Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 142274 AFFINITY GAMING Elizabeth Guth VP - Insurance & Benefits 3755 Breakthrough Way, Suite 300 Las Vegas NV 89135 702-341-2419

Association Name DBA Date Subsidiary Flamingo Paradise Gaming, LLC Hotel and 01-31-2017 Subsidiary Plantation Investments, LLC Rail City Casino 01-31-2017 Subsidiary Primadonna Company, LLC (The) Whiskey Pete's Hotel and Casino 01-31-2017 Subsidiary Primadonna Company, LLC (The) Buffalo Bill's Resort and Casino 01-31-2017 Subsidiary Primadonna Company, LLC (The) Primm Valley Resort and Casino 01-31-2017 Third Party Administrator Sierra Nevada Administrators 01-31-2017

C of A Employer 122997 ARCBEST CORPORATION (FKA ARKANSAS BEST CORPORATION) Lynette Woodie Manager, Loss Prevention & Administration 8401 McClure Drive Fort Smith AR 72916 479-785-6047

Association Name DBA Date Subsidiary ABF FREIGHT SYSTEM, INC. 12-15-1981 Subsidiary AcrBest II 11-01-2020 Third Party Administrator GALLAGHER BASSETT SERVICES, INC.(TPA) 12-15-1981 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 123211 BEST BUY CO INC Allison Klonne Senior Analyst - Casualty Risk 7601 Penn Avenue South B4 Richfield MN 55423 612-291-6958

Association Name DBA Date Subsidiary BEST BUY STORES LP 12-01-1997 Subsidiary BEST BUY WAREHOUSING LOGISTICS LLC 04-01-2017 Subsidiary GREATCALL INC 10-01-2018 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 12-01-1997

C of A Employer 123005 CORPORATION Kim Cowley GL & WC Claims Manager 6465 South Rainbow Blvd Las Vegas NV 89118 702-792-7352

Association Name DBA Date Subsidiary ALIANTE CASINO AND HOTEL 09-27-2016 Subsidiary BOYD ATLANTIC CITY, INC. 01-01-1999 Subsidiary BOYD CENTRAL REGION, INC. 02-01-1996 Subsidiary BOYD DEVELOPMENT CORPORATION 10-01-1995 Subsidiary BOYD GAMING CORPORATION 11-01-1990 Subsidiary BOYD SHARED SERVICES, INC. 06-01-2007 Subsidiary BOYD TRAVEL, INC. VACATIONS-HAWAII 10-01-1995 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List SAM'S TOWN HOTEL, GAMBLING HALL & Subsidiary CALIFORNIA HOTEL & CASINO 08-01-1982 BOWLING CENTER Subsidiary CALIFORNIA HOTEL & CASINO CALIFORNIA HOTEL AND CASINO 08-01-1982 Subsidiary 12-20-2016 Subsidiary COAST HOTEL & CASINO 02-01-1989 Subsidiary CONSTELLATION INSURANCE COMPANY 07-01-2005 Subsidiary HOTEL AND CASINO 12-20-2016 Subsidiary ELDORADO, INC. ELDORADO CASINO 04-01-1993 Subsidiary ELDORADO, INC. 04-01-1993 Subsidiary GOLD COAST HOTEL & CASINO 02-01-1989 MAIN STREET STATION HOTEL, CASINO & Subsidiary M.S.W., INC. 11-22-1996 BREWERY Subsidiary SAM-WILL, INC. 07-01-1981 Subsidiary SUNCOAST HOTEL & CASINO, THE 02-01-1989 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-1981

C of A Employer 123011 CAESARS ENTERTAINMENT, INC. Tracey Hudson Director of Risk Management 100 West Liberty St., Suite 1150 Reno NV 89501 775-348-3343

Association Name DBA Date Subsidiary 3535 LV CORP. 07-20-2020 Subsidiary 3535 LV NEWCO LLC HOTEL AND CASINO (fka The Quad) 07-20-2020 Subsidiary 3535 LV NEWCO LLC THE LINQ 07-20-2020 Subsidiary CAESARS ENTERPRISE SERVICES, LLC 07-20-2020 CAESARS HOLDINGS FKA CAESARS Subsidiary CAESARS HOLDINGS INC. 07-20-2020 ENTERTAINMENT CORPORATION Subsidiary CAESARS INTERACTIVE ENTERTAINMENT LLC 07-20-2020 Subsidiary CAESARS LINQ, LLC THE LINQ 07-20-2020 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Subsidiary CC-RENO, LLC Circus Circus Reno 11-23-2015 Subsidiary CEOC LLC HARRAH'S CASINO HOTEL RENO 07-20-2020 Subsidiary CEOC LLC HARRAH'S RENO 07-20-2020 Subsidiary CIRCUS AND ELDORADO JOINT VENTURE LLC Silver Legacy Hotel Casino 11-23-2015 Subsidiary COLUMBIA PROPERTIES TAHOE LLC Montbleu 10-01-2018 Subsidiary CORNER INVESTMENT COMPANY LLC THE CROMWELL 07-20-2020 Subsidiary DESERT PALACE LLC LAS VEGAS 07-20-2020 Subsidiary DESERT PALACE LLC CAESARS PALACE 07-20-2020 Subsidiary EASTSIDE CONVENTION CENTER LLC 07-20-2020 Subsidiary ELDORADO RESORTS, LLC Eldorado Hotel Casino 11-01-1982 Subsidiary OPERATING COMPANY, LLC FLAMINGO LAS VEGAS 07-20-2020 Subsidiary HARRAH SOUTH SHORE CORPORATION 07-20-2020 Subsidiary HARRAH'S LAS VEGAS, LLC HARRAH'S LAS VEGAS 07-20-2020 Subsidiary HARRAH'S LAS VEGAS, LLC HARRAH'S CASINO HOTEL, LAS VEGAS 07-20-2020 Subsidiary HARRAH'S LAUGHLIN, LLC HARRAH'S LAUGHLIN 07-20-2020 Subsidiary HARVEYS TAHOE MANAGEMENT COMPANY LLC HARRAH'S CASINO HOTEL LAKE TAHOE 07-20-2020 Subsidiary HARVEYS TAHOE MANAGEMENT COMPANY LLC HARVEY'S RESORT HOTEL/CASINO 07-20-2020 Subsidiary HARVEYS TAHOE MANAGEMENT COMPANY LLC HARRAH'S LAKE TAHOE 07-20-2020 Subsidiary HARVEYS TAHOE MANAGEMENT COMPANY LLC HARVEY'S LAKE TAHOE 07-20-2020 Subsidiary PARBALL LLC 07-20-2020 Subsidiary PARBALL NEWCO LLC THE SALON AT BALLY'S 07-20-2020 Subsidiary PARBALL NEWCO LLC BALLY'S LAS VEGAS 07-20-2020 Subsidiary OPERATING COMPANY, LLC PARIS LAS VEGAS 07-20-2020 Subsidiary PHW MANAGER, LLC 07-20-2020 Subsidiary PHWLV, LLC PLANET HOLLYWOOD 07-20-2020 Subsidiary RIO PROPERTIES, LLC RIO ALL-SUITES HOTEL & CASINO 07-20-2020 Subsidiary TROPICANA LAUGHLIN LLC Tropicana Laughlin 10-01-2018 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 11-01-1982

