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Workers' Compensation History

Contractor License #	667951
Contractor Name	BLISS DESIGN BUILD LLC

Workers' Compensation History

Insurance Company PALOMAR SPECIALTY INSURANCE COMPANY Policy # PSIC10141 Effective Date 07/23/2023 Expiration Date 07/23/2024

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON1014103 Effective Date 07/23/2022 Expiration Date 07/23/2023

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON10141 Effective Date 07/23/2021 Expiration Date 07/23/2022

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON1014101 Effective Date 07/23/2020 Expiration Date 07/23/2021

Insurance Company SIRIUSPOINT AMERICA INSURANCE COMPANY Policy # WC16103 Effective Date 07/23/2019 Expiration Date 07/23/2020

Insurance Company NORGUARD INSURANCE COMPANY Policy # BLWC955893 Effective Date 07/23/2017 Expiration Date 07/23/2019

Insurance Company NORGUARD INSURANCE COMPANY Policy # SAWC807387 Effective Date 07/23/2017 Expiration Date 07/23/2018

Insurance Company NORGUARD INSURANCE COMPANY Policy # SAWC728738 Effective Date 07/23/2016 Expiration Date 07/23/2017

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9048452 Effective Date 03/12/2013 Cancellation Date 08/29/2016

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 1955269 Effective Date 07/23/2010 Cancellation Date 02/04/2013