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Workers' Compensation History

Contractor License #	900450
Contractor Name	TIMBERLINE

Workers' Compensation History

Insurance Company INSURANCE COMPANY OF THE WEST Policy # WLV507146900 Effective Date 06/01/2023 Expiration Date 06/01/2024

Insurance Company SERVICE AMERICAN INDEMNITY COMPANY Policy # SAMTWC10001800 Effective Date 06/01/2022 Expiration Date 06/01/2023

Insurance Company EVEREST NATIONAL INSURANCE COMPANY Policy # 7600022441211 Effective Date 06/01/2021 Expiration Date 06/01/2022

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9221569 Effective Date 11/20/2017 Cancellation Date 06/01/2021

Insurance Company EVEREST NATIONAL INSURANCE COMPANY Policy # 760017728171 Effective Date 06/01/2017 Cancellation Date 11/21/2017

Insurance Company CALIFORNIA INSURANCE COMPANY Policy # 4633618001 Effective Date 06/01/2016 Cancellation Date 06/01/2017

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9133677 Effective Date 06/01/2015 Cancellation Date 06/01/2016

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 3990509125 Effective Date 06/01/2014 Expiration Date 06/01/2015

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 399-0509125 Effective Date 06/01/2014 Cancellation Date 05/29/2015

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 399509125 Effective Date 06/01/2013 Expiration Date 06/01/2014