Individual Self-Insured Employer List

Page: 1Program: names2.frxPrint Date:

Print Time:

12/01/2003

09:09:35

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

A B C Beverage Management, Inc.

400 N. Wolf RoadNorthlake, IL 60164

Mr. Robert B. Lydon

Frank Gates Service Company20002344Self-Insured ID:

A B F Freight System, Inc.

3801 Old Greenwood RoadP.O. Box 10048Fort Smith, AR 72917-0048

Mr. Stan McDaniel

Self-Administered42090248Self-Insured ID:

A B M Lakeside, Inc.

180 North La SalleChicago, IL 60601

Ms. Marian Nussbaumer

Cambridge Integrated Services Group, Inc.30057710Self-Insured ID:

A C O, Inc.

23333 Commerce DriveFarmington Hills, MI 48335-2764

Mr. David Gronbach

Citizens Management Inc.53093406Self-Insured ID:

A D Transport Express, Inc.

5601 Belleville RoadCanton, MI 48188

Mr. William S. Ruschak

Meadowbrook, Inc., dba Meadowbrook Claims Service42091119Self-Insured ID:

A J M Packaging Corporation

Suite 100E-4111 Andover RoadBloomfield Hills, MI 48302

Mr. Robert A. Epstein

Citizens Management Inc.26022282Self-Insured ID:

A S C, Inc.

14925 W. 11 Mile RoadOak Park, MI 48237

Ms. Rhonda Cougan

Citizens Management Inc.55097993Self-Insured ID:

A T & T Corporation

c/o Aon Consulting, Inc.270 Davidson Avenue, Room 8B03Somerset, NJ 08873

Ms. Deborah Beatty

Broadspire Services, Inc.48091397Self-Insured ID:

A Z Automotive Corp.

23745 Mound Rd.Warren, MI 48091

Mr. Daniel Pierce

CompOne Administrators, Inc.34002210Self-Insured ID:

ADAC Plastics, Inc.

5920 Tahoe Dr.P.O. Box 888375Grand Rapids, MI 49588-8375

Mr. Jim Green

Citizens Management Inc.30043041Self-Insured ID:

Abraham, S., & Sons Inc.

P.O. Box 17684001 Three Mile Road NWGrand Rapids, MI 49501-1768

Mr. Keith Anderson

Eagle Claims Management, LLC59063737Self-Insured ID:

Advance Packaging Corporation

4450 - 36th Street, S.E.Grand Rapids, MI 49512-1996

Ms. Janice F. Henry

Citizens Management Inc.26041562Self-Insured ID:

Alken Ziegler, Inc.

406 S. ParkKalkaska, MI 49646

Mr. Jeff Larson

Eagle Claims Management, LLC34007472Self-Insured ID:

Allegan County

113 Chestnut StreetAllegan, MI 49010

Mr. David B. Van de Roovaart

Citizens Management Inc.

Board of Commissioners

99900203Self-Insured ID:

Allied Mechanical Services, Inc.

2211 Miller RoadKalamazoo, MI 49001

Mr. Daniel Huizinga

Citizens Management Inc.17091550Self-Insured ID:

Alpena General Hospital

1501 W. Chisholm St.Alpena, MI 49707

Mr. Damone D. Sorensen

Michigan Health & Hospital Association Service Corp.80000804Self-Insured ID:

Individual Self-Insured Employer List

Page: 2Program: names2.frxPrint Date:

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Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Alro Steel Corporation

3100 E. High StreetP.O. Box 927Jackson, MI 49204-0927

Mr. Norris E. Hornbeck

Constitution State Services LLC33047766Self-Insured ID:

Alticor Inc.

7575 Fulton Street EastMail Code: 56-3SAda, MI 49355-0001

Mr. Paul Rutowski

Self-Administered59090441Self-Insured ID:

American National Red Cross

5th. Floor8111 Gatehouse RoadFalls Church, VA 22042

Ms. Jean Matthews

Gates, McDonald & Co.80001585Self-Insured ID:

American Plastic Toys, Inc.

799 Ladd RoadWalled Lake, MI 48390

Mr. Dale M. Polewach

Comprehensive Risk Services, Inc.29018264Self-Insured ID:

Amsted Industries, Incorporated

44th. Floor205 N. Michigan AvenueChicago, IL 60601

Ms. Rita Dieden

Self-Administered33000814Self-Insured ID:

Andersons, Inc., The

480 W. Dussel DriveP.O. Box 119Maumee, OH 43537

Ms. Mary L. Stacy

Self-Administered07032385Self-Insured ID:

Andrews University

Administration BuildingHuman ResourcesBerrien Springs, MI 49104-0840

Mr. Dan Agnetta

Cambridge Integrated Services Group, Inc.82000011Self-Insured ID:

Ann Arbor , City of

100 N. Fifth AvenueP.O. Box 8647Ann Arbor, MI 48107-8647

Mr. James Armstrong

Crawford & Company99900181Self-Insured ID:

Ann Arbor Public Schools

2555 S. State StreetAnn Arbor, MI 48104

Mr. Garry Doolittle

RSKCo Services, Inc.82000181Self-Insured ID:

Applegate Heating & Air Conditioning, Inc.

485 East South StreetJackson, MI 49203

Mr. Garry Applegate

Citizens Management Inc.17053158Self-Insured ID:

Arrow Uniform Rental Limited Partnership

6400 Monroe BoulevardTaylor, MI 48180

Mr. Kevin Dunivin

RSKCo Services, Inc.72011980Self-Insured ID:

ArvinMeritor, Inc.

444 Hebron RoadHeath, OH 43056

Ms. Janice DeHart

RSKCo Services, Inc.37090462Self-Insured ID:

Ascension Health

11775 Borman - Suite 300St. Louis, MO 63146-4134

Ms. Suzann Bylund

Sedgwick Claims Management Services, Inc.80000101Self-Insured ID:

Auto Pallets - Boxes, Inc. et al.

28000 Southfield RoadLathrup Village, MI 48076

Mr. Greg Van Dorn

Accident Fund Insurance Company of America26035325Self-Insured ID:

Auto-Wares, Inc.

440 Kirtland S.W.Grand Rapids, MI 49507

Mr. Gregory D. Hinkle

Citizens Management Inc.50018741Self-Insured ID:

Awrey Bakeries, Inc.

12301 Farmington RoadLivonia, MI 48150

Mr. Glenn A. Korzyn

Comprehensive Risk Services, Inc.20067875Self-Insured ID:

Balkema Excavating, Inc.

5300 Miller RoadKalamazoo, MI 49048

Mr. Clarence Batts

Eagle Claims Management, LLC17007112Self-Insured ID:

Individual Self-Insured Employer List

Page: 3Program: names2.frxPrint Date:

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Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Barry, County of

220 W. State StreetHastings, MI 49058

Mr. Michael Brown

Cambridge Integrated Services Group, Inc.99900008Self-Insured ID:

Battle Creek , City of

10 N. Division StreetBattle Creek, MI 49014

Mr. Kenneth L. Bell

Cambridge Integrated Services Group, Inc.99900113Self-Insured ID:

Battle Creek,School Dist. of the City of

3 W. Van Buren StreetBattle Creek, MI 49017

Mr. David A. Disler

Gallagher Bassett Services, Inc.82000513Self-Insured ID:

Bay City , City of

Room 305301 Washington AvenueBay City, MI 48708

Mr. Dale R. Berglund

RSKCo Services, Inc.99900209Self-Insured ID:

Bay City Public Schools

910 N. Walnut StreetBay City, MI 48706

Mr. Douglas L. Newcombe, CPA

Cambridge Integrated Services Group, Inc.82000309Self-Insured ID:

Bay County

515 Center AvenueBay City, MI 48708

Mr. Michael J. Regulski

Cambridge Integrated Services Group, Inc.99900009Self-Insured ID:

Bay County Road Commission

2600 E. Beaver RoadKawkawlin, MI 48631

Mr. Clarke Foco

Cambridge Integrated Services Group, Inc.99900109Self-Insured ID:

Bay Metro. Transportation Authority

1510 N. Johnson StreetBay City, MI 48708

Mr. Michael R. Stoner

Cambridge Integrated Services Group, Inc.99022009Self-Insured ID:

Beaumont, William, Hospital

William Beaumont Hospital / FSC3601 W. 13 Mile RoadRoyal Oak, MI 48073

Mr. Joseph B. Boivin

Michigan Health & Hospital Association Service Corp.80000882Self-Insured ID:

Benteler Automotive Corporation

1780 Pond RunAuburn Hills, MI 48306

Mr. Mark Schmink

Chubb Services Corporation37058041Self-Insured ID:

Berrien, County of

Berrien County Administration701 Main StreetSt. Joseph, MI 49085

Mr. John M. Henry

RSKCo Services, Inc.99900011Self-Insured ID:

Besser Company

801 Johnson StreetAlpena, MI 49707

Ms. Juli Musch

Comprehensive Risk Services, Inc.14010942Self-Insured ID:

Birds Eye Foods, Inc.

90 Linden OaksRochester, NY 14625

Ms. Karen L. Gruendike

RSKCo Services, Inc.20091500Self-Insured ID:

Birmingham, School Dist. of the City of

550 W. Merrill StreetBirmingham, MI 48009

Dr. E. Rhusha Scales

RSKCo Services, Inc.82000563Self-Insured ID:

Bissell, Inc.

2345 Walker Avenue, N.W.Walker, MI 49544

Mr. William J. Brennan

Citizens Management Inc.35028220Self-Insured ID:

Black & Decker Corporation, The

TW 230701 E. Joppa RoadTowson, MD 21286

Mr. M. Clayton Roop

Specialty Risk Services, Inc.34007885Self-Insured ID:

Blissfield Manufacturing Company

626 Depot StreetBlissfield, MI 49228

Mr. Gregory A. Hendel

Gates, McDonald & Co.39036455Self-Insured ID:

Bloomfield Hills School District

4175 Andover RoadBloomfield Hills, MI 48302

Ms. Shelly Holliday

Accident Fund Insurance Company of America82000463Self-Insured ID:

Individual Self-Insured Employer List

Page: 4Program: names2.frxPrint Date:

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09:09:35

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Blue Cross Blue Shield of Michigan

600 Lafayette EastMail Code 0128Detroit, MI 48226

Ms. Lynn Howe

Accident Fund Insurance Company of America80012082Self-Insured ID:

Bon Secours Cottage Health Services, Inc.

468 Cadieux RoadGrosse Pointe, MI 48230

Mr. Nicholas Vitale

J.P. Bender & Associates, Inc.80000231Self-Insured ID:

Bopp-Busch Manufacturing Company

545 E. HuronP.O. Box 589Au Gres, MI 48703

Mr. Robert A. Busch

RSKCo Services, Inc.34023820Self-Insured ID:

Bouma Corporation, The

4101 Roger B. Chaffee Memorial Blvd. SEGrand Rapids, MI 49548

Mr. Daniel DeRyke

Citizens Management Inc.25042660Self-Insured ID:

Boyne USA, Inc.

Boyne Mountain RoadP.O. Box 19Boyne Falls, MI 49713

Mr. Edward Dembek

Accident Fund Insurance Company of America70087534Self-Insured ID:

Brazeway, Inc.

2711 E. Maumee StreetP.O. Box 749Adrian, MI 49221

Mr. Terry Sheehan

Cambridge Integrated Services Group, Inc.35090022Self-Insured ID:

Bronson Healthcare Group, Inc.

One Healthcare PlazaKalamazoo, MI 49007

Ms. Susan Ulshafer

Michigan Health & Hospital Association Service Corp.80000839Self-Insured ID:

Brown Corporation of Ionia, Inc.

401 S. Steele StreetIonia, MI 48846

Mr. Timothy J. Oeschger

Eagle Claims Management, LLC34023934Self-Insured ID:

Burr Oak Tool And Gauge Company, Inc.

405 W. South StreetSturgis, MI 49091

Mr. David L. Franks

Citizens Management Inc.35013675Self-Insured ID:

Cadillac Products, Inc.

5800 Crooks RoadTroy, MI 48098

Mr. Roger K. Williams

Citizens Management Inc.52000798Self-Insured ID:

Calhoun, County of

315 W. Green StreetMarshall, MI 49068

Ms. Shelly A. Lehmann

Cambridge Integrated Services Group, Inc.99900013Self-Insured ID:

Canton, Charter Township of

1150 S. Canton Center RoadCanton, MI 48188

Mr. Daniel G. Durack

RSKCo Services, Inc.99900001Self-Insured ID:

Capital Area Transportation Authority

4615 Tranter AvenueLansing, MI 48910

Ms. Patricia Holloway

RSKCo Services, Inc.41046543Self-Insured ID:

Carboloy Inc.

