL VEHICLE INC. ECLIPSE RECREATIONAL VEHICLE INC. ADJ8740792 GONZALO GARCIA CONTAINERS FREIGHT LLC EMERALD CLAIMS MGMT PORTER ADJ7208747 JAMES WHYTE BEST DEDICATED EMERALD CLAIMS MGMT PORTER ADJ7208747 JAMES WHYTE FURNITURE TRANSPORTATION SERVICE EMERALD CLAIMS MGMT PORTER ADJ8897848 SCHENDELL REYES HORIZON PERSONNEL SERVICES EMERALD CLAIMS MGMT PORTER ADJ8897848 SCHENDELL REYES TECO DIAGNOSTICS EMERALD CLAIMS MGMT PORTER ADJ9522430 ADRIANA CERVANTES DE GROUP INC EMPLOYERS ASSURANCE GLENDALE ADJ9602370 CLAUDIA GILES GORDON LABORATORIES EMPLOYERS ASSURANCE GLENDALE ADJ9511064 ISMAEL CORDONA CANVAS TO ART DBA LEFT BANK ART EMPLOYERS ASSURANCE GLENDALE ADJ9578429 JESUS JARA S AND L FAMILY DBA DANIEL MARKET EMPLOYERS ASSURANCE GLENDALE ADJ9825963 LILIANA GUERRERO GLOBAL REBELS EMPLOYERS ASSURANCE GLENDALE ADJ7946494 MARIA DEL CARMEN HERNANDEZ MAGIC LAUNDRY SERVICES EMPLOYERS ASSURANCE GLENDALE ADJ8304103 MARVIN AKA OMAR HERNANDEZ ELIAS POETRY CORPORATION EMPLOYERS ASSURANCE GLENDALE ADJ758995 MIGUEL HERRERA DOUBLE K INDUSTRIES EMPLOYERS ASSURANCE GLENDALE ADJ9494968 SYLVIA BOLANOS RAINBOW MART EMPLOYERS ASSURANCE SAN FRANCISCO ADJ7246616 CHRISTINA GARCIA STATION PLATFORM INC EMPLOYERS COMP ADJ8734658 ABEL SANTIAGO CN AUTO BODY REPAIRS EMPLOYERS COMP GLENDALE ADJ9271911 AGUSTINA RODRIGUEZ KING KABOB EXPRESS EMPLOYERS COMP GLENDALE ADJ9161174 ALBINO ANGEL SSF IMPORTED AUTO PARTS EMPLOYERS COMP GLENDALE ADJ9546598 ALEJANDRO MORENO AUTO DETAIL SPEC SERV EMPLOYERS COMP GLENDALE ADJ7636364 ALEJANDRO RAMIREZ ARION INTERNATIONAL EMPLOYERS COMP GLENDALE ADJ9691560 ALEJANDRO SOTO CRYSTAL RESTAURANT EMPLOYERS COMP GLENDALE ADJ1296400 AMADO ROSAS AMERICAN PACIFIC CORE INC EMPLOYERS COMP GLENDALE ADJ7793757 ANA WILLIAMS COUNTRY FARMS EMPLOYERS COMP GLENDALE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9193211 ANDRES BARRAGAN H & D MOLDING CO EMPLOYERS COMP GLENDALE ADJ9193211 ANDRES BARRAGAN WEST COAST METRIC INC EMPLOYERS COMP GLENDALE ADJ8583330 BALTAZAR LEON THE MISFIT EMPLOYERS COMP GLENDALE ADJ9413603 BERTHA CERVANTES CLASSIC FOODS INC EMPLOYERS COMP GLENDALE ADJ8626565 BLAS SOLIS FLOOR CARE SYSTEMS EMPLOYERS COMP GLENDALE ADJ9409349 BONIFACIO ROJAS TACOS EL GAVILAN EMPLOYERS COMP GLENDALE ADJ6758079 BRENDA RUBIO DUKE`S STEAKHOUSE DBA GHIPRIEL INVESTMENTS EMPLOYERS COMP GLENDALE ADJ8574102 CANDIDO DOMINGUEZ ALAMO MEXICAN CAFE INC EMPLOYERS COMP GLENDALE ADJ7148519 CANDY VERGARA ZADRO PRODUCTS EMPLOYERS COMP GLENDALE ADJ7558493 CARLOS GARCIA MAGIC AUTO CENTER OF RESEDA EMPLOYERS COMP GLENDALE ADJ8842494 CARLOS GARCIA ORTIZ CUTTING SERVICE EMPLOYERS COMP GLENDALE ADJ9674588 CARLOS MARTINEZ MID TOWN MARKET EMPLOYERS COMP GLENDALE ADJ3635282 CARLOS SERVIN WICKETTS INTERNATIONAL EMPLOYERS COMP GLENDALE ADJ8361729 CARMEN KILSGAARD MARIO S MEXICAN RESTARURANT EMPLOYERS COMP GLENDALE ADJ7316354 CARMEN MAYA LA SALLE MEDICAL ASSOCIATION EMPLOYERS COMP GLENDALE ADJ9602370 CLAUDIA GILES GORDON LABORATORIES EMPLOYERS COMP GLENDALE ADJ8969563 CLEOTILDE CORTEZ BURGER KING 696 EMPLOYERS COMP GLENDALE ADJ9528694 CYNTHIA PINON IHOP RESTAURANT EMPLOYERS COMP GLENDALE ADJ7762889 CYNTHIA REYES MAHESH SEJPAL DDS EMPLOYERS COMP GLENDALE ADJ8551847 DONGWEI XU CHONG QING RESTAURANT HSIANG LI INC EMPLOYERS COMP GLENDALE ADJ7504787 DORIEL RAMOS HIBACHI SUSHI AND GRILL EMPLOYERS COMP GLENDALE ADJ9108292 EDUARDO ANGEL CORP29 EMPLOYERS COMP GLENDALE ADJ8084240 ELENA CARLOS H S ELNA INTERNATIONAL INC EMPLOYERS COMP GLENDALE ADJ9369364 ELENA MANCILLA AZTECA JEANS EMPLOYERS COMP GLENDALE ADJ6699036 ELIZABETH ALVAREZ SUBWAY EMPLOYERS COMP GLENDALE ADJ9064192 ELSA CARRANZA JOSTAR WHOLESALE EMPLOYERS COMP GLENDALE ADJ9267315 ESPERANZA VIZARRAGA BURGER KING EMPLOYERS COMP GLENDALE ADJ9058942 EVA JULFAYAN KNOCKOUT JEANS EMPLOYERS COMP GLENDALE ADJ8951193 EVELIN AYALA J A SHOE CO EMPLOYERS COMP GLENDALE ADJ6752814 FABIAN LOPEZ ALPHA SOURCE ELECTRONICS EMPLOYERS COMP GLENDALE ADJ9629597 FELIX PEREZ SERV RITE MEAT CO EMPLOYERS COMP GLENDALE ADJ9212529 FIDEL CONTRERAS MAYA STUDIOS INC EMPLOYERS COMP GLENDALE ADJ7842102 FLOR CASTILLO BERNAL MIGHTY FINE EMPLOYERS COMP GLENDALE ADJ1763608 FRANCISCO BUSTOS WORLD WIDE FABRIC,INC. EMPLOYERS COMP GLENDALE ADJ7337765 FRANCISCO RODRIGUEZ HAR LAM KEE RESTAURANT EMPLOYERS COMP GLENDALE ADJ9525211 FREDY GARCIA NANDOS TACO SHOP EMPLOYERS COMP GLENDALE ADJ7827898 GABRIELA CHINCHILLA CLASSIC FOODS EMPLOYERS COMP GLENDALE ADJ9175103 GERARDO ALARCON MAACO AMERICAS BODY SHOP EMPLOYERS COMP GLENDALE ADJ3452536 GERARDO GUZMAN DELFIN DESINS & MANUFACTURING INC EMPLOYERS COMP GLENDALE ADJ7829692 GLORIA CABRERA KYU APPAREL EMPLOYERS COMP GLENDALE ADJ9223154 GREGORIO MORALES BLOOMING DEALS INC DBA POPEYES CHICKEN EMPLOYERS COMP GLENDALE ADJ9614422 GUSTAVO JERONIMO MONTGOMERY PARTNERS EMPLOYERS COMP GLENDALE ADJ6661825 IGNACIO RAMOS VICTOR MEDICAL CO EMPLOYERS COMP GLENDALE ADJ9392189 ISRAEL CUMI AUTO BODY UNLIMITED EMPLOYERS COMP GLENDALE ADJ6958883 ISRAEL SANCHEZ HITI DIGITAL AMERICA EMPLOYERS COMP GLENDALE ADJ7689743 ISRAEL VALENCIA PRIME FABRICATION EMPLOYERS COMP GLENDALE ADJ9578429 JESUS JARA S AND L FAMILY DBA DANIEL MARKET EMPLOYERS COMP GLENDALE ADJ6715294 JOAQUINA FIGUEROA MAGNUM ABRA`SIVES INC EMPLOYERS COMP GLENDALE ADJ8477747 JOE ROBINSON MAGIC LAUNDRY SERVICES EMPLOYERS COMP GLENDALE ADJ8865472 JORGE TORRES CENTINELA FEED EMPLOYERS COMP GLENDALE ADJ7661823 JOSE ALONSO BIG LEAGUE DREAMS EMPLOYERS COMP GLENDALE ADJ8277887 JOSE CASTELLANOS TL MACHINE INC EMPLOYERS COMP GLENDALE ADJ8519772 JOSE ESPINOZA RHB MANAGEMENT COMPANY EMPLOYERS COMP GLENDALE ADJ9578021 JOSE PEREZ THE ORIGINAL PANTRY CAFE EMPLOYERS COMP GLENDALE ADJ7684342 JOSE PINEDA MARSA SPECIALTY PRODUCTS EMPLOYERS COMP GLENDALE ADJ9618996 JOSE RAMON LOPEZ CASTILLO C AND I FURNITURE EMPLOYERS COMP GLENDALE ADJ9373497 JOSE RAUL GARAY CABRERA AMICI TRATTORIA EMPLOYERS COMP GLENDALE ADJ9925229 JOSE RIVAS FOREVER SKY INC EMPLOYERS COMP GLENDALE ADJ8735660 JUAN CASTRO KENNY MAINTENANCE EMPLOYERS COMP GLENDALE ADJ7744604 JUAN CERVANTES JESUS CARDENAS EMPLOYERS COMP GLENDALE ADJ7744604 JUAN CERVANTES MOSS GROUP EMPLOYERS COMP GLENDALE ADJ7744604 JUAN CERVANTES NA GENERAL CONSTRUCTION EMPLOYERS COMP GLENDALE ADJ9626132 JUAN HERNANDEZ ESKA EMPLOYERS COMP GLENDALE ADJ7908957 JULIA CAMPOS PAPAGAYOS MEXICAN RESTAURANT EMPLOYERS COMP GLENDALE ADJ7880038 JULIO GALLEGOS ROMAN SHADES WEST INC EMPLOYERS COMP GLENDALE ADJ6987856 JULIO MANCILLA AQUACO INC EMPLOYERS COMP GLENDALE ADJ9389896 KENNETH NAPOLI SANTA CLARITA VALLEY PRODUCE INC EMPLOYERS COMP GLENDALE ADJ6875773 KIMIKO KIM GALLERIA MARKET EMPLOYERS COMP GLENDALE ADJ9623160 LASHONNE FIALA AMVEE EMPLOYERS COMP GLENDALE ADJ9623160 LASHONNE FIALA AMVEE CORPORATION DBA DENNY S EMPLOYERS COMP GLENDALE ADJ9364295 LEON VELASQUEZ ANDRES MORADO JEAN INC EMPLOYERS COMP GLENDALE ADJ9316471 LILIAN PINTO ODONOVANS RESTAURANT AND PUB EMPLOYERS COMP GLENDALE ADJ9825963 LILIANA GUERRERO GLOBAL REBELS EMPLOYERS COMP GLENDALE ADJ6932727 LILIANA MARTINEZ RESOP 1998 LLC EMPLOYERS COMP GLENDALE ADJ8842560 LILY LUGO DCG FULFILLMENT EMPLOYERS COMP GLENDALE ADJ8842560 LILY LUGO GAR LABORATORIES EMPLOYERS COMP GLENDALE ADJ8842560 LILY LUGO JC BLINDS MFG INC EMPLOYERS COMP GLENDALE ADJ8842560 LILY LUGO NEWPORT THIN FILM LABORATORY INC EMPLOYERS COMP GLENDALE ADJ8842560 LILY LUGO STAFF CHEX EMPLOYERS COMP GLENDALE ADJ8842560 LILY LUGO TRADEMARK COSMETICS EMPLOYERS COMP GLENDALE ADJ9524810 LISBETH NINO G & B SUBS SUBWAY EMPLOYERS COMP GLENDALE ADJ9086438 LU CHEN FORTUNE COOKIES RESTAURANT, INC. EMPLOYERS COMP GLENDALE ADJ6935860 LUCIO GONZALEZ STEVEN ANTHONY INC EMPLOYERS COMP GLENDALE ADJ3365030 LUZ FELIX CHAMPION TURF EQUIPMENT EMPLOYERS COMP GLENDALE ADJ7259077 MANUEL SAUCEDA MICRO WEST INC EMPLOYERS COMP GLENDALE ADJ6849186 MARIA ACOSTA COAST TO COAST BAKERY INC EMPLOYERS COMP GLENDALE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9432571 MARIA BENITEZ GREEN OLIVE RESTAURANT EMPLOYERS COMP GLENDALE ADJ8998818 MARIA CARO SB PIZZA COMPANY INC EMPLOYERS COMP GLENDALE ADJ7006603 MARIA CORDERO MAGNOLIA CLINICA MEDICA FAMILIAR EMPLOYERS COMP GLENDALE ADJ7006603 MARIA CORDERO MAGNOLIA CLINICA MEDICAL FAMILIAR EMPLOYERS COMP GLENDALE ADJ9431810 MARIA DE LEON RAMIREZ STEVEN M GRENROCK DBA BEE GEE EMPLOYERS COMP GLENDALE ADJ9375882 MARIA FAJARDO HERITAGE QUALITY CLEANERS EMPLOYERS COMP GLENDALE ADJ8034255 MARIA SANTANA COURTYARD MARRIOT AKA BALDWIN HOSPITALITY LLC EMPLOYERS COMP GLENDALE ADJ7376921 MARIANELA PALACIOS REFRIGERATION HARDWARE SUPPLY CORPORATION EMPLOYERS COMP GLENDALE ADJ9733708 MARIO MARTINEZ COLLISION 2000 INC EMPLOYERS COMP GLENDALE ADJ7849713 MIGUEL ANGEL ROJAS SOLANO ROSS RACING PISTONS EMPLOYERS COMP GLENDALE ADJ9167340 MIGUEL CANTOR LA PARADISE INC EMPLOYERS COMP GLENDALE ADJ8028986 MIGUEL DAVILA MICHAELS PIZZA EMPLOYERS COMP GLENDALE ADJ8997649 MIGUEL ESQUIVEL GARFIELD INTERNATIONAL CO INC EMPLOYERS COMP GLENDALE ADJ8664039 MIRTA LOPEZ ARCHIPELAGO BOTANICALS EMPLOYERS COMP GLENDALE ADJ6881652 NANCY ZARAGOSA ANNA`S BAKERY INC EMPLOYERS COMP GLENDALE ADJ8221184 NATALIE HANNA WELCH MANAGEMENT CORP FANTASTIC SAMS EMPLOYERS COMP GLENDALE ADJ8054165 OMAR ALVAREZ BJ COLLECTION INC EMPLOYERS COMP GLENDALE ADJ9183632 OSCAR GARCIA CORKY`S KITCHEN AND BAKERY EMPLOYERS COMP GLENDALE ADJ9520136 PABLO PAREDES SB PIZZA COMPANY INC DBA PIARA PIZZA EMPLOYERS COMP GLENDALE ADJ9561150 PETRA HERNANDEZ PAL PAL FASHION INC EMPLOYERS COMP GLENDALE ADJ9424036 PETRA SUAREZ DESIGN BY MADEMOISELLE INC EMPLOYERS COMP GLENDALE ADJ8542930 RAFAEL MANZO SILVERLAKE EMPLOYERS COMP GLENDALE ADJ9394622 RAMON BRACAMONTES JAMES A JACKSON DBA MIDAS EMPLOYERS COMP GLENDALE ADJ7298281 RAUL GONZALEZ TMB EMPLOYERS COMP GLENDALE ADJ9738302 RAUL HERNANDEZ OROZCO VIKE INVESTMENTS INC DBA TABLETOP GRILL EMPLOYERS COMP GLENDALE ADJ9651341 REBECCA CONTRERAS LINKYO EMPLOYERS COMP GLENDALE ADJ8975885 REYMUNDO RODRIGUEZ RAFFAELLO RISTORANTE EMPLOYERS COMP GLENDALE ADJ9552896 REYNA CLARIBEL MENDOZA DORA L INTERNATIONAL EMPLOYERS COMP GLENDALE ADJ9166367 REYNA GONZALEZ S S PETROLEUM EMPLOYERS COMP GLENDALE ADJ7802713 RICARDO SACAYON ALVAREZ STAR ALTADENA MARKET EMPLOYERS COMP GLENDALE ADJ10079944 ROBERT FNDKYAN OPUS ONE LABORATORIES EMPLOYERS COMP GLENDALE ADJ8339145 ROSA GONZALEZ HAROLS M COHEN MD EMPLOYERS COMP GLENDALE ADJ8655985 RUBEN DE LEON UNIVERSAL PLASTIC BAGS MFG CO INC EMPLOYERS COMP GLENDALE ADJ8448795 SALUD CEBALLOS BABETTES FEAST EMPLOYERS COMP GLENDALE ADJ8893309 SANTIAGO ARCETA WET WILLIES SAN DIEGO EMPLOYERS COMP GLENDALE ADJ9009842 SANTIAGO LAZALDE AOT GROUP USA LLC EMPLOYERS COMP GLENDALE ADJ9290826 SARA TERESA WELTY BEE WELL HOLISTIC WELLNESS EMPLOYERS COMP GLENDALE ADJ9290826 SARA TERESA WELTY BEE WELL HOLISTIC WELLNESS CENTER EMPLOYERS COMP GLENDALE ADJ9670690 SILVANO GOMEZ MARISCAL HAN SANG KOREAN RESTAURANT EMPLOYERS COMP GLENDALE ADJ9698182 SILVIA RODRIGUEZ MAA RATON EMPLOYERS COMP GLENDALE ADJ8398784 TAMI CUARON BRACKENS BIRD FARM EMPLOYERS COMP GLENDALE ADJ8692745 TORONDIA ALLEN LITTLE BURDGECOOPER EMPLOYERS COMP GLENDALE ADJ10012431 VAWN TRAN OPUS ONE LABORATORIES EMPLOYERS COMP GLENDALE ADJ9191432 VERONICA FALCON INNOVATIVE BUSINESS GROUP INC EMPLOYERS COMP GLENDALE ADJ9483283 VICENTE CASTELAN L R WHITE CO EMPLOYERS COMP GLENDALE ADJ9265051 YESMI LOPEZ COMPREHENDIVEMMUNITY HEALTH CENTER EMPLOYERS COMP GLENDALE ADJ9680596 YOLANDA VARGAS TOP STITCH MFG LLC EMPLOYERS COMP GLENDALE ADJ8035590 YOVANY BATRES ULTIMA MANAGEMENT EMPLOYERS COMP GLENDALE ADJ7239968 ZI FA LI FOO-CHOW RESTAURANT EMPLOYERS COMP GLENDALE ADJ1296400 AMADO ROSAS AMERICAN PACIFIC CORE INC EMPLOYERS COMP NEWBURY PARK ADJ7316354 CARMEN MAYA LA SALLE MEDICAL ASSOCIATION EMPLOYERS COMP NEWBURY PARK ADJ7433038 EDUARDO PALOMO PAYLESS FOR PLUMBING EMPLOYERS COMP NEWBURY PARK ADJ6631600 EZEQUIEL CABANILLAS KAMMCO CORPORATION EMPLOYERS COMP NEWBURY PARK ADJ9244643 MAGDALENA ESQUIVEL AJAY BERI EMPLOYERS COMP NEWBURY PARK ADJ8951892 MAJED KARIMI LAGUNA SERRANO LLC EMPLOYERS COMP NEWBURY PARK ADJ9475575 VICTORIO MUNGUIA LORI PRODUCTS INC EMPLOYERS COMP NEWBURY PARK ADJ8130208 GENEVA AGUILAR STAR AUTO PARTS EMPLOYERS COMP SAN FRANCISCO ADJ9483283 VICENTE CASTELAN L R WHITE CO EMPLOYERS COMP SAN FRANCISCO ADJ6778266 ANGEL REYNA BRK GROUP LLC EMPLOYERS COMPENSATION ADJ4132447 BENITO REYES PICO STORE EQUIP CO EMPLOYERS COMPENSATION ADJ4001672 EDGAR FLORES STYLE KNITS, INC. EMPLOYERS COMPENSATION ADJ2308774 FABIOLA RAMIREZ MRS REDD'S PIE EMPLOYERS COMPENSATION ADJ3687217 FERNANDO MARTINEZ AMZ PACKAGING INCORPORATED EMPLOYERS COMPENSATION ADJ696931 GLORIA MARTINEZ R AND S SPORTSWEAR EMPLOYERS COMPENSATION ADJ447742 GUADALUPE GUTIERREZ MIKE THOMPSON'S RV SUPER STORES EMPLOYERS COMPENSATION ADJ6968214 JOANNE NQUYEN WETZELS PRETZELS EMPLOYERS COMPENSATION ADJ3019315 LETICIA ESTRADA EGGOLOGY INC EMPLOYERS COMPENSATION ADJ3873740 MATILDE RODRIGUEZ ALL AMERICAN HOME CENTER EMPLOYERS COMPENSATION ADJ1103230 OSMON LEAL EQUIPMENT RENTALS LLC EMPLOYERS COMPENSATION ADJ9424036 PETRA SUAREZ DESIGN BY MADEMOISELLE INC EMPLOYERS COMPENSATION ADJ1404537 RICHELLE KRAUSE SWISHER HYGIENE EMPLOYERS COMPENSATION ADJ7746688 SHEILA COON STUDENT INSURANCE EMPLOYERS COMPENSATION ADJ758215 TERESA SUTTON DME INCORPORATED EMPLOYERS COMPENSATION ADJ7222658 VERONICA REBOLLAR CABRERAS FAMILY RESTAURANT INC EMPLOYERS COMPENSATION ADJ2497830 VICTOR ROBLES PORTA VIA EMPLOYERS COMPENSATION ADJ9266907 PETER HERNANDEZ GOLDEN TERRACE APARTMENTS EMPLOYERS COMPENSATION INSURANCE ADJ269839 CEASAR RODRIGUEZ ROLLED STEEL PRODUCTS EMPLOYERS DIRECT INSURANCE ADJ2709749 GUADALUPE VALENCIA LEINER HEALTH PRODUCTS EMPLOYERS DIRECT INSURANCE ADJ7430407 ALEJANDRO MONTENEGRO BIG O TIRES ENDURANCE SAN FRANCISCO ADJ1410539 CARMEN BLANDON DISABLED AMERICAN VETERANS ENDURANCE SAN FRANCISCO ADJ1410539 CARMEN BLANDON DISABLED AMERICAN VETS ENDURANCE SAN FRANCISCO ADJ1410539 CARMEN BLANDON DISABLED VETERANS CHARITIES ENDURANCE SAN FRANCISCO ADJ7222856 ERIBERTO VERA ROSITAS BAKERY ENDURANCE SAN FRANCISCO ADJ8010137 ABEL BELTRAN GOLDEN STATE ENGINEERING INC ENSTAR US ORANGE ADJ7653777 ABEL RODRIGUEZ WALLDESIGN INCORPORATED ENSTAR US ORANGE ADJ1531589 ANDRES RENDON MATRIX SURFACES INC ENSTAR US ORANGE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ1133008 ANTONIO MONTES ANGELICA WESTERN RENTAL GROUP ENSTAR US ORANGE ADJ1133008 ANTONIO MONTES GRAVES ROBERSON AND BOURASSA ENSTAR US ORANGE ADJ3547497 ARTEMIO LOPEZ DIE CAST PRODUCTS ENSTAR US ORANGE ADJ9264469 ARTURO SALINAS PINNACLE HOLDINGS GROUP INC ENSTAR US ORANGE ADJ8219452 CARLOS SORIANO WALLDESIGN ENSTAR US ORANGE ADJ8300946 CURTIS CHAMBERLAIN IRWIN INDUSTRIAL ENSTAR US ORANGE ADJ7554772 DAVID HERNANDEZ TN TRUSS COMPONENTS ENSTAR US ORANGE ADJ8932423 DAYANA GIACOMAN WINDSOR TERRANCE HEALTHCARE CENTER ENSTAR US ORANGE ADJ8635140 EFREN GUTIERREZ OAKRIDGE LANSCAPE ENSTAR US ORANGE ADJ6726437 FREDY ZANUNZINI GONSALEZ PAINTING CORP ENSTAR US ORANGE ADJ6726437 FREDY ZANUNZINI GONZALEZ PAINTING CORP ENSTAR US ORANGE ADJ7254403 HUMBERTO OLEA TRESIERRAS BROTHERS CORPORATION ENSTAR US ORANGE ADJ7651859 JAMES MACIAS DAVIDSON REINFORCING CO INC ENSTAR US ORANGE ADJ7548544 JESUS NAVA RCH CABLE CONTRACTORS ENSTAR US ORANGE ADJ3126197 JORGE MARROQUIN CIRCULATING AIR INC ENSTAR US ORANGE ADJ8598681 JOSE BERNAL OAKRIDGE LANDSCAPE INC ENSTAR US ORANGE ADJ7239186 JOSUE SANTOS RELIABLE CABLE HOLDINGS INC ENSTAR US ORANGE ADJ6489052 JUAN RODRIGUEZ TESERA ENSTAR US ORANGE ADJ1383694 JULIO JIMENEZ BINDERSON CONSTRUCTORS, INC ENSTAR US ORANGE ADJ7890905 JUSTIN DURAN ANDERSON CHARNESKY STRUCTURAL STEEL INCI ENSTAR US ORANGE ADJ7169245 LAZARO GOMEZ BCI FRAMING AND DRYWALL ENSTAR US ORANGE ADJ8248580 LEOPOLDO DE LA CRUZ NORMANDIE CLUB ENSTAR US ORANGE ADJ7937321 LETICIA VILLAFUERTE JA CONTRACTING ENSTAR US ORANGE ADJ8180909 LILLIAN PINON LEGACY POST ACUTE REHAB CENTER ENSTAR US ORANGE ADJ8120903 MARIA SANCHEZ NEW ORANGE HILLS ENSTAR US ORANGE ADJ9062938 MARY LANDA CYPRESS GARDENS CONV HOSPITAL ENSTAR US ORANGE ADJ8255479 MICAELA CORTES OXNARD HARVEST CO ENSTAR US ORANGE ADJ8538805 ORLANDO FLORES MC STARLITE ENSTAR US ORANGE ADJ9240622 RAFAEL ORTIZ GONZALEZ CLARMEONT MKENNA COLLEGE ENSTAR US ORANGE ADJ8869549 RENE AMARO TRESIERRAS BROTHERS ENSTAR US ORANGE ADJ8869549 RENE AMARO TRESIERRAS BROTHERS CORP ENSTAR US ORANGE ADJ8586175 ROBERTO FLORES GONZALEZ SUN VALLEY PAPER STAFF ENSTAR US ORANGE ADJ8454391 ROBERTO QUINTANILLA ACTIVE RECYCLING COMPANY, INC. ENSTAR US ORANGE ADJ8398633 RODRIGO GARCIA GRAND PARK CONVALESCENT HOSPITAL ENSTAR US ORANGE ADJ7643602 ROSA RODRIGUEZ JA CONTRACTING ENSTAR US ORANGE ADJ7053619 BRYANE SMITH RANSTAD SERVICES ESIS ADJ3582875 CARLOS CHICA SELECT PERSONNEL SERVICE ESIS ADJ6859267 CARMEN SANTIZO AMERICAN BUILDING MAINTENACE CO ESIS ADJ8617561 CIRILO GERONIMO SUN PACIFIC HARVESTING ESIS ADJ3545455 ERNESTO BOLADO KRAFT FOODS ESIS ADJ8030927 JIMMY OSORIO KOOSHAREM CORP DBA SELECT STAFFING ESIS ADJ8666755 JOSE AGUILAR TIMEC CONPANY INC ESIS ADJ7339403 JULIO DIAZ AMERLCAN BUILDING MAINTENANCE ESIS ADJ7555708 MYLES PROCTOR ELECTRO TECH MACHINING ESIS ADJ8588437 OCTAVIO ESPERICUETA EL POLLO LOCO ESIS ADJ4052577 THOMAS MYRICK INGERSOLL-RAND ESIS ADJ7177168 BENITO AVELAR NORTHGATE MARKET ESIS ADJ7174600 RAUL PEREZ VALLEYCREST LANDSCAPE MAINTENANCE ESIS ADJ7488911 ADAM PASCALE PERKINS AND MARIE CALLENDERS ESIS CHATSWORTH ADJ9465167 ALAN OMAR VILLEGAS QS WHOLESALE ESIS CHATSWORTH ADJ7082833 ALEJANDRO VASQUEZ HUTTING BUILDING PRODUCTS ESIS CHATSWORTH ADJ7338769 ALFREDO ANDRADE STAFFING SYSTEM CORP ESIS CHATSWORTH ADJ8424553 ALMA LILIA DE ANDA NATIONAL BEEF ESIS CHATSWORTH ADJ8731895 ANA MARISCAL INGRAM MICRO ESIS CHATSWORTH ADJ8371733 ANA RAMIREZ CONTAIN A WAY INC ESIS CHATSWORTH ADJ8543287 ANDRES ACEVES GREATWIDE DISTIBUTION LOGISTICS ESIS CHATSWORTH ADJ7071049 ANDRES GONZALEZ SELECT STAFFING ESIS CHATSWORTH ADJ8588424 ANDRES SARMIENTO BP AMERICA ESIS CHATSWORTH ADJ7580547 ANGELINA GUERRERO SELECT STAFFING ESIS CHATSWORTH ADJ6919762 ANTONIO HERNANDEZ MEDTRONICS INC ESIS CHATSWORTH ADJ8121033 ARACELY ROMERO ABM INDUSTRIES ESIS CHATSWORTH ADJ7690746 BALTASAR ROSALES CMC CONSTRUCTION SERVICES ESIS CHATSWORTH ADJ7690647 BARDYA CYROUS TIME WARNER CABLE ESIS CHATSWORTH ADJ8813748 BENITO NAVA BYRON BRIGHAM MAUSS AND DEBORAH K MAUSS ESIS CHATSWORTH ADJ8813748 BENITO NAVA OSCAR GUERRA PAINTING ESIS CHATSWORTH ADJ8813748 BENITO NAVA OSCAR HIGUERA ESIS CHATSWORTH ADJ7611850 BLANCA SEGURA KING MEAT ESIS CHATSWORTH ADJ7597901 BRANDI BARKER MAXIM HEALTHCARE ESIS CHATSWORTH ADJ8263088 CAMEO RODARTE STAPLES ESIS CHATSWORTH ADJ8263088 CAMEO RODARTE STAPLES INC ESIS CHATSWORTH ADJ9538041 CAMILO GUTIERREZ DRIVERS MANAGEMENT ESIS CHATSWORTH ADJ6686350 CARLOS MENESES BIMBO BAKERIES ESIS CHATSWORTH ADJ7525788 CARLOS RIVAS SELECT STAFFING ESIS CHATSWORTH ADJ3484343 CARLOS TREJO MEDINA SYSTEM PARKING ESIS CHATSWORTH ADJ4248589 CARLOS TREJO MEDINA SYSTEM PARKING ESIS CHATSWORTH ADJ1267564 CELIA ZEPEDA NORTHGATE GONZALEZ ESIS CHATSWORTH ADJ6642632 CESAR ISAIS KELLY SERVICES ESIS CHATSWORTH ADJ7110968 CLAUDIA LARA NORTHGATE GONZALEZ MARKET ESIS CHATSWORTH ADJ7110968 CLAUDIA LARA NORTHGATE MARKET ESIS CHATSWORTH ADJ8233031 CORRIE BAILEY ALLIED BARTON SECURITY SERVICE ESIS CHATSWORTH ADJ7010898 CYNTHIA EVANS WDS WAREHOUSE DEMO SERVICES ESIS CHATSWORTH ADJ8396361 DANDRE BROWN SELECT STAFFING ESIS CHATSWORTH ADJ6878412 DANIEL AGUIRRE NORTHGATE GONZALEZ MARKETS ESIS CHATSWORTH ADJ7516847 DANIEL VIGNOLI AMPCO SYSTEM PARKING ESIS CHATSWORTH ADJ8000659 DEBORA CERVANTES NAKED JUICE ESIS CHATSWORTH ADJ7331604 EBERTO VALLES 1270 HANCOCK STREET ESIS CHATSWORTH Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8874258 EDUARDO RAMIREZ THE CHEESECAKE FACTORY ESIS CHATSWORTH ADJ8619091 EDVIN MACHADO SELECT STAFFING ESIS CHATSWORTH ADJ8170167 EFREN URREA NATIONAL BEEF ESIS CHATSWORTH ADJ6945350 ELIA LAMPMAN MEDTRONIC MINMED ESIS CHATSWORTH ADJ6945350 ELIA LAMPMAN MRG INFUSION SYSTEMS LLC ESIS CHATSWORTH ADJ3545455 ERNESTO BOLADO KRAFT FOODS ESIS CHATSWORTH ADJ7236288 FELIX HERNANDEZ SELECT STAFFING ESIS CHATSWORTH ADJ9024218 GALE WEATHERSBY ALLEGIS GROUP ESIS CHATSWORTH ADJ8709905 GERSON REYES VASQUEZ WIN SOON DBA EPOCA ESIS CHATSWORTH ADJ8709905 GERSON REYES VASQUEZ WIN SOON INC ESIS CHATSWORTH ADJ9858566 GRACIELA GARCIA HERNANDEZ DAYS INN SUITES ESIS CHATSWORTH ADJ8836370 GRICELDA RIVERA SELECT STAFFING ESIS CHATSWORTH ADJ9188029 GUADALUPE BETANCOURT CYTEC INDUSTRIES ESIS CHATSWORTH ADJ9653118 GUADALUPE MARIA IBANEZ REAL TIME STAFFNG SERVICES ESIS CHATSWORTH ADJ8180418 GUADALUPE NAVARRO NATIONAL BEEF ESIS CHATSWORTH ADJ5806302 GUSTAVO CASTILLO RANDSTAD NORTH AMERICA ESIS CHATSWORTH ADJ9296468 HECTOR JIMENEZ MOJAVE FOODS CORPORATION MCCORMICK & COMPANY ESIS CHATSWORTH ADJ9296468 HECTOR JIMENEZ MOJAVE FOODS CORPORATION MCCORMICK & COMPANY INC. ESIS CHATSWORTH ADJ2287368 HECTOR SALVADOR SECURITAS ESIS CHATSWORTH ADJ8609344 HECTOR ZELAYA EL POLLO LOCO ESIS CHATSWORTH ADJ9345639 HIPOLITA HERNANDEZ SELECT STAFFING ESIS CHATSWORTH ADJ9104038 IGNACIO CERVANTES NORTHGATE GONZALEZ MARKETS 21 ESIS CHATSWORTH ADJ1442601 INOCENCIO VAZQUEZ BARRETT BUSINESS SERVICES ESIS CHATSWORTH ADJ1442601 INOCENCIO VAZQUEZ NATIONAL DYEING CO.,INC. ESIS CHATSWORTH ADJ9502998 ISAIAS RAMIREZ VALLEY CREST ESIS CHATSWORTH ADJ8045273 JAIME JIMENEZ AMPCO SYSTEM PARKING ESIS CHATSWORTH ADJ7324705 JAIME LOPEZ TEMPLE INLAND ESIS CHATSWORTH ADJ7724851 JANICE MACIAS STAPLES WAREHOUSE ESIS CHATSWORTH ADJ6544036 JANUARY BRAITHWAITE EMEROTIS MC ESIS CHATSWORTH ADJ9282854 JAVIER DIAZ VALLEY CREST LANDSCAPE ESIS CHATSWORTH ADJ7716895 JAVIER MARRON MASON ELECTRIC CO ESIS CHATSWORTH ADJ7347463 JAZMIN CUPICH WILSHIRE RESTAURANT GOUP DBA MARIE CALLENDER PIE SHOPS ESIS CHATSWORTH ADJ653421 JERRY VARELA LOCKHEED MARTIN ESIS CHATSWORTH ADJ7474342 JESUS CRUZ NATIONAL BEEF ESIS CHATSWORTH ADJ9125034 JESUS MANZO SELECT STAFFING ESIS CHATSWORTH ADJ7294880 JESUS SALES KOOSHAREM CORP ESIS CHATSWORTH ADJ7294880 JESUS SALES KOOSHAREN CORPORATION DBA SELECT PERSONNEL ESIS CHATSWORTH ADJ7294880 JESUS SALES SELECT STAFFING ESIS CHATSWORTH ADJ7294880 JESUS SALES SUN SWEEPING SERVICE ESIS CHATSWORTH ADJ7728689 JESUS ZERMENO MEDTRONIC ESIS CHATSWORTH ADJ8178168 JOHN LUTH INTERSTATE BRANDS ESIS CHATSWORTH ADJ1006854 JORGE FLORES SELECT STAFFING ESIS CHATSWORTH ADJ7495735 JORGE RIVAS CHIPOTLE MEXICAN GRILL ESIS CHATSWORTH ADJ7987268 JOSE HERNANDEZ UNIFIED PROTECTIVE SERVICES INC ESIS CHATSWORTH ADJ8177187 JOSE LUIS GONZALEZ EXOPACK ESIS CHATSWORTH ADJ6583113 JOSE LUIS RODRIGUEZ LABOR READY ESIS CHATSWORTH ADJ697305 JOSE RODRIGUEZ CMC FONTANA STEEL ESIS CHATSWORTH ADJ7617976 JOSE ZARATE ABM JANITORIAL SERVICES ESIS CHATSWORTH ADJ7718222 JOSEFINA VILLALVA MAXIM HEALTHCARE SERVICES ESIS CHATSWORTH ADJ587612 JOSUE HERNANDEZ SRD ENGINEERING, INC. ESIS CHATSWORTH ADJ7020757 JUAN ALVAREZ JR DEAN ENTERPRISES ESIS CHATSWORTH ADJ8042046 JUAN MELENDEZ THARCO ESIS CHATSWORTH ADJ8786559 JUAN NUNEZ CASTRO MASTER HALCO ESIS CHATSWORTH ADJ9675306 JUAN PEREZ REAL TIME STAFFING SERVICES ESIS CHATSWORTH ADJ2579724 JUAN SANDOVAL WALTCO TRUCK EQUIPMENT ESIS CHATSWORTH ADJ2579724 JUAN SANDOVAL WALTCO TRUCK EQUIPMENT CO ESIS CHATSWORTH ADJ9588781 JUDITH DIAZ RANDSTAD ESIS CHATSWORTH ADJ8944614 JULIO SAGASTUME ABM INDUSTRIES ESIS CHATSWORTH ADJ6489502 KIM BULLARD SELECT BUILD ESIS CHATSWORTH ADJ1883909 LARRY BACKER AMTECH ELEVATOR SERVICES ESIS CHATSWORTH ADJ1883909 LARRY BACKER UNITED TECHNOLOGIES CORP. ESIS CHATSWORTH ADJ7209087 LATISHA WOODS TIME WARNER CABLE ESIS CHATSWORTH ADJ4659624 LIBRADO BARRERAS BOULEVARD FUNERAL DIRECTORS CO. ESIS CHATSWORTH ADJ6776497 LUCAS ORTIZ SNELLING PERSONNEL ESIS CHATSWORTH ADJ1449428 LUZ MEZA SELECT PERSONNEL SERVICE ESIS CHATSWORTH ADJ2391384 LUZ MEZA SELECT PERSONNEL SERVICE ESIS CHATSWORTH ADJ6862608 MANOLO CARIAS KOOSHAREM CORP SELECT PERSONNEL SERVICES ESIS CHATSWORTH ADJ7351554 MARCO CISNEROS SELECT PERSONNEL SERVICES ESIS CHATSWORTH ADJ7122255 MARIA HUERTA KOOSHAREM CORP DBA SELECT STAFFING ESIS CHATSWORTH ADJ8209935 MARIA MENDOZA NORTHGATE GONZALES MARKETS ESIS CHATSWORTH ADJ7198293 MARIA MORALES SELECT STAFFING ESIS CHATSWORTH ADJ7492000 MARIA TORRES FULLERTON POST ACUTE CARE ESIS CHATSWORTH ADJ7636597 MARION SIMS DELTA AIRLINES ESIS CHATSWORTH ADJ9305705 MARISOL GUTIERREZ SELECT STAFFING ESIS CHATSWORTH ADJ7477530 MARK ORTIZ LABOR READY ESIS CHATSWORTH ADJ6795915 MARTHA BENITEZ STAPLES ESIS CHATSWORTH ADJ9355842 MARTIN CASILLAS GIUMARRA VINEYARDS ESIS CHATSWORTH ADJ9856176 MAURA TAMAYO KELLY SERVICES ESIS CHATSWORTH ADJ2720266 MAURO MARQUEZ INLAND PAPERBOARD & PACKAGING INC ESIS CHATSWORTH ADJ8836584 MAYRA RIVERA K MART CORP ESIS CHATSWORTH ADJ8253246 MERLY GONZALEZ PLACEMENT PROS ESIS CHATSWORTH ADJ8253246 MERLY GONZALEZ RANDSTAD NORTH AMERICA PLACEMENT PROS ESIS CHATSWORTH ADJ8253246 MERLY GONZALEZ RANDSTAD NORTH AMERICAPLACEMENT PROS ESIS CHATSWORTH ADJ6660304 MICHAEL MINHMAN ESTERLINE CORP MASON ESIS CHATSWORTH Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8334942 MIGUEL MEDINA SELECT STAFFING ESIS CHATSWORTH ADJ7630903 MINERVA GARCIA ABM JANITORIAL SERVICES ESIS CHATSWORTH ADJ7502709 MIRIAM CUAUTLE SELECT STAFFING ESIS CHATSWORTH ADJ871963 MOISES TAPIA MARIE CALANDERS PIE SHOP ESIS CHATSWORTH ADJ7165128 NAZARIO RAMIREZ SNELLING STAFFING ESIS CHATSWORTH ADJ8024697 NEFTALI FAJARDO GOLDEN STATE FENCE COMPANY ESIS CHATSWORTH ADJ7748170 NOE GARCIA CHAVEZ LOOMIS FARGO COMPANY ESIS CHATSWORTH ADJ7748170 NOE GARCIA CHAVEZ LOOMIS FARGO COMPANY ESIS CHATSWORTH ADJ3607894 NORMA TRINIDAD CYTEC ENGINEERED MATERIALS ESIS CHATSWORTH ADJ3607894 NORMA TRINIDAD CYTEC ENGINEERING MATERIALS INC ESIS CHATSWORTH ADJ9580196 OSCAR CONTRERAS ABM ONSITE SERVICES WEST INC ESIS CHATSWORTH ADJ214565 PATRICIA SUAREZ INTERMOUNTAIN STAFFING RESOURCES ESIS CHATSWORTH ADJ8359118 PAUL ORTIZ GERDAU AMERISTELL CORP ESIS CHATSWORTH ADJ7031079 PAULINA VELEY TEMPLE INLAND INC ESIS CHATSWORTH ADJ7483767 PEDRO AQUINO AMPCO SYSTEM PARKING ESIS CHATSWORTH ADJ7316896 RAFAEL HINOJOS THE QUIKRETE COMPANIES INC ESIS CHATSWORTH ADJ8098883 RAMON CARILLO HERNANDEZ SUN PACIFIC FARMING COOPERATIVE ESIS CHATSWORTH ADJ6621198 RAMON GONZALEZ ALLIED BARTON ESIS CHATSWORTH ADJ9313936 RICARDO ANAYA BORBON, INC. ESIS CHATSWORTH ADJ9541987 RICHARD BRITTAIN GERDAU ESIS CHATSWORTH ADJ9541987 RICHARD BRITTAIN GERDAU AMERISTEEL ESIS CHATSWORTH ADJ7284545 ROBERTO LOPEZ CROCKET CONTAINER COMPANY ESIS CHATSWORTH ADJ2582455 ROBERTO URRUNAGA EASTMAN CHEMICAL COMP ESIS CHATSWORTH ADJ9240800 ROBIN POWELL PENNYSAVER ESIS CHATSWORTH ADJ6568480 RONALD GAITHER TIME WARNER ESIS CHATSWORTH ADJ6859569 ROSA FLORES NORTHGATE MARKET ESIS CHATSWORTH ADJ7841361 ROSA LOPEZ EL POLLO LOCO ESIS CHATSWORTH ADJ2653317 ROSA MEJIA BROOKFIELD HEALTH CARE CENTER ESIS CHATSWORTH ADJ8203872 ROSA NAH AEROTEK, INC ESIS CHATSWORTH ADJ8203872 ROSA NAH SELECT STAFFING ESIS CHATSWORTH ADJ8203872 ROSA NAH THIBIANT ESIS CHATSWORTH ADJ371326 ROSA NAVARRO PSI GROUP ESIS CHATSWORTH ADJ371326 ROSA NAVARRO PSI GROUP INC ESIS CHATSWORTH ADJ6968390 ROSSELL BASILIO C CONSTRUCTION INC DBA SELECT BUILD ESIS CHATSWORTH ADJ6796996 SAHARA MERCADO KELLY SERVICING INC ESIS CHATSWORTH ADJ7058371 SAMUEL AREVALO MATA SELECT STAFFING ESIS CHATSWORTH ADJ7272943 SARA ROSALES COURTESY PARKING INC ESIS CHATSWORTH ADJ7794922 SERGIO CERVANTES CALIFORNIA THREAD AND SUPPLY ESIS CHATSWORTH ADJ7233631 SERGIO MURILLO ABM JANITORIAL SERVICES ESIS CHATSWORTH ADJ9086469 SHUHUA GUO SAN GABRIEL VALLEY MEDICAL CENTER ESIS CHATSWORTH ADJ8202150 SOLEDAD DELGADO COVIDIEN ESIS CHATSWORTH ADJ8970280 SOLEDAD WHITNEY DEMO WAREHOUSE SERVICES ESIS CHATSWORTH ADJ9395552 TELMA MORENO AREOTEK STAFFING ESIS CHATSWORTH ADJ7816705 TERESA CASTANEDA SELECT STAFFING ESIS CHATSWORTH ADJ4052577 THOMAS MYRICK INGERSOLL-RAND ESIS CHATSWORTH ADJ7431535 TRINIDAD FLORES NORTHGATE GONZALEZ MARKET ESIS CHATSWORTH ADJ7486566 VENANCIO CARDONA VALLEYCREST LANDSCAPE MAINTENANCE ESIS CHATSWORTH ADJ8023342 VICENTE CASTRO AMERICAN BUILDING MAINTENANCE ESIS CHATSWORTH ADJ7941652 VICTOR MAGANA VALLEY CREST LANDSCAPE ESIS CHATSWORTH ADJ7941652 VICTOR MAGANA VALLEY CREST LANDSCAPING ESIS CHATSWORTH ADJ9242100 VICTOR RODRIGUEZ AEROTEK ESIS CHATSWORTH ADJ4537801 ROSARIO SAIPHONG REMEDY TEMP ESIS EMPLOYERS SELF INSURANCE SERV ADJ4537801 ROSARIO SAIPHONG SELECT STAFFING ESIS EMPLOYERS SELF INSURANCE SERV ADJ1565054 ALFONSO GUIFARRO VALLEY SEAFOOD & POULTRY ESIS FREMONT ADJ1565054 ALFONSO GUIFARRO VALLEY SEAFOOD MARKET ESIS FREMONT ADJ7683014 ALFREDO ANDRADE STAFFING SYSTEMS ESIS FREMONT ADJ9338872 AMILCAR NOLASCO ABM JANITORIAL SERVICES ESIS FREMONT ADJ7083825 ARIEL GONZALEZ TOBO CONSTRUCTION INC ESIS FREMONT ADJ7010898 CYNTHIA EVANS WDS WAREHOUSE DEMO SERVICES ESIS FREMONT ADJ7491929 DALILA LOPEZ SNELLING STAFFING SERVICE ESIS FREMONT ADJ596934 DAVID REBOLLAR EZ FOODS ESIS FREMONT ADJ2306383 DOMINGA PEREZ SNELLING PERSONNAL SERVICES ESIS FREMONT ADJ7222856 ERIBERTO VERA ROSITAS BAKERY ESIS FREMONT ADJ7555543 ERUVIEL BOJORQUEZ CLASSIC BUILDING ARTS ESIS FREMONT ADJ7295407 GERARDO GUILLEN IRVINE VALENCIA GROWERS ESIS FREMONT ADJ6776860 ILEANA BENAVIDES SELECT STAFFING ESIS FREMONT ADJ7937113 JAVIER NUNEZ AMERIPRIDE ESIS FREMONT ADJ7937113 JAVIER NUNEZ AMERIPRIDE SERVICES INC ESIS FREMONT ADJ7653944 JESUS GARCIA STAFFING SYSTEMS INC ESIS FREMONT ADJ6669379 JOSE SILVA J&D ACQUISITION CORP DBA GENE ESIS FREMONT ADJ2134384 JUAN GONZALEZ SALAZAR CONSTRUCTION CO INC ESIS FREMONT ADJ7973422 LAWRENCE MICKEL REFUGE THE BANK OF NEW YORK MELLON ESIS FREMONT ADJ7105155 LIDIA OROS PACWEST SECURITY SERVICES ESIS FREMONT ADJ8290680 MAGDALENA SANTOS PACESETTER PERSONNEL SERVICES ESIS FREMONT ADJ6886050 MARGARITA PEREZ PACWEST SECURITY SERVICES ESIS FREMONT ADJ8221143 MARIA GONZALES PACIFIC LINE CLEAN UP INC ESIS FREMONT ADJ7198293 MARIA MORALES SELECT STAFFING ESIS FREMONT ADJ7460850 MARIO HULL INTERSTATE BRANDS CORPORATION ESIS FREMONT ADJ7968406 NORA DUBON REALITEE MIND CANDY ESIS FREMONT ADJ6989674 PAULA RIVERA LA PRINTING INC ESIS FREMONT ADJ6989674 PAULA RIVERA LOS ANGELES ESIS FREMONT ADJ7620116 ROLANDO JUAREZ STAFFING SYSTEMS INC ESIS FREMONT ADJ8222555 SAUL NUNGARAY PACIFIC LINE CLEAN UP INC ESIS FREMONT ADJ7939737 SILVIA ZELAYA ROYAL DENIM INC. ESIS FREMONT ADJ7990111 SOLEDAD RODRIGUEZ CORE BAKERSFIELD LLC ESIS FREMONT ADJ8183332 VICTOR MONTES TRUEBLUE ESIS FREMONT Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8963086 BART CLAVANO SELECT STAFFING ESIS PORTLAND ADJ8040893 DORA FLORES MARICOPA PACKERS LP ESIS PORTLAND ADJ8040893 DORA FLORES SUN PACIFIC ESIS PORTLAND ADJ7491584 EVA FLORES SELECT STAFFING ESIS PORTLAND ADJ7138725 JOSE TRINIDAD STANDARD PARKING ESIS PORTLAND ADJ6776497 LUCAS ORTIZ SNELLING PERSONNEL ESIS PORTLAND ADJ7395185 MIGUEL DELGADO NORTHGATE MARKET #10 ESIS PORTLAND ADJ7558114 PAULA AYALA CENTRAL PARKING ESIS PORTLAND ADJ7558114 PAULA AYALA STANDARD PARKING ESIS PORTLAND ADJ6725774 ROGER MEJIA CSV LAKESIDE ESIS PORTLAND ADJ8222555 SAUL NUNGARAY PACIFIC LINE CLEAN UP INC ESIS PORTLAND ADJ7084358 WILLIAM LARA LORI PRODUCTS ESIS PORTLAND ADJ9285178 JESUS HERNANDEZ SELECT STAFFING ESIS SAN DIEGO ADJ8944614 JULIO SAGASTUME ABM INDUSTRIES ESIS SAN DIEGO ADJ8135494 LUIS CUELLAR AMPCO SYSTEM PARKING ESIS SAN DIEGO ADJ9415190 RICARDO MARTINEZ GARCIA COSWAY COMPANY INC ESIS SAN DIEGO ADJ9415190 RICARDO MARTINEZ GARCIA REAL TIME STAFFING SERVICES INC ESIS SAN DIEGO ADJ8071171 SANDRA RAMOS BP ARCO ESIS SAN DIEGO ADJ7784201 RAUL MARTINEZ COMMERCIAL METALS COMPANY ESIS SOUTHFIELD ADJ7784201 RAUL MARTINEZ G&A PARTNERS ESIS SOUTHFIELD ADJ371326 ROSA NAVARRO PSI GROUP ESIS SOUTHFIELD ADJ371326 ROSA NAVARRO PSI GROUP INC ESIS SOUTHFIELD ADJ7287382 ALEJANDRO GARCIA KOOSHAREM CORPORATION ESIS TAMPA ADJ7174275 ANA OTERO ONE SOURCE ABM INDUSTRIES INC ESIS TAMPA ADJ7580547 ANGELINA GUERRERO SELECT STAFFING ESIS TAMPA ADJ6546495 BILL LERUE ALLEN AND HIEN ESIS TAMPA ADJ7056959 CHRISTINA RUIZ WAREHOUSE DEMO SERVICES ESIS TAMPA ADJ6451093 CONCEPCION VELASCO KRAFT FOODS GLOBAL ESIS TAMPA ADJ6542993 CUITLAHUAC GARCIA PC GREENS ESIS TAMPA ADJ7429129 DELFINA MORALES THE SELECT FAMILY OF STAFFING COMPANIES ESIS TAMPA ADJ7210545 ESPERANZA LOPEZ GENESIS PROFESSIONAL STAFFING ESIS TAMPA ADJ7210545 ESPERANZA LOPEZ KELLY SERVICES ESIS TAMPA ADJ8912637 EVANGELINA MUCINO TIME WARNER CABLE ESIS TAMPA ADJ8053494 FELIPE MORENO TUMAROS GOURMET TORTILLAS ESIS TAMPA ADJ7452097 FRANK FENGKUN LEE WERNER ENTERPRISES ESIS TAMPA ADJ6592856 JACOB HUERTH STAPLES ESIS TAMPA ADJ7174696 JESUS RIVERA SELECT STAFFING STAFF1NG GROUP WEST VOP INCI ESIS TAMPA ADJ7294880 JESUS SALES KOOSHAREM CORP ESIS TAMPA ADJ7294880 JESUS SALES KOOSHAREN CORPORATION DBA SELECT PERSONNEL ESIS TAMPA ADJ7294880 JESUS SALES SELECT STAFFING ESIS TAMPA ADJ7294880 JESUS SALES SUN SWEEPING SERVICE ESIS TAMPA ADJ7981877 JOSE AVINA INFANTE SIX FLAGS MAGIC MOUNTAIN ESIS TAMPA ADJ6491972 JOSE LEAL TIME WARNER CABLE ESIS TAMPA ADJ7516488 JOSE MARQUEZ CPC LOGISTICS INC ESIS TAMPA ADJ6719178 JOSE PEREZ PARSEC CO ESIS TAMPA ADJ6419785 JOVITA MORA ONE SOURCE BUILDING SERVICES, INC. ESIS TAMPA ADJ6671846 JUAN IBARRA ABM JANITORIAL SERVICE ESIS TAMPA ADJ6509706 KAREN RAMIREZ BRFIANS SUPERBURGER ESIS TAMPA ADJ4286875 KATHLEEN HOLT SHARP HEALTHCARE ESIS TAMPA ADJ6776497 LUCAS ORTIZ SNELLING PERSONNEL ESIS TAMPA ADJ6634346 LUCIO CHAIDEZ VERTIS INC ESIS TAMPA ADJ8253246 MERLY GONZALEZ PLACEMENT PROS ESIS TAMPA ADJ8253246 MERLY GONZALEZ RANDSTAD NORTH AMERICA PLACEMENT PROS ESIS TAMPA ADJ8253246 MERLY GONZALEZ RANDSTAD NORTH AMERICAPLACEMENT PROS ESIS TAMPA ADJ7788160 MICHAEL SALCIDO STAPLES ESIS TAMPA ADJ6646904 MIGUEL CASTRO MISSION VIEJO AUTO SPA ESIS TAMPA ADJ7442642 MIGUEL QUEVEDO SELECT STAFFING ESIS TAMPA ADJ7165128 NAZARIO RAMIREZ SNELLING STAFFING ESIS TAMPA ADJ7748170 NOE GARCIA CHAVEZ LOOMIS FARGO COMPANY ESIS TAMPA ADJ7748170 NOE GARCIA CHAVEZ LOOMIS FARGO COMPANY ESIS TAMPA ADJ214565 PATRICIA SUAREZ INTERMOUNTAIN STAFFING RESOURCES ESIS TAMPA ADJ7558114 PAULA AYALA CENTRAL PARKING ESIS TAMPA ADJ7558114 PAULA AYALA STANDARD PARKING ESIS TAMPA ADJ7041621 PORFIRIO FLORES CUSTOM DELUXE LAND SCAPING INC ESIS TAMPA ADJ6985591 RAFAEL GOMEZ FLOREZ LABOR READY ESIS TAMPA ADJ7073114 RAUL BERNAL HERNANDEZ INTERSTATE BRANDS CORPORATION ESIS TAMPA ADJ7807738 RICHARD GONZALES RELIANCE STEEL AND ALUMINUM CO ESIS TAMPA ADJ7620116 ROLANDO JUAREZ STAFFING SYSTEMS INC ESIS TAMPA ADJ579486 RUTH GONZALES A & D BUILDING MAINTENANCE ESIS TAMPA ADJ7605802 SERGIO GARCIA SELECT STAFFING ESIS TAMPA ADJ7777236 SILVIA DE LA PAZ NORTHGATE SUPERMARKET ESIS TAMPA ADJ6988521 SILVIANO ORTIZ ECOLOGY AUTO PARTS ESIS TAMPA ADJ8545701 VICENTE ARAGON IBC HOSTESS BRANDS 70 ESIS TAMPA ADJ7941652 VICTOR MAGANA VALLEY CREST LANDSCAPE ESIS TAMPA ADJ7941652 VICTOR MAGANA VALLEY CREST LANDSCAPING ESIS TAMPA ADJ7208298 VIRGILIO GARCIA VALLEY CREST LANDSCAPE ESIS TAMPA ADJ6747792 YOLANDA RODRIGUEZ MARIE CALLENDERS ESIS TAMPA ADJ9666141 VICTORIANO TERRIQUEZ UNIVERSAL BUILDING MAINTENANCE ESIS West WC Claims ADJ3412703 PEDRO MEJIA FINES MARKET EVEREST INSURANCE COMPANY ADJ3803997 PEDRO GARCIA ANAPLEX EVEREST NATIONAL INSURANCE ADJ3803997 PEDRO GARCIA ANAPLEX CORP EVEREST NATIONAL INSURANCE ADJ9505953 BLANCA LEAL EBS INC EVEREST NATIONAL INSURANCE OAKLAND ADJ8585680 GABRIEL CASTANEDA FIBER CARE BATHS INC EVEREST NATIONAL INSURANCE OAKLAND ADJ9213086 HORTENCIA BERMUDEZ J AND S PAPER SOUTHERN LLC EVEREST NATIONAL INSURANCE OAKLAND ADJ8692914 IGNACIO QUINTERO STASON PHARMACEUTICALS EVEREST NATIONAL INSURANCE OAKLAND ADJ9269576 JAVIER BUENROSTRO SILVA DICKSON SERVICES EVEREST NATIONAL INSURANCE OAKLAND Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9822488 JOSE GONZALEZ ANDERCO CARPET COMP INC EVEREST NATIONAL INSURANCE OAKLAND ADJ9678404 JUAN KUMUL CALIFORNIA WASTE SERVICE EVEREST NATIONAL INSURANCE OAKLAND ADJ8842560 LILY LUGO DCG FULFILLMENT EVEREST NATIONAL INSURANCE OAKLAND ADJ8842560 LILY LUGO GAR LABORATORIES EVEREST NATIONAL INSURANCE OAKLAND ADJ8842560 LILY LUGO JC BLINDS MFG INC EVEREST NATIONAL INSURANCE OAKLAND ADJ8842560 LILY LUGO NEWPORT THIN FILM LABORATORY INC EVEREST NATIONAL INSURANCE OAKLAND ADJ8842560 LILY LUGO STAFF CHEX EVEREST NATIONAL INSURANCE OAKLAND ADJ8842560 LILY LUGO TRADEMARK COSMETICS EVEREST NATIONAL INSURANCE OAKLAND ADJ9660288 MARCO BACAJOL XCVI LLC EVEREST NATIONAL INSURANCE OAKLAND ADJ9094338 MAURO CORTEZ HARLAND BRAUN AND CO EVEREST NATIONAL INSURANCE OAKLAND ADJ8358815 MIGUEL MAZARIEGO SHAMMA CONSTRUCTION EVEREST NATIONAL INSURANCE OAKLAND ADJ9584781 MYRNA DIAZ YEPEZ PACIFIC CLINICS EVEREST NATIONAL INSURANCE OAKLAND ADJ6813377 SALVADOR SANCHEZ CAL PARTITIONS INC EVEREST NATIONAL INSURANCE OAKLAND ADJ7083939 VELVET ESTRADA WEST LAKE FOOD CORP EVEREST NATIONAL INSURANCE OAKLAND ADJ9108161 VIRGINIA DAVILA MUJER MODERNA EVEREST NATIONAL INSURANCE OAKLAND ADJ9232895 YOLANDA GONZALEZ ARECONT VISION EVEREST NATIONAL INSURANCE OAKLAND ADJ6935846 AGUEDA ARROYO KELLY TOOL & MFG CO EVEREST NATIONAL ORANGE INVALID ADJ6839830 ANTONIO GONZALEZ SUNSHINE GKEENERY INC EVEREST NATIONAL ORANGE INVALID ADJ7220503 DEBERA JOHNSON WATTS HEALTHCARE ORGANIZATION EVEREST NATIONAL ORANGE INVALID ADJ2716833 GUSTAVO LOPEZ E. REYES ROLL-OFF SERVICE EVEREST NATIONAL ORANGE INVALID ADJ7024909 IRENE CHOY LEE KUM KEE USA EVEREST NATIONAL ORANGE INVALID ADJ6806868 JAVIER RAMIREZ DIX METALS INC EVEREST NATIONAL ORANGE INVALID ADJ2739502 JAVIER TAMAYO C PACIFIC FOOD INC EVEREST NATIONAL ORANGE INVALID ADJ4679308 JAVIER VEGA ELEMENT SKATE INC EVEREST NATIONAL ORANGE INVALID ADJ7179382 JESSE LOPEZ J AND M TOWING EVEREST NATIONAL ORANGE INVALID ADJ6715517 JOSE GOMEZ VASQUEZ HI TECH SEATING PRODUCTS INC KUSTOM FIT EVEREST NATIONAL ORANGE INVALID ADJ520461 JOSE MANUEL RUVALCABA FRANK MADISON LANDSCAPING EVEREST NATIONAL ORANGE INVALID ADJ6529015 KYLE EDWARDS RUCKER ETTIE LEE YOUTH AND FAMILY SERVICE EVEREST NATIONAL ORANGE INVALID ADJ6420130 MARIA GALVEZ MULTIPACK CORP EVEREST NATIONAL ORANGE INVALID ADJ9446699 MARTIN GALEANO NEW WORLD MAINTENANCE INC EVEREST NATIONAL ORANGE INVALID ADJ630924 NICOLAS LOPEZ KCA ELECTRONICS, INC EVEREST NATIONAL ORANGE INVALID ADJ7112846 ROBERTO RAMOS ACTIVE TEMPORARY PLACEMENT AGENCY EVEREST NATIONAL ORANGE INVALID ADJ572442 MARIO LOPEZ E-Z TOOL & ENGINEERING E-Z TOOL & ENGINEERING ADJ5790426 ELIGIO VARGAS SILVERWOOD LANDSCAPE CONSTRUCTION FARA ADJ9071266 ALBERTO ARVIZU NABORS INDUSTRIES INC FARA ORANGE ADJ5790426 ELIGIO VARGAS SILVERWOOD LANDSCAPE CONSTRUCTION FARA ORANGE ADJ2559597 JOSE LOPEZ LABOR FINDERS FARA ORANGE ADJ9444446 LUIS PEREZ MARTINEZ THE ORIGINAL MOWBRAY S TREE SERVICE FARA ORANGE ADJ6523965 MARIO HERNANDEZ ARTISONS COMPANY FARA ORANGE ADJ8717210 MAYRA MORALES CHONG MOM Y BEBE NUTRICION FARMERS ADJ7080479 OMAR LOPEZ PUENTE HILLS STEAKHOUSE FARMERS ADJ7291498 JAIME COBOS GATOR MACHINERY CO FARMERS ADJ7179151 MIRIAM MANCILLAS NADER A MOKRI FARMERS ADJ9439837 ANA PLATERO MICHAEL JOHNSTONE & ASSOCIATES FARMERS AURORA ADJ9421554 JOSE VILLATORO LAFAYETTE PARK PLACE FARMERS AURORA ADJ9421289 AUSENCIO FLORES SORENSON ENGINEERING FARMERS INSURANCE ADJ7505322 CHRISTINE MARCINKO ALCANTARA HOME APTS FARMERS INSURANCE ADJ9417760 FELIX CABRERA MARTINON BELLA INC FARMERS INSURANCE ADJ8040127 ISMAEL SILVA SUPREME GRAPHICS FARMERS INSURANCE ADJ6604539 RAUL SILVA BOBS BIG BOY FARMERS INSURANCE ADJ9470180 STEVEN MORALES LUCY S DRIVE INN FARMERS INSURANCE ADJ8308095 ANGELICA ROSAS SUPER FINE DRY CLEANERS INC FARMERS INSURANCE GROUP ADJ9230865 ADELA LEMUS HENRY B CHANDLER FARMERS INSURANCE IMAGING CENTER ADJ8251976 ADRIAN PALAFOX DENNYS RESTAURANT FARMERS PLEASANTON ADJ8643099 CESAR FAJARDO UNIVERSAL DYEING & PRINTING INC FARMERS PLEASANTON ADJ7923943 DANIEL HERNANDEZ BE ON PRODUCE INC FARMERS PLEASANTON ADJ9147890 EMIGDIO RODRIGUEZ MEDINA DARREL ESPE FARMERS PLEASANTON ADJ1918676 EMMA MARISA CRUZ DE LAZO ORO KING FARMERS PLEASANTON ADJ9103377 FABIOLA MOLINA TERIYAKI HOUSE FARMERS PLEASANTON ADJ7575906 FERNANDO VALENCIA REDNAB FARMERS PLEASANTON ADJ8043403 FRANCISCO MADERO ANDY RAMIREZ FARMERS PLEASANTON ADJ7317835 GLORIA HIPOLITO MR BAGUETTE FARMERS PLEASANTON ADJ8362195 GLORIA NAVARRO PASSAGES FARMERS PLEASANTON ADJ8637672 GUADALUPE AGUINAGA CPM FARMERS PLEASANTON ADJ8390563 JOHN WILSON APEX FARMERS PLEASANTON ADJ7955323 JOSE GUZMAN CALIFORNIA OAKS CAR WASH FARMERS PLEASANTON ADJ9202323 JOSE SALAZAR EL INDIO TORTILLERIA FARMERS PLEASANTON ADJ7571058 JOSUE LOPEZ TORRANCE STEEL WINDOW CO FARMERS PLEASANTON ADJ8707880 LUCIA CHAVEZ DRAMA 88 FARMERS PLEASANTON ADJ7616949 MARIA LOURDES TOPACIO FARMERS INSURANCE GROUP FARMERS PLEASANTON ADJ9103478 MARIA PRADO TEAM COLOR FARMERS PLEASANTON ADJ7243607 MARTHA MONTANEZ MEGAN MITCHELL FARMERS PLEASANTON ADJ9389749 MARTIN GARCIA ANTONIOS MISAFINS INDIVIDUAL DBA TOM'S BURGERS FARMERS PLEASANTON ADJ9389749 MARTIN GARCIA ANTONIOS MISAFINS, INDIVIDUAL DBA TOM'S BURGERS FARMERS PLEASANTON ADJ9389749 MARTIN GARCIA ANTONIOS MISAFIRIS FARMERS PLEASANTON ADJ9389749 MARTIN GARCIA TOMS BURGERS FARMERS PLEASANTON ADJ7756260 NELVI REYES VINYL TECHNOLOGY FARMERS PLEASANTON ADJ9814827 NICOLAS BASNI CM PAINTING AND CONSTRUCTION FARMERS PLEASANTON ADJ7690304 RAFAEL MARTINEZ SPEC FORMLINERS INC FARMERS PLEASANTON ADJ6949007 AGUSTIN CARRANZA CASA COLINA FARMERS SANTA ANA ADJ6949007 AGUSTIN CARRANZA PAUL J JOHNSON FARMERS SANTA ANA ADJ8210917 ALEYDA MENDOZA CALICO BRANDS INC FARMERS SANTA ANA ADJ6663263 ANTONIO CHAVEZ EASY LIFE FURNITURE INC FARMERS SANTA ANA ADJ9489728 ANTONIO GUTIERREZ GARCIA D AND R FOOD INC FARMERS SANTA ANA ADJ9489728 ANTONIO GUTIERREZ GARCIA VILLAGE RANCH MARKET FARMERS SANTA ANA ADJ9489728 ANTONIO GUTIERREZ GARCIA VILLAGE RANCH MARKET DBA LA FIESTA AMERICANA FARMERS SANTA ANA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8028961 BENJAMIN CARBAJAL EL NOPAL MARKET FARMERS SANTA ANA ADJ7210139 BUNMEE ROMERO DENNYS RESTUARANT FARMERS SANTA ANA ADJ8745144 CRESENCIO DOMINGUEZ PAULILLO AMECI PIZZA AND PASTA FARMERS SANTA ANA ADJ2871948 EBER LOPEZ PAPER COMPANY INC FARMERS SANTA ANA ADJ9124571 EVANGELINA VILLEGAS HUXTABLES KITCHEN FARMERS SANTA ANA ADJ7209144 FELIPE PENA L. JOHNSON CONSTRUCTIONJ INCI FARMERS SANTA ANA ADJ8226989 FIDEL BENITEZ TELLY`S CHARBURGERS INC FARMERS SANTA ANA ADJ9361956 GABRIEL CANELA LA HABANA CUBA RESTAURANT FARMERS SANTA ANA ADJ7726434 GABRIEL RODRIGUEZ BUN BOY FARMERS SANTA ANA ADJ6638750 GLADYS VELASQUEZ SAGAN FARMERS SANTA ANA ADJ7652294 GRISELDA ORNELAS TACO BELL FARMERS SANTA ANA ADJ9260297 HECTOR TRIANA RH FOODS LLC FARMERS SANTA ANA ADJ8774728 IGNACIO MARTINEZ WOODYS GROUP INC FARMERS SANTA ANA ADJ8901269 ISIDRA SOLIS FRESHWORKS INC FARMERS SANTA ANA ADJ9046580 JAVIER GARCIA LARDAS SYSTEMS DBA MC DONALDS FARMERS SANTA ANA ADJ6830875 JESUS VALDEZ MARKS AUTO BODY FARMERS SANTA ANA ADJ7237023 JIM VINSON D BURKE MECHANICAL INC FARMERS SANTA ANA ADJ6618530 JIMMIE WILLIAMS DENNYS FARMERS SANTA ANA ADJ9292425 JOSE LAUREAN D B CUSTOM CABINET INC FARMERS SANTA ANA ADJ8844494 JOSE VERDIN SUPERIOR DUCT FABRICATION INC FARMERS SANTA ANA ADJ7518421 JUAN AMADOR MARMALADE CAFE FARMERS SANTA ANA ADJ9299208 JUAN REYES JUN AND YOUNG INC DBA MAN DOO RANG DUMPLING FARMERS SANTA ANA ADJ7394392 JUAN RODRIGUEZ MEDINA MAYWOOD PIZZA INC FARMERS SANTA ANA ADJ3658322 JUAN SANCHEZ HANOVER BUILDERS FARMERS SANTA ANA ADJ9294275 KARINA MORENO THE WOMENS CLINIC FARMERS SANTA ANA ADJ4540186 LAURA MENDOZA GATEKEEPER SYSTEMS INC FARMERS SANTA ANA ADJ239034 LETICIA MIRANDA CROWN PLAZA HOTEL FARMERS SANTA ANA ADJ9623427 LUCAS VILLEDA DEKEL ASSOC INC FARMERS SANTA ANA ADJ9623427 LUCAS VILLEDA DEKEL ASSOCIATES INC FARMERS SANTA ANA ADJ7912764 LUIS GARCIA VINYL TECHNOLOGY INC FARMERS SANTA ANA ADJ9354273 MANUEL CASTANEDA GUZMAN FIESTA MARKET FARMERS SANTA ANA ADJ6740111 MARCO ROSALES CHANGS AUTO BODY REPAIR FARMERS SANTA ANA ADJ9337165 MARIA ARROYO PACIFIC HOTEL MANAGEMENT INC DBA RADISSON HOTEL FARMERS SANTA ANA ADJ9229639 MARIA CRESPO FIN CREATIVE CONCEPTS LLC FARMERS SANTA ANA ADJ9229639 MARIA CRESPO MI RANCHITO VERACRUZANO FARMERS SANTA ANA ADJ6958748 MARIA ESPINO DENNY`S INC FARMERS SANTA ANA ADJ6958748 MARIA ESPINO NAGI INC FARMERS SANTA ANA ADJ8865415 MARIA MARTINEZ QUEENS BAKERY FARMERS SANTA ANA ADJ7156145 MARIA MONTES BLLLY BOY RESTAURANT FARMERS SANTA ANA ADJ9292976 MARIA NAJARRO REVOLORIO ZOHAR LOSHITZER FARMERS SANTA ANA ADJ7534748 MARIA VASQUEZ DEL TACO AKA DEL ONE INC FARMERS SANTA ANA ADJ7502163 MARIO CARRIZAL AVILA JB INDUSTRIES CORPORATION FARMERS SANTA ANA ADJ9389749 MARTIN GARCIA ANTONIOS MISAFINS INDIVIDUAL DBA TOM'S BURGERS FARMERS SANTA ANA ADJ9389749 MARTIN GARCIA ANTONIOS MISAFINS, INDIVIDUAL DBA TOM'S BURGERS FARMERS SANTA ANA ADJ9389749 MARTIN GARCIA ANTONIOS MISAFIRIS FARMERS SANTA ANA ADJ9389749 MARTIN GARCIA TOMS BURGERS FARMERS SANTA ANA ADJ7752295 MARTIN MEJIA DARYA RESTAURANT FARMERS SANTA ANA ADJ9173603 MARTIN SINCLAIR W D TRUCKING FARMERS SANTA ANA ADJ7523199 MARTIRES GARCIA TRI STAR MANUFACTURING INC FARMERS SANTA ANA ADJ7271267 MAYOLO GARCIA PACIFIC RIM CONTRACTORS INC FARMERS SANTA ANA ADJ9299218 MIGUEL HERNANDEZ ALPHA MASTER BUILDERS INC FARMERS SANTA ANA ADJ9115209 MIGUEL SANTIZO JB PARTNERS GROUP INC FARMERS SANTA ANA ADJ8111800 MODESTO BRITO ARC COATING INCORPORATED FARMERS SANTA ANA ADJ9605509 OLGA MIRANDA VINYL TECHNOLOGY INC FARMERS SANTA ANA ADJ7350055 OLVIN HERNANDEZ AMMO FARMERS SANTA ANA ADJ7732631 OSCAR REYES EL CHOLO RESTAURANT FARMERS SANTA ANA ADJ7680048 OTILIA SANCHEZ GONZALEZ IRIS SABBAH FARMERS SANTA ANA ADJ9119421 OTONIEL MORALES ANTHONY LAUREN AND CO FARMERS SANTA ANA ADJ7006890 PEDRO JIMPIKIT VERMONT SEAFOOD MARKET INC FARMERS SANTA ANA ADJ6916632 RAFAEL LUCERO GIANT RV FARMERS SANTA ANA ADJ8835003 REGINALD ANTHONY THE DISH FACTORY FARMERS SANTA ANA ADJ811973 RODOLFO FRANCISCO PC DESIGN & RATTAN FARMERS SANTA ANA ADJ8205337 RODOLFO GUTIERREZ MARRIS PIZZA FARMERS SANTA ANA ADJ9070823 RONG JI MAI SEA HARBOUR SEAFOOD RESTAURANT FARMERS SANTA ANA ADJ6726290 SANDRA SALDANA POLLY`S INC FARMERS SANTA ANA ADJ8896903 SILVERIO ROMANO EAST WEST FRANCHISE INVESTMENTS FARMERS SANTA ANA ADJ2061008 TEODOLFO LOPEZ CONNELL CHEVROLET FARMERS SANTA ANA ADJ6550791 VICTOR HERNANDEZ THE VAULT BAR AND GRILL FARMERS SANTA ANA ADJ4680433 VICTORIA GUTIERREZ KFC FARMERS SANTA ANA ADJ6950902 YAEL ZAMORA COCO`S BAKERY RESTAURANT FARMERS SANTA ANA ADJ8387747 ABELARDO CRUZ FORAGE RESTAURANT FARMERS WESTLAKE VILLAGE ADJ6877078 ADOLFO SALGADO RITAS GOURMET RESTAURANT FARMERS WESTLAKE VILLAGE ADJ8375324 ADRIAN HERNANDEZ JEFF KERBER POOL PLASTERING INC FARMERS WESTLAKE VILLAGE ADJ9135115 ALFONSO AVILA GARCIA DAN MILLER ENTERPRISES INC DBA BARNEYS COFFEE SHOP FARMERS WESTLAKE VILLAGE ADJ9625100 ALFREDO MARTINEZ LOUSIANA FRIED CHICKEN AND CHINSSE FOOD INC FARMERS WESTLAKE VILLAGE ADJ6613527 ALICIA RODRIGUEZ NOVACK USA FARMERS WESTLAKE VILLAGE ADJ9145449 ANDRES RIVAS SUN VALLEY DAIRY INC FARMERS WESTLAKE VILLAGE ADJ8202232 ARMIDA RODRIGUEZ DE LOPEZ SELECT CLOTHING CO FARMERS WESTLAKE VILLAGE ADJ3344219 ARTURO CHAVEZ ANGIE ENTERPRISE, INC. FARMERS WESTLAKE VILLAGE ADJ6748276 BLADIMIRO HERNANDEZ CENTURY QUALITY MANAGEMENT INC FARMERS WESTLAKE VILLAGE ADJ6516570 CARLOS HERNANDEZ PACIFIC BLUE GARMENT SOLUTION INC FARMERS WESTLAKE VILLAGE ADJ1621412 CARLOS ORREGO RESEDA AUTO & ELECTRIC FARMERS WESTLAKE VILLAGE ADJ4475782 CARLOS REYES TONY HANDLER, INC. FARMERS WESTLAKE VILLAGE ADJ8304901 EDIL AKA ISIDRO GALICIAS AKA MAGANA SUN AIR CONVALESCENT HOSP FARMERS WESTLAKE VILLAGE ADJ6772781 EDWIN ROBLES CLASSIC DESIGN FARMERS WESTLAKE VILLAGE ADJ4413402 ERIKA RIOS UNIVERSAL PSYCHOLOGIST MEDICAL CTR FARMERS WESTLAKE VILLAGE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7128405 EVERARDO RODRIGUEZ DEEP KLEEN INC FARMERS WESTLAKE VILLAGE ADJ3154336 FRANCISCO VEGA SHAW ENGINEERING & CONSTRUCTION,INC FARMERS WESTLAKE VILLAGE ADJ7470286 GASTON ESCOBAR PROCARE TREE SERVICE INC FARMERS WESTLAKE VILLAGE ADJ959763 GILBERTO VALLE STONE ETC INC FARMERS WESTLAKE VILLAGE ADJ6967154 GONZALO AREVALO SPECTRA COLOR INC FARMERS WESTLAKE VILLAGE ADJ6471197 GRACIELA CASTRO SHADE HOTEL FARMERS WESTLAKE VILLAGE ADJ6471198 GRACIELA CASTRO SHADE HOTEL FARMERS WESTLAKE VILLAGE ADJ9353835 GREGORIO AGUILAR PACIFIC AEROSPACE MACHINE INC FARMERS WESTLAKE VILLAGE ADJ9758775 GUADALUPE CURIEL DBA TORTAS AHOGADAS TONY FARMERS WESTLAKE VILLAGE ADJ9758775 GUADALUPE CURIEL TORTAS AHOGADAS LAS ORIGINAELS INC FARMERS WESTLAKE VILLAGE ADJ8672779 GUALBERTO PEREZ COMMERCIAL DIE CASTING CORP FARMERS WESTLAKE VILLAGE ADJ7914462 HUGO PANIAGUA AGGRESSIVE ENGINEERING CORP FARMERS WESTLAKE VILLAGE ADJ6655855 IMELDA MEJIA CARNICERIA LA CHIGUITA FARMERS WESTLAKE VILLAGE ADJ6633524 JACQUELINE MEDINA AE INTERATATE PROPERTIES DBA DEER CREEK CAR WASH FARMERS WESTLAKE VILLAGE ADJ7135027 JAVIER PAIS BEVERLY HILLS AUTO FARMERS WESTLAKE VILLAGE ADJ6679608 JESUS GALLEGOS STEED AUTO FARMERS WESTLAKE VILLAGE ADJ7435328 JOSE DELGADO GOOD STUFF RESTAUANT FARMERS WESTLAKE VILLAGE ADJ7435328 JOSE DELGADO GOOD STUFF RESTAURANT FARMERS WESTLAKE VILLAGE ADJ9063165 JOSE MARTINEZ DECOR INTERIOR DESIGN FARMERS WESTLAKE VILLAGE ADJ7782104 JOSE SEGURA EVEREST FARMERS WESTLAKE VILLAGE ADJ7655155 JUAN MARTINEZ CREATION S GARDEN NATURAL PRODUCTS FARMERS WESTLAKE VILLAGE ADJ1514563 JUAN PABLO PENAFIEL EL MONTE FORD FARMERS WESTLAKE VILLAGE ADJ6465014 LI SHENG TAN ROLLINS NARROW FABRIC, INC. FARMERS WESTLAKE VILLAGE ADJ8788943 MARGARITA OROZCO GUS JR NO 10 FARMERS WESTLAKE VILLAGE ADJ8408436 MARIA ALVAREZ CALICO BRANDS INC FARMERS WESTLAKE VILLAGE ADJ7124626 MARIA LARIOS LEVINE MANAGEMENT GROUP INC FARMERS WESTLAKE VILLAGE ADJ9170285 MARIA MOTA POMONA LODGE INC FARMERS WESTLAKE VILLAGE ADJ9069034 MICAELA OCHOA SAIGON DELI RESTAURANT FARMERS WESTLAKE VILLAGE ADJ1502880 MINERVA MEDINA SOCORRO'S RESTAURANT FARMERS WESTLAKE VILLAGE ADJ2846689 NORMA PIRIR SUPER D DISTRIBUTION FARMERS WESTLAKE VILLAGE ADJ7690304 RAFAEL MARTINEZ SPEC FORMLINERS INC FARMERS WESTLAKE VILLAGE ADJ6678538 RAUL MORAN GREAT CHINA WALL FARMERS WESTLAKE VILLAGE ADJ7000202 ROBERTO TORREZ ADDRESSERS FARMERS WESTLAKE VILLAGE ADJ9197050 ROSA GUILLEN HONG KONG EXPRESS FARMERS WESTLAKE VILLAGE ADJ1221880 SALVADOR BARBA WEST CENTRAL PRODUCE FARMERS WESTLAKE VILLAGE ADJ9233846 SALVADOR MEJIA CHRISTY S ENTERPRISES FARMERS WESTLAKE VILLAGE ADJ8071171 SANDRA RAMOS BP ARCO FARMERS WESTLAKE VILLAGE ADJ8155222 SANG BO LEE OCTOPUS JAPANESE RESTAURANT FARMERS WESTLAKE VILLAGE ADJ7162202 STEVEN MARTINEZ JACK IN THE BOX FARMERS WESTLAKE VILLAGE ADJ7162202 STEVEN MARTINEZ JYM ENTERPRISES INC FARMERS WESTLAKE VILLAGE ADJ8028854 TANIA AYALA RIVERSIDE COLLISION CENTER INC FARMERS WESTLAKE VILLAGE ADJ8760743 TREVOR HAUGEN DEL TACO FARMERS WESTLAKE VILLAGE ADJ8057346 VICTOR RUVALCABA EXPRESS PIPES AND SUPPLIES FARMERS WESTLAKE VILLAGE ADJ6697500 VIRGINIO REYNA MONOBIND INC FARMERS WESTLAKE VILLAGE ADJ8089029 SYLVA BEJJANI FUDDRUCKERS FEDERAL INSURANCE LOS ANGELES ADJ3723339 ZEKERIA MEHRABI MACY'S FEDERATED CLAIMS SERVICE ADJ9416812 NOEMY RODRIGUEZ LAWRENCE PERKINS FIREMANS FUND INSURANCE CO ADJ7931233 SHARNEY BOURLAND FIRST AMERICAN HOMEBUYERS INSURANCE COMPANY FIRST AMERICAN HOMEBUYERS INSURANCE COMPANY ADJ2374045 TOWANDA COLLINS LONG BEACH UNIFIED SCHOOL DISTRICT FLEMING & ASSOCIATES ADJ7740983 ENEDINA COBIAN BALL HORTICULTURAL FLORISTS MUTUAL INS EDWARDSVILLE ADJ8103925 IGNACIO SILVA OCONNELL LANDSCAPE MAINTENANCE FLORISTS MUTUAL INS EDWARDSVILLE ADJ7918886 INES RODRIGUEZ BOETHING TREELAND FARMS INC FLORISTS MUTUAL INS EDWARDSVILLE ADJ7973158 ROGELIO RAMIREZ HARVEST LANDSCAPING ENTERPRISES INC FLORISTS MUTUAL INS EDWARDSVILLE ADJ7602009 SANDRA CEBALLOS CELMOL INC DBA MARK ROBERTS FLORISTS MUTUAL INS EDWARDSVILLE ADJ7267410 DEBRA HERRON FONTANA UNIFIED SCHOOL DISTRICT FONTANA UNIFIED SCHOOL DISTRICT ADJ9086438 LU CHEN FORTUNE COOKIES RESTAURANT, INC. FORTUNE COOKIES RESTAURANT, INC. ADJ9207286 BALTAZAR SALDANA FOSTER FARMS FOSTER FARMS ADJ9207286 BALTAZAR SALDANA FOSTER FARMS FOSTER FARMS LIVINGSTON ADJ8275841 FLORIBERTO ANDRADE BEDOLLA FOSTER FARMS FOSTER FARMS LIVINGSTON ADJ8945825 LOURDES ARISTA DE BELTRAN FOSTER POULTRY FARMS FOSTER FARMS LIVINGSTON ADJ593699 JESUS JAIME THE RAYMOND GROUP FREMONT COMPENSATION INSURANCE CO ADJ653725 FRANK CATHRILL PERRIS UNIFIED SCHOOL DISTRICT FREMONT COMPENSATION INSURANCE CO/KEENAN & ASSOC

ADJ653725 FRANK CATHRILL PERRIS UNION HIGH SCHOOL FREMONT COMPENSATION INSURANCE CO/KEENAN & ASSOC

ADJ653725 FRANK CATHRILL PERRIS UNION HIGH SCHOOL DISTRICT FREMONT COMPENSATION INSURANCE CO/KEENAN & ASSOC ADJ1256083 ARTHUR RODRIGUEZ NORTHRUP FREMONT INDEMNITY COMPANY ADJ1256083 ARTHUR RODRIGUEZ NORTHRUP AIRCRAFT FREMONT INDEMNITY COMPANY ADJ1707728 PEGGIE ELEBY NORTHROP FREMONT INDEMNITY COMPANY ADJ1707728 PEGGIE ELEBY NORTHROP CORPORATION FREMONT INDEMNITY COMPANY ADJ2629247 PETRA JARAMILLO MONROVIA NURSERY FREMONT INDEMNITY COMPANY ADJ2629247 PETRA JARAMILLO MONROVIA NURSERY FREMONT INDEMNITY COMPANY ADJ4082370 CARLO STEFANELLO GRAYSOFT FREMONT INDEMNITY INSURANCE CO ADJ2747814 LYNN LANDERS TORRES FRESNO UNIFIED SCHOOL DISTRICT FRESNO UNIFIED SCHOOL DISTRICT ADJ7726045 JOSE AKA HIPOLITO CONTRERAS DAVID RAJAMIN TRUCKING INC FRYE CLAIMS HAYWARD ADJ9240904 JULIO RAMOS G AND R AUTO REPAIR BODY G AND R AUTO REPAIR BODY ADJ6818185 DEBRA HIBBS US FOOD SERVICE GAB ROBINS ADJ2341729 ANTHONY CAMPBELL U.P.S GALLAGHER BASSETT ADJ4447337 CHRISTINE KOORNDYK ROSE HILLS GARDEN GROVE GALLAGHER BASSETT ADJ3773630 DIEDRA LEDUFF THE SWAN CORPORATION GALLAGHER BASSETT ADJ3296711 EZEQUIEL CISNEROS WASTE MANAGEMENT GALLAGHER BASSETT ADJ4224279 JESUS MURILLO EI TORITO RESTAI IRANT GALLAGHER BASSETT ADJ4224279 JESUS MURILLO EL TORITO MEXICAN GRILL GALLAGHER BASSETT ADJ992213 MARIA HERMOSILLO CHEESECAKE FACTORY BAKERY GALLAGHER BASSETT ADJ4327569 SALVADOR RODRIGUEZ CROWN FENCE CO GALLAGHER BASSETT Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7953005 VALENTIN BARRIOS IMPERIAL VILLA GALLAGHER BASSETT ADJ4696253 BERTHA ESPINOZA LA QUINTA INNS GALLAGHER BASSETT 255397 SACRAMENTO ADJ7634438 BLANCA GUERRA STREET AHEAD INCORPORATION GALLAGHER BASSETT 255397 SACRAMENTO ADJ7893664 CANDELARIA BECERRA ROMA FOODS GALLAGHER BASSETT 255397 SACRAMENTO ADJ4447337 CHRISTINE KOORNDYK ROSE HILLS GARDEN GROVE GALLAGHER BASSETT 255397 SACRAMENTO ADJ7276566 CONRADO MARTINEZ TCI TIRE CENTER GALLAGHER BASSETT 255397 SACRAMENTO ADJ7402871 CONRADO MARTINEZ TCI CENTER INC GALLAGHER BASSETT 255397 SACRAMENTO ADJ7402871 CONRADO MARTINEZ TIRE CENTERS LLC GALLAGHER BASSETT 255397 SACRAMENTO ADJ7162235 DELIA CASTILLO LA QUINTA INN AND SUITES GALLAGHER BASSETT 255397 SACRAMENTO ADJ9339960 DONNA MERRIWEATHER DELAWARE NORTH COMPANY GALLAGHER BASSETT 255397 SACRAMENTO ADJ7478104 EMERITA AMARAL RR DONNELLEY GALLAGHER BASSETT 255397 SACRAMENTO ADJ6803148 GLORIA HERNANDEZ BANK OF AMERICA GALLAGHER BASSETT 255397 SACRAMENTO ADJ7211012 JESUS GARCIA AIRGAS GALLAGHER BASSETT 255397 SACRAMENTO ADJ4536557 LIN MOU COUNTRY VILLA BROADWAY GALLAGHER BASSETT 255397 SACRAMENTO ADJ7298717 LUIS ALEMAN SWIFT TRANSPORTATION GALLAGHER BASSETT 255397 SACRAMENTO ADJ400193 MARIA QUINTERO OWENS CORNING GALLAGHER BASSETT 255397 SACRAMENTO ADJ7070893 MARIA SANCHEZ LA QUINTA MANAGEMENT LLC GALLAGHER BASSETT 255397 SACRAMENTO ADJ1616272 MELISSA KINCHERLOW RR DONNELLEY GALLAGHER BASSETT 255397 SACRAMENTO ADJ9256921 AGUSTIN DORANTES MORGADO ALLIANCE PROFESSIONAL BUSINESS SOLUTIONS GALLAGHER BASSETT 4040 SACRAMENTO ADJ9256921 AGUSTIN DORANTES MORGADO WESTERN FISH COMPANY GALLAGHER BASSETT 4040 SACRAMENTO ADJ7823462 ALEJANDRA GONZALEZ HOSPITAL STAFFING SOLUTIONS GALLAGHER BASSETT 4040 SACRAMENTO ADJ6905358 ANDREA PASTRANA KELLERMEYER BUILDING SERVICES GALLAGHER BASSETT 4040 SACRAMENTO ADJ8064725 BARBARA SANTIAGO BARRAZA FARM SERVICE GALLAGHER BASSETT 4040 SACRAMENTO ADJ7222282 BERNARDO ALEMAN THE MAILING HOUSE GALLAGHER BASSETT 4040 SACRAMENTO ADJ7222282 BERNARDO ALEMAN THE MAILING HOUSE INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ8827367 BERTHA ALICIA BASURTO AUTOZONE GALLAGHER BASSETT 4040 SACRAMENTO ADJ7564495 CESIAH SANDOVAL CHURCJS CHICKEN GALLAGHER BASSETT 4040 SACRAMENTO ADJ7181042 CORINNE KOSTER AUTOZONE GALLAGHER BASSETT 4040 SACRAMENTO ADJ8924360 DULCE FLORES AMC OUTSOURCING GALLAGHER BASSETT 4040 SACRAMENTO ADJ8924360 DULCE FLORES PARIS ACCESSORIES GALLAGHER BASSETT 4040 SACRAMENTO ADJ7658447 EBER JUAREZ CARDENAS MARKETS INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ8506651 EVA PEREA BREG GALLAGHER BASSETT 4040 SACRAMENTO ADJ9062471 GLORIA HERRERA WETMORE TOOLS AND ENGINEERING GALLAGHER BASSETT 4040 SACRAMENTO ADJ7238379 GLORIA JIMENEZ OTAY MESA REPACKERS AND DISTRIBUTORS GALLAGHER BASSETT 4040 SACRAMENTO ADJ9531400 GRACE LAFFERTY ADVANCED CLINICAL EMPLOYMENT STAFFING GALLAGHER BASSETT 4040 SACRAMENTO ADJ9531400 GRACE LAFFERTY EMERALD HEALTH SERVICES GALLAGHER BASSETT 4040 SACRAMENTO ADJ9531400 GRACE LAFFERTY HEALTHSOURCE GLOBAL STAFFING GALLAGHER BASSETT 4040 SACRAMENTO ADJ9531400 GRACE LAFFERTY PROCARE ONE NURSES LLC GALLAGHER BASSETT 4040 SACRAMENTO ADJ9531400 GRACE LAFFERTY US NURSING CORP GALLAGHER BASSETT 4040 SACRAMENTO ADJ1975493 HERLIN SEGOVIA BELL CONVALESCENT HOSPITAL GALLAGHER BASSETT 4040 SACRAMENTO ADJ1975493 HERLIN SEGOVIA TACO BELL/PIZZA HUT GALLAGHER BASSETT 4040 SACRAMENTO ADJ7482399 HUGO ALBA ROYAL AIRLINE LINEN SERVICE GALLAGHER BASSETT 4040 SACRAMENTO ADJ7282528 ISIDORO MUNDO DIAZ VOLT WORKFORCE SOLUTIONS GALLAGHER BASSETT 4040 SACRAMENTO ADJ8107843 JAIME LUPERCIO BENCH MARK STAFFING GALLAGHER BASSETT 4040 SACRAMENTO ADJ2178307 JUAN SOTO MATHESON POSTAL SERVICE GALLAGHER BASSETT 4040 SACRAMENTO ADJ9319198 LEONIDES PULIDO KBS GALLAGHER BASSETT 4040 SACRAMENTO ADJ8842560 LILY LUGO DCG FULFILLMENT GALLAGHER BASSETT 4040 SACRAMENTO ADJ8842560 LILY LUGO GAR LABORATORIES GALLAGHER BASSETT 4040 SACRAMENTO ADJ8842560 LILY LUGO JC BLINDS MFG INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ8842560 LILY LUGO NEWPORT THIN FILM LABORATORY INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ8842560 LILY LUGO STAFF CHEX GALLAGHER BASSETT 4040 SACRAMENTO ADJ8842560 LILY LUGO TRADEMARK COSMETICS GALLAGHER BASSETT 4040 SACRAMENTO ADJ7442334 LUIS MARTINEZ CARDENAS MARKETS INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ6966307 LUIS PINONES ALLSCAPE ARCHITECTURAL LANDSCAPE LIGHTING GALLAGHER BASSETT 4040 SACRAMENTO ADJ6966307 LUIS PINONES PHILIPS ELECTRONICS NORTH AMERICA CORPORATION GALLAGHER BASSETT 4040 SACRAMENTO ADJ7298565 MANUEL MELENDREZ CARDENAS MARKET INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ7967420 MARGARITA FLORES COUNTRY OAKS GALLAGHER BASSETT 4040 SACRAMENTO ADJ400193 MARIA QUINTERO OWENS CORNING GALLAGHER BASSETT 4040 SACRAMENTO ADJ9516232 MARIO AVALOS CLOTHES TERMINATION GALLAGHER BASSETT 4040 SACRAMENTO ADJ9516232 MARIO AVALOS DANNYS APPAREL INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ7476940 MARTHA ZEPEDA PIXIOR LLC GALLAGHER BASSETT 4040 SACRAMENTO ADJ7010757 MARTIN THOMPSON DELAWARE NORTH GALLAGHER BASSETT 4040 SACRAMENTO ADJ9095958 MARTINA JIMENEZ G AND M OIL GALLAGHER BASSETT 4040 SACRAMENTO ADJ6987891 MISTY JOHNSON AUTO ZONE GALLAGHER BASSETT 4040 SACRAMENTO ADJ6686340 OSCAR GUZMAN CARDENAS MARKET GALLAGHER BASSETT 4040 SACRAMENTO ADJ7360629 RAUL MONREAL QUEST CONSTRUCTION GALLAGHER BASSETT 4040 SACRAMENTO ADJ8731806 ROSA CARDENAS MARRIOTT HOTEL GALLAGHER BASSETT 4040 SACRAMENTO ADJ9381284 ROSA GONZALEZ KELLERMEYER BERGENSONS SERVICES GALLAGHER BASSETT 4040 SACRAMENTO ADJ8429818 ROSA M ZAMUDIO MCDONALD S OF FONTANA GALLAGHER BASSETT 4040 SACRAMENTO ADJ9475909 ROSMERY ALVAREZ KSM HEALTHCARE GALLAGHER BASSETT 4040 SACRAMENTO ADJ9475909 ROSMERY ALVAREZ KSM HEALTHCARE INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ9475909 ROSMERY ALVAREZ KSM HELTHCARE INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ7401183 ROY GIORDANI MEATCO PROVISIONS INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ7272943 SARA ROSALES COURTESY PARKING INC GALLAGHER BASSETT 4040 SACRAMENTO ADJ4146242 SILVIA CHILIN FASHION MANIA GALLAGHER BASSETT 4040 SACRAMENTO ADJ4146242 SILVIA CHILIN NUVO CO INC DBA FASHION MANIA GALLAGHER BASSETT 4040 SACRAMENTO ADJ8589586 VICTOR MARTINEZ AUTOZONE GALLAGHER BASSETT 4040 SACRAMENTO ADJ8977051 YAN YAN CHEN C&J EXPRESS GALLAGHER BASSETT 4040 SACRAMENTO ADJ3858249 AGUSTIN TORRES LASCO BATHWARE GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ6958734 ANA MONTERROSO ACAPULCO RESTAURANT GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ1133008 ANTONIO MONTES ANGELICA WESTERN RENTAL GROUP GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ1133008 ANTONIO MONTES GRAVES ROBERSON AND BOURASSA GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ6616580 ANTONIO VILLANUEVA UPS GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ6602001 BLANCA SOLIS LIBBEY GLASS GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ2626088 CARLOS MANCILLA PERSONNEL OPTIONS GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ171568 CARMEN BRAXTON CATHOLIC CHARITIES OF LOS ANGELES GALLAGHER BASSETT 70003 ANAHEIM CLOSED Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ1743362 DAVID VARGAS PENA 03 MENZIES AVIATION GROUP GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ2063069 ELMER RODRIGUEZ BARAHONA PENSKE TRUCK LEASING CO. GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ3883369 HERMILA DELGADO BECKMAN COULTER INC GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ6987287 IRMA ROMERO GOLDRICH & KEST MANAGEMENT GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ4224279 JESUS MURILLO EI TORITO RESTAI IRANT GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ4224279 JESUS MURILLO EL TORITO MEXICAN GRILL GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ3283523 JOSE LOPEZ SUBURBAN PLASTERING GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ3283523 JOSE LOPEZ SUBURBAN PLASTERING/PROLINE PLASTER GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ6527312 JUAN GARCIA IMPACT LOGISTICS INC GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ3432719 MARIELLA CAMACHO CHEVY'S