STATE OF GEORGIA

SUBSEQUENT INJURY TRUST FUND

July 2013 SITF 2012 Annual Report – Page 2

State of Georgia Subsequent Injury Trust Fund

Marriott Marquis Tower Two Suite 1250 285 Peachtree Center Avenue Atlanta, GA 30303-1229

Telephone: (404) 656-7000 Fax: (404) 656-7100 Website: http://sitf.georgia.gov

Board of Trustees John T. Fervier, II – Chairman E. Pauline Hale John L. Quinn Barbara Tempel Steve Heinen

Administrator Michael T. Coan

Deputy Administrator Allan Payne

SITF 2012 Annual Report – Page 3

Fund Administration ...... 4 Introduction ______4 How the Fund Works ______4 Reimbursement from the Fund ______4 Legislation ______4 Claims Administration ______7 Claims Activity – 2012 ______7 Settlement Reimbursement Limits ______8 Financial Activity ______9 Reimbursements Paid in 2012 ...... 10 Reimbursements to Insurance Companies ______10 Reimbursements to Self-Insurers ______15 Reimbursements to Group Self-Insurers ______21 Individual Employers Benefitting from SITF Reimbursements ...... 22 Assessment by the Fund ...... 46 Legal Requirements ______46 Assessment Calculation ______47 Assessment Adjustment for 2011 ______47 Assessment Rate for 2012 ______47 Assessments Due for 2012 ...... 48 Assessments Due from Insurance Companies ______48 Assessments Due from Self-Insurers ______55 Assessments Due from Group Self-Insurers ______63

SITF 2012 Annual Report – Page 4

Fund Administration employment provided the employer could Introduction demonstrate prior knowledge.

Reimbursement from the Fund On July 1, 1977, the Georgia General Assembly enacted legislation establishing All licensed workers' compensation the Subsequent Injury Trust Fund. It is insurance carriers and self-insured designed to reduce the impact of singularly employers authorized by the State Board of large workers' compensation claims in the Workers’ Compensation in the state of event a worker with a disability, injured on Georgia may access the fund. the job, aggravates a pre-existing permanent impairment. Employers/insurers must notify the fund of a possible claim by filing a Notice of Claim no The Subsequent Injury Trust Fund is later than 78 weeks following the date of governed by a five-member Board of injury. Trustees appointed by the Governor for six- year terms. The Administrator and staff In addition to the mandatory Notice of conduct the day-to-day administration of the Claim, the employer must submit a fund. notarized Employer’s Knowledge Affidavit, certifying prior knowledge of the worker’s How the Fund Works pre-existing permanent impairment. The fund helps workers with disabilities by providing employers, who are not subject to Employers/insurers may be reimbursed for the Americans with Disabilities Act, with all weekly income benefits payable after 104 incentives to hire or retain qualified workers weeks; for 50% of all medical and with disabilities. The fund supports insured rehabilitation expenses between $5,000 and employers by keeping workers' $10,000; and for 100% of all medical and compensation premiums under control, and rehabilitation expenses in excess of if an employer is self-insured, keeps the $10,000. workers' compensation exposure at the deductible levels. If the subsequent injury was not caused by or related to a prior impairment, the In order for an employer/insurer to be reimbursement for medical expenses may eligible for reimbursement from the fund, the be reduced or denied completely. on-the-job injury of the employee must be Legislation directly caused by or combined with a prior impairment to create a greater liability for In 2005, House Bill 200 amended the lost-time benefits and medical expenses. In Official Code of Georgia by adding addition, the employee must have a pre- Chapter 34-9-368 setting the date to existing impairment that the employer dissolve the agency and establishing June considered to be permanent and likely to be 30, 2006 as the last date of injury eligible for a hindrance to employment, and the reimbursement by the Fund. employer must have knowledge of the prior impairment before the subsequent injury 34-9-368. Reimbursement of self-insured occurs. employers or insurers; actuarial study required; dissolution of Subsequent Injury Trust Fund O.C.G.A.§34-9-361 contains a list of (a) The Subsequent Injury Trust Fund shall not conditions that are presumed to be reimburse a self-insured employer or an insurer permanent and likely to be a hindrance to for a subsequent injury for which a claim is made for an injury occurring after June 30, SITF 2012 Annual Report – Page 5

2006. The Subsequent Injury Trust Fund shall continue to reimburse self-insured employers or 34-9-362. Notice by employer or insurer of insurers for claims for injuries occurring on and claim against fund prior to June 30, 2006, which qualify for (a) An employer or insurer shall notify the reimbursement. administrator of the fund of any possible claim (b) Self-insured employers and insurers shall against the fund as soon as practicable, but in continue to pay assessments pursuant to Code no event later than 78 calendar weeks following Section 34-9-358 to the extent necessary to fund the injury or the payment of an amount claims for injuries occurring on and prior to equivalent to 78 weeks of income or death June 30, 2006. benefits, whichever occurs last. (c) Upon or in contemplation of the final (b) The claim must be filed in accordance with payment of all claims filed for subsequent the requirements of subsection (a) of this Code injuries for which claims are filed for injuries section prior to the final settlement of the claim. occurring on and prior to June 30, 2006, the (c) Failure to comply with the provisions of board of trustees shall adopt and implement subsections (a) and (b) of this Code section will resolutions providing for the final dissolution of constitute a bar to recovery from the Subsequent the Subsequent Injury Trust Fund. Such Injury Trust Fund. resolutions shall become effective when all (d) For those notices of claim filed with the claims made for injuries occurring on and prior fund on or before July 1, 2006, the employer or to June 30, 2006, have been fully paid or insurer shall have until June 30, 2009, to obtain otherwise resolved and shall include provisions a reimbursement agreement issued by the fund for: or the claim for reimbursement shall be deemed (1) The termination of assessments against automatically denied. insurers or self-insurers; (e) For those notices of claim filed with the (2) The pro rata refund of assessments fund after July 1, 2006, the employer or insurer previously collected and unexpended; shall have three years from the date the notice (3) The termination of employment of the was received by the fund to obtain a employees of the fund or the transfer of reimbursement agreement issued by the fund or employment of any employees to any other state the claim for reimbursement shall be deemed agency desiring to accept them; automatically denied. (4) A final accounting of the financial affairs (f) Notwithstanding subsections (d) and (e) of of the fund; and this Code section, if compensability of the (5) The transfer of the books, records, and underlying workers' compensation claim is at property of the fund to the custody of the State issue before the State Board of Workers' Board of Workers' Compensation. Compensation, then the employer or insurer Upon the completion of all matters provided for shall have three years from the date of final in such resolutions, but not later than December adjudication of compensability by the State 31, 2020, the Subsequent Injury Trust Fund and Board of Workers' Compensation or any the members of its board of trustees shall be appellate court to obtain a reimbursement discharged from their duties except for such agreement issued by the fund or the claim for personnel necessary to administer any reimbursement shall be deemed automatically remaining claims. denied. (g) Upon actual or statutory automatic denial In 2006, an amendment to OCGA 34-9-362 pursuant to subsection (d), (e), or (f) of this was passed to establish time limits for Code section, the employer or insurer shall have employers or insurers to satisfactorily prove 20 days from the date of denial to request a a claim once filed with the Subsequent hearing with the State Board of Workers' Injury Trust Fund. Compensation pursuant to Code Section 34-9- 100; otherwise recovery shall be barred.

SITF 2012 Annual Report – Page 6

In 2009, an amendment was passed to all related administrative costs have been OCGA 34-9-358 to establish a limit in the accrued or paid and a balance remains in the amount of funds collected from insurers and fund, all insurers and self-insurers in this state self-insurers in payment of assessments to who have maintained workers' compensation the Subsequent Injury Trust Fund. insurance in this state for any time during the preceding three years from the date that the last 34-9-358. Payment of assessments to fund by claim has been paid shall be entitled to a pro insurers and self-insurers; calculations rata refund of assessments previously collected (a) Prior to January 1, 2010, each insurer and and unexpended in the remaining fund balance. self-insurer under this chapter shall, under (2) The calculation for such pro rata refund to regulations prescribed by the board of trustees, be paid by the fund to each individual insurer make payments to the fund in an amount equal and self-insurer shall be determined by the to that proportion of 175 percent of the total following formula: disbursement made from the fund during the The balance remaining in the fund shall be preceding calendar year less the amount of the the numerator and shall be divided by the total net assets in the fund as of December 31 of the amount of assessments for workers' preceding calendar year which the total compensation coverage paid by all insurers and workers' compensation claims paid by the self-insurers during the three-year period, which insurer or self-insurer bears to the total workers' shall be the denominator. The quotient of the compensation claims paid by all insurers and numerator and denominator shall be multiplied self-insurers during the preceding calendar by the total amount of assessments that are paid year. by the individual insurer or self-insurer during (b) On or after January 1, 2010, each insurer the three-year period. The product of those and self-insurer under this chapter shall, under numbers shall represent the amount to be paid regulations prescribed by the board of trustees, to such insurer or self-insurer as its pro rata make payments to the fund in an amount equal refund from the balance remaining in the fund. to that proportion of 175 percent of the total (3) Nothing in this subsection shall preclude disbursement made from the fund during the the board of trustees from authorizing a loss preceding calendar year as of December 31 of portfolio transfer of any unresolved claims. the preceding calendar year which the total (e) An employer who has ceased to be a self- workers' compensation claims paid by the insurer prior to the end of the calendar year insurer or self-insurer bears to the total workers' shall be liable to the fund for the assessment of compensation claims paid by all insurers and the calendar year. Such employer who has self-insurers during the preceding calendar year ceased to be a self-insurer shall continue to be but not to exceed $100 million. The liable to the fund for assessments in subsequent administrator is authorized to create and calendar years so long as payments are made on maintain a reserve of surplus moneys as may be any workers' compensation claims made while deemed necessary by the board of trustees in in self-insured status. order to ensure sufficient moneys will be (f) The initial assessment of each insurer or available for the payment of all claims that are self-insurer for the purpose of generating to be paid by the fund in accordance with Code revenue to begin operation of the fund shall be Section 34-9-368. in the amount of one-half of 1 percent of the (c) The administrator is authorized to reduce workers' compensation premiums collected by or suspend assessments for the fund when a the insurer for the preceding calendar years completed actuarial survey shows further from an employer who is subject to this chapter assessments are not needed for all bona fide or the equivalent of such in the case of a self- claims that are to be paid by the fund. insurer. (d) (1) When further assessments are not needed as all eligible workers' compensation claims for which the fund is liable in accordance with Code Section 34-9-368 have been paid and SITF 2012 Annual Report – Page 7

Claims Administration reimbursement agreement is reached between the fund and the employer/insurer, The employer/insurer maintains it must be approved by the State Board of management of the employee’s claim for Workers' Compensation. the life of that claim. Once the fund has been notified of the claim, the The fund makes reimbursement payments employer/insurer must keep the fund to insurers and self-insurers in accordance informed of all developments, including with the Board approved reimbursement settlement negotiations. agreement.

The fund investigates the claim to determine eligibility for reimbursement. When a

Claims Activity – 2012 The following is a breakdown of claims activity for calendar year 2012. For information on prior years, please call (404) 656-7022 or visit our website at http://sitf.georgia.gov.

Open Claims 1/1/2012 3,347

Claims Received CY 2012 0

Closed Claims Reopened CY 2012 54

Claims Closed CY 2012 1,965

Open Claims 12/31/2013 1,436

Claims Accepted CY 2012 17

Claims Denied CY 2012 3

Notices in Pending CY 2012 524

SITF 2012 Annual Report – Page 8

available to cover the remaining liabilities in Settlement Reimbursement Limits 2020. The Fund has two types of reimbursements to issue to insurers and self-insurers. The Unless these structured installments are Fund has an ongoing obligation to issue made by the fund, there will only be reimbursement funds for accepted claims approximately $30 million available for that are open and will remain open for a settlements per year. This does not period of time, and for requests for accomplish the purpose of the Fund; results settlements that must be processed so that in additional administrative and backlog the settlement payments are made timely. costs, and creates a backlog for the insurer and self-insurer and may result in higher Reimbursement is made based on settlement costs to all parties. This program availability of monies for the regular will allow settlement of more cases over a reimbursement of indemnity and medical three year period. The Fund has instituted expenses as well as the reimbursement for the structured reimbursement process as total settlements of claims. follows:

Legislation requires a mandatory $100 (1) Any settlement up to $75,000.00 will million annual assessment (approximately be reimbursed in full as the current 7%) beginning in 2010 and continuing until backlog allows. an actuarial study determines assessments are no longer needed. (2) Any settlement of a case from $75,000.00 to $150,000.00 will be In an effort to recognize the effects of the paid under an installment process of $100 million cap, the Fund has implemented $75,000.00 paid in the first year. The a structured reimbursement for settled remaining installment will be claims. Settlement cases are placed on an reimbursed on the payment installment repayment plan so that cases anniversary date twelve (12) months can move forward in a timely fashion. later. The Fund will automatically issue a settlement reimbursement The purpose of the new installment program payment on the anniversary date of is to allow the Fund to authorize settlement the initial installment payment. of a claim with reimbursement of settlement proceeds over a period of one to three (3) Any settlements of $150,000.00 to years. In this way, the insurer and self $225,000.00 will be paid at insurer can minimize ongoing $75,000.00 per twelve (12) month reimbursement cost because the claim is period with the second and third settled and avoid the cost of staff monitoring payments being automatically issued reimbursement requests, and obtaining on the anniversary date of the initial appropriate reimbursement from the Fund. payment.

The purpose of the settlement structure (4) Any settlements above $250,000.00 reimbursement process is to ensure that the will be reimbursed in three (3) equal Fund has adequate monies on hand to installments per twelve (12) month accommodate the ongoing responsibility of period with the second and third reimbursement of medical and indemnity in payments being automatically issued cases that have not settled. Additionally, in on the anniversary date of the initial that the Fund has a sunset date of 2020, the payment. Fund will also be maximizing the amount of cases, which can be “settled” while still continuing to build a surplus of funds SITF 2012 Annual Report – Page 9

Financial Activity The following depicts the Fund’s revenues, expenditures, and fund balance for the calendar year ending December 31, 2012. The fund’s year-end balance is part of the formula for establishing the annual assessment. For information on prior years, please call (404) 656-7000 or visit our website at http://sitf.georgia.gov.

BEGINNING BALANCE, January 1, 2012 58,602,269.44

REVENUES

Assessment - 2011, Adj. 2010 99,958,255.36 payments and refunds from prior year 3,246.51

Interest Earned 64,983.28

Miscellaneous Income 285.68

TOTAL REVENUES 100,026,770.83

EXPENDITURES

Operating Cost 2,299,210.37

Reimbursements (Negotiated Checks) 101,025,779.67

TOTAL EXPENDITURES 103,324,990.04

Net Loss (3,298,219.21)

ENDING BALANCE, December 31, 2012 55,304,050.23

SITF 2012 Annual Report – Page 10

Reimbursements Paid in 2012

Reimbursements to Insurance Companies Total Dollars Paid by the Fund to Insurance Companies From 1/1/2012 Through 12/31/2012 Name Amount 21ST CENTURY NATIONAL INS CO $38,612.58 ACE AMERICAN INSURANCE CO $1,509,316.61 ACE PROPERTY & CASUALTY INS $228,304.62 ADVANTAGE WORKERS COMP. INS. $18,922.93 ALEA NORTH AMERICA $1.44 ALFA INSURANCE CORP $272,042.62 ALL AMERICA INS. CO $93,774.30 ALLIED INSURANCE COMPANY $9,453.58 ALLSTATE INSURANCE CO $22,869.25 AMERICAN ALTERNATIVE INS $50,557.23 AMERICAN CAS CO OF READING PA $439,719.38 AMERICAN ECONOMY INS CO $76.00 AMERICAN HOME ASSURANCE CO $1,234,183.71 AMERICAN INSURANCE CO $146,444.82 AMERICAN INTER INS CO OF GA $343,450.47 AMERICAN MFG. MUTUAL INS $31,278.07 AMERICAN MOTORISTS INS CO $37,019.75 AMERICAN PROTECTION INS CO $122,915.23 AMERICAN RESOURCES INS CO $47,334.82 AMERICAN ZURICH INS CO $50,005.75 AMERISURE INSURANCE CO $82,394.44 AMGUARD INSURANCE CO. $217.81 ARGONAUT INSURANCE CO $63,404.33 ARGONAUT LIMITED RISK INS CO $20,561.09 ARROWOOD INDEMNITY CO $164,860.25 ARROWPOINT CAPITAL $505,979.24 ASSOCIATED INDEMNITY CORP $1,898.04 ASSOCIATION INSURANCE CO $43,319.74 ATLANTIC MUTUAL INS. CO $46,194.36 ATLANTIC SPECIALTY INS CO $12.98 AUTO OWNERS INS. CO $531,957.98 AXIS INSURANCE CO $70,777.00 BANKERS STANDARD INS CO $166,836.73 BENCHMARK INS CO $77,325.34 BITUMINOUS CASUALTY CORP $96,757.12 BRIDGEFIELD CASUALTY $343,526.43 BUILDERS INSURANCE (A MUTUAL C $1,044,786.17 CANAL INSURANCE CO $825,330.74 SITF 2012 Annual Report – Page 11

Total Dollars Paid by the Fund to Insurance Companies From 1/1/2012 Through 12/31/2012 Name Amount CAPITAL CITY INS CO $236,846.48 CENTENNIAL INSURANCE CO $1,888.01 CENTRE INSURANCE CO $150,000.00 CHARTER OAK FIRE INS CO $41,129.14 CHARTIS CASUALTY COMPANY $493,223.27 CHURCH MUTUAL INS CO $183,447.19 CINCINNATI CASUALTY CO $42,733.26 CINCINNATI INSURANCE CO $320,980.71 CLARENDON NATIONAL INS CO $93,517.55 COLUMBIA NATIONAL INS CO $222,396.94 COMMERCE & INDUSTRY INS CO $225,362.21 COMPANION PROP & CAS $34,325.50 CONNECTICUT INDEMNITY CO $42,890.93 CONTINENTAL CASUALTY CO $984,961.32 CONTINENTAL INSURANCE CO $87,710.87 COREGIS INSURANCE CO $268.28 CRUM & FOSTER INDEMNITY CO $25,694.49 CYPRESS INSURANCE CO $262,544.67 DISCOVER PROPERTY & CAS $57,218.93 ELECTRIC INSURANCE CO $52,601.55 ELECTRIC MUTUAL LIAB INS LTD $54,356.18 EMPLOYERS ASSURANCE CO $18,292.00 EMPLOYERS INS OF WAUSAU $358,636.66 EMPLOYERS REINSURANCE CORP $84,467.93 EVEREST NATIONAL INS $138,993.01 FAIRFIELD INSURANCE CO $50,907.96 FAIRMONT SPECIALTY INS CO $210,078.62 FEDERAL INSURANCE CO $265,148.12 FEDERATED MUTUAL INS CO $458,772.91 FEDERATED RURAL ELECTRIC INS $227,560.65 FEDERATED SERVICE INS CO $27,351.82 FFVA MUTUAL INS CO $245,010.08 FIDELITY & CAS CO OF NY $68,149.32 FIDELITY & GUARANTY INS CO $170,344.89 FIREMAN'S FUND INS CO $222,366.07 FIREMAN's FUND INS CO OF GA $57,417.40 FIRST LIBERTY INS CORP $107,988.59 FLORISTS' MUTUAL INS CO $14,663.97 GA INSURERS INSOLVENCY POOL $2,920,618.31 GENERAL ACCIDENT INS OF AMER $215,848.19 GENERAL INS CO OF AMERIC $2.96 SITF 2012 Annual Report – Page 12

Total Dollars Paid by the Fund to Insurance Companies From 1/1/2012 Through 12/31/2012 Name Amount GEORGIA CASUALTY & SURETY CO $63,215.24 GLENS FALLS INS CO $34,332.96 GRAY INSURANCE CO $2,421.48 GREAT AMER INS CO OF NY $655,563.92 GREAT AMERICAN INS CO $105,724.83 GUIDEONE MUTUAL INS CO $4,004.98 GULF INSURANCE COMPANY $104,786.90 HANOVER INSURANCE CO $291,712.97 HARLEYSVILLE MUTUAL INS CO $65,029.90 HARLEYSVILLE-ATLANTIC INS CO $44,216.80 HARTFORD ACCIDENT & INDEMNITY $115,675.08 HARTFORD CASUALTY INS CO $983,164.03 HARTFORD FIRE INSURANCE CO $370,825.48 HARTFORD INS CO OF S.E. $75,579.07 HARTFORD INS OF THE MIDWEST $291,200.44 HARTFORD UNDERWRITERS INS $119,494.33 HEALTH CARE MUTUAL CAPTIVE $89,450.53 HIGHLANDS INS CO-IN RECEIVERSH $41,545.67 HOME INS. CO-IN LIQUIDATION $531.26 HOUSTON GENERAL INS CO $451,881.38 INDEMNITY INS CO OF NA $618,781.72 INSURANCE CO OF N.A. $491.49 INSURANCE CO OF STATE OF PA $1,342,637.83 JEFFERSON PILOT FIN INS CO $89,732.52 KEY RISK INSURANCE CO $86,208.00 LIBERTY INSURANCE CORP $1,105,807.90 LIBERTY MUTUAL FIRE INS $402,826.11 LIBERTY MUTUAL INS. CO. $1,927,170.40 LM INSURANCE CORP $22,500.00 LUMBERMENS MUTUAL CAS CO $561,475.60 LUMBERMEN'S UNDERWRITING $351,359.34 MAG MUTUAL INS CO $20,102.71 MANUFACTURER'S ALLIANCE INS $49,571.53 MARYLAND CASUALTY COMPANY $309,151.08 MASSACHUSETTS BAY INSURANCE CO $85,675.00 METLIFE INSURANCE CO OF CT. $1,024,170.67 MITSUI SUMITOMO INS CO OF AMER $77,168.19 NATIONAL FIRE INS CO HARTFORD $528,732.42 NATIONAL LIABILITY & FIRE INS $50,401.17 NATIONAL SURETY CORP $127,009.48 NATIONAL UNION FIRE OF PITT PA $235,985.33 SITF 2012 Annual Report – Page 13

Total Dollars Paid by the Fund to Insurance Companies From 1/1/2012 Through 12/31/2012 Name Amount NETHERLANDS INSURANCE CO $80,965.87 NEW HAMPSHIRE INSURANCE CO $490,690.43 NIPPONKAO INS CO LTD US BRANCH $1.58 NORTHBROOK PROP & CAS INS CO $21,892.47 OHIO CASUALTY INSURANCE CO $205,525.04 OHIO FARMERS INS CO $21.55 OLD REPUBLIC INSURANCE CO $1,005,652.18 ONEBEACON AMERICA INS CO $32,233.89 ONEBEACON MIDWEST INS CO $1.22 PACIFIC EMPLOYERS INSURANCE $1,524,041.84 PACIFIC INDEMNITY CO $51,104.95 PARK AVE PROP & CASUALTY INS $75,203.61 PEERLESS INSURANCE COMPANY $103,442.90 PENN MFG ASSOC INS $298,311.88 PENN MFG IND. CO $152,060.13 PHOENIX INSURANCE CO $3,627.21 PRINCETON INSURANCE CO $20,115.63 PROVIDENCE WASHINGTON INS CO $2,419.71 RELIANCE INS CO IN LIQUIDATION $76,504.89 REPUBLIC WESTERN INS CO $12,597.71 ROCHDALE INSURANCE COMPANY $35,373.77 ROYAL INS CO OF AMERICA $219,527.20 SAFECO INSURANCE CO AMERICA $310,857.88 SECURITY INS CO OF HARTFORD $70,169.30 SELECTIVE INS CO OF AMERICA $131,829.17 SELECTIVE INS CO OF SE $275,401.66 SELECTIVE INSURANCE CO OF SC $128,185.27 SENTRY INSURANCE A MUTUAL CO $250,344.92 SENTRY SELECT INSURANCE CO $1,431.52 SOMPO JAPAN INS, OF AMERICA $114,777.71 SOUTHEASTERN U.S. INS., INC $116,525.81 SOUTHERN FIRE & CASUALTY CO $30,290.80 SOUTHERN GUARANTY INSURANCE CO $13,442.56 SOUTHERN TRUST INSURANCE CO $36,750.20 ST PAUL FIRE & CASUALTY INS CO $181,047.66 ST PAUL FIRE & MARINE INS CO $609,929.92 STANDARD FIRE INSURANCE CO $31,267.53 STAR INSURANCE CO $84,787.01 STATE AUTOMOBILE MUTUAL INS $5,789.28 STATE FARM FIRE & CASUALTY CO $376,511.30 STATE FARM GENERAL INS CO $70,280.25 SITF 2012 Annual Report – Page 14

Total Dollars Paid by the Fund to Insurance Companies From 1/1/2012 Through 12/31/2012 Name Amount TECHNOLOGY INSURANCE CO $38,692.85 TIG INSURANCE CO $404,109.97 TOKIO MARINE & NICHIDO FIRE $84,365.11 TRANSCONTINENTAL INS CO $185,847.23 TRANSPORTATION INSURANCE CO $673,309.44 TRAVELERS CAS & SUR CO $706,956.70 TRAVELERS COMMERCIAL CASUALTY $13,958.34 TRAVELERS INDEMNITY CO OF CT $24,542.31 TRAVELERS INDEMNITY COMPANY $14,740.82 TRAVELERS INDEMNITY OF AMER $1,222,123.22 TRAVELERS PROP CAS CO OF AMER $1,490,444.37 TWIN CITY FIRE INSURANCE CO $290,450.10 U.S. FIDELITY & GUARANTY INS $94,374.96 UNISUN INSURANCE COMPANY $22,101.13 UNITED STATES FIRE INSURANCE $119,081.06 UNITRIN AUTO & HOME INS. CO. $3.08 UNIVERSAL UNDERWRITERS INS $62.72 UTICA MUTUAL INSURANCE CO $24,814.85 UTICA NATIONAL ASSURANCE CO $3,337.18 VALLEY FORGE INSURANCE CO $132,257.06 VIGILANT INSURANCE CO $6,938.06 VIRGINIA SURETY COMPANY, INC $75,009.87 WAUSAU GENERAL INS CO $29,593.33 WAUSAU UNDERWRITERS INS CO $381,921.07 WESTFIELD INSURANCE CO $121,585.35 WESTPORT INSURANCE CORP $541,628.84 XL SPECIALTY INSURANCE CO $105,315.58 YORK INSURANCE CO $48,843.35 ZENITH INSURANCE CO $485,441.67 ZURICH AMERICAN INS CO $1,480,295.57 ZURICH AMERICAN INS CO OF IL $1,091,175.84 Grand Total: $48,350,712.07

