STATE OF NEVADA DEPARTMENT OF BUSINESS AND INDUSTRY DIVISION OF INSURANCE SELF-INSURED EMPLOYER LIST 01-Apr-13

C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

397 AFFINITY GAMING LLC Elizabeth Guth SIERRA NEVADA ADMINISTRATORS formerly Herbst Gaming LLC V.P. Of Insurance and Benefits Certification Date: 1/1/2011 Affinity GAMING LLC Michele Taylor 3755 Breakthrough Way Suite 300 2716 N. Tenaya Way, 5th FL Las Vegas NV 89135 Las Vegas NV 89114-5750 (702) 341-2419 (702) 240-8935 Flamingo Paradise LLC 1/1/2011 Last Chance LLC 1/1/2011 Whiskey Pete's Hotel & Casino LLC 1/1/2011 Herbst Gaming LLC 1/1/2011 Zante LLC Sands Regency 1/1/2011 Buffalo Bills LLC 1/1/2011 Primmadonna Resort & Casino LLC 1/1/2011 Plantation Investment LLC 1/1/2011 Dayton Depot LLC 1/1/2011 ETT LLC 1/1/2011

106 AMERISTAR CASINOS INC Karen Burris SEDGWICK CLAIMS MANAGEMENT Benefits Manager SERVICES, INC. Certification Date: 10/1/1990 AMERISTAR CASINOS INC Janet Machado 3773 Howard Hughes Parkway, Ste 4 P O Box 34660 90 Las Vegas NV 89169 Las Vegas NV 89133 (702) 567-7060 (888)713-1112ex83828 Cactus Pete's Inc. 10/1/1990 Ameristar Casinos, Inc. 4/1/1994 The Horseshu 10/1/1990 Cactus Pete's Resort Casino 10/1/1990

1 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

55 ARCHON CORPORATION David Lowden SIERRA NEVADA ADMINISTRATORS Executive Office Administrator Certification Date: 8/15/1982 ARCHON CORPORATION Michele Taylor 3221 S Torrey Pines 2716 N. Tenaya Way, 5th FL Las Vegas NV 89146 Las Vegas NV 89114-5750 (702) 429-6742 (702) 240-8935 Pioneer Hotel Inc. 9/15/1989

45 ARKANSAS BEST CORPORATION Allen King GALLAGHER BASSETT SERVICES, INC. Workers Comp Manager Certification Date: 12/15/1981 ABF FREIGHT SYSTEMS Charles Rostad 3801 Old Greenwood Rd. 2110 East Flamingo Rd #314 Fort Smith AR 72903 Las Vegas NV 89119-0834 (479) 785-6218 (866)-889-4755 Cardinal Freight Lines 10/1/1995 ABF Freight Systems 12/15/1981 E-T-M-F Terminals 10/18/1982

326 BEST BUY CO INC Rebecca Schoff GALLAGHER BASSETT SERVICES, INC. BEST BUY STORES LP Consultant Certification Date: 12/1/1997 Aon Global Risk Consulting for Besy Buy Charles Rostad 5600 W. 83rd Street, Tower Ste 1100 2110 East Flamingo Rd #314 Minneapolis MN 55437 Las Vegas NV 89119-0834 952-807-0693 (866)-889-4755

2 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

52 BOYD GAMING CORPORATION Juliet Vestal CANNON COCHRAN MANAGEMENT Director of Benefits & Risk Managem SERVICES (CCMSI) ent Certification Date: 7/1/1981 Director of Benefits & Risk Management Brigid Wyszomirski 6465 South Rainbow Blvd PO BOX 35350 Las Vegas NV 89118 Las Vegas NV 89133-5350 (702) 692-4156 (702) 933-4800 Mare-Bear, Inc.Stardust Resort and Casino 7/1/1981 Boyd Shared Services, Inc. 6/1/2007 Boyd Gaming Corporation 11/1/1990 ETN Productions, Inc. 5/1/1994 Coast Hotel & Casino 1/1/1996 Sam-Will, Inc. Fremont Hotel and Casino 7/1/1981 Echelon Resorts Corporation 12/1/2005 Eldorado, Inc. Jokers Wild Casino 1/1/1993 Boyd Atlantic City, Inc. 1/1/1999 Boyd Travel, Inc.Vacations-Hawaii 10/1/1995 Eldorado, Inc. Eldorado Casino 8/1/1982 California Hotel & CasinoCalifornia Hotel and Casino 8/1/1982 Boyd Central Region, Inc. 2/1/1996 The SunCoast Hotel & Casino 4/1/2000 Echelon Resorts LLC 12/1/2005 Gold Coast Hotel & Casino 2/1/1989 M.S.W., Inc. Main Street Station Hotel, Casino 8/15/1995 ETN Development Corporation 11/17/2004 Boyd Development Corporation 10/1/1995 Rodney Petroleum, Inc.Downtown Texaco Station 9/4/1992 California Hotel & CasinoSam's Town Hotel, Gambling Hall 8/1/1982 Orleans Hotel & Casino, The 2/12/1996 Coast Vacations 8/13/1999 Constellation Insurance Company 7/1/2005

3 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

11 CAESARS ENTERTAINMENT CORPORATION Maila Aganon CANNON COCHRAN MANAGEMENT formerly Harrah's Insurance Manager SERVICES (CCMSI) Certification Date: 8/15/1980 HARRAHS ENTERTAINMENT INC Brigid Wyszomirski One Caesars Palace Drive PO BOX 35350 Las Vegas NV 89109 Las Vegas NV 89133-5350 (702) 407-6277 (702) 933-4800 Harrah's Laughlin 4/28/1988 Bill's Casino 7/1/1987 Harrah's Las Vegas 6/1/1983 Harveys Tahoe Management Co. 8/1/2001 Caesars Entertainment Inc 7/12/1980 Bill's Gambling Hall & Saloon 2/27/2007 Imperial Palace Casino Inc 2/8/1981 Rio Hotel & Casino Inc 6/1/1992 Harrah's Reno/Tahoe 8/15/1980

393 CARSON CITY Cecilia Meyer CANNON COCHRAN MANAGEMENT Risk Management Coordinator SERVICES (CCMSI) Certification Date: 7/1/2010 CARSON CITY FINANCE DIVISION Brigid Wyszomirski 201 North Carson Street Ste 3 P O BOX 20068 Carson City NV 89701 Reno NV 89515-0068 (775) 283-7484 (775) 324-3301 x 1011

394 CARSON CITY SCHOOL DISTRICT Amanda Prudhomme NELSON DAVISON ADMINISTRATORS INC HR/Workers' Comp Certification Date: 7/1/2010 CARSON CITY SCHOOL DISTRICT Tom Nelson 1402 West King Street 9855 DoubleR Blvd Ste 105/PO Box 12338 Carson City NV 89702 Reno NV 89521 (775) 283-2004 (775) 825-9299 x 1

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383 CATHOLIC CHARITIES OF SOUTHERN NEVADA Linda Summers NEVADA ALTERNATIVE SOLUTIONS, INC. Human Resource Director Certification Date: 1/1/2006 CATHOLIC CHARITIES OF SOUTHERN NV Charles R Nort 1501 Las Vegas Blvd North 9506 West Flamingo Rd Suite 102 Las Vegas NV 89101 Las Vegas NV 89147 (702) 385-2662 (702) 796-1333 ext 228

199 CEDAR ENTERPRISES INC Deborah S Harmon SIERRA NEVADA ADMINISTRATORS WENDY'S OF LAS VEGAS Director Human Resources Certification Date: 1/1/1994 CEDAR ENTERPRISES INC Michele Taylor 1328 Dublin Road Ste 300 2716 N. Tenaya Way, 5th FL Columbus OH 43215-1054 Las Vegas NV 89114-5750 (614) 787-7804 (702) 240-8935 Cedar Bon Bakeries, Ltd. 9/10/2001 Wendy's of Las Vegas, Inc. 1/1/1994

169 CITY OF HENDERSON Amy M. L. Wong CANNON COCHRAN MANAGEMENT Senior Disability Analyst SERVICES (CCMSI) Certification Date: 4/1/1993 CITY OF HENDERSON Brigid Wyszomirski P O Box 95050-MS 137 PO BOX 35350 Henderson NV 89009-5050 Las Vegas NV 89133-5350 (702) 267-1921 (702) 933-4800

78 CITY OF LAS VEGAS Connie I. Strauser CITY OF LAS VEGAS Workers' Compensation Analyst Certification Date: 12/29/1985 CITY OF LAS VEGAS Victoria J Robinson, Ins Svcs 495 S. Main St. 400 East Stewart Avenue Las Vegas NV 89101 Las Vegas NV 89101-2986 (702) 229-5044 (702)229-5043

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197 CITY OF NORTH LAS VEGAS Darlene Rosenberg CANNON COCHRAN MANAGEMENT Principal Benefits Analyst SERVICES (CCMSI) Certification Date: 1/1/1994 CITY OF NORTH LAS VEGAS Brigid Wyszomirski 2250 Las Vegas Blvd North PO BOX 35350 North Las Vegas NV 89030 Las Vegas NV 89133-5350 (702) 633-2124 (702) 933-4800

147 CITY OF RENO Renee Rungis CANNON COCHRAN MANAGEMENT Director of Human Resources SERVICES (CCMSI) Certification Date: 9/1/1992 CITY OF RENO Brigid Wyszomirski PO Box 1900 P O BOX 20068 Reno NV 89505 Reno NV 89515-0068 (775) 785-5854 (775) 324-3301 x 1011

