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SELF-INSURED EMPLOYER LIST01-Apr-13
STATE OF NEVADADEPARTMENT OF BUSINESS AND INDUSTRYDIVISION OF INSURANCE
C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
397 AFFINITY GAMING LLCformerly Herbst Gaming LLC
1/1/2011
Elizabeth GuthV.P. Of Insurance and Benefits
Affinity GAMING LLC3755 Breakthrough Way Suite 300Las Vegas NV 89135(702) 341-2419
Certification Date:
SIERRA NEVADA ADMINISTRATORS
Michele Taylor2716 N. Tenaya Way, 5th FLLas Vegas NV 89114-5750(702) 240-8935
Flamingo Paradise LLC 1/1/2011
Last Chance LLC 1/1/2011
Whiskey Pete's Hotel & Casino LLC 1/1/2011
Herbst Gaming LLC 1/1/2011
Zante LLC 1/1/2011Sands Regency
Buffalo Bills LLC 1/1/2011
Primmadonna Resort & Casino LLC 1/1/2011
Plantation Investment LLC 1/1/2011
Dayton Depot LLC 1/1/2011
ETT LLC 1/1/2011
106 AMERISTAR CASINOS INC
10/1/1990
Karen BurrisBenefits Manager
AMERISTAR CASINOS INC3773 Howard Hughes Parkway, Ste 490Las Vegas NV 89169(702) 567-7060
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
Cactus Pete's Inc. 10/1/1990
Ameristar Casinos, Inc. 4/1/1994
The Horseshu 10/1/1990
Cactus Pete's Resort Casino 10/1/1990
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
55 ARCHON CORPORATION
8/15/1982
David LowdenExecutive Office Administrator
ARCHON CORPORATION3221 S Torrey PinesLas Vegas NV 89146(702) 429-6742
Certification Date:
SIERRA NEVADA ADMINISTRATORS
Michele Taylor2716 N. Tenaya Way, 5th FLLas Vegas NV 89114-5750(702) 240-8935
Pioneer Hotel Inc. 9/15/1989
45 ARKANSAS BEST CORPORATION
12/15/1981
Allen KingWorkers Comp Manager
ABF FREIGHT SYSTEMS3801 Old Greenwood Rd.Fort Smith AR 72903(479) 785-6218
Certification Date:
GALLAGHER BASSETT SERVICES, INC.
Charles Rostad2110 East Flamingo Rd #314Las Vegas NV 89119-0834(866)-889-4755
Cardinal Freight Lines 10/1/1995
ABF Freight Systems 12/15/1981
E-T-M-F Terminals 10/18/1982
326 BEST BUY CO INCBEST BUY STORES LP
12/1/1997
Rebecca SchoffConsultant
Aon Global Risk Consulting for Besy Buy5600 W. 83rd Street, Tower Ste 1100Minneapolis MN 55437952-807-0693
Certification Date:
GALLAGHER BASSETT SERVICES, INC.
Charles Rostad2110 East Flamingo Rd #314Las Vegas NV 89119-0834(866)-889-4755
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
52 BOYD GAMING CORPORATION
7/1/1981
Juliet VestalDirector of Benefits & Risk ManagementDirector of Benefits & Risk Management6465 South Rainbow BlvdLas Vegas NV 89118(702) 692-4156
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
Mare-Bear, Inc. 7/1/1981Stardust Resort and Casino
Boyd Shared Services, Inc. 6/1/2007
Boyd Gaming Corporation 11/1/1990
ETN Productions, Inc. 5/1/1994
Coast Hotel & Casino 1/1/1996
Sam-Will, Inc. 7/1/1981Fremont Hotel and Casino
Echelon Resorts Corporation 12/1/2005
Eldorado, Inc. 1/1/1993Jokers Wild Casino
Boyd Atlantic City, Inc. 1/1/1999
Boyd Travel, Inc. 10/1/1995Vacations-Hawaii
Eldorado, Inc. 8/1/1982Eldorado Casino
California Hotel & Casino 8/1/1982California Hotel and Casino
Boyd Central Region, Inc. 2/1/1996
The SunCoast Hotel & Casino 4/1/2000
Echelon Resorts LLC 12/1/2005
Gold Coast Hotel & Casino 2/1/1989
M.S.W., Inc. 8/15/1995Main Street Station Hotel, Casino
ETN Development Corporation 11/17/2004
Boyd Development Corporation 10/1/1995
Rodney Petroleum, Inc. 9/4/1992Downtown Texaco Station
California Hotel & Casino 8/1/1982Sam's Town Hotel, Gambling Hall
Orleans Hotel & Casino, The 2/12/1996
Coast Vacations 8/13/1999
Constellation Insurance Company 7/1/2005
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
11 CAESARS ENTERTAINMENT CORPORATIONformerly Harrah's
8/15/1980
Maila AganonInsurance Manager
HARRAHS ENTERTAINMENT INCOne Caesars Palace DriveLas Vegas NV 89109(702) 407-6277
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
Harrah's Laughlin 4/28/1988
Bill's Casino 7/1/1987
Harrah's Las Vegas 6/1/1983
Harveys Tahoe Management Co. 8/1/2001
Caesars Entertainment Inc 7/12/1980
Bill's Gambling Hall & Saloon 2/27/2007
Imperial Palace Casino Inc 2/8/1981
Rio Hotel & Casino Inc 6/1/1992
Harrah's Reno/Tahoe 8/15/1980
393 CARSON CITY
7/1/2010
Cecilia MeyerRisk Management Coordinator
CARSON CITY FINANCE DIVISION201 North Carson Street Ste 3Carson City NV 89701(775) 283-7484
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiP O BOX 20068Reno NV 89515-0068(775) 324-3301 x 1011
394 CARSON CITY SCHOOL DISTRICT
7/1/2010
Amanda PrudhommeHR/Workers' Comp
CARSON CITY SCHOOL DISTRICT1402 West King StreetCarson City NV 89702(775) 283-2004
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
383 CATHOLIC CHARITIES OF SOUTHERN NEVADA
1/1/2006
Linda SummersHuman Resource Director
CATHOLIC CHARITIES OF SOUTHERN NV1501 Las Vegas Blvd NorthLas Vegas NV 89101(702) 385-2662
Certification Date:
NEVADA ALTERNATIVE SOLUTIONS, INC.