FRESH MEXICAN RESTAURANT GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ7359010 MARTHA LARES PETER PAN NOVELTY COMPANY GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ6956325 NORMA VIVIAN REGIS INVENTOR GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ4405879 PABLO RANGEL ISLANDS RESTAURANTS GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ2694656 SALVADOR SAUCEDA MASSIVE PRINTS GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ6769439 SECUNDINO REYES EL TORITO RESTAURANT GALLAGHER BASSETT 70003 ANAHEIM CLOSED ADJ9348195 DOMINGO MARURI SODEXO GALLAGHER BASSETT BURBANK ADJ9348195 DOMINGO MARURI SODEXO INC GALLAGHER BASSETT BURBANK ADJ1294284 ELSA VILLANUEVA DANIEL PANTELIZ GALLAGHER BASSETT BURBANK ADJ2335128 GABRIEL ANTONIO HERNANDEZ LAI PROPERTIES GALLAGHER BASSETT BURBANK ADJ7040173 JOHN DONALDSON AMERI PRIDE UNIFORM SERVICES GALLAGHER BASSETT BURBANK ADJ1541821 JOSE MACHUCA CONEJO COMPLETE GALLAGHER BASSETT BURBANK ADJ7728776 MARILUCI LOPEZ VIEW PARK CONV HOSPITAL GALLAGHER BASSETT BURBANK ADJ824397 MARISELA LUNA KERR CORPORATION GALLAGHER BASSETT BURBANK ADJ8079851 RODOLFO JIMENEZ VALLEY CREST LANDSCAPING GALLAGHER BASSETT BURBANK ADJ4204831 YOLANDA AGUIRRE ORMCO GALLAGHER BASSETT BURBANK ADJ4204831 YOLANDA AGUIRRE ORMCO CORPORATION GALLAGHER BASSETT BURBANK ADJ7127734 ALEJANDRO VAZQUEZ READY PAC PRODUCE GALLAGHER BASSETT CALABASAS ADJ8646407 ALICIA AGUILAR ST JUDE MEDICAL GALLAGHER BASSETT CALABASAS ADJ8940065 AMABILIA HERNANDEZ WHOLE FOODS MARKET GALLAGHER BASSETT CALABASAS ADJ9468689 ANA TECUN COMPASS ONE LLC GALLAGHER BASSETT CALABASAS ADJ8903449 BLAINE GOMEZ PENN AIR CONTROL GALLAGHER BASSETT CALABASAS ADJ7447358 CARLOS BARRIENTOS KOHLS BUILDING MAINTENANCE GALLAGHER BASSETT CALABASAS ADJ7417623 CARLOS MARQUEZ SODEXO GALLAGHER BASSETT CALABASAS ADJ9426098 CARMEN MEDRANO PACESETTER GALLAGHER BASSETT CALABASAS ADJ7678863 CESAR DEL PRADO THE CHEESECAKE FACTORY GALLAGHER BASSETT CALABASAS ADJ6966801 CHRISTINA SOLOMUA RBC INDUSTRIAL TECTONICS BEARINGS GALLAGHER BASSETT CALABASAS ADJ7078680 CHRISTOPHER LUONG RBC-ALL POWER MFG. GALLAGHER BASSETT CALABASAS ADJ7663527 CONCEPCION CENTENO THE CHEESECAKE FACTORY GALLAGHER BASSETT CALABASAS ADJ1212063 DANIEL MEDRANO GOTHIC LANDSCAPING INC GALLAGHER BASSETT CALABASAS ADJ9348195 DOMINGO MARURI SODEXO GALLAGHER BASSETT CALABASAS ADJ9348195 DOMINGO MARURI SODEXO INC GALLAGHER BASSETT CALABASAS ADJ3734731 EDUARDO ALVAREZ ERICKSON HALL CONSTRUCTION GALLAGHER BASSETT CALABASAS ADJ7407675 ESTELA CERVANTES RBC TRANSPORT GALLAGHER BASSETT CALABASAS ADJ6772960 ESTHER GALLEGOS MA COM TECHNOLOGY SOLUTIONS GALLAGHER BASSETT CALABASAS ADJ8960468 EVERARDO CHAVEZ BARON HR GALLAGHER BASSETT CALABASAS ADJ6827426 FRANCISCO RAMIREZ ROBAR ENTERPRISES INC GALLAGHER BASSETT CALABASAS ADJ9170786 GABRIEL FUENTES RENAISSANCE FRENCH DOORS GALLAGHER BASSETT CALABASAS ADJ7198522 GREGORY SIMS BENS ASPHALT INC GALLAGHER BASSETT CALABASAS ADJ554893 GUADALUPE CUX THE CHEESECAKE FACTORY GALLAGHER BASSETT CALABASAS ADJ8608983 GUSTAVO REYES FORCE FRAMING INC GALLAGHER BASSETT CALABASAS ADJ8179468 HECTOR FRANCO WHOLE FOODS MARKET GALLAGHER BASSETT CALABASAS ADJ6769675 HENRY STEPHENS READY PAC PRODUCE GALLAGHER BASSETT CALABASAS ADJ7729675 HERIBERTO MEDINA HMS HOST GALLAGHER BASSETT CALABASAS ADJ9469054 ISSAC DUMAS SODEXO GALLAGHER BASSETT CALABASAS ADJ7455003 JENNY VARELA SODEXO GALLAGHER BASSETT CALABASAS ADJ1507336 JESUS CHAVEZ DOUGLAS E BARNHART GALLAGHER BASSETT CALABASAS ADJ1507336 JESUS CHAVEZ DOUGLAS E BARNHART INC GALLAGHER BASSETT CALABASAS ADJ2074624 JORGE ALBERTO ORANTES CAM GUARD SECURITY GALLAGHER BASSETT CALABASAS ADJ7452506 JORGE LEMUS THE CHEESECAKE FACTORY BAKERY GALLAGHER BASSETT CALABASAS ADJ7105061 JORGE OCHOA INC SARGENT FLETCHER GALLAGHER BASSETT CALABASAS ADJ9115073 JOSE CANALES MURRAY GALLAGHER BASSETT CALABASAS ADJ8646114 LEONARDO ARELLANO RENAISSANCE FRENCH DOORS GALLAGHER BASSETT CALABASAS ADJ4573389 LIDUVINA MARTINEZ PIZZA HUT GALLAGHER BASSETT CALABASAS ADJ7807350 LOUANN HESS SODEXO CORPORATE SERVICES GALLAGHER BASSETT CALABASAS ADJ6606670 LUIS RAMIREZ GENERAL COATING CO GALLAGHER BASSETT CALABASAS ADJ3542975 LUZ MARINA PALACIOS SODEXHO GALLAGHER BASSETT CALABASAS ADJ7006485 MARIA GUZMAN SODEXO INC GALLAGHER BASSETT CALABASAS ADJ992213 MARIA HERMOSILLO CHEESECAKE FACTORY BAKERY GALLAGHER BASSETT CALABASAS ADJ9362609 MARIA SAUCEDO MARKLAND INDUSTRIES GALLAGHER BASSETT CALABASAS ADJ6959693 MARIA SERRATO PENN EMBLEM COMPANY GALLAGHER BASSETT CALABASAS ADJ6645558 MERCEDES MENDOZA GENTEX CORPORATION GALLAGHER BASSETT CALABASAS ADJ8427636 MICHAEL MCCOY TH CENTURY FOX GALLAGHER BASSETT CALABASAS ADJ7962336 NATHALY PAREDES SODEXO GALLAGHER BASSETT CALABASAS ADJ7962336 NATHALY PAREDES SODEXO INC GALLAGHER BASSETT CALABASAS ADJ8241842 NATIVIDAD FIGUEROA SODEXO INC GALLAGHER BASSETT CALABASAS ADJ8241842 NATIVIDAD FIGUEROA SODEXO INC AND AFFILIATED COMPANIES GALLAGHER BASSETT CALABASAS ADJ9313936 RICARDO ANAYA BORBON, INC. GALLAGHER BASSETT CALABASAS ADJ578783 SERHII ILCHUK RAND CORPORATION GALLAGHER BASSETT CALABASAS ADJ8716735 STEPHEN JOSEPH ST JUDE MEDICAL GALLAGHER BASSETT CALABASAS ADJ7573191 WILSON BOR NAJERA TOMRA PACIFIC INC GALLAGHER BASSETT CALABASAS ADJ7573191 WILSON BOR NAJERA TOMRA PACIFIC, INC. GALLAGHER BASSETT CALABASAS ADJ8359057 YAIR MENDEZ AMPAM PARKS MECHANICAL GALLAGHER BASSETT CALABASAS ADJ7548114 AFSOONGAR COMPANIVALA TACO BELL GALLAGHER BASSETT CORONA ADJ8302611 AGRIPINA CARON VOLT INFORMATION SCIENCES GALLAGHER BASSETT CORONA ADJ7562388 ALEJANDRA DUARTE TACO BELL GALLAGHER BASSETT CORONA ADJ6544669 ALICIA FLORES VOLT INFORMATION SCIENCES INC GALLAGHER BASSETT CORONA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ2978919 ALTA GAMBOA KFC GALLAGHER BASSETT CORONA ADJ8871344 ANA MARIA RUMBO LA HABRA CONVALESCENT HOSPITAL GALLAGHER BASSETT CORONA ADJ7884336 ANA ORTIZ UNITED STAFFING SERVICES GALLAGHER BASSETT CORONA ADJ7072075 ANGEL SANCHEZ VOLT INFORMATION SCIENCES INC GALLAGHER BASSETT CORONA ADJ9134321 ARLIN NAJERA ORTEGA TACO BELL 004819 GALLAGHER BASSETT CORONA ADJ7713197 BEATRIZ CATALAN CHIPOTLE MEXICAN GRILL GALLAGHER BASSETT CORONA ADJ7417171 CARMEN BECERRA COUNTRY VILLA MURRIETA GALLAGHER BASSETT CORONA ADJ10257174 CECILIA CRISOSTOMO TACO BELL YUM BRANDS GALLAGHER BASSETT CORONA ADJ9250682 CESAR CURIEL R B REINFORCING GALLAGHER BASSETT CORONA ADJ6451554 DUSTIN DEYOUNG VOLT TELECOM GROUP, INC. GALLAGHER BASSETT CORONA ADJ7683012 EDWIN PETERSON VELOCITY EXPRESS GALLAGHER BASSETT CORONA ADJ7295507 ELISEO GARRIDO AMERICAN GOLF CORP GALLAGHER BASSETT CORONA ADJ6893288 ELSA SANCHEZ COUNTRY VILLA SEAL BEACH HEALTH CARE GALLAGHER BASSETT CORONA ADJ7123199 EPIGMENIO DOMINGUEZ URIAS PROGRESS RAIL SERVICE GALLAGHER BASSETT CORONA ADJ7442658 ERICKA MORE COUNTRY VILLA OF RIVERSIDE GALLAGHER BASSETT CORONA ADJ8404054 EVA NIEVES VOLT INFORMATION SCIENCES GALLAGHER BASSETT CORONA ADJ8404054 EVA NIEVES VOLT MANAGEMENT GALLAGHER BASSETT CORONA ADJ6731329 FRANCISCO HINOJOSA LEGGETT PLATT INC GALLAGHER BASSETT CORONA ADJ9385511 FRANCISCO MANCILLAS OMEGA XTRUDING CORPORATION OF CALIFORNIA GALLAGHER BASSETT CORONA ADJ9170786 GABRIEL FUENTES RENAISSANCE FRENCH DOORS GALLAGHER BASSETT CORONA ADJ7522280 GERMAN LOVOS MCDONALDS RESTAURANT GALLAGHER BASSETT CORONA ADJ9447609 GINA FENIELLO TUTOR TIME LEARNING CARE CENTER GALLAGHER BASSETT CORONA ADJ9447609 GINA FENIELLO TUTOR TIME/LEARNING CARE CENTER GALLAGHER BASSETT CORONA ADJ9426366 GLADYS GARCIA ORANGE GROVE REHABILITATION HOSPITAL GALLAGHER BASSETT CORONA ADJ7872716 GLYNIS BELL WINDSOR GARDENS GALLAGHER BASSETT CORONA ADJ8176212 GRACIELA RODRIGUEZ PROFESSIONAL HOSPITAL SUPPLY GALLAGHER BASSETT CORONA ADJ511346 GUADALUPE MALDONADO PIZZA HUT GALLAGHER BASSETT CORONA ADJ9492705 IRMA ARREDONDO LA PETITE ACADEMY GALLAGHER BASSETT CORONA ADJ6858969 ISRAEL ANDREW LOPEZ KFC GALLAGHER BASSETT CORONA ADJ7096097 JAMES ALLEN JR DIAMOND HILLS AUTO GROUP GALLAGHER BASSETT CORONA ADJ6746136 JESUS NAVA LINK STAFFING SERVICES GALLAGHER BASSETT CORONA ADJ9564530 JOSE OLIVARES CIRCLE M CONTRACTORS GALLAGHER BASSETT CORONA ADJ7750509 JOSE TRIGUEROS VOLT SERVICES GROUP GALLAGHER BASSETT CORONA ADJ7264795 LORETTA ALLAN COURTY VILLA MURRIETA HCC GALLAGHER BASSETT CORONA ADJ9208312 LORRAINE ROJAS YRC WORLDWIDE INC. GALLAGHER BASSETT CORONA ADJ9339810 LUIS LINARES OMEGA EXTRUDING CORP OF CALIFORNIA GALLAGHER BASSETT CORONA ADJ6722740 MANUEL DE LEON KFC USA GALLAGHER BASSETT CORONA ADJ7254848 MARIA BAIRES ORANGEGROVE REHABILITATION GALLAGHER BASSETT CORONA ADJ7884303 MARIA ESPINOZA TACO BELL GALLAGHER BASSETT CORONA ADJ7413122 MARIA GUERRERO CHIPOTLE GALLAGHER BASSETT CORONA ADJ3676681 MARIA REYES G & K SERVICES INC GALLAGHER BASSETT CORONA ADJ6759881 MARIA REYES G&K SERVICES INC GALLAGHER BASSETT CORONA ADJ8839623 MARIBEL CUATLAYOTL CERIDIAN GALLAGHER BASSETT CORONA ADJ8621835 MARIBEL SIERRA TACO BELL GALLAGHER BASSETT CORONA ADJ1354252 MIGUEL ANGEL SANTANA DAVIS WIRE CORP GALLAGHER BASSETT CORONA ADJ1354252 MIGUEL ANGEL SANTANA DAVIS WIRE CORPORATION GALLAGHER BASSETT CORONA ADJ8283897 NORMAN STEWARD VOLT WORKFORCE SOLUTIONS GALLAGHER BASSETT CORONA ADJ385449 PAUL GARCIA SOLTER PACIFIC GALLAGHER BASSETT CORONA ADJ8420232 PEDRO ARREGUIN MARINA LANDSCAPE GALLAGHER BASSETT CORONA ADJ7818713 PEDRO CANDELARIA G K SERVICES INC GALLAGHER BASSETT CORONA ADJ1855417 PRIMITIVO ORTIZ VIKING WIRE LLC GALLAGHER BASSETT CORONA ADJ8852721 RAMON CAMACHO G AND K SERVICES GALLAGHER BASSETT CORONA ADJ3378983 REYNA SANCHEZ TEMPORARY SERVICES/ADVANTAGE SVCS GALLAGHER BASSETT CORONA ADJ8611676 ROGER PINEDA SNELLING EMPLOYER GALLAGHER BASSETT CORONA ADJ7605180 ROMAN HERNANDEZ ROLLINGS AUTOMOTIVE GALLAGHER BASSETT CORONA ADJ6790925 ROSA LAINEZ OMNI HOTELS GALLAGHER BASSETT CORONA ADJ8190454 ROSA VALVERDE CLAREMONT HEALTH SERVICES GALLAGHER BASSETT CORONA ADJ9625614 SALVADOR FARIAS YORBA LINDA COUNTRY CLUB GALLAGHER BASSETT CORONA ADJ8431273 SAUL GOMEZ LAKE FOREST NURSING CENTER GALLAGHER BASSETT CORONA ADJ6706563 VERNON MCCOY MONTYS CLUB SERVICE GALLAGHER BASSETT CORONA ADJ4495096 VERONICA PRECIADO VOLT SERVICES GROUP GALLAGHER BASSETT CORONA ADJ6914722 ALBERTO LUGO CARDENAS MARKET 22 GALLAGHER BASSETT ELK GROVE CLOSED ADJ3305190 ANA BAHENA KELLERMEYER BUILDING SERVICES GALLAGHER BASSETT ELK GROVE CLOSED ADJ6568612 ANTONIO MONTOYA AD FIRE SPRINKLERS GALLAGHER BASSETT ELK GROVE CLOSED ADJ6973830 BLANCA GARCIA KIRKHILL AIRCRAFT PARTS CO GALLAGHER BASSETT ELK GROVE CLOSED ADJ7005113 GENARO MUNIVE DUCOING ENTERPRISES GALLAGHER BASSETT ELK GROVE CLOSED ADJ3528979 MADEL GRAJEOLA HSN INTERACTIVE CORP GALLAGHER BASSETT ELK GROVE CLOSED ADJ6989865 MARIA CASILLAS KELLER MEYER BUILDING SERVICES LLC GALLAGHER BASSETT ELK GROVE CLOSED ADJ2984371 MARTIN ALVARADO PDEI INC GALLAGHER BASSETT ELK GROVE CLOSED ADJ7016355 MATEO SIMON INNER CITY CRIME PREVENTION GROUP GALLAGHER BASSETT ELK GROVE CLOSED ADJ6987891 MISTY JOHNSON AUTO ZONE GALLAGHER BASSETT ELK GROVE CLOSED ADJ3412703 PEDRO MEJIA FINES MARKET GALLAGHER BASSETT ELK GROVE CLOSED ADJ6677398 ROSA SILLAS QUICK CREATIONS USA GALLAGHER BASSETT ELK GROVE CLOSED ADJ1918935 SALVADOR VALLE METRO FIRE PROTECTION GALLAGHER BASSETT ELK GROVE CLOSED ADJ6467677 VICTORIA BAKER ANTHONY AND KATHERINE VIELE GALLAGHER BASSETT ELK GROVE CLOSED ADJ6467677 VICTORIA BAKER TOKA PROPERTIES GALLAGHER BASSETT ELK GROVE CLOSED ADJ9117121 ALFONZO CONTRERAS VICEROY PALM SPRINGS GALLAGHER BASSETT GLENDALE ADJ7243393 AMADO GARCIA HAYWARD POOL PRODUCTS INCI GALLAGHER BASSETT GLENDALE ADJ7940993 ANA RODRIGUEZ FOREVER 21 INCORPORATED GALLAGHER BASSETT GLENDALE ADJ7940993 ANA RODRIGUEZ FOREVER 21 LOGISTICS GALLAGHER BASSETT GLENDALE ADJ7445027 ARACELY MCGREW TERRANEA RESORT AND HOTELS GALLAGHER BASSETT GLENDALE ADJ7225727 CARLOS GONZALEZ EVERGREEN AVIATION INC GALLAGHER BASSETT GLENDALE ADJ7502719 DANIEL GERKEN ACE PARKING MANAGEMENT INC GALLAGHER BASSETT GLENDALE ADJ6935989 GRACIELA GALLEGOS THE STANDARD HOTEL GALLAGHER BASSETT GLENDALE ADJ7414250 JASMINE MCGOWAN AMERICAN HOME MORTGAGE INC GALLAGHER BASSETT GLENDALE ADJ7592522 JOSE MATEO EVERGREEN AVIATION INC GALLAGHER BASSETT GLENDALE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7486955 LOLA SMITH HYATT REGENCY CENTURY PLAZA GALLAGHER BASSETT GLENDALE ADJ8509794 OCTAVIO BAUTISTA THE IRVINE COMPANY APT GALLAGHER BASSETT GLENDALE ADJ8048910 RICARDO CHILLON HYATT REGENCY GALLAGHER BASSETT GLENDALE ADJ6581295 SERGIO GUZMAN KHM AVALON LLC GALLAGHER BASSETT GLENDALE ADJ8683862 STEPHANIE REID IRVINE COMPANY GALLAGHER BASSETT GLENDALE ADJ8774465 TEOFILO LOPEZ ISLAND HOTEL NEWPORT BEACH GALLAGHER BASSETT GLENDALE ADJ7241282 VICTOR BONNEVIE FOX INTERAVTIVE MEDIA INC GALLAGHER BASSETT GLENDALE ADJ8207352 ANNA ALAGULYAN BANK OF AMERICA GALLAGHER BASSETT GOLD RIVER ADJ8527835 BLANCA RODAS BANK OF AMERICA GALLAGHER BASSETT GOLD RIVER ADJ7193785 DANIEL JIMENEZ PRO INSTALLATIONS INC GALLAGHER BASSETT GOLD RIVER ADJ7146881 DIANA SANTIBANEZ BANK OF AMERICA GALLAGHER BASSETT GOLD RIVER ADJ8506479 ELVIA ESPINOSA HAMPTON INN GALLAGHER BASSETT GOLD RIVER ADJ3296711 EZEQUIEL CISNEROS WASTE MANAGEMENT GALLAGHER BASSETT GOLD RIVER ADJ9511687 FERNANDO GOMEZ CITISTAFF SOLUTIONS INC GALLAGHER BASSETT GOLD RIVER ADJ6552902 GERARDO URZUA CHIPOTLE MEXICAN GRILL GALLAGHER BASSETT GOLD RIVER ADJ9129107 GLORIA DIAZ CITI STAFF SOLUTION GALLAGHER BASSETT GOLD RIVER ADJ9554934 ISELA VILLAGRANA CROTHALL LAUNDRY SERVICES GALLAGHER BASSETT GOLD RIVER ADJ9301063 JAMES MERRITT NATIONAL OILWELL VARCO GALLAGHER BASSETT GOLD RIVER ADJ9628635 JOSE LIMON CITI STAFF SOLUTIONS INC GALLAGHER BASSETT GOLD RIVER ADJ8460962 JOSE RIVAS BAJA FRESH MEXICAN GRILL GALLAGHER BASSETT GOLD RIVER ADJ8870246 JOSE VALLES AMERON GALLAGHER BASSETT GOLD RIVER ADJ9318410 JUVENTINO PEREZ WASTE MANAGEMENT GALLAGHER BASSETT GOLD RIVER ADJ9230691 MARGARITA ARCEO THE JONATHAN CLUB GALLAGHER BASSETT GOLD RIVER ADJ9467384 MARIA HARO SAUCEDO CITISTAFF SOLUTIONS INC GALLAGHER BASSETT GOLD RIVER ADJ8732555 MARIA MONZON JONATHAN CLUB GALLAGHER BASSETT GOLD RIVER ADJ9542571 MARTIN RENDON CITISTAFF SOLUTIONS GALLAGHER BASSETT GOLD RIVER ADJ7715029 OLGA VILLALVAZO DENNYS GALLAGHER BASSETT GOLD RIVER ADJ7473410 SONIA HERNANDEZ BANK OF AMERICA GALLAGHER BASSETT GOLD RIVER ADJ7152499 LUZ PULIDO REDLANDS COUNTRY CLUB GALLAGHER BASSETT GOLD RIVER ADJ8221190 ADA GONZALEZ HOTEL PALOMAR OF LOS ANGELES WESTWOOD GALLAGHER BASSETT LAGUNA HILLS ADJ6857249 ALEJANDRINA ANTONIO MASSIVE PRINTS GALLAGHER BASSETT LAGUNA HILLS ADJ9402775 ANA TURCIOS WHOLE FOODS GALLAGHER BASSETT LAGUNA HILLS ADJ7125418 ANTHONY ALBA TEAM QUEST GALLAGHER BASSETT LAGUNA HILLS ADJ7325068 CHARLES SISON UNITED AIRLINES GALLAGHER BASSETT LAGUNA HILLS ADJ431605 CHIOMA ONYEJEWE ATC HEALTHCARE SERVICES, INC. GALLAGHER BASSETT LAGUNA HILLS ADJ754300 CLAUDIA ROMERO EAST-WEST STAFFING GALLAGHER BASSETT LAGUNA HILLS ADJ8668873 DOLORES RODRIGUEZ HOTEL PALOMAR LOS ANGELES WESTWOOD GALLAGHER BASSETT LAGUNA HILLS ADJ9921226 GONZALO VARGAS PRO ACTIVE STAFFING GALLAGHER BASSETT LAGUNA HILLS ADJ8985492 JAIME BELTRAN SOUTHERN FIBER OF LOS ANGELES GALLAGHER BASSETT LAGUNA HILLS ADJ7353246 JOSEPH SEPULVEDA UNITED PARCEL SERVICE GALLAGHER BASSETT LAGUNA HILLS ADJ2557586 JUAN ANGEL FLORES MARKLAND INDUSTRIES INC GALLAGHER BASSETT LAGUNA HILLS ADJ386032 MARIA VALENZUELA MOTEL 6 GALLAGHER BASSETT LAGUNA HILLS ADJ7457577 MARIA VERDUGO FIRST STUDENT TRANSPORTATION GALLAGHER BASSETT LAGUNA HILLS ADJ7932506 MARIA VILLALOBOS FIRST TRANSIT GALLAGHER BASSETT LAGUNA HILLS ADJ2255180 MIGUEL MEDINA OUR LADY OF TALPA SCHOOL GALLAGHER BASSETT LAGUNA HILLS ADJ7320876 OFELIA BAHENA ALAR STAFFING CORP GALLAGHER BASSETT LAGUNA HILLS ADJ7218082 PEDRO HUERTA CARLSON/ PICK UP STIX GALLAGHER BASSETT LAGUNA HILLS ADJ2431336 RAJI HILAL PIZZA HUT GALLAGHER BASSETT LAGUNA HILLS ADJ3139794 ROBERTO BARAJAS EAST-WEST STAFFING GALLAGHER BASSETT LAGUNA HILLS ADJ7698233 ROSA HERNANDEZ G2 SECURE STAFF LLC GALLAGHER BASSETT LAGUNA HILLS ADJ8223628 ROXANA MORENO HOTEL PALOMAR OF LOS ANGELES WESTWOOD GALLAGHER BASSETT LAGUNA HILLS ADJ6798963 SANDRA GOMEZ MEDISCAN STAFFING SERVICES GALLAGHER BASSETT LAGUNA HILLS ADJ7768864 STEPHEN BURKHEAD LOS ANGELES TIMES GALLAGHER BASSETT LAGUNA HILLS ADJ7242307 TIEU LE HYATT CORPORATION GALLAGHER BASSETT LAGUNA HILLS ADJ10221068 TONY TRUONG PRINTRONIX GALLAGHER BASSETT LAGUNA HILLS ADJ420229 VICTOR DE LA CRUZ WHOLE FOODS MARKET GALLAGHER BASSETT LAGUNA HILLS ADJ2045397 MARCOS QUIROZ BEST BUY GALLAGHER BASSETT LAS VEGAS ADJ6755624 MARTA ARENIVAR THE LONDON WEST HOLLYWOOD GALLAGHER BASSETT LAS VEGAS ADJ2408061 PEDRO ALVARADO SELECT BUILD GALLAGHER BASSETT LAS VEGAS ADJ2408061 PEDRO ALVARADO SELECT BUILD CO GALLAGHER BASSETT LAS VEGAS ADJ9301234 ROBERTO GARCIA SILVA WESTERN NATIONAL PROPERTY MANAGEMENT GALLAGHER BASSETT OKLAHOMA CITY ADJ7271787 ALEJANDRO DELGADILLO CERRITOS NISSAN GALLAGHER BASSETT ONTARIO ADJ8700450 DANIELA LOPEZ COLLECTIVE BRANDS INC GALLAGHER BASSETT ONTARIO ADJ6813214 ELIZABETH MINWALLA CVS PHARMACY GALLAGHER BASSETT ONTARIO ADJ8404054 EVA NIEVES VOLT INFORMATION SCIENCES GALLAGHER BASSETT ONTARIO ADJ8404054 EVA NIEVES VOLT MANAGEMENT GALLAGHER BASSETT ONTARIO ADJ2335128 GABRIEL ANTONIO HERNANDEZ LAI PROPERTIES GALLAGHER BASSETT ONTARIO ADJ836928 GUILLERMO RUIZ MENA O'HARA PLUMBING GALLAGHER BASSETT ONTARIO ADJ4414084 IRMA ARZOLA SHERWOOD MANAGEMENT COMPANY GALLAGHER BASSETT ONTARIO ADJ725833 IRMA ARZOLA SHERWOOD MANAGEMENT COMPANY GALLAGHER BASSETT ONTARIO ADJ2365522 MARIA DE ANDA ST. JOSEPH HOSPITAL GALLAGHER BASSETT ONTARIO ADJ1320892 MARIA GARCIA SERVI COM SYSTEM GALLAGHER BASSETT ONTARIO ADJ237201 REYNALDO TORRES US FOOD SERVICES GALLAGHER BASSETT ONTARIO ADJ998407 SANDRA MONTORO CVS GALLAGHER BASSETT ONTARIO ADJ8359265 SEANIA SOMERVILLE CHINO VALLEY HEALTH CARE GALLAGHER BASSETT ONTARIO ADJ7065546 SOFIA VARGAZ YOMICIAI OF GREATER WHITTIER GALLAGHER BASSETT ONTARIO ADJ7897685 ABEL GONZALEZ BBA AVIATION GALLAGHER BASSETT ORANGE ADJ7746078 AGUSTIN HERNANDEZ PANDA RESTAURANT GROUP INC GALLAGHER BASSETT ORANGE ADJ3819146 AGUSTIN TORRES ACUSHNET/FORTUNE BRANDS INC GALLAGHER BASSETT ORANGE ADJ3819146 AGUSTIN TORRES FORTUNE BRANDS/GOLF CLUB OPERATIONS GALLAGHER BASSETT ORANGE ADJ8583873 ALEJANDRO RAYGOZA CUSTOM GOODS GALLAGHER BASSETT ORANGE ADJ1295263 ALFRED DAVIS PENSKE TRUCK LEASING GALLAGHER BASSETT ORANGE ADJ9125059 ANTHONY HARRELL ATLANTIC RELOCATION SYSTEMS GALLAGHER BASSETT ORANGE ADJ6990097 ANTHONY HARRIS PENSKE TRUCK LEASING CO GALLAGHER BASSETT ORANGE ADJ7506009 ARMANDO FLORES HB PARKCO GALLAGHER BASSETT ORANGE ADJ7157598 ARMANDO VEGA CONSOLIDATED CONTAINER CO GALLAGHER BASSETT ORANGE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6602001 BLANCA SOLIS LIBBEY GLASS GALLAGHER BASSETT ORANGE ADJ7417171 CARMEN BECERRA COUNTRY VILLA MURRIETA GALLAGHER BASSETT ORANGE ADJ7480840 CESAR ZAMRANO PANDA RESTAURANT GROUP INC GALLAGHER BASSETT ORANGE ADJ7445101 CHRISTINA CASTRO GOLDRICH AND KEST INDUSTRIES GALLAGHER BASSETT ORANGE ADJ9196983 CIEARA HILL MCDONALDS GALLAGHER BASSETT ORANGE ADJ6839450 DAVID HEFFERAN HB PARKCO GALLAGHER BASSETT ORANGE ADJ6459669 DE BAO JU PANDA RESTAURANT GROUP, INC. GALLAGHER BASSETT ORANGE ADJ9419979 DEBRA ELLIS PENSKE LOGISTICS GALLAGHER BASSETT ORANGE ADJ7254936 DORA MORENO RGIS INVENTORY SPECIALISTS GALLAGHER BASSETT ORANGE ADJ7275510 ENRIQUE MENDEZ OREILLYS AUTO PARTS GALLAGHER BASSETT ORANGE ADJ6707066 ESTELA JIMENEZ PANDA EXPRESS GALLAGHER BASSETT ORANGE ADJ7285467 FELIPE VEGA FRONTIER LOGISTICS GALLAGHER BASSETT ORANGE ADJ8193271 GUILLERMO MARTINEZ EL TORITO RESTAURANTS GALLAGHER BASSETT ORANGE ADJ7813634 HANI REZK AKA SAAD MENZIES AVIATION GALLAGHER BASSETT ORANGE ADJ9296468 HECTOR JIMENEZ MOJAVE FOODS CORPORATION MCCORMICK & COMPANY GALLAGHER BASSETT ORANGE ADJ9296468 HECTOR JIMENEZ MOJAVE FOODS CORPORATION MCCORMICK & COMPANY INC. GALLAGHER BASSETT ORANGE ADJ3581848 IRMA DE VARGAS MCDONALD'S GALLAGHER BASSETT ORANGE ADJ6798823 IVAN ACOSTA SOLAR INTEGRATED TECH COM GALLAGHER BASSETT ORANGE ADJ7578746 JOEL OROSCO CONSOLIDATED CONTAINER GALLAGHER BASSETT ORANGE ADJ9378968 JOSE RAMIREZ ZAGAL BM HQ DBA ACAPULCO RESTAURANT GALLAGHER BASSETT ORANGE ADJ2053798 JUAN GARCIA ASG GALLAGHER BASSETT ORANGE ADJ2053798 JUAN GARCIA CLEARPOINT ADVANTAGE LLC GALLAGHER BASSETT ORANGE ADJ7492937 KARINA ESPINOZA GYMBOREE GALLAGHER BASSETT ORANGE ADJ4164352 KEN GROVE OPTION ONE MORTGAGE GALLAGHER BASSETT ORANGE ADJ9028427 LEONEL GARCIA CHUPIN PANDA EXPRESS GALLAGHER BASSETT ORANGE ADJ8803945 MANFRED DAVIS DECTON STAFFING GALLAGHER BASSETT ORANGE ADJ7041263 MARCOS LEON PANDA RESTAURANT GROUP GALLAGHER BASSETT ORANGE ADJ9221214 MARIA ALAS MCDONALDS GALLAGHER BASSETT ORANGE ADJ7707166 MARIA DEL CARMEN DEARCIA MCDONALDS GALLAGHER BASSETT ORANGE ADJ7040824 MARIA PEREZ ESPINOZA DART CONTAINER CORP GALLAGHER BASSETT ORANGE ADJ6786440 MARINA VILLALOBOS PANDA EXPRESS RESTAURANT GROUP GALLAGHER BASSETT ORANGE ADJ6755624 MARTA ARENIVAR THE LONDON WEST HOLLYWOOD GALLAGHER BASSETT ORANGE ADJ6600213 MAXIMILLIANO RUIZ FRESHPOINT OF SO. CAL. GALLAGHER BASSETT ORANGE ADJ7286168 MONIR BOKTAR SR HYATT HOTEL LONG BEACH GALLAGHER BASSETT ORANGE ADJ7693097 OLIVIA RAMIREZ OREILLY GALLAGHER BASSETT ORANGE ADJ7802637 PEDRO SANCHEZ PENSKE LOGISTICS GALLAGHER BASSETT ORANGE ADJ7058378 PETRONA HERNANDEZ COUNTRYSIDE GALLAGHER BASSETT ORANGE ADJ7180106 RAFAEL CARDENAS PREFERRED LEASING GALLAGHER BASSETT ORANGE ADJ7702308 RAMON GONZALES PANDA EXPRESS GALLAGHER BASSETT ORANGE ADJ6888503 REYNA OLIVAR EZ PAYROLL STAFFING SOLUTIONS GALLAGHER BASSETT ORANGE ADJ9305902 RUTILIA MARTINEZ RAINMAKER STAFFING INC GALLAGHER BASSETT ORANGE ADJ7768864 STEPHEN BURKHEAD LOS ANGELES TIMES GALLAGHER BASSETT ORANGE ADJ7347972 SUSANA LOPEZ JBS USA INC GALLAGHER BASSETT ORANGE ADJ7242307 TIEU LE HYATT CORPORATION GALLAGHER BASSETT ORANGE ADJ8596433 VIRGINIA MOREAU CVS CAREMARK GALLAGHER BASSETT ORANGE ADJ7199115 MARTHA MACHADO ACAPULCO CHEVY AND EL TORITO RESTAURANT GALLAGHER BASSETT ORANGE ADJ8329705 AARON BRADLEY SPRINT GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7589860 ANGEL VALENCIA ESTESS EXPRESS LINE GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7203790 BELEN SANCHEZ PARK REGENCY RETIREMENT RESIDENCE GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7460500 BRIAN GREVA PENSKE TRUCK LEASING GALLAGHER BASSETT RANCHO CUCAMONGA ADJ9250682 CESAR CURIEL R B REINFORCING GALLAGHER BASSETT RANCHO CUCAMONGA ADJ6541590 CHARLES SOWARDS YELLOW TRANSPORTATION GALLAGHER BASSETT RANCHO CUCAMONGA ADJ8665782 CLOTILDE SANCHEZ KIMCO STAFFING SERVICES INC GALLAGHER BASSETT RANCHO CUCAMONGA ADJ8665782 CLOTILDE SANCHEZ PERFORMANCE TEAM FREIGHT GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7880202 DORIS RODRIGUEZ J M SALES INC GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7741021 FARA SAFA LIMITED BRANDS INC GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7120301 FARIVAR TALAI YRC GALLAGHER BASSETT RANCHO CUCAMONGA ADJ8708116 FELIPE MORALES MEDINA SPARKLING FRESH POOLS GALLAGHER BASSETT RANCHO CUCAMONGA ADJ8317168 FERNANDO PUGA SODEXO GALLAGHER BASSETT RANCHO CUCAMONGA ADJ8855531 GABRIEL CHAN UICAB CHROMIZING COMPANY GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7281997 GRACIELA MORALES BIMBO BAKERIES GALLAGHER BASSETT RANCHO CUCAMONGA ADJ9669557 GUADALUPE VERA PICO RIVERA HEALTHCARE GALLAGHER BASSETT RANCHO CUCAMONGA ADJ3072844 JAMAL ELABED PAYLESS SHOES SOURCE GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7329901 JAMES SCHROELUCKE YELLOW TRANSPORATION GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7329901 JAMES SCHROELUCKE YELLOW TRANSPORTATION GALLAGHER BASSETT RANCHO CUCAMONGA ADJ6974959 JESUS GONZALEZ CENTRILIFT GALLAGHER BASSETT RANCHO CUCAMONGA ADJ570624 JOHN SELMAN ROADWAY EXPRESS GALLAGHER BASSETT RANCHO CUCAMONGA ADJ8376630 JOHN WALTER RENTIE YRC GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7795058 JOSE PACHECO SPRINT GALLAGHER BASSETT RANCHO CUCAMONGA ADJ6610080 LARRY STOKES ESTENSON LOGISTICS GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7567121 LAURELIN MARTIN TRADER JOES GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7567121 LAURELIN MARTIN TRADER JOES COMPANY GALLAGHER BASSETT RANCHO CUCAMONGA ADJ7156005 MARIA ARZATE FP STORES INC GALLAGHER BASSETT RANCHO CUCAMONGA ADJ2456013 MARIA GUADALUPE VELASCO SUNDANCE SPAS/JACCUZZI BRANDS GALLAGHER BASSETT RANCHO CUCAMONGA ADJ6687878 MIGUEL CAMPOS CCL TUBE INC GALLAGHER BASSETT RANCHO CUCAMONGA ADJ8911362 PEDRO VERA GORDON LANE CONVALESCENT HOSP GALLAGHER BASSETT RANCHO CUCAMONGA ADJ9133351 RONALD HARRIS TRADER JOE S GALLAGHER BASSETT RANCHO CUCAMONGA ADJ6610824 TOM CICINELLI COLLECTIVE BRANDS, INC. GALLAGHER BASSETT RANCHO CUCAMONGA ADJ9371298 ANA AYALA 7 FOR ALL MANKIND GALLAGHER BASSETT ROSEVILLE ADJ6947659 ANDREA CARRILLO SAN FERNANDO VALLEY COMM MENTAL GALLAGHER BASSETT ROSEVILLE ADJ7253886 ANTONIO AGUILAR HOME TOWN BUFFET GALLAGHER BASSETT ROSEVILLE ADJ7552118 ANTONIO GONZALEZ REDLANDS COUNTRY CLUB GALLAGHER BASSETT ROSEVILLE ADJ7458488 ARIANA RAMIREZ PIXIOR DISTRIBUTION GROUP GALLAGHER BASSETT ROSEVILLE ADJ8233723 BERTHA CAMPOS W I N T E R GALLAGHER BASSETT ROSEVILLE ADJ8233723 BERTHA CAMPOS WINTER GALLAGHER BASSETT ROSEVILLE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7371348 BILLY GASAWAY ATLAS VAN LINES GALLAGHER BASSETT ROSEVILLE ADJ6631567 CANDACE FOSTER OPARC GALLAGHER BASSETT ROSEVILLE ADJ8868770 CANDY GUARDADO VF CONTEMPORARY BRANDS INC GALLAGHER BASSETT ROSEVILLE ADJ7220503 DEBERA JOHNSON WATTS HEALTHCARE ORGANIZATION GALLAGHER BASSETT ROSEVILLE ADJ2552769 DINA CUETO HOMETOWN BUFFET GALLAGHER BASSETT ROSEVILLE ADJ8212597 EDELMIRA GONZALEZ GMI BUILDING SERVICES GALLAGHER BASSETT ROSEVILLE ADJ8897055 EDWARD RIGGS AMERICAN CORPORATE SECURITY INC GALLAGHER BASSETT ROSEVILLE ADJ978586 ERICA MEZA UNITED HEALTH GROUP GALLAGHER BASSETT ROSEVILLE ADJ978586 ERICA MEZA UNITED HEALTH GROUP INC GALLAGHER BASSETT ROSEVILLE ADJ7941897 EUSTAQUIO SANDOVAL CARDENAS MARKETS INC GALLAGHER BASSETT ROSEVILLE ADJ7260750 FELIXITAZ DEFACIO HOLIDAY INN GALLAGHER BASSETT ROSEVILLE ADJ8183729 GENOVEVA CERVANTES KIDS ADVENTURE LEARNING CENTER GALLAGHER BASSETT ROSEVILLE ADJ3269866 GILDARDO FUENTES HNR FRAMING SYSTEMS GALLAGHER BASSETT ROSEVILLE ADJ7728189 GRACIELA RAMOS BUFFETS INC GALLAGHER BASSETT ROSEVILLE ADJ8374890 GULLERMO ORTEGA ALV SECURITY & ALARM SERVICES INC GALLAGHER BASSETT ROSEVILLE ADJ8094471 HELEN BANEGAS LIFE ALERT GALLAGHER BASSETT ROSEVILLE ADJ8692914 IGNACIO QUINTERO STASON PHARMACEUTICALS GALLAGHER BASSETT ROSEVILLE ADJ4652449 JAMIE SALAZAR HSN GALLAGHER BASSETT ROSEVILLE ADJ8324036 JESSICA EQUIHUAS GALLAGHER BASSETT SERVICES GALLAGHER BASSETT ROSEVILLE ADJ8324036 JESSICA EQUIHUAS ORANGE COUNTY HEAD START GALLAGHER BASSETT ROSEVILLE ADJ6785359 JON WHISMAN GLOBAL SECURITY CONCEPTS GALLAGHER BASSETT ROSEVILLE ADJ10453255 JORGE ARCO BALLINA LAKEVIEW FARMS GALLAGHER BASSETT ROSEVILLE ADJ8241616 JOSE GARCIA CUSTOM DRYWALL INC GALLAGHER BASSETT ROSEVILLE ADJ8940327 JOSE HARO PLATT SECURITY GALLAGHER BASSETT ROSEVILLE ADJ7022635 JOSE MARQUEZ MARTINEZ AMERICAN GUARD SERVICES INC GALLAGHER BASSETT ROSEVILLE ADJ8290227 JUAN CHAVEZ UNIVERSAL FILTRATION INC GALLAGHER BASSETT ROSEVILLE ADJ2178307 JUAN SOTO MATHESON POSTAL SERVICE GALLAGHER BASSETT ROSEVILLE ADJ2726352 KHADIJAH STEPTOE CENTER POINT INC GALLAGHER BASSETT ROSEVILLE ADJ6529015 KYLE EDWARDS RUCKER ETTIE LEE YOUTH AND FAMILY SERVICE GALLAGHER BASSETT ROSEVILLE ADJ6966307 LUIS PINONES ALLSCAPE ARCHITECTURAL LANDSCAPE LIGHTING GALLAGHER BASSETT ROSEVILLE ADJ6966307 LUIS PINONES PHILIPS ELECTRONICS NORTH AMERICA CORPORATION GALLAGHER BASSETT ROSEVILLE ADJ7580238 MARGARITA CORNEJO SERVICE MANAGEMENT SYSTEMSS INCI GALLAGHER BASSETT ROSEVILLE ADJ6958748 MARIA ESPINO DENNY`S INC GALLAGHER BASSETT ROSEVILLE ADJ6958748 MARIA ESPINO NAGI INC GALLAGHER BASSETT ROSEVILLE ADJ8336129 MARIA ESTRADA CARDENAS MARKET 15 GALLAGHER BASSETT ROSEVILLE ADJ8732555 MARIA MONZON JONATHAN CLUB GALLAGHER BASSETT ROSEVILLE ADJ7529928 MARK MAGANA OPARC GALLAGHER BASSETT ROSEVILLE ADJ9282743 MARLIN YANES OCB RESTAURANT COMPANY LLC SUBSIDIARY OF BUFFETINC GALLAGHER BASSETT ROSEVILLE ADJ7725995 OLIVIA GARCIA HOMETOWN BUFFET GALLAGHER BASSETT ROSEVILLE ADJ7725995 OLIVIA GARCIA HOMETOWN BUFFETT GALLAGHER BASSETT ROSEVILLE ADJ7632456 OSCAR LONE PEP BOYS GALLAGHER BASSETT ROSEVILLE ADJ7669717 PATRICIA YRIBARREN YMCA GALLAGHER BASSETT ROSEVILLE ADJ2408061 PEDRO ALVARADO SELECT BUILD GALLAGHER BASSETT ROSEVILLE ADJ2408061 PEDRO ALVARADO SELECT BUILD CO GALLAGHER BASSETT ROSEVILLE ADJ7937016 PERLA MORENO ORANGE COUNTY HEAD START GALLAGHER BASSETT ROSEVILLE ADJ7308621 REBECCA PINEDA HOME SHOPPING NETWORK GALLAGHER BASSETT ROSEVILLE ADJ6905926 REYNALDA GONZALEZ BUFFETS INC GALLAGHER BASSETT ROSEVILLE ADJ7470143 RIGOBERTO ORNELAS THE PEP BOYS GALLAGHER BASSETT ROSEVILLE ADJ582461 SHARONDA THOMAS ADMINISTAFF COMPANIES GALLAGHER BASSETT ROSEVILLE ADJ582461 SHARONDA THOMAS ADMINSTAFF COMPANIES GALLAGHER BASSETT ROSEVILLE ADJ9153813 TERRANCE OJEDA THE EFFORT GALLAGHER BASSETT ROSEVILLE ADJ8294856 ULIVARDO AVALOS HOME TOWN BUTTET #727 GALLAGHER BASSETT ROSEVILLE ADJ6467677 VICTORIA BAKER ANTHONY AND KATHERINE VIELE GALLAGHER BASSETT ROSEVILLE ADJ6467677 VICTORIA BAKER TOKA PROPERTIES GALLAGHER BASSETT ROSEVILLE ADJ9232895 YOLANDA GONZALEZ ARECONT VISION GALLAGHER BASSETT ROSEVILLE ADJ8670400 YSAIAS DE SANTIAGO QUALITY STAFFING SOLUTIONS GALLAGHER BASSETT ROSEVILLE ADJ9880716 CESAR LEZO HARVEST MEAT COMPANY GALLAGHER BASSETT SACRAMENTO ADJ7204011 JENNIFER MARTINEZ BURLINGTON COAT FACTORY GALLAGHER BASSETT SACRAMENTO ADJ9484772 JORGE BARILLAS OLD DOMINION FREIGHT LINE GALLAGHER BASSETT SACRAMENTO ADJ950331 MARTIN SANCHEZ CONTROL LOGISTICS GALLAGHER BASSETT SACRAMENTO ADJ7495471 ANCELMO PENALOSA GARCIA JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ9485535 ANDRES DE LA CRUZ PEERLESS BUILDING MAINTENANCE COMPANY GALLAGHER BASSETT SAN DIEGO ADJ3930691 ARISTEO LOPEZ EARTH CARE INC GALLAGHER BASSETT SAN DIEGO ADJ9284462 BERTHA RODRIGUEZ JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ9196983 CIEARA HILL MCDONALDS GALLAGHER BASSETT SAN DIEGO ADJ6883823 CRISTINA CASTREJON JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ6798192 EDUARDO HERNANDEZ J T WINSATT CONTRACTING CO INC GALLAGHER BASSETT SAN DIEGO ADJ6943828 ELSA DIEGO JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ7739089 ERICK BAUTISTA CLASSIC PARTY RENTAL GALLAGHER BASSETT SAN DIEGO ADJ3951286 ESTELLA AVILEZ MARQUEZ JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ6749657 GILBERTO ALVAREZ JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ6941057 GUSTAVO TREJO CALIFORNIA COMFORT SYSTEMS GALLAGHER BASSETT SAN DIEGO ADJ9330570 IRMA HERRERA JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ7558746 IVAN CUEVAS JACK IN THE BOX INC GALLAGHER BASSETT SAN DIEGO ADJ7566604 JACKELINE MENA SENIOR JOY INCORPORATED GALLAGHER BASSETT SAN DIEGO ADJ7905927 JERONIMO VASQUEZ RUAN TRANSPORT CORPORATION GALLAGHER BASSETT SAN DIEGO ADJ1507336 JESUS CHAVEZ DOUGLAS E BARNHART GALLAGHER BASSETT SAN DIEGO ADJ1507336 JESUS CHAVEZ DOUGLAS E BARNHART INC GALLAGHER BASSETT SAN DIEGO ADJ4604396 JESUS GARCIA JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ6610125 JESUS GARCIA MINSHEW BROTHERS STEEL GALLAGHER BASSETT SAN DIEGO ADJ7309748 JORGE VILLEGAS ATILANO IMPERIAL VILLA PROPERTIES GALLAGHER BASSETT SAN DIEGO ADJ6914887 JOSE TREVIZO PACIFIC PRODUCTION PLUMBING INC GALLAGHER BASSETT SAN DIEGO ADJ9295260 LUZMI RODRIGUEZ CLASSIC PARTY RENTALS GALLAGHER BASSETT SAN DIEGO ADJ7279778 LYDIA PORRAS UNION BANK GALLAGHER BASSETT SAN DIEGO ADJ9105569 MARCO TAPIA COMMERCIAL CLEANING SYSTEMS GALLAGHER BASSETT SAN DIEGO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7351031 MARIA VASQUEZ DANA POINT ST REGIS MONARCH BEACH RESORT AND SPA GALLAGHER BASSETT SAN DIEGO ADJ7906452 PAOLA VADILLO JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ7445056 PATRICIA REYES JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ8574393 PEDRO BELMAN SANTIBANEZ CASS CONSTRUCTION GALLAGHER BASSETT SAN DIEGO ADJ7679258 REINA BONILLA R&L NEWSPAPER DISTRIBUTORS INC GALLAGHER BASSETT SAN DIEGO ADJ9017991 TAWONA NETTLES BAYADA HEALTHCARE GALLAGHER BASSETT SAN DIEGO ADJ964340 URSULA MADRIGAL JACK IN THE BOX GALLAGHER BASSETT SAN DIEGO ADJ9660072 VICENTE SILVA CAPETILLO PACIFIC BUILDING CARE/PBC HOLDING GALLAGHER BASSETT SAN DIEGO ADJ8681086 WILLIAM DORA DR PEPPER SNAPPLE GROUP GALLAGHER BASSETT SAN DIEGO ADJ7933957 XIOMARA MEJA WENDYS RESTAURANT GALLAGHER BASSETT SAN DIEGO ADJ7167134 MARIO MEDRANO HERNANDEZ CALIFORNIA DYNAMICS CORP GALLAGHER BASSETT SAN DIEGO ADJ7496282 ALMER REYES UHAUL GALLAGHER BASSETT SCOTTSDALE ADJ7304786 AUDREY WILEY LA CHRISTIAN HEALTH CENTERS GALLAGHER BASSETT SCOTTSDALE ADJ7503226 MARIA GONZALEZ SEASON PRODUCE CO GALLAGHER BASSETT SCOTTSDALE ADJ7339313 MARLON MUNNINGS MCKESSON CORPORATION GALLAGHER BASSETT SCOTTSDALE ADJ8085364 MIGUEL GONZALES ANGELICA CORP GALLAGHER BASSETT SCOTTSDALE ADJ8085364 MIGUEL GONZALES ANGELICA CORPORATION GALLAGHER BASSETT SCOTTSDALE ADJ7785452 ORALIA LOPEZ DIAZ S AND H PACKING AND SALES CO INC GALLAGHER BASSETT SCOTTSDALE ADJ8836041 PATRICIA VEGA UNITED STAFFING ASSOC GALLAGHER BASSETT SCOTTSDALE ADJ975270 JAMES WOODARD SOI INVESTIGATION LP Gallagher Bassett Services ADJ4411846 JOHN BRESYN CZARNOWSKI DISPLAY SERVICE GALLAGHER BASSETT SERVICES ADJ3979537 ANDREW URAINE ARTIC MECHANICAL GALLAGHER BASSETT SERVICES INC ADJ2879510 ARACELI GARCIA JACK IN THE BOX GALLAGHER BASSETT SERVICES INC ADJ1259700 ARMANDO ALVARADO SODEXHO GALLAGHER BASSETT SERVICES INC ADJ1259700 ARMANDO ALVARADO SODEXHO GALLAGHER BASSETT SERVICES INC ADJ1259700 ARMANDO ALVARADO SODEXHO MARRIOTT GALLAGHER BASSETT SERVICES INC ADJ1259700 ARMANDO ALVARADO SODEXHO MARRIOTT GALLAGHER BASSETT SERVICES INC ADJ2927155 BRIAN LEWIS STAFF MANAGEMENT TEMPORARY AGENCY GALLAGHER BASSETT SERVICES INC ADJ857770 CESAR SANCHEZ VALLEY CREST GALLAGHER BASSETT SERVICES INC ADJ3659520 LUZ MEDINA HILTON GALLAGHER BASSETT SERVICES INC ADJ1460102 VICTOR SALAZAR SODEXHO GALLAGHER BASSETT SERVICES INC DIEGO AKA GUADALUPE MAGANA AKA ADJ9540273 PROMPT STAFFING GALLAGHER BASSETT TWO MARTINEZ ADJ6608395 EDMUNDO VALDEZ U P S FREIGHT GALLAGHER BASSETT UPS5141 LAKE FOREST ADJ6608395 EDMUNDO VALDEZ UPS FREIGHT GALLAGHER BASSETT UPS5141 LAKE FOREST ADJ6825299 RAMON NIETO UNITED PARCEL SERVICE GALLAGHER BASSETT UPS5141 LAKE FOREST ADJ6825299 RAMON NIETO UPS GALLAGHER BASSETT UPS5141 LAKE FOREST ADJ7234240 URIEL ARREOLA UPS GALLAGHER BASSETT UPS5141 LAKE FOREST ADJ7191869 ALICIA SILVA GARDEN GROVE UNIFIED SCHOOL DISTRICT GARDEN GROVE UNIFIED SCHOOL DISTRICT ADJ7191869 ALICIA SILVA WAREHOUSE DEMO SERVICES GARDEN GROVE UNIFIED SCHOOL DISTRICT ADJ7384117 MARIA BETANCOURT GARDEN GROVE UNIFIED SCHOOL DISTRICT GARDEN GROVE UNIFIED SCHOOL DISTRICT ADJ4324472 CHRISTOPHER RAMSAY SOUTHERN CALIFORNIA GAS COMPANY GAS COMPANY ADJ4524318 ESTEBAN MARTINEZ DISTRIBUTION ALTERNATIVES GENERAL CASUALTY SUN PRAIRIE CLOSED ADJ8261139 CONRAD CARRILLO AIRCRAFT STAMPING CO GOLDEN EAGLE ALISO VIEJO ADJ9222777 GABRIEL GOMEZ GARVEY WHOLESALE BEVERAGE INC GOLDEN EAGLE ALISO VIEJO ADJ7259010 JORGE GUEVARA JENCO PRODUCTIONS INC GOLDEN EAGLE ALISO VIEJO ADJ7777380 LUIS MONZON MCKENNA S ON THE BAY GOLDEN EAGLE ALISO VIEJO ADJ8642632 RAMONA MEDINA CGP MANAGEMENT GOLDEN EAGLE ALISO VIEJO ADJ8200716 PETER LOPEZ FS COMMERCIAL LANDSCAPE INC GOLDEN EAGLE ORANGE ADJ7185903 VERONICA PENA BEAS SOYA SUSHI GOLDEN EAGLE ORANGE ADJ1024059 HOANG NGUYEN INTEGRATED MORTGAGE SERVICE GOLDEN EAGLE PORTLAND ADJ9431960 JAIME OROZCO BANN SHIANG LIZA YU GOLDEN EAGLE PORTLAND ADJ6975252 JOSE MARTINEZ GENERAL RESTAURANT EQUIPMENT GOLDEN EAGLE PORTLAND ADJ8555022 MARIANA YEPEZ KOGI GROUP GOLDEN EAGLE PORTLAND ADJ3159374 LAWRENCE GONZALEZ TIMEC INC GOLDMAN MAGDALIN OXNARD ADJ963733 GILBERTO JACOBO LA PALAPA MARKET GOLDMAN MAGDALIN SAN DIEGO GRANITE STATE INSURANCE CO/AMERICAN INT'L GROUP ADJ8195701 ANGELICA TORRES ADVANCED MULSERVICE CLAIMS SERV GRANITE STATE INSURANCE CO/AMERICAN INT'L GROUP ADJ9172752 ELIZABETH MARTINEZ JONATHAN AND GEORGE SALON INC CLAIMS SERV GRANITE STATE INSURANCE CO/AMERICAN INT'L GROUP ADJ7617830 MARIA GUTIERREZ SPOTLESS DETAIL CLAIMS SERV GRANITE STATE INSURANCE CO/AMERICAN INT'L GROUP ADJ9099888 MARTIN RAMIREZ LUCERO SF APPAREL CLAIMS SERV ADJ7880652 LUIS GALO SH TRADING INC GRAVES BOURASSA TUSTIN ADJ3559568 CHARLES CURTIS SPOTRUNNER GREAT AMERICA RISK ADJ3559568 CHARLES CURTIS TROY THROWER & ASSOCIATES GREAT AMERICA RISK ADJ623013 JOSE VELAZQUEZ TROJAN BATTERY CO GREAT AMERICAN INSURANCE ADJ3559568 CHARLES CURTIS SPOTRUNNER GREAT AMERICAN INSURANCE GROUP ADJ3559568 CHARLES CURTIS TROY THROWER & ASSOCIATES GREAT AMERICAN INSURANCE GROUP ADJ9216256 ADAN RODRIGUEZ FILE4 13 TRUCKING GREAT AMERICAN WALNUT CREEK ADJ9162064 CUAUHTEMOC GARCIA PDS TRUCKING INC GREAT AMERICAN WALNUT CREEK ADJ8141174 JAIME FLORES HARBOR CHOICE EXPRESS LTD CORP GREAT AMERICAN WALNUT CREEK ADJ7442731 MARIA COVARRUBIAS SUPERIOR QUALITY FOODS CORP GREAT AMERICAN WALNUT CREEK ADJ7858927 MICHAEL DIBELLA B K NELSON GREAT AMERICAN WALNUT CREEK ADJ8131945 AARON BURKETT MELTON TRUCK LINES GREAT WEST SOUTH SIOUX CITY ADJ9948911 ANGEL CAMPOS HUB GROUP TRUCKING GREAT WEST SOUTH SIOUX CITY ADJ1982866 LEON HOWARD MARTEN TRANSPORT GREAT WEST SOUTH SIOUX CITY ADJ9592022 HERIBERTO BENITEZ GREEN CONVERGENCE GREEN CONVERGENCE ADJ8568372 JESUS MUNIZ MENDOZA AUTOMOTIVE ENTERPRISES GUARD INSURANCE NASHUA ADJ8694042 ORFANEL MARTINEZ YOSHI S GREEN SUPPLY GUARD INSURANCE NASHUA ADJ8869186 JESUS GUTIERREZ CRESTA VERDE GOLF COURSE GUARD INSURANCE RANCHO CORDOVA ADJ9081739 JOAQUIN RODRIGUEZ GLOBAL TIRES OF CALIFORNIA INC GUARD INSURANCE RANCHO CORDOVA ADJ7590562 JOSE ARREOLA CITY TILE AND STONE TILE INC GUARD INSURANCE RANCHO CORDOVA ADJ9495659 LUIS RAMOS EL MONTE COLLISION CENTER GUARD INSURANCE RANCHO CORDOVA ADJ8958592 PATRICIA GABRIELA LEMUS ALVAREZ CABRERAS MEXICAN CUISINE GUARD INSURANCE RANCHO CORDOVA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8904828 RODRIGO GARCIA LA CASITA MEXICAN GRILL AND SEAFOOD GUARD INSURANCE RANCHO CORDOVA ADJ8465428 VICTOR CARDENAS AUTOMOTIVE PARTS WHOLESALE GUARD INSURANCE RANCHO CORDOVA ADJ8298823 ANA NOLASCO CARRENO LA SERENATA DE GARIBALDI GUARD INSURANCE WILKES BARRE ADJ7645710 CLAUDIA SOLORZANO PORTOLA INN SUITES GUARD INSURANCE WILKES BARRE ADJ7839851 DARIAN HOWELL ROUND TABLE PIZZA GUARD INSURANCE WILKES BARRE ADJ913499 DAVID WILKS GREG'S ROOTER AND PLUMBING GUARD INSURANCE WILKES BARRE ADJ8416146 ELISCHIA GAITHER I MAR GUARD INSURANCE WILKES BARRE ADJ9099601 FIDEL SUAREZ VICTORIA PUBLIC GOLF GUARD INSURANCE WILKES BARRE ADJ8335105 FRANCISCO NIETO BOTTEGA LOUIE GUARD INSURANCE WILKES BARRE ADJ7518607 GERARDO SALAS JB PLASTICS INC GUARD INSURANCE WILKES BARRE ADJ7592317 HAYDEE HERNANDEZ ANGELINAS FASHIONS GUARD INSURANCE WILKES BARRE ADJ8344643 IRMA OSORIO JUICE MAX GUARD INSURANCE WILKES BARRE ADJ9077072 ISAIAS GUERRERO US PRINT & TONER GUARD INSURANCE WILKES BARRE ADJ9081739 JOAQUIN RODRIGUEZ GLOBAL TIRES OF CALIFORNIA INC GUARD INSURANCE WILKES BARRE ADJ7590562 JOSE ARREOLA CITY TILE AND STONE TILE INC GUARD INSURANCE WILKES BARRE ADJ7728374 JOSE MEJIA FIRST CALL CONTRACTING GUARD INSURANCE WILKES BARRE ADJ8434150 JOSE RODRIGUEZ JC KRESS CONSTRUCTION GUARD INSURANCE WILKES BARRE ADJ7926348 JOSE TEMORES PACIFIC COAST BUILDING C GUARD INSURANCE WILKES BARRE ADJ7218590 KIMBER CUMMINGS SUN STAR ORGANICS GUARD INSURANCE WILKES BARRE ADJ9614870 LEONARDO DOMINGUEZ NORTH STAR DYE AND WASH GUARD INSURANCE WILKES BARRE ADJ8416110 LOURDES RAMIREZ SM ASIAN MARKET LLC GUARD INSURANCE WILKES BARRE ADJ7976744 LUIS BUENROSTRO CALIFORNIA LANDSCAPE DESIGN GUARD INSURANCE WILKES BARRE ADJ8392194 LUZ MARIA LOZANO DANISH ENVIRONMENT INC GUARD INSURANCE WILKES BARRE ADJ8752133 MARGARITA CURIEL CONROYS FLOWERS GUARD INSURANCE WILKES BARRE ADJ9374048 MARIO BASILIO VICTORIA PUBLIC GOLF GUARD INSURANCE WILKES BARRE ADJ7392576 MARISOL CARDENAS WESTERN SLOPE CLEANING LLC GUARD INSURANCE WILKES BARRE ADJ7895785 MARTHA MEDINA RODEWAY INN GUARD INSURANCE WILKES BARRE ADJ9267304 MISAEL SANCHEZ BOCANEGRA LAGO RESTAURANTS GUARD INSURANCE WILKES BARRE ADJ8958592 PATRICIA GABRIELA LEMUS ALVAREZ CABRERAS MEXICAN CUISINE GUARD INSURANCE WILKES BARRE ADJ7669560 RAUL FLORES RAYCON ENVIRONMENTAL GUARD INSURANCE WILKES BARRE ADJ8904828 RODRIGO GARCIA LA CASITA MEXICAN GRILL AND SEAFOOD GUARD INSURANCE WILKES BARRE ADJ9087476 VICTOR OROZCO REDRHINO THE EPOXY FLOORING CO INC GUARD INSURANCE WILKES BARRE ADJ7236533 ANA GAN UNITED METHODIIST CHURCH OF MAYWOOD GUIDEONE MUTUAL DES MOINES ADJ7236533 ANA GAN UNITED METHODIST CHURCH OF MAYWOOD GUIDEONE MUTUAL DES MOINES ADJ6658108 LEANDRO DEL REAL CORTANT HOUSING L ECONOMIC GUIDEONE MUTUAL DES MOINES ADJ9588892 DAVID REYES KMR LABEL LLC DBA AXIOM LABEL GROUP HANOVER INSURANCE GROUP WORCESTER ADJ9094006 FAUSTINO CATALAN THE BRIGANTINE HANOVER INSURANCE GROUP WORCESTER ADJ9062471 GLORIA HERRERA WETMORE TOOLS AND ENGINEERING HANOVER INSURANCE GROUP WORCESTER ADJ9214821 GUSTAVO FRAGA WEST COVINA HANOVER INSURANCE GROUP WORCESTER ADJ7935540 LEONOR RODRIGUEZ BREA 76 HANOVER INSURANCE GROUP WORCESTER ADJ8755311 PEDRO HERNANDEZ PETROLINK SUPERIOR INC HANOVER INSURANCE GROUP WORCESTER ADJ9166367 REYNA GONZALEZ S S PETROLEUM HANOVER INSURANCE GROUP WORCESTER ADJ9544324 SAMI ANSARI HASSAN SONS INC HANOVER INSURANCE GROUP WORCESTER ADJ9668892 STEVE GANCHEROV CLEARSHOT MANAGEMENT LLC HANOVER INSURANCE GROUP WORCESTER ADJ8866710 VICTOR BAUTISTA PLAYA VISTA CAR CARE HANOVER INSURANCE GROUP WORCESTER HARBOR SPECIALTY INSURANCE CO/FREMONT EMPLOYERS ADJ1390966 JESUS PACHECO ALUMAFOLD PACIFIC INC INSURANCE AGENCY ADJ7033097 GERMAN HERNANDEZ SENIOR SYSTEMS TECHNOLOGY HARTFORD ADJ2153716 MARIA SANCHEZ ARMOND BITTON & MIRIAM BITTON HARTFORD ADJ7523199 MARTIRES GARCIA TRI STAR MANUFACTURING INC HARTFORD INS CO OF THE MIDWEST ADJ6618124 SANDY DIAZ US HEALTHWORKS HARTFORD INSURANCE ADJ9465049 ABEL FLORES LUX BEAUTY GROUP HARTFORD SACRAMENTO ADJ8721444 ADRIAN PEREZ ARAUJO LABEL SPECIALTIES INC HARTFORD SACRAMENTO ADJ8045274 AIDEE SANTIAGO PREMIUM PRINT HARTFORD SACRAMENTO ADJ9604595 ALBERTO HUITZIL UKAS BIG SERVER FOOD HARTFORD SACRAMENTO ADJ9604595 ALBERTO HUITZIL UKAS BIG SERVER FOODS HARTFORD SACRAMENTO ADJ7936856 ALEJANDRA SUAREZ AVANTI HEALTH SYSTEMS HARTFORD SACRAMENTO ADJ7936856 ALEJANDRA SUAREZ COMMMUNITY HOSPITAL OF HUNTINGTON PARK HARTFORD SACRAMENTO ADJ7430407 ALEJANDRO MONTENEGRO BIG O TIRES HARTFORD SACRAMENTO ADJ8973672 ALEX LOPEZ KC ENGINEERING HARTFORD SACRAMENTO ADJ7644714 ALICIA VASQUEZ DE RUVALCABA G & S ENTERPRISES HARTFORD SACRAMENTO ADJ6985933 ALMA CEJA PHENIX GOURMET LLC HARTFORD SACRAMENTO ADJ6896618 AMALIA CABRERA OLIVE GROVE RETIREMENT RESORT HARTFORD SACRAMENTO ADJ8195701 ANGELICA TORRES ADVANCED MULSERVICE HARTFORD SACRAMENTO ADJ8859204 ANTHONY EDWARDS CONVERGENCE MARKETING INC HARTFORD SACRAMENTO ADJ6566733 ANTONIA NAVARRO 3 DAY BLINDS INC HARTFORD SACRAMENTO ADJ8209210 ANTONIO VALENCIA AMERICAN COVER DESIGN HARTFORD SACRAMENTO ADJ8166897 ARGIL SIERRA FIRST APPAREL HARTFORD SACRAMENTO ADJ7500680 ARIANA REDD OSI ELECTRONICS HARTFORD SACRAMENTO ADJ7282922 ARMANDO GRIJALVA TWIN MED LLC HARTFORD SACRAMENTO ADJ7112557 BENJAMIN GARCIA LA BREA BAKERY HARTFORD SACRAMENTO ADJ7171620 BERTHA DE ALBA GALVESTON EQUINE ENTERPRISES LLC HARTFORD SACRAMENTO ADJ1002232 BERTHA SOTO TTM TECHNOLOGIES HARTFORD SACRAMENTO ADJ7858921 BILL UZETA ACCELLENT ENDOSCOPY HARTFORD SACRAMENTO ADJ9126426 BLANCA BANUELOS ALTA ADVANCED TECHNOLOGIES INC HARTFORD SACRAMENTO ADJ2911407 CARITINA DOMINGUEZ OSI OPTOELECTRONICS, INC HARTFORD SACRAMENTO ADJ7550371 CARITINA GALICIA NUMATECH WEST KMP LLC HARTFORD SACRAMENTO ADJ8842494 CARLOS GARCIA ORTIZ CUTTING SERVICE HARTFORD SACRAMENTO ADJ1835559 CARLOS MEJIA PREMIER STAFFING SOLUTIONS HARTFORD SACRAMENTO ADJ9604789 CARLOS MEJIA POWER STAFF HARTFORD SACRAMENTO ADJ9400106 CARMELO RODRIGUEZ AMERICAN FUJI SEAL HARTFORD SACRAMENTO ADJ8533766 CARMEN GARIBAY PACKAGING PLUS SERVICES HARTFORD SACRAMENTO ADJ7234307 CARMEN HERNANDEZ ROLF C HAGENG USA CORP HARTFORD SACRAMENTO ADJ7901462 CARMEN HERNANDEZ PROGRESS FINANCIAL CORP HARTFORD SACRAMENTO ADJ9101204 CECILIA SOTO DECO CALIFORNIA INSURANCE AGENCY HARTFORD SACRAMENTO ADJ9464537 CLAUDIA GUADAMUZ DAZO HARTFORD SACRAMENTO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8665782 CLOTILDE SANCHEZ KIMCO STAFFING SERVICES INC HARTFORD SACRAMENTO ADJ8665782 CLOTILDE SANCHEZ PERFORMANCE TEAM FREIGHT HARTFORD SACRAMENTO ADJ4442467 CONNIE MALDONADO MEADOWBROOK OF CALIFORNIA HARTFORD SACRAMENTO ADJ7762889 CYNTHIA REYES MAHESH SEJPAL DDS HARTFORD SACRAMENTO ADJ9397935 DANIEL TREJO UKAS BIG SAVER FOODS INC HARTFORD SACRAMENTO ADJ8159400 DANIELLE CARROLL ONE CALL MEDICAL INC HARTFORD SACRAMENTO ADJ7922178 DAVID GALVAN HINES NURSERIES INC HARTFORD SACRAMENTO ADJ8279677 DELMY MIRANDA WAY OUT WEST HARTFORD SACRAMENTO ADJ7675759 DEMETRIUS ALLARD ACOSTA SALES AND MARKETING HARTFORD SACRAMENTO ADJ8211486 EFREN AVILA BERKELEY COMMUNICATIONS CORP HARTFORD SACRAMENTO ADJ7721417 ELISEO SANCHEZ ARCADIA LNC HARTFORD SACRAMENTO ADJ8073145 ELIZABETH PORTILLO FOREMOST SILK SCREEN & EMBOIDERY INC HARTFORD SACRAMENTO ADJ8537077 ELIZABETH SANCHEZ MASS MANUFACTURING HARTFORD SACRAMENTO ADJ9001760 ELVIA PANIAGUA SOUTHERN CALIFORNIA MEDICAL HARTFORD SACRAMENTO ADJ8766335 EMILIO SOTO BAJA FRESH HARTFORD SACRAMENTO ADJ7414497 ENRIQUE TORRES SELLATURA ITALIA DBA TURINMODEL INC HARTFORD SACRAMENTO ADJ8902505 ESPERANZA BUSTOS CARLISLE INTERCONNECT TECHNOLOGIES HARTFORD SACRAMENTO ADJ8013395 ESTEBAN PALMA SUMMIT INSPECTION SERVICES HARTFORD SACRAMENTO ADJ9516132 ESTELA MACIAS CHAVEZ DIFER FINISHING HARTFORD SACRAMENTO ADJ7591976 ESTER HERNANDEZ CAPSTONE CARE LLC HARTFORD SACRAMENTO ADJ6765309 EVA ESPERZA SIMPLY RIGHT HARTFORD SACRAMENTO ADJ7080505 EVA MANRIQUE CORTEZ WESTERN DENTAL HARTFORD SACRAMENTO ADJ7599951 EVELIN MONGE MJO STAFFING HARTFORD SACRAMENTO ADJ8306216 EVELYN ALVARADO ABERCROMBIE FITCH HARTFORD SACRAMENTO ADJ8306216 EVELYN ALVARADO ABERCROMBIE FITCH HARTFORD SACRAMENTO ADJ7634469 EVELYN REYES MOONSTAR MANUFACTURING INCORPORATED HARTFORD SACRAMENTO ADJ9028611 FRANCISCA ROMANO TRI PAC ENTERPRISES HARTFORD SACRAMENTO ADJ7215840 FRANCISCO CAMARILLO SUNSPORTS APPAREL HARTFORD SACRAMENTO ADJ8002479 FRED SCHONEKE TWO BUNCH PALMS RESORT AND SPA HARTFORD SACRAMENTO ADJ9322601 GERARDO VILLASENOR MAGGITT SAFETY SYSTEM INC HARTFORD SACRAMENTO ADJ9322601 GERARDO VILLASENOR MEGGITT SAFETY SYSTEMS HARTFORD SACRAMENTO ADJ9193941 GETANIA SCOTT SSC AN ALTEGRA HEALTH COMPANY HARTFORD SACRAMENTO ADJ9158709 GLORIA SANTA CRUZ CALIFORNIA SUSHI TERIYAKI HARTFORD SACRAMENTO ADJ6872628 GUADALUPE HERRERA VILLA GENNAROS RISTORANTE HARTFORD SACRAMENTO ADJ7282278 GUADALUPE PLASOLA PACKAGING PLUS HARTFORD SACRAMENTO ADJ6707994 GUADALUPE QUINTERO WESTERN SUMMIT MFG CORP HARTFORD SACRAMENTO ADJ9349661 GUILLERMO MANZO MALCOLITE CORPORATION HARTFORD SACRAMENTO ADJ8524348 HA NGUYEN MONEY MAILER HOLDING CORPORATION HARTFORD SACRAMENTO ADJ9152237 HECTOR ARNOLDO RAUDA CONTRACT SERVICES GROUP HARTFORD SACRAMENTO ADJ9139970 HECTOR CAPETILLO CONTRACT SERVICES GROUP INC HARTFORD SACRAMENTO ADJ7264192 HECTOR RODRIGUEZ ECONOMY IMPROVEMENT SERVICES INC HARTFORD SACRAMENTO ADJ8905331 HUMBERTO GARCIA LUMBAR METALS HARTFORD SACRAMENTO ADJ9754357 IMELDA SALAZAR SIGNATURE EYEWEAR HARTFORD SACRAMENTO ADJ8740800 IRIS VELASQUEZ CALIFORNIA EMPLOYERS SAFETY GROUP HARTFORD SACRAMENTO ADJ9227453 ISIDRO LOREDO FOREVER LINK INTERNATIONAL HARTFORD SACRAMENTO ADJ7908118 ISRAEL VILLALOBOS CLEMENTS DYE HARTFORD SACRAMENTO ADJ7616557 JAIME GUTIERREZ HR COMP LLC HARTFORD SACRAMENTO ADJ8643413 JAIRO RODRIGUEZ SOUTH EAST EMPLOYEE LEASING SERVICES INC HARTFORD SACRAMENTO ADJ9381588 JESUS ELIAS KC SOUTHCOAST INC DBA THE KICKIN CRAB HARTFORD SACRAMENTO ADJ8252044 JESUS SANDOVAL OG PRINTING CORP QUAD GRAPHICS HARTFORD SACRAMENTO ADJ8153842 JESUS VELASCO OS FACTORY INC HARTFORD SACRAMENTO ADJ6749658 JOE OLIVER VERTILEX WEST HARTFORD SACRAMENTO ADJ9350129 JORGE SALGADO MILLENIUM SHOES HARTFORD SACRAMENTO ADJ7631225 JOSE CAUDILLO BIOPLATE INC HARTFORD SACRAMENTO ADJ7910689 JOSE CHAVEZ LE PAIN QUOTIDIEA HARTFORD SACRAMENTO ADJ6775953 JOSE JAIMES CAMBRIDGE LEE INDUSTRIES HARTFORD SACRAMENTO ADJ2398837 JOSE REYNOSO AIR-SERVICE SOUTH WEST HARTFORD SACRAMENTO ADJ9022220 JUAN CARLOS CALDERON SPECIALIZED CLEANING CONTRACTORS INC HARTFORD SACRAMENTO ADJ8565275 JUAN CARRILLO CHP ENTERPRISES HARTFORD SACRAMENTO ADJ7071563 JUAN CASTILLO DELGADO PLATINUM WIRELESS HARTFORD SACRAMENTO ADJ7354120 JUAN MACIAS THREE DOTS LLC HARTFORD SACRAMENTO ADJ7463307 JUAN SALDANA GIUMARRA HARTFORD SACRAMENTO ADJ7634224 JUAN VILLANUEVA GIUMARRA VINEYARDS CORP HARTFORD SACRAMENTO ADJ9119422 JULIA VELASQUEZ PAYSTAFF PACIFIC HEADQUARTERS HARTFORD SACRAMENTO ADJ7359681 JULIE VILLALOBOS FREEDOM FINANCIAL MANAGEMENT HARTFORD SACRAMENTO ADJ7041021 JUVENCIO MENDOZA ORTIZ SUPERIOR SOD 1 HARTFORD SACRAMENTO ADJ7437403 KENIA ESCORSIA EDEN PHARMACY HARTFORD SACRAMENTO ADJ9366729 KIRK QUINTANA ADVANCED OFFICE SERVICES IMAGING PLUS HARTFORD SACRAMENTO ADJ1778175 LAMONT VANHOOK ALLSTAR GLASS HARTFORD SACRAMENTO ADJ9041935 LAURIE EASON CLAS CHARTER SCHOOL HARTFORD SACRAMENTO ADJ7346538 LEONARDO LARA ADVANCE INNOVATION WEST LLC HARTFORD SACRAMENTO ADJ7935540 LEONOR RODRIGUEZ BREA 76 HARTFORD SACRAMENTO ADJ7050145 LIGIA RODRIGUEZ PERRY ELLIS INTERNATIONAL HARTFORD SACRAMENTO ADJ6727530 LORENA PEREZ FORPLAY BORN IN HOLLYWOOD HARTFORD SACRAMENTO ADJ7897880 LUCIA GARCIA J MICHELLE OF CALIFORNIA HARTFORD SACRAMENTO ADJ7062757 LUIS MURILLO CREATIVE COMMUNICATION TECHNOLOGIES HARTFORD SACRAMENTO ADJ7643838 LUIS RESTREPO MARCEL ELECTRONICS INTERNATIONAL HARTFORD SACRAMENTO ADJ7335956 LUPE PEREZ SOLARIS PAPER HARTFORD SACRAMENTO ADJ7264197 LUZ GONZALEZ EVENFLO COMPANY INC HARTFORD SACRAMENTO ADJ1754748 MANUEL FURLONG FARA & ASSOCIATES HARTFORD SACRAMENTO ADJ6462862 MANUEL GALVEZ YORK CASKETS HARTFORD SACRAMENTO ADJ6523424 MANUEL GALVEZ YORK CASKETS HARTFORD SACRAMENTO ADJ6971110 MANUEL POLANCO OCZ TECHNOLOGY GROUP HARTFORD SACRAMENTO ADJ7731163 MARCOS SANCHEZ PACKAGING PLUS HARTFORD SACRAMENTO ADJ9046401 MARIA ACEVES INTERCARNES TEXAS EL PASO HARTFORD SACRAMENTO ADJ7776917 MARIA BAROJAS L AND M OPTICAL DISC WEST LLC HARTFORD SACRAMENTO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ1694893 MARIA BENITEZ VICENTE WARESTAFF LLC HARTFORD SACRAMENTO ADJ7486389 MARIA CERON ARBOR VIEW WELLNESS AND HEALTHCARE CENTER HARTFORD SACRAMENTO ADJ9374336 MARIA COLMENARES TRI STATE EMPLOYMENT SERVICES HARTFORD SACRAMENTO ADJ8842498 MARIA DE JESUS PACHECO BEJA HARTFORD SACRAMENTO ADJ9375882 MARIA FAJARDO HERITAGE QUALITY CLEANERS HARTFORD SACRAMENTO ADJ7436383 MARIA LOPEZ GREEN DEPOT PUBLIC SCHOOLS HARTFORD SACRAMENTO ADJ8001276 MARIA MEJIA PACKING PLUS SERVICES HARTFORD SACRAMENTO ADJ6748594 MARIA ORTIZ GUEVARA TELESCAPE COMMUNICATIONS HARTFORD SACRAMENTO ADJ7125304 MARIA RAMOS G & L GUITARS & BASES HARTFORD SACRAMENTO ADJ8937067 MARIA TERESA HERNANDEZ BHARTI INC HARTFORD SACRAMENTO ADJ8880855 MARIA VASQUEZ WATERSTONE LLC HARTFORD SACRAMENTO ADJ8038836 MARIBEL TORRES SUBWAY HARTFORD SACRAMENTO ADJ8808864 MARINO AKA CLAUDIO PAVIA AKA ALVAREZ CONTRACT SERVICES GROUP INC HARTFORD SACRAMENTO ADJ8082568 MARITZA MARTINEZ PACKAGING PLUS HARTFORD SACRAMENTO ADJ10212661 MARTA ZALDANA G & M HOLDINGS DBA MASTER HOLDING HARTFORD SACRAMENTO ADJ8766404 MARTHA MEJIA LEES MAINTENANCE SERVICES INC HARTFORD SACRAMENTO ADJ9446699 MARTIN GALEANO NEW WORLD MAINTENANCE INC HARTFORD SACRAMENTO ADJ7672375 MARTIN GONZALEZ IBARRA MAINTENANCE GARDENING SERVICE HARTFORD SACRAMENTO ADJ6943599 MAURA RODRIGUEZ AMERICAN TEXTILE MAINTENANCE HARTFORD SACRAMENTO ADJ7951756 MAXIMILIANO ROSALES GLP DESIGNS INC HARTFORD SACRAMENTO ADJ8346955 MIGUEL PALEMONTE ORANGE PACIFIC CONSTRUCTION HARTFORD SACRAMENTO ADJ7462007 MIKE PERZO MERCHANT SERVICES HARTFORD SACRAMENTO ADJ8045888 MIRNA CORTEZ FIRST APPAREL CO LLC HARTFORD SACRAMENTO ADJ8578406 MIRNA COSS MARROQUIN INDUSTRIES CORP HARTFORD SACRAMENTO ADJ9160166 NANCY CRUZ SAN DIEGO SEWING HARTFORD SACRAMENTO ADJ7721331 NORMA GASTELUM ONE CALL MEDICAL INC HARTFORD SACRAMENTO ADJ7109251 OGLA LOPEZ WEST COAST WAREHOUSE INC HARTFORD SACRAMENTO ADJ7043259 OMAR SANABRIA PADILLA JEWELERS HARTFORD SACRAMENTO ADJ9649583 OSMAN ARAUS PALMA UKA S BIG SAVER FOODS HARTFORD SACRAMENTO ADJ9649583 OSMAN ARAUS PALMA UKAS BIG SAVER FOODS HARTFORD SACRAMENTO ADJ9042322 PASTOR OCHOA MARUI WASABI HARTFORD SACRAMENTO ADJ7800435 PATRICIA PALACIOS DE DIAZ LOS BURRITOS HARTFORD SACRAMENTO ADJ9315978 PAUL GARCIA HOME RESTAURANT SAVP INC HARTFORD SACRAMENTO ADJ9187878 RACHQUEL NESBIT SHARP FRIEGHT SYSTEMS HARTFORD SACRAMENTO ADJ9642053 RAFAEL SIERRA RAW POWER DBA SAINT FELIX HARTFORD SACRAMENTO ADJ7106216 RAMIRO CAMPOS AMERICAN BUILDING SUPPLY HARTFORD SACRAMENTO ADJ9199011 RAMIRO MONTES ROADLINK SERVICES HARTFORD SACRAMENTO ADJ9199011 RAMIRO MONTES ROADLINK WORKFORCE HARTFORD SACRAMENTO ADJ566478 RAUL CISNEROS GRISWOLD INDUSTRIES HARTFORD SACRAMENTO ADJ8423889 RAUL ESTRADA LA BREA BAKERY HARTFORD SACRAMENTO ADJ7514303 RAUL GONZALEZ GRISWOLF INDUSTRIES HARTFORD SACRAMENTO ADJ7784201 RAUL MARTINEZ COMMERCIAL METALS COMPANY HARTFORD SACRAMENTO ADJ7784201 RAUL MARTINEZ G&A PARTNERS HARTFORD SACRAMENTO ADJ9313936 RICARDO ANAYA BORBON, INC. HARTFORD SACRAMENTO ADJ8977857 ROBERT BRINGINO NOVE STAFF SERVICES HARTFORD SACRAMENTO ADJ7271806 ROBERTO BAUTISTA GONZALEZ GRISWORLD INDUSTRIES HARTFORD SACRAMENTO ADJ9614874 ROBERTO ESCOBAR EVERGREEN LAWN SERVICE HARTFORD SACRAMENTO ADJ7102012 ROBERTO TORRES VALLEY FIG GROWERS HARTFORD SACRAMENTO ADJ7432990 ROSA CASILLAS COLORBOK INC HARTFORD SACRAMENTO ADJ7651939 ROSA RIOS ORGANIC FOOD BAR HARTFORD SACRAMENTO ADJ7858742 ROSALIOUS FORTUNE AWIL DHALLA ORTHOPEDICS CENTER INC HARTFORD SACRAMENTO ADJ8316268 ROSENDO VILLATORO S AND N LOGISTICS INC HARTFORD SACRAMENTO ADJ7530689 ROXANA BARCENAS INSURE NOW HARTFORD SACRAMENTO ADJ6997348 SAMUEL ORTEGA MONARCH LITHO INC HARTFORD SACRAMENTO ADJ9200672 SANDRA CAZARES CAPITAL FAMILIA INC HARTFORD SACRAMENTO ADJ8540838 SANDRA PINEDA BIRCHTER ANDERSON REALTY MANAGEMENT INC HARTFORD SACRAMENTO ADJ7248935 SANDRA RIVERA SUBWAY HARTFORD SACRAMENTO ADJ8939066 SAUL HERNANDEZ SUNNYS CAFE HARTFORD SACRAMENTO ADJ8897848 SCHENDELL REYES HORIZON PERSONNEL SERVICES HARTFORD SACRAMENTO ADJ8897848 SCHENDELL REYES TECO DIAGNOSTICS HARTFORD SACRAMENTO ADJ7576135 SELAH WILLIAMS KARL SORZ ENDOSKOPE HARTFORD SACRAMENTO ADJ8518067 SERAFIN TINOCO CAMDEN MARTINIQUE HARTFORD SACRAMENTO ADJ9287229 SEVERO HERNANDEZ METRIC MACHINING HARTFORD SACRAMENTO ADJ9114395 SHARON WASHINGTON RIBET ACADEMY HARTFORD SACRAMENTO ADJ9280976 SHERRY HERNANDEZ KIM TALOR PATRICIA SUGIHARA HARTFORD SACRAMENTO ADJ9280976 SHERRY HERNANDEZ KIM TAYLOR PATRICIA SUGIHARA HARTFORD SACRAMENTO ADJ7479061 SILVIA CHACON RUIZ HOLIDAY INN EXPRESS ANAHEIM HARTFORD SACRAMENTO ADJ7969295 SILVIA GONZALEZ GEMLINE FRAME COMPANY HARTFORD SACRAMENTO ADJ9032084 SILVIA GONZALEZ VITA HERB NUTRICEUTICALS HARTFORD SACRAMENTO ADJ9118489 SONIA CABANAS THE VILLAGE AT SHERMAN OAKS HARTFORD SACRAMENTO ADJ7435032 STEPHANIE AMOS SCHULZE SMART CREMATIONS HARTFORD SACRAMENTO ADJ7433248 SURAMA RODRIGUEZ SURVIVAL INSURANCE HARTFORD SACRAMENTO ADJ6599285 SYLVIA LOPEZ KN ENGINEERING INC HARTFORD SACRAMENTO ADJ8837759 TERRI ANDERSON FOX RENT A CAR HARTFORD SACRAMENTO ADJ9483283 VICENTE CASTELAN L R WHITE CO HARTFORD SACRAMENTO ADJ9158294 VICKY ZARRO CHICOS FAS INC HARTFORD SACRAMENTO ADJ8531884 VICTOR CRUZ SEQUOIA EQUITIES HARTFORD SACRAMENTO ADJ7620685 VICTOR DE SANTIAGO TEST AMERICA HARTFORD SACRAMENTO ADJ8062963 VIOLET KHASTI MINYA INTERNATIONAL HARTFORD SACRAMENTO ADJ8705129 XIUQUN LU GREAT WALL RESTAURANT SUPPLIES INC HARTFORD SACRAMENTO ADJ7304924 YAJAIRA CHAVEZ ARTHUR G KAISER DDS HARTFORD SACRAMENTO ADJ7873198 YESENIA QUINTERO TENACORE HOLDINGS INC HARTFORD SACRAMENTO ADJ7371184 ETHELBERT RESURRECCION A SONIC LOGISTICS USA INC HARTFORD SACRAMENTO ADJ7287321 MARIA RIOS GSI COMMERCE HARTFORD SACRAMENTO ADJ7162029 SANTIAGO CHAVEZ GARDEN OF EATING LLC HARTFORD SACRAMENTO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7972741 STEPHANIE BEAUCHAM DESERT KNOLLS CONV HOSPITAL HARTFORD SACRAMENTO ADJ4225992 DANEILLE PARRA GENTAL DENTAL HARTFORD UNDERWRITERS INSURANCE ADJ4225992 DANEILLE PARRA INTERDENT INC./DEDICATED DENTAL HARTFORD UNDERWRITERS INSURANCE ADJ7272239 MARIO AGUILAR HAWTHORNE SCHOOL DISTRICT HAWTHORNE SCHOOL DISTRICT ADJ3848218 CYNTHIA GONZALEZ LOS ANGELES COUNTY HAZELRIGG RISK MANAGEMENT ADJ9473724 JUAN RODRIGUEZ SUPER CENTER CONCEPTS INC DBA SUPERIOR GROCERS HCMS CHINO HILLS ADJ6720795 ANTONIO GONZALEZ SWISS DIARY HELMSMAN MANAGEMENT ADJ1461342 CHRISTIAN SKAHILL UPS HELMSMAN MANAGEMENT GLENDALE ADJ8979708 DAVID ABELAR WALT DISNEY PICTURES 3 TELEVISION HELMSMAN MANAGEMENT GLENDALE ADJ8296916 ELIAS VELASQUEZ THE HOME DEPOT HELMSMAN MANAGEMENT GLENDALE ADJ6946617 HOUY UNG FARMERS INSURANCE EXCHANGE HELMSMAN MANAGEMENT GLENDALE ADJ7905927 JERONIMO VASQUEZ RUAN TRANSPORT CORPORATION HELMSMAN MANAGEMENT GLENDALE ADJ8132417 JOSE LUIS NUNO HOME DEPOT HELMSMAN MANAGEMENT GLENDALE ADJ2022491 MARIA HERNANDEZ CERADYNE INC HELMSMAN MANAGEMENT GLENDALE ADJ7616949 MARIA LOURDES TOPACIO FARMERS INSURANCE GROUP HELMSMAN MANAGEMENT GLENDALE ADJ7229213 MARTIN MUNGUIA DUCOMMUN AEROSTRUCTURES HELMSMAN MANAGEMENT GLENDALE ADJ7470365 MIRNA MENDICUTI ACCOR LODGING NORTH AMERICA HELMSMAN MANAGEMENT GLENDALE ADJ8167566 MOHAMMADREZA NASERI HOME DEPOT HELMSMAN MANAGEMENT GLENDALE ADJ8132430 PAMELA SMITH HOME DEPOT HELMSMAN MANAGEMENT GLENDALE ADJ1171637 RICARDO RALPH GUTIERREZ HOME DEPOT HELMSMAN MANAGEMENT GLENDALE ADJ1844758 YOLANDA VASQUEZ WEEKS ROSES HELMSMAN MANAGEMENT GLENDALE ADJ8130944 BYRON HAYES RICOH CORPORATION HELMSMAN MANAGEMENT ROCKLIN ADJ6792447 JOSE RAMOS ASPLUNDH TREE EXPERT HELMSMAN MANAGEMENT ROCKLIN ADJ7379722 KRISTEL JONES HOME DEPOT HELMSMAN MANAGEMENT ROCKLIN ADJ6914920 LAURA AGUILAR HYDER PROPERTY MANAGEMENT HELMSMAN MANAGEMENT ROCKLIN ADJ7616546 RICHARD BRITO ASPLUNDH CONSTRUCTION CORP HELMSMAN MANAGEMENT ROCKLIN ADJ9407244 SALVADOR VALENCIANA COSTCO WHOLESALE HELMSMAN MANAGEMENT ROCKLIN ADJ1572961 FELIPE BALVERDE INLAND CONTAINER HIGHLANDS INSURANCE COMPANY ADJ2119074 MARIA SEVELINA ORTIZ COMMAND PACKAGING HIGHLANDS INSURANCE COMPANY ADJ691244 ERNESTO AGUAYO BEST LABEL COMPANY INC HIH AMERICA COMP/LIABILITY INS. ADJ1621412 CARLOS ORREGO RESEDA AUTO & ELECTRIC HIH AMERICA INS ADJ6490668 BLANCA PADILLA HOME DEPOT HOME DEPOT ADJ8904767 MANUEL MENDOZA HOWARD JOHNSON INN HOWARD JOHNSON INN ADJ7222645 MARIO ARECHIGA CALIFORNIA SNACK FOODS INC ICW GROUP ADJ6499597 ALBERTO HERNANDEZ FRANK GATES SERVICE COMPANY ICW GROUP INSURANCE PLEASANTON ADJ6499597 ALBERTO HERNANDEZ NORM'S AUTOMOTIVE ICW GROUP INSURANCE PLEASANTON ADJ6499597 ALBERTO HERNANDEZ NORMS AUTOMOTIVE CENTER INC ICW GROUP INSURANCE PLEASANTON ADJ9090776 EMAD AZIZ HADLEY TOW ICW GROUP INSURANCE PLEASANTON ADJ7728230 JOSE GUEVARA CDI INC ICW GROUP INSURANCE PLEASANTON ADJ8723700 JULIAN BENHUMEA GRESEAN INDUSTRIES ICW GROUP INSURANCE PLEASANTON ADJ8721444 ADRIAN PEREZ ARAUJO LABEL SPECIALTIES INC ILLINOIS MIDWEST SPRINGFIELD ADJ8373264 ALEJANDRA SANCHEZ TULA MARKET ILLINOIS MIDWEST SPRINGFIELD ADJ4144190 ALEX SAHAGUN CIRCLE FOOD PRODUCTS, INC ILLINOIS MIDWEST SPRINGFIELD ADJ7603592 ANITA AMADOR HILLCREST CARE CENTER ILLINOIS MIDWEST SPRINGFIELD ADJ7536450 ANTONIO ZUNIGA HOLIDAY INN ILLINOIS MIDWEST SPRINGFIELD ADJ7489640 BERTHA TAPIA AVANCE SERGURO INC ILLINOIS MIDWEST SPRINGFIELD ADJ9509233 BLANCA GOMEZ GRAPHIC INK CORP ILLINOIS MIDWEST SPRINGFIELD ADJ7671629 CARLOS GONZALEZ PASQUINI IMPORTS ILLINOIS MIDWEST SPRINGFIELD ADJ7390485 CARLOS MUNOZ CHARLES JACOBSEN, INC ILLINOIS MIDWEST SPRINGFIELD ADJ8869212 CLAUDIA NAVARRETE JIBBCO ILLINOIS MIDWEST SPRINGFIELD ADJ7639799 CLAUDIA RIESTRA BESTLAND INC DBA COMFORT INN ILLINOIS MIDWEST SPRINGFIELD ADJ7106189 DELIA WILSON VALUE PLUS ILLINOIS MIDWEST SPRINGFIELD ADJ9108292 EDUARDO ANGEL CORP29 ILLINOIS MIDWEST SPRINGFIELD ADJ9128499 EDUARDO REYES FREDERICK S PARDEE DBA PBM RENTAL APARTMENTS ILLINOIS MIDWEST SPRINGFIELD ADJ8252470 ELBA NAVARRO CLIFTONS CAFETERIA ILLINOIS MIDWEST SPRINGFIELD ADJ7550309 ELENA MARQUEZ SUPERIOR BIAS BINDING AND TEXTILES ILLINOIS MIDWEST SPRINGFIELD ADJ7204035 ELIZABETH MANILA N N INVESTMENTS INC ILLINOIS MIDWEST SPRINGFIELD ADJ7204035 ELIZABETH MANILA N N INVESTMENTS INVESTMENTS INC ILLINOIS MIDWEST SPRINGFIELD ADJ8766335 EMILIO SOTO BAJA FRESH ILLINOIS MIDWEST SPRINGFIELD ADJ8522099 EROK HERNANDEZ INTIMATE INNS OF CALIFORNIA INC ILLINOIS MIDWEST SPRINGFIELD ADJ7728488 ESMERALDA LEMUS L A TASTY FOOD INC ILLINOIS MIDWEST SPRINGFIELD ADJ7728488 ESMERALDA LEMUS LA TASTY FOOD INC ILLINOIS MIDWEST SPRINGFIELD ADJ3095347 ESPERANZA TINOCO BEST WESTERN LAGUNA BRISA SPA HOTEL ILLINOIS MIDWEST SPRINGFIELD ADJ3095347 ESPERANZA TINOCO GRUPO MEDLEGAL ILLINOIS MIDWEST SPRINGFIELD ADJ6806483 EVANGELINA CHAVARRIA BEST WESTERN ILLINOIS MIDWEST SPRINGFIELD ADJ7382446 FIDENCIO ESPINOZA MASTER BODY WORKS ILLINOIS MIDWEST SPRINGFIELD ADJ7454045 FRANCISCA AVILA BEST WESTERN DESERT VILLA ILLINOIS MIDWEST SPRINGFIELD ADJ7933970 GERBER GUERRA STREETS AHEAD ILLINOIS MIDWEST SPRINGFIELD ADJ7829692 GLORIA CABRERA KYU APPAREL ILLINOIS MIDWEST SPRINGFIELD ADJ8290825 GREGORIO BRITO NEW SEOUL BBQ BUFFET RESTAURANT ILLINOIS MIDWEST SPRINGFIELD ADJ8338732 HORTENCIA COVARRUBIAS DR BLUE JEANS ILLINOIS MIDWEST SPRINGFIELD ADJ8642981 HORTENCIA SOLIS DYNAMIC SEA FASHION INC ILLINOIS MIDWEST SPRINGFIELD ADJ8067245 ISABEL DIMAS CLIFTONS CAFETERIA ILLINOIS MIDWEST SPRINGFIELD ADJ6975244 JAIME CHAVEZ DE MIRANDA MGMT ILLINOIS MIDWEST SPRINGFIELD ADJ7196926 JAVIER SOLIS MAACO COLLISION REPAIR & AUTO ILLINOIS MIDWEST SPRINGFIELD ADJ7827888 JIAN QIANG WU BLUE