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1 fl it ^ * is «h.t t^t* J i Profess* o Services S^ml^28 t^ TH^P91179

2 MP HODGE, HART & ASSOCIATES, INC..fence Mitt CONCORD ST., 4TH FLOOR KENSINGTON, MARYLAND DAVID F. HODGE, JR., CPCU, MBA CHAIRMAN. CEO FAX HODGE HART & ASSOCIATES, INC. CAROLINE E. KELLY, CIC, CPIW loeos CONCORD ST.. «TH FLOOR COMMERCIAL INSURANCE DIVISION KENSINGTON. MARYLAND MANAGER TH

3 January 1,1999TOJanuary 1, 2800 PROPERTY 1 Company Travelers Policy # I660433N7044PHX99 Premium $ 8, Location I Street, NW, Washington, DC $ 567,530 Contents Glass (2 sets of doors) $ 103,000 Extra Expense (40/80/100) $ 661,414 Computer Hardware, $25,000 Software Location 2 2 Taft Ct., #201 Rockville, MD $437,750 Contents $103,000 Extra Expense ( ) $205,669 Computer Hardware, $25,000 Software Location 3 12 Sheridan Ave., Albany, NY $ 9,270 Contents $ 103,000 Extra Expense ( ) $ 10,000 Computer Hardware Location Airport Pkwy, #120, Greenwood, IN $ 11,330 Contents $103,000 Extra Expense ( ) $ 7,450 Computer Hardware Location Piper Jaffray Plaza, 444 Cedar St., St. Paul, MN $ 21,630 Contents $ 103,000 Extra Expense ( ) $ 12,000 Computer Hardware Location Cottonwood Dr., Parker, CO $ 9,270 Contents $ 103,000 Extra Expense ( ) $ 12,000 Computer Hardware Prepared by Hodge, Hart & Associates, Inc. 2/26/99 TIU

4 Location 7 Location Eighth St., #330 Sacramento, CA 815 Brazos St., #63, Austin, TX $ 9,270 Contents $ 103,000 Extra Expense ( ) $ 4,000 Computer Hardware $ 5,150 Improvements & Betterments $ 14,420 Contents $ 5,682 Computer Hardware Coverage: Special Form Replacement Cost 80% Coinsurance Applies $250 Deductible Applies RECOMMENDATIONS: EVALUATE COMPUTER LIMIT COMPUTER EXTRA EXPENSE EMPLOYEE DISHONESTY Prepared by Hodge, Hart & Associates, Inc. 2/23/39

5 IGENERAL LIABILITY Company Essex Policy # Premium $ 4, $ 2,000,000 General Aggregate Included Products/Completed Operations Aggregate Excluded Personal and Advertising Injury $ 1,000,000 Each Occurrence $ 50,000 Fire Legal $ 1,000 Medical Payments $ 500 Deductible Applies Per Claim 25% Minimum Earned Premium Classification Code Exposure Bidg. Premises ,824 Sq. Ft. -Total Exclusions: Pollution Asbestos, Lead, or Silica Dust Punitive or Exemplary Damage Assault and/or Battery Hiring and/or Supervision Employment Related Practices Errors, Omissions, Acts, Professional Liability, Malpractice Athletic Participants Discrimination Cross Suits Independent Contractors/Subcontractors - Conditional Classification Limitation Prepared by Hodge, Hart & Associates, Inc. 2/26/39 TI ?

