Michigan Workers Compensation Placement Facility Depopulation Report Page 1 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ACE EXCAVATING ACME 3116484A 814 2/28/2021 6217 CATCH ONE LLC ADA 5889553A 1,032 3/10/2021 9058 DDW SERVICES LLC ADA 6094627A 750 1/10/2021 5403 DLW DEVELOPMENTS LLC ADA 6144179A 545 3/30/2021 8742 JDV LLC ADA 5160650A 569 1/1/2021 9015 0.95 JRUITER LLC ADA 5966930A 385 2/13/2021 8810 LEVERING WILLIAM ADA 5697360A 750 3/31/2021 5551 MARTHAS HOME HEALTH CARE LLC ADA 3196828A 471 3/9/2021 8835 MICHAEL NOSKO INC ADA 5355877A 388 1/1/2021 5606 RAYNOR OVERHEAD DOOR OF GRAND RAPIDS ADA 0046809A 2,038 1/17/2021 3724 0.95 INC SCRIPSEMA JACK ADA 0304670A 530 1/1/2021 0913 SHAVELL DAREN ADA 5694019A 471 2/18/2021 8835 VANDER LUGT PHIL ADA 5961610A 530 2/13/2021 0913 VERKAIK CONTRACTING LLC ADA 4759400A 750 3/12/2021 5437 SKDT LLC ADDISON 6137261A 2,599 3/31/2021 8045 TACKETTS SERVICE COMPANY ADDISON TWP 4119088A 737 3/16/2021 3096 0.95 AFFORDABLE TOWING & AUTOMOTIVE REPAIR ADRIAN 5253080A 800 3/26/2021 8395 0.95 ANNAS ADULT NOVELTIES LLC ADRIAN 5447674A 639 1/30/2021 8017 H L GREEN MACHINE MOVING ADRIAN 4359941A 750 1/19/2021 7208 HABITAT FOR HUMANITY LENAWEE COUNTY INC ADRIAN 1959514A 6,699 3/22/2021 8017 0.96 KEENER DON ADRIAN 5695376A 571 3/27/2021 0908 KISMET ENTERPRISES INC ADRIAN 5378290A 882 2/27/2021 8017 0.95 RIGHT TOUCH FLOORING LLC ADRIAN 6101895A 1,838 1/20/2021 9521 S AND D ENDEAVORS LLC ADRIAN 5609879A 569 3/11/2021 9015 SAM BEAUFORD WOODSHOP ADRIAN 5977274A 963 3/20/2021 2790 WAYFINDER LLC ADRIAN 1606875A 565 3/11/2021 8395 YOUNGS AUTO PARTS & RECYCLING LLC ADRIAN 5253560A 752 3/25/2021 8395 HOUTHOOFD BUILDERS LLC AKRON 2230917A 750 1/1/2021 5437 HUNTMAN BUILDERS INC ALANSON 5845882A 750 3/23/2021 5645 WILLIAMS EXCAVATING INC ALANSON 0205095A 5,849 2/11/2021 6217 0.91 DORAN THOMAS C ALBION 6087973A 860 1/1/2021 0913 HEISLER FARMS ALBION 1722522A 524 1/1/2021 0128 MARENGO TOWNSHIP ALBION 0279870A 2,927 3/1/2021 7904 0.95 MICHIGAN INDUSTRIAL GASES INC ALBION 1987810A 3,826 2/17/2021 7380 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 2 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TREK TRANSPORT INC ALBION 1566695A 857 2/6/2021 8810 WBI INSULATION & BUILDING LLC ALBION 5077281A 825 1/19/2021 5479 MILLER PAUL ALGONAC 2975572A 896 3/7/2021 5183 ROBINS AIRE TEMP LLC ALGONAC 5003083A 750 3/1/2021 5550 SONNY TS INC ALGONAC 3580342A 3,022 3/1/2021 9058 0.95 AGERA CUSTOM HOMES LLC ALLEGAN 6058442A 9,110 1/9/2021 5645 ALLEGAN FIRE DISTRICT ALLEGAN 4207351A 13,347 1/1/2021 7904 1.48 27 % DECK MASTERS LLC ALLEGAN 6087124A 1,740 3/25/2021 5645 ELENBAAS RUSSEL B ALLEGAN 5682401A 750 3/1/2021 7208 HISCOCK DAVE ALLEGAN 2200570A 5,109 2/1/2021 7208 0.93 JRB PROPERTIES MANAGEMENT LLC ALLEGAN 6118925A 751 3/31/2021 5403 LAKE EFFECT INTERIOR INSTALLATION INC ALLEGAN 4184939A 751 3/28/2021 5445 1.00 LIGHTHOUSE ROOFING GROUP LLC ALLEGAN 5971047A 5,924 2/28/2021 5551 LOOMIS REDI MIX CONCRETE LLC ALLEGAN 3158438A 3,991 1/10/2021 7208 0.95 MORGAN CLARK ASSOCIATES LLC ALLEGAN 5520363A 333 2/24/2021 8601 DETROIT CAULKING LLC ALLEN PARK 5681855A 825 2/25/2021 5476 DETROIT LIONS INC ALLEN PARK 0042684A 930,043 1/1/2021 9179 2.90 40 % HAWLEY HEATING & COOLING LLC ALLEN PARK 4662407A 675 2/12/2021 5550 J AND J TORCH & WELD INC ALLEN PARK 4585984A 2,643 2/4/2021 3365 0.95 K AND W INSTALLATIONS LLC ALLEN PARK 5668280A 1,733 2/2/2021 5645 0.95 LJ AND T INC ALLEN PARK 2259532A 957 3/8/2021 9058 PANDA PRODUCTS LLC ALLEN PARK 4494113A 1,104 1/22/2021 9060 1.00 PROFESSIONAL LABORATORY MANAGEMENT INC ALLEN PARK 0393860A 2,984 2/2/2021 8810 0.95 PROSTAR PROFESSIONAL SERVICE GROUP LLC ALLEN PARK 5977061A 11,651 3/19/2021 7720 SEASONAL PROPERTY MANAGEMENT LLC ALLEN PARK 5807808A 5,426 1/11/2021 0042 0.95 SJH LLC ALLEN PARK 5819318A 1,027 2/3/2021 8017 TNT CONTRACTING ALLEN PARK 6134190A 1,328 3/11/2021 5221 VILLARREAL MAINTENANCE & SNOW ALLEN PARK 6101801A 750 1/18/2021 5437 VILLAS LANDSCAPING LLC ALLEN PARK 5966507A 1,165 2/9/2021 0042 XS TOTAL CLEAN UP AND JUNK REMOVAL LLC ALLEN PARK 5970474A 802 2/26/2021 9015 AROY THAI INC ALLENDALE 5627087A 942 3/13/2021 9058 0.95 DECKS IN A DAY LLC ALLENDALE 6137300A 1,795 3/19/2021 5403 ELITE PAINTING SOLUTIONS LLC ALLENDALE 5374456A 800 3/3/2021 5476 0.95 JEFF ROWLADER BUILDER LLC ALLENDALE 1044281A 750 1/7/2021 5645 POSTEMA CONSTRUCTION LLC ALLENDALE 4074700A 750 2/7/2021 5437 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 3 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PRECISE GRADING LLC ALLENDALE 4663853A 739 1/16/2021 6217 RIDGELAND BUILDERS LLC ALLENDALE 0720941A 750 1/28/2021 5645 TOM BRUGGINK DRYWALL COMPANY ALLENDALE 1967053A 750 2/25/2021 5445 SMALL TIME MASONRY LLC ALLENTON 1527169A 3,058 2/17/2021 5022 1.00 ADAM DREW TRUCKING LLC ALMA 5832918A 750 3/13/2021 7208 CLASSY AUTO WASH LLC ALMA 5904544A 735 1/1/2021 3724 0.95 DUHADWAY DANCE DIMENSIONS LLC ALMA 3892603A 572 1/10/2021 9063 TC PREMIER LINING LLC ALMA 6096506A 438 1/11/2021 4484 LEONARDO LJULJDURAJ CUSTOM PAINTING INC ALMONT 4320328A 800 3/9/2021 5476 ALPENA CLAY BUSTERS INC ALPENA 3878724A 346 1/27/2021 9061 ALPENA COUNTY ALPENA 6149693A 52,920 1/1/2021 7720 BCUBED MANUFACTURING LLC ALPENA 5966833A 9,444 2/12/2021 2802 BIG RED CONSTRUCTION CASEY KREY LLC ALPENA 5469066A 8,615 2/2/2021 5645 0.92 FORTY WINKS MOTEL AND VACATION RENTALS ALPENA 5655471A 379 1/5/2021 9052 GALLAGHERS AFC HOME LLC ALPENA 5953960A 471 1/17/2021 9053 GREAT LAKES AIR INC ALPENA 0590088A 2,375 1/1/2021 7422 0.95 HURON HUMANE SOCIETY INC ALPENA 1731106A 1,738 1/1/2021 8831 0.95 LALONDE BUILDING & REMODELING LLC ALPENA 5795842A 2,863 3/20/2021 5437 MB PAINTING ALPENA 3871908A 1,025 3/17/2021 5476 0.95 MELVILLE KENNETH W ALPENA 1337327A 735 1/1/2021 0908 RJF TECHNICAL SERVICES LLC ALPENA 5980526A 1,088 3/29/2021 3724 ROMEL ALEX ALPENA 5958989A 750 1/25/2021 2709 C AND J FLOOR COVERING INC ALTO 5232171A 750 1/28/2021 5437 J RITSEMA PAINTING LLC ALTO 5349990A 750 3/6/2021 5476 JACKSON AVIATION SERVICES LLC ALTO 4113349A 1,262 1/11/2021 7422 0.95 KLAAD CONSTRUCTION ALTO 6128980A 750 3/3/2021 5437 MSV CONSTRUCTION INC ALTO 5802814A 2,876 1/6/2021 1624 0.95 TRUMBLE JOSH ALTO 3674738A 750 3/20/2021 5348 TNE CORPORATION ANCHORVILLE 1190636A 2,778 1/4/2021 3724 0.95 STAFFING SERVICES INC ANGOLA, IN 5802903A 751 1/17/2021 2003 1.00 A 2 ELECTRIC PLLC ANN ARBOR 4599560A 1,066 3/13/2021 5190 0.95 AMERICAN CENTER FOR MOBILITY ANN ARBOR 5651743A 1,753 1/1/2021 8810 0.95 AMR INDUSTRIES INC ANN ARBOR 3587401A 15,923 1/16/2021 7214 0.83 ANN ARBOR AMATUER HOCKEY ASSOC ANN ARBOR 0639710A 302 1/19/2021 8810 ANN ARBOR AREA BOARD OF REALTORS ANN ARBOR 0666068A 298 3/13/2021 8742 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 4 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ANN ARBOR BED & BREAKFAST LLC ANN ARBOR 3846890A 1,143 3/28/2021 9052 0.95 ANN ARBOR FABRICATION INC ANN ARBOR 1743414D 711 1/1/2021 5606 0.95 ANN ARBOR STREET ART FAIR ANN ARBOR 0642592A 368 3/15/2021 8810 ANN ARBOR STUDENT BUILDING INDUSTRY ANN ARBOR 2622564A 750 1/5/2021 5476 PROGRAM INC ANNAS ACQUISITION COMPANY LLC ANN ARBOR 4946138A 2,078 1/1/2021 8017 0.95 ARACHNE TECHNOLOGIES LLC ANN ARBOR 5228905A 2,231 1/18/2021 8045 0.95 ARBOR CORPORATION INC ANN ARBOR 5900239A 431 2/5/2021 8810 ARBOR LANDSCAPING AND LAWN CARE INC ANN ARBOR 4752937A 801 3/31/2021 0042 0.95 ARBOR MILLWORKS & DESIGN ANN ARBOR 1522590A 650 2/17/2021 2812 ARTISAN COFFEE IMPORTS LLC ANN ARBOR 6104010A 215 2/1/2021 8810 ASHES INC ANN ARBOR 5978769A 1,616 2/13/2021 9015 AZTECH PAINTING & DRYWALL LLC ANN ARBOR 3627900A 2,202 3/24/2021 5445 0.95 BALMORAL PARK CONDOMINIUM ASSOCIATION ANN ARBOR 4163257A 568 3/13/2021 9015 BARTON HILLS COUNTRY CLUB OF ANN ARBOR ANN ARBOR 0000078A 547 2/1/2021 9060 1.12 BCN MEASUREMENT SERVICES INC ANN ARBOR 4405668A 89,851 1/28/2021 5183 0.79 BCN SERVICES MECHANICAL INC ANN ARBOR 4047419A 216,399 1/9/2021 5538 1.10 10 % BCN TRANSPORTATION WEST INC ANN ARBOR 3591085A 9,717 2/12/2021 3724 0.86 BEANS BEST LLC ANN ARBOR 5667046A 1,799 1/28/2021 9501 0.95 BRAINTRAINERS LIMITED LIABILITY COMPANY ANN ARBOR 4564464A 535 1/13/2021 8832 BRIDGETOWN CONDOMINIUM ASSOCIATION ANN ARBOR 2605856A 568 2/23/2021 9015 BRYANTS QUALITY PAINTING INC ANN ARBOR 1759523A 939 2/11/2021 5476 0.95 BY THE RIVER CARPENTRY LLC ANN ARBOR 4279034A 1,525 1/4/2021 5437 CARE MANAGEMENT BY NATALIE LLC ANN ARBOR 5948193A 1,542 1/2/2021 8835 CHRIS KURTZ PAINTING & HOME REPAIR ANN ARBOR 5830630A 826 2/22/2021 5476 CLIFFS LANDING CONDOMINIUM ASSOCIATION ANN ARBOR 0818917A 568 3/12/2021 9015 COTTONWOOD CONDOMINIUM ASSOCIATION ANN ARBOR 2585278A 580 1/1/2021 9015 CROSS STREET PROPERTIES LLC ANN ARBOR 5936225B 922 2/22/2021 9015 DETAIL ROOFING AND CONSTRUCTION LLC ANN ARBOR 4311779A 977 1/15/2021 5645 DIVERS INC ANN ARBOR 2210649A 1,310 2/13/2021 8017 0.95 DLC LLC DEANS LAWN CARE ANN ARBOR 4003993A 709 1/13/2021 0042 EP 2 INVESTMENT HOLDINGS LLC ANN ARBOR 0790672A 620 2/15/2021 8810 EVERGREEN MEADOWS CONDOMINIUM ANN ARBOR 3540677A 643 1/21/2021 5183 ASSOCIATION EWING THOMAS L ANN ARBOR 2314355A 763 1/1/2021 9015

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 5 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge EXCLUSIVE BRANDS LLC ANN ARBOR 5821770A 4,327 2/9/2021 0035 0.95 EXPLAINED LLC ANN ARBOR 6135900A 263 3/14/2021 4511 FAIRWAY OUTDOOR SERVICES INC ANN ARBOR 3221962A 17,829 3/11/2021 0106 1.44 GAILSCO INC ANN ARBOR 3756386A 800 2/21/2021 7208 GAILUNAS HOME SERVICES INC ANN ARBOR 1166140A 750 3/6/2021 5645 0.95 GARDEN ME UP LLC ANN ARBOR 6120199A 1,286 2/17/2021 0042 GATWARD CAROYLN ANN ARBOR 5974461A 851 3/9/2021 0908 GEORGE LESLIE G JR ANN ARBOR 6135358A 530 3/16/2021 0913 GERYCZ FINISH CARPENTRY ANN ARBOR 2289008A 750 2/21/2021 5437 GO TO ROOFING INC ANN ARBOR 5676932A 8,125 2/20/2021 5645 GYM AMERICA INC ANN ARBOR 1383400A 4,169 2/6/2021 9063 0.95 HABITAT FOR HUMANITY OF HURON VALLEY ANN ARBOR 2635224A 825 2/21/2021 5550 0.95 HARRIS SANDRA ANN ARBOR 5972680A 307 3/5/2021 0908 HENLYN CARE ANN ARBOR 3707083A 1,261 1/26/2021 9053 0.95 HEWETT CARPENTRY & CONSTRUCTION L L C ANN ARBOR 6114440A 825 2/7/2021 5437 INTENTIONS LLC ANN ARBOR 3369013A 670 3/26/2021 9063 IRVINE ONDREY ENGINEERING LLC ANN ARBOR 5515904A 3,764 2/12/2021 3724 0.95 J H CAMPBELL INC ANN ARBOR 3751112A 752 2/4/2021 5645 JEWISH RESOURCE CENTER ANN ARBOR 4827260A 1,192 3/26/2021 8868 0.95 KEIL POWER SKATING INC ANN ARBOR 5271665A 2,071 1/1/2021 9015 0.95 KIN MOVEMENT INC ANN ARBOR 5676371A 300 3/1/2021 9063 MAJESTIC BUILDING SERVICES LLC ANN ARBOR 3677249A 5,051 3/11/2021 5645 0.95 MAPLE VILLAGE CONDOMINIUM ASSOCIATION ANN ARBOR 3352277A 1,504 3/10/2021 9015 MAVEN DEVELOPMENT LLC ANN ARBOR 3763919A 1,237 3/22/2021 5606 MEYER SEAN ROBERT ANN ARBOR 5974240A 530 3/25/2021 0913 MICHIGAN MENTAL HEALTH NETWORKER INC ANN ARBOR 4331362A 960 3/24/2021 9402 0.95 MILFORD KNOLLS CONDOMINIUM ASSOCIATION ANN ARBOR 4725530A 568 3/3/2021 9015 NEWTACK LLC ANN ARBOR 5807913A 249 1/11/2021 8810 OAKBROOK VILLAS CONDOMINIUM ASSOCIATION ANN ARBOR 4724283A 568 2/3/2021 9015 PACKARD AUTO REPAIR LLC ANN ARBOR 5230500A 1,488 3/14/2021 8395 0.95 PENNISI BROTHERS LLC ANN ARBOR 5517389A 800 2/17/2021 5437 PHOENICIAN THYME LLC ANN ARBOR 3457761A 827 2/11/2021 9058 PINE RIDGE LLC ANN ARBOR 2327414A 1,184 1/9/2021 8835 0.95 POTTOW JOHN ANN ARBOR 4313534A 530 3/25/2021 0913 PREMIUM EVENT SERVICES LLC ANN ARBOR 6113605A 460 2/28/2021 8810 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 6 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge RED YOGA LLC ANN ARBOR 5478723A 612 3/12/2021 9063 0.95 RW PAINT AND DESIGN LLC ANN ARBOR 6137032A 751 3/19/2021 5476 SALLIE HAMILTON PERSONNEL INC ANN ARBOR 0855863A 1,871 3/7/2021 4484 STONEBRIDGE LINKS CONDOMINIUM ANN ARBOR 5960819A 568 1/31/2021 9015 ASSOCIATION SUMMIT HOMEBUILDING LLC ANN ARBOR 3743314A 750 3/6/2021 5645 TGAAS LLC ANN ARBOR 2653796A 798 1/18/2021 9015 TJT RENOVATION ANN ARBOR 5919886A 750 2/22/2021 5437 TOOL SHOP LLC ANN ARBOR 5382866A 467 3/7/2021 8010 WATZA BUSINESS ADVISORY SERVICES LLC ANN ARBOR 6112153A 522 1/31/2021 8601 WEIDMAYER FARMS LLC ANN ARBOR 0253642A 505 1/17/2021 0128 WORKFORCE ALTERNATIVES INC ANN ARBOR 0903523A 118,330 1/1/2021 3040 1.31 WORKFORCE TRADITIONS INC ANN ARBOR 3710823A 37,627 1/1/2021 8393 0.79 WRCO ACP A JOINT VENTURE ANN ARBOR 6112137A 825 1/31/2021 5020 C JS INSULATION LLC APPLEGATE 5250480A 957 3/14/2021 5479 0.95 NARRAMORE CHRISTIAN FOUNDATION ARCADIA, CA 5378770A 472 2/28/2021 8810 SCAFFOLD DESIGN & ERECTION INC ARCHBOLD, OH 1326660A 13,974 1/1/2021 9529 0.84 HARDWOOD CONSTRUCTION INC ARMADA 1850253A 750 2/5/2021 5437 MOORE LAWN MAINTENANCE ARMADA 4873505A 573 3/4/2021 9102 ORCHARD CONSTRUCTION INC ARMADA 2094592A 836 1/1/2021 8810 HEALTH AND SAFETY SCIENCES LLC ASHLAND, KY 5964962A 525 2/6/2021 7720 FISHER CONSTRUCTION ATLANTA 3724743A 2,737 3/22/2021 5437 0.95 GEORGIA DEPARTMENT OF REVENUE ATLANTA, GA 5977363A 313 3/22/2021 8810 HIBNER FOREST PRODUCTS LLC ATLANTA 4858085A 750 3/1/2021 2709 LAKE DEVELOPMENT CUSTOM HOMES LLC ATLANTA 3695611A 750 3/19/2021 5403 PORTERS PENINSULA LOGGING LLC ATLANTA 2039079A 1,463 3/6/2021 2702 VISIONARY CONSTRUCTION INC ATLANTA, GA 5693730A 3,884 3/29/2021 9015 0.93 THOMAS SANFORD & ASSOCIATES ATLAS 4904168A 618 2/9/2021 9015 ARBOR TREE SERVICE INC ATTICA 2737850A 49,844 1/1/2021 0106 1.17 13 % EXTREME TOOL DISTRIBUTION INC ATTICA 5386578A 433 3/14/2021 8010 MINORS LANDSCAPING LLC ATTICA 6111327A 1,181 2/3/2021 9102 N AND R CUSTOM CONSTRUCTION LLC ATTICA 2746123A 11,007 2/23/2021 5645 0.92 OBERTEIN CONSTRUCTION LLC ATTICA 4004965A 3,755 1/1/2021 5645 0.95 XTREME SHREDS LLC ATTICA 5383960A 705 3/10/2021 8264 SHF TRUCKING LLC AUBURN, IN 6009719A 6,226 1/28/2021 7208

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 7 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TOP PRIORITY TREE SERVICE LLC AUBURN 5377196A 2,919 3/18/2021 0106 0.95 BISHOP AND GUERIN MAINTENANCE INC AUBURN HILLS 0713694A 2,782 1/1/2021 9015 0.94 CAREER GROWTH ASSOCIATES INC AUBURN HILLS 3726495A 341 2/18/2021 8742 CASA VILLARREAL CLEANING SERVICE LLC AUBURN HILLS 5372755A 569 2/14/2021 9015 DREAMWORK CONSTRUCTION LLC AUBURN HILLS 5960100A 825 2/13/2021 5348 ECLIPSE LIGHTING LLC AUBURN HILLS 6110304A 1,288 1/29/2021 5191 FABULOUS PEOPLE LLC AUBURN HILLS 5813395A 2,563 1/20/2021 8868 0.95 FENKELL AUTOMOTIVE SERVICES LTD AUBURN HILLS 0176214A 30,893 1/1/2021 8395 0.95 HEATHER LAKE ESTATES HOMEOWNERS AUBURN HILLS 4410300A 569 2/25/2021 9015 ASSOCIATION HIBBARD INSHORE LLC AUBURN HILLS 3745864A 3,330 2/21/2021 8601 0.95 MR VALET LLC AUBURN HILLS 5968267A 902 2/19/2021 8392 SANDALWOOD SOUTH ASSOCIATION AUBURN HILLS 5819431A 568 2/3/2021 9015 USZTAN LLC AUBURN HILLS 0690333A 825 2/1/2021 5403 VILLAS AT NORTHRIDGE CONDOMINIUM OWNERS AUBURN HILLS 5680298A 568 3/1/2021 9015 ASSOCIATION CLEAR VIEW WINDOW CLEANING AUGRES 4927249A 869 1/1/2021 9015 POSTLEWAIT BUILDERS LLC AUGUSTA 4661257A 750 1/10/2021 5645 0.92 RADIX TECHNOLOGIES LLC AUGUSTA 5889286A 470 1/10/2021 5190 NL DALLAS STAFFING LLC AUSTIN, TX 6110258A 2,625 3/9/2021 7380 LESTER ROBERT B AVOCA 2956535A 2,081 1/13/2021 0913 0.95 MASE TRUCKING LLC AVOCA 6090419A 800 1/1/2021 7208 HURON COUNTY COALITION AGAINST DOMESTIC BAD AXE 4036107A 369 2/1/2021 8810 ABUSE SHEMKA AND SON TRUCKING LLC BAD AXE 5977940A 7,048 3/19/2021 7208 SHEMKA TRUCKING LLC BAD AXE 4730569A 41,259 3/23/2021 7208 0.85 THUMB RADIO INC BAD AXE 0140902A 5,705 1/3/2021 7600 0.87 THUMB TUMBLERS LLC BAD AXE 5816386A 467 2/6/2021 9063 HIGH PERFORMANCE HOMES LLC BAILEY 5237955A 3,039 2/20/2021 5645 0.95 M W ELECTRICAL LLC BANCROFT 5837421A 532 3/10/2021 5190 AMERICAN EAGLE HOME IMPROVEMENT LLC BANGOR 5657377A 800 1/10/2021 5551 0.95 C AND RS OUT ON A LIMB TREE CARE LLC BANGOR 5563194A 14,747 3/9/2021 0106 KULA FARMS LLC BANGOR 5972302A 7,947 3/7/2021 0035 SHARP TILE LLC BANGOR 3889840A 750 3/1/2021 5348 FERRALLS TREE TRIMMING & REMOVAL INC BANNISTER 3475700A 7,828 3/8/2021 0106 0.89 CCI ARNHEIM INC BARAGA 2647605A 574 1/1/2021 8810 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 8 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BRENDAN LEBOEUF TRUCKING BARK RIVER 5925061A 750 1/15/2021 7208 DEROCHERS SAND & GRAVEL BARK RIVER 2033194A 800 1/12/2021 7208 LAFAVE LOGGING INC BARK RIVER 5387892A 750 3/18/2021 2709 TOTO KLEENING INC BARK RIVER 5719100A 790 1/10/2021 9015 UP TOP NOTCH TREE CARE BARK RIVER 5636574A 753 1/19/2021 0106 ZACH DEROCHER TRUCKING BARK RIVER 5526310A 750 3/10/2021 7208 MERRILL WOOD PRODUCTS INC BARRYTON 0348775A 750 3/6/2021 2709 WILDCAT LANDSCAPE LLC BARRYTON 5485843A 1,124 2/10/2021 9402 0.95 WORLD SOURCE INTEGRATION INC BATAVIA, IL 5954657A 407 1/21/2021 8810 APEX SERVICES LLC BATH 5652995A 750 1/25/2021 5445 LERAY STEEL WELDING INC BATH 0466190A 2,954 2/15/2021 3040 0.94 LOOMIS CHAD BATH 6098010A 801 1/14/2021 5476 SCOTT FREDRICKSON CONSTRUCTION CORP BATH 1551787A 825 3/30/2021 5551 SIMPLY SOCIAL LLC BATH 5964075A 432 2/5/2021 8868 WILLORY LLC BATH, OH 5041880A 387 2/27/2021 8810 AFFORDABLE SYSTEM INSTALLATIONS INC BATTLE CREEK 4316045A 419 2/15/2021 5191 BATTLE CREEK AREA HABITAT FOR HUMANITY BATTLE CREEK 3777642A 800 3/1/2021 8742 BC HOME REPAIR BATTLE CREEK 6137580A 800 3/20/2021 5645 BEECH AND RICH INC BATTLE CREEK 0001074A 750 1/28/2021 5476 BOWERS ALUMINUM COMPANY BATTLE CREEK 5966906A 678 2/12/2021 8810 BULLSEYE PROPERTY MANAGEMENT LLC BATTLE CREEK 6135196A 524 3/13/2021 9102 CEREAL CITY CREATIVE CONCEPTS LLC BATTLE CREEK 5491703A 277 1/1/2021 8869 CHOICECARE IV INC BATTLE CREEK 4756088A 1,661 3/26/2021 9053 COWBOY STA2Z BATTLE CREEK 6113192A 317 2/7/2021 9586 EDWARDS CONSTRUCTION BATTLE CREEK 4214803A 800 2/11/2021 5645 FLEET WORKS OF WEST MICHIGAN LLC BATTLE CREEK 5228948A 532 1/18/2021 8395 J AND T PROPERTY SERVICES BATTLE CREEK 6111610A 524 1/30/2021 9102 MEJIA RAMIREZ YOLANDA BATTLE CREEK 6099076A 6,592 1/16/2021 5445 MOBILITY MOTORS LLC BATTLE CREEK 6128785A 443 2/28/2021 8742 NEW LEVEL SPORTS MINISTRIES INC BATTLE CREEK 5508738A 570 1/11/2021 9063 0.95 PRIMO CONSTRUCTION AND RESTORATION LLC BATTLE CREEK 6109500A 750 1/28/2021 5403 PRO FLOW DRAIN CLEANING LLC BATTLE CREEK 6118127A 562 2/13/2021 5183 ROCK AND DIRT TRANSPORTATION LLC BATTLE CREEK 4459458A 4,702 3/1/2021 7208 0.93 RUSSELL AND ASSOCIATES BATTLE CREEK 2949946A 229 1/5/2021 8742 SIOUX LAND MARKETING SERVICES INC BATTLE CREEK 4033108A 6,080 3/10/2021 0129 0.86 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 9 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WHAT A DO THEATRE INC BATTLE CREEK 6112102A 1,121 2/1/2021 9154 WINGS OF A DOVE BATTLE CREEK 5807824A 372 2/1/2021 8832 WYATT TRUCKING INC BATTLE CREEK 4244923A 3,813 2/2/2021 8395 0.95 ADVANCED FIBER & COAX COMMUNICATIONS BAY CITY 5190355A 2,435 2/24/2021 7600 LLC ALWAYS WIRED LLC BAY CITY 5804450A 877 1/4/2021 5190 BRADLEY JEANNE BAY CITY 5833361A 307 3/5/2021 0908 CAT V ENGINEERING INC BAY CITY 3425010A 802 2/7/2021 8810 CLIMAX FAMILY REMODEL BAY CITY 6029116A 750 3/1/2021 5403 EUCLID COATING SYSTEMS INC BAY CITY 4306694A 305 1/23/2021 3574 GOT ALL AUTO PARTS INC BAY CITY 5007445A 5,360 2/6/2021 8010 0.89 HASSO ENERGY LLC BAY CITY 6112463A 442 2/5/2021 1320 HAYWARD WILLIAM F BAY CITY 0619310A 751 3/8/2021 5476 KRAMERS FOOD EXPRESS BAY CITY 0974641A 719 1/18/2021 8031 MID MICHIGAN FIBERGLASS INC BAY CITY 3432467A 1,141 3/27/2021 6834 0.95 PINE RIDGE AFC HOME LLC BAY CITY 2116243A 1,059 2/5/2021 9053 0.95 PLEASURE CRAFT OUTFITTERS BAY CITY 0650730A 2,799 3/29/2021 9522 0.95 REVAN MARAGIRI MD PLC BAY CITY 3332233A 380 1/12/2021 8832 SCHWAB CONTRACTING LLC BAY CITY 5024498A 750 1/5/2021 6217 0.92 TAWAS BEACH CLUB BAY CITY 1457977A 653 1/24/2021 9061 TNT CONSTRUCTION BAY CITY 5202604A 750 3/16/2021 5645 UNCLE BUDS PROVISIONING CENTER LLC BAY CITY 5806518A 532 3/22/2021 8045 0.95 WALRAVENS POOL SERVICE INC BAY CITY 6126170A 1,817 2/27/2021 9015 WEST CONTRACTING LLC BAY CITY 4251784A 750 1/1/2021 5645 XSCAPEQUEST LLC BAY CITY 5710715A 1,327 2/8/2021 9015 C AND C DRYWALL LLC BEAR LAKE 5975220A 1,418 3/12/2021 5445 DITTMAN MECHANICAL CONTRACTORS INC BEAVERTON 1945181A 749 3/13/2021 5550 0.95 TERRY LEE CONSTRUCTION LLC BEAVERTON 2054590A 800 3/13/2021 5645 MOLL LEONA BELDING 1946579A 808 1/1/2021 0129 0.95 NORTHERN FINISHERS LLC BELDING 5977800A 800 3/16/2021 5645 P W PLUMBING LLC BELDING 5532531A 1,105 3/22/2021 5183 SELECT FINISHES BELDING 5654548A 1,857 2/13/2021 5445 0.95 FOREST TRAIL DESIGN PLC BELLAIRE 6098142A 239 1/14/2021 8601 LODGE AT CEDAR RIVER VILLAGE CONDOMINIUM BELLAIRE 4702425A 618 1/1/2021 9015 ASSOCIATION

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ROTH CONTRACTING LLC BELLAIRE 4839293A 750 2/17/2021 5348 ALL YEAR TREE SERVICE INC BELLEVILLE 3807991A 800 3/17/2021 0106 BASS HOME IMPROVEMENT LLC BELLEVILLE 5047030A 750 1/29/2021 5538 0.95 BIG PAULS HOME IMPROVEMENT LLC BELLEVILLE 4315740A 750 2/22/2021 5645 CASEYS GLASS BELLEVILLE 1394428A 2,354 1/15/2021 5462 0.95 ERIC CHRISTMAN & SONS BELLEVILLE 2503255A 1,387 1/11/2021 6217 0.95 EVANS TILE INC BELLEVILLE 6136982A 750 3/18/2021 5348 HARDER HOME IMPROVEMENTS INC BELLEVILLE 1562975A 11,508 1/28/2021 5437 HAWKEYE MAINTENANCE LLC BELLEVILLE 5812011A 569 1/19/2021 9015 HORTONS ROOFING BELLEVILLE 5279917A 800 2/19/2021 5551 IND TRUCKING LLC BELLEVILLE 5959780A 2,848 3/11/2021 7208 LAKE POINTE CONTRACTORS BELLEVILLE 3008932A 751 3/18/2021 5645 LOAD SIDE ELECTRIC CO INC BELLEVILLE 4432509A 546 3/28/2021 5190 MORRIS MACHINE SERVICES LLC BELLEVILLE 6127789A 631 2/28/2021 3724 NEW BEGINNINGS RESTORATION INC BELLEVILLE 4278267A 9,906 3/12/2021 5645 1.32 13 % NINETY FOUR & HAGGERTY INC BELLEVILLE 2785340A 1,113 3/23/2021 8017 0.90 PAULS TOWING & SERVICE INC BELLEVILLE 4716124A 826 3/3/2021 7208 0.94 REGENERATED CORE FLOORING LLC BELLEVILLE 6100872A 750 1/17/2021 5437 TIMBERWOLF CONSTRUCTION LLC BELLEVILLE 4795857A 750 2/15/2021 5645 0.95 TWO TS HOME CLEANING LLC BELLEVILLE 5976642A 568 3/16/2021 9015 WOLVERINE STATE PLUMBING INC BELLEVILLE 5978106A 636 3/22/2021 5183 BRYANTS TRUCKING & EXCAVATING BELLEVUE 5504996A 4,982 1/16/2021 5221 0.95 JOHN ANGUS TRUCKING LLC BELLEVUE 6100945A 750 1/17/2021 7219 K 9 BED BUG HUNTER LLC BELLEVUE 5955530A 416 1/21/2021 8720 K CS COLLISION LLC BELLEVUE 6096492A 3,775 1/11/2021 8393 R AND R OUTSTANDING SERVICES LLC BELLEVUE 5731771A 1,147 3/5/2021 9015 T BRIGGS TRUCKING LLC BELLEVUE 5968330A 800 2/19/2021 7208 TIP TOP CUSTOMS LLC BELLEVUE 5664187A 825 1/11/2021 5551 0.95 AGGRESSIVE SERVICES INC BELMONT 4281020A 2,392 2/16/2021 2702 0.95 D AND L LAUGHLIN FAMILY FARM BELMONT 5343046A 581 1/16/2021 5190 JUSTRESTE INCORPORATED BELMONT 5826080A 368 2/15/2021 8742 TUCKER CONSTRUCTION INC BELMONT 2899140A 750 1/15/2021 5645 1.00 WINKLER CONSTRUCTION LLC BELMONT 6091776A 750 1/4/2021 5645 CHRISTOPHER PERREAULT ENTERPRISES LLC BENTLEY 5695546A 720 3/29/2021 9519 ALVINS LAWN CARE SERVICE CO LLC BENTON HARBOR 5972337A 523 3/2/2021 9102 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 11 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BOYS AND GIRLS CLUB OF BENTON HARBOR BENTON HARBOR 3618951A 11,466 3/2/2021 9063 1.52 13 % COURT APPOINTED ADVOCATES OF SOUTHWEST BENTON HARBOR 5979730A 336 3/30/2021 8810 MICHIGAN INC DM WOOD INC BENTON HARBOR 0311960A 21,454 2/6/2021 9501 0.79 GROUP R LLC BENTON HARBOR 6101283A 2,192 1/17/2021 5445 METZ TOWING LLC BENTON HARBOR 5974216A 2,275 3/8/2021 7208 REYES TREE SERVICE LLC BENTON HARBOR 5976987A 5,656 2/20/2021 2702 TRUMPETER BAY CONDOMINIUM ASSOCIATION BENTON HARBOR 6098061A 781 1/14/2021 9015 WATER STREET GLASSWORKS BENTON HARBOR 5041899A 571 1/19/2021 8868 A AND A PAINTING INC BENZONIA 3799182A 750 1/14/2021 5476 RUSS NORDINE TRUCKING & CONTRACTING INC BERGLAND 0548065A 753 2/16/2021 8395 0.95 ABR ALPINE DESIGN BERKLEY 2969890A 800 1/27/2021 5645 APPLIED CONSTRUCTION SERVICES LLC BERKLEY 5120853A 20,776 2/7/2021 5610 1.38 BLS PLUMBING SERVICES INC BERKLEY 5373166A 561 2/14/2021 5183 DANS PAINTING SERVICE INC BERKLEY 1661710A 1,612 1/1/2021 5476 0.95 JEREMY LOCKE CONSTRUCTION INC BERKLEY 4347234A 750 3/28/2021 5437 KOSOVA CLEANING BEST LLC BERKLEY 5804469A 568 2/12/2021 9015 MICHIGAN PROPERTY MANAGERS COM LLC BERKLEY 5370329A 2,758 1/26/2021 9015 MICHIGANS CLEANEST BERKLEY 5971756A 846 3/8/2021 8387 STERNBERG MICHAEL BERKLEY 6098983A 382 1/15/2021 0908 PRECISION DOOR INSTALLATION LLC BERLIN 5843383A 1,719 3/20/2021 5102 BRIAN FELLOWS CONSTRUCTION BERRIEN CENTER 6131018A 6,251 3/5/2021 5645 A PLUS WINDOW AND DOOR LLC BERRIEN SPRINGS 5246520A 750 3/4/2021 5645 J AND M BUILDERS INC BERRIEN SPRINGS 6100007A 2,102 1/17/2021 5437 KC ROLLOFFS AND PROPERTY MAINTENANCE BERRIEN SPRINGS 3867005A 3,757 1/7/2021 7213 INC LIFE PULSE FITNESS LLC BERRIEN SPRINGS 5973325A 650 3/6/2021 9063 ROSE PROPERTY MGMT LLC BERRIEN SPRINGS 5495679A 720 1/5/2021 9015 UPTOWN PIZZA COMPANY LLC BERRIEN SPRINGS 5976898A 1,823 3/19/2021 9058 GOGEBIC UNDERWOOD CORP BESSEMER 1507613A 391 1/7/2021 9058 EMPYREAL ENTERPRISES LLC BETHEL PARK, CO 6097855A 1,764 1/20/2021 7720 JOHN DARIEN HOMES LLC BEULAH 0441830A 825 2/8/2021 5645 CJ MORGAN CLEANING SERVICES LLC BEVERLY HILLS 6124100A 568 2/28/2021 8835 KEIDAN BARBARA BECKER BEVERLY HILLS 1148290A 307 1/7/2021 0908 CAL PARK LOGGING LLC BIG RAPIDS 0248002A 825 2/6/2021 2702

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DUCKYS TILE AND FLOORING LLC BIG RAPIDS 6132766A 1,646 3/7/2021 5348 ISON ACOCKS JORDAN BIG RAPIDS 5725615A 698 1/29/2021 3365 MICHIGAN WIND LLC BIG RAPIDS 4996704A 224 2/19/2021 8810 PEAK PROPERTIES LLC BIG RAPIDS 3955737A 3,488 1/1/2021 9015 0.95 VANLANGEN MARK BIG RAPIDS 4841921A 750 1/29/2021 2702 COMMERCE PARK PROPERTIES II LLC BINGHAM FARMS 5963729A 650 2/1/2021 9015 FAMILY EQUITY INC BINGHAM FARMS 0034916A 870 2/1/2021 9015 FRANGIE LAW FIRM PLLC BINGHAM FARMS 2498529A 232 2/3/2021 8810 OAK CONTRACTING LLC BINGHAM FARMS 5963729B 825 3/30/2021 5437 AFFORDABLE EXTERIORS LLC BIRCH RUN 5554519A 4,893 3/23/2021 5645 0.94 BEST MARBLE AND TILE BIRCH RUN 5966400A 750 2/9/2021 5348 EXPERIENCED WINDOW CLEANING INC BIRCH RUN 6055397A 761 2/21/2021 9015 JC BUILDERS BIRCH RUN 5300002A 750 3/4/2021 5645 0.95 YOUNG ANTHONY BIRCH RUN 6135064A 800 3/13/2021 5551 ACCELERATED ASSETS LLC BIRMINGHAM 3730891A 557 1/7/2021 8810 ARIZONA SADDLERY OF BIRMINGHAM BIRMINGHAM 3178510A 419 1/1/2021 8008 AUSLANDER BENJAMIN BIRMINGHAM 5946727A 648 1/1/2021 0913 BARTHOLOMEW EDWARD G BIRMINGHAM 6132740A 637 3/7/2021 0908 CONCRETE SERVICES INC BIRMINGHAM 2370824A 825 1/23/2021 5221 DK OF OC LLC BIRMINGHAM 5547512A 321 3/23/2021 8868 HAUGHTY RESOURCES LLC BIRMINGHAM 5898862A 51,431 2/15/2021 8264 HOFFA JEANNE M BIRMINGHAM 5848318A 530 3/15/2021 0913 JEDI GROUP LLC BIRMINGHAM 4791517A 1,674 2/1/2021 5183 JEROME ALEXANDER AND ALICIA BIRMINGHAM 5603161A 530 1/6/2021 0913 KM PRODUCTIONS LLC BIRMINGHAM 6113885A 587 2/6/2021 7610 KOROTKIN KENNETH M BIRMINGHAM 1151886A 328 2/7/2021 0908 LJ PROPERTIES MI LLC BIRMINGHAM 6093132A 414 1/7/2021 5606 METRO DETROIT CLEANING SOLUTIONS INC BIRMINGHAM 5829771A 697 2/21/2021 9015 MILLER BETH & JASON BIRMINGHAM 4603265A 530 3/21/2021 0913 MILLS SIDING & ROOFING LLC BIRMINGHAM 3280381A 800 3/30/2021 5551 SHERBIN AARON & ELIZABETH BIRMINGHAM 5073278A 530 1/10/2021 0913 SINJIL 14 INC BIRMINGHAM 3760502A 463 2/3/2021 8017 WINDY CITY CONSTRUCTION LLC BIRMINGHAM 5979196A 800 3/26/2021 5645 ROBERTS TOWING & REPAIR LLC BITLEY 5949300A 751 1/16/2021 7208 YACHT HARBOR LTD BLASDELL, NY 4946111A 117,772 1/1/2021 7208 0.87 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 13 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ANDERSON TRUCK AND TRAILER LLC BLISSFIELD 1826697A 977 1/23/2021 3821 BLISSFIELD PRESCHOOL COOPERATIVE BLISSFIELD 0777609A 301 2/19/2021 8868 NURSERY INC BLISSFIELD TOWNSHIP BLISSFIELD 0206164A 5,421 2/1/2021 9410 1.00 BMC GLOBAL LLC BLISSFIELD 5127165A 7,936 3/17/2021 3179 1.36 LENAS PIZZA INC BLISSFIELD 3463990A 3,875 1/18/2021 9058 0.98 SKYLINE INFRASTRUCTURE LLC BLISSFIELD 6118267A 7,857 3/1/2021 5102 THERMALFAB PRODUCTS INC BLISSFIELD 2879352A 12,003 1/1/2021 3169 1.44 13 % GOURWITZ HOWARD J BLOOMFIELD 4176537A 357 2/4/2021 0908 JET STEEL INC BLOOMFIELD 1939211A 5,480 3/10/2021 5538 0.95 ORLEY GRAHAM BLOOMFIELD 1329103A 1,416 2/7/2021 0908 0.95 ALL TIME HOME IMPROVEMENT LLC BLOOMFIELD HILLS 5851076A 1,752 1/23/2021 5437 ANDERSON PERIODONTAL WELLNESS PLLC BLOOMFIELD HILLS 5366909A 370 1/28/2021 8832 ANDING BRIAN JOSEPH JR BLOOMFIELD HILLS 5511534A 750 1/23/2021 5645 ATTISHA PROPERTY MANAGEMENT LLC BLOOMFIELD HILLS 2073021A 632 1/18/2021 8810 B 4 SPORTS INC BLOOMFIELD HILLS 5948657A 1,317 1/1/2021 8810 BARTOLETTO LLC BLOOMFIELD HILLS 5231663A 605 1/25/2021 0913 0.95 BEHIND THE CELLAR DOOR IMPORTS LLC BLOOMFIELD HILLS 5951640A 505 1/11/2021 8742 CAMP TAMAKWA INC BLOOMFIELD HILLS 4476255A 227 2/18/2021 8810 CHIEF PROTECTIVE AGENCY INC BLOOMFIELD HILLS 0196100A 818 3/4/2021 7720 0.95 COLBURN MIRIAM BLOOMFIELD HILLS 0800317A 307 3/4/2021 0908 DONALD L HARKINS CPA PC BLOOMFIELD HILLS 0374997A 216 2/12/2021 8803 DUBIN HOWARD BLOOMFIELD HILLS 0912948A 580 3/17/2021 0913 EDDLESTON GRAHAM BLOOMFIELD HILLS 4168585A 307 3/18/2021 0908 EISENBERG SUE E BLOOMFIELD HILLS 1679678A 530 3/13/2021 0913 ENCORE GERIATRICS PLLC BLOOMFIELD HILLS 1276140A 3,592 1/30/2021 8835 FINSILVER BRETT BLOOMFIELD HILLS 4578597A 307 1/13/2021 0908 FIRST CLASS FLOOR CARE INC BLOOMFIELD HILLS 4889436A 984 2/19/2021 9015 FOLEY TUBE INC BLOOMFIELD HILLS 4489624A 684 3/5/2021 8810 FRANK DANIEL BLOOMFIELD HILLS 6131069A 403 3/5/2021 0908 GGC CONSTRUCTION LLC BLOOMFIELD HILLS 4864123A 803 2/28/2021 5606 0.95 HAYMAN LINDA BLOOMFIELD HILLS 1094203A 307 1/23/2021 0908 0.95 HENDERSON HARPER BLOOMFIELD HILLS 5812917A 357 1/24/2021 0908 HYOUNG JAE KIM CPA PC BLOOMFIELD HILLS 5834651A 324 3/3/2021 8803 HYSELL CHRISTOPHER DR BLOOMFIELD HILLS 5368499A 530 2/4/2021 0913

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge JACKMAN UNA BLOOMFIELD HILLS 4195760A 357 3/23/2021 0908 JOHN WINGERT LLC BLOOMFIELD HILLS 0434906A 3,113 2/23/2021 9015 0.95 KILANO CONSTRUCTION CO BLOOMFIELD HILLS 5949203A 800 1/3/2021 5437 KOJAIAN C MICHAEL BLOOMFIELD HILLS 2853779A 1,140 3/13/2021 0913 0.95 KOJAIAN SHIRLEY BLOOMFIELD HILLS 0324108A 307 3/3/2021 0908 KRAFT LAWRENCE H BLOOMFIELD HILLS 1151983A 530 2/19/2021 0908 L G K BUILDING INC BLOOMFIELD HILLS 0585424A 750 3/15/2021 5645 LAHSER INTERSPECIES RESEARCH FOUNDATION BLOOMFIELD HILLS 4437888A 2,097 2/1/2021 8831 0.95 LANDSCAPE PROPERTY WORKS LLC BLOOMFIELD HILLS 5834708A 573 3/3/2021 9102 LEVY FARMS LLC BLOOMFIELD HILLS 5255171A 1,838 3/31/2021 8279 0.95 MADISON REAL ESTATE COMPANY LLC BLOOMFIELD HILLS 5677947A 530 2/18/2021 0913 MAPLE RIDGE FARMS AND CLEARWATER BLOOMFIELD HILLS 5812933A 2,887 1/25/2021 8279 0.95 ARABIANS MICHAEL KILL SERVICES LLC BLOOMFIELD HILLS 4304888A 2,152 1/17/2021 0913 0.95 MIGHTYMAN ENTERPRISES INC BLOOMFIELD HILLS 3000583A 750 3/23/2021 5645 O C R INC BLOOMFIELD HILLS 3154009A 777 2/17/2021 5606 0.95 PINCUS MARILYN BLOOMFIELD HILLS 0991830A 840 2/14/2021 0912 PROPIS KAREN SIEGEL BLOOMFIELD HILLS 5662168A 231 1/19/2021 8832 PROVILLE BUILDING & RESTORATION CO INC BLOOMFIELD HILLS 4946472A 854 2/3/2021 5645 0.95 R S A E LLC BLOOMFIELD HILLS 3098257A 530 3/11/2021 8392 RADOM W FAIR BLOOMFIELD HILLS 4827449A 357 1/13/2021 0908 RAGO SERVICES LLC BLOOMFIELD HILLS 5973856A 2,867 3/7/2021 4902 ROOFING CONSULTANTS INC BLOOMFIELD HILLS 3021432A 216 1/17/2021 8810 STOLMAN CAROL BLOOMFIELD HILLS 5769086A 530 1/15/2021 0913 THEWES BEVERLY A BLOOMFIELD HILLS 5948134A 530 1/1/2021 0913 TRACE ZERO INC BLOOMFIELD HILLS 4716701A 3,186 2/6/2021 4511 0.95 USE TECH DESIGN LLC BLOOMFIELD HILLS 5801770A 441 2/22/2021 8810 WEISBERG STEVEN BLOOMFIELD HILLS 5681863A 414 2/25/2021 0908 YELLEN IRIS BLOOMFIELD TWP 6125921A 605 2/27/2021 0913 F AND J TRUCKING CO INC BLOOMFLD HLS 6087361A 18,685 1/1/2021 7208 GEA 1 INC BLOOMFLD HLS 6087531A 278 1/1/2021 8810 LUCAS LOGGING BOON 0209147A 750 1/7/2021 2702 MAC CONTRACTING BOSWELL, IN 5911966A 9,040 2/28/2021 0130 BAXTER BUILDERS INC BOYNE CITY 4146662A 1,235 2/20/2021 5606 0.95 BOWMAN PROPERTY MANAGEMENT LLC BOYNE CITY 4800303A 2,483 2/26/2021 0042 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 15 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CLUBB LLC BOYNE CITY 6131174A 750 3/5/2021 7600 ABSOLUTE COMFORT HEATING & COOLING NM BOYNE FALLS 6099343A 674 1/15/2021 5550 LLC D VERSIFIED SPECIALTY CONTRACTING LLC BRADENTON, FL 5692431A 800 3/16/2021 5476 CARR COMMUNITY VOLUNTEER FIRE BRANCH 2639718A 751 1/1/2021 7704 DEPARTMENT INC HEARTS CONTENT BRECKENRIDGE 4115066A 1,735 3/17/2021 9053 0.95 NORTHWOOD PRODUCTS BRETHREN 4154150A 10,993 1/10/2021 3040 0.83 JEFFS TOWING & RECOVERY LLC BRIDGEMAN 4186907A 11,449 1/7/2021 7208 1.22 BAY HARBOR STONE COMPANY LLC BRIDGEPORT 5390630A 18,395 3/26/2021 1624 1.45 27 % GRAPE AND GRAIN TOURS LLC BRIDGMAN 5370949A 1,045 2/10/2021 7212 0.95 NEW BEGINNING INC BRIDGMAN 5638046A 454 3/16/2021 7610 STINE WELDING INC BRIDGMAN 5662095A 2,461 2/13/2021 3066 0.95 ADVANCED MODULAR SOLUTIONS LLC BRIGHTON 5976081A 750 3/18/2021 5645 APEX IMPROVEMENTS LLC BRIGHTON 6096409A 4,650 1/13/2021 5645 ASHWIN PARTNERS LLC BRIGHTON 5860725A 5,700 1/15/2021 5645 CHRIS DAVIDSON HEATING & COOLING BRIGHTON 2366843A 674 3/22/2021 5550 CHRISS TREE SERVICE LLC BRIGHTON 3876080A 5,590 2/14/2021 0042 0.90 COPPER CREEK HOME IMPROVEMENT LLC BRIGHTON 6109217A 750 1/28/2021 5645 CUTTING EDGE CARPENTRY BRIGHTON 3895270A 3,420 2/10/2021 5437 DOMINION SERVICE COMPANY LLC BRIGHTON 6136320A 675 3/17/2021 5550 GARBAGE MAN LLC BRIGHTON 5668646A 3,963 2/1/2021 9403 0.95 GEORGETOWN COMMONS SOUTH BRIGHTON 0903361A 568 1/15/2021 9015 CONDOMINIUM ASSOCIATION GINNYS DANCEWORKS INC BRIGHTON 3605264A 577 3/16/2021 8868 HOME REMEDY CONSTRUCTION LLC BRIGHTON 5428831A 750 2/27/2021 5645 0.95 HOMETOWN INSTALLATION INC BRIGHTON 2503956A 750 1/11/2021 5645 0.95 LOGISTICS ONE INC BRIGHTON 4838769A 230 2/16/2021 8810 MICHIGAN MOLD SERVICES INC BRIGHTON 5402123A 1,259 3/29/2021 9015 0.95 NISWANDER ENVIRONMENTAL LLC BRIGHTON 4129164A 1,168 1/1/2021 8601 0.95 PLEASANT VALLEY BUILDING AND RESTORATION BRIGHTON 5432740A 1,199 3/14/2021 5606 LLC RC CONSTRUCTION INC BRIGHTON 0247499A 750 3/14/2021 5403 0.95 ROBERTSON AND STEWART BRIGHTON 5072069A 2,817 2/3/2021 4484 0.95 ROUNTREE MIKE BRIGHTON 6103138A 750 1/21/2021 5445 SARDO CONSTRUCTION SERVICES INC BRIGHTON 0228150A 3,464 1/21/2021 5221 0.82

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 16 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SHAW CONSTRUCTION SERVICE LLC BRIGHTON 3129497A 750 2/12/2021 5551 SUPERIOR CUSTOM HOMES INC BRIGHTON 1459015A 3,108 3/16/2021 5645 TEMPLAR INTEGRATED SECURITY SOLUTIONS BRIGHTON 5833477A 258 2/28/2021 8868 LLC THOMAS HOME & LAWN CARE INC BRIGHTON 3769151A 846 1/13/2021 9102 TOP JOBS LLC BRIGHTON 5960088A 15,077 2/2/2021 3808 VANSICKLE KATHLEEN BRIGHTON 5160030A 744 3/10/2021 0908 0.95 WALNUT HILLS SUBDIVISION ASSOCIATION BRIGHTON 5946760A 568 1/1/2021 9015 WILDLIFE X TEAM OF SE MICHIGAN BRIGHTON 6112064A 614 2/1/2021 8831 WILLIS BUILDING CO INC BRIGHTON 3276490A 807 1/1/2021 5606 CAMPEAU FARM LLC BRIMLEY 6105238A 705 1/24/2021 0129 PROPIPE LOGISTICS LLC BRISTOLVILLE, OH 6090290A 1,650 1/2/2021 5183 MOKEE ARABIANS BRITTON 4059549A 2,545 1/20/2021 8279 1.00 REAU LIVESTOCK BRITTON 1674005A 704 3/4/2021 0129 ADKINS DOUG BROCKWAY 5812305A 800 1/19/2021 7208 MICHAEL TOPPING INC BROHMAN 0000370A 750 1/17/2021 5445 ALDERMAN LUCE MEMORIAL HOME ASSOC BRONSON 0632708A 393 3/20/2021 9061 D T C METALS LLC BRONSON 4438221A 13,163 1/19/2021 8265 1.49 13 % BORDINE KENNETH BROOKLYN 6103200A 750 1/21/2021 5645 BUDDYS NO 21 INC BROOKLYN 4768892A 1,127 2/10/2021 8017 0.95 CAPITAL BUILDING SERVICE INC BROOKLYN 0869031A 5,205 3/26/2021 9015 0.89 FEARLESS FARM ENTERPRISES LLC BROOKLYN 4577647A 800 1/19/2021 7208 PSYCH RESOLUTIONS LLC BROOKLYN 5971098A 359 2/28/2021 8742 SVMOWCO LLC BROOKLYN 4728351A 813 3/20/2021 9102 0.95 SALES PARTNERSHIPS INCORPORATED BROOMFIELD, CO 5500818A 700 3/27/2021 8742 0.95 LAKESIDE SUPPLIERS TRUCKING INC BROWN CITY 1794370A 828 1/17/2021 8810 0.95 SHEPHARD AND SON TRUCKING LLC BROWN CITY 2676150A 750 3/4/2021 7219 CORNERSTONE FLOORING INSTALLATION LLC BROWNSBURG, IN 5688965A 3,368 3/15/2021 5606 0.95 BIG 1 INC BROWNSTOWN 5849535A 1,273 3/29/2021 8748 DETROIT GRADALL BROWNSTOWN 0886009A 815 2/7/2021 6217 TOP CHOICE HOME IMPROVEMENT LLC BROWNSTOWN 5290996A 750 2/21/2021 5437 0.95 FPC INC BROWNSTOWN TWP 3805140A 750 2/12/2021 5476 TILE BOYS CO BROWNSTOWN TWP 6133274A 750 3/7/2021 5348 MATTHEW JOSEPH ELECTRICAL INC BRUCE 3948439A 1,225 1/10/2021 5190 0.95 AVEDISIAN NATHAN BRUCE CROSSING 3565165A 750 3/23/2021 2702

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 17 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HOFFMAN DALE ROBERT BRUCE CROSSING 5695023A 750 3/25/2021 7208 J AND H LOGGERS ALLEY INC BRUCE CROSSING 2740842A 372 1/19/2021 9058 STADLER MARK BRUCE CROSSING 3862666A 750 1/12/2021 2702 CREATIVE BUILDING CONCEPTS INC BRUCE TWP 2714019A 838 1/14/2021 0042 GEORGE MATTHEW BRUCE TWP 5845270A 309 3/22/2021 8869 NIGHTHAWK GENERAL MAINTENANCE BRUCE TWP 2790866A 709 3/27/2021 0042 BYRDAK LAWN CARE LLC BUCHANAN 5261520A 1,501 3/24/2021 9102 GMS INDUSTRIES INC BUCHANAN 1881370A 1,723 2/5/2021 3632 MARK HIRDNING BUILDERS LLC BUCHANAN 5965934A 7,225 2/11/2021 5645 REDBUD RECREATION INC BUCHANAN 2120208A 5,244 1/1/2021 9015 0.90 TOWNSHIP OF BERTRAND BERRIEN COUNTY BUCHANAN 0261076A 5,459 1/1/2021 9015 0.90 GREEN TREE EXPERTS LLC BUCKLEY 5697042A 750 3/10/2021 0106 0.95 MITCHELL FARMS LLC BURR OAK 4733193A 9,453 3/27/2021 7208 0.87 SKAGGS ASSISTED LIVING LLC BURR OAK 5344344A 2,546 1/9/2021 9053 THUMB WELDING AND REPAIR LLC BURTCHVILLE 4552482A 1,181 2/6/2021 3365 0.95 ABOVE THE REST CONSTRUCTION LLC BURTON 5514983A 750 3/1/2021 5645 BATEMAN BILL BURTON 2833204A 750 2/7/2021 5551 BUCK CONCRETE INC BURTON 1154893A 1,051 2/7/2021 5221 0.95 CROWN ROYAL ENTERPRISES INC BURTON 1718827B 1,213 1/29/2021 9058 0.95 D AND R CARPET OF FLINT BURTON 2643081A 590 3/28/2021 9521 DOC CONSTRUCTION BURTON 3183742A 1,494 1/14/2021 5645 0.95 F AND L OF FLINT INC BURTON 1837281A 416 2/26/2021 9058 FABRIS PEARCE TILE & TERRAZZO INC BURTON 0214817A 2,249 2/2/2021 5348 0.79 HUDSON DEAN BURTON 2785994A 540 2/12/2021 9521 JOHN GRIFFITH CARPETS BURTON 3338843A 540 2/11/2021 9521 KEYSTONE ENVIRONMENTAL INC BURTON 4159993A 3,642 1/4/2021 4511 0.95 LAPINE AND SONS CONSTRUCTION BURTON 6116620A 750 2/11/2021 5645 LIEM ENTERPRISES INC BURTON 6109128A 784 1/28/2021 0042 LOCAL 119 UTILITY WORKERS UNION OF BURTON 0926531A 244 2/19/2021 8755 AMERICA AFL CIO BUILDING CORPORATION LUPU HOME SERVICES BURTON 6095593A 750 1/10/2021 5102 MAPLE POINTE GAS INC BURTON 5673682A 1,119 3/7/2021 8017 0.95 MI ELECTRICAL CONTRACTING LLC BURTON 5414253A 514 1/26/2021 5190 MOBIL TECH 10 INC BURTON 5386535A 335 3/13/2021 8017 OTTO BUILDING COMPANY BURTON 0705977A 750 2/11/2021 5437