163 CITY OF SPARKS Jill Valdez CANNON COCHRAN MANAGEMENT Human Resources Analyst SERVICES (CCMSI) Certification Date: 2/1/1993 CITY OF SPARKS Brigid Wyszomirski 431 Prater Way P O BOX 20068 Sparks NV 89431 Reno NV 89515-0068 (775) 353-4021 (775) 324-3301 x 1011

6 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

399 CITYCENTER HOLDINGS, LLC Tina Sanchez MGM MIRAGE RISK MANAGEMENT Director of Workers' Compensation Certification Date: 11/30/2011 MGM Resorts International Tina Sanchez 3260 Industrial Road 3260 So Industrial Road Las Vegas NV 89109 Las Vegas NV 89109 (702) 650-6746 (702) 650-7443 ARIA RESORTS AND CASINO LLC 11/30/2011 THE CRYSTALS AT CITY CENTER MA 11/30/2011 CITY CENTER REALTY CORPORATIO 11/30/2011 PROJECT CC, LLC 11/30/2011

75 CLARK COUNTY Sandra Swickard SIERRA NEVADA ADMINISTRATORS Asst. County Manager Certification Date: 7/15/1985 CLARK COUNTY RISK MGMT & SAFETY Michele Taylor 500 S Grand Central Pkwy, 5th Fl. 2716 N. Tenaya Way, 5th FL Las Vegas NV 89106 Las Vegas NV 89114-5750 (702)455-5524 (702) 240-8935 McCarran International Airport 7/15/1985 Volunteer Account (Ambulance & Fireme 4/1/1986 University Medical Center 8/1/1986

104 CLARK COUNTY SCHOOL DISTRICT Roque Lapuz Jr CLARK COUNTY SCHOOL DISTRICT Workers Comp Coordinator Certification Date: 7/1/1990 CLARK COUNTY SCHOOL DISTRICT Nancy Powell, W/C Claims Mgr 4828 S. Pearl Street MS 200 4204 Channel 10 Drive-Risk Mgt Las Vegas NV 89121 Las Vegas NV 89146 (702) 799-0060 X5601 (702) 799-2967 ext 5626

7 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

115 CLARK COUNTY WATER RECLAMATION DISTRICT Martin J Flynn NELSON DAVISON ADMINISTRATORS INC Assistant to General Manager Certification Date: 4/1/1992 CLARK COUNTY WATER RECLAMATION DISTRIC Tom Nelson T 5857 East Flamingo Road 9855 DoubleR Blvd Ste 105/PO Box 12338 Las Vegas NV 89122 Reno NV 89521 (702) 668-8066 (775) 825-9299 x 1

154 COSTCO WHOLESALE CORPORATION Uyen Nguyen SEDGWICK CLAIMS MANAGEMENT Workers Comp Data Analyst SERVICES, INC. Certification Date: 1/1/1993 COSTCO COMPANIES INC Janet Machado 999 Lake Drive P O Box 34660 Issaquah WA 98027 Las Vegas NV 89133 (425)313-2874 (888)713-1112ex83828 Costco Wholesale Corporation 1/1/1993

381 CPS SECURITY (USA) INC Vanessa Alvarez NELSON DAVISON ADMINISTRATORS INC Workers' Compensation Claim Speci alist Certification Date: 6/1/2004 CPS SECURITY (USA), INC Tom Nelson 436 West Walnut Street 9855 DoubleR Blvd Ste 105/PO Box 12338 Gardena CA 90248 Reno NV 89521 (310) 878-8177 (775) 825-9299 x 1 Construction Protective Services, Inc. 6/1/2004 Commercial Protective Services, Inc. 6/1/2004 eCamSecure, Inc. 6/1/2004

8 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

347 CREATIONS MEANDRES INC Mary Spees SIERRA NEVADA ADMINISTRATORS formerly cirque du soleil Sr. Director of Human Resources Certification Date: 2/1/1999 CIRQUE DU SOLEIL Michele Taylor 980 Kelly Johnson Drive Suite 200 2716 N. Tenaya Way, 5th FL Las Vegas NV 89119 Las Vegas NV 89114-5750 (702) 352-0190 (702) 240-8935 Cirque du Soleil Radio CT.L.L.C. 10/9/2012 Cirque du Soleil Zumanity, LLC 6/24/2003 Cirque EPE Las Vegas LLC 4/27/2009 Cirque du Soleil Illusion LLC 11/16/2006 Cirque du Soleil (US), Inc. 2/1/1999 Cirque du Soleil "O", LLC 12/29/2003 Cirque Apple Administration, LLC 12/5/2005 Cirque du Soleil Holding USA, Inc. 2/1/1999 Cirque du Soleil, Inc. 2/1/1999 Cirque du Soleil Nevada, Inc. 2/1/1999 Cirque du Soleil My Call L.L.C. 2/18/2013 Cirque du Soleil Perception, LLC 11/24/2003

361 DIGNITY HEALTH Hillery Trippe SEDGWICK CLAIMS MANAGEMENT changed name from Catholic Healthcare West VP, Risk Services SERVICES, INC. Certification Date: 10/1/2000 DIGNITY HEALTH Peggy Harper 185 Berry Street Suite 300 102 E. Lake Mead Drive San Francisco CA 94107 Henderson NV 89015 (415)438-5577 (702) 616-4445 St Rose Dominican Health Foundation 10/1/2000 Saint Mary's Preferred Health Insurance 3/1/1997 Nevada Physician's Choice 10/1/2000 St Rose Dominican Hospital - San Martin 8/1/2006 St Rose Dominican HospitalSt. Rose Dominican Hospital, Sien 10/1/2000 Saint Mary's Healthfirst 3/1/1997 Saint Mary's Regional Medical Center 10/24/1980

9 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

216 DOUGLAS COUNTY SCHOOL DISTRICT Debe Thomas CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)

Certification Date: 7/1/1994 DOUGLAS COUNTY SCHOOL DISTRICT Brigid Wyszomirski 1638 Mono Ave. P O BOX 20068 Minden NV 88423 Reno NV 89515-0068 (775)782-7177 (775) 324-3301 x 1011

323 EBSCO INDUSTRIES INC Heather Moore NELSON DAVISON ADMINISTRATORS INC Assistant Vice President/Acctg. Mgr. Certification Date: 10/1/1997 VALLEY JOIST INC Tom Nelson P O Box 1943 9855 DoubleR Blvd Ste 105/PO Box 12338 Birmingham AL 35201 Reno NV 89521 (205) 991-1473 (775) 825-9299 x 1 Valley Joist, Inc. 10/1/1997

58 ELDORADO RESORTS LLC Robert Bruce Mackay NELSON DAVISON ADMINISTRATORS INC ELDORADO HOTEL & CASINO Director of Administration Certification Date: 11/1/1982 ELDORADO HOTEL & CASINO Tom Nelson 345 North Virginia Street 9855 DoubleR Blvd Ste 105/PO Box 12338 Reno NV 89501 Reno NV 89521 (775) 786-5700 ext 7656 (775) 825-9299 x 1

192 ELKO COUNTY SCHOOL DISTRICT Mike Smith ALTERNATIVE SERVICES CONCEPTS LLC Assistant Superintendent Certification Date: 11/1/1993 ELKO COUNTY SCHOOL DISTRICT Mike Livermore P O Box 1012 1755 East Plumb Lane #148 Elko NV 89801 Reno NV 89502 (775) 738-5196 (775)329-1181

10 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

285 FEDEX CORPORATION (PARENT)(GROUND) Thomas P Dittoe BROADSPIRE SERVICES INC. FEDEX GROUND PACKAGE SYSTEM Inc Sr Manager Workers Compensation Certification Date: 8/1/1996 FEDEX GROUND PACKAGE SYSTEM INC Amy Kelley P O Box 535859 PO Box 30670 Moon Twp. PA 15108 Las Vegas NV 89173 (412) 747-8318 (702)242-3020 FedEx Ground Package System, Inc.Formerly RPS, Inc. 8/1/1996

29 FEDEX CORPORATION FOR FEDERAL EXPRESS CORP Julia Stegall SEDGWICK CLAIMS MANAGEMENT Formerly FDX Corporation Sr. Risk & Insurance Analyst SERVICES, INC. Certification Date: 4/1/1981 FEDERAL EXPRESS CORPORATION Janet Machado 3620 Hacks Cross Road Bldg B 3rd F P O Box 34660 loor Memphis TN 38125-8800 Las Vegas NV 89133 (901) 434-4557 (888)713-1112ex83828 Federal Express Corporation 4/1/1981

120 FEDEX CORPORATION FOR FEDEX FREIGHT INC Kayla Quandt SEDGWICK CLAIMS MANAGEMENT Formerly FDX Corporation Risk Management Advisor SERVICES, INC. Certification Date: 11/1/1991 FEDEX FREIGHT INC Janet Machado 2200 Forward Drive DC2256 P O Box 34660 Harrison AR 72601 Las Vegas NV 89133 (870) 704-5187 (888)713-1112ex83828 FedEx Freight Inc. 11/1/1991

174 FOUR QUEENS, LLC Brian R. Arlin NEVADA ALTERNATIVE SOLUTIONS, INC. FOUR QUEENS HOTEL & CASINO VP/Secretary/Treasurer Certification Date: 6/1/1993 FOUR QUEENS HOTEL & CASINO Charles R Nort 202 East Fremont Street 9506 West Flamingo Rd Suite 102 Las Vegas NV 89101 Las Vegas NV 89147 (702)366-7382 (702) 796-1333 ext 228 TLC Casino Enterprises Inc 1/1/2008