SITF 2012 Annual Report – Page 15

Reimbursements to Self-Insurers Total Dollars Paid by the Fund to Self-Insured Employers From 1/1/2012 Through 12/31/2012 Name Amount A T & T $268,251.30 AAA COOPER TRANSPORTATION $89,366.62 ABF FREIGHT SYSTEM, INC $78,269.38 ACUITY BRANDS $51,112.46 AGL RESOURCES, INC. $244,504.78 ALBANY, CITY OF $23,327.72 ALLIED SYSTEMS LTD $16,900.00 ALPHARETTA, CITY OF $2,020.29 ALSCO, INC. $2,000.00 AMERICAN NATIONAL RED CROSS $118,085.50 ARCHBOLD MEDICAL CENTER $601,008.01 ATHENS REG. HLTH SYS INC $57,275.79 ATHENS-CLARKE COUNTY $28,423.86 ATLANTA CITY OF $181,595.05 ATLANTA PUBLIC SCHOOLS $136,182.60 AUGUSTA-RICHMOND CO BD COMM $206,012.18 BANK OF AMERICA $6,300.00 BARTOW COUNTY BD OF EDUCATION $58,346.57 BEAULIEU GROUP LLC $14,624.45 BEAULIEU OF AMERICA $97,800.76 BELLSOUTH ENTERPRISES INC $165,839.69 BELLSOUTH TELECOMMUNICATIONS $328,933.57 BERRY COLLEGE $117,505.52 BIBB COUNTY BD-COMMISSION $47,631.72 BIG LOTS STORES, INC. $72,023.34 BLUE BIRD BODY COMPANY $607,895.16 BLUE CIRCLE AMERICA/LAFARGE $53,893.27 BREMEN-BOWDEN INVESTMENT CO. $44,039.62 BRUNSWICK, CITY OF $88,976.44 C.W. MATTHEWS CONTRACTING INC $49,889.62 CAGLE'S INC, & SUBSIDIARIES $126,265.94 CANDLER HEALTH SYSTEM $176,762.37 CARROLL CO. BOARD OF EDUCATION $37,461.64 CEMEX (SOUTHDOWN INC.) $22,867.18 CENTRAL GEORGIA HEALTH SYSTEMS $41,805.38 CERTAINTEED CORPORATION $110,263.09 CHATHAM COUNTY BD OF EDUCATION $134,350.55 CHATHAM COUNTY GEORGIA $215,739.86 CHEMICAL PRODUCTS CORP $18,400.00 SITF 2012 Annual Report – Page 16

Total Dollars Paid by the Fund to Self-Insured Employers From 1/1/2012 Through 12/31/2012 Name Amount CHEROKEE CO BD OF COMMISSIONER $6,048.09 CHEROKEE CO BD OF EDUCATION $6,798.88 CHILDREN'S HEALTHCARE OF ATL $26,835.57 CITIGROUP INC. $21,240.54 CITY OF FORSYTH $102,504.34 CLAYTON COUNTY BD OF EDUCATION $44,626.59 CLAYTON COUNTY COMMISSIONERS $24,163.92 COACHMAN REC. VEHICLE CO OF GA $24,576.20 COATS & CLARK, INC. $28,887.32 COBB COUNTY BD/COMMISSIONERS $128,196.65 COBB COUNTY SCHOOL SYSTEM $448,552.04 COCA-COLA COMPANY $179,078.51 COCA-COLA REFRESHMENTS USA INC $78,120.48 COLONIAL GROUP $105,777.07 COLUMBUS CITY OF $21,495.21 CONAGRA FOODS, INC $4.79 CONAGRA POULTRY CO $69,487.21 CONTINENTAL GRAIN COMPANY $31,389.00 CONTINENTAL TIRE N. AMER., INC $64,372.93 COOPER INDUSTRIES, LLC $76,489.13 COOPER TIRE AND RUBBER $70,007.23 COSTCO WHOLESALE CORP. $8,000.00 COTTRELL INC $45,288.41 COWETA CO BOARD OF EDUCATION $918.83 CRACKER BARREL OLD CNTRY STORE $201,405.47 DALTON CITY OF $155,917.60 DEKALB COUNTY BOARD-ED $157,224.40 DEKALB COUNTY GOVERNMENT $218,449.14 DEKALB REGIONAL HLTHCARE SYS $130,745.48 DELHAIZE AMERICA LLC. $78,202.79 DELTA AIRLINES, INC. $1,429,840.99 DOLLAR GENERAL CORP $159,525.27 DOUGHERTY COUNTY BOC $185,406.27 DOUGLAS CO BD OF COMMISSIONERS $22,038.40 DOUGLAS COUNTY SCHOOLS $8,500.00 DOUGLAS, CITY OF $52,656.57 DRY BRANCH KAOLIN COMPANY $29,747.22 E I DUPONT DE NEMOURS & CO $9,450.00 ELBERTON GRANITE ASSOCIATION $136,551.97 EMORY UNIVERSITY $381,524.80 ESTES EXPRESS LINES $75,000.00 SITF 2012 Annual Report – Page 17

Total Dollars Paid by the Fund to Self-Insured Employers From 1/1/2012 Through 12/31/2012 Name Amount FAYETTE COUNTY BD OF COMM $30,167.10 FAYETTE COUNTY BD OF EDUCATION $23,511.15 FEDERAL EXPRESS CORP $8,262.41 FLOWERS FOODS INC. $81,363.68 FLOYD CO. BD. OF COMMISSIONERS $89,503.43 FLOYD HLTHCARE MGMT INC $35,000.00 FORD MOTOR COMPANY $166,512.22 FORSYTH CO BD OF COMMISSIONERS $74,100.57 FORT JAMES CORP. $48,002.67 FRIGIDAIRE CO MICROWAVE PRODS. $12,650.00 FULTON COUNTY, GEORGIA $952,644.22 FULTON-DEKALB HOSPITAL AUTHY $46,505.83 GA S.I. GUARANTY TRUST FUND $3,355,544.29 GENERAL MOTORS CORPORATION $288,332.20 GEORGIA KRAFT CO $28,055.00 GEORGIA POWER CO $62,888.77 GEORGIA STATE OF $8,441,566.81 GEORGIA-PACIFIC CORPORATION $447,563.94 GLYNN COUNTY BOARD OF COMMSNRS $141,067.73 GLYNN COUNTY SCHOOLS $416,421.02 GREAT DANE LTD PARTNERSHIP $36,987.51 GULFSTREAM AEROSPACE CORP $58,870.60 GWINNETT CO BD OF EDUCATION $15,110.34 GWINNETT COUNTY BD OF COMMISS $110,455.61 GWINNETT HOSPITAL SYSTEM $82,030.69 HALL COUNTY BOARD OF EDUCATION $213,147.92 HAMILTON HEALTH CARE SYSTEM $235,714.94 HANSON AGGREGATES $12,362.88 HCA, INC. $406.83 HENRY CO BOARD OF EDUCATION $30,608.78 HERCULES INCORPORATED $118,187.10 HON INDUSTRIES, INC. $23,759.31 HORMEL FOODS CORP $57,895.09 HOUSTON COUNTY BD OF EDUCATION $143,669.62 HOUSTON COUNTY COMMISSIONERS $35,993.98 HOWARD SHEPPARD INC $5,149.65 HUTCHESON MEDICAL CENTER $147,705.13 IDA CASON CALLAWAY FOUNDATION $3,786.40 IKON OFFICE SOLUTIONS $8,000.00 INGLES MARKETS INC $213,817.89 INTERNATIONAL PAPER COMPANY $115,214.74 SITF 2012 Annual Report – Page 18

Total Dollars Paid by the Fund to Self-Insured Employers From 1/1/2012 Through 12/31/2012 Name Amount J & J INDUSTRIES INC $36,319.04 J H HARVEY COMPANY $17,350.07 JONES COMPANY $21,202.05 JONES COMPANY (THE) $378,288.71 KELLOGG CO & SUBSIDIARIES $410,303.64 KLEEN-TEX INDUSTRIES $5,238.68 KLLM TRANSPORT SERVICES LLC $12,187.74 K-MART CORP $580,932.23 KROGER COMPANY, THE $580,893.70 LANGDALE INDUSTRIES $151,662.48 LAWRENCEVILLE, CITY OF $2,539.62 LEGACY VULCAN $197,557.33 LEVI STRAUSS & CO $6,671.09 LOWE'S HOME CENTERS, INC $243,977.15 LOXCREEN COMPANY, INC. $3,803.13 MADISON CO BOARD OF EDUCATION $4,227.86 MARIETTA CITY SERVICES $29,788.70 MAR-JAC POULTRY, INC. $3,024.65 MARRIOTT INTERNATIONAL, INC. $1,599.36 MARTA $611,495.65 MAYO CLINIC HLTH SYS IN WAYCRO $246,860.39 MCG HEALTH INC $11,192.50 MCLANE COMPANY, INC. $169,199.56 MEAD CORPORATION $83,017.88 MEMORIAL MEDICAL CENTER $245,423.40 MERCK SHARP & DOHME CORP $14,426.17 MID GEORGIA AMBULANCE, inc $50,000.00 MILLEDGEVILLE, CITY OF $33,281.55 MOHAWK INDUSTRIES, INC $1,686,172.19 MOUNT VERNON MILLS $81,663.84 MUSCOGEE COUNTY SCHOOL DIST $8,496.48 NABISCO, INC $9,631.24 NORTHEAST GEORGIA HEALTH SYS $11,025.00 NORTHSIDE HOSPITAL $2,526,498.01 OLIVER RUBBER CO $99,509.00 OWENS-CORNING $20,938.68 OWENS-ILLINOIS INC $37,928.33 OXFORD CONSTRUCTION CO $103,051.31 PARKER HANNIFIN CORP. $57,924.70 PCC AIRFOILS LLC $95,264.28 PEPSICO, INC $15,842.88 SITF 2012 Annual Report – Page 19

Total Dollars Paid by the Fund to Self-Insured Employers From 1/1/2012 Through 12/31/2012 Name Amount PHOEBE PUTNEY MEMORIAL HOSP $600.44 PIEDMONT HOSPITAL $5,850.00 PIEDMONT LABORATORIES, INC. $9,333.85 PRINTPACK, INC $47,753.36 QUEEN CARPET CORPORATION $27,168.44 RALSTON PURINA COMPANY $18,543.66 RHODES NURSING HOME $93,542.33 RMC USA, INC. $88,034.91 ROLLINS INC $129,021.97 ROME, CITY OF $203,358.75 ROPER CORPORATION $9,599.53 RUBY TUESDAY INC $86,136.02 RYDER SYSTEM INC $27,441.08 SAINT JOSEPH'S HEALTH SYSTEM $35,159.59 SAINT JOSEPH'S OF SAVANNAH $232,074.31 SAINT MARY'S HEALTH CARE $32,669.48 SAVANNAH CITY OF $426,044.16 SCIENTIFIC-ATLANTA INC $266.16 SEARS, ROEBUCK & CO $18,919.90 SHAW INDUSTRIES INC $982,349.60 SHERWIN-WILLIAMS COMPANY $79,912.23 SMURFIT-STONE CONTAINER ENTERP $37,000.00 SOUTHEASTERN FREIGHT LINES $309.67 SOUTHERN COMPANY $687,437.56 SOUTHERN MILLS INC $208,374.98 SOUTHERN NUCLEAR OPERATING CO $242.25 SOUTHERN REGIONAL HEALTH SYS. $28,687.84 SOUTHWIRE COMPANY $423,883.24 SUPERIOR RIGGING & ERECTING CO $23,068.77 TARGET CORPORATION $217,293.54 TENNECO AUTOMOTIVE, INC $16,046.51 TEXTILE RUBBER & CHEMICAL $14,101.15 TEXTRON, INC $81,744.81 THE DIXIE GROUP, INC. $181,078.11 THERMAL CERAMICS $455,911.40 THREE SPRINGS INC. $11,931.30 TIP TOP POULTRY INC $11,790.00 TRANSUS, INC. $86,220.00 TRC STAFFING SERVICES, INC $4,806.48 TYSON FOODS INC $235,767.38 UNION CAMP CORPORATION $80,919.91 SITF 2012 Annual Report – Page 20

Total Dollars Paid by the Fund to Self-Insured Employers From 1/1/2012 Through 12/31/2012 Name Amount UNIVERSITY HOSPITAL $539,245.63 UPS FREIGHT $138,027.48 USF HOLLAND, INC. $70,000.00 VARIETY WHOLESALERS $147,092.67 VISITING NURSE HEALTH SYSTEM $18,514.02 WAFFLE HOUSE $200,153.75 WAGGONERS TRUCKING CO., THE $28,585.17 WAREHOUSE HOME FURNISHINGS $183,324.24 WARNER ROBINS CITY OF $104,453.27 WAYCROSS, CITY OF $118,710.42 WELLSTAR HEALTH SYSTEM $726,667.06 WESLEY WOODS $510.59 WEST GEORGIA HEALTH SYSTEM $182,296.49 WEYERHAEUSER COMPANY $107,045.74 WINN-DIXIE STORES INC $52,447.92 YELLOW TRANSPORTATION $124,775.20 Grand Total: $43,214,189.23

SITF 2012 Annual Report – Page 21

Reimbursements to Group Self-Insurers

Total Dollars Paid by the Fund to Group Self-Insurers From 1/1/2012 Through 12/31/2012 Name Amount AGRITRUST OF GEORGIA $96,704.57 ASSOCIATION CTY COM GA SI $2,756,693.16 COMPTRUST AGC OF GEORGIA $572,849.12 CONSTRUCTION SUPPLIERS' ASSOC $274,448.80 GA AUTO DEALERS ASSOCIATION SI $553,296.48 GA CONCRETE & PRODUCTS ASSOC $44,443.75 GA EDUCATION WC TRUST FUND $861,367.54 GA HOSPITAL ASSOC WCSI FUND $711,532.68 GA MOVERS ASSOCIATION $179,727.21 GA MUNICIPAL ASSN WCSIF $1,596,504.31 GA NURSING HOME SELECTIVE WC $103,037.00 GA OILMEN'S ASSOCIATION $16,653.74 GA OPERATORS SELF-INSURERS $98,040.76 GA RETAIL MERCHANTS' WCT $2,119.64 GA SCHOOL BD ASSOC W C FUND $1,445,714.35 GA WHOLESALE & RETAIL WC FUND $24,459.38 GEMC WORKERS' COMP FUND $181,007.06 GTMA/AYSA SELF INSURANCE $261,206.38 ROOFING & SHEET METAL ASSOC $66,876.27 W. C. FUND FOR HEALTH CARE $90,325.43 Grand Total: $9,937,007.63

SITF 2012 Annual Report – Page 22

Individual Employers Benefitting from SITF Reimbursements

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed A & S RENTALS CENTER, INC MOULTRIE GA $992.54 A & T FENCE CO. LAVONIA GA $2,419.71 A-1 BRANTLEY SEPTIC SERVICES ALBANY GA $268.28 A-1 CONTRACT STAFFING TAMPA FL $72,719.56 AACTION AUTO PARTS SAVANNAH GA $7,809.34 ABC GLASS ATLANTA GA $14,061.00 ACCORD HUMAN RESOURCES MONROE GA $63,356.11 ACE ELECTRIC, INC MACON GA $67,499.06 ACS WASTE SERVICE ALPHARETTA GA $86,666.67 ACTION BLUE PRINT CO. ATLANTA GA $24,814.85 ACTION ELECTRIC COMPANY, INC. SMYRNA GA $13,759.02 ACUITY BRANDS, INC. FO1 ATLANTA GA $25,076.83 ADCOX SERVICE CO. INC LAKE CITY GA $17,000.00 ADMINISTAFF ATLANTA GA $2,637.02 ADP TOTAL SOURCE DOUGLASVILLE GA $40,055.10 ADP TOTALSOURCE MACON GA $47,429.76 AFC/CHURCH'S ATLANTA GA $50,000.00 AIRGAS DRY ICE, INC. AUGUSTA GA $33,705.74 AIRTRAN AIRWAYS SAVANNAH GA $76,009.20 AKZO NOBEL RESINS, INC. BAXLEY GA $23,717.40 ALAN COX AUTOMOTIVE MARIETTA GA $39,309.68 ALBANY BEVERAGE CO ALBANY GA $8,676.18 ALEX FOODS INC ATLANTA GA $29,124.40 ALFRED MCCANNON WELL BORING COMER GA $19,633.34 ALIMENTA USA INC CAMILLA GA $3,939.46 ALL BUDGET MECHANIC SERVICES ROSWELL GA $952.91 ALL SEASON'S COMFORT SAVANNAH GA $35,373.77 ALL SOUTH SUPPLY CARTERSVILLE GA $23,491.53 ALLGOOD HEALTHCARE AUGUSTA GA $32,476.10 ALLISON SMITH CO. ATLANTA GA $6,524.39 ALLTEL CORPORATION DALTON GA $164.84 ALLTEL CORPORATION DAHLONEGA GA $91.42 ALLTELL GEORGIA COMM. CORNELIA GA $25,452.74 ALPHA PRODUCTS, INC. ATLANTA GA $14,367.47 ALSTOM, INC. WINDSOR CT $61,980.05 AMC, INC ATLANTA GA $93,522.99 AMERICAN MANAGEMENT TECH BOONES MILL VA $19,111.01 AMERICAN NATIONAL CAN FOREST PARK GA $10,698.75 SITF 2012 Annual Report – Page 23

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed AMERICAN SECURITY INSURANCE CO ATLANTA GA $10,996.76 AMERICAN WOODMARK CORP. JACKSON GA $95,315.58 AMERSON COMPANY MACON GA $25,860.50 AMPORTS, INC BRUNSWICK GA $144,088.23 ANCHOR GLASS CORP. WARNER ROBINS GA $51,904.75 ANDREW ELECTRIC LAWRENCEVILLE GA $41,199.98 ANIMAL MEDICAL CARE CENTER MARIETTA GA $1,888.01 ANSCO & ASSOCIATES/ DYCOM IND. MARIETTA GA $20,000.00 APACHE MILLS, INC CALHOUN GA $8,209.00 APL LOGISTICS LITHIA SPRING GA $87,357.03 APPLIED INDUSTRIAL TECHNOLOGY CLEVELAND OH $368,134.25 APPLING HEALTHCARE BAXLEY GA $56,494.12 AQUA KOOLERS, LLC MACON GA $21,439.13 ARCADIAN AUGUSTA GA $42,080.20 ARCTIC ENGINEERS & CONSTRCTOR ATLANTA GA $18,292.00 ARMOR PACKAGING CORP LAWRENCEVILLE GA $93,774.30 ARMSTRONG WORLD INDUSTRIES MACON GA $96,209.96 ARROW CO. BUCHANAN GA $3,880.40 ARROW CO. AUSTELL GA $23,424.90 ARROW TIRE CO. GAINESVILLE GA $104,786.90 ARTISTIC JANITORIAL SERVICES MARIETTA GA $57,188.86 ASSISTED LIVING CARE, LLC. MARTINEZ GA $65.97 ASSOCIATED HEALTHCARE SYSTEMS NASHVILLE GA $75,000.00 ATC HEALTHCARE SERVICES MACON GA $168,336.95 ATHENS COUNTRY CLUB INC. ATHENS GA $22,950.00 ATLANTA BUILDING MAINTENANCE ALPHARETTA GA $1,948.87 ATLANTA CASUALTY GROUP ALPHARETTA GA $52,916.54 ATLANTA FREIGHTLINER TRUCK SAL JEFFERSON GA $111,035.54 ATLANTA JOURNAL CONSTITUTION NORCROSS GA $132,007.44 ATLANTA MEDICAL CENTER ATLANTA GA $454.88 ATLANTA SAND & GRAVEL OF GA,. SAVANNAH GA $14.57 ATLANTA STEEL ERECTORS, INC. SMYRNA GA $37,614.52 ATLANTA STRUCTURAL CONCRETE BUCHANAN GA $67,500.00 ATLANTA UTILITY WORKS, INC. EAST POINT GA $127,468.56 ATLAS LOGISTICS GRP RETAIL SER ATLANTA GA $75,000.00 ATLAS ROOFING CO HAMPTON GA $97,605.61 ATLAS TECHNOLOGIES INC FENTON MI $59,248.38 ATLAS VAN LINES EVANSVILLE TN $230,679.61 AUGUSTA CANAL AUTHORITY AUGUSTA GA $15,349.50 AUSTELL BOX BOARD AUSTELL GA $59,270.67 SITF 2012 Annual Report – Page 24

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed AUTOMATED MACHINERY LTD, INC. CUMMING GA $5,789.28 AUTUMN BREEZE ASSISTED LIVING GAINESVILLE GA $176,796.67 AVERY DENNISON FLOWERY BRANCH GA $32,015.45 AVIS RENT A CAR ATLANTA GA $8,750.00 B & A CONSTRUCTION CO. INC. GAINESVILLE GA $83,805.10 B. B. TRUCK WASH OF JACKSON JACKSON GA $2,743.66 BABCOCK & WILCOX COMPANY BRUNSWICK GA $29,186.96 BAGCRAFT CORP. OF AMERICA FOREST PARK GA $160.15 BALLARD BROTHERS ELECTRIC MACON GA $42,661.26 BARRETT & ASSOCIATES ATLANTA GA $8,400.00 BARTENFELD ELECTRIC COMPANY ATLANTA GA $8,558.30 BATTLE LUMBER COMPANY, INC. WADLEY GA $6,300.00 BEAUMONT PRODUCTS KENNESAW GA $79,086.95 BEKAERT CORPORATION ROME GA $149,849.41 BELK INC NEWNAN GA $101,409.95 BELK STORES & AFFILIATES CARTERSVILE GA $34,827.49 BELKS, INC. TIFTON GA $14,019.15 BELL MINOR HOME INC GAINESVILLE GA $180,414.10 BELLSOUTH BUSINESS SYSTEMS ATLANTA GA $117,474.82 BELLSOUTH ENTERTAINMENT ATLANTA GA $34,544.98 BEN A. LONG CONST. CO., INC. APPLING GA $4,243.31 BERKEL & COMPANY CONTRACTORS BONNER SPRINGS KS $138,253.70 BERLIN & HODGES MACON GA $78,110.55 BEST WESTERN - SAVANNAH SAVANNAH GA $206,524.69 BETTER BACKERS, INC. CHATSWORTH GA $13,580.94 BETZ LAB'S JACKSONVILLE FL $34,146.78 BEVIS ROPE MANUFACTURING INC ROSSVILLE GA $18,398.52 BGD ENTER. DBA PAYLESS PLUMBI BYRON GA $100,900.42 BILL HEARD CHEVROLET COLUMBUS GA $27,613.56 BLAINE ALDRIDGE CONCRETE CUMMING GA $50,674.33 BLAIR HOUSE CONVALESCENT CENTE NORTH AUGUSTA SC $7,795.72 BLAKE CONSTRUCTION CO. ST. MARYS GA $5,580.00 BLOUNT CONSTRUCTION ATHENS GA $21,082.69 BLUE RIBBON RENTAL, INC. CUYAHOGA FALLS OH $20,412.11 BORAL MATERIALS JULIETTE GA $98,647.83 BOUCHILLON BODY SERVICE SAVANNAH GA $26,054.60 BOWDEN MUFFLER SHOP BOWDEN GA $75,000.00 BRANDON HALL SCHOOL ATLANTA GA $25,674.61 BRIGGS MEDICAL DES MOINES IA $7,677.08 BROCKWAY STANDARD INC HOMERVILLE GA $9,152.88 SITF 2012 Annual Report – Page 25

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed BROOKS INSTRUMENTS DIVISION STATESBORO GA $83,299.75 BROOKS WELDING INC. VALDOSTA GA $123,000.66 BROWN & WILLIAMSON TOBACCO MACON GA $201,595.21 BROWN STEEL CONTRACTORS, INC. NEWNAN GA $9,720.00 BROWNLOW AND SONS COMPANY INC MARIETTA GA $476.00 BUFORD CITY BOARD OF EDUCATION BUFORD GA $24,632.10 BUILDING TECHNOLOGY TALLAPOOSA GA $19,820.25 BURLINGTON INDUSTRIES SHANNON GA $7,258.38 BURLINGTON NORTHERN ALBANY GA $12,006.69 BURNT MOUNTAIN CENTER INC JASPER GA $94,139.24 C & S WHOLESALE GROCERS MACON GA $40,000.00 CAMBRIDGE PLACEMENT, INC. ATLANTA GA $36,216.64 CANOOCHEE EMC REIDSVILLE GA $7,443.95 CAPRO INC SWAINSBORO GA $75,000.00 CAR CRAFT ATHENS GA $26,677.17 CARDINAL INDUSTRIES COLLEGE PARK GA $49,875.00 CARE MORE, INC MACON GA $75,000.00 CAREMASTER MEDICAL SERVICES GRIFFIN GA $11,789.61 CAROLINA HANDLING CHARLOTTE NC $75,000.00 CARRIAGE INDUSTRIES, INC. CALHOUN GA $9,065.00 CARROLLTON MANOR, INC. CARROLLTON GA $152,060.13 CARTER CONCRETE COMPANY POWDER SPRINGS GA $157,862.66 CARWOOD MANUFACTURING COMPANY WINDER GA $22,245.14 CASWELL, INC. NEWNAN GA $38,612.58 CATERPILLAR INC GRIFFIN GA $28,941.34 C-E MINERALS ANDERSONVILLE GA $17,527.00 CECIL MALONE COMPANY ATLANTA GA $2,613.99 CELLO-FOIL PRODUCTS, INC. ALBANY GA $42,890.93 CENTRAL GA EMPLOYMENT ATLANTA GA $46,318.81 CENTRAL GA EMPLOYMENT & PAYROL WARNER ROBINS GA $70,207.00 CENTRAL GA EYE CENTER PC MACON GA $40,945.06 CENTRAL GA HOME HEALTH AGENCY MACON GA $7,756.05 CENTRAL GEORGIA HOME CARE MACON GA $43,290.84 CENTRAL HEALTH HOLDING FT. OGLETHORPE GA $11,275.00 CENTRAL HEATING AND AIR ATLANTA GA $9,240.51 CENTRAL INDUSTRIES, INC SAVANNAH GA $44,200.00 CENTURION INDUSTRIES FREDONIA KS $4,881.48 CETCO ( PC AMCOL INTL' GRP) VILLA RICA GA $15,000.00 CHAMBERS DEVELOPMENT CO. ATLANTA GA $13,339.45 CHAMPION GARMENT CO. ROME GA $596.01 SITF 2012 Annual Report – Page 26

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed CHAMPION INTERNATIONAL CORP WAYCROSS GA $7,000.00 CHARLES BLACK CONSTRUCTION CO. CLEVELAND GA $36,866.74 CHART INDUSTRIES INC. BALLGROUND GA $4,396.08 CHARTER COMMUNICATIONS, INC. GROVETOWN GA $182,341.35 CHATHAM STEEL CORPORATION SAVANNAH GA $199.08 CHEMICAL PRODUCTS CORP. CARTERSVILLE GA $1,008.46 CHICK-FIL-A STOCKBRIDGE GA $1,971.69 CHICK-FIL-A COLUMBUS GA $1,121.21 CHILDCARE NETWORK # 24 AUGUSTA GA $40,290.05 CHUMLEY'S PAVING & GRADING INC ACWORTH GA $28,029.93 CHURCH HOME FOR THE AGED PERRY GA $400.90 CHURCH OF JESUS CHRIST LDS ATLANTA GA $75,000.00 CIMCO WAYNESBORO GA $9,135.00 CINTAS CORPORATION CINCINNATI OH $10,000.00 CITIZENS BANK OF WASHINGTON CO SANDERSVILLE GA $13,442.56 CITY OF EAST POINT POLICE DEPT EAST POINT GA $3,713.06 CITY OF ELBERTON ELBERTON GA $288.05 CITY OF ROME ROME GA $27,184.82 CLARKE COUNTY SCHOOL DISTRICT ATHENS GA $22,101.13 CLARKLIFT OF ATLANTA ATLANTA GA $40,226.75 CLAUDE RICKMAN CONST. DILLARD GA $2,510.12 CLAYTON HOMES - CMH MFG. WAYCROSS GA $47,696.34 CLOTHING FABRICS INC WAYCROSS GA $20,893.25 CMI INDUSTRIES, INC CLARKESVILLE GA $49,571.53 COASTAL DEPOT GARDEN CITY GA $116.00 COASTAL GREAT SOUTHERN SAVANNAH GA $4,677.16 COASTAL SAND, INC. SAVANNAH GA $13,319.90 COBB COUNTY TRACTOR CO. MARIETTA GA $18,651.23 COCHRAN CEILING COMPANY, INC. COCHRAN GA $125,609.68 COCHRAN'S AUTO TRUCK STOP RINGGOLD GA $13,261.05 COFER & JACKSON PIPELINE, LLC LAWRENCEVILLE GA $430,683.88 COHUTTA WATER, INC ACWORTH GA $103,442.90 COLEMAN AMERICAN MOVING MIDLAND CITY AL $30,000.00 COLISEUM MEDICAL CENTER MACON GA $4,415.97 COLLINS & AIKMAN FLOORCOVERING DALTON GA $88,718.33 COLQUITT COUNTY MOULTRIE GA $101,404.68 COLUMBIA POLK GENERAL HOSPITAL CEDARTOWN GA $5,088.28 COMBINED INSURANCE CHICAGO IL $4,999.00 COMBINED SERVICES, INC. DECATUR GA $29.90 COMBUSTION ENGINEERING JULIETTE GA $16,909.13 SITF 2012 Annual Report – Page 27

