2000 annual report

STATE OF GEORGIA SUBSEQUENT INJURY TRUST FUND

Suite 500 North Tower 1720 Peachtree Street, NW
Atlanta, Georgia 30309

Telephone Number: TDD Number: Facsimile:

(404) 206-6360 (404) 206-5053 (404) 206-6363

BOARD OF TRUSTEES
Edward J. Bartlett, Chairman James C. Thompson, Vice-Chairman
Janis Murray, Secretary Peggy Rosser Lewis Lowe
EX-OFFICIO MEMBERS
Julie Y. John John W. Oxendine
ADMINISTRATOR
Anne D. Burnett
DEPUTY ADMINISTRATOR
David L. Taylor

On July 1, 1977, the Georgia General Assembly enacted legislation establishing the
Subsequent Injury Trust Fund. It is designed to reduce the impact of singularly large workers' compensation claims in the event a worker with a disability, injured on the job, aggravates a pre-existing impairment.
The Subsequent Injury Trust Fund is a separate state agency, governed by a five-member Board of Trustees appointed by the Governor for six-year terms. An administrator and staff consisting of 29 employees conduct the actual administration of the Fund.
The Fund helps workers with disabilities by providing employers, who are not subject to the Americans with Disabilities Act with incentives to hire or retain qualified workers with disabilities, assists insured employers by keeping workers' compensation premiums under control, and if an employer is self-insured, keeps the workers' compensation exposure at the deductible levels.
In order for an employer/insurer to be eligible for reimbursement from the Fund, the employee's subsequent injury must be directly caused by the prior impairment, or combine with a prior impairment to create greater employer liability for lost time benefits and medical expenses. In addition, the employee must have a pre-existing impairment that the employer considered to be permanent and likely to be a hindrance to employment, and the employer must have knowledge of the prior impairment before the subsequent injury occurs.
The law also contains a list of conditions which are presumed to be permanent and likely to be a hindrance to employment provided the employer can demonstrate prior knowledge.
Employers/insurers may be reimbursed for all weekly income benefits payable after 104 weeks, for 50% of all medical and rehabilitation expenses between $5,000 and $10,000, and for 100% of all medical and rehabilitation expenses in excess of $10,000. If the subsequent injury was not caused by or related to a prior impairment, the reimbursement for medical expenses may be reduced or denied completely. The employer/insurer files a claim for reimbursement directly with the fund. The Fund investigates the claim to determine eligibility for reimbursement. When a reimbursement agreement is reached between the Fund and the employer or insurer, it must be approved by the State Board of Workers' Compensation. If an agreement cannot be reached, either party may request a mediation conference or a hearing with the State Board of Workers' Compensation.

Table of Contents

REIMBURSEMENTS PAID TO INSURANCE COMPANIES REIMBURSEMENTS PAID TO GROUP SELF - INSURED EMPLOYERS REIMBURSEMENTS PAID TO SELF - INSURED EMPLOYERS INDIVIDUAL EMPLOYERS BENEFITING FROM REIMBURSEMENTS CLAIMS REPORTED BY INSURANCE COMPANIES CLAIMS REPORTED BY SELF-INSURED GROUPS CLAIMS REPORTED BY SELF-INSURERS REVENUES, EXPENDITURES AND FUND BALANCE 2000 CLAIMS ACTIVITY 2000 SECTION 34-9-358 OF THE OFFICIAL CODE OF GEORGIA ADJUSTED 1999 ASSESSMENT CALCULATION ASSESSMENT CALCULATION FOR 2000 ASSESSMENT - INSURANCE COMPANIES ASSESSMENT - GROUP SELF-INSURERS ASSESSMENT - SELF-INSURERS

PAGE 1 6 7
14 50 56 57 65 65 66 67 67 68 77 78

Total Dollars Paid By The Subsequent Injury Trust Fund To Insurance Companies
From 1/1/00 Through 12/31/00

Name ACE AMERICAN INSURANCE CO. ACE PROPERTY AND CASUALTY INS. ACTAVA RISK RETENTION GROUP AIG NATIONAL INSURANCE CO. AIU INSURANCE COMPANY ALFA INSURANCE CORPORATION ALLIANZ INSURANCE CO ALLSTATE INSURANCE COMPANY AMERICAN ALTERNATIVE INS AMERICAN CAS CO OF READING PA AMERICAN HOME ASSURANCE CO AMERICAN INSURANCE COMPANY AMERICAN INTER INS CO OF GA AMERICAN MANUFACTURERS MUT INS AMERICAN MOTORISTS INS COMPANY AMERICAN PROTECTION INS CO AMERICAN STATES INSURANCE CO AMERISURE INSURANCE COMPANY APAG MUTUAL CAPTIVE ARGONAUT INSURANCE COMPANY ARGONAUT-MIDWEST INS CO ASSOCIATED INDEMNITY CORPORATN ATLANTIC MUTUAL INSURANCE CO AUTO OWNERS INSURANCE COMPANY BANKERS STANDARD INSURANCE CO BIRMINGHAM FIRE INS CO OF PA BITUMINOUS CASUALTY CORP BROTHERHOOD MUTUAL INS CO BUILDERS INSURANCE CALIFORNIA COMPENSATION INS CO CANAL INSURANCE COMPANY CAPITAL CITY INSURANCE COMPANY CASUALTY RECIPROCAL EXCHANGE CENTENNIAL INSURANCE CO CENTRE INSURANCE COMPANY CHARTER OAK FIRE INSURANCE CO CHRYSLER INSURANCE COMPANY CHUBB INDEMNITY INS. CO. CHURCH MUTUAL INS CO CINCINNATI INDEMNITY COMPANY CINCINNATI INSURANCE COMPANY CLARENDON NATIONAL INS. CO. COLUMBIA NATIONAL INSURANCE CO COMMERCE & INDUSTRY INS CO COMMERCIAL MUTUAL INSURANCE CO COMMERCIAL UNION INSURANCE CO

Amount $60,311.64 $73,197.70
$7,448.40 $71,049.00 $28,837.88 $58,961.68
$46.74 $16,410.00
$6,796.93 $387.87
$80,237.15 $566,687.85
$3,534.75 $116,450.17 $552,529.28 $158,399.25
$62,826.12 $33,604.95
$36.03 $72,048.84
$12.23 $10,967.02 $144,949.08 $270,987.39 $201,185.53 $128,500.00 $45,074.36
$551.26 $1,116,966.20
$137,489.62 $173,655.72 $330,344.70
$34,935.47 $137,416.14 $205,092.13
$18,610.88 $10.21
$8,960.40 $27,634.94 $44,484.90 $257,093.22 $167,354.28 $34,287.49 $29,664.72 $553,710.76 $108,578.64

Total Dollars Paid By The Subsequent Injury Trust Fund To Insurance Companies
From 1/1/00 Through 12/31/00

Name COMPANION PROPERTY & CASUALTY CONNECTICUT INDEMNITY CO CONTINENTAL CASUALTY COMPANY CONTINENTAL INSURANCE COMPANY CORNERSTONE MUTUAL INS CO CREDIT GENERAL INSURANCE CO DISCOVER PROPERTY & CASUALTY ELECTRIC INSURANCE CO. ELECTRIC MUTUAL LIAB. INS. LTD EMPLOYERS INSURANCE OF WAUSAU EXCELSIOR INSURANCE COMPANY FARMINGTON CASUALTY COMPANY FEDERAL INSURANCE COMPANY FEDERATED MUTUAL INSURANCE CO FEDERATED RURAL ELECTRIC INS FIDELITY & CASUALTY CO OF NY FIREMAN'S FUND INS CO OF GA FIREMAN'S FUND INSURANCE CO FIRST NATL INS CO OF AMERICA FLORISTS' MUTUAL INSURANCE CO FRONTIER INSURANCE COMPANY GA INSURERS INSOLVENCY POOL GA TIMBER HARVERSTERS' MUTUAL GENERAL ACCIDENT INS OF AMER GENERAL CASUALTY CO OF WI GENERAL INSURANCE CO OF AMERIC GEORGIA CASUALTY & SURETY CO GEORG~INSURANCECOMPANY GERBER LIFE INSURANCE COMPANY GLENS FALLS INSURANCE COMPANY GRANITE STATE INSURANCE CO GREAT AMERICAN INSURANCE CO GREAT WEST CASUALTY COMPANY GROCERS INSURANCE COMPANY GUIDEONE MUTUAL INSURANCE CO GULF INSURANCE COMPANY HANOVER INSURANCE COMPANY HARBOUR SPECIALITY INSURANCE HARTFORD ACCIDENT & INDEMNITY HARTFORD CASUALTY INSURANCE CO HARTFORD FIRE INSURANCE CO HARTFORD UNDERWRITERS INS CO HIGHLANDS INSURANCE COMPANY HOME INDEMNITY COMPANY HOME INSURANCE COMPANY HOMESTEAD INSURANCE COMPANY

Amount $379,379.26 $484,681.30 $1,273, 111.69 $100,270.68 $231,021.31
$64,938.69 $56,446.05 $244,858.34 $19,570.21 $935,948.57
$74.53 $15,012.99 $146,771.26 $166,467.83
$2,863.95 $196,356.68 $328,558.52 $563,760.56 $101,245.68
$41,692.18 $23,832.13 $242,786.67
$5,293.49 $364,393.78
$6.40 $112,934.11 $139,493.17 $154,998.82
$17,953.00 $85,313.67 $30,716.85 $135,342.63
$6,047.46 $167.66
$28,885.91 $4,612.50
$144,885.79 $80,857.94
$1,265,589.69 $88,910.18 $25,623.44 $92,302.98 $72,057.64
$120,859.34 $1,055,756.94
$0.16

2

Total Dollars Paid By The Subsequent Injury Trust Fund To Insurance Companies
From 1/1/00 Through 12/31/00

Name HOUSTON GENERAL INSURANCE CO INDIANA LUMBERMENS MUTUAL INS INSURANCE CO OF NORTH AMERICA INSURANCE CO OF STATE OF PA INTERNATIONAL INDEMNITY CO JEFFERSON PILOT FIN INS CO LEGION INSURANCE COMPANY LIBERTY INSURANCE CORPORATION LIBERTY MUTUAL FIRE INS LIBERTY MUTUAL INSURANCE CO LUMBER MUTUAL INSURANCE CO LUMBERMENS MUTUAL CASUALTY CO LUMBERMEN'S UNDERWRITING ALLIA MANAGEDCARE MUT CAPTIVE INS MANUFACTURER'S ALLIANCE INS. MARYLAND CASUALTY COMPANY MASSACHUSETTS BAY INSURANCE CO MIDWEST EMPLOYERS CASUALTY CO MONUMENTAL GENERAL CASUALTY NATIONAL AMERICAN INSURANCE CO NATIONAL FIRE INS CO HARTFORD NATIONAL SURETY CORPORATION NATIONAL TRUST INSURANCE CO NATIONAL UNION FIRE OF PITT PA NATIONWIDE MUTUAL INSURANCE CO NEW HAMPSHIRE INSURANCE CO NIPPON FIRE & MARINE INS CO NORTH AMERICAN SPECIALTY INS NORTH RIVER INSURANCE COMPANY NORTHBROOK PROP & CAS INS CO NORTHERN ASSURANCE CO OF AMER OCCIDENTAL FIRE & CASCO OF NC OHIO FARMERS INSURANCE COMPANY OLD REPUBLIC INSURANCE COMPANY OLD REPUBLIC UNION INS CO PACIFIC EMPLOYERS INSURANCE CO PACIFIC INDEMNITY COMPANY PENNSYLVANIA MANUF ASSOC INS PENNSYLVANIA MANUF. IND. CO. PHOENIX INSURANCE COMPANY PREFERRED SURETY CORPORATION RAMPART INSURANCE COMPANY REGENT INSURANCE COMPANY RELIANCE INSURANCE COMPANY RELIANCE NATIONAL INDEMNITY CO RELIANCE NATIONAL INSURANCE CO

Amount $354,902.47
$53,619.69 $21,924.70 $1,210,258.79 $92,150.19 $319,508.29 $320,357.10 $41,900.90 $17,671.05 $1,534,089.67
$8,469.99 $495,080.71 $394,798.66
$56,782.61 $9.83
$192,303.93 $8,225.00 $5,930.05 $3,615.20
$239,251.91 $55,534.37 $23,776.17
$154,215.78 $732,623.57
$97,626.05 $21,210.56
$1.60 $30,752.03 $68,649.37 $72,215.03
$5.51 $7,155.00 $6,288.45 $494,874.00 $28,690.60 $833,208.66 $27,629.48 $5,164.79 $5,003.03 $26,556.49 $47,458.98
$2.04 $1,211.42 $229,556.56 $312,776.72 $261,828.54

3

Total Dollars Paid By The Subsequent Injury Trust Fund To Insurance Companies
From 1/1/00 Through 12/31/00

Name REPUBLIC WESTERN INS CO ROYAL INSURANCE CO OF AMERICA SAFECO INSURANCE CO AMERICA SECURITY INS CO OF HARTFORD SELECT INSURANCE COMPANY SELECTIVE INS CO OF AMERICA SELECTIVE INS CO OF SOUTHEAST SELECTIVE INSURANCE CO OF SC SENTRY INSURANCE A MUTUAL CO SOUTH CAROLINA INSURANCE CO SOUTHERN FIRE & CASUALTY CO SOUTHERN GUARANTY INSURANCE CO SOUTHERN MUTUAL CHURCH INS CO SOUTHERN PILOT INSURANCE CO. SOUTHERN TRUST INSURANCE CO ST PAUL FIRE & CASUALTY INS CO ST PAUL FIRE & MARINE INS CO STANDARD FIRE INSURANCE CO STAR INSURANCE COMPANY STATE AUTO PROPERTY & CASUALTY STATE AUTOMOBILE MUTUAL INS STATE FARM FIRE & CASUALTY CO STATE FARM GENERAL INS COMPANY SUMITOMO MARINE & FIRE INS CO SUPERIOR PACIFIC CASUALTY CO TIG INSURANCE COMPANY TIG PREMIER INSURANCE COMPANY TOKIO MARINE & FIRE INS CO TRANSCONTINENTAL INSURANCE CO TRANSPORT INSURANCE COMPANY TRANSPORTATION INSURANCE CO TRAVELERS CASUALTY & SURETY CO TRAVELERS INDEMNITY CO OF CT TRAVELERS INDEMNITY CO OF IL TRAVELERS INDEMNITY COMPANY TRAVELERS INDEMNITY OF AMERICA TRAVELERSINSURANCE-ALTERNAT TRAVELERS INSURANCE COMPANY TRAVELERS PROP & CAS INS CO TWIN CITY FIRE INSURANCE CO U. S. FIDELITY & GUARANTY INS UNISUN INSURANCE COMPANY UNITED PACIFIC INSURANCE CO UNITED STATES FIRE INSURANCE UNIVERSAL UNDERWRITERS INS CO UTICA MUTUAL INSURANCE COMPANY

Amount $96.27
$631,589.11 $494,691.64
$55,468.55 $15,372.34 $202,450.86 $12,314.64 $28,579.25 $268, 114.07 $24,003.54 $65,118.61 $20,443.78
$64.11 $2,655.04 $4,962.64 $19,391.09 $511,605.08 $18,113.05 $31,812.47 $70,646.48 $75,761.08 $375,222.50 $35,459.70
$213.88 $35,843.24 $78,961.59 $194,271.25 $237,117.15 $269,347.20
$2,860.00 $1,545,866.27 $2,096,544.04
$10,129.24 $95,045.39 $234,606.85 $79,715.44
$4,020.64 $2,711,783.78
$270,240.68 $48,666.23 $44,814.83 $12,596.25 $10,125.00 $38,437.33 $41,107.72
$171,575.66

4

Total Dollars Paid By The Subsequent Injury Trust Fund To Insurance Companies
From 1/1/00 Through 12/31/00

Name VALIANT INSURANCE COMPANY VALLEY FORGE INSURANCE COMPANY VIGILANT INSURANCE COMPANY VIRGINIA SURETY COMPANY INC WAUSAU UNDERWRITERS INS CO WESTFIELD INSURANCE COMPANY YASUDA FIRE & MAR INS OFAMERI ZENITH INSURANCE COMPANY ZURICH AMERICAN INS CO OF IL ZURICH INSURANCE COMPANY
Grand Total:

Amount $639.83 $201,988.00 $37,215.58 $269.00 $129,137.46 $284,012.77 $19,800.00 $282,426.68 $1,258,086.04 $468,356.78
$38,605,595.39

5

Total Dollars Paid By The Subsequent Injury Trust Fund To Group Self-Insured
From 1/1/00 Through 12/31/00

Name AGRITRUST OF GEORGIA AMERICAN APPAREL CONT. ASSOC AMERICAN SUBCONTRACTORS ASSOCIATION CTY COM GA SI COMPTRUST AGC OF GEORGIA CONDITIONED AIR ASSOCIATION GA CONSTRUCTION SUPPLIERS' ASSOC DALTON FLOOR COVERING MARKET GA ASSOC OF CONVENIENCE STORES GA AUTO DEALERS ASSOCIATION SI GA CONCRETE & PRODUCTS ASSOC GA EDUCATION WC TRUST FUND GA HIGHWAY CONTRACTORS SITF GA HOSPITAL ASSOC WCSI FUND GA MFG WORKERS' COMP. FUND GA MUNICIPAL ASSN WCSIF GA OILMEN'S ASSOCIATION GA OPERATORS SELF-INSURERS GA RETAIL MERCHANTS' GA SCHOOL BD ASSOC W C FUND GA UNITED BUSINESSES GA WHOLESALE & RETAIL WC FUND GAC CROP & LIVESTOCK SELF GAC MANUFACTURING/PROCESSING GAC WHOLESALE/RETAIL SELF GEMC WORKERS' COMP FUND GEORGIA MOTOR TRUCKING ASSOC HOME BUILDERS ASSOC GA SI FUND HOSPITALITY SELF-INSURER'S METRO ATLANTA LANDSCAPE/TURF PRINTING INDUSTRY ASSOC OF GA ROOFING & SHEET METAL ASSOC SOUTHEASTERN LUMBER MFR ASSOC W. C. FUND FOR HEALTH CARE
Grand Total:

Amount $105,071.54
$23,583.83 $5,000.00
$1,290,270.19 $931,227.29 $102,759.74 $161,759.93 $102,576.05 $79,138.53 $223,854.19 $123,439.12 $460,623.22 $113,474.80 $625,970.12 $374,643.20 $990,556.97 $112,885.21 $15,622.12 $219,975.52 $369,211.25 $67,249.62 $225,420.27 $15,430.10 $327.30 $16,489.76 $255,273.79 $74,500.02 $94,654.02 $35,239.85 $18,345.43 $165,891.33 $273,807.86 $88,419.50 $720.59
$7,763,412.26

6

Total Dollars Paid By The Subsequent Injury Trust Fund
To Self-Insured Employers From 1/1/00 Through 12/31/00

Name AGL RESOURCES, INC. ALADDIN MILLS INC ALBANY, CITY OF ALPHARETTA, CITY OF AMSTED INDUSTRIES INC ARCHER-DANIELS-MIDLAND CO. ARMSTRONG WORLD INDUSTRIES INC ASPLUNDH TREE EXPERT CO ATHENS-CLARKE COUNTY ATLANTA BOARD OF EDUCATION ATLANTA CITY OF ATLANTA HOUSING AUTHORITY ATLANTIC STEEL INDUSTRIES INC AUTOMOTIVE MOULDING COMPANY AUTOZONE, INC AVONDALE MILLS INC BANKHEAD ENTERPRISES, INC BAPTIST VILLAGE INC BARTOW COUNTY BD OF EDUCATION BAYLINER MARINE CORPORATION BEAULIEU OF AMERICA BELLSOUTH CORPORATION BELLSOUTH ENTERPRISES INC BENTON-GEORGIA INC BET USA, INC BIBB COMPANY BIBB COUNTY BO-COMMISSION BIG B, INCORPORATED BLOSSMAN COMPANIES, INC BLUE BIRD BODY COMPANY BLUE CIRCLE AMERICA BORDEN INC BREMEN-BOWDEN INVESTMENT CO. BROWNING-FERRIS IND OF GA INC BRUNO'S INC & SUBSIDIARIES C T HARRIS INC C. W. MATTHEWS CONTRACTING INC CAGLE'$ INC, & SUBSIDIARIES CALIBER SYSTEM, INC. CANDLER HEALTH SYSTEM CARADON, INC. CAREMORE INC CARROLL CO. BOARD OF EDUCATION CBS CORP CENTRAL GEORGIA HEALTH SYSTEMS CERTAINTEED CORPORATION

Amount $311,593.44
$36,204.12 $73,855.56 $237,527.55
$3,857.82 $60,070.70
$2,163.82 $13,241.87 $190,004.23 $57,597.21 $412,793.27 $43,500.00 $128,745.21 $25,894.60 $26,535.76 $14,284.24 $24,209.81
$1,347.97 $25,256.41 $38,029.98 $289,134.07 $80,470.71 $47,027.02 $25,920.30 $62,185.55 $68,111.80 $16,143.27 $13,500.00
$108.19 $285,518.75
$33,100.36 $2,760.87 $54.50 $3.75
$130,037.95 $48,624.72
$152,488.45 $15,101.06 $15,286.25 $33,212.34 $86,499.90 $15,491.95 $603.98 $42.22 $99,958.15 $5,098.87

7

Total Dollars Paid By The Subsequent Injury Trust Fund To Self-Insured Employers
From 1/1/00 Through 12/31/00

Name CHAMPION INTERNATIONAL CORP CHATHAM COUNTY BD OF EDUCATION CHATHAM COUNTY GEORGIA CHEROKEE BRICK & TILE CHEROKEE CO BD OF COMMISSIONER CHILDREN'S HEALTHCARE OF ATLAN CLAYTON COUNTY BD OF EDUCATION CLAYTON COUNTY COMMISSIONERS CMI INDUSTRIES INC. COATS & CLARK, INC. COBB COUNTY BO/COMMISSIONERS COBB COUNTY SCHOOL SYSTEM COCA-COLA COMPANY COCA-COLA ENTERPRISES INC COLLINS & AIKMAN FLOORCOVERING COLQUITT CO BD OF EDUCATION COLQUITT REGIONAL MEDICAL CENT COLUMBIA CO BOARD OF EDUCATION COLUMBIA FARMS, INC COLUMBIA GEORGIA CORP. COLUMBUS FOUNDRIES INC CONAGRA FOODS, INC CONOCO INC CONSOLIDATED FREIGHWAYS/DELWAR CONTI GROUP COMPANIES, INC CONTINENTAL TIRE N. AMER., INC COOPER INDUSTRIES, INC COOPER TIRE AND RUBBER CORONET INDUSTRIES INC COX ENTERPRISES INC CRACKER BARREL OLD CNTRY STORE CRAWFORD & COMPANY CRAWFORD W LONG MEM HOSPITAL D&W CARPET & RUG COMPANY INC DALTON CITY OF DAVIDSON MINNERAL PROPERTIES DECATUR, CITY OF DEKALB COUNTY GOVERNMENT DEKALB REGIONAL HLTHCARE SYS DELTA AIRLINES, INC. DIXIE GROUP & SUBSIDIARIES DOLLAR GENERAL CORP DOMINO'S PIZZA, INC DOUGLAS CO BD OF COMMISSIONERS DOUGLAS, CITY OF DRY BRANCH KAOLIN COMPANY

Amount $34,107.34 $30,337.74 $52,301.98 $56,613.79 $63,160.67 $181,413.49 $13,933.08 $306,254.94 $36,212.81 $16,705.92 $184,295.11 $138,961.13 $73,944.55
$648.06 $11,795.38 $20,496.96
$7,010.26 $50.43
$1,216.39 $43,448.72 $11,609.54 $175,726.65
$829.83 $11,668.90
$3,000.00 $19,870.63
$8,776.08 $58,694.60 $22,694.51 $62,871.92
$3,936.68 $476.28
$1,624.31 $3,255.10 $194,634.29 $39,080.47 $5,001.55 $123,709.99 $11,794.40 $471,617.18 $142,659.83 $8,200.28 $1,385.68 $101,422.90 $221,412.78 $19,409.12

8

Total Dollars Paid By The Subsequent Injury Trust Fund To Self-Insured Employers
From 1/1/00 Through 12/31/00

Name DURAND-WAYLAND, INC DURKAN PATTERNED CARPET E I DUPONT DE NEMOURS & CO EATON CORPORATION EGLESTON CHILDREN'S HLTH CARE ELBERTON GRANITE ASSOCIATION ENGELHARD CORPORATION FAYETTE COUNTY BD OF COMM FAYETTE COUNTY BD OF EDUCATION FEDERAL EXPRESS FEDERATED DEPARTMENT STORES FIELDALE FARMS CORPORATION FIELDCREST CANNON INC FIRST UNION CORPORATION FLEETWOOD HOMES OF GA INC FLORIDA ROCK & TANK LINES INC FLOWERS INDUSTRIES INC FORD MOTOR COMPANY FORSYTH CO BD OF COMMISSIONERS FORT JAMES CORP. FREUDENBERG-NOK FRIGIDAIRE CO MICROWAVE PRODS. FULTON COUNTY BD OF EDUCATION FULTON COUNTY, GEORGIA FULTON-DEKALB HOSPITAL AUTHY GA MEDCORP, INC. GALAXY CARPET MILLS INC GEIGER INTERNATIONAL, INC GENUINE PARTS COMPANY GEORGIA DUCK & CORDAGE MILL GEORGIA POWER CO GEORGIA SELF-INSURERS GUARANTY GEORGIA STATE OF GEORGIA-PACIFIC CORPORATION GFF HOLDING CO/GENERAL FIBERS GLYNN COUNTY BOARD OF COMMSNRS GOLD KIST INC GOLDEN PEANUT COMPANY GRAND UNION COMPANY GREAT DANE LTD PARTNERSHIP GULFSTREAM AEROSPACE CORP GWINNETT CO BD OF EDUCATION GWINNETT HOSPITAL SYSTEM HALL COUNTY BOARD OF EDUCATION HAMILTON HEALTH CARE SYSTEM HARDEE'S FOOD SYSTEMS INC

Amount $430.58
$52.34 $10,161.21
$76.38 $181,136.88
$5,720.00 $190,326.40
$25,039.16 $4,571.01
$57,165.66 $4,008.62
$43,663.07 $225,370.38
$37.40 $15,932.68 $10,832.50 $329,688.15 $409,832.86
$1,679.52 $58,292.05 $25,296.26
$7,412.10 $43,231.34 $163,546.73 $56,452.04 $76,977.03 $70,506.55 $81,133.50 $65,411.41 $11,475.00 $180,756.87 $568,838.50 . $7,027,912.09 $709,080.01 $14,506.88 $289,999.79 $79,570.11
$19.15 $206,243.11
$19,986.70 $102, 188.46
$51,938.39 $26,809.54 $36,240.61 $79,845.55
$13.15

9

Total Dollars Paid By The Subsequent Injury Trust Fund To Self-Insured Employers
From 1/1/00 Through 12/31/00

Name HARRIET & HENDERSON YARNS HARRISON POULTRY, INC HCA - THE HEALTHCARE CO. HILLCREST FOODS, INC HON INDUSTRIES, INC. HORMEL, GEORGE & COMPANY HORTON HOMES, INC HOUSE OF RONNIE, INC HOUSTON COUNTY BD OF EDUCATION HUTCHESON MEDICAL CENTER HYATT CORPORATION IDA CASON CALLAWAY FOUNDATION IH SERVICE, INC INTERFACE, INC INTERSTATE PAPER LLC J H HARVEY COMPANY J. C. PENNEY COMPANY, INC. JEAN HOSIERY MILL, INC JONES COMPANY KAHN CONSTRUCTION COMPANY INC KEEBLER COMPANY KENNESTONE REGIONAL HEALTH KERR-MCGEE PIGMENTS (SAV) INC. KLEEN-TEX INDUSTRIES K-MART CORP & SUBSIDIARIES LADY MADISON, DIV MADISON INC LOUISIANA-PACIFIC CORP LOW TEMP INDUSTRIES LOWE'S HOME CENTERS, INC LOXCREEN COMPANY, INC. MACON CITY OF MAPLEHURST DELI-BAKE STH MARGLEN INDUSTRIES INC MARIETTA CITY SERVICES MAR-JAC POULTRY, INC. MARMON INDUSTRIAL CORP MARTA MAYFAIR MILLS, INC MCDONALD'$ OF GEORGIA INC MCKESSON CORPORATION MCKIBBON BROTHERS INC MEAD CORPORATION MEMORIAL MEDICAL CENTER, INC. METROMEDIA INTERNATIONAL GRP MOHAWK CARPET CORPORATION MORRISON HEALTH CARE, INC.

Amount $62,300.04
$295.20 $345,018.96
$32,766.54 $754.96 $8.00
$13,216.87 $28,244.83 $49,044.65 $75,000.00 $69,931.59
$2,157.53 $9.17
$167.41 $9.51
$156,624.85 $27,456.89 $7.39 $138.20 $103.74
$238,714.43 $62,191.49 $2,092.88 $4,235.32
$271,361.30 $10.95
$17,270.00 $14,988.90 $42,046.02
$7,358.52 $331,256.37
$36,543.20 $138.25
$19,518.87 $39,563.20
$3,357.26 $54,881.80
$3,546.20 $85.65
$683.65 $3,055.00 $29,325.00 $59,988.48 $16,565.00 $254, 159.39 $68,158.67

10

Total Dollars Paid By The Subsequent Injury Trust Fund To Self-Insured Employers
From 1/1/00 Through 12/31/00

Name MORRISON RESTUARANTS, INC. MOUNT VERNON MILLS MULLITE CO OF AMERICA MULTITEX CORP MURPHY-HARPST-VASHTI, INC. MUSCOGEE COUNTY SCHOOL DIST NABISCO, INC NATIONAL SERVICES INDUSTRIES NATIONSBANK CORPORATION NEWMARK & JAMES, INC. NEWTON COUNTY NORDSON CORPORATION NORTHEAST GEORGIA HEALTH SYS NORTHSIDE HOSPITAL OAKWOOD HOMES CORP/DESTINY IND OLIVER RUBBER CO OPELIKA INDUSTRIES, INC OVERNITE TRANSPORTATION CO OWENS-CORNING FIBERGLASS PATTERSON PUMP COMPANY PCC AIRFOILS INC PEACH STATE PRESBYTERIAN HOMES PEPSICO, INC PIEDMONT HOSPITAL PIKE ELECTRIC, INC. PLANTATION PIPE LINE COMPANY QUEEN CARPET CORPORATION RACETRAC PETROLEUM, INC RALSTON PURINA COMPANY RANDSTAD STAFFING SERVICES RHODES NURSING HOME RICHMOND COUNTY BD OF COMMISS RICHMOND CTY BD OF EDUCATION ROADWAY EXPRESS, INC. ROBERDS, INC ROCOR INTERNATIONAL ROLLINS INC ROME, CITY OF ROOKER ADMINISTRATIVE SERVICES ROPER CORPORATION RTM, INC. RUSSELL CORPORATION RYAN'S FAMILY STEAK HOUSES RYDER SYSTEMS INC SAINT JOSEPH'S HEALTH SYSTEM SAINT JOSEPH'S OF SAVANNAH

Amount $76.67
$71,371.31 $73,812.00
$42.18 $46,068.65 $14,814.55 $91,912.59 $217,889.50
$101.69 $19.50
$8,407.09 $34,220.48 $121,226.59 $26,374.92
$5,443.10 $61,854.16
$28.49 $27,407.48 $50,072.55 $100,790.48 $206,791.69
$4.83 $51,788.06 $26,541.97 $167,649.37
$0.64 $96,412.39 $75,758.45 $132,216.81 $81,781.27
$8.43 $3,577.18 $59,756.63 $99,356.64
$73.98 $155,929.59
$10,965.12 $37,134.68
$907.88 $8,858.29 $26,857.44 $97,520.49 $5,280.16 $375,991.36 $15,188.50 $34,069.30

11

Total Dollars Paid By The Subsequent Injury Trust Fund
To Self-Insured Employers From 1/1/00 Through 12/31/00

Name SAINT MARY'S HEALTH CARE SANDERS BROTHERS INC SARA LEE CORPORATION SAVANNAH CITY OF SAVANNAH ELECTRIC & POWER CO SCIENTIFIC-ATLANTA INC SEARS, ROEBUCK & CO SHAW INDUSTRIES INC SHERWIN-WILLIAMS COMPANY SIZEMORE ,INC. SKF USA INC SOUTHDOWN INC. SOUTHEAST GA HLTH SYSTEMS SOUTHEAST-ATLANTIC BEVERAGE SOUTHERN AMBULANCE BUILDERS SOUTHERNBELLTEL&TEL SOUTHERN MILLS INC SOUTHWIRE COMPANY SPALDING & EVENFLO COMPANIES ST FRANCIS HOSPITAL STAFFMARK, INC. STONE CONTAINER CORPORATION STONE SAVANNAH PULP/PAPER SUPERIOR RIGGING & ERECTING CO SWIFT TEXTILES INC SYNTHETIC INDUSTRIES, INC T. M. POLYFILM, INC TARGET CORPORATION TENNECO AUTOMOTIVE, INC TEXFI INDUSTRIES, INC. TEXTILE RUBBER & CHEMICAL THERMAL CERAMICS TIFT GENERAL HOSPITAL TIFTON ALUMINUM CO INC TIP TOP POULTRY INC TRC STAFFING SERVICES, INC TYCO INTERNATIONAL LTD. TYSON FOODS INC UNION CAMP CORPORATION UNITED HEALTH SERVICES INC US GYPSUM/L & W SUPPLY & SUBS VF CORPORATION VISITING NURSE HEALTH SYSTEM VULCAN MATERIALS COMPANY WAFFLE HOUSE WAREHOUSE HOME FURNISHINGS

Amount $37,898.86
$25.06 $348.75 $5,340.00 $22,060.20 $229,298.94 $36,818.93 $729,702.68 $110,823.67 $1,215.23 $18,554.00 $11,550.00 $42,627.68 $1,000.00 $14,500.00 $7,790.49 $25,560.12 $276,052.84 $33.08 $26,417.27 $103,602.01 $24,681.44 $5,305.40 $10,800.00 $22.88 $43,027.77 $45,887.52 $7,847.43 $165,811.55 $18,588.80 $13,828.24 $93,828.78 $81.10 $178,008.28 $37,518.16 $71,023.99 $3,459.52 $76,833.45 $112,121.15 $24,982.69 $6,143.18 $32,883.89 $9,702.54 $7,020.00 $374,991.25 $44,425.86