11 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

400 FP HOLDINGS LLP Cheryl Kabes HELMSMAN MANAGEMENT SERVICES LLC PALMS CASINO HOTEL; fka Fiesta Palms LLC Analyst - Aon Global Risk Consulting Certification Date: 12/23/2011 AON GLOBAL RISK CONSULTING Cindy Riggio 5600 W. 83rd Street; 8200 Tower, Su P O Box 95577 ite 1100 Minneapolis MN 55437 Las Vegas NV 89193 (952)807-0661 (702) 562-5005 x218 NM Ventures II LLC 11/30/2011 PPII Holdings, llc 11/30/2011 Palms Place, LLC 11/30/2011 NM Ventures LLC 11/30/2011 Little Buddah Café Las Vegas 11/30/2011

141 FRIAS HOLDING COMPANY John Hickman R. A. WONG & ASSOCIATES ABC UNION CAB COMPANY Chief Operating Officer Certification Date: 7/1/1992 ABC UNION CAB COMPANY Paul Wong 5010 South Valley View Blvd 5110 S Valley View Blvd, Suite 100 Las Vegas NV 89118 Las Vegas NV 89118 (702) 798-3400 x2727 (702)798-8910 A-NLV Cab Company 7/1/1992 Virgin Valley Cab Company, Inc.A-Virgin Valley Cab Co. 8/1/1994 Vegas Western Cab Company 7/1/1992 Airline Limousine Corporation 4/1/2000 A Cowboy's Dream Bed & Breakfast, LLC 1/15/2010 Ace Cab Company 7/1/1992 Windmill Ridge, LLC 1/15/2010 A-NLV Cab CompanyLas Vegas Limousines 1/1/1996 Oxford Technologies, Inc.El Mirador Motel 7/1/1999

12 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

288 GANNETT CO INC Michael J. Baglio CONSTITUTION STATE SERVICES LLC Consultant Certification Date: 10/1/1996 GANNETT CO INC Brandi Lee 5600 West 83rd Street, 8200 Tower 7450 Arroyo Crossing Pkwy, Ste 200 Suite 1100 Minneapolis MN 55437 Las Vegas NV 89113-4081 (952) 807-0620 (702) 479-4218 x 94218 Gannett International Commumications, I 4/17/2000 Media West-SJC, Inc. 4/17/2000 Media West-MCN, Inc. 4/17/2000 Media West-SPC, Inc. 4/17/2000 Media West-TAC, Inc. 4/17/2000 Media West-NPP, Inc. 4/17/2000 Media West-THC, Inc. 4/17/2000 Media West-UWI, Inc. 4/17/2000 Media West-STI, Inc. 4/17/2000 Media West-SBC, Inc. 4/17/2000 Media West-PNJ, Inc. 4/17/2000 Gannett Satellite Information Network, In 10/1/1996 Media West-OPP, Inc. 4/17/2000 Media West-MSC, Inc. 4/17/2000 Media West-SNI, Inc. 4/17/2000 Gannett Pacific Publications, Inc. 10/1/2007 Media West-PCC, Inc. 4/17/2000 Media West-VNI, Inc. 4/17/2000 Media West-GRS, Inc. 4/17/2000 Media West-CNI, Inc. 4/17/2000 Media West-LCJ, Inc. 4/17/2000 Media West-INI, Inc. 8/4/2000 Media West-PNI, Inc. 8/4/2000 Media West-GMP, Inc. 7/1/2000 USA Today 10/1/1996

13 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date Media West-GUP, Inc. 7/1/2000 Media West-ANI, Inc. 8/4/2000 Media West-ATP, Inc. 4/17/2000 Reno Newspapers, Inc. 10/1/1996 Media West-APP, Inc. 4/17/2000 Media West-RNI, Inc. 4/17/2000 Media West-BCN, Inc. 4/17/2000 Media West-FCN, Inc. 4/17/2000 Media West-SCN, Inc. 4/17/2000 Media West-SFN, Inc. 4/17/2000 Media West-CPC, Inc. 4/17/2000 Media West-LCC, Inc. 4/17/2000 Media West-GSI, Inc. 4/17/2000 Media West-MMI, Inc. 4/17/2000 Media West-MNC, Inc. 4/17/2000 Media West-DSP, Inc. 4/17/2000 Media West-DNI, Inc. 4/17/2000 Media West-DMR, Inc. 4/17/2000 Media West-RDC, Inc. 4/17/2000 Media West-CPI, Inc. 4/17/2000 The Spectrum 7/21/2000 Media West-FPI, Inc. 4/17/2000 Media West-EPT, Inc. 4/17/2000

386 GAUGHAN SOUTH LLC Heather Hall NEVADA ALTERNATIVE SOLUTIONS, INC. SOUTH POINT HOTEL & CASINO Risk Manager Certification Date: 10/25/2006 SOUTH POINT HOTEL & CASINO Charles R Nort 9777 Las Vegas Blvd South 9506 West Flamingo Rd Suite 102 Las Vegas NV 89183 Las Vegas NV 89147 (702) 797-8245 (702) 796-1333 ext 228

14 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

380 GOLDEN NUGGET INC Maria Davila BROADSPIRE SERVICES INC. GOLDEN NUGGET HOTEL & CASINO Claim Representative Certification Date: 1/23/2004 GOLDEN NUGGET HOTEL & CASINO Amy Kelley 1510 W Loop South PO Box 30670 Houston TX 77027 Las Vegas NV 89173 (713) 386-7084 (702)242-3020 GNL, Corp 1/23/2004 GNLV, Corp. 1/23/2004

182 HAMILTON HOLDING MANAGEMENT CORP Carolyn Cooper HOMETOWN HEALTH PARTNERS INC Human Resources Generalist II Certification Date: 7/1/1993 HAMILTON HOLDING MGT CORP Michele Chapman 4990 Energy Way 830 Harvard Way Reno NV 89502 Reno NV 89502 (775) 858-3000 ext 284 (775) 982-3049 Hamilton Company 7/1/1993 Standard Pneumatic 7/1/1993

114 HAT LTD Mike Harrigan HAT LTD DBA/MANPOWER TEMPORARY MANPOWER TEMPORARY SERVICES President Harrigan Enterprises, Inc. SERVICES Certification Date: 3/1/1992 MANPOWER TEMPORARY SERVICES Leslie Bell-W/C Rep 1155 West 4th Street Suite 223 5301 Longley Lane Ste B-42 Reno NV 89503 Reno NV 89511 (775) 328-6020 (775) 328-6020

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165 HCA HOLDINGS INC Carrie A Binkley BROADSPIRE SERVICES INC. formerly Columbia/HCA Healthcare Senior Compliance Analyst Certification Date: 1/1/1986 HCA INC Amy Kelley One Park Plaza Bldg 11-4E PO Box 30670 Nashville TN 37203 Las Vegas NV 89173 (615) 344-1487 (702)242-3020 All About Staffing, Inc. 7/1/2002 Sahara Outpatient Surgery Center, Ltd. 12/1/1994 Sunrise Physician Services, LLC 9/1/2009 Sunrise Neuro Sciences, LLCNevada Neuro Sciences 12/1/2007 Central Shared Services LLCFar West Supply Chain 8/1/2007 HCA Management Services, LP 4/26/1999 CosCorp, LLC 4/23/1999 Specialty Surgicare of Las Vegas, LP 7/16/2005 Galen Health Care, Inc. 3/1/1993 Tennessee Healthcare Management Inc 3/1/2005 Nevada Psychiatric Company, Inc. 8/1/1994 Sunrise Hospital & Medical Center, LLC 3/1/1993 Las Vegas Surgicare, Inc. 12/1/1994 Sun-Med, LLC 1/14/2005 CHC Payroll Corporation 8/1/1994 CHC Venture Co. 8/1/1994 Healthcare Sales National Management 9/1/2009 HCA IT&S Field Operations, IncIT&S Far West Service Center 5/11/2008 Southern Hills Medical Center, LLC 3/1/2004 Sunrise Trauma Services, LLC 2/11/2005 Sunrise Mountainview Hospital, Inc. 1/1/1996 HSS Systems, LLCFar West Supply Chain 5/1/2002 HSS Systems, LLCHCA Patient Account Services 3/1/2001 Sunrise Flamingo Surgery Center, LP 1/30/1997 Las Vegas ASC, LLC 7/29/2005

16 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date Surgicare of Las Vegas, Inc. 10/1/1992 HCA, Inc. 1/1/1986

107 HEALTHSOUTH CORPORATION Josh Beam ESIS, INC. Risk Management Finance Manager Certification Date: 10/1/1990 HEALTHSOUTH CORPORATION Randy Barclay 3660 Grandview Parkway Ste 200 6935 Aliante Pkwy Ste 104-411 Birmingham AL 35243 Las Vegas NV 89084 (205) 968-6206 (702)731-1510 Rehabilitation Hospital of Nevada 2/1/1996 HEALTHSOUTH Valley View Surgery Ce 7/22/1998 HEALTHSOUTH Corporation 12/1/1997 HEALTHSOUTH Surgery Center 7/1/1998 Reno Rehabilitation Association 2/1/1996 Desert Canyon Rehabilitation Hospital 6/1/2010 HEALTHSOUTH Rehabilitation Hospital o 10/1/2001 HEALTHSOUTH Surgery Center of Reno 7/1/1998