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 18 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PARADISE CONSTRUCTION & REMODELING LLC BURTON 3793885A 750 3/3/2021 5437 PERSONNEL OFFICE INC BURTON 4944542A 19,141 1/5/2021 9102 1.43 10 % RADIANT FACILITY SERVICES LLC BURTON 5501393A 1,245 1/12/2021 9015 0.95 RIDLEY CHRISTOPHER E BURTON 3336611A 751 3/24/2021 0106 SNEED CONSTRUCTION BURTON 5224187A 750 1/6/2021 5645 TOP TO BOTTOM CONSTRUCTION LLC BURTON 6117139A 4,277 2/12/2021 5437 WALL PRO LLC BURTON 2630087A 751 1/26/2021 5445 WOOD DAVID BURTON 4341074A 590 2/27/2021 9521 ZUCCARO GIOVANNI BURTON 4989384A 750 1/21/2021 5437 A AND S ENERGY INC BYRON 3244237A 1,393 1/18/2021 1320 0.95 HIGH SIERRA BUILDERS LLC BYRON 3344444A 750 3/19/2021 5437 R 2 CONSTRUCTION BYRON 6103910A 750 1/22/2021 5215 RANDY ARMSTRONG CONCRETE & FOUNDATION BYRON 5845823A 750 3/23/2021 5215 0.95 LLC T AND J WATERFRONT SERVICES LLC BYRON 5688310A 1,969 3/8/2021 6400 0.95 ABA CONSTRUCTION LLC BYRON CENTER 5818281A 8,936 1/31/2021 5551 0.95 ALL CUSTOM CONSTRUCTION LLC BYRON CENTER 5972329A 750 3/4/2021 5645 BC CONSTRUCTION LLC BYRON CENTER 5474515A 750 1/3/2021 5403 1.00 BRAD KUIPER BUILDER LLC BYRON CENTER 4898664A 750 3/13/2021 5645 DAVID AUKEMAN BUILDER LLC BYRON CENTER 2219581A 750 3/31/2021 5645 E 5 VENTURES LLC BYRON CENTER 5516218A 2,478 2/12/2021 7421 0.95 FOREVER GREEN TRANSPLANTING LLC BYRON CENTER 3441288A 750 1/13/2021 0042 HAVERDINK ROOFING LLC BYRON CENTER 5581141A 750 1/8/2021 5551 HUIZINGHS MOVING LLC BYRON CENTER 5368189A 3,146 2/1/2021 8293 0.95 JMA SERVICES INC BYRON CENTER 1688596A 3,647 2/8/2021 5552 0.97 PRIORITY PAINTING LLC BYRON CENTER 1233882A 750 1/8/2021 5476 STEGINK ENTERPRISES LLC BYRON CENTER 3875687A 520 1/21/2021 2081 UNIQUE CARE SERVICES LLC BYRON CENTER 3742601A 4,081 1/30/2021 8835 0.86 ZAAGMAN HOME REMODELING LLC BYRON CENTER 5817714A 2,609 1/30/2021 5437 0.95 ALL BEANS COFFEE LLC CADILLAC 4579623A 752 1/15/2021 5192 LEGENDARY FOREST PRODUCTS LLC CADILLAC 5962307A 2,841 2/5/2021 2709 MID MICHIGAN ME GROUP LLC CADILLAC 5818737A 326 2/1/2021 8810 NORTHERN ROOTS ASSISTED LIVING LLC CADILLAC 5835160A 471 3/14/2021 9053 PAYNES COMPLETE JANITORIAL CADILLAC 4585364A 568 2/9/2021 9015 RANDY SEBRING BUILDER INC CADILLAC 3294382A 1,695 1/5/2021 5437 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 19 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BOYER JESSICA CALEDONIA 6134530A 580 3/20/2021 0913 ENCOMPASS BUILDERS LLC CALEDONIA 5971594A 800 2/28/2021 5645 FULL ARMOR CYCLE LLC CALEDONIA 5374782A 516 2/19/2021 8387 HENNYS YARN SHOP CALEDONIA 5243769A 329 3/7/2021 8017 JOHN DEBRUIN PAINTING INC CALEDONIA 0462748A 751 1/3/2021 8810 LEHMAN BUILDING AND RENOVATIONS LLC CALEDONIA 1250787A 750 3/6/2021 5645 WALTER DEBORAH ANN CALEDONIA 6096832A 568 1/11/2021 9015 CALUMET HOUSING COMMISSION CALUMET 0740942A 2,790 3/21/2021 9015 1.00 DALE JOHNS CONSTRUCTION INC CALUMET 4224159A 4,931 3/16/2021 5476 0.87 LANFRANKI GENEVIEVE CALUMET 5962129A 1,386 1/31/2021 0908 CAMDEN TOWNSHIP CAMDEN 0772020A 482 3/7/2021 9410 ADVANCED REAL ESTATE AFC HOME LLC CANTON 3927709A 3,066 1/30/2021 9053 0.95 ALL COMMUNITY HOME CARE SERVICE INC CANTON 4492072A 786 1/15/2021 8835 0.95 BARNETT ROOFING AND SIDING INC CANTON 1691325A 2,224 3/28/2021 8227 0.95 CANTON POWER EQUIPMENT CANTON 0768928A 732 1/14/2021 8010 CRAIG JESSICA CANTON 6142087A 530 3/30/2021 0913 CRESCENTINI BUILDING COMPANY INC CANTON 0798398A 750 2/15/2021 5645 FARHAT INC CANTON 3691365A 571 1/30/2021 9586 FORD AND HAGGERTY INC CANTON 3842177A 828 1/12/2021 8381 0.95 GOTTSCHALK BUILDERS INC CANTON 0105210A 800 1/3/2021 5645 GRACIOUS HANDS SERVICES LLC CANTON 5410665A 2,152 3/24/2021 9053 0.91 HALLIDAYS KENNELS INC CANTON 3891496A 1,319 3/7/2021 8831 1.05 HARBOR MASTER MARINE CONSULTATION CANTON 2959380A 594 1/13/2021 3724 SERVICES INC HARVEYS QUALITY FLOORING CANTON 4292219A 825 3/20/2021 5348 0.95 JRD GROUP LLC CANTON 5250471A 770 2/6/2021 8017 LIGHT HOUSE PAINTING CANTON 3457885A 750 2/22/2021 5476 MCMAHON HELICOPTER SERVICES INC CANTON 2122529A 6,236 1/26/2021 7422 0.90 MICHAEL J KELLY AND ASSOCIATES CANTON 1770004A 750 3/16/2021 5437 OMNE QUALE INC CANTON 5354560A 8,078 2/5/2021 5476 0.95 PHOENIX PAINTING LLC CANTON 4300378A 750 3/22/2021 5476 PRECISION SERVICE GROUP INC CANTON 3453960A 5,072 1/15/2021 9015 1.46 10 % RENJAY LLC CANTON 6137067A 644 3/19/2021 5606 RONS BUILDING & IMPROVEMENTS INC CANTON 3294781A 825 3/11/2021 5183 STEFANSKI WEALTH MANAGEMENT LLC CANTON 4170377A 265 2/13/2021 8810

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 20 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge STEFFES MATTHEW & STEFFES BARBARA CANTON 4316398A 580 2/23/2021 0913 T AND G GLASS INC CANTON 1851209A 900 2/25/2021 5462 TOWN AND COUNTRY LAWN MAINTENANCE LLC CANTON 0959642A 2,036 1/29/2021 9102 1.00 UNIFIED SECURITY SOLUTIONS LLC CANTON 5656060A 578 1/6/2021 5191 UNIQUE PAINTERS OF MICHIGAN CANTON 0497134A 750 3/10/2021 5476 ZIMMS RESTORATIONS INC CANTON 3354563A 571 2/4/2021 9015 ACCOUNTABLE COOLING & HEATING SOLUTIONS CAPAC 4723449A 674 2/27/2021 5550 LLC LAKEPOINTE OF THE SHORES CONDOMINIUM CAPAC 0648701A 618 3/14/2021 9015 ASSOCIATION MCB PERFORMANCE LLC CAPAC 5079730A 1,110 1/24/2021 8018 0.95 MIRACLE HOME IMPROVEMENT LLC CAPAC 5666899A 305 1/27/2021 8742 R AND S HOMES LAPEER LLC CAPAC 6121250A 750 2/18/2021 5645 AYALA PROPERTY MAINTENANCE LLC CARLETON 5764521A 618 3/14/2021 9015 D O ELECTRIC CO LLC CARLETON 1594133A 473 3/2/2021 5190 STRATEGIES FOR SUCCESS LLC CARLETON 5670179A 369 3/17/2021 8742 TMS CUSTOM BUILDERS LLC CARLETON 6137245A 3,500 3/22/2021 5645 TRADEMARK BUILDING CO INC CARLETON 3116751A 751 1/30/2021 5606 TRIPLE DDD TREE SERVICE LLC CARLETON 4342267A 4,881 2/26/2021 0106 0.93 FORGETTE TRUCKING LLC CARNEY 5250854A 751 3/15/2021 7208 MARSICEK PAUL CARNEY 6112501A 750 2/1/2021 7208 A AND J WINDOWS AND MORE CARO 1634267A 2,418 2/22/2021 5645 0.95 CORRADI CONSTRUCTION LLC CARO 2628392A 5,649 2/14/2021 5437 0.95 TUSCOLA COUNTY HEALTH INITIATIVE CARO 5947235A 580 1/9/2021 9063 MVC ENTERPRISES LLC CARP LAKE 4218116A 9,987 3/29/2021 5645 1.31 27 % STARFIRE CORPORATION CARROLLTOWN, PA 5941911A 643 1/22/2021 9015 KTI EXPRESS LLC CARSONVILLE 5677831A 4,618 2/22/2021 7208 0.93 SUES PAPER SERVICE CARSONVILLE 5826055A 449 2/15/2021 7720 BRUMLEY AND ENGLE HOMES LLC CASCO 4883691A 784 1/12/2021 5645 DGS DRYWALL LLC CASCO 4571347A 2,602 2/27/2021 5445 0.95 FRANKS TRUCKING CASCO 1850300A 750 2/7/2021 6217 GP FLOOR COVERING CASCO 0049867A 1,019 1/25/2021 9521 J AND H LANDSCAPING CO CASCO 0239470A 1,052 3/15/2021 9102 M AND M LAWNCARE LLC CASCO 5975492A 760 3/13/2021 9102 PLACIDO CONSTRUCTION LLC CASCO 4486986A 750 2/16/2021 5645

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 21 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge STEVE HAHN LLC CASCO 5194695A 750 2/6/2021 5645 WOELKERS ELECTRIC LLC CASCO 5476496A 928 3/15/2021 5190 0.95 KING AUTO INC CASEVILLE 4386094A 1,850 1/10/2021 8395 CC WORKS LLC CASS CITY 5948614A 1,347 1/1/2021 9015 D PARROTT CONSTRUCTION LLC CASS CITY 1505823A 750 1/14/2021 5538 GG CONSTRUCTION CASS CITY 0088960A 5,767 1/1/2021 5645 0.93 GLENVIEW CLYDESDALES CASS CITY 3758770A 825 2/16/2021 8279 GREGORY WOODRUFF BUILDERS CASS CITY 5657342A 750 1/10/2021 5645 ONE CALL CLEANING AND MAGNA DRY CARPET CASSOPOLIS 5820723A 1,205 2/7/2021 9015 CLEANING WALLACE 24 HR TOWING LLC CASSOPOLIS 5546478A 750 2/27/2021 7208 COUNTY CONSTRUCTION LLC CEDAR 6097898A 800 1/18/2021 5645 DUNKLOW CONSTRUCTION INC CEDAR 5954223A 750 1/17/2021 5645 RON STRONG INC CEDAR 2089203A 864 3/25/2021 4361 0.95 A AND D OUTDOOR SERVICE LLC CEDAR SPRINGS 5694698A 1,760 3/23/2021 0042 0.95 ABC VENTURES LLC CEDAR SPRINGS 5847940A 750 3/29/2021 5645 B D C T INC CEDAR SPRINGS 5230780A 1,976 1/13/2021 5437 0.95 BARTON BUILDERS LTD CEDAR SPRINGS 2141345A 750 3/22/2021 5437 0.95 BODENBERG EDWARD CEDAR SPRINGS 6112420A 470 2/4/2021 5190 DIAMOND DRYWALL INC CEDAR SPRINGS 4456920A 750 2/7/2021 5445 G BRAYMAN PAINTING LLC CEDAR SPRINGS 5382769A 750 3/7/2021 5476 0.95 GLEN HILL POST NO 287 AMERICAN LEGION INC CEDAR SPRINGS 0632562A 1,609 2/6/2021 9058 0.95 H AND S TIMBER CEDAR SPRINGS 0912255A 911 2/24/2021 2702 J CASTINE AND SON RENDERING LLC CEDAR SPRINGS 4087607B 6,980 3/15/2021 7208 1.03 TRAVIS PEST CONTROL INC CEDAR SPRINGS 5569290A 3,079 2/19/2021 9015 0.93 WAGNER CONTRACTING INC CEDAR SPRINGS 4390571A 795 1/1/2021 9402 ALLEGIANT PAINTING LLC CEMENT CITY 5967597A 800 2/15/2021 5476 BLAKE ELECTRIC INC CEMENT CITY 4862619A 840 2/25/2021 5190 CR ELECTRIC OF MICHIGAN LLC CEMENT CITY 5369428A 470 2/6/2021 5190 ANDING ERIC MICHAEL CENTER LINE 5509785A 750 1/23/2021 5645 Y H BUILDING CARE CENTER LINE 2979950A 568 2/5/2021 9015 ROXANA REPAIR LLC CENTERLINE 5848180A 833 3/30/2021 8395 EKLUND FORESTRY LLC CENTRAL LAKE 5058988A 758 1/9/2021 8601 FRANTTI LOGGING CENTRAL LAKE 5803845A 750 1/5/2021 2702 ELIASON EDWIN CHAMPION 4416708A 977 2/6/2021 0909

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MIKE JAUQUET TRUCKING CHANNING 0408123A 750 2/14/2021 7208 R J SMILTNEEK LLC CHANNING 5977878A 750 3/22/2021 7208 JOES PROFESSIONAL SERVICES LLC CHARLEVOIX 6127118A 751 3/2/2021 5403 NORTHERN NAUTICAL SERVICES LLC CHARLEVOIX 6139000A 568 3/28/2021 6836 NORTHERN UTILITY CONTRACTORS INC CHARLEVOIX 3768015A 4,417 3/5/2021 7600 0.82 SEB USA INC CHARLEVOIX 5845378A 2,289 3/22/2021 9015 UP NORTH BUILDERS CHARLEVOIX 2188031A 750 2/11/2021 5645 APPLIN REMODELING CHARLOTTE 4393406A 2,346 1/12/2021 5437 0.95 CLOVERFIELD INC CHARLOTTE 3763471A 1,053 3/24/2021 8831 GOLDEN DAYS II CHARLOTTE 0755150A 1,487 2/13/2021 9053 0.95 M DYBAS & ASSOCIATES LLC CHARLOTTE 4910648A 629 2/22/2021 4511 MAINTENANCE DIAGNOSTIC SYSTEMS INC CHARLOTTE 4295226A 1,935 1/9/2021 3724 0.95 MID MICHIGAN ELECTRICAL LLC CHARLOTTE 5583667A 470 1/15/2021 5190 STAGE AND SPORTS AUDIO CHARLOTTE 2118424A 1,844 1/5/2021 9154 0.95 TIRRELL JENNIFER CHARLOTTE 5492890A 573 2/13/2021 0913 WILCO INVESTMENTS INC CHARLOTTE 5802881A 569 2/27/2021 9015 CHETZ TOWING LLC CHASE 5938155A 6,994 1/3/2021 7208 H AND S MANUFACTURED HOMES LLC CHASE 4282965A 8,854 3/7/2021 8387 0.95 KUEHN FOREST PRODUCTS LLC CHASSELL 5273714A 750 2/25/2021 2709 0.95 BARN SANCTUARY CHELSEA 5899516A 8,470 3/6/2021 0129 CHELSEA GRAIN LLC CHELSEA 3203832A 1,985 3/12/2021 8215 0.95 MAXX ROOF LIFE LLC CHELSEA 6140025A 1,993 3/25/2021 9015 PARAMOUNT CARE AT HOME LLC CHELSEA 6127843A 1,204 2/28/2021 8835 SEITZ DAVID CHELSEA 5959063A 328 1/25/2021 0908 CHESANING BRADY FIRE AUTHORITY CHESANING 1417940A 3,460 3/1/2021 7704 1.00 DOUGS TILING AND REMODELING LLC CHESANING 5380235A 2,049 3/16/2021 5479 0.95 K M R EXCAVATING INC CHESANING 3192920A 971 3/1/2021 6217 KELBEY ENTERPRISE LLC CHESANING 5393914A 750 2/28/2021 5437 MMB ASSOCIATES LLC CHESANING 5785421A 286 1/1/2021 8810 S AND L SAWVEL LOGGING CHESANING 5224144A 750 1/4/2021 2702 ALL ABOUT DOORS LLC CHESTERFIELD 4865715A 825 3/29/2021 5102 APPINO MICHAEL CHESTERFIELD 4967089A 750 2/1/2021 5221 BELLE AIR MECHANICAL LLC CHESTERFIELD 6089062A 675 1/1/2021 5550 COAST TO COAST TRUCK DRIVING SCHOOL INC CHESTERFIELD 4600843A 756 3/17/2021 8868 DIVERSIFIED CONSTRUCTION SERVICES CHESTERFIELD 3370038A 800 2/14/2021 5445 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 23 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FAMILY LAWN CARE LLC CHESTERFIELD 4620836A 1,006 3/27/2021 9102 0.95 J SOLUTIONS LLC CHESTERFIELD 5961661A 4,695 1/30/2021 3040 JERRYS PAINTING & HANDYMAN SERVICES LLC CHESTERFIELD 5950724A 1,521 1/9/2021 5476 K AND E ELECTRIC SERVICES INC CHESTERFIELD 4000960A 520 2/1/2021 5190 KEYS LLC CHESTERFIELD 4095146A 800 2/5/2021 5645 0.95 KOVE INVESTIGATIONS INC CHESTERFIELD 4765540A 450 3/20/2021 7720 M POWER INC CHESTERFIELD 3643530A 568 2/26/2021 9015 MICRO BUSINESS SERVICES INC CHESTERFIELD 3705668A 898 1/12/2021 5191 RCI AND ASSOCIATES CHESTERFIELD 3854159A 470 3/24/2021 5190 ULTRA SERVICES LLC CHESTERFIELD 5095425A 800 1/10/2021 5645 UNITED STAFFING AGENCY INC CHESTERFIELD 4832280A 69,043 1/20/2021 9501 1.00 VALENTI CONSTRUCTION LLC CHESTERFIELD 5113644A 4,090 2/14/2021 5645 0.93 ANDARY MARTIN CHESTERFIELD TWP 3433951A 750 3/28/2021 5479 CHAMPINE SERVICES INC CHESTERFIELD TWP 4696387A 750 2/10/2021 5221 ENVIROMAX SERVICES INC CHESTERFIELD TWP 5102197A 1,301 2/28/2021 9015 0.95 J NEWPORT ELECTRIC LLC CHESTERFIELD TWP 5521858A 470 3/1/2021 5190 AQUAMOON LLC CHICAGO, IL 5565383A 1,296 1/29/2021 8831 BUSHMAN CONSTRUCTION MANAGEMENT INC CHICAGO, IL 5503841A 1,033 1/15/2021 5606 WIRTZ ALISON M & BRANSFIELD MICHAEL W CHICAGO, IL 5527953A 489 3/12/2021 0908 CM LAWN AND LANDSCAPE LLC CHINA 6026001A 944 2/18/2021 0042 ESP TRUCKING INC CHINA 0262730A 216 2/3/2021 8810 MACKIES BAIT FARM LLC CHINA 6131190A 551 3/12/2021 8017 BALKO WILL CHRISTMAS 5078032A 2,510 1/23/2021 5645 0.95 MASHED ROOTS LLC CINCINNATI, OH 6136222A 357 3/19/2021 9058 GREAT LAKES ROOFING AND COATINGS LLC CLARE 6139647A 9,040 3/24/2021 5552 JENNINGS REBECCA L SPECIAL NEEDS TRUST CLARE 5818079A 1,702 1/30/2021 0913 JOSHUAS HOUSE CLARE 5950341A 636 3/13/2021 8008 NORTHERN TANK LLC CLARE 5834732A 25,403 3/1/2021 7208 0.93 WALTERS FOREST PRODUCTS CLARE 2641860A 750 2/25/2021 2702 ADAMS FARM LLC CLARK LAKE 1855298A 444 3/13/2021 0035 HUFFS MARINA LLC CLARK LAKE 6088538A 4,786 2/7/2021 6836 PHILLIPS FARMS & SERVICE LLC CLARKLAKE 5837766A 6,060 3/12/2021 7208 0.95 SUPERIOR CRITTER CONTROL LLC CLARKLAKE 6133002A 1,675 3/23/2021 9015 AMERICAN CRAFTSMEN HOMES LLC CLARKSTON 0825204A 11,999 1/27/2021 5645 0.91 AMYLOIDOSIS FOUNDATION CLARKSTON 5515130A 395 2/8/2021 8810 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 24 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CHRIS MORGAN & ASSOCIATES INC CLARKSTON 5392063A 2,650 3/31/2021 5645 CREST HOMES REAL ESTATE AND BUILDING CLARKSTON 0040215A 800 1/6/2021 5645 0.95 COMPANY LLC DECOR LOGISTIC PARTNERS LLC CLARKSTON 4385543A 1,053 1/1/2021 7202 0.95 ELLSWORTH CONSTRUCTION CLARKSTON 4048652A 750 1/24/2021 5645 FRERICKS HOMES INC CLARKSTON 3281736A 800 1/28/2021 5645 GUTTER GUYS AND GALS LLC CLARKSTON 5252806A 706 3/22/2021 5538 JEFF STEINKE CUSTOM PAINTING CLARKSTON 0104990A 825 1/23/2021 5476 0.95 KAY FAMILY ENTERPRISES INC CLARKSTON 5522242A 827 3/2/2021 8810 METRO LAKES CONSTRUCTION LLC CLARKSTON 4035879A 1,030 2/18/2021 8742 0.95 MLC BUILDING LLC CLARKSTON 5250374A 1,379 3/14/2021 5606 0.95 NORTH CEDAR COVE ASSOCIATION CLARKSTON 1611372A 568 3/1/2021 9015 NORTH OAKLAND PROPERTY MANAGEMENT LLC CLARKSTON 4446950A 281 2/11/2021 8810 PROGRESSIVE DIRECTIONAL DRILLING LLC CLARKSTON 5491037A 826 1/8/2021 6204 RAMPABILITY INC CLARKSTON 5052289A 751 2/3/2021 5102 RIVERHOUSE BOATHOUSE CONDOMINIUM CLARKSTON 1968092A 750 2/1/2021 6826 ASSOCIATION RM ENCORE INC CLARKSTON 1371410A 464 3/27/2021 8810 SHELL HOMES LLC CLARKSTON 3180115A 750 3/16/2021 5403 SIDING BY SLONE CLARKSTON 2808978A 3,566 2/2/2021 5645 SPECIAL TOUCH PAINTING CLARKSTON 2688190A 826 2/7/2021 5476 J T TOWER SERVICE LLC CLARKSVILLE 0274143A 15,498 1/25/2021 5102 1.00 ROYCE WILCOX CONSTRUCTION LLC CLARKSVILLE 1523473A 750 2/17/2021 5645 CREATIVE COPPER WORKS LLC CLAWSON 3826449A 2,155 2/9/2021 5102 0.95 FUSION 2 RESTORATION SERVICES LLC CLAWSON 5047625B 800 1/6/2021 5437 0.95 KASSCO CONTRACTING CLAWSON 5950295A 801 1/7/2021 5476 ON POINT IMPORTING LLC CLAWSON 5966493A 1,335 2/9/2021 8392 PAUL FEENY COMPANY CLAWSON 0331759A 6,570 2/4/2021 9058 TWY FIT LLC CLAWSON 5385490A 889 3/16/2021 9063 BMCQ RESOURCES INC CLAY 3788563A 568 1/20/2021 9015 0.95 ENGEL CONSTRUCTION CLAY 4079531A 750 3/17/2021 5645 MAD DOG SIDING CLAY 3494420A 800 2/4/2021 5645 LCJ INTEGRATED ENTERPRISE LLC CLAY TOWNSHIP 6112471A 238 2/1/2021 8601 YOUR MAN TOURS INC CLEARWATER, FL 1530895A 931 1/1/2021 8810 0.95 MCDONNELL MASONRY CLIFFORD 2988283A 750 3/8/2021 5022

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MICHIGAN FIRE PROS LLC CLIFFORD 4731964A 825 3/25/2021 7704 DURATECH LLC CLINTON TOWNSHIP 5223750A 750 3/7/2021 5476 EMILIO CONSTRUCTION LLC CLINTON TOWNSHIP 4666267A 800 1/11/2021 5437 ACME AUTO LLC CLINTON TWP 5225213A 1,552 1/10/2021 8395 0.95 ADVANCE UNLIMITED LLC CLINTON TWP 5342279A 546 1/28/2021 5190 0.92 ALFA FLOORING INC CLINTON TWP 5961718A 540 2/12/2021 9521 ALL PHASE CONSTRUCTION SERVICES LLC CLINTON TWP 2300532A 338 3/3/2021 5606 ALLSTATE MECHANICAL LLC CLINTON TWP 4678702A 691 1/25/2021 5550 0.95 AMERICAN INK PRINTING COMPANY LLC CLINTON TWP 5006163A 670 2/4/2021 4299 0.95 BERG BROS LLC CLINTON TWP 4070321A 2,240 1/20/2021 0106 0.95 BLASTING SPECIALTIES INC CLINTON TWP 4535324A 2,783 1/1/2021 3632 0.95 BRIAR TOWNE ASSOCIATION CLINTON TWP 2644860A 885 2/16/2021 9015 BROTHERS MOBILE BLASTING LLC CLINTON TWP 6134890A 1,449 3/13/2021 9501 C AND H ASSOCIATES OF MICHGAN LLC CLINTON TWP 6112129A 2,129 2/1/2021 9053 CAREER CONNECTIONS INC CLINTON TWP 5420415A 37,799 2/1/2021 3307 0.76 CARPET WORLD PLUS LLC CLINTON TWP 4020537A 379 2/17/2021 8017 CASA VILLA BUILDERS INC CLINTON TWP 2474794A 1,371 2/24/2021 5606 0.95 COMPLETE RENOVATIONS INC CLINTON TWP 2192594A 830 1/9/2021 8810 0.95 CORNELIUS FIREWOOD & SNOWPLOWING CLINTON TWP 5807140A 941 1/10/2021 2731 COUNTY TREE II LLC CLINTON TWP 5816823A 2,587 2/25/2021 0106 0.95 CRYONICS INSTITUTE CLINTON TWP 1992090A 623 1/1/2021 4511 DAX M BILLCHECK LLC CLINTON TWP 3752135A 706 2/28/2021 5538 DIAPERS 2 DIPLOMAS CHILDRENS LEARNING CLINTON TWP 4865022A 1,983 3/17/2021 8869 1.00 CENTER INC DOR SAL ESTATES CONDOMINIUM ASSOCIATION CLINTON TWP 1057359A 568 1/1/2021 9015 EARLY RESPONSE HOLDINGS LLC CLINTON TWP 0576557A 351 1/20/2021 5191 EAST SIDE MASONRY CLINTON TWP 0788260A 5,060 3/27/2021 5022 0.92 ELIAS LUCILLE CLINTON TWP 4967909A 530 3/3/2021 0913 FIRST CHOICE PAINTING CLINTON TWP 5123593A 1,150 3/20/2021 5476 0.95 FLOOR TRANSFORMATIONS LLC CLINTON TWP 4953150A 800 1/19/2021 5437 GAM HOME IMPROVEMENT CLINTON TWP 3897184A 1,112 1/12/2021 9015 GDF PAINTING INC CLINTON TWP 3968120A 750 1/4/2021 5476 GJ FOOTBALL CLUB LLC CLINTON TWP 6123287A 12,578 2/20/2021 9178 HUGHEY JAMES CLINTON TWP 2635216A 540 1/19/2021 9521 HUNTERS POINTE ASSOCIATION CLINTON TWP 3293840A 569 3/10/2021 9015

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge IGNITED LIGHT & SOUND LLC CLINTON TWP 4538439A 545 3/9/2021 5190 INCLINE LANDSCAPING SERVICES LLC CLINTON TWP 5875900A 1,865 1/21/2021 0042 INTEGRITY MOVERS LLC CLINTON TWP 4854667A 2,131 3/29/2021 8293 0.95 J WORKS BUILDING COMPANY INC CLINTON TWP 2940710A 1,351 1/1/2021 5437 0.91 JEFFREY HOME IMPROVEMENT LLC CLINTON TWP 4479068A 2,902 3/12/2021 5645 0.95 JET TRANSPORTATION LLC CLINTON TWP 5818265A 750 2/26/2021 7208 K AND M GRANITE TOPS INC CLINTON TWP 5329140A 750 3/31/2021 1624 K G HOME IMPROVEMENT LLC CLINTON TWP 5539382A 825 3/31/2021 5403 KMB SERVICES LLC CLINTON TWP 5700043A 800 2/4/2021 6325 KV PAINTING LLC CLINTON TWP 6123236A 751 2/20/2021 5476 LABOR SERVICES OF MI INC CLINTON TWP 4831667A 7,939 1/18/2021 5183 0.90 LANCO DEVELOPMENT LLC CLINTON TWP 4246365A 1,601 3/3/2021 5403 0.95 MA PAINTING LLC CLINTON TWP 5806070A 751 3/4/2021 5476 MC EXPRESS INC CLINTON TWP 5956030A 750 1/22/2021 7208 MILLENIUM PAINTING LLC CLINTON TWP 5967392A 750 2/14/2021 5476 MMO STRATEGIC IT CONSULTING LLC CLINTON TWP 6126278A 1,102 2/26/2021 5191 MOTOWN FISH & SHRIMP LLC CLINTON TWP 5820278A 944 2/2/2021 9058 MPH HOME IMPROVEMENT LLC CLINTON TWP 4929284A 751 2/6/2021 5437 PARK RIDGE CONDOMINIUM HOMEOWNERS CLINTON TWP 5845912A 568 3/23/2021 9015 ASSOCIATION POBLO INTERNATIONAL MINISTRIES CLINTON TWP 2433109A 1,980 1/24/2021 8868 0.95 PRESTIGE BUILDING AND CONSTRUCTION CLINTON TWP 3823598A 808 1/1/2021 5645 COMPANY PROPERTY CONCEPTS INC CLINTON TWP 5184100A 750 1/27/2021 5221 PROSSERVE LLC CLINTON TWP 6114466A 524 2/26/2021 7720 PT PROMOTIONS LLC CLINTON TWP 4179501A 229 1/5/2021 8742 R AND D TILE LLC CLINTON TWP 5867649A 750 1/7/2021 5348 RAJCO INC CLINTON TWP 3688097A 2,060 1/5/2021 8017 0.95 RB 1 TRUCKING INC CLINTON TWP 5846765A 750 3/24/2021 7208 REAL DEAL SIDING LLC CLINTON TWP 3533689A 750 1/11/2021 5645 RENOVATIONS MARBLE AND GRANITE INC CLINTON TWP 5020140A 4,284 3/11/2021 5437 RIMODEC INC CLINTON TWP 4112083A 750 2/22/2021 5476 ROOF PATROL LLC CLINTON TWP 3744787A 765 2/15/2021 8720 S AND I MASONRY INC CLINTON TWP 5232180A 15,566 1/29/2021 5022 1.66 13 % SHORELINE CONTRACTORS LLC CLINTON TWP 4478541A 750 3/5/2021 5183 1.00

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SOMETHING SHINY INC CLINTON TWP 3841065A 1,024 3/8/2021 9053 0.95 STANDER RICHARD B CLINTON TWP 1461400A 666 2/14/2021 8835 TILTON CONSTRUCTION LLC CLINTON TWP 5260752A 893 3/17/2021 5506 TODAYS CONSTRUCTION LLC CLINTON TWP 1761854A 2,487 1/14/2021 5437 0.95 TRANS JACK INC CLINTON TWP 3580687A 756 3/12/2021 5645 VESPER CONSTRUCTION OF FAR NIENTE INC CLINTON TWP 5785944A 750 1/5/2021 8810 WATERTITE HOME IMPROVEMENT LLC CLINTON TWP 2739771A 2,514 3/7/2021 5645 0.95 WILLIAMS CARPET CARE LLC CLINTON TWP 4918509A 1,043 2/21/2021 9015 0.95 ZONE 1 LOGISTICS LLC CLINTON TWP 5850789A 3,457 2/23/2021 7206 0.95 A AND B CONSTRUCTION & ROOFING LLC CLIO 3735001A 7,121 3/7/2021 5645 0.89 BROOKS DRYWALL SERVICES LLC CLIO 4688996A 750 1/30/2021 5445 CLIO AUTO MALL & WHOLESALE LTD CLIO 4971221A 1,519 1/25/2021 8395 0.95 FIRST CLASS CONCRETE LLC CLIO 5834317A 750 3/2/2021 5221 HETZER AUTO INC CLIO 2697106A 1,346 2/17/2021 8264 JAMES CHRISTENSEN PROPERTIES CLIO 4833872A 8,639 1/25/2021 9015 0.85 KIMMER CONSULTING LLC CLIO 5949114A 916 1/3/2021 5606 M AND N CLIO SERVICE LLC CLIO 5236290A 826 2/6/2021 7208 RILEY CONSTRUCTION CO INC CLIO 3250130A 750 1/1/2021 5645 VIENNA CONTRACTING & EQUIPMENT CORP CLIO 0622478A 750 3/31/2021 5645 WHOLE 9 YARDS SNOW REMOVAL AND LAWN CLIO 5789354A 656 1/3/2021 9402 CARE ZACEK CAMERON ENTERPRISES LLC CLIO 5367549A 751 1/29/2021 9015 0.95 LAWN PRO CLYDE 4447352A 709 3/25/2021 0042 MASONRY PLUS CLYDE 2928256A 750 1/15/2021 5215 TORNADO DEMOLITION CLYDE 5811058A 7,739 1/18/2021 5437 0.95 MARK SPARLING CONSTRUCTION LLC CLYDE TWP 0173207A 750 1/17/2021 5437 ANYTIME MOVING LLC COCONUT CREEK, FL 3073025A 8,240 1/1/2021 7214 DEVONTECHNOLOGIES LLC COEUR D ALENE, ID 6113400A 278 2/5/2021 8810 CP TRAVERSE BAY LEASECO LLC COLDWATER 4207750A 33,030 3/31/2021 9053 1.24 FORTITUDE STRENGTH AND CONDITIONING LLC COLDWATER 6127096A 544 2/27/2021 9063 MICHIGAN COMMERCIAL INTERIORS LLC COLDWATER 5803861A 825 1/20/2021 5020 STORM CONSTRUCTION LLC COLDWATER 5370337A 18,394 2/10/2021 5462 1.59 13 % TOMMYS HOUSE INC COLDWATER 5647789A 751 1/11/2021 9052 D P LOGGING LLC COLEMAN 2808293A 750 3/31/2021 2702 FRIENDLY ACRES LLC COLEMAN 3306941A 820 2/21/2021 9053

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HORST GALEN COLEMAN 6129315A 1,168 3/3/2021 3724 JOEL RHODES CONSTRUCTION INC COLEMAN 3422518A 784 2/8/2021 5645 LOCAL LABOR COLEMAN 6131794A 710 3/6/2021 0042 HERITAGE HEALTH FOOD INC COLLEGEDALE, TN 0968919A 41,611 3/14/2021 6504 2.03 27 % XLNT AMISH HANDYMAN LLC COLON 6106145A 7,900 1/24/2021 5645 AMERICAN LAWNS LLC COLUMBIAVILLE 6090915A 573 1/3/2021 9102 GEMINI MANAGEMENT INC COLUMBIAVILLE 4139682A 2,797 1/25/2021 5437 0.95 TOM ZEMMER PLUMBING COLUMBIAVILLE 2602598A 561 1/16/2021 5183 WERTH ROOFING & SIDING INC COLUMBIAVILLE 3284182A 753 1/1/2021 8742 ANCHORS AWAY MARINE COLUMBUS 5977355A 801 3/20/2021 8387 BUSEMANN CATTLE CO INC COLUMBUS 2894335A 535 2/14/2021 8810 0.95 INVISION FINISHING LLC COLUMBUS 5368154A 825 1/31/2021 5437 KRISCOTT ENTERPRISES COLUMBUS 4786190A 750 2/26/2021 5476 CRAIGS LANDSCAPE SERVICES COMMERCE 4644450A 1,585 3/12/2021 0042 0.95 FOUR SEASON PAINTING COMMERCE 4082443A 750 3/20/2021 5476 LSS CONSULTING INC COMMERCE 0396044B 322 1/1/2021 8810 0.86 PRECISION P LLC COMMERCE 0208264A 2,316 3/20/2021 5476 0.95 R KINNEY DRYWALL LLC COMMERCE 4653327A 750 2/8/2021 5445 RASP TECHNOLOGIES LLC COMMERCE 6128106A 216 2/28/2021 8810 TIMMONS AND ASSOCIATES INC COMMERCE 0396044A 6,413 1/1/2021 7720 0.86 TREE HUGGERS LLC COMMERCE 5726832A 750 3/14/2021 0106 VERES ENVIRONMENTAL GRAPHICS & SIGNS LLC COMMERCE 5690277A 668 3/14/2021 8742 COMBAT ARMORY LLC COMMERCE TOWNSHIP 6129820A 1,798 3/3/2021 3004 MARION GARY COMMERCE TOWNSHIP 5847060A 7,808 2/8/2021 5437 NO LIMIT TRANSPORTATION LLC COMMERCE TOWNSHIP 5514444A 1,980 2/4/2021 7208 SHOEPAC OUTING CLUB COMMERCE TOWNSHIP 1449419A 569 2/24/2021 9015 A AND L LAND SPECIALISTS LLC COMMERCE TWP 5981379A 2,609 3/30/2021 0042 ACS CLASSIC CYCLE WORKS LLC COMMERCE TWP 5389186A 1,021 3/21/2021 8395 ADVANCED ARBORCULTURE LLC COMMERCE TWP 5382688A 2,507 1/28/2021 0106 0.95 ALL PEAKS EXTERIOR HOME MAINTENANCE LLC COMMERCE TWP 6102018A 750 1/18/2021 5551 CEDAR WORKS INC COMMERCE TWP 3513343A 8,091 2/16/2021 5645 1.38 13 % CLEAN AIR CONTRACTING AND REMEDIATION COMMERCE TWP 4269020A 4,545 3/24/2021 9015 0.95 INC CUSTOM SHINE LLC COMMERCE TWP 5532523A 4,880 3/22/2021 9015 0.95 DRS PROPERTY MANAGEMENT LLC COMMERCE TWP 1247832A 3,784 1/3/2021 9015 1.27 13 %

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 29 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge LAKRITZ CARES LLC COMMERCE TWP 5794447A 1,586 2/5/2021 0908 MAC CONCRETE DEMOLITION INC COMMERCE TWP 5228468A 1,177 3/15/2021 5221 0.95 MCKENZIE CONSTRUCTION LLC COMMERCE TWP 5680859A 4,650 2/24/2021 5606 0.95 MERIDIAN SERVICES INC COMMERCE TWP 5348056A 481 3/28/2021 8810 1.31 13 % NO LIMIT FREIGHT SOLUTIONS LLC COMMERCE TWP 5514444B 233 2/13/2021 8810 OLD SAWMILL WOODWORKING INC COMMERCE TWP 4174593A 750 3/18/2021 5437 ON THE DUNES SPORTS BAR INC COMMERCE TWP 5151163A 1,968 3/6/2021 8017 1.00 PARKINSON ENTERPRISES COMMERCE TWP 4351959A 743 2/27/2021 3724 PROPERTY RENEWAL LLC COMMERCE TWP 5492572A 750 1/8/2021 5645 R 7 MANAGEMENT LLC COMMERCE TWP 5597048A 1,627 2/27/2021 6325 0.95 R ROMO TREE SERVICE INC COMMERCE TWP 5978327A 1,067 3/25/2021 0106 ROOF RITE INC COMMERCE TWP 3201538A 1,458 1/1/2021 5645 0.95 ST CLAIR INVESTMENT PROPERTIES LLC COMMERCE TWP 4655109A 569 3/22/2021 8810 URBAN ARBOR CARE LLC COMMERCE TWP 5387329A 4,456 3/1/2021 0106 VLASIC LABS LLC COMMERCE TWP 6130690A 2,819 3/4/2021 4825 ALL CROP FARMS LLC COMSTOCK PARK 6140742A 11,498 3/25/2021 0130 CHASE ORCHARDS INC COMSTOCK PARK 1994760A 1,639 1/15/2021 0130 0.95 EXTERIOR MOBILE WASH COMSTOCK PARK 4982339A 568 3/29/2021 9015 HAWKS CONSTRUCTION SERVICES LLC COMSTOCK PARK 5975565A 800 3/13/2021 5020 JBJ BUILDING & REMODELING INC COMSTOCK PARK 4158628A 750 1/29/2021 5437 JNM AUTO TRANSPORT LLC COMSTOCK PARK 6087876A 4,309 1/13/2021 7208 ODLUND BRADLEY COMSTOCK PARK 6116884A 750 2/12/2021 5476 PLATINUM CONTRACTING GROUP LLC COMSTOCK PARK 5959373A 1,804 1/25/2021 5606 PREMIER PAINTING LLC COMSTOCK PARK 5371066A 750 2/10/2021 5476 WATSON ROOFING CONCORD 6102921A 750 1/22/2021 5551 A RESTROOM TRAILER COMPANY LLC CONSTANTINE 5124522A 14,047 3/22/2021 3824 1.45 13 % ADVANCED PROPERTY MAINTENANCE LLC CONSTANTINE 5980046A 1,841 3/28/2021 9102 RAY VINSON CONSTANTINE 4391047A 751 1/29/2021 8810 SHOTKO TILE INC COOPERSVILLE 4963806A 750 2/16/2021 5348 GOULD WILLIAM JR CORAL 5951160A 750 2/12/2021 2702 RILEY KEEFER CORAL 6098223A 750 1/14/2021 5476 TENDERCARE SUPPORT LLC CORUNNA 5829739A 3,085 2/21/2021 8835 0.95 CHAINSAW CHARLIES LANDSCAPING INC COTTERVILLE 3958906A 750 3/13/2021 0042 BELANGER MAINTENANCE LLC COTTRELLVILLE 6131247A 568 3/5/2021 9015 CDG NORTHERN COTTREVILLE 5834619A 750 3/5/2021 5645 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 30 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge RIEBER CONTRACTING INC COUNCIL BLUFFS, IA 6138241A 1,705 3/20/2021 5403 BAICORP SYSTEMS INC COVINGTON, KY 5847036A 7,164 3/27/2021 7208 0.95 CROSWELL STOCKYARDS INC CROSWELL 1414968A 1,540 1/29/2021 0129 0.95 LERMA CONCRETE CROSWELL 3539806A 801 2/20/2021 5221 WALLS BIN SALES INC CROSWELL 4401468A 813 3/14/2021 5538 0.95 SMITH TIMBERSTAND IMPROVEMENT LLC CRYSTAL FALLS 5360714A 750 1/15/2021 2702 BOHRN BRAD DAFTER 4950267A 750 1/11/2021 2709 NORTHERN TREE SERVICE LLC DAFTER 0256862A 3,600 3/28/2021 0106 COLE AND COLE FOREST PRODUCTS LLC DAGGETT 0071552A 750 1/19/2021 2702 HAFEMAN FOREST PRODUCTS DAGGETT 1248022A 750 1/20/2021 2709 IHANDER HOME DAGGETT 2276380A 471 3/19/2021 9053 KUNTZE PHILLIP J DAGGETT 6137652A 750 3/20/2021 5645 NELSON TRUCKING DAGGETT 2158884A 750 3/10/2021 7208 PHELPS TRUCKING LLC DAGGETT 5656702A 750 1/7/2021 7208 NORTH 80 FARMS LLC DALLAS, TX 5731720A 4,529 1/18/2021 0042 0.95 PRESERVE AT ISLAND LAKE ASSOCIATION DALLAS, TX 5959357A 580 1/25/2021 9015 ACCU GRIND INC DANSVILLE 3595951A 750 2/9/2021 0106 PIONEER CEL INC DANSVILLE 3010228A 3,806 3/4/2021 5645 0.95 AAGH INC DAVIDSON 5115493A 13,769 1/10/2021 9403 0.87 ADVANCED TREE SOLUTIONS INC DAVISBURG 4200497A 1,453 2/8/2021 0106 0.93 BAKER BUILDING COMPANY LLC DAVISBURG 5075734A 750 1/16/2021 5645 BID RITE CONTRACTING LLC DAVISBURG 5867215A 750 2/4/2021 5437 DEAN FARNER THE MICHIGAN HOME INSPECTOR DAVISBURG 5847001A 439 3/27/2021 8720 INC DIVINE MERCY COUNCIL 14883 DAVISBURG 5947561A 361 1/5/2021 9061 GREG MATZELLE WOODWORKER LLC DAVISBURG 5846684A 1,569 3/24/2021 5437 HUMPHREYS DOLORES J DAVISBURG 5526043A 530 3/10/2021 0913 MICHAEL CHRISTIAN HOMES INC DAVISBURG 3768090A 750 2/14/2021 5437 ROBINSON TIMOTHY A DAVISBURG 3692345A 750 1/12/2021 5645 SUPERIOR HOMES DAVISBURG 5210143A 750 2/17/2021 5645 ALEXANDER WELLPOINT DEWATERING LLC DAVISON 4982924A 611 2/25/2021 5183 0.95 BMJB LLC DAVISON 5821959A 414 2/9/2021 8742 COVERTS CREW LLC DAVISON 1877275A 750 3/17/2021 5645 DAVISON CARE N ASSIST LLC DAVISON 5378320A 5,837 3/2/2021 8835 0.86 FERGUSON FOAM LLC DAVISON 5389585A 1,411 3/5/2021 5479 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GREATER FLINT JANITORIAL SERVICES INC DAVISON 1962736A 27,559 1/1/2021 9015 1.67 27 % HOLLAND SALON LLC DAVISON 4833252A 334 1/22/2021 9586 K AND L EMERGENCY POWER SYSTEMS INC DAVISON 5340659A 1,148 1/9/2021 9519 0.95 KEHOE CRAIG DAVISON 6103197A 750 1/21/2021 5645 OUTREACH EAST DAVISON 5361982A 271 1/24/2021 8810 PICK UP AN GO DAVISON 6115845A 4,880 2/11/2021 7206 RIES GREG DAVISON 6102913A 750 1/21/2021 5645 SENIOR CARE OF MICHIGAN LLC DAVISON 3716503A 241 2/6/2021 8810 SUNSHINE HOME CARE OF MICHIGAN INC DAVISON 5033330A 15,696 1/6/2021 8835 1.56 13 % SYNTRONIC SYSTEMS LLC DAVISON 5522234A 719 3/2/2021 9519 WHALEN BROTHERS POWERWASHING & DAVISON 2674262A 751 3/20/2021 5476 PAINTING WRIGHT BROTHERS EXTERIORS DAVISON 4539419A 750 1/21/2021 5645 ALMANSOOB HAMZAH DEARBORN 6130321A 750 3/11/2021 7208 AMERICAN INTERNAL MEDICINE PC DEARBORN 5183057A 489 2/20/2021 8832 ANK FLOORING INC DEARBORN 3865851A 591 1/24/2021 9521 ARABIAN HORIZONS TRAVEL AND TOURISM CO DEARBORN 2862654A 239 1/15/2021 8810 0.95 INC ARMENIAN COMMUNITY CENTER OF GREATER DEARBORN 2569655A 242 1/1/2021 8810 DETROIT BEST CARPET SALES & SERVICES LLC DEARBORN 1614860A 591 2/21/2021 9521 CASINOS WILD INC DEARBORN 2872811A 931 1/17/2021 8017 0.95 CRYSTAL CLEAR IMAGES LLC DEARBORN 6134505A 301 3/12/2021 5191 D B N REFRIGERATION LLC DEARBORN 2546957A 674 2/10/2021 5550 DEARBORN AUTO ALL INC DEARBORN 6135161A 1,308 3/13/2021 8395 DEARBORN AVENUE BISTRO INC DEARBORN 0509450A 4,300 1/1/2021 9058 0.95 DELUXE CARPET INSTALLATION INC DEARBORN 3672085A 590 3/1/2021 9521 EDWARD HOTEL MANAGEMENT LLC DEARBORN 5533376A 3,877 3/7/2021 7720 0.88 EXECUTIVE INFUSION SERVICES LLC DEARBORN 5435129A 1,377 2/24/2021 8835 0.95 FAVOT INC DEARBORN 4101669A 3,866 2/3/2021 9058 FELT JULIA KAY DEARBORN 1530968A 459 2/4/2021 0909 HAZEN TRANSFER LLC DEARBORN 5905273A 1,469 2/5/2021 8810 HAZINSKI JASON DEARBORN 5210453A 750 1/21/2021 5437 HNK TRUCKING INC DEARBORN 5680875A 750 3/15/2021 7208 IM ELECTRIC INC DEARBORN 5338395A 471 3/20/2021 5190 LA EXPRESS TRUCKING INC DEARBORN 6134181A 2,574 3/11/2021 7208 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 32 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge LAPENGUINA DELI INC DEARBORN 1768336A 330 2/4/2021 9058 M E W C INC DEARBORN 0943398A 723 1/26/2021 9058 MAGIC CARPET THEATRE INC DEARBORN 5679605A 684 2/22/2021 9154 METROPOLITAN WINDOWS & IMPROVEMENTS DEARBORN 2304040A 800 3/6/2021 5645 0.95 INC NATIONAL TOWING LLC DEARBORN 4724488A 825 2/1/2021 7208 0.95 PANDORA CARPET INSTALLATION INC DEARBORN 4959035A 591 2/24/2021 9521 PD DEARBORN INC DEARBORN 5673593A 346 3/24/2021 9058 R AND R CARPET INC DEARBORN 5361664A 590 3/28/2021 9521 R AND R ROOF AND LEAK REPAIR LLC DEARBORN 4961250A 1,742 3/29/2021 9015 0.95 R AND W TOP NOTCH CONCRETE INC DEARBORN 3372227A 750 3/15/2021 5221 RADAN ENTERPRISES INC DEARBORN 4239172A 1,429 2/28/2021 9521 RAYS CARPET INSTALLATION INC DEARBORN 5253497A 976 3/25/2021 9521 RB LEGACY HOLDINGS INC DEARBORN 0100307A 825 1/30/2021 5102 0.84 RESTAURANT OAKMAN LLC DEARBORN 4926510A 3,654 3/6/2021 9058 1.00 ROMAN FLOORS & REMODELING INC DEARBORN 4371259A 752 3/3/2021 9521 0.95 ROSE MOTOR SALES LLC DEARBORN 2644614A 310 1/31/2021 8810 SALINAS WALLCOVERING & PAINTING DEARBORN 2345552A 800 2/20/2021 5476 SEVEN THOUSAND 954 EXPRESS INC DEARBORN 5667151A 694 3/27/2021 8017 0.95 SHERIDAN REAL ESTATE HOLDINGS LLC DEARBORN 0236284A 643 1/24/2021 9015 0.95 UNIVERSAL TRANSPORT II LLC DEARBORN 2799111A 510 1/29/2021 8810 AJ TRUCKING SERVICES LLC DEARBORN HEIGHTS 5974267A 3,540 3/9/2021 7380 BARRETTA MARBLE STONE AND TILE LLC DEARBORN HEIGHTS 5266904A 750 3/28/2021 5348 BURT AUTO REPAIR INC DEARBORN HEIGHTS 2970996A 878 3/5/2021 8395 0.95 DEMMON C ROBINSON INC DEARBORN HEIGHTS 0005061A 3,165 2/9/2021 5645 0.95 EXPRESS AUTO REPAIRS LLC DEARBORN heights 0917974A 540 1/9/2021 8395 FAB FLOORS LLC DEARBORN HEIGHTS 5357365A 1,343 3/5/2021 9521 FLOORING MASTER SERVICES INC DEARBORN HEIGHTS 5537967A 1,179 3/29/2021 9521 GREAT LAKES CONSTRUCTION ENTERPRISES DEARBORN HEIGHTS 4808991A 1,454 1/22/2021 5348 INC H AND N SERVICES INC DEARBORN HEIGHTS 4598571A 751 1/25/2021 7380 HILLS AUTO SERVICE INC DEARBORN HEIGHTS 3863085A 756 1/20/2021 8017 I B RESOURCES INC DEARBORN HEIGHTS 3623467A 5,012 1/12/2021 8810 0.81 INCREDIBLE HARDWOOD FLOORS LLC DEARBORN HEIGHTS 5969018A 750 2/21/2021 5437 JIORDANO CHRISTOPHER DEARBORN HEIGHTS 3856097A 750 3/10/2021 5645

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge JORDAN TRANSPORTATION AND LEASING LLC DEARBORN HEIGHTS 3906760A 754 1/9/2021 8810 KRISTI CLEANING SERVICE DEARBORN HEIGHTS 6141684A 718 3/26/2021 9015 MALIBOU INC DEARBORN HEIGHTS 5823307A 1,032 2/12/2021 9058 MIDFIELD GAS AND OIL CO DEARBORN HEIGHTS 3711820D 539 2/12/2021 8017 MLR TRANSPORT LLC DEARBORN HEIGHTS 5692393A 4,334 3/17/2021 7212 0.95 ND TOWING AND AUTO LLC DEARBORN HEIGHTS 6094651A 2,626 1/9/2021 7208 NORTHLINE TRANSIT LLC DEARBORN HEIGHTS 5972310A 1,844 1/7/2021 7208 ROADRUNNERS TRANS LLC DEARBORN heights 5951437A 309 1/12/2021 8810 S AND Y SERVICES INC DEARBORN HEIGHTS 5232554A 750 1/29/2021 5645 SDB INC DEARBORN HEIGHTS 0069361A 1,131 1/14/2021 9058 0.95 SEVEN 12 ELECTRIC LLC DEARBORN HEIGHTS 5059542A 520 3/9/2021 5190 0.95 TEDS CARPET SERVICE DEARBORN HEIGHTS 4468813A 540 1/13/2021 9521 TWC TRANSPORT INC DEARBORN HEIGHTS 5973295A 1,597 3/13/2021 7208 UD HOLDINGS LLC DEARBORN HEIGHTS 5220149A 645 2/5/2021 4511 0.95 YDM INC DEARBORN HEIGHTS 4551761A 591 1/17/2021 9521 IMONA LLC DEARBORN HTS 6144160A 750 3/31/2021 7208 JURASSIC ADVENTURES LLC DEARBORN HTS 5272548A 997 1/31/2021 9015 0.95 ROSIE DS PIZZERIA INC DEARBORN HTS 3213552A 2,157 1/30/2021 9058 0.95 KEINATH TIRE INC DECKERVILLE 5806453A 6,588 3/5/2021 8395 0.95 TWISS BUILDERS INC DECKERVILLE 2139235A 750 1/23/2021 5645 MAKI FOREST PRODUCTS DEERTON 2505304A 750 2/19/2021 2702 BOOTZ DAVID RENE DEFORD 0518840A 800 2/23/2021 5437 ZIMBA DAIRY INC DEFORD 2107910A 37,738 2/20/2021 0129 0.98 AMERICAN MARKETING & PUBLISHING LLC DEKALB, IL 4910974A 397 2/28/2021 8742 ZENZ FARMS INC DELTA, OH 6059945A 5,827 1/1/2021 3724 ANDERSON TILE DELTON 6131824A 751 3/6/2021 5348 MOUNTAIN TOP WINDOW COVERINGS LLC DELTON 5970750A 615 2/27/2021 9521 THIRD GENERATION EXCAVATING LLC DELTON 5791677A 814 1/12/2021 6217 VANAVERY AUSTIN DELTON 6099203A 568 1/15/2021 9015 ZERO DAY INC DELTON 5137250A 766 1/11/2021 8810 0.93 DUFECK MANUFACTURING CO INC DENMARK, WI 5474710A 12,808 3/21/2021 2731 0.82 PIRGIM PUBLIC INTEREST LOBBY INC DENVER, CO 1636456A 215 2/5/2021 8810 VANGST TEMP LLC DENVER, CO 6095232A 6,010 1/10/2021 0035 A AND A DELI INC DETROIT 5859743A 615 2/25/2021 9058 A C MANZIE TREE & STUMP REMOVAL LLC DETROIT 4803752A 880 3/12/2021 0106 0.95 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 34 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge A C TOWING INCORPORATED DETROIT 0838993A 5,075 3/27/2021 7208 0.90 ADVANCED MIXOLOGY INSTITUE LLC DETROIT 6109608A 1,011 1/28/2021 9058 AHD INVESTMENT INC DETROIT 4343921A 1,090 3/25/2021 8017 0.95 ALBERTOS CONSTRUCTION INC DETROIT 4973496A 1,537 3/23/2021 5645 AMANDLA COMMUNITY DEVELOPMENT DETROIT 4504070A 491 3/13/2021 8832 CORPORATION AMERICAN RENTAL SALES AND SERVICE LLC DETROIT 5958814A 750 1/24/2021 7208 ANA ENTERPRISES INC DETROIT 3306151A 710 1/12/2021 8017 ANDERSON PAINT STORE LLC DETROIT 2225573A 750 3/2/2021 5476 ANDRADE ALFREDO PACHECO DETROIT 5805678A 540 1/17/2021 9521 ANGEL CARE HOMES INC DETROIT 4692632A 3,299 3/14/2021 9053 0.95 APOSTOL ELEAZER DETROIT 5117089A 541 3/20/2021 9521 APOTHECARY SOLUTIONS LLC DETROIT 6104410A 2,045 1/22/2021 8835 ATSC AUTOMOTIVE GROUP INC DETROIT 4231414A 1,449 1/2/2021 8395 AZUL GARDENS LLC DETROIT 4903862A 523 2/26/2021 9102 B AND M GARAGE DOOR & INSTALLATION INC DETROIT 3875733A 241 3/18/2021 8810 BEARD ASSOCIATES INC DETROIT 2524597A 1,665 3/27/2021 5183 0.95 BEST ROOFING COMPANY LLC DETROIT 6097944A 750 1/14/2021 5551 BILTMORE DEVELOPMENT GROUP LLC DETROIT 6087787A 618 1/31/2021 9015 BING YOUTH INSTITUTE INC DETROIT 5357136A 517 1/6/2021 8810 BLUE HORIZON CONSTRUCTION LLC DETROIT 6127142A 5,700 2/27/2021 5645 BRIANNAS HOME DETROIT 5970407A 1,115 3/2/2021 9053 BRIANS HOME IMPROVEMENT DETROIT 6115306A 751 2/10/2021 5348 BRIGHTMOOR PETROLEUM INC DETROIT 5826110A 512 2/15/2021 8017 BUDS AUTO INC DETROIT 4962699A 468 1/24/2021 8393 CAREARBOR LC LLC DETROIT 6115756A 9,110 2/8/2021 8047 CELEBRITY MANAGEMENT COMPANY DETROIT 0637866A 2,628 1/1/2021 9058 1.00 CHAMBER MUSIC SOCIETY OF DETROIT DETROIT 1911821A 549 1/1/2021 8810 CHARITY HOME CARE SERVICES INC DETROIT 4572874A 2,407 1/17/2021 9053 0.95 CHENE AND TROMBLEY MARKET INC DETROIT 2468522A 1,173 2/20/2021 8017 0.95 CHI CHI GROUP HOME INCORPORATED DETROIT 4529480A 1,247 1/10/2021 9053 CHILDREN OF THE RISING SUN EMPOWERMENT DETROIT 5803160A 1,046 1/12/2021 8869 CENTER CITY SERVICE TOWING LLC DETROIT 6139817A 750 3/24/2021 7208 CLARK PARK COALITION DETROIT 3764940A 759 2/8/2021 9063 1.00

