AR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 2 Assigned Risk Renewals: October/November/December

Michigan Workers Compensation Placement Facility Depopulation Report Page 1 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge EMERSON GEOPHYSICAL LLC ACME 5066565A 2,755 12/20/2021 8601 1.00 BA VENTURES LLC ADA 6072330A 2,689 11/8/2021 9402 FUNNY BUSINESS AGENCY INC ADA 2464470A 830 10/25/2021 8742 0.95 JUNGLE SURVIVAL DRIVERS TRAINING LLC ADA 5003229A 1,228 10/28/2021 8868 0.95 MAKUSKI BUILDERS INC ADA 3236854A 750 10/25/2021 5645 RAM CREATIVE LLC ADA 5732875A 353 10/15/2021 8601 RED MAPLE ROOFING INC ADA 6284590A 800 12/19/2021 5551 ROLLING GREY ADA 5774233A 313 11/3/2021 8601 ROOF SEAL LLC ADA 6051880A 750 10/5/2021 5551 VAN DYKE MATTHEW ADA 5928729A 307 10/27/2021 0908 FIX ER UP CONSTRUCTION LLC ADRAIN 5638127A 3,951 10/10/2021 5645 CLEAR VIEW WINDOWS INC ADRIAN 3383822A 763 11/27/2021 8742 LENAWEE DEVELOPMENT CORP ADRIAN 3631710A 2,277 11/11/2021 9052 0.95 MAPLE CITY GYMNASTICS CENTER LLC ADRIAN 2020262A 1,011 12/29/2021 9063 METCAN USA CORPORATION ADRIAN 5280877A 7,821 12/31/2021 1748 0.91 PHENICIES ENTERPRISES LLC ADRIAN 6255582A 1,187 10/7/2021 5221 RUTTKOFSKY BUILDERS INC ADRIAN 3456218A 750 11/18/2021 5645 SHARE THE WARMTH ADRIAN 5930995A 737 11/2/2021 9052 WALLICH CONSTRUCTION COMPANY ADRIAN 2272822A 4,809 11/30/2021 5437 0.95 SHAUN HOPE ENTERPRISES LLC AFTON 4821491A 1,500 12/14/2021 0042 0.95 WILSONS DRYWALL AFTON 2840294A 750 11/3/2021 5445 0.95 DASHBOARD CONTRACTORS ALANSON 5929717A 833 11/2/2021 9015 ZEKELMAN ALAN ALBANY, NY 5941423A 637 12/1/2021 0908 LONG HAUL PRODUCTIONS INC ALBERTVILLE, MN 5632269A 446 12/14/2021 7610 STOWELL N SONS ALBION 6077897A 800 11/21/2021 5551 ARNOLD SCOT ALEXANDRA, VA 6276385A 1,026 11/20/2021 9015 CAPTAIN SALS MARINE SERVICE LLC ALGONAC 6253652A 515 10/1/2021 8387 CHAMPIONS AUTO FERRY INC ALGONAC 0318116A 2,680 12/31/2021 6826 0.95 DISCOUNT PEST CONTROL LLC ALGONAC 5984114A 613 10/8/2021 9015 WEATHER PROOF WINDOW & DOOR CO INC ALGONAC 0216186A 800 11/3/2021 5645 AGRI EQUIPMENT SERVICE INC ALLEGAN 2490536A 11,507 12/7/2021 3724 0.84 IDEMA RICK ALLEGAN 6265278A 750 10/28/2021 5645 KUGELARD CONSTRUCTION LLC ALLEGAN 5670489A 338 12/5/2021 5606 1.29 13 % LOMAXX ROOF REPAIR LLC ALLEGAN 5941369A 750 12/1/2021 5551 STRABBING STORM RESTORATION LLC ALLEGAN 6001718A 750 11/5/2021 5437 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 2 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ASTALOS LUXURY FLOOR COATINGS LLC ALLEN PARK 6138411A 906 10/3/2021 5221 BOLT REPAIR COMPANY ALLEN PARK 5198631A 1,838 10/24/2021 7208 0.95 LAURA A KOZLOWSKI INSURANCE AGENCY INC ALLEN PARK 4857437A 346 10/18/2021 8810 LIBERATI AND SONS CONSTRUCTION INC ALLEN PARK 3708705A 825 10/29/2021 5022 PRO UNDER PRESSURE CLEANING LLC ALLEN PARK 5743257A 643 11/13/2021 9015 PROGRESSIVE REAL ESTATE LLC ALLEN PARK 5788331A 917 11/28/2021 5606 SEAL WELD LLC ALLEN PARK 5795958A 2,392 12/12/2021 3365 0.95 TODD FELT INC ALLEN PARK 2269465A 2,099 12/29/2021 5445 1.00 TOTALLY AFFORDABLE SEAMLESS GUTTERS INC ALLEN PARK 2859637A 781 12/13/2021 5538 BAUGHER JONATHON M ALLENDALE 5901898A 750 10/3/2021 5645 BERENS DRYWALL INC ALLENDALE 2070162A 750 11/5/2021 5445 CAIN JACOB ALLENDALE 5902053A 750 12/13/2021 5645 ELYSIAN BUILDERS LLC ALLENDALE 5607086A 1,025 11/28/2021 5645 GUARANTEED APPLIANCE REPAIRS ALLENDALE 4221230A 769 10/22/2021 9519 HOMEWORK SERVICES INC ALLENDALE 4276779A 470 10/17/2021 5190 J AND J INSULATING LLC ALLENDALE 5937760A 2,946 11/29/2021 5479 0.95 LAKE EFFECT SNOWPLOWING LLC ALLENDALE 4706560A 739 12/2/2021 9402 0.95 MACS HEATING & COOLING INC ALLENDALE 4276175A 674 10/17/2021 5550 MIKE KUIPERS DRYWALL LLC ALLENDALE 2740737A 750 10/8/2021 5445 MORREN MOLD & MACHINE INC ALLENDALE 5753147A 788 10/12/2021 4484 TIMBER CREEK LLC ALLENDALE 5578515A 750 12/3/2021 5645 0.95 VRUGGINK GORDON ALLENDALE 6054200A 739 12/4/2021 6217 JAMES DZIESZKOWSKI LLC ALLENTON 2589508A 481 11/22/2021 8395 OASIS IRRIGATION & LIGHTING SYSTEMS INC ALLENTON 3051595A 1,234 11/7/2021 5190 JOHN CLARK TRUCKING LLC ALMA 6275281A 750 11/18/2021 7208 LOTT BUILDERS LLC ALMA 3851354A 2,662 11/6/2021 5645 0.95 SAFETY FIRST SECURITY SERVICES LLC ALMA 4150449A 499 11/13/2021 7720 SEVEN STAR PARTY STORE ALMA 6067212A 795 10/29/2021 8017 BC ROOFING & REMODELING LLC ALMONT 5942063A 750 12/4/2021 5437 TRI COUNTY PLUMBING & MECHANICAL INC ALMONT 6072208A 636 11/7/2021 5183 APR STEEL INC ALPENA 2026058A 9,798 10/9/2021 5538 1.38 13 % B AND J YOUNG INC ALPENA 3177769A 842 11/30/2021 8017 0.95 FITZS CARPET SERVICE ALPENA 6275265A 590 11/18/2021 9521 MEM NORTHERN PROPERTIES & RENOVATIONS ALPENA 6264433A 961 12/8/2021 5437 LLC

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 3 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SPEEDY BLAZE PRODUCTS LLC ALPENA 6251633A 2,439 10/8/2021 2841 TONYS TREE & YARD SERVICE ALPENA 5072719A 750 10/6/2021 0106 BLUE SKY LOGISTICS INC ALTO 5947936A 750 12/28/2021 7208 EDGAR HOME IMPROVEMENT LLC ALTO 6254462A 750 10/9/2021 5645 ZOOK FARM EQUIPMENT INC ALTO 2807173A 61,979 12/31/2021 5538 1.16 SOUTHERN MICHIGAN GYMNASTICS & FITNESS ANGOLA, IN 2492121A 353 11/17/2021 9063 CENTER LLC ADAMS TREE SERVICE LLC ANN ARBOR 3063801A 751 12/4/2021 0042 0.95 ADVANCED ENVIRO CLEAN LLC ANN ARBOR 6273718A 2,707 11/12/2021 9015 ALBIN OWEN ANN ARBOR 6253636A 307 10/1/2021 0908 ANN ARBOR ASPHALT AND CONCRETE PAVING ANN ARBOR 5177839A 2,080 11/15/2021 5221 1.00 LLC AUBREES FLAGSTAR LLC ANN ARBOR 5346886A 464 11/22/2021 8810 BISHARA SARAH ANN ARBOR 5947111A 910 12/18/2021 0913 CLARKCONSULTS LLC ANN ARBOR 5338182A 313 11/1/2021 8601 COMMUNITY MENTAL HEALTH PARTNERSHIP OF ANN ARBOR 5339189A 2,277 11/4/2021 8810 0.95 SOUTHEAST MICHIGAN CONTINENTAL WHOLESALE INC ANN ARBOR 5828155A 753 10/30/2021 8810 EXECUTIVE PAINTING SERVICES LLC ANN ARBOR 4497309A 1,849 10/24/2021 5476 FULL LIFE INDEPENDENCE LLC ANN ARBOR 5930162A 2,849 11/1/2021 8835 0.95 GILAD MARCIA ANN ARBOR 6266479A 307 11/2/2021 0908 GILAD YOAV ANN ARBOR 6266487A 307 11/2/2021 0908 I DRINK PRODUCTS INC ANN ARBOR 5330203A 569 10/20/2021 8018 INNOVATIVE SOLUTIONS TECHNOLOGIES ANN ARBOR 4641299A 2,671 12/21/2021 4558 0.95 JDP MANAGEMENT LLC ANN ARBOR 3416232A 666 11/3/2021 9015 JOYWORKS LLC ANN ARBOR 5213770A 601 10/7/2021 3081 KARIN AND COMPANY SALON LLC ANN ARBOR 6274323A 959 11/14/2021 9586 KB LANDSCAPE LLC ANN ARBOR 6284604A 2,544 12/21/2021 0042 KRULL ENTERPRISES LLC ANN ARBOR 6088147A 5,466 12/27/2021 9015 KRZYZANIAK EXCAVATING INC ANN ARBOR 1165364A 789 11/15/2021 6217 LABH ENTERPRISE INC ANN ARBOR 3415074A 1,462 12/3/2021 8017 1.00 M AND P CONSTRUCTION INC ANN ARBOR 3333396A 898 11/1/2021 8810 MAPLE VILLAGE SALINE CONDOMINIUM ANN ARBOR 5200741A 1,424 10/18/2021 9015 0.95 ASSOCIATION MENOMINEE OPERA HOUSE COMMITTEE INC ANN ARBOR 5340624A 349 11/6/2021 9154 MICHIGAN LEARNING COMMUNITY LLC ANN ARBOR 6274170A 793 11/14/2021 8835

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 4 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MICHIGAN MUTUAL AID BOX ALARM SYSTEM ANN ARBOR 5335302A 6,937 11/20/2021 7704 0.93 ASSOCIATION MOBILE AUTO TRIM INC ANN ARBOR 2207230A 496 12/5/2021 8810 MTRI INC ANN ARBOR 6074812A 864 12/3/2021 4361 MUSKOVITZ MELVIN ANN ARBOR 2180987A 307 11/2/2021 0908 OUR HOUSE ANN ARBOR 5913900A 502 11/29/2021 8832 PALMER AND JOY PROPERTY PRESERVATION ANN ARBOR 6273645A 618 11/19/2021 9015 LLC PAULS PLUMBING SERVICES LLC ANN ARBOR 6285651A 983 12/24/2021 5183 PAYZANT FREDERICK ANN ARBOR 2606550A 750 11/14/2021 5221 PHOTOCAD LLC ANN ARBOR 5269245A 797 11/9/2021 8017 RYAN CHRISTOPHER ANN ARBOR 5343771A 530 12/29/2021 0913 SERGE VAN DER VOO LANDSCAPES LLC ANN ARBOR 5481325A 288 11/19/2021 8601 SNOW X INC ANN ARBOR 0277983A 4,122 11/18/2021 9402 0.93 SPECTRUM THERAPY CENTER INC ANN ARBOR 5186668A 4,373 11/20/2021 8832 0.95 STATE THEATER CONDOMINIUM ASSOCIATION ANN ARBOR 6284566A 643 12/22/2021 9015 STATEWIDE TOWING AND RECOVERY MICHIGAN ANN ARBOR 5943019A 750 12/8/2021 7208 LLC TONYS ROOF REPAIR LLC ANN ARBOR 2906287A 750 10/24/2021 5645 VANFOSSEN MARCIA ANN ARBOR 6052789A 307 10/8/2021 0908 WALNUT RIDGE CONDOMINIUM ASSOCIATION INC ANN ARBOR 3964027A 568 10/21/2021 9015 WASHTENAW CONTRACTORS ASSN ANN ARBOR 0703834A 215 12/12/2021 8810 WORKFORCE CONTINGENT STAFFING INC ANN ARBOR 5142512A 454 10/24/2021 3629 SVARE ENGINEERING GROUP LLC ANOKA, MN 5079047A 2,289 11/18/2021 8720 0.95 ARCADIA TOWNSHIP OF MANISTEE COUNTY ARCADIA 0288950A 2,407 11/27/2021 7704 0.95 CERTIFIED PLUS STAFFING ARMADA 4510747A 768 12/23/2021 8810 1.33 13 % CORNERSTONE FLOORS LLC ARMADA 3456315A 750 12/4/2021 5437 GONZALEZ JOSE ARMADA 5723345A 598 11/7/2021 9102 LUANS WELDING AND STEEL COATING LLC ARMADA 4988035A 2,937 10/3/2021 3365 0.95 NORTHERN LIGHTS DECORATING LLC ARMADA 5630533A 470 11/1/2021 5190 USHER LOGGING LLC ARNOLD 2330652A 750 10/9/2021 7208 0.95 JL MEYERS TRUCKING LLC ASHLEY 6275206A 750 11/18/2021 7208 ZAMARRON JEREMY ASHLEY 4719336A 750 11/16/2021 2702 SUSANS ROADSIDE DINER ATLANTA 5580625A 653 12/19/2021 9058 TRI TOWNSHIP FIRE DEPARTMENT ATLANTA 2465540A 1,062 11/3/2021 7704 0.95 COPONEN DUANE ATLANTIC MINE 3960064A 750 12/7/2021 5645 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 5 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ROBERTS PLUMBING INC ATLAS 1240021A 562 12/14/2021 8742 0.95 THOMAS SANFORD & ASSOCIATES ATLAS 4904168A 618 10/23/2021 9015 ROUGH TERRAIN EQUIPMENT REPAIR LLC ATTICA 5941490A 1,082 12/1/2021 8116 C 2 J VENTURES LLC AUBURN 6279228A 794 12/3/2021 9519 COUNTRY SQUARE ADULT FOSTER CARE LLC AUBURN 4758633A 1,931 12/10/2021 8835 0.95 SKYLINE MIDWEST CONSTRUCTION LLC AUBURN 5862892A 751 11/17/2021 5403 AUTUMN DAYS BAGS & ACCESSORIES LLC AUBURN HILLS 5206120A 409 11/1/2021 8008 CEE PEE INDUSTRIES LLC AUBURN HILLS 6069215A 18,090 11/8/2021 0035 EQ GROUNDS LLC AUBURN HILLS 5603420A 598 10/1/2021 9102 0.95 EVOLUTION SPORTSPLEX LLC AUBURN HILLS 4987705A 1,369 10/7/2021 9015 0.95 KF HANDYMAN LLC AUBURN HILLS 5887763A 1,754 12/19/2021 5476 LAPEER BP INC AUBURN HILLS 2785340J 938 10/3/2021 8017 0.90 LEGACY WOODS OF WEST BLOOMFIELD AUBURN HILLS 5945305A 568 12/14/2021 9015 CONDOMINIUM ASSOCIATION M DECKER CONSTRUCTION LLC AUBURN HILLS 5333032A 2,325 10/22/2021 5348 0.95 SCRIPPS LAKEVIEW ASSOCIATION AUBURN HILLS 0104159A 568 10/21/2021 9015 TRILLIUM COMPANIES INC AUBURN HILLS 3142027A 4,461 12/3/2021 5645 1.00 UNIVERSITY TITLE AGENCY LLC AUBURN HILLS 6022065A 553 10/9/2021 8810 AUGRES SIMS WHITNEY FIRE & RESCUE AUGRES 0652288A 2,193 11/9/2021 7704 0.95 AUTHORITY ABEL TREE SERVICE LLC AUGUSTA 6284744A 3,176 12/21/2021 0106 LONG HOME IMPROVEMENT LLC AUGUSTA 4775805A 1,509 11/18/2021 5437 KGDR CONSULTANTS INC AURORA, IL 6258735A 346 11/6/2021 8601 UNIVERSITY PHYSICIANS INC AURORA, CO 6284175A 241 12/17/2021 8868 ONE FRISBEE LLC AUSTIN, TX 5649889A 1,691 12/1/2021 9058 0.95 SOPHA FARMS UNDERGROUND MAINTENANCE AVOCA 3380165A 739 12/3/2021 6217 ERRER FARMS SNOW REMOVAL LLC BAD AXE 0936952A 942 10/1/2021 9402 THUMB ONE MOVING INC BAD AXE 4753712A 978 11/9/2021 7214 MUDMAN CONSTRUCTION PLLC BANCROFT 3802264A 1,642 10/3/2021 5221 0.95 TWIN DOVES AFC BANGOR 5639247A 4,134 11/18/2021 9053 0.95 BARAGA PLAINS COMPANY INC BARAGA 2948265A 750 12/7/2021 2702 SHAWNS CUSTOM FIREWOOD PROCESSING LLC BARAGA 3833720A 1,545 12/16/2021 8232 ADAMS SAMUEL BARK RIVER 6088180A 750 12/20/2021 2709 MLOSTEK CHRIS BARK RIVER 6286046A 750 12/29/2021 7208 ROCKET HOMES LLC BARK RIVER 5771382A 750 12/5/2021 5645

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ZAWACKI TRUCKING BARK RIVER 3086046A 750 11/13/2021 7208 BACK 2 BACK TRUCKING LLC BARRYTON 6089372A 750 12/31/2021 7208 EXTREME TRUCKING USA LLC BARRYTON 2713985A 750 11/28/2021 7208 PRECISION WELDING & MACHINE REPAIR LLC BARRYTON 3380033A 2,515 12/7/2021 3724 0.95 HINK TRANSPORT BARTON CITY 6285341A 750 12/23/2021 7208 VAIL CONSTRUCTION BATH 3084671A 750 10/30/2021 5437 ABSOLUTE FLOORING LLC BATTLE CREEK 5024617A 825 12/19/2021 5437 0.95 B AND B FLEET & AUTOMOTIVE INC BATTLE CREEK 3675645A 1,413 12/24/2021 8395 0.95 BATTLE CREEK EXTERIORS LLC BATTLE CREEK 6276776A 751 12/5/2021 5645 BOLES TREE SERVICE INC BATTLE CREEK 3325318A 5,135 11/13/2021 0106 0.93 BRANCH GYMNASTICS & PHYSICAL BATTLE CREEK 0712990A 8,328 11/2/2021 9063 0.86 DEVELOPMENT INC COLUMBIA SUNSHINE LLC BATTLE CREEK 4762843A 286 12/9/2021 9586 CREEK VALLEY DEVELOPMENT CO BATTLE CREEK 0279412A 980 10/11/2021 9015 0.95 ENCHANTING LIGHTS LLC BATTLE CREEK 6249817A 1,068 10/1/2021 5190 HOTS INC BATTLE CREEK 4403924A 4,018 10/6/2021 9058 1.00 INFINITY AFC LLC BATTLE CREEK 6122663A 2,708 11/5/2021 9053 LA COCINA MEXICANA INC BATTLE CREEK 3994651A 4,037 11/2/2021 9058 0.95 LARNER CONSTRUCTION & REMODELING BATTLE CREEK 1737368A 1,212 11/1/2021 5645 METZGER SAWMILL BATTLE CREEK 2517221A 3,654 11/2/2021 2759 MICHIGAN SENIOR CARE LIVING LLC BATTLE CREEK 2801493A 1,941 12/13/2021 9053 1.00 MOUNTAIN TOP INSTALLATION COMPANY LLC BATTLE CREEK 6256260A 615 10/8/2021 9521 ONE HOUR MARTINIZING OF BATTLE CREEK LLC BATTLE CREEK 5462460A 1,753 10/12/2021 8017 0.95 REGION 3B AREA AGENCY ON AGING BATTLE CREEK 2564734A 13,602 12/9/2021 9063 1.43 40 % RONS ROOFING LLC BATTLE CREEK 2402211A 14,301 10/8/2021 5551 0.82 SHERLOCK ENTERPRISES LLC BATTLE CREEK 6263615A 390 10/22/2021 8720 THREE HUSKIES OUTDOOR SERVICES LLC BATTLE CREEK 6074740A 1,880 12/16/2021 0106 WILLIAMS COREY BATTLE CREEK 6277390A 750 11/25/2021 5348 WILLIS GEOFFREY BATTLE CREEK 6273793A 750 11/13/2021 5348 A AND J CONTRACTING SERVICES INC BAY CITY 2572893A 1,345 12/10/2021 0106 0.95 ALL VALLEY TRANSPORTATION LLC BAY CITY 5631688B 712 11/25/2021 7212 ALWAYS WIRED LLC BAY CITY 5804450A 1,068 10/20/2021 5190 BALL DALE BAY CITY 6255060A 755 10/6/2021 5551 BAY CAFE INC BAY CITY 2944847A 1,677 11/24/2021 9058 0.95 DANGELOS PIZZA LLC BAY CITY 6084290A 1,410 12/8/2021 9058

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 7 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ELLIOT ENVIRONMENTAL LLC BAY CITY 3712575A 1,729 11/1/2021 9015 0.95 GLICK DRYWALL & PAINT LLC BAY CITY 6066119A 1,456 10/26/2021 5445 GREAT EXPECTATIONS CARPENTRY BAY CITY 5349931A 750 12/6/2021 5437 HOLLYWOOD EXCAVATING LLC BAY CITY 4248783A 740 11/1/2021 6217 JAMESON TREE INC BAY CITY 5159520A 7,966 10/20/2021 0106 0.92 KNIGHTS ENTERTAINMENT INC BAY CITY 3140865B 995 10/22/2021 9156 MEYLAN CONNOR BAY CITY 6261590A 615 11/17/2021 9521 MICHAEL J SAMBORN INC BAY CITY 3917479A 400 10/18/2021 8810 0.95 NICE AND NEAT CLEANING SERVICE INC BAY CITY 4335538A 994 10/3/2021 9015 0.95 POOLTECH LLC BAY CITY 3530825A 800 10/5/2021 5223 RICHARD JASON BAY CITY 3034046A 750 10/4/2021 5445 0.95 TNT CONSTRUCTION BAY CITY 5202604A 750 10/1/2021 5645 UPTOWN MARATHON LLC BAY CITY 3827437A 465 11/16/2021 8017 0.95 VELODYNE CONSULTING LLC BAY CITY 4788699A 238 11/4/2021 8601 VOLLMER PLUMBING & HEATING INC BAY PORT 1902814A 4,647 10/11/2021 5183 1.05 A PLUS ACCOUNTING LLC BEAR LAKE 5764610A 206 10/17/2021 8803 MARTIN GAS & OIL LLC BEAVER ISLAND 0689386A 4,111 12/18/2021 8017 0.95 ROGERS HOME MAINTENANCE INC BEAVER ISLAND 4401298A 750 11/7/2021 5645 MILES INVESTIGATIONS INC BEAVERTON, OR 6254020A 449 10/2/2021 7720 R AND B METAL FAB LLC BEAVERTON 6282342A 698 12/12/2021 3365 AHS TREE SERVICE LLC BEDFORD 6276750A 1,900 11/24/2021 0106 BALTRUCZAK MICHAEL BELDING 6284213A 2,989 12/18/2021 5437 PLATTE FRUIT LLC BELDING 5486408A 526 12/12/2021 0130 SEIF ERNEST BELDING 6255108A 1,850 10/6/2021 0913 SEIF SUSAN BELDING 2267446A 656 11/15/2021 9402 DALE SNOOKS ONE ON ONE INC BELLAIRE 5612535A 543 10/13/2021 6836 POINTS WEST ASSOCIATION BELLAIRE 4685849A 568 11/6/2021 9015 SEE CON INC BELLAIRE 5066727A 279 12/21/2021 8810 TRADEMARK MASONRY LLC BELLAIRE 4670566A 750 10/19/2021 5022 WILD GINGER DAYCARE BELLAIRE 5921422A 424 10/10/2021 8869 A Z MAINTENANCE BELLEVILLE 3700135A 800 11/20/2021 5645 BAMS JANITORIAL SERVICE LLC BELLEVILLE 4126610A 669 11/4/2021 9015 BELLEVILLE PETROLEUM INC BELLEVILLE 3877655A 454 12/25/2021 8017 BETHEL ESTIMATING AND CONSTRUCTION BELLEVILLE 1587153A 2,431 10/25/2021 5645 0.95 CORP

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge D AND T TILE AND MARBLE LLC BELLEVILLE 3106047A 924 11/20/2021 5348 DEREK RIGGS CONSTRUCTION COMPANY BELLEVILLE 1785370A 859 11/14/2021 5645 GIRLSTOWN FOUNDATION BELLEVILLE 0596043A 26,006 12/26/2021 8833 1.67 27 % MCDANIEL MAINTENANCE INC BELLEVILLE 4278224A 751 10/19/2021 5645 0.95 PRO TECH RESTORATION INC BELLEVILLE 3892638A 618 11/8/2021 9015 ROBS ALL AMERICAN ROOFING BELLEVILLE 3893316A 750 11/20/2021 5551 SAFETY TRACK OF MICHIGAN LLC BELLEVILLE 4167066A 553 12/13/2021 8387 SCOTTS TOWING INC BELLEVILLE 3134679A 3,471 12/6/2021 7208 0.95 SIGN CRAFTSMEN LLC BELLEVILLE 5934036A 1,590 12/11/2021 4299 TOP QUALITY TILE MARBLE & STONE INC BELLEVILLE 4802772A 1,983 10/25/2021 5348 0.95 TRANSCENDING SERVICES LLC BELLEVILLE 6285350A 399 12/23/2021 8601 TROMEROS PROPERTY MANAGEMENT LLC BELLEVILLE 4703707A 568 10/18/2021 0913 BLACK FOREST FARMS BELLEVUE 4965736A 1,070 12/16/2021 8279 0.95 KNAPPS LANDSCAPE LLC BELLEVUE 5684021A 709 10/28/2021 0042 SECRET OF HOME HEALTH BELLEVUE 6262449A 893 11/17/2021 8835 WINGER CABLE BELLEVUE 3731316A 750 12/10/2021 7600 COASTLINE EQUIPMENT INC BELLINGHAM, WA 6253741A 429 10/10/2021 8742 FAUX REAL LLC BELMONT 4298799A 750 11/17/2021 5476 FWF FLOORING INC BELMONT 3936139A 751 11/19/2021 5348 0.95 EL SUPERMERCADO CO LLC BENTON HARBOR 3824713A 4,956 11/8/2021 8033 0.91 HOPE LOVE AND GRACE LLC BENTON HARBOR 5756421A 6,045 10/16/2021 9053 0.89 MARTIN BROTHERS MILL & FOUNDRY SUPPLY CO BENTON HARBOR 0467510A 18,709 10/1/2021 1438 0.78 S AND M GASMART INC BENTON HARBOR 1524925A 904 12/11/2021 8017 GOGEBIC AREA GROOMING INC BERGLAND 3875946A 1,490 12/16/2021 9015 0.95 SELMAR CONSTRUCTION INC BERKELEY 5334209A 1,571 10/24/2021 5645 0.95 CARPENTRY BY JIM BERKLEY 1859030A 750 10/9/2021 5437 ELLISON COLE INC BERKLEY 4976142A 3,084 12/19/2021 5550 0.93 KEN SHOWLER AUDIO VIDEO CONTROL LLC BERKLEY 6253857A 351 10/15/2021 5191 LONGTREE TREE SERVICE LLC BERKLEY 6220347A 4,840 10/6/2021 0106 PRESTON HEATHER BERKLEY 6279210A 1,926 12/4/2021 8835 TODAYS BUILDERS LLC BERKLEY 5931975A 750 11/6/2021 5645 TOMAS STONE INC BERKLEY 4301218A 351 12/9/2021 5191 TRI COMMUNITY COALITION OF BERKLEY BERKLEY 3717763A 264 12/8/2021 8810 HUNTINGTON WOODS AND OAK PARK MICHIGAN INC

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TRI COUNTY HEATING & COOLING INC BERKLEY 3030709A 1,174 11/15/2021 5550 WHISPERING PINES CHRISTMAS TREE FARM BERRIEN CENTER 4815009A 606 11/24/2021 0005 ASAP MINISTRIES INC BERRIEN SPRINGS 2709627A 604 11/1/2021 8810 0.95 HIBLER BUILDING COMPANY LLC BERRIEN SPRINGS 5760836A 1,034 11/25/2021 5348 0.95 HDE CONSTRUCTION LLC BERVILLE 5464323A 1,242 10/13/2021 5610 HELLMAN EXCAVATING LLC BESSEMER 6077510A 740 11/19/2021 6217 JDS ROOFING AND EXTERIORS LLC BEULAH 5765129A 10,378 10/19/2021 5551 0.93 CLEAR VISION INSPECTORS LLC BEVERLY HILLS 6271677A 652 11/10/2021 8720 CLEARVIEW LIGHTING LLC BEVERLY HILLS 5796164A 432 12/12/2021 8742 CYNTHIA NAGLE EDUCATIONAL SERVICES LLC BEVERLY HILLS 5323983A 447 10/2/2021 8742 REDCLOVER PROPERTIES LLC BEVERLY HILLS 5737109A 825 12/2/2021 5645 YELLOW DOG WATERSHED PRESERVE INC BIG BAY 4294920A 278 11/16/2021 8810 ATLANTIC CERTIFIED LLC BIG RAPIDS 6281710A 569 12/14/2021 9015 BEHLING KRISTON BIG RAPIDS 4035496A 698 11/14/2021 3365 BIG RAPIDS ELKS LODGE 974 BIG RAPIDS 0686654A 1,104 10/7/2021 9058 BINNEYS AUTO PARTS BIG RAPIDS 0159743A 1,684 10/9/2021 8010 0.95 CREEKSIDE MANOR BIG RAPIDS 4686870A 3,573 11/1/2021 9053 0.95 MANNA PANTRY OF BIG RAPIDS INC BIG RAPIDS 6273661A 440 11/12/2021 8031 MECOSTA COUNTY COUNCIL ON AGING INC BIG RAPIDS 1374788A 362 11/28/2021 8742 MECOSTA TOWNSHIP BIG RAPIDS 2631890A 1,722 12/1/2021 7904 1.00 AUTOMOTIVE MANAGEMENT GROUP INC BINGHAM FARMS 5930260A 1,020 11/1/2021 8601 KATZMAN LINDA BINGHAM FARMS 5618860A 357 10/8/2021 0908 MARC D LANDAU PLLC BINGHAM FARMS 3568822A 259 11/16/2021 8820 PRIMARY TRANSPORTATION LLC BINGHAM FARMS 5214378A 1,619 11/27/2021 7212 0.95 D AND K CLEANING SERVICE LLC BIRCH RUN 3033279A 568 10/22/2021 9015 AERO ONE LLC BIRMINGHAM 5926173A 786 11/1/2021 7421 0.81 AVIV JOSEPH AND LINDA BIRMINGHAM 3773540A 530 10/31/2021 0913 BABI CONSTRUCTION INC BIRMINGHAM 2718170A 800 10/6/2021 5645 BIRMINGHAM RACQUET CLUB ACQUISITION BIRMINGHAM 0748765A 344 10/15/2021 9065 COMPANY LLC BR CUSTOM HOMES INC BIRMINGHAM 6276296A 750 11/19/2021 5645 COHERENTRX INC BIRMINGHAM 5559740A 310 12/8/2021 8810 COHN AVERN BIRMINGHAM 0809896A 915 10/3/2021 0912 FELDMAN JAY S AND ANN T BIRMINGHAM 5487188A 1,212 12/4/2021 0913 0.95 FELDMAN MARLA BIRMINGHAM 5488699A 935 12/8/2021 0913

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FRANK WILLARD & ASSOCIATES INC BIRMINGHAM 3958264A 230 12/4/2021 8810 ITEC ENTERPRISES LLC BIRMINGHAM 3712150A 761 11/9/2021 5645 JEDI GROUP LLC BIRMINGHAM 4791517A 1,674 12/14/2021 5183 KAUFMAN DAVIS JODIE BIRMINGHAM 6264425A 605 10/24/2021 0913 LAKEVIEW CAPITAL INC BIRMINGHAM 4275551A 13,780 10/12/2021 7421 0.79 MARY E NICHOLSON REVOCABLE LIVING TRUST BIRMINGHAM 6278582A 580 12/4/2021 0913 MIL SPEC AUTOMOTIVE LLC BIRMINGHAM 5631475A 9,616 11/11/2021 8395 MOORE DEVELOPMENT GROUP LLC BIRMINGHAM 6059740A 750 10/23/2021 5645 OAKLAND RHYTHMICS BIRMINGHAM 2925621A 1,256 10/1/2021 9063 0.95 RENAISSANCE RESTORATIONS INC BIRMINGHAM 4003209A 825 11/19/2021 5645 TWO HUNDRED 50 MARTIN STREET BIRMINGHAM 5929695A 800 10/31/2021 5645 CONDOMINIUM ASSOCIATION VOLAT INC BIRMINGHAM 5781922A 2,278 11/15/2021 5348 0.95 WEINBAUM GROUP LLC BIRMINGHAM 5775426A 935 11/17/2021 0913 WILHEMINNA LLC BIRMINGHAM 5618762A 216 11/30/2021 8810 WURN KEITH BIRMINGHAM 5155207A 307 10/18/2021 0908 SCHOENBERG KAREN AND JEFFREY BIRMINGHANM 5761921A 605 10/12/2021 0913 FICEL TRANSPORT INC BLASDELL, NY 4282876A 4,162 11/5/2021 8395 0.92 ALOM ENTERPRISES INC BLISSFIELD 5374774A 801 12/27/2021 8279 SCHOLLS SLAUGHTER HOUSE INC BLISSFIELD 0664910A 1,014 10/15/2021 2081 0.95 BEES AND TREES LLC BLOOMFIELD 5422922A 738 12/5/2021 0034 0.95 ELSON IRWIN BLOOMFIELD 1122843A 874 10/9/2021 0913 0.95 MARK HARMER PHOTOGRAPHY BLOOMFIELD 3787869A 296 11/15/2021 4361 ARTISTE INC BLOOMFIELD HILLS 5937736A 420 11/20/2021 9586 ASHFORD CONNEX LLC BLOOMFIELD HILLS 6279830A 361 12/31/2021 8810 BLUE CHIP TALENT MSP LLC BLOOMFIELD HILLS 6252320A 25,856 10/1/2021 3632 DEVEREAUX LESLIE BLOOMFIELD HILLS 0877832A 1,240 12/5/2021 0913 0.95 DROBOT CUSTOM BUILDING INC BLOOMFIELD HILLS 6046649A 750 11/6/2021 5645 EAGLE GLOBAL SERVICES LLC BLOOMFIELD HILLS 6063365A 11,173 10/24/2021 3628 0.93 FISHER MARK A BLOOMFIELD HILLS 3406539A 357 10/7/2021 0908 FORREST JAMES E BLOOMFIELD HILLS 3727718A 840 11/17/2021 0912 GABER FLOORING LLC BLOOMFIELD HILLS 6258506A 750 10/13/2021 5348 GLOBAL INDUSTRIAL PARTNERS LLC BLOOMFIELD HILLS 5797241A 231 12/14/2021 8742 HAVEN HILL FARM LLC BLOOMFIELD HILLS 6076807A 2,016 11/16/2021 8279 J AND C PLOWING LLC BLOOMFIELD HILLS 0420530A 800 10/22/2021 7380 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge JASTER CORPORATION BLOOMFIELD HILLS 0663468A 645 10/20/2021 9015 0.95 JOAN GARGARO GROVES REV LIVING TRUST BLOOMFIELD HILLS 6279872A 820 12/5/2021 0912 KAFTAN CAROLE K BLOOMFIELD HILLS 3712508A 357 11/6/2021 0908 LAKEPOINTE CSG INC BLOOMFIELD HILLS 1996533A 800 11/19/2021 3365 LESTER MATTHEW BLOOMFIELD HILLS 5208394A 712 12/19/2021 0908 MANAGEMENT INVESTMENT CONSULTING BLOOMFIELD HILLS 4043200A 215 10/15/2021 8810 SERVICES INC MAXIMUS INC BLOOMFIELD HILLS 5789389A 3,171 12/8/2021 8726 0.95 OCG COMPANIES LLC BLOOMFIELD HILLS 3377822A 2,549 10/7/2021 0042 0.95 PINK CATHERINE BLOOMFIELD HILLS 6262058A 304 10/20/2021 8742 SAFFER MARK DR & PEGGY BLOOMFIELD HILLS 5341035A 414 11/7/2021 0908 SANDLEWOOD PROPERTIES LLC BLOOMFIELD HILLS 2320967A 755 11/1/2021 5606 SCHREIBMAN JAY BLOOMFIELD HILLS 0992534A 357 11/30/2021 0908 SCHWARTZ MARK S BLOOMFIELD HILLS 4934113A 1,734 12/1/2021 0913 0.95 SENTECH ENGINEERING SERVICES INC BLOOMFIELD HILLS 6088228A 226,052 12/26/2021 3400 SERVALL COMPANY BLOOMFIELD HILLS 0556262A 535 12/31/2021 8810 1.00 SHAVER BRYAN MICHAEL BLOOMFIELD HILLS 6276857A 530 11/24/2021 0913 SINGER STEVEN N BLOOMFIELD HILLS 2372436A 357 12/29/2021 0908 SOLUTION CLEANING SERVICE BLOOMFIELD HILLS 6081401A 818 11/28/2021 9015 SPIRO TIMOTHY & THERESA BLOOMFIELD HILLS 1274317A 382 11/11/2021 0908 SPRAGUE KEVIN DR & SPRAGUE CAROLINE BLOOMFIELD HILLS 0407267A 382 10/23/2021 0908 TESSLER MARTIN E BLOOMFIELD HILLS 5032644A 357 10/2/2021 0908 TLD ELECTRIC COMPANY LLC BLOOMFIELD HILLS 5593085A 520 11/21/2021 5190 VALUATION LINK LLC BLOOMFIELD HILLS 5384834A 290 10/13/2021 8810 WINSTON STEVE BLOOMFIELD HILLS 5031877A 307 10/16/2021 0908 KERNWAY ASSISTED LIVING INC BLOOMFIELD HLLS 5785545A 2,466 11/22/2021 9053 0.95 OAKFORD CAPITAL LLC BLOOMFIELD TWP 5316731A 2,036 10/19/2021 5606 0.95 RECRUITING AND RELOCATION ASSOCIATES LLC BLOOMFLD HLS 5609763A 322 11/16/2021 8601 ABC EXCAVATING LLC BLOOMINGDALE 5889146A 790 10/21/2021 8810 INMAN TRUCKING BOON 5945070A 750 12/13/2021 7208 VULTAGGIO BROTHERS TREE FARM BOON 0504203A 4,864 10/11/2021 0005 0.95 LODGING KIT COMPANY INC BOONVILLE, NY 5347912A 448 11/26/2021 8742 SHIRLEY PARSONS INC BOSTON, MA 5773180A 608 11/10/2021 5606 BOYNE AREA GYMNASTICS INC BOYNE CITY 1475606A 816 11/4/2021 9063 0.95 C J LOGGING LLC BOYNE CITY 3175650A 750 11/5/2021 2702

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DETROIT STILLWORKS LLC BOYNE CITY 5481570A 370 10/1/2021 8742 LS CONTRACTING BOYNE CITY 6075061A 800 11/14/2021 5645 WOODLAND FINISHING SYSTEMS LLC BOYNE CITY 4926072A 800 10/21/2021 5476 SUN SHADE NORTH INC BOYNE FALLS 4014855A 839 10/31/2021 9521 T E S CONSTRUCTION LLC BOYNE FALLS 5092604A 750 11/1/2021 5551 0.95 LAND LEASE AMERICA LLC BOZEMAN, MT 1190164A 4,011 12/17/2021 9015 0.95 HALLS TREE SERVICE LLC BRADLEY 6284051A 750 12/15/2021 0106 ALL PHASE SITE WORK LLC BRANCH 5927536A 741 10/26/2021 6217 BHWS ENTERTAINMENT LLC BRIDGEPORT 0342475A 1,607 11/18/2021 9058 0.94 MCLEOD WOOD & CHRISTMAS PRODUCTS INC BRIDGEPORT 6065163A 456 11/1/2021 8001 HARBOR COUNTRY MISSION BRIDGMAN 6053670A 1,438 10/9/2021 8017 ACCORD CLEANING SERVICES BRIGHTON 4409760A 3,963 11/24/2021 9015 0.95 AMERIVET SERVICES LLC BRIGHTON 4949854A 8,056 11/8/2021 3365 0.95 BARTON BUILDING CO BRIGHTON 2230909A 750 10/25/2021 5437 BD DONOVAN BUILDERS INC BRIGHTON 0515604A 750 12/27/2021 5645 BRIGHT TRANSPORTATION LLC BRIGHTON 6286070A 4,157 12/29/2021 7212 CLEAR WATER PROPERTY SERVICE INC BRIGHTON 3854744A 2,968 11/20/2021 9015 0.95 COMPASSIONATE HOSPICE CARE LLC BRIGHTON 6087086A 850 12/17/2021 9053 CONSTRUCTION SOLUTIONS INC BRIGHTON 0382191A 1,456 10/28/2021 5606 0.95 DAISY MEDICAL STAFFING INC BRIGHTON 6276970A 1,163 12/2/2021 8829 ELEGANT LLC BRIGHTON 5722241A 800 12/26/2021 5645 0.93 FISHER REMODELING LLC BRIGHTON 3614689A 750 11/4/2021 5437 0.95 FORTIS GROUP LLC BRIGHTON 6247920A 1,275 10/1/2021 7720 FRATELLI CONSTRUCTION SERVICE INC BRIGHTON 4296982A 800 11/1/2021 5437 G WILLIAMS CONSTRUCTION BRIGHTON 5365813A 750 11/18/2021 5437 GRAND RIVER GRILLE INC BRIGHTON 6253750A 3,693 10/1/2021 9058 1.44 27 % HANSEN EXPRESS LTD BRIGHTON 2612518A 751 12/23/2021 7208 JEROME MARINELLI LLC BRIGHTON 6285856A 750 12/29/2021 5437 LIVINGSTON COMMUNITY WATER AUTHORITY BRIGHTON 4821556A 266 12/15/2021 8810 MAJOR LEAGUE GUTTER & WINDOW CLEANING BRIGHTON 0894818A 3,548 12/31/2021 9015 1.00 INC MUHN INVESTMENTS LLC BRIGHTON 5218179A 618 12/10/2021 9015 NLB VENTURES INC BRIGHTON 1629182A 1,303 11/2/2021 9058 0.95 NOEKER LLC BRIGHTON 4345509A 524 10/1/2021 9102 PIETILA RICK BRIGHTON 3010333A 750 12/16/2021 5645

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PILLAR MEDICAL GROUP INC BRIGHTON 5623847A 2,275 10/19/2021 8829 1.00 PINE CREEK CONDOMINIUMS OF HASLETT BRIGHTON 4383451A 568 11/1/2021 9015 ASSOCIATION SERVICES ALWAYS COMPLETE LLC BRIGHTON 1516850A 800 10/1/2021 5022 SHAFFER WILLIAM J & KRISTI A BRIGHTON 6252370A 750 10/1/2021 5645 SHAW PLACE CONDOMINIUM ASSOCIATION BRIGHTON 5089379A 568 12/22/2021 9015 J AND W PAINTING BRIGHTON TWP 3616274A 750 10/22/2021 5476 TOWNSHIP OF SUPERIOR CHIPPEWA COUNTY BRIMLEY 0427314A 2,355 12/18/2021 9410 0.95 K AND S BROCKWAY 6073727A 811 11/9/2021 5645 APEX INDUSTRIAL ROOFING LLC BRONSON 5768276A 825 12/5/2021 5552 COX PERFORMANCE INC BRONSON 5336554A 1,654 10/1/2021 8010 0.95 SOUTHWEST MICHIGAN HANDYMAN SERVICE BRONSON 6251285A 3,500 10/22/2021 5645 LLC J MASON CONTRACTING LLC BROOKLYN 4090381A 6,207 12/20/2021 5645 1.29 13 % MILLER WALLBOARD BROOKLYN 6077900A 750 11/20/2021 5445 POPPAS PLACE INC BROOKLYN 2999390A 3,196 11/2/2021 9058 0.95 RIGID PAVEMENT CONSTRUCTION LLC BROOKLYN 5593492A 10,648 12/31/2021 5506 0.96 BROWN CITY ELEVATOR INC BROWN CITY 4542118A 10,859 12/1/2021 8304 1.00 BURNSIDE LOGGING LLC BROWN CITY 5649498A 750 12/15/2021 2709 PARKWAY GLEN CONDOMINIUM ASSOCIATION BROWN CITY 5349494A 568 12/4/2021 9015 DOLENCE AND DOLENCE LLC BROWNSTOWN 3166775A 2,609 12/6/2021 5437 0.95 GALLAZO CONSTRUCTION INC BROWNSTOWN 4759877A 1,561 12/12/2021 5022 0.95 HAULING BY EVANS INC BROWNSTOWN 1331000A 689 12/9/2021 5610 J AND J CONSTRUCTION PLUS INC BROWNSTOWN 4829930A 750 12/9/2021 5221 LIPETZKY ELECTRIC LLC BROWNSTOWN 4938410A 546 12/1/2021 5190 SPEEDY OIL INC BROWNSTOWN 3701956A 3,397 12/23/2021 8395 0.94 M A G ENTERPRISES 1 INC BROWNSTOWN TWP 5341434A 2,848 11/19/2021 3365 0.95 H AND H CLEANING SERVICE LLC BROWNSTWN TWP 5400511A 2,528 12/30/2021 9015 0.95 PALUSHI PAINTING INC BRUCE 4822374A 750 12/11/2021 5476 J L WHITE INC BRUCE TWP 2690870A 800 12/18/2021 5645 0.95 LLESH INK LLC BRUCE TWP 6279899A 801 12/5/2021 0106 SOUTH CHANNEL CONSTRUCTION LLC BRUCE TWP 3986403A 4,984 10/1/2021 5645 0.95 MARSHALL FARMS LLC BRUTUS 6262341A 750 10/20/2021 5403 RIVER BEND CONSULTING LLC BRUTUS 5624118A 238 10/20/2021 8601 UP NORTH SERVICE LLC BRUTUS 3962970A 1,392 11/6/2021 9015 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ELYS SERVICES BUCHANAN 4011007A 1,042 12/28/2021 9102 0.95 FJF STEEL ERECTORS INC BUCKLEY 4055500A 2,881 12/28/2021 5040 0.92 LONG ACRE FARMS BUCKLEY 4924037A 1,060 11/1/2021 0128 0.95 RRR MEAT PROCESSING LLC BUCKLEY 5473110A 4,579 11/1/2021 2081 0.91 SVEC FARMS LLC BUCKLEY 1358740A 1,033 12/6/2021 0129 WAYNE BANCROFT AUCTION SERVICE LLC BUCKLEY 0040290A 748 10/27/2021 9015 KRISH KRISHA 3 INC BURR RIDGE, IL 5628202A 806 11/8/2021 8381 0.95 RCR TRANSPORT INC BURT 6075118A 750 11/26/2021 7208 WHETSTONE HOME RESTORATION BURTCHVILLE 5761930A 750 10/12/2021 5551 BATES CLEANING BURTON 5359376A 569 10/30/2021 9015 BECKS PAINTING COMPANY INC BURTON 4002210A 825 10/25/2021 5476 0.95 FLOORS GALORE BURTON 5068835A 750 12/18/2021 5348 GENESEE POLYMERS CORPORATION BURTON 1909975A 2,707 10/8/2021 4829 0.95 MARK SCHWARTZ VIOLINS LLC BURTON 4864190A 560 11/4/2021 8017 MOE SALES AND SERVICE INC BURTON 3762335A 2,258 11/22/2021 3724 0.95 RACHIL INC BURTON 0019976A 481 11/25/2021 8395 RAPP CHRISTOPHER B BURTON 5202280A 750 12/14/2021 5645 TOTAL CONCRETE DESIGN LLC BURTON 6085997A 825 12/12/2021 5223 UNIQUE DRYWALL LTD BURTON 0450650A 750 10/26/2021 5445 A AND M ENTERPRISE BYRON 5338123A 750 11/1/2021 5645 J AND R HAULING BYRON 2521610A 689 11/16/2021 5610 SECLUDED ACRES CONDOMINIUM BYRON 6255604A 618 10/15/2021 9015 HOMEOWNERS ASSOCIATION ARTISAN WOODWORKING LLC BYRON CENTER 2597187A 750 11/2/2021 2802 ARTS PROJECTS LLC BYRON CENTER 6073670A 750 11/9/2021 5645 CUSTOM MAINTENANCE INSTALLATION INC BYRON CENTER 3979946A 470 10/16/2021 5190 FISHER EXTERIOR SOLUTIONS LLC BYRON CENTER 5985650A 270 10/6/2021 8810 H U G S FOR HORSES AND CHILDREN YOUTH BYRON CENTER 5941920A 3,812 11/29/2021 8279 0.95 RANCH INC PRIMOS ENTERPRISE LLC BYRON CENTER 6059040A 2,021 10/12/2021 9058 0.95 SAKSHAUG GROUP HOMES LLC BYRON CENTER 4975308A 10,068 12/4/2021 9053 1.03 SHELVING SPECIALIST BYRON CENTER 2214474A 751 12/15/2021 8810 TERMINIX OF WEST MICHIGAN INC BYRON CENTER 1459708A 9,205 11/1/2021 9015 0.90 BEYERSDORF ENTERPRISES LLC CADILLAC 3506916A 568 11/15/2021 9015 BLACKMER MOTORSPORTS LLC CADILLAC 0509825B 1,411 11/16/2021 9015 0.90

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 15 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BLUE IN THE FACE CADILLAC LLC CADILLAC 5252083A 468 10/1/2021 8045 ELECTRONIC WARNING TECHNOLOGIES LLC CADILLAC 5340560A 395 11/16/2021 8601 FOSTER BROS TRANSFER & STORAGE CO LLC CADILLAC 0176532A 1,635 11/5/2021 7214 0.95 IMPACT YOUTH SERVICES LLC CADILLAC 4286529A 685 11/10/2021 7720 J CRETE CONCRETE CONSTRUCTION LLC CADILLAC 6264441A 1,952 10/24/2021 5213 J D ATEN TRUCKING LLC CADILLAC 0247898A 750 11/27/2021 8810 0.95 NORTHWEST FOUNDATIONS INC CADILLAC 3028852A 2,979 12/5/2021 5215 0.93 SAR LOGGING LLC CADILLAC 2770920A 1,858 10/1/2021 2709 0.95 AB AND B CONSTRUCTION LLC CALEDONIA 5254795A 4,820 11/10/2021 5645 0.95 DIAMOND CONSTRUCTION COMPANY LLC CALEDONIA 6279821A 800 12/5/2021 5645 INNOVATIONS CUSTOM HOMES & REMODELING CALEDONIA 5193311A 750 12/23/2021 5645 LLC KOSTER ROBERT L CALEDONIA 1155288A 540 10/16/2021 9521 STEVE WEAVER CONTRACTOR CALEDONIA 2476657A 750 12/7/2021 5221 CIRCLE CARDIOVASCULAR IMAGING INC CALGARY, AB 5639972A 661 11/22/2021 8742 ERKKILA FOREST PRODUCTS LLC CALUMET 5464439A 750 10/17/2021 7208 SUPERIOR CARE GIVERS INC CALUMET 5633508A 5,637 11/10/2021 8835 0.92 AMS STATION INC CANTON 4757661B 616 11/25/2021 8017 ANTLER CONSTRUCTION CO INC CANTON 1876147A 1,300 12/8/2021 5606 0.95 ASW AMERICA INC CANTON 5377463A 3,137 10/18/2021 3628 0.95 CANTON FUEL INC CANTON 5646430A 1,024 12/7/2021 8017 CANTON PETRO INC CANTON 4334779B 639 12/31/2021 8017 0.95 CANTON PROFESSIONAL PARK CONDOMINIUM CANTON 2003473A 761 12/11/2021 8601 ASSOCIATION CENTRAL PARK ESTATES RECREATIONAL CANTON 3683613A 568 11/23/2021 9015 FACILITIES ASSOCIATION CHANDLER CAR CARRIERS OF MICHIGAN LLC CANTON 4208412A 4,124 11/12/2021 7208 COVENANT TO CARE INC CANTON 4722698A 2,046 10/4/2021 9053 0.95 DURON CONSTRUCTION LLC CANTON 5800951A 800 12/20/2021 5645 EMMETT CONTRACTING LLC CANTON 2295466A 750 10/6/2021 5403 HEALTHSHINE SOLUTIONS INC CANTON 4827341A 971 12/21/2021 8835 0.95 INTERNATIONAL TRADING SOLUTIONS INC CANTON 3497852A 11,218 11/15/2021 8032 1.50 27 % JOSS CONSTRUCTION LLC CANTON 5934117A 750 11/9/2021 5437 LONESTAR US LLC CANTON 6257917A 825 10/10/2021 7208 MARHOFER RENEWABLES LLC CANTON 5986354A 5,266 10/14/2021 3724 MBAF LLC CANTON 6275630A 2,450 11/20/2021 4825 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 16 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge OKAMURO KATHRYN CANTON 6042660A 239 10/1/2021 8601 OLIVER TRANSPORTATION LLC CANTON 5697719A 2,125 12/29/2021 7206 0.95 PROPER K LLC CANTON 6286321A 4,491 12/31/2021 9403 RANGA STORE INC CANTON 5440637A 1,061 12/2/2021 8017 SAMS ELECTRICAL SERVICES LLC CANTON 1584901A 754 12/17/2021 5190 SCHMIDT CONTRACTING CANTON 3273369A 569 10/23/2021 9015 SPEARS CRANE SERVICE LLC CANTON 6080898A 551 11/27/2021 9530 SURFACE SPECIALISTS OF SOUTH MICHIGAN INC CANTON 5755530A 2,041 10/1/2021 5348 0.95 T AND M AUTO INC CANTON 2491222A 2,038 12/2/2021 8010 0.95 VIOLA VINCENT CANTON 2287080A 1,146 12/15/2021 5437 WESTERN TOWNSHIP UTILITIES AUTHORITY CANTON 1469959A 666 11/3/2021 8810 WOODS OF CENTRAL PARK CONDOMINIUM CANTON 5199654A 709 10/15/2021 0042 ASSOCIATION D AND C ROOFING CAPAC 3850722A 800 11/13/2021 5551 EBC CONSTRUCTION LLP CAPAC 6067573A 8,346 11/5/2021 5645 VISITING FRIENDS HOME CARE LLC CAPAC 6279678A 3,051 12/5/2021 8835 G BALL GENERAL FARMING CARLETON 5647240A 739 12/16/2021 5610 R C ELECTRIC INC CARLETON 1357352A 470 11/29/2021 5190 TITAN BUILDING MAINTENANCE LLC CARLETON 6254160A 2,610 10/2/2021 9015 ALTEC SOLUTIONS LLC CARMEL, IN 5287740A 5,184 11/20/2021 4712 0.91 MUSKEGON RIVER YOUTH HOME INC CARMEL, IN 2758210A 154,745 11/21/2021 8833 2.75 40 % SKILL DEMAND CORP CARMEL, IN 6279350A 1,797 12/3/2021 8018 LENCA FOREST PRODUCTS CARNEY 2624176A 826 10/13/2021 8010 0.95 QUICK RAYMOND CARNEY 6259308A 750 10/14/2021 7208 WALECHKA INC CARNEY 1679619A 5,035 11/13/2021 6217 0.92 B AND M TIMBER CARO 6283080A 2,740 12/16/2021 2709 BYARS SHANNON CARO 6067638A 750 10/30/2021 7208 GALAXY OFFICE MACHINES CARO 1851080A 472 12/17/2021 5191 MICHAEL J URBAN & ASSOCIATES LLC CARO 4183665A 1,142 10/10/2021 9015 0.95 SCHMALTZ CONSTRUCTION CO CARO 1371118A 750 11/12/2021 5022 DAN WALL BUILDERS CARROLLTON 5934923A 2,179 11/15/2021 5437 0.95 ECO PRIORITY LLC CARROLLTON 5616387A 1,086 10/15/2021 8601 GOOD OL BOYS CUSTOM CARPENTRY LLC CASCO 5909198A 1,849 10/9/2021 5437 0.95 KALEBS PAINTING LLC CASCO 5763380A 750 10/16/2021 5476

