Date: 01/04/2021 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLST Time: 10:07 CARRIER LISTING Page: 1 TYPE: OWN RISK Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address 0083 C 4 STAR TRAILERS INC (OWN RISK) 0001 C AAON INC (OWN RISK) C/O INSURICA CLAIM MGMT - WAYNE OSMOND ATTN: NATALY KADDOURA PO BOX 25928 2425 S YUKON AVE OKLAHOMA CITY, OK 73125- TULSA, OK 74107-2728 0002 C ABF FREIGHT SYSTEM INC (OWN RISK) 0003 C ACME ENGINEERING & MANUFACTURING CORP (OWN RISK) ATTN: RACHELLE PRATT C/O CONSOLIDATED BENEFITS RESOURCES PO BOX 10048 ATTN: RICHARD FISHER FT SMITH, AR 72917-0048 PO BOX 581630 TULSA, OK 74158-1630 1340 C AHS HILLCREST HEALTHCARE SYSTEM LLC ( OWN RISK) 0008 S ALLIANCE STEEL INC (OWN RISK #18746) ATTN: SONYA WILBURN C/O RMS CLAIMS & RISK SERVICES - BEN ANDERSON ONE BURTON HILLS BLVD STE 250 PO BOX 21450 NASHVILLE, TN 37215- OKLAHOMA CITY, OK 73120- 0009 C ALLIED STEEL CONSTRUCTION CO LLC (OWN RISK) 1177 S AMERICAN ELECTRIC POWER CO (OWN RISK) C/O RMS CLAIMS & RISK SERVICES - SANDY CASSADY C/O CCMSI - MISTY JONES PO BOX 21450 1501 N UNIVERSITY AVE STE 767 OKLAHOMA CITY, OK 73156- LITTLE ROCK, AR 72207-5238 1329 S AMERICAN WASTE CONTROL INC (OWN RISK #19614) 0013 C AMITY CARE LLC (OWN RISK) CONSOLIDATED BENEFITS RESOURCES - R FISEHR ATTN: MICHAEL DEYONG PO BOX 581630 4350 WILL ROGERS PKWY STE 300 TULSA, OK 74158-1630 OKLAHOMA CITY, OK 73108- 0015 C ARCHDIOCESE OF OKLAHOMA CITY (OWN RISK) 1644 S ASCENSION HEALTH ALLIANCE (OWN RISK) SEDGWICK CLAIMS MGNT SERVICES - JHONNA GHRIGSBY C/O SEDGWICK CMS 131 SAUNDERVILLE RD STE 220 ATTN: MICHAEL BROWNING HENDERSONVILLE, TN 37075- 111 WESTPORT PLAZA DR STE 900 ST LOUIS, MO 63146- * Inv Flag 'S' indicates Service Company, 'C' indicates Corporate Date: 01/04/2021 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLST Time: 10:07 CARRIER LISTING Page: 2 TYPE: OWN RISK Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address 0019 S ASSOCIATED WHOLESALE GROCERS INC (OWN RISK) 0022 C BAMA COMPANIES INC (OWN RISK #14563) C/O SEDGWICK CMS - MERISSA RIOS UNITED SAFETY & CLAIMS - CHALI STEVENS 6100 TENNYSON PKWY SUITE 230 PO BOX 471647 PLANO, TX 75024- TULSA, OK 74147-1647 1611 S BANCFIRST CORP (OWN RISK #20060) 0023 S BAPTIST GENERAL CONVENTION OF OKLAHOMA (OWN RISK) C/O RMS CLAIMS & RISK SERVICES - VERN STONECIPHER CONSOLIDATED BENEFITS RESOURCES - R FISHER PO BOX 21450 PO BOX 581630 OKLAHOMA CITY, OK 73156- TULSA, OK 74158-1630 1246 C BECCO CONTRACTORS INC (OWN RISK) 0026 S BELGER CARTAGE SERVICE INC (OWN RISK) CONSOLIDATED BENEFITS RESOURCES - R FISHER SMARTCASUALTYCLAIMS PO BOX 581630 ATTN: JENE HUCKABAY TULSA, OK 74158- PO BOX 42048 OKLAHOMA CITY, OK 73134- 1793 S BEN E KEITH COMPANY (OWN RISK) 1279 S BENNETT STEEL INC (OWN RISK) C/O TERRY M KOLLMORGEN GALLAGHER BASSETT SERVICES - STACY KARBS 401 S BOSTON AVE STE 1100 14000 QUAIL SPRINGS PARKWAY STE 3000 TULSA, OK 74103- OKLAHOMA CITY, OK 73134- 0028 S BILLINGS FAIRCHILD CENTER INC (OWN RISK) 0033 C BRAUMS INC (OWN RISK) CONSOLIDATED BENEFITS RESOURCES - R FISHER ATTN: STEVE VANARSDEL PO BOX 581630 3000 NE 63 ST TULSA, OK 74158- OKLAHOMA CITY, OK 73121- 0035 S BROKEN ARROW PUBLIC SCHOOLS (OWN RISK #18680) 0036 S BRUNSWICK CORP (OWN RISK) CONSOLIDATED BENEFITS RESOURCES - R FISHER C/O ESIS - JENNIFER HARDEMAN PO BOX 581630 PO BOX 6563 TULSA, OK 74158-1630 SCRANTON, PA 18505-6563 * Inv Flag 'S' indicates Service Company, 'C' indicates Corporate Date: 01/04/2021 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLST Time: 10:07 CARRIER LISTING Page: 3 TYPE: OWN RISK Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address 0045 C CHEVRON USA INC (OWN RISK #16347) 0004 S CITY OF ADA (OWN RISK) C/O BROADSPIRE SERVICES INC - EMMA WILLIAMS C/O UNITED SAFETY & CLAIMS - CHALI STEVENS PO BOX 14351 PO BOX 471647 LEXINGTON, KY 40512- TULSA, OK 74147-1647 0016 C CITY OF ARDMORE (OWN RISK) 0024 C CITY OF BARTLESVILLE (OWN RISK) C/O RMS CLAIMS & RISK SERVICES - BEN ANDERSON CONSOLIDATED BENEFITS RESOURCES- R FISHER PO BOX 21450 PO BOX 581630 OKLAHOMA CITY, OK 73156- TULSA, OK 74158-1630 0034 S CITY OF BROKEN ARROW (OWN RISK #14157) 1620 S CITY OF CLAREMORE (OWN RISK) CONSOLIDATED BENEFITS RESOURCES - R FISHER C/O UNITED SAFETY & CLAIMS - JEFF MORRISON PO BOX 581630 PO BOX 471647 TULSA, OK 74158-1630 TULSA, OK 74147- 0061 S CITY OF DEL CITY (OWN RISK) 0066 S CITY OF DUNCAN (OWN RISK #11051) ATTN: MADONNA SANDERS C/O RISK MANAGEMENT SERV INC - BEN ANDERSON 3701 SE 15TH PO BOX 21450 DEL CITY, OK 73115- OKLAHOMA CITY, OK 73156- 0068 C CITY OF DURANT (OWN RISK) 0071 S CITY OF EDMOND (OWN RISK #14514) C/O BARNUM & CLINTON PLLC - CATHY C BARNUM C/O CCMSI 1011 24TH AVE NW ATTN: LASHAWNA SEARS NORMAN, OK 73069- 1501 N UNIVERSITY STE 767 LITTLE ROCK, AR 72207- 0072 S CITY OF EL RENO (OWN RISK) 0075 S CITY OF ENID (OWN RISK) C/O SMARTCASUALTYCLAIMS ATTN: CAROL LAHMAN ATTN: JENE HUCKABAY PO BOX 1768 PO BOX 42048 ENID, OK 73702- OKLAHOMA CITY, OK 73123- * Inv Flag 'S' indicates Service Company, 'C' indicates Corporate Date: 01/04/2021 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLST Time: 10:07 CARRIER LISTING Page: 4 TYPE: OWN RISK Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address 0129 S CITY OF LAWTON (OWN RISK) 0145 S CITY OF MCALESTER (OWN RISK) C/O UNITED SAFETY & CLAIMS - CHALI STEVENS CONSOLIDATED BENEFITS SOLUTIONS - R FISHER PO BOX 471647 PO BOX 581630 TULSA, OK 74147-1647 TULSA, OK 74158-1630 0665 C CITY OF MIAMI (OWN RISK) 0149 C CITY OF MIDWEST CITY (OWN RISK #13308) CONSOLIDATED BENEFITS RESOURCES - R FISHER CONSOLIDATED BENEFITS RESOURCES - R FISHER PO BOX 58160 PO BOX 581630 TULSA, OK 74158-1630 TULSA, OK 74158-1630 0152 S CITY OF MOORE (OWN RISK) 0156 S CITY OF MUSKOGEE (OWN RISK) C/O CONSOLIDATED BENEFITS RESOURCES C/O UNITED SAFETY & CLAIMS - JEFF MORRISON ATTN: RICHARD FISHER PO BOX 471647 PO BOX 581630 TULSA, OK 74147- TULSA, OK 74158-1630 0158 C CITY OF MUSTANG (OWN RISK) 0161 C CITY OF NORMAN (OWN RISK) SMARTCASUALTYCLAIMS - JENE HUCKABAY ATTN: KATHRYN WALKER PO BOX 42048 PO BOX 370 OKLAHOMA CITY, OK 73123- NORMAN, OK 73070- 0164 C CITY OF