Document r6pJJzva7zKZ1NDvvEBY3NX4E

^Six Becker Farm Road Roseland, New Jersey 07068-1743 Telephone: (201) 740-9400 LIBERTY MUTUAL MAY 2. 1994 ATTN : MS. SOLOMITA SHERWIN WILLIAMS CO 60 LISTER AVENUE NEWARK NJ 07105 ' WORKERS9 COMPENSATION MAY.1.-' 1994 r edac t ed EMPLOYEE ( INSURED: SHERWlN WILLIAMS CO CLAIM NUMBER WC 324-528873 DATE OF ACCIDENT: 12/30/89 Dear Ms. Solomita: In order for us to properly defend you against the allegations set forth in this claim petition, we need your cooperation. This is a second request for the attached information. Your anticipated cooperation is greatly appreciated Sincerely. MARIE A DEVITO Claims Department ENCLOSURE Liberty Mutual Insurance Group/Boston Equal Opportunity Employer N40264 0007-SWP-005803050 CONFIDENTIAL 524 0 940 ^0 0 48 7 April 5, 1994 .-'WORKERS* COMPENSATION WAY 1 G 1994 SHERW1N WILLIAMS CORF BROWN STREET & LISTER AVENUE NEWARK NJ 07102 REDACTED RE: - Sherwin Williams Corp. Claim Number: <J 324-528873 C.P. Number: 94-001539 Bate of Last Exposure: 7/1/90:____________ Dear Ms. Solomita: Please be advised a Formal Claims Petition has been filed on behalf of j. The petition alleges Mr. was exposed to dust, fumes, chemicals, asbestos, beading, 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, oyelodystlashia, 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. N40264.01 0007-SWP-005803051 CONFIDENTIAL