6 IAUTOMOBILEI Company Travelers Policy # N7044PHX99 Premium $ 1,993 $ 1,000,000 Liability $1,000,000 Uninsured Motorist $ 2,500 Personal Injury Protection included Hired Non-Owned Auto $ 250 Comprehensive Deductible $ 250 Collision Deductible No-Fault Limits as required by loss Hired Car Physical Damage - $25,000 Limit $100 Comp. and $500 Coll. Deductible $50 Towing and Labor $30 a day for 30 days Rental Reimbursement VEHICLE IDENTIFICATION COST GARAGED 98 Cadillac 1G6KF5499WU $ 45,000 Potomac, MD NOTE: THE ONLY AUTOS COVERED ARE THOSE SPECIFICALLY LISTED ON THE POLICY PLUS HIRED AND NON-OWNED AUTOS. PHYSICAL DAMAGE ONLY APPLIES TO SCHEDULED VEHICLES. EXCLUSIONS: Nuclear Energy Liability Punitive Damages NOTES: meeting, VP in the field have vehicles which are covered by the leasing company The leasing company may no longer provide coverage. Advised these vehicles could be added to this policy. Maria will check into and advise. Prepared by Hodge, Hart & Associates, Inc. 2/26/99 TI145911'

7 WORKERS COMPENSATION Company Policy # Premium A. Statutory Limits B. Employer's Liability Travelers IUB637Y $ 18,760 Bodily Injury by Accident $500,000 Each Accident Bodily Injury by Disease $500,000 Each Employee Bodily Injury by Disease $500,000 Policy Limit State Code Classification Payroll Rate CO CO DC DC DC IN IN MD MD MN MN NY NY TX TX Sales Clerical Sales Clerical Driver Sales Clerical Analytical Chemist Clerical Sales Clerical Sales Clerical Sales Clerical $ 103,530 $ 30,015 $ 1,665,881 $ 1,821,960 $ 90,199 $ 85,890 $ 30,634 $ 180,166 $ 220,572 $ 83,634 $ 28,061 $ 77,107 $ 30,949 $ 91,000 $ 27, Experience Mod applies AWAITING ENDORSEMENT TO ADD CALIFORNIA NEEDED: Listing of any additional states where you may do business within the next next 12 months Any foreign exposure Prepared by Ho±js, Hart & Associates, Inc. 2/25'99 11 K"yi I'OO

8 UMBRELLA Company Acceptance Policy # UL Premium $ 4, $ 4,000,000 Limit of Liability $ 4,000,000 Policy Aggregate $ 10,000 Self-Insured Retention Prepared by Hedge, Hart & Associates, Inc. 2/26/B9 Tl'4S911cc

9 jboiler AND MACHINERY Company Hartford Steam Boiler Policy # FBP Premium $ 1,488 Location 2 Taft Ct, Rockville, MD $ 1,250,000 Equipment Breakdown Limit $ 1,000,000 Property Damage $ 250,000 Business Income Service Interruption - Combined with Business Income Extra Expense - Combined with Business income $ 25,000 Perishable Goods $ 25,000 Computer Equipment $ 25,000 Demolition and ICC $ 25,000 Expediting Expense $ 25,000 Hazardous Substances $ 25,000 CFC Refrigerants $ 1,000,000 Newly Acquired Locations DEDUCTIBLES: Direct Coverages $1,000 Except A/C and Refrigeration Systems - $25/horsepower, $1,000 min. Indirect Coverages 12 Hours Prepared by Hodge, Hart & Assoc ates. Inc. 2/26/99

10 WORKERS' COMPENSATION NOTICE Your employer is required to provide for payment of benefits under the Workers' Compensation Act of the State of Indiana. Any employee who is injured while at work should report the injury immediately to their supervisor, employer, or designated representative. The Workers' Compensation insurance carrier or the administrator for THE TOBACCO INSTITUTE is THE TRAVELERS INSURANCE COMPANY P.O. BOX INDIANAPOLIS. IN WC Supervi sor === For more information about rights or procedures under the Indiana Workers' Compensation system, call *== or write: "555= Workers' Compensation Board of Indiana 555 Ombudsman Division W. Washington St Rm W196 * = Indianapolis, IN ==5 (317) YV13P1G91 (Rev ) T(1^59-