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed COMBUSTION TECHNOLOGIES INC FLOWERY BRANCH GA $9,857.94 COMCAST CORP. ROME GA $4,245.25 CONTAINER GENERAL CORP. FOREST PARK GA $22,869.25 CONTINENTAL CAN CO PERRY GA $13,328.00 CONTINENTAL GRAIN SAVANNAH GA $7,810.95 CONTINENTAL GRAIN CORDELE GA $8,324.72 CONTINENTAL TELEPHONE CO. ATLANTA GA $6,254.85 COOPER DDS, PC WAYCROSS GA $39,380.14 CORRECTIONS CORP OF AMERICA MCRAE GA $27,794.04 CORTEX, INC. ATLANTA GA $32,277.46 COUNTRY CLUB OF COLUMBUS INC COLUMBUS GA $9,818.75 COVENTRY ELECTRICAL SUPPLIES COVINGTON GA $9,709.86 COWABUNGA, INC.DBA DOMINO'S PI HAPEVILLE GA $519.64 COX ENTERPRISES ATLANTA GA $169,533.17 CROWN GLASS AND MIRROR ATLANTA GA $75,000.00 CROWN LIFT TRUCKS NORCROSS GA $96,282.62 CRYSTAL FARMS INC CHESTNUT MTN. GA $42,151.23 CSR INC. D/B/A AUSTELL GA $6,427.71 CTF HOLDINGS LTD LAKE LANIER GA $697.16 CUMBERLAND GAS & ICE KINGLAND GA $210,078.62 CUMMINS SOUTH INC COLLEGE PARK GA $14,364.00 CVS PHARMACY MARIETTA GA $55,162.84 CYNDERELLA'S FITZGERALD GA $922.00 DAIMLER/CHRYSLER CORPORATION MORROW GA $4,246.71 DALE LONG PLASTERING SOPERTON GA $67,065.27 DARBY PRINTING COMPANY ATLANTA GA $75,000.00 DAVIS CENTRAL AIR CONDITIONING VALDOSTA GA $37,447.72 DECK'S WHOLESALE & PINE GROVE RINGGOLD GA $19,052.85 DEERFIELD SPECIALTY PAPERS INC AUGUSTA GA $81,993.00 DELTA AIRLINES, INC. ATLANTA GA $79,013.33 DELTA LIFE INS CO MACON GA $5,167.40 DETAILS INC. MOORESVILLE NC $80,509.22 DEVEREUX FOUNDATION KENNESAW GA $81,841.67 DEVON CORPORATION FT. OGLETHORPE GA $83,421.00 DILLARD SMITH CONSTRUCTION CO. COLLEGE PARK GA $75,000.00 DILLARD SMITH CONSTRUCTION CO. SMYRNA GA $20,685.24 DILLARDS MACON GA $67,485.71 DILLON TRANSPORT, INC. WILLOWBROOK IL $120,215.91 DIVERSCO, INC SPARTANBURG SC $3,202.55 DIXON TIMBER CO. JESUP GA $323.59 SITF 2012 Annual Report – Page 28

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed DOGWOOD HOUSING MILLEGEVILLE GA $59,324.25 DOUGHERTTY EQUIPMENT COMPANY GARDEN CITY GA $243,298.48 DOUGLAS & LOMASON CARROLLTON GA $7,394.44 DRUG TRANSPORT, INC. TUCKER GA $86,656.10 DUBARD'S TIRE & ALIGNMENT AUSTELL GA $13,653.00 DUBLINAIR NURSING HOME DUBLIN GA $26,425.00 DYNCORP ATLANTA GA $15,447.73 EARL SMALL'S HARLEY DAVIDS MARIETTA GA $44,525.34 EARTHGRAINS COLUMBUS GA $4,948.82 EASTERN AIRLINES, INC. ATLANTA GA $82,265.94 EASTSIDE CONCRETE CONSTRUCTION DECATUR GA $13,680.00 EATON CORP CLEVELAND OH $66,099.01 ECC INTERNATIONAL SANDERSVILLE GA $130,964.17 ECHOSTAR COMMUNICATIONS CORPOR GARDEN CITY GA $92,472.59 ECKERD DRUG SHENANDOAH GA $37,448.19 ECKERD DRUGS PEACHTREE CITY GA $23,586.87 ECKERD YOUTH ALTERNATIVE CLEARWATER FL $11,580.25 ECONOMY MOBILE HOMES, INC. MILEDGEVILLEI GA $3,987.69 EDDIE'S FOREIGN AUTO MACON GA $50,036.25 EFFINGHAM COUNTY BOARD OF EDUC SPRINGFIELD GA $77,325.34 ELIXIR INDUSTRIES DOUGLAS GA $934.88 ELLIOTT TRANSPORT GAINESVILLE GA $70,169.30 EMORY EASTSIDE MEDICAL CENTER SNELLVILLE GA $29,104.79 ENGELHARD CORP. ATTAPULGUS GA $13,466.98 ENGELHARD CORP. GORDON GA $7,981.24 ENGELHARD CORP. MCINTYRE GA $49,558.62 ENGINEERED FABRICS CORP. ROCKMART GA $43,351.26 ENGINEERED REFRIGERATION MOBILE AL $583.88 EPPS HAULING, INC. MACON GA $184,806.21 EQUITY RESIDENTIAL PROPERTIES DUBLIN GA $240,492.94 ESSEX GROUP LITHONIA GA $2,243.38 ETHICON, INC. CORNELIA GA $19,807.11 EXEL, INC. FAIRBURN GA $50,005.75 EXIDE CORPORATION COLUMBUS GA $674.03 FACTORY MUTUAL INSURANCE CO. ALPHARETTA GA $565.01 FAMILY DOLLAR, INC. CHARLOTTE NC $13,081.05 FANNIN COUNTY BD. OF EDUCATION BLUE RIDGE GA $4,643.01 FANNIN REGIONAL HOSPITAL BLUE RIDGE GA $8,405.10 FAYETTE CO BD OF EDUCATION FAYETTEVILLE GA $36,711.35 FAYETTEVILLE BOWLING CENTER FAYETTEVILLE GA $20,100.99 SITF 2012 Annual Report – Page 29

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed FEDERAL RENT A CAR SYSTEM HAPEVILLE GA $13,127.23 FEDERAL STATE INSPECTION ALBANY GA $11,747.00 FEDERAL-MOGUL CORP LAGRANGE GA $103,786.66 FIRST BAPTIST CHURCH COCHRAN GA $4,004.98 FIRST BAPTIST CHURCH LAFAYETTE GA $3,033.09 FIRST DATA POS. INC. KENNESAW GA $20,967.00 FIRST NATIONAL BANK & TRUST CO LOUISVILLE GA $139,637.88 FITZGERALD UNDERWEAR CORP TIFTON GA $6,938.06 FLASH FOODS WAYCROSS GA $149.80 FLETCHER OIL CO., INC. DOUGLAS GA $27,351.82 FLINT CONSTRUCTION CO. LAWRENCEVILLE GA $7,210.41 FLINT LAND & CATTLE WOODBURY GA $1,329.71 FLINT RIVER TEXTILES, INC ALBANY GA $89,823.08 FLOWERS AND SONS LOGGING HORTENSE GA $27,179.14 FLOWERS, INC. BALLOONS BOGART GA $117.08 FOLGER POULTRY FARMS DAHLONEGA GA $7,020.00 FOREST RIVER INC OCILLA GA $1,021.75 FORSYTH NURSING HOME FORSYTH GA $75,000.00 FORT FORT OGLETHORPE NURSING OGLETHORPE GA $75,000.00 FOX & HOUND RESTAURANT GROUP WICHITA KS $4,172.21 FOXWORTH PAINTING CONTRACTORS COLUMBUS GA $40,776.44 FRANKLIN INDUSTRIES LAVONIA GA $10,166.49 FRED TAYLOR COMPANIES ALBANY GA $10,000.00 FRED'S INC. LAVONIA GA $31,371.00 FRIENDLY GUS DUBLIN GA $89,815.08 FUJICOLOR PROCESSING, INC. TIFTON GA $19,958.63 FUJITSU AMERICA, INC SUNNYVALE CA $24,562.22 FUTURE MANAGEMENT FOREST PARK GA $48,487.32 G & D CONSTRUCTION FRANKLIN GA $75,909.03 G & K SERVICES, INC. MACON GA $15,190.66 G & P TRUCKING CO., INC. GASTON SC $7,128.00 GAF MATERIALS CORP. SAVANNAH GA $33,304.78 GAINESVILLE CITY BD OF EDUC GAINESVILLE GA $63,629.00 GALAXY CARPET MILLS, INC. CHATSWORTH GA $7,965.00 GARNER BROTHERS COMPANY ROME GA $92,481.23 GATOR COCHRAN CONSTRUCTION CO AUGUSTA GA $27,073.12 GATX CORPORATION WAYCROSS GA $86,395.96 GE HEALTHCARE FLORENCE SC $16,232.64 GEICO CORP MACON GA $3,972.77 SITF 2012 Annual Report – Page 30

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed GEIGER INTERNATIONAL ATLANTA GA $18,040.28 GENERAL CABLE CORP. WATKINSVILLE GA $27,550.14 GENERAL CAR & TRUCK LEASING DAVENPORT IA $14,958.27 GENERAL ELECTRIC CO ROME GA $86,943.99 GENERAL ELECTRIC CO CHAMBLEE GA $3,781.10 GENERAL NUTRITION CTRS PITTSBURGH PA $190,989.24 GENERAL PARTS, INC. CARROLLTON GA $41,410.06 GENERAL PRODUCE, INC. FOREST PARK GA $45,104.24 GENTRY MACHINE WORKS, INC. COLUMBUS GA $1,459.94 GENUINE PARTS NORCROSS GA $857.54 GEORGE HORMELL & COMPANY TUCKER GA $39,179.66 GEORGE MUSE CLOTHING CO ATLANTA GA $8,100.16 GEORGIA BOOT INC BLAIRSVILLE GA $11,198.72 GEORGIA DUPLICATING PRODUCTS MACON GA $30,290.80 GEORGIA ENVIRONMENTAL MORROW GA $120,678.67 GEORGIA FURNITURE MART AND PRI MACON GA $15,115.47 GEORGIA HOME HEALTH CARE LYONS GA $24,350.47 GEORGIA MARBLE COMPANY ATLANTA GA $6,580.97 GEORGIA PIPING & FIREPROTECTIO WHITE GA $2,010.24 GEORGIA WAR VETERANS HOME MILLEDGEVILLE GA $75,000.00 GERAY INC EVANS GA $84,812.51 GILMAN BUILDING PRODUCTS BLACKSHEAR GA $59,303.07 GILMAN PAPER CO. ST. MARY'S GA $13,843.68 GILMER COUNTY SCHOOLS ELLIJAY GA $10,364.46 GIRL SCOUTS COUNCIL OF NW ATLANTA GA $100,646.62 GLOBAL STONE FILLER PRODUCTS ELLIJAY GA $214,917.64 GMTA MANAGEMENT FORT VALLEY GA $34,552.87 GOLD KIST INC.(PILGRIMS PRIDE) CARROLLTON GA $17,184.00 GOLD KIST, INC DBA PILGRIM'S P ATLANTA GA $2,657.24 GOLD KIST, INC. ATHENS GA $231,145.96 GOLDEN AGE PROPERTIES HAWKINSVILLE GA $25,232.29 GOLDEN STATE FOODS CORP CONYERS GA $20,187.16 GOODWILL INDUSTRIES SAVANNAH GA $217,922.08 GOODWILL INDUSTRIES OF ATLANTA ATLANTA GA $140,766.10 GOODY PRODUCTS, INC. EASTMAN GA $6,935.05 GOODY PRODUCTS, INC. MANCHESTER GA $1,471.56 GOODYEAR TIRE & RUBBER CEDARTOWN GA $7,628.41 GOODYEAR TIRE & RUBBER ROME GA $79,605.67 GORDON COUNTY FARM COMPANY CALHOUN GA $9,288.89 GRADY EMC CAIRO GA $220,083.75 SITF 2012 Annual Report – Page 31

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed GREAT OAKS NURSING HOME ROSWELL GA $166,625.36 GREBA METAL PRODUCTS, INC. WINSTON GA $102.68 GREEN ISLAND COUNTRY CLUB COLUMBUS GA $70,774.08 GREEN OAKS CENTER MOULTRIE GA $240.00 GREEN THUMB, INC. JESUP GA $22,973.47 GREENPOINT BANK COLUMBUS GA $24,755.22 GREENWOOD CEMETARY ATLANTA GA $367.30 GRIFFIN SERVICES ATLANTA GA $273,674.55 GUARDIAN FOUNDATION INC. ATLANTA GA $37,772.51 GULF LIFE INSURANCE COMPANY ALBANY GA $11,640.25 H.A. SACK CO., INC. D/B/A STATESBORO GA $1,234.65 HABITAT FOR HUMANITY, INC. ATLANTA GA $101,099.34 HAIRSTON CONSTRUCTION CO KENNESAW GA $46,293.00 HANCOCK FABRICS SAVANNAH GA $3,880.45 HANES HOSIERY, INC. LAGRANGE GA $7,641.98 HARBISON WALKER REFRACTORIES CALHOUN GA $2,050.29 BOWDON HARMONY ENTERPRISES, INC. JUNCTION GA $55,888.76 HARRIS INSULATION & SUPPLY INC ATLANTA GA $135,813.74 HARTWELL CO. WAREHOUSE HARTWELL GA $18,468.27 HARVEY'S PERSONAL CARE WAYCROSS GA $83,753.43 HAVERTY FURNITURE COMPANIES MACON GA $80,711.38 HAYES MICRO COMPUTER PRODUCTS NORCROSS GA $15,209.64 HAYGOOD CONTRACTING, INC. WOODSTOCK GA $30,258.71 HEALTH MANGEMENT ASSOC. STATESBORO GA $22,085.00 HEALTH SYSTEMS FACILITIES, INC THOMSON GA $18,505.46 HELEN'S ENTERPRISES, INC. ATHENS GA $105,925.00 HENDERSON ELECTRIC CO STONE MOUNTAIN GA $13,097.35 HENRY COUNTY TRAINING CENTER MCDONOUGH GA $9,461.10 HERTZ PENSKE/GEICO TRUCK LSNG FOREST PARK GA $203,890.93 HEWLETT PACKARD FIELD OFFICES ATLANTA GA $45,000.00 HI BRAND FOODS PEACHTREE CITY GA $13,490.08 HICKS PAVING CO., INC. ATHENS GA $44,137.93 HIGHTOWER TV ROME GA $4,909.71 HILLCREST HOSPICE INC RIVERDALE GA $237,165.04 HINESVILLE PLATE GLASS & MIRRO HINESVILLE GA $245,010.08 HINESVILLE RED & WHITE HINESVILLE GA $5,255.10 HOLIDAY INN-MCDONOUGH MCDONOUGH GA $16,996.72 HOME DEPOT SAVANNAH GA $34,427.90 HOME DEPOT BRUNSWICK GA $145,680.34 SITF 2012 Annual Report – Page 32

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed HOME DEPOT MARIETTA GA $105,602.33 HOME DEPOT DULUTH GA $18,065.66 HOME DEPOT ATLANTA GA $445,460.36 HOME DEPOT CONYERS GA $27,109.88 HOME DEPOT CUMMING GA $132,727.30 HOME DEPOT AUSTELL GA $8,502.76 HON INDUSTRIES CEDARTOWN GA $272,172.04 HONEYWELL INTERNATIONAL, INC ELBERTON GA $76,123.11 HOOVER PRECISION PRODUCTS CUMMING GA $75,000.00 HOPEWELL MISSION BAPTIST CHURCH NORCROSS GA $75,000.00 HOSPITAL AUTHORITY OF LIBERTY LUDOWICI GA $75,000.00 HOUSE OF TYROL CLEVELAND GA $36,293.58 HOUSING AUTHORITY OF COLUMBUS COLUMBUS GA $61,181.36 HOUSTON CO. ASSOCIATION WARNER ROBINS GA $1,447.00 HOWARD'S LANDSCAPING & GRADING LILBURN GA $10,381.93 HUGHES LOGGING COMPANY ARLINGTON GA $4,196.69 HUSSEY, GAY, BELL & DEYOUNG GAINESVILLE GA $96,996.76 I P S BALERS BAXLEY GA $16,876.80 IEF CLEARWATER FL $39,258.46 IMERYS CLAYS, INC. SANDERSVILLE GA $14,768.54 IMERYS CLAYS, INC. DEEPSTEP GA $13,961.21 IMERYS KAOLIN INC. DRY BRANCH GA $8,749.55 INDEPENDENT LIFE INSURANCE CO. ROME GA $7,075.61 INLAND CONTAINER CORP. ROME GA $491.49 INLAND CONTAINER CORP. MACON GA $41,545.67 INNER DIMENSIONS INC BLUE RIDGE GA $23,985.00 INTERIM PERSONNEL ATLANTA GA $12,138.43 INTERNATIONAL AUTO PROCESSING BRUNSWICK GA $27,040.60 INTERNATIONAL RESCUE COMM NEW YORK NY $11,000.00 INTERSTATE DISTRIBUTORS, INC. NORCROSS GA $8,325.00 ITHACA INDUSTRIES INC. MEIGS GA $63,690.59 ITR INDUSTRIES TOCCOA GA $47,996.00 J & M TANK LINES, INC. AMERICUS GA $80,824.79 J & S, INC. INDIANOLA PA $36,980.92 J PHILLIP HEATING & AIR CHAMBLEE GA $78,370.53 J. A. JONES CHARLOTTE NC $41,441.99 J. B. HUNT TRANSPORT, INC. FOREST PARK GA $75,000.00 J. C. NASH TRUCK PARTS, INC. ATHENS GA $38,251.58 J. C. PENNEY COMPANY ATLANTA GA $8,953.72 J. C. PENNEY COMPANY STONE MOUNTAIN GA $11,557.90 SITF 2012 Annual Report – Page 33

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed J. G. DAVIDSON JR. ELECTRICAL LAGRANGE GA $12,500.69 J. O. CONLEY CORPORATION MACON GA $38,561.87 JACKSON CO BD OF EDUCATION JEFFERSON GA $54,377.50 JAMES F. HOOVER LAVONIA GA $47,334.82 JAMES W. HURT & ASSOC. CORDELE GA $36,750.20 JEAN THOMAS COMMERCE GA $6,202.98 JEBCO, INC. WARRENTON GA $39,533.13 JM BURGESS, INC. LINCOLNTON GA $77,957.33 JOCKEY INTERNATIONAL, INC. KENOSHA WI $4,485.77 JOHANNSEN TROPHIES & SPORTING AUGUSTA GA $76.00 JOHN DEMORE LOCK & KEY SVC. NEWNAN GA $272,042.62 JOHNSON & JOHNSON ROYSTON GA $17,366.80 JOHNSON INDUSTRIES, INC. NORCROSS GA $43,970.85 JOHNSTON ELECTRIC CO., INC. WAYCROSS GA $93,333.32 JONES AUTOMATIC SPRINKLERS AMERICUS GA $40,590.39 JRH OPTICS/PEARL VISION EXPRES DULUTH GA $78,343.54 KENCO LOGISTIC SERVICES ELLENWOOD GA $38,102.00 KENNEDY EQUIPMENT CO. COLUMBUS GA $20,115.63 KEY HEALTH CENTER MACON GA $54,845.40 KING MUFFLER SHOP WAYCROSS GA $37,663.24 KINGS SAVANNAH, LLC SAVANNAH GA $83,087.30 KINNEY CONSTRUCTION CO LEESBURG GA $35,022.30 KINRO, INC. CAIRO GA $509.01 KLIKLOK WOODMAN CORP. DECATUR GA $49,781.42 KRAFT FOODS, INC. ATLANTA GA $333.66 KRAFT FOODS, INC. NORCROSS GA $32,334.70 KROGEL FREIGHT SYSTEMS OF GA MACON GA $13,504.69 KROGER CO. ATLANTA GA $526,527.17 KRYSTAL/M.A.E. THOMASVILLE THOMASVILLE GA $54,507.96 KUBOTA MFG. CO. OF AMERICA GAINESVILLE GA $75,000.00 LAFARGE NORTH AMERICA, INC.. DULUTH GA $29,669.95 LANCE TRUCKING CO., INC. BLUE RIDGE GA $127,479.21 LANCE, INC. CHARLOTTE NC $40,672.00 LANDRUM PLUMBING CO. INC. POWDER SPRINGS GA $86,151.37 LANIER PARKING SYSTEMS INC. ATLANTA GA $75,593.75 LAPP INSULATOR CO. SANDERSVILLE GA $88,256.40 LARSON & JUHL ADAIRSVILLE GA $35,290.02 LAUREL BAYE HEALTH LAKE LANIER BUFORD GA $60,679.08 LAW ENGINEERING CO ATLANTA GA $11,475.88 LAWLER HOSIERY MILL INC CARROLLTON GA $16,075.67 SITF 2012 Annual Report – Page 34

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed LEGGETT & PLATT INC COVINGTON GA $69,096.00 LEON FARMER & CO ATHENS GA $2,863.30 LEVI STRAUSS & COMPANY VALDOSTA GA $8,671.93 LEXINGTON PRECISION CORP JASPER GA $345,387.09 LIBERTY COUNTY SCHOOLS HINESVILLE GA $168.00 LIBERTY MUTUAL INSURANCE CO. GAINESVILLE GA $36,448.60 LINPAC, INC. ATLANTA GA $480.67 LOCKHEED MARTIN MARIETTA GA $645,941.54 LOCKHEED MARTIN KINGS BAY GA $448.13 LOOK PRODUCTS MILLEN GA $21,105.98 LORAL SPACE & COMMUNICATIONS/ ROCKMART GA $3,186.83 LOWE'S COMPANIES ALBANY GA $8,676.63 LUPTON-SMITH HOLDINGS ATLANTA GA $217.81 LYNN HAVEN NURSING HOME, LLC GRAY GA $40,000.00 MACON CIGAR & TOBACCO CO., INC MACON GA $2,164.91 MACON MALL/COLONIAL PROP. TR. MACON GA $39,739.40 MACON NORTHSIDE HOSPITAL MACON GA $6,500.00 MACON-BIBB CO WATER & SEWAGE MACON GA $9,980.84 MACY'S ATLANTA GA $9,300.00 MAIL CONTRACTORS OF ARKANSAS LITTLE ROCK AR $85,300.10 MANATRON PORTAGE MI $27,736.29 MANN MECHANICAL CO. INC. AVONDALE ESTS. GA $25,948.76 MANNINGTON CARPETS, INC. CALHOUN GA $190,162.40 MANPOWER TEMP. SERVICES DUBLIN GA $17,724.32 MANSOUR'S LAGRANGE GA $15,493.10 MAREK INTERIOR SYSTEMS, INC. HOUSTON TX $124,894.50 MARELL POULTRY COMPANY INC MURRAYVILLE GA $4,455.09 MARINER HEALTH CARE, INC. HOGANSVILLE GA $53,105.83 MARINER POST ACUTE NETWORK LUMBER CITY GA $8,639.04 MARK'S & MORGAN JEWELERS, INC. MACON GA $31,346.77 MARK'S & MORGAN JEWELERS, INC. AUGUSTA GA $17,884.27 MARLEY COOLING TOWER OVERLAND PARK KS $9,453.58 MARSHALLS DULUTH GA $27,705.49 MARTIN ASSOCIATES HOMEBUILDERS CUMMING GA $20,688.83 MARTIN CONSTRUCTION COMPANY SYLVESTER GA $21,959.61 MARTIN MARIETTA MATERIAL D/B/A AUGUSTA GA $52,320.00 MASTER PROMOTIONS LITHIA SPRINGS GA $21,963.51 MASTERCUTS ROME GA $15,531.39 MAXEY BROTHERS INC BISHOP GA $38,831.61 MAXWELL CHASE TECH. SMYRNA GA $78,605.36 SITF 2012 Annual Report – Page 35

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed MCARTHUR CONCRETE PRODUCTS ACWORTH GA $27,594.42 MCC INDUSTRIAL, INC. MACON GA $84,787.01 MCC PANASONIC PEACHTREE CITY GA $30,137.64 MCDONALD'S CORP CHATSWORTH GA $12,380.99 MCG HEALTH, INC. AUGUSTA GA $59,697.02 MCKINNEY COMMUNITY HEALTH WAYCROSS GA $258,172.64 MCLANAHAN CRUSHED STONE, INC. ELBERTON GA $48,374.17 MCMASTER-CARR SUPPLY CO ATLANTA GA $26,403.08 MC'S PAINTING & DECORATING CO. HIRAM GA $7,875.00 MCWHORTER TECHNOLOGIES COLUMBUS GA $148,024.66 MD HODGES ENTERPRISES, INC. ATLANTA GA $4,874.83 MEDICAL CENTER LLP DUBLIN GA $9,590.98 MEMORIAL HOSPITAL & MANOR BAINBRIDGE GA $13,727.16 MENLO PARK, INC. PEACHTREE CITY GA $255,796.05 MENLO WORLDWIDE LOGISTICS SUWANEE GA $15,443.12 MERCHANTS METALS, INC. FOREST PARK GA $178,323.37 MERICO, INC. FOREST PARK GA $9,660.00 MERRITT CONTRACTING CO. GAINESVILLE GA $39,198.56 METAL BUILDINGS, INC. THOMASVILLE GA $78,975.00 METAL PRODUCTS COMPANY SUWANEE GA $109,354.96 METRO BUILDERS SUPPLY INC. FAIRBURN GA $1,379.00 METRO IRON WORKS, INC. COVINGTON GA $138,480.42 METRO WATERPROOFING, INC. SCOTTSDALE GA $26,075.35 MGR HOMECARE, INC. GRIFFIN GA $4,695.29 MIC, INC. ELLABELL GA $12,441.41 MICRO MANAGEMENT CONSULTING LOGANVILLE GA $141.17 MID GEORGIA AMBULANCE MACON GA $2,464.83 MID SOUTH SUBCONTRACTORS, INC. FOREST PARK GA $76,666.68 MIDDLE GEORGIA HOSPITAL MACON GA $14,180.08 MID-SOUTH TRENCHLESS, INC. CHATTANOOGA GA $1,579.72 MILLER BREWING CO ALBANY GA $120,274.68 MILLER BREWING CO MOULTRIE GA $1,129.31 MILLIKEN & COMPANY LAGRANGE GA $128,680.77 MILLIKEN & COMPANY TOCCOA GA $10,557.00 MISCELLANEOUS ERECTORS, INC. POWDER SPRINGS GA $2,025.00 MODERN FIBERS INC FITZGERALD GA $1,997.40 MONROE AUTO EQUIPMENT HARTWELL GA $5,170.00 MOORE INGRAM JOHNSON AND STEEL MARIETTA GA $30,565.79 MOORE'S ASPHALT PAVING CO. SNELLVILLE GA $27,165.42 MOORMANS, INC. CORDELE GA $2,098.60 SITF 2012 Annual Report – Page 36