11177 East Eight Mile RoadWarren, MI 48089

Mr. Michael L. Neel

Alternative Service Concepts LLC35024850Self-Insured ID:

Cargill, Incorporated

P. O. Box 5612/ MS#12Minneapolis, MN 55440-5612

Mr. Brian Turnwall

Crawford & Company20024225Self-Insured ID:

Carman-Ainsworth Community Schools

G-3475 W. Court StreetFlint, MI 48532

Mr. Tony Skowronski

Accident Fund Insurance Company of America82000625Self-Insured ID:

Cascade Engineering, Inc.

5251 - 36th Street, S.E.Grand Rapids, MI 49508

Mr. Stephen M. Peterson

Eagle Claims Management, LLC30044567Self-Insured ID:

Individual Self-Insured Employer List

Page: 5Program: names2.frxPrint Date:

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09:09:36

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Cassens Corporation

145 North Kansas St.P.O. Box 468Edwardsville, IL 62025

Mr. William Molter

Crawford & Company42095685Self-Insured ID:

Cello-Foil Products, Inc.

155 Brook StreetBattle Creek, MI 49017

Mr. Terry A. McFall

Comprehensive Risk Services, Inc.27010033Self-Insured ID:

Center Line Public Schools

26400 Arsenal AvenueCenter Line, MI 48015

Ms. Mary Ann Blakely

Accident Fund Insurance Company of America82000050Self-Insured ID:

Central Distributors of Beer, Inc.

28100 Gorsuch AvenueRomulus, MI 48174

Mr. Kurt Gail

Citizens Management Inc.51017382Self-Insured ID:

Central Michigan University

Chip Facility South Grounds BuildingMt. Pleasant, MI 48859

Ms. Tammy Griffin

Eagle Claims Management, LLC82000037Self-Insured ID:

CertainTeed Corporation

750 E. Swedesford RoadValley Forge, PA 19482

Mr. Barry M. Kemper

ESIS, Inc.32066085Self-Insured ID:

Champion Bus, Inc.

419 West Pike StreetJackson Center, OH 45334

Mr. Walter Bennett

Cambridge Integrated Services Group, Inc.37009750Self-Insured ID:

Charlevoix, County of

203 Antrim StreetCharlevoix, MI 49720

Ms. Jane E. Brannon

Citizens Management Inc.99900015Self-Insured ID:

Chelsea Community Hospital

775 S. Main StreetChelsea, MI 48118-1399

Mr. Bruce Carty

Michigan Health & Hospital Association Service Corp.80000881Self-Insured ID:

Chelsea Milling Company

201 West North StreetChelsea, MI 48118

Mr. John Powers

Citizens Management Inc.20044114Self-Insured ID:

Cherry Growers, Inc.

6331 US 31 SouthP.O. Box 90Grawn, MI 49637

Mr. Thomas Denton

Citizens Management Inc.01066775Self-Insured ID:

Chippewa County War Memorial Hospital, Inc

500 Osborn BoulevardSault Ste. Marie, MI 49783

Ms. Betty Daniels

Michigan Health & Hospital Association Service Corp.80000317Self-Insured ID:

Chippewa Valley Schools

19120 CassClinton Township, MI 48038

Mr. James Gillette

Citizens Management Inc.82001250Self-Insured ID:

Clark Foundation Company

6851 Millett HighwayLansing, MI 48917

Mr. John Haglund

Mackinaw Administrators, LLC17034233Self-Insured ID:

Clark Retirement Community

1551 Franklin Street SEGrand Rapids, MI 49506-3331

Ms. Trisha A. Watkins

Eagle Claims Management, LLC80000341Self-Insured ID:

Clarkston Community Schools

6389 Clarkston RoadP.O. Box 1050Clarkston, MI 48347-1050

Mrs. Linda Nestor

Mackinaw Administrators, LLC82001163Self-Insured ID:

Clawson Tank Company

4545 Clawson Tank DriveClarkston, MI 48346

Ms. Tracy Lintz

Accident Fund Insurance Company of America34012163Self-Insured ID:

Cleveland-Cliffs Iron Company

1100 Superior AvenueCleveland, OH 44114-2589

Mr. Richard L. Bihn

Sedgwick Claims Management Services, Inc.10059318Self-Insured ID:

Individual Self-Insured Employer List

Page: 6Program: names2.frxPrint Date:

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09:09:36

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Clinton, Township of

40700 Romeo Plank RoadClinton Township, MI 48038

Mr. Frederick Wutzke

Citizens Management Inc.99900250Self-Insured ID:

Clintondale Community Schools

35100 Little MackClinton Township, MI 48035

Mr. Mitchell L. Ritter

Mackinaw Administrators, LLC82000550Self-Insured ID:

Coca-Cola Enterprises, Inc.

2500 Windy Ridge ParkwayP.O. Box 723040Atlanta, GA 31139-0040

Ms. Sylvia M. Johnson

Constitution State Services LLC20091685Self-Insured ID:

Cold Heading Company

21777 Hoover RoadWarren, MI 48089

Mr. Edward Miller

RTW, Inc. Michigan33033782Self-Insured ID:

Commercial Steel Treating Corporation

31440 Stephenson HighwayMadison Heights, MI 48071

Mr. Greg B. Schankin

Citizens Management Inc.33016001Self-Insured ID:

ConAgra Foods, Inc.

Suite 4008300 Norman Center DriveMinneapolis, MN 55437-3844

Ms. Linda J. Smith

Sedgwick Claims Management Services, Inc.20033685Self-Insured ID:

Consumers Energy Company

One Energy PlazaJackson, MI 49201

Mr. James E. Brunner

Self-Administered48092036Self-Insured ID:

Continental Plastics Company

33525 GroesbeckFraser, MI 48026

Ms. M. Victoria Thomas

Cambridge Integrated Services Group, Inc.30036163Self-Insured ID:

Contractors Steel Company

36555 Amrhein RoadP.O. Box 3364Livonia, MI 48151-3364

Mr. Donald R. Simon

Accident Fund Insurance Company of America50070854Self-Insured ID:

Cooper Industries, Inc.

P.O. Box 4446Houston, TX 77210

Mr. Walter E. Pliszka

Self-Administered37020785Self-Insured ID:

Costco Wholesale Corporation

999 Lake DriveIssaquah, WA 98027

Ms. Ann Loonam

Sedgwick Claims Management Services, Inc.53091300Self-Insured ID:

Covenant Medical Center, Inc.

1447 N. HarrisonSaginaw, MI 48602

Ms. Rebecca Schultz

Michigan Health & Hospital Association Service Corp.80000573Self-Insured ID:

Cranbrook Educational Community, Inc.

39221 N. Woodward AvenueP.O. Box 801Bloomfield Hills, MI 48303-0801

Ms. Beth Beadle

Accident Fund Insurance Company of America82003063Self-Insured ID:

Creative Foam Corporation

300 N. Alloy DriveFenton, MI 48430

Mr. Bruce G. Graham

Pro-Insurance Services, LLC30049025Self-Insured ID:

Crittenton Hospital

1101 W. University Dr.Rochester, MI 48307

Ms. Kathleen Gatz

Cambridge Integrated Services Group, Inc.

Crittenton Hospital Medical Center

80000263Self-Insured ID:

D & W Food Centers, Inc.

3001 Orchard Vista Dr., S.E.Grand Rapids, MI 49546

Mr. Floyd Wilson

Eagle Claims Management, LLC54044000Self-Insured ID:

D T E Energy Company

2000 Second Avenue, 1950 WCBDetroit, MI 48226

Mr. Stephen H. Meier

Self-Administered49090153Self-Insured ID:

DaimlerChrysler Corporation

(CIMS:485-07-26)1000 Chrysler DriveAuburn Hills, MI 48326-2766

Mr. August L. Biache

ESIS, Inc.37666000Self-Insured ID:

Individual Self-Insured Employer List

Page: 7Program: names2.frxPrint Date:

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Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Dana Corporation

P.O. Box 537Toledo, OH 43697

Ms. Becky Grogg

Specialty Risk Services, Inc.37090323Self-Insured ID:

Dart Container Corporation of Michigan

500 Hogsback RoadMason, MI 48854

Mr. Dan Ide

Self-Administered30099099Self-Insured ID:

Dart Energy Corporation

600 Dart RoadP.O. Box 177Mason, MI 48854

Ms. Deborah A. Fennell

Eagle Claims Management, LLC29035233Self-Insured ID:

Dean Foods Company

2515 McKinney Avenue Suite 1200Dallas, TX 75201

Ms. Jo Harris

Gallagher Bassett Services, Inc.54090285Self-Insured ID:

Dearborn , City of

13615 Michigan AvenueDearborn, MI 48126-3586

Ms. Meghan Jones

Accident Fund Insurance Company of America99900182Self-Insured ID:

Dearborn , School Dist. of the City of

18700 AudetteDearborn, MI 48124

Mr. Robert S. Cipriano

Accident Fund Insurance Company of America82000182Self-Insured ID:

Dearborn Heights , City of

6045 FentonDearborn Heights, MI 48127

Mr. Donald S. Barrow

RSKCo Services, Inc.99901682Self-Insured ID:

Decker Manufacturing Corporation

703 North Clark StreetAlbion, MI 49224

Mr. Terrence B. DeWeerd

Citizens Management Inc.34025791Self-Insured ID:

Delaco Steel Corporation

930 S. Saginaw StreetLapeer, MI 48446

Ms. Kristina O'Connor

Accident Fund Insurance Company of America50019330Self-Insured ID:

Delphi Corporation

5825 Delphi Dr.m/c 480 410 104Troy, MI 48098

Ms. Sharon L. Smith

Self-Administered37090063Self-Insured ID:

Detroit , Board of Education of the City of

Room #12225057 Woodward AvenueDetroit, MI 48202

Ms. Christina Polk-Osumah

Citizens Management Inc.82000482Self-Insured ID:

Detroit , City of

Finance - Risk Management611 Coleman A. Young Municipal CenterDetroit, MI 48226

Ms. Angela Moss

Self-Administered99900482Self-Insured ID:

Detroit Coil Company

2435 Hilton RoadFerndale, MI 48220

Mr. David C. Jencks

Meadowbrook, Inc., dba Meadowbrook Claims Service35092211Self-Insured ID:

Detroit Diesel Corporation

13400 West Outer Drive (B16A)Detroit, MI 48239

Ms. Cheryl Meyer

Gallagher Bassett Services, Inc.37055082Self-Insured ID:

Detroit Medical Center, The

Suite 6003740 John RDetroit, MI 48201

Ms. Juanita Johnson

Michigan Health & Hospital Association Service Corp.80000682Self-Insured ID:

Dickinson County Healthcare System

1721 S. Stephenson AvenueIron Mountain, MI 49801

Ms. Sheri LeBombard

Citizens Management Inc.80050022Self-Insured ID:

Dolgencorp, Inc.

100 Mission RidgeGoodlettsville, TN 37072

Ms. Ann Tenpenny

Frank Gates Service Company53002285Self-Insured ID:

Individual Self-Insured Employer List

Page: 8Program: names2.frxPrint Date:

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09:09:36

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Domestic Linen Supply & Laundry Company

30555 Northwestern Highway Suite 300Farmington Hills, MI 48334

Mr. George Collet

Cambridge Integrated Services Group, Inc.72008446Self-Insured ID:

Du Pont de Nemours, E.I., & Company

Room D-80651007 Market StreetWilmington, DE 19898

Ms. Rose O'Neill

Broadspire Services, Inc.28091314Self-Insured ID:

E Q Holding Company

36255 Michigan AvenueWayne, MI 48184

Mr. D. David Dietz

Alternative Service Concepts LLC95001081Self-Insured ID:

Eagle Alloy, Inc.

5142 Evanston AvenueMuskegon, MI 49442

Ms. Connie S. Larson

Eagle Claims Management, LLC26014061Self-Insured ID:

East Detroit,School Dist. of the City of

15115 DeerfieldEast Pointe, MI 48021

Mr. Ron J. Ciranna

Accident Fund Insurance Company of America82000250Self-Insured ID:

East Jordan Iron Works, Inc.