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TED RATTEE FOUNDATION & WATERPROOFING CASCO 6084982A 4,649 12/10/2021 6217 SOLUTIONS LLP TROMBLY AND TROMBLY BUILDERS INC CASCO 0709921A 2,341 12/17/2021 5437 0.95 J TODD AFFORDABLE ROOFING LLC CASCO TWP 3405770A 750 10/6/2021 5551 JLH CONSTRUCTION CO INC CASEVILLE 3504131A 16,293 10/20/2021 6217 0.85 P 2 PAINTERS LLC CASNOVIA 5210151A 750 11/13/2021 5476 HENNESSEY JEANNIE CASS CITY 6260713A 333 10/16/2021 8869 CB TREE CASSOPOLIS 6073450A 1,767 12/2/2021 0106 GIANT DREAM COMPANY LLC CEDAR FALLS, IA 6081002A 1,342 12/1/2021 9015 FINAL TOUCH CARPENTRY LLC CEDAR SPRINGS 6277330A 750 11/25/2021 5645 GOLDSMITH MATTHEW CEDAR SPRINGS 5480752A 750 12/1/2021 5437 HARDENBURG HOLLY CEDAR SPRINGS 5787661A 864 10/13/2021 9015 J AND J CLEANING SERVICES LLC CEDAR SPRINGS 5803128A 568 12/29/2021 9015 JK FOREST PRODUCTS INC CEDAR SPRINGS 4745914A 750 11/5/2021 2702 SMITH GREG CEDAR SPRINGS 1068849A 750 12/11/2021 5645 LES CHENEAUX PRESCHOOL INC CEDARVILLE 2970732A 255 11/8/2021 8868 LES CHENEAUX SNOWMOBILE CLUB CEDARVILLE 5752582A 731 10/1/2021 9402 PRENTISS COAST COMPANY LLC CEDARVILLE 6074057A 1,134 11/12/2021 9402 MORAWSKI AND SONS INC CENTER LINE 1895206A 215 11/1/2021 8810 E J AND SONS INC CENTERLINE 2331772A 568 10/14/2021 9015 0.95 MCINTYRE TRANSPORTATION LLC CENTERLINE 6092519A 5,787 12/11/2021 7208 J BATTYE LOGGING INC CHANNING 3866904A 750 11/28/2021 2702 ALL AREA TOWING LLC CHARLEVOIX 5947243A 1,113 12/21/2021 7208 ALL IN ONE PAINT & STAIN LLC CHARLEVOIX 5266181A 750 12/11/2021 5476 COASTAL CONSTRUCTION LLC CHARLEVOIX 6264760A 800 10/27/2021 5645 COGGON GARRETT CHARLEVOIX 5941806A 605 12/4/2021 0913 CORNERSTONE MASONRY CHARLEVOIX 5632919A 1,726 12/28/2021 5221 0.95 GLOVER SIDING & ROOFING LLC CHARLEVOIX 6278604A 800 12/2/2021 5551 MARINA BLUFF ASSOCIATION CHARLEVOIX 2470322A 618 12/30/2021 9015 TOWNHOUSE BAR OF CHARLEVOIX LLC CHARLEVOIX 2207419A 995 10/13/2021 9058 0.95 VILLAS OF STOVER CREEK CONDOMINIUM CHARLEVOIX 6279643A 568 12/10/2021 9015 ASSOCIATION VINTAGE HARDWOOD FLOORING INC CHARLEVOIX 2745194A 1,108 11/26/2021 5437 WOJAN TRANSPORTATION INC CHARLEVOIX 4540913A 14,045 11/6/2021 7208 0.82 BUTLER WILLIAM CHARLOTTE 5215811A 750 12/11/2021 2702

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CCS OPERATING COMPANY CHARLOTTE 2820978A 2,941 11/18/2021 0106 0.95 CHARLOTTE PLAZA FLORAL LLC CHARLOTTE 2770148A 621 12/6/2021 8001 CHUCKS CHARIOTS LLC CHARLOTTE 5852684A 487 12/27/2021 8748 CITIZENS LLC CHARLOTTE 0289736A 123,745 10/1/2021 8304 1.46 27 % DCE EXTERIORS LLC CHARLOTTE 6088570A 750 10/21/2021 5645 ETC SERVICES INC CHARLOTTE 4663330A 750 10/12/2021 9015 FALLING ROCK ENTERPRISES LLC CHARLOTTE 2904551A 917 10/4/2021 5550 0.95 LJT WELL DRILLING INC CHARLOTTE 1641719A 751 12/13/2021 5183 MOORE COUNTRY LIVING CHARLOTTE 2105900A 852 11/28/2021 9053 0.95 PAUL J FEENY BUILDING SPECIALTIES INC CHARLOTTE 1904884A 750 11/29/2021 5645 SANGSTER LANDSCAPE AND PATIO LLC CHARLOTTE 6256317A 1,385 10/8/2021 5221 AMERICAN TRACK TRUCK INC CHASSELL 4945212A 1,499 12/20/2021 4410 0.95 C AND J TRANSPORTATION LLC CHASSELL 4393856A 3,460 10/14/2021 7208 0.95 CHEBOYGAN TOWING INC CHEBOYGAN 2066351A 750 10/31/2021 7208 ECKER SURVEYING INC CHEBOYGAN 5209609A 322 11/12/2021 8601 FREESTYLE DEVELOPMENT LLC CHEBOYGAN 6279716A 750 12/4/2021 5645 LAVIGNE CALVIN R CHEBOYGAN 2284170A 1,009 11/10/2021 8395 0.95 LEVEL FIVE DRYWALL LLC CHEBOYGAN 2861496A 1,470 10/10/2021 5445 0.95 REINHARDT JAHN CHEBOYGAN 0501891A 568 12/2/2021 9015 SR JACOBS LLC CHEBOYGAN 6256481A 1,930 10/9/2021 7538 ALKEN ASSOCIATES LLC CHELSEA 1048643A 750 12/12/2021 0042 BEEKMAN RYAN & BEEKMAN KATHLEEN CHELSEA 5626072A 530 10/24/2021 0913 COMPASSIONATE DAUGHTERS HOME CARE LLC CHELSEA 4903277A 957 11/29/2021 8835 0.95 HARBORVIEW CARPENTRY CHELSEA 6050026A 800 10/4/2021 5645 J PALMER CARPENTRY LLC CHELSEA 4263537A 800 11/1/2021 5437 JIMS SCRAP IRON INC CHELSEA 2931540A 6,121 11/7/2021 7218 0.95 KIM SEXTON BUILDING & REMODELING LLC CHELSEA 3443248A 750 10/26/2021 5022 P AND M PAINTING INC CHELSEA 2414392A 750 12/16/2021 5476 SYLVAN TOWNSHIP WATER & SEWER CHELSEA 4578066A 911 11/12/2021 9410 UAW HALL 1284 CHELSEA 2047470A 636 11/30/2021 8755 UGLY DOG DISTILLERY LLC CHELSEA 5616824A 1,737 10/7/2021 9058 0.95 DENNIS INSURANCE SERVICES INC CHESANING 0402478A 317 12/19/2021 8810 EBENHOEH INC CHESANING 3916901A 374 11/10/2021 9052 FULL TIME FITNESS LLC CHESANING 5386080A 493 12/1/2021 9063 G COOPER ELECTRIC LLC CHESANING 5418879A 911 12/8/2021 5190 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 19 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge RON NIETLING CONSTRUCTION CHESANING 2697971A 2,478 10/21/2021 5223 0.95 AHERN CONTRACTING INC CHESTERFIELD 3121399A 800 12/31/2021 6217 B EZ FLOORING LLC CHESTERFIELD 5252628A 22,871 10/28/2021 9521 0.78 BRICK REPAIR MAINTENANCE CHESTERFIELD 5789265A 825 11/30/2021 5022 CARING HANDS HOME CARE SERVICES LLC CHESTERFIELD 1116894A 152,791 11/28/2021 8835 1.36 20 % CELTIC CARPENTRY LLC CHESTERFIELD 5772257A 2,706 10/31/2021 5437 0.95 CHERRY WOOD CONDOMINIUM ASSOCIATION CHESTERFIELD 1771914A 618 10/7/2021 9015 E M P CUSTOM CONSTRUCTION LLC CHESTERFIELD 4376323A 750 11/16/2021 5645 EMPIRE EQUESTRIAN CENTER LLC CHESTERFIELD 5469201A 9,035 10/28/2021 8279 0.90 J AND S KULMAN CONSTRUCTION INC CHESTERFIELD 0991813A 751 11/14/2021 5221 J MARTIN CARPENTRY CHESTERFIELD 2903105A 1,093 10/2/2021 5645 0.95 JENN STAR PAINTING CHESTERFIELD 2641763A 1,642 10/26/2021 5476 0.95 JPB CONSTRUCTION LLC CHESTERFIELD 2983770A 750 11/3/2021 5022 KURAS JOSHUA JOSEPH CHESTERFIELD 5967678A 751 12/11/2021 5645 METRO MOVERS OF MICHIGAN LLC CHESTERFIELD 5935520A 4,165 11/14/2021 7214 0.95 METRO PAINT GROUP LLC CHESTERFIELD 5327245A 848 10/10/2021 5476 MULLICA INDUSTRIES INC CHESTERFIELD 3927156A 6,314 11/8/2021 5403 0.95 PHENEY INC CONSTRUCTION SERVICES CHESTERFIELD 0986011A 828 11/15/2021 5606 PLATINUM PLUS FLOORING LLC CHESTERFIELD 4000340A 750 11/12/2021 5437 RENES PAINTING LLC CHESTERFIELD 5749816A 993 11/7/2021 5476 VALIANT NORTH INC CHESTERFIELD 4557360B 2,578 11/5/2021 9058 0.94 Z M R LIMITED CHESTERFIELD 6270417A 750 11/12/2021 5022 GREAT LAKES SYSTEMS & TECHNOLOGY LLC CHESTERFIELD TWP 5444624A 238 12/11/2021 8601 ANTHROMED LLC CHICAGO, IL 6048773A 382 10/3/2021 8868 DALEY JOHN P AND DALEY MARY LOU CHICAGO, IL 3195350A 810 12/16/2021 0908 PLOTNICK HARVEY CHICAGO, IL 6070566A 605 11/19/2021 0913 PRECISE INFORMATION SYSTEMS AND CHICAGO, IL 6204554A 542 12/1/2021 8810 PROFESSIONAL SERVICES INC SHULA INC CHICAGO, IL 2075180A 644 12/5/2021 9015 BISCARNERS TREE SERVICE LLC CHINA 0022845A 2,002 12/31/2021 0106 0.95 NAILED RITE CONSTRUCTION LLC CHINA TWP 4029119A 800 12/29/2021 5645 BEST UPON REQUEST CORPORATE INC CINCINNATI, OH 2448009A 1,185 10/17/2021 8742 0.95 BOLLE CONTRACTING LLC CLARE 3062619A 9,026 10/24/2021 5645 0.84 PRECISION BUILDING & REMODELING CLARE 6085520A 750 12/11/2021 5645 ZIEHM LP GAS SALES AND SERVICE INC CLARE 0091561A 54,909 12/9/2021 8350 1.64 13 %

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MICHIGAN TRUCK TOWING & RECOVERY LLC CLARKLAKE 5939046A 750 11/22/2021 7208 ABSOLUTE HOME IMPROVEMENT INC CLARKSTON 5352169A 825 12/11/2021 5437 AMERICAN DREAM CONSTRUCTION LLC CLARKSTON 5369150A 750 11/9/2021 5437 AUTUMN SHORES CONDOMINIUM ASSOCIATION CLARKSTON 3485412A 568 10/9/2021 9015 BARGER CONSTRUCTION LLC CLARKSTON 2245159A 750 10/17/2021 5403 CLARKSTON ROOFING PROFESSIONALS LLC CLARKSTON 5690129A 523 12/13/2021 8742 0.95 CNO ENTERPRISES INC CLARKSTON 1322818A 825 10/6/2021 5645 0.95 DEER LAKE ATHLETIC CLUB INC CLARKSTON 0300853A 26,574 10/1/2021 9063 1.72 20 % DRIPRITE HOME IMPROVEMENTS CLARKSTON 6284779A 750 12/21/2021 5551 FERRIS HOMES INC CLARKSTON 2875462A 750 12/11/2021 5645 FINE FINISHES CLARKSTON 6086209A 826 12/13/2021 5445 FOX HOLLOW ENTERPRISES LLC CLARKSTON 6279236A 750 12/3/2021 5645 FURNACES OVENS & BATHS INC CLARKSTON 2400316A 830 12/6/2021 8107 0.95 HERITAGE CONTRACTING LLC CLARKSTON 3586928A 829 11/20/2021 8810 HOLLOW METAL SERVICES LLC CLARKSTON 4551770A 750 10/27/2021 5102 INTERNATIONAL TRADE WINDS LLC CLARKSTON 6058892A 402 10/17/2021 8810 IVA LLC CLARKSTON 3671615A 3,442 11/1/2021 8868 1.00 IVAN CONTRACTING INC CLARKSTON 2634112B 800 12/22/2021 5476 L C B HOMES LLC CLARKSTON 3322491A 750 10/5/2021 5606 MILZOW FORREST G CLARKSTON 6264506A 825 10/24/2021 5645 OAKLAND COUNTY SNOW REMOVAL LLC CLARKSTON 5471729A 706 10/31/2021 9402 R E NOLL CONSTRUCTION LLC CLARKSTON 6085121A 6,800 12/10/2021 5645 ROOFING AND BEYOND LLC CLARKSTON 5286069A 750 12/5/2021 5551 SAVYER DRYWALL LLC CLARKSTON 3453308A 1,111 11/8/2021 5445 0.95 STATEWIDE TOWING AND RECOVERY LLC CLARKSTON 5021928A 751 12/12/2021 7208 STRUCTURAL PRECAST SERVICES INC CLARKSTON 4799585A 143,996 10/6/2021 5102 2.08 40 % TRIBUTE IN MOTION LLC CLARKSTON 5936349A 297 11/15/2021 4361 VICTOR MESTIZO PAINTING CLARKSTON 5927811A 750 10/26/2021 5476 VILLAGE TREE SERVICE LLC CLARKSTON 4857445A 1,900 12/7/2021 0106 WILHELM CUSTOM HOMES INC CLARKSTON 4282043A 800 10/18/2021 5183 ALGM STONE LLC CLAWSON 5928672A 750 10/27/2021 5437 COONHOUND CONSTRUCTION INC CLAWSON 4347226A 750 10/11/2021 5551 HR SYSTEMS AND STRATEGIES LLC CLAWSON 5531420A 354 12/15/2021 8810 0.95 MODERN KITCHENS LLC CLAWSON 2148420A 750 12/2/2021 5437 MCQUADE JOHN W CLAY 2445751A 751 10/6/2021 9015 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 21 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MICHIGAN SECURED DESTRUCTION SERVICES CLEVELAND, OH 4289587A 4,463 10/10/2021 8264 0.92 LLC A Z CONTRACTING CLINTON 4985486A 1,431 12/10/2021 5437 0.95 AHRENS AND SONS TRUCKING LLC CLINTON 4459148A 825 11/10/2021 7208 0.95 PFP ENTRUST CORP CLINTON 5941660A 13,790 12/10/2021 5462 FGJ TILE & MARBLE LLC CLINTON RIVER 6268900A 751 11/9/2021 5348 G SHOP COLLISION & RESTORATION LLC CLINTON TOWNSHIP 5813620A 1,526 11/19/2021 8395 HUNTS GYMNASTICS ACADEMY LLC CLINTON TOWNSHIP 4927516A 3,023 12/12/2021 9063 0.95 WBS ELITE TOWS LLC CLINTON TOWNSHIP 6261582A 750 10/17/2021 7208 AJK CONSTRUCTION INC CLINTON TWP 2994160A 750 12/27/2021 5645 ALL IN HAULING INC CLINTON TWP 6269389A 800 11/5/2021 7208 BALSAMO CONSTRUCTION INC CLINTON TWP 5207185A 750 12/23/2021 5645 BENMAR TERRACE CONDOMINIUM ASSOCIATION CLINTON TWP 1801139A 643 10/17/2021 9015 BEST WAY TRANSPORTATION INC CLINTON TWP 5622891A 13,483 10/18/2021 7208 0.82 BIRMINGHAM VILLAGE CONDOMINUM CLINTON TWP 5349435A 873 12/4/2021 9015 BUILD OUT SPECIALISTS LLC CLINTON TWP 6278868A 750 12/8/2021 5403 C AND C CEMENT CORPORATION CLINTON TWP 3044840A 750 10/4/2021 5221 C AND C SATELLITE INC CLINTON TWP 3222136A 750 12/6/2021 7600 0.95 C THOMAS CONTRACTING INC CLINTON TWP 0001406A 750 12/8/2021 5476 CHRIS AND ADRIAN RESIDENTIAL CLINTON TWP 6275338A 750 11/18/2021 5348 ENVIRONMENTAL SERVICES LLC COUMANS MASONRY INC CLINTON TWP 3431029A 750 10/6/2021 5022 D ANNA CONSTRUCTION COMPANY CLINTON TWP 4881338A 750 10/15/2021 5645 0.95 D M MARBLE GRANITE & TILE CLINTON TWP 4152832A 750 12/8/2021 5348 0.95 DAVES COLLISION COLLISION LLC CLINTON TWP 4745620A 2,733 11/27/2021 8393 DIGAETANO CONSTRUCTION LLC CLINTON TWP 5059119A 1,959 11/22/2021 5022 0.95 DOWNRIVER MAINTENANCE CORPORATION CLINTON TWP 0409928A 643 12/23/2021 8742 DS COMMERCIAL JANITORIAL SERVICES INC CLINTON TWP 3858197A 568 11/18/2021 9015 ELITE CUSTOM PAINTING & MAINTENANCE LLC CLINTON TWP 4937066A 800 12/23/2021 5476 ELMS FAMILY AND COMMUNITY SERVICES CLINTON TWP 6259944A 470 10/15/2021 8835 EXTERIOR RENOVATIONS LLC CLINTON TWP 5758521A 825 10/7/2021 5551 FAMILIES AGAINST NARCOTICS INC CLINTON TWP 5385270A 476 10/3/2021 8835 FANNING TILE & STONE CLINTON TWP 5197996A 750 10/9/2021 5348 FIRST STAFFING SOLUTIONS LLC CLINTON TWP 5067308A 10,688 12/31/2021 8010 1.38 10 % GREAT LAKES TRITONS INC CLINTON TWP 6260063A 1,336 11/5/2021 9061

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GROESBECK AUTO CARE INC CLINTON TWP 6254420A 1,130 10/3/2021 8395 HARBOR BAY CONSTRUCTION INC CLINTON TWP 2080370A 4,819 10/5/2021 5645 0.95 HICKSON HOME IMPROVEMENT INC CLINTON TWP 0134767A 825 11/25/2021 5645 ICON CONSTRUCTION CO LLC CLINTON TWP 5260370A 750 10/8/2021 5645 INDUSTRIAL ASSOCIATES CONDOMINIUM NO 2 CLINTON TWP 5349419A 750 12/4/2021 9015 J AND J CARPENTRY LLC CLINTON TWP 6264107A 750 10/23/2021 5645 J H CLEANING LLC CLINTON TWP 6274250A 569 11/16/2021 9015 LEOS HOME RENOVATION LLC CLINTON TWP 5755379A 993 10/6/2021 5348 M AND H PETRO LLC CLINTON TWP 4998626B 607 12/28/2021 8017 0.95 MANCHESTER TRUCKING LLC CLINTON TWP 6068367A 3,902 10/31/2021 7208 MANSFIELD ARMS ASSOCIATION CLINTON TWP 5349460A 568 12/4/2021 9015 MANZELLA VINCENZO CLINTON TWP 6258000A 530 10/10/2021 0913 OLD TIME SIDING CLINTON TWP 5786460A 750 10/23/2021 5645 PACAJ CONSTRUCTION LLC CLINTON TWP 5919649A 800 11/24/2021 5476 PREMIER BUILDER INC CLINTON TWP 1565753A 1,371 10/22/2021 5606 0.95 R AND S CONTRACTING LLC CLINTON TWP 5655404A 1,673 10/9/2021 9015 0.95 RL PAINTING COMPANY LLC CLINTON TWP 6088848A 751 12/24/2021 5476 RMM FLOORING CLINTON TWP 3440524A 540 10/29/2021 9521 SCHULTZ ESTATES III ASSOCIATION CLINTON TWP 2399776A 644 10/1/2021 9015 SILVER PINE ASSOCIATION CLINTON TWP 3262219A 568 11/7/2021 9015 SOLID CORE COMPOSITES LLC CLINTON TWP 5621399A 950 10/14/2021 8393 0.95 SZPARAGA JOSEPH CLINTON TWP 4675339A 540 10/9/2021 9521 TANDEM TIRE INC CLINTON TWP 4934750A 481 11/18/2021 8395 TOMMY DAVIDSON AND SON TRANSPORT INC CLINTON TWP 5484898A 750 12/5/2021 7208 TUSCAN PLAZA CONDOMINIUM ASSOC CLINTON TWP 5344263A 568 11/18/2021 9015 TWO BROTHERS PAINTING SERVICES LLC CLINTON TWP 6079091A 800 11/21/2021 5476 UNIQUE TILE & MARBLE LLC CLINTON TWP 6284868A 750 12/17/2021 5348 WHITES HOME IMPROVEMENT INC CLINTON TWP 2299240A 750 12/13/2021 5551 0.95 EXTREME INDOOR KART RACING LLC CLIO 5194210A 2,387 10/1/2021 9015 0.95 J AND D CONSTRUCTION AND SIDING LIMITED CLIO 6284205A 750 12/18/2021 5645 LIABILITY COMPANY MASTERCRAFT INC CLIO 4768140A 750 11/28/2021 5645 MITCH BURLEY ENTERPRISE INC CLIO 1962906A 6,015 11/29/2021 0042 1.33 27 % N AND E TRANSPORT INC CLIO 4971221B 5,439 10/12/2021 7208 0.95 OLSON HEATING AND COOLING LLC CLIO 6077820A 674 11/20/2021 5550

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PAULS TRACTOR SALES & SERVICE LLC CLIO 2579740A 1,583 12/18/2021 8116 0.95 PRIME CUT LAWNCARE SERVICES LLC CLIO 6284760A 1,200 12/21/2021 9402 R K HANDYMAN SERVICES CLIO 5847648A 750 12/21/2021 5437 VICS MOVING AND DELIVERY LLC CLIO 6061354A 750 12/17/2021 7206 MATTS SNOW AND LAWN CARE LLC CLYDE 5345480A 657 12/30/2021 9102 COLDWATER LODGE NO 1023 OF THE B P O E COLDWATER 0686484A 998 11/14/2021 9058 DEGOLIA CONSTRUCTION COLDWATER 3399818A 2,899 10/30/2021 5645 0.95 EXTREME EXTERMINATING LLC COLDWATER 5278767A 2,312 11/1/2021 9015 0.95 FIRST AVAILABLE TOWING LLC COLDWATER 5973600A 750 11/8/2021 7208 HADDEN INC COLDWATER 2216442A 466 10/3/2021 9058 MICHIANA LOGISTICS LLC COLDWATER 6267548A 11,280 11/3/2021 7216 UNION PALLET AND CONTAINER CO INC COLDWATER 2804654A 104,354 12/27/2021 2759 1.00 13 % UPC TRANSPORT LLC COLDWATER 4828615A 23,442 12/27/2021 7208 0.79 WILMAX EXPRESS TRUCKING LLC COLDWATER 6284280A 235 12/31/2021 8810 PAUL NELSON CONSTRUCTION LLC COLOMA 6273459A 2,420 11/20/2021 5437 CDM CONSTRUCTION COLUMBIAVILLE 5057213A 4,665 10/17/2021 5221 0.95 ELITE ARBORIST LLC COLUMBIAVILLE 5926530A 750 10/23/2021 0042 ENVIRONMENTAL CONSULTING AND TRAINING COLUMBIAVILLE 3082440B 290 10/11/2021 8868 LLC FRANKS CUSTOM CARPENTRY LLC COLUMBIAVILLE 4970969A 750 10/10/2021 5645 INCLINE SOLUTIONS INC COLUMBIAVILLE 4884060A 3,023 10/8/2021 5160 0.95 M D CARPENTRY COLUMBIAVILLE 3697053A 750 10/16/2021 5437 M J TORCHING COLUMBIAVILLE 2740176A 699 12/6/2021 3365 BARBARO ENTERPRISES CO COLUMBUS 2395088A 750 12/19/2021 5645 0.95 CUTTING EDGE TREE SERVICE LLC COLUMBUS 4949820A 1,721 10/27/2021 0106 0.95 GLEN AND MARYS PERSONALIZED CLEANING COLUMBUS 2885042A 568 11/2/2021 9015 SERVICE GRIMM INDUSTRIES LLC COLUMBUS 5945771A 449 12/15/2021 7720 K N E CONTRACTING INC COLUMBUS 3786935A 789 10/3/2021 6217 KT ENTERPRISES COLUMBUS 2344106A 3,427 11/13/2021 5645 0.94 LITECH LIGHTING MANAGEMENT SERVICES INC COLUMBUS, OH 4466659A 470 11/15/2021 5190 US TANK ALLIANCE INC COLUMBUS, OH 4163419A 12,234 12/31/2021 9015 0.80 ALL SEASONS CONTRACTING INC COMMERCE 3184552A 750 12/27/2021 0042 OFFICE FURNITURE SOLUTIONS INC COMMERCE 3024512A 800 11/1/2021 5146 1.31 13 % ARCTIC CIRCLE INC COMMERCE TS 1427350A 1,497 11/21/2021 0042 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge AJC MANAGEMENT SERVICES INC COMMERCE TWP 1881485A 278 12/11/2021 8810 0.84 ALL WATER INC COMMERCE TWP 4522303A 2,271 12/12/2021 5183 0.93 CERTI DRI LLC COMMERCE TWP 5514380A 568 11/5/2021 9015 CERTIFIED HOME SERVICES LLC COMMERCE TWP 5129265A 568 11/1/2021 9015 DFB BUILDING INC COMMERCE TWP 5763398A 6,229 10/14/2021 5645 0.95 DIGITAL COMMUNICATION SOLUTIONS LLC COMMERCE TWP 4313909A 2,915 12/17/2021 7600 0.86 EPLEY CUSTOM DESIGNS LLC COMMERCE TWP 3793044A 750 12/12/2021 5645 0.94 FOAM PROS LLC COMMERCE TWP 6265405A 1,784 10/28/2021 5479 JOHN DEMATTIA CONSTRUCTION LLC COMMERCE TWP 4812190A 1,251 11/16/2021 5606 0.95 KROMS TREE CARE AND LANDSCAPING INC COMMERCE TWP 5647754A 9,208 12/12/2021 0106 0.89 MICHAEL MCGINLEY & ASSOCIATES INC COMMERCE TWP 0516929A 750 12/10/2021 5476 R AND S MARKHAM LTD COMMERCE TWP 2545896A 825 10/15/2021 5403 RACHEL GREENBERG TRUST COMMERCE TWP 5788021A 571 11/28/2021 0908 SAROKIS PARTY STORE INC COMMERCE TWP 4937139A 922 11/5/2021 8017 STOCKER SERVICES LLC COMMERCE TWP 6279708A 710 12/4/2021 0042 WJM CONSTRUCTION INC COMMERCE TWP 3749061A 16,045 12/4/2021 5645 1.35 10 % XPRESS HOLIDAY LIGHTING COMMERCE TWP 6070744A 634 11/7/2021 5190 MLA ENTERPRISE COMSTOCK 4573889A 739 12/19/2021 6217 TECON TRUCKING CORPORATION COMSTOCK 0060798A 751 11/27/2021 9402 0.95 DDR REAL LOGISTICS INC COMSTOCK PARK 5947065A 1,393 12/20/2021 8018 ELVIN PAINTING COMSTOCK PARK 6063551A 6,134 10/23/2021 5476 1.00 FUENTES NELSON COMSTOCK PARK 6073034A 750 11/8/2021 5476 LTF VENTURES INC COMSTOCK PARK 5765617A 657 10/19/2021 0005 VIZIDEF LLC COMSTOCK PARK 5526906A 5,259 11/4/2021 5191 0.95 ACCURATE BUILDING & RENOVATION LLC CONKLIN 3808505A 801 10/15/2021 8810 AGRICULTURAL COMPLIANCE SERVICES LLC CONKLIN 5773130A 333 11/1/2021 8601 AROUND THE RIDGE GRAPHICS LLC CONKLIN 5773067A 285 11/1/2021 8810 JOHNS TOWING & TRANSPORT LLC COOPERSVILLE 0383260A 7,200 12/24/2021 7208 0.95 L A F INC OF MICHIGAN COOPERSVILLE 2873648A 750 12/12/2021 5437 0.95 NATE KAPTEIN BUILDERS LLC COOPERSVILLE 5785367A 750 11/23/2021 5403 STK CONSTRUCTION LLC COOPERSVILLE 5760640A 750 10/12/2021 5645 YOUNG GUYS TREE SERVICE LLC COOPERSVILLE 6269451A 1,900 11/5/2021 0106 SIMULA FARM AND FOREST PRODUCTS LLC COPPER CITY 3725707A 750 12/17/2021 7208 BRUCE PLOURDE TRUCKING CORNELL 3168468A 750 10/29/2021 7208 GAZAN EXCAVATING LLC CORNELL 5062217A 739 11/28/2021 6217 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 25 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge STILES DONALD CORNELL 6065210A 750 10/25/2021 5551 VPI ACQUISITION LLC CORRY, PA 4268555A 845 11/21/2021 8742 0.95 J S INSTALLATIONS CORUNNA 2546027A 935 11/23/2021 5538 0.95 MAXIMUM TOWING & RECOVERY LLC CORUNNA 4710339A 4,149 12/7/2021 7208 0.93 VAUGHN CONSTRUCTION SERVICE INC COTTRELLVILLE 3656268A 750 10/17/2021 5645 SAN DIEGO CARPET LLC COVERT 5987768A 615 12/24/2021 9521 ALEXANDER CONSTRUCTION CROSWELL 2623676A 750 10/21/2021 5645 BENS MIGHTY MOLE LLC CROSWELL 5706750A 1,949 10/1/2021 6325 0.95 COUNTRY HILL PINES LLC CROSWELL 5926963A 925 10/24/2021 9015 FULL METAL TOWER SERVICES LLC CROSWELL 5931150A 7,786 11/1/2021 5102 0.95 JERRY WOODRUFF CONSTRUCTION LLC CROSWELL 5616263A 23,281 10/5/2021 5551 1.56 13 % CRYSTAL CLEAR WATER WELL SYSTEMS LLC CRYSTAL 3478343A 2,364 10/16/2021 6204 0.95 JARVI KEVIN CRYSTAL FALLS 5927188A 750 10/24/2021 7208 LAKE ELLEN BIBLE CAMP AND RETREAT CENTER CRYSTAL FALLS 3995879A 6,116 12/1/2021 9015 0.87 PAINT RIVER FORESTRY CRYSTAL FALLS 4918452A 750 10/6/2021 2709 SANTI EXCAVATING DIVERSIFIED INC CRYSTAL FALLS 1601032A 1,938 10/19/2021 7380 0.95 TERRY JARDEEN LOGGING CRYSTAL FALLS 1859994A 750 11/18/2021 2709 TWO DOG TRUCKING CRYSTAL FALLS 5630541A 750 11/1/2021 7208 ABBE HUNTER CUMMINS 6284990A 750 12/22/2021 2702 X WEIGH SCALES AND SYSTEMS LLC CURTICE, OH 4872460A 2,426 10/15/2021 5550 0.95 FARNSWORTH FORESTRY CONSULTING CURTIS 3717100A 261 11/19/2021 8601 SERVICES LLC QUALITY KLEEN CUSTER 1514326A 568 10/8/2021 9015 TOM WANGERIN INC DAGGETT 2572966A 750 10/19/2021 7208 FASTER DGA CONVEYOR INSTALLATION LLC DALTON, GA 6286119A 6,320 12/30/2021 3724 RYKER CONSTRUCTION LLC DANSVILLE 6067689A 9,880 10/30/2021 5645 1.00 CORNERSTONE HOME IMPROVEMENTS INC DAVISBURG 4651570A 3,702 10/20/2021 5645 1.33 13 % CTD ELECTRICAL ENTERPRISE LLC DAVISBURG 4892275A 470 12/11/2021 5190 EAGLE ACRES SERVICES INC DAVISBURG 4932455A 3,668 11/11/2021 5403 0.95 LAWSON BALER SALES & SERVICE INC DAVISBURG 2618133A 845 11/16/2021 3628 OAKLAND BRICKSCAPE LLC DAVISBURG 3233669A 709 10/25/2021 0042 PRYJOMSKI LLC DAVISBURG 1588630A 761 10/5/2021 5645 SUN STRUCTURES BUILDING INTEGRITY DAVISBURG 3751589A 801 10/14/2021 5645 0.95 SVW BUILD INC DAVISBURG 4144708A 1,676 12/14/2021 5221 0.95 TERSIGNI BROTHERS CONSTRUCTION LLC DAVISBURG 4324870A 800 10/9/2021 5437

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ALL SEASONS TREE AND LAWN LLC DAVISON 6254446A 7,155 10/5/2021 0042 CHAD SMITH BUILDERS LLC DAVISON 3251748A 750 12/8/2021 5403 DAVISON AREA SENIOR CITIZEN ACTIVITY DAVISON 1783955A 578 12/1/2021 8810 CENTER FERGUSON FOAM LLC DAVISON 5389585A 1,364 11/17/2021 5479 0.95 J AND K NOVAK INC DAVISON 3912221A 1,070 11/13/2021 8869 M 15 AUTO SALVAGE DAVISON 1616919A 2,690 11/15/2021 3821 0.95 MICHIGAN SHOOTING CENTERS LLC DAVISON 3716490A 11,982 12/27/2021 9015 0.83 MORALES SETH DAVISON 6028128A 215 10/9/2021 8810 NGC ENTERPRISES LLC DAVISON 6081460A 760 11/30/2021 9402 PROFESSIONAL KARATE SCHOOLS OF AMERICA DAVISON 4064712A 351 10/10/2021 9063 DAVISON LLC RILEY CUSTOM HOMES INC DAVISON 2837846A 5,276 11/19/2021 5437 SUNSHINE IN HOME PRIVATE DUTY SERVICES DAVISON 5033330D 4,942 10/27/2021 8835 1.56 13 % INC T AND T SHEROSKI NO 3 INC DAVISON 0305227A 24,542 11/20/2021 9058 1.16 13 % TOP QUALITY COLLISION INC DAVISON 2931818A 2,038 11/30/2021 8393 0.95 A N F TRANS INC DEARBORN 6278043A 825 12/1/2021 7202 ACTION TIRE SERVICE CO DEARBORN 1451928A 9,881 12/27/2021 8387 1.51 40 % ALWAYS GENTLE DENTISTRY PLC DEARBORN 3889548A 770 11/22/2021 8832 ARS CONSTRUCTION LLC DEARBORN 5649501A 5,016 12/15/2021 5645 0.95 ASKAR CARPET LLC DEARBORN 4803906A 830 10/20/2021 9521 B AND H MACHINE SALES INC DEARBORN 0034231A 461 11/13/2021 8107 B SQUARE INTERIOR REMODELING LLC DEARBORN 6257186A 750 10/9/2021 5437 BEST INC DEARBORN 3098249A 802 11/3/2021 8810 BLUE RIBBON CONSTRUCTION MANAGEMENT DEARBORN 6064809A 448 11/1/2021 8601 LLC BLUE SKY INVESTMENTS GROUP LLC DEARBORN 4447379A 568 11/21/2021 9015 CHASE DEVELOPMENT GROUP INC DEARBORN 5319978A 825 10/13/2021 5645 DETROIT QUALITY STAFFING LLC DEARBORN 6255876A 2,518 10/7/2021 3808 DIVERSITY FLOORING LLC DEARBORN 4881052A 591 11/25/2021 9521 DUCLO DAYTON DEARBORN 6251846A 750 10/7/2021 5445 EMPIRE BUILDERS GROUP INC DEARBORN 5032679A 802 12/22/2021 8810 0.95 ERP SERVICES LLC DEARBORN 3354768A 255 10/28/2021 8803 F AND S DISTRIBUTOR LLC DEARBORN 6279244A 750 12/4/2021 7202 FARAJ CONSTRUCTION INC DEARBORN 5794056A 2,179 12/7/2021 9521 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FIRST STAR AUTO INC DEARBORN 6262368A 665 10/24/2021 8393 FOOT AND ANKLE SPECIALTY CLINIC PC DEARBORN 4689011A 361 11/17/2021 8832 GEOFFREY M EATON INC DEARBORN 1683217B 574 10/20/2021 9015 GLOBAL TRADING & SOURCING INC DEARBORN 5762855A 1,973 10/15/2021 8032 1.00 HARRYS TOWING SERVICES INC DEARBORN 5925169A 750 10/30/2021 7208 INTERLOGUS LLC DEARBORN 5770084A 587 10/26/2021 7610 JASMIN CARPETING & DESIGN INC DEARBORN 5943892A 826 12/4/2021 5437 K 3 K PIZZA LLC DEARBORN 5030307A 2,701 12/13/2021 7202 0.95 LOUKA CARPET LLC DEARBORN 5653428A 591 12/28/2021 9521 MI ASSOCIATES INC DEARBORN 4319230A 674 11/1/2021 5550 MOTOR X PRESS INC DEARBORN 6286402A 2,574 12/31/2021 7208 N A TRANSPORTATION LLC DEARBORN 5530253A 750 10/6/2021 7208 NASSAR CARPET & INSTALLATION INC DEARBORN 5773059A 591 11/1/2021 9521 NORTH SHORE CARPET SERIVCES INC DEARBORN 5517540A 541 11/6/2021 9521 NURTU CARE INC DEARBORN 5663970A 1,890 12/18/2021 8835 0.95 OFFICE GEEKS INSTALLATIONS LLC DEARBORN 6271545A 751 11/10/2021 5146 REHABILITATION ONE INC DEARBORN 4007085A 530 10/11/2021 8832 ROADWAY TOWING & SERVICES INC DEARBORN 5786541A 1,960 11/23/2021 7208 0.95 ROBS FLOORING LLC DEARBORN 6284574A 1,142 12/19/2021 9521 SAMA INVESTMENT & TRADING INC DEARBORN 5944554A 319 12/12/2021 8810 SLIM INTERNAL MEDICINE PLLC DEARBORN 5477409A 390 12/1/2021 8832 TEDS MARBLE AND TILE LLC DEARBORN 5292069A 750 11/10/2021 5348 TOMMYS MOVING TEAM LLC DEARBORN 5942608A 4,245 12/6/2021 8293 TRASH IT GROUP LLC DEARBORN 4055799A 3,844 11/14/2021 7213 0.96 TRUE COMFORT INC DEARBORN 3069397A 825 11/22/2021 5645 WILMAS TOWING LLC DEARBORN 5651557A 750 12/20/2021 7208 WISSAM DAHER CONTRACTING LLC DEARBORN 6262139A 665 10/20/2021 8393 ZAYOUR CARPET & FLOORING LLC DEARBORN 3188043A 540 11/21/2021 9521 ACE MANAGEMENT GROUP LLC DEARBORN HEIGHTS 6049605A 6,174 10/4/2021 8031 0.95 BAILEY JAMES DEARBORN HEIGHTS 6268676A 750 11/4/2021 5645 BAZZOUN CARPET INC DEARBORN HEIGHTS 5174651A 610 10/25/2021 9521 CITY RECYCLERS INC DEARBORN HEIGHTS 5065747A 3,803 10/23/2021 8018 1.52 13 % CONSTRUCTIVE DRYWALL & PAINTING DEARBORN HEIGHTS 6038913A 750 11/18/2021 5445 CS PARKING INC DEARBORN HEIGHTS 5647894A 1,025 12/3/2021 8392 DELPIZZO ENTERPRISES INC DEARBORN HEIGHTS 0354007A 751 10/15/2021 9058 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 28 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FORTITUDE TRUCKING INC DEARBORN HEIGHTS 6273386A 829 11/12/2021 8810 GERALD M BASKERVILLE & CO DEARBORN HEIGHTS 0680230A 317 10/31/2021 8810 HAIR CONNECTION LLC THE DEARBORN HEIGHTS 0229083A 241 10/17/2021 9586 LGH CONSTRUCTION LLC DEARBORN HEIGHTS 5867959A 750 12/10/2021 5645 M K FLOORING INC DEARBORN HEIGHTS 3686876A 540 11/11/2021 9521 MIDWEST TOWING INC DEARBORN HEIGHTS 5950740A 2,327 10/21/2021 7208 NHK AUTO SALES INC DEARBORN HEIGHTS 5965950A 1,322 12/11/2021 7208 PJW CONSTRUCTION INC DEARBORN HEIGHTS 4932471A 800 11/10/2021 9402 0.95 SUBCONTRACT SERVICES INC DEARBORN HEIGHTS 4609166A 2,787 12/10/2021 5437 TUNN TRANSPORT INC DEARBORN HEIGHTS 6264115A 2,740 10/23/2021 7208 UNION CAISSON INC DEARBORN HEIGHTS 4141938A 1,168 11/9/2021 5213 0.95 YASIN FLOORING LLC DEARBORN HEIGHTS 6058248A 1,456 10/16/2021 9521 ZEIN HVAC LLC DEARBORN HEIGHTS 6277357A 725 11/25/2021 5550 SMOKERZ SUPPLIES LLC DEARBORN HGTS 6272541A 483 11/12/2021 8017 QUICK N EAZY CONSTRUCTION LLC DEARBORN HTS 6035795A 800 10/20/2021 5551 AGRISPHERE LLC DECATUR, IL 5789435A 1,053 12/1/2021 8720 0.95 BUSS FARMS INC DECATUR 5638038A 813 11/20/2021 0128 SORENSEN TREE SALES LLC DECATUR 5474906A 358 10/20/2021 8010 DEERFIELD TOWNSHIP DEERFIELD 0374903A 1,853 11/21/2021 7704 0.95 UNRESTRICTED OUTDOOR SERVICES INC DEERFIELD 6068391A 739 10/31/2021 6217 OLYMPIA ENTERPRISES INC OF MARQUETTE DEERTON 0395269A 568 12/20/2021 9015 PARADISE LAWN & LANDSCAPE DELTON 5626900A 710 10/26/2021 9102 WILLAND MILLWRIGHT SERVICES LLC DELTON 3709310A 13,369 10/1/2021 3724 0.83 A 1 AMERICAN AUTO REPAIR INC DETROIT 6080960A 788 11/27/2021 8395 A 1 DRYWALL SERVICES LLC DETROIT 5737710A 2,192 10/18/2021 5445 0.95 A 2 EXPRESS INC DETROIT 2671867A 907 10/10/2021 8017 A AND B TRANSMISSIONS INC DETROIT 5940508A 3,345 11/29/2021 8395 0.95 ABA IMPOUNDS INCORPORATED DETROIT 3553990A 825 11/14/2021 7208 ACOSTA CUSTOM PAINTING LLC DETROIT 5469945A 750 10/29/2021 5476 ALKEBU LAN VILLAGE DETROIT 3369668A 1,819 12/8/2021 9063 0.95 ALNOUR SUPER MARKET LLC DETROIT 6269354A 715 11/5/2021 8006 AMERICAN ENVIRONMENTAL CONSULTANTS LLC DETROIT 3683990A 846 12/16/2021 4511 0.94 AML GAS INC DETROIT 3816524A 797 10/16/2021 8017 0.95 ANDREWS FRED DETROIT 6275729A 750 11/19/2021 5645

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 29 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ANGEL HANDS REMODELING & RENOVATIONS DETROIT 6270646A 750 11/9/2021 5476 LLC ANGEL ROOFING DETROIT 6274749A 1,127 11/17/2021 5551 AQUARIAN CONSTRUCTION INC DETROIT 5127920A 413 12/8/2021 5606 ARMADILLO SERVICES INC DETROIT 5353319A 707 12/9/2021 9402 0.95 ASSOCIATES COMPANY LLC DETROIT 6264751A 750 10/27/2021 5645 ATTENTIVE HEARTS HOMECARE SERVICES INC DETROIT 6054919A 842 10/10/2021 0908 AUBURN LLC DETROIT 4906667A 825 12/7/2021 9015 0.95 BACALL ENTERPRISES INC DETROIT 2515270A 1,172 11/8/2021 8017 0.95 BANGKOK CROSSING INC DETROIT 4192273A 1,271 11/11/2021 9058 0.95 BANGKOK CROSSING MILLENDER INC DETROIT 6269702A 608 11/5/2021 9058 BATOUL INC DETROIT 4372387A 2,337 12/23/2021 8265 BOBS PIZZA PALACE INCORPORATED DETROIT 0257249A 6,890 12/8/2021 9058 0.85 BROWN TRANSPORT SERVICES LLC DETROIT 6281206A 750 12/10/2021 7208 BSSN AUTO GROUP LLC DETROIT 6277292A 1,470 12/1/2021 8010 BUILDING BLOCKS HOME IMPROVEMENT LLC DETROIT 6067506A 2,533 12/17/2021 5437 CENTERFOLD INC DETROIT 0109665A 509 12/10/2021 9058 CHALMERS SERVICE STATION INC DETROIT 4740874A 864 10/20/2021 8017 0.95 CHAMI SHAMEL CORPORATION DETROIT 4534379A 457 10/24/2021 8017 CHARLES M JOHNSON PODIATRIST PC DETROIT 2248379A 435 10/10/2021 8832 CHECOS AUTO SALES LLC DETROIT 6270220A 344 11/6/2021 8748 CLIMB ON DETROIT LLC DETROIT 6265316A 3,602 11/2/2021 9063 COLLING HOMES INC DETROIT 4159284A 11,523 12/31/2021 9053 0.76 COMBS DRYWALL INC DETROIT 4834593A 750 10/6/2021 5445 COMMUNITY SOCIAL SERVICES OF WAYNE DETROIT 5160421A 421 10/1/2021 8810 0.81 COUNTY CUTTIN BOOSTERS LAWN CARE SERVICE LLC DETROIT 6254403A 1,107 10/3/2021 9102 D AND L SECURITY SOLUTIONS LLC DETROIT 6265375A 7,140 10/30/2021 7720 DATA DRIVEN DETROIT L3C DETROIT 5454557A 1,071 10/1/2021 8810 0.95 DETROIT CAR CENTER INC DETROIT 3622959A 1,287 11/9/2021 8395 DETROIT CAREGIVER ASSOCIATION LLC DETROIT 5958903A 1,129 11/23/2021 8045 DETROIT CENTRAL CITY COMMUNITY MENTAL DETROIT 0127701A 32,098 12/1/2021 8832 1.38 HEALTH INC DETROIT FITNESS FOUNDATION DETROIT 5611482A 2,735 12/13/2021 9063 1.00 DETROIT PUBLIC THEATRE DETROIT 5409853A 2,507 10/15/2021 9154 0.95 DETROIT RECOVERY PROJECT DETROIT 4318080A 2,453 12/17/2021 8832 0.95 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 30 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DIVERSIFIED CONCRETE & TRUCKING LLC DETROIT 2725967A 750 12/9/2021 5221 EAST BROOKE COMMONS LLC DETROIT 0186015A 1,545 12/9/2021 9015 0.95 EMCO CHEMICAL INC DETROIT 0353850A 2,657 10/5/2021 4511 1.00 ENERGY 59 INC DETROIT 4860810A 1,450 11/7/2021 8017 0.95 ESSEX ALLIANCE USA HOLDINGS LIMITED DETROIT 5884365A 2,165 10/14/2021 9015 0.95 PARTNERSHIP F M CARPENTERS LLC DETROIT 3927113A 4,160 12/15/2021 5645 0.90 FAIR NASH LIQUOR INC DETROIT 0315214A 890 12/15/2021 8017 FAITH FAMILY & DETERMINATION DETROIT 4479394A 1,100 10/28/2021 9053 0.95 FERCHOS FLOORING LLC DETROIT 5032601A 540 10/20/2021 9521 0.95 FIRST HAND RESTORATION LLC DETROIT 4635850A 1,835 10/29/2021 8835 0.95 FIVE CROWNS TRUCKING LLC DETROIT 6270760A 19,425 11/7/2021 7219 FORD ROAD BISTRO LLC DETROIT 4749642A 1,311 10/12/2021 9058 0.95 FORREST HAVEN LTD DETROIT 2346028A 617 10/29/2021 9052 FOUR THOUSAND 661 GAS & MORE INC DETROIT 1736523A 529 12/30/2021 8017 0.95 FUTURE BUILD CONSTRUCTION GROUP DETROIT 5621526A 4,628 10/22/2021 8720 0.95 GAYA INC DETROIT 1710710A 673 12/4/2021 2586 GAYANGA CO DETROIT 5657504A 77,830 12/14/2021 5645 0.79 GEMINI TOWING LLC DETROIT 6055834A 750 11/6/2021 7208 GIOVANNIS FLOORING LLC DETROIT 6262970A 540 10/21/2021 9521 GISMO WIRELESS INC DETROIT 5163838A 1,127 10/23/2021 8017 0.95 GOURMET FOOD CENTER INC DETROIT 2912732A 968 10/22/2021 8031 0.95 GREEKTOWN NEIGHBORHOOD PARTNERSHIP DETROIT 5926319A 327 10/23/2021 8810 GUARDIAN HOME INSPECTIONS INC DETROIT 1786750A 1,099 12/28/2021 8720 0.95 GUARDIAN SEWERS LLC DETROIT 5784646A 2,136 11/21/2021 6306 0.95 H AND D IMPROVEMENTS LLC DETROIT 6220550A 750 10/29/2021 5551 HARPER MINI MART LLC DETROIT 4458354A 604 12/24/2021 8006 0.95 HENNY PENNY INC DETROIT 4487710A 1,198 12/29/2021 8018 0.95 J AND D INTERIORS LLC DETROIT 5807174A 1,763 11/3/2021 5403 J KEITH CONSTRUCTION LLC DETROIT 5459958A 800 12/5/2021 5022 0.95 JAAS TRANSPORT LLC DETROIT 6261736A 825 10/27/2021 7208 JAMES AND SCHAEFER GAS & MORE INC DETROIT 3969835A 911 12/7/2021 8017 JET FUELS INC DETROIT 6137962A 720 11/25/2021 8017 JJS HOUSE COMPANY LLC DETROIT 5343011A 5,678 11/20/2021 5606 0.82 JO BIS ROOFING LLC DETROIT 5457173A 6,975 10/6/2021 5551 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge JUANES PAINTING LLC DETROIT 6029485A 800 10/12/2021 5476 JUNIORS JRS CONSTRUCTION LLC DETROIT 5874963A 11,287 12/11/2021 5645 K AND G SPECIALTIES LLC DETROIT 5340896A 756 11/7/2021 5476 0.95 KALAJ KONEY KING INC DETROIT 4538110A 697 12/22/2021 9058 LARIX ENTERPRISES DETROIT 6259499A 800 10/14/2021 0106 LIBERAL MANOR INC DETROIT 3080390A 2,789 10/14/2021 9053 0.95 LOBSTER FOOD TRUCK LLC DETROIT 5930103A 379 11/2/2021 9058 LOCAL CIRCLES DETROIT 6070698A 444 12/12/2021 8868 LODGE AND GREENFIELD LLC DETROIT 5433037A 565 11/14/2021 8017 LOVIO GEORGE INC DETROIT 0103195A 1,634 11/12/2021 8742 0.95 LP INDUSTRIES LTD DETROIT 5406854A 1,384 11/3/2021 9402 0.95 LUXURY AUTO SALES INC DETROIT 6250807A 3,556 10/8/2021 8395 M 1 RAIL DETROIT 5278007A 857 11/15/2021 8601 M 2 RAIL DETROIT 5279380A 313 11/15/2021 8601 MACK AND VAN DYKE MINI MART INC DETROIT 1709011A 512 12/24/2021 8017 0.95 MATTJACK LLC DETROIT 6266851A 800 10/31/2021 5476 METRO CARE GROUP LLC DETROIT 5219132A 1,563 12/12/2021 9053 0.95 METRO DETROIT AFL CIO DETROIT 0057908A 731 12/14/2021 8755 MICHIGAN AND LIVERNOIS GAS & MINIMART INC DETROIT 4545010A 779 10/15/2021 8017 MICHIGAN MINORITY PURCHASING COUNCIL DETROIT 0958581A 2,075 11/5/2021 8810 0.95 MICHIGAN SCIENCE CENTER DETROIT 0047287A 309 11/5/2021 8810 MICHIGAN VETERANS FOUNDATION INC DETROIT 0099694A 7,442 11/22/2021 8832 0.91 MIDTOWN MUSIC VENTURE LLC DETROIT 5937663A 490 12/6/2021 8810 MIDWEST COMMODITIES LLC DETROIT 4962192A 328 11/4/2021 8810 0.95 MLK FOOD CENTER INC DETROIT 5078717A 610 11/1/2021 8006 MOMS HEALING HANDS LLC DETROIT 5774217A 3,654 10/12/2021 9053 0.95 MOSS COMPANY LLC DETROIT 5756146A 5,375 10/4/2021 6217 0.95 NAJAR PETROLEUM LLC DETROIT 5657431A 720 10/31/2021 8017 NDW LOGISTICS LLC DETROIT 6272517A 750 11/13/2021 7208 NEW AGE FLOORING LLC DETROIT 6270697A 540 11/9/2021 9521 NEW BEGINNING LANDSCAPE SERVICE LLC DETROIT 4365097A 800 11/4/2021 0042 NEW MT SINAI BAPTIST CHURCH DETROIT 2438313A 241 12/20/2021 8868 NINE THOUSAND 801 GAS AND MORE LLC DETROIT 4629400A 959 10/3/2021 8017 NINETY NINE A LLC DETROIT 5942977A 477 12/7/2021 8820 NISRINE MINI MART INC DETROIT 4492447A 512 11/15/2021 8017 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 32 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge NOBLE HOME II INC DETROIT 2698587A 1,010 12/12/2021 9053 0.95 NORMANDY APARTMENTS CONDOMINIUM DETROIT 1318250A 1,003 11/30/2021 9015 ASSOCIATION INC NORTHLAND CLEANING SERVICES LLC DETROIT 5343780A 568 12/16/2021 9015 NORTHLAND PARTY STORE INC DETROIT 1312316A 977 12/31/2021 8017 0.95 NOVA CONTRACTING CORP DETROIT 1289969A 322 11/7/2021 8810 0.93 OLD NEWSBOYS GOODFELLOW FUND OF DETROIT 2786826A 353 12/28/2021 8810 DETROIT INC ORLANDOS LANDSCAPING & SNOW REMOVAL DETROIT 2765551A 2,117 12/12/2021 9402 SERVICE INC OSORIO AND COMPANY LLC DETROIT 6281184A 4,820 12/10/2021 5645 P AND P GROUP INC DETROIT 5492874A 1,754 11/5/2021 8601 0.95 PFI II LLC DETROIT 6257909A 351 10/20/2021 8810 PHO LUCKY LLC DETROIT 5497280A 3,320 12/16/2021 9058 1.00 PURE PETRO LLC DETROIT 6277462A 720 11/26/2021 8017 Q AND K INC DETROIT 3605159A 995 11/14/2021 8017 0.95 QUALITY AUTO SERVICE INC DETROIT 3517373A 425 10/13/2021 8748 QUALITY PAINTING AND DRYWALL SERVICES INC DETROIT 5252105A 750 11/21/2021 5476 QUEENS OF KLEEN LLC DETROIT 4174780A 1,043 10/15/2021 9015 0.95 QUICK TRACK TRANSPORTATION LLC DETROIT 6259286A 750 10/14/2021 7208 R AND JOHN PIZZA INC DETROIT 5693764A 1,260 10/7/2021 9058 0.95 RACQUET UP DETROIT DETROIT 4805437A 2,874 11/1/2021 8868 0.95 RAMOS CARPET LLC DETROIT 6256120A 540 10/27/2021 9521 RAQUELS COCINA LLC DETROIT 6269621A 330 11/5/2021 9058 REDLEY AFC INC DETROIT 3939685A 1,072 10/9/2021 9053 RIVER KRISPY CRUNCHY CHICKEN LLC DETROIT 6261558A 710 10/17/2021 9058 ROBOT LOGISTICS LLC DETROIT 6262090A 750 10/20/2021 7208 ROCKWELL CLEANING SERVICES LLC DETROIT 5946441A 643 12/15/2021 9015 ROMELS TOWING LLC DETROIT 5655340A 825 10/2/2021 8810 RSREFINISHING LLC DETROIT 6087779A 1,034 12/18/2021 9015 RUBY LEE TRANSPORT LLC DETROIT 6235042A 750 10/1/2021 7208 S AND M WIRELESS INC DETROIT 5801869A 461 12/21/2021 8017 SAAD AUTO PARTS INC DETROIT 4422120A 2,050 10/31/2021 8010 SAEED LLC DETROIT 6281141A 2,026 12/10/2021 7208 SALES AND SERVICE TIRE & SUSPENSION INC DETROIT 2247615A 1,634 10/6/2021 8387 0.95 SANAA INC DETROIT 2103427A 2,196 12/27/2021 9058 0.95 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 33 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SD 6 LLC DETROIT 6257119A 635 10/9/2021 7720 SEVEN AND SOUTHFIELD LLC DETROIT 1651285A 793 11/7/2021 8017 SIDEWALK DETROIT DETROIT 6085954A 365 12/12/2021 8810 SOMETHING NEW PAINTING AND RENOVATION DETROIT 5468620A 825 10/6/2021 5476 LLC SOUTHWEST DETROIT ENVIRONMENTAL VISION DETROIT 0567043A 766 12/2/2021 8742 PROJECT SSM INDUSTRIES LLC DETROIT 1396358A 1,862 10/27/2021 3066 0.95 STERLING RENTAL INC DETROIT 4927400A 2,519 10/26/2021 8393 0.95 SULLIVAN BUILDING COMPANY OF MICHIGAN LLC DETROIT 6270611A 3,738 11/7/2021 5437 SUPERIOR CONSTRUCTION & MANAGEMENT LLC DETROIT 3733700A 826 10/27/2021 5445 SUPERIOR INNOVATIVE SOLUTIONS LLC DETROIT 3535096A 1,059 12/31/2021 9015 SUPREME CUSTOM PLUMBING AND HVAC LLC DETROIT 6065155A 636 10/28/2021 5183 SWC DETROIT INC DETROIT 1407562A 1,083 12/7/2021 8832 T HERNANDEZ SERVICES INC DETROIT 5481899A 666 11/27/2021 9402 TDR PAINTING LLC DETROIT 6278086A 750 12/1/2021 5476 TEND 2 CARE LLC DETROIT 6275605A 1,324 11/19/2021 9053 THIRTY SEVEN ADVENTURES LLC DETROIT 5776066A 7,837 11/4/2021 6217 0.92 THREE D WRECKING LLC DETROIT 0619299A 750 12/10/2021 7208 0.95 THREE HUNDRED 13 CARPENTRY DETROIT 6272690A 750 11/12/2021 5645 INCORPORATED TIREMAN SERVICES INC DETROIT 4740882A 730 10/1/2021 8017 TMC ALLIANCE LLC DETROIT 5199751A 445 10/14/2021 8810 TON DEVELOPMENT LLC DETROIT 6274196A 5,867 11/14/2021 5551 TONY TONE CONSTRUCTION LLC DETROIT 6281133A 1,300 12/10/2021 5645 TRANSMISSION MAINTENANCE CONSTRUCTION DETROIT 4969880A 12,495 10/16/2021 7539 0.82 LLC TRI COUNTY CARE PROVIDERS INC DETROIT 1755048B 1,387 11/19/2021 9053 0.95 TRIPLE J STUCCO AND STONE COMPANY LLC DETROIT 6277489A 750 11/25/2021 5022 TRUSTWORTHY CONSTRUCTION LLC DETROIT 5868750A 800 10/1/2021 5102 UNITED HORIZON LLC DETROIT 4361768A 23,756 12/27/2021 8835 0.91 VAN DYKE MINI STOP LLC DETROIT 5019796A 2,080 11/9/2021 8017 0.95 VP TRUCKING LLC DETROIT 6282229A 750 12/15/2021 7208 W AND H GAS AND MORE INC DETROIT 1709011B 512 12/24/2021 8017 0.95 WALKERS HEATING & COOLING INC DETROIT 3351408A 1,385 12/29/2021 5550 0.89