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CMP EXPRESS LLC DETROIT 4446429A 8,247 1/10/2021 7208 0.95 CORPORATE ELEVATOR ASSET MANAGEMENT DETROIT 4062418A 883 3/30/2021 8720 INC COVENANT CONNECTIONS HOME CARE LLC DETROIT 4505751A 2,928 3/23/2021 8835 0.95 DEMMY VENTURES INC DETROIT 5451507A 481 2/13/2021 8395 DETROIT CITY FOOTBALL CLUB LLC DETROIT 5911621B 7,267 2/25/2021 9178 0.95 DETROIT TRAINING CENTER INC DETROIT 4882741B 354 1/5/2021 8810 1.08 DETROIT WINDSOR TRUCK FERRY INC DETROIT 0808342A 637 3/20/2021 8017 0.95 DIAZ BUILDING SOLUTIONS LLC DETROIT 6128076A 3,515 3/9/2021 5551 DIVERSIFIED CONCRETE & TRUCKING LLC DETROIT 2725967A 751 2/8/2021 5221 DOLLAR JOY PLUS INC DETROIT 5163838B 833 3/8/2021 8017 0.95 DOWNRIVER UTILITY WASTEWATER AUTHORITY DETROIT 5951542A 449 1/17/2021 8742 EAST WARREN HARDWARE INC DETROIT 5847710A 751 3/28/2021 8010 EDSO INSULATION LLC DETROIT 5811830A 750 2/25/2021 5479 EIGHT MILE AND TELEGRAPH MINI MART INC DETROIT 4728700A 497 1/22/2021 8017 0.95 EIGHTFOLD MARKETING & CREATIVE LLC DETROIT 5514401A 742 2/4/2021 7610 ELEVATOR TECHNOLOGY INC DETROIT 0097667A 10,060 1/6/2021 8720 1.40 13 % ESTIBI FLOORING LLC DETROIT 5968615A 750 2/20/2021 5348 EXQUISE INC DETROIT 5710570A 2,070 1/16/2021 5188 FAIR NASH LIQUOR INC DETROIT 0315214A 623 3/6/2021 8017 FAST SPLASH INC DETROIT 4025679A 17,796 1/15/2021 8387 2.01 10 % FEDERAL ARMORED TRUCK INC DETROIT 0228591B 470 3/27/2021 8810 0.95 FENKELL FUEL & GROCERY INC DETROIT 5721610A 367 1/18/2021 8017 FENKELL GAS & MART INC DETROIT 4725506A 329 2/28/2021 8017 FIRST FAST CONSTRUCTION LLC DETROIT 5839238A 2,052 3/28/2021 5551 FIRST HAND RESTORATION LLC DETROIT 4635850A 1,918 2/8/2021 8835 FORMIDABLE COMMUNICATIONS LLC DETROIT 5899893A 825 2/4/2021 7600 G AND B ROOFING INC DETROIT 2770881A 825 1/21/2021 5551 G GOMEZ CONSTRUCTION LLC DETROIT 5779715A 750 2/28/2021 5476 0.94 GABRIEL SAUCEDO SERVICES LLC DETROIT 5979714A 540 3/27/2021 9521 GARYS TREE AND HANDYMAN INC DETROIT 5695473A 1,750 3/27/2021 0106 GEORGE K NOVI GP INC DETROIT 3366570A 643 1/5/2021 9015 GOMEZ ROOFING LLC DETROIT 5613566A 750 1/3/2021 5551 GOSPEL AGAINST AIDS DETROIT 5380138A 264 3/5/2021 8742 GRAND RIVER BOOST MOBILE INC DETROIT 4618459B 302 3/27/2021 8810

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GTZ PAINTING LLC DETROIT 4513444A 4,063 1/24/2021 5476 0.95 GUZMAN LANDSCAPING SVCS INC DETROIT 5711100A 3,995 3/23/2021 0042 0.93 H AND A AUTO PARTS LLC DETROIT 5961653A 483 1/31/2021 8395 H AND S DRYWALL INC DETROIT 3059537A 750 2/26/2021 5445 HM PAINTING LLC DETROIT 5826160A 750 3/8/2021 5476 HMDS 1 LLC DETROIT 5952581A 1,450 1/15/2021 2003 HPS MULTI SERVICES LLC DETROIT 6131310A 2,905 3/5/2021 9015 HURON PLAZA LLC DETROIT 2754487A 648 1/4/2021 8810 I AND M MAINTENANCE LLC DETROIT 6125859A 750 2/26/2021 5445 INKWELL PARTNERS LLC DETROIT 6096905A 269 1/11/2021 8810 INTER CITY STEEL COMPANY LLC DETROIT 5515351A 756 2/17/2021 8810 IZZIE LOGISTICS & DISTRIBUTION LLC DETROIT 6101046A 568 1/17/2021 9015 IZZY AND DURAN CONSTRUCTION INC DETROIT 6116906A 750 2/12/2021 5645 J AND W CONTRACTORS LLC DETROIT 5505968A 3,207 3/7/2021 5022 0.95 JACKETS FOR JOBS INC DETROIT 3727726A 762 2/23/2021 8832 JACOB MOBIL MART LLC DETROIT 6093841A 757 1/17/2021 8017 JL PAINTING DETROIT 5614341A 751 1/9/2021 5476 JOE MARRA ENTERPRISES DETROIT 5522560A 750 3/3/2021 0106 JOLLETTE CLEANING SERVICES LLC DETROIT 5823978A 568 2/13/2021 9015 JONATHON CORP DETROIT 0742066A 512 1/31/2021 8017 0.95 JSGC TRUMPPS LLC DETROIT 2945711A 7,101 2/9/2021 9058 0.70 JUVENILE LAW GROUP PLLC DETROIT 4691750A 1,105 3/16/2021 8820 0.95 K AND M EXPRESS LLC DETROIT 5953570A 825 1/16/2021 7208 KINGSWAY BLDG & MAINTENANCE INC DETROIT 1192698A 750 2/20/2021 5645 0.95 KTA FOOD AND FUEL INC DETROIT 6134874A 720 3/12/2021 8017 L A W LAWN SERVICE INC DETROIT 3173771A 573 3/26/2021 9102 L THOMS LEASING INC DETROIT 2309467A 1,574 2/8/2021 8393 0.95 LA CASA DE LA HABANA DETROIT INC DETROIT 4803132A 2,027 2/20/2021 8017 0.95 LA SQUIRE LLC DETROIT 6131298A 357 3/5/2021 9058 LEGACY TRANSPORT SERVICES LLC DETROIT 5236126A 756 2/6/2021 8810 0.95 LINWOOD DEVELOPMENT LLC DETROIT 4040368A 644 1/10/2021 8810 LMD CONSTRUCTION LLC DETROIT 5410428A 750 3/3/2021 5437 LOTUS TECHNOLOGIES LLC DETROIT 6113621A 1,234 2/14/2021 5606 M I I A INC DETROIT 4305760A 750 1/17/2021 9015 MAH TRADING LLC DETROIT 3841499A 2,965 3/1/2021 3821 0.95 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 37 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MAJESTIC THEATRE CENTER INC DETROIT 0328731A 8,606 3/30/2021 9058 1.00 MAKAVELI CONSTRUCTION AND ASSOCIATES INC DETROIT 5911940A 750 3/31/2021 5221 MANNYS GENERAL LABOR INC DETROIT 5976910A 967 3/19/2021 9015 MARVEL EARTH MANAGEMENT LLC DETROIT 6114423A 1,088 3/25/2021 5606 MASTER Q CONSTRUCTION INC DETROIT 5459389A 3,462 3/23/2021 5552 0.95 MATT CONSTRUCTION INC DETROIT 4254643A 800 2/20/2021 5645 MAXIMIZE SECURITY SYSTEMS LLC DETROIT 2331667A 1,512 3/11/2021 5191 0.95 MELGAR CONSTRUCTION DETROIT 6123430A 800 2/24/2021 5551 METRO HAULING LLC DETROIT 6101089A 4,947 2/28/2021 7208 METRO VALET PARKING SOLUTION LLC DETROIT 5188172A 4,040 2/15/2021 8392 0.90 METROPOLITAN ARTS COMPLEX INC DETROIT 0916358A 490 1/28/2021 8832 MEXICANTOWN COMMUNITY DEVELOPMENT DETROIT 3124290A 284 2/7/2021 8810 CORPORATION MILIS CLEANING SERVICE DETROIT 6118232A 568 2/13/2021 9015 MOES SERVICE STATION 3 INC DETROIT 4122690A 552 2/4/2021 8017 0.95 MRA CONSTRUCTION LLC DETROIT 5422310A 750 1/7/2021 5645 0.95 MRM PRODUCTS CO DETROIT 1261258A 738 1/21/2021 8017 NATIONAL WINDOW CLEANING & MAINTENANCE DETROIT 0057266A 1,839 1/1/2021 9015 0.95 COMPANY NELSON AUTO SALE INC DETROIT 3148424A 261 3/3/2021 8748 NEW GENERATION ROOFING & CONSTRUCTION DETROIT 5367433A 750 3/16/2021 5538 LLC NIKA AND CO LLC DETROIT 6129501A 440 3/20/2021 8742 NO LIMIT TREE SERVICE AND LANDSCAPING LLC DETROIT 6102824A 1,369 1/21/2021 0042 NORMANS PLUMBING DETROIT 3918696A 2,390 2/19/2021 5183 0.95 NORTHLAND CLEANING SERVICES LLC DETROIT 5343780A 568 2/14/2021 9015 NORTHWEST COMMUNITY PROGRAMS INC DETROIT 0082686A 4,081 2/20/2021 9015 0.92 OBEID K ENTERPRISES INC DETROIT 3622541A 760 3/16/2021 9521 ONYX ENTERPRISE INC DETROIT 5407354A 979 2/27/2021 8601 0.95 PARKSIDE I LLC DETROIT 5520738A 740 1/1/2021 9015 PCC INTERIORS INC DETROIT 5739411A 12,291 2/9/2021 5437 0.92 PEREZ CARDENAS ROLDOLFO DETROIT 6131204A 750 3/5/2021 5445 PEREZ CARPET INC DETROIT 6125263A 590 2/25/2021 9521 PEREZ DRYWALL DETROIT 6113370A 750 2/5/2021 5445 PHO LUCKY LLC DETROIT 5497280A 4,924 1/10/2021 9058 1.27 13 % PHOENIX BUILDING AND CONSTRUCTION CO DETROIT 2200953A 3,626 3/27/2021 5606 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 38 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PIZARRO JUAN A LOPEZ DETROIT 6112099A 750 1/31/2021 5645 PLAYERS DETROIT 1364456A 235 1/8/2021 8810 QUICK DUMPSTER LLC DETROIT 4254643B 750 3/7/2021 7213 RECINOS DRYWALL DETROIT 6140734A 801 3/26/2021 5445 RIGGIO INVESTMENT COMPANY LLC DETROIT 5756405A 800 1/1/2021 5403 ROBINS DISTRIBUTORS INC DETROIT 1022024A 15,556 3/3/2021 6504 0.83 ROBYS ENTERPRISE LLC DETROIT 6061214A 1,028 1/22/2021 0042 RODRIGUEZ ARMANDO DETROIT 6108954A 750 2/5/2021 5445 ROMELS TOWING LLC DETROIT 5655340A 800 1/5/2021 7208 RYS CONST LLC DETROIT 5184690A 750 3/12/2021 5551 0.95 S AND C FLOORING DETROIT 6100260A 540 1/16/2021 9521 S AND R LIVERNOIS INC DETROIT 6120148A 699 2/22/2021 8017 SAMONA MARKET INC DETROIT 0976555A 830 3/15/2021 8017 0.95 SAN MINI MART INC DETROIT 4966759A 770 3/2/2021 8017 SANDERS LEARNING CENTER DETROIT 0496421A 623 2/3/2021 8869 SCHAEFER AUTO SALES LLC DETROIT 5813212A 449 1/23/2021 8748 SESSION VINCENT DETROIT 6112560A 750 2/19/2021 7213 SEVEN THOUSAND 930 MACK AVE LLC DETROIT 2408139A 5,853 1/16/2021 7214 0.93 SHAMEL ENTERPRISES LLC DETROIT 3501981A 751 1/15/2021 3821 SIX AND J GAS AND MORE INC DETROIT 2940507A 473 2/14/2021 8017 SMART DEVELOPMENT LLC DETROIT 6112005A 2,149 1/31/2021 7208 SMM INVESTMENT INC DETROIT 3646033A 572 3/20/2021 8017 SRL CONSTRUCTION LLC DETROIT 5422213A 750 3/3/2021 5221 STAR WELDING AND STEEL INC DETROIT 5697336A 941 2/9/2021 3365 SUN U S A CORPORATION DETROIT 1687603A 369 3/7/2021 8008 TEAMSTERS LOCAL UNION 1038 IBT DETROIT 1130064A 473 3/25/2021 8810 TIGRA CONSTRUCTION DETROIT 6115888A 800 2/19/2021 5551 TK FUND QOZB LLC DETROIT 6113869A 578 2/13/2021 8742 TODDS TOWING LLC DETROIT 6101089B 1,625 3/15/2021 7208 TOTAL ARMORED CAR SERVICE INC DETROIT 0228591A 1,927 3/26/2021 7720 0.95 TRADE FAIR MANAGEMENT INC DETROIT 3126820A 667 1/8/2021 8017 TRI STAR INTERNATIONAL TRADING COMPANY DETROIT 4375653A 2,037 3/7/2021 8292 0.95 TRIPLE CS CARE INC DETROIT 4525353A 1,720 1/30/2021 9053 0.95 TROTTIER INC DETROIT 0626376A 1,065 1/1/2021 9058 0.95 TURNER SEGUE HOME INC DETROIT 4570960A 1,704 1/17/2021 9053 0.95 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 39 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TWENTY FOUR SEVEN C STORE LLC DETROIT 5157617A 1,053 3/14/2021 8017 TYUS CONSTRUCTION LLC DETROIT 6074081A 4,051 1/10/2021 5645 U SNAP BAC INC DETROIT 2492300A 530 2/8/2021 8810 UNITED CONSTRUCTION SERVICES LIMITED LLC DETROIT 4730143A 4,240 3/27/2021 5645 0.95 V AND J INC DETROIT 1745484A 3,903 3/30/2021 7720 1.00 VARGS CARPET DETROIT 6120210A 590 3/3/2021 9521 VELASQUES CARPET DETROIT 5828600A 999 2/20/2021 9521 VIKING MANAGEMENT LLC DETROIT 1768000A 1,151 1/21/2021 9052 0.95 W 3 JJ BARNEY JV LLC DETROIT 6093175A 413 1/14/2021 5606 WARREN AND LIVERNOIS MINI MART INC DETROIT 4728700B 461 1/7/2021 8017 0.95 WASAN TRANSPORT LLC DETROIT 6134858A 825 3/12/2021 7214 WASHINGTON GREAT LAKES JV LLC DETROIT 5656834A 611 1/7/2021 5183 WHITE HELENE & LEVIN CHARLES DETROIT 0769088A 860 3/23/2021 0913 0.95 WICKLOW WINDOWS & WEATHERIZATION LLC DETROIT 5225191A 2,017 1/10/2021 5479 0.95 WILLIAMS COMMUNITY LIVING INC DETROIT 0908665A 4,929 2/28/2021 9053 0.90 WOODWARD AND HARMON MINI MART INC DETROIT 3763218A 522 1/22/2021 8017 YAAGS CARPET INSTALLATION LLC DETROIT 5815940A 618 1/17/2021 9521 BARBERS EXTERIOR LLC DEWITT 5951143A 800 1/10/2021 5645 FLORES AND COONEY DEVELOPMENT INC DEWITT 0179728A 826 1/22/2021 5437 ZIMMER FINISH CARPENTRY LLC DEWITT 2895870A 751 3/9/2021 5437 CLARAS HOUSE DEXTER 5533635A 3,729 2/28/2021 9053 0.93 FIRESIDE HOME CONSTRUCTION LLC DEXTER 3976505A 1,363 2/9/2021 5606 0.95 G S G PAINTING LLC DEXTER 1791389A 750 2/20/2021 5476 JCB HOMES LLC DEXTER 5834376A 825 3/2/2021 5645 RANDOLPH BUILDERS LLC DEXTER 6109233A 4,536 2/13/2021 5437 RB COMPANY CONSTRUCTION & MANAGEMENT DEXTER 0666459A 750 2/24/2021 5645 INC RON JOSEPHSON CEMENT INC DEXTER 2406659A 871 3/25/2021 5221 TRINKLE HOME IMPROVEMENTS INC DEXTER 4703499A 750 2/13/2021 5645 TROTTER GROUP LLC DEXTER 5744989A 568 3/8/2021 9015 WOLF TILE COMPANY LLC DEXTER 6084885A 2,128 2/4/2021 5348 B STEWART TRUCKING JLLC DIAMONDALE 6138225A 800 3/21/2021 7208 HAMMEL MANUFACTURING SERVICES LLC DIMONDALE 5117097A 418 3/20/2021 8601 B AND V SIDING & EXTERIORS LLC DORR 4072456A 750 2/17/2021 5645 DMX EXPRESS TRANSPORT INC DORR 4960122A 304 1/15/2021 8810

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 40 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge JAEGER CONTRACTING LLC DORR 5948592A 764 1/28/2021 5610 JOSHUA BOZE CONSTRUCTION DORR 6130399A 750 3/4/2021 5437 KERRYLU LLC DORR 6115098A 750 2/8/2021 7208 RON PAPIN FOREST PRODUCTS INC DORR 1371967A 1,527 1/31/2021 2731 1.00 SHAFFER TREE SERVICES LLC DORR 4929888A 8,807 1/1/2021 0106 0.94 WEST WOOD BUILDERS INC DORR 0343854A 750 1/28/2021 5645 LAKESIDE CO LLC DOWAGIAC 6135935A 792 3/14/2021 8010 PREFERRED PRINTING INC DOWAGIAC 1796089A 2,730 1/15/2021 4299 0.95 PROFESSIONAL MANAGEMENT SYSTEMS INC DOWAGIAC 3709671A 429 3/22/2021 8832 SIMS TREE LLC DOWAGIAC 5674778A 4,484 3/15/2021 0106 0.95 TOP HAT CHIMNEY SERVICE DOWAGIAC 3015513A 4,962 3/15/2021 9015 1.08 VYLONIS JOHN A DOWAGIAC 1767534A 750 3/13/2021 5403 BAKERS EXCAVATING LLC DOWLING 5846366A 1,810 3/23/2021 6217 0.95 KNOX LAWN & LANDSCAPE LLC DRYDEN 1293230A 1,127 3/23/2021 0042 TEBBEN FARMS LTD DRYDEN 1406760A 11,155 1/1/2021 9058 1.12 CLIFF R LATHROP INC DUNDEE, IL 5527570A 1,779 1/27/2021 7219 0.95 THEBOLT CONSTRUCTION DUNDEE 5842280A 750 3/26/2021 5645 CULP ELECTRIC INC DURAND 1730339A 1,910 2/10/2021 5190 CW BUILDERS DURAND 5682550A 750 2/28/2021 5437 DON HENRY CONSTRUCTION DURAND 3741753A 5,562 2/20/2021 6217 0.91 FREMD CONSTRUCTION DURAND 5970610A 750 2/26/2021 5645 FRIES VETERINARY CLINIC PC DURAND 4006968A 2,081 1/1/2021 8831 SPEC SERVICES LLC DURHAM, NC 5019788A 755 2/28/2021 5550 SCION PLASMA LLC E LANSING 5969662A 379 3/1/2021 8601 CHAPMAN ENTERPRISES LLC EAGLE 5655528A 1,841 1/5/2021 9402 0.95 R AND M ENTERPRISE EAGLE 4829050A 680 1/13/2021 3365 MATTHEW GRIFFOR LLC EAST CHINA 5944961A 3,562 1/1/2021 5437 L AND N CARPET CLEANING INC EAST GRAND RAPIDS 1553720A 576 3/9/2021 8810 ROJAS DIEGO EAST GRAND RAPIDS 5497027A 530 1/5/2021 0913 STAFFING GRAND RAPIDS LLC EAST GRAND RAPIDS 5687578A 12,115 1/25/2021 4459 0.89 BLACK BIRCH DESIGN & BUILD LLC EAST JORDAN 5804264A 750 1/3/2021 5645 DURABLE ROOFING SYSTEMS EAST JORDAN 1276867A 750 1/4/2021 5551 GAUDETTE HANDYMAN SERVICE LLC EAST JORDAN 5962897A 750 2/1/2021 5645 J AND PL FORESTRY EAST JORDAN 1001426A 238 3/8/2021 8601 OKKONEN CONSTRUCTION LLC EAST JORDAN 5375363A 750 2/21/2021 5645 0.95 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 41 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PINNEYS LOGGING INC EAST JORDAN 3139417A 750 1/29/2021 2702 TIM COOKS WINDOW CLEANING LLC EAST JORDAN 3126404A 568 3/13/2021 9015 WHITAKER CONSTRUCTION EAST JORDAN 2881322A 1,449 1/9/2021 6217 0.95 BAGLEY JEFFERY EAST LANSING 6110207A 750 1/29/2021 2709 BUHL ROSEMARY & ANDY EAST LANSING 4172604A 530 3/3/2021 0913 CHATEAU CONDOMINIUM ASSOCIATION THE EAST LANSING 1594168A 1,034 2/21/2021 9015 COVE AT WHITEHILLS LAKES CONDOMINIUIM EAST LANSING 4988221A 568 2/20/2021 9015 ASSOCIATION DOUGLAS ASSOCIATES INC EAST LANSING 2368293A 215 1/10/2021 8810 FALCON FUNDRAISING INCORPORATED EAST LANSING 5361850A 379 1/16/2021 8810 GENTILOZZI REAL ESTATE AND MANAGEMENT EAST LANSING 1715151A 3,129 3/9/2021 9015 0.95 COMPANY INC JULIE ANNS DAYCARE EAST LANSING 3383458A 283 1/29/2021 8869 MERIDIAN VILLAGE CONDOMINIUM ASSOCIATION EAST LANSING 2475340A 568 1/18/2021 9015 NEXT GEN THERAPY LLC EAST LANSING 6099017A 3,477 1/15/2021 8835 NOAHS AFC HOME INC EAST LANSING 4975103A 472 2/20/2021 9053 REIMANN LEE EAST LANSING 5505348A 328 1/16/2021 0908 WILDWOOD LAKES EMERALD LAKE EAST LANSING 2505339A 568 3/1/2021 9015 CONDOMINIUM ASSOCIATION CREEKSIDE LAWN & SNOW LLC EAST LEROY 5846625A 523 3/26/2021 9102 LEROY TOWNSHIP EAST LEROY 0183814A 4,465 3/8/2021 9410 0.92 MARKOS DEMOLITION LLC EAST LEROY 5690870A 750 3/15/2021 5645 COMMERCIAL IRRIGATION & TURF INC EAST PEORIA, IL 4625595A 1,621 1/1/2021 5190 0.95 ELITE TILE DESIGNS LLC EAST TAWAS 6096743A 750 1/11/2021 5348 ECO GREEN ENERGY LLC EASTPOINTE 4728670A 575 3/16/2021 5190 FPS STAFFING LLC EASTPOINTE 5995922A 3,238 2/8/2021 9015 GREAT LAKES FIREWORKS LLC EASTPOINTE 1746537A 7,810 1/15/2021 9015 1.47 13 % I HEART LAWN CARE LLC EASTPOINTE 5321514A 841 1/12/2021 9102 JC PAINTING EASTPOINTE 5356342A 750 2/24/2021 5476 0.95 KAROLYIS INC EASTPOINTE 3282767A 6,841 3/15/2021 5550 0.92 MAK FOODS INC EASTPOINTE 5978300A 1,164 3/22/2021 8017 MICHAEL NORTON BUILDERS INC EASTPOINTE 0019534A 752 3/15/2021 5476 0.95 OUR KIDZ WORLD LEARNING CENTER LLC EASTPOINTE 4569881A 609 3/21/2021 8869 R AND T SEWER CLEANING & SERVICE INC EASTPOINTE 5815304A 561 3/26/2021 5183 RUDY HOME IMPROVEMENT LLC EASTPOINTE 6127720A 750 2/28/2021 5437 SAVAGE BLDG CO INC EASTPOINTE 1827731A 750 3/15/2021 5645 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 42 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SUNBURST HOME IMPROVEMENT LLC EASTPOINTE 0013200A 750 2/11/2021 5645 1.00 SUPPLIER OF TECHNICAL ASSISTANCE LLC EASTPOINTE 4350448A 18,974 1/1/2021 9522 1.26 13 % LINESIDE LLC EASTPORT 4797264A 2,861 1/9/2021 5190 0.95 DONE RIGHT RESTORATION LLC EATON RAPIDS 2047993B 8,893 1/1/2021 5437 0.95 LUPINI CONSTRUCTION LLC EATON RAPIDS 2706431A 750 3/7/2021 5348 WOODSTONE BUILDERS INC EATON RAPIDS 1513982A 750 2/22/2021 6217 NORBERT SHEMBARGER CONSTRUCTION CO EAU CLAIRE 2002787A 939 3/1/2021 5645 INC POST FRAME BUILDERS LLC EAU CLAIRE 5683084A 2,499 3/3/2021 5645 0.95 VICINI PENNY EAU CLAIRE 4415590A 646 1/11/2021 0130 PIPESTONE BERRIEN TOWNSHIP EAU CLAIRE EAUCLAIRE 5948045A 3,533 1/1/2021 7904 1.20 13 % FIRE DEPARTMENT ANDY DRAYTON LOGGING LLC EBEN JUNCTION 5484960A 800 3/25/2021 2709 BORAVICH DRILLING LLC EBEN JUNCTION 3322246A 750 3/30/2021 6204 CHARLES O MILES SENIOR NON PROFIT ECORSE 3956369A 750 2/28/2021 5645 HOUSING CORPORATION CP AUTOMOTIVE ECORSE 4947940A 750 1/6/2021 3821 0.95 JBS AUTO REPAIR LLC ECORSE 5243777A 599 3/1/2021 8395 JR HOME IMPROVEMENT LLC ECORSE 5516250A 3,257 2/12/2021 5538 0.95 KM AND MD CEMENT LLC ECORSE 2269430A 1,329 3/6/2021 5221 0.96 MONTESINOS ERIK RAMIREZ ECORSE 6115870A 800 2/19/2021 5551 NAVARRO MIGUEL ECORSE 6115861A 800 2/19/2021 5551 OJIBWAY INC ECORSE 1821563A 5,591 3/11/2021 9501 1.31 27 % CLEAN HOME INC EDEN PRAIRIE, MN 3467970A 16,758 2/18/2021 8835 0.83 FOUR SEASONS TREE SERVICES LLC EDGEWATER, FL 3037924A 9,181 2/23/2021 0106 1.31 13 % METAL TEXTILES CORPORATION EDISON, NJ 2638398A 475 1/10/2021 8742 ALBRING SALVAGE COMPANY LLC EDMORE 5070260A 4,999 1/5/2021 8265 0.92 J AND L APRIARIES EDMORE 5224179A 2,039 1/7/2021 0034 0.95 KEN MOORE DRYWALL & PAINTING EDMORE 1240650A 750 3/15/2021 5445 MACLAREN AG COMMODITIES TRANSPORT LLC EDMORE 4493478A 11,230 2/8/2021 7208 0.93 ALL ABOUT YOU HOMECARE INC EDWARDSBURG 5218225A 23,694 1/1/2021 8835 1.02 E C FINLEY EXCAVATING & TRUCKING INC EDWARDSBURG 0410640A 751 1/22/2021 6217 SOPER CONSTRUCTION LLC ELK RAPIDS 3289273A 750 1/17/2021 5645 0.95 TRAVERSE BAY MANUFACTURING INC ELK RAPIDS 1700499A 322 3/12/2021 8810 1.59 13 % APPLIED MATERIAL SOLUTIONS INC ELKHORN, WI 5543436A 509 1/26/2021 8742 KEVIN EGGERS TRUCKING LLC ELLSWORTH 5965896A 750 2/27/2021 7208 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 43 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TODD EGGERS TRUCKING LLC ELLSWORTH 5022681A 750 3/18/2021 7208 0.94 TROY MARTIN BUILDING & DESIGN LLC ELLSWORTH 5538769A 750 3/30/2021 5645 TD CONSTRUCTION ELMIRA 3830926A 750 3/3/2021 5645 ELSIE PUBLIC LIBRARY ELSIE 4600258A 281 3/17/2021 8810 SEEMORE PAINTING LLC ELSIE 2800756A 750 2/4/2021 5476 A AND H FABRICATION LLC ELWELL 6103944A 438 1/22/2021 4484 BREENS FAB & MORE LLC ELWELL 6104100A 438 1/22/2021 4484 WAGNER ELECTRIC SIGN CO ELYRIA, OH 5676282A 368 2/16/2021 8742 HORD CONSTRUCTION EMMETT 5386420A 826 3/17/2021 5610 BOUCHA BARRY D ENGADINE 3830900A 750 1/31/2021 7208 INSTACOTE INC ERIE 2908506A 3,304 2/15/2021 4511 0.95 THUMBS UP AUTOMOBILES INC ERIE 3161889A 259 1/16/2021 8748 AIRCRAFT RENTAL SERVICES INC ESCANABA 2852470A 471 1/8/2021 7421 ANDYS ROOFING ESCANABA 5975751A 3,904 3/16/2021 5551 BAY DE NOC LOGGING COMPANY INC ESCANABA 5927544A 825 1/3/2021 2709 0.95 BEAUCHAMP DALE JR ESCANABA 5360889A 750 2/1/2021 2709 CHENIER ENTERPRISES INC ESCANABA 5804574A 750 1/1/2021 7202 CHRIS MATHIAS LLC ESCANABA 5498180A 750 2/12/2021 7208 DOMBROWSKI TREE SERVICE LLC ESCANABA 5814634A 2,295 1/24/2021 0106 0.95 J IVERSON TRUCKING ESCANABA 4147405A 2,657 1/12/2021 7208 0.95 LACHAPELLES CARPET CLEANING ESCANABA 6016022A 568 2/27/2021 9015 MQ HARVESTING INC ESCANABA 5365490A 3,206 1/27/2021 2709 0.94 PREGNANCY SERVICES OF DELTA COUNTY ESCANABA 5505070A 321 1/18/2021 8742 PRISED AUTO LLC ESCANABA 5815410A 1,334 1/25/2021 8395 TONY AND WENDY BEAUCHAMP F P TRUCKING ESCANABA 3177122A 750 1/14/2021 2709 INC TOP HAT EXPEDITING SERVICE ESCANABA 6106129A 750 1/24/2021 7208 UPHAULINGLLC ESCANABA 4921240A 752 2/20/2021 9015 CR HOWELL CONTRACTING INC ESSEXVILLE 4700627A 706 1/22/2021 9402 TREPANIER AND SON BUILERS ESSEXVILLE 6120369A 14,412 2/15/2021 5403 D AND L MARINE CONSULTING LLC FAIR HAVEN 4243854A 463 3/1/2021 6834 0.95 HUBBARD HOME IMPROVEMENTS LLC FAIR HAVEN 2757850A 750 1/11/2021 5645 BAY SHORE PERCH LLC FAIRGROVE 0682950A 827 2/18/2021 9058 0.95 SERVICE INDUSTRIAL RAILCAR LLC FAIRHOPE, AL 4170954A 4,771 1/27/2021 8395 0.90 WEAVER CONRAD FAIRVIEW 4318250A 750 3/14/2021 2702

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 44 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WEAVER LOGGING LLC FAIRVIEW 0948560A 750 1/13/2021 2702 G AND P TIMBER COMPANY INC FALMOUTH 5077389A 750 2/10/2021 8810 BLACK MOUNTAIN GRANITE INC FARMINGTON 5974585A 750 3/11/2021 5348 DOREL CONSTRUCTION LLC FARMINGTON 6135340A 750 3/13/2021 5348 FULL HOUSE MARKETING INC FARMINGTON 2851091A 38,261 1/1/2021 9015 0.95 HUTCHINSON STUDIOS LLC FARMINGTON 4190394A 288 3/9/2021 8742 ROCK STUDIO MUSIC INC FARMINGTON 5837782A 596 3/10/2021 8868 SEND INTERNATIONAL INC FARMINGTON 5732476A 301 1/8/2021 8810 USA 1 PAINTING COMPANY LLC FARMINGTON 1506862A 825 3/22/2021 5476 VALIDIAN APPRAISAL LLC FARMINGTON 6102069A 340 1/21/2021 8720 Z PAINTING LLC FARMINGTON 4750608A 1,930 2/14/2021 5476 0.91 A AND D WALLPAPER AND PAINTING LLC FARMINGTON HILLS 4692888A 750 3/1/2021 5476 ACCESS STAFFING ALTERNATIVES LLC FARMINGTON HILLS 4428005A 114,974 1/1/2021 2802 1.18 ACCESSPOINT WEST MICHIGAN LLC FARMINGTON HILLS 5951925A 11,342 1/10/2021 8045 ANTHONY J BORDOLEY PLC FARMINGTON HILLS 1714503A 221 2/14/2021 8810 ARBOR FARMS DEVELOPMENT LLC FARMINGTON HILLS 6135293A 800 3/13/2021 5645 BALLARD ASSOCIATES LLC FARMINGTON HILLS 5080916A 313 1/25/2021 8742 C AND C BIOCLEAN LLC FARMINGTON HILLS 5958792A 1,223 1/24/2021 9015 CAMP CASEY CORPORATION FARMINGTON HILLS 5410290A 7,879 1/25/2021 8279 0.88 CARNIVAL BOUNCE RENTALS LLC FARMINGTON HILLS 4781996A 761 1/19/2021 8017 0.95 CHERRY HILL PLACE CONDOMINIUMS FARMINGTON HILLS 4709373A 618 3/4/2021 9015 ASSOCIATION CHIMNEY GUY FARMINGTON HILLS 6127584A 750 2/27/2021 5022 CHRIST JAMES M FARMINGTON HILLS 2816652A 750 2/28/2021 5437 COLE RICHARD FARMINGTON HILLS 6130089A 605 3/2/2021 0913 COVERT INVESTIGATIVE SERVICES INC FARMINGTON HILLS 5987199A 2,328 1/11/2021 7720 D AND P SPECIALIZED LIVING INC FARMINGTON HILLS 5400040A 1,236 1/24/2021 9053 0.95 DAMKCAT REAL ESTATE HOLDINGS LLC FARMINGTON HILLS 6109055A 569 1/28/2021 9015 DAVIS GLOBAL LOGISTICS LLC FARMINGTON HILLS 5812879A 750 3/10/2021 7208 DIGESTIVE HEALTH CONSULTANTS PLC FARMINGTON HILLS 4057708A 231 2/5/2021 8810 EIGHT HUNDRED NEW LOOK LLC FARMINGTON HILLS 4631692A 1,007 3/10/2021 5606 0.95 ELECTROCYCLE INC FARMINGTON HILLS 5280184A 6,580 3/4/2021 8265 1.00 FIDELITY TRANSPORTATION OF MICHIGAN INC FARMINGTON HILLS 5805147A 21,881 1/5/2021 7212 1.50 13 % FIRST CLASS CONSULTING FIRM LLC FARMINGTON HILLS 6013457A 2,740 1/1/2021 7720 FRANKLIN PROPERTY CORPORATION FARMINGTON HILLS 2123290A 1,338 1/15/2021 5606 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HEART 2 HART DETROIT INC FARMINGTON HILLS 5356741A 1,143 1/19/2021 8006 HKM GROUP LLC FARMINGTON HILLS 6130305A 1,129 3/4/2021 8045 INTEGRITY STAFFING GROUP INC FARMINGTON HILLS 3049655A 17,319 1/1/2021 3808 0.78 INTERIOR PAINTING BY STELLA LLC FARMINGTON HILLS 5970601A 825 2/26/2021 5476 L AND G CONSTRUCTION LLC FARMINGTON HILLS 5837537A 3,596 2/12/2021 5403 0.95 LAIRDHAVEN CONDOMINIUM ASSOCIATION FARMINGTON HILLS 4456750A 618 2/6/2021 9015 LAKE FOREST TRAILS CONDOMINIUM FARMINGTON HILLS 4738152A 568 3/23/2021 9015 ASSOCIATION LATONYAS HOME HEALTH SERVICES LLC FARMINGTON HILLS 6133096A 1,003 3/24/2021 8835 LAWRENCE D KOHL PC FARMINGTON HILLS 2809800A 264 1/10/2021 8820 LOEFFLER WOOD FLOORS LLC FARMINGTON HILLS 1622900A 800 2/1/2021 5437 MILWAUKEE TILE INC FARMINGTON HILLS 6136893A 750 3/18/2021 5348 NANCY H WELBER PC FARMINGTON HILLS 2384825A 318 3/4/2021 8820 NAZARETH CARPENTRY SHOP INC FARMINGTON HILLS 4423062A 1,430 2/12/2021 5348 NORTH MACOMB MRT CENTER LLC FARMINGTON HILLS 5383480A 231 3/28/2021 8832 OFFICE AND PROFESSIONAL EMPLOYEES FARMINGTON HILLS 1333020A 350 2/28/2021 8755 INTERNATIONAL UNION LOCAL 42 OUELLETTE CARPENTRY INC FARMINGTON HILLS 3267571A 800 1/1/2021 5437 0.95 PARKSIDE INVESTMENT GROUP LLC FARMINGTON HILLS 1358855A 618 3/6/2021 9015 PIEDMONT CONCRETE INC FARMINGTON HILLS 0269298A 750 1/27/2021 7380 0.91 POTLURI GROUP LLC FARMINGTON HILLS 6109497A 999 1/28/2021 5606 REDSTONE TOWNHOMES A & D LLC FARMINGTON HILLS 5738164A 1,081 1/26/2021 9015 ROMAN EXPRESS INC FARMINGTON HILLS 4594266A 10,701 2/7/2021 7208 0.87 RTC HONING LLC FARMINGTON HILLS 5969077A 226 2/28/2021 8810 RUDIS MAINTENANCE SERVICE FARMINGTON HILLS 4850157A 750 2/14/2021 5437 S AND J BROTHERS CUSTOM PAINTING FARMINGTON HILLS 4720040A 800 3/10/2021 5476 SAPPHIRE SPRINGS HYDROTHERAPY CENTER FARMINGTON HILLS 5805694A 412 1/6/2021 9063 INC SARATOGA FARMS ASSOCIATION FARMINGTON HILLS 3871533A 568 1/31/2021 9015 SC 23 HOLDINGS INC FARMINGTON HILLS 5644100A 15,222 2/15/2021 7214 1.00 SCOTT QUALITY HOMES II LLC FARMINGTON HILLS 2635879A 2,808 3/21/2021 5437 0.95 SLOAN SHEILA FARMINGTON HILLS 1814443A 307 1/12/2021 0908 SRF ENTERPRISES INC FARMINGTON HILLS 0941743A 750 1/10/2021 5476 TRIANGLE DEVELOPMENT COMPANY INC FARMINGTON HILLS 2216523A 958 1/1/2021 9015 TSA CONSULTANTS INC FARMINGTON HILLS 5095557A 339 1/21/2021 5606 UNIVERSITY MOVING & STORAGE COMPANY FARMINGTON HILLS 0410098A 8,110 1/23/2021 8810 0.91 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 46 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge VILLAGE PARK INC FARMINGTON HILLS 1934546A 619 3/14/2021 8810 WESTACRES NORTH RIDGE ASSOCIATION FARMINGTON HILLS 0788724A 802 2/2/2021 9015 WINNING HAND POKER LLC FARMINGTON HILLS 5535395A 742 3/26/2021 8017 0.95 WRAP AND PACK MOVING LLC FARMINGTON HILLS 5583063A 948 1/7/2021 7214 0.95 ZARA MEDIA INC FARMINGTON HILLS 5803292A 395 3/28/2021 8810 C F TIMBER CRUISING FARWELL 4473094A 750 3/8/2021 2702 0.95 CENTRAL MICHIGAN CATHODIC PROTECTION FARWELL 5820596A 408 2/7/2021 8601 LLC JPA BUILDING CONTRACTORS INC FARWELL 0643475A 825 1/17/2021 5476 0.95 RIDENOUR DRYWALL & REMODELING LLC FARWELL 5696356A 1,788 3/29/2021 5445 0.95 ALLEN FORSTROM FARM FELCH 5515785A 750 2/11/2021 7208 PETERMORE KEVIN DARWIN FELCH 5660360A 750 1/18/2021 7208 SUNDHOLM STEWART A FELCH 2218941A 825 2/14/2021 2709 EXECUTIVE CONTAINERS LLC FENNVILLE 4870271A 750 1/5/2021 8010 0.95 HOTWAGNER JOSEPH FENNVILLE 5114810A 750 3/15/2021 9558 KYLE THOMPSON CONSTRUCTION INC FENNVILLE 3671747A 750 3/11/2021 5476 MASSA BODY LLC FENNVILLE 6126090A 443 3/1/2021 9063 TOWNSHIP OF GANGES FENNVILLE 0168793A 11,053 2/1/2021 7704 ARC CLEANING FENTON 6136915A 568 3/19/2021 9015 BAGNALL SALLY JO FENTON 5780934A 530 3/15/2021 0913 BG DATA TECH LLC FENTON 6124097A 750 2/21/2021 7600 BIRCHMEIER JOSEPH M FENTON 1460749A 305 1/29/2021 8810 CALLARD CHIROPRACTIC P C FENTON 2957680A 426 1/1/2021 8832 D AND WS INC FENTON 5950317A 412 1/5/2021 9058 GREEN HORIZONS LAWN CARE LLC FENTON 1952374A 656 2/11/2021 9102 HOLTSLANDER AND SONS TREE SERVICE LLC FENTON 5542464A 4,450 3/16/2021 0106 1.00 MCNEILL CONSTRUCTION LLC FENTON 3131912A 825 2/7/2021 5645 0.95 MICHIGAN BAT CONTROL SPECIALIST INC FENTON 4842014A 4,293 2/26/2021 8831 1.00 MICHIGAN FIRE SYSTEMS LLC FENTON 4719166A 714 2/18/2021 5188 MILFORD MASONRY AND BUILDING INC FENTON 4789024A 1,737 3/6/2021 5022 0.95 ON SITE FLEET CONSULTANTS LLC FENTON 3043207A 1,631 1/24/2021 8395 PARADISE DOG TRAINING LLC FENTON 5689554A 391 1/8/2021 8831 PAULYS CLEANING SERVICE LLC FENTON 5725950A 568 2/4/2021 9015 PEAK QUALITY SERVICING LLC FENTON 6092500A 205 1/4/2021 8803 RICK CALHOUN PAINTING LLC FENTON 2242931A 825 2/20/2021 5476

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 47 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge RLR CARPENTRY INC FENTON 0147346A 750 2/28/2021 5645 SEAN BALLARD CONSTRUCTION LLC FENTON 5804248A 7,550 1/4/2021 5437 0.94 TLK REMODELING FENTON 5189390A 775 1/7/2021 5645 0.95 WHITE AND SONS ROOFING LLC FENTON 1193678A 766 3/28/2021 5551 0.96 ACCUGLOW CLEANING SERVICES INC FERNDALE 2122600A 568 1/26/2021 9015 AFFIRMATIONS LESBIAN GAY COMMUNITY FERNDALE 1706594A 743 3/1/2021 8810 0.95 CENTER INC ALBADYAH INC FERNDALE 3411737A 2,248 2/26/2021 8017 1.00 BARGAIN CITY CABINETS & TOPS LLC FERNDALE 5306698A 750 2/4/2021 5437 COBBLESTONE SOLUTIONS LLC FERNDALE 5372151A 441 3/27/2021 8742 CRANDALL WORTHINGTON INCORPORATED FERNDALE 0516660A 4,511 3/24/2021 8010 0.95 FIVE EIGHTHS ARCHITECTURE LLC FERNDALE 5657318A 1,228 1/10/2021 8601 0.95 LEONARD BROTHERS INC FERNDALE 1551230A 364 1/6/2021 8810 NEXTGEN DETROIT LLC FERNDALE 5768373A 233 1/16/2021 8810 TWENTY TWO THOUSAND 757 WOODWARD AVE FERNDALE 6095321A 429 1/10/2021 9058 LLC TWENTY TWO THOUSAND 930 WOODWARD LLC FERNDALE 4315618A 877 1/9/2021 9058 DERIDDER TRUCKING OF MICHIGAN INC FERRYSBURG 4969340A 750 3/8/2021 7208 ROGERS JOHN FIFE LAKE 2197669A 1,212 3/28/2021 9521 0.95 VANDERBROOK TRUCKING FIFE LAKE 5387744A 750 3/20/2021 7208 ALWAYS PREFERRED PROPERTY SERVICES LLC FLAT ROCK 4723368A 7,635 1/20/2021 5437 0.90 CRUSE FACILITIES SERVICES LLC FLAT ROCK 4755022A 568 3/12/2021 9015 MRW TECHNICAL SERVICES FLAT ROCK 5957745A 676 1/24/2021 5183 NICKS CONCESSION LLC FLAT ROCK 4705220A 380 3/13/2021 9058 REALM COMMUNICATIONS LLC FLAT ROCK 6096468A 750 1/14/2021 7600 REMER CONSTRUCTION LLC FLAT ROCK 5362881A 1,165 1/1/2021 5645 WILL DEAL MOVING CO LLC FLAT ROCK 6127100A 2,856 2/27/2021 7214 AAA HOME IMPROVEMENT FLINT 6107699A 750 1/25/2021 5645 ABUAITA FAMILY C STORE INC FLINT 4556895A 668 1/23/2021 8017 0.95 ACTION HUMAN RESOURCES INC FLINT 4356756A 46,627 3/10/2021 8017 2.02 15 % AINSWORTH SALES INC FLINT 0488453A 615 1/25/2021 8387 1.05 AMERICAN PAWN BROKERS INC FLINT 4204581A 1,597 2/23/2021 8017 0.95 ATN OIL INC FLINT 5248876A 877 1/24/2021 8017 0.95 AUTISM SUPPORT AND RESOURCE CENTER FLINT 5969328A 2,801 3/15/2021 9015 BATS JANITORIAL SERVICE FLINT 0352420A 568 1/4/2021 9015

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 48 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BEAMER ENTERPRISES FLINT 0252174A 540 3/2/2021 9521 BONGIORNOS PIZZA LLC FLINT 4438035A 5,799 1/31/2021 9058 0.90 BOOTH PLUMBING & HEATING FLINT 0866784A 3,158 2/15/2021 5183 BROOKSIDE VILLAGE CONDOMINIUM FLINT 1000578A 750 1/16/2021 5022 ASSOCIATION CENTURY JANITORIAL SERVICE INC FLINT 3650510A 714 2/16/2021 9015 CHAD L SPRAGUE CONSTRUCTION FLINT 5762103A 1,245 1/1/2021 5645 0.95 COCINA MIO FLINT 6105505A 512 1/25/2021 9058 COMMUNITIES FIRST INC FLINT 5514428A 542 2/4/2021 8810 CRIM FITNESS FOUNDATION INC FLINT 2350335A 8,234 1/29/2021 8742 1.31 27 % DETROIT METRO SERVICES INC FLINT 4524608A 1,276 2/16/2021 9015 0.95 DISABILITY NETWORK INC FLINT 2184770A 2,288 3/10/2021 8832 0.95 EAST OAK GRANDE CONDOMINIUM ASSOCIATION FLINT 4688759A 568 2/1/2021 9015 ECONOMICAL HOME MOVERS INC FLINT 4341872A 750 1/30/2021 7208 EMERALD ISLE CONDOMINIUM ASSOCIATION FLINT 3335135A 568 3/6/2021 9015 FENTON ROAD COLLISION INC FLINT 5420466A 1,157 1/10/2021 8393 FLINT HOUSING COMMISSION FLINT 3732452A 66,754 1/10/2021 9015 1.83 27 % FLINT ODYSSEY HOUSE INC FLINT 2445573A 19,470 3/23/2021 8832 1.00 FURISTER ROBERT A FLINT 5229510A 540 1/21/2021 9521 G AND G LLC FLINT 4021240B 618 1/23/2021 9015 GENESEE WASTE SERVICES INC FLINT 4702670A 5,524 2/18/2021 7213 0.93 GERHOLZ INVESTMENT LLC FLINT 4021240A 568 1/28/2021 9015 GLENNS OF SQUIRE LAKE ASSOCIATION FLINT 5966051A 568 2/17/2021 9015 GLENS OF GENESEE CONDOMINIUM FLINT 3746062A 568 2/19/2021 9015 ASSOCIATION OF CO OWNERS H AND B JANITORIAL INC FLINT 1994824A 917 3/9/2021 9015 0.95 HALLEM ENTERPRISES INC FLINT 0460338A 825 3/12/2021 5476 HI TECH PROTECTION INC FLINT 3730050A 4,588 1/18/2021 7720 0.91 HOME SERVICES MICHIGAN LLC FLINT 5977258A 982 3/21/2021 8835 I J ABUFARHA LLC FLINT 5808324A 501 1/23/2021 8017 IGRAM ENVIRONMENTAL LLC FLINT 3749150A 613 1/19/2021 2841 J AND M TREE SERVICES FLINT 1358073A 13,718 3/12/2021 9102 1.44 27 % JACKSON LOREN FLINT 6093280A 750 3/4/2021 5437 JJS AFC LLC FLINT 5845815A 854 3/23/2021 9053 JONES ACCOUNTING AND AMERITAX LLC FLINT 2067463A 216 1/22/2021 8810

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge KELLY JUSTIN FLINT 5946280A 540 1/8/2021 9521 KLOCKZIEM SIDING AND CONSTRUCTION LLC FLINT 5815746A 3,055 2/19/2021 5645 L AND L COMMERCIAL CLEANING SERVICES FLINT 5975875A 569 3/15/2021 9015 LAKE VILLAS AT PINE CREEK CONDOMINIUM FLINT 4072707A 580 1/1/2021 9015 ASSOCIATION LAMBDA CHI ALPHA GILGAL INC FLINT 1144120A 434 1/11/2021 9058 LEISURETON SOUTH CONDOMINIUM FLINT 1235095A 568 3/9/2021 9015 ASSOCIATION LINCOLN COMMONS CONDOMINIUM FLINT 4295692A 568 2/22/2021 9015 ASSOCIATION MARTIN TRUCKING OF FLINT INC FLINT 0284947A 21,734 3/3/2021 7208 1.59 13 % MAXIM HOMES INC FLINT 4652029A 825 1/1/2021 5437 MERRITT JEFF FLINT 5863880A 750 2/1/2021 5476 METRO PRO BROTHERS LLC FLINT 5376122A 367 3/17/2021 8017 MFT LLC FLINT 4165551A 561 3/2/2021 9058 NAJJAR AND ABUAITA INC FLINT 5939003B 401 3/22/2021 8017 NATURES OUTDOOR SOLUTIONS LLC FLINT 5979986A 1,143 3/29/2021 0042 NORTH SHORE CONDOMINIUM ASSOCIATION FLINT 2534053A 580 1/1/2021 9015 PALIANI PHILIP FLINT 5676398A 750 2/16/2021 5645 PB FM ENTERPRISES LLC FLINT 4417003A 371 2/11/2021 9058 PINE CREEK CONDOMINIUMS OF HASLETT II FLINT 5690900A 568 3/15/2021 9015 ASSOCIATION POPPENFUSE LANCE FLINT 6115837A 864 2/11/2021 6325 PSR PROPERTY HOLDINGS LLC FLINT 4969553A 1,293 3/10/2021 9015 QUALITY WINDOW CLEANING FLINT 1830023A 619 3/9/2021 9015 R J INDUSTRIAL LLC FLINT 2295326A 780 3/25/2021 8264 0.95 REFLECTIONS BUILDING SERVICES CORP FLINT 4392060A 1,497 1/8/2021 9015 0.95 RITA C STORE INC FLINT 5125936A 675 3/8/2021 8017 RONALD L HALDY PC FLINT 1826646A 320 3/9/2021 8810 S AND K HOME IMPROVEMENTS LLC FLINT 5389224A 750 3/21/2021 5645 S I ABUAITA C STORE INC FLINT 4556895B 458 1/23/2021 8017 0.95 SMITHS CONCRETE FLINT 6095445A 750 1/10/2021 5221 STONE LAKE CONDOMINIUM ASSOCIATION FLINT 1429787A 568 2/7/2021 9015 STONEY MEADOWS FAMILY LLC FLINT 6111360A 1,068 1/30/2021 8835 SUTTON HERMAN FLINT 6120130A 750 2/15/2021 7208 THREE D SECURITY AND INVESTIGATIONS LLC FLINT 1787543A 450 2/12/2021 7720

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TORCH MANAGEMENT LLC FLINT 6125468A 1,675 3/1/2021 9015 TRIUMPHANT TEMPLE OF PRAISE FLINT 5178886A 1,079 2/21/2021 8868 0.95 TWISTED METAL COLLISION FLINT 5500613A 725 1/16/2021 8393 UNITED HOSPICE CARE LLC FLINT 6123899A 737 2/28/2021 8835 UNITY ADULT DAY CLUB FLINT 6120407A 1,111 2/15/2021 9063 W Q H OF FLUSHING INC FLINT 5369118A 398 2/5/2021 8017 WATER BROOKS LIVING LLC FLINT 6109632A 472 1/28/2021 9053 WEBBER CONSTRUCTION FLINT 2126850A 750 1/10/2021 5551 WEE LITTLE QUACKERS CHILD CARE CENTER FLINT 0501956A 1,313 2/3/2021 8869 INC WEXFORD GREEN CONDOMINIUM ASSOCIATION FLINT 0709476A 580 1/1/2021 9015 WOODHILL CONDOMINIUM ASSOCIATION FLINT 2462818A 568 1/29/2021 9015 WOODYS BOOM TRUCKS & USED BINS FLINT 2160196A 1,638 1/15/2021 5221 ZMA CORPORATION FLINT 2886065A 669 1/22/2021 8017 KINDNESS STEVE FLORENCE, WI 5663652A 750 1/23/2021 9402 ACCELERATED SOLUTIONS LLC FLUSHING 5958636A 367 1/24/2021 8810 AGUILAR DRYWALL LLC FLUSHING 6098231A 750 1/14/2021 5445 AKR CONSTRUCTION FLUSHING 4193075A 750 3/24/2021 5645 ALLISON CONTRACTING LLC FLUSHING 5837774A 750 3/22/2021 5645 ANGER LARRY FLUSHING 2519569A 561 3/13/2021 5183 BACKMEIER CONTRACTING INC FLUSHING 2057891A 969 2/25/2021 9015 CBM ENTERPRISES LLC FLUSHING 5463556A 1,420 2/7/2021 5190 0.95 H AND V CONSTRUCTION LLC FLUSHING 4189469A 750 1/22/2021 5645 HEAD SHOP PLUS TOBACCO INC FLUSHING 5939003A 458 3/31/2021 8017 J L KLETTE CUSTOM BUILDERS INC FLUSHING 1626353A 388 1/25/2021 5606 JMS CRANE INC FLUSHING 3751066A 269 2/27/2021 8810 JOHN F AND EDITH L WILSTERMAN FOUNDATION FLUSHING 6093019A 427 1/7/2021 8810 JOHNSON PROCESS SERVICE FLUSHING 4009754A 449 3/6/2021 7720 MARINESHIPPINGMI LLC FLUSHING 5323452A 1,503 3/6/2021 5476 0.95 PAINT PLUS FLUSHING 2649543A 800 1/28/2021 5476 PHARMA CARE INC FLUSHING 1980530A 899 2/5/2021 7213 0.95 RUSTY NAIL RENOVATIONS LLC FLUSHING 5703042A 1,736 2/11/2021 5437 0.95 SIGNATURE HOME PROS LLC FLUSHING 6138187A 800 3/23/2021 5645 TOWN AND COUNTRY BROKERS INC FLUSHING 4841751A 244 1/11/2021 8810 MIKES CUSTOMS INC FOREST HILL, MD 6123520A 1,652 2/22/2021 5476

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PAUL K MEYERS LLC FORT GRATIOT 3629520A 750 3/9/2021 5645 RENES INCORPORATED FORT GRATIOT 1673041A 1,787 2/21/2021 8107 0.95 SARENITY APPAREL TATTOOS AND PIERCING LTD FORT GRATIOT 4688899A 716 1/30/2021 9586 DRIVERS SELECT INC FORT SMITH, AR 5398037A 825 2/21/2021 7208 0.95 B AND B HUNTING PROPERTIES LLC FORT WAYNE, IN 0495689A 5,317 1/11/2021 9015 0.91 ASD DRYWALL FOSTORIA 1728482A 750 2/14/2021 5445 FOX EXCAVATING FOSTORIA 3526593A 739 2/21/2021 6217 NORTHERN MICHIGAN WOOD PRODUCTS INC FOUNTAIN 6115144A 13,034 2/25/2021 2731 SOVA LEASING BRIGHTON LLC FOUNTAIN HILLS, AZ 5967090A 953 2/13/2021 9015 G AND E GILLILAND LLC FOWLER 5147530A 357 2/14/2021 9058 GRUBAUGH JASON D FOWLER 4459334A 750 2/12/2021 2702 JANDERNOA WATER SYSTEMS INC FOWLER 5254736A 740 3/28/2021 5183 0.95 POHLS CUSTOM COUNTERTOPS & CABINETRY FOWLER 3960668A 1,859 3/25/2021 5437 PRICHARD TERRY FOWLER 5118190A 750 3/22/2021 7208 SHERD MIKE FOWLER 5246610A 750 3/5/2021 2702 AIRSTRIP LOUNGE INC FOWLERVILLE 1563602A 1,387 2/16/2021 9058 0.95 AMERICAN ACCESSIBILITY TECHNOLOGIES INC FOWLERVILLE 2849488A 474 2/1/2021 5160 CANFIELD CONSTRUCTION FOWLERVILLE 5954690A 750 1/18/2021 5645 CHRISTOPHER HALLER PLUMBING LLC FOWLERVILLE 5972868A 562 3/5/2021 5183 EXFORD BROTHERS TRUCKING LLC FOWLERVILLE 5950821A 750 1/9/2021 7208 FOWLERVILLE HOME IMPROVEMENT FOWLERVILLE 3027171A 750 1/1/2021 5645 G AND A SIDING LLC FOWLERVILLE 3298663A 750 3/29/2021 5645 1.00 GREAT LAKES CASTAWAY CUSTOMS LLC FOWLERVILLE 6112935A 505 2/4/2021 6834 HOME PRO EXTERIORS LLC FOWLERVILLE 4972546A 2,419 3/21/2021 5551 0.95 J HAMMOND LLC FOWLERVILLE 0968560A 750 1/1/2021 5437 0.95 MAJS RESTORATION LLC FOWLERVILLE 6100112A 750 1/16/2021 5645 OLD SCHOOL INSTALLATIONS LLC FOWLERVILLE 2380005A 800 1/10/2021 5645 0.95 SEBASTIAN PAINTING CO FOWLERVILLE 2520575A 750 1/1/2021 5476 WARREN FOR PRESIDENT INC FOXBOROUGH, MA 6086349A 805 1/9/2021 8810 AIR ADVANTAGE LLC FRANKENMUTH 4786068A 4,832 3/23/2021 5191 0.93 MADISON RESTORATION INCORPORATED FRANKENMUTH 6120172A 1,380 2/15/2021 9015 MICHIGAN SOYBEAN PROMOTION COMMITTEE FRANKENMUTH 3738663A 1,034 1/4/2021 8810 0.95 PINNACLE PROFESSIONAL SERVICES LLC FRANKENMUTH 4995376A 222 1/24/2021 8810 TECHNOLOGY SOLUTIONS PROVIDER INC FRANKENMUTH 4786068B 6,970 1/1/2021 5102 0.93 LINDERLAKE CORPORATION FRANKFORT, IL 3900479A 349 2/1/2021 8601 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 52 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SAULSON ELI J FRANKLIN 5347831A 382 1/21/2021 0908 SHAMIE DEVELOPMENT INC FRANKLIN 2371006A 394 2/19/2021 8810 TIMLIN CONSTRUCTION SERVICES INC FRANKLIN 2983745A 568 3/18/2021 9015 0.95 B AND J MATTIA LLC FRASER 6142044A 579 3/27/2021 8017 BARGY FLOORING FRASER 5979765A 615 3/27/2021 9521 BEST QUALITY HOME CARE LLC FRASER 1543814A 260 2/13/2021 8810 BREZANY RYAN FRASER 6093094A 540 1/7/2021 9521 CHAMPION TEMPERATURE SERVICE INC FRASER 4957504A 1,526 3/6/2021 5550 0.95 COMPLETE CONTRACTING SERVICES LLC FRASER 4569440A 2,593 1/9/2021 5348 0.95 DON COOK CONSTRUCTION FRASER 1269992A 750 1/14/2021 5403 FRANKIE JS GENERAL CONTRACTING INC FRASER 2880164A 750 2/12/2021 5221 PEAK ELECTRIC FRASER 3760898A 521 3/28/2021 5190 PREMIER RENOVATIONS LLC FRASER 5744547A 825 3/15/2021 5437 0.88 PURE HOME CARE SERVICES INC FRASER 4482263A 2,163 3/12/2021 8835 0.95 SELECT RESTORATIONS INC FRASER 4510976A 6,848 1/4/2021 5606 0.89 UNIVERSAL AUTO RECOVERY INC FRASER 1518305A 4,461 3/10/2021 7720 0.95 BUCK TECHNICAL SERVICES FREE SOIL 6006230A 674 2/14/2021 5550 ASSEMBLY PROFESSIONALS LLC FREELAND 4544293A 750 1/24/2021 5146 EDGECOMB LAWNCARE & SNOW PLOWING FREELAND 6089070A 1,084 1/1/2021 9102 HOMESTEAD CONTRACTING FREELAND 2498634A 1,493 2/20/2021 5437 JOHN WIRTZ & SONS INC FREELAND 2544784A 3,277 3/31/2021 0011 0.95 SPARTAN ACRES INC FREELAND 4886380A 1,664 3/3/2021 0128 0.95 WENDLING HOME IMPROVEMENT FREELAND 4262824A 801 3/1/2021 5437 D AND T CONSTRUCTION LLC FREEPORT 3290603A 750 2/21/2021 5403 D AND D ROOFING 4G LLC FREMONT 4963636A 8,737 1/30/2021 5551 0.89 FREMONT FABRICATION LLC FREMONT 6211577A 1,238 2/12/2021 3365 FREMONT METAL AND PAPER SUPPLY INC FREMONT 5517397A 1,320 2/17/2021 8264 0.95 FREMONT TOWING LLC FREMONT 5499933B 1,067 3/13/2021 7208 0.95 HOWE AND SON CONSTRUCTION LLC FREMONT 5523168A 750 3/4/2021 5190 NEWAYGO COUNTY COMPASSION HOME FOR FREMONT 5847095A 2,990 3/27/2021 8835 0.95 THE TERMINALLY ILL PAMPERED PETS PLUS INC FREMONT 3147240A 1,400 2/1/2021 8831 0.95 RAPID RECOVERY SERVICES LLC FREMONT 5499933A 2,867 1/8/2021 7720 0.95 REDEEMED CONSTRUCTION LLC FREMONT 6092284A 750 1/10/2021 5645 SEASONS PIZZERIA LLC FREMONT 5810477A 1,114 1/16/2021 9058