301 Spring StreetP.O. Box 439East Jordan, MI 49727

Mr. Jack Poindexter

Michigan Claim Service DBA The ASU Group33000821Self-Insured ID:

East Lansing , City of

410 Abbott RoadEast Lansing, MI 48823

Mr. Gary P. Murphy

Accident Fund Insurance Company of America99900233Self-Insured ID:

Eastern Michigan University

11 Welch HallYpsilanti, MI 48197

Ms. Mary C. Brooks

Accident Fund Insurance Company of America82000081Self-Insured ID:

Eaton, County of

1045 Independence BoulevardCharlotte, MI 48813

Mr. James A. Stewart

Michigan Claim Service DBA The ASU Group99900023Self-Insured ID:

Edison Institute, The

20900 Oakwood BoulevardP.O. Box 1970Dearborn, MI 48121-1970

Mr. Jim Rankine

Cambridge Integrated Services Group, Inc.

DBA Henry Ford Museum & Greenfield Vill.

84001082Self-Insured ID:

Edwards Brothers, Inc.

2500 South State StreetP.O. Box 1007Ann Arbor, MI 48106-1007

Ms. Colleen Hosken

Mackinaw Administrators, LLC27051221Self-Insured ID:

Emerson Electric Co.

8000 W. FlorissantP.O. Box 4100St. Louis, MO 63136

Ms. Linda Donahue

Crawford & Company36059055Self-Insured ID:

Empire Iron Mining Partnership

1100 Superior AvenueCleveland, OH 44114-2589

Mr. Richard L. Bihn

Sedgwick Claims Management Services, Inc.

c/o Cleveland Cliffs Iron Company

10090885Self-Insured ID:

Ervin Industries, Inc.

3893 Research Park DriveAnn Arbor, MI 48106-1168

Mr. Roger Nash

Cambridge Integrated Services Group, Inc.35028870Self-Insured ID:

Escanaba , City of

410 Ludington StreetP.O. Box 948Escanaba, MI 49829

Mr. Michael Dewar

Self-Administered99900121Self-Insured ID:

Evangelical Homes of Michigan

18000 Coyle AvenueDetroit, MI 48235

Ms. Denise Rabidoux

Eagle Claims Management, LLC80000821Self-Insured ID:

Evans, Bob, Farms Inc.

3776 South High StreetColumbus, OH 43207

Ms. Valerie K. Ogg

AIG Claim Services, Inc.20002443Self-Insured ID:

Individual Self-Insured Employer List

Page: 9Program: names2.frxPrint Date:

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09:09:36

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Evans, Stu, Automotive Group, Inc.

17500 Hall RoadClinton Township, MI 48036

Mr. James Lynn

Citizens Management Inc.55092200Self-Insured ID:

F. C. S. Industries, Inc.

9850 Pelham RoadTaylor, MI 48180-3852

Mr. Patrick W. Barron

Self-Administered42008282Self-Insured ID:

Fairmount Minerals, Ltd.

P.O. Box 177Wedron, IL 60557

Ms. Michelle Pezanoski

Specialty Risk Services, Inc.32004885Self-Insured ID:

Farmington Public Schools

32500 ShiawasseeFarmington, MI 48336

Ms. Barbara A. Fries

Mackinaw Administrators, LLC82000763Self-Insured ID:

Faygo Beverages, Inc.

Suite 400AOne North University DriveFt. Lauderdale, FL 33324

Mr. Don Hatcher

Sentry Insurance a Mutual Company

c/o National Beverage Corp.

20036782Self-Insured ID:

FedEx Freight East, Inc.

2200 Forward DriveP.O. Box 840Harrison, AR 72602-0840

Ms. Susan Thompson

Self-Administered42009485Self-Insured ID:

FedEx Ground Package System, Inc.

3925 Embassy ParkwayP.O. Box 5459Akron, OH 44334-0459

Mr. Larry Parks

Crawford & Company42008585Self-Insured ID:

FedEx Supply Chain Services, Inc.

1475 Boettler Rd.P.O. Box 5000Green, OH 44232-5000

Mr. Todd J. Rosenberg

Crawford & Company89009085Self-Insured ID:

Federal Express Corporation

P. O. Box 727Memphis, TN 38194-2132

Ms. Julia Stegall

Sedgwick Claims Management Services, Inc.43057760Self-Insured ID:

Federal Screw Works

20229 Nine Mile RoadSt. Clair Shores, MI 48080-1775

Mr. David C. Swerc

Comprehensive Risk Services, Inc.34090708Self-Insured ID:

Felpausch, G & R, Company

127 S. Michigan AvenueHastings, MI 49058

Mr. Mark S. Felpausch

Shield Risk Services, LLC54091008Self-Insured ID:

Ferndale , City of

300 E. Nine MileFerndale, MI 48220-1797

Ms. Jaynmarie C. Hubanks

RSKCo Services, Inc.99900763Self-Insured ID:

Ferris State University

Human Resource Development420 Oak Street - Prakken Building 150Big Rapids, MI 49307-2020

Ms. Marlene Dorman

Accident Fund Insurance Company of America82000101Self-Insured ID:

Ferrous Processing and Trading Co., Inc.

3400 E. LafayetteDetroit, MI 48207

Ms. Kim White

Alternative Service Concepts LLC50028776Self-Insured ID:

Fisher & Company, Inc.

33180 Freeway DriveSt. Clair Shores, MI 48082

Mr. Richard Retman

Cambridge Integrated Services Group, Inc.37002950Self-Insured ID:

Flexfab Horizons International, Inc.

102 Cook RoadHastings, MI 49058

Mr. Jeffrey L. Weiden

Eagle Claims Management, LLC30013322Self-Insured ID:

Flint , City of

1101 S. Saginaw StreetFlint, MI 48502

Mr. Robert C. Erlenbeck

Maxcis, Inc.99900125Self-Insured ID:

Individual Self-Insured Employer List

Page: 10Program: names2.frxPrint Date:

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09:09:36

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Flint Mass Transportation Authority

1401 South Dort HighwayFlint, MI 48503

Mr. Dale Felpausch

Cambridge Integrated Services Group, Inc.75098776Self-Insured ID:

Flint, School District of the City of

923 East Kearsley StreetFlint, MI 48503-1900

Ms. Lisa R. Leverette

Cambridge Integrated Services Group, Inc.82000125Self-Insured ID:

Flowserve US Inc.

2200 E. Monument St.Dayton, OH 45402

Ms. Jill T. Longendelpher

Constitution State Services LLC39014560Self-Insured ID:

Foamade Industries, Inc.

2550 Auburn CourtP.O. Box 215110Auburn Hills, MI 48321-5110

Mr. David Steinberg

Cambridge Integrated Services Group, Inc.30016600Self-Insured ID:

Foote, W. A., Memorial Hospital Inc.

205 North East AvenueJackson, MI 49201

Mr. Kenneth W. Empey

Michigan Health & Hospital Association Service Corp.80000999Self-Insured ID:

Ford , Henry, Health System

1 Ford Place, 4BHFHS Risk Finance & Insurance ServicesDetroit, MI 48202-3450

Mr. John R. Mucha

J.P. Bender & Associates, Inc.80000982Self-Insured ID:

Ford Motor Company

Room 24619540 Allen RoadMelvindale, MI 48122

Mr. Robert E. Finnessy

Self-Administered374F0000Self-Insured ID:

Frankenmuth Bavarian Inn, Inc.

713 S. Main StreetFrankenmuth, MI 48734

Mr. Vernon Schiefer

Citizens Management Inc.58011873Self-Insured ID:

Freedom Communications, Inc.

17666 FitchIrvine, CA 92614

Mr. Dean A. Reynolds

Sedgwick Claims Management Services, Inc.27021500Self-Insured ID:

Futuramic Tool & Engineering Co.

24680 GibsonWarren, MI 48089

Mr. C. J. Tanghe

Citizens Management Inc.35040050Self-Insured ID:

Garden City , City of

6000 Middlebelt RoadGarden City, MI 48135

Ms. Allyson Bettis

RSKCo Services, Inc.99901001Self-Insured ID:

Garden City Hospital

6245 Inkster RoadGarden City, MI 48135

Mr. Robert J. Giddings

Michigan Health & Hospital Association Service Corp.80001882Self-Insured ID:

General Motors Corporation

200 Renaissance CenterP.O. Box 200 Mail Code 482-B37-A68Detroit, MI 48265-2000

Mr. Daniel J. Osborne

Self-Administered37999000Self-Insured ID:

Genesee County

3rd. Floor1101 Beach StreetFlint, MI 48502

Ms. Annese Ashton

Michigan Claim Service DBA The ASU Group99900225Self-Insured ID:

Georgia-Pacific Corporation

8th Floor133 Peachtree Street NEAtlanta, GA 30303

Mr. Arden K. Young

Self-Administered52005211Self-Insured ID:

Georgie Boy Manufacturing, LLC.

2831 Dexter DriveP.O. Box 3300Elkhart, IN 46515

Mr. Joe Steele

GAB Robins Risk Management Services, Inc.37091414Self-Insured ID:

Individual Self-Insured Employer List

Page: 11Program: names2.frxPrint Date:

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09:09:36

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Gill Industries, Inc.

5271 Plainfield Ave. N.E.Grand Rapids, MI 49525

Ms. Rita Woodruff

Accident Fund Insurance Company of America35033841Self-Insured ID:

Grand Lodge of Free and Accepted Masons

233 Fulton Street EastGrand Rapids, MI 49503

Mr. Richard Amon

Michigan Health & Hospital Association Service Corp.

of the State of Michigan

86015041Self-Insured ID:

Grand Rapids City of

Risk Management Office300 Monroe Ave., NWGrand Rapids, MI 49503

Ms. Sheila Mahan

Self-Administered99900141Self-Insured ID:

Grand Rapids Gravel Company

2700 28th Street, SWP.O. Box 9160Grand Rapids, MI 49509

Mr. Bradner Rahn

Citizens Management Inc.32002241Self-Insured ID:

Grand Rapids Public Schools

1331 Franklin Street, S.E.P.O. Box 117Grand Rapids, MI 49501-0117

Ms. Dawn M. Berenyi

Michigan Claim Service DBA The ASU Group82000141Self-Insured ID:

Grand Traverse County

400 Boardman AvenueTraverse City, MI 49684

Ms. Marilyn Brown

Citizens Management Inc.99900028Self-Insured ID:

Grand Valley State University

140 Lake Michigan HallAllendale, MI 49401

Ms. Stephanie Matthews-Smith

Eagle Claims Management, LLC82001441Self-Insured ID:

Gratiot Health System

300 East Warwick DriveAlma, MI 48801

Ms. Robin Whitmore

Michigan Health & Hospital Association Service Corp.

dba Gratiot Community Hospital

80001029Self-Insured ID:

Great Atlantic & Pacific Tea Co., Inc.

2 Paragon DriveMontvale, NJ 07645

Ms. Betty Ann Moravek

Crawford & Company54090268Self-Insured ID:

Great Lakes Castings Corporation

800 N. Washington AvenueLudington, MI 49431

Ms. Carol Elenbaas

Citizens Management Inc.33077791Self-Insured ID:

Great Lakes Energy Cooperative

P.O. Box 70Boyne City, MI 49712

Mr. John E. Fought

Accident Fund Insurance Company of America49092315Self-Insured ID:

Grede Foundries, Inc.

9898 W. Bluemound RoadMilwaukee, WI 53226

Mr. Gary A. Ertel

Sentry Insurance a Mutual Company33017203Self-Insured ID:

Green, John E., Company Inc.

220 Victor AvenueHighland Park, MI 48203

Mr. John R. Green

Accident Fund Insurance Company of America36070127Self-Insured ID:

Griffin Beverage Co.

1901 North Dam RoadWest Branch, MI 48661

Mr. Robert T. Griffin

Citizens Management Inc.20070012Self-Insured ID:

Griswold Machine & Engineering, Inc.

8530 Highway M-60P.O. Box 98Union City, MI 49094

Mr. David L. Henion

Eagle Claims Management, LLC35004040Self-Insured ID:

Grosse Pointe Farms, City of

90 Kerby RoadGrosse Pointe Farms, MI 48236

Mr. Shane L. Reeside

Cambridge Integrated Services Group, Inc.99901782Self-Insured ID:

Grosse Pointe Public School System

389 St. ClairGrosse Pointe, MI 48230

Mr. Christian A. Fenton

Alternative Service Concepts LLC82001082Self-Insured ID:

Individual Self-Insured Employer List

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09:09:36

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Grosse Pointe Woods, City of

20025 Mack PlazaGrosse Pointe Woods, MI 48236

Mr. Clifford J. Maison

Alternative Service Concepts LLC99900663Self-Insured ID:

Guardian Industries Corp.

