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Workers' Compensation History

Contractor License #	996198
Contractor Name	INNSTONE INC

Workers' Compensation History

Insurance Company SERVICE AMERICAN INDEMNITY COMPANY Policy # SATIS0498601 Effective Date 05/07/2023 Expiration Date 05/07/2024

Insurance Company SERVICE AMERICAN INDEMNITY COMPANY Policy # SATIS0498600 Effective Date 05/07/2022 Expiration Date 05/07/2023

Insurance Company SECURITY NATIONAL INSURANCE COMPANY Policy # SWC1342200 Effective Date 05/07/2021 Expiration Date 05/07/2022

Insurance Company SECURITY NATIONAL INSURANCE COMPANY Policy # SWC1291734 Effective Date 05/07/2020 Expiration Date 05/07/2021

Insurance Company SECURITY NATIONAL INSURANCE COMPANY Policy # SWC1242280 Effective Date 05/07/2019 Expiration Date 05/07/2020

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9158507 Effective Date 05/07/2016 Cancellation Date 05/07/2019

Insurance Company EXEMPT Policy # Effective Date 08/19/2014 Expiration Date