11 STATE OF NEW YORK - WORKERS' COMPENSATION BOARD ESTADO DE MUEVA YORK - JUNTA DE COHPENSACION OBRERA NOTICE OF COMPLIANCE WORKERS' COMPENSATION LAW TO EMPLOYEES IMPORTANT INFORMATION FOR EMPLOYEES WHO ARE INJURED OR SUFFER AN OCCUPATIONAL DISEASE WHILE WORKING. 1. Your employer is in compliance with the Workers' Compensation Law. 2. Immediately tell your employer or supervisor when, where and how you were injured. 3. Obtain first aid or other necessary medical treatment immedlateiy. 4. Tell your doctor to file medical reports with the Board and with your employer or his or her Insurance carrier. 5. You may be entitled to compensation If your work-related injury keeps you from work for more than seven days, compels you to work at lower wages or results in permanent disability to any part of your body. You may be entitled to rehabilitation services if you need help returning to work. 6. Obtain and file a claim form (Form C-3) with the nearest Workers' Compensation Board Office. Failure to file within two years after the date of injury may result in your claim being denied. 7. Generally, you are entitled to be treated by a physician, psychologist (upon referral from an authorized physician), podiatrist or chiropractor of your choice, for treatment of your work-related Injury or illness, provided that he or she is authorized by the Chairman of the Workers' Compensation Board. If, however, your employer has been approved to participate in the New York State Managed Care Pilot Program, you must obtain initial treatment through a managed care organization which your employer has contracted with to provide health care services for workers' compensation injuries. Employers participating in the pilot program must notify you In writing (on Form MCP-3) and display a poster (Form MCP-4) describing your rights under the pilot program. 8. DO NOT pay your doctor or hospital. Their bills will be paid by the insurance carrier if your case is not disputed. If your case is disputed, the doctor or hospital must wait for payment until the Board decides your case. In the event you fail to prosecute your case or the board decides against you, you will have to pay the doctor or hospital. 9. You are not required to have anyone represent you in any : workers' compensation proceeding, but you have the right to be i represented by an attorney or licensed representative, if you so choose. If you obtain representation, do not pay your attorney ; or representative directly. When the Workers' Compensation jj Board rules on your case, the attorney's or representative's fee will be set by the Board and the amount will be deducted from your award. = 10. If you have difficulty in obtaining a claim form or need help in s filling it out, or if you have any other questions or problems about = a job-related injury, contact any office of the Workers' Compensation Board. I WORKERS' COMPENSATION BOARD OFFICES! Albany, Broadway - Menands - (518) '; Binghamton, State Office Bldg Hawley St - (607) i Buffalo, State Office Bldg Main St. - (716) ; Hempstead, Fulton Avenue - (516) ; New York City, Livingston St. - Brooklyn - (718) ; Rochester, Main Street West - (716) Syracuse State Office Bldg E. Washington St. - (315) AVISO DE CUMPLIMIENTO LEY DE COMPENSACION OBRERA A EMPLEADOS INFORMACION IMPORTANTE PARA EMPLEADOS QUE SEAN LESIONADOS O SUFRAN UNA ENFER- MEDAD OCUPACIONAL MIENTRAS TRABAJAN. 1. Su patron esta cumplimiento con la Ley de Compensacion Obrera. 2. Avise inmediatamente a su patron o a su supervisor cuando, donde y como sufrio la lesion. 