2300 Harmon RoadAuburn Hills, MI 48326-1714

Ms. Colleen M. Maloney

ESIS, Inc.51070263Self-Insured ID:

Hamilton Farm Bureau Co-Operative, Inc.

East Washington StreetP.O. Box 186Hamilton, MI 49419

Mr. Warren Berens

Eagle Claims Management, LLC59011234Self-Insured ID:

Hamtramck, City of

3401 EvalineHamtramck, MI 48212

Mr. William Barnett

Cambridge Integrated Services Group, Inc.99900282Self-Insured ID:

Haworth, Incorporated

One Haworth Center 3-34AHolland, MI 49423

Mr. Thomas F. Durkin

Chubb Services Corporation73016843Self-Insured ID:

Hayes Lemmerz International, Inc.

15300 Centennial DriveNorthville, MI 48167

Mr. Michael A. Coffman

Mackinaw Administrators, LLC37090157Self-Insured ID:

HealthSource Saginaw

3340 Hospital Rd.Saginaw, MI 48608

Mr. Lester Heyboer

Michigan Health & Hospital Association Service Corp.80001773Self-Insured ID:

Healthshare, Incorporated

416 Connable AvenuePetoskey, MI 49770

Ms. Christine VanSlembrouck

Michigan Health & Hospital Association Service Corp.80000324Self-Insured ID:

Hercules Drawn Steel Corp.

38901 Amrhein RoadLivonia, MI 48150

Mr. Mark Goodman

Michigan Claim Service DBA The ASU Group33078882Self-Insured ID:

Hercules Incorporated

1313 N. Market StreetHercules PlazaWilmington, DE 19894-0001

Ms. Barbara L. Buss

Self-Administered28091270Self-Insured ID:

Highland Park, City of

12050 Woodward AvenueHighland Park, MI 48203

Mr. Marcel Pultorak

Cambridge Integrated Services Group, Inc.99900582Self-Insured ID:

Highland Park,School Dist of the City of

20 Bartlett AvenueHighland Park, MI 48203

Mr. John D. White

RSKCo Services, Inc.82000382Self-Insured ID:

Hillsdale , County of

County Court House29 N. Howell StreetHillsdale, MI 49242

Mr. Gary A. Leininger

RSKCo Services, Inc.99900130Self-Insured ID:

Hirschfield, H., Sons Company

1414 N. Madison AvenueP.O. Box 460Bay City, MI 48707

Mr. Timothy J. Neal

Citizens Management Inc.17091632Self-Insured ID:

Holcim (US) Inc.

6211 Ann Arbor RoadP.O. Box 122Dundee, MI 48131

Mr. Kurt Walker

ESIS, Inc.14046058Self-Insured ID:

Holland Community Hospital

602 Michigan AvenueHolland, MI 49423

Mr. Chuck Kohlruss

Michigan Health & Hospital Association Service Corp.80000295Self-Insured ID:

Holland Home

2100 Raybrook Ave., S.E. #300Grand Rapids, MI 49546

Mr. Gene Gess

Eagle Claims Management, LLC80000741Self-Insured ID:

Individual Self-Insured Employer List

Page: 13Program: names2.frxPrint Date:

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09:09:36

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Hollywood Super Market Inc.

P.O. Box 1286Troy, MI 48099-1286

Ms. Kimberly Welch Harlan

Accident Fund Insurance Company of America54022112Self-Insured ID:

Home Depot U.S.A., Inc.

2455 Paces Ferry RoadAtlanta, GA 30339

Mr. Jim Bramlett

Sedgwick Claims Management Services, Inc.52030085Self-Insured ID:

Houghton County

401 East Houghton AvenueHoughton, MI 49931

Mr. John M. Kelly

Citizens Management Inc.99900031Self-Insured ID:

Howell Public Schools

411 N. Highlander WayHowell, MI 48843

Mrs. Lynn Parrish

Citizens Management Inc.82000347Self-Insured ID:

Hubert Distributors, Inc.

1200 Auburn RoadPontiac, MI 48342

Mr. Thomas A. Vella

Accident Fund Insurance Company of America51091463Self-Insured ID:

Huntington Bancshares Incorporated

41 South High StreetColumbus, OH 43215

Ms. Denise L. Thompson

Frank Gates Service Company60055885Self-Insured ID:

Huron Casting, Inc.

7050 Hartley StreetPigeon, MI 48755

Mr. Matthew Davis

RSKCo Services, Inc.33000988Self-Insured ID:

Huron County of

P.O. Box 69Bad Axe, MI 48413-0069

Ms. Roberta Moetteli

Citizens Management Inc.99900032Self-Insured ID:

Huron Valley Ambulance, Inc.

2215 Hogback RoadAnn Arbor, MI 48105

Ms. Judy Bolsenga

Citizens Management Inc.80000381Self-Insured ID:

Huron Valley Schools

2390 S. Milford RoadHighland, MI 48357

Mr. Samuel R. Osborn

Citizens Management Inc.82002063Self-Insured ID:

Hyatt Corporation

200 West MadisonChicago, IL 60606

Ms. Kelly Wasilewski

RSKCo Services, Inc.70091386Self-Insured ID:

Iafrate, Angelo, Construction Company

26400 SherwoodWarren, MI 48091

Mr. Craig S. Chall

Gallagher Bassett Services, Inc.17008850Self-Insured ID:

Inalfa Roof Systems, Inc.

1370 Pacific DriveAuburn Hills, MI 48326

Mr. Dave Peshke

Accident Fund Insurance Company of America37002320Self-Insured ID:

Indiana Michigan Power Company

Integrated Disability Management Center777 Hopewell DriveHeath, OH 43056-1581

Mr. L. Steven Tedrick

Frank Gates Service Company49090185Self-Insured ID:

Ingham County

121 E. MapleP.O. Box 319Mason, MI 48854

Ms. Connie L. Lange

Accident Fund Insurance Company of America99900033Self-Insured ID:

Inkster , City of

2121 Inkster RoadInkster, MI 48141

Ms. Jennifer J. Smith

Accident Fund Insurance Company of America99901382Self-Insured ID:

International Industrial Contracting Corporation

35900 Mound RoadSterling Heights, MI 48310

Mr. Jonathan H. Firsht

Cambridge Integrated Services Group, Inc.17045050Self-Insured ID:

International Paper Co.

Tower 26400 Poplar AvenueMemphis, TN 38197

Ms. Penny Humphrey

Sedgwick Claims Management Services, Inc.26066432Self-Insured ID:

Individual Self-Insured Employer List

Page: 14Program: names2.frxPrint Date:

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09:09:36

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Interstate Bakeries Corporation

P.O. Box 419627Kansas City, MO 64141-6627

Mr. Paul E. Yarick

Broadspire Services, Inc.20084085Self-Insured ID:

Inverness Castings Group, Inc.

101 PoplarP. O. Box 470Dowagiac, MI 49047

Mr. Chuck Varney

ESIS, Inc.33090544Self-Insured ID:

Irwin Seating Company

P.O. Box 2429Grand Rapids, MI 49501

Mr. Kevin Brower

Eagle Claims Management, LLC25042880Self-Insured ID:

Jackson , City of

161 West Michigan AvenueJackson, MI 49201

Ms. Catherine M. Brechtelsbauer

RSKCo Services, Inc.99900138Self-Insured ID:

Jackson , County of

120 West Michigan AvenueJackson, MI 49201

Mr. Chet Taraskiewicz

Citizens Management Inc.99900038Self-Insured ID:

Jacob, Daniel L., Co. Inc.

2403 East High StreetJackson, MI 49203-3421

Mr. Charles B. Mead

Eagle Claims Management, LLC51017338Self-Insured ID:

Johnson Controls, Inc.

c/o Marsh USA, Inc.411 E. Wisconsin Avenue Suite 1600Milwaukee, WI 53202

Ms. Kathleen E. Theisen

Underwriters Safety & Claims35046755Self-Insured ID:

Journal Communications, Inc.

333 West State StreetMilwaukee, WI 53203

Mr. Jeff D. Kluever

GAB Robins Risk Management Services, Inc.27095085Self-Insured ID:

Kalamazoo , City of

241 W. South StreetKalamazoo, MI 49007-4796

Mr. David M. Hess

Eagle Claims Management, LLC99900139Self-Insured ID:

Kalamazoo County

201 W. Kalamazoo AvenueKalamazoo, MI 49007

Mr. Richard Kinas

Eagle Claims Management, LLC99900039Self-Insured ID:

Kalamazoo, School Dist. of the City of

1220 Howard StreetKalamazoo, MI 49008

Mr. Richard W. Visel

Eagle Claims Management, LLC82000139Self-Insured ID:

Kasle Steel Corporation

4343 WyomingDearborn, MI 48126

Mr. Keith Bailey

Comprehensive Risk Services, Inc.42040648Self-Insured ID:

Keebler Company

One Kellogg SquareP.O. Box 3599Battle Creek, MI 49016-3599

Ms. Marguerite F. Mosher

Gallagher Bassett Services, Inc.20075520Self-Insured ID:

Kellogg Company

One Kellogg SquareP.O. Box 3599Battle Creek, MI 49016-3599

Ms. Marguerite F. Mosher

Gallagher Bassett Services, Inc.20075911Self-Insured ID:

Kelly Services, Inc.

999 West Big Beaver RoadTroy, MI 48084

Mr. Gary A. Pearce

CNA ClaimPlus Inc.73039449Self-Insured ID:

Kent , County of

Fiscal Services, County Admin. Bldg.300 Monroe Avenue, N.W.Grand Rapids, MI 49503

Mr. Phil Van Dyke

Michigan Health & Hospital Association Service Corp.99900041Self-Insured ID:

Key Plastics L.L.C.

21700 Haggerty Rd., Suite 100NNorthville, MI 48167

Ms. Ann J. Conigliaro

Michigan Claim Service DBA The ASU Group33085220Self-Insured ID:

Individual Self-Insured Employer List

Page: 15Program: names2.frxPrint Date:

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09:09:36

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Khoury, Inc.

1011 North Stephenson AvenueIron Mountain, MI 49801

Mr. Scott Larson

Comprehensive Risk Services, Inc.25071322Self-Insured ID:

Kimberly-Clark Corporation

1414 W. Larsen RdP.O. Box 349Neenah, WI 54957-0349

Ms. Jennifer Kissner

Self-Administered

Risk Management Department

26072079Self-Insured ID:

Klein Tools, Inc.

7200 McCormick BoulevardP.O. Box 599033Chicago, IL 60659

Mr. Victor Palazzolo

Alternative Service Concepts LLC34036650Self-Insured ID:

Kmart Corporation

Work Compensation Dept.3100 West Big Beaver RoadTroy, MI 48084

Mr. Lloyd A. Casto

Cambridge Integrated Services Group, Inc.53090033Self-Insured ID:

Knape & Vogt Manufacturing Company

2700 Oak Industrial Drive NEGrand Rapids, MI 49505

Ms. Leslie Cummings

Eagle Claims Management, LLC25048162Self-Insured ID:

Koppy Corporation

199 Kay Industrial Dr.Orion, MI 48359

Mr. Ronald Prater

Citizens Management Inc.35027700Self-Insured ID:

Kroger Co., The

Suite 40018334 Laurel Park Dr. N.Livonia, MI 48152-2686

Ms. Peggy Jones

Sedgwick Claims Management Services, Inc.54021957Self-Insured ID:

Kurdziel Industries, Inc.

Suite 300801 West Norton AvenueMuskegon, MI 49441-6607

Mr. Steven A. Wenk

Citizens Management Inc.35009880Self-Insured ID:

L & L Products, Inc.

160 McLean DriveRomeo, MI 48065

Ms. Susan R. Deeb

Citizens Management Inc.30013450Self-Insured ID:

L'Anse Creuse Public Schools

36727 Jefferson AvenueHarrison Township, MI 48045

Mr. Robert D. Randlett

Mackinaw Administrators, LLC82000450Self-Insured ID:

La Z Boy, Incorporated

1284 North Telegraph RoadMonroe, MI 48162

Mr. Scott Harrison

Crawford & Company25055577Self-Insured ID:

Labor Ready Midwest, Inc.