Charles R Nort9506 West Flamingo Rd Suite 102Las Vegas NV 89147(702) 796-1333 ext 228
199 CEDAR ENTERPRISES INCWENDY'S OF LAS VEGAS
1/1/1994
Deborah S HarmonDirector Human Resources
CEDAR ENTERPRISES INC1328 Dublin Road Ste 300Columbus OH 43215-1054(614) 787-7804
Certification Date:
SIERRA NEVADA ADMINISTRATORS
Michele Taylor2716 N. Tenaya Way, 5th FLLas Vegas NV 89114-5750(702) 240-8935
Cedar Bon Bakeries, Ltd. 9/10/2001
Wendy's of Las Vegas, Inc. 1/1/1994
169 CITY OF HENDERSON
4/1/1993
Amy M. L. WongSenior Disability Analyst
CITY OF HENDERSONP O Box 95050-MS 137Henderson NV 89009-5050(702) 267-1921
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
78 CITY OF LAS VEGAS
12/29/1985
Connie I. StrauserWorkers' Compensation Analyst
CITY OF LAS VEGAS495 S. Main St.Las Vegas NV 89101(702) 229-5044
Certification Date:
CITY OF LAS VEGAS
Victoria J Robinson, Ins Svcs400 East Stewart AvenueLas Vegas NV 89101-2986(702)229-5043
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
197 CITY OF NORTH LAS VEGAS
1/1/1994
Darlene RosenbergPrincipal Benefits Analyst
CITY OF NORTH LAS VEGAS2250 Las Vegas Blvd NorthNorth Las Vegas NV 89030(702) 633-2124
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
147 CITY OF RENO
9/1/1992
Renee RungisDirector of Human Resources
CITY OF RENOPO Box 1900Reno NV 89505(775) 785-5854
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiP O BOX 20068Reno NV 89515-0068(775) 324-3301 x 1011
163 CITY OF SPARKS
2/1/1993
Jill ValdezHuman Resources Analyst
CITY OF SPARKS431 Prater WaySparks NV 89431(775) 353-4021
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiP O BOX 20068Reno NV 89515-0068(775) 324-3301 x 1011
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
399 CITYCENTER HOLDINGS, LLC
11/30/2011
Tina SanchezDirector of Workers' Compensation
MGM Resorts International3260 Industrial RoadLas Vegas NV 89109(702) 650-6746
Certification Date:
MGM MIRAGE RISK MANAGEMENT
Tina Sanchez3260 So Industrial RoadLas Vegas NV 89109(702) 650-7443
ARIA RESORTS AND CASINO LLC 11/30/2011
THE CRYSTALS AT CITY CENTER MA 11/30/2011
CITY CENTER REALTY CORPORATIO 11/30/2011
PROJECT CC, LLC 11/30/2011
75 CLARK COUNTY
7/15/1985
Sandra SwickardAsst. County Manager
CLARK COUNTY RISK MGMT & SAFETY500 S Grand Central Pkwy, 5th Fl.Las Vegas NV 89106(702)455-5524
Certification Date:
SIERRA NEVADA ADMINISTRATORS
Michele Taylor2716 N. Tenaya Way, 5th FLLas Vegas NV 89114-5750(702) 240-8935
McCarran International Airport 7/15/1985
Volunteer Account (Ambulance & Fireme 4/1/1986
University Medical Center 8/1/1986
104 CLARK COUNTY SCHOOL DISTRICT
7/1/1990
Roque Lapuz JrWorkers Comp Coordinator
CLARK COUNTY SCHOOL DISTRICT4828 S. Pearl Street MS 200Las Vegas NV 89121(702) 799-0060 X5601
Certification Date:
CLARK COUNTY SCHOOL DISTRICT
Nancy Powell, W/C Claims Mgr4204 Channel 10 Drive-Risk MgtLas Vegas NV 89146(702) 799-2967 ext 5626
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
115 CLARK COUNTY WATER RECLAMATION DISTRICT
4/1/1992
Martin J FlynnAssistant to General Manager
CLARK COUNTY WATER RECLAMATION DISTRICT5857 East Flamingo RoadLas Vegas NV 89122(702) 668-8066
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
154 COSTCO WHOLESALE CORPORATION
1/1/1993
Uyen NguyenWorkers Comp Data Analyst
COSTCO COMPANIES INC999 Lake DriveIssaquah WA 98027(425)313-2874
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
Costco Wholesale Corporation 1/1/1993
381 CPS SECURITY (USA) INC
6/1/2004
Vanessa AlvarezWorkers' Compensation Claim SpecialistCPS SECURITY (USA), INC436 West Walnut StreetGardena CA 90248(310) 878-8177
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
Construction Protective Services, Inc. 6/1/2004
Commercial Protective Services, Inc. 6/1/2004
eCamSecure, Inc. 6/1/2004
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
347 CREATIONS MEANDRES INCformerly cirque du soleil
2/1/1999
Mary SpeesSr. Director of Human Resources
CIRQUE DU SOLEIL980 Kelly Johnson Drive Suite 200Las Vegas NV 89119(702) 352-0190
Certification Date:
SIERRA NEVADA ADMINISTRATORS
Michele Taylor2716 N. Tenaya Way, 5th FLLas Vegas NV 89114-5750(702) 240-8935
Cirque du Soleil Radio CT.L.L.C. 10/9/2012
Cirque du Soleil Zumanity, LLC 6/24/2003
Cirque EPE Las Vegas LLC 4/27/2009
Cirque du Soleil Illusion LLC 11/16/2006
Cirque du Soleil (US), Inc. 2/1/1999
Cirque du Soleil "O", LLC 12/29/2003
Cirque Apple Administration, LLC 12/5/2005
Cirque du Soleil Holding USA, Inc. 2/1/1999
Cirque du Soleil, Inc. 2/1/1999
Cirque du Soleil Nevada, Inc. 2/1/1999
Cirque du Soleil My Call L.L.C. 2/18/2013
Cirque du Soleil Perception, LLC 11/24/2003
361 DIGNITY HEALTHchanged name from Catholic Healthcare West
10/1/2000
Hillery TrippeVP, Risk Services
DIGNITY HEALTH185 Berry Street Suite 300San Francisco CA 94107(415)438-5577
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Peggy Harper102 E. Lake Mead DriveHenderson NV 89015(702) 616-4445
St Rose Dominican Health Foundation 10/1/2000
Saint Mary's Preferred Health Insurance 3/1/1997
Nevada Physician's Choice 10/1/2000
St Rose Dominican Hospital - San Martin 8/1/2006
St Rose Dominican Hospital 10/1/2000St. Rose Dominican Hospital, Sien
Saint Mary's Healthfirst 3/1/1997
Saint Mary's Regional Medical Center 10/24/1980
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
216 DOUGLAS COUNTY SCHOOL DISTRICT
7/1/1994
Debe Thomas
DOUGLAS COUNTY SCHOOL DISTRICT1638 Mono Ave.Minden NV 88423(775)782-7177
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiP O BOX 20068Reno NV 89515-0068(775) 324-3301 x 1011
323 EBSCO INDUSTRIES INC
10/1/1997
Heather MooreAssistant Vice President/Acctg. Mgr.
VALLEY JOIST INCP O Box 1943Birmingham AL 35201(205) 991-1473
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
Valley Joist, Inc. 10/1/1997
58 ELDORADO RESORTS LLCELDORADO HOTEL & CASINO
11/1/1982
Robert Bruce MackayDirector of Administration
ELDORADO HOTEL & CASINO345 North Virginia StreetReno NV 89501(775) 786-5700 ext 7656
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
192 ELKO COUNTY SCHOOL DISTRICT
11/1/1993
Mike SmithAssistant Superintendent
ELKO COUNTY SCHOOL DISTRICTP O Box 1012Elko NV 89801(775) 738-5196
Certification Date:
ALTERNATIVE SERVICES CONCEPTS LLC
Mike Livermore1755 East Plumb Lane #148Reno NV 89502(775)329-1181
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
285 FEDEX CORPORATION (PARENT)(GROUND)FEDEX GROUND PACKAGE SYSTEM Inc
8/1/1996
Thomas P Dittoe Sr Manager Workers Compensation
FEDEX GROUND PACKAGE SYSTEM INCP O Box 535859Moon Twp. PA 15108(412) 747-8318
Certification Date:
BROADSPIRE SERVICES INC.
Amy KelleyPO Box 30670Las Vegas NV 89173(702)242-3020
FedEx Ground Package System, Inc. 8/1/1996Formerly RPS, Inc.
29 FEDEX CORPORATION FOR FEDERAL EXPRESS CORPFormerly FDX Corporation
4/1/1981
Julia StegallSr. Risk & Insurance Analyst
FEDERAL EXPRESS CORPORATION3620 Hacks Cross Road Bldg B 3rd FloorMemphis TN 38125-8800(901) 434-4557
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
Federal Express Corporation 4/1/1981
120 FEDEX CORPORATION FOR FEDEX FREIGHT INCFormerly FDX Corporation
11/1/1991
Kayla QuandtRisk Management Advisor
FEDEX FREIGHT INC2200 Forward Drive DC2256Harrison AR 72601(870) 704-5187
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
FedEx Freight Inc. 11/1/1991
174 FOUR QUEENS, LLCFOUR QUEENS HOTEL & CASINO
6/1/1993
Brian R. ArlinVP/Secretary/Treasurer
FOUR QUEENS HOTEL & CASINO202 East Fremont StreetLas Vegas NV 89101(702)366-7382
Certification Date:
NEVADA ALTERNATIVE SOLUTIONS, INC.
Charles R Nort9506 West Flamingo Rd Suite 102Las Vegas NV 89147(702) 796-1333 ext 228
TLC Casino Enterprises Inc 1/1/2008
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
400 FP HOLDINGS LLPPALMS CASINO HOTEL; fka Fiesta Palms LLC
12/23/2011
Cheryl KabesAnalyst - Aon Global Risk Consulting
AON GLOBAL RISK CONSULTING5600 W. 83rd Street; 8200 Tower, Suite 1100Minneapolis MN 55437(952)807-0661
Certification Date:
HELMSMAN MANAGEMENT SERVICES LLC
Cindy RiggioP O Box 95577Las Vegas NV 89193(702) 562-5005 x218
NM Ventures II LLC 11/30/2011
PPII Holdings, llc 11/30/2011
Palms Place, LLC 11/30/2011
NM Ventures LLC 11/30/2011
Little Buddah Café Las Vegas 11/30/2011
141 FRIAS HOLDING COMPANYABC UNION CAB COMPANY
7/1/1992
John HickmanChief Operating Officer
ABC UNION CAB COMPANY5010 South Valley View BlvdLas Vegas NV 89118(702) 798-3400 x2727
Certification Date:
R. A. WONG & ASSOCIATES
Paul Wong5110 S Valley View Blvd, Suite 100Las Vegas NV 89118(702)798-8910
A-NLV Cab Company 7/1/1992
Virgin Valley Cab Company, Inc. 8/1/1994A-Virgin Valley Cab Co.