17 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

129 HOME DEPOT USA INC Michelle Casey HELMSMAN MANAGEMENT SERVICES LLC Risk Analyst Certification Date: 8/1/1992 HOME DEPOT USA INC Cindy Riggio 2455 Paces Ferry Road Bldg. C-20 P O Box 95577 Atlanta GA 30339 Las Vegas NV 89193 (770) 433-8211 Ext. 85195 (702) 562-5005 x218 Your "other" Warehouse 7/27/2004 HD Supply, Inc.White Cap Construction Supply In 5/31/2005 HD Supply, Inc.HD Supply Waterworks Group, Inc 8/25/2005 THD At-Home Service, Inc. 7/1/2006 U.S. Remodelers, Inc. 10/1/2012 Grand Floor Designs Inc 1/31/2005 HD Supply, Inc.HD Supply Management, Inc 3/31/2006 HD Supply, Inc.HD Supply Distribution Services, L 6/30/2005 THD At-Home Services, Inc. 10/1/2012 U.S. Home Systems, Inc. 10/1/2012

402 HRHH GAMING SENIOR MEZZ, LLC Kim Cowley YORK CLAIM SERVICES FORMERLY HARD ROCK HOTEL Risk Manager MEDCOMP Certification Date: 3/1/2011 HRHH Gaming Senior Mezz, LLC Yvette Bouldin 4455 Paradise Rd 9085 W Post Road #100 Las Vegas NV 89169 Las Vegas NV 89148 (702) 693-5026 (702) 727-2161

403 HUMBOLDT COUNTY SCHOOL DISTRICT David Jensen, Dr. NELSON DAVISON ADMINISTRATORS INC Assisstant Superintendent Certification Date: 7/1/2012 HUMBOLDT COUNTY SCHOOL DISTRICT Tom Nelson 310 East Fourth St 9855 DoubleR Blvd Ste 105/PO Box 12338 Winnemucca NV 89445 Reno NV 89521 775-623-8100 (775) 825-9299 x 1

18 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

338 HYATT HOTELS CORPORATION Jennifer Herzfeld GALLAGHER BASSETT SERVICES, INC. Risk Manager-Risk Management Certification Date: 2/1/1998 HYATT HOTELS CORPORATION Charles Rostad 71 S Wacker Drive 2110 East Flamingo Rd #314 Chicago IL 60606 Las Vegas NV 89119-0834 (312)-780-5861 (866)-889-4755 Hyatt Corporation 2/1/1998 Select Hotels Group, LLC 1/5/2008

63 IKE GAMING INC Joe Woody NEVADA ALTERNATIVE SOLUTIONS, INC. EL CORTEZ HOTEL & CASINO Chief Financial Officer Certification Date: 10/9/1983 ` Charles R Nort 107 North 6th Street 3rd Floor 9506 West Flamingo Rd Suite 102 Las Vegas NV 89101 Las Vegas NV 89147 (702) 474-3613 (702) 796-1333 ext 228

138 INCLINE VILLAGE GEN IMPROVEMENT DISTRICT Gerald W. Eick NELSON DAVISON ADMINISTRATORS INC Dir. Of Finance, Acctg and Risk Man agement Certification Date: 7/1/1992 INCLINE VILLAGE GEN IMPROVEMENT Tom Nelson 893 Southwood Blvd 9855 DoubleR Blvd Ste 105/PO Box 12338 Incline Village NV 89451 Reno NV 89521 (775) 832-1365 (775) 825-9299 x 1

99 INTERNATIONAL GAME TECHNOLOGY Sharolyn P Wilson INTERNATIONAL GAME TECHNOLOGY Workers Compensation Analyst Certification Date: 9/15/1989 IGT Celeste Wallick 9295 Prototype Drive 9295 Prototype Drive Reno NV 89521 Reno NV 89521 (775) 448-0411 (775)448-3843 IGT-International 10/1/1993 IGT & Subs 9/1/1990

19 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

152 INTERNATIONAL PAPER COMPANY Penny Humphrey SEDGWICK CLAIMS MANAGEMENT Administrator, Insurance Program SERVICES, INC. Certification Date: 1/1/1993 INTERNATIONAL PAPER COMPANY Janet Machado 6400 Poplar Ave Tower III, 4-110 P O Box 34660 Memphis TN 38197 Las Vegas NV 89133 (901) 419-3938 (888)713-1112ex83828 Western Paper Company 1/1/1993 Dixon Paper Company 1/1/1993 LLford Photo Corp. 1/1/1993

356 JOURNAL COMMUNICATIONS INC Jeffrey Kluever GALLAGHER BASSETT SERVICES, INC. KTNV-TV Channel 13 Risk Manager Certification Date: 10/1/1999 JOURNAL COMMUNICATIONS INC Charles Rostad 333 West State Street 2110 East Flamingo Rd #314 Milwaukee WI 53203 Las Vegas NV 89119-0834 (414) 224-2702 (866)-889-4755 Journal Broadcast CorporationKTNV-TV Channel 13 10/1/1999

119 KENNAMETAL INC (PARENT) Michael P Murphy NEVADA ALTERNATIVE SOLUTIONS, INC. KENNAMETAL INC NEVADA DIVISION Manager Prop & Casualty Claims Certification Date: 10/1/1991 KENNAMETAL INC Charles R Nort 1600 Technology Way, PO Box 231 9506 West Flamingo Rd Suite 102 Latrobe PA 15650 Las Vegas NV 89147 (724) 539-4647 (702) 796-1333 ext 228 Tricon 7/1/2009

20 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

357 KIEWIT CORPORATION Debra L Prochaska SPECIALTY RISK SERVICES LLC (SRS) Claims Analyst Certification Date: 11/1/1999 KIEWIT CORPORATION Lara Borel Kiewit Plaza P O Box 95518 Omaha NE 68131 Las Vegas NV 89193-5518 (402) 271-2862 (702) 387-8006 Gilbert Western Corp. 11/1/1999 Tpac, A Division of Kiewit Western 11/1/1999 Lake Mead Constructors 11/1/1999 Kiewit Infrastructure West Co. 9/1/2012 Kiewit Western Co. 11/1/1999 Kiewit Infrastructure Co. 11/1/1999 Aero Automatic Sprinkler Company 8/26/2009 Continental Fire Sprinkler Company 2/26/2009 Western Summit Constructors, Inc. 12/29/2008 Kiewit Industrial Co. 11/1/1999 TIC-The Industrial Company 12/29/2008

122 KINROSS GOLD CORPORATION Bridgett Gray PINNACLE RISK MANAGEMENT SERVICES Safety Dept. Clerk INC Certification Date: 12/1/1991 ROUND MOUNTAIN GOLD Su Crawford P O Box 480 4055 Spencer St Ste 102 Round Mountain NV 89045 Las Vegas NV 89119 (775) 377-3149 (877) 219-9395 Echo Bay Minerals Company 12/1/1991 Round Mountain Gold Corp 12/1/1991

21 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

382 KNIGHT TRANSPORTATION INC Todd Cantrill YORK CLAIM SERVICES FORMERLY Dir. Workers' Compensation MEDCOMP Certification Date: 10/1/2004 KNIGHT TRANSPORTATION Yvette Bouldin 5601 West Buckeye Road 9085 W Post Road #100 Phoenix AZ 85043 Las Vegas NV 89148 (602) 269-2000 (702) 727-2161

44 KROGER COMPANY Nathan Fraley SEDGWICK CLAIMS MANAGEMENT Corporate Assistant Claims Manager SERVICES, INC. Certification Date: 11/1/1981 THE KROGER CO Janet Machado 1014 Vine Street 17th Floor P O Box 34660 Cincinnati OH 45202 Las Vegas NV 89133 (513) 762-4360 (888)713-1112ex83828 Fred Meyer Jewelers 11/15/1998 Fred Meyer, Inc. 9/9/1997 Smith's Food & Drug Centers, Inc.Price Rite Stores 11/1/1981 Ralphs Grocery CompanyFood 4 Less 3/19/2001 Quik Stop Markets, Inc. 10/11/2001

369 LAS VEGAS CONVENTION & VISITORS AUTHORITY Timothy Callaway CANNON COCHRAN MANAGEMENT Benefits Coordinator SERVICES (CCMSI) Certification Date: 7/1/2002 LAS VEGAS CONVENTION & VISITORS AUTHORIT Brigid Wyszomirski Y 3150 Paradise Road PO BOX 35350 Las Vegas NV 89109 Las Vegas NV 89133-5350 (702) 892-7527 (702) 933-4800

22 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

159 LAS VEGAS METRO POLICE DEPARTMENT Jeff Roch CANNON COCHRAN MANAGEMENT Director of Risk Management SERVICES (CCMSI) Certification Date: 1/1/1993 LAS VEGAS METRO POLICE DEPARTMENT Brigid Wyszomirski 400 S. Martin Luther King BL. PO BOX 35350 Las Vegas NV 89106 Las Vegas NV 89133-5350 (702) 828-3406 (702) 933-4800

272 LAS VEGAS PAVING CORPORATION Lou Esposito CANNON COCHRAN MANAGEMENT Risk Manager SERVICES (CCMSI) Certification Date: 5/1/1996 LAS VEGAS PAVING CORPORATION Brigid Wyszomirski 4420 South Decatur Blvd PO BOX 35350 Las Vegas NV 89103 Las Vegas NV 89133-5350 (702) 251-5800 (702) 933-4800 Sunridge Corporation 2/1/2013