12

Total Dollars Paid By The Subsequent Injury Trust Fund To Self-Insured Employers
From 1/1/00 Through 12/31/00

Name WARREN SEWELL MFG. CO. WATKINS ASSOCIATED INDUSTRIES WATKINS ENGINEERS & CONST. WAYCROSS, CITY OF WELLINGTONLE~UREPRODUCTS WELLSTAR HEALTH SYSTEM WESLEY HOMES, INC WEST GEORGIA HEALTH SYSTEM WEST POINT STORES INC WESTVACO CORPORATION & SUBS WEYERHAEUSER COMPANY WHITFIELD COUNTY BD OF COMMISS WINN-DIXIE STORES INC WORLD CARPETS INC YANCEY BROTHERS COMPANY YELLOW FREIGHT SYSTEM INC ZARTIC INC
Grand Total:

Amount $53,220.72
$2,091.82 $38,017.00 $61,946.81 $31,428.10 $93,465.67
$49.32 $56,692.09 $66,604.01 $27,023.85 $38,409.27 $14,128.02 $119,483.75 $185,473.61
$52.38 $150,139.73
$19,749.09
$27,055,605.70

13

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
3 D EXCAVATORS, INC.
A & B PAINTING SERVICE A & E MECHANICAL CONTRACTORS
A.G. SPANOS A. ROCKDALE RENTAL CENTER INC
A.A. FRIEDMAN, INC.
AAA COOPER TRANSPORTATION AAA FLORIDA/GEORGIA, INC. AACTION AUTO PARTS ABB C-E SERIVCES, INC. ABB DAIMLER-BENZ TRANS. ABB SERVICES INC. ABC HOME HEALTH CARE ABRAMS FIXTURE CORP. ACANDS, INC. ACOUSTI, INC. ACREE DAVIS FUNERAL HOME ACTION BLUE PRINT CO. ACTION ELECTRIC COMPANY, INC. ACTION GROUP, INC. ADAMS-WARNOCK INC ADCOX SERVICE CO. INC ADD, INC./WARNER ROBINS BOYER ADDISON STEEL ADMINISTAFF COMPANIES, INC ADMINISTRATIVE MANAGERS ADVANCE EMPLOYMENT CONCEPTS ADVANCE STORES CO., INC. AE GOETZE - LAGRANGE AEROQUIP CORP. AFFAIRS TO REMEMBER AFFILIATED BUILDING SERVICE AFLAC, INC. AGCO AGGRECON OF GEORGIA, INC. AIR COMFORT HEATl.NG & A/C

City
DORAVILLE LAWRENCEVILLE LAWRENCEVILLE NORCROSS CONYERS AUGUSTA DOTHAN ATLANTA
SAVANNAH
ROME ATLANTA GARDEN CITY WARNER ROBINS
ATLANTA
CONYERS ATLANTA TOCCOA ATLANTA SMYRNA FOREST PARK SAVANNAH LAKE CITY
WAUPACA ALBANY
KINGWOOD CUMMING SAN ANTONIO CAIRO LANGRANGE JACKSON ATLANTA ATLANTA COLUMBUS DULUTH MARIETTA ALPHARETTA

State
GA GA GA GA GA GA AL GA GA GA GA GA
GA GA
GA
GA
GA GA GA GA GA GA
WI GA
TX GA TX GA GA Ml GA GA GA GA GA GA

Total Reimbursed
$4,377.75 $37,651.29
$3,240.00. $16,467.04 $15,225.96 $11,414.82 $10,800.00
$7,705.80 $10,904.43 $13,628.28
$1,266.67 $294.00
$6,915.27 $9,109.16 $22,869.80 $28,163.81 $9,111.32 $24,814.80 $28,294.44 $6,611.50 $10,303.78 $18,105.36 $100,497.96 $23,179.51 $1,696.64 $64,938.69 $15,376.67 $13,772.47 $4,397.13 $3,410.62
$867.50 $17,678.00 $68,484.91 $14,340.22
$50.00 $39,168.82

14

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
AIR CONDITIONING CORP. AIR CONDITIONING TECH.& SVCS AIR GAS INC - WELDING SUPPLY AIR TREADS -ATLANTA/GOODYEAR ALAN BROWN LOGGING ALBANY BEVERAGE CO ALBANY HERALD PUBLISHING CO. ALBANY UROLOGY CLINIC, P.C. ALBANY WATER, GAS, LIGHT ALCAN EXTRUSIONS USA ALEXANDER & ALEXANDER SVC INC ALFRED MCCANNON WELL BORING ALL CITY SECURITY ALL METAL, INC. ALL SOUTH SUPPLY ALL SOUTH TERMINALS, INC. ALLGOOD OUTDOORS, INC. ALLIED ASPHALT CO ALLIED WHEELER CORP. ALLISON SMITH COMPANY ALPHA PRODUCTS, INC. ALTAMAHA CONVALESCENT CENTE AMERCORD, INC. AMEruCANCANCOMPANY AMERICAN EXTRUSIONS AMERICAN FAMILY AMEruCANLANDMARKFENCE AMERICAN NATIONAL CAN AMERICAN RUG CRAFTSMEN AMERICAN SUZUKI MOTOR CORP AMERICAN VENDING CO., INC. AMERSON COMPANY AMES CONSTRUCTION, INC. AMF BAKERY SYSTEMS AMI SPALDING REGIONAL HOSPITAL ANCHOR GLASS CONTAINER CORP.

City
EAST POINT THOMASVILLE MACON FOREST PARK MILLEDGEVILLE ALBANY ALBANY ALBANY ALBANY ROME ATLANTA COMER HAPEVILLE TOCCOA CARTERSVILLE ATLANTA CUMMING MACON DOUGLASVILLE ATLANTA ATLANTA JESUP LUMBER CITY NEWMAN DALTON COLLEGE PARK MABLETON FOREST PARK SUGAR VALLEY ATLANTA EAST POINT MACON ARMUCHEE RICHMOND GRIFFIN WARNER ROBINS

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA VA GA GA

Total Reimbursed
$43,612.88 $320.00
$4,863.75 $20,911.51
$568.50 $18,059.31
$6,840.39 $10,496.92
$3,582.01 $12,500.00 $17,267.71
$60.00 $5,536.38 $22,570.67 $8,842.48 $21,774.82 $12,838.72 $5,906.35 $12,565.00 $8,555.76 $17,969.69
$758.95 $27,777.75
$1,414.52 $179,695.90 $187,103.88
$34,689.16 $12,396.50
$3,210.08 $14,300.00
$3,374.32 $18,166.03 $33,204.16 $36,042.78 $16,069.70 $18,113.05

15

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
ANDERSON & ASSOCIATES ANGELICA HEALTHCARE
ANGLO AMERICAN ENGLISH CH
ANNING JOHNSON COMPANY ANSLEY ONE, INC. APACHE TRANSPORT APB, INC. AQUA-CHEM, INC. ARAMARK CORP. ARATEX ARBOR ACRES FARM, INC. ARCADIAN ARCHER DANIELS MIDLAND CO. ARCHITECTURAL ACCENTS ARCHITECTURAL IMAGE MFG.INC. ARLINGTON MEMORIAL PARK ARNALL GROCERY ARROW CO. ARROW RENTALS, INC. ARROWHEAD NURSING CENTER ARTHUR PEW CONSTRUCTION ARTISTIC JANITORIAL SERVICES ASSOCIATED RUBBER CO. ASSOCIATED SERVICES ATEC ASSOCIATES ATHENS SEED CO. ATHENS YMCA ATLANTA BELTING COMPANY ATLANTA BEVERAGE COMPANY ATLANTA BRAVES NATIONAL LEAG ATLANTA CAPTAIN STEAMER ATLANTA FENCE COMPANY ATLANTA FURNITURE ATLANTA HAULING-WASTE MGMNT ATLANTA HILTON & TOWERS ATLANTA HISTORICAL SOCIETY

City
ALBANY ROME SANDERSVILLE ATLANTA
SAVANNAH
MONROE ELLENWOOD THOMASVILLE ATLANTA CHARLOTTE BLAIRSVILLE AUGUSTA
MACON
ATLANTA ATLANTA ATLANTA
NEWNAN
AUSTELL STATESBORO JONESBORO CHAMBLEE MARIETTA TALLAPOOSA AUGUSTA MARIETTA WATKINSVILLE ATHENS ATLANTA ATLANTA ATLANTA ATLANTA LITHONIA DECATUR
SMYRNA
ATLANTA ATLANTA

State
GA GA GA GA GA GA
GA
GA GA NC GA GA
GA
GA
GA
GA GA GA GA GA GA GA GA GA
GA
GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$12,107.46 $7,009.21
$21,248.28 $3,150.00 $6,133.18 $2,880.00
$21,858.30 $63,154.82 $65,537.04
$7,150.00 $2,059.11
$850.00 $12,407.50 $20,083.81
$519.30 $31,361.89
$63.62 $67,440.75 $12,797.00
$4,626.40 $3,960.00 $12,284.90 $75,888.55 $27,139.55 $4,152.33 $3,757.80 $2,038.12
$392.89 $19,569.05
$5,126.56 $138,047.75
$7,568.00 $11,575.58 $14,334.99
$4,514.48 $2,317.72

16

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
ATLANTA PROVISION COMPANY ATLANTA RUCKUS PROFESSIONAL ATLANTA STEEL ERECTORS, INC. ATLANTA UTILITY CO ATLANTA WEST CARPETS, INC. ATLANTA WIRE WORKS, INC. ATLANTIC COAST FIRE PROTECTION ATLANTIC HOME HEALTH CARE AUBREY SILVEY ENT. INC. AUTOMATIC DATA PROCESSING AUTOZONE, INC. AVERY LABEL COMPANY AVON PRODUCTS, INC. AYRES CORP B & E HEATING & A/C, INC. B &W PIPELINE & BOARDING CO. B.L.I. CONSTRUCTION CO. BABB'S AUTO SERVICE BABCOCK & WILCOX COMPANY BACE STAFFING CORP. BACON COUNTY BD OF EDUCATION BAGCRAFT CORP. OF AMERICA BAILEY CO BAKER HUGHES, INC. BALFOUR PULPWOOD CO. BALLARD BROTHERS ELECTRIC BANK SOUTH BARDI HEATING/AIR CONDITIONING BARNETT BANK OF SOUTHEAST GA BARRETT & ASSOCIATES BARRY MFG. CO. BARTENFELD ELECTRIC COMPANY BARTON SOUTHERN CO. BASF CORPORATION BATSON-COOK COMPANY BATTLE LUMBER COMPANY, INC.

City
ATLANTA ROSWELL SMYRNA EAST POINT AUSTELL JONESBORO DULUTH PEARSON CARROLLTON ATLANTA ROME FLOWERY BRANC SUWANEE ALBANY ROSWELL COVINGTON ATLANTA DALTON BRUNSWICK CHARLOTTE ALMA FOREST PARK NASHVILLE NORCROSS THOMASVILLE MACON FOREST PARK NORCROSS BRUNSWICK ATLANTA STONE MOUNTAIN ATLANTA CONYERS SYLVANIA WEST POINT WADLEY

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA NC GA GA TN GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$7,856.14 $13,266.43 $11,692.22
$5,030.71 $21,507.48 $12,553.21 $32,119.07 $11,650.06 $18,492.21
$312.84 $2,280.90 $2,182.48 $13,103.80 $160,654.03 $3,063.27 $7,036.19
$222.58 $21,028.83 $24,985.68 $36,094.70
$673.10 $340.00 $8,193.50 $14,001.02 $3,534.75 $9,047.50 $39,253.01 $10,313.24 $7,712.61 $6,475.00 $17,895.00 $9,153.00 $78,522.79 $7,299.79 $111,452.46 $15,750.00

17

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
BAX-STEEL BAXTER INTERNATIONAL BEACH TIMBER CO. BEAULIEU OF AMERICA BEAZER EAST dba REEVES CNS BEDWAY SECURITY AGENCY, INC. BEKAERT CORP. BELK SIMPSON COMPANY BELK STORES & AFFILIATES BELL EQUIPMENT NO. AMERICA BERRIEN COUNTY HOSPITAL BERRIEN NURSING CENTER BEST INNS AMERICA BEST MANUFACTURING INC. BEST WESTERN -SAVANNAH BETTER BACKERS, INC. BETZ DEARBORN, INC. BEVIS ROPE MANUFACTURING INC Bl-LO, INC. BICKERSTAFF CLAY PRODUCTS CO BILJO, INC. BILL HEARD CHEVROLET BIRDSONG PEANUTS BISHOP CLEAN CARE BLAKE CONSTRUCTION CO. BLOUNT CONSTRUCTION BLUE BEACON INTERNATIONAL BLUE CIRCLE BO'S OF TIFTON BOEING BORG WARNER PROTECTIVE SERVI BOY SCOUTS OF AMERICA BRADLEY PLYWOOD CORP. BRENT WALKER FORD INC BRIDGESTONE/FIRESTONE BRIGGS ENTERPRISES

City
BAXLEY NORCROSS NICHOLS DALTON AMERICUS VALDOSTA ROME BAINBRIDGE MACON GARDEN CITY NASHVILLE NASHVILLE DALTON ARABI SAVANNAH CHATSWORTH TREVOSE ROSSVILLE MAULDIN SMYRNA DUBLIN COLUMBUS BLAKELY VALDOSTA ST. MARYS ATHENS JACKSON MARIETTA TIFTON DULUTH ATLANTA ATLANTA SAVANNAH GLENVILLE MARIETTA WINSTON

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA PA GA SC GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$17,145.42 $15,778.21
$639.83 $128,500.00
$51,733.68 $445.78
$169,121.90 $6,195.59
$46,350.99 $530.64
$5,465.58 $33,464.38 $23,460.73 $35,032.50 $28,777.37 $12,921.55 $25,631.52
$9,225.00 $19,712.44 $16,376.62
$713.27 $43,339.65 $19,204.31 $42,592.25
$9,820.00 $11,135.19 $131,312.41 $22,407.34
$4,962.64 $41,573.16
$1,208.88 $7,040.00 $24,450.46 $6,380.00
$534.05 $55,950.38

18

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
BRIGHTMOOR NURSING CENTER BRITISH ROAD SERVICE,LTD BROCKWAY STANDARD INC BROWN & WILLIAMSON TOBACCO BROWN STEEL CONTRACTORS, INC. BROWN TRANSPORT CORPORATION BSE MANAGEMENT INC BUILDING TECHNOLOGY BURLINGTON COAT FACTORY BURLINGTON INDUSTRIES BURLINGTON NORTHERN BURNHAM SERVICE BURNS JANITOR SERVICE BUSINESS GRAPHICS CONSULTANT BUSINESS TEMPS/TEMP MASTER C & D CHARTER POWER SYSTEMS C & H MECHANICAL & PLUMBING C &J COMPANY
C & S WHOLESALE MEAT COMPANY
CADMUS COMMUNICATIONS CAL-MAINE FOODS, INC. CALHOUN MILLWORKS INC CALLAWAY TERMITE & PEST CTRL. CALVIN MFG CAMPBELL DECORATING CO. CAMPBELL TECHNOLOGIES, INC. CANOOCHEE ELECTRIC CANTON SUPPLY COMPANY, INC. CAP ENTERPRISES,INC. CAPRO, INC. CAPTAIN JOE'S SEAFOOD CAR CRAFT CARD CAGE-SUMMIT CORP CARDINAL SPECIALTY PRODUCTS CARMET COMPANY CARMICHAEL OIL OF WALTERB

City
GRIFFIN JONESBORO HOMERVILLE MACON NEWNAN TIFTON VENTURA TALLAPOOSA
MACON SHANNON ALBANY
COLUMBUS
MACON
FT OGLETHORPE AUGUSTA CONYERS DEMOREST DALTON ATLANTA ATLANTA SHADYDALE CALHOUN MARIETTA TALLAPOOSA ATLANTA NORCROSS REIDSVILLE CANTON JONESBORO SWAINSBORO BRUNSWICK ATHENS COLUMBUS CALHOUN GAINESVILLE RICHMOND HILL

State
GA
GA
GA GA GA GA CA GA
GA
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$182.16 $16,200.00 $46,313.34 $392,372.20 $123,847.45
$7,020.00 $10,750.00 $13,325.00
$1,157.67 $8,243.50 $10,810.00 $9,198.12 $40,388.40 $122,342.62 $7,728.00 $18,614.87 $8,215.95 $1,838.42 $8,625.92 $44,572.41 $18,567.12 $40,281.42 $28,837.88 $17,725.99 $146,176.60 $1,217.00 $2,863.95 $2,566.58 $56,999.60
$276.70 $2,773.44 $16,611.45 $12,695.21 $2,159.94
$144.48 $1,039.38

19

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
CAROLINA CABLE CONTRACTORS,! CARRIAGE INDUSTRIES, INC. CARROLL & CARROLL CARROLLTON NURSING & REHAB. CARTER & ASSOCIATES CARTER MECHANICAL, INC. CARTERSVILLE COUNTRY CLUB CARWOOD MANUFACTURING COMP CASTLEBERRY'S FOOD CO, INC CATHCART ALLIED STORAGE CATOOSA UTILITY DISTRICT CBS RECORDS, INC CEBCOR/EBBA IRON, INC. CEBCOR/SPRINGHILL SERVICES CECIL MALONE COMPANY CEDARTOWN PAPER BOARD CO CEDARTOWN POLICE DEPT CENTER BROTHERS , INC. CENTRAL FOOD MANAGEMENT CENTRAL GA EYE CENTER PC CENTRAL GA HOME HEALTH AGENC CENTRAL HEALTH HOLDING CENTRAL PARK APARTMENTS CHAMBERS DEVELOPMENT CO. CHAMPION INTERNATIONAL CORP CHAPARRAL BOATS, INC. CHARTER CENTRAL GA. CHARTER GROUP CHARTER MOBILE HOMES, INC. CHARTER TALBOT BHS CHATSWORTH HEALTH CARE CENT CHEMCO, INC. CHEMICAL LEAMAN TRUCK LINES CHEMICAL PRODUCTS CORP CHEMLAWN CHEROKEE TOWN & COUNTRY CLU

City
FRANKLIN CALHOUN SAVANNAH CARROLLTON ATLANTA MACON CARTERSVILLE WINDER AUGUSTA ALPHARETTA RINGGOLD CARROLLTON DALLAS DALLAS ATLANTA CEDARTOWN CEDARTOWN ATLANTA ATLANTA MACON MACON FT. OGLETHORPE WAYCROSS ATLANTA WAYCROSS NASHVILLE ATLANTA STOCKBRIDGE HINESVILLE ATLANTA CHATSWORTH ATLANTA JONESBORO CARTERSVILLE COLLEGE PARK ATLANTA

State
NC GA GA GA GA GA GA GA GA GA GA GA TX TX GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$1,272.29 $12,250.00 $10,129.24 _ $106,065.00 $37,853.86 $16,794.46 $70,502.47 $16,918.03
$3,276.66 $5,018.90 $6,869.65 $89,263.42 $14,638.00 $140,580.00 $14,350.00 $8,793.03 $3,322.00 $50,353.73 $9,823.90 $7,682.78 $8,245.23 $20,753.76
$629.64 $30,582.40 $17,206.04 $13,660.60 $60,413.30
$1,736.82 $8,126.00 $4,740.30 $14,434.67
$872.92 $4,152.46 $4,086.22 $92,109.49 $124,544.99

20

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
CHESTNUT RIDGE NURSING
CHICK-FIL-A, INC CHICOPEE MANUFACTURING CO CHILDREN'S FRIEND, IN. CHRISTIAN MINISTRIES CHUMLEY'S PAVING & GRADING INC CHURCHWELL'S DRYWALL CIBA VISION CORPORATION CIMCO CIRCLE K CORPORATION CIRCLE K STORES, INC. CISCO TRAVEL PLAZA CITY OF COVINGTON CITY OF DALTON FIRE DEPARTMENT CITY OF EAST POINT POLICE DEPT CITY OF FORT VALLEY CITY OF HOGANSVILLE CITY OF LINWOOD CITY OF METTER CITY OF QUITMAN CITY OF RIVERDALE CITY OF ROME
CITY OF SMYRNA
CITY OF WAYCROSS CIVITAN REGIONAL BLOOD CTR. CJT INDUSTRIAL CONTRACTORS CKS PACKAGING COMPANY CLARK'S SUPER MARKET CLARKE BUMPER TO BUMPER CLARKE COUNTY SCHOOL DISTRICT CLASSIC CITY BEVERAGES INC CLASSIC COLLISION CLATON NEWS & DAILY CLAY-RIC, INC. CLEM ENVIRONMENTAL CORP. CLEVELAND CONSOLIDATED, INC.

City
CUMMING
ATHENS GAINESVILLE AUGUSTA ST.SIMONS ISLAN ACWORTH COCHRAN ATLANTA
WAYNESBORO
NORCROSS LAWRENCEVILLE KINGSLAND COVINGTON DALTON EAST POINT FT VALLEY HOGANSVILLE LINWOOD METTER QUITMAN RIVERDALE ROME
SMYRNA
WAYCROSS GAINESVILLE
MACON
MABLETON GRIFFIN ATHENS ATHENS ATHENS CHAMBLEE JONESBORO
SAVANNAH
FAIRMOUNT
WAYNESBORO

State
GA
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA FL GA GA
GA
GA GA GA GA GA GA GA GA

Total Reimbursed
$103,823.64 $13,880.80 $5,768.00 $6,374.07 $2,307.36 $24,003.54 $8,575.00 $182,890.51 $13,416.96 $3,660.94 $37,906.11 $40.00 $26,523.37 $6,177.69 $4,392.56 $16,484.13 $52,030.00 $18,985.98 $3,978.55 $50,450.59 $133.85 $3,401.78 $41,711.65 $4,995.00 $154,215.78 $18,069.43 $7,164.35 $5,752.90 $15,151.13 $3,675.00 $6,222.00 $30,483.94 $64,716.19 $1,104.98 $1,577.84 $29,904.88

21

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
CLEVELAND ELECTRIC COMPANY
CLIMATE CARE, INC. CLINICAL ARTS HOME CARE SVCS CLINTON MILLS INDUSTRIES INC CLOROX MFG. CO. COALTRUCKTRANSPORT COASTAL AREA STORES COASTAL PLAIN AREA EOA, INC. COATED ABRASIVE PRODUCTS CO. COBB COUNTY TRACTOR CO. COHEN BROTHERS DRESS CORP COLONIAL OIL INDUSTRIES COLONIAL PAINTING COMPANY COLUMBIA ENGINEERING COLUMBUS LEDGER-ENQUIRER COLUMBUS MILLS, INC. COLUMBUS PRODUCTIONS COLUMBUS TIRE COMBUSTION ENGINEERING COMFORT INN 1-95 COMMERCIAL MANAGEMENT COMPAC INDUSTRIES COMPUTERISTICS CON MAC CONCORD FABRICS CONE MACHINERY INC CONFEDERATE PACKAGING, INC. CONQUEST CARPET MILL CONSET, INC. CONSOLIDATED FREIGHTWAYS CONTAINER GENERAL CORPORATIO CONTAINER MARKETING, INC. CONTAINER SERVICE CORP. CONTINENTAL BAKING COMPANY CONTINENTAL CAN CO CONTINENTAL GRAIN

City
MACON ROME
COVINGTON CLARKESVILLE FOREST PARK LAWRENCEVILLE GLENVILLE VALDOSTA
RAMSEY MARIETTA WAYCROSS SAVANNAH
CHAMBLEE NORCROSS COLUMBUS COLUMBUS COLUMBUS COLUMBUS JULIETTE BRUNSWICK WAYCROSS DECATUR ATLANTA ATLANTA MILLEDGEVILLE THOMASVILLE MACON ROSSVILLE LAFAYETTE NORCROSS FOREST PARK AMERICUS RINGGOLD ROME PERRY CORDELE

State
GA GA GA
GA
GA GA GA GA
MN GA
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$15,795.79 $145,693.22
$5,436.10 $8,751.71
$187.93 $7,268.03
$94.04 $6,545.75 $1,954.64 $9,964.00 $33,008.24 $25,678.28 $10,015.78
$105.87 $3,809.90
$50.25 $8,496.76 $4,034.72 $26,814.22 $4,708.89 $64,355.97 $3,673.94 $3,613.62 $13,045.39 $163,329.91 $1,580.41 $87,280.89 $21,603.81 $2,647.89 $122,039.10 $19,324.75
$857.25 $4,035.00 $8,122.00 $10,758.44 $21,989.69

22

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
CONTINENTAL TELEPHONE CO. CONWOOD CORPORATION COOKSON GROUP COOPERATIVE PURCHASING AG ENC CORBETT PLYWOOD CORDEV, INC CORONET INDUSTRIES CORROSION SERVICES, INC. COUNTRY HOME BAKERY, INC. COUNTRY PRIDE FOODS, INC. COURIER COWAN HARDWARE CO. CRANE CO. CRESWELL CONVALESCENT CENTE CROWN CRAFTS CRYSTAL FARMS INC CRYSTAL SPRINGS PRINT WORKS CURT'S CURTIS 1000 CYCLONE LAND DEVELOPMENT CO. D & L APPLIANCE PARTS, INC. D & M CONTRACTORS, INC. D & N ELECTRIC COMPANY, INC. D & S ELECTRIC, INC. D L LEE & SONS DAEWOO HEAVY INDUSTRIES AMER. DAHAR CHEMICAL DALTON FARM SUPPLY DANNY MCGRAW LOGGING CO DARBY PRINTING COMPANY DAVEY TREE EXPERT COMPANY DAVID SHAPIRO & COMPANY, INC. DAVIDSON-KENNEDY CO. DAVIS WATER & WASTE IND INC
DAY STAR LAWN MAINTENANCE
DEARFIELD NURSING FACILITY

City

State

ATLANTA

GA

MEMPHIS

TN

ALPHARETTA

GA

CLEVELAND

GA

TENNILLE

GA

HINESVILLE

GA

DALTON

GA

CEDAR SPRINGS

GA

ATLANTA

GA

GAINESVILLE

GA

ELLIJAY

GA

CONYERS

GA

MACON

GA

ROME

GA

CALHOUN

GA

CHESTNUT MOUNT GA

CHICKAMAUGA

GA

OAKWOOD

GA

DULUTH

GA

ATLANTA

GA

ATLANTA

GA

DECATUR

GA

HAPEVILLE

GA

CONYERS

GA

ALMA

GA

BRUNSWICK

GA

ALBANY

GA

DALTON

GA

SUMMERVILLE

GA

ATLANTA

GA

CHAMBLEE

GA

VALDOSTA

GA

ATLANTA

GA

THOMASVILLE

GA

DALLAS

GA

COLUMBUS

GA

Total Reimbursed
$18,067.41 $28,903.63
$6,114.74 $13,696.70
$3,720.00 $50.00
$123,737.13 $32,437.78 $17,845.34 $42,316.31 $587.79 $40.00 $1,262.71 $971.18 $2,400.72 $30,840.21 $4,067.38 $71,695.47 $960.60 $7,867.59 $1,170.14 $2,702.00 $58,664.08 $14,816.79 $12,794.29 $935.13 $7,309.39 $68,652.70 $11,160.00 $9,299.42 $10,850.71 $9,331.15 $23,695.56 $8,750.00 $24,312.16 $16,954.00

23

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
DECATUR FEDERAL SAVINGS
DEERFIELD SPECIALTY PAPERS INC DEL MAR WINDOW COVERINGS DELCO INDUSTRIES DELTA AIRLINES, INC. DELTA COLLEGE, INC. DELTA LIFE INS. CO. DENNIS TAYLOR & CO, INC. DERST BAKING CO DESTER PRODUCTION CORP DEVEREUX CENTER OF GA. DEVRO-TEEPAK, INC. DIAMOND SHAMROCK CORP. DILLARD SMITH CONSTRUCTION CO. DIRECT EXPRESS DITTLER BROTHERS, INC DIVERSCO, INC DIXIE INDUSTRIAL FINISHING CO. DIXIE ROADBUILDERS, INC. DIXIELAND FUN PARK, INC. DJC ENTERPRISES, INC. DOBBS INTERNATIONAL SERVICES DOLPHIN REALTY CORP. DOMINO'S PIZZA DON SIE CONTRACTORS DONNIE'S STEAK & BARBEQUE DOUGLAS & LOMASON DOUGLAS BATTERY MANUFACTURI DOUGLAS GENERAL HOSPITAL DUBARD'$ TIRE & ALIGNMENT DUBLIN INDUSTRIAL SERVICES DUBLINAIR NURSING HOME DUNAGAN & SONS, INC. DURDEN ENTERPRISES DWB CARPET HOLDINGS DYSON-KISSNER-MORAN CORP.

City

State

DECATUR

GA

AUGUSTA

GA

ATHENS

GA

TUCKER

GA

ATLANTA

GA

LILBURN

GA

MACON

GA

DULUTH

GA

SAVANNAH

GA

THOMASTON

GA

KENNESAW

GA

ATLANTA

GA

CEDARTOWN

GA

SMYRNA

GA

CHARLOTTE

NC

OAKWOOD

GA

SPARTANBURG

SC

TUCKER

GA

WAYCROSS

GA

FAYETTEVILLE

GA

MARIETTA

GA

ATLANTA

GA

ATLANTA

GA

CALHOUN

GA

CUMMING

GA

POWDER SPRINGS GA

CARROLLTON

GA

NEWNAN

GA

DOUGLASVILLE

GA

AUSTELL

GA

DUBLIN

GA

DUBLIN

GA

ROME

GA

AUBURN

GA

CHATSWORTH

GA

ROSSVILLE

GA

Total Reimbursed
$7,598.30 $36,308.22 $61,760.64
$9,244.76 $38,854.99 $18,785.50
$5,323.20 $22,019.94
$260.73 $20,020.23 $57,630.29
$5,912.26 $2,238.16 $14,786.58 $5,534.52 $12,500.43 $22,118.91 $9,597.70 $41,900.90 $9,115.00 $6,531.79 $2,282.50 $34,717.55 $3,615.20 $38,897.79 $3,391.79 $33,604.95 $5,485.21 $8,543.57 $21,125.00 $162,442.68 $32,046.78 $11,453.41
$233.71 $16,500.00 $16,923.42

24

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name E. COBB LAND DEVELOPMENT CO.
E.C. SERVICES, INC. E.C.C. INTERNATIONAL CORP. EAST WEST ENTERPRISES EASTERN AIRLINES, INC. EAVES FOODS, INC. ECC INTERNATIONAL ECKARDT ELECTRIC CO. ECKERD DRUG EDDIE BAUER INC. EDWARDS BAKING CO. ELECTRICAL TECHNOLOGY SERVIC ELECTROMAGNETIC SERVICES, INC ELLIOTT MACHINE SHOP ELLIS CROOKS, INC. ELLSWORTH FOODS, INC EMRO MARKETING/MARATHON EMS VENTURES, INC. ENGELHARD CORP. ENGINEERED FABRICS CORP. ENGLEHARD CORP. ENGLISH CHINA CLAY'S INT. ENICHEM OF AMERICA ENTERPRISE RENT-A-CAR EPICURE MANAGEMENT SERVICES EQUIPMENT RESEARCH INC EQUITABLE/COMPASS MGT. ERNST ENTERPRISES OF GA. ESSEX GROUP ETHICON, INC. EVANS MEMORIAL HOSPITAL EXECUTIVE CAR WASH F & L SEDOWICZ F R GRANTHAM CONTRACTING FAMILY DOLLAR, INC. FAYETTE COUNTY BD OF EDUCATIO

City
MARIETTA
ATLANTA SANDERSVILLE TOCCOA ATLANTA
WAYCROSS
SANDERSVILLE CHAMBLEE SHENANDOAH DALTON ATLANTA ATLANTA NORCROSS
MACON
SENOIA TIFTON SPRINGFIELD GAINESVILLE GORDON
ROCKMART
ATTAPULGUS SANDERSVILLE CONYERS ST.LOUIS
MACON
NORCROSS
ATLANTA
LAWRENCEVILLE LITHONIA CORNELIA CLAXTON MARIETTA SNELLVILLE DECATUR ROME FAYETTEVILLE

State
GA
GA
GA GA GA GA GA GA
GA
GA GA GA GA GA GA GA OH GA GA
GA
GA GA GA MO GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$8,225.00 $4,221.40 $1,356.55 $3,646.74 $60,092.27 $75,533.32 $26,935.46 $43,196.28 $119,460.52 $8,030.73 $9,915.00 $19,261.19 $8,874.04 $21,077.35 $11,807.71 $5,111.15
$309.60 $31,196.08
$9,100.00 $32,681.75 $22,100.00 $18,095.00
$8,100.00 $657.00
$4,169.89 $14,314.04 $18,336.18
$8,799.72 $2,541.11 $22,058.80 $10,955.18 $19,686.57 $6,693.31 $32,906.21 $100,789.01 $21,210.56

25

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
FAYETTEVILLE BOWLING CENTER
FEDERAL PAPER BOARD CO., INC. FEDERAL STATE INSPECTION FEDERATED DEPT. STORES FIBER ONE FIRST AMERICAN HEALTHCARE FIRST AMERICAN RENTAL FIRST DATA CORP.-FDR. FIRST UNION NAT'L BANK OF GA FLANAGAN & WAYCASTER CONST. FLIGHT SAFETY INTERNATIONAL FLINT CONSTRUCTION CO. FLINT RIVER TEXTILES, INC FLOURNOY PROPERTIES FLOWERS INC FLOYD CONCRETE FOi ANIXTER INTERNATIONAL FOi-COALE TRUCK TRANSPORT FOLGER POULTRY FARMS FOLKS, INC. FORDS & GANTT COMPANY, INC. FORSTMANN & COMPANY, INC FORT OGLETHORPE NURSING CTR. FOSTER INDUSTRIES FRANK SHELTON, INC.
FRANKLIN ALUMINUM FRANKLIN INDUSTRIES
FREEMAN DECORATING CO. FREEPORT KAOLIN CO FRESENIUS MEDICAL CARE FREUDENBERG-NOK FRUEHAUF CORPORATION FULGHUM INDUSTRIES FULTON PAPER COMPANY G.C. QUALITY LUBRICANTS G.E. CAPITAL SERVICE

City
FAYETTEVILLE AUGUSTA
ALBANY ATLANTA
DALTON
MACON LITHONIA ATLANTA AUGUSTA MARIETTA SAVANNAH
LAWRENCEVILLE
ALBANY COLUMBUS ATHENS SAVANNAH
SUWANEE LAWRENCEVILLE DAHLONEGA
NORCROSS MACON
TIFTON FORT OGLETHORP CORNELIA
PERRY FRANKLIN LAVONIA ATLANTA GORDON
AUGUSTA LAGRANGE CONLEY
WADLEY ATLANTA MACON MACON