RIDGE HOME FASHIONS INC ILLINOIS MIDWEST SPRINGFIELD RAJESHKUMAR AND JASODA NATHRAJ DBA COUNTRY INN ADJ7893346 JOAQUINA VASQUEZ ILLINOIS MIDWEST SPRINGFIELD BANNING RAJESHKUMAR AND JOSADA NATHRAJ DBA COUNTRY INN ADJ7893346 JOAQUINA VASQUEZ ILLINOIS MIDWEST SPRINGFIELD BANNING ADJ7823716 JOSE ESCOBEDO ASI AMERICAN TRADING CO ILLINOIS MIDWEST SPRINGFIELD ADJ7425732 JOSE GARCIA LOCK RIDGE TOOL CO INC ILLINOIS MIDWEST SPRINGFIELD ADJ6709642 JOSE HERNANDEZ LA CHULADA MARKET ILLINOIS MIDWEST SPRINGFIELD ADJ7423776 JOSE LUIS CAMACHO EXPRESS LENS LAB INC ILLINOIS MIDWEST SPRINGFIELD ADJ7887163 JOSE MOLINA 1114 GROUP LLC ILLINOIS MIDWEST SPRINGFIELD ADJ9500867 JUAN HERNANDEZ SMITHS BAKERIES INC ILLINOIS MIDWEST SPRINGFIELD Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8119120 JUAN MANUEL VEJAR EIGHT TWENTY THREE IHOP 823 ILLINOIS MIDWEST SPRINGFIELD ADJ8119120 JUAN MANUEL VEJAR K J MANAGEMENT DBA IHOP ILLINOIS MIDWEST SPRINGFIELD ADJ4405089 JUAN ZEPEDA PACIFIC GOURMET PRODUCE ILLINOIS MIDWEST SPRINGFIELD ADJ8853326 KATHLEEN MARY JACK LGM APPLE VALLEY ILLINOIS MIDWEST SPRINGFIELD ADJ6773361 LAM YUNG ASIA SEAFOOD BUFFET ILLINOIS MIDWEST SPRINGFIELD ADJ9099575 LEONARDA NAVARRO PRO YOUTH HEART ILLINOIS MIDWEST SPRINGFIELD ADJ9166076 LETICIA MARCIAL TH CLEANERS AND TAILORING ILLINOIS MIDWEST SPRINGFIELD ADJ8358726 LUKE YANG GREENLADN TRADING COMPANY ILLINOIS MIDWEST SPRINGFIELD ADJ8358726 LUKE YANG GREENLAND TRADING COMPANY ILLINOIS MIDWEST SPRINGFIELD ADJ8358726 LUKE YANG GRENNLAND TRADING COMPANY ILLINOIS MIDWEST SPRINGFIELD ADJ7601959 LUZ MARTINEZ HUSTON SALEM INC ILLINOIS MIDWEST SPRINGFIELD ADJ8564157 MANUEL GARCIA JUMBO WIN INC ILLINOIS MIDWEST SPRINGFIELD ADJ7256926 MANUEL MORALES MC PRODUCE ILLINOIS MIDWEST SPRINGFIELD ADJ8180283 MARCELINO CONTRERAS VINH SANH TRADING CORP ILLINOIS MIDWEST SPRINGFIELD ADJ6849186 MARIA ACOSTA COAST TO COAST BAKERY INC ILLINOIS MIDWEST SPRINGFIELD ADJ7043885 MARIA LUISA DIAZ JOLI FASHION INC ILLINOIS MIDWEST SPRINGFIELD ADJ7411105 MARLA DEL CARMEN HERNANDEZ HAMPTON INN ILLINOIS MIDWEST SPRINGFIELD ADJ9107313 MARTHA FIGUEROA ELITE DRYCLEANER SHIRT LAUNDRY ILLINOIS MIDWEST SPRINGFIELD ADJ7024152 MICHELLE GAINES MILESTONE RISK MANAGEMENT ILLINOIS MIDWEST SPRINGFIELD ADJ7298711 NERI QUEVEDO MANGIARE EI BERE INC DBA CAIBREA ILLINOIS MIDWEST SPRINGFIELD ADJ8623511 NERI QUEVEDO MANGIARE EI BERE ILLINOIS MIDWEST SPRINGFIELD ADJ9012458 NOE FLORES COMPUVAC INDUSTRIES ILLINOIS MIDWEST SPRINGFIELD ADJ2437015 NORMA RUELAS AGAPE D&J COMMERCIAL ILLINOIS MIDWEST SPRINGFIELD ADJ9158195 OSWALDO URQUIZA EL MEXICALY CAFE 2 ILLINOIS MIDWEST SPRINGFIELD ADJ7410534 PATRICIA PASILLAS WESTMINISTER LODGING INC DBA BUDGET INN ILLINOIS MIDWEST SPRINGFIELD ADJ7410534 PATRICIA PASILLAS WESTMINSTER LODGING INC DBA BUDGET INN ILLINOIS MIDWEST SPRINGFIELD ADJ6810430 PATRICIA PEREZ MITCHELL LABORATORIES INC ILLINOIS MIDWEST SPRINGFIELD ADJ9018708 PEDRO GUZMAN CHRONIC TACOS ILLINOIS MIDWEST SPRINGFIELD ADJ7863400 PEDRO PEREZ CLIFTON CAFETERIA ILLINOIS MIDWEST SPRINGFIELD ADJ7611938 PEDRO SANCHEZ GATEWAY MATTRESS CO INC ILLINOIS MIDWEST SPRINGFIELD ADJ7708960 PRIMAVERA CAMPA NNE MEDICAL SUPPLY AND EQUIPMENT INC ILLINOIS MIDWEST SPRINGFIELD ADJ7433114 RAYMUNDO MONTIEL 4 WHEEL SPECIALTY ILLINOIS MIDWEST SPRINGFIELD ADJ7204076 REYES RUBIO SAGEBRUSH CANTINA ILLINOIS MIDWEST SPRINGFIELD ADJ7641870 REYNALDO CAMPOS KMAK INTERNATIONAL TEXTILE INC ILLINOIS MIDWEST SPRINGFIELD ADJ4165348 RICARDO SANDOVAL H & G CUSTOM UPHOLSTERY INC ILLINOIS MIDWEST SPRINGFIELD ADJ8099154 RIGOBERTO LOPEZ TAP ELECTRONICS ILLINOIS MIDWEST SPRINGFIELD ADJ7605180 ROMAN HERNANDEZ ROLLINGS AUTOMOTIVE ILLINOIS MIDWEST SPRINGFIELD ADJ6673039 RUBEN MORALES STR AUTO REPAIR AND SERVICE INC ILLINOIS MIDWEST SPRINGFIELD ADJ3869103 SALVADOR MANRIQUEZ PAGE PRINTING SERVICES ILLINOIS MIDWEST SPRINGFIELD ADJ7033264 SALVADOR RODRIGUEZ APPAREL MASTERS INC ILLINOIS MIDWEST SPRINGFIELD ADJ7213023 SERGIO DOMINGUEZ ON THE ROCKS ILLINOIS MIDWEST SPRINGFIELD ADJ7479061 SILVIA CHACON RUIZ HOLIDAY INN EXPRESS ANAHEIM ILLINOIS MIDWEST SPRINGFIELD ADJ7783803 VERONICA MARTINEZ ROYAL CLEANERS ILLINOIS MIDWEST SPRINGFIELD ADJ941427 VICENTE TELLO 26 CALIFORNIA BAZAR INC ILLINOIS MIDWEST SPRINGFIELD ADJ7213890 NORA HERNANDEZ IRVINE PYROS ROSFOODS INC ILLINOIS MIDWEST SPRINGFIELD ADJ7213891 NORA HERNANDEZ IRVINE PYROS ROSFOODS INC ILLINOIS MIDWEST SPRINGFIELD ADJ7365751 NORA HERNANDEZ IRVINE PYROS ROSFOODS INC ILLINOIS MIDWEST SPRINGFIELD ADJ7155233 MARTHA BANDA QPERFUMES IMPERIUM INSURANCE NEW YORK ADJ7548288 MARIBEL BARAJAS INDEX FRESH INC INDEX FRESH INC ADJ2629247 PETRA JARAMILLO MONROVIA NURSERY INDUSTRIAL INDEMNITY ADJ8345335 OSCAR PRECICHI LABELTEX MILLS INS CO OF THE WEST SAN DIEGO ADJ9175106 ADRIAN TAPIA AMADOR OVER HILL FARMS INS CO OF THE WEST WOODLAND HILLS ADJ7935499 CELIA AVALOS EL SUPER INS CO OF THE WEST WOODLAND HILLS ADJ9411323 LUIS CAMARENA CUSTOMLINE INS CO OF THE WEST WOODLAND HILLS ADJ7178625 MARIA ESCALANTE SUNRIDER MANUFACTURING LP INS CO OF THE WEST WOODLAND HILLS ADJ588379 MIGUEL GARCIA PARCELL STEEL COMPANY INS CO OF THE WEST WOODLAND HILLS ADJ9650721 NANCY RESENDIZ OPTIONS CHILD CARE INS CO OF THE WEST WOODLAND HILLS ADJ8127854 ROMAN ROMERO COASTAL EMPLOYMENT INS CO OF THE WEST WOODLAND HILLS ADJ8127854 ROMAN ROMERO CULVER CITY MEAT COMPANY INS CO OF THE WEST WOODLAND HILLS ADJ7795005 SAUL HERNANDEZ VENUS GROUP INS CO OF THE WEST WOODLAND HILLS ADJ6811293 ADAN LEON AG SOD FARMS INC INSURANCE CO OF THE WEST PLEASANTON ADJ8506054 ALFREDO ARROYO MICRO SURFACE ENG INSURANCE CO OF THE WEST PLEASANTON ADJ9267218 ANTHONY NUNEZ BP AIR HEATING AND AIR CONDITIONING INSURANCE CO OF THE WEST PLEASANTON ADJ8261985 BERTHA MACIAS DUNHAM METAL PROCESSING INSURANCE CO OF THE WEST PLEASANTON ADJ8890902 CESAR VENEGAS ANNANDALE GOLF CLUB INSURANCE CO OF THE WEST PLEASANTON ADJ9090776 EMAD AZIZ HADLEY TOW INSURANCE CO OF THE WEST PLEASANTON ADJ9482785 GENNY VERA H W ALL STARS INC DBA RADISSON SUITES HOTEL INSURANCE CO OF THE WEST PLEASANTON ADJ8166983 GUILLERMO RABAGO SCHAFFER GRINDING COMPANY INSURANCE CO OF THE WEST PLEASANTON ADJ9561797 GUILLERMO RIEKEN ANZA MANAGEMENT INSURANCE CO OF THE WEST PLEASANTON ADJ7586159 GUSTAVO OLMOS LOPEZ 1 DAY PAINT AND BODY CENTERS INC INSURANCE CO OF THE WEST PLEASANTON ADJ9589891 JORGE HERNANDEZ SALINAS ARCHITECTURAL STONE WORKS INSURANCE CO OF THE WEST PLEASANTON ADJ8010319 JOSE MEZA GATEWAY CONCRETE INC INSURANCE CO OF THE WEST PLEASANTON ADJ7181314 JOSE ZETINA DESERT COMERCIAL CONCRETE INSURANCE CO OF THE WEST PLEASANTON ADJ9105546 JUAN PERALES LEGENDS BY SOUTHWINDS INSURANCE CO OF THE WEST PLEASANTON ADJ8723700 JULIAN BENHUMEA GRESEAN INDUSTRIES INSURANCE CO OF THE WEST PLEASANTON ADJ8914474 LEO KWAI SUM KAM MANCHU WOK ENTERPRISES INSURANCE CO OF THE WEST PLEASANTON ADJ8842560 LILY LUGO DCG FULFILLMENT INSURANCE CO OF THE WEST PLEASANTON ADJ8842560 LILY LUGO GAR LABORATORIES INSURANCE CO OF THE WEST PLEASANTON ADJ8842560 LILY LUGO JC BLINDS MFG INC INSURANCE CO OF THE WEST PLEASANTON ADJ8842560 LILY LUGO NEWPORT THIN FILM LABORATORY INC INSURANCE CO OF THE WEST PLEASANTON ADJ8842560 LILY LUGO STAFF CHEX INSURANCE CO OF THE WEST PLEASANTON ADJ8842560 LILY LUGO TRADEMARK COSMETICS INSURANCE CO OF THE WEST PLEASANTON ADJ8734783 MARIA ATILANO AMERICAN FUSION INC INSURANCE CO OF THE WEST PLEASANTON ADJ7162665 MARIO VILLEGAS SPECTRUM CARE LANDSCAPE & IRRIGATION MANAGEMENT INSURANCE CO OF THE WEST PLEASANTON ADJ9287229 SEVERO HERNANDEZ METRIC MACHINING INSURANCE CO OF THE WEST PLEASANTON ADJ6868936 YADIRA CERVANTES EMBEE INCORPORATES INSURANCE CO OF THE WEST PLEASANTON Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8279454 ABRAHAM GALLEGOS GOLDEN EAGLE CONSTRUCTION INSURANCE CO OF THE WEST SAN DIEGO ADJ6644971 ADRIAN TEJADA RUTHERFORD LATH1NG COMPANY INC. INSURANCE CO OF THE WEST SAN DIEGO ADJ6644971 ADRIAN TEJADA RUTHERFORD LATHING CO INC INSURANCE CO OF THE WEST SAN DIEGO ADJ7415425 ALEJANDRO GARCIA GS BROTHERS LANDSCAPING INSURANCE CO OF THE WEST SAN DIEGO ADJ8905811 ALEJANDRO ROSAS PACIFIC PLASTICS INC INSURANCE CO OF THE WEST SAN DIEGO ADJ7850405 AMADOR PAPOCA VILLA PACIFIC CONTRACTORS INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9612804 ARCELIA GUTIERREZ BERSHTEL ENTERPRISES INSURANCE CO OF THE WEST SAN DIEGO ADJ9475974 ARMANDO MORALES NAVARRO PRIME CONVERTING INSURANCE CO OF THE WEST SAN DIEGO ADJ8482267 ARNULFO LUPERCIO TRICOM MANAGEMENT INSURANCE CO OF THE WEST SAN DIEGO ADJ9526863 ARTURO CANUT SOSA GREEN TRUCKING, LLC INSURANCE CO OF THE WEST SAN DIEGO ADJ6818414 BENJAMIN MORALES WESTERN TUBE & CONDUIT CORP INSURANCE CO OF THE WEST SAN DIEGO ADJ4534923 BERTHA RAMIREZ THE CLEANING AUTHORITY INSURANCE CO OF THE WEST SAN DIEGO ADJ7517250 BLANCA ALVAREZ B AND H FOODS POPEYES CHICKEN INSURANCE CO OF THE WEST SAN DIEGO ADJ9126426 BLANCA BANUELOS ALTA ADVANCED TECHNOLOGIES INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9613149 CARLOS GONZALEZ TAMA TRADING CO INS INSURANCE CO OF THE WEST SAN DIEGO ADJ9651345 CARLOS ORDUNEZ SLEEPAIR MATTRESS INSURANCE CO OF THE WEST SAN DIEGO ADJ8890902 CESAR VENEGAS ANNANDALE GOLF CLUB INSURANCE CO OF THE WEST SAN DIEGO ADJ7298472 CHRISTIAN NOVERON CS DRYWALL INC INSURANCE CO OF THE WEST SAN DIEGO ADJ7191477 CIPRIANO ARMENTA CALIFORNIA LANDSCAPE INSURANCE CO OF THE WEST SAN DIEGO ADJ7364795 CLYDE THOMAS PARAMOUNT READY MIX INSURANCE CO OF THE WEST SAN DIEGO ADJ9068598 CONSUELO PEREIDA FAMILY SERVICE ASSOCIATION INSURANCE CO OF THE WEST SAN DIEGO ADJ8083786 DAVID GUTIERREZ MOTHERS NUTR1TLONAL CENTER INC INSURANCE CO OF THE WEST SAN DIEGO ADJ6596618 DAVID PALACIOS PROFESSIONAL MAINTENANCE INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9217318 DENISE RODRIGUEZ ESPINOZA MODERN PARKING INSURANCE CO OF THE WEST SAN DIEGO ADJ9050025 DORIS SOUTHARD THOMPSON BUILDING MATERIAL INSURANCE CO OF THE WEST SAN DIEGO ADJ10055604 EDGAR GOMEZ CARRILLO WEST COAST DRYWALL INC INSURANCE CO OF THE WEST SAN DIEGO ADJ6676963 EDWIN ANDRADE CALICO BUILDING SERVICES INC INSURANCE CO OF THE WEST SAN DIEGO ADJ8558116 EMIGDIO FIGUEROA DISTINCTIVE CONCRETE INC INSURANCE CO OF THE WEST SAN DIEGO ADJ8839960 ENELBA BARANDA CROWNE PLAZA LOS ANGELES HARBOR SAN PEDRO HOTEL INSURANCE CO OF THE WEST SAN DIEGO ADJ8110889 ENRIQUE DE LEON HOMEGLANCE LA INC INSURANCE CO OF THE WEST SAN DIEGO ADJ7505525 ENRIQUE GIL OROZCO PACIFIC SHORES MASONRY INC INSURANCE CO OF THE WEST SAN DIEGO ADJ8377380 EUGENE BISCEGLIA JOHNRE CARE LLC DBA MEADOWBROOK HCC AND SENIOR LIVING INSURANCE CO OF THE WEST SAN DIEGO ADJ8377380 EUGENE BISCEGLIA MEADOWBROOK CONVALESCENT HOSP INSURANCE CO OF THE WEST SAN DIEGO ADJ7231346 FERNANDO JIMENEZ MCPEEKS DODGE OF ANAHEIM INSURANCE CO OF THE WEST SAN DIEGO ADJ8583282 FLAVIO GUERRERO LANKEN ENTERPRISES INC DBA DC CONCRETECO INSURANCE CO OF THE WEST SAN DIEGO ADJ6980671 FLOR GUTIERREZ B & H EDUCATIONAL INC INSURANCE CO OF THE WEST SAN DIEGO ADJ6980671 FLOR GUTIERREZ B AND H EDUCATION INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9166593 FRANCISCO SALAZAR KV MART INSURANCE CO OF THE WEST SAN DIEGO ADJ8892660 GABRIEL IRIGOYEN QUIROZ CELESTINO DRAGO ENTERPRISES INSURANCE CO OF THE WEST SAN DIEGO ADJ9591877 GERARDO HERRERA HMS MANAGEMENT INC DBA DICKS A W INSURANCE CO OF THE WEST SAN DIEGO ADJ8645190 GERMAN MEDINA ANDERCO INC INSURANCE CO OF THE WEST SAN DIEGO ADJ2510307 GREGORIO VELAZQUEZ A 1 FENCE COMPANY INSURANCE CO OF THE WEST SAN DIEGO ADJ6509717 GUADALUPE SANCHEZ BURLINGAME INDUSTRIES, INC. INSURANCE CO OF THE WEST SAN DIEGO ADJ9561797 GUILLERMO RIEKEN ANZA MANAGEMENT INSURANCE CO OF THE WEST SAN DIEGO ADJ8065145 HECTOR ESCAMILLA G AND M TRAILER REPAIR AND PAINTING INSURANCE CO OF THE WEST SAN DIEGO ADJ8049127 HORACIO GARCIA ARIANA WORLDWIDE INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9061825 HOWARD DAVIS B B PIPE AND TOOL COMPANY INSURANCE CO OF THE WEST SAN DIEGO ADJ8033491 IMGARD LIMA EASTERN TECHNOLOGY INSURANCE CO OF THE WEST SAN DIEGO ADJ7684296 ISIDRO HERNANDEZ HALLMARK SOUTHWEST CORP INSURANCE CO OF THE WEST SAN DIEGO ADJ3535227 ISIDRO VALADEZ UNITED BROTHERS CONCRETE INSURANCE CO OF THE WEST SAN DIEGO ADJ8972749 JAVIER PLASCENCIA ACE CLEARWATER ENTERPRISES INSURANCE CO OF THE WEST SAN DIEGO ADJ7092981 JESUS MARQUEZ METRIC MACHINING INC INSURANCE CO OF THE WEST SAN DIEGO ADJ7705529 JIM WEST A 1 ELECTRIC INSURANCE CO OF THE WEST SAN DIEGO ADJ8878435 JOHELY VILLATORO MELMARC PRODUCT INSURANCE CO OF THE WEST SAN DIEGO ADJ6664871 JONATHAN RODRIGUEZ SCHEN STEEL SUPPLY CO INSURANCE CO OF THE WEST SAN DIEGO ADJ9589891 JORGE HERNANDEZ SALINAS ARCHITECTURAL STONE WORKS INSURANCE CO OF THE WEST SAN DIEGO ADJ8668800 JORGE MUNIZ ECLIPSE RECREATIONAL VEHICLES INSURANCE CO OF THE WEST SAN DIEGO ADJ7493260 JORGE PACHECO RENT A BIN INSURANCE CO OF THE WEST SAN DIEGO ADJ8856873 JOSE CRUZ TLAPPA OXNARD CENTER COMPANY INSURANCE CO OF THE WEST SAN DIEGO ADJ8280074 JOSE GALLO EPLASTERING INSURANCE CO OF THE WEST SAN DIEGO ADJ7244575 JOSE GOMEZ KILLION INDUSTRIES INC INSURANCE CO OF THE WEST SAN DIEGO ADJ7461822 JOSE GONZALEZ DISTINCTIVE CONCRETE INC INSURANCE CO OF THE WEST SAN DIEGO ADJ6713455 JOSE GUZMAN HEAVILAND ENTERPRISES INC INSURANCE CO OF THE WEST SAN DIEGO ADJ2855504 JOSE MAGDALENO ORANGE COUNTY MINING CO INSURANCE CO OF THE WEST SAN DIEGO ADJ9205235 JOSE RAMIREZ DLS LANDSCAPE INSURANCE CO OF THE WEST SAN DIEGO ADJ8739238 JOSUE OCHOA DOMINGUEZ SUSHI CALIFORNIA INC INSURANCE CO OF THE WEST SAN DIEGO ADJ7875077 JUAN DOMINGUEZ SOUTH BAY FENCE CO INSURANCE CO OF THE WEST SAN DIEGO ADJ661043 JUAN LOPEZ PLASTIC DRESS-UP CO INSURANCE CO OF THE WEST SAN DIEGO ADJ6769549 JUAN SOTELO JENSON CUSTOM FURNITURE INC INSURANCE CO OF THE WEST SAN DIEGO ADJ6466009 JULIAN CACERES SUPERIOR BUILDING PRODUCTS INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9244308 JULIO QUIJADA SOLARIS PAPER INC INSURANCE CO OF THE WEST SAN DIEGO ADJ8227188 JULIO REYES WHOLESOME CHOICE INSURANCE CO OF THE WEST SAN DIEGO ADJ8853473 KENNETH RUSSELL PRIME LINE INSURANCE CO OF THE WEST SAN DIEGO ADJ8180331 LASHARA BLAYLOCK GLENDORA GRAND INC INSURANCE CO OF THE WEST SAN DIEGO ADJ6914920 LAURA AGUILAR HYDER PROPERTY MANAGEMENT INSURANCE CO OF THE WEST SAN DIEGO ADJ9801124 LIDIA MONTES ECLIPSE RECREATIONAL VEHICLE INC. INSURANCE CO OF THE WEST SAN DIEGO ADJ9610861 LILIA HERRERA ONE STOP STORAGE INSURANCE CO OF THE WEST SAN DIEGO ADJ7354267 LILIA JAIMES BAL SEAL ENGINEERING CO INSURANCE CO OF THE WEST SAN DIEGO ADJ9623427 LUCAS VILLEDA DEKEL ASSOC INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9623427 LUCAS VILLEDA DEKEL ASSOCIATES INC INSURANCE CO OF THE WEST SAN DIEGO ADJ2161861 LUCIA ALVAREZ PAT & OSCAR'S INSURANCE CO OF THE WEST SAN DIEGO ADJ9266631 LUIS DIAZ ANZA MANAGEMENT INSURANCE CO OF THE WEST SAN DIEGO ADJ9266631 LUIS DIAZ ANZA MANGEMENT INSURANCE CO OF THE WEST SAN DIEGO ADJ7385671 MANUEL MEZA A G SOD FARMS INC INSURANCE CO OF THE WEST SAN DIEGO ADJ7250347 MANUEL URIBE SOUTHERN WINE AND SPIRITS INSURANCE CO OF THE WEST SAN DIEGO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7731057 MARIA BARRIGA EVOLUTION FRESH INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9246176 MARIA BUENROSTRO HOTEL MENAGE INSURANCE CO OF THE WEST SAN DIEGO ADJ9246176 MARIA BUENROSTRO HOTEL MENAGE DBA CASA RESORTS INC INSURANCE CO OF THE WEST SAN DIEGO ADJ7514399 MARIA CARDENAS BAL SEAL ENGINEERING COMPANY INSURANCE CO OF THE WEST SAN DIEGO ADJ7178625 MARIA ESCALANTE SUNRIDER MANUFACTURING LP INSURANCE CO OF THE WEST SAN DIEGO ADJ9655124 MARIA ESCOTO AMERICAN ALL CARE SERVICES INSURANCE CO OF THE WEST SAN DIEGO ADJ9655124 MARIA ESCOTO DYNAMIC NURSING SERVICES INSURANCE CO OF THE WEST SAN DIEGO ADJ9211193 MARIA RAMIREZ DMSI STAFFING INSURANCE CO OF THE WEST SAN DIEGO ADJ7543259 MARIA ROMO SNAPWARE INSURANCE CO OF THE WEST SAN DIEGO ADJ7968596 MARIA ROMO STARCREST OF CALIFORNIA INSURANCE CO OF THE WEST SAN DIEGO ADJ9408621 MARTIN REYES RELIABLE FLOOR COVERING INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9158777 MARTIN URBINA BBE SOUND INSURANCE CO OF THE WEST SAN DIEGO ADJ7752360 NELSON PACHECO PRIMETIME NUTRITION INSURANCE CO OF THE WEST SAN DIEGO ADJ7120280 NOE TORRES WEST PICO FOODS INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9332847 NORA VALCARCEL RIO VISTA DEVELOPMENT INSURANCE CO OF THE WEST SAN DIEGO ADJ6485973 ORALIA GONZALEZ GONZALEZ CROWERS LA MEXICANA INSURANCE CO OF THE WEST SAN DIEGO ADJ6535755 PABLO LOPEZ THIRD PARTY ENTERPRISES INC INSURANCE CO OF THE WEST SAN DIEGO ADJ8799119 PATRICIA VILLAVERDE CUSTOMLINE SCREENPRINTING INSURANCE CO OF THE WEST SAN DIEGO ADJ2774430 RAMIRO DIAZ SAN DIEGO EROSION CONTROL INSURANCE CO OF THE WEST SAN DIEGO ADJ9531194 RAUL JIMENEZ MARTINEZ WILLIAM M PERKINS CO INSURANCE CO OF THE WEST SAN DIEGO ADJ9531194 RAUL JIMENEZ MARTINEZ WILLIAM M PERKINS COMPANY INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9614829 RENE HERNANDEZ COAST PACKING INSURANCE CO OF THE WEST SAN DIEGO ADJ9614829 RENE HERNANDEZ KAMRAN STAFFING INSURANCE CO OF THE WEST SAN DIEGO ADJ7675757 RICARDO BALLINAS LUCKY FARMS INC INSURANCE CO OF THE WEST SAN DIEGO ADJ188095 RICARDO RODRIGUEZ PRESTIGE CONCRETE INSURANCE CO OF THE WEST SAN DIEGO ADJ8142506 RICARDO SALINAS OVERHILL FARMS INSURANCE CO OF THE WEST SAN DIEGO ADJ7030933 RICARDO SANCHEZ AIRTEL PLAZA HOTEL INSURANCE CO OF THE WEST SAN DIEGO ADJ3578917 ROCIO ZERMENO CALIFORNIA SPLENDOR INC INSURANCE CO OF THE WEST SAN DIEGO ADJ8935631 RUBI ESPINOZA MELMARC PRODUCTS INSURANCE CO OF THE WEST SAN DIEGO ADJ8159834 SALVADOR LEETOY NIBBLELINK MASONRY INSURANCE CO OF THE WEST SAN DIEGO ADJ4225518 SHWU HWA YU MINSON CORPORATION INSURANCE CO OF THE WEST SAN DIEGO ADJ7791936 SILVIA GARCIA TOWN AND COUNTRY RESORT INSURANCE CO OF THE WEST SAN DIEGO ADJ9425210 TANYA VOUNOV F&G TOWING DBA HELMS & HILL TOW INSURANCE CO OF THE WEST SAN DIEGO ADJ3515232 TEODORO MAYORQUIN VIERRA O CONNELL LANDSCAPE MAINTENANCE INSURANCE CO OF THE WEST SAN DIEGO ADJ3515232 TEODORO MAYORQUIN VIERRA O'CONNELL LANDSCAPE MAINTENANCE INSURANCE CO OF THE WEST SAN DIEGO ADJ3515232 TEODORO MAYORQUIN VIERRA OCONNELL LANDSCAPE MAINTENANCE INSURANCE CO OF THE WEST SAN DIEGO ADJ7551814 TIMOTHY HAWKINS SUPERIOR CONCRETE CONSTRUCTION INSURANCE CO OF THE WEST SAN DIEGO ADJ7786250 VERONICA ALEGRIA RITMO LATINO INSURANCE CO OF THE WEST SAN DIEGO ADJ7463193 VICKIE BROWN HOLLYWOOD PARK CAS1NO INSURANCE CO OF THE WEST SAN DIEGO ADJ7120089 VICTOR MAYA PARCELL STEEL CO INSURANCE CO OF THE WEST SAN DIEGO ADJ7451457 VICTOR OSUNA FRIENDS AMERICA INSURANCE CO OF THE WEST SAN DIEGO ADJ7451457 VICTOR OSUNA FRIENDS AMERICA INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9128980 YOLANDA AGUILAR DE SANCHEZ PACIFIC COAST CLEANING INSURANCE CO OF THE WEST SAN DIEGO ADJ8869397 YOLANDA CAMPOS VERGARA RUIZ MEXICAN FOOD INC INSURANCE CO OF THE WEST SAN DIEGO ADJ9150633 YUNUEN PIMENTEL CUSTOMLINE SCREENPRINTING DISTRIBUTION INSURANCE CO OF THE WEST SAN DIEGO ADJ9150633 YUNUEN PIMENTEL GOLDEN COAST SPORTSWEAR INSURANCE CO OF THE WEST SAN DIEGO ADJ8336892 ZOILA CORTEZ ES RING MANAGEMENT CORP INSURANCE CO OF THE WEST SAN DIEGO ADJ9375464 RAMON TOSCANO SAVAGE SERVICE CORPORATION INSURANCE COMPANY OF THE STATE OF PA ADJ3963910 ALBERTO TREVINO 99 CENTS ONLY STORES INTEGRATED CLAIMS TORRANCE ADJ7104283 MARIA JONES CITY OF INGLEWOOD POLICE DEPARTMENT INTEGRATED CLAIMS TORRANCE ADJ6599441 ALICE ALONSO COUNTY OF LOS ANGELES INTERCARE 14243 ORANGE ADJ6599441 ALICE ALONSO OFFICE OF THE COUNTY COUNSEL INTERCARE 14243 ORANGE ADJ3936559 DIANNE WRIGHT COUNTY OF LOS ANGELES SUPERIOR COUR INTERCARE 14243 ORANGE ADJ7321100 EDYTHE WOODS COUNTY OF LOS ANGELES INTERCARE 14243 ORANGE ADJ9062935 IRENE RIVERA LOS ANGELES COUNTY SUPERIOR COURT ELA INTERCARE 14243 ORANGE ADJ7033031 JOHN BARGER LOS ANGELES COUNTY CHILD SUPPORT SRVS INTERCARE 14243 ORANGE ADJ7398717 KARLENE BAUERLEIN COUNTY OF LA CHILD SUPPORT SERVICES INTERCARE 14243 ORANGE ADJ7398717 KARLENE BAUERLEIN COUNTY OF LOS ANGELES INTERCARE 14243 ORANGE ADJ6938962 LEOPOLDO GUERRERO COUNTY OF LOS ANGELES PARKS INTERCARE 14243 ORANGE ADJ8130909 MARIA LUNA WESTLAKE FINANCIAL INTERCARE 14243 ORANGE ADJ7235087 MARIA RODRIGUEZ LOS ANGELES COUNTY CSSD INTERCARE 14243 ORANGE ADJ4468039 MATIAS LARIOS VALLEJO ROOFING INTERCARE 14243 ORANGE ADJ463944 MICHAEL LEE COUNTY OF LOS ANGELES INTERCARE 14243 ORANGE ADJ7567231 ROSE MACHADO LOS ANGELES SUPERIOR COURT INTERCARE 14243 ORANGE ADJ6626310 SANDRA THOMPSON COUNTY OF LOS ANGELES SUPERIOR COURT INTERCARE 14243 ORANGE ADJ7667286 SOFIA CARBAJAL FASTUARANTS INC INTERCARE 14243 ORANGE ADJ8758779 STEPHEN DERRY COUNTY OF LOS ANGELES INTERCARE 14243 ORANGE ADJ8032064 TIFFANY LOYDS COUNTY OF LOS ANGELES CHILD SUPPORT SERVICES INTERCARE 14243 ORANGE ADJ9383275 ADAM HARDING CALIFORNIA COMPACTION INTERCARE 5915 ORANGE ADJ7968683 CRISTOFORO CAPUTO DAVID ELLIS CHRYSLER JEEP INTERCARE 5915 ORANGE ADJ6929268 DIANE FERGUSON LA COUNTY DA OFFICE INTERCARE 5915 ORANGE ADJ9299261 ELVA ALCALA MARTINEZ AWARE PRODUCTS INTERCARE 5915 ORANGE ADJ9299261 ELVA ALCALA MARTINEZ STAY SAFE STAFFING INC DBA HORIZON PERSONNEL SERVICES IN INTERCARE 5915 ORANGE ADJ8404682 JOSE CORTEZ BARKER MANAGEMENT INC INTERCARE 5915 ORANGE ADJ9582925 JOSE JIMENEZ HORIZON PERSONNEL SERVICES INTERCARE 5915 ORANGE ADJ8706980 JULIO ACEVEDO SUPER KING MARKET INTERCARE 5915 ORANGE ADJ8173746 LASHONDA LENARD ALLEN ORANGE COUNTY TRANSIT AUTHORITY OCTA INTERCARE 5915 ORANGE ADJ8823016 LUIS SORIA CONSOLIDATED STAFFING SOLUTION INTERCARE 5915 ORANGE ADJ9308004 TERESA FLACK OCTA INTERCARE 5915 ORANGE ADJ691244 ERNESTO AGUAYO BEST LABEL COMPANY INC INTERCARE CIGA FRESNO CLOSED ADJ7493434 EVA HERNANDEZ ESPARZA ENTERPRISES INC INTERCARE CIGA FRESNO CLOSED ADJ974584 BENITO CRUZ HEIN HETTINGA INTERCARE CIGA GLENDALE ADJ8266758 CAROLINA HERNANDEZ SUPER CENTER INTERCARE CIGA GLENDALE ADJ8266758 CAROLINA HERNANDEZ SUPER CENTER INC INTERCARE CIGA GLENDALE ADJ3936803 JORGE CHAVEZ ROYAL PRODUCE INTERCARE CIGA GLENDALE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7462890 JOSE SOBERANO WARESTAFF LLC INTERCARE CIGA GLENDALE ADJ9651616 LOURDES CALDERON INTERGRATED SUPPORT SOLUTIONS INC. INTERCARE CIGA GLENDALE ADJ2758654 MARIA GONZALEZ MCDONALDS INTERCARE CIGA GLENDALE ADJ707830 MIRIAM ESPINOLA ESTEY INTERNATIONAL, INC. INTERCARE CIGA GLENDALE ADJ8441291 PILAR FERNANDEZ WINDSOR GARDENS OF ANAHEIM INTERCARE CIGA GLENDALE ADJ4213107 RODRIGO ROBLES COVE BUILDERS, INC. INTERCARE CIGA GLENDALE ADJ8967374 VICKY MEDRANO PLAZA RESIDENT ENTERPRISES INTERCARE CIGA GLENDALE ADJ3013083 ALFONSO GUERRERO ESPARZA ENTERPRISES INTERCARE FRESNO ADJ3013083 ALFONSO GUERRERO ESPARZA ENTERPRISES, INC INTERCARE FRESNO ADJ9591252 AMELIA LOPEZ COASTAL HARVESTING INC INTERCARE FRESNO ADJ7493434 EVA HERNANDEZ ESPARZA ENTERPRISES INC INTERCARE FRESNO ADJ8268589 GENARO REYES CARVALLO ESPARZA ENTERPRISES INTERCARE FRESNO ADJ9256351 GUILLERMO MAGALLANES COASTAL HARVESTING INTERCARE FRESNO ADJ9312813 JESUS MANUEL ESCAPITE B&A INTERNATIONAL FARM LABOR SERVICES INC. INTERCARE FRESNO ADJ7879633 JOEL LANDA ESPARZA ENTERPRISES INC INTERCARE FRESNO ADJ3169556 JOHNNY WALLACE ANCHOR AUDIO INC. INTERCARE FRESNO ADJ9128006 JORGE RICO CERDA CALIFORNIA AG SERVICES INC INTERCARE FRESNO ADJ3660972 JOSE MACIAS JACK PINHEIRO DAIRY INTERCARE FRESNO ADJ8294923 JULIAN SAAVEDRA ALL AG INC INTERCARE FRESNO ADJ7355243 LETICIA ALCANTAR HEDLEY INC INTERCARE FRESNO ADJ7686706 MARIA CERVANTES ESPARZA ENTERPRISES INC INTERCARE FRESNO ADJ6877577 MARIA RIVADENEYRA ESPARA ENTERPRISES INC INTERCARE FRESNO ADJ2119074 MARIA SEVELINA ORTIZ COMMAND PACKAGING INTERCARE FRESNO ADJ9250765 MIGUEL VALLEJO GOLD STAR CATTLE COMPANY LLC INTERCARE FRESNO ADJ8799257 PEDRO VASQUEZ ESPARZA ENTERPRISES INC INTERCARE FRESNO ADJ7437674 RAUL BRAVO ROBERT HILARDES DBA SIERRA CATTLE COMPANY INTERCARE FRESNO ADJ7437674 RAUL BRAVO SIERRA CATTLE CO INTERCARE FRESNO ADJ6536777 GRICELDA BEGA ARROW STAFFING INTERCARE HOLDINGS ADJ6536777 GRICELDA BEGA REDLANDS EMPLOYMENT SERVICES INTERCARE HOLDINGS ADJ495257 EFRAIN VERDUZCO SOUTHWEST TRAILS INTERCARE IRVINE CLOSED ADJ1194813 FLAVIO MARTINEZ SIZZLER INTERCARE IRVINE CLOSED ADJ1390966 JESUS PACHECO ALUMAFOLD PACIFIC INC INTERCARE IRVINE CLOSED ADJ3936803 JORGE CHAVEZ ROYAL PRODUCE INTERCARE IRVINE CLOSED ADJ3251301 JUAN CHI SANCHEZ FAMILY CORP INTERCARE IRVINE CLOSED ADJ4496429 MARIA ZEPEDA JACK IN THE BOX INTERCARE IRVINE CLOSED ADJ4184254 MARICELA VIDAL MCDONALDS INTERCARE IRVINE CLOSED ADJ1654771 MIGUEL SORIANO CHESAPEAKE FISH CO INTERCARE IRVINE CLOSED ADJ8656502 VERONICA HERNANDEZ SNSI STAFFING LLC INTERCARE LAS VEGAS ADJ10073844 MARIA PASCUAL CALIFOFRNIA MUSHROOM FARM INTERCARE ORANGE ADJ7611147 ALICIA RAMIREZ SPARKS MIDDLE SCHOOL INTERCARE PASADENA ADJ7518997 BRICK ZEGARRA HAMER TOYOTA INTERCARE PASADENA ADJ7487024 CHRISTOPHER MANZANARES PROVIDIAN STAFFING INTERCARE PASADENA ADJ9093577 DANNYRA ESCARENO ALANIZ AMBITIONS INC INTERCARE PASADENA ADJ7608227 ELIAS SANDOVAL HAMER TOYOTA INTERCARE PASADENA ADJ7509771 FRANK ESTRADA EMPLOYMENT SOLUTIONS INC INTERCARE PASADENA ADJ7509771 FRANK ESTRADA EMPLOYMENT SOLUTIONS, INC. INTERCARE PASADENA ADJ7187357 GABRIEL LOPEZ BRADLEY LANDSCAPE INTERCARE PASADENA ADJ6687390 GABRIELA OCHOA RODRIGUEZ ACCUPRINT SERVICES INC INTERCARE PASADENA ADJ6687390 GABRIELA OCHOA RODRIGUEZ PERSONA 1 HR INTERCARE PASADENA ADJ8398670 JOSE OJEDA DIVERSIFIED TRANSPORTATION LLC INTERCARE PASADENA ADJ7822942 JOSE SERGIO BRAVO PRECISION DIRECT INC INTERCARE PASADENA ADJ9764101 JUAN GONZALEZ ATLAS ENVIRONMENTAL SERVICES INTERCARE PASADENA ADJ6842004 LEONARDO MELGAR RIAD DECOR INC INTERCARE PASADENA ADJ8757349 LUISA ARMENTA AMANDA HOME CARE INTERCARE PASADENA ADJ6470074 MADELYN ARCHIBALD RANCHO CUCAMONGA COMMUNITY HOSPITAL INTERCARE PASADENA ADJ6470074 MADELYN ARCHIBALD RANCHO SPECIALTY HOSPITAL INTERCARE PASADENA ADJ7341857 MICHAEL GOODMAN ARROW STAFFING INTERCARE PASADENA ADJ8190145 YADIRA REYES ALLIANCE STAFFING INTERCARE PASADENA ADJ7041575 ARTURO MORALES JUAN GREAT FIESTA INTERCARE ROSEVILLE ADJ7247240 ARTURO NAVA WOOD RANCH BAR B Q & GRILL RESTAURANT INTERCARE ROSEVILLE ADJ7460805 CARLOS BALTAZAR CORNERSTONE STAFFING INTERCARE ROSEVILLE ADJ8235549 CARLOS DAMACEN PRESIDENTE RESTAURANT INTERCARE ROSEVILLE ADJ2039182 CELESTINO HERNANDEZ AMERICAN STAFF RESOURCES OF CA INTERCARE ROSEVILLE ADJ2039182 CELESTINO HERNANDEZ AMERICAN STAFF RESOURCES/MERRY MAID INTERCARE ROSEVILLE ADJ7378559 EDNA GONZALEZ BURGER KING INTERCARE ROSEVILLE ADJ7139481 GERARDO BELLO TACOS 2000 INC TACO BELL NO 3670 INTERCARE ROSEVILLE ADJ3986605 GRISELDA CONTRERAS TRI STAR PLASTICS INTERCARE ROSEVILLE ADJ6955689 JOSE HERNANDEZ KFC INTERCARE ROSEVILLE ADJ2332510 KATHRYN WOODLEY BURGER KING INTERCARE ROSEVILLE ADJ8776624 LAURIE BENN CHILD CARE AMENITY GROUP INC STEP BY STEP INTERCARE ROSEVILLE ADJ7401755 MARCELO GATICA JACK IN THE BOX INTERCARE ROSEVILLE ADJ7037978 MARIA NAVARRETE BURGER KING INTERCARE ROSEVILLE ADJ7037978 MARIA NAVARRETE CALIFORNIA RESTAURANT MUTUAL BENEFI INTERCARE ROSEVILLE ADJ6792309 MIGUEL CAL JACK IN THE BOX INTERCARE ROSEVILLE ADJ497474 REFUGIO GONZALEZ MAINSTAY BUSINESS SOLUTIONS INTERCARE ROSEVILLE ADJ497474 REFUGIO GONZALEZ SOUTH COAST LOGISTICS INTERCARE ROSEVILLE ADJ7605385 SANDRA GONZALEZ JACK IN THE BOX INTERCARE ROSEVILLE ADJ7162202 STEVEN MARTINEZ JACK IN THE BOX INTERCARE ROSEVILLE ADJ7162202 STEVEN MARTINEZ JYM ENTERPRISES INC INTERCARE ROSEVILLE ADJ4318966 ELIZABETH RODAS SELECT PERSONNEL SERVICE INTERCARE SACRAMENTO CLOSED ADJ1272257 RUDY CHICAS STAFF CHEX INTERCARE SACRAMENTO CLOSED ADJ2637810 DYCIE GLOVER WONDER BREAD INTERSTATE BRANDS SAN DIEGO ADJ7210912 ELEAZAR ORTEGA R RANCH MARKET INC IWC GROUP INSURANCE ADJ3951286 ESTELLA AVILEZ MARQUEZ JACK IN THE BOX JACK IN THE BOX ADJ8326571 MIRIAM LINARES JEAN GENIE STUDIO JEAN GENIE STUDIO ADJ7344086 BEATRIZ CORPENO JOAN ROSENBERG JOAN ROSENBERG Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6781237 ADOLFO MERAZ PACIFIC CONTAINER TERMINALS JUDITH TILLEY LONG BEACH ADJ6781237 ADOLFO MERAZ SSA MARINE JUDITH TILLEY LONG BEACH ADJ6773098 HATTIE SIMSISULU SSA AMERICA JUDITH TILLEY LONG BEACH ADJ7162202 STEVEN MARTINEZ JACK IN THE BOX JYM ENTERPRISES INC ADJ7162202 STEVEN MARTINEZ JYM ENTERPRISES INC JYM ENTERPRISES INC ADJ6945025 ANA IRIS ROSALES KAISER FOUNDATION HOSPITAL KAISER FOUNDATION HOSPITAL ADJ6945025 ANA IRIS ROSALES KAISER FOUNDATION HOSPITAL KAISER OAKLAND ADJ7184999 KARLA BERNIER KAISER PERMANENTE KAISER OAKLAND ADJ9058775 PEDRO ALVARENGA KAISER FOUNDATION HOSPITAL KAISER OAKLAND ADJ9058775 PEDRO ALVARENGA KAISER FOUNDATION HOSPITALS KAISER OAKLAND ADJ7176681 RICHARD CUADROS KAISER PREMANENTE KAISER OAKLAND ADJ8134502 RICK ALEGRE KAISER PERMANENTE KAISER OAKLAND ADJ8184588 NAFEESAH REED KAISER PERMANENTE KAISER PERMANENTE ADJ7752117 ROCHELE JOHNSON KAISER PERMANENTE KAISER PERMANENTE ADJ3985728 VIDAIL MENJIVAR KAISER PERMANENTE KAISER PERMANETE W/C ADJ7176681 RICHARD CUADROS KAISER PREMANENTE KAISER PREMANENTE ADJ7880111 ARELI RAMIREZ RIVERSIDE COUNTY OFFICE OF EDUCATIO KEENAN ASSOCIATES RIVERSIDE ADJ7457011 CATHERINE CREEDEN CORONA NORCO UNIFIED SCHOOL DIST KEENAN ASSOCIATES RIVERSIDE ADJ1752070 CHRISTINA LIRA WARD GROBERMAN DESERT SANDS UNIFIED SCHOOL DIST KEENAN ASSOCIATES RIVERSIDE ADJ7432590 GABRIELA QUESADA VICTOR VALLEY COLLEGE KEENAN ASSOCIATES RIVERSIDE ADJ7583375 IGNACIO ALVARADO CORONA NORCO UNIFIED SCHOOL DISTRICT KEENAN ASSOCIATES RIVERSIDE ADJ7072179 JACQUELINE DUPERRON PERRIS SCHOOL DISTRICT KEENAN ASSOCIATES RIVERSIDE ADJ7968537 KIMBERLY MCCLENDON BRYANT RIALTO UNIFIED SCHOOL DISTRICT KEENAN ASSOCIATES RIVERSIDE ADJ8199070 LAURA BROWN MT SAN JACINTO COMMUNITY COLLEGE KEENAN ASSOCIATES RIVERSIDE ADJ8543275 MANUEL GONZALEZ PALM SPRINGS UNIFIED SCHOOL KEENAN ASSOCIATES RIVERSIDE ADJ8543275 MANUEL GONZALEZ SEVEN LAKES HOME OWNERS ASSOCIATION KEENAN ASSOCIATES RIVERSIDE ADJ6720374 MARC BLACKMAN COUNTY SANITATION DISTRICTS OF LA KEENAN ASSOCIATES RIVERSIDE ADJ7171668 MAYRA PICAZO CORONA NORCO UNIFIED SCHOOL DISTRICT KEENAN ASSOCIATES RIVERSIDE ADJ4468926 MEMORY BATTON ONTARIO MONTCLAIR SCHOOL DIST KEENAN ASSOCIATES RIVERSIDE ADJ8233747 CORNELIUS LEFLORE COMMUNITY HOSPITAL KEENAN ASSOCIATES TORRANCE ADJ7910747 EDUARDO SOTO ABC UNIFIED SCHOOL DISTRICT KEENAN ASSOCIATES TORRANCE ADJ8066246 JUAN GUTIERREZ LAS VIRGENES UNIFIED SCHOOL DISTRICT KEENAN ASSOCIATES TORRANCE ADJ9258099 MARIA MARTINEZ COMMUNITY HOSPITAL OF LONG BEACH KEENAN ASSOCIATES TORRANCE ADJ5770126 MARISELA GUTIERREZ PRESBYTERIAN INTERCOMMUNITY HOSPITAL KEENAN ASSOCIATES TORRANCE ADJ3853138 NASRIN KALANTARI IRVINE UNIFIED SCHOOL DISTRICT KEENAN ASSOCIATES TORRANCE ADJ1450003 RAUL SADA GLENDALE UNIFIED SCHOOL DISTRICT KEENAN ASSOCIATES TORRANCE ADJ6730877 RITA FIGUEROA KIRKWOOD OF ORANGE KEENAN ASSOCIATES TORRANCE ADJ7191153 ROBERTO LARACUENTE HOAG MEMORIAL HOSP PRESBYTER KEENAN ASSOCIATES TORRANCE ADJ7028491 ROSE LOPEZ PRESBYTERIAN COMMUNITY HOSPITAL KEENAN ASSOCIATES TORRANCE ADJ2164228 SALVADOR JACOBO AMPAM PARKS MECHANICAL INC KEENAN ASSOCIATES TORRANCE ADJ2164228 SALVADOR JACOBO PARKS MECHANICAL CONSTRUCTION KEENAN ASSOCIATES TORRANCE ADJ7809255 VICTOR MUNOZ KIRKHILL MANUFACTURING CO KIRKHILL MANUFACTURING CO ADJ6868715 PATRICIA GALINDO KOREAN RESTAURANT TOBAKI KOREAN RESTAURANT TOBAKI ADJ6735579 PAULINE CHAN LA COUNTY DEPARTMENT OF SOCIAL SERVICES LA COUNTY/DEPARTMENT OF PUBLIC SOCIAL SERVICES ADJ6735579 PAULINE CHAN LA COUNTY/DEPARTMENT OF PUBLIC SOCIAL SERVICES LA COUNTY/DEPARTMENT OF PUBLIC SOCIAL SERVICES ADJ7669825 CHI MOSELEY LAC USC MEDICAL CENTER LAC USC MEDICAL CENTER ADJ7067283 PATTY SCRANTON LACMA LACMA ADJ7366531 GEORGE GARCIA LACMTA LACMTA ADJ6515062 JUAN MANUEL HERNANDEZ ORTIZ LACMTA LACMTA ADJ8754540 RAFAEL ZUNIGA LANCE CAMPER LANCE CAMPER ADJ6671671 JOSE AGUILAR LANCE CAMPER MFG CORP LANCE CAMPER LANCASTER ADJ8754540 RAFAEL ZUNIGA LANCE CAMPER LANCE CAMPER LANCASTER ADJ7967439 SUGEY PEREZ LANCE CAMPER LANCE CAMPER LANCASTER ADJ8583282 FLAVIO GUERRERO LANKEN ENTERPRISES INC DBA DC CONCRETECO LANKEN ENTERPRISES INC DBA DC CONCRETECO ADJ7737056 JOSE OSUNA BEVERLY WILSHIRE FOUR SEASONS HOTEL LAUGHLIN FALBO SANTA MONICA ADJ7841175 ELPIDIO COVARRUBIAS LAUSD LAUSD ADJ3794387 PETER SHERWOOD ISLAND CONSTRUCTION LEGION INSURANCE COMPANY/NOVA PRO ADJ3409814 SINDY BOWMAN PRIORITY ONE MEDICAL TRANSPORT LEGION/CIGA ADJ8207192 ALEJANDRA VALENZUELA ALTA MED HEALTH SERVICES LIBERTY MUTUAL ADJ4381684 ANH KIM PHAN DRIESSEN AIRCRAFT LIBERTY MUTUAL ADJ3315225 CARMEN STENSRUD MOTEL 6 LIBERTY MUTUAL ADJ8836122 DENISE SHORTIS RIALTO MOBILE VILLA LIBERTY MUTUAL ADJ933686 ENRIQUE ALCALA TAMA TRADING LIBERTY MUTUAL ADJ7482361 ADRIANA MENDOZA ACCOR LODGING NORTH AMERICA LIBERTY MUTUAL 29073 GLENDALE ADJ7482361 ADRIANA MENDOZA MOTEL 6 LIBERTY MUTUAL 29073 GLENDALE ADJ6855332 ALBERTO VASQUEZ RANCHO PACIFIC BERRY LIBERTY MUTUAL 29073 GLENDALE ADJ9599877 ALEJANDRO CASTRO PERFECTION CABINETS INC LIBERTY MUTUAL 29073 GLENDALE ADJ9192163 AMADOR RAMOS HAWKER PACIFIC AEROSPACE LIBERTY MUTUAL 29073 GLENDALE ADJ9160152 AMALIA RODRIGUEZ REITER BROTHERS INC BERRY CENTRAL LIBERTY MUTUAL 29073 GLENDALE ADJ8743119 ANGIE FUENTES THE HOME DEPOT LIBERTY MUTUAL 29073 GLENDALE ADJ8380410 ANTHONY ALDAMA WALDEN STRUCTURES LIBERTY MUTUAL 29073 GLENDALE ADJ8518592 BLANCA PONCE WALT DISNEY STUDIOS LIBERTY MUTUAL 29073 GLENDALE ADJ9507860 CARLOS CASTELLANOS PORTOS BAKERY LIBERTY MUTUAL 29073 GLENDALE ADJ7038976 CATALINA SANCHEZ MONTEL 6 LIBERTY MUTUAL 29073 GLENDALE ADJ4648881 CHARLESTON CARR UNITED PARCEL SERVICE LIBERTY MUTUAL 29073 GLENDALE ADJ7926303 CHARLI TINSLEY RAGING WATERS LIBERTY MUTUAL 29073 GLENDALE ADJ1461342 CHRISTIAN SKAHILL UPS LIBERTY MUTUAL 29073 GLENDALE ADJ2490449 CHRISTINA GUTIERREZ UPS LIBERTY MUTUAL 29073 GLENDALE ADJ8580694 CIPRIANO LONGSTONE BRINKS INC LIBERTY MUTUAL 29073 GLENDALE ADJ7261197 CRUZ NAVA CERADYNE INC LIBERTY MUTUAL 29073 GLENDALE ADJ1798839 DAVID GOMEZ PACIFIC BELL LIBERTY MUTUAL 29073 GLENDALE ADJ7672168 DEEANNA ASHLEY UPS LIBERTY MUTUAL 29073 GLENDALE ADJ7322451 DELENE CONE SOUTHLAND TRANSIT INC LIBERTY MUTUAL 29073 GLENDALE ADJ4701587 DIMAS TORUNO ANDERSON DESK/STEELCASE LIBERTY MUTUAL 29073 GLENDALE ADJ7359469 DONNA WILSON ARS INVESTMENT HOLDINGS LIBERTY MUTUAL 29073 GLENDALE ADJ3898274 EDITH HERNANDEZ ACCOR NORTH AMERICA INC LIBERTY MUTUAL 29073 GLENDALE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ4665455 FRANCISCO ANDUAGA COUNTY LA AGRICULTURAL DEPT LIBERTY MUTUAL 29073 GLENDALE ADJ4665455 FRANCISCO ANDUAGA COUNTY OF LOS ANGELES LIBERTY MUTUAL 29073 GLENDALE ADJ1427303 FRANCISCO SANCHEZ UNITED PARCEL SERVICES LIBERTY MUTUAL 29073 GLENDALE ADJ6845555 GLORIA ALOMIA AAREN SCIENTIFIC INC LIBERTY MUTUAL 29073 GLENDALE ADJ6845555 GLORIA ALOMIA OPHTALMIC INOVATION INTERNATIONAL LIBERTY MUTUAL 29073 GLENDALE ADJ6845555 GLORIA ALOMIA PIZZA HUT LIBERTY MUTUAL 29073 GLENDALE ADJ1014495 GRANT DAVIS GOLDEN STATE FOODS LIBERTY MUTUAL 29073 GLENDALE ADJ7136577 GUSTAVO VAZQUEZ WALDEN STRUCTURES INCORPORATION LIBERTY MUTUAL 29073 GLENDALE ADJ6729482 HECTOR TELLEZ SAN GABRIEL TRANSIT INC LIBERTY MUTUAL 29073 GLENDALE ADJ6946617 HOUY UNG FARMERS INSURANCE EXCHANGE LIBERTY MUTUAL 29073 GLENDALE ADJ6799958 HUMBERTO LUNA PRIME STEEL INC LIBERTY MUTUAL 29073 GLENDALE ADJ8540443 ISABEL GONZALEZ MOZARELLA FRESCA LIBERTY MUTUAL 29073 GLENDALE ADJ7732645 JAIME FERNANDEZ MCGUIRE CONTRACTING LIBERTY MUTUAL 29073 GLENDALE ADJ7208747 JAMES WHYTE BEST DEDICATED LIBERTY MUTUAL 29073 GLENDALE ADJ7208747 JAMES WHYTE FURNITURE TRANSPORTATION SERVICE LIBERTY MUTUAL 29073 GLENDALE ADJ7091514 JIMMY BRANCATELLI NUTRO PRODUCTS LIBERTY MUTUAL 29073 GLENDALE ADJ8244042 JOEL REYES CSM BAKERY PRODUCTS LIBERTY MUTUAL 29073 GLENDALE ADJ6726111 JOSE DE LA CRUZ CHARLES EVERETT RADNEY LIBERTY MUTUAL 29073 GLENDALE JOSEPH CHARLES LANG AS SUB SHLDR OF MSR CONSTRUCTION ADJ6726111 JOSE DE LA CRUZ LIBERTY MUTUAL 29073 GLENDALE INC ADJ6726111 JOSE DE LA CRUZ MARIA MUNOZ SUB SHAREHOLDER OF MSR CONSTRUCTION INC LIBERTY MUTUAL 29073 GLENDALE ADJ9374255 JOSE DE LA TRINIDAD UTILITY TREE SERVICE INC LIBERTY MUTUAL 29073 GLENDALE ADJ6589475 JOSE HERRERA B & R FARM LIBERTY MUTUAL 29073 GLENDALE ADJ8293548 JOSE NUNEZ BRADY COMPANY LIBERTY MUTUAL 29073 GLENDALE ADJ6975410 JOSE URTUSUASTEGUI PARAMOUNT SCAFFOLD COMPANY LIBERTY MUTUAL 29073 GLENDALE ADJ8224553 JOSEFINA CALDERON RUIZ CONTRACTING LIBERTY MUTUAL 29073 GLENDALE ADJ9595101 JOSHUA D AMBRA UNITED PARCEL SERVICE LIBERTY MUTUAL 29073 GLENDALE ADJ8501966 JUAN CARMONA AVENDANO REITER BROTHERS INC LIBERTY MUTUAL 29073 GLENDALE ADJ6827935 JUAN DEL REAL ACOSTA EDELBROCK CORPORATION LIBERTY MUTUAL 29073 GLENDALE ADJ3543123 JUAN DIAZ GLOBAL BUILDING SERVICES LIBERTY MUTUAL 29073 GLENDALE ADJ4387825 JUAN GUEVARA BAKEMARK WESTCO CORP LIBERTY MUTUAL 29073 GLENDALE ADJ7484466 KIMBERLY SAMPSON NOVE STAFF RESOURCES GROUP LIBERTY MUTUAL 29073 GLENDALE ADJ7484466 KIMBERLY SAMPSON NOVE STAFF RESOURCES GROUP EASY STAFF LLC LIBERTY MUTUAL 29073 GLENDALE ADJ7484466 KIMBERLY SAMPSON CENTURY BLINDS LIBERTY MUTUAL 29073 GLENDALE ADJ7484466 KIMBERLY SAMPSON EASY STAFF LLC LIBERTY MUTUAL 29073 GLENDALE ADJ7880210 LARRY FONTENOT HOME DEPOT LIBERTY MUTUAL 29073 GLENDALE ADJ7094332 LEANDRO ANTUNEZ ALSTYLE LIBERTY MUTUAL 29073 GLENDALE ADJ8144911 LEODEGARIO NUNEZ MOTEL 6 LIBERTY MUTUAL 29073 GLENDALE ADJ7894800 LETICIA VELASCO EASTER SEALS LIBERTY MUTUAL 29073 GLENDALE ADJ7894800 LETICIA VELASCO EASTER SEALS SOUTHERN CALIFORNIA LIBERTY MUTUAL 29073 GLENDALE ADJ7046402 LUIS MEGGS THE HOME DEPOT LIBERTY MUTUAL 29073 GLENDALE ADJ9139546 MARIA DE LOS ANGELES CORTEZ PREFERRED FREEZER SERVICE LIBERTY MUTUAL 29073 GLENDALE ADJ9162728 MARIA FLORES SELECT STAFFING LIBERTY MUTUAL 29073 GLENDALE ADJ2022491 MARIA HERNANDEZ CERADYNE INC LIBERTY MUTUAL 29073 GLENDALE ADJ7165166 MARIA LANCERIO HERNANDEZ MEGAN BIRTHISTLE LIBERTY MUTUAL 29073 GLENDALE ADJ7616949 MARIA LOURDES TOPACIO FARMERS INSURANCE GROUP LIBERTY MUTUAL 29073 GLENDALE ADJ7199117 MARIA RAMIREZ FIGUEROA RANCHO LAS PALMAS COUNTRY CLUB LIBERTY MUTUAL 29073 GLENDALE ADJ7358229 MARIA SERRANO MONROVIA NURSERY LIBERTY MUTUAL 29073 GLENDALE ADJ1390844 MARIA TORRES TEAM SIMPSON RACING INC. LIBERTY MUTUAL 29073 GLENDALE ADJ721267 MARIA VILMA PORTILLO DISNEY WORLDWIDE SERVICE INC LIBERTY MUTUAL 29073 GLENDALE ADJ7028306 MARIO VILLATORO WALDEN STRUCTURES INC LIBERTY MUTUAL 29073 GLENDALE ADJ7028306 MARIO VILLATORO WALDEN STRUCTURES INC LIBERTY MUTUAL 29073 GLENDALE ADJ3243585 MARISELA VENTURA LOS ANGELES UNIFIED SCHOOL DISTRICT LIBERTY MUTUAL 29073 GLENDALE ADJ4231766 MARSHA WADE LACMTA LIBERTY MUTUAL 29073 GLENDALE ADJ7593899 MATIAS CUEVAS TWR ENTERPRISES LIBERTY MUTUAL 29073 GLENDALE ADJ6773377 MICHAEL GUTIERREZ UPS LIBERTY MUTUAL 29073 GLENDALE ADJ8982220 MYRTHA LOPEZ FOAM DEPOT LIBERTY MUTUAL 29073 GLENDALE ADJ7266845 NATIVIDAD JIMENEZ RESIDENT GROUP SERVICES LIBERTY MUTUAL 29073 GLENDALE ADJ931520 NELLIE BRIONES COUNTY OF LOS ANGELES LIBERTY MUTUAL 29073 GLENDALE ADJ931520 NELLIE BRIONES USC MED CTR LIBERTY MUTUAL 29073 GLENDALE ADJ7989502 NICOLE PENA JUNIOR BLIND OF AMERICA LIBERTY MUTUAL 29073 GLENDALE ADJ6883885 OLGA MARIAN KOKUBU THE HOME DEPOT LIBERTY MUTUAL 29073 GLENDALE ADJ7860691 OMAR AGUILAR TWR FRAMING LIBERTY MUTUAL 29073 GLENDALE ADJ6479305 PEDRO SANTIAGO AMERICAN RESIDENTIAL SERVICES LLC RESCUE ROOTER LIBERTY MUTUAL 29073 GLENDALE ADJ9138047 RAMONA GUIPOCO RAYTHEON SENSORS AND ELECTRONICS LIBERTY MUTUAL 29073 GLENDALE ADJ7513655 RAYNELL WILLIAMS TIMBERLAND COMPANY LIBERTY MUTUAL 29073 GLENDALE ADJ6708109 RICARDO SALGADO GOLDEN WEST FARM CONTRACTOR INC LIBERTY MUTUAL 29073 GLENDALE ADJ8801429 RICHARD BAIRD SWISS DAIRY LIBERTY MUTUAL 29073 GLENDALE ADJ2753148 ROQUE TOLEDO HP FORMING INTERNATIONAL LIBERTY MUTUAL 29073 GLENDALE ADJ8203872 ROSA NAH AEROTEK, INC LIBERTY MUTUAL 29073 GLENDALE ADJ8203872 ROSA NAH SELECT STAFFING LIBERTY MUTUAL 29073 GLENDALE ADJ8203872 ROSA NAH THIBIANT LIBERTY MUTUAL 29073 GLENDALE ADJ924878 ROSARIO VALDEZ ATLANTIC EXPRESS LIBERTY MUTUAL 29073 GLENDALE ADJ8205512 ROSARIO WILLIAMS EASTER SEALS OF SC LIBERTY MUTUAL 29073 GLENDALE ADJ7470393 ROSIE REYES AMC PROPERTY MANAGEMENT LIBERTY MUTUAL 29073 GLENDALE ADJ8489420 SANDRA BAUTISTA HUNTER DOUGLAS FABRICATION CO LIBERTY MUTUAL 29073 GLENDALE ADJ6857449 SOCORRO CARRILLO ALTA MED HEALTH SERVICES LIBERTY MUTUAL 29073 GLENDALE ADJ3500674 SUSAN KOONCE LAUSD LIBERTY MUTUAL 29073 GLENDALE ADJ8424948 TERESA VALDIVIA ACCUFLEET LIBERTY MUTUAL 29073 GLENDALE ADJ6916590 VALENTINA ACOSTA LSG SKY CHEFS LIBERTY MUTUAL 29073 GLENDALE ADJ7357713 VELIA GOMEZ GLOBAL BUILDING SERVICE INC LIBERTY MUTUAL 29073 GLENDALE ADJ7647623 VICTOR CARDENAS MONTEBELLO AUTO TRUCK SALES LIBERTY MUTUAL 29073 GLENDALE ADJ7261633 LOURDES FREGOSO JC RESORTS LIBERTY MUTUAL 29073 GLENDALE ADJ7943355 WENDY VILLALOBOS HOME DEPOT LIBERTY MUTUAL 29073 GLENDALE ADJ8615700 AGUSTIN LOPEZ INVESTMENT CONCEPTS LIBERTY MUTUAL BEAVERTON Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8179656 ALEJANDRO GARCIA HERNANDEZ 99 RANCH MARKET LIBERTY MUTUAL BEAVERTON ADJ6980663 ALICIA PAREDES VOZZCOM LIBERTY MUTUAL BEAVERTON ADJ8742351 ANDREW ESPARZA LOS ANGELES SIGNAL CONSTRUCTION LIBERTY MUTUAL BEAVERTON ADJ7493483 ANGELES RODRIGUEZ ISS GROUNDS CONTROL LIBERTY MUTUAL BEAVERTON ADJ7481303 ANTONIA GONZALEZ MENDOZA THE TERRACES AT PARK MARINO LIBERTY MUTUAL BEAVERTON ADJ9478700 ARNULFO CASTRO WEST COAST ARBORISTS, INC. LIBERTY MUTUAL BEAVERTON ADJ7809268 BRANDON JACKSON ASHLEY FURNITURE INDUSTRIES INC LIBERTY MUTUAL BEAVERTON ADJ7592692 CARLOS CISNEROS ALSTYLE APPAREL LIBERTY MUTUAL BEAVERTON ADJ6912270 CARLOS DIAZ ASHLEY FURNITURE LIBERTY MUTUAL BEAVERTON ADJ8012157 CARLOS NUNEZ JC SALES LIBERTY MUTUAL BEAVERTON ADJ7779257 CATALINA TERRAZAS CATAPULT LEARNING LLC LIBERTY MUTUAL BEAVERTON ADJ8144912 CECILIA CORTEZ ASHLEY FURNITURE LIBERTY MUTUAL BEAVERTON ADJ8381599 CINDY MARQUEZ ANNAS LINENS COMPANY LIBERTY MUTUAL BEAVERTON ADJ6919903 CINDY NIEVES DIAGNOSTIC HEALTH OF LOS ANGELES LIBERTY MUTUAL BEAVERTON ADJ6779928 DANIEL AGUIRRE UNITED ALLOYS AND METALS LIBERTY MUTUAL BEAVERTON ADJ7298723 DANIEL MARTINEZ MID WEST TOWER LIBERTY MUTUAL BEAVERTON ADJ6973303 EDGAR ACERO NORTH HILLS LANDSCAPE LIBERTY MUTUAL BEAVERTON ADJ7211912 EDGAR ACERO NORTH HILLS LANDSCAPE LIBERTY MUTUAL BEAVERTON ADJ7215225 FABIOLA VASQUEZ BIG SAVER FOODS LIBERTY MUTUAL BEAVERTON ADJ7077383 FELICITA MARTINEZ RICHARD BAGDASARIAN INC LIBERTY MUTUAL BEAVERTON ADJ8932940 GABRIEL BENITEZ SOUTHERN PACPIZZA LLC DBA PIZZA HUT LIBERTY MUTUAL BEAVERTON ADJ8932940 GABRIEL BENITEZ TARGET CORPORATION LIBERTY MUTUAL BEAVERTON ADJ7956493 GASPAR MONTESINO B AND B PALLET INC LIBERTY MUTUAL BEAVERTON ADJ7386191 GEORGE BALLESTEROS MOODY NATIONAL MANAGMENT LP LIBERTY MUTUAL BEAVERTON ADJ7020778 GERARDO SANCHEZ CONTINENTAL PROCESSORS LIBERTY MUTUAL BEAVERTON ADJ8836370 GRICELDA RIVERA SELECT STAFFING LIBERTY MUTUAL BEAVERTON ADJ7171671 GUADALUPE ALATORRE ANNAS LINENS LIBERTY MUTUAL BEAVERTON ADJ6949691 GUADALUPE MONTES CITIZENS DEVELOPMENT CORP LIBERTY MUTUAL BEAVERTON ADJ7457806 GUADALUPE MURO T-Y NURSERY INC LIBERTY MUTUAL BEAVERTON ADJ7458400 GUANQIAO CHENG CASINO MASSAGE LIBERTY MUTUAL BEAVERTON ADJ7458400 GUANQIAO CHENG CASINO MASSAGE INC LIBERTY MUTUAL BEAVERTON ADJ9214821 GUSTAVO FRAGA WEST COVINA LIBERTY MUTUAL BEAVERTON ADJ9174018 GUSTAVO HERNANDEZ CANAM MINERALS LIBERTY MUTUAL BEAVERTON ADJ8656552 HECTOR SILVA ASHLEY FURNITURE INDUSTRIES LIBERTY MUTUAL BEAVERTON ADJ7263473 ISRAEL ARZATE MFG WEST LIBERTY MUTUAL BEAVERTON ADJ7263473 ISRAEL ARZATE MSG WEST LIBERTY MUTUAL BEAVERTON ADJ7442069 ISRAEL REZA LIFOAM INDUSTRIES LLC LIBERTY MUTUAL BEAVERTON ADJ7434932 JAVIER ROSALES ISS FACILITY SERVICES LIBERTY MUTUAL BEAVERTON ADJ7101798 JERRY SANTIZO SCHEU STEEL SUPPLY CO LIBERTY MUTUAL BEAVERTON ADJ7474342 JESUS CRUZ NATIONAL BEEF LIBERTY MUTUAL BEAVERTON ADJ8375582 JORGE VARGAS PRIDE TRANSPORT LIBERTY MUTUAL BEAVERTON ADJ9208514 JOSE ABESAMES HARRIS CARE CENTER LIBERTY MUTUAL BEAVERTON ADJ6711913 JOSE SOLIS SJ AMOROSO CONSTRUCTION LIBERTY MUTUAL BEAVERTON ADJ8223518 JOSUE GARCIA PRIORITTY PALLET LIBERTY MUTUAL BEAVERTON ADJ1314130 JUAN RODRIGUEZ ATLAS RESOURCES INC LIBERTY MUTUAL BEAVERTON ADJ8664591 JUANA MERCADO FULLERTON GARDENS LIBERTY MUTUAL BEAVERTON ADJ9242794 JULIO LAZARO THOUSAND OAKS INN LIBERTY MUTUAL BEAVERTON ADJ7483382 LEONEL RAMIREZ UNITED SITE SERVICE OF CALIFORNIA INC LIBERTY MUTUAL BEAVERTON ADJ8239945 LINA SOLIS ANNA S LINENS LIBERTY MUTUAL BEAVERTON ADJ6830017 LUIS OSORIO GREGG INDUSTRIES INC LIBERTY MUTUAL BEAVERTON ADJ5835914 MARIA MANRIQUEZ SETTON PISTACHIO COMPANY LIBERTY MUTUAL BEAVERTON ADJ2846385 MARIA RUIZ PACKING ADVANTAGE CORP. LIBERTY MUTUAL BEAVERTON ADJ8950033 MARIO FLORES WESCO AIRCRAFT HARDWARE LIBERTY MUTUAL BEAVERTON ADJ6820016 MARIO ZEPEDA AZTECA LANDSCAPING LIBERTY MUTUAL BEAVERTON ADJ7595275 MELANIE CHANEY UNITED SPIRIT ASSOCIATION LIBERTY MUTUAL BEAVERTON ADJ9171048 MIGUEL PADILLA S & N LOGISTICS LIBERTY MUTUAL BEAVERTON ADJ7661366 NICKOLAS AMAYA VALBRUNA STAINLESS INC LIBERTY MUTUAL BEAVERTON ADJ7467020 PASHTANA AKBARI VQ ORTHOCARE LIBERTY MUTUAL BEAVERTON ADJ6463328 PATRICIA GUTIERREZ MELLANO COMPANY LIBERTY MUTUAL BEAVERTON ADJ7907962 PATRICIA ORTIZ PLATINUM GROUP OF COMPANIES LIBERTY MUTUAL BEAVERTON ADJ6860377 PEDRO CASAS AQUA TRI LIBERTY MUTUAL BEAVERTON ADJ7312399 RAUL REVOLORIO OHLINE CORPORATION LIBERTY MUTUAL BEAVERTON ADJ7006477 REGINALDO GUTIERREZ BAUSMAN & COMPANY LIBERTY MUTUAL BEAVERTON ADJ7941005 RENE ANTONIO COAST CITRUS DISTRIBUTORS LIBERTY MUTUAL BEAVERTON ADJ1010459 REYNA URIAS FLORENCE MEAT PACKING, INC. 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Case Number Injured Worker Employer Claims Administrator ------ADJ3336564 CAROLYN CAVERLY COUNTY OF ORANGE LIBERTY MUTUAL ORANGE ADJ3336564 CAROLYN CAVERLY KIMKO STAFFING LIBERTY MUTUAL ORANGE ADJ1561186 CUAUHTEMOC CHAVEZ TEL PHIL ENTERPRISES LIBERTY MUTUAL ORANGE ADJ6431538 DELIA MURILLO CONCEPTS IN COMMUNITY LIVING LIBERTY MUTUAL ORANGE ADJ4323889 DELIA REGLA UKA'S BIG SAVER FOODS INC LIBERTY MUTUAL ORANGE ADJ6863921 DIONISIO SANCHEZ SUNRIDER MANUFACTURE LIBERTY MUTUAL ORANGE ADJ1021695 ELIA MACIAS FIESTA MEXICAN MARKET LIBERTY MUTUAL ORANGE ADJ7146122 ELISA TORRES EDS DISTRIBUTION SERVICES LLC LIBERTY MUTUAL ORANGE ADJ7457866 ENVANGELINA MARTINEZ HERB THYME FARMS INC LIBERTY MUTUAL ORANGE ADJ1091944 GUILLERMO LOPEZ FLYING FOOD GROUP LIBERTY MUTUAL ORANGE ADJ4363500 JESUS GOMEZ UNITED PARCEL SERVICE LIBERTY MUTUAL ORANGE ADJ7003636 JESUS IGNACIO CRUZ BRAWLEY BEEF LIBERTY MUTUAL ORANGE ADJ7091514 JIMMY BRANCATELLI NUTRO PRODUCTS LIBERTY MUTUAL ORANGE ADJ7932700 JUAN SUAREZ KKW TRUCKING INC LIBERTY MUTUAL ORANGE ADJ7761976 JULIAN OJEDA HILTON GARDEN INN LIBERTY MUTUAL ORANGE ADJ3334113 JUVENTINO BACA VANGUARD LIBERTY MUTUAL ORANGE ADJ7894800 LETICIA VELASCO EASTER SEALS LIBERTY MUTUAL ORANGE ADJ7894800 LETICIA VELASCO EASTER SEALS SOUTHERN CALIFORNIA LIBERTY MUTUAL ORANGE ADJ4257701 LUIS ROMERO GENCO / SMART & FINAL LIBERTY MUTUAL ORANGE ADJ8400872 MARIA DEL CARMEN ALLEGRO MANUFACTURING LIBERTY MUTUAL ORANGE ADJ3386639 MARIA SOCORRO MATA DOBBS INTERNATIONAL LIBERTY MUTUAL ORANGE ADJ7162665 MARIO VILLEGAS SPECTRUM CARE LANDSCAPE & IRRIGATION MANAGEMENT LIBERTY MUTUAL ORANGE ADJ8580380 MOISES NAVARRETE AGOURA HILLS SENIOR RETREAT LIBERTY MUTUAL ORANGE ADJ4566961 NANCY NICHOLS ITT TECHNICAL INSTITUTE LIBERTY MUTUAL ORANGE ADJ9366379 NOEMI PADILLA MALARKEY ROOFING LIBERTY MUTUAL ORANGE ADJ7475228 PEDRO GARCIA ROSS MCLAREN FUEL SYSTEM LIBERTY MUTUAL ORANGE ADJ8716813 RACHEL RANGEL OLIVE CREST LIBERTY MUTUAL ORANGE ADJ6825299 RAMON NIETO UNITED PARCEL SERVICE LIBERTY MUTUAL ORANGE ADJ6825299 RAMON NIETO UPS LIBERTY MUTUAL ORANGE ADJ4055607 RAMON VIRAMONTES QST INDUSTRIES INC LIBERTY MUTUAL ORANGE ADJ3208843 RAUL FONSECA BURRTEC WASTE INDUSTRIES, INC LIBERTY MUTUAL ORANGE ADJ7274556 REFUGIO NAVARRO MODULAR STRUCTURES INTERNATIONAL INC LIBERTY MUTUAL ORANGE ADJ6528298 RICARDO ROSILLO CARAMEDIX INC LIBERTY MUTUAL ORANGE ADJ271043 ROBERTO RODRIGUEZ ELECTROLURGY LIBERTY MUTUAL ORANGE ADJ429540 ROSA MENDEZ VENTURI STAFFING LIBERTY MUTUAL ORANGE ADJ7355167 RUBEN CHICA PACIFIC FABRIC FINISHING INC LIBERTY MUTUAL ORANGE ADJ7236838 SAMY RENDON APPA FINE FOODS LIBERTY MUTUAL ORANGE ADJ8424948 TERESA VALDIVIA ACCUFLEET LIBERTY MUTUAL ORANGE ADJ8043604 ARNULFO IBANEZ VILLAR EDMUND KIM INTERNATIONAL INC LIBERTY MUTUAL PLEASANTON ADJ7174375 ARTEMIZA AH NEWTON NEW HORIZONS LIBERTY MUTUAL PLEASANTON ADJ7981905 JESUS GALVAN ASHLEYS FURNITURE LIBERTY MUTUAL PLEASANTON ADJ976276 MAGDALENA VILLASENOR HACOR INC. LIBERTY MUTUAL PLEASANTON ADJ7283862 MARIA HERRERA TEAMWORK ATHLETIC APPAREL LIBERTY MUTUAL PLEASANTON ADJ8719802 AIDA AVILA BCI THE NEWARK GROUP LIBERTY MUTUAL ROCKLIN ADJ2691710 ANDRES MARCOS US TILE CO LIBERTY MUTUAL ROCKLIN ADJ8454601 ANGEL ARECHIGA JUST TIRES LIBERTY MUTUAL ROCKLIN ADJ2954599 ANGEL LAZO ASPLUNDH TREE EXPERT LIBERTY MUTUAL ROCKLIN ADJ7632831 ANGELICA LOPEZ IKEA LIBERTY MUTUAL ROCKLIN ADJ7189130 ANGELICA MOLINA LOPEZ WINCO FOODS LIBERTY MUTUAL ROCKLIN ADJ9319197 ARTURO CHAVEZ TRIUMPH AEROSTRUCTURES LIBERTY MUTUAL ROCKLIN ADJ7432959 BEATRIZ TORRES ARS NATIONAL LIBERTY MUTUAL ROCKLIN ADJ690013 BOONSONG MANLEY SHURFLO LIBERTY MUTUAL ROCKLIN ADJ6598564 BRADLEY PARRISH TURNER CONSTRUCTION LIBERTY MUTUAL ROCKLIN ADJ8130944 BYRON HAYES RICOH CORPORATION LIBERTY MUTUAL ROCKLIN ADJ7898225 CANDELARIO ROSAS PROS RANCH MARKET LIBERTY MUTUAL ROCKLIN ADJ8407556 CANDELARIO ROSAS PROS RANCH MARKET LIBERTY MUTUAL ROCKLIN ADJ9617305 CARLOS NAVARRO ANTHONY A DOVER LIBERTY MUTUAL ROCKLIN ADJ3661222 CARMEN VALLARDES PHILIPS VAN HUESEN CORP LIBERTY MUTUAL ROCKLIN ADJ6818070 CECILIA ROBLEDO SIEMENS LIBERTY MUTUAL ROCKLIN ADJ7558206 CESAR PEREZ CHAVEZ OLIVE GARDEN USA LIBERTY MUTUAL ROCKLIN ADJ8781760 CHRIE CHISM U.S. EXPRESS ENTERPRISER, INC. 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Case Number Injured Worker Employer Claims Administrator ------ADJ6974959 JESUS GONZALEZ CENTRILIFT LIBERTY MUTUAL ROCKLIN ADJ1545982 JOHN BODNAR UNITED TECHNOLOGIES CORP. LIBERTY MUTUAL ROCKLIN ADJ7925446 JOSE ANTONIO PEREZ MAMMOTH MOUNTAIN LIBERTY MUTUAL ROCKLIN ADJ9514836 JOSE COVARRUBIAS UTILITY TREE SERVICE LIBERTY MUTUAL ROCKLIN ADJ9374255 JOSE DE LA TRINIDAD UTILITY TREE SERVICE INC LIBERTY MUTUAL ROCKLIN ADJ8370868 JOSE DIAZ GREENBERRY TANK AND IRON LIBERTY MUTUAL ROCKLIN ADJ7355046 JOSE INGUANZO BAY ALARM LIBERTY MUTUAL ROCKLIN ADJ2244446 JOSE MONTIEL TRIUMPH STRUCTURES LIBERTY MUTUAL ROCKLIN ADJ7562073 JOSE NOCHEZ PHILLIPS VAN HEUSEN CORPORATION LIBERTY MUTUAL ROCKLIN ADJ7181314 JOSE ZETINA DESERT COMERCIAL CONCRETE LIBERTY MUTUAL ROCKLIN ADJ8765058 JOSEFINA PELAYO ADDUS HEALTHCARE INC LIBERTY MUTUAL ROCKLIN ADJ2572030 JOSH RODRIGUEZ GATE GOURMET LIBERTY MUTUAL ROCKLIN ADJ9539525 JOSUE PATRICIO BAKEMARK USA LLC LIBERTY MUTUAL ROCKLIN ADJ8223553 JUANA ESCOBAR GRACIELA KIM LIBERTY MUTUAL ROCKLIN ADJ7770128 JULIO SANTOS UNITED SITE SERVICES LIBERTY MUTUAL ROCKLIN ADJ8534175 KAREN JOVEL DIRECTV HOME SVCS LIBERTY MUTUAL ROCKLIN ADJ999003 LANE MOORE 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WINCO FOODS LIBERTY MUTUAL ROCKLIN ADJ8111127 TYREE BURNETT FAIRFIELD RESIDENTIAL LLC LIBERTY MUTUAL ROCKLIN ADJ7951329 ULYSSES ABURTO DIRECT TV OPERATIONS LLC LIBERTY MUTUAL ROCKLIN ADJ8807098 VICENTE VALENZUELA REPIPE CALIFORNIA INC LIBERTY MUTUAL ROCKLIN ADJ7750738 VICTOR ARELIS PRO S RANCH MARKET INC LIBERTY MUTUAL ROCKLIN ADJ3808359 WINIFRED DEMAREE REGAL ENTERTAINMENT LIBERTY MUTUAL ROCKLIN ADJ7144942 YOLANDA LOPEZ WINCO HOLDING 36 LIBERTY MUTUAL ROCKLIN ADJ7130898 SYLVIA SALAZAR CATERPILLAR LIBERTY MUTUAL ROCKLIN ADJ8402729 DAVID BRECEDA ASPLUNDH TREE EXPERTS LIBERTY MUTUAL SACRAMENTO ADJ7580456 JOSE BRIZUELA COPART SALVAGE AUTO AUCTION LIBERTY MUTUAL SACRAMENTO ADJ6784433 ARELY LOVATO LIGHTHOUSE HEALTH LIGHTHOUSE HEALTH ADJ6746136 JESUS NAVA LINK STAFFING SERVICES LINK STAFFING SERVICES ADJ8979763 SERGIO MALDONADO LOMA LINDA UNIVERSITY LOMA LINDA UNIVERSITY ADJ8050164 ANGELICA LAWRENCE LOMA LINDA MEDICAL CENTER LOMA LINDA UNIVERSITY LOMA LINDA ADJ8463041 ELIDA RODRIGUEZ LOMA LINDA MEDICAL CENRTER LOMA LINDA UNIVERSITY LOMA LINDA ADJ997838 RUBEN CHAVIRA LOMA LINDA UNIVERSITY MEDICAL CENTE LOMA LINDA UNIVERSITY LOMA LINDA ADJ8979763 SERGIO MALDONADO LOMA LINDA UNIVERSITY LOMA LINDA UNIVERSITY LOMA LINDA ADJ7465282 LORI ERICKSON LONG BEACH UNIFIED SCHOOL DISTRICT LONG BEACH UNIFIED SCHOOL DISTRICT ADJ6698924 CHARMETRA BURRUS LOS ANGELES COUNTY MTA LOS ANGELES COUNTY MTA ADJ7247697 MARIA PEREZ LOS ANGELES COUNTY USC MEDICAL LOS ANGELES COUNTY USC MEDICAL ADJ6698924 CHARMETRA BURRUS LOS ANGELES COUNTY MTA LOS ANGELES METROPOLITAN AUTHORITY ADJ7366531 GEORGE GARCIA LACMTA LOS ANGELES METROPOLITAN AUTHORITY ADJ708710 JOHN CAMMON LACMTA LOS ANGELES METROPOLITAN AUTHORITY ADJ6515062 JUAN MANUEL HERNANDEZ ORTIZ LACMTA LOS ANGELES METROPOLITAN AUTHORITY ADJ1423360 PATRICIA LEWIS LACMTA LOS ANGELES METROPOLITAN AUTHORITY ADJ7067283 PATTY SCRANTON LACMA LOS ANGELES METROPOLITAN AUTHORITY ADJ7165452 GEORGE PARSONS LOS ANGELES UNIFIED SCHOOL DISTRICT LOS ANGELES UNIFIED 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LUMBERMENS UNDERWRITING BOCA RATON ADJ9052633 BELINDA MALDONADO TSE PEO INC CALIFORNIA BUSINESS STAFFING INC LUMBERMENS UNDERWRITING BOCA RATON ADJ8937445 BRENDA PEREZ TRI STATE PEO LUMBERMENS UNDERWRITING BOCA RATON ADJ7505328 BRITTANIE JENSEN PREMIER MEDICAL TRANSPORTATION LUMBERMENS UNDERWRITING BOCA RATON Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ968312 CARMEN PEREZ CARDENAS MARKETS INC LUMBERMENS UNDERWRITING BOCA RATON ADJ8504577 CHESTER THOMAS TRI STATE STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ7191477 CIPRIANO ARMENTA CALIFORNIA LANDSCAPE LUMBERMENS UNDERWRITING BOCA RATON ADJ9171138 DANNY GUERRERO DIAMOND STAFFING INC LUMBERMENS UNDERWRITING BOCA RATON ADJ8399846 EMILLIANO SEVERIANO TRI-STATE STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ8119961 ENRIQUE VELASQUEZ ACCOUNTABILITIES EMPLOYMENT SERVICES INC LUMBERMENS UNDERWRITING BOCA RATON ADJ7608344 ESTELA CALDERON REDBARN PET PRODUCTS LUMBERMENS UNDERWRITING BOCA RATON ADJ9129290 EVA DE LA TORRE TRI STATE EMPLOYMENT LUMBERMENS UNDERWRITING BOCA RATON ADJ7646403 FLAVIO MARTINEZ PRIME SKILL STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ9309837 FRANCISCO VELAZQUEZ PIRATE STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ9198558 GABRIELA ISLAS CALIBER GROUP LUMBERMENS UNDERWRITING BOCA RATON ADJ8879184 GUADALUPE GUERRERO MALDONADO TRI STATE STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ6918360 GUADALUPE MURATALLA TRI STATE STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ8177764 HOVHANNES HOVHANNISYAN TRI STATE STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ7900920 JESUS AYALA CALIFORNIA MEDICAL INNOVATION LUMBERMENS UNDERWRITING BOCA RATON ADJ9268879 JOVITA CORTEZ EMPLOYERS RESOURCE MANAGEMENT LUMBERMENS UNDERWRITING BOCA RATON ADJ8274415 LILIA HERNANDEZ TRI STATE STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ8193278 LUIS PRECIADO TEAM ONE STAFFING SERVICES INC LUMBERMENS UNDERWRITING BOCA RATON ADJ8448659 MANUEL RAMIREZ TRI STATE STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ8267361 MARCOS LOPEZ ATLAS RESOURCES LUMBERMENS UNDERWRITING BOCA RATON ADJ8267361 MARCOS LOPEZ BBSI LUMBERMENS UNDERWRITING BOCA RATON ADJ7626247 MARGARITA MURILLO SUNSHINE LANDSCAPE LUMBERMENS UNDERWRITING BOCA RATON ADJ9374336 MARIA COLMENARES TRI STATE EMPLOYMENT SERVICES LUMBERMENS UNDERWRITING BOCA RATON ADJ8400872 MARIA DEL CARMEN ALLEGRO MANUFACTURING LUMBERMENS UNDERWRITING BOCA RATON ADJ7079472 MARIA MARTINEZ GLEN PARK RETIREMENT HOME LUMBERMENS UNDERWRITING BOCA RATON ADJ8811171 MARIA RUIZ FLEETWOOD FIBRE LUMBERMENS UNDERWRITING BOCA RATON ADJ8811171 MARIA RUIZ LG STAFFING SOLUTIONS ON DEMAND INC LUMBERMENS UNDERWRITING BOCA RATON ADJ8103876 MARIA VAZQUEZ PRIORITY BLDG SERVICES LUMBERMENS UNDERWRITING BOCA RATON ADJ9201221 MARIO CRUZ TRI STATE DIAMOND STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ8951328 MARIO PEREZ TRI STATE PEO LUMBERMENS UNDERWRITING BOCA RATON ADJ8536660 MILI AVILA PRIORITY BUILDING SERVICES LLC LUMBERMENS UNDERWRITING BOCA RATON ADJ8664253 NAHUN ALDANA MORENO A K LANDSCAPE LUMBERMENS UNDERWRITING BOCA RATON ADJ9185856 PATRICIA SANDOVAL TS STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ8601000 PORFIRIO DOMINGUEZ TR-STE LUMBERMENS UNDERWRITING BOCA RATON ADJ9000100 RAMONA RUBIO ZAMORA EMPLOYMENT RESOURCES AND SOLUTIONS LUMBERMENS UNDERWRITING BOCA RATON ADJ9000100 RAMONA RUBIO ZAMORA PROVIDIAN STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ9000100 RAMONA RUBIO ZAMORA TRI STATE EMPLOYMENT SERVICES INC LUMBERMENS UNDERWRITING BOCA RATON ADJ7919068 RAUL FLORES PHARAOHS ADVENTURE PARK LUMBERMENS UNDERWRITING BOCA RATON ADJ8727107 RAYMOND RODARTE REEIS LUMBERMENS UNDERWRITING BOCA RATON ADJ9614829 RENE HERNANDEZ COAST PACKING LUMBERMENS UNDERWRITING BOCA RATON ADJ9614829 RENE HERNANDEZ KAMRAN STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ8472143 REYNA DIAZ FIRST LINE STAFFING INC DBA TRI STATE EMPLOYMENT SERVICE LUMBERMENS UNDERWRITING BOCA RATON ADJ8235571 RICARDO MUNOZ JK RESIDENTIAL SERVICES LUMBERMENS UNDERWRITING BOCA RATON ADJ9188851 ROBERT JONES TRI STATE STAFFING LUMBERMENS UNDERWRITING BOCA RATON ADJ8197809 SALVADOR PELAYO STAVROS ENTERPRISES INC DBA FACILITEC WEST ERM LUMBERMENS UNDERWRITING BOCA RATON ADJ7815681 YOLANDA NAVARRO ACCOUNTABILITIES INC LUMBERMENS UNDERWRITING BOCA RATON ADJ150324 BLANCA AYALA DAY BREAK CARE CENTER LWP CLAIMS GLENDALE ADJ3353957 JORGE SORIA GENTLE GIANT MOVING COMPANY LWP CLAIMS GLENDALE ADJ8018511 MICHAEL CAESAR ANDREWS INTERNATIONAL SECURITY LWP CLAIMS GLENDALE ADJ8548889 MICHAEL GREAVES LOS ANGELES COUNTY LWP CLAIMS GLENDALE ADJ7785452 ORALIA LOPEZ DIAZ S AND H PACKING AND SALES CO INC LWP CLAIMS GLENDALE ADJ9322594 ROSA AVILES QUAKER GARDENS LWP CLAIMS GLENDALE ADJ3979537 ANDREW URAINE ARTIC MECHANICAL LWP CLAIMS SACRAMENTO ADJ9137507 CARLOS LOPEZ SO CAL CONCEPTS LWP CLAIMS SACRAMENTO ADJ9137507 CARLOS LOPEZ SO CAL CONCEPTS INC LWP CLAIMS SACRAMENTO ADJ6559099 DANIEL MARTINEZ DAVID REAUME CONSTRUCTION INC LWP CLAIMS SACRAMENTO ADJ6559099 DANIEL MARTINEZ PILCAYA HARDWOOD FLOOR LWP CLAIMS SACRAMENTO ADJ3353957 JORGE SORIA GENTLE GIANT MOVING COMPANY LWP CLAIMS SACRAMENTO ADJ3004024 JULIAN GALLARDO HOLT ELECTRIC LWP CLAIMS SACRAMENTO ADJ6632994 LUIS FIGUEROA MISSION LANDSCAPING SERVICES LWP CLAIMS SACRAMENTO ADJ1099212 MANUEL FIGUEROA MISSION LANDSCAPE SERVICE INC LWP CLAIMS SACRAMENTO ADJ7406178 RAMIRO ROMERO HOME DELIVERY LINK LWP CLAIMS SACRAMENTO ADJ1222177 ROBERT OCHOA KING RELOCATION LWP CLAIMS SACRAMENTO ADJ6875565 SALVADOR OJEDA FARMDALE CREAMERY LWP CLAIMS SACRAMENTO ADJ2186553 ANTONIO SANDOVAL JOHNSON & KNUE LWP CLAIMS SOLUTIONS ADJ1409602 FERNANDO HERNANDEZ PACIFIC WEST INTERIOR LWP CLAIMS SOLUTIONS ADJ3883143 JOE SHAB PILGRIM PLACE LWP CLAIMS SOLUTIONS ADJ2630420 LIDIA RAMOS PELICAN PRODUCTS LWP CLAIMS SOLUTIONS ADJ1820428 PEDRO ALVAREZ ACCREDITED CLEANIN SERVICES INC. LWP CLAIMS SOLUTIONS ADJ1261552 PERFECTO BARRIOS GROUND MAINTENANCE SERVICES LWP CLAIMS SOLUTIONS ADJ1222177 ROBERT OCHOA KING RELOCATION LWP CLAIMS SOLUTIONS ADJ7438042 ELLEN TOMINELLO MACY'S INC MACYS INC ADJ7438042 ELLEN TOMINELLO MACYS INC MACYS INC ADJ7438042 ELLEN TOMINELLO MACY'S INC MACY'S INC ADJ7438042 ELLEN TOMINELLO MACYS INC MACY'S INC ADJ6726069 ADOLFO GARCIA MACYS LOGISTIC AND OPERATIONS MACYS LOGISTIC AND OPERATIONS ADJ6726069 ADOLFO GARCIA MACYS LOGISTIC AND OPERATIONS MACYS REDONDO BEACH ADJ7924598 ANNE MADISON MACY S MACYS REDONDO BEACH ADJ9072639 DAVID IRIZARRY MACYS MACYS REDONDO BEACH ADJ7438042 ELLEN TOMINELLO MACY'S INC MACYS REDONDO BEACH ADJ7438042 ELLEN TOMINELLO MACYS INC MACYS REDONDO BEACH ADJ806926 GUADALUPE AYALA MACY'S MACYS REDONDO BEACH ADJ1362174 HONARVAR BAHMAN MACY'S WEST MACYS REDONDO BEACH ADJ2536609 JUAN GARCIA MACYS MACYS REDONDO BEACH ADJ7510544 LEVON ASLANYAN MACYS WEST INC MACYS REDONDO BEACH Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6816521 MADELINE WRIGHT MACYS MACYS REDONDO BEACH ADJ9223303 PAULA SARRADE BLOOMINGDALES MACYS REDONDO BEACH ADJ639466 SERGIO GUTIERREZ ROBINSON'S MAY MACYS REDONDO BEACH ADJ7111404 SUSANA MARTINEZ MACYS MACYS REDONDO BEACH ADJ7459671 WENDY CHACON MACY`S LOGISTICS & OPERATIONS MACYS REDONDO BEACH ADJ3934073 ZACHERY STEWARD MACYS INC MACYS REDONDO BEACH ADJ7936487 MARTHA TELLES MACYS MACYS REDONDO BEACH ADJ9557851 ASUNCION LOPEZ MAGNA FLOW MAGNA FLOW ADJ4676421 ROBERT BARRON AVL STAFFING MAINSTAY BUSINESS SOLUTIONS ADJ4676421 ROBERT BARRON CA SELF INSURED SECURITY FUND ESTATE MAINSTAY MAINSTAY BUSINESS SOLUTIONS ADJ6631985 CYNTHIA CUEVAS MAINSTAY BUSINESS SOLUTIONS MAINSTAY BUSINESS SOLUTIONS FOLSOM ADJ7543124 GERARDO HERRERA ON TIME STAFFING INC MAINSTAY BUSINESS SOLUTIONS FOLSOM ADJ1272257 RUDY CHICAS STAFF CHEX MAINSTAY BUSINESS SOLUTIONS FOLSOM ADJ7954830 RICARDO ARIAS AGUIRRE MANGEN GROUP MANGEN GROUP ADJ7954830 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SERVICES OMAHA ADJ7353027 IRMA CASTRO CAREER DEVELOPMENT INSTITUTE MARKEL SERVICES OMAHA ADJ7301706 IRMA CORRALES PREMIER MAILING SERVICES MARKEL SERVICES OMAHA ADJ7490726 ISRAEL CABRERA WASHINGTON SOUARE MARKET MARKEL SERVICES OMAHA ADJ7908118 ISRAEL VILLALOBOS CLEMENTS DYE MARKEL SERVICES OMAHA ADJ6613598 JOSE CASTELLON MARTINEZ TOM DEJON DAIRY MARKEL SERVICES OMAHA ADJ6543131 JOSE DIAZ K YOUNG FASHION INC MARKEL SERVICES OMAHA ADJ7238333 JOSE FIGUEROA AY NURSERY MARKEL SERVICES OMAHA ADJ7926348 JOSE TEMORES PACIFIC COAST BUILDING C MARKEL SERVICES OMAHA ADJ7191661 JOSEFINA CORNEJO PATE GROUP HOMES DBA PATE SMALL FAMILY HOME MARKEL SERVICES OMAHA ADJ7006226 JUAN ORTEGA NAMON USA CO DBA EC WORLD MARKEL SERVICES OMAHA ADJ6812425 JULIA MARTINEZ LIFE STYLES MAID SERVICES MARKEL SERVICES OMAHA ADJ7268941 MARIA CARDENAS ELITE BUILDING SERVICES MARKEL