OKLAHOMA CITY (OWN RISK) 0175 S CITY OF OWASSO (OWN RISK) C/O CITY OF OKC RISK MGMT DIVISION C/O UNITED SAFETY & CLAIMS - ROD RANDALL ATTN: LA VETA BREATH PO BOX 471647 420 W MAIN ST STE 630 TULSA, OK 74147-1647 OKLAHOMA CITY, OK 73102- 0180 S CITY OF PONCA CITY (OWN RISK) 0190 C CITY OF SHAWNEE (OWN RISK) UNITED SAFETY & CLAIMS - JANET KNOERNSCHILD CONSOLIDATED BENEFITS RESOURCES - R FISHER PO BOX 471647 PO BOX 581630 TULSA, OK 74147-1647 TULSA, OK 74158- * Inv Flag 'S' indicates Service Company, 'C' indicates Corporate Date: 01/04/2021 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLST Time: 10:07 CARRIER LISTING Page: 5 TYPE: OWN RISK Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address 0208 S CITY OF STILLWATER (OWN RISK #11364) 0213 C CITY OF TULSA (OWN RISK #10435) CONSOLIDATED BENEFITS RESOURCES - R FISHER C/O BRANDON DODD PO BOX 581630 175 E 2 ST STE 1450 TULSA, OK 74158-1630 TULSA, OK 74127- 0057 S COF AGGREGATE HOLDINGS INC FKA CUST O FAB INC (OWN 0048 S COMANCHE COUNTY MEMORIAL HOSPITAL (OWN RISK) CONSOLIDATED BENEFITS RESOURCES - R FISHER C/O SMARTCASUALTYCLAIMS PO BOX 581630 ATTN: JENE HUCKABAY TULSA, OK 74158- PO BOX 42048 OKLAHOMA CITY, OK 73123- 0056 C CUMMINS CONSTRUCTION CO INC (OWN RISK) 0063 C DOLESE BROS CO (OWN RISK) CONSOLIDATED BENEFITS RESOURCES - F FISHER C/O CONSOLIDATED BENE RES - JERRY WHORTON PO BOX 581630 PO BOX 581630 TULSA, OK 74158-1630 TULSA, OK 74158- 0064 C DOLLAR GENERAL CORP (OWN RISK) 1354 C DUNCAN REGIONAL HOSPITAL INC (OWN RISK) ATTN: MICHELLE HUGHES C/O UNITED SAFETY & CLAIMS - CHALI STEVENS PO BOX 1728 PO BOX 471647 GOODLETTSVILLE, TN 37070-1728 TULSA, OK 74147- 1738 S EJ AMERICAS LLC (OWN RISK #19189) 1362 C EVANS & ASSOCIATES ENTERPRISES INC (OWN RISK #1972 C/O THE ASU GROUP - CHAD JOHNSON EVANS & ASSOCIATES ENTERPRISES INC - BRAD FOX PO BOX 77 PO BOX 30 OKEMOS, MI 48805- PONCA CITY, OK 74602- 0077 C FEDERAL EXPRESS CORP (OWN RISK) 0011 C FEDEX FREIGHT INC (OWN RISK #16728) C T CORPORATION C/O SEDGWICK CMS - ANTHONY CHAPPELL 1833 S MORGAN RD PO BOX 14499 OKLAHOMA CITY, OK 73128- LEXINGTON, KY 40512-4499 * Inv Flag 'S' indicates Service Company, 'C' indicates Corporate Date: 01/04/2021 OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS Rpt ID: CARLST Time: 10:07 CARRIER LISTING Page: 6 TYPE: OWN RISK Carrier ID Inv Flag Carrier Name/Service Agent Name & Address Carrier ID Inv Flag Carrier Name/Service Agent Name & Address 1134 C FEDEX GROUND PACKAGE SYSTEM INC (OWN RISK) 0084 S FRANKLIN ELECTRIC CO INC (OWN RISK) C/O SEDGWICK CLAIMS MANAGEMENT SERVICES INC C/O HELMSMAN MGMT SERV INC -MATT SEKULA ATTN: LATRICE HAYES 175 BERKELEY STREET PLAZA OF AMERICAS 600 N PEARL ST STE 1200 BOSTON, MA 02116- DALLAS, TX 75201- 1922 C GGP PARKS LLC 0091 C GOODYEAR TIRE & RUBBER CO (OWN RISK) ATTN: WILLIAM STAVA III C/O HELMSMAN MGMT SERV LLC - MATT SEKULA 7030 S YALE AVE STE 600 175 BERKELEY ST TULSA, OK 74136- BOSTON, MA 02116- 0092 C GRADY MEMORIAL HOSPITAL (OWN RISK) 1601 S HAC INC (OWN RISK #20023) C/O SMARTCASUALTYCLAIMS THE CORPORATION