State
GA
GA
GA
GA
GA
GA
GA GA GA GA GA
GA GA
GA GA GA GA
GA GA
GA GA GA GA GA
GA
GA GA GA GA
GA GA GA
GA GA GA
GA

Total Reimbursed
$14,468.20 $532.87
$19,800.00 $920.00
$29,701.19 $107,858.69
$14,639.54 $35,185.29
$2,592.87 $89,128.35
$7,425.00 $9,557.57 $6,804.00
$450.00 $26,169.00
$412.33 $55,884.24
$632.46 $7,475.00 $3,447.56 $25,381.78 $30,380.23 $27,951.81 $52,584.75 $6,678.29 $1,432.23 $10,690.00 $2,275.00 $5,520.00 $16,887.06 $21,149.00 $3,857.00 $57,467.30 $4,200.00 $3,180.17 $100,841.67

26

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
GAINESVILLE IRON WORKS GAINESVILLE MFG CO GALAXY CARPET MILLS, INC. GALEY & LORD INDUSTRIES, INC. GARLAND SALES, INC. GARY CONCRETE PRODUCTS GATEWAY HEALTH CARE GATEWAY SERVICES INC GATX CORP. GAY CONSTRUCTION COMPANY GEICO GENE BUSH GENERAL CABLE CORP. GENERAL ELECTRIC CO GENERAL FELT INDUSTRIES GENERAL NUTRITION CTRS GENERAL NUTRITION PRODUCTS GENUINE PARTS GEORGEHORMELL&COMPANY GEORGE MUSE CLOTHING COMPAN GEORGIA BAPTIST CONVENTION GEORGIA DUPLICATING PRODUCTS GEORGIA MARBLE COMPANY GEORGIA MOBILE HOMES, INC GEORGIA PERIODONTICS, P.C. GEORGIA SPECIALTY CONSTRUCT! GEORGIA TECH ATHLETIC ASSOC. GFA TRANSPORTATION COMPANY GIBSON GREETINGS, INC. GILBERT & BENNETT GILBERT SOUTHERN CORP. GILMAN PAPER CO. GILMER COUNTY BD OF EDUCATION GLEN ARVEN COUNTRY CLUB GLEN MCLENDON TRUCKING CO. IN GLOBE UNION INC

City
GAINESVILLE GAINESVILLE CHATSWORTH SHANNON DALTON MARTINEZ CLEVELAND ATLANTA WAYCROSS ATLANTA MACON THOMASVILLE WATKINSVILLE ROME DALTON PITTSBURGH PITTSBURGH SYLVESTER TUCKER ATLANTA ATLANTA MACON ATLANTA SAVANNAH ATLANTA UNION CITY ATLANTA FOREST PARK CINCINNATI TOCCOA RESACA ST. MARY'S ELLIJAY THOMASVILLE LAFAYETTE ATLANTA

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA PA PA GA GA GA GA GA GA GA GA GA GA GA OH GA GA GA GA GA AL GA

Total Reimbursed
$7,700.00 $1,000.02 $11,027.00 $5,351.05 $8,703.69 $114,523.18
$424.82 $4,720.14 $52,218.58 $13,320.00 $35,576.15 $4,266.56 $20,407.07 $163,586.88 $58,884.11 $243,798.25 $12,412.51 $28,542.71 $39,210.40 $10,500.21 $11,377.82 $38,340.60 $16,174.57 $3,432.72 $19,577.33 $75,083.72 $7,500.00 $8,021.19 $1,822.23 $11,342.10 $2,347.00 $13,471.44 $10,941.52 $7,199.34 $2,650.00 $4,630.08

27

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
GLYNN COUNTY GNB TECHNOLOGIES GOLD CITY HEALTH CARE GOLDEN AGE PROPERTIES GOLDEN GALLON, INC. GOLDEN STATE FOODS GOOCH ELECTRICAL & PLUMBING GOODWILL INDUSTRIES GOODY PRODUCTS, INC. GOODYEAR AEROSPACE GOODYEAR TIRE & RUBBER GORDON COUNTY FARM COMPANY GRACON CORPORATION GRAHAM BROTHERS CONSTRUCTIO GRAND MANOR, INC. GREAT AMERICAN COOKIE CO. GREAT AMERICAN STEAK & BUFFET GREAT OAKS NURSING HOME GREAT SOUTH CONSTRUCTION CO. GREATSOUTHERNPAPERCOMPAN GREEN FIRE SYSTEMS, INC. GREENWOOD CEMETARY GREIF BROTHERS CORP GRENZEBACH GRIFFIN LUMBER GRIFFITH LABORATORIES GROUP VI CORP. GSC ENTERPRISES, INC GUARDSMARK, INC. GULF LIFE INSURANCE COMPANY GUNTER CONSTRUCTION GWINNETT CENTER FOR OUTPATIEN GWINNETT PLACE HONDA H & H CONSTRUCTION H.C. BRILL CO., INC. H.J. RUSSELL & COMPANY

City
BRUNSWICK COLUMBUS DAHLONEGA BARNESVILLE CHATTANOOGA CONYERS JEFFERSON SAVANNAH EASTMAN ROCKMART ROME CALHOUN ARMUCHEE DUBLIN THOMASVILLE ATHENS LAWRENCEVILLE ROSWELL PELHAM CEDAR SPRINGS CONYERS ATLANTA TUCKER NEWNAN CORDELE LITHONIA STOCKBRIDGE COLUMBUS ATLANTA STATESBORO LAWRENCEVILLE SNELLVILLE DULUTH BRUNSWICK TUCKER ATLANTA

State
GA GA GA GA TN GA GA GA GA GA GA GA GA GA GA GA GA GA AL GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$14,665.00 $61,699.75
$1,887.00 $14,981.90 $14,550.61 $112,211.18 $70,646.48
$6,828.28 $11,380.91 $12,177.00 $348,988.23 $16,278.94
$6,556.47 $9,908.75 $8,544.37 $3,560.87 $53,773.55 $53,722.52 $81,282.09 $11,642.83
$50.00 $12,467.43 $91,510.31
$3,420.00 $68,649.37 $24,027.89 $116,860.03
$2,965.92 $6,544.00 $22,470.68 $9,388.96 $103,100.00
$740.83 $74,128.94 $10,931.85 $44,776.61

28

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
HA SACK COMPANY, INC. HALEY FARMS, INC. HALL REALTY INC HAMBERSHAM MEDICAL GROUP P. HANCOR, INC HANES HOSIERY, INC. HANSEN, INC. HANSON NORTH AMERICA dba HARBIN CLINIC HARCON, INC. HARDEE'S OF JESUP HARPER GAS SERVICE, INC HARRIS CALORIFIC HARRIS CORP/LANIER WORLDWIDE HARRIS INSULATION HARRIS WASTE MGMT HARRIS WHOLESALE HARRISON'S BODY SHOP HARRY MOSES CONSTRUCTION CO. HART CARE CENTER HARTWELL COMPANY WAREHOUSE HARTWELL SPORTS, INC. HARVEY'S PERSONAL CARE HAYES MICRO COMPUTER PRODUC HAYGOOD CONTRACTING, INC. HAZARDOUS ENVIR. PRODUCTS HCA COLISEUM PSYCHIATRIC HOSP. HEALTH CARE SERVICES HEILIG MEYERS HELEN'S ENTERPRISES, INC. HENDERSON ELECTRIC HENKEL OF AMERICA CORPORATIO HENRY COUNTY TRAINING CENTER HERTZ PENSKE/GEICO TRUCK LSIN HI BRAND FOODS HI-TEK ASSOC, INC

City
STATESBORO CANTON CALHOUN CLARKESVILLE CORDELE LAGRANGE PITTSBURG AMERICUS ROME ALPHARETTA BAXLEY JESUP GAINESVILLE TUCKER ATLANTA BAXLEY ATLANTA MACON VIDALIA HARTWELL HARTWELL HARTWELL WAYCROSS NORCROSS WOODSTOCK TUCKER MACON AUGUSTA THOMASVILLE ATHENS STONE MTN. CEDARTOWN MCDONOUGH FOREST PARK PEACHTREE CITY BRUNSWICK

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$55,065.14 $11,205.00
$7,183.55. $48,944.68
$9,824.23 $19,261.16
$2,768.66 $24,950.00
$372.40 $117.00 $4,612.50 $71,631.90 $17,622.69 $4,183.70 $23,687.90 $985.50 $92,633.00 $25,956.59 $13,903.22 $977.61 $16,661.30 $11,727.74 $29,997.48 $6,031.38 $19,680.69 $55,878.31 $2,427.48 $315.50 $9,528.49 $16,564.00 $27,640.17 $35,001.41 $6,191.91 $63,430.66 $17,421.70 $15,649.25

29

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
HIDDEN HILLS GRILL HIGGINS GENERAL HOSPITAL HIGH PERFORMANCE TUBE HIGHTOWER TV HINESVILLE RED & WHITE HOLLIS EYE CARE CENTER HOLLOWAY CONSTRUCTION CO. HOLLYE EQUIPMENT CO., INC. HOMETONW FOOD PRIDE HOMEWOOD RESIDENCE AT W HON INDUSTRIES HOOVER-HANES TRUCKING CO. HOST MARRIOTT SERVICES CORP. HOUSE MOVERS, INC. HOUSTON CO. ASSOCIATION HOUSTON STEEL, INC. HUBBARD MILLING COMPANY HUBERT MOORE LUMBER HUDDLE HOUSE HURST BOILER & WELDING CO, INC HYDRO-CHEM HYPONEX CORP 1-MEDEX USA, INC. IHS HOME CARE IHS OF ATLANTA AT SHOREHAM IMAGE CARPETS IMCVIGORO IMPERIAL PACKAGING CORP. INDEPENDENT LIFE INSURANCE CO. INDUSTRIAL PLASTICS CORP INDUSTRIAL TOOL & SUPPLY INGERSOLL-RAND INGLETT & STRUBBS, INC. INGRAM CONSTRUCTION CO. INLAND CONTAINER CORP.
INSURAMERICA

City
STONE MTN.
BREMAN BRUNSWICK ROME HINESVILLE COLUMBUS
BALLGROUND
GAINESVILLE BRUNSWICK MARIETTA CEDARTOWN TALLAPOOSA ATLANTA CALHOUN WARNER ROBINS BYRON CARTERSVILLE
ALAPAHA
DAHLONEGA COOLIDGE CANTON JACKSON ALPHARETTA DUBLIN MARIETTA ROME ATHENS THOMASVILLE ROME FITZGERALD
SAVANNAH
CALHOUN ATLANTA WINTERVILLE
MACON
LILBURN

State
GA GA GA GA GA GA
GA
GA GA GA GA GA GA GA GA GA GA GA
GA
GA GA GA
GA GA
GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$723.49 $7,155.00 $33,662.50 $19,802.41 $11,203.11 $21,934.83 $10,125.00 $6,199.00 $4,228.26 $12,230.80 $242,087.58 $31,642.24 $5,492.88 $240,683.51 $7,031.55 $8,219.08 $3,228.03 $44,882.48 $11,075.24 $10,212.35 $49,230.99 $18,123.99 $9,983.77 $1,309.58 $51,447.98 $16,409.33 $57,822.80 $38,625.63 $72,358.77 $7,131.57 $16,694.65
$570.50 $29,471.49
$4,276.75 $76,884.54 $15,650.32

30

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
INTEGRATED HEALTH SYSTEMS INTERIOR DESIGN ATLANTA INTERNATIONAL AUTO PROCESSIN INTERNATIONAL PROCESSING COR INTERNATIONAL RESCUE COMM INTERSTATE BRANDS CORP INTERSTATE DISTRIBUTORS, INC. INTERSTATE GENERAL GOVERNME INTREPID CORP/BAKER BROTHERS IRWIN COUNTY HOSPITAL ISS INTERNATIONAL SERVICES ITEL CORPORATION ITHACA INDUSTRIES INC. ITT AUTOMOTIVE ITTCPC ITT THOMPSON ITT-RAYONIER, INC. J & M TANK LINES J & R SCHUGEL J. GRADY RANDOLPH J.P. BEAMER CO., INC. J.A. JONES MGM'T. SERVICE J.C. COX LOGGING, INC. J.M. FAMILY ENTERPRISES, INC. J.P. STEVENS & COMPANY, INC. JACKSON CO BD OF EDUCATION JAMES GAMBLE MASONARY JAMES HILL CONTRACTOR JARVIS WEBB JEBCO, INC. JET CORR, INC. - PLANT 1
JIM YOUNG CONSTRUCTION CO.INC
JM MILES CONSTRUCTION CO. JOE E. KNOWLES TRUCKING JOHN D. STEPHENS, INC. JOHN DEMORE LOCK & KEY SERVIC

City
ATLANTA NORCROSS BRUNSWICK
CONLEY NEW YORK COLUMBUS NORCROSS
SAVANNAH ALBANY
OCILLA ATHENS
SUWANEE QUITMAN
ROME
NORCROSS
ADEL MIDVILLE AMERICUS NORCROSS GAFFNEY CALHOUN CHARLOTTE RICHMOND HILL DEERFIELD BCH LOUISVILLE JEFFERSON VALDOSTA ACWORTH MARIETTA
WARRENTON CONYERS
CLEVELAND
BAXLEY
TYRONE STONE MOUNTAIN
NEWNAN

State
GA GA GA GA NY
GA GA GA GA
GA
GA
GA GA GA GA
GA GA GA GA SC
GA NC
GA FL GA GA GA GA GA
GA GA GA GA
GA GA GA

Total Reimbursed
$2,229.16 $2,339.63 $28,359.83. $24,585.89 $14,217.50 $126,832.63 $20,245.93 $12,909.47 $65,035.59
$764.40 $3,022.82 $19,771.12 $113,875.51 $2,598.39
$557.25 $11,787.46 $67,413.74
$1,075.89 $53,165.00
$788.56 $15,813.43 $36,167.78 $77,922.16
$312.77 $6,480.00 $41,224.03 $19,327.68 $6,270.00 $5,602.33 $26,041.92 $12,766.40
$852.50 $3,033.31 $43,114.37 $14,779.84 $58,915.69

31

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
JOHN PITTS COMPANY, INC. JOHNNY PHILLIP HEATING JOHNSON & JOHNSON JOHNSON CONTROLS, INC. JOHNSON COUNTY NURSING HOME JRC TRUCKING JULIAN LECRAW & CO JWI GROUP PRESS FABRIC JWI GROUP-ATLANTA WIRE WORKS K & C MACHINE DEVELOPMENT, INC K & F INDUSTRIES K & M MAINTENANCE SERVICES INC K. C. GYPSUM KAMO MFG. KASON INDUSTRIES, INC KATSUSHURO ROME CORP. KAWNEER COMPANY KEH, INC. KELLWOOD COMPANY KEMIRA, INC. KENDALL COMPANY KENDRICK TOOL & ENGINEERING C KENNEDY EQUIPMENT CO. KENNESAW TRANSPORTATION KENS SERVICE COMPANY KENTUCKY-TENNESSEE CLAY CO. KERSH CONSTRUCTION KEVCO, INC. KING & SPALDING KING MUFFLER SHOP KING PACKAGING COMPANY KINNETT DAIRIES, INC KLIKLOK CORPORATION KLOCKNER NAMASCO CORP. KNIGHT RIDER NEWSPAPER/MACON KOLE INVESTMENT CO.

City
FORSYTH CHAMBLEE CORNELIA ST. MARYS ADRIAN CALHOUN ATLANTA JONESBORO JONESBORO BUFORD ROCKMART WARNER ROBINS LENEXA AUGUSTA SHENANDOAH ROME JONESBORO ATLANTA ST. LOUIS SAVANNAH AUGUSTA MABLETON COLUMBUS WHITE GAINESVILLE SANDERSVILLE OAKWOOD FT. WORTH ATLANTA WAYCROSS BREMEN COLUMBUS DECATUR SUWANEE MACON SAVANNAH

State
GA GA GA GA GA GA GA GA GA GA GA GA KS GA GA GA GA GA MO GA GA GA GA GA GA GA GA TX GA GA GA GA GA GA GA GA

Total Reimbursed
$17,251.30 $41,496.95 $18,157.35.
$2,129.10 $6,788.09 $2,290.35 $6,081.30 $3,354.55 $29,529.13 $29,639.39 $6,824.24 $16,992.96 $55,513.82 $34,917.29 $125,504.80 $2,048.14 $5,645.97
$72.50 $40,409.12 $33,203.17 $49,683.70
$4,909.63 $181.98
$6,030.91 $119.00
$12,438.00 $46,521.57 $109,074.90 $50,249.38 $49,349.17 $25,596.37 $53,007.73 $146,960.56 $19,124.88 $21,596.00 $19,248.55

32

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
KRAFT FOOD SERVICE, INC KRAFT FOODS, INC. KROGEL FREIGHT SYSTEMS OF GA KROGER CO. KUPPENHEIMER MFG. CO. KYSOR WARREN L & H SHEET METAL CO. L & L OUTDOORS D/B/A BLIMPIE L A T SPORTSWEAR LABORATORY CORP. OF AMERICA LAGRANGE MACHINE SHOP LAGRANGE MEMORIAL LIBRARY LAGRANGE SCHOOL SYSTEM LANCE, INC. LAND O'SUN DAIRIES LANDRUM PLDG. CO., INC. LANIER CONTRACTING CO., INC. LAPP INSULATOR CO. LARISCY MECHANICAL FABRICATO LARSON & JUHL LAW COMPANIES GROUP, INC. LAW ENGINEERING CO LAWLER HOSIERY MILL INC LEASEWAY PERSONNEL CORPORAT LEGGETT & PLATT INC LEGION INDUSTRIES, INC. LENBROOK SQUARE LEON FARMER & COMPANY LEON JONES FEED & GRAIN LESHNER MILLS, INC LESLIE FAY SPORTSWEAR LESTER PRECISION LEVITON MANUFACTURING COMPA LEWIS M. CARTER MFG. CO., INC. LEWIS TAYLOR FARMS, INC. LIBERTY REGIONAL MED CENT

City

State

NORCROSS

GA

ATLANTA

GA

MACON

GA

ATLANTA

GA

LOGANVILLE

GA

CONYERS

GA

JONESBORO

GA

MARIETTA

GA

DORAVILLE

GA

SAVANNAH

GA

LAGRANGE

GA

LAGRANGE

GA

LAGRANGE

GA

CHARLOTTE

NC

ATLANTA

GA

POWDER SPRINGS GA

SUWANEE

GA

SANDERSVILLE

GA

SYLVANIA

GA

NORCROSS

GA

ATLANTA

GA

ATLANTA

GA

CARROLLTON

GA

READING

PA

SOCIAL CIRCLE

GA

WAYNESBORO

GA

ATLANTA

GA

ATHENS

GA

CUMMING

GA

HAWKINSVILLE

GA

MORROW

GA

ROME

GA

ATLANTA

GA

DONALSONVILLE

GA

TIFTON

GA

HINESVILLE

GA

Total Reimbursed
$19,955.34 $276.50
$9,000.00. $418,954.78
$14,840.80 $27,068.81 $24,933.02
$3,803.55 $2,454.82 $12,133.03 $2,659.83
$835.54 $7,700.20 $18,268.10 $24,847.46 $26,831.25
$365.36 $21,689.92
$5,959.70 $18,364.97 $14,876.41 $12,376.56 $14,345.13 $223,960.57 $23,238.70
$9,661.88 $34,503.38 $61,490.76 $18,538.56 $33,476.20 $15,022.94
$7,781.27 $29,498.78
$6,575.38 $21,307.00
$216.51

33

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
LIFELIKE, INC. LIFT ATLANTA, INC. LOCKHEED MARTIN CORP. LOGAN PAVING COMPANY LOMBARDI'S LONDON IRON & METAL LONGHORN STEAKS LOOK PRODUCTS LOOKOUT MTN FAIRYLAND CLUB IN LORAL SPACE & COMMUNICATIONS LOWE ELECTRIC & PLUMBING LOWE'S CARPET CORP. LOWE'S COMPANIES LUCAS INDUSTRIES LUKE'S SERVICE STATION LUMMUS INDUSTRIES, INC. M & M CONTRACTING OF JASPER M & M SUPERMARKETS INC M & S CLEANING SERVICE MACGREGOR GOLF COMPANY MACON HILTON HOTEL MACON KRAFT MACON MALL/COLONIAL PROP. TR. MACON NORTHSIDE HOSPITAL MACON-BIBB CTY WATER & SEWAG MACY'S MACY'S HOMESTORE MALL AIR OF GA. MANAGEMENT & TRAINING CORP. MANHATTAN SHIRT COMPANY MANNINGTON CARPETS, INC. MANPOWER TEMP. SERVICES MAPLEHURST, INC. MARELL POULTRY COMPANY INC MARI STAFF, INC. MARK'S & MORGAN JEWELERS, INC.

City
KENNESAW DECATUR MARIETTA ATHENS ATLANTA ATLANTA ATLANTA MILLEN LOOKOUT MOUNT ROCKMART MACON CHATSWORTH ALBANY MACON LENOX COLUMBUS JASPER SAVANNAH WARNER ROBINS ALBANY MACON MACON MACON MACON MACON UNION CITY MARIETTA WINDER ALBANY AMERICUS CALHOUN DUBLIN CARROLLTON MURRAYVILLE ATLANTA MACON

State
GA GA GA GA GA GA GA GA TN GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$15,737.00 $42,093.07 $999,390.63
$9,675.00 $19,840.50
$681.00 $2,514.17 $57,253.52 $3,029.52 $37,530.92 $5,540.71 $20,174.24 $9,680.00 $3,865.38 $52,510.69 $36,172.35 $3,464.24 $3,240.00 $10,241.13 $11,250.00 $37,320.00
$761.09 $11,532.21 $197,107.80
$8,369.23 $15,193.87
$1,776.50 $2,991.79
$236.70 $14,082.03 $49,278.45
$6,157.96 $205,225.45
$308.75 $4,447.06 $56,423.69

34

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
MARLEY COOLING TOWER MARSHALL'S MATHEWS CONVEYOR/BOBCOCK IN MATHIS DAIRY MATSUSHITA STORAGE BATTERY C MATTHEWS SERVICES GROUP MATTHEWS TRUCKING, INC. MAYO CHEMICAL CO., INC. MC'S PAINTING & DECORATING CO. MCC PANASONIC MCCLESKY MILLS MCDANIEL PHARMACY MCDONALD GROUP/LAKE DIVISION MCI COMMUNICATIONS MCKENNEYS, INC. MCRAE MANOR NURSING HOME MEAD CORPORATION MEARL CORP. MECHANICAL MAINTENANCE MED CARE INC/ COOSA VALLEY MEDEX, INC. MENLO PARK, INC. MERIAL LLC MERICO, INC. MERRITT MAINTENANCE & WELi METAL BUILDINGS, INC. METAL PRODUCTS COMPANY METRIC CONSTRUCTION METROPOLITAN GOLF CLUB MGR HOMECARE, INC. MICHAEL'S STORES, INC. MID GEORGIA AMBULANCE MID-SOUTH PIPELINE CONST., INC MIDAS, INC. MIDDLE GEORGIA HOSPITAL MIDSTATE STEEL, INC.

City
OVERLAND PARK DECATUR DANVILLE COLUMBUS COLUMBUS GRIFFIN BAXLEY SMYRNA HIRAM PEACHTREE CITY SMITHVILLE DUBLIN GAINESVILLE ATLANTA ATLANTA MCRAE ATLANTA HARTWELL AUGUSTA ROME DULUTH P'TREE CITY ATHENS FOREST PARK ALBANY THOMASVILLE SUWANEE MARIETTA LITHONIA GRIFFIN TUCKER MACON RICHMOND HILL PANAMA CITY MACON MACON

State
KS GA KY GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA FL GA GA

Total Reimbursed
$8,112.04 $196,899.59
$1,800.00 $387.87 $312.54
$34,101.63 $19,800.00 $12,046.24 $17,487.64
$8,176.78 $12,426.47
$9,177.99 $16,529.00
$6,468.16 $3,859.50 $27,780.62 $45,371.77 $249,465.05 $19,433.59 $30,412.99
$820.68 $8,205.26 $6,406.82 $7,993.42 $5,200.40 $36,954.35 $11,406.11 $24,451.69 $19,852.57 $21,218.80 $7,100.59 $1,592.07 $5,026.70 $19,295.13 $36,374.64 $73,211.50

35

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
MILCO BUILDING PRODUCTS, INC. MILES MOTES ELECTRIC MILLBROOK SALES MILLER BREWING CO MILLIKEN & COMPANY MINKIN & SNYDER, PC MISCELLANEOUS ERECTORS, INC. MITSUBISHI CONSUMER ELECTIC MIXON AND ASSOCIATES MOBIL CHEMICAL CO. MONROE AUTO EQUIPMENT MORGAN CORPORATION MORRIS-BRIDGE PROPANE GAS MORTENSEN WOODWORK, INC. MORTON HEATING & AIR MOTHER MAID MOULTRIE PULPWOOD/TIMBER MTC-TURNER JOB CORPS CENTER MUSCOGEE MANOR NURSING HOME N. G. GILBERT N.A. WEST BLOCK COMPANY NAMES FOR DAMES, INC. NASH CHEVROLET NASHVILLE TEXTILE CORP NATIONAL CEMENT CO., INC NATIONAL DATA CORPORATION NATIONAL DISTRIBUTING COMPANY NATIONAL GYPSUM COMPANY NATIONAL HEALTH LABORATORIES NATIONWISE AUTOMOTIVE, INC. NEFF MOTIVATION, INC. NEIGHBORHOOD VARIETY, INC NESTLE TRANSPORTATION CO. NETCARE HEALTH SYSTEMS, INC. NEWHOUSE ELECTRIC CO., INC. NICHOLSON CONSTRUCTION CO.

City
SWAINSBORO ACWORTH LESTER ALBANY LAGRANGE ATLANTA POWDER SPRINGS BRASELTON MCINTYRE LAGRANGE GA HARTWELL RYDELL DOUGLAS UNION CITY CHAMBLEE BALLGROUND MOULTRIE ALBANY COLUMBUS PARKER CITY EAST ELLIJAY CALHOUN LAWRENCEVILLE NASHVILLE LAWRENCEVILLE NORCROSS ATLANTA ATLANTA MARIETTA ATLANTA UNADILLA ST. SIMONS ISLAN MCDONOUGH ELLIJAY CARTERSVILLE CUDDY

State
GA GA MA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA IN GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA PA

Total Reimbursed
$676.50 $2,200.00 $14,850.86 $48,610.43 $22,640.03
$654.43 $4,278.00 $102,359.14 $61,335.00 $18,927.81 $17,255.89 $67,953.99
$571.20 $1,397.73 $5,113.65 $4,298.57 $21,975.00 $5,621.20 $11,205.86 $7,203.00 $17,198.02 $6,833.39 $132,486.30 $7,187.64 $1,227.55 $1,316.55
$649.15 $5,042.65 $20,475.00 $42,225.00 $4,032.29 $3,258.01 $21,749.99 $1,782.92 $18,853.13 $3,023.80

36

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
NOLAND COMPANY
NORCOM, INC. NORCROSS EXCAVATING, INC. NORD KAOLIN CO NORTH BROAD BAPTIST CHURCH NORTH GA. POURED WALLS INC. NORTHEAST SALES DISTRIBUTING NORTHERN TELECOM, INC. NORTHLAKE PLUMBING NORTHROP GRUMMAN CORP. NORTHWEST AIRLINES, INC.
NOVI AMERICAN, INC
NOVOSTE CORP OAK GROVE ISLAND GOLF CLUB OCEAN PROPERTIES LTD. OCTAGON AIR SYSTEMS OELSCHIG'S NURSERY, INC. OLIN WOOTEN TRANSPORT CO. INC. OLSTEN, INC. OMC ONDEMANDTEMPORA~ES ONEDA CORPORATION OPTI-WORLD, INC. ORGILL INC ORIGINAL BRAND FOODS OUTBOARD MARINE CORP. OVERHEAD DOOR COMPANY OF AT OVERHEAD DOOR CORP. OWENS & PRIDGEN, INC. OXFORD INDUSTRIES, INC. OXFORD OF DUBLIN OXFORD SECURITY SERVICES P.P.G. INDUSTRIES P.S.I. INC. PACESETTER CORPORATION PALMER INSTALLATIONS

City
MACON
NORCROSS BUFORD JEFFERSONVILLE ROME DALTON ATHENS STONE MOUNTAIN LILBURN
PERRY ATLANTA ATLANTA
NORCROSS BRUNSWICK COLUMBUS CONLEY SAVANNAH HAZLEHURST DALTON CALHOUN TIFTON COLUMBUS ATLANTA TIFTON ATLANTA CALHOUN ATLANTA ATHENS BRUNSWICK MONROE DUBLIN ATLANTA EAST POINT MARIETTA NORCROSS FLOWERY BRANC

State
GA
GA
GA
GA
GA GA GA GA GA GA GA
GA
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$18,515.48 $6,026.07
$37,446.59 $13,801.61 $12,016.50 $48,643.17 $28,320.03
$8,454.21 $269.55
$10,845.10 $4,600.39 $369.90 $3,996.90 $6,454.85
$38,101.93 $4,875.00 $8,197.62
$11,407.00 $280.00
$22,783.17 $39,053.25 $36,671.29 $17,247.88 $35,536.66 $99,083.72 $54,251.55 $44,187.43 $15,479.20 $22,173.19
$838.34 $11,146.38
$2,696.56 $2,125.22 $4,125.00
$631.96 $8,903.12

37

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
PALMER JOHNSON PARAMONT GRADING CO. PARK 'N FLY PARKWAY MEDICAL CTR. PARMALOT NEW ATLANTA DAIRIES PARRISH DRUG STORE PARSONS BRINCKERHOFF/TUDOR PCSPHOSPATECOMPANY PDS MECHANICAL PEACH AUTO PAINTING PEACHTREE DEVELOPMENT CORP PEACHTREE PARK, INC. PEARSON & SON, INC. PEAVY SPREADER PEELER JERSEY FARMS, INC. PENSKE AUTO CENTER PEPSI-COLA COMPANY PERSIAN RUG COMPANY PERSONAL CARE HOMES MANAGEM PHILADELPHIA CHRISTIAN SCHOOL PIGGLY WIGGLY SOUTHERN PILGRIM MILL CAFE PILOT PROPERTY COMPANY PINCKARD & MORGAN CLEANERS PINE KNOLL NURSING & REHAB. PINKERTON & LAWS, INC. PIPE ORGAN SALES-SERVICE PITNEY BOWES PIZZA HUT, INC. PLYMARTS, INC. POETIC LICENSE, INC. PONCE DE LEON CHEVRON POREX TECHNOLOGIES POST PROPERTIES, INC. PRECISE MAINTENANCE, INC. PREMARK INTERNATIONAL INC.

City
SAVANNAH ALPHARETTA COLLEGE PARK LITHIA SPRINGS ALBANY JACKSON ATLANTA MOULTRIE JESUP TUCKER PEACHTREE CITY ASHBURN WAYCROSS PINEHURST ATHENS VALDOSTA ATLANTA ATHENS PERRY CONYERS
CUMMING ATLANTA DECATUR CARROLLTON ATLANTA LITHONIA NORCROSS WOODSTOCK NORCROSS ATLANTA ATLANTA FAIRBURN ATLANTA DOUGLASVILLE CHAMBLEE

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$56,463.17 $32,595.72
$9,228.04, $16,948.34
$2,281.24 $274,999.30
$12,798.13 $31,036.41 $14,219.02 $13,249.74
$1,593.65 $11,825.57 $28,690.60 $20,272.99
$5,833.50 $25,300.00
$4,900.00 $5,964.00 $15,490.89 $6,743.06 $8,069.28 $38,007.02 $130,674.48 $1,802.70 $39,246.18 $24,828.43 $42,441.70 $89,689.97 $44,534.56 $2,680.60 $22,741.30 $23,594.53 $15,837.62 $46,119.72 $23,786.22 $33,394.07

38

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
PREMIUM BEVERAGE PREMIUM PORK, INC. PRESTIGE FUND RAISERS PRESTOLITE WIRE CORP. PRICE INDUSTRIES INC. PRIME CHILD CARE OF MACON PRINCETON CARPETS PRINCIPAL FINANCIAL GROUP PRINTED FABRICS, INC PRO AIR SVCS LTD PARTNERSHIP PROFESSIONAL EMPLOYEE MGM'T. PROFESSIONAL MEDICAL SERVICES PROFESSIONAL TEMP. SERVICES PROMUS HOTELS, INC. PUBLIC STORAGE PUBLIX SUPERMARKETS, INC. PURCELL SERVICE COMPANY PURINA MILLS PYE-BARKER WELDING QUAD GRAPHICS QUEBECOR ATLANTA QUIKSET DEKALB QUIKSET-ARCHWA Y R& B, INC. R & D MANUFACTURING CO., INC. R & R SUPERIOR PLUMBING R.M.HURST R.C. PIERCE ROOFING CO. R/S EXPRESS, INC. RABERN NASH CO., INC. RACETRACPETROLEUM RACO, INC. RADISSON HOTEL ATLANTA RADISSON INN RALPH W SMITH CONSTRUCTION CO RANDAL LOWE ENTERPRISES, INC.