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FLOREA HOMES LLC FRUITPORT 2746905A 750 1/22/2021 5645 FREDRICK ENTERPRISES LLC FRUITPORT 5221803A 666 1/1/2021 3632 GOOD GUYS GARAGE LLC FRUITPORT 6122876A 1,444 2/19/2021 8395 STILLWATER SPRINGS ASSOCIATION FRUITPORT 4649524A 618 3/1/2021 9015 PRICE GORDON SERVICES LLC FULSHEAR, TX 5950082A 4,465 1/4/2021 7212 A AND E FOREST PRODUCTS LLC GAASTRA 5925851A 750 1/23/2021 2709 CALVIN LINDBERG LOGGING GAASTRA 0408662A 750 3/29/2021 2702 ADVANCED CUSTOM INTERIORS LLC GALESBURG 4060377A 750 3/21/2021 5437 ALS PROPERTY ASSOCIATES INC GALESBURG 5735025A 2,528 1/15/2021 9015 0.95 BUB SHERWOODS AUTO REPAIR INC GALESBURG 3718670A 494 3/23/2021 8395 0.95 CLASSIC SADDLERY LTD GALESBURG 0276375A 472 3/24/2021 4902 JON HOMRICH DIESEL LLC GALESBURG 5973988A 1,896 3/8/2021 8395 ORLANDO PLUMBING LLC GALESBURG 4083164A 561 3/20/2021 5183 REACH OUTDOOR SERVICES LLC GALESBURG 5947855A 1,771 1/5/2021 9558 BUNGALOW LLC GALIEN 5694728A 877 3/23/2021 9058 TOWNSHIP OF GALIEN BARRY COUNTY GALIEN 0532347A 1,866 1/4/2021 9410 0.95 W BUILDERS LLC GALIEN 5975794A 750 3/14/2021 5645 LATULIPS CUSTOM LOGGING GARDEN 1957120A 750 2/13/2021 2702 EDGE MAINTENANCE SERVICES LLC GARDEN CITY 4831799A 4,150 3/1/2021 9015 0.95 FORD AND INKSTER AUTO CENTER LLC GARDEN CITY 0182257A 1,375 1/8/2021 8395 1.00 GALES INSTALLATION INC GARDEN CITY 4309057A 750 2/12/2021 5645 GRAYS OUTDOOR SERVICES LLC GARDEN CITY 4771036A 6,640 1/8/2021 0042 0.92 HOGAN WAYNE GARDEN CITY 5357667A 751 1/7/2021 5437 JKT CONSTRUCTION INC GARDEN CITY, NY 5975662A 1,988 3/14/2021 5403 K C CONSTRUCTION INC GARDEN CITY 2662248A 10,288 1/1/2021 5551 MICHIGAN LAND DEVELOPMENT LLC GARDEN CITY 3761347A 3,855 1/20/2021 6217 0.95 RCA HOME IMPROVEMENTS GARDEN CITY 3312399A 756 3/29/2021 8810 STUDENT TRANSPORTATION SERVICES LLC GARDEN CITY 5947090A 4,994 1/8/2021 7380 THREE B CARPENTRY GARDEN CITY 2310384A 750 3/3/2021 5645 TOP NOTCH GLAZING LLC GARDEN CITY 6009832A 750 3/11/2021 5462 BLUE TOOL SERVICE LLC GAYLORD 1521063A 228 1/7/2021 8810 BURZYNSKI MICHAEL R GAYLORD 1848356A 1,954 1/25/2021 1320 0.95 CUTTITTA ENTERPRISES INC GAYLORD 2757320A 750 3/13/2021 5348 0.95 G C T SERVICES INC GAYLORD 5647720A 800 1/5/2021 7208 GELOW GARY L ATTORNEY AT LAW GAYLORD 4441672A 280 2/14/2021 8820 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 54 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GORILLA EXCAVATING GAYLORD 3803287A 1,633 3/18/2021 6217 0.95 MOTEKS FINER CARPENTRY LLC GAYLORD 5232589A 750 1/28/2021 5437 NORTON WILLIAM GAYLORD 5953979A 750 3/18/2021 5476 R AND B INVESTMENT LLC GAYLORD 2181177A 4,226 1/1/2021 9015 1.00 REDPINE WHITETAILS INC GAYLORD 0677108A 929 2/1/2021 9015 0.95 ROGAN ENTERPRISES LLC GAYLORD 6136397A 750 3/17/2021 5221 SMITH CONSTRUCTION GAYLORD 5813484A 750 1/23/2021 5645 TAYLOR COSTELLO LLC GAYLORD 6023193A 1,828 1/17/2021 8835 WEGMEYER MARCUS & SHARON GAYLORD 2785110A 750 2/20/2021 5645 COCHRAN DRYWALL LLC GERMFASK 0205168A 800 3/4/2021 5445 H AND K LUSTILA TRUCKING LLC GERMFASK 1817221A 750 3/30/2021 7208 BDS HAULING SERVICES LLC GIBRALTAR 6144250A 750 3/31/2021 7208 STEAM TEC LLC GIBRALTAR 5576024A 1,041 2/1/2021 9015 0.95 TARJEFT SERVICES LLC GIBRALTAR 6095518A 2,099 1/21/2021 7208 AFFORDABLE APPRAISALS INC GLADSTONE 5951674A 787 1/11/2021 8720 DON MURRAY TRUCKING INC GLADSTONE 3636992A 750 2/28/2021 7208 FOX POWER INC GLADSTONE 2621452A 16,072 3/28/2021 7538 0.83 GLEN SMITH TREE SERVICE LLC GLADSTONE 4757890A 2,267 3/1/2021 0106 0.95 ROCK ELECTRIC SERVICE LLC GLADSTONE 4862805A 1,240 1/3/2021 5190 SEAN CLARK CONSTRUCTION GLADSTONE 5428092A 750 3/23/2021 5348 CENTRAL MICHIGAN LOGGING GLADWIN 0562947A 750 1/1/2021 2702 GLADWIN AUTO SALVAGE & SALES GLADWIN 3934969A 752 2/13/2021 8010 0.95 GROVE TRANSPORT GLADWIN 5976448A 750 1/24/2021 7219 HOJOS TREE SERVICE GLADWIN 4727835A 2,680 3/16/2021 2702 1.00 DIGGER DAN DEVELOPMENT COMPANY GLENNIE 5251834A 836 3/24/2021 0912 0.95 JENKINS JAMES A GOBLES 5330149A 750 3/5/2021 5476 SIMPLE AND FIT GOBLES LLC GOBLES 5959209A 457 1/25/2021 9063 RABER TOWNSHIP GOETZVILLE 1386913A 1,198 2/22/2021 9410 0.95 BROOK VALLEY HOMES INC GOODRICH 2388723A 800 3/24/2021 6217 C AND C EXCAVATING INC GOODRICH 4148126A 740 3/7/2021 6217 HEMPTONS GOODRICH BODY SHOP INC GOODRICH 1145355A 1,866 3/12/2021 8393 0.95 PAL BURGLAR ALARM LLC GOODRICH 4964918A 648 2/18/2021 5191 ABC LOCKSMITH AND KEY LLC GRAND BLANC 3133524A 358 3/20/2021 8010 ALL AROUND PORTABLE WELDING LLC GRAND BLANC 5103193A 698 3/3/2021 3365

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge B AND B THOMPSON FAMILY LIMITED GRAND BLANC 4211928A 619 2/10/2021 9015 PARTNERSHIP EISENBEIS KEVIN GRAND BLANC 5113520A 750 3/14/2021 5476 EXPRESS BUILDING SERVICES INC GRAND BLANC 2848333A 825 3/20/2021 5645 HUSSEIN A MAZLOUM MD PC GRAND BLANC 4788508B 316 1/21/2021 8832 LARSEN ROOFING INC GRAND BLANC 3650740A 750 2/20/2021 5551 PECK MICHAEL GRAND BLANC 5809533A 750 2/15/2021 5645 PINE HOLLOW CUSTOM HOMES LLC GRAND BLANC 3916715A 800 3/4/2021 5606 PRISTINE CLEAN II LLC GRAND BLANC 5974569A 568 3/9/2021 9015 QUALIFIED BUILDERS GRAND BLANC 3906469A 750 2/9/2021 5022 RICHFIELD REAL ESTATE LLC GRAND BLANC 3149560A 1,157 2/28/2021 5645 RPS PROTECTION LTD GRAND BLANC 5247993A 11,762 3/23/2021 7720 1.20 SWANEBECK HARVEY GRAND BLANC 1466062A 257 1/1/2021 8810 EH AND S CONSULTING LLC GRAND HAVEN 5535484A 238 2/4/2021 8601 FINE LY FINISHED LLC GRAND HAVEN 5663644A 1,621 1/21/2021 5348 0.95 HEX 5 INC GRAND HAVEN 3304523A 1,518 1/1/2021 8017 0.95 LAKE PINE CONSTRUCTION LLC GRAND HAVEN 6110193A 750 1/29/2021 5348 LEE ALLEN HOMES LLC GRAND HAVEN 5367450A 750 3/6/2021 5645 0.95 LG INDUSTRIES LLC GRAND HAVEN 4996798A 5,148 1/15/2021 3724 MEANINGFUL BUSINESS SOLUTIONS INC GRAND HAVEN 5967333A 361 2/14/2021 8742 SPECIALTY RETAIL SOLUTIONS LLC GRAND HAVEN 4033434A 931 1/25/2021 9015 0.95 STEADFAST ENGINEERED PRODUCTS LLC GRAND HAVEN 3118754A 440 1/14/2021 3145 YETZKE JONATHAN THOMAS GRAND HAVEN 6133657A 750 3/10/2021 5403 AKER AND COMPANY CUSTOM HOME DESIGN GRAND LEDGE 6130682A 750 3/16/2021 5645 AND REMODEL LLC KEMPF AUTO SERVICE INC GRAND LEDGE 0054313A 693 2/13/2021 8395 0.95 LEDGE AIR REPAIR INC GRAND LEDGE 5085446A 1,986 2/2/2021 7423 0.95 MY ENTERPRISES INC GRAND LEDGE 5378699A 1,351 2/28/2021 9058 0.95 SUNDANCE RIDING STABLE INC GRAND LEDGE 1370278A 7,532 1/15/2021 8279 0.92 TOM STEPHENS INC GRAND LEDGE 4735587A 750 3/2/2021 5403 0.93 BBBB LLC GRAND MARAIS 5659221A 379 1/13/2021 9052 GRAND MARAIS OUTFITTERS LLC GRAND MARAIS 5649951A 338 1/1/2021 8017 AAA LEAD INSPECTION INC GRAND RAPIDS 3324605A 748 2/21/2021 8720 0.95 AAABSOLUTE SERVICES LLC GRAND RAPIDS 0718637A 731 1/14/2021 9402 AARDVARK SEAMLESS GUTTERS GRAND RAPIDS 5818290A 706 3/9/2021 5538

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge AERIALS AND BARANIS GYMNASTICS CENTER GRAND RAPIDS 1755960A 750 2/15/2021 9063 INC ALLSTATE AUTO SALES INC GRAND RAPIDS 5654610A 259 1/19/2021 8748 AVALON POINTE CONDOMINIUM ASSOCIATION GRAND RAPIDS 4232534A 568 2/28/2021 9015 BAKOS CUSTOM HOMES LLC GRAND RAPIDS 3129489A 750 1/26/2021 5645 BELK VICTORSON RESTORATION LLC GRAND RAPIDS 5967104A 2,961 2/15/2021 9015 BOER BRIAN L GRAND RAPIDS 6134548A 530 3/11/2021 0913 C AND G PRO PAINTING LLC GRAND RAPIDS 6113656A 800 2/5/2021 5476 CARRILLO ARTURO GRAND RAPIDS 5951119A 800 2/20/2021 5645 CASCADE HILLS CONDOMINIUM ASSOCIATION GRAND RAPIDS 4699564A 618 1/27/2021 9015 CASTRO ROOFING GRAND RAPIDS 6092446A 7,364 1/4/2021 5551 CHRISTIAN AND VREEKE PROPERTIES LLC GRAND RAPIDS 5847907A 750 3/29/2021 5437 CHRISTMAS DECOR BY LAKESHORE LIGHTING GRAND RAPIDS 3993345A 765 1/30/2021 5190 0.95 LLC CLEAN BY DESIGN LLC GRAND RAPIDS 6094708A 470 1/9/2021 8835 CLEMENTS MILL VILLAGE CONDOMINIUM GRAND RAPIDS 4699548A 618 1/27/2021 9015 ASSOCIATION COLLINS AND ASSOCIATES CORPORATION GRAND RAPIDS 0810193A 2,799 3/1/2021 7421 0.95 COLORHUB LLC GRAND RAPIDS 5693756A 458 1/25/2021 4299 1.23 13 % CSB CONSTRUCTION LLC GRAND RAPIDS 6120296A 826 2/15/2021 5645 D AND B ASSET MANAGEMENT LLC GRAND RAPIDS 2835550A 8,574 2/3/2021 5437 0.80 DAVID DE VRIES PAINTING LLC GRAND RAPIDS 4843657A 1,221 3/30/2021 5476 DESOUZAS DRYWALL SERVICES LLC GRAND RAPIDS 4172086A 3,555 2/9/2021 5445 1.00 DEWOLF FLOORING INC GRAND RAPIDS 5036143A 800 3/17/2021 5348 DULCE CONSTRUCTION AND EXTERIORS LLC GRAND RAPIDS 5968364A 750 2/19/2021 5445 EARLY LEARNING NEIGHBORHOOD GRAND RAPIDS 5299039A 7,329 1/1/2021 8868 1.32 13 % COLLABORATIVE ED HEKSTRA BUILDER INC GRAND RAPIDS 1147080A 750 1/1/2021 5190 ENAS TRUCKING LLC GRAND RAPIDS 5258430A 21,357 1/1/2021 7208 1.83 27 % FORSLUND CONDOMINIUM ASSOCIATION GRAND RAPIDS 4699521A 618 1/1/2021 9015 FOX FARMS OF MICHIGAN INC GRAND RAPIDS 0824127A 656 2/23/2021 0005 G H CONSTRUCTION LLC GRAND RAPIDS 6131085A 5,394 3/6/2021 5645 GO SAVVY BUILDERS LLC GRAND RAPIDS 5499852A 750 3/1/2021 5183 0.95 GOLDEN EAGLES CONSTRUCTION LLC GRAND RAPIDS 4239105A 825 3/16/2021 5445 GRAND PACKAGING SOLUTIONS LLC GRAND RAPIDS 4973330A 533 3/26/2021 8601 GREINER ADAM GRAND RAPIDS 6123147A 561 2/20/2021 3632

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HARR CREATIVE LLC GRAND RAPIDS 5366836A 833 1/28/2021 4361 0.95 HERITAGE WINDOW RESTORATION LLC GRAND RAPIDS 5805040A 1,362 1/5/2021 4130 HOEVE SPECIALTY CONSTRUCTION INC GRAND RAPIDS 4191374A 750 3/14/2021 5645 HUFFMAN HOMES LLC GRAND RAPIDS 5682657A 750 2/13/2021 5645 IN A PINCH INC GRAND RAPIDS 4107586A 1,941 3/3/2021 9058 0.92 INDEPENDENT DELIVERY SERVICE INC GRAND RAPIDS 1167740A 1,193 1/4/2021 7202 1.24 INGALLS PICTURES LLC GRAND RAPIDS 5946077A 296 3/12/2021 4361 INSPIRED INSTALLATIONS LLC GRAND RAPIDS 5690820A 1,825 3/15/2021 5348 0.95 IRISH ROOFING & EXTERIORS LLC GRAND RAPIDS 5833469A 4,694 2/28/2021 5606 0.95 J AND B CARPET INSTALLATION INC GRAND RAPIDS 2600285A 540 1/28/2021 9521 J AND R COMPANY GRAND RAPIDS 6089690A 2,765 1/1/2021 5445 JC PAINTING LLC GRAND RAPIDS 6112404A 750 2/1/2021 5476 JOHN FORSYTHE DRYWALL GRAND RAPIDS 3748154A 750 3/21/2021 5445 JOUSTRA GARRIT M GRAND RAPIDS 6115594A 338 2/8/2021 5606 K 2 K CONSULTING LLC GRAND RAPIDS 5817943A 920 2/18/2021 8742 KAM SHARP ENTERPRISES INC GRAND RAPIDS 6078265A 4,742 3/4/2021 9015 KEITH M JOHNSON CONSULTING INC GRAND RAPIDS 5952301A 563 1/12/2021 8601 KELLEY GROUND AIR EXPEDITE LLC GRAND RAPIDS 3033449A 1,086 2/4/2021 7202 0.95 KINGSBURY KABINETRY INC GRAND RAPIDS 4494199A 2,609 2/17/2021 5437 0.95 LEISURE SOUTH CONDOMINIUM ASSOCOCIATION GRAND RAPIDS 3180654A 618 1/1/2021 9015 LIFE INTERNATIONAL GRAND RAPIDS 3605370A 1,427 3/25/2021 8810 0.95 LINK CONSTRUCTION GRAND RAPIDS 5610460A 823 3/28/2021 5645 LOPEZ VELASQUEZ AUDILIO GRAND RAPIDS 6136346A 6,895 3/18/2021 5445 MADFOOLISH LLC GRAND RAPIDS 6113451A 1,577 2/11/2021 5476 MAPLE VILLA CONDOMINIUM ASSOCIATION GRAND RAPIDS 3180662A 618 1/1/2021 9015 MARCECO AVIATION LLC GRAND RAPIDS 4947134A 978 1/13/2021 7421 0.95 MARINEWORKS LLC GRAND RAPIDS 5659248A 494 2/20/2021 6836 MAXVIA LLC GRAND RAPIDS 5653223A 7,468 1/1/2021 7208 0.93 MCQUIRTER NICOLE GRAND RAPIDS 5823854A 568 2/13/2021 9015 MENDEZ BROTHERS PAINTING & LANDSCAPING GRAND RAPIDS 5519152A 11,315 2/20/2021 5476 0.90 MICHIGAN INDUSTRIAL CONTAINER LLC GRAND RAPIDS 5832950A 1,531 2/27/2021 2802 MIDWEST APPRAISAL MANAGEMENT INC GRAND RAPIDS 6113010A 309 3/25/2021 8810 MIDWEST BIN ERECTORS LLC GRAND RAPIDS 5820740A 1,418 2/7/2021 5538 MOVE WITH MICAH LLC GRAND RAPIDS 6106307A 274 1/24/2021 8810 MSP ENTERPRISES GRAND RAPIDS 4631811A 751 3/17/2021 5476 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 58 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge NEWTON PLONT PLLC GRAND RAPIDS 5880572A 332 3/9/2021 8820 NORTHWEST FOOD PANTRY COALITION GRAND RAPIDS 6097901A 241 1/15/2021 8810 OLD FARM VILLAGE CONDOMINIUM ASSOCIATION GRAND RAPIDS 3433692A 618 1/1/2021 9015 PC REID LLC GRAND RAPIDS 5972850A 304 1/3/2021 8810 PERFORMANCE POTENTIAL GRAND RAPIDS 5089506A 238 2/16/2021 8601 PICTURE PERFECT BUILDERS LLC GRAND RAPIDS 6090532A 750 1/2/2021 5645 POLTROCK CORPORATION GRAND RAPIDS 2969572A 698 1/24/2021 7610 0.95 PRB AND ASSOCIATES LLC GRAND RAPIDS 4734777A 265 3/9/2021 8810 PREFERRED DRYWALL LLC GRAND RAPIDS 3903435A 750 3/5/2021 5445 QUALITY METAL FABRICATING LLC GRAND RAPIDS 6091628A 1,864 1/3/2021 3030 RACHLAN 26 INC GRAND RAPIDS 4267648A 390 1/22/2021 8742 0.95 RADCLIFFE VILLAGE CONDOMINIUMS INC GRAND RAPIDS 2217430A 618 1/27/2021 9015 RAPIDCOM UNDERGROUND CONSTRUCTION INC GRAND RAPIDS 4435770A 5,671 3/25/2021 7600 0.89 RATHKE NANNY LLC GRAND RAPIDS 5789443A 960 1/30/2021 8835 RDV STAFFING INC GRAND RAPIDS 3465420A 81,007 3/13/2021 7720 0.87 REVIVE AND THRIVE PROJECT GRAND RAPIDS 5823293A 330 2/24/2021 9058 RINCON CRIOLLO RESTAURANT LLC GRAND RAPIDS 5770157A 1,048 1/25/2021 9058 RMY CUSTOM CONSTRUCTION LLC GRAND RAPIDS 5090059A 866 3/25/2021 5606 ROBLES PRO PAINTING LLC GRAND RAPIDS 5980461A 825 3/29/2021 5476 SAGANEK JOHN GRAND RAPIDS 4967917A 568 3/3/2021 9015 SAHARA HOOKAH LOUNGE INC GRAND RAPIDS 5210895A 373 1/29/2021 9058 SEAMLESS CARPENTRY LLC GRAND RAPIDS 6088520A 800 1/13/2021 5437 SHAGGY PINES DOG PARK LLC GRAND RAPIDS 5523770A 755 3/16/2021 8810 SHREDHUB LLC GRAND RAPIDS 5833949A 755 3/24/2021 8264 SURGICAL CRITICAL CARE ASSOCIATES PC GRAND RAPIDS 4725344A 470 1/26/2021 8832 TESSELLATURA TILE AND STONE LLC GRAND RAPIDS 5528925A 750 3/15/2021 5348 TEXAS CONSTRUCTION LLC GRAND RAPIDS 3724379A 801 2/7/2021 5645 TIDY WINDOW CLEANING LLC GRAND RAPIDS 5257255A 1,590 2/6/2021 9015 0.95 TMGRM INC GRAND RAPIDS 0070084A 14,005 1/6/2021 3085 0.85 TNK DRYWALL LLC GRAND RAPIDS 5947910A 750 1/1/2021 5445 TREE FISH TREE SERVICE LLC GRAND RAPIDS 5238900A 2,539 2/12/2021 0106 0.92 TREECOLOGY LLC GRAND RAPIDS 5944651A 5,781 2/28/2021 0106 TRI CITY ACQUISITIONS LLC GRAND RAPIDS 6129900A 750 3/3/2021 5645 TRIUMPHANT CARPENTRY LLC GRAND RAPIDS 6126863A 825 2/27/2021 5645 TRUE WOMENS HEALTH LLC GRAND RAPIDS 5969921A 246 2/23/2021 8810 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 59 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TWO BEARDS DELI LLC GRAND RAPIDS 4107586B 2,828 3/3/2021 9058 0.92 VINCENT KOK CONSTRUCTION LLC GRAND RAPIDS 5805139A 751 2/14/2021 5645 WALL NATURAL INC GRAND RAPIDS 3905063A 800 2/15/2021 5445 WEST MICHIGAN FLOORING INNOVATIONS GRAND RAPIDS 6130470A 750 3/4/2021 5146 WEST MICHIGAN TECHNICAL INC GRAND RAPIDS 5508045A 511 1/21/2021 8810 WHITE MITTEN MOVERS LLC GRAND RAPIDS 5967210A 2,025 2/14/2021 7214 A AND H PAINTING LLC GRANDVILLE 5980798A 750 3/30/2021 5476 ABSOLUTE SECURITY GROUP LLC GRANDVILLE 5656710A 1,000 2/19/2021 7720 CONCEPT CUSTOM PAINTING LLC GRANDVILLE 1797468A 750 3/13/2021 5476 EAGLE RIDGE BUILDERS INC GRANDVILLE 3938298A 750 1/10/2021 5645 GRANDVILLE CONSTRUCTION GRANDVILLE 4058372A 750 3/11/2021 5403 HD BUILDING SERVICES LLC GRANDVILLE 6122930A 825 2/20/2021 5538 HOEKSTRA PROPERTY SERVICES LLC GRANDVILLE 5253187A 7,413 3/22/2021 5476 0.91 JIM MYS TRUCKING LLC GRANDVILLE 2062194A 4,830 1/24/2021 7208 KOETJE ROOFING COMPANY GRANDVILLE 2647435A 3,547 2/23/2021 5551 1.00 MAVERICKS HOME STYLES GRANDVILLE 4678389A 825 3/26/2021 5403 PLAYWORLD CORPORATION GRANDVILLE 0168084A 1,200 3/15/2021 9015 0.95 STERK SAM GRANDVILLE 5674204A 270 2/11/2021 8810 VELDMAN BROTHERS PAINTING GRANDVILLE 2237865A 750 3/13/2021 5476 WEST MICHIGAN NANNIES LLC GRANDVILLE 5909058A 1,910 1/21/2021 8835 DOTY DONALD R GRANITE SHOALS, TX 5536472A 1,556 3/29/2021 0913 0.95 AVERY BUILDERS INC GRANT 1925784A 5,335 1/1/2021 5551 0.95 GOODIN PATRICK GRANT 6135366A 750 3/14/2021 5445 IKES TIRE AND AUTO LLC GRANT 5962919A 1,295 2/1/2021 7208 STERLING ZACHARY GRANT 5953383A 750 1/16/2021 2702 WALLINGA FAMILY FARM LLC GRANT 5953626A 972 1/12/2021 0011 WEST MICHIGAN SITE MAINTENANCE LLC GRANT 5967821A 656 2/15/2021 9402 ALL AMERICAN HOME BUILDERS LLC GRASS LAKE 2740699A 800 3/8/2021 5645 D AND D TRIM LLC GRASS LAKE 5826926A 750 2/16/2021 5437 DESIGN DRYWALL GRASS LAKE 1296175A 750 3/12/2021 5445 DEWOLFE CONTRACTING LLC GRASS LAKE 5978270A 750 3/22/2021 5645 GARY GREENE CONSTRUCTION GRASS LAKE 1863827A 825 1/23/2021 5645 0.87 R AND D CEILING & PARTITION LLC GRASS LAKE 4326911A 750 2/17/2021 5445 1.00 RK STUDIOS LLC GRASS LAKE 5546567A 296 1/25/2021 4361 KNAPP DUANE L GRAWN 2247372A 750 3/22/2021 7219 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 60 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HENDRICKS MARK GRAYLING 5610680A 583 1/5/2021 9015 ATTACHMENT SUPPLIES & PRODUCTS LLC GRAYSLAKE, IL 5355940A 1,143 1/1/2021 3632 0.95 THARIO BUILDING SERVICES INC GREEN BAY, WI 6113907A 613 2/6/2021 9015 WECONNECT INC GREEN BAY, WI 3354644A 328,314 3/29/2021 9519 1.88 ALL THINGS CONSTRUCTION LLC GREENVILLE 6121683A 750 2/18/2021 5645 DAVID E CLIFFORDS TOWING INC GREENVILLE 5594812A 3,682 3/24/2021 7208 0.94 DYNAMIC CRUSHING LLC GREENVILLE 5522684A 12,131 3/7/2021 1624 1.41 13 % HALSTEAD MASONRY GREENVILLE 5902681A 750 2/20/2021 5022 J HOUSE CONSTRUCTION LLC GREENVILLE 5830370A 750 2/22/2021 5645 K MAC STAFFING INC GREENVILLE 4886402A 1,674 2/17/2021 7208 0.95 MICROAIR CONSULTING LLC GREENVILLE 5114977A 373 3/22/2021 8601 MID MICHIGAN HELICOPTER INC GREENVILLE 1019627A 803 1/24/2021 7422 0.95 SUBURBAN SPECIALISTS REAL ESTATE INC GREENVILLE 1451952A 574 1/25/2021 9015 SUBURBAN SPECIALISTS REAL ESTATE INC GREENVILLE 1451952A 585 1/25/2021 9015 TALON AVIATION LLC GREENVILLE 6130500A 877 3/4/2021 7403 WEATHERSKIN OF WEST MICHIGAN LLC GREENVILLE 5651948A 750 3/16/2021 5437 JIM BARBOUR CONSTRUCTION INC GREGORY 3539180A 338 3/5/2021 5606 TERRYS CAULKING CO LLC GREGORY 3950158A 825 1/11/2021 5476 ANCHOR INVESTMENTS LLC GROSSE ILE 5665647A 630 1/26/2021 9015 CANCILLIARI CONSTRUCTION LLC GROSSE ILE 3330800A 801 3/24/2021 5476 DORMAR SOLUTIONS INC GROSSE ILE 5968356A 235 3/1/2021 8810 DOWNRIVER HOCKEY ACADEMY LLC GROSSE ILE 5230772A 857 1/23/2021 9015 0.95 EAST SHORE CONDOMINIUM APARTMENT GROSSE ILE 0907650A 626 2/23/2021 9015 GROSSE ILE HISTORICAL SOCIETY GROSSE ILE 5826888A 369 2/26/2021 8810 LUTON RIDING ACADEMY INC GROSSE ILE 6097731A 751 2/22/2021 8279 ARBOR PRO TREE SERVICE INC GROSSE POINTE 1247956A 5,435 3/21/2021 0042 0.93 CLARK BLISS GROSSE POINTE 5516137A 855 2/12/2021 0908 DONALDSON PETER & DONALDSON LAURIE GROSSE POINTE 4157230A 307 2/23/2021 0908 FRASER TOOL AND GAUGE LLC GROSSE POINTE 6091253A 561 1/3/2021 3632 GRAND CIRCUS MEDIA LLC GROSSE POINTE 6131409A 304 3/5/2021 8742 GROSSE POINTE EDUCATION ASSOCIATION GROSSE POINTE 2960400A 228 1/24/2021 8810 IP TELECOM SOLUTIONS LLC GROSSE POINTE 6137130A 301 3/19/2021 5191 ITS TRANSPORTATION INC GROSSE POINTE 5666937A 2,294 1/28/2021 7212 0.95 KDJS LLC GROSSE POINTE 5951453A 750 1/11/2021 7208 MARGES BAR INC GROSSE POINTE 5673160A 851 2/10/2021 9058 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 61 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TAYLOR DOOR INSTALLS LLC GROSSE POINTE 5951755A 825 1/15/2021 5645 WINIARSKI ROBERT J & DENISE L GROSSE POINTE 5248086A 530 3/8/2021 0913 CHILD ADVOCACY PROGRAM PLLC GROSSE POINTE FARMS 6084060A 804 1/1/2021 8820 EDS CARE MANAGEMENT LLC GROSSE POINTE FARMS 4121244A 6,229 2/25/2021 0913 0.87 CHRISTIAN HURTTIENNE CONSTRUCTION LLC GROSSE POINTE PARK 5412684A 413 2/5/2021 5606 0.95 CORNERSTONE 3 LLC GROSSE POINTE PARK 6117392A 750 2/12/2021 5645 J MACK AGENCY LLC GROSSE POINTE PARK 3785300A 3,819 1/1/2021 7720 0.95 MOTOR CITY MITTEN MISSION GROSSE POINTE PARK 6126910A 2,045 3/11/2021 8810 TRIPLE T CONSTRUCTION INC GROSSE POINTE PARK 2009048A 1,148 2/23/2021 5445 BELINE OBEID LLC GROSSE POINTE WOODS 3748685A 270 2/27/2021 8810 CHICHESTER MICHAEL & ELEANOR GROSSE POINTE WOODS 4833988A 489 3/1/2021 0908 D WEISS PLUMBING SEWER & DRAIN CLEANING GROSSE POINTE WOODS 5663830A 584 1/21/2021 5183 SERVICE INC HIGGINS GARY GROSSE POINTE WOODS 1284967A 1,911 1/4/2021 5645 0.95 LOCHMOOR INVESTMENTS LLC GROSSE POINTE WOODS 6114431A 238 2/7/2021 8601 MOTOR CITY MANAGERS LLC GROSSE POINTE WOODS 5515475A 569 2/9/2021 9015 DREAMLAND MOTEL & RESTAURANT GULLIVER 0896721A 646 3/13/2021 9058 0.95 GULLIVER FOREST PRODUCTS GULLIVER 5368502A 4,629 2/3/2021 2702 1.00 CORKIN TERRY GWINN 5723701A 750 3/13/2021 2709 FIVE STAR DRYWALL LLC GWINN 6099033A 1,196 1/20/2021 5445 SUPERIOR MANUFACTURING SOLUTIONS LLC GWINN 5812445A 2,557 1/20/2021 6834 0.95 COLENSO BUILDING & REMODELING HALE 0860360A 750 2/7/2021 5645 STREETERS EXCAVATING LLC HALE 5974780A 2,080 3/9/2021 5403 TIMLICKS TREE SERVICE LLC HALE 5676266A 2,801 3/20/2021 0106 0.95 WHITETAIL RESTAURANT LLC HALE 3333167A 730 2/8/2021 9058 COUNTY PLUMBING & HEATING LLC HAMBURG 5187664A 611 1/24/2021 5183 TORCH WINDOW CLEANING LLC HAMBURG 5872472A 1,285 3/22/2021 9015 TURNKEY ENVIRONMENTAL SERVICES INC HAMBURG 5862698A 11,962 1/31/2021 5479 0.89 BOYLES KEVIN HAMILTON 5696399A 523 3/30/2021 9102 CAMBIUM LIFESTYLES LLC HAMILTON 5972817A 523 3/5/2021 9102 GENESIS AT 42 NORTH SURVEYING HAMILTON 5973910A 413 3/7/2021 8601 GRANFORS PHILLIP HAMILTON 5691605A 750 3/16/2021 5645 JAG EXPRESS TRUCKING COMPANY LLC HAMILTON 5979838A 3,529 3/26/2021 7208 JEFF KRAGT CONSTRUCTION LLC HAMILTON 4877845A 800 1/17/2021 5645 VAN RHEE BUILDERS HAMILTON 5520835A 750 2/28/2021 5445

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ADULT AND PEDIATRIC MD PLLC HAMTRAMCK 4302001A 856 3/5/2021 8832 ALASHWAL MOKTAR HAMTRAMCK 6130313A 750 3/11/2021 7208 B AND E CONSTRUCTION COMPANY HAMTRAMCK 2748614A 2,308 3/1/2021 5645 0.95 BAZZI MOBIL INC HAMTRAMCK 5090180A 1,884 3/17/2021 8017 0.95 IRM REMODELING LLC HAMTRAMCK 5695465A 751 3/23/2021 5348 JOZEF CONTRACTOR INC HAMTRAMCK 3610144A 4,977 1/12/2021 5645 0.93 K AND N GAS MART INC HAMTRAMCK 6092527A 914 1/4/2021 8017 KOWALSKI COMPANIES INC HAMTRAMCK 0338052A 580 1/4/2021 2095 M A A REMODELING LLC HAMTRAMCK 5962854A 707 3/14/2021 5538 OSLO GROUP LLC HAMTRAMCK 5081637A 751 1/26/2021 9015 PERFECT EDGE LLC HAMTRAMCK 5968186A 707 2/21/2021 5538 WAYNE PLUTO LLC HAMTRAMCK 6141706A 657 3/26/2021 3724 ZACKS FUEL AND MINI MART 1 INC HAMTRAMCK 5481678A 382 1/14/2021 8017 0.95 MATTFOLK JEFFREY P HANCOCK 3271315A 750 1/15/2021 2702 WOODSIDE LOGGING LLC HANCOCK 6111866A 750 1/29/2021 2709 B AND M CLEANING HANOVER 6109624A 568 1/28/2021 9015 CURRENT SPORTS LLC HANOVER 5408490A 825 3/15/2021 5221 K AND C LAWN CARE LLC HANOVER 1029690A 2,206 3/8/2021 0106 0.95 MLC PLUMBING AND MECHANICAL LLC HANOVER 3658198A 2,480 1/6/2021 5550 DDH INC HARBOR SPRINGS 3600912A 706 3/1/2021 9402 GREAT LAKES STEWARDSHIP INITIATIVE HARBOR SPRINGS 6088759A 356 1/1/2021 8810 MATT JAKEWAY BUILDERS HARBOR SPRINGS 5655331A 800 1/5/2021 5645 MESNER ENTERPRISES LLC HARBOR SPRINGS 5668174A 3,061 2/1/2021 0106 WATERS EDGE CONTRACTING LLC HARBOR SPRINGS 3233502A 19,991 3/16/2021 5437 1.37 13 % MURRAY THOMAS HARMANSVILLE 5120071A 750 3/27/2021 7208 HAWKS HOME IMPROVEMENTS HARPER WOODS 5979480A 750 3/26/2021 5645 NAZ MARY JANE REVOCABLE LIVING TRUST HARPER WOODS 5947286A 935 1/1/2021 0913 SADINA MINI MART INC HARPER WOODS 4295765A 764 1/17/2021 8017 SANA MINI MART INC HARPER WOODS 0018015A 1,759 2/18/2021 8017 0.95 KEVIN SQUIER CONSTRUCTION LLC HARRIETTA 5665124A 3,442 1/24/2021 5645 0.95 COLOR TIME PAINTING HARRISON 5245095A 750 3/1/2021 5476 H AND H LAWN CARE LLC HARRISON 4712838A 656 1/1/2021 9102 KTW ENTERPRISES LLC HARRISON 5290902A 752 3/21/2021 8232 LAKESIDE MOTEL LLC HARRISON 4232828A 374 1/14/2021 9052 MILLER LOGGING INC HARRISON 3047970A 753 1/26/2021 8810 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 63 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WYSOCKI TODD M HARRISON TOWNSHIP 5886830A 530 1/1/2021 0913 A 1 ROOFING & SIDING INC HARRISON TWP 3986861A 801 1/1/2021 8742 0.95 ADVANCED MACHINE SERVICES LLC HARRISON TWP 3792897A 12,669 3/3/2021 3724 ARROW EXPEDITING LLC HARRISON TWP 5578620A 800 2/12/2021 7208 BEYOND MARVELOUS CLEANING COMPANY HARRISON TWP 4860527A 470 3/7/2021 8835 BUCHMAN BROTHERS INC HARRISON TWP 3498484A 750 3/1/2021 3040 CAPTAINS LOGISTICS LLC HARRISON TWP 5815894A 7,554 1/29/2021 7208 0.95 CRESSWELL PROPERTY MANAGEMENT LLC HARRISON TWP 3361489A 215 3/14/2021 8810 DEL RAY SECURITY CONSULTANTS INC HARRISON TWP 4476360A 3,324 2/21/2021 7720 0.95 DOCS MARINE FIBERGLASS INC HARRISON TWP 5077834A 1,025 1/27/2021 6834 ENVIRONMENTAL BUILDING CO INC HARRISON TWP 1681788A 710 1/7/2021 5606 GIOVANNIS HOME CONCEPTS LLC HARRISON TWP 5976650A 1,786 3/16/2021 5551 GRIFFIN SECURE TRANSPORT LLC HARRISON TWP 5976030A 499 3/15/2021 7720 HART INDUSTRIES LLC HARRISON TWP 6093817A 898 1/8/2021 5191 LOUIS MIHELICH LANDSCAPE INC HARRISON TWP 0471275A 1,145 2/27/2021 0042 NORTH STAR SAIL CLUB HARRISON TWP 1703331A 412 1/1/2021 8810 OAK INTERIORS HARRISON TWP 4266552A 1,379 3/7/2021 5437 0.95 OLENCO INC HARRISON TWP 4818598A 771 3/22/2021 5160 RCS LAWN CARE INC HARRISON TWP 3040550A 1,366 3/4/2021 9102 0.95 SOURCE 1 USA INC HARRISON TWP 2727846A 228 1/24/2021 8742 TASK MAINTENANCE HARRISON TWP 3058824A 1,994 1/24/2021 6826 0.95 TROMLEYS FLOORING PROS LLC HARRISON TWP 5246644A 960 3/20/2021 9521 XTREME REMODELING LLC HARRISON TWP 5494575A 2,123 1/1/2021 5445 0.95 TEAM TPC LLC HARSENS ISLAND 4280512A 750 3/14/2021 5437 JOE MCGHANS INC HART 3474623A 1,350 1/19/2021 7208 KELLEY BRANDON HART 6100368A 750 1/16/2021 2709 SILVER LAKE SAND DUNES HART VISITORS HART 5098165A 216 2/1/2021 8810 BUREAU HARTFORD VOLUNTEER FIRE DEPARTMENT HARTFORD 0125199A 5,065 1/1/2021 7904 0.94 HAYES STEVEN HARTFORD 5184550A 750 3/1/2021 5645 ROBERTS INTERIORS OF HARTFORD LLC HARTFORD 3105032A 3,188 3/9/2021 5445 TIM FOSTER FARMS HARTFORD 1005090A 15,752 3/12/2021 7208 0.81 A MAXONS TREE CARE LLC HARTLAND 1045628A 12,680 3/4/2021 0106 0.95 BIG SKY DEVELOPMENT INC HARTLAND 3404706A 751 3/1/2021 8810

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DAVID KORODY AND ASSOCIATES HARTLAND 2505916A 755 2/26/2021 8742 0.95 CONSTRUCTION INC LBS SERVICES HARTLAND 1066145A 1,300 1/1/2021 5645 PELEG CONSTRUCTION HARTLAND 3811271A 750 1/6/2021 5645 R A MANTUA HARTLAND 4992199A 807 3/17/2021 5445 UGLY SHINGLES LLC HARTLAND 5460204A 618 3/27/2021 9015 BENNETT VILLAGE CONDOMINIUM ASSOCIATION HASLETT 3965473A 568 3/1/2021 9015 BOARDWALK CONDOMINIUM ASSOCIATION HASLETT 4256948A 568 1/18/2021 9015 COUNTRY WALK OF DEWITT CONDOMINIUM HASLETT 5966019A 618 2/8/2021 9015 ASSOCIATION CREED BROTHERS DIRECTIONAL LLC HASLETT 6137733A 800 3/20/2021 6325 DETAILED DRYWALL FINISHING LLC HASLETT 5519217A 750 2/20/2021 5445 ENGLISH MEADOWS CONDOMINIUM HASLETT 4483642A 568 3/14/2021 9015 ASSOCIATION GLENS OF WILLOUGHBY HOMEOWNERS HASLETT 4610520A 568 2/24/2021 9015 ASSOCIATION JACKARD LLC HASLETT 5536480A 611 3/28/2021 5183 LAKESIDE VILLAGE ASSOCIATION HASLETT 4875460A 618 1/3/2021 9015 PEPPER TREE CLUB ASSOCIATION HASLETT 6121624A 568 2/18/2021 9015 SPARTAN TOWING & LOCK OUT LLC HASLETT 5950376A 1,620 1/7/2021 7208 WALDEN POND CONDOMINIUM HASLETT 3611213A 568 3/22/2021 9015 WEATHERHILL COURT CONDOMINIUM HASLETT 6121870A 568 2/18/2021 9015 ASSOCIATION INC BENNETT TREE SERVICE & LOGGING HASTINGS 3070085A 800 1/13/2021 0106 0.95 FEDEWA INC HASTINGS 3107337A 21,461 1/1/2021 5038 0.81 GEE LAW FIRM PLLC HASTINGS 1120204A 293 2/20/2021 8810 HALL CHRIS HASTINGS 3789403A 1,539 3/24/2021 5445 0.95 HAMILTON SNOW PLOW PLUS LLC HASTINGS 5482852A 656 2/12/2021 9402 HAWTHORNE MASONRY LLC HASTINGS 5863279A 825 2/12/2021 5221 MADDOX LOGGING HASTINGS 5435730A 750 1/1/2021 2702 WATERMAN INTERIOR SOLUTIONS LLC HASTINGS 6123910A 800 2/21/2021 5146 ADAN CONSTRUCTION LLC HAZEL PARK 6117007A 800 2/18/2021 5551 CONTINENTAL CONTRACTING COMPANY LLC HAZEL PARK 3314650A 1,580 2/20/2021 5476 0.95 ELECTRONIC MONITORING SYSTEMS INC HAZEL PARK 5455502A 423 1/12/2021 8810 EML CONSTRUCTION LLC HAZEL PARK 6095615A 750 1/10/2021 5445 KB WINDOWS INC HAZEL PARK 5478901A 750 2/25/2021 5437

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge LANE JAMES HAZEL PARK 6105297A 750 1/23/2021 5476 NEW CENTURY WELDING AND CONSTRUCTION HAZEL PARK 5389895A 4,816 3/21/2021 3030 0.92 LLC ONE HUNDRED 10 PERCENT PAINTING LLC HAZEL PARK 5952298A 751 1/12/2021 5476 ROCKWOOD RECOVERY INC HAZEL PARK 5674905A 1,730 2/22/2021 7720 STERLING DATACOM HAZEL PARK 4015835A 750 1/25/2021 7600 TOTAL WINDOW CLEANING LLC HAZEL PARK 4204301A 6,137 3/12/2021 9015 0.87 AAA SEWER SERVICES INC HEMLOCK 3293220A 713 1/29/2021 5183 L T SECURITY LLC HEMLOCK 4244710A 449 1/27/2021 7720 P JS CONSTRUCTION HEMLOCK 3251489A 1,350 2/17/2021 5645 SPLASH AND DASH CAR WASH LLC HEMLOCK 6111548A 516 1/30/2021 8387 HARRIS VAN R HENDERSON 1619659A 750 2/12/2021 2702 BILL HULL CUSTOM SKIDDING HERMANSVILLE 2019485A 750 1/1/2021 2702 TARRIS STANLEY HERMANSVILLE 2810441A 750 3/31/2021 7208 CONTEGO PROPERTY SERVICES LLC HERSEY 0829013A 644 1/1/2021 9015 COOKS TREE SERVICE LLC HERSEY 5521807A 4,018 3/20/2021 2702 0.95 ACT NEMT LLC HIGGINS LAKE 5448913A 1,369 3/18/2021 7212 0.95 SPLICE TECH COMMUNICATIONS HIGGINS LAKE 2738350A 750 3/23/2021 7600 ACTION CLEANING SERVICE INC HIGHLAND 4211731A 568 2/24/2021 9015 BUGNELL BERNARD J HIGHLAND 2220075A 540 3/13/2021 9521 BURT CRAWFORD DRYWALL INC HIGHLAND 5079748A 800 1/24/2021 5445 DJH AUTO SALES INC HIGHLAND 6090524A 536 1/1/2021 8748 GREAT LAKES REMEDIATION INC HIGHLAND 4257367A 2,520 3/28/2021 9015 0.95 HIGHLAND STORE INC HIGHLAND 4042476A 898 2/15/2021 8017 0.95 JANSIGN LLC HIGHLAND 0093750A 338 2/27/2021 5606 JKD GROUP INC HIGHLAND 2707977A 7,532 2/28/2021 4828 0.83 M AND B HEATING AND COOLING INC HIGHLAND 4342283A 1,720 3/12/2021 5550 1.00 MICHIGAN ALL PRO ASPHALT LLC HIGHLAND 2514370A 4,816 3/24/2021 5221 0.93 RANDYS FLOORS LLC HIGHLAND 5823846A 825 2/13/2021 5437 ROBBINS CUSTOM PAINTING HIGHLAND 2366398A 750 1/23/2021 5476 ROBERTS PLUMBING OF HIGHLAND INC HIGHLAND 0714259A 562 3/27/2021 5183 SHOWCASE WINDOWS & SIDING LLC HIGHLAND 3444163A 750 3/11/2021 5645 0.95 TOMS CHAMPION POOL SERVICE LLC HIGHLAND 5012953A 750 1/18/2021 9015 TRADITION GRAPHIC SOLUTIONS LLC HIGHLAND 5974445A 290 3/9/2021 8810 FLORES JOSE HIGHLAND PARK 6124518A 750 2/22/2021 5445

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GIFT MART & PAYMENT CENTER INC HIGHLAND PARK 4618459A 276 3/27/2021 8810 GREAT LAKES AUTO SALES ACQUISITION LLC HIGHLAND PARK 5566720A 462 2/4/2021 8748 HAMILTON ONE STOP INC HIGHLAND PARK 5676320A 849 2/16/2021 8017 CVMS SYSTEMS LLC HIGHLANDS RANCH, CO 5949807A 6,018 2/15/2021 3724 EDGAR FOREST PRODUCTS HILLMAN 2806452A 750 1/6/2021 2702 C S ROOFING CO LLC HILLSDALE 2858312A 34,346 1/26/2021 5552 1.34 13 % EMBRACE YOUR HEALTH LLC HILLSDALE 5384575A 4,100 3/11/2021 8835 0.95 HOPE FOR DEVELOPMENTAL DISABILITIES HILLSDALE 6103022A 2,110 1/21/2021 7212 M AND S LAWNCARE HILLSDALE 2558424A 1,148 2/6/2021 9102 0.95 ROGER GLENN FOUST LLC HILLSDALE 5541476A 322 3/27/2021 8810 ALL SEASONS HVAC RENTAL LLC HOLLAND 5950260A 923 1/5/2021 8010 BEST WAY ANIMAL REMOVAL LLC HOLLAND 6132138A 840 3/6/2021 8831 BOSMA AND SONS CONSTRUCTION LLC HOLLAND 6138276A 279 3/25/2021 8742 CLEANING GUY HOLLAND 3249131A 568 3/4/2021 9015 COMMERCIAL PRINT GROUP HOLLAND 5678951A 456 2/22/2021 4299 DBD VENTURES LLC HOLLAND 4971477A 3,033 3/23/2021 9015 0.95 DC BATTERY HUB MI LLC HOLLAND 5824818A 1,120 2/14/2021 3179 DEBACK DAVID HOLLAND 5947146A 800 1/1/2021 5645 DEL ROSA CONSTRUCTION LLC HOLLAND 6054935A 22,066 3/20/2021 5022 DIVERSIFIED MARINE CONSTRUCTION LLC HOLLAND 6122884A 26,337 2/28/2021 6217 EDGE ELECTRIC & CONTROLS LLC HOLLAND 5809525A 470 1/13/2021 5190 ELEMENT MARINE CONSTRUCTION LLC HOLLAND 6107770A 2,775 2/11/2021 6217 EYE CAN SEE CLEARLY NOW LLC HOLLAND 3078663A 2,241 2/22/2021 9015 0.95 GARZA RICARDO HOLLAND 5962889A 750 2/4/2021 5645 HOLLAND COMMUNITY THEATRE THE HOLLAND 5369746A 341 1/13/2021 8810 IRON LAB LLC HOLLAND 5446660A 403 3/27/2021 9063 JOEL SWEET BUILDER LLC HOLLAND 6094864A 750 1/10/2021 5645 JTS TREE SERVICES LLC HOLLAND 3203913A 4,980 2/1/2021 0106 0.95 KANDUIT ELECTRIC LLC HOLLAND 5688477A 470 3/8/2021 5190 KEY PERSONNEL INC HOLLAND 0871940A 54,946 2/1/2021 4511 1.00 LADDER INCORPORATED HOLLAND 4268148A 623 3/5/2021 9015 M 3 ELECTRIC LLC HOLLAND 5976901A 1,154 3/27/2021 5190 M 40 AUTO REPAIR LLC HOLLAND 4992733A 658 3/19/2021 8395 0.95 MEDELLIN VICTOR HOLLAND 5807778A 750 1/11/2021 5645 MICHIGAN WOOD FUELS LLC HOLLAND 4292421A 13,316 2/21/2021 4207 1.44 13 % 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 67 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MMQ STAFFING LLC HOLLAND 5963656A 6,771 3/7/2021 3808 MODERN FLOORING LLC HOLLAND 5675928A 750 2/15/2021 5437 MOKMA CONSTRUCTION LLC HOLLAND 4132181A 800 1/11/2021 5645 MONTOYA ROMAN M HOLLAND 6090923A 750 1/10/2021 5403 MULDER BROTHERS BROKERAGE INC HOLLAND 5664152A 822 1/1/2021 8810 MY HOUSE MINISTRY HOLLAND 5653045A 350 1/1/2021 8832 NATIONAL ILLUMINATION & SIGN CORPORATION HOLLAND 6113419A 750 2/13/2021 9558 NEW LIFE WOODZ LLC HOLLAND 5947200A 800 1/1/2021 5645 OVERISEL ELECTRIC LLC HOLLAND 4967844A 581 3/6/2021 3724 PRECISION LAND MANAGEMENT LLC HOLLAND 6137954A 789 3/20/2021 6217 REFRESH PROPERTY MAINTENANCE SERVICES HOLLAND 5967813A 800 2/18/2021 5645 LLC RENEW THERAPEUTIC RIDING CENTER HOLLAND 5379512A 1,938 3/3/2021 8279 0.95 ROGUE WAVE CONSULTING LLC HOLLAND 5962790A 215 2/5/2021 8810 SCRAPYARD CLIMBING COLLECTIVE LLC HOLLAND 5970962A 686 2/28/2021 9063 SMALLEGAN SIDING INC HOLLAND 4591143A 750 2/28/2021 5645 SUNDBURG QUALITY ENGINEERING TRAINING HOLLAND 6132073A 238 3/6/2021 8601 AND CONSULTING TATLOCK PROPERTY SERVICES LLC HOLLAND 3235114A 1,666 2/10/2021 5645 1.00 TEKTON INTERIORS LLC HOLLAND 6109560A 750 2/1/2021 5437 TREE TECH LLC HOLLAND 5955467A 3,668 1/21/2021 0106 TROOST DOUGLAS HOLLAND 6112447A 769 2/1/2021 9519 WATKIN TREE PRO LLC HOLLAND 4625889A 5,740 3/5/2021 0106 0.91 WEATHERWAX CONSTRUCTION & CUSTOM HOLLAND 4402260A 800 1/1/2021 5645 0.95 WOODWORKING LLC WESTCORE NEIGHBORS HOLLAND 5071330A 252 1/5/2021 8742 BAVARIAN WOODS CONDOMINIUM ASSOCIATION HOLLY 0204080A 215 1/15/2021 8810 INC FLOOR CRAFTERS HOLLY 0872474A 750 2/2/2021 5437 GTS CONTRACTING INC HOLLY 3212483A 825 2/1/2021 5403 0.95 HIGHLANDER PLUMBING AND HEATING LLC HOLLY 4105893A 659 1/1/2021 5183 0.95 HOLLY VAULT LLC HOLLY 5975808A 1,290 3/14/2021 9058 J AND W CUSTOM INSTALLATIONS INC HOLLY 1069616A 750 2/13/2021 5645 0.95 KC CONSTRUCTION & WEATHERIZATION HOLLY 5694655A 750 3/23/2021 5645 MICHIGAN RECYCLED AGGREGATES LLC HOLLY 3294269A 1,597 2/19/2021 1624 0.95 OAKHURST TRIM & STAIR LLC HOLLY 2650827A 825 3/16/2021 5437

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge RG CUSTOM SERVICES INC HOLLY 5818192A 750 3/10/2021 5437 RICHMAN WELL DRILLING LLC HOLLY 5251176A 750 3/18/2021 6204 AHW TRANSPORT INC HOLT 5690889A 750 2/22/2021 7208 ALSON SERVICES INC HOLT 3227782A 358 3/13/2021 8601 BACH ORNAMENTAL & STRUCTURAL STEEL INC HOLT 3085260A 11,143 2/17/2021 3030 0.86 CHRISTIES ENTERPRISES INC HOLT 5973309A 1,337 3/6/2021 8831 CUSTOM DESIGN INTERIORS & STRUCTURES HOLT 2863600A 750 2/13/2021 5445 LLC D AND D QUALITY SERVICING INC HOLT 5253543A 1,402 3/25/2021 5550 FETA TRANSPORT INC HOLT 5198488A 11,251 1/11/2021 7208 0.93 LAKESIDE VILLAGE NORTH ASSOCIATION HOLT 1820613A 568 2/21/2021 9015 MILLER THOMAS INSULATION CONTRACTING HOLT 5224454A 750 1/8/2021 5479 WINEGAR SIDING LLC HOLT 0991228A 800 3/26/2021 5645 TOWNSHIP OF HOPE HOPE 0167959A 1,809 3/8/2021 9220 0.95 COLE CONCRETE HOPKINS 5972795A 751 3/5/2021 5221 PEACEFUL ROAD FARM PRODUCTS LLC HOPKINS 3160017A 6,738 1/23/2021 2014 0.88 C AND S PLASTERING LLC HORTON 4785479A 750 2/24/2021 5480 CUSTOM CLEANING HORTON 5291208A 569 2/15/2021 9015 0.95 HOUGHTON TANNING LLC HOUGHTON 3435202A 263 2/20/2021 9586 J JS WOK N GRILL INC HOUGHTON 4432452A 839 1/15/2021 9058 0.95 K AND N CONTRACTORS LLC HOUGHTON 5441749A 1,300 2/21/2021 5645 BOS FIELD MACHINE & SONS LLC HOUGHTON LAKE 6086853A 4,078 1/7/2021 3724 CREEKSIDE IRRIGATION LLC HOUGHTON LAKE 5594340A 561 1/12/2021 5183 PURE MEMORIES LLC HOUGHTON LAKE 5818168A 627 1/31/2021 9052 MOSBACHER ENERGY COMPANY HOUSTON, TX 2239370A 1,379 3/31/2021 1320 0.95 KLEAN GUTTERS MIDWEST INC HOWARD CITY 6129650A 6,485 3/3/2021 5538 RANKIN KODY HOWARD CITY 5702224A 750 1/16/2021 5445 RAU ELECTRIC HOWARD CITY 2303914A 470 3/23/2021 5190 ROUHAN NATHANIEL T HOWARD CITY 5951151A 750 2/12/2021 2702 RUSTYS AMBLE INN LLC HOWARD CITY 2944332A 720 3/6/2021 9058 SCHNEIDER CONSTRUCTION HOWARD CITY 4878400A 750 1/31/2021 5437 ABSTRACT CEILINGS INC HOWELL 4447336A 750 3/1/2021 5020 AIR SERVICE ENTERPRISE INC HOWELL 0251771A 1,256 2/3/2021 7422 0.95 APT DRYWALL HOWELL 3945294A 750 1/25/2021 5445 ARROW STRAIGHT TECHNOLOGIES LLC HOWELL 5810825A 1,915 3/5/2021 5191