3. Obtenga primeros auxilios u otro tratamiento medico necesario inmediatamente. 4. Pfdale a su doctor que presente informes medicos a la Junta y a! patron suyo, o a la compania de seguros de el/ella. 5. Usted podrfa tener derecho a compensacion si su lesion relaclonada con el trabajo le impide de trabajar por mas de siete dias o le obliga a trabajar a sueldo mas bajo o resulta en incapacidad permanente de alguna parte de su cuerpo. Usted puede tener derecho a recibir servlcios de rehabilitacion si necesita usted ayuda para volver al trabajo. 6. Consiga y presente una forma de reclamacion (Forma C-3) en la oficina mas cercana de la Junta de Compensacion Obrera. El no presentar reclamacion dentro de dos afios a partir de la fecha de la lesion puede ser motivo de que se le rechace la reclamacion. 7. Por lo general usted tiene derecho a ser atendido por un medico, psicologo (cuando es referido por un medico autorizado), podiatra o quiropractico que usted seleccione para ser tratado de una lesion o enfermedad relacionada con su trabajo, siempre y cuando ia persona que provea el servlcio este validado por el Presldente de la Junta de Compensacion Obrera. Sin embargo si su patrono ha sido autorizado a participar en el Programa Piloto de Gerencla de Salud del Estado de Nueva York, usted debera recibir su tratamiento inicial a traves de la organlzacion de servlcios de salud que su patrono haya contratado para proveer servicios medicos para lesiones o enfermedades relacionadas con el trabajo. Los patronos que participan en el programa piloto deberan notificario por escrito a todos ios empleados (Forma MCP-3) y desplegar un cartel (Forma MCP-4) que explique todos sus derechos. 8. NO PAGUE a su doctor nl al hospital. Esas facturas seran pagadas por el asegurador si el caso suyo no ha sido disputado. Si es disputado, el doctor o el hospital debe esperar para recibir pago hasta que la Junta decida su caso. Si deja usted de prosegulr su caso o si la Junta fallara contra usted, se vera obligado a pagar usted mlsmo a su doctor o hospital. 9. No se le exige a usted tener a alguien que lo/la represente en ninguno de Ios tramites de compensacion obrera; sin embargo, usted tiene el derecho de ser representado/a pr un/a abogado/a o un representante llcenciado si prefiere esto. En caso de obtener usted representation, no pague directamente al abogado/a o representante. Cuando la Junta de Compensacion decida en el caso de usted, Ios honorarios de abogado/a o de representante seran fijados por la Junta y seran deducldos de Ios beneficios que se le den a usted. 10. Si tiene usted difioultad en conseguir una forma de reclamacion o necesita ayuda para llenar la forma, o si tiene algunas preguntas o algunos problemas con respecto a lesion relacionada con el trabajo. comuniquese con cualquiera de las oficinas de la Junta de Compensacion Obera. /Uu*/- X ^ Robert R. Snashall Chairman (Presidente) Workers Compensation benefits, when Que, Will be pa d by (Los berefiaos de Compensacion Oorera, cuando dsbidos, seran pagados por): THE TRAVELERS INSURANCE COMPANY ONE TOWER SQUARE S-6225 Name of employer (Nombre del patron) THE TOBACCO INSTITUTE By. Effective From.'3c»s2«; To Pel'c/ No. (I-L'B -637Y ) T-= 7., C=K P3" CCV : =\EiT OM 321=0 E'.'FwQYS AN2 SELVES FEC^^E ill TH D SAE.'TE3.V."VC/T C HC^ V \AT Z'i. LA..\TA ZZ C~l*-E*.SAC Z\ CS-H-A, ','=_E\ '( 3.-".H «FE-SCSAS CC\ v?h:'«.'=vr;3 ~«, c irfi»/nar C-105 (6-96) r.t^-'c:'-^: ' ~-» ". ;'i'e : THIS NOTICE MUST BE POSTED CONSPICUOUSLY IN AND ABOUT THE EMPLOYERS PLACE OR PLACES OF BUSINESS,