City
ATLANTA MOULTRIE FAYETTEVILLE TIFTON SUWANEE MACON ADAIRSVILLE MARIETTA CARROLLTON DULUTH SARASOTA ORLANDO THOMASVILLE BRUNSWICK GLENDALE COLUMBUS DOUGLASVILLE GAINESVILLE NOCROSS THE ROCK ATLANTA TOCCOA TOCCOA CARROLLTON GAINESVILLE ACWORTH SYLVESTER EAST POINT ATLANTA DECATUR CORDELE GRETNA ATLANTA ATLANTA DECATUR MARIETTA

State
GA GA GA GA GA GA GA GA GA GA FL FL GA GA CA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA VA GA GA GA GA

Total Reimbursed
$61,946.33 $9,187.07 $1,413.90
$34,470.57 $441.13
$32,657.50 $132,748.24
$291.67 $5,221.07
$269.00 $2,140.31 $10,595.88 $21,624.76 $3,246.61 $53,461.87 $413,205.90 $110,220.00
$33.44 $24,832.00 $33,604.14
$5,698.01 $1,543.76 $16,438.90 $61,426.90 $15,341.20 $116,218.41 $66,051.63 $49,260.02 $5,785.98 $6,288.45 $51,144.46 $24,022.47 $160,326.85 $2,106.36
$36.00 $1,364.50

39

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
RAX RESTAURANTS, INC. RAYLOC RCS, INC. RCS-NORTHSIDE DISTR. CTR. RCS-SOUTHSIDE DISTR. CTR. RECREATIONAL FACTORY WAREHO REDDINGS HEATING REDMOND REGIONAL MEDICAL CTR. REECE CONSTRUCTION, INC. REEVES TRUCKING CO., INC. REFFIELD TIRE MASTER REID PACKAGING, INC. REIMBURSEMENT CONSULTANTS, IN RELIABLE INVESTORS RELIANCE COMM/TEC REMEDIATION SERVICES, INC. RENTOKIL CONTRACT SVC., INC. RENTZ CABINET CO. RESORTQUEST INT'L. RETIREMENT CARE ASSOC. INC. REYNOLDS, INC. RHEEM MANUFACTURING CO. RHODES COOLING & HEATING RHODES, INC. RHONE POULENC, INC. RHONE POULNEC, INC. RICH SEAPACK CORP RICH'S RIGID BUILDING SUPPLIES RINGGOLD TELEPHONE CO. RITE AID PHARMACY RITE INDUSTRIES RNERASSOCLLCCADYBAGCO RIVERSIDE MANUFACTURING RIVERSIDE MILITARY ACADEMY RIVERWOOD INTERNATIONAL

City
DUBLIN ATLANTA NORCROSS NORCROSS FAYETTEVILLE JONESBORO DORAVILLE ROME DALTON FITZGERALD MACON TUCKER ROSWELL THOMASVILLE TOCCOA FITZGERALD DULUTH RENTZ ST. SIMONS ISLAN COLUMBUS FAIRBURN MILLEDGEVILLE MOULTRIE DECATUR WOODBINE MARIETTA BRUNSWICK ATLANTA VALDOSTA RINGGOLD MCRAE DALTON PEARSON MOULTRIE GAINESVILLE MACON

State
OH GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$5,000.00 $7,163.37 $11,035.00 $25,268.14 $71,701.62 $34,614.05 $23,800.00 $34,596.02 $4,757.25 $15,750.00 $1,904.63 $157,872.23 $24,440.71
$515.39 $1,463.35 $36,440.88 $138,180.38 $4,020.80 $7,748.33
$989.28 $27,242.12 $51,559.89 $59,971.06 $20,250.00 $56,525.00 $19,220.00
$9,389.70 $3,227.12 $1,457.00
$356.84 $11,844.98
$356.49 $2,657.04 $18,530.65
$668.64 $1,137.50

40

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
RNF WHOLESALE PRINTING, IN ROAD ATLANTA ROADWAY EXPRESS ROBERT BOSCH CORP. ROBERT SHAW CONTROLS CO. ROBERTA NURSING HOME ROBINSON MASONRY ROCHE BIOMEDICAL LABORATORY ROCK TENN CO. ROCKMART NURSING & REHAB. ROGERS CASH & CARRY ROME PLUMBING AND AIR ROME TOOL & DYE COMPANY, INC. ROPER PUMP ROSCOE LAIRCEY CO., INC. ROSEDALE TRANSPORT, INC. ROSES DEPARTMENT STORE# 235 ROSIEK CONSTRUCTION CO. ROSS LIGHTING, INC. ROSWELL NURSING & REHAB. CTR. ROUSE FAMILY CARPET & TILE RTM FAMILY RESTAURANTS RUSSELL & YOUNG BUILDERS S & L CONSTRUCTION CO S & S GRILL S P RICHARDS COMPANY SADDLE CREEK CORP. SAFETY KLEEN CORP. SAKS FIFTH AVENUE SALLY BEAUTY COMPANY SALTERS INDUSTRIAL SERVICE SANDBURY CORPORATION RIVER P SANDERSON INDUSTRIES, INC. SANDY SPRINGS METHODIST CHUR SAVANNAH COCA-COLA BOTTLING SAVANNAH COCOA, INC.

City
MARIETTA BRASELTON MARIETTA BROADVIEW ELLIJAY ROBERTA VALDOSTA ATHENS NORCROSS ROCKMART THOMASTON ROME ROME COMMERCE STATESBORO DALTON ALBANY BRUNSWICK JESUP ROSWELL BRUNSWICK ATLANTA MARIETTA ACWORTH ELBERTON ATLANTA MACON NORCROSS ATLANTA COLUMBUS TARRYTOWN ATLANTA ATLANTA ATLANTA POOLER SAVANNAH

State
GA GA GA IL GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$3.57 $10,351.89 $118,263.27 $54,881.36 $129,519.85 $98,387.94
$2,102.26 $673.77
$54,980.64 $135,004.35
$4,375.00 $759.92 $708.66
$3,355.28 $592.90
$38,339.83 $8,784.54
$21,942.50 $3,530.50
$31,600.99 $12,639.37 $103,653.12 $12,870.59 $85,402.01 $15,955.82 $17,034.67 $12,963.72
$967.45 $11,021.22 $26,767.34 $18,587.76 $50,000.00 $25,252.34 $20,837.85 $16,636.32 $12,718.03

41

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
SAVANNAH DOUGHNUT COMPANY
SAVANNAH NEWS PRESS SAVANNAH SUGAR REFINERY SCAPE DRYER FABRICS SCHULLER INTERNATIONAL SCHUSTER ENTERPRISES, INC. SCHWITZER, INC SCOTT BRIDGE CO. SCOVILL, INC. SCRIPPS HOWARD CABLE SOR, INC. SE BUILDING MAINTENANCE IN SEABOARD FARMS OF ATHENS SEARS LOGISTIC SERVICES SEARS ROEBUCK & CO. SELIG ENTERPRISES, INC SERVICE MERCHANDISE SERVICEMASTER SERVICEMASTER CONSUMER SERV. SERVPRO OF EAST COBB SHC ASSOCIATES SHELL EXPRESS SHEPARD EXPOSITION SERVICES SHEPHERD CONSTRUCTION CO SHO/LINK,INC. SHOE CITY, INC. SHOEMAKER IRRIGATION COMPANY SIEMANS ENERGY CORP. SIGNATURE FLIGHT SUPPORT SILVER EAGLE TRANSPORT, INC SIMKINS INDUSTRIES, INC. SIMPLEX TIME RECORDER CO. SINGLETON FURNITURE CO SIPCO, INC. SIX FLAGS OVER GEORGIA SMI GEORGIA

City
SAVANNAH SAVANNAH SAVANNAH WAYCROSS MACON
COLUMBUS GAINESVILLE OPELIKA CLARKESVILLE ROME
ATLANTA
LOGANVILLE ATHENS TUCKER
MACON ATLANTA
BRENTWOOD
ATLANTA
LAWRENCEVILLE MARIETTA BUFORD
WAYCROSS ATLANTA ATLANTA ATLANTA
MONTGOMERY ATHENS ALPHARETTA GARDEN CITY ALBANY MARIETTA NORCROSS
WAYCROSS ATLANTA
ATLANTA LAWRENCEVILLE

State
GA GA GA GA GA GA GA AL GA GA GA GA GA GA GA
GA
TN GA GA GA GA
GA
GA GA
GA
AL GA GA GA GA GA GA GA
GA
GA GA

Total Reimbursed
$9,770.21 $11,000.00
$4,635.00. $13,902.17
$118.00 $253.00 $4,934.49 $3,483.23 $7,000.00
$22.50 $1,917.04 $19,716.48 $29,737.44 $3,810.00 $70,977.54 $157,795.83 $32,725.00 $60,016.08 $120,147.89 $36,496.00 $9,344.90 $50,272.71 $2,087.31 $3,826.89 $3,575.00 $111,116.22 $5,440.00 $22,493.60 $12,044.86 $8,959.86 $22,141.28 $2,075.41 $8,858.12 $23,093.50 $20,769.71 $3,533.10

42

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
SMILE GAS/BOARDMAN PET. INC. SMITH INDUSTRIES SMITHKLINE BEECHAM SMITHS MARKET SMOKER - CRAFT SNELLING & SNELLING SOLOMON WHITE SONY ELECTRONICS SONY MUSIC SOSSNER TAP & TOOL SOUTHEAST BUILDING MAINT. TECH SOUTHEAST PAPER CO. SOUTHEASTERN MEAT CO INC SOUTHEASTERN METAL SOUTHERN AGGREGATES CO. SOUTHERN AMBULANCE BUILDERS SOUTHERN CELLULOSE, INC. SOUTHERN CONTRACTORS SOUTHERN CROSS CORP SOUTHERN ELECTRONICS SOUTHERN FOODS SOUTHERN FOODSERVICE MANAGM SOUTHERN HERITAGE SOUTHERN MANOR FURNITURE CO. SOUTHERN PAPER RECOVERY INC SOUTHERN PIZZA VENTURES SOUTHERN SAW SERVICE, INC. SOUTHERN STATES PHOSPHATE SOUTHLAND ASSOCIATES, INC. SOUTHWESTERN GREAT AMER. INS. SPARTECH CORP. SPC COMPANY SPECIAL PROJECTS, INC. SPIRIT CONSTRUCTION SERVICES SPORTSLIFE, INC. SPRING CITY KNITTING

City

State

AUGUSTA

G3

CUMMING

GA

TUCKER

GA

TALLAPOOSA

GA

LAGRANGE

GA

RINGGOLD

GA

DALTON

GA

ATLANTA

GA

CARROLLTON

GA

BRUNSWICK

GA

LOGANVILLE

GA

DUBLIN

GA

ATLANTA

GA

LYONS

GA

MACON

GA

LAGRANGE

GA

ATLANTA

GA

VALDOSTA

GA

NORCROSS

GA

TUCKER

GA

ROSWELL

GA

ATLANTA

GA

TUCKER

GA

THOMASVILLE

GA

SAVANNAH

GA

COMMERCE TOWN Ml

ATLANTA

GA

SAVANNAH

GA

THOMASVILLE

GA

NASHVILLE

TN

ATLANTA

GA

LAGRANGE

GA

DALTON

GA

SAVANNAH

GA

ATLANTA

GA

CARTERSVILLE

GA

Total Reimbursed
$76,488.82 $25,589.66
$3,934.05 $35,459.70 $12,474.87
$5,643.65 $2,901.16 $22,860.71 $14,883.87 $58,126.36 $5,412.05 $12,626.83 $16,375.36 $41,140.73 $48,050.00
$522.00 $51,585.29 $13,212.95 $13,186.22 $16,274.03 $61,364.11 $13,425.02 $44,484.90 $58,146.36 $33,633.57 $36,791.31
$6,804.94 $23,076.12
$9,486.96 $1,337.84 $1,328.73 $34,714.66 $13,621.88 $16,474.97 $8,139.32 $8,645.11

43

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
ST.IVES COUNTRY CLUB STANDARD TELEPHONE COMPANY STAPLES, INC. STEPHEN CHENG, M.D. STEPHENS COUNTY SCHOOLS STEVE CRAWFORD FOREST PROD. STONE MOUNTAIN GROUP STORK GAMCO STOVALL NISSAN STRAIN POULTRY SUITT CONSTRUCTION COMPANY SULLIVAN CONSTRUCTION CO. SUN MOUNTAIN HEALTH CARE SUNDANCE PLUMBING, INC. SUNGLASS HUT CORPORATION SUNTRUST BANK SUPER 8 MOTEL SUPERIOR ELECTRIC SUPERIOR INSURANCE COMPANY SUPERIOR LANDFILL SUPERIOR PANTS COMPANY SUPERIOR STEEL, INC. SUPREME CARPET, INC. SUPREME INDUSTRIES, INC. SUZANNA'S KITCHEN, INC. SWEETHEART CUP CO., INC. SWIFT INDEPENDENT PACKING CO SWIFT TRANSPORTATION SWINFORD CARPETS SWISHER INTERNATIONAL ,INC. SYNOVUS FINANCIAL CORP. SYSCO FOODS SYSTEM SERVICES AND INDUSTRIAL T & L SERVICES, INC. TABLE AND CHAIRS,INC. TACO BELL

City
DULUTH CORNELIA ATLANTA SAVANNAH TOCCOA WAYNESBORO SNELLVILLE GAINESVILLE MORROW GAINESVILLE ALBANY HOMER ROME MARIETTA MIAMI ROME SAVANNAH JULIETTE ATLANTA SAVANNAH ATHENS ROCKMART CHATSWORTH GOSHEN DULUTH CONYERS MOULTRIE PHOENIX ATHENS JACKSONVILLE COLUMBUS COLLEGE PARK SAVANNAH PALMETTO ATLANTA AUGUSTA

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA FL GA GA GA GA GA GA GA GA GA GA GA GA AZ GA FL GA GA GA GA GA GA

Total Reimbursed
$7,974.14 $2,007.62
$770.85 $2,809.70 $8,921.25
$355.59 $41,040.18 $65,508.86 $41,741.47
$4,050.00 $14,690.58 $11,499.05 $14,346.15
$7,175.00 $27,831.97 $47,458.98
$231.33 $18,961.96 $13,456.05
$1,817.71 $11,246.04 $29,456.90 $13,840.12 $93,986.21 $32,780.00 $43,761.53
$7,600.50 $200.00
$8,199.49 $4,745.59 $21,069.86 $57,227.64 $17,892.77 $8,747.98 $6,710.67 $15,595.29

44

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
TALON, INC. TARA MATERIALS, INC. TAYLOR GAS TDK ELECTRONICS CORP. TDS TELECOM TEC AMERICA INC TECH CON, INC. TEETS INTERNATIONAL TRUCKS INC TELEPHONE & DATA SYSTEMS TEMPLE INLAND, INC. TENNECO AUTOMOTIVE TENNECO OIL CO. TERMINIX (SERVICEMASTER) TERMI NIX AT CHAMBLEE TEXAS PERSONNEL SERVICES THE ATHLETE'S FOOT GROUP INC THE CORP. OF MERCER UNIVERSITY THE DAVIS GROUP, INC. THE GILBERT COMPANIES THE GREATER TRAVELERS REST THE HAYS CORP. THE MOTOR CONVOY, INC. THE RAYMOND KING CO., INC. THE TAPPAN COMPANY THE WILLIAM L BONNELL CO., INC THERMAL INDUSTRIES/HEAT, INC. THOMAS COUNTY PUBLIC SCHOOLS THOMAS PACKING CO. THOMAS R. HOPSON THOMASTON-UPSON CO. BD. OF ED. THOMPSON CONSTRUCTION CO. THOMPSON'S FARM SUPPLY THOMSON OAK FLOORING CO. THORNWOOD BUILDERS INC TIFT COUNTY BOE TIMBER HARVESTING, INC.

City
CLEVELAND LAWRENCEVILLE FAIRBURN PEACHTREE CITY ST. MARY'S ATLANTA BLUE RIDGE AUGUSTA SAINT MARYS MACON HARTWELL EAST POINT FOREST PARK CHAMBLEE HOUSTON COLUMBUS MACON CAMPBELLSVILLE MUNCIE DECATUR MACON ATLANTA CALHOUN DALTON NEWNAN MARIETTA THOMASVILLE GRIFFIN MARIETTA THOMASTON CHAMBLEE VIDALIA THOMSON LILBURN TIFTON DANVILLE

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA TX GA GA KY IN GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$113,701.34 $14,431.76 $9,590.40. $22,026.65 $5,285.20 $832.00 $6,788.38 $4,609.00 $5,495.49 $14,529.97 $13,975.00 $80,067.54 $232.83 $68,181.63 $80,096.63 $1,302.07 $490.40 $3,687.74 $109,551.15 $3,903.80 $101,657.95 $4,875.00 $29,430.92 $16,039.79 $10,525.80 $71.54 $951.52 $13,014.06 $684.00 $16,502.70 $17,729.78 $13,400.41 $19,187.01 $39,817.00 $139,692.38 $253,166.99

45

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
TIMBERLINE TRANSPORATION. TIPPINS CONTRACTING CO., INC. TNS MILLS TOBACCO EXPORTERS INT'L TODD UNIFORM, INC TOGA/ADV. FORM TOM'S FOOD, INC. TOMMY GIBSON BUILDERS INC TONY'S FOOD MART. TONYS UNION 76/WEST GA MUFFLE TOPCON AMERICA CORP. TOPPAN INTERAMERICA, INC TORRINGTON TOSCO MARKETING CO. TOWN OF TRION POLICE DEPARTMN TOWNS COUNTY BD OF EDUCATION TRAILMOBILE, INC. TRANE COMMERCIAL SYSTEMS TRANS WORLD AIRLINES, INC. TRANSAC, INC TRANSPOWER TRENT TUBE DIVISION TRIBUNE COMPANY TRINOVA CORPORPATION/ TROJAN BATTERY COMPANY TRUCKSTOPS OF AMERICA TRUS JOIST MACMILLIAN TUFTCO CORP. TUFTING MACHINE CO., INC. TURNER BROADCASTING SYSTEM I TURNER FOOD SYSTEMS, INC. TWIGGS COUNTY BOE U F I MICRO FIBERS U.S. CAN CO U.S. ELEVATOR CORP. U.S. FILTER

City
EASTMAN MARIETTA LAVONIA TUCKER NASHVILLE JACKSON COLUMBUS MACON ROCKMART CARROLTON PARAMUS MCDONOUGH SYLVANIA FORT MILLS TRION HIAWASSEE CONLEY MACON ATLANTA MACON ALBANY CARROLLTON ATLANTA ATLANTA LITHONIA BRUNSWICK COLBERT DALTON DALTON ATLANTA ROME JEFFERSONVILLE JASPER TALLAPOOSA ATLANTA THOMASVILLE

State
GA GA GA GA TN GA GA GA GA GA NJ GA GA SC GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$118,100.75 $8,397.86 $1,165.43
$12,801.33 $3,648.44
$10,906.21 $11,874.39 $21,871.87 $31,601.19
$2,655.04 $24,662.37
$9,045.59 $19,782.50 $50,688.60 $28,579.25
$3,085.36 $38,196.12
$300.75 $55,763.68
$326.40 $1,022.75 $3,675.00 $1,901.84 $13,382.18 $30,752.03 $120,859.34 $24,520.23 $1,977.25 $20,697.68 $6,846.44 $5,004.70 $1,263.33 $5,054.00 $51,629.74 $22,810.07 $16,518.92

46

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
U.S. FILTER WHEELABRATOR UHAUL CO. UNDERWOOD ADMINISTRATIVE SVC UNION MISSION INC. UNITED DISTRIBUTORS, INC. UNITED HOSPICE-CALHOUN UNITED INSURANCE UNITED INSURANCE CO OF AMERIC UNITED PARCEL SERVICE UNITED STATIONERS, INC UNITED TRANSPORT (DSI) UNIVERSAL DISPERSIONS UNNERSALFORESTPRODUCTS US XPRESS, INC. USA CORP. USA WASTE SERVICES USCO DISTRIBUTION SVCS UTILITIES CONST. CO OF SC UVALDA MANUFACTURING COMPAN V.F. CORPORATION/LEE CO. VALLEY HOME CARE VARN WOOD PRODUCTS VAUGHAN CARTAGE CO., INC. VENCOR REHAB CTR. VENDOR'S SUPPLY OF GEORGIA VENDORS SUPPLY VIACON, INC VICTORY BAPTIST CHURCH VILLAGE MEATS/BIRCHWOOD MEAT VINCE HOSIERY MILL VINING FUNERAL HOME VISITING NURSES ASSOCIATION VISTA HOSPITAL CARE VITAL CARE EMS VOLUME TRANSPORTATION,INC. W &J, INC.

City
LAGRANGE COLUMBUS ATLANTA SAVANNAH ALBANY CALHOUN CHICAGO SAVANNAH JACKSONVILLE NORCROSS FAIRBURN FITZGERALD EATONTON TUNNEL HILL DORAVILLE MARIETTA STOCKBRIDGE CHARLESTON UVALDA JASPER FORT VALLEY HOBOKEN LAGRANGE MARIETTA LITHONIA DECATUR NORCROSS STONE MTN. NORCROSS VILLA RICA EATON BAXLEY MACON NEWNAN LITHONIA SMYRNA

State
GA GA GA GA GA GA IL GA FL GA GA GA GA GA GA GA GA SC GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Total Reimbursed
$2,193.32 $14,525.00
$160.74 $48,737.12
$5,122.00 $8,566.08 $32,639.50 $17,786.19 $83,718.34 $1,052.34 $1,487.22 $10,633.70 $25,064.69 $7,562.76 $3,018.13 $24,885.07 $1,270.00 $17,281.23 $12,495.39 $13,268.84 $60,258.08 $8,469.99 $1,891.64 $11,521.40 $20,925.00 $61,376.30 $5,771.70 $7,088.24 $75,999.00 $3,565.00 $6,969.69 $20,486.99 $3,328.38 $3,722.28 $80,857.94 $37,658.59

47

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
W. DUKES BUILDERS W.GARNERCONSTRUCTION W.C. BRADLEY CO. W.T HARVEY LUMBER COMPANY WAL-MART DISTRIBUTION CENTER WAL-MART STORES, INC. WALDEN HALL CHRISTIAN SCHOOL WALDON ROCK SERVICES WALT FREEMAN CONSTRUCTION C WARD MACHINERY SERVICES WAREHOUSE CARPET WARNACO, INC. WASTE MANAGEMENT OF AUGUSTA WATER, GAS & LIGHT COMMISSION WATTYL PAINT CORP. WAYCROSS COCA-COLA WAYFIELD FOODS, INC. WAYNE COUNTY BD OF ED WAYNE POULTRY WEBCO TIRE & WHEEL WEEKS CONSTRUCTION CO WEEKS TEXTILE WELDING SERVICES WELLS FARGO ARMORED WELLS STEEL CO. WEST FOODS WEST GA. ROOFING INC. WEST GEORGIA AUTO PARTS INC WEST UNION CORP. WESTERN SIZZLIN' WESTIN PEACHTREE PLAZA WESTVALE MANUFACTURING CO WHISTLEVILLE CHRISTIAN CHURCH WHITAKER ELECTRIC CO., INC. WHITE CONSOLIDATED INDUSTRIES WHITEHALL CORPORATION

City
MARIETTA MCDONOUGH COLUMBUS COLUMBUS DOUGLAS THOMASVILLE AUGUSTA ADAIRSVILLE HAPEVILLE CORDELE RIVERDALE SYLVANIA AUGUSTA ALBANY ATLANTA WAYCROSS ATLANTA JESUP PENDERGRASS WAYCROSS SPARKS QUITMAN NORCROSS ATHENS ELLERSUE EDISON CARROLLTON CARROLLTON MEMPHIS ALBANY ATLANTA CANTON WINDER APPLING NORCROSS MACON

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA TN GA GA GA GA GA GA GA

Total Reimbursed
$1,627.46 $52,823.71 $32,047.43 $53,077.07
$7,239.35 $211,794.52 $131,546.81
$7,550.65 $2,556.00 $11,025.00 $5,738.48 $44,610.00 $14,267.08 $107,477.05 $74,878.36 $10,463.41 $8,962.16 $1,313.12 $9,000.17 $72,770.85 $3,489.10 $14,910.68 $16,405.00 $85,512.06 $5,518.84 $66,781.54
$824.06 $3,476.00 $1,471.00 $1,145.62 $590,566.43 $7,133.44 $1,305.00 $24,087.07 $5,529.03 $160,245.91

48

Individual Employers Benefitting from Reimbursements Paid to Insurance Companies by The Subsequent Injury Trust Fund
January 1, 2000 through December 31, 2000

Employer Name
WIKA INSTRUMENT CORP WILBERT BURIAL VAULT CO WILDES VENDING COMPANY, INC WILKINS INDUSTRIES WILKINSON CO. BD OF EDUCATION WILLIAM BARNET & SON WILLIAM CARTER CO. WILLIAM G. RICE, DDS WILLIAM LLOYD SMITH WILLIAMS & ASSOCIATES WILLIAMS ELECTRIC, INC. WILLIAMS ENTERPRISES OF GA INC WILSEY FOODS, INC. WILSON CROSBY/CROSBY PULP PR WILTON T. YAWN, INC. WINGATE TAYLOR MAID/ WINN EXPRESS CO. WOODSTOCK NURSING & REHAB. C WORLEY & SON CONSTRUCTION WORTH CO. BD. OF EDUCATION Y D K AMERICA, INC. Y.T. INDUSTRIES, INC. YAMAHA MUSIC MFG YKK (U.S.A), INC. YOKOGAWA CORP OF AMERICA YORK BEE CO ZARTRAN, INC.

Total

City

State

Reimbursed

LAWRENCEVILLE

GA

ATLANTA

GA

VALDOSTA

GA

ATHENS

GA

IRWINGTON

GA

MILLEDGEVILLE

GA

BARNESVILLE

GA

ATHENS

GA

CLAYTON

GA

ATLANTA

GA

FT. WALTON BEAC FL

SMYRNA

GA

ATLANTA

GA

LAKE PARK

GA

BAXLEY

GA

ALBANY

GA

ATLANTA

GA

WOODSTOCK

GA

LULA

GA

SYLVESTER

GA

CANTON

GA

HOLSTEIN

IA

THOMASTON

GA

MACON

GA

NEWNAN

GA

JESUP

GA

CEDARTOWN

GA

$5,592.36 $10,883.15 $20,294.46
$1,405.63 $1,963.40 $15,343.00 $150,926.13 $66,814.00 $2,628.78
$466.31 $5,562.00 $18,750.00
$380.70 $64,527.88
$534.95 $10,500.00 $94,992.28 $144,865.86
$1,984.55 $15,258.57
$5,672.51 $108,556.36
$213.88 $1,530.12 $19,800.00 $12,321.72 $49,722.05

Total:

$35,998,825.73

49

Subsequent Injury Trust Fund

Claims Reported by Insurance Companies For 1/1/00 To 12/31/00

Name

Claims Reported

ACCEPTANCE INSURANCE CO

1

ACE AMERICAN INSURANCE CO.

12

ACE FIRE UNDERWRITERS INS. CO.

1

ACE INDEMNITY INSURANCE CO.

1

ACE PROPERTY AND CASUALTY INS.

1

AIG NATIONAL INSURANCE CO.

6

AIU INSURANCE COMPANY

3

ALLMERICA FIN BENEFIT INS CO

3

AMERICAN ALTERNATIVE INS

57

AMERICAN AUTOMOBILE INS CO

6

AMERICAN CASCO OF READING PA

13

AMERICAN ECONOMY INSURANCE CO

10

AMERICAN HOME ASSURANCE CO

125

AMERICAN INSURANCE COMPANY

54

AMERICAN INTER INS CO OF GA

22

AMERICAN INTERN. SOUTH INS CO

55

AMERICAN INTERNATIONAL INS CO

2

AMERICAN MANUFACTURERS MUT INS

36

AMERICAN MOTORISTS INS COMPANY

20

AMERICAN PROTECTION INS CO

21

AMERICAN STATES INS CO OFTX

2

AMERICAN STATES INSURANCE CO

21

AMERICAN ZURICH INSURANCE CO

1

AMERISURE INSURANCE COMPANY

2

ASSOCIATED INDEMNITY CORPORATN

9

ATLANTIC MUTUAL INSURANCE CO

33

AUTO OWNERS INSURANCE COMPANY

7

BANKERS STANDARD INSURANCE CO

28

BITUMINOUS CASUALTY CORP

6

BITUMINOUS FIRE AND MARINE INS

1

BUILDERS INSURANCE

60

CALIFORNIA COMPENSATION INS CO

7

CANAL INSURANCE COMPANY

31

CAPITAL CITY INSURANCE COMPANY

18

CASUALTY RECIPROCAL EXCHANGE

34

CENTRAL MUTUAL INSURANCE CO

3

CENTRE INSURANCE COMPANY

15

CGU INSURANCE CO OF NJ

3

CHARTER OAK FIRE INSURANCE CO

47

CHUBB INDEMNITY INS. CO.

6

CHURCH MUTUAL INS CO

20

50

Subsequent Injury Trust Fund Claims Reported by Insurance Companies For 1/1/00 To 12/31/00

Name

Claims Reported

CINCINNATI INSURANCE COMPANY

85

CITIZENS INS CO OF AMERICA

40

CLARENDON NATIONAL INS. CO.

25

COLUMBIA NATIONAL INSURANCE CO

5

COMMERCIAL MUTUAL INSURANCE CO

55

COMMERCIAL UNION INSURANCE CO

19

COMMERCIAL UNION MIDWEST INS

1

COMPANION PROPERTY & CASUALTY

37

CONNECTICUT INDEMNITY CO

58

CONTINENTAL CASUALTY COMPANY

150

CONTINENTAL INSURANCE COMPANY

6

CORNERSTONE MUTUAL INS CO

14

CORNERSTONE MUTUAL INS CO

7

CREDIT GENERAL INSURANCE CO

22

CYPRESS INSURANCE COMPANY

11

DEERFIELD INSURANCE CO

7

DISCOVER PROPERTY & CASUALTY

1

EMPLOYERS FIRE INSURANCE CO

1

EMPLOYERS INSURANCE OF WAUSAU

39

EVEREST NATIONAL INSURANCE

7

FAIRMONT INSURANCE COMPANY

5

FARMLAND MUTUAL

1

FEDERAL INSURANCE COMPANY

26

FEDERATED MUTUAL INSURANCE CO

29

FIDELITY & DEPOSIT CO OF MD

1

FIDELITY & GUARANTY INS CO

15

FIRE & CASUALTY INS CO OF CT

1

FIREMAN'S FUND INS CO OF GA

20

FIREMAN'S FUND INS OF GA

3

FIREMAN'S FUND INSURANCE CO

81

FIREMAN'S FUND OF WISCONSIN

2

FIRST LIBERTY INSURANCE CORP

1

FIRST NATL INS CO OF AMERICA

14

FLORISTS' MUTUAL INSURANCE CO

2

FREMONT COMPENSATION

11

FREMONT PACIFIC INSURANCE CO.

1

FRONTIER INSURANCE COMPANY

16

GA RESTAURANT MUTUAL CAP INS C

2

GA TIMBER HARVERSTERS' MUTUAL

4

GCAP MUTUAL CAPTIVE INS

6

GENERAL ACCIDENT INS CO

1

51

Subsequent Injury Trust Fund Claims Reported by Insurance Companies For 1/1/00 To 12/31/00

Name

Claims Reported

GENERAL ACCIDENT INS OF AMER

2

GENERAL INSURANCE CO OF AMERIC

21

GEORGIA CASUALTY & SURETY CO

35

GEORGIA INSURANCE COMPANY

3

GERBER LIFE INSURANCE COMPANY

5

GRAPHIC ARTS MUTUAL INS CO

1

GREAT AMERICAN ALLIANCE INS CO

1

GREAT AMERICAN INSURANCE CO

28

GREAT NORTHERN INSURANCE CO

3

GREAT WEST CASUALTY COMPANY

1

GREENWICH INSURANCE CO

1

GUIDEONE MUTUAL INSURANCE CO

1

HANOVER INSURANCE COMPANY

12

HARBOUR SPECIALITY INSURANCE

9

HARLEYSVILLE MUTUAL INS CO

1

HARLEYSVILLE-ATLANTIC INS CO

12

HARTFORD ACCIDENT & INDEMNITY

21

HARTFORD CASUALTY INSURANCE CO

88

HARTFORD FIRE INSURANCE CO

31

HARTFORD INS CO OF SOUTHEAST

3

HARTFORD INS OF THE MIDWEST

6

HARTFORD UNDERWRITERS INS CO

19

HOME INSURANCE COMPANY

2

HOUSTON GENERAL INSURANCE CO

4

INSURANCE CO OF NORTH AMERICA

4

INSURANCE CO OF STATE OF PA

150

INTERNATIONAL BUS & MERCANTILE

1

INTERNATIONAL INDEMNITY CO

2

LEGION INSURANCE COMPANY

136

LIBERTY INSURANCE CORPORATION

21

LIBERTY MUTUAL FIRE INS

58

LIBERTY MUTUAL INSURANCE CO

33

LM INSURANCE CORPORATION

3

LMI INSURANCE COMPANY

1

LUMBER MUTUAL INSURANCE CO

19

LUMBERMENS MUTUAL CASUALTY CO

37

LUMBERMEN'$ UNDERWRITING ALLIA

57

MADISON INSURANCE COMPANY

16

MAG MUTUAL INS CO

2

MANAGEDCARE MUT CAPTIVE INS

5

MASSACHUSETTS BAY INSURANCE CO

4

52

Subsequent Injury Trust Fund Claims Reported by Insurance Companies For 1/1/00 To 12/31/00

Name

Claims Reported

MID-CENTURY INSURANCE COMPANY

1

MIDDLESEX INSURANCE COMPANY

1

MIDWEST EMPLOYERS CASUALTY CO

1

MONUMENTAL GENERAL CASUALTY

12

NATIONAL FARMERS UNION STANDRD

1

NATIONAL FIRE INS CO HARTFORD

14

NATIONAL SURETY CORPORATION

20

NATIONAL TRUST INSURANCE CO

16

NATIONAL UNION FIRE OF PITT PA

36

NATIONWIDE MUTUAL INSURANCE CO

1

NEW HAMPSHIRE INSURANCE CO

3

NORTH AMERICAN SPECIALTY INS

4

NORTH RIVER INSURANCE COMPANY

1

NORTHERN INSURANCE CO OF NY

1

OHIO CASUALTY INSURANCE CO

13

OHIO FARMERS INSURANCE COMPANY

1

OLD REPUBLIC INSURANCE COMPANY

81

PACIFIC EMPLOYERS INSURANCE CO

272

PACIFIC INDEMNITY COMPANY

19

PENNSYLVANIA LUMBERMENS MUTUAL

1

PENNSYLVANIA MANUF ASSOC INS

5

PENNSYLVANIA MANUF. IND. CO.

2

PENNSYLVANIA NATIONAL MUT CAS

1

PHICO INSURANCE COMPANY

1

PHOENIX INSURANCE COMPANY

40

PREFERRED PROFESSIONAL INS CO

1

PREFERRED SURETY CORPORATION

1

PRINCETON INSURANCE COMPANY

2

REALM NATIONAL INSURANCE

63

REDLAND INSURANCE CO

4

RELIANCE INSURANCE COMPANY

72

RELIANCE NATIONAL INDEMNITY CO

116

RELIANCE NATIONAL INSURANCE CO

91

RELIANCE SURETY COMPANY

1

REPUBLIC-FRANKLIN INSURANCE CO

1

ROYAL & SUNALLIANCE INS. CO.