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed MORGAN CORPORATION RYDAL GA $57,920.43 MORI LUGGAGE & GIFTS ATLANTA GA $30,353.73 MRS. FIELD'S ORIGINAL COOKIES EAST POINT GA $18,922.93 MSI INVENTORY SERVICE FLOWWOD MS $11,846.98 MULLINAX WATERPROOFING BUCHANAN GA $3,000.00 MURATA ELECTRONICS SMYRNA GA $1,698.35 MURRAY COUNTY BOARD OF EDUCATI CHATSWORTH GA $4,500.00 MUSCOGEE GLASS COMPANY, INC. COLUMBUS GA $1,107.10 MYERS FLOOR COVERING INC LOGANVILLE GA $10,000.00 NATIONAL EMPLOYER SOLUTIONS ROME GA $22,510.85 NATIONAL EMPLOYER SOLUTIONS DALTON GA $31,782.32 NATIONAL EMPLOYER SOLUTIONS ALPHARETTA GA $62,683.71 NATIONAL PUBLIC RADIO, INC. WASHINGTON DC $985.25 NATIONAL VISION, INC. LAWRENCEVILLE GA $22,981.85 NATIONWIDE INSURANCE CO LEXINGTON KY $12,250.18 NATURALIZER SHOES/BROWN SHOES ATLANTA GA $86,220.00 NCR CORPORATION NORCROSS GA $92,445.90 NCR CORPORATION PEACHTREE CITY GA $15,518.92 NEATON ROME, INC. ROME GA $114,777.71 NEFF RENTALS, INC. AUGUSTA GA $1,431.52 NESTLE CORPORATION MCDONOUGH GA $90,913.62 NESTLE TRANSPORTATION CO. MCDONOUGH GA $64,328.54 NETWORK COMMUNICATIONS LAWRENCEVILLE GA $40,212.56 NEW CENTENNIAL, INC. COLUMBUS GA $5,406.32 NEW MORN FOODS GAINESVILLE GA $264,053.48 NEW YORK LIFE INSURANCE CO. ALPHARETTA GA $118,656.34 NEWS / SHOPPER, INC. WOODSTOCK GA $27,494.73 NEWS PUBLISHING COMPANY, INC. ROME GA $210,516.08 NICOLON / BAYCOR CORNELIA GA $49,907.30 NOLAND COMPANY MACON GA $4,871.44 NORCROSS AUTOMOTIVE INC DORAVILLE GA $97,360.69 NORDIC COLD STORAGE ATLANTA GA $602,647.38 NORTH FULTON REGIONAL ROSWELL GA $94,785.00 NORTH GEORGIA READY MIX DALTON GA $192,930.90 NORTHERN TELECOM, INC. STONE MOUNTAIN GA $19,611.82 NORTHLAKE MEDICAL CENTER ATLANTA GA $64,217.79 NORTHROP GRUMMAN CORP. PERRY GA $4,448.25 NORTHSIDE WOMENS SPECIALIS PC ATLANTA GA $289,438.45 NORTHWEST AIRLINES, INC. ATLANTA GA $6,200.88 NPC INTERNATIONAL CORDELE GA $153,510.19 SITF 2012 Annual Report – Page 37

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed NPC INTERNATIONAL HAZELHURST GA $24,104.81 NSR, INC. CHAMBLEE GA $18,773.90 NUCRAFT DENTAL ARTS, INC. BOGART GA $40,536.10 O. ANDERSON CURRIE JR., DDS ATLANTA GA $40,153.36 OAK GROVE LANDFILL WINDER GA $7,395.00 OAK MOUNTAIN VILLAGE ASSISTED CARROLLTON GA $13,958.34 OCMULGEE FIELDS MACON GA $18,176.21 OELSCHIG'S NURSERY, INC. SAVANNAH GA $11,084.68 OFFICE SERVICES, LLC SAVANNAH GA $19,898.49 OFS BRIGHTWAVE, LLC NORCROSS GA $2,566.35 OGLETHORPE COUNTY SCHOOLS LEXINGTON GA $24,373.94 OLIN WOOTEN TRANSPORT CO. INC. HAZLEHURST GA $6,300.00 OMNOVA SOLUTIONS CALHOUN GA $16,933.44 ONEDA CORPORATION COLUMBUS GA $4,774.01 ORIGINAL APPALACHIAN ARTWORKS CLEVELAND GA $24,542.31 OTIS SPUNKMEYER, INC. NORCROSS GA $12,688.26 OUTBOARD MARINE CORP. CALHOUN GA $16,511.44 OVERHEAD DOOR CORP. ATHENS GA $11,190.40 OWENS & PRIDGEN, INC. BRUNSWICK GA $120,844.91 OXFORD OF DUBLIN DUBLIN GA $7,474.86 PACTIV COVINGTON GA $93,051.35 PAPER PAK PRODUCTS WASHINGTON GA $19,320.16 PAYCHEX INC KENNESAW GA $53,624.29 PDS MECHANICAL JESUP GA $139,414.08 PEDIATRIC SERVICES OF AMERICA NORCROSS GA $9,971.27 PEPSI-COLA COMPANY ATLANTA GA $9,163.92 PETE ALEWINE POOL CO. INC. MARTINEZ GA $94,299.82 PETSMART INC DOUGLASVILLE GA $5,706.24 PHOENIX CRANE RENTAL CO. MABLETON GA $198,189.37 PIERCE & COMPANY, INC. CONYERS GA $53,061.23 PIERCE CO BOARD OF EDUCATION BLACKSHEAR GA $75,364.01 PIGGLY WIGGLY VIDALIA GA $7,150.00 PIKE ELECTRIC, INC. MOUNT AIRY NC $168,464.94 PILGRIM'S PRIDE, INC. ATHENS GA $110,428.16 PINE RIDGE MEMORIAL PARK KENNESAW GA $22,118.99 PIOLAX CORPORATION CANTON GA $6,427.52 PITNEY BOWES NORCROSS GA $22,602.10 PIZZA HUT, INC. ROSWELL GA $2,061.27 PIZZA HUT, INC. WOODSTOCK GA $4,699.16 PLATEAU EXCAVATION AUSTELL GA $105,335.87 SITF 2012 Annual Report – Page 38

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed POETIC LICENSE, INC. ATLANTA GA $5,218.50 POLLUTION EQUIPMENT MGMT. CO. ATLANTA GA $17,648.93 PORTEC INC WINDER GA $8,910.00 POST PROPERTIES, INC. ATLANTA GA $28,717.58 PRECISION MILLWORKS, INC CUMMING GA $80,352.33 PREMARK INTERNATIONAL INC. CHAMBLEE GA $832.97 PREMIER TRANSPORTATION FOREST PARK GA $170,899.15 PRESTIGE FUND RAISERS, LLC TYRONE GA $274.24 PRIME SOURCE SAVANNAH GA $7,636.50 PRIORITY ONE SERVICES ALEXANDRIA VA $17,946.40 PROCORE SOLUTIONS MARIETTA GA $179,203.28 PROFESSIONAL MEDICAL SERVICES ORLANDO FL $531.26 PROFESSIONAL TRANSPORTATION EVANSVILLE IN $2,937.47 PTREE/CARDON DOORS & WINDOWS GAINSVILLE GA $116,030.00 PUBLIX VALDOSTA GA $75,000.00 PUBLIX CARROLLTON GA $482.80 PUBLIX SMYRNA GA $24,211.58 PUBLIX ATLANTA GA $90,491.45 PUBLIX LITHONIA GA $21,077.61 PUBLIX KENNESAW GA $140,649.74 PUBLIX DACULA GA $178,540.44 PUBLIX ALPHARETTA GA $159,859.55 PUBLIX DACULA GA $2,776.68 PUBLIX SMYRNA GA $12,815.25 PUBLIX CONYERS GA $53,200.60 PUBLIX ROSWELL GA $131,495.74 PUBLIX SUPERMARKETS, INC. VILLA RICA GA $11,433.42 QUAD GRAPHICS THE ROCK GA $121,210.65 QUALA SYSTEMS, INC AUGUSTA GA $250,260.12 QUALITY ENTERPRISES ATLANTA GA $75,160.16 QUALITY MACHINE & FAB. LAFAYETTE GA $15,686.40 QUEBECOR - AUGUSTA EVANS GA $190,541.41 QUICK CHANGE #33 DOUGLAS GA $18,274.05 R. J. REYNOLDS TOBACCO CO MACON GA $146,123.23 R. J. REYNOLDS TOBACCO CO WINSTON-SALEM NC $5,200.00 RABUN APPAREL RABUN GAP GA $75,000.00 RAMON FRANCO. MD ATLANTA GA $20,102.71 RAYLOC ATLANTA GA $9,275.00 RAYONIER, INC. JESUP GA $744,597.18 RAYONIER, INC. MIDVILLE GA $7,000.00 SITF 2012 Annual Report – Page 39

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed RAZZI CORP. ALPHARETTA GA $75,113.32 RCS-GRIFFON CORP CONYERS GA $74,964.69 READY MIX USA, LLC DALTON GA $26,055.15 REDMOND REGIONAL MEDICAL CTR ROME GA $89,076.75 REEVES & WAGNER CONSTRUCTION WOODSTOCK GA $143,918.96 REEVES TRUCKING CO., INC. FITZGERALD GA $16,563.58 REGAL MARINE INDUSTRIES VALDOSTA GA $91,906.31 RELIABLE FASTENERS INC SMYRNA GA $48,843.35 RELIABLE SUPPLY COMPANY ATLANTA GA $36,630.10 RELIANCE HEATING & AIR CONDITI CONYERS GA $75,000.00 REMEDIATION SERVICES, INC. FITZGERALD GA $22,262.60 RENTOKIL, INC. ATLANTA GA $75,000.00 REPUBLIC SERVICES, INC. WINDER GA $8,368.41 RESCARE, INC. GORDON GA $31,029.82 RESPIRONICS KENNESAW GA $39,943.39 REYNOLDS AMERICAN INC MACON GA $24,442.11 RHEEM MANUFACTURING TAMPA FL $701.57 RHEEM MANUFACTURING NEW YORK NY $75,083.00 RHEEM MANUFACTURING MILLEDGEVILLE GA $324,826.48 RICHPORT PROPERTIES INC. TUCKER GA $4,971.26 RICH'S ATLANTA GA $8,317.90 RICOH ELECTRONICS LAWRENCEVILLE GA $8,260.87 RJK ENTERPRISES INC COLUMBUS GA $38,193.47 ROADWAY EXPRESS ATLANTA GA $12,458.48 ROBERT SHAW CONTROLS CO. ELLIJAY GA $8,545.21 ROGER WOOD FOODS SAVANNAG GA $43,645.52 ROGERS CASH & CARRY THOMASTON GA $5,049.07 ROME CITY SCHOOLS ROME GA $3,927.10 ROSES DEPARTMENT STORE # 235 ALBANY GA $646.17 ROSS SIMON CRANSTON RI $41,657.05 ROSS STORES, INC. CANTON GA $82,716.66 ROYS BOYS PIZZA LOGANVILLE GA $1,251.87 RUMMEL STAMPINGS, INC ROME GA $225,086.22 S & S ELECTRIC WINDER GA $23,131.47 S & S GRILL ELBERTON GA $7,292.36 SADDLE CREEK CORPORATION VILLA RICA GA $12,107.93 SAFT AMERICA, INC. VALDOSTA GA $1,297.39 SAIA MOTOR FREIGHT ATLANTA GA $12,557.08 SAMSONITE CORP COMMERCE GA $29,593.33 SARA LEE CORPORATION FOREST PARK GA $108,443.65 SITF 2012 Annual Report – Page 40

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed SARA LEE CORPORATION STONE MOUNTAIN GA $9,400.00 SAVANNAH AREA FAMILY EMERGENCY SAVANNAH GA $56,655.74 SAVANNAH CHRISTIAN SCHOOL SAVANNAH GA $15,866.88 SAVANNAH COCA-COLA BOTTLING CO POOLER GA $12,825.00 SAVANNAH FOODS INDUSTRY PORT WENTWORTH GA $19,761.76 SAWYER & WIEDEMEYER, INC. BRUNSWICK GA $119,149.67 SCALE SYSTEMS NORCROSS GA $62,505.30 SCAPE DRYER FABRICS WAYCROSS GA $25,435.92 SCHOLASTIC INC KENNESAW GA $266.75 SCI/STOCKBRIDGE SENIOR LIVING TAMPA FL $6,695.81 SCOVILL CLARKESVILLE GA $51,823.82 SEA ISLAND COMPANY SEA ISLAND GA $5,231.52 SECURITY FINANCE VIDALIA GA $84,950.69 SECURITY GROUP INC SPARTANBURG SC $75,000.00 SELECTIVE HR/DIXIE PAINTING ATHENS GA $149,398.00 SERVPRO OF EAST COBB MARIETTA GA $6,374.68 SHAPIRO PACKING CO. AUGUSTA GA $119,843.62 SHEPARD ELECTRIC INC SHEPARD L FAYETTEVILLE GA $113,252.44 SHEPARD EXPOSITION SERVICES ATLANTA GA $498.26 SHO ENTERPRISES SMYRNA GA $17,029.60 SHOWHOMES OF ATLANTA ALPHARETTA GA $36,676.08 SIEMENS ENERGY & AUTOMATION TUCKER GA $132,947.00 SIEMENS ENERGY CORP ALPHARETTA GA $2,174.92 SIGVARIS INC PEACHTREE CITY GA $32,909.42 SIMCO INTERIORS INC CLEVELAND GA $8,595.84 SIMKINS INDUSTRIES, INC. MARIETTA GA $16,207.88 SKILSTAFF INC ALEXANDER CITY AL $1,906.15 SMCS-TERMINIX ATHENS GA $75,259.80 SMITH & SONS FOOD, INC. ATLANTA GA $22,500.00 SMITHS MARKET TALLAPOOSA GA $70,280.25 SOLO CUP AUGUSTA GA $893.90 SOUTHEAST EXPRESS LUBES ATLANTA GA $3,061.56 SOUTHEASTERN ELECTRIC COMPANY LAVONIA GA $42,733.26 SOUTHEASTERN FREIGHT LINE SUWANEE GA $23,190.76 SOUTHEASTERN HOSE BREMEN GA $85,748.00 SOUTHEASTERN PORTABLE BLDG INC EATONTON GA $93,025.16 SOUTHERN CONCRETE CONSTRUCTION ALBANY GA $9,788.34 SOUTHERN CRAFT MASTERS LOGANVILLE GA $773,699.92 SOUTHERN MACHINE & FABRICATION CARTERSVILLE GA $2,563.94 SOUTHERN MANAGEMENT ABBEVILLE GA $83,167.72 SITF 2012 Annual Report – Page 41

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed SOUTHERN SAW SERVICE LP ATLANTA GA $166,958.80 SOUTHERN SENIOR LIVING DOUGLAS GA $50,401.17 SOUTHERN STAIRCASE ALPHARETTA GA $86,040.00 SOUTHERN WAREHOUSE SERVICES MACON GA $23,209.75 SOUTHSIDE MECHANICAL, INC FAYETTEVILLE GA $410,875.75 SPARTAN MECHANICAL INC CHAMBLEE GA $39,112.50 SPC COMPANY LAGRANGE GA $25,155.44 SPECTRA GEM, INC. NORCROSS GA $255,024.33 SPECTRUM CABLE SERVICES JONESBORO GA $48,392.32 SPECTRUM STORES WEST POINT GA $43,976.00 SPRINGHILL SERVICES INC MCINTYRE GA $174,254.79 STAFFING CONCEPTS INC/ M & S BAXLEY GA $75,203.61 STAFFING CONCEPTS, INC. GAINESVILLE GA $27,896.64 STAFFING SOLUTIONS GAINESVILLE GA $37,957.84 STANDRIDGE COLOR CORP. SOCIAL CIRCLE GA $28,724.12 STAR CHOICES INC MACON GA $13.44 STAR MANUFACTURING COMPANY CEDARTOWN GA $36,448.25 STAR PACKAGING CORPORATION COLLEGE PARK GA $300,000.00 STATEWIDE HEALTH CARE INC SAVANNAH GA $16,112.70 STEAK N SHAKE TIFTON GA $63,812.00 STEPHENS COUNTY SCHOOLS TOCCOA GA $4,137.24 STEVE CRAWFORD FOREST PROD. WAYNESBORO GA $18,825.41 STOCK BUILDING SUPPLY TUCKER GA $30,565.20 STORK GAMCO, INC. GAINESVILLE GA $56,333.95 SUMTER REGIONAL HOSPITAL AMERICUS GA $4,513.97 SUNLINK HEALTH SYSTEMS ELLIJAY GA $38,949.65 SUNSHINE BISQUITS, INC COLUMBUS GA $27,161.99 SUPER 8 MOTEL COLUMBUS GA $1,494.58 SUPERIOR ELECTRIC JULIETTE GA $3,645.00 SUPERIOR PLUMBING SERVICE MARIETTA GA $810.50 SUPREME CARPET, INC. CHATSWORTH GA $10,690.39 SWAN CONSTRUCTION CO. AUGUSTA GA $501.25 SWEETHEART CUP CO., INC. CONYERS GA $16,720.66 SWIFT INDEPENDENT PACKING CO MOULTRIE GA $6,204.00 SWIFTY SERVE CORP CORAOOPLOIS PA $7,796.73 SYNOVUS FINANCIAL CORP. COLUMBUS GA $22,383.41 SYSTEM SERVICES AND INDUSTRIAL SAVANNAH GA $12,625.57 T.T.C. ILLINOIS, INC. KANKAKEE IL $121,995.80 TAPPI TECHNICAL ASSOC THE PULP NORCROSS GA $10,848.80 TARTAN TEXTILE SERVICES HOUSTON TX $33,328.26 SITF 2012 Annual Report – Page 42

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed TARTAN TEXTILE SERVICES ROME GA $45,041.57 TAYLOR ORCHARDS, INC. REYNOLDS GA $14,663.79 TEETS INTERNATIONAL TRUCKS INC AUGUSTA GA $6,380.00 TENNECO AUTOMOTIVE INC HARTWELL GA $285,833.77 TENNECO OIL CO. MOULTRIE GA $25,424.49 TERRY NIX EQUIPMENT UNION CITY GA $670.34 THACKSTON & SONS CONSTRUCTION MARIETTA GA $531.24 THE BOOK WAREHOUSE KNOXVILLE TN $12,340.95 THE CAPITAL CITY MACHINE SHOP ATLANTA GA $658.16 THE DARIEN NEWS, INC. DARIEN GA $41,129.14 THE HERTZ CORPORATION HAPEVILLE GA $75,000.00 THE KINGS CARPENTERS, INC. CANTON GA $19,427.39 THE MASQUERADE, INC. ATLANTA GA $41,898.81 THE MOTOR CONVOY, INC. ATLANTA GA $12,090.00 THE R & R MFG CO INC AUBURN GA $2,769.80 THE RAYMOND KING CO., INC. CALHOUN GA $47,474.17 THE SEA PALMS CORP ST SIMONS ISLAND GA $130.98 THE TAPPAN COMPANY DALTON GA $10,912.46 THE TIMKEN CO. DAHLONGA GA $16,585.60 THOMAS CONCRETE OF GEORGIA INC ATLANTA GA $10,155.00 THOMAS COUNTY BD OF EDUCATION THOMASVILLE GA $10,902.64 THOMPSON HARDWOODS, INC. HAZELHURST GA $25,618.17 THOMPSON CONSTRUCTION CO. CHAMBLEE GA $27,455.80 THOMPSON'S FARM SUPPLY VIDALIA GA $8,999.33 THOMS TRANSPORT BLACKSHEAR GA $90,160.08 THOMSON OAK FLOORING CO. THOMSON GA $16,900.00 TIFTON ALUMINUM CO., INC. TIFTON GA $3,752.30 TIMBER HARVESTING, INC. DANVILLE GA $17,894.37 TIMESAVER, INC- 56 TWIN CITY GA $126,414.62 TIRE KINGDOM RIVIERA BEACH FL $42,114.87 TIRE PRO, INC. LAGRANGE GA $22,610.00 TOLBERT PLASTERING CO. INC. ATHENS GA $30,930.00 TOM JAMES COMPANY BREMEN GA $68,175.38 TOM'S FOODS, INC. COLUMBUS GA $10,000.00 TOOMSBORO NURSING CTR COLUMBUS GA $46,941.00 TOWN OF TRION POLICE DEPT. TRION GA $87,240.21 TOWNS COUNTY SCHOOLS HIAWASSEE GA $3,441.47 TRANCO LOGISTICS, LLC CHATTANOOGA TN $75,000.00 TRANSPORTATION SERVICES UNLMTD ETON GA $146,790.08 TRANSPOWER ALBANY GA $26,243.62 SITF 2012 Annual Report – Page 43

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed TREDEGAR CORPORATION NEWNAN GA $5,119.82 TRENT TUBE DIVISION CARROLLTON GA $3,204.20 TRIANGLE PACIFIC CORPORATION ATLANTA GA $26,922.94 TRINTEX CORP. BOWDON GA $70,007.00 TRIVEST INC MIAMI FL $74,624.80 TRIZECHAHN CORPORATION ATLANTA GA $592.55 TRU-CHECK INC SOMERSET KY $9,319.28 TRUCKSTOPS OF AMERICA BRUNSWICK GA $27,273.23 TRUS JOIST MACMILLAN VALDOSTA GA $603.00 TRW-BRUNSWICK JOB CORPS BRUNSWICK GA $41,425.17 TUCKER CONCRETE CO. TUCKER GA $1,523.19 TUFTCO CO. DALTON GA $3,627.21 TUGALO GAS CO INC TOCCOA GA $230,075.81 TURBINE ENGINE COMPONENTS THOMASVILLE GA $78,769.61 TYTAM SERVICES INC STOCKBRIDGE GA $70,979.74 U.S. CAN CO MORROW GA $69,398.00 U.S. CAN CO TALLAPOOSA GA $203,236.33 U.S. SECURITY ASSOCIATES, INC. GAINESVILLE GA $16,724.50 U-HAUL CO. COLUMBUS GA $12,597.71 UNITED DISTRIBUTORS, INC. SAVANNAH GA $10,822.59 UNITED DISTRIBUTORS, INC. ALBANY GA $75,000.00 UNITED NORTH TRANSFER STATION WINDER GA $12,553.24 UNITED PARCEL SERVICE ATLANTA GA $55,950.00 UNITED PARCEL SERVICE UNADILLA GA $6,153.50 UNITED PARCEL SERVICE BLACKSHEAR GA $1,346.73 UNITED PARCEL SERVICE JACKSONVILLE FL $14,831.10 UNIVERSAL TRAILER FITZGERALD GA $24,933.81 US FOODSERVICE FAIRBURN GA $50,000.00 US XPRESS ENTERPRISES INC. CHATTANOOGA TN $95,758.84 UTILITIES CONST. CO OF SC CHARLESTON SC $19,125.00 UVALDA MANUFACTURING CO UVALDA GA $17,220.07 V.T. GRIFFIN SERVICES KINGS BAY GA $27,715.57 VALUE STORAGE, LTD. ARLINGTON TX $27,081.66 VARN TURPENTINE & CATTLE FOLKSTON GA $6,810.82 VIACON, INC NORCROSS GA $27,334.42 VINCE HOSIERY MILL VILLA RICA GA $75,000.00 VISION WEB PRESS, INC. LILBURN GA $52,220.10 VOITH FABRICS, INC. WAYCROSS GA $46,570.91 VOS ELECTRIC GREEN BAY WI $12,375.00 VT INDUSTRIES, INC. ROME GA $46,030.36 SITF 2012 Annual Report – Page 44

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed W & J, INC. SMYRNA GA $23,003.51 W. CLAIRE HICKS, M.D. JESUP GA $141,637.15 W.A. BRAGG & CO. AUGUSTA GA $192,122.21 WADE & SONS INC MACON GA $7,525.00 WAL-MART HIRAM GA $66,121.05 WAL-MART CANTON GA $25,000.00 WAL-MART NEWNAN GA $76,354.47 WAL-MART TIFTON GA $12,475.42 WAL-MART WINDER GA $92,494.76 WAL-MART CORNELIA GA $47,711.41 WAL-MART CARROLLTON GA $31,107.21 WAL-MART FITZGERALD GA $45,239.44 WAL-MART DOUGLASVILLE GA $1,389.32 WAL-MART DALTON GA $16,472.56 WAL-MART TOCCOA GA $46,200.19 WAL-MART BRUNSWICK GA $47,483.95 WALTERS MANAGEMENT COMPANY GAINESVILLE GA $25,262.99 WARD CONSTRUCTION INC. CORNELIA GA $76,217.47 WASTE MANAGEMENT OF ATLANTA LAKE CITY GA $76,504.89 WATER, GAS & LIGHT COMMISSION ALBANY GA $5,720.00 WATSON-HUNT FUNERAL HOME PERRY GA $79,245.02 WAYCON PIZZA ENTERPRISES ATHENS GA $101,772.02 WAYCROSS COCA-COLA WAYCROSS GA $4,331.47 WAYNE POULTRY PENDERGRASS GA $8,160.53 WAYNE SHEET METAL WORKS JESUP GA $75,000.00 WEEKS TEXTILE QUITMAN GA $6,581.64 WELCH TARKINGTON, INC. ATLANTA GA $91,666.67 WELLS CARGO, INC. WAYCROSS GA $77,999.42 WESLEYAN COLLEGE MACON GA $8,608.20 WEST GEORGIA AUTO PARTS INC CARROLLTON GA $5,830.00 WEST GEORGIA EYE CARE CENTER COLUMBUS GA $53,667.40 WESTEC, INC. THOMASTON GA $24,287.29 WESTERN PLASTICS INC CALHOUN GA $79,017.00 WHISNANT CONTRACTING CO. STOCKBRIDGE GA $15,390.54 WHITLOW ELECTRIC SERVICE, INC. ELBERTON GA $121,893.03 WHOLE FOODS MARKET ATLANTA GA $29,881.38 WIKA INSTRUMENT CORP LAWRENCEVILLE GA $103,296.36 WILLIAM CARTER CO BARNESVILLE GA $130,260.73 WILLIAM CARTER CO HOGANSVILLE GA $1,855.78 WILLIAMS & ASSOCIATES ATLANTA GA $1,655.70 SITF 2012 Annual Report – Page 45

Individual Employers Benefiting from SITF Reimbursements 01/01/2012 Through 12/31/2012 Employer City State Total Reimbursed WILLIAMS SERVICE GROUP MILLEDGVILLE GA $37,819.80 WINGFOOT COMMERCIAL TIRE SYSTEM MACON GA $34,845.10 WOODRUFF CO COLUMBUS GA $3,337.18 WORLD AIRWAYS, INC PEACHTREE CITY GA $13,797.21 WORLD CHAMPIONSHIP WRESTLING SMYRNA GA $93,840.55 WOW EXPRESS, INC. MONROE GA $65,000.00 XEROX CORPORATION ATLANTA GA $17,343.19 YAMAHA MUSIC MFG. THOMASTON GA $75,469.84 YATES BLEACHERY CO. FLINTSTONE GA $77,835.47 YUM! BRANDS, INC. LOUISVILLE KY $35,792.82 TOTAL: $48,043,559.11

SITF 2012 Annual Report – Page 46

Assessment by the Fund 34-9-359. Reports by employers of Legal Requirements compensation and benefits paid; failure to pay 34-9-358. Payment of assessments to fund by assessments insurers and self-insurers (a) As soon as practicable after January 1 but (a) Prior to January 1, 2010, each insurer and not later than January 31 of each calendar year, self-insurer under this chapter shall, under the administrator shall forward to each insurer regulations prescribed by the board of trustees, and self-insured employer a questionnaire make payments to the fund in an amount equal asking for the total amount of compensation, to that proportion of 175 percent of the total medical benefits, and rehabilitation benefits disbursement made from the fund during the paid by each insurer and self-insured employer preceding calendar year less the amount of the during the preceding calendar year. This report net assets in the fund as of December 31 of the is to be completed and returned to the preceding calendar year which the total administrator no later than March 1 of the same workers' compensation claims paid by the calendar year in which the request for this insurer or self-insurer bears to the total workers' information is submitted. Failure to submit the compensation claims paid by all insurers and report to the administrator of the fund by March self-insurers during the preceding calendar 1 shall result in an automatic penalty of $50.00 year. per day for each day the report is delinquent or (b) On or after January 1, 2010, each insurer 10 percent of the assessment, whichever is and self-insurer under this chapter shall, under greater. This penalty will be added to the regulations prescribed by the board of trustees, assessment. make payments to the fund in an amount equal (b) Any assessment levied or established in to that proportion of 175 percent of the total accordance with this article in a specified disbursement made from the fund during the amount as may be determined pursuant to this preceding calendar year as of December 31 of article shall constitute a personal debt of every the preceding calendar year which the total employer or insurer so assessed and shall be workers' compensation claims paid by the due and payable to the Subsequent Injury Trust insurer or self-insurer bears to the total workers' Fund when payment is called for by the compensation claims paid by all insurers and administrator. In the event of failure to pay any self-insurers during the preceding calendar year assessment upon the date determined by the but not to exceed $100 million. The administrator, the administrator may file a administrator is authorized to create and complaint for collection against the employer or maintain a reserve of surplus moneys as may be insurer in a court of competent jurisdiction. deemed necessary by the board of trustees in (c) In the event any employer or insurer duly order to ensure sufficient moneys will be assessed fails to pay to the administrator on available for the payment of all claims that are behalf of the Subsequent Injury Trust Fund the to be paid by the fund in accordance with Code amount so assessed on or before the date Section 34-9-368. specified by the administrator, the administrator (c) The administrator is authorized to reduce is authorized to add to the unpaid assessment an or suspend assessments for the fund when a amount not exceeding 10 percent of the unpaid completed actuarial survey shows further assessment and reasonable attorney's fees to assessments are not needed for all bona fide defray the cost of enforcing collection. claims that are to be paid by the fund.