12 TO THE EMPLOYER This notice must be posted in a conspicuous place upon your premises. EMPLEADOR Es obligatorio fijar este cartel en un lugar visible. WORKERS COMPENSATION ACT LEY DE RECOMPENSACION PARA LOS TRABAJADORES NOTICE TO EMPLOYEES AVISO PARA EMPLEADOS Your employer is insured under the above-named law by: Su empleador tiene seguros bajo esta ley por: THE TRAVELERS INSURANCE COMPANY If you are iniured or sustain an occupational disease Si usted se Jesiona o contrae una enfermedad en su while at work, you may be entitled to compensation pentro. de. trabajo, es posible que tenga derecho a benefits as provided by law. NOTIFY YOUR EMPLOYER indemnizacion segun, la, ley.\, JWISE USTED IMMEDIATELY. If you fail to report your injury or oc- IMMEDIAJAMENTE.A SU EMPLEADOR. Si no le avisai en cupational disease promptly. Loss of Benefit penalties seguida no de su herida o enfermedad existe la posibihdad may be assessed against you. Wfi reciba los benefipios de la ley. No compensation is payable for the first 3 days' disa-.n,?* PfigS an b^fr!?' ^,» 3 po Ji Xli&V JL r,r?s,\jl2% bility unless the periodof disability exceeds two weeks. 3 e rj n m a a p s ac j ad dof Sm 3 n S as q PasUf S^dn-f JJffi 1^ Thereafter, the compensation rate while disabled is 2/3 "[ "Jf 3,g% bene!fctos mientrav II trabiildo?^:ontihuj of your average weekly wage subject to a statutory ^a^joserade'^st'lskv ^? J 3e" u " M maximum determined annually as provided by law. semanal, sujeto a un maximp fijacio cada anp por la ley. You are entitled to reasonable and necessary medical, a trabajador tiene el derecho de recibir servicips surgical and hospital treatment for.treatment of injuries medicos, cirugia, o, Tjospitalizacjon para ser atendido de or occupational diseases and vocational rehabilitation, as hendas o enfermedades profesionales. Tambien tiene el needed. If no Physician is designated by the Insurance derecho a rehabilitacion.vocacional, cuando se estime Carrier or your employer, you may select the services necesanp. Si la compania de seguro no ha designado of any regularly licensed Physician. Your Insurance Carrier un medico representandq su empleador, usted puede reserves the right, however, to designate a different selecionar el medico titulado, pero la compania de physician or specialist, if, in its opinion, facts and cirse 9 ur os,: t ene el i derecho a nqmbrar otro medico o cumstances warrant it especialista, si en la opinion de la compania, los hechos c a Tri!r P a h r y e carrier are. S - icians designated by your employer's insurance v {* ^^I^Snbrad^por"la Compania de seguros de su empleador son: Aparte de, los. reportes.que el empleador debe completar, el empleado herido tambien compleatara su propio reporte para recibir beneficios medicos, y In addition to any reports the employer is required to proteger sus derechos futuros. Para obtener los papeles file, an injured employee must file his own claim for Dp,SS?, a^'? s JiiJ, r t m, as 'J e i?i nar J os b?2s flc,? s de ' sp.agqs Srf^e^rlghTs' "if c ^ ^ ^ m f ov TO W ' j f f i it^'tse^fec^amfa?o?s?o S mj»o r rl B S%ot ^./fep^'y^durintyou^ d l L * * *% ^ W ^ ^ S ^ ^ r & T. «fev& atos? or it you wish any information concerning your rights Workers Comrjpnsatmri ssrtinn n11 ShUrman <t r?^ *e Workers fcompensat.on Act write a the Colorado ^vef 3 CO S^of.^AI f l t t aualqsier informacio^ri Division of Labor Workers Compensation Section, 1313 favor de rncluir: nombre y apeflido tal como esta Sherman Street. Denver, Colorado , giving your registrado con su empleador. nombre y direccion de su name as it appears on the payroll the name of your empleador. y fecha exacta de! dia que ocurno el employer, and the date of your accident accidente. '.VD5P1G90 COLORADO DIVISION OF WORKERS COMPENSATION THE CHANCERY BUILDING 1120 LINCOLN STREET. 14TH FLOOR DENVER, COLORADO Tf1489'