C of A Employer 122973 CARSON CITY Cecilia Meyer, ASHM Risk Management Coordinator, CC Finance Division Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 201 North Carson Street Ste 3 Carson City NV 89701 775-283-7484

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-2010

C of A Employer 122974 CARSON CITY SCHOOL DISTRICT Ann Cyr Risk Manager 1402 West King Street Carson City NV 89703 775-283-2006

Association Name DBA Date Third Party Administrator DAVIES CLAIMS SOLUTIONS, LLC 07-01-2010

C of A Employer 122963 CATHOLIC CHARITIES OF SOUTHERN NEVADA Mary Spees

1501 Las Vegas Blvd North Las Vegas NV 89101 702-385-2662

Association Name DBA Date Third Party Administrator NEVADA ALTERNATIVE SOLUTIONS INC 10-01-2012 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 130131 CHURCHILL COUNTY SCHOOL DISTRICT Christi Fielding Comptroller 690 S MAINE ST FALLON NV 89406-3807 775-428-7220

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-2015

C of A Employer 123103 CITY OF HENDERSON Carol Banks Workers' Compensation Analyst 240 Water StreetPO Box 95050, MSC122 Henderson NV 89015 702-267-1922

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 04-01-1993

C of A Employer 123239 CITY OF LAS VEGAS John Raftery, Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 495 S. Main St. Las Vegas NV 89101 702-229-5048

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 12-29-1985

C of A Employer 123155 CITY OF NORTH LAS VEGAS William Harty

2250 Las Vegas Blvd NorthSte. 820 North Las Vegas NV 89030 702-633-1462

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-01-1994

C of A Employer 123079 CITY OF RENO Mark Gregersen Director of HR BACK UP 1 E. First Street, 9th Floor Reno NV 89501 775-334-1284

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 09-01-1992 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 123097 CITY OF SPARKS Jill Valdez Human Resources Analyst 431 Prater Way Sparks NV 89432 775-353-4021

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 02-01-1993

C of A Employer 122979 CITYCENTER HOLDINGS, LLC Mike Jokerst Director of Workers Compensation MGM Administration Building71 E Harmon Avenue Las Vegas NV 89109 702-692-9583

Association Name DBA Date Subsidiary LLC 11-30-2011 Subsidiary CITY CENTER REALTY CORPORATION 11-30-2011 Subsidiary PROJECT CC, LLC 11-30-2011 Third Party Administrator SELF-ADMINISTERED 11-30-2012

C of A Employer Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 123236 CLARK COUNTY Erin DeFrates Employee Benefits Manager Workers' Compensation500 S Grand Central Pkwy Las Vegas NV 89155 702-455-5524

Association Name DBA Date Subsidiary MCCARRAN INTERNATIONAL AIRPORT 07-15-1985 Subsidiary UNIVERSITY MEDICAL CENTER 08-01-1986 Subsidiary VOLUNTEER ACCOUNT 04-01-1986 Third Party Administrator CORVEL ENTERPRISE COMP INC HRMS 07-15-1985

C of A Employer 123140 CLARK COUNTY SCHOOL DISTRICT Kimberly Krumland Director III, Risk and Environmental Services 4828 S. Pearl Street MS 200 Las Vegas NV 89121 702-799-6496 x 5690

Association Name DBA Date Third Party Administrator Sierra Nevada Administrators 07-01-1990

C of A Employer 123152 CLARK COUNTY WATER RECLAMATION DISTRICT Brenda Pappas Assistant General Manager 5857 East Flamingo Road Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Las Vegas NV 89122 702-668-8051

Association Name DBA Date Third Party Administrator DAVIES CLAIMS SOLUTIONS, LLC 04-01-1992

C of A Employer 156199 COMMONSPIRIT HEALTH Alan McVay Insurance Specialist 3900 Olympic Blvd.Suite #400 Erlanger KY 41018 859-594-3039

Association Name DBA Date DIGNITY HEALTH MANAGEMENT SERVICES ORGANIZATION Subsidiary 02-01-2020 LLP Subsidiary DIGNITY HEALTH MEDICAL GROUP NEVADA, LLC 02-01-2020 Subsidiary ST ROSE DOMINICAN HEALTH FOUNDATION 02-01-2020 Subsidiary ST ROSE DOMINICAN HOSPITAL-DE LIMA CAMPUS 02-01-2020 Subsidiary ST ROSE DOMINICAN HOSPITAL-SAN MARTIN CAMPUS 02-01-2020 Subsidiary ST ROSE DOMINICAN HOSPITAL-SIENA CAMPUS 02-01-2020 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 02-01-2020

C of A Employer 123087 COSTCO WHOLESALE CORPORATION Uyen Nguyen Integrated Leave Data Analyst 999 Lake Drive Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Issaquah WA 98027 425-313-2874

Association Name DBA Date Third Party Administrator HELMSMAN MANAGEMENT SERVICES LLC 01-01-1993

C of A Employer 143601 DOUGLAS COUNTY Wendy Lang HR Director PO Box 218 Minden NV 89423 775-782-9860

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-2017

C of A Employer 123176 DOUGLAS COUNTY SCHOOL DISTRICT Leeann Caires Benefits & Risk Management Coordinator 1638 Mono Ave. Minden NV 89423 775-782-7177 x 1639

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-1994 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 123129 ELKO COUNTY SCHOOL DISTRICT Julie Davis Chief Finance Officer 850 Elm Street Elko NV 89801 775-738-5196

Association Name DBA Date Third Party Administrator DAVIES CLAIMS SOLUTIONS, LLC 11-01-1993

C of A Employer 123143 ENCOMPASS HEALTH CORPORATION Sandy Gilbert Risk Insurance Coordinator 9001 Liberty Parkway Birmingham AL 35242 205-970-3553

