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Workers' Compensation History

Contractor License #	960994
Contractor Name	TAHOE MOLD AND WATER INC

Workers' Compensation History

Insurance Company NATIONAL LIABILITY AND FIRE INSURANCE COMPANY Policy # A9WC408388 Effective Date 06/01/2023 Expiration Date 06/01/2024

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9099936 Effective Date 06/01/2014 Cancellation Date 06/01/2023

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 431-509252 Effective Date 06/01/2013 Expiration Date 06/01/2014

Insurance Company WILLIAMSBURG NATIONAL INSURANCE COMPANY Policy # WC0670193 Effective Date 06/01/2012 Expiration Date 06/01/2013

Insurance Company WILLIAMSBURG NATIONAL INSURANCE COMPANY Policy # WC0670193 Effective Date 06/01/2011 Expiration Date 06/01/2012

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 713-0033991 Effective Date 06/29/2010 Cancellation Date 06/01/2011