SITF 2012 Annual Report – Page 47

This amount is divided into the fund Assessment Calculation assessment of $100,000,000.00 and yields The assessment and assessment rate are an (adjusted) assessment rate of derived from the fund’s financial activity for .07115495. This adjustment has caused an the calendar year and the claims loss data increase to be applied to the 2011 provided by insurance companies and self- assessment. insured employers. This claims loss data is obtained on an annual basis in the form of Assessment Rate for 2012 an Annual Assessment Report. As required in O.C.G.A.§34-9-359, this is a report of the The Georgia Subsequent Injury Trust Fund total amount of compensation, medical Assessment for calendar year 2012 is benefits, and rehabilitation benefits paid by $100,000,000.00. This was computed in each insurer and self-insured employer the following manner: during the calendar year. Total Fund $103,324,990.04 Assessment Adjustment for 2011 disbursements/calendar The Georgia Subsequent Injury Trust Fund year 2012 Assessment for calendar year 2011 was $100,000,000.00. This was computed in x 175% the following manner: Fund Assessment not to $180,818,732.57 exceed $100 million Total Fund $125,230,471.93 disbursements/calendar Fund Assessment $100,000,00.00 year 2011 Based on data received from insurers and x 175% self-insured employers, the reported total of Fund Assessment not to $219,153,325.88 workers' compensation benefits paid in exceed $100 million Georgia during calendar year 2012 was Fund Assessment $100,000,00.00 $1,464,074,070.22. This amount is divided into the fund assessment of $100,000,000.00, which yields an The assessment rate is based on data assessment rate of .06830256. provided by insurers and self-insured employers’ in the Annual Assessment In addition to the assessment, an additional Reports; the actual total of workers' $328,134.12 in penalties for late filing of compensation benefits (indemnity, medical, Claims Loss report forms will be levied. and rehabilitation) paid in Georgia during calendar year 2011 was $1,405,383,670.63. .

SITF 2012 Annual Report – Page 48

Assessments Due for 2012

Assessments Due from Insurance Companies

2012 Assessment due from Insurance Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Adjustment Assessment Balance Total Company Name Claims Paid Amt Amt Amt Due Assessment ACCIDENT FUND GENERAL INS CO $44,013.50 $44,015.83 $992,724.00 $67,805.59 $2.33 $67,807.92 ACCIDENT FUND INS CO OF AMER $440,135.63 $440,158.95 $6,752,786.00 $461,232.57 $23.32 $461,255.89 ACCIDENT FUND NATIONAL INS CO $30,156.72 $30,158.31 $1,293,061.00 $88,319.38 $1.59 $88,320.97 ACCIDENT INSURANCE CO. $428,711.55 $428,734.26 $5,413,193.00 $369,734.94 $22.71 $369,757.65 ACE AMERICAN INSURANCE CO $2,017,666.10 $2,017,773.01 $25,396,959.00 $1,734,677.32 $106.91 $1,734,784.23 ACE FIRE UNDERWRITERS INS. CO $75,425.73 $75,429.73 $775,347.00 $52,958.18 $4.00 $52,962.18 ACE PROPERTY & CASUALTY INS $77,039.87 $77,043.95 $1,443,979.00 $98,627.46 $4.08 $98,631.54 ACIG INSURANCE COMPANY $26,887.46 $26,888.89 $424,345.00 $28,983.85 $1.43 $28,985.28 ADVANTAGE WORKERS COMP. INS. $35,543.93 $35,545.81 $300,996.00 $20,558.80 $1.88 $20,560.68 AIU INSURANCE CO $10,870.19 $10,870.77 $308,489.00 $21,070.59 $0.58 $21,071.17 ALFA INSURANCE CORP $4,413.79 $4,414.03 $0.00 $0.00 $0.24 $0.24 ALL AMERICA INS. CO $3,837.89 $3,838.10 $619,854.00 $42,337.62 $0.21 $42,337.83 ALLIED EASTERN INDEMNITY CO $26.82 $26.83 $165,247.00 $11,286.79 $0.01 $11,286.80 ALLIED PROPERTY & CASUALTY INS $0.00 $0.00 $6,646.00 $453.94 $0.00 $453.94 ALLMERICA FIN BENEFIT INS CO $29,678.51 $29,680.08 $523,643.00 $35,766.16 $1.57 $35,767.73 AMCO INSURANCE CO $0.00 $0.00 $1.00 $0.07 $0.00 $0.07 AMER BUS & MERCANTILE INS MUT. $4,843.47 $4,843.73 $119,969.00 $8,194.19 $0.26 $8,194.45 AMER MOTORISTS INS CO IN REHAB $97,975.26 $97,980.46 $609,138.57 $41,605.72 $5.20 $41,610.92 AMERICAN ALTERNATIVE INS $83,041.40 $83,045.80 $484,071.00 $33,063.29 $4.40 $33,067.69 AMERICAN AUTOMOBILE INS CO $12,621.58 $12,622.25 $135,793.00 $9,275.01 $0.67 $9,275.68 AMERICAN CAS CO OF READING PA $653,489.66 $653,524.28 $8,117,788.49 $554,465.74 $34.62 $554,500.36 AMERICAN COMPENSATION INS CO $112.99 $112.99 $7,827.00 $534.60 $0.00 $534.60 AMERICAN ECONOMY INS CO $81,514.85 $81,519.17 $1,063,731.00 $72,655.55 $4.32 $72,659.87 AMERICAN FAMILY INSURANCE CO $0.00 $0.00 $9,617.00 $656.87 $0.00 $656.87 AMERICAN FIRE & CASUALTY CO $11,890.43 $11,891.06 $576,431.00 $39,371.71 $0.63 $39,372.34 AMERICAN GUAR & LIAB INS CO $126,213.16 $126,219.84 $1,583,502.00 $108,157.24 $6.68 $108,163.92 AMERICAN HOME ASSURANCE CO $629,909.65 $629,943.03 $9,655,838.00 $659,518.45 $33.38 $659,551.83 AMERICAN INSURANCE CO $82,800.26 $82,804.65 $1,100,224.00 $75,148.12 $4.39 $75,152.51 AMERICAN INTER INS CO OF GA $745,498.64 $745,538.14 $13,784,205.41 $941,496.52 $39.50 $941,536.02 AMERICAN MFG. MUT INS- IN REHA $8,614.25 $8,614.70 $147,344.59 $10,064.01 $0.45 $10,064.46 AMERICAN RESOURCES INS CO $4,324.92 $4,325.15 $189,020.00 $12,910.55 $0.23 $12,910.78 AMERICAN SAFETY CASUALTY INS $7,620.86 $7,621.26 $4,852.00 $331.40 $0.40 $331.80 AMERICAN SELECT INSURANCE CO $0.00 $0.00 $40,258.00 $2,749.72 $0.00 $2,749.72 AMERICAN STATES INS CO $65,357.20 $65,360.66 $612,179.00 $41,813.39 $3.46 $41,816.85 AMERICAN STATES INS CO OF TX $6,855.13 $6,855.49 $134,698.00 $9,200.22 $0.36 $9,200.58 AMERICAN ZURICH INS CO $2,428,765.74 $2,428,894.43 $45,308,653.00 $3,094,696.99 $128.69 $3,094,825.68 AMERISURE INSURANCE CO $196,400.74 $196,411.14 $3,923,717.00 $267,999.92 $10.40 $268,010.32 AMERISURE MUTUAL INS CO $143,442.13 $143,449.73 $1,605,402.00 $109,653.07 $7.60 $109,660.67 AMGUARD INSURANCE CO. $313,287.33 $313,303.93 $4,171,379.00 $284,915.86 $16.60 $284,932.46 AMTRUST INS CO OF KS $11,957.10 $11,957.73 $577,456.00 $39,441.72 $0.63 $39,442.35 ANSUR AMERICAN INS CO $151,781.97 $151,790.02 $1,311,026.32 $89,546.45 $8.05 $89,554.50 ARCH INSURANCE CO $558,961.61 $558,991.22 $7,367,963.00 $503,250.73 $29.61 $503,280.34 ARGONAUT GREAT CENTRL INS CO $65,433.40 $65,436.87 $380,863.00 $26,013.92 $3.47 $26,017.39 ARGONAUT INSURANCE CO $66,654.28 $66,657.81 $788,049.00 $53,825.76 $3.53 $53,829.29 ARGONAUT LIMITED RISK INS CO $0.00 $0.00 $208,858.00 $14,265.54 $0.00 $14,265.54 ARGONAUT-MIDWEST INS CO $39,615.98 $39,618.08 $274,884.00 $18,775.28 $2.10 $18,777.38 ARROWOOD INDEMNITY CO $218,540.28 $218,551.86 $0.00 $0.00 $11.58 $11.58 ASSOCIATED INDEMNITY CORP $32,042.22 $32,043.92 $461,433.00 $31,517.06 $1.70 $31,518.76 SITF 2012 Annual Report – Page 49

2012 Assessment due from Insurance Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Adjustment Assessment Balance Total Company Name Claims Paid Amt Amt Amt Due Assessment ASSOCIATED INDUSTRIES INS CO $4,836.43 $4,836.69 $25,961.00 $1,773.20 $0.26 $1,773.46 ASSOCIATION CASUALTY INS CO $139,631.84 $139,639.24 $2,986,326.00 $203,973.71 $7.40 $203,981.11 ASSOCIATION INSURANCE CO $349,603.46 $349,621.98 $5,576,256.00 $380,872.56 $18.52 $380,891.08 ASSURANCE CO. OF AMERICA $87,212.14 $87,216.76 $811,733.00 $55,443.44 $4.62 $55,448.06 ATLANTIC SPECIALTY INS CO $0.00 $0.00 $162.00 $11.07 $0.00 $11.07 ATLANTIC STATES INS. CO. $30,790.25 $30,791.88 $319,154.00 $21,799.04 $1.63 $21,800.67 AUTO OWNERS INS. CO $882,920.76 $882,967.54 $13,478,135.00 $920,591.12 $46.78 $920,637.90 BANCINSURE, INC. $2,028.59 $2,028.70 $0.00 $0.00 $0.11 $0.11 BANKERS STANDARD INS CO $58,164.24 $58,167.32 $1,639,109.00 $111,955.34 $3.08 $111,958.42 BENCHMARK INS CO $39,707.13 $39,709.23 $879,606.00 $60,079.34 $2.10 $60,081.44 BERKLEY NATIONAL INS. CO. $0.00 $0.00 $2,102.00 $143.57 $0.00 $143.57 BERKSHIRE HATHAWAY HOMESTATE I $2,354.18 $2,354.30 $1,193,007.00 $81,485.43 $0.12 $81,485.55 BITUMINOUS CASUALTY CORP $169,230.05 $169,239.02 $3,112,483.16 $212,590.57 $8.97 $212,599.54 BITUMINOUS FIRE & MARINE INS $54,724.53 $54,727.43 $864,336.83 $59,036.42 $2.90 $59,039.32 BRIDGEFIELD CASUALTY $1,475,175.57 $1,475,253.73 $18,773,881.00 $1,282,304.13 $78.16 $1,282,382.29 BRIDGEFIELD EMPLOYERS INS. CO $10,662.29 $10,662.85 $91,550.00 $6,253.10 $0.56 $6,253.66 BROTHERHOOD MUTUAL INS CO $16,035.13 $16,035.98 $417,120.00 $28,490.36 $0.85 $28,491.21 BUILDERS INSURANCE (A MUTUAL C $2,030,605.73 $2,030,713.32 $26,272,450.00 $1,794,475.59 $107.59 $1,794,583.18 BUILDERS MUTUAL INSURANCE CO $10,471.46 $10,472.02 $317,959.00 $21,717.41 $0.56 $21,717.97 CALIFORNIA INSURANCE CO $59,471.71 $59,474.86 $513,605.00 $35,080.54 $3.15 $35,083.69 CANAL INSURANCE CO $319,655.55 $319,672.49 $2,822,623.00 $192,792.38 $16.94 $192,809.32 CAROLINA CASUALTY INS CO $83,430.45 $83,434.87 $1,476,249.00 $100,831.59 $4.42 $100,836.01 CASTLEPOINT NATIONAL INS CO $322,485.89 $322,502.98 $3,610,359.00 $246,596.76 $17.09 $246,613.85 CENTRAL MUTUAL INS CO $53,407.71 $53,410.54 $50,861.05 $3,473.94 $2.83 $3,476.77 CENTRE INSURANCE CO $2,382.57 $2,382.69 $0.00 $0.00 $0.12 $0.12 CENTURY INDEMNITY CO $5,283.69 $5,283.97 $59,373.00 $4,055.33 $0.28 $4,055.61 CHARTER OAK FIRE INS CO $352,092.25 $352,110.91 $5,097,076.00 $348,143.34 $18.66 $348,162.00 CHARTIS CASUALTY COMPANY $931,270.19 $931,319.53 $16,242,966.00 $1,109,436.16 $49.34 $1,109,485.50 CHARTIS PROPERTY CASUALTY CO $20,150.94 $20,152.01 $495,702.00 $33,857.72 $1.07 $33,858.79 CHEROKEE INSURANCE CO $43,541.18 $43,543.49 $557,640.00 $38,088.24 $2.31 $38,090.55 CHUBB INDEMNITY INS CO $111,860.51 $111,866.44 $1,477,286.79 $100,902.47 $5.93 $100,908.40 CHURCH MUTUAL INS CO $112,698.42 $112,704.39 $1,545,756.00 $105,579.09 $5.97 $105,585.06 CINCINNATI CASUALTY CO $229,663.57 $229,675.74 $2,907,744.89 $198,606.42 $12.17 $198,618.59 CINCINNATI INDEMNITY CO $101,159.35 $101,164.71 $1,350,485.73 $92,241.63 $5.36 $92,246.99 CINCINNATI INSURANCE CO $114,593.63 $114,599.70 $1,281,179.94 $87,507.87 $6.07 $87,513.94 CITIZENS INS CO OF AMERICA $30,132.10 $30,133.69 $907,504.00 $61,984.85 $1.59 $61,986.44 CLARENDON NATIONAL INS CO $87,260.95 $87,265.57 $1,524,136.00 $104,102.39 $4.62 $104,107.01 COLONIAL AMERICAN CAS & SURETY $1,464.86 $1,464.94 $28,583.00 $1,952.29 $0.08 $1,952.37 COLUMBIA NATIONAL INS CO $44,343.05 $44,345.40 $946,704.00 $64,662.31 $2.35 $64,664.66 COMMERCE & INDUSTRY INS CO $1,549,356.50 $1,549,438.60 $20,595,571.00 $1,406,730.22 $82.10 $1,406,812.32 COMPANION COMMERCIAL INS CO $270,184.37 $270,198.68 $4,915,052.00 $335,710.63 $14.31 $335,724.94 COMPANION PROP & CAS $977,452.85 $977,504.65 $12,245,615.00 $836,406.85 $51.80 $836,458.65 COMPTRUST ACG MUTUAL CAP. INS $255,681.62 $255,695.17 $2,772,955.00 $189,399.93 $13.55 $189,413.48 CONTINENTAL CASUALTY CO $363,025.62 $363,044.85 $3,579,294.49 $244,474.98 $19.23 $244,494.21 CONTINENTAL INSURANCE CO $48,949.95 $48,952.54 $722,551.93 $49,352.15 $2.59 $49,354.74 CONTINENTAL WESTERN INS CO $810.70 $810.74 $25,696.00 $1,755.10 $0.04 $1,755.14 COUNTRY MUTUAL INS. CO. $1,382.33 $1,382.40 $42,797.00 $2,923.14 $0.07 $2,923.21 CRUM & FORSTER INDEMNITY CO $9,200.63 $9,201.12 $130,342.00 $8,902.69 $0.49 $8,903.18 CUMIS INS SOCIETY INC $6,498.81 $6,499.15 $1,638.00 $111.88 $0.34 $112.22 CYPRESS INSURANCE CO $208,231.75 $208,242.79 $2,483,571.00 $169,634.26 $11.04 $169,645.30 DALLAS NATIONAL INSURANCE CO $108,284.55 $108,290.29 $3,025,048.00 $206,618.52 $5.74 $206,624.26 DELTA FIRE & CASUALTY INS $0.00 $0.00 $21,496.00 $1,468.23 $0.00 $1,468.23 DISCOVER PROPERTY & CAS $4,416.14 $4,416.37 $0.00 $0.00 $0.23 $0.23 DONEGAL MUTUAL INSURANCE CO $16,595.66 $16,596.54 $377,226.00 $25,765.50 $0.88 $25,766.38 SITF 2012 Annual Report – Page 50

2012 Assessment due from Insurance Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Adjustment Assessment Balance Total Company Name Claims Paid Amt Amt Amt Due Assessment EASTERN ADVANTAGE ASSURANCE CO $1,386.88 $1,386.95 $19,625.00 $1,340.44 $0.07 $1,340.51 EASTERN ALLIANCE INS. CO $10,583.31 $10,583.87 $281,319.00 $19,214.81 $0.56 $19,215.37 EASTGUARD INSURANCE CO $126,321.16 $126,327.86 $1,655,261.00 $113,058.56 $6.70 $113,065.26 ELECTRIC INSURANCE CO $49,054.40 $49,057.00 $739,198.00 $50,489.12 $2.60 $50,491.72 EMCASCO INSURANCE CO $13.59 $13.59 $121,608.00 $8,306.14 $0.00 $8,306.14 EMPLOYERS ASSURANCE CO $391,147.92 $391,168.65 $4,944,300.00 $337,708.35 $20.73 $337,729.08 EMPLOYERS FIRE INS CO $13,802.83 $13,803.56 $208,751.00 $14,258.23 $0.73 $14,258.96 EMPLOYERS INS OF WAUSAU $323,167.59 $323,184.72 $4,555,931.00 $311,181.75 $17.13 $311,198.88 EMPLOYERS MUTUAL CAS INS CO $21,444.82 $21,445.96 $826,385.00 $56,444.21 $1.14 $56,445.35 EMPLOYERS PREFERRED INS. CO. $129,511.23 $129,518.09 $4,210,577.00 $287,593.19 $6.86 $287,600.05 EVEREST NATIONAL INS $95,827.90 $95,832.98 $1,230,477.00 $84,044.73 $5.08 $84,049.81 EVEREST SECURITY INS CO $4,440.33 $4,440.57 $6,611.00 $451.55 $0.24 $451.79 EXCELSIOR INSURANCE CO $95,560.94 $95,566.01 $910,637.00 $62,198.84 $5.07 $62,203.91 FAIRMONT SPECIALTY INS CO $68,911.63 $68,915.28 $739,973.00 $50,542.05 $3.65 $50,545.70 FARMINGTON CASUALTY CO $128,580.29 $128,587.10 $2,010,979.00 $137,355.01 $6.81 $137,361.82 FARMLAND MUTUAL $4,224.74 $4,224.97 $342,707.00 $23,407.77 $0.23 $23,408.00 FCCI INSURANCE COMPANY $369,038.62 $369,058.17 $3,861,453.00 $263,747.13 $19.55 $263,766.68 FEDERAL INSURANCE CO $487,282.17 $487,307.98 $5,723,486.53 $390,928.78 $25.81 $390,954.59 FEDERATED MUTUAL INS CO $207,784.36 $207,795.37 $3,385,268.00 $231,222.47 $11.01 $231,233.48 FEDERATED RURAL ELECTRIC INS $0.00 $0.00 $386,041.00 $26,367.59 $0.00 $26,367.59 FEDERATED SERVICE INS CO $13,611.15 $13,611.87 $878,178.00 $59,981.81 $0.72 $59,982.53 FFVA MUTUAL INS CO $734,324.22 $734,363.13 $12,147,656.00 $829,716.00 $38.91 $829,754.91 FHM INSURANCE COMPANY $184,093.43 $184,103.19 $4,326,514.00 $295,511.98 $9.76 $295,521.74 FIDELITY & DEPOSIT CO OF MD $13,729.12 $13,729.85 $55,975.00 $3,823.24 $0.73 $3,823.97 FIDELITY & GUAR UNDERWRITERS $11,461.32 $11,461.92 $436,542.00 $29,816.94 $0.60 $29,817.54 FIDELITY & GUARANTY INS CO $637,469.18 $637,502.96 $5,719,158.00 $390,633.13 $33.78 $390,666.91 FIREMAN'S FUND INS CO $51,492.11 $51,494.84 $1,021,111.00 $69,744.50 $2.73 $69,747.23 FIRST DAKOTA INDEMNITY CO $0.00 $0.00 $547.00 $37.36 $0.00 $37.36 FIRST LIBERTY INS CORP $138,268.16 $138,275.49 $1,903,006.00 $129,980.18 $7.33 $129,987.51 FIRST NATL INS CO OF AMER $12,781.17 $12,781.85 $19,272.00 $1,316.33 $0.68 $1,317.01 FIRST NONPROFIT INS. CO. $13,228.78 $13,229.48 $421,883.00 $28,815.69 $0.70 $28,816.39 FLORISTS INSURANCE CO $3,223.08 $3,223.25 $56,588.00 $3,865.11 $0.17 $3,865.28 FLORISTS' MUTUAL INS CO $19,500.90 $19,501.94 $418,639.00 $28,594.12 $1.04 $28,595.16 FRANK WINSTON CRUM INS CO $131,051.08 $131,058.03 $1,957,394.00 $133,695.02 $6.95 $133,701.97 FRANKENMUTH MUTUAL INS $40,145.99 $40,148.11 $578,644.14 $39,522.88 $2.12 $39,525.00 GA FARM BUREAU MUTUAL INS CO $0.00 $0.00 $1,759.00 $120.14 $0.00 $120.14 GATEWAY INSURANCE CO $0.00 $0.00 $10,000.00 $683.03 $0.00 $683.03 GENERAL CASUALTY CO OF WI $17,980.69 $17,981.64 $332,428.00 $22,705.68 $0.95 $22,706.63 GENERAL INS CO OF AMERIC $0.00 $0.00 $38,495.00 $2,629.31 $0.00 $2,629.31 GENESIS INSURANCE CO $0.00 $0.00 $29,083.00 $1,986.44 $0.00 $1,986.44 GEORGIA CASUALTY & SURETY CO $82,914.68 $82,919.07 $1,439,071.00 $98,292.23 $4.39 $98,296.62 GERBER LIFE INS CO $663.20 $663.24 $0.00 $0.00 $0.04 $0.04 GRANGE MUTUAL CASUALTY COMPANY $26,885.75 $26,887.18 $373,502.01 $25,511.14 $1.43 $25,512.57 GRANITE STATE INS CO $165,213.32 $165,222.08 $1,274,721.00 $87,066.71 $8.76 $87,075.47 GRAPHIC ARTS MUTUAL INS CO $80,071.19 $80,075.43 $895,532.00 $61,167.13 $4.24 $61,171.37 GRAY INSURANCE CO $6,103.47 $6,103.79 $26,555.45 $1,813.81 $0.32 $1,814.13 GREAT AMER ALLIANCE INS CO $539,091.50 $539,120.07 $10,061,731.00 $687,241.99 $28.57 $687,270.56 GREAT AMER INS CO OF NY $196,606.22 $196,616.64 $1,653,095.00 $112,910.62 $10.42 $112,921.04 GREAT AMERICAN ASSUR CO $14,539.03 $14,539.80 $61,988.00 $4,233.94 $0.77 $4,234.71 GREAT AMERICAN INS CO $423.92 $423.94 $1,030.00 $70.35 $0.02 $70.37 GREAT DIVIDE INS CO $22,843.66 $22,844.87 $545,723.00 $37,274.28 $1.21 $37,275.49 GREAT NORTHERN INS CO $39,750.88 $39,752.99 $392,430.00 $26,803.97 $2.11 $26,806.08 GREAT WEST CASUALTY CO $198,329.43 $198,339.94 $1,801,608.00 $123,054.44 $10.51 $123,064.95 GREATER NEW YORK MUTUAL INS $3,126.81 $3,126.98 $39,974.00 $2,730.33 $0.17 $2,730.50 SITF 2012 Annual Report – Page 51