Association Name DBA Date Encompass Health Rehabilitation Hospital of Desert Subsidiary Encompass Health Rehabilitation Hospital of Desert Canyon, LLC 06-01-2010 Canyon Subsidiary Encompass Health Rehabilitation Hospital of Henderson, LLC HealthSouth Home Health of Henderson 10-01-2001 Encompass Health Rehabilitation Hospital of Subsidiary Encompass Health Rehabilitation Hospital of Henderson, LLC 10-01-2001 Henderson Encompass Health Rehabilitation Hospital of Las Subsidiary Encompass Health Rehabilitation Hospital of Las Vegas, LLC 02-01-1996 Vegas Third Party Administrator CORVEL ENTERPRISE COMP INC HRMS 08-01-2021 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 122931 FEDEX CORPORATION FOR FEDEX GROUND PACKAGE SYSTEM INC Jeff Kulbago Lead, Risk & Insurance 1000 Fedex Drive Moon Twp. PA 15108 412-747-8323

Association Name DBA Date Subsidiary FEDEX GROUND PACKAGE SYSTEM, INC. 08-01-1996 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 08-01-1996

C of A Employer 122936 FEDEX CORPORATION for Federal Express Corporation Gael Johnson Sr. Risk Analyst 3620 Hacks Cross Road Bldg B 2nd Floor Memphis TN 38125 901-434-4557

Association Name DBA Date Subsidiary FEDERAL EXPRESS CORPORATION 04-01-1981 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 04-01-1981

C of A Employer 123050 FEDEX CORPORATION for Fedex Freight Inc Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Kayla Quandt Advisor - Risk Management 2200 Forward Drive Delivery Code 2256 Harrison AR 72601 870-704-5187

Association Name DBA Date Subsidiary FEDEX FREIGHT INC. 11-01-1991 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 11-01-1991

C of A Employer 123109 LLC Brian Arlin VP/CFO 202 East Fremont Street Las Vegas NV 89101 702-387-5188

Doing Business As FOUR QUEENS HOTEL & CASINO Effective Date: 06-01-1993

Association Name DBA Date Subsidiary TLC CASINO ENTERPRISES, INC. 01-01-2008 Third Party Administrator NEVADA ALTERNATIVE SOLUTIONS INC 06-01-1993

C of A Employer 122964 Focus Plumbing LLC Andrea Gould Risk Manager 1220 S Commerce Street, #120 Las Vegas NV 89102 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 702-220-5621

Association Name DBA Date Subsidiary Focus Concrete 01-01-2010 Subsidiary Focus Electric 06-01-2009 Subsidiary Focus Fire Protection LLC 07-10-2018 Subsidiary Focus Framing, Door & Trim 09-15-2011 Third Party Administrator SELF-ADMINISTERED 08-18-2003

C of A Employer 122965 GAUGHAN SOUTH LLC Heather Hall Risk Manager 9777 Las Vegas Blvd South Las Vegas NV 89183 702-797-8245

Doing Business As SOUTH POINT HOTEL AND CASINO Effective Date: 10-25-2006

Association Name DBA Date Third Party Administrator NEVADA ALTERNATIVE SOLUTIONS INC 10-25-2006

C of A Employer 122987 GOLDEN NUGGET LLC Lea Ann Lopez Associate Director Risk Management 1510 W Loop South Houston TX 77027 713-386-7202 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

Association Name DBA Date Subsidiary GNL, LLC. GOLDEN NUGGET LAUGHLIN 01-23-2004 Subsidiary GNLV, LLC 01-23-2004 Third Party Administrator CORVEL ENTERPRISE COMP INC HRMS 01-23-2004

C of A Employer 123118 HAMILTON HOLDING MANAGEMENT CORP Ashley Rife

4990 Energy Way Reno NV 89502 775-352-3286

Association Name DBA Date Subsidiary HAMILTON COMPANY 07-01-1993 Third Party Administrator HOMETOWN HEALTH PROVIDERS INSURANCE COMPANY WorkersChoice 07-01-1993

C of A Employer 123151 HAT LTD A NEVADA LIMITED PARTNERSHIP Kim Hill CFO 63 Keystone Avenue, Suite 202 Reno NV 89503 775-328-6020

Doing Business As MANPOWER TEMPORARY SERVICES Effective Date: 03-01-1992

Association Name DBA Date Third Party Administrator SELF-ADMINISTERED 03-01-1992 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 123099 HCA HEALTHCARE INC. Leah Larkin Senior Compliance Analyst 2515 Park Plaza Bldg. 2-3E Nashville TN 37203 615-344-1487

Association Name DBA Date COLUMBIA/HCA HEALTHCARE CORPORATION OF CENTRAL Subsidiary 01-01-2017 TEXAS Subsidiary COSCORP, LLC 04-23-1999 Subsidiary FAR WEST DIVISION, INC. 07-11-2011 Subsidiary GALEN HEALTH INSTITUTES, INC. 01-02-2020 Subsidiary HCA - INFORMATION TECHNOLOGY & SERVICES INC 04-26-2019 Subsidiary HCA ASD FINANCIAL OPERATIONS, LLC 06-03-2011 Subsidiary HCA ASD SALES SERVICES, LLC 12-26-2010 Subsidiary HCA HUMAN RESOURCES, LLC 01-01-2015 Subsidiary HCA IT&S FIELD OPERATIONS, INC. IT&S FAR WEST SERVICE CENTER 05-11-2008 Subsidiary HCA MANAGEMENT SERVICES, LP 01-01-1999 HEALTHCARE SALES NATIONAL MANAGEMENT SERVICES Subsidiary 09-01-2009 GROUP LLC Subsidiary INTENSIVE CARE CONSORTIUM, INC. 06-09-2019 Subsidiary LAS VEGAS ASC, LLC 07-29-2005 Subsidiary LAS VEGAS SURGICARE, INC. 12-01-1994 Subsidiary MEDICREDIT, INC. 10-20-2014 Subsidiary MIDAMERICA ONCOLOGY 06-26-2017 Subsidiary NATIONAL CONTACT CENTER MANAGEMENT GROUP, LLC 04-01-2016 Subsidiary OUTPATIENT SERVICES HOLDINGS, INC. 03-18-2013 Subsidiary PARALLON ENTERPRISES, LLC 01-01-2012 Subsidiary SOUTHERN HILLS MEDICAL CENTER, LLC 03-01-2004 Subsidiary SUN-MED, LLC 01-14-2005 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Subsidiary SUNRISE HOSPITAL & MEDICAL CENTER, LLC 03-01-1993 Subsidiary SUNRISE MOUNTAINVIEW HOSPITAL, INC. 01-30-1997 Subsidiary SUNRISE MOUNTAINVIEW MULTI-SPECIALTY CLINICS, LLC 12-01-2007 Subsidiary SURGICARE OF LAS VEGAS, INC. 10-01-1992 Subsidiary TENNESSEE HEALTHCARE MANAGEMENT INC 03-01-2005 Subsidiary UR SERVICES, LLC 12-15-2020 Subsidiary URGENT CARE NEVADA, LLC 01-01-2016 Third Party Administrator BROADSPIRE SERVICES INC 04-01-2004

