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Workers' Compensation History

Contractor License #	807242
Contractor Name	JNL DEVELOPMENT INC

Workers' Compensation History

Insurance Company EXEMPT Policy # Effective Date 06/11/2012 Expiration Date

Insurance Company AN EMPLOYEE SERVICE GROUP HOLDS THE INSURANCE Policy # WC475868800 Effective Date 06/20/2011 Expiration Date 06/01/2012

Insurance Company WILLIAMSBURG NATIONAL INSURANCE COMPANY Policy # WC0461404 Effective Date 02/05/2011 Expiration Date 02/05/2012

Insurance Company STAR INSURANCE COMPANY Policy # WC0461404 Effective Date 02/05/2010 Expiration Date 02/05/2011

Insurance Company STAR INSURANCE COMPANY Policy # WC0461404 Effective Date 02/05/2009 Expiration Date 02/05/2010

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 238-0005700 Effective Date 01/01/2008 Cancellation Date 02/05/2009

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 3010012 Effective Date 01/01/2008 Expiration Date 01/01/2009

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 046-0015163 Effective Date 01/01/2005 Cancellation Date 01/01/2008

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 1711869 Effective Date 01/01/2004 Cancellation Date 01/01/2005

Insurance Company EXEMPT Policy # Effective Date 09/06/2002 Expiration Date