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WOODBRIDGE NEIGHBORHOOD DEVELOPMENT DETROIT 4451392A 375 10/24/2021 8810 CORPORATION WOODMERE MANAGEMENT INC DETROIT 1307533A 911 12/10/2021 8017 YA DIGG RENOVATIONS LLC DETROIT 6258565A 750 10/17/2021 5645 YABLINSKYY REMODELING LLC DETROIT 5515661A 751 11/20/2021 5645 0.95 YORKSHIRE EAST INC DETROIT 4158547A 809 12/7/2021 9015 1.00 R KIMBALL TRUCKING DEWITT 6088007A 750 12/19/2021 7208 TAVELLI KELLY AND ANDREW DEWITT 6263666A 580 10/22/2021 0913 WILDFLOWER MEADOWS CONDOMINIUM DEWITT 5208114A 568 11/18/2021 9015 ASSOCIATION A 1 TREE INC DEXTER 2696134A 1,320 11/3/2021 0042 0.95 GREENSTREET TREE CARE LLC DEXTER 0138126A 32,319 11/29/2021 0106 1.05 TFF INC DEXTER 5182875A 3,233 10/9/2021 9015 0.95 WOODS KEVIN & JUDY DEXTER 4683900A 800 10/11/2021 8279 ARTISTIC TRANSITIONS LLC DIMONDALE 4829921A 222 10/12/2021 8810 GO GREEN PAINTING LLC DIMONDALE 5645468A 750 11/17/2021 5476 LANSING PETROLEUM ENTERPRISES INC DIMONDALE 6079016A 1,096 12/14/2021 8017 NEW HAVEN FOSTER CARE INC DIMONDALE 2102242A 1,611 10/21/2021 9053 0.95 BARTELDS TRIM AND CABINETRY DORR 5280761A 750 11/20/2021 5437 0.95 FARMERS DISPOSAL LLC DORR 6081835A 7,354 12/3/2021 7213 PREFERRED PAINTING & WALL COVERING LLC DORR 3226689A 750 12/3/2021 5476 TNT TOWING LLC DORR 6284795A 800 12/19/2021 7208 BSY ENTERPRISES INC DOWAGIAC 2941686A 3,383 10/7/2021 8395 0.95 FRYMANS RECYCLING 1 INC DOWAGIAC 2726106A 21,337 10/4/2021 4459 1.87 27 % RANK TRUCKING & REPAIRS INC DOWAGIAC 5032652A 4,675 10/13/2021 8395 1.26 13 % TRUES SERVICE INC DOWAGIAC 1477986A 12,784 11/23/2021 7208 0.96 WAYNE TOWNSHIP DOWAGIAC 1490192A 2,313 12/9/2021 9410 0.95 KENNY LEE BUILDERS DOWLING 3351300A 825 10/6/2021 5645 SPINSTER SISTERS LLC DRAYTON PLAINS 5480132A 2,126 11/18/2021 9015 0.95 BONNIE AERO LLC DRYDEN 6264719A 750 11/1/2021 7422 METHOD CONSTRUCTION LLC DRYDEN 6085890A 750 12/12/2021 5645 RAY EVANS AND SONS EXCAVATING LLC DRYDEN 2813343A 740 10/29/2021 6217 CONVEYOR BELT SERVICE INC DULUTH, MN 4946120A 2,368 12/31/2021 3724 0.95 BARANOWSKI CONSTRUCTION INC DUNDEE 0711276A 800 11/15/2021 5538 STEWART ALLEN MOTORS LLC DUNDEE 6088333A 483 12/20/2021 8395

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DP REMODELING DURAND 6267483A 750 11/3/2021 5645 DURAND FEED & GRAIN CO DURAND 4985648A 2,170 12/11/2021 2014 0.95 DURAND MEAT PROCESSING INC DURAND 0162779A 1,788 10/8/2021 8031 0.95 SECOND CHANCE WOOD LLC DURAND 4826159A 6,609 11/22/2021 2731 0.89 TCE LAWN CARE LLC DURAND 5898463A 656 12/19/2021 9402 VINTAGE MASONARY DURAND 3414019A 750 11/10/2021 5022 C R SMITH CONTRACTOR AND HOME EAST CHINA 4771222A 5,782 12/15/2021 5645 0.95 MAINTENANCE INC K TIMMERMANS DESIGN & CONSULTING LLC EAST GRAND RAPIDS 5764440A 313 10/18/2021 8601 RENNER RYAN & WHITNEY EAST GRAND RAPIDS 5767016A 580 11/2/2021 0913 BEAL CREEK MASONRY EAST JORDAN 5201276A 750 10/18/2021 5022 CHICKADEE HILL SERVICES LLC EAST JORDAN 5720435A 313 12/3/2021 8601 MACS ELECTRIC EAST JORDAN 5924537A 743 10/17/2021 5190 COMMUNITY BASED INTERVENTIONS EAST LANSING 2768020A 13,017 12/1/2021 0035 1.23 KALKIDAN AFC CORP EAST LANSING 5785510A 1,130 11/22/2021 9053 0.95 PETROWITZ ENTERPRISES INC EAST LANSING 5221501A 943 12/19/2021 8832 0.95 ZIELINKSKI SEAN P EAST LANSING 5981832B 307 12/19/2021 0908 M AND J MULTI SERVICES EAST POINTE 4701402A 709 12/29/2021 0042 RELY ON ELECTRIC & CONSTRUCTION CO EAST POINTE 3847390A 470 10/23/2021 5190 ALPHA AND OMEGA MOVING LLC EASTPOINTE 6089704A 750 12/31/2021 7214 ANDERSON AND SONS PAINTING INC EASTPOINTE 3251624A 1,628 10/7/2021 5476 0.95 B B AND C COURT SERVICES LLC EASTPOINTE 5921821A 732 10/26/2021 7720 B O S PROPERTY SERVICES INC EASTPOINTE 3151760A 747 10/25/2021 8720 0.95 BIG TYME CATS LLC EASTPOINTE 6196934A 5,606 11/19/2021 7380 BLUEPRINT TRUCKING LLC EASTPOINTE 5947472A 750 12/27/2021 7208 CHRIST LIBERTY MINISTRY EASTPOINTE 4811607A 1,133 11/13/2021 8868 0.95 FIFTEEN THOUSAND 035 STREET ENTERPRISE EASTPOINTE 6077501A 1,240 11/19/2021 8017 LLC NUNU ENTERPRISES INC EASTPOINTE 5656583A 616 11/14/2021 8017 SHEPHERDS HOME CARE LLC EASTPOINTE 6266606A 1,068 11/26/2021 8835 TOMA VENTURES LLC EASTPOINTE 3123898A 1,405 12/31/2021 8017 0.95 SPRINGWATER FARM LLC EASTPORT 2305445A 1,095 12/12/2021 8279 0.95 ELLIOTT BRIAN CHARLES EATON RAPIDS 6279660A 750 12/8/2021 5645 LOUS CUTTING EDGE TREE SERVICE LLC EATON RAPIDS 5060320A 5,674 12/14/2021 0106 0.95 MLP DOORS LLC EATON RAPIDS 6010644A 964 10/15/2021 5102

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 36 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MODERN HOMES INC EATON RAPIDS 3262618A 751 10/10/2021 5348 RIVER CITY INTERIORS LLC EATON RAPIDS 2932148A 750 12/20/2021 5445 SOUTHWELL CONSTRUCTION LLC EATON RAPIDS 4296931A 750 12/9/2021 5645 TAYLORED LAWNS EATON RAPIDS 3010902A 744 10/23/2021 9102 TS CONSULTING INC EATON RAPIDS 6281664A 800 12/11/2021 5403 MATT FERRY CONSTRUCTION EAU CLAIRE 3641139A 2,973 11/30/2021 5645 0.95 PAUSTIAN INC EAU CLAIRE 2560208A 739 10/9/2021 6217 TIM TROWBRIDGE & SON HOME BUILDERS INC EAU CLAIRE 0275638A 750 11/1/2021 9102 0.95 GREG MILLS TRUCKING LLC ECKERMAN 5412420A 750 12/12/2021 7208 TOP HAT TOWING & AUTO SALES INC ECORSE 6279937A 481 12/5/2021 8395 NATIONAL WILD TURKEY FEDERATION INC EDGEFIELD, SC 2619890A 1,487 11/28/2021 8810 0.95 STAFF UP STAFF DOWN LLC EDINA, MN 5628415A 672 12/5/2021 9052 0.95 SPRING HILLS MARKETING LLC EDISON, NJ 5907470A 923 12/31/2021 8742 B AND R CONSTRUCTION EDMORE 3056775A 1,309 11/30/2021 5645 0.95 EDWARDSBURG SPORTS COMPLEX INC EDWARDSBURG 5500117A 1,151 10/15/2021 9015 0.95 MERRY ME EVENTS INC EDWARDSBURG 4453786A 978 12/28/2021 9015 1.00 RKM FIREWORKS COMPANY INC EDWARDSBURG 3363678A 1,128 11/1/2021 9015 0.95 RUBY CONSTRUCTION LLC EDWARDSBURG 5587786A 750 10/10/2021 5403 TJ PROPERTY VALETS LLC EDWARDSBURG 6254365A 838 10/3/2021 0042 KIDDER COTTAGE AND LAWN SERVICES LLC ELBERTA 5481066A 825 10/22/2021 5476 CDS ENTERPRISE INC ELLSWORTH 5118050A 801 11/9/2021 5645 0.92 K R BURR LLC ELMIRA 2721325A 750 12/14/2021 7208 TIMBER AND TREES LLC ELMIRA 1771175A 800 12/21/2021 2702 0.89 WALSTON TRANSPORT LLC ELMIRA 4343972A 7,209 12/28/2021 7208 1.25 JML ELSIE 4802918A 750 10/25/2021 2702 LENON ELECTRIC & SON ELSIE 5364558A 862 10/5/2021 5190 PRO SURFACES ELSIE 4101197A 826 11/12/2021 5221 0.95 YORDY ENTERPRISES LLC ELSIE 6260047A 5,169 10/15/2021 0106 BIGELOW DISTRIBUTING ENGADINE 4973712A 7,669 11/16/2021 7208 1.38 13 % ANDYS ROOFING ESCANABA 5975751A 3,719 11/17/2021 5551 CRYDERMAN TINA ESCANABA 6260780A 568 10/20/2021 9015 HARDWICK TYLER ESCANABA 5927471A 750 10/25/2021 5348 MCKENZIE KYLE PETER ESCANABA 6259570A 750 10/14/2021 7208 MYHREN KEITH NORMAN ESCANABA 5159261A 750 10/14/2021 7208 PASCOE CONSTRUCTION COMPANY ESCANABA 0398519A 750 11/22/2021 5183 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 37 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge R TRUCKING INC ESCANABA 6082416A 750 12/6/2021 7208 SM LOGGING LLC ESCANABA 4158920A 750 12/30/2021 2702 CAPITAL STAFFING SOLUTIONS LLC ETOBICOKE, ON 5903343A 32,713 10/17/2021 7213 0.95 EVART AREA JOINT FIRE DEPARTMENT EVART 1821040A 930 10/28/2021 7704 0.95 HOLLINGSHEAD GEORGE EVART 0586099A 825 12/17/2021 5645 JB MASONRY FAIR HAVEN 2053322A 801 11/5/2021 5022 VECTOR FOILTEC LLC FAIRFIELD, NJ 5484936A 826 12/4/2021 5040 0.88 MICHIGAN PRO WASH LLC FAIRGROVE 6267173A 656 10/31/2021 3724 MAINTENANCE FORECASTERS INC FALMOUTH 6270735A 399 11/7/2021 8601 MAPLE LEAF FARM & CREAMERY LLC FALMOUTH 5760151A 1,139 10/15/2021 8006 0.95 WOODTICK FALMOUTH 1459929A 750 10/27/2021 2702 ANNIE LEE ADULT FAMILY SERVICES LLC FARMINGTON 6075070A 1,329 11/14/2021 8835 CAMM PRO LLC FARMINGTON 4545427A 805 10/15/2021 8810 E 2 ENTERPRISES LLC FARMINGTON 5176379A 266 10/24/2021 8810 MONIQUE INC FARMINGTON 5214157A 224 11/26/2021 8810 PAPKE ENTERPRISES INC FARMINGTON 6270085A 1,012 11/6/2021 9015 A 1 CEMENT INC FARMINGTON HILLS 2395525A 753 10/15/2021 8742 0.95 ADVANCED VEHICLE TECHNOLOGIES LLC FARMINGTON HILLS 5335280A 1,409 11/9/2021 8601 0.95 ALIGNED CONSTRUCTION SERVICES LLC FARMINGTON HILLS 6085083A 800 12/17/2021 5403 ALL AMERICAN TOWING AND RECOVERY INC FARMINGTON HILLS 4206630A 801 12/4/2021 8810 ANDREI TILE AND MARBLE LLC FARMINGTON HILLS 4722922A 750 10/16/2021 5348 ARCH ENVIRONMENTAL GROUP INC FARMINGTON HILLS 2694409A 40,563 12/29/2021 8601 1.80 27 % ASMAR CONSTRUCTION COMPANY INC FARMINGTON HILLS 6070043A 825 11/1/2021 5403 AWESOME FACTORY LLC FARMINGTON HILLS 4961218A 763 11/1/2021 9063 0.95 BERNSTEIN SUSAN FARMINGTON HILLS 3560708A 307 10/17/2021 0908 BLISS HOME HEALTH CARE INC FARMINGTON HILLS 4775767A 593 10/16/2021 8835 BOTTOMLINE SNOW REMOVAL LLC FARMINGTON HILLS 5628970A 1,027 11/6/2021 9402 0.95 BRIGHT IDEAS CONSULTING LLC FARMINGTON HILLS 6082084A 358 12/4/2021 8601 CLAUDIOS PAINTING LLC FARMINGTON HILLS 4104579A 800 11/6/2021 5476 CRYSTAL SQUARE INVESTMENTS LLC FARMINGTON HILLS 0685542A 568 10/29/2021 9015 CULAJ BROTHERS CONSTRUCTION AND FARMINGTON HILLS 5053480A 800 10/22/2021 5476 0.95 PAINTING LLC ECI ENVIRONMENTAL CONSULTANTS AND FARMINGTON HILLS 2744147A 238 10/30/2021 8601 ENGINEERS LLC FACILITYRX SERVICES LLC FARMINGTON HILLS 6066950A 721 10/24/2021 9015

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 38 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FELLOWS ENTERPRISES LLC FARMINGTON HILLS 3701360A 750 10/23/2021 5476 FIFTH ROYAL OAK CONDOMINIUM ASSOCIATION FARMINGTON HILLS 4672755A 618 11/23/2021 9015 FORGE ALLOY INC FARMINGTON HILLS 2364131A 314 12/20/2021 8742 0.95 FRANKLIN KNOLLS HOMEOWNERS ASSOCIATION FARMINGTON HILLS 6066321A 568 12/1/2021 9015 FREEBIRD AVIATION SERVICES INC FARMINGTON HILLS 5206243A 6,650 11/1/2021 7423 0.93 GOLDEN STARS ENTERPRISES INC FARMINGTON HILLS 6278655A 750 12/2/2021 7208 H TARNOW & CO FARMINGTON HILLS 0397970A 4,284 12/28/2021 3724 0.90 HALO HARMONY INC FARMINGTON HILLS 5831083A 1,658 10/24/2021 8835 0.95 HOME RENEWAL SYSTEMS LLC FARMINGTON HILLS 3649539A 1,838 10/7/2021 9015 0.95 ILAS MARBLE & TILE FARMINGTON HILLS 3931110A 5,858 11/5/2021 5348 0.92 JIMMYS PAINTING FARMINGTON HILLS 5411572A 2,790 11/3/2021 5476 K AND F SERVICES INC FARMINGTON HILLS 3310280A 481 10/1/2021 8395 0.95 KHMORO INC FARMINGTON HILLS 4920791A 485 10/12/2021 8017 KISVARDA LLC FARMINGTON HILLS 6081860A 290 12/3/2021 8810 KUZCO FOODS INC FARMINGTON HILLS 4110528A 1,447 10/4/2021 7380 LINWOOD TIRE RECYCLING LLC FARMINGTON HILLS 5627605A 1,304 10/26/2021 7219 1.00 LOCK UP LLC FARMINGTON HILLS 2332094A 618 12/2/2021 8810 MARCUS TILE AND MARBLE INC FARMINGTON HILLS 4221850A 750 10/12/2021 8810 MCC CONSTRUCTION COMPANY FARMINGTON HILLS 3594165A 750 10/19/2021 5645 MERRIWOOD PARK CONDOMINIUM ASSOCIATION FARMINGTON HILLS 4361270A 644 12/12/2021 9015 MICHIGAN FIRE RESTORATION LLC FARMINGTON HILLS 3337472A 3,043 12/20/2021 5403 0.95 MILLENNIUM LIMOUSINES INC FARMINGTON HILLS 5490375A 699 12/11/2021 8810 MODERN STONE FITTERS LLC FARMINGTON HILLS 5643546A 800 12/1/2021 5437 OAKEWOOD SERVICES LLC FARMINGTON HILLS 5458099A 238 11/12/2021 8601 ON THE POND CONDOMINIUM ASSOCIATION FARMINGTON HILLS 2796465A 800 12/15/2021 9015 0.95 PHOENIX PROFESSIONAL CONTRACTING INC FARMINGTON HILLS 2978458A 903 10/9/2021 8601 0.92 PINNACLE MOBILE PHLEBOTOMY LLC FARMINGTON HILLS 6266665A 692 10/29/2021 4511 PLYMOUTH PARK WEST CONDO ASSOCIATION FARMINGTON HILLS 5637295A 978 12/31/2021 9102 Q C N HOME CARE SYSTEMS INC FARMINGTON HILLS 4020561A 2,277 11/19/2021 8835 0.95 QUALITY HANDYMAN SERVICES FARMINGTON HILLS 4566076A 750 11/25/2021 5437 RG CONTRACTING LLC FARMINGTON HILLS 2525429A 750 11/20/2021 5645 S AND D PAINTING FARMINGTON HILLS 2656230A 750 10/19/2021 5476 SENIOR COUNSELING SERVICES LLC FARMINGTON HILLS 5251273A 340 10/16/2021 8810 SOUTHERN CRAB SACKS LLC FARMINGTON HILLS 6279392A 329 12/4/2021 9058 SR COMMUNICATIONS LLC FARMINGTON HILLS 4868560A 435 11/5/2021 8017 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 39 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SRF ENTERPRISES INC FARMINGTON HILLS 0941743A 800 11/25/2021 5476 STI CONSTRUCTION LLC FARMINGTON HILLS 3296822A 750 10/23/2021 5437 STONE FOR YOU INC FARMINGTON HILLS 4366204A 800 12/20/2021 5348 0.95 SUNSOFT TECHNOLOGIES INC FARMINGTON HILLS 3426491A 715 10/30/2021 8810 TA INVESTMENTS LLC FARMINGTON HILLS 2899159A 248 12/17/2021 8601 TANGLEWOOD CONDOMINIUMS LLC FARMINGTON HILLS 5620465A 730 10/18/2021 5606 TOTAL CUSTOM SERVICES LLC FARMINGTON HILLS 5418895A 751 11/3/2021 5476 USA PAINTING 2 FARMINGTON HILLS 6281281A 751 12/10/2021 5476 VPS OF MI PLLC FARMINGTON HILLS 5324130A 1,486 11/22/2021 8835 0.95 VULAJS CARPENTRY INC FARMINGTON HILLS 3431762A 1,157 10/22/2021 5645 0.95 WOODHAVEN GLENS CONDOMINIUM FARMINGTON HILLS 0194719A 800 12/21/2021 5183 ASSOCIATION INC WOODLAND MANOR CONDOMINIUM FARMINGTON HILLS 1961977A 618 10/17/2021 9015 ASSOCIATION ZA DESIGN BUILD LLC FARMINGTON HILLS 6057063A 825 12/4/2021 5645 ZERBO ENTERPRISES INC FARMINGTON HILLS 0355887A 7,447 12/10/2021 5551 0.86 LIGHTHOUSE COVE INCORPORATED FARWELL 2950561A 568 11/8/2021 9015 SURREY SIGNS & SERVICE LLC FARWELL 6065015A 3,685 10/25/2021 0106 0.95 CRIPPLE CREEK LAND & CATTLE FELCH 1509217A 750 12/6/2021 2709 HINOJO CARLOS GARCIA FENNVILLE 5913837A 750 11/12/2021 5437 PINEDAS LLC FENNVILLE 5781000A 750 11/14/2021 5645 PROFESSIONAL ROOFING OF HOLLAND LLC FENNVILLE 3586677A 750 12/27/2021 5551 VANDERLIP EXCAVATING LLC FENNVILLE 5066883A 5,727 11/6/2021 6217 A TEAM GUTTERS AND COVERS LLC FENTON 4940733A 4,548 12/30/2021 5538 0.94 BALLOON QUEST INC FENTON 2350459A 332 10/20/2021 8810 CECIL CONSULTING & TRAINING LLC FENTON 5903793A 406 12/3/2021 8601 CHAPMAN HOMES LLC FENTON 5511666A 1,720 12/21/2021 5445 0.95 DAM IT DAMS INC FENTON 4498038A 582 11/4/2021 4410 DIGTWOSWIM POOLS AND SPAS LLC FENTON 5286638A 825 10/1/2021 5223 GO TO GUYS LLC FENTON 6079687A 621 11/22/2021 9522 JKC CONSULTING INC FENTON 5355664A 750 12/23/2021 5437 MICHIGAN AUTOMOTIVE REPAIR LLC FENTON 6273807A 1,986 11/13/2021 8395 NELSON CHARLES JR FENTON 6264131A 750 10/26/2021 5551 RODS HOME IMPROVEMENT FENTON 5331544A 1,613 11/29/2021 5437 0.95 RUMBLE CONSTRUCTION LLC FENTON 2905809A 2,531 10/22/2021 5221 1.00

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 40 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge RUTHLESS FAB LLC FENTON 6061370A 1,411 10/21/2021 3365 SKYTOWER LLC FENTON 5797942A 16,942 12/15/2021 5191 0.93 STATEWIDE CONSTRUCTION AND ROOFING LLC FENTON 5279003A 825 12/14/2021 5551 0.95 THUNDER CONSTRUCTION SERVICES LLC FENTON 1443372A 750 11/11/2021 5645 TOM HOOSE CONSTRUCTION INC FENTON 1106821A 802 11/24/2021 8810 VISIONS IN MOTION DANCE INC FENTON 6072143A 821 11/7/2021 9063 WALSH MATTHEW P FENTON 1995901A 750 10/13/2021 5022 B AND Z OUTDOOR SOLUTION FERNDALE 6075614A 776 11/15/2021 6229 COLONY HOUSE CONDO ASSOCIATION FERNDALE 4013662A 618 12/23/2021 9015 DERELICTS OF SPACE LLC FERNDALE 6253920A 643 10/1/2021 8742 DETROIT AXE LLC FERNDALE 5770726A 11,480 11/1/2021 9015 0.90 DUSTY DAVIS INC FERNDALE 6274730A 1,135 11/17/2021 9015 KISPERT DOROTHY FERNDALE 6089348A 794 12/30/2021 0908 LIGHTHOUSE ALL MEDIA DESIGN LLC FERNDALE 0360899A 423 11/27/2021 7610 POW STRATEGIES INC FERNDALE 6088864A 279 12/26/2021 8742 PRO HOME IMPROVEMENT INC FERNDALE 4920686A 4,785 10/13/2021 5606 0.95 PROFESSIONAL WINDOW AND GUTTER FERNDALE 6274218A 984 11/14/2021 9015 CLEANING INC RADISH CREATIVE GROUP INC FERNDALE 3673251A 674 12/23/2021 7610 ROSS KIMBERLY ANN FERNDALE 6016855A 5,977 12/23/2021 5645 MESYN BUILDERS FIFE LAKE 5487986A 1,823 11/18/2021 5215 PRISTINE CEILING AND WALLS LLC FIFE LAKE 5155819A 825 11/17/2021 5445 0.93 AIR O DYNAMIC HEATING & COOLING LLC FILION 6271634A 1,193 11/10/2021 5550 DAVES AUTO FILION 0998664A 661 12/5/2021 8395 AMERICAN PLUMBING INC FLAT ROCK 5026539A 611 12/20/2021 5183 BMW CONTRACTING LLC FLAT ROCK 5072042A 4,766 12/28/2021 6217 0.94 MAF ENTERPRISES INC FLAT ROCK 4802322A 560 11/21/2021 8017 ON DEKK TRANSPORTATION LLC FLAT ROCK 4919572A 544 10/11/2021 8810 A AND S & SONS HEATING INCORPORATED FLINT 0137294A 1,578 11/24/2021 5550 1.00 ACTION TRAFFIC MAINTENANCE INC FLINT 1767151A 292,203 12/18/2021 6400 0.93 ALL CATALYTIC CONVERTERS INC FLINT 4498461A 8,969 11/19/2021 8264 0.88 BARNETT CONSTRUCTION SERVICES OF FLINT 4316924A 752 10/10/2021 8810 0.95 MICHIGAN LLC BURNASH WRECKING INC FLINT 0756709A 5,821 11/11/2021 6217 0.90 C AND J DIRECTIONAL BORING INC FLINT 3850986A 825 12/6/2021 6204

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 41 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CHRISTIAN EVANGELICAL BROADCASTING FLINT 0297321A 891 11/15/2021 7610 0.95 ASSOCIATION INC COMPUNINJAS LLC FLINT 6057160A 352 11/4/2021 5191 COST CUTTERS LAWN AND LANDSCAPE LLC FLINT 5640679A 974 12/5/2021 0042 CREEKWOOD COLONY CONDOMINIUM FLINT 4404602A 568 11/2/2021 9015 ASSOCIATION DEDICARE SOLUTIONS LLC FLINT 6080901A 1,956 12/11/2021 8835 DOUBLE K & S TOWING LLC FLINT 4637720A 911 11/30/2021 7208 0.95 EDEN PRAIRIE RESIDENTIAL CARE SERVICES FLINT 6146937A 842 11/14/2021 9053 LLC FAITH FOUNDATION RESOURCES FLINT 5912385A 450 11/12/2021 8832 FARE BROTHERS FLINT 5698740A 9,990 11/21/2021 5645 1.00 FIRST RESPONSE RESTORATION LLC FLINT 5594570A 5,835 10/1/2021 9015 0.87 FISHLAND MARKET INC FLINT 3968910A 692 10/4/2021 9058 0.95 FUNCHITECTURE LLC FLINT 4905733A 459 11/29/2021 8601 GRAYER LOGISTICS LLC FLINT 6260896A 1,366 10/16/2021 7219 GROVES AND COMPANY INC FLINT 0098132A 1,253 10/7/2021 8264 0.95 HECT HOME IMPROVEMENT LLC FLINT 5494583A 800 12/22/2021 5645 HUCKLEBERRY JUNCTION PLAYHOUSE THEATER FLINT 4676769A 329 10/15/2021 8810 INC INNOVATIVE PROPERTY MANAGEMENT INC FLINT 1813471A 1,707 11/1/2021 9015 0.95 J P BOWER HOME IMPROVEMENT FLINT 3558223A 750 10/11/2021 5551 JOHN HOWRANI INSURANCE FLINT 1893963A 572 11/5/2021 0128 JOHNSON JAMES FLINT 6284221A 800 12/18/2021 5551 JPS CARPET SERVICES FLINT 2355205A 540 12/14/2021 9521 KARLA INC FLINT 2852462A 591 10/10/2021 8017 KRAFT ENGINEERING AND SURVEYING INC FLINT 1585690A 1,698 10/24/2021 8601 0.95 LUDA INVESTMENT GROUP INC FLINT 4860519A 750 11/12/2021 5645 0.95 M 66 DORT FUEL INC FLINT 6086179A 572 12/13/2021 8017 M AND C BEAN FLINT 6261850A 4,400 10/31/2021 5476 MAIA AND AMEER INC FLINT 3588823A 330 11/8/2021 8017 MCALISTER SARAH FLINT 6278175A 530 12/16/2021 0913 MERRIMAN ADULT FOSTER CARE FLINT 3613569A 533 12/20/2021 9053 MIKES BEST SERVICES LLC FLINT 4211359A 523 10/12/2021 9102 MORGAN CREEK CONDO ASSOCIATION FLINT 4436709A 618 11/21/2021 9015 NATIONAL CUSTOM SOLUTIONS LLC FLINT 4838548A 616 12/31/2021 9521 0.95

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 42 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ON THE MOVE COACHES INC FLINT 4034481A 8,804 11/18/2021 7212 0.81 PARTICULAR COUNCIL OF FLINT SOCIETY OF ST FLINT 0071501A 1,965 11/9/2021 8017 0.95 VINCENT DEPAUL PHILIP AND SONS INC FLINT 4727851A 558 10/10/2021 8017 RIVER HILL CONDOMINIUM ASSOCIATION FLINT 1857029A 568 11/15/2021 9015 ROAD RUNNER TOWING & SERVICES LLC FLINT 5141761A 4,997 10/17/2021 8395 0.94 ROSS CHARLIE FLINT 6259278A 750 10/15/2021 5403 ROY CUSTOM EXTERIOR FLINT 5942284A 750 12/5/2021 5645 SALIB INSURANCE SERVICES FLINT 5191823A 291 10/12/2021 8810 SPARKLING WINDOWS CORP FLINT 5632692A 568 10/24/2021 9015 SPARKS BUILDERS LLC FLINT 0821403A 750 10/15/2021 5645 STANGS FLOOR COVERING FLINT 4408128A 540 10/19/2021 9521 STEEPLECHASE OF GRAND BLANC FLINT 4752503A 568 12/6/2021 9015 CONDOMINIUM ASSOCIATION TOUCHSTONE SERVICES INC FLINT 2756749A 5,720 10/1/2021 8017 1.21 TS SOLUTIONS LLC FLINT 6048560A 3,328 10/28/2021 3365 0.95 WATER BROOKS LIVING LLC FLINT 6109632A 608 11/26/2021 9053 WATERS EDGE VILLAGE CONDOMINIUM FLINT 4950100A 568 10/26/2021 9015 ASSOCIATION WYNDHAM HILL II HOMEOWNERS ASSOCIATION FLINT 4963890A 568 11/5/2021 9015 DOUBLE D LOGGING FLORENCE, WI 5334748A 750 10/27/2021 2709 GRAHAM JAN FLUSHING 6280412A 288 12/8/2021 8601 JBS TREE & YARD SERVICES FLUSHING 1830163A 5,527 11/8/2021 0106 0.89 JEFF HARING LLC FLUSHING 0947601A 750 10/15/2021 5645 RSC EXTERIORS FLUSHING 4091213A 11,387 11/19/2021 5645 0.93 TW CONSTRUCTION LLC FLUSHING 5940125A 750 11/28/2021 5645 WALKER GRAIN & FREIGHT LLC FLUSHING 6053866A 826 10/9/2021 7208 LEVEL UP HOME IMPROVEMENT LLC FORT GRATIOT 6052738A 800 10/8/2021 5645 WINDSONG WEST BUILDERS LLC FORT GRATIOT 2411075A 800 10/18/2021 9015 ELITE PIPELINE SERVICES INC FORT MYERS BEACH, FL 4131274A 5,058 10/12/2021 8720 0.91 STAFF FINDERS INC FORT WAYNE, IN 5339685A 938 11/14/2021 9015 TEXAS REFINERY CORPORATION FORT WORTH, TX 1494163A 519 11/1/2021 8742 CARLSON STEVE F FOSTER CITY 2068281A 750 12/22/2021 2702 GRUBAUGH CHAD FOWLER 4424433A 750 12/13/2021 2702 ARMOURED RESISTANCE MECHANISMS INC FOWLERVILLE 3657957A 1,747 10/1/2021 4459 0.95 FOWLERVILLE AGRICULTURAL SOCIETY FOWLERVILLE 0977420A 703 12/19/2021 9015 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 43 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FOWLERVILLE FEED AND PET SUPPLIES INC FOWLERVILLE 0064653A 5,184 11/11/2021 2014 0.91 HARRISONS PLUMBING HEROES LLC FOWLERVILLE 6280927A 1,046 12/11/2021 5183 JIM GREGG LANDCLEARING INC FOWLERVILLE 2658577A 789 11/3/2021 6217 JOHN FULLER LOGGING FOWLERVILLE 4872215A 750 11/21/2021 2702 MURPHY FARMS LLC FOWLERVILLE 5895723A 1,218 12/16/2021 0011 WORLD CLASS CONTRACTING FOWLERVILLE 5582962A 750 12/22/2021 5645 HEMP TEMPS INC FOXFIELD, CO 6254373A 444 10/20/2021 0035 DESIGN BUILD CONSTRUCTION LLC FRANKENMUTH 6077552A 800 11/19/2021 5645 PINE HILL CONDOMINIUM OWNERS INC FRANKENMUTH 5651913A 618 11/23/2021 9015 WEISS APPRAISAL SERVICE INC FRANKENMUTH 2426420A 662 11/14/2021 8742 BERKSHIRE RESOURCES CITY LLC FRANKLIN 4800354A 800 10/8/2021 9015 GANS BETH FRANKLIN 4538927A 307 10/5/2021 0908 MARTINI CONSTRUCTION COMPANY FRANKLIN 2926547A 750 10/28/2021 0042 ROSENTHAL BENJAMIN FRANKLIN 1402528A 307 12/19/2021 0908 SCHWARTZ ALAN & SCHWARTZ SANDY FRANKLIN 1490168A 357 11/27/2021 0908 TREMONT CONSTRUCTION LLC FRANKLIN 3278689A 800 12/5/2021 5645 AIR RITE DUCT CLEANING LLC FRASER 5930090A 751 11/4/2021 5550 MASCHING ENTERPRISES INC FRASER 5396301A 1,192 10/6/2021 8742 MICHAEL TORRICE PRIVATE INVESTIGATOR PLLC FRASER 2915472A 527 10/16/2021 7720 S AND P SYSTEMS LLC FRASER 4698967A 3,703 10/23/2021 9015 0.95 THREE CS FORESTRY LLC FRASER 3985580A 3,797 10/15/2021 0042 0.95 WILLIAM R MARTIN & SONS INC FRASER 1340859A 1,597 10/3/2021 5437 1.00 STAIGHTWAY CONSTRUCTION FREE SOIL 5925550A 750 10/19/2021 5645 COMMERCIAL FLOORS AND MORE INC FREELAND 6284639A 750 12/19/2021 5348 FIRE SYSTEMS INSPECTION GROUP LLC FREELAND 6262996A 358 10/21/2021 8601 NEXGEN CONSTRUCTION SERVICES INC FREELAND 6191495A 2,080 11/5/2021 5221 REM VENDING FREELAND 4152794A 536 12/8/2021 5192 RUSCH PRODUCTIONS INC FREELAND 1737805A 529 12/31/2021 9156 0.95 APPLIED LUBRICATION TECHNOLOGY INC FREMONT 3818462A 1,770 10/1/2021 3724 0.95 COTTAGES AT MARTIN LAKE LLC FREMONT 6059090A 2,423 10/17/2021 9053 0.95 FREMONT MOBILE HOMES INC FREMONT 4702468A 6,014 12/27/2021 8748 0.95 ADAMS CONSTRUCTION CO LLC FRUITPORT 2661241A 751 10/16/2021 5476 JBS COATING INC FRUITPORT 5469937A 2,984 10/19/2021 9501 0.95 WOODLAND GARDENS FRUITPORT 6277268A 4,215 11/25/2021 8835 PRYOR TRUCKING GAASTRA 2632047A 750 11/15/2021 7208 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 44 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HEISER STAFFING SERVICES LLC GAHANNA, OH 6263704A 735 10/22/2021 4484 BLOUGH TODD D GAINES 1371894A 750 10/6/2021 5437 GOLDEN NEEDLE AWNING LLC GAINES 2722496A 757 10/9/2021 5538 0.95 I CON BUILDERS GAINES 5708117A 750 12/5/2021 5437 NORTH WOODS CRAFTS GAINES 3079392A 750 10/17/2021 5476 COLE CRAFTED CONSTRUCTION LLC GALESBURG 6021255A 1,701 10/1/2021 5403 GUTTER WORX LLC GALESBURG 6253067A 756 10/1/2021 5538 IMMANUEL CLEANING GALESBURG 5605075A 1,236 11/1/2021 5476 A 1 FLOORING INC GARDEN CITY 5502926A 1,360 10/18/2021 9521 0.95 ASANPEE CARE INC GARDEN CITY 4284070A 2,409 10/10/2021 9053 0.95 ETERNAL FLOORS LLC GARDEN CITY 6278612A 1,468 12/24/2021 5437 FISHBONE RECOVERY LLC GARDEN CITY 5929598A 750 10/31/2021 7208 GUIDING LIGHT HOME CARE LLC GARDEN CITY 6048889A 1,307 12/11/2021 8835 NEWSTYLE WINDOWS GARDEN CITY 1127624A 750 11/10/2021 5403 P J CONTRACTING & SON LLC GARDEN CITY 5934389A 2,455 11/10/2021 5437 0.95 PENTELECUC KEVIN GARDEN CITY 6279163A 750 12/3/2021 5437 BASE SAND AND GRAVEL LLC GAYLORD 5759579A 1,052 10/10/2021 9402 DIVERSIFIED ROOFING SYSTEMS LLC GAYLORD 6280862A 709 12/9/2021 0042 EXECUTIVE OFC SERVICES LLC GAYLORD 5219779A 535 12/14/2021 8810 GAYLORD TOWING LLC GAYLORD 6085075A 1,206 12/10/2021 7208 RJD INC GAYLORD 3372332A 750 10/17/2021 5183 0.95 SIMMONS AND SON BUILDERS LLC GAYLORD 5202701A 750 10/24/2021 5551 TAYLOR MADE RENOVATIONS GAYLORD 4640098A 1,279 11/10/2021 5476 0.95 TEMPEST ENTERPRISES LLC GAYLORD 4274318A 2,060 10/11/2021 5191 0.95 CONVENTIONAL CONSTRUCTION GENESEE 2092190A 1,575 11/21/2021 5645 SUPERIOR SERVICES OF MICHIGAN LLC GENESEE 6285880A 656 12/30/2021 9402 AMERITRONICS SYSTEMS INC GIBRALTAR 3091414A 1,100 10/6/2021 5191 0.95 HOGAN MICHAEL GIBRALTER 6067484A 750 11/7/2021 5437 BECKER CHRISTOPHER L GLADSTONE 5483786A 750 12/31/2021 7208 BRETT BRYANT DRYWALL GLADSTONE 5773610A 2,336 11/3/2021 5445 0.95 JC PROPERTY MAINTENANCE LLC GLADSTONE 6266932A 750 11/7/2021 0106 JEFF DONOVAN JR TRUCKING INC GLADSTONE 4012496A 4,734 12/19/2021 7208 0.95 SARGENT JAY GLADSTONE 3576248A 606 12/3/2021 0005 ALS SCRAP METAL GLADWIN 5226015A 2,415 11/16/2021 3821 0.95 BE GREEN INC GLADWIN 6279864A 478 12/8/2021 5606 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 45 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GREGG GLEASON INC GLADWIN 3763854A 750 12/18/2021 5348 J AND J PROPERTY MAINTENANCE GLADWIN 3122867A 1,235 12/23/2021 9402 JACOBS LOGGING GLADWIN 4275918A 750 10/14/2021 2702 EAGLE RIDGE GOLF CLUB OF GLENNIE INC GLENNIE 2894793A 1,596 10/1/2021 9060 0.95 GOBLES PINE GROVE FIRE ADMINISTRATIVE GOBLES 2586193A 2,877 10/7/2021 7904 0.95 BOARD REILLY LOIS GOLDEN, CO 5925355A 530 10/29/2021 0913 COMPRESSION FUELING SERVICES LLC GOODELLS 5367727A 494 12/22/2021 8395 CENTERPIECEPLAZA COM LLC GOODRICH 5343054A 569 11/14/2021 9015 LANGE BUILDING CO LLC GOODRICH 2397404A 800 12/21/2021 5348 MOONEY LAWRENCE III GOODRICH 6255132A 750 10/6/2021 5551 RICHMOND CONCEPT INC GOODRICH 5327199A 376 10/10/2021 8810 TREVINOS TOWING & HAULING LLC GOODRICH 4589670A 750 12/13/2021 7208 TRI COUNTY COATINGS LLC GOODRICH 5614910A 825 10/1/2021 5476 0.95 BOYS AND GIRLS CLUB OF ELKHART COUNTY GOSHEN, IN 6268714A 796 11/4/2021 9063 INC FRONTLINE FORESTRY SERVICES LLC GOWEN 5348994A 750 11/15/2021 2702 A AND E LAWN CARE LLC GRAND BLANC 6256490A 1,832 10/8/2021 0042 A PLUS EMPLOYEE STAFFING INC GRAND BLANC 5463602A 15,308 10/16/2021 3146 0.91 BULLARD BUILDERS INC GRAND BLANC 0609706A 750 10/20/2021 5437 COMMSERVE COMMUNICATIONS INC GRAND BLANC 4184220A 806 11/9/2021 6325 0.94 COMPLETE COMFORT LLC GRAND BLANC 4234570A 1,115 12/17/2021 5550 0.95 EUROBLOOMS LLC GRAND BLANC 5938970A 406 11/22/2021 8810 FIRST METRO REALTY LLC GRAND BLANC 4788508A 644 12/10/2021 9015 HENRY HAGENSTEIN DO PC GRAND BLANC 2022311A 730 12/14/2021 8832 0.95 ILLUMISCAPES LAWNCARE INC GRAND BLANC 4910265A 523 10/31/2021 9102 JENNINGS RICHARD GRAND BLANC 5351308A 750 12/10/2021 5645 JERRYS MANUFACTURED HOME REMOVAL LLC GRAND BLANC 2375052A 3,950 11/21/2021 8387 0.95 MC II INC GRAND BLANC 3737640A 2,781 12/11/2021 9058 0.95 TARKLESON ENTERPRISES INC GRAND BLANC 3948935A 338 10/21/2021 5606 WARWICK PARTY SHOPPE INC GRAND BLANC 2357984A 516 10/25/2021 8017 0.95 WHIGVILLE MARKET GRAND BLANC 0424781A 574 11/7/2021 8006 D SQUARED CREATIVE LLC GRAND HAVEN 6074618A 338 11/13/2021 7610 DAS BUILDERS LLC GRAND HAVEN 6282555A 750 12/15/2021 5437 LAKESIDE ROOFING CO LLC GRAND HAVEN 3665755A 771 10/15/2021 8742

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 46 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge LIGHTHOUSE DRYWALL LLC GRAND HAVEN 4156048A 750 12/16/2021 5445 0.95 MULLIGANS HOLLOW SKI BOWL ASSOCIATION GRAND HAVEN 4685865A 3,064 12/23/2021 9015 0.95 VOYAGE JUICE COMPANY LLC GRAND HAVEN 6010784A 512 10/2/2021 9058 GRAND WEST KITCHENS AND DESIGN LLC GRAND LEDGE 5937230A 1,261 11/17/2021 9521 HEDBERG HOMECARE SERVICES INC GRAND LEDGE 4603737A 9,380 10/3/2021 8835 0.83 KELLER SIDING GRAND LEDGE 0886238A 750 12/27/2021 5645 WORKHORSE STAFFING COMPANY LLC GRAND LEDGE 5585740A 64,060 11/5/2021 3400 2.02 13 % BURT TOWNSHIP OF ALGER COUNTY GRAND MARAIS 0443190A 4,918 12/16/2021 7520 0.86 A AND S LOGISTICS LLC GRAND RAPIDS 4253027A 234 12/29/2021 8810 AA AUTO SALES OF GRAND RAPIDS INC GRAND RAPIDS 1990136A 259 12/14/2021 8748 AI DOGWOOD LLC GRAND RAPIDS 4279905A 15,142 10/21/2021 9015 0.69 ALONZOS PRO PAINTING LLC GRAND RAPIDS 6267017A 825 10/31/2021 5476 ARCHSTONE HOMES LLC GRAND RAPIDS 5033071A 1,098 11/13/2021 5610 0.96 ASTER HOME CONSTRUCTION LLC GRAND RAPIDS 6254047A 800 10/2/2021 5645 AXIOM INVESTIGATIVE SERVICE LLC GRAND RAPIDS 2882833A 1,540 10/16/2021 7720 0.95 BENTLEY RYAN GRAND RAPIDS 5203678A 586 10/25/2021 8292 BEST PRO CLEANING SERVICES LLC GRAND RAPIDS 6279686A 569 12/4/2021 9015 BLINGER LLC GRAND RAPIDS 6266525A 536 10/30/2021 5192 BRUSH CHRISTOPHER GRAND RAPIDS 5223164A 288 11/30/2021 8601 BUSHNELL ADULT FOSTER CARE HOME GRAND RAPIDS 5918537A 593 10/5/2021 9053 CALDERON MIGUEL ANGEL GRAND RAPIDS 6260160A 750 10/15/2021 5551 CASTILLO APARICIO AVISAI GRAND RAPIDS 6082505A 750 12/5/2021 5476 CC CLEAN AND PAINT GRAND RAPIDS 6264530A 801 10/31/2021 5476 CHARVATS AUTO & TRUCK REPAIR GRAND RAPIDS 2079666A 2,619 11/2/2021 8395 0.95 CJS HANDYMAN SERVICE GRAND RAPIDS 6266509A 1,560 10/30/2021 8835 CONTRERAS PEDRO ENRIQUE RUANO GRAND RAPIDS 6082661A 750 12/5/2021 5476 CR MECHANICAL SERVICES LLC GRAND RAPIDS 6057268A 1,118 10/24/2021 3724 CVI DESIGN LLC GRAND RAPIDS 6050433A 279 10/4/2021 8742 D AND D WINDOW SERVICE INC GRAND RAPIDS 5469899A 750 10/29/2021 5645 DEREK BIRD ENTERPRISE GRAND RAPIDS 4560280A 750 11/13/2021 5221 DIVERSIFIED INDUSTRIES OF GRAND RAPIDS LTD GRAND RAPIDS 2764377A 251 11/26/2021 8810 DYKEMA SNOW PLOW SERVICE INC GRAND RAPIDS 4968034A 656 11/17/2021 9402 EDWARD JOSEPH LLC GRAND RAPIDS 5032660A 242 10/1/2021 8810 FINKEL CRAIG GRAND RAPIDS 6253725A 1,064 10/1/2021 6217 FIRST CLASS COMMUNICATION SERVICES LLC GRAND RAPIDS 6086098A 750 12/13/2021 7600 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 47 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FLORES MIKE & VANKALKER JULIE GRAND RAPIDS 6278051A 580 12/7/2021 0913 GABES PAINTING LLC GRAND RAPIDS 6278116A 2,019 12/1/2021 5476 GB INDUSTRIAL CLEANERS GRAND RAPIDS 4544099A 568 11/29/2021 9015 GL EXCAVATING GRAND RAPIDS 4133579A 789 10/15/2021 6217 GO GREEN EXTREME CLEANERS LLC GRAND RAPIDS 5668760A 568 10/3/2021 9015 HARBOR HAWK LLC GRAND RAPIDS 6044611A 67,409 10/29/2021 5040 1.29 HEARTSIDE GLEANING INITIATIVE GRAND RAPIDS 5709474A 952 11/5/2021 7380 HOTWATER DRX LLC GRAND RAPIDS 5285887A 2,840 11/21/2021 9015 0.95 INDOOR CLIMATE SOLUTIONS LLC GRAND RAPIDS 4369092A 1,802 11/13/2021 5550 0.95 J AND F PAINTING LLC GRAND RAPIDS 4312252A 750 12/22/2021 5476 J AND R DRYWALL LLC GRAND RAPIDS 5752922A 9,365 10/31/2021 5445 0.92 J B PRODUCTIONS GR LLC GRAND RAPIDS 5764050A 355 10/17/2021 7610 JAMES AUSTIN THE PAINTER GRAND RAPIDS 0034347A 750 10/31/2021 5476 JAO CONSTRUCTION GRAND RAPIDS 6074510A 750 12/16/2021 5437 JB DREAM VENTURES LLC GRAND RAPIDS 6269958A 1,136 10/23/2021 8017 JC VISUALS LLC GRAND RAPIDS 6087280A 346 12/17/2021 4361 JEFFS TRANSPORT LLC GRAND RAPIDS 5014778A 4,613 11/17/2021 7208 0.95 KEGEL PAINTING INC GRAND RAPIDS 3279669A 750 11/2/2021 5476 0.95 LIFES CHOICE LIMITED LIABILITY COMPANY GRAND RAPIDS 6280226A 723 10/8/2021 9053 LINARES JOSE GRAND RAPIDS 6082521A 750 12/5/2021 5476 LORIS VOICE GRAND RAPIDS 6256350A 364 10/8/2021 8810 M 6 TRUCK AND TRAILER REPAIR GRAND RAPIDS 4312546A 5,821 12/24/2021 8395 MARTIN REMODEL LLC GRAND RAPIDS 6278639A 750 12/2/2021 5645 MARTINEZ EVER ELUD GRAND RAPIDS 6048684A 750 10/3/2021 5476 MC BUILDERS GRAND RAPIDS 4388542A 800 12/9/2021 5645 0.89 MICHIGAN GLOBAL TRADE LLC GRAND RAPIDS 6284060A 229 12/17/2021 8742 MICHIGAN PRO PAINTERS LLC GRAND RAPIDS 5155649A 750 12/7/2021 5476 0.95 MIDWEST RECRUITERS LLC GRAND RAPIDS 4987209A 1,044 12/9/2021 3095 0.95 MORRISON DANIEL GRAND RAPIDS 5818290A 2,028 12/24/2021 5538 MPR CONTROLS INC GRAND RAPIDS 3859606A 470 11/3/2021 5190 MR BILLS LAND TREE SNOW LLC GRAND RAPIDS 3663078A 8,811 10/16/2021 9102 0.95 NABER JEFFREY GRAND RAPIDS 5789613A 860 12/1/2021 0913 NEGRON JUSTIN GRAND RAPIDS 6080600A 750 11/26/2021 5437 NEW HOPE GROUP HOME LLC GRAND RAPIDS 5931550A 3,508 11/3/2021 9053 0.95 NICK NICOLA SERVICES GRAND RAPIDS 3276481A 750 10/31/2021 5645 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 48 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ONE WAY AUTO SALES LLC GRAND RAPIDS 5048486A 260 11/6/2021 8748 ONIT TRANSPORTATION INC GRAND RAPIDS 3949273A 750 12/15/2021 8810 PATHFINDER HOLDING COMPANY LLC GRAND RAPIDS 6049737A 750 10/14/2021 5437 PATHOLOGY ASSOCIATES OF GRAND RAPIDS PC GRAND RAPIDS 3870871A 3,993 11/30/2021 8832 0.92 PEREZ IBARRA ESAU ERICK GRAND RAPIDS 6082580A 750 12/5/2021 5476 PETER FABER D GRAND RAPIDS 0918555A 825 10/12/2021 5645 PIXELSAURUS LLC GRAND RAPIDS 5217172A 926 12/7/2021 4361 0.95 POLISH FALCONS AID SOCIETY OF GRAND GRAND RAPIDS 1360027A 465 12/9/2021 9058 RAPIDS PRO TECH PAINTING SYSTEMS LLC GRAND RAPIDS 6061010A 825 10/24/2021 5476 QUEZADA RAMIREZ MARIO ANIBAL GRAND RAPIDS 6048544A 1,577 10/3/2021 5476 RADON MAN LLC GRAND RAPIDS 6051871A 1,036 10/5/2021 5183 RAMIREZ GUTTERS LLC GRAND RAPIDS 6279902A 5,169 12/5/2021 5538 RAPID AUTO REPAIR LLC GRAND RAPIDS 6083250A 1,699 12/6/2021 8395 RIDDERING MASONRY GRAND RAPIDS 0472425A 826 10/6/2021 5022 ROBERTOS PIZZERIA PLAINFIELD INC GRAND RAPIDS 3165604B 1,616 10/25/2021 9058 0.95 RODRIGUEZ HECTOR LUIS JR GRAND RAPIDS 6082483A 750 12/5/2021 5476 RODRIGUEZ NAVARRO JOSE L GRAND RAPIDS 6082564A 750 12/5/2021 5476 SANCHEZ ENCARNACION DEMETRIO GRAND RAPIDS 5759552A 750 10/10/2021 5476 SHERRY INC GRAND RAPIDS 2999404A 433 12/15/2021 8017 SPAULDING LOGISTICS LLC GRAND RAPIDS 6265871A 3,852 11/2/2021 7208 SQUARE FIT INSTALLATIONS LLC GRAND RAPIDS 5037778A 4,538 11/1/2021 9521 1.00 T Q QUALITY HOMES INC GRAND RAPIDS 2784521A 750 12/7/2021 5437 TAYLORS HOME CARE LLC GRAND RAPIDS 5349672A 8,925 12/5/2021 9053 0.83 TEN RING CONSTRUCTION LLC GRAND RAPIDS 5128072A 2,324 11/2/2021 5645 0.95 THINKGOD LLC GRAND RAPIDS 5555167A 3,992 10/24/2021 2881 1.05 10 % THOUGHTFULL LLC GRAND RAPIDS 5047838A 330 11/17/2021 8810 TIETEMA PAINTING COMPANY LLC GRAND RAPIDS 6278671A 750 12/2/2021 5476 TIMOTHY VERSTRATE CUSTOM HOMES INC GRAND RAPIDS 2320401A 3,403 10/30/2021 5645 0.95 TOMS HOME IMPROVEMENT INC GRAND RAPIDS 0428418A 750 12/21/2021 5645 TUSCAN MEDITERRANEAN CUISINE INC GRAND RAPIDS 1597876A 1,584 11/11/2021 9058 0.95 TYLER BRUIN BUILDERS LLC GRAND RAPIDS 5495920A 750 10/26/2021 5645 UDECON LLC GRAND RAPIDS 4162927A 945 11/3/2021 9015 0.95 VA ENTERPRISES LLC GRAND RAPIDS 3339157A 44,748 11/1/2021 7720 0.97 VANACKER CONSTRUCTION LLC GRAND RAPIDS 5349230A 750 12/3/2021 5645 0.95

