Document 2JJk5Zex4LngqVvOZE1yjdBER

Six Becker Farm Road Roseland, New Jersey 07068-1743 Telephone: (201) 740-9400 April 5, 1994 LIBERTY MUTUAL SHERWIN WILLIAMS CORP BROWN STREET & LISTER AVENUE NEWARK NJ 07102 r edac t ed COMP 51994 RE: Sherwin Williams Corp. Claim Mumoer: WC 324-528873 C.P. Number: 94-001539 Date of Last Exposure: 7/1/90: Dear Ms. Solomita: Please be advised a Formal Claims Petition has been filed on behalf of The petition alleges was exposed to dust, fumes, chemicals, asbestos, bending, lifting, stress, strain and an adverse environment causing occupational conditions and diseases while employed at Sherwin Williams, Brown & Lister Avenue, Newark, New Jersey, from 7/1/87 through 7/1/90. The resulting disability is to the petitioner's chest, lungs, nose, throat, eyes, back, orthopedic system, hearing, stomach, internal organs, vascular system, myelodystlashia, nervous system, neurosis and complications arising therefrom. In order for us to properly defend you against the allegations set forth in this claim petition, we need your cooperation. Would you kindly provide the following information and return it to us as soon as possible. 1. State the exact dates of employment. 2. Indicate any periods of lost time and the reason for same. 3. List and describe the positions held by the employee. Also, please state the length of time in each position. 4. State the specific area/departments employed. 5. State the exact nature/duration of any occupational exposure. 6. Please list any protective devices used. 7. Please describe the character of the employee. Did the employee have any complaints? 8. State the reason for employment separation. Also, please advise the employee's weekly wages and hourly rate on the date of last employment. Liberty Mutual Insurance Group/Boston N40267 0007-SWP-005803060 CONFIDENTIAL