1015 A StreetP.O. Box 2910Tacoma, WA 98401

Mr. Chip McKenna

ESIS, Inc.73013485Self-Insured ID:

Lacks Enterprises, Inc.

5460 Cascade Road SEGrand Rapids, MI 49546

Mr. Chester J. Anisko

Citizens Management Inc.30036101Self-Insured ID:

Lake Orion Community Schools

315 North Lapeer StreetLake Orion, MI 48362

Ms. Christine Lehman

Accident Fund Insurance Company of America82001463Self-Insured ID:

Lake Shore Public Schools

28850 Harper AvenueSt. Clair Shores, MI 48081

Ms. M. Grace Stafford

Accident Fund Insurance Company of America82000003Self-Insured ID:

Lake Superior State University

650 West Easterday AvenueSault Ste. Marie, MI 49783

Ms. Beverly E. White

Michigan Claim Service DBA The ASU Group82000221Self-Insured ID:

Lakeland Regional Health System

1234 Napier AvenueSt. Joseph, MI 49085

Mr. Gerard Guinane

Michigan Health & Hospital Association Service Corp.80000275Self-Insured ID:

Individual Self-Insured Employer List

Page: 16Program: names2.frxPrint Date:

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12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Lakeview Public Schools

20300 StatlerSt. Clair Shores, MI 48081

Mr. Scott E. Johnson

Accident Fund Insurance Company of America82000650Self-Insured ID:

Lansing , Board of Water & Light of the

P.O. Box 13007Lansing, MI 48901

Mr. Dana Tousley

Cambridge Integrated Services Group, Inc.

City of

49059333Self-Insured ID:

Lansing , City of

4th Floor City Hall124 W. Michigan AvenueLansing, MI 48933

Ms. Sharon Bommarito

Accident Fund Insurance Company of America99900133Self-Insured ID:

Lapeer Community Schools

1025 West Nepessing StreetLapeer, MI 48446

Mr. Michael Meldrum

Citizens Management Inc.82000644Self-Insured ID:

Lapeer County

255 Clay StreetLapeer, MI 48446

Mr. John Biscoe

Accident Fund Insurance Company of America99900044Self-Insured ID:

Lapeer Metal Stamping Companies, Inc.

930 South Saginaw StreetLapeer, MI 48446-2699

Ms. Kristina O'Connor

Accident Fund Insurance Company of America33048888Self-Insured ID:

Lefere Forge & Machine Company

665 Hupp AvenueJackson, MI 49203

Mr. Gerald B. Lefere

Citizens Management Inc.34030986Self-Insured ID:

Lenawee Health Alliance, Inc.

818 Riverside AvenueAdrian, MI 49221

Mr. Dennis Wright

Michigan Health & Hospital Association Service Corp.80000846Self-Insured ID:

Levy, Edw. C., Co.

9300 Dix AvenueDearborn, MI 48120

Ms. Linda Wyatt

Cambridge Integrated Services Group, Inc.15052604Self-Insured ID:

Limited Brands, Inc.

Three Limited ParkwayColumbus, OH 43230

Ms. Sally A. Essmyer

Specialty Risk Services, Inc.23001885Self-Insured ID:

Lincoln Consolidated Schools

8970 Whittaker RoadYpsilanti, MI 48197

Mr. Albert A. Widner

RSKCo Services, Inc.82000481Self-Insured ID:

Little Caesar Enterprises, Inc.

2211 Woodward AvenueDetroit, MI 48201-3400

Mr. C. Michael Healy

Constitution State Services LLC58011999Self-Insured ID:

Livonia , City of

33000 Civic Center DriveLivonia, MI 48154

Mr. Michael T. Slater

Accident Fund Insurance Company of America99900982Self-Insured ID:

Livonia Public Schools

15125 Farmington RoadLivonia, MI 48154-5474

Mr. J. Stephen Smith

Citizens Management Inc.82000782Self-Insured ID:

Louisiana-Pacific Corporation

Suite 1200805 SW BroadwayPortland, OR 97205

Mr. Guy Boileau

Sedgwick Claims Management Services, Inc.24048042Self-Insured ID:

Lowe's Home Centers, Inc.

P.O. Box 1111North Wilkesboro, NC 28656

Ms. Tia W. Schweikert

Specialty Risk Services, Inc.52005310Self-Insured ID:

Lutheran Homes of Michigan, Inc.

9710 Junction RoadP.O. Box 329Frankenmuth, MI 48734

Mr. George J. Rummel

Citizens Management Inc.80000819Self-Insured ID:

Lutheran Social Services of MI

8131 East JeffersonDetroit, MI 48214

Mr. David Steele

Michigan Claim Service DBA The ASU Group80066082Self-Insured ID:

Individual Self-Insured Employer List

Page: 17Program: names2.frxPrint Date:

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12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

M G M Mirage

3260 S. Industrial RoadLas Vegas, NV 89109

Ms. Deborah Nelson

Self-Administered70092555Self-Insured ID:

M N P Corporation

P.O. Box 18900244225 Utica RoadUtica, MI 48318-9002

Mr. Randy Allison

Meadowbrook, Inc., dba Meadowbrook Claims Service34023050Self-Insured ID:

Mac Valves, Inc.

30569 Beck RoadP.O. Box 111Wixom, MI 48393

Ms. Martha C. Welch

Alternative Service Concepts LLC35028135Self-Insured ID:

MacDonald's Industrial Products, Inc.

4242 - 44th Street, SEKentwood, MI 49512

Ms. Melanie MacDonald

Eagle Claims Management, LLC35022332Self-Insured ID:

Macomb , County of

8th FloorOne South Main StreetMt. Clemens, MI 48043

Mr. Richard Gasowski

Accident Fund Insurance Company of America

Macomb County Board of Commissioners

99900050Self-Insured ID:

Macomb County Road Commission

156 MalowP.O. Box 2347Mt. Clemens, MI 48046-2347

Mr. Bo Kirk

Accident Fund Insurance Company of America99900350Self-Insured ID:

Magna Donnelly Corporation

49 West Third StreetHolland, MI 49423

Ms. Lori Klokkert

Self-Administered32090470Self-Insured ID:

Magnesium Products of America, Inc.

2001 Industrial DriveEaton Rapids, MI 48827

Mr. Tim Daiss

Citizens Management Inc.33050123Self-Insured ID:

Malloy Incorporated

P.O. Box 1124Ann Arbor, MI 48106

Mr. Ben Mattison

Citizens Management Inc.27077000Self-Insured ID:

Manor Care, Inc.

333 N. Summit StreetP.O. Box 10086Toledo, OH 43699-0086

Ms. Lisa Jurski

Self-Administered80001485Self-Insured ID:

Manthei, Inc.

3996 U.S. 31 SPetoskey, MI 49770

Mr. John A. Kopp

Comprehensive Risk Services, Inc.24058072Self-Insured ID:

Marquette General Health System

580 West College Ave.Marquette, MI 49855

Ms. Diane Bur-Smith

Michigan Health & Hospital Association Service Corp.80000452Self-Insured ID:

Marriott International, Inc.

Dept. 52/924.36Marriott DriveWashington, DC 20058

Mr. Steve Huy

Self-Administered70008085Self-Insured ID:

Mary Free Bed Hospital & Rehab. Center

235 Wealthy Street, S.E.Grand Rapids, MI 49503-5299

Ms. Anne H. Dierker

Eagle Claims Management, LLC80001441Self-Insured ID:

Masco Corporation

21001 Van Born RoadTaylor, MI 48180-1340

Ms. Denise Peltz

Constitution State Services LLC33013705Self-Insured ID:

Mason , County of

307 E. Ludington AvenueLudington, MI 49431

Mr. Fabian Knizacky

Eagle Claims Management, LLC99900101Self-Insured ID:

May Department Stores Company, The

611 Olive StreetSt. Louis, MO 63101

Ms. Debbie Young

Self-Administered

DBA Lord & Taylor

53092700Self-Insured ID:

Individual Self-Insured Employer List

Page: 18Program: names2.frxPrint Date:

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12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

McClain Industries, Inc.

P.O. Box 180913Utica, MI 48318

Mr. Carl Jaworski

Eagle Claims Management, LLC34023650Self-Insured ID:

McLaren Health Care Corporation

401 South Ballenger HighwayFlint, MI 48532-3685

Ms. Linda L. Ford

Michigan Health & Hospital Association Service Corp.80000525Self-Insured ID:

MeadWestvaco Corporation

3475 Newmark DriveMiamisburg, OH 45342

Ms. Tonya Allbery

Sedgwick Claims Management Services, Inc.26040630Self-Insured ID:

Mebus Manufacturing, Inc.

30350 Ecorse RoadRomulus, MI 48174

Mr. Christopher Mebus

Citizens Management Inc.33093543Self-Insured ID:

Medstar, Inc.

380 North GratiotClinton Twsp., MI 48036

Mr. Stewart Slipiec

Specialty Risk Services, Inc.80001350Self-Insured ID:

Meijer Companies, Ltd.

2929 Walker, N.W.Grand Rapids, MI 49544

Mr. Timothy B. McNally

Self-Administered53090114Self-Insured ID:

Melling Tool Company

2620 Saradan DriveP.O. Box 1188Jackson, MI 49204

Mr. Thomas C. Evanson

Citizens Management Inc.35011038Self-Insured ID:

Melody Foods, Inc. et al.

31111 Industrial RoadLivonia, MI 48150

Ms. Terri A. Moore

Citizens Management Inc.20075982Self-Insured ID:

Memorial Hospital, The

826 West KingOwosso, MI 48867

Mr. Michael F. Grisdela

Michigan Health & Hospital Association Service Corp.

dba Memorial Healthcare

80000178Self-Insured ID:

Mercy Memorial Hospital Corporation

740 N. Macomb StreetP.O. Box 67Monroe, MI 48161

Mr. Dennis G. Pogarch

Michigan Health & Hospital Association Service Corp.80001582Self-Insured ID:

Meridian Automotive Systems, Inc.

Mail Box #114 N. Beardsley RoadIonia, MI 48846

Ms. Barbara Ferguson

Michigan Claim Service DBA The ASU Group37007534Self-Insured ID:

Mervyn's

c/o Target Stores1000 Nicollet Mall, TPN-1300Minneapolis, MN 55403

Ms. Angela Fethers

Constitution State Services LLC53086585Self-Insured ID:

Metaldyne Company LLC

29125 Hall St.Solon, OH 44139

Mr. Dean Teeples

ESIS, Inc.33093082Self-Insured ID:

Metalworks, Inc.

902 E. Fourth St.Ludington, MI 49431

Mr. Thomas Paine

Accident Fund Insurance Company of America34007390Self-Insured ID:

Metropolitan Hospital

MetroHealth, Breton Plaza1925 Breton RoadGrand Rapids, MI 49506

Ms. Sandra Sefton

Cambridge Integrated Services Group, Inc.80000241Self-Insured ID:

Michigan Bell Telephone Company

Room 7-P-40175 E. HoustonSan Antonio, TX 78205

Ms. Julie K. Long

Sedgwick Claims Management Services, Inc.48090154Self-Insured ID:

Michigan Conf Assoc / 7th-Day Adventists

320 W. St. Joseph StreetP.O. Box 19009Lansing, MI 48901

Ms. Carol Thomas

Eagle Claims Management, LLC86012333Self-Insured ID:

Individual Self-Insured Employer List

Page: 19Program: names2.frxPrint Date:

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12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Michigan Paving & Materials Company

5905 Belleville Rd.Belleville, MI 48111

Ms. Marlene J. VanPatten

Helmsman Management Services, Inc.17091566Self-Insured ID:

Michigan Rubber Products, Inc.

1200 Eighth AvenueCadillac, MI 49601-9274

Mr. Thomas R. McHugh

Eagle Claims Management, LLC30052203Self-Insured ID:

Michigan Seat Company

2313 Brooklyn RoadJackson, MI 49203

Mr. John Rappleye

Eagle Claims Management, LLC34005538Self-Insured ID:

Michigan State Of

Capital Commons Ctr., 4th Floor400 S. Pine StreetLansing, MI 48933

Mr. Kenneth R. Swisher

Citizens Management Inc.

Department of Management & Budget

99904433Self-Insured ID:

Michigan State University

Suite 1401407 S. HarrisonEast Lansing, MI 48823

Ms. Renee Rivard

Self-Administered82000033Self-Insured ID:

Michigan Technological University

1400 Townsend DriveHoughton, MI 49931

Ms. Ingrid E. Cheney

RSKCo Services, Inc.82000432Self-Insured ID:

Michigan Tractor & Machinery Company

P.O. Box 1020Wixom, MI 48393

Dr. Wesley W. Winn

Citizens Management Inc.