96 LAS VEGAS SANDS CORP Lee Ann Hamilton SIERRA NEVADA ADMINISTRATORS Workers Comp Manager Certification Date: 4/28/1989 THE VENETIAN RESORT HOTEL CASINO Michele Taylor 3355 Las Vegas Blvd South 2716 N. Tenaya Way, 5th FL Las Vegas NV 89109 Las Vegas NV 89114-5750 702-414-4395 (702) 240-8935 Venetian Hotel Operations, LLC 4/1/2003 Venetian Operating Co. LLC 3/31/2000 Lido Casino Resort, LLC 3/31/2000 Las Vegas Sands, LLC 4/28/1989 Venetian Casino Resort, LLCVenetian Resort Hotel Casino 1/1/1998 Lido Casino Resort Holding Co. LLC 8/1/2004

23 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

371 LAS VEGAS VALLEY WATER DISTRICT Matt Chorpening CANNON COCHRAN MANAGEMENT Risk Manager SERVICES (CCMSI) Certification Date: 1/1/2003 LAS VEGAS VALLEY WATER DISTRICT Brigid Wyszomirski 1001 South Valley View Blvd. PO BOX 35350 Las Vegas NV 89153 Las Vegas NV 89133-5350 (702) 259-8165 (702) 933-4800

325 LES SCHWAB WAREHOUSE CENTER INC Denny Carter ESIS, INC. Risk Services Supervisor Certification Date: 12/1/1997 LES SCHWAB WAREHOUSE CENTER INC Randy Barclay P O Box 5350 6935 Aliante Pkwy Ste 104-411 Bend OR 97708-5350 Las Vegas NV 89084 (541) 416-5479 (702)731-1510 Les Schwab Warehouse Center, Inc.Les Schwab Tire Centers of Neva 12/1/1997

374 LYON COUNTY SCHOOL DISTRICT (Ms.) Ronnie Rowley NELSON DAVISON ADMINISTRATORS INC Risk Management Certification Date: 7/1/2003 LYON COUNTY SCHOOL DISTRICT Tom Nelson 25 East Goldfield Ave 9855 DoubleR Blvd Ste 105/PO Box 12338 Yerington NV 89447 Reno NV 89521 (775) 463-6800 ext 144 (775) 825-9299 x 1

24 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

349 MACY'S INC Evan Ripley HELMSMAN MANAGEMENT SERVICES LLC Senior Accountant Certification Date: 4/1/1999 Federated Dept Stores c/o Aon Risk Consultants Inc Cindy Riggio 7 West Seventh Street P O Box 95577 Cincinatti OH 45202 Las Vegas NV 89193 (513) 562-6782 (702) 562-5005 x218 Macy's Inc. 4/1/1999 Macy's Systems and Technology, Inc. 4/1/1999 Bloomingdale's, Inc. 11/1/2002 Macy's Retail Holdings, Inc. 5/1/1995 Macy's Corporate Services, Inc. 4/1/1999 Macy's West Stores, Inc. 8/10/2009

136 MANOR CARE INC Lisa Jurski BROADSPIRE SERVICES INC. Sr Mgr Workers Comp Program Certification Date: 7/1/1992 HCR MANOR CARE INC, MANOR CARE, INC. Amy Kelley 333 N Summit Street PO Box 30670 Toledo OH 43699-0086 Las Vegas NV 89173 (419) 254-5416 (702)242-3020 ManorCare Health Service, Inc.ManorCare Health Services 7/1/1992 Richards Healthcare, Inc.Richards Healthcare 10/14/2002 Heartland Employment Services, Inc. 1/1/2002 MileStone Staffing Services, Inc. 11/1/2002 MileStone Health Systems, Inc. 11/1/2002 MileStone Therapy Services, Inc. 11/1/2002

25 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

47 MARRIOTT INTERNATIONAL INC Steve Huy MARRIOTT CLAIMS SERVICES Compliance Analyst Certification Date: 2/1/1982 MARRIOTT INTERNATIONAL INC Nik Srauser 10400 Fernwood Road Dept 52/924. 2795 E Desert Inn Road Ste. 200 3 Bethesda MD 20817 Las Vegas NV 89121 (301) 380-4450 (702) 227-7678 Marriott Claims Services Corporation 10/1/2006 Residence Inn by Marriott, LLC 8/1/1989 Courtyard Management, Inc. 8/1/1989 Marriott Hotel Services, Inc. 12/1/1999 The Ritz-Carlton Hotel Company LLC 10/1/2006 Marriott Int'l Administrative Services, Inc. 10/1/1997 Springhill SMC, LLC 10/1/2011 Fairfield FMC LLC 11/1/1993

26 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

309 MASCO CORPORATION Kelly M. Davison CONSTITUTION STATE SERVICES LLC Risk Manager Certification Date: 4/1/1997 MASCO CORPORATION Brandi Lee 21001 Van Born Road 7450 Arroyo Crossing Pkwy, Ste 200 Taylor MI 48180 Las Vegas NV 89113-4081 (313)792-6214 (702) 479-4218 x 94218 Masco Cabinetry Middlefield, LLC 1/1/2011 Builder Services Group, Inc.Gale Industries 4/1/1997 Behr Paint Corporation 9/1/2010 RSA Supply, LLC 11/1/2003 Milgard Manufacturing Inc 12/31/2003 Masco Cabinetry LLC 1/1/2011 Buildlogix, Inc. 5/30/2006 Builder Services Group, Inc.Root Industries 7/19/2006 Masco Contractor Services West, Inc.Sacramento Insulation Contractor 5/1/2001 Builder Services Group, Inc.Insulpro Projects Inc 4/1/1997 Masco Contractor Services West, IncDesert Specialties 5/1/2001 Masco Contractor Services West, Inc.Gale Building Products 5/1/2001 Computerized Security Systems 7/1/1999

194 MCDONALD'S CORPORATION Steve Laughlin GALLAGHER BASSETT SERVICES, INC. Director Insurance & Safety Dept. Certification Date: 12/1/1993 McDONALDS CORPORATION Charles Rostad McDonald Plaza 2915 Jorie Blvd 2110 East Flamingo Rd #314 Oak Brook IL 60523 Las Vegas NV 89119-0834 (630) 623-8079 (866)-889-4755 McDonald's Restaurants of Nevada, Inc. 12/1/1993

27 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

15 MCKESSON CORPORATION Kirsti Lawson GALLAGHER BASSETT SERVICES, INC. Risk Manager Certification Date: 10/1/1980 MCKESSON CORPORATION Charles Rostad One Post Street 34th Floor 2110 East Flamingo Rd #314 San Francisco CA 94104-5296 Las Vegas NV 89119-0834 (415) 983-7053 (866)-889-4755 Zee Medical, Inc. 9/1/2003 McKesson Information Solutions 1/12/1999 Per-Se Technologies Inc 3/1/2007 McKesson Medical-Surgical Inc. 12/1/1997 McKesson Medications Management LL 8/30/2000

398 MESQUITE GAMING LLC Barry Winter NELSON DAVISON ADMINISTRATORS INC formerly Black Gaming Dir Risk Management & Benefits Certification Date: 8/1/2011 Mesquite Gaming LLC Tom Nelson 950 W. Mesquite Blvd. 9855 DoubleR Blvd Ste 105/PO Box 12338 Mesquite NV 89027 Reno NV 89521 (702) 346-6827 (775) 825-9299 x 1 VRCC, LLC 8/1/2011 Oasis Recreational Properties, Inc. 8/1/2011 CasaBlanca Resorts, LLC 8/1/2011 RBG, LLC 8/1/2011

28 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

43 MGM RESORTS INTERNATIONAL Tina Sanchez MGM MIRAGE RISK MANAGEMENT Director Workers' Comp Certification Date: 10/26/1981 MGM MIRAGE RISK MANAGEMENT Tina Sanchez 3260 South Industrial Road 3260 So Industrial Road Las Vegas NV 89109 Las Vegas NV 89109 (702) 650-6746 (702) 650-7443 Shadow Creek 5/1/1989 Gold Strike Hotel & Gambling Hall 6/1/1995 Bellagio 10/6/1994 Mandalay Place 5/1/2001 Slots-A-Fun 11/15/1980 M.I.R. Travel 1/1/1992 Atlandia Design & Furniture 10/26/1981 Ramparts, Inc.Luxor Hotel/Casino 7/1/1993 Railroad Pass Hotel & Casino 6/1/1995 Victoria Partners 7/1/1996 Mandalay Resort Group 11/15/1980 Revive Partners, LLC 1/1/2003 Mandalay Development 2/1/1996 Circus Circus Hotel (Las Vegas) 11/15/1980 Circus Circus (Reno) 11/15/1980 New Castle Corp.Excalibur Hotel/Casino 10/1/1989 MGM Grand Laundry, Inc. 12/1/1993 Ramparts International 3/1/1997 Boardwalk Hotel & Casino, Inc.Holiday Inn Casino Boardwalk 6/30/1998 Mandalay Bay 4/1/1998 Mandalay Vacation Resorts, Inc 11/1/1998 Mirage Casino & Hotel, The 5/1/1989 New York-New York Hotel & Casino 12/1/1996 GO VEGAS 3/1/2000 Nevada Landing Hotel & Casino 6/1/1995

29 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date MGM Grand Las Vegas 12/1/1993