C of A Employer 123059 HOME DEPOT USA INC Shemida Hamilton Risk Analyst Store Support Center, Bldg C-202455 Paces Ferry Road, N.W. Atlanta GA 30339 770-333-8211

Association Name DBA Date Subsidiary INTERLINE BRANDS, INC. 03-01-2016 Subsidiary YOUR 'OTHER' WAREHOUSE 07-27-2004 Third Party Administrator HELMSMAN MANAGEMENT SERVICES LLC 08-01-1992

C of A Employer 122983 HUMBOLDT COUNTY SCHOOL DISTRICT Dr. David Jensen Superintendent 310 East Fourth St Winnemucca NV 89445 775-623-8218 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-2012

C of A Employer 122842 HYATT HOTELS CORPORATION Laurene Dufault Consultant, Aon Global Risk Consulting 5600 W. 83rd St. Suite. 1100Risk Management Minneapolis MN 55437 952-807-0701

Association Name DBA Date Subsidiary HYATT CORPORATION 02-01-1998 Subsidiary HYATT RESIDENTIAL GROUP, INC. 11-01-2012 Subsidiary SELECT HOTELS GROUP, LLC 01-05-2008 Third Party Administrator GALLAGHER BASSETT SERVICES, INC.(TPA) 02-01-1998

C of A Employer 123017 IKE GAMING INC Joe Woody Chief Financial Officer 600 East Fremont Street Las Vegas NV 89101 702-474-3613

Doing Business As HOTEL & CASINO Effective Date: 05-08-2009

Association Name DBA Date Third Party Administrator NEVADA ALTERNATIVE SOLUTIONS INC 10-09-1983 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 153613 Intermountain Health Care Inc. Harlan Hammond Asst. Vice President c/o Intermountain Health Care Inc.36 S. State Street, 16th Floor Salt Lake City UT 84111 801-381-6731

Association Name DBA Date Subsidiary IHC Health Services Inc. 06-28-2019 Subsidiary SelectHealth, Inc. 06-28-2019 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 06-28-2019

C of A Employer 123048 KENNAMETAL INC Michael Murphy Director, Corporate Risk Management 1600 Technology Way Latrobe PA 15650 724-539-4647

Association Name DBA Date Third Party Administrator NEVADA ALTERNATIVE SOLUTIONS INC 10-01-2007

C of A Employer 123021 KIEWIT CORPORATION Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Shannon Pechar Risk Management Specialist Kiewit Plaza Omaha NE 68131 402-271-2931

Association Name DBA Date Subsidiary AERO AUTOMATIC SPRINKLER COMPANY 08-26-2009 Subsidiary CONTINENTAL FIRE SPRINKLER COMPANY 02-26-2009 Subsidiary KIEWIT INFRASTRUCTURE CO. 11-01-1999 Subsidiary KIEWIT INFRASTRUCTURE WEST CO. 09-01-2012 Subsidiary KIEWIT POWER CONSTRUCTORS CO. 12-29-2007 Subsidiary MASS. ELECTRIC CONSTRUCTION CO. 12-01-2011 Subsidiary TIC-INDUSTRIAL COMPANY, THE 12-29-2008 Subsidiary WESTERN SUMMIT CONSTRUCTORS, INC. 12-29-2008 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 11-01-1999

C of A Employer 123052 KINROSS GOLD CORPORATION Caroline Wild Director, Global Pension & Benefits 5075 South Syracuse Street, Suite 800 Denver CO 80237 303-802-1443

Association Name DBA Date Subsidiary KG MINING (BALD MOUNTAIN) INC. 06-01-2016 Subsidiary ROUND MOUNTAIN GOLD CORP 12-01-1991 Third Party Administrator TRISTAR RISK MANAGEMENT 12-01-1991 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 146761 KNIGHT-SWIFT TRANSPORTATION HOLDINGS INC FOR KNIGHT TRANSPORTATION INC Brett Sant SVP - Safety and Risk Management 20002 N. 19th Avenue Phoenix AZ 85027 602-606-6218

Association Name DBA Date Subsidiary KNIGHT-SWIFT TRANSPORTATION HOLDINGS INC. 01-01-2018 Third Party Administrator YORK RISK SERVICES GROUP INC 09-08-2017

C of A Employer 122996 KROGER CO (THE) Nathan Fraley Corporate Claims Manager 1014 Vine Street Cincinnati OH 45202 513-762-4360

Association Name DBA Date Subsidiary FRED MEYER JEWELERS, INC 11-15-1998 Subsidiary QUIK STOP MARKETS, INC. 10-11-2001 Subsidiary SMITH'S FOOD & DRUG CENTERS, INC. 11-01-1981 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 11-01-1981 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 123034 LAS VEGAS CONVENTION AND VISITORS AUTHORITY Jessica Lerner Sr. Manager of People Rewards 3150 PARADISE RD LAS VEGAS NV 89109-9096 702-892-2839

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-2002

C of A Employer 123092 LAS VEGAS METROPOLITAN POLICE DEPARTMENT Jeff Roch Director of Risk Management 400 S. Martin Luther King Blvd. Las Vegas NV 89106 702-828-3406

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-01-1993

C of A Employer 122959 LAS VEGAS SANDS CORP George Batarseh Associate General Counsel 3355 Las Vegas Blvd South Las Vegas NV 89109 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 702-414-1395

Association Name DBA Date Subsidiary LAS VEGAS SANDS, LLC 04-28-1989 Subsidiary VENETIAN CASINO RESORT, LLC VENETIAN RESORT HOTEL CASINO 01-01-1998 Third Party Administrator Sierra Nevada Administrators 04-28-1989

C of A Employer 123037 WATER DISTRICT Kenya Henderson EHS Manager 1001 South Valley View Blvd.m/s 380 Las Vegas NV 89153 702-822-8403

Association Name DBA Date Third Party Administrator Sierra Nevada Administrators 01-01-2003

C of A Employer 161960 LS GROUP PARENT OPCO LLC Denny Carter Risk Services Manager 20900 Cooley Rd Bend OR 97701 541-416-5479