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BENTLEY LAKE FARMS LLC HOWELL 5951518A 506 1/11/2021 0128 BRIGHTON STAIR INC HOWELL 3343910A 750 2/14/2021 2802 BRUSSEAU AND SONS INC HOWELL 0036510A 1,663 2/12/2021 7720 0.95 DENNIS WILKINSON BUILDING LLC HOWELL 3098672A 10,732 3/1/2021 5645 1.00 ESME CLEANING HOWELL 5128285A 2,210 2/28/2021 9015 0.95 FERGUSON ROOFING INC HOWELL 3636712A 756 1/25/2021 8810 FOUR SEASONS OUTDOOR SERVICES LLC HOWELL 2697939A 710 2/9/2021 0042 GENOA WOODS CONDOMINIUM ASSOCIATION HOWELL 4631137A 568 3/22/2021 9015 GREAT WHITE UNLIMITED LLC HOWELL 3347311A 750 1/17/2021 5445 HD SPOONER & ASSOCIATES INC HOWELL 6090303A 265 1/1/2021 8810 HICKORY HILLS CONDOMINIUM ASSOCIATION HOWELL 5515335A 618 2/9/2021 9015 HIDDEN LAKE ESTATES ASSOCIATION HOWELL 4832396A 568 1/1/2021 9015 HIDDEN LAKE MARINA ASSOCIATION HOWELL 4830296A 580 2/14/2021 8810 JUST DAN N DEE TRUCKING INC HOWELL 5978165A 825 3/22/2021 7208 LEKANDER COACHING LLC HOWELL 5834368A 786 3/3/2021 8832 LIFT LEVEL INC HOWELL 4982720A 6,187 3/29/2021 5221 0.90 LIVINGSTON COUNTY GYMNASTS INC HOWELL 5230136A 668 1/22/2021 9063 0.95 LORIS CUSTOM CLEANING SOLUTIONS LLC HOWELL 5948207A 802 1/1/2021 9015 MASON ELECTRIC LLC HOWELL 5942080A 674 1/10/2021 5190 MCGRAIN LAND SERVICES LLC HOWELL 3874389A 710 1/9/2021 0042 0.95 MUNGUIA INVESTMENTS LLC HOWELL 4955390A 568 2/2/2021 9015 PREMIER FARM INC HOWELL 1372386A 596 1/15/2021 8742 0.95 PREMIUM ROOFING LLC HOWELL 3040690A 827 3/20/2021 8742 PRESERVE OF RIVERSIDE CONDOMINIUM HOWELL 5955998A 568 2/1/2021 9015 ASSOCIATION RELIABLE CONSTRUCTION SERVICES LLC HOWELL 5190606A 750 1/31/2021 5221 RIGELSTAR DEVELOPMENT LLC HOWELL 6117023A 750 2/12/2021 5183 RPM PLUMBING AND HEATING LLC HOWELL 6135803A 926 3/18/2021 5183 RTD FLOORING LLC HOWELL 4831756A 556 1/13/2021 8017 S D ROLLINS CONSTRUCTION INC HOWELL 1314386A 750 3/30/2021 5645 SOUTHEAST MICHIGAN CONSORTIUM HOWELL 6089011A 2,932 1/1/2021 9058 STACYS HOUSE INC HOWELL 3053334A 956 3/2/2021 8869 T H STEEL INC HOWELL 2682427A 3,614 1/15/2021 3365 0.95 THEATRE TECHNICIANS LLC HOWELL 2662493A 489 1/6/2021 5191 0.95 TIMBER GREEN HOMEOWNERS ASSOCIATION HOWELL 5834171A 568 3/10/2021 9015

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TITAN SPRINKLER LLC HOWELL 4728904A 760 2/16/2021 9102 0.95 WAVELENGTH VIDEO PRODUCTIONS LLC HOWELL 5674271A 328 2/13/2021 7610 CAMERON BRANDON SCOTT HUBBARD LAKE 5739128A 618 3/8/2021 9015 K AND D BISSLAND TRUCKING LLC HUBBARD LAKE 5811163A 750 1/18/2021 7208 KEN WYERS TRUCKING LLC HUBBARD LAKE 1974980A 3,371 3/8/2021 7208 0.95 ALL CARE INC HUDSON 4223365A 11,872 2/5/2021 8835 1.28 C R TIMBER LLC HUDSON 6112021A 750 1/31/2021 2702 K SPENCER CONSTRUCTION LLC HUDSON 5120152A 751 3/27/2021 5437 ROWLEY INC HUDSON 2969955A 751 2/13/2021 8810 ADAMS K 9 LLC HUDSONVILLE 5370876A 3,176 1/14/2021 8831 1.00 ANDREW SNIP CONSTRUCTION LLC HUDSONVILLE 5657385A 750 1/10/2021 5645 BEECHRIDGE NORTH CONDOMINIUM HUDSONVILLE 4741153A 568 2/8/2021 9015 ASSOCIATION BOSSCHER KEN HUDSONVILLE 5370477A 750 2/10/2021 5022 C B DRYWALL INC HUDSONVILLE 3600246A 750 2/26/2021 5445 CENTERLINE BUILDERS LLC HUDSONVILLE 5811783A 4,677 1/19/2021 5645 0.95 COELING TANNER HUDSONVILLE 6103006A 750 1/21/2021 5645 DANIEL MOELKER BUILDER LLC HUDSONVILLE 5976162A 750 3/22/2021 5645 DEFINITION BUILDERS LLC HUDSONVILLE 4347358A 750 2/28/2021 5645 DOUGLAS CUSTOM HOMES HUDSONVILLE 5361427A 750 3/23/2021 5645 DUIMSTRA BRIAN HUDSONVILLE 3846652A 750 1/8/2021 5645 EISENGA MASONRY LLC HUDSONVILLE 3109917A 750 3/29/2021 5022 FOUNDATION HOMES LLC HUDSONVILLE 3697185A 750 1/26/2021 5437 HEARTH AND HOME BUILDERS LLC HUDSONVILLE 3941906A 3,500 3/12/2021 5645 HELP AT HOME SENIOR CARE LLC HUDSONVILLE 5358396A 593 1/8/2021 8835 INTEGRITY DRYWALL INC HUDSONVILLE 2618672A 751 3/23/2021 5445 JAY VAN BAREN BUILDER LLC HUDSONVILLE 3211738A 750 1/4/2021 5645 JOHN E MULDER BUILDER HUDSONVILLE 1242806A 750 1/26/2021 5645 JOHNNIE DEBRUIN BUILDER LLC HUDSONVILLE 5675081A 750 2/14/2021 5437 LAWRENCE ROOFING LLC HUDSONVILLE 5690234A 3,223 3/17/2021 5551 MATTICE CONNIE HUDSONVILLE 6137598A 238 3/20/2021 8601 NDH HOMES LLC HUDSONVILLE 5379539A 750 3/3/2021 5403 OK ROOFING COMPANY HUDSONVILLE 3302490A 1,634 2/17/2021 5551 0.94 RGD BUILDERS LLC HUDSONVILLE 5708303A 750 2/24/2021 5645 ROBERT MOELKER BUILDER HUDSONVILLE 2800950A 750 1/27/2021 5348

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ROYAL FINISHING INC HUDSONVILLE 5947308A 1,754 1/1/2021 5476 SCHUT NATHAN J HUDSONVILLE 5690242A 470 3/22/2021 5190 STARLIGHT MINISTRIES INC HUDSONVILLE 5354331A 375 1/30/2021 8832 VAN DAM BUILDERS INC HUDSONVILLE 2839040A 750 3/17/2021 5645 CAMPAU FARMS ASSOCIATION HUNTINGTON WOODS 3483827A 618 3/10/2021 9015 SACHSE TODD HUNTINGTON WOODS 4966465A 357 2/28/2021 0908 APPLIED FINISHES USA LLC HURRICANE, WV 6100287A 1,754 1/20/2021 5476 TONYS SONS PLUMBING AND HEATING INC IDA 1757857A 2,066 2/21/2021 5550 1.05 BIG JOES NORTH LLC IMLAY CITY 0953814A 916 1/2/2021 9058 0.95 CHB CARPENTRY INC IMLAY CITY 5608058A 761 2/27/2021 5645 ESSO WRECKING CO IMLAY CITY 5182786A 463 1/23/2021 5606 0.95 JC LAWN & LANDSCAPING IMLAY CITY 5465141A 710 3/20/2021 0042 0.95 KALUK CONSTRUCTION LLC IMLAY CITY 0884944A 750 1/4/2021 5645 0.95 KERB AND SONS TRANSPORT LLC IMLAY CITY 5971730A 4,856 3/8/2021 7208 LANGE THOMAS IMLAY CITY 2992400A 788 3/31/2021 8232 1.00 PLACENCIA CONTRACTING IMLAY CITY 6118291A 750 2/13/2021 5348 RHINO LANDSCAPE CONSTRUCTION IMLAY CITY 6088783A 656 1/3/2021 9402 KURKO INC INDEPENDENCE 2833603A 1,968 3/23/2021 9058 1.00 G B WOLFGRAM INC INDIAN RIVER 1346598A 750 1/9/2021 5190 HANDLEDNOW LLC INDIANAPOLIS, IN 5817153A 7,136 1/29/2021 7208 1.00 LANSING SENIOR PARTNERS LLC INDIANAPOLIS, IN 6099297A 32,521 1/15/2021 8833 MARIO AND SONS LLC INDIANAPOLIS, IN 6121659A 800 2/19/2021 5551 SBS ENVIRONMENTAL LLC INDIANAPOLIS, IN 4650646A 750 3/27/2021 5183 AAKY INC INKSTER 6110509A 981 3/27/2021 8017 B E S T OF INKSTER LLC INKSTER 6135218A 2,939 3/13/2021 7208 BRANTLEY DEVELOPMENT LLC INKSTER 4545451A 5,718 3/21/2021 0042 0.91 GRACIE SEE PASTA RIA LLC INKSTER 4424417A 3,136 2/17/2021 9058 0.95 STEF CONSTRUCTION INC INKSTER 5961599A 750 1/30/2021 5437 TOP FLIGHT ENTERTAINMENT LTD INKSTER 3099202A 4,268 1/1/2021 9058 0.87 JRN DESIGN ASSOCIATES LLC INTERLOCHEN 6072119A 825 1/1/2021 5645 STACHNIK LOGGING & SNOWBLOWING LLC INTERLOCHEN 3594114A 750 2/2/2021 2702 AP LAWNCARE LLC IONIA 5600758A 523 3/6/2021 9102 0.95 IONIA TRUCK & EQUIPMENT REFURBISH LLC IONIA 5962234A 451 2/7/2021 9501 JUST LIKE HOME ADULT CENTER LLC IONIA 5975611A 315 3/13/2021 9063 LIVING FOODS INC IONIA 0286729A 3,876 1/30/2021 0035 1.00 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 72 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GERAMI BUILDERS LLC IRA 3276147A 750 2/1/2021 5645 ST CLAIR MARINE SERVICES LLC IRA 5551170A 750 3/31/2021 3724 BILL NEUENS ENTERPRISES INC IRON MOUNTAIN 4024761A 8,951 2/1/2021 8748 0.91 KEN VARDIAN TRUCKING INC IRON MOUNTAIN 4415493A 750 1/3/2021 7208 KIWANIS SKI CLUB INC IRON MOUNTAIN 5663822A 580 1/21/2021 9015 M CARLSON TRUCKING INC IRON MOUNTAIN 4428307A 751 3/21/2021 7208 MARKS SERVICES IRON MOUNTAIN 2405296A 750 3/18/2021 5476 0.95 MILLER PRODUCTS & SUPPLY COMPANY INC IRON MOUNTAIN 0397822A 20,817 1/16/2021 8232 2.09 13 % PINE CREEK LOGGING IRON MOUNTAIN 5245133A 750 3/1/2021 2702 SMEESTER BRANDON IRON MOUNTAIN 5761891A 750 2/11/2021 7208 ASIL MANAGMENT SERVICES INC IRON RIVER 5966434A 5,917 2/9/2021 9015 BONIFAS CUSTOM HAULING LLC IRON RIVER 4608755A 750 3/30/2021 7208 0.94 BUSH CREEK LLC IRON RIVER 6101968A 750 1/18/2021 2702 DMW SERVICES LLC IRON RIVER 5381738A 750 2/14/2021 7208 G AND G SERVICE CENTER INC IRON RIVER 5818729A 739 1/31/2021 6217 IRON RIVER COOPERATIVE TV ANTENNA IRON RIVER 0280747A 2,930 3/8/2021 7600 0.95 MARLOWE GAS CO INC IRON RIVER 1792768A 3,386 1/31/2021 7380 0.95 NICHOLS LOGGING LLC IRON RIVER 3113515A 750 3/12/2021 2702 R AND D LOGGING LLC IRON RIVER 0159298A 750 2/18/2021 2702 R R SHAMION TRUCKING INC IRON RIVER 3298183A 750 3/18/2021 2702 STEBBINS LOGGING IRON RIVER 1924885A 750 1/13/2021 2702 ENCHANTED ACRES CAMPGROUND IRONS 2914182A 751 2/8/2021 9015 JER W LAWN CARE LLC IRONS 5659140A 720 1/13/2021 9402 COPPER PEAK INC IRONWOOD 1068822A 2,499 1/22/2021 9015 0.95 GOGEBIC RANGE HEALTH FOUNDATION IRONWOOD 5688396A 310 3/8/2021 8810 HELP ORPHANED PETS EVERYWHERE IRONWOOD 3446735A 954 1/30/2021 8831 0.95 NEW BEGINNINGS PREGNANCY SUPPORT IRONWOOD 4178548A 279 2/9/2021 8832 SERVICES INC SSK TRUCKING INC IRONWOOD 0906476A 750 3/18/2021 7208 SUMMIT LOGGING LLC IRONWOOD 5415306A 750 2/14/2021 2709 PARLAKE LLC IRVING, TX 5963826A 3,713 2/5/2021 9102 CAPITAL HEALTHCARE SOLUTIONS IRWIN, PA 5653177A 413 1/10/2021 8833 MASHPOINT LLC ISELIN, NJ 5383560A 635 1/16/2021 8868 CONCEPTS CONSULTING INC ISHPEMING 0869058A 247 3/25/2021 8810 CROSCHERES CONSTRUCTION ISHPEMING 5950554A 825 1/8/2021 5403

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HARJU LOGGING INC ISHPEMING 1965085A 3,740 2/10/2021 2709 0.95 B AND W SAND N STONE LLC ITHACA 4524110A 1,089 3/22/2021 4000 0.95 SHAWS AUTO BODY LLC ITHACA 4716671A 1,659 3/1/2021 8393 0.95 SHERMAN BUILDERS ITHACA 3833321A 2,429 2/21/2021 5437 0.95 ALLANS CRANE RENTAL INC JACKSON 4731379A 582 3/21/2021 3724 ANGEL OF MINE HOME CARE LLC JACKSON 5697298A 4,374 3/28/2021 8835 0.95 ARGYLE PLASTIC & RECONSTRUCTIVE SURGERY JACKSON 1689398A 846 3/28/2021 8832 PC BILLY WHITE ROOFING LLC JACKSON 4272129A 32,285 3/1/2021 5551 0.88 COLONIAL 365 INC JACKSON 0139726A 12,685 2/1/2021 7212 0.80 D AND L EQUIPMENT INC JACKSON 1846450A 6,802 2/5/2021 8107 0.88 FLOURISH CENTER FOR CULTIVATING HUMAN JACKSON 5405831A 231 1/30/2021 8832 POTENTIAL LLC GANAWAY CONSTRUCTION LLC JACKSON 4616642A 825 2/18/2021 5551 GORCZYCA CONSTRUCTION JACKSON 0664766A 750 2/5/2021 5183 HILTS SERVICES LLC JACKSON 5640083A 217 1/1/2021 8810 HOLIDAYS ADULT CARE AT HOME JACKSON 5968259A 2,502 2/23/2021 8835 IRON CLAD CONSTRUCTION LLC JACKSON 5994624B 14,282 1/1/2021 5403 J WROZEK ROOFING AND HOME IMPROVEMENTS JACKSON 4970160A 2,753 3/13/2021 5403 0.95 JACKSON AUTO SALVAGE INC JACKSON 0093564A 1,357 3/22/2021 3821 0.95 JOHNNYS TREE SERVICE INC JACKSON 0323128A 4,531 3/23/2021 0042 0.93 MASTERS THOMAS J JACKSON 5250706A 215 3/15/2021 8810 MULLINS ROOFING LLC JACKSON 4439759A 768 3/20/2021 9015 0.95 NEBELUNG LD JACKSON 6123775A 825 2/21/2021 5645 NORTH STAR LAWNCARE LLC JACKSON 5114772A 784 3/26/2021 0042 OLD SCHOOL FITNESS LLC JACKSON 5231060A 301 1/23/2021 9063 PAGE ELECTRIC SERVICE LLC JACKSON 4853270A 1,856 1/21/2021 5190 0.95 PARTICULAR COUNCIL OF JACKSON SOCIETY OF JACKSON 1393847A 5,133 1/1/2021 8008 0.92 ST VINCENT DE PAUL PROFESSIONAL TREE CARE LLC JACKSON 5243041A 15,382 2/25/2021 0106 0.80 SAYRE BUILDERS INC JACKSON 3011054A 18,303 1/23/2021 5403 SEAL JEREMY JACKSON 6103103A 750 1/21/2021 5645 STAR TRANSMISSION JACKSON 2826984A 757 1/8/2021 8395 SYDS AUSSIE STAR GYMNASTICS CLUB LLC JACKSON 3870014A 328 1/3/2021 9063 TOKARSKI EDWARD JACKSON 5971861A 750 3/1/2021 5551 UTILITY WORKERS UNION AMERICA AFL CIO 101 JACKSON 0994936A 250 2/12/2021 8755 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 74 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WILLIAMS ELECTRICAL SERVICES INC JACKSON 5951461A 1,398 1/11/2021 5190 X ADLER INC JACKSON 0123625A 807 2/28/2021 9058 X CELL TRUCK ENTERPRISES INC JACKSON 4064879A 750 3/26/2021 7208 AARON JARRETT LLC JENISON 5434572A 3,840 3/5/2021 5551 0.95 ANDY QUIST BUILDERS JENISON 5803217A 750 1/1/2021 5645 APEX CUSTOM INTERIORS LLC JENISON 4410700A 750 1/22/2021 5476 0.95 BELD BUILDERS INC JENISON 2281465A 750 3/6/2021 5437 BOLHOUSE LLC JENISON 5499186A 759 1/7/2021 8810 BRENT DEYOUNG BUILDER INC JENISON 2805782A 750 3/2/2021 5437 BUILDING CONTRACTOR SERVICES LLC JENISON 5646421A 750 1/7/2021 5445 BYKER BARRY JENISON 1996665A 750 1/13/2021 5645 CINDYS HAIR CARE LLC JENISON 1772309A 710 1/1/2021 9586 0.95 DUTCH PAINTERS THE JENISON 5949190A 750 1/3/2021 5476 ERIC HOOGEWIND BUILDER LLC JENISON 5365627A 750 1/27/2021 5645 EXECUTIVE PAINTING INC JENISON 2792133A 750 1/14/2021 5476 GLS CUSTOM HOMES INC JENISON 3422500A 338 1/1/2021 5606 0.95 GREAT LAKES FINISHERS LLC JENISON 5965977A 750 2/8/2021 5445 HUIZENGA HEATING & COOLING LLC JENISON 6118887A 724 2/14/2021 5550 KEYSTONE CONSTRUCTION & CONSULTING LLC JENISON 6094970A 825 1/9/2021 5020 PINE RIDGE TRANSPORT INC JENISON 5653916A 800 1/1/2021 7208 0.95 PRINS HERMAN L JENISON 1545086A 750 2/22/2021 5645 RIVERBEND TRUCKING LLC JENISON 5834694A 750 3/3/2021 7208 WESCO RACING ENGINES LLC JENISON 5666945A 975 1/27/2021 3827 ELDERLY SOLUTIONS INC JEROME 3808416A 5,278 3/20/2021 9053 0.93 GREEN ENERGY LP LLC JEROME 5314771A 2,552 1/28/2021 8810 0.95 RIGHT CHOICE CONTRACTORS JEROME 5971896A 825 3/1/2021 5645 HOY PRODUCTION LLC JOHANNESBURG 5942047A 945 2/26/2021 1320 OTSEGO OUTDOOR MAINTENANCE LLC JOHANNESBURG 2683695A 1,078 1/6/2021 0042 HRE REHAB & REMODEL LLC JOLIET, IL 5806011A 3,566 3/2/2021 5645 WEST MICHIGAN EARTHWORKS LLC JONES 5812224A 789 1/19/2021 6217 ACME TREE SERVICE LLC KALAMAZOO 0255548A 750 1/1/2021 0106 ADHESIVE TEMPLATES INC KALAMAZOO 6101828A 2,170 1/31/2021 9501 ALFREDOS SERVICE KALAMAZOO 5836670A 800 3/8/2021 5551 BARK PARK DOG PARK LLC KALAMAZOO 4810430A 434 2/10/2021 8831 BIRCH SALON & COMPANY LLC KALAMAZOO 5976529A 534 3/18/2021 9586 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 75 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BOYS TO MEN GROUP HOME LLC KALAMAZOO 5321603A 2,684 3/5/2021 9052 0.95 BUILDING BLOCKS OF KALAMAZOO KALAMAZOO 3925013A 1,390 3/29/2021 8601 0.95 CHAPIN SERVICES LLC KALAMAZOO 5969034A 1,142 2/21/2021 0106 CLOCK N LOCK ESCAPE ROOMS LLC KALAMAZOO 5817790A 903 1/30/2021 8017 COLLEAGUES INTERNATIONAL KALAMAZOO 3099385A 292 1/6/2021 8810 COOPER MARKET LLC KALAMAZOO 4564324A 660 1/8/2021 8006 1.00 CROOKSTON ENDLESS EAVESTROUGH KALAMAZOO 1721275A 706 3/12/2021 5538 CUSTOM WIRTH LLC KALAMAZOO 5545200A 511 1/30/2021 5191 D AND C HOME IMPROVEMENT INC KALAMAZOO 4066065A 800 1/1/2021 5645 DEGROOT COLLISION CENTER INC KALAMAZOO 0169889A 12,648 3/10/2021 8393 1.43 40 % EARTH RESOURCES INTERNATIONAL LLC KALAMAZOO 2655527A 263 1/26/2021 4511 EMPIRE CONSTRUCTION ENTERPRISES LLC KALAMAZOO 5519837A 750 2/23/2021 5645 ENGBERS MASONRY KALAMAZOO 1973436A 1,513 2/14/2021 5022 0.95 FARRER CONTRACTING SERVICES LLC KALAMAZOO 3086801A 1,106 1/25/2021 5550 FINELINE STUDIOS LLC KALAMAZOO 5515890A 2,134 3/1/2021 9586 0.95 FNS EXTERIORS LLC KALAMAZOO 5680387A 800 3/8/2021 5645 0.91 GARCIA RAFAEL CONCHA KALAMAZOO 6127770A 750 2/28/2021 5645 GMS USA LLC KALAMAZOO 5138230A 2,953 3/12/2021 9060 0.95 HOUSE OF MEMORIES LLC KALAMAZOO 4975120A 508 3/30/2021 8017 JABLONSKI JOEL KALAMAZOO 5947316A 260 1/1/2021 7610 KALAMAZOO CONTRACTORS INC KALAMAZOO 2572273A 825 2/12/2021 5183 KALAMAZOO COUNTY CONSOLIDATED DISPATCH KALAMAZOO 5521297A 1,010 2/27/2021 8810 AUTHORITY KALAMAZOO CUSTOM HOME PAINTING LLC KALAMAZOO 5973155A 750 3/6/2021 5476 KAUFMAN ELLEN KALAMAZOO 5971691A 530 3/1/2021 0913 KAZOO CHIMNEY & HOME SERVICES LLC KALAMAZOO 6115942A 1,578 2/11/2021 9015 KOZAR CONSTRUCTION INC KALAMAZOO 2663414A 750 3/14/2021 5645 0.95 KUSTER BUILDING AND DESIGN LLC KALAMAZOO 5413150A 2,290 1/21/2021 5645 0.95 LAKE VILLA WEST ASSOCIATION KALAMAZOO 6091032A 568 1/3/2021 9015 LAM CREATIVE LLC KALAMAZOO 2545063A 815 1/1/2021 9063 0.95 LITTLE STEPS LLC KALAMAZOO 4421337A 1,484 2/12/2021 8869 1.00 LUKES TRUCK SERVICE INC KALAMAZOO 0049590A 3,071 3/1/2021 8395 0.95 M AND A MACHINING INC KALAMAZOO 0602000A 945 1/1/2021 3632 0.95 MERCY HOMES ASSISTED LIVING LLC KALAMAZOO 5964873A 1,313 2/6/2021 9053 MICHIGAN CABLE SERVICES KALAMAZOO 1150790A 750 3/21/2021 6325

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MRR ROOFING & EXTERIORS LLC KALAMAZOO 5296129A 750 3/30/2021 5551 NEXT STAGE LABS LLC KALAMAZOO 6107664A 269 1/27/2021 4511 NORTHERNMEN MECHANICAL LLC KALAMAZOO 5976855A 724 3/19/2021 5550 OHARE HELENA KALAMAZOO 6099190A 568 1/15/2021 9015 PEST PROS OF MICHIGAN LLC KALAMAZOO 5643376A 3,716 3/1/2021 9015 0.95 PRECIOUS CARE ASSISTED LIVING LLC KALAMAZOO 6118305A 958 2/13/2021 9053 RECOVERY SERVICES UNLIMITED INC KALAMAZOO 5673348A 471 2/15/2021 8835 ROBERTS STEEL ERECTION INC KALAMAZOO 2810565A 7,715 2/1/2021 3040 1.00 SECURITY PLUS LLC KALAMAZOO 5539358A 1,780 2/7/2021 7720 SINGLETON EXTERIORS KALAMAZOO 4885040A 800 3/19/2021 5551 0.99 STORE 159 86 KALAMAZOO 3891038A 393 1/1/2021 8017 0.95 TENRIDGE BOOKKEEPING INC KALAMAZOO 5506190A 231 1/15/2021 8810 TODD TOPHAM LLC KALAMAZOO 4110439A 1,307 2/1/2021 8831 TOLSONS TOTAL ENVIRONMENTAL LLC KALAMAZOO 5743788A 3,124 3/26/2021 5020 TREE MOVER LLC KALAMAZOO 2425211A 1,444 2/20/2021 0042 WIESSNER GROUP LLC KALAMAZOO 4303512A 800 3/28/2021 5645 CROSBY ROBERT KALKASKA 3579107A 555 1/23/2021 0128 MS PATTIS DAYCARE LLC KALKASKA 4435699A 344 1/25/2021 8869 ODONNELL BRYAN KALKASKA 5903521A 568 2/8/2021 9015 RICHARD ALLEN INC KALKASKA 3880931A 850 3/15/2021 5040 RUSSELL SIDING KALKASKA 1775537A 750 2/18/2021 5403 SUPERIOR OILFIELD SERVICES INC KALKASKA 2325411A 2,875 3/14/2021 5606 0.95 TIMBERLIES SALON STUDIO KALKASKA 6104150A 361 1/22/2021 9586 MILLENNIUM TECHNICAL SERVICE INC KANKAKEE, IL 2810514A 1,285 2/17/2021 5190 CAROL ANNS DANCE STUDIO LLC KAWKAWLIN 2194856A 300 2/23/2021 8008 WOLVERINE FIREWORKS DISPLAY CO INC KAWKAWLIN 2402220A 12,236 1/2/2021 9015 0.82 BLOOMFIELD ON SQUARE LAKE CONDOMINIUM KEEGO HARBOR 2630168A 569 1/5/2021 9015 ASSOCIATION MIDWEST COMPUTER SERVICES INC KEEGO HARBOR 0129500A 1,062 2/18/2021 5191 SANDEL ROOFING LLC KEEGO HARBOR 5976600A 800 3/16/2021 5551 SELECT MEDICAL INC KEEGO HARBOR 3680290A 576 1/29/2021 8868 VILLAS AT BEACON HILL ASSOCIATION KEEGO HARBOR 4446925A 568 2/23/2021 9015 JLA INSULATION AND FABRICATION INC KENOCKEE 5407915A 1,545 3/18/2021 5479 0.95 BARBER CREEK BUILDERS & REMODELERS LLC KENT CITY 6104118A 5,506 1/22/2021 5437 REISTERS GROWER SERVICES LLC KENT CITY 2082985A 3,558 3/18/2021 8292 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 77 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge S AND H FLOOR INSTALLATION INC KENT CITY 4485971A 750 1/10/2021 9521 ABSOLUTE MEDICAL WASTE LLC KENTWOOD 5967783A 800 2/15/2021 7202 ANAYAS DRYWALL KENTWOOD 5824699A 1,253 2/11/2021 5445 0.95 CDA SERVICES LLC KENTWOOD 5671558A 3,099 3/22/2021 7219 0.95 CICHOS JOSEPH KENTWOOD 5966442A 540 2/9/2021 9521 CINDYS DONUTS & ICE CREAM KENTWOOD 5845360A 684 3/23/2021 9058 COMMUNITY SPAY NEUTER INITIATIVE KENTWOOD 3457800A 9,455 2/7/2021 8831 1.35 27 % PARTNERSHIP CREATIVE BRICKSCAPES INC KENTWOOD 2713292A 750 1/24/2021 5221 GREAT LAKES SATELLITE & WIRING LLC KENTWOOD 5373182A 1,344 2/16/2021 3724 0.95 GREEN SHIELD HOME LLC KENTWOOD 6134734A 7,587 3/12/2021 5645 JAYS DRYWALL LLC KENTWOOD 6104355A 3,736 1/22/2021 5445 OTTERBACHER JEFFREY LEE KENTWOOD 2496763A 1,479 1/1/2021 5348 1.00 SG CONSTRUCTION LLC KENTWOOD 5810078A 800 3/13/2021 5445 STEVEN E BRATSCHIE & ASSOCIATES PC KENTWOOD 2835550B 506 3/31/2021 8820 0.80 TRADITIONAL ELECTRIC INC KENTWOOD 2896400A 520 3/28/2021 5190 BLUE WATER SPORTSMANS ASSOCIATION KIMBALL 0723398A 601 1/4/2021 9015 EDWARD J INDUSTRIAL SERVICES INC KIMBALL 5806623A 5,741 1/15/2021 7704 0.95 OMH COMMUNICATIONS LLC KIMBALL 6139086A 4,520 3/26/2021 7600 VESTED RENOVATIONS LLC KIMBALL 4659805A 13,284 2/15/2021 5645 EUP WOOD SHAVINGS INC KINCHELOE 1751395A 1,794 1/3/2021 4207 1.00 GLR LAPONSIE LOGGING KINCHELOE 6118941A 750 2/19/2021 2702 AERIAL DYNAMICS CORPORATION KINGSBURY, IN 2190494B 643 1/16/2021 9015 0.95 ANOTHER ADVENTURE CLEANING KINGSFORD 5973376A 568 3/15/2021 9015 DICKINSON CONSERVATION DISTRICT KINGSFORD 0831921A 1,082 1/1/2021 8601 OKLER CONSTRUCTION & SERVICES INC KINGSFORD 4218957A 7,213 1/16/2021 8227 0.90 T AND C TRANSPORT INC KINGSFORD 4036158A 800 2/22/2021 7208 R CUBED LLC KINGSLEY 5097002A 238 1/10/2021 8601 0.92 UNCUT MOUNTAIN SUPPLY KINGSLEY 5953677A 1,720 3/1/2021 2841 CCM HOSPITALITY INC KINGSTON 5106443A 547 2/15/2021 9058 0.95 PRIME FINISHED DRYWALL INC KINGSTON 3676021A 750 3/23/2021 5445 OTTER CREEK LEASING LLC LA SALLE 6100228A 3,852 1/16/2021 7208 CANNABAR LLC LAFAYETTE, CO 6108032A 1,202 3/20/2021 8045 DAN AUSTIN CONSTRUCTION LAINGSBURG 2624788A 750 1/19/2021 5645 0.95 INTERNATIONAL CEILINGS INC LAINGSBURG 2018314A 825 2/6/2021 5020

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 78 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WILDCATS CHEER PRIDE LLC LAINGSBURG 6125573A 752 2/25/2021 9063 BILL BOWDEN LLC LAKE ANN 5835801A 800 3/7/2021 5645 CULLENS CARE LLC LAKE ANN 6128742A 593 3/1/2021 9053 NORTHERN DEN REALTY LLC LAKE ANN 5970717A 233 2/27/2021 8810 BOB ROOT MASON CONTRACTOR LAKE CITY 2118041A 751 3/27/2021 5221 DAP PAINTING LAKE CITY 1748947A 750 2/27/2021 5476 0.95 HILL LOUIS LAKE CITY 5969425A 750 2/22/2021 2702 J AND S LOGGING LAKE CITY 3860914A 750 2/5/2021 2702 PARK ORLO LAKE CITY 2008394A 750 1/30/2021 2702 RENDON BRUCE LAKE CITY 1766651A 238 2/1/2021 8601 BUCHANAN BUILDERS OF CENTRAL MICHIGAN LAKE ISABELLA 3744884A 2,618 3/2/2021 5437 LLC SLANEC HEATING & COOLING INC LAKE LEELANAU 4689704A 750 1/12/2021 5645 DOUBLE L TRANSPORT LLC LAKE LINDEN 1910809A 750 2/20/2021 7208 HODGES FLOOR COVERINGS AND INSTALLATION LAKE LINDEN 5357764A 1,182 1/8/2021 9521 0.95 INC JR FOREST PRODUCTS INC LAKE LINDEN 2434628A 750 1/16/2021 7208 CUNNINGHAM LLOYD J LAKE ODESSA 5537843A 556 3/29/2021 0128 LAKE ODESSA LIVESTOCK AUCTION INC LAKE ODESSA 0216798A 5,436 3/28/2021 0129 1.00 BHI CONTRACTING INC LAKE ORION 1911279A 814 3/9/2021 6217 0.95 D AND S MASONRY INC LAKE ORION 3988457A 800 1/8/2021 5022 0.96 DUNNS WILDLIFE CONTROL LLC LAKE ORION 3169413A 1,724 2/15/2021 8831 0.95 FORTIFIED CONSTRUCTION LLC LAKE ORION 5956102A 1,815 1/22/2021 5645 GABBARD AARON LAKE ORION 5954410A 750 3/6/2021 5437 HABEL MASONRY LLC LAKE ORION 6101887A 750 1/18/2021 5022 HIGHLAND HORTICULTURAL SERVICES INC LAKE ORION 3834794A 709 3/30/2021 0042 INFONORM INC LAKE ORION 4787781A 1,896 3/23/2021 8017 0.95 MERKLE HOME IMPROVEMENTS LLC LAKE ORION 2860279A 750 3/22/2021 5551 0.95 MICHIGAN GREENSKEEPER INC LAKE ORION 3337014A 4,370 2/15/2021 9102 0.95 MJB ROOFING INC LAKE ORION 3286231A 750 1/19/2021 5551 0.95 OAKLAND ARBOR CARE INC LAKE ORION 5123275A 7,296 1/31/2021 0042 0.90 OAKLAND CLEANING SERVICES INC LAKE ORION 2904756A 742 2/8/2021 9015 ORION WATERPROOFING INC LAKE ORION 2685736A 824 3/15/2021 8810 1.00 OUTDOOR ESCORTS LLC LAKE ORION 5843952A 493 3/20/2021 6836 REHABILITATION AND COMMUNITY INTEGRATION LAKE ORION 5091497A 784 2/14/2021 8835 PLLC 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 79 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ROCK HARD EXTERIORS LLC LAKE ORION 3816273A 750 2/15/2021 5022 RWC MANAGEMENT SERVICES LLC LAKE ORION 4975332A 619 2/20/2021 9015 0.95 S AND S ROBOTICS LLC LAKE ORION 5386438A 351 3/14/2021 5191 TIMBER BEAST LLC LAKE ORION 5824001A 10,584 2/13/2021 0106 0.95 TWENTY FOUR SEVEN TREE SERVICES LLC LAKE ORION 5246679A 1,484 3/7/2021 0106 0.95 W M SULLIVAN LLC LAKE ORION 6107273A 830 2/1/2021 5606 WATERBED MART EAST INC LAKE ORION 2409682A 293 1/1/2021 8810 SAMS CLEANING CORP LAKELAND 3355730A 1,026 1/12/2021 9015 0.95 WHITE BUFFALO INC LAKELAND, TN 5803144A 257 1/1/2021 8601 AMBLE ELECTRIC LLC LAKEVIEW 5838665A 6,543 3/13/2021 5190 0.95 BOON JOHN LAKEVIEW 5128900A 998 3/20/2021 2702 0.95 HUCKLEBERRY ROBERT LAKEVIEW 6136389A 800 3/17/2021 5551 INDUSTRIAL MACHINERY NJ LLC LAKEWOOD, NJ 5233631A 1,698 2/8/2021 8107 0.95 AFFORDABLE CONSTRUCTION COMPANY INC LAMBERTVILLE 2117630A 802 1/4/2021 8810 BEDFORD BEHAVIORAL HEALTH PLLC LAMBERTVILLE 5677807A 278 2/18/2021 8832 ENLIGHTEN FAMILY CHIROPRACTIC LLC LAMBERTVILLE 5674956A 406 2/14/2021 8832 INDIAN CREEK INVESTMENTS III LLC LAMBERTVILLE 5056020A 1,161 1/1/2021 8831 1.05 QUALITY HOME CARE LLC LAMBERTVILLE 4477316A 4,872 3/1/2021 8835 0.89 WOODSON EXTERIOR REMODELING LAMBERTVILLE 2884810A 9,965 3/8/2021 5551 0.87 NEWMAN DAVID LANSE 5903025A 750 3/24/2021 2702 ABSOLUTE ENVIRONMENTAL SOLUTIONS LLC LANSING 6133894A 3,044 3/10/2021 5550 ACKERMANN LANDSCAPING INC LANSING 4121520A 523 2/18/2021 9102 AVERAGE JOES GLOBAL SPORTS NETWORK LLC LANSING 2640767A 3,001 2/11/2021 5645 B AND B CONSTRUCTION CONCEPTS LLC LANSING 6136435A 750 3/20/2021 5645 BRAD GILREATH LLC LANSING 5966795A 238 2/12/2021 8601 BRUEGGEMAN MICHAEL J LANSING 3298124A 633 1/28/2021 9015 BRUNETTE ROOFING & SIDING INC LANSING 2293900A 7,163 2/1/2021 8227 0.94 C AND M CUSTOM CARPENTRY LLC LANSING 5923514A 2,102 2/1/2021 5437 C AND S LOGGING LLC LANSING 6128890A 750 3/2/2021 2702 CAMPUS CARS INC LANSING 4062337A 344 2/1/2021 8748 CAPITAL CITY REPROGRAPHICS INC LANSING 3865240A 710 1/5/2021 8015 CHESNEY PAINTING LANSING 5763169A 750 1/24/2021 5476 DLB LLC LANSING 0246476A 278 2/27/2021 8810 DREW LOGGING LANSING 5433959A 750 1/26/2021 2702 EM DESIGNS LLC LANSING 5366852A 750 3/1/2021 5645 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 80 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge EXPERIENCED EXTERIORS LLC LANSING 6137091A 6,104 3/19/2021 5645 GEEKED OUT NANNY AGENCY LANSING 6114385A 269 2/7/2021 8869 GOOD SERVICE LLC LANSING 5979064A 750 3/23/2021 5550 INDUSTRIAL FLEET SERVICE INC LANSING 0295434A 936 1/17/2021 8107 ISAIAS ROOFING & SIDING LLC LANSING 5367646A 1,688 2/1/2021 5551 0.95 JALAPENOS MEXICAN RESTAURANTE INC LANSING 2487250A 1,620 2/22/2021 9058 0.95 JUST RIGHT PAINTERS LANSING 5958784A 801 1/24/2021 5476 KIDTIME CHILD DEVELOPMENT CENTER INC LANSING 2798360A 779 1/24/2021 8869 KLEEN TEAM INC LANSING 5899117A 569 3/5/2021 9015 LAFEVE DRYWALL LLC LANSING 3737810A 2,406 1/28/2021 5445 0.95 LOCAL 47 J A T C LANSING 3730590A 1,127 1/4/2021 9015 MENDEZ DRYWALL & ALL LLC LANSING 6132120A 750 3/6/2021 5445 MIPERC LANSING 4802900A 1,226 3/10/2021 8868 NEW WAVE HOME CARE LLC LANSING 6101275A 851 1/28/2021 8835 NEXT LEVEL INDUSTRIES INC LANSING 6045332A 343 2/1/2021 8601 NOW AND ZEN PRO CLEANERS LLC LANSING 5816815A 619 1/27/2021 9015 ONE LOVE GLOBAL INC LANSING 5681979A 608 2/7/2021 8742 OWEN DRYWALL LANSING 3783243A 7,543 3/31/2021 5445 0.91 PASCHAL SECURITY SYSTEMS LLC LANSING 4670639A 842 3/21/2021 7720 PRO ADVANTAGE LAWN CARE LLC LANSING 5671698A 524 2/8/2021 9102 0.95 PROPERTY PRESERVATION SOLUTIONS LLC LANSING 5228891A 338 1/18/2021 5606 RACHELS ADULT FOSTER CARE LANSING 6128939A 521 3/1/2021 8835 RAGLANDS TRUCKING LLC LANSING 5496640A 1,375 3/1/2021 7208 0.95 REESE FARMS LANSING 1387413A 1,142 1/22/2021 0011 0.95 ROGER D CLINARD BUILDER INC LANSING 3286401A 1,572 3/9/2021 5476 S SULSKI CONSTRUCTION INC LANSING 1072722A 789 3/12/2021 6217 SAJ EXTERIORS LLC LANSING 6136230A 8,154 3/17/2021 5645 SHOTWELL RUTTER BAER INC LANSING 6100244A 484 1/16/2021 8810 SJSII LLC LANSING 6114415A 7,060 2/7/2021 0035 SUPREME HOME IMPROVEMENTS LLC LANSING 6100589A 1,656 2/26/2021 5476 T C INVENTIONS LLC LANSING 4580974A 644 1/21/2021 9015 TABOA CONSTRUCTION LANSING 6096786A 1,926 1/11/2021 5645 TAK EXPRESS INC LANSING 4503503A 17,129 1/31/2021 7202 THREE THOUSAND 200 NORTH LLC LANSING 6117414A 2,335 2/12/2021 8045 TODD AND ASSOCIATES INC LANSING 3728285A 283 1/17/2021 8810 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 81 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TOPDUCK PRODUCTS LLC LANSING 5184134A 397 3/28/2021 4712 0.95 UNITED AUTO SALES LLC LANSING 5667623A 309 1/3/2021 8748 VOORWINDEN GREENHOUSE BUILDING LTD LANSING 5362768A 3,624 1/17/2021 5538 0.95 WALKER TRANSPORT INC LANSING 2928132A 750 1/1/2021 7208 WILKINSON BUILDERS INC LANSING 3032620A 860 2/7/2021 5645 ADD CONCRETE LLC LAPEER 5375240A 825 3/3/2021 5221 ARCHER MICHAELS HARDWOOD FLOORING LLC LAPEER 1659146A 750 3/1/2021 5437 BACKPACK TRUCKING LLC LAPEER 5539390A 800 3/31/2021 7208 BRADSHAW DANA LAPEER 4016700A 750 3/23/2021 5645 CARROW DUSTIN LAPEER 6112056A 750 1/31/2021 5645 CB MASONRY & CONSTRUCTION INC LAPEER 5821126A 751 3/6/2021 5022 COLLINS HEAVY HAUL LLC LAPEER 3968278A 14,203 3/12/2021 7208 0.80 CONTOUR MOLD CORPORATION LAPEER 5846986A 4,835 3/27/2021 4484 0.95 COOPER AND SON PLUMBING LAPEER 3180336A 880 2/1/2021 5183 EIGHTY TWENTY CLUB LLC LAPEER 6088554A 736 1/11/2021 9063 EXPERIENCED FLOORING INC LAPEER 4599063A 750 3/13/2021 5348 FINISH LINE AUTO SALES INC LAPEER 3916499A 1,100 1/1/2021 8395 HAVE TRACTOR WILL TRAVEL INC LAPEER 5028108A 750 2/7/2021 5606 0.95 JAMS MEDIA LLC LAPEER 3837947A 229 1/27/2021 8742 JEFF SMITH CUSTOM TILE & MARBLE LAPEER 5045479A 750 3/6/2021 5348 KEN ROBINSON CONSTRUCTION LAPEER 2531887A 16,340 1/6/2021 5645 0.81 LAPEER COUNTY K I N D KIDS IN NEW DIRECTION LAPEER 3287947A 541 2/25/2021 8832 LEES SPRAY FOAM LLC LAPEER 6135234A 2,384 3/13/2021 5479 LOCAL MOVES LLC LAPEER 5943027A 750 1/1/2021 7214 MAIN STREET IMPROVEMENTS LLC LAPEER 5508088A 3,090 1/21/2021 5437 0.95 MAPLE VALLEY HARDWOODS LLC LAPEER 3490572A 825 1/26/2021 5437 MATTHEW EDWARDS CONSTRUCTION LAPEER 6095372A 750 1/10/2021 5437 POLLUMS NATURAL RESOURCES LLC LAPEER 5088496A 2,413 2/8/2021 8232 0.95 RELIABLE DOORS INC LAPEER 2439409A 581 3/27/2021 3724 RICHARD VOSS CUSTOM BUILDER INC LAPEER 4303695A 750 2/2/2021 5645 SAWYER BUILDERS INC LAPEER 5511801A 750 1/29/2021 5645 SNOBLEN CONSTRUCTION LAPEER 2593700A 825 1/25/2021 5645 0.95 STACER ROBOTICS LLC LAPEER 5253110A 317 3/22/2021 8810 SUNNYSIDE EXTERIORS LAPEER 5519209A 750 2/23/2021 5645 MIAND INC LAPORTE, IN 2202573A 1,828 2/4/2021 9015 0.95 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 82 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TREE MANN INC LAPORTE, IN 1041304A 4,028 2/20/2021 0106 0.95 ABS CONSTRUCTION LASALLE 5950333A 750 1/5/2021 5645 PATRIOT TOWING CO LAURIUM 5937345A 4,949 1/7/2021 7208 TAZ TRANSPORTATION LLC LAWRENCE 6131921A 800 3/6/2021 7208 IN HIS HANDS PREEMIES LLC LAWTON 5941644A 299 1/16/2021 8810 MCALLISTER TRUCKING LLC LAWTON 5975816A 750 3/14/2021 7208 VERLEGER BUILDER LAWTON 1111205A 750 1/1/2021 5183 0.95 FISHTOWN PRESERVATION SOCIETY INC LELAND 4335309A 694 3/1/2021 8810 LASARGE LAKE & HOME LLC LELAND 5652561A 6,360 1/1/2021 9102 0.89 HAWKINS CONSTRUCTION LLC LENNON 0119903A 3,027 1/8/2021 5645 0.95 INVISALINK WIRELESS ENTERPRISES LLC LENNON 4048148A 2,123 2/11/2021 5191 1.00 MORNING STAR GRAIN LLC LENNON 3976858A 1,716 1/1/2021 8304 0.95 DESIGNED TO MOVE MI LLC LENOX 5964695A 751 2/6/2021 7214 SALT RIVER ELECTRIC INC LENOX 2386062A 470 2/7/2021 5190 STRAIGHTLINE CONTRACTING LLC LENOX 6095313A 1,754 1/29/2021 5476 JOHN FOGLER FARMS LLC LEONARD 5882737A 2,026 3/13/2021 7208 MASTERCRAFT AND ASSOCIATES LLC LEONARD 0384127A 1,173 3/17/2021 5476 NOVAKS YOUTH SPORTS LEAGUES LLC LEONARD 4966384A 305 3/7/2021 9063 R WHITE SERVICES INC LEONARD 1358995A 720 1/10/2021 9102 KANOUSE EXCAVATION LEROY 2451530A 739 3/4/2021 6217 JEFFERY HACKWORTH LOGGING INC LESLIE 3079228A 750 2/26/2021 2702 READMOND COLIN LEVERING 4967950A 750 3/5/2021 0042 STURGEON BAY WOODWORKS INC LEVERING 3442853A 1,945 1/1/2021 5645 0.95 REED KEN LEWISTON 5671493A 751 2/14/2021 5403 ALPINE LANDSCAPING LLC LEXINGTON 3706265A 717 2/25/2021 9102 0.95 BLUEWATER DRYWALL & CONSTRUCTION LLC LEXINGTON 4728750A 4,685 3/17/2021 5445 0.95 INTERDYNE CORPORATION LIMA, OH 4179684A 1,210 1/16/2021 9015 0.95 NORTHERN WOODS & LAND LLC LINCOLN 0096920A 724 1/30/2021 8232 A PLUS HOME SERVICES INC LINCOLN PARK 4215362A 800 3/29/2021 5645 AK RENOVATIONS LLC LINCOLN PARK 6121381A 5,810 2/18/2021 5645 CHEROKEE MACHINE SERVICE INC LINCOLN PARK 0630462A 1,309 2/13/2021 3724 0.97 CHUYS CONSTRUCTION LINCOLN PARK 5568870A 750 3/20/2021 5022 DIX AND GODDARD AUTO REPAIRS LLC LINCOLN PARK 5213720A 599 1/8/2021 8395 0.95 DIX AUTOMOTIVE RECYCLERS INC LINCOLN PARK 0512214A 680 1/14/2021 8748 DORTON KENNETH JR LINCOLN PARK 4069129A 750 1/30/2021 5645 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 83 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FELTNER JAMES OWEN JR LINCOLN PARK 5846536A 1,300 3/24/2021 5645 GONZALEZ CONSTRUCTION LLC LINCOLN PARK 6118283A 750 2/13/2021 5551 J R CONSTRUCTION SERVICES LLC LINCOLN PARK 5956323A 2,059 1/22/2021 5221 JOHNS LANDSCAPING LINCOLN PARK 5334896A 3,286 2/18/2021 0042 0.95 O P BROTHERS FLOORING LLC LINCOLN PARK 6128858A 2,852 2/28/2021 5348 OM CONSTRUCTION LLC LINCOLN PARK 6130518A 750 3/11/2021 5445 R W ALL AMERICAN HOME REPAIR LLC LINCOLN PARK 5462150A 7,515 3/3/2021 5645 0.95 TRENTON AUTO PARTS LINCOLN PARK 0084450A 645 1/30/2021 8010 CENTRIC PHYSICAL & OCCUPATIONAL THERAPY LINDEN 4418549A 279 3/30/2021 8832 SERVICES INC CONTRACTING MANAGEMENT CORP LINDEN 3332632A 689 2/20/2021 5610 DVM ENTERPRISE LINDEN 5286239A 750 3/20/2021 5437 INNOVATIVE RETIREMENT SOLUTIONS INC LINDEN 4256786A 502 3/13/2021 8742 J AND H DRYWALL LINDEN 5191513A 750 2/25/2021 5445 0.95 K D EDWARDS DO PLLC LINDEN 4022149A 240 1/27/2021 8868 LC CONTRACTING LLC LINDEN 5391164A 750 3/27/2021 5645 LINDEN SPORTSMEN CLUB INC LINDEN 3592049A 568 1/8/2021 9015 P AND P ENTERPRISES CO LLC LINWOOD 3153029A 3,927 1/24/2021 7208 0.95 LONG LAKE GROCERY COMPANY LLC LITCHFIELD 3332624A 1,485 2/13/2021 8017 0.95 STEVE EDWARDS TRUCKING INC LITTLE LAKE 0323756A 750 3/15/2021 7208 A AND M MOVING SERVICES LLC LIVONIA 6004610A 4,787 1/14/2021 8293 ABRAHAM DOUGLAS LIVONIA 2007509A 279 1/12/2021 8810 ACCURATE HOIST CO INC LIVONIA 4947037A 1,056 1/1/2021 3724 0.95 ADVANCE CLERICAL AND TECHNICAL LLC LIVONIA 0076791B 11,965 3/2/2021 3628 1.87 ADVANCE STAFFING CORPORATION LIVONIA 0076791A 98,316 1/1/2021 8018 1.87 ALEX BANKOWSKI SERVICES LIVONIA 2719371A 750 1/31/2021 5645 ALL RENOVATIONS COMPANY LLC LIVONIA 4966368A 2,579 2/23/2021 5403 0.95 AMERICAN CARPET CARE INC LIVONIA 4317327A 568 2/28/2021 9015 AMERICAN MADE TREE SERVICE INC LIVONIA 5951747A 6,857 1/11/2021 0042 ANDRE JELKS TRUCKING LLC LIVONIA 5836433A 750 3/9/2021 7208 0.95 ANTONIOS LEATHER EXPERTS LLC LIVONIA 5071410A 3,903 1/1/2021 2623 ARTISTIC STONE MASONRY LLC LIVONIA 0533165A 826 2/11/2021 5022 ASCENDANT STAFFING LLC LIVONIA 5135877B 517 2/6/2021 8833 0.95 ASHER LLC LIVONIA 5599997A 17,665 1/12/2021 8018 1.94 27 % AYUDA HOME HEALTH CARE LLC LIVONIA 5115760A 3,035 2/17/2021 8835 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 84 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge B AND B MECHANICAL LLC LIVONIA 6112943A 674 2/5/2021 5550 BELAGGIO HOMES INC LIVONIA 4663306A 755 2/5/2021 5606 BELLACINI CONSTRUCTION COMPANY LIVONIA 6112030A 801 1/31/2021 5645 BEST WOOD FLOORS LLC LIVONIA 4005546A 825 3/7/2021 5437 0.95 BUGNELL DAVID C LIVONIA 0739898A 540 2/22/2021 9521 C 3 WORKFORCE INC LIVONIA 4713907A 60,070 2/3/2021 3146 1.26 CAPITAL BOWLING SERVICE LIVONIA 4030788A 750 3/19/2021 5437 DAY ELECTRIC COMPANY LIVONIA 5970377A 470 3/1/2021 5190 DEDICARE LLC LIVONIA 4470494A 22,109 1/1/2021 4828 0.72 DELTA PAINTING LIVONIA 1402218A 750 2/3/2021 5476 DETROIT SONAVOX INC LIVONIA 4317882A 1,758 2/21/2021 8742 0.95 ELDER EMPOWERMENT SERVICES UNLIMITED LIVONIA 6089933A 634 1/1/2021 8835 LLC FINISH LINE CONSTRUCTION & RESTORATION LIVONIA 5902550A 2,336 3/21/2021 5403 GROUP LLC FIRM CONSULTING GROUP LLC LIVONIA 5790433A 569 1/13/2021 9015 GENESIS CONSTRUCTION LIVONIA 4589114A 19,734 2/18/2021 5645 0.79 GLASS CITY MOVERS LIVONIA LLC LIVONIA 5850266A 2,193 3/27/2021 7214 0.95 GREEN THUMB OF MICHIGAN INC LIVONIA 3662837A 1,158 3/19/2021 9102 0.95 HAROLD EKLUND PAINTING LLC LIVONIA 3216314A 6,435 3/23/2021 5476 0.95 HEAVYWEIGHT LOGISTICS INC LIVONIA 4953517A 267 1/20/2021 8810 HEGIRA PROGRAMS INC LIVONIA 0546844A 192,809 2/1/2021 8832 1.70 13 % HOT DIGGITTY DOG LLC LIVONIA 5255740A 1,005 3/31/2021 8017 0.95 ILLUMINATE YOUR SPIRIT LLC LIVONIA 5828902A 351 2/20/2021 9063 J AND B CONSTRUCTION INC LIVONIA 3673367A 338 3/8/2021 5606 JAY BILT CONSTRUCTION LLC LIVONIA 2779463A 314 3/5/2021 8742 JT PAINTING LIVONIA 1110225A 750 2/17/2021 5476 0.95 K AND C ENTERPRISE LLC LIVONIA 4428382A 750 1/3/2021 7208 KAJK LLC LIVONIA 4386078A 805 2/1/2021 5183 0.95 KENS HOME MAINTENANCE LIVONIA 4366549A 1,271 1/17/2021 5476 0.95 L AND D TRANSPORT INC LIVONIA 4223675A 161,373 2/12/2021 7208 1.52 27 % LIVONIA SELF STORAGE CO INC LIVONIA 2411385A 1,041 1/29/2021 9015 0.95 LONG JAISON & LONG DOUGLAS LIVONIA 4433220A 540 3/16/2021 9521 MALONEY MICHAEL LIVONIA 5020204A 304 1/31/2021 8742 MARYLAND COURT INC LIVONIA 1197126A 874 1/13/2021 9015 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 85 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MASTERS LLC LIVONIA 5530962A 2,629 1/21/2021 5645 0.81 MB CONTRACTING LIVONIA 6113834A 750 2/6/2021 5645 MCMILLAN DOOR INC LIVONIA 2608480A 1,797 3/30/2021 5102 0.95 MICHIGAN INSTITUTE OF MEDICINE PC LIVONIA 0189774A 435 3/31/2021 8832 0.95 MOTHER BEARS CUB CARE LLC LIVONIA 5458919A 699 1/8/2021 8869 NATES MAINTENANCE LLC LIVONIA 4022963A 2,196 2/14/2021 9015 0.94 PRIVATE DUTY SERVICES LLC LIVONIA 4997077A 16,895 3/1/2021 8835 1.29 PURE PAINT CO LLC LIVONIA 5478880A 750 2/12/2021 5476 RABIDUE STEVEN D LIVONIA 1474839A 750 3/4/2021 5403 RAYS WINDOW CLEANING AND BUILDING LIVONIA 2513331A 568 3/9/2021 9015 MAINTENANCE SALS PIZZA & CAFE INC LIVONIA 5076161A 1,578 1/17/2021 9058 0.95 SAMCO SALES AND SERVICE INC LIVONIA 2911582A 794 3/17/2021 9519 SHAWARMA PALACE & BAKERY LLC LIVONIA 6136591A 673 3/18/2021 9058 SIMONS LAWN SERVICE LLC LIVONIA 5950236A 709 1/12/2021 0042 SPRING LOADED I LLC LIVONIA 5517451A 8,480 1/26/2021 9063 0.92 STATE CUSTOM BUILDERS LLC LIVONIA 4588258A 750 3/21/2021 5645 STERNDRIVE SYSTEMS LLC LIVONIA 6128955A 931 2/28/2021 6836 TOTAL FLEET IMAGING INC LIVONIA 5976537A 456 3/30/2021 9522 TRI ENERGY SOLUTIONS LLC LIVONIA 1263382A 315 1/20/2021 8810 0.95 US ICE BLASTING LLC LIVONIA 5972876A 1,812 3/5/2021 3724 VETFORCE INC LOCK HAVEN, PA 6142990A 5,800 3/27/2021 7720 TOP DRIVER ACQUISITION LLC LOMBARD, IL 5947553A 1,512 3/11/2021 8868 INDUSTRIAL SERVICES & CONSULTING INC LOUISBURG, NC 5848270A 1,066 3/30/2021 3724 MILFORD CONTRACTING LLC LOUISVILLE, KY 4006917A 17,386 3/21/2021 6217 1.30 13 % ALLISSAS SHEAR INDULGENCE LLC LOWELL 5959101A 547 1/23/2021 9586 BILD MIDWEST SERVICES LOWELL 5694116A 825 3/22/2021 5146 CWI INC LOWELL 5357063A 835 1/6/2021 8810 0.95 IMMACULATE IMPROVEMENTS LOWELL 5580668A 4,777 3/20/2021 5476 0.95 J W INSPECTION SERVICES OF MICHIGAN INC LOWELL 4942809A 398 1/15/2021 8810 O E BIERI & SONS INC LOWELL 0261319A 739 3/11/2021 6217 ONE ETHANOL LLC LOWELL 5969786A 2,550 2/23/2021 8350 PREFERRED ROOFING CONTRACTORS LLC LOWELL 2140063A 14,976 3/7/2021 5551 0.79 ROBERT RAYMOND BUILDERS LOWELL 5822815A 2,592 2/10/2021 5645 0.95 ROTH EDWARD C III LOWELL 3507882A 800 1/15/2021 5551

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 86 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SANBORN AMY AND JAMES LOWELL 5978289A 530 3/22/2021 0913 VZ TEC LLC LOWELL 6117260A 561 2/20/2021 3632 D J R HAMLIN INC LUDINGTON 3531988A 454 1/9/2021 9058 DIRT BUSTERS II OF WEST MICHIGAN LLC LUDINGTON 2779927A 568 2/10/2021 9015 1.00 DUNA VISTA RESORTS LUDINGTON 4474171A 569 3/1/2021 9015 FOAM WORKS ACQUISITION LLC LUDINGTON 6099246A 9,300 1/15/2021 5479 GENE ADAMS ENTERPRISES INC LUDINGTON 4867785A 2,701 1/22/2021 7208 KOVAR CONSTRUCTION INC LUDINGTON 3283453A 750 1/2/2021 5437 LUDINGTON DOCK & HOIST LUDINGTON 6118097A 2,062 2/13/2021 6400 ARCADIA TOWNSHIP OF LAPEER COUNTY LUM 0007404A 2,795 1/21/2021 9015 0.95 BLOOD JAMES O JR LUPTON 0332739A 750 2/5/2021 2702 BAKERSVILLE ADULT FOSTER CARE LUTHER 5644925A 832 1/31/2021 9053 GAME ON SPORTS FLOORING LUTHER 5949840A 750 1/4/2021 5437 JEFF LUCAS LOGGING LLC LUTHER 1099981A 826 3/7/2021 8810 LUCAS LOGGING LUTHER 4828232A 750 1/11/2021 2702 ICEBREAKER MACKINAW MARITIME MUSEUM INC MACKINAW CITY 4319702A 1,912 3/7/2021 9101 0.95 MACKINAW TOWNSHIP OF CHEBOYGAN COUNTY MACKINAW CITY 1216287A 446 2/16/2021 9410 AC LAWN SERVICE INC MACOMB 3075362A 959 3/31/2021 9102 0.95 ALMIR CAUSEVIC TRANSPORT INC MACOMB 5002966A 1,672 3/26/2021 7219 0.95 ANGELS OF MERCY LLC MACOMB 6136800A 5,664 3/18/2021 8835 BLINDS PLUS MACOMB LLC MACOMB 4193091A 540 3/3/2021 9521 BOB BECKER PLUMBING MACOMB 2576546A 659 2/12/2021 5183 CTT LLC MACOMB 5734452A 11,847 2/11/2021 7208 0.95 CUSTOM WOODWORKING INTERIORS LLC MACOMB 3580067A 750 1/28/2021 5437 D C DEDICATED PLUMBING LLC MACOMB 5947898A 1,062 1/2/2021 5183 ECLIPSE ELECTRIC LLC MACOMB 4320450A 1,046 3/10/2021 5190 EVERETT INTERIORS LLC MACOMB 6132847A 825 3/7/2021 5437 GRAND T INC MACOMB 3912302A 5,192 3/30/2021 9058 0.79 GRAND T2 INC MACOMB 3912302B 4,331 1/17/2021 9058 0.79 GREYSTONE CONSTRUCTION PAINTING AND MACOMB 2840286A 750 2/8/2021 9521 0.95 BUILDING LLC HIRTHS HARDWOOD FLOORS LLC MACOMB 4256484A 800 2/6/2021 5437 HM TRANSPORTATION INC MACOMB 4842138A 2,233 2/23/2021 7215 0.95 HPH TOWING INC MACOMB 6129390A 2,174 3/3/2021 7208 JAMES TOWN CONSTRUCTION LLC MACOMB 4167414A 750 3/8/2021 5348

