Document omjQLL42zVDnKrvVJq2zj4zo3

endTHE B.F. GOODRICH COMPANY Nsmeef twowwr Offic* eddrw 500 South Main StAkron, Ohio 44318~ Number and Street Dry or fawn Stew hew* r*och*d on agreement in regard to compensation for th* injury Wftoifted by said employ** end submit the following statement of feds relative theceioi-- Dot* of injury. Nature oi Injury March 31t 1975 Liver Damaoe .Dot* disability began. 6-1-80 Place of co. of Louisville* Ky.__________________________________________________ No accident - Liver danage due to exposure to vinyl chloride Probobl# length el duality PcnB&nftnt The terms of this ogreement under the above feds or* as follower-- That the sold. ] and his dependents -jhafl receive compensation at the rat* of S. 88.00 week based upon an average weekly wag* af Sufficient for maximum .end that sold compensation shall be payable _6_0% ($52.80) to be paid by the anplover and 40% ($35.20) by the Special Fund.________ from end including the. 1st Joy of. June .. _ 80 nth 19. until WrmiMWd in eccordonc* with th* pravisians of the Workmen's Compensation Law ef the Slot* of________Kentucky . Brplpyfir shall pay full weekly benefits and be reimbursed quarterly fcy Special Fund. Number* edStreeT k fvWlf ddinn SA xoilA Special Fund Deis ef AppraveL the Siendord Prtmtne Conceit, hw. tmilnllls. Ky. .Witness 3L.' -IiS-.B.F COQPRICH COMPANY tsnrw mvaar Claims Administrator THW ..UArlfment Pnwp ^ May 15. 1980 Dot* of ftpreenwnl- - __ Employee or Dependent ----- Emptier Carrier <L_ f NGC39401