200 MONARCH CASINO & RESORT INC Doug Simpson NELSON DAVISON ADMINISTRATORS INC Atlantis Hotel & Casino Dir. Of Security & Risk Management Certification Date: 1/1/1994 ATLANTIS HOTEL & CASINO Tom Nelson 3800 South Virginia Street 9855 DoubleR Blvd Ste 105/PO Box 12338 Reno NV 89502 Reno NV 89521 (775) 335-4534 (775) 825-9299 x 1 Golden Road Motor Inn, Inc.Atlantis Casino Resort 1/1/1994

232 NEV YELLOW NEV CHECKER & NEV STAR CAB CORP Gene Auffert YORK CLAIM SERVICES FORMERLY MEDCOMP

Certification Date: 1/1/1995 NEVADA YELLOW & CHECKER CABS Yvette Bouldin 5225 W Post Rd. 9085 W Post Road #100 Las Vegas NV 89118 Las Vegas NV 89148 (702) 933-1620 (702) 727-2161

210 NEVADA READY MIX CORPORATION Larry Miller NELSON DAVISON ADMINISTRATORS INC Corporate Administrator Certification Date: 3/1/1994 NEVADA READY MIX CORPORATION Tom Nelson 151 Cassia Way 9855 DoubleR Blvd Ste 105/PO Box 12338 Henderson NV 89014 Reno NV 89521 (702) 457-1115 ext 3038 (775) 825-9299 x 1

30 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

379 NEVADA SYSTEM OF HIGHER EDUCATION Lisa Schaller CANNON COCHRAN MANAGEMENT formerly University & College System of Nevada Director of Insurance & Loss Mgt. SERVICES (CCMSI) Certification Date: 1/1/2004 NEVADA SYSTEM OF HIGHER EDUCATION Brigid Wyszomirski 2601 Enterprise Rd., Mail Stop 014 PO BOX 35350 Reno NV 89512-1666 Las Vegas NV 89133-5350 (775) 784-3472 (702) 933-4800 Desert Research Institute 1/1/2004 University of Nevada Reno 1/1/2004 Henderson Community College 1/1/2004 Western Nevada Community College 1/1/2004 University of Nevada Las Vegas 1/1/2004 Great Basin College 1/1/2004 Nevada State College at Henderson 1/1/2004 Cheyenne Community College 1/1/2004 Truckee Meadows Community College 1/1/2004 Charleston Community College 1/1/2004

6 NEW ALBERTSON'S INC Gail R Sylvester SPECIALTY RISK SERVICES LLC (SRS) Risk Mangement Financial Analyst II Certification Date: 7/4/1980 ALBERTSONS INC Lara Borel 155 North 400 West Suite 300 P O Box 95518 Salt Lake City UT 84103 Las Vegas NV 89193-5518 (801) 961-3358 (702) 387-8006 American Drug Stores LLC 4/1/1996 American Stores Company LLC 8/1/1982 New Albertson's Inc. 7/4/1980

31 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

373 NEW-COM, INC. Michael Threet CANNON COCHRAN MANAGEMENT CFO SERVICES (CCMSI) Certification Date: 7/29/2003 NEW-COM, INC. Brigid Wyszomirski 412 East Gowan Road PO BOX 35350 North Las Vegas NV 89032 Las Vegas NV 89133-5350 (702) 642-3331 (702) 933-4800 MMC INC MMC Southwest Inc 6/1/2007 L.L.O, Inc. ACME Electric 7/29/2003 Airway, Inc. Airway Rock Products 7/29/2003 All Electric, Inc. 7/29/2003 TAB Contractors, Inc. 7/29/2003 MMC, Inc. 7/29/2003 Biodiesel of Las Vegas Inc. 2/1/2007

388 NEWMONT MINING CORPORATION Courtney Muir SEDGWICK CLAIMS MANAGEMENT Risk Management Analyst SERVICES, INC. Certification Date: 4/29/2008 NEWMONT MINING CORPORATION Janet Machado 6363 S. Fiddlers Green Cr. P O Box 34660 Greenwood Village CO 80111 Las Vegas NV 89133 (303) 837-6019 (888)713-1112ex83828 Newmont Indonesia Investment Ltd 4/29/2008 Newmont International Services Ltd 4/29/2008 Newmont Global Employment Ltd Partner 4/29/2008 Battle Mountain Gold Company 4/29/2008 Newmont USA LtdNewmont Mining Corporation 4/29/2008 Santa Fe Pacific Gold Corporation 4/29/2008 Newmont Nevada Energy Investment, LL 4/29/2008 Turquoise Ridge JV 4/29/2008 Elko Land and Livestock Company 4/29/2008 Newmont Exploration Ltd 4/29/2008 Newmont Gold Company 4/29/2008

32 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

133 NV ENERGY INC Camille Williams CANNON COCHRAN MANAGEMENT Senior Benefits Consultant SERVICES (CCMSI) Certification Date: 7/1/1992 NV ENERGY INC Brigid Wyszomirski 6226 W. Sahara Ave. PO BOX 35350 Las Vegas NV 89146 Las Vegas NV 89133-5350 (702) 402-2101 (702) 933-4800 Sierra Pacific Power Company 7/1/1992 Lands of Sierra 7/1/1994 Sierra Gas Holdings Company 7/1/1994 Sierra Pacific Energy Company 9/1/1998 Nevada Power Company 7/28/1999 Nevada Electric Investment Company 7/28/1999 Sierra Pacific Communications 6/18/2001 NV Energy Inc 7/1/1994

389 NYE COUNTY SCHOOL DISTRICT Raymond Ritchie NELSON DAVISON ADMINISTRATORS INC CFO & Administrative Officer Certification Date: 7/1/2008 NY COUNTY SCHOOL DISTRICT Tom Nelson 484 S West Street 9855 DoubleR Blvd Ste 105/PO Box 12338 Pahrump NV 89048 Reno NV 89521 (775)727-7743 ext 234 (775) 825-9299 x 1

221 OCEAN SPRAY CRANBERRIES INC Lori Henault HELMSMAN MANAGEMENT SERVICES LLC Treasury Supervisor Certification Date: 9/1/1994 OCEAN SPRAY CRANBERRIES INC Cindy Riggio One Ocean Spray Drive P O Box 95577 Lakeville-Middleboro MA 02349 Las Vegas NV 89193 (508) 923-3995 (702) 562-5005 x218

33 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

319 OFFICEMAX INCORPORATED Catherine Graham HELMSMAN MANAGEMENT SERVICES LLC formerly Boise Cascade Corporation Risk Management Analyst Certification Date: 8/1/1997 OFFICEMAX INCORPORATED Cindy Riggio 263 Shuman Blvd P O Box 95577 Naperville IL 60563-1255 Las Vegas NV 89193 (630) 864-6829 (702) 562-5005 x218 OfficeMax North America, Inc. 1/1/2005 OfficeMax Contract, Inc. 4/20/2000

230 PACCAR INC DeeAnne Flegel SEDGWICK CLAIMS MANAGEMENT Manager, Workplace Absence Progra SERVICES, INC. ms Certification Date: 1/1/1995 PACCAR INC Janet Machado P O Box 1518 P O Box 34660 Bellevue WA 98009 Las Vegas NV 89133 (425) 468-7939 (888)713-1112ex83828 Paccar Parts Division 1/1/1995

90 PEPPERMILL CASINO'S INC Michael Heward HOMETOWN HEALTH PARTNERS INC Formerly Nevada Properties Director of Risk Management Certification Date: 7/1/1988 PEPPERMILL CASINOS INC Michele Chapman 830 Brinkby Ave, Suite B 830 Harvard Way Reno NV 89509 Reno NV 89502 (775) 982-8992 (775) 982-3049 Wendover PropertiesPeppermill Inn & Casino (3/1/94) 7/1/1988 Nevada PropertiesPeppermill Hotel & Casino 7/1/1988 Rainbow Casino, The 1/31/1995 Peppermill Hotel, Reno 7/1/1988 Western Village Limited PartnershipWestern Village Casino (7/1/93) 7/1/1988 Rainbow Associates, Inc.Rainbow Club (3/1/94) 7/1/1988

34 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

401 PILOT TRAVEL CENTERS, LLC Don Graham HELMSMAN MANAGEMENT SERVICES LLC acquired Flying J Senior Manager, Corporate Risk Certification Date: 3/1/2012 Pilot Travel Centers, LLC Cindy Riggio P.O. Box 10146 P O Box 95577 Knoxville TN 37939 Las Vegas NV 89193 (800) 562-6210 (702) 562-5005 x218

391 POLY-AMERICA FOR POLY-WEST INC Ron Hall YORK CLAIM SERVICES FORMERLY Chief Financial Officer MEDCOMP Certification Date: 2/1/2009 POLY-AMERICA FOR POLY-WEST INC Yvette Bouldin 251 Conestoga Way 9085 W Post Road #100 Henderson NV 89002 Las Vegas NV 89148 972-337-7266 (702) 727-2161

333 PURCELL TIRE & RUBBER COMPANY Amy Scheldberg GALLAGHER BASSETT SERVICES, INC. Claims Administrator Certification Date: 1/1/1998 PURCELL TIRE & RUBBER COMPANY Charles Rostad 301 N. Hall Street 2110 East Flamingo Rd #314 Potosi MO 63664 Las Vegas NV 89119-0834 (573) 438-2138 X1153 (866)-889-4755 Purcell Tire & Rubber Co.Purcell Rossi Tire 1/1/1998 Purcell Tire & Rubber Co.Purcell's Western States Tire 1/1/1998