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 87 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge LAND MECHANICAL LLC MACOMB 5672058A 674 2/9/2021 5550 LDS EXTERIORS LLC MACOMB 1825437A 750 2/13/2021 5551 LEADING EDGE HOME IMPROVEMENT COMPANY MACOMB 5520851A 800 2/25/2021 5645 INC M AND K CONSTRUCTION COMPANY LLC MACOMB 1913700A 14,155 1/2/2021 5645 0.85 M K CLEANING INC MACOMB 1544802A 643 2/27/2021 8810 MACOMB ORTHODONTICS PLLC MACOMB 4355334A 1,536 3/25/2021 8832 0.95 MOVADO CONSTRUCTION LLC MACOMB 5352142A 533 3/29/2021 5606 MR FINISH CARPENTRY INC MACOMB 3892646A 750 2/9/2021 5437 MW GROUP INC MACOMB 4266536A 749 3/7/2021 8742 NAVA CONSTRUCTION LLC MACOMB 5967830A 4,051 2/15/2021 5645 NORTH WINDS BUILDING & CONSTRUCTION LTD MACOMB 4518128A 750 2/9/2021 5645 NORTHSTAR TRANSPORTATION INC MACOMB 5080991A 791 2/21/2021 7212 NOUVEAU PAINTING INC MACOMB 4713087A 750 1/8/2021 5476 0.95 PALAZZOLOS CONCRETE REMOVAL INC MACOMB 5594219A 1,638 2/8/2021 5221 0.95 PARAGON SPECIAL SERVICES INC MACOMB 5504961A 2,826 3/20/2021 9015 0.95 PLG CONTRACTING LLC MACOMB 5817706A 750 1/30/2021 5437 PROFESSIONAL CLEANING SYSTEMS INC MACOMB 3374092A 568 1/14/2021 9015 RIGID CONSTRUCTION LLC MACOMB 5118263A 750 1/15/2021 5551 ROCC PHIL HOMES INC MACOMB 1593722A 750 2/9/2021 5645 ROCK PAINTING SERVICES MACOMB 3100847A 1,236 1/10/2021 5476 ROCKPORT CONTRACTING INC MACOMB 2928434A 825 1/16/2021 5348 SAFETY PROFESSIONAL SERVICES LLC MACOMB 4867220A 1,425 1/24/2021 8601 0.95 SOMERSET HARDWOOD FLOOR CARE INC MACOMB 1662872A 750 2/6/2021 5437 STEVES SIDING UNLIMITED LLC MACOMB 2397579A 761 2/6/2021 8742 0.79 STONECREST BUILDING COMPANY MACOMB 5818699A 750 2/1/2021 5645 TANI HARDWOOD FLOORING LLC MACOMB 6106188A 834 3/11/2021 5437 TRI COUNTY ROOFERS LLC MACOMB 3069834A 800 2/6/2021 5551 TWENTY FOUR 7 ELECTRIC DOCTOR INC MACOMB 4101740A 589 1/29/2021 5190 USA PAINTING LLC MACOMB 5971675A 751 3/1/2021 5476 VETERANS REMODELING MACOMB 5975549A 750 3/13/2021 5551 VIRINT LLC MACOMB 5795141A 449 3/6/2021 8601 VLAR HOMES LLC MACOMB 6007929A 7,977 2/18/2021 5645 WILLIS FLOYD MACOMB 6126847A 750 2/27/2021 5183 AQUA CARPET CLEANING LLC MACOMB TWP 4651146A 618 1/28/2021 9015

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 88 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BLUE MOUNTAIN CONSTRUCTION GROUP LLC MACOMB TWP 4677684A 755 3/4/2021 8742 J S HOME IMPROVEMENTS LLC MACOMB TWP 3030598A 751 3/27/2021 8810 P AND G CUSTOM PAINTING INC MACOMB TWP 4243625A 750 1/25/2021 5476 ROBINSON PAINTING COMPANY INC MACOMB TWP 1796348A 750 1/22/2021 5476 COMCO USA INC MADISON, TN 4210131A 345 3/13/2021 8742 HUMANE EQUINE AID AND RAPID TRANSPORT MADISON, VA 5817781A 753 2/21/2021 8810 INC A 1 INVESTMENTS PLUS LLC MADISON HEIGHTS 4028848A 800 1/22/2021 5476 AIMM HOME HEALTHCARE INC MADISON HEIGHTS 4968808A 2,073 2/23/2021 8835 0.95 AMERICAN SCREW PRODUCTS INC MADISON HEIGHTS 0232670A 1,875 1/15/2021 3145 0.95 BERCHIOLLYS FLOORING LLC MADISON HEIGHTS 3672158A 618 1/25/2021 9521 BK 2 HOME IMPROVEMENT LLC MADISON HEIGHTS 6118550A 750 2/13/2021 5645 COMPLETE MANUFACTURERS EQUIPMENT MADISON HEIGHTS 2658623A 600 1/27/2021 8010 0.95 CORPORATION ELIAS LYNN LLC MADISON HEIGHTS 5764475A 2,673 3/24/2021 7202 HMA ENTERPRISES INC MADISON HEIGHTS 4668863A 863 3/17/2021 8017 HOME MEDIC HANDYMAN LLC MADISON HEIGHTS 3854205A 825 1/17/2021 5645 0.95 INDUSTRIAL REALTY INC MADISON HEIGHTS 5364515A 572 1/16/2021 9015 J G CLARK CONTRACTING MADISON HEIGHTS 2852934A 750 2/25/2021 5645 0.95 JOHN ALLEN CUSTOM PAINTING MADISON HEIGHTS 2766035A 750 2/26/2021 5476 KEMP AND SHERMAN COMPANY MADISON HEIGHTS 3232107A 361 3/19/2021 8810 LUBO INC MADISON HEIGHTS 5006708A 1,476 2/18/2021 8010 0.95 PROFESSIONAL PLUMBING SERVICES LLC MADISON HEIGHTS 2194490A 1,178 1/31/2021 5183 QMI GROUP INC MADISON HEIGHTS 1078950A 295 1/1/2021 4351 0.95 ROYAL RESTORATION SERVICES LLC MADISON HEIGHTS 5844568A 2,010 3/21/2021 9015 0.95 SLV PAINTING MADISON HEIGHTS 5105722A 750 3/21/2021 5476 TWIN RIVERS TRADING INC MADISON HEIGHTS 5044448A 15,353 1/18/2021 7380 0.77 GOLDEN TAN TANNING SALON INC MADISON HTS 3116905A 331 1/31/2021 9586 MOGHUL FOODS LLC MADISON HTS 5212383A 1,638 3/19/2021 8032 0.95 NORTHERN MICHIGAN SERVICES MANCELONA 5562686A 1,001 1/18/2021 5606 0.95 FARMER SAND & GRAVEL INC MANCHESTER 3929116A 225 1/6/2021 8810 0.95 KOBY CRAFTSMEN LLC MANCHESTER 5971845A 800 3/5/2021 5437 MANCHESTER DINER LLC MANCHESTER 6094830A 543 1/9/2021 9058 WYATT ELECTRICAL CONTRACTORS LLC MANCHESTER 3767248A 545 2/23/2021 5190 ZAP ENTERPRISE LLC MANCHESTER 4537998A 1,293 3/27/2021 7208 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 89 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BARNEYS SEWER AND DRAIN CLEANING LLC MANISTEE 4793412A 656 1/10/2021 9402 FOREST PATH ENTERPRISES INC MANISTEE 3748219A 512 3/15/2021 9058 0.95 ORCHARD BEACH AVIATION INC MANISTEE 2490870A 7,635 2/25/2021 7403 0.88 WETMORE PROPERTIES LLC MANISTEE 5809754A 750 1/11/2021 5403 A SWAYER TRUCKING INC MANISTIQUE 4309707A 750 1/29/2021 7208 SANTI TRUCKING MANISTIQUE 2849925A 581 2/3/2021 3724 REYNOLDS CUSTOM FLOORING LLC MANITOU BEACH 5381088A 1,232 3/5/2021 9521 FOUNTAIN DON MANTON 5281326A 750 1/13/2021 2702 LDH LOGGING MANTON 5528666A 750 3/15/2021 2702 TD DRILLING CONSULTANT INC MANTON 4580184A 283 1/24/2021 8601 TERRY PORTER BUILDER MANTON 3102181A 800 3/14/2021 5645 AMYS FABULOUS DINER LLC MARCELLUS 3698351A 1,043 3/7/2021 9058 BRIDGES AUDIO VISUAL MARCELLUS 3318478A 334 2/8/2021 5191 GOGEBICRANGE NET LLC MARENISCO 5691621A 1,518 3/16/2021 7600 0.95 GREGS ELECTRIC COMPANY INC MARINE CITY 4829344A 686 1/8/2021 5190 0.95 EMERGENCY RESCUE SQUAD INC MARINETTE, WI 0684198A 1,065 2/7/2021 7380 0.95 PINTSCH TIEFENBACH US INC MARION, IL 4949498A 2,618 1/28/2021 3724 0.95 PLEASANTRIDGE MANOR AFC MARION 2930609A 1,508 3/15/2021 9053 EXCEL APPRAISALS INC MARLETTE 4795156A 224 2/19/2021 8810 FAIR DEAL USED VEHICLES AND SALVAGE LLC MARLETTE 6111513A 505 1/30/2021 8395 FLYNNS LLC MARLETTE 5867282A 753 3/9/2021 8810 H CUMMINGS AND SONS MARLETTE 2668556A 750 3/5/2021 5215 HILLMAN TRANSPORT LLC MARLETTE 5676851A 750 2/17/2021 7208 HULL ISOLATION INC MARLETTE 5499062A 998 1/7/2021 0035 KORTE CONSTRUCTION CO MARLETTE 3027406A 750 2/21/2021 5645 NAVARRO CONNIE MARLETTE 4447883A 530 3/9/2021 0913 TRACYS INSULATION & CONTRACTING INC MARLETTE 3742270A 1,621 1/8/2021 5479 RDT TILE MARNE 2745259A 750 2/28/2021 5348 RICH KAMP INC MARNE 5352118A 534 2/5/2021 0129 0.95 BULLDOG INVESTIGATIONS LLC MARQUETTE 4974824A 517 3/29/2021 7720 0.95 FRALEY BROTHERS & SONS MARQUETTE 0391123A 750 1/1/2021 2702 LAKESHORE ENVIRONMENTAL INDUSTRIES INC MARQUETTE 3439500A 3,305 1/7/2021 9521 0.95 MARQUETTE MOUNTAIN RACING TEAM INC MARQUETTE 5947227A 573 1/10/2021 9015 MOOSEWOOD NATURE CENTER INC MARQUETTE 3621987A 240 2/26/2021 8868 NORTHERN AWNING & WINDOW COMPANY INC MARQUETTE 0235423A 22,171 3/2/2021 5437 1.68 13 % 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 90 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SUPERIOR ALLIANCE FOR INDEPENDENT LIVING MARQUETTE 3462617A 4,721 1/12/2021 9015 0.97 ALLEGIANT LEGAL PC MARSHALL 5544238A 333 3/14/2021 8820 BROOKS INVESTIGATIONS LLC MARSHALL 3132170A 841 3/23/2021 7720 0.95 EXCELLERATED TOWING & RECOVERY LLC MARSHALL 6112994A 750 2/4/2021 7208 FRANKE THOMAS MARSHALL 6112072A 1,925 1/31/2021 0913 FRESH LOOK CLEANING MARSHALL 5981930A 643 3/30/2021 9015 GUO LLC MARSHALL 5656087A 875 1/6/2021 9058 JENNIFER GALLOWAY LLC MARSHALL 4084012A 336 3/6/2021 9586 MARSHALL METAL PRODUCTS INC MARSHALL 4369319A 3,619 1/1/2021 3400 0.95 MARSHALL MINI STORAGE LLC MARSHALL 5833604A 691 2/28/2021 9015 TOP TO BOTTOM TREE SERVICE LLC MARSHALL 6111556A 7,559 2/3/2021 0106 HUNT PAYTON MARTIN 6118070A 750 2/14/2021 5437 BLUE WATER RIGGING SERVICES LLC MARYSVILLE 4598237A 7,139 1/14/2021 3724 0.92 BRAUN BARRY MARYSVILLE 0583545A 751 1/7/2021 5538 PINERY CONDOMINIUM ASSOCIATION MARYSVILLE 4232194A 588 1/23/2021 9015 SONS OF CARPENTRY LLC MARYSVILLE 3522113A 3,076 3/16/2021 5645 0.95 ST CLAIR RIVER APARTMENTS LLC MARYSVILLE 5813425A 569 1/23/2021 9015 ADVANTAGE WELDING & REPAIR LLC MASON 5804256A 1,402 1/3/2021 3365 ARC WELDING AND REPAIR LLC MASON 3060012A 4,815 1/12/2021 3365 0.95 BULLS EYE AXE THROWING LLC MASON 5967805A 2,547 2/15/2021 9015 COMPLETE CONTRACTING LLC MASON 4204891A 739 2/14/2021 6217 DAKOTAS TREE SERVICE LLC MASON 4950968A 801 1/13/2021 0106 EAGLE EYE CONSTRUCTION & REMODELING LLC MASON 5688752A 750 2/7/2021 5645 0.95 ELLIOTTS AMUSEMENTS LLC MASON 3627586A 7,340 1/29/2021 9015 0.85 GARFIELD DRYWALL LLC MASON 3539741A 3,704 3/19/2021 5445 0.95 M AND H BACK ROOM MASON 0664588A 2,605 2/28/2021 8395 0.95 MASON INSTALLATION LLC MASON 4802012A 556 1/15/2021 9521 MICHAEL R FRENCH INC MASON 5830427A 815 2/23/2021 8720 NEW TRADITIONS IN BUILDING INC MASON 3281000A 750 1/5/2021 5645 RAI RESTORATION LLC MASON 0856010A 5,116 3/25/2021 9015 0.80 SHOWERMANS CONSTRUCTION LLC MASON 5654220A 750 1/30/2021 5645 0.95 SWALLOWTAIL FARM LLC MASON 6118178A 445 2/13/2021 0035 TIGES BAR MASS CITY 1454412A 534 2/7/2021 9058 CALDWELLS MOBILE REPAIR LLC MATTAWAN 5959195A 2,068 2/5/2021 8387 CLEAN AND RELIABLE C & R CONSTRUCTION LLC MATTAWAN 5115400A 750 3/19/2021 5645 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 91 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DENTIS MICHIGAN LLC MATTAWAN 5975034A 450 3/12/2021 8742 H AND H PROPERTY MAINTENANCE MATTAWAN 6140750A 784 3/25/2021 0042 PRIME HOMES LLC MATTAWAN 6127932A 800 2/28/2021 5645 RUSSELL WILLIAMS INCORPORATED MATTAWAN 3614352A 750 3/13/2021 5645 0.95 TMC EXTERIORS LLC MATTAWAN 5968135A 761 2/16/2021 5645 M E PUFFENBERGER DESIGN LLC MAUMEE, OH 6143083A 235 3/28/2021 8810 CORBROOK TRUCKING MAYVILLE 4620712A 3,852 3/20/2021 7208 FOWLER CENTER INC MAYVILLE 0244848A 8,638 3/15/2021 9015 1.19 10 % STEMAR TRANSPORT INC MAYVILLE 3784525A 750 2/8/2021 7208 0.93 NATURAL LOG BUILDERS MC BAIN 4367227A 750 3/6/2021 5645 VIKING ENERGY OF MCBAIN LLC MC BAIN 6137687A 30,669 3/15/2021 7539 K HILL TRUCKING INC MCBAIN 4975715A 750 1/18/2021 7208 0.95 NORTHERN BOVINE VETERINARY SERVICES PC MCBAIN 0001139A 4,796 2/10/2021 8831 1.39 13 % DARRELL WILLIAMS TRUCKING MCMILLAN 2328267A 750 1/17/2021 7208 PURPOSE POINT HARVESTING LLC MEARS 5684994A 22,487 1/15/2021 0011 0.95 CANADIAN LAKES REFUSE CENTER LLC MECOSTA 5828309A 1,308 2/20/2021 9403 CENTRAL MICHIGAN SHELVING & GLASS INC MECOSTA 3131238A 541 3/16/2021 9521 ZANDER ENTERPRISES LLC MECOSTA 6091792A 2,012 1/6/2021 6400 CORNERSTONE INNOVATIONS INC MEDINA, OH 4058992A 502 1/17/2021 8742 0.95 PREFERRED INSULATION INC MEDINA, OH 6111335A 751 1/30/2021 5479 MSH HEALTH SERVICES LLC MELBOURNE, FL 6143512A 339 3/30/2021 8833 BROOKSTONE FINANCIAL LLC MELVILLE, NY 5449880A 644 2/12/2021 9015 CARTESSA AESTHETICS MELVILLE, NY 6085687A 490 1/1/2021 8742 L AND L MASONRY MELVIN 5978785A 750 3/27/2021 5022 ALVEREZ JOSE MANUEL HERNANDEZ MELVINDALE 5291704A 750 1/6/2021 5022 COLE ENTERPRISES INC MELVINDALE 5386551A 760 3/14/2021 0042 MARTINEZ ADAN MELVINDALE 5367557A 1,110 1/29/2021 5022 0.95 MELVINDALE FILL UP INC MELVINDALE 0091030A 589 1/8/2021 8017 SHOW TIME PIPING LLC MELVINDALE 6093353A 825 1/7/2021 5183 B GEE TRUCKING LLC MEMPHIS 6136419A 750 3/17/2021 7208 LOEHNIS ENTERPRISES INC MEMPHIS 3549690A 828 1/1/2021 7208 0.95 CASA OF MENOMINEE COUNTY MENOMINEE 4601645A 234 1/9/2021 8810 CONKLIN JESSE MENOMINEE 6111602A 750 1/30/2021 7208 FIRST CHOICE ROOF INC MENOMINEE 5167779A 9,920 1/29/2021 5551 0.88 GARY SCHULTZ TRUCKING MENOMINEE 1421042A 750 3/9/2021 7208 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 92 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge M AND M AVIATION LLC MENOMINEE 5730678A 457 3/4/2021 7423 NORPORT INC MENOMINEE 3587223A 1,436 1/24/2021 7309 0.95 RULEAU MICHEAL MENOMINEE 5569150A 750 2/27/2021 2709 STANG WISCONSIN CORP MENOMINEE 1084496A 803 1/3/2021 8810 J AND T TRUCKING MESICK 3523446A 3,396 3/13/2021 7208 ABSOLUTE CONSTRUCTION SLF LLC METAMORA 3586308A 914 1/27/2021 5606 0.95 EDWARDS TREE & LAND CLEARING SERVICES METAMORA 4293681A 4,932 3/29/2021 0106 0.93 INC GKS ENGINEERING LLC METAMORA 4967240A 290 3/2/2021 8810 GROUNDHOG PROPERTIES LLC METAMORA 5870011A 662 2/22/2021 5606 HARTWICK JUSTUN METAMORA 6131913A 750 3/6/2021 5645 LAKE METAMORA ASSOCIATION METAMORA 2716160A 579 3/27/2021 9015 0.95 MCALLISTER EVENTING LLC METAMORA 5517311A 1,409 2/17/2021 8279 METAMORA BUILDING LLC METAMORA 5805767A 800 1/6/2021 5645 N AND J CONSTRUCTION METAMORA 1937502A 7,060 1/2/2021 5022 0.92 RUSSELL NATHAN METAMORA 4832272A 750 2/28/2021 5645 STEFANI FINISH INC METAMORA 5443822A 2,016 1/29/2021 5022 0.95 TRU PRO SERVICES INC METAMORA 6034195A 4,898 3/4/2021 5403 R ONE TRUCKING LLC MICHIGAN CENTER 5843243A 825 3/23/2021 7208 TOTAL TREE ENTERPRISE LLC MICHIGAN CENTER 6104380A 1,050 1/23/2021 0106 LW TRANSPORT LLC MIDDLETON 5977010A 3,396 3/19/2021 7208 CJL CONSTRUCTION LLC MIDDLEVILLE 5941385A 750 2/1/2021 5645 COREY VANDYKE PAINTING MIDDLEVILLE 4835832A 750 2/23/2021 5476 DIG A TREE TRANSPLANTING LLC MIDDLEVILLE 3893006A 606 3/2/2021 0005 EBERBACH PAINTING MIDDLEVILLE 5392829A 750 2/6/2021 5476 0.95 LOCAL UNION NO 1002 UAW BUILDING MIDDLEVILLE 5654700A 693 1/6/2021 8755 CORPORATION REBUILT CONSTRUCTION LLC MIDDLEVILLE 6139841A 800 3/25/2021 5437 RIVERSIDE CONSTRUCTION MANAGEMENT LLC MIDDLEVILLE 3051048A 977 1/1/2021 5606 APEX MIDWEST INC MIDLAND 2692147A 1,872 1/25/2021 5437 ART HOUSE STUDIOS LLC MIDLAND 6143075A 247 3/28/2021 8601 BEEHRS TOWING INC MIDLAND 5954126A 750 1/17/2021 7208 BETTER LAWNS & LANDSCAPING LLC MIDLAND 4330072A 598 2/27/2021 9102 FISCHER ROOFING & SHEET METAL COMPANY MIDLAND 5333202A 8,825 1/1/2021 5551 0.85 LLC INNOVATIVE EXTERIORS INC MIDLAND 5404290A 11,934 1/1/2021 5552 0.96 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 93 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge INTEGRITY HOMES LIMITED LLC MIDLAND 3588343A 516 1/11/2021 8810 J SCOTT PRO COATINGS MIDLAND 5959330A 751 1/25/2021 5476 KOLHOFF AMANDA MIDLAND 4028562A 1,132 2/12/2021 0908 0.95 LINCOLN TOWNSHIP OF MIDLAND CO MIDLAND 0661244A 1,459 1/1/2021 9410 0.95 LIVE OAK COFFEEHOUSE LLC MIDLAND 5668611A 1,493 2/9/2021 8017 0.95 MCKINNEY SHANEQUA MIDLAND 4718836A 414 2/28/2021 0908 MIDLAND CORROSION MATERIALS INC MIDLAND 0743623A 437 1/31/2021 8742 PARSONS INSULATION LLC MIDLAND 5649536A 1,505 1/20/2021 5479 0.95 RAY BENSCH TREE SERVICE LLC MIDLAND 4644409A 1,815 1/1/2021 0106 0.95 VOLZ HOME SERVICES & CONSTRUCTION MIDLAND 4010922A 751 2/5/2021 5445 CLASSIC COLLISION LLC MILAN 4041283A 1,513 1/5/2021 8393 DAVID PAUL REMODELING AND CONSTRUCTION MILAN 5680417A 4,380 3/28/2021 5645 0.95 LLC DUNBAR MEATS LLC MILAN 0891762A 4,648 2/15/2021 2081 0.95 FERRIS LARRY MILAN 4593618A 750 2/28/2021 5445 JENNIFERS TRANSPORT LLC MILAN 5819385A 7,142 2/9/2021 7380 0.95 KRAJNIAK RAYMOND MILAN 6103049A 750 1/21/2021 5645 MOLD PRO LLC MILAN 5544815A 4,547 1/1/2021 9015 0.95 PETERSBURG WINDOWS LLC MILAN 6112927A 750 2/4/2021 5645 RLM CREATIVE LLC MILAN 6120393A 609 2/15/2021 2003 SP PETROL LLC MILAN 1900749A 694 1/24/2021 8017 0.95 BURROW CONSTRUCTION INC MILFORD 3276449A 750 2/13/2021 5645 DIVERSIFIED CONSTRUCTION INC MILFORD 5693535A 800 1/9/2021 5403 EDWIN INVESTMENTS LLC MILFORD 3946576A 750 3/4/2021 5645 FIVE K CONCRETE LLC MILFORD 5918510A 1,284 3/19/2021 5221 FOX GLEN APARTMENTS LIMITED PARTNERSHIP MILFORD 0568996A 643 1/15/2021 9015 HARBOR CLUB LLC MILFORD 0285358A 643 1/17/2021 9015 HAYES SAND & GRAVEL CO INC MILFORD 0066486A 800 2/21/2021 7208 0.95 HERMANN CONSTRUCTION INC MILFORD 1927540A 750 3/14/2021 5645 MILL POINTE HOMEOWNERS ASSOCIATION MILFORD 5421381A 655 1/1/2021 9015 R J POWERS CONSTRUCTION INC MILFORD 1392239A 750 1/9/2021 5437 TOCCOS RENOVATING SERVICE LLC MILFORD 6125476A 750 2/25/2021 5645 TRUE CUT TREE CARE LLC MILFORD 4930215A 5,315 2/6/2021 0106 0.95 WMBN INVESTORS FLINT LIMITED PARTNERSHIP MILFORD 5951739A 643 1/7/2021 9015 GREAT LAKES RAIL SERVICE INC MILLBURY, OH 3170861A 770 2/26/2021 5506

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 94 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CEDAR LOG & LUMBER OF MILLERSBURG INC MILLERSBURG 2035790A 3,112 1/18/2021 2731 0.93 ADVANCED DIGITAL SOLUTIONS INC MILLINGTON 5848113A 364 2/21/2021 5191 L AND L TRANSPORT MILLINGTON 5976707A 750 3/16/2021 7208 MICHIGAN TRANSPORTATION AND LOGISTICS MILLINGTON 5968232A 4,922 2/23/2021 7208 LLC TERRY DIENER CABLE MILLINGTON 2737922A 1,870 2/4/2021 7600 WAYNE JARUZEL LOGGING INC MILLINGTON 1031252A 5,432 1/1/2021 2702 STARGATE MANUFACTURING 2020 LTD MILTON, ON 6135307A 536 3/23/2021 8742 PIERSON PILING INC MINDEN CITY 0515922A 2,118 1/17/2021 5040 0.95 ENVIROBATE INC MINNEAPOLIS, MN 4952235A 801 1/14/2021 5183 0.95 ALLIANCE TREE SERVICE LLC MIO 4936302A 1,136 3/25/2021 0106 0.95 MCGREGOR CHRISTINE MIO 4839412A 750 2/23/2021 9403 THREE D EXPRESS & FARM INC MIO 5518539A 750 1/29/2021 7208 WAYLAND BP LLC MOLINE 0056022A 6,749 2/8/2021 8395 1.38 13 % INNOVA LINER INC MONCLOVA, OH 5523273A 826 3/4/2021 6306 DAN THE FLOOR GUY LLC MONROE 5948150A 2,089 1/2/2021 5437 E SCAPES NETWORK LLC MONROE 4846087A 336 1/11/2021 7610 0.95 ESCUE SERVICE MONROE 5367484A 800 1/29/2021 5645 GOODNIGHT CLEANING MONROE 5046700A 618 2/22/2021 9015 GRACE CONSTRUCTION GROUP LLC MONROE 2909634A 852 1/25/2021 9015 HEARTBEAT OF MONROE INC MONROE 5648947A 291 1/1/2021 8832 HEISERMAN RYAN MONROE 6111998A 750 1/31/2021 5551 HUMANE SOCIETY OF MONROE COUNTY INC MONROE 1126849A 2,272 3/11/2021 8831 MONROE CONSTRUCTION LLC MONROE 6128092A 750 3/2/2021 5645 MONROE TRUCK WASH LLC MONROE 6118950A 984 2/14/2021 8387 NICKS HOME IMPROVEMENT MONROE 3638146A 800 1/29/2021 5551 NORTH SOUTH TRUCKING INC MONROE 4058020A 38,973 2/10/2021 7208 1.00 10 % PREFERRED CONTRACT SOLUTIONS INC MONROE 5667585A 1,961 1/30/2021 3628 0.95 S AND J TREE SERVICE MONROE 6107613A 1,159 1/25/2021 0106 STONES LAWNCARE AND SNOW REMOVAL MONROE 6117449A 657 2/12/2021 9102 T A JEWELL FARM MONROE 3434923A 3,446 3/10/2021 7208 TOTALLY AWESOME CHILD CARE LLC MONROE 5855730A 475 3/12/2021 8869 KASHUK JEFFRY MONSEY, NY 5228956A 15,657 1/24/2021 8835 0.71 EAGLE TOWING MONTAGUE 0672327A 4,523 1/9/2021 7208 0.95 GRAND ALPACA COMPANY LLC MONTAGUE 6101267A 584 1/20/2021 0129

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 95 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GRATT CONSTRUCTION LLC MONTAGUE 6128971A 750 2/28/2021 5645 KOZICKI JONATHON D MONTAGUE 5268052A 750 1/26/2021 2702 LINNE JARED MONTAGUE 6138101A 1,604 3/23/2021 7600 REILLYS ROOFING MONTAGUE 5960339A 1,200 1/29/2021 5610 SUNDBERG ERIC MONTAGUE 5820626A 750 2/7/2021 5645 DANIEL J PIERCE CONSTRUCTION LLC MONTROSE 4470745A 750 1/23/2021 5437 GUTZEIT QUALITY CONSTRUCTION MONTROSE 3623386A 750 1/20/2021 5403 MICHIGAN TRAIL RIDERS ASSOCIATION INC MONTROSE 4204565A 757 2/21/2021 9015 ROXYS DINER INC MONTROSE 4085205A 714 1/5/2021 9058 0.95 SAYLES LEROY MORAN 4035240A 750 2/9/2021 2702 D AND N HOME IMPROVEMENTS LLC MORLEY 6120300A 1,901 2/15/2021 5645 DRIVE DIRECT EXPRESS LOGISTICS LLC MORLEY 6100023A 390 1/16/2021 8810 FOR US TREE MORLEY 4012712A 750 2/12/2021 2702 L AND H GROUP INC MORLEY 5508886A 348 1/22/2021 8869 TEACHWORTH RICK MORLEY 5806780A 750 1/10/2021 2702 SROUFES EXTERIORS LLC MORRICE 5975654A 757 3/14/2021 5538 VERY COOL STUFF LLC MORRICE 5950228A 1,083 1/30/2021 8010 JANUARY 2015 INC MORRIS 5382858A 379 3/7/2021 8017 SUPER WASH INC MORRISON, IL 3131106A 660 1/1/2021 8387 SWITALSKI LAW & CONSULTING PLLC MOUNT CLEMENS 6132936A 263 3/7/2021 8810 AKIN MATTHEW MOUNT MORRIS 6134602A 750 3/12/2021 5215 LOVELY LADIES WHO TRIM LLC MOUNT MORRIS 6049729A 3,326 2/12/2021 0035 SERENITY QUALITY HOME CARE LLC MOUNT MORRIS 5824702A 743 2/14/2021 8835 COURTNEY JEROME MEDIA LLC MOUNT PLEASANT 6096360A 305 1/24/2021 7610 C 3 HOLDINGS LLC MT CLEMENS 4419081A 229 1/20/2021 8742 GRAND OAKS VILLAGE I ASSOCIATION MT CLEMENS 2458390A 568 3/9/2021 9015 GRAND OAKS VILLAGE II ASSOCIATION MT CLEMENS 5680379A 568 3/1/2021 9015 IMPERIAL MANOR CONDOMINIUM ASSOCIATION MT CLEMENS 0010065A 568 2/28/2021 9015 JC LANDSCAPING & SPRINKLER SYSTEMS MT CLEMENS 2523388A 751 1/1/2021 0042 0.95 SERVICE INC REITERS METAL CRAFT INC MT CLEMENS 1021249A 7,076 2/1/2021 8393 1.36 13 % TEMPTATION YACHT SALES INC MT CLEMENS 5514436A 229 2/4/2021 8742 TRAFFIC LIGHT LTD MT CLEMENS 1781707A 2,501 3/10/2021 9058 0.92 TRI COUNTY COMMERCIAL SERVICES LLC MT CLEMENS 5845874A 1,153 1/1/2021 9015 TRIPLE M CONSTRUCTION LLC MT CLEMENS 5767369A 750 1/4/2021 5645

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 96 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge UTICA BASEMENT WATERPROOFING MT CLEMENS 2246163A 981 3/13/2021 5476 0.95 FINISHING TOUCHES DRYWALL LLC MT MORRIS 1866281A 750 3/13/2021 5445 MCELRATH HEATING & COOLING MT MORRIS 3259609A 674 3/28/2021 5550 PRECISE HOME RENEWAL LLC MT MORRIS 6030530A 3,904 3/21/2021 5551 RMD FLOOR COVERING MT MORRIS 5559014A 540 3/13/2021 9521 SAUVAGEAU LLC MT MORRIS 5604362A 689 2/4/2021 9058 0.95 ZODIAC HAULING AND OUTDOOR SERVICES LLC MT MORRIS 4962826A 750 2/15/2021 5610 CENTRAL MICHIGAN LOGGING LLC MT PLEASANT 5515092A 750 2/6/2021 2702 DLC FLOOR INSTALLATIONS INC MT PLEASANT 1445863A 591 3/10/2021 9521 GAS REAL ESTATE INVESTMENTS LLC MT PLEASANT 5364132A 643 1/16/2021 9015 NEXT SENSATION INC MT PLEASANT 1407830A 3,286 3/17/2021 9058 0.95 PRECISION FLOOR COVERING INC MT PLEASANT 4416007A 2,445 3/22/2021 9521 0.95 ROSEWOOD NORTH I CONDOMINIUM MT PLEASANT 4929420A 568 3/10/2021 9015 ASSOCIATION T COUGHLIN LLC MT PLEASANT 2404974A 1,491 1/30/2021 9058 TOLAS BROTHERS INC MT PLEASANT 2500086A 1,042 1/19/2021 9402 0.95 ARK BUILDERS LLC MULLIKEN 6105254A 800 1/23/2021 5645 COTTONWOOD SPRINGS FARM LLC MUNCIE, IN 4282566A 1,540 3/3/2021 0129 0.95 COUNTRY ROAD KENNELS MUNGER 3824870A 630 3/2/2021 8831 HALF PINT PUB LLC MUNISING 5495253A 435 1/1/2021 9058 MUNISING VISITORS BUREAU MUNISING 5500982A 273 1/9/2021 8810 PICTURED ROCKS CRUISES INC MUNISING 1637010A 4,147 1/1/2021 8017 0.92 TIMBERLAND FORESTERY SERVICES INC MUNISING 2332361A 700 1/7/2021 0005 MUSICO PETE MUNITH 6128831A 750 3/1/2021 5022 MUSICO PETE MUNITH 6128831A 750 3/1/2021 9015 A 1 GUTTER CO LLC MUSKEGON 4521790A 1,012 3/9/2021 5538 0.95 BAKER MARINE SERVICE LLC MUSKEGON 5537878A 1,521 3/29/2021 6834 CHOICE PROPERTY MANAGEMENT SOLUTIONS MUSKEGON 5806364A 4,888 1/9/2021 9015 0.95 LLC COMPETITION CRANE INC MUSKEGON 5817145A 1,272 1/27/2021 3724 CREATURE COMFORTS GROOMING LLC MUSKEGON 6094490A 391 1/12/2021 8831 DERBY SALES LLC MUSKEGON 0457302A 515 1/25/2021 8387 KAREN CAMPBELL MEDIA INC MUSKEGON 5644275A 280 1/30/2021 8810 KRIESELS SANITATION INC MUSKEGON 3910113A 3,168 1/21/2021 7213 0.95 LKK INC MUSKEGON 2908905A 2,264 1/27/2021 9058 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MANA SPORTS LLC MUSKEGON 6130704A 568 3/4/2021 8810 MUSKEGON R & M TRANSPORT LLC MUSKEGON 4192850A 6,365 2/22/2021 7208 0.93 NORTH POLE ICE CREAM LLC MUSKEGON 2152355A 384 1/1/2021 9058 PIGEON KEY MARINA CONDOMINIUM MUSKEGON 3196968A 582 3/1/2021 6836 ASSOCIATION PJW EMPLOYEE LEASING MUSKEGON 3262600A 780 1/1/2021 8395 POSTMA ZACHARY MUSKEGON 5947863A 750 1/1/2021 5348 RCB PROJECTS LLC MUSKEGON 0059196A 238 3/6/2021 8601 0.87 RUITER HEATING AND COOLING LLC MUSKEGON 3516288A 674 1/14/2021 5550 SECURITY STEELCRAFT CORPORATION MUSKEGON 0412724A 733 3/3/2021 3076 0.95 TJH CONSTRUCTION MUSKEGON 6138098A 1,604 3/23/2021 7600 TODD VIERECK CONSTRUCTION LLC MUSKEGON 0846988A 825 2/13/2021 5437 USS SILVERSIDES SUBMARINE MUSEUM MUSKEGON 0017086A 4,233 3/1/2021 9101 0.95 WEST MICHIGAN HARDWOOD FLOORS LLC MUSKEGON 3882098A 750 1/17/2021 5437 WOLF LAKE APARTMENTS & RESORT INC MUSKEGON 4993330A 568 2/21/2021 9015 CRITTER CATCHERS INC NAPLES, FL 4190785A 7,853 3/9/2021 8831 1.37 13 % SHOTWELL LYNNE W NAPLES, FL 0604690A 927 3/9/2021 0912 0.95 JACKSON PIZZA TIME LLC NAPOLEON 4402103A 1,700 1/28/2021 9058 0.95 DRIFTWOOD FLOORING LLC NASHVILLE 6134793A 750 3/12/2021 5437 ANDREWS COMPLETE HOME REMODELING LLC NEW BALTIMORE 6107907A 750 1/25/2021 5551 BAYSIDE EQUESTRIAN CENTER LLC NEW BALTIMORE 5067430A 8,958 1/2/2021 8279 1.46 40 % CLOVER APARTMENTS NEW BALTIMORE 5658144A 1,440 1/11/2021 9015 0.95 COUNTRY CLUB LAWN LLC NEW BALTIMORE 5398703A 561 1/1/2021 9102 FAMILY MATTERS 2 INC NEW BALTIMORE 6094171A 1,089 1/8/2021 8835 GRAVELLE AND CO FINANCIAL NEW BALTIMORE 3135977A 301 2/26/2021 8810 HOME MEDIX LLC NEW BALTIMORE 2753170A 800 2/20/2021 5645 INSTALLATIONS SPECIALIST LLC NEW BALTIMORE 5384621A 590 3/11/2021 9521 JOHNS MECHANICAL NEW BALTIMORE 5956129A 782 1/22/2021 5550 LOYALTY CONTRACTING LLC NEW BALTIMORE 5381185A 2,435 3/5/2021 5645 0.95 R RAMBO TREE SERVICE & LANDSCAPING INC NEW BALTIMORE 0189740A 801 1/15/2021 8810 RAPID INTERIORS INC NEW BALTIMORE 4725778A 750 3/9/2021 5445 SUMMIT RETAIL SOLUTIONS INC NEW BEDFORD, MA 5731356A 2,843 3/21/2021 8017 1.00 ALL THAT CONSTRUCTION LLC NEW BOSTON 5349877A 800 1/16/2021 5551 CEZAR MARBLE & GRANITE LLC NEW BOSTON 6137547A 750 3/20/2021 5348 DORUS CONSTRUCTION LLC NEW BOSTON 6098959A 750 1/15/2021 5437

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge H AND A 1 TOWING INC NEW BOSTON 3647501A 2,391 3/5/2021 7208 JOEL CARS EXHIBITION NEW BOSTON 4440340A 612 1/29/2021 8395 MCCONNELL PAINTING NEW BOSTON 3817105A 750 1/5/2021 5476 TINAS PAINT JOB NEW BOSTON 2992868A 750 3/16/2021 5476 DONKERSLOOT AND SONS MARINE NEW BUFFALO 1864882A 4,229 1/9/2021 5606 0.92 DEVELOPMENT CO MANNA ENTERPRISE INC NEW BUFFALO 4573722A 2,815 1/1/2021 9058 0.95 PUSKUNIGIS BENEDIKTAS NEW BUFFALO 6110355A 825 1/31/2021 5645 LAKES EDGE SEAWALLS LLC NEW ERA 6134785A 1,806 3/12/2021 6217 MALDA LAWN CARE NEW ERA 4356349A 709 3/2/2021 0042 0.95 EQUINOX TRANSPORTATION INC NEW HUDSON 2636727A 750 2/19/2021 7208 GREAT LAKES HOME AND REMODELING LLC NEW HUDSON 5612454A 5,976 1/1/2021 5445 0.93 J L TILE & STONE LLC NEW HUDSON 5834716A 751 3/3/2021 5348 ADAPTIVE TECHNOLOGY SOLUTIONS LLC NEW LOTHROP 5823820A 978 2/13/2021 5191 MCALLISTER DRYWALL NEW LOTHROP 1898914A 800 1/1/2021 5445 PREMIER PRE OWNED AUTO GROUP LLC NEW LOTHROP 6135820A 472 3/16/2021 8748 HERMAN KIEFER DEVELOPMENT LLC NEW YORK, NY 5826934A 266 2/16/2021 8810 LIONPOINT GROUP LLC NEW YORK, NY 6142028A 448 3/27/2021 8601 SOUTHFIELD GALLERIA OWNER LLC NEW YORK, NY 5915228A 618 2/10/2021 8742 BRADS CUSTOM COVERS LLC NEWAYGO 6112412A 468 2/2/2021 9522 PREFERRED MASONRY NEWAYGO 5976103A 800 3/15/2021 5022 ROBBINS MECHANICAL SERVICES LLC NEWAYGO 5966388A 1,329 2/8/2021 5550 SOSTENES SOFIO NEWAYGO 4013360A 750 3/20/2021 5551 SWINEHART PHYSICAL THERAPY INC NEWAYGO 5362008A 1,507 1/17/2021 8835 0.95 YENTZ CONSTRUCTION NEWAYGO 6136281A 750 3/17/2021 5645 JOHNSON TAX AND ACCOUNTING LLC NEWBERRY 5192560A 216 1/20/2021 8810 JORDANS SHUTTLE SERVICE LLC NEWBERRY 5974470A 711 3/9/2021 7212 PETER K ANDERSON & SONS EXCAVATING INC NEWBERRY 0644137A 1,123 1/1/2021 6217 0.95 RIFE JERRY L II NEWBERRY 5068088A 698 1/1/2021 3365 SANDERS PAINTING NEWBERRY 5373751A 750 2/19/2021 5476 KAWADRI AND COMPANY LLC NEWPORT 4058798A 568 1/29/2021 9015 M AND W FORKLIFT REPAIR LLC NEWPORT 4966058A 1,358 1/11/2021 3724 0.95 SOCHA JASON NEWPORT 5970490A 750 2/26/2021 5645 WIGGINS DEVELOPMENT GROUP INC NEWPORT 4737652A 857 1/20/2021 5221 0.95 LHK PARTNERS INC NEWTOWN SQUARE, PA 3581870A 471 1/1/2021 8742

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CODY VANGINKEL LOGGING NIAGARA, WI 6130615A 3,058 3/4/2021 2709 AWESOME ANIMAL CONTROL INC NILES 5834341A 720 3/13/2021 8831 COMPLETE POOLS AND CONSTRUCTION NILES 5335612A 952 3/15/2021 5223 ENVISION AUTOMATION LLC NILES 6024246A 5,506 2/27/2021 3724 KACHUR TREE SERVICE LLC NILES 1764276A 22,715 3/17/2021 0106 1.00 PAYNES SERVICES LLC NILES 5064708A 5,121 1/14/2021 0106 0.95 REPELLEX USA INC NILES 5344379A 696 2/26/2021 4828 0.95 SCARE INC NILES 2712040A 5,050 1/8/2021 9015 0.95 TYS AUTOMOTIVE LLC NILES 5837960A 838 3/12/2021 8393 VERSATILE ENTERPRISES LLC NILES 5733596A 2,670 1/4/2021 5348 0.95 AGCO INC NORCROSS, GA 6136494A 2,689 3/18/2021 4036 ADVANCED DRIVER TRAINING SERVICES INC NORRISTOWN, PA 5969760A 263 2/23/2021 8868 STOLL AND GARRETT BUILDERS NORTH ADAMS 3150801A 1,207 3/24/2021 5645 0.88 B RAD CONSTRUCTION NORTH BRANCH 4866142A 750 1/17/2021 5445 DC ROOFING AND CONSTRUCTION LLC NORTH BRANCH 5818222A 800 2/1/2021 5551 DOHERTY HARDWOODS LLC NORTH BRANCH 5516285A 750 2/23/2021 2702 INDUSTRIAL TRADE SOLUTIONS LLC NORTH BRANCH 5409888A 54,952 2/1/2021 3724 0.78 K AND K CARPENTRY NORTH BRANCH 6135404A 1,300 3/13/2021 5645 M F S TRANSPORT LLC NORTH BRANCH 3234959A 6,766 3/15/2021 7208 0.89 STRATTON HOME IMPROVEMENT & REPAIR LLC NORTH BRANCH 3082440A 752 1/30/2021 8810 BARTHEL CONTRACTING COMPANY NORTHVILLE 0294977A 1,134 1/31/2021 5606 BLAKE ANTHONY LAWN CARE LLC NORTHVILLE 6130720A 4,490 3/4/2021 9102 BLATT SHARON NORTHVILLE 5367492A 530 1/29/2021 0913 BOULAND INC NORTHVILLE 4464010A 5,893 1/1/2021 5476 1.31 13 % BRIARSTONE BUILDING INC NORTHVILLE 2806541A 750 2/19/2021 0042 C J SYSTEMS INC NORTHVILLE 1372092A 313 3/24/2021 8803 CERVI INVESTMENTS LLC NORTHVILLE 5043190B 800 3/5/2021 5645 COLVIN SERVICES INC NORTHVILLE 2296020A 800 3/20/2021 5022 0.95 CRAMPTON SCHOENBORN CORP NORTHVILLE 2331063A 800 1/4/2021 5645 ELECTRIC SOURCE INC NORTHVILLE 0718025A 520 3/2/2021 5190 EPIPHANY KITCHENS LLC NORTHVILLE 4972589A 774 3/21/2021 9015 0.95 G AND M CONSTRUCTION CO INC NORTHVILLE 3267903A 800 2/22/2021 5022 0.95 IHUMAN LLC NORTHVILLE 5647746A 85,515 2/13/2021 6319 1.69 27 % IMPERIAL TILE & STONE INC NORTHVILLE 5241812A 894 3/22/2021 5348 KEHRES DIETRICH CHERYL A NORTHVILLE 5688825A 1,297 3/9/2021 0913 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 100 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge KRI NORTHVILLE 1107194A 750 1/20/2021 5645 0.95 LA CHANCE BROTHERS EXCAVATING LLC NORTHVILLE 0054003A 814 1/30/2021 6217 LAURAN ARABIANS LLC NORTHVILLE 5643953A 993 1/10/2021 8279 LEGAL MANDY NORTHVILLE 5666465A 530 2/3/2021 0913 M AND R FLOOR COVERING INC NORTHVILLE 0251534A 626 1/3/2021 9521 0.95 MADUSON EAGLE HOMES INC NORTHVILLE 3257088A 4,294 2/24/2021 9053 0.90 NEW HORIZON PAINTING AND WALLPAPERING NORTHVILLE 0854972A 1,970 2/4/2021 5476 0.95 NEWPORT CREEK NEW HOMES LLC NORTHVILLE 5374294A 750 2/18/2021 5645 NORTHVILLE MOTOR GROUP LLC NORTHVILLE 5728126A 262 1/3/2021 8748 PARACLETE RENTAL LLC NORTHVILLE 5131804A 2,622 2/8/2021 9015 0.95 REHABPOINTE LLC NORTHVILLE 5664705A 500 3/22/2021 8832 REX SPECIALTIES INC NORTHVILLE 1376055A 804 2/6/2021 8810 0.95 SMITH CHEMICAL & WAX OF SAVANNAH INC NORTHVILLE 3906884A 1,194 3/30/2021 9015 SOFT TOUCH AUTO WASH NORTHVILLE 1623303A 566 1/1/2021 8387 0.95 STAR TRANSPORTATION INC NORTHVILLE 2156083A 313 3/22/2021 8810 TRUVIAND CORPORATION NORTHVILLE 5520339A 1,243 2/24/2021 9521 0.95 SHIELDS EDWARD NORTON SHORES 5728142A 580 2/5/2021 0913 NORTH ALERT EMS AMBULANCE AUTHORITY NORWAY 3893880A 2,089 3/15/2021 7380 0.95 BLUE STAR PAINTING LLC NOVI 5754720A 750 3/20/2021 5476 BOSANDCO BUILDING SOLUTIONS CORP NOVI 6131980A 825 3/17/2021 5606 CARPET WORKROOM INC NOVI 2179890A 4,518 1/1/2021 8018 0.95 CDH GROUP LLC NOVI 5965314A 304 2/6/2021 8742 CHIMNEY HILL OF WEST BLOOMFIELD NOVI 3988937A 568 2/20/2021 9015 ASSOCIATION CLINE JASON NOVI 5239265A 530 2/13/2021 0908 COBBLESTONE RIDGE ESTATES HOMEOWNERS NOVI 6111483A 568 2/10/2021 9015 ASSOCIATION COBBLESTONE RIDGE MANOR CONDOMINIUM NOVI 5957818A 568 1/22/2021 9015 ASSOCIATION DESCO PROPERTIES LLC NOVI 4961609A 805 3/2/2021 5606 FENIX AMMUNITION LLC NOVI 5694515A 2,041 3/23/2021 3628 0.95 FIVE STAR RESIDENTIAL INC NOVI 5679680A 1,595 3/13/2021 9053 0.95 FOREST PARK CONDOMINIUM ASSOCIATION NOVI 4243544A 568 2/10/2021 9015 INFINEIGHTY INC NOVI 5824940A 691 2/14/2021 4351 JOHN C LASKO MEMORIAL REAL ESTATE LLC NOVI 5446945A 568 3/26/2021 9015 KLING MURRAY & MINNA NOVI 6128696A 489 3/13/2021 0908 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 101 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge LEONELLI LAND COMPANY LLC NOVI 0205710A 644 1/21/2021 9015 0.95 LIFESTYLE HOME BUILDING LLC NOVI 5523192A 750 1/3/2021 5437 0.95 MARATHON COMMERCIAL CLEANING LLC NOVI 6131220A 569 3/5/2021 9015 MICHIGAN JAGUARS FC HOLDING INC NOVI 5806526A 49,225 2/8/2021 9015 0.71 MICHIGAN ROOFING COMPANY LLC NOVI 6137768A 750 3/23/2021 5551 MIRAGE DEVELOPMENT LLC NOVI 1734270A 5,773 1/26/2021 5645 0.93 NOVI UNITED METHODIST CHURCH NOVI 1317555A 649 1/15/2021 8868 OAKWAYNE REAL ESTATE & INVESTMENT LLC NOVI 5831865A 269 3/26/2021 8810 PREZIGN SOLUTIONS INC NOVI 5044359A 985 3/6/2021 8601 0.95 R AND B MAINTENANCE NOVI 2225239A 568 3/21/2021 9015 RAMBLEWOOD FOREST ESTATES ASSOCIATION NOVI 2624257A 618 2/10/2021 9015 RIGHT WAY JANITORIAL SERVICE LLC NOVI 0516430A 618 1/25/2021 9015 ROMA PAINTING NOVI 1631020A 750 1/18/2021 5476 0.95 ROTARY CLUB OF NOVI FOUNDATION INC NOVI 5952590A 334 1/16/2021 9058 SBGM LLC NOVI 6132065A 313 3/6/2021 8601 SEIPPEL AIR INNOVATIONS INC NOVI 4112598A 768 3/22/2021 9015 0.95 SITE LAYOUT INC NOVI 4866770B 814 2/22/2021 6217 0.95 SUSAN L ELKOURI PC NOVI 3151328A 236 3/30/2021 8820 TASMIN DEVCO LLC NOVI 3215229A 618 2/27/2021 9015 TECHHUB LLC NOVI 5677750A 376 1/15/2021 5191 VANDERHAEGHEN AFC LLC NOVI 4734513A 472 3/9/2021 9053 VARTANIAN STEPHEN AND REBECCA NOVI 5073839A 530 1/23/2021 0913 VANWIK CONSTRUCTION LLC NUNICA 3496058A 750 1/31/2021 5403 AFFORDABLE ABATEMENT AND INSPECTIONS OAK PARK 4714768A 4,783 2/8/2021 5479 0.92 LLC D A CENTRAL INC OAK PARK 1517473A 311 1/1/2021 5191 0.85 HENDERSON TOWING LLC OAK PARK 1769111A 750 2/12/2021 8395 KEVIN KEYS CONSTRUCTION LLC OAK PARK 2933349A 1,093 1/22/2021 5437 0.95 MAPLE HOME HEALTH CARE INC OAK PARK 5160065A 6,015 2/9/2021 8835 0.90 TH RELIABLE SERVICES LLC OAK PARK 5529182A 750 1/27/2021 5403 SUPERIOR DESIGNS INC OAKLAND 1486950A 17,350 1/1/2021 5022 0.83 PETROLEUM CONSTRUCTION CONSTRUCTION OAKLAND PARK, FL 5914299A 1,774 3/13/2021 3724 LLC CROSSTOWN WIRELESS LLC OAKLAND TWP 4702417A 750 1/1/2021 7600 D AND M LLC OAKLAND TWP 5237610A 481 2/24/2021 9063

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DIMARIA HOMES & ASSOCIATES INC OAKLAND TWP 1888544A 754 2/4/2021 8810 0.95 NETOS DRYWALL & PLASTER LLC OAKLAND TWP 3912418A 750 2/28/2021 5445 SJOBERG ALAN OAKLEY 2349078A 750 1/11/2021 2702 THEILE TIMBER MANAGEMENT OAKLEY 4084586A 750 2/8/2021 2702 KASZUBOWSKI LOGGING LLC OCQUEOC 2475251A 750 1/25/2021 2702 BLUE MITTEN FARMS LLC OKEMOS 6136630A 2,017 3/23/2021 0035 COOK ALICE OKEMOS 6102930A 521 2/18/2021 0908 ESQUIRE DEVELOPMENT & CONSTRUCTION INC OKEMOS 1010832A 750 3/16/2021 9015 FIELDSTONE MEADOWS LLC OKEMOS 5964059A 784 2/5/2021 8279 MYLES CONSTRUCTION OKEMOS 5511437A 750 2/26/2021 5645 NORTH AMERICAN DRILLING COMPANY LLC OKEMOS 6108008A 3,017 1/27/2021 6216 SAFE HAVEN ASSISTED LIVING LLC OKEMOS 5313910A 4,249 2/15/2021 9053 0.91 TOGA HOLDINGS OC INC OLIVET 5118131A 2,058 3/22/2021 9058 0.95 PRITCHARD AND SONS OMER 6132731A 618 3/7/2021 9015 C AND M MASONRY ONAWAY 3053091A 2,772 3/7/2021 5221 0.95 JLS AND CKS PROPERTIES LLC ONAWAY 6087701A 1,162 1/1/2021 0129 MICHAEL LEWIS DEMAESTRI FOREST PRODUCTS ONAWAY 0254720A 750 3/3/2021 2702 RED OAK GUNSMITHING LTD ONAWAY 5228484A 480 3/5/2021 3628 WATSON FOREST PRODUCTS LLC ONAWAY 0815594A 751 1/25/2021 2702 GENESIS PROCESS SOLUTIONS LLC ONSTED 5137543A 585 1/17/2021 5606 0.95 GUDAKUNST TRUCKING LLC ONSTED 4579445A 800 2/7/2021 7208 JODIE RANDOLPH DANCE ONSTED 6119174A 800 2/14/2021 9154 ROOT BUILDERS LLC ONSTED 4446712A 751 2/28/2021 8810 VILLAGE OF ONSTED ONSTED 0245712A 4,092 2/28/2021 7580 0.98 FAISON SAMUEL ONTONAGON 6096719A 605 1/13/2021 0913 HARRIS LYNELL ONTONAGON 6116892A 605 2/12/2021 0913 HOLMSTROM TRUCK & EQUIPMENT REPAIR ONTONAGON 4080718A 1,194 3/2/2021 8387 0.95 HULL GLORIA ONTONAGON 6143121A 605 3/28/2021 0913 RED METAL EXPLORATIONS INC ONTONAGON 2388782A 1,132 3/10/2021 3383 0.95 SHELTON DORIS ONTONAGON 5751365A 605 1/11/2021 0913 CAMELOT HOMES INC ORCHARD LAKE 0244880A 750 1/11/2021 5437 EVANGELICAL HOME LLC ORCHARD LAKE 5524318A 3,843 1/15/2021 8835 1.44 13 % RED CARPET CAPITAL INC ORCHARD LAKE 3455351A 765 3/8/2021 5437 UNITED CUSTOM PAINTING LLC ORCHARD LAKE 4977793A 750 3/22/2021 5476 WINE GARY ORCHARD LAKE 1326783A 637 3/10/2021 0908 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 103 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge J S YARNALL & SONS HOME IMPROVEMENT ORION 2507307A 926 2/25/2021 5348 0.95 PACHECO POULTRY SERVICES LLC ORLEANS 6124593A 10,914 2/22/2021 0034 ACA HARDWOOD FLOORS ORTONVILLE 4367812A 4,799 3/18/2021 5437 0.95 D AND S TREE & LANDSCAPE SERVICES OF ORTONVILLE 3334821A 2,476 3/23/2021 0042 0.95 MICHIGAN INC D TIPPETT EXCAVATING LLC ORTONVILLE 2751348A 1,400 2/21/2021 6217 0.95 JPL CLEANING LLC ORTONVILLE 6137016A 618 3/19/2021 9015 LENTINI AVIATION INC ORTONVILLE 1560859A 2,179 1/6/2021 7422 0.95 MORELLI ASSOCIATES INC ORTONVILLE 4442849A 369 2/20/2021 8810 NICHOLS ELECTRIC INC ORTONVILLE 2101203A 526 3/14/2021 5190 TLK INSPECTIONS INC ORTONVILLE 4179200A 561 2/10/2021 5183 DENNIS W MOLLARD DDS OSCODA 4767055A 231 1/12/2021 8832 EASTERN NATIONAL FORESTS INTERPRETIVE OSCODA 1555693A 297 1/4/2021 8810 ASSOCIATION JENT ELECTRICAL CONSULTING AND OSCODA 5954371A 1,927 2/18/2021 5190 CONTRACTING INC JML INSTALLS LLC OSCODA 5377277A 825 3/1/2021 5437 PFC FARM SERVICES INC OSSEO 5954681A 581 1/29/2021 0011 A S I IMPROVEMENT COMPANY OTISVILLE 1679996A 750 3/5/2021 5551 B AND G MASONRY LLC OTISVILLE 5624932A 750 1/10/2021 5022 0.95 EGAN DEVON OTISVILLE 6088155A 825 1/3/2021 5551 FREELAND BRIAN OTISVILLE 3997600A 750 2/22/2021 5645 JOES MASONRY LLC OTISVILLE 2956055A 1,944 1/4/2021 5022 0.95 BLANCHARD DRYWALL LLC OTSEGO 5578493A 3,238 1/7/2021 5445 BURR GREG OTSEGO 5736366A 750 2/28/2021 5437 GABE REX TREE SERVICE LLC OTSEGO 5970970A 801 2/28/2021 0106 INVIZION GROUP LLC OTSEGO 3183149A 300 3/4/2021 9063 KURT COLE CONSTRUCTION OTSEGO 5365201A 750 1/23/2021 5022 SCOTT KEYZER ROOFING LLC OTSEGO 5975999A 27,132 3/15/2021 5551 L E UNITED LLC OTTAWA LAKE 4323858A 1,374 3/24/2021 9058 0.95 DCV INC OTTER LAKE 6088805A 1,009 1/1/2021 8387 PLUMBING UNLIMITED INC OTTER LAKE 3334848A 561 3/10/2021 5183 BILLS HEATING & COOLING INC OVID 3387305A 675 2/28/2021 5550 BOWEN AND SONS RESIDENTIAL BUILDERS INC OWOSSO 3276333A 3,931 3/1/2021 5645 0.95 BRUCKMANS MOVING AND TRUCKING OWOSSO 0740802A 3,386 1/5/2021 7214 0.95 CARLTON TREE SERVICE OWOSSO 3333469A 3,264 3/27/2021 0106 0.95 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 104 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CARPENTRY BY NATE LLC OWOSSO 5586283A 2,706 3/4/2021 5437 0.95 CARTER BROTHERS CONSTRUCTION LLC OWOSSO 5914868A 2,420 1/15/2021 5437 FROMM FARMS TRUCKING LLC OWOSSO 5705347A 2,939 1/4/2021 7208 GAFFNER TOWING & RECOVERY LLC OWOSSO 5953669A 801 1/16/2021 7208 J AND S INSTALLATION CO OWOSSO 6137318A 637 3/21/2021 9521 LENON ELECTRIC LLC OWOSSO 3620379A 470 3/1/2021 5190 LEPLEY SONS AND TOWING OWOSSO 5970792A 750 3/9/2021 7208 MSS BOH INC OWOSSO 4805801A 616 2/1/2021 9058 NORTHWOOD MOBILE HOMES ESTATES INC OWOSSO 3509125A 13,109 2/1/2021 6217 1.39 13 % OSHUST JON AUSTIN OWOSSO 6100937A 750 1/17/2021 5445 WEGMAN ENTERPRISES LLC OWOSSO 5357128A 566 1/6/2021 8387 WEINERTS TREE SERVICE OWOSSO 5696801A 14,254 3/30/2021 0106 0.86 ALVAREZ MASONRY OXFORD 5788374A 750 1/12/2021 5022 B AND B TOOL INC OXFORD 5843863A 2,691 3/20/2021 3629 0.95 C THREE COMMUNICATIONS INC OXFORD 3393496A 5,129 2/1/2021 7600 0.92 CARE ADULT DAYCARE INC OXFORD 4865006A 1,236 3/27/2021 9053 0.95 COMPLETE PROJECT MANAGEMENT LLC OXFORD 5538068A 388 3/29/2021 5606 CURTIS PLUMBING OXFORD 5356563A 561 1/10/2021 5183 DANIELS LAWN & TREE SERVICE OXFORD 4805747A 750 3/23/2021 7380 DONS LIL JOHNS LLC OXFORD 4127978A 3,316 3/12/2021 9402 1.05 ESBA ENGINEERING CORP OXFORD 2209551A 1,175 3/10/2021 8601 GENESIS BUILDING & DEVELOPMENT INC OXFORD 3435520A 750 1/10/2021 5022 0.95 GREAT LAKES AIRCRAFT DETAILING INC OXFORD 3737861A 1,049 1/28/2021 7423 0.95 KENNEDY SURVEYING INC OXFORD 0911372A 740 2/10/2021 8601 1.00 OXFORD OAKS CONDOMINIUM ASSOCIATION OXFORD 3411729A 630 2/12/2021 9015 RAVEN ENGINEERING INC OXFORD 2831716A 4,677 3/31/2021 5191 0.91 SKY ADVENTURES INC OXFORD 2523027A 429 1/18/2021 7422 SUREGUARD CONSTRUCTION COMPANY INC OXFORD 2435403A 2,077 1/5/2021 5645 0.95 T AND F CONSTRUCTION INC OXFORD 0037311A 750 1/11/2021 5645 WESCO CONSULTING SERVICES INC OXFORD 0433020A 570 2/22/2021 8810 ROTH JANET J PALM BEACH GARDENS, 1388711A 357 1/8/2021 0908 FL C SLAGTER CONSTRUCTION INC PALM CITY, FL 4066340A 321 2/4/2021 8810 0.95 JM HARROP REMODELING AND CONSTRUCTION PALMS 2063743A 750 2/27/2021 5476 LLC