SERVICES OMAHA ADJ7350242 MARIA GONZALEZ SOUTH STREET THRIFT MARKEL SERVICES OMAHA ADJ8085398 MARIA LEONOR ZD ENTERPRISES INC MARKEL SERVICES OMAHA ADJ6884074 NAHID SHADROOZ DISPENSE XPRESS INC MARKEL SERVICES OMAHA ADJ9200972 PETRA HERRERA LEE S SANDWICHES MARKEL SERVICES OMAHA ADJ8699717 ROBERT LUCAS SADDLEBACK GRILL MARKEL SERVICES OMAHA ADJ8105808 SALVADOR GARCIA MARTINEZ TRIEPKE GLASS CO MARKEL SERVICES OMAHA ADJ7723740 SHAUN RODRIGUEZ SO CALIFORNIA RETAIL SERVICES INC MARKEL SERVICES OMAHA ADJ7265433 VICTOR DIAZ ARIAS IRON GRIP BARBELL MARKEL SERVICES OMAHA ADJ6809045 YVONNE DAWSON MARGARET ATKINS CREATIVE LIVING MARKEL SERVICES OMAHA ADJ1967938 MARITZA RENGIFO MARRIOTT RESIDENCE INN MARRIOTT CLAIMS SERVICES ADJ7491276 ARLETTE DE LOS RIOS ANAHEIM MARRIOTT MARRIOTT HOT SPRINGS ADJ8929923 ARTURO MORINO MARRIOTT HOTELS RESORTS MARRIOTT HOT SPRINGS ADJ6789087 CARMEN MARTINEZ RITZ CARLTON HOTEL MARRIOTT HOT SPRINGS ADJ8288938 GUADALUPE PEREZ MARRIOTT MARRIOTT HOT SPRINGS ADJ8364586 HERLINA DE CORTEZ MARRIOTT BUSINESS SERVICES MARRIOTT HOT SPRINGS ADJ6932553 HUMBERTO GOMEZ ANAHEIM MARRIOTT MARRIOTT HOT SPRINGS ADJ2728177 MARIA ARGUELLO DESERT SPRINGS RESORT MARRIOTT HOT SPRINGS ADJ9538133 MICHELLE RODRIGUEZ RENAISSANCE LAX MARRIOTT HOT SPRINGS ADJ8268173 NICANOR CANUL ANAHEIM MARRIOTT MARRIOTT HOT SPRINGS ADJ910032 OFELIA GARCIA MARRIOTT VILAS MARRIOTT HOT SPRINGS ADJ7279152 RAFAEL SORIA MARRIOT HOTEL MARRIOTT HOT SPRINGS ADJ7279152 RAFAEL SORIA MARRIOTT INTERNATIONAL MARRIOTT HOT SPRINGS ADJ8857178 RAUL GONZALEZ MARRIOT HOTEL MARRIOTT HOT SPRINGS ADJ6630520 SONIA POSADA MARRIOTT HOTEL MARRIOTT HOT SPRINGS ADJ7870451 TITUS PALMER MANHATTAN BEACH MARRIOTT MARRIOTT HOT SPRINGS ADJ1982866 LEON HOWARD MARTEN TRANSPORT MARTEN TRANSPORT ADJ9442350 PATRICIA ALVARADO PACIFIC ALLIANCE MEDICAL CENTER MATRIX ABSENCE MANAGEMENT ADJ8019042 HUMBERTO VELADO EL SUPER NO 37 MATRIX LAS VEGAS ADJ6422257 JAIME GONZALEZ SUPERIOR WAREHOUSE MATRIX LAS VEGAS ADJ9139870 FERNANDO ALONSO LA SPECIALTY PRODUCE CO INC MATRIX RANCHO CUCAMONGA ADJ1883909 LARRY BACKER AMTECH ELEVATOR SERVICES MATRIX RANCHO CUCAMONGA ADJ1883909 LARRY BACKER UNITED TECHNOLOGIES CORP. MATRIX RANCHO CUCAMONGA ADJ6995348 NATALIO CANCHE SUPERIOR GROCERIES MATRIX RANCHO CUCAMONGA ADJ6995348 NATALIO CANCHE SUPERIOR GROCERS MATRIX RANCHO CUCAMONGA ADJ2760461 CAYETANO ESTRADA-CASTILLO WALLDESIGN INC MATRIX ROCKLIN ADJ9394601 FRANCISCO SOTO EL SUPER MATRIX ROCKLIN ADJ9211069 JOSE GARCIA PEREZ EL SUPER MATRIX ROCKLIN ADJ7898208 JOSE JESUS SEVILLA EL SUPER MATRIX ROCKLIN ADJ9511487 JUAN QUINONEZ EL SUPER MARKET MATRIX ROCKLIN ADJ7404121 JULIO SALAS VINTAGE PLASTERING INC MATRIX ROCKLIN ADJ8508732 JUQIONG YIN TAWA SUPERMARKET INC MATRIX ROCKLIN ADJ9184624 MARIA AVINA EL SUPER MATRIX ROCKLIN ADJ6939776 MARIO RODRIGUEZ VINTAGE PLASTERING INC MATRIX ROCKLIN ADJ6995348 NATALIO CANCHE SUPERIOR GROCERIES MATRIX ROCKLIN ADJ6995348 NATALIO CANCHE SUPERIOR GROCERS MATRIX ROCKLIN Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7865647 RAMON GONZALEZ SUPERIOR SUPER WAREHOUSE MATRIX ROCKLIN ADJ1210650 RIGOBERTO TORRES LUCILLE SMOKEHOUSE BAR-B-QUE MATRIX ROCKLIN ADJ6860471 SHIRLEY VILLARREAL SOUTH BAY FAMILY MEDICAL GROUP MATRIX ROCKLIN ADJ8246546 ADOLFO CASTILLO GONZALEZ FARM SERVICES MEADOWBROOK INSURANCE LAS VEGAS ADJ7645725 ALONDRA PARAMO NINO FARM LABOR CONTRACTOR MEADOWBROOK INSURANCE LAS VEGAS ADJ8221192 AURELIO LEON VELORIA FARM LABOR CONTRACTING MEADOWBROOK INSURANCE LAS VEGAS ADJ7148519 CANDY VERGARA ZADRO PRODUCTS MEADOWBROOK INSURANCE LAS VEGAS ADJ9173606 CONSUELO ROSALES SANTIAGO RIOS DBA RIOS FARM LABOR CONTRACTING MEADOWBROOK INSURANCE LAS VEGAS ADJ9511692 DELFINA HERNANDO SYSTEMS PRINT AND MAIL MEADOWBROOK INSURANCE LAS VEGAS ADJ7159790 DELFINO MONDRAGON MEDWILL INC MEADOWBROOK INSURANCE LAS VEGAS ADJ7159790 DELFINO MONDRAGON POPULAR FURNITURE DBA MEDWILL INC MEADOWBROOK INSURANCE LAS VEGAS ADJ9252152 EMILIA REYES E AND J LABOR INC MEADOWBROOK INSURANCE LAS VEGAS ADJ9028460 EMILIANO CASTRO CHARLES SIHILLING METAL POLISHING INC MEADOWBROOK INSURANCE LAS VEGAS ADJ8009796 FAUSTINO BASABES MIKE ETCHANDRY FARIAS INC MEADOWBROOK INSURANCE LAS VEGAS ADJ8009796 FAUSTINO BASABES MIKE ETCHANDY FARIAS INC MEADOWBROOK INSURANCE LAS VEGAS ADJ7460484 FRANCISCO GUZMAN MEG GUNITE INC MEADOWBROOK INSURANCE LAS VEGAS ADJ8784690 FRANCISCO VENTURA MENDOZA FARM LABOR CONTRACTI MEADOWBROOK INSURANCE LAS VEGAS ADJ7822777 GEORGE GOMEZ ONE STOP PARTS SOURCE MEADOWBROOK INSURANCE LAS VEGAS ADJ7848218 GONZALO FAUSTINO MIKE ETCHANDY FARMS MEADOWBROOK INSURANCE LAS VEGAS ADJ9042697 GONZALO MENDOZA FRANCISCO RODRIGUEZ FARM LABOR MEADOWBROOK INSURANCE LAS VEGAS ADJ7871127 GREGORIO VAZQUEZ J L PADILLA SONS LABOR SERVICES MEADOWBROOK INSURANCE LAS VEGAS ADJ7110481 GUADALUPE MEJIA ALVARO MERCADO PEREGRINA MEADOWBROOK INSURANCE LAS VEGAS ADJ9128320 JAVIER RIZO PEREZ MANUEL ALONSO MENDOZA MEADOWBROOK INSURANCE LAS VEGAS ADJ9128320 JAVIER RIZO PEREZ MANUEL ALONZO MENDOZA MEADOWBROOK INSURANCE LAS VEGAS ADJ8538376 JORGE CEBALLOS POSADA ROYALE HOTEL SUITES MEADOWBROOK INSURANCE LAS VEGAS ADJ9203065 JOSE DE JESUS ORGANISTA STATEWIDE LABOR CORPORATION MEADOWBROOK INSURANCE LAS VEGAS ADJ7807122 JOSE DIAZ M M LABOR SERVICE MEADOWBROOK INSURANCE LAS VEGAS ADJ7893567 JOSE QUIJANO DIAMOND LANDSCAPING INC MEADOWBROOK INSURANCE LAS VEGAS ADJ8480617 JOSEFA SOTO MIKE ETCHANDY FARMS INC MEADOWBROOK INSURANCE LAS VEGAS ADJ8033311 LUCINO REYES BARBOSA ONE WAY AUTO USED AUTO PARTS MEADOWBROOK INSURANCE LAS VEGAS ADJ8643223 MANUEL AYON LA VINA CONTRACTING MEADOWBROOK INSURANCE LAS VEGAS ADJ8564157 MANUEL GARCIA JUMBO WIN INC MEADOWBROOK INSURANCE LAS VEGAS ADJ8443008 MARIA CARRILLO S AND K FARM LABOR SERVICE MEADOWBROOK INSURANCE LAS VEGAS ADJ8958361 MARIA NAVARRO SUPREME VALLEY AGRICULTURE MEADOWBROOK INSURANCE LAS VEGAS ADJ9288863 MARIA SANDOVAL SUNSET FARMS MEADOWBROOK INSURANCE LAS VEGAS ADJ8056229 MARIA TAMAYO HMN INC MEADOWBROOK INSURANCE LAS VEGAS ADJ7548288 MARIBEL BARAJAS INDEX FRESH INC MEADOWBROOK INSURANCE LAS VEGAS ADJ8664499 MARIBEL ORTIZ KERN AGRICULTURAL LABOR MANAGEMENT MEADOWBROOK INSURANCE LAS VEGAS ADJ7811828 MAURICIO GARZON VISION BUILDERS GROUP MEADOWBROOK INSURANCE LAS VEGAS ADJ8177717 NARZIDALIA MEDINA CENTRAL COAST PACKING MEADOWBROOK INSURANCE LAS VEGAS ADJ8869207 NATHANIEL MCNURLIN A1 EVENT RENTALS MEADOWBROOK INSURANCE LAS VEGAS ADJ8161543 OLGA VELASQUEZ MODERN EMBROIDERY INC MEADOWBROOK INSURANCE LAS VEGAS ADJ7410534 PATRICIA PASILLAS WESTMINISTER LODGING INC DBA BUDGET INN MEADOWBROOK INSURANCE LAS VEGAS ADJ7410534 PATRICIA PASILLAS WESTMINSTER LODGING INC DBA BUDGET INN MEADOWBROOK INSURANCE LAS VEGAS ADJ8827131 ROBERTO COLIN HERNANDEZ CITY NATIONAL SECURITY SERVICES MEADOWBROOK INSURANCE LAS VEGAS ADJ8827131 ROBERTO COLIN HERNANDEZ CITY NATIONAL SECURITY SERVICES INC MEADOWBROOK INSURANCE LAS VEGAS ADJ8117392 ROBERTO HERNANDEZ TAPATIO AUTO AND TRUCK WRECKING INCORPORATED MEADOWBROOK INSURANCE LAS VEGAS ADJ8305843 ROBERTO MENDEZ RANCHO HARVEST INC MEADOWBROOK INSURANCE LAS VEGAS ADJ9490804 ROGELIO ROMAN RAMON HAYDEE AMADOR ORTIZ DBA LUXES FARM MEADOWBROOK INSURANCE LAS VEGAS ADJ7605180 ROMAN HERNANDEZ ROLLINGS AUTOMOTIVE MEADOWBROOK INSURANCE LAS VEGAS ADJ7702173 SANDRA LEON MODERN EMBROIDERY INC MEADOWBROOK INSURANCE LAS VEGAS ADJ8895798 SERGIO GARCIA E J LABOR MEADOWBROOK INSURANCE LAS VEGAS ADJ8895798 SERGIO GARCIA EJ LABOR MEADOWBROOK INSURANCE LAS VEGAS ADJ7929235 SILVANO MARTINEZ S AND R FARM LABOR CONTRACTOR MEADOWBROOK INSURANCE LAS VEGAS ADJ7929235 SILVANO MARTINEZ SR FARM LABOR CONSTRUCTION MEADOWBROOK INSURANCE LAS VEGAS ADJ8398784 TAMI CUARON BRACKENS BIRD FARM MEADOWBROOK INSURANCE LAS VEGAS ADJ8398839 VICENTA ARENAS RMT CONTRACTING MEADOWBROOK INSURANCE LAS VEGAS ADJ7766786 WERCLEIN MENDOZA R AND L CONTRACTING MEADOWBROOK INSURANCE LAS VEGAS ADJ7135029 YOLANDA CUEVAS WENDYS MEADOWBROOK INSURANCE LAS VEGAS ADJ7356765 OSCAR ARDON MA MEDINA FLS MEADOWBROOK INSURANCE LAS VEGAS ADJ8602056 SHOUSHIK MARDIROSIAN MEDPOINT MANAGEMENT MEDPOINT MANAGEMENT ADJ6781237 ADOLFO MERAZ PACIFIC CONTAINER TERMINALS METRO RISK LONG BEACH ADJ6781237 ADOLFO MERAZ SSA MARINE METRO RISK LONG BEACH ADJ2456001 ALEJANDRO BOJORQUEZ FLEETWOOD ENTERPRISES METRO RISK LONG BEACH ADJ2456001 ALEJANDRO BOJORQUEZ FLEETWOOD MOTORS METRO RISK LONG BEACH ADJ7414096 ANTHONY WILLIAMS METRO CRUISE SERVICES METRO RISK LONG BEACH ADJ7414096 ANTHONY WILLIAMS METRO CRUSE LINES METRO RISK LONG BEACH ADJ6784433 ARELY LOVATO LIGHTHOUSE HEALTH METRO RISK LONG BEACH ADJ6631985 CYNTHIA CUEVAS MAINSTAY BUSINESS SOLUTIONS METRO RISK LONG BEACH ADJ904681 ELIZABETH MENDOZA BELLA VISTA HOME METRO RISK LONG BEACH ADJ904681 ELIZABETH MENDOZA SELF INSURERS FUND METRO RISK LONG BEACH ADJ4633788 GEORGE HERNANDEZ GOLDEN STATE HEALTH CENTERS METRO RISK LONG BEACH ADJ3161563 JAIME LOPEZ VALADEZ VINTAGE PLASTERING INC METRO RISK LONG BEACH ADJ6625052 JAIME TORRES BLANCO DIVERSE STAFFING METRO RISK LONG BEACH ADJ3693701 JOEL RAMIREZ TEMPLE COMMUNITY HOSPITAL METRO RISK LONG BEACH ADJ2928607 JUAN MARITNEZ PRODUCTION PLUS PLUMBING METRO RISK LONG BEACH ADJ6839975 JUAN SOTELO NATIONAL RV METRO RISK LONG BEACH ADJ6470074 MADELYN ARCHIBALD RANCHO CUCAMONGA COMMUNITY HOSPITAL METRO RISK LONG BEACH ADJ6470074 MADELYN ARCHIBALD RANCHO SPECIALTY HOSPITAL METRO RISK LONG BEACH ADJ7095634 MARCELINO ORTIZ FREEDOM COMMUNICATIONS INC METRO RISK LONG BEACH ADJ6939776 MARIO RODRIGUEZ VINTAGE PLASTERING INC METRO RISK LONG BEACH ADJ9861527 MARTHA PERALES VARGAS OXFORD SERVICES METRO RISK LONG BEACH ADJ4676421 ROBERT BARRON AVL STAFFING METRO RISK LONG BEACH ADJ4676421 ROBERT BARRON CA SELF INSURED SECURITY FUND ESTATE MAINSTAY METRO RISK LONG BEACH ADJ7460204 SATANYA SWEENEY VISTA HOSPITAL OF RIVERSIDE METRO RISK LONG BEACH ADJ1687883 ELENO GONZALEZ PASADENA BAKING COMPANY MICHAEL COLARUSSO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9439837 ANA PLATERO MICHAEL JOHNSTONE & ASSOCIATES MICHAEL JOHNSTONE & ASSOCIATES ADJ6596404 MARLENE HERNANDEZ DENNYS RESTUARNT MID CENTURY INSURANCE ADJ9489728 ANTONIO GUTIERREZ GARCIA D AND R FOOD INC MID CENTURY INSURANCE COMPLANY ADJ9489728 ANTONIO GUTIERREZ GARCIA VILLAGE RANCH MARKET MID CENTURY INSURANCE COMPLANY ADJ9489728 ANTONIO GUTIERREZ GARCIA VILLAGE RANCH MARKET DBA LA FIESTA AMERICANA MID CENTURY INSURANCE COMPLANY ADJ9602501 ANA ARECHEGA MENDOZA TONHO INTERNATIONAL MID CENTURY INSURANCE FARMERS ADJ1621412 CARLOS ORREGO RESEDA AUTO & ELECTRIC MID CENTURY INSURANCE ORANGE ADJ8606265 CARMEN JAIME BALBAO ACQUISITION DBA BALBOA DESSERT COMPANY MID CENTURY INSURANCE ORANGE ADJ7804867 GUILLERMO ESTRADA K J BECKS INC (MCDONALDS) MID CENTURY INSURANCE ORANGE ADJ7804867 GUILLERMO ESTRADA KJ BECKS INC MCDONALDS MID CENTURY INSURANCE ORANGE ADJ7804867 GUILLERMO ESTRADA TALLYRAND MID CENTURY INSURANCE ORANGE ADJ8744351 JUAN ALBA GRAFFY FOODS INC DBA JACK IN THE BOX MID CENTURY INSURANCE ORANGE ADJ8233355 OMAR JIMENEZ CALIFORNIA CREATIVE FOODS MID CENTURY INSURANCE ORANGE ADJ9311480 YAN NING TANG J AND X INVESTMENT INC MID CENTURY INSURANCE ORANGE ADJ9509233 BLANCA GOMEZ GRAPHIC INK CORP MID CENTURY INSURANCE PLEASANTON ADJ7652294 GRISELDA ORNELAS TACO BELL MID CENTURY INSURANCE PLEASANTON ADJ7454498 JOSE YEPEZ RAH INDUSTRIES INC MID CENTURY INSURANCE PLEASANTON ADJ2061008 TEODOLFO LOPEZ CONNELL CHEVROLET MID-CENTURY INSURANCE ADJ7701458 MARICELA BORREGO TOM`S ORIGINAL SUPER BURGER MIDWEST INSURANCE COMPANIES ADJ8202795 FRANCISCO RAMOS IDS USA WEST MITSUI SUMITOMO CINCINNATI ADJ7443171 JOSE RAMOS NUMERO UNO MITSUI SUMITOMO CINCINNATI ADJ7620676 MARIO LOPEZ 7ELEVEN MITSUI SUMITOMO CINCINNATI ADJ6818414 BENJAMIN MORALES WESTERN TUBE & CONDUIT CORP MITSUI SUMITOMO UNIVERSAL CITY ADJ9383078 ELIZABETH ESCOBAR MCL FRESH MITSUI SUMITOMO UNIVERSAL CITY ADJ623013 JOSE VELAZQUEZ TROJAN BATTERY CO MITSUI SUMITOMO UNIVERSAL CITY ADJ8323334 MARIA JASSO CALAVO GROWERS INC MITSUI SUMITOMO UNIVERSAL CITY ADJ7495313 MARIA SANCHEZ CARROWS MITSUI SUMITOMO UNIVERSAL CITY ADJ7837318 OBLASTER GANDARILLA JSL FOODS INC MITSUI SUMITOMO UNIVERSAL CITY ADJ7470365 MIRNA MENDICUTI ACCOR LODGING NORTH AMERICA MOTEL 6 ADJ7072944 GILBERTO TORRES SYSTEM TRANSPORT INC MULLEN FILIPPI LOS ANGELES ADJ2164228 SALVADOR JACOBO AMPAM PARKS MECHANICAL INC NATIONAL FIRE INSURANCE COMPANY ADJ2164228 SALVADOR JACOBO PARKS MECHANICAL CONSTRUCTION NATIONAL FIRE INSURANCE COMPANY ADJ9533264 DAVID MORAN PAREDES HAWNK TRANSPORTATION NATIONAL INTERSTATE RICHFIELD ADJ6918398 EDWARD LEGARRETA GARDNER TRUCKING NATIONAL INTERSTATE RICHFIELD ADJ6918398 EDWARD LEGARRETA GARDNER TRUCKING, INC. NATIONAL INTERSTATE RICHFIELD ADJ8646005 JUANA MARTINEZ VILLANUEVA SANTA BARBARA TRANSPORTATION CORP NATIONAL INTERSTATE RICHFIELD ADJ9522631 MARIA HERNANDEZ UNITED OIL NATIONAL INTERSTATE RICHFIELD ADJ9212507 SERGIO DIAZ GARDNER TRUCKING INC NATIONAL INTERSTATE RICHFIELD ADJ6521438 ABELMIRA VARGAS WESTERN STATES POSTAL, INC. NATIONAL LIA AND FIRE SAN FRANCISCO ADJ6726144 ABRAHAM GARCIA DAYS INN & SUITES NATIONAL LIA AND FIRE SAN FRANCISCO ADJ4462208 INES GARCIA PARIS BAQUETT USA, INC. NATIONAL LIA AND FIRE SAN FRANCISCO NATIONAL UNION FIRE INSURANCE CO/GALLAGHER BASSETT ADJ2431336 RAJI HILAL PIZZA HUT SERVICES INC ADJ9531400 GRACE LAFFERTY ADVANCED CLINICAL EMPLOYMENT STAFFING NATIONAL UNION FIRE INSURANCE PITTSBURG ADJ9531400 GRACE LAFFERTY EMERALD HEALTH SERVICES NATIONAL UNION FIRE INSURANCE PITTSBURG ADJ9531400 GRACE LAFFERTY HEALTHSOURCE GLOBAL STAFFING NATIONAL UNION FIRE INSURANCE PITTSBURG ADJ9531400 GRACE LAFFERTY PROCARE ONE NURSES LLC NATIONAL UNION FIRE INSURANCE PITTSBURG ADJ9531400 GRACE LAFFERTY US NURSING CORP NATIONAL UNION FIRE INSURANCE PITTSBURG ADJ7024110 DIANA LARA ALBERTSONS NEW ALBERTSONS ADJ7024110 DIANA LARA NEW ALBERTSONS NEW ALBERTSONS ADJ9531400 GRACE LAFFERTY ADVANCED CLINICAL EMPLOYMENT STAFFING NEW HAMPSHIRE INSURANCE COMPANY ADJ9531400 GRACE LAFFERTY EMERALD HEALTH SERVICES NEW HAMPSHIRE INSURANCE COMPANY ADJ9531400 GRACE LAFFERTY HEALTHSOURCE GLOBAL STAFFING NEW HAMPSHIRE INSURANCE COMPANY ADJ9531400 GRACE LAFFERTY PROCARE ONE NURSES LLC NEW HAMPSHIRE INSURANCE COMPANY ADJ9531400 GRACE LAFFERTY US NURSING CORP NEW HAMPSHIRE INSURANCE COMPANY ADJ9313936 RICARDO ANAYA BORBON, INC. NEW HAMPSHIRE INSURANCE COMPANY ADJ7750178 MARIA HERNANDEZ NEWELL RUBBERMAID NEWELL RUBBERMAID ADJ7772209 RAFAELA HERNANDEZ NEWPORT CENTER ANIMAL HOSPITAL NEWPORT CENTER ANIMAL HOSPITAL ADJ4178496 EUGENIO MORENO NEXUS SERVICES INC NEXUS SERVICES INC ADJ8065065 AZENETH HERNANDEZ NFI INDUSTRIES INC NFI INDUSTRIES INC ADJ950331 MARTIN SANCHEZ CONTROL LOGISTICS NICA ADJ1433114 ANTONIO RAMIREZ TRINITY BROADCASTING NETWORK NORTH AMERICAN RISK ALTAMONTE SPRINGS ADJ1433114 ANTONIO RAMIREZ TRINITY CHRISTIAN CENTER NORTH AMERICAN RISK ALTAMONTE SPRINGS ADJ1297344 SARAH NELSON FRESNO LOCAL CONSERVATION CORPS NORTH AMERICAN RISK ALTAMONTE SPRINGS ADJ7722762 ANA NIETO LIFE CARE CENTERS OF AMERICA NOVAPRO RISK LAKE FOREST ADJ7872894 JAMES CARTER ESTENSON LOGISTICS NOVAPRO RISK LAKE FOREST ADJ6624656 MELQUIADES RAMIREZ ROYAL COURT-ENSIGN GROUP NOVAPRO RISK LAKE FOREST ADJ7499133 ARMANDO RODRIGUEZ AMERICAN GRAPHIC BOARD INC NOVAPRO RISK SOLUTIONS ADJ4337771 ROSARIO DE LA CRUZ U.S. GARMENTS OAK RIVER INSURANCE CO ADJ4337771 ROSARIO DE LA CRUZ US GARMENTS INC OAK RIVER INSURANCE CO ADJ8903528 HENRY BOJORGUEZ OCCIDENTAL COLLEGE OCCIDENTAL COLLEGE ADJ3757661 MERCEDES VILLEGAS ST MARYS MEDICAL CENTER OCTAGON RISK SERVICES ADJ7459816 ALVA WALLACE WELLS FARGO AND CO OLD REPUBLIC BROOKFIELD ADJ7722762 ANA NIETO LIFE CARE CENTERS OF AMERICA OLD REPUBLIC BROOKFIELD ADJ9313936 RICARDO ANAYA BORBON, INC. OLD REPUBLIC BROOKFIELD ADJ3283523 JOSE LOPEZ SUBURBAN PLASTERING OMNE STAFFING INC ADJ3283523 JOSE LOPEZ SUBURBAN PLASTERING/PROLINE PLASTER OMNE STAFFING INC ADJ6703397 MARIA BRISENO AMKOTRON INC ONE BEACON ANAHEIM ADJ8212504 RODOLFO JIMENEZ CITY OF LOS ANGELES ONE BEACON CANTON ADJ8627422 ANTONIO BERROSPE AVALON LABORATORIES ONE BEACON ENGLEWOOD ADJ8754080 JOSE JUAREZ CITY OF LOS ANGELES ONE BEACON ENGLEWOOD ADJ7280776 LEONEL GARCIA FOX TRANSPORTATION ONE BEACON ENGLEWOOD ADJ7174275 ANA OTERO ONE SOURCE ABM INDUSTRIES INC ONE SOURCE ABM INDUSTRIES INC ADJ6560671 HERMILLA SALGADO ORANGE COUNTY REGISTER ORANGE COUNTY REGISTER ADJ6968622 FRANCISCO RODRIGUEZ MENDOZA OUTBACK STEAKHOUSE OUTBACK STEAKHOUSE ADJ4235345 RAUL REYES VILLAGE NURSERIES PACIFIC ADMINISTRATOR Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ4235345 RAUL REYES VILLAGE NURSERY PACIFIC ADMINISTRATOR ADJ3013083 ALFONSO GUERRERO ESPARZA ENTERPRISES PACIFIC CLAIMS MANAGEMENT FRESNO ADJ3013083 ALFONSO GUERRERO ESPARZA ENTERPRISES, INC PACIFIC CLAIMS MANAGEMENT FRESNO ADJ8752803 CARMEN FELIX ESPARZA ENTERPRISES PACIFIC CLAIMS MANAGEMENT FRESNO ADJ7879633 JOEL LANDA ESPARZA ENTERPRISES INC PACIFIC CLAIMS MANAGEMENT FRESNO ADJ7686706 MARIA CERVANTES ESPARZA ENTERPRISES INC PACIFIC CLAIMS MANAGEMENT FRESNO ADJ6877577 MARIA RIVADENEYRA ESPARA ENTERPRISES INC PACIFIC CLAIMS MANAGEMENT FRESNO ADJ8799257 PEDRO VASQUEZ ESPARZA ENTERPRISES INC PACIFIC CLAIMS MANAGEMENT FRESNO ADJ815235 ABADIAS CEJA G & R GORCERS PACIFIC COMP CLAIM THOU OAKS ADJ9509734 ALFONSO FIGUEROA ZENITH SPECIALTY BAG PACIFIC COMP CLAIM THOU OAKS ADJ6555203 ALFREDO GALENO AVIONIC STRUCTURES INC PACIFIC COMP CLAIM THOU OAKS ADJ4173475 ANTONIA BENITEZ EDDIE CHENG CORP PACIFIC COMP CLAIM THOU OAKS ADJ6810690 ANTONIO GONZALEZ ROBINSON SCOTT PONTIAC INC PACIFIC COMP CLAIM THOU OAKS ADJ6855275 BEATRICE GRANADOS BODEGA LATINA CORPORATION PACIFIC COMP CLAIM THOU OAKS ADJ8398558 CARLOS ALMEIDA ANDRE LANSCAPE SERVICE INC PACIFIC COMP CLAIM THOU OAKS ADJ6673071 CARLOS CALDERON PAYLESS FOODS PACIFIC COMP CLAIM THOU OAKS ADJ6673071 CARLOS CALDERON PAYLESSFOODS PACIFIC COMP CLAIM THOU OAKS ADJ269839 CEASAR RODRIGUEZ ROLLED STEEL PRODUCTS PACIFIC COMP CLAIM THOU OAKS ADJ7364795 CLYDE THOMAS PARAMOUNT READY MIX PACIFIC COMP CLAIM THOU OAKS ADJ7365302 DAGOBERTO BERMUDES DOWN TO EARTH LAWN AND GARDEN SERVICE PACIFIC COMP CLAIM THOU OAKS ADJ7600898 DAVID RODRIGUEZ DYNAFLEX PRODUCTS PACIFIC COMP CLAIM THOU OAKS ADJ4323889 DELIA REGLA UKA'S BIG SAVER FOODS INC PACIFIC COMP CLAIM THOU OAKS ADJ7000639 DELMA CARDOZA EL SUPER PACIFIC COMP CLAIM THOU OAKS ADJ6863921 DIONISIO SANCHEZ SUNRIDER MANUFACTURE PACIFIC COMP CLAIM THOU OAKS ADJ2870711 EDIN GUZMAN HUNTLEY HOUSE HOTEL PACIFIC COMP CLAIM THOU OAKS ADJ2870711 EDIN GUZMAN SECOND STREET CORP PACIFIC COMP CLAIM THOU OAKS ADJ7119363 EMILIO BALLARDO CARDENAS MARKET PACIFIC COMP CLAIM THOU OAKS ADJ6871131 ENELDINA HERNANDEZ EL SUPER PACIFIC COMP CLAIM THOU OAKS ADJ6495200 ENRIQUE BARRAGAN TCI PRECISION METALS PACIFIC COMP CLAIM THOU OAKS ADJ640933 ERNESTO ESTRADA STUDIO GRAPHICS PACIFIC COMP CLAIM THOU OAKS ADJ4522208 ESPIRIDION CONTRERAS ROYAL CABINETS PACIFIC COMP CLAIM THOU OAKS ADJ7608344 ESTELA CALDERON REDBARN PET PRODUCTS PACIFIC COMP CLAIM THOU OAKS ADJ6708843 FLORIBERTA BALTAZAR ARTISTIC PLASTIC MOLDING INC PACIFIC COMP CLAIM THOU OAKS ADJ7470286 GASTON ESCOBAR PROCARE TREE SERVICE INC PACIFIC COMP CLAIM THOU OAKS ADJ7733379 GLORIA BERUMEN CALIFORNIA CREATIVE FOODS PACIFIC COMP CLAIM THOU OAKS ADJ6856298 GREGORIO LOPEZ MONTEBELLO CONTAINER CORP. PACIFIC COMP CLAIM THOU OAKS ADJ447742 GUADALUPE GUTIERREZ MIKE THOMPSON'S RV SUPER STORES PACIFIC COMP CLAIM THOU OAKS ADJ2709749 GUADALUPE VALENCIA LEINER HEALTH PRODUCTS PACIFIC COMP CLAIM THOU OAKS ADJ6954867 HILDA CASTRO MEDWAY PLASTIC CORPORATION PACIFIC COMP CLAIM THOU OAKS ADJ6903348 ISMAEL BUSTOS LANDSCAPES PACIFIC COMP CLAIM THOU OAKS ADJ7993739 JAIME CASTANEDA LOS ALTOS FOOD PRODUCTS INC PACIFIC COMP CLAIM THOU OAKS ADJ7465646 JESUS GUERRERO PAYSAGE INC PACIFIC COMP CLAIM THOU OAKS ADJ7767102 JESUS RAMIREZ MORA EVERGREEN LIGHTING PACIFIC COMP CLAIM THOU OAKS ADJ3375549 JOSE AGUILAR PALOS VERDES GOLF CLUB PACIFIC COMP CLAIM THOU OAKS ADJ1961298 JOSE CRUZ TUBE TRAINER PACIFIC COMP CLAIM THOU OAKS ADJ6941116 JOSE GODOY RIVERSIDE LANDSCAPE AND IRRIGATION PACIFIC COMP CLAIM THOU OAKS ADJ4333100 JOSE JIMENEZ SWISSTEX CALIFORNIA PACIFIC COMP CLAIM THOU OAKS ADJ7339475 JOSE LOPEZ R H PETERSON PACIFIC COMP CLAIM THOU OAKS ADJ6994350 JOSE LUIS NAVA EL SUPER #13 PACIFIC COMP CLAIM THOU OAKS ADJ7298565 MANUEL MELENDREZ CARDENAS MARKET INC PACIFIC COMP CLAIM THOU OAKS ADJ889905 MANUEL RAMOS SMITHS AEROSPACE LLC PACIFIC COMP CLAIM THOU OAKS ADJ7177723 MARCOS ALVAREZ KOSHAN INC DBA PAYLESS FOODS PACIFIC COMP CLAIM THOU OAKS ADJ7726040 MARGARITA VENEGAS EL SUPER/BODEGA LATINA CORPORATION PACIFIC COMP CLAIM THOU OAKS ADJ7117851 MARIA ARMENTA AMERICAN INTERNATIONAL INDUSTRIES PACIFIC COMP CLAIM THOU OAKS ADJ3055986 MARIA FLORES INTERCONTINENTAL ART PACIFIC COMP CLAIM THOU OAKS ADJ6718482 MARIA PADILLA RICHARDSONS RV CENTER INC PACIFIC COMP CLAIM THOU OAKS ADJ943887 MARIA PEREZ HAMROCK INC PACIFIC COMP CLAIM THOU OAKS ADJ996790 MARIA SANTELMO OUTBACK STEAK HOUSE PACIFIC COMP CLAIM THOU OAKS ADJ2453306 MARIA TAPIA MANCHESTER GRAND HYATT PACIFIC COMP CLAIM THOU OAKS ADJ2748714 MARILU SALAZAR MERRICK ENGINEERING PACIFIC COMP CLAIM THOU OAKS ADJ7162665 MARIO VILLEGAS SPECTRUM CARE LANDSCAPE & IRRIGATION MANAGEMENT PACIFIC COMP CLAIM THOU OAKS ADJ3873740 MATILDE RODRIGUEZ ALL AMERICAN HOME CENTER PACIFIC COMP CLAIM THOU OAKS ADJ6962945 MIGUEL CAMPOS AMERICAN SECURITY PRODUCTS COMPANY PACIFIC COMP CLAIM THOU OAKS ADJ7368173 MIGUEL GARCIA EXCEL LANDSCAPE PACIFIC COMP CLAIM THOU OAKS ADJ7368173 MIGUEL GARCIA EXCEL LANDSCAPE INC PACIFIC COMP CLAIM THOU OAKS ADJ2866209 NORMA PUENTES OVERHILL FARM INC PACIFIC COMP CLAIM THOU OAKS ADJ6451752 OMAR CASTRO CARDENAS MARKETS INC PACIFIC COMP CLAIM THOU OAKS ADJ354727 OSCAR RIMOLA INFINITY PAPER CONVERTERS, INC. PACIFIC COMP CLAIM THOU OAKS ADJ6939689 PAUL KEEPOLRUJEE MAGTEK INC PACIFIC COMP CLAIM THOU OAKS ADJ2990237 REFUGIO GONZALEZ LOUISE TRATTORIA PACIFIC COMP CLAIM THOU OAKS ADJ1333954 RINA BONILLA HUNTLEY HOUSE HOTEL PACIFIC COMP CLAIM THOU OAKS ADJ6529266 ROBERTO PEREZ SCOPE PACKAGING INC PACIFIC COMP CLAIM THOU OAKS ADJ2952498 ROSENDO IRULA STUART COOPER PACIFIC COMP CLAIM THOU OAKS ADJ6699197 SALVADOR EDGARDO NUNEZ SILVERSTRI STUDIO INC PACIFIC COMP CLAIM THOU OAKS ADJ6997348 SAMUEL ORTEGA MONARCH LITHO INC PACIFIC COMP CLAIM THOU OAKS ADJ7602009 SANDRA CEBALLOS CELMOL INC DBA MARK ROBERTS PACIFIC COMP CLAIM THOU OAKS ADJ334361 SOMER BERMUDEZ CALIFORNIA BOX INC PACIFIC COMP CLAIM THOU OAKS ADJ4630083 VALENTIN DELGADO MILLIE'S RESTAURANT AND BAKERY PACIFIC COMP CLAIM THOU OAKS ADJ7951091 MAGDIEL GOMEZ LOPEZ TIERRA VERDE LANDSCAPE INC PACIFIC COMP CLAIM THOU OAKS ADJ7500094 ROSA MENDOZA TIANELLO PACIFIC COMP LIT THOU OAKS ADJ7505525 ENRIQUE GIL OROZCO PACIFIC SHORES MASONRY INC PACIFIC SHORES MASONRY INC PACIFIC STATES CASUALTY COMPANY/CALIFORNIA INS ADJ1942794 SAMUEL RICHARDSON CARDIS CORP GUARANTEE ASSOC PACIFIC STATES CASUALTY COMPANY/CALIFORNIA INS ADJ1942794 SAMUEL RICHARDSON CARDIS CORPORATION GUARANTEE ASSOC ADJ9524227 NAZARIO FRANCO MARVIN E WRIGHT INC PACKARD CLAIMS ADMIN TARPON SPRINGS Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9615512 RICARDO GAYTAN KAMR STAFFING PACKARD CLAIMS ADMIN TARPON SPRINGS ADJ9237189 YOLANDA VILLAFANA JAVIER ZENDEJAS PIMENTAL PACKARD CLAIMS ADMIN TARPON SPRINGS ADJ1814795 SHAWN WASHINGTON PALMDALE SCHOOL DISTRICT PALMDALE SCHOOL DISTRICT ADJ3847343 ALEJANDRA RONQUILLO PATRICIA VILLA PATRICIA VILLA ADJ7917532 ALICIA ORTIZ CORONA CARE PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7884336 ANA ORTIZ UNITED STAFFING SERVICES PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8011721 ANNA ESTRADA SUPERIOR SUPER WAREHOUSE PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8327424 ARNULFO LOPEZ ESPARZA A1 COAST RENTALS PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8266758 CAROLINA HERNANDEZ SUPER CENTER PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8266758 CAROLINA HERNANDEZ SUPER CENTER INC PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7970410 CESAR ALONZO RALLY STAFFING PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7628812 DIONICIA CRUZ ON-CALL STAFFING SERVICES PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8736942 DOLORES FLORES WARE STAFFING PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8096751 ELVY MEZA BLOOMFIELD BAKERS PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8096751 ELVY MEZA SELECT PEO INC DBA SELECT STAFFING PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7123199 EPIGMENIO DOMINGUEZ URIAS PROGRESS RAIL SERVICE PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7850081 FERNANDO MARTINEZ PEREZ THE PARLOR SM LLC PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8069644 FLORIBERTO CRUZ J A CONTRACTING LABOR PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8545581 JAZMIN VELASGUEZ NORWALK SKILLED NURSING AND WELLNESS CENTER PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8109191 JOSE ABOITE JA CONTRACTING LABOR MANAGEMENT INC PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7347579 JUAN JAIMES CHOCOLATES A LA CARTE PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7347579 JUAN JAIMES EXPRESS SERVICES GROUP INC PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7347579 JUAN JAIMES STAFFLINK OUTSOURCING INC PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7545653 JUAN MIGUEL HERRERA SELECT PEO C & J EXPRESS PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8136603 JUANA LOPEZ SUPERIOR GROCERS PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8094973 KARIME GARCIA SUPER CENTER CONCEPTS PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7512542 LEODEGARIO VALDEZ SUPERIOR SUPER WAREHOUSE PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7485889 MARIA ROSALES WORKERS TEMPORARY STAFFING INC PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8122855 ONDINA FLORES FANTASTIC FACTORY INC PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8565799 RAFAEL HERRERA J H TREE SERVICES PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7865647 RAMON GONZALEZ SUPERIOR SUPER WAREHOUSE PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8109465 RAUL LOPEZ BARON HR PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8109465 RAUL LOPEZ CALIFORNIA FLORA AND HOME PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8109465 RAUL LOPEZ CALIFORNIA FLORAL AND HOME PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8977857 ROBERT BRINGINO NOVE STAFF SERVICES PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7401120 RODOLFO SAGASTUME COATE AND SONS INC EOHR PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8127854 ROMAN ROMERO COASTAL EMPLOYMENT PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8127854 ROMAN ROMERO CULVER CITY MEAT COMPANY PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8902805 ROSA NAVARRO JACOBO DENNIS FOLAND, INC. PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8902805 ROSA NAVARRO JACOBO NOVESTAFF PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7720236 ROSA SALINAS SUPERIOR GROCERIES PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7443110 RUTH MONTANCHEZ HOME INSTEAD SENIOR CARE PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7783023 SOLOMON HELECHIE HYDE PARK CONVALESCENT HOSPITAL PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7852900 TERI MCNEAL SOUTHLAND TRANSIT INC PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7609558 VICENTE HUERTA SOURCE ONE STAFFING PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ8967374 VICKY MEDRANO PLAZA RESIDENT ENTERPRISES PATRIOT RISK CIGA RANCHO CORDOVA CLOSED ADJ7088935 MARICELA RODRIGUEZ RALLY MANAGEMENT SERVICES PATRIOT RISK SERVICES ORANGE CLOSED ADJ7570581 DAINA LEWIS HHR LLC SENIOR HELPERS PATRIOT RISK SERVICES WOODLAND HILLS ADJ8837627 ERICA GALVAN CENTER CONCEPTS PATRIOT RISK SERVICES WOODLAND HILLS ADJ8429816 FIDEL GUZMAN SUPERIOR STORE PATRIOT RISK SERVICES WOODLAND HILLS ADJ9730317 MARIA BRAVO BAKERSFIELD HEALTHCARE WELLNESS CENTRE PATRIOT RISK SERVICES WOODLAND HILLS ADJ9730317 MARIA BRAVO COUNTRY VILLA HEALTH SERVICES PATRIOT RISK SERVICES WOODLAND HILLS ADJ7733382 MARIO HERRERA EMPLOYER OPTIONS PATRIOT RISK SERVICES WOODLAND HILLS ADJ7978607 ROSALINDA KOSKI BRIGHTSTAR HEALTHCARE PATRIOT RISK SERVICES WOODLAND HILLS ADJ7176377 YOREL MCDOWELL PAUL MAURER SHOWS PAUL MAURER SHOWS ADJ8982220 MYRTHA LOPEZ FOAM DEPOT PEERLESS INDEMNITY BOSTON ADJ8429816 FIDEL GUZMAN SUPERIOR STORE PEGASUS MODESTO ADJ4352769 MARIA HERRERA ALDERWOOD CONVALESCENT HOSPITAL PEGASUS MODESTO ADJ7060906 SORAYA ANDERSON LIFE CENTER VISTA COVE PEGASUS MODESTO ADJ7229080 GRETCHEN BEARD SANCHEZ MEDCOAST AMBULANCE SERVICE PEGASUS MODESTO ADJ7246612 JOSE SANDOVAL ARTHUR SCHUMAN WEST PENNSYLVANIA MANUFACTURERS ADJ7246612 JOSE SANDOVAL ARTHUR SCHUMAN WEST LLC PENNSYLVANIA MANUFACTURERS ADJ9284161 JOAQUIN VALENZUELA PERSONEL PERSONEL ADJ7004190 YENY GONZALEZ PLANETA ROJO PLANETA ROJO ADJ4300657 WILLIE BARNES ACCU CUT INC PRAETORIAN FINANCIAL NEW YORK ADJ6973303 EDGAR ACERO NORTH HILLS LANDSCAPE PRAETORIAN INSURANCE CO SACRAMENTO ADJ9531400 GRACE LAFFERTY ADVANCED CLINICAL EMPLOYMENT STAFFING PRAETORIAN INSURANCE CO SACRAMENTO ADJ9531400 GRACE LAFFERTY EMERALD HEALTH SERVICES PRAETORIAN INSURANCE CO SACRAMENTO ADJ9531400 GRACE LAFFERTY HEALTHSOURCE GLOBAL STAFFING PRAETORIAN INSURANCE CO SACRAMENTO ADJ9531400 GRACE LAFFERTY PROCARE ONE NURSES LLC PRAETORIAN INSURANCE CO SACRAMENTO ADJ9531400 GRACE LAFFERTY US NURSING CORP PRAETORIAN INSURANCE CO SACRAMENTO ADJ9105321 JUAN MALDONADO EXPAK GROUND INC PRAETORIAN INSURANCE CO SACRAMENTO ADJ9105321 JUAN MALDONADO UNITY COURIER SERVICES PRAETORIAN INSURANCE CO SACRAMENTO ADJ9105321 JUAN MALDONADO UNITY COURIER SVCS PRAETORIAN INSURANCE CO SACRAMENTO ADJ1663514 MAYRA BRAMBILA FOREMOST SPRING PREFERRED EMPLOYERS ADJ3954726 ADRIAN RODRIGUEZ R K ENGINE & AUTOMOTIVE PREFERRED EMPLOYERS SAN DIEGO ADJ9203683 ALVARO MONZON TILE AND STONE PREFERRED EMPLOYERS SAN DIEGO ADJ9260634 ANGEL GODOY DRAIN ROOTER INC PREFERRED EMPLOYERS SAN DIEGO ADJ918236 CARLOS TORRES JDM PREFERRED EMPLOYERS SAN DIEGO ADJ7735458 CHARLENE RAMIREZ SHADOW HILLS MOBILE HOME PREFERRED EMPLOYERS SAN DIEGO ADJ8736942 DOLORES FLORES WARE STAFFING PREFERRED EMPLOYERS SAN DIEGO ADJ7187353 EDUARDO MORENO J&H ASSET PROPERTY MANAGEMENT PREFERRED EMPLOYERS SAN DIEGO ADJ9361030 ELISA ORTEGO DOLLAR USA PREFERRED EMPLOYERS SAN DIEGO ADJ8073145 ELIZABETH PORTILLO FOREMOST SILK SCREEN & EMBOIDERY INC PREFERRED EMPLOYERS SAN DIEGO ADJ6437710 ERIBERTO MARQUEZ ROUND TABLE PIZZA PREFERRED EMPLOYERS SAN DIEGO ADJ8960346 EVANGELINDA ARCINIEGA ADVANCE COATING TECHNOLOGIES INC PREFERRED EMPLOYERS SAN DIEGO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9277076 FIDEL BARRANCO SURF CLEANERS PREFERRED EMPLOYERS SAN DIEGO ADJ8328578 FREDDY ROMERO LA SPEC INDUSTRIES PREFERRED EMPLOYERS SAN DIEGO ADJ9196939 GABRIELA RODRIGUEZ GREWAL INC DBA SUBWAY PREFERRED EMPLOYERS SAN DIEGO ADJ2592847 JACQUELINE SOLOMON CARNEY EDUCATIONAL SERVICES PREFERRED EMPLOYERS SAN DIEGO ADJ7164957 JOSE CASTRO TRANSKO ELECTRONICS PREFERRED EMPLOYERS SAN DIEGO ADJ9556932 JOSE IBARRA ADCRAFT BUSINESS MAIL PREFERRED EMPLOYERS SAN DIEGO ADJ2297271 LINDA RAWLINGS CAMERON FINANCIAL PREFERRED EMPLOYERS SAN DIEGO ADJ2373937 MARIA CHRISTINA MORA BEST WAY USA INC. PREFERRED EMPLOYERS SAN DIEGO ADJ8216873 MARIA GUIZAR PACIFICA FLOWERS INC PREFERRED EMPLOYERS SAN DIEGO ADJ7617830 MARIA GUTIERREZ SPOTLESS DETAIL PREFERRED EMPLOYERS SAN DIEGO ADJ9460310 MARTA GODOY ARMANDS DISCOUNT INCORPORATED PREFERRED EMPLOYERS SAN DIEGO ADJ9460310 MARTA GODOY ARMAND`S DISCOUNT PREFERRED EMPLOYERS SAN DIEGO ADJ7876000 MARTIN PINON CHULADA INC PREFERRED EMPLOYERS SAN DIEGO ADJ3636853 NATHANIEL ROBINSON DIAMOND STAR PREFERRED EMPLOYERS SAN DIEGO ADJ9152249 NELSON ECHEVERRY PHARMACEUTIC LITHO AND LABEL PREFERRED EMPLOYERS SAN DIEGO ADJ7772762 RAFAEL RODRIGUEZ CEJA TORAGRAFIX MACHINEWORLD PREFERRED EMPLOYERS SAN DIEGO ADJ8666634 RAYMIRO GOMEZ STAR AUTOMOTIVE PREFERRED EMPLOYERS SAN DIEGO ADJ9052640 TRINIDAD MEZA LOPEZ BLACK OXIDE SERVICE PREFERRED EMPLOYERS SAN DIEGO ADJ9008090 VALENTE SOSA PREMIER FLEET MAINTENANCE INC PREMIER FLEET MAINTENANCE INC ADJ7028491 ROSE LOPEZ PRESBYTERIAN COMMUNITY HOSPITAL PRESBYTERIAN COMMUNITY HOSPITAL ADJ7680912 NOEMI NAVARRETE MERIKO INC PRESERVER INSURANCE IRVINE ADJ9424036 PETRA SUAREZ DESIGN BY MADEMOISELLE INC PRESERVER INSURANCE IRVINE ADJ8902805 ROSA NAVARRO JACOBO DENNIS FOLAND, INC. PRESERVER INSURANCE IRVINE ADJ8902805 ROSA NAVARRO JACOBO NOVESTAFF PRESERVER INSURANCE IRVINE ADJ3693701 JOEL RAMIREZ TEMPLE COMMUNITY HOSPITAL PRIVATE ADJUSTING RANCHO CUCAMONGA ADJ6484067 JOSE GUEVARA PACIFIC HOSPITAL OF LONG BEACH PRIVATE ADJUSTING RANCHO CUCAMONGA ADJ4012556 JOYCE ROBINSON HAYWOOD MAGNOLIA REHABILITATION & CONVELES PRIVATE ADJUSTING RANCHO CUCAMONGA ADJ4012556 JOYCE ROBINSON HAYWOOD MAGNOLIA REHABILITATION AND NURSING CENTER PRIVATE ADJUSTING RANCHO CUCAMONGA ADJ7460204 SATANYA SWEENEY VISTA HOSPITAL OF RIVERSIDE PRIVATE ADJUSTING RANCHO CUCAMONGA ADJ2039182 CELESTINO HERNANDEZ AMERICAN STAFF RESOURCES OF CA PROFESSIONAL CLAIM SERVICE ADJ2039182 CELESTINO HERNANDEZ AMERICAN STAFF RESOURCES/MERRY MAID PROFESSIONAL CLAIM SERVICE ADJ6596618 DAVID PALACIOS PROFESSIONAL MAINTENANCE INC PROFESSIONAL MAINTENANCE INC ADJ6618371 OSCAR SOTO OSCARS DELIVERIES INC PROTECTIVE INSURANCE ADJ8446842 OMAR ANTUNEZ WDF ENTERPRISES PROTECTIVE INSURANCE COMPANY ADJ8750104 DOUGLAS THOMPSON DZT PROTECTIVE INSURANCE INDIANAPOLIS ADJ9229363 DULCE MARTINEZ GUTIERREZ JINNY ENTERPRISES INC PUBLIC SERVICE MUTUAL LOS ANGELES ADJ8841164 OMAR VILLEGAS COVERKING PUBLIC SERVICE MUTUAL LOS ANGELES ADJ3979537 ANDREW URAINE ARTIC MECHANICAL QBE SPECIALTY INS SACRAMENTO ADJ9657612 GASPAR CORONA LA TAQUIZA QBE SPECIALTY INS SACRAMENTO ADJ9348247 HILDA BONILLA SPOTLESS COMPLETE SERVICES QBE SPECIALTY INS SACRAMENTO ADJ7485889 MARIA ROSALES WORKERS TEMPORARY STAFFING INC QBE SPECIALTY INS SACRAMENTO ADJ4300657 WILLIE BARNES ACCU CUT INC QBE SPECIALTY INS SACRAMENTO ADJ3070248 JUDITH HUNTIMER RALPH'S GROCERY CO RALPHS/KROEGER CO/RALPHS GROCERY CO REDLANDS EMPLOYMENT SERVICES DBA ARROW STAFFING REDLANDS EMPLOYMENT SERVICES DBA ARROW STAFFING ADJ7558169 MARIA TOVAR DE MORALES AGENCY AGENCY ADJ6812620 ANGELICA LUNA PRORIDE INC REDWOOD FIRE CASUALTY NOT A UAN ADJ6968547 IGNACIO PARRA PACIFIC CAST PRODUCTS REDWOOD FIRE CASUALTY NOT A UAN ADJ7041816 JOE GIL ARROYO PLUMBING REDWOOD FIRE CASUALTY NOT A UAN ADJ6438427 JUANA PEREZ PREMIER LABOR SERVICES REDWOOD FIRE CASUALTY NOT A UAN ADJ6836821 OSCAR VEGA RIGHTWAY PORTABLE TOLIETS REDWOOD FIRE CASUALTY NOT A UAN ADJ3102578 RAUL SERRANO PREMIER WEST CONSTRUCTION INC REDWOOD FIRE CASUALTY NOT A UAN ADJ7818852 SALVADOR GARCIA STANLEY PEST CONTROL REDWOOD FIRE CASUALTY NOT A UAN ADJ4468391 VEDRAN BARBIC MURPHY INDUSTRIAL COATINGS RELIANCE INSURANCE COMPANY RELIANCE NATIONAL INSURANCE CO/INTERCARE INSURANCE ADJ4213107 RODRIGO ROBLES COVE BUILDERS, INC. SERVICES ADJ3690098 ALBERT SNIDER OLYMPIC STAFFING REPUBLIC INDEMNITY ENCINO ADJ8143119 ALFONSO SOTO AMES INDUSTRIAL SUPPLY REPUBLIC INDEMNITY ENCINO ADJ8200720 ALVARO HERNANDEZ NAGISA SUSHI RESTAURANT REPUBLIC INDEMNITY ENCINO ADJ7363100 BEDROS ODABASHIAN VRAM GOLDSMITH REPUBLIC INDEMNITY ENCINO ADJ6523545 CARLOS RODRIGUEZ FLAVOURS, INC. REPUBLIC INDEMNITY ENCINO ADJ6780276 CARLOS RODRIGUEZ FLAVOURS INC REPUBLIC INDEMNITY ENCINO ADJ7914636 ELEAZAR BARRIOS SCIENTIFIC SPRAY FINISHES REPUBLIC INDEMNITY ENCINO ADJ3741339 EVERARDAO ZAVALA GRIP RITE WEST REPUBLIC INDEMNITY ENCINO ADJ3311273 FABIO OLIVAREZ VAN LAW FOODS PRODUCTS REPUBLIC INDEMNITY ENCINO ADJ9011913 FERNANDO GODINEZ VICTORIA PUBLIC GOLF REPUBLIC INDEMNITY ENCINO ADJ9011913 FERNANDO GODINEZ VICTORIA PUBLIC GOLF COURSE DBA REPUBLIC INDEMNITY ENCINO ADJ9525312 ISRAEL ZEPAHUA SANCHEZ NAKORN GROUP INC REPUBLIC INDEMNITY ENCINO ADJ765273 JOSE VELASQUEZ BRAVO COLLISION REPUBLIC INDEMNITY ENCINO ADJ9314196 LUIS MALDONADO MR ROOTER PLUMBING REPUBLIC INDEMNITY ENCINO ADJ7631118 MARIA GUTIERREZ FINAL FINISH INC REPUBLIC INDEMNITY ENCINO ADJ7900832 NICOLAS BARRERA GENNARDS RESTAURANT REPUBLIC INDEMNITY ENCINO ADJ1507312 PATRICIA ZARATE L.A. LIGHTING MFG., INC. REPUBLIC INDEMNITY ENCINO ADJ8768830 PAULA BRAVO KIMSU SEAFOOD REPUBLIC INDEMNITY ENCINO ADJ3803997 PEDRO GARCIA ANAPLEX REPUBLIC INDEMNITY ENCINO ADJ3803997 PEDRO GARCIA ANAPLEX CORP REPUBLIC INDEMNITY ENCINO ADJ497474 REFUGIO GONZALEZ MAINSTAY BUSINESS SOLUTIONS REPUBLIC INDEMNITY ENCINO ADJ497474 REFUGIO GONZALEZ SOUTH COAST LOGISTICS REPUBLIC INDEMNITY ENCINO ADJ9475909 ROSMERY ALVAREZ KSM HEALTHCARE REPUBLIC INDEMNITY ENCINO ADJ9475909 ROSMERY ALVAREZ KSM HEALTHCARE INC REPUBLIC INDEMNITY ENCINO ADJ9475909 ROSMERY ALVAREZ KSM HELTHCARE INC REPUBLIC INDEMNITY ENCINO ADJ408389 RUBEN LOPEZ J & C SPORTSWEAR INC REPUBLIC INDEMNITY ENCINO ADJ408389 RUBEN LOPEZ J AND C SPORTSWEAR INC REPUBLIC INDEMNITY ENCINO ADJ7228179 RUFINO RAMIREZ MOLA SEWING INC REPUBLIC INDEMNITY ENCINO ADJ8481642 TOMAS SERRANO ANAHEIM ZANKOU REPUBLIC INDEMNITY ENCINO ADJ7527242 VICTORIA GONZALEZ MOLA SEWING INC REPUBLIC INDEMNITY ENCINO ADJ3808328 ZHUO MA GOLDEN CITY RESTAURANT REPUBLIC INDEMNITY ENCINO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7462030 JEFFREY ESPINOZA ULTRA STAR CINEMA REPUBLIC INDEMNITY SAN DIEGO ADJ7783373 KATHLEEN CARROLL DOLPHIN PARTNERS INC REPUBLIC INDEMNITY SAN DIEGO ADJ7449833 LETICIA SANDOVAL BECKERS FABRICATION INC REPUBLIC INDEMNITY SAN DIEGO ADJ880431 RICHARD MORENO CHROMAL PLATING REPUBLIC INDEMNITY SAN DIEGO ADJ1933902 ADAN RODRIGUEZ HANSEN STEEL SERVICES RISICO CLAIMS MANAGEMENT FRESNO ADJ6885984 ALREDO MANZO KINGS MILL GUILD RISICO CLAIMS MANAGEMENT FRESNO ADJ2751551 ANTONIO GOMEZ ARTISTIC STONE INC RISICO CLAIMS MANAGEMENT FRESNO ADJ7630108 ARMANDO CORONA KAR CONSTRUCTION INC RISICO CLAIMS MANAGEMENT FRESNO ADJ896094 CESAR MARTINEZ VHL PLUMBING, INC RISICO CLAIMS MANAGEMENT FRESNO ADJ8962489 DIONICIO VILLAFANA QUEVEDO DURAN CONTRACTING RISICO CLAIMS MANAGEMENT FRESNO ADJ1112067 DOMENICA GONZALEZ POPEYE'S CHICKEN & BISCUITS RISICO CLAIMS MANAGEMENT FRESNO ADJ7495194 DOMINGO RODRIGUEZ PIMA CORPORATION RISICO CLAIMS MANAGEMENT FRESNO ADJ6818467 EFRAIN REYNOZO D DAVIS PLASTERING INC RISICO CLAIMS MANAGEMENT FRESNO ADJ6804908 ELISEO JUAREZ MALDONADO BOLTHOUSE FARMS RISICO CLAIMS MANAGEMENT FRESNO ADJ8475321 ERNESTO CRUZ A R WHOLESALE DISTRIBUTION RISICO CLAIMS MANAGEMENT FRESNO ADJ9205234 GABRIEL VASQUEZ AAA STAMPING INC RISICO CLAIMS MANAGEMENT FRESNO ADJ7451573 JESUS LEON JUAN MUNOZ FARM LABOR CONTRACTOR RISICO CLAIMS MANAGEMENT FRESNO ADJ9260513 JOEL RODRIGO HERRERA OCI SIT WELL RISICO CLAIMS MANAGEMENT FRESNO ADJ926454 JORGE VARGAS-MARTINEZ PROPERTY SERVICE PLUS RISICO CLAIMS MANAGEMENT FRESNO ADJ4433811 JOSE DIAZ CALIVAS INC RISICO CLAIMS MANAGEMENT FRESNO ADJ7128771 JOSE GODOS KAR CONSTRUCTION INC RISICO CLAIMS MANAGEMENT FRESNO ADJ7176369 JOSE SANCHEZ ELECTRI TEL SERVICES INC RISICO CLAIMS MANAGEMENT FRESNO ADJ6629378 JUAN PINEDA THE PATTERSON CO INC RISICO CLAIMS MANAGEMENT FRESNO ADJ6629378 JUAN PINEDA THE PATTERSON COMPANY INC RISICO CLAIMS MANAGEMENT FRESNO ADJ8300895 JUAN RODRIGUEZ SOUTHERN FAMAND CULTIVATION RISICO CLAIMS MANAGEMENT FRESNO ADJ6886024 MANUEL VASQUEZ COVIAN STEVES PLATING CORPORATION RISICO CLAIMS MANAGEMENT FRESNO ADJ6795916 MARIA ALONZO AMERICAN STORAGE MANAGEMENT CO INC RISICO CLAIMS MANAGEMENT FRESNO ADJ1304759 MAYRA MORALES L W REINHOLD PLASTICS INC RISICO CLAIMS MANAGEMENT FRESNO ADJ6506974 MIGUEL CURIEL LIVING COLORS INC RISICO CLAIMS MANAGEMENT FRESNO ADJ4328329 PEDRO VELASQUEZ FOREST WOOD FIBER PRODUCTS RISICO CLAIMS MANAGEMENT FRESNO ADJ9211196 PRISCILIANO GONZALEZ RTM CONTRACTING RISICO CLAIMS MANAGEMENT FRESNO ADJ6706546 RAFAEL ELENA STEVE JULIUS CONSTRUCTIONS RISICO CLAIMS MANAGEMENT FRESNO ADJ6978500 RAFAEL GONZALEZ BOLTHOUSE FARMS INC RISICO CLAIMS MANAGEMENT FRESNO ADJ1621717 RAMON CASTILLO MEADOW FARMS SAUSAGE CO. RISICO CLAIMS MANAGEMENT FRESNO ADJ7204076 REYES RUBIO SAGEBRUSH CANTINA RISICO CLAIMS MANAGEMENT FRESNO ADJ2421108 SUZANNE WINDMILLER RAMONA MANOR CONVALESCENT HOSP RISICO CLAIMS MANAGEMENT FRESNO ADJ7584394 VICTOR REYES MID VALLEY DISPOSAL RISICO CLAIMS MANAGEMENT FRESNO ADJ4300657 WILLIE BARNES ACCU CUT INC RISICO CLAIMS MANAGEMENT FRESNO ADJ6777068 YUEMING XIAO ARES MANAGEMENT INC RISICO CLAIMS MANAGEMENT FRESNO ADJ7451573 JESUS LEON JUAN MUNOZ FARM LABOR CONTRACTOR RISK ENTERPRISE 2307 BREA CLOSED ADJ3271853 ALFONSO SERNA TOWER STAFFING SOLUTIONS RISK ENTERPRISE 2314 BREA CLOSED ADJ3271853 ALFONSO SERNA TOWER TEMPS RISK ENTERPRISE 2314 BREA CLOSED ADJ3078452 DAVID ARCIGA POREX CORPORATION RISK ENTERPRISE 2314 BREA CLOSED ADJ2497473 FRANCISCO TORRES HOSPITAL HOUSKEEPING SYSTEMS RISK ENTERPRISE 2314 BREA CLOSED ADJ7679956 FRANEL RAMIREZ STAFFING SERVICES INC RISK ENTERPRISE MANAGEMENT ADJ5806302 GUSTAVO CASTILLO RANDSTAD NORTH AMERICA RISK ENTERPRISE MANAGEMENT ADJ7923849 YOLANDA GARCIA L A RESTAURANT MANAGEMENT RISK ENTERPRISE MANAGEMENT ADJ511358 WILLIAM DOWER RIVERSIDE COUNTY PROBATION DEPT RISK MANAGEMENT SPECIALIST ADJ6539782 ANTHONY TRUJILLO RIVERSIDE REGIONAL COUNTY MEDICAL CENTER RIVERSIDE REGIONAL COUNTY MEDICAL CENTER ADJ570624 JOHN SELMAN ROADWAY EXPRESS ROADWAY SERVICES, INC. ADJ7191485 LEE WINWARD ROBERTSONS READY MIX ROBERTSONS READY MIX CORONA ADJ9884357 MARCO GRACIA RYDER INTERGRATED RYDER SERVICES CORP ALPHARETTA ADJ8742351 ANDREW ESPARZA LOS ANGELES SIGNAL CONSTRUCTION S C CLAIMS LAS VEGAS ADJ9141554 SOCORRO COLMENARES MARY E DANENHAUER SAFECO ADJ889037 BULMARO SERRANO SKECHERS USA INC SAFECO INSURANCE CO. ADJ889037 BULMARO SERRANO SKETCHERS, USA SAFECO INSURANCE CO. ADJ889037 BULMARO SERRANO TEAM ONE STAFFING SAFECO INSURANCE CO. ADJ889037 BULMARO SERRANO TEAM ONE/SKETCHERS SAFECO INSURANCE CO. ADJ7279218 ALMA MENJIVAR AGUIRRE SOYA SUSHI SAFECO LOS ANGELES CLOSED ADJ889037 BULMARO SERRANO SKECHERS USA INC SAFECO LOS ANGELES CLOSED ADJ889037 BULMARO SERRANO SKETCHERS, USA SAFECO LOS ANGELES CLOSED ADJ889037 BULMARO SERRANO TEAM ONE STAFFING SAFECO LOS ANGELES CLOSED ADJ889037 BULMARO SERRANO TEAM ONE/SKETCHERS SAFECO LOS ANGELES CLOSED ADJ540586 IVONNE PALACIOS BETH ANSERSON SAFECO LOS ANGELES CLOSED ADJ7258997 JORGE GUEVARA JENCO PRODUCTIONS INC SAFECO LOS ANGELES CLOSED ADJ7259010 JORGE GUEVARA JENCO PRODUCTIONS INC SAFECO LOS ANGELES CLOSED ADJ2212442 LOUIS HERNANDEZ P & R PAPER SUPPLY CO SAFECO LOS ANGELES CLOSED ADJ6710221 MARIA ANAYA PROMA SAFECO LOS ANGELES CLOSED ADJ6790993 MARIA MERAZ THE CLASSIC SOFT TRIM GROUP SAFECO LOS ANGELES CLOSED ADJ7196234 MARIELA MARTINEZ STAR FISHERIES INC SAFECO LOS ANGELES CLOSED ADJ4587937 MICHELLE MARTINEZ QUIZNOS SAFECO LOS ANGELES CLOSED ADJ9531400 GRACE LAFFERTY ADVANCED CLINICAL EMPLOYMENT STAFFING SAFETY NATIONAL CASUALTY ST LOUIS ADJ9531400 GRACE LAFFERTY EMERALD HEALTH SERVICES SAFETY NATIONAL CASUALTY ST LOUIS ADJ9531400 GRACE LAFFERTY HEALTHSOURCE GLOBAL STAFFING SAFETY NATIONAL CASUALTY ST LOUIS ADJ9531400 GRACE LAFFERTY PROCARE ONE NURSES LLC SAFETY NATIONAL CASUALTY ST LOUIS ADJ9531400 GRACE LAFFERTY US NURSING CORP SAFETY NATIONAL CASUALTY ST LOUIS ADJ9113899 GUSTAVO CUEVAS VALLARTA SUPERMARKET SAFETY NATIONAL CASUALTY ST LOUIS ADJ9730317 MARIA BRAVO BAKERSFIELD HEALTHCARE WELLNESS CENTRE SAFETY NATIONAL CASUALTY ST LOUIS ADJ9730317 MARIA BRAVO COUNTRY VILLA HEALTH SERVICES SAFETY NATIONAL CASUALTY ST LOUIS ADJ9107076 MAURICIO VAZQUEZ JEONG WON KOREAN BBQ BUFFET SAFETY NATIONAL CASUALTY ST LOUIS ADJ6568725 ANTONIO CHAVEZ CENTRAL OREGON TRUCK CO SAIF CORPORATION ADJ7505183 CINDY DIAZRIVERO SAMS CLUB SAMS CLUB ADJ9345195 ALBERTO CASTRO PACIFIC CONCEPT LAUNDRY SAMSUNG FIRE AND MARINE INSURANCE ADJ6772685 BRUCE SCOTT SAN BERNARDINO COUNTY SAN BERNARDINO COUNTY ADJ6868654 MARK PIRAINO SAN BERNARDINO COUNTY SAN BERNARDINO COUNTY Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------

ADJ8954761 ROBIN RASK SAN BERNARDINO COUNTY SUPERINTENDANT OF SCHOOLS SAN BERNARDINO COUNTY SUPERINTENDANT OF SCHOOLS SAN BERNARDINO RISK MANAGEMENT/SAN BERNARDINO ADJ3637086 NICK GASCA DEPARTMENT OF TRANSPORTATION COUNTY RISK MGMT DIV ADJ9132951 MICHAEL APPIS SAN BERNARDINO CITY UNIFIED SCHOOL DISTRICT SAN BERNARDINO UNIFIED SCHOOL DIST ADJ8775641 DONALD JONES SAN DIEGO GAS AND ELECTRIC SAN DIEGO GAS ELECTRIC SAN DIEGO ADJ7814956 ANDREA TALAVERA SANTA ANA UNIFIED SCHOOL DISTRICT SANTA ANA UNIFIED SCHOOL DISTRICT ADJ2306933 PETER LEWIS SANTA ANA UNIFIED SCHOOL DISTRICT SANTA ANA UNIFIED SCHOOL DISTRICT ADJ7538529 VICTOR GONZALEZ SANTA ANA UNIFIED SCHOOL DISTRICT SANTA ANA UNIFIED SCHOOL DISTRICT ADJ9629597 FELIX PEREZ SERV RITE MEAT CO SCIF ADJ7783721 GELACIO MORENO ORTEGA MON MAY ENTERPRISES INC SCIF ADJ7672373 GUADALUPE GUTIERREZ COAST TO COAST WEST SCIF ADJ7427906 JORGE ALVAREZ DESERT EMPIRE HOMES SCIF ADJ824498 JOSE REYNALDO ROMO MON-MAY ENTERPRISES INC SCIF ADJ4599392 LOLA RODRIGUEZ FRESNO'S CHAFFEE ZOO SCIF ADJ3112251 MARIA BERMUDEZ ACTIVE TEMPORARY SERVICES SCIF ADJ3112251 MARIA BERMUDEZ LIGHTS OF AMERICA SCIF ADJ7776578 MARIBEL GARCIA RODRIGUEZ DENNY'S REASTAURANT SCIF ADJ3121646 MEREGILDA SMITH ALAR STAFFING CORP SCIF ADJ6619159 MICHAEL FLORES ARAGON DEVELOPMENT INC SCIF ADJ3455299 MILTON SERRANO PRESTIGE CONSTRUCTION DESIGN SCIF ADJ766296 SALVADOR FLORES JERRY SLOUGH FARMING COMPANY SCIF ADJ3937997 WALTER NAVAS RUIZ BROTHERS CONSTRUCTION CO INC SCIF ADJ6837638 NICHOLAS RAMIREZ CHEVYS RESTAURANT SCIF CMS SACRAMENTO CLOSED ADJ7215768 MICHAEL ORTEGA PACIFIC COMPACTOR CORP SCIF INSURED ADJ2066443 ROBERTO CHINO HANLEY'S WELDING SCIF INSURED ADJ7279607 TRINIDAD URIOSTEGUI SERVICE CONNECTIONS INC SCIF INSURED ADJ7498052 ARTEMIO MORALES MAYTE SALAS FARM LABOR SCIF INSURED ADJ7246911 DAVID MASSAS CENTURJON SECURLTY SERVLCES LNC SCIF INSURED ADJ7364658 MAURO SANCHEZ TELEDATA COMMUNICATIONS INC SCIF INSURED ADJ7167847 SONIA MONTELONGO AGENT #1148 INC SCIF INSURED ADJ7172244 VIRGINIA ALBARRAN AMERICAN COPAK PRO PACKAGES SCIF INSURED ADJ3820716 JOSE FRANCISCO ZEPEDA ORANGE INNOVATION INC SCIF INSURED ANAHEIM ADJ6673809 ALBERTO SANCHEZ GUTIERREZ PRIME BORE DIRECTIONAL BORING SCIF INSURED BAKERSFIELD ADJ8034277 ALEX GARCIA GOODWILL INDUSTRIES OF S CALIFORNIA SCIF INSURED BAKERSFIELD ADJ1583935 ANDRES MENDOZA J.T.I. INDUSTRIES, INC. SCIF INSURED BAKERSFIELD ADJ3863525 ANITA VALDOVINOS J AND E HARVESTING SCIF INSURED BAKERSFIELD ADJ6563084 AYDEE NAVA COOPER AG SCIF INSURED BAKERSFIELD ADJ8204803 BERNICE DIXON DEPARTMENT OF CORRECTION AND REHABILITATION SCIF INSURED BAKERSFIELD ADJ9336419 BRAULIO CRUZ ESQUIVEL MT CONTRACTING SCIF INSURED BAKERSFIELD ADJ8252415 CALIXTO JIMENEZ HARVESTER LANDSCAPE SCIF INSURED BAKERSFIELD ADJ7284015 CARLOS MEJIA D D PAINTING INC SCIF INSURED BAKERSFIELD ADJ7422768 CURTIS COWDEN R RANCH ASSOCIATION SCIF INSURED BAKERSFIELD ADJ7411469 DANIEL GONZALES KARS TOWING AND TRANSPORT SCIF INSURED BAKERSFIELD ADJ3490505 ERIK BRISENO CAL PACIFIC FARM MANAGEMENT SCIF INSURED BAKERSFIELD ADJ3452688 FIDEL GARCIA J H BIOTECH SCIF INSURED BAKERSFIELD ADJ9362466 FLAVIO HERNANDEZ PANOCHE LIVESTOCK SCIF INSURED BAKERSFIELD ADJ8302104 HECTOR TZUNTZUN COUNTRY AIR, INC. SCIF INSURED BAKERSFIELD ADJ7198333 IRMA FERRER WRIGHT WAY MAINTENANCE SCIF INSURED BAKERSFIELD ADJ6971114 ISRAEL TORRES BM LANDSCAPE AND MAINTENANCE SCIF INSURED BAKERSFIELD ADJ6971114 ISRAEL TORRES BM LANDSCAPE AND MAINTENANCE INC SCIF INSURED BAKERSFIELD ADJ7371817 JABE SATTERFIELD TRISIS TRANSPORT SCIF INSURED BAKERSFIELD ADJ7115423 JESSE SANCHEZ PIRATE STAFFING SCIF INSURED BAKERSFIELD ADJ6733970 JOSE CURIEL OLYMPIC STAFFING SERVICES SCIF INSURED BAKERSFIELD ADJ9181678 JOSE RAMON VELASCO FARM FRESH INC SCIF INSURED BAKERSFIELD ADJ6697083 JUAN MENDEZ ITO OZAWA FARMS SCIF INSURED BAKERSFIELD ADJ8315058 JUAN MOLINA FINE LINE CONSTRUCTION SCIF INSURED BAKERSFIELD ADJ9621197 MARCELINO CASTANEDA NAVARRO`S PRODUCE SCIF INSURED BAKERSFIELD ADJ7964833 MARIA GUADALUPE GUERRERO KERN ADULT PROGRAM INC SCIF INSURED BAKERSFIELD ADJ6953524 MARIA VARGAS DIAZ ALTHA PRIVATE SECURITY SCIF INSURED BAKERSFIELD ADJ6953524 MARIA VARGAS DIAZ ALTHA PRIVATE SECURITY SERVICES SCIF INSURED BAKERSFIELD ADJ690402 MARIELA VASQUEZ GOLDEN GRAIN SCIF INSURED BAKERSFIELD ADJ8962869 MARISELA JAIME GIGI AG INC SCIF INSURED BAKERSFIELD ADJ6599326 MAXIMILIANO DUARTE SOCAL UNIFORM RENTAL SCIF INSURED BAKERSFIELD ADJ6808247 MIKE MULLENAX CALIFORNIA HIGHWAY PATROL SCIF INSURED BAKERSFIELD ADJ1770945 OVIDIO GARCIA LARRY BASHOR SANDLBASTING SCIF INSURED BAKERSFIELD ADJ7645897 ROBERTO GOMEZ CRUZ LT FARMS SCIF INSURED BAKERSFIELD ADJ1816668 RUBEN HERNANDEZ RON ROGERS CONSTRUCTION SCIF INSURED BAKERSFIELD ADJ8053691 SAUL IRIBARREN ORMONDE FENCE SCIF INSURED BAKERSFIELD ADJ203503 SERGIO FERNANDEZ TEMP SERVICES SCIF INSURED BAKERSFIELD ADJ6527366 SHERI PEKAREK DOGGIELAND AKA SUNNY DOG PLACE SCIF INSURED BAKERSFIELD ADJ8268803 SOLOMON JIMENEZ ESQUIVEL PAINTING SCIF INSURED BAKERSFIELD ADJ7481099 URSULA AYALA VIVID ENTERTAINMENT INC SCIF INSURED BAKERSFIELD ADJ8272029 GLORIA GARCIA ALPHA JANITORIAL SCIF INSURED EUREKA ADJ9036634 GREGORIO RUIZ ERIC VON GEHRKE SCIF INSURED EUREKA ADJ9036634 GREGORIO RUIZ GERLUND BUILDERS SCIF INSURED EUREKA ADJ8286419 JAIME LARA AVENAL STATE PRISON SCIF INSURED EUREKA ADJ8286419 JAIME LARA DEPT OF CORRECTIONS AVENAL SCIF INSURED EUREKA CALIFORNIA DEPARTMENT OF CORRECTIONS AND ADJ8933143 JOHNNY FISHER SCIF INSURED EUREKA REHABILITATION ADJ8933143 JOHNNY FISHER DEPARTMENT OF CORRECTIONS INMATE CLAIMS SCIF INSURED EUREKA ADJ7498565 LOIS GOODLOE STAT EOF CALIFORNIA DEPTARTMENT OF REHABILITATION SCIF INSURED EUREKA ADJ8822047 LUCIA ZAMBRANO DIVA HAIR JEWELRY AND ACCESSORIES SCIF INSURED EUREKA ADJ8123283 RAMIRO FRANCO JA CONTRACTING LABOR MANAGEMENT SCIF INSURED EUREKA ADJ8123283 RAMIRO FRANCO JA CONTRACTING LABOR MANAGEMENT INC SCIF INSURED EUREKA ADJ7022674 ABEL VELEZ JAGUAR FARM LABOR SCIF INSURED FRESNO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8682356 ALTHANIEL LUNSFORD IHSS PUBLIC AUTHORITY RIVERSIDE COUNTY SCIF INSURED FRESNO ADJ6504396 ANDREW FOREMAN MORENOS FUNERAL ESCORT SCIF INSURED FRESNO ADJ8545648 ANGEL GOMEZ THRIFTY TREE SERVICE SCIF INSURED FRESNO ADJ4402086 ANTONIO ZAMORA R & N PACKING SCIF INSURED FRESNO ADJ4402086 ANTONIO ZAMORA R & N PACKING CO SCIF INSURED FRESNO ADJ1560869 ARNULFO CERVANTES L & T LANDSCAPE MAINTENANCE INC SCIF INSURED FRESNO ADJ7483917 ARTURO VASQUEZ THE ORIGINAL PANCAKE HOUSE SCIF INSURED FRESNO ADJ7472436 AUDI COBON CLAREMONT WEST SUITES SCIF INSURED FRESNO ADJ8270324 BENJAMIN RODRIGUEZ TSG UPHOLSTERY SCIF INSURED FRESNO ADJ9413603 BERTHA CERVANTES CLASSIC FOODS INC SCIF INSURED FRESNO ADJ4445091 BETSY CRUZ ZOTEC PARTNERS SCIF INSURED FRESNO ADJ8482265 BING DONG OWENS CFS INC SCIF INSURED FRESNO ADJ8918807 BRENDA NICOLS TERRA UNIVERSAL INC SCIF INSURED FRESNO ADJ8144589 BRIAN KORNOFF MIRACLE METHOD OF CALIFORNIA SCIF INSURED FRESNO ADJ3466676 CARLOS GALLARDO MISSION STEEL CO SCIF INSURED FRESNO ADJ6527103 CATARINO CERVANTES ALUMINUM DIE CASTING CO INC SCIF INSURED FRESNO ADJ9435754 CELIA HERNANDEZ GUEVARA SILVER LINE MANAGEMENT SCIF INSURED FRESNO ADJ7422768 CURTIS COWDEN R RANCH ASSOCIATION SCIF INSURED FRESNO ADJ8601072 DANA EDWARDS DEPARTMENT OF MOTOR VEHICLES SCIF INSURED FRESNO ADJ7245778 DARWLN VALLADARES THE SHALE COMPANIES SCIF INSURED FRESNO ADJ9623305 DAVID HINKEY RAJA ENTERPRISES INC SCIF INSURED FRESNO ADJ4354946 DAVID NUNEZ FRESNO MEAT COMPANY SCIF INSURED FRESNO ADJ9468484 DAVID OSARIO K C RESTORATION INC SCIF INSURED FRESNO ADJ466709 EDUARDO CHIU THE SIGNS AND SERVICES SCIF INSURED FRESNO ADJ466709 EDUARDO CHIU THE SIGNS AND SERVICES COMPANY SCIF INSURED FRESNO ADJ8992443 ERMELINDA SOZA APEX IMAGING SERVICES SCIF INSURED FRESNO ADJ9765462 ESTHER MIRANDA INVESTMENTS INC. SCIF INSURED FRESNO ADJ141292 EULONCIO MADERA SUPERIOR SOD SCIF INSURED FRESNO ADJ9118297 EVANGELINA PUGA CLUB LOS GLOBOS CORPORATION SCIF INSURED FRESNO ADJ4350487 FELIX RODRIGUEZ DAVID JONES CONSTRUCTION CO SCIF INSURED FRESNO ADJ7663300 FERNANDO DE LA TORRE CARRILLOS TRUCKING LLC SCIF INSURED FRESNO ADJ8790489 FERNANDO GAMBOA POWER PRO PLUMBING SCIF INSURED FRESNO ADJ1971732 FERNANDO GOMEZ PYRAMID DRYWALL SCIF INSURED FRESNO ADJ9252917 FERNANDO HERNANDEZ DEL ANGEL TOPPERS PIZZA PLACE SCIF INSURED FRESNO ADJ9076429 FRANCISCO DORANTE RAMIIREZ KENSHIN MANAGEMENT LLC SCIF INSURED FRESNO ADJ9781294 FRANCISCO VEGA MAGANA DEL SOL HARVESTING SCIF INSURED FRESNO ADJ9398808 GABRIEL RAMIREZ AFFINITY MEDICAL TECHNOLOGIES SCIF INSURED FRESNO ADJ831486 GERARDO DELGADO TREE ELEMENTS INX SCIF INSURED FRESNO ADJ8373504 GERARDO HERNANDEZ J AND J FARM LABOR SCIF INSURED FRESNO ADJ9537416 GREGORY TRETTEL RAYCO SECURITY LOSS PREVENTION SCIF INSURED FRESNO ADJ8237566 GUILLERMO MENDOZA SERV WELL LLC SCIF INSURED FRESNO ADJ9675922 HILBER AGUILAR VALENTINO S PIZZA ALTO RESTAURANTS SCIF INSURED FRESNO ADJ7388255 IRENE YUAN LANTERMAN DEVELOP CENTER SCIF INSURED FRESNO ADJ8286419 JAIME LARA AVENAL STATE PRISON SCIF INSURED FRESNO ADJ8286419 JAIME LARA DEPT OF CORRECTIONS AVENAL SCIF INSURED FRESNO ADJ9229490 JAZMIN CEDOMIO DREAM TEAM SERVICES INC SCIF INSURED FRESNO ADJ6528937 JEFFREY IKLER FRANK SCOTTO TOWING SCIF INSURED FRESNO ADJ7395776 JERRIE HARTLINE METAL CLAD INSULATION SCIF INSURED FRESNO ADJ9430450 JOE LUIS GONZALEZ RYAN MICHAEL S WEST COAST TREE SERVICE SCIF INSURED FRESNO ADJ9365376 JORGE DIONICIO LOPEZ REYES HARVESTING DIVISION SCIF INSURED FRESNO ADJ9432321 JOSE AGUILAR PARKING CORPORATION SCIF INSURED FRESNO ADJ3733116 JOSE GONZALEZ AVILAS FARM LABOR SERVICE SCIF INSURED FRESNO ADJ9511449 JOSE GONZALEZ HIGAS HORTICULTURE SCIF INSURED FRESNO ADJ9544338 JOSE MALDONADO GMA PALLET RECYCLING CORPORATION SCIF INSURED FRESNO ADJ7371110 JOSE VILLALOBOS SANCHEZ BORTHERS SCIF INSURED FRESNO ADJ8321933 JOSUE FUENTES G BILAVER CONSTRUCTION SCIF INSURED FRESNO ADJ8284242 JUAN AHUMADA OKAMI SCIF INSURED FRESNO ADJ3792237 JUVENAL GAONA ALFREDO PADILLA SCIF INSURED FRESNO ADJ3633569 KAREN EZQUIVEL JACK IN THE BOX SCIF INSURED FRESNO ADJ1850032 KIM MARIE VILLASENOR RAMADA INN SCIF INSURED FRESNO ADJ9419451 LARRY WILLIAMS SG LABELSGR LABELS SCIF INSURED FRESNO ADJ4425221 LEOBARDO LOPEZ VALLEY AG SCIF INSURED FRESNO ADJ4599392 LOLA RODRIGUEZ FRESNO'S CHAFFEE ZOO SCIF INSURED FRESNO ADJ9325260 LUIS PACHECO JOHN NESLER JR SCIF INSURED FRESNO ADJ9024458 LUIS PELAYO BRAMBLES INC SCIF INSURED FRESNO ADJ9495117 MARCO ALCALA DE LA TORRE LANDSCAPING SOLUTIONS SCIF INSURED FRESNO ADJ9495117 MARCO ALCALA DE LA TORRE PROPERTY CARE SCIF INSURED FRESNO ADJ9413671 MARCOS SANTOS CHAVEZ KENNESON FARMS SCIF INSURED FRESNO ADJ7513779 MARIA GONZALEZ FIRST SOURCE STAFFING SCIF INSURED FRESNO ADJ7513779 MARIA GONZALEZ TULARE FROZEN FOODS LLC SCIF INSURED FRESNO ADJ6953524 MARIA VARGAS DIAZ ALTHA PRIVATE SECURITY SCIF INSURED FRESNO ADJ6953524 MARIA VARGAS DIAZ ALTHA PRIVATE SECURITY SERVICES SCIF INSURED FRESNO ADJ8731246 MARIANA PAREDES ANPPM SCIF INSURED FRESNO ADJ8273781 MARIO ABONCE PARTIDA GREEN VALLEY AG SCIF INSURED FRESNO ADJ8273781 MARIO ABONCE PARTIDA GREEN VALLEYAG SCIF INSURED FRESNO ADJ2249119 MARIO LEON GALLES RANCH SCIF INSURED FRESNO ADJ2249119 MARIO LEON GALLES RANCH INC. SCIF INSURED FRESNO ADJ4069765 MARTIN SAGASTE CALIFORNIA GOLD AGRICULTURAL SVS SCIF INSURED FRESNO ADJ9252936 MARVIN SUCHITE 1111 SUNSET LLC SCIF INSURED FRESNO ADJ4230629 MAURO BARRERA SPECIALTY DRYWALL SCIF INSURED FRESNO ADJ2968273 MIGUEL AVALOS COORDINATED WIRE ROPE & RIGGING SCIF INSURED FRESNO ADJ6812838 MIGUEL NAVARRO COMMERCIAL SHEET METAL WORKS SCIF INSURED FRESNO ADJ6808247 MIKE MULLENAX CALIFORNIA HIGHWAY PATROL SCIF INSURED FRESNO ADJ9584781 MYRNA DIAZ YEPEZ PACIFIC CLINICS SCIF INSURED FRESNO ADJ7580460 NANCY CRUZ ABSURD SHIRTS SCIF INSURED FRESNO ADJ9463293 OMAR CHAVEZ PERFECT PLANTS SCIF INSURED FRESNO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ2335873 OSCAR RODRIGUEZ DAVIS ROOFING SCIF INSURED FRESNO ADJ8279646 PAHOUAB VANG CALIF TRAFFIC SAFETY INSTITUTE SCIF INSURED FRESNO ADJ1505770 RAMON DE LA TORRE ORTIZ TRACTOR SERVICE SCIF INSURED FRESNO ADJ8031428 RAMON SEGURA MYERS BROTHERS WELL AND DRILLING SCIF INSURED FRESNO ADJ9367179 REFUGIO MERCADO RIVER VALLEY RANCHES SCIF INSURED FRESNO ADJ3077273 REINA MEJIA NORTHRIDGE MILLS INC SCIF INSURED FRESNO ADJ7018692 RICARDO PACHECO MCILROY FARM EQUIPMENT SCIF INSURED FRESNO ADJ7384135 RICHARD VIRGIL FRANEYS FLOOR COVERING INC SCIF INSURED FRESNO ADJ9390538 ROSA CURIEL KAMRAN STAFFING SCIF INSURED FRESNO ADJ3887511 ROSALINDA BLANCO REYES VACATION MARKETING GROUP SCIF INSURED FRESNO ADJ8119497 RUFINA GONZALEZ ALLIED STAFFING INCORPORATED SCIF INSURED FRESNO ADJ9252594 SAMUEL MONTOYA ROCKS TREE & HILLSIDE SERVICES INC SCIF INSURED FRESNO ADJ9320601 SANTOS ESTRADA BARAJAZ HOLLYWOOD PARK CATERING SCIF INSURED FRESNO ADJ9373903 SERGIO GARCIA MIA BELLA FOODS SCIF INSURED FRESNO ADJ9542350 STEPHANIE RUSSO THE DONUT MAN SCIF INSURED FRESNO ADJ4468391 VEDRAN BARBIC MURPHY INDUSTRIAL COATINGS SCIF INSURED FRESNO ADJ3941506 VICTOR BETANCOURT K G MULLEN INC SCIF INSURED FRESNO ADJ7135029 YOLANDA CUEVAS WENDYS SCIF INSURED FRESNO ADJ7322209 ZAIRA PLASCENCIA DIRECT WAY PERSONNEL SCIF INSURED FRESNO ADJ7701892 ABEL CASTANEDA MARY E. UBERTI SCIF INSURED GLENDALE ADJ7701892 ABEL CASTANEDA RUBEN COVARRUBIAS CONSTRUCTION SCIF INSURED GLENDALE ADJ7172467 ABEL CERDA CUSTOM SIGNS INC SCIF INSURED GLENDALE ADJ3815219 ABRAHAM ALVARADO SHERMAN OAKS AUTO RESORT SCIF INSURED GLENDALE ADJ9356632 ADAN ROSALES MARQUEE FRAMING SCIF INSURED GLENDALE ADJ6846206 ADRIANA FIGARI MODEL CLEANING GROUP SCIF INSURED GLENDALE ADJ2904534 AGUSTIN CHAVARRIA K.B. MART CO. SCIF INSURED GLENDALE ADJ2904534 AGUSTIN CHAVARRIA K.V. MART COMPANY DBA TOP VALU MARK SCIF INSURED GLENDALE ADJ2305457 ALBERT OCAMPO PLATT SECURITY INC SCIF INSURED GLENDALE ADJ9233842 ALBERTO ALBA CASILLAS CENTRAL CITY ENTERPRISES SCIF INSURED GLENDALE ADJ7915500 ALBERTO DUARTE DSD COMPANIES SCIF INSURED GLENDALE ADJ4316188 ALEJANDRO GALVEZ MAH PATROL SCIF INSURED GLENDALE ADJ7893063 ALEJANDRO LUNA AHR SIGNS INC SCIF INSURED GLENDALE ADJ1167116 ALEJANDRO PEREZ DIVERSIFIED APPAREL SCIF INSURED GLENDALE ADJ9190566 ALEJANDRO REYES ZARAGOZA EYE ON BUILDER DBA EYE ON GROUP SCIF INSURED GLENDALE ADJ9482973 ALEX VALENZUELA DELTA RESCUE SCIF INSURED GLENDALE ADJ10080654 ALFREDO BERUMEN SHOWCASE FACILITY SOLUTIONS SCIF INSURED GLENDALE ADJ6964819 ALVARO ZAPATA HOLLYWOOD DELIVERY SERVICE SCIF INSURED GLENDALE ADJ9371157 AMADEO SANDOVAL TRUSTAFFING SCIF INSURED GLENDALE ADJ7191737 AMBROSIO SIXTOS EL ESPINAL LLC SCIF INSURED GLENDALE ADJ7628617 ANADELIA MARTINEZ ALL CITY MANAGEMENT SERVICES SCIF INSURED GLENDALE ADJ1600404 ANASTASIA CALDWELL PHOENIX HOUSE SCIF INSURED GLENDALE ADJ540132 ANDREA MELENDEZ THE PENINSULA BEVERLY HILLS HOTEL SCIF INSURED GLENDALE ADJ1699279 ANDREW MONTES ACTION DATA SUPPLIES SCIF INSURED GLENDALE ADJ9363395 ANDREW VALENCIA GEN KOREAN BBQ HOUSE SCIF INSURED GLENDALE ADJ2097558 ANGEL ALCAZAR COASTAL HOT SPRINGS SPAS SCIF INSURED GLENDALE ADJ300248 ANGELA RESENDIZ MULLIGANS FAMILY FUN CENTER SCIF INSURED GLENDALE ADJ2235169 ANNETTE NORTHUP ABC CHILD DEVELOPMENT SCIF INSURED GLENDALE ADJ7515128 ANTHONY GUTIERREZ PINK PLUMBING SCIF INSURED GLENDALE ADJ7228982 ANTONIO CASTANEDA NAMAR COMPANY GROUP SCIF INSURED GLENDALE ADJ176999 ANTONIO ROJAS REEL SECURITY CORP SCIF INSURED GLENDALE ADJ1653712 ARACELI QUIJANO AVALONS FOOD SCIF INSURED GLENDALE ADJ7172434 ARLETTE GUERRA PRONTO LII INC SCIF INSURED GLENDALE ADJ2018088 ARMANDO CARDENAS EL RANCHO FURNITURE COMPANY SCIF INSURED GLENDALE ADJ4427188 ARMANDO ESQUIVEL UNLIMITED ENVIRONMENTAL SCIF INSURED GLENDALE ADJ7064728 ARMANDO MILLAN WEST COAST ROTOR INC SCIF INSURED GLENDALE ADJ6917675 ARMANDO MORA J DURAN CONSTRUCTION SCIF INSURED GLENDALE ADJ6917675 ARMANDO MORA J DURAN CONSTRUCTION INCI SCIF INSURED GLENDALE ADJ6694220 ARMANDO RODRIGUEZ CALIFORNIA ARBORIST SCIF INSURED GLENDALE ADJ7902437 ARNULFO CIRILO GARCIA LANDVESTMENT SCIF INSURED GLENDALE ADJ6786374 BALDEMAR CORONA WINALL OIL CO SCIF INSURED GLENDALE ADJ8558685 BEATRIZ PRADO OKAMI FOODS SCIF INSURED GLENDALE ADJ4148511 BEHROOZ RAJA A 1 DRIVING SCHOOL SCIF INSURED GLENDALE ADJ3656836 BERNARDINO SANCHEZ AZURELITE INC SCIF INSURED GLENDALE ADJ3656836 BERNARDINO SANCHEZ AZURELITEJ INC DBA DAEHAN GLASS SCIF INSURED GLENDALE ADJ2805301 BIBIANO GUTIERREZ C V LEASING SCIF INSURED GLENDALE ADJ7231245 BLAS VALENZUELA QUALITY CLEANUP SCIF INSURED GLENDALE ADJ4342044 BRIEN HUNT ACCREDITED NURSING SERVICES SCIF INSURED GLENDALE ADJ1429271 CARLOS ACENTARES ZWENER INDUSTRIES SCIF INSURED GLENDALE ADJ2691290 CARLOS ALVARADO ORESTES PENA TRUCKING CO SCIF INSURED GLENDALE ADJ2199557 CARLOS BONILLA H TREE & LANDSCAPING CORP. SCIF INSURED GLENDALE ADJ6939942 CARLOS CLAVERIA EDWARDS PAINTING INC SCIF INSURED GLENDALE ADJ7673776 CARLOS CLAVERIA EDWARDS PAINTING SCIF INSURED GLENDALE ADJ6429985 CARLOS GALARZA P D MECHANICAL INC SCIF INSURED GLENDALE ADJ7558493 CARLOS GARCIA MAGIC AUTO CENTER OF RESEDA SCIF INSURED GLENDALE ADJ9497691 CARLOS RAMIREZ HR LINK INC SCIF INSURED GLENDALE ADJ7094111 CARLOS RAMOS LOPEZ SAN MAR CONSTRUCTION SCIF INSURED GLENDALE ADJ441664 CARLOS SALAZAR RNP CONSTRUCTION SCIF INSURED GLENDALE ADJ9534831 CARLOS SERRANO VENT VUE WINDOW PRODUCTS SCIF INSURED GLENDALE ADJ6580750 CARMELA ARREAGA BURBANK RECYCLING SCIF INSURED GLENDALE ADJ1410539 CARMEN BLANDON DISABLED AMERICAN VETERANS SCIF INSURED GLENDALE ADJ1410539 CARMEN BLANDON DISABLED AMERICAN VETS SCIF INSURED GLENDALE ADJ1410539 CARMEN BLANDON DISABLED VETERANS CHARITIES SCIF INSURED GLENDALE ADJ1167751 CARRIE THOMPSON HIGH ROAD DEVELOPMENT SERVICES SCIF INSURED GLENDALE ADJ1871570 CATHERINE SPRINGER ABLE HOME HEALTH SCIF INSURED GLENDALE ADJ6876252 CECILIA PALENCIA 970 MENLO AVENUE LLC SCIF INSURED GLENDALE ADJ8515756 CECILIO MATEOS FINLEYS TREE AND LANDCARE SCIF INSURED GLENDALE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9511621 