113

ROYAL INDEMNITY COMPANY

2

ROYAL INSURANCE CO OF AMERICA

5

SAFECO INS CO OF.ILLINOIS

9

SAFECO INSURANCE CO AMERICA

58

SECURITY INS CO OF HARTFORD

1

53

Subsequent Injury Trust Fund

Claims Reported by Insurance Companies For 1/1/00 To 12/31/00

Name

Claims Reported

SELECT INSURANCE COMPANY

7

SELECTIVE INS CO OF AMERICA

7

SELECTIVE INS CO OF SOUTHEAST

2

SELECTIVE INSURANCE CO OF SC

3

SENTRY INSURANCE A MUTUAL CO

10

ST PAUL FIRE & CASUALTY INS CO

1

ST PAUL FIRE & MARINE INS CO

41

ST PAUL GUARDIAN INSURANCE CO

1

ST PAUL MERCURY INSURANCE CO

1

STAR INSURANCE COMPANY

21

STATE AUTO PROPERTY & CASUALTY

2

STATE AUTOMOBILE MUTUAL INS

2

STATE FARM FIRE & CASUALTY CO

15

STATE FARM GENERAL INS COMPANY

5

SUMITOMO MARINE & FIRE INS CO

14

SUPERIOR PACIFIC CASUALTV CO

1

TIG INSURANCE COMPANY

58

TIG PREMIER INSURANCE COMPANY

2

TOKIO MARINE & FIRE INS CO

13

TRANSCONTINENTAL INSURANCE CO

172

TRANSPORTATION INSURANCE CO

95

TRAVELERS CAS & SUR CO OF ILL

4

TRAVELERS CASUALTV CO OF CT

1

TRAVELERS INDEMNITY CO OF CT

17

TRAVELERS INDEMNITY CO OF IL

547

TRAVELERS INDEMNITY COMPANY

46

TRAVELERS INDEMNITY OF AMERICA

14

TRAVELERSINSURANCE-ALTERNAT

4

TRAVELERS INSURANCE COMPANY

44

TRINITY UNIVERSAL INSURANCE CO

3

TRUCK INSURANCE EXCHANGE

1

TWIN CITY FIRE INSURANCE CO

12

U. S. FIDELITY & GUARANTY INS

10

UNITED PACIFIC INSURANCE CO

4

UNITED STATES FIRE INSURANCE

1

VALLEY FORGE INSURANCE COMPANY

65

VALLEY NATIONAL INSURANCE CO

1

VANLINER INSURANCE COMPANY

1

VIGILANT INSURANCE COMPANY

1

VIRGINIA SURETY COMPANY INC

12

WAUSAU BUSINESS INSURANCE CO.

7

54

Subsequent Injury Trust Fund

Claims Reported by Insurance Companies For 1/1/00 To 12/31/00

Name

Claims Reported

WAUSAU GENERAL INS CO

1

WAUSAU UNDERWRITERS INS CO

1

WESTFIELD INSURANCE COMPANY

5

YASUDA FIRE & MAR INS OF AMERI

3

YORK INSURANCE COMPANY

1

ZENITH INSURANCE COMPANY

9

ZURICH AMERICAN INS CO OF IL

222

ZURICH INSURANCE COMPANY

88

ZURICH/AMERICAN GUARANTEE

1

# of Companies:

214

Total:

5181

55

Subsequent Injury Trust Fund

Claims Reported by Group Self-Insured For 1/1/00 To 12/31/00

Name

Claims Reported

AGRITRUST OF GEORGIA

6

ASSOCIATION CTY COM GA SI

71

COMPTRUST AGC OF GEORGIA

23

CONSTRUCTION SUPPLIERS' ASSOC

18

GA AUTO DEALERS ASSOCIATION SI

15

GA CONCRETE & PRODUCTS ASSOC

1

GA EDUCATION WC TRUST FUND

81

GA HOSPITAL ASSOC WCSI FUND

58

GA MFG WORKERS' COMP. FUND

1

GA MUNICIPAL ASSN WCSIF

68

GA NURSING HOME SELECTIVE

3

GA OILMEN'S ASSOCIATION

21

GA OPERATORS SELF-INSURERS

16

GA SCHOOL BD ASSOC W C FUND

39

GA UNITED BUSINESSES

1

GEMC WORKERS' COMP FUND

37

HOSPITALITY SELF-INSURER'S

2

METRO ATLANTA LANDSCAPE/TURF

3

ROOFING & SHEET METAL ASSOC

2

# of Companies:

19

Total:

466

56

Name

Subsequent Injury Trust Fund Claims Reported by Self-Insurers For 1/1/00 To 12/31/00
Claims Reported

AT&T

14

AAA COOPER TRANSPORTATION

1

ABF FREIGHT SYSTEM, INC

1

AGL RESOURCES, INC.

9

ALBANY, CITY OF

2

ALLIED SYSTEMS LTD

10

ALPHARETTA, CITY OF

1

AMERICAN NATIONAL RED CROSS

2

AMERICAN PROTEINS, INC

1

AMOCO CORPORATION

2

ANHEUSER-BUSCH COMPANIES, INC.

2

ARCHBOLD MEDICAL CENTER

2

ARCHDIOCESES OF ATLANTA

1

ARMSTRONG WORLD INDUSTRIES INC

1

ASPLUNDH TREE EXPERT CO

4

ATHENS REG. HLTH SYS INC

1

ATHENS-CLARKE COUNTY

4

ATLANTA BOARD OF EDUCATION

8

ATLANTA CITY OF

2

ATLANTA HOUSING AUTHORITY

2

ATLANTIC STEEL INDUSTRIES INC

1

AUGUSTA-RICHMOND CO BD COMM

4

AUTOZONE, INC

6

BARTOW COUNTY BD OF EDUCATION

1

BASS HOTELS & RESORTS

3

BEAULIEU OF AMERICA

18

BELLSOUTH CORPORATION

10

BELLSOUTH ENTERPRISES INC

2

l:IERRY COLLEGE

1

BIBB COUNTY BOARD OF EDUCATION

1

BLOSSMAN COMPANIES, INC

1

BLUE BIRD BODY COMPANY

26

BLUE CIRCLE AMERICA

9

BOBS CANDIES, INC.

1

BRUNO'S INC & SUBSIDIARIES

2

BRUNSWICK, CITY OF

1

BURLEN CORPORATION

2

CT HARRIS INC

3

C. W. MATTHEWS CONTRACTING INC

4

CAGLE FOODS, JV, LLC

7

CAGLE'S INC, & SUBSIDIARIES

6

57

Name

Subsequent Injury Trust Fund Claims Reported by Self-Insurers For 1/1/00 To 12/31/00
Claims Reported

CALFEE COMPANY OF DALTON, INC

1

CALIBER SYSTEM, INC.

5

CANDLER HEALTH SYSTEM

9

CAREMORE INC

3

CARROLL CO. BOARD OF EDUCATION

5

CATOOSA CO. BD. OF EDUCATION

2

CENTRAL GEORGIA HEALTH SYSTEMS

9

CERTAINTEED CORPORATION

4

CHAMPION INTERNATIONAL CORP

6

CHATHAM AREA TRANSIT AUTHORITY

1

CHATHAM COUNTY BD OF EDUCATION

8

CHATHAM COUNTY GEORGIA

5

CHEROKEE BRICK & TILE

1

CHILDREN'S HEALTHCARE OF ATLAN

3

CITIGROUP INC.

2

CLAYTON COUNTY BD OF EDUCATION

10

CLAYTON COUNTY COMMISSIONERS

28

COASTAL TRANSPORT INC

1

COATS & CLARK, INC.

1

COBB COUNTY BO/COMMISSIONERS

9

COBB COUNTY SCHOOL SYSTEM

21

COCA-COLA COMPANY

20

COCA-COLA ENTERPRISES INC

99

COLONIAL GROUP

1

COLQUITT CO BD OF EDUCATION

6

COLUMBIA CO BOARD OF EDUCATION

5

COLUMBIA GEORGIA CORP.

3

COLUMBUS CITY OF

5

COLUMBUS FOUNDRIES INC

2

COLUMBUS REGIONAL HEALTHCARE

4

COLUMBUS WATER WORKS

2

CONAGRA FOODS, INC

5

CONSOLIDATED STORES CORP.

1

CONTI GROUP COMPANIES, INC

2

CONTINENTAL TIRE N. AMER., INC

10

COOPER INDUSTRIES, INC

6

COOPER TIRE AND RUBBER

1

CORPORATION OF MERCER UNIV

1

COSCO,INC

1

COTTRELL INC

1

COX ENTERPRISES INC

1

58

Name

Subsequent Injury Trust Fund Claims Reported by Self-Insurers For 1/1/00 To 12/31/00
Claims Reported

CRACKER BARREL OLD CNTRY STORE

21

CRAWFORD & COMPANY

9

CRAWFORD W LONG MEM HOSPITAL

3

CRIDER'S POULTRY INC

1

CROWN CORK & SEAL COMPANY INC

1

DALTON CITY OF

10

DART CONTAINER CORPORATION

4

DEAN FOODS COMPANY

1

DEKALB COUNTY GOVERNMENT

29

DEKALB REGIONAL HLTHCARE SYS

8

DELHAIZE AMERICA INC.

13

DELPHI AUTOMOTIVE SYS INC.

1

DELTA AIRLINES, INC.

186

DIXIE GROUP & SUBSIDIARIES

10

DOLLAR GENERAL CORP

7

DOUGHERTY COUNTY COMMISSION

1

DOUGHERTY COUNTY SCHOOL SYSTEM

8

DOUGLAS ASPHALT COMPANY

1

DOUGLAS CO BD OF COMMISSIONERS

4

DOUGLAS COUNTY SCHOOLS

1

DOUGLAS, CITY OF

1

DRY BRANCH KAOLIN COMPANY

2

E I DUPONT DE NEMOURS & CO

2

EAST POINT, CITY OF

3

EATON CORPORATION

1

EGLESTON CHILDREN'S HLTH CARE

1

ELBERTA CRATE & BOX COMPANY

1

EMORY CLINIC, INC.,

4

EMORY UNIVERSITY

33

ENGELHARD CORPORATION

2

ESTES EXPRESS LINES

2

FAYETTE COUNTY BD OF COMM

2

FAYETTE COUNTY BD OF EDUCATION

2

FEDERAL EXPRESS

25

FEDERATED DEPARTMENT STORES

2

FEDEX GROUND PKG SYS

1

FIELDALE FARMS CORPORATION

16

FIRST UNION CORPORATION

2

FLEETWOOD HOMES OF GA INC

5

FLEXSTEEL INDUSTRIES INC

3

FLORIDA ROCK & TANK LINES INC

3

59

Name

Subsequent Injury Trust Fund Claims Reported by Self-Insurers For 1/1/00 To 12/31/00
Claims Reported

FLOYD COUNTY BD OF EDUCATION

4

FLOYD HLTHCARE MGMT INC

4

FLYING J, INC.

4

FORD MOTOR COMPANY

16

FOREST PARK, CITY OF

1

FORSYTH CO BD OF COMMISSIONERS

7

FORSYTH CO. BD. OF EDUCATION

5

FORT JAMES CORP.

16

FREUDENBERG-NOK

4

FULTON COUNTY BD OF EDUCATION

13

FULTON COUNTY, GEORGIA

28

FULTON-DEKALB HOSPITAL AUTHY

2

GA BAPTIST HEALTH CARE SYSTEM

1

GA INTAL HEALTH/SOUTH FULTON

1

GA MEDCORP, INC.

4

GENERAL MOTORS CORPORATION

23

GEORGIA DUCK & CORDAGE MILL

7

GEORGIA POWER CO

1

GEORGIA SELF-INSURERS GUARANTY

1

GEORGIA STATE OF

448

GEORGIA-PACIFIC CORPORATION

7

GLYNN COUNTY BOARD OF COMMSNRS

4

GLYNN COUNTY SCHOOLS

6

GOLD KIST INC

7

GOLDEN PANTRY FOOD STORES INC

1

GREAT ATLANTIC & PACIFIC TEA

2

GREAT DANE LTD PARTNERSHIP

5

GRIFFIN-SPALDING SCHOOLS

1

GULFSTREAM AEROSPACE CORP

5

GWINNETT CO BD OF EDUCATION

103

GWINNETT COUNTY BD OF COMMISS

12

GWINNETT HOSPITAL SYSTEM

3

HALL COUNTY BOARD OF EDUCATION

5

HAMILTON HEALTH CARE SYSTEM

2

HAPEVILLE CITY OF

1

HCA - THE HEALTHCARE CO.

4

HENRY CO BOARD OF EDUCATION

3

HERCULES INCORPORATED

1

HILLCREST FOODS, INC

1

HILTON HOTELS CORPORATION

1

HORMEL, GEORGE & COMPANY

4

60

Subsequent Injury Trust Fund Claims Reported by Self-Insurers For 1/1/00 To 12/31/00

Name

Claims Reported

HORTON HOMES, INC

11

HOSPITAL AUTHORITY HOUSTON CTY

4

HOUSTON COUNTY BD OF EDUCATION

6

HOUSTON COUNTY COMMISSIONERS

1

HOWARD SHEPPARD INC

1

HUTCHESON MEDICAL CENTER

6

HYATT CORPORATION

2

IDA CASON CALLAWAY FOUNDATION

2

IKON OFFICE SOLUTIONS

2

ILLINOIS TOOL WORKS INC

2

INGLES MARKETS INC

6

INTERNATIONAL PAPER COMPANY

12

J & J INDUSTRIES INC

4

J H HARVEY COMPANY

2

J. C. PENNEY COMPANY, INC.

5

JEFFERSON SMURFIT CORP. U.S.

1

JOHN WIELAND HOMES, INC

2

JOHNSTON INDUSTRIES, INC.

1

KEEBLER COMPANY

21

KERR-MCGEE PIGMENTS (SAV) INC.

2

KING & PRINCE SEAFOOD CORP.

1

KLLM TRANSPORT

1

K-MART CORP & SUBSIDIARIES

18

KROGER COMPANY, THE

7

LAWRENCEVILLE, CITY OF

1

LEVI STRAUSS & CO

6

LIFE INSURANCE CO OF GEORGIA

1

LINDALE MANUFACTURING INC

2

LOUISIANA-PACIFIC CORP

1

LOW TEMP INDUSTRIES

2

LOWE'S HOME CENTERS, INC

17

LOXCREEN COMPANY, INC.

1

LUCENT TECHNOLOGIES INC.

3

MACON CITY OF

14

MACON/BIBB CO WATER & SEWERAGE

1

MARIETTA CITY SERVICES

1

MAR-JAC POULTRY, INC.

1

MARMON CORP & SUBS

2

MARRIOTT INTERNATIONAL, INC.

11

MARTA

46

MASTEC, INC SUBSIDIARIES

1

61

Name

Subsequent Injury Trust Fund Claims Reported by Self-Insurers For 1/1/00 To 12/31/00
Claims Reported

MCDONALD'S OF GEORGIA INC

2

MEAD CORPORATION

10

MEMORIAL MEDICAL CENTER, INC.

12

MERCK & CO INC

1

MILLEDGEVILLE, CITY OF

3

MILTON J. WOOD COMPANY

2

MOHAWK CARPET CORPORATION

45

MONROE, CITY OF

1

MONTGOMERY WARD

2

MOUNT VERNON MILLS

6

MURPHY-HARPST-VASHTI, INC.

1

MURRAY COUNTY BD OF EDUCATION

1

NABISCO, INC

5

NATIONAL SERVICES INDUSTRIES

4

NEWTON COUNTY BD OF EDUCATION

1

NORDSON CORPORATION

1

NORMAN W FRIES/CLAXTON POULTRY

5

NORTHEAST GEORGIA HEALTH SYS

19

NORTHSIDE HOSPITAL

11

OLIVER RUBBER CO

1

OPELIKA INDUSTRIES, INC

1

OWENS-CORNING FIBERGLASS

6

PARKER HANNIFIN CORPATION

2

PATTERSON PUMP COMPANY

2

PCC AIRFOILS INC

3

PHOEBE PUTNEY MEMORIAL HOSPTL

4

PIEDMONT HOSPITAL

2

PIGGLY WIGGLY CAROLINA CO INC

8

QUITRIP

2

RHODES NURSING HOME

1

RIEGEL FIBER CORPORATION

1

RMC INDUSTRIES

4

ROCKWELL INTERNATIONAL

13

ROCOR INTERNATIONAL

2

ROME, CITY OF

5

ROOKER ADMINISTRATIVE SERVICES

2

ROPER CORPORATION

1

ROSWELL CITY OF

1

RUBY TUESDAY INC

2

RYAN'S FAMILY STEAK HOUSES

15

RYDER SYSTEMS INC

2

62

Name

Subsequent Injury Trust Fund Claims Reported by Self-Insurers For 1/1/00 To 12/31/00
Claims Reported

SAINT JOSEPH'S HEALTH SYSTEM

3

SAINT JOSEPH'S OF SAVANNAH

2

SAINT MARV'S HEALTH CARE

1

SATILLA HEALTH SERVICES INC

4

SAVANNAH CITY OF

6

SAVANNAH ELECTRIC & POWER CO

1

SCIENTIFIC-ATLANTA INC

2

SEABOARD CORPORATION

1

SHAW INDUSTRIES INC

25

SHERWIN-WILLIAMS COMPANY

2

SHONEV'S & COMMISSARY INC

10

SILVER DOLLAR CITY INC

1

SIZEMORE ,INC.

4

SNELL CONTRACTORS

1

SONOCO PRODUCTS COMPANY

8

SOUTHEAST GA HLTH SYSTEMS

1

SOUTHEASTERN MILLS, INC

7

SOUTHERN COMPANY SERVICES INC

9

SOUTHERN PAN SERVICES

2

SPALDING CO BOARD OF COMM

1

SPRINGS INDUSTRIES INC

12

ST FRANCIS HOSPITAL

1

STAFFMARK, INC.

1

STANLEY WORKS & SUBSIDIARIES

2

STONE CONTAINER CORPORATION

2

SUPER DISCOUNT MARKETS

3

SUPERIOR UNIFORM GROUP

1

SYNTHETIC INDUSTRIES, INC

4

TARGET CORPORATION

57

TECUMSEH PRODUCTS COMPANY

2

TENNECO AUTOMOTIVE, INC

2

TEXTILE RUBBER & CHEMICAL

1

TEXTRON, INC

16

THERMAL CERAMICS

4

THOMASTON MILLS INC

2

THREE SPRINGS INC.

5

TIFTON ALUMINUM CO INC

4

TIPTOP POULTRY INC

1

TYCO INTERNATIONAL LTD.

2

TYSON FOODS INC

6

UNILEVER UNITED STATES

1

63

Name

Subsequent Injury Trust Fund Claims Reported by Self-Insurers For 1/1/00 To 12/31/00
Claims Reported

UNITED AIRLINES

1

UNITED CATALYSTS, INC

1

USF HOLLAND, INC.

5

USG CORPORATION

2

VALDOSTA CITY OF

6

VISITING NURSE HEALTH SYSTEM

3

WAFFLE HOUSE

48

WALKER COUNTY BO OF EDUCATION

4

WAREHOUSE HOME FURNISHINGS

5

WARNER ROBINS CITY OF

1

WARREN SEWELL MFG. CO.

4

WATKINS ASSOCIATED INDUSTRIES

3

WATKINS ENGINEERS & CONST.

2

WAYCROSS, CITY OF

4

WELLINGTON LEISURE PRODUCTS

6

WELLSTAR HEALTH SYSTEM

4

WENDY'S INTERNATIONAL INC

1

WEST POINT STORES INC

3

WESTVACO CORPORATION & SUBS

3

WEYERHAEUSER COMPANY

3

WHITFIELD CO-BD OF EDUCATION

3

WHITFIELD COUNTY BD OF COMMISS

2

WILLAMETTE INDUSTRIES, INC.

2

WINN-DIXIE STORES INC

55

YELLOW FREIGHT SYSTEM INC

27

# of Companies:

312

Total:

2550

64

SUBSEQUENT INJURY TRUST FUND FOR YEAR ENDED DECEMBER, 2000

REVENUES Assessment - 1999, Adjusted 1998; Payments and Refunds from prior years Interest Earned Miscellaneous Income
TOTAL REVENUES EXPENDITURES Operating Cost Reimbursements (Negotiated Checks)
TOTAL EXPENDITURES Net Gain Balance in Fund January 1, 2000 Balance in Fund December 31, 2000

$95,584,742.85
2,629,794.09 45.00
$98,214,581.94
$1,845,488.86 71,389,637.98
$73,235,126.84
24,979,455.10 34,990,965.53 63,479,516.06

CLAIMS ACTIVITY 2000 Open Claims Claims Received Previously Closed Claims Reopened Claims Closed Open Claims Claims Accepted Claims Denied Notices in Pending Status January 1, 2000

through

January 1, 2000 2000 2000 2000
December 31, 2000 2000 2000
December 31, 2000

9,998 8,192
673 8,498 10,822
817 140 2,324

65

SECTION 34-9-358 OF THE OFFICIAL CODE OF GEORGIA
Payment of assessments to fund by insurers and self-insurers. (a) Each insurer and self-insurer under this Title shall, under regulations prescribed by the Board of Trustees, make payments to the fund in an amount equal to that proportion of 175% of the total disbursement made from the fund during the preceding calendar year less the amount of the net assets in the fund as of December 31 of the preceding calendar year which the total workers' compensation claims paid by the insurer or self-insurer bears to the total workers' compensation claims paid by all insurers and self-insurers during the preceding calendar year. The Administrator is authorized to reduce or suspend assessments for the fund when a completed actuarial survey shows further assessments are not needed. An employer who has ceased to be a self-insurer prior to the end of the calendar year shall be liable to the fund for the assessment of the calendar year. The initial assessment of each insurer or self-insurer for the purpose of generating revenue to begin operation of the fund shall be in the amount of one-half of 1 percent of the workers' compensation premiums collected by the insurer for the preceding calendar years from and employer who is subject to this Chapter or the equivalent of such in the case of a selfinsurer.
66

ASSESSMENT CALCULATIONS
ASSESSMENT ADJUSTMENT FOR CALENDAR YEAR 1999 The Georgia Subsequent Injury Trust Fund Assessment for calendar year 1999 was $96,274,726.92 This is computed in the following manner:
Total Fund disbursements/calendar year 1999 ($77,261,314.59) x 175% minus Net Assets ($38,932,573.61) = Fund Assessment ($96,274,726.92). Based on adjusted insurers'/self-insurers' assessment reports, the total actual workers' compensation benefits (indemnity and medical) paid in Georgia during calendar year 1999 amounts to $888,790,294.27. This amount divided into the Fund assessment ($96,274,726.92) yields an assessment rate of .10832108.
CALENDAR YEAR 2000 The Georgia Subsequent Injury Trust Fund Assessment for calendar year 2000 amounts to $64,681,955.91. This is computed in the following manner:
Total Fund disbursements/calendar year 2000 ($73,235,126.84) x 175% minus Net Assets ($63,479,516.06) = Fund Assessment ($64,681,955.91). Based on insurers'/self-insurers' assessment reports, the total actual workers' compensation benefits (indemnity and medical) paid in Georgia during calendar year 2000 amounts to $995,774,759.01. This amount ($995,774,759.01) divided into the Fund assessment ($64,881,955.91) yields an assessment rate of .06495837. In addition to the assessment ($64,681,955.91) an additional $209,047.74 in penalties for late filing of Assessment Report Forms will be levied.
67

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Insurance Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

ACCEPTANCE INSURANCE CO ACE AMERICAN INSURANCE CO. ACE FIRE UNDERWRITERS INS. ACE INDEMNITY INSURANCE CO ACE PROPERTY & CASUALTY IN AIU INSURANCE CO ALFA INSURANCE CORP. ALL AMERICA INS. CO. ALLIANZ INSURANCE CO ALLSTATE INSURANCE CO. AMCOMP ASSURANCE AMCOMP PREFERRED AMERICAN & FOREIGN INS CO. AMERICAN ALTERNATIVE INS AMERICAN AUTOMOBILE INS C AMERICAN CAS CO OF READIN AMERICAN CENTRAL INS CO AMERICAN ECONOMY INS CO AMERICAN EMPLOYERS INS CO AMERICAN FIRE & CASUALTY C AMERICAN GUAR & LIAB INS CO AMERICAN HARDWARE MUT INS AMERICAN HOME ASSURANCE AMERICAN INSURANCE CO AMERICAN INTER INS CO OF GA AMERICAN INTERN. SOUTH INS AMERICAN MANUFACTURERS M AMERICAN MOTORISTS INS CO

$0.00 $509,116.19
$22,452.31 $631.49
$52,437.55 $243,526.26
$0.00 $20,402.68
$0.00 $7,487.89
$0.00 $3,583.07 $76,804.81 $371,431.45 $22,185.56 $241,810.50 $93,675.75 $18,036.36 $10,939.66 $7,110.56 $96,192.02 $7,950.35 $179,704.37 $427,490.01 $558,998.15 $84,134.71 $622,453.96 $875,929.33

$0.00 $513,068.75 $22,626.62
$636.39 $52,844.65 $245,416.90
$0.00 $20,561.07
$0.00 $7,546.02
$0.00 $3,610.88 $77,401.09 $374,315.09 $22,357.80 $243,687.81 $94,403.01 $18,176.39 $11,024.59 $7,165.76 $96,938.81 $8,012.08 $181,099.52 $430,808.86 $563,337.98 $84,787.89 $627,286.43 $882,729.67

AMERICAN PROTECTION INS CO AMERICAN RESOURCES INS CO AMERICAN STATES INS CO OFT AMERICAN STATES INSURANCE AMERICAN ZURICH INSURANCE AMERISURE INSURANCE COMP AMERISURE MUTUAL INSURAN ARGONAUT GREAT CENTRAL IN ARGONAUT INSURANCE CO. ARGONAUT-MIDWEST INS CO ASSOCIATED INDEMNITY CORP. ASSOCIATED INDUSTRIES INS C

$548,544.15 $45,310.01 $1,532.65 $85,826.76
$242,392.28 $30,306.02 $0.00 $27,725.09 $12,183.71 $0.00 $68,362.12 $2,787.56

$552,802.81 $45,661.78 $1,544.55 $86,493.08
$244,274.11 $30,541.30 $0.00 $27,940.34 $12,278.30 $0.00 $68,892.86 $2,809.20

2000 Claims Paid

2000 Assessment Amt

$7,687.00 $2,403,503.40
$112,416.02 $23,668.00
$257,044.09 $2,065,457.12
$65,629.00 $169,085.00
$1,614.00 $0.00
$105,737.00 $0.00
$532,779.00 $8,597,685.00
$865,181.00 $2,546,217.29
$281,013.00 $535,164.00 $167,929.00 $123,214.00 $1,076,348.00
$56,143.00 $7,151,842.85 $4,530,548.00 $11,230,177.96 $1,308,823.00 $7,093,142.12 $4,634,872.34 $5,299,331.78
$413,303.00 $139,252.00 $1,312,938.00 $3,556,639.00 $422,934.00 $655,825.00 $299,399.00 $251,467.00
$603.00 $322,212.00
$51,460.00

$499.33 $156,127.66
$7,302.36 $1,537.43 $16,697.17 $134,168.73 $4,263.15 $10,983.49
$104.84 $0.00
$6,868.50 $0.00
$34,608.46 $558,491.60
$56,200.75 $165,398.12
$18,254.15 $34,763.38 $10,908.39
$8,003.78 $69,917.81
$3,646.96 $464,572.05 $294,297.01 $729,494.06
$85,019.01 $460,758.95 $301,073.75 $344,235.95
$26,847.49 $9,045.58
$85,286.31 $231,033.47
$27,473.10 $42,601.32 $19,448.47 $16,334.89
$39.17 $20,930.37
$3,342.76

1999 Balance Due

1999 And 2000 Total Assessment

$0.00 $3,952.56
$174.31 $4.90
$407.10 $1,890.64
$0.00 $158.39
$0.00 $58.13
$0.00 $27.81 $596.28 $2,883.64 $172.24 $1,877.31 $727.26 $140.03 $84.93 $55.20 $746.79 $61.73 $1,395.15 $3,318.85 $4,339.83 $653.18 $4,832.47 $6,800.34 $4,258.66 $351.77 $11.90 $666.32 $1,881.83 $235.28
$0.00 $215.25
$94.59 $0.00
$530.74 $21.64

$499.33 $160,080.22
$7,476.67 $1,542.33 $17,104.27 $136,059.37 $4,263.15 $11,141.88
$104.84 $58.13 $6,868.50 $27.81 $35,204.74 $561,375.24 $56,372.99 $167,275.43 $18,981.41 $34,903.41 $10,993.32 $8,058.98 $70,664.60 $3,708.69 $465,967.20 $297,615.86 $733,833.89 $85,672.19 $465,591.42 $307,874.09 $348,494.61 $27,199.26 $9,057.48 $85,952.63 $232,915.30 $27,708.38 $42,601.32 $19,663.72 $16,429.48 $39.17 $21,461.11 $3,364.40

68

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Insurance Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

ASSURANCE COMPANY OF AME ATLANTIC MUTUAL INS. CO AUTO OWNERS INS. CO. AUTOMOBILE INS OF HARTFOR BANKERS STANDARD INSURAN BIRMINGHAM FIRE INS CO OF P BITUMINOUS CASUALTY CORP BITUMINOUS FIRE AND MARINE BOSTON OLD COLONY INSURAN BROTHERHOOD MUTUAL INS C BUILDERS INSURANCE CALIFORNIA COMPENSATION IN CANAL INSURANCE COMPANY CAPITAL CITY INSURANCE COM CAROLINA CASUALTY INSURAN CASUALTY RECIPROCAL EXCH CENTENNIAL INSURANCE CO CENTRAL MUTUAL INSURANCE CENTRE INSURANCE COMPANY CENTURY INDEMNITY COMPAN CGU INSURANCE CO OF NJ CHARTER OAK FIRE INSURANC CHRYSLER INSURANCE COMPA CHUBB INDEMNITY INS. CO. CHURCH MUTUAL INS CO CINCINNATI CASUALTY COMPA CINCINNATI INDEMNITY COMPA CINCINNATI INSURANCE COMPA CITIZENS INS CO OF AMERICA CLARENDON NATIONAL INS. CO. COLONIAL CASUALTY INS CO COLUMBIA MUTUAL INS. CO. COLUMBIA NATIONAL INS. CO. COMMERCE & INDUSTRY INS C COMMERCIAL COMP INS CO COMMERCIAL INS OF NEWARK COMMERCIAL MUTUAL INSURA COMMERCIAL UNION INSURANC COMMERCIAL UNION MIDWEST I COMPANION COMMERICAL INS

$82,010.66 $153,976.60 $246,060.29
$2,243.68 $113,994.85
$12,527.56 $94,469.40 $71,222.14 $21,540.32
$6,224.01 $2,445,261.22
$116,142.07 $1,094,984.05
$279,271.58 $9,325.11
$143,630.80 $82,757.80 $18,741.58
$585,686.21 $41,708.49 $94,529.20
$414,640.42 $0.00
$537.65 $50,502.04 $273,374.65 $90,153.42 $206,357.29 $130,544.48 $414,054.51
$0.00 $80.83 $116,607.41 $4,664.60 $1,802.98 $1,555.87 $327,185.80 $139,265.87
$0.00 $0.00

$82,647.36 $155,172.01 $247,970.60
$2,261.09 $114,879.86
$12,624.82 $95,202.82 $71,775.08 $21,707.55 $6,272.33 $2,464,245.19 $117,043.75 $1,103,485.04 $281,439.72 $9,397.50 $144,745.88 $83,400.30 $18,887.08 $590,233.22 $42,032.30 $95,263.08 $417,859.51
$0.00 $541.82 $50,894.12 $275,497.01 $90,853.33 $207,959.36 $131,557.98 $417,269.05
$0.00 $81.46 $117,512.70 $4,700.81 $1,816.98 $1,567.95 $329,725.93 $140,347.07
$0.00 $0.00

2000 Claims Paid

2000 Assessment Amt

$532,606.00 $1,801,055.00 $3,854,549.93
$90,571.09 $460,646.98
$0.00 $1,078,622.84
$873,530.04 $0.00
$153,779.74 $25,635,322.00
$0.00 $8,289,604.77 $2,986,127.00
$22,236.00 $2,057,995.00
$865,473.00 $290,556.00 $3,466,609.00 $213,394.16 $843,264.00 $3,838,098.39
$67,903.00 $1,125.00
$450,319.00 $2,238,948.00
$636,718.00 $985,367.00 $1,803,934.96 $5,133,926.00
$198.00 $1,409.00 $675,793.28
$0.00 $0.00 $14,025.00 $3,896,294.38 $1,379,763.00 $32,875.00 $119,815.00

$34,597.22 $116,993.60 $250,385.28
$5,883.35 $29,922.88
$0.00 $70,065.58 $56,743.09
$0.00 $9,989.28 $1,665,228.73
$0.00 $538,479.21 $193,973.94
$1,444.41 $133,684.00
$56,219.72 $18,874.04 $225,185.27 $13,861.74 $54,777.05 $249,316.62
$4,410.87 $73.08
$29,251.99 $145,438.41
$41,360.16 $64,007.83 $117,180.67 $333,491.46
$12.86 $91.53 $43,898.43
$0.00 $0.00 $911.04 $253,096.93 $89,627.16 $2,135.51 $7,782.99

1999 Balance Due

1999 And 2000 Total Assessment

$636.70 $1,195.41 $1,910.31
$17.41 $885.01 .
$97.26 $733.42 $552.94 $167.23
$48.32 $18,983.97
$901.68 $8,500.99 $2,168.14
$72.39 $1,115.08
$642.50 $145.50 $4,547.01 $323.81 $733.88 $3,219.09
$0.00 $4.17 $392.08 $2,122.36 $699.91 $1,602.07 $1,013.50 $3,214.54 $0.00 $0.63 $905.29 $36.21 $14.00 $12.08 $2,540.13 $1,081.20 $0.00 $0.00

$35,233.92 $118,189.01 $252,295.59
$5,900.76 $30,807.89
$97.26 $70,799.00 $57,296.03
$167.23 $10,037.60 $1,684,212.70
$901.68 $546,980.20 $196,142.08
$1,516.80 $134,799.08 $56,862.22 $19,019.54 $229,732.28 $14,185.55 $55,510.93 $252,535.71
$4,410.87 $77.25
$29,644.07 $147,560.77 $42,060.07 $65,609.90 $118,194.17 $336,706.00
$12.86 $92.16 $44,803.72 $36.21 $14.00 $923.12 $255,637.06 $90,708.36 $2,135.51 $7,782.99

69

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Insurance Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

COMPANION PROPERTY & CAS CONNECTICUT INDEMNITY CO CONTINENTAL CASUALTY COM CONTINENTAL INSURANCE COM CORNERSTONE MUTUAL INS CO CREDIT GENERAL INS. CO.