Association Name DBA Date Subsidiary Les Schwab Tire Centers of Nevada, LLC 11-02-2020 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 12-01-1997

C of A Employer 123040 LYON COUNTY SCHOOL DISTRICT Blake Smith Risk Management 25 East Goldfield Ave Yerington NV 89447 775-463-6800 x 10027

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-2003

C of A Employer 122854 MACY'S INC Ann Back Senior Manager, Risk Mgmt Accounting Macy's Corporate ServicesAttn: Ann Back - Risk Accounting Springdale OH 45246 513-562-6647

Association Name DBA Date Subsidiary BLOOMINGDALE'S, INC. 11-01-2002 Subsidiary Bluemercury, Inc. 08-29-2016 Subsidiary MACY'S CORPORATE SERVICES, INC. 04-01-1999 Subsidiary MACY'S RETAIL HOLDINGS, INC. 05-01-1995 Subsidiary MACY'S SYSTEMS AND TECHNOLOGY, INC. 04-01-1999 Subsidiary MACY'S WEST STORES, INC. 05-01-1995 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 03-05-2018 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 122999 MARRIOTT INTERNATIONAL INC Steve Huy Compliance Analyst 10400 Fernwood Road Dept 52/924.36 Bethesda MD 20817 301-380-4450

Association Name DBA Date Subsidiary COURTYARD MANAGEMENT CORPORATION 08-01-1989 Subsidiary FAIRFIELD FMC, LLC 11-01-1993 Subsidiary MARRIOTT CLAIMS SERVICES CORPORATION 10-01-2006 Subsidiary MARRIOTT HOTEL SERVICES, INC. 12-01-1999 Subsidiary MARRIOTT INTERNATIONAL ADMINISTRATIVE SERVICES, INC. 10-01-1997 Subsidiary RESIDENCE INN BY MARRIOTT, LLC 08-01-1989 Subsidiary SPRINGHILL SMC, LLC 10-01-2011 Subsidiary THE RITZ-CARLTON HOTEL COMPANY, LLC 10-01-2006 Subsidiary W Hotel Managment, Inc. 12-31-2016 Third Party Administrator SELF-ADMINISTERED 02-01-1982

C of A Employer 123131 MCDONALD'S CORPORATION Jody Sundquist Insurance Compliance Supervisor 110 North Carpenter Street Chicago IL 60607 630-306-9653 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Association Name DBA Date Subsidiary McDonald's Restaurants of Nevada, Inc. 12-01-1993 Third Party Administrator GALLAGHER BASSETT SERVICES, INC.(TPA) 12-01-1993

C of A Employer 123082 MCKESSON CORPORATION Debra Levy Director of Claims, Global Risk Management 1110 Sanctuary Parkway Alpharetta GA 30009 770-462-7611

Association Name DBA Date Subsidiary MCKESSON MEDICAL-SURGICAL INC. 12-01-1997 Subsidiary MCKESSON PHARMACY OPTIMIZATION LLC 05-01-2008 Subsidiary McKesson Specialty Arizona, Inc. 10-01-2015 Subsidiary McKesson Specialty Health Technology Products LLC 04-01-2015 Subsidiary US ONCOLOGY RESEARCH LLC 01-01-2012 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 02-28-2011

C of A Employer 122978 MESQUITE GAMING LLC Deisy Duran Director, Benefits & Workers Compensation 950 W MESQUITE BLVD MESQUITE NV 89027-5204 702-346-4000 x 3916

Association Name DBA Date Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Subsidiary C&HRV, LLC 10-04-2011 Subsidiary CasaBlanca Resort & Casino 08-01-2011 Subsidiary Casablanca Resorts, LLC. 08-01-2011 Subsidiary Oasis Recreational Properties, Inc. 08-01-2011 Subsidiary Oasis Resort & Casino 08-01-2011 Subsidiary RBG, LLC. 08-01-2011 Subsidiary Virgin River Hotel, Casino, & Bingo 08-01-2011 Third Party Administrator YORK RISK SERVICES GROUP INC 04-01-1995

C of A Employer 122995 MGM RESORTS INTERNATIONAL Mike Jokerst

MGM ADMINISTRATION BUILDING71 E HARMON AVE LAS VEGAS NV 89109-4539 702-692-9583

Association Name DBA Date Subsidiary 10-06-1994 Subsidiary M.I.R. Travel 01-01-1992 Subsidiary MGM Grand Las Vegas 12-01-1993 Subsidiary MGM Grand Laundry, Inc. 12-01-1993 Subsidiary MGM Resorts Design & Development 10-26-1981 Subsidiary LLC 04-01-1998 Subsidiary Mandalay Place 05-01-2001 Subsidiary Mandalay Resort Group 11-15-1980 Subsidiary New Castle LLC Excalibur Hotel/Casino 10-01-1989 Subsidiary New York New York Hotel & Casino 12-01-1996 Subsidiary Park District Holdings, LLC 06-18-2013 Subsidiary Ramparts, LLC Luxor Hotal/Casino 07-01-1993 Subsidiary Shadow Creek 05-01-1989 Subsidiary Slots-A-Fun 11-15-1980 Subsidiary Casino-Hotel, LLC 05-01-1989 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Subsidiary Victoria Partners Park MGM Las Vegas 07-01-1996 Subsidiary Victoria Partners Monte Carlo 07-01-1996 Third Party Administrator SELF-ADMINISTERED 10-26-1981

C of A Employer 123160 MONARCH CASINO & RESORT INC Aaron Theis

3800 S VIRGINIA ST RENO NV 89502-6005 775-335-4534

Association Name DBA Date Subsidiary Golden Road Motor Inn, Inc. Atlantis Casino Resort 01-01-1994 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-01-1994

C of A Employer 135181 Marnell Gaming, LLC Geri-Lynn VanOrman Risk & Insurance Manager 222 Via Marnell Way Las Vegas NV 89119 707-739-2000 x 2113

Doing Business As Colorado Bell Hotel & Casino Effective Date: 04-01-2015 Doing Business As Edgewater Hotel & Casino Effective Date: 04-01-2015

Association Name DBA Date Subsidiary Nugget Sparks, LLC Nugget Casino Resort 05-01-2016 Third Party Administrator YORK RISK SERVICES GROUP INC 05-01-2016 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 122873 NEV YELLOW NEV CHECKER & NEV STAR CAB CORP Zel Bales Payroll Manager/Assistant HR Manager 5225 W POST RD LAS VEGAS NV 89118-4331 702-933-1826