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 49 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge VANDERLAAN ANDREW GRAND RAPIDS 6048013A 750 10/2/2021 5645 VASQUEZ ANGEL MARIO MARTINEZ GRAND RAPIDS 6082475A 750 12/5/2021 5476 WESTON SHEET METAL INC GRAND RAPIDS 3377504A 3,774 11/22/2021 5538 0.95 WHISPERING LEAF FARMS LLC GRAND RAPIDS 6081452A 995 12/3/2021 0035 WOMENS RESOURCE CENTER GRAND RAPIDS 1539531A 215 12/21/2021 8810 WORDS OF HOPE INC GRAND RAPIDS 1528181A 2,356 12/26/2021 7610 0.95 WORKBOX EXTH LLC GRAND RAPIDS 6077625A 315 11/20/2021 8810 ANDYMAN IMPROVEMENTS LLC GRANDVILLE 6283101A 750 12/16/2021 5645 DAKOTA J CONCRETE LLC GRANDVILLE 6254098A 750 10/2/2021 5221 DESIGNED AUTOMATION LLC GRANDVILLE 6080553A 1,761 12/1/2021 3724 J AND M RENOVATIONS GRANDVILLE 4097254A 750 11/17/2021 5445 LOESCHNER MINIATURE GOLF GRANDVILLE 0724874A 570 10/12/2021 8017 PREMIER ROOFING AND EXTERIORS LLC GRANDVILLE 4314271A 1,213 10/24/2021 5645 PT FINISH CARPENTRY GRANDVILLE 6049923A 750 11/1/2021 5645 RIDGE TOP PLUMBING LLC GRANDVILLE 4822340A 561 11/21/2021 5183 RMD CONSTRUCTION GRANDVILLE 4272102A 750 12/27/2021 5645 RUSS BROEK BUILDER INC GRANDVILLE 2906473A 750 11/10/2021 5645 SUMMIT CONTRACTING LLC GRANDVILLE 5339758A 618 11/5/2021 9015 TUCKER ANDREW GRANDVILLE 6051162A 750 11/30/2021 5437 ZS GREEN CLEAN LLC GRANDVILLE 5802890A 16,154 12/27/2021 9015 1.35 10 % ASHLAND AUTO SALES LLC GRANT 5155460A 1,113 12/21/2021 7208 DCL BUILDERS LLC GRANT 6056768A 800 10/12/2021 5645 TASKEY TIMBERLINE LOGGING LLC GRANT 3243060A 750 10/27/2021 2702 PRECISION ROOFING AND CONSTRUCTION INC GRANT TWP 4354583A 5,818 11/22/2021 5403 1.00 K AND S QUALITY CONSTRUCTION LLC GRASS LAKE 4479297A 800 12/31/2021 5190 RANDYS ROOFING & SIDING LLC GRASS LAKE 5930960A 825 11/2/2021 5551 WATERLOO HUNT INC GRASS LAKE 0366714A 2,574 11/2/2021 9061 0.95 GRAYLING COOPERATIVE PRESCHOOL INC GRAYLING 1021966A 886 10/19/2021 8868 0.95 HAWK HILL TRUCKING INC GRAYLING 0912883B 17,403 12/13/2021 7208 1.57 13 % JAKE HELSEL FIREWOOD GRAYLING 5779278A 750 11/10/2021 2731 MCLEANS PROMART HOME CENTER 2 GRAYLING 5589886A 4,594 10/3/2021 8010 0.90 NORTHERN MICHIGAN LAW ENFORCEMENT GRAYLING 5345499A 905 11/21/2021 9063 TRAINING GROUP INC TOP NOTCH SNOW REMOVAL LLC GRAYLING 5702909A 732 10/5/2021 9402 WOODLAND HOME CARE LLC GRAYLING 5633834A 20,734 11/11/2021 8835 0.75

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WHISPERING PINES CLUB INC GREEN BAY, WI 1545205A 600 11/4/2021 9015 GOLDEN WEISE AND ASSOCIATES LLC GREEN COVE SPRINGS, 4428455A 241 10/24/2021 8868 FL CEDAR CUSTOM CARPENTRY LLC GREENVILLE 5578205A 750 10/8/2021 5437 CLIMBIN HIGH TREE SERVICE GREENVILLE 4359305A 1,941 11/13/2021 0106 0.95 J HOUSE CONSTRUCTION LLC GREENVILLE 5830370A 3,632 10/21/2021 5645 JASEN PLUMB CONTRACTING LLC GREENVILLE 4752040A 750 11/1/2021 5645 0.95 MAGNUM SPORTS LLC GREENVILLE 5033810A 974 10/4/2021 8017 0.95 SE PAINTER GREENVILLE 5209595A 750 11/12/2021 5476 WOODSMAN FLOORING LLC GREENVILLE 6266908A 2,736 10/31/2021 5437 ATFAB CONSTRUCTION LLC GREGORY 1905813A 750 11/4/2021 5221 COVENANT CONSTRUCTION GROUP LLC GREGORY 5430119A 1,816 11/19/2021 5645 0.95 MUZZIN BUILDING & REMODELING INC GREGORY 3910369A 3,239 12/6/2021 5645 0.95 R M B CONSTRUCTION LLC GRINDSTONE CITY 4914066A 751 10/11/2021 9015 BOAT HOIST USA INC GROSSE ILE 0709786A 3,625 12/8/2021 3724 0.95 CROSSTOWN MAINTENANCE & SERVICES LLC GROSSE ILE 5640008A 913 11/22/2021 9015 DOWNRIVER CLINIC P C GROSSE ILE 5358779A 569 11/7/2021 8832 HAWTHORN GLEN CONDOMINIUM ASSOCIATION GROSSE ILE 1824325A 618 12/1/2021 9015 ISLAND PINES RESIDENTIAL ASSISTED LIVING GROSSE ILE 4685210A 3,438 10/4/2021 9053 0.95 LLC J JS PIZZA WYANDOTTE INC GROSSE ILE 3484521A 752 11/2/2021 9058 PETER POLGAR SERVICES LLC GROSSE ILE 6085130A 706 12/10/2021 9402 SHERMAN EQUIPMENT CO INC GROSSE ILE 2215209A 816 11/20/2021 8810 0.95 CB CONSTRUCTION CO INC GROSSE POINTE 6284850A 800 12/22/2021 5437 CONVEYED AGGREGATE PLACEMENT LLC GROSSE POINTE 4231155A 2,163 11/2/2021 7380 0.95 HUDSON GILBERT GROSSE POINTE 1120050A 641 10/12/2021 0908 JL RUSSELL AND ASSOCIATES INC GROSSE POINTE 6067719A 7,605 10/31/2021 5437 0.95 LEVICK CUSTOM HOMES INC GROSSE POINTE 2235145A 568 10/10/2021 9015 MICHIGAN HOME BUILDERS INC GROSSE POINTE 0167720A 828 10/13/2021 8742 MJM MANISTEE INC GROSSE POINTE 3718530A 574 12/31/2021 8810 0.95 OPPERWALL THEODORE GROSSE POINTE 0981079A 307 11/7/2021 0908 RIVARD PARK ASSOCIATION INC GROSSE POINTE 5290651A 280 10/18/2021 8810 SERVICES FOR OLDER CITIZENS INC GROSSE POINTE 1414950A 1,676 10/1/2021 9015 0.95 STEVEN PROPERTIES INC GROSSE POINTE 0306665B 858 10/4/2021 9015 0.95 BABCOCK ARTHUR COOPERATIVE INC GROSSE POINTE FARMS 5789087A 568 11/29/2021 9015

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge C A KIME INC GROSSE POINTE FARMS 3078043A 5,607 11/4/2021 5645 0.95 CRACCHIOLO RAYMOND GROSSE POINTE FARMS 0832596A 1,136 12/8/2021 0909 0.95 FRIENDS OF DETROIT ROWING INC GROSSE POINTE FARMS 0571083A 711 11/15/2021 9063 0.95 KNOELL GRETCHEN AND HIGBIE MARK GROSSE POINTE FARMS 6075452A 509 11/15/2021 0908 PANTOS THEODORE G & PANTOS NANA GROSSE POINTE FARMS 5614392A 929 10/1/2021 0913 0.95 SOMMERVILLE CONSTRUCTION LLC GROSSE POINTE FARMS 6272576A 751 11/18/2021 5437 FILDEW JOHN GROSSE POINTE PARK 6074014A 571 11/12/2021 0908 MARINE CITY VENTURE LLC GROSSE POINTE PARK 3586561A 398 10/9/2021 9058 NATIONAL REAL ESTATE MANAGEMENT GROUP GROSSE POINTE PARK 6031650A 750 11/21/2021 5645 LLC WHANG ALEXANDER GROSSE POINTE PARK 6283110A 530 12/31/2021 0913 FERRARA DERMATOLOGY CLINIC PC GROSSE POINTE WOODS 0584550A 230 12/1/2021 8832 HOFFMAN LOGGING GULLIVER 5783674A 1,141 11/20/2021 2702 KEITH SPENCER FOREST PRODUCTS INC OF GULLIVER 5324068A 750 10/29/2021 2702 GULLIVER MICHIGAN GEOMATERIALS LLC GWINN 6071643A 2,676 11/6/2021 7208 ROBERTO LOGGING GWINN 0074721A 750 12/21/2021 2702 MAIN STREET PIZZERIA AND BBQ INC HALE 5218276A 2,581 10/2/2021 9058 0.92 ANN ARBOR HOT SHOTS LLC HAMBURG TWP 6034020A 750 10/4/2021 7208 EVAS AFC HOME LLC HAMILTON 4610180A 1,687 11/20/2021 9053 0.95 HAMILTON DISTRIBUTING CO HAMILTON 0300101A 20,196 10/1/2021 3724 0.92 HAMILTON DISTRIBUTING CRANE SERVICES LLC HAMILTON 0300101B 692 10/3/2021 3724 0.92 HOLLAND EQUIPMENT HUNTERS INC HAMILTON 3546250A 3,510 12/30/2021 8107 0.95 J C WALKER & SONS CORPORATION HAMILTON, IN 3363066A 2,228 10/25/2021 6400 0.95 OAKLAND CONSTRUCTION LLC HAMILTON 6284329A 750 12/18/2021 5645 AMAR PIZZA LLC HAMTRAMCK 5123410A 1,524 11/21/2021 9058 0.95 BOZEK MEAT MARKET INC HAMTRAMCK 3667880A 15,013 10/9/2021 8033 1.48 10 % DOUBLE DIGITS INC HAMTRAMCK 5201918A 456 10/21/2021 9058 HUGHES AND LYNN BUILDING AND RENOVATIONS HAMTRAMCK 4274105A 750 10/7/2021 5437 LLC JM COMFORTCARE LLC HAMTRAMCK 6070620A 471 11/5/2021 8835 MUHIC INC HAMTRAMCK 5763355A 2,505 10/14/2021 7208 0.95 VADYM CONSTRUCTION LLC HAMTRAMCK 6275745A 750 11/19/2021 5445 LITTLE BROTHERS FRIENDS OF THE ELDERLY HANCOCK 2171864A 792 10/16/2021 9015 PHI KAPPA TAU GAMMA ALPHA CHAPTER HANCOCK 0915890A 357 12/9/2021 9061 SUPERIOR PROSTHETICS AND ORTHOTICS LLC HANCOCK 5388040A 233 10/9/2021 8810 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 52 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ACKLEYS PROPERTY SERVICES LLC HANOVER 6276946A 900 11/24/2021 9102 CCH ACQUISITIONS LLC HANOVER 6033482A 4,989 10/2/2021 0035 0.95 HARMONY HOME HEALTH LLC HANOVER 3777480A 9,149 12/22/2021 8835 0.81 CROSS VILLAGE ROOFING INC HARBOR SPRINGS 1431811A 3,745 12/22/2021 5551 0.90 JM HOME MAINTENANCE HARBOR SPRINGS 5933951A 618 11/10/2021 9015 KUJAT DARREN HARBOR SPRINGS 6278876A 750 12/2/2021 5645 SOUL SPRINGS PERMACULTURE L3C HARBOR SPRINGS 5645654A 581 12/6/2021 0011 TIMBERWOLF TREE CARE LLC HARBOR SPRINGS 3800202A 6,874 10/11/2021 0106 0.91 WEATHERAIN LLC HARBOR SPRINGS 2750872A 611 10/6/2021 5183 WOODS AT BAY HARBOR ASSOCIATION HARBOR SPRINGS 3570029A 800 11/6/2021 5476 0.95 CARY FAMILY FORESTRY INC HARDWOOD 2216205A 750 12/17/2021 2702 LUCAS NORRIS E HARDWOOD 5625190A 750 11/1/2021 7208 COSMETIC INTERIORS INC HARPER WOODS 5479819A 456 11/17/2021 9522 DCA PRODUCTS INC HARPER WOODS 5353742A 1,824 11/21/2021 5102 0.95 VALUED SERVICE DIRECT HOME CARE INC HARPER WOODS 6275591A 635 11/19/2021 8835 SLAGLE AND HARRIETTA VOLUNTEER FIRE HARRIETTA 5036054A 801 11/29/2021 7704 DEPARTMENT CLARE TRANSPORT HARRISON 4501470A 750 10/29/2021 7202 GENESEE CONTRACTORS LLC HARRISON 5324599A 3,774 10/3/2021 5221 0.95 ADVANCED MACHINE SERVICES LLC HARRISON TWP 3792897A 6,811 11/21/2021 3724 ALPHA STAFFING SOLUTIONS LLC HARRISON TWP 5782813A 411 11/17/2021 9052 1.29 10 % ANCHOR BAY EXPRESS LLC HARRISON TWP 3589455A 830 11/15/2021 8810 0.95 ARBOR LIFTS LLC HARRISON TWP 5545641A 1,511 12/12/2021 0106 0.95 ASV INVESTMENTS INC HARRISON TWP 4285638A 1,432 11/6/2021 9058 0.95 CLASSIC LANDSCAPING LLC HARRISON TWP 3032400A 710 11/9/2021 0042 COLLETA DENNIS HARRISON TWP 1465538A 750 10/25/2021 5437 DETROIT METRO MECHANICAL INC HARRISON TWP 5507669A 4,659 12/7/2021 3726 0.95 ENVIRONMENTAL LIGHTING MAINTENANCE LTD HARRISON TWP 2028956A 751 10/22/2021 5403 EXCEL LANDSCAPING LLC HARRISON TWP 4073304A 1,738 11/1/2021 0042 0.95 GC ROOFING & SIDING LLC HARRISON TWP 5200881A 6,029 12/20/2021 5551 0.73 MARK MILLER BUILDING LLC HARRISON TWP 2459728A 800 10/4/2021 5645 MP PAINT AND REPAIR HARRISON TWP 4918460A 750 10/6/2021 5476 POWER MARINE LLC HARRISON TWP 4133862A 914 10/12/2021 8395 0.95 SMART TRACKING SERVICES LLC HARRISON TWP 6062512A 650 10/18/2021 7720 SOMMERS MARINE LLC HARRISON TWP 0509833A 2,919 12/1/2021 6836 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SUPERIOR MARINE INC HARRISON TWP 1653016A 2,633 11/20/2021 6834 0.95 GREG GEBHART CONSTRUCTION HART 3959287A 750 12/22/2021 5645 0.95 MASTERPIECE CONSTRUCTION CO LLC HART 6275419A 750 11/18/2021 5437 ROUTLEY VICTOR HART 0331490A 750 11/25/2021 2702 RHINO RECOVERY LLC HARTFORD 6276334A 800 11/20/2021 7208 ALL NATURAL LANDSCAPE INC HARTLAND 3676536A 1,758 10/14/2021 0042 0.95 APPLEGATE CONDOMINIUM ASSOCIATION HARTLAND 1596896A 619 11/17/2021 9015 CONRADS GYMNASTICS ACADEMY INC HARTLAND 4281713A 2,005 12/21/2021 9063 0.95 DOUGIES DISPOSAL & RECYCLING LLC HARTLAND 5676363A 7,078 12/18/2021 7213 0.92 ICE HOUSE SKATING ACADEMY HARTLAND 5927552A 7,699 10/25/2021 9015 0.90 MARTIN TREE SERVICE LLC HARTLAND 5765277A 13,528 10/19/2021 0106 0.86 TRINITY CONSTRUCTION LLC HARTLAND 5218918A 750 10/24/2021 5437 0.95 CHARTWELL CONDOMINIUM ASSOCIATION HASLETT 0799254A 569 10/5/2021 9015 HICKORY HILL CONDOMINIUM OWNERS HASLETT 1113887A 568 12/5/2021 9015 ASSOCIATION OF EAST LANSING AFFORDABLE METAL LLC HASTINGS 5066450A 9,724 10/24/2021 5538 1.16 HASTINGS FLIP CLUB LLC HASTINGS 5917727A 300 10/12/2021 9063 HIGH POINTE PROPERTY PRESERVATION LLC HASTINGS 5750890A 2,611 12/22/2021 0106 0.95 HOMETOWN TREE SERVICE HASTINGS 1877917A 4,020 10/2/2021 0106 0.95 JIMS AND SONS PICKUP SERVICE LLC HASTINGS 4855396A 8,177 12/27/2021 7213 0.90 STARTING OVER FOR SUCCESS SOS HASTINGS 5462193A 8,638 10/15/2021 3146 1.00 WHISPERING WATERS INC HASTINGS 2245450A 568 10/1/2021 8810 BUMBLEBEE GAS AND EXTRACTION SUPPLY LLC HAZEL PARK 6084087A 374 12/7/2021 7502 FOUR BOTTLE SERVICE INC HAZEL PARK 5638224A 418 12/10/2021 9058 JOSHUA CARNES TRUCKING LLC HAZEL PARK 4906691A 3,470 11/20/2021 7214 MCPHERSON LEGAL PROCESS SERVICES HAZEL PARK 5026482A 1,950 12/16/2021 7720 0.95 MOMO AJ LLC HAZEL PARK 6259421A 1,736 10/19/2021 7208 REDWING HOME IMPROVEMENTS INC HAZEL PARK 0463566A 750 12/19/2021 5645 RICH HUTTON CONSTRUCTION COMPANY HAZEL PARK 4829905A 750 10/24/2021 5437 SAVAYA AUTO SERVICE INC HAZEL PARK 0154130A 1,222 12/22/2021 8395 STS BUILDERS LLC HAZEL PARK 5764580A 800 10/18/2021 5645 DITTMARS SNOW PLOWING PROS LLC HEMLOCK 5340535A 656 11/6/2021 9402 LAGALOS LAWN CARE & BUILDING HEMLOCK 5397103A 977 10/24/2021 9102 MAINTENANCE LLC HOLLE RICHARD A HERMANSVILLE 1957228A 750 12/20/2021 2702

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge B AND D FOREST PRODUCTS INC HERRON 2739445A 750 10/19/2021 0106 MAJOR LEAGUE BLASTING LLC HERSEY 5994209A 8,527 10/20/2021 5022 H AND H TIMBER LLC HESPERIA 0332364A 750 12/12/2021 2702 AMERICAN MADE CONSTRUCTION LLC HIGHLAND 3548821A 1,374 11/8/2021 5437 0.95 CHRISTIAN BROTHERS PAINT CONTRACTOR LLC HIGHLAND 0121703A 751 11/15/2021 5476 COLLINS EDWARD HIGHLAND 5324033A 750 10/2/2021 5348 COMPREHENSIVE CONSTRUCTION SERVICES HIGHLAND 3429903A 800 12/7/2021 5403 INC GOOD OL BOYS MASONRY HIGHLAND 3591620A 3,958 11/21/2021 5022 HAMMER AND PLOW LLC HIGHLAND 6274773A 656 11/17/2021 9015 HURON VALLEY LAWN CARE LLC HIGHLAND 5800005A 1,229 12/19/2021 0042 0.95 IMKER BRIAN HIGHLAND 6006086A 750 12/10/2021 5645 INNOVATIVE RECYCLING AND WASTE SERVICES HIGHLAND 3133877A 850 12/19/2021 7213 INC JEFFS HANDYMAN SERVICES & REMODELING HIGHLAND 6286097A 751 12/30/2021 5645 INC JUSTIN CLEVELAND HOME IMPROVEMENT HIGHLAND 5695821A 750 10/27/2021 5645 SLAYS CONSTRUCTION SERVICE INC HIGHLAND 1450182A 1,228 10/10/2021 5645 THADEOUS S CALUS CONSTRUCTION INC HIGHLAND 0421600A 750 12/12/2021 5437 TOP QUALITY MAINTENANCE INC HIGHLAND 0845914A 714 11/1/2021 2501 0.95 B AND B WOODWARD MARATHON INC HIGHLAND PARK 4334779A 595 12/31/2021 8017 0.95 KING CONSULTING SERVICES LLC HIGHLAND PARK 5783933A 529 11/20/2021 8601 OUR LADY OF LOURDES INC HIGHLAND PARK 5317916A 3,360 10/8/2021 8395 0.95 AD VENTURES OF MICHIGAN INC HILLMAN 0965731A 1,938 11/1/2021 8017 1.00 CRAWFORD LEWIS W HILLMAN 2784238A 750 12/17/2021 2702 NOVOTNY TRANSPORT LLC HILLMAN 6285546A 750 12/23/2021 7208 BAXTER LAWN AND SNOW SERVICE HILLSDALE 5547210A 931 11/22/2021 9102 CRISIS PREGNANCY CENTER OF HILLSDALE HILLSDALE 5442842A 293 12/17/2021 8742 COUNTY INC EXTRODINARY SOLUTIONS L L C HILLSDALE 5646316A 3,803 12/7/2021 8835 LIFE CHALLENGE OF MICHIGAN HILLSDALE 5036780A 764 11/21/2021 8832 US SYSTEMS INC HILLSDALE 4727940A 471 12/13/2021 7610 ALLPRO SERVICES OF WEST MICHIGAN INC HOLLAND 2831368A 800 11/20/2021 5645 AQ TRUCKING LLC HOLLAND 6277500A 4,583 11/30/2021 7208 BALER SUPPLY CO INC HOLLAND 5763304A 656 10/14/2021 3724 BARKEL PLASTERING SERVICE HOLLAND 0442054A 750 10/8/2021 5480

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BRICK WORLD LLC HOLLAND 5928664A 835 10/29/2021 8010 BRINK SERVICES LLC HOLLAND 5773687A 750 11/2/2021 5645 COASTAL CAREERS INC HOLLAND 2824949A 57,579 10/1/2021 3612 0.74 DEZWAAN JON HOLLAND 6274803A 800 11/18/2021 5437 ELMWOOD LAKE CONDOMINIUM ASSOCIATION HOLLAND 5431409A 569 10/3/2021 9015 GARCIA AGUINALDO HOLLAND 6071481A 750 11/6/2021 5645 HOMES BY HOLMES LLC HOLLAND 5912121A 1,885 10/11/2021 5437 0.95 KEVIN FRIELING BUILDER LLC HOLLAND 4409396A 750 10/24/2021 5437 KRAGT KONSTRUCTION KOMPANY HOLLAND 1765833A 750 10/7/2021 5645 KYLE HARTER WELDING & FABRICATION LLC HOLLAND 5940982A 1,261 11/30/2021 3365 LAKESHORE TREE SERVICE LLC HOLLAND 2501589A 1,873 11/18/2021 8395 0.95 MILLENNIUM GYMNASTICS INC HOLLAND 1962795A 1,249 10/27/2021 9063 0.95 MILLER FIREWORKS COMPANY INC HOLLAND, OH 4946618A 542 10/24/2021 8017 OTTAWA COUNTY FAIR ASSOCIATION HOLLAND 1338862A 993 11/17/2021 9015 PLATFORM 127 HOLLAND 5603960A 365 11/2/2021 8868 POLLARD TREE SERVICE LLC HOLLAND 6266584A 3,600 11/5/2021 0106 PRO LOW MOVING LLC HOLLAND 5921350A 6,491 10/19/2021 7214 0.94 SANTOS GEOBANI OSORIO HOLLAND 6281273A 750 12/16/2021 5445 SPECIALTY SPRAY FOAM LLC HOLLAND 6276903A 750 11/24/2021 5479 STAR RIGGING AND CRANE LLC HOLLAND 4981391A 2,917 12/9/2021 9530 STOVETOP COFFEE ROASTERS LLC HOLLAND 5647827A 1,688 12/10/2021 9058 0.95 STRATUS GROUP INC HOLLAND 0492892A 1,015 11/1/2021 7423 0.95 TANKS R US LLC HOLLAND 3623440A 750 10/17/2021 8350 VERSENDAAL CONSTRUCTION & IMPROVEMENT HOLLAND 3986187A 750 10/16/2021 5645 LLC WASSINK PLUMBING LLC HOLLAND 6064337A 636 10/24/2021 5183 WATERFRONT LIFESTYLE SERVICES LLC HOLLAND 6071546A 568 11/6/2021 9015 DENNIS FRANCIS ROOFING HOLLY 2531321A 14,467 11/20/2021 5551 0.93 EPIC ERECTORS LLC HOLLY 5707544A 7,522 11/18/2021 5040 0.95 FRANK D HEKKER DIVERSIFIED INC HOLLY 5217253A 2,080 12/5/2021 0106 0.95 GUSTIN ENTERPRISES LLC HOLLY 6251668A 470 10/7/2021 5190 HOLLY AREA YOUTH ASSISTANCE HOLLY 1858564A 216 11/3/2021 8810 J AND O ENTERPRISES LLC HOLLY 6279651A 875 12/4/2021 9519 KENNETH HOOVER HOME SERVICES HOLLY 4359437A 340 11/4/2021 8720 KENS FLOORING HOLLY 2712520A 933 11/11/2021 9521

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge KEVINS ELECTRIC LLC HOLLY 5217741A 470 12/31/2021 5190 PDB INVESTMENTS LLC HOLLY 5633249A 568 12/16/2021 9015 PEARL MANOR AFC LLC HOLLY 5845815B 645 10/3/2021 9053 QUANTUM VENTURES LLC HOLLY 5763207A 3,354 10/14/2021 8835 0.91 ROLL A LOT PAINTING LLC HOLLY 3308960A 825 11/8/2021 5476 ASSOCIATED GENERAL CONTRACTORS LLC HOLT 4440137A 800 10/26/2021 5403 CEDAR WOODS CONDOMINIUM ASSOCIATION HOLT 1068679A 568 10/27/2021 9015 EVERETT COMMUNICATIONS LLC HOLT 6074723A 6,800 12/11/2021 3724 FRISCOS MECHANICAL & FABRICATING INC HOLT 5422051A 720 11/15/2021 9519 MIKES TRANSPORT INC HOLT 0964905A 800 11/22/2021 7208 CROSSMAN PLUMBING & HEATING INC HONOR 4286979A 674 12/6/2021 5183 ORENCO LLC HONOR 4547799A 860 10/15/2021 5645 SUPERIOR OUTDOOR SERVICES HONOR 6049877A 706 10/4/2021 9402 BURDICK CONTRACTING HOPE 2081539A 750 10/5/2021 3821 ROLLING HOME TRANSPORT LLC HOPKINS 6275702A 800 11/19/2021 7208 W L HALL CO HOPKINS, MN 5935024A 1,618 11/13/2021 5403 WEST MICHIGAN CONVENTION VENTURES LLC HOPKINS 5463041A 2,906 10/15/2021 9015 0.95 NITE LITES OF JACKSON LLC HORTON 1812408A 2,344 10/28/2021 5190 0.95 JDM CONSTRUCTION INC HOUGHTON 4920066A 1,348 10/14/2021 5645 1.29 13 % BODES WELDING INC HOUGHTON LAKE 3132781A 2,012 12/29/2021 3365 0.95 INGLESON ROOFING HOUGHTON LAKE 3683290A 750 11/1/2021 5551 JORDAN HAF CONSTRUCTION LLC HOUGHTON LAKE 5113229A 1,769 10/22/2021 5645 0.95 NORTHERN MICHIGAN GRANITE LLC HOUGHTON LAKE 5628725A 750 10/28/2021 5437 CORE BENEFIT SOLUTIONS LLC HOUSTON, TX 6279600A 405 12/4/2021 8810 BARTLETT TRANSPORT LLC HOWARD CITY 6085393A 750 12/11/2021 7208 SILVERCREEKBUILDERS LLC HOWARD CITY 6085946A 1,768 12/12/2021 5610 ACTON PLUMBING & HEATING CO HOWELL 1872524A 674 11/19/2021 5183 ADVANCED TREE MOVING COMPANY HOWELL 3501426A 12,718 10/1/2021 0005 0.82 AMBERLY WOODS HOMEOWNERS ASSOCIATION HOWELL 6055532A 775 10/14/2021 9015 ASI SOLUTIONS INC HOWELL 4696670A 215 12/10/2021 8810 BOBS ROOFING INC HOWELL 2617501A 750 12/13/2021 5551 CORNELL LOGGING LLC HOWELL 3103749A 750 10/31/2021 2702 CORNERSTONE BUILDING LLC HOWELL 5129583A 5,059 11/9/2021 5645 0.95 DIMENSIONAL IMPROVEMENTS LLC HOWELL 5923468A 750 10/13/2021 5437 DIMOSKI HOME LLC HOWELL 5328055A 338 12/16/2021 5606 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 57 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DKC LLC HOWELL 0498220A 4,434 12/23/2021 5215 0.95 E AND J ELECTRIC LLC HOWELL 3065030A 470 11/11/2021 5190 FILLION CONSTRUCTION INC HOWELL 1579967A 801 10/10/2021 5190 0.95 HASLOCK PLOWING LLC HOWELL 6280366A 656 12/8/2021 8810 HUNTMORE ESTATES CONDOMINIUM HOWELL 5640652A 568 11/19/2021 9015 ASSOCIATION K S MITAL PLUMBING INC HOWELL 2451913A 561 10/11/2021 5183 KWIATKOWSKI STEVEN HOWELL 6281702A 750 12/11/2021 5348 LAKESIDE CONSTRUCTION AND SIDING LLC HOWELL 2476150A 751 10/25/2021 5183 LAW OFFICE OF MONICA J COPELAND HOWELL 3709248A 303 11/1/2021 8820 LIFT LEVEL INC HOWELL 4982720A 6,187 10/16/2021 5221 0.91 LIVINGSTON METALS LLC HOWELL 6057560A 10,332 10/15/2021 3066 0.94 LLOYDS HOMES INC HOWELL 4939930A 750 12/4/2021 5437 MICHIGAN DECKING LLC HOWELL 5048079A 3,948 11/1/2021 5437 0.95 MICHIGAN PIANO MOVING LLC HOWELL 4905792A 3,451 10/1/2021 8293 0.94 MIDWEST MILITARY FASTENERS LLC HOWELL 5332095A 216 10/21/2021 8810 MONTAGE II INC HOWELL 4769996A 10,628 11/17/2021 5645 0.95 PREMIER STEEL CONSTRUCTION LLC HOWELL 3313042A 338 10/13/2021 5606 RB INSTALLATIONS LLC HOWELL 4740670A 706 11/27/2021 5538 0.95 REGAL RIGGING & DEMOLITION LLC HOWELL 5125537A 7,199 10/25/2021 5040 0.91 SEVERE WEATHER NETWORK LIVINGSTON HOWELL 6081843A 573 12/3/2021 8810 COUNTY THE SLC LIGHTING LLC HOWELL 6258611A 503 10/13/2021 5190 SMITHSONEON LLC HOWELL 4921941A 750 10/14/2021 5645 SMOKESTACK SWEEP LLC HOWELL 5463670A 2,164 10/31/2021 9015 0.95 STANDLEY PROFESSIONAL CARPENTRY INC HOWELL 3463958A 750 12/10/2021 5645 0.95 SUNSHINE COTTAGE LLC HOWELL 5922488A 2,896 10/11/2021 9053 0.95 THEIS PROPERTY MAINTENANCE HOWELL 6150721A 1,252 12/16/2021 9102 TIMBERLINE OUTDOOR SERVICES HOWELL 3145557A 926 10/31/2021 0042 TODD M JOHNSON CONSTRUCTION CO LLC HOWELL 3191982A 7,030 11/30/2021 5445 0.84 TRIPLE D DEMOLITION HOWELL 6134149A 1,605 10/14/2021 5610 WATERS EDGE DOCK & BOAT HOIST MMXI INC HOWELL 4911083A 5,506 10/4/2021 6836 0.92 HUBBARD LAKE DRYWALL HUBBARD LAKE 5946379A 750 12/19/2021 5445 HAMDAN QUALITY ROOFING LLC HUDSON 5943728A 825 12/18/2021 5551 RANSOM ENTERPRISES LLC HUDSON 2759870A 569 10/23/2021 9015

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge AMERICAN TREE WORKS LLC HUDSONVILLE 5767202A 1,647 11/6/2021 0106 0.95 BOVEN HARDWOOD FLOORING INC HUDSONVILLE 1555634A 750 10/19/2021 5437 BUILDERS UNLIMITED INC HUDSONVILLE 1944622A 750 10/13/2021 5645 0.95 CRYSTAL IMAGE DETAILING LLC HUDSONVILLE 6260039A 833 11/6/2021 8387 DARIN HOLMAN BUILDERS LLC HUDSONVILLE 4430360A 750 10/23/2021 5645 DEGOEDE DRYWALL INC HUDSONVILLE 3535878A 750 10/18/2021 5445 DYKSTRA SIDING LLC HUDSONVILLE 5354420A 750 12/18/2021 5645 ENSING EXCAVATING AND TRANSPORT INC HUDSONVILLE 5774110A 739 12/14/2021 6217 0.95 HTH LOGISTICS LLC HUDSONVILLE 6020640A 2,540 10/28/2021 7206 0.95 JOHN WHELAN BUILDER LLC HUDSONVILLE 4162447A 750 11/25/2021 5645 NICK HENRY BUILDERS LLC HUDSONVILLE 6064914A 750 10/25/2021 5645 OK ROOFING COMPANY HUDSONVILLE 3302490A 2,670 10/8/2021 5551 0.95 PHOENIX QA1 INCORPORATED HUDSONVILLE 3639495A 358 12/11/2021 8810 RABBIT RIVER CONTRACTORS LLC HUDSONVILLE 5206782A 751 10/31/2021 8810 RICOS LLC HUDSONVILLE 5708303A 800 10/6/2021 5645 SCHOUT BUILDERS INC HUDSONVILLE 3195619A 750 11/19/2021 5645 SCOTT VANDERLAAN BUILDING HUDSONVILLE 3237389A 750 10/17/2021 5645 SELECT HARDWOOD FLOORS LLC HUDSONVILLE 5351278A 750 12/10/2021 5437 SHEPARD INC HUDSONVILLE 5760119A 750 10/10/2021 5445 STEVE LANINGA BUILDER LLC HUDSONVILLE 4933710A 750 12/18/2021 5645 SW PAINTING SOLUTIONS LLC HUDSONVILLE 2849550A 750 11/8/2021 5476 TIMMER DRYWALL LLC HUDSONVILLE 5382130A 750 12/24/2021 5445 TROY MOL DRYWALL INC HUDSONVILLE 3685730A 750 11/4/2021 5445 VANDERMOLEN CONSTRUCTION HUDSONVILLE 2792265A 750 10/18/2021 5437 VANDYKE JOEL HUDSONVILLE 6262791A 750 10/21/2021 5476 WE CARE 4 U LLC HUDSONVILLE 6274765A 471 12/18/2021 8835 ECOTEC INC HUNTINGTON WOODS 5754577A 1,808 10/20/2021 9015 0.95 FOXCROFT OF BLOOMFIELD CONDOMINIUM HUNTINGTON WOODS 2356996A 569 10/20/2021 9015 0.95 ASSOCIATION INTERGOVERNMENTAL CABLE HUNTINGTON WOODS 2326906A 215 12/27/2021 8810 COMMUNICATIONS AUTHORITY J GREATHOUSE LANDSCAPING INC HUNTINGTON WOODS 5049300A 679 12/19/2021 9102 SCHLAEN SANDRA E AND LERNER JOSHUA A HUNTINGTON WOODS 5484901A 605 12/1/2021 0913 PREMIER CORPORATE SECURITY INC IDA 4849205A 378 10/6/2021 8810 SCHUMAKER BROTHERS CONSTRUCTION IDA 1415263A 709 11/27/2021 0042

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MT PIZZA LLC IMLAY 5482860A 3,439 10/5/2021 9058 0.95 LAPEER COUNTY AGRICULTURAL SOCIETY IMLAY CITY 1199722A 2,024 10/8/2021 9015 0.95 MOORS MASONRY IMLAY CITY 5166934A 1,318 10/10/2021 5022 S T C RIGGING COMPANY IMLAY CITY 2211270A 1,908 10/1/2021 3724 0.95 DUKES DENNIS INDIAN RIVER 6251641A 566 10/23/2021 0908 ERC INSULATION INDIAN RIVER 2456877A 561 12/28/2021 5183 GORAL CONSTRUCTION & REMODELING LLC INDIAN RIVER 3451410A 750 11/6/2021 5645 0.95 MAPLE WOODS HEATING LLC INDIAN RIVER 5799198A 3,430 12/16/2021 5550 0.95 NORTHERN MICHIGAN PROPERTY CARE LLC INDIAN RIVER 6085679A 1,307 12/11/2021 9102 EAZ ENVIRONMENTAL SERVICES LLC INDIANAPOLIS, IN 5054052A 1,153 10/19/2021 5020 LGR MULTI SERVICES LLC INDIANAPOLIS, IN 5848156A 4,866 12/19/2021 5022 YOLANDA SERVICES LLC INDIANPOLIS, IN 6280331A 1,292 12/8/2021 5479 SVINICKI JUSTIN INGALLS 4600274A 750 10/27/2021 5403 A TO Z CAR CARE INC INKSTER 4620593A 608 10/10/2021 8395 AA RENOVATIONS LLC INKSTER 6285295A 750 12/23/2021 5476 BRANTLEY DEVELOPMENT LLC INKSTER 4545451A 2,591 10/23/2021 0042 0.95 DR 1 PAINTING AND PLUS LLC INKSTER 5998670A 750 10/5/2021 5476 HERNANDEZ CARPENTRY LLC INKSTER 5974518A 800 10/1/2021 5645 MGC CLEANING SERVICES LLC INKSTER 6276911A 568 12/3/2021 8835 TC INSTALLATION INC INKSTER 5469902A 750 10/19/2021 5645 TONYS INSTALLATION LLC INKSTER 6284264A 750 12/18/2021 5645 US 12 TRUCKING LLC INKSTER 6051286A 751 10/5/2021 7208 INTERLOCHEN PERENNIAL FARMS LLC INTERLOCHEN 3628264A 445 10/13/2021 0035 KEN HAZEL BUILDERS INTERLOCHEN 2610698A 800 11/1/2021 5645 STONEWORX MI LLC INTERLOCHEN 6084168A 753 12/7/2021 8810 SOUTHSIDE PROPERTY MAINTENANCE LLC IONA 3926257A 1,718 12/2/2021 9102 0.95 BELLEVIEW A F C LLC IONIA 5321140A 854 10/7/2021 9053 FIRST CHOICE INSTALLATIONS LLC IONIA 6254179A 800 10/2/2021 5146 LOCAL 436 CWA IONIA 2833867A 239 11/3/2021 8810 PRIDE HOME IMPROVEMENT LLC IONIA 6261647A 751 10/17/2021 5645 SCHOOL OF MISSIONARY AVIATION IONIA 2914328A 2,808 11/16/2021 8868 0.95 TECHNOLOGY INC COMPLETE CONCRETE CONSTRUCTION LLC IRA 5044944A 1,990 11/19/2021 5221 FOX POINTE EQUESTRIAN CENTER LLC IRA 6250696A 6,634 11/2/2021 8279 KURTS HOMETOWN LLC IRA 4928253A 750 11/1/2021 5645

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BIERNASZ DANIEL E IRON MOUNTAIN 5460140A 750 10/9/2021 2709 BLACKSTONE PIZZA CO IRON MOUNTAIN 3995038A 2,607 12/29/2021 9058 0.95 CHANG INC IRON MOUNTAIN 1089919A 572 12/17/2021 9058 CLEVELAND PATRICK D IRON MOUNTAIN 2827310A 750 10/31/2021 2702 K AND S PIPER LLC IRON MOUNTAIN 5621542A 750 10/14/2021 7208 NEUENS AUTO SALES INC IRON MOUNTAIN 4024761B 2,055 12/30/2021 8748 1.20 10 % OLD 69 LIMITED INC IRON MOUNTAIN 4677706A 844 10/17/2021 9058 0.95 ZOLLNERS TRUCKING INC IRON MOUNTAIN 6271553A 3,396 11/10/2021 7208 BRICKMAN LOGGING LLC IRON RIVER 0754250A 750 12/15/2021 2702 CHRISTENSEN CHARLES E IRON RIVER 1611356A 750 12/9/2021 2709 CLEMENTS TRUCKING IRON RIVER 4874447A 750 12/15/2021 7208 HOCKBERGER WILLIAM M IRON RIVER 6286208A 750 12/30/2021 2702 J AND J FOREST PRODUCTS IRON RIVER 1125087A 750 10/20/2021 2702 M AND M CLEMENTS TRUCKING IRON RIVER 1998633A 750 12/28/2021 2702 M D AHO INC IRON RIVER 2080141A 750 12/10/2021 2702 PIWARSKI BROS LOGGING INC IRON RIVER 1653091A 750 11/9/2021 2709 JIM LEACH MECHANICAL IRONS 1232932A 2,100 10/2/2021 5550 EARTH AND SKY DAY SPA LLC IRONWOOD 6061168A 298 10/27/2021 9586 RAMMES COLLISION CENTER IRONWOOD 1709615A 1,786 11/19/2021 8393 0.95 SUPERIOR TRANSPORTATION IRONWOOD 6257879A 800 10/10/2021 7208 MOA MICHIGAN INC IRVING, TX 6257895A 8,131 10/16/2021 8292 VIN WORLDWIDE TRANSPORT LLC ISELIN, NJ 5849390A 373 10/7/2021 8810 TALSMA CONTROLS COMPANY ISHPEMING 1677691A 313 12/19/2021 8601 CLAYBROOK FARMS LLC ITHACA 3716953A 3,884 11/1/2021 8279 0.95 RYDER FARMS LLC ITHACA 6027911A 506 10/30/2021 0128 SHERMAN BUILDERS ITHACA 3833321A 2,941 11/18/2021 5437 0.95 WIDEMAN APPRAISAL SERVICE INC ITHACA 3869814A 552 11/23/2021 8720 ALL AROUND GYMNASTICS CENTER INC JACKSON 1562916A 1,079 12/10/2021 9063 0.95 ASBESTOS AND LEAD ABATEMENT OF MICHIGAN JACKSON 2311658A 4,999 12/5/2021 5183 0.91 LLC BAILEY AND MOORE ROOFING & SIDING JACKSON 6066640A 825 10/28/2021 5551 BRANHAM ROBERT JACKSON 4686160A 580 10/8/2021 9102 CARELINE PALLIATIVE CARE LLC JACKSON 4962060A 1,323 12/19/2021 8832 0.95 COMPASSIONATE CARE AT HOME LLC JACKSON 4242440A 1,095 11/29/2021 8835 0.95 CSR LOGGING & LAND CLEARING LLC JACKSON 6261477A 750 10/26/2021 2702

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DAUGHERTY TREE SERVICE LLC JACKSON 3801926A 9,127 10/1/2021 0106 0.92 EKQUIST CUSTOM WOODWORKING & JACKSON 5770785A 800 10/27/2021 5403 CONSTRUCTION LLC FRIENDS LAWN & LANDSCAPE JACKSON 3486524A 975 10/28/2021 9102 0.95 GANAWAY SERVICES JACKSON 6068413A 825 10/31/2021 5551 GARY WEINHARDT PAINTING JACKSON 2286319A 800 11/21/2021 5476 0.94 GRIFKA MARKETING LLC JACKSON 6081479A 247 12/2/2021 8810 JACKSON COUNTY SPORTSMENS CLUB JACKSON 1131702A 569 11/1/2021 9015 JASONS NEW & USED APPLIANCES LLC JACKSON 2788926A 2,289 12/5/2021 9519 0.95 JONES ENTERPRISES LLC JACKSON 5320704A 6,218 10/12/2021 5190 0.79 LAUTH CONSTRUCTION JACKSON 6251730A 750 10/16/2021 5645 MID MICHIGAN TRAILERS LLC JACKSON 6267050A 1,158 11/10/2021 8017 MTB WAYNE LLC JACKSON 5555086A 750 11/12/2021 5645 NANCY MINIX ENTERPRISES LLC JACKSON 0803979A 990 11/17/2021 9058 0.95 NORTH STAR MONTESSORI LLC JACKSON 3835952A 400 10/25/2021 8869 RIDGE LINE ENTERPRISE LLC JACKSON 5480671A 800 12/7/2021 5645 ROSE CITY LAWN & GARDEN JACKSON 1541218A 707 12/22/2021 9402 ROXY CAFE LLC JACKSON 5329868A 1,618 10/8/2021 9058 0.95 SLOAN AGENCY INC JACKSON 0681563A 782 10/24/2021 8810 0.95 SOMMER ENTERPRISES LLC JACKSON 4030290A 625 12/12/2021 9058 STOREY FIREPLACE & CHIMNEY JACKSON 6256457A 3,075 10/8/2021 9015 THOMAS SEWER SERVICE LLC JACKSON 5181364A 706 10/23/2021 9402 UNITED MONITORING SOLUTIONS LLC JACKSON 5944120A 305 12/11/2021 8742 XCEL SPECIALIZED LLC JACKSON 6268684A 9,196 11/4/2021 0035 BK EXTERIORS AND TRIM LLC JACKSONVILLE, NC 5917328A 750 10/4/2021 5645 ABOVE AND BEYOND PRIVATE DUTY CARE LLC JEDDO 5756251A 901 10/6/2021 8835 ARBORIST SERVICES LLC JENISON 6250670A 1,292 10/1/2021 0042 BOYNTON LAND COMPANY INC JENISON 0558818A 241 12/27/2021 8810 DIVERSIFIED DRYWALL SERVICES LLC JENISON 2785811B 750 11/23/2021 5445 0.94 HARRISON CORVET JENISON 6277365A 750 11/25/2021 5476 HORIZON KIDS COMPLEX LLC JENISON 1415395B 801 11/24/2021 9063 0.87 HORIZON LEARNING CENTER LLC JENISON 1415395A 1,007 11/24/2021 8869 0.87 INTEGRITY EXTERIOR SOLUTIONS JENISON 6087914A 750 12/26/2021 5645 JASON DUSENDANG PAINTING JENISON 5619734A 750 11/9/2021 5437 JOSEPH JOHN JENISON 3576647A 800 11/27/2021 7600

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge KUIPER TREE CARE LLC JENISON 6264280A 1,050 10/29/2021 0106 R AND S QUALITY STUMP GRINDING LLC JENISON 5016185A 800 10/13/2021 0106 ROBERTS DELIVERY LLC JENISON 5944155A 1,038 12/15/2021 7208 SCRUBBER DUCT CLEANING LLC JENISON 5598664A 568 11/19/2021 9015 ALPINE PRECISION SURFACE LLC JOHANNESBURG 5850134A 19,919 12/22/2021 5348 SWISS VALLEY INC JONES 0007951A 16,660 12/1/2021 9015 1.53 27 % CERTIFIED MAINTENANCE LLC JONESVILLE 2230747A 2,265 11/12/2021 9015 0.95 ADVANCED ACCESS SYSTEMS INC KALAMAZOO 2013932A 421 10/27/2021 5191 BRUSH UP PAINTING KALAMAZOO LLC KALAMAZOO 6275346A 750 11/18/2021 5476 DAVID A CHENOWETH ROOFING INC KALAMAZOO 0803472A 12,539 10/10/2021 5552 1.64 13 % DINAN INC KALAMAZOO 5616107A 571 10/4/2021 8810 DOUGLAS S EPLEE CPA PLLC KALAMAZOO 2045737A 287 12/15/2021 8810 DYKSTERHOUSE BUILDERS LLC KALAMAZOO 5394848A 750 10/27/2021 5437 ENERGY SUPPLIERS LLC KALAMAZOO 5020239A 1,081 10/23/2021 4712 0.95 EXPERT CLEANING SERVICES INC KALAMAZOO 2071657A 1,835 11/3/2021 8835 0.95 FISH EXPRESS RIVERVIEW LLC KALAMAZOO 3294234A 1,571 11/2/2021 9058 0.95 GASCON CONTRACTING LLC KALAMAZOO 5492700A 825 12/17/2021 5551 GULL ROAD WINE & SPIRIT LLC KALAMAZOO 4182960A 978 11/19/2021 8017 IN HOME COMPANIONS INC KALAMAZOO 6087515A 607 12/17/2021 8835 JOSHUA J ENTERPRISES INC KALAMAZOO 1497391A 2,139 10/31/2021 9058 0.95 JR JARVIS BUILDERS LLC KALAMAZOO 5949750A 4,650 10/5/2021 5645 0.93 JUANS TREE REMOVAL LLC KALAMAZOO 6263674A 8,202 10/22/2021 0106 KALAMAZOO CENTER FOR YOUTH AND KALAMAZOO 4948998A 790 10/19/2021 8869 COMMUNITY KANDLER TOOL COMPANY KALAMAZOO 1593439A 30,507 12/21/2021 7208 2.01 27 % KLH CUSTOM HOMES LLC KALAMAZOO 5337399A 3,153 11/1/2021 5476 0.95 KOSS CONTRACTING LLC KALAMAZOO 2708914A 825 12/11/2021 5645 LEGACY ENERGY COMPANY LLC KALAMAZOO 2442396A 633 10/1/2021 8810 0.95 MC BUILDERS LLC KALAMAZOO 6087396A 1,323 12/17/2021 5403 MCENROE LOGISTICS INC KALAMAZOO 5943302A 826 12/10/2021 7208 NEKTON CONSTRUCTION LLC KALAMAZOO 6257062A 9,310 10/9/2021 5645 NELSON DEREK F KALAMAZOO 6281192A 530 12/14/2021 0913 NEW GENERATION PLASTERING & STUCCO LLC KALAMAZOO 5821886A 750 10/17/2021 5022 NORTHWOOD GROUP LLC KALAMAZOO 2189313A 15,094 12/31/2021 7421 0.80 O BRIEN REAL ESTATE INC KALAMAZOO 3336883A 590 10/29/2021 8810

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge OLECH CONSTRUCTION INC KALAMAZOO 4421760A 750 12/1/2021 5403 ONSITE STAFFING SOLUTIONS INC KALAMAZOO 3768961A 27,194 10/13/2021 3066 1.00 PJ CONTRACTORS LLC KALAMAZOO 6266533A 3,516 11/6/2021 5445 ROCKETSHIP CLEANING SERVICE LLC KALAMAZOO 5613639A 668 12/23/2021 9015 RONS MOTOR SALES LLC KALAMAZOO 5147913A 259 12/10/2021 8748 RSVP INTERNATIONAL LLC KALAMAZOO 4408039A 766 10/16/2021 8810 RUIZ UBALDO III KALAMAZOO 6254055A 790 10/6/2021 9015 SAFE HAVEN HOME CARE LLC KALAMAZOO 6283306A 1,552 12/16/2021 8835 SCARY STUFF INC KALAMAZOO 4133609A 1,430 10/1/2021 9154 SHALOM INC KALAMAZOO 4408241A 307 10/1/2021 8810 SLR HOME IMPROVEMENT KALAMAZOO 5504937A 825 10/9/2021 5551 SMITHS DRYWALL KALAMAZOO 1578294A 750 10/28/2021 5445 SUGARLOAF MHP LLC KALAMAZOO 6049613A 568 10/4/2021 9015 SUJI HOME LLC KALAMAZOO 5837855A 954 12/15/2021 9053 0.95 SUN GREEN LLC KALAMAZOO 2778696A 1,055 11/17/2021 9063 0.95 T C C CONSTRUCTION KALAMAZOO 5915716A 750 10/6/2021 5645 THOMAS FAMILY WATERPROOFING LLC KALAMAZOO 6265391A 1,054 10/28/2021 6229 VANBECKS LLC KALAMAZOO 2109891A 907 12/28/2021 5606 0.95 WHITE PINE FURNITURE LLC KALAMAZOO 6081509A 605 12/3/2021 2881 WLP EXECUTIVE PROTECTION GROUP LLC KALAMAZOO 5408695A 6,370 12/7/2021 7720 0.95 EXODUS PRESSURE CONTROL INC KALKASKA 2945010A 919 12/9/2021 8601 0.95 JJS PUMPING UNIT SERVICE LLC KALKASKA 5194849A 827 10/2/2021 8810 0.95 MD PRODUCTION SOLUTIONS LLC KALKASKA 5745454A 773 11/16/2021 3365 MICHIGAN STONE & BOULDER LLC KALKASKA 5848679A 800 12/3/2021 5022 NORTH MICHIGAN CONSTRUCTION CO LLC KALKASKA 4257553A 750 12/7/2021 5645 RICHARD ALLEN INC KALKASKA 3880931A 825 12/11/2021 5040 RSI ROOSE SERVICES INC KALKASKA 3427161A 825 10/12/2021 5606 KADER REFRIGERATION INC KAWKAWLIN 6099734A 674 10/2/2021 5550 MADZIAR DONALD KAWKAWLIN 2511916A 15,156 10/13/2021 5645 0.83 SPECIALTY CONCRETE KAWKAWLIN 1999877A 801 11/11/2021 5221 JSD MECHANICAL PLUMBING LLC KEEGO HARBOR 2161370A 561 12/19/2021 5183 0.89 OXFORD ESTATES CONDOMINIUM ASSOCIATION KEEGO HARBOR 4548108A 568 10/18/2021 9015 RIKER PROPERTIES LLC KEEGO HARBOR 5263069A 801 11/28/2021 5183 0.95 LIMB WALKERS TREE AND SNOW LLC KENOCKEE 6280935A 1,007 12/9/2021 9402 EDENS ROOFING CONSTRUCTION LLC KENT CITY 6018807A 9,645 12/31/2021 5551 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 64 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge NJB CONSTRUCTION LLC KENT CITY 6272460A 750 11/11/2021 5645 ROEDE ELECTRIC LLC KENT CITY 5399548A 1,073 10/3/2021 5190 0.95 AUTO WORLD RECOVERY & TOWING INC KENTWOOD 4932803A 1,416 11/15/2021 7720 0.95 BERGHUIS PSYCHOLOGICAL SERVICES PC KENTWOOD 5035848A 2,276 11/7/2021 8832 0.95 GONZALEZ TONY KENTWOOD 5898382A 750 11/24/2021 5476 HILLIS BROTHERS SERVICE INC KENTWOOD 1278010A 750 11/11/2021 5476 0.95 JC ADULT FAMILY HOME KENTWOOD 5978238A 964 10/8/2021 9053 MARTIN AND MARTIN BUILDERS INC KENTWOOD 1591304A 750 11/19/2021 5645 MAX TRUCKING LLC KENTWOOD 4141857A 6,051 11/15/2021 7208 0.90 MOHAGER JAWDT BABIKER ALI KENTWOOD 6263607A 586 10/23/2021 8292 NATIONAL ASSOCIATION OF LETTER CARRIERS KENTWOOD 3963390A 442 12/13/2021 8810 BRANCH 56 NORTON KARL KENTWOOD 5920523A 530 10/10/2021 0913 EAGLE LAND SURVEYING COMPANY KEWADIN 3106683A 238 12/9/2021 8601 LYNDEN SERVICES LLC KEWADIN 6262856A 568 10/21/2021 9015 TNT OUTDOOR LANDSCAPE SERVICES LLC KEWADIN 5404282A 7,786 12/13/2021 9402 1.21 13 % ESTATE CONSTRUCTION KIMBAL 3743560A 6,674 10/8/2021 5645 0.91 ALL STAR CONSTRUCTION KIMBALL 5691702A 750 11/11/2021 9015 L S HEATING & COOLING LLC KIMBALL 5173922A 5,169 12/22/2021 5550 0.95 T A CONSTRUCTION KIMBALL 3595030A 5,016 12/18/2021 5645 0.95 BRESKY SIDING & BUILDING REPAIR KINDE 2260778A 1,554 12/27/2021 5645 KOZLOWSKI WAYNE KINDE 6085016A 751 12/10/2021 5445 MAJESKIS BUILDING SERVICE KINDE 3844820A 750 11/11/2021 5437 B JOHNSON CONTRACTING AND CONSULTING KINGSFORD 6050336A 750 10/7/2021 5645 BATES JAMES NORMAN JR KINGSFORD 5930910A 750 11/3/2021 7208 BOURGEOIS JESSICA KINGSFORD 6053033A 242 10/11/2021 9586 CHOICE TRANSPORTATION LLC KINGSFORD 5630428A 5,471 11/1/2021 7380 0.95 GUTH BILL KINGSFORD 1568701A 750 10/25/2021 7208 MC CONSTRUCTION KINGSFORD 3921506A 750 10/1/2021 5645 SETZER MICHAEL D KINGSFORD 5925894A 750 10/23/2021 7208 B AND S PILING SOLUTIONS LLC KINGSLEY 5936551A 12,078 11/19/2021 5040 0.94 BRIANS PRO AUTOGLASS INC KINGSLEY 6258638A 879 10/13/2021 8387 MERCENARY TELECOMMUNICATION SOLUTIONS KINGSLEY 5505046A 856 12/15/2021 5191 0.95 LLC S AND J FREIGHT LLC KINGSLEY 6284426A 750 12/22/2021 7208

