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Workers' Compensation History

Contractor License #	1054694
Contractor Name	ADOLFO RAMOS PORTILLO

Workers' Compensation History

Insurance Company INSURANCE COMPANY OF THE WEST Policy # WSD506578200 Effective Date 05/25/2022 Expiration Date 05/25/2023

Insurance Company FALLS LAKE FIRE AND CASUALTY COMPANY Policy # FLA017132 Effective Date 05/25/2021 Expiration Date 05/25/2022

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9254495 Effective Date 05/25/2019 Expiration Date 05/25/2021