DBA Michigan CAT

50090463Self-Insured ID:

MidMichigan Health

4005 Orchard DriveMidland, MI 48670

Ms. Chandra Morse

Michigan Health & Hospital Association Service Corp.80000556Self-Insured ID:

Midland , County of

220 W. Ellsworth StreetMidland, MI 48640-5194

Mr. Richard A. Enszer

Eagle Claims Management, LLC99900056Self-Insured ID:

Midland Public Schools

600 East Carpenter StreetMidland, MI 48640

Ms. Carol E. Laux

Citizens Management Inc.82000156Self-Insured ID:

Miller, Howard, Clock Company

860 East Main AvenueZeeland, MI 49464

Mr. Dennis J. Palasek

Citizens Management Inc.

DBA Howard Miller Company

35078239Self-Insured ID:

Moeller Mfg. Company, Inc.

30100 Beck RoadWixom, MI 48393

Mr. Joseph R. Baker

Citizens Management Inc.35078082Self-Insured ID:

Monitor Sugar Company

2600 South Euclid AvenueBay City, MI 48706

Ms. June Lutz

Cambridge Integrated Services Group, Inc.54090884Self-Insured ID:

Monroe , City of

120 East First StreetMonroe, MI 48161

Mr. Joseph S. Lybik

Comprehensive Risk Services, Inc.99900158Self-Insured ID:

Monroe , County of

125 East Second StreetMonroe, MI 48161

Mr. Charles A. Londo

Michigan Claim Service DBA The ASU Group99900058Self-Insured ID:

Monroe County Road Commission

840 South Telegraph RoadMonroe, MI 48161

Ms. Deborah Turner

Meadowbrook, Inc., dba Meadowbrook Claims Service99900258Self-Insured ID:

Monroe Public Schools

1275 North Macomb StreetP.O. Box 733Monroe, MI 48162

Mr. Terry L. Serbin

Citizens Management Inc.82000558Self-Insured ID:

Individual Self-Insured Employer List

Page: 20Program: names2.frxPrint Date:

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12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Morbark, Inc.

8507 S. Winn RoadWinn, MI 48896

Mr. Craig Price

Eagle Claims Management, LLC39041122Self-Insured ID:

Mount Clemens General Hospital, Inc.

1000 Harrington BoulevardMt. Clemens, MI 48043

Ms. Paula Mutch

Michigan Health & Hospital Association Service Corp.80000850Self-Insured ID:

Munson Health Care

1105 Sixth StreetTraverse City, MI 49684-2386

Ms. Sue Peters

Michigan Health & Hospital Association Service Corp.80000128Self-Insured ID:

Muskegon , County of

133 E. Apple AvenueMuskegon, MI 49442

Mr. James B. Delaney

Self-Administered99900061Self-Insured ID:

Myr, Arthur B., Industries Inc.

39635 I-94 South Service DriveBelleville, MI 48111

Mr. Ronald E. Breaugh

RSKCo Services, Inc.17001122Self-Insured ID:

National City Corporation

4100 West 150th Street Locator 5123Cleveland, OH 44135-1389

Ms. Kelly Blum

Helmsman Management Services, Inc.60077285Self-Insured ID:

Newcor, Inc.

Suite #1004850 Coolidge HighwayRoyal Oak, MI 48073

Mr. Scott Wright

Alternative Service Concepts LLC35009763Self-Insured ID:

Nicholas Plastics, Inc.

11700 48th Ave. P.O. Box 136Allendale, MI 49401-0136

Mr. James A. Kieft

Citizens Management Inc.30012203Self-Insured ID:

Nordstrom, Inc.

3501 W. Sunflower Ave.Santa Ana, CA 92704

Ms. Dorene Wade

Self-Administered53069985Self-Insured ID:

Northern Michigan University

Human Resources1401 Presque IsleMarquette, MI 49855

Ms. Susan J. Menhennick

Accident Fund Insurance Company of America82001552Self-Insured ID:

O D L, Inc.

215 E. RooseveltZeeland, MI 49464

Mr. Michael Burke

Accident Fund Insurance Company of America24067700Self-Insured ID:

O S F Healthcare System

800 N.E. Glen Oak AvenuePeoria, IL 61603

Mr. Daniel E. Baker

ESIS, Inc.

DBA St. Francis Hospital

80000625Self-Insured ID:

Oakland Community College

2480 Opdyke RoadBloomfield Hills, MI 48304

Mr. Ernest A. Harrison

RSKCo Services, Inc.82001863Self-Insured ID:

Oakland County

Department 4711200 North Telegraph RoadPontiac, MI 48341-0471

Mr. Stanley B. Fayne

Accident Fund Insurance Company of America99900063Self-Insured ID:

Oakland County, Road Commission for

31001 Lahser RoadBeverly Hills, MI 48025

Ms. Donna K. Cianciolo

Mackinaw Administrators, LLC99900263Self-Insured ID:

Oakland University

142 North Foundation HallRochester, MI 48309-4401

Ms. Barbara McGuire

Michigan Claim Service DBA The ASU Group82000063Self-Insured ID:

Oakwood Healthcare, Inc.

Village Plaza, Suite 23023400 Michigan AvenueDearborn, MI 48124

Ms. Dorinda A. Sherman

Specialty Risk Services, Inc.80000182Self-Insured ID:

Individual Self-Insured Employer List

Page: 21Program: names2.frxPrint Date:

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12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Ogihara America Corporation

1480 W. McPherson Park DriveHowell, MI 48843

Mr. Patrick Casady

Citizens Management Inc.39013147Self-Insured ID:

Ottawa County

Room 33112220 Fillmore StreetWest Olive, MI 49460

Mr. Mark Scheerhorn

Cambridge Integrated Services Group, Inc.99900270Self-Insured ID:

Ottawa County Road Commission

P.O. Box 739Grand Haven, MI 49417

Mr. Michael C. Mikita

Eagle Claims Management, LLC99900070Self-Insured ID:

Owens-Illinois, Inc.

One SeaGateToledo, OH 43666

Mr. Thad E. Franklin

Gates, McDonald & Co.51070223Self-Insured ID:

P G P Corporation

7925 Beech Daly RoadTaylor, MI 48180

Mr. Paul Michael Voss

Cambridge Integrated Services Group, Inc.33016904Self-Insured ID:

P P G Industries, Inc.

4325 Rosanna Drive, Building CP. O. Box 2009Allison Park, PA 15101

Ms. Cyndi J. Greco

Sentry Insurance a Mutual Company51091052Self-Insured ID:

Palace Sports & Entertainment, Inc.

2 Championship DriveAuburn Hills, MI 48326

Ms. Kristin Frisbie

ESIS, Inc.79007763Self-Insured ID:

Parker Hannifin Corporation

6035 Parkland BoulevardCleveland, OH 44124-4141

Ms. Karen Olden

Frank Gates Service Company34091478Self-Insured ID:

Pemco Die Casting Corporation

9864 Church StreetP.O. Box 367Bridgman, MI 49106

Mr. Terrence J. Allen

Cambridge Integrated Services Group, Inc.33048842Self-Insured ID:

Perfection Bakeries, Inc.

350 Pearl StreetFort Wayne, IN 46802

Mr. Jay E. Miller

Michigan Claim Service DBA The ASU Group20030330Self-Insured ID:

Perrigo, L., Company

515 Eastern AvenueAllegan, MI 49010

Mr. James R. Ondersma

Michigan Claim Service DBA The ASU Group28091100Self-Insured ID:

Peterson American Corporation

21200 Telegraph RoadSouthfield, MI 48034

Mr. Timothy J. Masserant

Michigan Claim Service DBA The ASU Group33090975Self-Insured ID:

Petitpren, Inc.

44500 GroesbeckClinton Township, MI 48036-1111

Mr. R. Thomas Snyder

Mackinaw Administrators, LLC51038082Self-Insured ID:

Pilkington North America, Inc.

8300 Norman Center Drive, Suite 400Minneapolis, MN 55437-3844

Ms. Linda J. Smith

Specialty Risk Services, Inc.28090210Self-Insured ID:

Pine Rest Christian Mental Health Services

300 - 68th Street, S.E.P.O. Box 165Grand Rapids, MI 49508

Mr. Andrew George

Eagle Claims Management, LLC80000650Self-Insured ID:

Pine River Plastics, Inc.

1111 FW Moore HighwaySt. Clair, MI 48079

Mr. James Ciaramella

Citizens Management Inc.30036774Self-Insured ID:

Pinecrest Medical Care Facility

N15995 Main StreetP.O. Box 603Powers, MI 49874-0603

Mr. Gerald A. Betters

Citizens Management Inc.80000655Self-Insured ID:

Plastech Engineered Products, Inc.

22000 GarrisonDearborn, MI 48124

Mr. James Beining

Constitution State Services LLC30046063Self-Insured ID:

Individual Self-Insured Employer List

Page: 22Program: names2.frxPrint Date:

Print Time:

12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Plastomer Corporation

37819 Schoolcraft RoadLivonia, MI 48150-1096

Mr. Walter P. Baughman III

Cambridge Integrated Services Group, Inc.30036750Self-Insured ID:

Plymouth-Canton Community Schools

454 South Harvey StreetPlymouth, MI 48170

Mr. Ray Bihun

Accident Fund Insurance Company of America82000982Self-Insured ID:

Pontiac , City of

47450 Woodward AvenuePontiac, MI 48342

Ms. Paulette Poehlman

RSKCo Services, Inc.99900163Self-Insured ID:

Pontiac General Hospital & Medical Center

Suite 201461 West Huron StreetPontiac, MI 48341-1651

Mr. Gary Barnes

Citizens Management Inc.

DBA North Oakland Medical Centers

80001163Self-Insured ID:

Pontiac Osteopathic Hospital

50 North Perry StreetPontiac, MI 48342

Mr. Christopher J. Allman

Citizens Management Inc.

dba P.O.H. Medical Center

80000563Self-Insured ID:

Pontiac School District of the City of

47200 Woodward AvenuePontiac, MI 48342

Mr. Wallace L. Dunn

RSKCo Services, Inc.82000163Self-Insured ID:

Port Huron , City of

100 McMorran BoulevardPort Huron, MI 48060

Mr. John Berry

Accident Fund Insurance Company of America99900174Self-Insured ID:

Port Huron Area School District

1925 Lapeer AvenuePort Huron, MI 48061-5013

Mr. Martin J. Prout

Accident Fund Insurance Company of America82000074Self-Insured ID:

Port Huron Hospital

1221 Pine Grove AvenuePort Huron, MI 48060

Mr. Dennis L. Hoover

Cambridge Integrated Services Group, Inc.80000174Self-Insured ID:

Portage , City of

7900 South Westnedge AvenuePortage, MI 49002

Ms. Patti Thompson

Eagle Claims Management, LLC99900339Self-Insured ID:

Portage Public Schools

8111 S. Westnedge AvenuePortage, MI 49002

Ms. Vickie Herzberg

Accident Fund Insurance Company of America82000439Self-Insured ID:

Pridgeon & Clay, Inc.

50 Cottage Grove, S.W.Grand Rapids, MI 49507

Ms. Therese Labenz

Cambridge Integrated Services Group, Inc.35096648Self-Insured ID:

Procter & Gamble Distributing Company

5299 Spring Grove AvenueBox 209Cincinnati, OH 45217

Ms. B. A. Tribbe

Gates, McDonald & Co.26025284Self-Insured ID:

Progressive Tool & Industries Co.

21000 Telegraph RoadSouthfield, MI 48034

Ms. Tamara Contesti

Maxcis, Inc.34040999Self-Insured ID:

Quality Dairy Company

111 W. Mt. Hope AvenueLansing, MI 48910

Mr. Ron Belinsky

Accident Fund Insurance Company of America54021933Self-Insured ID:

Ralcorp Holdings, Inc.

P.O. Box 618St. Louis, MO 63188-0618

Ms. Cindy M. Boeckmann

Constitution State Services LLC20036885Self-Insured ID:

Randell Manufacturing, Inc.

520 South Coldwater RoadWeidman, MI 48893

Ms. Letha J. Raymond

Citizens Management Inc.35002210Self-Insured ID:

Individual Self-Insured Employer List

Page: 23Program: names2.frxPrint Date:

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12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Red Spot Paint & Varnish Co., Inc.