Vegas Western Cab Company 7/1/1992
Airline Limousine Corporation 4/1/2000
A Cowboy's Dream Bed & Breakfast, LLC 1/15/2010
Ace Cab Company 7/1/1992
Windmill Ridge, LLC 1/15/2010
A-NLV Cab Company 1/1/1996Las Vegas Limousines
Oxford Technologies, Inc. 7/1/1999El Mirador Motel
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
288 GANNETT CO INC
10/1/1996
Michael J. BaglioConsultant
GANNETT CO INC5600 West 83rd Street, 8200 Tower Suite 1100Minneapolis MN 55437(952) 807-0620
Certification Date:
CONSTITUTION STATE SERVICES LLC
Brandi Lee7450 Arroyo Crossing Pkwy, Ste 200Las Vegas NV 89113-4081(702) 479-4218 x 94218
Gannett International Commumications, I 4/17/2000
Media West-SJC, Inc. 4/17/2000
Media West-MCN, Inc. 4/17/2000
Media West-SPC, Inc. 4/17/2000
Media West-TAC, Inc. 4/17/2000
Media West-NPP, Inc. 4/17/2000
Media West-THC, Inc. 4/17/2000
Media West-UWI, Inc. 4/17/2000
Media West-STI, Inc. 4/17/2000
Media West-SBC, Inc. 4/17/2000
Media West-PNJ, Inc. 4/17/2000
Gannett Satellite Information Network, In 10/1/1996
Media West-OPP, Inc. 4/17/2000
Media West-MSC, Inc. 4/17/2000
Media West-SNI, Inc. 4/17/2000
Gannett Pacific Publications, Inc. 10/1/2007
Media West-PCC, Inc. 4/17/2000
Media West-VNI, Inc. 4/17/2000
Media West-GRS, Inc. 4/17/2000
Media West-CNI, Inc. 4/17/2000
Media West-LCJ, Inc. 4/17/2000
Media West-INI, Inc. 8/4/2000
Media West-PNI, Inc. 8/4/2000
Media West-GMP, Inc. 7/1/2000
USA Today 10/1/1996
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
Media West-GUP, Inc. 7/1/2000
Media West-ANI, Inc. 8/4/2000
Media West-ATP, Inc. 4/17/2000
Reno Newspapers, Inc. 10/1/1996
Media West-APP, Inc. 4/17/2000
Media West-RNI, Inc. 4/17/2000
Media West-BCN, Inc. 4/17/2000
Media West-FCN, Inc. 4/17/2000
Media West-SCN, Inc. 4/17/2000
Media West-SFN, Inc. 4/17/2000
Media West-CPC, Inc. 4/17/2000
Media West-LCC, Inc. 4/17/2000
Media West-GSI, Inc. 4/17/2000
Media West-MMI, Inc. 4/17/2000
Media West-MNC, Inc. 4/17/2000
Media West-DSP, Inc. 4/17/2000
Media West-DNI, Inc. 4/17/2000
Media West-DMR, Inc. 4/17/2000
Media West-RDC, Inc. 4/17/2000
Media West-CPI, Inc. 4/17/2000
The Spectrum 7/21/2000
Media West-FPI, Inc. 4/17/2000
Media West-EPT, Inc. 4/17/2000
386 GAUGHAN SOUTH LLCSOUTH POINT HOTEL & CASINO
10/25/2006
Heather HallRisk Manager
SOUTH POINT HOTEL & CASINO9777 Las Vegas Blvd SouthLas Vegas NV 89183(702) 797-8245
Certification Date:
NEVADA ALTERNATIVE SOLUTIONS, INC.
Charles R Nort9506 West Flamingo Rd Suite 102Las Vegas NV 89147(702) 796-1333 ext 228
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
380 GOLDEN NUGGET INCGOLDEN NUGGET HOTEL & CASINO
1/23/2004
Maria DavilaClaim Representative
GOLDEN NUGGET HOTEL & CASINO1510 W Loop SouthHouston TX 77027(713) 386-7084
Certification Date:
BROADSPIRE SERVICES INC.
Amy KelleyPO Box 30670Las Vegas NV 89173(702)242-3020
GNL, Corp 1/23/2004
GNLV, Corp. 1/23/2004
182 HAMILTON HOLDING MANAGEMENT CORP
7/1/1993
Carolyn CooperHuman Resources Generalist II
HAMILTON HOLDING MGT CORP4990 Energy WayReno NV 89502(775) 858-3000 ext 284
Certification Date:
HOMETOWN HEALTH PARTNERS INC
Michele Chapman830 Harvard WayReno NV 89502(775) 982-3049
Hamilton Company 7/1/1993
Standard Pneumatic 7/1/1993
114 HAT LTDMANPOWER TEMPORARY SERVICES
3/1/1992
Mike HarriganPresident Harrigan Enterprises, Inc.
MANPOWER TEMPORARY SERVICES1155 West 4th Street Suite 223Reno NV 89503(775) 328-6020
Certification Date:
HAT LTD DBA/MANPOWER TEMPORARY SERVICES
Leslie Bell-W/C Rep5301 Longley Lane Ste B-42Reno NV 89511(775) 328-6020
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
165 HCA HOLDINGS INCformerly Columbia/HCA Healthcare
1/1/1986
Carrie A BinkleySenior Compliance Analyst
HCA INCOne Park Plaza Bldg 11-4ENashville TN 37203(615) 344-1487
Certification Date:
BROADSPIRE SERVICES INC.
Amy KelleyPO Box 30670Las Vegas NV 89173(702)242-3020
All About Staffing, Inc. 7/1/2002
Sahara Outpatient Surgery Center, Ltd. 12/1/1994
Sunrise Physician Services, LLC 9/1/2009
Sunrise Neuro Sciences, LLC 12/1/2007Nevada Neuro Sciences
Central Shared Services LLC 8/1/2007Far West Supply Chain
HCA Management Services, LP 4/26/1999
CosCorp, LLC 4/23/1999
Specialty Surgicare of Las Vegas, LP 7/16/2005
Galen Health Care, Inc. 3/1/1993
Tennessee Healthcare Management Inc 3/1/2005
Nevada Psychiatric Company, Inc. 8/1/1994
Sunrise Hospital & Medical Center, LLC 3/1/1993
Las Vegas Surgicare, Inc. 12/1/1994
Sun-Med, LLC 1/14/2005
CHC Payroll Corporation 8/1/1994
CHC Venture Co. 8/1/1994
Healthcare Sales National Management 9/1/2009
HCA IT&S Field Operations, Inc 5/11/2008IT&S Far West Service Center
Southern Hills Medical Center, LLC 3/1/2004
Sunrise Trauma Services, LLC 2/11/2005
Sunrise Mountainview Hospital, Inc. 1/1/1996
HSS Systems, LLC 5/1/2002Far West Supply Chain
HSS Systems, LLC 3/1/2001HCA Patient Account Services
Sunrise Flamingo Surgery Center, LP 1/30/1997
Las Vegas ASC, LLC 7/29/2005
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
Surgicare of Las Vegas, Inc. 10/1/1992
HCA, Inc. 1/1/1986
107 HEALTHSOUTH CORPORATION
10/1/1990
Josh BeamRisk Management Finance Manager
HEALTHSOUTH CORPORATION3660 Grandview Parkway Ste 200Birmingham AL 35243(205) 968-6206
Certification Date:
ESIS, INC.