13 T>E TOBACCO INSTITUTE Employees' Rights Under Minnesota Workers 5 Compensation Almost All Employees Are Covered - Full- or part-time, temporary or seasonal, new workers or minors - who have a work-related injury or disease are covered under Minnesota Workers' Compensation. If You Are Injured - Report any injury to your supervisor as soon as possible no matter how slight it appears. Provide all necessary information so that a proper injury report can be filed. Get necessary treatment as soon as possible. You may see your own doctor. Under Minnesota Workers' Compensation, You Are Entitled To * Compensation for lost wages * Medical treatment expenses, including transportation * Compensation for permanent disability * Rehabilitation services, if necessary * Death benefits for dependents Benefits Due You Will Be Paid By - The Travelers Insurance Companies Workers' Compensation Insurance Company or Self-Insured P.O. Box 35, Minneapolis, MN (612) Address Phone If you have questions or problems concerning - * Reporting claims see your supervisor * Benefits payments - contact the party listed above * General workers' compensation information -call or write one of the offices listed on back and request the "What Employees Need To Know About Workers' Compensation" pamphlet * See back for more information W22P1G90 (6 92) Posting Required By Law w^fe^o*^ I i --T r ~! I

14 For More Information Contact: Workers' Compensation Main Office Workers' Compensation Duluth Office Department of Labor and Industry Government Services Center 443 Lafayette Road 320 West Second Street St. Paul, Minnesota Duluth, Minnesota Phone: (612) Phone: (218) TDD: (612) or Outside of the Twin Cities Area Phone: $. t39 police of flights Posted;] NOTICE TO EMPLOYER Subdivision 1. posting Requirement! Ail employer* required or electing to oany workers* compensation coverage in tie State of Minnesota shall post an disp&y in a oonspteiaouts location a notice, in a form approved by the Commissioner, advising employees of their rights and obligations under this chapter, assistance available to them, and the operation of the workers* compensation system, the name ano" address of the wonders* compensation.oafrier insuring them ar the fact that the employer is selmnstired Ine notice shall oe displayed at ail ideations where the empfoyer is angage in business, Subdivision^. ffaiiureta- Post, Psnaity.J The Commissioner may assess a penalty of $3QG against #» employer payable to the Special Compensation Fynd if, after notice from the Commissioner, the employer violates the posting requirement of this section. NOTE: ML& 17&23!, subd, 2, REQUIRES THAT THE EMPLOYEE MUST EE PROVIDED WITH A COPY OF THE FIRST REPORT OF INJURY, WHERE AN INJURY OCCURS WHICH WHOLLY OR PARTLY INCAPACITATES THE EMPLOYEE FROM PERFORMING LABOR OR SERVICES FOR MORE THAN THREE CALENDAR DAYS, TI1459

15 NOTICE TO EMPLOYEES CONCERNING WORKERS' COMPENSATION IN TEXAS COVERAGE: [THETOBACCO INSTITUTE ] has workers' Name of Employer compensation insurance coverage from [ THE TRAVELERS INSURANCE COMPANIES 1 to *"^ " nam* of commarlcail insurance company protect you in the event of work-related injury or illness. This coverage is effective from [ 01 -oi Any injuries or illnesses which occur on or after that date will be handled by [THE TRAVELERS INSURANCE COMPANIES 1. An employee or a person acting on name of commercial insurance company the employee's behalf must notify the employer of an injury or illness not later than the 30th day after the date on which the injury occurs or the date the employee knew or should have known of an illness, unless the Commission determines that good cause existed for failure to provide timely notice. Your employer is required to provide you with coverage information when you are hired or whenever the employer becomes, or ceases to be, covered by workers' compensation insurance. EMPLOYEE ASSISTANCE: The Commission provides free information about how to file a workers' compensation claim. Commission staff will explain your rights and responsibilities under the Workers' Compensation Act and assist in resolving disputes about a claim. You can obtain this assistance by contacting your local Commission field office or by calling SAFETY HOTLINE: The Commission has established a 24-hour toll-free telephone number for reporting unsafe conditions in the workplace that may violate occupational health and safety laws. Employers are prohibited by law from suspending, terminating, or discriminating against any employee because he or she in good faith reports an alleged occupational health or safety violation. Contact j the Division of Workers' Health and Safety at ' x ' wl^t^n «,««TEXAS WORKERS'COMPENSATION COMMISSION Rule 110,101 -* W42P1F91 (Rov. 9/94) 0 (...)