P.O. Box 418Evansville, IN 47703-0418

Mr. Stephen K. Halling

Cambridge Integrated Services Group, Inc.28090885Self-Insured ID:

Redford Union Schools

18499 Beech Daly RoadRedford, MI 48240

Mr. Frank R. Thomas

Eagle Claims Management, LLC82001482Self-Insured ID:

Ritsema, Herb, Company, The

3000 DormaxGrandville, MI 49418

Ms. Judith Overbeek

Citizens Management Inc.17001041Self-Insured ID:

Rochester Community Schools

501 West University DriveRochester, MI 48307

Dr. John J. Dietz

RSKCo Services, Inc.82000663Self-Insured ID:

Rollins, Inc. et al

2170 Piedmont RoadAtlanta, GA 30324

Mr. Nelson Jackson

Gallagher Bassett Services, Inc.26026327Self-Insured ID:

Roman Catholic Archdiocese of Detroit

510 South Capitol AvenueLansing, MI 48933

Mr. Vincent P. Andrews

Gallagher Bassett Services, Inc.

and all related entities

86000200Self-Insured ID:

Roman Catholic Diocese of Gaylord

510 South Capitol AvenueLansing, MI 48933

Mr. Vincent P. Andrews

Gallagher Bassett Services, Inc.

and all related entities

86000600Self-Insured ID:

Roman Catholic Diocese of Grand Rapids

510 South Capitol AvenueLansing, MI 48933

Mr. Vincent P. Andrews

Gallagher Bassett Services, Inc.

and all related entities

86000700Self-Insured ID:

Roman Catholic Diocese of Kalamazoo

510 South Capitol AvenueLansing, MI 48933

Mr. Vincent P. Andrews

Gallagher Bassett Services, Inc.

and all related entities

86000400Self-Insured ID:

Roman Catholic Diocese of Lansing

510 South Capitol AvenueLansing, MI 48933

Mr. Vincent P. Andrews

Gallagher Bassett Services, Inc.

and all related entities

86000300Self-Insured ID:

Roman Catholic Diocese of Marquette

510 South Capitol AvenueLansing, MI 48933

Mr. Vincent P. Andrews

Gallagher Bassett Services, Inc.

and all related entities

86000900Self-Insured ID:

Roman Catholic Diocese of Saginaw

510 South Capitol AvenueLansing, MI 48933

Mr. Vincent P. Andrews

Gallagher Bassett Services, Inc.

and all related entities

86000500Self-Insured ID:

Romeo Community Schools School District

316 North Main StreetRomeo, MI 48065

Ms. Synthia Schwark

Citizens Management Inc.82001350Self-Insured ID:

Roseville Community Schools

18975 Church StreetRoseville, MI 48066

Ms. Rebecca Vasil

RSKCo Services, Inc.82000350Self-Insured ID:

Rouge Steel Company

3001 Miller RoadP. O. Box 1699Dearborn, MI 48121

Ms. Shirley A. Priskorn

Self-Administered33013982Self-Insured ID:

Royal Oak , City of

211 Williams StreetP.O. Box 64Royal Oak, MI 48068-0064

Mr. Lawrence M. Doyle

Citizens Management Inc.99900463Self-Insured ID:

Individual Self-Insured Employer List

Page: 24Program: names2.frxPrint Date:

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12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Royal Oak , School Dist. of the City of

1123 Lexington BoulevardRoyal Oak, MI 48073

Mr. G. Anders Linell

RSKCo Services, Inc.82001763Self-Insured ID:

Royal Plastics, Inc.

3765 QuincyHudsonville, MI 49426

Mr. Kirk Lambers

Citizens Management Inc.30012045Self-Insured ID:

Ryder System, Inc.

3600 N.W. 82nd AvenueMiami, FL 33166

Ms. Linda Zingsheim

Self-Administered42056445Self-Insured ID:

S P X Corporation

13515 Ballantyne Corporate PlaceCharlotte, NC 28277

Ms. Carol Brocci

Constitution State Services LLC37090204Self-Insured ID:

SEMCO Energy, Inc.

405 Water StreetPort Huron, MI 48061-5026

Mr. Steven W. Warsinske

Accident Fund Insurance Company of America49092074Self-Insured ID:

Saginaw , City of

Room 2021315 South Washington AvenueSaginaw, MI 48601

Ms. Marsha W. Ostler

Cambridge Integrated Services Group, Inc.99900173Self-Insured ID:

Saginaw , County of

111 South Michigan AvenueSaginaw, MI 48602

Mr. Marc A. McGill

Citizens Management Inc.99900073Self-Insured ID:

Saint Clair , County of

Suite 201200 Grand RiverPort Huron, MI 48060

Mr. Troy Feltman

RSKCo Services, Inc.99900374Self-Insured ID:

Saint Clair Shores , City of

27600 Jefferson Circle DriveSt. Clair Shores, MI 48081

Mr. Timothy P. Haney

Citizens Management Inc.99900150Self-Insured ID:

Saint Joseph , City of

700 Broad StreetSt. Joseph, MI 49085

Mr. Frank L. Walsh

Accident Fund Insurance Company of America99900111Self-Insured ID:

Sanders, Joseph, Inc.

237 South MainCuster, MI 49405

Mr. Dale Sanders

Self-Administered20084002Self-Insured ID:

Sarnamotive Blue Water, Inc.

1515 Busha HighwayP.O. Box 129Marysville, MI 48040-0129

Mr. Daniel Lockwood

Cambridge Integrated Services Group, Inc.30090274Self-Insured ID:

Schoolcraft College

18600 Haggerty RoadLivonia, MI 48152-2696

Ms. Jill F. O'Sullivan

Cambridge Integrated Services Group, Inc.82002082Self-Insured ID:

Schreiber Corporation

2239 FenkellP.O. Box 38119Detroit, MI 48238

Ms. Rita M. Bravo

Mackinaw Administrators, LLC17091663Self-Insured ID:

Sherriff-Goslin Company

10 Avenue CBattle Creek, MI 49015

Mr. William Ticknor

Citizens Management Inc.17005000Self-Insured ID:

Sherwin-Williams Company

101 Prospect Avenue N.W.Cleveland, OH 44115

Mr. Anthony J. Colangelo

Gallagher Bassett Services, Inc.28087088Self-Insured ID:

Shiawassee County

Surbeck Building201 North Shiawassee StreetCorunna, MI 48817

Ms. Christina F. Volek

RSKCo Services, Inc.99900078Self-Insured ID:

Individual Self-Insured Employer List

Page: 25Program: names2.frxPrint Date:

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12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Southgate , City of

14400 Dix Toledo RoadSouthgate, MI 48195

Mr. David Angileri

RSKCo Services, Inc.99901582Self-Insured ID:

Southgate Community School District

13201 Trenton Rd.Southgate, MI 48195

Mr. Rick Henegar

Accident Fund Insurance Company of America82001282Self-Insured ID:

Sparrow Health System

Suite 2351215 East Michigan AvenueLansing, MI 48909

Ms. Susan A. Root

Michigan Health & Hospital Association Service Corp.80000533Self-Insured ID:

Spartan Motors, Inc.

1165 Reynolds RoadCharlotte, MI 48813

Ms. Janine Nierenberger

Citizens Management Inc.37009823Self-Insured ID:

Spartan Stores, Inc.

P. O. Box 8700850 - 76th Street S.W.Grand Rapids, MI 49518

Mr. Charles R. Behrend

Shield Risk Services, LLC53091346Self-Insured ID:

Spectrum Health Hospitals

Spectrum Health Human Resources100 Michigan NEGrand Rapids, MI 49503

Mr. Richard P. Mieskowski

Michigan Health & Hospital Association Service Corp.80000941Self-Insured ID:

Stanley Works, The

1000 Stanley DriveNew Britain, CT 06053

Mr. M. Michael Maznio

Specialty Risk Services, Inc.35030885Self-Insured ID:

Stanton, David J., and Associates Inc.

714 West Michigan AvenueJackson, MI 49201

Ms. Karen Gutowski

Eagle Claims Management, LLC58065039Self-Insured ID:

Steel Tex Corporation

4527 Old Plank RoadMilford, MI 48381

Mr. Ronald Hanaway

Citizens Management Inc.34040444Self-Insured ID:

Steelcase Inc.

901 44th S.E.P. O. Box 1967Grand Rapids, MI 49508

Mr. Mark Meyer

Helmsman Management Services, Inc.33006641Self-Insured ID:

Stephenson & Lawyer, Inc.

3831 Patterson, S.E.Grand Rapids, MI 49512

Ms. Judith Banker

Eagle Claims Management, LLC34026690Self-Insured ID:

Sterling Heights, City of

40555 Utica RoadP.O. Box 8009Sterling Heights, MI 48311-8009

Mr. Mark Carufel

Accident Fund Insurance Company of America99900750Self-Insured ID:

Stora Enso North America Corp.

P. O. Box 8050Wisconsin Rapids, WI 54495-8050

Mr. David A. Carlson

Self-Administered26018963Self-Insured ID:

Stryker Corporation

2725 Fairfield RoadKalamazoo, MI 49002

Mr. Christopher F. Homrich

Constitution State Services LLC38041001Self-Insured ID:

Sturgis , City of

130 North Nottawa StreetSturgis, MI 49091

Mr. Michael L. Vance

Eagle Claims Management, LLC99900175Self-Insured ID:

Sturgis Iron & Metal Company, Inc.

70675 Centerville RoadP.O. Box 579Sturgis, MI 49091

Mr. John A. Smits

Citizens Management Inc.50018736Self-Insured ID:

Individual Self-Insured Employer List

Page: 26Program: names2.frxPrint Date:

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12/01/2003

09:09:37

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Suburban Mobility Auth. for Regional Transportation

Suite 950660 Woodward AvenueDetroit, MI 48226

Mr. Avery E. Gordon

Michigan Claim Service DBA The ASU Group35034894Self-Insured ID:

Summit Polymers, Inc.

6715 Sprinkle RoadPortage, MI 49002

Ms. Janice M. Jett

Alternative Service Concepts LLC28090239Self-Insured ID:

Sunoco, Inc.

17th floor1801 Market StreetPhiladelphia, PA 19103

Mr. Steve Metzler

ESIS, Inc.13099031Self-Insured ID:

Target Corporation

Risk Management Department TPN-13001000 Nicollet MallMinneapolis, MN 55403-2467

Ms. Angela Fethers

Constitution State Services LLC53001952Self-Insured ID:

Taylor , City of

23555 Goddard RoadTaylor, MI 48180

Ms. Debra A. Kinde

Accident Fund Insurance Company of America99900782Self-Insured ID:

Taylor School District

23033 Northline RoadTaylor, MI 48180

Mr. Michael L. Johnson

Gallagher Bassett Services, Inc.82000282Self-Insured ID:

Tecumseh Products Company

100 East Patterson StreetTecumseh, MI 49286

Mr. Randall Krichbaum

Self-Administered34005432Self-Insured ID:

Ternes, Howard, Packaging Company

12285 Dixie StreetRedford, MI 48239

Mr. Richard Everhart

Cambridge Integrated Services Group, Inc.26036682Self-Insured ID:

Textron Inc.

Aon Risk Consultants, Inc.8300 Norman Center Drive, Suite 400Minneapolis, MN 55437-3844

Ms. Linda J. Smith

Broadspire Services, Inc.35013580Self-Insured ID:

ThyssenKrupp Budd Company

3155 W. Big Beaver RoadP.O. Box 2601Troy, MI 48007-2601

Ms. April D. Oakes

Self-Administered37004364Self-Insured ID:

Tilden Mining Company L. C.

1100 Superior AvenueCleveland, OH 44114-2589

Mr. Richard L. Bihn

Sedgwick Claims Management Services, Inc.10057085Self-Insured ID:

Toledo Commutator Co.

1101 South ChestnutP.O. Box 700Owosso, MI 48867

Ms. Sue Stender

Citizens Management Inc.36063078Self-Insured ID:

Tomkins Industries, Inc.