$266,970.60 $400,904.70 $3,139,825.18 $265,429.47 $328,685.24 $340,026.17

$269,043.24 $404,017.16 $3,164,201.44 $267,490.15 $331,237.01 $342,665.99

CRUM & FOSTER INDEMNITY CO CUMIS INSURANCE SOCIETY IN CYPRESS INSURANCE COMPAN DEERFIELD INSURANCE CO DISCOVER PROPERTY & CASUA ELECTRIC INSURANCE CO.

$88.14 $22,157.83 $37,065.79 $245,639.99
$7,728.99 $81,446.25

$88.82 $22,329.85 $37,353.55 $247,547.03
$7,789.00 $82,078.57

EMC PROPERTY & CASUALTY

$33,099.42

$33,356.39

EMPLOYERS FIRE INSURANCE

$16,413.31

$16,540.74

EMPLOYERS INSURANCE OF W EMPLOYERS MUTUAL CAS INS

$1,833,642.43 $15,699.71

$1,847,878.05 $15,821.59

EVEREST NATIONAL INSURANC EXCELSIOR INSURANCE COMPA

$32,506.10 $745.20

$32,758.46 $750.99

FAIRFIELD INSURANCE CO. FAIRMONT INSURANCE COMPA FARMINGTON CASUALTY COMP

$0.00 $321,270.89 $186,759.69

$0.00 $323,765.10 $188,209.61

FARMLAND MUTUAL FEDERAL INSURANCE COMPAN

$0.00 $195,396.13

$0.00 $196,913.10

FEDERATED MUTUAL INSURAN FEDERATED RURAL ELECTRIC I

$258,945.65 $28,246.62

$260,955.99 $28,465.91

FEDERATED SERVICE INS. CO.

$0.00

$0.00

FFVA MUTUAL INSURANCE CO FIDELITY & CASUALTY CO OF N FIDELITY & DEPOSIT CO OF MD

$0.00 $124,130.82
$18,688.16

$0.00 $125,094.52
$18,833.24

FIDELITY & GUAR UNDERWRITE

$27,349.21

$27,561.54

FIDELITY & GUARANTY INS CO

$44,178.60

$44,521.59

FIRE & CASUALTY INS CO OF CT

$49,229.94

$49,612.14

FIREMAN'S FUND INS CO OF GA

$183,384.93

$184,808.65

FIREMAN'S FUND INSURANCE C

$688,103.74

$693,445.88

FIREMAN'S FUND OF WISCONSI FIREMAN'S INS CO OF NEWARK

$14,441.58 $1,784.37

$14,553.70 $1,798.22

FIRST LIBERTY INSURANCE CO

$11,565.99

$11,655.78

FIRST NATL INS CO OF AMERIC FLORISTS' MUTUAL INSURANCE

$67,878.00 $7,325.56

$68,404.98 $7,382.43

FREMONT COMPENSATION

$44,811.92

$45,159.82

2000 Claims Paid

2000 Assessment Amt

$3,052,788.00

$198,304.13

$5,210,520.00 $30,028,886.89
$1,240,950.25 $3,597,225.39

$338,466.89 $1,950,627.55
$80,610.11 $233,669.90

$0.00

$0.00

$1,258.00 $184,688.13 $496,220.00 $3,440,237.00

$81.72 $11,997.04 $32,233.64 $223,472.19

$51,225.57 $868,905.00 $210,839.00 $176,083.00

$3,327.53 $56,442.65 $13,695.76 $11,438.06

$14,781,486.20

$960,181.25

$180,281.00

$11,710.76

$1,787,824.00 $41,948A7 $9,445.81
$6,757,097.00

$116,134.13 $2,724.90 $613.58
$438,930.01

$428,718.78

$27,848.87

$918.00 $1,963,348.00

$59.63 $127,535.89

$2,584,619.00 $195,309.00

$167,892.64 $12,686.95

$41,793.00

$2,714.81

$152,246.00 $628,110.89 $261,699.00 $549,531.06 $1,461,740.08

$9,889.65 $40,801.06 $16,999.54 $35,696.64 $94,952.25

$750,582.00

$48,756.58

$1,697,421.00

$110,261.70

$8,653,281.00

$562,103.03

$210,180.00

$13,652.95

$33,614.00

$2,183.51

$79,923.00 $1,078,357.66
$113,458.09 $641,664.00

$5,191.67 $70,048.36
$7,370.05 $41,681.45

1999 Balance Due

1999 And 2000 Total Assessment

$2,072.64 $3,112.46 $24,376.26 $2,060.68 $2,551.77 . $2,639.82
$0.68 $172.02 $287.76 $1,907.04
$60.01 $632.32 $256.97 $127.43 $14,235.62 $121.88 $252.36
$5.79 $0.00 $2,494.21

$200,376.77 $341,579.35 $1,975,003.81
$82,670.79 $236,221.67
$2,639.82 $82.40
$12,169.06 $32,521.40 $225,379.23 $3,387.54 $57,074.97 $13,952.73 $11,565.49 $974,416.87 $11,832.64 $116,386.49 $2,730.69
$613.58 $441,424.22

$1,449.92 $0.00
$1,516.97 $2,010.34
$219.29 $0.00 $0.00
$963.70 $145.08 $212.33 $342.99

$29,298.79 $59.63
$129,052.86 $169,902.98
$12,906.24 $2,714.81 $9,889.65 $41,764.76 $17,144.62 $35,908.97 $95,295.24

$382.20 $1,423.72 $5,342.14

$49,138.78 $111,685.42 $567,445.17

$112.12

$13,765.07

$13.85 $89.79 $526.98 $56.87 $347.90

$2,197.36 $5,281.46 $70,575.34 $7,426.92 $42,029.35

70

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit
2000 Assessment 1999 Assessment Adjustment
Insurance Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

FREMONT INDEMNITY COMPAN FREMONT INDUSTRIAL INDEMNI FREMONT PACIFIC INSURANCE FRONTIER INSURANCE COMPAN GA FARM BUREAU MUTUAL INS GA RESTAURANT MUTUAL CAP GA TIMBER HARVERSTERS' MU GCAP MUTUAL CAPTIVE INS GENERAL ACCIDENT INS CO GENERAL ACCIDENT INS OF AM GENERAL CASUALTY CO OF WI GENERAL INSURANCE CO OF A GEORGIA CASUALTY & SURETY GEORGIA INSURANCE COMPAN GERBER LIFE INSURANCE COM GLENS FALLS INSURANCE COM GLOBE INDEMNITY COMPANY GRANITE STATE INSURANCE C GRAPHIC ARTS MUTUAL INS CO GRAY INSURANCE COMPANY GREAT AMERICAN ALLIANCE IN GREAT AMERICAN ASSURANCE GREAT AMERICAN INS CO OF N GREAT AMERICAN INSURANCE GREAT NORTHERN INSURANCE GREAT WEST CASUALTY COMP GREATER NEW YORK MUTUAL I

$2,968.35 $77,974.31
$1,690.66 $67,034.45 $90,369.47 $49,659.13 $113,276.15 $45,729.33 $26,125.91 $185,072.90
$4,154.46 $95,721.46 $525,998.79 $422,876.90 $399,014.23 $29,071.80 $13,618.91 $130,317.72 $53,203.55
$1,243.34 $171,622.10
$48,860.43 $132,382.47
$78,335.70 $22,056.04
$6,057.41 $17,323.72

$2,991.39 $78,579.67
$1,703.78 $67,554.87 $91,071.06 $50,044.66 $114,155.58 $46,084.36 $26,328.74 $186,509.73
$4,186.72 $96,464.60 $530,082.42 $426,159.93 $402, 112.00 $29,297.50 $13,724.64 $131,329.45 $53,616.60
$1,253.00 $172,954.50
$49,239.76 $133,410.23 $78,943.86
$22,227.27 $6,104.43
$17,458.22

GREENWICH INSURANCE CO GROCERS INSURANCE COMPAN GUIDEONE MUTUAL INSURANCE GULF INSURANCE COMPANY HANOVER INSURANCE COMPAN HARBOUR SPECIALITY INSURAN HARCO NATIONAL INS CO HARLEYSVILLE MUTUAL INS CO HARLEYSVILLE-ATLANTIC INS C HARTFORD ACCIDENT & INDEM HARTFORD CASUALTY INSURA HARTFORD FIRE INSURANCE C HARTFORD INS CO OF SOUTHE

$0.00 $152.42 $56,674.57 $157,223.87 $227,226.55 $131,277.25 $1,060.36 $46,451.95 $133,924.76 $62,733.80 $1,150,616.97 $234, 143.87 $118,793.65

$0.00 $153.60 $57,114.56 $158,444.49 $228,990.64 $132,296.43 $1,068.59 $46,812.58 $134,964.49 $63,220.84 $1,159,549.86 $235,961.66 $119,715.92

2000 Claims Paid

2000 Assessment Amt

$827,219.00 $1,289,324.00
$199,220.00 $986,229.00 $557,501.51 $552,843.00 $1,053,005.00 $1,079,846.43 $479,459.00 $1,573,937.00
$40,908.00 $1,177,895.02 $6,448,858.00 $3,649,797.00 $3,919,247.00
$233,327.00 $119,657.00 $3,032,977.15 $440,575.61
$0.00 $2,748,660.02
$390,909.41 $1,471,424.20 $1,924,849.91
$286,815.00 $97,766.00 $96,088.00 $195.00 $91,375.00
$603,074.00 $1,535,776.00 $1,715,808.81 $2,936,347.00
$2,927.00 $360,732.00 $1,409,321.00 $708,367.00 $13,049,557.00 $2,347,108.00 $1,056,732.00

$53,734.80 $83,752.39 $12,941.01 $64,063.83 $36,214.39 $35,911.78 $68,401.49 $70,145.06 $31,144.88 $102,240.38
$2,657.32 $76,514.14 $418,907.30 $237,084.86 $254,587.90 $15,156.54
$7,772.72 $197,017.25 $28,619.07
$0.00 $178,548.47
$25,392.84 $95,581.32 $125,035.11 $18,631.03
$6,350.72 $6,241.72
$12.67 $5,935.57 $39,174.70 $99,761.51 $111,456.14 $190,740.31
$190.13 $23,432.56 $91,547.19 $46,014.37 $847,677.95 $152,464.31 $68,643.59

1999 Balance Due

1999 And 2000 Total Assessment

$23.04 $605.36
$13.12 $520.42 $701.59 . $385.53 $879.43 $355.03 $202.83 $1,436.83
$32.26 $743.14 $4,083.63 $3,283.03 $3,097.77 $225.70 $105.73 $1,011.73 $413.05
$9.66 $1,332.40
$379.33 $1,027.76
$608.16 $171.23
$47.02 $134.50
$0.00 $1.18 $439.99 $1,220.62 $1,764.09 $1,019.18 $8.23 $360.63 $1,039.73 $487.04 $8,932.89 $1,817.79 $922.27

$53,757.84 $84,357.75 $12,954.13 $64,584.25 $36,915.98 $36,297.31 $69,280.92 $70,500.09 $31,347.71 $103,677.21
$2,689.58 $77,257.28 $422,990.93 $240,367.89 $257,685.67 $15,382.24
$7,878.45 $198,028.98 $29,032.12
$9.66 $179,880.87
$25,772.17 $96,609.08 $125,643.27 $18,802.26
$6,397.74 $6,376.22
$12.67 $5,936.75 $39,614.69 $100,982.13 $113,220.23 $191,759.49
$198.36 $23,793.19 $92,586.92 $46,501.41 $856,610.84 $154,282.10 $69,565.86

71

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Insurance Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

HARTFORD INS OF THE MIDWES HARTFORD UNDERWRITERS INS HIGHLANDS INSURANCE COMPA HIGHLANDS UNDERWRITERS IN HIH AMERICA COMP LIAB INS C HOME INSURANCE COMPANY HOUSTON GENERAL INSURANC INDEMNITY INS OF NORTH AME INDIANA LUMBERMENS MUTUA INSURA PROPERTY & CASUALT INSURANCE CO OF NORTH AME INSURANCE CO OF STATE OF P INTERNATIONAL INDEMNITY CO INTERNATIONAL INSURANCE C JEFFERSON PILOT FIN INS CO KANSAS CITY FIRE & MARINE IN KEY RISK INSURANCE COMPAN LEGION INSURANCE COMPANY LIBERTY INSURANCE CORPORA LIBERTY LIFE OF BOSTON LIBERTY MUTUAL FIRE INS LIBERTY MUTUAL INSURANCE C LM INSURANCE CORPORATION LMI INSURANCE COMPANY LUMBER MUTUAL INSURANCE C LUMBERMENS MUTUAL CASUA LUMBERMEN"S UNDERWRITING MADISON INSURANCE COMPAN MAG MUTUAL INS CO MANAGEDCARE MUT CAPTIVE I MANUFACTURER"S ALLIANCE IN MARKEL INSURANCE COMPANY MARYLAND CASUALTY COM PA MASSACHUSETTS BAY INSURA MID-CENTURY INSURANCE COM MIDDLESEX INSURANCE COMPA

$308,950.02 $579,924.28
$7,933.50 $0.00
$7,007.59 $176,598.23 $293,716.27
$37,744.15 $5,472.68 $5,353.91 $4,219.79
$2,460,524.56 $208,229.81 $0.00 $309,913.00 $6,294.06 $0.00
$1,669,452.74 $530,841.17 $25,294.82
$2,687,864.67 $881,265.88 $458,129.17 $33,477.99 $75,560.63
$1,306,798.64 $437,437.76 $18,854.87 $24,451.37 $323,883.69 $101.90 $959.75 $151,219.03 $24,547.36 $2,898.05 $19,964.13

$311,348.58 $584,426.56
$7,995.09 $0.00
$7,061.99 $177,969.26 $295,996.56
$38,037.18 $5,515.17 $5,395.47 $4,252.56
$2,479,627.02 $209,846.42 $0.00 $312,319.03 $6,342.92 $0.00
$1,682,413.66 $534,962.39 $25,491.20
$2,708,732.11 $888,107.65 $461,685.89 $33,737.90 $76,147.25
$1,316,944.07 $440,833.84 $19,001.25 $24,641.20 $326,398.18 $102.69 $967.20 $152,393.03 $24,737.93 $2,920.55 $20,119.12

MIDWEST EMPLOYERS CASUAL MILLERS MUTUAL INS ASSOC 0 MONUMENTAL GENERAL CASU NATIONAL AMERICAN INSURAN

$6,043.11 $60.19
$506,437.90 $57,059.80

$6,090.03 $60.66
$510,369.67 $57,502.79

2000 Claims Paid

2000 Assessment Amt

$1,718,412.00 $4,011,943.00
$201,736.00 $1,991.70 $0.00
$1,732,373.00 $3,530,686.00
$408,683.11 $69,793.00 $45,571.00
$102,229.42 $29,786,377.21
$1,413,555.81 $735,014.00
$1,236,498.00 $65,571.00 $193.00
$28,459,626.00 $6,151,202.04 $110,814.00 $26,104,232.24 $12,179,227.46 $4,062,551.12
$921,225.00 $11,035,960.16
$5,046,836.70 $271,217.00 $344,320.00
$1,826,330.00 $5,655.00 $7,846.00
$1,049,121.90 $669,338.20 $50,207.76 $100,999.00 $53,832.00 $466.00
$3,455,621.00 $102,077.00

$111,625.24 $260,609.28
$13,104.44 $129.38 $0.00
$112,532.13 $229,347.61
$26,547.39 $4,533.64 $2,960.22 $6,640.66
$1,934,874.51 $91,822.28 $47,745.31 $80,320.89 $4,259.39 $12.54
$1,848,690.92 $399,572.06 $7,198.30
$1,695,688.38 $791,142.76 $263,896.70 $0.00 $59,841.27 $716,877.98 $327,834.29 $17,617.81 $22,366.47 $118,635.42 $367.34 $509.66 $68,149.25 $43,479.12 $3,261.41 $6,560.73 $3,496.84 $30.27 $224,471.51 $6,630.76

1999 Balance Due

1999 And 2000 Total Assessment

$2,398.56 $4,502.28
$61.59 $0.00
$54.40. $1,371.03 $2,280.29
$293.03 $42.49 $41.56 $32.77
$19,102.46 $1,616.61 $0.00 $2,406.03 $48.86 $0.00
$12,960.92 $4,121.22 $196.38
$20,867.44 $6,841.77 $3,556.72 $259.91 $586.62
$10,145.43 $3,396.08 $146.38 $189.83 $2,514.49 $0.79 $7.45 $1,174.00 $190.57 $22.50 $154.99 $46.92 $0.47 $3,931.77 $442.99

$114,023.80 $265, 111.56
$13,166.03 $129.38 $54.40
$113,903.16 $231,627.90
$26,840.42 $4,576.13 $3,001.78 $6,673.43
$1,953,976.97 $93,438.89 $47,745.31 $82,726.92 $4,308.25 $12.54
$1,861,651.84 $403,693.28 $7,394.68
$1,716,555.82 $797,984.53 $267,453.42 $259.91 $60,427.89 $727,023.41 $331,230.37 $17,764.19 $22,556.30 $121,149.91 $368.13 $517.11 $69,323.25 $43,669.69 $3,283.91 $6,715.72 $3,543.76 $30.74 $228,403.28 $7,073.75

72

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Insurance Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

NATIONAL FARMERS UNION P & NATIONAL FARMERS UNION ST NATIONAL FIRE INS CO HARTFO NATIONAL LIABILITY & FIRE INS NATIONAL SURETY CORPORATI NATIONAL TRUST INSURANCE C NATIONAL UNION FIRE OF PITT NATIONWIDE AGRIBUSINESS NATIONWIDE MUTUAL FIRE INS NATIONWIDE MUTUAL INSURAN NEW HAMPSHIRE INSURANCE C NIAGARA FIRE INSURANCE CO NIPPON FIRE & MARINE INS CO NN INSURANCE COMPANY NORTH AMERICAN LUMBER INS NORTH AMERICAN SPECIALTY I NORTH RIVER INSURANCE COM NORTHBROOK INDEMNITY COM NORTHBROOK PROP & CAS INS NORTHERN ASSURANCE CO OF NORTHERN INSURANCE CO OF NORTHWESTERN NATIONAL CA NORTHWESTERN NATIONAL INS OHIO CASUALTY INSURANCE C OHIO FARMERS INSURANCE CO OHIO SECURITY INSURANCE CO OLD REPUBLIC INSURANCE CO OLD REPUBLIC UNION INS CO OWNERS INSURANCE COMPAN PACIFIC EMPLOYERS INSURAN PACIFIC INDEMNITY COMPANY PATRIOT GENERAL INSURANCE PENNSYLVANIA LUMBERMENS PENNSYLVANIA MANUF ASSOC I PENNSYLVANIA MANUF. IND. CO PENNSYLVANIA MILLERS MUTU PENNSYLVANIA NATIONAL MUT PETROLEUM CASUALTY COMP PHICO INSURANCE COMPANY PHOENIX INSURANCE COMPANY

$695.44 $20,669.57 $90,188.79 $22,257.25 $100,467.40 $40,499.77 $381,377.40
$0.00 $101,024.61
$96,634.75 $112,981.53
$3,270.74 $0.00
$10,612.80 $0.00
$4,453.28 $38,749.89
$2,137.85 $81,443.39
$0.00 $66,243.67 $34,359.83
$6,195.64 $89,025.02 $59,860.62
$0.00 $601,270.37
$7,076.92 $18,315.94 $1,664,446.43 $156,073.02 $61,950.55 $21,831.07 $51,736.20 $50,030.28 $13,933.70
$9,541.16 $463.70 $86.10
$60,603.95

$700.84 $20,830.04 $90,888.98 $22,430.05 $101,247.39 $40,814.19 $384,338.25
$0.00 $101,808.92 $97,384.98 $113,858.67
$3,296.13 $0.00
$10,695.20 $0.00
$4,487.85 $39,050.72
$2,154.45 $82,075.69
$0.00 $66,757.96 $34,626.58
$6,243.74 $89,716.18 $60,325.35
$0.00 $605,938.37
$7,131.86 $18,458.14 $1,677,368.48 $157,284.70 $62,431.50 $22,000.55 $52,137.86 $50,418.70 $14,041.88
$9,615.23 $467.30 $86.77
$61,074.46

2000 Claims Paid

2000 Assessment Amt

$7,560.00 $235,705.00 $1,073,239.05
$12,738.00 $1,533,196.00 $1,025,803.31 $7,962,795.93
$300,760.00 $881,173.00 $501,350.00 $259,479.44 $10,995.00
$994.72 $60,408.61 $72,200.00 $63,999.00 $813,110.00 $18,590.35 $162,342.22 $27,769.00 $715,201.00 $249,696.73 $43,914.00 $1,353,335.00 $675,380.97
$3,792.00 $5,259,287.00
$170,603.00 $664,945.05 $17,442,192.54 $1,609,358.00 $664,899.00 $248,166.00 $948,605.00 $672,066.00 $192,939.00 $136,646.00
$4,459.21 $75,209.00 $901,051.50

$491.09 $15,311.01 $69,715.86
$827.44 $99,593.91 $66,634.51 $517,250.24 $19,536.88 $57,239.56 $32,566.88 $16,855.36
$714.22 $64.62
$3,924.04 $4,689.99 $4,157.27 $52,818.30 $1,207.60 $10,545.49 $1,803.83 $46,458.29 $16,219.89 $2,852.58 $87,910.44 $43,871.65
$246.32 $341,634.71
$11,082.09 $43,193.75 $1,133,016.40 $104,541.27 $43,190.76 $16,120.46 $61,619.83 $43,656.31 $12,533.00
$8,876.30 $289.66
$4,885.45 $58,530.84

1999 Balance Due

1999 And 2000 Total Assessment

$5.40 $160.47 $700.19 $172.80 $779.99. $314.42 $2,960.85
$0.00 $784.31 $750.23 $877.14
$25.39 $0.00
$82.40 $0.00
$34.57 $300.83
$16.60 $632.30
$0.00 $514.29 $266.75
$48.10 $691.16 $464.73
$0.00 $4,668.00
$54.94 $142.20 $12,922.05 $1,211.68 $480.95 $169.48 $401.66 $388.42 $108.18
$74.07 $3.60 $0.67
$470.51

$496.49 $15,471.48 $70,416.05
$1,000.24 $100,373.90
$66,948.93 $520,211.09
$19,536.88 $58,023.87 $33,317.11 $17,732.50
$739.61 $64.62 $4,006.44 $4,689.99 $4,191.84 $53,119.13 $1,224.20 $11,177.79 $1,803.83 $46,972.58 $16,486.64 $2,900.68 $88,601.60 $44,336.38 $246.32 $346,302.71 $11,137.03 $43,335.95 $1,145,938.45 $105,752.95 $43,671.71 $16,289.94 $62,021.49 $44,044.73 $12,641.18 $8,950.37 $293.26 $4,886.12 $59,001.35

73

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Insurance Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

POTOMAC INSURANCE CO OF IL PRINCETON INSURANCE COMPA PROTECTIVE INSURANCE COMP

$31,126.94 $116,024.80
$10,394.55

$31,368.59 $116,925.56
$10,475.25

PROTECTIVE LIFE INS/DIAMOND PROVIDENCE WASHINGTON INS PROVIDENCE WASHINGTON INS

$3,930.99 $17,458.08
$117.16

$3,961.51 $17,593.62
$118.07

PUBLIC SERVICE MUTUAL INS C RANGER INSURANCE COMPANY

$1,496.97 $45,854.64

$1,508.59 $46,210.64

REALM NATIONAL INSURANCE REDLAND INSURANCE CO REGENT INSURANCE COMPANY RELIANCE INSURANCE COMPAN RELIANCE NATIONAL INDEMNIT RELIANCE NATIONAL INSURANC RENAISSANCE MUTUAL CAPTIV

$632,818.65 $4,950.40 $1,217.82
$359,940.16 $1,126,698.40
$392,155.62 $100,161.86

$637,731.58 $4,988.84 $1,227.28
$362,734.58 $1,135,445.61
$395,200.14 $100,939.47

REPUBLIC-FRANKLIN INSURANC

$21,377.65

$21,543.62

ROYAL & SUNALLIANCE INS. CO

$1,196.33

$1,205.61

ROYAL INDEMNITY COMPANY ROYAL INSURANCE CO OF AME S.E. EMPLOYER MUT. CAP. INS SAFECO INS CO OF ILLINOIS SAFECO INSURANCE CO AMERI

$411,237.91 $365,562.94
$53,383.76 $168,560.81
$97,199.06

$414,430.59 $368,401.02
$53,798.21 $169,869.44
$97,953.67

SAFEGUARD INSURANCE CO

$83,937.87

$84,589.53

SAFETY NATIONAL CASUALTY

$0.00

$0.00

SECURITY INS CO OF HARTFOR

$123,741.58

$124,702.26

SECURITY NATIONAL INS COMP

$7,910.48

$7,971.89

SELECT INSURANCE COMPANY

$7,170.22

$7,225.88

SELECTIVE INS CO OF AMERICA

$122,072.42

$123,020.14

SELECTIVE INS CO OF SOUTHE SELECTIVE INSURANCE CO OF SELECTIVE WAY INSURANCE C

$44,150.39 $89,179.05
$1,463.43

$44,493.16 $89,871.40
$1,474.79

SENTRY INSURANCE A MUTUAL

$227,491.53

$229,257.67

SENTRY SELECT INSURANCE C

$53,358.07

$53,772.32

SHELBY INSURANCE COMPANY SOUTH CAROLINA INSURANCE

$490.14 $13,061.88

$493.94 $13,163.29

SOUTHERN FIRE & CASUALTY C

$11,226.01

$11,313.16

SOUTHERN GUARANTY INS CO

$23,357.59

$23,538.93

SOUTHERN MUTUAL CHURCH IN SOUTHERN PILOT INSURANCE C SOUTHERN TRUST INSURANCE

$642.55 $5,811.37 $21,228.17

$647.54 $5,856.49 $21,392.98

2000 Claims Paid

2000 Assessment Amt

$880,711.00 $2,250,857.00
$10,184.42

$57,209.55 $146,212.00
$661.56

$80,442.92 $260,244.00

$5,225.44 $16,905.03

$51,123.00

$3,320.87

$27,254.00

$1,770.38

$180,732.00 $9,622,810.00
$358,604.00 $40,919.00
$4,146,814.00 $13,529,067.00
$6,808,325.00 $206,670.64 $572,030.30

$11,740.06 $625,082.05
$23,294.33 $2,658.03
$269,370.28 $878,826.14 $442,257.69
$13,424.99 $37,158.16

$3,091.00 $4,867,629.00 $2,861,294.62
$208,706.00 $1,890,735.44
$790,666.18 $568,063.00
$28,807.00 $1,878,514.00
$126,786.00 $34,276.00

$200.79 $316,193.25 $185,865.03
$13,557.20 $122,819.09
$51,360.39 $36,900.45
$1,871.26 $122,025.21
$8,235.81 $2,226.51

$733,772.90 $490,176.50 $747,018.40 $220,175.21 $3,537,293.69 $899,637.00
$0.00 $121,218.00 $121,195.00 $94,851.00

$47,664.69 $31,841.07 $48,525.10 $14,302.22 $229,776.83 $58,438.95
$0.00 $7,874.12 $7,872.63 $6,161.37

$15,954.00 $78,390.00 $132,089.00

$1,036.35 $5,092.09 $8,580.29

1999 Balance Due

1999 And 2000 Total Assessment

$241.65 $900.76
$80.70 $30.52 $135.54 .
$0.91 $11.62

$57,451.20 $147,112.76
$742.26 $5,255.96 $17,040.57 $3,321.78 $1,782.00

$356.00 $4,912.93
$38.44 $9.46
$2,794.42 $8,747.21 $3,044.52
$777.61 $165.97
$9.28 $3,192.68 $2,838.08
$414.45 $1,308.63
$754.61 $651.66
$0.00 $960.68
$61.41 $55.66 $947.72 $342.77 $692.35 $11.36 $1,766.14 $414.25
$3.80 $101.41
$87.15 $181.34
$4.99 $45.12 $164.81

$12,096.06 $629,994.98 $23,332.77
$2,667.49 $272,164.70 $887,573.35 $445,302.21
$14,202.60 $37,324.13
$210.07 $319,385.93 $188,703.11
$13,971.65 $124,127.72
$52,115.00 $37,552.11
$1,871.26 $122,985.89
$8,297.22 $2,282.17 $48,612.41 $32,183.84 $49,217.45 $14,313.58 $231,542.97 $58,853.20
$3.80 $7,975.53 $7,959.78 $6,342.71 $1,041.34 $5,137.21 $8,745.10

74

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit
2000 Assessment 1999 Assessment Adjustment
Insurance Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

ST PAUL FIRE & CASUALTY INS ST PAUL FIRE & MARINE INS CO ST PAUL GUARDIAN INSURANCE ST PAUL MERCURY INSURANCE STANDARD FIRE INSURANCE C STAR INSURANCE COMPANY STATE AUTO PROPERTY & CAS STATE AUTOMOBILE MUTUAL I STATE CAPITAL INSURANCE CO STATE FARM FIRE & CASUALTY SUMITOMO MARINE & FIRE INS SUPERIOR PACIFIC CASUALTY TIG INSURANCE COMPANY TIG PREMIER INSURANCE COM TOKIO MARINE & FIRE INS CO TRANS PACIFIC INSURANCE CO TRANSCONTINENTAL INSURAN TRANSPORT INSURANCE COMP TRANSPORTATION CASUALTY I TRANSPORTATION INSURANCE TRAVELERS CAS & SUR CO OF TRAVELERS CAS & SUR CO OF I TRAVELERS CASUALTY & SURE TRAVELERS INDEMNITY CO OF TRAVELERS INDEMNITY CO OF I TRAVELERS INDEMNITY COMPA TRAVELERS INDEMNITY OF AM TRAVELERSINSURANCE-ALTE TRAVELERS INSURANCE COMP TRINITY UNIVERSAL INS CO OF TRINITY UNIVERSAL INSURANC TRUCK INSURANCE EXCHANGE TRUSTGUARD INSURANCE CO TWIN CITY FIRE INSURANCE CO U. S. FIDELITY & GUARANTY INS ULICO CASUALTY COMPANY UNITED PACIFIC INSURANCE CO UNITED STATES FIRE INSURANC UNIVERSAL UNDERWRITERS IN UTICA MUTUAL INSURANCE CO

$298,782.17 $265,892.55 $231,121.92
$7,804.18 $172,101.09 $258,056.84
$38,422.42 $7,107.27 $0.00
$435,142.22 $63,011.87
$889,903.57 $73,571.35
$415,595.86 $55,758.24 $16,729.11
$1,742,350.72 $8,119.26 $64.81
$1,492,546.88 $3,243.19 $6,165.22
$1,029,918.76 $133,336.27
$2,498,158.74 $280,257.87 $738,392.85 $26,301.00 $321,343.44 $49,479.31 $54,467.22 $177.35 $0.00 $433,141.76 $171,847.93 $17.95 $372,691.08 $0.00 $96,846.61 $60,107.10

$301,101.79 $267,956.83 $232,916.25
$7,864.77 $173,437.21 $260,060.28
$38,720.71 $7,162.45 $0.00
$438,520.48 $63,501.07
$896,812.40 $74,142.53
$418,822.37 $56,191.13 $16,858.98
$1,755,877.58 $8,182.30 $65.32
$1,504,134.38 $3,268.37 $6,213.08
$1,037,914.61 $134,371.43
$2,517,553.37 $282,433.68 $744,125.42 $26,505.19 $323,838.22 $49,863.44 $54,890.08 $178.73 $0.00 $436,504.49 $173,182.08 $18.09 $375,584.50 $0.00 $97,598.48 $60,573.74

2000 Claims Paid

2000 Assessment Amt

$3,392,789.56 $2,176,488.07 $2,745,115.20
$60,010.08 $737,842.02 $2,681,096.00 $172,910.00 $154,312.00
$2,571.83 $3,070,964.00
$737,505.00 $0.00
$974,040.00 $4,591,576.00 $1,025,507.00
$215,807.00 $16,189,263.75
$73,840.00 $18,227.00 $10,505,285.79
$9,483.75 $112,079.68 $5,845,406.38 $1,393,129.49 $25,224,132.04 $4,006,647.00 $4,468,352.00 $999,198.00 $1,820,827.50 $760,627.00 $431,159.00
$41,723.20 $1,234.00
$4,368,108.00 $1,929,962.91
$3,243.00 $4,643,699.00 $1,115,507.00 $1,344,411.00
$697,938.25

$220,390.08 $141,381.12 $178,318.21
$3,898.16 $47,929.01 $174,159.63 $11,231.95 $10,023.86
$167.06 $199,484.82
$47,907.12 $0.00
$63,272.05 $298,261.29
$66,615.26 $14,018.47 $1,051,628.18
$4,796.53 $1,184.00 $682,406.24
$616.05 $7,280.51 $379,708.07 $90,495.42 $1,638,518.50 $260,265.26 $290,256.86 $64,906.27 $118,277.99 $49,409.09 $28,007.39 $2,710.27
$80.16 $283,745.18 $125,367 .24
$210.66 $301,647.12
$72,461.52 $87,330.75 $45,336.93

1999 Balance Due

1999 And 2000 Total Assessment

$2,319.62 $2,064.28 $1,794.33
$60.59 $1,336.12 . $2,003.44
$298.29 $55.18 $0.00
$3,378.26 $489.20
$6,908.83 $571.18
$3,226.51 $432.89 $129.87
$13,526.86 $63.04 $0.51
$11,587.50 $25.18 $47.86
$7,995.85 $1,035.16 $19,394.63 $2,175.81 $5,732.57
$204.19 $2,494.78
$384.13 $422.86
$1.38 $0.00 $3,362.73 $1,334.15 $0.14 $2,893.42 $0.00 $751.87 $466.64

$222,709.70 $143,445.40 $180,112.54
$3,958.75 $49,265.13 $176,163.07 $11,530.24 $10,079.04
$167.06 $202,863.08
$48,396.32 $6,908.83
$63,843.23 $301,487.80
$67,048.15 $14,148.34 $1,065,155.04
$4,859.57 $1,184.51 $693,993.74
$641.23 $7,328.37 $387,703.92 $91,530.58 $1,657,913.13 $262,441.07 $295,989.43 $65,110.46 $120,772.77 $49,793.22 $28,430.25 $2,711.65
$80.16 $287,107.91 $126,701.39
$210.80 $304,540.54
$72,461.52 $88,082.62 $45,803.57