16 EMPLOYER: Per Rule (e)(1) of the Texas Workers' Compensation Commission, TWCC Notice 6 is required to advise your employees that you have workers' compention insurance through a commercial insurance company and to advise your employees of the Texas Workers' Compensation Commission's toll free number to obtain additional information about their workers' compensation rights. As of January 1, 1994, notices in English, Spanish and any other language common to the employer's employee population must be posted and: (1) Prominently displayed in the employer's personnel office, if any; (2) Located about the workplace in such a way that each employee is likely to see the notice on a regular basis; (3) Printed with a title in at least 30 point bold type, subject in at least 20 point bold type, and text in at least 19 point normal type; and (4) Contain the exact words as prescribed in Rule (e)(1). The notice on the reverse meets the above requirements. Failure to post or to provide notice as required in the rule is a violation of the Act and Commission rules. The violator may be subject to administrative penalties. Notice 6 (7/94) TEXAS WORKERS' COMPENSATION COMMISSION RulB

17 AVISO SOBRE COMPENSACION PARA TRABAJADORES EN TEJAS COBERTURA: [ THE TOBACC0INSTITUTE «]tiene aseguranza para compensar al trabajador con [ THE TRAVELERS ^VSLSESS* ] para protegerla en el caso de una lesion o enfermedad relacionada con su trabajo. Esta aseguranza esta vigente desde [ 1K -=SSMS;]. Cualquier lesion o enfermedad que ocurra en o a partir de esa fecha sera manejada por la [ THE TRAVELERS m *lt!;l ZZ* s ] El trabajodor o la persona que lo representa debe notificar al patron cuando ocurra una lesion o enfermedad antes de treinta (30) dfas despues de que ocurra la lesion o dentro de treinta (30) dias de la fecha en que el empleado se entero o deberia estar enterado de la enfermedad, salvo que la Comision determine que existfa un buen motivo para no haber notificado al patron dentro del tiempo senalado. Su patron esta obligado a proporcionarle informacion sobre la aseguranza cuando lo contrate para trabajar y asi mismo debe de informarle cuando obtenga o deje de tener seguro de compensacion para el trabajador. ASISTENCIA AL EMPLEADO: La Comision le proporcionara informacion gratuita sobre como someter un reclamo de compensacion para el trabajador. El personal de la Comision le explicara cuales son sus derechos y responsabilidades bajo la Ley de Compensacion para el Trabajador y le asistira para resolver culaquier controversia que surja al hacer su reclamo. Usted puede obtener esta ayuda comunfcandose con la oficina local de la Comision o llamando al numero LINEA PARA REPORTAR CONDICIONES INSEGURAS: La Comision ha establecido una Iinea telefonica gratuita las 24 horas del dia, para reportar condiciones inseguras en el lugar de trabajo que pudiera violar las leyes occupacionales de salud y seguridad. La ley prohibe que los patrones suspendan, despidan o descriminen al empleado o empleada porque el o ella, de buena fe, reporta una alegada violacion occupacional de salud o seguridad. Comuniquese con la Seccion de Salud y Seguridad Laboral al numero No.ee 6S (7/94, W42P2F91 (R.v. 9/94) TD(AS WQRKERS, C0MpEfgSAT 0N C0MM ssl0n Rula 1,0.101

