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FILE NAME: Flour (FLU) DATE: 1968 DOC#: FLU011 OCUMENT DESCRIPTION: Stanley Hallmark's Workers' Comp Claim
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Morgan Pltfs' Ex. 0289 pg 1
EXHIBIT *A*
KAKES AND ADDRESSES 0? EMPLOY EftS
WORK PERIOD ENDING
NAME OP INSURANCE CARRIER
REPORTED WAGES
Western Asbestos Company_
9/30/44
Unknown prior to 1/1/56 (State
$ 22.50
Box 3784, Rincon Annex
Fund Policy 93224-56 after
San Francisco, California
1/1/56 thru 65.)
*
*
12/31/44
1,247.63
*
*
"
3/31/45
1,025.33
*'
"
6/30/4S
1,049.95
-
"
"
9/30/45 3/31/47
924.72 59.20
*
*
"
6/30/47
968.40
'
*
*
9/30/47
973.85
'
'
*
12/31/47
579.50
Armstrons..Cork_ Company Liberty and Charlotte Streets
12/31/48 3/31/48 -- --
No record prior to 1/1/53
^
Travelers, Policy RUB-2673804, f
360.72 456.00
Lancaster, Pennsylvania
1/1/S3 thru 58
Aetna Casualty, Policy G-98C2001SR
1/1/63 thru 64
Western Asbestos Company
3/31/49
Unknown prior to 1/1/56 (State
926.28
Box 3784, Rincon Annex
Fund Policy 93224-56 after
San Francisco, California
1/1/56 thru 65.)
6/30/49
w
819.23
9/30/49
986.34
n
m
J, T. Thorpe and Incorporated
It
u
Son,
12/31/49 3/31/50 6/30/50 6/30/5
Pacific Employers, PolicyNo. WCC5-30077, 1/1/50 thru 51
266.15 1,156.89
258.39 204.46
1351 Ocean Avenue
'Industrial Indemnity, Policy
j
Emeryvillo, California
Mo. 3531-00017, 1/1/53 thru 62
American Employers, Policy
No. WCP81001, 1/1/62 thru 63
Morgan Pltfs' Ex. 0289 pg 2
HAKES AND ADDRESSES OF EMPLOERS
San Francisco Bay Naval Shipyard
Vallejo, California
Western Asbestos Company Box 37B4, Rincon Annex San Francisco, California
San Francisco Bay Naval Shipyard
Vallejo, California
Fluor Maintenance, Inc. 2500 South Atlantic Blvd. Los Angeles, California
Rex Regne11 1421 Lander street Reno, Nevada
Western Asbestos Company flex 3784, Rincon Annex San Francisco, California
EXHIBIT WORK PERIOD
ENDING 3/31/51 *
6/30/51 9/30/51 12/31/51 3/31/52 6/30/52 9/30/52 12/31/53
3/31/53 6/30/S3 9/30/53 12/31/53 12/31/53
12/31/53
3/31/54
12/n/si
2
- Cent.
nmr, er in su r a n ce c a r r ie r
No record of coverage
reported wages
* $ 892.48
*
*
* *
"
* No record prior to State Fund, Policy
1/1/56 thru 65
1/1/56 93224-56,
1,210-00
1 (084-12
413-20 1,160.24
l r3 3 0 . 2 4
1,10$.52 1S9.77
No record ofcoverage M
* -
No record ofcoverageprior to 4/25/54.
Ccntinental Casualty Policy 1562300, 4/25/54 thru 5S
No record ofcoverage
No record prior to 1/1/S6 State Fund, Policy 93224-56,
1/1/56 t h m 65 "
1,148-08 1,207.68
1,236.72 '7.52 122.00
439.20 I
48.80
378.00
. i
Morgan Pltfs' Ex. 0289 pg 3
J4AME3 AHD ADDRESSES OF EMPLOYERS
Armstrong Cork Company iXibei^y"'and Charlotte Street Lancaster, Pennsylvania
J, T* Thorpe and Son Incorporated
1351 Ocean Avenue Efaeryville, California
EXHIBIT m\
VORX PERIOD ENDING 3/31/54
6/30/54 9/30/54
Rex Regnell
Charles Ayres Company 698 Minnesota Street San Francisco, California
Dutton Asbestos and Supply Company
532 Natoma Street San Francisco, California
Fiberglas Engineering and Supply Company
S41 East Second Street Los Angalea, California
tie5 tern Asbestos Company Bax 31B4, Rincon Annex San Francisco, California
12/31/54 6/30/54 9/30/54 3/31/54
3/31/54
9/30/54 12/31/54
3/31/55
COBt*
NAME OP INSURANCE CARRIER
No record prior to 1/1/S3 Travelers, Policy RUB/267380-t
1/1/53 thru 58 Aetna Casualty, Policy No.
