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Workers' Compensation History

Contractor License #	436951
Contractor Name	D L R CUSTOM BUILDERS

Workers' Compensation History

Insurance Company INSURANCE COMPANY OF THE WEST Policy # WSA507470200 Effective Date 12/17/2023 Expiration Date 12/17/2024

Insurance Company PALOMAR SPECIALTY INSURANCE COMPANY Policy # PSIC1214702 Effective Date 12/17/2022 Expiration Date 12/17/2023

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON1214701 Effective Date 12/17/2021 Expiration Date 12/17/2022

Insurance Company FALLS LAKE FIRE AND CASUALTY COMPANY Policy # FLA01044602 Effective Date 12/17/2020 Expiration Date 12/17/2021

Insurance Company FALLS LAKE FIRE AND CASUALTY COMPANY Policy # FLA01044600 Effective Date 12/17/2018 Expiration Date 12/17/2020

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9063288 Effective Date 06/28/2013 Cancellation Date 03/05/2019

Insurance Company EXEMPT Policy # Effective Date 03/25/2013 Expiration Date

Insurance Company EXEMPT Policy # Effective Date 07/07/2011 Expiration Date 03/25/2013

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 713-0015071 Effective Date 10/01/2005 Cancellation Date 02/16/2011

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 1600226 Effective Date 10/07/2000 Cancellation Date 10/01/2005