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Workers' Compensation History

Contractor License #	976476
Contractor Name	GOMEZ A CONSTRUCTION INC

Workers' Compensation History

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9354866 Effective Date 02/27/2024 Expiration Date 02/27/2025

Insurance Company FALLS LAKE FIRE AND CASUALTY COMPANY Policy # FLA015603 Effective Date 11/01/2022 Cancellation Date 05/24/2023

Insurance Company FALLS LAKE FIRE AND CASUALTY COMPANY Policy # FLA01560301 Effective Date 11/01/2021 Expiration Date 11/01/2022

Insurance Company FALLS LAKE FIRE AND CASUALTY COMPANY Policy # FLA01560300 Effective Date 11/01/2020 Expiration Date 11/01/2021

Insurance Company BENCHMARK INSURANCE COMPANY Policy # CST5017725 Effective Date 11/01/2019 Expiration Date 11/01/2020

Insurance Company EXEMPT Policy # Effective Date 08/31/2018 Expiration Date

Insurance Company EXEMPT Policy # Effective Date 02/27/2018 Expiration Date 08/31/2018

Insurance Company STATE COMPENSATION INSURANCE FUND Policy # 9214800 Effective Date 07/22/2017 Cancellation Date 11/13/2017

Insurance Company EVEREST NATIONAL INSURANCE COMPANY Policy # 7600016602 Effective Date 07/22/2016 Cancellation Date 06/17/2017

Insurance Company NORGUARD INSURANCE COMPANY Policy # GOWC650885 Effective Date 07/22/2015 Expiration Date 07/22/2016