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Workers' Compensation History

Contractor License #	737538
Contractor Name	LEE TOLLEFSRUD

Workers' Compensation History

Insurance Company EXEMPT Policy # Effective Date 01/04/2021 Expiration Date

Insurance Company EXEMPT Policy # Effective Date 01/16/2019 Expiration Date 01/04/2021

Insurance Company EXEMPT Policy # Effective Date 01/25/2017 Expiration Date 01/16/2019

Insurance Company EXEMPT Policy # Effective Date 12/24/2014 Expiration Date 01/25/2017

Insurance Company EXEMPT Policy # Effective Date 02/15/2011 Expiration Date 12/24/2014

Insurance Company EXEMPT Policy # Effective Date 07/07/2006 Expiration Date

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 1761373 Effective Date 11/10/2003 Expiration Date 11/10/2004

Insurance Company EXEMPT Policy # Effective Date 11/30/1999 Expiration Date 11/10/2003

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 1533184 Effective Date 08/21/1998 Cancellation Date 08/01/1999

Insurance Company EXEMPT Policy # Effective Date 06/03/1997 Expiration Date 08/21/1998