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge JEFF WHITED TRUCKING LLC PALMYRA 6112552A 800 2/1/2021 7208 DIAMOND SECURITY SERVICES LLC PARCHMENT 5958601A 1,000 1/24/2021 7720 COLES CONSTRUCTION PARIS, KY 6113397A 750 2/5/2021 5645 DL DUSENDANG CONSTRUCTION INC PARIS 3442233A 750 1/19/2021 5437 HERGOTT MICHAEL PARIS 4783158A 748 1/10/2021 3365 WEST COAST HOMES INC PARMA 0693723A 758 1/4/2021 5645 WILLIAMS SEAL COATING LLC PARMA 6133878A 1,986 3/10/2021 5221 ADVANCED ADULT FOSTER CARE INC PAW PAW 5952859A 2,814 2/16/2021 9053 CJN CARPENTRY LLC PAW PAW 5539943A 800 1/19/2021 5645 COMMUNITY EMERGENCY RESPONSE TEAM PAW PAW 4312155A 761 2/6/2021 7704 LITTLE BLESSINGS CHILD CARE PAW PAW 5966841A 420 2/13/2021 8869 MAPLE LAKE BUILDERS LLC PAW PAW 0009598A 4,444 1/10/2021 5403 0.95 ELK TOWNSHIP SANILAC COUNTY PECK 0933406A 1,098 1/5/2021 9410 0.95 JOHNSTONS MEATS LLC PECK 0246794A 5,785 2/4/2021 8031 1.33 13 % WMG INC PEEKSKILL, NY 4202562A 586 3/11/2021 8601 KOSTAMO LOGGING PELKIE 0430323A 750 1/24/2021 2702 YODER GALEN PELKIE 6099041A 750 1/15/2021 2702 RANCH PRODUCTION LLC PENTWATER 2646838A 1,839 2/9/2021 1320 0.95 HOGLE TRUCKLINES INC PERRINTON 1682962A 765 3/16/2021 8810 0.95 BRAD ANDERSON TRUCKING PERRONVILLE 3154602A 34,543 3/12/2021 7208 0.75 E AND C ENTERPRISES LLC PERRONVILLE 5496071A 750 2/15/2021 7208 FENNECKEN CUSTOM INTERIORS LLC PERRY 6114393A 750 2/7/2021 5445 CL ENTERPRISES LLC PERU, IL 5973350A 2,597 3/6/2021 0128 FLEIG SCOTT PETERSBURG 5462690A 590 1/24/2021 9521 S AND K PLUMBING SOLUTIONS LLC PETERSBURG 5951526A 1,087 1/11/2021 5183 CREATIVE TOUCH PETOSKEY LLC PETOSKEY 4966775A 750 2/28/2021 5348 DAN HAYES MASONRY PETOSKEY 1801945A 6,467 3/24/2021 5022 0.96 EQUITY HOSPITALITY MANAGEMENT COMPANY PETOSKEY 5364698A 761 1/22/2021 7212 JENSENS ANIMAL HOSPITAL PLC PETOSKEY 1154990A 5,050 2/1/2021 8831 0.95 KRECKE PAUL R PETOSKEY 5336740A 581 1/1/2021 9015 KRISTI HAUSLER LLC PETOSKEY 6089143A 553 1/1/2021 9586 LOVE IN THE NAME OF CHRIST OF LITTLE PETOSKEY 5680280A 285 3/21/2021 8742 TRAVERSE BAY MARK AND LESA DELISLE LLC PETOSKEY 4340191A 335 1/28/2021 9063 MICHIGAN YACHT MANAGEMENT PETOSKEY 5556821A 1,472 1/10/2021 6836 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge NORTHERN PAINTING SERVICES INC PETOSKEY 5977118A 5,471 3/19/2021 5476 PAINTING BY STEPHEN YOUNGS INC PETOSKEY 3813614A 750 1/15/2021 5476 0.95 PROFESSIONAL MEDICAL PLACEMENT INC PETOSKEY 0109606A 102,929 1/1/2021 3632 0.76 SECOND GENERATION DRYWALL LLC PETOSKEY 5302943A 750 3/6/2021 5445 SUTFIN CONSTRUCTION PETOSKEY 2056321A 868 2/7/2021 5022 WILLCOMES WOOD PRODUCTS LLC PETOSKEY 5387817A 1,700 3/18/2021 8232 HILL INVESTIGATIONS LLC PICKFORD 6085598A 501 3/4/2021 7720 JPS SERVICES LLC PICKFORD 5767091A 3,846 3/2/2021 5403 0.96 OLSON CONSTRUCTION PIERSON 4300874A 750 1/3/2021 5645 SPOT ON UNDERGROUND INC PIERSON 5709318A 3,856 2/8/2021 6325 0.95 GREAT LAKES SPRAY FOAM AND CELLULOSE LLC PIGEON 6045952A 750 2/28/2021 5479 ANDRONACO JOSEPH P PINCKNEY 5973651A 510 3/22/2021 0912 B AND W TREE SERVICE INC PINCKNEY 5449855A 1,900 2/23/2021 0106 BP ENGINEERING SERVICES INC PINCKNEY 5827116B 301 3/21/2021 5191 CERTUS LLC PINCKNEY 4867793A 238 3/19/2021 8601 COMPLETE OUTDOOR SERVICES INC PINCKNEY 4025547A 710 2/5/2021 9102 CREATIVE SIDING SOLUTION LLC PINCKNEY 2208644A 750 3/20/2021 5645 DOBRACKI WOJCIECH PINCKNEY 6128734A 718 3/3/2021 0909 DRC OF MICHIGAN REALTY LLC PINCKNEY 5949122A 279 1/3/2021 8810 ELECTRICAL CONSULTING SERVICES INC PINCKNEY 3922278A 1,216 1/25/2021 5190 NO LIMIT CONSTRUCTION & REMODELING LLC PINCKNEY 4949340A 2,418 1/10/2021 5645 0.95 OLD WORLD CRAFTSMANSHIP LLC PINCKNEY 4936396A 750 2/8/2021 5551 RUSSELL TREE AND SAWMILL SERVICE PINCKNEY 3717003A 895 2/22/2021 8232 0.95 SUNBURST ELECTRIC INC PINCKNEY 1664816A 470 3/29/2021 5190 VANGORDEN JOE PINCKNEY 5530733A 750 3/18/2021 5645 0.95 VARGAS HOMES PINCKNEY 5545277A 750 2/4/2021 5645 0.94 BRIDGES OF HOPE ALLEGAN COUNTY PLAINWELL 5520886A 215 3/1/2021 8810 CB MARCELLUS METALCASTERS INC PLAINWELL 3391272A 20,817 3/22/2021 3081 1.24 JL CONSTRUCTION PLAINWELL 5814456A 800 1/24/2021 5645 0.92 STEELE CONSTRUCTION LLC PLAINWELL 3916634A 800 3/24/2021 5645 AXTION BUILDERS LLC PLEASANT LAKE 3561348A 9,007 2/13/2021 5403 0.95 DULLY PPM LLC PLEASANT LAKE 4974964A 266 1/23/2021 8810 RAPID SIGN INSTALLS LLC PLEASANT RIDGE 6117430A 4,690 2/14/2021 9558 SQUAWK BOX LLC PLEASANT RIDGE 6112439A 407 2/11/2021 8017 A AND C PROPERTY SERVICES INC PLYMOUTH 5950716A 583 1/9/2021 5606 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 107 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ACCUEDATA SOLUTIONS LLC PLYMOUTH 2489597A 291 3/1/2021 8810 ADVANCED PURCHASING DYNAMICS INC PLYMOUTH 4946308A 2,604 3/2/2021 8742 0.95 AMERICAN CARPET & FLOORS INC PLYMOUTH 2967359A 540 2/26/2021 9521 AMERICAN FURNITURE GROUP INC PLYMOUTH 4015479A 800 1/23/2021 5146 0.95 ARCTIC INSULATION COMPANY OF MICHIGAN PLYMOUTH 3596079A 905 2/12/2021 5479 0.95 BROOKFIELD ESTATES NORTH CONDOMINIUM PLYMOUTH 4738241A 568 3/23/2021 9015 ASSOCIATION COMMERCIAL COATING INC PLYMOUTH 5811317A 711 2/28/2021 9501 CORPORE SANO HOME HEALTH CARE INC PLYMOUTH 5517400A 7,516 2/17/2021 8835 0.87 COUNTRY CLUB VILLAGE OF NORTHVILLE III PLYMOUTH 1184377A 618 3/11/2021 9015 CONDO ASSOC DESNA INC PLYMOUTH 5093686A 3,394 1/7/2021 4511 0.95 DHU VARREN ON THE PARK ASSOCIATION PLYMOUTH 3805506A 618 1/22/2021 9015 EDWIN AND DIANE SCHULZ PLYMOUTH 6092551A 307 1/4/2021 0908 ELITE MARBLE DESIGN INC PLYMOUTH 5652545A 750 2/20/2021 5348 FAIRWAYS AT PHEASANT RUN ASSOCIATION INC PLYMOUTH 3269850A 568 1/14/2021 9015 FIRST RATE CONSTRUCTION LLC PLYMOUTH 5811082A 751 1/18/2021 5645 FZB INDUSTRY INC PLYMOUTH 5815789A 684 2/15/2021 8601 GLOBAL EQUIPMENT & REPAIR SERVICES LLC PLYMOUTH 6138306A 656 3/21/2021 3724 GOLD AND ASSOCIATES PC PLYMOUTH 2013371A 216 2/20/2021 8810 IMPACT BUILDING CO LLC PLYMOUTH 5668212A 800 3/27/2021 5403 INQUE MEDIA LLC PLYMOUTH 5826128A 216 2/15/2021 8810 INTIMATE IDEAS ON GRATIOT LLC PLYMOUTH 5630894B 824 3/4/2021 8017 JOSEPH P SCHUCK LLC PLYMOUTH 5024919A 750 2/2/2021 5645 KEYSTONE HR LLC PLYMOUTH 4416341A 42,810 1/1/2021 9058 0.82 KLUTHE NA INC PLYMOUTH 5648408A 4,421 1/7/2021 4828 0.95 LPM LLC PLYMOUTH 5959888A 800 1/26/2021 5645 MAST ENTERPRISES LLC PLYMOUTH 6086322A 1,611 1/3/2021 8835 MIKE WHELANS TREE SERVICE LLC PLYMOUTH 5511968A 4,406 1/28/2021 0106 0.95 MILE ROAD PROPERTY SERVICE INC PLYMOUTH 5946808A 800 1/28/2021 5403 N E TIME EXPRESS LLC PLYMOUTH 5787980A 750 1/10/2021 7208 PAMA INVESTMENT & CONTRACTING CO INC PLYMOUTH 0030856A 813 2/15/2021 5645 PLANET KABOB LLC PLYMOUTH 3751988A 333 1/5/2021 9058 0.95 PLYMOUTH DOOR INC PLYMOUTH 5084504A 824 3/26/2021 3724 SANDUSKY MOTORS INC PLYMOUTH 4349784A 260 3/28/2021 8748

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SASH MASTERS INC PLYMOUTH 2646110A 750 1/27/2021 5645 SILVIA ON MONROE LLC PLYMOUTH 0935158A 242 2/16/2021 9586 SPECIALTY SHOWER DOOR & GLASS LLC PLYMOUTH 5116198A 750 3/16/2021 5462 ST LAWRENCE ESTATES CONDOMINIUM PLYMOUTH 2078384A 618 3/1/2021 9015 ASSOCIATION STEP BY STEP HEALTH COACH SERVICES LLC PLYMOUTH 5836093A 720 3/7/2021 9063 SUPERB CUSTOM HOMES LLC PLYMOUTH 3918262A 750 1/6/2021 5645 NORTHWOODS TIMBER PRODUCTS INC POINTE AUX PINS 1562991A 1,026 2/14/2021 2731 0.95 A 1 AUTO SALES S7 LLC PONTIAC 4695380A 259 1/21/2021 8748 A GRENNAN COMPANY PONTIAC 3096661A 3,091 3/23/2021 5606 0.95 ARANJO DRYWALL PONTIAC 4253817A 750 2/21/2021 5445 AUTOCLEARS INC PONTIAC 6124550A 623 2/22/2021 3400 BAHENA CONSTRUCTION LLC PONTIAC 2762501A 750 2/25/2021 5645 CARTAGENA LOIDA ESTILLE PONTIAC 6134807A 569 3/12/2021 9015 CORNERSTONE PROPERTIES CO INC PONTIAC 5828147A 3,168 2/17/2021 9015 0.95 FATHER AND SON CLEANING SERVICE LLC PONTIAC 5880220A 568 1/17/2021 9015 GUTIERREZ SANCHEZ CARPENTRY LLC PONTIAC 6100317A 3,032 1/16/2021 9015 H AND R LOPEZ MASONRY CO PONTIAC 3371913A 5,182 3/31/2021 5022 0.94 HPA DRYWALL LLC PONTIAC 5869544A 750 3/6/2021 5445 J JOHNSON BUILDER & STD CONTRACTORS PONTIAC 2056984A 802 3/21/2021 5610 SERVICE GROUP INC LOPEZ CARLOS PONTIAC 6101160A 750 1/17/2021 5445 MEP CONSTRUCTION LLC PONTIAC 5926165A 4,308 1/23/2021 5403 MICHIGAN CRAFTSMAN LLC PONTIAC 5975255A 750 3/12/2021 5645 MULTI SERVICES LLC PONTIAC 5525616A 750 1/11/2021 9015 O JONES CONSTRUCTION LLC PONTIAC 5813565A 1,447 1/23/2021 5221 R C SPOTLESS INC PONTIAC 2825503A 569 2/21/2021 9015 RAMONE MASONRY PONTIAC 3234177A 750 1/25/2021 5022 RIVET TRUCKING LLC PONTIAC 4398254A 935 2/26/2021 7208 SCORPION DRYWALL INNOVATIONS PONTIAC 6132685A 750 3/7/2021 5445 STRONG MASONRY PONTIAC 5977851A 4,268 3/21/2021 5022 THOMPSON MARBLE & TILE CO PONTIAC 2479109A 2,070 3/28/2021 5348 0.95 UBARIO JOSE DE JESUS ROQUE PONTIAC 6128700A 750 2/28/2021 5445 QUESTOVER INC PORT AUSTIN 5503965A 1,877 1/15/2021 9053 0.95 BWROC INC PORT HURON 5962099A 323 2/12/2021 8742

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 109 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DYNAMIC DRAIN SERVICES LLC PORT HURON 4733240A 706 3/29/2021 8810 FOOD MART & FUEL FURRY LLC PORT HURON 6051316A 1,136 3/18/2021 8017 FORTONS EXPRESS INC PORT HURON 5975727A 7,343 2/14/2021 8395 FRIENDS OF THE ST CLAIR RIVER WATERSHED PORT HURON 5656737A 331 1/9/2021 8601 GUNN MACHINE AND TOOL CO PORT HURON 6128653A 581 3/1/2021 3724 LAMSAR INC PORT HURON 3406946A 1,869 3/31/2021 5183 0.95 LOZEN DAVIDSON & KOVAR PC PORT HURON 4359500A 494 3/21/2021 8820 MARITIME BUILDERS INC PORT HURON 5102464A 14,711 3/1/2021 5645 1.39 13 % MODERN TECHNOLOGY MACHINING LLC PORT HURON 5273560A 425 1/16/2021 3629 REASONABLE ROOFING & REMODELING INC PORT HURON 4248384A 10,929 2/12/2021 5551 0.95 TECHNICAL LOADARM INC PORT HURON 2796600A 1,941 1/21/2021 8720 0.95 WALT PERRY LLC PORT HURON 5940710A 750 1/10/2021 5645 WINKLEY BUILDING CONTRACTORS INC PORT SANILAC 1883917A 750 1/1/2021 5645 0.95 ARBOR WOODS HOME HEALTH CARE INC PORTAGE 5646413A 1,919 1/1/2021 8835 0.95 ARNOLD AFC PORTAGE 4816943A 472 1/10/2021 9053 BEK CONSTRUCTION INC PORTAGE 3226514A 750 3/23/2021 5645 BUILDING RENOVATION AND DESIGN LLC PORTAGE 6102042A 2,736 1/18/2021 5437 CHARACTER EXTERIORS LLC PORTAGE 5833957A 750 3/5/2021 5551 DIRKSEN ROOFING INC PORTAGE 3276406A 2,066 1/1/2021 5551 0.95 EDEN HAVEN LLC PORTAGE 4001583A 2,484 3/4/2021 9053 0.95 INNOVATIVE MEDIA GROUP LLC PORTAGE 6126960A 772 2/27/2021 4361 KALAMAZOO DECORATING COMPANY PORTAGE 2489139A 582 2/1/2021 9521 LIVING WATER AFC PORTAGE 5961602A 1,264 1/30/2021 9053 MARY HASKIN DESIGNS LLC PORTAGE 5963443A 215 2/4/2021 8810 MOORSBRIDGE LAW BUILDING LLC PORTAGE 4837312A 281 2/11/2021 8810 ONSTAFF GROUP LLC PORTAGE 4701046A 128,478 1/1/2021 8264 1.63 27 % SEABEN TREE SERVICE LLC PORTAGE 5675863A 8,317 2/28/2021 0106 0.93 ALLEGANY GREENHOUSES INC PORTAGEVILLE, NY 5950791A 4,709 1/9/2021 5462 KURT HINDS BUILDING AND RENOVATION LLC PORTLAND 5263778A 4,166 2/19/2021 5645 0.93 WINDY BROOK COMPANIES INC PORTLAND 5429706A 5,922 1/16/2021 5645 0.95 CROSS D LLC POSEN 5835135A 11,401 3/6/2021 7208 0.94 KRAJNIAK AND SONS FOREST PRODUCTS POSEN 4722140A 750 2/26/2021 2702 ROMEL SERVICES INC POSEN 1410784A 750 3/15/2021 2081 WOLOSZYK ANTHONY POSEN 2574705A 750 2/20/2021 2702 JIMMY ROSE TRUCKING LLC POTTERVILLE 5393450A 800 3/30/2021 7208 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 110 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge RICHS RESIDENTIAL & HOME CARE OPTIONS POTTERVILLE 6128777A 415 2/28/2021 0908 WINDFALL CONSTRUCTION CO POTTERVILLE 5968194A 800 2/16/2021 8810 INTEGRITY MUNICIPAL SYSTEMS LLC POWAY, CA 5093759A 3,133 1/1/2021 4511 0.95 CREATIVE BUSINESS INNOVATIONS LLC POWELL, OH 6112080A 3,777 2/1/2021 8107 DAN CASPERSON TRUCKING POWERS 2930404A 750 2/28/2021 7208 INDEPENDENCE WOODS MHC HOLDINGS LLC PROVO, UT 5085438A 1,266 2/19/2021 9015 0.95 OAKLAND ESTATES MHC HOLDINGS LLC PROVO, UT 5083893A 2,312 2/19/2021 9015 0.95 MARTIN ROBERT PULLMAN 2652250A 750 3/6/2021 5445 GRAVITATIONAL CHURCHES LLC PUYALLUP, WA 5843294A 322 3/20/2021 8868 QUINCY HOUSE ASSISTED LIVING LLC QUINCY 5184363A 4,367 1/4/2021 9053 0.90 ANTHONY P BELLMORE INC QUINNESEC 2295156A 750 1/20/2021 7208 ISEARCHFINANCE LLC RALEIGH, NC 6132030A 380 3/6/2021 8810 TOUCH OF GRAY INTERIORS RAMSAY 6093809A 751 1/13/2021 5476 BOARDMAN VALLEY CARPENTRY LLC RAPID CITY 6101062A 750 1/17/2021 5645 MARTINDALE QUALITY LINERS LLC RAPID CITY 4677897A 825 1/14/2021 6216 0.95 RAPID DELIVERY LLC RAPID RIVER 5528917A 1,756 2/1/2021 7208 0.95 HARVEST CONSTRUCTION LLC RAVENNA 3867668A 967 3/26/2021 5645 0.95 WILKERSON AND SON EXCAVATING LLC RAVENNA 5899621A 3,091 1/1/2021 6217 CTM FLOORING RESTORATION INC RAY 4538889A 750 1/1/2021 5348 GRADER FARMS INC RAY 2674130A 750 1/3/2021 7208 RUDICH FARMS INC RAY 0344419A 9,874 1/1/2021 0011 0.83 ANTONELLI POOLS LLC RAY TWP 6136460A 800 3/18/2021 5223 D FENCE LLC RAY TWP 3904164A 750 1/11/2021 5645 EURO STONE & CONCRETE LLC RAY TWP 4967305A 750 3/1/2021 5221 GREAT LAKES WELDING LLC RAY TWP 4181840A 826 1/1/2021 8810 0.95 K J ELECTRIC LLC RAY TWP 5665728A 985 1/26/2021 5190 NEW BALTIMORE PROPERTY MANAGEMENT LLC RAY TWP 6088813A 825 1/8/2021 5645 ALPINE BUILDING & DEVELOPMENT CORP REDFORD 2864088A 561 3/6/2021 5183 ANDERER RICHARD REDFORD 4012194A 583 1/20/2021 9015 ANDERS INSURANCE AGENCY INC REDFORD 5118719A 265 3/19/2021 8810 B SMITH CONSTRUCTION REDFORD 1566121A 2,446 2/21/2021 5645 0.95 BEARDEN JAMES II REDFORD 5665167A 414 1/24/2021 0908 BERLINGIERI GEORDI REDFORD 5179297A 414 1/30/2021 0908 BREECH KELVIN SR REDFORD 5976928A 530 3/19/2021 0913 CHRISTAL INC REDFORD 0844829A 442 3/11/2021 8017 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 111 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge COLTER AMANDA REDFORD 6135960A 530 3/14/2021 0913 DANIEL DEVIN REDFORD 5752787A 530 3/11/2021 0913 DAY 1 TOWING LLC REDFORD 6124615A 2,574 2/22/2021 7208 DOBSON MELISSA REDFORD 5665035A 328 1/24/2021 0908 FORTE CONTRACTING INC REDFORD 5945003A 752 1/5/2021 8810 FUNCHES DONNY REDFORD 6135781A 530 3/14/2021 0913 FUNCHES SHERICKA REDFORD 6135862A 530 3/14/2021 0913 IMPERIAL CARE SERVICES LLC REDFORD 4282400A 2,370 1/14/2021 8835 INNER CITY TREE SERVICE INC REDFORD 3228517A 2,465 1/30/2021 0106 INTEGRITY PROPERTY MAINTENANCE LLC REDFORD 6090265A 800 1/1/2021 5403 ISAACS AMY REDFORD 5480795A 414 1/12/2021 0908 JOHNSON IVORY REDFORD 6111521A 414 1/30/2021 0908 KEITH MICHAEL REDFORD 5639980A 810 1/12/2021 0908 0.95 KINNELL DEREK REDFORD 6135315A 530 3/14/2021 0913 KLEBBA JAMES REDFORD 4709004A 750 3/21/2021 5437 LOBB JONATHAN REDFORD 6135790A 530 3/14/2021 0913 MARSHALL GREGORY REDFORD 3656241A 307 3/30/2021 0908 MARSHALL LINDA REDFORD 5848229A 307 3/30/2021 0908 MCCOGGLE DASHAWN REDFORD 6111491A 530 1/30/2021 0913 MCGLINCH AND SONS COMPANY REDFORD 0318396A 3,617 2/11/2021 5606 1.56 13 % MICHAEL J MCCARTHY PC REDFORD 1655361A 241 2/27/2021 8810 MOMENTUM INTERIORS LLC REDFORD 5088429A 807 2/8/2021 9521 NEW VISION HOMECARE INC REDFORD 4926714A 856 3/18/2021 8835 0.93 NOSTRAY CONSTRUCTION LLC REDFORD 5546389A 822 1/17/2021 5610 0.95 PASSION FOR PEOPLE LLC REDFORD 5668247A 2,704 1/31/2021 8835 0.95 PERKINS KATIE REDFORD 5953251A 307 1/16/2021 0908 ROSATI MASONRY CO INC REDFORD 0394696A 850 1/29/2021 5022 SOUND PLANNING COMMUNICATIONS INC REDFORD 1091409A 6,223 2/1/2021 5191 1.33 27 % SZLAMKOWICZ ABE REDFORD 5479878A 829 1/12/2021 0908 T WELLS HVAC REDFORD 5365287A 674 1/23/2021 5550 ULTRA GREEN HYDROPONICS INC REDFORD 6182550A 4,469 1/8/2021 8010 0.95 WERDA SONIA REDFORD 6135617A 307 3/14/2021 0908 WOODS ALFONSO JR REDFORD 6111351A 530 1/30/2021 0913 GLOBAL BUILDING MAINTENANCE COMPANY REDFORD TWP 1756184A 16,182 1/1/2021 9015 0.73 RANDOLPH BOURNE INSTITUTE REDWOOD CITY, CA 4440773A 236 2/12/2021 8810 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 112 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CHARLES QUINN INC REED CITY 1921479A 540 2/1/2021 9521 GREAT LAKES EQUIPMENT AND TRUCK SALES REED CITY 4950976A 2,017 1/13/2021 8748 0.95 INC REED CITY FITNESS LLC REED CITY 5202671A 566 3/11/2021 9063 STEIG MOBIL REPAIR SERVICES LLC REED CITY 1938142A 493 1/22/2021 8395 0.95 SCRAPPERS LLC REESE 5786622A 1,042 1/24/2021 8264 DEGELMAN INDUSTRIES USA LTD REGINA, SK 5671442A 408 2/7/2021 8742 INNOVATIVE INSULATION SYSTEMS LLC REMUS 4935381A 751 3/19/2021 5479 CMT INC REPUBLIC 4548906A 330 2/15/2021 9058 SPEAR ENTERPRISES LLC REPUBLIC 5675871A 359 1/15/2021 8010 KRAUSE CONSTRUCTION OF MICHIGAN LLC RICHFIELD, WI 5888980A 750 3/27/2021 5437 BC LAWN MAINTENANCE LLC RICHLAND 5808170A 2,145 1/12/2021 9102 BECKMAN DAVID RICHLAND 5859484A 580 3/3/2021 0913 GRAMPAS PASTYS LLC RICHLAND 5787378A 1,068 2/19/2021 2003 0.95 PREMIER BUILDING & REMODELING INC RICHLAND 0791350A 750 3/26/2021 5645 R AND M ROOFING AND EXTERIORS LLC RICHLAND 5959268A 751 2/19/2021 8810 GARY BERTOSSI BULLDOZING LLC RICHMOND 1328760A 789 3/28/2021 6217 SHERIDAN PLUMBING LLC RICHMOND 5943329A 611 3/26/2021 5183 DORCHAK ADAM J SR RIGA 6134130A 750 3/11/2021 5022 FG CONSTRUCTION RIVER ROUGE 6130640A 750 3/4/2021 5221 JONMAR CONSTRUCTION LLC RIVER ROUGE 4881117A 825 1/29/2021 5645 SUPERIOR WRECKING INC RIVER ROUGE 3467201A 800 2/8/2021 5645 ARGONAF CLEANING LLC RIVERVIEW 5913799A 2,306 1/16/2021 9015 HOMEPRO SERVICES LLC RIVERVIEW 6099238A 750 1/15/2021 5437 LECTRO MECH INC RIVERVIEW 1521810A 594 1/31/2021 3724 SEL SERVICES CORP RIVERVIEW 5717825A 751 2/1/2021 5403 0.95 SHROOG TRUCKING CO RIVERVIEW 6115535A 802 2/10/2021 7208 RIVES TOMPKINS FIRE AND RESCUE RIVES JUNCTION 5374707A 3,931 3/1/2021 7904 0.95 DEPARTMENT ACS ELECTRIC LLC ROCHESTER 4075846A 471 2/2/2021 5190 AJ AND J PIZZA INC ROCHESTER 1621297A 7,348 2/2/2021 9058 1.00 AMERICAN ASSOCIATION OF UNIVERSITY ROCHESTER 0630101A 419 3/28/2021 8810 PROFESSORS OAKLAND UNIVERSITY CHAPTER ATLAS HR CONSULTANTS LLC ROCHESTER 5084024A 19,109 1/29/2021 7208 0.77 AXXO SALES COMPANY INC ROCHESTER 4166299A 365 1/19/2021 8742 BRIGHTMORE PLACE FARM LLC ROCHESTER 3267237A 509 3/3/2021 0909 0.95 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 113 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge DHCM LLC ROCHESTER 5973341A 755 3/6/2021 5606 EPIC OUTDOOR SERVICES LLC ROCHESTER 6123830A 1,959 3/15/2021 9102 GENSLER NEIL PHILIP II ROCHESTER 6096395A 750 1/11/2021 5476 GRAND VIEW CONSTRUCTION INC ROCHESTER 2946050A 811 2/11/2021 5645 0.95 HEMIEDDIE RESTORATIONS LLC ROCHESTER 4716876A 444 2/12/2021 8393 J B L ELECTRICAL CONTRACTORS INC ROCHESTER 3135314A 521 1/27/2021 5190 JAYNES MATT ROCHESTER 5969310A 751 2/25/2021 5476 KNOLLS NORTH CONDOMINIUM ASSOCIATION ROCHESTER 3028461A 568 2/10/2021 9015 KOJTARI ADMIR ROCHESTER 5969395A 751 2/25/2021 5476 MAIN GROUP LLC ROCHESTER 4572408A 455 1/1/2021 8742 MEAD MANAGEMENT LLC ROCHESTER 5234476A 237 1/31/2021 8810 MICHIGAN GRANITE & MARBLE ROCHESTER 5971357A 750 2/28/2021 5437 MOTOR CITY CHAPTER OF THE YOUNG ROCHESTER 3116913A 278 2/16/2021 8810 PRESIDENTS ORGANIZATION INC NOBRIGA RUSSELL ROCHESTER 5969344A 751 2/25/2021 5476 OAKLAND CHEMICAL INC ROCHESTER 5661285A 1,004 1/25/2021 4511 PAINT A MIRACLE ROCHESTER 3689433A 1,187 1/29/2021 9063 RESCUE INTERNATIONAL ROCHESTER 4320476A 309 3/15/2021 8810 0.95 RRD CONSTRUCTION CO ROCHESTER 3293343A 1,234 2/10/2021 5606 0.95 SERVICE FIRST LOGISTICS INC ROCHESTER 5134706A 2,801 1/1/2021 8810 0.90 STATEWIDE FENCE AND SUPPLY LLC ROCHESTER 5635306A 750 3/14/2021 5403 TIMS TILE INSTALLATION ROCHESTER 3879259A 750 1/31/2021 5348 0.95 TWENTY FIRST CENTURY WINDOW CLEANERS ROCHESTER 2296705A 645 1/22/2021 9015 0.95 USA CUSTOM PAINTING LLC ROCHESTER 3867838A 750 1/25/2021 5476 0.95 SINKO DEVELOPMENT LLC ROCHESTER HILLS 5645565A 750 1/4/2021 5645 ALB TILE ARTWORK LLC ROCHESTER HILLS 5674816A 2,181 2/15/2021 5348 0.95 BIOSCAPE INC ROCHESTER HILLS 4819411A 701 1/21/2021 8831 0.95 CELAJ PAINTING LLC ROCHESTER HILLS 5357071A 800 1/6/2021 5476 CLINT VERRAN SPORTS MEDICINE INC ROCHESTER HILLS 5793548A 400 2/23/2021 8832 DANIELLES DAYCARE ROCHESTER HILLS 5647541A 380 1/3/2021 8869 DK SERVICE LLC ROCHESTER HILLS 5076102A 750 1/18/2021 5102 FORTRESS HOME IMPROVEMENTS LLC ROCHESTER HILLS 4561198A 3,337 1/22/2021 5437 0.95 GREENTREES INC ROCHESTER HILLS 0464619A 18,575 3/29/2021 0042 1.58 13 % HANDY HOPE ROCHESTER HILLS 5242711A 2,500 2/22/2021 5437 0.95 HANUMATAY SAINATH LLC ROCHESTER HILLS 4852052A 2,433 3/23/2021 5550 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 114 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge IEMPLOYEE SERVICES LLC ROCHESTER HILLS 5977290A 28,570 3/27/2021 0035 IMPACT LLC ROCHESTER HILLS 4318900A 618 2/7/2021 9015 0.95 LEADER CONSTRUCTION LLC ROCHESTER HILLS 5715075A 1,547 2/11/2021 5476 METRO DOOR & HARDWARE INC ROCHESTER HILLS 5389267A 800 3/21/2021 5102 MOOSE ATHLETICS LLC ROCHESTER HILLS 6131182A 524 3/14/2021 9063 NETWORK CONSTRUCTION AND DEVELOPMENT ROCHESTER HILLS 2115182A 1,553 3/30/2021 5445 0.95 INC NICKY DS INC ROCHESTER HILLS 5974631A 762 3/13/2021 9058 1.00 OLMACK BUILDERS INC ROCHESTER HILLS 3285260A 2,845 3/23/2021 5645 0.95 PRECISION FOUNDATION SYSTEMS LLC ROCHESTER HILLS 2962608A 2,896 1/17/2021 5213 0.95 PRECISION LAWN IRRIGATION INC ROCHESTER HILLS 4353781A 777 3/2/2021 5183 1.87 27 % SEQUOIA TECHNOLOGIES LLC ROCHESTER HILLS 5655900A 1,923 2/12/2021 5191 1.00 SEVEN HUNDRED ONE COMPANY A MICHIGAN ROCHESTER HILLS 5273870A 388 3/10/2021 5606 LIMITED LIABILITY COMPANY SJR MASONRY ROCHESTER HILLS 2380927A 750 1/21/2021 5022 WADDELL ROBERT G ROCHESTER HILLS 1502689A 568 1/10/2021 9015 ZARA TUTORING LLC ROCHESTER HILLS 5949882A 316 1/25/2021 8868 ARTHURS PAINTING & CONSTRUCTION LLC ROCHESTER HLS 5668719A 750 2/1/2021 5476 CALIN INC ROCHESTER HLS 4506804A 750 3/26/2021 7208 0.95 GARY KANERVA TRUCKING INC ROCK 4037766A 750 1/4/2021 7208 MIKES MECHANICAL INC ROCK 6095356A 675 1/10/2021 5550 ARMSTRONGS GOODS AND SERVICES LLC ROCKFORD 5947839A 330 1/1/2021 8742 BIZ WOODWORKING LLC ROCKFORD 5808332A 750 1/12/2021 5551 COURTLAND TREE SERVICE LLC ROCKFORD 5494338A 2,623 1/8/2021 0106 0.95 CULLEN CONSTRUCTION GROUP LLC ROCKFORD 6111319A 750 2/6/2021 5645 DC CONCEPTS INC ROCKFORD 5656680A 750 1/9/2021 5437 FROM THE LOG UP LLC ROCKFORD 4906241A 750 2/12/2021 2731 GCK PRODUCTS LLC ROCKFORD 5915171A 265 1/11/2021 8810 K 2 CONTRACTORS LLC ROCKFORD 5185807A 731 1/31/2021 5190 KAMINSKI DENNIS J ROCKFORD 2495066A 750 1/26/2021 7208 KITCHEN AND BATH BY DESIGN INC ROCKFORD 3456820A 2,139 2/25/2021 8017 MICROINDIE LLC ROCKFORD 5119006A 1,468 3/23/2021 7610 1.00 MITTEN EXTERIORS LLC ROCKFORD 6124070A 6,800 2/21/2021 5645 MORONEY ROOFING LLC ROCKFORD 2238080A 750 2/6/2021 5551 NORTH STAR GYMNASTICS INC ROCKFORD 0280763A 1,368 3/30/2021 9063 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 115 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge NYSTROM BUILDERS LLC ROCKFORD 5226902A 750 1/15/2021 5403 0.95 RILEY MICHAEL ROCKFORD 4206959A 750 1/16/2021 5437 ROGUE RIVER RUNNER LLC ROCKFORD 6082130A 470 1/1/2021 5190 SCHUYTEN BUILDING AND ROOFING LLC ROCKFORD 5803705A 1,054 2/14/2021 5645 0.95 TCB AIR & HYDRAULICS LLC ROCKFORD 4932927A 408 2/26/2021 8010 WKB ENTERPRISES LLC ROCKFORD 6101810A 2,463 1/18/2021 9015 SUB ZERO FOREST PRODUCTS ROCKLAND 5964822A 750 2/19/2021 2709 POZNER ENTERPRISES LLC ROCKWOOD 3203662A 785 2/17/2021 9402 ROBS TILE LLC ROCKWOOD 6094074A 800 1/8/2021 5348 BREGE SCOTT M ROGERS CITY 6134963A 1,606 3/13/2021 2702 EAST COAST SERVICES ROGERS CITY 6129307A 568 3/3/2021 9015 SUPERIOR SERVICES LLC ROGERS CITY 6119026A 1,085 2/14/2021 9015 BULLDOG MECHANICAL LLC ROMEO 4447999A 636 3/24/2021 5183 0.95 CODY WRANOSKY LLC ROMEO 6093434A 750 1/7/2021 5645 COLD FRAME FARM LLC ROMEO 5836646A 1,507 3/8/2021 0128 DANN DEVELOPMENT CO ROMEO 1045679A 1,714 1/9/2021 3628 DEPREZ COMPANIES LLC ROMEO 0527858A 750 3/14/2021 5645 LOGAN GANFIELD LLC ROMEO 6125107A 750 2/25/2021 5645 M L PAINTING CO ROMEO 1344927A 920 3/13/2021 5476 0.95 MICHAEL WRANOSKY LLC ROMEO 5876923A 750 1/17/2021 5645 REVOCABLE TRUST OF SHAYN GREER ABBOTT ROMEO 4843860A 949 3/15/2021 0908 0.95 SCHOENHERR HOMES LLC ROMEO 3833895A 834 1/3/2021 8742 0.95 AAA PETROLEUM INC ROMULUS 2766663A 403 1/14/2021 8017 0.95 ABR INSTALLATIONS LLC ROMULUS 2642743A 800 1/15/2021 5645 BAKER BOYS PAINTING ROMULUS 2014319A 800 3/3/2021 8810 CACAU DORIN ROMULUS 4974565A 418 3/28/2021 8393 DAVES GUTTERS LLC ROMULUS 5248655A 706 1/21/2021 5538 1.00 EVEREST BUILDING MANAGEMENT INC ROMULUS 3605191A 750 3/16/2021 5437 HOPE MARIE YONO INC ROMULUS 5515386A 546 2/10/2021 9058 INT EX RENOVATIONS LLC ROMULUS 1324977A 873 2/12/2021 5445 MCLEARENS JJJ ROMULUS 0505617A 739 1/12/2021 6217 MIDFIELD CONCESSIONS ENTERPRISES INC ROMULUS 3661830A 404 3/28/2021 8810 MILLER ALUMINUM PRODUCTS INC ROMULUS 3600033A 229 3/30/2021 8742 R AND R DRUMMONDS LLC ROMULUS 3536718A 35,933 3/17/2021 7208 1.85 13 % SIMPSON GROUP INC ROMULUS 1933353A 215 2/1/2021 8810 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 116 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TORE CORP ROMULUS 6133983A 3,778 3/12/2021 1624 VOLARE DELIVERY COMPANY LLC ROMULUS 4753720A 4,454 1/16/2021 7202 0.89 WAYNE CONSUMER CENTER LLC ROMULUS 4335090B 720 1/22/2021 8017 WEB MARBLE & TILE ROMULUS 1813110A 1,034 3/22/2021 5348 WESTLAND FIRE EXTINGUISHER INC ROMULUS 5534380A 855 3/24/2021 4828 YESTOFFLO LLC ROMULUS 2945711B 9,285 2/11/2021 9058 0.70 COMAP LLC ROSCOE, IL 5499542A 549 2/7/2021 8742 MICHIGAN WARM HUGS LLC ROSCOMMON 5787319A 298 2/1/2021 8008 PAST TO PRESENT BUILDING AND REMODELING ROSCOMMON 2933233A 750 3/11/2021 5645 LLC CUSTOM SOFTWARE INC ROSE CITY 3644723A 3,585 2/7/2021 8901 0.89 MASON PAULINE ROSE CITY 6115101A 1,337 2/14/2021 5190 T BUHLMAN TRUCKING ROSE CITY 2867125A 750 3/5/2021 7208 FOUNTAIN OF LOVE LLC ROSEBUSH 5064830A 940 3/20/2021 9053 MILLER SHANE W ROSEBUSH 5389232A 750 3/21/2021 2702 AJP CONSTRUCTION LLC ROSEVILLE 5217229A 3,550 2/8/2021 5645 1.00 ALL CARE HOME IMPROVEMENT LLC ROSEVILLE 4045718A 750 2/20/2021 5437 0.95 AMERICAN GRANITE TOP INC ROSEVILLE 4236238A 13,894 2/28/2021 5437 0.86 ANTO GLASS BLOCK INC ROSEVILLE 0876585A 805 1/26/2021 5022 B AND B HOME REPAIR LLC ROSEVILLE 5971560A 800 3/16/2021 5551 DEUTSCHTROIT LLC ROSEVILLE 6104142A 404 1/22/2021 9058 DUSING SECURITY & SURVEILLANCE INC ROSEVILLE 3576264A 2,869 3/11/2021 5191 0.95 GOLD CHOICE SERVICE LLC ROSEVILLE 6113877A 751 2/13/2021 5645 JAD FITNESS LLC ROSEVILLE 5463971A 855 1/3/2021 9063 JMB HOME PROS LLC ROSEVILLE 2663686A 825 2/11/2021 5645 KEVLAR KOATINGS LLC ROSEVILLE 5669030A 2,086 2/18/2021 3372 0.95 KIDNEY CONSULTANTS OF MICHIGAN ROSEVILLE 3872483A 1,097 1/25/2021 8832 0.95 LADUKE MATT ROSEVILLE 5878349A 750 1/15/2021 5437 M A M TECH INC ROSEVILLE 3810577A 5,389 2/23/2021 3724 0.95 MINCHEYS AUTO REPAIR LLC ROSEVILLE 4579097A 2,073 2/22/2021 8395 0.95 PERPETUAL LC ROSEVILLE 5538653A 20,383 3/12/2021 7600 0.90 SRPATEL LLC ROSEVILLE 6128807A 565 3/1/2021 8017 TOP PROPERTY SOLUTIONS LLC ROSEVILLE 5817676A 988 1/30/2021 9015 AFFORDABLE MODULAR & MOBILE HOME SETUP ROTHBURY 4725476A 4,644 2/9/2021 8387 0.94 & SERVICE INC

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GEMINI SERVICES ROTHBURY 6138284A 1,604 3/23/2021 7600 ALEXANDER REAL ESTATE SERVICES LLC ROYAL OAK 5373212A 800 3/6/2021 5645 ALL STATE TREE SERVICE INC ROYAL OAK 1737104A 5,887 2/14/2021 9102 0.86 BACK TO YOU REHAB PLLC ROYAL OAK 5979951A 595 3/28/2021 8832 BLUE LAKES HOMES LLC ROYAL OAK 4142802B 750 2/28/2021 5437 0.95 C AND L AND SON ROYAL OAK 5979994A 751 3/28/2021 5437 CAPALDI BUILDING CO ROYAL OAK 3322483A 809 1/1/2021 8810 CAPTAINS CORNER LLC ROYAL OAK 3761428A 1,040 2/14/2021 9015 0.95 CARPENTER MANAGEMENT LLC ROYAL OAK 0266620A 569 2/10/2021 8810 CHISHOLM AND SHUTTIE ROYAL OAK 3491625A 569 1/19/2021 9015 CLW WINDOWS INC ROYAL OAK 2810867A 750 2/25/2021 5645 DAUTERMANN MICHAEL DAVID ROYAL OAK 5840635A 637 3/16/2021 0913 DIGNITY DETROIT ROYAL OAK 6087728A 291 1/1/2021 8868 DORFMAN MATTHEW & WENDY ROYAL OAK 5960835A 530 2/4/2021 0913 EDGE HOMES LLC ROYAL OAK 5825920A 750 2/15/2021 5645 0.95 EXPERT CONSULTING AND MECHANICAL ROYAL OAK 6102956A 750 1/21/2021 5437 SERVICE EYE OF THE TIGER ENTERPRISES LLC ROYAL OAK 1603850A 14,681 3/7/2021 9058 1.20 GARY PAUL PURKEY BUILDERS LLC ROYAL OAK 1919547A 750 2/20/2021 5476 JLM PLUMBING LLC ROYAL OAK 6106161A 561 1/24/2021 5183 LAPEER HOSPITALITY GROUP LLC ROYAL OAK 6100210A 814 1/24/2021 6217 M 1 BAR AND GRILLE LLC ROYAL OAK 5119022A 1,041 3/23/2021 9058 0.95 MAX SAFETY LLC ROYAL OAK 6106544A 1,873 1/25/2021 8720 OCWEN LEASING LLC ROYAL OAK 5549990A 800 1/5/2021 7208 PETROVSKY GARY ROYAL OAK 3005941A 750 2/8/2021 5437 QUANTUM LEAP LLC ROYAL OAK 5827116A 301 3/21/2021 5191 RUGGERO CHRISTOPHER ROYAL OAK 2385155A 750 2/22/2021 5476 SIPORIN AND ASSOCIATES INC ROYAL OAK 4179358A 520 1/1/2021 8820 SIX HUNDRED 26 FOURTH STREET LLC ROYAL OAK 5953472A 800 1/16/2021 5403 SOUTH OAKLAND CITIZENS FOR THE HOMELESS ROYAL OAK 3882055A 336 2/4/2021 8810 STADLER MAINTENANCE ROYAL OAK 5177510A 750 2/6/2021 5645 STEFANI AND STEFANI PC ROYAL OAK 3871606A 693 1/1/2021 8820 UNIVERSAL HOSPITALITY ADVISORS LLC ROYAL OAK 4904125A 576 1/24/2021 8810 VERSA MANAGEMENT LLC ROYAL OAK 5365783A 646 1/31/2021 8810 FIVE K FARMS TRANSPORTATION LLC RUDYARD 6129420A 4,947 3/3/2021 7208

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HAKOLA LOGGING INC RUDYARD 3594610A 750 3/8/2021 2702 JONDAR ENTERPRISE RUSHVILLE, NE 4302028A 1,143 1/13/2021 9015 MESSING TRUCKING LLC RUTH 5647703A 4,357 1/25/2021 7208 0.95 ABOVE ALL HOME & PROPERTY MAINTENANCE SAGINAW 6126065A 3,575 2/26/2021 5645 ADVANCED HOSPICE CARE INC SAGINAW 5974224A 679 3/8/2021 8835 ALLSTAR WIRELESS MI 713 INC SAGINAW 5802989A 380 1/4/2021 8017 BARBS CLEANING SERVICE SAGINAW 4280016A 568 3/16/2021 9015 BECKER LAWN CARE AND LANDSCAPING SAGINAW 4005490A 8,084 1/13/2021 0042 0.92 BEST PRICE SERVICES LLC SAGINAW 5727898A 657 1/31/2021 9402 BEST RECOVERY SERVICES LLC SAGINAW 3600076A 35,063 2/26/2021 7720 1.97 27 % BOB HOWELL INC SAGINAW 2033321A 504 2/17/2021 8010 BOOKER REMODELING LLC SAGINAW 6111270A 750 1/31/2021 5645 COUNTRY CLUB DRY CLEANERS SAGINAW 1393944A 2,177 2/8/2021 2586 0.95 CURRENT ELECTRIC COMPANY LLC SAGINAW 5953650A 471 1/17/2021 5190 CUSTOM TRANSPORT LLC SAGINAW 5073251A 5,812 1/10/2021 7212 0.89 DIESEL TRANSPORT LLC SAGINAW 5418275A 6,305 1/28/2021 7208 0.95 DIRECT SATELLITE SERVICE INC SAGINAW 4461223A 1,902 3/27/2021 7600 0.95 FBT EVICTION CLEANING SERVICES SAGINAW 6119018A 644 2/14/2021 9015 GAK INTERIORS SAGINAW 4975286A 750 3/31/2021 5437 GENERIS ENTERTAINMENT II SAGINAW 3542866B 3,656 3/13/2021 9058 GENERIS ENTERTAINMENT LLC SAGINAW 3542866A 680 2/21/2021 9058 HAAS BUILDING & REMODELING LLC SAGINAW 2793920A 800 1/18/2021 5645 HELMREICH JENNIFER SAGINAW 5949874A 915 1/4/2021 0913 J D BISMACK SAGINAW 4975340A 750 3/31/2021 5645 J V ELECTRIC INC SAGINAW 4286464A 3,845 1/23/2021 5190 0.95 MICHIGAN RECOVERY SERVICES INC SAGINAW 3598314A 23,023 2/26/2021 7720 1.00 MIS CORPORATION MICHIGAN SAGINAW 0556645A 40,656 2/1/2021 5183 0.68 MOBILE BOOGIE INC SAGINAW 4975324A 1,086 3/31/2021 7212 0.95 MOD MASTERS OF DETECTION SECURITY SAGINAW 5172349A 2,701 3/6/2021 7720 SERVICES INC MY ANGEL AFC LLC SAGINAW 5523265A 737 3/4/2021 9053 PB SAGINAW LLC SAGINAW 4740939A 568 3/17/2021 9063 0.95 PETERSON CLEANING SERVICE SAGINAW 6116990A 569 2/12/2021 9015 PRH STORM RESTORATION LLC SAGINAW 5818230A 11,161 1/31/2021 7538 0.95 PROTRAX LLC SAGINAW 6135250A 740 3/13/2021 6217

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge QUEEN MAX SERVICES INC SAGINAW 5847729A 964 3/28/2021 8018 RETAIL WHOLESALE DEPARTMENT STORE LOCAL SAGINAW 1477153A 337 3/20/2021 8755 87 SHOWTIME GUNS AND AMMO SALES LLC SAGINAW 5615283A 537 1/22/2021 8010 SUTTER KEN SAGINAW 3590313A 540 1/16/2021 9521 TOM AND MARILYNS HI FI SHOPPE LLC SAGINAW 5236401A 302 3/24/2021 5191 TOP FLIGHT TREE REMOVAL LLC SAGINAW 5349451A 4,859 1/16/2021 0106 0.93 TRI CITY REHAB PHYSICIANS PLLC SAGINAW 5975573A 231 3/14/2021 8832 TRIANGLE MOVERS INC SAGINAW 5811368A 269 1/18/2021 8810 VICTORY TRANSPORT EXPRESS INC SAGINAW 4714555A 7,025 3/1/2021 7212 1.44 13 % WASHINGTON BUILDERS LLC SAGINAW 5598761A 825 1/15/2021 5437 YEAGER ROOFING LLC SAGINAW 4805488A 21,798 1/19/2021 5551 0.89 PELLERITO LANDSCAPING LLC SAINT CLAIR 3190900A 710 1/10/2021 0042 HERON CONSTRUCTION SERVICES LLC SAINT CLAIR SHORES 6120253A 2,129 2/17/2021 5022 NORTHSIDE HOME SERVICES LLC SAINT JOHNS 6127037A 834 2/27/2021 5437 ROSEWOOD TREE SERVICES LLC SAINT JOHNS 5964660A 1,117 2/6/2021 0106 ANN ARBOR ELECTRIC LLC SALINE 4832868A 470 1/21/2021 5190 CHADTOUGH FOUNDATION SALINE 5686326A 367 3/4/2021 8810 COLE SUMMER SALINE 5828970A 328 2/20/2021 0908 DIUBLE MASONRY LLC SALINE 2656310A 750 3/28/2021 5022 H 2O TOWERS LLC SALINE 5328764A 12,366 1/12/2021 5038 0.95 HIGHPOINTE HOMEOWNERS ASSOCIATION SALINE 4985559A 568 1/16/2021 9015 IVS COMM INC SALINE 5949157A 17,790 1/3/2021 5102 LK ENTERPRISES LLC SALINE 5697310A 800 3/31/2021 5551 NEED A HAND LLC SALINE 5402646A 1,469 3/20/2021 8835 0.95 NO SUCH PLACE LLC SALINE 5977100A 320 3/19/2021 8742 ROYAL GRANITE INC SALINE 3940241A 4,399 2/15/2021 5348 0.95 ZINK TRUCKING LLC SALINE 5505313A 826 1/16/2021 7208 TRANS GLOBAL MOTORS LLC SAMARIA 4971124A 1,539 3/28/2021 8393 CYBERNET ENTERTAINMENT LLC SAN FRANCISCO, CA 6144470A 382 3/31/2021 8810 FLEXABILITY LLC SAN FRANCISCO, CA 6114997A 298 2/8/2021 8810 ADVANCED FIBER SOLUTIONS LLC SAND LAKE 5536065A 1,563 3/11/2021 7600 0.95 BAZZETT ROBERT J SAND LAKE 3833607A 750 2/11/2021 2702 COUNTRYSIDE TOURS INC SAND LAKE 5550793A 718 1/10/2021 8742 ENSLEY ROOFING LLC SAND LAKE 5379482A 4,093 3/3/2021 5551 1.00

