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Workers' Compensation History

Contractor License #	374770
Contractor Name	JACK D OLSON DESIGN & CONSTRUCTION CO

Workers' Compensation History

Insurance Company EXEMPT Policy # Effective Date 04/10/2023 Expiration Date

Insurance Company EXEMPT Policy # Effective Date 03/26/2021 Expiration Date 04/10/2023

Insurance Company EXEMPT Policy # Effective Date 03/25/2019 Expiration Date 03/26/2021

Insurance Company EXEMPT Policy # Effective Date 04/03/2017 Expiration Date 03/25/2019

Insurance Company EXEMPT Policy # Effective Date 04/15/2015 Expiration Date 04/03/2017

Insurance Company EXEMPT Policy # Effective Date 04/03/2013 Expiration Date 04/15/2015

Insurance Company EXEMPT Policy # Effective Date 07/22/2002 Expiration Date 04/03/2013

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 1183923 Effective Date 04/01/1992 Cancellation Date 06/12/2002