Randy Barclay6935 Aliante Pkwy Ste 104-411Las Vegas NV 89084(702)731-1510
Rehabilitation Hospital of Nevada 2/1/1996
HEALTHSOUTH Valley View Surgery Ce 7/22/1998
HEALTHSOUTH Corporation 12/1/1997
HEALTHSOUTH Surgery Center 7/1/1998
Reno Rehabilitation Association 2/1/1996
Desert Canyon Rehabilitation Hospital 6/1/2010
HEALTHSOUTH Rehabilitation Hospital o 10/1/2001
HEALTHSOUTH Surgery Center of Reno 7/1/1998
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
129 HOME DEPOT USA INC
8/1/1992
Michelle CaseyRisk Analyst
HOME DEPOT USA INC2455 Paces Ferry Road Bldg. C-20Atlanta GA 30339(770) 433-8211 Ext. 85195
Certification Date:
HELMSMAN MANAGEMENT SERVICES LLC
Cindy RiggioP O Box 95577Las Vegas NV 89193(702) 562-5005 x218
Your "other" Warehouse 7/27/2004
HD Supply, Inc. 5/31/2005White Cap Construction Supply In
HD Supply, Inc. 8/25/2005HD Supply Waterworks Group, Inc
THD At-Home Service, Inc. 7/1/2006
U.S. Remodelers, Inc. 10/1/2012
Grand Floor Designs Inc 1/31/2005
HD Supply, Inc. 3/31/2006HD Supply Management, Inc
HD Supply, Inc. 6/30/2005HD Supply Distribution Services, L
THD At-Home Services, Inc. 10/1/2012
U.S. Home Systems, Inc. 10/1/2012
402 HRHH GAMING SENIOR MEZZ, LLCHARD ROCK HOTEL
3/1/2011
Kim CowleyRisk Manager
HRHH Gaming Senior Mezz, LLC4455 Paradise RdLas Vegas NV 89169(702) 693-5026
Certification Date:
YORK CLAIM SERVICES FORMERLY MEDCOMP
Yvette Bouldin9085 W Post Road #100Las Vegas NV 89148(702) 727-2161
403 HUMBOLDT COUNTY SCHOOL DISTRICT
7/1/2012
David Jensen, Dr.Assisstant Superintendent
HUMBOLDT COUNTY SCHOOL DISTRICT310 East Fourth StWinnemucca NV 89445775-623-8100
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
18
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338 HYATT HOTELS CORPORATION
2/1/1998
Jennifer HerzfeldRisk Manager-Risk Management
HYATT HOTELS CORPORATION71 S Wacker DriveChicago IL 60606(312)-780-5861
Certification Date:
GALLAGHER BASSETT SERVICES, INC.
Charles Rostad2110 East Flamingo Rd #314Las Vegas NV 89119-0834(866)-889-4755
Hyatt Corporation 2/1/1998
Select Hotels Group, LLC 1/5/2008
63 IKE GAMING INCEL CORTEZ HOTEL & CASINO
10/9/1983
Joe WoodyChief Financial Officer
`107 North 6th Street 3rd FloorLas Vegas NV 89101(702) 474-3613
Certification Date:
NEVADA ALTERNATIVE SOLUTIONS, INC.
Charles R Nort9506 West Flamingo Rd Suite 102Las Vegas NV 89147(702) 796-1333 ext 228
138 INCLINE VILLAGE GEN IMPROVEMENT DISTRICT
7/1/1992
Gerald W. EickDir. Of Finance, Acctg and Risk ManagementINCLINE VILLAGE GEN IMPROVEMENT893 Southwood BlvdIncline Village NV 89451(775) 832-1365
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
99 INTERNATIONAL GAME TECHNOLOGY
9/15/1989
Sharolyn P WilsonWorkers Compensation Analyst
IGT9295 Prototype DriveReno NV 89521(775) 448-0411
Certification Date:
INTERNATIONAL GAME TECHNOLOGY
Celeste Wallick9295 Prototype DriveReno NV 89521(775)448-3843
IGT-International 10/1/1993
IGT & Subs 9/1/1990
19
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152 INTERNATIONAL PAPER COMPANY
1/1/1993
Penny HumphreyAdministrator, Insurance Program
INTERNATIONAL PAPER COMPANY6400 Poplar Ave Tower III, 4-110Memphis TN 38197(901) 419-3938
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
Western Paper Company 1/1/1993
Dixon Paper Company 1/1/1993
LLford Photo Corp. 1/1/1993
356 JOURNAL COMMUNICATIONS INCKTNV-TV Channel 13
10/1/1999
Jeffrey KlueverRisk Manager
JOURNAL COMMUNICATIONS INC333 West State StreetMilwaukee WI 53203(414) 224-2702
Certification Date:
GALLAGHER BASSETT SERVICES, INC.
Charles Rostad2110 East Flamingo Rd #314Las Vegas NV 89119-0834(866)-889-4755
Journal Broadcast Corporation 10/1/1999KTNV-TV Channel 13
119 KENNAMETAL INC (PARENT)KENNAMETAL INC NEVADA DIVISION
10/1/1991
Michael P MurphyManager Prop & Casualty Claims
KENNAMETAL INC1600 Technology Way, PO Box 231Latrobe PA 15650(724) 539-4647
Certification Date:
NEVADA ALTERNATIVE SOLUTIONS, INC.
Charles R Nort9506 West Flamingo Rd Suite 102Las Vegas NV 89147(702) 796-1333 ext 228
Tricon 7/1/2009
20
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357 KIEWIT CORPORATION
11/1/1999
Debra L ProchaskaClaims Analyst
KIEWIT CORPORATION Kiewit PlazaOmaha NE 68131(402) 271-2862
Certification Date:
SPECIALTY RISK SERVICES LLC (SRS)
Lara BorelP O Box 95518Las Vegas NV 89193-5518(702) 387-8006
Gilbert Western Corp. 11/1/1999
Tpac, A Division of Kiewit Western 11/1/1999
Lake Mead Constructors 11/1/1999
Kiewit Infrastructure West Co. 9/1/2012
Kiewit Western Co. 11/1/1999
Kiewit Infrastructure Co. 11/1/1999
Aero Automatic Sprinkler Company 8/26/2009
Continental Fire Sprinkler Company 2/26/2009
Western Summit Constructors, Inc. 12/29/2008
Kiewit Industrial Co. 11/1/1999
TIC-The Industrial Company 12/29/2008
122 KINROSS GOLD CORPORATION
12/1/1991
Bridgett GraySafety Dept. Clerk
ROUND MOUNTAIN GOLDP O Box 480Round Mountain NV 89045(775) 377-3149
Certification Date:
PINNACLE RISK MANAGEMENT SERVICES INC
Su Crawford4055 Spencer St Ste 102Las Vegas NV 89119(877) 219-9395
Echo Bay Minerals Company 12/1/1991
Round Mountain Gold Corp 12/1/1991
21
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382 KNIGHT TRANSPORTATION INC
10/1/2004
Todd CantrillDir. Workers' Compensation
KNIGHT TRANSPORTATION5601 West Buckeye RoadPhoenix AZ 85043(602) 269-2000
Certification Date:
YORK CLAIM SERVICES FORMERLY MEDCOMP
Yvette Bouldin9085 W Post Road #100Las Vegas NV 89148(702) 727-2161
44 KROGER COMPANY
11/1/1981
Nathan FraleyCorporate Assistant Claims Manager
THE KROGER CO1014 Vine Street 17th FloorCincinnati OH 45202(513) 762-4360
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
Fred Meyer Jewelers 11/15/1998
Fred Meyer, Inc. 9/9/1997
Smith's Food & Drug Centers, Inc. 11/1/1981Price Rite Stores
Ralphs Grocery Company 3/19/2001Food 4 Less
Quik Stop Markets, Inc. 10/11/2001
369 LAS VEGAS CONVENTION & VISITORS AUTHORITY
7/1/2002
Timothy CallawayBenefits Coordinator
LAS VEGAS CONVENTION & VISITORS AUTHORITY3150 Paradise RoadLas Vegas NV 89109(702) 892-7527
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
22
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159 LAS VEGAS METRO POLICE DEPARTMENT
1/1/1993
Jeff RochDirector of Risk Management
LAS VEGAS METRO POLICE DEPARTMENT400 S. Martin Luther King BL.Las Vegas NV 89106(702) 828-3406
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
272 LAS VEGAS PAVING CORPORATION
5/1/1996
Lou EspositoRisk Manager
LAS VEGAS PAVING CORPORATION4420 South Decatur BlvdLas Vegas NV 89103(702) 251-5800
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
Sunridge Corporation 2/1/2013
96 LAS VEGAS SANDS CORP
4/28/1989
Lee Ann HamiltonWorkers Comp Manager
THE VENETIAN RESORT HOTEL CASINO3355 Las Vegas Blvd SouthLas Vegas NV 89109702-414-4395
Certification Date:
SIERRA NEVADA ADMINISTRATORS
Michele Taylor2716 N. Tenaya Way, 5th FLLas Vegas NV 89114-5750(702) 240-8935
Venetian Hotel Operations, LLC 4/1/2003
Venetian Operating Co. LLC 3/31/2000
Lido Casino Resort, LLC 3/31/2000
Las Vegas Sands, LLC 4/28/1989
Venetian Casino Resort, LLC 1/1/1998Venetian Resort Hotel Casino
Lido Casino Resort Holding Co. LLC 8/1/2004
23
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371 LAS VEGAS VALLEY WATER DISTRICT
1/1/2003
Matt ChorpeningRisk Manager
LAS VEGAS VALLEY WATER DISTRICT1001 South Valley View Blvd.Las Vegas NV 89153(702) 259-8165
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
325 LES SCHWAB WAREHOUSE CENTER INC
12/1/1997
Denny CarterRisk Services Supervisor
LES SCHWAB WAREHOUSE CENTER INCP O Box 5350Bend OR 97708-5350(541) 416-5479
Certification Date:
ESIS, INC.