CELIA BRIONES ZUNIGA COMIDA MEXICANA SCIF INSURED GLENDALE ADJ6557095 CELIDA MEZA TRAVEL CENTER / AM-PM SCIF INSURED GLENDALE ADJ6631565 CESAR FIGUEROA EVERLASTING ADULT DAY CARE INC SCIF INSURED GLENDALE ADJ7611464 CESAR GARCIA ASHFORD APARTMENTS, INC SCIF INSURED GLENDALE ADJ1597059 CESAR SANDOVAL BCTC CORPORATION SCIF INSURED GLENDALE ADJ4629718 CESARIO GEMENIANO NEW HORIZONS SAN FERNANDO VALLEY SCIF INSURED GLENDALE ADJ4629718 CESARIO GEMENIANO SAN FERNANDO VALLEY ASSOCIATES SCIF INSURED GLENDALE ADJ7200807 CHANG LEE THOMAS LIQUOR SCIF INSURED GLENDALE ADJ3559568 CHARLES CURTIS SPOTRUNNER SCIF INSURED GLENDALE ADJ3559568 CHARLES CURTIS TROY THROWER & ASSOCIATES SCIF INSURED GLENDALE ADJ8800164 CHO CHO LWIN HELEN EVANS HOME SCIF INSURED GLENDALE ADJ7880208 CHRYSTAL HOPPER CARE PROVIDER CHILDREN FAMILY SERV SCIF INSURED GLENDALE ADJ2599170 CLAUDETTE JONES ELLINGTON NURSING CARE OF AMERICA SCIF INSURED GLENDALE ADJ2599170 CLAUDETTE JONES ELLINGTON NURSING YUKON AVE. #201 SCIF INSURED GLENDALE ADJ8610203 CONCEPCION MARTINEZ THE RITZ COMPANY SCIF INSURED GLENDALE ADJ3060574 CONSUELO AMADOR JIMWAY INC SCIF INSURED GLENDALE ADJ3446752 CUAUHTEMOC ABURTO GEN WEST TRANSPORTAION SCIF INSURED GLENDALE ADJ4225992 DANEILLE PARRA GENTAL DENTAL SCIF INSURED GLENDALE ADJ4225992 DANEILLE PARRA INTERDENT INC./DEDICATED DENTAL SCIF INSURED GLENDALE ADJ7508664 DANIEL CERVANTES STONE ETC INC SCIF INSURED GLENDALE ADJ7146129 DANIEL GALLARDO KITCHEN CONNECTION SCIF INSURED GLENDALE ADJ2759670 DANIEL GOMEZ WINSTON TIRES SCIF INSURED GLENDALE ADJ2122800 DANIEL SOSA AMERITEX INTERNATIONAL BEDSPREADS SCIF INSURED GLENDALE ADJ2227280 DANNY SANCHEZ DICKSON MOTOR SERVICE SCIF INSURED GLENDALE ADJ2534015 DAVID SILVA COAST WEST PLUMBING SCIF INSURED GLENDALE ADJ527801 DELIA CONTRERAS AMERICAN TEXTILE SCIF INSURED GLENDALE ADJ527801 DELIA CONTRERAS AMERICAN TEXTILE MAINTENANCE CO SCIF INSURED GLENDALE ADJ7015217 DEVRA DEMARCO I-ADARP/KYDS SCIF INSURED GLENDALE ADJ7039332 DEWI YANI DWIWARDANI CHARTER HOSPICE SCIF INSURED GLENDALE ADJ6668917 DIOCELINA ANDRADE AGAPE EMPLOYMENT INC SCIF INSURED GLENDALE ADJ5099239 DONALD LEWIS CALIFORNIA OFFSET PRINTERS SCIF INSURED GLENDALE ADJ5099239 DONALD LEWIS CALIFORNIA OFFSET PRINTING SCIF INSURED GLENDALE ADJ1615659 DONGUK PAEK MTM CONSTRUCTION, INC. SCIF INSURED GLENDALE ADJ6630913 DONNA JOHNSON PRIMARY CARE MEDICAL TRANSPORTATION SCIF INSURED GLENDALE ADJ6886799 DOUGLAS LORENZO AIE PHARMACEUTICALS INC SCIF INSURED GLENDALE ADJ7677715 EDGAR PACHECO WARISAN INC SCIF INSURED GLENDALE ADJ1979343 EDGAR RODRIGUEZ BALFAB MANUFACTURING CO SCIF INSURED GLENDALE ADJ1313648 EDGARDO FLORES GUTIERREZ SOUTHLAND BUILDERS SCIF INSURED GLENDALE ADJ2594493 EDWARD QUEZADA PERFORMANCE TEAR OFF INC SCIF INSURED GLENDALE ADJ7014736 EDWARD SHAMIRIAN ED'S BOILER AND STEAM FITTING SCIF INSURED GLENDALE ADJ9423587 EDWIN ERNESTO RIVAS MARAVILLA KAZEMI ASSOCIATES SCIF INSURED GLENDALE ADJ2823188 EFRAIN FOMBONA UNIVERSAL BIAS & TRIMMING SCIF INSURED GLENDALE ADJ9525299 ELENA DOMINGUEZ CRUZ LA ADELITA FOOD 5 SCIF INSURED GLENDALE ADJ7523853 ELISEO GOMEZ FLEXEN AND SON INSTALLATIONS SCIF INSURED GLENDALE ADJ8096751 ELVY MEZA BLOOMFIELD BAKERS SCIF INSURED GLENDALE ADJ8096751 ELVY MEZA SELECT PEO INC DBA SELECT STAFFING SCIF INSURED GLENDALE ADJ7892972 EMANUEL GLOVER J F MOTOR ESCORT PATROL SERVICE SCIF INSURED GLENDALE ADJ6739648 EMMANUEL GONZALEZ GARDA SCIF INSURED GLENDALE ADJ3280757 ENRIQUE VALENCIA PHILIP GIBA FARMS SCIF INSURED GLENDALE ADJ9615371 ERICK VEGA B G COMM SCIF INSURED GLENDALE ADJ8193227 ERNESTO LOPEZ M J TRUCKING INC SCIF INSURED GLENDALE ADJ7124683 ERNESTO ORDAZ EXPRESS CONTRACTORS INC SCIF INSURED GLENDALE ADJ4118951 ERNESTO SOTO PRECISE GENERAL CONTRACTING SCIF INSURED GLENDALE ADJ8199105 ERNESTO SOTO EUROCRAFT CABINETS SCIF INSURED GLENDALE ADJ7555543 ERUVIEL BOJORQUEZ CLASSIC BUILDING ARTS SCIF INSURED GLENDALE ADJ3008369 ERWIN ARCHILA HOME FRONT, INC. SCIF INSURED GLENDALE ADJ7435570 ERY ANDRADE DAVE THE WINDOW WASHER SCIF INSURED GLENDALE ADJ2630076 ESTHER GARCIA J.A.M. INDUSTRIES, INC. SCIF INSURED GLENDALE ADJ2630076 ESTHER GARCIA JAM INDUSTRIES, INC SCIF INSURED GLENDALE ADJ7148454 EZEQUIEL MARTINEZ BRABANT REALTY AND MANAGEMENT INC SCIF INSURED GLENDALE ADJ6896837 FELIPE CASTILLO MILESTONES RANCH MALIBU SCIF INSURED GLENDALE ADJ8864539 FELIPE GARCIA HORIZON CONSTRUCTION COMPANY SCIF INSURED GLENDALE ADJ7150405 FELIPE GONZALEZ GULBRANSON SERVICES INC SCIF INSURED GLENDALE ADJ7276570 FELIPE GONZALEZ GULBRANSON SERVICES INC SCIF INSURED GLENDALE ADJ7390440 FELIPE QUINTERO DUROVILLE RECEIVERSHIP ORG SCIF INSURED GLENDALE ADJ4133840 FERNANDO AVENDANO WORKFORCE PERSONNEL INC SCIF INSURED GLENDALE ADJ2083478 FERNANDO HINOJOSA SOUTHERN CONSTRUCTION CORP SCIF INSURED GLENDALE ADJ2707985 FIDEL CHETE ARCHISIS INC. SCIF INSURED GLENDALE ADJ4069596 FIDEL PANTOJA MARTINEZ SPRING PEDIC, INC. SCIF INSURED GLENDALE ADJ6902335 FLORA EASON DEL RICHARDSON AND ASSOC SCIF INSURED GLENDALE ADJ1137144 FLORO RAMIREZ STEPHEN THOMAS PAINTING SCIF INSURED GLENDALE ADJ429443 FRANCISCO ACEVEDO TRICO CONVERTING INC SCIF INSURED GLENDALE ADJ2305202 FRANCISCO LOPEZ DANIEL MOORE DBA PHOENIX INDUSTRIES SCIF INSURED GLENDALE ADJ2305202 FRANCISCO LOPEZ DAVID MOORE DBA KITCHENS BY DESIGN SCIF INSURED GLENDALE ADJ3607457 FRANCISCO MENENDEZ MARTINEZ DISTRIBUTING CO SCIF INSURED GLENDALE ADJ7762007 FRANCISCO RIOS BAYCO FINANCIAL CORPORATION SCIF INSURED GLENDALE ADJ6729392 FREHIWOT WORKU LOS ANGELES URBAN LEAGUE SCIF INSURED GLENDALE ADJ8466753 GABRIEL COSIO COMMONWEALTH INTERNATINOAL INC SCIF INSURED GLENDALE ADJ3100653 GABRIEL QUINTANA INSTA TUNE SCIF INSURED GLENDALE ADJ2947782 GARY WOODS BROWN'S AUTO GLASS SCIF INSURED GLENDALE ADJ9657612 GASPAR CORONA LA TAQUIZA SCIF INSURED GLENDALE ADJ1145786 GERALD STEARN 6 8 10 CONSTRUCTION SCIF INSURED GLENDALE ADJ8491032 GERARDO CARBAJAL DNK BUILDERS INC SCIF INSURED GLENDALE ADJ495593 GILBERTO ESPINOZA HANSON TANK COMPANY SCIF INSURED GLENDALE ADJ534900 GILBERTO SOTO 310 MOTORING SCIF INSURED GLENDALE ADJ9271841 GLORIA CORONA PDA GROUP SCIF INSURED GLENDALE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ696931 GLORIA MARTINEZ R AND S SPORTSWEAR SCIF INSURED GLENDALE ADJ4445323 GRACIELA SAINZ ROZE ROOM HOSPICE SCIF INSURED GLENDALE ADJ3124014 GRASIANO LOYA A & M SCULPTURED METALS SCIF INSURED GLENDALE ADJ3270705 GREGORIO CHODAKOWSKY KEN GUO WEI CHAN SCIF INSURED GLENDALE ADJ3703946 GUILLERMO SALAS LA COLONIAL TORTILLA PRODUCTS SCIF INSURED GLENDALE ADJ3956270 GUSTAVO CHAMARRO R.J. RULEY & SON CONSTRUCTION CO. SCIF INSURED GLENDALE ADJ1743603 GUSTAVO VILLANUEVA CHIKATO BROS ICE CO SCIF INSURED GLENDALE ADJ8049404 HAIHONG SY FAIRVIEW DEVELOPMENTAL CENTER SCIF INSURED GLENDALE ADJ7602090 HAN DONG DONG SUPER COACH INC SCIF INSURED GLENDALE ADJ1349227 HECTOR CHAVARRIA AUTUMN COTTAGE ADULT DAY CARE SCIF INSURED GLENDALE ADJ7582746 HERON VILLEGAS NEW CENTURY INDUSTRIES INC SCIF INSURED GLENDALE ADJ7833419 HILDA BUCHELLI ALL STAR DRIVING SCHOOL SCIF INSURED GLENDALE ADJ4311594 HOA NGUYEN PACIFIC ASIAN CONSORTIUM SCIF INSURED GLENDALE ADJ3213659 HORTENCIA BRAVO MATRIX PERSONNEL STAFFING SERVICES SCIF INSURED GLENDALE ADJ3213659 HORTENCIA BRAVO RELY STAFF SCIF INSURED GLENDALE ADJ3124947 HUGO LOPEZ S.J. ROCKS INC SCIF INSURED GLENDALE ADJ1426580 HUMBERTO RANGEL LINDSEY-RAMME INC SCIF INSURED GLENDALE ADJ7281696 HYUNG KIM DANNY`S LIQUOR SCIF INSURED GLENDALE ADJ693255 IGNACIO PENALOZA BCI FRAMING AND DRYWALL SCIF INSURED GLENDALE ADJ187555 IGNACIO ZENDEJAS SALSBURY ENGINEERING & GRADING SCIF INSURED GLENDALE ADJ4414084 IRMA ARZOLA SHERWOOD MANAGEMENT COMPANY SCIF INSURED GLENDALE ADJ725833 IRMA ARZOLA SHERWOOD MANAGEMENT COMPANY SCIF INSURED GLENDALE ADJ7043916 IRMA GONZALEZ CARMEL AT THE COLONY APTS SCIF INSURED GLENDALE ADJ138062 IRMA MORALES CHILD ABUSE PREVENTION CENTER SCIF INSURED GLENDALE ADJ9037906 IRMA RUIZ PAYNE S JANITORIAL SERVICES SCIF INSURED GLENDALE ADJ2474598 IRMA SAMAYOA LA CURACAO SCIF INSURED GLENDALE ADJ2536170 ISAAC OWUSU ADM ASSOCIATES INC SCIF INSURED GLENDALE ADJ3125188 ISAIAS SANDOVAL RAH INDUSTRIES SCIF INSURED GLENDALE ADJ7200656 ISIDRO LOPEZ G R WILCOXSON CONSTRUCTION INC SCIF INSURED GLENDALE ADJ2996137 ISIDRO REZA LANDA HARLINE ENTERPRISES SCIF INSURED GLENDALE ADJ7153856 ISRAEL GUILLEN CORYDON CONSTRUCTION INC SCIF INSURED GLENDALE ADJ430189 ISRAEL TRUJILLO HOLCOMB ENGINEERING SCIF INSURED GLENDALE ADJ2383784 IVONNE HERNANDEZ 907 NITE CLUB SCIF INSURED GLENDALE ADJ2383784 IVONNE HERNANDEZ NITE CLUB C O IRVING KAUFMAN SCIF INSURED GLENDALE ADJ7814314 JAIME LOPEZ CAPS PAINT AND BODY SCIF INSURED GLENDALE ADJ4287836 JAMES MANOR EVANS DEDICATED SYSTEMS SCIF INSURED GLENDALE ADJ3414499 JAMES TOMLINSON CORPORATED DRIVER SERVICES SCIF INSURED GLENDALE ADJ7010816 JAVIER AGUILAR TOWN AND COUNTRY DISTIVE EVENT SCIF INSURED GLENDALE ADJ9379777 JAVIER BRAMBILA KENS SPRAY EQUIPMENT INC SCIF INSURED GLENDALE ADJ7555123 JAVIER SANTOS ROSALIO RICHLINE TEXTILE INC SCIF INSURED GLENDALE ADJ3231577 JESSICA SANCHEZ SAINT VINCENT DE PAUL SCIF INSURED GLENDALE ADJ6628899 JESSY LOPEZ BK CONSTRUCTION SERVICE SCIF INSURED GLENDALE ADJ2038251 JESUS CEJA CROSS BROTHERS SCIF INSURED GLENDALE ADJ1457469 JESUS DE OCA MONTES UNIFIRST CORPORATION SCIF INSURED GLENDALE ADJ4316712 JESUS JIMENEZ PAINT BOY, INC. SCIF INSURED GLENDALE ADJ8188294 JESUS MORALES ABILITY SEPTIC AND SEWER SCIF INSURED GLENDALE ADJ6877024 JESUS MORALES POSADA FERNANDO DAVILA & SONS SCIF INSURED GLENDALE ADJ7458210 JESUS PALMA PRESTIGE MOVING AND STORAGE SCIF INSURED GLENDALE ADJ2652284 JESUS SANCHEZ ALCAST FOUNDRY INC SCIF INSURED GLENDALE ADJ2478620 JESUS TELLEZ METAL FABRICATION NATIONAL SCIF INSURED GLENDALE ADJ7180839 JESUS VELASCO MGD SCIF INSURED GLENDALE ADJ3475065 JESUS VERA AMERICAN EAGLE ROOFING INC SCIF INSURED GLENDALE ADJ3475065 JESUS VERA EAGLE ROOFING SCIF INSURED GLENDALE ADJ7535320 JOAQUIN ALARCON ACOSTA PERLEY CABLE CONSTRUCTLON OF CALIFORNIA SCIF INSURED GLENDALE RAJESHKUMAR AND JASODA NATHRAJ DBA COUNTRY INN ADJ7893346 JOAQUINA VASQUEZ SCIF INSURED GLENDALE BANNING RAJESHKUMAR AND JOSADA NATHRAJ DBA COUNTRY INN ADJ7893346 JOAQUINA VASQUEZ SCIF INSURED GLENDALE BANNING ADJ7635055 JONATHAN CURL BJK INC GALLERY SERVICE SCIF INSURED GLENDALE ADJ361090 JORGE ACOSTA PACIFIC STATES SCIF INSURED GLENDALE ADJ361090 JORGE ACOSTA PACIFIC STATES ENGINEERING SCIF INSURED GLENDALE ADJ2074624 JORGE ALBERTO ORANTES CAM GUARD SECURITY SCIF INSURED GLENDALE ADJ1749330 JORGE JARAMILLO CECIL SAYDAH CO SCIF INSURED GLENDALE ADJ2008840 JORGE JARAMILLO GARDEN PRINTS SCIF INSURED GLENDALE ADJ7493260 JORGE PACHECO RENT A BIN SCIF INSURED GLENDALE ADJ429934 JOSE ALVAREZ UNITED STEEL AND METALS SCIF INSURED GLENDALE ADJ6658131 JOSE ALVAREZ KOBOLD CONSTRUCTION SCIF INSURED GLENDALE ADJ7899247 JOSE AREVALO CAL PAC ENGINEERING SCIF INSURED GLENDALE ADJ7588008 JOSE CALDERON SRHT PROPERTY MANAGEMENT SCIF INSURED GLENDALE ADJ7588008 JOSE CALDERON SRHT PROPERTY MANAGEMENT CO SCIF INSURED GLENDALE ADJ6931058 JOSE CALIXTO VEGA EXPRESS CONTRACTORS INC SCIF INSURED GLENDALE ADJ6908713 JOSE CASTANEDA EXKO DRYWALL SCIF INSURED GLENDALE ADJ6867892 JOSE DE LA SANCHA GLASS INC INTERNATIONAL/ UNITED CASTINGS SCIF INSURED GLENDALE ADJ4615968 JOSE DUBOIS ALEX MARTIN CONSTRUCTION SCIF INSURED GLENDALE ADJ2615665 JOSE ESPINOZA YAEGAKI CORP OF USA SCIF INSURED GLENDALE ADJ3609444 JOSE GARCIA OMNI METAL FINISHING SCIF INSURED GLENDALE ADJ2257686 JOSE GODOY C & R DRYWALL SCIF INSURED GLENDALE ADJ7204725 JOSE GUZMAN RED LION TAVERN SCIF INSURED GLENDALE ADJ7120251 JOSE HERNANDEZ SOLTANI CONSTRUCTION SCIF INSURED GLENDALE ADJ611103 JOSE LUIS MEJIA HAMMERMILL INDUSTRIES SCIF INSURED GLENDALE ADJ625061 JOSE MOLINA PRO COURTS SCIF INSURED GLENDALE ADJ7431034 JOSE MOLINAR GSL COMMUNICATIONS SCIF INSURED GLENDALE ADJ9202580 JOSE MUNOZ ROBERT COLLINS DBA SOCAL TENAT IMPROVEMENT SCIF INSURED GLENDALE ADJ8053614 JOSE OLIVARES PAKS CABINET SCIF INSURED GLENDALE ADJ4305533 JOSE ORTIZ ROYAL CATERING COMPANY SCIF INSURED GLENDALE ADJ8548424 JOSE PANAMENO CUELLAR FLO TE PLUMBING SCIF INSURED GLENDALE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7014583 JOSE PEREZ CALIFORNIA TOUCH OF CLASS SCIF INSURED GLENDALE ADJ7014583 JOSE PEREZ EVANS AND SON TOUR SERV INC AKA CALIF TOUCH OF CLASS SCIF INSURED GLENDALE ADJ6796533 JOSE RAMOS RUDY YBARRA CONSTRUCTION SCIF INSURED GLENDALE ADJ8619621 JOSE REYES JOSE MARTINEZ SCIF INSURED GLENDALE ADJ4675095 JOSE RIOS BYRON H COX PAINTS SCIF INSURED GLENDALE ADJ411547 JOSE SANCHEZ CUSTOM PROCESSORS/P &C POULTRY SCIF INSURED GLENDALE ADJ2034592 JOSE VARGAS MALLIN CASUAL FURNITURE SCIF INSURED GLENDALE ADJ7829829 JOSE VASQUEZ RUDY CARRILLO DRYWALL INC SCIF INSURED GLENDALE ADJ6702959 JOSE ZAVALA SAVALAS ROOFING COMPANY SCIF INSURED GLENDALE ADJ7181314 JOSE ZETINA DESERT COMERCIAL CONCRETE SCIF INSURED GLENDALE ADJ1135840 JOSEFINA JIMENEZ AB/TI INC. SCIF INSURED GLENDALE ADJ7020757 JUAN ALVAREZ JR DEAN ENTERPRISES SCIF INSURED GLENDALE ADJ6819990 JUAN CABRERA NOEL WELDING CENTER INC SCIF INSURED GLENDALE ADJ9716820 JUAN CAMPOS COMMUNITY OF CHANGE SCIF INSURED GLENDALE ADJ9354693 JUAN CARLOS PACHECO JOHN NESLER JR SCIF INSURED GLENDALE ADJ1369209 JUAN DURAN VELOCITY STAFFING CORP SCIF INSURED GLENDALE ADJ7612228 JUAN GONZALEZ GARIDELLES MOVING DBA WALTERS TRANSFER SCIF INSURED GLENDALE ADJ8839488 JUAN GUERRA GT ALDERMAN INC SCIF INSURED GLENDALE ADJ4590010 JUAN GUZMAN PAUL CALVO & COMPANY SCIF INSURED GLENDALE ADJ7089131 JUAN IGNACIO ALVAREZ SR DEAN ENTERPRISES SCIF INSURED GLENDALE ADJ7089131 JUAN IGNACIO ALVAREZ SR WHITING COMPANY SCIF INSURED GLENDALE ADJ9394598 JUAN JOSE MELENDEZ RAMI DESIGNS SCIF INSURED GLENDALE ADJ1810800 JUAN MANUEL RIVERA TEMPLOY INC SCIF INSURED GLENDALE ADJ6697083 JUAN MENDEZ ITO OZAWA FARMS SCIF INSURED GLENDALE ADJ7431523 JUAN VELA YOSEMITE SAM TRANSPORT SCIF INSURED GLENDALE ADJ1234191 JULIAN UBIARCO PANIAN'S SHOE FASHION CO SCIF INSURED GLENDALE ADJ8053583 JULIO MARTINEZ CALIFORNIA GREEN GENERAL GARDEN SCIF INSURED GLENDALE ADJ9366790 JUVENTINO LOPEZ PRIMED PRODUCTIONS SCIF INSURED GLENDALE ADJ7615799 KAREN GARCIA CAREGIVERS USA INC SCIF INSURED GLENDALE ADJ7410690 KAREN VARGAS LG PROFESSIONALS SCIF INSURED GLENDALE ADJ8117121 KENNETH GARCIA NATIONAL PROTECTIVE SERVICES INC SCIF INSURED GLENDALE ADJ4705762 KIMBERLY MAC SOUTHLAND TITLE CORPORATION SCIF INSURED GLENDALE ADJ7286313 LEOBARDO VARGAS RAND FARM INC SCIF INSURED GLENDALE ADJ8548617 LIZBETH BOJORQUEZ JUMP FOR FUN CALIFORNIA SCIF INSURED GLENDALE ADJ7065224 LORENZO RUBIO HOLLYWOOD REALITY SCIF INSURED GLENDALE ADJ1979926 LOUIS DE ARMAS PREMIER HEALTH CARE SCIF INSURED GLENDALE ADJ977566 LUIS CONTRERAS PHILATRON INTERNATIONAL SCIF INSURED GLENDALE ADJ9426412 LUIS GOMEZ NATIONAL GROUP SECURITY SCIF INSURED GLENDALE ADJ6687387 LUIS GUZMAN HERRON CONSTRUCTION INC SCIF INSURED GLENDALE ADJ1456432 LUIS MANUEL PEREZ ATLAS TEXTILES SCIF INSURED GLENDALE ADJ3365030 LUZ FELIX CHAMPION TURF EQUIPMENT SCIF INSURED GLENDALE ADJ7261663 MANUEL GUTIERREZ PREMIUM WOODSTAKES INC SCIF INSURED GLENDALE ADJ4392416 MANUEL VELASQUEZ KO RANCH & CAMPGROUND SCIF INSURED GLENDALE ADJ6849162 MANUEL VILLA TNT AERIAL AND CRANE REPAIR SERVICE SCIF INSURED GLENDALE ADJ4524916 MARCELINO HERNANDEZ BEST TREND, INC. SCIF INSURED GLENDALE ADJ4524916 MARCELINO HERNANDEZ PALM KNITS INC. SCIF INSURED GLENDALE ADJ6751571 MARCELO MATURANA EDWARDS PAINTING SCIF INSURED GLENDALE ADJ6751571 MARCELO MATURANA EDWARDS PAINTING INC SCIF INSURED GLENDALE ADJ247821 MARCOS SUREC R.B. WELDING, INC. SCIF INSURED GLENDALE ADJ4380826 MARIA AMAYA NORTHRIDGE MILLS INC SCIF INSURED GLENDALE ADJ9432571 MARIA BENITEZ GREEN OLIVE RESTAURANT SCIF INSURED GLENDALE ADJ2462746 MARIA CAMARGO DISTINCTIVE INDUSTRIES SCIF INSURED GLENDALE ADJ4693173 MARIA DE CARMEN TEOBA PERFECT INK, INC. SCIF INSURED GLENDALE ADJ9482672 MARIA DOLORES HIGUERA ENJOY FACTORY JERKY BEEF SCIF INSURED GLENDALE ADJ653597 MARIA ELIZABETH RIVAS KINARA SPA SCIF INSURED GLENDALE ADJ8216873 MARIA GUIZAR PACIFICA FLOWERS INC SCIF INSURED GLENDALE ADJ8176192 MARIA PALMER CALIFORNIA INSTITUTION FOR WOMEN SCIF INSURED GLENDALE ADJ8176192 MARIA PALMER DEPT CORRECTIONS FOR WOMEN SCIF INSURED GLENDALE ADJ2499318 MARIA REYES TRIMCO SCIF INSURED GLENDALE ADJ6547206 MARICELA HERNANDEZ HESPERIA SENIOR CAMPUS AKA SENIOR CAMPUS BY LEGACY SCIF INSURED GLENDALE ADJ7119993 MARIE GUERRERO SUNNY HILLS ASSISTED LIVING SCIF INSURED GLENDALE ADJ7502163 MARIO CARRIZAL AVILA JB INDUSTRIES CORPORATION SCIF INSURED GLENDALE ADJ1869080 MARIO GONZALEZ LO HA GAS CORPORATION SCIF INSURED GLENDALE ADJ1060125 MARIO ROBLES SO CAL PORTABLE RESTROOM CO SCIF INSURED GLENDALE ADJ9061890 MARISOL SERRANO NATIONAL CHARITY SUPPORT FOUNDATION SCIF INSURED GLENDALE ADJ8207721 MARITZA FLORES GENERAL CLEANING SERVICES SCIF INSURED GLENDALE ADJ2480993 MARK LANDSBERGER ACE ENGINEERING INC SCIF INSURED GLENDALE ADJ6783445 MARTA ASTORGA THE CLASSIC SOFT TRIM GROUP SCIF INSURED GLENDALE ADJ6682948 MARTHA CAMP VISITING ANGELS OF HOLLYWOOD HILLS SCIF INSURED GLENDALE ADJ7261600 MARTHA JUAREGUI HARBOR DENTAL CARE SCIF INSURED GLENDALE ADJ6666703 MARTIN SALAS DENNYS PALMDALE DENNYS ONTARIO DBA DENNYS RESTAURANT SCIF INSURED GLENDALE ADJ6666703 MARTIN SALAS DENNYS REATAURANT SCIF INSURED GLENDALE ADJ7430076 MARVIN MENDOZA TED LEVINE DRUM CO SCIF INSURED GLENDALE ADJ8233726 MARY LOU PEREZ ROBERT BRIDGES FOUNDATION SCIF INSURED GLENDALE ADJ4468039 MATIAS LARIOS VALLEJO ROOFING SCIF INSURED GLENDALE ADJ7160917 MAXIMO CRUZ PACIFIC FABRIC FINISHING INC SCIF INSURED GLENDALE ADJ7160917 MAXIMO CRUZ PACIFIC FABRIC FINISHING INC DBA CHRIS STONE INC SCIF INSURED GLENDALE ADJ7304187 MICHAEL KIEWERT CANOGA REBAR INC SCIF INSURED GLENDALE ADJ3927181 MICHAEL SERCL TRIAD FINANCIAL CORPORATION SCIF INSURED GLENDALE ADJ4526210 MIGUEL GUERRERO RGE TRUCKLINES, INC. SCIF INSURED GLENDALE ADJ3909266 MIGUEL GUEVARA SUNWEST CLEAN UP, INC. SCIF INSURED GLENDALE ADJ7977176 MIGUEL JIMENEZ A2Z PLATING CO INC SCIF INSURED GLENDALE ADJ9580361 MIGUEL MENENDEZ MARLEON SCIF INSURED GLENDALE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8364396 MIGUEL MUNOZ COOLING CONNECTION II SCIF INSURED GLENDALE ADJ6597285 MOISES OLIVA AI FOODS CORPORATION SCIF INSURED GLENDALE ADJ8479760 NATHAN CABRERA CALIFORNIA MOTOR CLUB SCIF INSURED GLENDALE ADJ10187163 NESTOR CABRERA SUPER LIGHT CENTER SCIF INSURED GLENDALE ADJ7427935 NICK CATALANO CAPITAL PROTECTION INC SCIF INSURED GLENDALE ADJ7367459 NICOLAS VERA HP CONSTRUCTION AND MANAGEMENT SCIF INSURED GLENDALE ADJ6666673 NICOLE KOLLER CHOIX VOCATIONAL SCIF INSURED GLENDALE ADJ8610176 NORA ESTABAN ONE CALL MEDICAL INC SCIF INSURED GLENDALE ADJ6731932 NORMA FLORES THE SPA AT SOUTH COAST PLAZA SCIF INSURED GLENDALE ADJ9004046 NORMA LEYBA IMHO DENNYS 7566 SCIF INSURED GLENDALE ADJ2929768 NUBI LANDAVERDE RIGHT WAY DRIVING SCHOOL SCIF INSURED GLENDALE ADJ253809 OLIVIA MORFIN STAFFING SERVICES SCIF INSURED GLENDALE ADJ9076557 OMAR HERNANDEZ ALPHA INFINITY CONSTRUCTION SCIF INSURED GLENDALE ADJ9400025 OSCAR HERNANDEZ LEONARD CHAIDEZ TREE SERVICES SCIF INSURED GLENDALE ADJ3162378 OSCAR RODRIGUEZ D&D WELDING INC SCIF INSURED GLENDALE ADJ1275991 PATRICK RIDGLE CONNECT TELEVISION INC SCIF INSURED GLENDALE ADJ9212682 PEDRO CAMPUSANO GARCIA RAZMIK CONSTRUCTION INC SCIF INSURED GLENDALE ADJ3803997 PEDRO GARCIA ANAPLEX SCIF INSURED GLENDALE ADJ3803997 PEDRO GARCIA ANAPLEX CORP SCIF INSURED GLENDALE ADJ7475228 PEDRO GARCIA ROSS MCLAREN FUEL SYSTEM SCIF INSURED GLENDALE ADJ7150209 PEDRO REBOLLAR ROMANTIX INC SCIF INSURED GLENDALE ADJ6820888 PEDRO VIVALDO CMT CORP SCIF INSURED GLENDALE ADJ6548209 PHILLIP WILLIAMS FOLEY BUILDING AND ELECTRIC SCIF INSURED GLENDALE ADJ7211265 PONCIANO SAMUS STANDARD OVERSEAS INC SCIF INSURED GLENDALE ADJ8583585 PRINSA MORALES ACADEMIC ADVANTAGE SCIF INSURED GLENDALE ADJ6573787 RAFAEL ARAIZA SOLIDWAY CONSTRUCTION GROUP SCIF INSURED GLENDALE ADJ6789084 RAFAEL MEDINA AERODYNAMIC PLATING CO INC SCIF INSURED GLENDALE ADJ7303676 RAMIRO HURTADO WELD IT COMPANY SCIF INSURED GLENDALE ADJ6818204 RAMIRO ORTEGA MUSCOY MUTUAL WATER SCIF INSURED GLENDALE ADJ6997336 RAMON BARAJAS-DIAZ JENSEN MCCLARTY LLC SCIF INSURED GLENDALE ADJ1621717 RAMON CASTILLO MEADOW FARMS SAUSAGE CO. SCIF INSURED GLENDALE ADJ3448258 RAMON CONTRERAS SINAI CONSTRUCTION SCIF INSURED GLENDALE ADJ6845637 RAMON GARCIA SOUTH BAY STONE INC SCIF INSURED GLENDALE ADJ6845637 RAMON GARCIA SOUTH BAY STONE INCORPORATED SCIF INSURED GLENDALE ADJ4068988 RAMON SANTAMARIA MESA INC SCIF INSURED GLENDALE ADJ6411273 RAMON ZACARIAS MACHIS FLOOR CO SCIF INSURED GLENDALE ADJ7360629 RAUL MONREAL QUEST CONSTRUCTION SCIF INSURED GLENDALE ADJ3169984 RAUL PADILLA SOUTHWEST AUTO TRANSFER SCIF INSURED GLENDALE ADJ6894984 RAYMUNDO QUINTERO SUPERIOR SCIF INSURED GLENDALE ADJ909139 RAYMUNDO RODRIGUEZ GORDON FLOOR COVERING SCIF INSURED GLENDALE ADJ8905699 REFUGIO CASTANEDA ANCA SOLAR INC SCIF INSURED GLENDALE ADJ3077273 REINA MEJIA NORTHRIDGE MILLS INC SCIF INSURED GLENDALE ADJ6942087 REYNALDO PEREZ CAL TRANS SCIF INSURED GLENDALE ADJ7673751 RICARDO CARRILLO CARNICERIA 21 SCIF INSURED GLENDALE ADJ8642784 RICARDO ESTRADA ZION MULTIMEDIA CORP SCIF INSURED GLENDALE ADJ7915220 RICARDO GARZA MULTI CABLE INC SCIF INSURED GLENDALE ADJ7269776 RICARDO HERRERA IMPERIAL CFS INC SCIF INSURED GLENDALE ADJ7802713 RICARDO SACAYON ALVAREZ STAR ALTADENA MARKET SCIF INSURED GLENDALE ADJ9512463 RIGOBERTO GARCIA CORREA PRO DEK SCIF INSURED GLENDALE ADJ9626231 RIGOBERTO HERRERA SPEEDWAY CAR WASH INC SCIF INSURED GLENDALE ADJ6588398 ROBERT 111 THOMAS JC TOWING SCIF INSURED GLENDALE ADJ919058 ROBERT HAYWOOD POINT WEST TRUCKING INC SCIF INSURED GLENDALE ADJ919058 ROBERT HAYWOOD POINTS WEST TRUCKING SCIF INSURED GLENDALE ADJ3513796 ROBERTO BECERRA CHRYSALIS CENTER SCIF INSURED GLENDALE ADJ3243331 ROBERTO CONTRERAS MCFARLANE CONSTRUCTION SCIF INSURED GLENDALE ADJ9311504 ROBERTO CORONA CRISANTO COIN LAUNDRY CHO CO SCIF INSURED GLENDALE ADJ646504 ROBERTO DIAZ CITIPOST, INC. SCIF INSURED GLENDALE ADJ3111880 ROBERTO LARA BUDDY BAR CASTING SCIF INSURED GLENDALE ADJ7144774 RODOLFO GONZALEZ SOUTHLAND COMMERCIAL INTERIORS INC SCIF INSURED GLENDALE ADJ6878776 RODOLFO RODRIGUEZ TREEMENDOUS TREE TRIMMING SCIF INSURED GLENDALE ADJ7344905 ROGELIO MENDEZ PERFORMERS CONCRETE SCIF INSURED GLENDALE ADJ3568698 ROGER SCHENDEL B & B SALES SCIF INSURED GLENDALE ADJ1519738 ROLANDO ROMAN BUILDING & CONTRACTING CORP. SCIF INSURED GLENDALE ADJ6665744 RONALD NOYOLA MCKINLEY CHILDRENS CENTER SCIF INSURED GLENDALE ADJ4069584 RONALD VINCENT CITY OF WEST HOLLYWOOD SCIF INSURED GLENDALE ADJ3568167 ROSA CARDENAS CPE STAFF INC/GIUMARRA SCIF INSURED GLENDALE ADJ7298568 ROSA CASTRO ABOUT TIME CATERING SCIF INSURED GLENDALE ADJ1988078 ROSA MISNER B & A CONSULTING SCIF INSURED GLENDALE ADJ7419833 RUBEN MENDOZA CREATING CONCRETE PAVING SCIF INSURED GLENDALE ADJ8019924 SALVADOR GUZMAN SOUTHERN CALIFORNIA AIR SCIF INSURED GLENDALE ADJ7162197 SALVADOR TORRES MACO IMPORT & EXPORT INC SCIF INSURED GLENDALE ADJ6774815 SAMUEL AKA CARLOS BRAVO AKA BRAVO EL 7 MARES RESTAURANT SCIF INSURED GLENDALE ADJ6520156 SAMUEL SANTANA NOICO FEED AND RECYELING SCIF INSURED GLENDALE ADJ6520156 SAMUEL SANTANA NORCO FEED AND RECYCLING SCIF INSURED GLENDALE ADJ982835 SANDI DWYER TOM KALILI DMD SCIF INSURED GLENDALE ADJ2574802 SANTIAGO LUA INDUSTRIAL WIRE PRODUCTS SCIF INSURED GLENDALE ADJ7165083 SELVIN NAVARRO HOLLYWOOD FOREVER INC SCIF INSURED GLENDALE ADJ4376528 SERGIO CARCAMO WAPO GROUP SCIF INSURED GLENDALE ADJ9034452 SERVANDO SANCHEZ BEVERLY HILLS LAUNDRIES SCIF INSURED GLENDALE ADJ8312888 SHARI ORTIZ PACIFIC CHILD FAMILY ASSOCIATES SCIF INSURED GLENDALE ADJ2785578 SHARON HARRISON CHARLES DREW MED. SCHOOL SCIF INSURED GLENDALE ADJ2785578 SHARON HARRISON CHARLES DREW UNIVERSITY SCIF INSURED GLENDALE ADJ582461 SHARONDA THOMAS ADMINISTAFF COMPANIES SCIF INSURED GLENDALE ADJ582461 SHARONDA THOMAS ADMINSTAFF COMPANIES SCIF INSURED GLENDALE ADJ7477263 SHERRY WHITE ALL CITY MANAGEMENT SERVICES SCIF INSURED GLENDALE ADJ933029 SILVIA GARCIA ALLIED WEST PAPER CORP. SCIF INSURED GLENDALE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7033057 SILVIA HERNANDEZ THE BENTLEY HOMES SCIF INSURED GLENDALE ADJ1949704 SIMITRIO PEDROZA KRAMER MASONRY CONSTRUCTION SCIF INSURED GLENDALE ADJ1949704 SIMITRIO PEDROZA KRAMERS MASONRY CONSTRUCTION SCIF INSURED GLENDALE ADJ3555316 SINDY BOWMAN DAVID & MARGARET HOME SCIF INSURED GLENDALE ADJ851457 SOLEDAD OLIVO BALLY'S TOTAL FITNESS SCIF INSURED GLENDALE ADJ7096220 SOLEDAD REYES ELEGANT CABINET DOORS SCIF INSURED GLENDALE ADJ1199001 STANLEY MATHEWS SYSTEMS INTEGRATED SCIF INSURED GLENDALE ADJ2158306 SULEMA WILBORN VENGROFF, WILLIAMS & ASSOCIATES SCIF INSURED GLENDALE ADJ7375647 TAMARA ORTIZ WILLIS GVD GUFFEY PTR DBA VALERO GAS STATION SCIF INSURED GLENDALE ADJ6564918 TERESA CARDENAS CEMENT AND PAVEMENT CLEANING SCIF INSURED GLENDALE ADJ1467472 TERESA ELENA LOPEZ INTERSTATE HOME SERVICES SCIF INSURED GLENDALE ADJ4465831 TIMOTHY TIRRE HOLIDAY PORCELAIN ENAMEL COMPANY SCIF INSURED GLENDALE ADJ3334060 VANESSA CHALMERS BALLY TOTAL FITNESS SCIF INSURED GLENDALE ADJ2565403 VICTOR VELADOR STANDARD SALES INC SCIF INSURED GLENDALE ADJ7129264 VIRGINIA ALBARRAN AMERICAN COPAK CORPORATION SCIF INSURED GLENDALE ADJ8809465 VIRGINIA GONZALEZ GARCIA FARMING SCIF INSURED GLENDALE ADJ6928543 WILLIAM FUENTES CB TYRES RECYCLING SCIF INSURED GLENDALE ADJ400775 YOLANDA GARCIA CITY SERVICES MANAGEMENT SCIF INSURED GLENDALE ADJ3112696 ZACARIAS DIZON PROFILE STRUCTURES SCIF INSURED GLENDALE ADJ3112696 ZACARIAS DIZON PROFILE STRUCTURES INC SCIF INSURED GLENDALE ADJ3112696 ZACARIAS DIZON PROFILE STRUCTUTRES SCIF INSURED GLENDALE ADJ3053090 FRANCISCO ACEVEDO TRICO CONVERTING INC SCIF INSURED GLENDALE UNIT B ADJ3603910 JOSE ALCALA AADLEN BROS AUTO WRECKING SCIF INSURED GLENDALE UNIT B ADJ1073753 JERONIMO ARGUETA CUSTOM GOODS LLC SCIF INSURED GLENDALE UNIT C ADJ1083005 FRANCISCO ZUNIGA NDK FOODS SCIF INSURED GLENDALE UNIT F ADJ7992443 ARACELY PEREZ 3360 MAGNOLIA AVE INC SCIF INSURED GLENDALE ADJ7203976 DORIS LEHOULLIER THE HEALTHCARE FOUNDATION FOR ORANGE COUNTY SCIF INSURED GLENDALE ADJ7357843 MAGDA MUNOZ SOUTH BAY WIC DBA ST MARGARETS CENTER SCIF INSURED GLENDALE ADJ7172467 ABEL CERDA CUSTOM SIGNS INC SCIF INSURED INLAND EMPIRE ADJ269961 ADELA GARCIA VALLEY THRIFT / ATLAS MANAGEMENT SCIF INSURED INLAND EMPIRE ADJ1999269 ALFRED JAIMEZ ROBERT STINCHFIELD INC. SCIF INSURED INLAND EMPIRE ADJ2381367 ANGEL PEREZ WET SET, INC. SCIF INSURED INLAND EMPIRE ADJ7658731 ANTONIO ROBLES CONTROLLED ENVIROMENTAL SOLUTIONS SCIF INSURED INLAND EMPIRE ADJ7658731 ANTONIO ROBLES CONTROLLED ENVIRONMENTAL SOLUTIONS SCIF INSURED INLAND EMPIRE ADJ8859158 ARMANDO MELGOZA F AND J ENTERPRISE SCIF INSURED INLAND EMPIRE ADJ9228823 BARBARA MONTANEZ VAN NUYS TREATMENT CENTER SCIF INSURED INLAND EMPIRE ADJ8680090 BRAULIO MONDRAGON RAMOS LEE S METALS DBA DYM METAL SCIF INSURED INLAND EMPIRE ADJ3764070 CAMILO RODRIGUEZ B AND B FRAMING SCIF INSURED INLAND EMPIRE ADJ971830 CANDELARIO HERNANDEZ DESERT VALLEY CONSTRUCTION AND ROOFING SCIF INSURED INLAND EMPIRE ADJ971830 CANDELARIO HERNANDEZ DESERT VALLEY CONTRUCTION & ROOFING SCIF INSURED INLAND EMPIRE ADJ9616686 CHRISTINE NELSON MONTE VISTA CARE CENTER SCIF INSURED INLAND EMPIRE ADJ3168187 CORY OWEN BAKER CONSTRUCTION SCIF INSURED INLAND EMPIRE ADJ8617230 CRUZ HERRERA 11 SHEA ROOFING SCIF INSURED INLAND EMPIRE ADJ140115 DALLAS TIENTER R & S BEVERAGE SCIF INSURED INLAND EMPIRE ADJ140115 DALLAS TIENTER R S BEVERAGE COMPANY SCIF INSURED INLAND EMPIRE ADJ3766521 DUC LAM GALASSO S BAKERY SCIF INSURED INLAND EMPIRE ADJ3766521 DUC LAM GALASSO'S BAKERY SCIF INSURED INLAND EMPIRE ADJ220051 EDRULFO TESTA R & B REINFORCING STEEL SCIF INSURED INLAND EMPIRE ADJ7337798 ELENA GARCIA RELIABLE BUILDING MAINTENANCE SCIF INSURED INLAND EMPIRE ADJ3627470 EMMA CANALES UPLAND REHABILITAION & CARE CENTER SCIF INSURED INLAND EMPIRE ADJ4566094 ENJOLI MERCADEL CHARLIE FAMILY CARE SCIF INSURED INLAND EMPIRE ADJ7502548 ERASMO PINEDA SOUTHERN CALIFORNIA WEST COAST ELECTRIC SCIF INSURED INLAND EMPIRE ADJ6778132 ESTEBAN GUZMAN JLF CONTRACT FURNISHINGS SCIF INSURED INLAND EMPIRE ADJ6856251 FEDERICO GONZALEZ BAY CONSTRUCTION INC SCIF INSURED INLAND EMPIRE ADJ3980281 FERNANDO MENDOZA NAVARRO RBI FRAMING SCIF INSURED INLAND EMPIRE ADJ1337670 FERNANDO SANDOVAL GENERATIONS PAINTING INC. SCIF INSURED INLAND EMPIRE ADJ1131784 FLAVIO ORTEGA OREGON PACIFIC BUILDING PRODUCTS SCIF INSURED INLAND EMPIRE ADJ2113251 FRANCISCO HERNANDEZ GOLDENWEST FARM LABOR CONTRACTOR SCIF INSURED INLAND EMPIRE ADJ4384415 FRANCISCO MORENO WORLD TRIANGLE INC SCIF INSURED INLAND EMPIRE ADJ653725 FRANK CATHRILL PERRIS UNIFIED SCHOOL DISTRICT SCIF INSURED INLAND EMPIRE ADJ653725 FRANK CATHRILL PERRIS UNION HIGH SCHOOL SCIF INSURED INLAND EMPIRE ADJ653725 FRANK CATHRILL PERRIS UNION HIGH SCHOOL DISTRICT SCIF INSURED INLAND EMPIRE ADJ7366606 GEORGE MARTINEZ WHITE HOUSE SANITATION SCIF INSURED INLAND EMPIRE ADJ6737447 GERARDO ALBA CASILLAS CLARY ROOFING SCIF INSURED INLAND EMPIRE ADJ7615634 GILBERT ARMIJO US TRUCKING AND MOVING SCIF INSURED INLAND EMPIRE ADJ3371146 GLORIA BRADFORD PECHINEY CAST PLATE SCIF INSURED INLAND EMPIRE ADJ2022374 GONZALO LOPEZ QUICK PERSONNEL STAFFING SCIF INSURED INLAND EMPIRE ADJ1209716 GUADALUPE SANCHEZ COACHELLA VALLEY CITRUS SCIF INSURED INLAND EMPIRE ADJ2599587 GUSTAVO BARAJAS SW CONSTRUCTION INC SCIF INSURED INLAND EMPIRE ADJ6729316 HECTOR FLORES CALIFORNIA EXPANDED SCIF INSURED INLAND EMPIRE ADJ6729316 HECTOR FLORES HART EMPLOYMENT SCIF INSURED INLAND EMPIRE ADJ3886522 HECTOR JIMENEZ DEL RIO ENTERPRISES SCIF INSURED INLAND EMPIRE ADJ2812038 HECTOR LOPEZ DANKO INC SCIF INSURED INLAND EMPIRE ADJ1700636 HECTOR SANCHEZ WEATHER LINE ROOFING SCIF INSURED INLAND EMPIRE ADJ6842292 HIRAM SANCHEZ DAVID LAMBARD ENTERPRISES INC SCIF INSURED INLAND EMPIRE ADJ2992214 IGNACIO DE LARA AMKO FIXTURES & SEATING CO.,INC. SCIF INSURED INLAND EMPIRE ADJ4025092 ISAIAS CUEVAS CRANK BROTHERS SCIF INSURED INLAND EMPIRE ADJ4025092 ISAIAS CUEVAS CRANK BROTHERS DECK COMPANY INC SCIF INSURED INLAND EMPIRE ADJ8218776 ISRAEL LARA GREEN LEAF SCIF INSURED INLAND EMPIRE ADJ6836745 JAMES GEYER STEVE GIBSON CONSTRUCTION INC SCIF INSURED INLAND EMPIRE ADJ1296972 JAMES PERRONE JD PACKAGING GROUP INC SCIF INSURED INLAND EMPIRE ADJ3148508 JAMES STEWART CITY ELECTRIC SCIF INSURED INLAND EMPIRE ADJ3475065 JESUS VERA AMERICAN EAGLE ROOFING INC SCIF INSURED INLAND EMPIRE ADJ3475065 JESUS VERA EAGLE ROOFING SCIF INSURED INLAND EMPIRE ADJ486298 JORGE RUBIO DESERT PRINCESS HOMEOWNERS CLUB SCIF INSURED INLAND EMPIRE ADJ1814734 JOSE ACOSTA SELBOR CONSTRUCTION INC SCIF INSURED INLAND EMPIRE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8117100 JOSE CABRERA MICRO ETCH COMPANY SCIF INSURED INLAND EMPIRE ADJ3851332 JOSE DE JESUS HERRERA DYMOND FRAMING & LUMBER CORP. SCIF INSURED INLAND EMPIRE ADJ8614953 JOSE MARTINEZ LOPEZ HULSEY CONTRACTING SCIF INSURED INLAND EMPIRE ADJ7365812 JOSE QUINTERO BARRETT BUSINESS SERV1CES SCIF INSURED INLAND EMPIRE ADJ7365812 JOSE QUINTERO JIMS CARPET SERVICE SCIF INSURED INLAND EMPIRE ADJ7724433 JOSE TRINIDAD ARREDONDO MORENO EDCO HARVEST SCIF INSURED INLAND EMPIRE ADJ7724433 JOSE TRINIDAD ARREDONDO MORENO MAINAS FARMS SCIF INSURED INLAND EMPIRE ADJ7217410 JUAN CONTRERAS HOVEY TILE ART SCIF INSURED INLAND EMPIRE ADJ4314779 JUAN GASTELUM EXPREX GENERAL CONTRACTOR SCIF INSURED INLAND EMPIRE ADJ7599411 JUAN MEZA RZ LANDSCAPING SCIF INSURED INLAND EMPIRE ADJ1409901 JUAN PEREZ WATER WELL DRILLING SCIF INSURED INLAND EMPIRE ADJ804498 JUAN VASQUEZ PHIL FERGUSON PLASTERING SCIF INSURED INLAND EMPIRE ADJ6486101 JUANA ROCHA SERVICE MASTER SCIF INSURED INLAND EMPIRE ADJ6843238 JUANA ROCHA SERVICE MASTER SCIF INSURED INLAND EMPIRE ADJ6870462 JUVENTINO RICO TURN AROUND COMMUNICATIONS SCIF INSURED INLAND EMPIRE ADJ6465014 LI SHENG TAN ROLLINS NARROW FABRIC, INC. SCIF INSURED INLAND EMPIRE ADJ7247323 LILIA ACEVEDO LOS TRES AMIGOS MEAT MARKET SCIF INSURED INLAND EMPIRE ADJ883052 LONNY KEMPF TICKEMYER CONSTRUCTION, INC. SCIF INSURED INLAND EMPIRE ADJ914716 MANUEL AMEZOLA RAGS AND MORE SCIF INSURED INLAND EMPIRE ADJ2938641 MANUEL MENDEZ SPANGLER CONSTRUCTION SCIF INSURED INLAND EMPIRE ADJ2310864 MARC POLIDORO OPTIMUM INC SCIF INSURED INLAND EMPIRE ADJ4654783 MARCO OLIVA GATEWAY PET CEMETERY SCIF INSURED INLAND EMPIRE ADJ154703 MARGARITA CARDENAS TRADEMARK PLASTIC SCIF INSURED INLAND EMPIRE ADJ154703 MARGARITA CARDENAS TRADEMARK PLASTICS SCIF INSURED INLAND EMPIRE ADJ556243 MARIA ECHEVERRIA WAREHOUSE TECHNOLOGIES SCIF INSURED INLAND EMPIRE ADJ2249119 MARIO LEON GALLES RANCH SCIF INSURED INLAND EMPIRE ADJ2249119 MARIO LEON GALLES RANCH INC. SCIF INSURED INLAND EMPIRE ADJ766189 MARIO MARQUEZ J/K EXCAVATING AND GRADING CO SCIF INSURED INLAND EMPIRE ADJ365627 MARTHA ROSALES JUICE HARVEST INC SCIF INSURED INLAND EMPIRE ADJ7517049 MIGUEL GARCIA IBARRA COATINGS SCIF INSURED INLAND EMPIRE ADJ7177780 MIGUEL SALAZAR BRIAN SOYLAND CONSTRUCTION SCIF INSURED INLAND EMPIRE ADJ2862424 MIGUEL SANDOVAL INLAND EMPIRE CONSTRUCTION SCIF INSURED INLAND EMPIRE ADJ3099375 MONICA MENDEZ METROPOLE STAFFING, INC. SCIF INSURED INLAND EMPIRE ADJ6611326 NANCY BELLAVANCE GOLDEN VILLAGE PALMS PAYDAR PROPERTIES SCIF INSURED INLAND EMPIRE ADJ3396893 OMAR GUTIERREZ COMMODITY LOGISTICS WEST, INC. SCIF INSURED INLAND EMPIRE ADJ7265392 PAULA BOYD BAKERS BURGERS INC SCIF INSURED INLAND EMPIRE ADJ9358916 RAFAEL ZAMORA KAMRAN STAFFING SCIF INSURED INLAND EMPIRE ADJ1505770 RAMON DE LA TORRE ORTIZ TRACTOR SERVICE SCIF INSURED INLAND EMPIRE ADJ7563528 REMIGIO CHAVEZ DANS ROOFING INC SCIF INSURED INLAND EMPIRE ADJ1649257 RICARDO MUNGUIA M L STEEL CONSTRUCTION SCIF INSURED INLAND EMPIRE ADJ9090563 RICHARD CUMMINS RELIABLE HAULING SCIF INSURED INLAND EMPIRE ADJ3709254 RICHARD RIJOS EAGLE IRON CONSTRUCTION, INC SCIF INSURED INLAND EMPIRE ADJ2147596 RODOLFO LOBO STC NETCOM INC SCIF INSURED INLAND EMPIRE ADJ3020918 ROLANDO RAMIREZ HANDY & HARPER SCIF INSURED INLAND EMPIRE ADJ2631586 ROSALIO SANABRIA ROCK HARD TRANSPORATION SCIF INSURED INLAND EMPIRE ADJ4196299 SALVADOR SOTO BOUDREAU PIPELINE CORPORATION SCIF INSURED INLAND EMPIRE ADJ6520156 SAMUEL SANTANA NOICO FEED AND RECYELING SCIF INSURED INLAND EMPIRE ADJ6520156 SAMUEL SANTANA NORCO FEED AND RECYCLING SCIF INSURED INLAND EMPIRE ADJ3662910 SCOTT CAMPBELL MAYERS GLASS COMPANY SCIF INSURED INLAND EMPIRE ADJ8647760 SEBASTIAN AGUILAR ACAPULCO MOTORS SCIF INSURED INLAND EMPIRE ADJ7521771 SPRING PETERS IN HOME HEALTH SERVICES SCIF INSURED INLAND EMPIRE ADJ7669922 STEPHANIE AUD APPLIED BEHAVIOR CONSULTANTS SCIF INSURED INLAND EMPIRE ADJ6642564 STEVE DELONG ICE TOWN INC SCIF INSURED INLAND EMPIRE ADJ6642564 STEVE DELONG ICE TOWN, INC. SCIF INSURED INLAND EMPIRE ADJ104290 SYLVIA GONZALEZ MATERIAL SUPPLY INC SCIF INSURED INLAND EMPIRE ADJ4020996 TONY STASKA EGGLETON TRUCKING, INC. SCIF INSURED INLAND EMPIRE ADJ819822 URIEL DOMINGUEZ NOVA COACHWORKS SCIF INSURED INLAND EMPIRE ADJ9257101 VALENTIN CORREA PEARL OF THE EAST RTC LP SCIF INSURED INLAND EMPIRE ADJ1764405 VICTOR FLORES STK INTERNATIONAL INC SCIF INSURED INLAND EMPIRE ADJ1764405 VICTOR FLORES STK INTERNATIONAL, INC. SCIF INSURED INLAND EMPIRE ADJ1121461 VICTORIA GALLEGOS STRATHAVEN ASSISTED LIVING SCIF INSURED INLAND EMPIRE ADJ1718697 VICTORIA VELEZ ANDROP PACKAGING SCIF INSURED INLAND EMPIRE ADJ9103508 VIRGINIA PEREZ ESQUIVEL MERCI SCIF INSURED INLAND EMPIRE ADJ7322209 ZAIRA PLASCENCIA DIRECT WAY PERSONNEL SCIF INSURED INLAND EMPIRE ADJ7957209 CLEMENCIA CARRILLO E Z COIN LAUNDRY SCIF INSURED OXNARD ADJ4632235 CRESCENCIO RODRIGUEZ ISAAC CONSTRUCTION CO INC SCIF INSURED OXNARD ADJ4632235 CRESCENCIO RODRIGUEZ ISAAC CONSTRUCTION INC SCIF INSURED OXNARD ADJ558502 ELIZABETH ESQUIVEL PROJECT HEADWAY SCIF INSURED OXNARD ADJ3014620 FILEMON PENALOZA EARTH CONCEPTS SCIF INSURED OXNARD ADJ8064584 HUGO LOPEZ ALLIED CRAFT BUILDERS SCIF INSURED OXNARD ADJ7839514 JAIME MONTES MISSION VIEJO GLASS INC SCIF INSURED OXNARD ADJ7979026 JESUS SERRANO JVC TRUCK LINES INC SCIF INSURED OXNARD ADJ2948125 JUAN ANGUIANO L & H CONCRETE ,INC. SCIF INSURED OXNARD ADJ7166931 JULIO CABRERA LOU IVAYLO MODERN MARBLE INC SCIF INSURED OXNARD ADJ7237150 LAZARO DIAZ CRUZ NETWORK MERCHANDISING INC SCIF INSURED OXNARD ADJ7259734 LENA SALEHI DMV SCIF INSURED OXNARD ADJ7286313 LEOBARDO VARGAS RAND FARM INC SCIF INSURED OXNARD ADJ2399958 LUIS ALFONSO CANTADERIO ROBERTS FIVE POINTS APPLIANCES SCIF INSURED OXNARD ADJ7158315 MARIO GUTIERREZ CORBY CONSTRUCTION SCIF INSURED OXNARD ADJ3504613 MARY AVALOS TIERRA DEL SOL FOUNDATION SCIF INSURED OXNARD ADJ6446841 MIGUEL VASQUEZ NATURES BEST NURSERY SCIF INSURED OXNARD ADJ4358855 PABLO GONZALEZ ULTIMATE REMOVAL SCIF INSURED OXNARD ADJ6548209 PHILLIP WILLIAMS FOLEY BUILDING AND ELECTRIC SCIF INSURED OXNARD ADJ7968653 RAQUINA HARRIS CALIFORNIA CONSERVATION SCIF INSURED OXNARD ADJ7805452 RIGOBERTO TORRES GAVRIELI SCIF INSURED OXNARD ADJ7805452 RIGOBERTO TORRES GAVRIELI PLASTICS AND SIGNS SCIF INSURED OXNARD Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ2906080 ROBERTO OCEGUEDA MJD CONSTRUCTION SCIF INSURED OXNARD ADJ6621786 ROLANDO OCHOA LYNN AND DARLA LLC SCIF INSURED OXNARD ADJ6711048 TERESA GARCIA J AND S RESTAURANT INC SCIF INSURED OXNARD ADJ6711048 TERESA GARCIA J AND S RESTAURANTS INC SCIF INSURED OXNARD ADJ6523150 VIDAL PULIDO JP WHITEROW ROOFING COMPANY SCIF INSURED OXNARD ADJ6698141 JOSE MENDOZA EAGLES NEST RETIREMENT RANCH INC SCIF INSURED PLEASANTON ADJ2511054 LAMONT KING DOMINO'S PIZZA SCIF INSURED PLEASANTON ADJ6967052 LESLIE PEREZ DOMINOS PIZZA SCIF INSURED PLEASANTON ADJ8217067 MARIA DEL CARMEN MEDRANO ORTIZ MANGEN GROUP INC SCIF INSURED PLEASANTON ADJ9002519 RENE SOLIS CHEMCOR CHEMICAL CORPORATION SCIF INSURED PLEASANTON ADJ8970144 TALITA WOODS STATE OF CALIFORNIA - CAL WORKS SCIF INSURED PLEASANTON ADJ8216497 JESUS SALAS S&S CONSTRUCTION SCIF INSURED POMONA ADJ1429271 CARLOS ACENTARES ZWENER INDUSTRIES SCIF INSURED REDDING ALL COMMERCIAL INDUSTRIES INC DBA ALL COMMERCIAL HYDRO ADJ8338730 DAVID MAYA J SCIF INSURED RIVERSIDE ADJ8101983 JESUS HERRERA L A BUILDERS INC SCIF INSURED RIVERSIDE ADJ7080585 ALFONSO RANGEL GIANNINI PACKING CORPORATION SCIF INSURED SACRAMENTO ADJ9610785 ANTONIO CORDERO ESFAHANI CONTRACTING CORPORATION SCIF INSURED SACRAMENTO ADJ5826367 BERTHA SOTO TREEHOUSE FARMS INC SCIF INSURED SACRAMENTO ADJ6966471 DANA LEACH STATE OF CALIFORNIA CHP SCIF INSURED SACRAMENTO ADJ4199930 FERMINA DURAN SAN GABRIEL VALLEY TRAINING CENTER SCIF INSURED SACRAMENTO ADJ6971114 ISRAEL TORRES BM LANDSCAPE AND MAINTENANCE SCIF INSURED SACRAMENTO ADJ6971114 ISRAEL TORRES BM LANDSCAPE AND MAINTENANCE INC SCIF INSURED SACRAMENTO ADJ1643310 JOSE ACOSTA VILPARK CONSTRUCTION,INC SCIF INSURED SACRAMENTO ADJ4716568 MANOUCHER TALEGHANI NEW WEST PETROLEUM SCIF INSURED SACRAMENTO ADJ2310864 MARC POLIDORO OPTIMUM INC SCIF INSURED SACRAMENTO ADJ8267361 MARCOS LOPEZ ATLAS RESOURCES SCIF INSURED SACRAMENTO ADJ8267361 MARCOS LOPEZ BBSI SCIF INSURED SACRAMENTO ADJ800741 MARTHA BAUTISTA MARIA ESTELA TEJEDA SCIF INSURED SACRAMENTO ADJ7363006 MARY LOU SAENZ CORCORAN STATE PRISON SCIF INSURED SACRAMENTO ADJ8998030 PEDRO MORA ALL VALLEY TREE SERVICE SCIF INSURED SACRAMENTO ADJ4561220 RICK FERNANDEZ AMERICAN CITY PEST CONTROL SCIF INSURED SACRAMENTO ADJ8473329 ROBERT SCHEHL LYDIG CONSTRUCTION INC SCIF INSURED SACRAMENTO ADJ840896 SALVADOR ABREGO EXPERIENCE THE DIFFERENCE INC SCIF INSURED SACRAMENTO ADJ766296 SALVADOR FLORES JERRY SLOUGH FARMING COMPANY SCIF INSURED SACRAMENTO ADJ1094639 ALEJO HURTADO EDDIE WIEST; THERESA WIEST SCIF INSURED SAN DIEGO ADJ1892617 ALFONSO CASTRO ARMSTRONG CONSTRUCTION SCIF INSURED SAN DIEGO ADJ4339378 ALVARO HERRERA GARCIA DON HENELY SCIF INSURED SAN DIEGO ADJ8525830 ANGEL SANTIAGO ASPEN SCIF INSURED SAN DIEGO ADJ6543930 ANTONIO ESTRELLA BREWERS LAWN MAINTENANCE INC SCIF INSURED SAN DIEGO ADJ1809318 AURORA BRISENO FRESH FOOD CONCEPTS, INC. SCIF INSURED SAN DIEGO ADJ6708401 BRAULIO PEREZ CORNERSTONE SCIF INSURED SAN DIEGO ADJ6708401 BRAULIO PEREZ KITCHEN WORX SCIF INSURED SAN DIEGO ADJ3764070 CAMILO RODRIGUEZ B AND B FRAMING SCIF INSURED SAN DIEGO ADJ7417004 CARLOS RAMIREZ OUTDOOR HARDSCAPES SCIF INSURED SAN DIEGO ADJ196231 CONSTANCIO CRUZ WILDOMAR SENIOR ASSISTED LIVING COM SCIF INSURED SAN DIEGO ADJ1469963 FIDENCIO ZARAGOZA BRONZE-WAY POWDER COATING SCIF INSURED SAN DIEGO ADJ7378458 GUADALUPE SALAZAR DE MADERA C CLUNN CONSULTING INC SCIF INSURED SAN DIEGO ADJ1386016 GUSTAVO BECERRA PRO CON CONCRETE SCIF INSURED SAN DIEGO ADJ1817401 IGNACIO VARGAS DAIRY KING MILK FARMS INC SCIF INSURED SAN DIEGO ADJ2009357 ISMAEL RODRIGUEZ ELM'S EQUIPMENT RENTAL INC SCIF INSURED SAN DIEGO ADJ1640983 JESUS ORTEGA HATHAWAY DOOR & TRIM SCIF INSURED SAN DIEGO ADJ7300738 JOSE GALLO ABILITY CENTER SCIF INSURED SAN DIEGO ADJ7103716 LINDA DILLHUNT WRIGHT IMAGE STAFFING SCIF INSURED SAN DIEGO ADJ2850427 LORENA CEBRERO CORTES T FETTER & COMPANY INC SCIF INSURED SAN DIEGO ADJ315046 LORENZO GARCIA HP AUTOMOTIVE & TOW SVS INC SCIF INSURED SAN DIEGO ADJ6543977 LUIS PADILLA VLAD CONSTRUCTION WORKS SCIF INSURED SAN DIEGO ADJ154703 MARGARITA CARDENAS TRADEMARK PLASTIC SCIF INSURED SAN DIEGO ADJ154703 MARGARITA CARDENAS TRADEMARK PLASTICS SCIF INSURED SAN DIEGO ADJ707031 MARIA MONDACA A.E.S.S., INC SCIF INSURED SAN DIEGO ADJ707031 MARIA MONDACA REMEDY TEMPORARY SCIF INSURED SAN DIEGO ADJ3917005 MARIBEL LOPEZ RANCHO SANTA FE PRODUCE SCIF INSURED SAN DIEGO ADJ9526793 MARIO LOZANO UNITED AG PERSONNEL MANAGEMENT SCIF INSURED SAN DIEGO ADJ7919625 MAURILLO PASCUAL FRUTERIA MICHOACAN SCIF INSURED SAN DIEGO ADJ2902677 RAMIRO LEBRON TRANSCAL CONSTRUCTION SCIF INSURED SAN DIEGO ADJ2551229 ROSA EMERITA HERNANDEZ SUPER FOOD WAREHOUSE SCIF INSURED SAN DIEGO ADJ2308712 SALVADOR MIRANDA AV BUILDERS SCIF INSURED SAN DIEGO ADJ3013213 SILVESTRE RAMOS CUSTOM LIGHT AND IRON SCIF INSURED SAN DIEGO ADJ3013213 SILVESTRE RAMOS EMPLOYERS RESOURCE SCIF INSURED SAN DIEGO ADJ3555970 STERLING BIAS JOURNEY ELECTRICAL TECHNOLOGY SCIF INSURED SAN DIEGO ADJ4397775 VICENTE LOPEZ CRISTOBAL CASTRO SCIF INSURED SAN DIEGO ADJ2181460 VICTOR ESPINOSA RYERSON RY-NEL SCIF INSURED SAN DIEGO ADJ1168307 VICTORIA CHANDLER BRIAN YOUNG-CITY LIGHTS SCIF INSURED SAN DIEGO ADJ1707479 ANTONIO ORTEGA CHAVEZ FURNITURE INC SCIF INSURED SAN JOSE ADJ2920774 INOCENCIA CONTRERAS CRISALIDA BERRY FARMS SCIF INSURED SAN JOSE ADJ9366589 JUAN NERI TRANSLINK COACHLINE SCIF INSURED SAN JOSE ADJ7175049 ROBERTO MONTOYA WILDCATS METAL SCIF INSURED SAN JOSE ADJ7150973 ABUNDIO SANCHEZ AQUATIC MODULAR OFFICE FURNITURE SCIF INSURED SANTA ANA ADJ6446127 ALDO SOTO POSADA CONSTRUCTION SCIF INSURED SANTA ANA ADJ2734696 ALEJANDRO FLORES COLORS 4 U SCIF INSURED SANTA ANA ADJ7447532 ALEJANDRO RAMIREZ SPIRES SCIF INSURED SANTA ANA ADJ8558147 ALEJANDRO TRUJILLO RODRIGUEZ ADOPT A HIGHWAY SCIF INSURED SANTA ANA ADJ9456338 ALEJO CURIEL VIDRIO HORIZON CONSTRUCTION SCIF INSURED SANTA ANA ADJ754373 ALMA MENDEZ ARBONNE INTERNATIONAL INC SCIF INSURED SANTA ANA ADJ8298921 ANA TORRES IHSS SCIF INSURED SANTA ANA ADJ456892 ANDRES CRUZ PACIFIC PRECISION METALS SCIF INSURED SANTA ANA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ456892 ANDRES CRUZ PACIFIC PRECISION METALS INC SCIF INSURED SANTA ANA ADJ9363395 ANDREW VALENCIA GEN KOREAN BBQ HOUSE SCIF INSURED SANTA ANA ADJ1869163 ANGEL MOTA BRANCA DRYWALL SCIF INSURED SANTA ANA ADJ1869163 ANGEL MOTA BRANCA DRYWALL CO SCIF INSURED SANTA ANA ADJ9563540 ANTHONY WILLIAMS SHERWOOD MART INC/CIRCLE K SCIF INSURED SANTA ANA ADJ1433114 ANTONIO RAMIREZ TRINITY BROADCASTING NETWORK SCIF INSURED SANTA ANA ADJ1433114 ANTONIO RAMIREZ TRINITY CHRISTIAN CENTER SCIF INSURED SANTA ANA ADJ6845981 ARMANDO ELIZALDE ESCAMILLA JR2 COATINGS INC DBA CALIFORNIA COATINGS SCIF INSURED SANTA ANA ADJ1165861 ARTURO HERNANDEZ 22ND ST LANDING SCIF INSURED SANTA ANA ADJ7483917 ARTURO VASQUEZ THE ORIGINAL PANCAKE HOUSE SCIF INSURED SANTA ANA ADJ1154241 AURORA MEJIA PHOENIX WAREHOUSE OF CA SCIF INSURED SANTA ANA ADJ8926173 BARBARITA MILLAN SN MANAGEMENT INC SCIF INSURED SANTA ANA ADJ9830009 BORIS HERNANDEZ KARL M LINDENLAUB DBA MARTIN CONSTRUCTION SCIF INSURED SANTA ANA ADJ4226627 CARLOS MORALES HBL SECURITY SYSTEMS, INC SCIF INSURED SANTA ANA ADJ6580750 CARMELA ARREAGA BURBANK RECYCLING SCIF INSURED SANTA ANA ADJ1677269 CARMEN GOMEZ SALAZAR LA BARCA MEXICAN DELI INC SCIF INSURED SANTA ANA ADJ7231491 CAROLYN FERNANDEZ STATE OF CA DEPT OF TRASPORTATION SCIF INSURED SANTA ANA ADJ830613 CATALINA CANLAS VICTORIA TOWNHOUSE APTS SCIF INSURED SANTA ANA ADJ9500991 CHARLOTTE CORNELIUS CAINE WEINER SCIF INSURED SANTA ANA ADJ8724071 CLARENCE GAINES STATE OF CALIF DEPT OF CORRECTIONS SCIF INSURED SANTA ANA ADJ8724071 CLARENCE GAINES STATE OF CALIFORNIA DEPT OF CORRECTIONS SCIF INSURED SANTA ANA ADJ7041824 CLEMENTINO TINTI MONROY EL POTRERO NIGHT CLUB SCIF INSURED SANTA ANA ADJ4442467 CONNIE MALDONADO MEADOWBROOK OF CALIFORNIA SCIF INSURED SANTA ANA ADJ7155203 CRESENCIO ACOSTA OLVERA ATE INC SCIF INSURED SANTA ANA ADJ7573184 DANIEL GRIEGO MILAN JOHN NELLANS SCIF INSURED SANTA ANA ADJ2709568 DANIEL SIXTOS GENERAL BUILDING MAINTENANCE SCIF INSURED SANTA ANA ADJ7562277 DAVID BALLADARES CALMEX FIREPLACE EQUIPMENT MANUFACTURING INC SCIF INSURED SANTA ANA ADJ579339 DAVID GARCIA E PLASTERING SCIF INSURED SANTA ANA ADJ6447622 DELFINO RODRIGUEZ PETEERSONS TREE WORKS INC SCIF INSURED SANTA ANA ADJ176740 DENNIS PEREZ UNITED CALIFORNIA BUILDERS SCIF INSURED SANTA ANA ADJ6668917 DIOCELINA ANDRADE AGAPE EMPLOYMENT INC SCIF INSURED SANTA ANA ADJ8661111 DONNA PEREZ STATE OF CALIFORNIA SCIF INSURED SANTA ANA ADJ6868766 EDSON GARCIA DUFFY ELECTRIC BOAT COMPANY SCIF INSURED SANTA ANA ADJ466709 EDUARDO CHIU THE SIGNS AND SERVICES SCIF INSURED SANTA ANA ADJ466709 EDUARDO CHIU THE SIGNS AND SERVICES COMPANY SCIF INSURED SANTA ANA ADJ7959104 EDWARD VASQUEZ DIRECT DOOR SCIF INSURED SANTA ANA ADJ1939894 ELEZAIN OCAMPO PETRONELLA ROOFING SCIF INSURED SANTA ANA ADJ7458446 ELIZABETH MONTES DIAMANTE BAR SCIF INSURED SANTA ANA ADJ7143828 ELVA SCHLAR NEWPORT DEL MAR GUEST HOMES SCIF INSURED SANTA ANA ADJ399016 ELVA TORRES ACME AUTO HEADLINING CO SCIF INSURED SANTA ANA ADJ3045179 EMIGDIO LEON PCH ENTERPRISES SCIF INSURED SANTA ANA ADJ6816402 EMILIO BOJORQUEZ PENNY ROOFING COMPANY SCIF INSURED SANTA ANA ADJ222950 EMILIO MENDOZA CENTRA FREIGHT SERVICES SCIF INSURED SANTA ANA ADJ222950 EMILIO MENDOZA CENTRA FREIGHT SERVICES, INC. SCIF INSURED SANTA ANA ADJ3860301 EMMA MEJIA BRASSTECH, INC SCIF INSURED SANTA ANA ADJ9359988 ENRIQUE CASTILLO FERNANDO CAMBEROS FINISHING SCIF INSURED SANTA ANA ADJ9748728 ERICK MARTINEZ ORTEGA SO CAL LAND MAINTENANCE SCIF INSURED SANTA ANA ADJ691244 ERNESTO AGUAYO BEST LABEL COMPANY INC SCIF INSURED SANTA ANA ADJ6733236 ERNESTO AVILA WESSELN CONSTRUCTION COMPANY SCIF INSURED SANTA ANA ADJ2340943 ERNESTO FLORES PEOPLE FIRST RESOURCES SCIF INSURED SANTA ANA ADJ2340943 ERNESTO FLORES PEOPLE FIRTS RESOURSES SCIF INSURED SANTA ANA ADJ6980099 ERNESTO RAMIREZ CITY SPACE INC SCIF INSURED SANTA ANA ADJ7569084 EVARISTO GONZALEZ C R MARTIN CONSTRUCTION INC SCIF INSURED SANTA ANA ADJ7264965 FABIO IBARRA JOHN GRIFFIN CONSTRUCTION SCIF INSURED SANTA ANA ADJ2436596 FAVIAN HIGAREDA TSI PROPERTY SERVICES SCIF INSURED SANTA ANA ADJ272606 FEDERICO MOREN TREE ELEMENTS INX SCIF INSURED SANTA ANA ADJ3173094 FELIX SALAS WESTAR NUTRITION INC SCIF INSURED SANTA ANA ADJ3110881 FERNANDO CALDERON MATHARU ASSISTED LIVING, INC. SCIF INSURED SANTA ANA ADJ1614888 FERNANDO REYES PRESTIGE SECURITY SCIF INSURED SANTA ANA ADJ3014620 FILEMON PENALOZA EARTH CONCEPTS SCIF INSURED SANTA ANA ADJ2300872 FRANCISCO DELGADO ROSSCRETE ROOFING INC SCIF INSURED SANTA ANA ADJ2464966 FRANCISCO MEDINA SCURRAH'S ROOFING SCIF INSURED SANTA ANA ADJ7411124 FRANCISCO MEJIA DINAHS CHICKEN SCIF INSURED SANTA ANA ADJ2901122 FRANCISCO TIMOTEO PYRAMID FRAMING SCIF INSURED SANTA ANA ADJ9657612 GASPAR CORONA LA TAQUIZA SCIF INSURED SANTA ANA ADJ6639733 GEORGINA MARTINEZ CHAPMAN ENGINEERING INC SCIF INSURED SANTA ANA ADJ7444714 GILDARDO RAMIREZ TOLLY LANDSCAPE INC SCIF INSURED SANTA ANA ADJ884725 GLORIA MEDINA HOLIDAY INN SCIF INSURED SANTA ANA ADJ8506704 GUADALUPE LIZARRAGA MEXICO DE NOCHE SCIF INSURED SANTA ANA ADJ7378458 GUADALUPE SALAZAR DE MADERA C CLUNN CONSULTING INC SCIF INSURED SANTA ANA ADJ4626630 HEATHER SKINNER PAPA JOHN'S PIZZA SCIF INSURED SANTA ANA ADJ2311042 HENRY MELCHOR MAT PARCEL EXPRESS SCIF INSURED SANTA ANA ADJ8209930 HSIAO YANG NATIONAL ASIAN PACIFIC SCIF INSURED SANTA ANA ADJ7281696 HYUNG KIM DANNY`S LIQUOR SCIF INSURED SANTA ANA ADJ3202869 IGNACIO PEREZ FRANCO ROYOLA PACIFIC SOUTHERN CALIFORNIA SCIF INSURED SANTA ANA ADJ7198333 IRMA FERRER WRIGHT WAY MAINTENANCE SCIF INSURED SANTA ANA ADJ8477019 ISAAC TRUJILLO JR ADMIRE ROOFING CO SCIF INSURED SANTA ANA ADJ4057027 ISABEL OCANA PRECISE INDUSTRIES SCIF INSURED SANTA ANA ADJ8523389 ISRAEL HERNANDEZ IRVINE CAPITAL SCIF INSURED SANTA ANA ADJ7423543 JAGNA KOWALSKA FAIRVIEW DEVELOPMENT CENTER SCIF INSURED SANTA ANA ADJ8692916 JAVIER MARTINEZ THE RICHARD P POISSANT LIVING TRUST SCIF INSURED SANTA ANA ADJ7395776 JERRIE HARTLINE METAL CLAD INSULATION SCIF INSURED SANTA ANA ADJ7574673 JESUS APODACA PALMCAST STEEL FABRICATION INC SCIF INSURED SANTA ANA ADJ147359 JIM MINISCI TEAMSTERS LOCAL 578 SCIF INSURED SANTA ANA ADJ4696522 JIM MINISCI TEAMSTERS LOCAL 578 SCIF INSURED SANTA ANA ADJ9284161 JOAQUIN VALENZUELA PERSONEL SCIF INSURED SANTA ANA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ361090 JORGE ACOSTA PACIFIC STATES SCIF INSURED SANTA ANA ADJ361090 JORGE ACOSTA PACIFIC STATES ENGINEERING SCIF INSURED SANTA ANA ADJ7100715 JORGE GOMEZ J & H DEBURRING, INC. SCIF INSURED SANTA ANA ADJ6917641 JORGE MARTINEZ SANDORS GOURMET CATERING SCIF INSURED SANTA ANA ADJ7081777 JORGE MUNOZ BAKER DESIGN AND CONSTRUCTION SCIF INSURED SANTA ANA ADJ9108483 JOSE CARDENAS TROYS ORNIMENTAL IRON CRAFT SCIF INSURED SANTA ANA ADJ7296696 JOSE DIAZ JUNE PAINTING SCIF INSURED SANTA ANA ADJ1985539 JOSE FRANCISCO MUNOZ OAK GROVE, INC. SCIF INSURED SANTA ANA ADJ6788767 JOSE HORTA ARANDA WOODCRAFT INC SCIF INSURED SANTA ANA ADJ7949120 JOSE LASCANO PARAISO LANDSCAPE SCIF INSURED SANTA ANA ADJ3911105 JOSE LOPEZ ABLE DEGASSING INC SCIF INSURED SANTA ANA ADJ2127318 JOSE LUIS BUENROSTRO KLISTOFF AND SONS, INC. SCIF INSURED SANTA ANA ADJ2296673 JOSE LUIS HERNANDEZ N L LANDSCAPING SERVICES, INC. SCIF INSURED SANTA ANA ADJ611103 JOSE LUIS MEJIA HAMMERMILL INDUSTRIES SCIF INSURED SANTA ANA ADJ6436402 JOSE MENDOZA LA HABRA PLATING SCIF INSURED SANTA ANA ADJ8071481 JOSE MORALES ANTONELLO RISTORANTE SCIF INSURED SANTA ANA ADJ7263875 JOSE PARRA CALCON STEEL CONSTRUCTION SCIF INSURED SANTA ANA ADJ239178 JOSE PATRICIO FOUR POINT BUILDERS SCIF INSURED SANTA ANA ADJ8487734 JOSE PEREZ CANYON CREEK APARTMENTS SCIF INSURED SANTA ANA ADJ8578401 JOSE PRECIADO DURANS PAINTING AND DECORATING SCIF INSURED SANTA ANA ADJ6953488 JOSE RODRIGUEZ DANIEL COMPANY LLC SCIF INSURED SANTA ANA ADJ6669379 JOSE SILVA J&D ACQUISITION CORP DBA GENE SCIF INSURED SANTA ANA ADJ7462648 JOSEFA LARIOS OCHOA FIELD ENTERPRISES SCIF INSURED SANTA ANA ADJ3133531 JOSEPH BRANNON UNIVERSITY RESTAURANT GROUP/KINGS SCIF INSURED SANTA ANA ADJ1374740 JUAN BERNARDINO CALIFORNIA ACRYLIC INDUSTRIES SCIF INSURED SANTA ANA ADJ9058288 JUAN GIRON 7 DAY GRAND TIRE AND AUTO REPAIR SCIF INSURED SANTA ANA ADJ9502727 JUAN PALMA CORNERSTONE CONSTRUCTION COMP. SCIF INSURED SANTA ANA ADJ2115324 JUAN SALGADO VIRGIL'S IRON WORK SCIF INSURED SANTA ANA ADJ7841745 JUAN ULLOA CANOGA REBAR INC SCIF INSURED SANTA ANA ADJ1647905 JUAN VICTORIA TEMPORARY PLACEMENT SPECIALIST SCIF INSURED SANTA ANA ADJ7722651 JUANA ORTEGA ENERGY CONVERSION APPLICATIONS INC SCIF INSURED SANTA ANA ADJ6757463 JULIO NUNEZ BALLY TOTAL FITNESS SCIF INSURED SANTA ANA ADJ7086305 KELLY LANDRY COASTAL TOWING SCIF INSURED SANTA ANA ADJ1090492 KENNETH MARINO CAUSEY ELECTRIC INC SCIF INSURED SANTA ANA ADJ7706581 LEE HEUER BADGER DAYLIGHT SO CAL SCIF INSURED SANTA ANA ADJ4402130 LOURDES CARVAJAL GOLD COAST FOODS SCIF INSURED SANTA ANA ADJ2154526 LUCIA LEON VITESSE RECRUITING SCIF INSURED SANTA ANA ADJ6537787 LUIS RAMOS WESTEND STAFFING SOLUTIONS SCIF INSURED SANTA ANA ADJ8431366 MACARIO BOHORQUEZ TICE VALLEY LANDSCAPE SCIF INSURED SANTA ANA ADJ10142283 MACARIO MONTERO DE LA TORRE LANDSCAPE SOLUTIONS CORP SCIF INSURED SANTA ANA ADJ4716568 MANOUCHER TALEGHANI NEW WEST PETROLEUM SCIF INSURED SANTA ANA ADJ9495117 MARCO ALCALA DE LA TORRE LANDSCAPING SOLUTIONS SCIF INSURED SANTA ANA ADJ9495117 MARCO ALCALA DE LA TORRE PROPERTY CARE SCIF INSURED SANTA ANA ADJ8303980 MARCO SANDOVAL ALL STAR JUMPER RENTALS SCIF INSURED SANTA ANA ADJ7516929 MARGARET BIONDINO FRIENDSHIP SHELTER SCIF INSURED SANTA ANA ADJ7192325 MARGARET VELARDE POPA FEDERAL CREDIT UNION SCIF INSURED SANTA ANA ADJ240286 MARGARITA BICANA HOME WATCH CARE GIVERS SCIF INSURED SANTA ANA ADJ3725824 MARGARITA GARCIA ALL CITY MANAGEMENT SERVICES SCIF INSURED SANTA ANA ADJ7942659 MARIA MUNOZ PROMISES GUEST VILLAGE SCIF INSURED SANTA ANA ADJ6781198 MARIA RIVAS BRIGHTSIDE INC SCIF INSURED SANTA ANA ADJ1357313 MARIA SANCHEZ PRECISION FERRITES & CERAMICS SCIF INSURED SANTA ANA ADJ1379126 MARIA VASQUEZ DELHI CENTER SCIF INSURED SANTA ANA ADJ2620636 MARIO GARCIA JD TRANSPORT SCIF INSURED SANTA ANA ADJ964982 MARIO MEDINA MILLANS HONDA SCIF INSURED SANTA ANA ADJ6815789 MARIO MELENDEZ ATLAS WOOD PRODUCTS SCIF INSURED SANTA ANA ADJ7523199 MARTIRES GARCIA TRI STAR MANUFACTURING INC SCIF INSURED SANTA ANA ADJ9384856 MARVIN GUILLEN JEFF KAPLAN CONSTRUCTION INC SCIF INSURED SANTA ANA ADJ7772485 MEL TURNBOUGH DMV SCIF INSURED SANTA ANA ADJ7221843 MICHAEL ALBA PACIFIC WINDOW WASHING SCIF INSURED SANTA ANA ADJ3351913 MICHAEL HERRERA HANDYMAN NETWORK INC SCIF INSURED SANTA ANA ADJ7295366 MICHAEL REFINO KAIL PROPERTIES MANAGEMENT SCIF INSURED SANTA ANA ADJ1032669 MICHAEL SHUBIN FEDERAL DISPOSAL SERVICE SCIF INSURED SANTA ANA ADJ353409 MIGUEL CONTRERAS LANDIS WILLIAMS CONTRUCTION SCIF INSURED SANTA ANA ADJ4608843 MIGUEL GARCIA GRIZZLY PRODUCTS SCIF INSURED SANTA ANA ADJ7274519 MIGUEL ULLOA TRIUNE ENTERPRISES INC SCIF INSURED SANTA ANA ADJ9103363 MIKE COMBS A ACTION TOWING SCIF INSURED SANTA ANA ADJ1993830 MODESTO HERNANDEZ CALICO BRANDS INC. SCIF INSURED SANTA ANA ADJ1955055 MONICA AVILA PACIFIC PIONEER CORPORTATION SCIF INSURED SANTA ANA ADJ293936 MYUNG PARK GEORGE SMITH AUTO PARTS SUPPLY INC SCIF INSURED SANTA ANA ADJ3183761 NEMER ESTRADA COAST SIGN INC SCIF INSURED SANTA ANA ADJ7772676 NICOLAS LARA SILVA THE MAVRICK COMPANY INC SCIF INSURED SANTA ANA ADJ2070086 NILVIA PEREZ STAFFING SERVICES SCIF INSURED SANTA ANA ADJ7680912 NOEMI NAVARRETE MERIKO INC SCIF INSURED SANTA ANA ADJ9714112 OCTAVIO CASTILLO RIGHT TOUCH SCIF INSURED SANTA ANA ADJ9196546 OLIVER MOULIN MOMENTUM CONSTRUCTION SCIF INSURED SANTA ANA ADJ2749187 OLIVIA LAWLESS MARINA MEDICAL BILLING SCIF INSURED SANTA ANA ADJ3526482 ORLANDO HERNANDEZ FLAVIO BEAUTY COLLEGE SCIF INSURED SANTA ANA ADJ1950417 OSCAR FRANCIA CITY OF INDUSTRY DISPOSAL SCIF INSURED SANTA ANA ADJ1950417 OSCAR FRANCIA ZEREP MANAGEMENT CORPORATION SCIF INSURED SANTA ANA ADJ2741422 PATSY AUGUSTER THESSALONIKA FAMILY SERVICE SCIF INSURED SANTA ANA ADJ8636136 PEDRO TORRES BONITA STEEL ERECTORS INC SCIF INSURED SANTA ANA ADJ6548209 PHILLIP WILLIAMS FOLEY BUILDING AND ELECTRIC SCIF INSURED SANTA ANA ADJ981175 PROTACIO VARGAS L AND W TRUCKING INC SCIF INSURED SANTA ANA ADJ3271481 RACHEL GONZALEZ PLAZA COPY & IMAGING SCIF INSURED SANTA ANA ADJ8312885 RAMON CAMPA GALCOS CONSTRUCTION SCIF INSURED SANTA ANA ADJ6845637 RAMON GARCIA SOUTH BAY STONE INC SCIF INSURED SANTA ANA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6845637 RAMON GARCIA SOUTH BAY STONE INCORPORATED SCIF INSURED SANTA ANA ADJ7352883 RAMON GOMEZ LOS ALTOS REMODELING CONTRACTORS SCIF INSURED SANTA ANA ADJ7269776 RICARDO HERRERA IMPERIAL CFS INC SCIF INSURED SANTA ANA ADJ7730201 ROBERTO RAMIREZ MODERN TREE SERVICE INC SCIF INSURED SANTA ANA ADJ4592858 RODOLFO SANCHEZ CURRIE ENTERPRISES SCIF INSURED SANTA ANA ADJ6519066 ROSA ORTEGA EXCEL BINDERY SCIF INSURED SANTA ANA ADJ3368955 ROSSCO CAHILL CBI CONSTRUCTION SCIF INSURED SANTA ANA ADJ9167178 ROY ERNST WEST COAST RELOCATION SCIF INSURED SANTA ANA ADJ6552711 ROY SKINNER GOLDEN GATE CONCRETE CUTTING SCIF INSURED SANTA ANA ADJ7355167 RUBEN CHICA PACIFIC FABRIC FINISHING INC SCIF INSURED SANTA ANA ADJ9239541 RUFINO VARGAS CUSTOM RESURFACING SPECIALIST SCIF INSURED SANTA ANA ADJ6551683 SAUL AMEZCUA RICKS MOBIL GLASS INC SCIF INSURED SANTA ANA ADJ7795005 SAUL HERNANDEZ VENUS GROUP SCIF INSURED SANTA ANA ADJ1671665 SECUNDINO AMARAL DRAGAN PETROVIC CONSTRUCTION SCIF INSURED SANTA ANA ADJ6716379 SERGIO TORRES TUNSTILL PLASTERING INC SCIF INSURED SANTA ANA ADJ3274011 SOCORRO MORENO FOASBERG LAUNDRY & CLEANERS SCIF INSURED SANTA ANA ADJ3640415 SOFIA DEL CID DIVERSE STAFFING SCIF INSURED SANTA ANA ADJ9571981 SONIA GUTIERREZ UNIVERSAL LOGISTICS GROUP SCIF INSURED SANTA ANA ADJ7804844 TAE SOO KIM COMPLEX MEDIA INC SCIF INSURED SANTA ANA ADJ684089 TERESA MORALES CHAM-CAL ENGINEERING SCIF INSURED SANTA ANA ADJ1716798 VICENTE GOMEZ ALMEN FURNITURE INC SCIF INSURED SANTA ANA ADJ3065225 VICTOR DIAZ IMPERIAL CFS, INC. SCIF INSURED SANTA ANA ADJ1764405 VICTOR FLORES STK INTERNATIONAL INC SCIF INSURED SANTA ANA ADJ1764405 VICTOR FLORES STK INTERNATIONAL, INC. SCIF INSURED SANTA ANA ADJ6577247 VINCENTE GAVARRETTE MEGA FUME INC SCIF INSURED SANTA ANA STATE OF CALIFORNIA DEPARTMENT OF TRANSPORATION ADJ8229084 VIRGAL WOOLFOLK SCIF INSURED SANTA ANA CALTRANS ADJ7176377 YOREL MCDOWELL PAUL MAURER SHOWS SCIF INSURED SANTA ANA ADJ7977017 NORMA BARCO HOLIDAY INN EXPRESS AND SUITES SCIF INSURED SANTA ANA ADJ7354459 REFUGIO SANTANA MAROTTO CORP SCIF INSURED SANTA ANA ADJ6625533 ELVIN CLAUSELL WILD WOOD STRUCTURES SCIF INSURED SANTA ROSA ADJ4383044 MIGUEL ROBLES F & L MACHINE SCIF INSURED SANTA ROSA ADJ7481099 URSULA AYALA VIVID ENTERTAINMENT INC SCIF INSURED SANTA ROSA ADJ7197052 FERNANDO AGUILAR MESA ENVIRONMENTAL SERVICES INC SCIF INSURED STOCKTON ADJ2791458 ISMAEL ANGEL STATEWIDE LABOR CORP SCIF INSURED STOCKTON ADJ9511449 JOSE GONZALEZ HIGAS HORTICULTURE SCIF INSURED STOCKTON ADJ7437673 LUIS BERMUDEZ VIN LUX LLC SCIF INSURED STOCKTON ADJ6446127 ALDO SOTO POSADA CONSTRUCTION SCIF SCIF EMPLOYEES ALL ADJ1341734 DENISE CENICEROS STATE COMPENSATION INSURANCE FUND SCIF SCIF EMPLOYEES ALL ADJ2168291 LUIS AGUADO INLAND CONCRETE ENTERPRISES INC SCIF SCIF EMPLOYEES ALL ADJ2168291 LUIS AGUADO INLAND CONCRETE ENTERPRISES, INC. SCIF SCIF EMPLOYEES ALL ADJ6564673 MIGUEL MENDOZA ANGEL JEWELERS SCIF SCIF EMPLOYEES ALL ADJ7744678 ALBERTO ARROYOS DEALERSHIP COLLISION AUTO CENTER SCIF SCO MONTEREY PARK ADJ7416392 ALEJANDRO ESPINOZA TODAY TRUCK WASH SCIF SCO MONTEREY PARK ADJ7416392 ALEJANDRO ESPINOZA TODAY TRUCK WASH INC SCIF SCO MONTEREY PARK ADJ6553055 ALEX AGUAYO RESPONSIVE INTERNET SYSTEM SCIF SCO MONTEREY PARK ADJ2891588 ALVARO GONZALEZ FIRST CHOICE STAFFING, INC. SCIF SCO MONTEREY PARK ADJ6515967 AMADO RODRIGUEZ CENTRAL METAL, INC. SCIF SCO MONTEREY PARK ADJ6991835 AMINDA MARTINEZ ROMANTIX INC SCIF SCO MONTEREY PARK ADJ7526217 ARMANDO FAVELA PERFORMANCE TEAM GALE TRIAGLE SCIF SCO MONTEREY PARK ADJ7229243 BAVETTE ANDERSON AIDS HEALTH CARE FOUNDATION SCIF SCO MONTEREY PARK ADJ7731006 BONNIE GOMEZ YDP OF GREATER LOS ANGELES SCIF SCO MONTEREY PARK ADJ7331530 CHARLES JOHNSON FINESSE PERSONNEL ASSOCIATES SCIF SCO MONTEREY PARK ADJ7724083 DAVID BRANNON BALLY S TOTAL FITNESS SCIF SCO MONTEREY PARK ADJ7352601 EDUARDO SANCHEZ ADEE PLUMBING AND HEATING INC SCIF SCO MONTEREY PARK ADJ7605800 EFRAIN GARCIA ROUND TRIP TRANSPORTATION SCIF SCO MONTEREY PARK ADJ6945350 ELIA LAMPMAN MEDTRONIC MINMED SCIF SCO MONTEREY PARK ADJ6945350 ELIA LAMPMAN MRG INFUSION SYSTEMS LLC SCIF SCO MONTEREY PARK ADJ6519857 ERIS NAVARRO DELIVERY ZONE, LLC DBA SUNFARE SCIF SCO MONTEREY PARK ADJ6837594 FAUSTINO GARCIA NEW LIFE ADULT DAY HEALTH CARE SCIF SCO MONTEREY PARK ADJ6856251 FEDERICO GONZALEZ BAY CONSTRUCTION INC SCIF SCO MONTEREY PARK ADJ6531619 FERNANDO ORELLANA HORUSICKY CONSTRUCTION INC SCIF SCO MONTEREY PARK ADJ7513637 FRANCISCO GALLAGA DEL STEEL ORNAMENTAL AND TUBE SUPPLY INC SCIF SCO MONTEREY PARK ADJ6680109 GILBERTO RUIZ WMG CONTRACTOR WAREHOUSE INC SCIF SCO MONTEREY PARK ADJ6935989 GRACIELA GALLEGOS THE STANDARD HOTEL SCIF SCO MONTEREY PARK ADJ1700636 HECTOR SANCHEZ WEATHER LINE ROOFING SCIF SCO MONTEREY PARK ADJ7221806 HUGO HERNANDEZ FLAT RATE MOVING SYSTEMS LLC SCIF SCO MONTEREY PARK ADJ7300468 JAVIER SERRANO JB MARBLE SCIF SCO MONTEREY PARK ADJ361090 JORGE ACOSTA PACIFIC STATES SCIF SCO MONTEREY PARK ADJ361090 JORGE ACOSTA PACIFIC STATES ENGINEERING SCIF SCO MONTEREY PARK ADJ7584910 JORGE CARRILLO VIZCAYA C S CONCRETE SOLUTIONS INC SCIF SCO MONTEREY PARK ADJ9397934 JOSE DE LA CRUZ STANDARD DRYWALL INC SCIF SCO MONTEREY PARK ADJ7185971 JOSE DIAZ ALLSTATE LANDSCAPE SERVICES INC SCIF SCO MONTEREY PARK ADJ8543406 JOSE HERNANDEZ ALBA CONSTRUCTION SCIF SCO MONTEREY PARK ADJ7014583 JOSE PEREZ CALIFORNIA TOUCH OF CLASS SCIF SCO MONTEREY PARK ADJ7014583 JOSE PEREZ EVANS AND SON TOUR SERV INC AKA CALIF TOUCH OF CLASS SCIF SCO MONTEREY PARK ADJ7048013 JULIO GUTIERREZ PICK RAR PART AUTO DISMANTLING INC0 SCIF SCO MONTEREY PARK ADJ9757255 MANUEL BASTIDAS CALIFORNIA CARE CENTERS INC SCIF SCO MONTEREY PARK ADJ7584256 MANUEL GOMEZ WEST COAST METAL FINISHING SCIF SCO MONTEREY PARK ADJ6993558 MANUEL RAMIREZ DOCUMENT DISINTEGRATION INC SCIF SCO MONTEREY PARK ADJ6903953 MARCOS SOTO ACETEK ROOFING CO SCIF SCO MONTEREY PARK ADJ9664541 MARIA ORTEGA FORESTO TRENDS SCIF SCO MONTEREY PARK ADJ7155233 MARTHA BANDA QPERFUMES SCIF SCO MONTEREY PARK ADJ3120280 MAURO JORGE MARTINEZ QUALITY INN SCIF SCO MONTEREY PARK ADJ7160917 MAXIMO CRUZ PACIFIC FABRIC FINISHING INC SCIF SCO MONTEREY PARK Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7160917 MAXIMO CRUZ PACIFIC FABRIC FINISHING INC DBA CHRIS STONE INC SCIF SCO MONTEREY PARK ADJ6777264 MIGUEL SANCHEZ JCB CONSTRUCTION SCIF SCO MONTEREY PARK ADJ6857433 MIGUEL ZEPEDA ZAREPE RW SELBY SCIF SCO MONTEREY PARK ADJ2866209 NORMA PUENTES OVERHILL FARM INC SCIF SCO MONTEREY PARK ADJ7391760 PEDRO ALAMILLO EAGLESTONE PACIFIC INC DBA CUSTOM MARBLE MASTER SCIF SCO MONTEREY PARK ADJ6668546 PEDRO PIMENTEL PINNACLE MASONRY INC SCIF SCO MONTEREY PARK ADJ6810691 PRISCILIANO DIAZ INFINITY WASHER SCIF SCO MONTEREY PARK ADJ6741174 RODOLFO BARAJAS AUTOMATION PLATING CORP SCIF SCO MONTEREY PARK ADJ6878776 RODOLFO RODRIGUEZ TREEMENDOUS TREE TRIMMING SCIF SCO MONTEREY PARK ADJ9028411 ROSELIO ZUNIGA LOPEZ CAL TOP BUILDERS INC SCIF SCO MONTEREY PARK ADJ6923942 SALVADOR TOPETE ATLAS TESTING LABORATORIES INC SCIF SCO MONTEREY PARK ADJ6663696 SANTIAGO CALZADA TIBURON CONSTRUCTION SCIF SCO MONTEREY PARK ADJ7636693 SHIRLEY NICHOLSON ALL CITIES MANAGEMENT SERVICES SCIF SCO MONTEREY PARK ADJ7567301 SUSY MORALES DOTS CUPCAKES LLC SCIF SCO MONTEREY PARK ADJ6551375 TERESA ROBLES KAREN KANE COMPANY SCIF SCO MONTEREY PARK ADJ6587063 YENI LOPEZ 34 SUSHI STATION SCIF SCO MONTEREY PARK ADJ6895878 ALICIA GONZALEZ HUMAN SERVICES SCIF SCO SAN BERNARDINO ADJ6832089 ELIZABETH HAGOOD STATE COMPENSATION INSURANCE FUND SCIF SCO SAN BERNARDINO ADJ6832089 ELIZABETH HAGOOD DEPT OF AGING AND ADULT SERVICES SCIF SCO SAN BERNARDINO ADJ7780202 JOHN KIORPEOGLOU CAL TRANS SCIF SCO SAN BERNARDINO ADJ7205564 JUAN LAREDO PARR LUMBER SCIF SCO SAN BERNARDINO ADJ7048013 JULIO GUTIERREZ PICK RAR PART AUTO DISMANTLING INC0 SCIF SCO SAN BERNARDINO ADJ6590744 PORFIRIO RODRIGUEZ DEPARTMENT OF SOCIAL SERVICES SCIF SCO SAN BERNARDINO ADJ6913767 YOLANDA BARCENAS LOS ANGELES COUNTY IN HOME SUPPORT SERVICES 0IHSSD SCIF SCO SAN BERNARDINO ADJ8724071 CLARENCE GAINES STATE OF CALIF DEPT OF CORRECTIONS SCIF SCO SANTA ANA ADJ8724071 CLARENCE GAINES STATE OF CALIFORNIA DEPT OF CORRECTIONS SCIF SCO SANTA ANA ADJ3715669 ELIZABETH JACKSON CHARLES R DREW UNIVERSITY SCIF SCO SANTA ANA ADJ6708440 ELPIDIO GARCIA TRI CITY GLASS SCIF SCO SANTA ANA ADJ6437692 MANUELA ARIAS ARC VALUE VILLAGE SCIF SCO SANTA ANA ADJ9095208 MARIA PUGA CLUBS LOS GLOBOS INC SCIF SCO SANTA ANA ADJ6622513 RITA GOMEZ SUBSTANCE ABUSE CLINIC OF LONG BEACH SCIF SCO SANTA ANA ADJ3511246 GUILLERMINA ARECHIGA STATE OF CALIFORNIA EDD SCIF STATE EMPLOYEES LEGAL GLENDALE ADJ6589475 JOSE HERRERA B & R FARM SCIF STATE EMPLOYEES OXNARD ADJ1699416 ALFONSO DE LA CUEVA DEPARTMENT OF SOCIAL SERVICES SCIF STATE EMPLOYEES RIVERSIDE ADJ3990734 ALICIA GAMEZ DEPARTMENT OF SOCIAL SERVICES SCIF STATE EMPLOYEES RIVERSIDE ADJ3990734 ALICIA GAMEZ I.H.S.S. SCIF STATE EMPLOYEES RIVERSIDE ADJ7129643 AMBER DARNELL DEPARTMENT OF SOCIAL SERVICES SCIF STATE EMPLOYEES RIVERSIDE ADJ7676368 CASSANDRA WEST STATE OF CALIFORNIA DEPT OF CORRECTIONS SCIF STATE EMPLOYEES RIVERSIDE ADJ443735 CECILIA PRADA CALIF DEPT OF CORRECTIONS SCIF STATE EMPLOYEES RIVERSIDE ADJ3453248 DAVID FUENTES CALIFORNIA DEPT OF CORRECTIONS SCIF STATE EMPLOYEES RIVERSIDE ADJ3453248 DAVID FUENTES DEPT OF CORRECTIONS SCIF STATE EMPLOYEES RIVERSIDE ADJ7221878 DEREJE DENBEL LANTERMAN DEVELOPMENT CENTER SCIF STATE EMPLOYEES RIVERSIDE ADJ9059038 ELVA ESCOBAR STATE OF CALIFORNIIA DEPARTMENT OF MOTOR VEHICLES SCIF STATE EMPLOYEES RIVERSIDE ADJ6681615 EUGENIO REYNA INLAND CONCRETE CONSTRUCTORS SCIF STATE EMPLOYEES RIVERSIDE ADJ2475058 GENE BUCKHANNAN DEPARTMENT OF CORRECTIONS SCIF STATE EMPLOYEES RIVERSIDE ADJ4047954 GUILLERMINA ARECHIGA EMPLOYMENT DEVELOPMENT DEPARTMENT SCIF STATE EMPLOYEES RIVERSIDE ADJ7388255 IRENE YUAN LANTERMAN DEVELOP CENTER SCIF STATE EMPLOYEES RIVERSIDE ADJ6620172 JAIME PRIER HAIG ENGINEERING & CONSTRUCTION SCIF STATE EMPLOYEES RIVERSIDE ADJ3233459 JESUS MARIA MARTINEZ DEPARTMENT OF SOCIAL SERVICES SCIF STATE EMPLOYEES RIVERSIDE ADJ7446784 JOSEPHINE ALCOSER STATE OF CALIFORNIA PRISON SCIF STATE EMPLOYEES RIVERSIDE ADJ7421899 JOSEPHINE BORREGO DEPARTMENT OF CORRECTIONS C I M SCIF STATE EMPLOYEES RIVERSIDE ADJ6780154 LIZBETH BARRON CORRECTIONS AND REHABILITATION PAROLE SCIF STATE EMPLOYEES RIVERSIDE ADJ1334550 LUISA REYES HAWTHORNE IN HOME SUPPOERT SVC. SCIF STATE EMPLOYEES RIVERSIDE ADJ2580202 MARGARITA RAMIREZ I.H.S.S. SCIF STATE EMPLOYEES RIVERSIDE ADJ3853540 MARIA CHAVEZ DEPT OF SOCIAL SERVICES SCIF STATE EMPLOYEES RIVERSIDE ADJ4371565 MARIA JESUS SANCHEZ COUNTY OF LOS ANGELES/DPSS SCIF STATE EMPLOYEES RIVERSIDE ADJ9034598 MICHAEL YARDLEY CAL FIRE SCIF STATE EMPLOYEES RIVERSIDE ADJ4552123 RUBEN VASQUEZ STATE OF CA/DEPT OF CORRECTIONS SCIF STATE EMPLOYEES RIVERSIDE ADJ6720818 SHELLY ROTH STATE OF CA DEPT OF SOCIAL SERVICES SCIF STATE EMPLOYEES RIVERSIDE ADJ7125357 TONI MADRID VETERANS HOME BARSTOW SCIF STATE EMPLOYEES RIVERSIDE ADJ3026440 TRAVIS ROCKWELL PATTON STATE HOSP SCIF STATE EMPLOYEES RIVERSIDE ADJ7476875 VANICA LONGSWORTH PATTON STATE HOSPITAL SCIF STATE EMPLOYEES RIVERSIDE ADJ1500313 VERONICA MAY DEPARTMENT OF CORRECTIONS SCIF STATE EMPLOYEES RIVERSIDE STATE OF CALIFORNIA DEPARTMENT OF TRANSPORATION ADJ8229084 VIRGAL WOOLFOLK SCIF STATE EMPLOYEES RIVERSIDE CALTRANS ADJ727175 VIRGINIA CHAVEZ EMPLOYMENT DEVELOPMENT DEPARTMENT SCIF STATE EMPLOYEES RIVERSIDE ADJ7221888 ZURICK SELLERS DEPT OF CORRECTION SCIF STATE EMPLOYEES RIVERSIDE ADJ7379890 EDELITA DANIEL LANTERMAN DEVELOPMENT CENTER SCIF STATE EMPLOYEES RIVERSIDE CALIFORNIA DEPARTMENT OF CORRECTIONS AND ADJ8933143 JOHNNY FISHER SCIF STATE EMPLOYEES ROHNERT PARK REHABILITATION ADJ8933143 JOHNNY FISHER DEPARTMENT OF CORRECTIONS INMATE CLAIMS SCIF STATE EMPLOYEES ROHNERT PARK ADJ8297108 ALBERT ORELLANA CA DEPT OF PARKS & RECREATION SCIF STATE EMPLOYEES SACRAMENTO ADJ8297108 ALBERT ORELLANA CA DEPT OF PARKS AND RECREATION SCIF STATE EMPLOYEES SACRAMENTO ADJ7940257 FELIPE GONZALEZ GREEN VALLEY SCIF STATE EMPLOYEES SACRAMENTO ADJ9318252 ISAAC PIERCE ACTION DUCT CLEANING SCIF STATE EMPLOYEES SACRAMENTO ADJ987871 JAVIER NINO CALIFORNIA DEPARTMENT OF CORRECTION SCIF STATE EMPLOYEES SACRAMENTO ADJ1534189 LAURA HALTERMAN DEPARTMENT OF CORRECTIONS SCIF STATE EMPLOYEES SACRAMENTO ADJ4253361 MICHAEL FONTENOT DEPT OF CORRECTION SCIF STATE EMPLOYEES SACRAMENTO ADJ1919573 PETER MCINTYRE CORRECTIONAL DIVISION 101 SCIF STATE EMPLOYEES SACRAMENTO ADJ3813336 ABDOL MANSOURI CAL TRANS SCIF STATE EMPLOYEES SANTA ANA ADJ3981583 ARNETTE MARTIN STATE OF CA DEPT OF MOTOR VEHICLES SCIF STATE EMPLOYEES SANTA ANA ADJ3981583 ARNETTE MARTIN STATE OF CA/DEPT OF MOTOR VEHICLES SCIF STATE EMPLOYEES SANTA ANA ADJ987966 BERNICE DIXON DEPARTMENT OF CORRECTIONS SCIF STATE EMPLOYEES SANTA ANA ADJ7280790 BEVERLY CHAVARRIA STATE OF CALIFORNIA LANCASTER STATE PRISON SCIF STATE EMPLOYEES SANTA ANA ADJ7632160 BRIAN MENDES CALIFORNIA STATE PRISON SCIF STATE EMPLOYEES SANTA ANA ADJ6580750 CARMELA ARREAGA BURBANK RECYCLING SCIF STATE EMPLOYEES SANTA ANA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ1425466 CAROLYN UNDERWOOD DMV SCIF STATE EMPLOYEES SANTA ANA ADJ1633366 DIVINA CARDENO RICAFORT DEPARTMENT OF MOTOR VEHICLES SCIF STATE EMPLOYEES SANTA ANA ADJ1043004 DONNA KENNON DEPARTMENT OF MOTOR VEHICLES SCIF STATE EMPLOYEES SANTA ANA ADJ7861965 ERMA MILES PATTON STATE HOSPITAL SCIF STATE EMPLOYEES SANTA ANA ADJ1590048 FAY MCGEE S D I INDUSTRIES SCIF STATE EMPLOYEES SANTA ANA ADJ4047954 GUILLERMINA ARECHIGA EMPLOYMENT DEVELOPMENT DEPARTMENT SCIF STATE EMPLOYEES SANTA ANA ADJ7040150 JASON SOILEAU METROPOLITAN STATE HOSPITAL SCIF STATE EMPLOYEES SANTA ANA ADJ1159327 JEANNE LUNSFORD DEPARTMENT OF INDUSTRIAL RELATIONS SCIF STATE EMPLOYEES SANTA ANA ADJ1159327 JEANNE LUNSFORD DEPT OF INDUSTRIAL RELATIONS SCIF STATE EMPLOYEES SANTA ANA ADJ7784720 JUAN BECERRA 699 RENT A CAR SCIF STATE EMPLOYEES SANTA ANA ADJ7106725 JUAN RAMOS DEPT DEPARTMENT DIST 7 SCIF STATE EMPLOYEES SANTA ANA ADJ3329947 KATHERINE DIMAYUGA EDD SCIF STATE EMPLOYEES SANTA ANA ADJ7486771 LAURA CORTEZ DEPARTMENT OF MOTOR VEHICLES SCIF STATE EMPLOYEES SANTA ANA ADJ289689 LESTER HUMPHREY STATE OF CA/DEPT OF TRANSPORTATION SCIF STATE EMPLOYEES SANTA ANA ADJ2992867 MILLICENT PETERSON DEPT OF MOTOR VEHICLES SCIF STATE EMPLOYEES SANTA ANA ADJ7447579 RICHARD POWERS STATE OF CALIFORNIA SCIF STATE EMPLOYEES SANTA ANA ADJ3384995 SAUNDRA BUTLER DEPT. 