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WOJDA FOREST PRODUCTS LLC LACHINE 2226081A 3,329 11/15/2021 2709 0.95 CODY CONSTRUCTION LAINGSBURG 2844524A 750 10/12/2021 5445 SHOOLTZ MICHELLE LAINGSBURG 6046541A 568 12/24/2021 9015 GREEN VALLEY TREE FARM LLC LAKE CITY 0036838A 750 10/15/2021 0005 M 66 TREE FARMS LLC LAKE CITY 6278108A 606 12/2/2021 0005 PARK FOREST PRODUCTS LLC LAKE CITY 0262463A 750 11/1/2021 2702 RED THORN TREE SALES LAKE CITY 5771510A 615 10/30/2021 0005 TLK ADULT FOSTER CARE HOME INC LAKE CITY 5597889A 6,531 11/21/2021 9053 0.95 SWISS INN BAR AND GRILL LLC LAKE GEORGE 0087840A 765 11/8/2021 9058 0.95 POPP MASONRY INC LAKE LEELANAU 3346870A 800 10/15/2021 5022 SL COMMERCIAL CONSTRUCTION INC LAKE LEELANAU 4688406A 9,551 12/27/2021 5213 0.91 ANDERSON WINDOW STORE SUPER WINDOW LAKE LINDEN 2012138A 1,017 10/14/2021 5645 MAN DOCKSIDE RESORT LLC LAKE LINDEN 5776341A 568 11/7/2021 9015 BEMADA SERVICES INC LAKE ODESSA 5036046A 1,906 10/10/2021 7720 0.95 DIXON ENGINEERING INC LAKE ODESSA 0794570A 4,571 10/13/2021 8601 0.93 WOLVERTON ROBERT LAKE ODESSA 5480647A 556 12/3/2021 0128 BRIGHTWAY CARPENTRY LAKE ORION 5877822A 750 10/10/2021 5437 DOLLAR CORNER LLC LAKE ORION 6267491A 408 11/3/2021 8017 ENSURE SERVICES LLC LAKE ORION 6280650A 2,786 12/12/2021 5437 FASTER BETTER EASIER LLC LAKE ORION 6056423A 1,004 10/14/2021 4452 GREENAWAY REMOVAL HAULING LLC LAKE ORION 5777186A 2,765 10/2/2021 9403 0.95 KEATINGTON HOMEOWNERS ASSOCIATION INC LAKE ORION 1047647A 1,045 12/4/2021 9015 KNOWLDENS GARAGE LLC LAKE ORION 6070710A 750 11/5/2021 3040 L AND L TREE & LANDSCAPING LLC LAKE ORION 4707273A 3,722 11/1/2021 0106 0.95 LAKE ORION ROOFING INC LAKE ORION 2152533A 838 12/1/2021 8810 LAKE STATE CLEANING INC LAKE ORION 3640027A 8,511 11/30/2021 9015 0.87 MARTIN DIANNE LAKE ORION 6266495A 238 10/30/2021 8601 MORENCI BROTHERS HOLDING GROUP LLC LAKE ORION 5977380A 494 11/14/2021 0035 MOSS HARDWOOD FLOORS LLC LAKE ORION 0140007A 800 10/31/2021 5437 0.95 TIMBER CREEK CONSTRUCTION AND LAKE ORION 4815696A 656 11/24/2021 9402 MANAGEMENT LLC STORAGE BUILDING COMPANY LLC LAKELAND, FL 6257160A 830 10/12/2021 5606 SCHMID LOGGING LLC LAKEVIEW 5030617A 750 10/30/2021 2702 SIFI PAINT & DRYWALL LAKEVIEW 2893860A 911 10/21/2021 5445 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WILSON TIMOTHY LAKEVIEW 5941342A 750 12/23/2021 5348 GENESIS SYSTEM INTEGRATION LLC LAKEVILLE 4985150A 301 11/1/2021 5191 0.95 JON HUNTER SPLICING LAKEVILLE 3375757A 800 10/23/2021 7600 ALL TRANSPORTATION NETWORK INC LAKEWOOD RANCH, FL 4895860A 257 11/3/2021 8810 PURPLE PENGUIN LLC LAMBERTVILLE 5490693A 978 11/20/2021 8017 SUMMERLYN BUILDERS LLC LAMBERTVILLE 5352541A 3,402 12/12/2021 5606 0.95 CHRIS CAVANAUGH LOGGING INC LANSE 5075513A 11,126 10/17/2021 2709 0.91 HERMAN HILLS LOGGING LLC LANSE 6281168A 1,888 12/14/2021 2709 A C MECHANICAL SYSTEMS LLC LANSING 3706508A 2,520 10/6/2021 5550 1.00 A TO Z BUSINESS SOLUTIONS LLC LANSING 2965542A 2,874 11/14/2021 5437 ALEX LISHINSKI AND AMY LISHINSKI LANSING 6260225A 530 10/24/2021 0913 CAPITAL CITY VENDING LLC LANSING 5180597A 606 10/10/2021 5192 CHRISTIE MICHAEL LANSING 4794796A 826 10/29/2021 9015 COUNT MI VOTE LANSING 6264727A 878 11/13/2021 8810 DEB MUCHMORE CONSULTING LLC LANSING 5924642A 510 10/18/2021 8601 EINSTEIN CONSTRUCTION MANAGEMENT LLC LANSING 6280390A 750 12/8/2021 5645 EMERALD WAY LLC LANSING 3863140A 750 12/14/2021 7208 GILLESPIE LARRY LANSING 5058120A 750 12/6/2021 5645 HALL DAVID L LANSING 6253687A 750 10/1/2021 5476 HANKINS INC LANSING 4280180A 751 10/25/2021 8810 HAZAR BESTOS CORPORATION LANSING 2518104A 35,644 12/4/2021 5183 0.92 HMK LANDSCAPING LLC LANSING 5802725A 1,362 12/10/2021 0042 ICON SIGN & DESIGN INC LANSING 3054594A 750 11/25/2021 8810 J AND J HARDWOODS INC LANSING 5354528A 1,723 12/17/2021 8395 1.00 JEREMIAH BUILT CONSTRUCTION LLC LANSING 5176948A 750 10/23/2021 5645 0.95 LEADING TRANSPORT SOLUTIONS LLC LANSING 5831040A 1,839 10/28/2021 8292 1.31 13 % MASS MOVERS LLC LANSING 6022448A 2,167 12/24/2021 7214 MCCARDEL DEVELOPMENT & MANAGEMENT INC LANSING 1047558A 2,912 11/9/2021 9015 1.00 MD INDUSTRIES LLC LANSING 5916259A 31,366 10/2/2021 5403 2.24 13 % MICHIGAN ASSOCIATION OF SECONDARY LANSING 1296671A 2,134 10/12/2021 8810 0.95 SCHOOL PRINCIPALS INC MID MICHIGAN GUARDIANSHIP SERVICES INC LANSING 1686690A 1,248 10/13/2021 8820 0.95 NAPIER INDUSTRIES LLC LANSING 5936039A 808 12/15/2021 5606 NLS BUILDERS INC LANSING 5993334A 800 10/23/2021 5645 ONE STOP AUTO INC LANSING 5685168A 573 10/30/2021 8748

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PEACEFUL ASSISTED LIVING LLC LANSING 6144837A 634 12/24/2021 8835 QUEEN OF CLEANING LLC LANSING 6220312A 1,317 12/24/2021 9015 RAYOS HOME IMPROVEMENT LLC LANSING 6264166A 750 10/23/2021 5551 RED CEDAR GYMNASTICS LLC LANSING 3243508A 2,360 10/13/2021 9063 0.95 RS INNOVATIONS LANSING 5783712A 751 11/18/2021 5403 0.95 SHADD RYDAHL BUILDERS INC LANSING 4359364A 750 12/21/2021 5645 SHAPESHIFT LLC LANSING 5394015A 968 11/10/2021 3146 SPRINGZ LTD LANSING 5986389A 1,194 12/2/2021 9015 SUPERIOR SKYLIGHTS AND SOLAR SOLUTIONS LANSING 4276868A 229 11/15/2021 8742 0.93 INC TILE DESIGNS BY TODD INC LANSING 4942108A 750 12/10/2021 5348 VITAS HOME CARE LLC LANSING 5944481A 2,866 12/17/2021 8835 0.95 WHITE T MAINTENANCE LLC LANSING 5909511A 619 10/2/2021 9015 ANDBAZA INC LAPEER 6281125A 227 12/10/2021 8810 BILL JOSTOCK SNOWPLOWING & LAWNCARE LLC LAPEER 0962830A 1,318 12/24/2021 9402 0.95 DIRECT LABOR FORCE LLC LAPEER 5239893A 15,463 10/17/2021 9015 0.80 ECO FUEL SERVICES LLC LAPEER 5944430A 604 12/12/2021 4712 GARDNERS NURSERY INC LAPEER 2255065A 523 11/2/2021 9102 JIM AVERY ENTERPRISES LAPEER 6027490A 5,199 12/19/2021 8748 JOSTOCK KENNETH H LAPEER 2363186A 1,310 12/31/2021 0011 0.95 LARSONS CARPET SERVICE LAPEER 1654284A 540 10/19/2021 9521 M 21 AUTO AND TRUCK SALVAGE LLC LAPEER 5787025A 750 10/7/2021 3821 0.95 ONE 800 ROLLOFF COM INC LAPEER 4650883A 266 11/25/2021 8810 PARAGON PRIVATE INVESTIGATIONS LLC LAPEER 6052827A 1,258 10/15/2021 7720 PATRIOT MANAGEMENT SERVICES LAPEER 5931460A 643 11/3/2021 9015 ROBERT E DICE BUILDER LAPEER 0737151A 1,769 11/4/2021 5645 0.95 ROTHENHOEFFER ROBERT JR LAPEER 1811207A 750 12/28/2021 5551 STERLING SERVICES MANAGEMENT INC LAPEER 5768039A 978 10/25/2021 9402 TLC CONSTRUCTION INC LAPEER 2719711A 750 11/13/2021 5645 MAPLE CITY TREE SERVICE LAPORTE, IN 5607493A 3,075 10/1/2021 0106 0.95 V AND G TELECOM LLC LAS VEGAS, NV 6248560A 1,841 10/13/2021 7600 PERSONALIZE ADVANCED THERAPY SERVICES LATHRUP VILLAGE 6263631A 226 10/22/2021 8810 LLC PRINCIPAL PROFESSIONAL SERVICES LLC LATHRUP VILLAGE 4920651A 619 11/1/2021 9015 RAINBOW COVE ASSOCIATION LATHRUP VILLAGE 2949270A 568 12/11/2021 8810

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GREEN HILL ORCHARDS LAWRENCE 1598724A 910 10/16/2021 0130 0.95 GENOVESI CUSTOM CONSTRUCTION LLC LENNON 5931363A 750 11/1/2021 5437 NEPTUNE ENTERPRISES LLC LENNON 5201578A 4,391 10/10/2021 9015 0.95 D AND J LAWN SPRINKLER SYSTEMS INC LENOX 1874918A 709 12/10/2021 9102 0.95 G AND B TILE CO LEONARD 4485874A 825 10/29/2021 5348 0.95 JTS CARPET SERVICE LEONARD 0920614A 615 10/20/2021 9521 DOUBLE A INSPECTIONS LLC LEROY 5767342A 381 11/1/2021 8601 K AND S SERVICES LEROY 5919665A 750 11/3/2021 5645 AARONS NUISANCE ANIMAL CONTROL LLC LESLIE 4425278A 569 12/18/2021 8831 BILL MYERS BUILDER LLC LESLIE 6276865A 750 11/24/2021 5645 MCM BUILDERS LLC LESLIE 2978342A 750 12/27/2021 5645 0.95 BEAUREGARD LARRY GALE LEWISTON 3998380A 238 11/2/2021 8601 THOMAS CHARTRAND X LLC LEWISTON 6256325A 750 10/8/2021 5403 DMP PROPERTY MANAGEMENT LLC LEXINGTON 6049907A 826 10/4/2021 6217 WEISS EXCAVATING & SAND LLC LEXINGTON 3050050A 1,812 11/1/2021 7380 0.95 FEONIX MOBILITY RISING LINCOLN, NE 6260217A 325 10/19/2021 8742 JOHNS HOME MAINTENANCE LINCOLN 2544130A 19,668 10/17/2021 5645 0.81 NORTHEAST MICHIGAN HOME HEALTH CARE LLC LINCOLN 5777860A 21,042 11/9/2021 8835 0.87 VILLAGE OF LINCOLN LINCOLN 0139033A 1,988 12/14/2021 7904 1.05 ELITE PROJECT SERVICE LINCOLN PARK 6056270A 313 10/12/2021 8601 GAELIC TUGBOAT COMPANY LINCOLN PARK 1985558A 4,483 11/9/2021 6826 0.95 HOME BASE INC LINCOLN PARK 4671775A 3,074 10/15/2021 5476 0.95 HOTWIREZ LINCOLN PARK 6260900A 470 12/18/2021 5190 JALISCO EXPRESS INC LINCOLN PARK 6260870A 750 11/24/2021 7208 LINCOLN TOWNE LLC LINCOLN PARK 6064353A 512 10/24/2021 8017 R J TRUCKING LTD LLC LINCOLN PARK 5938961A 800 10/30/2021 7208 RAVIDA CORPORATION LINCOLN PARK 1675788A 330 10/4/2021 9058 STAR GAS & GO INC LINCOLN PARK 5166616B 558 12/13/2021 8017 0.95 TWINS ROOFING LLC LINCOLN PARK 5474647A 6,881 11/4/2021 5437 1.46 13 % JEFF NELSON CONSTRUCTION LINDEN 6262406A 750 10/20/2021 5645 PRECISION DECKS INC LINDEN 5911230A 750 12/22/2021 5645 THREE HUNDRED 9 INSPECTION GROUP LLC LINDEN 5857791A 340 10/10/2021 8720 TINSMAN PAINTING SERVICES LLC LINDEN 2252724A 751 11/2/2021 5476 0.95 US ENGINE PRODUCTION MI INC LINDENHURST, NY 5125499A 12,946 12/1/2021 3827 1.58 13 % BAY HOLDINGS LLC LINWOOD 4707125A 1,820 10/1/2021 9063 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 69 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge POWERS TRANSPORTATION LITCHFIELD 6272762A 2,665 11/11/2021 7208 A M SHOES & TEXTILE INC LIVONIA 4977009A 4,025 11/7/2021 8032 0.91 B AND M CONTRACTING LIVONIA 2034689A 750 12/10/2021 5551 B L INSTALLATION INC LIVONIA 5273420A 750 10/15/2021 5645 BC HOME IMPROVEMENTS LLC LIVONIA 6057993A 825 10/17/2021 5645 BLACKBEAR RENOVATIONS LLC LIVONIA 6063306A 800 10/23/2021 5102 BRADFORD COMPANY LLC LIVONIA 5773652A 433 11/2/2021 8010 BRIGHT HOUSE ROOFING AND SIDING LLC LIVONIA 6261485A 800 10/19/2021 5551 CAMCO BUILDING SOLUTIONS LLC LIVONIA 6260730A 750 10/13/2021 5645 CAREGIVING EXPERTS LLC LIVONIA 5918359A 10,141 10/5/2021 8835 0.91 COMPLETE CARE LLC LIVONIA 5135877A 5,431 10/4/2021 8835 0.95 CROSS COUNTRY ENTERPRISES LLC LIVONIA 6253709A 4,520 10/1/2021 8045 CUSTOM STONE WORKS INC LIVONIA 2236915A 43,868 10/1/2021 1624 1.89 27 % CUTTING TIME INC LIVONIA 1711814A 1,244 10/31/2021 9102 0.95 DAB MGMT LLC LIVONIA 4927559A 2,135 10/27/2021 9015 0.95 DIMASSA CONSTRUCTION LLC LIVONIA 5895839A 825 12/18/2021 5476 ESTELVIN ENTERPRISES INC LIVONIA 5311420A 3,928 12/10/2021 9015 0.95 FILTER TECHNOLOGY LLC LIVONIA 4899776A 765 12/7/2021 3146 0.95 FIRE AND MATERIALS RESEARCH LABORATORY LIVONIA 4958632A 1,539 12/16/2021 4511 0.95 LLC FOREVER YOUNG LIVING LLC LIVONIA 5915368A 3,826 10/1/2021 9053 0.95 FRAME A BEAR INC LIVONIA 6263593A 1,071 10/22/2021 2501 G M PAINTING INC LIVONIA 2782480A 2,677 12/21/2021 5476 0.95 GAITS HOME IMPROVEMENT LLC LIVONIA 1893432A 750 10/27/2021 5551 GLEN EDEN LUTHERAN CHURCH LIVONIA 0420417A 11,560 12/27/2021 9220 0.78 GREENE ENVIRONMENTAL SERVICES INC LIVONIA 5305268A 2,079 11/16/2021 5348 0.95 H DANESHVAR MD PC LIVONIA 4521188A 422 10/23/2021 8832 HAMILTON WOOD FLOORS LLC LIVONIA 3246000A 750 11/4/2021 5437 HIGHLIFE HOMECARE INC LIVONIA 5876095A 1,103 12/12/2021 8835 HJ BEHAVIORALHEALTH LLC LIVONIA 6255116A 1,057 10/6/2021 8835 HOUSEWORKS LIVONIA 5054117A 569 11/17/2021 9015 HYGIENIC EARTH ENVIRONMENTAL SOLUTION LIVONIA 5640032A 2,161 11/22/2021 5479 0.95 LLC J 3 LOGISTICS LLC LIVONIA 6238351A 3,047 11/10/2021 7213 JOHN ROGIN LIVONIA INC LIVONIA 4946723A 803 12/28/2021 8748

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge KEEN WOODWORK LLC LIVONIA 5926009A 2,188 10/20/2021 5437 0.95 KITCHEN AND BATH SOLUTIONS INC LIVONIA 5487552A 1,807 11/1/2021 2812 0.95 KRT CONSTRUCTION INC LIVONIA 0583189A 800 11/19/2021 5445 KURTZ BRICHFORD COMMUNICATIONS LIVONIA 2125609A 825 12/23/2021 7600 LIBERTY HOME CARE INC LIVONIA 3932842A 477 11/1/2021 8835 LIVONIA NURSERY INC LIVONIA 1248618A 319 10/16/2021 8868 MARK J MOSS DPM PC LIVONIA 0612464A 282 12/5/2021 8832 MECHANICAL AND SAFETY CONSULTANTS LLC LIVONIA 5635489A 1,312 11/16/2021 8720 MIKE ROBERSON MANAGEMENT SERVICES LLC LIVONIA 3759997A 916 12/28/2021 5606 MIPONDEROSA LLC LIVONIA 5399580A 6,877 10/12/2021 8279 1.22 MY FERTILIZING COMPANY INC LIVONIA 5545463A 4,064 11/1/2021 0005 0.95 NC CARPENTRY II INC LIVONIA 5616352A 750 10/5/2021 5645 ONE THOUSAND 750 PROPERTIES LLC LIVONIA 5355265A 750 12/21/2021 5645 PHOENIX FREERUNNING LLC LIVONIA 5461030A 362 10/10/2021 9063 PRINCIPAL CONSTRUCTION SERVICES INC LIVONIA 3059243A 750 10/9/2021 5437 RAINBOW INDUSTRIES PRODUCTION COMPANY LIVONIA 0258989A 12,855 12/26/2021 3146 0.84 LLC ROADWAYS LOGISTICS INC LIVONIA 6280404A 750 12/15/2021 7208 ROOFING TECHNOLOGY ASSOCIATES LTD LIVONIA 0302813A 2,129 11/1/2021 8601 0.95 T AND C CREATIONS LLC LIVONIA 5975590A 751 11/26/2021 5403 TECHNOLOGY SOLUTIONS LLC LIVONIA 3187101A 414 11/10/2021 5191 0.95 TISEO BUILDERS LLC LIVONIA 6054986A 495 10/5/2021 5606 TOMINNA LLC LIVONIA 4433432A 1,978 12/18/2021 9058 0.95 TORRES OSCAR LIVONIA 6258190A 750 10/10/2021 5551 V COATINGS LIVONIA 2873680A 1,155 11/18/2021 5476 0.95 WALTERS INSTALLATION CO LIVONIA 1767348A 750 10/7/2021 5645 WELLNESS FACTORY LLC LIVONIA 5959853A 839 10/6/2021 4825 WESTERN WAYNE HOME & OFFICE CLEANING LIVONIA 4823664A 569 12/4/2021 9015 0.95 LLC WISDOM 1 INC LIVONIA 5194296A 215 11/23/2021 8810 ZOROS CHRISTMAS LIGHTS LLC LIVONIA 4307305A 1,153 10/30/2021 5190 BERNAL SERVICES INC LOWELL 4224310A 5,801 12/6/2021 5551 0.95 JOE MALONE CONSTRUCTION LLC LOWELL 6256376A 750 10/8/2021 5645 RBR BUILDERS LLC LOWELL 6082467A 800 12/5/2021 5645 S AND T METALS LLC LOWELL 4146557A 800 11/1/2021 5403 0.94

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SHADOW ELECTRICAL ENTERPRISES LTD LOWELL 1230042A 470 10/19/2021 5190 STOCKREEF TREE LLC LOWELL 6086934A 1,117 12/14/2021 0106 STREAMSIDE ECOLOGICAL SERVICES INC LOWELL 5468477A 740 11/9/2021 4511 AUTOMOTIVE MANAGEMENT CONCEPTS INC LOXAHATCHEE, FL 6047548A 420 10/2/2021 8810 ONSITE TRUCK & EQUIPMENT REPAIR INC LUDINGTON 5034671A 1,866 10/6/2021 8395 0.95 RIVER AFC LLC LUDINGTON 4531361A 842 12/20/2021 9053 0.95 GAME ON SPORTS FLOORING LUTHER 5949840A 750 10/7/2021 5437 LUTHER FIRE DISTRICT 1 LUTHER 1252801A 1,589 10/6/2021 7704 0.95 ALLEN BROWN WOODCUTTING LUZERNE 2123460A 750 11/11/2021 2702 ROBINSON SPECIAL HOME SERVICES LUZERNE 6040519A 825 10/8/2021 5437 RUDDLES NATIVE PAINTING LLC MACKINAC ISLAND 2262037A 3,400 11/7/2021 5476 0.95 SHEPLERS INC MACKINAW CITY 0400556A 84,003 11/15/2021 6826 0.92 A AND D REMODELING MACOMB 3403955A 801 11/7/2021 5476 A AND S PAINTING LLC MACOMB 5941750A 750 12/4/2021 5476 A JARVIS CUSTOM CARPENTRY LLC MACOMB 6277403A 800 11/25/2021 5437 A N PAINTING MACOMB 5441706A 750 10/4/2021 5476 ALL SHINE CLEANING SERVICE LLC MACOMB 5741378A 568 11/8/2021 9015 ALPHA CONSTRUCTION LLC MACOMB 4571177A 800 12/13/2021 5348 AMERICAN BOAT CARE LLC MACOMB 5768969A 683 10/25/2021 8387 BEST WAY EXPEDITE INC MACOMB 5925207A 750 10/18/2021 7208 0.95 BSR CUSTOM CARPENTRY MACOMB 4883721A 750 12/1/2021 5437 CANADA ROBIN MACOMB 3717550A 1,344 11/20/2021 0913 0.95 CANGEMI TILE AND MARBLE LLC MACOMB 5316642A 750 12/6/2021 5348 0.95 CZ INSTALLATIONS LLC MACOMB 3580059A 657 11/19/2021 9402 D SANO LLC MACOMB 5462100A 750 10/13/2021 5221 DODAJ PAINTING LLC MACOMB 6070582A 751 11/5/2021 5476 DUNCAN ANDREW MACOMB 6255213A 750 10/6/2021 5551 DYLANG CARPETS INC MACOMB 3838560A 668 11/15/2021 9521 DYNASTY FLOORS COVERING INC MACOMB 5246083A 800 10/11/2021 5437 E AND E REMODELING LLC MACOMB 5916283A 800 10/2/2021 5348 E AND K PAINTING MACOMB 5927145A 750 10/24/2021 5476 EAGLE AIRCRAFT SERVICES LLC MACOMB 5924553A 3,125 11/7/2021 7423 0.95 EBS TRUCKING INC MACOMB 6254110A 5,024 10/2/2021 7208 G AND J CUSTOM PAINTING LLC MACOMB 5758483A 800 12/14/2021 5476

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge J A F MANAGEMENT & CONSULTING SERVICES MACOMB 4746597A 228 11/23/2021 8810 INC J S HOME IMPROVEMENTS LLC MACOMB 3030598A 751 11/2/2021 8810 JACD EXPRESS LLC MACOMB 6072186A 2,780 11/7/2021 9519 JBM CONCRETE LLC MACOMB 3367762A 750 10/26/2021 5221 JK NOBELL INC MACOMB 6060013A 1,274 10/18/2021 9063 JUANES CONSTRUCTION LLC MACOMB 5408946A 34,189 10/22/2021 5645 1.40 JULIAN CONSTRUCTION LLC MACOMB 5865000A 858 12/17/2021 5221 KENDALL KONSTRUCTION LLC MACOMB 4260392A 10,074 10/24/2021 5645 0.95 LACHARITE CHRISTINA MACOMB 6063535A 541 11/14/2021 9521 M S CO MACOMB 4417240A 238 12/1/2021 8601 MAGICA DESIGN COMPANY INC MACOMB 3165094A 750 12/23/2021 5476 MARKU DEVELOPMENTS LLC MACOMB 6279295A 750 12/3/2021 5645 NATIONAL PAINTING LLC MACOMB 4569083A 750 12/16/2021 5476 0.95 NEW HORIZONS AFC LLC MACOMB 5170036A 1,317 12/3/2021 9053 0.95 NICKS DO ALL CONSTRUCTION LLC MACOMB 6263020A 750 10/21/2021 5645 NORTHSTAR FREIGHT SYSTEMS LLC MACOMB 5789699A 288 12/1/2021 8810 NORTHWEST TRANSPORTATION INC MACOMB 5116147A 750 11/1/2021 7208 NUCENTURY PAINTING LLC MACOMB 6255094A 750 10/6/2021 5476 OAKLAND TREE SERVICE LLC MACOMB 1223038A 7,646 10/20/2021 0106 1.00 OSCARS PAINTING LLC MACOMB 4842308A 750 12/9/2021 5476 PRIMO CUSTOMS LLC MACOMB 6285660A 2,102 12/24/2021 5437 RAYMOND WORLEY ACCOUNTING SERVICE INC MACOMB 0178900A 216 12/23/2021 8810 RE BRICK RESTORATION INC MACOMB 5761999A 1,184 10/12/2021 5022 0.95 SHRI HARI INC MACOMB 3679039A 461 10/15/2021 8017 SOCIAL RESOURCES INC MACOMB 0485756A 752 12/31/2021 8837 0.95 SUNNYS PROFESSIONAL ROOF SOLUTIONS LLC MACOMB 6078354A 802 11/20/2021 5606 VAHID LLC MACOMB 6255124A 750 10/6/2021 7208 WOJOS CARPET INSTALLATION MACOMB 2750465A 540 10/16/2021 9521 COMAN ION MACOMB TWP 4424328A 750 10/20/2021 5348 HSC MACOMB II LLC MACOMB TWP 6269370A 711 11/5/2021 9053 MAYDAY MASONRY MACOMB TWP 6265332A 800 10/28/2021 5022 S A M TRUCKING LLC MACOMB TWP 6275788A 750 11/19/2021 7208 T R THOMPSON BUILDERS INC MADISON, WI 1265741A 374 11/24/2021 9052 D AND G PAINTING INC MADISON HEIGHTS 4116879A 750 11/5/2021 5476

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FLATLANDERS LAWN & SNOW MAINTENANCE LLC MADISON HEIGHTS 5714524A 1,341 11/16/2021 9102 HARRISON WILLIAM P MADISON HEIGHTS 4606140A 750 11/20/2021 5437 INTRUST BUILDING INC MADISON HEIGHTS 5775418A 954 11/11/2021 5645 MICHIGAN FABRICATIONS & MAINTENANCE LLC MADISON HEIGHTS 5394503A 761 10/25/2021 3365 RJK PAINT & DRYWALL LLC MADISON HEIGHTS 6268722A 751 11/4/2021 5476 SIMIRON INC MADISON HEIGHTS 2609142A 32,904 11/1/2021 4558 1.51 SPRAY PATCH ROAD REPAIR INC MADISON HEIGHTS 4674553A 7,223 10/8/2021 5506 0.91 VALIANT HOLDINGS INC MADISON HEIGHTS 4557360A 2,246 10/8/2021 9058 0.94 YES HOME SERVICES INC MADISON HEIGHTS 4999312A 3,279 12/20/2021 5645 0.95 NORTHWOODS CONSTRUCTION LLC MANCELONA 4006038A 1,653 10/12/2021 5645 1.00 PINNEYS WELDING MANCELONA 5324076A 750 10/10/2021 2702 TRAYLOR MARCUS MANCELONA 3635643A 750 12/23/2021 7208 ACE PYRO LLC MANCHESTER 4086333A 3,598 11/1/2021 3179 0.95 ED STAHLEY CONSTRUCTION & EXCAVATING INC MANCHESTER 2841070A 739 10/15/2021 6217 HILLSIDE CHRISTMAS TREE FARM LLC MANCHESTER 5641721A 606 11/24/2021 0005 JACKSON RESTORATION LLC MANCHESTER 6280897A 3,001 12/9/2021 5645 JF CUSTOM CONSTRUCTION LLC MANCHESTER 3786129A 750 11/30/2021 5437 0.95 R D DAVIS CONSTRUCTION MANCHESTER 1951386A 750 11/7/2021 5645 WESTERN WASHTENAW CONSTRUCTION MANCHESTER 5342392A 646 11/12/2021 9410 AUTHORITY CUSTOM LOGGING MANISTEE 1784897A 750 12/2/2021 2702 KROLCZYK AND SON LLC MANISTEE 1195573A 750 11/19/2021 5645 SHIPWATCH CONDOMINIUM ASSOCIATION II MANISTEE 5059216A 569 12/4/2021 9015 VANS TOWING INC MANISTEE 5442508A 825 12/16/2021 7208 WOLFRUNNERS TRANSPORTATION MANISTEE 6261663A 800 10/17/2021 7208 WJD EXCAVATING & TRUCKING LLC MANISTIQUE 5933463A 739 12/6/2021 6217 BEST PRICE TREE SERVICE LLC MANTON 5202353A 750 10/11/2021 0106 CEDAR VALLEY CABINET INC MANTON 2249677A 700 10/1/2021 2812 DT FOREST PRODUCTS MANTON 5490529A 750 12/14/2021 2702 0.95 LONGSTREET FORESTRY LLC MANTON 6046550A 750 10/1/2021 2702 NORTHLAND DRYWALL LLC MANTON 0529176A 1,292 12/18/2021 5445 0.95 SEASONS OF LIFE AFC HOME LLC MANTON 5751543B 5,270 11/1/2021 9053 0.88 SHEPLERS SENIOR CONNECTION INC MANTON 5751543A 5,281 10/5/2021 9053 0.88 SUNSHINE HOME MANTON 5784336A 907 11/19/2021 9053 0.95 GUFFEYS AUTOMOTIVE SERVICE LLC MAPLE CITY 4661516A 482 10/12/2021 8395

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge INTEGRITY SECURITY CONSULTING AND MAPLE PARK, IL 5635071A 217 11/12/2021 8810 INVESTIGATIONS INC REAL PRO SOLUTIONS LLC MARCELLUS 5376300A 569 12/14/2021 9015 RC DRYWALL & CONSTRUCTION MARENISCO 2979802A 750 12/14/2021 5445 SUPERIOR PARTS AND SALES LLC MARENISCO 5213681A 1,650 11/25/2021 8107 0.95 ECONOWASH LLC MARINE CITY 4320921A 1,043 11/13/2021 2586 0.95 L B HOMES LLC MARINE CITY 5196701A 568 10/8/2021 9015 0.95 MECHANICAL FABRICATORS INC MARINE CITY 0463850A 13,658 10/31/2021 3030 0.86 SALEM J CARPENTRY LLC MARINE CITY 6276938A 1,851 11/24/2021 5645 HALL STEPHEN MARION 5922372A 301 10/12/2021 5191 JRD SERVICES LLC MARION 5741424A 313 12/27/2021 8601 JOHN AND LEROY TOMLINSON LLC MARLETTE 6258549A 531 10/13/2021 8116 GIL ROSE TRANSPORTATION LLC MARNE 5864291A 7,532 12/21/2021 7208 0.95 PARKERS SNOWPLOWING LLC MARNE 6074650A 707 11/15/2021 9402 CONGREGATION OF THE SISTERS OF ST PAUL MARQUETTE 0508438A 570 12/10/2021 9015 DE CHARTRES FAHRENHEIT 55 FINE WINE DISTRIBUTORS LLC MARQUETTE 4922883A 900 12/14/2021 7210 LAKENEN CRANE AND RIGGING SERVICE LLC MARQUETTE 6263720A 551 10/22/2021 9530 MEISTER TREES MARQUETTE 4293797A 358 11/8/2021 8010 CROSSTOWN COMMUNICATIONS INC MARSHALL 4023765A 753 11/18/2021 9501 0.95 SIGNWORLD CONCEPTS MARSHALL 3844692A 451 12/28/2021 4299 CONSTRUCTION SERVICE & INSPECTIONS MARTIN 3603016A 750 10/15/2021 5437 DONAHUE ELECTRIC LLC MARYSVILLE 5940060A 471 12/9/2021 5190 RIVER ESTATES ASSOCIATION MARYSVILLE 2176785A 568 10/27/2021 9015 VIKING FITNESS CENTER INC MARYSVILLE 2198002A 560 11/10/2021 9063 DW CONTRACTING L L C MASON 5418453A 1,814 12/21/2021 5645 GARMON HARRISON STONEWORKS MASON 0331031A 750 10/20/2021 5348 0.95 GUSTAFSON LLC MASON 1915320A 739 10/23/2021 6217 S AND W CAR WASH INC MASON 3462307A 2,091 10/28/2021 9402 0.95 WWZ LLC MASON 5206090A 520 11/14/2021 8868 YESTERYEAR AVIATION INC MASON 4918487A 1,519 10/7/2021 3628 0.95 JOLLIFF KORY D MASS CITY 5945267A 750 12/13/2021 2709 AMBROSO CONSTRUCTION LLC MATTAWAN 5058937A 750 11/13/2021 5645 ASHBAUGH INC MATTAWAN 4009789A 345 12/23/2021 8869 MODERN GARAGE DOOR MATTAWAN 4811119A 581 11/11/2021 3724

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CARDINAL SERVICE AND STAFFING OF MICHIGAN MAUMEE, OH 5158761A 2,346 11/20/2021 6834 0.95 LLC ANSON LESLIE MAYBEE 5334187A 750 10/24/2021 7208 MARKSMAN ROOFING & MAINTENANCE INC MAYVILLE 0318604A 2,535 10/24/2021 5552 0.95 BRANT SMITH TRUCKING INC MCBAIN 3957128A 750 11/1/2021 7208 D JS HEATING & COOLING LLC MCBAIN 2880156A 674 11/4/2021 5550 QUIST FARMS LLC MCBAIN 4483987A 2,014 10/23/2021 0129 0.95 TERRY L KOETJE BUILDER LLC MCBAIN 3320685A 750 10/27/2021 5215 SHIFTMED LLC MCLEAN, VA 6274510A 2,290 12/1/2021 8829 NATURES KENNEL SLED DOG RACING AND MCMILLAN 4574923A 570 12/25/2021 8831 ADVENTURES LLC CONLEYS HOME STYLE BAKERY LLC MECOSTA 0124524A 1,283 12/15/2021 8017 0.95 MATRIX ASSOCIATES INC MELVILLE, NY 5426928A 644 11/9/2021 9015 BBS FORGING EQUIPMENT & SERVICES LLC MELVINDALE 5935083A 1,918 11/10/2021 3724 D GONZALEZ CLEANING & LANDSCAPING LLC MELVINDALE 4881648A 568 11/20/2021 9015 LUCEROS CARPET LLC MELVINDALE 3644987A 590 10/1/2021 9521 TRIPLE CROWN SPORTS BAR LLC MELVINDALE 6057594A 434 10/15/2021 9058 B AND D AUTO & TRUCK SERVICE LLC MEMPHIS 1029053A 687 11/16/2021 8017 M AND M CONSTRUCTION MEMPHIS 6058094A 2,951 10/16/2021 5645 RANSOM CARPENTRY LLC MEMPHIS 1852663A 750 11/1/2021 5645 ALADDIN FIRE SERVICES LLC MENOMINEE 5966485A 424 12/9/2021 4828 BAXA CONTRACTING CO MENOMINEE 2118556A 750 10/9/2021 5645 0.95 EXTREME TRANSPORTATION MENOMINEE 3730905A 4,765 10/14/2021 7208 0.95 SCOTT HANSON BUILDERS INC MENOMINEE 2668750A 14,286 12/22/2021 5645 CT CONSULTANTS INC MENTOR, OH 5916089A 1,163 10/4/2021 7422 OTTERSKIN ROOF GEAR & CONSTRUCTION INC MERRILL 3586120A 825 11/21/2021 5552 0.91 MESICK RESCUE SQUAD INC MESICK 4552130A 3,212 11/22/2021 7980 0.95 MICHIGAN SURGICAL SPECIALISTS PC METAMORA 5779855A 230 12/1/2021 8832 B AND M MOTORSPORTS LLC MIDDLEBURY, IN 6283128A 1,075 12/16/2021 8393 INDUSTRIAL LASER SERVICE LLC MIDDLEVILLE 5928702A 376 10/27/2021 5191 KOOIKER DUANE MIDDLEVILLE 0120936A 750 10/21/2021 5645 P S FENCING MIDDLEVILLE 2773910A 3,903 12/1/2021 5645 SQUIDS ROOFING INC MIDDLEVILLE 2934728A 2,709 10/27/2021 5437 1.00 TAUNIAS TREASURE TRUNK LLC MIDDLEVILLE 5916186A 330 10/2/2021 8017 VANDERWEIDE ROOFING INC MIDDLEVILLE 3295990A 20,044 11/16/2021 5551

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BOOTHE CLEANING SERVICE INC MIDLAND 4916026A 1,041 11/16/2021 9015 CENTRAL MICHIGAN MECHANICAL LLC MIDLAND 4023021A 5,626 11/29/2021 5550 0.92 DAYLIGHT OUTFITTERS LLC MIDLAND 6243177A 2,879 11/13/2021 9015 EAST POINT CONDOMINIUM ASSOCIATION MIDLAND 1929623A 568 11/22/2021 8810 GOOD DESIGN GROUP LLC MIDLAND 4570944A 283 10/29/2021 8810 JOKELA GROUP LLC MIDLAND 5081629A 757 10/17/2021 5437 0.95 KINDY TREE SERVICE LLC MIDLAND 4293690A 4,686 12/1/2021 0106 0.95 MARTELLI HOMES INC MIDLAND 2228386A 1,231 11/29/2021 5445 MCINTOSH RILEY MIDLAND 6253830A 568 10/1/2021 9015 MCLACHLAN WILLIAM MIDLAND 6065953A 656 10/26/2021 9102 NORTHRUP PAINTING MIDLAND 2858266A 751 12/5/2021 5476 QUALITY PRO SOLUTIONS LLC MIDLAND 6272428A 1,236 11/11/2021 5476 RM DODICK REAL ESTATE LLC MIDLAND 6263623A 568 10/22/2021 9015 RUDISH HEATHER MIDLAND 5455073A 530 10/8/2021 0908 WOODEN COMPASS LLC MIDLAND 6254470A 5,428 10/3/2021 5437 CALLAGHAN WILLIAM MIDLOTHIAN, IL 6053459A 2,147 11/8/2021 5215 THUNDER BAY MOVING & STORAGE LLC MIKADO 0225673A 887 11/29/2021 7214 0.95 JUDDS MORTUARY TRANSPORT LLC MILAN 5930235A 331 11/7/2021 9620 LARRY SPIVEY DRYWALL MILAN 1200194A 2,634 10/15/2021 5445 0.96 NEMETH LAWNCARE MILAN 3840514A 657 12/4/2021 9402 OPEN ROAD DELIVERY LLC MILAN 6274277A 4,302 11/14/2021 7206 WHITNEY HAYES PASSINO LLC MILAN 4350847A 1,549 12/29/2021 7208 0.95 YORKSHIRE SQUARE CONDOMINIUM MILAN 3238474A 568 10/16/2021 9015 ASSOCIATION FRONTLINE NATIONAL LLC MILFORD, OH 6255787A 980 10/7/2021 4511 FUMI DOLCI LLC MILFORD 5196132A 875 12/16/2021 8017 HADDAD JONES INC MILFORD 6073433A 601 12/23/2021 8810 HITCH PLUMBING LLC MILFORD 6045383A 561 10/2/2021 5183 HOT WORKS LLC MILFORD 4807553A 275 10/30/2021 8810 LMP WORLDWIDE INC MILFORD 4646401A 5,689 12/18/2021 8032 0.95 MARKETPLACE MACHINERY INC MILFORD 5502322A 370 11/10/2021 8720 MIDWEST DOCK AND DREDGE INC MILFORD 4458141A 1,514 11/11/2021 0005 0.95 MILFORD COUNSELING INC MILFORD 5080029A 1,256 10/30/2021 8832 0.95 PRECISION PIPE WORKS LLC MILFORD 5197953A 561 10/9/2021 5183 RACOS CUSTOM HOME BUILDERS INC MILFORD 4817125A 800 12/12/2021 5645

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge STARLIGHT PAINTING INC MILFORD 2792117A 750 11/17/2021 5476 0.95 WALL PRO MILFORD 3885089A 750 10/9/2021 5445 0.95 WEST OAKLAND HOME CARE LLC MILFORD 6274757A 2,913 11/17/2021 8835 BRUCES DEMOLITION & DISPOSAL INC MILFORD TWP 4028147A 689 10/20/2021 5610 OCQUEOC BEARINGER FIRE DEPARTMENT MILLERSBURG 1643568A 1,092 11/17/2021 7704 0.95 RIEGER ROLLAND MILLERSBURG 4979117A 750 11/29/2021 2709 0.95 DUNN BRAD MILLINGTON 2855836A 750 12/3/2021 5022 NEW LIGHT CONSULTANTS MILLINGTON 4204930A 3,022 10/8/2021 8832 0.95 JAZ CO INC MINNEAPOLIS, MN 2795540A 3,032 11/14/2021 7212 0.89 B SMITH LOGGING MIO 2021951A 750 11/14/2021 2702 EAGLE REAL ESTATE & LAND CO LLC MIO 4293231A 239 11/30/2021 8810 HOMESTEAD HARDWOODS LLC MIO 4743466A 4,255 10/29/2021 2731 0.88 KINGDOM FOCUSED FORESTRY MIO 6280919A 750 12/9/2021 2702 PRECISION EXCAVATING OF MIO INC MIO 3107876A 814 12/28/2021 6217 SMITYS TREE SERVICE MIO 1853007A 3,637 10/21/2021 0106 0.95 AARDVARK HOME INSPECTORS INC MISHAWAKA, IN 5764190A 391 10/18/2021 8720 BJORN EXCAVATING LLC MOHAWK 5872367A 2,925 12/3/2021 5221 0.95 KEWEENAW COUNTY HOUSING CORPORATION MOHAWK 1946722A 572 12/4/2021 8810 MOHAWK AHMEEK UNITED METHODIST CHURCH MOHAWK 6066798A 241 11/9/2021 8868 AERIAL EXPRESS INC MONROE 4398343A 950 12/8/2021 9063 0.95 CARRINGTON VILLAS HOMEOWNERS MONROE 4109309A 568 12/24/2021 9015 ASSOCIATION ELDERLY SOLUTIONS INC MONROE 3808416A 4,848 11/20/2021 9053 0.95 FIVE STAR FLEET SERVICES LLC MONROE 6282199A 2,244 12/14/2021 8387 HALSTEAD NURSING SERVICES LLC MONROE 6258263A 5,733 10/11/2021 8835 KABOB ONE PLUS INC MONROE 6024220A 949 10/7/2021 9058 KINKADE CONTRACTING MONROE 5022070A 800 10/12/2021 5437 NINAS PIZZERIA MONROE 2128705A 866 10/4/2021 9058 REHABILITATION SPECIALISTS OF MONROE PC MONROE 1135481A 230 12/25/2021 8832 ROSALES CONSTRUCTION LLC MONROE, GA 6271715A 1,127 11/10/2021 5551 SHAUN MYERCHALK CONSTRUCTION MONROE 4557093A 11,792 10/6/2021 5645 0.84 SOLOMON DIVING INC MONROE 1464388A 2,874 10/1/2021 7394 0.95 SWARTOUT DAVID MONROE 2157810A 750 12/5/2021 5645 SWIFT RESTORATION LLC MONROE 6266940A 750 11/2/2021 5445

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge YOUNG MENS CHRISTIAN ASSOCIATION OF MONROE 0200077A 12,187 10/15/2021 9063 0.90 MONROE MICHIGAN ZINNER BUILDER LLC MONROE 5322677A 2,102 10/9/2021 5437 BRITTONS CUSTOM FLOORING INC MONTAGUE 4186796A 750 12/12/2021 5348 0.95 NEIL FLANDERS BUILDERS INC MONTAGUE 3961435A 750 12/27/2021 5437 ROSE NANCY MONTAGUE 5407451A 935 12/9/2021 0913 0.95 DRAKKAR HUMAN RESOURCES INC MONTREAL, QC 4814509A 47,356 10/4/2021 7208 0.68 BETTER 2 ENTERPRISES INC MONTROSE 5616409A 3,251 10/5/2021 5221 0.95 JAYLER TRANSPORT INC MONTROSE 6267521A 2,483 11/3/2021 7208 DANSK INVESTMENT GROUP INC MOORPARK, CA 1587579A 2,484 12/1/2021 8381 0.95 AGRICULTURAL QUALITY PACKING LLC MORLEY 6281044A 4,553 12/9/2021 8209 ALOHA TAN LLC MORLEY 6077463A 242 11/19/2021 9586 PEACOCK FORESTRY PRODUCTS LLC MORLEY 5945909A 750 10/12/2021 2702 BBT TRANSPORT LLC MORRICE 4928431A 825 11/1/2021 7208 DAILY HEATING AND AIR CONDITIONING LLC MORRICE 5929431A 1,241 10/30/2021 5550 STICKS AND STONES CONSTRUCTION MORRICE 1261096A 750 12/18/2021 5022 MT MANSFIELD MEDIA INC MORRISVILLE, VT 5765935A 266 12/3/2021 8810 ADVANCED AUTOMATION LLC MT CLEMENS 5755603A 2,023 10/2/2021 8601 0.95 ARS LAWN CARE SERVICES LLC MT CLEMENS 6283160A 1,694 12/16/2021 9102 CLINTONAIRE LLC MT CLEMENS 5671302A 674 10/5/2021 5550 COMPREHENSIVE YOUTH SERVICES INC MT CLEMENS 0112542A 14,066 10/1/2021 8832 1.50 27 % FIRST CLASS EXPRESS SERVICE LLC MT CLEMENS 4940547A 1,051 12/2/2021 9015 GO LAWN BARBER INC MT CLEMENS 3610390A 2,974 12/15/2021 0042 0.95 GRATIOT FUEL & MORE INC MT CLEMENS 6050166A 616 10/4/2021 8017 GTR COMPANIES LLC MT CLEMENS 0027472A 3,001 11/19/2021 5606 0.95 LIFE SKILLS CENTERS INC MT CLEMENS 0000132A 32,309 10/4/2021 8868 1.71 27 % MALDONADO FLOORING LLC MT CLEMENS 6278620A 750 12/2/2021 5437 MCVICAR MEADOWS ASSOCIATION MT CLEMENS 2796236A 568 10/19/2021 9015 METRO PROCESS SERVING LLC MT CLEMENS 6059856A 1,250 10/18/2021 7720 NEST MOUNT CLEMENS LLC mt CLEMENS 5924464A 459 10/17/2021 8017 PROLINE ENTERPRISES INC MT CLEMENS 2761335A 825 10/26/2021 5183 0.95 RUEHLES TOWING INC MT CLEMENS 1919229A 17,202 11/24/2021 7208 0.77 SLIMS LANDSCAPING MT CLEMENS 5267986A 784 11/15/2021 0042 AFTC HOME TRANSPORT & SERVICE INC MT MORRIS 4630955A 7,266 10/25/2021 8387 0.89 B D COMPANY MT MORRIS 1706780A 14,891 10/1/2021 7208 0.80

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BONHAM MAINTENANCE & REPAIR SERVICE CO MT MORRIS 3970701A 825 12/5/2021 5476 0.95 EXPERT EXTERIORS LLC MT MORRIS 5394171A 935 11/28/2021 5645 0.95 G A S H OF MT MORRIS INC MT MORRIS 0964107A 1,959 12/20/2021 8017 0.95 MID MICHIGAN MANUFACTURING & MT MORRIS 1549952A 3,116 12/18/2021 9402 0.95 MAINTENANCE INC THREE THOUSAND 389 S HURON LLC MT MORRIS 6069576A 3,939 11/2/2021 8045 BEDROCK DATA LLC MT PLEASANT 5472466A 284 11/3/2021 8601 CENTRAL MICHIGAN UNIVERSAL CLEANING MT PLEASANT 6209548A 482 12/10/2021 8835 SERVICES FELAN PAINTING LLC MT PLEASANT 4428234A 1,184 11/22/2021 5476 0.95 FIRST CLASS PLUMBING LLC MT PLEASANT 6085415A 644 12/11/2021 5183 HARBOR WEST LLC MT PLEASANT 6260560A 825 10/16/2021 5403 ISABELLA COUNTY RESTORATION HOUSE MT PLEASANT 5472385A 1,538 11/17/2021 8837 0.95 LAING ENVIRONMENTAL CONTRACTING INC MT PLEASANT 5040183A 263 10/19/2021 4511 ABATEMENT AND DEMOLITION SERVICES LLC MULLIKEN 5636655A 12,529 10/12/2021 5183 0.85 ALL STAR EXTERIORS LLC MULLIKEN 5198763A 707 10/11/2021 5538 GUILFORD CONSTRUCTION LLC MULLIKEN 2573660A 5,860 12/29/2021 5645 1.45 13 % ABLE DIVING CO MUNGER 2823594A 2,599 12/31/2021 7394 0.95 LEFFEL RONALD MUNISING 4942647A 750 12/15/2021 0106 MCNALLY CLIFFORD J MUNISING 0145874A 750 10/5/2021 2702 NORTHERN EXCAVATING LLC MUNISING 3949710A 815 11/3/2021 6217 RAUTANEN JARED MUNISING 4942639A 750 12/13/2021 0106 UP WILDERNESS TOWING & RECOVERY LLC MUNISING 5470765A 4,584 11/1/2021 7208 0.92 UPPER PENINSULA RECREATION INC MUNISING 5928761A 569 10/27/2021 9015 BANNER HOME HEALTH CARE LLC MUSKEGON 4493451A 5,650 12/14/2021 8835 0.86 BLOOMSTROM SERVICES LLC MUSKEGON 5426626A 750 11/23/2021 5645 DEITZ HOUSE MOVING ENGINEERS INC MUSKEGON 0138789A 4,001 10/1/2021 9530 1.00 DYNASTY ROOF SYSTEMS MUSKEGON 6062326A 750 10/22/2021 5551 FIGUEROA FEDERICO MUSKEGON 5918502A 521 10/5/2021 0908 GREATER MUSKEGON WOMANS CLUB MUSKEGON 5317983A 568 11/16/2021 9015 LINNE LODGE 57 INDEPENDENT ORDER OF MUSKEGON 0961086A 649 11/26/2021 9015 VIKINGS INC MAINTENANCE UNLIMITED MUSKEGON 6087892A 3,653 12/19/2021 5645 MB REMODELING LLC MUSKEGON 5883490A 800 10/21/2021 5645 MUSKEGON ST JOSEPH FEDERAL CREDIT UNION MUSKEGON 0946109A 298 10/21/2021 8810 NORTHERN ROOTS ROOFING LLC MUSKEGON 6277454A 5,756 12/15/2021 5551 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 80 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PLATINUM DEVELOPMENT BUILDERS LLC MUSKEGON 5211913A 751 11/19/2021 8810 PORT CITY INDUSTRIAL FINISHING INC MUSKEGON 2211025A 809 11/1/2021 8810 SADONY CREATIVE LLC MUSKEGON 6059120A 470 10/21/2021 8810 SUNDBERG CONSTRUCTION MUSKEGON 3578500A 750 10/3/2021 5645 0.95 SUNDBERG LOGGING LLC MUSKEGON 2077450A 750 10/25/2021 2702 0.95 VILLAGE SERVICES LLC MUSKEGON 5465990A 4,030 10/21/2021 8835 0.90 VOLUNTEERS OF MUSKEGON COUNTY ANIMAL MUSKEGON 4801431A 3,267 10/1/2021 8831 0.95 CONTROL WICKED MOTOR SPORTS LLC MUSKEGON 4134869A 287 12/2/2021 8748 0.87 WORKMAN COMMUNICATIONS MUSKEGON 3275841A 825 12/22/2021 7600 0.95 VISION DR CONSTRUCTION MUSKEGON HEIGHTS 6254004A 4,051 10/2/2021 5645 N J EXCAVATING MUSSEY 4438108A 1,410 12/10/2021 6217 KOESTER EDMOND E NAPLES, FL 5783135A 1,236 11/17/2021 0909 NAPOLEON LIVESTOCK COMMISSION COMPANY NAPOLEON 0473650A 2,491 11/23/2021 0129 1.00 LLC BURPEE HARDWOODS LLC NASHVILLE 5295432A 750 11/5/2021 2702 CAMP THORNAPPLE INC NASHVILLE 0740071A 1,595 11/25/2021 9015 0.95 MAKALU VENTURES LLC NASHVILLE, TN 6262457A 254 10/20/2021 8810 AA LAWN CARE NATIONAL CITY 4335180A 756 11/20/2021 9402 PEGASUS SPRINGS THERAPEUTIC RIDING NATIONAL CITY 6270654A 786 11/7/2021 8279 CENTER HV LOGGING NAUBINWAY 5342570A 750 11/13/2021 2702 WILLIAMSON CLEANING SERVICE LLC NAZARETH 6267530A 568 11/3/2021 9015 NORTHWOODS CONSULTING FORESTRY LLC NEGAUNEE 6280820A 288 12/10/2021 8601 ANCHOR BAY TILE WORKS LLC NEW BALTIMORE 5221552A 750 11/22/2021 5348 GAP HEALTHCARE SOLUTIONS LLC NEW BALTIMORE 5641748A 864 11/24/2021 8833 0.95 NATIONWIDE INC NEW BALTIMORE 0880450A 2,965 10/1/2021 7208 0.79 NICOLA HOME BUILDING & DESIGN COMPANY NEW BALTIMORE 4496590A 288 12/15/2021 8601 RIGHT WAY POWERWASHING LLC NEW BALTIMORE 3148386A 750 11/1/2021 5476 THREE GEE SERVICE NEW BALTIMORE 1688561A 750 10/14/2021 5022 CALLAHANS LAWN CARE LLC NEW BOSTON 5702313A 523 10/9/2021 9102 HNT LOGISTICS LLC NEW BOSTON 4899687A 417 10/15/2021 8810 J HARRIS CARPENTRY LLC NEW BOSTON 5039258A 801 10/17/2021 5403 KURRENT WELDING INC NEW BOSTON 0603821A 773 10/7/2021 3365 0.95 S AND H AUTO PARTS INC NEW BOSTON 0765422A 3,357 12/27/2021 3821 0.95 SOS PLUMBING LLC NEW BOSTON 5255686A 1,021 11/8/2021 5183 0.95 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 81 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge LAKE FRONT PROPERTY MANAGEMENT INC NEW BUFFALO 4810872A 618 11/13/2021 9015 LOWRY COMPANY INC NEW BUFFALO 3569039A 1,759 11/2/2021 0913 0.95 MOORINGS ASSOCIATION NEW BUFFALO 2092662A 1,309 12/29/2021 6836 0.92 OSELKAS SNUG HARBOR MARINA INC NEW BUFFALO 2198568A 9,343 12/5/2021 6836 1.48 27 % SUPERIOR HARD SURFACE SOLUTIONS LLC NEW CARLISLE, OH 6270298A 825 11/6/2021 5221 BERRY DAVID L NEW HAVEN 3236544A 750 10/8/2021 5645 FUTURE WIRELESS 1 LLC NEW HAVEN 5485916A 497 12/2/2021 8017 HURON POINTE SPORTSMENS ASSOCIATION INC NEW HAVEN 3517802A 569 10/9/2021 9015 PGT CONSTRUCTION NEW HAVEN 6276326A 750 11/19/2021 0042 ROYAL AMERICAN HOMES INC NEW HAVEN 2159147A 750 10/21/2021 5437 VICTORY HOME IMPROVEMENT LLC NEW HAVEN 6279279A 3,123 12/3/2021 5645 CARMONAS LANDSCAPING LLC NEW HUDSON 6064345A 785 12/14/2021 9402 FIRST CLASS CARPET CARE & RESTORATION NEW HUDSON 1728580A 568 10/7/2021 9015 SERVICE INC SINGLE SOURCE CONTRACTING LLC NEW HUDSON 3458938A 801 10/20/2021 5183 0.95 FIT PHYSIQUE LLC NEW LOTHROP 5629594A 301 11/7/2021 9063 HENIGES CUSTOM WOODWORKING NEW LOTHROP 1930729A 986 10/1/2021 2812 ALL MARINE SERVICE & STORAGE INC NEWAYGO 5605970A 1,225 10/6/2021 6834 0.95 BEERMAN TIMBER FELLING NEWAYGO 5143721A 750 11/19/2021 2702 BERT MARVIN FLOORING INSTALLATIONS LLC NEWAYGO 5833914A 750 12/11/2021 5437 DIAMOND MOBILE IMPROVEMENT NEWAYGO 4575598A 750 10/22/2021 5437 IDA MAES GROUP HOMES LLC NEWAYGO 5942276A 1,606 12/10/2021 9053 TERRENCE A WESTCOTT LPT INC NEWAYGO 5355346A 2,596 12/23/2021 8835 0.95 C AND CS PINE GROVE SERVICE INC NEWBERRY 0153435A 235 12/29/2021 8810 LUCE COUNTY COMMUNITY RESOURCE & NEWBERRY 4959930A 411 11/8/2021 9063 RECREATION CENTER INC PATCH TRUCKING LLC NEWBERRY 6088511A 750 12/21/2021 7208 RAHILLY BRIAN D NEWBERRY 5044340A 229 10/26/2021 8810 COCIUBA NATHANAEL NEWPORT 6279252A 750 12/4/2021 5348 HOUSING SPECIALIST INC NEWPORT 2014580A 4,655 11/1/2021 5538 0.85 HYDRO TECHNOLOGY INC NEWPORT 1281976A 656 11/1/2021 3724 VILLAGE OF ESTRAL BEACH NEWPORT 0385280A 2,914 12/31/2021 9015 0.95 KLR RENOVATIONS LLC NIAGARA, WI 5627664A 750 10/26/2021 5645 KVG LOGGING NIAGARA, WI 3253228A 750 11/24/2021 2702 AMERICAN TREE AND LAWN CARE LLC NILES 3227740A 7,382 10/31/2021 0042 0.92