Randy Barclay6935 Aliante Pkwy Ste 104-411Las Vegas NV 89084(702)731-1510
Les Schwab Warehouse Center, Inc. 12/1/1997Les Schwab Tire Centers of Neva
374 LYON COUNTY SCHOOL DISTRICT
7/1/2003
(Ms.) Ronnie RowleyRisk Management
LYON COUNTY SCHOOL DISTRICT25 East Goldfield AveYerington NV 89447(775) 463-6800 ext 144
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
24
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349 MACY'S INC
4/1/1999
Evan RipleySenior Accountant
Federated Dept Stores c/o Aon Risk Consultants Inc7 West Seventh StreetCincinatti OH 45202(513) 562-6782
Certification Date:
HELMSMAN MANAGEMENT SERVICES LLC
Cindy RiggioP O Box 95577Las Vegas NV 89193(702) 562-5005 x218
Macy's Inc. 4/1/1999
Macy's Systems and Technology, Inc. 4/1/1999
Bloomingdale's, Inc. 11/1/2002
Macy's Retail Holdings, Inc. 5/1/1995
Macy's Corporate Services, Inc. 4/1/1999
Macy's West Stores, Inc. 8/10/2009
136 MANOR CARE INC
7/1/1992
Lisa JurskiSr Mgr Workers Comp Program
HCR MANOR CARE INC, MANOR CARE, INC.333 N Summit StreetToledo OH 43699-0086(419) 254-5416
Certification Date:
BROADSPIRE SERVICES INC.
Amy KelleyPO Box 30670Las Vegas NV 89173(702)242-3020
ManorCare Health Service, Inc. 7/1/1992ManorCare Health Services
Richards Healthcare, Inc. 10/14/2002Richards Healthcare
Heartland Employment Services, Inc. 1/1/2002
MileStone Staffing Services, Inc. 11/1/2002
MileStone Health Systems, Inc. 11/1/2002
MileStone Therapy Services, Inc. 11/1/2002
25
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47 MARRIOTT INTERNATIONAL INC
2/1/1982
Steve HuyCompliance Analyst
MARRIOTT INTERNATIONAL INC10400 Fernwood Road Dept 52/924.3Bethesda MD 20817(301) 380-4450
Certification Date:
MARRIOTT CLAIMS SERVICES
Nik Srauser2795 E Desert Inn Road Ste. 200Las Vegas NV 89121(702) 227-7678
Marriott Claims Services Corporation 10/1/2006
Residence Inn by Marriott, LLC 8/1/1989
Courtyard Management, Inc. 8/1/1989
Marriott Hotel Services, Inc. 12/1/1999
The Ritz-Carlton Hotel Company LLC 10/1/2006
Marriott Int'l Administrative Services, Inc. 10/1/1997
Springhill SMC, LLC 10/1/2011
Fairfield FMC LLC 11/1/1993
26
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309 MASCO CORPORATION
4/1/1997
Kelly M. DavisonRisk Manager
MASCO CORPORATION21001 Van Born RoadTaylor MI 48180(313)792-6214
Certification Date:
CONSTITUTION STATE SERVICES LLC
Brandi Lee7450 Arroyo Crossing Pkwy, Ste 200Las Vegas NV 89113-4081(702) 479-4218 x 94218
Masco Cabinetry Middlefield, LLC 1/1/2011
Builder Services Group, Inc. 4/1/1997Gale Industries
Behr Paint Corporation 9/1/2010
RSA Supply, LLC 11/1/2003
Milgard Manufacturing Inc 12/31/2003
Masco Cabinetry LLC 1/1/2011
Buildlogix, Inc. 5/30/2006
Builder Services Group, Inc. 7/19/2006Root Industries
Masco Contractor Services West, Inc. 5/1/2001Sacramento Insulation Contractor
Builder Services Group, Inc. 4/1/1997Insulpro Projects Inc
Masco Contractor Services West, Inc 5/1/2001Desert Specialties
Masco Contractor Services West, Inc. 5/1/2001Gale Building Products
Computerized Security Systems 7/1/1999
194 MCDONALD'S CORPORATION
12/1/1993
Steve LaughlinDirector Insurance & Safety Dept.
McDONALDS CORPORATIONMcDonald Plaza 2915 Jorie BlvdOak Brook IL 60523(630) 623-8079
Certification Date:
GALLAGHER BASSETT SERVICES, INC.
Charles Rostad2110 East Flamingo Rd #314Las Vegas NV 89119-0834(866)-889-4755
McDonald's Restaurants of Nevada, Inc. 12/1/1993
27
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15 MCKESSON CORPORATION
10/1/1980
Kirsti LawsonRisk Manager
MCKESSON CORPORATIONOne Post Street 34th FloorSan Francisco CA 94104-5296(415) 983-7053
Certification Date:
GALLAGHER BASSETT SERVICES, INC.
Charles Rostad2110 East Flamingo Rd #314Las Vegas NV 89119-0834(866)-889-4755
Zee Medical, Inc. 9/1/2003
McKesson Information Solutions 1/12/1999
Per-Se Technologies Inc 3/1/2007
McKesson Medical-Surgical Inc. 12/1/1997
McKesson Medications Management LL 8/30/2000
398 MESQUITE GAMING LLCformerly Black Gaming
8/1/2011
Barry WinterDir Risk Management & Benefits
Mesquite Gaming LLC950 W. Mesquite Blvd.Mesquite NV 89027(702) 346-6827
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
VRCC, LLC 8/1/2011
Oasis Recreational Properties, Inc. 8/1/2011
CasaBlanca Resorts, LLC 8/1/2011
RBG, LLC 8/1/2011
28
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43 MGM RESORTS INTERNATIONAL
10/26/1981
Tina SanchezDirector Workers' Comp
MGM MIRAGE RISK MANAGEMENT3260 South Industrial RoadLas Vegas NV 89109(702) 650-6746
Certification Date:
MGM MIRAGE RISK MANAGEMENT
Tina Sanchez3260 So Industrial RoadLas Vegas NV 89109(702) 650-7443
Shadow Creek 5/1/1989
Gold Strike Hotel & Gambling Hall 6/1/1995
Bellagio 10/6/1994
Mandalay Place 5/1/2001
Slots-A-Fun 11/15/1980
M.I.R. Travel 1/1/1992
Atlandia Design & Furniture 10/26/1981
Ramparts, Inc. 7/1/1993Luxor Hotel/Casino
Railroad Pass Hotel & Casino 6/1/1995
Victoria Partners 7/1/1996
Mandalay Resort Group 11/15/1980
Revive Partners, LLC 1/1/2003
Mandalay Development 2/1/1996
Circus Circus Hotel (Las Vegas) 11/15/1980
Circus Circus (Reno) 11/15/1980
New Castle Corp. 10/1/1989Excalibur Hotel/Casino
MGM Grand Laundry, Inc. 12/1/1993
Ramparts International 3/1/1997
Boardwalk Hotel & Casino, Inc. 6/30/1998Holiday Inn Casino Boardwalk
Mandalay Bay 4/1/1998
Mandalay Vacation Resorts, Inc 11/1/1998
Mirage Casino & Hotel, The 5/1/1989
New York-New York Hotel & Casino 12/1/1996
GO VEGAS 3/1/2000
Nevada Landing Hotel & Casino 6/1/1995
29
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MGM Grand Las Vegas 12/1/1993
200 MONARCH CASINO & RESORT INCAtlantis Hotel & Casino
1/1/1994
Doug SimpsonDir. Of Security & Risk Management
ATLANTIS HOTEL & CASINO3800 South Virginia StreetReno NV 89502(775) 335-4534
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
Golden Road Motor Inn, Inc. 1/1/1994Atlantis Casino Resort
232 NEV YELLOW NEV CHECKER & NEV STAR CAB CORP
1/1/1995
Gene Auffert
NEVADA YELLOW & CHECKER CABS5225 W Post Rd.Las Vegas NV 89118(702) 933-1620
Certification Date:
YORK CLAIM SERVICES FORMERLY MEDCOMP
Yvette Bouldin9085 W Post Road #100Las Vegas NV 89148(702) 727-2161
210 NEVADA READY MIX CORPORATION
3/1/1994
Larry MillerCorporate Administrator
NEVADA READY MIX CORPORATION151 Cassia WayHenderson NV 89014(702) 457-1115 ext 3038
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
30
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379 NEVADA SYSTEM OF HIGHER EDUCATIONformerly University & College System of Nevada
1/1/2004
Lisa SchallerDirector of Insurance & Loss Mgt.