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SEDGWICK 14154 SACRAMENTO ADJ2554492 FRANCISCO VELASCO CAMEO EMPLOYMENT SERVICE SEDGWICK 14154 SACRAMENTO ADJ6804144 HIGINIO RODRIGUEZ SEGURA 1 LEVEL BY WEYERHAEUSER CO SEDGWICK 14154 SACRAMENTO ADJ8716692 JAMES POLLOCK AMERACOLD SEDGWICK 14154 SACRAMENTO ADJ6523608 JORGE RICO PAULSSON GEOPHYSICAL SERVICES INC SEDGWICK 14154 SACRAMENTO ADJ3342882 JOSE TLATENCHI AIR GROUND MANPOWER CONSULTING SEDGWICK 14154 SACRAMENTO ADJ3342882 JOSE TLATENCHI MONARCH CONSULTING DBA PES PAYROLL SEDGWICK 14154 SACRAMENTO ADJ3342882 JOSE TLATENCHI RALLY MANAGEMENT SERVICES LLC SEDGWICK 14154 SACRAMENTO ADJ2265337 JUAN PLATA DARLING INTERNATIONAL SEDGWICK 14154 SACRAMENTO ADJ2949765 KRISTEN DORREN TRADER JOES SEDGWICK 14154 SACRAMENTO ADJ1820706 LASHONDA BROWN PIER 1 IMPORTS SEDGWICK 14154 SACRAMENTO ADJ1820706 LASHONDA BROWN PIER 1 IMPORTS, INC SEDGWICK 14154 SACRAMENTO ADJ7457577 MARIA VERDUGO FIRST STUDENT TRANSPORTATION SEDGWICK 14154 SACRAMENTO ADJ1261881 MIGUEL SANCHEZ PREFERRED PERSONNEL SEDGWICK 14154 SACRAMENTO ADJ9485544 CANDIDA TOBAR GARFIELD BEACH CVS SEDGWICK 14424 ORANGE Fermin Iglesias

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Case Number Injured Worker Employer Claims Administrator ------ADJ4644900 ALFREDO GUTIERREZ SEARS SEDGWICK 14450 LONG BEACH ADJ9129291 BILLIE ROBERTS ORCHARD SUPPLY HARDWARE SEDGWICK 14450 LONG BEACH ADJ8888997 FRANCISCO RAMIREZ MIMI S CAFE SEDGWICK 14450 LONG BEACH ADJ6801218 GILBERTO URREA SR SEARS SEDGWICK 14450 LONG BEACH ADJ8916696 GUSTAVO CHAIREZ MURILLO SMART FINAL STORES LLC SEDGWICK 14450 LONG BEACH ADJ7693021 JOHN BOLOGNIA COCA COLA ENTERPRISES INCORPORATED SEDGWICK 14450 LONG BEACH ADJ3926833 JOSEPH ACEVEDO HENRY'S FARMERS MARKET SEDGWICK 14450 LONG BEACH ADJ6839917 JUAN ESCALANTE NESTLE USA SEDGWICK 14450 LONG BEACH ADJ8058224 MANUEL PARUNGAO BOEING COMPANY SEDGWICK 14450 LONG BEACH ADJ1505870 MARIA BARAJAS KROGER WEST RALPHS SEDGWICK 14450 LONG BEACH ADJ1505870 MARIA BARAJAS RALPHS GROCERY CO SEDGWICK 14450 LONG BEACH ADJ7414192 MARIA PARADA SEARS SEDGWICK 14450 LONG BEACH ADJ7658020 MARIBEL VALLE LOPEZ ROSS WAREHOUSE SEDGWICK 14450 LONG BEACH ADJ8982246 MARIO MARROQUIN LOWES SEDGWICK 14450 LONG BEACH ADJ7748882 MARTHA LOPEZ DAVITA INC SEDGWICK 14450 LONG BEACH ADJ7222350 MARTINA HUIZAR AMERICAN AIRLINES SEDGWICK 14450 LONG BEACH ADJ3123080 MELISSA PALOMINO WALGREENS SEDGWICK 14450 LONG BEACH ADJ1086388 MERCEDES ROMERO LOWE'S SEDGWICK 14450 LONG BEACH ADJ4660956 MICHAEL IRVING DREYER'S GRAND ICE CREAM SEDGWICK 14450 LONG BEACH ADJ4660956 MICHAEL IRVING DREYER'S GRAND ICE CREAM HOLDINGS SEDGWICK 14450 LONG BEACH ADJ4660956 MICHAEL IRVING DREYERS GRAND ICE CREAM HOLDINGS SEDGWICK 14450 LONG BEACH ADJ8451646 ONORIO GANDARILLA MIMIS CAFE SEDGWICK 14450 LONG BEACH ADJ9133034 RAYLENE GRAHAM JCPENNEY SEDGWICK 14450 LONG BEACH ADJ7641542 SASHA ANDREAS BOEING SEDGWICK 14450 LONG BEACH ADJ8918706 YOLANDA VAN GELDER SMART & FINAL SEDGWICK 14450 LONG BEACH ADJ6796372 BRIAN DERAS COCA-COLA ENTERPRISES INC SEDGWICK 14458 ONTARIO ADJ2644147 CHRIS ECHARD COCA COLA SEDGWICK 14458 ONTARIO ADJ2644147 CHRIS ECHARD COCOA COLA BOTTLING SEDGWICK 14458 ONTARIO ADJ7211010 LETICIA TAPIA FOOD 4 LESS SEDGWICK 14458 ONTARIO ADJ7316042 MARIA VILLAGRANA COCA COLA SEDGWICK 14458 ONTARIO ADJ7106048 SIJIFREDO OROZCO SUAREZ COCA COLA ENTERPRISE SEDGWICK 14458 ONTARIO ADJ7836363 WALTER LIZA COCA COLA SEDGWICK 14458 ONTARIO ADJ7836363 WALTER LIZA WORLD FLIGHT SERVICES SEDGWICK 14458 ONTARIO ADJ8546137 DANIEL CUEVAS SEARS HOLDINGS CORP SEDGWICK 14479 MCU IVOS VAN NUYS ADJ552375 ERNEST DICKERSON ST. VINCENT MEDICAL CENTER SEDGWICK 14479 MCU IVOS VAN NUYS ADJ1392822 FRANCISCO CARDENAS KIMKO SEDGWICK 14479 MCU IVOS VAN NUYS ADJ7929191 MARGARITA BARTOLO KIMCO SEDGWICK 14479 MCU IVOS VAN NUYS ADJ8149505 MARTHA BELTRAN KIMCO STAFFING SERVICES SEDGWICK 14479 MCU IVOS VAN NUYS ADJ2466441 ROSENDO RIVERA KIMCO SERVICES SEDGWICK 14479 MCU IVOS VAN NUYS ADJ2466441 ROSENDO RIVERA KIMCO STAFFING SERVICES SEDGWICK 14479 MCU IVOS VAN NUYS ADJ8911642 ALLEN KATZ SECURITAS SEDGWICK 14522 VAN NUYS ADJ8911642 ALLEN KATZ SECURITAS SECURITY SERVICES USA INC SEDGWICK 14522 VAN NUYS ADJ9325100 ANA ECHEVERRIA KIMCO STAFFING SERVICES INC SEDGWICK 14522 VAN NUYS ADJ8599404 ANTHONY AVILA VALLARTA SUPERMARKETS SEDGWICK 14522 VAN NUYS ADJ7785326 ANTONIA GOMEZ VALLARTA SUPERMARKETS SEDGWICK 14522 VAN NUYS ADJ8050259 CHARLOTTE HERRERA PRESCRIPTION SOLUTIONS SEDGWICK 14522 VAN NUYS ADJ9372914 CHRISTINE CIUDADANO UNITED HEALTH CARE SEDGWICK 14522 VAN NUYS ADJ9372914 CHRISTINE CIUDADANO UNITED HEALTH GROUP SEDGWICK 14522 VAN NUYS ADJ7554124 EDUARDO MENDEZ SECURITAS SECURITY SVCS USA SEDGWICK 14522 VAN NUYS ADJ9822489 FRANCISCO ARREDONDO VALLARTA FOOD ENTERPRISES INC SEDGWICK 14522 VAN NUYS ADJ8081219 GREGORIO ARZATE VALLARTA FOOD ENTERPRISES INC DBA VALLARTA SUPERMARKETS SEDGWICK 14522 VAN NUYS ADJ9190665 JUAN CORONA SECURITAS SECURITY SERVICES USA INC SEDGWICK 14522 VAN NUYS ADJ9300488 JUAN OLIVARES SECURITAS SECURITY SERVICES USA INC SEDGWICK 14522 VAN NUYS ADJ9725325 LINDA REED POTTS RALPHS GROCERY STORE SEDGWICK 14522 VAN NUYS ADJ9173661 MANUEL AYALA SECURITAS SEDGWICK 14522 VAN NUYS ADJ9173661 MANUEL AYALA SECURITAS SECURITY SERVICES USA INC SEDGWICK 14522 VAN NUYS ADJ8107371 MANUEL CHAGOLLA KIMCO AGENCY SEDGWICK 14522 VAN NUYS ADJ8536815 MARIA TERESA VEGA 99 CENTS ONLY STORE SEDGWICK 14522 VAN NUYS ADJ8536815 MARIA TERESA VEGA 99 CENTS ONLY STORES INC SEDGWICK 14522 VAN NUYS ADJ7245343 RAMON RODRIGUEZ VALLARTA SUPERMARKETS SEDGWICK 14522 VAN NUYS ADJ1389119 ROBERT FULLER SECURITAS SEDGWICK 14522 VAN NUYS ADJ8568385 ROLAND WARREN CALIFORNIA HOSPITAL MEDICAL CENTER SEDGWICK 14522 VAN NUYS ADJ8049788 RONALD ALMAZAN LOWE S SEDGWICK 14522 VAN NUYS ADJ8049788 RONALD ALMAZAN LOWES HOME CENTERS SEDGWICK 14522 VAN NUYS ADJ8614719 VICTOR BARRIENTOS HERTZ RENT A CAR SEDGWICK 14522 VAN NUYS ADJ9699389 VICTORIA SINSON ST FRANCIS MEDICAL CENTER SEDGWICK 14522 VAN NUYS ADJ7114848 WALTER GUADRON VALLARTA SUPERMARKETS SEDGWICK 14522 VAN NUYS ADJ7124819 WELDON GOODEN THE BOEING COMPANY SEDGWICK 14522 VAN NUYS ADJ7435274 CHEYENNE PADDOCK UNITED HEALTH GROUP SEDGWICK 14535 OAKLAND ADJ978586 ERICA MEZA UNITED HEALTH GROUP SEDGWICK 14535 OAKLAND ADJ978586 ERICA MEZA UNITED HEALTH GROUP INC SEDGWICK 14535 OAKLAND ADJ9000218 SHANNON CLAYTON DURHAM D AND M SEDGWICK 14535 OAKLAND ADJ7063985 BENNY BALTAZAR PACIFIC CUSTOM MATERIALS INC SEDGWICK 14563 LONG BEACH ADJ7253763 CARLOS MOLINA FOOD 4 LESS SEDGWICK 14563 LONG BEACH ADJ7752010 DANNY ZEBANEH RALPHS SEDGWICK 14563 LONG BEACH ADJ7543315 DARREN NORWOOD UNITED HEALTH GROUP SEDGWICK 14563 LONG BEACH ADJ7090954 DEARDREW LUCAS FOOD 4 LESS SEDGWICK 14563 LONG BEACH ADJ8454163 DORA HERNANDEZ RALPHS SEDGWICK 14563 LONG BEACH ADJ7724848 EFREN CAALIM FOOD LESS SEDGWICK 14563 LONG BEACH ADJ7168675 ESPERANZA OROZCO FOOD 4 LESS SEDGWICK 14563 LONG BEACH ADJ7113570 GREGORY CURTIS RALPHS GROCERY SEDGWICK 14563 LONG BEACH ADJ7113570 GREGORY CURTIS RALPHS GROCERY COMPANY SEDGWICK 14563 LONG BEACH ADJ8719645 GUADALUPE CONTRERAS RALPHS SEDGWICK 14563 LONG BEACH ADJ6903073 JILMA VEGA RALPHS NO 256 SEDGWICK 14563 LONG BEACH ADJ6662620 JOSIE MARIE PEDROZA SMART & FINAL SEDGWICK 14563 LONG BEACH Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6968565 KARINA PEREZ THE KROGER CO SEDGWICK 14563 LONG BEACH ADJ6609694 KEVIN RAMIREZ RALPHS GROCERY SEDGWICK 14563 LONG BEACH ADJ6857898 NATALIE MORRIS RALPH`S SEDGWICK 14563 LONG BEACH ADJ6526207 OSVALDO ZARATE RALPHS 288 SEDGWICK 14563 LONG BEACH ADJ6987016 PETRA AVELINO KMART CORP / SEARS HOLDING SEDGWICK 14563 LONG BEACH ADJ6987016 PETRA AVELINO KMART CORP SEARS HOLDING SEDGWICK 14563 LONG BEACH ADJ7890463 PETRA ORTEGA DURHAM SCHOOL SERVICES SEDGWICK 14563 LONG BEACH ADJ7663026 ROSA MONTES RALPH S GROCERY SEDGWICK 14563 LONG BEACH ADJ582461 SHARONDA THOMAS ADMINISTAFF COMPANIES SEDGWICK 14563 LONG BEACH ADJ582461 SHARONDA THOMAS ADMINSTAFF COMPANIES SEDGWICK 14563 LONG BEACH ADJ6638602 WILLIAM TAYLOR FOOD 4 LESS SEDGWICK 14563 LONG BEACH ADJ2144241 ALBERTO ARRIAGA MORALES CINTAS CORP SEDGWICK 14573 SACRAMENTO ADJ7256986 ALFONSO MONTERO FED-EX NATIONAL LTL INC SEDGWICK 14573 SACRAMENTO ADJ9613149 CARLOS GONZALEZ TAMA TRADING CO INS SEDGWICK 14573 SACRAMENTO ADJ8254847 DEVON HOWARD FED EX FREIGHT SEDGWICK 14573 SACRAMENTO ADJ8254817 FLOR VELOZ MCDONALD S SEDGWICK 14573 SACRAMENTO ADJ6739993 GRACIELA FLORES CINTAS CORPORATION SEDGWICK 14573 SACRAMENTO ADJ9614739 HILDA SANCHEZ LANGLOIS FANCY FROZEN FOODS SEDGWICK 14573 SACRAMENTO ADJ4077715 JOSE FLORES COAST FRAMING SEDGWICK 14573 SACRAMENTO ADJ3055524 LINDA GILLILAND ALFONSO MEXICAN FOODS SEDGWICK 14573 SACRAMENTO ADJ2790706 REGINALD TURNER MANPOWER SEDGWICK 14573 SACRAMENTO ADJ3669710 THERESA CHRISTY YOUNG MEAT CO SEDGWICK 14573 SACRAMENTO ADJ7084473 TOMASI MANUATU SOUTHWEST AIRLINES SEDGWICK 14573 SACRAMENTO ADJ4468391 VEDRAN BARBIC MURPHY INDUSTRIAL COATINGS SEDGWICK 14573 SACRAMENTO ADJ1198509 AUDREY WHITEHEAD AT&T SEDGWICK 14627 ONTARIO ADJ1798839 DAVID GOMEZ PACIFIC BELL SEDGWICK 14627 ONTARIO ADJ7817139 ELIZABETH SMITH AT T SEDGWICK 14627 ONTARIO ADJ4312846 GEORGE NAVA COCA COLA ENTERPRISES SEDGWICK 14627 ONTARIO ADJ588982 KIMBERLY AYALA AT&T COMMUNICATIONS SEDGWICK 14627 ONTARIO ADJ9371169 LARISSA RAMIREZ DE RUELAS LAUSD SEDGWICK 14627 ONTARIO ADJ9400381 MAYRA CASTRO COUNTY OF LOS ANGELES/DPSS SEDGWICK 14627 ONTARIO ADJ7110482 OLGA BECERRA AT AND T SEDGWICK 14627 ONTARIO ADJ3434567 ROLANDO VARGAS COCA COLA BOTTLING CO. SEDGWICK 14627 ONTARIO ADJ9191748 VANESSA RODRIGUEZ TARGET SEDGWICK 14627 ONTARIO ADJ7437588 KRISTEN OCALLAGHAN STARBUCKS SEDGWICK 14667 ORANGE ADJ7437588 KRISTEN OCALLAGHAN STARBUCKS COFFEE COMPANY SEDGWICK 14667 ORANGE ADJ7123991 PEREGRENA MOLINA USC SEDGWICK 14667 ORANGE ADJ7254557 ROBERT JACKSON 7 UP RC BOTTLING COMPANY SEDGWICK 14667 ORANGE ADJ9011913 FERNANDO GODINEZ VICTORIA PUBLIC GOLF SEDGWICK 14779 SAN DIEGO ADJ9011913 FERNANDO GODINEZ VICTORIA PUBLIC GOLF COURSE DBA SEDGWICK 14779 SAN DIEGO ADJ9206658 HEIDI ELIZABETH MARIN PADILLA MAID CLEANING SERVICES SEDGWICK 14779 SAN DIEGO ADJ9577732 JOSE MARTINEZ SLADE INDUSTRIAL LANDSCAPE SEDGWICK 14779 SAN DIEGO ADJ9577732 JOSE MARTINEZ SLADE INDUSTRIAL LASDSCAPE SEDGWICK 14779 SAN DIEGO ADJ9475909 ROSMERY ALVAREZ KSM HEALTHCARE SEDGWICK 14779 SAN DIEGO ADJ9475909 ROSMERY ALVAREZ KSM HEALTHCARE INC SEDGWICK 14779 SAN DIEGO ADJ9475909 ROSMERY ALVAREZ KSM HELTHCARE INC SEDGWICK 14779 SAN DIEGO ADJ9368968 TERESA LOPEZ FINANCIAL COMUNICATIONS SEDGWICK 14779 SAN DIEGO ADJ950622 FRANCES FOREMAN TARGET IMPORT CORP. SEDGWICK 2065 OAKLAND ADJ8634016 SULIN VITELA FED EX GROUND SEDGWICK 2065 OAKLAND ADJ8266249 ALICIA DIAZ CSU LONG BEACH SEDGWICK 2078 OAKLAND ADJ9394208 JOE WALKER CAL POLY POMONA SEDGWICK 2078 OAKLAND ADJ8912148 PATRICIA WILLIAMS CALIFORNIA STATE UNIVERSITY LONG BEACH SEDGWICK 2078 OAKLAND ADJ7162714 TANISHA GIBSON CALIFORNIA STATE POLYTECHNIC UNIVERSITY OF POMONA SEDGWICK 2078 OAKLAND ADJ6815361 GLORIA RAMIREZ CALIFORNIA STATE UNIVERSITY DOMINGUEZ HILLS SEDGWICK 3110 RANCHO CORDOVA ADJ8149505 MARTHA BELTRAN KIMCO STAFFING SERVICES SEDGWICK 3110 RANCHO CORDOVA ADJ7235149 DANIEL NIXON AT AND T SEDGWICK 51460 ONTARIO ADJ568529 EILEEN MC ALPINE PACIFIC BELL SEDGWICK 51460 ONTARIO ADJ1228493 JESUS LORENZO GIL MONCADA RALPHS SEDGWICK 51460 ONTARIO ADJ7536950 HARRY GEVSHENIAN CAST AND CREW ENTERTAINMENT SERVICES SEDGWICK ALBANY ADJ7536950 HARRY GEVSHENIAN ENTERTAINMENT PARTNERS EPSG SEDGWICK ALBANY ADJ7536950 HARRY GEVSHENIAN WARNER BROTHERS NETWORK SEDGWICK ALBANY ADJ7934932 MICHAEL OREFICE ENTERTAINMENT PARTNERS SEDGWICK ALBANY ADJ7934932 MICHAEL OREFICE FSI/FPS SERVICES INC. SEDGWICK ALBANY ADJ7934932 MICHAEL OREFICE NBC ULVERSAL SEDGWICK ALBANY ADJ7815122 URIEL LUNA UNIVERSAL CITY STUDIOS LLP SEDGWICK ALBANY ADJ8573816 ANNA ROMERO ALBERTSONS SEDGWICK ALBERTSONS BREA ADJ8608439 GENESEE NIXON ALBERTSONS SEDGWICK ALBERTSONS BREA ADJ9069256 NOEMI LOPEZ ANGELIQUE PITNEY SEDGWICK ALBERTSONS BREA ADJ8537526 SANDRA SANCHEZ LANDMARK MEDICAL MANAGEMENT SEDGWICK ALBERTSONS BREA ADJ9389996 TAMIKA WHITTIKER ALBERTSON'S INC SEDGWICK ALBERTSONS BREA ADJ9389996 TAMIKA WHITTIKER DOWNEY UNIFIED SCHOOL DISTRICT SEDGWICK ALBERTSONS BREA ADJ9389996 TAMIKA WHITTIKER KNOTTS BERRY FARM SEDGWICK ALBERTSONS BREA ADJ6664263 ABEL PLATA ACTION BAG & COVER INC SEDGWICK BREA ADJ7823226 ALEJANDRO ORDIANO CAMEO EMPLOYMENT SERVICES SEDGWICK BREA ADJ2947605 ALEXANDER OROZCO LOWES SEDGWICK BREA ADJ7118297 ANDRES MANZO ALCOA INC AKA ALCOA GLOBAL FASTENERS INC SEDGWICK BREA ADJ7253886 ANTONIO AGUILAR HOME TOWN BUFFET SEDGWICK BREA ADJ3135718 APRIL JAURIGUE ZALES - THE DIAMOND STORE SEDGWICK BREA ADJ9016607 ARACELI ARAUJO FIRST AMERICAN TITLE INSURANCE COMPANY SEDGWICK BREA ADJ6431614 AURELIO MARQUEZ AIRFLOW SOLUTIONS SEDGWICK BREA ADJ7337837 AXEL FERNANDEZ UNIVERSAL FACTORIES CORP SEDGWICK BREA ADJ8177894 BEATRIZ PALACIOS NBC UNIVERSAL SEDGWICK BREA ADJ7112557 BENJAMIN GARCIA LA BREA BAKERY SEDGWICK BREA ADJ3999193 BLANCA SANCHEZ CHERRY RUFFO SEDGWICK BREA ADJ8041184 BRIAN WOOD ALL WAYZ TOWING SEDGWICK BREA ADJ6415422 CARLETTE WAFER DHL SEDGWICK BREA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6415422 CARLETTE WAFER DHL EXPRESS SEDGWICK BREA ADJ1214217 CARLOS FLORES NATIONAL OILWELL VARCO SEDGWICK BREA ADJ8227048 CECELIA RAMIREZ RESCARE POMONA VALLEY SEDGWICK BREA ADJ6512546 CLEMENTINA JOYA HOMETOWN BUFFET INC SEDGWICK BREA ADJ7146189 CONSUELO CONTRERAS CALIFFAME OF LOS ANGELESJ INCI SEDGWICK BREA ADJ460212 CZARINA IBARRA HOMETOWN BUFFET SEDGWICK BREA ADJ9197805 DESIREE GUZMAN AMERICAN EAGLE ARILINES INC SEDGWICK BREA ADJ9197805 DESIREE GUZMAN AMERICAN EAGLE AIRLINES INC SEDGWICK BREA ADJ2552769 DINA CUETO HOMETOWN BUFFET SEDGWICK BREA ADJ7237364 DONTAY BENSON RENT A CENTER SEDGWICK BREA ADJ7632802 EDITH GONZALEZ DEL TACO INC SEDGWICK BREA ADJ7632802 EDITH GONZALEZ DEL TACO INC SEDGWICK BREA ADJ2417705 EDUARDO RODRIGUEZ ALCOA GLOBAL FASTENERS INC SEDGWICK BREA ADJ7920903 ELIDIA IDIAQUEZ LA BREA BAKERY SEDGWICK BREA ADJ7920903 ELIDIA IDIAQUEZ LA BREA BAKERY INC SEDGWICK BREA ADJ6778096 EPIFANIO SALDANA VOLT SERVICES GROUP SEDGWICK BREA ADJ2560539 ERNESTO DELAFUENTE SUNRISE SENIOR LIVING MANAGEMENT SEDGWICK BREA ADJ6790644 ESMERALDA GUEVARA LOWES SEDGWICK BREA ADJ6556935 GERARDO VASQUEZ RED ROBIN SEDGWICK BREA ADJ7091657 GUILLERMO REMEDIOS FLOIT HOMES SEDGWICK BREA ADJ7024909 IRENE CHOY LEE KUM KEE USA SEDGWICK BREA ADJ3768735 IRMA HERNANDEZ WURMS JANITORIAL SRVS. SEDGWICK BREA ADJ7558376 ISRAEL AVILA VICTOR SEDGWICK BREA ADJ7558376 ISRAEL AVILA VICTOR RODRIGUEZ AND WENDY D RODRIGUEZ SEDGWICK BREA ADJ4495271 JAVIER FIGUEROA FREE FLOW PRODUCTS, INC SEDGWICK BREA ADJ2739502 JAVIER TAMAYO C PACIFIC FOOD INC SEDGWICK BREA ADJ1346767 JOSE CRUZ MEZA HUERTA WEST END RACQUET SEDGWICK BREA ADJ7339475 JOSE LOPEZ R H PETERSON SEDGWICK BREA ADJ2170203 JOSE LUIS VARAS TERESA LOBATOS SEDGWICK BREA ADJ7257399 JOSE RUELAS ADP TOTAL SOURCE SEDGWICK BREA ADJ6418111 JOSE SEGUNDO PACIFIC BUILDING CARE SEDGWICK BREA ADJ7663530 JUAN CASTRO STEEL T AC INCORPORATED SEDGWICK BREA ADJ3601207 JUAN MUNETON ARAMACK SEDGWICK BREA ADJ790228 JUAN NAJERA NEDCO ELECTRONICS SEDGWICK BREA ADJ6773075 JULIET MOROVATI TURTLE ROCK PRESCHOOL INC SEDGWICK BREA ADJ6763267 JULIO MARTINEZ TRITON CHANDELIER INC SEDGWICK BREA ADJ3096174 KAREN DWINELL LLC STARPOINT PROPERTIES SEDGWICK BREA ADJ6914920 LAURA AGUILAR HYDER PROPERTY MANAGEMENT SEDGWICK BREA ADJ7337958 LAURA DE PAZ EL POLLO LOCO INC SEDGWICK BREA ADJ9422723 LIONEL AGUIRRE STANDARD PARKING CORP SEDGWICK BREA ADJ9422723 LIONEL AGUIRRE STANDARD PARKING CORPORATION SEDGWICK BREA ADJ3118106 LUCY GUTIERREZ USC NORRIS CANCER CENTER SEDGWICK BREA ADJ7250347 MANUEL URIBE SOUTHERN WINE AND SPIRITS SEDGWICK BREA ADJ6863384 MARCOS MORENO HARBOR PRODUCTS INC SEDGWICK BREA ADJ1481906 MARIA HERNANDEZ RES-CARE ORANGE COUNTY SEDGWICK BREA ADJ7781351 MARIA POLANCO LETICIA M VILLASENOR SEDGWICK BREA ADJ126314 MARIA VILLA TECHNICOLOR HOME ENTERTAINMENT SERV SEDGWICK BREA ADJ9219065 MARTHA LOMELI ROSS DEPARTMENT STORE SEDGWICK BREA ADJ531002 MARTHA MEZA SC STAFFING SOLUTIONS SEDGWICK BREA ADJ9375520 MAXIMINA GUTIERREZ STANDARD PARKING SEDGWICK BREA ADJ1086388 MERCEDES ROMERO LOWE'S SEDGWICK BREA ADJ762454 MIGUEL FONSECA SALMERON STRICYCLE INC SEDGWICK BREA ADJ6799657 MIRIAN DE JESUS SALAZAR ALPHA SOURCE SEDGWICK BREA ADJ7345353 NAVIDAD CARRASCO DOLLAR TREE DISTRIBUTION INC SEDGWICK BREA ADJ1749304 NGOC NGA DUONG GARDEN GROVE HOSPITAL SEDGWICK BREA ADJ8009612 NICOLAS ROSAS PENG CHENG ALUMINUM ENTERPRISES INC SEDGWICK BREA ADJ7782913 NIDIA BENAVIDES HOMETOWN BUFFET SEDGWICK BREA ADJ6769219 NOOMANE TRABELSI STATER BROS SEDGWICK BREA ADJ6830932 OSCAR SALAS WALTERS MANAGEMENT INC SEDGWICK BREA ADJ7882503 RICARDO PIEDRA SANTA STANDARD PARKING SEDGWICK BREA ADJ7882503 RICARDO PIEDRA SANTA STANDARD PARKING CORPORATION SEDGWICK BREA ADJ7112846 ROBERTO RAMOS ACTIVE TEMPORARY PLACEMENT AGENCY SEDGWICK BREA ADJ7207424 ROCELIA MORALES AMERICAN APPAREL SEDGWICK BREA ADJ7483176 SAI DASYAM PRIME HEALTHCARE SERVICES SEDGWICK BREA ADJ113924 SALVADOR TAMAYO L.A.R.K. INDUSTRIES, INC. SEDGWICK BREA ADJ2336613 SANTOS AGUILAR MAR LEE MFG SEDGWICK BREA ADJ7794922 SERGIO CERVANTES CALIFORNIA THREAD AND SUPPLY SEDGWICK BREA ADJ7931233 SHARNEY BOURLAND FIRST AMERICAN HOMEBUYERS INSURANCE COMPANY SEDGWICK BREA ADJ7194022 SHAWNAMARIE MONTANO SECOND IMAGE INC SEDGWICK BREA ADJ3785683 SYED BOKHARI WESTERN MEDICAL CENTER SEDGWICK BREA ADJ9391573 SYLVIA VILLAGRANA LUXOTTICA U S HOLDINGS CORP SEDGWICK BREA ADJ3817010 TATANISHA KNOTTS FIRST AMERICAN TITLE SEDGWICK BREA ADJ7870169 TERISA DEMARCO RESCARE SEDGWICK BREA ADJ7937923 VERONICA VARELA INSPERITY BUSINESS SERVICE LP SEDGWICK BREA ADJ7937923 VERONICA VARELA TWO CHEF ON A ROLL SEDGWICK BREA ADJ6599906 WALTER CABRERA THE DULING CORPORATION DBA MODEL INTERIORS SEDGWICK BREA ADJ1591383 WENDY CALHOUN PETCO SEDGWICK BREA ADJ8681086 WILLIAM DORA DR PEPPER SNAPPLE GROUP SEDGWICK BREA ADJ1246820 YOLANDA WEEKS SUBURBAN HOSPITAL SEDGWICK BREA ADJ6777068 YUEMING XIAO ARES MANAGEMENT INC SEDGWICK BREA ADJ4709408 BEATRICE MONJICA CAITAC GARMENT PROCESSING INC. SEDGWICK BURBANK ADJ7858913 CURTIS CALLOWAY ARAMARK SEDGWICK BURBANK ADJ8440072 DANA IVAN COOK ARAMARK SEDGWICK BURBANK ADJ7033345 EDUARDO MIGUEL ARAMARK BUSINESS FACILITIES LLC SEDGWICK BURBANK ADJ8373490 ELVIA CASTRO ARAMARK SEDGWICK BURBANK ADJ7116789 EMILIANA TORRES ARAMARK SEDGWICK BURBANK Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6743506 JANICE GAY TUTOR TIME LEARNING SEDGWICK BURBANK ADJ6800371 JAVIER SOLIS ARAMARK SEDGWICK BURBANK ADJ6783209 JOSE CAMACHO ARAMARK SEDGWICK BURBANK ADJ6795837 JOSE CORONA ARAMARK SEDGWICK BURBANK ADJ8374446 JUAN HERRERA BASAW MANUFACTURING SEDGWICK BURBANK ADJ128617 JUAN MUNETON ARAMARK HEALTHCARE SERVICES SEDGWICK BURBANK ADJ7185843 JUANA MENDEZ STARPOINT PROPERTY MANAGEMENT LLC SEDGWICK BURBANK ADJ7225013 MARIA MARQUEZ ARAMARK SPORTS LLC SEDGWICK BURBANK ADJ8049797 REGINALD WILLIAMS ARAMARK SEDGWICK BURBANK ADJ8218977 ROSA CAMPOS ARAMARK SEDGWICK BURBANK ADJ6767423 RUTH PEREZ TWO CHEFS ON ROLL SEDGWICK BURBANK ADJ968312 CARMEN PEREZ CARDENAS MARKETS INC SEDGWICK CHARLESTON ADJ6444831 VERONICA LOPEZ LEVY`S RESTAURANT SEDGWICK CHARLESTON ADJ3271853 ALFONSO SERNA TOWER STAFFING SOLUTIONS SEDGWICK CIGA GLENDALE ADJ3271853 ALFONSO SERNA TOWER TEMPS SEDGWICK CIGA GLENDALE ADJ8516521 ARMANDO FLORES MADRONE CONSTRUCTION SEDGWICK CIGA GLENDALE ADJ9432009 ELVIRA OLIVAS JUAN MUNOZ DBA FARM LABOR CONTRACTOR SEDGWICK CIGA GLENDALE ADJ1197723 EMILIANO GOMEZ OLYMPIC DYEING FINISHING PAINTING SEDGWICK CIGA GLENDALE ADJ653725 FRANK CATHRILL PERRIS UNIFIED SCHOOL DISTRICT SEDGWICK CIGA GLENDALE ADJ653725 FRANK CATHRILL PERRIS UNION HIGH SCHOOL SEDGWICK CIGA GLENDALE ADJ653725 FRANK CATHRILL PERRIS UNION HIGH SCHOOL DISTRICT SEDGWICK CIGA GLENDALE ADJ1093811 HECTOR JIMENEZ CRESCENT TRUCK LINES SEDGWICK CIGA GLENDALE ADJ2832219 JORGE HERNANDEZ KLUNE INDUSTRIES, INC. SEDGWICK CIGA GLENDALE ADJ1891794 JUAN MORELOS TAG TOYS INC SEDGWICK CIGA GLENDALE ADJ9492472 JUAN RAMIREZ SALT CREEK GOLLE RESTAURANT SEDGWICK CIGA GLENDALE ADJ3636212 LARRY SHARP HALEY BROTHERS SEDGWICK CIGA GLENDALE ADJ2389804 LUCERO SESTEAGA INDUSTRIAL INDEMNITY SEDGWICK CIGA GLENDALE ADJ2389804 LUCERO SESTEAGA INDUSTRIAL INDEMNITY COMPANY SEDGWICK CIGA GLENDALE ADJ1868683 LUIS ZARAGOSA TORRES FOREST RIVER INC SEDGWICK CIGA GLENDALE ADJ1167286 MERCEDES SARIOL SOUTHERN CA OFF TRACK WAGERING SEDGWICK CIGA GLENDALE ADJ4645734 MICHAEL CROUGH MCDONNELL DOUGLAG AIRCRAFT SEDGWICK CIGA GLENDALE ADJ9553116 PEDRO CASTILLO MAG INSTRUMENTAL AVE SEDGWICK CIGA GLENDALE ADJ1707728 PEGGIE ELEBY NORTHROP SEDGWICK CIGA GLENDALE ADJ1707728 PEGGIE ELEBY NORTHROP CORPORATION SEDGWICK CIGA GLENDALE ADJ9358916 RAFAEL ZAMORA KAMRAN STAFFING SEDGWICK CIGA GLENDALE ADJ7977184 ROCIO URRUTIA AMS OUTSOURCING STAFF CHEX INC SEDGWICK CIGA GLENDALE ADJ7977184 ROCIO URRUTIA STAFF CHEX SEDGWICK CIGA GLENDALE ADJ3426967 SANDRA LANZA GCB COMMUNICATIOS, INC SEDGWICK CIGA GLENDALE ADJ3013213 SILVESTRE RAMOS CUSTOM LIGHT AND IRON SEDGWICK CIGA GLENDALE ADJ3013213 SILVESTRE RAMOS EMPLOYERS RESOURCE SEDGWICK CIGA GLENDALE ADJ895454 YONG HONG FAN LIANG TAI KNITWEAR CO. SEDGWICK CIGA GLENDALE ADJ8177764 HOVHANNES HOVHANNISYAN TRI STATE STAFFING SEDGWICK CIGA ROSEVILLE ADJ9473023 JOSE ARAUJO TS EMPLOYMENT SEDGWICK CIGA ROSEVILLE ADJ9201221 MARIO CRUZ TRI STATE DIAMOND STAFFING SEDGWICK CIGA WEST HILLS ADJ7434876 HOSSEIN FALLAH LIFE SOURCE WATER SEDGWICK CLAIMS ADJ1198509 AUDREY WHITEHEAD AT&T SEDGWICK CLAIMS MANAGEMENT ADJ4044577 FORTUNATO MORAN PEPSI BOTTLING GROUP SEDGWICK CLAIMS MANAGEMENT ADJ3918763 MARIA CANCINO BIG LOTS SEDGWICK CLAIMS MANAGEMENT ADJ1796239 MARIETTA HABON SPHERION CORP SEDGWICK CLAIMS MANAGEMENT ADJ3572795 GARY DONNEL HARNAGE SEARS AUTO CENTER SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ412663 JOSEPH HOLMES RALPHS GROCERY COMPANY SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ714455 LEILA PARKER VERIZON CALIFORNIA INC SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ2755502 LESTER DIXON CONSOLIDATED FREIGHTWAYS SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ1505870 MARIA BARAJAS KROGER WEST RALPHS SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ1505870 MARIA BARAJAS RALPHS GROCERY CO SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ4264175 MARIO SOTO COSTCO SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ2378186 MARTHA CORONA TARGET SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ1207791 MIRNA SANTOS SUNRISE SENIOR LIVING MGMT INC SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ2695099 REBECCA MACIAS RALPH'S GROCERY STORE SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ1171637 RICARDO RALPH GUTIERREZ HOME DEPOT SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ1828880 TIMOTHY WAGNER BIG LOTS SEDGWICK CLAIMS MANAGEMENT SERVICES ADJ1058282 PETER COOPER LOS ANGELES UNIFIED SCHOOL DISTRICT SEDGWICK CLAIMS MANAGMENT SERVICES ADJ1455996 JERRY LOPEZ MCDONALD'S SEDGWICK CMS ADJ1228493 JESUS LORENZO GIL MONCADA RALPHS SEDGWICK CMS ADJ7682559 MARIA RAMOS EXPRESS EMPLOYMENT SEDGWICK CMS ADJ7447366 MARIO SALAZAR AZITEX TRADING CORP SEDGWICK CMS ADJ4100513 NATIVIDAD GIL BOEING COMPANY- SPECTRO LAB INC SEDGWICK CMS ADJ9633661 ROBERTO GUERRERO MELS DRIVE IN SEDGWICK CMS ADJ3642336 YOLANDA MCCREE UCLA MEDICAL CENTER SEDGWICK CMS ADJ7848125 AGNES COLEMAN LA COUNTY DCFS SEDGWICK COLA ONTARIO ADJ958847 AIDA DELGADILLO DEPT OF SOCIAL SERVICES SEDGWICK COLA ONTARIO ADJ958847 AIDA DELGADILLO DEPT. OF SOCIAL SERVICES SEDGWICK COLA ONTARIO ADJ8150396 ARMA SCOTT LA COUNTY DEPARTMENT OF SOCIAL SERV SEDGWICK COLA ONTARIO ADJ1614914 BETTY TIDWELL COUNTY OF LOS ANGELES DPSS SEDGWICK COLA ONTARIO ADJ7626768 CONSTANCE MC MILLER LA COUNTY SEDGWICK COLA ONTARIO ADJ7626768 CONSTANCE MC MILLER LA COUNTY DEPARTMENT OF SERVICES SEDGWICK COLA ONTARIO ADJ6702693 CRISTINA HERNANDEZ COUNTY OF LOS ANGELES SEDGWICK COLA ONTARIO ADJ7453062 DANIELLE MCQUEEN DPSS LOS ANGELES COUNTY SEDGWICK COLA ONTARIO ADJ6899789 DARIUS SIMNS LOS ANGELES COUNTY PROBATION DEPARTMENT SEDGWICK COLA ONTARIO ADJ7471058 DOLORES HERNANDEZ COUNTY OF LA PUBLIC WORKS SEDGWICK COLA ONTARIO ADJ9142381 ELISEO SANCHEZ PARKER HANNIFIN SEDGWICK COLA ONTARIO ADJ7829423 FRANCISCA ARMENTA PARKER HANNIFIN CORPORATION SEDGWICK COLA ONTARIO ADJ4665455 FRANCISCO ANDUAGA COUNTY LA AGRICULTURAL DEPT SEDGWICK COLA ONTARIO ADJ4665455 FRANCISCO ANDUAGA COUNTY OF LOS ANGELES SEDGWICK COLA ONTARIO ADJ6568519 GABRIELLA SANDOVAL COUNTY OF LA SEDGWICK COLA ONTARIO ADJ7841884 GABRIELLA SANDOVAL COUNTY OF L A SEDGWICK COLA ONTARIO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7135077 GERARDO CADENA LOS ANGELES COUNTY PROBAT10N DEPARTMENT SEDGWICK COLA ONTARIO ADJ7135077 GERARDO CADENA LOS ANGELES COUNTY PROBATION DEPARTMENT SEDGWICK COLA ONTARIO ADJ531977 HECTOR KNIGHT DPSS SEDGWICK COLA ONTARIO ADJ6464150 JANET GUZMAN LOS ANGELES COUNTY DPSS SEDGWICK COLA ONTARIO ADJ7131377 JESSICA DE LA CRUZ COUNTY OF LOS ANGELES DEPARTMENT OF PROBATION SEDGWICK COLA ONTARIO ADJ4653966 JOHN LAKE COUNTY OF LOS ANGELES REGISTRAR RECORDER COUNTY CLERK SEDGWICK COLA ONTARIO ADJ4653966 JOHN LAKE LOS ANGELES COUNTY REGISTRAR RECORDER SEDGWICK COLA ONTARIO ADJ7289898 JUAN GARCIA LA COUNTY DEPARTMENT OF AGRICULTURE SEDGWICK COLA ONTARIO ADJ2679756 KATRINA LOPEZ L.A. COUNTY/REGISTER RECORDER CLERK SEDGWICK COLA ONTARIO ADJ2679756 KATRINA LOPEZ LA COUNTY/REGISTER RECORDER SEDGWICK COLA ONTARIO ADJ8548889 MICHAEL GREAVES LOS ANGELES COUNTY SEDGWICK COLA ONTARIO ADJ9115022 MILLICENT TOWNSEND COUNTY OF LOS ANGELES SEDGWICK COLA ONTARIO ADJ7658997 PATRICIA RAMOS COUNTY OF LOS ANGELES SEDGWICK COLA ONTARIO ADJ6735579 PAULINE CHAN LA COUNTY DEPARTMENT OF SOCIAL SERVICES SEDGWICK COLA ONTARIO ADJ6735579 PAULINE CHAN LA COUNTY/DEPARTMENT OF PUBLIC SOCIAL SERVICES SEDGWICK COLA ONTARIO ADJ8203305 PEDRO HERNANDEZ DEPARTMENT OF PUBLIC SOCIAL SERVICES SEDGWICK COLA ONTARIO ADJ3814645 PERLA DIAZ COUNTY OF LOS ANGELES SEDGWICK COLA ONTARIO ADJ7717063 PHARINY LIM COUNTY OF LOS ANGELES PROBATION DEPARTMENT SEDGWICK COLA ONTARIO ADJ8951891 PURITA PRATHER COUNTY OF LOS ANGELES COUNTY ASSESORS OFFICE SEDGWICK COLA ONTARIO ADJ948155 RAYMOND BAKER LOS ANGELES COUNTY PROBATION SEDGWICK COLA ONTARIO ADJ7845619 REYNALDO ANAYA COUNTY OF LOS ANGELES DPSS SEDGWICK COLA ONTARIO ADJ2089669 ROBERT HIGGINS COUNTY OF LOS ANGELES SEDGWICK COLA ONTARIO ADJ9233370 ROCIO RODRIGUEZ DPSS SEDGWICK COLA ONTARIO ADJ8232024 SANDRA WILLIAMS LOS ANGELES COUNTY PROBATION DEPARTMENT SEDGWICK COLA ONTARIO ADJ8528312 VAREE ANDERSON LA COUNTY DEPT CHILDREN AND FAMILY SERVICES SEDGWICK COLA ONTARIO ADJ4486853 VERA WASHINGTON LOS ANGELES COUNTY-HAWTHORNE IHSS SEDGWICK COLA ONTARIO ADJ1305251 WENDY DANIELS COUNTY OF LOS ANGELES/DPSS SEDGWICK COLA ONTARIO ADJ9167986 BILLIE RAMIREZ TARGET SEDGWICK CONCORD ADJ397720 BRENDA CHAN SEES CANDY SEDGWICK CONCORD ADJ397720 BRENDA CHAN SEE`S CANDY SHOPS INC SEDGWICK CONCORD ADJ9205444 HUGO NOE MIDNIGHT AUTO AND TRUCK RECYCLERS SEDGWICK CONCORD ADJ7175289 JASON HOLLAND RAMONA TIRE INC SEDGWICK CONCORD ADJ9103162 JOCELYN BERNAL UNITED HEALTH GROUP SEDGWICK CONCORD ADJ9104083 MONSERRAT CABRERA ISS FACILITY SERVICES INC SAN DIEGO SEDGWICK CONCORD ADJ6695978 DONNA DOMINGUEZ KAISER PERMANENTE SEDGWICK KAISER LEXINGTON ADJ1369247 JULIO LEIVA KAISER PERMANENTE SEDGWICK KAISER LEXINGTON ADJ7924569 MARCELINO MONTERO KAISER PERMANENTE SEDGWICK KAISER LEXINGTON ADJ8184588 NAFEESAH REED KAISER PERMANENTE SEDGWICK KAISER LEXINGTON ADJ7752117 ROCHELE JOHNSON KAISER PERMANENTE SEDGWICK KAISER LEXINGTON ADJ2110809 RUDY PEREZ KAISER PERMANENTE SEDGWICK KAISER LEXINGTON ADJ9779795 SUZETTE KILBREATH KAISER PERMANENTE SEDGWICK KAISER LEXINGTON ADJ1312204 ALEX FLORES FULTON COLLEGE & PREP SCHOOL SEDGWICK PASADENA ADJ309271 ANITA GONZALEZ LAUSD SEDGWICK PASADENA ADJ8055118 ANTONIA MARQUEZ LAUS ADMINISTRATION BUILDING FINANCE CORPORATION SEDGWICK PASADENA ADJ209551 BARBARA WASHINGTON LAUSD SEDGWICK PASADENA ADJ3186694 DANA TKAC LAUSD SEDGWICK PASADENA ADJ9385068 DARREN ABRAHAM LA UNIFIED SCHOOL DISTRICT SEDGWICK PASADENA ADJ7303071 DEANNA SANDERS LAUSD SEDGWICK PASADENA ADJ8816012 DINO STIRPE LAUSD SEDGWICK PASADENA ADJ2949728 EDDIE RAY L.A.U.S.D. SEDGWICK PASADENA ADJ7502752 ELIZABETH GONZALEZ MAGANA MAERSK DISTRIBUTION SERVICES INC SEDGWICK PASADENA ADJ8536317 ELIZABETH MEZA L A UNIFIED SCHOOL DISTRICT SEDGWICK PASADENA ADJ7841175 ELPIDIO COVARRUBIAS LAUSD SEDGWICK PASADENA ADJ9069101 ELSA CANAS GARAY LOS ANGELES UNIFIED SCHOOL DRISTRICT SEDGWICK PASADENA ADJ9892859 ENRIQUETA LOPEZ 109TH STREET ELEMETARY SCHOOL SEDGWICK PASADENA ADJ7165452 GEORGE PARSONS LOS ANGELES UNIFIED SCHOOL DISTRICT SEDGWICK PASADENA ADJ7479460 GLORIA LOERA LAUSD SEDGWICK PASADENA ADJ7776741 GREGORIO GOMEZ LAUSD SEDGWICK PASADENA ADJ928183 HSIEN MAO LIAO LAUSD SEDGWICK PASADENA ADJ7517091 JAIME RAMIREZ LAUSD SEDGWICK PASADENA ADJ7446973 JUANA CHORA LAUSD SEDGWICK PASADENA ADJ7442338 KATHERINE SABILLON LAUSD SEDGWICK PASADENA ADJ6853550 LAURA LAPHAM LAUSD SEDGWICK PASADENA ADJ2532876 LEAH SATORRE LAUSD SEDGWICK PASADENA ADJ2532876 LEAH SATORRE LAUSD-DISTRICT NURSING SERVICES SEDGWICK PASADENA ADJ6852253 MARIA ARRIAGA LAUS ADMINISTRATION BUILDING FINANCE CORPORATION SEDGWICK PASADENA ADJ6852253 MARIA ARRIAGA LAUSD SEDGWICK PASADENA ADJ1666930 MARIA VICTORIA MAGNOLIA AVENUE SCHOOL SEDGWICK PASADENA ADJ3243585 MARISELA VENTURA LOS ANGELES UNIFIED SCHOOL DISTRICT SEDGWICK PASADENA ADJ7386216 MERCEDES ROSALES LOS ANGELES UNIFIED SCHOOL DISTRICT SEDGWICK PASADENA ADJ9379822 NANCY RUVALCABA LAUS ADMINISTRATION BUILDING FINANCE CORPORATION SEDGWICK PASADENA ADJ9379822 NANCY RUVALCABA LAUSD SEDGWICK PASADENA ADJ9513708 REFUGIO GERARDO MM FAB SEDGWICK PASADENA ADJ7555211 RINA CASTILLO LAUSD FOOD SERVICE DIVISION SEDGWICK PASADENA ADJ1965535 ROBERT VALENCIA L.A.U.S.D. SEDGWICK PASADENA ADJ8551956 ROSA ARECHIGA DE LOPEZ LAUSD SEDGWICK PASADENA ADJ7611145 ROY BORTOLUZZI LOS ANGELES UNIFIED SCHOOL DISTRICT SEDGWICK PASADENA ADJ8772368 RUHI WEIGAND LOS ANGELES UNIFIED SCHOOL DISTRICT SEDGWICK PASADENA ADJ7449157 SHAMIKA BROWN LAUS ADMINISTRATION BUILDING FINANCE CORPORATION SEDGWICK PASADENA ADJ7449157 SHAMIKA BROWN LOS ANGELES UNIFIED SCHOOL DISTRICT SEDGWICK PASADENA ADJ6783163 SILVIA LOVATO LAUSD SEDGWICK PASADENA ADJ3506326 TAMARA COLEMAN LAUSD SEDGWICK PASADENA ADJ3506326 TAMARA COLEMAN LOS ANGELES UNIFIED SCHOOL DISTRICT SEDGWICK PASADENA ADJ4364160 TWONDA ZUNIGA LAUSD SEDGWICK PASADENA ADJ6986616 VALERIE BECKLUND LOS ANGELES UNIFIED SCHOOL DISTRICT SEDGWICK PASADENA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ4053733 VERNON WILLIAMS LAUSD SEDGWICK PASADENA ADJ7830084 WILLIE ANDERSON LAUSD VAN GOGH ELEMENTARY SEDGWICK PASADENA ADJ6614105 WYNEE DUNSON LAUS ADMINISTRATION BUILDING FINANCE CORPORATION SEDGWICK PASADENA ADJ7181057 ANA MORIERA JRK ASSOCIATES SEDGWICK PASADENA ADJ7459816 ALVA WALLACE WELLS FARGO AND CO SEDGWICK PLEASANTON ADJ2532439 ANGEL SALAS NORCAL WASTE SERVICES, INC. SEDGWICK PLEASANTON ADJ7517327 DAVID PERNELL FIRST TRANSIT SEDGWICK PLEASANTON ADJ2554492 FRANCISCO VELASCO CAMEO EMPLOYMENT SERVICE SEDGWICK PLEASANTON ADJ8250683 IRENE THOMPSON PETCO DISTRIBUTION SEDGWICK PLEASANTON ADJ8109191 JOSE ABOITE JA CONTRACTING LABOR MANAGEMENT INC SEDGWICK PLEASANTON ADJ3342882 JOSE TLATENCHI AIR GROUND MANPOWER CONSULTING SEDGWICK PLEASANTON ADJ3342882 JOSE TLATENCHI MONARCH CONSULTING DBA PES PAYROLL SEDGWICK PLEASANTON ADJ3342882 JOSE TLATENCHI RALLY MANAGEMENT SERVICES LLC SEDGWICK PLEASANTON ADJ2238611 MARGARITA MENDEZ PACTIV CORPORATION SEDGWICK PLEASANTON ADJ7396611 MARIA ADAME PACTIV SEDGWICK PLEASANTON ADJ6857433 MIGUEL ZEPEDA ZAREPE RW SELBY SEDGWICK PLEASANTON ADJ6747903 PABLO CASTILLO VERA CABO YACHTS SEDGWICK PLEASANTON ADJ7673597 SANDRA BRAVO GAP INC SEDGWICK PLEASANTON ADJ582461 SHARONDA THOMAS ADMINISTAFF COMPANIES SEDGWICK PLEASANTON ADJ582461 SHARONDA THOMAS ADMINSTAFF COMPANIES SEDGWICK PLEASANTON ADJ7430668 WANDA BROWN FIRST TRANSIT SEDGWICK PLEASANTON ADJ6643505 BERTA MARTINEZ CINTAS CORPORATION SEDGWICK PORTLAND ADJ6821547 IRMA ARCE TRI STATE STAFFING SEDGWICK PORTLAND ADJ4561120 JEANETTE REYES TRI STATE STAFFING SEDGWICK PORTLAND ADJ771242 SALVADOR CASTILLO TRI STATE STAFFING SEDGWICK PORTLAND ADJ6668397 VERONICA VELARDE MASONITE SEDGWICK PORTLAND ADJ7254374 VICTOR HERNANDEZ AUTOMATING PLATING CORP SEDGWICK PORTLAND ADJ644223 ALBERTO GARCIA INTERNATIONAL PAPER SEDGWICK RIVERSIDE ADJ8095568 ALEJANDRO AGUIRRE MBM CORPORATION SEDGWICK RIVERSIDE ADJ9020125 AMBER EILEEN BLANCO SOUTHWEST HEALTHCARE SYSTEM SEDGWICK RIVERSIDE ADJ8092995 AMPARO AVALOS 99 CENTS ONLY STORES SEDGWICK RIVERSIDE ADJ7131132 ANDREW HERNANDEZ FIRESTONE COMPLETE AUTO CARE SEDGWICK RIVERSIDE ADJ9309678 BILL GONZALEZ ANHEUSER BUSCH SEDGWICK RIVERSIDE ADJ6461713 CLARK HARDMAN CHICAGO CUBS BASEBALL CLUB SEDGWICK RIVERSIDE ADJ7054641 CRISTOBAL ACOSTA EMERSON SEDGWICK RIVERSIDE ADJ7136541 DANIEL DE LA ROSA LA Z BOY MANUFACTURING SEDGWICK RIVERSIDE ADJ6821375 ENRIQUE HERNANDEZ CARDENA HEALTH SEDGWICK RIVERSIDE ADJ7863659 ESPERANZA CASTILLO JAMES R GLIDEWELL DENTAL CERAMICS SEDGWICK RIVERSIDE ADJ6772960 ESTHER GALLEGOS MA COM TECHNOLOGY SOLUTIONS SEDGWICK RIVERSIDE ADJ6888999 GUADALUPE AGUILAR PITNEY BOWES COMP SEDGWICK RIVERSIDE ADJ6560671 HERMILLA SALGADO ORANGE COUNTY REGISTER SEDGWICK RIVERSIDE ADJ9105451 JOSE CASTRO REYES GLIDEWELL DENTAL LABORATORIES SEDGWICK RIVERSIDE ADJ7213015 MARIA ELENA PULIDO SECURITAS SECURITY SERVICES SEDGWICK RIVERSIDE ADJ1979366 MARY PENA FRITO LAY SEDGWICK RIVERSIDE ADJ7521284 NORMA GARCIA GLIDEWELL DENTAL CERAMICS SEDGWICK RIVERSIDE ADJ7521284 NORMA GARCIA JAMES R GLIDEWELL DENTAL CERAMICS SEDGWICK RIVERSIDE ADJ9419464 PATRICIA GREEN CARE FUSION SEDGWICK RIVERSIDE ADJ2816767 ROBERTO RODRIGUEZ ADT SEDGWICK RIVERSIDE ADJ7454433 ROSA GRANT PITNEY BOWES SEDGWICK RIVERSIDE ADJ6978430 SUSANA RUVALCABA CAMACHO D D S DISCOUNT SEDGWICK RIVERSIDE ADJ4060442 TAI HUYNH 99 CENTS STORE SEDGWICK RIVERSIDE ADJ7572727 VERONICA NECOCHEA 99 CENT ONLY STORES SEDGWICK RIVERSIDE ADJ8977884 WILLIAM RAMIREZ CJ INVESTMENT PARTNERS A CALIFORNIA LIMITED PARTNERSHIP SEDGWICK RIVERSIDE ADJ8019964 YOLANDA AVALOS CANYON RIDGE HOSPITAL SEDGWICK RIVERSIDE ADJ7387765 YOLANDA THUNE GLIDEWELL DENTAL LABORATORIES SEDGWICK RIVERSIDE ADJ7387765 YOLANDA THUNE GLIDEWELL LABORATORIES SEDGWICK RIVERSIDE ADJ7387765 YOLANDA THUNE GLIDEWELL LABS SEDGWICK RIVERSIDE ADJ7570860 AMPARO ALVAREZ MANPOWER SEDGWICK ROSEVILLE ADJ1726247 ANNETTE ALVARADO WALGREENS SEDGWICK ROSEVILLE ADJ6490668 BLANCA PADILLA HOME DEPOT SEDGWICK ROSEVILLE ADJ6415422 CARLETTE WAFER DHL SEDGWICK ROSEVILLE ADJ6415422 CARLETTE WAFER DHL EXPRESS SEDGWICK ROSEVILLE ADJ6815784 DARL MCGEE KHOLS INC SEDGWICK ROSEVILLE ADJ6815784 DARL MCGEE KOHLS INC SEDGWICK ROSEVILLE ADJ7500416 DEYANIRA DURAN MACDONALD DBA ANTHONY MICHAEL INC SEDGWICK ROSEVILLE ADJ6844912 DIMAS DE LEON AIR INDUSTRIES CORP SEDGWICK ROSEVILLE ADJ7686758 EDGAR GRIJALVA EXEL SEDGWICK ROSEVILLE ADJ7973420 EVELYN MARTINEZ WM BOLTHOUSE FARMS SEDGWICK ROSEVILLE ADJ9379777 JAVIER BRAMBILA KENS SPRAY EQUIPMENT INC SEDGWICK ROSEVILLE ADJ8539376 JESUS PEREZ MCDONALDS 32618 SEDGWICK ROSEVILLE ADJ6707047 JOE AIDOO DHL EXPRESS SEDGWICK ROSEVILLE ADJ6973795 JUAN MORALES AVIBANK MFG INC SEDGWICK ROSEVILLE ADJ7204171 KELLY SCHLABS KOHLS DEPARTMENT STORES SEDGWICK ROSEVILLE ADJ8572254 LEONEL GARDUNO GONZALEZ MCDONALDS #6803 SEDGWICK ROSEVILLE ADJ4437598 LIDIA CASTELO EXEL, INC. SEDGWICK ROSEVILLE ADJ9546759 LIONEL JACOBO BRUNSWICK CORP/CABO YACHTS SEDGWICK ROSEVILLE ADJ6715231 MARGARITO BAHENA CLAIM JUMPERS RESTAURANTS LLC SEDGWICK ROSEVILLE ADJ7940101 MARIA MARTINEZ KOHLS SEDGWICK ROSEVILLE ADJ7427375 MARIA ZARAGOZA MCDONALD 5619 SEDGWICK ROSEVILLE ADJ7427375 MARIA ZARAGOZA MCDONALDS SHALHOUB MGMT CO SEDGWICK ROSEVILLE ADJ7495300 MIRNA PARRAL TULAPHORN INC SEDGWICK ROSEVILLE ADJ8378141 NOEMY RODRIGUEZ KOHL S DEPARTMENT STORE SEDGWICK ROSEVILLE ADJ9415791 PATRICIA BARAJAS MCDONALD S/NLC ENTERPRISES SEDGWICK ROSEVILLE ADJ9415791 PATRICIA BARAJAS NLC ENTERPRISES SEDGWICK ROSEVILLE ADJ9203591 RAMON BARAJAS PICK A PART SEDGWICK ROSEVILLE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8193117 RAMON VASQUEZ FIRSTGROUP AMERICA SEDGWICK ROSEVILLE ADJ8458698 RONALD BARRERAS KOHLS SEDGWICK ROSEVILLE ADJ8842573 ROSIBEL RIVAS MCDONALDS SEDGWICK ROSEVILLE ADJ6933281 SEFERINA MUNOZ UC LOS ANGELES SEDGWICK ROSEVILLE ADJ7454562 TINA JACKSON WALGREENS SEDGWICK ROSEVILLE ADJ9257095 TOMAS VELASQUEZ WALGREEN SEDGWICK ROSEVILLE ADJ9052236 VICTOR GUERRA ESPITIA CARLTON FORGE WORKS SEDGWICK ROSEVILLE ADJ7948687 TERESA FERNANDEZ MAN POWER SEDGWICK ROSEVILLE ADJ9914522 ALMA MORALES UMANA ACME LAUNDRY PRODUCTS SEDGWICK SEQUOIA ADJ884093 BETTY CLARK UCLA SEDGWICK UC 14533 LOS ANGELES ADJ6731974 GLORIA CARDONA UCLA SEDGWICK UC 14533 LOS ANGELES ADJ7590149 JOEL VALDIVIA SANCHEZ UNIVERSITY OF CALIFORNIA IRVINE SEDGWICK UC 14533 LOS ANGELES ADJ6973795 JUAN MORALES AVIBANK MFG INC SEDGWICK UC 14533 LOS ANGELES ADJ6455635 LORENA ORELLANA SANTA MONICA UCLA MEDICAL CENTER SEDGWICK UC 14533 LOS ANGELES ADJ1939558 ROBERT SOLIS UCLA SEDGWICK UC 14533 LOS ANGELES ADJ6887888 ROSARIO LOPEZ UCLA SEDGWICK UC 14533 LOS ANGELES ADJ7200874 TERRY GUMBS UCLA SEDGWICK UC 14533 LOS ANGELES ADJ7601361 CATHERINE COVER UCI MEDICAL CENTER SEDGWICK UC 14533 ORANGE ADJ7300738 JOSE GALLO ABILITY CENTER SEDGWICK UC 14533 ORANGE ADJ7336574 NORMA SANDBERG UCI MEDICAL CENTER SEDGWICK UC 14533 ORANGE ADJ7388169 ROCKY HASAN UCLA LOS ANGELES SEDGWICK UC 14533 ORANGE ADJ7532971 AVELINA GARCIA MCDONALDS SEDGWICK UC 14533 ROSEVILLE ADJ7294151 GRISELDA SORIA KOHLS DEPARTMENT STORE SEDGWICK UC 14533 ROSEVILLE ADJ1519244 ANNA PENA UC IRVINE SEDGWICK UC 14533 SAN DIEGO ADJ4383185 FILADELFIA PENALOZA UC RIVERSIDE SEDGWICK UC 14533 SAN DIEGO ADJ1979366 MARY PENA FRITO LAY SEDGWICK UC 14533 SAN DIEGO ADJ1771190 MICHELLE GILL UCSD SEDGWICK UC 14533 SAN DIEGO ADJ3641886 PABLO ARELLANO UCI SEDGWICK UC 14533 SAN DIEGO ADJ2319844 VIRGINIA RIOS UNIVERSITY OF CALIFORNIA RIVERSIDE SEDGWICK UC 14533 SAN DIEGO ADJ8911642 ALLEN KATZ SECURITAS SEDGWICK VAN NUYS ADJ8911642 ALLEN KATZ SECURITAS SECURITY SERVICES USA INC SEDGWICK VAN NUYS ADJ6548899 AUGUSTO SANDOVAL T R PAINTING DRYWALL SEDGWICK VAN NUYS ADJ3055612 BONNIE MOON NORTHRIDGE HOSPITAL MEDICAL CENTER SEDGWICK VAN NUYS ADJ7532393 DARCEL BLACK COMMUNITY HOSPITAL OF SAN BERNARDINO SEDGWICK VAN NUYS ADJ9300488 JUAN OLIVARES SECURITAS SECURITY SERVICES USA INC SEDGWICK VAN NUYS ADJ2204613 MARICELA MENDOZA ST MARY MEDICAL CENTER SEDGWICK VAN NUYS ADJ6805368 MARLA CRAYTON ST BERNARDINE MEDICAL CENTER SEDGWICK VAN NUYS ADJ6805368 MARLA CRAYTON ST BERNARDINE MEDICAL CENTER CATHOLIC HEALTHCARE WEST SEDGWICK VAN NUYS ADJ6545270 MARTIN ESPINOSA SECURITAS CO SEDGWICK VAN NUYS ADJ3757661 MERCEDES VILLEGAS ST MARYS MEDICAL CENTER SEDGWICK VAN NUYS ADJ2466441 ROSENDO RIVERA KIMCO SERVICES SEDGWICK VAN NUYS ADJ2466441 ROSENDO RIVERA KIMCO STAFFING SERVICES SEDGWICK VAN NUYS ADJ413980 RUBEN OCHOA GLENDALE MEMORIAL HOSPITAL SEDGWICK VAN NUYS ADJ2188461 ALEJANDRA ACEVES TARGET SEDGWICK WALNUT CREEK ADJ9009760 ANA LUNA SUPER TARGET SEDGWICK WALNUT CREEK ADJ8261266 ANA RAMIREZ MEJORADO TARGET CORPORATION SEDGWICK WALNUT CREEK ADJ7091228 ANIQUE EVANS TARGET SEDGWICK WALNUT CREEK ADJ6754667 BONNIE GUILLORY TARGET SEDGWICK WALNUT CREEK ADJ6977006 CARMELA HERNANDEZ TARGET SEDGWICK WALNUT CREEK ADJ7354606 CAROL HESSON TARGET SEDGWICK WALNUT CREEK ADJ9556605 CECILIA AGUILAR ROSS STORE SEDGWICK WALNUT CREEK ADJ8239736 CHANDRANI BOTEJUE BIG LOTS SEDGWICK WALNUT CREEK ADJ7046511 COLLEEN VELEZ TARGET SEDGWICK WALNUT CREEK ADJ7682099 DOBORAH SPECHT DURHAM SCHOOL SERVICES SEDGWICK WALNUT CREEK ADJ9158711 DULCE CASTILLO TARGET SEDGWICK WALNUT CREEK ADJ9400078 EDGARDO LUGO LOPEZ LKQ PICK YOUR PART SEDGWICK WALNUT CREEK ADJ9085546 EULOGIO DURAN GARDUNO ROSS SEDGWICK WALNUT CREEK ADJ7744245 FABIOLA GARCIA TARGET SEDGWICK WALNUT CREEK ADJ8932940 GABRIEL BENITEZ SOUTHERN PACPIZZA LLC DBA PIZZA HUT SEDGWICK WALNUT CREEK ADJ8932940 GABRIEL BENITEZ TARGET CORPORATION SEDGWICK WALNUT CREEK ADJ7777413 GILDA RENDON TARGET SEDGWICK WALNUT CREEK ADJ9205444 HUGO NOE MIDNIGHT AUTO AND TRUCK RECYCLERS SEDGWICK WALNUT CREEK ADJ4391049 JACQUELINE DELGADO TARGET STORE SEDGWICK WALNUT CREEK ADJ4391049 JACQUELINE DELGADO TARGET STORES SEDGWICK WALNUT CREEK ADJ7191021 JESUS ELIZABETH OKITA ROSS SEDGWICK WALNUT CREEK ADJ7349625 JOSE PEREZ TARGET DISTRIBUTOR SEDGWICK WALNUT CREEK ADJ9816276 JOSE PEREZ HRK PET FOOD PRODUCTS INC SEDGWICK WALNUT CREEK ADJ2201253 JULIA OLIVAR DE ARROYO TARGET SEDGWICK WALNUT CREEK ADJ7794376 KEYSHAWN SCOTT DD`S DISCOUNT/ROSS STORES INC SEDGWICK WALNUT CREEK ADJ7523578 LESLIE MAZARIEGOS ROSS STORES SEDGWICK WALNUT CREEK ADJ7523578 LESLIE MAZARIEGOS ROSS STORES INC SEDGWICK WALNUT CREEK ADJ6810798 MALOAUFAATASI SATELE COACH AMERICA SEDGWICK WALNUT CREEK ADJ7492915 MARIA MORA CORE MARK SEDGWICK WALNUT CREEK ADJ8385654 MARIA PRIETO ROSS SEDGWICK WALNUT CREEK ADJ731613 MARIO ALVAREZ ROSS DISTRIBUTION SEDGWICK WALNUT CREEK ADJ7841976 MIGUEL G PROSPERO TARGET SEDGWICK WALNUT CREEK ADJ7694773 MONICA SOLANO TARGET CORPORATION SEDGWICK WALNUT CREEK ADJ7622534 OI LAN CHAN AMERICAN MEDICAL RESPONSE SEDGWICK WALNUT CREEK ADJ7622534 OI LAN CHAN AMR SEDGWICK WALNUT CREEK ADJ7890463 PETRA ORTEGA DURHAM SCHOOL SERVICES SEDGWICK WALNUT CREEK ADJ9374235 RUDY JUAN MUNOZ MANCILLA HPK PET FOOD PRODUCTS DBA NATURAL BALANCE PET FOODS SEDGWICK WALNUT CREEK

ADJ9374235 RUDY JUAN MUNOZ MANCILLA HRK PET FOOD PRODUCTIONS NATURAL BALANCE PET FOODS SEDGWICK WALNUT CREEK ADJ6974612 SAHARA ORTIZ ROSS SEDGWICK WALNUT CREEK Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7457004 SERGIO AVINA HP ENTERPRISE SERVICES LLC SEDGWICK WALNUT CREEK ADJ7347972 SUSANA LOPEZ JBS USA INC SEDGWICK WALNUT CREEK ADJ6621738 TERESA TORRES ROSS SEDGWICK WALNUT CREEK ADJ4610712 VERONICA HENDERSON DURHAM SCHOOL SERVICES SEDGWICK WALNUT CREEK ADJ4229837 YOLANDA MILIAN TARGET DEPARTMENT STORES SEDGWICK WALNUT CREEK ADJ8746900 BRANDI LUMFORD SEES CANDY SHOPS INC SEES CANDY SHOPS INC ADJ7876872 BENITA HUNT WILSONA SCHOOL DISTRICT SELF INSURED SCHOOLS BAKERSFIELD ADJ7073114 RAUL BERNAL HERNANDEZ INTERSTATE BRANDS CORPORATION SELF INSURERS SECURITY FUND OAKLAND ADJ4626743 JOSE CABRAL BERGANDI MACHINERY COMPANY SENTRY CLAIMS SERVICE ADJ6885996 ANDRES MONTIEL TITAN METAL FABRICATORS SENTRY SELECT STEVENS POINT ADJ7207634 ANTHONY LUNSFORD SERTA INTERNATIONAL SENTRY SELECT STEVENS POINT ADJ9538240 ESTER REYES CEDARLANE NATURAL FOODS INC. SENTRY SELECT STEVENS POINT ADJ8868638 FLOR CARDENAS DAYTON ROGERS SENTRY SELECT STEVENS POINT ADJ7585034 IGNACIO RODRIGUEZ BEST BRANDS CORPORATION CMS BAKERY PRODUCTS SENTRY SELECT STEVENS POINT ADJ4626743 JOSE CABRAL BERGANDI MACHINERY COMPANY SENTRY SELECT STEVENS POINT ADJ8109812 MIREYA ROJAS NUBS PLASTICS INC SENTRY SELECT STEVENS POINT ADJ1124981 MIRIAM LLAMAS PACKAGING DYNAMICS CORP. SENTRY SELECT STEVENS POINT ADJ3226137 NORMAN ENRIQUEZ REPUBLIC BAG, INC. SENTRY SELECT STEVENS POINT ADJ9524780 RANDALL HAYS CAL LIFT SENTRY SELECT STEVENS POINT ADJ9524780 RANDALL HAYS CAL-LIFT SENTRY SELECT STEVENS POINT ADJ4222524 THELMA PACHECO STELLEX BANDY MACHINING INC SENTRY SELECT STEVENS POINT ADJ4063752 ESTEBAN LARIOS HERNANDEZ KENNAMETAL INC SENTRY WISCONSIN ADJ6610211 EVIA LUCAS CP DOCUMENT TECHNOLOGIES SENTRY WISCONSIN ADJ7249011 INOCENCIO GONZALEZ NORTHWEST PIPE COMPANY SENTRY WISCONSIN ADJ3617467 KIMBERLY MAC LAND AMERICA SOUTHLAND TITLE CO. SENTRY WISCONSIN ADJ3617467 KIMBERLY MAC LAND AMERICA SOUTHLAND TITLE COMPANY SENTRY WISCONSIN ADJ7457532 MARIA MEZA COLOUR CONCEPTS INC SENTRY WISCONSIN ADJ7414289 MIGUEL HUERTA ZODIAC MARINE AND POOL NORTH AMERICA SENTRY WISCONSIN ADJ7893577 MIGUEL ROJAS HUNTER INDUSTRIES SENTRY WISCONSIN ADJ7373382 NANCY URQUILLA BEST BRAND CORP SENTRY WISCONSIN ADJ8361066 PASCUAL RAMIREZ S2K GRAPHICS SENTRY WISCONSIN ADJ2617461 PATRICIA FRANCO JARDEN CONSUMER SOLUTION SENTRY WISCONSIN ADJ7495602 PAUL SINOHUE HARTWELL CORP SENTRY WISCONSIN ADJ7198977 ROSA RIOS EDRIS PLASTIC SENTRY WISCONSIN ADJ6784319 RUBEN RIOS CLEMENT PAPPAS SENTRY WISCONSIN ADJ4222524 THELMA PACHECO STELLEX BANDY MACHINING INC SENTRY WISCONSIN ADJ4559187 AVELINO SANCHEZ TORREZ ALLEN & DARIAN SHAPIRO SGD CHATSWORTH ADJ4559187 AVELINO SANCHEZ TORREZ FRANK HOCHULE SGD CHATSWORTH ADJ4559187 AVELINO SANCHEZ TORREZ ROBERT WAGNER SGD CHATSWORTH ADJ4559187 AVELINO SANCHEZ TORREZ VICTORIA AND DENIS HOOPER SGD CHATSWORTH ADJ5790426 ELIGIO VARGAS SILVERWOOD LANDSCAPE CONSTRUCTION SILVERWOOD LANDSCAPE CONSTRUCTION ADJ4038688 SALVADOR BERNAL MARTINEZ SORIA CONSTRUCTION SORIA CONSTRUCTION ADJ8723566 ADRIANA MUNOZ SOUTHERN CALIFORNIA EDISON SOUTHERN CAL EDISON ROSEMEAD ADJ7234070 CARL LINDEMAN SOUTHERN CALIFONIA EDISON SOUTHERN CAL EDISON ROSEMEAD ADJ4716286 DIANE ORTEGA SOUTHERN CALIFORNIA GAS COMPANY SOUTHERN CAL GAS LOS ANGELES ADJ7294172 TANISHA HOPKINS SOUTHERN CALIFORNIA GAS COMPANY SOUTHERN CAL GAS LOS ANGELES ADJ960903 GLORIA VASQUEZ PARAMOUNT UNIFIED SCHOOL DIST SOUTHERN CALIF RISK MGMT ASSOC ADJ2631654 MANUEL RAMIREZ SOUTHERN CALIFORNIA EDISON CO. SOUTHERN CALIFORNIA EDISON ADJ7510609 SALVADOR AGUIRRE SOUTHERN CALIFORNIA GAS COMPANY SOUTHERN CALIFORNIA GAS COMPANY ADJ7294172 TANISHA HOPKINS SOUTHERN CALIFORNIA GAS COMPANY SOUTHERN CALIFORNIA GAS COMPANY ADJ7697382 ENRIQUE GONZALEZ AGI MARBLE CO SOUTHERN INSURANCE DALLAS ADJ7697382 ENRIQUE GONZALEZ STONEWARE TILE INC SOUTHERN INSURANCE DALLAS ADJ8708116 FELIPE MORALES MEDINA SPARKLING FRESH POOLS SOUTHERN INSURANCE DALLAS ADJ9241958 JESUS AGUIRRE EL CAMINO CONSTRUCTION INC SOUTHERN INSURANCE DALLAS ADJ7926348 JOSE TEMORES PACIFIC COAST BUILDING C SOUTHERN INSURANCE DALLAS ADJ7616557 JAIME GUTIERREZ HR COMP LLC SOUTHLAND CLAIMS GARDEN GROVE ADJ1410196 ISABELITA PEREZ-SOTELO PREFERRED PERSONNEL SOUTHLAND CLAIMS SERVICE ADJ8134489 LUZ COSIO PIER 1 IMPORTS SPECIALTY RISK ADJ7942631 MARGARITO ALVAREZ AMERICAN APPAREL SPECIALTY RISK ADJ9016607 ARACELI ARAUJO FIRST AMERICAN TITLE INSURANCE COMPANY SPECIALTY RISK BREA ADJ8177894 BEATRIZ PALACIOS NBC UNIVERSAL SPECIALTY RISK BREA ADJ6988351 CESAR ESQUIVEL FAMILY TREE PRODUCE SPECIALTY RISK BREA ADJ7024110 DIANA LARA ALBERTSONS SPECIALTY RISK BREA ADJ7024110 DIANA LARA NEW ALBERTSONS SPECIALTY RISK BREA ADJ6786391 DORA MEDINA HY LOND HOME SPECIALTY RISK BREA ADJ3562578 GERONIMO MADRIGAL ADSI- SAVON OSCO SPECIALTY RISK BREA ADJ3562578 GERONIMO MADRIGAL ADSI-OSCO/SAV-ON SPECIALTY RISK BREA ADJ6795837 JOSE CORONA ARAMARK SPECIALTY RISK BREA ADJ7339475 JOSE LOPEZ R H PETERSON SPECIALTY RISK BREA ADJ4260285 LISA ZOELLER ALBERTSONS SPECIALTY RISK BREA ADJ643551 MARIO FLORES ALBERTSONS SPECIALTY RISK BREA ADJ7750270 REYNA CASTANEDA ARG RESOURCES LLC SPECIALTY RISK BREA ADJ7882503 RICARDO PIEDRA SANTA STANDARD PARKING SPECIALTY RISK BREA ADJ7882503 RICARDO PIEDRA SANTA STANDARD PARKING CORPORATION SPECIALTY RISK BREA ADJ7357708 SABDIZARET RAMIREZ ALBERTSONS SPECIALTY RISK BREA ADJ8614719 VICTOR BARRIENTOS HERTZ RENT A CAR SPECIALTY RISK BREA ADJ7836363 WALTER LIZA COCA COLA SPECIALTY RISK BREA ADJ7836363 WALTER LIZA WORLD FLIGHT SERVICES SPECIALTY RISK BREA ADJ7537542 CHRISTINA BOOKER AMERICAN AIRLINES SPECIALTY RISK DALLAS ADJ7222350 MARTINA HUIZAR AMERICAN AIRLINES SPECIALTY RISK DALLAS ADJ8256702 PHIL RICO ALBERTSON SPECIALTY RISK DALLAS ADJ8124527 ANNA LIZA VELEZ CENTINELA HOSPITAL SPECIALTY RISK LEXINGTON ADJ1214217 CARLOS FLORES NATIONAL OILWELL VARCO SPECIALTY RISK LEXINGTON ADJ7858913 CURTIS CALLOWAY ARAMARK SPECIALTY RISK LEXINGTON ADJ6699937 HECTOR FONSECA CIPOLLA AND CALABA SPECIALTY RISK LEXINGTON ADJ6699937 HECTOR FONSECA NATION AUCTION SYSTEMS INC SPECIALTY RISK LEXINGTON Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8859561 JOSE GALLEGOS AMAYA ARAKELIAN ENTERPRISES DBA ATHENS SERVICES SPECIALTY RISK LEXINGTON ADJ7537606 JUANA MUNIZ CARGILL BEEF PACKERS SPECIALTY RISK LEXINGTON ADJ7376720 MARIA ESTRADA MINI PHARMACY & MEDICAL SUPPLIES SPECIALTY RISK LEXINGTON ADJ7073333 OSVALDO RODRIGUEZ PANCHO VILLA MARKET SPECIALTY RISK LEXINGTON ADJ7882503 RICARDO PIEDRA SANTA STANDARD PARKING SPECIALTY RISK LEXINGTON ADJ7882503 RICARDO PIEDRA SANTA STANDARD PARKING CORPORATION SPECIALTY RISK LEXINGTON ADJ7902115 STEVEN LIAU CROWNE PLAZA HOTEL SPECIALTY RISK LEXINGTON ADJ2345281 VELIA PRECIADO DEL TACO SPECIALTY RISK LEXINGTON ADJ7139028 ABEL NORIEGA TRITON CHANDELIER INC SPECIALTY RISK RIVERSIDE ADJ2780984 ALEJANDRO RODRIGUEZ D&S INDUSTRIAL SERVICES INC SPECIALTY RISK RIVERSIDE ADJ2762336 ANTONIETA RODRIGUEZ COASTAL BUILDING SERVICES SPECIALTY RISK RIVERSIDE ADJ7596556 BENJAMIN ACEVES STATER BROS SPECIALTY RISK RIVERSIDE ADJ2644147 CHRIS ECHARD COCA COLA SPECIALTY RISK RIVERSIDE ADJ2644147 CHRIS ECHARD COCOA COLA BOTTLING SPECIALTY RISK RIVERSIDE ADJ697863 DANIEL TELLEZ GATX RAIL SPECIALTY RISK RIVERSIDE ADJ6977100 DENTON CLARE CALIFORNIA PAVING AND GRADING CO SPECIALTY RISK RIVERSIDE ADJ1232081 EDGAR GUERRERO EXCEL STAFFING SERVICES SPECIALTY RISK RIVERSIDE ADJ1232081 EDGAR GUERRERO EXCEL STAFFING SERVICES, INC. SPECIALTY RISK RIVERSIDE ADJ692891 ERIKA DIEGO ANDERSON NEWS CO SPECIALTY RISK RIVERSIDE ADJ7370790 EVANGELINA CARRILLO FIRST AMERICAN FINANCIAL CORPORATION SPECIALTY RISK RIVERSIDE ADJ3865071 FRANKLIN GALLEGOS RANCHO READY MIX SPECIALTY RISK RIVERSIDE ADJ7728189 GRACIELA RAMOS BUFFETS INC SPECIALTY RISK RIVERSIDE ADJ6641911 GUADALUPE FLORES STATER BROS MARKETS SPECIALTY RISK RIVERSIDE ADJ7395632 HECTOR MORENO STATER BROS SPECIALTY RISK RIVERSIDE ADJ6708954 IRMA LOPEZ UNITED CARE HOMES SPECIALTY RISK RIVERSIDE ADJ6708954 IRMA LOPEZ UNITED CARE HOMES INC SPECIALTY RISK RIVERSIDE ADJ6894209 JULIO VASQUEZ PFG CUTOMIZEZ DISTRIBUTION SPECIALTY RISK RIVERSIDE ADJ6468677 LIZZETH HERNANDEZ PACIFIC BUILDING CARE RED SPECIALTY RISK RIVERSIDE ADJ6724050 MARIA AGUILAR INTERNATIONAL SERVICE SPECIALTY RISK RIVERSIDE ADJ6762402 MARIA CRUZ VALLARTA SUPERMARKETS SPECIALTY RISK RIVERSIDE ADJ7155233 MARTHA BANDA QPERFUMES SPECIALTY RISK RIVERSIDE ADJ7522349 MICHAEL POOLE MYERS CONTAINERS SPECIALTY RISK RIVERSIDE ADJ6905926 REYNALDA GONZALEZ BUFFETS INC SPECIALTY RISK RIVERSIDE ADJ2465653 RICARDO BETANCOURT PACIFIC AGGREGATE INC SPECIALTY RISK RIVERSIDE ADJ7170396 ROSARIO ORTEGA STATER BROTHERS MARKET SPECIALTY RISK RIVERSIDE ADJ1288488 SANDRA GALLEGLY CONTACT SECURITY INC. SPECIALTY RISK RIVERSIDE ADJ7839503 STEPHANIE KETCHAN DOLLAR THRIFTY AUTOMOTIVE GROUP SPECIALTY RISK RIVERSIDE ADJ7093566 SUSAN DAO ENKI HEALTH AND RESEARCH SYST INC SPECIALTY RISK RIVERSIDE ADJ4548183 TABINDA RAHMAN KINDERCARE SPECIALTY RISK RIVERSIDE ADJ3325824 TOM TAU HOT WINGS SPECIALTY RISK RIVERSIDE ADJ3325824 TOM TAU SALVATION ARMY SPECIALTY RISK RIVERSIDE ADJ8408626 VERONICA GODINEZ CLASSIC INDUSTRIES SPECIALTY RISK RIVERSIDE ADJ7836363 WALTER LIZA COCA COLA SPECIALTY RISK RIVERSIDE ADJ7836363 WALTER LIZA WORLD FLIGHT SERVICES SPECIALTY RISK RIVERSIDE ADJ4187149 CAROLINA CERVANTES WESTERN MEDICAL CENTER SPECIALTY RISK SERVICES ADJ1181389 CESAR SOTO OLIVARES ANTONIO ROCA SPECIALTY RISK SERVICES ADJ538756 JOSEFINA CABADA INTERNATIONAL SEAL SPECIALTY RISK SERVICES ADJ2609216 PETER PARENT TRADESMAN INTERNATIONAL SPECIALTY RISK SERVICES ADJ2068149 PHILLIP CROUCH LOWES HOME IMPROVEMENT SPECIALTY RISK SERVICES ADJ2904534 AGUSTIN CHAVARRIA K.B. MART CO. SPRINGFIELD COVINA ADJ2904534 AGUSTIN CHAVARRIA K.V. MART COMPANY DBA TOP VALU MARK SPRINGFIELD COVINA ADJ6678787 CLAUDIA ADAME VALLARTA SUPERMARKET SPRINGFIELD COVINA ADJ9108289 EDUARDO CASTELLANOS ALHAMBRA FOUNDRY COMPANY LTD SPRINGFIELD COVINA ADJ782211 FELIPE TORRES UNIFIED WESTERN GROCERS SPRINGFIELD COVINA ADJ8832614 GABRIELA RANGEL FRESH GRILL SPRINGFIELD COVINA ADJ2343679 GUSTAVO GARCIA UNIFIED WESTERN GROCERS SPRINGFIELD COVINA ADJ7124182 JOSEFA ROSALES GOOD SAMARITAN HOSPITAL SPRINGFIELD COVINA ADJ8062638 JUAN CARLOS CUEVAS S AND H FOOD INC SPRINGFIELD COVINA ADJ8454319 JUANA CHAVEZ ARVIN RANCH MARKET SPRINGFIELD COVINA ADJ205778 MICHAEL OGAZ UNIFIED WESTERN GROCERS SPRINGFIELD COVINA ADJ6804683 MIRNA SOLARES KV MART TOP VALUE SPRINGFIELD COVINA ADJ7215855 NOE GOMEZ K V MART COMPANY A CORP SPRINGFIELD COVINA ADJ7215855 NOE GOMEZ K V MART CORPORATION SPRINGFIELD COVINA ADJ6617642 PABLO RAMIREZ UNIFIED WESTERN GROCERS SPRINGFIELD COVINA ADJ7236680 PAUL NARANJO R & G`S FOOD BASKET SPRINGFIELD COVINA ADJ7613215 RON THY UNIFIED GROCERS SPRINGFIELD COVINA ADJ414343 ROSALIND HERRON POMONA RANCHO MARKET SPRINGFIELD COVINA ADJ8196103 TOBIAS ROBLES UNIFIED GROCERS SPRINGFIELD COVINA ADJ1716597 MIKAELE SIVELIO BEHR ST PAUL DIAMOND BAR ADJ4605360 MARIA CECILIA RAMOS MCCARTHY BUILDING COMPANIES ST. PAUL INSURANCE ADJ4605360 MARIA CECILIA RAMOS TRADE UNION INTERNATIONAL ST. PAUL INSURANCE ADJ1528177 JUAN CARRANZA NATVAR ST. PAUL TRAVELERS ADJ4594533 MICHAEL VENEGAS LINKUS ENTERPRISES ST. PAUL TRAVELERS ADJ7802713 RICARDO SACAYON ALVAREZ STAR ALTADENA MARKET STAR ALTADENA MARKET ADJ7419982 ENEDINA FREGOSO NUNEZ TAQUERIAS GUADALAJARA INC STAR INSURANCE COMPANY ADJ7437588 KRISTEN OCALLAGHAN STARBUCKS STARBUCKS ADJ7437588 KRISTEN OCALLAGHAN STARBUCKS COFFEE COMPANY STARBUCKS ADJ7437588 KRISTEN OCALLAGHAN STARBUCKS STARBUCKS COFFEE COMPANY ADJ7437588 KRISTEN OCALLAGHAN STARBUCKS COFFEE COMPANY STARBUCKS COFFEE COMPANY ADJ1955055 MONICA AVILA PACIFIC PIONEER CORPORTATION STATE COMP ADJ558502 ELIZABETH ESQUIVEL PROJECT HEADWAY STATE COMP INS FUND ADJ1437348 JOSE VILLANUEVA RICHARTZ PLASTERING STATE COMP INS FUND ADJ3156617 GLORIA PEREZ IHSS/PA STATE COMPENSATION