18 EMPLOYER: II llll II III III llll IIII III II III II Per Rule (e)(1) of the Texas Workers' Compensation Commission, TWCC Notice 6 is required to advise your employees that you have workers' cormpention insurance through a commercial insurance company and to advise your employees of the Texas Workers' Compensation Commission's toll free number to obtain additional information about their workers' compensation rights. As of January 1, 1994, notices in English, Spanish and any other language common to the employer's employee population must be posted and: (1) Prominently displayed in the employer's personnel office, if any; (2) Located about the workplace in such a way that each employee is likely to see the notice on a regular basis; (3) Printed with a title in at least 30 point bold type, subject in at least 20 point bold type, and text in at least 19 point normal type; and (4) Contain the exact words as prescribed in Rule (e)(1). The notice on the reverse meets the above requirements. Failure to post or to provide notice as required in the rule is a violation of the Act and Commission rules. The violator may be subject to administrative penalties. Notice 6 (7/94) TEXAS WORKERS' COMPENSATION COMMISSION Rule

19 THE DISTRICT OF COLUMBIA GOVERNMENT DEPARTMENT OF EMPLOYMENT SERVICES OFFICE OF WORKERS' COMPENSATION P.O. BOX WASHINGTON, D.C NOTICE OF COMPLIANCE TO EMPLOYEES 1 - You are required by law to report promptly to your employer and the Office of Workers' Compensation an occupational injury or disease, even if you deem it to be minor. Form No. 7 DCWC, Notice of Accidental Injury or Occupational Disease, to be obtained from the employer or the Office of Workers' Compensation, must be used for that purpose. After you have completed and signed it, you should mail if to the Office of Workers' Compensation at the above address, and to your employer. 2- You are entitled, if need be, to the services of a physician or hospital of your choice from an approved panel. A list is available at the Office of Workers' Compensation. Call for information. 3- You may not sue your employer as a result of a work-connected injury or disease by reason of your exclusive remedy under the Workers' Compensation Law. 4- In order to preserve your right to benefits under D.C. Workers' Compensation Law, you must file a written claim on Form No. 7a DCWC, Employee's Claim Application, within one (1) year after your injury, or within one (1) year after the last payment of benefits. 5- If you desire any information regarding your rights and entitlement to benefits as prescribed by law, you may call or write to the Office of Workers' Compensation at the above address, or telephone number (202) The law gives you the right to be represented if you so desire. TO EMPLOYERS 1 - You are required to display this poster so that it will be of the greatest possible benefit to your employees. 2- You are required to file an Employer's First Report of Injury or Occupational Disease, Form No. 8 DCWC, with the Office of Workers' Compensation, copy to the nearest claim office of your insurer, on all occupational Injuries or disease, as soon as possible, but no later than 10 days after the date of knowledge thereof. 3- Your employee must file Form No. 7 DCWC, Notice of Accidental Injury or Occupational Disease. Please provide your employee with Form No. 7 DCWC and urge them to complete it and return it to you and the Office of Workers' Compensation. 4- You are required to report to the Office of Workers' Compensation, and your insurer any disability of more than 3 days which was not previously reported, as soon as possible, but no later than 10 days after the date of knowledge thereof. 5- You are required to furnish, or cause to be furnished, reasonable medical and hospital services, other remedial care or vocational rehabilitation, and various types of disability compensation, to an injured or disabled employee. 6- You are required to obtain from the insurer identified below a supply of all required workers' compensation forms. NOTICE: Violation of the various provisions of the Workers' Compensation Law provides for civil penalties, court fines and/or imprisonment. The undersigned employer hereby gives notice of compliance with all provisions of the Workers' Compensation Law and Administrative Regulations. NAME OF INSURANCE COMPANY: THE TRAVELERS INSURANCE COMPANY NAME OF EMPLOYER: By THE TOBACCO INSTITUTE EMPLOYER l.d. NUMBER (If number unknown, employer to request from IRS.) THIS NOTICE TO BE POSTED CONSPICUOUSLY IN AND ABOUT EMPLOYER'S PLACE(S) OF BUSINESSS. FC=V to i CC.VC 1,V0B D 1G93 T11433'

20 Hodge, Hart & Associates, fee Concord Street.' Kensington, Maryland (301) FAX; (301)

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