G - 9 B C 2 00 1 S R , 1/1/63 thru 64
Pacific Employers, Policy WCC5-30077, 1/1/50.-51
Industrial Indemnity policy 3531-00017, 1/1/53-62
American Employers, Policy WCP81001, 1/1/62-63
No record of coverage
ti
No record of coverage
REPORTED WAGES $ SOS.00
771.00 151.20
628,43
631.35 475,65 286.61
No record of coverage
33.55
Aetna Casualty, Policy n o . 31C700RR, 9/1/53-67
23S.60 302.40
No record prior to 1/1/56 State Fund, Policy 93224-56,
1/1/56-65
252.00
Morgan Pitfs' Ex. 0289 pg 4
NAMES AWD ADDRESSES OP EHPLOVERS
San Francisco Bay Naval Shipyard
Vallejo,"California
OK Myers, Til Counties Roof atid Insulation Company
33D North Bridge Street Viaalia, California
Owens C o m i n g Corporation
P. 0. Box 901 Toledo, Ohio
M
Fiberglas
Floor Maintenance, Incorporated
P. 0. Box 7030 East Los Angeles Branch Los Angeles, California
Cork Insulation Sales Company, Incorporated
2412 First Avenue, So. Seattle, Washington
The E. J, Bartells Company 1212 Sixth Avenue, South Seattle, Washington
Western Asbestos Company Box 3784, Rincon Annex San Francisco, California
EXHIBIT *j
WORK PERIOD ESDIKG
6/30/S5
3/31/55
9/30/55
12/31/55 3/31/55
9/30/55
12/31/55 12/31/55
9/30/56 12/31/56
- Cortt NAME OP INSOBAHCS CARRIER
No record of coverage
R E P O R T E D VTM3E3
$
921*60
State Fund, Policy 1879<8-55, 2/1/55-56
252.00
Aetna Casualty Policy 310700-RR 9/1/53-67
No record of coverage
552.30
1 , 2 3 4 . eo 727*65
No record of coverage
365.40
* No record of coverage for period
126.00 179.56
No record prior to 1/1/56 State Fund, Policy 93224-56,
1/1/56-65
314.40
209.60 ~ I
Morgan Pltfs' Ex. 0289 pg 5
NAMES AND ADDRESSES OP EMPLOYERS______
Owens Corning Fiberglas Corporation
J- T* Thorpe, Inc. 940 East Second Street Los Angeles, California
Plant Asbestos Company 1300 - 64fch Street Tjeryville, California
J. T. Thorps and Son, Incorporated
EXHIBIT V VORX PERIOD
ENDING 3/31/56
6/30/56 9/30/56 3/31/56
6/30/56 6/3D/56
9/30/56
M. R Carpenter
12/31/56
Kestarn Asbestos Company Box 3784, Rincon Annex San Francisco, California
*
9/30/57 ' : . 12/31/57*:: *
KAKE OF INSURANCE CARRIER
Aetna Casualty, Policy 310700-RR, 9/1/53-67
m a
American Motorists, Policy 6CM 431 898, 1/1/56-57
V
Industrial Indemnity, Policy CP-100654, 1/1/56-58
American Employers, Policy MCPA-19-9102-012, 1/1/67-68
Pacific Employers, Policy WCC5-30077 , 1/1/50-51
Industrial Indemnity, Policy 3531-00017, 1/1/53-62
American Employers, Policy WCP81001, 1/1/62-63
American Motorists, Policy 6CM 431 B98, 1/1/S6-57
State Fund, Policy 10/1/56-58
State Fund, Policy 10/1/63-64
No record prior to State Fund, Policy
1/1/56-65 k
92969-56,
92969-63,
1/1/56 93224-56,
REPORTED WAGES
5
429,76
734.00 542,24
1,038.38
565.50 139.70
693.80
1,283.80 14.20
736.45
M organ Pltfs' Ex. 0289 pg 6
KM4ES AND ADDRESSES OF EMPLOYERS
Owens Corniny Corporation
P. O. Box 901 Toledo, Ohio
Fiberglas
Plant Asbestos Company 1300 - 54th street Emeryville, California
EXHIBIT WORK PERIOD
'__ ENDING
3/31/57
5/30/57
V30/S?