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ASTRO STAR AVIATION INC NILES 0459313A 662 12/1/2021 7422 0.95 WATSONS TREE SERVICE FARM INC NILES 0424137A 15,353 10/2/2021 8232 1.00 ITS MY TIME JJH NORFOLK, VA 6281214A 2,189 12/10/2021 5057 BATES DAVID D NORTH BRANCH 0673560A 505 12/3/2021 0128 JANKOWSKY CORP NORTH BRANCH 5470498A 750 11/12/2021 5445 LEON FLOORS NORTH BRANCH 5853710A 825 10/24/2021 5437 WEE OAKS CHILDCARE NORTH BRANCH 5641772A 319 11/24/2021 8869 TVM ENTERPRISES INC NORTH ROYALTON, OH 5564387A 3,652 12/29/2021 7720 0.95 A AND K TRANSPORT INC NORTHVILLE 5711606A 800 12/17/2021 7208 0.95 AVE CARE LLC NORTHVILLE 6068995A 1,831 11/1/2021 9053 BIONDO DESIGN & BUILD LLC NORTHVILLE 1983148A 985 10/8/2021 5645 0.95 CAMP GINGER QUILL NORTHVILLE 1904124A 568 10/10/2021 9015 ESTATE OF JOELLE MAIE EINEM NORTHVILLE 4815653A 967 11/30/2021 0913 0.95 EXECUTIVE GROUNDS MAINTENANCE AND NORTHVILLE 5216613A 568 11/20/2021 9015 DESIGN COMPANY GLASS GURU WINDOW CLEANING LLC NORTHVILLE 5984017A 1,203 11/22/2021 9015 JVV INCORPORATED NORTHVILLE 1222260A 800 11/14/2021 5476 KEYSTONE LANDSCAPE & DESIGN LLC NORTHVILLE 4922689A 759 10/20/2021 0042 0.95 LAKEWOOD FORESTRY LLC NORTHVILLE 5756189A 3,407 10/5/2021 0106 0.95 METRO ALARM SYSTEMS LLC NORTHVILLE 3773582A 749 12/15/2021 5191 PRIMESTAFF LLC NORTHVILLE 5486416A 1,243 12/4/2021 8810 0.95 R A R CONSTRUCTION SERVICES INC NORTHVILLE 1972715A 825 10/1/2021 5221 0.95 REBOTTARO ALFRED NORTHVILLE 5616751A 750 12/19/2021 5645 ROMANO DANIEL NORTHVILLE 5210690A 5,183 11/15/2021 8279 0.95 SILVESTRI LANDSCAPING LLC NORTHVILLE 5930146A 710 12/9/2021 0042 TURNING POINT COMPANIES LLC NORTHVILLE 4322959A 825 10/10/2021 5550 ACCURATE MECHANICAL SERVICES LLC NORTON SHORES 6078931A 1,340 11/21/2021 5550 BLACK DOG REMODELING & REPAIR SERVICES NORTON SHORES 5918405A 750 10/5/2021 5645 LLC SHORELINE STAFFING LLC NORTON SHORES 6087418A 3,030 12/11/2021 2003 STEPPING STONE EDUCATIONAL SYSTEM INC NORTON SHORES 4515080A 625 11/3/2021 8868 VERSATILE RENOVATIONS NORTON SHORES 6264824A 750 10/27/2021 5348 WEST MICHIGAN GROUNDS SERVICES LLC NORTON SHORES 6262872A 1,173 10/21/2021 9402 BIOWAVE CORPORATION NORWALK, CT 6110460A 303 11/6/2021 8742 KEVIN R VANGINKEL LOGGING NORWAY 5788340A 750 11/29/2021 2702

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 83 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge KNIGHT OWL INC NORWAY 2901595A 330 10/11/2021 9058 KUESTER KEVIN JOHN NORWAY 6081355A 750 12/7/2021 7208 ROWELL GEORGE NORWAY 5264685A 750 12/7/2021 5645 BIOTECH CLINICAL LABORATORIES INC NOVI 0294918A 31,739 10/12/2021 8832 0.67 COMFORT ZONE UNLIMITED NOVI 5134366A 2,481 10/30/2021 9053 0.95 CROWNING CONSULTING INC NOVI 5279305A 3,819 10/12/2021 2731 1.70 27 % DIAMOND DEVELOPMENTS LLC NOVI 6256694A 3,467 10/8/2021 5645 DIRECT BUILDER CABINETRY COM LLC NOVI 2751852A 500 12/6/2021 8810 DIVINE CARING HOME LLC NOVI 6265260A 2,467 10/28/2021 9053 DRISCOLL CONSTRUCTION LLC NOVI 4911881A 800 10/24/2021 5645 ELECTRICAL LIGHTING MAINTENANCE LLC NOVI 6257178A 520 10/9/2021 5190 FITNESS MANAGEMENT CORP NOVI 1007572A 799 12/10/2021 7421 0.95 HERB FISCHER PLUMBING & HEATING INC NOVI 2185555A 611 12/20/2021 5183 HUNTERS SQUARE OFFICE BUILDING LLC NOVI 2123444A 702 11/10/2021 9015 JB INTERIORS INC NOVI 5132258A 1,104 10/28/2021 5437 0.95 KNR HOME MAINTENANCE LLC NOVI 5734797A 1,468 10/31/2021 5437 KRAZY KOPZ RENTALS LLC NOVI 5392985A 1,937 12/1/2021 8017 0.95 LEADHEAD CONSTRUCTION LLC NOVI 4021860A 4,074 12/19/2021 5403 0.93 LEGENDS OF POTAWATOMI CREEK NOVI 2514796A 568 12/10/2021 9015 CONDOMINIUM ASSOCIATION LENOX PARK HOMEOWNERS ASSOCIATION NOVI 5271525A 568 12/9/2021 9015 LIFESTYLE HOME BUILDING LLC NOVI 5523192A 750 12/10/2021 5437 0.95 METAL CRAFT TECHNOLOGIES LLC NOVI 6259480A 392 10/14/2021 8601 MOORE ROOFING INC NOVI 2861992A 9,160 10/2/2021 8227 0.92 NOVI PARK INC NOVI 4801415A 1,943 11/17/2021 9015 1.00 OAKLAND PLACE EAST CONDOMINIUM NOVI 3492109A 568 11/20/2021 9015 ASSOCIATION INC OKUNO INTERNATIONAL CORPORATION NOVI 5220386A 1,263 11/1/2021 4511 0.95 REEVES SHADA NOVI 5269555A 568 10/1/2021 9015 STEPUSA LLC NOVI 3971813A 2,958 10/18/2021 3146 0.95 SUNGLO RESTORATION SERVICES INC NOVI 1626990A 70,988 12/22/2021 5606 TEN AND 2 DRIVING ACADEMY LLC NOVI 6086160A 537 12/13/2021 8868 THREE HUNDRED 60 CONSTRUCTION GROUP NOVI 5825237A 1,335 12/18/2021 5606 0.95 LLC NV EXCAVATING LLC NUNICA 5778590A 1,129 11/10/2021 6217 ASCENDANT CARE INC OAK PARK 3529371A 15,956 12/24/2021 8835 0.81 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 84 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HATZALAH OF MICHIGAN OAK PARK 5672252A 2,563 10/11/2021 7380 JONNYLAWN LLC OAK PARK 5829194A 1,120 12/21/2021 9102 M AND J PIZZA INC OAK PARK 5325080A 2,140 10/6/2021 9058 0.95 MY PLACE CENTER FOR WELLNESS INC OAK PARK 5621569A 1,612 11/9/2021 9063 0.95 OMI ENTERPRISES INC OAK PARK 6262171A 235 10/20/2021 8810 ON POINT HOME CARE INC OAK PARK 6246362A 471 10/2/2021 8835 REB RESEARCH & CONSULTING CO OAK PARK 2129140A 352 11/10/2021 8601 WOODWARD ELECTRIC INC OAK PARK 4717066A 3,181 10/10/2021 5190 0.95 ALLARD KELLER CONSTRUCTION COMPANY LLC OAKLAND 5532620A 5,062 12/24/2021 5552 0.95 BISHOP CLEANING LLC OAKLAND 5532515A 643 10/26/2021 9015 ELECTRIC CONCEPTS INC OAKLAND 1332759A 2,543 10/27/2021 5190 0.95 LANDS PROPERTY MAINTENANCE LLC OAKLAND 6255701A 2,030 10/7/2021 9402 NORTH CONSULTING SERVICE INC OAKLAND 5925150A 240 10/18/2021 8810 SAFETY COMPANY LLC OAKWOOD VILLAGE, OH 5935628A 376 11/14/2021 8742 AKATANYA LLC OKEMOS 5887844A 948 10/9/2021 9058 ARENS LINDA OKEMOS 6068405A 530 10/31/2021 0913 BALLARD DEVELOPMENT INC OKEMOS 0669822A 825 12/14/2021 5348 EMINATE LLC OKEMOS 6064132A 750 11/5/2021 5437 FLOORHEAT LLC OKEMOS 5213223A 1,789 10/18/2021 8292 0.95 HAREL ELAD OKEMOS 6282520A 580 12/22/2021 0913 ITTNER ILSA AND TAYLOR ANDREW OKEMOS 5426340A 530 11/2/2021 0913 LVP ASSOCIATES OKEMOS 4610288A 1,092 10/13/2021 9015 0.95 RUSSELL L PEABODY ARCHITECT PC OKEMOS 0547581A 614 12/30/2021 8601 OMARS CONSTRUCTION LLC OLIVET 4667190A 14,692 11/15/2021 5645 0.91 XACT EXCAVATING OLIVET 6276377A 739 11/20/2021 6217 BAUMGARTEN FOREST PRODUCTS INC ONAWAY 3174670A 229 10/31/2021 8742 HYDE KODY ONAWAY 6275737A 750 11/19/2021 2702 INNOVATIVE SERVICES INC ONAWAY 1544624A 2,942 10/4/2021 5221 1.00 TWO THOUSAND 125 CABLE COMPANY LLC ONAWAY 4310144A 9,641 12/5/2021 7600 1.41 13 % VANHOUTENS WOODCRAFTS LAWN CARE & ONAWAY 4195531A 1,325 12/11/2021 9102 0.95 SNOWPLOWING LLC VANANDEL AFC INC ONONDAGA 3290980A 3,078 11/14/2021 9053 0.95 AMERICAN 1 TOWING LLC ONSTED 5210704A 3,849 11/27/2021 7208 0.95 GREAT LAKES TRUCK AND TRANSPORT LLC ONSTED 6075088A 750 11/23/2021 7208 MCGRAW JOHN ONTARIO, CA 3214052A 459 12/1/2021 0909

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BARNES FARRELL ONTONAGON 6267076A 605 11/2/2021 0913 CAMPBELL DOROTHY ONTONAGON 6277527A 605 11/28/2021 0913 ELZROUI SABEH ONTONAGON 5621321A 605 11/16/2021 0913 GADDIES MARILYN ONTONAGON 6266886A 605 11/2/2021 0913 GOLIDAY VANESSA ONTONAGON 6267211A 605 11/2/2021 0913 GREEN FLANNEL ENTERPRISES INC ONTONAGON 1879553A 373 10/12/2021 9052 HARRIS CORNELIA ONTONAGON 6266959A 605 11/2/2021 0913 HAVRO MICHELLE ONTONAGON 6228186A 605 10/16/2021 0913 HENDERSON ATIBA ONTONAGON 5797870A 605 11/3/2021 0913 HUGHES DOMINICA ONTONAGON 5936012A 605 10/27/2021 0913 HUNTER TENISHA ONTONAGON 6267009A 605 11/2/2021 0913 HUSKIC SAJMA ONTONAGON 6266924A 605 11/2/2021 0913 INGRAM BEVERLY ONTONAGON 6274293A 605 11/16/2021 0913 JAJOU NAWAL ONTONAGON 6254144A 605 10/2/2021 0913 JAMES HENRY ONTONAGON 6267203A 605 11/2/2021 0913 JONES DIANE ONTONAGON 6266916A 605 11/2/2021 0913 MYHREN CONTRACTING LLC ONTONAGON 5428513A 2,468 12/3/2021 2709 0.95 MYLES THOMAS ONTONAGON 6267114A 605 11/2/2021 0913 NORFLEET LATRICE ONTONAGON 6267181A 605 11/2/2021 0913 PARKER SHARON ONTONAGON 6267165A 605 11/2/2021 0913 PHILLIPS TAPLIN ROSETTA ONTONAGON 6266967A 605 11/2/2021 0913 QASEM AHMED ONTONAGON 6277446A 605 11/28/2021 0913 RENO KATHERINE ONTONAGON 6277721A 935 11/28/2021 0913 ROSS NEBRA ONTONAGON 6267068A 605 11/2/2021 0913 SAMS CYNTHIA ONTONAGON 6285899A 605 12/29/2021 0913 SANDERS CYNTHIA ONTONAGON 6277543A 605 11/28/2021 0913 SCOTT GAIL ONTONAGON 6277519A 605 11/28/2021 0913 SHELTON MARY ONTONAGON 6277497A 605 11/28/2021 0913 SKINNER ANNE ONTONAGON 5927757A 605 10/26/2021 0913 STIRLING KAREN ONTONAGON 6267106A 605 11/2/2021 0913 TRIPLETT BRENDA ONTONAGON 6285848A 605 12/29/2021 0913 VANDERROEST GEORGENE ONTONAGON 6267084A 605 11/2/2021 0913 WILLIS GEORGE ONTONAGON 5916704A 605 10/3/2021 0913 YOUNGBLOOD RICHARDSON SELENA ONTONAGON 6254012A 605 10/2/2021 0913 ABS CARPENTRY LLC ORCHARD LAKE 5790310A 1,730 12/2/2021 5437 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 86 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge KARP GARY ORCHARD LAKE 1911040A 530 12/22/2021 0913 SOLVEARY INC ORION TWP 6281249A 643 12/10/2021 9015 A CUT ABOVE TREE LLC ORTONVILLE 4784693A 750 10/27/2021 0106 BIG TWIGS ARBORICULTURAL SERVICES LLC ORTONVILLE 4783344A 8,792 10/28/2021 0106 0.88 BUCCMANN CONSTRUCTION SERVICES LLC ORTONVILLE 6054692A 750 10/10/2021 5437 CARPENTRY BY ZWACK INC ORTONVILLE 1976249A 1,535 11/3/2021 5645 DIAMOND FOREST PROPERTIES INC ORTONVILLE 2462877A 2,135 11/26/2021 9015 0.95 FACILITY MAINTENANCE & CONSTRUCTION OF ORTONVILLE 1816403A 409 11/11/2021 8601 MICHIGAN LLC HIGH SIDE ORTONVILLE 6002390A 970 11/19/2021 5645 HUTCHISON HOME SERVICES LLC ORTONVILLE 6263682A 2,943 10/23/2021 5476 PAULA J WHITE LLC ORTONVILLE 5795176A 321 10/22/2021 8810 RESIDENTIAL HOMES OF DISTINCTION LLC ORTONVILLE 4280261A 2,172 11/4/2021 5645 0.95 SR 1 OF MICHIGAN INC ORTONVILLE 4357370A 750 10/13/2021 5645 D AND B ENVIRONMENTAL TRANSPORTATION INC OSCEOLA, IN 5047137A 2,900 11/2/2021 7208 0.95 ANSCHUETZ DOUG F OSCODA 6274200A 750 11/14/2021 2709 J PARSONS GROUP LLC OSCODA 6195059A 4,947 11/19/2021 7208 MACEDO TRUCKING COMPANY LLC OSCODA 5739314B 6,773 11/9/2021 7208 0.95 PATHWAY TO LEARNING CHILD DEVELOPMENT OSCODA 0425532A 2,365 12/16/2021 9058 0.95 CENTER LLC TINY REBELS DAYCARE LLC OSCODA 6080278A 341 11/23/2021 8869 TIGER ADVANTAGE LLC OSHTEMO 4819144A 643 10/4/2021 9015 REBEL FARM LLC OSSEO 6262716A 1,180 10/20/2021 0035 TITUS CONSTRUCTION ENTERPRISES LLC OSSEO 1399098A 1,770 11/11/2021 5645 0.95 WILLIAM BROWN FOREST PRODUCTS OSSINEKE 0230324A 750 12/29/2021 2702 FOREST TOWNSHIP AREA SENIOR CENTER INC OTISVILLE 4533461A 592 11/8/2021 9058 PRECISION FOUNDATIONS OTISVILLE 2057468A 800 12/30/2021 5215 0.95 ALL AROUND TREES OTSEGO 6253016A 750 10/6/2021 0106 ANDRESS GRAIN & COMMODITIES INC OTSEGO 1808435A 2,343 12/16/2021 7380 0.95 COWDREYS MOBILE HOME SERVICE INC OTTAWA LAKE 4693353A 3,189 10/21/2021 5645 0.95 DS CONSTRUCTION OTTAWA LAKE 5800374A 800 12/19/2021 5645 MCCORMICK PATRICK OTTAWA LAKE 4295838A 363 12/12/2021 8869 OLDE FARM LLC OTTAWA LAKE 6265286A 664 12/4/2021 5606 TRINITY TECH USA INC OTTAWA LAKE 5691362A 1,019 12/2/2021 8601 1.00 WHITEFORD TOWNSHIP OF MONROE COUNTY OTTAWA LAKE 0281638A 2,596 12/11/2021 9410 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ESSENMACHERS PAINTING OTTER LAKE 1919164A 750 10/12/2021 5476 MJG CONTRACTING OTTER LAKE 5943370A 540 12/24/2021 9521 HARDEN ROBERT OVID 1556630A 825 11/11/2021 7208 AVENUE BAR AND GRILL LLC OWOSSO 6011497A 526 12/26/2021 9058 BARNS BY BRADY OWOSSO 6256295A 750 10/8/2021 5403 CLE CONSTRUCTION OWOSSO 5945836A 800 12/15/2021 5403 CROWE REAL ESTATE LLC OWOSSO 6261612A 2,407 10/17/2021 8292 HOME IMPROVEMENT PLUS LLC OWOSSO 6082602A 750 12/5/2021 5403 L 5 TRANSPORTATION INC OWOSSO 1029657A 1,125 11/23/2021 8810 0.95 MCLAREN INC OWOSSO 0102296A 674 12/1/2021 5183 NEHEMIAH MINISTRIES CORP OWOSSO 3174441A 984 10/23/2021 9015 PRECISION CABLE SERVICES LLC OWOSSO 3897770A 1,477 11/13/2021 7600 R AND M LAWN & SNOW OWOSSO 6019692A 656 11/25/2021 9102 RECREATION WAREHOUSE LLC OWOSSO 5086132A 6,131 11/23/2021 5183 1.35 13 % U A W LOCAL 743 OWOSSO 1482467A 247 12/4/2021 8755 VALS PIZZA LLC OWOSSO 4672216A 2,972 10/28/2021 9058 0.95 ACT LIVE TRAPPING SERVICES LLC OXFORD 4210700A 3,140 11/5/2021 9015 D AND A HOME SOLUTIONS OXFORD 6070612A 1,306 11/16/2021 9519 GREAT LAKES ELITE GYMNASTICS INC OXFORD 4427971A 3,710 12/29/2021 9063 0.95 GRIFFIN TREE CARE LLC OXFORD 5666414A 2,481 10/9/2021 0106 0.95 HERMANSON LANDSCAPE LLC OXFORD 2848929A 709 10/14/2021 0042 JOHNS BRICK CLEANING & CAULKING LLC OXFORD 0685925A 2,132 12/1/2021 5022 0.95 KLMN ENTERPRISES LLC OXFORD 3918823A 19,911 12/13/2021 5437 1.32 NEDS FLOORING REMOVAL INC OXFORD 4878426A 4,175 10/1/2021 9521 0.95 OXFORD GEAR MACHINERY INC OXFORD 0515752A 516 10/18/2021 8107 0.95 RICHARDS INDUSTRIAL MAINTENANCE INC OXFORD 4807782A 6,477 12/3/2021 9015 0.90 SAADIA DESIGN LLC OXFORD 5392861A 591 11/20/2021 9521 STACO RESOURCES LLC OXFORD 0434744A 800 11/5/2021 5645 WEDGEWOOD REALTY SERVICES LLC OXFORD 4405404A 272 12/20/2021 8742 DAVE EVANS SAND AND GRAVEL LLC PALMETTO, FL 5939500A 751 11/28/2021 7208 OPTIC EDGE SIGNS LLC PARIS 5032946A 4,701 11/6/2021 9559 0.95 POPSYCLE LLC PARK CITY, UT 6086004A 306 12/12/2021 8810 HAAKSMA SPEECH PATHOLOGY INC PARKER, CO 6039820A 474 10/3/2021 8832 RYCAM ROOFING LLC PARMA 6255647A 19,393 10/7/2021 5551 ANGLES ABOVE LLC PAW PAW 4142845A 752 11/8/2021 8810 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 88 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge APRILS TEA POT DOME LLC PAW PAW 5225051A 1,120 11/6/2021 9058 ELITE RESIDENTIAL BUILDERS LLC PAW PAW 2795647A 1,027 12/24/2021 5645 0.95 FLORAISON LLC PAW PAW 6055370A 1,537 10/15/2021 8045 PAW PAW FIRE DEPARTMENT PAW PAW 4635680A 1,764 11/5/2021 7904 0.95 RED ARROW CONSTRUCTION GROUP LLC PAW PAW 6262422A 6,800 10/20/2021 5645 J AND T LAWN SERV AND SNOW REMOVAL PECK 5352924A 759 12/17/2021 0042 YODER LOGGING PELKIE 2780526A 750 11/18/2021 2702 JIM BOELTER CONSTRUCTION LLC PELLSTON 4089030A 758 10/6/2021 5645 ROSS DARRIN PELLSTON 4674618A 750 11/11/2021 2702 DECREMER CONSTRUCTION LLC PERKINS 5958768A 569 12/30/2021 9015 MARTELL DEVIN ALAN PERKINS 6259510A 750 10/14/2021 7208 BRAD ANDERSON TRUCKING PERRONVILLE 3154602A 35,227 10/15/2021 7208 0.70 BOZZO PAUL PERRY 2968630A 750 10/6/2021 5645 BRUSH AND PALETTE INTERIOR PERRY 5800170A 751 12/19/2021 5476 G AND A PROPERTY MANAGEMENT LLC PERRY 6264450A 569 10/26/2021 9015 MOSHERS TIRE & TRUCK SERVICE LLC PERRY 5946000A 750 12/27/2021 7208 NORTH SHORE LEGACY PAINTING & PERRY 0785725A 825 10/14/2021 5476 CONSTRUCTION LLC RICK JOHNSON CONSTRUCTION MANAGEMENT PERRY 3879291A 4,599 10/22/2021 5403 0.90 LLC ECO PARTNERS LLC PETERSBURG 5202345A 291 10/23/2021 8810 BJS PROPERTIES LLC PETOSKEY 0657190A 624 11/1/2021 8810 CHARLEVOIX EQUITY PARTNERS US LLC PETOSKEY 5927498A 3,449 10/25/2021 9015 0.95 H AND H FORESTRY SERVICES LLC PETOSKEY 6067603A 288 10/31/2021 8810 LE ROOFING PETOSKEY 6072100A 1,711 11/7/2021 5551 PETOSKEY CHILDRENS NURSERY INC PETOSKEY 1592980A 279 11/6/2021 8868 PINE SHORES OWNERS ASSOCIATION PETOSKEY 4447190A 233 12/18/2021 8810 SEAN MEYER CONSTRUCTION LLC PETOSKEY 5478839A 750 11/14/2021 5645 J DEWITT COMMUNICATIONS INC PIERSON 6025560A 11,632 10/29/2021 7600 SHETLER PLUMBING AND HEATING INC PIGEON 3561844A 9,044 10/1/2021 5550 0.98 TLC HOME DAY CARE PIGEON 4293444A 569 12/19/2021 8869 BEECHWOOD LLC PINCKNEY 2421364A 4,367 10/16/2021 0106 0.93 C AND L LANDSCAPE INC PINCKNEY 3171388A 917 11/26/2021 0042 FIELD TRIPS UNLIMITED INC PINCKNEY 5568730A 370 12/22/2021 8810 JP LANDSCAPING LLC PINCKNEY 6040829A 784 12/23/2021 0042

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SEWARD CONSTRUCTION INC PINCKNEY 0321486A 1,401 12/30/2021 5437 0.95 GODS LITTLE BLESSINGS DAY CARE LLC PINCONNING 5934338A 473 11/13/2021 8869 PREMIER COMP SOLUTIONS LLC PITTSBURGH, PA 6267513A 356 11/3/2021 8810 FETHER LOGGING PITTSFORD 5615801A 1,632 10/4/2021 2702 CHAPPELL CONSTRUCTION PLAINWELL 1491466A 825 12/2/2021 5645 LJ HARPER ENTERPRISES LLC PLAINWELL 5947480A 568 12/27/2021 9015 MCBAIN CONSTRUCTION LLC PLAINWELL 2915936A 4,679 12/5/2021 5645 0.91 RICK WALTER ELECTRIC LLC PLAINWELL 3565700A 615 12/6/2021 5190 THOMAS SEAN PLAINWELL 3351661A 750 11/24/2021 2702 DUNLAP DESIGN GROUP LLC PLEASANT RIDGE 4822854A 608 10/21/2021 9015 0.95 ROYAL OAK DOG WALKERS LLC PLEASANT RIDGE 6003761A 677 12/15/2021 8831 ADVANCED MATRIX INC PLYMOUTH 4868447A 520 11/1/2021 4511 AQL STAFFING LLC PLYMOUTH 5728177A 290 10/13/2021 8810 BLACK BOX LIGHTING LLC PLYMOUTH 5776333A 626 11/7/2021 7610 CANTON CHAMBER OFFICE CONDOMINIUM PLYMOUTH 4014472A 568 12/21/2021 9015 COLONIAL COLLISION & RECONDITIONING INC PLYMOUTH 1860917A 418 10/2/2021 8810 0.95 DEFINITIVE BUILDING COMPANY LLC PLYMOUTH 5057256A 750 11/28/2021 5645 FARMER EXPRESS LLC PLYMOUTH 5554942A 750 11/10/2021 7208 FREDERICKS LLC PLYMOUTH 6281630A 750 12/11/2021 5476 FRIENDS OF THE ROUGE PLYMOUTH 2409577A 507 10/1/2021 8810 GINS TRANSPORTATION INC PLYMOUTH 1969714A 766 12/31/2021 8810 GR CONSTRUCTION LLC PLYMOUTH 5934303A 825 11/10/2021 5348 GREATER TOWING & RECOVERY LLC PLYMOUTH 4282302A 800 10/15/2021 7208 JANCO OF MICHIGAN INC PLYMOUTH 1994298A 910 12/14/2021 0913 JBCE LLC PLYMOUTH 5570603A 775 11/29/2021 8742 0.94 JOHN BLEAU CREATIVE SERVICES LLC PLYMOUTH 5836590A 317 11/10/2021 8810 JOHN BLEAU CREATIVE SERVICES LLC PLYMOUTH 5836590A 316 11/6/2021 8810 KIRKWAY ESTATES CONDOMINIUM ASSOCIATION PLYMOUTH 5647070A 568 12/8/2021 9015 INC MCGLINN ELAINE PLYMOUTH 6268633A 530 11/4/2021 0913 MICHIGAN URBAN SEARCH AND RESCUE PLYMOUTH 6258620A 5,346 10/13/2021 7704 TRAINING FOUNDATION INC MIDWEST TAE KWON DO LLC PLYMOUTH 5052190A 570 11/14/2021 9015 MJA RESTAURANT ENTERPRISES LLC PLYMOUTH 5298172A 329 12/22/2021 9058 MOSAIC BUILDING GROUP LLC PLYMOUTH 5325668A 3,106 10/5/2021 5606 0.95

6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 90 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge OAKWOOD CUSTOM HOMES LLC PLYMOUTH 3582876A 753 10/7/2021 8810 OMA PIZZA LLC PLYMOUTH 5298172B 329 10/29/2021 9058 PERLONGO EXCAVATING CO INC PLYMOUTH 0116017A 5,872 11/11/2021 6217 PHOENIX MANAGEMENT HOLDINGS LLC PLYMOUTH 5474639A 2,156 11/6/2021 5437 0.95 RELIABLE HELP LLC PLYMOUTH 6087426A 215 12/17/2021 8810 S M F INC PLYMOUTH 1472925A 15,339 12/1/2021 7208 0.88 SALINE MOBILE HOME PARK LLC PLYMOUTH 1368206A 621 11/15/2021 9015 SULI INC PLYMOUTH 4584805A 7,361 10/21/2021 7216 0.96 SUPERIOR MEDICAL WASTE DISPOSAL LLC PLYMOUTH 6282539A 2,173 12/16/2021 7213 WESTERN WAYNE COUNTY CONSERVATION PLYMOUTH 0778400A 1,458 11/9/2021 9015 0.95 ASSOCIATION INC A HAMILTON PONTIAC 3829154A 2,080 12/6/2021 5221 ANNOINTED HOME CARE INC PONTIAC 2567555A 3,949 10/27/2021 8835 0.95 BALDWIN EXPRESS INC PONTIAC 4332938A 1,841 12/12/2021 8006 BALTAS CONSTRUCTION INC PONTIAC 3482472A 750 12/18/2021 5022 0.93 CANIZ CONSTRUCTION INC PONTIAC 4202236A 689 11/19/2021 5610 ELEKTRICITY EVENTS LLC PONTIAC 6066780A 2,054 10/24/2021 9058 0.95 EXPRESS SNOW REMOVAL PONTIAC 6276784A 1,714 11/21/2021 9402 FAUSTRO IVAN PONTIAC 6264778A 750 10/31/2021 5022 FPB STUDIO LLC PONTIAC 6074251A 750 11/12/2021 5645 GET IT DONE RIGHT LLC PONTIAC 4420764A 709 11/30/2021 0042 GINASIS CONSTRUCTION & DESIGN INC PONTIAC 5763401A 1,168 10/14/2021 5645 GRIFFON STEEL CORPORATION PONTIAC 1593986A 674 10/25/2021 8106 IN N OUT CONVENIENCE STORE INC PONTIAC 3131572A 1,778 12/7/2021 8006 INDUSTRIAL COMMERCIAL & PAINT INC PONTIAC 5946417A 750 12/18/2021 5476 J F GARCIA CONSTRUCTION LLC PONTIAC 4103416A 21,102 12/22/2021 5022 0.80 JIMS KRISPY CHICKEN LLC PONTIAC 6262066A 565 10/20/2021 9058 LAGOS TREE AND LANDSCAPING INC PONTIAC 5370957A 2,338 11/3/2021 0042 0.95 LOMAS HERNANDEZ MASONRY PONTIAC 0714640A 800 12/20/2021 5022 LONIK CONTRACTING LLC PONTIAC 5324610A 800 10/4/2021 5022 LOPEZ PAUL PONTIAC 6278590A 750 12/2/2021 5022 MCKENZIE MOVING & FREIGHT SYSTEMS INC PONTIAC 0005851A 983 12/1/2021 8293 0.95 MIRELES ALAN DAVID PONTIAC 6280889A 800 12/9/2021 5445 OAKLAND COUNTY PIONEER & HISTORICAL PONTIAC 1112260A 568 12/11/2021 9015 SOCIETY

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge RAMOS DANIEL PONTIAC 6264891A 750 10/31/2021 5022 RAY KATZ SCULPTOR LLC PONTIAC 0228966A 1,684 10/13/2021 3040 0.95 RODRIGUEZ CO PONTIAC 3159647A 759 12/13/2021 9015 0.95 SAUCEDA JAVIER R PONTIAC 3205754A 938 10/31/2021 9015 SMART SOLUTIONS RENOVATIONS INC PONTIAC 5568528A 750 12/12/2021 5476 SOLIDO DRYWALL PONTIAC 3854183A 750 12/28/2021 5445 0.95 TODDS ROOFING REMDOELING & REPAIRS LLC PONTIAC 6282474A 750 12/12/2021 5551 ZARATE JAIRO RIVAS PONTIAC 6280870A 800 12/9/2021 5445 HOODY BRIAN PORT AUSTIN 5733804A 750 11/11/2021 5645 BLUE MOON ABATEMENT PORT HURON 4701062A 825 12/25/2021 5183 CUSTOM RENTALS PORT HURON 0112178A 1,791 11/18/2021 9015 0.95 JOIS TRUCKING LLC PORT HURON 3414345A 732 10/10/2021 9402 LOGISTICS DESIGN SOLUTIONS INC PORT HURON 6265324A 215 10/28/2021 8810 MANNS HOME REMODELING LLC PORT HURON 6262899A 750 10/21/2021 5551 N F A C LLC PORT HURON 6273432A 750 11/13/2021 5645 OWSA RAIL CAR INC PORT HURON 3400832A 2,556 12/16/2021 7382 0.95 REASONABLE CONTRACTING SERVICES INC PORT HURON 2707470B 17,862 10/17/2021 5552 0.95 BARTOLETTIS LAWNCARE & LANDSCAPING LLC PORTAGE 5509629A 1,097 10/15/2021 9102 BESTIRE LLC PORTAGE 2108399A 1,093 11/5/2021 8387 0.95 BOAT CITY VENTURES LLC PORTAGE 0721387A 4,197 12/1/2021 8748 0.97 DJS PROFESSIONAL TREE SERVICE LLC PORTAGE 4684125A 1,415 11/3/2021 0106 0.95 INSULATION MECHANIC SERVICES LLC PORTAGE 6264514A 724 10/24/2021 5550 JAMB LLC PORTAGE 4408667A 750 10/23/2021 5476 VISION BUILDER LLC PORTAGE 4843789A 750 12/1/2021 5645 CJH CONSTRUCTION PORTLAND 6069940A 800 11/2/2021 5645 COMPAS POULTRY LLC PORTLAND, IN 6271596A 12,370 11/10/2021 0034 JWP CONSTRUCTION PORTLAND 6069673A 800 11/2/2021 5645 HINCKA LOGGING LLC POSEN 0451444A 22,342 10/27/2021 2709 0.74 JNK WOOD PRODUCTS LLC POSEN 3163229A 1,277 10/24/2021 8232 0.95 BURLE MOORE MASONRY POTTERVILLE 1330608A 904 11/2/2021 5022 0.95 CRYDERMAN ROBERT W POWERS 4546890A 825 11/13/2021 7208 HARRY BRAD PRESCOTT 6054846A 751 10/10/2021 7208 SAND BAY MARINA SALES SERVICE AND PRESQUE ISLE 0689475A 1,760 10/6/2021 8387 0.95 STORAGE LLC DANKERT WOOD PRODUCTS PRUDENVILLE 2202808A 750 12/16/2021 2702

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SAJDAK CONTRACTOR LLC PRUDENVILLE 3074897A 750 10/14/2021 5645 0.84 PREFERRED MARKET INC PULLMAN 3272761A 1,011 12/6/2021 8006 POTAWATOMIE CAMPGROUND & RECREATIONAL QUINCY 3963063A 570 12/16/2021 8017 0.95 AREA INC CHESHIRE AND ASSOCIATES QUINNESEC 1101226A 3,144 10/11/2021 0042 1.00 OLSON DENNIS LEE QUINNESEC 1334980A 750 12/1/2021 7208 EXECUTIVE SAFE AND SECURITY CORPORATION RANCHO CUCAMONGA, 5198461A 403 10/10/2021 8742 CA FIELD MAPPING SOLUTIONS LLC RAPID CITY 5618800A 402 10/11/2021 8810 MLC OUTDOOR RAPID CITY 1230662A 709 12/6/2021 9402 CONSTANTINO TRUCKING INC RAPID RIVER 4010159A 751 12/14/2021 9015 0.95 KERRY SUNDBERG FOREST PRODUCTS & RAPID RIVER 1190253A 750 12/19/2021 7208 TRUCKING INC MAX CONSTANTINO TRUCKING LLC RAPID RIVER 4672534A 18,097 12/28/2021 7208 0.84 ZMP HARVESTING LLC RAPID RIVER 5894379A 750 11/20/2021 2709 BRAD KELLER BUILDER LLC RAVENNA 6277322A 750 12/1/2021 5645 MUSKEGON FURNACE CLEANING LLC RAVENNA 0696536A 674 12/15/2021 5550 PLINE BONNIE RAVENNA 5325170A 530 10/6/2021 0913 RAVENNA AUCTION LLC RAVENNA 3287971A 5,732 11/23/2021 0129 0.91 WESTSIDE MOBILE HOMES INC RAVENNA 5347459A 5,949 10/30/2021 8387 0.92 J TROMLEY SERVICE RAY 6063454A 541 11/14/2021 9521 J W VAN HAVERBECK CUSTOM BUILDER INC RAY 2002353A 830 10/10/2021 5606 0.95 QUINTERO DURAN ANGEL RAY 6080952A 750 12/2/2021 5645 SKY SERVICES LLC RAY 0272906A 1,687 10/18/2021 8393 0.95 SPRINGERS CARPENTRY LLC RAY 3652750A 750 10/8/2021 5437 BAMM INVESTMENT INC READING 5755760A 568 10/2/2021 9015 ANDINOS TREE CARE REDFORD 5640687A 750 11/23/2021 0106 BALLARD JOTINA REDFORD 5099145A 307 10/5/2021 0908 BRASSEUR JACKIE REDFORD 6274188A 530 11/15/2021 0913 CURRY DWAYNE JR REDFORD 5179319A 530 11/15/2021 0913 CURTIS REAL ESTATE SERVICES LLC REDFORD 6279848A 750 12/7/2021 5645 D ARCY JAMES REDFORD 5217679A 530 10/15/2021 0913 DECKER SCOTT REDFORD 6270174A 530 11/6/2021 0913 DETROIT TEMPERATURE ENGINEERS INC REDFORD 0412040A 479 10/1/2021 8601 DIAKOW CARLY REDFORD 5936187A 530 11/15/2021 0913 DOBSON MELISSA REDFORD 5665035A 530 11/24/2021 0913 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 93 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge EDGAR IAN REDFORD 6281265A 530 12/10/2021 0913 ELITE DEVELOPMENT CORP REDFORD 3058816A 800 11/8/2021 5437 FENECH MEGAN REDFORD 5288916A 530 11/15/2021 0913 GARDNER JEREMIAH REDFORD 5288975A 307 11/15/2021 0908 GERGES DAVID REDFORD 5288860A 530 11/15/2021 0913 GREEN PAUL W REDFORD 5306973A 860 10/26/2021 0913 GRIER THOMAS REDFORD 3253279A 530 10/15/2021 0913 0.95 GRIFFIN ALICIA REDFORD 6270077A 530 11/6/2021 0913 HANSEN DREW REDFORD 5722330A 307 10/5/2021 0908 HARRIS TODD REDFORD 6270166A 307 11/6/2021 0908 HAZELWOOD ROBERTO REDFORD 4732480A 307 10/5/2021 0908 HERMATZ DANIEL REDFORD 5149371A 530 10/26/2021 0913 HINZ TERRY REDFORD 5729327A 530 10/5/2021 0913 HOME CARE CENTRAL INC REDFORD 5796598A 525 12/13/2021 8835 0.95 HOWARD SHEENA REDFORD 4698770A 860 10/5/2021 0913 0.95 HUGHES CONNELLY JR REDFORD 5179467A 307 11/21/2021 0908 JERDEN BRITTANY REDFORD 4786980A 530 12/28/2021 0913 JOHNSON CECIL III REDFORD 5179181A 307 11/21/2021 0908 JOHNSTON AGAIN INC REDFORD 5409993A 458 10/31/2021 9058 KANDAH MARWAN REDFORD 4000854A 521 11/16/2021 0908 KEITH MICHAEL REDFORD 5639980A 1,132 11/24/2021 0908 0.95 KRANZ HAZELWOOD LARESSA REDFORD 4220641A 530 10/5/2021 0913 LATOUR SHAWN REDFORD 4888405A 414 11/1/2021 0908 LAVIGNE RACHEL REDFORD 5543525A 530 11/6/2021 0913 LB 3 ELECTRIC LLC REDFORD 2621584A 520 12/4/2021 5190 LOPEZ EILEEN DONOVAN REDFORD 5706726A 530 10/3/2021 0913 LUTFY MARGAUX REDFORD 4787676A 530 10/26/2021 0913 MARZEC MARISSA STEPHANIE REDFORD 6270190A 530 11/6/2021 0913 MCCLAIN KENYON REDFORD 4561040A 637 11/15/2021 0908 MCINTOSH AARON REDFORD 6264905A 307 10/27/2021 0908 MUSA YAHYA REDFORD 6270131A 530 11/6/2021 0913 NEXTCAR AUTO INC REDFORD 6077498A 535 11/19/2021 8393 OLIVAS DEAN JR REDFORD 5180015A 637 11/15/2021 0908 PALAZZOLO AMANDA REDFORD 5179947A 414 11/15/2021 0908 PAULISON SUZANNE M REDFORD 4690532A 307 11/28/2021 0908 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 94 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PILOTTO MICHAEL REDFORD 6274234A 414 11/14/2021 0908 PITERA KENNETH REDFORD 2891581A 800 11/21/2021 5476 PRASAD SHILPI REDFORD 6276733A 530 11/21/2021 0913 REDFORD COUNSELING CENTER REDFORD 0339830A 649 10/1/2021 8832 REDFORD GARAGE DOORS REDFORD 1073370A 581 11/9/2021 3724 RIGGIO ROXANNE REDFORD 5179971A 530 11/15/2021 0913 ROTH TIMOTHY REDFORD 4682726A 307 11/24/2021 0908 SARKODY JOSEPH REDFORD 4534409A 470 11/26/2021 5190 SCHERER LYNN REDFORD 5179920A 530 11/15/2021 0913 SCHILLING JEFFREY REDFORD 4704070A 1,556 11/15/2021 0913 0.95 SCHMITT AMY REDFORD 6130984A 530 10/5/2021 0913 SHELTON SAUNDRA REDFORD 5075076A 307 11/21/2021 0908 SIEBERT SERVICES LLC REDFORD 3400840A 750 11/12/2021 0106 SILLS KENNIBURG BRIDGET REDFORD 4690516A 530 10/18/2021 0913 SOBCZAK STEVEN REDFORD 6270123A 414 11/6/2021 0908 SPRAY BOOTH PRODUCTS INC REDFORD 4426738A 8,411 12/16/2021 8107 1.05 STAMBERSKY IAN REDFORD 6259960A 530 10/15/2021 0913 STROTHER MARTHA REDFORD 5288835A 414 11/15/2021 0908 TREX PAINTING REDFORD 5182107A 800 10/9/2021 5476 TYSZKIEWICZ THERESA REDFORD 3802248A 307 10/5/2021 0908 UNLIMITED AUTO REPAIR AND COLLISION LLC REDFORD 5072913A 488 10/11/2021 8748 WADRZYK LAUREN REDFORD 5288908A 2,708 11/15/2021 0913 0.95 YOUNG MARK II REDFORD 5019834A 307 10/3/2021 0908 ZELENAK RYAN REDFORD 4561120A 530 11/15/2021 0913 CHAD SPRINGER FOREST PRODUCTS REED CITY 2781000A 750 11/7/2021 2702 COVEY RICHARD REED CITY 3908291A 750 11/7/2021 2702 CROSS ROADS PEST CONTROL REED CITY 6008232A 569 11/5/2021 9015 PAPAS PLACE ADULT DAY CARE LLC REED CITY 5924502A 1,318 11/1/2021 9063 ONE THOUSAND 709 MARQUETTE LLC REESE 6040624A 494 10/1/2021 0035 GREENAN GARY REMUS 0973475A 750 11/14/2021 5645 STANOLIS PAUL G REPUBLIC 1899953A 750 12/19/2021 2709 BOXER AUTOMOTIVE LLC RICHLAND 5936772A 273 11/16/2021 8748 LAKE SAVERS LLC RICHLAND 4698444A 5,090 11/1/2021 5183 0.95 S AND F PROPANE LLC RICHLAND 4002180A 6,914 11/8/2021 7502 1.31 13 % TANKERSLEY MODERN CONSTRUCTION LLC RICHLAND 2202298A 750 10/16/2021 5403 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 95 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge D R T ENTERPRISES INC RICHMOND 2380803A 789 11/15/2021 6217 KNUST SAWMILLING LLC RICHMOND 5347580A 3,327 11/27/2021 2731 0.95 TREASURED FRIENDS DAY CARE INC RICHMOND 4501756A 2,140 12/12/2021 8869 0.95 MICHIGAN RESCUE CONCEPTS LLC RICHMOND TWP 6071589A 1,688 11/6/2021 7380 BIG DAWGS DIRTWORX LLC RIGA 5925088A 1,284 11/1/2021 0042 ADVANCED TREE EXPERTS INC RILEY 3322378A 4,234 11/11/2021 0106 0.91 EMERALD CITY PROFESSIONAL MAINTENANCE RIVER ROUGE 5724643A 568 10/1/2021 9015 LLC GREAT LAKES RAIL CAR REPAIR SERVICES INC RIVER ROUGE 1768220A 7,443 10/1/2021 3365 0.89 ECKELBERRY CONCRETE RAISING INC RIVERVIEW 1312251A 750 10/31/2021 5221 F ROEHLER SERVICES LLC RIVERVIEW 5751764A 7,001 10/15/2021 5551 1.00 J A R INCINERATOR SERVICE INC RIVERVIEW 3745392A 1,222 12/18/2021 9620 0.95 JFK TRANSPORTATION INC RIVERVIEW 6277314A 283 11/25/2021 8810 JIM THE FLOOR GUY LLC RIVERVIEW 1316303A 3,077 11/22/2021 9521 0.95 PERFECTION VENDING CO RIVERVIEW 3903710A 917 10/24/2021 5192 SANDBEAR EXPRESS INC RIVERVIEW 1668277A 750 12/7/2021 7208 ABIDE MINISTRIES INC ROCHESTER 5941962A 507 12/1/2021 8742 AD AND C BUSINESS SOLUTIONS INC ROCHESTER 6281222A 305 12/10/2021 8803 C P R III INC ROCHESTER 4278798A 215 10/21/2021 8810 CENTRIC SOLUTIONS GROUP LLC ROCHESTER 5295238A 5,232 11/13/2021 3179 1.00 CREEKSIDE VILLAGE OWNERS ASSOCIATION ROCHESTER 3165132A 568 12/8/2021 9015 FAX AGENCY INC ROCHESTER 3165493A 229 12/1/2021 8742 HUDOCK ANTOINETTE ROCHESTER 6272436A 530 11/11/2021 0913 L AND R PAINTING CONTRACTORS LLC ROCHESTER 5224870A 1,135 12/18/2021 5476 0.95 MASTER ROCKS LLC ROCHESTER 5103177A 800 10/26/2021 5348 MATTHEWS SEPTIC SEAWALL AND EXCAVATING ROCHESTER 6284035A 8,172 12/17/2021 6217 LLC MICULI CONSTRUCTION COMPANY ROCHESTER 3661172A 751 10/22/2021 5348 OAK ARBOR CHURCH OF THE NEW JERUSALEM ROCHESTER 3413969A 496 11/2/2021 8868 ORION ABBEY LLC ROCHESTER 5228298A 775 11/15/2021 9058 0.95 PASILLAS CONSTRUCTION LLC ROCHESTER 6257135A 2,919 10/9/2021 5022 PLYMOUTH VILLAGE ASSOCIATION ROCHESTER 5426995A 568 11/1/2021 9015 RLD ENTERPRISES LLC ROCHESTER 6264158A 800 10/23/2021 5437 SCHWARTZMEIER STEPHEN ROCHESTER, NY 6275770A 338 11/30/2021 5606 THOMAS DME LLC ROCHESTER 4854110A 329 10/31/2021 8017

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge A AND J CUSTOM PAINTING ROCHESTER HILLS 5204771A 800 11/23/2021 5476 AAC PAINTING AND CONTRACTING SERVICES ROCHESTER HILLS 5763193A 800 10/16/2021 5476 LLC ADVANCED WEB ENVIRONMENTS LLC ROCHESTER HILLS 5802512A 327 12/22/2021 8742 AGGRESSIVE COMMERCIAL CLEANING ROCHESTER HILLS 5050022A 1,057 11/10/2021 9015 0.95 ALEXANDERS PAINTING COMPANY LLC ROCHESTER HILLS 3632091A 751 10/1/2021 5476 ALM TECHNOLOGIES LLC ROCHESTER HILLS 3430553A 430 12/21/2021 8742 BEST GRANITE DESIGN LLC ROCHESTER HILLS 5797950A 2,079 12/15/2021 5437 BYTE CONSULTING LLC ROCHESTER HILLS 3963217A 308 10/8/2021 8810 COFFMANS TREE SERVICE LLC ROCHESTER HILLS 3188930A 6,660 10/21/2021 0106 0.92 DAVIS TILE MARBLE & GRANITE ROCHESTER HILLS 4245199A 750 10/3/2021 5348 DISCOUNT SKYLIGHT LLC ROCHESTER HILLS 5796504A 750 10/20/2021 5551 EAGLE RECOVERY ROCHESTER HILLS 4810759A 524 11/12/2021 7720 ELITE DETECTION K9 ROCHESTER HILLS 5923565A 340 10/12/2021 8831 F AND M CONSTRUCTION INC ROCHESTER HILLS 2299119A 750 12/2/2021 5645 GAMEZ CONSTRUCTION INC ROCHESTER HILLS 3296008A 2,450 11/12/2021 5645 GIULIA TRANS INC ROCHESTER HILLS 5212618A 750 11/21/2021 7208 GREY OAKS CHIMNEY SERVICE INC ROCHESTER HILLS 5920981A 3,342 10/10/2021 5022 0.95 GRUITS AND ASSOCIATES PLC ROCHESTER HILLS 4950879A 238 10/27/2021 8601 HAVENS DAVID ROCHESTER HILLS 5152607A 530 12/15/2021 0913 J AND A MASONRY LLC ROCHESTER HILLS 5285844A 750 10/20/2021 5022 0.94 KEN JACKSON CLEAN UP INC ROCHESTER HILLS 2272148A 22,516 12/1/2021 5610 1.55 13 % LA RESTORATION LLC ROCHESTER HILLS 5721881A 800 11/7/2021 5476 MAD EXPRESS INC ROCHESTER HILLS 4866932A 750 11/7/2021 7208 0.95 MGM PAINTING ROCHESTER HILLS 3119947A 800 10/6/2021 5476 OAKLAND HUNT CLUB ROCHESTER HILLS 1607120A 330 10/13/2021 9058 ROCHESTER MASONRY DESIGN LLC ROCHESTER HILLS 1145894A 3,114 11/11/2021 5022 0.95 SMITH RICHARD L ROCHESTER HILLS 6050018A 238 10/7/2021 8601 STUDIO OF ROCHESTER LLC ROCHESTER HILLS 6064299A 712 10/24/2021 9063 WESTSIDE PAINTING LLC ROCHESTER HILLS 5447178A 751 10/7/2021 5476 JACKSON STEEL ERECTORS LLC ROCK CREEK, OH 5300185A 6,330 11/1/2021 5102 CLEAN ROOM TECHNOLOGIES LLC ROCKFORD 1038788A 747 10/15/2021 5213 COMPTON JAMES ROCKFORD 3096254A 1,851 11/14/2021 5645 COPPER RIDGE CONSTRUCTION INC ROCKFORD 4060237A 750 10/14/2021 5645 DILLE CONSTRUCTION LLC ROCKFORD 5615780A 750 10/4/2021 5550