75

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit
2000 Assessment 1999 Assessment Adjustment
Insurance Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

2000 Claims Paid

2000 Assessment Amt

1999 Balance Due

1999And 2000 Total Assessment

UTICA NATIONAL ASSURANCE C VALIANT INSURANCE COMPANY VALLEY FORGE INSURANCE CO VANLINER INSURANCE COMPAN VIGILANT INSURANCE COMPAN VIRGINIA INSURANCE RECIPRO VIRGINIA SURETY COMPANY IN WAUSAU BUSINESS INSURANCE WAUSAU GENERAL INS CO WAUSAU UNDERWRITERS INS C WEST AMERICAN INSURANCE C WESTERN CONTINENTAL INS. C WESTFIELD INSURANCE COMPA WILLIAMSBURG NATIONAL INS XL SPECIALTY INSURANCE CO YASUDA FIRE & MAR INS OF AM YORK INSURANCE COMPANY ZENITH INSURANCE COMPANY ZURICH AMERICAN INS CO OF IL ZURICH INSURANCE COMPANY

$489.92 $86,852.50 $402,337.70 $14,121.27 $67,775.78
$9,788.05 $232,793.19 $167,640.56
$11,252.34 $325,406.84
$24,362.27 $17.20
$116,867.61 $0.00
$3,133.56 $101,711.45
$20,852.83 $128,835.27
$61,103.55 $1,516,801.99

$493.73 $87,526.79 $405,461.27 $14,230.90 $68,301.97
$9,864.04 $234,600.50 $168,942.05
$11,339.70 $327,933.16
$24,551.41 $17.33
$117,774.92 $0.00
$3,157.88 $102,501.10
$21,014.72 $129,835.49
$61,577.93 $1,528,577.79

$198,109.68 $1,110,286.00 $6,052,816.89
$111,708.00 $91,613.00
$171,192.00 $1,394,323.00 $1,317,457.95
$221,065.38 $3,149,405.14
$309,568.00 $0.00
$1,286,823.12 $145,446.00 $34,914.00
$1,323,997 .oo
$299,735.00 $1,272,734.03
$499,906.27 $17,055,984.59

$12,868.88 $72,122.37 $393,181.12
$7,256.37 $5,951.03 $11,120.35 $90,572.95 $85,579.92 $14,360.05 $204,580.22 $20,109.03
$0.00 $83,589.93
$9,447.94 $2,267.96 $86,004.69 $19,470.30 $82,674.73 $32,473.10 $1,107,928.96

$3.81 $674.29 $3,123.57 $109.63 $526.19 .
$75.99 $1,807.31 $1,301.49
$87.36 $2,526.32
$189.14 $0.13
$907.31 $0.00
$24.32 $789.65 $161.89 $1,000.22 $474.38 $11,775.80

$12,872.69 $72,796.66 $396,304.69 $7,366.00
$6,477.22 $11,196.34 $92,380.26 $86,881.41 $14,447.41 $207,106.54 $20,298.17
$0.13 $84,497.24
$9,447.94 $2,292.28 $86,794.34 $19,632.19 $83,674.95 $32,947.48 $1,119,704.76

Total:

340 Grand Total: $66,554,970.02

$67,071,674.31 $695,992,337.10 $45,210,527.75

$516,704.29

$45,727,232.04

76

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Group Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

2000 Claims Paid

2000 Assessment Amt

1999 Balance Due

1999 And 2000 Total Assessment

AGRITRUST OF GEORGIA AMERICAN APPAREL CONT. AS ASSOCIATION CTY COM GA SI COMPTRUST AGC OF GEORGIA CONSTRUCTION SUPPLIERS' AS GA AUTO DEALERS ASSOCIATI GA EDUCATION WC TRUST FUN GA HIGHWAY CONTRACTORS SI GA HOSPITAL ASSOC WCSI FUN GA MUNICIPAL ASSN WCSIF GA NURSING HOME SELECTIVE GA OILMEN'S ASSOCIATION GA OPERATORS SELF-INSURER GA RETAIL MERCHANTS' GA SCHOOL BD ASSOC WC FUN GEMC WORKERS' COMP FUND GTMA/AYSA SELF INSURANCE HOSPITALITY SELF-INSURER'S ROOFING & SHEET METAL ASS SOUTHEASTERN LUMBER MFR

$204,898.21 $49,507.16
$885,286.65 $493,840.43 $237,423.91 $412,651.06 $150,127.28 $117,857.42 $266,577.30 $794,316.99
$74,883.34 $135,288.79 $104,780.15
$11,994.36 $216,233.31 $195,496.96
$24,075.90 $23,794.22 $46,270.41 $17,136.88

$206,488.95 $49,891.51
$892,159.63 $497,674.40 $239,267.17 $415,854.71 $151,292.81 $118,772.42 $268,646.89 $800,483.73
$75,464.70 $136,339.11 $105,593.62
$12,087.48 $217,912.05 $197,014.71
$24,262.81 $0.00
$46,629.63 $0.00

$1,538,169.82 $0,.00
$9,870,081.46 $4,204,965.33 $2,694,777.07 $2,907,468.33 $1,312,658.38
$0.00 $704,135.24 $8,216,733.51
$0.00 $1,525,335.33 $1,098,189.51
$0.00 $2,393,272.63 $1,849,245.42
$0.00 $0.00 $589,685.00 $0.00

$99,917.00 $0.00
$641,144.40 $273,147.69 $175,048.33 $188,864.40
$85,268.15 $0.00
$45,739.48 $533,745.62
$0.00 $99,083.30 $71,336.60
$0.00 $155,463.09 $120,123.97
$0.00 $0.00 $38,304.98 $0.00

$1,590.74 $384.35
$6,872.98 $3,833.97 $1,843.26. $3,203.65 $1,165.53
$915.00 $2,069.59 $6,166.74
$581.36 $1,050.32
$813.47 $93.12
$1,678.74 $1,517.75
$186.91 ($23,794.22)
$359.22 ($17,136.88)

$101,507.74 $384.35
$648,017.38 $276,981.66 $176,891.59 $192,068.05
$86,433.68 $915.00
$47,809.07 $539,912.36
$581.36 $100,133.62
$72,150.07 $93.12
$157,141.83 $121,641.72
$186.91 ($23,794.22)
$38,664.20 ($17,136.88)

Total:

20 Grand Total: $4,462,440.73

$4,455,836.33 $38,904,717.03

$2,527,187.01

($6,604.40)

$2,520,582.61

77

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit
2000 Assessment 1999 Assessment Adjustment
Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

AT&T AAA COOPER TRANSPORTATIO ABF FREIGHT SYSTEM, INC AGL RESOURCES, INC. ALBANY, CITY OF ALLIED SYSTEMS LTD ALPHARETTA, CITY OF ALTERMAN TRANSPORT LINES AMERICAN FREIGHTWAYS INC AMERICAN NATIONAL RED CRO AMERICAN PROTEINS, INC AMOCO CORPORATION ANHEUSER-BUSCH COMPANIES, ARCHBOLD MEDICAL CENTER ARCHDIOCESES OF ATLANTA ARCHER-DANIELS-MIDLAND CO. ARMSTRONG WORLD INDUSTRI ASPLUNDH TREE EXPERT CO ATCO RUBBER PRODUCTS, INC. ATHENS REG. HLTH SYS INC ATHENS-CLARKE COUNTY ATLANTA BOARD OF EDUCATIO ATLANTA CITY OF ATLANTA HOUSING AUTHORITY ATLANTIC STEEL INDUSTRIES I AUGUSTA-RICHMOND CO BD CO AUTOMOTIVE MOULDING COMP AUTOZONE, INC AVERITT EXPRESS, INC AVONDALE MILLS INC BALDWIN COUNTY COMMISSIO BANKHEAD ENTERPRISES, INC BAPTIST VILLAGE INC BARTOW COUNTY BD OF EDUC BASS HOTELS & RESORTS BAYLINER MARINE CORPORATI BEAULIEU OF AMERICA BELLSOUTH CORPORATION BELLSOUTH ENTERPRISES INC

$200,727.40 $52,772.00 $37,422.64 $70,470.07 $54,836.21 $87,981.09 $4,625.69 $1,511.46 $20,569.00 $34,398.65 $16,449.26 $124,483.84 $31,048.04 $14,695.59 $19,070.58 $18,732.72 $24,731.84 $9,842.22 $3,381.65 $24,307.11 $54,162.10 $225,472.45
$872,863.34 $21,870.11 $28,509.74 $77,521.39 $26,644.27 $75,209.45 $26,734.02 $15,137.57 $6,908.63 $23,473.89 $13,607.45 $14,825.20 $8,830.45 $50,480.69
$284,568.94 $229,359.96
$50,460.99

$202,285.76 $53,181.70 $37,713.18 $71,017.17 $55,261.93 $88,664.14 $4,661.60 $1,523.19 $20,728.69 $34,665.71 $16,576.96 $125,450.28 $31,289.09 $14,809.69 $19,218.63 $18,878.15 $24,923.84 $9,918.63 $3,407.91 $24,495.82 $54,582.59 $227,222.92 $879,639.88 $22,039.90 $28,731.08 $78,123.23 $26,851.13 $75,793.34 $26,941.57 $15,255.09 $6,962.27 $23,656.13 $13,713.09 $14,940.29 $8,899.01 $50,872.60 $286,778.21 $231,140.61 $50,852.75

BENTON-GEORGIA INC

$19,176.09

$19,324.97

2000 Claims Paid

2000 Assessment Amt

$1,807, 139.18 $520,009.63 $384,851.00 $655,073.07 $701,927.84 $932,025.08 $0.00 $19,497.85 $133,135.00 $107,163.00 $195,576.83 $0.00 $243,940.31 $164,842.30 $118,758.91 $174,014.79 $0.00 $302,034.98 $95,719.15 $134,330.03 $334,874.44
$1,637,227.25 $8,001,065.25
$121,884.53 $0.00
$644,255.77 $366,930.62 $673, 138.97 $318,968.26 $160,142.82
$58,212.44 $511,076.00
$0.00 $76,836.59 $8,949.00 $457,322.94 $2,734,021.28 $2,767,526.87 $561,567.65 $95,971.70

$117,388.82 $33,778.98 $24,999.29 $42,552.48 $45,596.09 $60,542.83 $0.00 $1,266.55 $8,648.23 $6,961.13 $12,704.35 $0.00 $15,845.96 $10,707.89 $7,714.39 $11,303.72 $0.00 $19,619.70 $6,217.76 $8,725.86 $21,752.90 $106,351.61 $519,736.16 $7,917.42 $0.00 $41,849.80 $23,835.21 $43,726.01 $20,719.66 $10,402.62 $3,781.39 $33,198.66 $0.00 $4,991.18 $581.31 $29,706.95 $177,597.57 $179,774.03 $36,478.52 $6,234.17

1999 Balance Due

1999 And 2000 Total Assessment

$1,558.36 $409.70 $290.54 $547.10 $425.72. $683.05 $35.91 $11.73 $159.69 $267.06 $127.70 $966.44 $241.05 $114.10 $148.05 $145.43 $192.00 $76.41 $26.26 $188.71 $420.49
$1,750.47 $6,776.54
$169.79 $221.34 $601.84 $206.86 $583.89 $207.55 $117.52
$53.64 $182.24 $105.64 $115.09
$68.56 $391.91 $2,209.27 $1,780.65 $391.76 $148.88

$118,947.18 $34,188.68 $25,289.83 $43,099.58 $46,021.81 $61,225.88 $35.91 $1,278.28 $8,807.92 $7,228.19 $12,832.05 $966.44 $16,087.01 $10,821.99 $7,862.44 $11,449.15 $192.00 $19,696.11 $6,244.02 $8,914.57 $22,173.39 $108,102.08 $526,512.70 $8,087.21 $221.34 $42,451.64 $24,042.07 $44,309.90 $20,927.21 $10,520.14 $3,835.03 $33,380.90 $105.64 $5,106.27 $649.87 $30,098.86 $179,806.84 $181,554.68 $36,870.28 $6,383.05

78

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit
2000 Assessment 1999 Assessment Adjustment
Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

BERRY COLLEGE BHA GROUP INC BIBB COUNTY BO-COMMISSION BIBB COUNTY BOARD OF EDUC BIRMINGHAM SOUTHEAST, LLC BLACK & DECKER CORPORATIO BLOSSMAN COMPANIES, INC BLUE BIRD BODY COMPANY BLUE CIRCLE AMERICA BOBS CANDIES, INC. BROWN INDUSTRIES BRUNSWICK, CITY OF BULL MOOSE TUBE CO BURLEN CORPORATION C T HARRIS INC C. W. MATTHEWS CONTRACTIN CAGLE FOODS, JV, LLC CAGLE'S INC, & SUBSIDIARIES CAHABA GOV'T BENEFIT ADMIN. CALFEE COMPANY OF DALTON, CALIBER SYSTEM, INC. CANDLER HEALTH SYSTEM CAREMORE INC CARROLL CO. BOARD OF EDUC CASCADE CORPORATION CATOOSA CO. BO. OF EDUCATI CENTRAL GEORGIA HEALTH SY CERTAINTEED CORPORATION CERULEAN COMPANIES INC. CHAMPION INTERNATIONAL CO CHATHAM AREA TRANSIT AUTH CHATHAM COUNTY BO OF EDUC CHATHAM COUNTY GEORGIA CHEROKEE BRICK & TILE CHEROKEE CO BO OF COM MISS CHEROKEE CO BO OF EDUCATI CHEVRON USA INC SOU DIV CHILDREN'S HEALTHCARE OF A CITIGROUP INC. CLAYTON COUNTY BO OF EDUC

$6,915.75 $4,127.83 $40,118.01 $35,911.06 $3,691.97 $12,241.57
$0.00 $135,185.00 $150,329.53
$37,404.10 $9,580.42 $7,509.85
$10,964.61 $20,341.95
$3,145.50 $44,381.20 $96,805.18 $129,136.33
$5,330.39 $23,759.94 $30,210.21 $41,768.13 $21,648.35 $23,168.43
$698.12 $8,888.62 $73,989.62 $10,103.35 $16,649.86 $17,359.95 $9,226.19 $44,100.49 $30,545.10 $15,791.47 $14,677.08 $30,359.95 $6,680.61 $48,136.51 $31,251.85 $36,140.59

$6,969.44 $4,159.87 $40,429.47 $36,189.86 $3,720.64 $12,336.61
$0.00 $136,234.51 $151,496.62
$37,694.49 $9,654.79 $7,568.16
$11,049.74 $20,499.87
$3,169.92 $44,725.76 $97,556.73 $130,138.89
$5,371.77 $23,944.40 $30,444.75 $42,092.40 $21,816.42 $23,348.30
$703.54 $8,957.62 $74,564.05 $10,181.79 $16,779.12 $17,494.72 $9,297.82 $44,442.87 $30,782.24 $15,914.07 $14,791.02 $30,595.65 $6,732.48 $48,510.22 $31,494.48 $36,421.17

2000 Claims Paid

2000 Assessment Amt

$97,333.20 $23,299.44 $589,000.70 $228,205.00 $549,563.60 $131,913.64 $127,096.91 $2,113,150.29 $1,168,868.10 $204,004.38 $97,560.00 $120,830.08 $75,254.04 $150,472.97 $306,437.65 $716,321.26 $762,977.28 $1,168,721.84 $44,565.80 $88,127.23
$0.00 $321,889.27 $453,479.90 $273,307.74
$33,170.02 $132,954.00 $666,159.48 $247,509.82 $124,375.03 $302,829.42 $162,640.86 $566,626.01 $525,848.46 $161,029.45 $114,137.14 $316,542.34
$25,326.45 $510,424.02
$0.00 $384,869.17

$6,322.61 $1,513.49 $38,260.53 $14,823.82 $35,698.76 $8,568.90 $8,256.01 $137,266.80 $75,927.77 $13,251.79 $6,337.34 $7,848.93 $4,888.38 $9,774.48 $19,905.69 $46,531.06 $49,561.76 $75,918.27 $2,894.92 $5,724.60
$0.00 $20,909.40 $29,457.32 $17,753.63
$2,154.67 $8,636.48 $43,272.63 $16,077.83 $8,079.20 $19,671.31 $10,564.89 $36,807.10 $34,158.26 $10,460.21 $7,414.16 $20,562.07 $1,645.16 $33,156.31
$0.00 $25,000.47

1999 Balance Due

1999 And 2000 Total Assessment

$53.69 $32.04 $311.46 $278.80 $28.67 . $95.04
$0.00 $1,049.51 $1,167.09
$290.39 $74.37 $58.31 $85.13 $157.92 $24.42 $344.56 $751.55
$1,002.56 $41.38
$184.46 $234.54 $324.27 $168.07 $179.87
$5.42 $69.00 $574.43 $78.44 $129.26 $134.77 $71.63 $342.38 $237.14 $122.60 $113.94 $235.70 $51.87 $373.71 $242.63 $280.58

$6,376.30 $1,545.53 $38,571.99 $15,102.62 $35,727.43 $8,663.94 $8,256.01 $138,316.31 $77,094.86 $13,542.18 $6,411.71 $7,907.24 $4,973.51 $9,932.40 $19,930.11 $46,875.62 $50,313.31 $76,920.83 $2,936.30 $5,909.06
$234.54 $21,233.67 $29,625.39 $17,933.50
$2,160.09 $8,705.48 $43,847.06 $16,156.27 $8,208.46 $19,806.08 $10,636.52 $37,149.48 $34,395.40 $10,582.81 $7,528.10 $20,797.77 $1,697.03 $33,530.02
$242.63 $25,281.05

79

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

CLAYTON COUNTY COMMISSIO CLAYTON COUNTY WATER AUT

$76,667.30 $2,696.87

$77,262.51 $2,717.81

CMI INDUSTRIES INC.

$6,889.18

$6,934.90

COASTAL TRANSPORT INC

$69,260.34

$69,720.41

COATS & CLARK, INC.

$29,087.28

$29,313.10

COBB COUNTY BO/COMMISSION COBB COUNTY SCHOOL SYSTE COCA-COLA COMPANY COCA-COLA ENTERPRISES INC COLLEGE PARK CITY OF COLLIS FOODS INC COLONIAL GROUP COLONIAL PIPELINE COMPANY

$110,224.18 $148,216.49
$33,524.86 $101,398.15
$12,549.92 $1,655.96 $5,296.74 $1,178.83

$111,079.91 $149,367.18
$33,785.13 $102,185.36
$12,647.35 $1,668.82 $5,337.86 $1,187.98

COLQUITT CO BD OF EDUCATIO

$14,807.90

$14,922.86

COLQUITT REGIONAL MEDICAL COLUMBIA CO BOARD OF EDUC

$19,936.97 $16,880.59

$20,091.75 $17,011.64

COLUMBIA GEORGIA CORP. COLUMBUS CITY OF COLUMBUS FOUNDRIES INC COLUMBUS REGIONAL HEALTH COLUMBUS WATER WORKS CONAGRA FOODS, INC

$7,139.26 $26,773.83 $51,803.70 $33,682.22
$3,619.93 $127,335.79

$7,194.69 $26,981.69 $52,205.89 $33,943.71
$3,648.04 $128,324.37

CONOCO INC.

$3,782.13

$3,811.49

CONSOLIDATED STORES CORP.

$23,190.10

$23,370.14

CONTI GROUP COMPANIES, INC CONTINENTAL TIRE N. AMER., I COOPER INDUSTRIES, INC COOPER TIRE AND RUBBER CORPORATION OF MERCER UNI COSCO,INC

$69,036.25 $40,783.48 $37,961.09 $76,509.93
$7,238.81 $9,307.63

$59,494.58 $41,100.10 $38,255.80 $77,103.92
$7,295.01 $9,379.89

COSTCO WHOLESALE CORP.

$1,598.76

$1,611.17

COTTRELL INC

$9,911.55

$9,988.50

COVINGTON, CITY OF COWETA CO BOARD OF EDUCA

$1,428.07 $22,001.65

$1,439.15 $22,172.46

COX ENTERPRISES INC CRACKER BARREL OLD CNTRY CRAWFORD & COMPANY CRAWFORD W LONG MEM HOS

$84,448.49 $79,913.59 $19,267.06 $55,026.95

$85,104.11 $80,534.00 $19,416.64 $55,454.15

CRIDER'S POULTRY INC

$27,675.81

$27,890.67

CRISP COUNTY BD OF EDUCATI

$4,085.52

$4,117.24

2000 Claims Paid

2000 Assessment Amt

$721,525.70 $107,322.26
$62,430.22 $681,176.07 $271,312.72 $1,291,418.45 $1,629,278.87 $235,440.46 $1,430,470.94
$69,607.29 $3,769.12
$79,237.35 $0.00
$61,810.74 $244,839.16 $221,105.16 $114,915.28 $296,693.22 $285,290.46 $392,681.85
$62,485.45 $1,664,636.00
$13,652.00 $208,967.45 $647,262.79 $503,651.52 $457,557.50 $1,010,415.72
$52,903.39 $128,186.28
$56,502.00 $199,919.00
$8,886.00 $148,956.88
$0.00 $869,347.73 $207,721.27
$0.00 $353,212.31
$43,417.38

$46,869.13 $6,971.48 $3,406.78
$44,248.09 $17,624.03 $83,888.44 $105,835.30 $15,293.83 $92,921.06
$4,521.68 $244.84
$5,147.13 $0.00
$4,016.12 $15,904.35 $14,362.63
$7,464.71 $19,272.71 $18,532.00 $25,507.97
$4,058.95 $101,636.20
$886.81 $13,574.18 $42,045.14 $32,716.38 $29,722.19 $65,634.96
$3,436.52 $8,326.77 $3,670.28 $12,986.41
$577.22 $9,676.00
$0.00 $56,471.41 $13,493.24
$0.00 $22,944.10
$2,820.32

1999 Balance Due

1999 And 2000 Total Assessment

$696.21

$47,464.34

$20.94

$6,992.42

$46.72

$3,451.60

$460.07

$44,708.16

$226.82 , $855.73 $1,150.69 $260.27 $787.21
$97.43

$17,849.85 $84,744.17 $106,986.99 $15,554.10 $93,708.27
$4,619.01

$12.86 $41.12

$257.70 $5,188.25

$9.15

$9.15

$114.96

$4,130.08

$154.78

$16,059.13

$131.06

$14,493.68

$55.43

$7,520.14

$207.86 $402.19

$19,480.57 $18,934.19

$261.49

$25,769.46

$28.11

$4,087.06

$988.68 $29.36

$102,624.78 $916.17

$180.04

$13,754.22

$458.33

$42,503.47

$316.62

$33,033.00

$294.71 $593.99
$56.20

$30,016.90 $66,228.95
$3,492.72

$72.26

$8,399.03

$12.41

$3,682.69

$76.95

$13,063.36

$11.08

$588.30

$170.81 $656.62

$9,846.81 $655.62

$620.41 $149.58

$57,091.82 $13,642.82

$427.20 $214.86

$427.20 $23,158.96

$31.72

$2,852.04

80

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

CROWN CENTRAL PETROLEUM CROWN CORK & SEAL COMPAN CWW GROUP, INC D L LEE & SONS INC DALTON CITY OF DAN RIVER, INC. DART CONTAINER CORPORATIO DEAN FOODS COMPANY DECATUR, CITY OF DEKALB COUNTY BOARD-ED DEKALB COUNTY GOVERNMEN DEKALB FARMERS MARKET DEKALB REGIONAL HLTHCARE DELHAIZE AMERICA INC. DELPHI AUTOMOTIVE SYS INC. DELTA AIRLINES, INC. DELTA WOODSIDE INDUSTRIES I DIAGEO, INC. DIXIE GROUP & SUBSIDIARIES DOLLAR GENERAL CORP DOUGHERTY COUNTY COM MIS DOUGHERTY COUNTY SCHOOL DOUGLAS ASPHALT COMPANY DOUGLAS CO BO OF COMMISSI DOUGLAS COUNTY SCHOOLS DOUGLAS, CITY OF DOUGLASVILLE-DOUGLAS COU DOWLING TEXTILE MANUFACTU DRY BRANCH KAOLIN COMPAN DSM CHEMICALS N. AMERICA DULUTH, CITY OF DURAND-WAYLAND, INC E I DUPONT DE NEMOURS & CO EAST POINT, CITY OF EASTERN SERVICE CORPORATI EASTMAN KODAK COMPANY EATON CORPORATION ELBERTA CRATE & BOX COMPA ELBERTON GRANITE ASSOCIATI ELBERTON, CITY OF

$7,025.87 $8,817.40 $3,579.56 $16,926.36 $68,016.38 $34,073.33 $14,031.59 $19,550.47
$208.01 $239,165.15 $203,991.08
$5,678.44 $43,477.93 $107,589.16 $15,881.90 $727,027.76 $18,801.79 $13,150.34 $86,214.82 $82,968.49 $18,970.06 $21,054.64 $77,759.48 $34,655.85 $13,750.01 $65,109.94
$245.39 $15,329.95 $24,587.28 $12,244.37
$7,547.00 $4,312.36 $11,963.93 $24,810.89 $9,780.96 $1,404.67
$0.00 $22,781.13 $59,237.75
$556.21

$7,080.42 $8,885.85 $3,607.34 $17,057.76 $68,544.43 $34,337.86 $14,140.52 $19,702.25
$209.62 $241,021.92 $205,574.78
$5,621.74 $43,815.47 $108,424.44 $16,005.20 $732,672.09 $18,947.76 $13,252.43 $86,884.16 $83,612.63 $19,117.33 $21,218.10 $78,363.17 $34,924.90 $13,856.76 $55,537.79
$247.30 $15,448.97 $24,778.17 $12,339.43
$7,605.59 $4,345.84 $12,056.82 $25,003.51 $9,856.89 $1,415.57
$0.00 $22,958.00 $59,697.65
$560.53

2000 Claims Paid

2000 Assessment Amt

$0.00 $29,082.69 $97,498.24 $204,851.43 $319,218.15 $163,059.00 $199,369.00 $170,060.76 $13,684.45 $2,027,934.00 $2,414,342.78 $96,955.86

$0.00 $1,889.16 $6,333.33 $13,306.81 $20,735.89 $10,592.05 $12,950.69 $11,046.87
$888.92 $131,731.29 $156,831.77
$6,298.09

$374,460.60 $628,586.47 $210,050.33 $7,633,523.64
$0.00 $18,568.00 $1,092,209.07 $1,110,774.37 $192,433.00 $310,322.41 $966,511.64

$24,324.35 $40,831.95 $13,644.53 $495,861.25
$0.00 $1,206.15 $70,948.12 $72,154.09 $12,500.13 $20,158.04 $62,783.02

$312,076.66 $170,611.00
$86,265.59 $16,933.00 $58,615.50
$0.00 $103,714.74
$10,632.35 $20,680.77 $170,780.24 $337,986.04
$0.00 $0.00 $161,173.36 $223,471.66 $636,483.46 $13,582.45

$20,271.99 $11,082.61
$5,603.67 $1,099.94 $3,807.57
$0.00 $6,737.14
$690.66 $1,343.39 $11,093.61 $21,955.02
$0.00 $0.00 $10,469.56 $14,516.35 $41,344.93 $882.29

1999 Balance Due

1999 And 2000 Total Assessment

$54.55 $68.45

$54.56 $1,957.61

$27.79 $131.41

$6,361.12 $13,438.22

$528.05 .

$21,263.94

$264.63

$10,856.58

$108.93 $151.78

$13,059.62 $11,198.66

$1.61 $1,866.77 $1,583.70
$43.30

$890.63 $133,588.06 $158,415.47
$6,341.39

$337.64 $835.28 $123.30 $5,644.33

$24,661.89 $41,667.23 $13,767.83 $501,505.58

$145.97 $102.09 $669.34 $644.14 $147.27

$145.97 $1,308.24 $71,617.46 $72,798.23 $12,647.40

$163.46

$20,321.60

$603.69

$63,386.71

$269.05 $106.75 $427.85

$20,541.04 $11,189.36
$6,031.52

$1.91

$1,101.85

$119.02 $190.89
$95.06 $58.59

$3,926.59 $190.89
$6,832.20 $749.25

$33.48

$1,376.87

$92.89 $192.62

$11,186.50 $22,147.64

$75.93 $10.90

$75.93 $10.90

$0.00

$10,469.56

$176.87 $459.90
$4.32

$14,693.22 $41,804.83
$886.61

81

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit
2000 Assessment 1999 Assessment Adjustment
Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

EMERSON ELECTRIC CO EMORY CLINIC, INC., EMORY UNIVERSITY ENGELHARD CORPORATION ESTES EXPRESS LINES EVANS GRADING CO., INC EVENFLO COMPANY INC FAYETTE COUNTY BD OF COMM FAYETTE COUNTY BD OF EDUC FEDERAL EXPRESS FEDERAL RESERVE BANK/ATLA FEDERATED DEPARTMENT STO FEDEX GROUND PKG SYS FEDEX SUPPLY CHAIN SERV INC FIELDALE FARMS CORPORATIO FLEETWOOD HOMES OF GA INC FLEXSTEEL INDUSTRIES INC FLORIDA ROCK & TANK LINES I FLORIDA ROCK INDUSTRIES INC FLOWERS INDUSTRIES INC FLOYD CO. BD. OF COMMISSION FLOYD COUNTY BD OF EDUCATI FLOYD HLTHCARE MGMT INC FLYING J, INC. FORD MOTOR COMPANY FOREST PARK, CITY OF FORSYTH CO BD OF COMMISSI FORSYTH CO. BD. OF EDUCATIO FORT JAMES CORP. FREUDENBERG-NOK FROZEN FOOD EXPRESS IND FULTON COUNTY BD OF EDUCA FULTON COUNTY, GEORGIA FULTON-DEKALB HOSPITAL AU GA BAPTIST HEALTH CARE SYS GA INTAL HEALTH/SOUTH FULT GA MEDCORP, INC. GANNETT CO. INC & SUBSIDIARI GENERAL MOTORS CORPORATI GEORGIA CRATE & BASKET CO

$23,525.05 $3,946.00
$67,551.02 $139,925.79
$22,353.19 $2,033.43 $0.00 $1,805.03 $5,900.15
$270,759.34 $6,686.71
$60,450.53 $0.00 $0.00
$76,125.14 $118,304.84
$16,759.31 $45,178.48
$2,620.54 $67,406.13 $24,015.31 $24,507.02 $79,271.99 $10,897.26 $93,057.68
$4,461.88 $4,226.05 $15,053.96 $33,391.80 $12,329.28 $6,044.23 $95,802.15 $153,361.21 $169,758.59 $79,433.28 $8,787.41 $23,966.44 $3,601.37 $346,472.84 $1,555.25

$23,707.69 $3,976.63
$68,075.46 $141,012.12
$22,526.73 $2,049.21 $0.00 $1,819.04 $5,945.96
$272,861.40 $6,738.63 $60,919.84 $0.00 $0.00 $76,716.14
$119,223.31 $16,889.42 $45,529.23 $2,640.88 $67,929.44 $24,201.75 $24,697.28 $79,887.43 $10,981.87 $93,780.14 $4,496.52 $4,258.86 $15,170.83 $33,651.04 $12,425.00 $6,091.16 $96,545.92
$154,551.85 $171,076.53
$80,049.96 $8,855.63
$24,152.51 $3,629.33
$349,162.71 $1,567.33

2000 Claims Paid

2000 Assessment Amt

$199,365.00 $106,483.91 $4,443,930.22 $339,432.73 $177,183.11

$12,950.43 $6,917.02
$288,670.46 $22,049.00 $11,509.53

$24,331.77 $324,163.49 $123,452.61 $142,502.99 $2,368,886.51
$67,231.07 $579,356.57 $106,129.75
$52,489.00 $831,104.42 $1,310,629.82 $304,244.00 $353,871.89
$49,787.45 $407,806.19 $348,308.11 $177,079.82 $556,685.11 $77,740.49 $1,717,777.88 $115,566.00 $494,686.48 $161,492.38 $292,687.04 $195,607.57
$56,186.00 $1,121,885.59 $1,309,705.27 $1,399,214.19
$873,140.61

$1,580.55 $21,057.13
$8,019.28 $9,256.76 $153,879.01 $4,367.22 $37,634.06 $6,894.02 $3,409.60 $53,987.19 $85,136.38 $19,763.19 $22,986.94 $3,234.11 $26,490.43 $22,625.53 $11,502.82 $36,161.36 $5,049.90 $111,584.05 $7,506.98 $32,134.03 $10,490.28 $19,012.47 $12,706.35 $3,649.75 $72,875.86 $85,076.32 $90,890.67 $56,717.79

$0.00 $246,014.13

$0.00 $15,980.68

$24,758.13 $3,587,758.00
$58,517.12

$1,608.25 $233,054.91
$3,801.18

1999 Balance Due

1999 And 2000 Total Assessment

$182.64 $30.63
$524.44 $1,086.33
$173.54. $15.78 $0.00 $14.01 $45.81
$2,102.06 $51.92
$469.31 $0.00 $0.00
$591.00 $918.47 $130.11 $350.75
$20.34 $523.31 $186.44 $190.26 $615.44
$84.61 $722.46
$34.64 $32.81 $116.87 $259.24 $95.72 $46.93 $743.77 $1,190.64 $1,317.94 $616.68 $68.22 $186.07 $27.96 $2,689.87 $12.08

$13,133.07 $6,947.65
$289,194.90 $23,135.33 $11,683.07 $1,596.33 $21,057.13 $8,033.29 $9,302.57
$155,981.07 $4,419.14
$38,103.37 $6,894.02 $3,409.60 $54,578.19
$86,054.85 $19,893.30 $23,337.69 $3,254.45 $27,013.74 $22,811.97 $11,693.08 $36,776.80 $5,134.51 $112,306.51 $7,541.62 $32,166.84 $10,607.15 $19,271.71 $12,802.07 $3,696.68 $73,619.63 $86,266.96 $92,208.61 $57,334.47
$68.22 $16,166.75
$1,636.21 $235,744.78
$3,813.26

82

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit
2000 Assessment 1999 Assessment Adjustment
Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

