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Workers' Compensation History

Contractor License #	960382
Contractor Name	MERCURYBOX INC

Workers' Compensation History

Insurance Company BENCHMARK INSURANCE COMPANY Policy # CST5026462 Effective Date 12/15/2023 Expiration Date 12/15/2024

Insurance Company BENCHMARK INSURANCE COMPANY Policy # CST5024707 Effective Date 12/15/2022 Expiration Date 12/15/2023

Insurance Company CLEAR SPRING PROPERTY AND CASUALTY COMPANY Policy # CWC01055000 Effective Date 08/10/2022 Expiration Date 08/10/2023

Insurance Company FALLS LAKE FIRE AND CASUALTY COMPANY Policy # FLA006811 Effective Date 08/10/2021 Expiration Date 08/10/2022

Insurance Company FALLS LAKE FIRE AND CASUALTY COMPANY Policy # FLA00681103 Effective Date 08/10/2020 Expiration Date 08/10/2021

Insurance Company FALLS LAKE FIRE AND CASUALTY COMPANY Policy # FLA006811 Effective Date 08/10/2017 Expiration Date 08/10/2020

Insurance Company GRANITE STATE INSURANCE COMPANY Policy # WC020736038 Effective Date 08/10/2015 Expiration Date 08/10/2017

Insurance Company EXEMPT Policy # Effective Date 08/12/2015 Expiration Date

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9124503 Effective Date 03/26/2015 Cancellation Date 06/25/2015

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9124503 Effective Date 02/10/2015 Expiration Date 03/26/2015