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Workers' Compensation History

Contractor License #	409618
Contractor Name	BLACKTOP PAVING

Workers' Compensation History

Insurance Company INSURANCE COMPANY OF THE WEST Policy # WSA507198400 Effective Date 07/01/2023 Expiration Date 07/01/2024

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON0902304 Effective Date 07/01/2022 Expiration Date 07/01/2023

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON0902303 Effective Date 07/01/2021 Expiration Date 07/01/2022

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON0902302 Effective Date 07/01/2020 Expiration Date 07/01/2021

Insurance Company AN EMPLOYEE SERVICE GROUP HOLDS THE INSURANCE Policy # C66355548 Effective Date 07/01/2019 Expiration Date 07/01/2020

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON0902301 Effective Date 07/01/2019 Expiration Date 07/01/2020

Insurance Company ACE AMERICAN INSURANCE COMPANY Policy # RWCC65193048 Effective Date 07/01/2018 Cancellation Date 07/01/2019

Insurance Company AN EMPLOYEE SERVICE GROUP HOLDS THE INSURANCE Policy # RWCC64391112 Effective Date 07/13/2017 Expiration Date 07/01/2018

Insurance Company EVEREST NATIONAL INSURANCE COMPANY Policy # 7690000129 Effective Date 07/13/2014 Expiration Date 07/13/2017

Insurance Company HARTFORD CASUALTY INSURANCE COMPANY Policy # 53WECDZ5679 Effective Date 07/13/2013 Expiration Date 07/13/2014