12/31/S7
ArrastEDag Cork Company Tiberty and Charlotte Streets Lancaster, Pennsylvania
3/31/57
J, T. Thorpe and Son, Incorporated
5/30/57 9/30/57
M* R* Carpenter 90? Front Street Sacramento, California
3/31/57
- Cent.
NAME OF INSURANCE CARRIER
Aetna Casualty, Policy 3 1Q700-RR, 9/1/53-67
REPORTED WAGES
$
33B,00
556,10
643.20
Industrial indemnity, Policy CP-100654, 1/1/56-58
American Employers, Policy HCPA-19-9102-012, 1/1/67-68
233.60
No record prior to 1/1/53 Travelers, Policy RUB-2673804,
1/1/53-58 Aetna Casualty, Policy G-98C2001SR,
1/1/63-64 m
Pacific Employers, Policy WCC5-30077, 1/1/SD-S1
Industrial Indemnity, Policy 3531-00017, 1/1/53-62
American Emoloyers, Policy WCPB1001, 1/1/62-63
American Motorists, Policy 6CM 431 898, 1/1/56-57
941.70
91^60 127.80
State Fund, 10/1/56-58
State fund, 10/1/63-64
Policy policy
92969-56, 92969-63,
628.80
I
M organ P ltfs' Ex. 0289 pg 7
NAMES AND ADDRESSES OF ______ EMPLOYEES_______
Insulation and AsbestC3 Industry Works of Northern California, Vacation Trust Fund Loc. No. IS
2iJ0 Guerrero Strict Gan Francisco, California
Lorentzen Company 1155 Fifth Street Oakland, California
M. R. Carpenter, Incorporated
Box 1514 Sacramento, Calif.
VJestern Asbestos Company Sox 3784, Rincon Annex San Francisco, California
Kuldoon Company, Inc* 6S57 East Shaw Avenue Clovia, California
Insulators and Asbestos Industry of California and l o g . Union 16, Vacation Plan
200 Guerrero Street San Francisco, California
EXHIBIT mh m KORX PERIOD
ENOING 9/30/57 ^
9/30/57
9/30/57
3/31/56
3/31/56 6/30/58 9/30/58 9/30/58
-Cent.
NAME OF INSURANCE CARRIER Ho record of coverage
7
REPORTED WAGES 117.05
Ho record for period
State Fund, 10/1/S6-5B
State Fund, 10/1/63-64
Policy Policy
92569-56, 92969-63,
No record prior to 1/1/56 State Fund, Policy 93224-56,
1/1/56-65
Ho record of coverage
m * m
No Record of coverage
513.49
235.80
823.60
851.20 1,915.20 1,433.60
42.60
Morgan Pltfs' Ex. 0289 pg 8
HAKES AND ADDRESSES OF EMPLOYERS ____
Charles Ayres Company
Cramer Accoustics 1035 Folgern Street San Francisco, California
Caw insulations 6420 Fair Oaks Boulevard Carmichael, California
Western Asbestos Company Box 37B4, Kinccn Annex San Francisco, California Caw Insulations 6420 Fair Oaks Boulevard Carmichael, California
J. T. Thorpe and Sonr Incorporated
EXHIBIT m? WORK PERIOD
ENDING 3/31/59 6/30/53 9/30/5 9 9/30/53
12/31/59 3/31/60 6/30/60 9/30/60
12/31/60 12/31/61
3/31/61
6/30/61 9/30/61 3/31/62 6/30/62
- Cont.
