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Workers' Compensation History

Contractor License #	384852
Contractor Name	NANCY SMITH CONSTRUCTION INC

Workers' Compensation History

Insurance Company EXEMPT Policy # Effective Date 11/06/2023 Expiration Date

Insurance Company EXEMPT Policy # Effective Date 09/29/2021 Expiration Date 11/06/2023

Insurance Company EXEMPT Policy # Effective Date 09/30/2019 Expiration Date 09/29/2021

Insurance Company EXEMPT Policy # Effective Date 04/21/2018 Expiration Date 09/30/2019

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9207923 Effective Date 04/01/2017 Cancellation Date 04/01/2018

Insurance Company ZURICH AMERICAN INSURANCE COMPANY Policy # WC0192015 Effective Date 04/01/2016 Expiration Date 04/01/2017

Insurance Company AMERICAN ZURICH INSURANCE COMPANY Policy # WC019201500 Effective Date 04/01/2016 Expiration Date 04/01/2017

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9128606 Effective Date 04/01/2015 Expiration Date 04/01/2016

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 8250510580 Effective Date 04/01/2014 Expiration Date 04/01/2015

Insurance Company CYPRESS INSURANCE COMPANY Policy # 3300061071131 Effective Date 04/01/2013 Expiration Date 04/01/2014