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HOPPS JOHN ROCKFORD 6069630A 530 11/2/2021 0913 KITSON CUSTOM HOMES LLC ROCKFORD 5925975A 753 10/22/2021 8742 LUXHOJ CONSULTING LLC ROCKFORD 5185734A 464 10/1/2021 8601 MEADOW RIDGE BUILDERS LLC ROCKFORD 4158652A 750 12/28/2021 5645 PT REMODELING LLC ROCKFORD 6253660A 4,054 10/13/2021 5437 RILEY REMODELING LLC ROCKFORD 4523970A 800 10/11/2021 5645 ROCKFORD SPORTS BOOSTER ROCKFORD 4882725A 329 12/6/2021 8017 STRUCTURED HOMES BY WILSON INC ROCKFORD 4156137A 750 12/1/2021 5645 SUN PAINTING INC ROCKFORD 2154404A 750 10/26/2021 5476 0.95 TUKARIC DAVORIN ROCKFORD 5940940A 3,239 12/3/2021 7208 0.95 AJE CONTRACTING INC ROCKWOOD 1029983A 750 12/24/2021 5221 GREAT LAKES CONVEYOR BELT SERVICE INC ROGERS CITY 2211971A 3,884 11/3/2021 3724 0.92 HUNTER CONCRETE & EXCAVATING ROGERS CITY 3845290A 739 11/22/2021 6217 ROBINSON DARWIN ROGERS CITY 6285325A 750 12/23/2021 7208 BARG CONSTRUCTION LLC ROMEO 6058183A 750 10/16/2021 5403 BELE AND SOLIS IMPROVEMENTS ROMEO 6128416A 750 12/1/2021 5403 ISLAND LAKE INVESTMENTS LLC ROMEO 3976394A 947 10/19/2021 0912 0.95 JAMES P CONTRACTING INC ROMEO 1042238A 2,275 10/1/2021 5606 0.95 MARTONE SERVICES LLC ROMEO 5900867A 229 11/14/2021 8742 PARAMOUNT BUILDING INC ROMEO 4913841A 831 10/31/2021 8810 ROMEO FLOORS ROMEO 3128733A 825 10/27/2021 5348 ALAN BERGMOOSER CONSTRUCTION LLC ROMULUS 2202433A 750 10/7/2021 5348 ARGONAUT KENNEDY LLC ROMULUS 3860582A 498 11/25/2021 8810 CITATION PROPERTIES LLC ROMULUS 5326834A 455 10/9/2021 8392 DOULANI LLC ROMULUS 4908139A 595 10/19/2021 8017 0.95 DOWS EQUIPMENT SERVICES INC ROMULUS 0096890A 468 11/18/2021 8810 EJH TRUCKING LLC ROMULUS 5939038A 750 12/27/2021 7206 GREATWAY TRANSPORTATION INC ROMULUS 5127610A 9,981 12/30/2021 7208 1.38 13 % H AND C PROPERTY MAINTENANCE LLC ROMULUS 4635310A 656 12/31/2021 9402 J A PITMAN EXCAVATING INC ROMULUS 3566943A 739 11/1/2021 6217 J HILL CLEANING ROMULUS 5789583A 644 11/24/2021 9015 LENOS SERVICES LLC ROMULUS 6002935A 750 11/18/2021 5552 NUMBER 1 BAR & GRILL LLC ROMULUS 0845809A 1,094 10/21/2021 9058 0.95 PAVEMASTER ASPHALT PAVING ROMULUS 4270762A 837 11/8/2021 5221 RAND ENVIRONMENTAL SERVICES INC ROMULUS 0731625A 54,866 10/28/2021 5183 1.56 13 % 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 98 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TELEGRAPH HEATING COMPANY INC ROMULUS 1808400A 675 11/30/2021 5550 0.95 TREE MAN SERVICES LLC ROMULUS 5241731A 5,932 11/27/2021 0106 0.92 UNITED AIR & VENTILATION LLC ROMULUS 2907283A 749 12/20/2021 5550 HEPA ENVIRONMENTAL SERVICES INC ROOTSTOWN, OH 4980042A 612 12/5/2021 5183 ADVANCED DIESEL AND EQUIPMENT REPAIR LLC ROSCOMMON 6284612A 515 12/21/2021 8387 FREDS OF ROSCOMMON LLC ROSCOMMON 4581660A 330 12/17/2021 9058 GERDES DANIELLE L ROSCOMMON 6277284A 530 11/25/2021 0913 J B CABLE LLC ROSCOMMON 3275299A 750 10/5/2021 7600 K AND D RV CENTER LLC ROSCOMMON 6280846A 1,758 12/9/2021 8393 TRAVEL INFORMATION SERVICES INC ROSCOMMON 1557300A 366 10/24/2021 8810 UAW LOCAL 1819 ROSCOMMON 5461057A 310 11/13/2021 8755 MAYHEW JOSEPH A ROSE CITY 3252485A 750 11/23/2021 2702 STONEY ACRE ENTERPRISES LLC ROSE CITY 6063586A 597 10/23/2021 9102 TRAPPERS UP NORTH SPORTS BAR INC ROSE CITY 4701399A 1,001 10/3/2021 9058 CUT CUSTOM PROCESSING LLC ROSEBUSH 6254438A 2,579 10/3/2021 2081 DWC DIVERSIFIED INC ROSEBUSH 3022846A 1,197 12/1/2021 0042 0.95 EXPERIENCED GLASS BLOCK LLC ROSEVILLE 5352100A 800 12/11/2021 5022 EXPERT MACHINE REPAIR INC ROSEVILLE 0124354A 4,253 11/22/2021 3628 1.33 27 % F AND U ENTERPRISES LLC ROSEVILLE 3577996A 1,321 12/30/2021 8017 0.95 FIVE M MANAGEMENT LLC ROSEVILLE 6276768A 908 11/21/2021 9015 GLEASON AND ASSOCIATES INC ROSEVILLE 1067273A 1,432 11/13/2021 5221 0.95 GONZALEZ INSULATION ROSEVILLE 5452740A 751 10/27/2021 5479 GROESBECK ENTERPRISE SERVICE INC ROSEVILLE 4406818B 493 11/8/2021 8017 0.95 HANNAFORD CONSTRUCTION ROSEVILLE 4207858A 825 10/14/2021 5645 J AND J ROOFING CO ROSEVILLE 1697870A 363 10/27/2021 8810 J W V TILE ROSEVILLE 6284582A 750 12/19/2021 5348 MAXX TOWING INC ROSEVILLE 4905229A 8,625 12/14/2021 8395 1.30 10 % MCINERNEY PEST CONTROL INC ROSEVILLE 2144794A 568 10/5/2021 9015 MICHIGAN DRIVING SCHOOL INC ROSEVILLE 3496252A 790 11/23/2021 8868 0.95 PRO HOME EXTERIORS LLC ROSEVILLE 1044907A 5,786 10/20/2021 5645 0.95 QUALITY OVER QUANTITY EVERYTIME INC ROSEVILLE 5429315A 809 12/5/2021 5606 ROSEVILLE GAS INC ROSEVILLE 5809347B 666 12/22/2021 8017 0.95 SG RENOVATIONS LLC ROSEVILLE 4340493A 751 11/25/2021 5437 SUNCREST MANAGEMENT INC ROSEVILLE 4101090A 4,997 11/7/2021 5403 THIRTEENTH HOUR TATTOOS LLC ROSEVILLE 5853460A 710 12/29/2021 9586 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 99 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DLS CONSTRUCTION SERVICES ROTHBURY 5635888A 4,003 11/15/2021 5645 AAW INFRASTRUCTURE PARTNERS L3C ROYAL OAK 4821971A 613 12/16/2021 7538 BLACK MARLIN TRANSIT LLC ROYAL OAK 6261604A 4,063 10/20/2021 7208 BLACKETT BUILDERS ROYAL OAK 1211200A 932 10/15/2021 5437 1.34 13 % BUSY BEES CLEANING SERVICES LLC ROYAL OAK 6012434A 643 12/19/2021 9015 CONSTRUCTION DEVELOPMENT CO ROYAL OAK 4996844A 739 12/10/2021 0042 COSMIC PAINTING AND DRYWALL LLC ROYAL OAK 6089631A 750 12/31/2021 5348 EUGENE PAULS LANDSCAPING LLC ROYAL OAK 1009672A 2,308 10/24/2021 9102 1.00 HASHTAG MAINTENANCE LLC ROYAL OAK 6264263A 1,871 10/23/2021 9015 HIPPIES PIZZA ROYAL OAK 5355559A 3,691 10/23/2021 9058 0.95 K CUSTOM LLC ROYAL OAK 5165326A 750 12/29/2021 5437 LAURENCE WINE CONSTRUCTION CO ROYAL OAK 3356833A 800 11/16/2021 5437 LEAH VANDERHOFF LLC ROYAL OAK 6285287A 320 12/23/2021 8742 MURPHY CONSTRUCTION INC ROYAL OAK 3757900A 750 10/15/2021 5645 R AND K COMMODITIES TRANSPORT LLC ROYAL OAK 5195330A 800 10/3/2021 7208 SAL DEVELOPMENT LLC ROYAL OAK 3135233A 751 12/22/2021 5183 0.91 SANCTUM HOUSE INC ROYAL OAK 5756138A 3,692 10/4/2021 9052 0.95 SUNSTAR CLEANING SERVICES ROYAL OAK 0812889A 761 11/11/2021 9015 SUSTAINABLE ENERGY ENGINEERING LLC ROYAL OAK 6018742A 597 11/7/2021 8601 TRANSFORMER INSPECTION RETROFILL CORP ROYAL OAK 1481061A 21,127 12/27/2021 3724 1.70 13 % VL PAINTING INC ROYAL OAK 5605113A 800 11/28/2021 5476 0.95 WBWL LLC ROYAL OAK 5622069A 800 10/27/2021 5645 XACT FLOORING INSTALLATIONS LLC ROYAL OAK 4913507A 2,859 12/4/2021 9521 0.95 MICHIGAN ROOFING & REMODELING RUBY 5191432A 750 10/11/2021 5551 CHILDRENS CHOICE INITIATIVE INC SAGINAW 5915813A 415 10/20/2021 8742 D LOGISTICS INC SAGINAW 6068316A 750 11/11/2021 7208 EMMONS AND ASSOCIATES LLC SAGINAW 5197546A 3,893 12/20/2021 7720 0.95 HART BENJAMIN SAGINAW 6080103A 750 11/25/2021 5645 I SUPPORT THE 1 PERCENT SAGINAW 5616310A 330 10/5/2021 8017 JAIME AND JENNA INC SAGINAW 5300894A 751 11/13/2021 5645 0.95 JIMENEZ BUILDERS INC SAGINAW 4886810A 800 11/7/2021 5437 KRAUSE BRAD SAGINAW 5454204A 750 11/25/2021 5645 SAGINAW VALLEY FOOT & ANKLE CENTER SAGINAW 4280679A 388 11/26/2021 8832 SURVIVORS OF SUICIDE INC SAGINAW 5643481A 520 12/1/2021 8742 VERDUSCO KYLE SAGINAW 5454069A 750 12/10/2021 5645 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 100 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WHISMAN SHERMAN F SAGINAW 4632230A 1,079 12/13/2021 0042 0.95 KUZAK ROGER SAGOLA 5139473A 750 11/23/2021 2709 KARVER CONTRACTING LLC SAINT CLAIR 1022733A 750 12/12/2021 5645 DUDA HOME MAINTENANCE LLC SAINT CLAIR SHORES 6278361A 1,885 12/1/2021 5437 PROWORK CONSTRUCTION INC SAINT CLAIR SHORES 4113225A 750 12/12/2021 5645 RIVERSIDE HOME SERVICES OF MICHIGAN LLC SAINT CLAIR SHORES 6036520A 825 11/3/2021 5476 ADELAIDE ENERGY LLC SAINT JOHN, IN 4047494A 1,151 10/15/2021 5550 INCIDENTCLEAR LLC SAINT JOHN, IN 5925533A 13,409 10/24/2021 7720 0.84 CITADEL WILDLIFE LLC SAINT JOHNS 6272452A 420 11/12/2021 8831 STONEY CREEK OUTDOOR PROPERTIES LLC SAINT JOHNS 6285821A 750 12/29/2021 2702 FRED E RICHARDS POST 3055 VETERANS OF SAINT LOUIS 2974592A 404 12/2/2021 9058 FOREIGN WARS OF THE UNITED ANARCHY CONSTRUCTION LLC SALINE 6279856A 751 12/5/2021 5645 BRIDGEWATER SALES & SERVICE LLC SALINE 3702928A 1,958 10/24/2021 8387 0.95 C AND Q PAINTING LLC SALINE 1701428A 2,493 12/14/2021 5476 0.95 FLETCHER INSPECTIONS INC SALINE 3917576A 3,191 10/8/2021 8720 0.95 HARD MASTER CONSTRUCTION LLC SALINE 5063868A 16,740 10/24/2021 5445 0.84 KBK LANDSCAPING INC SALINE 4148240A 27,588 10/20/2021 9102 1.62 27 % MOSER BUILDING & CARPENTRY LLC SALINE 4093534A 7,581 11/16/2021 5645 0.90 GUIDING LIGHT LLC SAN ANTONIO, TX 6087736A 275 12/18/2021 8810 PILLAR GROUP DEVELOPMENT LLC SAN DIEGO, CA 3793281A 1,236 10/17/2021 5476 DUCHEMIN JONATHON SAND LAKE 6264786A 800 10/27/2021 5551 JACKSON MARK SAND LAKE 6260004A 750 10/15/2021 5437 KROPACZEWSKI ANTHONY SAND LAKE 1424742A 750 10/19/2021 5476 LUMBERJACK LOGGING LLC SAND LAKE 4375483A 750 11/6/2021 2702 WEST RIVER FRAMING SAND LAKE 3389898A 750 10/16/2021 5403 A PLUS LAWN & SNOW CARE SANDUSKY 5622956A 732 12/4/2021 9402 J CAMBRIDGE LLC SANDUSKY 1020560A 2,075 11/13/2021 6204 MILLER MASONRY SANDUSKY 5931401A 1,896 11/10/2021 5221 SPIKES CONSULTING LLC SANFORD 5862566A 313 10/25/2021 8601 MY 3 SONS HEATING & COOLING LLC SARANAC 5515653A 724 12/11/2021 5550 VANSPRONSEN CHRIS SARANAC 3740730A 750 12/22/2021 5476 ANDERSEN BOAT WORKS INC SAUGATUCK 2058154A 1,930 10/18/2021 6834 0.95 TUCKER MARINE CONSTRUCTION INC SAUGATUCK 0271934A 7,557 10/27/2021 4000 1.27 10 % AMERICAN AND CANADIAN LOCK TOURS INC SAULT STE MARIE 0342432A 4,845 12/31/2021 8726 0.92

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge EUP DRYWALL INC SAULT STE MARIE 3763617A 801 11/14/2021 5445 FAMOUS AND WELCH LOCK TOURS SAULT STE MARIE 0942502A 1,954 12/31/2021 9058 0.95 MCM MARINE INC SAULT STE MARIE 0940593A 70,232 12/31/2021 7333 1.07 13 % NICOLET SHORES PLUMBING INC SAULT STE MARIE 6196314A 1,001 11/12/2021 5183 CHIP STEFFEY GENERAL CONTRACTOR INC SAWYER 4722965A 800 12/6/2021 5645 DODSON TIMBER LLC SCHOOLCRAFT 5092973A 825 12/18/2021 9102 HUNTS EXTERIORS LLC SCHOOLCRAFT 6075347A 800 11/15/2021 5645 JD CONSTRUCTION OF SOUTHWEST MICHIGAN SCHOOLCRAFT 5763282A 750 10/14/2021 5645 LLC RED ARROW ENTERPRISE LLC SCHOOLCRAFT 6264522A 4,034 10/24/2021 7208 SIMONDS SOFTWASH LLC SCOTTS 5995230A 643 10/3/2021 9015 WORTHINGTON FLOOR COVERING SCOTTS 1858750A 750 10/9/2021 5348 AESTHETIC PHYSICIANS PC SCOTTSDALE, AZ 5743001A 230 11/24/2021 8832 0.95 WILLOWBROOK CARE HOME SCOTTVILLE 1210149A 4,343 10/30/2021 9053 0.91 CONSOLIDATED FLEET SERVICES INC SEARCY, AR 4808398A 942 10/1/2021 8720 0.95 NORTH COAST DESIGN BUILD LLC SHEFFIELD LAKE, OH 6030289A 1,100 10/3/2021 5606 C A S HOME IMPROVEMENT SHELBY 2193914A 750 11/9/2021 5551 EMPIRE CONTRACTORS LLC SHELBY 3042855A 5,237 12/19/2021 5552 1.17 OCEANA COUNTY AGRICULTURAL SOCIETY SHELBY 1570200A 927 10/1/2021 9015 RED LINE CARPENTRY SHELBY 3161200A 750 11/27/2021 5437 BULLDOG CARPENTRY LLC SHELBY TOWNSHIP 5733561A 12,825 10/22/2021 5645 0.89 DEPENDABLE SERVICES GROUP LLC SHELBY TOWNSHIP 5864780A 3,424 10/30/2021 5606 0.95 ROYCE RIDGE CONDOMINIUM ASSOC SHELBY TOWNSHIP 3565092A 568 11/9/2021 9015 A AND J FUELS INC SHELBY TWP 1682318A 461 10/31/2021 8017 ABLE DEMOLITION INC SHELBY TWP 2627639A 9,000 12/16/2021 5403 0.71 ALL SEASONS CONSTRUCTION LLC SHELBY TWP 5811392A 800 10/28/2021 5348 0.95 AS MASONRY AND STONE LLC SHELBY TWP 3154645A 750 10/22/2021 5348 B TS CONSTRUCTION INC SHELBY TWP 1684426A 842 10/24/2021 8742 0.95 BLACK MOUNTAIN BUILDING LLC SHELBY TWP 5765897A 750 10/20/2021 5476 BLC CONSTRUCTION INC SHELBY TWP 4012690A 750 10/20/2021 5437 0.95 BRIGHTER OUTLOOK PROFESSIONAL WINDOW SHELBY TWP 3977374A 1,912 10/15/2021 9015 0.95 CLEANING INC C LYNCH & ASSOCIATES INC SHELBY TWP 4307755A 1,962 12/23/2021 0908 0.95 CAVATAIO ELAINA M SHELBY TWP 6264077A 471 10/26/2021 9053 CEDRONI ASSOCIATES INC SHELBY TWP 0732060A 5,598 12/13/2021 5403 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CHESTERFIELD 5 LLC SHELBY TWP 5915236A 619 10/16/2021 8810 CLOSE QUARTERS TACTICAL LLC SHELBY TWP 4830938A 6,120 11/6/2021 9061 0.85 CORINTHIAN BUILDING COMPANY LLC SHELBY TWP 1757865B 750 12/25/2021 5645 CREEKSIDE VILLAGE SUBDIVISION ASSN SHELBY TWP 5198755A 568 10/3/2021 9015 D SIGN LLC SHELBY TWP 1770373A 750 12/22/2021 9558 DANA STEVENS ARBORIST INC SHELBY TWP 5223210A 750 12/17/2021 0106 DAVID SURINCK LLC SHELBY TWP 5466059A 800 11/9/2021 5645 0.95 EEK TRUCKING CORP SHELBY TWP 5148545A 2,511 10/17/2021 7208 0.95 ENCORE BUILDING INC SHELBY TWP 4859316A 388 11/12/2021 5606 ENVIROAIR CONSULTANTS INC SHELBY TWP 1157914A 390 11/13/2021 8720 EURO MILANO TILE INC SHELBY TWP 4419219A 935 10/27/2021 5348 0.95 G AND J CUSTOM PAINTING SHELBY TWP 3091759A 1,304 10/6/2021 5476 0.95 GENT PAINTING COMPANY SHELBY TWP 5751713A 750 11/2/2021 5476 GLENWOOD ESTATES NORTH ASSOC SHELBY TWP 3671607A 618 10/5/2021 9015 GXH PAINTING LLC SHELBY TWP 6255620A 751 10/7/2021 5476 HIGHWAY STAR SHELBY TWP 4496060A 750 12/3/2021 7208 HILLCREST ON THE PARK CONDOMINIUM SHELBY TWP 5475805A 568 11/10/2021 9015 ASSOCIATION INEX CONSTRUCTION SERVICES LLC SHELBY TWP 4234545A 825 11/6/2021 5476 L AND B PAINTING LLC SHELBY TWP 5182921A 801 12/17/2021 5476 L J ELECTRICAL SERVICES INC SHELBY TWP 4140575A 793 10/4/2021 5190 LA ROCCA IMAGE INCORPORATED SHELBY TWP 1005499A 402 10/10/2021 8742 M G V INC SHELBY TWP 3678261A 221,082 12/31/2021 3628 0.69 MALAJ CONSTRUCTION INC SHELBY TWP 6065929A 751 10/26/2021 5348 MICHIGAN CEMENT CONTRACTORS INC SHELBY TWP 1969730A 750 12/5/2021 5221 MICHIGAN FINEST TILE & CEMENT WORKERS SHELBY TWP 0476595A 800 12/4/2021 5348 MILANIA CONSTRUCTION LLC SHELBY TWP 5924081A 825 10/16/2021 5645 MY 3 ANGELS LLC SHELBY TWP 4718909A 1,450 12/19/2021 8835 NEW DESIGN CONSTRUCTION CORP SHELBY TWP 1685953A 750 12/30/2021 5022 NINO HOMES & ASSOCIATES INC SHELBY TWP 0324019A 804 12/31/2021 8810 NMC COMPANIES INC SHELBY TWP 3361373A 750 10/2/2021 5437 0.95 ON THE LEVEL HOME IMPROVEMENT & BUILDING SHELBY TWP 0740101A 2,277 10/13/2021 5645 0.95 CO LLC PALERMO CONSTRUCTION COMPANY LLC SHELBY TWP 4939050A 800 10/22/2021 5221 0.95 PAULS PRIME PAINTING INC SHELBY TWP 4800389A 750 10/9/2021 5476

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge POLKOWSKI EDWARD S SHELBY TWP 0262340A 530 11/14/2021 0913 0.95 RIDGECON CONSTRUCTION INC SHELBY TWP 2896524A 765 11/8/2021 5645 0.95 SAVISA SOLUTIONS LLC SHELBY TWP 4979680A 1,022 12/10/2021 7720 0.95 SEAL TIGHT CONSTRUCTION INC SHELBY TWP 3234525A 754 10/22/2021 8810 SEBRING BUILDING COMPANY LLC SHELBY TWP 5858402A 825 12/6/2021 5645 SK CUSTOM CARPENTRY LLC SHELBY TWP 5943280A 750 12/11/2021 5437 START INC SHELBY TWP 5609771A 39,469 11/1/2021 3629 2.13 27 % STONEHENGE II OF CHESTERFIELD SHELBY TWP 6254080A 568 10/2/2021 9015 CONDOMINIUM ASSOCIATION SUNSET HOMES LLC SHELBY TWP 3036987A 14,849 10/12/2021 5645 0.86 THREE HUNDRED 8 CONSTRUCTION SHELBY TWP 5794021A 750 12/8/2021 5645 TILE RENOVATIONS LLC SHELBY TWP 5454506A 750 10/11/2021 5348 TRIM GUY LLC SHELBY TWP 4738616A 800 11/15/2021 5645 WAM LOGISTICS LLC SHELBY TWP 5740819A 291 12/6/2021 8601 WEATHERSEAL HOME IMPROVEMENTS CO INC SHELBY TWP 1927671A 3,759 11/22/2021 5606 1.03 WOODALL PAINTING & REMODELING SHELBY TWP 6064949A 800 10/25/2021 5476 SWEET ASHLEY SHELBYVILLE 6250572A 568 10/6/2021 9015 AG MARVELS LLC SHEPHERD 6261574A 1,199 10/17/2021 4825 MOES CONSULTING LLC SHEPHERD 5721261A 313 10/27/2021 8601 LESTER J SITTS POST 5065 VETERANS OF SHERIDAN 0743232A 620 11/26/2021 9061 FORIEGN WARS OF THE UNITED STATES INC PLEASANT ACRES LLC SHERWOOD 5490936A 2,840 12/15/2021 9053 0.90 T AND D LOGGING INC SHINGLETON 1177486A 750 11/1/2021 2702 RVN REMODELING LLC SIDNEY 5003687A 750 12/11/2021 5645 TYE NOAH LLC SIDNEY 6277373A 750 11/27/2021 5645 MAKI FARM & FOREST SKANDIA 1654128A 750 12/20/2021 2702 DEAN V WITZ TRUCKING SKANEE 1530810A 751 11/15/2021 8810 LAKESHORE MANAGEMENT AND DEVELOPMENT SODUS 5080754A 1,196 10/27/2021 9015 0.95 LLC NORTHERN WINN SERVICES LLC SOUTH BOARDMAN 5929407A 1,307 10/30/2021 5190 AL VAN HUMANE SOCIETY INC SOUTH HAVEN 0326879A 2,718 11/29/2021 8831 1.00 ELITE TREE CARE LLC SOUTH HAVEN 6279309A 2,717 12/2/2021 0106 LIGHTHOUSE ASSISTED LIVING LLC SOUTH HAVEN 6258204A 1,994 10/10/2021 9053 PACELINE AUTO GROUP LLC SOUTH HAVEN 6006973A 1,309 12/31/2021 8748 SOUTH HAVEN REGIONAL AIRPORT AUTHORITY SOUTH HAVEN 0380083A 3,047 12/27/2021 9015 0.95 ARROW TREE EXPERTS & STUMP REMOVAL LLC SOUTH LYON 2244012A 1,560 12/15/2021 0106 0.95 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 104 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BLUE RIVER BUILDERS LLC SOUTH LYON 6253644A 750 10/1/2021 5645 CROWN INSULATION INC SOUTH LYON 3267920A 2,330 10/8/2021 5479 1.05 CTS TREE SERVICE LLC SOUTH LYON 4464834A 2,133 10/28/2021 0106 0.95 DOHANY HOME IMPROVEMENTS INC SOUTH LYON 2047659A 800 11/1/2021 5645 0.95 G S H LLC SOUTH LYON 3722589A 750 12/4/2021 5462 HAMMOND KRISTINE N SOUTH LYON 6267467A 530 11/3/2021 0913 JAS PROFESSIONAL PLUMBING INC SOUTH LYON 3263118A 1,046 10/10/2021 5183 JWI LLC SOUTH LYON 5912377A 2,420 10/22/2021 5437 0.95 LANDMASTER PROPERTIES LLC SOUTH LYON 4798872A 750 12/22/2021 5645 MODERN CONCEPTS CLEANING SOUTH LYON 5917735A 3,707 10/4/2021 9015 0.95 RAPHIA HOMES INC SOUTH LYON 6084273A 800 12/9/2021 5645 ROOF COMPANY NET LLC SOUTH LYON 4863518A 755 12/13/2021 8742 0.78 SPECIALLY MADE CO LLC SOUTH LYON 6029051A 3,095 10/1/2021 0913 0.95 WILHELM FAMILY CHIROPRACTIC AND MASSAGE SOUTH LYON 6281753A 350 12/11/2021 8832 PLLC WISEMAN TRUCKING LLC SOUTH LYON 5340497A 750 11/6/2021 7208 0.95 MICHIGAN MARINE SERVICES INC SOUTH ROCKWOOD 3836592A 781 12/13/2021 4000 0.95 A AND G WIRELESS INC SOUTHFIELD 5464200A 329 11/11/2021 8017 ACADEMIC INTERNAL MEDICINE SPECIALISTS SOUTHFIELD 3251527A 269 11/18/2021 8810 PLLC ALL SEASONS JUNK REMOVAL SOUTHFIELD 4823087A 751 12/3/2021 9403 ALTERNATIVE ADULT RESIDENCE INC SOUTHFIELD 5773970A 1,679 11/2/2021 9053 0.95 ALTERNATIVE ADULTS LLC SOUTHFIELD 4575547A 1,800 10/27/2021 9053 0.95 AMOND H TOUSCANY TRUST SOUTHFIELD 1485148A 708 10/1/2021 0908 0.95 ASBESTOS REMOVAL TECHNOLOGIES INC SOUTHFIELD 2481278A 1,897 12/12/2021 9015 0.95 ASSURANCE PAYROLL LLC SOUTHFIELD 4573544A 32,785 10/1/2021 8832 0.71 BLACK AND WHITE LOOK OPTICAL SOUTHFIELD 5181542A 471 11/17/2021 8832 CORPORATION C J DELIVERY SERVICE INC SOUTHFIELD 6047807A 2,909 10/10/2021 7208 0.95 COMFORT HOME HEALTHCARE LLC SOUTHFIELD 4243838A 8,082 12/24/2021 8835 0.86 DESIGNER ELECTRIC INC SOUTHFIELD 3244610A 854 12/30/2021 5190 0.95 DETROIT CRIME COMMISSION SOUTHFIELD 4921461A 1,170 10/12/2021 8810 0.95 DR REUVEN BAR LEVAV AND ASSOCIATES P C SOUTHFIELD 0671550A 375 12/17/2021 8832 DYNAMIC HOME CARE SERVICES INC SOUTHFIELD 2956918A 6,906 10/10/2021 8835 EASY LIFE BUILDING COMPANY SOUTHFIELD 0098779A 750 11/14/2021 8810 EDEN AT HOME LLC SOUTHFIELD 6285686A 471 12/24/2021 8835 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 105 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ELF TRUCKING INC SOUTHFIELD 4218027A 5,442 11/6/2021 7208 0.95 GEES PLACE AFC INC SOUTHFIELD 5959829A 2,050 10/31/2021 9053 GIVE A LIFT INC SOUTHFIELD 1403869A 1,770 10/14/2021 7212 1.16 GOLDEN YEARS ADVOCATES LLC SOUTHFIELD 5467640A 5,183 12/1/2021 8835 0.85 HERMELIN DOREEN SOUTHFIELD 1094726A 1,223 10/20/2021 0913 0.95 HERTZBERG NEIL DPM SOUTHFIELD 0511218A 297 11/8/2021 8832 HOPE HOSPICE LLC SOUTHFIELD 6259340A 470 10/15/2021 8835 INDUSTRY SPECIFIC SOLUTIONS LLC SOUTHFIELD 4363930A 1,193 10/7/2021 8810 1.00 IPG SERVICES CORPORATION SOUTHFIELD 0124842A 25,405 12/30/2021 8393 0.66 ITS MICHIGAN INC SOUTHFIELD 6042554A 291 10/11/2021 8810 J A BLOCH & COMPANY INC SOUTHFIELD 1358537A 415 12/1/2021 8810 JRAB EDUCATIONAL SUPPORT SERVICES INC SOUTHFIELD 6213782A 248 10/23/2021 8810 JUST IN TIME CLEANING SERVICES LLC SOUTHFIELD 5635152A 1,348 11/14/2021 9015 0.95 L AND Y HOME IMPROVEMENT INC SOUTHFIELD 2848902A 2,392 12/5/2021 5437 0.95 LITTLE PRINCE PROPERTIES INC SOUTHFIELD 2730529A 750 10/27/2021 5645 LP LIGHTHOUSE LLC SOUTHFIELD 5596297A 3,199 10/3/2021 9053 0.93 MAIN ATTRACTION CONTRACTING LLC SOUTHFIELD 5282500B 750 12/15/2021 5022 0.95 MU TECHNOLOGY CO SOUTHFIELD 5623600A 681 10/19/2021 3643 NW OIL INC SOUTHFIELD 4158946A 978 12/3/2021 8017 P J HOSPITALITY INC SOUTHFIELD 2928574A 3,046 12/18/2021 9058 0.88 PERFECT SKY RANCH LLC SOUTHFIELD 6280854A 8,487 12/15/2021 8279 R V PATRICK CONSTRUCTION LLC SOUTHFIELD 3411982A 1,919 11/14/2021 5403 0.95 RENAISSANCE ENDODONTICS PLLC SOUTHFIELD 3877906A 761 10/11/2021 8832 REVIVAL HOME HEALTH CARE LLC SOUTHFIELD 5020271A 1,018 10/10/2021 8835 0.95 ROCK CITY LOGISTICS LLC SOUTHFIELD 6087965A 850 12/19/2021 8810 SAINT MARINA HOME DIALYSIS LLC SOUTHFIELD 6279627A 2,254 12/4/2021 8835 SHEPHERD PROPERTIES LLC SOUTHFIELD 6069649A 495 11/2/2021 5606 SPOT REALTY INC SOUTHFIELD 0486256A 608 10/23/2021 8810 TBI RESIDENTIAL REHAB LLC SOUTHFIELD 5214360A 5,786 11/27/2021 9053 0.88 TECH HOME BUILDING CO LLC SOUTHFIELD 5219078A 1,123 12/12/2021 5606 0.95 TELEGRAPH AND NINE MILE BP INC SOUTHFIELD 4639677A 1,022 12/5/2021 8017 0.95 TRANSNATIONAL STAFFING INC SOUTHFIELD 5875447A 27,026 12/29/2021 8292 0.95 VITALITY HOME CARE INC SOUTHFIELD 4840160A 760 11/28/2021 8835 0.95 WORKHORSE SERVICES LLC SOUTHFIELD 6270638A 785 11/7/2021 0042 YURA CORPORATION MEXICO SOUTHFIELD 5644046A 731 12/1/2021 8810 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 106 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ZEST PROPERTY MANAGEMENT LLC SOUTHFIELD 6276873A 1,274 11/24/2021 8720 A CUT ABOVE MAINTAINING LLC SOUTHGATE 5859042A 599 10/15/2021 9102 CARE FIRST HOMECARE LLC SOUTHGATE 4744608A 5,400 12/27/2021 8835 0.88 E C BILLING SOLUTIONS LLC SOUTHGATE 4557271A 229 11/6/2021 8810 ETHOS RISK MANAGEMENT LLC SOUTHGATE 6254390A 16,200 10/30/2021 7720 GARY K SMITH INSURANCE AGENCY LLC SOUTHGATE 0519987A 356 11/13/2021 8810 GB TOWING LLC SOUTHGATE 6049095A 2,994 10/3/2021 7208 ISHA REHAB LLC SOUTHGATE 6272380A 471 11/11/2021 8835 MORENOS CONSTRUCTION & REPAIR LLC SOUTHGATE 5628210A 800 10/27/2021 5645 PALAZZOLO DIRECTIONAL BORING INC SOUTHGATE 3232832A 825 11/2/2021 6325 SHEILA M RAY MD PC SOUTHGATE 1269305A 756 12/6/2021 8832 ZUZU LLC SOUTHGATE 4023412A 453 10/3/2021 9058 GP ENTERPRISES INC SPARTA 3852482A 330 10/1/2021 8017 GWATKIN CHRIS SPARTA 6046584A 750 10/1/2021 2702 RIDGE REALTY INC SPARTA 3088359A 216 11/4/2021 8810 RLF OF WM LLC SPARTA 3816672A 800 12/4/2021 5476 STUCKEYS DO IT ALL SERVICES LLC SPARTA 6276881A 5,563 11/24/2021 5403 UAW CIO LOCAL 8 SPARTA 4992318A 234 12/17/2021 8755 KENYON INTERNATIONAL EMERGENCY SPRING, TX 6258280A 263 12/2/2021 8810 SERVICES INC MOONEY HOLDINGS COMPANY SPRING HILLS, FL 4129490A 305 12/24/2021 8810 CENTRAL MARKETING INC SPRING LAKE 3388069A 263 12/19/2021 8601 DEYOUNG ROGER SPRING LAKE 6276350A 449 11/20/2021 7720 GREAT LAKES TOLL SERVICES INC SPRING LAKE 2960885A 1,748 12/23/2021 8059 1.00 MITCHELL BRIAN K SPRING LAKE 5774250A 750 11/3/2021 7202 WHITE STONE STEEL DETAILING LLC SPRING LAKE 5648440A 582 12/13/2021 8601 AMERICAN HOCKEY LEAGUE INC SPRINGFIELD, MA 3582078A 1,008 10/23/2021 9015 0.95 ARMOUR CONTRACTING LLC SPRINGFIELD 4387678A 3,122 11/15/2021 8395 1.05 SOUTH SHORE HUBBARD LAKE FIRE SPRUCE 1432974A 751 10/23/2021 7704 DEPARTMENT INC BERG MICHAEL ST CHARLES 5910609A 707 11/20/2021 9402 S AND R ENVIRONMENTAL CONSULTING ST CHARLES 1404091A 289 11/12/2021 8601 UNITED LABORATORIES INC ST CHARLES, IL 0373184A 995 11/23/2021 8742 0.95 AMERICAN FINISHING LLC ST CLAIR 2720817A 1,278 12/3/2021 9522 0.95 CRANE GIANT LLC ST CLAIR 4647262B 750 12/1/2021 0106 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GILL MAINTENANCE ST CLAIR 5619882A 750 11/18/2021 5403 MR CHIMNEY SWEEP LLC ST CLAIR 2912023A 1,321 11/15/2021 9015 0.95 O C D ORGANIZE CLEAN DE CLUTTER ST CLAIR 5320763A 1,040 10/30/2021 8835 O P ELEVEN INC ST CLAIR 3730174A 13,889 12/30/2021 5183 1.00 PAUL RIVARD CONSTRUCTION LLC ST CLAIR 1691031A 2,508 11/21/2021 5445 0.95 RESTAURANT EQUIPMENT PRODUCTS AND ST CLAIR 5363098A 796 12/1/2021 8044 SERVICES LLC SCM ENGINEER DEMOLITION INC ST CLAIR 3439461A 1,884 10/18/2021 5022 0.95 STEVES TOWING LLC ST CLAIR 5757380A 750 12/10/2021 7208 0.95 SULLIVAN CONSTRUCTION OF ST CLAIR COUNTY ST CLAIR 3959201A 19,535 10/17/2021 5040 0.95 LLC WELSER WELL DRILLING LLC ST CLAIR 2575868A 944 10/15/2021 6204 B AND D ROOFING ST CLAIR SHORES 1274112A 750 11/29/2021 5551 BILL PLUS DRILLS HOME SERVICES LLC ST CLAIR SHORES 4124014A 752 10/16/2021 5437 BROWN BUILD LLC ST CLAIR SHORES 0719986A 706 10/20/2021 5538 CASINO PARKING ST CLAIR SHORES 5126207A 455 11/6/2021 8392 CHARRING CROSS CONDOMINIUMS ST CLAIR SHORES 3694135A 568 10/9/2021 9015 ASSOCIATION CHOSEN HOME IMPROVEMENT INC ST CLAIR SHORES 4753933A 1,345 10/31/2021 5538 0.95 CLEAN FUEL SOLUTIONS LLC ST CLAIR SHORES 5631815A 865 11/7/2021 3726 CORPORATE CENTRAL SERVICES INC ST CLAIR SHORES 1579789A 242 12/31/2021 8810 DIFRANCO JAMES ST CLAIR SHORES 3193055A 753 10/6/2021 8810 FRANS REMARKABLE CLEANING AND MORE LLC ST CLAIR SHORES 5946301A 711 12/19/2021 9015 HOME PERFORMANCE LLC ST CLAIR shores 5334179A 825 10/24/2021 0042 J NOSEDA AND SON INC ST CLAIR SHORES 4423690A 850 12/11/2021 8293 JOSEPH HOME IMPROVEMENT LLC ST CLAIR SHORES 1970712A 800 12/31/2021 5645 MICHIGAN ENHANCED HOME IMPROVEMENT ST CLAIR SHORES 4566181A 750 10/23/2021 5221 NATHANIEL BROWN ST CLAIR SHORES 6258514A 750 10/13/2021 5645 OCD BUILDING SERVICES LLC ST CLAIR SHORES 6040748A 825 12/29/2021 5437 PETER TRENT SMITH MD PC ST CLAIR SHORES 6269028A 339 11/4/2021 8833 ROBERT R SFIRE & ASSOCIATES INC ST CLAIR SHORES 2589559A 345 11/10/2021 8810 SERENITY FACILITY LLC ST CLAIR SHORES 5068037A 4,219 12/29/2021 9053 0.95 SEWER SOLUTIONS LLC ST CLAIR SHORES 4530985A 828 11/19/2021 5183 UNICARE HOME HEALTH SYSTEM INC ST CLAIR SHORES 3293068A 2,561 12/16/2021 8829 WINC LLC ST CLAIR SHORES 5414270A 643 10/21/2021 9015 A 1 ELECTRICAL SERVICES INCORPORATED ST CLR SHORES 5302145A 545 10/7/2021 5190 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 108 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DNR FINISH CARPENTRY INC ST CLR SHORES 6071503A 750 11/6/2021 5437 NO LIMITS PIZZA & POOL LLC ST HELEN 4603052A 753 10/25/2021 9058 RUSS NELSON LOGGING LLC ST IGNACE 2895862A 2,778 10/1/2021 2702 0.95 BILLBOARD SPECIALISTS LLC ST JOHNS 5619980A 850 10/12/2021 9558 CARING AND SHARING FAMILY LIFE SERVICES ST JOHNS 5413087A 3,884 10/30/2021 8835 0.95 INC GOODKNECHT LOGGING LLC ST JOHNS 5036950A 750 12/7/2021 2702 HEINLEN TRANSPORT ST JOHNS 3397050A 750 10/11/2021 7208 HOME DIAGNOSTICS LLC ST JOHNS 5617561A 341 10/21/2021 8720 JEDI COMMUNICATIONS INC ST JOHNS 4674049A 376 10/7/2021 5191 TODOSCIUK ANDREW ST JOHNS 2179334A 5,789 10/2/2021 8006 1.00 MOONRISE LLC ST JOSEPH 5618738A 582 10/8/2021 0011 ALPHA CUSTOM EXTRUSIONS INC ST LOUIS 4959132A 21,362 12/9/2021 4459 1.70 27 % BEST OF ALL INC ST LOUIS 6067212B 691 10/30/2021 8017 GOMEZ DARY AXEL AMAYA ST LOUIS, MO 6260080A 750 10/15/2021 5551 HESSLER WORLDWIDE LLC ST LOUIS, MO 5196124A 1,380 10/19/2021 8017 MARGARET ANN DENNIS REVOCABLE LIVING ST LOUIS, MO 5915317A 822 12/11/2021 8835 TRUST MCCUNE CHARLES AND CATHY st LOUIS 5939615A 609 11/27/2021 0128 NICK CARTER TRUCKING ST LOUIS 5623839A 752 10/19/2021 8395 TAMMY LEE HAMMOND LLC DSI ST LOUIS 4931513A 750 11/9/2021 5445 0.95 TOPNSL LLC ST PETERSBURG, FL 6259251A 561 10/14/2021 5183 CUSACK COLLISION LLC STANTON 5646332A 943 12/7/2021 8393 JACOBS CONSTRUCTION STANTON 3592480A 750 12/5/2021 5645 NEWMAN INTERIORS STANTON 3405788A 1,944 10/7/2021 5445 0.95 FOUR COOKS LLC STANWOOD 2797801A 9,000 11/21/2021 5645 DAVE ZWERGEL LOGGING STEPHENSON 3576027A 750 11/16/2021 2702 MID COUNTY RESCUE SQUAD INC STEPHENSON 0184896A 952 11/12/2021 7380 YOOPER NUTS STEPHENSON 5167833B 551 10/30/2021 0130 BRAD LUTZ DRYWALL STERLING 2756285A 750 12/21/2021 5445 A TEAM SNOW AND ICE CONTROL LLC STERLING HEIGHTS 5221684A 1,225 12/24/2021 9402 0.95 ACCETTA PETER STERLING HEIGHTS 4232674A 952 10/1/2021 5348 0.95 AM PAINTING AND DRYWALL LLC STERLING HEIGHTS 4316649A 750 11/29/2021 8810 APEX STAFFING LLC STERLING HEIGHTS 5300223A 46,294 10/22/2021 8292 0.67 ASHFORD CROSSING ASSOCIATION STERLING HEIGHTS 4695011A 618 11/1/2021 9015

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge AVERHILL PARC ASSOCIATION STERLING HEIGHTS 4623479A 568 11/12/2021 9015 BAGHDAD MARKET MANAGEMENT INC STERLING HEIGHTS 6279635A 3,047 12/4/2021 8006 BALI FLOORS STERLING HEIGHTS 6087299A 961 12/17/2021 5437 BEST INTERIOR SERVICES INC STERLING HEIGHTS 0541419A 1,885 10/16/2021 5437 BLENDED INTEGRATION LLC STERLING HEIGHTS 6277276A 824 11/25/2021 5191 BRZOZKA MARIUSZ STERLING HEIGHTS 3377440A 540 10/1/2021 9521 BUNAJ CONSTRUCTION LLC STERLING HEIGHTS 6262830A 750 10/21/2021 5645 CAMERON TRANSPORTATION LLC STERLING HEIGHTS 4283180A 800 10/17/2021 7208 CARRIAGE PARK AT LAKESIDE CONDOMINIUM STERLING HEIGHTS 0202843A 568 10/2/2021 9015 ASSOCIATION CEDAR CREEK REMODELING STERLING HEIGHTS 4961595B 800 12/14/2021 5476 CITY CENTER SQUARE NO 5 ASSOCIATION STERLING HEIGHTS 0807907A 568 11/7/2021 9015 CITY WHEELS COURIER CORPORATION STERLING HEIGHTS 3647048A 2,303 12/17/2021 7202 0.95 COLONY CONDOMINIUM ASSOCIATION STERLING HEIGHTS 2292092A 750 11/16/2021 9015 COMPLETE COMMERCIAL MAINTENANCE STERLING HEIGHTS 5333890A 724 10/23/2021 5550 CONNOR WELDING INC STERLING HEIGHTS 2688719A 831 11/11/2021 3365 0.95 CONTAINMENT ASSEMBLY TRAINING & SAFETY STERLING HEIGHTS 5209781A 1,026 11/12/2021 3146 0.81 SOLUTIONS LLC CRISAN OLTEAN ALEXANDRU H STERLING HEIGHTS 5939992A 750 11/28/2021 5437 DIRECT STAFF INC STERLING HEIGHTS 2941155A 20,637 11/6/2021 8393 1.00 E AND J TRANSPORTATION INC STERLING HEIGHTS 6262473A 2,939 11/30/2021 7208 EASTSIDE MULCH LLC STERLING HEIGHTS 6274790A 709 11/17/2021 0042 EXPRESS INSTALLATION LLC STERLING HEIGHTS 5936837A 750 10/19/2021 5102 FAIRWAYS CONDOMINIUM ASSOCIATION STERLING HEIGHTS 2640180A 568 10/23/2021 9015 FREE AGE LLC STERLING HEIGHTS 5346193A 1,592 11/21/2021 7610 0.95 G AND I PAINTING LLC STERLING HEIGHTS 5620708A 1,837 10/13/2021 5476 0.95 GAZEBO VILLAGE CONDOMINIUM ASSOCIATION STERLING HEIGHTS 2853086A 568 11/13/2021 9015 GIBB SERVICES LLC STERLING HEIGHTS 4778049A 750 12/28/2021 5476 GLP MAINTENANCE LLC STERLING HEIGHTS 4251415A 1,226 11/10/2021 9015 GRANITE SHOP LLC STERLING HEIGHTS 6262244A 229 10/20/2021 8742 HIGH DETAIL POLISHING CO STERLING HEIGHTS 3524060A 380 10/7/2021 2790 HIGHLAND HILLS CONDOMINIUM ASSOCIATION STERLING HEIGHTS 3863921A 568 11/16/2021 9015 HOLISTIC HEALTH SERVICES INC STERLING HEIGHTS 2912430A 2,188 10/27/2021 9063 0.95 HUNTERS EXPRESS INC STERLING HEIGHTS 5208416A 750 12/11/2021 7208 HUNTERS POINTE CONDOMINIUM ASSOCIATION STERLING HEIGHTS 4242998A 878 10/10/2021 9015 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge JAL WINDOWS & SIDING LLC STERLING HEIGHTS 4417364A 800 11/15/2021 5645 JANA TRUCKING LLC STERLING HEIGHTS 6275222A 750 11/18/2021 7208 JULIAN 17 TRUCKING INC STERLING HEIGHTS 5693772A 750 12/23/2021 7208 K A AND SONS CONSTRUCTION INC STERLING HEIGHTS 6079768A 750 11/22/2021 5645 KINA TRUCKING INC STERLING HEIGHTS 6251897A 750 12/22/2021 7208 LA CASA CONSTRUCTION INC STERLING HEIGHTS 5628806A 6,544 10/28/2021 5645 0.90 LIGHTHOUSE COVE CONDOMINIUM ASSOCIATION STERLING HEIGHTS 2201321A 568 12/10/2021 9015 LINDAS CLEANING SERVICES INC STERLING HEIGHTS 5204747A 1,182 10/11/2021 9015 0.95 LUCIANOS PLUMBING LLC STERLING HEIGHTS 6278663A 562 12/2/2021 5183 MANNINO TILE LLC STERLING HEIGHTS 0277363A 800 12/17/2021 5348 0.95 MELDRUM FLOORING STERLING HEIGHTS 3913570A 540 12/6/2021 9521 MERIDIAN TRUCKING LLC STERLING HEIGHTS 6052754A 750 10/16/2021 7208 METUSHI FLOORING LLC STERLING HEIGHTS 4144457A 987 12/18/2021 9521 NDI PAINTING COMPANY LLC STERLING HEIGHTS 2033712A 750 12/3/2021 5476 ORION WOODS CONDOMINIUM ASSOCIATION STERLING HEIGHTS 5934133A 568 11/22/2021 9015 P AND J CONTRACTING INC STERLING HEIGHTS 3050793A 854 10/29/2021 5645 PALAZZOLO BROTHERS OF OAKLAND LLC STERLING HEIGHTS 5918588A 750 10/4/2021 5645 PRODESIGN HOME IMPROVEMENT LLC STERLING HEIGHTS 6273416A 750 11/12/2021 5437 S AND S TOWING SERVICES INC STERLING HEIGHTS 5945275A 2,075 12/14/2021 7208 0.95 SARAS PLACE INC STERLING HEIGHTS 4427025A 2,766 12/2/2021 9063 1.00 SENIOR SHUTTLE PLUS LLC STERLING HEIGHTS 6264484A 816 11/23/2021 7212 SOLAR PAINTING LLC STERLING HEIGHTS 3660630A 750 12/9/2021 5476 SOLUTIONS INTERNATIONAL INC STERLING HEIGHTS 2595990A 1,237 12/30/2021 5191 0.95 SPECK CARPENTRY INC STERLING HEIGHTS 3947521A 8,080 12/29/2021 5645 0.90 SPRINGWATER PARK ASSOCIATION STERLING HEIGHTS 4665945A 938 10/8/2021 9015 STARS AND STRIPES GYMNASTICS ACADEMY INC STERLING HEIGHTS 3662560A 3,392 12/1/2021 8869 0.95 STERLING CARPENTRY STERLING HEIGHTS 4254210A 750 10/1/2021 5403 STERLING GLASS CONTRACTORS INC STERLING HEIGHTS 4281560A 800 10/28/2021 9015 SUMMERFIELD ESTATES SUBDIVISION STERLING HEIGHTS 3990346A 568 10/22/2021 9015 ASSOCIATION SUMMIT STAFFING AND REHAB CONSULTING STERLING HEIGHTS 4462734A 2,534 12/27/2021 8835 0.95 SERVICES LLC SURPLUS EXTINGUISHER WORLD INC STERLING HEIGHTS 5474914A 664 11/10/2021 4828 T AND S LIMITED LLC STERLING HEIGHTS 5196680A 329 10/5/2021 8017 TRANSILVANIA GROUP INC STERLING HEIGHTS 5326850A 750 10/9/2021 7208

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TURNER INSULATION INC STERLING HEIGHTS 1723588A 7,417 12/27/2021 5479 0.87 TWIN LAKES HOMEOWNERS ASSOCIATION STERLING HEIGHTS 6052916A 568 10/31/2021 9015 VINEYARDS COMMUNITY ASSOCIATION STERLING HEIGHTS 3103250A 568 12/10/2021 9015 VR CONSTRUCTION INC STERLING HEIGHTS 5631408A 2,916 12/18/2021 5437 0.95 RALEIGH PLACE CONDOMINIUM ASSN STERLING HGTS 1959077A 618 11/4/2021 9015 VITA ELECTRICAL LLC STERLING HGTS 5022304A 470 12/8/2021 5190 CORRAL OF WESTLAND LLC STERLING HTS 4945700A 19,172 12/23/2021 9058 1.67 13 % BLUE DOOR VISUALS LLC STEVENSVILLE 6251749A 216 11/21/2021 8810 DREAM BUILDERS OF MI INC STEVENSVILLE 2994623A 4,051 12/14/2021 5645 GENERAL BUILDING SYSTEMS INC STEVENSVILLE 5396492A 10,253 11/18/2021 5645 1.34 13 % WINPRO LLC STEVENSVILLE 4871766A 1,658 11/13/2021 9015 0.95 BGK BUILDERS LLC STOCKBRIDGE 5908531A 7,552 10/21/2021 5437 0.95 DALTON AND ZICK BUILDERS LLC STOCKBRIDGE 3884953A 1,026 12/29/2021 5606 0.95 K N C FLOOR COVERING LLC STOCKBRIDGE 3810216A 540 10/12/2021 9521 AFIMAC US INC STRONGSVILLE, OH 2741105A 4,216 12/17/2021 3632 MORGAN PUBLISHING LLC STURGIS 5454921A 215 10/27/2021 8810 PERRY PERSONNEL PLUS INC STURGIS 4697146A 34,368 12/1/2021 8102 1.00 STURGIS AVIATION INC STURGIS 3280780A 4,658 10/19/2021 9501 0.91 STURGIS HISTORICAL SOCIETY STURGIS 5929997A 237 10/31/2021 8810 MILLER CONSTANCE SUN PRAIRIE, WI 6070884A 530 11/5/2021 0913 FIRE DEPARTMENT SUNFIELD SEBEWA DANBY SUNFIELD 1452355A 2,793 11/10/2021 7904 0.95 INITIATIVE CONSTRUCTION AND CONSULTANT SUNFIELD 6048552A 750 10/3/2021 5403 LLC MCALLISTER LAWN CARE SUNFIELD 6276890A 759 11/24/2021 0042 ODA ROOFING AND PAINTING LLC SUNFIELD 6246281A 2,013 10/9/2021 5476 JENN ENTERPRISES LLC SUPERIOR TWP 5066107A 750 12/19/2021 5437 FOUNDATION STEEL LLC SWANTON, OH 5099692A 19,873 12/31/2021 5213 0.84 ADVANCED TREE CARE SERVICE INC SWARTZ CREEK 3212700A 9,713 12/28/2021 0106 0.91 CLARK DETTORE ELECTRIC SWARTZ CREEK 5341965A 470 11/11/2021 5190 CRAIGS CONSTRUCTION LLC SWARTZ CREEK 2056569A 750 11/15/2021 5183 D AND H CONCRETE LLC SWARTZ CREEK 5933579A 2,834 11/8/2021 5221 HOWE ART SUPPLIES & GALLERY LLC SWARTZ CREEK 6272487A 752 11/11/2021 8017 JJ HUNTER & ASSOCIATES LLC SWARTZ CREEK 5846528A 464 10/16/2021 7720 K RAY PAINTING SWARTZ CREEK 5728207A 751 11/21/2021 5476 MJ PARAGON BUILDERS SWARTZ CREEK 2446960A 750 10/25/2021 5645

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ONE HUNDRED 17 LLC SWARTZ CREEK 5771579A 750 12/21/2021 5645 PENOYER SCOTT W SWARTZ CREEK 4576977A 825 12/24/2021 5645 R K L ASSOCIATES INC SWARTZ CREEK 4927800A 1,039 12/11/2021 8017 0.95 RELIANT ROOFING LLC SWARTZ CREEK 6262112A 750 10/20/2021 5551 TS LAWNCARE & SNOW REMOVAL SWARTZ CREEK 5126622A 685 12/7/2021 9102 0.95 YOUTH ARTS UNLOCKED SWARTZ CREEK 5921856A 657 10/11/2021 9063 HANSON PROPERTY SERVICES LLC SYLVANIA, OH 5970725A 801 11/26/2021 9102 BLAST TECH SERVICES LLC TAYLOR 5576709A 28,335 12/3/2021 3724 0.77 CUTMYTREEDOWN COM INC TAYLOR 2851415A 49,308 10/26/2021 0106 0.75 DIVERSE TRANSPORTATION SERVICES LLC TAYLOR 5619939A 3,606 10/12/2021 7212 0.95 FOX BUILDING & HOME IMPROVEMENT LLC TAYLOR 6260071A 2,042 10/15/2021 5146 GOURMET AIRFARE DETROIT LLC TAYLOR 5107679A 712 10/22/2021 9058 0.95 HELPERS AT HOME INC TAYLOR 5765919A 1,438 10/20/2021 8835 0.95 HOPPERS TRUCKING INC TAYLOR 4994248A 2,015 10/3/2021 8395 0.95 INDUSTRIAL PAINTING CONTRACTORS INC TAYLOR 3491250A 3,907 10/28/2021 5476 0.95 JAYCO COMFORT SYSTEMS TAYLOR 2382849A 749 10/24/2021 5550 JUST GUTTERS INC TAYLOR 5935636A 707 11/14/2021 5538 KEYES MAINTENANCE LLC TAYLOR 3544206A 619 10/15/2021 9015 0.95 NATE THE CARPET GUY LLC TAYLOR 5075840A 541 12/5/2021 9521 ON THE LEVEL HOME IMPROVEMENT INC TAYLOR 3568997A 800 11/15/2021 5645 PEREZ CONCRETE & REMODELING LLC TAYLOR 5711720A 750 10/19/2021 5221 PRIME TIME DELIVERY INC TAYLOR 3618552A 624 10/23/2021 7360 PRUDENTIAL ALARM INC TAYLOR 5054613D 2,325 10/8/2021 7600 2.58 40 % PRUDENTIAL SECURITY INC TAYLOR 5054613A 75,049 11/10/2021 7720 2.58 40 % RAM ENVIRONMENTAL & CONSULTING SERVICES TAYLOR 5983134A 289 12/4/2021 8601 LLC REA BUILDING CO INC TAYLOR 0418765A 750 10/28/2021 5221 ROCK N RODNEYS SPORTS BAR AND GRILL LLC TAYLOR 5350697A 430 12/20/2021 9058 RUIZ BROTHERS CONSTRUCTION INC TAYLOR 3662470A 833 11/8/2021 5022 0.95 SLOAN ENVIRONMENTAL SERVICES INC TAYLOR 5264588A 932 11/3/2021 5020 2.40 13 % WIELKOPOLAN NICHOLAS TAYLOR 6078214A 750 11/20/2021 5645 TECUMSEH BREAD & PASTRY TECUMSEH 5906229A 559 11/6/2021 2003 BRADS SEPTIC AND SEWER SERVICE LLC TEMPERANCE 3051412A 1,172 12/2/2021 9402 0.95 BROWN PROPERTY MAINTENANCE & SNOW TEMPERANCE 6049532A 806 10/4/2021 9102 REMOVAL LLC

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CARTER BUILDING SERVICES INC TEMPERANCE 2200457A 4,538 12/9/2021 5645 0.90 ER ZEILER EXCAVATING INC TEMPERANCE 0475408A 15,291 11/16/2021 8227 1.54 13 % FRITZ PAINTING LLC TEMPERANCE 6278299A 3,826 12/1/2021 5476 RABB CHERI & MATHEWSON HOLLY TEMPERANCE 6052932A 597 10/8/2021 9015 STEVENS AUTO & TRUCK SALES & PARTS TEMPERANCE 0472840A 753 10/5/2021 8810 TODDS TREE AND CRANE SERVICE LLC TEMPERANCE 4062400A 2,390 10/20/2021 0106 0.95 NORTHWESTERN CONTRACTING INC THOMPSONVILLE 4297237A 1,736 10/27/2021 5445 0.95 DOMESTIC AND SEXUAL ABUSE SERVICES THREE RIVERS 2245221A 3,861 12/1/2021 8832 0.95 JMC CONTRACTING LLC THREE RIVERS 6283276A 755 12/16/2021 5606 AL PEAKE & SONS FOOD SERVICE TOLEDO, OH 6069606A 851 11/4/2021 8742 CLEARVIEW TINTING LLC TOLEDO, OH 6069975A 615 11/2/2021 9521 COMPUTER SOLUTIONS TOLEDO, OH 0162965A 448 10/30/2021 8601 GARDNER CEMENT CONTRACTORS INC TOLEDO, OH 2423626A 750 12/15/2021 5221 0.95 JOB 1 AMERICA INC TOLEDO, OH 4403568A 240,166 10/3/2021 3559 1.21 13 % MIKE WILLIAMS INC TOLEDO, OH 5134307A 915 10/14/2021 5645 NORDMANN ROOFING CO INC TOLEDO, OH 1008064A 825 10/20/2021 5538 RANDLES COMPANY LLC TOLEDO, OH 6260829A 811 10/17/2021 5606 RENHILL HOLDINGS INC TOLEDO, OH 4597966A 6,131 10/3/2021 3681 0.90 RIVERSIDE MARINE INDUSTRIES INC TOLEDO, OH 1563920A 826 10/22/2021 3365 PASONA NA INC TORRANCE, CA 4142977A 717 11/8/2021 8742 ACES MARINE & SALVAGE LLC TRAVERSE CITY 5322766A 5,955 10/31/2021 6400 0.95 AFFORDABLE MOVERS MI LLC TRAVERSE CITY 6081851A 751 12/3/2021 7214 ASSOCIATED RETINAL PROPERTIES LLC TRAVERSE CITY 6278450A 291 12/1/2021 8810 BAY AREA DEMOLITION LLC TRAVERSE CITY 6094740A 8,218 12/11/2021 5403 BAYGEO INC TRAVERSE CITY 0536814A 5,718 10/1/2021 8601 0.95 CALYBR HOMES LLC TRAVERSE CITY 4189132A 750 11/30/2021 5645 CARLYSLE AND LLOYD INC TRAVERSE CITY 3215946A 750 11/20/2021 5645 CASIER GLEN LAKE ORCHARD TRAVERSE CITY 3895033A 475 11/5/2021 0130 CBBN RESTORATION LLC TRAVERSE CITY 6276393A 569 12/6/2021 9015 CLOSETS PLUS OF TRAVERSE CITY LLC TRAVERSE CITY 5327210A 592 10/13/2021 9521 CONSTRUCTION MANAGEMENT CORPORATION TRAVERSE CITY 4956540A 750 10/31/2021 5645 COSTANZA HOMES LLC TRAVERSE CITY 5783747A 800 11/18/2021 5645 COUNCIL OF VOLUNTEERS & MENTORS INC TRAVERSE CITY 4453395A 331 12/31/2021 9058 DAILY STAFFING LLC TRAVERSE CITY 5553008A 4,639 11/6/2021 9058 0.89 DEVRIES DESIGNS INC TRAVERSE CITY 2266890A 238 12/22/2021 8601 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 114 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FANTASIES FANTASIES UNLIMITED LLC TRAVERSE CITY 4041186A 4,089 10/29/2021 8017 0.95 FORTY FIFTH PARALLEL MARINE INC TRAVERSE CITY 6280480A 2,185 12/8/2021 6217 FRESH COAST CLEANING AND MAINTENANCE TRAVERSE CITY 6254268A 619 10/22/2021 9015 LLC GPM PLUMBING & MECHANICAL TRAVERSE CITY 4259378A 674 12/12/2021 5183 GREGORY D SEMAN & CO PC TRAVERSE CITY 2785579A 434 12/20/2021 8803 HARBOR OXYGEN OF TRAVERSE CITY LLC TRAVERSE CITY 3972739A 753 10/10/2021 8810 JOHN ERICKSON INC TRAVERSE CITY 0919535A 750 12/31/2021 5437 LAZAR STUART TRAVERSE CITY 5727618A 530 12/27/2021 0913 LC WELDING TRAVERSE CITY 5637813A 773 11/17/2021 3365 LEO OCANAS FARM TRAVERSE CITY 1358014A 515 10/16/2021 0130 0.95 LUMINEX WINDOW CLEANING LLC TRAVERSE CITY 4886348A 2,772 11/10/2021 9015 0.95 MICHIGAN TOWERS INC TRAVERSE CITY 5407079A 41,261 12/31/2021 7600 0.72 MIGHTY MAID INC TRAVERSE CITY 1822756A 800 12/20/2021 5645 NEITHERCUT PHILANTHROPY ADVISORS LLC TRAVERSE CITY 4953240A 281 12/2/2021 8810 NORTHERN WELDING SPECIALTIES TRAVERSE CITY 2313863A 698 11/19/2021 3365 ON SITE ENGINEERING LLC TRAVERSE CITY 3324680A 584 12/31/2021 8601 0.95 PARSHALL TREE SERVICE LLC TRAVERSE CITY 4805135A 26,874 10/22/2021 0106 0.74 PENFOLD MAUREEN TRAVERSE CITY 3529991A 256 10/30/2021 8810 PLUMBERS PRIDE LLC TRAVERSE CITY 6266878A 561 11/6/2021 5183 PRECISION GAS DETECTION & MEASUREMENT TRAVERSE CITY 5769752A 376 10/26/2021 5191 LLC RANDYS CARPET SERVICE LLC TRAVERSE CITY 2925818A 825 10/9/2021 5403 RICK STRINGER CREATIVE SERVICES LLC TRAVERSE CITY 6285678A 340 12/28/2021 8601 RIDGEBACK OPERATIONS LLC TRAVERSE CITY 5939020A 2,985 12/14/2021 8279 ROLLAND GARY INC TRAVERSE CITY 3688887A 248 12/19/2021 8742 SEUNG NI MARTIAL ARTS ACADEMY INC TRAVERSE CITY 3841006A 1,868 10/11/2021 9063 0.95 SEVENTH LEGACY EVIRONMENTAL LLC TRAVERSE CITY 6084257A 945 12/7/2021 8601 TC FIX IT LLC TRAVERSE CITY 5660602A 2,436 12/21/2021 5437 0.95 TCWC LLC TRAVERSE CITY 5386497A 3,928 12/1/2021 2131 0.95 TIM J SCHAUB CONSTRUCTION INC TRAVERSE CITY 5784026A 800 11/11/2021 5645 0.95 TRAVERSE AREA COMMUNITY SAILING TRAVERSE CITY 4423844A 1,639 12/15/2021 9060 0.95 TRAVERSE CITY HOME INSPECTIONS LLC TRAVERSE CITY 5633192A 1,759 11/11/2021 8720 0.95 TRINITY TILE LLC TRAVERSE CITY 6246397A 750 10/7/2021 5348 TW BUILDING COMPANY LLC TRAVERSE CITY 6069967A 294 11/2/2021 8601