2012 Assessment due from Insurance Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Adjustment Assessment Balance Total Company Name Claims Paid Amt Amt Amt Due Assessment GREENWICH INSURANCE CO $17,416.81 $17,417.74 $175,484.00 $11,986.01 $0.93 $11,986.94 GUARANTEE INSURANCE CO $652,189.57 $652,224.13 $13,996,016.00 $955,963.72 $34.56 $955,998.28 GUIDEONE MUTUAL INS CO $52,571.54 $52,574.33 $945,106.00 $64,553.16 $2.79 $64,555.95 HANOVER INSURANCE CO $0.00 $0.00 $30,396.00 $2,076.12 $0.00 $2,076.12 HARBOR SPECIALITY INS $8,967.04 $8,967.52 $148,578.00 $10,148.26 $0.48 $10,148.74 HARCO NATIONAL INS CO $5,391.20 $5,391.48 $25,064.00 $1,711.94 $0.28 $1,712.22 HARLEYSVILLE INSURANCE CO $595.68 $595.71 $75,046.00 $5,125.83 $0.03 $5,125.86 HARLEYSVILLE MUTUAL INS CO $42,125.13 $42,127.36 $0.00 $0.00 $2.23 $2.23 HARLEYSVILLE PREFERRED INS CO $35,236.77 $35,238.64 $500,947.00 $34,215.96 $1.87 $34,217.83 HARLEYSVILLE WORCESTER INS CO $110,539.69 $110,545.55 $1,035,133.00 $70,702.23 $5.86 $70,708.09 HARTFORD ACCIDENT & INDEMNITY $195,030.79 $195,041.13 $3,893,508.00 $265,936.56 $10.34 $265,946.90 HARTFORD CASUALTY INS CO $378,084.99 $378,105.02 $8,350,023.00 $570,327.95 $20.03 $570,347.98 HARTFORD FIRE INSURANCE CO $2,011,127.81 $2,011,234.37 $31,285,991.00 $2,136,913.28 $106.56 $2,137,019.84 HARTFORD INS CO OF S.E. $162,557.68 $162,566.29 $2,971,224.00 $202,942.21 $8.61 $202,950.82 HARTFORD INS OF THE MIDWEST $323,805.25 $323,822.41 $8,107,665.00 $553,774.28 $17.16 $553,791.44 HARTFORD UNDERWRITERS INS $650,873.56 $650,908.05 $8,506,274.00 $581,000.29 $34.49 $581,034.78 HDI-GERLING AMERICA INS CO $0.00 $0.00 $5,038.00 $344.11 $0.00 $344.11 HEALTH CARE MUTUAL CAPTIVE $228,823.62 $228,835.74 $3,466,363.00 $236,761.47 $12.12 $236,773.59 HIGHLANDS INS CO-IN RECEIVERSH $4,862.72 $4,862.98 $0.00 $0.00 $0.26 $0.26 HOUSTON GENERAL INS CO $0.00 $0.00 $123,281.00 $8,420.41 $0.00 $8,420.41 INDEMNITY INS CO OF NA $3,518,908.68 $3,519,095.13 $53,155,995.00 $3,630,690.54 $186.45 $3,630,876.99 INSURANCE CO OF N.A. $19,572.55 $19,573.59 $223,736.00 $15,281.74 $1.04 $15,282.78 INSURANCE CO OF STATE OF PA $1,743,357.74 $1,743,450.11 $20,328,348.00 $1,388,478.21 $92.37 $1,388,570.58 INSURANCE COMPANY OF THE WEST $251.95 $251.96 $819.61 $55.98 $0.01 $55.99 JEFFERSON PILOT FIN INS CO $6,581.61 $6,581.96 $32,623.91 $2,228.30 $0.35 $2,228.65 KEY RISK INSURANCE CO $890,009.90 $890,057.06 $12,469,556.00 $851,702.60 $47.16 $851,749.76 KODIAK INSURANCE CO. $22,774.78 $22,775.99 $116,489.00 $7,956.50 $1.21 $7,957.71 LIBERTY INSURANCE CORP $3,185,208.94 $3,185,377.71 $45,506,729.00 $3,108,226.09 $168.77 $3,108,394.86 LIBERTY MUTUAL FIRE INS $1,091,259.66 $1,091,317.49 $11,662,437.00 $796,574.30 $57.83 $796,632.13 LIBERTY MUTUAL INS. CO. $339,445.92 $339,463.90 $5,352,898.00 $365,616.64 $17.98 $365,634.62 LM INSURANCE CORP $1,024,412.99 $1,024,467.27 $15,641,020.00 $1,068,321.71 $54.28 $1,068,375.99 LUMBER MUTUAL INSURANCE CO $191.58 $191.59 $1,516.69 $103.59 $0.01 $103.60 LUMBERMENS MUT CAS CO- IN REHA $46,049.90 $46,052.34 $332,464.55 $22,708.18 $2.44 $22,710.62 LUMBERMEN'S UNDERWRITING $288,115.32 $288,130.59 $3,711,246.00 $253,487.60 $15.27 $253,502.87 MADISON INSURANCE CO $950.51 $950.56 $267,680.00 $18,283.23 $0.05 $18,283.28 MAG MUTUAL INS CO $126,143.64 $126,150.33 $1,794,881.00 $122,594.97 $6.69 $122,601.66 MANUFACTURER'S ALLIANCE INS $62,635.88 $62,639.20 $2,047,187.00 $139,828.11 $3.32 $139,831.43 MARYLAND CASUALTY COMPANY $34,230.12 $34,231.93 $462,780.00 $31,609.06 $1.81 $31,610.87 MASSACHUSETTS BAY INSURANCE CO $32,860.39 $32,862.13 $582,996.00 $39,820.12 $1.74 $39,821.86 MEMIC INDEMNITY CO $9,817.87 $9,818.39 $37,964.00 $2,593.04 $0.52 $2,593.56 MERIDIAN SECURITY INS CO $514.14 $514.17 $87,720.00 $5,991.50 $0.03 $5,991.53 MICHIGAN COMMERCIAL INS MUTUAL $11,498.32 $11,498.92 $194,465.00 $13,282.46 $0.60 $13,283.06 MIDDLESEX INSURANCE CO $15,616.76 $15,617.59 $60,360.00 $4,122.74 $0.83 $4,123.57 MIDWEST BUILDER'S CAS. MUT. CO $0.00 $0.00 $62.46 $4.27 $0.00 $4.27 MIDWEST EMPLOYERS CASUALTY CO $199,280.22 $199,290.78 $3,961,203.00 $270,560.31 $10.56 $270,570.87 MIDWESTERN INDEMNITY CO $29,657.88 $29,659.45 $161,679.00 $11,043.09 $1.57 $11,044.66 MITSUI SUMITOMO INS CO OF AMER $23,310.05 $23,311.29 $478,975.00 $32,715.22 $1.24 $32,716.46 MITSUI SUMITOMO INS USA, INC $48,444.99 $48,447.56 $612,571.00 $41,840.17 $2.57 $41,842.74 MONROE GUARANTY INS. CO. $79,353.77 $79,357.98 $1,500,389.00 $102,480.41 $4.21 $102,484.62 MOTORISTS COMMERCIAL MUT INS C $1,254.83 $1,254.90 $19,195.00 $1,311.07 $0.07 $1,311.14 NATIONAL AMERICAN INSURANCE CO $5,099.55 $5,099.82 $180,152.00 $12,304.84 $0.27 $12,305.11 NATIONAL CASUALTY COMPANY $0.00 $0.00 $21,306.00 $1,455.25 $0.00 $1,455.25 NATIONAL FIRE INS CO HARTFORD $246,067.31 $246,080.35 $3,857,522.94 $263,478.69 $13.04 $263,491.73 NATIONAL INTERSTATE INS $3,133.21 $3,133.38 $51,483.00 $3,516.42 $0.17 $3,516.59 SITF 2012 Annual Report – Page 52

2012 Assessment due from Insurance Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Adjustment Assessment Balance Total Company Name Claims Paid Amt Amt Amt Due Assessment NATIONAL LIABILITY & FIRE INS $406,231.76 $406,253.28 $3,436,266.00 $234,705.76 $21.52 $234,727.28 NATIONAL SURETY CORP $61,739.16 $61,742.43 $446,771.00 $30,515.60 $3.27 $30,518.87 NATIONAL TRUST INSURANCE CO $1,031,930.25 $1,031,984.93 $11,460,833.00 $782,804.23 $54.68 $782,858.91 NATIONAL UNION FIRE OF PITT PA $632,530.29 $632,563.81 $10,846,844.00 $740,867.21 $33.52 $740,900.73 NATIONWIDE AGRIBUSINESS $43,735.42 $43,737.74 $433,725.00 $29,624.53 $2.32 $29,626.85 NATIONWIDE MUTUAL FIRE INS CO $4,513.12 $4,513.36 $89,358.00 $6,103.38 $0.24 $6,103.62 NATIONWIDE MUTUAL INS CO $9,970.91 $9,971.44 $1,228,245.00 $83,892.28 $0.53 $83,892.81 NETHERLANDS INSURANCE CO $262,099.60 $262,113.49 $4,493,625.00 $306,926.09 $13.89 $306,939.98 NEW HAMPSHIRE INSURANCE CO $2,891,328.66 $2,891,481.86 $43,570,602.00 $2,975,983.66 $153.20 $2,976,136.86 NEW YORK MARINE & GENERAL INS $0.00 $0.00 $20,579.00 $1,405.60 $0.00 $1,405.60 NORGUARD INSURANCE CO. $163,699.01 $163,707.69 $2,603,552.00 $177,829.27 $8.68 $177,837.95 NORTH AMERICAN SPECIALTY INS $98,616.89 $98,622.11 $1,025,116.00 $70,018.05 $5.22 $70,023.27 NORTH POINTE INSURANCE CO $182,625.37 $182,635.05 $1,092,910.00 $74,648.55 $9.68 $74,658.23 NORTH RIVER INSURANCE CO $119,547.07 $119,553.41 $911,688.00 $62,270.62 $6.34 $62,276.96 NORTHBROOK INDEMNITY CO $505.32 $505.34 $0.00 $0.00 $0.02 $0.02 NORTHERN ASSUR CO OF AMER $2,942.60 $2,942.76 $37,935.00 $2,591.06 $0.16 $2,591.22 NORTHERN INS CO OF NY $118,147.67 $118,153.93 $982,480.00 $67,105.90 $6.26 $67,112.16 NORTHWESTERN NATIONAL INS CO $193.06 $193.07 $2,704.10 $184.70 $0.01 $184.71 NOVA CASUALTY COMPANY $2,125.07 $2,125.18 $56,644.00 $3,868.93 $0.11 $3,869.04 OCCIDENTAL FIRE & CAS CO OF NC $413.03 $413.05 $5,481.00 $374.37 $0.02 $374.39 OHIO CASUALTY INSURANCE CO $46,776.64 $46,779.11 $144,598.00 $9,876.41 $2.47 $9,878.88 OHIO SECURITY INSURANCE CO $14,253.50 $14,254.26 $92,807.00 $6,338.96 $0.76 $6,339.72 OLD DOMINION INSURANCE CO $75,674.47 $75,678.48 $1,365,393.00 $93,259.84 $4.01 $93,263.85 OLD REPUBLIC GENERAL INS CORP $35,661.26 $35,663.15 $1,219,534.00 $83,297.29 $1.89 $83,299.18 OLD REPUBLIC INSURANCE CO $1,052,203.07 $1,052,258.83 $4,180,422.00 $285,533.52 $55.76 $285,589.28 OLD REPUBLIC UNION INS CO $792.20 $792.24 $17,183.00 $1,173.64 $0.04 $1,173.68 ONEBEACON AMERICA INS CO $32,690.98 $32,692.71 $218,109.00 $14,897.40 $1.73 $14,899.13 ONEBEACON INSURANCE CO $18,447.79 $18,448.77 $0.00 $0.00 $0.98 $0.98 OWNERS INSURANCE CO $890,823.52 $890,870.72 $11,802,610.00 $806,148.48 $47.20 $806,195.68 PACIFIC EMPLOYERS INSURANCE $253,220.08 $253,233.49 $8,965,006.00 $612,332.86 $13.41 $612,346.27 PACIFIC INDEMNITY CO $56,912.76 $56,915.77 $930,403.31 $63,548.93 $3.01 $63,551.94 PATRIOT GENERAL INSURANCE CO $102,592.67 $102,598.10 $1,100,468.25 $75,164.80 $5.43 $75,170.23 PEERLESS INDEMNITY INS CO $4,707.93 $4,708.18 $175,470.00 $11,985.05 $0.25 $11,985.30 PEERLESS INSURANCE COMPANY $83,958.39 $83,962.84 $547,532.00 $37,397.84 $4.45 $37,402.29 PENN MFG ASSOC INS $428,236.54 $428,259.23 $6,438,837.00 $439,789.05 $22.69 $439,811.74 PENN MFG IND. CO $226,125.78 $226,137.76 $2,310,087.00 $157,784.86 $11.98 $157,796.84 PENN MILLERS MUTUAL $42,949.27 $42,951.55 $708,133.00 $48,367.30 $2.28 $48,369.58 PENN NATIONAL MUTUAL CAS $4,603.98 $4,604.22 $76,178.00 $5,203.15 $0.24 $5,203.39 PENNSYLVANIA GENERAL INS CO $3,548.88 $3,549.07 $485,519.00 $33,162.19 $0.19 $33,162.38 PETROLEUM CASUALTY CO $7,088.29 $7,088.67 $101,038.00 $6,901.15 $0.38 $6,901.53 PHARMACISTS MUTUAL INS CO $13,962.71 $13,963.45 $601,235.00 $41,065.89 $0.74 $41,066.63 PHOENIX INSURANCE CO $223,207.73 $223,219.55 $3,519,069.00 $240,361.42 $11.82 $240,373.24 PRAETORIAN INSURANCE CO $120,853.55 $120,859.96 $2,907,148.00 $198,565.65 $6.41 $198,572.06 PREFERRED PROFESSIONAL INS CO $0.00 $0.00 $16,150.00 $1,103.09 $0.00 $1,103.09 PREMIER GROUP INS. CO. $4,419.13 $4,419.36 $201,732.00 $13,778.81 $0.23 $13,779.04 PRINCETON INSURANCE CO $17,403.37 $17,404.29 $53,124.00 $3,628.51 $0.92 $3,629.43 PROP & CAS INS CO OF HARTFORD $1,043.08 $1,043.13 $262,633.00 $17,938.51 $0.05 $17,938.56 PROTECTIVE INSURANCE CO $132,169.79 $132,176.79 $1,870,346.00 $127,749.42 $7.00 $127,756.42 PUBLIC SERVICE INS CO $2,733.98 $2,734.13 $1,189.00 $81.21 $0.15 $81.36 QBE INSURANCE CORPORATION $0.00 $0.00 $10,437.00 $712.87 $0.00 $712.87 REGENT INSURANCE CO $30,203.25 $30,204.85 $297,505.00 $20,320.35 $1.60 $20,321.95 REPUBLIC IND. CO. OF AMERICA $0.00 $0.00 $21,173.00 $1,446.17 $0.00 $1,446.17 REPUBLIC-FRANKLIN INSURANCE CO $86,852.11 $86,856.71 $1,186,220.00 $81,021.86 $4.60 $81,026.46 ROCHDALE INSURANCE COMPANY $351,778.62 $351,797.26 $6,209,443.00 $424,120.85 $18.64 $424,139.49 SITF 2012 Annual Report – Page 53

2012 Assessment due from Insurance Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Adjustment Assessment Balance Total Company Name Claims Paid Amt Amt Amt Due Assessment SAFECO INS CO OF ILLINOIS $4,247.73 $4,247.95 $0.00 $0.00 $0.22 $0.22 SAFECO INSURANCE CO AMERICA $2,896.78 $2,896.93 $8,876.00 $606.25 $0.15 $606.40 SAFETY FIRST INS CO $1,743.77 $1,743.87 $74,493.00 $5,088.06 $0.10 $5,088.16 SAFETY NATIONAL CASUALTY $62,927.81 $62,931.15 $2,216,290.00 $151,378.28 $3.34 $151,381.62 SEABRIGHT INSURANCE CO $44,848.72 $44,851.10 $674,108.00 $46,043.30 $2.38 $46,045.68 SECURITY NATIONAL INS CO $3,529.03 $3,529.21 $27,700.00 $1,891.98 $0.18 $1,892.16 SELECT INSURANCE CO $7,714.14 $7,714.55 $87,639.00 $5,985.97 $0.41 $5,986.38 SELECTIVE INS CO OF AMERICA $145,381.93 $145,389.63 $1,348,683.00 $92,118.50 $7.70 $92,126.20 SELECTIVE INS CO OF SE $48,823.87 $48,826.46 $806,942.00 $55,116.20 $2.59 $55,118.79 SELECTIVE INSURANCE CO OF SC $41,663.71 $41,665.92 $1,867,902.00 $127,582.49 $2.21 $127,584.70 SELECTIVE WAY INSURANCE CO $192,779.92 $192,790.14 $2,416,638.00 $165,062.56 $10.22 $165,072.78 SENTINEL INSURANCE CO LTD $116,538.45 $116,544.62 $1,145,499.00 $78,240.51 $6.17 $78,246.68 SENTRY CASUALTY COMPANY $99,276.28 $99,281.54 $1,332,052.37 $90,982.59 $5.26 $90,987.85 SENTRY INSURANCE A MUTUAL CO $484,316.78 $484,342.44 $6,470,923.88 $441,980.67 $25.66 $442,006.33 SENTRY SELECT INSURANCE CO $27,481.47 $27,482.93 $476,308.56 $32,533.09 $1.46 $32,534.55 SOMPO JAPAN FIRE & MARINE INS $12,619.37 $12,620.04 $311,333.00 $21,264.84 $0.67 $21,265.51 SOMPO JAPAN INS, OF AMERICA $31,276.07 $31,277.72 $557,590.00 $38,084.82 $1.65 $38,086.47 SOUTHERN FIRE & CASUALTY CO $4,875.21 $4,875.47 $239,701.00 $16,372.19 $0.26 $16,372.45 SOUTHERN GUARANTY INSURANCE CO $13,162.75 $13,163.45 $66,727.00 $4,557.62 $0.70 $4,558.32 SOUTHERN INS CO OF VIRGINIA $21,025.74 $21,026.86 $357,842.00 $24,441.52 $1.12 $24,442.64 SOUTHERN INSURANCE COMPANY $11,493.12 $11,493.73 $136,047.00 $9,292.36 $0.61 $9,292.97 SOUTHERN MUTUAL CHURCH INS $13,237.61 $13,238.31 $225,724.00 $15,417.53 $0.70 $15,418.23 SOUTHERN MUTUAL INS CO $0.00 $0.00 $1,339.00 $91.46 $0.00 $91.46 SOUTHERN PILOT INSURANCE CO $36,956.71 $36,958.66 $406,014.00 $27,731.80 $1.95 $27,733.75 SOUTHERN STATES INS EXCHANGE $35,291.91 $35,293.78 $1,334,371.00 $91,140.96 $1.87 $91,142.83 SOUTHERN TRUST INSURANCE CO $58,078.22 $58,081.30 $207,259.00 $14,156.32 $3.08 $14,159.40 SPARTA INSURANCE COMPANY $45,594.03 $45,596.45 $1,534,075.00 $104,781.25 $2.42 $104,783.67 ST PAUL FIRE & CASUALTY INS CO $29,178.17 $29,179.72 $771,561.00 $52,699.59 $1.55 $52,701.14 ST PAUL FIRE & MARINE INS CO $135,380.56 $135,387.73 $674,955.00 $46,101.15 $7.17 $46,108.32 ST PAUL GUARDIAN INS CO $16,177.50 $16,178.36 $90,615.00 $6,189.24 $0.86 $6,190.10 ST PAUL MERCURY INS CO $724.75 $724.78 $9,938.00 $678.79 $0.03 $678.82 ST PAUL PROTECTIVE INS CO $4,022.96 $4,023.17 $110,319.00 $7,535.07 $0.21 $7,535.28 STANDARD FIRE INSURANCE CO $73,600.56 $73,604.46 $1,072,629.00 $73,263.31 $3.90 $73,267.21 STAR INSURANCE CO $173,876.48 $173,885.69 $2,050,493.00 $140,053.92 $9.21 $140,063.13 STARNET INSURANCE CO $91,393.54 $91,398.39 $2,974,178.00 $203,143.97 $4.85 $203,148.82 STATE AUTO PROP & CAS $6,280.87 $6,281.20 $144,185.00 $9,848.20 $0.33 $9,848.53 STATE AUTOMOBILE MUTUAL INS $5,463.06 $5,463.35 $46,506.00 $3,176.48 $0.29 $3,176.77 STATE FARM FIRE & CASUALTY CO $232,939.29 $232,951.63 $3,502,631.00 $239,238.66 $12.34 $239,251.00 STONEBRIDGE CASUALTY INS CO $0.00 $0.00 $9,319.00 $636.51 $0.00 $636.51 SUNZ INSURANCE COMPANY $79,735.36 $79,739.58 $2,857,713.00 $195,189.11 $4.22 $195,193.33 SYNERGY INSURANCE COMPANY $32.71 $32.71 $35,381.00 $2,416.61 $0.00 $2,416.61 T.H.E. INSURANCE CO $441.14 $441.16 $24,813.00 $1,694.79 $0.02 $1,694.81 TECHNOLOGY INSURANCE CO $669,776.79 $669,812.28 $12,884,922.00 $880,073.16 $35.49 $880,108.65 TIG INSURANCE CO $3,914.38 $3,914.59 $0.00 $0.00 $0.21 $0.21 TNUS INSURANCE COMPANY $8,022.22 $8,022.65 $170,684.00 $11,658.15 $0.43 $11,658.58 TOKIO MARINE & NICHIDO FIRE $140,373.45 $140,380.89 $1,622,216.30 $110,801.53 $7.44 $110,808.97 TOWER INSURANCE CO OF NY $78,811.60 $78,815.78 $1,630,367.00 $111,358.24 $4.18 $111,362.42 TOWER NATIONAL INS. CO. $29,694.45 $29,696.02 $1,104,833.00 $75,462.92 $1.57 $75,464.49 TRANS PACIFIC INS CO $14,669.92 $14,670.69 $181,102.88 $12,369.79 $0.77 $12,370.56 TRANSGUARD INS CO OF AMERICA $3,587.09 $3,587.28 $8,385.00 $572.72 $0.19 $572.91 TRANSPORT INSURANCE CO $155.25 $155.26 $1,293.00 $88.32 $0.01 $88.33 TRANSPORTATION INSURANCE CO $236,707.52 $236,720.06 $2,534,929.68 $173,142.19 $12.54 $173,154.73 TRAVELERS CAS & SUR CO $207,970.13 $207,981.15 $2,525,298.00 $172,484.32 $11.02 $172,495.34 TRAVELERS CAS & SUR CO OF AMER $7.40 $7.40 $305.00 $20.83 $0.00 $20.83 SITF 2012 Annual Report – Page 54

2012 Assessment due from Insurance Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Adjustment Assessment Balance Total Company Name Claims Paid Amt Amt Amt Due Assessment TRAVELERS CAS INS CO OF AMER $77,128.09 $77,132.18 $2,736,741.00 $186,926.42 $4.09 $186,930.51 TRAVELERS INDEMNITY CO OF CT $340,973.60 $340,991.67 $5,532,471.00 $377,881.93 $18.07 $377,900.00 TRAVELERS INDEMNITY COMPANY $629,588.33 $629,621.69 $10,849,006.00 $741,014.88 $33.36 $741,048.24 TRAVELERS INDEMNITY OF AMER $3,207,282.10 $3,207,452.04 $49,207,297.00 $3,360,984.36 $169.94 $3,361,154.30 TRAVELERS PROP CAS CO OF AMER $720,208.04 $720,246.20 $10,364,439.00 $707,917.72 $38.16 $707,955.88 TRINITY UNIVERSAL INS CO $3,611.52 $3,611.71 $43,230.00 $2,952.72 $0.19 $2,952.91 TRUCK INSURANCE EXCHANGE $5,798.11 $5,798.42 $116,313.00 $7,944.48 $0.31 $7,944.79 TRUMBULL INSURANCE COMPANY $5,123.81 $5,124.08 $380,072.00 $25,959.89 $0.27 $25,960.16 TRUSTGUARD INSURANCE CO $14,078.11 $14,078.86 $171,661.10 $11,724.89 $0.75 $11,725.64 TWIN CITY FIRE INSURANCE CO $902,919.08 $902,966.92 $15,810,195.00 $1,079,876.79 $47.84 $1,079,924.63 U.S. FIDELITY & GUARANTY INS $133,219.27 $133,226.33 $2,303,092.00 $157,307.08 $7.06 $157,314.14 U.S. SPECIALTY INS. CO. $1,438.04 $1,438.11 $24,530.00 $1,675.46 $0.07 $1,675.53 ULLICO CASUALTY CO $44,835.42 $44,837.79 $1,015,768.00 $69,379.55 $2.37 $69,381.92 UNION INSURANCE COMPANY $10,363.53 $10,364.07 $249,306.00 $17,028.24 $0.54 $17,028.78 UNITED BUSINESS INS CO (A MUTU $71,020.26 $71,024.02 $1,290,862.00 $88,169.18 $3.76 $88,172.94 UNITED STATES FIRE INSURANCE $320,728.96 $320,745.95 $3,281,665.00 $224,146.12 $16.99 $224,163.11 UNITED WISCONSIN INS CO $30,670.36 $30,671.98 $1,081,190.00 $73,848.04 $1.62 $73,849.66 UNIVERSAL UNDERWRITERS INS $0.00 $0.00 $167,205.00 $11,420.53 $0.00 $11,420.53 UTICA MUTUAL INSURANCE CO $48,312.58 $48,315.14 $978,823.00 $66,856.12 $2.56 $66,858.68 UTICA NATIONAL ASSURANCE CO $64,674.86 $64,678.28 $1,510,035.00 $103,139.26 $3.42 $103,142.68 VALLEY FORGE INSURANCE CO $451,511.65 $451,535.57 $4,945,909.60 $337,818.29 $23.92 $337,842.21 VANLINER INSURANCE CO $101,351.30 $101,356.67 $1,279,949.00 $87,423.79 $5.37 $87,429.16 VIGILANT INSURANCE CO $13,401.97 $13,402.68 $231,767.00 $15,830.28 $0.71 $15,830.99 VININGS INSURANCE CO $30,133.45 $30,135.05 $1,314,272.00 $89,768.14 $1.60 $89,769.74 VIRGINIA SURETY COMPANY, INC $0.00 $0.00 $25,298.00 $1,727.92 $0.00 $1,727.92 WAUSAU BUSINESS INSURANCE $347,051.98 $347,070.36 $3,611,067.00 $246,645.12 $18.38 $246,663.50 WAUSAU GENERAL INS CO $71,386.98 $71,390.76 $381,462.00 $26,054.83 $3.78 $26,058.61 WAUSAU UNDERWRITERS INS CO $670,147.99 $670,183.50 $9,444,803.00 $645,104.22 $35.51 $645,139.73 WESCO INSURANCE COMPANY $27,162.67 $27,164.11 $1,330,394.00 $90,869.32 $1.44 $90,870.76 WEST AMERICAN INSURANCE CO $15,476.73 $15,477.55 $105,716.00 $7,220.67 $0.82 $7,221.49 WESTFIELD INSURANCE CO $475,068.32 $475,093.50 $7,242,806.00 $494,702.19 $25.18 $494,727.37 WESTFIELD NATIONAL INS CO $21,913.14 $21,914.30 $97,040.00 $6,628.08 $1.16 $6,629.24 WESTPORT INSURANCE CORP $225,393.56 $225,405.50 $4,382,662.00 $299,347.03 $11.94 $299,358.97 WILLIAMSBURG NATIONAL INS CO $38,718.69 $38,720.74 $815,071.00 $55,671.44 $2.05 $55,673.49 WORK FIRST CASUALTY CO $46,088.67 $46,091.12 $990,693.00 $67,666.87 $2.45 $67,669.32 XL INSURANCE AMERICA INC $16,455.28 $16,456.15 $312,563.00 $21,348.85 $0.87 $21,349.72 XL SPECIALTY INSURANCE CO $199,101.35 $199,111.90 $2,740,557.00 $187,187.06 $10.55 $187,197.61 YORK INSURANCE CO $123.02 $123.03 $994.00 $67.89 $0.01 $67.90 ZENITH INSURANCE CO $305,108.00 $305,124.17 $5,405,898.00 $369,236.67 $16.17 $369,252.84 ZNAT INSURANCE COMPANY $0.00 $0.00 $299,695.00 $20,469.94 $0.00 $20,469.94 ZURICH AMERICAN INS CO $1,953,101.10 $1,953,204.59 $24,822,027.00 $1,695,407.99 $103.49 $1,695,511.48 ZURICH AMERICAN INS CO OF IL $7,940.76 $7,941.18 $84,099.00 $5,744.18 $0.42 $5,744.60 Grand Total: $72,055,885.51 $72,059,703.49 $1,052,539,848.51 $71,891,166.19 $3,817.98 $71,894,984.17

