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Workers' Compensation History

Contractor License #	924418
Contractor Name	BLACK CREEK BUILDERS INC

Workers' Compensation History

Insurance Company PALOMAR SPECIALTY INSURANCE COMPANY Policy # PSIC0879406 Effective Date 02/01/2024 Expiration Date 02/01/2025

Insurance Company PALOMAR SPECIALTY INSURANCE COMPANY Policy # PSIC0879405 Effective Date 02/01/2023 Expiration Date 02/01/2024

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON0879404 Effective Date 02/01/2022 Expiration Date 02/01/2023

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON0879403 Effective Date 02/01/2021 Expiration Date 02/01/2022

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON0879402 Effective Date 02/01/2020 Expiration Date 02/01/2021

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON0879401 Effective Date 02/01/2019 Expiration Date 02/01/2020

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON0855001 Effective Date 07/27/2018 Expiration Date 07/27/2019

Insurance Company PREFERRED PROFESSIONAL INSURANCE COMPANY Policy # ON0855001 Effective Date 07/20/2018 Expiration Date 07/20/2019

Insurance Company AN EMPLOYEE SERVICE GROUP HOLDS THE INSURANCE Policy # RWCC65175964 Effective Date 02/01/2018 Expiration Date 02/01/2019

Insurance Company AN EMPLOYEE SERVICE GROUP HOLDS THE INSURANCE Policy # RWCC64373377 Effective Date 02/01/2017 Cancellation Date 02/01/2018