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Workers' Compensation History

Contractor License #	494071
Contractor Name	KGM CONSTRUCTION

Workers' Compensation History

Insurance Company AN EMPLOYEE SERVICE GROUP HOLDS THE INSURANCE Policy # C5553889 Effective Date 08/01/2023 Expiration Date 08/01/2024

Insurance Company AN EMPLOYEE SERVICE GROUP HOLDS THE INSURANCE Policy # C51254399 Effective Date 08/01/2022 Expiration Date 08/01/2023

Insurance Company AN EMPLOYEE SERVICE GROUP HOLDS THE INSURANCE Policy # C69969823 Effective Date 08/01/2021 Expiration Date 08/01/2022

Insurance Company ACE AMERICAN INSURANCE COMPANY Policy # C68618666 Effective Date 08/01/2020 Expiration Date 08/01/2021

Insurance Company AN EMPLOYEE SERVICE GROUP HOLDS THE INSURANCE Policy # C68618666 Effective Date 08/01/2020 Expiration Date 08/01/2021

Insurance Company ACE AMERICAN INSURANCE COMPANY Policy # C66365414 Effective Date 08/23/2019 Expiration Date 08/23/2020

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9129172 Effective Date 03/31/2015 Cancellation Date 08/23/2019

Insurance Company EXEMPT Policy # Effective Date 05/12/2014 Expiration Date

Insurance Company AN EMPLOYEE SERVICE GROUP HOLDS THE INSURANCE Policy # WC025052594 Effective Date 05/01/2013 Expiration Date 05/01/2014

Insurance Company EXEMPT Policy # Effective Date 07/31/2013 Expiration Date