SITF 2012 Annual Report – Page 55

Assessments Due from Self-Insurers

2012 Assessment Due from Self-Insured Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Assessment Total Company Name Adjustment Amt Claims Paid Balance Due Amt Amt Assessment A T & T $4,848.86 $4,849.11 $0.00 $0.00 $0.25 $0.25 AAA COOPER TRANSPORTATION $50,952.68 $50,955.38 $642,053.13 $43,853.87 $2.70 $43,856.57 ABF FREIGHT SYSTEM, INC $63,116.14 $63,119.48 $1,179,580.62 $80,568.38 $3.34 $80,571.72 ADVENTIST HEALTH SYS SUNBELT $34,239.87 $34,241.68 $442,328.47 $30,212.17 $1.81 $30,213.98 AGL RESOURCES, INC. $3,825.61 $3,825.81 $855,595.25 $58,439.35 $0.20 $58,439.55 ALBANY INTERNATIONAL $2,731.28 $2,731.43 $0.00 $0.00 $0.15 $0.15 ALBANY WATER GAS & LIGHT COMM $1,868.72 $1,868.82 $36,348.00 $2,482.66 $0.10 $2,482.76 ALBANY, CITY OF $16,032.68 $16,033.53 $403,827.15 $27,582.43 $0.85 $27,583.28 ALLENS INC $6,739.60 $6,739.96 $0.00 $0.00 $0.36 $0.36 ALLIED SYSTEMS LTD $26,125.50 $26,126.89 $375,641.00 $25,657.24 $1.39 $25,658.63 ALPHARETTA, CITY OF $4,835.74 $4,836.00 $322,351.87 $22,017.46 $0.26 $22,017.72 AMERICAN PROTEINS, INC $21,610.95 $21,612.09 $123,267.18 $8,419.46 $1.14 $8,420.60 ANHEUSER-BUSCH COMPANIES, INC. $6,664.06 $6,664.42 $38,026.48 $2,597.31 $0.36 $2,597.67 ARCHBOLD MEDICAL CENTER $27,931.05 $27,932.53 $358,504.50 $24,486.78 $1.48 $24,488.26 ARCHER-DANIELS-MIDLAND CO $8,952.38 $8,952.86 $108,840.53 $7,434.09 $0.48 $7,434.57 ASPLUNDH TREE EXPERT CO $22,445.46 $22,446.65 $715,571.59 $48,875.37 $1.19 $48,876.56 ATCO RUBBER PRODUCTS, INC. $1,474.05 $1,474.12 $36,147.63 $2,468.98 $0.07 $2,469.05 ATHENS REG. HLTH SYS INC $31,426.68 $31,428.34 $570,561.19 $38,970.79 $1.66 $38,972.45 ATHENS-CLARKE COUNTY $32,248.12 $32,249.82 $472,598.94 $32,279.72 $1.70 $32,281.42 ATLANTA CITY OF $691,099.95 $691,136.57 $7,295,722.28 $498,316.51 $36.62 $498,353.13 ATLANTA HOUSING AUTHORITY $396.91 $396.93 $41,274.96 $2,819.19 $0.02 $2,819.21 ATLANTA PUBLIC SCHOOLS $185,750.15 $185,760.00 $2,156,423.68 $147,289.26 $9.85 $147,299.11 AUGUSTA-RICHMOND CO BD COMM $112,227.09 $112,233.04 $1,662,913.71 $113,581.26 $5.95 $113,587.21 AUTOZONE, INC $3,668.29 $3,668.48 $879,366.74 $60,063.00 $0.19 $60,063.19 AVERITT EXPRESS, INC $74,061.59 $74,065.52 $2,049,290.20 $139,971.77 $3.93 $139,975.70 BALDWIN COUNTY COMMISSIONERS $5,895.65 $5,895.97 $119,931.84 $8,191.65 $0.32 $8,191.97 BARTOW COUNTY BD OF EDUCATION $20,737.08 $20,738.18 $569,222.43 $38,879.35 $1.10 $38,880.45 BASF CORPORATION $713.48 $713.52 $42,347.93 $2,892.47 $0.04 $2,892.51 BEASLEY FOREST PRODUCTS INC $0.00 $0.00 $66,948.90 $4,572.78 $0.00 $4,572.78 BEAULIEU GROUP LLC $93,325.94 $93,330.89 $1,547,464.78 $105,695.81 $4.95 $105,700.76 BELLSOUTH ENTERPRISES INC $4,080.42 $4,080.64 $0.00 $0.00 $0.22 $0.22 BELLSOUTH TELECOMMUNICATIONS $166,770.04 $166,778.88 $1,598,208.19 $109,161.71 $8.84 $109,170.55 BENTON-GEORGIA INC $32,787.30 $32,789.04 $225,345.19 $15,391.65 $1.74 $15,393.39 BERRY COLLEGE $6,014.27 $6,014.59 $289,169.37 $19,751.01 $0.32 $19,751.33 BIBB COUNTY BD-COMMISSION $13,374.78 $13,375.49 $357,566.30 $24,422.69 $0.71 $24,423.40 BIBB COUNTY BOARD OF EDUCATION $34,041.15 $34,042.95 $678,523.15 $46,344.87 $1.80 $46,346.67 BIG LOTS STORES, INC. $15,676.10 $15,676.93 $286,490.23 $19,568.02 $0.83 $19,568.85 BJ'S WHOLESALE CLUB INC $10,211.91 $10,212.46 $336,941.36 $23,013.96 $0.55 $23,014.51 BLOSSMAN COMPANIES, INC $23,989.93 $23,991.20 $0.00 $0.00 $1.27 $1.27 BLUE BIRD BODY COMPANY $142,645.57 $142,653.13 $1,834,261.89 $125,284.78 $7.56 $125,292.34 BLUE CIRCLE AMERICA/LAFARGE $32,734.36 $32,736.09 $29,401.25 $2,008.18 $1.73 $2,009.91 BREMEN-BOWDEN INVESTMENT CO. $25,570.65 $25,572.00 $393,978.49 $26,909.74 $1.35 $26,911.09 BRIGGS & STRATTON CORP $14,598.90 $14,599.68 $307,106.05 $20,976.13 $0.78 $20,976.91 BROWN INDUSTRIES $10,152.07 $10,152.61 $82,453.14 $5,631.76 $0.54 $5,632.30 BRUNSWICK FAMILY BOAT CO. $598.08 $598.11 $9,403.71 $642.30 $0.03 $642.33 BRUNSWICK, CITY OF $31,835.91 $31,837.60 $451,314.85 $30,825.96 $1.69 $30,827.65 BURLEN CORPORATION $1,420.58 $1,420.66 $21,216.32 $1,449.13 $0.08 $1,449.21 C.W. MATTHEWS CONTRACTING INC $43,210.48 $43,212.76 $1,455,609.16 $99,421.83 $2.28 $99,424.11 CAMDEN COUNTY BOC $6,526.81 $6,527.15 $134,761.55 $9,204.56 $0.34 $9,204.90 CANDLER HEALTH SYSTEM $41,758.43 $41,760.64 $1,056,497.63 $72,161.49 $2.21 $72,163.70 CARROLL CO. BOARD OF EDUCATION $443.74 $443.77 $0.00 $0.00 $0.03 $0.03 SITF 2012 Annual Report – Page 56

2012 Assessment Due from Self-Insured Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Assessment Total Company Name Adjustment Amt Claims Paid Balance Due Amt Amt Assessment CASCADE CORPORATION $90.49 $90.50 $585.61 $40.00 $0.01 $40.01 CATHOLIC ARCHDIOCESES OF ATL $11,824.41 $11,825.03 $292,779.48 $19,997.59 $0.62 $19,998.21 CATOOSA CO. BD. OF EDUCATION $12,939.44 $12,940.12 $350,834.95 $23,962.93 $0.68 $23,963.61 CENTRAL GEORGIA HEALTH SYSTEMS $131,870.33 $131,877.32 $2,120,424.01 $144,830.39 $6.99 $144,837.38 CERTAINTEED CORPORATION $32,164.27 $32,165.98 $269,923.25 $18,436.45 $1.71 $18,438.16 CGLA LIQUIDATION, INC. $29,158.23 $29,159.78 $301,536.62 $20,595.72 $1.55 $20,597.27 CHATHAM COUNTY BD OF EDUCATION $45,728.66 $45,731.09 $719,022.00 $49,111.04 $2.43 $49,113.47 CHATHAM COUNTY GEORGIA $49,930.26 $49,932.90 $778,999.84 $53,207.68 $2.64 $53,210.32 CHEMICAL PRODUCTS CORP $4,845.36 $4,845.61 $59,780.91 $4,083.19 $0.25 $4,083.44 CHEROKEE BRICK & TILE $37,514.00 $37,515.99 $80,329.93 $5,486.74 $1.99 $5,488.73 CHEROKEE CO BD OF COMMISSIONER $106,842.71 $106,848.38 $996,994.39 $68,097.27 $5.67 $68,102.94 CHEROKEE CO BD OF EDUCATION $48,981.05 $48,983.64 $1,079,276.73 $73,717.36 $2.59 $73,719.95 CHEVRON USA INC SOU DIV $0.00 $0.00 $20,507.42 $1,400.71 $0.00 $1,400.71 CHILDREN'S HEALTHCARE OF ATL $79,516.25 $79,520.47 $1,687,851.43 $115,284.57 $4.22 $115,288.79 CITY OF CARTERSVILLE $2,267.88 $2,268.00 $47,515.51 $3,245.43 $0.12 $3,245.55 CLAYTON COUNTY BD OF EDUCATION $83,810.90 $83,815.34 $1,197,504.08 $81,792.59 $4.44 $81,797.03 CLAYTON COUNTY COMMISSIONERS $57,542.39 $57,545.44 $622,693.64 $42,531.57 $3.05 $42,534.62 CLAYTON COUNTY WATER AUTHORITY $23,796.44 $23,797.70 $54,984.00 $3,755.55 $1.26 $3,756.81 COACHMAN REC. VEHICLE CO OF GA $1,919.17 $1,919.27 $0.00 $0.00 $0.10 $0.10 COASTAL TRANSPORT INC $11,924.60 $11,925.23 $68,743.18 $4,695.34 $0.63 $4,695.97 COATS & CLARK, INC. $8,575.82 $8,576.28 $189,329.94 $12,931.72 $0.46 $12,932.18 COBB COUNTY BD/COMMISSIONERS $124,454.64 $114,380.56 $2,488,343.54 $169,960.23 ($10,074.08) $159,886.15 COBB COUNTY SCHOOL SYSTEM $200,632.43 $200,643.06 $2,633,261.94 $179,858.53 $10.63 $179,869.16 COCA-COLA COMPANY $94,448.15 $94,453.15 $1,825,120.74 $124,660.42 $5.00 $124,665.42 COCA-COLA REFRESHMENTS USA INC $103,356.28 $103,361.76 $1,053,366.07 $71,947.60 $5.48 $71,953.08 COLLEGE PARK CITY OF $18,494.51 $18,495.49 $378,277.88 $25,837.35 $0.98 $25,838.33 COLONIAL GROUP $27,674.61 $27,676.07 $77,833.77 $5,316.25 $1.46 $5,317.71 COLQUITT CO BD OF EDUCATION $21,377.24 $21,378.37 $253,824.95 $17,336.89 $1.13 $17,338.02 COLQUITT REGIONAL MEDICAL CENT $15,711.26 $15,712.10 $307,379.33 $20,994.80 $0.84 $20,995.64 COLUMBIA COUNTY BOE $37,278.87 $37,280.85 $522,226.42 $35,669.40 $1.98 $35,671.38 COLUMBUS REGIONAL HEALTHCARE $53,444.57 $53,447.40 $453,522.00 $30,976.71 $2.83 $30,979.54 COLUMBUS WATER WORKS $10,449.58 $10,450.14 $106,624.42 $7,282.72 $0.56 $7,283.28 CONAGRA FOODS, INC $0.00 $0.00 $59,815.60 $4,085.56 $0.00 $4,085.56 CONAGRA POULTRY CO $4,513.52 $4,513.76 $550,687.80 $37,613.39 $0.24 $37,613.63 CONTINENTAL GRAIN COMPANY $843.43 $843.47 $0.00 $0.00 $0.04 $0.04 CONTINENTAL TIRE N. AMER., INC $20,937.30 $20,938.41 $459,767.91 $31,403.33 $1.11 $31,404.44 COOPER INDUSTRIES, LLC $1,483.56 $1,483.64 $0.00 $0.00 $0.08 $0.08 COOPER TIRE AND RUBBER $16,810.65 $16,811.54 $448,608.39 $30,641.10 $0.89 $30,641.99 COSTCO WHOLESALE CORP. $59,599.11 $59,602.27 $767,395.47 $52,415.08 $3.16 $52,418.24 COTTRELL INC $8,651.19 $8,651.65 $89,621.11 $6,121.35 $0.46 $6,121.81 COVINGTON, CITY OF $4,458.23 $4,458.46 $100,546.17 $6,867.56 $0.23 $6,867.79 COWETA CO BOARD OF EDUCATION $51,838.12 $51,840.87 $535,276.17 $36,560.73 $2.75 $36,563.48 COWETA COUNTY BOC $0.00 $0.00 $110,027.79 $7,515.18 $0.00 $7,515.18 CRACKER BARREL OLD CNTRY STORE $34,885.61 $34,887.46 $863,102.23 $58,952.09 $1.85 $58,953.94 CRAWFORD & COMPANY $19,785.45 $19,786.50 $181,630.00 $12,405.79 $1.05 $12,406.84 CRIDER'S POULTRY INC $70,795.37 $70,799.13 $530,125.05 $36,208.90 $3.76 $36,212.66 CRISP COUNTY BD OF EDUCATION $920.08 $920.13 $0.00 $0.00 $0.05 $0.05 D L LEE & SONS INC $8,527.96 $8,528.41 $117,129.10 $8,000.22 $0.45 $8,000.67 DALTON CITY OF $49,515.87 $49,518.49 $306,891.69 $20,961.49 $2.62 $20,964.11 DART CONTAINER CORP OF CA $299.14 $299.15 $44,763.00 $3,057.43 $0.01 $3,057.44 DART CONTAINER CORP. OF GA $7,482.70 $7,483.09 $115,094.00 $7,861.21 $0.39 $7,861.60 DEAN FOODS COMPANY $7,711.60 $7,712.01 $320,773.91 $21,909.68 $0.41 $21,910.09 DECATUR, CITY OF $5,925.33 $5,925.64 $264,406.00 $18,059.61 $0.31 $18,059.92 DEKALB COUNTY BOARD-ED $292,232.24 $292,247.72 $4,294,358.24 $293,315.66 $15.48 $293,331.14 SITF 2012 Annual Report – Page 57

2012 Assessment Due from Self-Insured Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Assessment Total Company Name Adjustment Amt Claims Paid Balance Due Amt Amt Assessment DEKALB COUNTY GOVERNMENT $341,772.83 $341,790.94 $3,943,242.40 $269,333.55 $18.11 $269,351.66 DEKALB FARMERS MARKET $3,214.72 $3,214.89 $70,747.68 $4,832.25 $0.17 $4,832.42 DEKALB REGIONAL HLTHCARE SYS $84,742.99 $84,747.48 $820,495.56 $56,041.95 $4.49 $56,046.44 DELHAIZE AMERICA LLC. $135,318.38 $135,325.55 $2,242,724.74 $153,183.84 $7.17 $153,191.01 DELTA AIRLINES, INC. $783,779.04 $783,820.57 $11,524,584.87 $787,158.65 $41.53 $787,200.18 DOLLAR GENERAL CORP $243,283.88 $243,296.77 $4,392,470.36 $300,016.97 $12.89 $300,029.86 DOUGHERTY COUNTY BOC $2,415.36 $2,415.49 $96,142.34 $6,566.77 $0.13 $6,566.90 DOUGHERTY COUNTY SCHOOL SYSTEM $51,482.26 $51,484.99 $802,947.02 $54,843.34 $2.73 $54,846.07 DOUGLAS CO BD OF COMMISSIONERS $44,532.53 $44,534.89 $840,305.60 $57,395.02 $2.36 $57,397.38 DOUGLAS COUNTY SCHOOLS $69,021.22 $69,024.87 $1,177,412.30 $80,420.27 $3.65 $80,423.92 DOUGLAS, CITY OF $46,371.69 $46,374.14 $504,422.04 $34,453.32 $2.45 $34,455.77 DSM CHEMICALS N. AMERICA $10,329.48 $10,330.02 $113,578.53 $7,757.70 $0.54 $7,758.24 DULUTH, CITY OF $7,377.43 $7,377.82 $135,703.55 $9,268.90 $0.39 $9,269.29 E I DUPONT DE NEMOURS & CO $7,549.62 $7,550.02 $43,957.00 $3,002.38 $0.40 $3,002.78 EAST POINT, CITY OF $25,389.59 $25,390.93 $315,032.96 $21,517.56 $1.34 $21,518.90 EATON CORPORATION $3,768.81 $3,769.01 $40,154.87 $2,742.68 $0.20 $2,742.88 ELBERTA CRATE & BOX COMPANY $6,312.45 $6,312.78 $100,513.08 $6,865.30 $0.33 $6,865.63 ELBERTON GRANITE ASSOCIATION $119,374.24 $119,380.56 $1,169,705.42 $79,893.87 $6.32 $79,900.19 ELBERTON, CITY OF $1,152.77 $1,152.83 $25,122.40 $1,715.92 $0.06 $1,715.98 EMERSON ELECTRIC CO $4,453.49 $4,453.73 $59,038.00 $4,032.45 $0.24 $4,032.69 EMORY UNIVERSITY $139,052.79 $139,060.16 $1,090,740.52 $74,500.37 $7.37 $74,507.74 ENGINEERED FABRICS CORP. $22,886.32 $22,887.53 $253,179.82 $17,292.83 $1.21 $17,294.04 EQUITY GROUP GA DIVISION $20,228.90 $20,229.97 $440,351.01 $30,077.10 $1.07 $30,078.17 ESTES EXPRESS LINES $84,413.57 $84,418.05 $969,308.24 $66,206.23 $4.48 $66,210.71 EVANS GRADING CO., INC $2,192.41 $2,192.53 $119,481.58 $8,160.90 $0.12 $8,161.02 EXEL HOLDINGS, USA, INC $2,942.86 $2,943.02 $45,396.99 $3,100.73 $0.16 $3,100.89 FAMILY DOLLAR STORES OF GA $0.00 $0.00 $884,225.75 $60,394.88 $0.00 $60,394.88 FAYETTE COUNTY BD OF COMM $18,303.99 $18,304.96 $429,926.48 $29,365.08 $0.97 $29,366.05 FAYETTE COUNTY BD OF EDUCATION $20,844.12 $20,845.23 $478,191.89 $32,661.73 $1.11 $32,662.84 FEDERAL EXPRESS CORP $213,573.93 $213,585.25 $4,202,881.91 $287,067.59 $11.32 $287,078.91 FEDEX FREIGHT, INC $78,667.99 $78,672.16 $1,177,809.70 $80,447.42 $4.17 $80,451.59 FEDEX GROUND PKG SYS $37,809.71 $37,811.71 $878,943.97 $60,034.12 $2.00 $60,036.12 FIELDALE FARMS CORPORATION $162,038.50 $162,047.09 $1,956,468.65 $133,631.82 $8.59 $133,640.41 FLEXSTEEL INDUSTRIES INC $2,591.47 $2,591.61 $76,118.59 $5,199.09 $0.14 $5,199.23 FLORIDA ROCK & TANK LINES INC $6,805.89 $6,806.26 $49,446.00 $3,377.29 $0.37 $3,377.66 FLORIDA ROCK INDUSTRIES INC $427.88 $427.91 $2,952.59 $201.67 $0.03 $201.70 FLOWERS FOODS INC. $95,873.33 $95,878.41 $1,767,288.15 $120,710.30 $5.08 $120,715.38 FLOYD CO. BD. OF COMMISSIONERS $20,557.46 $20,558.55 $510,850.64 $34,892.41 $1.09 $34,893.50 FLOYD COUNTY BD OF EDUCATION $28,956.93 $28,958.46 $168,537.33 $11,511.53 $1.53 $11,513.06 FLOYD HLTHCARE MGMT INC $40,854.16 $40,856.32 $831,718.04 $56,808.47 $2.16 $56,810.63 FLYING J, INC. $18,288.32 $18,289.29 $156,607.95 $10,696.72 $0.97 $10,697.69 FORD MOTOR COMPANY $50,132.83 $50,135.49 $427,798.03 $29,219.70 $2.66 $29,222.36 FOREST PARK, CITY OF $7,841.39 $7,841.81 $136,514.57 $9,324.29 $0.42 $9,324.71 FORSYTH CO. BD. OF EDUCATION $49,304.09 $49,306.70 $625,772.76 $42,741.88 $2.61 $42,744.49 FRANKLIN ALUMINUM CO INC $9,276.98 $9,277.47 $11,021.39 $752.79 $0.49 $753.28 FREUDENBERG NORTH AMERICA L.P. $6,826.23 $6,826.59 $279,041.00 $19,059.21 $0.36 $19,059.57 FULTON COUNTY BD OF EDUCATION $260,292.10 $260,305.90 $4,470,252.89 $305,329.72 $13.80 $305,343.52 FULTON COUNTY, GEORGIA $83,912.96 $83,917.41 $2,766,438.60 $188,954.84 $4.45 $188,959.29 FULTON-DEKALB HOSPITAL AUTHY $117,289.72 $117,295.93 $1,612,650.09 $110,148.13 $6.21 $110,154.34 GANNETT CO. INC & SUBSIDIARIES $1,457.89 $1,457.96 $88,259.00 $6,028.32 $0.07 $6,028.39 GEORGIA CRATE & BASKET CO $1,975.18 $1,975.28 $7,430.28 $507.51 $0.10 $507.61 GEORGIA DUCK & CORDAGE MILL $0.00 $0.00 $26,051.25 $1,779.37 $0.00 $1,779.37 GEORGIA STATE OF $4,714,503.62 $4,714,753.43 $73,298,798.03 $5,006,495.55 $249.81 $5,006,745.36 GEORGIA-PACIFIC CORPORATION $120,248.58 $120,254.95 $1,148,425.39 $78,440.39 $6.37 $78,446.76 SITF 2012 Annual Report – Page 58

2012 Assessment Due from Self-Insured Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Assessment Total Company Name Adjustment Amt Claims Paid Balance Due Amt Amt Assessment GFF HOLDING CO/GENERAL FIBERS $919.97 $920.02 $0.00 $0.00 $0.05 $0.05 GIW INDUSTRIES INC $26,235.67 $26,237.06 $212,895.74 $14,541.32 $1.39 $14,542.71 GLYNN COUNTY BOARD OF COMMSNRS $98,172.35 $98,177.56 $970,365.46 $66,278.45 $5.21 $66,283.66 GLYNN COUNTY SCHOOLS $55,635.26 $55,638.21 $550,082.02 $37,572.01 $2.95 $37,574.96 GOLDEN PANTRY FOOD STORES INC $2,743.81 $2,743.95 $95,509.47 $6,523.54 $0.14 $6,523.68 GOODY PRODUCTS, INC. $7,608.76 $7,609.17 $12,326.00 $841.90 $0.41 $842.31 GREAT ATLANTIC & PACIFIC TEA $13,634.28 $13,635.00 $0.00 $0.00 $0.72 $0.72 GREAT DANE LTD PARTNERSHIP $22,454.64 $22,455.83 $328,038.74 $22,405.89 $1.19 $22,407.08 GRIFFIN-SPALDING SCHOOLS $13,550.89 $13,551.61 $211,317.46 $14,433.52 $0.72 $14,434.24 GUARDIAN AUTOMOTIVE CORP $2,587.55 $2,587.69 $219,626.00 $15,001.02 $0.14 $15,001.16 GULFSTREAM AEROSPACE CORP $60,262.11 $60,265.30 $996,537.52 $68,066.06 $3.19 $68,069.25 GWINNETT CO BD OF EDUCATION $355,765.03 $355,783.88 $5,168,440.03 $353,017.69 $18.85 $353,036.54 GWINNETT COUNTY BD OF COMMISS $150,973.47 $150,981.47 $2,515,411.03 $171,809.01 $8.00 $171,817.01 GWINNETT HOSPITAL SYSTEM $142,798.64 $142,806.21 $2,228,764.70 $152,230.33 $7.57 $152,237.90 HALL COUNTY BOARD OF EDUCATION $44,901.38 $44,903.76 $376,870.83 $25,741.24 $2.38 $25,743.62 HAMILTON HEALTH CARE SYSTEM $34,077.69 $34,079.49 $709,736.06 $48,476.79 $1.80 $48,478.59 HANSON AGGREGATES $0.00 $0.00 $49,739.12 $3,397.31 $0.00 $3,397.31 HAPEVILLE CITY OF $3,707.11 $3,707.31 $17,700.51 $1,208.99 $0.20 $1,209.19 HARRISON POULTRY, INC $24,082.98 $24,084.26 $541,931.48 $37,015.31 $1.28 $37,016.59 HEARTLAND EXPRESS $29,015.40 $29,016.94 $526,233.60 $35,943.10 $1.54 $35,944.64 HENRY CO BOARD OF EDUCATION $90,801.48 $90,806.29 $1,456,114.23 $99,456.33 $4.81 $99,461.14 HERSCHEND FAMILY ENTERTAINMENT $12,002.09 $12,002.72 $139,640.53 $9,537.81 $0.63 $9,538.44 HILLCREST FOODS, INC $3,552.95 $3,553.14 $99,397.99 $6,789.14 $0.19 $6,789.33 HILTON WORLDWIDE, INC $1,701.39 $1,701.48 $620.00 $42.35 $0.09 $42.44 HOME DEPOT INC (THE) $4,597.82 $4,598.06 $1,018,122.48 $69,540.37 $0.24 $69,540.61 HON INDUSTRIES, INC. $25,261.74 $25,263.07 $468,309.73 $31,986.75 $1.33 $31,988.08 HORMEL FOODS CORP $35,037.22 $35,039.08 $1,396,030.06 $95,352.43 $1.86 $95,354.29 HORTON HOMES, INC $14,994.39 $14,995.19 $186,401.00 $12,731.67 $0.80 $12,732.47 HOUSTON COUNTY BD OF EDUCATION $75,935.04 $75,939.07 $729,712.62 $49,841.24 $4.03 $49,845.27 HOUSTON COUNTY COMMISSIONERS $28,734.62 $28,736.14 $155,152.91 $10,597.34 $1.52 $10,598.86 HOUSTON HEALTHCARE $57,448.36 $57,451.41 $713,058.80 $48,703.74 $3.05 $48,706.79 HOWARD SHEPPARD INC $18,594.23 $18,595.22 $537,924.68 $36,741.63 $0.99 $36,742.62 HUTCHESON MEDICAL CENTER $30,891.78 $30,893.41 $511,050.80 $34,906.08 $1.63 $34,907.71 HYATT CORPORATION $23,481.22 $23,482.46 $265,375.49 $18,125.83 $1.24 $18,127.07 IDA CASON CALLAWAY FOUNDATION $8,021.44 $8,021.86 $91,719.38 $6,264.67 $0.42 $6,265.09 INGLES MARKETS INC $253,297.74 $253,311.16 $3,510,271.00 $239,760.50 $13.42 $239,773.92 INTERFACE, INC $21,209.81 $21,210.94 $478,469.99 $32,680.73 $1.13 $32,681.86 INTERNATIONAL PAPER COMPANY $29,449.89 $29,451.45 $985,058.00 $67,281.98 $1.56 $67,283.54 INTERSTATE PAPER LLC $4,254.80 $4,255.02 $115,423.90 $7,883.75 $0.22 $7,883.97 J & J INDUSTRIES INC $20,336.53 $20,337.61 $627,899.54 $42,887.15 $1.08 $42,888.23 J. C. PENNEY COMPANY, INC. $13,704.07 $13,704.80 $373,228.00 $25,492.43 $0.73 $25,493.16 JESUP CITY OF $13,964.44 $13,965.18 $153,632.90 $10,493.52 $0.74 $10,494.26 JOHN WIELAND HOMES, INC $39,287.25 $39,289.33 $534,094.75 $36,480.04 $2.08 $36,482.12 JOHNS MANVILLE INT'L., INC. $10,239.73 $10,240.27 $105,985.79 $7,239.10 $0.54 $7,239.64 JONES COMPANY (THE) $124,808.49 $124,815.10 $780,711.82 $53,324.62 $6.61 $53,331.23 KELLEY MANUFACTURING COMPANY $3,370.01 $3,370.19 $95,014.91 $6,489.76 $0.18 $6,489.94 KELLOGG CO & SUBSIDIARIES $33,167.62 $33,169.37 $1,093,287.37 $74,674.33 $1.75 $74,676.08 KIMBERLY-CLARK CORP $2,167.97 $2,168.09 $46,876.98 $3,201.82 $0.12 $3,201.94 KING & PRINCE SEAFOOD CORP. $1,466.27 $1,466.35 $28,621.72 $1,954.94 $0.08 $1,955.02 KLEEN-TEX INDUSTRIES $285.46 $285.48 $12,680.54 $866.11 $0.02 $866.13 KLLM TRANSPORT SERVICES LLC $15,244.96 $15,245.77 $345,404.70 $23,592.03 $0.81 $23,592.84 K-MART CORP $28,759.88 $28,761.41 $426,701.54 $29,144.81 $1.53 $29,146.34 KNIGHT TRANSPORTATION $8,025.66 $8,026.08 $158,081.48 $10,797.37 $0.42 $10,797.79 KROGER COMPANY, THE $503,947.76 $503,974.46 $6,974,805.67 $476,397.08 $26.70 $476,423.78 SITF 2012 Annual Report – Page 59