Association Name DBA Date Subsidiary Cab Transport, LLC 02-28-2019 Subsidiary NewCab 21 LLC Operations Series 07-01-2020 Subsidiary NewCab ACQ LLC Operations Series 07-01-2020 Subsidiary NewCab CT LLC Operations Series 07-01-2020 Subsidiary NewCab TT LLC Operations Series 07-01-2020 Subsidiary Taxi Management, LLC 02-28-2019 Subsidiary Taxi Transport, LLC 02-28-2019 Subsidiary Twenty First Century Taxi, LLC 02-28-2019 Subsidiary YCS Acquisition, LLC 02-28-2019 Subsidiary YCS Checker LLC Operations Series 07-01-2020 Subsidiary YCS Star LLC Operations Series 07-01-2020 Subsidiary YCS Yellow LLC Operations Series 07-01-2020 Third Party Administrator CORVEL ENTERPRISE COMP INC HRMS 01-01-1995

C of A Employer 123170 NEVADA READY MIX CORPORATION Larry Miller Corporate Administrator 151 CASSIA WAY HENDERSON NV 89014-6616 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 702-457-1115 x 3038

Association Name DBA Date Third Party Administrator BENCHMARK ADMINISTRATORS, LLC 04-01-2020

C of A Employer 123045 NEVADA SYSTEM OF HIGHER EDUCATION Lisa Schaller Director of Insurance & Loss Mgt. 2601 Enterprise Rd., Mail Stop 014 Reno NV 89512-1666 775-784-3472

Association Name DBA Date Subsidiary COMMUNITY COLLEGE OF SOUTHERN NEVADA 01-01-2004 Subsidiary DESERT RESEARCH INSTITUTE 01-01-2004 Subsidiary GREAT BASIN COLLEGE 01-01-2004 Subsidiary NEVADA STATE COLLEGE AT HENDERSON 01-01-2004 Subsidiary TRUCKEE MEADOWS COMMUNITY COLLEGE 01-01-2004 Subsidiary UNIVERSITY OF NEVADA LAS VEGAS 01-01-2004 Subsidiary UNIVERSITY OF NEVADA RENO 01-01-2004 Subsidiary WESTERN NEVADA COMMUNITY COLLEGE 01-01-2004 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-01-2004

C of A Employer 123039 NEW-COM, INC. Mark Summers Risk Manager 6600 AMELIA EARHART CT STE B Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List LAS VEGAS NV 89119-3535 702-642-3331

Association Name DBA Date Subsidiary Biodiesel of Las Vegas, Inc. 07-29-2003 Subsidiary L.L.O., Inc. Acme Electric 07-29-2003 Subsidiary MMC, Inc. MMC Southwest, Inc. 07-29-2003 Subsidiary TAB Contractors, Inc. 07-29-2003 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-29-2003

C of A Employer 122968 NEWMONT CORPORATION Jim Yates Sr. Director , Risk Finance 6900 E Layton AvenueSuite 800 Denver CO 80237 720-299-6147

Doing Business As Newmont Mining Corpoation Effective Date: 04-29-2008

Association Name DBA Date Subsidiary Battle Mountain Gold Company 04-29-2008 Subsidiary Elko Land and Livestock Company 04-29-2008 Subsidiary Fronteer Gold 04-06-2011 Subsidiary Newmont Exploration Ltd. 04-29-2008 Subsidiary Newmont Global Employment Ltd Partnership 04-29-2008 Subsidiary Newmont Gold Company 04-29-2008 Subsidiary Newmont Indonesia Investment Ltd 04-29-2008 Subsidiary Newmont International Services Ltd. 04-29-2008 Subsidiary Newmont Nevada Energy Investment, LLC 04-29-2008 Subsidiary Newmont USA Ltd Newmont Mining Corporation 09-20-2008 Subsidiary Santa Fe Pacific Gold Corporation 04-29-2008 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Subsidiary Turquoise Ridge JV 04-29-2008 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 04-29-2008

C of A Employer 123064 NV ENERGY INC Eric Wright

6226 W SAHARA AVE LAS VEGAS NV 89146-3060 702-402-5343

Association Name DBA Date Subsidiary NV ENERGY POWER COMPANY 07-01-1994 Subsidiary Nevada Power Company 07-28-1999 Subsidiary Sierra Pacific Power Company 07-01-1992 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 02-01-2018

C of A Employer 122969 NYE COUNTY SCHOOL DISTRICT Raymond Ritchie CFO 484 S WEST ST PAHRUMP NV 89048-2104 775-727-7743 x 234

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-2008 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 163132 Nye County Lorina Dellinger Assistant County Manager PO Box 153 Tonopah NV 89049 775-482-7319

Association Name DBA Date Subsidiary Amargosa Valley, Town of 06-18-2021 Subsidiary Beatty General Improvement District 06-18-2021 Subsidiary Beatty, Town of 06-18-2021 Subsidiary Gabbs, Town of 06-18-2021 Subsidiary Nye County Water District 06-18-2021 Subsidiary Pahrump, Town of 06-18-2021 Subsidiary Tonopah Ambulance 06-18-2021 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-2021

C of A Employer 122871 PACCAR INC Alison Lowe

PO BOX 1518 BELLEVUE WA 98009-1518 425-468-7384

Association Name DBA Date Subsidiary PACCAR PARTS DIVISION 01-01-1995 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 01-01-1995 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 122953 PEPPERMILL CASINOS INC Michael Heward Director of Risk Management 380 Brinkby Ave, Suite B Reno NV 89509 775-689-8992

Association Name DBA Date Subsidiary Nevada Properties Peppermill Hotel & Casino 07-01-1998 Subsidiary Peppermill Hotel, Reno 07-01-1998 Subsidiary Rainbow Associates, Inc. Rainbow Club 07-01-1998 Subsidiary Rainbow Casino, The 01-31-1995 Subsidiary Wendover Properties Peppermill Inn & Casino 07-01-1988 Subsidiary Western Village Limited Partnership Western Village Casino 07-01-1998 Third Party Administrator HOMETOWN HEALTH PROVIDERS INSURANCE COMPANY WorkersChoice 09-11-2013

C of A Employer 122981 PILOT TRAVEL CENTERS, LLC Bill Beuchat Senior Risk Manager PO BOX 10146 KNOXVILLE TN 37939-0146 800-562-6210 x 2902

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 09-01-2017

C of A Employer Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 122971 POLY-AMERICA FOR POLY-WEST INC Kelsey Pigneri Human Resources Manager 2000 West Marshall Drive Grand Prairie TX 75051 972-337-7619