NEVADA SYSTEM OF HIGHER EDUCATION2601 Enterprise Rd., Mail Stop 014Reno NV 89512-1666(775) 784-3472
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
Desert Research Institute 1/1/2004
University of Nevada Reno 1/1/2004
Henderson Community College 1/1/2004
Western Nevada Community College 1/1/2004
University of Nevada Las Vegas 1/1/2004
Great Basin College 1/1/2004
Nevada State College at Henderson 1/1/2004
Cheyenne Community College 1/1/2004
Truckee Meadows Community College 1/1/2004
Charleston Community College 1/1/2004
6 NEW ALBERTSON'S INC
7/4/1980
Gail R SylvesterRisk Mangement Financial Analyst II
ALBERTSONS INC155 North 400 West Suite 300Salt Lake City UT 84103(801) 961-3358
Certification Date:
SPECIALTY RISK SERVICES LLC (SRS)
Lara BorelP O Box 95518Las Vegas NV 89193-5518(702) 387-8006
American Drug Stores LLC 4/1/1996
American Stores Company LLC 8/1/1982
New Albertson's Inc. 7/4/1980
31
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373 NEW-COM, INC.
7/29/2003
Michael ThreetCFO
NEW-COM, INC.412 East Gowan RoadNorth Las Vegas NV 89032(702) 642-3331
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
MMC INC 6/1/2007MMC Southwest Inc
L.L.O, Inc. 7/29/2003ACME Electric
Airway, Inc. 7/29/2003Airway Rock Products
All Electric, Inc. 7/29/2003
TAB Contractors, Inc. 7/29/2003
MMC, Inc. 7/29/2003
Biodiesel of Las Vegas Inc. 2/1/2007
388 NEWMONT MINING CORPORATION
4/29/2008
Courtney MuirRisk Management Analyst
NEWMONT MINING CORPORATION6363 S. Fiddlers Green Cr.Greenwood Village CO 80111(303) 837-6019
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
Newmont Indonesia Investment Ltd 4/29/2008
Newmont International Services Ltd 4/29/2008
Newmont Global Employment Ltd Partner 4/29/2008
Battle Mountain Gold Company 4/29/2008
Newmont USA Ltd 4/29/2008Newmont Mining Corporation
Santa Fe Pacific Gold Corporation 4/29/2008
Newmont Nevada Energy Investment, LL 4/29/2008
Turquoise Ridge JV 4/29/2008
Elko Land and Livestock Company 4/29/2008
Newmont Exploration Ltd 4/29/2008
Newmont Gold Company 4/29/2008
32
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133 NV ENERGY INC
7/1/1992
Camille WilliamsSenior Benefits Consultant
NV ENERGY INC6226 W. Sahara Ave.Las Vegas NV 89146(702) 402-2101
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
Sierra Pacific Power Company 7/1/1992
Lands of Sierra 7/1/1994
Sierra Gas Holdings Company 7/1/1994
Sierra Pacific Energy Company 9/1/1998
Nevada Power Company 7/28/1999
Nevada Electric Investment Company 7/28/1999
Sierra Pacific Communications 6/18/2001
NV Energy Inc 7/1/1994
389 NYE COUNTY SCHOOL DISTRICT
7/1/2008
Raymond RitchieCFO & Administrative Officer
NY COUNTY SCHOOL DISTRICT484 S West StreetPahrump NV 89048(775)727-7743 ext 234
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
221 OCEAN SPRAY CRANBERRIES INC
9/1/1994
Lori HenaultTreasury Supervisor
OCEAN SPRAY CRANBERRIES INCOne Ocean Spray DriveLakeville-Middleboro MA 02349(508) 923-3995
Certification Date:
HELMSMAN MANAGEMENT SERVICES LLC
Cindy RiggioP O Box 95577Las Vegas NV 89193(702) 562-5005 x218
33
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319 OFFICEMAX INCORPORATEDformerly Boise Cascade Corporation
8/1/1997
Catherine GrahamRisk Management Analyst
OFFICEMAX INCORPORATED263 Shuman BlvdNaperville IL 60563-1255(630) 864-6829
Certification Date:
HELMSMAN MANAGEMENT SERVICES LLC
Cindy RiggioP O Box 95577Las Vegas NV 89193(702) 562-5005 x218
OfficeMax North America, Inc. 1/1/2005
OfficeMax Contract, Inc. 4/20/2000
230 PACCAR INC
1/1/1995
DeeAnne FlegelManager, Workplace Absence ProgramsPACCAR INCP O Box 1518Bellevue WA 98009(425) 468-7939
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
Paccar Parts Division 1/1/1995
90 PEPPERMILL CASINO'S INCFormerly Nevada Properties
7/1/1988
Michael HewardDirector of Risk Management
PEPPERMILL CASINOS INC830 Brinkby Ave, Suite BReno NV 89509(775) 982-8992
Certification Date:
HOMETOWN HEALTH PARTNERS INC
Michele Chapman830 Harvard WayReno NV 89502(775) 982-3049
Wendover Properties 7/1/1988Peppermill Inn & Casino (3/1/94)
Nevada Properties 7/1/1988Peppermill Hotel & Casino
Rainbow Casino, The 1/31/1995
Peppermill Hotel, Reno 7/1/1988
Western Village Limited Partnership 7/1/1988Western Village Casino (7/1/93)
Rainbow Associates, Inc. 7/1/1988Rainbow Club (3/1/94)
34
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401 PILOT TRAVEL CENTERS, LLCacquired Flying J
3/1/2012
Don GrahamSenior Manager, Corporate Risk
Pilot Travel Centers, LLCP.O. Box 10146Knoxville TN 37939(800) 562-6210
Certification Date:
HELMSMAN MANAGEMENT SERVICES LLC
Cindy RiggioP O Box 95577Las Vegas NV 89193(702) 562-5005 x218
391 POLY-AMERICA FOR POLY-WEST INC
2/1/2009
Ron HallChief Financial Officer
POLY-AMERICA FOR POLY-WEST INC251 Conestoga WayHenderson NV 89002972-337-7266
Certification Date:
YORK CLAIM SERVICES FORMERLY MEDCOMP
Yvette Bouldin9085 W Post Road #100Las Vegas NV 89148(702) 727-2161
333 PURCELL TIRE & RUBBER COMPANY
1/1/1998
Amy ScheldbergClaims Administrator
PURCELL TIRE & RUBBER COMPANY301 N. Hall StreetPotosi MO 63664(573) 438-2138 X1153
Certification Date:
GALLAGHER BASSETT SERVICES, INC.