2012 Assessment Due from Self-Insured Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Assessment Total Company Name Adjustment Amt Claims Paid Balance Due Amt Amt Assessment LAGRANGE, CITY OF $5,039.13 $5,039.39 $90,408.78 $6,175.15 $0.26 $6,175.41 LANGDALE INDUSTRIES $37,933.96 $37,935.97 $680,543.78 $46,482.88 $2.01 $46,484.89 LAWRENCEVILLE, CITY OF $5,789.24 $5,789.55 $114,629.21 $7,829.47 $0.31 $7,829.78 LEGACY VULCAN $9,189.93 $9,190.42 $761,188.14 $51,991.10 $0.49 $51,991.59 LEVI STRAUSS & CO $9,266.00 $9,266.49 $87,622.50 $5,984.84 $0.49 $5,985.33 LIBERTY NATIONAL LIFE INS CO $725.43 $725.47 $9,579.28 $654.29 $0.04 $654.33 LIMITED BRANDS, INC $86.16 $86.17 $711.31 $48.58 $0.01 $48.59 LOUISIANA-PACIFIC CORP $6,705.31 $6,705.66 $80,739.57 $5,514.72 $0.35 $5,515.07 LOW TEMP INDUSTRIES $11,934.34 $11,934.98 $202,336.02 $13,820.07 $0.64 $13,820.71 LOWE'S HOME CENTERS, INC $448,062.67 $448,086.41 $5,633,291.85 $384,768.25 $23.74 $384,791.99 MACON CITY OF $86,407.37 $86,411.95 $2,160,792.48 $147,587.66 $4.58 $147,592.24 MACON/BIBB CO WATER & SEWERAGE $10,287.05 $10,287.60 $204,655.85 $13,978.52 $0.55 $13,979.07 MACY'S $75,631.00 $75,635.01 $2,392,791.00 $163,433.75 $4.01 $163,437.76 MAPLEHURST DELI-BAKE STH $4,588.43 $4,588.67 $0.00 $0.00 $0.24 $0.24 MARIETTA CITY SERVICES $38,577.93 $38,579.97 $473,848.71 $32,365.08 $2.04 $32,367.12 MAR-JAC POULTRY, INC. $97,650.04 $97,655.21 $1,180,345.90 $80,620.65 $5.17 $80,625.82 MARKETPLACE HOLDINGS, INC $2,486.53 $2,486.66 $20,908.12 $1,428.08 $0.13 $1,428.21 MARRIOTT INTERNATIONAL, INC. $135,079.35 $135,086.51 $1,938,651.80 $132,414.88 $7.16 $132,422.04 MARTA $476,499.63 $476,524.88 $8,567,683.05 $585,194.69 $25.25 $585,219.94 MASTEC NORTH AMERICA INC $14,076.76 $14,077.50 $428,161.04 $29,244.50 $0.74 $29,245.24 MAYO CLINIC HLTH SYS IN WAYCRO $54,896.40 $54,899.31 $1,226,202.40 $83,752.76 $2.91 $83,755.67 MCG HEALTH INC $12,279.98 $12,280.63 $68,768.99 $4,697.10 $0.65 $4,697.75 MCLANE COMPANY, INC. $4,379.04 $4,379.27 $98,025.84 $6,695.42 $0.23 $6,695.65 M-D BUILDING PRODUCTS $1,232.69 $1,232.76 $0.00 $0.00 $0.07 $0.07 MEADOWS REGIONAL MEDICAL CTR $7,780.69 $7,781.11 $111,322.52 $7,603.61 $0.42 $7,604.03 MEADWESTVACO $6,938.97 $6,939.33 $24,782.17 $1,692.69 $0.36 $1,693.05 MEMORIAL MEDICAL CENTER $32,599.07 $32,600.80 $179,265.08 $12,244.26 $1.73 $12,245.99 MERCER UNIV. (THE CORP OF) $6,289.92 $6,290.25 $122,289.39 $8,352.68 $0.33 $8,353.01 MERCK SHARP & DOHME CORP $836.11 $836.15 $66,075.98 $4,513.16 $0.04 $4,513.20 METALPLATE GALVANIZING L P $157.10 $157.11 $6,741.00 $460.43 $0.01 $460.44 MICROMERITICS INSTRUMENTS CORP $1,062.39 $1,062.45 $18,407.94 $1,257.31 $0.06 $1,257.37 MILLEDGEVILLE, CITY OF $37,983.08 $37,985.09 $436,366.67 $29,804.96 $2.01 $29,806.97 MILTON J. WOOD COMPANY $810.28 $810.33 $710.20 $48.51 $0.05 $48.56 MOHAWK INDUSTRIES, INC $139,838.32 $139,845.73 $0.00 $0.00 $7.41 $7.41 MONROE, CITY OF $11,900.03 $11,900.67 $68,461.11 $4,676.07 $0.64 $4,676.71 MOUNT VERNON MILLS $52,236.87 $52,239.63 $838,522.44 $57,273.23 $2.76 $57,275.99 MURRAY COUNTY BD OF EDUCATION $5,772.16 $5,772.47 $533.27 $36.42 $0.31 $36.73 MUSCOGEE COUNTY SCHOOL DIST $41,981.23 $41,983.45 $625,014.57 $42,690.10 $2.22 $42,692.32 NASH JOHNSON & SONS' FARMS INC $0.00 $0.00 $59,202.00 $4,043.65 $0.00 $4,043.65 NEWTON COUNTY BD OF EDUCATION $44,056.39 $44,058.72 $733,336.48 $50,088.76 $2.33 $50,091.09 NORDSON CORPORATION $12,676.22 $12,676.89 $511,233.00 $34,918.52 $0.67 $34,919.19 NORDSTROM, INC. $22,086.18 $22,087.35 $265,568.00 $18,138.97 $1.17 $18,140.14 NORMAN W FRIES/CLAXTON POULTRY $48,467.51 $48,470.08 $844,389.70 $57,673.98 $2.57 $57,676.55 NORTHEAST GEORGIA HEALTH SYS $52,990.92 $52,993.73 $394,995.71 $26,979.22 $2.81 $26,982.03 NORTHSIDE HOSPITAL $183,929.65 $183,939.39 $0.00 $0.00 $9.74 $9.74 OLD DOMINION FREIGHT LINES INC $67,511.74 $67,515.32 $354,945.44 $24,243.68 $3.58 $24,247.26 OWENS-CORNING $24,731.36 $24,732.67 $180,944.73 $12,358.99 $1.31 $12,360.30 OWENS-ILLINOIS INC $21,976.52 $21,977.68 $299,589.05 $20,462.70 $1.16 $20,463.86 OXFORD CONSTRUCTION CO $13,404.35 $13,405.06 $371,178.62 $25,352.45 $0.71 $25,353.16 PARKER HANNIFIN CORP. $12,808.45 $12,809.13 $312,686.20 $21,357.27 $0.68 $21,357.95 PATTERSON PUMP COMPANY $4,881.45 $4,881.71 $115,777.73 $7,907.92 $0.26 $7,908.18 PCC AIRFOILS LLC $7,554.23 $7,554.63 $43,126.70 $2,945.66 $0.40 $2,946.06 PHOEBE PUTNEY MEMORIAL HOSP $6,785.05 $6,785.41 $641,019.08 $43,783.24 $0.36 $43,783.60 PIEDMONT HOSPITAL $78,705.50 $78,709.67 $1,123,478.33 $76,736.45 $4.17 $76,740.62 SITF 2012 Annual Report – Page 60

2012 Assessment Due from Self-Insured Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Assessment Total Company Name Adjustment Amt Claims Paid Balance Due Amt Amt Assessment PIEDMONT LABORATORIES, INC. $895.90 $895.95 $14,917.45 $1,018.90 $0.05 $1,018.95 PIGGLY WIGGLY CAROLINA CO INC $8,389.99 $8,390.44 $336,623.00 $22,992.21 $0.45 $22,992.66 PIKE ELECTRIC, LLC. $84.96 $84.96 $1,881.43 $128.51 $0.00 $128.51 PILOT TRAVEL CENTERS $14,520.75 $14,521.52 $192,382.04 $13,140.19 $0.77 $13,140.96 PPG INDUSTRIES INC. $14,194.09 $14,194.84 $222,610.00 $15,204.83 $0.75 $15,205.58 PRESBYTERIAN HOMES OF GA $998.25 $998.30 $85,211.40 $5,820.16 $0.05 $5,820.21 PRINTPACK, INC $6,936.93 $6,937.30 $129,049.32 $8,814.40 $0.37 $8,814.77 PROCTER & GAMBLE COMPANY $48,910.89 $48,913.48 $698,705.58 $47,723.38 $2.59 $47,725.97 QUIKTRIP CORPORATION $30,183.91 $30,185.50 $689,030.42 $47,062.54 $1.59 $47,064.13 RACETRAC PETROLEUM, INC $28,549.27 $28,550.78 $403,641.00 $27,569.71 $1.51 $27,571.22 RANDOLPH COUNTY HOSP AUTHORITY $3,235.67 $3,235.85 $107,825.89 $7,364.78 $0.18 $7,364.96 RAYONIER INC $32,281.13 $32,282.84 $466,800.56 $31,883.67 $1.71 $31,885.38 RECONSERVE OF GEORGIA INC $3,912.40 $3,912.61 $5,162.24 $352.59 $0.21 $352.80 REGIONS FINANCIAL CORP $8,870.56 $8,871.03 $174,249.05 $11,901.66 $0.47 $11,902.13 RHODES NURSING HOME $9,306.01 $9,306.50 $13,530.47 $924.17 $0.49 $924.66 RICHMOND CTY BD OF EDUCATION $109,656.21 $109,662.02 $1,352,592.00 $92,385.50 $5.81 $92,391.31 RIVERDALE, CITY OF $8,740.99 $8,741.46 $43,096.00 $2,943.57 $0.47 $2,944.04 ROCKDALE CO. BD OF EDUCATION $43,007.89 $43,010.17 $457,946.55 $31,278.92 $2.28 $31,281.20 ROCKTENN CP, LLC $9,316.99 $9,317.48 $8,213.58 $561.01 $0.49 $561.50 ROCKWELL AUTOMATION, INC $6,446.14 $6,446.48 $154.00 $10.52 $0.34 $10.86 ROCOH USA, INC. $54,670.37 $54,673.26 $714,428.84 $48,797.32 $2.89 $48,800.21 ROLLINS INC $14,696.76 $14,697.54 $408,213.80 $27,882.05 $0.78 $27,882.83 ROME, CITY OF $1,624.82 $1,624.91 $308,621.57 $21,079.64 $0.09 $21,079.73 ROOKER ADMINISTRATIVE SERVICES $7,779.13 $7,779.54 $818.24 $55.89 $0.41 $56.30 ROPER CORPORATION $17,599.73 $17,600.66 $218,848.70 $14,947.93 $0.93 $14,948.86 ROSEBURG FOREST PRODUCTS $8,613.79 $8,614.25 $146,959.32 $10,037.70 $0.46 $10,038.16 ROSWELL CITY OF $8,774.86 $8,775.33 $404,300.00 $27,614.73 $0.47 $27,615.20 RTM, LLC $9,340.99 $9,341.49 $223,181.50 $15,243.87 $0.50 $15,244.37 RUBY TUESDAY INC $4,752.28 $4,752.53 $111,486.00 $7,614.78 $0.25 $7,615.03 RUSSELL BRANDS, LLC $3,709.61 $3,709.81 $6,083.05 $415.49 $0.20 $415.69 RYAN'S FAMILY STEAK HOUSES $106.22 $106.22 $42,062.00 $2,872.94 $0.00 $2,872.94 RYDER SYSTEM INC $28,499.18 $28,500.69 $572,630.04 $39,112.10 $1.51 $39,113.61 SAIA MOTOR FREIGHT LINE LLC $11,730.28 $11,730.90 $338,474.10 $23,118.65 $0.62 $23,119.27 SAINT JOSEPH'S OF SAVANNAH $37,466.16 $37,468.15 $556,502.56 $38,010.55 $1.99 $38,012.54 SAINT MARY'S HEALTH CARE $0.00 $0.00 $11,567.92 $790.12 $0.00 $790.12 SAVANNAH CITY OF $257,190.56 $257,204.19 $4,117,355.88 $281,225.95 $13.63 $281,239.58 SCIENTIFIC-ATLANTA INC $850.16 $850.21 $5,860.92 $400.32 $0.05 $400.37 SEVEN-UP SNAPPLE SOUTHEAST $158.75 $158.76 $173.34 $11.84 $0.01 $11.85 SHAW INDUSTRIES INC $386,370.51 $386,390.98 $3,985,147.98 $272,195.81 $20.47 $272,216.28 SHEPHERD CONSTRUCTION $17,585.73 $17,586.67 $568,585.87 $38,835.87 $0.94 $38,836.81 SHEPHERD MEDICAL CENTER $13,864.31 $13,865.04 $462,731.24 $31,605.73 $0.73 $31,606.46 SHERWIN-WILLIAMS COMPANY $54,885.73 $54,888.63 $942,072.77 $64,345.98 $2.90 $64,348.88 SHONEY'S LLC $0.00 $0.00 $38,754.00 $2,647.00 $0.00 $2,647.00 SIMMONS FOODS, INC $1,047.42 $1,047.48 $8,201.70 $560.20 $0.06 $560.26 SIMPSON LUMBER CO LLC $4,625.83 $4,626.07 $43,423.66 $2,965.95 $0.24 $2,966.19 SIZEMORE ,INC. $4,344.92 $4,345.15 $193,076.03 $13,187.59 $0.23 $13,187.82 SKF USA INC $532.07 $532.10 $3,448.33 $235.53 $0.03 $235.56 SNELL CONTRACTORS $10,665.82 $10,666.39 $433,055.36 $29,578.79 $0.57 $29,579.36 SOUTH GEORGIA MEDICAL CENTER $0.00 $0.00 $755,833.17 $51,625.34 $0.00 $51,625.34 SOUTHEAST GA HLTH SYSTEM $99,842.99 $99,848.28 $954,179.72 $65,172.92 $5.29 $65,178.21 SOUTHEASTERN FREIGHT LINES $44,107.56 $44,109.90 $889,758.07 $60,772.75 $2.34 $60,775.09 SOUTHERN COMPANY $428,441.71 $428,464.41 $5,033,179.05 $343,779.01 $22.70 $343,801.71 SOUTHERN MILLS INC $11,887.92 $11,888.55 $301,027.09 $20,560.92 $0.63 $20,561.55 SOUTHERN PAN SERVICES $9,347.63 $9,348.12 $0.00 $0.00 $0.49 $0.49 SITF 2012 Annual Report – Page 61

2012 Assessment Due from Self-Insured Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Assessment Total Company Name Adjustment Amt Claims Paid Balance Due Amt Amt Assessment SOUTHERN REGIONAL HEALTH SYS. $26,356.63 $26,358.03 $284,233.62 $19,413.88 $1.40 $19,415.28 SOUTHWIRE COMPANY $83,818.88 $83,823.32 $1,255,628.98 $85,762.67 $4.44 $85,767.11 SPALDING CO BOARD OF COMM $29,775.93 $29,777.51 $42,155.00 $2,879.29 $1.58 $2,880.87 SPARTA CITY OF $915.71 $915.76 $21,911.72 $1,496.63 $0.05 $1,496.68 SPRINGS INDUSTRIES INC $2,087.15 $2,087.26 $28,427.00 $1,941.64 $0.11 $1,941.75 ST FRANCIS HOSPITAL $14,538.90 $14,539.67 $350,542.00 $23,942.92 $0.77 $23,943.69 ST JOSEPH HOSPITAL/AUGUSTA $335.76 $335.78 $0.00 $0.00 $0.02 $0.02 STANLEY BLACK & DECKER, INC. $517.41 $517.44 $3,884.02 $265.29 $0.03 $265.32 STANLEY WORKS & SUBSIDIARIES $0.00 $0.00 $947.30 $64.70 $0.00 $64.70 SUPERIOR RIGGING & ERECTING CO $718.17 $718.21 $141,115.77 $9,638.57 $0.04 $9,638.61 SUTHERLAND'S FOODSERVICE, INC. $1,681.84 $1,681.93 $23,400.00 $1,598.28 $0.09 $1,598.37 SWIFT TRANSPORTATION COMPANY $0.00 $0.00 $21,640.05 $1,478.07 $0.00 $1,478.07 T. M. POLYFILM, INC $7,549.90 $7,550.30 $68,113.62 $4,652.33 $0.40 $4,652.73 TALON EQUITIES, INC $6,006.65 $6,006.96 $42,163.29 $2,879.86 $0.31 $2,880.17 TANNER HEALTH SERVICES $17,471.12 $17,472.05 $252,599.44 $17,253.19 $0.93 $17,254.12 TARGET CORPORATION $265,067.24 $265,081.28 $2,887,870.79 $197,248.97 $14.04 $197,263.01 TECUMSEH PRODUCTS COMPANY $3,290.35 $3,290.52 $112,978.35 $7,716.71 $0.17 $7,716.88 TENNECO AUTOMOTIVE, INC $134.86 $134.87 $9,399.39 $642.00 $0.01 $642.01 TERMINIX SERVICE, INC $3,495.36 $3,495.55 $30,751.23 $2,100.39 $0.19 $2,100.58 TEXTILE RUBBER & CHEMICAL $12,487.78 $12,488.45 $0.00 $0.00 $0.67 $0.67 TEXTRON, INC $13,744.58 $13,745.31 $192,143.19 $13,123.87 $0.73 $13,124.60 THE DIXIE GROUP, INC. $57,584.88 $57,587.93 $128,046.26 $8,745.89 $3.05 $8,748.94 THERMAL CERAMICS $47,721.82 $47,724.35 $234,642.81 $16,026.70 $2.53 $16,029.23 THOMASVILLE CITY OF $16,919.02 $16,919.92 $468,215.33 $31,980.31 $0.90 $31,981.21 THREE SPRINGS INC. $338.25 $338.27 $6,782.98 $463.29 $0.02 $463.31 TIP TOP POULTRY INC $53,352.37 $53,355.20 $888,205.61 $60,666.72 $2.83 $60,669.55 TRC STAFFING SERVICES, INC $6,989.83 $6,990.20 $753,252.11 $51,449.05 $0.37 $51,449.42 TRONOX PIGMENTS (SAV) INC. $2,331.54 $2,331.66 $20,682.51 $1,412.67 $0.12 $1,412.79 TROUP CO. BOARD OF EDUCATION $19,981.39 $19,982.45 $283,594.32 $19,370.22 $1.06 $19,371.28 TRUEBLUE, INC. $65,973.82 $65,977.32 $530,871.78 $36,259.90 $3.50 $36,263.40 TYSON FOODS INC $154,996.98 $155,005.19 $2,150,387.21 $146,876.95 $8.21 $146,885.16 UNILEVER UNITED STATES $952.36 $952.41 $30,658.62 $2,094.06 $0.05 $2,094.11 UNITED AIRLINES $8,928.54 $8,929.01 $999,165.79 $68,245.58 $0.47 $68,246.05 UNIVERSITY HOSPITAL $47,195.74 $47,198.24 $266,986.36 $18,235.85 $2.50 $18,238.35 USF HOLLAND, INC. $31,470.42 $31,472.09 $435,104.04 $29,718.72 $1.67 $29,720.39 VALDOSTA CITY OF $28,827.73 $28,829.25 $395,939.98 $27,043.71 $1.52 $27,045.23 VARIETY WHOLESALERS $21,414.21 $21,415.34 $533,214.72 $36,419.93 $1.13 $36,421.06 VISITING NURSE HEALTH SYSTEM $29,244.39 $29,245.94 $271,189.64 $18,522.95 $1.55 $18,524.50 WACHOVIA (nka WELLS FARGO $556.52 $556.54 $23,354.43 $1,595.17 $0.02 $1,595.19 WAFFLE HOUSE $115,021.27 $115,027.37 $1,169,114.79 $79,853.53 $6.10 $79,859.63 WAGGONERS TRUCKING CO., THE $28,424.30 $28,425.80 $255,706.48 $17,465.41 $1.50 $17,466.91 WAL MART ASSOCIATES INC $374,604.19 $374,624.03 $10,136,051.57 $692,318.27 $19.84 $692,338.11 WALKER COUNTY BD OF EDUCATION $11,098.15 $11,098.73 $330,980.65 $22,606.83 $0.58 $22,607.41 WALTON CO BOARD OF ED $14,162.43 $14,163.18 $127,219.44 $8,689.41 $0.75 $8,690.16 WAREHOUSE HOME FURNISHINGS $50,533.41 $50,536.09 $768,050.17 $52,459.79 $2.68 $52,462.47 WARNER ROBINS CITY OF $0.00 $0.00 $599,015.11 $40,914.27 $0.00 $40,914.27 WATKINS ASSOCIATED INDUSTRIES $4,511.06 $4,511.30 $16,225.70 $1,108.26 $0.24 $1,108.50 WAYCROSS MOLDED PRODUCTS INC $3,580.69 $3,580.88 $350.00 $23.91 $0.19 $24.10 WAYCROSS, CITY OF $19,019.35 $19,020.36 $0.00 $0.00 $1.01 $1.01 WAYNE FARMS LLC $21,334.06 $21,335.19 $174,235.12 $11,900.70 $1.13 $11,901.83 WELLSTAR HEALTH SYSTEM $142,199.67 $142,207.20 $929,336.77 $63,476.08 $7.53 $63,483.61 WENDY'S INTERNATIONAL INC $6,495.33 $6,495.67 $94,207.36 $6,434.60 $0.34 $6,434.94 WEST GEORGIA HEALTH SYSTEM $12,045.56 $12,046.19 $195,352.16 $13,343.05 $0.63 $13,343.68 WEYERHAEUSER COMPANY $20,922.37 $20,923.48 $557,299.52 $38,064.98 $1.11 $38,066.09 SITF 2012 Annual Report – Page 62

2012 Assessment Due from Self-Insured Companies 2011 2011 2012 2012 2011 2011 And 2012 Assessment Assessment Assessment Total Company Name Adjustment Amt Claims Paid Balance Due Amt Amt Assessment WHITFIELD COUNTY BOE $33,162.36 $33,164.12 $413,382.27 $28,235.07 $1.76 $28,236.83 WINN-DIXIE STORES INC $143,625.35 $143,632.96 $2,054,731.48 $140,343.42 $7.61 $140,351.03 YELLOW TRANSPORTATION $51,762.70 $51,765.44 $0.00 $0.00 $2.74 $2.74 YKK CORPORATION OF AMERICA $10,587.19 $10,587.75 $246,710.71 $16,850.97 $0.56 $16,851.53 Grand Total: $22,038,326.59 $22,029,413.69 $329,647,084.38 $22,515,739.87 ($8,912.90) $22,506,826.97

SITF 2012 Annual Report – Page 63

Assessments Due from Group Self-Insurers

2012 Assessment Due from Group Self-Insured Companies 2011 2011 Assessment 2012 2012 2011 2011 And 2012

Company Name Assessment Amt Adjustment Amt Claims Paid Assessment Amt Balance Due Total Assessment AGRITRUST OF GEORGIA $293,223.74 $293,239.28 $5,420,110.69 $370,207.44 $15.54 $370,222.98 ASSOCIATION CTY COM GA SI $1,792,475.05 $1,792,570.03 $25,231,426.95 $1,723,371.05 $94.98 $1,723,466.03 CONSTRUCTION SUPPLIERS' ASSOC $58,346.47 $58,349.56 $708,016.05 $48,359.31 $3.09 $48,362.40 GA AUTO DEALERS ASSOCIATION SI $574,152.31 $574,182.73 $9,870,804.19 $674,201.20 $30.42 $674,231.62 GA EDUCATION WC TRUST FUND $551,899.84 $551,929.08 $6,661,364.00 $454,988.21 $29.24 $455,017.45 GA HOSPITAL ASSOC WCSI FUND $298,839.30 $298,855.13 $3,451,454.00 $235,743.14 $15.83 $235,758.97 GA MUNICIPAL ASSN WCSIF $1,128,034.03 $1,128,093.80 $14,809,727.23 $1,011,542.28 $59.77 $1,011,602.05 GA NURSING HOME SELECTIVE WC $89,007.35 $89,012.07 $1,502,586.80 $102,630.53 $4.72 $102,635.25 GA OILMEN'S ASSOCIATION $190,025.28 $190,035.35 $2,028,414.20 $138,545.88 $10.07 $138,555.95 GA OPERATORS SELF-INSURERS $175,840.08 $175,849.40 $2,177,931.85 $148,758.32 $9.32 $148,767.64 GA RETAIL MERCHANTS' WCT $4,678.35 $4,678.59 $0.00 $0.24 $0.24

GA SCHOOL BD ASSOC W C FUND $462,112.86 $462,137.35 $5,984,299.05 $408,742.94 $24.49 $408,767.43 GEMC WORKERS' COMP FUND $291,781.81 $291,797.27 $4,041,002.32 $276,010.80 $15.46 $276,026.26 Grand Total: $5,910,416.47 $5,910,729.64 $81,887,137.33 $5,593,101.10 $313.17 $5,593,414.27