20334 Superior RoadTaylor, MI 48180

Mr. William G. Kiley

Gallagher Bassett Services, Inc.33092940Self-Insured ID:

Total Logistic Control, LLC

8300 Logistic DriveZeeland, MI 49464

Mr. John Giraud

Zurich Services Corporation, The42007070Self-Insured ID:

Trendway Corporation

13467 Quincy StreetP.O. Box 9016Holland, MI 49422-9016

Mr. Harlan Sprik

Eagle Claims Management, LLC39003114Self-Insured ID:

Tri-State Hospital Supply Corporation

301 Catrell DriveP.O. Box 170Howell, MI 48843

Mr. John J. Welter

Cambridge Integrated Services Group, Inc.38021047Self-Insured ID:

Individual Self-Insured Employer List

Page: 27Program: names2.frxPrint Date:

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12/01/2003

09:09:38

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Trinity Health-Michigan

34605 Twelve Mile RoadFarmington Hills, MI 48331

Ms. Barbara Cook

Specialty Risk Services, Inc.80000163Self-Insured ID:

Trostel, Albert, & Sons Company

Plaza East Office Center - Suite 750330 East Kilbourn Ave.Milwaukee, WI 53202

Mr. Michael S. Curry

Sentry Insurance a Mutual Company31027128Self-Insured ID:

Troy School District

4400 Livernois RoadTroy, MI 48098

Mr. Michael M. Adamczyk

Citizens Management Inc.82001063Self-Insured ID:

Tuscola , County of

207 East Grant StreetCaro, MI 48723

Mr. Michael R. Hoagland

Citizens Management Inc.99900079Self-Insured ID:

Tyson Foods, Inc.

2210 OaklawnP. O. Box 2020Springdale, AR 72762

Ms. Connie Downum

Self-Administered02469085Self-Insured ID:

Tyson Fresh Meats, Inc.

Tyson Foods, Inc.2210 Oaklawn DriveSpringdale, AR 72762

Ms. Connie Downum

Self-Administered51070085Self-Insured ID:

U S F Holland, Inc.

750 East 40th StreetHolland, MI 49423

Mr. Ron Nyhoff

Constitution State Services LLC42096114Self-Insured ID:

U.S. Manufacturing Corporation

28201 VanDykeWarren, MI 48093

Ms. Laura Hudson

Accident Fund Insurance Company of America35033774Self-Insured ID:

Unilever United States, Inc.

700 Sylvan AvenueC-28-mailstopEnglewood Cliffs, NJ 07632

Ms. Donna M. Hughes

RSKCo Services, Inc.28075885Self-Insured ID:

United Air Lines, Inc.

Workers' Compensation Programs - WHQHRP.O. Box 66100Chicago, IL 60666-0100

Mr. John Smolk

Gallagher Bassett Services, Inc.41048000Self-Insured ID:

United Brass Manufacturers, Inc.

P.O. Box 74095Romulus, MI 48174-0095

Mr. Raymond L. Frisbie

Citizens Management Inc.34090929Self-Insured ID:

United Jewish Foundation &

6735 Telegraph Road Suite 210P.O. Box 2030Bloomfield Hills, MI 48303

Ms. Dorothy Benyas

Accident Fund Insurance Company of America

Jewish Federation of Metro. Detroit

86011198Self-Insured ID:

United Methodist Retirement Communities, Inc.

805 West Middle StreetChelsea, MI 48118-1397

Mr. Dale Cole

Citizens Management Inc.80000642Self-Insured ID:

United States Gypsum Company

c/o USG Corporation125 S. Franklin Street, Dept. #198Chicago, IL 60606-4678

Mr. Bruce A. Czyl

Gallagher Bassett Services, Inc.32091099Self-Insured ID:

United States Steel Corporation

600 Grant Street Room 2544BPittsburgh, PA 15219-2800

Mr. Carl A. Masters

Self-Administered33030718Self-Insured ID:

University of MI, The Regents of the

Argus II Building400 South Fourth StreetAnn Arbor, MI 48103-4816

Mr. G. Paul Moggach

Self-Administered82000581Self-Insured ID:

Individual Self-Insured Employer List

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09:09:38

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Utica Community Schools

11303 GreendaleSterling Heights, MI 48312

Ms. Diane M. Robinson

RSKCo Services, Inc.82000750Self-Insured ID:

Valassis Communications, Inc.

19975 Victor ParkwayLivonia, MI 48152

Ms. Wendy Robinson

Alternative Service Concepts LLC27022552Self-Insured ID:

Van, Art, Furniture, Inc.

6500 Fourteen Mile RoadWarren, MI 48092

Mr. Michael Bolton

Meadowbrook, Inc., dba Meadowbrook Claims Service57012809Self-Insured ID:

Veltri Metal Products, Inc.

Suite 270900 Wilshire DriveTroy, MI 48084

Mr. Mark J. MacGuidwin

Chubb Services Corporation59001050Self-Insured ID:

Venture Industries Corporation

33662 James J. PompoP.O. Box 278Fraser, MI 48026

Ms. Debra Wangrud

Cambridge Integrated Services Group, Inc.30055350Self-Insured ID:

Visiting Nurse Association of S.E. MI., Inc.

Suite 60025900 Greenfield RoadOak Park, MI 48237

Mr. John Byrne

Mackinaw Administrators, LLC80001382Self-Insured ID:

Visteon Corporation

Suite C490-11217000 Rotunda Dr.Dearborn, MI 48121

Ms. Karin S. Frederick

Self-Administered37066063Self-Insured ID:

Walker Acquisition Corp.

660 East Ten Mile RoadFerndale, MI 48220

Mr. Daniel Gendron

Citizens Management Inc.

DBA Walker Wire (ISPAT) Inc.

33025448Self-Insured ID:

Walled Lake Consolidated Schools

Building D850 Ladd RoadWalled Lake, MI 48390

Mr. Craig S. Aleo

Citizens Management Inc.82000363Self-Insured ID:

Warren , City of

29500 Van DykeWarren, MI 48093

Ms. Denise L. Williams

Mackinaw Administrators, LLC99901150Self-Insured ID:

Warren Consolidated Schools

31300 Anita Drive - Administration Bldg.Warren, MI 48093

Dr. William Kiefer

RSKCo Services, Inc.82000150Self-Insured ID:

Washers, Incorporated

33375 Glendale AvenueLivonia, MI 48150

Mr. Mark Schilling

RSKCo Services, Inc.

c/o Alpha Coatings, Inc.

39036410Self-Insured ID:

Washtenaw Community College

P.O. Box D-1Ann Arbor, MI 48106

Mr. Steve Hardy

Accident Fund Insurance Company of America82000881Self-Insured ID:

Washtenaw County

220 North MainP.O. Box 8645Ann Arbor, MI 48107

Ms. Verna J. McDaniel

RSKCo Services, Inc.99900081Self-Insured ID:

Waterford , Charter Township of

Treasurer's Office5200 Civic Center DriveWaterford, MI 48329-3773

Ms. Dee A. Minton

Comprehensive Risk Services, Inc.99901063Self-Insured ID:

Waterford School District

4584 Pontiac Lake RoadWaterford, MI 48328

Mr. Mark A. Zager

Meadowbrook, Inc., dba Meadowbrook Claims Service82000263Self-Insured ID:

Individual Self-Insured Employer List

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09:09:38

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Wayne , City of

3355 South Wayne RoadWayne, MI 48184

Mr. Timothy D. McCurley

Michigan Claim Service DBA The ASU Group99901282Self-Insured ID:

Wayne , County of

5th Floor600 RandolphDetroit, MI 48226

Ms. Mary Lou Solomon

Accident Fund Insurance Company of America99900082Self-Insured ID:

Wayne County Airport Authority

Mezzanine LevelDetroit, MI 48242

Ms. Leigh Stepaniak

Accident Fund Insurance Company of America99901882Self-Insured ID:

Wayne County Community College

801 West Fort StreetDetroit, MI 48226

Ms. Linda Azzam-Harmn

RSKCo Services, Inc.82002182Self-Insured ID:

Wayne State University

Suite 32005700 Cass AvenueDetroit, MI 48202

Mr. Homer L. Isaac

Self-Administered

Office of Risk Management Academic/Admin. Bldg.

82000082Self-Insured ID:

Wayne Westland Community School District

36745 MarquetteWestland, MI 48185

Mr. Bernard M. LaPorte

Michigan Claim Service DBA The ASU Group82001182Self-Insured ID:

Wayne Wire Cloth Products, Inc.

200 DresdenKalkaska, MI 49646

Ms. Patricia Malone

Citizens Management Inc.34008770Self-Insured ID:

Wendy's International, Inc.

4288 West Dublin-Granville RoadP.O. Box 256Dublin, OH 43017

Ms. Mary Ann Fielding

ESIS, Inc.58035885Self-Insured ID:

Western Michigan University

Business Services2324 Seibert Administration BuildingKalamazoo, MI 49008

Mr. Timothy R. Kellogg

Michigan Claim Service DBA The ASU Group82000039Self-Insured ID:

Western-Southern Life Insurance Co.

400 BroadwayCincinnati, OH 45202

Ms. Noreen J. Hayes

Gates, McDonald & Co.63074853Self-Insured ID:

Westland, City of

36601 Ford RoadWestland, MI 48185

Mr. Keith Madden

Alternative Service Concepts LLC99901082Self-Insured ID:

Weyerhaeuser Company

Workers' CompensationP.O. Box 9777 MS:EC2-2B2Federal Way, WA 98063-9777

Ms. Betsie Doust

Self-Administered26091257Self-Insured ID:

Whirlpool Corporation

Maildrop #29032000 North M-63Benton Harbor, MI 49022

Ms. Cristene D. Snow

Helmsman Management Services, Inc.39036578Self-Insured ID:

White Castle System, Inc.

555 West Goodale StreetColumbus, OH 43215-1158

Ms. Linda Kahkonen

Specialty Risk Services, Inc.58034085Self-Insured ID:

Wirtz Manufacturing Co., Inc.

1105 24th StreetP.O. Box 5006Port Huron, MI 48061-5006

Mr. Keith Lepla

Citizens Management Inc.30012799Self-Insured ID:

Wisconsin Electric Power Company

Room P378231 West Michigan StreetMilwaukee, WI 53203

Mr. Michael S. Kaminski

Self-Administered49092100Self-Insured ID:

Individual Self-Insured Employer List

Page: 30Program: names2.frxPrint Date:

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09:09:38

Bureau of Workers' & Unemployment CompensationSelf-Insured Programs

Wisconsin Public Service Corporation

700 North Adams StreetP.O. Box 19001Green Bay, WI 54301

Mr. David S. Nalepka

GAB Robins Risk Management Services, Inc.49059585Self-Insured ID:

Wohlert Corporation

708 East Grand River AvenueLansing, MI 48906

Mr. James W. Barnes

Cambridge Integrated Services Group, Inc.37077016Self-Insured ID:

Wolpin Company, The

1600 Modern StreetDetroit, MI 48203

Mr. Walter J. Wolpin

Gallagher Bassett Services, Inc.51017450Self-Insured ID:

Wolverine Packing Company

2535 RivardDetroit, MI 48207

Mr. A. James Bonahoom

Comprehensive Risk Services, Inc.20043617Self-Insured ID:

Wright & Filippis, Inc.

2845 Crooks RoadRochester Hills, MI 48309

Ms. Sharon Myatt

Specialty Risk Services, Inc.38043302Self-Insured ID:

Wyandotte , City of

3131 Biddle AvenueWyandotte, MI 48192

Mr. Todd A. Drysdale

RSKCo Services, Inc.99900682Self-Insured ID:

Wyandotte , School Dist. of the City of

639 Oak StreetWyandotte, MI 48192

Mr. David Gutenschwager

Cambridge Integrated Services Group, Inc.82000682Self-Insured ID:

Wyoming , City of

1155 - 28th Street S.W.P.O. Box 905Wyoming, MI 49509

Mr. Timothy H. Smith

Accident Fund Insurance Company of America99900341Self-Insured ID:

Yellow Transportation, Inc.

10990 Roe AvenueP.O. Box 7270Overland Park, KS 66207

Ms. Cathy Wilson Pec

Self-Administered42095556Self-Insured ID:

Ypsilanti , City of

One South Huron StreetYpsilanti, MI 48197

Ms. Shari Gregory

RSKCo Services, Inc.99900381Self-Insured ID:

Zehnder's of Frankenmuth, Inc.

730 S. Main StreetFrankenmuth, MI 48734

Ms. Martha Shelton

Citizens Management Inc.58034765Self-Insured ID:

Zieger Health Care Corporation

28050 Grand River AvenueFarmington Hills, MI 48336

Ms. Judy O'Connor

Michigan Health & Hospital Association Service Corp.80001263Self-Insured ID: