2007 annual report

State of Georgia Subsequent Injury Trust Fund
2007 Annual Report

Subsequent Injury Trust Fund 2007 Annual Report

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State of Georgia Subsequent Injury Trust Fund
1720 Peachtree Street, Suite 500 Atlanta, Georgia 30309-2462
Telephone: (404) 206-6360 Fax: (404) 206-6363
Website: http://sitf.georgia.gov
Board of Trustees John T. Fervier, II Chairman
Jimmy C. Beck, Sr. James F. Braswell
E. Pauline Hale
Administrator Richard W. McGee
Deputy Administrator David L. Taylor

Subsequent Injury Trust Fund 2007 Annual Report

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Contents
Fund Administration ....................................................................................................................... 4 Introduction ................................................................................................................................ 4 How the Fund Works .................................................................................................................. 4 Reimbursement from the Fund .................................................................................................. 4 Claims Administration................................................................................................................. 5 Claims Activity 2007 ................................................................................................................. 5
Financial Activity ............................................................................................................................. 6 Legislation ....................................................................................................................................... 7 Claims Reported for 2007 ............................................................................................................... 9
Claims Reported by Insurance Companies ................................................................................. 9 Claims Reported by Group Self-Insured Companies................................................................. 13 Claims Reported by Self-Insured Companies............................................................................ 14 Reimbursements Paid in 2007 ...................................................................................................... 18 Reimbursements Paid to Insurance Companies ....................................................................... 18 Reimbursements Paid to Group Self-Insured Companies ........................................................ 24 Reimbursements Paid to Self-Insured Companies ................................................................... 25 Individual Employers Benefiting from Reimbursements.......................................................... 32 Assessment for 2007..................................................................................................................... 74 Legal Requirements .................................................................................................................. 74 Assessment Calculation ............................................................................................................ 75 Assessment Adjustment for 2006............................................................................................. 75 Assessment Rate for 2007 ........................................................................................................ 76 Assessment Due from Insurance Companies ........................................................................... 77 Assessment Due from Group Self-Insured Companies............................................................. 86 Assessment Due from Self-Insured Companies........................................................................ 87

Subsequent Injury Trust Fund 2007 Annual Report

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FUND ADMINISTRATION
Introduction
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 permanent 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. The administrator with a staff of 30 employees conducts the actual administration of the fund.
How the Fund Works
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. The fund supports 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 on-the-job injury of the employee must be directly caused by or combined with a prior impairment to create a greater 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.
O.C.G.A.34-9-361 contains a list of conditions that are presumed to be permanent and likely to be a hindrance to employment provided the employer could demonstrate prior knowledge.
Reimbursement from the Fund
All licensed workers' compensation insurance carriers and self-insured employers authorized by the State Board of Workers' Compensation in the state of Georgia may access the fund.
Employers/insurers must notify the fund of a possible claim by filing a Notice of Claim no later than 78 weeks following the date of injury.
In addition to the mandatory Notice of Claim, the employer must submit a notarized Employer's Knowledge Affidavit, certifying prior knowledge of the worker's pre-existing permanent impairment.

Subsequent Injury Trust Fund 2007 Annual Report

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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.

Claims Administration
The employer/insurer maintains management of the employee's claim for the life of that claim. Once the fund has been notified of the claim, the employer/insurer must keep the fund informed of all developments, including settlement negotiations.
The fund investigates the claim to determine eligibility for reimbursement. When a reimbursement agreement is reached between the fund and the employer/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.

Claims Activity 2007
The following is a breakdown of claims activity for calendar year 2007. For information on prior years, please call (404) 206-6357 or visit our website at www.sitf.georgia.gov.

Claims Accepted Claims Closed Claims Denied Claims Received Closed Claims Reopened Notices in Pending Open Claims Open Claims

Calendar Year 2007 Calendar Year 2007 Calendar Year 2007 Calendar Year 2007 Calendar Year 2007 Calendar Year 2007 January 1, 2007 December 31, 2007

1,596 14,848
81 2,310 1,359 5,386 20,889 9,710

Subsequent Injury Trust Fund 2007 Annual Report

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FINANCIAL ACTIVITY
The following depicts the fund's revenues, expenditures, and fund balance for the calendar year ending December 31, 2007. The fund's year-end balance is part of the formula for establishing the annual assessment. For information on prior years, please call (404) 206-6357 or visit our website at http://sitf.georgia.gov

BEGINNING BALANCE, January 1, 2007

REVENUES

Assessment - 2006, Adjusted 2005 201,810,566.12

payments and refunds from prior year

64,938.18

Interest

4,009,678.76

58,919,196.07

TOTAL REVENUES

EXPENDITURES

Operating Cost

2,628,416.85

Reimbursements (Negotiated Checks)

TOTAL EXPENDITURES

Net Gain

ENDING BALANCE, December 31, 2007

205,885,183.06
146,157,317.15 148,785,734.00
57,099,449.06

116,018,645.13

Subsequent Injury Trust Fund 2007 Annual Report

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LEGISLATION
In 2006, an amendment was passed to OCGA 34-9-362 to establish time limits for employers or insurers to satisfactorily prove a claim once filed with the Subsequent Injury Trust Fund.
34-9-362. Notice by employer or insurer of claim against fund.
(a) An employer or insurer shall notify the administrator of the fund of any possible claim against the fund as soon as practicable, but in no event later than 78 calendar weeks following the injury or the payment of an amount equivalent to 78 weeks of income or death benefits, whichever occurs last.
(b) The claim must be filed in accordance with the requirements of subsection (a) of this Code section prior to the final settlement of the claim.
(c) Failure to comply with the provisions of subsections (a) and (b) of this Code section will constitute a bar to recovery from the Subsequent Injury Trust Fund.
(d) For those notices of claim filed with the fund on or before July 1, 2006, the employer or insurer shall have until June 30, 2009, to obtain a reimbursement agreement issued by the fund or the claim for reimbursement shall be deemed automatically denied.
(e) For those notices of claim filed with the fund after July 1, 2006, the employer or insurer shall have three years from the date the notice was received by the fund to obtain a reimbursement agreement issued by the fund or the claim for reimbursement shall be deemed automatically denied.
(f) Notwithstanding subsections (d) and (e) of this Code section, if compensability of the underlying workers' compensation claim is at issue before the State Board of Workers' Compensation, then the employer or insurer shall have three years from the date of final adjudication of compensability by the State Board of Workers' Compensation or any appellate court to obtain a reimbursement agreement issued by the fund or the claim for reimbursement shall be deemed automatically denied.
(g) Upon actual or statutory automatic denial pursuant to subsection (d), (e), or (f) of this Code section, the employer or insurer shall have 20 days from the date of denial to request a hearing with the State Board of Workers' Compensation pursuant to Code Section 34-9100; otherwise recovery shall be barred.

Subsequent Injury Trust Fund 2007 Annual Report

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In 2005, House Bill 200 amended the Official Code of Georgia by adding Chapter 34-9368 establishing June 30, 2006 as the last date of injury eligible for reimbursement by the Fund.
34-9-368. Reimbursement of self-insured employers or insureds; actuarial study required; dissolution of Subsequent Injury Trust Fund
(a) The Subsequent Injury Trust Fund shall not reimburse a self-insured employer or an insurer for a subsequent injury for which a claim is made for an injury occurring after June 30, 2006. The Subsequent Injury Trust Fund shall continue to reimburse self-insured employers or insurers for claims for injuries occurring on and prior to June 30, 2006, which qualify for reimbursement.
(b) Self-insured employers and insurers shall continue to pay assessments pursuant to Code Section 34-9-358 to the extent necessary to fund claims for injuries occurring on and prior to June 30, 2006.
(c) Upon or in contemplation of the final payment of all claims filed for subsequent injuries for which claims are filed for injuries occurring on and prior to June 30, 2006, the board of trustees shall adopt and implement resolutions providing for the final dissolution of the Subsequent Injury Trust Fund. Such resolutions shall become effective when all claims made for injuries occurring on and prior to June 30, 2006, have been fully paid or otherwise resolved and shall include provisions for:
(1) The termination of assessments against insurers or self-insurers;
(2) The pro rata refund of assessments previously collected and unexpended;
(3) The termination of employment of the employees of the fund or the transfer of employment of any employees to any other state agency desiring to accept them;
(4) A final accounting of the financial affairs of the fund; and
(5) The transfer of the books, records, and property of the fund to the custody of the State Board of Workers' Compensation.
Upon the completion of all matters provided for in such resolutions, but not later than December 31, 2020, the Subsequent Injury Trust Fund and the members of its board of trustees shall be discharged from their duties except for such personnel necessary to administer any remaining claims.

Subsequent Injury Trust Fund 2007 Annual Report

CLAIMS REPORTED FOR 2007
Claims Reported by Insurance Companies
For the period January 1, 2007 December 31, 2007
Insurance Company
ACCIDENT FUND INS CO OF AMER ACE AMERICAN INSURANCE CO ACE FIRE UNDERWRITERS INS. CO ACE INDEMNITY INSURANCE CO ACE PROPERTY & CASUALTY INS ADVANTAGE WORKERS COMP. INS. AIG NATIONAL INS. CO. AIG PREMIER INSURANCE CO ALEA NORTH AMERICA ALL AMERICA INS. CO AMCOMP ASSURANCE AMCOMP PREFERRED AMERICAN CAS CO OF READING PA AMERICAN GUAR & LIAB INS CO AMERICAN HOME ASSURANCE CO AMERICAN INSURANCE CO AMERICAN INTER INS CO OF GA AMERICAN INTERN. SOUTH INS CO AMERICAN INTERNATIONAL INS CO AMERICAN ZURICH INS CO AMGUARD INSURANCE CO. ARCH INSURANCE CO ARGONAUT INSURANCE CO ASSOCIATED INDUSTRIES INS CO ASSOCIATION CASUALTY INS CO ASSOCIATION INSURANCE CO ASSURANCE CO. OF AMERICA ATLANTIC SPECIALTY INS CO AUTO OWNERS INS. CO BITUMINOUS CASUALTY CORP BRIDGEFIELD CASUALTY BUILDERS INSURANCE CANAL INSURANCE CO CAPITAL CITY INS CO CHARTER OAK FIRE INS CO

Claims Reported
1 93 2 1 1 1 6 1 3 1 13 2 36 3 58 7 7 21 2 20 8 1 1 1 1 8 2 1 15 2 18 25 4 13 2

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Subsequent Injury Trust Fund 2007 Annual Report
Insurance Company
CINCINNATI INDEMNITY CO CLARENDON NATIONAL INS CO COLONIAL AMERICAN CAS & SURETY COMMERCE & INDUSTRY INS CO COMMERCIAL MUTUAL INS CO COMPANION COMMERCIAL INS CO COMPANION PROP & CAS CONNECTICUT INDEMNITY CO CONTINENTAL CASUALTY CO CONTINENTAL INSURANCE CO CORNERSTONE MUTUAL INS CO CRUM & FOSTER INDEMNITY CO CUMIS INS SOCIETY INC CYPRESS INSURANCE CO EASTGUARD INSURANCE CO ELECTRIC INSURANCE CO EMPLOYERS INS OF WAUSAU EMPLOYERS REINSURANCE CORP EXCELSIOR INSURANCE CO FCCI INSURANCE COMPANY FEDERAL INSURANCE CO FEDERATED MUTUAL INS CO FIDELITY & DEPOSIT CO OF MD FIDELITY & GUARANTY INS CO FIREMAN'S FUND INS CO FIRST LIBERTY INS CORP GA RESTAURANT MUTUAL CAP INS C GA TIMBER HARVERSTERS' GEORGIA CASUALTY & SURETY CO GRANITE STATE INS CO GREAT AMER INS CO OF NY GREAT AMERICAN ASSUR CO GREAT DIVIDE INS CO GREAT WEST CASUALTY CO HANOVER INSURANCE CO HARTFORD ACCIDENT & INDEMNITY HARTFORD CASUALTY INS CO HARTFORD FIRE INSURANCE CO HARTFORD INS CO OF S.E. HARTFORD INS OF THE MIDWEST HARTFORD UNDERWRITERS INS

Claims Reported
1 1 1 39 2 1 18 3 13 1 1 1 1 1 1 4 5 6 1 6 19 2 1 46 1 2 3 2 6 3 3 2 2 5 1 1 40 88 14 12 63

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Subsequent Injury Trust Fund 2007 Annual Report
Insurance Company
HEALTH CARE MUTUAL CAPTIVE IMPERIAL CASUALTY & IND. CO INDEMNITY INS CO OF NA INSURANCE CO OF STATE OF PA KEY RISK INSURANCE CO LIBERTY INSURANCE CORP LIBERTY MUTUAL FIRE INS LIBERTY MUTUAL INSURANCE CO LINCOLN GENERAL INS CO LM INSURANCE CORP LUMBERMENS MUTUAL CAS CO MARYLAND CASUALTY COMPANY MIDWEST EMPLOYERS CASUALTY CO MITSUI SUMITOMO INS CO OF AMER MITSUI SUMITOMO INS USA, INC NATIONAL FIRE INS CO HARTFORD NATIONAL LIABILITY & FIRE INS NATIONAL SURETY CORP NATIONAL TRUST INSURANCE CO NATIONAL UNION FIRE OF PITT PA NATIONWIDE MUTUAL FIRE INS CO NATIONWIDE MUTUAL INS CO NETHERLANDS INSURANCE CO NEW HAMPSHIRE INSURANCE CO NORGUARD INSURANCE CO. NORTH AMERICAN SPECIALTY INS OLD DOMINION INSURANCE CO OLD REPUBLIC INSURANCE CO OWNERS INSURANCE CO PACIFIC EMPLOYERS INSURANCE PEERLESS INSURANCE COMPANY PENN LUMBERMENS MUTUAL PENN MFG ASSOC INS PROVIDENCE PROP & CAS INS CO PUBLIC SERVICE MUTUAL INS CO RELIANCE INS CO IN LIQUIDATION SAFETY NATIONAL CASUALTY SELECTIVE INS CO OF AMERICA SELECTIVE INS CO OF SE SELECTIVE INSURANCE CO OF SC SENTRY INSURANCE A MUTUAL CO

Claims Reported
9 1 35 44 19 36 10 6 1 5 2 2 1 1 2 11 2 1 5 2 1 1 3 22 14 1 1 35 2 2 3 1 12 6 1 2 3 1 1 3 9

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Subsequent Injury Trust Fund 2007 Annual Report

Insurance Company

SENTRY SELECT INSURANCE CO

SOUTHEASTERN U.S. INS., INC

SOUTHERN GUARANTY INSURANCE CO

SOUTHERN MUTUAL CHURCH INS

ST PAUL FIRE & CASUALTY INS CO

ST PAUL FIRE & MARINE INS CO

ST PAUL MERCURY INS CO

STATE FARM FIRE & CASUALTY CO

SUA INSURANCE COMPANY

TECHNOLOGY INSURANCE CO

TOKIO MARINE & NICHIDO FIRE

TRANSCONTINENTAL INS CO

TRANSPORTATION INSURANCE CO

TRAVELERS CAS & SUR CO

TRAVELERS CAS INS CO OF AMER

TRAVELERS COMMERCIAL INS CO

TRAVELERS INDEMNITY OF AMER

TRAVELERS PROP CAS CO OF AMER

TWIN CITY FIRE INSURANCE CO

UNITED BUSINESS INS CO (A MUTU

UNITED STATES FIRE INSURANCE

UNIVERSAL UNDERWRITERS INS

VALLEY FORGE INSURANCE CO

VIGILANT INSURANCE CO

VILLANOVA INS CO-IN LIQUIDATIO

VIRGINIA SURETY COMPANY, INC

WAUSAU BUSINESS INSURANCE

WAUSAU UNDERWRITERS INS CO

WESTFIELD INSURANCE CO

WESTPORT INSURANCE CORP

XL SPECIALTY INSURANCE CO

ZENITH INSURANCE CO

ZURICH AMERICAN INS CO

Total of Companies

153

Total:

Claims Reported
3 112 1 1 1 7 2 2 3 5 8 3 4 8 1 1 18 4 98 1 5 1 5 2 1 3 2 4 6 12 4 10 111 1572

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Subsequent Injury Trust Fund 2007 Annual Report

Claims Reported by Group Self-Insured Companies
For the period January 1, 2007 December 31, 2007

Group Self-Insured Company
AMBULANCE PROVIDERS ASSOC. ASSOCIATION CTY COM GA SI COMPTRUST AGC OF GEORGIA GA AUTO DEALERS ASSOCIATION SI GA EDUCATION WC TRUST FUND GA HOSPITAL ASSOC WCSI FUND GA MUNICIPAL ASSN WCSIF GA NURSING HOME SELECTIVE WC GA OILMEN'S ASSOCIATION GA OPERATORS SELF-INSURERS GA SCHOOL BD ASSOC W C FUND GTMA/AYSA SELF INSURANCE ROOFING & SHEET METAL ASSOC
Total of Companies 13

Total:

Claims Reported
1 19 8 2 16 6 25 1 3 6 35 5 2 129

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Subsequent Injury Trust Fund 2007 Annual Report

Claims Reported by Self-Insured Companies
For the period January 1, 2007 December 31, 2007
Self-Insured Company
A T & T AAA COOPER TRANSPORTATION AGL RESOURCES, INC. ALBANY, CITY OF AMERICAN NATIONAL RED CROSS AMOCO CORPORATION ANHEUSER-BUSCH COMPANIES, INC. ARCHBOLD MEDICAL CENTER ATHENS REG. HLTH SYS INC ATLANTA CITY OF ATLANTA PUBLIC SCHOOLS AUGUSTA-RICHMOND CO BD COMM AUTOZONE, INC AVERITT EXPRESS, INC BEAULIEU GROUP LLC BELLSOUTH CORPORATION BENTON-GEORGIA INC BLUE BIRD BODY COMPANY C T HARRIS INC CENTRAL GEORGIA HEALTH SYSTEMS CHATHAM COUNTY GEORGIA CHEROKEE CO BD OF COMMISSIONER CHEROKEE CO BD OF EDUCATION CHILDREN'S HEALTHCARE OF ATL CLAYTON COUNTY BD OF EDUCATION CLAYTON COUNTY COMMISSIONERS COATS & CLARK, INC. COBB COUNTY BD/COMMISSIONERS COBB COUNTY SCHOOL SYSTEM COCA-COLA ENTERPRISES INC CONTINENTAL TIRE N. AMER., INC COOPER TIRE AND RUBBER CRACKER BARREL OLD CNTRY STORE CRIDER'S POULTRY INC DEAN FOODS COMPANY DEKALB COUNTY BOARD-ED

Claims Reported
1 2 2 1 1 1 1 3 5 28 6 1 2 1 1 3 2 2 5 2 2 2 1 2 8 1 2 1 7 3 6 7 2 2 2 2

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Subsequent Injury Trust Fund 2007 Annual Report
Self-Insured Company
DEKALB COUNTY GOVERNMENT DEKALB REGIONAL HLTHCARE SYS DELHAIZE AMERICA INC. DELPHI CORPORATION DELTA AIRLINES, INC. DOLLAR GENERAL CORP DOUGHERTY COUNTY BOC DOUGHERTY COUNTY SCHOOL SYSTEM DOUGLAS ASPHALT COMPANY DOUGLAS CO BD OF COMMISSIONERS DOUGLAS, CITY OF EQUITY GROUP GA DIVISION FAYETTE COUNTY BD OF COMM FAYETTE COUNTY BD OF EDUCATION FEDERATED DEPARTMENT STORES FEDEX FREIGHT EAST FIELDALE FARMS CORPORATION FLEETWOOD HOMES OF GA INC FLOWERS FOODS INC. FLOYD HLTHCARE MGMT INC FLYING J, INC. FORD MOTOR COMPANY FORSYTH CO. BD. OF EDUCATION FREUDENBERG-NOK FULTON COUNTY BD OF EDUCATION FULTON COUNTY, GEORGIA GENERAL MOTORS CORPORATION GEORGIA POWER CO GEORGIA STATE OF GEORGIA-PACIFIC CORPORATION GLYNN COUNTY SCHOOLS GOLDEN PEANUT COMPANY GREAT DANE LTD PARTNERSHIP GULFSTREAM AEROSPACE CORP GWINNETT CO BD OF EDUCATION GWINNETT COUNTY BD OF COMMISS GWINNETT HOSPITAL SYSTEM HAVERTYS FURNITURE HENRY COUNTY BD OF COMMISSION HERCULES INCORPORATED HILTON HOTELS CORPORATION

Claims Reported
2 1 1 4 25 3 2 1 2 2 1 2 1 1 1 1 2 2 5 3 2 8 1 1 1 1 20 2 29 7 5 1 1 7 3 2 2 1 1 1 1

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Subsequent Injury Trust Fund 2007 Annual Report
Self-Insured Company
HOME DEPOT INC/HOME DEPOT USA HORTON HOMES, INC HOSPITAL AUTHORITY HOUSTON CTY HOUSTON COUNTY COMMISSIONERS HUTCHESON MEDICAL CENTER HYATT CORPORATION IKON OFFICE SOLUTIONS INGLES MARKETS INC INTERFACE, INC INTERNATIONAL PAPER COMPANY INTERSTATE PAPER LLC J H HARVEY COMPANY KELLOGG CO & SUBSIDIARIES KING & PRINCE SEAFOOD CORP. K-MART CORP KROGER COMPANY, THE LAGRANGE, CITY OF LANGDALE INDUSTRIES LAWRENCEVILLE, CITY OF LOWE'S HOME CENTERS, INC MACON CITY OF MAPLEHURST DELI-BAKE STH MARRIOTT INTERNATIONAL, INC. MARTA MCG HEALTH INC MEMORIAL MEDICAL CENTER MERCK & CO INC MOHAWK INDUSTRIES, INC MUSCOGEE COUNTY SCHOOL DIST NO COVERAGE NORMAN W FRIES/CLAXTON POULTRY NORTHEAST GEORGIA HEALTH SYS NORTHSIDE HOSPITAL OLD DOMINION FREIGHT LINES INC OWENS-ILLINOIS INC OXFORD CONSTRUCTION CO PCC AIRFOILS LLC PHOEBE PUTNEY MEMORIAL HOSP PIGGLY WIGGLY CAROLINA CO INC RHODES NURSING HOME ROCKWELL AUTOMATION, INC

Claims Reported
2 2 1 3 1 2 1 11 1 13 1 1 12 1 1 8 1 5 2 39 1 1 9 19 2 3 1 9 42 3 3 1 2 1 1 1 2 3 3 1 1

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Subsequent Injury Trust Fund 2007 Annual Report
Self-Insured Company
ROLLINS INC RUBY TUESDAY INC RYDER SYSTEM INC SAINT JOSEPH'S OF SAVANNAH SATILLA HEALTH SERVICES INC SAVANNAH CITY OF SHAW INDUSTRIES INC SHERWIN-WILLIAMS COMPANY SOUTHERN COMPANY SOUTHWIRE COMPANY SPRINGS INDUSTRIES INC ST JOSEPH HOSPITAL/AUGUSTA THREE SPRINGS INC. TYSON FOODS INC UNIVERSITY HOSPITAL WAREHOUSE HOME FURNISHINGS WARNER ROBINS CITY OF WATKINS ASSOCIATED INDUSTRIES WELLSTAR HEALTH SYSTEM WEST GEORGIA HEALTH SYSTEM WINN-DIXIE STORES INC YKK CORPORATION OF AMERICA Total of Companies 140

Total:

Claims Reported
4 3 1 2 1 4 18 6 7 6 1 5 1 31 11 2 4 2 2 1 1 2 611

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Subsequent Injury Trust Fund 2007 Annual Report

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REIMBURSEMENTS PAID IN 2007
Reimbursements Paid to Insurance Companies
For the period January 1, 2007 December 31, 2007

Insurance Company
ACE AMERICAN INSURANCE CO ACE PROPERTY & CASUALTY INS AEQUICAP INSURANCE CO AIG NATIONAL INS. CO. ALFA INSURANCE CORP ALLIED INSURANCE COMPANY ALLSTATE INSURANCE CO AMCOMP ASSURANCE AMCOMP PREFERRED AMERICAN ALTERNATIVE INS AMERICAN AUTOMOBILE INS CO AMERICAN CAS CO OF READING PA AMERICAN ECONOMY INS CO AMERICAN GUAR & LIAB INS CO AMERICAN HOME ASSURANCE CO AMERICAN INSURANCE CO AMERICAN INTER INS CO OF GA AMERICAN INTERN. SOUTH INS CO AMERICAN INTERNATIONAL INS CO AMERICAN MFG. MUTUAL INS AMERICAN MOTORISTS INS CO AMERICAN PROTECTION INS CO AMERICAN RESOURCES INS CO AMERICAN SAFETY CASUALTY INS AMERICAN STATES INS CO AMERICAN ZURICH INS CO AMERISURE INSURANCE CO AMGUARD INSURANCE CO. ARGONAUT GREAT CENTRL INS CO ARGONAUT INSURANCE CO ARGONAUT LIMITED RISK INS CO ARROWOOD INDEMNITY CO ARROWPOINT CAPITAL ASSOCIATED INDEMNITY CORP ASSOCIATION INSURANCE CO

Reimbursement Amount Paid
$904,155.81 $58,177.24 $4,244.58 $69,038.83 $77,290.20 $13,789.09 $44,840.48
$231,011.76 $298,093.99 $382,241.99
$1,669.12 $1,125,642.46
$32,737.07 $16,295.84 $1,036,821.04 $439,832.18 $1,318,600.63 $461,319.43 $9,704.20 $285,027.98 $244,488.00 $591,294.03 $23,469.69 $86,053.15 $34,352.72 $123,278.26 $39,806.01 $90,447.18 $373,783.16 $26,037.77 $43,128.40 $308,802.34 $1,215,796.43 $16,514.92 $70,082.07

Subsequent Injury Trust Fund 2007 Annual Report
Insurance Company
ATLANTIC MUTUAL INS. CO AUTO OWNERS INS. CO AXIS INSURANCE CO BANKERS STANDARD INS CO BITUMINOUS CASUALTY CORP BRIDGEFIELD CASUALTY BUILDERS INSURANCE CANAL INSURANCE CO CAPITAL CITY INS CO CENTENNIAL INSURANCE CO CENTRE INSURANCE CO CHARTER OAK FIRE INS CO CHUBB INDEMNITY INS CO CHURCH MUTUAL INS CO CINCINNATI INSURANCE CO CITIZENS INS CO OF AMERICA CLARENDON NATIONAL INS CO COLUMBIA NATIONAL INS CO COMMERCE & INDUSTRY INS CO COMMERCIAL MUTUAL INS CO COMPANION PROP & CAS CONNECTICUT INDEMNITY CO CONTINENTAL CASUALTY CO CONTINENTAL INSURANCE CO CORNERSTONE MUTUAL INS CO CORNERSTONE MUTUAL INS CO CRUM & FOSTER INDEMNITY CO CYPRESS INSURANCE CO DEERFIELD INSURANCE CO DISCOVER PROPERTY & CAS ELECTRIC INSURANCE CO ELECTRIC MUTUAL LIAB INS LTD EMC PROPERTY & CASUALTY EMPLOYERS INS OF WAUSAU EVEREST NATIONAL INS FAIRFIELD INSURANCE CO FAIRMONT PREMIER INS CO FARMLAND MUTUAL FCCI INSURANCE COMPANY FEDERAL INSURANCE CO FEDERATED MUTUAL INS CO

Reimbursement Amount Paid $484,805.07 $737,578.79 $44,293.35 $270,681.42 $318,094.61 $350,294.40
$3,207,277.09 $207,179.83 $261,578.30 $260,606.26 $27,686.04 $37,233.98 $17,810.33 $78,432.69 $758,734.67 $8,878.73 $584,670.20 $115,023.16 $121,371.42 $654,773.55 $188,112.32 $178,952.95
$1,480,657.67 $136,668.14 $305,343.43 $14,570.63 $136,705.34 $9,360.53 $66,567.91 $431,011.17 $30,569.66 $29,224.17 $1,409.30
$1,172,984.39 $1,002,795.59
$300,181.76 $18,983.42 $36,696.00
$243,387.26 $439,556.74 $657,722.96

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Subsequent Injury Trust Fund 2007 Annual Report
Insurance Company
FEDERATED RURAL ELECTRIC INS FEDERATED SERVICE INS CO FFVA MUTUAL INS CO FIDELITY & CAS CO OF NY FIDELITY & GUARANTY INS CO FIREMAN'S FUND INS CO FIREMAN'S FUND INS CO OF GA FIRST LIBERTY INS CORP FIRST NATL INS CO OF AMER FLORISTS' MUTUAL INS CO GA INSURERS INSOLVENCY POOL GA RESTAURANT MUTUAL CAP INS C GA TIMBER HARVERSTERS' GCAP MUTUAL CAPTIVE INS GENERAL ACCIDENT INS OF AMER GENERAL INS CO OF AMERIC GEORGIA CASUALTY & SURETY CO GERBER LIFE INS CO GLENS FALLS INS CO GRAY INSURANCE CO GREAT AMER INS CO OF NY GREAT AMERICAN INS CO GREAT WEST CASUALTY CO GULF INSURANCE COMPANY HANOVER INSURANCE CO HARBOR SPECIALITY INS HARLEYSVILLE MUTUAL INS CO HARLEYSVILLE-ATLANTIC INS CO HARTFORD ACCIDENT & INDEMNITY HARTFORD CASUALTY INS CO HARTFORD FIRE INSURANCE CO HARTFORD INS CO OF S.E. HARTFORD INS OF THE MIDWEST HARTFORD UNDERWRITERS INS HEALTH CARE MUTUAL CAPTIVE HOME INS. CO-IN LIQUIDATION HOSPITALITY MUT CAPTIVE INS HOUSTON GENERAL INS CO INDEMNITY INS CO OF NA INSURANCE CO OF N.A. INSURANCE CO OF STATE OF PA

Reimbursement Amount Paid $21,103.83 $2,276.36 $84,113.58 $32,314.42 $921,809.63 $939,197.50 $120,000.59 $7,128.57 $65,996.96 $13,969.62
$3,351,111.35 $182,957.10 $392,935.86 $137,694.93 $432,179.84 $9,111.41 $447,599.12 $7,577.23 $41,661.07 $18,426.94 $179,124.81 $162,712.59 $168,519.25 $42,400.70 $481,301.19 $15,021.29 $155,200.13 $63,679.30 $951,833.37
$1,342,332.24 $268,932.18 $262,403.63 $356,844.46 $457,525.52 $193,914.59 $16,350.66 $393,252.41 $255,107.35 $224,344.32 $26,885.78
$1,884,626.15

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Subsequent Injury Trust Fund 2007 Annual Report
Insurance Company
JEFFERSON PILOT FIN INS CO KEY RISK INSURANCE CO LEGION INS CO-IN LIQUIDATION LIBERTY INSURANCE CORP LIBERTY MUTUAL FIRE INS LIBERTY MUTUAL INSURANCE CO LM INSURANCE CORP LUMBERMENS MUTUAL CAS CO LUMBERMEN'S UNDERWRITING MAG MUTUAL INS CO MARYLAND CASUALTY COMPANY METLIFE INSURANCE CO OF CT. MIDWESTERN INDEMNITY CO MITSUI SUMITOMO INS CO OF AMER NATIONAL FIRE INS CO HARTFORD NATIONAL SURETY CORP NATIONAL TRUST INSURANCE CO NATIONAL UNION FIRE OF PITT PA NATIONWIDE MUTUAL INS CO NETHERLANDS INSURANCE CO NEW HAMPSHIRE INSURANCE CO NORGUARD INSURANCE CO. NORTHBROOK PROP & CAS INS CO OCCIDENTAL FIRE & CAS CO OF NC OHIO CASUALTY INSURANCE CO OLD REPUBLIC INSURANCE CO OLD REPUBLIC UNION INS CO ONEBEACON AMERICA INS CO ONEBEACON INSURANCE CO PACIFIC EMPLOYERS INSURANCE PACIFIC INDEMNITY CO PEERLESS INSURANCE COMPANY PENN LUMBERMENS MUTUAL PENN MFG ASSOC INS PENN MFG IND. CO PHARMACISTS MUTUAL INS CO PHOENIX INSURANCE CO PRINCETON INSURANCE CO PROVIDENCE WA INS CO OF N Y PROVIDENCE WASHINGTON INS CO REALM NATIONAL INS-IN LIQUIDAT

Reimbursement Amount Paid $70,479.87 $164,981.53 $338,381.14 $894,685.34 $934,911.66
$1,629,393.11 $50,390.11
$1,297,856.62 $1,151,130.22
$291,139.68 $300,980.52 $957,882.28
$9,098.00 $110,985.80 $751,933.76
$75,381.59 $750,308.61 $815,806.93
$5,385.30 $66,497.13 $136,937.76 $5,493.05 $35,018.11 $2,970.00 $32,156.11 $1,738,198.11 $94,840.33 $606,036.30 $250,655.64 $2,256,867.58 $32,046.03 $109,336.09 $192,551.05 $1,159,766.23 $28,442.14 $59,945.00 $219,919.74 $395,257.24 $52,350.37 $124,667.30 $8,322.16

Page | 21

Subsequent Injury Trust Fund 2007 Annual Report
Insurance Company
RELIANCE INS CO IN LIQUIDATION RELIANCE NAT INS CO IN LIQ. RELIANCE NAT. IND. IN LIQ. ROCHDALE INSURANCE COMPANY ROYAL INS CO OF AMERICA S.E. EMPLOYER MUT. CAP. INS CO SAFECO INSURANCE CO AMERICA SAFETY NATIONAL CASUALTY SECURITY INS CO OF HARTFORD SELECTIVE INS CO OF AMERICA SELECTIVE INS CO OF SE SELECTIVE INSURANCE CO OF SC SELECTIVE WAY INSURANCE CO SENTRY INSURANCE A MUTUAL CO SENTRY SELECT INSURANCE CO SOUTHEASTERN U.S. INS., INC SOUTHERN FIRE & CASUALTY CO SOUTHERN GUARANTY INSURANCE CO SOUTHERN TRUST INSURANCE CO ST PAUL FIRE & CASUALTY INS CO ST PAUL FIRE & MARINE INS CO ST PAUL GUARDIAN INS CO STANDARD FIRE INSURANCE CO STAR INSURANCE CO STATE AUTOMOBILE MUTUAL INS STATE FARM FIRE & CASUALTY CO TECHNOLOGY INSURANCE CO TIG INSURANCE CO TOKIO MARINE & NICHIDO FIRE TRANS PACIFIC INS CO TRANSCONTINENTAL INS CO TRANSPORTATION INSURANCE CO TRAVELERS CAS & SUR CO TRAVELERS INDEMNITY COMPANY TRAVELERS INDEMNITY OF AMER TRAVELERS PROP CAS CO OF AMER TWIN CITY FIRE INSURANCE CO U.S. FIDELITY & GUARANTY INS U.S. SPECIALTY INS. CO. UNITED BUSINESS INS CO (A MUTU UNITED STATES FIRE INSURANCE

Reimbursement Amount Paid $201,481.61 $4,864.60 $236,374.72 $109,832.37 $157,286.38 $118,116.13 $158,994.65 $42,055.64 $274,060.36 $131,288.12 $39,169.28 $238,839.93 $101,899.84 $490,895.47 $1,321.55
$1,340,275.49 $16,790.07 $69,672.86 $10,150.63 $79,742.92
$569,305.15 $10,080.00 $5,644.12 $64,636.59 $13,665.35 $79,686.32 $29,609.94
$172,091.08 $732,239.49
$18,620.00 $500,842.75 $1,433,114.78 $661,840.30 $181,587.10 $669,721.94 $2,065,175.89 $195,366.54 $278,721.41
$75,646.82 $344,682.01 $130,052.70

Page | 22

Subsequent Injury Trust Fund 2007 Annual Report
Insurance Company
UNIVERSAL UNDERWRITERS INS UTICA MUTUAL INSURANCE CO UTICA NATIONAL ASSURANCE CO VALLEY FORGE INSURANCE CO VIGILANT INSURANCE CO VIRGINIA SURETY COMPANY, INC WAUSAU GENERAL INS CO WAUSAU UNDERWRITERS INS CO WESTFIELD INSURANCE CO WESTPORT INSURANCE CORP WORK FIRST CASUALTY CO XL SPECIALTY INSURANCE CO YORK INSURANCE CO ZENITH INSURANCE CO ZURICH AMERICAN INS CO ZURICH AMERICAN INS CO OF IL Grand Total:

Reimbursement Amount Paid $316,388.74 $37,198.36 $31,950.25 $75,487.68 $28,135.96 $2,205.35 $14,845.75 $144,689.05 $54,305.54 $24,865.00 $13,730.25 $229,875.32 $67,018.63 $489,381.25
$1,650,974.83 $3,359,550.10 $77,463,241.61

Page | 23

Subsequent Injury Trust Fund 2007 Annual Report

Reimbursements Paid to Group Self-Insured Companies
For the period January 1, 2007 December 31, 2007

Group Self-Insured Company
AGRITRUST OF GEORGIA ASSOCIATION CTY COM GA SI COMPTRUST AGC OF GEORGIA CONSTRUCTION SUPPLIERS' ASSOC DALTON FLOOR COVERING MARKET GA AUTO DEALERS ASSOCIATION SI GA CONCRETE & PRODUCTS ASSOC GA EDUCATION WC TRUST FUND GA HOSPITAL ASSOC WCSI FUND GA MFG WORKERS' COMP. FUND GA MUNICIPAL ASSN WCSIF GA NURSING HOME SELECTIVE WC GA OILMEN'S ASSOCIATION GA OPERATORS SELF-INSURERS GA RETAIL MERCHANTS' GA SCHOOL BD ASSOC W C FUND GA WHOLESALE & RETAIL WC FUND GEMC WORKERS' COMP FUND GTMA/AYSA SELF INSURANCE SOUTHEASTERN LUMBER MFR ASSOC W. C. FUND FOR HEALTH CARE Grand Total:

Reimbursement Amount Paid $509,400.09
$2,975,241.28 $213,101.87 $469,195.98 $727.53 $95,927.96 $26,201.94 $536,317.76 $732,805.80 $4,529.00
$2,305,708.10 $116,136.05
$1,202,654.02 $196,572.05 $53,254.97
$1,472,465.04 $42,954.26
$1,027,987.74 $300,743.56 $36,975.36 $97,310.38
$12,397,637.70

Page | 24

Subsequent Injury Trust Fund 2007 Annual Report

Reimbursements Paid to Self-Insured Companies
For the period January 1, 2007 December 31, 2007

Self-Insured Company
A T & T AAA COOPER TRANSPORTATION ABF FREIGHT SYSTEM, INC ACUITY BRANDS AGL RESOURCES, INC. ALBANY, CITY OF ALLIED SYSTEMS LTD AMERICAN PROTEINS, INC ANHEUSER-BUSCH COMPANIES, INC. ANSON AGGREGATES ARCHBOLD MEDICAL CENTER ASPLUNDH TREE EXPERT CO ATHENS REG. HLTH SYS INC ATHENS-CLARKE COUNTY ATLANTA CITY OF AUGUSTA, CITY COUNCIL OF AUGUSTA-RICHMOND CO BD COMM AVERITT EXPRESS, INC BARTOW COUNTY BD OF EDUCATION BAYLINER MARINE CORPORATION BEAULIEU GROUP LLC BEAULIEU OF AMERICA BELLSOUTH CORPORATION BELLSOUTH ENTERPRISES INC BIBB COUNTY BD-COMMISSION BIG LOTS STORES, INC. BLACK & DECKER CORPORATION BLUE BIRD BODY COMPANY BLUE CIRCLE AMERICA BREMEN-BOWDEN INVESTMENT CO. BRUNO'S INC & SUBSIDIARIES BRUNSWICK, CITY OF C. W. MATTHEWS CONTRACTING INC CALIBER SYSTEM, INC. CANDLER HEALTH SYSTEM CARROLL CO. BOARD OF EDUCATION

Reimbursement Amount Paid $170,748.00 $87,351.45 $53,199.73 $230,873.22 $127,772.42 $239,624.26 $29,199.94 $20,427.40 $1,587.52 $14,098.88 $79,038.66 $131,380.00 $297,262.76 $46,420.02
$1,337,306.32 $2,611.53
$197,938.29 $134,897.71 $179,882.26 $309,032.11
$13,336.53 $74,479.25 $445,007.44 $19,773.68 $32,045.70 $40,818.11 $53,082.68 $2,458,155.33 $165,873.70 $37,258.47 $29,261.23 $60,859.61 $25,627.35 $74,321.11 $166,291.81 $528,651.16

Page | 25

Subsequent Injury Trust Fund 2007 Annual Report

Self-Insured Company
CATOOSA CO. BD. OF EDUCATION CEMEX (SOUTHDOWN INC.) CENTRAL GEORGIA HEALTH SYSTEMS CERTAINTEED CORPORATION CHATHAM AREA TRANSIT AUTHORITY CHATHAM COUNTY BD OF EDUCATION CHATHAM COUNTY GEORGIA CHEMICAL PRODUCTS CORP CHEROKEE CO BD OF COMMISSIONER CHEROKEE CO BD OF EDUCATION CHILDREN'S HEALTHCARE OF ATL CITIGROUP INC. CLAYTON COUNTY BD OF EDUCATION CLAYTON COUNTY COMMISSIONERS CMI INDUSTRIES INC. COATS & CLARK, INC. COBB COUNTY BD/COMMISSIONERS COBB COUNTY SCHOOL SYSTEM COCA-COLA COMPANY COCA-COLA ENTERPRISES INC COLLEGE PARK CITY OF COLONIAL GROUP COLUMBIA COUNTY BOE COLUMBUS CITY OF COLUMBUS FOUNDRIES INC COLUMBUS REGIONAL HEALTHCARE CONAGRA POULTRY CO CONTINENTAL TIRE N. AMER., INC COOPER INDUSTRIES, INC COOPER TIRE AND RUBBER COTTRELL INC COVINGTON, CITY OF COWETA CO BOARD OF EDUCATION COX ENTERPRISES INC CRACKER BARREL OLD CNTRY STORE CRIDER'S POULTRY INC CRISP COUNTY BD OF EDUCATION DALTON CITY OF DAN RIVER, INC. DEAN FOODS COMPANY DEKALB COUNTY BOARD-ED

Reimbursement Amount Paid $6,114.75 $9,670.20 $467,796.21 $44,440.71 $42,485.27 $84,039.09 $11,592.26 $41,419.49 $3,530.76 $30,980.57 $67,489.83 $10,336.67 $18,518.57 $363,807.25 $146,268.21 $6,572.70 $510,628.17 $455,978.24 $135,420.71 $41,813.44 $26,046.34 $52,287.63 $39,945.46 $14,524.51 $44.86 $43,417.91 $587,757.35 $149,934.44 $22,922.93 $540,733.44 $92,141.20 $6,647.15 $77,353.28 $70,865.00 $326,196.22 $11,724.57 $56,978.78 $192,255.29 $77,259.45 $60,458.48 $221,092.55

Page | 26

Subsequent Injury Trust Fund 2007 Annual Report

Self-Insured Company
DEKALB COUNTY GOVERNMENT DEKALB REGIONAL HLTHCARE SYS DELTA AIRLINES, INC. DOUGHERTY COUNTY BOC DOUGLAS ASPHALT COMPANY DOUGLAS CO BD OF COMMISSIONERS DOUGLAS COUNTY SCHOOLS DOUGLAS, CITY OF DRY BRANCH KAOLIN COMPANY E I DUPONT DE NEMOURS & CO ELBERTON GRANITE ASSOCIATION EMERSON ELECTRIC CO EMORY UNIVERSITY ESTES EXPRESS LINES FAYETTE COUNTY BD OF COMM FAYETTE COUNTY BD OF EDUCATION FEDERAL EXPRESS CORP FIELDALE FARMS CORPORATION FLEETWOOD HOMES OF GA INC FLORIDA ROCK INDUSTRIES INC FLOWERS FOODS INC. FLOYD CO. BD. OF COMMISSIONERS FLOYD COUNTY BD OF EDUCATION FLOYD HLTHCARE MGMT INC FORD MOTOR COMPANY FORSYTH CO BD OF COMMISSIONERS FORSYTH CO. BD. OF EDUCATION FORT JAMES CORP. FRIGIDAIRE CO MICROWAVE PRODS. FULTON COUNTY BD OF EDUCATION FULTON COUNTY, GEORGIA FULTON-DEKALB HOSPITAL AUTHY GA BAPTIST HEALTH CARE SYSTEM GA S.I. GUARANTY TRUST FUND GENERAL MOTORS CORPORATION GENUINE PARTS COMPANY GEORGIA DUCK & CORDAGE MILL GEORGIA POWER CO GEORGIA STATE OF GEORGIA-PACIFIC CORPORATION GLYNN COUNTY BOARD OF COMMSNRS

Reimbursement Amount Paid $473,908.27 $71,833.15
$1,512,146.64 $353,203.97 $101,431.12 $58,668.09 $115,435.00 $114,254.01 $84,065.11 $9,625.00 $25,112.31 $167,334.95 $928,076.33 $19,761.36 $19,387.68 $63,335.60 $314,615.31 $35,193.31 $178,435.51 $229,125.00 $77,710.17 $96,228.49 $6,218.67 $15,914.81 $215,156.76 $79,519.03 $80,238.21 $43,749.99 $14,300.00 $66,560.69 $145,832.10 $224,975.04 $84,353.16 $273,284.71
$2,462,053.81 $54,647.14 $11,925.00
$136,019.26 $12,912,427.38
$565,758.26 $96,235.15

Page | 27

Subsequent Injury Trust Fund 2007 Annual Report

Self-Insured Company
GLYNN COUNTY SCHOOLS GOLD KIST INC GREAT DANE LTD PARTNERSHIP GWINNETT CO BD OF EDUCATION GWINNETT COUNTY BD OF COMMISS GWINNETT HOSPITAL SYSTEM HALL COUNTY BOARD OF EDUCATION HAMILTON HEALTH CARE SYSTEM HAVERTYS FURNITURE HCA, INC. HENRY CO BOARD OF EDUCATION HERCULES INCORPORATED HON INDUSTRIES, INC. HORMEL FOODS CORP HORTON HOMES, INC HOUSTON COUNTY BD OF EDUCATION HOWARD SHEPPARD INC HUTCHESON MEDICAL CENTER HYATT CORPORATION IDA CASON CALLAWAY FOUNDATION ILLINOIS TOOL WORKS INC INGLES MARKETS INC INTERNATIONAL PAPER COMPANY J & J INDUSTRIES INC J H HARVEY COMPANY J. C. PENNEY COMPANY, INC. JOHN WIELAND HOMES, INC JONES COMPANY JONES COMPANY (THE) KELLEY MANUFACTURING COMPANY KELLOGG CO & SUBSIDIARIES KENNESTONE REGIONAL HEALTH KING & PRINCE SEAFOOD CORP. KLEEN-TEX INDUSTRIES K-MART CORP KROGER COMPANY, THE LAGRANGE, CITY OF LANGDALE INDUSTRIES LAWRENCEVILLE, CITY OF LEVI STRAUSS & CO LOW TEMP INDUSTRIES

Reimbursement Amount Paid $317,261.35 $11,247.62 $89,317.00 $647,690.38 $331,885.02 $80,936.59 $197,185.49 $259,792.15 $3,309.93 $7,059.10 $26,810.12 $25,610.22 $186,930.00 $94,699.12 $37,017.68 $129,684.10 $68,514.01 $367,006.21 $82,374.16 $15,189.98 $7,165.18 $554,313.86 $203,879.78 $30,034.66 $176,994.68 $99,730.72 $87,359.96 $97,213.39 $122,938.32 $91.55 $233,113.10 $84,474.03 $29,341.78 $37,702.90 $996,278.72 $738,054.22 $5,925.64 $67,957.02 $2,077.33 $774,144.43 $197,576.55

Page | 28

Subsequent Injury Trust Fund 2007 Annual Report
Self-Insured Company
LOWE'S HOME CENTERS, INC LOXCREEN COMPANY, INC. MACON CITY OF MARIETTA CITY SERVICES MARRIOTT INTERNATIONAL, INC. MARTA MCKENZIE TANK LINES INC MCLANE COMPANY, INC. MEAD CORPORATION MEADWESTVACO MEMORIAL MEDICAL CENTER MERCK & CO INC MILLEDGEVILLE, CITY OF MOHAWK INDUSTRIES, INC MOUNT VERNON MILLS MULLITE CO OF AMERICA MUSCOGEE COUNTY SCHOOL DIST NABISCO, INC NATIONAL SERVICES INDUSTRIES NEWTON COUNTY NEWTON COUNTY BD OF EDUCATION NORTHEAST GEORGIA HEALTH SYS NORTHSIDE HOSPITAL OLD DOMINION FREIGHT LINES INC OLIVER RUBBER CO OWENS-CORNING OWENS-ILLINOIS INC PARKER HANNIFIN CORP. PCC AIRFOILS LLC PEPSICO, INC PHOEBE PUTNEY MEMORIAL HOSP PIEDMONT HOSPITAL QUEEN CARPET CORPORATION QUIKTRIP CORPORATION RACETRAC PETROLEUM, INC RALSTON PURINA COMPANY RICHMOND COUNTY BD OF COMMISS RICHMOND CTY BD OF EDUCATION RIVERDALE, CITY OF RMC USA, INC. ROCKDALE CO. BD OF EDUCATION

Reimbursement Amount Paid $403,486.05 $4,779.26 $163,953.73 $127,970.88 $274,455.34 $861,236.53 $13,950.00 $13,636.68 $238,291.18 $129,844.25 $154,393.96 $46,094.21 $7,626.37
$1,813,185.10 $196,120.08 $16,205.24 $80,584.89 $284,337.46 $15,626.14 $4,294.62 $168,160.85 $8,325.00 $646,753.35 $34,056.69 $73,566.74 $53,568.97 $88,558.70 $2,433.35 $86,589.69 $33,956.98 $47,069.60 $63,145.87 $8,741.62 $84,381.73 $43,287.85 $13,334.05 $5,208.30 $63,593.85 $482.83 $75,658.09 $34,465.66

Page | 29

Subsequent Injury Trust Fund 2007 Annual Report
Self-Insured Company
ROCKWELL AUTOMATION, INC ROLLINS INC ROME, CITY OF ROPER CORPORATION RTM, INC. RUBY TUESDAY INC RYDER SYSTEM INC SAINT JOSEPH'S HEALTH SYSTEM SAINT JOSEPH'S OF SAVANNAH SAINT MARY'S HEALTH CARE SATILLA HEALTH SERVICES INC SAVANNAH CITY OF SCIENTIFIC-ATLANTA INC SEARS, ROEBUCK & CO SHAW INDUSTRIES INC SHONEY'S LLC SI GEOSOLUTIONS CORPORATION SIZEMORE ,INC. SNELL CONTRACTORS SOUTH GEORGIA MEDICAL CENTER SOUTHEAST GA HLTH SYSTEM SOUTHEASTERN FREIGHT LINES SOUTHEASTERN MILLS, INC SOUTHERN BELL TEL & TEL SOUTHERN COMPANY SOUTHERN MILLS INC SOUTHERN NUCLEAR OPERATING CO SOUTHERN REGIONAL HEALTH SYS. SOUTHWIRE COMPANY SPALDING & EVENFLO COMPANIES SPALDING CO BOARD OF COMM ST FRANCIS HOSPITAL SUPERIOR RIGGING & ERECTING CO SUTHERLAND'S FOODSERVICE, INC. SYNTHETIC INDUSTRIES, INC TENNECO AUTOMOTIVE, INC TEXTRON, INC THE DIXIE GROUP, INC. THERMAL CERAMICS TIFT GENERAL HOSPITAL TIP TOP POULTRY INC

Reimbursement Amount Paid $10,849.93 $106,914.06 $251,252.91 $9,478.23 $46,270.81 $4,983.84 $20,391.73 $24,050.68 $125,078.38 $39,247.81 $267,808.19 $23,779.81 $300,363.30 $31,599.55 $418,869.40 $220,991.80 $663,437.14 $200,204.17 $95,276.29 $13,173.29 $191,049.23 $53,342.64 $18,632.29 $11,075.32 $461,617.31 $84,101.80 $5,167.78 $44,122.51 $135,440.45 $16,961.73 $3,581.07 $48,213.13 $23,550.56 $535.25 $298,209.79 $139,018.14 $12,100.90 $72,439.55 $208,893.99 $16,289.18 $117,472.48

Page | 30

Subsequent Injury Trust Fund 2007 Annual Report

Self-Insured Company
TRANSUS, INC. TYSON FOODS INC UNILEVER UNITED STATES UNION CAMP CORPORATION UNITED AIRLINES UNIVERSITY HOSPITAL UPS FREIGHT US GYPSUM/L & W SUPPLY & SUBS VALDOSTA CITY OF VISITING NURSE HEALTH SYSTEM VULCAN MATERIALS COMPANY WACHOVIA WAFFLE HOUSE WALTON CO BOARD OF ED WAREHOUSE HOME FURNISHINGS WARNER ROBINS CITY OF WARREN SEWELL MFG. CO. WATKINS ASSOCIATED INDUSTRIES WELLSTAR HEALTH SYSTEM WEST GEORGIA HEALTH SYSTEM WEST POINT STEVENS, INC WESTVACO CORPORATION & SUBS WEYERHAEUSER COMPANY WHITFIELD COUNTY BOE WINN-DIXIE STORES INC YELLOW TRANSPORTATION YKK CORPORATION OF AMERICA ZARTIC INC
Grand Total:

Reimbursement Amount Paid $2,860.00 $405,988.28 $16,594.92 $37,120.36 $111,760.00 $377,031.60 $55,946.24 $295.46 $227.51 $41,722.22 $9,214.00 $39,614.23 $194,421.95 $6,299.95 $287,618.42 $80,078.66 $44,474.79 $116,629.13 $594,344.61 $10,157.51 $11,880.00 $4,212.48 $286,221.64 $3,789.71 $524,066.95 $78,110.23 $40,541.72 $15,800.36
$57,799,901.41

Page | 31

Subsequent Injury Trust Fund 2007 Annual Report

Page | 32

Individual Employers Benefiting from Reimbursements
For the period January 1, 2007 December 31, 2007

Employer
1599 D D P ENTERPRISES INC 7 HILLS TRANSPORT A & B PAINTING SERVICE A.A. FRIEDMAN, INC. A.B. DICK CO A.B. DICK CO. A-1 CONTRACT STAFFING AAA HARDWOOD FLOORS AACTION AUTO PARTS AARON RENTS INC AB & B AUTO PARTS, INC ABB DAIMLER-BENZ TRANS. ABB OVERHEAD DISTRIBUTION ACANDS, INC. ACCORD HUMAN RESOURCE ACCORD HUMAN RESOURCES ACCORD SERVICES, LLC ACE ELECTRIC, INC ACE HARDWARE CORP ACE MAINTENANCE A-COM ENTERPRISES, INC ACS WASTE SERVICE ACTION ELECTRIC COMPANY, INC. ACUITY BRANDS ADDINGTON ENTERPRISES ADMINISTAFF ADMINISTRATION MANAGERS, I ADP TOTAL SOURCE ADVANCE AUTO ADVANCE AUTO ADVANCE AUTO ADVANCE AUTO PARTS ADVANCE STORES CO ADVANCED ELECTRICAL CONTRACTOR ADVANCED STEEL TECHNOLOGY ADVANTAGE SALES

City
DAWSONVILLE CARTERSVILLE LAWRENCEVILLE AUGUSTA MARIETTA NILES TAMPA SAVANNAH SAVANNAH ATLANTA CALLAHAN ATLANTA ATHENS CONYERS OKLAHOMA CITY MONROE MARIETTA MACON GAINESVILLE AUGUSTA FORTSON ALPHARETTA SMYRNA ATLANTA TOCCOA ATLANTA WARNER ROBINS DOUGLASVILLE DOUGLAS THOMSON WAYCROSS CUMMING CUMMING POWDER SPRINGS ROME IRVINE

State
GA GA GA GA GA IL FL GA GA GA FL GA GA GA OK GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA CA

Total Reimbursed
$9,899.73 $257.19
$2,800.00 $37,791.62 $26,177.14 $65,702.17 $42,876.29 $1,907.92 $14,427.80 $60,571.92
$833.40 $412.88 $40,082.82 $2,589.60 $19,737.10 $43,387.38
$46.48 $78,528.10 $9,130.70 $115,534.24 $39,642.40 $50,222.42 $33,392.58 $19,868.58 $10,925.32 $77,483.92 $142,096.72 $3,141.02 $3,402.19 $80,941.10 $20,273.59 $2,041.53 $27,545.76 $5,033.85 $57,011.20 $14,053.67

Subsequent Injury Trust Fund 2007 Annual Report

Employer
AEGON MONUMENTAL LIFE INS AERUS, LLC AFC/CHURCH'S AFFILIATED COMPUTER SERVICES AIR CANADA AIRGAS, INC AIRTRAN AIRWAYS AJM PACKAGING AKZO NOBEL COATINGS, INC. AKZO NOBEL RESINS, INC. AL ROGERS' HOMEWORK ALAN COX AUTOMOTIVE ALBANY BEVERAGE CO ALBANY SHEET METAL ALBANY UROLOGY CLINIC, P.C. ALBRIGHTS FLOOR COVERING ALDEAN DUKES LOGGING INC ALDSWORTH COMPANY ALEX FOODS INC ALEXANDER & ALEXANDER SVC INC ALFRED MCCANNON WELL BORING ALIMENTA USA INC ALL AMERICAN QUALITY FOODS INC ALL SOUTH SUPPLY ALLEN'S PAINT AND BODY SHOP ALLERGY & ASTHMA CLINIC ALLGOOD HEALTHCARE ALLISON SMITH CO. ALLSTAFF MGMT/GA ARENA FTBALL ALLSTATE INS CO ALLSTATE INSURANCE CO ALLTEL COMMUNICATIONS INC. ALLTELL GEORGIA COMM. ALPHA PRODUCTS, INC. ALPHA STAFF, INC ALTAMAHA HOMECARE ALTAMAHA HOMECARE INC ALUM-A-LIFT, INC ALUMINUM FINISHING OF GEORGIA AMERICAL CORP AMERICAN AIRLINES

City
MACON TIFTON ATLANTA NEWNAN ATLANTA AUGUSTA SAVANNAH FOLKSTON BAXLEY BAXLEY ATHENS MARIETTA ALBANY ALBANY ALBANY LOGANVILLE VALDOSTA LYNNFIELD ATLANTA ATLANTA COMER CAMILLA STOCKBRIDGE CARTERSVILLE CLEVELAND MACON AUGUSTA ATLANTA LAWRENCEVILLE ATLANTA SO. BARRINGTON MOULTRIE CORNELIA ATLANTA BOCA RATON BLACKSHEAR BAXLEY WINSTON ADEL CARROLLTON DALLAS

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA MA GA GA GA GA GA GA GA GA GA GA GA GA IL GA GA GA FL GA GA GA GA GA TX

Page | 33
Total Reimbursed
$5,217.71 $404.69
$18,808.46 $6,984.48 $30,124.48 $24,568.34 $48,603.48 $40,465.47 $27,306.65 $8,788.41 $18,481.39 $2,706.63 $5,462.78 $60,494.72 $18,764.19 $1,593.72 $1,572.76 $32,719.49
$717.42 $12,434.29 $15,086.18 $17,776.67 $3,150.00 $14,975.13 $1,571.04 $194,939.68 $20,102.83 $14,719.35 $56,358.10 $127,607.07 $39,806.01 $16,432.54 $26,248.94 $27,318.11 $2,207.59
$149.01 $4,058.54 $126,382.91 $63,388.54 $20,123.85 $22,781.02

Subsequent Injury Trust Fund 2007 Annual Report

Employer
AMERICAN CRYSTAL, INC AMERICAN EXCELSIOR CO. INC. AMERICAN FRESH FOODS AMERICAN GENERAL LIFE ACCIDENT AMERICAN GLASS & MIRROR INC. AMERICAN MANAGEMENT TECH AMERICAN MEDICAL RESPONSE AMERICAN NATIONAL CAN AMERICAN RESIDENTIAL SERVICES AMERICAN SECURITY INSURANCE CO AMERICAN SERVICE CONTRACTORS AMERICAN VENDING CO., INC. AMERIGAS PROPANE INC AMERIGAS PROPANE INC. AMERISUITES AMERSON COMPANY AMF BAKERY SYSTEMS AMTICO INTERNATIONAL, INC ANCHOR GLASS CONTAINER CORP. ANCHOR HOSPITAL ANDREW CORP. ANDREW ELECTRIC ANIMAL MEDICAL CARE CENTER APB, INC. APEX SUPPLY CO APPALACHIAN SURVEYORS APPLE CREEK MGM'T. CO., INC. ARAMARK C/O GE POWER SYSTEMS ARCADIAN ARCHER DANIELS MIDLAND CO. ARCHER WESTERN CONTRACTORS ARCILLA MINING & LAND CO. ARMSTRONG WORLD INDUSTRIES ARROW CO. ARROW CO. ARROW TIRE CO. ASA ASAP HEALTHCARE NETWORK ASHBURN HEALTH CARE CTR. ASHLAND INC ASHLAND, INC

City
EATONTON GRIFFIN THOMASVILLE SAVANNAH VALDOSTA BOONES MILL CLARKSTON FOREST PARK MARIETTA ATLANTA COLUMBUS EAST POINT WINTERVILLE CLEVELAND DULUTH MACON RICHMOND LITHONIA WARNER ROBINS ATLANTA NEWNAN LAWRENCEVILLE MARIETTA ELLENWOOD LAWRENCEVILLE CUMMING DULUTH ATLANTA AUGUSTA MACON ATLANTA MCINTYRE MACON AUSTELL BUCHANAN GAINESVILLE ATLANTA MARIETTA ASHBURN AUGUSTA TYRONE

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

Page | 34
Total Reimbursed
$14,929.22 $10,277.28 $46,122.02 $8,045.64 $80,248.86 $44,325.45 $20,369.72 $10,350.00
$58.85 $5,900.27 $44,697.48 $6,691.10 $75,139.38 $30,436.53
$492.13 $12,031.24 $34,736.71
$709.30 $6,042.48 $7,724.89 $243,707.27 $38,377.62 $179,240.34 $12,926.20 $311,272.23 $2,746.63 $37,391.67
$854.57 $26,622.86 $17,500.00 $73,291.29
$592.00 $32,728.18 $19,046.04 $7,093.18 $17,186.91
$975.15 $676.00 $19,320.85 $144.00
$20.54

Subsequent Injury Trust Fund 2007 Annual Report

Employer
ASHLAND, INC. ASSET MANAGEMENT OUTSOURCING ASSOCIATED HEALTHCARE SYSTEMS ASSOCIATED RUBBER COMPANY ATC HEALTHCARE SERVICES ATHENS BANNER HERALD ATHENS COMMUNITY COUNCIL ON AG ATHENS DOWNTOWN DEVELOP ATLANTA BONDED WAREHOUSE ATLANTA BRAVES ATLANTA CASUALTY GROUP ATLANTA DRYWALL & ACOUSTICS ATLANTA FENCE COMPANY ATLANTA FREIGHTLINER TRUCK SAL ATLANTA FURNITURE ATLANTA JOURNAL CONSTITUTION ATLANTA MEDICAL CENTER ATLANTA NEWSPAPERS ATLANTA PERMA-PAVE ATLANTA STEEL ERECTORS, INC. ATLANTIC COAST FIRE PROTECTION ATLANTIC RESAURANT ENTERPRISES ATLANTIC SIGN & GRAPHICS ATLANTIC SOUTHEAST AIRLINES ATLANTIC TRUCKING CO INC ATLAS COLD STORAGE HOLDING ATLAS ROOFING COMPANY ATLAS SAND & GRAVEL OF GA INC. ATRIA COMMUNITIES AUBREY SILVEY ENTERPRISES AUBURN DISTRIBUTION CENTER AURORA CARES DBA TARA CARE AUSTELL BOX BOARD AUTOMATED MACHINERY LTD, INC. AUTOZONE, INC. AVERY DENNISON AVON PRODUCTS INC B & A CONSTRUCTION CO. INC. B & D CONTRACTING INC B & H TRANSFER COMPANY B & M WOOD PRODUCTS

City
ATLANTA NORCROSS NASHVILLE TALLAPOOSA MACON ATHENS ATHENS ATHENS KENNESAW ATLANTA ALPHARETTA NORCROSS LITHONIA JEFFERSON DECATUR ATLANTA ATLANTA ATLANTA ATLANTA SMYRNA DULUTH MARIETTA BUFORD ATLANTA N. CHARLESTON ATLANTA FOREST PARK SAVANNAH BUFORD CARROLLTON AUBURN DOUGLASVILLE AUSTELL CUMMING ROME FLOWERY BRANCH SUWANEE GAINESVILLE JASPER SANDERSVILLE MANOR

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 SC GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA

Page | 35
Total Reimbursed
$187.00 $768.72 $60,766.87 $10,375.32 $81,345.17 $46,059.36 $7,198.29 $10,292.33 $189,602.86 $2,205.35 $29,968.63 $269,010.00 $3,410.00 $55,973.07 $13,275.00 $11,331.01 $41,852.03 $955.86 $13,730.25 $30,413.72 $75,918.01 $317,301.34 $61,290.83 $49,925.32 $17,147.18 $5,201.40
$55.00 $33,017.68 $26,724.01 $78,882.76 $121,672.56 $6,967.02 $12,000.00 $13,665.35
$310.06 $60,303.00 $31,084.94 $33,670.96 $47,517.11 $3,713.58 $75,646.82

Subsequent Injury Trust Fund 2007 Annual Report

Employer
B H ELECTRONICS B.B. TRUCK WASH OF JACKSON B.H. TRANSFER B.L. HARBERT INTERNATIONAL LLC BABCOCK & WILCOX COMPANY BABCOCK & WILCOX COMPANY BACON COUNTY B. O. E. BAGCRAFT CORP. OF AMERICA BAILEY MONUMENT COMPANY BAKER & TAYLOR, INC BAKER CARPET MILLS, INC. BAKER DISTRIBUTING COMPANY BANK SOUTH BANK SOUTH BARDI HEATING & A/C BARRETT & ASSOCIATES BARRETT PLUMBING & ELECTRIC BARRINGTON HALL DEVELOPMENT BARROW ENTERPRISES BARRY MFG. CO. BARTENFELD ELECTRIC COMPANY BATES HARDWARD CO. BATTLE LUMBER CO., INC. BAXLEY WILDERNESS INSTITUTE BAYCOR BC NATURAL FOODS BEASLEY RAILROAD COSNTRUCTION BEAULIEU GROUP, INC BECK ATLANTA, INC. BEKAERT CORPORATION BEL ARBOR NURSING HOME BELK OF SAVANNAH BELK STORES & AFFILIATES BELK STORES & AFFILIATES BELK, INC. BELL MINOR HOME INC BELLSOUTH ADV. & PUBLISH BELLSOUTH CORPORATION BEN MCELROY ASSOCIATES BERKEL & COMPANY CONTRACTORS BERLIN & HODGES

City
NASHVILLE JACKSON SANDERSVILLE BIRMINGHAM ATLANTA BRUNSWICK ALMA FOREST PARK WAYCROSS COMMERCE DALTON AUGUSTA ATLANTA FOREST PARK NORCROSS ATLANTA CAIRO WARNER ROBINS SMYRNA STONE MOUNTAIN ATLANTA ATLANTA WADLEY BAXLEY CORNELIA GAINESVILLE JESUP DALTON ATLANTA ROME MACON SAVANNAH CARTERSVILE MACON VALDOSTA GAINESVILLE ATLANTA ATLANTA ATHENS BONNER SPRINGS MACON

State
GA GA GA AL 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 KS GA

Page | 36
Total Reimbursed
$60,718.61 $1,270.83 $12,503.04 $1,407.14
$79.83 $21,077.33 $6,477.90 $9,341.34 $2,752.89 $119,578.64 $123,372.46 $66,897.85 $9,100.15 $28,549.95 $15,021.29 $4,025.00 $30,096.05 $328,528.90 $55,598.80 $247,281.41 $78,268.79 $36,451.43 $14,552.94 $28,245.04 $1,016.85 $30,913.21 $26,496.71 $42,213.60 $231,569.69 $264,738.81 $50,969.51 $3,710.41 $23,031.52 $164,963.44 $24,253.36 $66,844.96 $134,205.92 $26,249.05 $123,967.78 $32,557.49 $57,472.99

Subsequent Injury Trust Fund 2007 Annual Report

Employer
BERRY PLUMBING & EQUIPMEN BESAM, INC. BESCO STEEL SUPPLY OF GA INC BEST TEXTILES BETTER BACKERS, INC. BETZ LAB'S BEVERLY HEALTH & REHAB BEVIS ROPE MANUFACTURING INC BGD ENTER. DBA PAYLESS PLMGB. BI LO BILL HEARD CHEVROLET BILLINGS CABINET CO INC BILL'S HEATING & COOLING INC BILLY GERRELL GRADING BLAINE ALDRIDGE CONCRETE BLAIR HOUSE CONVALESCENT CENTE BLAKE CONSTRUCTION CO. BLC HARDWOOD FLOORING LLC BLOSSMAN GAS, INC. BLOUNT CONSTRUCTION BLUE RIBBON RENTAL, INC. BOAEN MECHANICAL CONTRACTOR BOEING BOMBARDIER TRANSPORT BOOMERSHINE PONTIAC BOSAL INDUSTRIES GEORGIA BOSTON MARKET BRAD COLE CONSTRUCTION BRASSTOWN VALLEY RESORT BRENCOR ASSET MANAGEMENT INC. BRENT WALKER FORD INC BRENTWOOD HEALTH CARE BRENTWOOD HEALTH CARE, LLC BRIGGS EQUIPMENT BRIGGS MEDICAL BRIGHT HORIZONS FAMILY SOL. BROCK PLUMBING BROCKWAY STANDARD INC BROOKDALE/CHAMBREL AT ROSWELL BROOKHAVEN PLUMBING CO., INC BROOKS AUTO PARTS

City
CLERMONT HIGHTSTOWN NORCROSS CORDELE CHATSWORTH JACKSONVILLE CORDELE ROSSVILLE BYRON ELBERTON COLUMBUS ROME SUMMERVILLE CUMMING CUMMING NORTH AUGUSTA ST. MARYS MACON QUITMAN ATHENS CUYAHOGA FALLS SAVANNAH DULUTH ATLANTA SMYRNA LAVONIA MARIETTA CARROLLTON YOUNG HARRIS ATLANTA GLENVILLE ROSWELL ROBERTA VALDOSTA DES MOINES ATLANTA MARIETTA HOMERVILLE ROSWELL ATLANTA DOUGLAS

State
GA NJ GA GA GA FL GA GA GA GA GA GA GA GA GA SC GA GA GA GA OH GA GA GA GA GA GA GA GA GA GA GA GA GA IA GA GA GA GA GA GA

Page | 37
Total Reimbursed
$25,162.42 $87,894.05 $2,458.68 $65,087.65 $12,656.00 $10,136.64 $36,889.23 $10,042.11 $36,390.69 $35,753.14 $210,301.16 $47,897.33 $8,212.13 $226,724.18 $94,290.57 $34,303.26 $9,145.00 $1,399.90 $184,749.73 $5,839.14 $14,851.51 $130,310.75 $62,673.52 $32,000.00 $7,349.97 $40,758.82 $85,744.09 $61,969.41 $9,760.00 $35,800.00 $10,208.00 $26,568.54 $48,647.27 $5,198.35 $21,251.19 $11,845.34
$652.42 $170,380.80 $123,252.58
$40,574.33 $4,415.56

Subsequent Injury Trust Fund 2007 Annual Report

Employer
BROOKS BODY SHOP BROOKS INSTRUMENTS DIVISION BROOKS WELDING INC. BROWN & WILLIAMSON TOBACCO BROWN BROTHERS OF GA., INC. BROWN STEEL CONTRACTORS, INC. BRUNSWICK FLOORS, INC. BRUNSWICK JOB CORPS CENTER BRUNSWICK-I.S. MARINE BUILDER'S STEEL SUPPLY CO., IN BUILDING TECHNOLOGY BULLOCH & BULLOCH, INC. BUNN LOGGING, INC. BURGER KING BURLINGTON INDUSTRIES BURLINGTON NORTHERN BURNS INTERNATIONAL BURT LUMBER CO., INC. BUTLER INTERNATIONAL INC BWAY CORP BWAY CORP BWAY CORP C & D CHARTER POWER SYSTEMS C & D TECHNOLOGIES INC C.A. MURREN & SONS CO INC C.E.C. ENTERTAINMENT, INC. C.R. BARD, INC. CADILLAC JACK, INC. CALHOUN HEALTH CARE CENTER CAL-MAINE FOODS, INC. CAMBRIDGE PLACEMENT, INC. CANOOCHEE ELECTRIC MEM. CORP. CANOPIES UNLIMITED INC CANTON CONVALESCENT CENTER INC CAPITAL CONTRACTORS CAPITOL MATERIALS, INC CAPITOL MATERIALS, INC. CAPRO INC CAR CRAFT CARDINAL SPECIALTY PRODUCTS CARE GIVER'S INC

City
TIFTON STATESBORO VALDOSTA MACON CONYERS NEWNAN BRUNSWICK BRUNSWICK VALDOSTA LILBURN TALLAPOOSA MACON FORSYTH COMMERCE SHANNON ALBANY ROME WASHINGTON VALDOSTA ATLANTA HOMERVILLE LITHONIA CONYERS CONYERS GRAYSON DOUGLASVILLE COVINGTON DULUTH TUCKER SHADYDALE ATLANTA REIDSVILLE GILLSVILLE CANTON ATLANTA DULUTH ATLANTA SWAINSBORO ATHENS CALHOUN 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 GA GA GA GA GA

Page | 38
Total Reimbursed
$73,352.41 $1,854.73 $24,327.26 $304,156.96 $1,409.30 $12,285.00 $3,112.76 $1,602.12 $56,407.00
$202.50 $7,739.43 $32,052.69 $39,754.10 $8,317.17 $9,505.22 $4,315.42 $110,552.48 $18,401.92 $43,120.00 $2,248.09 $36,579.61 $74,786.75
$650.62 $22,786.35 $226,987.93 $33,401.89 $15,959.88 $10,507.96 $5,137.85 $8,223.91 $56,115.21 $13,689.24 $58,856.37 $2,047.05 $23,644.76 $100,931.19 $12,735.20 $16,225.57 $19,753.52 $6,402.59
$684.00

Subsequent Injury Trust Fund 2007 Annual Report

Employer
CARE MORE MANAGEMENT CO., INC CARE MORE MGMT. CO. CARE MORE, INC CARE MORE, INC CAREMORE INC. TREUTLEN CARNETTS CARROLLTON MANOR, INC. CARSON, INC CARTER & ASSOCIATES CARTER CONCRETE COMPANY CARWOOD MANUFACTURING COMPANY CASTLEBERRY INTERIORS CASWELL, INC. CATHERINE'S CHARMING SHOPS C-E MINERALS CEC ENTERTAINMENT/ CHUCK E. CH CECIL MALONE COMPANY CEDARWOOD APTS CELLOFOAM NORTH AMERICA CELLO-FOIL PRODUCTS, INC. CENTRAL GA EYE CENTER PC CENTRAL GA HOME HEALTH AGENCY CENTRAL GEORGIA HOME CARE CENTRAL HEALTH HOLDING CENTRAL INDUSTRIES, INC CENTRAL LEASING MANAGEMENT,INC CENTURION INDUSTRIES CENTURY SUPPLY CORPORATION CETCO ( PC AMCOL INTL' GRP) CHAMBERS DEVELOPMENT CO. CHAMPION INTERNATIONAL CORP CHAPARRAL BOATS, INC. CHARLES ALFORD DRYWALL CHARLES BLACK CONSTRUCTION CHARLES MILLER CONSTRUCTION CHARLES SMITHGALL CENTRAL OFF. CHART INDUSTRIES INC. CHARTER MOBILE HOMES, INC. CHASTAIN CONSTRUCTION CHATTANOOGA SUBWAY, LLC CHEMICAL PRODUCTS CORP.

City
MACON SUMMERVILLE DOUGLAS MACON SOPERTON MARIETTA CARROLLTON SAVANNAH ATLANTA POWDER SPRINGS WINDER ROSWELL NEWNAN DULUTH ANDERSONVILLE KENNESAW ATLANTA AUGUSTA CONYERS ALBANY MACON MACON MACON FT. OGLETHORPE SAVANNAH OAK BROOK FREDONIA ALPHARETTA VILLA RICA ATLANTA WAYCROSS NASHVILLE ROME CLEVELAND NORCROSS GAINSVILLE CANTON HINESVILLE NORCROSS KNOXVILLE CARTERSVILLE

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 IL KS GA GA GA GA GA GA GA GA GA GA GA GA TN GA

Page | 39
Total Reimbursed
$35,596.66 $19,695.11 $11,776.97 $73,058.38
$612.64 $6,846.81 $28,442.14 $4,301.54 $39,130.02 $283,195.13 $21,887.81 $3,909.57 $9,704.20 $103,381.08 $46,349.02 $20,685.00 $26,319.61 $18,340.35 $2,657.84 $61,444.41 $33,928.88 $19,733.52 $18,637.93
$591.14 $38,229.50 $90,644.06 $2,450.21 $4,158.03 $8,625.00 $41,310.14 $6,058.64 $196,173.32 $6,319.19 $75,291.93 $17,677.30 $14,096.60 $20,528.95
$162.12 $133,994.32
$31,400.09 $10,266.52

Subsequent Injury Trust Fund 2007 Annual Report

Employer
CHESTATEE REGIONAL HOSPITAL CHESTNUT RIDGE NURSING CHICKAMAUGA TELEPHONE CHICK-FIL-A CHICK-FIL-A CHICK-FIL-A CHICK-FIL-A CHILDREN'S FRIEND CHIPMAN-UNION, INC. CHRISTIAN CITY CHUMLEY'S PAVING & GRADING INC CHURCH OF JESUS CHRIST LDS CIBA VISION CORPORATION CIMCO CITIZENS BANK OF WASHINGTON CO CITY OF COVINGTON CITY OF EAST POINT POLICE DEPT CITY OF ELBERTON CITY OF FORT VALLEY CITY OF HOGANSVILLE CITY OF LINWOOD CITY OF ROME CJT INDUSTRIAL CONTRACTORS CKS PACKAGING CLARE BRIDGE OF DECATUR CLARK ENTERPRISES CLARKLIFT OF ATLANTA CLARK'S SUPER MARKET CLASSIC COLLISION CLAY M. NEWMAN LOGGING, INC CLAYTON HOMES CLAYTON HOMES # 930 CLEVELAND ELECTRIC CO. CLEVELAND GROUP CLOTHING FABRICS INC CMC, INC. COALE TRUCK TRANSPORT COASTAL DEPOT COASTAL GREAT SOUTHERN COASTAL PLAINS CONSTRN. COASTAL SAND, INC.

City
DAHLONEGA CUMMING CHICKAMAUGA ATLANTA AUSTELL CARTERSVILLE FOREST PARK MACON UNION POINT UNION CITY ACWORTH ATLANTA DULUTH WAYNESBORO SANDERSVILLE COVINGTON EAST POINT ELBERTON FT VALLEY HOGANSVILLE LINWOOD ROME MACON ATLANTA DECATUR ALBANY ATLANTA GRIFFIN CHAMBLEE HAZLEZHURST ROSSVLLE WAYCROSS ATLANTA ATLANTA WAYCROSS MCDONOUGH LAWRENCEVILLE GARDEN CITY SAVANNAH TIFTON SAVANNAH

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 GA GA GA GA GA

Page | 40
Total Reimbursed
$2,865.44 $49,784.92 $74,486.05 $1,210.80 $13,107.00 $85,377.45 $21,088.52 $17,773.22 $3,217.21 $2,727.32 $33,525.74 $82,701.53 $212,420.00 $3,850.00 $16,372.23 $17,441.99 $13,752.77 $1,515.41 $11,469.81 $5,186.41 $12,401.13 $89,857.03 $30,453.80 $2,021.24 $16,386.09 $70,588.02 $84,854.57 $5,202.05 $20,172.94 $28,286.56 $65,815.59 $12,740.32 $10,080.00 $61,638.70 $11,663.46 $56,462.41
$60.88 $19,768.26 $3,161.79 $29,380.01 $184,014.52

Subsequent Injury Trust Fund 2007 Annual Report

Employer
COBB COUNTY TRACTOR CO. COBB ERECTORS, INC. COCHRAN CEILING COMPANY, INC. COCHRAN'S AUTO TRUCK STOP COHUTTA WATER INC. COLCRAFT INC. COLE ELECTRIC COMPANY COLE MASONRY, INC. COLEMAN AMERICAN MOVING COLISEUM MEDICAL CENTER COLISEUM PSYCHIATRIC HOSP COLLINS & AIKMAN FLOORCOVERING COLT SECURITY AGENCY COLUMBIA POLK GENERAL HOSPITAL COLUMBIA SUSSEX CORPORATION COLUMBUS LEDGER ENQUIRER COLUMBUS ROOFING, INC. COMBINED INSURANCE COMBINED PROPERTIES COMBINED SERVICES, INC. COMBUSTION ENGINEERING COMCAST CORPORATION COMCAST CORPORATION COMMERCE HARDWARE COMMERCE RENTAL & SALES COMPASS @ CO. D RAY JAMES ST P COMPLETE PERSONNEL INC. COMPLETE PERSONNEL/ GREAT SOUTH CONDITIONED AIR SYSTEMS CONE MACHINERY INC. CONSOLIDATED JET PRINTERS INC CONSOLIDATED PLUMBING SERVICES CONSTANTINE DYEING CONTAINER GENERAL CORP. CONTAINER MARKETING, INC CONTINENTAL BAKING COMPANY CONTINENTAL CAN CO CONTINENTAL COMMERCE CO CONTINENTAL GRAIN CONTINENTAL GRAIN CONTINENTAL TELEPHONE CO.

City
MARIETTA POWDER SPRINGS COCHRAN RINGGOLD ACWORTH STILLMORE ATLANTA GAINSVILLE MIDLAND CITY MACON MACON DALTON CLARKSTON CEDARTOWN FT. MITCHELL COLUMBUS COLUMBUS CHICAGO ATLANTA DECATUR JULIETTE AUGUSTA CHAMBLEE COMMERCE COMMERCE FOLKSTON DALTON DALTON GAINSVILLE THOMASVILLE DALTON SAVANNAH CALHOUN FOREST PARK AMERICUS ROME PERRY WAYCROSS CORDELE SAVANNAH ATLANTA

State
GA GA GA GA GA GA GA GA AL GA GA GA GA GA KY 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

Page | 41
Total Reimbursed
$23,815.11 $360.49
$25,133.31 $8,004.74 $88,569.73 $4,349.53 $37,723.22 $1,156.21 $15,096.19 $131,293.01 $14,203.38 $95,228.93 $6,722.09 $25,350.53 $19,486.60 $49,631.87 $41,059.59 $2,905.70 $24,175.12
$986.70 $38,133.40 $193,744.88 $122,954.38 $11,970.04 $109,832.37 $2,800.00 $124,500.56 $14,206.89 $54,803.82 $4,288.62 $46,609.53 $5,493.05 $85,838.31 $12,075.81 $3,451.02 $5,425.00 $15,540.51
$410.18 $10,779.80 $4,417.42 $12,142.12

Subsequent Injury Trust Fund 2007 Annual Report

Employer
CONWAY SOUTHERN EXPRESS CONWED PLASTICS COOPER DDS, PC CORONET INDUSTRIES CORPORATE ENVIRONMENTS OF GA CORRECTIONAL SERVICE CORorate COUNTRY PRIDE FOODS, INC. COURIER SYSTEMS, INC. COVENTRY ELECTRICAL SUPPLIES COWAN DISTRIBUTION COX CRAVEN POTTERY INC. CREWS AUTO REPAIR, INC. CROWN GLASS AND MIRROR CROWN NORTH/THOMASTON CRUM RESOURCES INC. CRUM'S GARDEN CENTER CRYOLIFE INC. CRYSTAL FARMS INC CRYSTAL SPRINGS PRINT WORKS CTF HOLDINGS LTD CULLENS SEPTIC TANK CULVER & CO CULVER RUG CO INC CUMMINS SOUTH INC CUSTOMBILT PRODUCTS CYNDERELLA'S CYPRESS HEALTH CARE MGMT CYPRESS RESTAURANTS, INC. D & D SERVICE, INC D & D TIMBER PRODUCTS D L LEE & SONS D.W. ADCOCK, PC DABNEY'S INC-BOJANGLES DACCO DAIMLER/CHRYSLER CORPORATION DAIRY QUEEN DALLAS MILL WORKS, INC. DANA AUGUSTINE, INC DARBY PRINTING COMPANY DARRELL BLACK, INC.

City
BYRON MINNIAPOLIS WAYCROSS DALTON ATLANTA CORDELE GAINESVILLE BAYONNE COVINGTON BALTIMORE ATLANTA COMMERCE LAWRENCEVILLE ATLANTA THOMASTON CLEARWATER BAINBRIDGE, KENNESAW CHESTNUT MTN. CHICKAMAUGA LAKE LANIER MACON ROSWELL SAVANNAH COLLEGE PARK WAYCROSS FITZGERALD HOSCHTON ORLANDO POWDER SPRINGS BARTOW ALMA MOULTRIE CEDARTOWN COOKEVILLE MORROW MCRAE HIRAM KENNESAW ATLANTA MILLEDGEVILLE

State
GA MN GA GA GA GA GA NJ GA MD GA GA GA GA GA FL GA GA GA GA GA GA GA GA GA GA GA GA FL GA GA GA GA GA TN GA GA GA GA GA GA

Page | 42
Total Reimbursed
$10,087.40 $84,527.14 $30,571.79 $16,057.45 $41,617.31 $11,839.67 $25,400.13 $48,113.86 $49,889.65 $21,600.00 $34,858.02 $39,801.02 $11,233.23 $5,360.00 $79,617.36 $18,603.18 $27,186.71 $86,165.02 $42,394.07
$562.55 $10,762.27 $1,746.00 $155,432.56 $93,118.99
$203.70 $69,526.55 $5,340.88 $112,721.59 $1,257.76 $42,480.71 $50,404.00 $19,392.28 $96,200.00 $206,284.70 $25,158.41 $15,795.49 $7,942.53 $18,620.00 $10,971.57 $18,883.37 $63,705.60

Subsequent Injury Trust Fund 2007 Annual Report

Employer
DATA TECH DAVE & SONS, INC. DAVID CLAY DAVID CORE & PAD, INC DAVID T PICKLE TIMBER DAVIS POULTRY INC DAVIS WATER & WASTE IND INC DAWN FOOD PRODUCTS 32140 DAYS GLASS SERVICE DAYS INN-ROME DE STER CORP. DEERFIELD SPECIALTY PAPERS INC DEL MAR WINDOW COVERINGS DEL-COOK LUMBER COMPANY DELTA AIRLINES, INC. DELTA LIFE INS CO DENNIS TAYLOR AND COMPANY, INC DENON DIGITAL INDUSTRIES DENSON CONTRACTING COMPANY DESTINY INDUSTRIES DETAILS INC. DEVEREUX FOUNDATION DEVRO-TEEPAK, INC. DIAMOND HOLDING DIAMOND TRIUMPH AUTO GLASS DICKERSON TILE COMPANY DIEBOLD, INC DILLARD SMITH CONSTRUCTION CO. DILLARD SMITH-GA OVERHEAD DILLARD'S, INC. DILLON TRANSPORT DIVERSCO, INC DIXIE INDUSTRIAL FINISHING CO. DIXIE TANK LINES, INC. DIXIEN, LLC DIXON TIMBER CO. DOCTORS HOSPITAL OF COLUMBUS DODGE COUNTY HOSPITAL DOGWOOD HOUSING DONALSONVILLE HOSPITAL DOUGLAS GENERAL HOSPITAL

City
ALPHARETTA ALBANY ROME CAVE SPRINGS HELENA LESLIE THOMASVILLE DOUGLASVILLE DOUGLAS ROME THOMASTON AUGUSTA ATHENS ADEL ATLANTA ALBANY DULUTH MADISON COLUMBUS MOULTRIE MOORESVILLE KENNESAW ATLANTA MARIETTA LILBURN BOWMAN ATLANTA SMYRNA COLLEGE PARK VALDOSTA, WILLOWBROOK SPARTANBURG TUCKER CARTERSVILLE LAKE CITY JESUP COLUMBUS EASTMAN MILLEGEVILLE DONALSONVILLE DOUGLASVILLE

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA NC GA GA GA GA GA GA GA GA GA IL SC GA GA GA GA GA GA GA GA GA

Page | 43
Total Reimbursed
$11,829.20 $23,137.44 $13,462.17 $63,965.02 $9,730.04 $84,804.85 $3,850.00
$60.00 $52,234.24 $21,830.47 $85,506.03 $32,354.75
$85.93 $554.40 $91,217.58 $2,583.68 $57,184.24 $195,480.00 $5,095.85 $189,050.70 $58,462.16 $33,811.24 $85,686.16 $37,087.78 $133,315.05 $276.17 $10,200.00 $9,111.61 $173,200.00 $7,953.26 $21,692.94 $1,945.11 $6,606.37 $4,312.88 $21,438.67 $687.37 $16,438.93 $24,623.12 $15,552.22 $5,891.60 $4,186.00

Subsequent Injury Trust Fund 2007 Annual Report

Employer
DOUGLASVILLE NURSING & REHAB DOW-CONTAINER OPERATIONS DRUG TRANSPORT, INC. DRUG TRANSPORT, INC. DRUID HILLS GOLF CLUB, INC. DSB LOGISTICS DSI SECURITY SERVICES DUBARD'S TIRE & ALIGNMENT DUBLINAIR NURSING HOME DUNCAN'S LANDSCAPING INC DUPREE PLUMBING CO INC DURANGO GEORGIA PAPER CO DURON, INC. DYNCORP E. COBB LAND DEVELOPMENT CO. E.E. NEWCOMER ENTERPRISES INC E/Z BORE CONSTRUCTION & MFG EAGLE CONTAINER EAGLE POINT LANDFILL EAGLE UTILITY CONTRACTING EARL SMALL'S HARLEY DAVIDS EARTHGRAINS BAKING CO EASLER SAND & GRAVEL, INC EAST - WEST EXPRESS EAST & WEST INVESTMENTS EASTERN AIRLINES, INC. ECC INTERNATIONAL ECKERD ECKERD DRUG ECKERD YOUTH ALTERNATIVE EDDIE'S FOREIGN AUTO EDUCATION & TRAINING RESOURCES EDWARDS BAKING CO. ELBERT FLOWERS TIMBER ELECTRIC CONTRACTORS OF ATL ELECTROLUX HOME PRODUCTS ELECTROMAGNETIC SERVICES, INC ELEGANCE CLEANERS ELIXIR INDUSTRIES ELLIOTT TRANSPORT EMPLOYMENT MATCH MAKERS

City
DOUGLASVILLE DALTON MACON TUCKER ATLANTA DES PLAINES DOTHAN AUSTELL DUBLIN JONESBORO MARIETTA ST MARY'S BELTSVILLE ATLANTA MARIETTA ATLANTA TOCCOA ATLANTA BALL GROUND BISHOP MARIETTA AUGUSTA FORT VALLEY VILLA RICA VALDOSTA, ATLANTA SANDERSVILLE COLUMBUS SHENANDOAH CLEARWATER MACON BOWLING GREEN ATLANTA HORTENSE DAWSONVILLE MCRAE NORCROSS KENNESAW DOUGLAS GAINESVILLE MACON

State
GA GA GA GA GA IL AL GA GA GA GA GA MD GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA FL GA KY GA GA GA GA GA GA GA GA GA

Page | 44
Total Reimbursed
$37,705.75 $34,006.59 $218,158.85 $345,564.11 $11,077.39 $33,223.33 $3,333.80 $10,632.89 $10,850.00 $6,162.97 $148,349.72 $458,086.68 $14,845.75 $8,775.00 $19,950.00 $11,898.74 $49,991.69 $224,520.00 $8,567.01
$893.41 $9,524.25 $205,342.46 $106,839.28 $3,208.10
$593.68 $63,066.10 $28,600.00 $8,500.00 $19,532.50 $3,826.26 $44,000.00 $115,981.21 $9,455.00 $8,196.41 $132,700.56 $8,552.05 $13,629.62 $16,202.61 $8,175.26 $76,288.06 $32,737.07

Subsequent Injury Trust Fund 2007 Annual Report

Employer
EMS VENTURES, INC. ENGINEERED FABRICATION INC ENGINEERED FABRICS CORP. ENGINEERED REFRIGERATION ENGLEHARD CORP. ENGLEHARD CORP. ENGLEHARD CORP. EPICURE MANAGEMENT SERVICES EPILEPSY ASSOC OF GA EQUITY GROUP ERNST OF GEORGIA INC ESSEX GROUP ETHICON, INC. EVERGREEN TIMBER CO EXIDE CORPORATION EXPERIENCE DRYWALL INC F & P AMERICA MFG. F & W FARM SERVICE, INC F R GRANTHAM CONTRACTING FAB TECH FAB TECH INDUSTRIES FAIRBANKS SCALES INC. FAMILY DOLLAR, INC. FANNIN REGIONAL HOSPITAL FAYETTE CO BD OF EDUCATION FAYETTEVILLE BOWLING CENTER FEDERAL PAPER BOARD CO., INC. FEDERAL RENT A CAR SYSTEM FEDERAL RESERVE BANK OF ATLANTA FEDERAL-MOGUL CORP FIELDS CUSTOM CABINETS FIRST AMERICAN HOLDINGS, LLC FIRST BAPTIST CHURCH FIRST DATA FIRST DATA POS. INC. FIRST DATA RESOURCES FITZGERALD & SONS PLUMBING FITZGERALD UNDERWEAR CORP FLEX-A-BED FLEXIBLE METAL INC FLINT CONSTRUCTION CO.

City
GAINESVILLE WATKINSVILLE ROCKMART MOBILE ATTAPULGUS GORDON MCINTYRE MACON WARNER ROBINS CAMILLA LAWRENCEVILLE LITHONIA CORNELIA CUTHBERT COLUMBUS NORCROSS ROME THOMASVILLE DECATUR DOUGLAS ROCKMART DORAVILLE CHARLOTTE BLUE RIDGE FAYETTEVILLE FAYETTEVILLE AUGUSTA HAPEVILLE ATLANTA LAGRANGE HAHIRA MOULTRIE LAFAYETTE MACON KENNESAW MACON PEACHTREE CITY TIFTON LAFAYETTE TUCKER LAWRENCEVILLE

State
GA GA GA AL GA GA GA GA GA GA GA GA GA 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

Page | 45
Total Reimbursed
$5,559.08 $14,682.85 $57,072.19 $14,223.36 $14,000.00 $32,119.54 $5,254.03 $22,621.36 $10,867.38 $12,557.83 $60,870.37
$694.72 $20,027.14 $71,554.32 $1,049.16 $21,351.77
$272.87 $2,076.35 $241,347.90 $46,877.40 $14,401.85 $22,647.45 $13,931.98 $64,494.77 $45,669.94 $22,475.81 $19,471.30 $31,264.15 $69,407.18 $11,960.68 $11,125.46 $45,439.33 $6,200.77 $73,501.02 $11,819.04 $21,540.44 $73,280.51 $17,785.96 $5,222.24
$169.38 $9,450.00

Subsequent Injury Trust Fund 2007 Annual Report

Employer
FLINT RIVER TEXTILES, INC FLINT RIVER TRUCKING, INC. FLUOR CORP FOLGER POULTRY FARMS FORSTMANN & COMPANY, INC FORSYTH NURSING HOME FOWLER-FLIMESTER CONCRETE, INC FRANKLIN INDUSTRIES FREEMAN DECORATING CO. FREIGHTLINER OF CHATTANOOGA FRITO-LAY FRUEHAUF CORPORATION FUJITSU AMERICA, INC FUTURECALL TELEMARKITING WEST G & K SERVICES INC G & K SERVICES, Inc. G & L MARBLE, INC. G & P TRUCKING CO., INC G.I.R. SYSTEMS GA ALLTEL TELECOM-HOMERVILLE GABRIEL DESSERTS, INC. GAF MATERIALS CORP. GAINESVILLE CITY BD OF EDUCATION GAINEY TRANSPORTATION SERVICES GALAXY CARPET MILLS, INC. GALEY & LORD INC GALEY & LORD INDUSTRIES, INC. GARLAND CONSTRUCTION INC. GARNER BROS. CO GARY MCBRIDE PLUMBING GATE GOURMET INC. GATE GOURMET INC. GATX CORPORATION GAY CONSTRUCTION COMPANY GCC DRUM, INC. GCO APPAREL CORP. GE MEDICAL SYSTEMS GEICO GEIGER INTERNATIONAL GEMI TRUCKING GENE KNIGHT PAINTING

City
ALBANY OGLETHORPE ALISO VIEJO DAHLONEGA TIFTON FORSYTH MILLEDGEVILLE LAVONIA ATLANTA TUNNEL HILL KATHLEEN CONLEY SUNNYVALE AUGUSTA ATLANTA MACON WINSTON GASTON DALTON HOMERVILLE MARIETTA SAVANNAH GAINESVILLE CONLEY CHATSWORTH COLUMBUS SHANNON BOGART ROME POOLER ATLANTA MEMPHIS WAYCROSS ATLANTA LAWRENCEVILLE BOWDON FLORENCE MACON ATLANTA SAVANNAH RINCON

State
GA GA CA GA GA GA GA GA GA GA GA GA CA GA GA GA GA SC GA GA GA GA GA GA GA GA GA GA GA GA GA TN GA GA GA GA SC GA GA GA GA

Page | 46
Total Reimbursed
$12,514.89 $126,940.50
$70,800.34 $8,795.10 $4,165.00 $2,377.12 $134,725.06 $4,994.48 $8,851.78 $19,379.81 $5,988.00 $11,408.62 $190,662.26
$224.18 $930.12 $82,682.51 $22,313.22 $8,474.35 $592.30 $298,903.10 $40,564.15 $25,108.34 $14,590.66 $1,501.91 $6,048.00 $35,711.49 $11,050.00 $202,297.16 $66,984.81 $42,367.47 $47,138.75 $15,310.68 $78,430.37 $8,751.14 $17,595.94 $6,542.17 $9,516.68 $95,067.83 $10,676.51 $63,200.21 $75,636.06

Subsequent Injury Trust Fund 2007 Annual Report

Employer
GENERAL BUILDING MAINTENANCE GENERAL CAR AND TRUCK LEASING GENERAL ELECTRIC CO GENERAL NUTRITION CTRS GENERAL PARTS INC GENERAL SHALE PRODUCTS GENERAL SHALE PRODUCTS GENESIS TECHNOLOGY, INC. GENTIVA HEALTH SERVICES GENUINE PARTS GENUINE PARTS GEORGE HORMELL & COMPANY GEORGE MUSE CLOTHING CO GEORGIA BAPTIST CONVENTION GEORGIA BOOT INC GEORGIA DUPLICATING PRODUCTS GEORGIA ELECTRIC COMPANY GEORGIA ENVIRONMENTAL GEORGIA MARBLE COMPANY GEORGIA OPTIONS GEORGIA TECH ATHLETIC ASSOC. GEORGIA WAR VETERANS HOME GERALD L. DAVIS ASSOC., INC. GILBERT & BENNETT GILL PLUMBING COMPANY GILMAN BUILDING PRODUCTS GILMAN PAPER CO. GILMAN PAPER CO. GILMER COUNTY OF B. O. E. GIRL SCOUTS COUNCIL OF NW GLASS SERVICE CENTER OF AUGUST GLOBE UNION INC GLOVER FOODS GMTI LESTER PRECISION DIE CAST GOBER PAINT & CONTRACTING GOLD KIST INC GOLD KIST INC GOLD KIST INC GOLD KIST INC GOLDEN AGE PROPERTIES GOLDEN APPLE MANAGEMENT

City
MACON DAVENPORT ROME PITTSBURGH CARROLLTON ATLANTA SMYRNA NORCROSS SAVANNAH NORCROSS SYLVESTER TUCKER ATLANTA ATLANTA BLAIRSVILLE MACON ALBANY MORROW ATLANTA BOGART ATLANTA MILLEDGEVILLE STONE MOUNTAIN TOCCOA LILBURN BLACKSHEAR BLACKSHEAR ST. MARYS ELLIJAY ATLANTA AUGUSTA ATLANTA AMERICUS ROME LOGANVILLE ATHENS CARROLLTON DOUGLAS ELLIJAY HAWKINSVILLE DOTHAN

State
GA IA GA PA 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 AL

Page | 47
Total Reimbursed
$90,237.18 $9,528.60 $50,277.15 $139,140.42 $27,648.68 $19,549.32 $211,555.79 $59,945.00 $124,297.77 $56,493.28 $5,738.31 $88,788.20 $10,833.55 $9,700.75 $13,013.53 $16,790.07 $14,622.53 $56,133.40 $18,381.33
$996.44 $172,627.48
$31,904.83 $293.62
$13,317.10 $59,360.50 $8,961.60 $4,785.04 $48,485.08 $7,323.67 $8,781.20 $19,085.61 $5,513.67 $160,528.92 $11,180.00 $106,502.65 $264,254.67 $93,079.23 $454,937.97 $57,691.77 $78,883.81 $37,948.45

Subsequent Injury Trust Fund 2007 Annual Report

Employer
GOLDEN GALLON STORES, INC GOLDEN PEANUT GOLDEN PERSONAL CARE HOME, INC GOODWILL INDUSTRIES GOODWILL INDUSTRIES THE COASTAL GOODY PRODUCTS, INC. GOODY PRODUCTS, INC. GOODYEAR TIRE & RUBBER GOODYEAR TIRE & RUBBER GOODYEAR TIRE & RUBBER GOODYEAR TIRE & RUBBER GORDON COUNTY FARM COMPANY GPS ENTERPRISES, INC. GRACEMORE NURSING & REHAB GRAND STAR-HARDEE'S GRASSO CONVEST DEVELOP. CORP. GREAT AMERICAN EATERY GREAT BARRIER INSULATION GREAT COMMISSION PUBLCIATIONS GREAT OAKS NURSING HOME GREAT SOUTHERN WOOD PRESERVING GREBA METAL PRODUCTS, INC. GREEN OAKS CENTER GREEN THUMB, INC. GREENMAN TECHNOLOGIES OF GA GREENWOOD CEMETARY GREYHOUND LINES GRIFFIN SERVICES GROGAN AND COMPANY, INC. GROOV PIN CORP. GULF LIFE INSURANCE COMPANY GUNTER CONTRACTORS, INC H C BRILL CO., INC. H.H. TIMBER & LOGGING CO. HABASIT BELTING, INC. HAIRSTON CONSTRUCTION CO. HALLING RERFUSE/ALLIED WA HAMBY'S GARAGE HAMMOCK-WICKS TIMBER HAMPTON INN COLUMBUS AIRPORT HANCOCK FABRICS

City
CHATTANOOGA ASHBURN EASTMAN COLUMBUS SAVANNAH EASTMAN MANCHESTER CARTERSVILLE CEDARTOWN ROCKMART FOREST PARK CALHOUN AUBURN BRUNSWICK ADEL ATLANTA ATLANTA BIRMINGHAM NORCROSS ROSWELL CONYERS WINSTON MOULTRIE JESUP JACKSON ATLANTA ATLANTA ATLANTA CUMMING NEWNAN STATESBORO NORCROSS TUCKER CUTHBERT SUWANEE KENNESAW ATLANTA CUMMING ROBERTA COLUMBUS SAVANNAH

State
TN GA GA GA 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 GA GA GA GA GA GA

Page | 48
Total Reimbursed
$5,494.50 $7,074.90 $9,267.13 $4,498.62 $38,370.16 $3,423.17 $3,704.04 $177,422.08 $4,008.25 $65,407.24 $18,664.48 $10,960.02 $36,246.16
$41.80 $1,159.61 $10,300.57 $29,246.56 $1,565.54 $7,219.24 $57,267.65 $34,310.00 $21,495.83 $36,750.97 $38,439.19 $24,541.35 $5,954.08 $37,957.46 $73,206.94
$237.68 $62,493.65 $76,534.50 $25,543.46 $61,156.37 $26,338.85 $18,971.15 $23,412.77 $17,871.82 $20,519.28 $71,531.78 $9,402.74 $2,684.64

Subsequent Injury Trust Fund 2007 Annual Report

Employer
HANCOR, INC HANES HOSIERY, INC. HANNER TRANSPORT, INC. HARALSON COUNTY SCHOOLS HARBIN LUMBER CO HARBISON WALKER REFRACTORIES HARRIS INSULATION & SUPPLY INC HARRIS SERVICE CENTER HARRISON'S BODY SHOP HARTWELL CO. WAREHOUSE HARVEY'S PERSONAL CARE HAYES MICRO COMPUTER PRODUCTS HAYGOOD CONTRACTING, INC. HEALTH MANGEMENT ASSOC. HEALTHPRIME INC. HEALTHSOUTH CORPORATION HENDERSON ELECTRIC CO HENDRIX HAULING CO., INC. HENRY CO WATER AND SEWAGE HENRY COUNTY TRAINING CENTER HERITAGE RETIREMENT HERTZ PENSKE/GEICO TRUCK LSNG HEWITT ASSOCIATES HI BRAND FOODS HICKS PAVING CO., INC. HIDDEN HILLS GRILL HIGGINS GENERAL HOSPITAL HIGH FALLS GRADING INC. HIGHGROVE PARTNERS LLC HIGHTOWER TV HILB, ROGAL, & HAMILTON HILL ELECTRICAL CONTRACTORS HILL PHOENIX REFRIGERATION SYS HILL TIRE COMPANY, INC HILLCREST HOSPICE INC HILLIARD, INC. HINESVILLE RED & WHITE HOLBROOK SERVICE COMPANY, INC. HOLCOMBE' S SUPER VALUE HOLIDAY INN-BRUNSWICK HOLIDAY INN-MCDONOUGH

City
CORDELE LAGRANGE ASHBURN BUCHANAN LAVONIA CALHOUN ATLANTA DALTON MACON HARTWELL WAYCROSS NORCROSS WOODSTOCK STATESBORO ALPHARETTA ATLANTA STONE MOUNTAIN JESUP MCDONOUGH MCDONOUGH ST. SIMON ISLAND FOREST PARK LINCOLNSHIRE PEACHTREE CITY ATHENS STONE MTN. BREMAN WOODSTOCK AUSTELL ROME SAVANNAH DOUGLAS CONYERS FOREST PARK RIVERDALE EASTMAN HINESVILLE COLUMBIA TALLAPOOSA BRUNSWICK MCDONOUGH

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

Page | 49
Total Reimbursed
$62,381.60 $6,831.60 $34,800.00 $22,031.43 $4,423.76 $1,364.15 $17,205.42 $1,030.07 $20,600.24 $17,109.06 $27,574.93 $16,364.26 $68,426.23 $23,059.27 $50,917.33 $4,011.26 $20,868.81 $68,778.37 $63,693.50 $5,307.56 $7,364.55 $99,700.90 $38,092.53 $4,111.28 $25,956.08 $1,183.52 $2,970.00 $192,574.32 $13,589.96 $73,451.74 $14,355.87 $24,865.00 $7,745.00 $50,671.60 $383,960.90 $12,080.42 $14,507.92 $137,297.69 $101,178.86
$785.05 $8,264.61

Subsequent Injury Trust Fund 2007 Annual Report

Employer
HOLIDAY RETIREMENT CORP HOLLAND AMER C/O TBG SERVICES HOLLOWAY CONSTRUCTION CO. HOLMAN CONTRACT WAREHOUSING INC HOLTCO, INC. HOME DEPOT HOME DEPOT HOME DEPOT HOME DEPOT HOME DEPOT HOME DEPOT HOME DEPOT HOME DEPOT HOMELIFE COMMUNITIES GROUP, INC HON INDUSTRIES HOOTERS OF ROME HOOVER PRECISION PRODUCT HOOVER-HANES RUBBER COMPANY HOPKINS HEATING & COOLING HORMEL FOODS CORP HOSHIZAKI AMERICA INC HOSPITAL AUTHORITY OF LIBERTY HOUSE OF TYROL HOUSING AUTHORITY OF COLU HOUSTON CO. ASSOCIATION HOUSTON STEEL, INC. HOWARD BAER INC HOWARD HEATING & AIR INC HOWARD'S LANDSCAPING & GRADING HOWINGTON HEATING & AIR HR AMERICA/FLORIDA COMMERICAL HUB ONE LOGISTICS HUBERT MOORE LUMBER HUDDLE HOUSE HUGHES CABINET SHOP HUGHES SUPPLY, INC. HUNT-MILLER INSURANCE HURST BOILER & WELDING CO HUXFORD ENTERPRISES INC I P S BALERS IDLE HOUR GOLF & COUNTRY CLUB

City
ATLANTA ROSSVILLE BALLGROUND GARDEN CITY ATLANTA ATLANTA AUSTELL CUMMING DAWSONVILLE DULUTH FAYETTEVILLE LOGANVILLE MACON ALBANY CEDARTOWN ROME CUMMING TALLAPOOSA DAWSON TUCKER PEACHTREE CITY LUDOWICI CLEVELAND COLUMBUS WARNER ROBINS BYRON NASHVILLE ROSSVILLE LILBURN CORNELIA CHARLOTTE LITHIA SPRINGS ALAPAHA DAHLONEGA DANIELSVILLE ORLANDO WARNER ROBINS COOLIDGE CUMMING BAXLEY 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 TN GA GA GA NC GA GA GA GA FL GA GA GA GA GA

Page | 50
Total Reimbursed
$145.95 $97,230.87 $5,670.00 $65,384.58 $149,053.81 $991,958.28
$418.75 $13,084.14 $13,014.23 $56,409.80 $12,433.86 $6,679.14 $9,928.66 $34,728.32 $55,691.54 $57,295.35 $28,665.16 $39,030.45 $120,340.33 $4,117.61 $20,591.92 $23,978.07 $44,523.05 $27,160.00
$259.00 $10,975.52 $112,327.12 $9,098.00 $8,100.12 $29,609.94 $19,671.27 $1,635.19 $13,546.12 $11,787.24 $80,487.75
$343.13 $3,451.08
$463.30 $23,923.28 $121,575.42 $10,036.95

Subsequent Injury Trust Fund 2007 Annual Report

Employer
IEF IFS LAGRANGE IHOP ILLINOIS TOOL WORKS/FLA TILE IMAGISTICS INTERNATIONAL INC IMERYS CLAYS, INC. IMERYS CLAYS, INC. IMERYS KAOLIN INDEPENDENT LIFE INSURANCE CO. INDUSTRIAL SUPPLY INGLETT & STRUBBS, INC. INLAND CONTAINER CORP. INNER HARBOUR, LTD INNOVATIVE CONCEPT GROUP INC. INSTALLATION DESIGN SERVICES INTERFACE FLOORING, INC. INTERIM PERSONNEL INTERLINE BRANDS INC INTERNATIONAL AUTO PROCESSING INTERNATIONAL ENERGY SOLUTIONS INTERNATIONAL RESCUE COMM INTERSTATE BRANDS CORP INTERSTATE DISTRIBUTORS, INC. INT'L ASSOC. OF MACHINISTS IRON MOUNTAIN INC. IRWIN MANUFACTURING Corp. ITHACA INDUSTRIES INC. ITHACA INDUSTRIES INC. ITR INDUSTRIES ITT AUTOMOTIVE ITT THOMPSON ITT-RAYONIER, INC. ITT-RAYONIER, INC. IVAN ALLEN WORKSPACE J & J FOODS INC J & S, INC. J K UTILITIES LLC J&M TRANSPORTATION J. C. PENNEY COMPANY J. P. BEAMER CO., INC. J.A. JONES MANAGEMENT

City
CLEARWATER LAGRANGE RIVERDALE SHANNON WAYCROSS DEEPSTEP SANDERSVILLE DRY BRANCH ROME SALISBURY ATLANTA ROME DOUGLASVILLE TAMPA CONYERS LA GRANGE ATLANTA JACKSONVILLE BRUNSWICK ROSWELL NEW YORK COLUMBUS NORCROSS MARIETTA ATLANTA OCILLA GLENNVILLE MEIGS TOCCOA ROME ADEL JESUP MIDVILLE ATLANTA GAINESVILLE INDIANOLA JEFFERSON LASCRUSES STONE MOUNTAIN CALHOUN KINGS BAY

State
FL GA GA GA GA GA GA GA GA NC GA GA GA FL GA GA GA FL GA GA NY GA GA GA GA GA GA GA GA GA GA GA GA GA GA PA GA NM GA GA GA

Page | 51
Total Reimbursed
$108,641.17 $24,721.03 $15,336.00 $27,166.51 $30,679.92 $11,896.38 $31,926.15
$210,999.01 $18,566.18 $40,009.32 $243.00 $7,059.39 $48,795.90 $19,460.93 $140.51 $13,355.45 $4,962.95 $9,271.78 $22,344.57 $21,589.48 $3,575.00 $349.86 $15,844.20 $11,797.02 $40,385.66 $903.15 $36,305.93 $20,511.55 $30,774.02 $11,509.22 $14,350.00 $26,959.08 $7,700.00 $3,878.96 $17,102.00 $30,016.45
$105,730.06 $5,561.32 $4,587.80 $5,385.30 $24,419.58

Subsequent Injury Trust Fund 2007 Annual Report

Employer
J.B. HUNT TRANSPORT J.C. PENNEY COMPANY J.G. DAVIDSON JR. ELECTRICAL J.M. HUBER J.P. THAYER CO JACKSON CO BD OF EDUCATION JAMES F. HOOVER JAMES HILL CONTRACTOR JAMES W. HURT & ASSOC. JAMESON HOSPITALITY, LLC JARVIS WEBB JB HUNT TRANSPORT JEAN THOMAS JEBCO, INC. JEFF & MAX MAULDIN dba CODY J' JERED INDUSTRIES INC JERRY & DEBBIE FIELDS JERRY OWENS JIM LUCA ELECTRIC JIM WALTER HOMES, INC. JM BURGESS, INC. J-M MANUFACTURING CO INC JOEL ANDERSON JOHN DEMORE LOCK & KEY SVC. JOHN H. HARLAND COMPANY JOHN HARLAND CO JOHN O. COOK, INC JOHN PITTS COMPANY, INC. JOHNNY NOBLES STUMPWOOD, INC JOHNNY PHILLIP HEATING JOHNSON & JOHNSON JOHNSON CONTROLS WORLD JONATHAN R. JOWERS JONES AUTOMATIC SPRINKLER JONES FLOOR COVERING INC JOWERS & COMPANY INC JOY TRUCK LINE JRH OPTICS/PEARL VISION EXPRES J-T MANAGEMENT JTM CORP. JUNCTION CITY MINING

City
LOWELL ATLANTA LAGRANGE WRENS LAGRANGE JEFFERSON LAVONIA ACWORTH CORDELE ATLANTA MARIETTA LOWELL COMMERCE WARRENTON EMERSON BRUNSWICK DALLAS DUBLIN POWDER SPRINGS FOREST PARK LINCOLNTON ADEL MAYSVILLE NEWNAN DECATUR CONYERS FITZGERALD FORSYTH NICHOLLS CHAMBLEE ROYSTON FT. GORDON MARTINEZ AMERICUS PENSACOLA ATLANTA DALTON DULUTH DORAVILLE PHENIX CITY MIDWAY GADSDEN

State
AR GA GA GA GA GA GA GA GA GA GA AR 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 AL FL

Page | 52
Total Reimbursed
$481.02 $89,298.16 $18,143.84 $58,605.60 $1,641.51 $40,300.19 $23,469.69 $73,330.00 $10,150.63
$292.50 $1,939.20 $78,580.00 $6,432.72 $72,299.62 $46,200.90 $72,514.17
$88.14 $257,174.90
$2,276.36 $15,526.33 $130,206.53 $907,158.20 $2,557.11 $77,290.20 $14,509.42 $53,237.64 $2,159.93 $35,337.91 $2,354.50 $99,821.25 $4,032.18 $20,636.79 $26,182.40 $33,029.02 $18,055.00 $75,707.43 $36,976.87 $57,509.29 $11,646.57 $112,572.23 $31,276.60

Subsequent Injury Trust Fund 2007 Annual Report

Employer
JUST BRAKES JWI GROUP PRESS FABRIC K & F INDUSTRIES KASON INDUSTRIES KEANE, INC. KELLEY BUICK KELLOGG CO. KELLOGG COMPANY KELLWOOD COMPANY KEMKO LAWN SERVICE KENNEDY EQUIPMENT CO. KENNESAW TRANSPORTATION, INC. KEY HEALTH CENTER KEYS GROUP HOLDINGS KEYSTONE MEMORIALS, INC. KICKBUSH CONSTRUCTION KILLEARN PROPERTIES INC OF GA KING MUFFLER SHOP KINNEY CONSTRUCTION CO KLIKLOK WOODMAN CORPORATION KNIGHT'S ELECTRIC CO. KOCH FOODS KOCH FOODS MEAT COMPANY KOCH MATERIALS SYSTEMS KOLE INVESTMENT CO. KRAFT FOOD INC KROGER CO. KROGER CO. KRYSTAL/M.A.E. THOMASVILLE KUBOTA MANUFACTURING KUEHNE & NAGEL, INC KUPPENHEIMER MFG. CO. L & L MANAGEMENT (BURGER KING) L & M, INC L.E. SCHWARTZ & SONS INC LA99, INC LAGRANGE MACHINE SHOP LAGRANGE SCHOOL SYSTEM LAKEWOOD BAPTIST CHURCH LAMAR COUNTY BOE LANCE INC

City
STOCKBRIDGE JONESBORO ROCKMART NEWNAN ATLANTA ROSWELL ATLANTA ELMHURST ST. LOUIS LOGANVILLE COLUMBUS WHITE MACON SAVANNAH ELBERTON BISHOP CLAYTON WAYCROSS LEESBURG DECATUR MOULTRIE GAINESVILLE CUMMING ALPHARETTA SAVANNAH NORCROSS ATHENS ATLANTA THOMASVILLE GAINESVILLE MCDONOUGH LOGANVILLE MARIETTA VIDALIA MACON ROSWELL LAGRANGE LAGRANGE GAINESVILLE BARNESVILLE VALDOSTA

State
GA GA GA GA GA GA GA IL MO 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

Page | 53
Total Reimbursed
$27,988.67 $6,560.01 $37,771.52 $5,221.40 $4,875.00 $1,826.43 $14,162.64 $2,951.98 $20,601.30 $68,694.72 $4,799.09 $29,350.16 $42,059.05 $42,979.25 $281,758.28 $41,261.23 $8,969.34 $49,419.54 $59,028.91 $22,229.30
$178.34 $511.51 $22,200.70 $36,385.47 $200,366.73 $64,889.45 $7,251.70 $330,954.74 $43,346.08 $94,728.83 $11,953.63 $228.32 $23,674.00 $142,575.32 $26,497.51
$38.25 $1,154.07 $11,025.00 $29,438.13 $27,862.92 $28,800.00

Subsequent Injury Trust Fund 2007 Annual Report

Employer
LANCE, INC. LAND O'LAKES, INC. LAND O'SUN DAIRIES LANE BRYANT LANE REALTY CONST LANEHART ELEC. CONTRACTORS LANIER PARKING SYSTEMS INC LAPP INSULATOR CO LARSON & JUHL LARSON & JUHL LATEX CONSTRUCTION CO LAUREL BAYE HEALTH LAKE LANIER LAW ENGINEERING CO LAWLER HOSIERY MILL INC LAYTON GLASS INC LEAR CORP LEASEWAY PERSONNEL CORP. LEE A. FINCH LEGGETT & PLATT, INC. LEGION INDUSTRIES, INC LEON FARMER & CO. LEON JONES FEED & GRAIN LESLIE FAY SPORTSWEAR LESTER PRECISION DIE LEVI STRAUSS & COMPANY LEVITON MANUFACTURING CO. LEXUS OF SOUTH ATLANTA LIBERTY COUNTY SCHOOLS LIBERTY REGIONAL MEDICAL CENTER LIFE LIKE, INC. LILBURN DEVELOPERS, INC LIN R. ROGERS ELECTRICAL LINCOLN PROPERTY CO ECW INC LINPAC, INC. LOCKHEED MARTIN LOCKHEED MARTIN LOCKHEED MARTIN CORP LODINS SERVICES # 1, INC. LOGAN PAVING COMPANY LONG'S PLASTERING & REMODELING LOOK PRODUCTS

City
CHARLOTTE CAMILLA ATLANTA ATLANTA ATLANTA IRVING ATLANTA SANDERSVILLE ADAIRSVILLE NORCROSS CONYERS BUFORD ATLANTA CARROLLTON CARTERSVILLE ATLANTA READING SAUTEE NACOOC MONROE WAYNESBORO GAINESVILLE CUMMING MORROW ROME VALDOSTA ATLANTA UNION CITY HINESVILLE HINESVILLE KENNESAW LILBURN ROSWELL ALPHARETTA ATLANTA BETHESADA KINGS BAY MARIETTA DECATUR ATHENS SOPERTON MILLEN

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

Page | 54
Total Reimbursed
$5,320.00 $84,754.29 $30,031.92 $77,045.61 $78,432.78 $16,295.84 $65,194.30 $75,827.19 $14,151.69 $4,875.00 $5,187.62 $73,398.52 $4,258.40 $11,132.33 $67,441.40 $65,858.12 $49,304.47 $28,718.76 $181,605.89 $25,286.49 $5,897.39 $68,685.92 $28,484.35 $9,849.61 $8,348.02 $46,134.37 $22,371.96 $14,246.15 $74,129.87 $2,060.72 $25,827.19 $18,445.90 $3,240.93 $10,918.21 $1,765.59
$182.00 $922,055.71
$6,673.28 $11,925.00 $150,082.20 $81,493.22

Subsequent Injury Trust Fund 2007 Annual Report

Employer
LORAL SPACE & COMMUNICATIONS LORD & STEPHENS FUNERAL L'OREAL USA INC LOWE'S COMPANIES LTC HEALTHCARE M T VENTURES M&M LOGGING INC M.T. DAY CONTRACTING, INC. MACALIJON/SCL, INC MACON CIGAR & TOBACCO CO., INC MACON KRAFT MACON MALL/COLONIAL PROP. TR. MACON NORTHSIDE HOSPITAL MACON-BIBB CO WATER & SEWAGE MACTEC, INC MADISON CO. BD. OF ED. MAG MUTUAL INSURANCE MAGNOLIA MANOR MAGNOLIA MANOR MAIL TERMINAL SERVICES MAIL-WELL, INC. MAKITA CORP. OF AMERICA MALL EXPRESS MANN MECHANICAL CO. INC. MANPOWER INC MANPOWER TEMP. SERVICES MANSOUR'S MAPLEHURST, INC. MAREK INTERIOR SYSTEMS, INC. MARELL POULTRY COMPANY INC MARI STAFF, INC. MARIETTA DRYWALL MARK DUNNING INDUSTRIES MARK'S & MORGAN JEWELERS, INC. MARK'S & MORGAN JEWELERS, INC. MARLEY COOLING TOWER MARMON HOLDINGS MARSHALLS MARTIN CONSTRUCTION COMPANY MARTIN MARIETTA MATERIALS MARTINS RESTAURANT SYSTEM

City
ROCKMART ATHENS SAVANNAH ALBANY FT. VALLEY HAMPTON CUTHBERT DALLAS SAVANNAH MACON MACON MACON MACON MACON ATLANTA DANIELSVILLE DULUTH MOULTRIE RICHMOND HILL FOREST PARK ATLANTA BUFORD ALBANY AVONDALE ESTS. LAGRANGE DUBLIN LAGRANGE CARROLLTON HOUSTON MURRAYVILLE ATLANTA MARIETTA KING'S BAY AUGUSTA MACON OVERLAND PARK VALDOSTA DECATUR SYLVESTER SUWANEE MABLETON

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 TX GA GA GA GA GA GA KS GA GA GA GA GA

Page | 55
Total Reimbursed
$6,932.38 $109,417.64
$108.08 $2,786.81 $187,760.15 $25,888.00 $150,902.60 $64,178.78 $26,524.51 $13,560.82 $2,975.00 $53,331.77 $17,605.73 $8,086.67
$33.94 $6,174.35 $8,321.51 $1,588.42 $1,384.02
$670.06 $15,290.41 $271,940.30 $192,771.60 $10,575.13 $30,185.18
$737.77 $27,925.56 $98,842.66 $10,580.76 $4,314.43 $39,288.51 $1,000.41 $102,026.07 $37,527.78 $34,164.07 $2,866.04 $1,898.47 $7,998.83 $17,854.03 $82,009.75 $100,543.23

Subsequent Injury Trust Fund 2007 Annual Report

Employer
MASCO CONTRACTOR SERV CENTRAL MASTER PROMOTIONS MATHEWS TRUCKING INC MATT DAVIS LIGHTING INC MAVERICK MATERIALS MAVERICK MATERIALS MAVERICK MATERIALS MAXWELL CHASE TECH. MAYS INTERNATIONAL MC DESIGNS MCC INDUSTRIAL, INC. MCC PANASONIC MCCLESKY MILLS McCRANIE MOTOR/TRACTOR MCDONALDS CORP MCG HEALTH, INC. MCGUIRE TRUCKING McINVALE ENTERPRISES McKENNEY'S, INC. MCKIBBON BROTHERS, INC MCKINNEY COMMUNITY HEALTH MCMASTER-CARR SUPPLY CO MC'S PAINTING & DECORATING CO. McWHORTER TECHNOLOGIES MD HODGES ENTERPRISES, INC. MEADOWDALE NURSERIES MEADOWS REGIONAL MEDICAL CTR. MED CARE INC/ COOSA VALLEY MEDICAL CENTER LLP MEDICAL GAS SPECIALISTS, INC. MEMORIAL HOSPITAL & MANOR MENLO PARK, INC. MERICO, INC. MERIDIAN BEVERAGE CO INC MERRY ACRES METAL BUILDINGS, INC. METAL PRODUCTS COMPANY METAL STRIPPING SYSTEM, INC. METRO BUILDERS SUPPLY INC. MGR HOMECARE, INC. MID GEORGIA AMBULANCE

City
AUGUSTA LITHIA SPRINGS BAXLEY VILLA RICA GAINESVILLE LITHONIA NEWBORN SMYRNA AUGUSTA CANTON MACON PEACHTREE CITY SMITHVILLE UNADILLA CEDARTOWN AUGUSTA CLEVELAND REYNOLDS ATLANTA GAINESVILLE WAYCROSS ATLANTA HIRAM COLUMBUS ATLANTA WARNER ROBINS VIDILIA ROME DUBLIN CANTON BAINBRIDGE PEACHTREE CITY FOREST PARK NORCROSS ALBANY THOMASVILLE SUWANEE NASHVILLE FAIRBURN GRIFFIN 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 GA TN GA GA GA

Page | 56
Total Reimbursed
$2,177.61 $19,129.05 $24,987.28 $25,396.56 $18,279.02 $26,717.35
$625.84 $36,487.26 $23,110.76 $95,862.68 $29,836.59 $43,178.15 $27,350.21 $33,052.36
$102.38 $249,559.07
$65,251.99 $178,621.38
$200.73 $12,578.68 $88,409.95 $37,071.01 $13,544.62 $26,459.88 $1,690.18 $18,983.42 $30,709.28 $11,608.13 $6,164.00 $28,660.36 $7,814.75 $45,403.80 $18,616.81
$151.69 $16,090.22 $58,164.38 $53,316.12 $31,976.12 $27,537.69 $31,085.50 $3,779.18

Subsequent Injury Trust Fund 2007 Annual Report

Employer

City

MID SOUTH SUBCONTRACTORS INC MIDDLE GA COMMUNITY ACTION AGENCY MIDDLE GEORGIA HOSPITAL MID-GA COURIER MID-GEORGIA AMBULANCE MIKE L MOON ENTERPRISES MILLER BREWING CO MILLER BREWING COMPANY MILLIKEN & COMPANY MILLIS TRANSFER, INC. MISCELLANEOUS ERECTORS, INC. MITCHELL A. NEIDLINGER MITCHELL COUNTY BD OF EDU MODERN BUILDERS SUPPLY, INC. MODERN DAY SYSTEM MODULAR CONTAINER SYSTEM MONCRIEF HEATING & A/C MONROE AUTO EQUIPMENT MOORE TRUCK LINES MOORE'S ASPHALT PAVING CO MOORMANS, INC. MOR PPM, Inc. MORGAN CORPORATION MORI LUGGAGE & GIFTS MORNING STAR TREATMENT SERVICE MOTIVA ENTERPRISES MOTOROLA INC MOULTRIE PULPWOOD/TIMBER MR. PLUMBER, INC. MR. ZIP INC. OF TENN MRS FIELD'S ORIGINAL COOKIES MURATA ELECTRONICS MURATA ELECTRONICS NORTH MURRAY COUNTY BOARD OF EDUCATI MVE INC N&N ASPHALT NATIONAL EMP. SOLUTIONS/SISKEY NATIONAL EMPLOYER SOLUTIONS NATIONAL EMPLOYER SOLUTIONS NATIONAL ENERGY SERVICES, INC NATIONAL GYPSUM

FOREST PARK WARNER ROBINS MACON COLLEGE PARK MACON BUENA VISTA MOULTRIE ALBANY LAGRANGE BLACK RIVER FALLS POWDER SPRINGS SPRINGFIELD CAMILLA WAYCROSS MARIETTA LAVONIA ATLANTA HARTWELL ALAPAHA SNELLVILLE CORDELE JULIETTE RYDAL ATLANTA BRUNSWICK ALPHARETTA LAWRENCEVILLE MOULTRIE DORAVILLE CLEVELAND SALT LAKE CITY SMYRNA ROCKMART CHATSWORTH CANTON SHARPSBURG MABLETON ALPHARETTA DALTON ROSWELL GARDEN CITY

State
GA GA GA GA GA GA GA GA GA WI GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA TN UT GA GA GA GA GA GA GA GA GA GA

Page | 57
Total Reimbursed
$63,721.50 $42,180.27 $16,704.63 $15,968.19 $16,276.21 $10,808.64
$631.58 $457,006.13
$31,933.26 $110,954.30
$2,647.66 $18,470.48 $24,739.05 $219,007.05 $30,392.12 $65,394.07 $19,702.76 $9,102.49
$847.52 $13,618.67 $12,666.75
$156.63 $14,145.81 $30,365.83 $9,280.07 $150,169.75
$30.00 $969.65 $8,307.46 $428.97 $9,236.58 $8,815.74 $67,490.36 $12,971.20 $73,819.87 $27,057.44 $79,837.05 $1,787.68 $13,704.12 $14,725.94 $155,955.81

Subsequent Injury Trust Fund 2007 Annual Report

Employer
NATIONAL HEALTH LABORATORIES NATIONAL PUBLIC RADIO, INC. NAU, INC. NCR CORP. NEFF RENTALS, INC. NEMA, INC NES/AIKEN MANUFACTURING NESTLE TRANSPORTATION CO. NETCARE HEALTH SYSTEMS, INC. NEW BIRTH MISSIONARY BAPTIST C NEW RIVERSIDE OCHRE CO. NEW VIASYS HOLDINGS, LLC NEWCOMB SPRING CORP NEWS/SHOPPER, INC NIBCO INC NICHOLLS LOGGING, INC. NICHOLSON ENTERPRISES, INC NICHOLSON ENTERPRISES, INC. NOLAND COMPANY NORCOM INC NORD KAOLIN CO NORDIC COLD STORAGE NORTH AMERICA CONT. NORTH FULTON REGIONAL HOSPITAL NORTH GEORGIA CONVERTING, INC. NORTH GEORGIA DISTRIBUTING NORTH GEORGIA FOODS INC NORTH GEORGIA INDUSTRY NORTH GEORGIA READY MIX NORTHROP GRUMMAN CORP. NORTHWEST GEORGIA FOODS, INC. NSR, INC. NU CRAFT DENTAL ARTS INC NUC02, INC O. ANDERSON CURRIE JR., DDS OASIS OUTSOURCING OCMULGEE FIELDS ODC OF ATLANTA OELSCHIG'S NURSERY, INC. OFFICE DEPOT OFS BRIGHTWAVE, LLC

City
MARIETTA WASHINGTON AUGUSTA PEACHTREE CITY AUGUSTA DULUTH ALPHARETTA MCDONOUGH ELLIJAY LITHONIA CARTERSVILLE ALBANY LITHONIA WOODSTOCK GREENSBORO DOUGLAS YOUNG HARRIS HOLLY SPRINGS MACON NORCROSS JEFFERSONVILLE ATLANTA ADAIRSVILLE ROSWELL CLARKSVILLE ROME TALLULAH FALLS GAINESVILLE DALTON ST MARYS ROME CHAMBLEE BOGART STUART ATLANTA SARASOTA MACON ATLANTA SAVANNAH KENNESAW CARROLLTON

State
GA DC 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 FL GA FL GA GA GA GA GA

Page | 58
Total Reimbursed
$28,455.61 $22,093.54
$590.32 $9,614.04 $1,321.55 $33,151.83 $2,581.86 $39,911.80 $41,737.94 $5,386.96 $161,357.72 $1,704.00 $3,014.33 $34,371.68 $18,052.00 $10,850.00 $39,655.98 $18,985.03 $3,382.32 $14,956.78 $7,965.00 $134,646.74 $11,945.87 $22,098.03 $117,448.06 $41,983.58 $6,120.13 $1,424.27 $45,031.07 $1,623.01 $121,296.59 $99,109.29 $55,725.64 $96,287.29 $37,520.00 $168,946.81 $22,067.25 $45,143.99 $13,255.21 $48,005.03 $25,161.21

Subsequent Injury Trust Fund 2007 Annual Report

Employer
OFS BRIGHTWAVE, LLC OGLETHORPE COUNTY SCHOOL OIL-DRI CORPORATION OLD FASHION FOODS OLIN WOOTEN TRANSPORT CO. INC. OLYMPIC TRANSPORT, Inc. OLYMPUS BUILDING SERVICE OMC OMI, INC ONEDA CORPORATION OPERATIONS MANAGEMENT INT OPTIMUS SOLUTIONS, LLC ORDER INC. ORIENTAL WEAVERS RUG MFG.,INC. ORTHOLINK PHYSICIANS OSRAM SYLVANIA INC OTS KITCHENS INC OUTDOOR SYSTEMS, INC. OUTSOURCING SOLUTIONS, INC OVERHEAD DOOR CO. OF ATL. OVERHEAD DOOR CORP. OWENS & PRIDGEN, INC. OXFORD OF DUBLIN OXYGEN SERVICE COMPANY P &M TRUCKING PACE AMERICA PACKARD INC. PACTIV COMPANY PAI INDUSTRIES INC PANAPRINT, INC PANASONIC MATSUSHITA COMP. CO PAPER PAK PRODUCTS PARAMONT GRADING INC. PARKWOOD NURSING & REHAB PARRISH MONUMENT COMPANY PATRICK RENTALS PATRICK TRACTOR COMPANY PAYLESS SHOE SOURCE INC PCI PROCOATERS INC PEACHFORD BEHAVIORAL HEALTH PEACHTREE DOORS AND WINDOWS

City
NORCROSS LEXINGTON OCHLOCKNEE AUSTELL HAZLEHURST HOBOKEN DOYLESTOWN CALHOUN SWAINSBORO COLUMBUS WAYNESBORO NORCROSS ATLANTA DALTON BRENTWOOD ATLANTA DALLAS ATLANTA DULUTH ATLANTA ATHENS BRUNSWICK DUBLIN MACON DOUGLAS EASTMAN KENNESAW COVINGTON SUWANEE MACON PEACHTREE CITY WASHINGTON CUMMING SNELLVILLE VALDOSTA STOCKBRIDGE TIFTON ATHENS DECATUR ATLANTA GAINESVILLE

State
GA GA GA GA GA GA PA 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

Page | 59
Total Reimbursed
$33,310.88 $17,701.71 $53,851.07 $145,878.35 $10,442.27 $90,399.43 $103,410.00 $56,705.34 $8,989.46 $5,279.73 $42,131.36 $8,963.96 $134,856.00 $64,617.04 $6,949.48 $28,400.00 $153,056.71
$597.31 $1,240.80 $13,282.81 $10,716.96 $19,927.16 $11,730.80 $2,955.07 $188,817.13
$640.94 $2,229.28 $35,673.41 $27,920.21 $10,761.17 $108,827.80 $39,780.26 $37,830.52 $4,320.00 $58,868.40 $56,275.58 $11,374.02 $25,790.00
$194.33 $656.97 $22,753.71

Subsequent Injury Trust Fund 2007 Annual Report

Employer
PEACHTREE SOFTWARE PEAVY SPREADER PEEKS FIFTH AVE. PEEPLES IND./MAT. HAND & ENG PEERLESS MANUFACTURING CO PEPSI BOTTLING GROUP PEPSI-COLA COMPANY PERFORMANCE TEMPORARY STAFFING PERFORMANCE TRUCKING, INC PETE ALEWINE POOL CO. INC PETSMART PETSMART PHILLIPS ELECTRONIC/ASSEMBLEO PHOENIX CRANE RENTAL CO PHOENIX RECLAMATION PICKLE LOGGING, INC PIERCE & COMPANY, INC. PIERCE COUNTY BOARD OF ED PIGGLY WIGGLY PIGGLY WIGGLY SOUTHERN PIKE ELECTRIC INC PIKE NURSERIES PILLSBURY CO PILOT CORP. PINE KNOLL NURSING & REHAB. PINE MTN. WILD ANIMAL PARK PINE RIDGE MEMORIAL PARK PINEHILL NURSING CENTER PINEHURST EQUIPMENT PINKERTON-BURNS SECURITY PINNACLE FINANCIAL CORP PIOLAX CORPORATION PIONEER CONCRETE PUMPING PIPE CONSTRUCTION PITNEY BOWES PIZZA HUT PIZZA HUT, INC. PLANT CORPORATION PLANTERS TIRE & AUTO SERVICE PLUMBING DISTRIBUTERS INC PNC BANK CORP

City
NORCROSS PINEHURST ROME SAVANNAH SHELLMAN WAYCROSS ATLANTA ATLANTA SUWANEE MARTINEZ DOUGLASVILLE MORROW ALPHARETTA MABLETON MACON AMERICUS CONYERS BLACKSHEAR BLUE RIDGE VIDALIA MOUNT AIRY NORCROSS LITHONIA KNOXVILLE CARROLLTON PINE MOUNTAIN KENNESAW BYROMVILLE PINEHURST NORCROSS ELBERTON CANTON SMYRNA ST. SIMONS ISLA NORCROSS MONROE WOODSTOCK CALHOUN FITZGERALD LAWRENCEVILLE ATLANTA

State
GA 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 GA GA GA GA

Page | 60
Total Reimbursed
$464.56 $101,561.09 $103,884.47 $166,250.00
$34,999.24 $54,640.00 $4,550.00 $37,843.79 $168,519.25 $148,275.31 $13,314.44 $21,199.43 $288,047.22 $144,227.28 $22,680.12 $10,721.71 $68,998.62 $75,340.99 $172,833.42 $7,370.00 $200,827.99 $39,574.88
$265.03 $82,856.46 $7,766.86 $67,138.72 $57,170.65
$748.95 $100,000.00
$1,431.67 $1,079.49 $21,734.93 $33,418.48 $130,979.49 $12,117.65 $4,762.57 $2,975.00
$765.23 $30,900.30 $16,022.33 $11,738.06

Subsequent Injury Trust Fund 2007 Annual Report

Employer
POLLUTION EQUIPMENT MGMT. CO. PORTEC INC PORTERFIELD TIRE INC POST PROPERTIES INC PRECISION COMPONENTS PRECISION ELECTRICAL SYSTEMS I PREMARK INTERNATIONAL INC. PRESTOLITE WIRE CORPORATION PRIME PAK FOODS PRIME PUMP WELL, INC. PRIME SOURCE PRIMERICA FINANCIAL SERVICE PRIORITY ONE SERVICES PRITCHETT TRUCKING PROCARE SOLUTIONS PROFESSIONAL & TEMP SERVICES PROFESSIONAL MEDICAL SERVICES PROGRESSIVE MANAGEMENT PROPERTY RESOURCES, INC PTREE/CARDON DOORS & WINDOWS PUBLIC HEALTH PERSONAL SUPPORT PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX

City
ATLANTA WINDER ATHENS ATLANTA COLUMBUS GAINESVILLE CHAMBLEE TIFTON GAINESVILLE DAHLONEGA SAVANNAH DULUTH ALEXANDRIA LAKE BUTLER MARIETTA THOMASVILLE ORLANDO MACON DECATUR GAINSVILLE VALDOSTA ALPHARETTA ATLANTA BRUNSWICK BUFORD CANTON COLUMBUS CONYERS DACULA DECATUR DULUTH FLOWERY BRANCH KENNESAW LAKELAND LAWRENCEVILLE LITHONIA LOGANVILLE MARIETTA MARTINEZ MCDONOUGH ROSWELL

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

Page | 61
Total Reimbursed
$22,441.97 $4,510.00 $171,572.88 $4,416.87 $21,588.01
$751.96 $575.63 $3,261.36 $30,172.30 $207,914.02 $3,518.84 $130,158.14 $18,785.50 $3,887.88 $42,055.64 $8,100.76 $16,350.66 $7,500.00 $121,586.94 $12,905.08 $41,224.74 $56,565.42 $156,217.14 $168,336.12 $15,352.68 $35,409.25 $2,339.85 $15,905.90 $120,303.79 $14,500.61 $9,047.21 $209,511.11 $28,221.34 $23,247.36 $4,917.69 $26,267.46 $50,649.10 $448.00 $28,190.18 $16,831.40 $36,653.81

Subsequent Injury Trust Fund 2007 Annual Report

Employer
PUBLIX PUBLIX PUBLIX PUBLIX PUBLIX PURAFIL, INC. PYLES PLUMBING & UTILITY QUAD GRAPHICS QUALITY DIST.-QUALA SYSTEMS QUALITY FOODS OF COMMERCE, INC QUALITY MACHINE & FAB. QUICK CHANGE #33 R & D MANUFACTURING CO., INC. R & R TEXTILES R & W LOGISTICS R.C. MOORE D/B/A SUWANEE R.E. SERVICES R.W. ALEXANDER CONTRACTORS RAILSERVE, INC. RAINEY ELECTRIC SERVICE RA-LIN ASSOCIATES, INC. RAMBO NURSERY RANDALL BROTHERS RANDSTAD RANEW'S PAINT & BODY SHOP RAYLOC RAY-O-LITE SOUTHEAST INC RAYONIER, INC. RAZZI CORP. RCS-GRIFFON CORP RED LOBSTER/DARDEN RESTAURANT REDMOND EMERGENCY MED SVCS REDMOND REGIONAL MEDICAL CTR REECE LOGGING INC REEVES CONSTRUCTION CO. REEVES CONSTRUCTION CO. REEVES HARDWARE COMPANY REEVES TRUCKING CO., INC. REGAL MARINE INDUSTRIES REGAL RUGS REGIS

City
SMYRNA SUWANEE VALDOSTA WARNER ROBINS WOODSTOCK NORCROSS MACON THE ROCK AUGUSTA COMMERCE LAFAYETTE DOUGLAS GAINESVILLE CHATSWORTH AUGUSTA WALESKA LAFAYETTE VALDOSTA ATLANTA BONAIRE CARROLLTON DALLAS ATLANTA ATLANTA MILNER ATLANTA ATLANTA JESUP ALPHARETTA CONYERS COLUMBUS ROME ROME JASPER AMERICUS THOMSON CLAYTON FITZGERALD VALDOSTA ELLIJAY ATHENS

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 GA GA GA GA GA

Page | 62
Total Reimbursed
$69,024.48 $13,840.89 $88,098.48 $105,578.15 $13,077.67
$684.89 $26,654.99 $9,141.41 $86,678.94 $20,093.06 $30,418.55 $19,024.45 $2,642.27 $26,813.93 $23,697.75 $28,047.82 $5,053.94 $2,310.31 $4,433.08 $43,273.39 $28,955.06
$714.41 $146,459.56
$86,086.00 $21,939.69 $4,375.00 $40,785.76 $11,362.76 $8,002.66 $134,520.02 $8,745.93 $7,647.35 $71,218.85 $31,692.09 $10,300.06 $10,173.10 $17,193.30 $14,850.00 $7,733.90 $5,881.66 $15,865.82

Subsequent Injury Trust Fund 2007 Annual Report

Employer
REID & REID CONTRACTORS, LLP RELIABLE FASTENERS INC REMEDIATION SERVICES, INC. RENEWED PAINTING RENT A CENTER RENT-A-CENTER INC. RENTOKIL CONTRACT SVC., INC. RENTOKIL, INC. RENTZ COMMUNICATIONS INC REPUBLIC SERVICES RESCAR, INC RESOURCING SERVICE OF ATLANTA RESPIRONICS, INC. RHEEM MANUFACTURING CO. RHEEM MANUFACTURING CO. RHEEM MANUFACTURING CO. RHODES FURNITURE RHONE POULNEC, INC. RICH'S RIDGEWOOD MANOR RIVERWOOD INT'L. CORP. RJ REYNOLDS TOBACCO CO. ROBERT BRYAN ROBERT M. ANDERSON, INC. ROBERT SHAW CONTROLS CO. ROBINSON PAVING & SO ASPHALT ROBLAW INDUSTRIES ROEHL TRANSPORT ROEHL TRANSPORT, INC ROGERS CARTAGE CO ROGERS CASH & CARRY ROME CITY SCHOOLS ROME TOOL & DYE COMPANY, INC. RONILE OF GEORGIA, INC. ROOMS TO GO FURNITURE CORP ROOMS TO GO FURNITURE CORP ROPER INDUSTRIES ROSES DEPARTMENT STORE # 235 ROSIEK CONSTRUCTION CO. ROSS SIMON ROTATING ENGINEERED PRODUCTS

City
CUMMING SMYRNA FITZGERALD STOCKBRIDGE LITHIA SPRINGS WAYCROSS DULUTH ATLANTA BAXLEY WINDER GORDON ATLANTA KENNESAW MILLEDGEVILLE NEW YORK TAMPA SMYRNA WOODBINE ATLANTA DALTON MACON MACON TAYLORSVILLE COVINGTON ELLIJAY COLUMBUS FOLKSTON MARSHFIELD ELLENWOOD FORSTON THOMASTON ROME ROME LAFAYETTE ALPHARETTA SUWANEE COMMERCE ALBANY BRUNSWICK CRANSTON GAINESVILLE

State
GA GA GA GA GA GA GA GA GA GA GA GA GA GA NY FL GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA RI GA

Page | 63
Total Reimbursed
$33,611.03 $67,018.63 $16,167.11 $48,228.15 $50,669.88 $71,925.66 $150,350.60 $83,010.30 $12,514.40 $270,224.69 $22,150.09 $99,610.92 $5,734.35 $1,007,833.22 $23,788.37 $33,938.51 $13,934.31 $10,150.00 $2,978.89 $46,578.97 $18,022.87 $18,895.00 $4,071.11 $101,965.20 $4,670.76 $16,399.33 $77,500.00 $1,829.76 $82,750.82 $40,581.23 $11,375.00 $7,539.88 $130,002.36 $47,706.86 $45,515.31 $141,068.37 $33,750.55 $2,045.26 $22,500.00 $45,040.25 $11,989.98

Subsequent Injury Trust Fund 2007 Annual Report

Employer
ROWLAND LAND CLEARING, INC. ROYAL ENTERPRISE d/b/aDAYS ROYAL TEN -CATE NICOLON ROYSTER CONSTRUCTION CO RUSSELL & YOUNG BUILDERS RYERSON TULL INC S & D COFFEE, INC. S & S ELECTRIC S & S GRILL S I CORPORATION S. LICHTENBERG & CO., INC. SADDLE CREEK CORPORATION SAFECO CORP SAFETY KLEEN CORP SAFEWAY FIRE PROTECTION INC SAFT AMERICA SAIA MOTOR FREIGHT SAVANNAH COCA-COLA BOTTLING CO SAVANNAH FOODS INDUSTRY SCALE SYSTEMS SCAPE DRYER FABRICS SCENIC VIEW CONVALESCENT CENTER SCHAFER, BETSY B. SCHNADIG CORP. SCHNEIDER NATIONAL CARRIERS SCHOLASTIC INC SCHREIBER FOODS INC SCHUSTER ENTERPRISES, INC SCOTT BRIDGE CO. SCOVILL SEA ISLAND COMPANY SEALY INC SEARS ROEBUCK & CO. SEARS ROEBUCK & CO. SEARS ROEBUCK & CO. SEARS ROEBUCK & CO. SEARS ROEBUCK & CO. SEARS ROEBUCK & CO. SECURITY FINANCE SENIOR CONNECTIONS SENTRY CONSTRUCTION

City
HAZELHURST TOWNSEND CORNELIA HORTENSE MARIETTA NORCROSS CONCORD WINDER ELBERTON CHICKAMAUGA WAYNESBORO VILLA RICA SEATTLE NORCROSS SUWANEE VALDOSTA ATLANTA POOLER PT WENTWORTH NORCROSS WAYCROSS BALDWIN THOMASVILLE CORNELIA GREEN BAY KENNESAW GAINESVILLE MACON OPELIKA CLARKESVILLE SEA ISLAND CONYERS ALBANY ATLANTA BRUNSWICK CHICAGO MACON TUCKER VIDALIA CHAMBLEE MACON

State
GA GA GA GA GA GA NC GA GA GA GA GA WA GA GA GA GA GA GA GA GA GA GA GA WI GA GA GA AL GA GA GA GA GA GA IL GA GA GA GA GA

Page | 64
Total Reimbursed
$20,905.15 $86,053.15 $202,091.25 $287,609.95 $1,959.22 $4,420.86 $15,502.62 $62,430.32 $19,316.50 $290,337.20
$19.80 $157,797.97
$9,111.41 $5,695.09 $119,865.21 $58,732.92 $5,654.00 $10,750.09 $10,931.47 $118,151.31 $10,928.82 $43,549.80 $27,236.00 $68,827.36 $53,516.46
$453.03 $92,545.49 $133,483.35 $229,793.05 $51,787.08 $100,694.64 $3,104.00
$93.86 $7,548.68 $2,565.00 $34,632.94 $68,637.23 $55,858.97 $14,759.65
$159.00 $1,286.68

Subsequent Injury Trust Fund 2007 Annual Report

Employer
SERVICE MERCHANDISE SERVICE TRANSPORT, INC. SERVPRO OF EAST COBB SEWELL MANUFACTURING CO SHARE CARE SERVICES SHARP RESIDENTIAL BUILDERS & SHAW INVESTMENTS INC SHC ASSOCIATES SHEPARD EXPOSITION SERVICES SHEPHERD CONSTRUCTION CO SHILOH INDUSTRIES SHOE CITY, INC. SIEMENS ENERGY & AUTOMATION SIEMENS ENERGY & AUTOMATION SIEMENS ENERGY CORP SIGHT SOUND INNOVATIONS, INC SIGNS GRAPHICS PRINTING SIMKINS INDUSTRIES, INC. SINGLETON FURNITURE CO SIX FLAGS OVER GEORGIA SKANSKA, INC SKB INDUSTRIES INC. SKILSTAF/BARROW MFG. SKILSTAFF INC SMARTWAY SMCS-TERMINIX SMCS-TRUGREEN CHEMLAWN SMITH & SONS FOOD, INC. SMITH BROTHERS MECHANICAL SMITH CUSTOM PAINTING SMITH-GRAY ELECTRIC CO. INC. SOI/NATURE MARKETING SOLOMON WHITE SOLVAY PHARMACEUTICALS SONY MUSIC SOUTH GEORGIA PAINT & WALLCOVE SOUTHEAST ASSOCIATES, INC. SOUTHEAST BUILDING MAINTENANCE SOUTHEAST FOREST INDUSTRI SOUTHEAST FROZEN FOODS CO SOUTHEASTERN FREIGHT LINE

City
BRENTWOOD CONLEY MARIETTA BREMEN BRUNSWICK ALPHARETTA ROCKY FACE BUFORD ATLANTA ATLANTA PENDERGRASS MONTGOMERY STONE MOUNTAIN TUCKER ALPHARETTA ATLANTA DALTON MARIETTA WAYCROSS ATLANTA ATLANTA LILBURN ALEXANDER CITY ALEXANDER CITY AUGUSTA ATHENS ELLENWOOD ATLANTA AUGUSTA MCDONOUGH COLUMBUS ATLANTA DALTON MARIETTA CARROLLTON ALBANY KENNESAW LOGANVILLE DAMASCUS CORDELE SUWANEE

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

Page | 65
Total Reimbursed
$4,675.00 $14,376.73 $23,223.54 $20,112.54 $8,085.39 $11,897.22 $4,200.00 $38,177.03
$895.86 $168,286.48
$2,349.73 $52,815.97 $23,171.20 $9,201.71
$729.53 $4,094.46 $7,302.90 $28,698.10 $10,850.20 $480,618.99 $5,023.52 $72,473.84 $48,845.70 $1,126.97 $1,369.34 $10,718.55 $31,859.18
$575.23 $2,636.67 $5,760.26 $17,605.60
$794.40 $2,151.44 $10,706.24 $61,240.23 $25,279.78 $60,741.13
$84.08 $35,780.39 $5,000.00 $14,749.65

Subsequent Injury Trust Fund 2007 Annual Report

Employer
SOUTHEASTERN STAGES SOUTHERN AG CARIERS, INC. SOUTHERN BULK INDUSTRIES SOUTHERN CONCRETE CONSTRUCTION SOUTHERN CRAFT MASTERS SOUTHERN CROSS TIMBER CO. SOUTHERN ELECTRONICS SOUTHERN FOREST INDUSTRIES SOUTHERN HOME CARE SERVICES SOUTHERN LOGISTICS AND EQUIPMENT SOUTHERN MECHANICAL CONTRACTOR SOUTHERN MOVING INC SOUTHERN SAW SERVICE LP SOUTHERN SAW SERVICE, INC. SOUTHERN STAIRCASE, INC SOUTHERN VENETIAN BLINDS SOUTHERN WAREHOUSE SERVICES SOUTHLAND ASSOCIATES, INC. SOUTHTRUST BANK SOUTHWEST GEORGIA OIL SP NEWSPRINT CO-DUBLIN SPARTAN MECHANICAL INC SPC COMPANY SPECIAL PROJECTS, INC. SPECIALTY FIXTURES, INC SPECIALTY STAMPING, LLC SPECTRA GEM, INC. SPECTRUM CABLE SERVICES SPECTRUM STORES SPELMAN COLLEGE SPHERION SPRING HILL COUNTRY CLUB SPRINGHILL SERVICES, INC STAFF LEASING STAFFING SOLUTIONS STANDARD SUPPLY STANDRIDGE COLOR CORP. STAPLES INC STAR MANUFACTURING COMPANY STATE FARM INSURANCE STATESBORO NURSING HOME

City
ATLANTA ALBANY GARDEN CITY ALBANY LOGANVILLE NEWINGTON TUCKER SMARR VALDOSTA MACON TUCKER LAWRENCEVILLE ATLANTA ATLANTA ALPHARETTA SAVANNAH MACON THOMASVILLE COLUMBUS BAINBRIDGE DUBLIN CHAMBLEE LAGRANGE DALTON LAWRENCEVILLE ADEL NORCROSS JONESBORO WEST POINT ATLANTA GAINESVILLE TIFTON MCINTYRE BRADENTON GAINESVILLE FITZGERALD SOCIAL CIRCLE MARIETTA CEDARTOWN ATLANTA STATESBORO

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 FL GA GA GA GA GA GA GA

Page | 66
Total Reimbursed
$21,790.64 $52,350.37
$40.21 $16,739.87 $336,825.03 $5,775.00 $16,989.41 $36,975.36 $18,594.12 $4,338.47 $3,458.81 $2,275.00 $34,852.85 $7,901.77 $3,480.42 $2,543.38 $11,858.42 $14,507.12 $67,128.45 $36,696.00 $77,037.33 $48,695.36 $46,495.55 $39,376.62 $5,977.77 $1,874.58 $394,486.24 $41,034.73 $1,557.68 $38,825.46 $4,334.44 $54,398.21 $55,100.39 $13,875.00 $31,481.06 $62,454.18 $80,695.51 $2,935.86 $25,110.85 $55,372.70
$136.22

Subsequent Injury Trust Fund 2007 Annual Report

Employer
STATEWIDE HEALTH CARE INC STEELCASE STEVE CRAWFORD FOREST PROD. STEVENS GRAPHICS, INC. STOFFEL SEAL CORPORATION STOKES CONTRACTING CO STORE SUPPORT, INC STOREHOUSE, INC STORES AUTOMATED SYSTEMS STORK GAMCO, INC. STRINGER LUMBER CO. SUBARU OF AMERICA, INC SUITT CONSTRUCTION COMPANY SULLIVANS ADMINISTRATIVE MANAGER SUMTER REGIONAL HOSPITAL SUN BRIDGE CARE & REHAB SUN INTERNATIONAL TRAVEL SUNBELT GREENHOUSES, INC. SUNBELT STRUCTURES SUNBRIDGE HEALTHCARE SUNDANCE PLUMBING, INC. SUNDIAL PLUMBING SUNLINK HEALTH SYSTEMS SUNSHINE BISQUITS, INC SUNSHINE CLEANING SERVICE SUPER 8 MOTEL SUPERIOR COMMERCIAL ROOFING SUPERIOR ELECTRIC SUPERIOR FREIGHT SUPERIOR INSURANCE COMPANY SUPERIOR PLUMBING SERVICE SUPERIOR YARN TECHNOLOGY SUPREME CARPET, INC. SUWANEE TIMBER INC SWAT SERVICES, Inc. SWEETHEART CUP CO SWEETHEART CUP CO., INC. SWIFT DENIM SWIFT TRANSPORTATION SWIFTY SERVE CORP SWISHER INTERNATIONAL ,INC.

City
SAVANNAH LITHIA SPRINGS WAYNESBORO ATLANTA TALLAPOSSA BLOOMINGDALE WEST PALM BEACH NORCROSS BRISTOL GAINESVILLE MCDONOUGH CHERRY HILL ALBANY SAVANNAH AMERICUS BRUNSWICK NORCROSS DOUGLAS TUCKER CARTERSVILLE MARIETTA MARIETTA ELLIJAY COLUMBUS Columbus COLUMBUS TUCKER JULIETTE DANIELSVILLE ATLANTA MARIETTA DALTON CHATSWORTH FARGO MARIETTA AUGUSTA CONYERS COLUMBUS DECATUR CORAOOPLOIS JACKSONVILLE

State
GA GA GA GA GA GA FL GA PA GA GA NJ 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 PA FL

Page | 67
Total Reimbursed
$130,052.83 $66,464.94 $36,127.24 $17.10 $1,210.03 $14,639.41 $40,549.86 $1,950.90 $621.96
$128,818.88 $112,903.57
$9,018.64 $17,050.00 $58,963.32 $44,261.98 $9,144.81 $28,352.52 $6,611.36 $15,265.67 $15,204.76 $9,800.00 $78,781.17 $5,337.85 $7,999.74 $37,420.57 $9,277.17 $15,118.73 $4,995.00 $22,492.20 $114,929.22 $20,733.49 $129,543.38 $5,732.49 $37,845.30 $24,162.14 $217,384.45 $3,182.30 $61,987.06 $64,384.19 $10,440.70 $41,432.98

Subsequent Injury Trust Fund 2007 Annual Report

Employer
SYNOVUS FINANCIAL CORP. SYNTHETIC INDUSTRIES T & M TILT-UP, INC. T.D. REESE CONSTRUCTION T.T.C. ILLINOIS, INC. TAFCO-MABRY & HAYNES INC. TALON INC TAMPA ARMATURE WORKS, INC. TAPPI TECHNICAL ASSOC THE PULP TARA FOODS TARTAN TEXTILE SERVICE TAYLOR ORCHARDS, INC. TAYLOR REPO, INC. TBN OF GA., INC./TBN OF TENN. TEAMWORK SERVICES TEETS INTERNATIONAL TRUCKS INC TEMPLE INLAND CO TENET/SOUTH FULTON MED CTR TENNECO TENNECO OIL CO. TERRY STOVER CONSTRUCTION TETON INDUSTRIAL THACKSTON & SONS CONSTRUCTION THE BOMBAY COMPANY THE BOOK WAREHOUSE THE BUCKHEAD BREWERY & GRILL THE CONCRETE CO., INC. THE COOK'S WAREHOUSE, INC The CURA GROUP THE DARIEN NEWS, INC. THE DICKERSON GROUP THE GILBERT COMPANIES THE KINGS CARPENTERS, INC. THE KRYSTAL COMPANY THE LOVETT SCHOOL THE MARTIN BROWER CO THE MASQUERADE, INC. THE PLANT PEDDLER THE RAYMOND KING CO., INC. THE STANDARD CLUB THE STANDARD COMPANIES, INC.

City
COLUMBUS CHICKAMAUGA BETHLEHEM SAVANNAH KANKAKEE AUSTELL CHAROLETTE TAMPA NORCROSS ALBANY ROME REYNOLDS WEST BLACKSHEAR BRUNSWICK BRUNSWICK AUGUSTA ROME EAST POINT HARTWELL MOULTRIE KINGSLAND CEDAR SPRINGS MARIETTA DAWSONVILLE KNOXVILLE MCDONOUGH COLUMBUS ATLANTA FT LAUDERDALE DARIEN LAWRENCEVILLE MUNCIE CANTON TUCKER ATLANTA ATLANTA ATLANTA SMYRNA CALHOUN DULUTH NEW ORLEANS

State
GA GA GA GA IL GA NC FL GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA TN GA GA GA FL GA GA IN GA GA GA GA GA GA GA GA LA

Page | 68
Total Reimbursed
$10,182.11 $135.48 $190.00 $534.00
$35,122.63 $48,443.51 $15,520.00 $2,035.65 $14,665.09 $16,033.15 $35,530.57 $28,289.51 $49,061.96 $5,611.00 $116,443.55 $6,050.00 $165,160.00 $49,468.67 $268,050.27 $9,269.16 $10,329.14 $19,000.00 $84,649.66 $5,688.88 $5,400.00
$514.00 $88,955.31 $2,677.81 $209,228.77 $32,773.47 $8,322.16 $107,408.11 $15,321.28 $15,925.34 $27,818.12 $148,493.20 $62,257.91 $29,990.05 $39,032.95 $25,258.89 $20,457.12

Subsequent Injury Trust Fund 2007 Annual Report

Employer
THE TAPPAN COMPANY THE WESTMINSTER SCHOOL THE WILLIAM L BONNELL CO., INC THIELE KAOLIN CO THOMAS AND BETTS THOMAS CONCRETE INDUSTRIES THOMAS COUNTY BD OF EDUCATION THOMAS PACKING CO. THOMASTON HEALTH & REHAB THOMPSON CONSTRUCTION CO. THOMPSON HARDWOODS, INC. THOMPSON'S FARM SUPPLY THOMSON OAK FLOORING CO. THREE SPRINGS, INC. TIC-THE INDUSTRIAL COMPANY TIFT COUNTY BOARD OF EDUCATION TIFT HEALTH CARE TIFTON ALUMINUM CO., INC TILLOTSON CORP TIMBER HARVESTING, INC. TIMESAVER, INC- 56 TINDALL CORPORATION TIRE KINGDOM TNI HOLDINGS, INC TOLBERT PLASTERING CO. INC. TOM JAMES CO TOMMY GIBSON BUILDERS INC TOM'S FOODS, INC. TONY PERKINS TOOMSBORO NURSING CTR TOPCON AMERICA CORP. TOPCPR SVC TORCO INC TOWN OF TRION POLICE DEPT. TOWNS COUNTY B. O. E. TOYS R US TPS STAFFING INC. TRAILMOBILE, INC. TRAILWAY SOUTHEASTERN LINES TRANE COMMERCIAL SYSTEMS TRANS WORLD AIRLINES, INC.

City
DALTON ATLANTA NEWNAN SANDERSVILLE BAINBRIDGE ATLANTA THOMASVILLE GRIFFIN THOMASTON CHAMBLEE HAZELHURST VIDALIA THOMSON HUNTSVILLE STEAMBOAT SPRINGS TIFTON TIFTON TIFTON MENLO DANVILLE TWIN CITY CONLEY RIVIERA BEACH NORCROSS ATHENS BREMEN MACON COLUMBUS VIDALIA COLUMBUS PARAMUS Baton Rouge MARIETTA TRION HIAWASSEE MCDONOUGH DALTON CONLEY ATLANTA MACON ATLANTA

State
GA GA GA GA GA GA GA GA GA GA GA GA GA AL CO GA GA GA GA GA GA GA FL GA GA GA GA GA GA GA NJ LA GA GA GA GA GA GA GA GA GA

Page | 69
Total Reimbursed
$23,088.73 $32,845.53 $5,928.10 $13,278.85 $6,965.30 $7,484.78 $70,888.43 $8,028.46 $18,758.80 $30,402.83 $46,651.02 $4,719.50 $30,686.20 $36,669.90 $48,105.28 $210,509.96
$196.24 $56,424.66 $62,074.70 $38,516.45 $6,521.68 $42,215.62 $73,575.22 $1,613.15 $59,472.74 $16,255.76 $1,062.20 $19,957.79 $24,556.06 $2,484.22 $10,350.00 $18,426.94 $13,269.91 $115,613.66 $1,559.19
$737.61 $88,723.25 $5,274.75 $2,530.00
$12.59 $18,637.37

Subsequent Injury Trust Fund 2007 Annual Report

Employer
TRANSPOWER TRAVEL CENTERS OF AMERICA TREE SUMMIT APARTMENTS TRENT TUBE DIVISION TRIANGLE PACIFIC CORPORATION TRINTEX CORPORATION TRI-SOUTH CONTRACTORS,INC TRI-STATE EMC TRIVEST INC TRIWOOD CORP. OF GEORGIA TRUCKSTOPS OF AMERICA TRU-GREEN LANDCARE TRUS JOIST MACMILLIAN TRUS JOIST MACMILLIAN TRW-BRUNSWICK JOB CORPS TSL, LTD TUCKER CONCRETE CO TUFTCO CO. TUGALO GAS CO INC TUMI INC TURBINE ENGINE COMPONENTS TURNER BROADCASTING SYS., INC TURNER CORP. TURNER FOOD SYSTEMS, INC. TUSCARORA TWIGGS COUNTY BOE TWIN CEDARS YOUTH SVCS. TWIN OAKS DRIVE-IN INC U TEC CONSTRUCTION CO U.S. CAN CO U.S. CAN CO U.S. SECURITY ASSOCIATES, INC U.S. XPRESS UNIMIN CORPORATION UNITED DISTRIBUTORS, INC. UNITED DISTRIBUTORS, INC. UNITED HEALTH SERVICES, INC. UNITED PARCEL SERVICE UNITED PARCEL SERVICE UNITED PARCEL SERVICE UNITED PARCEL SERVICE

City
ALBANY WESTLAKE DULUTH CARROLLTON ATLANTA BOWDON STONE MTN. MCCAYSVILLE MIAMI AMERICUS BRUNSWICK LILBURN COLBERT VALDOSTA BRUNSWICK NEWNAN TUCKER DALTON TOCCOA VIDALIA THOMASVILLE ATLANTA ATLANTA ROME HAYWARD JEFFERSONVILLE LAGRANGE BRUNSWICK LAWRENCEVILLE MORROW TALLAPOOSA GAINESVILLE COLLEGE PRK MCINTYRE ALBANY Savannah TOCCOA ATLANTA BLACKSHEAR FOREST PARK JACKSONVILLE

State
GA OH GA GA GA GA GA GA FL GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA CA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA FL

Page | 70
Total Reimbursed
$3,812.23 $45,838.03 $135,599.04 $5,228.50 $73,068.36 $46,459.93 $2,445.67 $7,414.59 $49,857.07 $14,002.67 $26,499.61 $196,766.10 $13,911.22 $145,997.93 $14,209.32 $75,361.92 $51,522.88
$887.08 $53,094.00 $15,428.32 $27,671.28 $1,316.11 $13,136.13 $8,179.38 $2,721.60 $5,636.14 $22,566.20 $16,081.03 $2,242.05 $11,372.88 $354,485.61 $40,602.92 $40,095.61 $52,172.61 $8,442.18 $24,260.04 $11,918.73 $16,991.19 $2,343.23 $26,564.27 $5,771.25

Subsequent Injury Trust Fund 2007 Annual Report

Employer
UNITED PARCEL SERVICE UNITED PARCEL SERVICES UNITED STATIONERS SUPPLY CO. UNIVAR CORPORATION UNIVERSITY CAR WASH, INC UNIVERSITY YACHT CLUB, INC. UPS UPS UPS UPSON ALLIANCE WAREHOUSE US FOODSERVICE US XPRESS, INC. UTILITIES CONST. CO OF SC UVALDA MANUFACTURING CO V.F. CORPORATION/LEE CO. V.T. GRIFFIN SERVICES VANCEVILLE TURF VANGUARD SERVICES VARN TURPENTINE & CATTLE VARN TURPENTINE & CATTLE VARN WOOD PRODUCTS VENDOR'S SUPPLY OF GEORGIA VENTURE EXPRESS, INC. VHS FORT OGLETHORPE NURSING VIACON, INC VINCE HOSIERY MILL VISITING NURSES ASSOCIATION VISITING NURSES ASSOCIATION VLR CONSTRUCTION nc. VNU USA, Inc. VOS ELECTRIC VOUGHT AIRCRAFT VT INDUSTRIES INC W & J, INC. W.A. BRAGG & CO. W.B. RODDENBERRY CO., INC. W.M. ORR INC. WADE & SONS INC WALKER BROS HEATING AND AC INC WALKER CONCRETE CO. WALLACE ELEC. CO

City
MACON TIFTON SUWANEE SAVANNAH DULUTH FLOWERY BRANCH AUGUSTA CAIRO CARNESVILLE THOMASTON FAIRBURN TUNNEL HILL CHARLESTON UVALDA JASPER KINGS BAY TIFTON INDIANAPOLIS FOLKSTON JACKSONVILLE HOBOKEN LITHONIA LAVERGNE FORT OGLETHORPE NORCROSS VILLA RICA BAXLEY TIFTON KENNESAW NEW YORK GREEN BAY MILEDGEVILLE ROME SMYRNA AUGUSTA CAIRO LILBURN MACON ALBANY JONESBORO MCDONOUGH

State
GA GA GA GA GA GA GA GA GA GA GA GA SC GA GA GA GA IN GA FL GA GA TN GA GA GA GA GA GA NY WI GA GA GA GA GA GA GA GA GA GA

Page | 71
Total Reimbursed
$13,936.00 $7,585.03 $89,685.19 $15,418.47 $12,644.37 $18,351.56 $12,167.18 $1,486.24 $50,851.61 $169,576.25 $5,466.01 $206,120.20 $18,062.93 $5,875.69 $4,185.00 $63,987.78 $2,999.48 $332,739.01 $3,379.62 $4,636.02 $81,422.30 $10,462.50 $143,600.76 $18,054.43 $91,117.08 $66,778.21 $6,525.00 $26,243.35 $185,789.52 $12,856.29 $15,030.00 $23,720.12 $279,823.03 $36,494.11 $85,768.53 $1,350.00 $56,842.94 $7,700.00 $107,734.85 $2,969.87 $28,493.23

Subsequent Injury Trust Fund 2007 Annual Report

Employer
WAL-MART WAL-MART WAL-MART WAL-MART WAL-MART WAL-MART WAL-MART WAL-MART WAL-MART WALTER INDUSTRIES WALTON COUNTY BD OF ED WALTON MONROE MILLS, INC. WARREN SCOTT CONTRACTING CO. / WASTE MANAGEMENT OF AUGUSTA WASTE MGMT OF ATLANTA SOUTH WASTE MGMT OF SAVANNAH WATER VISTA APARTMENTS WATER, GAS & LIGHT COMMISSION WATSON-HUNT FUNERAL HOME, INC WATTYL PAINT CORP. WAYCROSS COCA-COLA WAYNE MEMORIAL HOSPITAL WAYNE POULTRY WAYNE SHEET METAL WORKS WEEKS TEXTILE WELLINGTON BUILDERS INC WELLINGTON HEALTHCARE SERVICES WELLS MANAGEMENT CO WELLSTONE/TNS MILLS, INC WENDY'S WENDY'S WEST CORPORATION WEST GA AERIAL LIFT, INC. WEST GEORGIA AUTO PARTS INC WEST LUMBER CO WEST PLUMBING SALES & SERVICE WEST ROME BAPTIST CHURCH WESTEK INC. WESTERN PLASTICS INC WHEELS UNLIMITED WHISNANT CONTRACTING CO

City
AUGUSTA DUBLIN HINESVILLE HIRAM JESUP LAGRANGE NEWNAN CEDARTOWN MARIETTA TAMPA MONROE MONROE AMERICUS AUGUSTA LAKE CITY GARDEN CITY LAWRENCEVILLE ALBANY PERRY ATLANTA WAYCROSS JESUP PENDERGRASS JESUP QUITMAN GRAYSON COVINGTON ATLANTA LAVONIA MILLEDGEVILLE VALDOSTA WEST POINT CARROLLTON CARROLLTON ATLANTA WARNER ROBINS ROME THOMASTON CALHOUN WAYCROSS STOCKBRIDGE

State
GA GA GA GA GA GA GA GA GA FL 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

Page | 72
Total Reimbursed
$35,622.53 $198,797.34
$456.56 $30,391.73 $49,898.27 $4,196.16 $78,499.19 $8,093.08 $82,491.87 $30,800.00 $230,314.96 $6,885.00 $79,314.27
$39.60 $135.15 $4,558.01 $211,383.54 $6,820.00 $7,022.80 $297,478.79 $10,768.05 $10,926.33 $3,533.79 $12,226.35 $20,316.70 $538.73 $6,101.12 $42,533.03 $23,589.89 $108,242.42 $74,714.68 $4,710.61 $355.06 $2,640.00 $25,093.16 $457.98 $27,043.69 $103,115.01 $47,411.52 $23,023.79 $23,612.35

Subsequent Injury Trust Fund 2007 Annual Report

Employer
WHITEHEAD DIE CASTING CO. WHITLOW ELECTRIC SERVICE INC WIKA INSTRUMENT CORP WILLIAM CARTER CO WILLIAM CARTER CO WILLIAMS ENTERPRISES WILLIAMS ENTERPRISES OF GA WILLIAMS ENVIRONMENTAL SVC INC WILLIAMS SERVICE GROUP WILLIAMSON RENTALS WILLINGHAM MECHANICAL INC WILSON BROTHERS, INC. WIREGRASS HOSPICE WISE BUSINESS FORMS WOMACK ELECTRIC WOOD HOLLOW CABINET, INC. WOODRUFF CO WRIGLEY MFG CO. WSM TRUCKING CO., INC. WWF, INC. WYNFIELD DEVELOPMENT COMPANIES X-STREAM PLUMBING YAMAHA MUSIC MFG. YANCEY BROTHERS COMPANY YATES ASTRO/PESTSURE YORK BEE CO YUM! BRANDS, INC ZARTRAN, INC ZF INDUSTRIES ZUA AUTOPARTS INC

City
GAINESVILLE ELBERTON LAWRENCEVILLE BARNESVILLE HOGANSVILLE CHATTANOOGA SMYRNA STONE MOUNTAIN MILLEDGVILLE MONROE BOLINGBROKE GLENNVILLE DOTHAN ALPHARETTA ALPHARETTA DALTON COLUMBUS FLOWER BRANCH ROME ATHENS ATLANTA LOGANVILLE THOMASTON MACON SAVANNAH JESUP LOUISVILLE CEDARTOWN GAINESVILLE OAKWOOD

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

Page | 73
Total Reimbursed
$346.66 $28,336.94 $41,693.15 $348,611.28 $1,990.21 $163,561.20 $10,090.48 $10,240.00 $15,373.99 $67,316.85
$646.90 $50,020.76 $10,761.72 $46,276.04 $66,676.20
$580.18 $31,950.25 $73,459.62 $83,587.05 $45,931.06 $219,030.91 $65,399.21 $34,679.70 $1,742.24 $74,993.22 $11,330.40 $254,150.44 $188,716.63 $197,362.94
$375.00 $77,014,608.81

Subsequent Injury Trust Fund 2007 Annual Report

Page | 74

ASSESSMENT FOR 2007
Legal Requirements
34-9-358. Payment of assessments to fund by insurers and self-insurers.
Each insurer and self-insurer under this chapter shall, under regulations prescribed by the board of trustees, make payments to the fund in an amount equal to that proportion of 175 percent 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. Such employer who has ceased to be a self-insurer shall continue to be liable to the fund for assessments in subsequent calendar years so long as payments are made on any workers' compensation claims made while in selfinsured status. 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 an employer who is subject to this chapter or the equivalent of such in the case of a self-insurer.
34-9-359. Reports by employers of compensation and benefits paid; failure to pay assessments
(a) As soon as practicable after January 1 but not later than January 31 of each calendar year, the administrator shall forward to each insurer and self-insured employer a questionnaire asking for the total amount of compensation, medical benefits, and rehabilitation benefits paid by each insurer and self-insured employer during the preceding calendar year. This report is to be completed and returned to the administrator no later than March 1 of the same calendar year in which the request for this information is submitted. Failure to submit the report to the administrator of the fund by March 1 shall result in an automatic penalty of $50.00 per day for each day the report is delinquent or 10 percent of the assessment, whichever is greater. This penalty will be added to the assessment.
(b) Any assessment levied or established in accordance with this article in a specified amount as may be determined pursuant to this article shall constitute a personal debt of every employer or insurer so assessed and shall be due and payable to the Subsequent Injury Trust Fund when payment is called for by the administrator. In the event of failure to pay any assessment upon the date determined by the administrator, the

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administrator may file a complaint for collection against the employer or insurer in a court of competent jurisdiction.
(c) In the event any employer or insurer duly assessed fails to pay to the administrator on behalf of the Subsequent Injury Trust Fund the amount so assessed on or before the date specified by the administrator, the administrator is authorized to add to the unpaid assessment an amount not exceeding 10 percent of the unpaid assessment and reasonable attorney's fees to defray the cost of enforcing collection.

Assessment Calculation
The assessment and assessment rate are derived from the fund's financial activity for the calendar year and the claims loss data provided by insurance companies and self-insured employers. This claims loss data is obtained on an annual basis in the form of an Annual Assessment Report. As required in O.C.G.A. 34-9-359, this is a report of the total amount of compensation, medical benefits, and rehabilitation benefits paid by each insurer and selfinsured employer during the calendar year.

Assessment Adjustment for 2006
The Georgia Subsequent Injury Trust Fund Assessment for calendar year 2006 was $204,450,135.75. This was computed in the following manner:

Total Fund Disbursements/Calendar Year 2006

$150,496,761.00

(minus) Net Assets (as of 12/31/2006) Fund Assessment

x

175%

- 58,919,196.00

$204,450,135.75

The assessment rate is based on data provided by insurers and self-insured employers' in the Annual Assessment Reports; the actual total of workers' compensation benefits (indemnity, medical, and rehabilitation) paid in Georgia during calendar year 2006 was $1,315,369,974.69. This amount is divided into the fund assessment of $204,450,135.75 and yields an (adjusted) assessment rate of .15543166. This adjustment has caused an increase to be applied to the 2006 assessment.

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Assessment Rate for 2007
The Georgia Subsequent Injury Trust Fund Assessment for calendar year 2007 is $144,356,389.37. This was computed in the following manner:

Total Fund Disbursements/Calendar Year 2007

$148,785,734.00

(minus) Net Assets (as of 12/31/2007) Fund Assessment

x

175%

260,375,034.50

- 116,018,645.13

$144,356,389.37

Based on data received from insurers and self-insured employers, the reported total of workers' compensation benefits paid in Georgia during calendar year 2007 was $1,422,240,134.26. This amount is divided into the fund assessment $144,356,389.37 which yields an assessment rate of .10149931.

In addition to the assessment, an additional $889,907.73 in penalties for late filing of Claims Loss report forms will be levied.

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Assessment Due from Insurance Companies

Insurance Company
ACCIDENT FUND INS OF AMER ACCIDENT INSURANCE CO. ACE AMERICAN INSURANCE CO ACE FIRE UNDERWRITERS INS. ACE INDEMNITY INSURANCE CO ACE PROPERTY & CASUALTY INS ACIG INSURANCE COMPANY ADVANTAGE WORKERS COMP AEQUICAP INSURANCE CO AIG CASUALTY COMPANY AIU INSURANCE CO ALEA NORTH AMERICA ALFA INSURANCE CORP ALL AMERICA INS. CO AMCOMP ASSURANCE AMCOMP PREFERRED AMERICAN ALTERNATIVE INS AMERICAN AUTOMOBILE INS AMERICAN CAS OF READING PA AMERICAN ECONOMY INS CO AMERICAN FIRE & CASUALTY AMERICAN GUAR & LIAB INS CO AMERICAN HARDWARE MUT AMERICAN HOME ASSURANCE AMERICAN INSURANCE CO AMERICAN INTER INS CO OF GA AMERICAN INTERN. SOUTH INS AMERICAN MFG. MUTUAL INS AMERICAN MOTORISTS INS CO AMERICAN RESOURCES INS CO AMERICAN SAFETY CASUALTY AMERICAN STATES INS CO AMERICAN STATES INS OF TX AMERICAN ZURICH INS CO AMERISURE INSURANCE CO AMERISURE MUTUAL INS CO

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$129,194.11 $0.00
$5,522,136.40 $43,581.80 $3,845.83
$577,702.62 $52,210.96 $18,309.75 $42,419.98 $36,516.21 $67,182.53 $58,624.55 $0.00
$153,665.56 $832,337.21 $231,074.16 $314,750.29
$16,691.22 $1,820,178.15
$149,836.87 $7,292.87
$86,169.77 $3,572.71
$7,233,749.80 $342,891.01
$2,739,908.25 $1,416,297.63
$208,868.75 $606,504.29 $119,801.56
$30,266.59 $134,982.49
$31,575.09 $2,107,878.74
$1,527.74 $177,784.69

$130,061.24 $0.00
$5,559,199.84 $43,874.32 $3,871.65
$581,580.04 $52,561.39 $18,432.64 $42,704.69 $36,761.30 $67,633.44 $59,018.02 $0.00
$154,696.93 $837,923.69 $232,625.08 $316,862.83
$16,803.25 $1,832,394.81
$150,842.54 $7,341.81
$86,748.12 $3,596.69
$7,282,301.23 $345,192.42
$2,758,297.95 $1,425,803.53
$210,270.63 $610,575.02 $120,605.64
$30,469.73 $135,888.46
$31,787.02 $2,122,026.39
$1,538.00 $178,977.94

2007 Claims
Paid
$1,012,142.00 $36,726.00
$37,394,413.00 $835,687.00 $130,276.00
$4,212,904.00 $69,118.00 $84,615.00
$213,799.00 $576,507.00 $430,366.00 $500,987.00
$50,905.98 $2,091,371.97 $7,485,749.00
$630,660.00 $280,763.00 $150,545.00 $8,391,042.90 $706,613.00
$17,352.00 $645,523.00
$23,140.00 $53,989,584.00
$1,389,742.00 $17,724,957.64 $14,431,832.00
$282,108.62 $2,493,119.67
$569,323.00 $0.00
$953,321.00 $270,477.00 $17,184,289.00 $127,479.00 $1,124,628.00

2007 Assessment
Amount
$102,731.71 $3,727.66
$3,795,507.12 $84,821.65 $13,222.92
$427,606.85 $7,015.43 $8,588.36
$21,700.45 $58,515.06 $43,681.85 $50,849.83
$5,166.92 $212,272.81 $759,798.36
$64,011.55 $28,497.25 $15,280.21 $851,685.06 $71,720.73
$1,761.22 $65,520.14
$2,348.69 $5,479,905.52
$141,057.85 $1,799,070.97 $1,464,820.99
$28,633.83 $253,049.93
$57,785.89 $0.00
$96,761.42 $27,453.23 $1,744,193.48 $12,939.03 $114,148.97

2006 Balance
Due
$867.13 $0.00
$37,063.44 $292.52 $25.82
$3,877.42 $350.43 $122.89 $284.71 $245.09 $450.91 $393.47 $0.00
$1,031.37 $5,586.48 $1,550.92 $2,112.54
$112.03 $12,216.66
$1,005.67 $48.94
$578.35 $23.98
$48,551.43 $2,301.41
$18,389.70 $9,505.90 $1,401.88 $4,070.73 $804.08 $203.14 $905.97 $211.93
$14,147.65 $10.26
$1,193.25

2006 and 2007 Total
Assessment Due
$103,598.84 $3,727.66
$3,832,570.56 $85,114.17 $13,248.74
$431,484.27 $7,365.86 $8,711.25
$21,985.16 $58,760.15 $44,132.76 $51,243.30
$5,166.92 $213,304.18 $765,384.84
$65,562.47 $30,609.79 $15,392.24 $863,901.72 $72,726.40
$1,810.16 $66,098.49
$2,372.67 $5,528,456.95
$143,359.26 $1,817,460.67 $1,474,326.89
$30,035.71 $257,120.66
$58,589.97 $203.14
$97,667.39 $27,665.16 $1,758,341.13 $12,949.29 $115,342.22

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Insurance Company
AMGUARD INSURANCE CO. ANSUR AMERICAN INS CO ARCH INSURANCE CO ARGONAUT GREAT CENTRL INS ARGONAUT INSURANCE CO ARGONAUT LIMITED RISK INS ARGONAUT-MIDWEST INS CO ARROWOOD INDEMNITY CO ASSOCIATED INDEMNITY CORP ASSOCIATED INDUSTRIES INS ASSOCIATION CASUALTY INS CO ASSOCIATION INSURANCE CO ASSURANCE CO. OF AMERICA ATHENA ASSURANCE CO ATLANTIC MUTUAL INS. CO ATLANTIC SPECIALTY INS CO AUTO OWNERS INS. CO AXIS INSURANCE CO BANCINSURE, INC. BANKERS STANDARD INS CO BENCHMARK INS CO BITUMINOUS CASUALTY CORP BITUMINOUS FIRE & MARINE BRIDGEFIELD CASUALTY BROTHERHOOD MUTUAL INS BUILDERS INSURANCE CALIFORNIA INSURANCE CO CANAL INSURANCE CO CAPITAL CITY INS CO CAROLINA CASUALTY INS CO CENTENNIAL INSURANCE CO CENTRAL MUTUAL INS CO CENTRE INSURANCE CO CENTURY INDEMNITY CO CHARTER OAK FIRE INS CO CHEROKEE INSURANCE CO CHUBB INDEMNITY INS CO CHURCH MUTUAL INS CO CINCINNATI CASUALTY CO CINCINNATI INDEMNITY CO

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$181,667.33 $140,591.98 $174,344.51
$80,549.46 $97,628.37 $473,240.55
$6,250.23 $694,710.86 $144,582.02
$46,155.27 $125,109.52 $884,814.97 $116,410.57
$6,340.56 $176,085.47
$80,941.78 $675,113.91
$4,440.74 $13,938.20
$3,367.83 $968,951.35
$0.00 $52,505.70 $1,893,520.21 $36,014.11 $5,429,042.93
$0.00 $1,111,600.19
$814,914.15 $27,426.33 $91,426.77
$205,310.82 $9,377.98
$18,572.38 $392,661.13
$0.00 $13,340.38 $131,908.47 $561,571.00 $404,061.59

$182,886.64 $141,535.60 $175,514.67
$81,090.10 $98,283.64 $476,416.85
$6,292.18 $699,373.61 $145,552.42
$46,465.05 $125,949.23 $890,753.66 $117,191.90
$6,383.11 $177,267.32
$81,485.05 $679,645.14
$4,470.55 $14,031.75
$3,390.43 $975,454.75
$0.00 $52,858.11 $1,906,229.12 $36,255.83 $5,465,481.54
$0.00 $1,119,061.02
$820,383.69 $27,610.41 $92,040.41
$206,688.82 $9,440.92
$18,697.03 $395,296.60
$0.00 $13,429.92 $132,793.82 $565,340.15 $406,773.56

2007 Claims
Paid
$1,715,842.40 $2,277,462.00 $1,649,956.00
$750,629.00 $1,170,551.00 $1,781,019.00
$77,228.00 $6,651,109.00
$671,753.00 $432,006.00 $823,971.00 $6,963,809.00 $506,059.00
$48,992.00 $2,610,148.00
$355,894.00 $8,069,155.00
$49,760.00 $28,848.00 $550,344.00 $5,000,040.00 $2,058,031.00 $407,371.00 $15,581,767.00 $296,095.00 $41,707,422.00 $326,639.00 $8,113,969.81 $5,513,298.00
$8,507.00 $456,576.00 $1,523,599.70
$96,717.00 $127,839.00 $3,416,478.00
$71,579.44 $128,670.00 $1,053,612.00 $3,698,975.58 $2,539,905.39

2007 Assessment
Amount
$174,156.82 $231,160.82 $167,469.40
$76,188.33 $118,810.12 $180,772.20
$7,838.59 $675,082.97
$68,182.47 $43,848.31 $83,632.49 $706,821.81 $51,364.64
$4,972.65 $264,928.22
$36,123.00 $819,013.66
$5,050.61 $2,928.05 $55,859.54 $507,500.61 $208,888.73 $41,347.88 $1,581,538.60 $30,053.44 $4,233,274.55 $33,153.63 $823,562.34 $559,595.94
$863.45 $46,342.15 $154,644.32
$9,816.71 $12,975.57 $346,770.16
$7,265.26 $13,059.92 $106,940.89 $375,443.47 $257,798.64

2006 Balance
Due
$1,219.31 $943.62
$1,170.16 $540.64 $655.27
$3,176.30 $41.95
$4,662.75 $970.40 $309.78 $839.71
$5,938.69 $781.33 $42.55
$1,181.85 $543.27
$4,531.23 $29.81 $93.55 $22.60
$6,503.40 $0.00
$352.41 $12,708.91
$241.72 $36,438.61
$0.00 $7,460.83 $5,469.54
$184.08 $613.64 $1,378.00
$62.94 $124.65 $2,635.47
$0.00 $89.54 $885.35 $3,769.15 $2,711.97

2006 and 2007 Total
Assessment Due
$175,376.13 $232,104.44 $168,639.56
$76,728.97 $119,465.39 $183,948.50
$7,880.54 $679,745.72
$69,152.87 $44,158.09 $84,472.20 $712,760.50 $52,145.97
$5,015.20 $266,110.07
$36,666.27 $823,544.89
$5,080.42 $3,021.60 $55,882.14 $514,004.01 $208,888.73 $41,700.29 $1,594,247.51 $30,295.16 $4,269,713.16 $33,153.63 $831,023.17 $565,065.48 $1,047.53 $46,955.79 $156,022.32 $9,879.65 $13,100.22 $349,405.63 $7,265.26 $13,149.46 $107,826.24 $379,212.62 $260,510.61

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Insurance Company
CINCINNATI INSURANCE CO CITIZENS INS CO OF AMERICA CLARENDON NATIONAL INS CO COLONIAL AMER. CAS & SURETY COLUMBIA NATIONAL INS CO COMMERCE & INDUSTRY INS COMMERCIAL MUTUAL INS CO COMPANION COMMERCIAL INS COMPANION PROP & CAS CONTINENTAL CASUALTY CO CONTINENTAL INSURANCE CO COREGIS INSURANCE CO CORNERSTONE MUTUAL INS CO CRUM & FOSTER INDEMNITY CUMIS INS SOCIETY INC CYPRESS INSURANCE CO DAIMLER CHRYSLER INS CO DALLAS NATIONAL INSURANCE DEERFIELD INSURANCE CO DELTA FIRE & CASUALTY INS DISCOVER PROPERTY & CAS EASTGUARD INSURANCE CO ELECTRIC INSURANCE CO EMC PROPERTY & CASUALTY EMCASCO INSURANCE CO EMPLOYERS FIRE INS CO EMPLOYERS INS OF WAUSAU EMPLOYERS MUTUAL CAS INS EMPLOYERS REINSU. CORP EVEREST NATIONAL INS EVEREST SECURITY INS CO EXCELSIOR INSURANCE CO FAIRFIELD INSURANCE CO FAIRMONT SPECIALTY INS CO FARMINGTON CASUALTY CO FARMLAND MUTUAL FCCI INSURANCE COMPANY FEDERAL INSURANCE CO FEDERATED MUTUAL INS CO FEDERATED RURAL ELE. INS

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$280,120.13 $75,224.27
$531,713.17 $316.82
$178,377.78 $4,871,328.64
$399,581.64 $131,748.83 $2,219,677.52 $1,822,202.97
$84,748.39 $185,155.58 $554,225.14
$27,581.96 $24,525.55 $606,488.25
$719.17 $9,878.06
$0.00 $48,743.86 $26,648.64 $82,939.97 $144,941.45
$6,804.36 $20,977.39 $14,452.18 $2,260,641.24 $53,183.04 $818,115.54 $387,531.35 $62,767.75 $130,725.80 $97,123.19
$9,892.58 $54,322.17 $22,469.78 $930,516.78 $1,215,126.61 $442,907.42 $58,357.44

$282,000.24 $75,729.16
$535,281.92 $318.95
$179,575.02 $4,904,023.99
$402,263.55 $132,633.10 $2,234,575.54 $1,834,433.22
$85,317.20 $186,398.31 $557,944.98
$27,767.09 $24,690.16 $610,558.88
$724.00 $9,944.36
$0.00 $49,071.02 $26,827.50 $83,496.64 $145,914.27
$6,850.03 $21,118.19 $14,549.18 $2,275,814.20 $53,539.99 $823,606.56 $390,132.38 $63,189.03 $131,603.21 $97,775.06
$9,958.97 $54,686.76 $22,620.59 $936,762.21 $1,223,282.29 $445,880.12 $58,749.13

2007 Claims
Paid
$1,740,896.59 $327,572.11
$4,390,746.00 $13,378.00
$1,553,808.00 $40,184,474.00
$1,017,962.79 $1,213,031.00 $16,376,419.00 $10,167,153.28 $1,016,419.60
$0.00 $1,512,353.18
$147,952.00 $135,477.00 $4,349,563.00
$3,360.00 $82,444.00 $171,492.00 $82,797.00 $181,809.00 $724,031.56 $728,965.00
$0.00 $94,631.00 $241,218.00 $9,629,404.00 $419,977.00 $6,204,456.00 $1,450,416.00 $394,073.00 $1,341,863.00
$0.00 $177,037.00 $486,216.00 $268,833.00 $5,708,047.00 $8,348,847.64 $4,576,397.00 $284,866.00

2007 Assessment
Amount
$176,699.80 $33,248.34
$445,657.69 $1,357.86
$157,710.44 $4,078,696.38
$103,322.52 $123,121.81 $1,662,195.23 $1,031,959.04 $103,165.89
$0.00 $153,502.80
$15,017.03 $13,750.82 $441,477.64
$341.04 $8,368.01 $17,406.32 $8,403.84 $18,453.49 $73,488.70 $73,989.44
$0.00 $9,604.98 $24,483.46 $977,377.86 $42,627.38 $629,748.00 $147,216.22 $39,998.14 $136,198.17
$0.00 $17,969.13 $49,350.59 $27,286.36 $579,362.83 $847,402.27 $464,501.14 $28,913.70

2006 Balance
Due
$1,880.11 $504.89
$3,568.75 $2.13
$1,197.24 $32,695.35
$2,681.91 $884.27
$14,898.02 $12,230.25
$568.81 $1,242.73 $3,719.84
$185.13 $164.61 $4,070.63
$4.83 $66.30
$0.00 $327.16 $178.86 $556.67 $972.82
$45.67 $140.80
$97.00 $15,172.96
$356.95 $5,491.02 $2,601.03
$421.28 $877.41 $651.87
$66.39 $364.59 $150.81 $6,245.43 $8,155.68 $2,972.70 $391.69

2006 and 2007 Total
Assessment Due
$178,579.91 $33,753.23
$449,226.44 $1,359.99
$158,907.68 $4,111,391.73
$106,004.43 $124,006.08 $1,677,093.25 $1,044,189.29 $103,734.70
$1,242.73 $157,222.64
$15,202.16 $13,915.43 $445,548.27
$345.87 $8,434.31 $17,406.32 $8,731.00 $18,632.35 $74,045.37 $74,962.26
$45.67 $9,745.78 $24,580.46 $992,550.82 $42,984.33 $635,239.02 $149,817.25 $40,419.42 $137,075.58
$651.87 $18,035.52 $49,715.18 $27,437.17 $585,608.26 $855,557.95 $467,473.84 $29,305.39

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Insurance Company
FFVA MUTUAL INS CO FIDELITY & DEPOSIT CO OF MD FIDELITY & GUAR UNDRWRTRS FIDELITY & GUARANTY INS CO FIREMAN'S FUND INS CO FIREMAN'S FUND INS CO OF GA FIRST DAKOTA INDEMNITY CO FIRST LIBERTY INS CORP FIRST NATL INS CO OF AMER FLORIDA HOSPITALITY MUT INS FLORISTS INSURANCE CO FLORISTS' MUTUAL INS CO FRANKENMUTH MUTUAL INS FRONTIER INS CO-IN REHAB. GA FARM BUREAU MUTUAL INS GA RESTAU. MUTUAL CAP INS C GA TIMBER HARVTERS' MUT CA GENERAL CASUALTY CO OF WI GENERAL INS CO OF AMERIC GEORGIA CASUALTY & SURETY GERBER LIFE INS CO GRANGE MUTUAL CASUALTY GRANITE STATE INS CO GRAPHIC ARTS MUTUAL INS CO GRAY INSURANCE CO GREAT AMER ALLIANCE INS CO GREAT AMER INS CO OF NY GREAT AMERICAN ASSUR CO GREAT AMERICAN INS CO GREAT DIVIDE INS CO GREAT NORTHERN INS CO GREAT WEST CASUALTY CO GREATER NEW YORK MUTUAL GREENWICH INSURANCE CO GUARANTEE INSURANCE CO GUIDEONE MUTUAL INS CO HANOVER INSURANCE CO HARBOR SPECIALITY INS HARCO NATIONAL INS CO HARLEYSVILLE MUTUAL INS CO

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$736,089.71 $32,896.72
$159,803.71 $2,570,890.29
$94,170.38 $51,863.57
$2,491.17 $149,226.54
$0.00 $0.00 $23,249.84 $41,917.12 $33,882.07 $32,121.65 $64,677.31 $234,653.20 $281,644.21 $13,069.72 $1,450.54 $558,600.05 $109,997.03 $212,976.26 $1,239,155.94 $98,829.58 $6,365.40 $74,457.79 $808,919.44 $228,784.02 $20,910.54 $9,439.50 $23,124.26 $368,824.03 $31,629.13 $29,528.43 $166,914.08 $131,438.80 $161,905.13 $89,449.28 $8,100.35 $85,884.13

$741,030.19 $33,117.51
$160,876.28 $2,588,145.57
$94,802.43 $52,211.67
$2,507.89 $150,228.12
$0.00 $0.00 $23,405.89 $42,198.46 $34,109.48 $32,337.25 $65,111.41 $236,228.15 $283,534.55 $13,157.45 $1,460.28 $562,349.26 $110,735.31 $214,405.71 $1,247,472.90 $99,492.90 $6,408.13 $74,957.54 $814,348.74 $230,319.57 $21,050.89 $9,502.86 $23,279.47 $371,299.50 $31,841.42 $29,726.62 $168,034.37 $132,320.99 $162,991.81 $90,049.64 $8,154.72 $86,460.57

2007 Claims
Paid
$4,493,096.00 $363,790.00 $0.00
$10,711,810.00 $915,553.00 $201,292.00 $0.00
$1,334,353.00 $196,194.00 $858.00 $231,464.00 $156,769.00 $590,730.00 $54,172.00 $2,361.00
$1,605,125.00 $549,037.00 $47,391.00 $76,878.00
$3,371,379.00 $75,134.00
$586,133.82 $9,517,668.00
$891,881.61 $3,854.72
$778,230.00 $7,525,321.00 $1,066,353.00
$112,219.00 $254,324.41 $198,850.00 $2,502,693.00 $137,261.00 $800,891.00 $1,188,164.00 $755,229.00 $439,108.36 $110,074.00
$91,679.00 $380,223.00

2007 Assessment
Amount
$456,046.14 $36,924.43 $0.00
$1,087,241.32 $92,928.00 $20,431.00 $0.00
$135,435.91 $19,913.56 $87.09 $23,493.44 $15,911.95 $59,958.69 $5,498.42 $239.64
$162,919.08 $55,726.88 $4,810.15 $7,803.06
$342,192.64 $7,626.05
$59,492.18 $966,036.73
$90,525.37 $391.25
$78,989.81 $763,814.89 $108,234.09
$11,390.15 $25,813.75 $20,183.14 $254,021.61 $13,931.90 $81,289.88 $120,597.83 $76,655.22 $44,569.20 $11,172.44
$9,305.36 $38,592.37

2006 Balance
Due
$4,940.48 $220.79
$1,072.57 $17,255.28
$632.05 $348.10
$16.72 $1,001.58
$0.00 $0.00 $156.05 $281.34 $227.41 $215.60 $434.10 $1,574.95 $1,890.34 $87.73 $9.74 $3,749.21 $738.28 $1,429.45 $8,316.96 $663.32 $42.73 $499.75 $5,429.30 $1,535.55 $140.35 $63.36 $155.21 $2,475.47 $212.29 $198.19 $1,120.29 $882.19 $1,086.68 $600.36 $54.37 $576.44

2006 and 2007 Total
Assessment Due
$460,986.62 $37,145.22 $1,072.57
$1,104,496.60 $93,560.05 $20,779.10 $16.72
$136,437.49 $19,913.56 $87.09 $23,649.49 $16,193.29 $60,186.10 $5,714.02 $673.74
$164,494.03 $57,617.22 $4,897.88 $7,812.80
$345,941.85 $8,364.33
$60,921.63 $974,353.69
$91,188.69 $433.98
$79,489.56 $769,244.19 $109,769.64
$11,530.50 $25,877.11 $20,338.35 $256,497.08 $14,144.19 $81,488.07 $121,718.12 $77,537.41 $45,655.88 $11,772.80
$9,359.73 $39,168.81

Subsequent Injury Trust Fund 2007 Annual Report

Page | 81

Insurance Company
HARLEYSVILLE-ATLANTIC INS CO HARTFORD ACCIDENT & INDM HARTFORD CASUALTY INS CO HARTFORD FIRE INSURANCE CO HARTFORD INS CO OF S.E. HARTFORD INS / THE MIDWEST HARTFORD UNDERWRITERS INS HEALTH CARE MUTUAL CAPTIVE HIGHLANDS INS CO-IN RECEIV HOSPITALITY MUT CAPTIVE INS HOUSTON GENERAL INS CO IMPERIAL CASUALTY & IND. CO INDEMNITY INS CO OF NA INDIANA LUMB. MUTUAL INS INSURANCE CO OF N.A. INSURANCE CO OF STATE OF PA INSURANCE CO. OF THE WEST INSURANCE CORP. / NEW YORK JEFFERSON PILOT FIN INS CO KEY RISK INSURANCE CO LIBERTY INSURANCE CORP LIBERTY MUTUAL FIRE INS LIBERTY MUTUAL INSURANCE LM INSURANCE CORP LUMBER MUTUAL INSURANCE LUMBERMENS MUTUAL CAS CO LUMBERMEN'S UNDERWRITING LYNDON PROPERTY INS MADISON INSURANCE CO MAG MUTUAL INS CO MANUFACTURER'S ALLIANCE MARYLAND CASUALTY CO MASSACHUSETTS BAY INS CO MEDMARC CASUALTY INS METLIFE INSURANCE CO OF CT. MID-CENTURY INSURANCE CO MIDDLESEX INSURANCE CO MIDWEST EMPLOYERS CAS CO MIDWESTERN INDEMNITY CO MITSUI SUMITOMO INS / AMER

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$149,157.68 $48,952.29
$890,451.48 $1,679,984.88
$235,660.48 $1,359,519.50 $2,006,863.70
$282,011.36 $16,696.06
$111,664.71 $0.00
$7,975.14 $3,136,185.69
$297.83 $6,945.94 $3,813,285.60
$0.00 $66,509.06 $34,379.22 $1,663,856.59 $1,390,410.15 $2,759,536.44 $1,709,765.75 $1,217,401.17
$2,469.83 $685,212.29 $422,955.36
$5,490.30 $5,056.60 $159,666.29 $132,446.23 $278,136.50 $88,461.47 $23,009.54 $69,270.88
$28.25 $43,452.11 $33,256.61 $63,592.06 $80,964.63

$150,158.80 $49,280.85
$896,428.01 $1,691,260.60
$237,242.18 $1,368,644.31 $2,020,333.36
$283,904.16 $16,808.12
$112,414.18 $0.00
$8,028.67 $3,157,235.13
$299.83 $6,992.56 $3,838,879.58
$0.00 $66,955.45 $34,609.97 $1,675,024.05 $1,399,742.30 $2,778,057.88 $1,721,241.34 $1,225,572.11
$2,486.41 $689,811.29 $425,794.15
$5,527.15 $5,090.54 $160,737.94 $133,335.18 $280,003.30 $89,055.20 $23,163.98 $69,735.81
$28.44 $43,743.75 $33,479.82 $64,018.88 $81,508.05

2007 Claims
Paid
$916,697.00 $1,556,800.00 $5,752,804.00 $13,891,891.00 $1,539,058.00 $7,128,485.00 $11,413,687.00 $2,412,820.00
$137,139.00 $414,460.32 $205,552.00
$13,161.00 $26,238,406.00
$2,636.00 $75,839.00 $26,432,194.00
$182.61 $187,483.67
$65,148.00 $8,440,225.00 $12,362,590.00 $21,806,695.00 $12,802,749.00 $11,915,003.00
$8,811.00 $1,039,672.60 $1,902,673.00
$33,423.00 $4,689.00
$1,771,844.00 $1,072,589.00 $1,589,157.00
$262,772.61 $12,691.00 $0.00 $676.00
$197,561.00 $433,536.00 $794,251.00 $428,576.00

2007 Assessment
Amount
$93,044.11 $158,014.13 $583,905.64 $1,410,017.35 $156,213.33 $723,536.31 $1,158,481.36 $244,899.57
$13,919.51 $42,067.44 $20,863.39
$1,335.83 $2,663,180.10
$267.55 $7,697.61 $2,682,849.45
$18.53 $19,029.46
$6,612.48 $856,677.01 $1,254,794.35 $2,213,364.50 $1,299,470.19 $1,209,364.58
$894.31 $105,526.05 $193,120.00
$3,392.41 $475.93
$179,840.94 $108,867.04 $161,298.34
$26,671.24 $1,288.13 $0.00 $68.61
$20,052.31 $44,003.60 $80,615.93 $43,500.17

2006 Balance
Due
$1,001.12 $328.56
$5,976.53 $11,275.72
$1,581.70 $9,124.81 $13,469.66 $1,892.80
$112.06 $749.47
$0.00 $53.53 $21,049.44
$2.00 $46.62 $25,593.98
$0.00 $446.39 $230.75 $11,167.46 $9,332.15 $18,521.44 $11,475.59 $8,170.94
$16.58 $4,599.00 $2,838.79
$36.85 $33.94 $1,071.65 $888.95 $1,866.80 $593.73 $154.44 $464.93
$0.19 $291.64 $223.21 $426.82 $543.42

2006 and 2007 Total
Assessment Due
$94,045.23 $158,342.69 $589,882.17 $1,421,293.07 $157,795.03 $732,661.12 $1,171,951.02 $246,792.37
$14,031.57 $42,816.91 $20,863.39
$1,389.36 $2,684,229.54
$269.55 $7,744.23 $2,708,443.43
$18.53 $19,475.85
$6,843.23 $867,844.47 $1,264,126.50 $2,231,885.94 $1,310,945.78 $1,217,535.52
$910.89 $110,125.05 $195,958.79
$3,429.26 $509.87
$180,912.59 $109,755.99 $163,165.14
$27,264.97 $1,442.57 $464.93 $68.80
$20,343.95 $44,226.81 $81,042.75 $44,043.59

Subsequent Injury Trust Fund 2007 Annual Report

Page | 82

Insurance Company
MITSUI SUMITOMO INS USA MONROE GUARANTY INS. CO. MUTUAL ASSURANCE INC. NATIONAL AMERICAN INS CO NATIONAL FIRE INS HARTFORD NATIONAL INTERSTATE INS NATIONAL LIABILITY & FIRE INS NATIONAL SURETY CORP NATIONAL TRUST INSURANCE NATIONAL UN FIRE OF PITT PA NATIONWIDE AGRIBUSINESS NATIONWIDE MUTUAL FIRE INS NATIONWIDE MUTUAL INS CO NETHERLANDS INSURANCE CO NEW HAMPSHIRE INSURANCE NIPPONKAO LTD US BRANCH NORGUARD INSURANCE CO. NORTH AMERICAN SPECIALTY NORTH RIVER INSURANCE CO NORTHBROOK INDEMNITY CO NORTHERN ASSUR CO OF AMER NORTHERN INS CO OF NY NORTHWESTERN NATIONAL INS OCCIDENTAL FIRE & CAS OF NC OHIO CASUALTY INSURANCE CO OHIO FARMERS INS CO OHIO SECURITY INSURANCE CO OLD DOMINION INSURANCE CO OLD REPUBLIC GEN. INS CORP OLD REPUBLIC INSURANCE CO OLD REPUBLIC UNION INS CO ONEBEACON AMERICA INS CO ONEBEACON INSURANCE CO ONEBEACON MIDWEST INS CO OWNERS INSURANCE CO PACIFIC EMPLOYERS INS PACIFIC INDEMNITY CO PATRIOT GENERAL INSURANCE PEERLESS INDEMNITY INS CO PEERLESS INSURANCE CO

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$35,660.86 $0.00
$38,629.57 $15,474.12 $777,314.19
$4,077.58 $325,764.85 $128,502.05 $1,052,177.56 $491,599.86
$35,635.69 $68,876.25 $54,159.28 $71,789.69 $1,434,256.75
$9.88 $547,741.58
$30,582.33 $45,858.06
$1,443.60 $2,146.87 $38,180.28 $4,072.95 $84,602.03 $103,206.37 $9,898.44 $19,323.51 $227,296.11 $9,413.80 $2,073,342.19 $10,918.53 $153,909.66 $159,705.36 $6,002.74 $979,209.53 $1,069,870.04 $93,060.89 $146,692.45 $1,148.39 $174,879.34

$35,900.21 $0.00
$38,888.85 $15,577.98 $782,531.36
$4,104.95 $327,951.32 $129,364.53 $1,059,239.56 $494,899.38
$35,874.87 $69,338.53 $54,522.78 $72,271.53 $1,443,883.18
$9.95 $551,417.91
$30,787.59 $46,165.85
$1,453.29 $2,161.28 $38,436.54 $4,100.29 $85,169.87 $103,899.07 $9,964.88 $19,453.20 $228,821.67 $9,476.98 $2,087,258.03 $10,991.82 $154,942.67 $160,777.27 $6,043.03 $985,781.78 $1,077,050.79 $93,685.50 $147,677.02 $1,156.10 $176,053.09

2007 Claims
Paid
$542,810.00 $74,210.00 $0.00 $58,675.00
$4,466,405.38 $39,660.00
$3,745,837.00 $946,962.00
$8,778,514.00 $4,746,343.00
$206,199.00 $307,116.00 $163,239.00 $1,325,801.00 $18,158,190.00
$0.00 $4,330,856.31
$83,327.00 $443,882.00
$12,950.00 $38,210.00 $87,585.00 $17,088.00
$0.00 $744,358.00
$38,196.63 $261,163.00 $1,202,201.00 $163,696.00 $13,454,024.00
$9,521.00 $354,603.00 $870,085.00
$56,915.00 $8,465,565.00 $6,839,046.00
$505,751.74 $1,247,294.00
$6,145.00 $1,774,683.00

2007 Assessment
Amount
$55,094.84 $7,532.26 $0.00 $5,955.47
$453,337.06 $4,025.46
$380,199.87 $96,115.99
$891,013.11 $481,750.54
$20,929.06 $31,172.06 $16,568.65 $134,567.89 $1,843,043.76
$0.00 $439,578.93
$8,457.63 $45,053.72
$1,314.42 $3,878.29 $8,889.82 $1,734.42
$0.00 $75,551.82
$3,876.93 $26,507.86 $122,022.57 $16,615.03 $1,365,574.15
$966.37 $35,991.96 $88,313.03
$5,776.83 $859,249.01 $694,158.45
$51,333.45 $126,599.48
$623.71 $180,129.10

2006 Balance
Due
$239.35 $0.00
$259.28 $103.86 $5,217.17
$27.37 $2,186.47
$862.48 $7,062.00 $3,299.52
$239.18 $462.28 $363.50 $481.84 $9,626.43
$0.07 $3,676.33
$205.26 $307.79
$9.69 $14.41 $256.26 $27.34 $567.84 $692.70 $66.44 $129.69 $1,525.56 $63.18 $13,915.84 $73.29 $1,033.01 $1,071.91 $40.29 $6,572.25 $7,180.75 $624.61 $984.57
$7.71 $1,173.75

2006 and 2007 Total
Assessment Due
$55,334.19 $7,532.26 $259.28 $6,059.33
$458,554.23 $4,052.83
$382,386.34 $96,978.47
$898,075.11 $485,050.06
$21,168.24 $31,634.34 $16,932.15 $135,049.73 $1,852,670.19
$0.07 $443,255.26
$8,662.89 $45,361.51
$1,324.11 $3,892.70 $9,146.08 $1,761.76
$567.84 $76,244.52
$3,943.37 $26,637.55 $123,548.13 $16,678.21 $1,379,489.99
$1,039.66 $37,024.97 $89,384.94
$5,817.12 $865,821.26 $701,339.20
$51,958.06 $127,584.05
$631.42 $181,302.85

Subsequent Injury Trust Fund 2007 Annual Report

Page | 83

Insurance Company
PENN LUMBERMENS MUTUAL PENN MFG ASSOC INS PENN MFG IND. CO PENN MILLERS MUTUAL PENN NATIONAL MUTUAL CAS PENNSYLVANIA GENERAL INS PETROLEUM CASUALTY CO PHARMACISTS MUTUAL INS CO PHOENIX INSURANCE CO PRAETORIAN INSURANCE CO PREFERRED PROFESSIONAL INS PREMIER GROUP INS. CO. PRINCETON INSURANCE CO PROTECTIVE INSURANCE CO PROVIDENCE PROP & CAS INS PROVIDENCE WASHINGTON INS PUBLIC SERVICE MUTUAL INS REDLAND INSURANCE CO REGENT INSURANCE CO REPUBLIC WESTERN INS CO REPUBLIC-FRANKLIN INS CO ROCHDALE INSURANCE CO S.E. EMPLOYER MUT. CAP. INS SAFECO INS CO OF ILLINOIS SAFECO INSURANCE AMERICA SAFETY FIRST INS CO SAFETY NATIONAL CASUALTY SEABRIGHT INSURANCE CO SECURITY INS CO OF HARTFORD SECURITY NATIONAL INS CO SELECT INSURANCE CO SELECTIVE INS CO OF AMERICA SELECTIVE INS CO OF SE SELECTIVE INSURANCE OF SC SELECTIVE WAY INSURANCE CO SENTINEL INSURANCE CO SENTRY INSURANCE A MUTUAL SENTRY SELECT INSURANCE CO SOMPO JAPAN INS/ AMERICA SOUTHEASTERN U.S. INS., INC

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$37,890.79 $969,414.53
$37,788.89 $61,078.97
$7,145.73 $10,033.54 $12,381.61 $11,918.40 $75,056.39
$0.00 $0.00 $1,487.29 $151,255.61 $98,626.93 $323,744.44 $19,995.13 $3,367.05 $4,298.37 $0.00 $4,799.38 $42,172.95 $209,858.54 $22,736.73 $38,961.06 $11,662.26 $2,773.40 $111,257.47 $481.56 $120,238.50 $442.94 $10,235.95 $272,004.69 $332,346.73 $261,116.88 $305,615.48 $370.86 $1,323,321.65 $125,475.28 $123,060.69 $3,051,287.53

$38,145.11 $975,921.04
$38,042.52 $61,488.92
$7,193.69 $10,100.88 $12,464.72 $11,998.39 $75,560.15
$0.00 $0.00 $1,497.27 $152,270.80 $99,288.89 $325,917.34 $20,129.33 $3,389.65 $4,327.22 $0.00 $4,831.59 $42,456.00 $211,267.06 $22,889.33 $39,222.56 $11,740.53 $2,792.02 $112,004.21 $484.79 $121,045.51 $445.92 $10,304.65 $273,830.33 $334,577.37 $262,869.44 $307,666.71 $373.35 $1,332,203.51 $126,317.44 $123,886.65 $3,071,767.14

2007 Claims
Paid
$28,389.00 $6,315,143.00
$447,499.00 $390,392.00
$1,716.00 $99,836.00 $136,547.72
$0.00 $1,204,712.00
$592.00 $225.00 $20,772.00 $1,790,358.00 $219,659.47 $3,247,148.00
$0.00 $57,700.00 $27,970.00 $10,677.00 $34,559.70 $574,768.32 $9,399,872.00 $65,468.70 $17,606.00 $102,004.00 $10,794.00 $762,736.00 $20,233.00
$0.00 $113,154.66 $144,911.00 $2,237,190.00 $2,607,211.00 $1,278,962.00 $1,836,344.00
$37,472.00 $10,721,665.42
$908,089.00 $630,988.00 $16,805,521.00

2007 Assessment
Amount
$2,881.46 $640,982.66
$45,420.84 $39,624.52
$174.17 $10,133.29 $13,859.50
$0.00 $122,277.44
$60.09 $22.84 $2,108.34 $181,720.10 $22,295.28 $329,583.28
$0.00 $5,856.51 $2,838.94 $1,083.71 $3,507.79 $58,338.59 $954,080.52 $6,645.03 $1,787.00 $10,353.34 $1,095.58 $77,417.18 $2,053.64
$0.00 $11,485.12 $14,708.37 $227,073.24 $264,630.12 $129,813.76 $186,387.65
$3,803.38 $1,088,241.64
$92,170.41 $64,044.85 $1,705,748.79

2006 Balance
Due
$254.32 $6,506.51
$253.63 $409.95
$47.96 $67.34 $83.11 $79.99 $503.76
$0.00 $0.00 $9.98 $1,015.19 $661.96 $2,172.90 $134.20 $22.60 $28.85 $0.00 $32.21 $283.05 $1,408.52 $152.60 $261.50 $78.27 $18.62 $746.74 $3.23 $807.01 $2.98 $68.70 $1,825.64 $2,230.64 $1,752.56 $2,051.23 $2.49 $8,881.86 $842.16 $825.96 $20,479.61

2006 and 2007 Total
Assessment Due
$3,135.78 $647,489.17
$45,674.47 $40,034.47
$222.13 $10,200.63 $13,942.61
$79.99 $122,781.20
$60.09 $22.84 $2,118.32 $182,735.29 $22,957.24 $331,756.18 $134.20 $5,879.11 $2,867.79 $1,083.71 $3,540.00 $58,621.64 $955,489.04 $6,797.63 $2,048.50 $10,431.61 $1,114.20 $78,163.92 $2,056.87 $807.01 $11,488.10 $14,777.07 $228,898.88 $266,860.76 $131,566.32 $188,438.88 $3,805.87 $1,097,123.50 $93,012.57 $64,870.81 $1,726,228.40

Subsequent Injury Trust Fund 2007 Annual Report

Page | 84

Insurance Company
SOUTHERN CASUALTY INS CO SOUTHERN FIRE & CASUALTY SOUTHERN INS CO OF VIRGINIA SOUTHERN MUTUAL CHURCH SOUTHERN PILOT INSURANCE SOUTHERN STATES INS EXCHG SOUTHERN TRUST INSURANCE ST PAUL FIRE & CASUALTY INS ST PAUL FIRE & MARINE INS CO ST PAUL GUARDIAN INS CO ST PAUL MERCURY INS CO ST PAUL PROTECTIVE INS CO STANDARD FIRE INSURANCE CO STAR INSURANCE CO STATE AUTO PROP & CAS STATE AUTOMOBILE MUTUAL STATE FARM FIRE & CASUALTY STONEBRIDGE CASUALTY INS SUA INSURANCE COMPANY T.H.E. INSURANCE CO TECHNOLOGY INSURANCE CO THE CAMDEN FIRE INS ASSOC TIG INSURANCE CO TOKIO MARINE & NICHIDO FIRE TOWER INSURANCE CO OF NY TRANS PACIFIC INS CO TRANSCONTINENTAL INS CO TRANSGUARD INS OF AMERICA TRANSPORT INSURANCE CO TRANSPORTATION INSURANCE TRAVELERS CAS & SUR CO TRAVELERS CAS INS OF AMER TRAVELERS INDEMNITY OF CT TRAVELERS INDEMNITY CO TRAVELERS INDEMNITY AMER TRAVELERS INSURANCE ALT TRAVELERS PROP CAS OF AMER TRINITY UNIVERSAL INS CO TRINITY UNIVERSAL INS OF KS TRUCK INSURANCE EXCHANGE

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$102,367.08 $0.00
$16,157.94 $9,643.07
$31,493.57 $39,597.63 $36,438.24 $237,589.65 $2,462,880.68 $132,988.16 $51,901.71 $15,991.81 $70,495.24 $215,226.25 $47,357.85 $26,404.70 $689,988.21
$2,538.88 $64,155.45
$461.18 $874,350.51
$952.62 $225,094.43 $378,997.91
$0.00 $3,844.91 $636,672.92 $17,336.44 $13,708.15 $918,126.65 $616,355.66 $1,101.46 $168,113.27 $439,477.83 $4,732,224.88
$0.00 $3,899,132.21
$16,633.68 $52,431.48 $11,614.55

$103,054.14 $0.00
$16,266.39 $9,707.80
$31,704.95 $39,863.40 $36,682.80 $239,184.30 $2,479,411.02 $133,880.75 $52,250.06 $16,099.15 $70,968.39 $216,670.80 $47,675.71 $26,581.92 $694,619.27
$2,555.92 $64,586.05
$464.27 $880,218.97
$959.01 $226,605.22 $381,541.67
$0.00 $3,870.71 $640,946.14 $17,452.80 $13,800.16 $924,288.92 $620,492.51 $1,108.85 $169,241.61 $442,427.52 $4,763,986.60
$0.00 $3,925,302.38
$16,745.32 $52,783.39 $11,692.50

2007 Claims
Paid
$0.00 $10,763.00 $280,775.00 $106,567.00 $292,671.00 $68,269.00 $191,981.00 $1,864,204.00 $6,399,921.00 $971,958.00 $313,660.00 $71,140.00 $224,690.00 $1,236,403.00 $74,301.00 $440,212.00 $4,991,820.00 $290,851.00 $1,316,257.00
$2,883.00 $17,742,479.00
$30,405.00 $2,194,125.00 $2,183,022.00
$65,822.00 $47,555.00 $3,293,020.27 $136,406.00 $75,101.00 $4,703,878.16 $3,555,722.00 $62,517.00 $1,947,253.00 $3,369,318.00 $34,204,452.00
$19.00 $22,583,739.00
$64,068.88 $665,241.47
$0.00

2007 Assessment
Amount
$0.00 $1,092.44 $28,498.47 $10,816.48 $29,705.90 $6,929.26 $19,485.94 $189,215.42 $649,587.57 $98,653.07 $31,836.27 $7,220.66 $22,805.88 $125,494.05 $7,541.50 $44,681.21 $506,666.29 $29,521.18 $133,599.18
$292.62 $1,800,849.38
$3,086.09 $222,702.17 $221,575.23
$6,680.89 $4,826.80 $334,239.29 $13,845.11 $7,622.70 $477,440.39 $360,903.33 $6,345.43 $197,644.84 $341,983.45 $3,471,728.28
$1.93 $2,292,233.93
$6,502.95 $67,521.55
$0.00

2006 Balance
Due
$687.06 $0.00
$108.45 $64.73
$211.38 $265.77 $244.56 $1,594.65 $16,530.34 $892.59 $348.35 $107.34 $473.15 $1,444.55 $317.86 $177.22 $4,631.06
$17.04 $430.60
$3.09 $5,868.46
$6.39 $1,510.79 $2,543.76
$0.00 $25.80 $4,273.22 $116.36 $92.01 $6,162.27 $4,136.85
$7.39 $1,128.34 $2,949.69 $31,761.72
$0.00 $26,170.17
$111.64 $351.91
$77.95

2006 and 2007 Total
Assessment Due
$687.06 $1,092.44 $28,606.92 $10,881.21 $29,917.28 $7,195.03 $19,730.50 $190,810.07 $666,117.91 $99,545.66 $32,184.62 $7,328.00 $23,279.03 $126,938.60 $7,859.36 $44,858.43 $511,297.35 $29,538.22 $134,029.78
$295.71 $1,806,717.84
$3,092.48 $224,212.96 $224,118.99
$6,680.89 $4,852.60 $338,512.51 $13,961.47 $7,714.71 $483,602.66 $365,040.18 $6,352.82 $198,773.18 $344,933.14 $3,503,490.00
$1.93 $2,318,404.10
$6,614.59 $67,873.46
$77.95

Subsequent Injury Trust Fund 2007 Annual Report

Page | 85

Insurance Company

2006 Assessment
Amount

2006 Assessment Adjustment Amount

2007 Claims
Paid

2007 Assessment
Amount

2006 Balance
Due

2006 and 2007 Total
Assessment Due

TRUSTGUARD INSURANCE CO TWIN CITY FIRE INSURANCE CO U.S. FIDELITY & GUARANTY INS U.S. SPECIALTY INS. CO. UNION INSURANCE COMPANY UNITED BUSINESS INS CO UNITED STATES FIRE INS. UNIVERSAL UNDERWRITERS INS UTICA MUTUAL INSURANCE CO UTICA NATIONAL ASSURANCE VALIANT INSURANCE CO VALLEY FORGE INSURANCE CO VANLINER INSURANCE CO VIGILANT INSURANCE CO VININGS INSURANCE CO VIRGINIA SURETY COMPANY WAUSAU BUSINESS INSURANCE WAUSAU GENERAL INS CO WAUSAU UNDERWRITERS INS WEST AMERICAN INSURANCE WESTFIELD INSURANCE CO WESTFIELD NATIONAL INS CO WESTPORT INSURANCE CORP WILLIAMSBURG NATIONAL INS WORK FIRST CASUALTY CO YORK INSURANCE CO ZENITH INSURANCE CO ZURICH AMERICAN INS CO ZURICH AMERICAN INS CO OF IL Grand Total:

$18,816.78 $1,926,857.71
$160,368.48 $60,955.61 $4,400.73
$277,744.10 $647,302.21 $190,277.96 $119,939.27
$26,330.51 $14,384.56 $547,694.01 $206,273.63 $37,510.51
$5,339.15 $197,034.30 $225,456.33
$9,920.52 $735,700.36
$9,460.73 $636,612.95
$16,018.21 $1,095,971.66
$2,844.43 $48.33
$51,647.11 $669,128.93 $6,593,890.06
$5,900.37 $144,646,746.60

$18,943.08 $1,939,790.38
$161,444.84 $61,364.73 $4,430.27
$279,608.26 $651,646.77 $191,555.07 $120,744.28
$26,507.23 $14,481.10 $551,370.02 $207,658.10 $37,762.28
$5,374.98 $198,356.76 $226,969.55
$9,987.11 $740,638.23
$9,524.23 $640,885.77
$16,125.72 $1,103,327.60
$2,863.52 $48.65
$51,993.76 $673,619.99 $6,638,146.89
$5,939.98 $145,617,585.76

$176,587.00 $13,038,018.00
$1,206,315.00 $102,744.00 $42,807.00
$1,265,042.00 $3,538,874.00
$818,018.00 $1,093,293.28
$367,595.49 $81,415.00
$5,913,833.78 $1,149,713.00
$292,205.00 $112,346.00 $1,846,126.00 $2,525,716.00 $278,813.00 $6,971,395.00
$37,673.00 $6,760,023.82
$30,518.44 $8,311,550.00
$38.00 $167,468.00
$0.00 $4,081,352.00 $46,603,272.00
$16,919.00 $1,028,933,385.22

$17,923.46 $1,323,349.83
$122,440.14 $10,428.45 $4,344.88
$128,400.89 $359,193.27
$83,028.26 $110,968.51
$37,310.69 $8,263.57
$600,250.05 $116,695.08
$29,658.61 $11,403.04 $187,380.52 $256,358.43 $28,299.33 $707,591.78
$3,823.78 $686,137.75
$3,097.60 $843,616.59
$3.86 $16,997.89
$0.00 $414,254.41 $4,730,199.95
$1,717.27 $104,436,028.66

$126.30 $12,932.67
$1,076.36 $409.12 $29.54
$1,864.16 $4,344.56 $1,277.11
$805.01 $176.72
$96.54 $3,676.01 $1,384.47
$251.77 $35.83
$1,322.46 $1,513.22
$66.59 $4,937.87
$63.50 $4,272.82
$107.51 $7,355.94
$19.09 $0.32
$346.65 $4,491.06 $44,256.83
$39.61 $970,839.16

$18,049.76 $1,336,282.50
$123,516.50 $10,837.57 $4,374.42
$130,265.05 $363,537.83
$84,305.37 $111,773.52
$37,487.41 $8,360.11
$603,926.06 $118,079.55
$29,910.38 $11,438.87 $188,702.98 $257,871.65 $28,365.92 $712,529.65
$3,887.28 $690,410.57
$3,205.11 $850,972.53
$22.95 $16,998.21
$346.65 $418,745.47 $4,774,456.78
$1,756.88 $105,403,140.16

Subsequent Injury Trust Fund 2007 Annual Report

Page | 86

Assessment Due from Group Self-Insured Companies

Group Self-Insured Company
AGRITRUST OF GEORGIA ASSOCIATION CTY COM GA SI COMPTRUST AGC OF GEORGIA CONSTRUCTION SUPLIERS' ASSO GA AUTO DEALERS ASSN SI GA EDUCA WC TRUST FUND GA HOSPITAL ASSOC WCSI FUND GA MUNICIPAL ASSN WCSIF GA NURSING HOME SELECT WC GA OILMEN'S ASSOCIATION GA OPERATORS SELF-INSURERS GA SCHOOL BD ASSOC WC FUND GEMC WORKERS' COMP FUND GTMA/AYSA SELF INSURANCE ROOFING & SHEETMETAL ASSOC Grand Total:

2006 Assessment
Amount
$361,765.43 $2,766,528.10
$763,924.77 $387,182.83 $822,816.82 $622,097.78 $634,716.99 $2,843,438.02 $145,536.33 $400,093.26 $214,617.24 $926,782.09 $392,474.04 $251,911.47 $260,727.65 $11,794,612.82

2006 Assessment Adjustment
Amount $364,193.52 $2,785,096.47 $769,052.07 $389,781.52 $828,339.40 $626,273.17 $638,977.07 $2,862,522.59 $146,513.14 $402,778.60 $216,057.71 $933,002.46 $395,108.24 $253,602.25 $262,477.60 $11,873,775.81

2007 Claims
Paid
$2,538,996.01 $19,371,161.59
$6,988,291.00 $2,586,921.08 $6,070,049.24 $5,986,673.00 $5,501,284.02 $17,075,443.46 $1,048,288.79 $2,312,066.54 $1,088,420.78 $4,622,068.19 $1,943,085.00 $1,486,918.54 $1,279,078.00 $79,898,745.24

2007 Assessment
Amount
$257,706.34 $1,966,159.54
$709,306.71 $262,570.70 $616,105.81 $607,643.18 $558,376.53 $1,733,145.73 $106,400.59 $234,673.16 $110,473.96 $469,136.73 $197,221.79 $150,921.21 $129,825.53 $8,109,667.51

2006 Balance
Due
$2,428.09 $18,568.37
$5,127.30 $2,598.69 $5,522.58 $4,175.39 $4,260.08 $19,084.57
$976.81 $2,685.34 $1,440.47 $6,220.37 $2,634.20 $1,690.78 $1,749.95 $79,162.99

2006 and 2007 Total
Assessment Due
$260,134.43 $1,984,727.91
$714,434.01 $265,169.39 $621,628.39 $611,818.57 $562,636.61 $1,752,230.30 $107,377.40 $237,358.50 $111,914.43 $475,357.10 $199,855.99 $152,611.99 $131,575.48 $8,188,830.50

Subsequent Injury Trust Fund 2007 Annual Report

Page | 87

Assessment Due from Self-Insured Companies

Self-Insured Company
A T & T AAA COOPER TRANSPORTATION ABF FREIGHT SYSTEM, INC ACUITY BRANDS ADVENTIST HEALTH SYS SUNBELT AGL RESOURCES, INC. ALBANY INTERNATIONAL CORP ALBANY, CITY OF ALLENS INC ALLIED SYSTEMS LTD ALPHARETTA, CITY OF AMERICAN NAT'L RED CROSS AMERICAN PROTEINS, INC ANHEUSER-BUSCH COMPANIES ARCHBOLD MEDICAL CENTER ARCHER-DANIELS-MIDLAND CO ASPLUNDH TREE EXPERT CO ATCO RUBBER PRODUCTS, INC. ATHENS REG. HLTH SYS INC ATHENS-CLARKE COUNTY ATLANTA CITY OF ATLANTA HOUSING AUTHORITY ATLANTA PUBLIC SCHOOLS AUGUSTA-RICHMOND BD COMM AUTOZONE, INC AVERITT EXPRESS, INC AVONDALE MILLS INC BALDWIN COUNTY COMM BANKHEAD SERVICES, INC BARTOW COUNTY BD OF EDUC BEAULIEU GROUP LLC BELLSOUTH CORPORATION BELLSOUTH ENTERPRISES INC BENTON-GEORGIA INC BERRY COLLEGE BHA GROUP INC BIBB COUNTY BD-COMMISSION

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$205,105.32 $119,963.12
$61,063.94 $242,959.98
$30,228.97 $109,019.57
$0.00 $23,744.32
$0.00 $153,157.27
$53,495.80 $23,682.86 $126,556.01 $30,558.27 $112,923.96
$5,233.81 $151,787.34
$8,243.87 $74,423.19 $86,006.25 $1,271,033.12 $12,537.21 $363,353.32 $149,173.07 $299,161.73 $141,837.18 $10,039.52 $16,065.20 $65,957.91 $45,886.68 $191,799.08 $655,003.86
$0.00 $63,915.76 $36,645.40
$403.13 $121,106.03

$206,481.95 $120,768.28
$61,473.79 $244,590.68
$30,431.86 $109,751.29
$0.00 $23,903.69
$0.00 $154,185.23
$53,854.86 $23,841.82 $127,405.43 $30,763.37 $113,681.88
$5,268.94 $152,806.11
$8,299.20 $74,922.71 $86,583.51 $1,279,564.04 $12,621.36 $365,792.07 $150,174.29 $301,169.64 $142,789.16 $10,106.90 $16,173.03 $66,400.61 $46,194.67 $193,086.39 $659,400.11
$0.00 $64,344.75 $36,891.35
$405.83 $121,918.87

2007 Claims
Paid
$468,486.37 $717,512.57 $1,439,315.00 $1,279,715.78 $212,312.10 $754,360.90
$4,147.90 $50,205.58 $23,437.29 $660,196.06 $329,548.70 $189,131.00 $868,403.17 $196,277.27 $527,744.71 $100,413.73 $606,725.00 $37,805.62 $428,169.53 $960,090.46 $6,623,478.77 $64,333.94 $2,597,149.14 $1,438,479.15 $1,980,105.11 $629,930.29 $95,388.52 $157,945.50 $429,639.00 $280,580.40 $1,019,100.52 $3,114,686.56 $93,341.51 $80,588.00 $132,851.24
$0.00 $516,478.96

2007 Assessment
Amount
$47,551.04 $72,827.03 $146,089.48 $129,890.27 $21,549.53 $76,567.11
$421.01 $5,095.83 $2,378.87 $67,009.44 $33,448.97 $19,196.67 $88,142.32 $19,922.01 $53,565.72 $10,191.92 $61,582.17 $3,837.24 $43,458.91 $97,448.52 $672,278.52 $6,529.85 $263,608.85 $146,004.64 $200,979.30 $63,937.49 $9,681.87 $16,031.36 $43,608.06 $28,478.72 $103,438.00 $316,138.54 $9,474.10 $8,179.63 $13,484.31
$0.00 $52,422.26

2006 Balance
Due

2006 and 2007 Total
Assessment Due

$1,376.63 $805.16 $409.85
$1,630.70 $202.89 $731.72 $0.00 $159.37 $0.00
$1,027.96 $359.06 $158.96 $849.42 $205.10 $757.92 $35.13
$1,018.77 $55.33
$499.52 $577.26 $8,530.92
$84.15 $2,438.75 $1,001.22 $2,007.91
$951.98 $67.38
$107.83 $442.70 $307.99 $1,287.31 $4,396.25
$0.00 $428.99 $245.95
$2.70 $812.84

$48,927.67 $73,632.19 $146,499.33 $131,520.97 $21,752.42 $77,298.83
$421.01 $5,255.20 $2,378.87 $68,037.40 $33,808.03 $19,355.63 $88,991.74 $20,127.11 $54,323.64 $10,227.05 $62,600.94 $3,892.57 $43,958.43 $98,025.78 $680,809.44 $6,614.00 $266,047.60 $147,005.86 $202,987.21 $64,889.47 $9,749.25 $16,139.19 $44,050.76 $28,786.71 $104,725.31 $320,534.79 $9,474.10 $8,608.62 $13,730.26
$2.70 $53,235.10

Subsequent Injury Trust Fund 2007 Annual Report

Page | 88

Self-Insured Company
BIBB COUNTY BOARD OF EDUC BIG LOTS STORES, INC. BJ'S WHOLESALE CLUB INC BLACK & DECKER CORPORATION BLOSSMAN COMPANIES, INC BLUE BIRD BODY COMPANY BOBS CANDIES, INC. BREMEN-BOWDEN INVESTMENT BROWN INDUSTRIES BRUNSWICK, CITY OF BURLEN CORPORATION C T HARRIS INC C. W. MATTHEWS CONTRACTING CAGLE'S INC, & SUBSIDIARIES CAHABA GOV'T BENEFIT ADMIN. CALDWELL TANKS ALLIANCE, INC. CALFEE COMPANY OF DALTON, CAMDEN COUNTY BOC CANDLER HEALTH SYSTEM CASCADE CORPORATION CATHOLIC ARCHDIOCESES OF ATL CATOOSA CO. BD. OF EDUC CEMEX (SOUTHDOWN INC.) CENTRAL GEORGIA HEALTH SYS CERTAINTEED CORPORATION CHATHAM AREA TRANSIT AUTH CHATHAM COUNTY BD OF EDUC CHATHAM COUNTY GEORGIA CHEMICAL PRODUCTS CORP CHEROKEE BRICK & TILE CHEROKEE CO BD OF COMM CHEROKEE CO BD OF EDUCATION CHEVRON USA INC SOU DIV CHILDREN'S HEALTHCARE OF ATL CITY OF CARTERSVILLE CLAYTON COUNTY BD OF EDUC CLAYTON COUNTY COMM CLAYTON COUNTY WATER AUTH COACHMAN REC. VEHICLE OF GA COASTAL TRANSPORT INC

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$130,384.16 $68,946.92 $46,265.92 $355.37 $814.14
$651,477.36 $10,491.77 $37,667.61 $40,453.18 $41,483.48 $734.68 $78,031.09
$140,522.31 $109,504.62
$0.00 $1,949.20 $33,137.86 $23,682.94 $30,963.19 $3,853.40 $44,026.07 $24,587.81 $5,376.72 $308,843.25 $20,126.34 $30,063.92 $105,310.53 $120,079.62 $2,729.08 $18,125.37 $59,110.05 $118,105.00 $18,185.39 $188,447.24
$0.00 $113,781.27
$89,330.29 $11,769.37 $27,439.09 $68,065.36

$131,259.28 $69,409.68 $46,576.45 $357.75 $819.60
$655,849.94 $10,562.19 $37,920.43 $40,724.69 $41,761.90 $739.61 $78,554.82
$141,465.47 $110,239.59
$0.00 $1,962.29 $33,360.27 $23,841.89 $31,171.01 $3,879.26 $44,321.56 $24,752.84 $5,412.81 $310,916.14 $20,261.42 $30,265.70 $106,017.35 $120,885.57 $2,747.39 $18,247.02 $59,506.78 $118,897.70 $18,307.44 $189,712.06
$0.00 $114,544.94
$89,929.86 $11,848.36 $27,623.25 $68,522.20

2007 Claims
Paid
$332,767.96 $155,049.00 $346,254.89
$0.00 $68,354.69 $1,183,021.74
$2,611.67 $289,696.11 $188,757.79 $289,081.91
$16,825.96 $659,665.27 $464,386.74 $985,684.00
$23,985.96 $34,909.53 $304,856.82 $528,353.86 $502,239.78 $27,231.44 $71,969.08 $221,420.56 $20,919.20 $1,619,804.96 $213,174.42
$0.00 $927,563.11 $1,264,071.00
$23,187.78 $197,337.34 $335,267.75 $799,578.33
$80,349.97 $1,511,323.84
$8,708.65 $1,513,365.91
$746,660.72 $96,646.01
$265,437.80 $871,678.00

2007 Assessment
Amount
$33,775.72 $15,737.37 $35,144.63
$0.00 $6,937.95 $120,075.89
$265.08 $29,403.96 $19,158.79 $29,341.61
$1,707.82 $66,955.57 $47,134.93 $100,046.25
$2,434.56 $3,543.29 $30,942.76 $53,627.55 $50,976.99 $2,763.97 $7,304.81 $22,474.03 $2,123.28 $164,409.09 $21,637.06
$0.00 $94,147.02 $128,302.33
$2,353.54 $20,029.60 $34,029.45 $81,156.65
$8,155.47 $153,398.33
$883.92 $153,605.60
$75,785.55 $9,809.50
$26,941.75 $88,474.72

2006 Balance
Due

2006 and 2007 Total
Assessment Due

$875.12 $462.76 $310.53
$2.38 $5.46 $4,372.58 $70.42 $252.82 $271.51 $278.42 $4.93 $523.73 $943.16 $734.97 $0.00 $13.09 $222.41 $158.95 $207.82 $25.86 $295.49 $165.03 $36.09 $2,072.89 $135.08 $201.78 $706.82 $805.95 $18.31 $121.65 $396.73 $792.70 $122.05 $1,264.82 $0.00 $763.67 $599.57 $78.99 $184.16 $456.84

$34,650.84 $16,200.13 $35,455.16
$2.38 $6,943.41 $124,448.47
$335.50 $29,656.78 $19,430.30 $29,620.03
$1,712.75 $67,479.30 $48,078.09 $100,781.22
$2,434.56 $3,556.38 $31,165.17 $53,786.50 $51,184.81 $2,789.83 $7,600.30 $22,639.06 $2,159.37 $166,481.98 $21,772.14
$201.78 $94,853.84 $129,108.28
$2,371.85 $20,151.25 $34,426.18 $81,949.35
$8,277.52 $154,663.15
$883.92 $154,369.27
$76,385.12 $9,888.49
$27,125.91 $88,931.56

Subsequent Injury Trust Fund 2007 Annual Report

Page | 89

Self-Insured Company
COATS & CLARK, INC. COBB COUNTY BD/COMM COBB COUNTY SCHOOL SYSTEM COCA-COLA COMPANY COCA-COLA ENTERPRISES INC COLLEGE PARK CITY OF COLONIAL GROUP COLONIAL PIPELINE COMPANY COLQUITT CO BD OF EDUCATION COLQUITT REGIONAL MED CTR COLUMBIA COUNTY BOE COLUMBUS FOUNDRIES INC COLUMBUS REG HEALTHCARE COLUMBUS WATER WORKS CONAGRA FOODS, INC CONTI GROUP COMPANIES, INC CONTINENTAL TIRE N. AMER. COOPER INDUSTRIES, INC COOPER TIRE AND RUBBER CORPORATION OF MERCER UNIV COSTCO WHOLESALE CORP. COTTRELL INC COVINGTON, CITY OF COWETA CO BOARD OF EDUC COWETA COUNTY BOC CRACKER BARREL OLD CTRY STOR CRAWFORD & COMPANY CRIDER'S POULTRY INC CRISP COUNTY BD OF EDUC D L LEE & SONS INC DALTON CITY OF DAN RIVER, INC. DART CONTAINER CORPORATION DEAN FOODS COMPANY DECATUR, CITY OF DEKALB COUNTY BOARD-ED DEKALB COUNTY GOVERNMENT DEKALB FARMERS MARKET DEKALB REGNL HLTHCARE SYS DELHAIZE AMERICA INC.

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$44,362.19 $330,053.49 $273,180.93
$41,993.74 $207,007.37
$61,615.64 $31,328.72
$43.73 $19,023.98 $47,835.92 $48,161.71 $60,553.87 $66,036.00 $34,893.66
$0.00 $97,554.44 $137,786.12 $41,585.72 $517,379.21 $30,137.95 $51,643.71 $23,376.13
$6,926.01 $58,804.26 $23,682.94 $104,194.79 $52,144.02 $85,270.62
$7,933.97 $22,077.76 $41,916.31
$9,719.43 $17,645.08 $262,584.71 $22,806.37 $446,801.73 $514,242.60
$3,971.36 $83,634.56 $312,290.04

$44,659.94 $332,268.74 $275,014.46
$42,275.59 $208,396.76
$62,029.19 $31,538.99
$44.02 $19,151.66 $48,156.99 $48,484.96 $60,960.30 $66,479.22 $35,127.86
$0.00 $98,209.21 $138,710.92 $41,864.84 $520,851.75 $30,340.23 $51,990.34 $23,533.02
$6,972.49 $59,198.94 $23,841.89 $104,894.12 $52,494.00 $85,842.94
$7,987.22 $22,225.94 $42,197.64
$9,784.66 $17,763.51 $264,347.13 $22,959.44 $449,800.57 $517,694.09
$3,998.01 $84,195.90 $314,386.07

2007 Claims
Paid
$479,347.15 $1,599,940.68 $2,184,246.78
$518,577.54 $3,302,178.12
$221,021.87 $145,420.20
$1,998.70 $173,079.54 $191,417.95 $459,509.61 $327,099.14 $275,420.10
$35,201.43 $167,975.60 $308,252.58 $1,039,270.20 $418,253.25 $2,246,484.13 $106,884.44 $508,587.00 $135,480.64
$13,701.05 $197,463.75 $451,820.02 $1,068,764.00 $211,040.50 $495,158.90 $249,964.55 $140,737.93 $470,333.11
$56,954.40 $165,655.00 $1,467,048.42 $191,958.51 $2,996,476.10 $2,876,158.11
$26,702.00 $871,958.17 $1,477,994.65

2007 Assessment
Amount
$48,653.40 $162,392.88 $221,699.54
$52,635.26 $335,168.80
$22,433.57 $14,760.05
$202.87 $17,567.45 $19,428.79 $46,639.91 $33,200.34 $27,954.95
$3,572.92 $17,049.41 $31,287.42 $105,485.21 $42,452.42 $228,016.59 $10,848.70 $51,621.23 $13,751.19
$1,390.65 $20,042.43 $45,859.42 $108,478.81 $21,420.47 $50,258.29 $25,371.23 $14,284.80 $47,738.49
$5,780.83 $16,813.87 $148,904.40 $19,483.66 $304,140.26 $291,928.06
$2,710.23 $88,503.15 $150,015.44

2006 Balance
Due

2006 and 2007 Total
Assessment Due

$297.75 $2,215.25 $1,833.53
$281.85 $1,389.39
$413.55 $210.27
$0.29 $127.68 $321.07 $323.25 $406.43 $443.22 $234.20
$0.00 $654.77 $924.80 $279.12 $3,472.54 $202.28 $346.63 $156.89
$46.48 $394.68 $158.95 $699.33 $349.98 $572.32
$53.25 $148.18 $281.33
$65.23 $118.43 $1,762.42 $153.07 $2,998.84 $3,451.49
$26.65 $561.34 $2,096.03

$48,951.15 $164,608.13 $223,533.07
$52,917.11 $336,558.19
$22,847.12 $14,970.32
$203.16 $17,695.13 $19,749.86 $46,963.16 $33,606.77 $28,398.17
$3,807.12 $17,049.41 $31,942.19 $106,410.01 $42,731.54 $231,489.13 $11,050.98 $51,967.86 $13,908.08
$1,437.13 $20,437.11 $46,018.37 $109,178.14 $21,770.45 $50,830.61 $25,424.48 $14,432.98 $48,019.82
$5,846.06 $16,932.30 $150,666.82 $19,636.73 $307,139.10 $295,379.55
$2,736.88 $89,064.49 $152,111.47

Subsequent Injury Trust Fund 2007 Annual Report

Page | 90

Self-Insured Company
DELPHI CORPORATION DELTA AIRLINES, INC. DOLLAR GENERAL CORP DOUGHERTY COUNTY BOC DOUGHERTY CO SCHOOL SYSTEM DOUGLAS ASPHALT COMPANY DOUGLAS CO BD OF COMM DOUGLAS COUNTY SCHOOLS DOUGLAS, CITY OF DOUGLASVILLE-DOUGLAS CO DSM CHEMICALS N. AMERICA DULUTH, CITY OF DURAND-WAYLAND, INC E I DUPONT DE NEMOURS & CO EAST POINT, CITY OF EATON CORPORATION ELBERTA CRATE & BOX CO ELBERTON GRANITE ASSN ELBERTON, CITY OF EMERSON ELECTRIC CO EMORY UNIVERSITY ENCOMPASS GROUP, LLC EQUITY GROUP GA DIVISION ESTES EXPRESS LINES EVANS GRADING CO., INC EXEL HOLDINGS, USA, INC FAYETTE COUNTY BD OF COMM FAYETTE COUNTY BD OF EDUC FEDERAL EXPRESS CORP FEDERATED DEPT STORES FEDEX FREIGHT EAST FEDEX GROUND PKG SYS FIELDALE FARMS CORPORATION FLEETWOOD HOMES OF GA INC FLEXSTEEL INDUSTRIES INC FLORIDA ROCK & TANK LINES INC FLORIDA ROCK INDUSTRIES INC FLOWERS FOODS INC. FLOYD CO. BD. OF COMM FLOYD COUNTY BD OF EDUC

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$28,592.22 $1,625,408.43
$411,731.99 $91,580.87
$109,951.89 $187,725.81
$70,857.71 $68,080.19 $52,385.28
$43.71 $26,243.28
$1,219.89 $11,522.49
$0.00 $76,099.37
$7,583.74 $12,336.61 $121,272.32
$7,019.17 $13,255.17 $504,018.13 $59,009.65 $34,930.48 $186,929.83 $23,849.19 $80,177.53
$6,919.45 $30,016.29 $234,868.65 $375,750.64 $80,752.21 $107,054.40 $96,431.31 $129,454.66
$4,141.98 $8,884.19 $55,196.50 $166,564.09 $81,919.46 $39,669.80

$28,784.13 $1,636,317.84
$414,495.45 $92,195.55
$101,693.74 $188,985.79
$71,333.29 $68,537.14 $52,736.87
$44.00 $26,419.42
$1,228.08 $11,599.83
$0.00 $76,610.13
$7,634.64 $12,419.41 $122,086.28
$7,066.28 $13,344.14 $507,401.00 $59,405.71 $35,164.93 $188,184.46 $24,009.26 $80,715.66
$6,965.89 $30,217.75 $236,445.04 $378,272.60 $81,294.20 $107,772.93 $97,078.54 $130,323.54
$4,169.78 $8,943.82 $55,566.96 $167,682.04 $82,469.28 $39,936.05

2007 Claims
Paid
$247,015.34 $10,410,532.04
$3,442,998.86 $393,003.42 $991,472.56 $0.00 $437,944.08 $371,237.59 $484,144.27 $0.00 $137,964.33 $41,882.48 $100,984.47 $17,342.95 $526,198.41 $24,037.99 $64,644.66 $870,709.25 $45,951.43 $87,958.05
$2,098,263.65 $20,577.13
$344,695.54 $469,729.27
$59,598.87 $768,453.36 $246,385.93 $336,865.73 $2,407,462.89 $1,539,498.68 $654,534.36 $599,888.45 $1,099,515.69 $737,052.24 $134,832.00 $112,981.83 $162,646.14 $1,642,450.04 $851,120.43 $499,850.33

2007 Assessment
Amount
$25,071.89 $1,056,661.82
$349,462.01 $39,889.58
$100,633.78 $0.00
$44,451.02 $37,680.36 $49,140.31
$0.00 $14,003.28
$4,251.04 $10,249.85
$1,760.30 $53,408.78
$2,439.84 $6,561.39 $88,376.39 $4,664.04 $8,927.68 $212,972.31 $2,088.56 $34,986.36 $47,677.20 $6,049.24 $77,997.49 $25,008.00 $34,191.64 $244,355.82 $156,258.05 $66,434.79 $60,888.26 $111,600.08 $74,810.29 $13,685.35 $11,467.58 $16,508.47 $166,707.55 $86,388.14 $50,734.46

2006 Balance
Due

2006 and 2007 Total
Assessment Due

$191.91 $10,909.41
$2,763.46 $614.68
($8,258.15) $1,259.98 $475.58 $456.95 $351.59 $0.29 $176.14 $8.19 $77.34 $0.00 $510.76 $50.90 $82.80 $813.96 $47.11 $88.97 $3,382.87 $396.06 $234.45 $1,254.63 $160.07 $538.13 $46.44 $201.46 $1,576.39 $2,521.96 $541.99 $718.53 $647.23 $868.88 $27.80 $59.63 $370.46 $1,117.95 $549.82 $266.25

$25,263.80 $1,067,571.23
$352,225.47 $40,504.26 $92,375.63 $1,259.98 $44,926.60 $38,137.31 $49,491.90 $0.29 $14,179.42 $4,259.23 $10,327.19 $1,760.30 $53,919.54 $2,490.74 $6,644.19 $89,190.35 $4,711.15 $9,016.65
$216,355.18 $2,484.62
$35,220.81 $48,931.83
$6,209.31 $78,535.62 $25,054.44 $34,393.10 $245,932.21 $158,780.01 $66,976.78 $61,606.79 $112,247.31 $75,679.17 $13,713.15 $11,527.21 $16,878.93 $167,825.50 $86,937.96 $51,000.71

Subsequent Injury Trust Fund 2007 Annual Report

Page | 91

Self-Insured Company
FLOYD HLTHCARE MGMT INC FLYING J, INC. FORD MOTOR COMPANY FOREST PARK, CITY OF FORSYTH CO. BD. OF EDUCATION FRANKLIN ALUMINUM CO INC FREUDENBERG-NOK FULTON COUNTY BD OF EDUC FULTON COUNTY, GEORGIA FULTON-DEKALB HOSPTL AUTHY GANNETT CO. INC & SUBSIDI GENERAL MOTORS CORP GEORGIA CRATE & BASKET CO GEORGIA DUCK & CORD MILL GEORGIA STATE OF GEORGIA-PACIFIC CORPORATION GFF HOLDING CO/GENL FIBERS GLYNN CO BOARD OF COMM GLYNN COUNTY SCHOOLS GOLDEN PANTRY FOOD STORES GOODY PRODUCTS, INC. GREAT ATLANTIC & PACIFIC TEA GREAT DANE LTD PARTNERSHIP GRIFFIN-SPALDING SCHOOLS GUARDIAN AUTOMOTIVE CORP GULFSTREAM AEROSPACE CORP GWINNETT CO BD OF EDUC GWINNETT CO BD OF COMMISS GWINNETT HOSPITAL SYSTEM HALL COUNTY BOARD OF EDUCA HAMILTON HEALTH CARE SYS HAPEVILLE CITY OF HARRISON POULTRY, INC HAVERTYS FURNITURE HEARTLAND EXPRESS HENRY CO BOARD OF EDUC HERCULES INCORPORATED HERSCHEND FAMILY ENTERTAI HILLCREST FOODS, INC HILTON HOTELS CORPORATION

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$34,745.08 $37,561.06 $216,209.12
$9,947.31 $41,076.82 $13,465.75 $81,714.86 $390,895.51 $312,331.69 $226,335.59
$2,224.84 $728,950.32
$3,649.23 $32,251.40 $5,917,073.70 $451,468.94
$0.00 $42,160.42 $67,538.89 $20,518.97 $19,288.92 $30,467.04 $71,859.50 $33,684.13 $43,467.81 $140,647.47 $617,976.48
$0.00 $186,878.27 $100,970.45
$49,455.04 $2,400.85
$32,863.02 $0.00 $0.00
$101,485.07 $80,189.53 $9,145.30 $17,780.71 $1,976.57

$34,978.28 $37,813.16 $217,660.27 $10,014.07 $41,352.52 $13,556.13 $82,263.31 $393,519.12 $314,427.99 $227,854.71
$2,239.77 $733,842.88
$3,673.72 $32,467.86 $5,956,787.87 $454,499.11
$0.00 $42,443.40 $67,992.20 $20,656.69 $19,418.39 $30,671.52 $72,341.81 $33,910.21 $43,759.56 $141,591.46 $622,124.21
$0.00 $188,132.56 $101,648.14
$49,786.97 $2,416.97
$33,083.59 $0.00 $0.00
$102,166.22 $80,727.75 $9,206.68 $17,900.10 $1,989.84

2007 Claims
Paid
$488,403.21 $104,200.39 $913,206.58
$82,187.94 $303,790.12 $134,837.00 $329,067.69 $3,171,894.73 $3,410,787.44 $2,431,055.12
$71,900.00 $3,577,406.31
$45,601.72 $140,093.40 $52,631,089.47 $1,676,678.51
$52,995.75 $537,357.95 $557,616.07 $330,018.70 $155,911.68 $296,645.00 $864,047.05 $372,476.00 $687,740.86 $717,378.52 $3,824,927.03 $509,182.07 $1,769,960.41 $418,095.92 $486,967.67
$5,835.19 $380,860.16 $309,570.84
$16,621.32 $998,286.22 $231,823.59 $121,547.23 $314,086.61
$26,343.17

2007 Assessment
Amount
$49,572.59 $10,576.27 $92,689.84
$8,342.02 $30,834.49 $13,685.86 $33,400.14 $321,945.13 $346,192.57 $246,750.42
$7,297.80 $363,104.27
$4,628.54 $14,219.38 $5,342,019.27 $170,181.71
$5,379.03 $54,541.46 $56,597.65 $33,496.67 $15,824.93 $30,109.26 $87,700.18 $37,806.06 $69,805.22 $72,813.42 $388,227.45 $51,681.63 $179,649.76 $42,436.45 $49,426.88
$592.27 $38,657.04 $31,421.23
$1,687.05 $101,325.36
$23,529.93 $12,336.96 $31,879.57
$2,673.81

2006 Balance
Due

2006 and 2007 Total
Assessment Due

$233.20 $252.10 $1,451.15
$66.76 $275.70
$90.38 $548.45 $2,623.61 $2,096.30 $1,519.12
$14.93 $4,892.56
$24.49 $216.46 $39,714.17 $3,030.17
$0.00 $282.98 $453.31 $137.72 $129.47 $204.48 $482.31 $226.08 $291.75 $943.99 $4,147.73
$0.00 $1,254.29
$677.69 $331.93
$16.12 $220.57
$0.00 $0.00 $681.15 $538.22 $61.38 $119.39 $13.27

$49,805.79 $10,828.37 $94,140.99
$8,408.78 $31,110.19 $13,776.24 $33,948.59 $324,568.74 $348,288.87 $248,269.54
$7,312.73 $367,996.83
$4,653.03 $14,435.84 $5,381,733.44 $173,211.88
$5,379.03 $54,824.44 $57,050.96 $33,634.39 $15,954.40 $30,313.74 $88,182.49 $38,032.14 $70,096.97 $73,757.41 $392,375.18 $51,681.63 $180,904.05 $43,114.14 $49,758.81
$608.39 $38,877.61 $31,421.23
$1,687.05 $102,006.51
$24,068.15 $12,398.34 $31,998.96
$2,687.08

Subsequent Injury Trust Fund 2007 Annual Report

Page | 92

Self-Insured Company
HON INDUSTRIES, INC. HORMEL FOODS CORP HORTON HOMES, INC HOSPITAL AUTH HOUSTON CTY HOUSTON COUNTY BD OF EDUC HOUSTON COUNTY COMM HOWARD SHEPPARD INC HUTCHESON MEDICAL CENTER HYATT CORPORATION IDA CASON CALLAWAY FDTN IKON OFFICE SOLUTIONS INGLES MARKETS INC INTERFACE, INC INTERNATIONAL PAPER CO INTERSTATE PAPER LLC J & J INDUSTRIES INC J H HARVEY COMPANY J. C. PENNEY COMPANY, INC. JESUP CITY OF JOHN WIELAND HOMES, INC JOHNS MANVILLE INT'L., INC. JONES COMPANY (THE) K & F INDUSTRIES KAHN CONSTRUCTION CO INC KELLEY MANUFACTURING CO KELLOGG CO & SUBSIDIARIES KIMBERLY-CLARK CORP KING & PRINCE SEAFOOD CORP. KLEEN-TEX INDUSTRIES KLLM TRANSPORT K-MART CORP KNIGHT TRANSPORTATION KROGER COMPANY, THE LAGRANGE, CITY OF LANGDALE INDUSTRIES LAWRENCEVILLE, CITY OF LEVI STRAUSS & CO LIMITED BRANDS, INC LOUISIANA-PACIFIC CORP LOW TEMP INDUSTRIES

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$88,030.09 $60,864.82 $105,921.74 $24,194.23 $73,425.32 $38,887.82 $33,819.69 $153,935.56 $82,961.16 $10,465.90 $53,256.47 $508,807.07 $22,094.06 $326,165.60 $15,799.94 $28,669.94 $43,162.85 $152,070.90
$8,379.74 $140,486.70
$29,070.43 $183,623.45
$34,734.41 $4,793.29
$18,651.51 $94,742.47
$6,994.75 $2,048.96 $12,347.52 $35,326.29 $338,703.70 $27,323.36 $795,162.00 $38,476.00 $119,502.68 $20,044.37
$0.00 $6,095.22 $24,225.56 $5,617.82

$88,620.93 $61,273.33 $106,632.67 $24,356.62 $73,918.14 $39,148.82 $34,046.68 $154,968.74 $83,517.98 $10,536.14 $53,613.92 $512,222.08 $22,242.35 $328,354.76 $15,905.99 $28,862.37 $43,452.55 $153,091.56
$8,435.98 $141,429.62
$29,265.55 $184,855.89
$34,967.54 $4,825.46
$18,776.69 $95,378.36
$7,041.70 $2,062.71 $12,430.40 $35,563.39 $340,977.01 $27,506.75 $800,498.96 $38,734.24 $120,304.76 $20,178.91
$0.00 $6,136.13 $24,388.16 $5,655.52

2007 Claims
Paid
$689,031.90 $362,996.74 $399,507.54 $192,643.31 $439,401.35 $188,486.33 $203,083.78 $590,115.25 $151,341.72
$51,975.88 $519,050.17 $2,622,753.59 $257,126.93 $537,396.71 $235,255.33 $159,597.19 $108,525.99 $307,200.37
$86,759.26 $787,212.89 $200,037.17 $792,156.06 $223,164.74
$47,179.78 $115,964.56 $1,049,420.99
$78,354.24 $48,707.06 $63,926.50 $303,110.90 $3,528,144.75 $131,783.01 $5,498,934.75 $252,531.86 $566,346.19 $196,774.39 $315,625.46 $42,766.71 $65,027.00 $24,437.76

2007 Assessment
Amount
$69,936.26 $36,843.92 $40,549.74 $19,553.16 $44,598.93 $19,131.23 $20,612.86 $59,896.29 $15,361.08
$5,275.52 $52,683.23 $266,207.68 $26,098.21 $54,545.40 $23,878.25 $16,199.00 $11,015.31 $31,180.63
$8,806.01 $79,901.57 $20,303.63 $80,403.29 $22,651.07
$4,788.72 $11,770.32 $106,515.51
$7,952.90 $4,943.73 $6,488.50 $30,765.55 $358,104.26 $13,375.88 $558,138.08 $25,631.81 $57,483.75 $19,972.46 $32,035.77 $4,340.79 $6,600.20 $2,480.42

2006 Balance
Due

2006 and 2007 Total
Assessment Due

$590.84 $408.51 $710.93 $162.39 $492.82 $261.00 $226.99 $1,033.18 $556.82
$70.24 $357.45 $3,415.01 $148.29 $2,189.16 $106.05 $192.43 $289.70 $1,020.66
$56.24 $942.92 $195.12 $1,232.44 $233.13
$32.17 $125.18 $635.89
$46.95 $13.75 $82.88 $237.10 $2,273.31 $183.39 $5,336.96 $258.24 $802.08 $134.54
$0.00 $40.91 $162.60 $37.70

$70,527.10 $37,252.43 $41,260.67 $19,715.55 $45,091.75 $19,392.23 $20,839.85 $60,929.47 $15,917.90
$5,345.76 $53,040.68 $269,622.69 $26,246.50 $56,734.56 $23,984.30 $16,391.43 $11,305.01 $32,201.29
$8,862.25 $80,844.49 $20,498.75 $81,635.73 $22,884.20
$4,820.89 $11,895.50 $107,151.40
$7,999.85 $4,957.48 $6,571.38 $31,002.65 $360,377.57 $13,559.27 $563,475.04 $25,890.05 $58,285.83 $20,107.00 $32,035.77 $4,381.70 $6,762.80 $2,518.12

Subsequent Injury Trust Fund 2007 Annual Report

Page | 93

Self-Insured Company
LOWE'S HOME CENTERS, INC MACON CITY OF MACON/BIBB CO WATER & SEWE MARIETTA CITY SERVICES MAR-JAC POULTRY, INC. MARKETPLACE HOLDINGS, INC MARRIOTT INTERNATIONAL, INC. MARTA MCG HEALTH INC MCLANE COMPANY, INC. M-D BUILDING PRODUCTS MEADOWS REGNL MEDICAL CTR MEADWESTVACO MEMORIAL MEDICAL CENTER MERCK & CO INC METALPLATE GALVANIZING L P METROMEDIA INTERN'L GRP MICROMERITICS INSTRU CORP MILLEDGEVILLE, CITY OF MILTON J. WOOD COMPANY MOHAWK INDUSTRIES, INC MONROE, CITY OF MOUNT VERNON MILLS MURRAY COUNTY BD OF EDUC MUSCOGEE CO SCHOOL DIST NASH JOHNSON & SONS' FARMS NATIONAL SERVICES INDUSTRIES NEWTON COUNTY NEWTON COUNTY BD OF EDUC NORDSON CORPORATION NORDSTROM, INC. NORMAN FRIES CLAXTN POLTRY NORTHEAST GEOR HEALTH SYS NORTHSIDE HOSPITAL OLD DOMINION FREIGHT LINES OLIN CORPORATION OWENS-CORNING OWENS-ILLINOIS INC OXFORD CONSTRUCTION CO PARKER HANNIFIN CORP.

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$781,712.19 $181,582.70
$30,882.65 $1,898.57
$67,018.41 $2,807.04
$199,996.02 $709,829.18
$52,204.48 $89,100.65 $21,099.97
$5,072.52 $71,904.14 $86,000.30
$0.00 $4,815.22
$0.00 $1,567.29 $25,758.69 $31,472.97 $970,561.72 $19,792.56 $135,755.76 $1,644.37 $119,279.83 $2,546.33 $7,712.53 $17,299.49 $58,241.13 $19,067.87 $34,842.87 $63,449.01 $91,218.96 $280,993.57 $54,697.14
$325.05 $55,688.26 $180,520.17 $27,068.66
$0.00

$786,958.88 $182,801.45
$31,089.93 $1,911.32
$67,468.22 $2,825.88
$201,338.35 $714,593.40
$52,554.87 $89,698.68 $21,241.59
$5,106.56 $72,386.75 $86,577.52
$0.00 $4,847.54
$0.00 $1,577.81 $25,931.58 $31,684.21 $977,075.93 $19,925.40 $136,666.93 $1,655.40 $120,080.41 $2,563.42 $7,764.29 $17,415.60 $58,632.04 $19,195.85 $35,076.73 $63,874.86 $91,831.20 $282,879.54 $55,064.26
$327.23 $56,062.03 $181,731.78 $27,250.34
$0.00

2007 Claims
Paid
$6,042,520.36 $852,643.99 $299,596.23 $368,387.81 $585,633.00 $80,049.63
$1,169,471.09 $4,535,427.70
$322,533.57 $557,648.15
$0.00 $77,906.44 $272,273.98 $517,696.77 $278,603.00
$3,873.99 $64,538.00 $11,244.36 $305,553.05 $64,000.38 $6,823,760.90 $46,148.93 $236,758.08
$9,848.99 $745,541.10
$51,761.24 $42,831.97 $88,970.64 $114,387.52 $116,501.65 $129,364.00 $388,591.87 $538,568.00 $1,984,013.05 $929,614.87
$0.00 $501,596.48 $650,406.30 $291,754.34 $223,746.34

2007 Assessment
Amount
$613,311.65 $86,542.78 $30,408.81 $37,391.11 $59,441.35 $8,124.98
$118,700.51 $460,342.78
$32,736.93 $56,600.90
$0.00 $7,907.45 $27,635.62 $52,545.86 $28,278.01
$393.21 $6,550.56 $1,141.29 $31,013.42 $6,495.99 $692,607.02 $4,684.08 $24,030.78
$999.67 $75,671.91
$5,253.73 $4,347.42 $9,030.46 $11,610.25 $11,824.84 $13,130.36 $39,441.81 $54,664.28 $201,375.96 $94,355.27
$0.00 $50,911.70 $66,015.79 $29,612.86 $22,710.10

2006 Balance
Due

2006 and 2007 Total
Assessment Due

$5,246.69 $1,218.75
$207.28 $12.75
$449.81 $18.84
$1,342.33 $4,764.22
$350.39 $598.03 $141.62
$34.04 $482.61 $577.22
$0.00 $32.32
$0.00 $10.52 $172.89 $211.24 $6,514.21 $132.84 $911.17 $11.03 $800.58 $17.09 $51.76 $116.11 $390.91 $127.98 $233.86 $425.85 $612.24 $1,885.97 $367.12
$2.18 $373.77 $1,211.61 $181.68
$0.00

$618,558.34 $87,761.53 $30,616.09 $37,403.86 $59,891.16 $8,143.82
$120,042.84 $465,107.00
$33,087.32 $57,198.93
$141.62 $7,941.49 $28,118.23 $53,123.08 $28,278.01
$425.53 $6,550.56 $1,151.81 $31,186.31 $6,707.23 $699,121.23 $4,816.92 $24,941.95 $1,010.70 $76,472.49 $5,270.82 $4,399.18 $9,146.57 $12,001.16 $11,952.82 $13,364.22 $39,867.66 $55,276.52 $203,261.93 $94,722.39
$2.18 $51,285.47 $67,227.40 $29,794.54 $22,710.10

Subsequent Injury Trust Fund 2007 Annual Report

Page | 94

Self-Insured Company
PATTERSON PUMP COMPANY PCC AIRFOILS LLC PHOEBE PUTNEY MEM HOSP PIEDMONT HOSPITAL PIEDMONT LABORATORIES, INC PIGGLY WIGGLY CAROLINA CO PILOT TRAVEL CENTERS PPG INDUSTRIES INC. PRESBYTERIAN HOMES OF GA PRINTPACK, INC PROCTER & GAMBLE COMPANY QUIKTRIP CORPORATION RACETRAC PETROLEUM, INC RANDOLPH COUNTY HOSP AUTH RAYONIER INC RECONSERVE REGIONS FINANCIAL CORP RHODES NURSING HOME RICHMOND CTY BD OF EDUC RIVERDALE, CITY OF RMC USA, INC. ROCKDALE CO. BD OF EDUC ROCKWELL AUTOMATION, INC ROLLINS INC ROOKER ADMINISTRATIVE SVCS ROPER CORPORATION ROSEBURG FOREST PRODUCTS ROSWELL CITY OF RTM, INC. RUBY TUESDAY INC RUSSELL CORPORATION RYAN'S FAMILY STEAK HOUSES RYDER SYSTEM INC SAINT JOSEPH'S OF SAVANNAH SATILLA HEALTH SERVICES INC SAVANNAH CITY OF SCIENTIFIC-ATLANTA INC SHAW INDUSTRIES INC SHEPHERD CONSTRUCTION SHEPHERD MEDICAL CENTER

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$3,115.83 $34,505.47 $75,087.84 $166,103.85
$4,529.34 $27,108.50 $28,752.15 $13,272.35
$7,747.54 $11,595.01 $33,131.45 $92,783.92 $28,193.84
$2,153.35 $0.00
$1,142.01 $0.00
$4,563.56 $121,974.38
$4,819.14 $35,340.92 $37,262.22 $60,214.67 $81,858.12 $27,828.14 $82,605.03
$0.00 $57,226.15 $110,938.18 $148,361.17
$71.04 $58,444.68 $86,870.00 $79,867.49 $99,940.14 $375,521.15 $46,713.32 $1,331,766.15 $29,046.26 $31,614.99

$3,136.75 $34,737.06 $75,591.82 $167,218.70
$4,559.74 $27,290.44 $28,945.13 $13,361.43
$7,799.54 $11,672.83 $33,353.82 $93,406.67 $28,383.07
$2,167.80 $0.00
$1,149.67 $0.00
$4,594.19 $122,793.05
$4,851.48 $35,578.12 $37,512.31 $60,618.82 $82,407.53 $28,014.92 $83,159.46
$0.00 $57,610.24 $111,682.78 $149,356.94
$71.51 $58,836.95 $87,453.05 $80,403.55 $100,610.92 $378,041.57 $47,026.85 $1,340,704.69 $29,241.21 $31,827.18

2007 Claims
Paid
$88,848.80 $176,653.66 $848,616.40 $1,131,630.90
$0.00 $344,771.00 $300,663.13 $117,035.29
$72,583.72 $352,991.35 $466,899.32 $367,575.02 $364,201.89
$5,333.02 $140,816.37 $152,673.93
$17,093.58 $27,686.58 $697,136.23 $33,321.41 $27,931.32 $189,673.46 $313,220.43
$0.00 $19,248.37 $903,194.69
$611.65 $394,060.48 $257,287.11 $240,601.00
$6,486.00 $543,901.75 $425,385.71 $399,521.18 $271,626.46 $713,071.73
$0.00 $11,240,598.47
$259,309.28 $134,719.00

2007 Assessment
Amount
$9,018.09 $17,930.22 $86,133.98 $114,859.76
$0.00 $34,994.02 $30,517.10 $11,879.00
$7,367.20 $35,828.38 $47,389.96 $37,308.61 $36,966.24
$541.30 $14,292.76 $15,496.30
$1,734.99 $2,810.17 $70,758.85 $3,382.10 $2,835.01 $19,251.73 $31,791.66
$0.00 $1,953.70 $91,673.64
$62.08 $39,996.87 $26,114.46 $24,420.84
$658.32 $55,205.65 $43,176.36 $40,551.12 $27,569.90 $72,376.29
$0.00 $1,140,912.99
$26,319.71 $13,673.89

2006 Balance
Due

2006 and 2007 Total
Assessment Due

$20.92 $231.59 $503.98 $1,114.85
$30.40 $181.94 $192.98
$89.08 $52.00 $77.82 $222.37 $622.75 $189.23 $14.45
$0.00 $7.66 $0.00 $30.63 $818.67 $32.34 $237.20 $250.09 $404.15 $549.41 $186.78 $554.43 $0.00 $384.09 $744.60 $995.77 $0.47 $392.27 $583.05 $536.06 $670.78 $2,520.42 $313.53 $8,938.54 $194.95 $212.19

$9,039.01 $18,161.81 $86,637.96 $115,974.61
$30.40 $35,175.96 $30,710.08 $11,968.08
$7,419.20 $35,906.20 $47,612.33 $37,931.36 $37,155.47
$555.75 $14,292.76 $15,503.96
$1,734.99 $2,840.80 $71,577.52 $3,414.44 $3,072.21 $19,501.82 $32,195.81
$549.41 $2,140.48 $92,228.07
$62.08 $40,380.96 $26,859.06 $25,416.61
$658.79 $55,597.92 $43,759.41 $41,087.18 $28,240.68 $74,896.71
$313.53 $1,149,851.53
$26,514.66 $13,886.08

Subsequent Injury Trust Fund 2007 Annual Report

Page | 95

Self-Insured Company
SHERWIN-WILLIAMS COMPANY SHONEY'S LLC SI GEOSOLUTIONS CORP SIMMONS FOODS, INC SIZEMORE ,INC. SKF USA INC SMURFIT-STONE CONTAINER EN SNELL CONTRACTORS SONOCO PRODUCTS COMPANY SOUTH GEORGIA MED CENTER SOUTHEAST GA HLTH SYSTEM SOUTHEAST-ATLANTIC BEV SOUTHEASTERN FREIGHT LINES SOUTHERN COMPANY SOUTHERN MILLS INC SOUTHERN PAN SERVICES SOUTHERN REGNL HEALTH SYS SOUTHWIRE COMPANY SPALDING CO BOARD OF COMM SPARTA CITY OF SPRINGS INDUSTRIES INC ST FRANCIS HOSPITAL ST JOSEPH HOSPITAL/AUGUSTA STANLEY WORKS & SUBSIDIARIES SUPERIOR RIGGING & ERECTING SUPERIOR UNIFORM GROUP SUTHERLAND'S FOODSERVICE T. M. POLYFILM, INC TALON EQUITIES, INC TANNER HEALTH SERVICES TARGET CORPORATION TECUMSEH PRODUCTS CO TERMINIX SERVICE, INC TEXTILE RUBBER & CHEMICAL TEXTRON, INC THE DIXIE GROUP, INC. THERMAL CERAMICS THOMASVILLE CITY OF THREE SPRINGS INC. TIP TOP POULTRY INC

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$37,251.59 $86,025.41 $235,487.68
$1,033.52 $100,630.73
$7,124.42 $44,674.31 $73,783.34
$0.00 $33,552.18 $190,148.04
$3,728.92 $136,841.13 $833,002.12
$26,300.26 $42,218.80 $78,505.41 $756,402.65 $36,488.78
$738.34 $112,661.91
$34,699.45 $19,913.93 $24,706.39 $48,540.97
$253.14 $5,346.40 $15,417.68 $11,360.41 $44,842.84 $284,270.51 $16,201.33
$238.21 $3,105.52 $82,655.92 $173,770.00 $2,445.68 $49,392.73 $8,737.89 $56,565.47

$37,501.62 $86,602.79 $237,068.23
$1,040.46 $101,306.14
$7,172.24 $44,974.15 $74,278.56
$0.00 $33,777.38 $191,424.28
$3,753.95 $137,759.57 $838,593.06
$26,476.78 $42,502.17 $79,032.32 $761,479.47 $36,733.68
$743.30 $113,418.07
$34,932.35 $20,047.59 $24,872.22 $48,866.76
$254.84 $5,382.28 $15,521.16 $11,436.66 $45,143.82 $286,178.48 $16,310.07
$239.81 $3,126.36 $83,210.69 $174,936.31 $2,462.09 $49,724.25 $8,796.53 $56,945.12

2007 Claims
Paid
$701,334.00 $342,471.12 $648,516.13
$27,696.00 $0.00
$1,657.00 $474,565.00 $400,712.04
$4,727.81 $342,001.92 $582,389.09
$92,069.59 $689,393.48 $4,863,568.61 $307,371.53 $338,075.68 $640,369.88 $2,554,546.41 $130,184.66
$3,655.30 $295,538.00 $509,796.21 $197,033.48
$51,577.94 $242,173.82
$0.00 $106,336.11
$84,473.62 $63,277.09 $350,495.82 $2,858,759.24 $41,699.39 $19,002.99 $257,473.00 $315,984.51 $633,775.05 $241,592.19 $396,044.88 $25,061.83 $352,761.46

2007 Assessment
Amount
$71,184.92 $34,760.58 $65,823.94
$2,811.12 $0.00
$168.18 $48,168.02 $40,672.00
$479.87 $34,712.96 $59,112.09
$9,345.00 $69,972.96 $493,648.86 $31,198.00 $34,314.45 $64,997.10 $259,284.70 $13,213.65
$371.01 $29,996.90 $51,743.96 $19,998.76
$5,235.13 $24,580.48
$0.00 $10,793.04
$8,574.01 $6,422.58 $35,575.08 $290,162.09 $4,232.46 $1,928.79 $26,133.33 $32,072.21 $64,327.73 $24,521.44 $40,198.28 $2,543.76 $35,805.04

2006 Balance
Due

2006 and 2007 Total
Assessment Due

$250.03 $577.38 $1,580.55
$6.94 $675.41
$47.82 $299.84 $495.22
$0.00 $225.20 $1,276.24
$25.03 $918.44 $5,590.94 $176.52 $283.37 $526.91 $5,076.82 $244.90
$4.96 $756.16 $232.90 $133.66 $165.83 $325.79
$1.70 $35.88 $103.48 $76.25 $300.98 $1,907.97 $108.74
$1.60 $20.84 $554.77 $1,166.31 $16.41 $331.52 $58.64 $379.65

$71,434.95 $35,337.96 $67,404.49
$2,818.06 $675.41 $216.00
$48,467.86 $41,167.22
$479.87 $34,938.16 $60,388.33
$9,370.03 $70,891.40 $499,239.80 $31,374.52 $34,597.82 $65,524.01 $264,361.52 $13,458.55
$375.97 $30,753.06 $51,976.86 $20,132.42
$5,400.96 $24,906.27
$1.70 $10,828.92
$8,677.49 $6,498.83 $35,876.06 $292,070.06 $4,341.20 $1,930.39 $26,154.17 $32,626.98 $65,494.04 $24,537.85 $40,529.80 $2,602.40 $36,184.69

Subsequent Injury Trust Fund 2007 Annual Report

Page | 96

Self-Insured Company
TRC STAFFING SERVICES, INC TROUP CO. BOARD OF EDUC TRUEBLUE, INC. TYSON FOODS INC UNILEVER UNITED STATES UNITED AIRLINES UNITED CATALYSTS, INC UNIVERSITY HOSPITAL UPS FREIGHT USF HOLLAND, INC. VALDOSTA CITY OF VARIETY WHOLESALERS VISITING NURSE HEALTH SYSTEM VULCAN MATERIALS COMPANY WAFFLE HOUSE WAGGONERS TRUCKING CO. WALKER COUNTY BD OF EDUC WALTON CO BOARD OF ED WAREHOUSE HOME FURNISH WARNER ROBINS CITY OF WATKINS ASSOCIATED INDUS WAYCROSS MOLDED PRODUCTS WAYCROSS, CITY OF WAYNE FARMS LLC WELLSTAR HEALTH SYSTEM WENDY'S INTERNATIONAL INC WEST GEORGIA HEALTH SYSTEM WEYERHAEUSER COMPANY WHITFIELD COUNTY BOE WILD ADVENTURES, INC. WINN-DIXIE STORES INC YELLOW TRANSPORTATION YKK CORPORATION OF AMERICA Grand Total:

2006 Assessment
Amount

2006 Assessment Adjustment Amount

$80,178.98 $30,660.59 $55,478.85 $453,110.79
$4,628.81 $33,126.52
$9,619.91 $128,370.43 $125,871.15
$53,802.94 $39,207.51 $102,225.30 $23,752.53 $13,938.94 $244,383.80 $187,134.33 $44,448.61 $19,008.48 $86,576.01 $60,409.03 $212,837.81 $10,433.05 $35,612.97 $16,113.54 $741,832.97 $17,452.86 $42,277.19 $187,484.82 $44,356.60
$5,109.51 $447,953.80
$86,176.85 $47,018.28 $46,654,636.83

$80,717.12 $30,866.38 $55,851.21 $456,151.98
$4,659.88 $33,348.86
$9,684.48 $129,232.03 $126,715.97
$54,164.05 $39,470.66 $102,911.42 $23,911.96 $14,032.49 $246,024.06 $188,390.33 $44,746.94 $19,136.06 $87,157.09 $60,814.49 $214,266.33 $10,503.08 $35,852.00 $16,221.69 $746,812.00 $17,570.00 $42,560.94 $188,743.18 $44,654.31
$5,143.80 $450,960.37
$86,755.25 $47,333.85 $46,958,777.02

2007 Claims
Paid
$765,897.57 $266,419.42 $758,913.36 $2,476,991.12
$0.00 $516,941.31
$29,580.30 $479,169.06 $546,351.02 $520,523.58 $266,013.60 $531,629.81 $129,168.22 $1,164,194.54 $2,828,095.55 $307,683.84 $424,954.61 $192,854.59 $568,896.45 $525,665.88 $932,669.60
$55,279.07 $202,622.88 $213,586.45 $5,263,738.31
$72,908.35 $226,229.40 $775,808.74 $593,531.23
$0.00 $3,333,207.54 $1,277,218.03
$611,764.82 $313,408,003.80

2007 Assessment
Amount

2006 Balance
Due

2006 and 2007 Total
Assessment Due

$77,738.07 $27,041.39 $77,029.18 $251,412.89
$0.00 $52,469.19
$3,002.38 $48,635.33 $55,454.25 $52,832.78 $27,000.20 $53,960.06 $13,110.49 $118,164.94 $287,049.75 $31,229.70 $43,132.60 $19,574.61 $57,742.60 $53,354.72 $94,665.32
$5,610.79 $20,566.08 $21,678.88 $534,265.81
$7,400.15 $22,962.13 $78,744.05 $60,243.01
$0.00 $338,318.27 $129,636.75
$62,093.71 $31,810,696.14

$538.14 $205.79 $372.36 $3,041.19
$31.07 $222.34
$64.57 $861.60 $844.82 $361.11 $263.15 $686.12 $159.43
$93.55 $1,640.26 $1,256.00
$298.33 $127.58 $581.08 $405.46 $1,428.52
$70.03 $239.03 $108.15 $4,979.03 $117.14 $283.75 $1,258.36 $297.71
$34.29 $3,006.57
$578.40 $315.57 $304,140.19

$78,276.21 $27,247.18 $77,401.54 $254,454.08
$31.07 $52,691.53
$3,066.95 $49,496.93 $56,299.07 $53,193.89 $27,263.35 $54,646.18 $13,269.92 $118,258.49 $288,690.01 $32,485.70 $43,430.93 $19,702.19 $58,323.68 $53,760.18 $96,093.84
$5,680.82 $20,805.11 $21,787.03 $539,244.84
$7,517.29 $23,245.88 $80,002.41 $60,540.72
$34.29 $341,324.84 $130,215.15
$62,409.28 $32,043,802.08