GEORGIA DUCK & CORDAGE Ml GEORGIA POWER CO GEORGIA STATE OF GEORGIA.PACIFIC CORPORATI GFF HOLDING CO/GENERAL FIB GLYNN COUNTY BOARD OF CO GLYNN COUNTY SCHOOLS GOLDEN PANTRY FOOD STORE GOODY PRODUCTS, INC. GREAT ATLANTIC & PACIFIC TE GREAT DANE LTD PARTNERSHI GRIFFIN-SPALDING SCHOOLS GUILFORD MILLS INC GULFSTREAM AEROSPACE CO GWINNETT CO BD OF EDUCATIO GWINNETT COUNTY BD OF COM GWINNETT HOSPITAL SYSTEM HALL COUNTY BOARD OF EDUC HAMILTON HEALTH CARE SYST HAPEVILLE CITY OF HARRIET & HENDERSON YARNS HARRISON POULTRY, INC HAVERTYS FURNITURE HENRY CO BOARD OF EDUCATI HERCULES INCORPORATED HILLCREST FOODS, INC HILTON HOTELS CORPORATION HON INDUSTRIES, INC. HORMEL, GEORGE & COMPANY HORTON HOMES, INC HOSPITAL AUTHORITY HOUSTO HOUSTON COUNTY BD OF EDUC HOUSTON COUNTY COMMISSIO HOWARD SHEPPARD INC HUTCHESON MEDICAL CENTER HYATT CORPORATION IDA CASON CALLAWAY FOUNDA IKON OFFICE SOLUTIONS ILLINOIS TOOL WORKS INC INGLES MARKETS INC

$43,720.24 $302,801.09 $3,608,712.95 $334,990.43
$4,131.86 $0.00
$23,877.60 $1,748.87 $7,493.86
$38,297.10 $56,647.44
$3,215.63 $13,688.44 $46,302.19 $184,165.78 $120,839.10 $39,058.51
$5,955.73 $11,078.38
$897.73 $12,812.64 $11,670.09 $16,056.96 $31,500.13 $134,067.78 $11,666.60 $12,259.42 $40,729.03 $31,747.26 $59,011.42 $11,079.99 $20,867.88 $7,042.05 $7,782.02 $29,078.47 $20,425.37 $27,324.91 $25,203.57 $31,791.22 $259,203.93

$44,059.67 $305,151.91 $3,636,729.46 $337,591.15
$4,163.94 $0.00
$24,062.97 $1,762.45 $7,552.04
$38,594.42 $57,087.23
$3,240.60 $13,794.71 $46,661.66 $185,595.57 $121,777.24 $39,361.74
$6,001.96 $11,164.39
$904.70 $12,912.11 $11,760.69 $16,181.62 $31,744.68 $135,108.63 $11,757.17 $12,354.59 $41,045.23 $31,993.74 $59,469.56 $11,166.01 $21,029.89 $7,096.72 $7,842.44 $29,304.22 $20,583.94 $27,537.05 $25,399.24 $32,038.04 $261,216.28

2000 Claims Paid

2000 Assessment Amt

1999 Balance Due

1999 And 2000 Total Assessment

$389,264.18 $0.00
$39,515,996.02 $2,246,073.15 $108,911.57 $402,247.49 $207,195.30 $296,749.14 $73,170.00 $184,328.95 $785,652.68 $102,867.34 $0.00 $174,071.82 $1,638,821.27 $1,576,425.00 $466, 165.56 $148,626.39 $246,029.32 $36,357.00 $0.00 $135,476.14 $195,125.88 $262,025.40 $305,023.00 $135,989.03 $38,354.79 $213,831.68 $592,855.86 $509,666.89 $220,548.36 $157,391.35 $88,914.94 $159,235.42 $372,655.13 $181,374.56 $222,026.05 $201,106.14 $353,404.61 $2,569,900.28

$25,285.97 $0.00
$2,566,894.69 $145,901.25 $7,074.72 $26,129.34 $13,459.07 $19,276.34 $4,753.00 $11,973.71 $51,034.72 $6,682.09 $0.00 $11,307.42 $106,455.16 $102,402.00 $30,281.35 $9,654.53 $15,981.66 $2,361.69 $0.00 $8,800.31 $12,675.06 $17,020.74 $19,813.80 $8,833.63 $2,491.46 $13,890.16 $38,510.95 $33,107.13 $14,326.46 $10,223.89 $5,775.77 $10,343.67 $24,207.07 $11,781.80 $14,422.45 $13,063.53 $22,956.59 $166,936.53

$339.43 $2,350.82 $28,016.51 $2,600.72
$32.08 $0.00
$185.37 $13.58 $58.18
$297.32 $439.79
$24.97 $106.27 $359.47 $1,429.79 $938.14 $303.23
$46.23 $86.01
$6.97 $99.47 $90.60 $124.66 $244.55 $1,040.85 $90.57 $95.17 $316.20 $246.48 $458.14 $86.02 $162.01 $54.67 $60.42 $225.75 $158.57 $212.14 $195.67 $246.82 $2,012.35

$25,625.40 $2,350.82
$2,594,911.20 $148,501.97 $7,106.80 $26,129.34 $13,644.44 $19,289.92 $4,811.18 $12,271.03 $51,474.51 $6,707.06 $106.27 $11,666.89 $107,884.95 $103,340.14 $30,584.58 $9,700.76 $16,067.67 $2,368.66 $99.47 $8,890.91 $12,799.72 $17,265.29 $20,854.65 $8,924.20 $2,586.63 $14,206.36 $38,757.43 $33,565.27 $14,412.48 $10,385.90 $5,830.44 $10,404.09 $24,432.82 $11,940.37 $14,634.59 $13,259.20 $23,203.41 $168,948.88

83

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

INTERFACE, INC INTERNATIONAL PAPER COMPA

$35,435.10 $41,389.29

$35,710.20 $41,710.62

INTERSTATE PAPER LLC J & J INDUSTRIES INC J H HARVEY COMPANY J. C. PENNEY COMPANY, INC.

$4,372.34 $7,796.88 $69,369.23 $123,714.15

$4,406.28 $7,857.41 $69,907.78 $124,674.61

JEFFERSON SMURFIT CORP. U.

$15,203.06

$15,321.09

JESUP CITY OF JOHN WIELAND HOMES, INC JOHNS MANVILLE INT'L., INC. JOHNSTON INDUSTRIES, INC.

$6,297.34 $194,122.86
$9,403.14 $4,518.03

$6,346.23 $195,629.95
$9,476.14 $4,553.11

KAHN CONSTRUCTION COMPAN

$1,038.45

$1,046.52

KEEBLER COMPANY

$60,023.31

$60,489.31

KELLEY MANUFACTURING COM

$972.75

$980.31

KERR-MCGEE PIGMENTS (SAV)

$21,049.88

$21,213.31

KIMBERLY-CLARK CORP

$18,489.63

$18,633.18

KING & PRINCE SEAFOOD CORP

$4,483.91

$4,518.72

KLEEN-TEX INDUSTRIES KLLM TRANSPORT K-MART CORP & SUBSIDIARIES

$0.00 $3,318.11 $329,576.87

$0.00 $3,343.87 $332,135.56

KROGER COMPANY, THE

$0.00

$0.00

LABOR READY SE Ill LP

$0.00

$0.00

LAGRANGE, CITY OF LANGDALE INDUSTRIES LAWRENCEVILLE, CITY OF

$9,544.66 $34,523.82
$5,431.73

$9,618.76 $34,791.85
$5,473.90

LEVI STRAUSS & CO

$216,447.40

$218,127.80

LIBERTY NATIONAL LIFE INS CO

$5,530.94

$5,573.88

LIFE INSURANCE CO OF GEORG

$9,541.05

$9,615.12

LIMITED, INC., THE LINDALE MANUFACTURING INC

$2,980.50 $163,508.90

$3,003.64 $164,778.32

LOUISIANA-PACIFIC CORP

$20,880.67

$21,042.77

LOW TEMP INDUSTRIES

$6,167.42

$6,215.30

LOWE'S HOME CENTERS, INC

$193,638.40

$195,141.73

LOXCREEN COMPANY, INC.

$2,867.84

$2,890.10

LUCENT TECHNOLOGIES INC.

$41,541.01

$41,863.52

MACON CITY OF

$122,741.85

$123,694.76

MACON/BIBB CO WATER & SEW MANAGEMENT ANALYSIS & UTI MARIETTA CITY SERVICES

$9,056.10 $14,640.00 $24,999.51

$9,126.41 $14,753.66 $25,193.59

MAR-JAC POULTRY, INC.

$70,285.22

$30,960.53

2000 Claims Paid

2000 Assessment Amt

$316,816.00 $1,433,349.85

$20,579.85 $93,108.07

$4,663.79

$302.95

$386,687.00 $1,791,844.00

$25,118.56 $116,395.27

$1,028,025.14

$66,778.84

$119,099.00

$7,736.48

$15,351.66 $1,598,374.60
$184,716.00

$997.22 $103,827.81
$11,998.85

$30,130.84

$1,957.25

$127.94

$8.31

$781,259.00

$50,749.31

$54,837.00

$3,562.12

$358,345.88

$23,277.56

$217,747.00

$14,144.49

$53,727.28 $114,741.94 $312,367.10 $4,003,012.70

$3,490.04 $7,453.45 $20,290.86 $260,029.18

$3,283,734.00

$213,306.01

$1,132,120.33

$73,540.69

$68,414.56

$4,444.10

$385,236.83

$25,024.36

$101,369.00

$6,584.77

$1,996,568.56

$129,693.84

$27,473.52

$1,784.64

$8,317.00 $89,364.00

$540.26 $5,804.94

$304,137.96 $469,041.61

$19,756.31 $30,468.18

$116,396.00

$7,560.89

$2,581,441.00

$167,686.20

$32,605.63 $157,675.81

$2,118.01 $10,242.36

$1,189,051.99

$77,238.88

$69,363.13

$4,505.72

$53,968.00 $319,936.71

$3,505.67 $20,782.57

$146,021.94

$9,485.35

1999 Balance Due

1999 And 2000 Total Assessment

$275.10 $321.33
$33.94 $60.53 $538.55. $960.46 $118.03 $48.89 $1,507.09 $73.00 $35.08

$20,854.95 $93,429.40
$336.89 $25,179.09 $116,933.82 $67,739.30
$7,854.51 $1,046.11 $105,334.90 $12,071.85 $1,992.33

$8.07 $466.00
$7.56

$16.38 $51,215.31
$3,569.68

$163.43 $143.55
$34.81 $0.00
$25.76 $2,558.69
$0.00 $0.00 $74.10 $268.03 $42.17 $1,680.40 $42.94 $74.07 $23.14 $1,269.42 $162.10

$23,440.99 $14,288.04
$3,524.85 $7,453A5 $20,316.62 $262,587.87 $213,306.01 $73,540.69 $4,518.20 $25,292.39 $6,626.94 $131,374.24 $1,827.58
$614.33 $5,828.08 $21,025.73 $30,630.28

$47.88 $1,503.33
$22.26 $322.51

$7,608.77 $169,189.53
$2,140.27 $10,564.87

$952.91 $70.31
$113.66 $194.08 ($39,324.69)

$78,191.79 $4,576.03 $3,619.33
$20,976.65 ($29,839.34)

84

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit
2000 Assessment 1999 Assessment Adjustment
Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

MARMON CORP & SUBS MARMON INDUSTRIAL CORP MARRIOTT INTERNATIONAL, INC MARTA MASTEC, INC SUBSIDIARIES MAY DEPARTMENT STORES CO/ MAYER ELECTRIC SUPPLY CO MCLANE COMPANY, INC. M-D BUILDING PRODUCTS MEAD CORPORATION MEMORIAL MEDICAL CENTER, I MERCK & CO INC MERVYN'$, METALPLATE GALVANIZING INC METROMEDIA INTERNATIONAL MICROMERITICS INSTRUMENTS MILLEDGEVILLE, CITY OF MILTON J. WOOD COMPANY MOBIL OIL CORPORATION MOHAWK CARPET CORPORATI MONROE, CITY OF MOUNT VERNON MILLS MULLITE CO OF AMERICA MURPHY-HARPST-VASHTI, INC. MURRAY COUNTY BD OF EDUC MUSCOGEE COUNTY SCHOOL D NABISCO, INC NASH JOHNSON & SONS' FARM NATIONAL SERVICES INDUSTRI NEWTON COUNTY NEWTON COUNTY BD OF EDUC NORDSON CORPORATION NORDSTROM, INC. NORMAN W FRIES/CLAXTON PO NORTHEAST GEORGIA HEALTH NORTHSIDE HOSPITAL OLD DOMINION FREIGHT LINES I OLIN CORPORATION OLIVER RUBBER CO OVERNITE TRANSPORTATION C

$1,622.62 $13,329.01 $75,379.28 $201,403.10 $16,354.23
$2,213.84 $18,644.58 $28,072.67 $12,774.60 $45,314.55 $19,035.97
$8,407.45 $8,171.67
$197.63 $20,671.51
$507.52 $20,577.26
$5,248.19 $1,989.37 $569,623.26 $4,919.34 $88,523.47 $3,259.71 $14,150.82 $4,680.87 $54,224.37 $46,544.74
$2.85 $171,844.04
$182.33 $11,827.07 $10,598.59
$8,613.56 $46,272.18 $56,245.08 $85,823.98 $64,157.15
$118.32 $21,194.95 $18,293.19

$1,635.22 $13,432.49 $75,964.49 $202,966.71 $16,481.20
$2,231.03 $18,789.33 $28,290.61 $12,873.78 $45,666.35 $19,183.76
$8,472.72 $8,235.11
$199.17 $20,832.00
$511.46 $20,737.01
$5,288.93 $2,004.81 $574,045.57 $4,957.54 $89,210.73 $3,285.02 $14,260.68 $4,717.21 $54,645.34 $46,906.09
$2.87 $173,178.17
$183.74 $11,918.89 $10,680.87
$8,680.43 $46,631.42 $56,681.74 $86,490.28 $64,655.24
$119.24 $21,359.50 $18,435.22

2000 Claims Paid

2000 Assessment Amt

$0.00 $142,066.94 $818,879.00 $3,574,182.96
$0.00 $8,767.65
$0.00 $212,812.91 $148,407.88 $449,994.14 $216,172.14 $497,753.00
$0.00 $73,570.96 $96,721.66
$3,074.33 $222,222.66
$66,934.88 $0.00
$6,740,222.05 $141,420.60
$1,252,131.84 $0.00 $0.00
$90,354.00 $433,582.29 $673,654.53
$11,352.25 $1,544,852.57
$37,594.57 $150,720.00
$80,450.95 $34,376.29 $580,095.19 $366,330.41 $1,072,737.51 $531,855.17 $13,310.29
$0.00 $489,037.52

$0.00 $9,228.44 $53,193.05 $232,173.10
$0.00 $569.53
$0.00 $13,823.98
$9,640.33 $29,230.89 $14,042.19 $32,333.22
$0.00 $4,779.05 $6,282.88
$199.70 $14,435.22
$4,347.98 $0.00
$437,833.84 $9,186.45
$81,336.44 $0.00 $0.00
$5,869.25 $28,164.80 $43,759.50
$737.42 $100,351.10
$2,442.08 $9,790.53 $5,225.96 $2,233.03 $37,682.04 $23,796.23 $69,683.28 $34,548.44
$864.61 $0.00
$31,767.08

1999 Balance Due

1999 And 2000 Total Assessment

$12.60 $103.48 $585.21 $1,563.61 $126.97 .
$17.19 $144.75 $217.94
$99.18 $351.80 $147.79
$65.27 $63.44
$1.54 $160.49
$3.94 $159.75
$40.74 $15.44 $4,422.31 $38.20 $687.26 $25.31 $109.86 $36.34 $420.97 $361.35
$0.02 $1,334.13
$1.41 $91.82 $82.28 $66.87 $359.24 $436.66 $666.30 $498.09
$0.92 $164.55 $142.03

$12.60 $9,331.92 $53,778.26 $233,736.71
$126.97 $586.72 $144.75 $14,041.92 $9,739.51 $29,582.69 $14,189.98 $32,398.49 $63.44 $4,780.59 $6,443.37 $203.64 $14,594.97 $4,388.72 $15.44 $442,256.15 $9,224.65 $82,023.70 $25.31 $109.86 $5,905.59 $28,585.77 $44,120.85 $737.44 $101,685.23 $2,443.49 $9,882.35 $5,308.24 $2,299.90 $38,041.28 $24,232.89 $70,349.58 $35,046.53 $865.53 $164.55 $31,909.11

85

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

OWENS-CORNING FIBERGLASS OWENS-ILLINOIS INC PARKER HANNIFIN CORPATION PATTERSON PUMP COMPANY PCC AIRFOILS INC PHOEBE PUTNEY MEMORIAL HO PIEDMONT HOSPITAL PIEDMONT LABORATORIES, INC PIGGLY WIGGLY CAROLINA CO I PILOT CORPORATION PLANTATION PIPE LINE COMPA PPG INDUSTRIES INC. PRESBYTERIAN HOMES OF GA PRINTPACK, INC PROCTER & GAMBLE COMPANY QUITRIP RACETRAC PETROLEUM, INC RANDOLPH COUNTY HOSP AUT RANDSTAD STAFFING SERVICE RHODES NURSING HOME RICHMOND CTY BD OF EDUCATI RIVERDALE, CITY OF RMC INDUSTRIES ROCKDALE CO. BD OF EDUCATI ROCKWELL INTERNATIONAL ROCOR INTERNATIONAL ROLLINS INC ROME, CITY OF ROOKER ADMINISTRATIVE SER ROPER CORPORATION ROSWELL CITY OF RTM,INC. RUBY TUESDAY INC RUSSELL CORPORATION RYAN'S FAMILY STEAK HOUSES RYDER SYSTEMS INC SAINT JOSEPH'S OF SAVANNAH SAINT MARY'S HEALTH CARE SANDERS BROTHERS INC SATILLA HEALTH SERVICES INC

$45,902.80 $44,663.91
$9,300.06 $14,740.97 $23,343.13 $27,180.48 $42,184.22
$8,299.98 $7,004.04
$0.00 $0.00 $8,943.74 $498.96 $13,934.24 $23,526.55 $0.00 $20,512.29 $185.55 $74,924.32 $0.00 $48,755.85 $2,522.80 $31,622.05 $14,360.50 $29,277.28 $3,235.88 $14,769.56 $2,524.57 $9,122.77 $32,058.03 $5,143.57 $20,889.94 $11,519.88 $2,389.82 $29,580.10 $94,728.17 $26,233.52 $27,162.43 $29.77 $34,653.13

$46,259.17 $45,010.66
$9,372.26 $14,855.41 $23,524.35 $27,391.50 $42,511.72
$8,364.41 $7,058.42
$0.00 $0.00 $9,013.18 $502.84 $14,042.42 $23,709.20 $0.00 $20,671.54 $186.99 $0.00 $0.00 $49,134.37 $2,542.39 $31,867.55 $14,471.99 $29,504.58 $59,045.76 $14,884.23 $2,544.17 $9,193.60 $32,306.91 $5,183.50 $21,052.12 $11,609.31 $2,408.37 $29,809.74 $95,463.60 $26,437.18 $27,373.31 $30.00 $34,922.16

2000 Claims Paid

2000 Assessment Amt

$587,154.07 $681,371.00
$75,373.00 $48,842.54 $640,301.69 $84,192.44 $980,678.70 $14,337.00 $159,775.00 $37,620.53

$38,140.57 $44,260.75
$4,896.11 $3,172.73 $41,592.95 $5,469.00 $63,703.29
$931.31 $10,378.72
$2,443.77

$8,631.59 $69,782.83
$0.00 $99,155.00 $330,282.16 $42,158.57

$560.69 $4,532.98
$0.00 $6,440.95 $21,454.59 $2,738.55

$231,411.50 $179.24 $0.00
$19,583.57 $679,365.13
$55,008.37 $255,804.00
$99,239.52 $620,530.51 $396,672.92 $204,315.25

$15,032.11 $11.64 $0.00
$1,272.12 $44,130.45
$3,573.25 $16,616.61
$6,446.44 $40,308.65 $25,767.23 $13,271.99

$401,347.48 $282,645.75 $397,856.25 $101,617.56 $250,987.02 $233,989.00
$11,828.43 $277,171.84 $813,552.97 $129,268.92

$26,070.88 $18,360.21 $25,844.09
$6,600.91 $16,303.71 $15,199.54
$768.36 $18,004.63 $52,847.07
$8,397.10

$0.00

$0.00

$0.00 $430,921.29

$0.00 $27,991.94

1999 Balance Due

1999And 2000 Total Assessment

$356.37 $346.75
$72.20 $114.44 $181.22 $211.02 $327.50
$64.43 $54.38
$0.00 $0.00 $69.44 $3.88 $108.18 $182.65 $0.00 $159.25 $1.44 ($74,924.32) $0.00 $378.52 $19.59 $245.50 $111.49 $227.30 $55,809.88 $114.67 $19.60 $70.83 $248.88 $39.93 $162.18 $89.43 $18.55 $229.64 $735.43 $203,66 $210.88 $0.23 $269.03

$38,496.94 $44,607.50
$4,968.31 $3,287.17 $41,774.17 $5,680.02 $64,030.79
$995.74 $10,433.10
$2,443.77 $560.69
$4,602.42 $3.88
$6,549.13 $21,637.24
$2,738.55 $15,191.36
$13.08 ($74,924.32)
$1,272.12 $44,508.97
$3,592.84 $16,862.11
$6,557.93 $40,535.95 $81,577.11 $13,386.66 $26,090.48 $18,431.04 $26,092.97
$6,640.84 $16,465.89 $15,288.97
$786.91 $18,234.27 $53,582.50
$8,600.76 $210.88 $0.23
$28,260.97

86

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

SAVANNAH CITY OF SAVANNAH ELECTRIC & POWER SCIENTIFIC-ATLANTA INC SHAW INDUSTRIES INC SHEPHERD MEDICAL CENTER SHERWIN-WILLIAMS COMPANY SHONEY'S & COMMISSARY INC SILVER DOLLAR CITY INC SIZEMORE ,INC. SKF USA INC SNELL CONTRACTORS SONOCO PRODUCTS COMPANY SOUTH GEORGIA MEDICAL CEN SOUTHDOWN INC. SOUTHEAST GA HLTH SYSTEM SOUTHEAST-ATLANTIC BEVERA SOUTHEASTERN FREIGHT LINE SOUTHEASTERN MILLS, INC SOUTHERN AMBULANCE BUILD SOUTHERN COMPANY SERVICE SOUTHERN MILLS INC SOUTHERN NUCLEAR OPERATI SOUTHERN PAN SERVICES SOUTHWIRE COMPANY SPALDING & EVENFLO COMPAN SPALDING CO BOARD OF COMM SPRINGS INDUSTRIES INC ST FRANCIS HOSPITAL ST JOSEPH HOSPITAUAUGUST

$201,266.05 $20,333.24 $70,475.23
$671,178.52 $5,784.28
$22,639.50 $17,584.93
$7,845.86 $31,779.29 $25,838.00 $15,829.96
$9,579.61 $32,260.56 $13,565.94 $53,867.72
$2,277.33 $77,339.31 $114,880.37
$7,963.74 $7,588.98 $10,551.59 $14,614.85 $29,123.12 $153,736.28 $11,340.77 $6,611.61 $71,230.92 $27,624.93 $26,095.15

$202,828.59 $20,491.10 $71,022.37
$676,389.26 $5,829.19
$22,815.27 $17,721.46
$7,906.77 $32,026.01 $26,038.59 $15,952.85
$9,653.98 $32,511.02 $13,671.26 $54,285.93
$2,295.01 $77,939.74 $115,772.25
$8,025.56 $7,647.90 $10,633.51 $14,728.31 $29,349.22 $154,929.82 $11,428.82 $6,662.94 $71,783.92 $27,839.39 $26,297.74

ST MARYS, CITY OF STAFFMARK, INC. STANLEY WORKS & SUBSIDIARI STONE CONTAINER CORPORATI SUPER DISCOUNT MARKETS SUPERIOR RIGGING & ERECTIN SUPERIOR UNIFORM GROUP SUTHERLAND'S EGGS SYNTHETIC INDUSTRIES, INC T. M. POLYFILM, INC TANNER HEALTH SERVICES

$1,438.90 $59,862.22 $14,748.34 $43,513.05 $16,441.58 $19,350.95
$3,775.09 $9,095.53 $91,655.86 $3,097.42 $15,406.94

$1,450.07 $60,326.97 $14,862.84 $43,850.86 $16,569.22 $19,501.18
$3,804.40 $9,166.14 $92,367.44 $3,121.47 $15,526.55

2000 Claims Paid

2000 Assessment Amt

$2,055,526.08 $186,380.80 $288,286.75
$8,256,829.40 $69,867.19
$117,436.00 $1,311,521.01
$198,544.59 $350,434.75
$59,425.00 $141,277.70
$76,101.11 $419,864.66 $114,681.14 $745,240.02
$70,294.37 $469,662.46 $879,888.41 $200,885.00 $2,455,399.00 $154,000.00 $349,937.00 $396,287.04 $1,552,917.22
$0.00 $72,061.00 $1,119,137.50 $222,995.02 $208,265.79
$0.00 $411,938.54
$25,578.00 $65,347.56 $632,632.38 $181,700.28 $25,792.83 $43,689.87 $1,188,511.33 $42,716.95 $233,229.58

$133,523.62 $12,106.99 $18,726.64
$536,350.18 $4,538.46 $7,628.45
$85,194.27 $12,897.13 $22,763.67
$3,860.15 $9,177.17 $4,943.40 $27,273.72 $7,449.50 $48,409.58 $4,566.21 $30,508.51 $57,156.12 $13,049.16 $159,498.72 $10,003.59 $22,731.34 $25,742.16 $100,874.97
$0.00 $4,680.97 $72,697.35 $14,485.39 $13,528.61
$0.00 $26,758.86
$1,661.51 $4,244.87 $41,094.77 $11,802.95 $1,675.46 $2,838.02 $77,203.76 $2,774.82 $15,150.21

1999 Balance Due

1999 And 2000 Total Assessment

$1,562.54 $157.86 $547.14
$5,210.74 $44.91
$175.77 $136.53
$60.91 $246.72

$135,086.16 $12,264.85 $19,273.78
$541,560.92 $4,583.37 $7,804.22
$85,330.80 $12,958.04 $23,010.39

$200.59 $122.89
$74.37 $250.46 $105.32 $418.21
$17.68 $600.43 $891.88
$61.82 $58.92 $81.92 $113.46 $226.10 $1,193.54 $88.05 $51.33 $553.00 $214.46 $202.59 $11.17 $464.75 $114.50 $337.81 $127.64 $150.23 $29.31 $70.61

$4,060.74 $9,300.06 $5,017.77 $27,524.18 $7,554.82 $48,827.79 $4,583.89 $31,108.94 $58,048.00 $13,110.98 $159,557.64 $10,085.51 $22,844.80 $25,968.26 $102,068.51
$88.05 $4,732.30 $73,250.35 $14,699.85 $13,731.20
$11.17 $27,223.61 $1,776.01
$4,582.68 $41,222.41 $11,953.18
$1,704.77 $2,908.63

$711.58 $24.05
$119.61

$77,915.34 $2,798.87 $15,269.82

87

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit 2000 Assessment
1999 Assessment Adjustment Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

TARGET CORPORATION TECUMSEH PRODUCTS COMPA TENNECO AUTOMOTIVE, INC TERMINIX SERVICE, INC TEXTILE RUBBER & CHEMICAL TEXTRON, INC THERMAL CERAMICS THOMASTON MILLS INC THOMASVILLE CITY OF THREE SPRINGS INC. TIFTON ALUMINUM CO INC TIP TOP POULTRY INC TRC STAFFING SERVICES, INC TRI-STATE STEEL DRUM INC/WS TROUP CO. BOARD OF EDUCATI TYSON FOODS INC UNILEVER UNITED STATES UNION CAMP CORPORATION UNITED AIRLINES UNITED CATALYSTS, INC UNIVERSITY HOSPITAL USF HOLLAND, INC. USG CORPORATION VALDOSTA CITY OF VERMONT AMERICAN CORPOR VF CORPORATION VISITING NURSE HEALTH SYSTE VULCAN MATERIALS COMPANY WACHOVIA WAFFLE HOUSE WAGGONERS TRUCKING CO., T WALKER COUNTY BD OF EDUCA WAREHOUSE HOME FURNISHIN WARNER ROBINS CITY OF WARREN FEATHERBONE COMP WARREN SEWELL MFG. CO. WATKINS ASSOCIATED INDUST WATKINS ENGINEERS & CONST. WAYCROSS MOLDED PRODUCT WAYCROSS, CITY OF

$156,316.04 $46,882.86 $23,362.53 $458.22 $15,845.04 $99,634.02 $20,010.48 $28,249.04 $36,471.69 $9,060.77 $40,763.86 $40,913.78 $5,5,414.53 $4,063.16 $3,647.39 $188,676.64 $5,460.64 $30,148.13 $27,549.45 $797.34 $40,371.35 $905.03 $1,774.58 $21,106.49 $280.54 $19,546.06 $23,702.69 $27,794.75 $51,446.74
$199,039.27 $31,430.05 $8,905.95 $51,710.89 $6,054.62 $3,496.98 $17,903.41 $58,832.32 $32,120.43 $27,876.19 $27,390.50

$157,529.61 $47,246.84 $23,543.91 $461.78 $15,968.06
$100,407.54 $20,165.83 $28,468.35 $36,754.84 $9,131.12 $41,080.33 $41,231.42 $55,844.74 $4,094.70 $3,675.71 $190,141.45 $5,503.03 $30,382.18 $27,763.33 $803.53 $40,684.77 $912.06 $1,788.35 $21,270.36 $282.72 $19,697.81 $23,886.70 $28,010.54 $51,846.15
$200,584.53 $31,674.06 $8,975.09 $52,112.35 $6,101.62 $3,524.13 $18,042.40 $59,289.06 $32,369.80 $28,092.61 $27,603.15

2000 Claims Paid

2000 Assessment Amt

$1,286,161.57 $605,383.12 $121,538.45 $11,373.67 $212,869.00
$1,069,484.05 $159,553.36 $304,801.89 $172,307.74 $108,580.46 $38,023.79 $270,222.57 $359,283.65 $0.00 $50,651.48
$2,165,212.55 $84,634.39 $0.00
$236,671.13 $23,258.22
$402,893.74 $35,077.04 $90,624.25
$208,948.60 $2,704.85 $0.00
$213,613.96 $345,371.72 $426,034.00 $1,606,570.72 $250,105.04
$86,213.90 $752,218.76 $251,107.40
$30,313.00 $598,703.51 $1,085,392.14 $394,888.62 $340,402.54 $137,160.31

$83,546.96 $39,324.70
$7,894.94 $738.82
$13,827.62 $69,471.94 $10,364.33 $19,799.43 $11,192.83
$7,053.21 $2,469.96 $17,553.22 $23,338.48
$0.00 $3,290.24 $140,648.68 $5,497.71
$0.00 $15,373.77
$1,510.82 $26,171.32
$2,278.55 $5,886.80 $13,572.96
$175.70 $0.00
$13,876.01 $22,434.78 $27,674.47 $104,360.22 $16,246.42
$5,600.31 $48,862.90 $16,311.53
$1,969.08 $38,890.80 $70,505.30 $25,651.32 $22,111.99
$8,909.71

1999 Balance Due

1999 And 2000 Total Assessment

$1,213.57 $363.98 $181.38 $3.56 $123.02 $773.52 $155.35 $219.31 $283.15 $70.35 $316.47 $317.64 $430.21 $31.54 $28.32
$1,464.81 $42.39
$234.05 $213.88
$6.19 $313.42
$7.03 $13.77 $163.87
$2.18 $151.75 $184.01 $215.79 $399.41 $1,545.26 $244.01
$69.14 $401.46
$47.00 $27.15 $138.99 $456.74 $249.37 $216.42 $212.65

$84,760.53 $39,688.68
$8,076.32 $742.38
$13,950.64 $70,245.46 $10,519.68 $20,018.74 $11,475.98
$7,123.56 $2,786.43 $17,870.86 $23,768.69
$31.54 $3,318.56 $142,113.49 $5,540.10
$234.05 $15,587.65 $1,517.01 $26,484.74 $2,285.58 $5,900.57 $13,736.83
$177.88 $151.75 $14,060.02 $22,650.57 $28,073.88 $105,905.48 $16,490.43 $5,669.45 $49,264.36 $16,358.53 $1,996.23 $39,029.79 $70,962.04 $25,900.69 $22,328.41 $9,122.36

88

Georgia Subsequent Injury Trust Fund Assessment Adjustment - Debit/Credit
2000 Assessment 1999 Assessment Adjustment
Self-Insured Companies

Company Name

1999 Assessment Amt

1999 Assessment Adjustment Amt

2000 Claims Paid

2000 Assessment Amt

1999 Balance Due

1999 And 2000 Total Assessment

WCI OUTDOOR PRODUCTS INC WELLINGTON LEISURE PRODUC WELLSTAR HEALTH SYSTEM WENDY'S INTERNATIONAL INC WEST GEORGIA HEALTH SYSTE WEST POINT STORES INC WESTVACO CORPORATION & S WEYERHAEUSER COMPANY WHITFIELD CO-BD OF EDUCATI WHITFIELD COUNTY BD OF COM WILLAMETTE INDUSTRIES, INC. WINN-DIXIE STORES INC YELLOW FREIGHT SYSTEM INC YKK CORPORATION OF AMERI

$55,990.43 $7,005.12
$138,498.94 $9,638.48
$24,161.48 $43,302.68 $13,841.41 $57,726.70 $11,913.14
$7,808.23 $5,685.07 $498,253.30 $76,341.55 $27,895.50

$56,425.11 $7,059.50
$139,574.19 $9,713.31
$24,349.06 $43,638.87 $13,948.87 $58,174.87 $12,005.63 $7,868.85 $5,729.21 $502,121.52 $76,934.24 $28,112.07

$567,653.48 $131,612.90 $1,753,414.86 $103,927.89
$10,665.06 $317,830.08 $110,737.75 $525,781.03 $158,849.37 $166,748.90
$54,669.00 $4,148,167.32
$542,320.05 $214,243.48

$36,873.84 $8,549.36
$113,898.97 $6,750.99 $692.78
$20,645.72 $7,193.34
$34,153.88 $10,318.60 $10,831.74
$3,551.21 $269,458.19
$35,228.23 $13,916.91

$434.68 $54.38
$1,075.25 $74.83
$187.58 $336.19 $107.46 $448.17 $92.49 $60.62
$44.14 $3,868.22
$592.69 $216.57

$37,308.52 $8,603.74
$114,974.22 $6,825.82 $880.36 $20,981.91 $7,300.80 $34,602.05
$10,411.09 $10,892.36
$3,595.35 $273,326.41
$35,820.92 $14,133.48

Total:

454 Grand Total: $24,615,699.78

$24,747,213.91 $260,877,704.88 $16,946,190.50

$131,514.13

$17,077,704.63

89