Association Name DBA Date Third Party Administrator GALLAGHER BASSETT SERVICES, INC.(TPA) 02-01-2009

C of A Employer 123219 PURCELL TIRE & RUBBER COMPANY Roxanna Wilson Claims Administrator 301 N HALL ST POTOSI MO 63664-1403 573-438-2131 x 1153

Association Name DBA Date Subsidiary Purcell Tire & Rubber Company Purcell Tire and Service Center 01-01-1998 Subsidiary Purcell Tire Company Tires @ Wholesale 01-01-1998 Subsidiary Purcell Tire Company Purcell's Western States Tire 01-01-1998 Subsidiary Purcell Tire Company Purcell Tire and Service Center 01-01-1998 Subsidiary Purcell Tire NW, Inc. 09-14-2016 Third Party Administrator GALLAGHER BASSETT SERVICES, INC.(TPA) 01-01-1998

C of A Employer 123242 RALEY'S INC Fiona Williams Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Senior Risk Manager 500 W Capitol Ave West Sacramento CA 95605 916-373-6214

Doing Business As RALEY'S AISLE 1 Effective Date: 06-30-2014

Association Name DBA Date Subsidiary Warehouse Concepts, a California Corporation Beverage Market 02-17-2011 Subsidiary Warehouse Concepts, a California Corporation Food Source 02-17-2011 Third Party Administrator CORVEL ENTERPRISE COMP INC HRMS 07-01-1986

C of A Employer 123237 RENOWN HEALTH Shawn Lavac Risk Management Workers' Compensation 1155 MILL ST MS J-11 RENO NV 89502-1576 775-982-6902

Association Name DBA Date Subsidiary HOMETOWN HEALTH MGT CO 01-01-1989 Subsidiary HOMETOWN HEALTH PLAN INC. 01-01-1989 Subsidiary RENOWN BUSINESSES 01-01-1992 Subsidiary RENOWN HEALTH FOUNDATION 01-01-1989 Subsidiary RENOWN NETWORK SERVICES 01-01-1989 Subsidiary RENOWN REGIONAL MEDICAL CENTER 08-01-1985 Subsidiary RENOWN SKILLED NURSING 06-17-2004 Subsidiary RENOWN SOUTH MEADOWS MEDICAL CENTER 02-01-1999 Third Party Administrator HOMETOWN HEALTH PROVIDERS INSURANCE COMPANY WorkersChoice 08-01-1995 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 123238 RIVERSIDE RESORT & CASINO Steve Willett Director Human Resources 1650 S Casino Center Drive Laughlin NV 89029 702-298-2535

Association Name DBA Date Subsidiary LAUGHLIN TRANSIT, INC. 07-09-2003 Third Party Administrator YORK RISK SERVICES GROUP INC 09-28-1985

C of A Employer 153157 Robertson's Ready Mix, Ltd. Hortick Roger

200 S. Main St., Suite 200 Corona CA 92882 951-493-6500

Association Name DBA Date Third Party Administrator MATRIX ABSENCE MANAGEMENT INC 06-11-2019

C of A Employer 123217 SCHNEIDER NATIONAL INC Amy Sawyer Risk Insurance Analyst Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 3101 PACKERLAND DR GREEN BAY WI 54313-6187 920-592-3071

Association Name DBA Date Subsidiary SCHNEIDER LOGISTICS, INC. 01-01-1998 Subsidiary SCHNEIDER NATIONAL BULK CARRIERS 01-01-1998 Subsidiary SCHNEIDER NATIONAL CARRIERS 01-01-1998 Subsidiary SCHNEIDER SPECIALIZED CARRIERS 01-01-1998 Subsidiary SCHNEIDER TANK LINES 01-01-1998 Subsidiary SCHNEIDER TRANSPORT, INC. 01-01-1998 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 03-01-2017

C of A Employer 123154 SHERWIN-WILLIAMS COMPANY Anthony Colangelo Manager Workers Comp 101 Prospect Avenue NW Cleveland OH 44115-1075 216-566-3095

Association Name DBA Date Subsidiary SHERWIN-WILLIAMS MANUFACTURING COMPANY 01-01-2018 Third Party Administrator GALLAGHER BASSETT SERVICES, INC.(TPA) 08-01-2017

C of A Employer 123201 SILVERTON CASINO LLC & MAJESTIC NV PROPERTY HOLDINGS LLC Darlene Koch HR Benefits Manager Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 3333 BLUE DIAMOND RD LAS VEGAS NV 89139-7888 702-914-8513

Association Name DBA Date Subsidiary MNPH Hotels, LLC Hyatt Place Las Vegas at Silverton Village 07-01-2019 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-1997

C of A Employer 123167 SOUTHWEST AIRLINES CO Patti Colwell Manager Workers' Compensation 2195 Research Row, WGS-1SE DALLAS TX 75235 469-603-4828

Association Name DBA Date Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 03-01-1994

C of A Employer 122955 SOUTHWEST GAS CORPORATION Bradley Anderson Corporate Risk Management PO BOX 98510 LAS VEGAS NV 89193-8510 702-876-7017

Association Name DBA Date Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Third Party Administrator SELF-ADMINISTERED 07-01-1988

C of A Employer 122976 STATION CASINOS LLC Tim Cameron Corp Director Risk Management 1505 S PAVILION CENTER DR LAS VEGAS NV 89135-1403 702-495-3476

Association Name DBA Date Subsidiary FP Holding, L.P. dba 10-01-2016 Subsidiary GREENS CAFE, LLC dba The Greens The Greens 06-14-2011 Subsidiary N-M Ventures II LLC 10-01-2016 Subsidiary N-M Ventures LLC 10-01-2016 Subsidiary NP BOULDER LLC dba Hotel & Casino Boulder Station Hotel & Casino 06-14-2011 Subsidiary NP FIESTA LLC dba Fiesta Casino Hotel Fiesta Casino Hotel 06-14-2011 Subsidiary NP GOLD RUSH LLC dba Wildfire Sunset Wildfire Sunset 06-14-2011 Subsidiary NP LAKE MEAD LLC dba Casino Hotel Fiesta Henderson Casino Hotel 06-14-2011 Subsidiary NP LML LLC dba Wildfire Casino - Lake Mead Wildfire Casino - Lake Mead 06-14-2011 Subsidiary NP MAGIC STAR LLC dba Wildfire Casino - Boulder Wildfire Casino - Boulder 06-14-2011 Subsidiary NP PALACE LLC dba Hotel & Casino Palace Station Hotel & Casino 06-14-2011 Subsidiary NP RANCHO LLC dba Wildfire Casino Wildfire Casino 06-14-2011 Subsidiary NP RED ROCK LLC dba Red Rock Casino Resort Spa Red Rock Casino Resort Spa 06-14-2011 Subsidiary NP SANTA FE LLC dba Hotel & Casino Santa Fe Station Hotel & Casino 06-14-2011 Subsidiary NP SUNSET LLC dba Sunset Station Hotel & Casino Sunset Station Hotel & Casino 06-14-2011 Subsidiary NP TEXAS LLC dba Gambling Hall & Hotel Texas Station Gambling Hall & Hotel 06-14-2011 Subsidiary NP TROPICANA LLC dba Days Inn @ Wild Wild West Gambling Hall Days Inn @Wild Wild West Gambling Hall 06-14-2011 Subsidiary PPII Holdings, L.L.C. 10-01-2016 Subsidiary LLC dba Palms Place 10-01-2016 Subsidiary SC SP 2 LLC dba Wildfire Valley View Wildfire Valley View 09-30-2014 Subsidiary SC SP 4 LLC dba Wildfire Anthem Wildfire Anthem 09-30-2014 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List STATION GVR ACQUISITION, LLC dba Resort Subsidiary Green Valley Ranch Resort Spa Casino 06-14-2011 Spa Casino Subsidiary SUNSET GV, LLC dba Wildfire Casino and Lanes Wildfire Casino and Lanes 06-14-2011 TOWN CENTER AMUSEMENTS, INC. A LIMITED LIABILITY Subsidiary Barley's Casino & Brewing Company 06-14-2011 COMPANY dba Barley's Casino & Brewing Company Third Party Administrator YORK RISK SERVICES GROUP INC 09-11-2013

C of A Employer 135224 T & R CONSTRUCTION GROUP Alisa Foster VP 4367 W Sunset Rd. LAS VEGAS NV 89118 702-789-4933

Association Name DBA Date Third Party Administrator NEVADA ALTERNATIVE SOLUTIONS INC 12-01-1997

C of A Employer 123055 TARGET CORPORATION Laurene Dufault Consultant - Risk Consulting AON Global Risk Consulting5600 W 83rd St. MINNEAPOLIS MN 55437 952-807-0701

Association Name DBA Date Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 02-01-1992 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 122972 TREASURE ISLAND LLC Tara Cummins V/P Human Resources 2880 SOUTH LAS VEGAS BLVD LAS VEGAS NV 89109 702-894-7506

Association Name DBA Date Subsidiary CIRCUS CIRCUS LV LLC CIRCUS CIRCUS HOTEL & CASINO 03-20-2020 Third Party Administrator YORK RISK SERVICES GROUP INC 08-01-2009

C of A Employer 123180 TRUE BLUE INC Tori Livernash Risk Specialist 1015 A Street TACOMA WA 98402 253-680-8498

Association Name DBA Date Subsidiary PeopleReady. Inc. 09-20-2016 Third Party Administrator ESIS INC 09-11-2013

C of A Employer 123102 US FOODS INC Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Cinthia Castillo Risk Analyst 9399 W. Higgins RoadSuite 100 Rosemont IL 60018 847-720-8206

Association Name DBA Date Subsidiary AMERISTAR MEATS, INC 09-13-2019 Subsidiary FOOD SERVICES OF AMERICA, INC 09-13-2019 Subsidiary SMART FOODSERVICE STORES, LLC 04-24-2020 Subsidiary STOCKYARDS OF LAS VEGAS HARRISON'S PRIMEMEATS AND PROVISIONS 03-01-1997 Subsidiary STOCKYARDS OF LAS VEGAS OUTWEST MEAT COMPANY 04-01-1998 Subsidiary SYSTEM SERVICES OF AMERICA, INC 09-13-2019 Third Party Administrator GALLAGHER BASSETT SERVICES, INC.(TPA) 04-01-1993 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 11-01-2016

C of A Employer 123153 VIAD CORP Matt Heacock Assistant Client Services Specialist 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE AZ 85254-1804 602-787-6112

Association Name DBA Date Subsidiary Global Experience Specialists, Inc. 02-02-2010 Subsidiary ON Services AV Specialists, Inc. 08-11-2018 Subsidiary Shows Unlimited, Inc. 01-01-1997 Third Party Administrator CORVEL ENTERPRISE COMP INC HRMS 09-01-1991 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List

C of A Employer 123024 WASHOE COUNTY Celeste Wallick Risk Analyst 1001 E. Ninth Street RENO NV 89512 775-328-2662

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-1981

C of A Employer 123035 WASHOE COUNTY SCHOOL DISTRICT Brandon Perry Risk Coordinator PO BOX 30425 RENO NV 89520-3425 775-348-3854

Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 07-01-1986

C of A Employer 123036 WENDOVER CASINOS INC Michael Heward Director of Risk Management Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 380 Brinkby Ave, Suite B Reno NV 89509 775-689-8992

Doing Business As Montego Bay Casino and Resort Effective Date: 07-29-2002

Association Name DBA Date Subsidiary PPLLC 12-19-2002 Third Party Administrator HOMETOWN HEALTH PROVIDERS INSURANCE COMPANY WorkersChoice 12-19-2002

C of A Employer 122888 WESTERN STATES CONTRACTING INC Kade Stratton CFO 4129 W Cheyenne, Suite A North Las Vegas NV 89032 702-644-1117

Association Name DBA Date Subsidiary BDF Employment Services LLC 01-15-2013 Subsidiary Badger Underground 12-31-2017 Subsidiary Tejas Underground LLC 05-01-1998 Subsidiary WS-Dynoco II, LLC 02-21-2014 Subsidiary Western States Ranches LLC 12-01-2020 Third Party Administrator SELF-ADMINISTERED 09-01-1995

C of A Employer 123231 YOUNG ELECTRIC SIGN COMPANY Clark Smith Director of Finance/Treasurer Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 1605 Gramercy Road Salt Lake City UT 84104 801-464-4600

Association Name DBA Date Subsidiary YESCO ADMINISTRATION LLC 01-01-2008 Subsidiary YESCO OUTDOOR MEDIA LLC 01-01-2008 Subsidiary YESCO, LLC 01-01-2008 Third Party Administrator NEVADA ALTERNATIVE SOLUTIONS INC 07-05-1984

C of A Employer 123240 YRC, INC. Greg Zinkiewicz Sr. Risk Analyst 10990 ROE AVE OVERLAND PARK KS 66211-1213 913-266-6573

Doing Business As YRC FREIGHT Effective Date: 02-01-2012

Association Name DBA Date Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 05-01-1986