Charles Rostad2110 East Flamingo Rd #314Las Vegas NV 89119-0834(866)-889-4755
Purcell Tire & Rubber Co. 1/1/1998Purcell Rossi Tire
Purcell Tire & Rubber Co. 1/1/1998Purcell's Western States Tire
179 QUALITY MECHANICAL CONTRACTORS LLC
7/1/1993
Denise MachadoSafety/HR Director
QUALITY MECHANICAL CONTRACTORS3175 Westwood DriveLas Vegas NV 89117(702) 732-2545
Certification Date:
YORK CLAIM SERVICES FORMERLY MEDCOMP
Yvette Bouldin9085 W Post Road #100Las Vegas NV 89148(702) 727-2161
35
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80 RALEY'S INC
7/1/1986
Mark E FieldSr. Risk Manager
RALEYS, INCP O Box 15618Sacramento CA 95605(916) 373-6214
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
105 RENO SPARKS CONVENTION & VISITORS AUTHORITY
7/1/1990
Charlotte AndersonHuman Resources Manager
RENO SPARKS CONVENTION CENTER4001 S. Virginia St., #GReno NV 89502(775) 827-7618
Certification Date:
ALTERNATIVE SERVICES CONCEPTS LLC
Mike Livermore1755 East Plumb Lane #148Reno NV 89502(775)329-1181
National Bowling Stadium 10/1/1994
76 RENOWN HEALTH
8/1/1985
Larry MonsonDirector of Risk Management
RENOWN REGIONAL MEDICAL CENTER1155 Mill Street - MAIL STOP J-11Reno NV 89502(775) 982-4798
Certification Date:
HOMETOWN HEALTH PARTNERS INC
Michele Chapman830 Harvard WayReno NV 89502(775) 982-3049
Renown Health Foundation 1/1/1989
Renown Regional Medical Center 8/1/1985
Renown Network Services 1/1/1989
Renown Health 8/1/1985
Nevada Heart Institute 1/1/2011
Hometown Health Mgt Co (incl. Medical 1/1/1989
Renown South Meadows Medical Center 2/1/1999
Hometown Health Plan Inc. 1/1/1989
Renown Businesses 1/1/1992
Renown Skilled Nursing 6/17/2004
Nevada Healthcare Cooperative 10/15/2004
36
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
77 RIVERSIDE RESORT & CASINO
9/28/1985
Steve WillettDirector Human Resources
RIVERSIDE RESORT & CASINO1650 S Casino DriveLaughlin NV 89029(702) 298-2535
Certification Date:
YORK CLAIM SERVICES FORMERLY MEDCOMP
Yvette Bouldin9085 W Post Road #100Las Vegas NV 89148(702) 727-2161
Laughlin Transit, Inc. 7/9/2003
218 RIVIERA OPERATING CORPORATIONformerly Riviera Holdings
7/1/1994
Tullio MarchionneLegal Exec. VP
RIVIERA HOLDINGS CORPORATION2901 Las Vegas Blvd SouthLas Vegas NV 89109-1931(702) 794-9511
Certification Date:
RIVIERIA OPERATING COMPANY
LeCretia Evans2901 Las Vegas Blvd. SouthLas Vegas NV 89109(702) 794-9511
Riviera Operating Company 7/1/1994Riviera Hotel & Casino
311 SAFEWAY INC
4/8/1997
Gilbert B. CabreraVP of Finance - Corp. Risk ManagementSAFEWAY INC11555 Dublin Canyon RdPleasanton CA 94588(925) 226-5100
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
Groceryworks Holdings Inc 5/11/2005
Groceryworks.com Operating Company 5/11/2005
Vons Companies, Inc., The 4/8/1997
37
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
331 SCHNEIDER NATIONAL INC
1/1/1998
Jessica UhlenbrauckSr Insurance Administrator
SCHNEIDER NATIONAL INC3101 S. Packerland Dr.Green Bay WI 54313(920) 592-3071
Certification Date:
HELMSMAN MANAGEMENT SERVICES LLC
Cindy RiggioP O Box 95577Las Vegas NV 89193(702) 562-5005 x218
Schneider National Carriers 1/1/1998
Schneider National Bulk Carriers 1/1/1998
Schneider Logistics, Inc. 1/1/1998
Schneider Specialized Carriers 1/1/1998
Schneider Transport, Inc. 1/1/1998
Schneider Tank Lines 1/1/1998
117 SHERWIN-WILLIAMS COMPANY
7/1/1991
Anthony Colangelo; Matt FlynnManager Workers Comp
SHERWIN-WILLIAMS COMPANY101 Prospect Avenue NWCleveland OH 44115-1075(216) 566-3095
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
244 SILVER LEGACY RESORT CASINO
7/1/1995
Tracy HudsonGst. Relations Mgr./Wkrs' Comp. Mgr
SILVER LEGACY RESORT CASINO407 N. Virginia StreetReno NV 89502(775) 325-7040
Certification Date:
NELSON DAVISON ADMINISTRATORS INC
Tom Nelson9855 DoubleR Blvd Ste 105/PO Box 12338Reno NV 89521(775) 825-9299 x 1
38
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
317 SILVERTON CASINO LLC & MAJESTIC NV PROPERTY H
7/1/1997
Darlene KochBenefits Manager
SILVERTON HOTEL CASINO3333 Blue Diamond RoadLas Vegas NV 89139(702) 914-8513
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
Silverton Casino, LLC 12/2/1997Silverton Hotel Casino & RV Park
Silverton Casino, LLC 12/2/1997Silverton RV Park & Sundries Stor
375 SOUTHERN NEVADA HARLEY DAVIDSON SALES INC & LV Harley-Davidson & Red Rock Harley-Davidson
8/1/1996
Jeffry RosenblattController
LAS VEGAS HARLEY DAVIDSON2605 South Eastern Avenue, Ste 100Las Vegas NV 89169(702) 431-8500 ext 103
Certification Date:
NEVADA ALTERNATIVE SOLUTIONS, INC.
Charles R Nort9506 West Flamingo Rd Suite 102Las Vegas NV 89147(702) 796-1333 ext 228
Henderson Harley-Davidson, Inc. 9/1/2002
376 SOUTHERN NEVADA HEALTH DISTRICT
7/1/2005
Susan DamitzHuman Resources Analyst
SOUTHERN NEVADA HEALTH DISTRICTP O Box 3902Las Vegas NV 89127(702) 759-1106
Certification Date:
SIERRA NEVADA ADMINISTRATORS
Michele Taylor2716 N. Tenaya Way, 5th FLLas Vegas NV 89114-5750(702) 240-8935
263 SOUTHERN NEVADA TBA SUPPLY COMPANY INCTED WIENS TIRE & AUTO
3/1/1996
Brenda MartzHR Manager
TED WIENS TIRE & AUTO1701 Las Vegas Blvd SouthLas Vegas NV 89104(702) 732-2382 ext 139
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiPO BOX 35350Las Vegas NV 89133-5350(702) 933-4800
39
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
208 SOUTHWEST AIRLINES CO
3/1/1994
Patti ColwellManager, Workers Compensation
SOUTHWEST AIRLINES CO2702 Love Field Dr.Dallas TX 75235(214) 792-6462
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
92 SOUTHWEST GAS CORPORATION
7/1/1988
Carol RichardsSupervisor Workers' Comp & InsuranceSOUTHWEST GAS CORPORATIONPO Box 98510Las Vegas NV 89193-8510(702) 364-3025
Certification Date:
SOUTHWEST GAS CORPORATION
Donna Dynek, Workers Comp5241 Spring Mountain Rd/Box 98510Las Vegas NV 89193-8510(800)277-7074
42 SPARKS NUGGET INC
10/1/1981
Larry HarveyExec VP-HR & Risk Mgmt
SPARKS NUGGET INC1100 Nugget AveSparks NV 89431(775) 356-3397
Certification Date:
NEVADA ALTERNATIVE SOLUTIONS, INC.
Charles R Nort9506 West Flamingo Rd Suite 102Las Vegas NV 89147(702) 796-1333 ext 228
Double J.A. Land & Livestock Company 12/1/1993Ascuaga's Cattle Co.