INS. FUND ADJ3976272 ADAN VARGAS PANTOJA PALACE MARBLE & GRANITE STATE COMPENSATION INSURANCE FUND ADJ2463142 ALFONSO ORTIZ SPW CONSTRUCTION STATE COMPENSATION INSURANCE FUND ADJ1433114 ANTONIO RAMIREZ TRINITY BROADCASTING NETWORK STATE COMPENSATION INSURANCE FUND Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ1433114 ANTONIO RAMIREZ TRINITY CHRISTIAN CENTER STATE COMPENSATION INSURANCE FUND ADJ1383451 CONNIE MALDONADO MEADOWBROOK OF CALIFORNIA STATE COMPENSATION INSURANCE FUND ADJ3453248 DAVID FUENTES CALIFORNIA DEPT OF CORRECTIONS STATE COMPENSATION INSURANCE FUND ADJ3453248 DAVID FUENTES DEPT OF CORRECTIONS STATE COMPENSATION INSURANCE FUND ADJ3297007 HUMBERTO ZARATE CRITERION CUSTOM FLOORS STATE COMPENSATION INSURANCE FUND ADJ693255 IGNACIO PENALOZA BCI FRAMING AND DRYWALL STATE COMPENSATION INSURANCE FUND ADJ3927420 JESTIN STRAIN ASTRO CONSTRUCTION TRUCKS STATE COMPENSATION INSURANCE FUND ADJ549530 JOHN WADE FOWLER GLACIER DESIGN SYSTEMS STATE COMPENSATION INSURANCE FUND ADJ3464049 MARTIN COTA KRIEGER STEEL STATE COMPENSATION INSURANCE FUND ADJ3464049 MARTIN COTA KRIEGER STEEL STATE COMPENSATION INSURANCE FUND ADJ3464049 MARTIN COTA KRIEGER STEEL PROD STATE COMPENSATION INSURANCE FUND ADJ3464049 MARTIN COTA KRIEGER STEEL PROD STATE COMPENSATION INSURANCE FUND ADJ1032669 MICHAEL SHUBIN FEDERAL DISPOSAL SERVICE STATE COMPENSATION INSURANCE FUND ADJ1955055 MONICA AVILA PACIFIC PIONEER CORPORTATION STATE COMPENSATION INSURANCE FUND ADJ3815123 SERVANDO BALTAZAR WESTERN MEDICAL TRANSPORTATION STATE COMPENSATION INSURANCE FUND ADJ1716798 VICENTE GOMEZ ALMEN FURNITURE INC STATE COMPENSATION INSURANCE FUND ADJ4130817 JOSE CALSADA MJA CAR WASH INC DBA ROYAL CAR WASH STATE FARM 21567 BAKERSFIELD CLOSED ADJ3936607 MARIA DURAN BERTHAIM VOOHEES STATE FARM 21567 BAKERSFIELD CLOSED ADJ613217 RAMIRO VASQUEZ PAUL KAPHIRSCY STATE FARM 21567 BAKERSFIELD CLOSED ADJ3980006 RUBEN GARCIA STAN BILCHICK CARPET CO. INC STATE FARM 21567 BAKERSFIELD CLOSED ADJ1466088 VICTORIA ESCOBEDO POPEYES CHICKEN STATE FARM 21567 BAKERSFIELD CLOSED ADJ6684811 ALEJANDRO AYALA NELIS INC STATE FARM BAKERSFIELD ADJ7227862 AMELIA FLORES SHERRIL SILK STATE FARM BAKERSFIELD ADJ7462393 ANTHONY CASTRO SOUTH BAY BICYCLES INC STATE FARM BAKERSFIELD ADJ7115553 BELBA GARCIA RAJEEV KRISHAN STATE FARM BAKERSFIELD ADJ7513841 BRENDA BARKLEY NORWALK DENTAL VILLAGE STATE FARM BAKERSFIELD ADJ8652596 DELINDA SMITH CDR FINANCIAL SERVICES LLC STATE FARM BAKERSFIELD ADJ7125301 GLORIA AVILA ARTHUR FOX STATE FARM BAKERSFIELD ADJ7125301 GLORIA AVILA GARDENA SURGICAL INC STATE FARM BAKERSFIELD ADJ7491672 GREGORIO TORRES THE CHRISTIAN COMPANY INC STATE FARM BAKERSFIELD ADJ7211849 GUILLERMO VELASCO PALACIOS JAVIER SILVA STATE FARM BAKERSFIELD ADJ7479176 IGNACIO NAVARRO SAN FERNANDO MARBLE AND GRANITE STATE FARM BAKERSFIELD ADJ3352539 ISABEL CANIZ JANE G. TROUTMAN STATE FARM BAKERSFIELD ADJ7056966 JOSE FIGUEROA ONE DOLLAR DISCOUNT CENTER STATE FARM BAKERSFIELD ADJ9421554 JOSE VILLATORO LAFAYETTE PARK PLACE STATE FARM BAKERSFIELD ADJ9066750 JUAN AYALA ILOBASCO ENTERPRISES INC DBA ILOBASCO RESTAURANT BAKERY STATE FARM BAKERSFIELD ADJ7859229 KATHYANN VINCENT CARSON CHAMBER OF COMMERCE STATE FARM BAKERSFIELD ADJ7281840 KENNETH ELMAN BALPOST LOCK AND SAFE STATE FARM BAKERSFIELD ADJ176141 LUCIA RUIZ SUBWAY STATE FARM BAKERSFIELD ADJ8947019 LUIS TRUJILLO FURNITURE WAREHOUSE STATE FARM BAKERSFIELD ADJ2245118 MARIA DEJESUS ROSALES GOLDEN TOUCH CLEANERS INC STATE FARM BAKERSFIELD ADJ7758891 MARIA ESPARSA WIENERSCHNITZEL RESTAURANT STATE FARM BAKERSFIELD ADJ6681581 MARIA LOPEZ MERRILLS CLEANERS STATE FARM BAKERSFIELD ADJ9821009 MARICELA GONZALEZ LA TAQUIZA SUPREMA STATE FARM BAKERSFIELD ADJ8294753 MARTHA PEREZ YUM YUM DONUTS STATE FARM BAKERSFIELD ADJ7279400 MAYRA PEREZ FANTASTIC SAMS STATE FARM BAKERSFIELD ADJ7615572 MICHAEL THACKER GREAT CLIPS HAIR SALON STATE FARM BAKERSFIELD ADJ7680635 NATALIE ARREOLA DR KENNETH NAKAMURA STATE FARM BAKERSFIELD ADJ7019632 OSCAR OBIDIO MOLINA EL FARO DISCOUNT CENTER LLC STATE FARM BAKERSFIELD ADJ7394584 RAQUEL JIMENEZ COAST CITY MEDICAL GROUP STATE FARM BAKERSFIELD ADJ9627517 RICARDO MARIN VINEERAA SUBWAY STATE FARM BAKERSFIELD ADJ7184975 ROXANNE VALDEZ FISHER CHIROPRACTIC INC STATE FARM BAKERSFIELD ADJ6969442 SERGIO ALCARAZ G8 CAPITAL STATE FARM BAKERSFIELD ADJ9310162 SONIA VIDES LESLEY BOONE TENG AN INDIVIDUAL STATE FARM BAKERSFIELD ADJ7892551 TONYA ROSS CDR FINANCIAL SERVICES STATE FARM BAKERSFIELD ADJ1035201 VICTOR DURAN DONUT INN STATE FARM BAKERSFIELD ADJ6720818 SHELLY ROTH STATE OF CA DEPT OF SOCIAL SERVICES STATE OF CA DEPT OF SOCIAL SERVICES ADJ7676368 CASSANDRA WEST STATE OF CALIFORNIA DEPT OF CORRECTIONS STATE OF CALIFORNIA DEPT OF CORRECTIONS ADJ7280790 BEVERLY CHAVARRIA STATE OF CALIFORNIA LANCASTER STATE PRISON STATE OF CALIFORNIA LANCASTER STATE PRISON ADJ889037 BULMARO SERRANO SKECHERS USA INC SUPERIOR NATIONAL INSURANCE CO ADJ889037 BULMARO SERRANO SKETCHERS, USA SUPERIOR NATIONAL INSURANCE CO ADJ889037 BULMARO SERRANO TEAM ONE STAFFING SUPERIOR NATIONAL INSURANCE CO ADJ889037 BULMARO SERRANO TEAM ONE/SKETCHERS SUPERIOR NATIONAL INSURANCE CO ADJ3509612 LAWRENCE THOMPSON MAC ELECTRIC SUPERIOR NATIONAL INSURANCE CO ADJ3509612 LAWRENCE THOMPSON MAC ELECTRIC INC SUPERIOR NATIONAL INSURANCE CO ADJ3725824 MARGARITA GARCIA ALL CITY MANAGEMENT SERVICES SUPERIOR NATIONAL INSURANCE CO ADJ449949 MARIA PADILLA MIRAMAR SHERATON HOTEL SUPERIOR NATIONAL INSURANCE CO/BROADSPIRE ADJ9233842 ALBERTO ALBA CASILLAS CENTRAL CITY ENTERPRISES SUSSEX INSURANCE COLUMBIA ADJ9264469 ARTURO SALINAS PINNACLE HOLDINGS GROUP INC SUSSEX INSURANCE COLUMBIA ADJ9299261 ELVA ALCALA MARTINEZ AWARE PRODUCTS SUSSEX INSURANCE COLUMBIA ADJ9299261 ELVA ALCALA MARTINEZ STAY SAFE STAFFING INC DBA HORIZON PERSONNEL SERVICES IN SUSSEX INSURANCE COLUMBIA ADJ8018202 JACQUELINE VASQUEZ SAMBA GROUP SUSSEX INSURANCE COLUMBIA ADJ8018202 JACQUELINE VASQUEZ SAMBA GROUP INC SUSSEX INSURANCE COLUMBIA ADJ9317813 JOEL HERRERA AMR STAFFING INC SUSSEX INSURANCE COLUMBIA ADJ9128006 JORGE RICO CERDA CALIFORNIA AG SERVICES INC SUSSEX INSURANCE COLUMBIA ADJ8823016 LUIS SORIA CONSOLIDATED STAFFING SOLUTION SUSSEX INSURANCE COLUMBIA ADJ9256177 MARTIN RUVALCABA JA CONTRACTING SUSSEX INSURANCE COLUMBIA ADJ9256177 MARTIN RUVALCABA JUAN LUIS AYALA DBA JA CONTRACTING SUSSEX INSURANCE COLUMBIA ADJ8454517 SHERRY FEHLMAN DMSI INC SUSSEX INSURANCE COLUMBIA ADJ8454517 SHERRY FEHLMAN DMSI STAFFING SUSSEX INSURANCE COLUMBIA ADJ8454517 SHERRY FEHLMAN MJO STAFFINGS SERVICE CORPORATE SUSSEX INSURANCE COLUMBIA ADJ9150633 YUNUEN PIMENTEL CUSTOMLINE SCREENPRINTING DISTRIBUTION SUSSEX INSURANCE COLUMBIA ADJ9150633 YUNUEN PIMENTEL GOLDEN COAST SPORTSWEAR SUSSEX INSURANCE COLUMBIA ADJ7139481 GERARDO BELLO TACOS 2000 INC TACO BELL NO 3670 TACOS 2000 INC TACO BELL NO 3670 Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ2156593 ALONDRA CUENCA TACOS OLE TACOS OLE ADJ3259548 JAIME GARCIA VILLA FURNITURE MFG CO TARHEEL INSURANCE MGMT CO ADJ9594609 TEOFILO AGUIRRE CHAVEZ ALL YELLOW TAXI THARPE HOWELL SHERMAN OAKS ADJ9594609 TEOFILO AGUIRRE CHAVEZ ALL YELLOW TAXI, INC DBA ALL YELLOW TAXI THARPE HOWELL SHERMAN OAKS ADJ9176594 LORENZO SANTOS JAPAN GRAPHICS THE HARTFORD SYRACUSE ADJ9322902 MARCY RICHARDS USI INSURANCE SERVICES LLC THE HARTFORD SYRACUSE ADJ9016282 MARIA OROZCO ARDEN COMPANIES THE HARTFORD SYRACUSE ADJ9119421 OTONIEL MORALES ANTHONY LAUREN AND CO THE HARTFORD SYRACUSE ADJ8833149 RODNEY MORRIS JR LEWIS PROFESSIONAL SERVICES THE HARTFORD SYRACUSE ADJ6919785 ROSARIO CARMONA SENIOR SYSTEMS TECHNOLOGY INC THE HARTFORD SYRACUSE ADJ9992794 RUBEN GONZALEZ JUANCHOS THE HARTFORD SYRACUSE ADJ9368968 TERESA LOPEZ FINANCIAL COMUNICATIONS THE HARTFORD SYRACUSE ADJ3053702 ISIDRO HERNANDEZ EURODESIGN CABINETS INC THE TRAVELERS ADJ2331934 RAMON DE LUNA H & E EQUIPMENT RENTAL THE TRAVELERS INSURANCE CO ADJ5811216 JOSE ZERMENO IMPORT GLASS CORPORATION THE ZENITH INSURANCE CO ADJ5827396 YESENIA DIAZ HEDMAN MANUFACTURING INC THE ZENITH INSURANCE CO ADJ384542 AUGUSTIN GUTIERREZ LIMON ENRIQUE ELIAS TIDEWATER CLAIMS ADJ384542 AUGUSTIN GUTIERREZ LIMON JOSE LUIS RAMIREZ TIDEWATER CLAIMS ADJ2146370 MELANIE MEGOW EVANS HOTELS/BAHIA RESORT HOTEL TIG INSURANCE COMPANY ADJ7210005 JOSE MARTINEZ TK SAFEWAY TK SAFEWAY ADJ3512755 DESHAWN WILLIAMS C & M FINE PACK TOKIO MARINE PASADENA ADJ9004451 ELSA ESCOBAR KAMRAN STAFFING INC TOKIO MARINE PASADENA ADJ8951782 FRANK SALDANA PANASONIC DISC MANUFACTURING CORPORATION TOKIO MARINE PASADENA ADJ7773347 JUAN MORENO MARUJU SEAFOOD INC TOKIO MARINE PASADENA ADJ9644805 LORENZO GONZALEZ SUPER CENTER CONCEPTS INC DBA SUPERIOR GROCERS TOKIO MARINE PASADENA ADJ7136482 RANDALL STANFILL AMANO MC GANN INC TOKIO MARINE PASADENA ADJ7724960 ROCIO BRAVO NATURES BEST TOKIO MARINE PASADENA ADJ7089464 SILVANA PEREZ RAIN BIRD CORP TOKIO MARINE PASADENA ADJ7355489 UTAHNA TAVITA KNOBBE MARTENS OLSEN AND BEAR LLP TOKIO MARINE PASADENA ADJ7772762 RAFAEL RODRIGUEZ CEJA TORAGRAFIX MACHINEWORLD TORAGRAFIX MACHINEWORLD ADJ8751347 AMPARO CORONA PRINTING INDUSTRY INC TOWER NATIONAL INSURANCE IRVINE ADJ9060130 BEATRIZ RAMON SOCAL GARMENT LLC TOWER NATIONAL INSURANCE IRVINE ADJ7509771 FRANK ESTRADA EMPLOYMENT SOLUTIONS INC TOWER NATIONAL INSURANCE IRVINE ADJ7509771 FRANK ESTRADA EMPLOYMENT SOLUTIONS, INC. TOWER NATIONAL INSURANCE IRVINE ADJ9007274 HIRMA RODRIGUEZ HOTEL CLEANING SERVICES TOWER NATIONAL INSURANCE IRVINE ADJ7432791 INOCENSIO HURTADO MACARIOS TREE SERVICE TOWER NATIONAL INSURANCE IRVINE ADJ8643413 JAIRO RODRIGUEZ SOUTH EAST EMPLOYEE LEASING SERVICES INC TOWER NATIONAL INSURANCE IRVINE ADJ8404682 JOSE CORTEZ BARKER MANAGEMENT INC TOWER NATIONAL INSURANCE IRVINE ADJ9606775 JUAN CARLOS ZENDEJAS OPTIMUS GROUP TOWER NATIONAL INSURANCE IRVINE ADJ8533007 MARCELA SANDOVAL Y AND R FASHION TOWER NATIONAL INSURANCE IRVINE ADJ9385253 MARIA BARRAZA PJ WEST PAPA JOHNS PIZZA TOWER NATIONAL INSURANCE IRVINE REDLANDS EMPLOYMENT SERVICES DBA ARROW STAFFING ADJ7558169 MARIA TOVAR DE MORALES TOWER NATIONAL INSURANCE IRVINE AGENCY ADJ9210919 MARIO CRUZ J H CONSTRUCTION TOWER NATIONAL INSURANCE IRVINE ADJ7875610 MIGUEL SANCHEZ PENGUIN NATURAL FOODS TOWER NATIONAL INSURANCE IRVINE ADJ7875610 MIGUEL SANCHEZ PENGUIN NATURAL FOODS INC TOWER NATIONAL INSURANCE IRVINE ADJ8265388 MIGUEL SIMON SAN SAI JAPANESE GRILL TOWER NATIONAL INSURANCE IRVINE ADJ7680912 NOEMI NAVARRETE MERIKO INC TOWER NATIONAL INSURANCE IRVINE ADJ8552079 OSVALDO PEREZ USI UNIVERSAL SHIPPING TOWER NATIONAL INSURANCE IRVINE ADJ9442114 RAMON HERNANDEZ ARCHITECTURAL ICI MILLWORK TOWER NATIONAL INSURANCE IRVINE ADJ7566126 ALICIA BAUTISTA WOORI MARKET TOWER SELECT INSURANCE IRVINE ADJ9559390 ELFEGA SELENE VERGARA SO CAL GARMENT TOWER SELECT INSURANCE IRVINE ADJ7831960 FAUSTO LEYVA CPEHR TOWER SELECT INSURANCE IRVINE ADJ8609168 HECTOR HERRERA SANTA MARGARITA FORD TOWER SELECT INSURANCE IRVINE ADJ7646259 IGNACIA SOTO FULL SPECTRUM SERVICES TOWER SELECT INSURANCE IRVINE ADJ9525312 ISRAEL ZEPAHUA SANCHEZ NAKORN GROUP INC TOWER SELECT INSURANCE IRVINE ADJ7053705 JANET IBARRA SAN JACINTO DENTAL GROUP TOWER SELECT INSURANCE IRVINE ADJ8986977 JUAN GUILLEN OTTO EHMIG PANTING CO TOWER SELECT INSURANCE IRVINE ADJ7741115 LORELEI CISNEROS CORNERSTONE STAFFING SOLUTIONS INC TOWER SELECT INSURANCE IRVINE ADJ8247162 MARIA HERNANDEZ MR DRYCLEAN TOWER SELECT INSURANCE IRVINE ADJ8243772 MARIANO ALEMAN ROYAL ROOFING CONSTRUCTION CO TOWER SELECT INSURANCE IRVINE ADJ7041107 MARVIN MORALES NOVESTAFF RESOURCES / ESSENTIAL PERSONNEL TOWER SELECT INSURANCE IRVINE ADJ8552079 OSVALDO PEREZ USI UNIVERSAL SHIPPING TOWER SELECT INSURANCE IRVINE ADJ8509256 REYNALDO LOZANO JF LANDSCAPE TOWER SELECT INSURANCE IRVINE ADJ8835954 RICARDO LOPEZ LEXUS OF VALENCIA TOWER SELECT INSURANCE IRVINE ADJ8516521 ARMANDO FLORES MADRONE CONSTRUCTION TOWER SELECT INSURANCE NEW YORK ADJ9063165 JOSE MARTINEZ DECOR INTERIOR DESIGN TOWER SELECT INSURANCE NEW YORK ADJ8199799 MARIA RODRIGUEZ CORONA CARE CONVALESCET TOWER SELECT INSURANCE NEW YORK ADJ2146370 MELANIE MEGOW EVANS HOTELS/BAHIA RESORT HOTEL TRANSAMERICA ADJ7527189 HORTENCIA CASTANEDA VALASSIS TRAVELERS ADJ4676814 RUBEN VELARDE SOLOMON TRANSPORT SERVICES TRAVELERS ADJ990266 EDWARD SIMS BOHEMIAN DISTRIBUTING TRAVELERS CASUALTY & SURETY CO ADJ7434678 ABRAHAM PLASCENCIA HAVI LOGISTICS TRAVELERS DIAMOND BAR ADJ1822243 ABRAHAM RIOS WILBUR CURTIS COMPANY TRAVELERS DIAMOND BAR ADJ9028412 ABRAHAM RODRIGUEZ ELITE SLIDES INC TRAVELERS DIAMOND BAR ADJ7691095 ADA HERNANDEZ LA CURACAO TRAVELERS DIAMOND BAR ADJ6778130 ADELINA LUCATERO CFD ZODIAC TRAVELERS DIAMOND BAR ADJ2342545 ADRIAN SANTANA LUBERSKI INC TRAVELERS DIAMOND BAR ADJ9256921 AGUSTIN DORANTES MORGADO ALLIANCE PROFESSIONAL BUSINESS SOLUTIONS TRAVELERS DIAMOND BAR ADJ9256921 AGUSTIN DORANTES MORGADO WESTERN FISH COMPANY TRAVELERS DIAMOND BAR ADJ10120503 AGUSTIN NUNEZ AKA FERMIN GASPAR HOFS HOT RESTAURANT INC TRAVELERS DIAMOND BAR ADJ915639 ALBA ZELADA ASIG TRAVELERS DIAMOND BAR ADJ7636331 ALBERTO GARCIA AMCO PET PACKAGING TRAVELERS DIAMOND BAR ADJ8462939 ALEJANDRO MARTINEZ MNR CONSTRUCTION INC TRAVELERS DIAMOND BAR ADJ8380284 ALLAN MORATAYA MACARONI GRILL TRAVELERS DIAMOND BAR ADJ3319789 ALVARO PEREZ BODYCOTE THERMAL PROCESSING TRAVELERS DIAMOND BAR Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7577203 ANA BAEZ FUENTES WILLIAMS TRAVELERS DIAMOND BAR ADJ8728699 ANA LUGO CONSOLIDATED RESTAURANT OF CALIFORNIA INC DBA WENDYS TRAVELERS DIAMOND BAR ADJ9493566 ANA LUZ CORONA DE TERAN INTERNATIONAL EZ UP TRAVELERS DIAMOND BAR ADJ7495292 ANALILIA SANCHEZ EMBASSY SUITES HOTEL TRAVELERS DIAMOND BAR ADJ6508158 ANTONIA CARRANZA CHAVEZ DECORE ACTIVE SPECIALTIES TRAVELERS DIAMOND BAR ADJ1749996 ANTONIO CHAVEZ EMTEK PRODUCTS TRAVELERS DIAMOND BAR ADJ3242089 ANTONIO DE REAL USF BESTWAY TRAVELERS DIAMOND BAR ADJ8979389 ANTONIO NAVARRO WORTHINGTON INDUSTRIES INC TRAVELERS DIAMOND BAR ADJ7088544 ANTONIO VILLAGOMEZ IMPRESS USA INC TRAVELERS DIAMOND BAR ADJ7088566 ANTONIO VILLAGOMEZ IMPRESS USA INC TRAVELERS DIAMOND BAR ADJ1479834 ARLENE GARDUNO CARLS JR #357 TRAVELERS DIAMOND BAR ADJ1256083 ARTHUR RODRIGUEZ NORTHRUP TRAVELERS DIAMOND BAR ADJ1256083 ARTHUR RODRIGUEZ NORTHRUP AIRCRAFT TRAVELERS DIAMOND BAR ADJ2251247 ARTHUR RODRIGUEZ NORTHROP TRAVELERS DIAMOND BAR ADJ2251247 ARTHUR RODRIGUEZ NORTHRUP AIRCRAFT TRAVELERS DIAMOND BAR ADJ9062704 ARTURO GOMEZ MICROMETALS TRAVELERS DIAMOND BAR ADJ6991484 ASTRID REYES FAMSA TRAVELERS DIAMOND BAR ADJ6988411 AURELIO JIMENEZ FAMSA INC TRAVELERS DIAMOND BAR ADJ7492036 AVIGAIL YEBARA AARONS INC TRAVELERS DIAMOND BAR ADJ7275945 BAYRON MADRID HERNANDEZ GCA PRODUCTIONS SERV INC TRAVELERS DIAMOND BAR ADJ2914747 BENITO MATA DEDICATED TRANSPORTATION TRAVELERS DIAMOND BAR ADJ7247635 BERNARDINO VALADEZ HEL1X MEDLCAL LLC TRAVELERS DIAMOND BAR ADJ8066777 BERNARDO LIERA EDCO DISPOSAL CORPORATION TRAVELERS DIAMOND BAR ADJ7040866 BLANDINA MARTINEZ CARLS JR TRAVELERS DIAMOND BAR ADJ8746900 BRANDI LUMFORD SEES CANDY SHOPS INC TRAVELERS DIAMOND BAR ADJ8991416 BRITTNEY THORNE CARL S JR TRAVELERS DIAMOND BAR ADJ6841981 BYRON CLARK BEST NATURES INC TRAVELERS DIAMOND BAR ADJ7255608 CARLOS MEDINA HARVEST LANDSCAPE ENTERPRISES TRAVELERS DIAMOND BAR ADJ7255608 CARLOS MEDINA HARVEST LANDSCAPE ENTERPRISES INC TRAVELERS DIAMOND BAR ADJ6472146 CECILIA PICASSO DECORATIVE SPECIALTIES TRAVELERS DIAMOND BAR ADJ2039182 CELESTINO HERNANDEZ AMERICAN STAFF RESOURCES OF CA TRAVELERS DIAMOND BAR ADJ2039182 CELESTINO HERNANDEZ AMERICAN STAFF RESOURCES/MERRY MAID TRAVELERS DIAMOND BAR ADJ8098811 CELIA ALBARRAN BUENA VISTA FOOD PRODUCTS TRAVELERS DIAMOND BAR ADJ1203427 CELIA PALLARES CHARLOTTE RUSSE DISTRIBUTORS TRAVELERS DIAMOND BAR ADJ1203427 CELIA PALLARES CHARLOTTE RUSSE HOLDING INCORPORATED TRAVELERS DIAMOND BAR ADJ8869908 CELIA SERNA C D ZODIAC TRAVELERS DIAMOND BAR ADJ4413920 CHANCHAI VEESAPEN C & D ZODIAC, INC. TRAVELERS DIAMOND BAR ADJ4413920 CHANCHAI VEESAPEN C&D ZODIAC INC TRAVELERS DIAMOND BAR ADJ6801336 CHARLIE AU CD ZODIAC TRAVELERS DIAMOND BAR ADJ2117694 CHERI PEREZ RICOH BUSINESS SYSTEMS TRAVELERS DIAMOND BAR ADJ6553231 CINDY JOHNSON PETSMART TRAVELERS DIAMOND BAR ADJ6678787 CLAUDIA ADAME VALLARTA SUPERMARKET TRAVELERS DIAMOND BAR ADJ3124188 CLAUDIA SANTOS VALLARTA SUPERMARKET, #11 TRAVELERS DIAMOND BAR ADJ3124188 CLAUDIA SANTOS VALLARTA SUPERMARKETS TRAVELERS DIAMOND BAR ADJ8974306 COVARRUBIAS JUAN CARL KARCHER ENTERPRISES TRAVELERS DIAMOND BAR ADJ9968619 DANIEL BOSEL GARDEN FRESH RESTAURANT CORP TRAVELERS DIAMOND BAR ADJ9107227 DANIELA MAY CARLS JR TRAVELERS DIAMOND BAR ADJ7205396 DARRELL TAYLOR DAYLIGHT TRANSPORT TRAVELERS DIAMOND BAR ADJ7816219 DAVID RIVERA ADVANCED FRESH CONCEPTS TRAVELERS DIAMOND BAR ADJ6860840 DAVID SOLIS LA CURACAO TRAVELERS DIAMOND BAR ADJ9217318 DENISE RODRIGUEZ ESPINOZA MODERN PARKING TRAVELERS DIAMOND BAR ADJ4086014 DIANE ALEMAN NBA CALIFORNIA CHRISTIAN HOME TRAVELERS DIAMOND BAR ADJ2092867 DIOSDADO GUEVARA CONTINENTAL HOSPITAL SUPPLY TRAVELERS DIAMOND BAR ADJ7455246 DOMINGO VENTURA FRESH START BAKERIES TRAVELERS DIAMOND BAR ADJ8745133 ECTOR JIMENEZ PAN PACIFIC PLUMBING MECHANICAL TRAVELERS DIAMOND BAR ADJ9654931 EDITH CABRERA AMCOR RIGID PLASTICS USA TRAVELERS DIAMOND BAR ADJ9654931 EDITH CABRERA AMCOR RIGID PLASTICS USA INC TRAVELERS DIAMOND BAR ADJ9108289 EDUARDO CASTELLANOS ALHAMBRA FOUNDRY COMPANY LTD TRAVELERS DIAMOND BAR ADJ3930678 ELEAZAR LOPEZ CONWAY WESTERN EXPRESS TRAVELERS DIAMOND BAR ADJ8636478 ENRIQUE DUARTE PARKWEST LANDSCAPE MAINTENANCE TRAVELERS DIAMOND BAR ADJ3576827 ENRIQUE VELAZQUEZ WESTERN STATES MEASUREMENT CO INC TRAVELERS DIAMOND BAR ADJ8238228 ERIKA GIL OCE BUSINESS SOLUTIONS TRAVELERS DIAMOND BAR ADJ6816849 ERNESTINA CAJINA LA CURACAO TRAVELERS DIAMOND BAR ADJ6943826 ESTEBANA CORPENO SEES CANDY SHOPS INC TRAVELERS DIAMOND BAR ADJ9129290 EVA DE LA TORRE TRI STATE EMPLOYMENT TRAVELERS DIAMOND BAR ADJ7006103 FAUSTO QUEZADA CON-WAY FREIGHT TRAVELERS DIAMOND BAR ADJ4657182 FEDELIZA ALVAREZ AEGIS SENIOR LIVING TRAVELERS DIAMOND BAR ADJ6486903 FELICITAS MARQUEZ APL LOGISTICS WAREHOUSE TRAVELERS DIAMOND BAR ADJ7590265 FELIPE MARROQUIN GARDEN FRESH RESTAURANTS CORP TRAVELERS DIAMOND BAR ADJ7590265 FELIPE MARROQUIN SOUPLANTATION TRAVELERS DIAMOND BAR ADJ8514476 FILIBERTO BORJA VIDO ARTUKOVICH SON TRAVELERS DIAMOND BAR ADJ1204678 FLORA FRANKE LANCASTER COMMUNITY HOSPITAL TRAVELERS DIAMOND BAR ADJ9533267 FLORENCIO DEL CARMEN COMMERCE CASINO TRAVELERS DIAMOND BAR ADJ7701909 FRANCISCA CRUZ AMERICAN TEXTILE MAINTENANCE CO TRAVELERS DIAMOND BAR ADJ7972677 FRANCISCO HERNANDEZ BODYCOTE THERMAL PROCESSING TRAVELERS DIAMOND BAR ADJ2815503 FRANCISCO MORALES CAL SPAS TRAVELERS DIAMOND BAR ADJ323964 FRANCISCO SERRATO FAMSA INC TRAVELERS DIAMOND BAR ADJ944633 GABRIELA LINARES METQAL IMPROVEMENT TRAVELERS DIAMOND BAR ADJ9264411 GALINDO SANTANA FLEETWOOD WINDOWS DOORS TRAVELERS DIAMOND BAR ADJ6793027 GERMAN MELARA IFCO SYSTEMS NORTH AMERICA INC TRAVELERS DIAMOND BAR ADJ7949289 GLORIA ARMENDARIZ KLEENHOUSE BUILDING MAINTENANCE INC TRAVELERS DIAMOND BAR ADJ9530723 GOLDA MORRIS REDLANDS HEALTHCARE CENTER TRAVELERS DIAMOND BAR ADJ3078712 GONZALO BEDOLLA RUIZ AGRICULTURAL PRODUCTS TRAVELERS DIAMOND BAR ADJ3452964 GRACIELA SANTANA DECORE-ATIVE SPECIALTIES TRAVELERS DIAMOND BAR ADJ8153882 GUADALUPE GARATE WALKER ZANGER TRAVELERS DIAMOND BAR Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6711502 GUADALUPE RAMIREZ WILLIAM FURNANCE TRAVELERS DIAMOND BAR ADJ6711502 GUADALUPE RAMIREZ WILLIAMS FURNACE COMPANY TRAVELERS DIAMOND BAR ADJ8086531 GUILLERMINA QUINTERO LITTLE CAESAR TRAVELERS DIAMOND BAR ADJ1038989 HAYDEE KEYES HUNTINGTON BEACH HOSPITAL TRAVELERS DIAMOND BAR ADJ9007274 HIRMA RODRIGUEZ HOTEL CLEANING SERVICES TRAVELERS DIAMOND BAR ADJ3858089 HORTENCIA OROZCO ADVO, INC. TRAVELERS DIAMOND BAR ADJ3858089 HORTENCIA OROZCO VALASSIS TRAVELERS DIAMOND BAR ADJ7728768 HORTENCIO AVILA COMMERCE CASINO LOS ANGELES TRAVELERS DIAMOND BAR ADJ9250560 HUGO BALBUENA CARL S JR RESTAURANTS TRAVELERS DIAMOND BAR ADJ3106194 IRENE LAZARO CARL'S JR TRAVELERS DIAMOND BAR ADJ3106194 IRENE LAZARO CARLS JR TRAVELERS DIAMOND BAR ADJ8239943 IRENE MURRAY LA COUNTY OFFICE OF EDUCATION TRAVELERS DIAMOND BAR ADJ7008274 IRMA GUTIERREZ AYRES GROUP TRAVELERS DIAMOND BAR ADJ7008274 IRMA GUTIERREZ AYRES HOTELS TRAVELERS DIAMOND BAR ADJ8928092 IRMA VALDIVIA BRASSTECH TRAVELERS DIAMOND BAR ADJ9554692 ISIDRO ANGEL RICH PRODUCTS CORP TRAVELERS DIAMOND BAR ADJ3053702 ISIDRO HERNANDEZ EURODESIGN CABINETS INC TRAVELERS DIAMOND BAR ADJ7252558 ISMAEL VALDEZ POMONA COLLEGE TRAVELERS DIAMOND BAR ADJ7884595 ISRAEL SORIANO LAKESHORE TRAVELERS DIAMOND BAR ADJ8733604 JAIME MEJIA ORANGE COUNTY CONTAINER GROUP TRAVELERS DIAMOND BAR ADJ9400497 JAN MCCLOSKEY RITE AID TRAVELERS DIAMOND BAR ADJ6588995 JAVIER MORALES FAMSA INC TRAVELERS DIAMOND BAR ADJ9473141 JAVIER ROSALES THE WIREMOLD COMPANY TRAVELERS DIAMOND BAR ADJ7564015 JEFFREY PARKER NIAGRA BOTTLING TRAVELERS DIAMOND BAR ADJ9239327 JESUS LUCATERO AEROSPACE DYNAMICS INTERNATIONAL TRAVELERS DIAMOND BAR ADJ9251131 JIN ESTANLEY OMAR SERRANO ALEMAN NORMAN S NURSERY TRAVELERS DIAMOND BAR ADJ226311 JOEL LOPEZ EDCO DISPOSAL TRAVELERS DIAMOND BAR ADJ1700450 JONATHAN BARELA NATIONAL CONSTRUCTION RENTALS TRAVELERS DIAMOND BAR ADJ4431437 JORGE HERNANDEZ NISSAN INTERNATIONAL TRANSPORT,USA. TRAVELERS DIAMOND BAR ADJ1357131 JOSE AMAYA HOLLANDER HOME FASHIONS TRAVELERS DIAMOND BAR ADJ1357131 JOSE AMAYA HOLLANDER HOME FASHIONS CORPORATION TRAVELERS DIAMOND BAR ADJ4433811 JOSE DIAZ CALIVAS INC TRAVELERS DIAMOND BAR ADJ6935850 JOSE DIAZ C.R. LAURENCER CO INC TRAVELERS DIAMOND BAR ADJ6635179 JOSE GARCIA CURACAO TRAVELERS DIAMOND BAR ADJ8734016 JOSE HERRERA J FLETCHER CREAMER SON TRAVELERS DIAMOND BAR ADJ2099350 JOSE JIMENEZ FREUND BAKING COMPANY TRAVELERS DIAMOND BAR ADJ2099350 JOSE JIMENEZ OAKHURST INDUSTRIES FREUND BAKING CO TRAVELERS DIAMOND BAR ADJ7298289 JOSE LEIVA YOSHINOYA STORE 232 TRAVELERS DIAMOND BAR ADJ1933513 JOSE LEON MONTERO C&D ZODIAC TRAVELERS DIAMOND BAR ADJ7495635 JOSE PELAYO LIGHTOLIER TRAVELERS DIAMOND BAR ADJ7169396 JOSE SALAZAR ZIXTA ENTERPRISES TRAVELERS DIAMOND BAR ADJ7169396 JOSE SALAZAR ZIXTA ENTERPRISES DBA VALLARTA SUPERMARKETS TRAVELERS DIAMOND BAR ADJ8897052 JOSE SANDOVAL HOFS HUT TRAVELERS DIAMOND BAR ADJ7303017 JOSE SANTOS TTM PRINTED CIRCUIT GROUPINC TRAVELERS DIAMOND BAR ADJ7303017 JOSE SANTOS TTM TECHNOLOGIES TRAVELERS DIAMOND BAR ADJ6472202 JOSEFINA VENEGAS SKECHERS TRAVELERS DIAMOND BAR ADJ1528177 JUAN CARRANZA NATVAR TRAVELERS DIAMOND BAR ADJ477934 JUAN GONZALEZ NHBB TRAVELERS DIAMOND BAR ADJ7146352 JUAN MACEDO AMERICAN TEXTILE MAINTENANCE CO TRAVELERS DIAMOND BAR ADJ7146352 JUAN MACEDO REPUBLIC MASTER CHEFS TRAVELERS DIAMOND BAR ADJ7948624 JUANA ALBERTO AERO ELECTRIC CONNECTOR INC TRAVELERS DIAMOND BAR ADJ9499429 JUANA LOPEZ SPECTRA PREMIUM USA CORP TRAVELERS DIAMOND BAR ADJ9371165 JUANA MATA JEFFREY PINES HOLDINGS TRAVELERS DIAMOND BAR ADJ9371165 JUANA MATA VILLA LAS PALMAS HEALTHCARE CENTER TRAVELERS DIAMOND BAR ADJ7132069 JUANITA FIGUEROA COAST PLAZA DOCTORS HOSPITAL TRAVELERS DIAMOND BAR ADJ8467347 JULIA GONZALEZ CALIFORNIA PIZZA KITCHEN INC TRAVELERS DIAMOND BAR ADJ6473580 JULIAN CASTILLO COLUMBIA ADVENTURES TRAVELERS DIAMOND BAR ADJ7663145 JULIE HUANG CATHAY BANK TRAVELERS DIAMOND BAR ADJ8929881 JULIE RIVERA CITRUS VALLEY HEALTH PARTNERS TRAVELERS DIAMOND BAR ADJ7792166 JUNE GOTANDA BRANDON FOUCHE DOG REHABILITATION TRAVELERS DIAMOND BAR ADJ7371787 JUSTIN RIDDLE RITE AID TRAVELERS DIAMOND BAR ADJ7280207 KARYN BERNARD AYRES GROUP TRAVELERS DIAMOND BAR ADJ2255531 KATHLEEN UMBERSON CARL'S JR TRAVELERS DIAMOND BAR ADJ6786905 KATHY MARIE SAUCIER JAMABA JUICE CO TRAVELERS DIAMOND BAR ADJ2171093 KEWIN CAPPS CONWAY FREIGHT TRAVELERS DIAMOND BAR ADJ7183427 KRIS KWIATKIOWSKI CZARVOWSKI DISPLAY SERVICES INC TRAVELERS DIAMOND BAR ADJ8538422 LARRY BAETIONG LITTLE CESARS TRAVELERS DIAMOND BAR ADJ4014425 LEANA ROSTRAN IMPREMEDIA LLC TRAVELERS DIAMOND BAR ADJ7825444 LETICIA LEMUS MISSION FOODS TRAVELERS DIAMOND BAR ADJ6656839 LETICIA VELASCO CINNAWORKS, LLC TRAVELERS DIAMOND BAR ADJ8879093 LIANG YU ZHOU CALIFORNIA COMMERCE CLUB TRAVELERS DIAMOND BAR ADJ1176674 LIDIA RAMIREZ ALTA CARE CENTER TRAVELERS DIAMOND BAR ADJ7042882 LIDIA TAPIA CARL KARCHER ENTERPRISES INC TRAVELERS DIAMOND BAR ADJ7042882 LIDIA TAPIA CARL KARCHER ENTERPRISES INC TRAVELERS DIAMOND BAR ADJ7401765 LISA ESTELL BASS PRO SHOP TRAVELERS DIAMOND BAR ADJ8635527 LISA JACKSON GCA PRODUCTION SERVICES INC TRAVELERS DIAMOND BAR ADJ8635527 LISA JACKSON GCA SERVICES GROUP TRAVELERS DIAMOND BAR ADJ7198940 LOURDES MORON LEEGIN CREATIVE LEATHER PRODUCTS TRAVELERS DIAMOND BAR ADJ6924327 LUISA FREEMAN DEVONSHIRE CARE CENTER LLC TRAVELERS DIAMOND BAR ADJ4684692 MAGDALENA NEGRETE EDCO DISPOSAL CORP TRAVELERS DIAMOND BAR ADJ6648471 MANUEL MENDEZ PRIORITY BUSINESS SERVICES TRAVELERS DIAMOND BAR ADJ6994216 MARGARITA OROZCO PBC PACIFIC BUILDING CARE TRAVELERS DIAMOND BAR ADJ7628511 MARGARITO VAZQUEZ MACARONI GRILL TRAVELERS DIAMOND BAR ADJ6420227 MARIA BERNAL FAMSA INC TRAVELERS DIAMOND BAR ADJ7293928 MARIA CONSOLE HFS NORTH AMERICA TRAVELERS DIAMOND BAR ADJ9644181 MARIA ESTRADA MEDICO PROFESSIONAL LINEN SERVICE TRAVELERS DIAMOND BAR Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7200532 MARIA FLEMING RING CONTAINER TRAVELERS DIAMOND BAR ADJ7843768 MARIA GUADALUPE GRAJEDA FIVE STAR QUALITY CARE INK TRAVELERS DIAMOND BAR ADJ7528071 MARIA LOMELI MCCAIN FOODS USA TRAVELERS DIAMOND BAR ADJ3206672 MARIA MENDOZA TANABE HOLDING AMERICA INC TRAVELERS DIAMOND BAR ADJ6790993 MARIA MERAZ THE CLASSIC SOFT TRIM GROUP TRAVELERS DIAMOND BAR ADJ7006822 MARIA PACHECO YONEKYU USA INC TRAVELERS DIAMOND BAR ADJ8135482 MARIA PARDINEZ GARDEN FRESH RESTAURANTS TRAVELERS DIAMOND BAR ADJ8135482 MARIA PARDINEZ SOUPLANTATION AND SWEET TOMATOES TRAVELERS DIAMOND BAR ADJ4529793 MARIA PEREZ CARL KARCHER ENTERPRISES TRAVELERS DIAMOND BAR ADJ4529793 MARIA PEREZ CARL'S JR TRAVELERS DIAMOND BAR ADJ8026936 MARIA SANCHEZ WOODLAND CARE CENTER LLC TRAVELERS DIAMOND BAR ADJ8034255 MARIA SANTANA COURTYARD MARRIOT AKA BALDWIN HOSPITALITY LLC TRAVELERS DIAMOND BAR ADJ1606808 MARIA VELAZQUEZ REPUBLIC MASTERS CHEFS TRAVELERS DIAMOND BAR ADJ7196234 MARIELA MARTINEZ STAR FISHERIES INC TRAVELERS DIAMOND BAR ADJ2371507 MARINA MARTINEZ INTER CO PRINT TRAVELERS DIAMOND BAR ADJ1688406 MARLEEN HARTSON RITE AID TRAVELERS DIAMOND BAR ADJ4231766 MARSHA WADE LACMTA TRAVELERS DIAMOND BAR ADJ6783445 MARTA ASTORGA THE CLASSIC SOFT TRIM GROUP TRAVELERS DIAMOND BAR ADJ7112579 MARTHA CASAS SUBWAY NO TRAVELERS DIAMOND BAR ADJ7329988 MARTHA HERNANDEZ BLOOMFIELD BAKERIES TRAVELERS DIAMOND BAR ADJ9339937 MARTHA HIGUERA SEPULVEDA ACACIA BACKERY TRAVELERS DIAMOND BAR ADJ8508123 MAURINO FLORES SOUTHLAND TRANSIT TRAVELERS DIAMOND BAR ADJ7877570 MAYOLA ACUNA UNIVERSITY OF SAN DIEGO TRAVELERS DIAMOND BAR ADJ7371212 MICHAEL CARTER CIRCLE K TRAVELERS DIAMOND BAR ADJ4243932 MICHAEL O'NEAL LAKIN TIRE OF CALIFORNIA, INC. TRAVELERS DIAMOND BAR ADJ7050863 MICHELLE RICKETTS HEALTHCARE PARTNERS TRAVELERS DIAMOND BAR ADJ9020122 MIGUEL ANGEL PEREZ BEACON SALES ACQUISITION TRAVELERS DIAMOND BAR ADJ4431532 MIGUEL VENEGAS NBTY MFG TRAVELERS DIAMOND BAR ADJ1494396 MIRIAM PACHECO AMVETS THRIFT STORE TRAVELERS DIAMOND BAR ADJ8563445 MIRNA MORENO LAKESHORE LEARNING MATERIAL TRAVELERS DIAMOND BAR ADJ8511414 MOISES BENAVIDES COUNTRY CLUB OF THE DESERT HIDEAWAY GOLF CLUB TRAVELERS DIAMOND BAR ADJ7647677 NANCY REYES CLAIRE`S TRAVELERS DIAMOND BAR ADJ3265519 NELLY LOPEZ FIVE STAR PARKING TRAVELERS DIAMOND BAR ADJ8175156 NELSON GONZALEZ CONAM MANAGEMENT CORP TRAVELERS DIAMOND BAR ADJ6956325 NORMA VIVIAN REGIS INVENTOR TRAVELERS DIAMOND BAR ADJ7710904 OFELIA LIZARRAGA RICOH ELECTRONICS INC TRAVELERS DIAMOND BAR ADJ8156735 OFELIA ROSALES CARLS JR TRAVELERS DIAMOND BAR ADJ7035273 OLIVIA HERNANDEZ CARLS JR TRAVELERS DIAMOND BAR ADJ4644962 OSCAR MORALES JUAREZ DECEASED CACIQUE, INC. TRAVELERS DIAMOND BAR ADJ6836821 OSCAR VEGA RIGHTWAY PORTABLE TOLIETS TRAVELERS DIAMOND BAR ADJ7558284 PABLO RUIZ AEROSPACE DYNAMICS INTERNATIONAL INC TRAVELERS DIAMOND BAR ADJ6528777 PAMELA ELMORE CHELSEA PROPERTY GROUP INC TRAVELERS DIAMOND BAR ADJ3075053 PARVANEH ALIPANAH SAKS FIFTH AVE TRAVELERS DIAMOND BAR ADJ7385877 PATRICIA HERNANDEZ LA CURACAO TRAVELERS DIAMOND BAR ADJ8487946 PATRICIA TAPIA INTERNATIONAL LASER GROUP TRAVELERS DIAMOND BAR ADJ6538572 PAUL FLORES WINDSOR CAPITOL TRAVELERS DIAMOND BAR ADJ1707728 PEGGIE ELEBY NORTHROP TRAVELERS DIAMOND BAR ADJ1707728 PEGGIE ELEBY NORTHROP CORPORATION TRAVELERS DIAMOND BAR ADJ128961 PIEDAD LICEA CINRAM MANUFACTURING, INC. TRAVELERS DIAMOND BAR ADJ7458120 PRIMITIVO JIMENEZ FREEDOM GRAPHIC SYSTEM TRAVELERS DIAMOND BAR ADJ8550488 RACHEL WU CALIFORNIA COMMERCE CLUB TRAVELERS DIAMOND BAR ADJ7919471 RAFAEL JUAREZ COAST PLAZA DOCTORS HOSPITAL TRAVELERS DIAMOND BAR ADJ9240622 RAFAEL ORTIZ GONZALEZ CLARMEONT MKENNA COLLEGE TRAVELERS DIAMOND BAR ADJ6726433 RAMON PARRA MCCAIN FOODS USA INC TRAVELERS DIAMOND BAR ADJ8095179 RAQUEL ACEVEDO DE VEGA CARLS JR TRAVELERS DIAMOND BAR ADJ8109465 RAUL LOPEZ BARON HR TRAVELERS DIAMOND BAR ADJ8109465 RAUL LOPEZ CALIFORNIA FLORA AND HOME TRAVELERS DIAMOND BAR ADJ8109465 RAUL LOPEZ CALIFORNIA FLORAL AND HOME TRAVELERS DIAMOND BAR ADJ7347225 RAUL NAVA WEST COAST MATERIALS TRAVELERS DIAMOND BAR ADJ7347225 RAUL NAVA WEST COAST SAND AND GRAVEL INC TRAVELERS DIAMOND BAR ADJ4436804 RAVI HARRYMAN CITRUS VALLEY HEALTH PARTNERS/INTER TRAVELERS DIAMOND BAR ADJ7177165 REGINA LUCERO BURKE WILLIAMS TRAVELERS DIAMOND BAR ADJ7216140 REINA CARRILLO COMMERCE CASINO TRAVELERS DIAMOND BAR ADJ6628868 REINA HUEZO SOUTHWEST OFFSET PRINTING TRAVELERS DIAMOND BAR ADJ6693563 RENE POLANCO FAMSA INC TRAVELERS DIAMOND BAR ADJ8705118 RENEE JIE FANG CHEN CALIFORNIA COMMERCE CLUB TRAVELERS DIAMOND BAR ADJ8842381 RENEE LANG COMMUNITY MEMORIAL TRAVELERS DIAMOND BAR ADJ7861192 ROBERT HALL PACIFIC CONSOLIDATED INDUSTRIES TRAVELERS DIAMOND BAR ADJ6839250 RODRIGO LOPEZ REYNA PACIFIC BMW TRAVELERS DIAMOND BAR ADJ3111733 ROLANDO HICHOS ELKAY MANUFACTURING CO. TRAVELERS DIAMOND BAR ADJ6826047 ROSA BALTASAR ROYALTY CARPET MILLS TRAVELERS DIAMOND BAR ADJ6826047 ROSA BALTASAR ROYALTY CARPET MILLS INC TRAVELERS DIAMOND BAR ADJ1907977 ROSA LOPEZ MOTORSPORT INTERNATIONAL TRAVELERS DIAMOND BAR ADJ1723459 ROSA PANIAGUA BRASS CRAFT MFG TRAVELERS DIAMOND BAR ADJ8878832 ROSA ROSELL ATI WINDOWS TRAVELERS DIAMOND BAR ADJ806666 ROSALBA MARTINEZ VINTAGE ASSOCIATES INC TRAVELERS DIAMOND BAR ADJ1172277 ROSALIA MARTINEZ SUN GLASS PRODUCTS INC TRAVELERS DIAMOND BAR ADJ1001393 ROSALIA VILLAESCUSA BAHIA HOTEL TRAVELERS DIAMOND BAR ADJ7194315 ROSALINDA RODRIGUEZ MERCURY INSURANCE GROUP TRAVELERS DIAMOND BAR ADJ8307394 ROSALIO ESPARZA INTERAMERICAN MOTOR CORPORATION TRAVELERS DIAMOND BAR ADJ7839473 ROTONDA JUKONIS AMERICAN MOBILE HEALTHCARE TRAVELERS DIAMOND BAR ADJ7854491 RUBEN PADILLA CONESYS DBA J TECH TRAVELERS DIAMOND BAR ADJ2781254 RUTH PAUL L.A.C.M.T.A. TRAVELERS DIAMOND BAR ADJ2781254 RUTH PAUL LOS ANGELES COUNTY MTA TRAVELERS DIAMOND BAR ADJ541218 SALVADOR JIMENEZ PETER RABBIT FARMS TRAVELERS DIAMOND BAR ADJ9809752 SALVADOR RODRIGUEZ THE LODGE AT TORREY PINES PARTNERSHIP TRAVELERS DIAMOND BAR Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7170449 SAMUEL VALENCIA ROYALTY CARPET MILLS TRAVELERS DIAMOND BAR ADJ6880206 SANDRA STRIBLING FAMSA INT TRAVELERS DIAMOND BAR ADJ7275587 SANTIAGO GUZMAN JMS BUILDING SOLUTIONS LLC TRAVELERS DIAMOND BAR ADJ3548282 SILVERIA ORANTES SERRANO CONVALESCENT HOSP TRAVELERS DIAMOND BAR ADJ6729572 SILVIA GARCIA LITTLE CAESARS ENT TRAVELERS DIAMOND BAR ADJ7591754 SOCORRO CANCINO RMS ELECTRICAL CONTRACTING TRAVELERS DIAMOND BAR ADJ2965151 STEPHEN BELL CATALINA PACIFIC CONCRETE TRAVELERS DIAMOND BAR ADJ4370349 SUNGMI YI CALIFORNIA COMMERCE CLUB TRAVELERS DIAMOND BAR ADJ7022757 SUSAN STEWARD FOX TRANSPORTATION TRAVELERS DIAMOND BAR ADJ908791 SUSANNA EVARISTO MISSION LINEN SUPPLY TRAVELERS DIAMOND BAR ADJ4208494 TAMALA CARROLL-DAVIS REMEC INC TRAVELERS DIAMOND BAR ADJ7020773 THANG NGUYEN MISSION FOODS OLYMPIC TRAVELERS DIAMOND BAR ADJ3678900 THOMAS UGARTE AARON'S TRAVELERS DIAMOND BAR ADJ3436477 VALERIE CONRAD EBSCO INDUSTRIES INC TRAVELERS DIAMOND BAR ADJ8311908 VERONICA MORENO CALIFORNIA PIZZA KITCHEN TRAVELERS DIAMOND BAR ADJ9660072 VICENTE SILVA CAPETILLO PACIFIC BUILDING CARE/PBC HOLDING TRAVELERS DIAMOND BAR ADJ5825149 VICTOR DONIS OCEAN BEAUTY SEAFOODS INC TRAVELERS DIAMOND BAR ADJ6909909 VICTOR QUIINTANILLA HFS NORTH AMERICA TRAVELERS DIAMOND BAR ADJ9271901 VIRGINIA ALICEA TIGER EYE SOLUTIONS TRAVELERS DIAMOND BAR ADJ407801 WILFREDO MELGAR M S I TRAVELERS DIAMOND BAR ADJ407801 WILFREDO MELGAR MATERIAL SUPPLY INC TRAVELERS DIAMOND BAR ADJ7456998 WILVER RIVERA ADIR INTERNATIONAL LLC DBA LA CURACAO TRAVELERS DIAMOND BAR ADJ4204831 YOLANDA AGUIRRE ORMCO TRAVELERS DIAMOND BAR ADJ4204831 YOLANDA AGUIRRE ORMCO CORPORATION TRAVELERS DIAMOND BAR ADJ9723240 YOLANDA MENDEZ HIGHLAND AND PALM TRAVELERS DIAMOND BAR ADJ7860928 YOLILIA ARELLANO SOUPLANTATION TRAVELERS DIAMOND BAR ADJ8132421 ZINOET JIMENEZ PREFERRED FREEZER SERVICES TRAVELERS DIAMOND BAR ADJ7243414 GONZALEZ GALDINO MISSION FOODS A DIVISION OF GRUMA CORPORATION TRAVELERS DIAMOND BAR ADJ7374817 LUIS GUERRERO MISSION FOODS TRAVELERS DIAMOND BAR ADJ7136203 MARCOS HERNANDEZ LEGGIN CREATIVE LEATHER PRODUCTS TRAVELERS DIAMOND BAR ADJ3318800 RENE MATAMOROS KLEENHOUSE BUILDING MAINTENANCE TRAVELERS INDEMNITY ADJ4537734 MARIA GOMEZ TARGET STORE TRAVELERS INSURANCE ADJ4644962 OSCAR MORALES JUAREZ DECEASED CACIQUE, INC. TRAVELERS INSURANCE ADJ9443928 ALEJANDRO HEREDIA VEGA BAKERS BURGERS INC TRAVELERS INSURANCE HARTFORD ADJ1771108 GRACIELA GUTIERREZ VEGA ANAHEIM HILLS CAR WASH TRAVELERS INSURANCE HARTFORD ADJ8692745 TORONDIA ALLEN LITTLE BURDGECOOPER TRAVELERS INSURANCE HARTFORD ADJ9158294 VICKY ZARRO CHICOS FAS INC TRAVELERS INSURANCE HARTFORD ADJ6840637 ADELAIDE OBARD COMMAND SECURITY CORP TRAVELERS ORANGE ADJ7656401 ADRIANA VERGARA CARLS JR TRAVELERS ORANGE ADJ950272 AMELIA ROBLERO PROFESSIONAL HOSPITAL SUPPLY TRAVELERS ORANGE ADJ9366994 ANTONIO BUENROSTRO MANZO SOUTHLAND TRANSIT TRAVELERS ORANGE ADJ6430001 ARMANDO MORALES ASBURY AUTOMOTIVE SOUTHERN CALIFORNIA LLC TRAVELERS ORANGE ADJ2918943 CARLYN FERRELL AURORA BEHAVORIAL HEALTH CARE TRAVELERS ORANGE ADJ2918943 CARLYN FERRELL SIGNATURE HEALTH CARE DBA TRAVELERS ORANGE ADJ1561668 CASSANDRA CHURCH BURKE WILLIAMS TRAVELERS ORANGE ADJ7590261 CELIA DIAZ SEES CANDY SHOPS INC TRAVELERS ORANGE ADJ1203427 CELIA PALLARES CHARLOTTE RUSSE DISTRIBUTORS TRAVELERS ORANGE ADJ1203427 CELIA PALLARES CHARLOTTE RUSSE HOLDING INCORPORATED TRAVELERS ORANGE ADJ3979821 DAVID BARRERA WORLD SUPER SERVICES TRAVELERS ORANGE ADJ2424078 DEMETRIO SANTOS CANO ST JOHN HUMAN RESOURCES TRAVELERS ORANGE ADJ3495171 EDUARDO REYES BUILDER SERVICES TRAVELERS ORANGE ADJ7590265 FELIPE MARROQUIN GARDEN FRESH RESTAURANTS CORP TRAVELERS ORANGE ADJ7590265 FELIPE MARROQUIN SOUPLANTATION TRAVELERS ORANGE ADJ508888 FELIPE VENEGAS WESTERN WATERPROOFING CO TRAVELERS ORANGE ADJ6863884 FLAVIO GONZALEZ ANTHONY INTERNATIONAL TRAVELERS ORANGE ADJ8328243 GRACIELA CARMONA ALTA GARDEN CARE CENTER TRAVELERS ORANGE ADJ6711502 GUADALUPE RAMIREZ WILLIAM FURNANCE TRAVELERS ORANGE ADJ6711502 GUADALUPE RAMIREZ WILLIAMS FURNACE COMPANY TRAVELERS ORANGE ADJ6885991 GUMARO RODRIGUEZ ARIZONA PIPELINE INC TRAVELERS ORANGE ADJ6729316 HECTOR FLORES CALIFORNIA EXPANDED TRAVELERS ORANGE ADJ6729316 HECTOR FLORES HART EMPLOYMENT TRAVELERS ORANGE ADJ3375297 IRENE AREVALO BEST AMERICAN HOSPITALITY INC DBA TRAVELERS ORANGE ADJ9046592 ISMAEL SORIANO SOLAR LINK INTERNATIONAL TRAVELERS ORANGE ADJ7175289 JASON HOLLAND RAMONA TIRE INC TRAVELERS ORANGE ADJ6735569 JOSE AYLLON EARL SCHEIB INC TRAVELERS ORANGE ADJ8183675 JOSE LEON CASAS RINCO TRAVELERS ORANGE ADJ8179747 JOSE NORIEGA PACIFIC HANDY CUTTER TRAVELERS ORANGE ADJ8891630 JOSEFINA CASTRO LUIS VUITTON U S MANUFACTURING INC TRAVELERS ORANGE ADJ7849542 JOSEFINA TORRES CARL`S JR TRAVELERS ORANGE ADJ9373018 JOSEPHINE SULLIVAN WALLY PARK EXPRESS TRAVELERS ORANGE ADJ3191026 JULIA GUZMAN GOODWILL INDUSTRIES TRAVELERS ORANGE ADJ3740026 LAURA PEREZ HEALTHCARE PARTNERS TRAVELERS ORANGE ADJ8081279 LUIS TOVAR BEDOLLA SPENCER REED GROUP LLC TRAVELERS ORANGE ADJ7467043 MAGDALENA MORENO CHAMPION ENTERPRISES TRAVELERS ORANGE ADJ1754748 MANUEL FURLONG FARA & ASSOCIATES TRAVELERS ORANGE ADJ112239 MANUEL GARCIA SKETCHERS, U.S.A. TRAVELERS ORANGE ADJ2544760 MARIA HERNANDEZ LA PALMA INTERCOMMUNITY HOSP LA PALMA TRAVELERS ORANGE ADJ9137728 MARIA MEDINA BAKERS BURGERS TRAVELERS ORANGE ADJ9137728 MARIA MEDINA BAKERS BURGERS INC TRAVELERS ORANGE ADJ678854 MARTHA FAJARDO WINDSOR FOODS TRAVELERS ORANGE ADJ2122167 MATT DINASO THE RADOS COMPANIES TRAVELERS ORANGE ADJ3430999 MIGUEL BOGUETT SPECIALTY BRANDS TRAVELERS ORANGE ADJ605953 NIKETA HALE SKECHERS USA INC TRAVELERS ORANGE ADJ6946172 NIKKI WRIGHT IHOP CORPORATION TRAVELERS ORANGE ADJ6870428 PABLO ALVAREZ VELASCO SUGAR FOODS CORP TRAVELERS ORANGE ADJ3261419 PEDRO LOPEZ EARL SCHEIB INC TRAVELERS ORANGE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ6674033 RAINER BARRIOS ACI DISTRIBUTION WEST TRAVELERS ORANGE ADJ7638461 RAMON GALVEZ ANTHONY INTERNATIONAL TRAVELERS ORANGE ADJ7593574 RAUL DURAN GYU KAKU RESTAURANT TRAVELERS ORANGE ADJ8796311 RAUL GUIZAR MISSION FOODS TRAVELERS ORANGE ADJ6833031 ROLAND DE LEON DEB CONSTRUCT TRAVELERS ORANGE ADJ4504542 RUTH GARCIA BRASSTECH INCORPORATED TRAVELERS ORANGE ADJ6913612 SAUL ESTRADA HEALTHCARE PARTNERS MEDICAL GROUP TRAVELERS ORANGE ADJ2890041 SHAIDA ARDALAN LOUIS VUITTON, N.A. TRAVELERS ORANGE ADJ3277448 THANH NGUYEN B BRAUN OF AMERICA INC TRAVELERS ORANGE ADJ2242428 VAUGHN HORTON EARL SCHEIB INC TRAVELERS ORANGE ADJ2242428 VAUGHN HORTON QUALITY FLEET & TRUCK CENTERS TRAVELERS ORANGE ADJ407801 WILFREDO MELGAR M S I TRAVELERS ORANGE ADJ407801 WILFREDO MELGAR MATERIAL SUPPLY INC TRAVELERS ORANGE ADJ7659052 MARIA LEYVA SAMORA RODRIGO LAGOS D D S INC TRAVELERS PROP CAS CO OF AMERICA ADJ8096751 ELVY MEZA BLOOMFIELD BAKERS TRAVELERS PROPERTY CASUALTY COMPANY ADJ8096751 ELVY MEZA SELECT PEO INC DBA SELECT STAFFING TRAVELERS PROPERTY CASUALTY COMPANY ADJ8186236 ADRIAN SOTELO CROWN MARK TRAVELERS SACRAMENTO ADJ9707825 AIDA RUBIO COMMON SENSE ASSOCIATES TRAVELERS SACRAMENTO ADJ7557927 AJ SCROGGINS WORLD COLOR TRAVELERS SACRAMENTO ADJ278746 ALEXANDER VILLACORTA FRONTIER WOK TRAVELERS SACRAMENTO ADJ9641472 AMADO HINOJOS TOBE STAFF RESOURCES, INC. DBA IRON CHEF TRAVELERS SACRAMENTO ADJ8361735 AMERICA GARCIA DAYSNN TRAVELERS SACRAMENTO ADJ6845527 AMERICO ROMERO RITE AID TRAVELERS SACRAMENTO ADJ6845527 AMERICO ROMERO RITE AID CORP TRAVELERS SACRAMENTO ADJ7162121 ANGEL MORA ROSCOE GRILL TRAVELERS SACRAMENTO ADJ7607850 BLANCA BUESO AUBREY INC TRAVELERS SACRAMENTO ADJ7628264 BLANCA RIOS HARBOR BUILDING SERVICES TRAVELERS SACRAMENTO ADJ6436225 CANDIDO DE JESUS REYES E & C FASHION TRAVELERS SACRAMENTO ADJ6724863 CINDY PEEL TRILADY INC ROCKLIN BAJA COASTAL CANTINA TRAVELERS SACRAMENTO ADJ1307748 DAVID PINEDA BAKER COMMODITIES TRAVELERS SACRAMENTO ADJ8750430 DULCE PEREZ TAMPICO SPICE COMPANY TRAVELERS SACRAMENTO ADJ8250324 EVA ORANTES SAN FERNANDO DIAGNOSTIC TRAVELERS SACRAMENTO ADJ8250324 EVA ORANTES STI JOHN MED1CAL ASSOC1ATES TRAVELERS SACRAMENTO ADJ8288196 GERMAN CAHUANTZI PLEASANT VALLEY FLOWERS TRAVELERS SACRAMENTO ADJ9200435 GLORIA ALVARADO BRANDY MELVILLE TRAVELERS SACRAMENTO ADJ8472267 GRISELDA FLORES OMEGA MAINTENANCE SERVICES INC TRAVELERS SACRAMENTO ADJ7693202 HERMELINDA VARGAS TXD INTERNATIONAL USA INC TRAVELERS SACRAMENTO ADJ8489422 JAIME REVELES IFCO SYSTEMS NORTH AMERICA INC TRAVELERS SACRAMENTO ADJ8238003 JENNIFER CANGEMI SMILE PEDIATRIC SPEECH TRAVELERS SACRAMENTO ADJ8635626 JORGE CAMPOS PEP BOYS AUTO TRAVELERS SACRAMENTO ADJ7484062 JOSE GOMEZ COPPER CLAD MULTIPLAYER PRODUCT TRAVELERS SACRAMENTO ADJ6993304 JOSE LUIS JOVE RICHARD HABICHT TRAVELERS SACRAMENTO ADJ8530537 JUAN GUZMAN STEVENS TRANSPORTATION TRAVELERS SACRAMENTO ADJ9419451 LARRY WILLIAMS SG LABELSGR LABELS TRAVELERS SACRAMENTO ADJ8064496 LAURA CERVANTES BERNAL LA PICOSITA RESTAURANT TRAVELERS SACRAMENTO ADJ9313945 LEOPOLDO GOMEZ LOMA VISTA NURSERY INC TRAVELERS SACRAMENTO ADJ8414107 LETICIA GARCIA KHALID HAMDAM TAREK JENENA TRAVELERS SACRAMENTO ADJ8077650 MARIA CASTILLO SEAL METHOD TRAVELERS SACRAMENTO ADJ8627249 MARIA GARCIA NAZILA GADANIAN TRAVELERS SACRAMENTO ADJ6790993 MARIA MERAZ THE CLASSIC SOFT TRIM GROUP TRAVELERS SACRAMENTO ADJ7095074 MARIA SANCHEZ FRIDA MEXICAN CUISINE TRAVELERS SACRAMENTO ADJ8390667 MARIANNA KOLAROVA JOAN S GOLDWYN TRAVELERS SACRAMENTO ADJ2003397 MARTHA EDWARDS RITE AID TRAVELERS SACRAMENTO ADJ8568378 MIGUEL PEREZ PACIFIC TIRE SERVICE N 1 TRAVELERS SACRAMENTO ADJ7136551 MIRNA FLORES DWMS INCORORATION TRAVELERS SACRAMENTO ADJ6781674 NATALY PUERTO JAIME AND IRENE SIREBRENIC TRAVELERS SACRAMENTO ADJ6781674 NATALY PUERTO JAIME SIREBRENIK IRENE SIREBRENIK TRAVELERS SACRAMENTO ADJ8542930 RAFAEL MANZO SILVERLAKE TRAVELERS SACRAMENTO ADJ8830410 RICHARD DUARTE ADVANCED DISCOVERY LLC TRAVELERS SACRAMENTO ADJ7410249 ROSA CUBERO ALL SERVICES CLEANER TRAVELERS SACRAMENTO ADJ212699 SARAH PEREZ RITE AID TRAVELERS SACRAMENTO ADJ8651441 SARINEH DADOU FASHION NOVA TRAVELERS SACRAMENTO ADJ7007764 SERGIO CONTRERAS MATTARAZIUOMO INC TRAVELERS SACRAMENTO ADJ7822602 SERGIO MURGUIA INTERNATIONAL LASER GROUP TRAVELERS SACRAMENTO ADJ954128 SHAUN MCGRATH AUTOWERKES, INC. TRAVELERS SACRAMENTO ADJ3548282 SILVERIA ORANTES SERRANO CONVALESCENT HOSP TRAVELERS SACRAMENTO ADJ1109156 THIEU DINH PHO BISTRO EXPRESS TRAVELERS SACRAMENTO ADJ9650842 TINASHA SULLIVAN RITE AID CORPORATION TRAVELERS SACRAMENTO ADJ8681267 TRACI BROWN CONTINUUM SERVICE CARE MANAGEMENT TRAVELERS SACRAMENTO ADJ6640642 VICKI MYERS RITE AID TRAVELERS SACRAMENTO ADJ6707997 WALTER BURKE EDMARK GRAPHICS TRAVELERS SACRAMENTO ADJ8740949 WYATT COOVER EXTREME RECYCLING TRAVELERS SACRAMENTO ADJ6681383 BEATRIZ ESPINO JASSO EXEMPLIS CORPORATION TRAVELERS SAINT PAUL ADJ9050582 BRIAN KUCHAREK CONTROL TECHNOLOGIES, INC. TRAVELERS SAINT PAUL ADJ7273973 DOLORES MARTINEZ CHRISTIE DIGITAL TRAVELERS SAINT PAUL ADJ1210336 EDITH DORANTES FOUR STAR DISTRIBUTION TRAVELERS SAINT PAUL ADJ6845254 FRANCISCO VALENCIA FRONTIER ALUMINUM TRAVELERS SAINT PAUL ADJ717647 LITZA CUEVAS METRO REPUBLIC COLLECTION SERVICES TRAVELERS SAINT PAUL ADJ4605360 MARIA CECILIA RAMOS MCCARTHY BUILDING COMPANIES TRAVELERS SAINT PAUL ADJ4605360 MARIA CECILIA RAMOS TRADE UNION INTERNATIONAL TRAVELERS SAINT PAUL ADJ7229213 MARTIN MUNGUIA DUCOMMUN AEROSTRUCTURES TRAVELERS SAINT PAUL ADJ9448567 MICHAEL BOWLING JERRY MELTON AND SONS CONSTRUCTION INC TRAVELERS SAINT PAUL ADJ7052169 RAQUEL COTA SUBWAY TRAVELERS SAINT PAUL ADJ6962691 ROSALYNDA WEBLER PRO ACTIVE TECHNOLOGIES LLC TRAVELERS SAINT PAUL ADJ6962691 ROSALYNDA WEBLER PROACTIVE TECHNOLOGIES LLC TRAVELERS SAINT PAUL ADJ8210096 WUYI YANG CCC INFORMATINO SERVICES INC TRAVELERS SAINT PAUL Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9028412 ABRAHAM RODRIGUEZ ELITE SLIDES INC TRAVELERS WALNUT CREEK ADJ8624997 ALFREDO RUBALCAVA TIFFANY COACHWORKS TRAVELERS WALNUT CREEK ADJ7111379 ALICIA ZAMBRANO SOLAR LINK INTERNATIONAL INC TRAVELERS WALNUT CREEK ADJ7495940 ANA GARCIA STAR FISHERIES TRAVELERS WALNUT CREEK ADJ6820871 ANDREA OTANO HIGH DESERT MEDICAL GROUP HERITAGE PROVIDER NETWORK TRAVELERS WALNUT CREEK ADJ9485535 ANDRES DE LA CRUZ PEERLESS BUILDING MAINTENANCE COMPANY TRAVELERS WALNUT CREEK ADJ9662106 ANGELICA ROCHA CUSTOM FOOD PRODUCTS TRAVELERS WALNUT CREEK ADJ6566733 ANTONIA NAVARRO 3 DAY BLINDS INC TRAVELERS WALNUT CREEK ADJ9612804 ARCELIA GUTIERREZ BERSHTEL ENTERPRISES TRAVELERS WALNUT CREEK ADJ9256675 BERNABE MARTINEZ GRUMA CORPORATION TRAVELERS WALNUT CREEK ADJ8147398 BRIAN DIOSDADO E A BERG AND SONS INC TRAVELERS WALNUT CREEK ADJ6710405 CARLOS PAREDES PEP BOYS AUTO TRAVELERS WALNUT CREEK ADJ7380463 CESAR AGUERO PREFERED FREEZER SERVICES OF LOS ANGELES LLC TRAVELERS WALNUT CREEK ADJ9071277 CONSUELO A ZAMORA NEWPORT DIVERSIFIED, INC. TRAVELERS WALNUT CREEK ADJ7816219 DAVID RIVERA ADVANCED FRESH CONCEPTS TRAVELERS WALNUT CREEK ADJ8140246 EDUARDO RAMIREZ MARQUEZ MARQUEZ FOOD PRODUCTS TRAVELERS WALNUT CREEK ADJ9299261 ELVA ALCALA MARTINEZ AWARE PRODUCTS TRAVELERS WALNUT CREEK ADJ9299261 ELVA ALCALA MARTINEZ STAY SAFE STAFFING INC DBA HORIZON PERSONNEL SERVICES IN TRAVELERS WALNUT CREEK ADJ7848205 EMILIO GONZALEZ FS PRECISION TECH CO TRAVELERS WALNUT CREEK ADJ8876842 FABIOLA HERNANDEZ ACOSTA LITHOGRAPHIX TRAVELERS WALNUT CREEK ADJ7479929 FRANCISCO FRANCO BRENTWOOD SCHOOL TRAVELERS WALNUT CREEK ADJ9363242 GERARDO PEREZ AMERICAN TIRE DEPOT INC TRAVELERS WALNUT CREEK ADJ9212559 GILBERTO LOPEZ TURBO WHOLESALE TIRES TRAVELERS WALNUT CREEK ADJ7946566 GOLD LUEE ITO INC TRAVELERS WALNUT CREEK ADJ9007274 HIRMA RODRIGUEZ HOTEL CLEANING SERVICES TRAVELERS WALNUT CREEK ADJ8277558 IMELDA RAMOS MARQUEZ BROTHERS ENTERPRISES INC TRAVELERS WALNUT CREEK ADJ7829484 JAIRO PATINO RODRIGUEZ AMERICAN NATIONAL MANUFACTURING INC TRAVELERS WALNUT CREEK ADJ9425418 JESUS NAVA VOZZCOM TRAVELERS WALNUT CREEK ADJ7635168 JESUS RAMIREZ MONTCLAIR WOOD CORPORATION TRAVELERS WALNUT CREEK ADJ8764372 JOSE CRUZ HERNANDEZ ANTEX KNITTING MILLS TRAVELERS WALNUT CREEK ADJ7089020 JOSE MENDEZ NEWPORT DIVERSIFIED INC TRAVELERS WALNUT CREEK ADJ7010875 JOSE NAVARRO FS PRECISION TECH TRAVELERS WALNUT CREEK ADJ7246612 JOSE SANDOVAL ARTHUR SCHUMAN WEST TRAVELERS WALNUT CREEK ADJ7246612 JOSE SANDOVAL ARTHUR SCHUMAN WEST LLC TRAVELERS WALNUT CREEK ADJ8203318 JOSE VEGA AVALON SHUTTERS TRAVELERS WALNUT CREEK ADJ7354120 JUAN MACIAS THREE DOTS LLC TRAVELERS WALNUT CREEK ADJ6631542 JUAN RIVERA NOROTOS INC TRAVELERS WALNUT CREEK ADJ9143577 LUIS ORTEGA RAMONAS MEXICAN FOOD PRODUCTS INC TRAVELERS WALNUT CREEK ADJ6966307 LUIS PINONES ALLSCAPE ARCHITECTURAL LANDSCAPE LIGHTING TRAVELERS WALNUT CREEK ADJ6966307 LUIS PINONES PHILIPS ELECTRONICS NORTH AMERICA CORPORATION TRAVELERS WALNUT CREEK ADJ8804543 MAINOR AGUIRRE CONRACTOR WARDROBE TRAVELERS WALNUT CREEK ADJ9664541 MARIA ORTEGA FORESTO TRENDS TRAVELERS WALNUT CREEK ADJ8811171 MARIA RUIZ FLEETWOOD FIBRE TRAVELERS WALNUT CREEK ADJ8811171 MARIA RUIZ LG STAFFING SOLUTIONS ON DEMAND INC TRAVELERS WALNUT CREEK ADJ8118840 MARIO SALAZAR PALM SPRINGS BAKING COMPANY INC TRAVELERS WALNUT CREEK ADJ7463351 MARTHA MARTINEZ CORONET LIGHTING TRAVELERS WALNUT CREEK ADJ6762929 MARTHA VILLEDA MIAS FASHION MFG CO INC TRAVELERS WALNUT CREEK ADJ7550356 MERCEDES SANDOVAL KING ARCHITECTURAL METALS TRAVELERS WALNUT CREEK ADJ7837327 MICHAEL CHAVEZ DATA CLEAN CORPORATION TRAVELERS WALNUT CREEK ADJ8942565 OSCAR DIAZ CLASSIC DISTRIBUTIION BEVERAGE TRAVELERS WALNUT CREEK ADJ9108443 PABLO CRUZ CALIFORNIA REALTY AND INVESTMENT GROUP TRAVELERS WALNUT CREEK ADJ9229234 PETER PHAM SIEMENS TRAVELERS WALNUT CREEK ADJ6675859 RAFAEL CALIXTO PACIFIC CONCEPT LAUNDRY TRAVELERS WALNUT CREEK ADJ7665176 REBECA SILVA ALL AMERICAN MAINTENANCE TRAVELERS WALNUT CREEK ADJ8876601 RENE HERNANDEZ PETER PEPPER PRODUCTS INC TRAVELERS WALNUT CREEK ADJ2417543 REX HUHA USF REDDAWAY INC TRAVELERS WALNUT CREEK ADJ6772887 RHONDA ROCHA RITE AID TRAVELERS WALNUT CREEK ADJ7405772 ROSA PEREZ F. GAVINA & SONS, INC TRAVELERS WALNUT CREEK ADJ9250685 SAMUEL NUNEZ THE LODGE AT TORREY PINES PARTNERSHIP TRAVELERS WALNUT CREEK ADJ7976555 TERESA GONZALEZ AFORESTON TRENDS TRAVELERS WALNUT CREEK ADJ2479590 TONY BERUMEN INDUSTRIAL VALCO INC TRAVELERS WALNUT CREEK ADJ7105135 TRINIDAD ESTRADA KENTUCKY TRAILER SERVICES, LLC C/O FBT LLC TRAVELERS WALNUT CREEK ADJ7105135 TRINIDAD ESTRADA TRANSADVANTAGE TRAVELERS WALNUT CREEK ADJ6876250 YOUNG JANG EXPRESS MAINTENANCE COI INCE TRAVELERS WALNUT CREEK ADJ6876250 YOUNG JANG EXPRESS MAINTENANCE COMPANY INC TRAVELERS WALNUT CREEK ADJ8379967 ALEJANDRINA LOERA PACIFICA DBA HOLIDAY INN TRAVELERS WALNUT CREEK ADJ8317008 REY AKA JUAN ESCALONA LIBORIO MARKET TRAVELERS WALNUT CREEK ADJ7181251 EFIGENIA SOSA RED CHAMBER CO TRAVELERS WALNUT CREEK ADJ7611865 MARIA MONTANEZ TRI STATE STAFFING TRI STATE STAFFING ADJ6855248 HECTOR FLOWERFIELD SYCUAN CASINO RESORT TRIBAL FIRST AFFINITY SAN DIEGO ADJ7554244 MARIA VELEZ PALA CASINO RESORT AND SPA TRIBAL FIRST AFFINITY SAN DIEGO ADJ6716913 RAMON DIAZ SOBOBA SPRINGS COUNTRY CLUB TRIBAL FIRST AFFINITY SAN DIEGO ADJ9665085 ARTURO LOMELI KAMRAN STAFFING TRINITY INSURE SERVICES MANDEVILLE ADJ9665085 ARTURO LOMELI KAMRAN STAFFING INC TRINITY INSURE SERVICES MANDEVILLE ADJ7616557 JAIME GUTIERREZ HR COMP LLC TRINITY INSURE SERVICES MANDEVILLE ADJ8200418 JOSEPH THOMAS HR COMP STAFFING LLC TRINITY INSURE SERVICES MANDEVILLE ADJ8200418 JOSEPH THOMAS QUALITY DRIVING SOLUTIONS TRINITY INSURE SERVICES MANDEVILLE ADJ9236408 MARIA GIORDANI ALL CITY MANAGEMENT SERVICES TRINITY INSURE SERVICES MANDEVILLE ADJ9358916 RAFAEL ZAMORA KAMRAN STAFFING TRINITY INSURE SERVICES MANDEVILLE ADJ7968896 RAUL MENDOZA SIMPLE STAFFING INC TRINITY INSURE SERVICES MANDEVILLE ADJ8148550 CEDRICK BUCKNER COUNTY OF LOS ANGELES DEPT OF PARKS AND RECREATION TRISTAR 10480 SANTA ANA ADJ9687648 ELBA AMERICA CASTILLO COUNTRY VILLA WILSHIRE HEALTHCARE CENT TRISTAR 2805 SANTA ANA ADJ7907897 MARTHA ARREOLA LYNWOOD UNIFIED SCHOOL DISTRICT TRISTAR 2805 SANTA ANA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7907897 MARTHA ARREOLA LYNWOOD USD TRISTAR 2805 SANTA ANA ADJ1323591 ANTHONY COUCH CITY OF LOS ANGELES TRISTAR 29104 GLENDALE ADJ4081462 JESUS MEDRANO FED EX NATIONAL TRISTAR 29104 GLENDALE ADJ6839568 REBECCA JOHNSON COUNTY OF LOS ANGELES TRISTAR 29104 GLENDALE ADJ7497211 KAREN OWENS LAPD TRISTAR 29106 GLENDALE ADJ8572548 PATRICIA STOUT CITY OF LOS ANGELES TRISTAR 29106 GLENDALE ADJ1508960 ROBERTO MARTINEZ ROBINSON RANCH TRISTAR 29106 GLENDALE ADJ1326031 RUDOLF PICHARDO CITY OF LOS ANGELE TRISTAR 29106 GLENDALE ADJ2059816 MAXIMO MOLINA OPTIMUS GROUP INC TRISTAR 880287 SAN DIEGO CLOSED ADJ8390085 ADRIANA SANCHEZ AUTOMOBILE CLUB OF SOUTHERN CALIFORNIA TRISTAR BREA ADJ8318901 ANA MENDEZ PLACEMENT PROS RANDSTAND TRISTAR BREA ADJ7541301 ANDRE DAVENPORT VELOCITY ENERGY PARTNERS TRISTAR BREA ADJ7656346 ARTEMIO CHAVEZ MAPLE DAIRY TRISTAR BREA ADJ7588411 DAVID DE LOS SANTOS CAM SERVICES TRISTAR BREA ADJ6632032 ERLINDA VASQUEZ ANGELUS PLAZA TRISTAR BREA ADJ7211849 GUILLERMO VELASCO PALACIOS JAVIER SILVA TRISTAR BREA ADJ7937113 JAVIER NUNEZ AMERIPRIDE TRISTAR BREA ADJ7937113 JAVIER NUNEZ AMERIPRIDE SERVICES INC TRISTAR BREA ADJ8472963 JESUS DEL RIO ACEVEDO DMSI STAFFING TRISTAR BREA ADJ8169013 JOSE HERNANDEZ T AND R BANGIS AG SERVICES TRISTAR BREA ADJ8504631 JOSE HINDU ROBLES JACQUES GOURMENT TRISTAR BREA ADJ8288282 JUAN GUEVARA VALLARTA SUPERMARKET TRISTAR BREA ADJ7915224 JUAN PARRA MEGA FUME INC TRISTAR BREA ADJ7915224 JUAN PARRA MEGA FUME INC TRISTAR BREA ADJ8253246 MERLY GONZALEZ PLACEMENT PROS TRISTAR BREA ADJ8253246 MERLY GONZALEZ RANDSTAD NORTH AMERICA PLACEMENT PROS TRISTAR BREA ADJ8253246 MERLY GONZALEZ RANDSTAD NORTH AMERICAPLACEMENT PROS TRISTAR BREA ADJ4570185 MODESTO GRANILLO EXIDE CORPORATION TRISTAR BREA ADJ7383712 ORLANDO RAMIREZ EKEDAL CONCRETE INC TRISTAR BREA ADJ7375097 REFUGIO HERRERA JIMENEZ FRED GARZA JR INC DBA FRUIT HARVEST TRISTAR BREA ADJ6585607 REFUGIO VAZQUEZ KLOSTERMAN FLOOR SERVICES TRISTAR BREA ADJ6716845 ROGELIO DIAZ SEDIG MASONRY INC TRISTAR BREA ADJ7724475 ROLANDO RIVERA PERDOMO CRITERION CATALYST COMPANY TRISTAR BREA ADJ7698233 ROSA HERNANDEZ G2 SECURE STAFF LLC TRISTAR BREA ADJ9609434 SANDRA GONZALEZ CEDARS SINAI MEDICAL CENTER TRISTAR BREA ADJ8076157 VIDAL GUTIERREZ ASSOCIATE MANAGEMENT RESOCURCES TRISTAR BREA ADJ7848649 YINAN QIN UNICARGO EXPRESS INC TRISTAR BREA ADJ3013083 ALFONSO GUERRERO ESPARZA ENTERPRISES TRISTAR FRESNO ADJ3013083 ALFONSO GUERRERO ESPARZA ENTERPRISES, INC TRISTAR FRESNO ADJ8121290 ALMA ALFARO JOHN W SADLER RACING STABLES TRISTAR FRESNO ADJ8252095 AURELIO MUNOZ GRIMMWAY ENTERPRISE INC TRISTAR FRESNO ADJ8134356 BERTIN SILVA WAWONA PACKING TRISTAR FRESNO ADJ8134356 BERTIN SILVA WAWONA PACKING CO LLC TRISTAR FRESNO ADJ6997799 BLANCA VILLATORO GRIMMWAY FARMS TRISTAR FRESNO ADJ7559857 ELVIA HERNANDEZ GRIMMWAY ENTERPRISES TRISTAR FRESNO ADJ7090769 MARCELA MENDOZA GRIMMWAY ENTERPRISES5 INC TRISTAR FRESNO ADJ9730317 MARIA BRAVO BAKERSFIELD HEALTHCARE WELLNESS CENTRE TRISTAR FRESNO ADJ9730317 MARIA BRAVO COUNTRY VILLA HEALTH SERVICES TRISTAR FRESNO ADJ7360575 MARIA GONZALES GRIMMWAY ENTERPRISES TRISTAR FRESNO ADJ9404951 MARIA MARTHA GONZALEZ KERN MEDICAL CENTER TRISTAR FRESNO ADJ978429 MARTIN OLIVARES GRIMMWAY FARMS TRISTAR FRESNO ADJ6784433 ARELY LOVATO LIGHTHOUSE HEALTH TRISTAR LOS ANGELES ADJ9088360 CANDIDA RIVERA MEMORIAL HEALTH SERVICES TRISTAR LOS ANGELES ADJ9499144 DENISE STIERS LONG BEACH UNIFIED SCHOOL DISTRICT TRISTAR LOS ANGELES ADJ4349922 ETTIWANDA BECKS PAIGE LONG BEACH UNIFIED SCHOOL DISTRICT TRISTAR LOS ANGELES ADJ4534282 JAVIER AREVALO LONG BEACH UNIFIED SCHOOL DISTRIC TRISTAR LOS ANGELES ADJ3693701 JOEL RAMIREZ TEMPLE COMMUNITY HOSPITAL TRISTAR LOS ANGELES ADJ6484067 JOSE GUEVARA PACIFIC HOSPITAL OF LONG BEACH TRISTAR LOS ANGELES ADJ4012556 JOYCE ROBINSON HAYWOOD MAGNOLIA REHABILITATION & CONVELES TRISTAR LOS ANGELES ADJ4012556 JOYCE ROBINSON HAYWOOD MAGNOLIA REHABILITATION AND NURSING CENTER TRISTAR LOS ANGELES ADJ7465282 LORI ERICKSON LONG BEACH UNIFIED SCHOOL DISTRICT TRISTAR LOS ANGELES ADJ7139124 LUIS VALADEZ LARA FINISH LINE TRISTAR LOS ANGELES ADJ7139124 LUIS VALADEZ LARA LOS ALAMITOS RACE TRACK TRISTAR LOS ANGELES ADJ6470074 MADELYN ARCHIBALD RANCHO CUCAMONGA COMMUNITY HOSPITAL TRISTAR LOS ANGELES ADJ6470074 MADELYN ARCHIBALD RANCHO SPECIALTY HOSPITAL TRISTAR LOS ANGELES ADJ7240872 NORMA BARCENAS LONG BEACH MEMORIAL MEDICAL CENTER TRISTAR LOS ANGELES ADJ9485186 PEDRO CARLOS MOTA PRUDENTIAL OVERALL SUPPLY TRISTAR LOS ANGELES ADJ7178702 RODOLFO RAMIREZ SKB CORPORATION TRISTAR LOS ANGELES ADJ9173169 SABRINA GUERRERO PRUDENTIAL OVERALL SUPPLY TRISTAR LOS ANGELES ADJ701696 SHARON WRIGHT LONG BEACH MEMORIAL MEDICAL CENTER TRISTAR LOS ANGELES ADJ701696 SHARON WRIGHT LONG BEACH MEMORIAL MEDICAL SERV TRISTAR LOS ANGELES ADJ6654264 SHAWNA BOWEN PRUDENTIAL OVERALL SUPPLY TRISTAR LOS ANGELES ADJ1241701 VIRASINEE BLACKBURN MEMORIAL HEALTH SERVICES TRISTAR LOS ANGELES ADJ2182701 TERENCE MCCARTY COUNTY OF LOS ANGELES TRISTAR RISK MANAGEMENT ADJ9559575 OCTAVIO ORTIZ NATIONAL RETAIL TRAN ENERGY TRISTAR RISK MGMT ADJ7783840 WEST ARECHIGA HSS INC TRISTAR SACRAMENTO ADJ6975525 BLANCA GARCIA PLOTT NURSING HOME TRISTAR SAN DIEGO ADJ7141078 DANIEL MONTES CEDAR SINAI MEDICAL CENTER TRISTAR SAN DIEGO ADJ7636592 DESIREE BAPTIST CEDAR SINAI MEDICAL CENTER TRISTAR SAN DIEGO ADJ9094006 FAUSTINO CATALAN THE BRIGANTINE TRISTAR SAN DIEGO ADJ2497473 FRANCISCO TORRES HOSPITAL HOUSKEEPING SYSTEMS TRISTAR SAN DIEGO ADJ7626587 JENNIFER CACERES CEDARS SINAI MEDICAL CENTER LOS ANGELES TRISTAR SAN DIEGO ADJ3201084 JOSE GARCIA OPTIMUS GROUP INC TRISTAR SAN DIEGO ADJ8252427 JOSE GUTIERREZ CONTRACTORS AND BUILDERS TRISTAR SAN DIEGO ADJ8252427 JOSE GUTIERREZ EPLICA INC TRISTAR SAN DIEGO ADJ7167765 JUSTA GUZMAN VALLEY HEALTH SYSTEMS TRISTAR SAN DIEGO Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7597949 MARIA GARCIA DEOCOJA GRIMMWAY ENTERPRISES TRISTAR SAN DIEGO ADJ9312815 MARIA LUZ VALLE GRIMMWAY ENTERPRISES INC. TRISTAR SAN DIEGO ADJ7638434 MARIA MUNOZ CEDAR SINAI HOSPITAL TRISTAR SAN DIEGO ADJ4497274 MICHELLE MUNOZ MADRID MT RUBIDAUX CONVALESCENT TRISTAR SAN DIEGO ADJ6610548 RENEE GUERRA CHULA VISTA ELEMENTARY SCHOOL DISTRICT TRISTAR SAN DIEGO ADJ7184932 ROSE WILLIAMS CEDAR SINAI TRISTAR SAN DIEGO ADJ4377620 TERESA GARCIA MT. RUBIDOUX CONVALESCENT TRISTAR SAN DIEGO ADJ7913187 BRENDA PACHECO HARBOR UCLA MEDICAL CENTER TRISTAR SANTA ANA ADJ7498812 CAMILLE PADILLA LAC USC MEDICAL CENTER TRISTAR SANTA ANA ADJ7498812 CAMILLE PADILLA LAC/USC HOSPITAL TRISTAR SANTA ANA ADJ7539131 CARLA SMICKLE LOS ANGELES COUNTY USC MEDICAL CENTER AUXILIARY TRISTAR SANTA ANA ADJ7457011 CATHERINE CREEDEN CORONA NORCO UNIFIED SCHOOL DIST TRISTAR SANTA ANA ADJ8089070 EARL WHITT COUNTY OF LOS ANGELES TRISTAR SANTA ANA ADJ7133422 GEORGIA BARNES LAC-USC HEALTH CARE TRISTAR SANTA ANA ADJ6965040 GERTRUDE WILLIAMSON COUNTY OF LA DHS TRISTAR SANTA ANA ADJ2304108 GISLAINE AARNDELL LAC/USC MEDICAL TRISTAR SANTA ANA ADJ6789089 HAZEL JACKSON COUNTY OF LOS ANGELES USC MEDICAL CENTER TRISTAR SANTA ANA ADJ8410923 KAREN RENEE WEBB LA COUNTY HARBOR UCLA MEDICAL CENTER TRISTAR SANTA ANA ADJ7796707 LAURA MCDOWELL COUNTY OF LOS ANGELES TRISTAR SANTA ANA ADJ7495969 LEN TARLTON LOS ANGELES COUNTY DEPARTMENT OF HEALTH TRISTAR SANTA ANA ADJ1127141 LINDA WILSON COUNTY OF L.A.(MLK MEDICAL CENTER) TRISTAR SANTA ANA ADJ6709909 LUZ HESSLER LA COUNTY DEPARTMENT OF HEALTH SERVICES TRISTAR SANTA ANA ADJ7247697 MARIA PEREZ LOS ANGELES COUNTY USC MEDICAL TRISTAR SANTA ANA ADJ1491583 MARTHA RUIZ LA COUNTY OFFICE OF AIDS PROGRAM & TRISTAR SANTA ANA ADJ8655936 MURDIS BOSTON LOS ANGELES COUNTY MENTAL HEALTH DEPT TRISTAR SANTA ANA ADJ931520 NELLIE BRIONES COUNTY OF LOS ANGELES TRISTAR SANTA ANA ADJ931520 NELLIE BRIONES USC MED CTR TRISTAR SANTA ANA ADJ476176 SAMIA SALEH COUNTY OF LA/ML KING DREW MEDICAL TRISTAR SANTA ANA ADJ7592595 SHEKKENA FOSTER COUNTY OF LOS ANGELES TRISTAR SANTA ANA ADJ7260905 SIDNEY PEARSON COUNTY OF LOS ANGELES USC MEDICAL CENTER TRISTAR SANTA ANA ADJ7386683 SOPHIA THOMPSON CEDAR SINAI TRISTAR SANTA ANA ADJ8847758 STEPHEN ECHESIRIM HARBOR UCLA TRISTAR SANTA ANA ADJ7382511 SUE WANG COUNTY OF LOS ANGELES TRISTAR SANTA ANA ADJ9351184 VIOLA REILLY EXMINSTER PHARMACY TRISTAR SANTA ANA ADJ8753970 WENDY TING COUNTY OF LA TRISTAR SANTA ANA ADJ8132005 YANIRA MELENDEZ HARBOR UCLA TRISTAR SANTA ANA ADJ7150880 ZHONG JUAN CHEN COUNTY OF LOS ANGELES TRISTAR SANTA ANA ADJ7327354 ZITA RODRIGUEZ COUNTY OF LOS ANGELES TRISTAR SANTA ANA ADJ7420417 ZOILA TAPIA LOS ANGELES COUNTY B.F.S.O. TRISTAR SANTA ANA ADJ8806864 GUADALUPE DUARTE U S METRO GROUP INC U S METRO GROUP INC ADJ7184094 RAFAEL JIMENEZ GARDEN GROVE UNIFIED SCH DIST UCI ADJ7184094 RAFAEL JIMENEZ UCI UCI ADJ3885365 SILVIA FLORES TW PERSONNEL UEBTF ANAHEIM ADJ7701892 ABEL CASTANEDA MARY E. UBERTI UEBTF LOS ANGELES ADJ7701892 ABEL CASTANEDA RUBEN COVARRUBIAS CONSTRUCTION UEBTF LOS ANGELES ADJ9612326 ANDRES LOPEZ JOSE JUAREZ UEBTF LOS ANGELES ADJ9612326 ANDRES LOPEZ JOSE MANUEL JUAREZ CAMPOS UEBTF LOS ANGELES ADJ9166647 ANDY LAM GLOBAL COMMERCE INC UEBTF LOS ANGELES ADJ3460305 ANGELO GREEN G.S.S. LOGISTICS, INC. UEBTF LOS ANGELES ADJ384542 AUGUSTIN GUTIERREZ LIMON ENRIQUE ELIAS UEBTF LOS ANGELES ADJ384542 AUGUSTIN GUTIERREZ LIMON JOSE LUIS RAMIREZ UEBTF LOS ANGELES ADJ4275660 BENEDICTO ALDANA GEORGE NIKOLIS CONTRACTOR UEBTF LOS ANGELES ADJ8813748 BENITO NAVA BYRON BRIGHAM MAUSS AND DEBORAH K MAUSS UEBTF LOS ANGELES ADJ8813748 BENITO NAVA OSCAR GUERRA PAINTING UEBTF LOS ANGELES ADJ8813748 BENITO NAVA OSCAR HIGUERA UEBTF LOS ANGELES ADJ6547461 BERNADETTE ROJAS SAAB ENTERPRISES UEBTF LOS ANGELES ADJ6547461 BERNADETTE ROJAS WALEED SAAB UEBTF LOS ANGELES ADJ6547461 BERNADETTE ROJAS WALEED SAAB INC UEBTF LOS ANGELES ADJ7975169 BLANCA RAMOS GENESIS RESAURANTE Y PUPUSERIA UEBTF LOS ANGELES ADJ7975169 BLANCA RAMOS GENESIS RESTAURANTE Y PUPUSERIA UEBTF LOS ANGELES ADJ7975169 BLANCA RAMOS RESTAURANTE SALVADORENO GENESIS UEBTF LOS ANGELES ADJ3624675 CARLOS DELGADO F/S MOTORSPORTS UEBTF LOS ANGELES ADJ3108523 EDUARDO MONTANEZ ALVAREZ EDWARD GROUP INC UEBTF LOS ANGELES EDWARD KUEO CHENG WANG SSH OF EDWARD GROUP INC A ADJ3108523 EDUARDO MONTANEZ ALVAREZ UEBTF LOS ANGELES CALIFORNIA CORPORATION ADJ6792189 FILADELFO MARTINEZ MULTI AUTO GROUP UEBTF LOS ANGELES ADJ6823610 GILBERTO PEREZ TOPIFRUTA UEBTF LOS ANGELES ADJ6721903 GORA SINGH ASHOKKUMAR UEBTF LOS ANGELES ADJ6721903 GORA SINGH ASHOKKUMAR A PATEL DBA LUCKY LIQUOR UEBTF LOS ANGELES ADJ9036634 GREGORIO RUIZ ERIC VON GEHRKE UEBTF LOS ANGELES ADJ9036634 GREGORIO RUIZ GERLUND BUILDERS UEBTF LOS ANGELES ADJ8712304 GUADALUPE VALENZUELA VAN NOORD LLC UEBTF LOS ANGELES ADJ9467050 GYUNGSIN HONG JANG KUM YI NE UEBTF LOS ANGELES ADJ9467050 GYUNGSIN HONG JANG KUM YINE KOREAN RESTAURANT UEBTF LOS ANGELES MICHELLE MOONSOON HWANG AKA MICHELLE HWANG AKA ADJ9467050 GYUNGSIN HONG UEBTF LOS ANGELES MOON S HW ADJ8433410 HECTOR TREJO LA CANADA FLINTRIDGE COUNTRY CLUB UEBTF LOS ANGELES