NAME OF INSURANCE CARRIER
REPORTED WAGES
585-99
2,S12.60
910.79
Eldorado Insurance, Policy 591116$, 7/1/59-61
975-72
2,166.31
2,251.61 1,852.82
No record prior to 4/21/61 Pacific Employers, Policy
22WC-36721, 4/21/61 - 7/1/63 Aetna Casualty, Policy
5C5G637CC fPT), 7/1/63 - 9/1/64 n
68-00 2,142.00
No record prior to 1/1/56 State Fund, Policy 93224-56,
1/1/56-65
491.92
No record prior to 4/21/51 Pacific Employers, Policy
22WC-36721, 4/21/61 - 7/1/63 Aetna Casualty, Policy
5C56637CC(PT) , 71/1/63 - S/l/6<
2,398.60
2,192.40 209-00
Pacific Employers, Policy WCCS-3 0077 , 1/1/50-S1
Industrial Indemnity, Policy 3531-00017, 1/1/53-62
American Unployera, Policy WCP81001, 1/1/62-63
AinerJcar. Motorists, Pol. 6CnO!89a, 1/1/56-5?
1,863.69 1,027.92
Morgan Pltfs' Ex. 0289 pg 9
NAMES AND ADDRESSES OF EMPLOYERS______
Caw Insulations
EXHIBIT "A*
WORK PERIOD ENDJDC
9/30/62 12/31/62
Berkeley Farms 47th and San Pablo Emeryville, California
Caw Insulations
Caw Insulations, Inc, 2127 Hudson Way Sacramento, California
^Armstrong Contracting and Supply Corporation
120 North Lime Street Lancaster, Pennsylvania
Kaiser Engineers Division of Henry J. Kaiser Company
P. CX Box 187 Fontana, California
Westorn Asbestos Company Box 3784 f Rincon Annex San Francisco, California
3/31/62
3/31/63 6/30/63 9/30/63 9/30/63 12/31/63 12/31/63
12/31/63
3/31/64 6/30/64 9/30/64
9
^ Conta
NAME OF INSURANCE CARRIER
REPORTED WAGES
Ho record prior to 4/21/61 Pacific Employers, Policy
22WC-36721, 4/21/61 - 7/1/63 Aetna Casualty, Policy
5C56637CC9(PT), 7/1/63 - 9/1/64
1,690,90 2,801,34
Republic Indemnity, Policy PC 904926 , 5/1/61-62
26,06
Ho record prior to 4/21/61 Pacific Employers, Policy
22WC-36721, 4/21/61 - 7/1/63 Aetna Casualty, Policy
5C56637CCH(PT), 7/1/63 - 9/1/64
2,451,02 2,296,28
50.7Q
568.00 84.00
1,826.44
Industrial Indemnity, Policy CC 100620, 3/1/63-64
Ho record prior to 1/1/56 State Fund, Policy 93224-S6, - 1/1/56-65
155,12
; , .* i ,,: i
1,081.08 2,873,97
844.95
f
Morgan Pltfs' Ex. 0289 pg 10
HAKES AND ADDRESSES OF EMPLOYERS
H. R. C a r p enter, Incorporated
907 Front Street Sacramento, California
Gwens Corning Corporation
P. O, Box 901 Toledo, Ohio
pibergla3
Associated Insulation: of California
238 South 24th Street Richmond, California
Baker Perkins,
Incorporated
*
Plant Asbestos Company 1300 - 64th Street fiaeryville, California
EXHIBIT "i WORK PERIOD
ENDING 3/31/64
6/30/65 9/30/65 12/31/65 3/31/66 6/30/66
12/31/66 3/31/67
3/31/67
3/31/67
KME OF INSURANCE CARRIER
State Fund, 10/1/56-58
State Fund, 10/1/63-64
Policy Policy
9296.9-56, 92969-63,
Aetna Casualty, Policy 31070Q-RK, 9/1/53-67
REPORTED WAGES
$
216.40
1,093.03 3,332.56 1,421-68 3,991.16 2,608.84
American Employers In**, Policy HCP 4663663, 7/23/66-68
104-18
1,153.46
Liberty Mutual, Policy WC1-141-050518-017, 1/1/67-68
Industrial indemnity, Policy CP-100654, 1/1/56-58
American Employers, Policy WCPA-19-9102-012, 1/1/67-68
694-72 984.96
Morgan Pltfs' Ex. 0289 pg 11