179 QUALITY MECHANICAL CONTRACTORS LLC Denise Machado YORK CLAIM SERVICES FORMERLY Safety/HR Director MEDCOMP Certification Date: 7/1/1993 QUALITY MECHANICAL CONTRACTORS Yvette Bouldin 3175 Westwood Drive 9085 W Post Road #100 Las Vegas NV 89117 Las Vegas NV 89148 (702) 732-2545 (702) 727-2161

35 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

80 RALEY'S INC Mark E Field NELSON DAVISON ADMINISTRATORS INC Sr. Risk Manager Certification Date: 7/1/1986 RALEYS, INC Tom Nelson P O Box 15618 9855 DoubleR Blvd Ste 105/PO Box 12338 Sacramento CA 95605 Reno NV 89521 (916) 373-6214 (775) 825-9299 x 1

105 RENO SPARKS CONVENTION & VISITORS AUTHORITY Charlotte Anderson ALTERNATIVE SERVICES CONCEPTS LLC Human Resources Manager Certification Date: 7/1/1990 RENO SPARKS CONVENTION CENTER Mike Livermore 4001 S. Virginia St., #G 1755 East Plumb Lane #148 Reno NV 89502 Reno NV 89502 (775) 827-7618 (775)329-1181 National Bowling Stadium 10/1/1994

76 RENOWN HEALTH Larry Monson HOMETOWN HEALTH PARTNERS INC Director of Risk Management Certification Date: 8/1/1985 RENOWN REGIONAL MEDICAL CENTER Michele Chapman 1155 Mill Street - MAIL STOP J-11 830 Harvard Way Reno NV 89502 Reno NV 89502 (775) 982-4798 (775) 982-3049 Renown Health Foundation 1/1/1989 Renown Regional Medical Center 8/1/1985 Renown Network Services 1/1/1989 Renown Health 8/1/1985 Nevada Heart Institute 1/1/2011 Hometown Health Mgt Co (incl. Medical 1/1/1989 Renown South Meadows Medical Center 2/1/1999 Hometown Health Plan Inc. 1/1/1989 Renown Businesses 1/1/1992 Renown Skilled Nursing 6/17/2004 Nevada Healthcare Cooperative 10/15/2004

36 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

77 RIVERSIDE RESORT & CASINO Steve Willett YORK CLAIM SERVICES FORMERLY Director Human Resources MEDCOMP Certification Date: 9/28/1985 RIVERSIDE RESORT & CASINO Yvette Bouldin 1650 S Casino Drive 9085 W Post Road #100 Laughlin NV 89029 Las Vegas NV 89148 (702) 298-2535 (702) 727-2161 Laughlin Transit, Inc. 7/9/2003

218 RIVIERA OPERATING CORPORATION Tullio Marchionne RIVIERIA OPERATING COMPANY formerly Riviera Holdings Legal Exec. VP Certification Date: 7/1/1994 RIVIERA HOLDINGS CORPORATION LeCretia Evans 2901 Las Vegas Blvd South 2901 Las Vegas Blvd. South Las Vegas NV 89109-1931 Las Vegas NV 89109 (702) 794-9511 (702) 794-9511 Riviera Operating CompanyRiviera Hotel & Casino 7/1/1994

311 SAFEWAY INC Gilbert B. Cabrera NELSON DAVISON ADMINISTRATORS INC VP of Finance - Corp. Risk Managem ent Certification Date: 4/8/1997 SAFEWAY INC Tom Nelson 11555 Dublin Canyon Rd 9855 DoubleR Blvd Ste 105/PO Box 12338 Pleasanton CA 94588 Reno NV 89521 (925) 226-5100 (775) 825-9299 x 1 Groceryworks Holdings Inc 5/11/2005 Groceryworks.com Operating Company 5/11/2005 Vons Companies, Inc., The 4/8/1997

37 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

331 SCHNEIDER NATIONAL INC Jessica Uhlenbrauck HELMSMAN MANAGEMENT SERVICES LLC Sr Insurance Administrator Certification Date: 1/1/1998 SCHNEIDER NATIONAL INC Cindy Riggio 3101 S. Packerland Dr. P O Box 95577 Green Bay WI 54313 Las Vegas NV 89193 (920) 592-3071 (702) 562-5005 x218 Schneider National Carriers 1/1/1998 Schneider National Bulk Carriers 1/1/1998 Schneider Logistics, Inc. 1/1/1998 Schneider Specialized Carriers 1/1/1998 Schneider Transport, Inc. 1/1/1998 Schneider Tank Lines 1/1/1998

117 SHERWIN-WILLIAMS COMPANY Anthony Colangelo; Matt Flynn SEDGWICK CLAIMS MANAGEMENT Manager Workers Comp SERVICES, INC. Certification Date: 7/1/1991 SHERWIN-WILLIAMS COMPANY Janet Machado 101 Prospect Avenue NW P O Box 34660 Cleveland OH 44115-1075 Las Vegas NV 89133 (216) 566-3095 (888)713-1112ex83828

244 SILVER LEGACY RESORT CASINO Tracy Hudson NELSON DAVISON ADMINISTRATORS INC Gst. Relations Mgr./Wkrs' Comp. Mgr Certification Date: 7/1/1995 SILVER LEGACY RESORT CASINO Tom Nelson 407 N. Virginia Street 9855 DoubleR Blvd Ste 105/PO Box 12338 Reno NV 89502 Reno NV 89521 (775) 325-7040 (775) 825-9299 x 1

38 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

317 SILVERTON CASINO LLC & MAJESTIC NV PROPERTY H Darlene Koch CANNON COCHRAN MANAGEMENT Benefits Manager SERVICES (CCMSI) Certification Date: 7/1/1997 SILVERTON HOTEL CASINO Brigid Wyszomirski 3333 Blue Diamond Road PO BOX 35350 Las Vegas NV 89139 Las Vegas NV 89133-5350 (702) 914-8513 (702) 933-4800 Silverton Casino, LLCSilverton Hotel Casino & RV Park 12/2/1997 Silverton Casino, LLCSilverton RV Park & Sundries Stor 12/2/1997

375 SOUTHERN NEVADA HARLEY DAVIDSON SALES INC & Jeffry Rosenblatt NEVADA ALTERNATIVE SOLUTIONS, INC. LV Harley-Davidson & Red Rock Harley-Davidson Controller Certification Date: 8/1/1996 LAS VEGAS HARLEY DAVIDSON Charles R Nort 2605 South Eastern Avenue, Ste 100 9506 West Flamingo Rd Suite 102 Las Vegas NV 89169 Las Vegas NV 89147 (702) 431-8500 ext 103 (702) 796-1333 ext 228 Henderson Harley-Davidson, Inc. 9/1/2002

376 SOUTHERN NEVADA HEALTH DISTRICT Susan Damitz SIERRA NEVADA ADMINISTRATORS Human Resources Analyst Certification Date: 7/1/2005 SOUTHERN NEVADA HEALTH DISTRICT Michele Taylor P O Box 3902 2716 N. Tenaya Way, 5th FL Las Vegas NV 89127 Las Vegas NV 89114-5750 (702) 759-1106 (702) 240-8935

263 SOUTHERN NEVADA TBA SUPPLY COMPANY INC Brenda Martz CANNON COCHRAN MANAGEMENT TED WIENS TIRE & AUTO HR Manager SERVICES (CCMSI) Certification Date: 3/1/1996 TED WIENS TIRE & AUTO Brigid Wyszomirski 1701 Las Vegas Blvd South PO BOX 35350 Las Vegas NV 89104 Las Vegas NV 89133-5350 (702) 732-2382 ext 139 (702) 933-4800

39 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

208 SOUTHWEST AIRLINES CO Patti Colwell SEDGWICK CLAIMS MANAGEMENT Manager, Workers Compensation SERVICES, INC. Certification Date: 3/1/1994 SOUTHWEST AIRLINES CO Janet Machado 2702 Love Field Dr. P O Box 34660 Dallas TX 75235 Las Vegas NV 89133 (214) 792-6462 (888)713-1112ex83828

92 SOUTHWEST GAS CORPORATION Carol Richards SOUTHWEST GAS CORPORATION Supervisor Workers' Comp & Insuran ce Certification Date: 7/1/1988 SOUTHWEST GAS CORPORATION Donna Dynek, Workers Comp PO Box 98510 5241 Spring Mountain Rd/Box 98510 Las Vegas NV 89193-8510 Las Vegas NV 89193-8510 (702) 364-3025 (800)277-7074

42 SPARKS NUGGET INC Larry Harvey NEVADA ALTERNATIVE SOLUTIONS, INC. Exec VP-HR & Risk Mgmt Certification Date: 10/1/1981 SPARKS NUGGET INC Charles R Nort 1100 Nugget Ave 9506 West Flamingo Rd Suite 102 Sparks NV 89431 Las Vegas NV 89147 (775) 356-3397 (702) 796-1333 ext 228 Double J.A. Land & Livestock CompanyAscuaga's Cattle Co. 12/1/1993

396 STATION CASINOS LLC Tim Cameron YORK CLAIM SERVICES FORMERLY Corp Director Risk Management MEDCOMP Certification Date: 6/14/2011 STATION CASINOS Yvette Bouldin 1505 S. Pavilion Center Drive 9085 W Post Road #100 Las Vegas NV 89135 Las Vegas NV 89148 (702) 495-3476 (702) 727-2161