396 STATION CASINOS LLC
6/14/2011
Tim CameronCorp Director Risk Management
STATION CASINOS1505 S. Pavilion Center DriveLas Vegas NV 89135(702) 495-3476
Certification Date:
YORK CLAIM SERVICES FORMERLY MEDCOMP
Yvette Bouldin9085 W Post Road #100Las Vegas NV 89148(702) 727-2161
40
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
384 SUN CITY ELECTRIC INC
8/18/2003
Andrea GouldRisk Manager
SUN CITY ELECTRIC INC C/O SEASORE HOLDINGS1220 S Commerce Street #120Las Vegas NV 89102(702) 220-5621
Certification Date:
SUN CITY ELECTRIC INC
Andrea Gould1220 S Commerce St Ste 120Las Vegas NV 89102(702) 220-5621
Focus Plumbing, LLC 6/1/2009
Focus Concrete, LLC 1/1/2010
Floor Designs of Nevada LLC 10/1/2005
Focus Electric, LLC 6/1/2009
Green Image, LLC 2/1/2011G T I
125 TARGET CORPORATION (TARGET STORES)
2/1/1992
Judy EssenConsultant - Risk Consulting
AON Global RISK CONSULTING C/O TARGET5600 W. 83rd Street, Suite 1100Minneapolis MN 55437(952) 807-0637
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
330 THE COCA-COLA COMPANY AND/OR COCA-COLA REF
1/1/1998
Lawanda HallPrinciple Risk Analyst
THE COCA-COLA COMPANYOne Coca-Cola PlazaAtlanta GA 30313(404) 676-7494
Certification Date:
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
Janet MachadoP O Box 34660Las Vegas NV 89133(888)713-1112ex83828
BCI Coca-Cola Bottling Co of Los Angele 1/1/1998Coca-Cola Bottling Co of Las Veg
Coca-Cola Refreshments USA, Inc. 10/2/2010
41
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
124 TITANIUM METALS CORP OF AMERICATIMET
1/1/1992
Adam BleiferNA Assistant Controller
TIMET224 Valley Creek Blvd., Suite 200Exton PA 19341(610) 968-1327
Certification Date:
YORK CLAIM SERVICES FORMERLY MEDCOMP
Yvette Bouldin9085 W Post Road #100Las Vegas NV 89148(702) 727-2161
TiPro 10/1/1997
Titanium Hearth Technologies 1/1/1997
392 TREASURE ISLAND LLC
8/1/2009
Gayle KurokawaV/P Human Resources
TREASURE ISLAND LLC3300 Las Vegas Blvd SouthLas Vegas NV 89109(702) 894-7506
Certification Date:
YORK CLAIM SERVICES FORMERLY MEDCOMP
Yvette Bouldin9085 W Post Road #100Las Vegas NV 89148(702) 727-2161
395 TROPICANA LAS VEGAS HOTEL & CASINOTROPICANA LAS VEGAS, INC.
12/2/2010
Joanne M BeckettVP & Gen. Counsel
TROPICANA LAS VEGAS, INC3801 Las Vegas Blvd SouthLas Vegas NV 89109(702)739-3530
Certification Date:
NEVADA ALTERNATIVE SOLUTIONS, INC.
Charles R Nort9506 West Flamingo Rd Suite 102Las Vegas NV 89147(702) 796-1333 ext 228
Tropicana Las Vegas Intermediate Holdin 12/2/2010
Armenco Holdings LLC 12/2/2010
Trilliant Management LP 12/2/2010
42
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
299 TRUE BLUE INCFORMERLY LABOR READY INC
12/1/1996
April SmithAssociate Financial/Insurance CoordinatorLABOR READY INCPO Box 2910Tacoma WA 98401(800) 610-8920 x 8498
Certification Date:
ESIS, INC.
Randy Barclay6935 Aliante Pkwy Ste 104-411Las Vegas NV 89084(702)731-1510
Labor Ready Southwest, Inc. 1/1/1999
Labor Ready Northwest, Inc. 8/28/1998
168 U S FOODS INCFKA US Foodservice Inc
4/1/1993
Dena AbdallahDirector-Risk Management
U S FOODS9399 W. Higgins RoadRosemont IL 60018(847) 720-1689
Certification Date:
GALLAGHER BASSETT SERVICES, INC.
Charles Rostad2110 East Flamingo Rd #314Las Vegas NV 89119-0834(866)-889-4755
Harrison's Prime Meats & Provisions 3/1/1997
Outwest Meat Company 4/1/1998
73 UNITED AIR LINES INC
3/1/1985
Kevin MitchellSr. Risk Analyst, Corp. Ins.
UNITED AIRLINES INC77 W. Wacker DriveChicago IL 60601(312) 997-7641
Certification Date:
GALLAGHER BASSETT SERVICES, INC.
Charles Rostad2110 East Flamingo Rd #314Las Vegas NV 89119-0834(866)-889-4755
43
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
116 VIAD CORP
7/1/1991
Terry CrullSr. Vice President-Willis of AZ
WILLIS CORROON CORP FOR VIAD CORP16220 N. Scottsdale Rd. #600Scottsdale AZ 85254(602) 787-6040
Certification Date:
NEVADA ALTERNATIVE SOLUTIONS, INC.
Charles R Nort9506 West Flamingo Rd Suite 102Las Vegas NV 89147(702) 796-1333 ext 228
Shows Unlimited, Inc. 1/1/1997
Restaura, Inc. 10/10/1995
GES Exposition Services, Inc. 7/1/1991
Game Financial Corporation 4/1/1998
Giltspur, Inc. 3/1/1996
36 WASHOE COUNTY
7/1/1981
Celeste WallickRisk Management Analyst
WASHOE COUNTYPO Box 11130Reno NV 89520(775) 328-2074
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiP O BOX 20068Reno NV 89515-0068(775) 324-3301 x 1011
37 WASHOE COUNTY SCHOOL DISTRICT
7/1/1986
Jackie JamesSr. Risk Mgt Analyst
WASHOE COUNTY SCHOOL DISTRICTPO Box 30425Reno NV 89520(775) 348-3854
Certification Date:
CANNON COCHRAN MANAGEMENT SERVICES (CCMSI)
Brigid WyszomirskiP O BOX 20068Reno NV 89515-0068(775) 324-3301 x 1011
Hot Lunch Progam 7/1/1987
44
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
370 WENDOVER CASINOS INCMONTEGO BAY CASINO & RESORT
12/19/2002
Michael HewardDirector of Risk Management
Peppermill Casinos Inc for Wendover Casinos380 Brinby Ave, Suite BReno NV 89509(775) 689-8992
Certification Date:
HOMETOWN HEALTH PARTNERS INC
Michele Chapman830 Harvard WayReno NV 89502(775) 982-3049
PPLLC 12/19/2002
365 WESTERN CAB COMPANY INC
9/1/2001
Martha A SarverGeneral Manager
WESTERN CAB CO801 South Main StreetLas Vegas NV 89101(702) 382-7100
Certification Date:
R. A. WONG & ASSOCIATES
Paul Wong5110 S Valley View Blvd, Suite 100Las Vegas NV 89118(702)798-8910
246 WESTERN STATES CONTRACTING INC
9/1/1995
Troy ShiozawaRisk Manager
WESTERN STATES CONTRACTING INC4129 W Cheyenne Suite BNorth Las Vegas NV 89032(702)336-4656
Certification Date:
WESTERN STATES CONTRACTING INC
Troy Shiozawa, Asst Controller2810 North Nellis BlvdLas Vegas NV 89115(702) 326-9374
BDF Employment Services LLC 1/15/2013
WS-Dynoco Petroleum Management LLC 1/15/2013Wesley's
Tejas Underground LLC 5/1/1998
45
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C of A # Employer Name/DBA Self-Insured Contact Third Party AdministratorSubsidiary DBA Eff. Date
94 WEYERHAEUSER COMPANY
1/1/1989
Lisa WysockiSelf-Insurance Administrator
WEYERHAEUSER COMPANYP O Box 9777 CH3K33Federal Way WA 98063-9777(253) 924-7471
Certification Date:
SPECIALTY RISK SERVICES LLC (SRS)
Lara BorelP O Box 95518Las Vegas NV 89193-5518(702) 387-8006
Weyerhaeuser NR Company 1/1/2009
Pardee Homes of Nevada 1/1/1989
Pardee Homes 1/1/1989
70 YOUNG ELECTRIC SIGN COMPANY
7/1/1984
Clark SmithDirector of Finance/Treasurer
YOUNG ELECTRIC SIGN COMPANY2401 Foothill DriveSalt Lake City UT 84109(801) 464-4600
Certification Date:
NEVADA ALTERNATIVE SOLUTIONS, INC.
Charles R Nort9506 West Flamingo Rd Suite 102Las Vegas NV 89147(702) 796-1333 ext 228
YESCO Outdoor Media LLC 1/1/2008
YESCO Administration LLc 1/1/2008
YESCO Electronics LLC 1/1/2008
YESCO LLC 1/1/2008
79 YRC INCYRC Freight
5/1/1986
Becci McMahonSenior Risk Analyst
YRC WORLDWIDE INC10990 Roe Avenue, MS A305Overland Park KS 66211-1213(913) 696-6107
Certification Date:
GALLAGHER BASSETT SERVICES, INC.
Charles Rostad2110 East Flamingo Rd #314Las Vegas NV 89119-0834(866)-889-4755
46