ADJ4601009 HILDA DE LA CRUZ STA NORTHERN CALIFORNIA DEVELOPMENTAL SERVICES INC UEBTF LOS ANGELES ADJ367465 HUGO SOLORZANO COUNTRY MART SHOE REPAIR UEBTF LOS ANGELES ADJ7432791 INOCENSIO HURTADO MACARIOS TREE SERVICE UEBTF LOS ANGELES ADJ1648927 IRENE SALAZAR UNDERWATER SYSTEM INC. UEBTF LOS ANGELES ADJ9325655 IRMA CHILEL CUISINE OF THE HIMALAYAS UEBTF LOS ANGELES ADJ8208128 JAVIER BARAJAS FRANCISCO VILLEGAS UEBTF LOS ANGELES ADJ8208128 JAVIER BARAJAS LORENZO MAXIMO ALEJO UEBTF LOS ANGELES ADJ8208128 JAVIER BARAJAS MELITON VILLEGAS UEBTF LOS ANGELES Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8208128 JAVIER BARAJAS MI TIERRA POLISHING UEBTF LOS ANGELES ADJ6593079 JORGE VARGAS OPTIMA STAFFING DBA TOWER STAFF SERVICE UEBTF LOS ANGELES ADJ7726045 JOSE AKA HIPOLITO CONTRERAS DAVID RAJAMIN TRUCKING INC UEBTF LOS ANGELES ADJ4037692 JOSE CERVANTES SHOP 4 TECH UEBTF LOS ANGELES ADJ6726111 JOSE DE LA CRUZ CHARLES EVERETT RADNEY UEBTF LOS ANGELES JOSEPH CHARLES LANG AS SUB SHLDR OF MSR CONSTRUCTION ADJ6726111 JOSE DE LA CRUZ UEBTF LOS ANGELES INC ADJ6726111 JOSE DE LA CRUZ MARIA MUNOZ SUB SHAREHOLDER OF MSR CONSTRUCTION INC UEBTF LOS ANGELES ADJ7647490 JOSE LUGO D & S AUTO WRECKING UEBTF LOS ANGELES ADJ7069231 JOSE MANUEL PEREGRINO KEYEXPRESS INC UEBTF LOS ANGELES ADJ7069231 JOSE MANUEL PEREGRINO THOMAS SO CHANG SSH KEYEXPRESS INC A CALIFORNIA CORP UEBTF LOS ANGELES ADJ6559062 JOSE MEDINA PROKNIT CO UEBTF LOS ANGELES ADJ6559062 JOSE MEDINA YOUNG CHUL KIM UEBTF LOS ANGELES ADJ9160739 JOSE SANTOS ZAMORA JAMES PAINTING UEBTF LOS ANGELES ADJ9160739 JOSE SANTOS ZAMORA JAMES'S PAINTING CONST-FDBA-JAMES'S PAINTING UEBTF LOS ANGELES ADJ9160739 JOSE SANTOS ZAMORA PAINTING CONST-FDBA-JAMES'S PAINTING UEBTF LOS ANGELES ADJ9532502 JUAN MEDINA SANTANA DEBURRING UEBTF LOS ANGELES ADJ9038865 JUAN VARGAS CIMA MORTGAGE SERVICES INC UEBTF LOS ANGELES ADJ9038865 JUAN VARGAS ONE STOP HANDYMAN SERVICES UEBTF LOS ANGELES ADJ947073 KEUM SOON SEO JUSTIN DENTAL ART UEBTF LOS ANGELES ADJ9137172 MARIA CANDIDA MARIANO XEIBA SPORTSWEAR INC UEBTF LOS ANGELES ADJ6865253 MARIA FLORES OSCAR M ESPITIA DBA O.E. ESPITIA ENTERPRISES UEBTF LOS ANGELES ADJ9713855 MAURICIO CORNEJO DOLPHIN POOL AND SPA SUPPLY INC UEBTF LOS ANGELES ADJ9713855 MAURICIO CORNEJO DOLPHIN POOL SPA UEBTF LOS ANGELES ADJ9713855 MAURICIO CORNEJO MURRAY R HUNT SSH DOLPHIN POOL AND SPA SUPPLY INC UEBTF LOS ANGELES ADJ9303014 MAYRA RIVERA ARZATE CALIFORNIA LEGAL AND FINANCIAL SOLUTIONS INC UEBTF LOS ANGELES ADJ1923391 MIGUEL GOMEZ ROYAL ROOFING COMPANY UEBTF LOS ANGELES ADJ8511048 MIGUEL RODRIGUEZ RAYMOND AKA RAY RINCON UEBTF LOS ANGELES ADJ8511048 MIGUEL RODRIGUEZ RINCONS FINE UPHOLSTERING UEBTF LOS ANGELES ADJ195076 MILTON MILIAN ARTISAN GENERAL CONSTRUCTION INC UEBTF LOS ANGELES ADJ6881652 NANCY ZARAGOSA ANNA`S BAKERY INC UEBTF LOS ANGELES ADJ4348232 OLIVA RUEDAS FASHION MANIA UEBTF LOS ANGELES ADJ8649477 PEDRO PEREZ HERNANDEZ SISYPHUS HAUL UEBTF LOS ANGELES ADJ8649477 PEDRO PEREZ HERNANDEZ SISYPHUS HAUL INC DBA KAOS GLASS UEBTF LOS ANGELES ADJ8649477 PEDRO PEREZ HERNANDEZ VIDRIO WORKS INC UEBTF LOS ANGELES ADJ2450884 PRISCILLA CASTRO JACK IN THE BOX UEBTF LOS ANGELES ADJ2450884 PRISCILLA CASTRO SYED IRFAN AHMAD INC DBA JACK IN THE BOX 3585 UEBTF LOS ANGELES ADJ497474 REFUGIO GONZALEZ MAINSTAY BUSINESS SOLUTIONS UEBTF LOS ANGELES ADJ497474 REFUGIO GONZALEZ SOUTH COAST LOGISTICS UEBTF LOS ANGELES ADJ1559647 RICHARD RANGEL DANNY AVILA AUTO BODY INC UEBTF LOS ANGELES ADJ7008706 ROSA BARBER ROMANO UNLIMITED UEBTF LOS ANGELES ADJ9552064 ROSALVA AGUILAR LAS CUATRO MILPAS UEBTF LOS ANGELES ADJ4146242 SILVIA CHILIN FASHION MANIA UEBTF LOS ANGELES ADJ4146242 SILVIA CHILIN NUVO CO INC DBA FASHION MANIA UEBTF LOS ANGELES ADJ1422086 VALENTIN VERGARA CUERITOS AND BOTANAS COAHUILA UEBTF LOS ANGELES ADJ2930637 VICTOR TRIVINO DONEL MEJIA UEBTF LOS ANGELES ADJ2930637 VICTOR TRIVINO GIOVANNI TRIVINO UEBTF LOS ANGELES ADJ2930637 VICTOR TRIVINO LIBERTY FINANCIAL SERVICES UEBTF LOS ANGELES ADJ2930637 VICTOR TRIVINO VICTOR MEJIA AKA RIGOBERTO T MEJIA UEBTF LOS ANGELES ADJ9924095 CECILIA LEPE DUARTE ROSA SAPPELLO INDIVIDUALLY AND DBA MASTER CUTS BARBER & UEBTF OAKLAND ADJ3194701 HORACIO LOPEZ DR PLASTICS UEBTF OAKLAND ADJ8008002 JOSE MUNOZ NARINE ALADJANIAN DBA PRUDENTAIL AUTO BODY & COLLISION UEBTF OAKLAND ADJ8008002 JOSE MUNOZ PRUDENTIAL AUTO BODY AND COLLISION INC UEBTF OAKLAND ADJ7744604 JUAN CERVANTES JESUS CARDENAS UEBTF OAKLAND ADJ7744604 JUAN CERVANTES MOSS GROUP UEBTF OAKLAND ADJ7744604 JUAN CERVANTES NA GENERAL CONSTRUCTION UEBTF OAKLAND ADJ9334445 KATHELYN GARCIA TOTAL KONCEPTS ACS UEBTF OAKLAND ADJ9334445 KATHELYN GARCIA TOTAL KONCEPTS ACS INC A CALIFORNIA CORPORATION UEBTF OAKLAND ADJ9256177 MARTIN RUVALCABA JA CONTRACTING UEBTF OAKLAND ADJ9256177 MARTIN RUVALCABA JUAN LUIS AYALA DBA JA CONTRACTING UEBTF OAKLAND ADJ3992483 MIGUEL MARTINEZ CHIRINO RISING STAR INDUSTRIES UEBTF OAKLAND ADJ3191771 STEVE KRUITBOSH SAN JOAQUIN VALLEY COURIERS UEBTF OAKLAND ADJ8924360 DULCE FLORES AMC OUTSOURCING ULLICO CASUALTY CO SILVER SPRING ADJ8924360 DULCE FLORES PARIS ACCESSORIES ULLICO CASUALTY CO SILVER SPRING ADJ7613215 RON THY UNIFIED GROCERS UNIFIED GROCERS ADJ7352468 JULIO CESAR FLORES ALFREDO CRUZ UNINSURED EMPLOYERS FUND ADJ7352468 JULIO CESAR FLORES EXQUISITE MARBLE UNINSURED EMPLOYERS FUND ADJ7352468 JULIO CESAR FLORES RENE CERVANTES SUBSH AAPI USA CORPORATION INC UNINSURED EMPLOYERS FUND ADJ644745 ROSA GARFIAS ABC EMBROIDERY UNINSURED EMPLOYERS FUND ADJ644745 ROSA GARFIAS ARNULFO CARDENAS DBA ABC UNIFORM UNINSURED EMPLOYERS FUND ADJ691244 ERNESTO AGUAYO BEST LABEL COMPANY INC UNITED STATES FIRE INSURANCE CO ADJ7562280 AMADOR ESPINOZA DEL MAR DIE CASTING UNITED STATES FIRE INSURANCE COMPANY ADJ7053818 GABRIEL JIMENEZ VALENCIA WISEWAY MOTOR FREIGHT UNITED WISCONSIN INS NEW BERLIN ADJ8708116 FELIPE MORALES MEDINA SPARKLING FRESH POOLS US ADMINISTRATOR CLAIMS OAK RIDGE ADJ8543774 RAUL CARRILLO ECO CONSTRUCTION US ADMINISTRATOR CLAIMS OAK RIDGE ADJ9374255 JOSE DE LA TRINIDAD UTILITY TREE SERVICE INC UTILITY TREE SERVICE INC ADJ8347526 DEMITRIUS JACKSON STARVING STUDENTS VANLINER INSURANCE FENTON ADJ3353957 JORGE SORIA GENTLE GIANT MOVING COMPANY VANLINER INSURANCE FENTON ADJ1222177 ROBERT OCHOA KING RELOCATION VANLINER INSURANCE FENTON ADJ8845696 CIRINO JACOBO LOCKHART STAFFING SMART TEK AUTOMATED SERVICES VENTURA REGIONAL SANITATION DISTRICT ADJ8845696 CIRINO JACOBO VENTURA REGIONAL SANITATION DISTRICT VENTURA REGIONAL SANITATION DISTRICT ADJ7686497 EUNICE SERRATOS VERIZON WIRELESS VERIZON WIRELESS Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9393433 JESUS AVENDANO VICTORY ZEN BUFFET VICTORY ZEN BUFFET ADJ6783304 JUAN MARTINEZ VONS COMPANIES INC VONS COMPANIES INC ADJ3188803 PATRICIA SANTOS WARNER BROTHERS WARNER BROTHERS STUDIOS WC ADJ214365 ALAND PERCY ROJAS SERVICE CRAFT LOGISTICS WAUSAU BEAVERTON ADJ1418337 ALBERTO ESCOBAR ADAMS RITE AEROSPACE WAUSAU BEAVERTON ADJ1125480 ANA MARIA JUAREZ DIAMOND CONTRACT SERVICES INC WAUSAU BEAVERTON ADJ1027910 ANGELICA LOPEZ MOLLY MAIDS WAUSAU BEAVERTON ADJ4381684 ANH KIM PHAN DRIESSEN AIRCRAFT WAUSAU BEAVERTON ADJ630273 ANTONIO NUNEZ CAMPOS WEST-END RACQUET HEALTH, INC WAUSAU BEAVERTON ADJ6708104 BARBARA RIVERA HIDDEN VILLA RANCH WAUSAU BEAVERTON ADJ7809268 BRANDON JACKSON ASHLEY FURNITURE INDUSTRIES INC WAUSAU BEAVERTON ADJ6833412 CAROLINA SANTOS PERSONAL PLUS INC WAUSAU BEAVERTON ADJ6779928 DANIEL AGUIRRE UNITED ALLOYS AND METALS WAUSAU BEAVERTON ADJ3047302 DIEM VAN TRAN F.C.I. U.S.A., INC. WAUSAU BEAVERTON ADJ6642559 DORA VALERIO NOBEL BIOCARE WAUSAU BEAVERTON ADJ9118764 EDGAR DOMINGUEZ OXFORD PALACE HOTEL WAUSAU BEAVERTON ADJ7946318 ERIC CAZARES US LEGAL SUPPORT WAUSAU BEAVERTON ADJ951783 EVA GIL DISORDERLY KIDS LLC WAUSAU BEAVERTON ADJ881463 FERNANDO TORRES RMI MFG WAUSAU BEAVERTON ADJ7661405 FLAULO MARTINEZ OAK CREEK RANCH GOLF CLUB INC WAUSAU BEAVERTON ADJ7222492 GILDARDO TAPIA ASHLEY FURNITURE INDUSTRIES INC WAUSAU BEAVERTON ADJ7171671 GUADALUPE ALATORRE ANNAS LINENS WAUSAU BEAVERTON ADJ6509717 GUADALUPE SANCHEZ BURLINGAME INDUSTRIES, INC. WAUSAU BEAVERTON ADJ7458400 GUANQIAO CHENG CASINO MASSAGE WAUSAU BEAVERTON ADJ7458400 GUANQIAO CHENG CASINO MASSAGE INC WAUSAU BEAVERTON ADJ9214821 GUSTAVO FRAGA WEST COVINA WAUSAU BEAVERTON ADJ2473673 HECTOR LOPEZ SOUTHCOAST CABINET INC WAUSAU BEAVERTON ADJ6523517 HERNAN ORTIZ ASHLEY FURNITURE WAUSAU BEAVERTON ADJ6523517 HERNAN ORTIZ ASHLEY FURNITURE INDUSTRIES WAUSAU BEAVERTON ISMAEL AKA ALFREDO DE LOS SANTOS AKA ADJ7155083 SEPULVEDA BUILDING MATERIALS WAUSAU BEAVERTON ROMERO ADJ3784225 JEREMY FERNANDEZ PERSONNEL PLUS WAUSAU BEAVERTON ADJ3127680 JESUS ALCANTAR AMERIMAX WAUSAU BEAVERTON ADJ2076662 JORGE RAMIREZ 99 RANCH MARKET WAUSAU BEAVERTON ADJ7189003 JOSE ALFARO AMERICAN BOX CORPORATION WAUSAU BEAVERTON ADJ6589057 JOSE CORDOVA GREGG INDUSTRIES WAUSAU BEAVERTON ADJ1504487 JOSE ORELLANA M. STEPHENS MFG. INC. WAUSAU BEAVERTON ADJ7347579 JUAN JAIMES CHOCOLATES A LA CARTE WAUSAU BEAVERTON ADJ7347579 JUAN JAIMES EXPRESS SERVICES GROUP INC WAUSAU BEAVERTON ADJ7347579 JUAN JAIMES STAFFLINK OUTSOURCING INC WAUSAU BEAVERTON ADJ6638857 JUAN MEZA HOFS HUT RESTAURANT WAUSAU BEAVERTON ADJ8508732 JUQIONG YIN TAWA SUPERMARKET INC WAUSAU BEAVERTON ADJ2626865 KEVIN HARRIS UNITED OIL WAUSAU BEAVERTON ADJ7281691 LEONARDO DELGADO MOLDED FIBER GLASS COMPANIES WEST WAUSAU BEAVERTON ADJ6830017 LUIS OSORIO GREGG INDUSTRIES INC WAUSAU BEAVERTON ADJ217604 MALENA MORFIN PERSONNEL PLUS WAUSAU BEAVERTON ADJ3968901 MARIA CARDONA BRITE WORKS INC WAUSAU BEAVERTON ADJ4194538 MARIA MEDINA WALDEN STRUCTURES WAUSAU BEAVERTON ADJ6592824 MARIA RAMOS DECTON INC WAUSAU BEAVERTON ADJ6772982 MARIA ZAMORA GOODWILL WAUSAU BEAVERTON ADJ6772982 MARIA ZAMORA GOODWILL SERVING THE PEOPLE OF SOUTHERN LA COUNTY WAUSAU BEAVERTON ADJ7415407 MARILYN GONZALEZ TOMMYS HAMBURGERS TOMDAN ENTERPRISES WAUSAU BEAVERTON ADJ7415407 MARILYN GONZALEZ TOMMYS HAMBURGERS TOMDAN ENTERPRISES INC WAUSAU BEAVERTON ADJ7162665 MARIO VILLEGAS SPECTRUM CARE LANDSCAPE & IRRIGATION MANAGEMENT WAUSAU BEAVERTON ADJ9107076 MAURICIO VAZQUEZ JEONG WON KOREAN BBQ BUFFET WAUSAU BEAVERTON ADJ714352 OFELIA BELTRAN ASHLEY FURNITURE INDUSTRIES WAUSAU BEAVERTON ADJ6939689 PAUL KEEPOLRUJEE MAGTEK INC WAUSAU BEAVERTON ADJ6806668 PETER PARKER VOZCOM WAUSAU BEAVERTON ADJ7312399 RAUL REVOLORIO OHLINE CORPORATION WAUSAU BEAVERTON ADJ6717757 RICARDO MENDOZA NORMANIS NURSERY INC WAUSAU BEAVERTON ADJ6717757 RICARDO MENDOZA NORMANS NURSERY INC WAUSAU BEAVERTON ADJ3775104 RODRIGO COLCHADO MISSION POOLS WAUSAU BEAVERTON ADJ3775104 RODRIGO COLCHADO MISSION POOLS OF ESCONDIDO WAUSAU BEAVERTON ADJ4109035 ROSA GONZALEZ STAFFING SOLUTIONS WAUSAU BEAVERTON ADJ6430092 ROSA VARGAS 3 DAY BLINDS INC WAUSAU BEAVERTON ADJ579486 RUTH GONZALES A & D BUILDING MAINTENANCE WAUSAU BEAVERTON ADJ8035521 SANTIAGO ASTUDILLO OXNARD HARVEST HARDWARE WAUSAU BEAVERTON ADJ7069803 SONIA RAMOS CARLS JR WAUSAU BEAVERTON ADJ6651641 UCIEL ARRIVILLAGA GRIVER GOLF LLC WAUSAU BEAVERTON ADJ429508 ROSA VARGAS 3 DAY BLINDS WAUSAU INSURANCE CO ADJ3419022 PRISCILLA KRAFT MELTON FRANCHISE SYSTEMS INC WAUSAU NATIONWIDE INSURANCE ADJ6641430 ANASTACIA CRUZ JOIE DE VIVRE ORCHARD LLC WAUSAU WAUSAU ADJ7469492 JAVIER RAMIREZ CALIFORNIA PIZZA LLC PIZZA HUT WAUSAU WAUSAU ADJ6765155 RAMON CARRILLO YANEZ WESTERN PRECOOLING WAUSAU WAUSAU ADJ9538041 CAMILO GUTIERREZ DRIVERS MANAGEMENT WERNER ENTERPRISES OMAHA ADJ6804144 HIGINIO RODRIGUEZ SEGURA 1 LEVEL BY WEYERHAEUSER CO WEYERHAEUSER SACRAMENTO ADJ7371113 PATRICIA JOHNSON AAFES WILLIAM BROOKS LONG BEACH ADJ9511228 CLAUDIA MENDEZ WILSHIRE SUITE HOTEL INC WILSHIRE SUITE HOTEL INC ADJ7279906 PEDRO JUAN BACA BISON ENGINEERING INC YORK ADJ9124281 RUBEN NAVARRO RIO ELEMENTARY SCHOOL DISTRICT YORK ADJ2235169 ANNETTE NORTHUP ABC CHILD DEVELOPMENT YORK 1498 SANTA ANA ADJ9502843 CESAR VALTIERRA VALUE COLD STORAGE YORK 1498 SANTA ANA ADJ7574803 HUGO MARTINEZ STAFFING SOLUTION YORK 1498 SANTA ANA ADJ9046580 JAVIER GARCIA LARDAS SYSTEMS DBA MC DONALDS YORK 1498 SANTA ANA ADJ7470131 JESUS AMARO CAL COAST CONSTRUCTION SPECIALISTS INC YORK 1498 SANTA ANA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8764372 JOSE CRUZ HERNANDEZ ANTEX KNITTING MILLS YORK 1498 SANTA ANA ADJ8151693 JOSE MOJARDIA ESPINOZA AFFILIATED TEMPORARY HELP YORK 1498 SANTA ANA ADJ1334550 LUISA REYES HAWTHORNE IN HOME SUPPOERT SVC. YORK 1498 SANTA ANA ADJ9040813 MARIA BRUSTER STEELWORKERS OLDTIMERS FOUNDATION YORK 1498 SANTA ANA ADJ8937065 RICARDO CERVANTES STEELTECH REINFORCING INC. YORK 1498 SANTA ANA ADJ9288554 ANAHI QUEZADA RIVERSIDE COUNTY IH55 YORK 1738 SANTA ANA ADJ7626580 ARMANDO MENDEZ DESERT CONCEPTS CONSTRUCTION INC YORK 1738 SANTA ANA ADJ3336564 CAROLYN CAVERLY COUNTY OF ORANGE YORK 1738 SANTA ANA ADJ3336564 CAROLYN CAVERLY KIMKO STAFFING YORK 1738 SANTA ANA ADJ1928906 ESPERANZA MACIEL COUNTY OF ORANGE YORK 1738 SANTA ANA ADJ9558233 FELIX BUZO DOLLAR GENERAL YORK 1738 SANTA ANA ADJ8806864 GUADALUPE DUARTE U S METRO GROUP INC YORK 1738 SANTA ANA ADJ8424559 LEILA GUIRAGOSSIAN DUARTE UNIFIED SCHOOL DISTRICT YORK 1738 SANTA ANA ADJ9831828 MARIA DE LOS PALOS PARAMOUNT UNIFIED DISTRICT YORK 1738 SANTA ANA ADJ9199011 RAMIRO MONTES ROADLINK SERVICES YORK 1738 SANTA ANA ADJ9199011 RAMIRO MONTES ROADLINK WORKFORCE YORK 1738 SANTA ANA ADJ7675830 RODRIGO FIGUEROA CENTRAL REINFORCING CORPORATION YORK 1738 SANTA ANA ADJ6733092 STEVEN ARMAND ORANGE COUNTY SHERIFFS DEPARTMENT YORK 1738 SANTA ANA ADJ9442341 DANIEL MAXIMILIANO MARTINEZ VISTA EXCAVATION AND DEMO YORK 619058 ROSEVILLE ADJ8010113 DANIEL ORTIZ BOY SCOUTS OF AMERICA YORK 619058 ROSEVILLE ADJ8643413 JAIRO RODRIGUEZ SOUTH EAST EMPLOYEE LEASING SERVICES INC YORK 619058 ROSEVILLE ADJ9444446 LUIS PEREZ MARTINEZ THE ORIGINAL MOWBRAY S TREE SERVICE YORK 619058 ROSEVILLE ADJ9184624 MARIA AVINA EL SUPER YORK 619058 ROSEVILLE ADJ9338638 MI MOON UNI CAPS YORK 619058 ROSEVILLE ADJ7240706 SABINO RIVERA TULE RIVER RANCH INC YORK 619058 ROSEVILLE ADJ9389996 TAMIKA WHITTIKER ALBERTSON'S INC YORK 619058 ROSEVILLE ADJ9389996 TAMIKA WHITTIKER DOWNEY UNIFIED SCHOOL DISTRICT YORK 619058 ROSEVILLE ADJ9389996 TAMIKA WHITTIKER KNOTTS BERRY FARM YORK 619058 ROSEVILLE ADJ7078680 CHRISTOPHER LUONG RBC-ALL POWER MFG. YORK ANAHEIM ADJ4086014 DIANE ALEMAN NBA CALIFORNIA CHRISTIAN HOME YORK ANAHEIM ADJ7136515 GERARDO RAMIREZ SAM BO INC YORK ANAHEIM ADJ7634094 GUSTAVO RAMOS GREAT SCOTT TREE SERVICES INC YORK ANAHEIM ADJ7634094 GUSTAVO RAMOS HOWARD JOHNSON HOTEL YORK ANAHEIM ADJ6737934 JAIME PALAFOX INTERNATIONAL COATINGS INC YORK ANAHEIM ADJ6755349 JESUS GALAN STAFFMARK YORK ANAHEIM ADJ8234009 JESUS PADILLA RAINBOW DISPOSAL YORK ANAHEIM ADJ7298117 JOSE HERNANDEZ SERCO INC YORK ANAHEIM ADJ8452457 JOSE TELLEZ R D METAL FABRICATIONS INC YORK ANAHEIM ADJ8565275 JUAN CARRILLO CHP ENTERPRISES YORK ANAHEIM ADJ8666228 JUAN QUINONEZ TOS FARMS YORK ANAHEIM ADJ3334113 JUVENTINO BACA VANGUARD YORK ANAHEIM ADJ7352939 LEOPOLDO PRIETO THE BICYCLE CASINO YORK ANAHEIM ADJ3207976 LYNWOOD MORGAN ENTERPRISE RENT-A-CAR YORK ANAHEIM ADJ7935346 OSCAR SILVA WALMART YORK ANAHEIM ADJ7155371 RICHARD YBARRA WAL MART YORK ANAHEIM ADJ7155371 RICHARD YBARRA WAL-MART YORK ANAHEIM ADJ7254557 ROBERT JACKSON 7 UP RC BOTTLING COMPANY YORK ANAHEIM ADJ3869103 SALVADOR MANRIQUEZ PAGE PRINTING SERVICES YORK ANAHEIM ADJ6975362 VIVIAN NGO ENTREPRISE RENT A CAR YORK ANAHEIM ADJ2773460 AMELIA PARTIDA WALMART YORK EL DORADO HILLS ADJ4656360 ANAHITA ARIAN WAL MART YORK EL DORADO HILLS ADJ7220508 ANDREW PORTILLO WAL-MART YORK EL DORADO HILLS ADJ7220508 ANDREW PORTILLO WALMART YORK EL DORADO HILLS ADJ8229025 BERTHA AVILA SAMS CLUB YORK EL DORADO HILLS ADJ7541093 BRAULIO NARVAEZ WAL MART STORE YORK EL DORADO HILLS ADJ7505183 CINDY DIAZRIVERO SAMS CLUB YORK EL DORADO HILLS ADJ9462054 CLARA VINLOVE WALMART YORK EL DORADO HILLS ADJ9151922 CRYSTAL WITHROW WALMART YORK EL DORADO HILLS ADJ4691106 EMETRIO MARTINEZ WAL MART YORK EL DORADO HILLS ADJ4372663 ERIC SMITH WAL MART YORK EL DORADO HILLS ADJ2850273 GINA DALOOL WAL MART YORK EL DORADO HILLS ADJ7175365 GRACIELA ESTRADA WALMART YORK EL DORADO HILLS ADJ8825294 ISRAEL VASQUEZ WAL MART YORK EL DORADO HILLS ADJ7680418 LEONORA SMITH WAL MART YORK EL DORADO HILLS ADJ7240042 LORETTA FRIAS SAMS CLUB YORK EL DORADO HILLS ADJ7218508 MARIA CORTEZ WALMART YORK EL DORADO HILLS ADJ2821038 MARIA TORRES SAM'S CLUB YORK EL DORADO HILLS ADJ2578344 MARKEESE SLOCUM SAMS CLUB YORK EL DORADO HILLS ADJ6946730 NORMA DURAN WALLMART STORES INC YORK EL DORADO HILLS ADJ8932558 PAULINE GARCIA WAL MART STORES INC YORK EL DORADO HILLS ADJ7071359 ROBBY PHILLIPS WALMART STORES YORK EL DORADO HILLS ADJ9524522 ROBERT KATZ WALMART ASSOCIATES INC YORK EL DORADO HILLS ADJ8775058 ROSA BECERRA WALMART YORK EL DORADO HILLS ADJ7177641 ROSALBA MATA WAL-MART YORK EL DORADO HILLS ADJ6968152 SAID RASOULI WAL MART ASSOCIATES INC YORK EL DORADO HILLS ADJ6968152 SAID RASOULI WALMART YORK EL DORADO HILLS ADJ7411023 SHANNON REILLY WAL MART YORK EL DORADO HILLS ADJ7222630 OSCAR PEREZ MKT INNOVATIONS YORK INSURANCE SERVICES FRESNO CLOSED ADJ9062471 GLORIA HERRERA WETMORE TOOLS AND ENGINEERING YORK INSURANCE SERVICES SACRAMENTO ADJ8326571 MIRIAM LINARES JEAN GENIE STUDIO YORK INSURANCE SERVICES SACRAMENTO ADJ8814216 DELILAH GARCIA OXNARD SCHOOL DISTRICT YORK OXNARD ADJ7426483 JOSE GONZALEZ CONSOLIDATED PRECSION YORK OXNARD ADJ7148712 JULIA LIRA VENTURA COUNTY OFFICE OF EDUCATION YORK OXNARD ADJ7272239 MARIO AGUILAR HAWTHORNE SCHOOL DISTRICT YORK OXNARD ADJ7874608 ALEJANDRO GONZALEZ COUNTY OF LOS ANGELES SHERIFFS DEPT YORK PASADENA ADJ6762902 BRYANT JIMENEZ COUNTY OF LOS ANGELES YORK PASADENA Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ4454475 CAROL HALL COUNTY OF LOS ANGELES YORK PASADENA ADJ2525562 CLAUDETTE CALLEGARI RANDALL COUNTY OF ORANGE YORK PASADENA ADJ2449541 DARYL KNIGHT COUNTY OF LOS ANGELES YORK PASADENA ADJ3966642 DARYL KNIGHT COUNTY OF LOS ANGELES YORK PASADENA ADJ6778989 ERICKA CAMPA LOS ANGELES COUNTY SHERIFF DEPT YORK PASADENA ADJ9928547 FEIRA VILLALBA COUNTY OF LOS ANGELES YORK PASADENA ADJ9014138 FRANK BARRAGAN COUNTY OF LOS ANGELES YORK PASADENA ADJ3305432 JOYCE COBBS HARBOR UCLA MEDICAL CENTER YORK PASADENA ADJ8053906 KATHY PARRA COUNTY OF LOS ANGELES SHERIFFS DEPARTMENT YORK PASADENA ADJ3442280 KATIE CREED COUNTY OF LOS ANGELES YORK PASADENA ADJ3442280 KATIE CREED COUNTY OF LOS ANGELES SHERIFFS DEPT YORK PASADENA ADJ6860265 WILFREDO SANTOS COUNTY OF LOS ANGELES YORK PASADENA ADJ8933152 WILLIAM NELSON LOS ANGELES COUNTY SHERIFFS DEPARTMENT YORK PASADENA ADJ6793755 ANA TINOCO DENNIS RESTAURANT NO 7020 YORK RANCHO CUCAMONGA ADJ6930963 ARTHUR GARCIA SAN BERNARDINO COUNTY SUPERINTENDENT OF SCHOOL YORK RANCHO CUCAMONGA ADJ1348084 BARBARA CLENDINENG NORWALK LA MIRADA UNIFIED SCHOOL DI YORK RANCHO CUCAMONGA ADJ3141826 DEBRA GREEN ORANGE UNIFIED SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ8814216 DELILAH GARCIA OXNARD SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ6905354 DIANE JUVERA LOPEZ ROWLAND UNIFIED SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ3532364 ERLINDA RAYMUNDO CLOVIS UNIFIED SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ8935912 JORGE LOPEZ E AND J TLC YORK RANCHO CUCAMONGA ADJ8424559 LEILA GUIRAGOSSIAN DUARTE UNIFIED SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ7198625 LILLIAN MONTALVO POMONA UNIFIED SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ914809 LORINDA MACIAS BREA-OLINDA UNIFIED SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ7339103 MAGDALENA SAN ROMAN ROWLAND UNIFIED SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ6711459 MARIA DEL ROSARIO VILLEGAS BALDWIN PARK SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ7472191 MARIA ZACARIAS BOYS AND GIRLS CLUBS OF GARDEN GROVE YORK RANCHO CUCAMONGA ADJ8731246 MARIANA PAREDES ANPPM YORK RANCHO CUCAMONGA ADJ7071193 MARINA QUIROZ BALDWIN PARK UNIFIED SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ8167431 MARTIN MEDINA DEPT OF SOCIAL SERVICES IHS YORK RANCHO CUCAMONGA ADJ8145922 MICAELA ORTIZ DEPARTMENT OF SOCIAL SERVICES IHSS YORK RANCHO CUCAMONGA ADJ6773809 PHYLLIS HOLMES POMONA USD YORK RANCHO CUCAMONGA ADJ7162272 RAFI MAKERIAN LOS ANGELES COMMUNITY PIERCE COLLEGE YORK RANCHO CUCAMONGA ADJ6564697 ROSALVA CRUZ FULLERTON SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ8237230 TERRY PEARSON IN HOME SUPPORTIVE SERVICES STATE OF CALIFORNIA YORK RANCHO CUCAMONGA ADJ7440904 VINCENT ESCARCEGA SNOW SUMMIT SKI CORPORATION YORK RANCHO CUCAMONGA ADJ7905824 ZACCHEUS COOPER PASADENA UNIFIED SCHOOL DISTRICT YORK RANCHO CUCAMONGA ADJ7534723 GLORIA LECHUGA PANORAMA GARDENS YORK RISK SERVICES GROUP ADJ1417605 JOSE BECERRA LA COUNTY/DPSS YORK RISK SERVICES GROUP ADJ7411143 SARA DEL RIO LOS ANGELES COUNTY D P S S YORK RISK SERVICES GROUP INC ADJ9502843 CESAR VALTIERRA VALUE COLD STORAGE YORK RIVERSIDE ADJ7153807 HILDA RAMIREZ BARFIELD ELEMENTARY YORK RIVERSIDE ADJ7153807 HILDA RAMIREZ BARFIELD ELEMENTARY SCHOOL YORK RIVERSIDE ADJ803597 JUANA GONZALEZ MONTEBELLO UNIFIED SCHOOL DISTRICT YORK RIVERSIDE ADJ9524810 LISBETH NINO G & B SUBS SUBWAY YORK RIVERSIDE ADJ6754408 LOA GRIFFITH MONTEBELLO UNIFIED SCHOOL DISTRICT YORK RIVERSIDE ADJ4676736 MARGARITA MELENDEZ 99 CENTS ONLY STORES YORK RIVERSIDE ADJ6974616 MARIA ANGEL PEREZ 99 CENTS ONLY STORES YORK RIVERSIDE ADJ9040813 MARIA BRUSTER STEELWORKERS OLDTIMERS FOUNDATION YORK RIVERSIDE ADJ7268240 RAMIRO CRUZ DUTTON PLUMBING YORK RIVERSIDE ADJ6556079 ROBERT SCHILLING 99 CENTS STORE YORK RIVERSIDE ADJ6622862 RUDY SANCHEZ LUXFER GAS CYLINDERS YORK RIVERSIDE ADJ9447110 VICTOR ORTEGA ROBERTSONS TRANSPORT YORK RIVERSIDE ADJ8586270 AIDA AVAQ PETROSYAN IHSS YORK ROSEVILLE ADJ7656077 ALINA GARCIA FREAM TEAM SERVICES INC YORK ROSEVILLE ADJ2235169 ANNETTE NORTHUP ABC CHILD DEVELOPMENT YORK ROSEVILLE ADJ9561934 CHRISTINE JOHNSON IHSS RIVERSIDE COUNTY YORK ROSEVILLE ADJ8845696 CIRINO JACOBO LOCKHART STAFFING SMART TEK AUTOMATED SERVICES YORK ROSEVILLE ADJ8845696 CIRINO JACOBO VENTURA REGIONAL SANITATION DISTRICT YORK ROSEVILLE ADJ9070680 DENNIS BAKER LINCOLN TRAINING CENTER YORK ROSEVILLE ADJ8153384 DENYCE BUCK ORANGE COUNTY IN HOME SUPPORTIVE SERVICES YORK ROSEVILLE ADJ9184422 EMELIA CRUZ IHSS SAN DIEGO COUNTY YORK ROSEVILLE ADJ7329746 FLAVIO AMADO BAKERSFIELD POOL PLASTERING YORK ROSEVILLE ADJ7793730 GABRIELA SANCHEZ DREAM TEAM SERVICES INC YORK ROSEVILLE ADJ3156617 GLORIA PEREZ IHSS/PA YORK ROSEVILLE ADJ9371159 GOHAR DOURGARYAN IHSS YORK ROSEVILLE ADJ1771108 GRACIELA GUTIERREZ VEGA ANAHEIM HILLS CAR WASH YORK ROSEVILLE ADJ7196312 GREG HIATT JD ELECTRICIAN YORK ROSEVILLE ADJ8609175 HECTOR GUARNEROS DELTA HI TECH INC YORK ROSEVILLE ADJ6737934 JAIME PALAFOX INTERNATIONAL COATINGS INC YORK ROSEVILLE ADJ7384047 JESUS JIMENEZ ROADLINK SERVICES LP YORK ROSEVILLE ADJ9730315 JOSE FUNES VS CAR WASH YORK ROSEVILLE ADJ9606775 JUAN CARLOS ZENDEJAS OPTIMUS GROUP YORK ROSEVILLE ADJ7731157 KELLY CARRASCO SAN BERNARDINO CITY IN HOME SS YORK ROSEVILLE ADJ8953585 LUIS PERALTA MIS STAFFING SERVICES INC YORK ROSEVILLE ADJ8501803 MALUISA SARMIENTO DEPARTMENT OF SOCIAL SERVICES IHSS YORK ROSEVILLE ADJ8279581 MARIA ISABEL MARTINEZ IN HOME SUPPORT SERVICES YORK ROSEVILLE ADJ7124769 MARIA NAVARRO DEPT OF SOCIAL SERVICES IHSS YORK ROSEVILLE ADJ7124769 MARIA NAVARRO DEPT OF SOCIAL SEVICES IHSS YORK ROSEVILLE ADJ9491295 MARIA ROA ASSOCIATES MANAGEMENT RESOURCES YORK ROSEVILLE ADJ7671163 MILLIE ROSENQUEST COVINA VALLEY UNIFIED SCHOOL DISTRICT YORK ROSEVILLE ADJ6819262 MIN CHEN CA DEPT OF SOCIAL SERVICES YORK ROSEVILLE ADJ8326571 MIRIAM LINARES JEAN GENIE STUDIO YORK ROSEVILLE ADJ7041833 PEDRO GARCIA GARZA CONTRACTING INCORPORATION YORK ROSEVILLE ADJ6988854 QI YONG SHENG KROOUSA INC YORK ROSEVILLE ADJ7437674 RAUL BRAVO ROBERT HILARDES DBA SIERRA CATTLE COMPANY YORK ROSEVILLE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7437674 RAUL BRAVO SIERRA CATTLE CO YORK ROSEVILLE ADJ7410099 RAYMOND VILLASENOR ROWLAND UNIFIED SCHOOL DISTRICT YORK ROSEVILLE ADJ7220022 SHAADI GHASE EMAMI SOCIAL SERVICES AGENCY YORK ROSEVILLE ADJ9271892 SOILA ISABEL HERNANDEZ IHSS YORK ROSEVILLE ADJ9271892 SOILA ISABEL HERNANDEZ STATE OF CALIFORNIA YORK ROSEVILLE ADJ7521771 SPRING PETERS IN HOME HEALTH SERVICES YORK ROSEVILLE ADJ7693686 THOMAS ELSEY HESPERIA UNIFIED SCHOOL DISTRICT YORK ROSEVILLE ADJ8214373 WENDY BUMANLAG CENTRAL SCHOOL DIST YORK ROSEVILLE ADJ8682356 ALTHANIEL LUNSFORD IHSS PUBLIC AUTHORITY RIVERSIDE COUNTY YORK SACRAMENTO ADJ7358933 HELEN HERNANDEZ COUNTY OF ORANGE YORK SACRAMENTO ADJ804931 ANDRELL HOLLAND IN HOME SUPPORT SERVICE YORK SAN BERNARDINO ADJ6581088 DOLORES HERNANDEZ LOS ANGELES COUNTY DPSS YORK SAN BERNARDINO ADJ6910480 GISELE WHITE ADELANTO SCHOOL DIST YORK SAN BERNARDINO ADJ6910480 GISELE WHITE ADELANTO SCHOOL DISTRICT YORK SAN BERNARDINO ADJ7693686 THOMAS ELSEY HESPERIA UNIFIED SCHOOL DISTRICT YORK SAN BERNARDINO ADJ8365547 LINDA ARZAGA CATHOLIC CHARITIES YORK STOCKTON ADJ8169235 CARLOS GARCIA ADAMS LANDSCAPING YORK VALENCIA ADJ7470286 GASTON ESCOBAR PROCARE TREE SERVICE INC YORK VALENCIA ADJ1505706 GISSELE NOGUERA ARCHDIOCESE OF LOS ANGELES YORK VALENCIA ADJ7239410 JOSE ACOSTA SAN CONRADO CATHOLIC MISSION DBA ST PETERS CHURCH YORK VALENCIA ADJ7803063 MARIA MALANCO AMPM MAINTENANCE SERVICES YORK VALENCIA ADJ7284059 MARIO CASTELLANOS ROADLINK WORKFORCE SOLUTIONS YORK VALENCIA ADJ8265388 MIGUEL SIMON SAN SAI JAPANESE GRILL YORK VALENCIA ADJ6988854 QI YONG SHENG KROOUSA INC YORK VALENCIA ADJ1814795 SHAWN WASHINGTON PALMDALE SCHOOL DISTRICT YORK VALENCIA ADJ7578674 STEVE VALENCIA OUTSOURCE YORK VALENCIA ADJ7277437 WEI YING ZHOU FORTUNE AVENUE FOODS INC YORK VALENCIA ADJ7458231 WENDY GONZALEZ CAPITOL CLEANING WEST COAST YORK VALENCIA ADJ7092889 ANGELA CHAVEZ ROYAL CATERING ZENITH ADJ6645824 CONRADO SANCHEZ MORALES DASHUN FISHERIES, INC ZENITH ADJ8432504 GABINO ARELLANO SIMPLY SPLENDID BAKERY ZENITH ADJ7181314 JOSE ZETINA DESERT COMERCIAL CONCRETE ZENITH ADJ9801124 LIDIA MONTES ECLIPSE RECREATIONAL VEHICLE INC. ZENITH ADJ3709525 MARIANO MICHEL DAMERON ALLOY FOUNDRIES ZENITH ADJ322896 REBECCA READING STEVEN M. WOLFRAM. DDS. INC. ZENITH ADJ322896 REBECCA READING STEVEN WOLFRAM DDS ZENITH ADJ644745 ROSA GARFIAS ABC EMBROIDERY ZENITH ADJ644745 ROSA GARFIAS ARNULFO CARDENAS DBA ABC UNIFORM ZENITH ADJ5827704 TOMASA LOPEZ COLORADO FARMS ZENITH ADJ7876865 AILIRIO QUINTERO VASQUEZ RUSNAK AUDI ZENITH FRESNO ADJ7838355 ALFREDO HERNANDEZ PRM CORPORATION ZENITH FRESNO ADJ7838355 ALFREDO HERNANDEZ RUSNAK WESTLAKE ZENITH FRESNO ADJ8024586 CARLOS CHAVEZ RICHMAR FARMS ZENITH FRESNO ADJ7910803 ELIGIO NAVA HEIN ELLEN HETTINGA DAIRY ZENITH FRESNO ADJ7827914 FERNANDO AREVALO EXCELSIOR FARMING LLC ZENITH FRESNO ADJ9294092 GERARDO GONZALEZ MISSION PRODUCE ZENITH FRESNO ADJ6935989 GRACIELA GALLEGOS THE STANDARD HOTEL ZENITH FRESNO ADJ8272356 HECTOR RODRIGUEZ BENNIE GONSALVES DAIRY ZENITH FRESNO ADJ8115166 HOMERO GALVAN ARTESIA DAIRY FARMS LLC ZENITH FRESNO ADJ8033491 IMGARD LIMA EASTERN TECHNOLOGY ZENITH FRESNO ADJ9420113 JOSE CORNEJO TAPIA BIDART DAIRY II ZENITH FRESNO ADJ7425079 JOSE TAPIA NAVA SANTILLAN FARM LABOR ZENITH FRESNO ADJ7917727 JUAN CASTRO BRENT WOOD PRODUCTS INC ZENITH FRESNO ADJ7932701 LAKHBIR SINGH HARMAN STAR MART DBA G AND P MINI MART ZENITH FRESNO ADJ6670527 MARGARITO HERNANDEZ ORTIZ DICK DYKSTRA DAIRIES ZENITH FRESNO ADJ8264091 MARIA CARACOZA LEMINOR ZENITH FRESNO ADJ7339441 MARIA TERESA ANDRADE SANTELLAN FARM LABOR ZENITH FRESNO ADJ9366346 MARIA VENTURA DE MARTINEZ KUNDERT BROTHERS FARMS ZENITH FRESNO ADJ9417750 MARIBEL BELLO DIAZ WAHOOS FISH TACOS ZENITH FRESNO ADJ7711453 MARIO JUAREZ VALET SERVICES LAUNDRY ZENITH FRESNO ADJ9149334 MARTIN LOPEZ MAPLE DAIRY LP ZENITH FRESNO ADJ7493175 MAURICIO RAMOS VANDEN BURGE DAIRY ZENITH FRESNO ADJ9242744 MIGUEL ZAMORA MENDOZA SEQUOIA ORANGE COMPANY INC ZENITH FRESNO ADJ9375852 RAFAEL ANAYA AWI MANAGEMENT CORPORATION ZENITH FRESNO ADJ9179447 ROMANO LUEVANO LEMINOR INCORPORATED ZENITH FRESNO ADJ7122292 SAN JUANA HERNANDEZ KINGSBURG ORCHARDS ZENITH FRESNO ADJ9352038 SAUL GOMEZ ENRIQUEZ CURTI FAMILY INC ZENITH FRESNO ADJ8454611 SILVESTRE VELASCO JERRYS FAMOUS DELI ZENITH FRESNO ADJ7977765 UBALDO VIEYRA TREEHOUSE CALIFORNIA ALMONDS ZENITH FRESNO ADJ9500705 BERTA MONTES REYES COLORADO FARMS ZENITH INSURANCE COMPANY ADJ3618180 PEDRO ROCHA TOM ALGER DAIRY ZENITH INSURANCE COMPANY ADJ7767174 ANA PEREZ DE VILLANUEVA CAPAY INC DBA FARM FRESH TO YOU ZENITH ORANGE ADJ9405168 ANDRES GUZMAN SAM WOO RESTAURANT ZENITH ORANGE ADJ7404126 ANTONIO GONZALEZ GATEWAYS HOSPITAL AND MENTAL HEALTH CENTER ZENITH ORANGE ADJ7471903 CESAR CABRERA THE QUARRY ATLA ZENITH ORANGE ADJ8229265 CHERYL TAGLAVORE CONVENIENCE MANAGEMENT VALERO ZENITH ORANGE ADJ7077578 ELIAS QABILLE SOLARI ENTERPRISES INC ZENITH ORANGE ADJ7177644 ENRIQUE ALVARADO SOUTHWEST AQUATICS ZENITH ORANGE ADJ7648607 ERIC HERNANDEZ ESCOTO GRANA INDUSTRIAL FINISHER ZENITH ORANGE ADJ7648607 ERIC HERNANDEZ ESCOTO PENTRATE METAL PROCESSING INC ZENITH ORANGE ADJ8629432 FERNANDO PENAFIEL KIMSUSEA FOOD RESTAURANT ZENITH ORANGE ADJ7578609 FILIBERTO CANO TUDOR RANCH INC ZENITH ORANGE ADJ8009777 FRANCISCO DURAN YALE CHASE ZENITH ORANGE ADJ7411124 FRANCISCO MEJIA DINAHS CHICKEN ZENITH ORANGE ADJ7088602 HERMENENGILO GAXIOLA KELLOGG GARDEN PRODUCTS ZENITH ORANGE Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9525312 ISRAEL ZEPAHUA SANCHEZ NAKORN GROUP INC ZENITH ORANGE ADJ6743506 JANICE GAY TUTOR TIME LEARNING ZENITH ORANGE ADJ7082756 JAVIER MARTINEZ AMERICAS LABOR SUPPLY ZENITH ORANGE ADJ7568301 JOSE GARCIA SENCO ENTERPRISES INC ZENITH ORANGE ADJ7603152 JOSE VAZOUEZ ALEWYN FAMILY TRUST DAIRY ZENITH ORANGE ADJ5811216 JOSE ZERMENO IMPORT GLASS CORPORATION ZENITH ORANGE ADJ7932701 LAKHBIR SINGH HARMAN STAR MART DBA G AND P MINI MART ZENITH ORANGE ADJ6821265 LORETTA LOPEZ ROBERT DAVIES DDS ZENITH ORANGE ADJ8095249 LUIS LOZANO LA DESSERTS ZENITH ORANGE ADJ7787792 MANUEL RODRIGUEZ PINNACLE FARMS ZENITH ORANGE ADJ6692383 MARIE QUINONES COMPEX ZENITH ORANGE ADJ6692383 MARIE QUINONES COMPEX LEGAL SERVICES INC ZENITH ORANGE ADJ9107076 MAURICIO VAZQUEZ JEONG WON KOREAN BBQ BUFFET ZENITH ORANGE ADJ8768830 PAULA BRAVO KIMSU SEAFOOD ZENITH ORANGE ADJ6803181 PEDRO ORTEGA RANCHEVENTS ZENITH ORANGE ADJ7164589 RAMON RODRIGUEZ GRUBER FARMS INC ZENITH ORANGE ADJ7349651 RIGOBERTO DE ANDA DICK DYKSTRA DAIRIES ZENITH ORANGE ADJ9032316 SHU ZHANG AJISEN RAMEN NORTH AMERICA INC ZENITH ORANGE ADJ8849066 JOSE MEDEL SALAS JOHN WESTSTEYN CATTLE ZENITH PLEASANTON ADJ8584690 LUCIA BARAJAS PREMIERE RASPBERRIES LLC ZENITH PLEASANTON ADJ7822808 RUDY CATALAN GOLDEN EMPIRESHELLING ZENITH PLEASANTON ADJ8822981 RODRIGO LARIOS MILKY WAY DAIRY ZENITH SACRAMENTO ADJ7523217 ADAN JABALERA MOOLANE RANCH ZENITH SAN DIEGO ADJ4505942 ALEJANDRO GONZALEZ PENINSULA INDUSTRIES ZENITH SAN DIEGO ADJ7073472 CARLOS ARELLANES D A V INDUSTRIES ZENITH SAN DIEGO ADJ6796583 EDUARDO MORAN ESCONDIDO LANDSCAPE INC ZENITH SAN DIEGO ADJ7968676 ELISA GOMEZ DE CORTEZ WESTERN HORTICULTURE INC ZENITH SAN DIEGO ADJ9094006 FAUSTINO CATALAN THE BRIGANTINE ZENITH SAN DIEGO ADJ7706652 FELIPE BEDOLLA COUNTY BUILDING SERVICES INC ZENITH SAN DIEGO ADJ7264995 FREDDY RAMIREZ GRAND PACIFIC RESORTS ZENITH SAN DIEGO ADJ9149340 GERARDO GONZALEZ J C ENTERPRISES ZENITH SAN DIEGO ADJ9149340 GERARDO GONZALEZ JSC ENTERPRISES ZENITH SAN DIEGO ADJ6610611 GRACIELA AGUILAR GRAND PACIFIC RESORTS ZENITH SAN DIEGO ADJ8269710 GREGORIO REYES DAVLYN INVESTMENTS ZENITH SAN DIEGO ADJ9625602 GUADALUPE HUGHLETT MACC RPJECT HEADSTART ZENITH SAN DIEGO ADJ8396199 HECTOR SEVILLA PACIFIC PROPERTIES SERVICE ZENITH SAN DIEGO ADJ533536 JADHIR VIDANO ROGERS & ROGERS NISSAN ZENITH SAN DIEGO ADJ4115038 JAMES REID BRAD STONER PAINTING ZENITH SAN DIEGO ADJ6595490 JESUS SANCHEZ ISLAND APARTMENTS ZENITH SAN DIEGO ADJ7724433 JOSE TRINIDAD ARREDONDO MORENO EDCO HARVEST ZENITH SAN DIEGO ADJ7724433 JOSE TRINIDAD ARREDONDO MORENO MAINAS FARMS ZENITH SAN DIEGO ADJ8696704 JULIO PACHECO WAHOOS FISH TACOS ZENITH SAN DIEGO ADJ6485847 KATHERINE TOOMER NEIGHBORHOOD HOUSE ASSOCIATION ZENITH SAN DIEGO ADJ6726015 LYNDA HURD MOTIVIATIONAL SYSTEMS ZENITH SAN DIEGO ADJ7283862 MARIA HERRERA TEAMWORK ATHLETIC APPAREL ZENITH SAN DIEGO ADJ4168314 MARIA QUINTANA T REX PRODUCTS ZENITH SAN DIEGO ADJ2081452 MARIA ROMERO CEJA PLASTIC ENGINEERING & DEVELOPMENT ZENITH SAN DIEGO ADJ4219208 MARIA TERESA MARTINEZ CALDERON BUILDING MAINTENANCE ZENITH SAN DIEGO ADJ3169528 MARIA TRONCOSO TAYLOR-LISTUG, INC ZENITH SAN DIEGO ADJ6960347 MIRNA VEGA AMERICAN INNOTEK INC ZENITH SAN DIEGO ADJ8216493 NOEL GALEANA LA JOLLA BEACH AND TENNIS CLUB ZENITH SAN DIEGO ADJ9289053 OCTAVIO PINEDA RODRIGUEZ CHANNEL ISLANDS VEGETABLE FARM ZENITH SAN DIEGO ADJ7863400 PEDRO PEREZ CLIFTON CAFETERIA ZENITH SAN DIEGO ADJ9375852 RAFAEL ANAYA AWI MANAGEMENT CORPORATION ZENITH SAN DIEGO ADJ1293788 ROBERT VILLEGAS EUROPEAN NATURAL STONE CO ZENITH SAN DIEGO ADJ8519888 SILVINO GONZALEZ MARZ FARMS ZENITH SAN DIEGO ADJ6452483 SOCORRO SANCHEZ PFS MANAGEMENT CO. ZENITH SAN DIEGO ADJ8033393 VICTORIANO IBARRA FARM ACW ZENITH SAN DIEGO ADJ8950041 VIRIDIANA SERRANO GANESH INVESTMENTS ZENITH SAN DIEGO ADJ7169548 ACENCIO NUNEZ STERLING PACIFIC MEAT COMPANY ZENITH WOODLAND HILLS ADJ8949526 ALFREDO ARGUETA LA BREA DINING CALIFORNIA ZENITH WOODLAND HILLS ADJ6796395 ALFREDO CAMPOS JAMES R CHEN INC ZENITH WOODLAND HILLS ADJ7838355 ALFREDO HERNANDEZ PRM CORPORATION ZENITH WOODLAND HILLS ADJ7838355 ALFREDO HERNANDEZ RUSNAK WESTLAKE ZENITH WOODLAND HILLS ADJ9241008 ANA LUISA DIAZ EL TAPATIO MARKETS INC ZENITH WOODLAND HILLS ADJ7884336 ANA ORTIZ UNITED STAFFING SERVICES ZENITH WOODLAND HILLS ADJ300248 ANGELA RESENDIZ MULLIGANS FAMILY FUN CENTER ZENITH WOODLAND HILLS ADJ2949619 ARMANDO MANZO STARVING STUDENTS ZENITH WOODLAND HILLS ADJ974584 BENITO CRUZ HEIN HETTINGA ZENITH WOODLAND HILLS ADJ7737960 BRAGANA JOHNSON HATHAWAY SYCAMORE ZENITH WOODLAND HILLS ADJ1135805 BRIAN COOPER MASTERS SERVICES ZENITH WOODLAND HILLS ADJ8164774 BYRON VALLECILLO VISTA PROFESSIONAL OUTDOOR LIGHTING ZENITH WOODLAND HILLS ADJ7437406 CARLOS BERNAL AMAPOLA RICO TACO ZENITH WOODLAND HILLS ADJ8031291 CELINA CAMPOS BROADWAY CENTURY ZENITH WOODLAND HILLS ADJ8031291 CELINA CAMPOS BROADWAY CETURY DBA GRAND SHELL & SUBWAY ZENITH WOODLAND HILLS ADJ8229265 CHERYL TAGLAVORE CONVENIENCE MANAGEMENT VALERO ZENITH WOODLAND HILLS ADJ7371954 CHRISTIAN AVELAR LOWEY ENTERPRISES INC ZENITH WOODLAND HILLS ADJ6500273 CHRISTIAN POLANCO I AND E CABINETS ZENITH WOODLAND HILLS ADJ2959769 DEARDRA WASHINGTON PHYSICIANS MGMT GROUP PARTNERS LLC ZENITH WOODLAND HILLS ADJ9064879 EDALI SALGADO RINCON PACIFIC LLC ZENITH WOODLAND HILLS ADJ1734047 EDGAR CALDERON LAWRENCE ROLL UP DOORS ZENITH WOODLAND HILLS ADJ2786872 EDGAR MATZAR VISTA PROF OUTDOOR LIGHT ZENITH WOODLAND HILLS ADJ6890803 EDITH HERNANDEZ BLUE RIVER DENIM INC ZENITH WOODLAND HILLS ADJ6637360 ELIAS GARDUNO ANA MARIA LOPEZ AND JORGE LOPEZ ZENITH WOODLAND HILLS ADJ6637360 ELIAS GARDUNO ANA MARIA REYES LOPEZ ZENITH WOODLAND HILLS ADJ7648607 ERIC HERNANDEZ ESCOTO GRANA INDUSTRIAL FINISHER ZENITH WOODLAND HILLS Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7648607 ERIC HERNANDEZ ESCOTO PENTRATE METAL PROCESSING INC ZENITH WOODLAND HILLS ADJ1300065 EVELYN CHAVES GIRL SCOUT COUNCIL OF ORANGE COUNTY ZENITH WOODLAND HILLS ADJ8380341 FELIPE FLORES ATLAS CONSTRUCTION SUPPLY ZENITH WOODLAND HILLS ADJ9122980 FERNANDO MURILLO IMPERIAL CITY HOTPOT RESTAURANT ZENITH WOODLAND HILLS ADJ8629432 FERNANDO PENAFIEL KIMSUSEA FOOD RESTAURANT ZENITH WOODLAND HILLS ADJ1607820 FLOYD MAYS RAPHAELS PARTY RENTALS ZENITH WOODLAND HILLS ADJ7639879 FRANCISCO ALVAREZ AMERICA BERRY FARMS ZENITH WOODLAND HILLS ADJ9216520 FREDDY PEREZ STEVE GUTIERREZ DBA MARINA CLASSIC CARWASH ZENITH WOODLAND HILLS ADJ6513883 GLORIA VIDAURRI LELAND NURSERY & PATIO SUPPLY INC. ZENITH WOODLAND HILLS ADJ3670186 GRACIELA ROJANO RED BARN PET PRODUCTS ZENITH WOODLAND HILLS ADJ551430 GREGORIO GONZALEZ CALIFORNIA FURNITURE SUPPLY INC ZENITH WOODLAND HILLS ADJ2884922 GREGORIO SONCHAY SNUGTOP ZENITH WOODLAND HILLS ADJ7234177 GUSTAVO VILLALPANDO EL MONTE RV ZENITH WOODLAND HILLS ADJ6699937 HECTOR FONSECA CIPOLLA AND CALABA ZENITH WOODLAND HILLS ADJ6699937 HECTOR FONSECA NATION AUCTION SYSTEMS INC ZENITH WOODLAND HILLS ADJ9150781 HERMELINDA JUAN GUPPY LAS TUNAS ZENITH WOODLAND HILLS ADJ2342280 HORACIO BRAN ROJAS U.S. POLE INC ZENITH WOODLAND HILLS ADJ8033491 IMGARD LIMA EASTERN TECHNOLOGY ZENITH WOODLAND HILLS ADJ884706 IRENE TIRADO MINSON CORPORATION ZENITH WOODLAND HILLS ADJ4414084 IRMA ARZOLA SHERWOOD MANAGEMENT COMPANY ZENITH WOODLAND HILLS ADJ725833 IRMA ARZOLA SHERWOOD MANAGEMENT COMPANY ZENITH WOODLAND HILLS KATHY TUCKER DBA TELECOMMUNICATIONS BUSINESS ADJ2359790 JAVIER CRISANTO ZENITH WOODLAND HILLS SOLUTIONS ADJ2359790 JAVIER CRISANTO TELECOMMUNICATIONS BUSINESS SOLUTIO ZENITH WOODLAND HILLS ADJ7603688 JESUS CALVILLO WESTWOOD HORIZONS ZENITH WOODLAND HILLS ADJ6466038 JOAQUIN HERBACH BWN PARTNERS DBA BEN WA NOVELTY ZENITH WOODLAND HILLS ADJ6909443 JOHN CLOVIS ANGEL VIEW CRIPPLED CHILDRENS FOUNDATION INC ZENITH WOODLAND HILLS ADJ1749330 JORGE JARAMILLO CECIL SAYDAH CO ZENITH WOODLAND HILLS ADJ2008840 JORGE JARAMILLO GARDEN PRINTS ZENITH WOODLAND HILLS ADJ6729111 JOSE CARVALLO R W LYALL AND CO INC ZENITH WOODLAND HILLS ADJ7661375 JOSE CERVANTES TOTAL RESOURCESNTERNATIONAL ZENITH WOODLAND HILLS ADJ9203065 JOSE DE JESUS ORGANISTA STATEWIDE LABOR CORPORATION ZENITH WOODLAND HILLS ADJ6611302 JOSE DIAZ JANITORIAL MANAGEMENT SERVICES ZENITH WOODLAND HILLS ADJ6610106 JOSE HIGAREDA GONZALEZ SOUTHWEST AQUATICS ZENITH WOODLAND HILLS ADJ3047305 JOSE NOE FONSECA CORSICAN FURNITURE ZENITH WOODLAND HILLS ADJ8218793 JOSE TORRES INDEPENDENT REPAIR ZENITH WOODLAND HILLS ADJ6718289 JUAN DIAZ SUN VALLEY JERSEY DAIRY INC ZENITH WOODLAND HILLS ADJ6420109 JUAN FRANCISCO SOSA MOUNTAIN VIEW TERRACE ZENITH WOODLAND HILLS ADJ8193252 JUAN MARIN R R LEONARD CO ZENITH WOODLAND HILLS ADJ3081605 JUAN NUNO WESTERN INTEGRATED MATERIALS ZENITH WOODLAND HILLS ADJ4472208 JULIA JUAREZ SUPER COLOR DIGITAL ZENITH WOODLAND HILLS ADJ7058905 KAREN CANDELAS RIMPCO INC ZENITH WOODLAND HILLS ADJ9089326 LIZBETH SANCHEZ R M PACIFIC RIM ZENITH WOODLAND HILLS ADJ6821265 LORETTA LOPEZ ROBERT DAVIES DDS ZENITH WOODLAND HILLS ADJ7534721 LUIS HURTADO ALEWYN DAIRY ZENITH WOODLAND HILLS ADJ3904269 LUIS LANGARICA TWIN PALMS ENTERTAINMENT ZENITH WOODLAND HILLS ADJ8629191 MANUEL ARIAS WINCHESTER FARMS ZENITH WOODLAND HILLS ADJ9142637 MARBELLA RAMIREZ PFS MANAGEMENT CO INC DBA MCDONALD S ZENITH WOODLAND HILLS ADJ7608116 MARIA CIPRES EL TAPATIO MARKETS INC ZENITH WOODLAND HILLS ADJ3392521 MARIA NUNEZ ANZA MANAGEMENT CO ZENITH WOODLAND HILLS ADJ7682447 MARIA RICO CALANDRI SONRISE FARMS LP ZENITH WOODLAND HILLS ADJ7339441 MARIA TERESA ANDRADE SANTELLAN FARM LABOR ZENITH WOODLAND HILLS ADJ6692383 MARIE QUINONES COMPEX ZENITH WOODLAND HILLS ADJ6692383 MARIE QUINONES COMPEX LEGAL SERVICES INC ZENITH WOODLAND HILLS ADJ7931373 MARIO OCAMPO D E L T A RESCUE ZENITH WOODLAND HILLS ADJ7931373 MARIO OCAMPO DELTA RESCUE ZENITH WOODLAND HILLS ADJ955380 MARIO VIVAR JMS AIR CONDITIONING & HEATING, INC ZENITH WOODLAND HILLS ADJ9058085 MARTHA SEDANO FOODOLOGY ZENITH WOODLAND HILLS ADJ8546209 MICHAEL CONNELLY LA PHILHARMONIC ASSOC ZENITH WOODLAND HILLS ADJ8019159 MIGUEL RANGEL ALARCON PRIME CONVERTING CORPORATION ZENITH WOODLAND HILLS ADJ6839833 MINERVA PADILLA KRACO ENTERPRISES LLC ZENITH WOODLAND HILLS ADJ9480605 MORENA CALDERON COLORADO FARMS LLC ZENITH WOODLAND HILLS ADJ3711075 NASRULLA MUSTAFA THE HUNTINGTON LIBRARY ZENITH WOODLAND HILLS ADJ6629467 NEFTALI MEDRANO PACIFIC TERRAIN LANDSCAPE MAINTENANCE ZENITH WOODLAND HILLS ADJ9332847 NORA VALCARCEL RIO VISTA DEVELOPMENT ZENITH WOODLAND HILLS ADJ8720748 OCIEL VASQUEZ TJ LAM & COMPANY DBA THAI BAMBO BISTRO ZENITH WOODLAND HILLS ADJ8196257 OCTAVIA GALIZ DELTA RESCUE ZENITH WOODLAND HILLS ADJ7819021 OFELIA MORALES FLORES MUGU RANCH PARTNERSHIP ZENITH WOODLAND HILLS ADJ3229749 PAMELA MCDANIEL ADVANCED BUSINESS GRAPHICS ZENITH WOODLAND HILLS ADJ7353225 PATRICIA RUIZ WAHOOS FISH TACOS ZENITH WOODLAND HILLS ADJ1305354 PATRICIA SEGOVIA CAFE SOBOBA ZENITH WOODLAND HILLS ADJ8189211 PHETCHARAT WIENGIN 02 JAPANESE RESTAURANT INC ZENITH WOODLAND HILLS ADJ8189211 PHETCHARAT WIENGIN 02 SUSHI JAPANESE RESTAURANT INC ZENITH WOODLAND HILLS ADJ3271481 RACHEL GONZALEZ PLAZA COPY & IMAGING ZENITH WOODLAND HILLS ADJ6416684 RAFAEL RUIZ COSMEDX SCIENCE INC ZENITH WOODLAND HILLS ADJ411355 RAMIRO OSEGUERA M.T.M. CORP. DBA AIRPORT PARK VIEW ZENITH WOODLAND HILLS ADJ7383365 RAUL MEDINA GUILLEN MAGANA LABOR SERVICES ZENITH WOODLAND HILLS ADJ322896 REBECCA READING STEVEN M. WOLFRAM. DDS. INC. ZENITH WOODLAND HILLS ADJ322896 REBECCA READING STEVEN WOLFRAM DDS ZENITH WOODLAND HILLS ADJ7476265 SANG NHAT LY DER LIH ELECTRIC INC ZENITH WOODLAND HILLS ADJ7189766 SARBELIO GALINDO MODERN VIDEOFILM, INC, ZENITH WOODLAND HILLS ADJ7194022 SHAWNAMARIE MONTANO SECOND IMAGE INC ZENITH WOODLAND HILLS ADJ5827704 TOMASA LOPEZ COLORADO FARMS ZENITH WOODLAND HILLS ADJ7544188 VERONICA PORON PALMDALE ELVADO MARKET INC/ARCO ZENITH WOODLAND HILLS ADJ7521551 VICTOR VILLALTA SUNRISE PRODUCE ZENITH WOODLAND HILLS ADJ3469067 ZOILA MIRANDA JOHNSON DIELECTRICS ZENITH WOODLAND HILLS Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7169396 JOSE SALAZAR ZIXTA ENTERPRISES ZIXTA ENTERPRISES ADJ7169396 JOSE SALAZAR ZIXTA ENTERPRISES DBA VALLARTA SUPERMARKETS ZIXTA ENTERPRISES ADJ7884336 ANA ORTIZ UNITED STAFFING SERVICES ZNAT INSURANCE COMPANY ADJ7254166 TRINIDAD OMANA ROOSEVELT HOTEL ZURICH ADJ7205444 ALMA BARBA BURLINGTON COAT FACTORY ZURICH AMERICAN ADJ9328734 JESUS CORRAL LAX WHEEL REFINISHING INC ZURICH AMERICAN DALLAS ADJ9328734 JESUS CORRAL PLATINUM STAFFING 6 ZURICH AMERICAN DALLAS ADJ9533652 PRICILIANA GUTIERREZ QUALITY BUSINESS SOLUTIONS ZURICH AMERICAN DALLAS ADJ9757255 MANUEL BASTIDAS CALIFORNIA CARE CENTERS INC ZURICH AMERICAN INSURANCE COMPANY ADJ7474877 JESUS RUIZ ALLAN COMPANY ZURICH INSURANCE ADJ9465178 ADELA MONTOYA MICRO SOLUTION ENTERPRISES ZURICH LOS ANGELES ADJ8306326 ADRIAN ANAYA CAMPUS FOODS ZURICH LOS ANGELES ADJ8721444 ADRIAN PEREZ ARAUJO LABEL SPECIALTIES INC ZURICH LOS ANGELES ADJ6806987 AGUSTIN OCHOA DOS ORDERLY KIDS LLC ZURICH LOS ANGELES ADJ7016356 ALEJANDRO CURIEL SOUTH BAY SAND BLASTING ZURICH LOS ANGELES ADJ9653321 ALEJANDRO GALINDO SANMINA ZURICH LOS ANGELES ADJ9060286 ALEJANDRO TORRES CARDINAL LOGISTICS ZURICH LOS ANGELES ADJ7430496 ALEJO HIGAREDA BEVERLY HILLS PRESBYTERIAN CHURCH ZURICH LOS ANGELES ADJ7191869 ALICIA SILVA GARDEN GROVE UNIFIED SCHOOL DISTRICT ZURICH LOS ANGELES ADJ7191869 ALICIA SILVA WAREHOUSE DEMO SERVICES ZURICH LOS ANGELES ADJ7724142 AMALIA MONTANO LIFOAM INDUSTRIES LLC ZURICH LOS ANGELES ADJ4224251 AMANDA MEDINA DIVERSIFIED MAINTENANCE SERVICES ZURICH LOS ANGELES ADJ7201112 AMPARO ORTIZ LAKE BALBOA POST ACUTE REHABILITATION ZURICH LOS ANGELES ADJ7627163 ANA LEDESMA HISHEAR CORP ZURICH LOS ANGELES ADJ7123473 ANDRES MARCOS PACIFIC CLAY PRODUCTS INC ZURICH LOS ANGELES ADJ6806724 ANDRES TUCUBAL CRAIG PAULEY AND ASSOCIATES INC ZURICH LOS ANGELES ADJ7147004 ANDREW DOWDELL TERMINEX INTERNATIONAL ZURICH LOS ANGELES ADJ6958658 ANGEL GARCIA HI SHEAR CORP A DELAWARE ZURICH LOS ANGELES ADJ326967 ANGEL MENDOZA BENIHANA INC ZURICH LOS ANGELES ADJ7203967 ANGELICA MACIAS WILLIAM SCOTSMAN INC ZURICH LOS ANGELES ADJ3387049 ANGELICA RODRIGUEZ MARRIOTT ZURICH LOS ANGELES ADJ6489441 ANTONIO AYALA SUMMIT PLASTERING INC ZURICH LOS ANGELES ADJ7827948 ARCELY VALENCIA HEALTHCARE SERVICES GROUP ZURICH LOS ANGELES ADJ8804253 ARCHIE RAY WALKER BRINDERSON CONSTRUCTORS ZURICH LOS ANGELES ADJ6983829 ASUSENA LOPEZ LAGUNA CLIFF MARRIOTT ZURICH LOS ANGELES ADJ6983829 ASUSENA LOPEZ LAGUNA CLIFFS MARRIOTT ZURICH LOS ANGELES ADJ9247963 AYDEE NIETO HEALTHCARE SERVICES GROUP ZURICH LOS ANGELES ADJ6585618 BEATRIZ AGUIRRE DIVERSIFIED MAINTENANCE SERVICES ZURICH LOS ANGELES ADJ9743219 BEATRIZ GONZALEZ STAYSAFE STAFFING INC DBA HORIZON PERSONNEL SERVICES ZURICH LOS ANGELES

ADJ9743219 BEATRIZ GONZALEZ STAYSAFE STAFFING INC. DBA HORIZON PERSONNEL SERVICES ZURICH LOS ANGELES ADJ7222282 BERNARDO ALEMAN THE MAILING HOUSE ZURICH LOS ANGELES ADJ7222282 BERNARDO ALEMAN THE MAILING HOUSE INC ZURICH LOS ANGELES ADJ6669514 BERTHA ARGUETA PHILLIPS INDUSTRIES ZURICH LOS ANGELES ADJ7636860 BIJAN ARJANG SMG LONG BEACH F AND B ZURICH LOS ANGELES ADJ8903449 BLAINE GOMEZ PENN AIR CONTROL ZURICH LOS ANGELES ADJ8905663 BLANCA RODRIGUEZ EASY WORK SOLUTIONS WEST LLC ZURICH LOS ANGELES ADJ9134333 BRIAN RAMPERSAD VERENGO SOLAR ZURICH LOS ANGELES ADJ7348721 CARLOS AGUINAGA LAC IRVINE CO ZURICH LOS ANGELES ADJ9472889 CARLOS CASTELLANOS MT SINAI MEMORIAL PARK ZURICH LOS ANGELES ADJ9412362 CARLOS GARCIA AFFORDABLE MOVERS ZURICH LOS ANGELES ADJ8036916 CARLOS GUERRERO AUTUMN MILLING CO ZURICH LOS ANGELES ADJ7505762 CARLOS REYES JOE S CRAB SHACK INC ZURICH LOS ANGELES ADJ8236049 CARLOS SOTELO ORANGE COUNTY INSTALLERS ZURICH LOS ANGELES ADJ3492557 CARMEN CASTANEDA DIVERSIFIED MAIN SERVICES DBA D.M.S ZURICH LOS ANGELES ADJ3734994 CESAR CALLEROS PICK YOUR PART ZURICH LOS ANGELES ADJ9432598 CLAUDIA LOPEZ ABLE BUILDING MAINTENANCE ZURICH LOS ANGELES ADJ2973393 CLEVETTE THOMAS WELLPOINT INC ZURICH LOS ANGELES ADJ7234015 CONSUELO SANTIAGO VENTURE RESOURCE GROUP SUPERIOR EMPLOYMENT SERVICES ZURICH LOS ANGELES ADJ7456865 CYNTHIA VAN DYKE PEREZ ANCON MARINE INC ZURICH LOS ANGELES ADJ9288656 DANIEL MARTINEZ SALAZAR COURTESY STAFFING INC ZURICH LOS ANGELES ADJ1212063 DANIEL MEDRANO GOTHIC LANDSCAPING INC ZURICH LOS ANGELES ADJ7912855 DANIEL RODRIGUEZ DSC LOGISTICS ZURICH LOS ANGELES ADJ8083786 DAVID GUTIERREZ MOTHERS NUTR1TLONAL CENTER INC ZURICH LOS ANGELES ADJ7188800 DELIA ALAMO VICTORIA SPRINGS ZURICH LOS ANGELES ADJ3428841 DELMYS TURCIOS R&B REALTY GROUP ZURICH LOS ANGELES ADJ7350981 DESIREE LEWIS CHUGACH MCKINLEY ZURICH LOS ANGELES ADJ3810225 DIANNA SCOGGINS COMMODITY LOGISTICS WEST, INC. ZURICH LOS ANGELES ADJ3810225 DIANNA SCOGGINS INGRAM MICRO ZURICH LOS ANGELES ADJ3810225 DIANNA SCOGGINS INGRAN MICRO ZURICH LOS ANGELES ADJ3047302 DIEM VAN TRAN F.C.I. U.S.A., INC. ZURICH LOS ANGELES ADJ7628812 DIONICIA CRUZ ON-CALL STAFFING SERVICES ZURICH LOS ANGELES ADJ6644809 DIONICIA REYES DIVERSIFIED MAINTENANCE SERVICES ZURICH LOS ANGELES ADJ8924360 DULCE FLORES AMC OUTSOURCING ZURICH LOS ANGELES ADJ8924360 DULCE FLORES PARIS ACCESSORIES ZURICH LOS ANGELES ADJ7628785 EDGAR NAVA KHS & S CONTRACTORS ZURICH LOS ANGELES ADJ7651877 ELENA MARTINEZ HOLIDAY INN SANTA MONICA ZURICH LOS ANGELES ADJ8479065 ELIJIO PEDRAZA CARDENAS DEL AMO CONTRUCTION INC ZURICH LOS ANGELES ADJ7690716 ELISEO CASTANEDA JOHNNY CARINOS ZURICH LOS ANGELES ADJ8087685 ELSA CONTRERAS OKAMI ZURICH LOS ANGELES ADJ9299261 ELVA ALCALA MARTINEZ AWARE PRODUCTS ZURICH LOS ANGELES ADJ9299261 ELVA ALCALA MARTINEZ STAY SAFE STAFFING INC DBA HORIZON PERSONNEL SERVICES IN ZURICH LOS ANGELES ADJ9404813 ELVIRA JUAREZ WORLD VARIETY PRODUCE ZURICH LOS ANGELES Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ7427611 EMILIO RAMOS FLYING J INC ZURICH LOS ANGELES ADJ9362196 EMMANUEL CHOLULA SHERATON UNIVERSAL ZURICH LOS ANGELES ADJ8374887 ENRIQUE CONTRERAS COOPER SERVICES ZURICH LOS ANGELES ADJ8226812 ERIC CARTMELL SEARLES VALLEY MINERAL ZURICH LOS ANGELES ADJ6749655 ERIC CASTRO DS WATERS SPARKLETTS ZURICH LOS ANGELES ADJ7442658 ERICKA MORE COUNTRY VILLA OF RIVERSIDE ZURICH LOS ANGELES ADJ9270809 ERNEST FORD MONDRIAN HOTEL ZURICH LOS ANGELES ADJ8253235 ERNESTO HUERTA EL POLLO LOCO ZURICH LOS ANGELES ADJ8484531 ERNESTO NAVARRO CSM BAKERY PRODUCTS ZURICH LOS ANGELES ADJ8902505 ESPERANZA BUSTOS CARLISLE INTERCONNECT TECHNOLOGIES ZURICH LOS ANGELES ADJ7347467 FERNANDO CARRILLO CORNER BAKERY ZURICH LOS ANGELES ADJ1850182 FERNANDO GONZALEZ TUFF SHED ZURICH LOS ANGELES ADJ1850182 FERNANDO GONZALEZ TUFF SHED INC ZURICH LOS ANGELES ADJ7190973 FERNANDO VASQUEZ FRIENDLY FRANCISEES CORP ZURICH LOS ANGELES ADJ6937550 FIDEL HERNANDEZ HEAVILAND ENTERPRISES ZURICH LOS ANGELES ADJ8989163 FIDEL HERNANDEZ LIRA BKB CONSTRUCTION ZURICH LOS ANGELES ADJ973403 FRANCISCO HERNANDEZ TELCO FOOD ZURICH LOS ANGELES ADJ9198558 GABRIELA ISLAS CALIBER GROUP ZURICH LOS ANGELES ADJ9303020 GABRIELA MIRANDA V & E MANAGEMENT LLC ZURICH LOS ANGELES ADJ685417 GARY HAYES CITY OF LOS ANGELES ZURICH LOS ANGELES ADJ7998888 GARY HERNANDEZ WESTERN TEAR OFF DISPOSAL ZURICH LOS ANGELES ADJ7956493 GASPAR MONTESINO B AND B PALLET INC ZURICH LOS ANGELES ADJ7822777 GEORGE GOMEZ ONE STOP PARTS SOURCE ZURICH LOS ANGELES ADJ6916456 GLENDY CARDENAS HEALTHCARE ZURICH LOS ANGELES ADJ884725 GLORIA MEDINA HOLIDAY INN ZURICH LOS ANGELES ADJ9531400 GRACE LAFFERTY ADVANCED CLINICAL EMPLOYMENT STAFFING ZURICH LOS ANGELES ADJ9531400 GRACE LAFFERTY EMERALD HEALTH SERVICES ZURICH LOS ANGELES ADJ9531400 GRACE LAFFERTY HEALTHSOURCE GLOBAL STAFFING ZURICH LOS ANGELES ADJ9531400 GRACE LAFFERTY PROCARE ONE NURSES LLC ZURICH LOS ANGELES ADJ9531400 GRACE LAFFERTY US NURSING CORP ZURICH LOS ANGELES ADJ8985403 GREGORIA RAMOS IHG MANAGEMENT MARYLAND LLC ZURICH LOS ANGELES ADJ6768472 GUADALUPE AVINA QC FINANCIAL SERVICES ZURICH LOS ANGELES ADJ6776496 GUILLERMINA ARMAS KIK INTERNAT10NAL ZURICH LOS ANGELES ADJ7536950 HARRY GEVSHENIAN CAST AND CREW ENTERTAINMENT SERVICES ZURICH LOS ANGELES ADJ7536950 HARRY GEVSHENIAN ENTERTAINMENT PARTNERS EPSG ZURICH LOS ANGELES ADJ7536950 HARRY GEVSHENIAN WARNER BROTHERS NETWORK ZURICH LOS ANGELES ADJ2537408 HECTOR LIZALDE TRUGREEN LANDCARE ZURICH LOS ANGELES ADJ7602095 HERMELINDA FLORES HIXSON METAL FINISHING ZURICH LOS ANGELES ADJ9435755 HONORIO PERES IL FONAIO ZURICH LOS ANGELES ADJ7585034 IGNACIO RODRIGUEZ BEST BRANDS CORPORATION CMS BAKERY PRODUCTS ZURICH LOS ANGELES ADJ1567840 IRASEMA RAMIREZ JON DONAIRE DESSERTS ZURICH LOS ANGELES ADJ7593953 IRMA MARIN SPRINGHILL SUITES ZURICH LOS ANGELES ADJ2330545 ISIDRO ESCOBEDO AMERICAN SERVICES, INC. ZURICH LOS ANGELES ADJ7442069 ISRAEL REZA LIFOAM INDUSTRIES LLC ZURICH LOS ANGELES ADJ7606523 JAMES SEYLER CONTROL AIR CONDITIONING CORPORATION ZURICH LOS ANGELES ADJ7454097 JAMES VLHA DS WATERS OF AMERICA ZURICH LOS ANGELES ADJ7286573 JESSICA VALENCIA GNN RESTAURANTS DBA FARMER BOYS RESTAURANT ZURICH LOS ANGELES ADJ6966287 JESSIE PONCE INTERTEC EMPLOYMENT AGENCY ZURICH LOS ANGELES ADJ9453763 JESUS BAROCIO CORTEZ ABLE BUILDING MAINTENANCE ZURICH LOS ANGELES ADJ7183451 JESUS GARCIA FOUR SEASONS HOTEL ZURICH LOS ANGELES ADJ7217543 JESUS NAVARRO KELLY PIPE ZURICH LOS ANGELES ADJ8164498 JOAO FREITAS LIBERTY LANDSCAPING INC ZURICH LOS ANGELES ADJ2822835 JOEL TORRES TRU GREEN LAND CAKE ZURICH LOS ANGELES ADJ2822835 JOEL TORRES TRU GREEN LAND CARE ZURICH LOS ANGELES ADJ7583478 JOHN MEDINA PACIFIC MOTOR TRUCKING ZURICH LOS ANGELES ADJ2926596 JORGE QUINTANA ID INVESTIGATORS ZURICH LOS ANGELES ADJ6702667 JORGE ROA AZ MANUFACTURING INC ZURICH LOS ANGELES ADJ9026077 JOSE ANGEL GOMEZ BENIHANA NATIONAL ZURICH LOS ANGELES ADJ7915218 JOSE FLORES SYSTECHS ZURICH LOS ANGELES ADJ7222530 JOSE GONZALEZ AMERICAN BOX COMPANY ZURICH LOS ANGELES ADJ8094778 JOSE GONZALEZ AMERICAN INTERNATIONAL IND ZURICH LOS ANGELES ADJ8094778 JOSE GONZALEZ AMERICAN INTERNATIONAL INDUSTRIES ZURICH LOS ANGELES ADJ6775953 JOSE JAIMES CAMBRIDGE LEE INDUSTRIES ZURICH LOS ANGELES ADJ9582925 JOSE JIMENEZ HORIZON PERSONNEL SERVICES ZURICH LOS ANGELES ADJ6570197 JOSE LOPEZ BALFOUR BEATY ZURICH LOS ANGELES ADJ8056986 JOSE MOSQUEDA TRUEGREEN LANDSCAPE ZURICH LOS ANGELES ADJ10442499 JOSE ORTEGA ABLE BUILDING ZURICH LOS ANGELES ADJ9378968 JOSE RAMIREZ ZAGAL BM HQ DBA ACAPULCO RESTAURANT ZURICH LOS ANGELES ADJ2538465 JOSE VARGAS TRU GREEN COMPANIES ZURICH LOS ANGELES ADJ2538465 JOSE VARGAS TRUGREENLANDCARE ZURICH LOS ANGELES ADJ7422753 JOSEFINA CASTILLO ROSA MARIAS RESTAURANT ZURICH LOS ANGELES ADJ8053660 JOSELITO HIDALGO SWISSTEX CALIFORNIA INC ZURICH LOS ANGELES ADJ6835198 JOSEPH GARCIA TRIANGLE SERVICES ZURICH LOS ANGELES ADJ7870221 JOSUE RIVERA DART LOGISTICS SERVICE ZURICH LOS ANGELES ADJ7921481 JUAN DE DIOS AGUILAR SERRANO STAYBRIDGE HOTEL ZURICH LOS ANGELES ADJ7981906 JUAN MARTINEZ MIMIS CAFE ZURICH LOS ANGELES ADJ8062949 JUAN MAYA ABLE BUILDING MAINTENANCE ZURICH LOS ANGELES ADJ7483755 JUAN MELCHOR THE GREEN LANDCARE ZURICH LOS ANGELES ADJ3981516 JUAN PAZ ABLE BUILDING MAINTENANCE ZURICH LOS ANGELES ADJ8989046 JUAN PEREZ ST GEORGE EMPLOYEE LEASING ZURICH LOS ANGELES ADJ3935109 JUAN VASQUEZ VULCAN MATERIALS CO ZURICH LOS ANGELES ADJ7873579 JULIAN HURTADO VELA CALIFORNIA PIZZA KITCHEN INC ZURICH LOS ANGELES ADJ7948720 JULIO MARTINEZ MICROSOLUTIONS ENTERPRISE ZURICH LOS ANGELES ADJ9175701 LAURA FIGUEROA COVENANT CARE CA DBA COVENANT CARE LA JOLLA ZURICH LOS ANGELES ADJ7539056 LEISA SOLT HEALTHCARE SERVICES ZURICH LOS ANGELES ADJ6726439 LESTER HOLLINS BRINDERSON CONSTRUCTOR ZURICH LOS ANGELES Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ9505198 LETICIA MUNOZ BARRERA COASTLINE FOOD SERVICES ZURICH LOS ANGELES ADJ1076739 LILIAN PORTOBANCO SPRINGS WINDOW FASHION DIVISION ZURICH LOS ANGELES ADJ6972452 LISA HERNANDEZ HEALTH CARE SERVICES GROUP ZURICH LOS ANGELES ADJ7210063 LUCIA ESPINOZA SUNSTONE HOTEL PROPERTIES INC ZURICH LOS ANGELES ADJ6694739 LUCIANO CONTRERAS POLE MAINTENANCE CO ZURICH LOS ANGELES ADJ7811720 LUIS AGUILAR CALIFORNIA PIZZA KITCHEN INC ZURICH LOS ANGELES ADJ628651 LUIS ESPINOZA A&S METAL RECYCLING ZURICH LOS ANGELES ADJ7161872 LUIS PRECIADO BROWN METAL COMPANY INCORPORETED ZURICH LOS ANGELES ADJ7161872 LUIS PRECIADO BROWN METALS COMPANY ZURICH LOS ANGELES ADJ8939618 LYDIA POHL MEMORIAL HOSPITAL OF GARDENA ZURICH LOS ANGELES ADJ2645971 MANUEL ARREDONDO COVENANT CARE INC ST EDNA ZURICH LOS ANGELES ADJ3115995 MARCO CASILLAS DSE LOGISTICS ZURICH LOS ANGELES ADJ7899687 MARCO MARTINEZ BRINDERSON ZURICH LOS ANGELES ADJ2334028 MARGARITA ZAVALETA ARV ASSISTED LIVING INC/DBA VILLA D ZURICH LOS ANGELES ADJ738866 MARIA APOLINAR UNITED BUILDING SERVICES ZURICH LOS ANGELES ADJ2180224 MARIA FLORES KIK AEROSOL SOCAL LLC ZURICH LOS ANGELES ADJ2619696 MARIA FLORES IT'S ALL GREEK TO ME ZURICH LOS ANGELES ADJ7162643 MARIA FRANCO EHDOC ELDERLY HOUSING DEVELOPMENT & OPERATIONS CORP ZURICH LOS ANGELES ADJ9031950 MARIA GARCIA ABLE ZURICH LOS ANGELES ADJ9236408 MARIA GIORDANI ALL CITY MANAGEMENT SERVICES ZURICH LOS ANGELES ADJ956379 MARIA HUIZAR SOUTHERN CALIFORNIA FOOD SERVICE ZURICH LOS ANGELES ADJ6976898 MARIA NAVARRO DMS FACILTY SERVICE ZURICH LOS ANGELES ADJ6686296 MARIA RODRIGUEZ KELLERMEYER BUILDING SERVICES ZURICH LOS ANGELES ADJ8057126 MARIA RODRIGUEZ CAMINO REAL KITCHEN FOOD ZURICH LOS ANGELES ADJ8034255 MARIA SANTANA COURTYARD MARRIOT AKA BALDWIN HOSPITALITY LLC ZURICH LOS ANGELES ADJ616457 MARIA TIZACARENO HEALTH CARE SERVICES ZURICH LOS ANGELES ADJ970407 MARIA VALDOVINOS DIVERSIFIED MAINTENANCE SERVICES ZURICH LOS ANGELES ADJ6961470 MARIANA RANGEL IN N OUT BURGERS ZURICH LOS ANGELES ADJ7172390 MARIBEL MONGE LOPEZ FRIENDLY FRANCHISE CORPORATION DBA CARLS JR ZURICH LOS ANGELES ADJ7172390 MARIBEL MONGE LOPEZ FRIENDLY FRANCHISEES CORPORATION ZURICH LOS ANGELES ADJ7084115 MARIO LOPEZ PREMIER BUILDING MAINTENANCE ZURICH LOS ANGELES ADJ6921728 MARIO LOZADA CLASSIC PARTY RENTALS ZURICH LOS ANGELES ADJ8096701 MARISOL HERNANDEZ CAREMORE MEDICAL GROUP ZURICH LOS ANGELES ADJ7180157 MARTHA RAMIREZ HERITAGE GARDENS ZURICH LOS ANGELES ADJ7180157 MARTHA RAMIREZ LIFE GENERATIONS HEALTHCARE ZURICH LOS ANGELES ADJ6974739 MARTIN NORIEGA TRIANGLE ENTERPRISES INC ZURICH LOS ANGELES ADJ9256177 MARTIN RUVALCABA JA CONTRACTING ZURICH LOS ANGELES ADJ9256177 MARTIN RUVALCABA JUAN LUIS AYALA DBA JA CONTRACTING ZURICH LOS ANGELES ADJ966869 MARVIN ORTIZ DIVERSIFIED TRANSPORTATION ZURICH LOS ANGELES ADJ635473 MARY MOORE ACKERMAN BRYMAN COLLEGE ZURICH LOS ANGELES ADJ7731059 MARZIEH SPIVEY MARSHALLS ZURICH LOS ANGELES ADJ7934932 MICHAEL OREFICE ENTERTAINMENT PARTNERS ZURICH LOS ANGELES ADJ7934932 MICHAEL OREFICE FSI/FPS SERVICES INC. ZURICH LOS ANGELES ADJ7934932 MICHAEL OREFICE NBC ULVERSAL ZURICH LOS ANGELES ADJ2628783 MIGUEL BARRAGAN MR MOVE MOVING & STORAGE ZURICH LOS ANGELES ADJ804541 MIGUEL LOYOLA PICK YOUR PART ZURICH LOS ANGELES ADJ6859113 MIGUEL TAPIA ANN`S TRADING INC ZURICH LOS ANGELES ADJ195076 MILTON MILIAN ARTISAN GENERAL CONSTRUCTION INC ZURICH LOS ANGELES ADJ7314730 MINERVA TORRES PHILLIPS INDUSTRIES ZURICH LOS ANGELES ADJ7941000 NATALI NAVARRO LEMUS AMERICAN INTERNATIONAL INDUSTRIES ZURICH LOS ANGELES ADJ7667761 NORA GONZALEZ MASTROIANNI FAMILY ENTERPRISES, LTD ZURICH LOS ANGELES ADJ7875947 OMAR MARQUINA TRUSFRAME INC ZURICH LOS ANGELES ADJ6690608 OSCAR GONZALEZ THOREAU JANITORIAL SERVICES ZURICH LOS ANGELES ADJ7380357 OSCAR LOZANO MAGIC PLASTIC ZURICH LOS ANGELES ADJ6603029 OSCAR NAVA DART ENTITIES ZURICH LOS ANGELES ADJ6870428 PABLO ALVAREZ VELASCO SUGAR FOODS CORP ZURICH LOS ANGELES ADJ6608136 PAMELA GENTILE GRAND TERRACE CONVALESCENT HOSPITAL ZURICH LOS ANGELES ADJ8409230 PATRICIA SALGADO SPRING HILLS SUITES MARRIOTT ZURICH LOS ANGELES ADJ6674272 PEDRO CERVANTES COASTLINE FOOD SERVICES CORP DBA WENDYS ZURICH LOS ANGELES ADJ6479305 PEDRO SANTIAGO AMERICAN RESIDENTIAL SERVICES LLC RESCUE ROOTER ZURICH LOS ANGELES ADJ8584354 PENNY SCHILLACI AIM SPECIALTY HEALTHCARE ZURICH LOS ANGELES ADJ9533652 PRICILIANA GUTIERREZ QUALITY BUSINESS SOLUTIONS ZURICH LOS ANGELES ADJ3636842 QUINTEN PEETE CLAIM JUMPER RESTAURANT ZURICH LOS ANGELES ADJ9177866 RAFAEL GONZALEZ MICRO SOLUTIONS ENTERPRISE ZURICH LOS ANGELES ADJ7580582 RAFAEL GUTIERREZ CRYOQUIP ZURICH LOS ANGELES ADJ8123283 RAMIRO FRANCO JA CONTRACTING LABOR MANAGEMENT ZURICH LOS ANGELES ADJ8123283 RAMIRO FRANCO JA CONTRACTING LABOR MANAGEMENT INC ZURICH LOS ANGELES ADJ3243855 RAMON AYALA OAKWOOD WORLD WIDE ZURICH LOS ANGELES ADJ9000100 RAMONA RUBIO ZAMORA EMPLOYMENT RESOURCES AND SOLUTIONS ZURICH LOS ANGELES ADJ9000100 RAMONA RUBIO ZAMORA PROVIDIAN STAFFING ZURICH LOS ANGELES ADJ9000100 RAMONA RUBIO ZAMORA TRI STATE EMPLOYMENT SERVICES INC ZURICH LOS ANGELES ADJ7784201 RAUL MARTINEZ COMMERCIAL METALS COMPANY ZURICH LOS ANGELES ADJ7784201 RAUL MARTINEZ G&A PARTNERS ZURICH LOS ANGELES ADJ9645095 RAUL PADILLA BRIDGE PROPERTY MANAGEMENT ZURICH LOS ANGELES ADJ9645095 RAUL PADILLA FRAMING ASSOCIATES ZURICH LOS ANGELES ADJ8921545 RAUL PALAFOX ANCON MARINE ZURICH LOS ANGELES ADJ9611316 RAUL SANTANA FLEXO ZURICH LOS ANGELES ADJ8815741 RAYMOND GUTIERREZ SMG ZURICH LOS ANGELES ADJ9132539 REBECCA COBB PACIFIC CONVENIENCE & FUEL, LLC ZURICH LOS ANGELES ADJ7118022 REFUGIO CARDOZA CALIFORNIA PIZZA KITCHEN ZURICH LOS ANGELES ADJ1902987 RIGOBERTO RUBIO USS CAL BUILDERS ZURICH LOS ANGELES ADJ9328885 ROBERT GARCIA CLARK ROOFING CO ZURICH LOS ANGELES ADJ7693485 ROBERTO VITAL NUNEZ BOBBINS INC ZURICH LOS ANGELES ADJ6584891 ROGELIO ROMERO SUPERIOR ENGINEERED PRODUCTS CORPORAT10N ZURICH LOS ANGELES ADJ7359449 ROGER BISWELL IMAGE IV BUSINESS SYSTEMS ZURICH LOS ANGELES Fermin Iglesias

Case Number Injured Worker Employer Claims Administrator ------ADJ8123400 RONALD FIERRO COMPUTER SCIENCE ZURICH LOS ANGELES ADJ8010025 ROSA CRUZ MARRIOTT ZURICH LOS ANGELES ADJ1354295 ROSA FLORES SAUCIER THE WESTIN BONAVENTURE HOTEL ZURICH LOS ANGELES ADJ6649447 ROSARIO DIAZ DOLPHINS COVE RESORT ZURICH LOS ANGELES ADJ2302671 RUBEN MUNOZ PATINA RESTAURANT ZURICH LOS ANGELES ADJ9208739 RUTH DOMINGUEZ FIRST CLASS STAFFING ZURICH LOS ANGELES ADJ7940253 SALVADOR ARCHUNDIA CONTINENTAL INTERIORS ZURICH LOS ANGELES ADJ9125078 SALVADOR DIAZ G AND K SERVICES ZURICH LOS ANGELES ADJ6794461 SALVADOR SANCHEZ CLAIM JUMPER ZURICH LOS ANGELES ADJ7816690 SAMANTHA WIGHTMAN CONVENIENCE RETAILERS LLC DBA CIRCLE K ZURICH LOS ANGELES ADJ7157299 SAMUEL PANTOJA BEST INTERIORS INC ZURICH LOS ANGELES ADJ7822657 SANDRA FIGUEROA GRAND TERRACE CARE CENTER ZURICH LOS ANGELES ADJ8657761 SANDRA MARTINEZ RCIH LLC ZURICH LOS ANGELES ADJ8824692 SANTA CRUZ PANCHO EMPLOYMENT RESOURCES GROUP INC ZURICH LOS ANGELES ADJ7114180 SHANE OH RESORT AT PELICAN HILL ZURICH LOS ANGELES ADJ6836492 SILVIA ZAMUDIO PROFESSIONAL BUILDING MAINTENANCE ZURICH LOS ANGELES ADJ3760625 SUSANA MARIA HERNANDEZ NAVE AMERICAN APPAREL ZURICH LOS ANGELES ADJ1807330 SUSANNE CARROLL KPMG LLP ZURICH LOS ANGELES ADJ9602505 TEODORA CHAVEZ SOUTHERN CALIFORNIA PIZZA DBA PIZZA HUT ZURICH LOS ANGELES ADJ7208742 TEODORO TORRES CASUDA CANYON RESTAURANT ZURICH LOS ANGELES ADJ8774465 TEOFILO LOPEZ ISLAND HOTEL NEWPORT BEACH ZURICH LOS ANGELES ADJ6549535 TERESA ESCAMILLA PARTNERS IN DIVERSITY INC ZURICH LOS ANGELES ADJ8937060 TORRY NERHEIM TERMINIX ZURICH LOS ANGELES ADJ7006358 TRINIDAD BORBON NIBCO INC TOLCO ZURICH LOS ANGELES ADJ6668401 TRINIDAD ZARAGOZA DIVERSIFIED TRANSPORTATION ZURICH LOS ANGELES ADJ8111142 TUNISIA SHAW ARBONNE INTERNATIONAL ZURICH LOS ANGELES ADJ7967398 TYREN PERRY LONDON WEST HOLLYWOOD HOTEL ZURICH LOS ANGELES ADJ3196940 VICENTE MORALES WESTIN BONAVENTURE HOTEL & SUITES ZURICH LOS ANGELES ADJ8086470 VILMA SALAZAR A J WRIGHT ZURICH LOS ANGELES ADJ8086470 VILMA SALAZAR AJ WRIGTH ZURICH LOS ANGELES ADJ7343901 FLORA DIAZ CAMBROS MANUFACTURING ZURICH LOS ANGELES ADJ7300194 MARTIN RAMIREZ US ALUMINUM ZURICH LOS ANGELES ADJ7538581 FREDERICK SMITH JIM MORAN & ASSOCIATES ZURICH NORTH AMERICA ADMIN BY SEDGWICK CMS ADJ8416142 CARLOS NAREZ LISIAEROSPACE DBA HI SHEAR ZURICH NORTH AMERICA CHICAGO ADJ7593619 GRISELDA BAUTISTA NARAYAN CORP PLASTIC PROCESSING CO ZURICH NORTH AMERICA CHICAGO ADJ9435755 HONORIO PERES IL FONAIO ZURICH NORTH AMERICA CHICAGO ADJ8283897 NORMAN STEWARD VOLT WORKFORCE SOLUTIONS ZURICH NORTH AMERICA CHICAGO ADJ8497845 ANA MUNOZ TOLEDO RESIDENCE INN BEVERLY HILLS ZURICH SACRAMENTO ADJ6905358 ANDREA PASTRANA KELLERMEYER BUILDING SERVICES ZURICH SACRAMENTO ADJ7517384 ARCELI AGBALOG STYROTEK ZURICH SACRAMENTO ADJ7348721 CARLOS AGUINAGA LAC IRVINE CO ZURICH SACRAMENTO ADJ6929597 CHARLES ALLEN BMW OF NORTH AMERICA ZURICH SACRAMENTO ADJ9044155 FERNANDO GARCIA EVERGREEN SHINGLE RECOVERY ZURICH SACRAMENTO ADJ7978567 FRANCISCO HERNANDEZ THE BLAKELY CO ZURICH SACRAMENTO ADJ7942289 GEORGINA PEREZ HEALTHCARE SERVICES GROUP ZURICH SACRAMENTO ADJ7035201 JESUS ALONSO BLUEWATER SERVICES INC ZURICH SACRAMENTO ADJ9598454 JESUS BUENAVENTURA PLATINUM STAFFING ZURICH SACRAMENTO ADJ9180235 MARIA REGALADO WALMART ZURICH SACRAMENTO ADJ7432798 NEMESIO SANCHEZ THE FAIRMONT MIRAMAR HOTEL AND BUNGALOUS ZURICH SACRAMENTO ADJ9179988 NORMA CABRERA TECHNOCELL ZURICH SACRAMENTO ADJ9381284 ROSA GONZALEZ KELLERMEYER BERGENSONS SERVICES ZURICH SACRAMENTO ADJ4056944 SOCORRO MUNOZ SHERATON HOTEL ZURICH SACRAMENTO ADJ8210068 WAN LI ZHAO COSMO FIBER CORPORATION ZURICH SACRAMENTO ADJ9217028 CARLOS CARRIZALES PROMPT STAFFING ZURICH SAN FRANCISCO ADJ7678464 CESAR REYES INTERTEC PERSONAL AGENCY ZURICH SAN FRANCISCO ADJ7756416 CONCEPCION GASPAR GULF SOUTH MEDICAL SUPPLY ZURICH SAN FRANCISCO ADJ7953787 DILCIA RODRIGUEZ EL POLLO LOCO ZURICH SAN FRANCISCO ADJ7447814 HUBER RAMIREZ PACIFIC CHOICE BRANDS ZURICH SAN FRANCISCO ADJ6713455 JOSE GUZMAN HEAVILAND ENTERPRISES INC ZURICH SAN FRANCISCO ADJ4601264 LAURA MARTINEZ UNIVERSITY OF SAN DIEGO ZURICH SAN FRANCISCO ADJ8261016 LEONARDO HERNANDEZ RUIZ FOOD PRODUCTS ZURICH SAN FRANCISCO ADJ7517055 LISA ARMENTA UBS FINANCIAL ZURICH SAN FRANCISCO ADJ9516232 MARIO AVALOS CLOTHES TERMINATION ZURICH SAN FRANCISCO ADJ9516232 MARIO AVALOS DANNYS APPAREL INC ZURICH SAN FRANCISCO ADJ8096701 MARISOL HERNANDEZ CAREMORE MEDICAL GROUP ZURICH SAN FRANCISCO ADJ2727890 MARY JANE PONTERO ULTIMATE STAFFING SERVICES ZURICH SAN FRANCISCO ADJ9248724 RIGOBERTO LEDESMA M H BUILDING SPECIALTIES INC ZURICH SAN FRANCISCO ADJ9162778 ROBERTO RIVERA JANUS ZURICH SAN FRANCISCO ADJ9532662 ROSA PADILLA AYALA TELEDYNE RELAYS ZURICH SAN FRANCISCO ADJ7390694 ROSARIO CONTRERAS GOMEZ FAIRMONT NEWPORT BEACH ZURICH SAN FRANCISCO