40 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

384 SUN CITY ELECTRIC INC Andrea Gould SUN CITY ELECTRIC INC Risk Manager Certification Date: 8/18/2003 SUN CITY ELECTRIC INC C/O SEASORE HOLDING Andrea Gould S 1220 S Commerce Street #120 1220 S Commerce St Ste 120 Las Vegas NV 89102 Las Vegas NV 89102 (702) 220-5621 (702) 220-5621 Focus Plumbing, LLC 6/1/2009 Focus Concrete, LLC 1/1/2010 Floor Designs of Nevada LLC 10/1/2005 Focus Electric, LLC 6/1/2009 Green Image, LLCG T I 2/1/2011

125 TARGET CORPORATION (TARGET STORES) Judy Essen SEDGWICK CLAIMS MANAGEMENT Consultant - Risk Consulting SERVICES, INC. Certification Date: 2/1/1992 AON Global RISK CONSULTING C/O TARGET Janet Machado 5600 W. 83rd Street, Suite 1100 P O Box 34660 Minneapolis MN 55437 Las Vegas NV 89133 (952) 807-0637 (888)713-1112ex83828

330 THE COCA-COLA COMPANY AND/OR COCA-COLA REF Lawanda Hall SEDGWICK CLAIMS MANAGEMENT Principle Risk Analyst SERVICES, INC. Certification Date: 1/1/1998 THE COCA-COLA COMPANY Janet Machado One Coca-Cola Plaza P O Box 34660 Atlanta GA 30313 Las Vegas NV 89133 (404) 676-7494 (888)713-1112ex83828 BCI Coca-Cola Bottling Co of Los AngeleCoca-Cola Bottling Co of Las Veg 1/1/1998 Coca-Cola Refreshments USA, Inc. 10/2/2010

41 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

124 TITANIUM METALS CORP OF AMERICA Adam Bleifer YORK CLAIM SERVICES FORMERLY TIMET NA Assistant Controller MEDCOMP Certification Date: 1/1/1992 TIMET Yvette Bouldin 224 Valley Creek Blvd., Suite 200 9085 W Post Road #100 Exton PA 19341 Las Vegas NV 89148 (610) 968-1327 (702) 727-2161 TiPro 10/1/1997 Titanium Hearth Technologies 1/1/1997

392 TREASURE ISLAND LLC Gayle Kurokawa YORK CLAIM SERVICES FORMERLY V/P Human Resources MEDCOMP Certification Date: 8/1/2009 TREASURE ISLAND LLC Yvette Bouldin 3300 Las Vegas Blvd South 9085 W Post Road #100 Las Vegas NV 89109 Las Vegas NV 89148 (702) 894-7506 (702) 727-2161

395 TROPICANA LAS VEGAS HOTEL & CASINO Joanne M Beckett NEVADA ALTERNATIVE SOLUTIONS, INC. TROPICANA LAS VEGAS, INC. VP & Gen. Counsel Certification Date: 12/2/2010 TROPICANA LAS VEGAS, INC Charles R Nort 3801 Las Vegas Blvd South 9506 West Flamingo Rd Suite 102 Las Vegas NV 89109 Las Vegas NV 89147 (702)739-3530 (702) 796-1333 ext 228 Tropicana Las Vegas Intermediate Holdin 12/2/2010 Armenco Holdings LLC 12/2/2010 Trilliant Management LP 12/2/2010

42 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

299 TRUE BLUE INC April Smith ESIS, INC. FORMERLY LABOR READY INC Associate Financial/Insurance Coordi nator Certification Date: 12/1/1996 LABOR READY INC Randy Barclay PO Box 2910 6935 Aliante Pkwy Ste 104-411 Tacoma WA 98401 Las Vegas NV 89084 (800) 610-8920 x 8498 (702)731-1510 Labor Ready Southwest, Inc. 1/1/1999 Labor Ready Northwest, Inc. 8/28/1998

168 U S FOODS INC Dena Abdallah GALLAGHER BASSETT SERVICES, INC. FKA US Foodservice Inc Director-Risk Management Certification Date: 4/1/1993 U S FOODS Charles Rostad 9399 W. Higgins Road 2110 East Flamingo Rd #314 Rosemont IL 60018 Las Vegas NV 89119-0834 (847) 720-1689 (866)-889-4755 Harrison's Prime Meats & Provisions 3/1/1997 Outwest Meat Company 4/1/1998

73 UNITED AIR LINES INC Kevin Mitchell GALLAGHER BASSETT SERVICES, INC. Sr. Risk Analyst, Corp. Ins. Certification Date: 3/1/1985 UNITED AIRLINES INC Charles Rostad 77 W. Wacker Drive 2110 East Flamingo Rd #314 Chicago IL 60601 Las Vegas NV 89119-0834 (312) 997-7641 (866)-889-4755

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116 VIAD CORP Terry Crull NEVADA ALTERNATIVE SOLUTIONS, INC. Sr. Vice President-Willis of AZ Certification Date: 7/1/1991 WILLIS CORROON CORP FOR VIAD CORP Charles R Nort 16220 N. Scottsdale Rd. #600 9506 West Flamingo Rd Suite 102 Scottsdale AZ 85254 Las Vegas NV 89147 (602) 787-6040 (702) 796-1333 ext 228 Shows Unlimited, Inc. 1/1/1997 Restaura, Inc. 10/10/1995 GES Exposition Services, Inc. 7/1/1991 Game Financial Corporation 4/1/1998 Giltspur, Inc. 3/1/1996

36 WASHOE COUNTY Celeste Wallick CANNON COCHRAN MANAGEMENT Risk Management Analyst SERVICES (CCMSI) Certification Date: 7/1/1981 WASHOE COUNTY Brigid Wyszomirski PO Box 11130 P O BOX 20068 Reno NV 89520 Reno NV 89515-0068 (775) 328-2074 (775) 324-3301 x 1011

37 WASHOE COUNTY SCHOOL DISTRICT Jackie James CANNON COCHRAN MANAGEMENT Sr. Risk Mgt Analyst SERVICES (CCMSI) Certification Date: 7/1/1986 WASHOE COUNTY SCHOOL DISTRICT Brigid Wyszomirski PO Box 30425 P O BOX 20068 Reno NV 89520 Reno NV 89515-0068 (775) 348-3854 (775) 324-3301 x 1011 Hot Lunch Progam 7/1/1987

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370 WENDOVER CASINOS INC Michael Heward HOMETOWN HEALTH PARTNERS INC MONTEGO BAY CASINO & RESORT Director of Risk Management Certification Date: 12/19/2002 Peppermill Casinos Inc for Wendover Casinos Michele Chapman 380 Brinby Ave, Suite B 830 Harvard Way Reno NV 89509 Reno NV 89502 (775) 689-8992 (775) 982-3049 PPLLC 12/19/2002

365 WESTERN CAB COMPANY INC Martha A Sarver R. A. WONG & ASSOCIATES General Manager Certification Date: 9/1/2001 WESTERN CAB CO Paul Wong 801 South Main Street 5110 S Valley View Blvd, Suite 100 Las Vegas NV 89101 Las Vegas NV 89118 (702) 382-7100 (702)798-8910

246 WESTERN STATES CONTRACTING INC Troy Shiozawa WESTERN STATES CONTRACTING INC Risk Manager Certification Date: 9/1/1995 WESTERN STATES CONTRACTING INC Troy Shiozawa, Asst Controller 4129 W Cheyenne Suite B 2810 North Nellis Blvd North Las Vegas NV 89032 Las Vegas NV 89115 (702)336-4656 (702) 326-9374 BDF Employment Services LLC 1/15/2013 WS-Dynoco Petroleum Management LLCWesley's 1/15/2013 Tejas Underground LLC 5/1/1998

45 C of A # Employer Name/DBA Self-Insured Contact Third Party Administrator Subsidiary DBA Eff. Date

94 WEYERHAEUSER COMPANY Lisa Wysocki SPECIALTY RISK SERVICES LLC (SRS) Self-Insurance Administrator Certification Date: 1/1/1989 WEYERHAEUSER COMPANY Lara Borel P O Box 9777 CH3K33 P O Box 95518 Federal Way WA 98063-9777 Las Vegas NV 89193-5518 (253) 924-7471 (702) 387-8006 Weyerhaeuser NR Company 1/1/2009 Pardee Homes of Nevada 1/1/1989 Pardee Homes 1/1/1989

70 YOUNG ELECTRIC SIGN COMPANY Clark Smith NEVADA ALTERNATIVE SOLUTIONS, INC. Director of Finance/Treasurer Certification Date: 7/1/1984 YOUNG ELECTRIC SIGN COMPANY Charles R Nort 2401 Foothill Drive 9506 West Flamingo Rd Suite 102 Salt Lake City UT 84109 Las Vegas NV 89147 (801) 464-4600 (702) 796-1333 ext 228 YESCO Outdoor Media LLC 1/1/2008 YESCO Administration LLc 1/1/2008 YESCO Electronics LLC 1/1/2008 YESCO LLC 1/1/2008

79 YRC INC Becci McMahon GALLAGHER BASSETT SERVICES, INC. YRC Freight Senior Risk Analyst Certification Date: 5/1/1986 YRC WORLDWIDE INC Charles Rostad 10990 Roe Avenue, MS A305 2110 East Flamingo Rd #314 Overland Park KS 66211-1213 Las Vegas NV 89119-0834 (913) 696-6107 (866)-889-4755

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