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge VIDEO REPORTING CORPORATION TRAVERSE CITY 2081938A 304 12/8/2021 8742 VISIT UP NORTH VACATION RENTALS LLC TRAVERSE CITY 4201710A 2,536 12/1/2021 9015 0.91 APK INVESTMENTS LLC TRENTON 5944287A 1,523 12/11/2021 5476 BARTRON INC TRENTON 4800532A 810 10/9/2021 8742 0.95 DOUG AND MATTHEW HOME REMODELING LLC TRENTON 5113458A 750 10/21/2021 5437 1.39 13 % LAKEWOOD CONSTRUCTION TEAM LLC TRENTON 0141887A 750 11/14/2021 5645 LITTLE BEAVER LOGGING LLC TROUT LAKE 3003043A 750 10/29/2021 2702 0.95 ABSOLUTE BEST BUILDING MAINTENANCE LLC TROY 5423686A 5,335 12/29/2021 9015 1.00 ADKIN GRIFFIN PAINTING TROY 2407078A 800 11/21/2021 5476 ADVANCED STOREFRONTS INC TROY 1943251A 1,462 10/14/2021 5462 ANNIE FLOORING LLC TROY 4401409A 766 11/7/2021 9521 0.95 APIDERM SKIN CARE CENTER LLC TROY 3043843A 254 10/2/2021 8832 BEACON SQUARE SUBDIVISION ASSOCIATION TROY 4578759A 568 11/30/2021 9015 BOTSFORD COMMONS CONDOMINIUM TROY 5616468A 568 10/6/2021 9015 ASSOCIATION CARE FIRST HOME HEALTH SERVICES INC TROY 5406480A 1,768 12/27/2021 8835 0.95 CHOICE PROPERTIES INC TROY 2148200A 800 12/1/2021 0042 0.95 CORNER CABLE INC TROY 3802205A 13,665 12/2/2021 7600 0.77 DART GROUP INCORPORATED TROY 5336449A 1,868 10/10/2021 7720 0.95 DELTA CONSTRUCTION LLC TROY 5931924A 750 11/3/2021 5403 DEMETER GROUP LLC TROY 6264468A 6,181 10/24/2021 0035 DS INSTALLATION GROUP INC TROY 5947189A 1,849 12/26/2021 5437 EURO MARBLE & TILE INC TROY 3131947A 916 10/6/2021 5348 EVANS INDUSTRIES INC TROY 5943060A 6,848 12/1/2021 3146 1.34 13 % F AND P PAINTING INC TROY 1652508A 750 11/23/2021 5476 0.94 FINISH CARPENTRY COMPANY LLC TROY 6285430A 805 12/23/2021 8810 G AND B TILE & CARPENTRY LLC TROY 5850053A 834 11/20/2021 5437 G W BOAT REPAIR LLC TROY 0080543A 1,751 10/26/2021 6834 0.95 GARDEN OF HOPE SENIOR LIVING LLC TROY 6285864A 2,370 12/29/2021 8835 GLENGARY HILLS CONDOMINIUM ASSOCIATION TROY 5945313A 568 12/14/2021 9015 GREAT LAKES SLEEP MEDICINE INSTITUTE PC TROY 4031628A 305 12/21/2021 8832 HANHO AMERICA CO LTD TROY 6081380A 1,033 12/1/2021 8742 HERITAGE AT RIVERBEND CONDOMINIUM TROY 4684281A 568 10/1/2021 9015 ASSOCIATION HOPE MATTHEW TROY 4769090A 307 12/27/2021 0908 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge IRYNAS CLEANING SERVICES LLC TROY 5903602A 568 10/25/2021 9015 J P CRAIG INC TROY 2321343A 750 12/1/2021 5645 J SAMP CONTRACTING INC TROY 2842173A 750 10/17/2021 5645 KLIMKIEWICS SKYLAR TROY 6080634A 307 11/26/2021 0908 LAKE ARROWHEAD ASSOCIATION TROY 5637155A 568 11/18/2021 9015 LEGACY OF LYON CONDOMINIUM ASSOCIATION TROY 6073042A 568 12/4/2021 9015 LIFE CONSTRUCTION AND DESIGN LLC TROY 5519276A 825 12/8/2021 5183 0.95 LYDIAS CLEANING COMPANY LLC TROY 3043304A 736 10/30/2021 9015 0.95 MAPLE MACHINERY INC TROY 3000397A 32,312 10/16/2021 8265 1.25 13 % MCCANN KURTIS TROY 5010691A 414 11/26/2021 0908 MICHIGAN GENERAL CONTRACTORS LLC TROY 5937795A 750 11/20/2021 5645 NATIONAL MORTGAGE HOME LOANS LLC TROY 5796610A 319 12/13/2021 8810 NAZISH INC TROY 0029289A 1,386 12/19/2021 8017 0.95 NORMANDY OAKS CONDOMINIUM ASSOCIATION TROY 3846059A 568 10/1/2021 9015 OWC MANAGEMENT LLC TROY 6251293A 2,624 10/14/2021 8045 PAOLA M P SEIDEL MD PLLC TROY 5789095A 264 12/1/2021 8810 PINE EAGLES CONDOMINIUM ASSOCIATION TROY 2567199A 568 11/22/2021 9015 POWELL STEVEN AND HOLLY TROY 4639634A 530 10/17/2021 0913 PREMIER POOLS INC TROY 1839942A 477 12/16/2021 8017 PROFORCE PAINT COMPANY LLC TROY 3958809A 750 11/20/2021 5476 R L GREEN CONSTRUCTION INC TROY 3253830A 2,167 11/30/2021 5645 0.95 RJV SOLUTIONS LLC TROY 5891639A 525 12/20/2021 3628 ROSE GARDEN ESTATES ASSOCIATION TROY 5483166A 568 11/23/2021 9015 ROYAL TROON HOMEOWNERS ASSOCIATION TROY 5475155A 568 10/23/2021 9015 SELECTIA PAINTING INC TROY 5919746A 1,003 10/6/2021 5476 SHARP CONCEPTS TROY 0141585A 2,377 12/10/2021 5645 0.95 SIMPAC AMERICA CO LTD TROY 5609933A 705 11/25/2021 8810 TANK JAMES TROY 5849241A 307 12/24/2021 0908 TEMP LABOR INC TROY 6073646A 1,907 11/9/2021 3400 THIRTY THOUSAND 294 LLC TROY 4843240A 8,843 10/3/2021 8831 1.32 27 % TOP QUALITY GRANITE INC TROY 3433633A 1,424 10/23/2021 5348 0.95 TREE SERVICE OF TROY LLC TROY 5009154A 750 12/5/2021 0106 TRION SOLUTIONS III INC TROY 5020050A 412,346 10/3/2021 8395 1.02 TROY GYMNASTICS INC TROY 4181808A 3,276 10/14/2021 9063 1.54 13 % TROY YOUTH ASSISTANCE COMMITEE INC TROY 3262413A 215 11/29/2021 8810 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 117 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TURNBERRY ON THE NEW COURSE AT TROY 5354382A 568 12/17/2021 9015 INDIANWOOD HOMEOWNERS ASSOCIATION TYGRUS LLC TROY 5488745A 2,952 10/18/2021 4828 0.95 VICTORIOUS MMA LLC TROY 5673178A 416 12/8/2021 9063 VICTORY PAINTING LLC TROY 4752481A 800 11/1/2021 5476 VIPER CARBIDE AND METALS INC TROY 6255205A 718 10/6/2021 8018 WOLCOTT MILLS ESTATE ASSOCIATION TROY 6088813B 568 12/1/2021 9015 WOLFE LANDSCAPING AND SNOW SERVICES LLC TROY 5127793A 709 10/17/2021 0042 ANY OL TIME TRANSPORTATION LLC TWIN LAKE 5916992A 2,004 10/3/2021 7212 CBOYS SERVICES LLC TWIN LAKE 3948528A 750 10/29/2021 5645 0.96 SKYLINE SYSTEMS LLC TWIN LAKE 5229499A 522 12/23/2021 8601 VANCE BROWN CONSTRUCTION LLC TWIN LAKE 2429195A 4,270 10/27/2021 5645 TWINING MASON TURNER FIRE DEPARTMENT TWINING 4189639A 1,010 10/17/2021 7704 NAGEL EXCAVATING LLC UNION CITY 2469570A 1,530 10/17/2021 6217 0.95 CASS LAKESIDE COMMUNITY ASSOCIATION UNION LAKE 1628526A 569 10/18/2021 9015 ALDO REMODELING LLC UTICA 5972825A 750 11/3/2021 5645 DOMINGUEZ MENESES BONNIE UTICA 6281150A 750 12/10/2021 5645 HIRED HANDS LLC UTICA 3229700A 825 12/20/2021 5183 MICHIGAN ABOLITIONIST PROJECT UTICA 5783925A 383 12/1/2021 8742 SBK NATIONAL INC UTICA 6064825A 3,034 11/8/2021 8017 SSC CONTRACTING II LLC UTICA 1338307A 825 12/1/2021 5221 B AND L TREE SERVICE VANDERBILT 6278060A 750 12/1/2021 2702 CHAFFEE EXCAVATING & SEPTIC SERVICE VANDERBILT 2247402A 804 10/7/2021 6229 0.95 GLAWE EQUIPMENT CO INC VANDERBILT 0263087A 77,534 10/12/2021 2709 1.72 20 % NORTH EXCAVATING & ASPHALT VANDERBILT 2767350A 750 12/10/2021 5221 LOG N IRON INC VASSAR 3023613A 4,869 11/4/2021 2802 0.92 TREADZ TIRE AND WHEEL LLC VASSAR 6281672A 482 12/11/2021 8395 STEURY CONSTRUCTION LLC VERMONTVILLE 4059158A 750 10/10/2021 5645 ZACHARY KIRKEY MASONRY VERNON 6087485A 750 12/17/2021 5022 LACLEARS DELIVERY SERVICE LLC VESTABURG 5925525A 850 11/9/2021 7208 V CROSS AND SONS LOGGING VESTABURG 4953169A 750 10/8/2021 2702 EILER JOHN VICKSBURG 5139228A 307 12/30/2021 0908 HENDERSON ROOFING GROUP LLC VICKSBURG 5107610A 4,829 11/20/2021 5551 0.95 MR GUTTER VICKSBURG 6119506A 706 11/12/2021 5538 OCTANE TRAILERS LLC VICKSBURG 5815126A 4,024 12/27/2021 3824 1.32 27 %

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge K AND J NORTHBOUND LLC VULCAN 5485886A 2,505 12/7/2021 7208 0.95 WINDGATE TRANSPORTATION INC W BLOOMFIELD 6122361A 10,561 11/14/2021 7202 TRUE NORTH WILDERNESS PROGRAMS LLC WAITSFIELD, VT 5470625A 291 11/16/2021 8810 CLUB 28 INC WAKEFIELD 6246907A 575 10/1/2021 9058 PARTNERS CONSTRUCTION LLC WALDRON 6233830A 750 10/16/2021 5645 BAYER BRENT WALKER 5614864A 750 10/9/2021 5645 DIE TECH SERVICES INC WALKER 3646378A 6,343 12/4/2021 3095 0.76 ALL STAR GUTTER INC WALLED LAKE 4437527A 707 11/2/2021 5538 0.95 BEYOND RESTORATION INC WALLED LAKE 1121995A 1,543 11/23/2021 5437 1.00 ETKIN HELEN WALLED LAKE 0107956A 637 10/31/2021 0908 JAMES BELANGER PLASTERING & DRYWALL LLC WALLED LAKE 5347939A 751 11/26/2021 5445 JEWISH ENSEMBLE THEATRE WALLED LAKE 0282898A 3,735 12/22/2021 9156 0.95 KINVILLE BUILDING LLC WALLED LAKE 5342406A 750 11/12/2021 5645 MAHER RESTORATION INC WALLED LAKE 6278132A 1,924 12/1/2021 9015 MIKE STREHL ENTERPRISES LLC WALLED LAKE 3340120A 1,732 12/9/2021 5437 0.95 PBS TRUCKING INC WALLED LAKE 5329108A 750 10/15/2021 7208 VICKERS LANDSCAPING WALLED LAKE 2396262A 709 12/20/2021 0042 XTREME CONCRETE & CONTRACTING INC WALLED LAKE 5277833A 825 10/12/2021 5221 0.95 ZOLMAN RESTORATION LLC WALLED LAKE 5205549A 55,923 10/31/2021 9015 1.67 10 % GREAT LAKES SEAMLESS GUTTERS & QUALITY WALLOON LAKE 3087115A 750 10/24/2021 5538 ROOFING LLC BRATT LILLIAN WAPPINGERS FALLS, NY 5214831A 1,234 11/28/2021 0908 0.95 A AND C SIDING COMPANY WARREN 3561585A 3,453 10/16/2021 5645 0.95 ABOVE AND BEYOND RENOVATIONS LLC WARREN 6273408A 750 11/12/2021 5645 ARGOS HOME MODERNIZATION WARREN 4039734A 750 10/11/2021 5645 ARK GRANITE & CONSTRUCTION LLC WARREN 5957761A 750 12/17/2021 5437 B AND L PLATING INC WARREN 0429503A 2,840 10/24/2021 3372 0.93 BBEK ENVIRONMENTAL LLC WARREN 5237777A 42,597 10/4/2021 9521 1.35 27 % BOWRON PAUL WARREN 1104764A 615 12/6/2021 9521 BUTCHER BOY FOODS WARREN 1692003A 590 11/21/2021 8031 BWD PAINTING SERVICES LLC WARREN 4648412A 751 12/9/2021 5476 CLOWNEY ALLIANCE LLC WARREN 6205437A 9,645 12/18/2021 5551 CRANBROOK REAL PROPERTY HOLDINGS LLC WARREN 2262240A 750 11/10/2021 5645 DETROIT FABRICATION COMPANY INC WARREN 5187680A 800 10/2/2021 3030 EIGHT MILE PAWN INC WARREN 6340369A 1,823 10/17/2021 8017 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ELEVEN THOUSAND 766 COMMERCE LLC WARREN 6282571A 568 12/15/2021 9015 ELITE TREE SERVICE WARREN 3793460A 751 11/13/2021 0106 EREP ACQUISITION MANAGEMENT LLC WARREN 5068681A 518 12/4/2021 8010 EZ FLOORS LLC WARREN 5921864A 750 10/11/2021 5437 FIRST CHOICE ELECTRIC INC WARREN 3369862A 545 10/23/2021 5190 FLENOR JOHNNY WARREN 3210677A 750 11/7/2021 5437 GREAT LAKES RECOVERY & REPOSSESSIONS WARREN 4606191A 1,530 12/18/2021 7720 0.95 INC HALF PINT INDUSTRIES WARREN 4166272A 750 10/6/2021 5445 HOLY FAMILY LLC WARREN 6271693A 1,583 12/31/2021 9053 HOT SCRUB CARPET LTD WARREN 2269678A 1,545 11/23/2021 9015 0.95 JABLONSKI W J WARREN 2125005A 750 12/28/2021 5462 JOHN WRINKLE CUSTOM PAINTING LLC WARREN 4486552A 750 11/13/2021 5476 KMT SERVICES LLC WARREN 5817684A 3,205 10/18/2021 8018 0.95 LOGISTIC ONE EXPRESS CO WARREN 4916689A 825 10/4/2021 7208 MACOMB PROFESSIONAL BUILDING LLC WARREN 5780365A 618 11/8/2021 9015 MAIN PROPERTY HOLDINGS LLC WARREN 6285732A 885 12/31/2021 8045 MCINTYRE TEMEAKA WARREN 6273394A 569 11/18/2021 9015 MCM CONSTRUCTION LLC WARREN 5942942A 750 12/7/2021 5645 MEDA QUALITY PAINTING LLC WARREN 5756103A 825 10/3/2021 5476 MELVILLES ENTERPRISE INC WARREN 6253334A 4,320 10/8/2021 7219 MICHIGAN DIAGNOSTIC ALCOHOL AND DRUG WARREN 5641497A 865 11/24/2021 8832 SERVICES LLC MICHIGAN MATHEMATICS AND SCIENCE WARREN 4687892A 546 12/3/2021 8868 0.95 INITIATIVE MICHIGAN STORMHAVEN CONSTRUCTION LLC WARREN 4213238A 750 11/6/2021 5476 MICHIGAN YOUTH APPRECIATION FOUNDATION WARREN 5335183A 336 11/1/2021 8810 MIDWEST FUEL INC WARREN 5045215A 1,065 12/11/2021 8017 MIKES CONSTRUCTION WARREN 3720560A 750 12/31/2021 5551 MJC INC WARREN 2463911A 13,327 10/13/2021 8395 0.79 NONOS PIZZA LLC WARREN 1625950A 802 12/18/2021 9058 0.95 PATRIOT MOVING SYSTEMS LLC WARREN 6286135A 750 12/30/2021 8293 PD PAINTING LLC WARREN 6270140A 750 11/6/2021 5476 PETES MARKET INC WARREN 1983806A 544 10/26/2021 8017 PHOENIX FLOORS INC WARREN 2214954A 541 11/14/2021 9521 0.95 PLATINUM PRESERVATION SERVICES INC WARREN 4562828A 568 11/18/2021 9015 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 120 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge POLYTEC FOHA INC WARREN 2049309A 8,011 11/13/2021 8018 0.88 PPI LLC WARREN 5498252A 25,564 10/5/2021 3372 0.71 PROMPT PATTERN INC WARREN 0157724A 4,342 11/7/2021 3085 0.92 PRONKO ENTERPRISES LLC WARREN 6071600A 755 11/20/2021 6504 RALPHS POWERWASHING LLC WARREN 4930290A 568 11/5/2021 8835 REMUS STEPHEN J WARREN 1952412A 750 10/2/2021 5020 RICHARDS FENCE WARREN 1117009A 750 11/11/2021 6400 RICHARDSONS LAWN CARE INC WARREN 4928130A 759 10/29/2021 0042 RINKE HEATING AIR CONDITIONING WARREN 3435539A 674 12/30/2021 5550 REFRIDGERATION LLC ROMAN GRANITE FABRICATORS INC WARREN 3119106A 805 10/25/2021 8810 SASHO INC WARREN 4834127A 878 12/22/2021 9058 SCHWARTZ MOW & SNOW LLC WARREN 4051173A 656 11/28/2021 9102 SKM PROPERTY MAINTENANCE LLC WARREN 6267033A 954 10/31/2021 9015 SPACE CLEANING SERVICES INC WARREN 3422402A 2,424 11/16/2021 9015 0.95 T HOLMES HAULING MOVING LLC WARREN 2218968A 750 12/12/2021 8293 TALIC TRANSPORTATION LLC WARREN 6285376A 750 12/29/2021 7202 TIMS CONSTRUCTION LLC WARREN 2733889A 1,886 10/24/2021 6217 0.95 TQT LLC WARREN 4897919A 837 11/1/2021 8810 TRUDEAU AND ASSOCIATES LLC WARREN 6066763A 229 10/29/2021 8742 VAN DYKE & TOEPFER GAS & MORE INC WARREN 1709011C 512 12/24/2021 8017 0.95 VAUGHAN JAMES WARREN 1015214A 1,366 10/22/2021 5645 0.95 WOODWORK PLUS INC WARREN 3793575A 750 10/15/2021 5437 0.95 ZMW FINISHES WARREN 6255728A 751 10/7/2021 5437 ARTS FINISH CARPENTRY INC WASHINGTON 4254384A 1,145 11/23/2021 5437 BOLLINI FINISH CARPENTRY INC WASHINGTON 3912191A 750 12/13/2021 5437 BOYD EXCAVATING SERVICES LLC WASHINGTON 5247071A 739 12/21/2021 6217 CESARE ANTHONY GROUP LLC WASHINGTON 6010601A 1,372 10/30/2021 5645 0.95 D AND A PAINTING INC WASHINGTON 2709180A 750 11/7/2021 5476 ENVIRONMENTAL SITE SERVICES LLC WASHINGTON 5943051A 739 11/23/2021 6217 KIRIOS ROOFING AND PAINTING INC WASHINGTON 5937515A 834 10/31/2021 5437 0.90 L AND M BUILDING COMPANY LLC WASHINGTON 0171549A 750 10/2/2021 5645 PATILLAS CONSTRUCTION LLC WASHINGTON 5975786A 750 11/25/2021 5645 R AND R TRUCKING INC WASHINGTON 4369890A 1,913 12/5/2021 7208 TIME SAVING REAL ESTATE WASHINGTON 2598531A 307 12/28/2021 8810

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge UNITED SKILLED TRADES OF AMERICA LLC WASHINGTON 3735400A 1,147 10/30/2021 3724 0.95 VIVIANO PAINTING INC WASHINGTON 4062876A 750 10/17/2021 5476 ALB PAINTING & IMPROVEMENTS INC WASHINGTON TOWNSHIP 3019454A 750 12/22/2021 5476 AMBASSADOR PLUS LLC WASHINGTON TWP 4623657A 534 10/29/2021 4361 BURG JAMES AND PARKER BURG CAROL WASHINGTON TWP 5199662A 357 10/15/2021 0908 CLAS ACT CONSTRUCTION LLC WASHINGTON TWP 5635918A 750 11/16/2021 5437 MJ GOLDEN LANDSCAPE LLC WASHINGTON TWP 5789028A 2,622 11/29/2021 0042 0.95 SALVA HOMES INC WASHINGTON TWP 3435245A 753 10/15/2021 8810 SMITH WILLIAM L WASHINGTON TWP 5040698A 631 10/20/2021 3724 THUNDER TRANSPORTATION INC WASHINGTON TWP 6251307A 3,120 10/5/2021 7208 WORLD CLASS PAINTING & EPOXY FLOORING WASHINGTON TWP 4128818A 750 10/4/2021 5476 LLC CARPIN MANUFACTURING INC WATERBURY, CT 5623561A 430 10/25/2021 8742 ABSOLUTE MOBILE HOME INC WATERFORD 4872134A 800 11/18/2021 5476 ALL PHASES ASPHALT PAVING LLC WATERFORD 3777723A 2,441 10/10/2021 5221 0.95 ARBORIST PRIME LLC WATERFORD 5862388A 2,800 10/19/2021 0106 0.95 BOSS CONSTRUCTION & LANDSCAPING WATERFORD 3093913A 784 10/4/2021 9402 SERVICES INC BURKES PAINTING WATERFORD 0410888A 800 12/19/2021 5476 0.95 BURNS CONSTRUCTION MAINTENANCE INC WATERFORD 3377288A 706 12/2/2021 9015 BUTCHS WOODWORK WATERFORD 2893363A 750 12/30/2021 5213 CLARKSTON EMPLOYEE LEASING SERVICES INC WATERFORD 4057970A 48,096 12/2/2021 8395 1.50 27 % CORNELL FIELD VIBRATION SERVICES INC WATERFORD 4800125A 529 10/8/2021 3685 DOUBLE PANE WINDOW CLEANING LLC WATERFORD 5538033A 1,673 11/20/2021 9015 0.95 FIREPLACES PLUS LLC WATERFORD 1772295A 882 11/17/2021 5022 GENERAL MOVERS INC WATERFORD 5944104A 750 12/15/2021 7214 GOLD BY DESIGN LLC WATERFORD 5318912A 313 10/22/2021 8601 HAQ HOME IMPROVEMENT LLC WATERFORD 5923115A 5,595 11/20/2021 5645 HP RENOVATIONS INC WATERFORD 5492920A 6,159 12/18/2021 5437 K C DRYWALL INC WATERFORD 5785405A 750 11/22/2021 5445 KENNICO CONSTRUCTION LLC WATERFORD 0022411A 1,399 11/6/2021 5645 0.95 KEVIN EDWARDS CONSTRUCTION INC WATERFORD 1433636A 750 11/12/2021 5645 LITTLE DEVIL CLEANING INC WATERFORD 5723302A 1,135 10/30/2021 8835 LIVING IN STYLE DESIGN LLC WATERFORD 6270107A 1,042 11/6/2021 5476 MANGA AUTO COLLISION INC WATERFORD 6284027A 419 12/17/2021 8393

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MOTOR CITY AUTOMOTIVE OF WATERFORD LLC WATERFORD 6257275A 977 10/9/2021 3821 NE QUICK LUBE & DETAILING INC WATERFORD 5944171A 1,847 12/11/2021 8387 0.95 NEW SKYLINE CONSTRUCTION LLC WATERFORD 3692728A 7,967 11/14/2021 5215 0.93 OAKWOOD TREE SERVICE LLC WATERFORD 0406376A 751 11/26/2021 0042 ON THE GO MOWING WATERFORD 6070574A 706 11/6/2021 9102 POWWOW LLC WATERFORD 3939081A 5,073 10/10/2021 7422 0.91 PREMIER KNOCK OUT CLEANING AND TRASH INC WATERFORD 6076289A 1,164 11/16/2021 9015 RUMO CONSTRUCTION LLC WATERFORD 3708063A 800 10/29/2021 5551 SBF SERVICE CO INC WATERFORD 4704614A 992 11/23/2021 9402 SHOOK LISA WATERFORD 6285333A 860 12/23/2021 0913 SOS NOW BUILDING AND CONTRACTING LLC WATERFORD 6278884A 750 12/2/2021 5437 SPECTACULAR BUILDING COMPANY LLC WATERFORD 6049893A 825 10/4/2021 5645 STATEWIDE STONEWORKS INC WATERFORD 6066070A 750 11/17/2021 5022 SUPERIOR LANDSCAPE CORPORATION WATERFORD 5768101A 1,785 10/24/2021 9102 0.95 THORNBERRY LAWN CARE LLC WATERFORD 6280617A 706 12/8/2021 9102 TOP NOTCH TILE INC WATERFORD 5424224A 750 11/6/2021 5348 TRANSCENDENCE PROCESS LLC WATERFORD 6080316A 302 11/25/2021 5191 TRIPLE H ELECTRIC LLC WATERFORD 4739876A 2,445 10/14/2021 5190 0.95 UNIQUE ONE AIRCRAFT INTERIORS INC WATERFORD 5210879A 1,784 11/15/2021 7423 0.95 W J STEWART CONTRACTING CORPORATION WATERFORD 0563382A 6,030 11/5/2021 5538 0.87 WHEELKARE LLC WATERFORD 6081789A 828 12/14/2021 7212 WATERSMEET CUSTOM FLOORING WATERSMEET 4687493A 751 12/2/2021 5348 ANGAD INC WATERVLIET 5342090A 583 11/1/2021 8017 ANDERSON FOREST PRODUCTS LLC WAUSAUKEE, WI 0646377A 750 11/15/2021 2702 EXTENSION INC WAUWATOSA, WI 5770700A 343 10/30/2021 8810 ABLE CONSTRUCTION COMPANY LLC WAYLAND 3633829A 750 12/7/2021 5645 0.95 BIONDO RICHARD WAYLAND 5842395A 750 11/7/2021 5645 DORR LEIGHTON WASTEWATER AUTHORITY WAYLAND 3457354A 467 10/1/2021 8810 ELITE CLEANING AND PAINTING WAYLAND 6278388A 568 12/7/2021 9015 GREENWAY TRANSPORTATION INC WAYLAND 2645394A 750 12/28/2021 7208 VANDERROEST THOMAS WAYLAND 0458007A 750 10/30/2021 5645 B T S LOGISTICS INC WAYNE 5214254A 758 12/19/2021 8810 BAILEY STEPHEN WAYNE 6275362A 750 11/18/2021 5645 BLUE LINE CONSTRUCTION SERVICES INC WAYNE 5917662A 750 11/4/2021 5645 HOLISTIC HEALTH WAYNE INC WAYNE 6081827A 3,510 12/3/2021 8045 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 123 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge J N WINDOWS LLC WAYNE 6272444A 750 11/11/2021 5645 JOHNNY CS PAINTING WAYNE 6275192A 750 11/18/2021 5476 LITTLE DANIEL B WAYNE 3111032A 750 11/13/2021 5645 METRO FENCE LLC WAYNE 4210140A 750 12/31/2021 5645 SIGNATURE RECOVERY SERVICES INC WAYNE 4305957A 10,180 12/11/2021 7720 1.63 27 % TWO BROTHERS CONSTRUCTION LLC WAYNE 5396727A 5,666 10/1/2021 5403 0.93 USA CONSTRUCTION OF MICHIGAN INC WAYNE 3378179A 1,980 11/21/2021 5645 0.95 JUDD JEFFREY D WEBBERVILLE 0478830A 750 11/16/2021 7208 BLOCK FARM OPERATIONS LLC WEIDMAN 5796601A 2,962 12/13/2021 0128 0.95 DOUG THEISEN MASONRY WEIDMAN 2710960A 1,093 10/28/2021 5221 0.95 HUMANE ANIMAL TREATMENT SOCIETY WEIDMAN 4548183A 3,805 10/5/2021 8831 0.95 C E & G TRANSPORT SERVICES INC WENTZVILLE, MO 5913284A 3,259 10/1/2021 7202 0.95 PAWL INVENTIONEERING CORP WEST BLOOMFIELD 3098427A 215 11/17/2021 8810 ASHMARK CONSTRUCTION LLC WEST BLOOMFIELD 4138210A 825 12/31/2021 5190 ASKAR FAISAL WEST BLOOMFIELD 6047211A 215 10/29/2021 8810 AUSIS EXTERIOR WEST BLOOMFIELD 5184703A 800 12/10/2021 5552 0.95 AYAR CONSTRUCTION LLC WEST BLOOMFIELD 5609909A 800 10/18/2021 5403 0.95 BAKERS BRICKCLEANING & CAULKING INC WEST BLOOMFIELD 2693577A 800 12/17/2021 5476 BELLA VISTA APARTMENTS OF LINCOLN PARK WEST BLOOMFIELD 6252311A 568 10/7/2021 9015 LLC CAPTIVATING HOMES LLC WEST BLOOMFIELD 3634434A 750 10/19/2021 5645 CHELSEA CONSTRUCTION LLC WEST BLOOMFIELD 6084044A 750 12/7/2021 5645 CLYDE CONSTRUCTION INC WEST BLOOMFIELD 4570863A 751 10/31/2021 5190 COSTA PROPERTIES INC WEST BLOOMFIELD 4698991A 1,034 12/17/2021 9015 CURRAN DEVELOPMENT COMPANY WEST BLOOMFIELD 2310473A 750 11/11/2021 5445 DDR CONTRACTORS LLC WEST BLOOMFIELD 4081269A 750 12/11/2021 5183 EASTERN RAPID RESPONSE SANITIZE LLC WEST BLOOMFIELD 6284787A 643 12/19/2021 8835 ELIAS ENTERTAINMENT COMPANY LLC WEST BLOOMFIELD 3842282A 963 11/6/2021 9058 0.95 ELITE CONSTRUCTION GROUP INC west BLOOMFIELD 5930740A 831 11/15/2021 5606 EXCEPTIONAL AUTO DETAIL LLC WEST BLOOMFIELD 6027075A 515 10/9/2021 8387 GOUTMAN STEPHEN WEST BLOOMFIELD 5642604A 580 12/8/2021 0913 HONEY LOCUST PRODUCTIONS LLC WEST BLOOMFIELD 5444233A 288 10/23/2021 8601 HOWARD S WEINGARTEN BUILDER LLC WEST BLOOMFIELD 3575900A 959 11/9/2021 5606 0.95 IDEAL BUILDERS & REMODELING INC WEST BLOOMFIELD 2526883A 754 11/2/2021 5606 JRT ARCADE VENDING LEASING REPAIR LLC WEST BLOOMFIELD 6281559A 1,416 12/10/2021 5192

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge KARP GABRIELLA WEST BLOOMFIELD 1999958A 530 12/20/2021 0913 KAUFMAN EMILY west BLOOMFIELD 5916933A 382 10/3/2021 0908 LUCIANOS CUSTOM PAINTING LLC WEST BLOOMFIELD 4081536A 800 10/10/2021 5476 0.95 METRO MOBILITY TRANSPORTATION AND WEST BLOOMFIELD 5773113A 2,940 11/19/2021 7212 0.95 CONSULTING SERVICES LLC NELSON MASONRY & CONSTRUCTION INC WEST BLOOMFIELD 5607132A 1,728 11/15/2021 5022 0.95 ON THE MARK CONTRACTORS LLC WEST BLOOMFIELD 4855744A 2,001 12/27/2021 5445 0.95 PIONEER DEVELOPMENT COMPANY WEST BLOOMFIELD 0190381A 643 10/13/2021 8810 RAFI AND NIVEEN CORP WEST BLOOMFIELD 3166902A 1,002 10/7/2021 9058 0.95 SAIF HERMEZ INC WEST BLOOMFIELD 6257100A 2,355 10/9/2021 8017 SATOVSKY NEIL A WEST BLOOMFIELD 1396269A 307 12/7/2021 0908 SEELIG ENTERPRISES INC WEST BLOOMFIELD 2786290A 1,496 12/19/2021 5476 SHERMAN GERALD DR WEST BLOOMFIELD 1449338A 307 12/24/2021 0908 SIGNED IDEAS LLC WEST BLOOMFIELD 0785121A 590 12/19/2021 4299 STARWOOD WASTE LLC WEST BLOOMFIELD 6280838A 800 12/11/2021 7213 SUDDRAM UMA WEST BLOOMFIELD 6073409A 860 11/9/2021 0913 TECHBORNE INC WEST BLOOMFIELD 3018814A 749 10/30/2021 5550 TRITECH ELECTRICAL SERVICES LLC WEST BLOOMFIELD 4261950A 471 12/4/2021 5190 VAN ACKER ASSOCIATES LLC WEST BLOOMFIELD 6058434A 229 10/16/2021 8742 VERSATILE CONTRACTORS INC WEST BLOOMFIELD 0734756A 2,490 11/17/2021 5476 0.95 VPN LLC WEST BLOOMFIELD 5634881A 2,517 11/16/2021 7206 0.95 WINTER WALDEN SKI CLUB INC WEST BLOOMFIELD 1546341A 1,554 12/12/2021 9015 0.95 HAYMAN ALAN WEST BLOOMFIELD TWP 1094270A 307 11/16/2021 0908 DARRIS B RICHARDS ATTORNEY AT LAW PLLC WEST BRANCH 3069877A 223 10/9/2021 8820 GODFREY CHRISTOPHER WEST BRANCH 6253822A 750 10/1/2021 5645 GOJCAJ FOODS INC WEST BRANCH 1615041A 4,747 11/15/2021 9058 0.95 GREG WANGLER TRUCK REPAIR LLC WEST BRANCH 4315367A 992 10/2/2021 8395 JNS WOOD PRODUCTS WEST BRANCH 3712281A 750 11/7/2021 2702 KELLY CONSTRUCTION WEST BRANCH 4654900A 750 11/19/2021 5221 LUCAS HOBIE WEST BRANCH 4270142A 3,106 10/18/2021 2731 0.95 OGEMAW COUNTY AGRICULTURAL SOCIETY WEST BRANCH 1820524A 568 10/1/2021 9015 PARTLO MARK WEST BRANCH 6280951A 750 12/9/2021 2702 SAWYER LOGGING LLC WEST BRANCH 5650542A 750 12/19/2021 2702 LE TOTE INC WEST CHESTER, OH 6141366A 2,156 11/8/2021 8039 AIRE TITE LLC WEST OLIVE 5596289A 675 11/6/2021 5550

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge K AND M PRECISION SHOOTING PRODUCTS LLC WEST OLIVE 5052980A 649 12/21/2021 3400 LAKE MICHIGAN HEATING AND COOLING LLC WEST OLIVE 6268595A 674 11/4/2021 5550 M E CLEANING LLC WEST OLIVE 5356040A 568 12/30/2021 9015 MACHINE CONTROL INTEGRATORS LLC WEST OLIVE 5201900A 470 10/23/2021 5190 GLOBAL TECHNICAL RECRUITERS WESTLAKE, OH 5325110A 17,726 10/11/2021 8059 0.72 A HEATING AND COOLING OUTLET WESTLAND 6254381A 674 10/5/2021 5550 AJ TREE SERVICE INC WESTLAND 2902753A 8,157 10/10/2021 0106 1.33 13 % ANDYS PRO PAINTING LLP WESTLAND 6275257A 751 11/18/2021 5476 B AND C CONSTRUCTION CONSULTANTS LLC WESTLAND 5783895A 278 11/18/2021 8810 BCA CUSTOM CARPENTRY LLC WESTLAND 5598125A 750 10/28/2021 5645 0.95 BEST WAY EXPEDITING LLC WESTLAND 2684489A 833 11/4/2021 8810 0.92 DIXSON LANDSCAPING INC WESTLAND 5125820A 4,076 10/8/2021 0042 1.00 DOWLING JOSEPH T WESTLAND 6275613A 750 11/20/2021 5645 DPI GRAPHICS INC WESTLAND 4998499A 1,175 10/8/2021 9522 0.95 FAITHFUL HANDS CORP WESTLAND 4474112A 4,420 10/5/2021 8835 0.95 FREEDOM HOLSTERS LLC WESTLAND 6255639A 454 10/9/2021 8010 FSQ ENTERPRISE LLC WESTLAND 5693640A 750 11/14/2021 7208 HOME HEALTH CARE SERVICES LLC WESTLAND 5961700A 2,906 12/6/2021 8835 HUSH HAUNTED ATTRACTION LLC WESTLAND 6018130A 1,970 10/1/2021 9015 0.95 J AND A CONSULTING LLC WESTLAND 5630894A 1,679 10/1/2021 8017 KAUR CONSTRUCTION LLC WESTLAND 5702771A 732 11/7/2021 5606 0.95 LTW CONSTRUCTION LLC WESTLAND 6282300A 750 12/14/2021 5645 M D SMOKER SHOP LLC WESTLAND 4908139C 395 10/20/2021 8006 0.95 MDM WELDING INC WESTLAND 5291739A 826 12/5/2021 5102 NEW REGAL LIQUOR & FOOD MARKET INC WESTLAND 4579011A 594 12/28/2021 8017 0.95 SHAHAN JOSEPH WESTLAND 6281117A 541 12/10/2021 9521 STEWARTS TREE SERVICE INC WESTLAND 3096041A 750 10/14/2021 0106 SURE CARE ENTERPRISES LLC WESTLAND 5322910A 350 10/14/2021 9063 WORLDWIDE PAINTING WESTLAND 3133389A 750 12/10/2021 5476 DEBBIE WASSERMAN SCHULTZ FOR CONGRESS WESTON, FL 6266800A 241 11/3/2021 8810 NORTH COUNTRY INSPECTION SERVICES LLC WHITE CLOUD 4477413A 842 10/14/2021 8720 B ROBERTS BUILDING SERVICES LLC WHITE LAKE 5927137A 750 10/24/2021 5645 BARAIACS LANDSCAPING LLC WHITE LAKE 6264220A 709 10/23/2021 0042 HAVERHILL EQUESTRIAN CENTER LLC WHITE LAKE 1177788A 5,179 12/21/2021 8279 0.91 ICON MATERIAL HANDLING LLC WHITE LAKE 6274722A 2,067 11/24/2021 5146 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 126 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge INNOVATE CONSTRUCTION SERVICES LLC WHITE LAKE 2928531A 750 11/14/2021 5437 JAKES LAWN CARE LLC WHITE LAKE 6053815A 523 10/15/2021 9102 JM CONSTRUCTION LLC WHITE LAKE 4784120A 750 10/26/2021 5645 QUALITYS BEST PAINTING WHITE LAKE 0750697A 750 10/16/2021 5476 RICKS PLUMBING WHITE LAKE 2246260A 561 10/26/2021 5183 SENTRY CONTRACTORS INC WHITE LAKE 0579289A 750 12/16/2021 5403 SUPERIOR AUTOMOTIVE LIFTS & EQUIPMENT WHITE LAKE 4923065A 2,034 10/21/2021 3724 0.95 LLC VINCELLI CONSTRUCTION & RESTORATIONS LLC WHITE LAKE 5203660A 750 11/8/2021 5479 0.95 WILLIS LAWN & SNOW WHITE LAKE 2393425A 728 12/19/2021 9102 LAWS LAWN CARE & PROPERTY MAINTENANCE WHITE PIGEON 6278078A 656 12/1/2021 9402 LLC ALGOT JOHNSON POST 69 INC WHITEHALL 0413585A 963 12/12/2021 9061 0.95 ARBOR MASTER TREE SERVICE INC WHITMORE LAKE 4389697A 4,351 10/22/2021 0042 0.92 BIG IKES ROOFING CO WHITMORE LAKE 1420747A 6,074 11/16/2021 5645 0.92 DESTRUCTION DEPOT LLC WHITMORE LAKE 6259332A 1,194 10/31/2021 9015 FLOORING DESIGN SPECIALTIES LLC WHITMORE LAKE 5031559A 2,866 11/26/2021 9521 0.95 GREAT LAKES ENVIRONMENTAL SERVICE INC WHITMORE LAKE 3594629A 21,316 10/26/2021 9015 0.71 MRI LEASING LLC WHITMORE LAKE 5803179A 571 12/22/2021 8832 NORTHWEST CONTRACTING INC WHITMORE LAKE 0882038A 38,159 11/7/2021 5645 1.20 SBREI INC WHITMORE LAKE 0563188A 675 10/14/2021 8810 ALLY EXPLORATION LLC WILLIAMSBURG 5082293A 324 10/30/2021 8810 BRADSHAW CUSTOM TILE INC WILLIAMSBURG 5587832A 750 11/4/2021 5348 GOD BLESS OUR BUSINESS INC WILLIAMSTON 5346118A 706 10/27/2021 9402 JACK DUNCAN PALMER BUILDER WILLIAMSTON 0326160A 4,991 11/21/2021 5437 1.00 WYN FARM LLC WILLIAMSTON 5342465A 4,313 12/19/2021 8279 1.00 BENCHEA PAVEL WILLIS 4030770A 750 10/11/2021 5348 HUNTINGTON VALLEY VENTURES INC WILMINGTON, DE 6066020A 10,582 10/26/2021 8045 0.95 DENNIS MOTTO TRUCKING INC WILSON 2152118A 750 10/15/2021 7208 HAMMERBERG EXCAVATING WILSON 2036339A 825 10/26/2021 7208 WILLA DOUGLAS WILSON 2988321A 750 11/22/2021 2709 BELLA SOL WELLNESS CENTERS OF MICHIGAN WIMAUMA, FL 6029396A 1,573 12/3/2021 8045 LLC ISABELLA COUNTY SPORTSMANS CLUB WINN 2764415A 343 11/23/2021 9061 BATTERY SOLUTIONS LLC WIXOM 0383880A 568 10/29/2021 8810 C AND M CONSTRUCTION CORP WIXOM 1968173A 750 10/9/2021 2802 6/30/2021 9:11:11 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 127 Assigned Risk Renewals: October/November/December

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CEDAR PRESERVATION SYSTEMS LLC WIXOM 4704347A 12,594 11/23/2021 9015 1.44 13 % CONVEYALL INDUSTRIAL SUPPLY INC WIXOM 3689816A 730 12/15/2021 8742 0.95 DETROIT FINNISH CO OPERATIVE SUMMER CAMP WIXOM 1893696A 630 10/18/2021 9015 ASSOC INC MARSH CLEANING SERVICE WIXOM 6036244A 569 10/6/2021 9015 PAULSON MICHAEL WIXOM 5489300A 750 12/9/2021 5445 R AND G PAINTING HOME AND IMPROVIEMENT WIXOM 5570611A 825 10/6/2021 5476 LLC TREEMAN TREE SERVICE INC WIXOM 2571595A 2,737 10/22/2021 0106 0.95 TRUMOTION AUTOMATION SYSTEMS INC WIXOM 1755722A 422 11/7/2021 8601 VIP CONSTRUCTION LLC WIXOM 6052762A 5,907 10/22/2021 5645 0.95 WE CARE MOVERS LLC WIXOM 6080286A 2,424 11/23/2021 8293 AFFORDABLE TREE MAINTENANCE WOLVERINE 4859952A 750 10/21/2021 0106 GODDARD CONSTRUCTION WOLVERINE 6286348A 750 12/31/2021 5645 KARL VROMAN TIMBER SERVICES LLC WOLVERINE 2052024A 750 10/26/2021 2702 WHITTAKER CONSTRUCTION LLC WOLVERINE 3443310A 750 10/10/2021 5645 CRH 1227 LLC WOLVERINE LAKE 5915660A 800 10/6/2021 5403 ONE HUNDRED 14 LLC WOODBRIDGE, NJ 3534570A 7,640 10/1/2021 8279 0.88 A B E TRUCKING LLC WOODHAVEN 6263658A 750 10/22/2021 7208 HERBERT AND SON CONSTRUCTION WOODHAVEN 3717933A 750 10/15/2021 5403 TOMS MAINTENANCE CO INC WOODHAVEN 1775979A 568 11/16/2021 9015 WOODLAND FOREST PRODUCTS INC WOODLAND 0926671A 3,359 11/11/2021 2731 0.95 A 1 SUNSHINE WINDOW CLEANING LLC WYANDOTTE 4107063A 953 10/1/2021 9015 0.95 BEST BUY BLINDS BY THE LEIGHS LLC WYANDOTTE 3569632A 279 10/10/2021 8742 BRIGHT AND SHINY LLC WYANDOTTE 5713501A 1,413 11/10/2021 9015 CLEAN CUT ABATEMENT INC WYANDOTTE 5199735A 4,475 10/5/2021 5183 0.92 DIVISION ABATEMENT & DISMANTLEMENT INC WYANDOTTE 2445654A 587 11/5/2021 8742 0.95 KAREN AND DEAN INC WYANDOTTE 6061060A 750 10/21/2021 5645 KOSTELNIK INC WYANDOTTE 3278913A 2,770 12/27/2021 5551 0.84 OVERLAND TRUCK & TRAILER REPAIR INC WYANDOTTE 4951344A 4,502 10/13/2021 8395 1.00 RB TOOL AND ENGINEERING INC WYANDOTTE 6070086A 471 11/2/2021 8742 ROLSTON TRANSPORTATION LLC WYANDOTTE 1441728A 750 11/12/2021 7208 ROMINES CARPET SERVICE LLC WYANDOTTE 3875792A 1,812 11/16/2021 9521 ROYAL MOVERS ENTERPRISES LLC WYANDOTTE 6261450A 1,898 10/17/2021 7214 STOREY TIMOTHY WYANDOTTE 5915643A 750 10/1/2021 5645

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TABIN CARPETS LLC WYANDOTTE 5939011A 1,888 11/22/2021 9521 TRENTON PIER I CONDOMINIUM ASSOCIATION WYANDOTTE 5941113A 618 12/3/2021 9015 ABC DRYWALL WYOMING 4536266A 5,344 10/12/2021 5445 0.94 BEST MAINTENANCE SERVICES INC WYOMING 4556011A 7,624 10/3/2021 9015 0.84 CASTLE IMPOUND LLC WYOMING 6278647A 335 12/2/2021 8748 DESIGN PINNACLE GROUP LLC WYOMING 6262813A 359 10/21/2021 8601 DIAZ GULIBANDO WYOMING 3588025A 750 12/9/2021 5445 GRUCZ KATHY WYOMING 4158334A 618 12/28/2021 9015 JEREMY JUREWICZ PAINTING WYOMING 4225198A 750 11/23/2021 5476 KELLEY DEWATERING AND CONSTRUCTION INC WYOMING 1153803A 30,599 10/1/2021 5183 1.72 13 % KLINE INSTALLATIONS INC WYOMING 3569462A 590 12/9/2021 9521 0.95 MAC WALLCOVERING AND PAINTING WYOMING 5882281A 750 10/9/2021 5476 CRAFTSMEN LLC NEW BEGINNING STAFFING LLC WYOMING 6284019A 6,479 12/17/2021 8209 PROFESSIONAL MTZ INTERIORS WYOMING 5622182A 25,001 10/15/2021 5403 0.78 PROPER ROOFING SOLUTIONS LLC WYOMING 6262384A 750 10/21/2021 5551 PROPERTY DOUGH LLC WYOMING 6280382A 800 12/8/2021 5445 RAMIREZ GALVEZ ERIK JEU WYOMING 5956633A 825 11/23/2021 5645 RODRIGUEZ ALFREDO WYOMING 6082424A 750 12/5/2021 5476 SECURITY OVERHEAD DOOR LLC WYOMING 3508951A 750 11/10/2021 5102 STONEGATE CONDOMINIUM ASSOCIATION WYOMING 2616092A 568 10/21/2021 9015 TOP CARE LAWN MAINTENANCE LLC WYOMING 2662973A 523 10/26/2021 9102 YANEZ MATIAS BARRON WYOMING 6048510A 750 10/3/2021 5445 GARDNER CONTRACTING YALE 0273899A 1,183 11/8/2021 6217 0.95 KELLER AUSTIN YALE 6255140A 750 10/7/2021 5645 A AND C TILES & HARDWOOD FLOORS YPSILANTI 3545067A 750 11/12/2021 5348 A CHILDS WORLD LEARNING CENTER LLC YPSILANTI 3279545A 645 11/25/2021 8869 B AND G AUTO SALVAGE LLC YPSILANTI 2486067A 751 12/9/2021 3821 0.95 BALDWIN LAWN CARE LLC YPSILANTI 4988302A 656 12/15/2021 9102 CAMPUS CONCEPTS MOVE SHIP AND STORE LLC YPSILANTI 5772419A 11,731 10/31/2021 7214 1.17 CARL THE CARPET INSTALLER LLC YPSILANTI 5171350A 1,001 11/27/2021 9521 CLASSIC CARPET CARE INC YPSILANTI 2427532A 568 10/7/2021 9015 CMJ SECURITY LLC YPSILANTI 4150279A 449 11/29/2021 7720 CONTEMPORARY MEDIA WORKS INC YPSILANTI 4912705A 564 12/22/2021 7610 CORRY S CONTRUCTION CO INC YPSILANTI 6082181A 750 11/30/2021 6325

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CUSTOM CARE PROS YPSILANTI 6063217A 760 10/23/2021 0042 D W HAUSHALTER DESIGNER BUILDER LLC YPSILANTI 2518325A 1,216 10/12/2021 5022 0.95 DANILOS CLEANING SERVICES YPSILANTI 5934320A 2,064 11/10/2021 9015 ECF CLEANING SERVICES LLC YPSILANTI 6084370A 568 12/7/2021 9015 FOE AERIE 2250 YPSILANTI 1014986A 533 11/30/2021 9058 HERNANDEZ CONSTRUCTION YPSILANTI 6264476A 750 10/26/2021 5645 HOHMAN BATTERY SUPPLY INC YPSILANTI 0847054A 888 12/15/2021 8395 HOLY CREEK NON PROFIT HOUSING YPSILANTI 6036643A 1,428 12/12/2021 9015 CORPORATION JEFF BRAMLETT HEATING & COOLING INC YPSILANTI 5942896A 3,165 12/5/2021 5550 0.95 JIMMY VS CONSTRUCTION LLC YPSILANTI 4067541A 9,961 10/10/2021 5645 0.78 LTR GENERAL CONSTRUCTION YPSILANTI 5723272A 825 12/23/2021 5403 MACS CONSTRUCTION SOLUTIONS LLC YPSILANTI 5930936A 800 11/9/2021 5645 MCGUIRE ANTHONY YPSILANTI 5921813A 658 11/20/2021 9102 MICH CONSTRUCTION INC YPSILANTI 4630424A 800 11/13/2021 5403 NELSONS CONSTRUCTION LLC YPSILANTI 5324009A 3,024 10/28/2021 5476 0.95 PEDRO SALAZAR DRYWALL INC YPSILANTI 4267494A 750 12/14/2021 5445 PJ RENOVATIONS LLC YPSILANTI 5415829A 1,831 10/10/2021 5645 0.95 PREMIUM GREEN LLC YPSILANTI 6281648A 569 12/11/2021 9015 PVL CONSTRUCTION YPSILANTI 3559050A 825 11/5/2021 5551 0.95 QDEN CONSTRUCTION LLC YPSILANTI 6086810A 800 12/16/2021 5645 SEVEN ELEVEN STORE 1971 32330D YPSILANTI 4521072A 1,140 10/16/2021 8017 0.95 TEAMSYLVESTER ROOFING AND CONSTRUCTING YPSILANTI 2718600A 750 10/3/2021 5551 LLC VOGUE SQUARED LLC YPSILANTI 5920272A 290 10/9/2021 8810 ZELISSE DAVID YPSILANTI 1371878A 800 12/1/2021 0042 ZEN RESTORATION INC YPSILANTI 5922968A 825 12/15/2021 9015 BLACK CREEK CONSTRUCTION INC ZEELAND 3983102A 750 12/27/2021 5190 CLAYS CONSTRUCTION LLC ZEELAND 5646510A 750 12/13/2021 5645 CREATIVE DIMENSIONS INC ZEELAND 3979148A 1,010 11/8/2021 5645 DAVE DEZWAAN BUILDERS LLC ZEELAND 4386507A 750 10/15/2021 5348 J AND M TRANSPORT SYSTEMS LLC ZEELAND 6254411A 7,185 10/3/2021 7208 JAGER MCCLEERY ENTERPRISES LLC ZEELAND 6055427A 750 10/11/2021 5645 JOHNSONS ROOFING LLC ZEELAND 2967405A 1,784 10/15/2021 5551 0.95 MISSION PARTNERS INDIA INC ZEELAND 5062195A 342 12/11/2021 8810

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PATRICK J SIBLEY BUILDER INC ZEELAND 2665018A 750 12/1/2021 5437 0.95 PK ELECTRICAL LLC ZEELAND 5795095A 470 12/20/2021 5190 TEKTON CERAMIC TILE LLC ZEELAND 4282191A 751 11/1/2021 5348 UNITED CAR PROCESSING INC ZEELAND 2064960A 14,136 10/31/2021 7208 0.81 VEENSTRA KENNETH K ZEELAND 5623863A 750 10/19/2021 5348

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