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge QUIST BUILDERS LLC SAND LAKE 4304578A 750 1/7/2021 5437 QUIST JOHN SAND LAKE 6112480A 750 2/1/2021 5645 REINHARD ANTHONY SAND LAKE 6097910A 750 1/15/2021 2702 FLYBOYZ AVIATION LLC SANDUSKY 6089356A 3,159 1/7/2021 7423 PARADISE TROPHY RANCH LLC SANDUSKY 3300382A 2,080 2/8/2021 9015 SANDUSKY AUTO & PERFORMANCE LLC SANDUSKY 4137582A 763 2/4/2021 8395 SANDUSKY COMMUNITY FIRE DEPARTMENT SANDUSKY 3479439A 1,794 3/1/2021 7704 0.95 SANILAC COUNTY HOCKEY ASSOCIATION SANDUSKY 3867722A 569 1/1/2021 9015 COLES OF SANFORD INC SANFORD 0036030A 3,019 1/9/2021 8395 0.95 DAVE HARVEY CONSTRUCTION SANFORD 5950252A 750 1/17/2021 5445 GLOBAL G L O W SANTA ANA, CA 6092985A 675 2/1/2021 8742 OPEN DOORS WITH BROTHER ANDREW INC SANTA ANA, CA 3747638A 569 2/2/2021 8742 WEST COAST GEOLOGIC SANTA ROSA, CA 6144225A 433 3/31/2021 8601 EDWARD OVERBECK BUILDER INC SARANAC 3913139A 800 1/24/2021 5445 0.95 MY 3 SONS HEATING & COOLING LLC SARANAC 5515653A 743 2/19/2021 5550 NOORMAN PAINTING INC SARANAC 5650135A 750 2/20/2021 5476 TANGLEWOOD ASSOCIATES LLC SARASOTA, FL 3729966A 1,303 1/4/2021 9015 0.95 SPLASH PROPERTIES LLC SAUGATUCK 1851039A 569 1/1/2021 9015 WEST SHORE WOODS CONSTRUCTION LLC SAUGATUCK 5811120A 8,606 1/18/2021 5645 WRITING THAT WORKS LLC SAUGATUCK 5680344A 315 2/23/2021 8810 ZURUCK GEBEN LLC SAUGATUCK 5223830A 825 1/24/2021 5645 C B MOBILE HOME REPAIRS INC SAULT STE MARIE 2913348A 4,147 2/1/2021 5221 0.95 GREAT LAKES ENVIRONMENTAL LLC SAULT STE MARIE 5696372A 6,403 3/29/2021 5183 1.00 KIDS KASTLE DAY CARE INC SAULT STE MARIE 5587638A 678 2/6/2021 8869 LAW OFFICE OF MONICA LUBIARZ QUIGLEY PC SAULT STE MARIE 4429818A 242 1/1/2021 8820 NICOLET PAINTING SAULT STE MARIE 5513570A 2,661 2/2/2021 5476 0.95 SAULT STE MARIE LODGE NO 717 LOYAL ORDER SAULT STE MARIE 3499251A 416 2/16/2021 9058 OF MOOSE INC SMART DRYWALL PAINTING & PRESSURE SAULT STE MARIE 5053269A 1,350 3/25/2021 5445 0.95 WASHING LLC SOO MARINE SUPPLY INC SAULT STE MARIE 3781909A 32,727 1/27/2021 7317 0.72 UP NORTHSTAR REALTY INC SAULT STE MARIE 0596116A 235 2/7/2021 8810 ASHCRAFT ENTERPRISES LLC SAWYER 5332966A 750 3/30/2021 5645 0.95 ALL INDIA MOVEMENT FOR SEVA INC SAYLORSBURG, PA 5368006A 560 1/30/2021 8742 CAPTIVATE FARMS LLC SCHOOLCRAFT 4401697A 9,976 3/17/2021 8279 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FORESTER AMY SCHOOLCRAFT 5021863A 530 3/3/2021 0913 J L MILLING INC SCHOOLCRAFT 0983675A 66,617 3/31/2021 8227 1.96 13 % PETERSONS ELECTRIC INC SCHOOLCRAFT 2181983A 890 3/31/2021 5190 TIMBERCREEK REMODELING LLC SCHOOLCRAFT 5688949A 761 2/13/2021 5645 PAWS RESCUE SCHWARTZ CREEK 4852826A 348 3/22/2021 8831 R VANDYKE BUILDING & REMODELING LLC SCOTTS 3266435A 825 1/1/2021 5437 THUE PAINTING LLC SCOTTVILLE 5904170A 750 2/18/2021 5476 TILES FARMS TRUCKING INC SCOTTVILLE 6119085A 750 2/14/2021 7208 VANWAY LLC SCOTTVILLE 6136370A 3,175 3/17/2021 5183 KEEL JOHN H SEARS 3274225A 752 1/28/2021 8116 P T TRUCKING LLC SEARS 5949033A 4,898 1/3/2021 7208 DAVIS ALLOYS MANUFACTURING LLC SHARPSVILLE, PA 6114679A 320 2/7/2021 8742 JWS TRANSPORT INC SHELBY 4864735A 4,765 1/20/2021 7208 SAM NEAR ROOFING LLC SHELBY 2004879A 11,917 3/5/2021 5551 0.85 BEAR DRYWALL SHELBY TOWNSHIP 4434439A 750 3/19/2021 5445 BULLDOG CARPENTRY LLC SHELBY TOWNSHIP 5733561A 8,706 2/16/2021 5645 0.95 ERJON SERVICES LLC SHELBY TOWNSHIP 6102832A 825 1/21/2021 5476 PAL CONSULTANTS INC SHELBY TOWNSHIP 6106331A 418 1/24/2021 8601 SIERRA CONSTRUCTION SERVICES LLC SHELBY TOWNSHIP 5962072A 966 3/24/2021 3724 A AND B HOME IMPROVEMENT LLC SHELBY TWP 5964784A 750 2/6/2021 5645 A D MASONARY SHELBY TWP 5977975A 750 3/21/2021 5022 ACADIA HOME BUILDERS LLC SHELBY TWP 4566203A 803 2/15/2021 5606 ADVANCED AUTOMATION SERVICES LLC SHELBY TWP 4959817A 4,135 2/8/2021 3179 0.92 ALDO REMODELING LLC SHELBY TWP 5972825A 750 3/5/2021 5645 ALL POINTE ENTERPRISES INC SHELBY TWP 5832225A 15,447 2/28/2021 7208 0.91 ALL SEASON CONSTRUCTION LLC SHELBY TWP 5811392A 2,370 1/18/2021 5476 0.95 ALL SERVICES MANAGEMENT LLC SHELBY TWP 5069726A 1,558 3/24/2021 0042 0.95 ALLANTE BUILDING COMPANY SHELBY TWP 2313626A 757 3/22/2021 9521 ALLSTAFF INC SHELBY TWP 5501091A 63,063 1/25/2021 4484 1.20 AMERICAN TILE AND STONEWORKS LLC SHELBY TWP 5279313A 1,246 1/18/2021 5348 AN TILE LLC SHELBY TWP 5524733A 750 3/8/2021 5348 ARBENS PAINTING SHELBY TWP 6094546A 750 1/9/2021 5476 AVIANO BUILDING CO INC SHELBY TWP 4381564A 750 1/4/2021 5022 0.95 BAER WILLIAM P SHELBY TWP 2642794A 510 2/28/2021 0912 CAD ENGINEERING RESOURCES INC SHELBY TWP 4793579A 561 3/3/2021 8107 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 122 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CAPITAL LENDING INC SHELBY TWP 5806399A 246 1/28/2021 8810 CARD HALL RESTAURANTS INC SHELBY TWP 4050177A 13,871 3/2/2021 9058 1.51 27 % CHAMPAGNE BUILDING COMPANY INC SHELBY TWP 2337231A 801 2/1/2021 8810 CHRISTOS DAGITSES DDS PC SHELBY TWP 1368575A 272 2/5/2021 8832 CHUCK WAYS CONTRACTING INC SHELBY TWP 3278905A 14,534 1/1/2021 5437 1.71 13 % COLLINS SEAN J SHELBY TWP 5820618A 750 2/16/2021 5476 COMMERCIAL MOVING & RIGGING INC SHELBY TWP 2081199A 3,445 1/13/2021 7214 0.95 CONSTANTINE CONSTRUCTION INC SHELBY TWP 1654756A 2,071 1/15/2021 5645 0.95 DI MARIA CARPENTRY INC SHELBY TWP 2035553A 750 1/18/2021 5437 DNS TRANSPORTATION INC SHELBY TWP 5398100A 1,214 2/6/2021 7208 0.95 DREAM LIMOUSINES INC SHELBY TWP 4639243A 5,106 3/20/2021 7212 0.89 EAGLE EYE PAINTING LLC SHELBY TWP 6115896A 751 2/11/2021 5476 ECLIPSE LAWN & LANDSCAPE LLC SHELBY TWP 5837820A 709 3/11/2021 0042 EDDYS CARPENTRY AND CONSTRUCTION LLC SHELBY TWP 6129439A 750 3/3/2021 5437 FOUR C MEASUREMENTS LLC SHELBY TWP 5804949A 822 1/8/2021 4511 FREAKY CLEAN SHELBY TWP 5489407A 618 2/2/2021 9015 GRASSROOTS CLEANING LLC SHELBY TWP 5966965A 568 2/13/2021 9015 GREAT LAKES RIDGE ASSOCIATION SHELBY TWP 5009170A 568 1/1/2021 9015 HAMILTON HOMES OF SOUTHEAST MICHIGAN SHELBY TWP 5958628A 240 1/24/2021 8810 LLC HARSENS CONSTRUCTION LLC SHELBY TWP 5243092A 5,663 3/9/2021 9015 0.92 HIDDEN PONDS SUBDIVISION LLC SHELBY TWP 5240468A 756 2/26/2021 8810 HIGH R INSULATION INC SHELBY TWP 2929775A 751 2/14/2021 5479 INTERIOR CONSTRUCTION & DESIGN LLC SHELBY TWP 6103189A 2,579 1/28/2021 5437 J C CARPENTRY LLC SHELBY TWP 4739701A 2,811 1/18/2021 5645 0.95 J ELIAS MANAGEMENT INC SHELBY TWP 6135676A 2,208 3/15/2021 8045 J TAYLOR CONSTRUCTION LLC SHELBY TWP 3651665A 2,036 1/20/2021 5645 0.95 JMR FLOORCOVERING SHELBY TWP 3385930A 1,432 1/13/2021 5437 0.95 KALASHO TRUCKING LLC SHELBY TWP 5978157A 750 3/22/2021 7208 KLE FLOORING SHELBY TWP 3135306A 750 1/26/2021 5437 KRG PERFORMANCE RACING LLC SHELBY TWP 5522951A 829 1/25/2021 3114 L AND J CUSTOM PAINTING LLC SHELBY TWP 5840139A 800 3/15/2021 5476 L AND T PAINTING COMPANY INC SHELBY TWP 4497198A 6,966 3/9/2021 5476 0.81 L C HOMES INC SHELBY TWP 3285839A 812 2/4/2021 8742 LAFATA PAINTING LLC SHELBY TWP 5515220A 750 2/14/2021 5476

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 123 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge LAKES CONTRACTING LLC SHELBY TWP 1771418A 825 1/20/2021 5403 LOCAL BUSINESS NETWORK LLC SHELBY TWP 5269857A 215 2/10/2021 8810 LOGRASSO CONTRACTORS INC SHELBY TWP 4710495A 825 2/19/2021 5476 0.95 LTL INC SHELBY TWP 4029194A 2,331 2/15/2021 9063 0.99 LULGJURAJ LENA SHELBY TWP 5232155A 568 1/28/2021 9015 MARKUS CARPENTRY LLC SHELBY TWP 4433122A 750 3/5/2021 5437 METRO DETROIT ROOFS LLC SHELBY TWP 5283876A 3,500 1/2/2021 5645 METRO DETROIT WINDOW INC SHELBY TWP 5163331A 226 1/15/2021 8810 MICHIGAN BUILDER SUPPLY LLC SHELBY TWP 5000599A 229 2/16/2021 8742 NATIONAL ROOFING & SIDING LLC SHELBY TWP 0722448A 754 3/4/2021 8810 NIKOLA PAINTING SHELBY TWP 5388449A 750 1/10/2021 5476 0.95 NKB AND ASSOCIATES INC SHELBY TWP 2787725A 800 1/1/2021 5437 NLA PAINTING INC SHELBY TWP 4303300A 825 1/9/2021 5476 OAK CONSTRUCTION COMPANY LLC SHELBY TWP 3148521A 750 3/31/2021 5645 OLSON ROOFING & SIDING INC SHELBY TWP 6127223A 753 2/27/2021 8810 PAINT SYSTEM SPECIALISTS LLC SHELBY TWP 4716884A 238 2/12/2021 8601 PATRIOTS AMMO & ARMS LLC SHELBY TWP 6116108A 404 2/11/2021 8010 PAULS IDEAL PAINTING SHELBY TWP 5719852A 800 1/17/2021 5476 QUAD ESTATES ASSOCIATION SHELBY TWP 1656058A 1,061 1/29/2021 9015 QUEEN SWEEP CO SHELBY TWP 1812505A 618 2/7/2021 9015 RGF COMPANIES INC SHELBY TWP 4697723A 750 1/6/2021 5645 ROCHESTER COURT CONDOMINIUM SHELBY TWP 5803012A 580 1/1/2021 9015 ASSOCIATION SCHOENHERR GAS AND MART LLC SHELBY TWP 5392276A 942 3/27/2021 8017 0.95 SCHWADERER ADAM SHELBY TWP 5355303A 573 1/1/2021 0913 SIENA GARDENS SUBDIVISION ASSOCIATION SHELBY TWP 5058490A 568 3/14/2021 9015 SINGHS UNLIMITED INC SHELBY TWP 3638480A 5,378 1/1/2021 8017 0.88 STONY LAKE VILLAGE HOMEOWNERS SHELBY TWP 4578058A 568 2/28/2021 9015 ASSOCIATION TEACHERS PET DOGS AND KIDS LEARNING SHELBY TWP 4918193A 375 3/19/2021 8832 TOGETHER TIMBERLAND BUILDING MAINTENANCE CORP SHELBY TWP 1552112A 750 3/2/2021 5476 0.95 VBM CONSTRUCTION LLC SHELBY TWP 3901807A 1,436 3/14/2021 5022 1.00 VOLPE VITO INC SHELBY TWP 1852078A 755 2/15/2021 9015 WALDEN ESTATES CONDOMINIUM ASSOCIATION SHELBY TWP 4601300A 568 2/16/2021 8810 INC

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WELLINGTON PLACE CONDOMINIUM SHELBY TWP 5484618A 568 1/14/2021 9015 ASSOCIATION WHITE PINE BUILDING & DEVELOPMENT LLC SHELBY TWP 4408624A 750 1/18/2021 5645 WILLOWAY CONDOMINIUM ASSOCIATION SHELBY TWP 0853828A 568 1/24/2021 9015 FIFELSKI CONSTRUCTION LLC SHELBYVILLE 5792797A 750 2/17/2021 5645 0.95 TOP GUN CONSTRUCTION SERVICES SHELBYVILLE 6091300A 750 1/3/2021 5645 BE GREEN LAWN SERVICE COMPANY SHEPHERD 2860422A 751 3/21/2021 5509 SHEPHERD FRONT END LLC SHEPHERD 5248370A 1,072 3/10/2021 8395 0.95 UNIQUE COATINGS INC SHEPHERD 5922380A 791 3/26/2021 9521 BOWEN INSULATION INC SHERIDAN 0257044A 2,317 3/30/2021 5479 0.95 LINCOLN LUXURY HOMES SHERIDAN 5971888A 761 3/1/2021 5645 LUIS CONSTRUCTION LLC SHERIDAN 5056098A 5,817 2/19/2021 5538 1.38 13 % YOUNG SHANE SHERIDAN 5980950A 643 3/30/2021 9015 RIEHL CHRISTIAN E SHERWOOD 5953952A 750 1/21/2021 5645 MILLER MARK SIDNEY 5096537A 750 2/27/2021 2731 SUPERIOR UNDERGROUND SERVICES LLC SIX LAKES 5946123A 5,513 1/3/2021 6325 A AND M CUSTOM CUTTING LLC SKANDIA 2628546A 826 1/18/2021 2709 BOYD KING BUILDERS LLC SNOVER 3302458A 750 3/20/2021 5645 M R WAGNER CONSTRUCTION SOUTH BEND, IN 5948568A 2,400 1/1/2021 5645 NAVARRE INC SOUTH BEND, IN 6136621A 2,092 3/18/2021 7538 PORTAGE TERRACE MOBILE HOME PARK SOUTH BEND, IN 2473992A 2,225 3/20/2021 9015 0.95 SPECIALTY SYSTEMS OF SOUTH BEND INC SOUTH BEND, IN 1177176A 997 3/1/2021 5479 MORANS ART STUDIO INC SOUTH BOARDMAN 5524687A 750 3/8/2021 5476 FLEMINGS TREE SERVICE LLC SOUTH HAVEN 5980429A 750 3/29/2021 0106 GEORGE S DUNN & ASSOCIATES PLLC SOUTH HAVEN 1500945A 262 2/13/2021 8820 HTS DIRECT LLC SOUTH HAVEN 5601118A 1,321 1/17/2021 8107 0.95 LIBERTY HYDE BAILEY MUSEUM MEMORIAL SOUTH HAVEN 6104401A 252 1/22/2021 8810 FUND INC MEJIA CONSTRUCTION LLC SOUTH HAVEN 6134696A 750 3/12/2021 5645 O SULLIVAN BUILDERS LLC SOUTH HAVEN 4352947A 750 2/26/2021 5645 TRUE ORGANICS LLC SOUTH HAVEN 6111238A 2,665 2/1/2021 0035 ABERNETHY TODD SOUTH LYON 3866572A 751 3/4/2021 5437 BILLS HOME IMPROVEMENT SOUTH LYON 5118336A 568 3/23/2021 9015 CLOUDD SOFTWARE LLC SOUTH LYON 5970709A 343 3/1/2021 8810 CWD SALES LLC SOUTH LYON 5392098A 341 3/31/2021 8742

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HAMLET INSTALLATION INC SOUTH LYON 5971713A 800 3/1/2021 5645 KATHRYN E DARLING LLC SOUTH LYON 6138985A 901 3/24/2021 8835 LEES CUSTOM CONSTRUCTION LLC SOUTH LYON 0539279A 4,010 1/30/2021 5221 0.95 MICHIGAN MARINE CONSTRUCTION LLC SOUTH LYON 5367638A 3,083 1/30/2021 6217 0.95 PURPOSE FOR LIFE HOME CARE LLC SOUTH LYON 5959276A 470 1/28/2021 8835 SIDE JOBZ LLC SOUTH LYON 5954673A 800 1/18/2021 5606 SILVERBACK INC SOUTH LYON 4561589A 333 1/19/2021 8832 SOUTH LYON AREA YOUTH ASSISTANCE INC SOUTH LYON 1842129A 268 3/18/2021 8832 STEVES AUTO BODY LLC SOUTH LYON 5341019A 481 3/5/2021 8395 0.95 STONE LLC SOUTH LYON 5499739A 751 1/28/2021 5348 THOMPSON HAULING INC SOUTH LYON 3590143A 689 3/7/2021 5610 TIMBERCRAFT CUSTOM CARPENTRY LLC SOUTH LYON 5967040A 750 2/15/2021 5645 WOOD FLOOR PROZ LLC SOUTH LYON 5951488A 2,736 1/16/2021 5437 VILLAS OF WESBURN CONDOMINIUM SOUTH ROCKWOOD 5206871A 580 1/12/2021 9015 ASSOCIATION ALEMAR PAINTING SOUTHFIELD 5101573A 750 3/4/2021 5476 ASSURANCE PAYROLL LLC SOUTHFIELD 4573544A 46,858 1/1/2021 8832 1.11 CCSI LLC SOUTHFIELD 2903091A 2,916 3/17/2021 8018 0.95 CENTERPOINT TEAM 1A LLC SOUTHFIELD 5962323A 590 2/1/2021 5606 CHAMPIONS FOREVER LLC SOUTHFIELD 5808030A 802 1/10/2021 8387 CHRISTIAN FAMILY SERVICES PROTESTANT SOUTHFIELD 0018953A 573 1/17/2021 8832 0.95 YOUTH ORGANIZATION COLONIAL HOME CARE LLC SOUTHFIELD 4870557B 768 3/13/2021 8835 0.81 COSTAFF CONNECT INC SOUTHFIELD 5944970A 11,002 1/1/2021 9015 COSTAFF SPECIALIZED HR INC SOUTHFIELD 4429923A 131,289 1/1/2021 3632 1.12 CRUSADER PAINT LLC SOUTHFIELD 5951631A 405 1/11/2021 8810 CUSTOM HOME HEALTHCARE AGENCY INC SOUTHFIELD 6131360A 1,719 3/5/2021 8835 DETROIT FAMILY HOME INC SOUTHFIELD 5924499A 3,470 2/18/2021 9053 EFUND INSURANCE AND FINANCIAL SERVICES SOUTHFIELD 4937880A 239 1/10/2021 8810 LLC ELITE PROPERTY MANAGEMENT LLC SOUTHFIELD 5101697A 215 3/7/2021 8810 ENDOSCOPY CORP OF AMERICA SOUTHFIELD 3089126A 2,791 3/15/2021 3685 1.00 GARY D NITZKIN PC SOUTHFIELD 1378848A 712 3/24/2021 8820 GEES PLACE AFC INC SOUTHFIELD 5959829A 1,037 1/26/2021 9053 GOTO STAFFING LLC SOUTHFIELD 3623645A 18,923 2/5/2021 3179 1.00 H AND P PROTECTIVE SERVICES INC SOUTHFIELD 4507509A 11,734 3/16/2021 7720 0.90 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 126 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge HARPER ON MAIN LLC SOUTHFIELD 5371040A 800 2/17/2021 5403 HEART 2 HEART HOME AIDE SERVICES LLC SOUTHFIELD 5817757A 1,730 1/30/2021 8835 HEAVEN SENT HOME SUPPORT SERVICES LLC SOUTHFIELD 5361842A 4,111 1/25/2021 8835 0.89 HOMESOURCE REALTORS LLC SOUTHFIELD 3867650A 256 1/10/2021 8742 IN AND OUT LOGISTICS LLC SOUTHFIELD 6128122A 7,185 2/28/2021 7208 INFINIA STAFFING INC SOUTHFIELD 5528712A 9,095 3/15/2021 9058 1.35 13 % J MAC TREE & DEBRIS LLC SOUTHFIELD 5307635A 8,295 2/28/2021 0106 0.95 JEFF STAR MOVERS LLC SOUTHFIELD 6110347A 2,870 3/14/2021 7214 LB DEVELOPMENT COMPANY LLC SOUTHFIELD 5442567A 800 2/28/2021 5645 LEADHEAD CONSTRUCTION INC SOUTHFIELD 4021860A 9,539 1/18/2021 5610 0.95 LOTUS HOME IMPROVEMENT LLC SOUTHFIELD 6089321A 750 1/1/2021 5645 MAS BUILDING & RENOVATIONS LLC SOUTHFIELD 3012557A 801 3/5/2021 5348 0.95 MOUNTAIN GREEN LLC SOUTHFIELD 6101143A 751 1/17/2021 5445 NATIONWIDE HOME HEALTH CARE INC SOUTHFIELD 4858360A 2,088 3/2/2021 8835 0.95 NOWELL INVESTIGATIVE SERVICES SOUTHFIELD 5860679A 4,995 3/3/2021 7720 INCORPORATED PRODUCT DESIGN AND AUTOMOTIVE CONCEPTS SOUTHFIELD 4324269A 269 3/21/2021 8810 INC PUBLICCITY PR LLC SOUTHFIELD 5951585A 890 1/11/2021 8810 RENTAL MANAGEMENT ONE LLC SOUTHFIELD 5345570A 4,227 1/1/2021 9015 0.94 RULE OF ONES LLC SOUTHFIELD 4834925A 3,814 1/31/2021 7422 0.92 SESSION KEVIN SOUTHFIELD 3342964A 750 2/19/2021 7213 SHER MACKSAFETY SOLUTIONS LLC SOUTHFIELD 6143008A 820 3/30/2021 8601 SO BRITE CLEANING LLC SOUTHFIELD 5807182A 569 1/10/2021 9015 SUNRIZE SAFARIS INC SOUTHFIELD 3759342A 1,486 3/25/2021 9060 0.95 UNITED HOSPITALITY GROUP III LLC SOUTHFIELD 6128025A 825 2/28/2021 5403 VITAL COMMUNITY CARE PC SOUTHFIELD 5252482A 2,517 3/14/2021 8832 0.92 WE PRESERVE MICHIGAN LLC SOUTHFIELD 4973410A 1,844 3/23/2021 5645 0.95 WOOF WOOF PUPPIES & BOUTIQUE INC SOUTHFIELD 5813840A 329 1/28/2021 8017 X MEN SECURITY INC SOUTHFIELD 2655101A 1,375 3/5/2021 7720 0.95 XPRESS NON EMERGENCY MEDICAL SOUTHFIELD 4582918A 29,536 1/1/2021 7212 1.46 13 % TRANSPORTATION INC ZAMAN DEVELOPMENT LLC SOUTHFIELD 5819407A 800 2/3/2021 5645 ALL IN ONE SEWER AND DRAIN SOUTHGATE 3573974A 1,360 2/26/2021 5183 ANGELINAS MEXICAN RESTAURANT SOUTHGATE 4803299A 2,079 3/14/2021 9058 0.95 ARROW ROOFING SERVICES LLC SOUTHGATE 6131930A 833 3/6/2021 8810 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 127 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BIG B SEWER & DRAIN CLEANING LLC SOUTHGATE 5370299A 656 2/7/2021 9402 BOSMAN AUTOMOTIVE INC SOUTHGATE 3087158A 556 3/20/2021 8395 GHJH INC SOUTHGATE 2301520A 557 2/12/2021 8017 N E C I INC SOUTHGATE 2625075A 874 2/8/2021 9058 0.95 ONE OF A KIND SERVICES LLC SOUTHGATE 5710162A 1,515 1/23/2021 0106 0.95 SAMI SERVICE CENTER LLC SOUTHGATE 5240441A 375 2/15/2021 8017 STROIA SECURITY SERVICES INC SOUTHGATE 5969085A 252 2/21/2021 8810 TOMS ROOFING & SIDING SOUTHGATE 5820758A 750 3/25/2021 5551 VALRIE AND ASSOCIATES LLC SOUTHGATE 5793386A 1,085 2/10/2021 9015 DOUBLE B BROKERAGE LLC SPALDING 5517036A 750 2/16/2021 7208 WEBBER RAILROAD SERVICES SPALDING 0175021A 2,081 3/15/2021 5506 0.95 AMERICAN RESOURCE RECOVERY COMPANY SPARTA 2080184A 800 3/21/2021 9403 0.95 LLC Z AND Z CONSTRUCTION LLC SPARTA 6118895A 1,019 2/14/2021 9521 A TO Z AUTO PARTS INC SPRING LAKE 4957580A 938 2/7/2021 3821 0.95 BULLSHIP LOGISTICS LLC SPRING LAKE 6017711A 4,361 1/16/2021 7208 KARNES CLASSIC CLEANING LLC SPRING LAKE 4591712A 689 2/24/2021 5610 KLEERSNYDER CONSTRUCTION LLC SPRING LAKE 5977029A 800 3/20/2021 5645 PAUL TWA BUILDER LLC SPRING LAKE 3970019A 750 1/14/2021 5645 POSH CONSTRUCTION LLC SPRING LAKE 3230430A 2,253 3/3/2021 5437 PRO HAUL LLC SPRING LAKE 6090575A 3,396 1/4/2021 7208 RB WINDOWS LLC SPRING LAKE 4467493A 825 2/7/2021 5476 SELLEN TRANSPORT & REPAIR LLC SPRINGFIELD 3616177A 21,016 3/17/2021 8395 1.53 13 % STETLER BUILT HOMES INC SPRINGFIELD 2880091A 613 1/3/2021 5606 SPRINGPORT CLARENCE FIRE DEPARTMENT SPRINGPORT 1468669A 3,916 2/10/2021 7904 0.95 STEVENS SAWMILL SPRUCE 3903567A 753 1/7/2021 2731 DEV 6 LLC ST AUGUSTINE, FL 5674344A 825 2/11/2021 8742 A AND M CONTRACTING LLC ST CHARLES 4865693A 825 2/24/2021 5437 BILA EXCAVATING INC ST CHARLES 2883686A 789 2/1/2021 6217 LEE CONTRACTING ST CHARLES 6040756A 3,830 3/12/2021 5645 NATIONWIDE ORGAN RECOVERY ST CHARLES, IL 5662192A 15,599 1/19/2021 7380 1.00 TRANSPORTATION ALLIANCE A AND JS VISION LLC st CLAIR 5836476A 5,842 3/8/2021 9053 1.00 DAVID T INDUSTRIES LLC ST CLAIR 3221229A 1,500 3/15/2021 5437 0.95 ERBA CARE LLC ST CLAIR 5816769A 822 1/30/2021 8045

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge FRALEY JACOB ST CLAIR 6136567A 814 3/19/2021 6217 HAPPY DOG YOGA STUDIO LLC ST CLAIR 5971039A 301 2/28/2021 9063 LANZI LAWN CARE LLC ST CLAIR 5405840A 710 3/16/2021 9102 STEVE MINANO LLC ST CLAIR 5656761A 1,767 1/7/2021 5476 0.95 AMERICAN CAR CARE INC ST CLAIR SHORES 5821940A 531 2/9/2021 8395 B C A S ASSOCIATES LLC ST CLAIR SHORES 4932102A 261 1/9/2021 8748 BABCOCK JAMES P ST CLAIR SHORES 1662074A 246 1/20/2021 8810 BOAT WASH LLC ST CLAIR SHORES 4591720A 2,366 3/12/2021 6836 0.95 BRICK AND BEYOND MASONARY ST CLAIR SHORES 6127878A 751 3/4/2021 5221 DETROIT DOG RESCUE ST CLAIR SHORES 4970500A 2,811 3/25/2021 8831 0.95 DRYWALL BY SEELINGER ST CLAIR SHORES 3125637A 750 1/29/2021 5445 FERNANDEZ LANDSCAPE INC ST CLAIR SHORES 3816230A 574 2/10/2021 9102 GEML CONSTRUCTION INC ST CLAIR SHORES 1019465A 2,618 2/24/2021 5403 HDM BUILDERS LLC ST CLAIR SHORES 6129641A 2,951 3/3/2021 5645 INTELLIGENT EMPLOYEE SOLUTIONS INC ST CLAIR SHORES 4196538D 149,911 1/1/2021 7208 0.89 J SCHREWE CONSTRUCTION ST CLAIR SHORES 3044394A 750 1/10/2021 5403 JJ CORPORATION OF AMERICA ST CLAIR SHORES 4631110A 657 1/3/2021 9102 0.95 LAKEVIEW CLUB CONDOMINIUM ASSOCIATION ST CLAIR SHORES 3041093A 568 1/26/2021 9015 LUCAS NELSON H ST CLAIR SHORES 0444251A 800 2/28/2021 5645 MILLER MODERNIZATION LLC ST CLAIR SHORES 6112013A 825 1/31/2021 5645 MNC ENTERPRISE LLC ST CLAIR SHORES 5951470A 750 1/11/2021 5437 MRS CLEAN BIZ INC ST CLAIR SHORES 4157478A 470 1/14/2021 8835 0.95 PMW ENTERPRISES LLC ST CLAIR SHORES 4210018A 1,062 1/4/2021 9015 0.95 POWER HARDWOOD FLOORS LLC ST CLAIR SHORES 0746568A 750 2/18/2021 5437 PRIME PROPERTY ASSOCIATES INC ST CLAIR SHORES 1983741A 577 2/28/2021 8810 PRO FIT HEATING & COOLING ST CLAIR SHORES 4732499A 674 3/26/2021 5550 RADAR SECURITY ALARM COMPANY ST CLAIR SHORES 0572292A 698 1/31/2021 5191 RDM HOLDINGS LTD ST CLAIR SHORES 0255254A 808 1/1/2021 8810 SEA SIDE DIVING INC ST CLAIR SHORES 2104156A 529 2/22/2021 1164 SOPFE SECURITY INC ST CLAIR SHORES 0714992A 1,454 1/22/2021 7720 0.95 TITAN COMPREHENSIVE CLEANING SOLUTIONS ST CLAIR SHORES 5950813A 619 1/9/2021 9015 LLC TWENTY THOUSAND 605 NINE MILE LLC ST CLAIR SHORES 4020537B 540 3/5/2021 9521 BRUNS CONSTRUCTION ENTERPRISES INC ST HENRY, OH 5976553A 5,126 3/16/2021 5059 GLASHAW DRYWALL ST IGNACE 2456230A 751 2/18/2021 5445

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MACKINAC ISLAND FREIGHT COMPANY LLC ST IGNACE 3597113A 9,056 3/28/2021 6826 0.92 STAR LINE MACKINAC ISLAND PASSENGER ST IGNACE 0430706A 69,703 3/10/2021 6826 0.98 SERVICE INC WHITEWOOD SHORES CO ST IGNACE 1204041A 2,208 1/10/2021 9052 0.95 AUTUMN PLUMBING AND REMODELING LLC ST JOHNS 5443229A 750 2/1/2021 5183 0.95 CUTTEN EDGE LOGGING LLC ST JOHNS 5240697A 750 2/17/2021 2709 J GALLOWAY FARMS INC ST JOHNS 3509796A 507 3/5/2021 8116 0.95 M AND M CONTRACT BUILD LLC ST JOHNS 3191435A 782 3/1/2021 5437 MARC GRAMS MASONRY & CONCRETE LLC ST JOHNS 6122434A 750 2/27/2021 5221 MARINES LOGGING LLC st JOHNS 5950309A 750 2/13/2021 2702 MOON DRYWALL LLC ST JOHNS 1305131A 750 3/23/2021 5445 QUALITY AG SERVICE LLC ST JOHNS 5356717A 248 1/14/2021 8742 RANGELS WATERPROOFING & CONSTRUCTION ST JOHNS 5540879A 5,746 2/1/2021 5183 0.95 T AND A ALL AMERICAN TRIMMING ST JOHNS 5431883A 751 2/11/2021 2702 A G E TRUCKING LLC ST JOSEPH 5669235A 825 2/3/2021 7208 BUTLER COMPUTER SERVICES INC ST JOSEPH 1689975A 353 1/11/2021 5191 C S INC ST JOSEPH 2729792A 269 2/13/2021 8742 CARE MANAGEMENT SOLUTIONS SERVICES LLC ST JOSEPH 5661153A 353 3/31/2021 8742 FISKARS INC ST JOSEPH 1299352A 2,591 3/19/2021 5606 0.95 HUMANE SOCIETY SOUTHWESTERN MICHIGAN ST JOSEPH 1133462A 2,196 1/27/2021 8831 0.95 RESTED PILLOW LLC ST JOSEPH 5642698A 757 1/6/2021 8810 ROGGOW CONSTRUCTION COMPANY LLC ST JOSEPH 5791553A 3,315 1/1/2021 5437 0.95 ROOFERS WORKFORCE LLC ST JOSEPH 5460158A 15,535 1/22/2021 5552 0.81 SUNSET COAST STAFFING LLC ST JOSEPH 5655994A 10,344 1/6/2021 9015 0.89 TRINITY LUTHERAN CHURCH OF ST JOSEPH ST JOSEPH 0184616A 14,814 1/1/2021 8868 1.46 40 % ALDRICHS AUTO ST LOUIS 3235262A 401 1/11/2021 8748 BREEN LINING & MORE LLC ST LOUIS 6123473A 438 2/20/2021 4484 DOSSON TRUCKING LLC ST LOUIS 4766440A 751 2/21/2021 7208 0.88 MYERS WELDING & FAB LLC ST LOUIS 5975468A 2,151 3/14/2021 3365 RAMIREZ QUALITY DRYWALL LLC ST LOUIS 4018419A 751 1/12/2021 5445 SALSBURY SERVICES LLC ST LOUIS 5075505A 750 3/7/2021 7208 TRIPLE D TRUCKING LLC ST LOUIS 5378249A 750 2/27/2021 7208 LEONARD J LECLAIR DC INC STANDISH 1479466A 315 3/16/2021 8832 STANDISH AREA FIRE AUTHORITY STANDISH 2965348A 1,207 1/1/2021 7704 0.95 CONTROLLED ENVIRONMENT STRUCTURES INC STANTON 2497689A 230 2/8/2021 8810 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MASTERTECH SERVICES LLC STANTON 5271819A 4,702 2/4/2021 5437 0.95 WAZNY DAWN M STANTON 5095395A 750 2/19/2021 2702 B AND C LOGGING STEPHENSON 3736245A 750 2/20/2021 2702 GENE THONEY FORESTRY STEPHENSON 0208817A 750 2/13/2021 2702 H W BLAHNIK TRUCKING INC STEPHENSON 3607062A 801 1/7/2021 8395 0.99 JOHNSON MICHAEL M STEPHENSON 6137563A 750 3/20/2021 5645 STERLING AREA FIRE AUTHORITY STERLING 1469711A 751 1/1/2021 7904 A HELPING HAND HOME HELP LLC STERLING HEIGHTS 6091954A 1,833 1/6/2021 8835 ABO CO EMPLOYMENT SERVICES INC STERLING HEIGHTS 5496560A 596,688 1/1/2021 3076 1.44 10 % ABO STAFFING SERVICES INC STERLING HEIGHTS 6139728A 10,230 3/19/2021 8832 ALL PAINTING STERLING HEIGHTS 6136974A 751 3/19/2021 5476 ANGLIN AGENCY STERLING HEIGHTS 3485790A 257 1/9/2021 8742 ARBORS ASSOCIATION STERLING HEIGHTS 3470873A 568 3/22/2021 9015 ARBORS NORTH ASSOCIATION STERLING HEIGHTS 3878368A 568 3/3/2021 9015 BLACKETT STEVEN STERLING HEIGHTS 0425494A 750 3/16/2021 5437 CDI LOGISTICS STERLING HEIGHTS 2006740A 750 2/1/2021 7380 CLINTON GROVE CONDOMINIUM ASSOCIATION STERLING HEIGHTS 2959542A 568 2/1/2021 9015 COACH LIGHT MANOR CONDOMINIUM STERLING HEIGHTS 0781924A 569 3/12/2021 9015 ASSOCIATION COMPLETE PAINTING & RENOVATION LLC STERLING HEIGHTS 6117082A 750 2/12/2021 5437 CRYSTAL CLEAR TRANSPORTATION INC STERLING HEIGHTS 5809681A 6,591 1/13/2021 7208 D V PAINTING STERLING HEIGHTS 5902010A 750 2/13/2021 5476 DELTA PRESSURE WASHING INC STERLING HEIGHTS 3665097A 632 2/19/2021 9015 0.95 DETROIT DENTAL DESIGN LAB CO STERLING HEIGHTS 0717215A 319 2/27/2021 4692 DYNAMIC SECURITY OF MICHIGAN LLC STERLING HEIGHTS 4693396A 2,263 2/28/2021 7720 0.95 EXCELLENCY LIMOUSINES LLC STERLING HEIGHTS 5968097A 3,220 2/19/2021 7212 F G HOME IMPROVEMENT INC STERLING HEIGHTS 4409019A 888 1/25/2021 5348 0.95 FIVE POINTE MOVING LLC STERLING HEIGHTS 4449002A 750 3/2/2021 7214 FIVE STAR FREEDOM PAINTING LLC STERLING HEIGHTS 5659531A 5,119 1/14/2021 5476 0.94 FIVE STAR MAINTENANCE LLC STERLING HEIGHTS 4838920A 2,854 1/19/2021 9015 0.95 FLOOR GALLERY LLC STERLING HEIGHTS 5670144A 591 1/23/2021 9521 FUBANG AUTOMOTIVE INTERIOR TECHNOLOGIES STERLING HEIGHTS 6123740A 229 2/21/2021 8742 LLC GABBERTS U CART CONCRETE PRODUCTS LLC STERLING HEIGHTS 3729842A 9,695 2/17/2021 4034 0.88 GARFIELD MANOR CONDOMINIUM ASSOCIATION STERLING HEIGHTS 1808192A 568 3/16/2021 9015

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge I AND G SERVICE LLC STERLING HEIGHTS 6098096A 750 1/14/2021 7208 IDEAL SERVICES LLC STERLING HEIGHTS 3817245A 25,567 1/26/2021 5437 0.75 IMPERIUM CONSTRUCTION LLC STERLING HEIGHTS 3622630A 800 2/7/2021 5146 IVEZA BUILDING SERVICES LLC STERLING HEIGHTS 5823030A 790 2/10/2021 9015 J B A GENERAL CONSTRUCTION LLC STERLING HEIGHTS 6104070A 1,966 3/12/2021 5403 KALEEL MICHAEL & JOYCE STERLING HEIGHTS 1662422A 618 1/4/2021 9015 KEVINS TOWING LLC STERLING HEIGHTS 4956656A 1,592 2/20/2021 7208 LETS HEAR IT FOR SPIRIT LLC STERLING HEIGHTS 5841011A 1,052 2/18/2021 4299 LINDON AND GABRIEL LLC STERLING HEIGHTS 5619572A 569 1/10/2021 9015 MAGNUM EXCAVATING INC STERLING HEIGHTS 2564602A 789 2/24/2021 6217 MALTESE BLDG CONTRACTORS LLC STERLING HEIGHTS 2880512A 4,245 1/8/2021 5551 0.95 MAR FILL UP INC STERLING HEIGHTS 5115418A 1,221 3/13/2021 8017 0.95 MARYS PRECIOUS LAMBS DAY CARE STERLING HEIGHTS 3381765A 390 3/4/2021 8869 METALFORM SERVICES LLC STERLING HEIGHTS 3844412A 6,033 3/22/2021 3724 1.32 27 % METRO FREIGHT BROKERS LLC STERLING HEIGHTS 1372840A 265 2/18/2021 8810 METRO WINDOWS INC STERLING HEIGHTS 5481058A 750 2/25/2021 5437 METROPOLES PAINTING STERLING HEIGHTS 4035550A 750 3/8/2021 5476 MMM MASONRY STERLING HEIGHTS 5817838A 750 2/14/2021 5022 MNARZ LLC STERLING HEIGHTS 6100422A 1,570 1/20/2021 7208 NEW WORLD CONSTRUCTION INC STERLING HEIGHTS 6136176A 751 3/17/2021 5645 PANTHEON GROUP INC STERLING HEIGHTS 3653889A 1,288 2/17/2021 8017 0.95 PARKDALE FOREST CONDOMINIUM ASSOCIATION STERLING HEIGHTS 4326997A 618 3/27/2021 9015 PLATINUM WEALTH MANAGEMENT GROUP INC STERLING HEIGHTS 4586859A 233 2/6/2021 8810 R S LOGISTICS LTD STERLING HEIGHTS 4894642A 750 2/15/2021 7208 RO MAR TILE & MARBLE INSTALLER STERLING HEIGHTS 3742563A 750 2/11/2021 5348 ROBA CONSTRUCTION STERLING HEIGHTS 6095330A 1,851 1/10/2021 5645 RYANS GENERAL CONSTRUCTION CO LLC STERLING HEIGHTS 6106218A 750 1/24/2021 5403 SAMSON MECHANICAL INC STERLING HEIGHTS 1830414A 674 3/3/2021 5550 SARGENTS CROSSING ASSOCIATION STERLING HEIGHTS 4430093A 568 1/5/2021 9015 SHELL TRUCKING INC STERLING HEIGHTS 5441757A 1,414 2/13/2021 7208 0.95 SHREE NIDHI CORPORATION STERLING HEIGHTS 3612961A 511 2/10/2021 8017 STAVRO A TRUCKING INC STERLING HEIGHTS 4903900A 750 3/2/2021 7208 STERLING LOGISTICS COMPANY STERLING HEIGHTS 5036330A 15,127 1/14/2021 7208 0.83 STERLING METAL WORKS LLC STERLING HEIGHTS 4145844A 21,450 3/30/2021 3085 1.33 SUN LITE CLEANING SERVICES INC STERLING HEIGHTS 4188730A 591 1/29/2021 8835 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 132 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TECHROM INC STERLING HEIGHTS 4599551A 229 3/14/2021 8742 TRANSPAK INC STERLING HEIGHTS 1007661A 348 1/1/2021 8810 0.95 TWINS A TRUCKING INC STERLING HEIGHTS 5442257A 3,808 2/7/2021 7208 0.95 UNIQUE HOME LLC STERLING HEIGHTS 3172201A 750 3/31/2021 5437 US WHEEL AND TIRE ONE INC STERLING HEIGHTS 5866057A 1,555 3/1/2021 8401 V D M CONSTRUCTION LLC STERLING HEIGHTS 5962196A 707 1/31/2021 5538 VIC HOME IMPROVEMENT STERLING HEIGHTS 4019121A 750 3/15/2021 5437 WALKARS HOME RELIEF SERVICES LLC STERLING HEIGHTS 5352754A 851 3/1/2021 8835 0.95 WOOTEN SCOTT STERLING HEIGHTS 5699274A 750 3/22/2021 5437 WORD OF MOUTH LLC STERLING HEIGHTS 6089275A 2,532 1/16/2021 5476 Z BEST CONTRACTING LLC STERLING HEIGHTS 3376818A 750 3/30/2021 5403 CALLAHAN DANIEL STERLING HTS 5975735A 637 3/14/2021 0908 HRONOS INC STERLING HTS 6123139A 750 2/20/2021 7208 COMMUNITY HOME BUILDERS CORPORATION STEVENSVILLE 5960118A 1,949 1/26/2021 5606 SHORELINE CONSTRUCTION SERVICES LLC STEVENSVILLE 5251974A 1,622 3/20/2021 5645 0.95 B SQUARED CONSULTING LLC STOCKBRIDGE 5813603A 324 2/11/2021 8601 ROBS PIZZA STOCKBRIDGE 1625136A 887 3/10/2021 9058 STEFFEY LARRY L STOCKBRIDGE 2248034A 1,274 3/31/2021 0129 0.95 EDGE ONE ARMORED INC STOUGHTON, WI 5971152A 4,361 3/1/2021 7720 BARTELT AVIATION INC STURGIS 0000086A 4,095 2/1/2021 7423 0.93 GW IT SOLUTIONS LLC STURGIS 5632935A 528 1/9/2021 5191 MOHNEY FOUNDATION STURGIS 5818818A 233 1/30/2021 8810 PRATER RONDAL STURGIS 5679672A 751 2/22/2021 5437 STURGIS AREA COMMUNITY FOUNDATION STURGIS 2808714A 330 2/25/2021 8742 TJ PANT LLC STURGIS 5967058A 7,255 2/13/2021 7208 PARADISE HOME IMPROVEMENT LLC SUGAR hills, GA 5384923A 480 1/15/2021 8742 PREEMP INC SUGAR LAND, TX 6062199A 2,017 3/26/2021 9403 A NEW LAWN CARE & LANDSCAPING INC SUMPTER TWP 0772119A 1,241 2/4/2021 9402 WHITTLE ADVISORS LLC SUTTON BAY 5253977A 229 3/26/2021 8742 JELINEK TRANSPORTATION LLC SUTTONS BAY 5153131A 1,102 1/15/2021 7208 MOSES WINDOW CLEANING SUTTONS BAY 2038366A 1,653 1/7/2021 9015 0.95 BUILT TO LAST CONSTRUCTION LLC SWARTZ CREEK 3388913A 4,653 3/10/2021 5645 0.95 CRYSTAL CUSTOM CARPENTRY SWARTZ CREEK 5294843A 750 2/21/2021 5437 JEFF JOHNSON CARPENTRY SWARTZ CREEK 1873130A 750 3/6/2021 5437 MAY MICHAEL SWARTZ CREEK 4565053A 750 3/18/2021 5551 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 133 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PEC ELECTRIC INC SWARTZ CREEK 3895300A 720 1/7/2021 5190 RHINO VISION TECHNOLOGIES LLC SWARTZ CREEK 6131760A 840 2/27/2021 9015 AGUAFINA GARDENS & IMPORTS INC SYLVAN LAKE 2587890A 811 3/1/2021 5183 0.93 BENCHMARK HOMES INC SYLVAN LAKE 2815168A 2,908 3/13/2021 5610 0.95 LAKES DEVELOPMENT GROUP INC SYLVAN LAKE 5676290A 5,199 3/1/2021 5606 FRAME PEST CONTROL INC SYLVANIA, OH 4853555A 5,933 1/20/2021 9015 0.88 JETS HOCKEY CLUB LLC TAMPA, FL 5957460A 2,457 2/9/2021 9015 ADVANCE MACHINE CORP TAWAS CITY 1815776A 1,078 1/30/2021 3629 WOJAHN FLOOR COVERING INC TAWAS CITY 0563161A 3,224 3/29/2021 9521 0.92 A AND N PETRO MART INC TAYLOR 1334743A 594 1/14/2021 8017 ADVANTAGE ROOFING & CONSTRUCTION LLC TAYLOR 5007640A 800 3/19/2021 5551 AGGRESSIVE HIRING GROUP SERVICES INC TAYLOR 5004608A 10,747 3/5/2021 8292 1.05 10 % ALL CONSTRUCTION SERVICE CO INC TAYLOR 5744539A 2,102 2/1/2021 5437 ALPHA PAINTING & DRYWALL REPAIR LLC TAYLOR 4441990A 801 1/23/2021 5476 0.95 AML GAS II INC TAYLOR 5684730A 836 1/16/2021 9058 0.95 BIANCO TRAVEL & TOURS INC TAYLOR 2491354A 216 3/13/2021 8810 BLUE STARS INC TAYLOR 5350778A 757 2/1/2021 8810 CHRIS PETERS HOME IMPROVEMENTS TAYLOR 4976932A 750 1/25/2021 5551 0.95 DAVE NICHOLS HANDY SERVICES TAYLOR 4329007A 750 3/31/2021 5437 MCBAINS HOME IMPROVEMENT LLC TAYLOR 3410099A 2,102 3/8/2021 5437 MD HEALTH CARE LLC TAYLOR 5482410A 471 2/21/2021 8835 NAVICORP LLC TAYLOR 5680727A 11,264 2/24/2021 9501 0.89 PAULEYS CONSTRUCTION INC TAYLOR 3062740A 800 3/19/2021 5183 0.95 QUALITY AND AFFORDABLE MASONRY TAYLOR 5038880A 825 2/25/2021 5645 RED AUSTINS FUNERAL COACH SERVICE LLC TAYLOR 0026700A 10,164 2/1/2021 7380 1.42 10 % TIKAL ROOFING & HOME IMPROVEMENT LLC TAYLOR 3517292A 17,191 2/27/2021 5551 1.52 27 % TJ TRANSPORT LLC TAYLOR 6120504A 3,917 2/15/2021 7208 TRI COUNTY NURSES PLUS LLC TAYLOR 3784240A 18,158 3/20/2021 8829 0.71 WESTWIND COMPANIES LLC TAYLOR 2167590A 825 3/3/2021 5437 0.95 BASH EVENT PLANNING & DESIGN LLC TECUMSEH 5972353A 279 3/2/2021 8742 CREEK PLASTICS LLC TECUMSEH 4871456A 26,467 3/16/2021 4459 1.59 40 % D AND D CONTRACTING TECUMSEH 3385914A 751 3/6/2021 5403 EBM CONSTRUCTION INC TECUMSEH 3469344A 752 1/10/2021 8810 NEWSCAPE FORESTRY LLC TECUMSEH 6133827A 825 3/10/2021 0106 POTES MARY TECUMSEH 5977886A 470 3/21/2021 8835 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 134 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge LONE CREEK CONTROLS LLC TEKONSHA 4854594A 1,627 2/10/2021 3179 0.95 TWO FELLERS TREE SERVICE LLC TEKONSHA 4969294A 1,253 3/24/2021 0106 0.95 VANWORMER EXCAVATING LLC TEKONSHA 3529835A 789 3/18/2021 6217 BRUCE E CROWLEY CARPENTER & BUILDER LLC TEMPERANCE 4198891A 800 1/17/2021 5437 FOX MEADOW FARM INC TEMPERANCE 5114250A 4,706 3/12/2021 8279 0.95 FROST MUSIC LLC TEMPERANCE 2278103A 415 3/4/2021 9156 HUNTERS RUN STABLE LLC TEMPERANCE 1117351A 5,964 1/19/2021 8279 0.93 JNR SERVICES INC TEMPERANCE 4077032A 1,131 3/24/2021 8292 0.95 PROFESSIONAL TOWING AND RECOVERY LLC TEMPERANCE 4342712A 4,221 2/8/2021 7208 1.42 13 % SIMPLY PROPERTY MAINTENANCE TEMPERANCE 6088740A 731 1/3/2021 9102 SUPERIOR PAINT FINISHES TEMPERANCE 5774756A 800 1/21/2021 5476 VAUGHNS TREE SERVICE TEMPERANCE 3946630A 826 1/16/2021 0106 LAKESHORE PAINTING AND RESTORATIONS LLC THOMPSONVILLE 5640598A 750 1/9/2021 5476 1.00 NORTHERN ROOFING THOMPSONVILLE 1994921A 1,419 3/30/2021 5551 0.95 LONG HAUL PRODUCTIONS INC THREE OAKS 5727162A 851 1/4/2021 7610 S AND J LANDSCAPING & SERVICES LLC THREE OAKS 2843706A 709 2/18/2021 0042 0.95 A W JONES INC THREE RIVERS 4864085A 750 3/1/2021 8304 CONRAD AERO LLC THREE RIVERS 0532436A 2,001 3/3/2021 7423 0.95 COOL BREEZE MECHANICAL THREE RIVERS 5677777A 674 2/18/2021 5550 DEBOER THEODORE THREE RIVERS 4965264A 750 2/22/2021 5551 GRAHAM HAL THREE RIVERS 3678148A 750 1/9/2021 7208 KENNETH LINN CONSTRUCTION INC THREE RIVERS 3034259A 495 2/18/2021 5606 MUEHLBERGER CUSTOM HOMES INC THREE RIVERS 6089593A 2,228 1/1/2021 5437 RICHMAN LARRY D REVOKABLE TRUST THREE RIVERS 3164519A 1,151 3/27/2021 9015 0.95 THOMPSON EMMA THREE RIVERS 6098967A 568 1/15/2021 9015 WILLOW LAKE SPORTSMANS CLUB INC THREE RIVERS 2856050A 568 3/3/2021 9015 LAGUNA INDUSTRIES LLC TIGARD, OR 5603927A 3,160 1/17/2021 3724 0.93 JNJS TILE LLC TIPTON 5319455A 800 1/17/2021 5437 ARNOLDS HOME IMPROVEMENT LLC TOLEDO, OH 4094697A 352 2/9/2021 5606 BRIAN ROOD ART INC TOLEDO, OH 5802954A 248 1/4/2021 8810 CHRISTIAN HOME CARE LLC TOLEDO, OH 4973275A 629 3/22/2021 8835 CLASSICALA FARM INC TOLEDO, OH 1992066A 6,589 2/16/2021 8279 0.96 DMD ENVIRONMENTAL INC TOLEDO, OH 4840593A 982 2/24/2021 8601 0.95 GEO GRADEL CO TOLEDO, OH 1244035A 1,846 3/31/2021 6217 1.49 13 % HENRY GURTZWEILER INC TOLEDO, OH 0051489A 5,127 1/10/2021 5057 0.70 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 135 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge LIVING WELL LABORATORIES LLC TOLEDO, OH 6128670A 3,140 2/28/2021 0035 MAINS CONSTRUCTION SERVICES LLC TOLEDO, OH 5004594A 831 1/23/2021 5606 MELDRUM MECHANICAL SERVICES INC TOLEDO, OH 5668638A 7,153 2/3/2021 3632 0.94 RUSK INDUSTRIES INC TOLEDO, OH 2622122A 568 1/3/2021 9015 DETROIT APARTMENT CORP TORONTO, ON 5273307A 7,032 1/31/2021 9015 0.87 KALAMAZOO PROPERTY CORP TORONTO, ON 4751795A 5,445 2/22/2021 9015 0.92 SHIPMAN JOHANNA TRAVERSE 5973490A 568 3/7/2021 9015 A AND M CUSTOM HOMES INC TRAVERSE CITY 4000994A 750 2/2/2021 5437 AMS ASSISTED MOVING SERVICES LLC TRAVERSE CITY 5956056A 750 1/22/2021 7214 BROTHERS TREE SERVICE TRAVERSE CITY 4352750A 13,981 3/27/2021 0106 0.87 BUCKLEY LAND & CATTLE CO LLC TRAVERSE CITY 2612186A 967 2/12/2021 0129 0.95 CARLSON TIMOTHY DAVID TRAVERSE CITY 5881595A 530 2/26/2021 0913 CITY CENTRE PLAZA LLP TRAVERSE CITY 1347411A 574 2/19/2021 9015 CONSOLIDATED DRILLING CO LLC TRAVERSE CITY 4531850A 17,039 3/16/2021 6235 0.87 COOPER PEGGY R M TRAVERSE CITY 5813050A 2,081 1/20/2021 0913 0.95 CORE ENERGY LLC TRAVERSE CITY 2891204A 6,727 3/1/2021 1320 0.90 CREW FACILITY SERVICES LLC TRAVERSE CITY 4311957A 619 3/21/2021 9015 D AND D WELDING AND FABRICATION LLC TRAVERSE CITY 5601460A 983 1/31/2021 3365 DAVID GLEASON INC TRAVERSE CITY 0292303A 4,799 1/1/2021 5645 0.94 EZ ERECTORS INC TRAVERSE CITY 5065887A 10,595 2/8/2021 5146 1.67 13 % FATHER FRED FOUNDATION TRAVERSE CITY 2840723A 615 1/8/2021 8810 FIELDSPORT LTD LLC TRAVERSE CITY 2457822A 1,375 2/1/2021 8010 0.95 FRONT STREET HOLDINGS LLC TRAVERSE CITY 5653665A 568 1/1/2021 9015 GILLCOM LLC TRAVERSE CITY 1142356A 1,543 3/21/2021 5191 0.95 GMK CONSTRUCTION CO LLC TRAVERSE CITY 4346114A 803 3/16/2021 5606 0.95 HITCHENS J DANIEL TRAVERSE CITY 0075884A 764 3/21/2021 8810 INTER LAKES INSULATION LLC TRAVERSE CITY 2411547A 1,630 3/23/2021 5479 0.95 JD FRAMING TRAVERSE CITY 6094848A 5,151 1/9/2021 5645 K AND R TRANSPORTATION TRAVERSE CITY 4996755A 1,162 3/20/2021 7202 0.95 KEVIN HALL BUILDER INC TRAVERSE CITY 6096417A 800 1/11/2021 5645 LADY BUG SERVICES TRAVERSE CITY 5951097A 569 1/10/2021 9015 LAKESHORE PAINTING CO TRAVERSE CITY 5969093A 800 2/21/2021 5476 LANGES PAINTING & WALLCOVERINGS LLC TRAVERSE CITY 4298713A 800 3/1/2021 5476 MERIDIAN ENTERTAINMENT INC TRAVERSE CITY 1200054A 1,553 3/3/2021 9015 0.95 MONARCH HOME HEALTH SERVICES LLC TRAVERSE CITY 4028805A 520 1/17/2021 8810 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 136 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge NORTHERN DRYWALL SPECIALISTS INC TRAVERSE CITY 1030787A 7,336 2/24/2021 5445 0.93 NORTHSHORE EXTERIORS LLC TRAVERSE CITY 3510620A 13,783 2/27/2021 5551 0.81 NORTHWOODS TRUCKING LLC TRAVERSE CITY 4899229A 4,391 2/15/2021 7208 OLTERSDORF JENNIFER TRAVERSE CITY 5695384A 618 3/25/2021 9015 POBUDA FLAT WORKS TRAVERSE CITY 2825732A 1,315 2/6/2021 5221 0.95 PRACTICAL RENOVATIONS LLC TRAVERSE CITY 3502325A 750 1/8/2021 5437 0.95 RODRIGUEZ CONCRETE CONSTRUCTION LLC TRAVERSE CITY 2847426A 800 2/22/2021 5221 S D INSULATION TRAVERSE CITY 5977410A 750 3/20/2021 5479 SHAWNS BOATS AND CABINS TRAVERSE CITY 6124534A 618 2/22/2021 9015 SIDE TRAXX INC TRAVERSE CITY 0415138A 935 3/24/2021 9058 0.95 SINNTEL LLC TRAVERSE CITY 6019790A 7,028 2/26/2021 5102 SOLSTICE SAILING INC TRAVERSE CITY 2115263A 4,174 1/9/2021 6836 0.95 STANDARD CONTRACTING SERVICES III LLC TRAVERSE CITY 6107451A 800 1/24/2021 5645 STIEBEL AND ASSOCIATES INC TRAVERSE CITY 5951500A 245 1/11/2021 8810 TARRAS BROTHERS CONSTRUCTION LLC TRAVERSE CITY 5975093A 750 3/15/2021 5645 TIMBERLEE HOLDINGS LLC TRAVERSE CITY 5807875A 938 1/11/2021 9015 TRANSFORMER EXCHANGE LLC TRAVERSE CITY 6115853A 552 2/11/2021 8017 TRAVERSE CITY TRACK CLUB INC TRAVERSE CITY 5682525A 369 3/1/2021 8810 TUCKER ROBERT E JR TRAVERSE CITY 5511755A 1,039 2/15/2021 0908 US 131 SMOKE SHOP & BOUTIQUE LLC TRAVERSE CITY 5970806A 674 2/27/2021 8017 VISIT UP NORTH VACATION RENTALS LLC TRAVERSE CITY 4201710A 2,672 1/1/2021 9015 WHETSTONE COMPANY TRAVERSE CITY 4838360A 1,047 2/16/2021 8810 WHITEWATER IRRIGATION LLC TRAVERSE CITY 5831210A 702 2/23/2021 6229 WOMANS TOUCH PAINTING AND DECORATING TRAVERSE CITY 5676304A 750 2/16/2021 5476 LLC YACHT SOLUTIONS LLC TRAVERSE CITY 5649471A 493 2/6/2021 6836 JAMES KANERVA FOREST PRODUCTS TRENARY 2451646A 750 2/11/2021 2702 A TO Z CONTRACTING INC TRENTON 0436666A 3,070 2/11/2021 5221 ADVANTAGE PEST CONTROL LLC TRENTON 0417637A 643 3/21/2021 9015 B A S FLOORING LLC TRENTON 5969131A 1,620 2/21/2021 9521 DETROIT STEEL COMPANY LLC TRENTON 2915731A 1,048 3/19/2021 9015 1.56 27 % ERWIN JONATHAN TRENTON 4904494A 750 3/17/2021 5437 MARLINS LAWN CARE LLC TRENTON 5099773A 523 3/7/2021 9102 MOBILE LETTERING LLC TRENTON 5523958A 494 3/30/2021 4351 ROYAL VAPE AND SMOKE LLC TRENTON 6003249A 408 2/5/2021 8017

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge TITAN CONSULTING NORTH LLC TRENTON 5950287A 1,500 1/5/2021 7720 ROGER GUSTAFSON LOGGING TROUT CREEK 5963419A 750 1/31/2021 2709 A L B PAINTING LLC TROY 5718767A 801 3/12/2021 5476 ACE CONSTRUCTION & FIREPLACE LLC TROY 3896218A 2,529 1/25/2021 5348 ADVANTAGE GROUP SERVICES INC TROY 0429813A 239 3/16/2021 8810 ALDO CARPET CLEANING LLC TROY 4723163A 771 1/7/2021 5550 ALEX MASTER PAINTING LLC TROY 3875784A 750 1/21/2021 5476 ALPHA ELECTRIC AND ENGINEERING LLC TROY 4845072A 2,859 1/22/2021 5190 0.74 AMERICAN ASPHALT PAVING & SEALCOATING LLC TROY 2700760A 1,725 3/22/2021 5221 0.95 ARENA INSURANCE AGENCY LLC TROY 5223326A 240 1/1/2021 8810 ASAHI TEC NORTH AMERICA INC TROY 5503817A 902 1/15/2021 8742 B AND N INC TROY 2023008A 509 1/9/2021 9052 BERRY CHRISTOPHER TROY 1151274A 750 1/1/2021 5645 BMT CONSTRUCTION LLC TROY 4057848A 800 2/28/2021 5645 BOWER LUCILLE TROY 5835674A 765 3/7/2021 8835 CADENCE FARM LLC TROY 6144071A 2,333 3/30/2021 8279 CARMICHAEL BENJAMIN TROY 5794757A 307 2/19/2021 0908 CENTRAL PARK MASTER COMMUNITY TROY 5667607A 580 1/28/2021 9015 ASSOCIATION CLIFFS LANDING CONDOMINIUM PHASE TWO TROY 1989022A 568 3/12/2021 9015 ASSOCIATION CREATIVE TECH TALENT SOLUTIONS LLC TROY 5960770A 300 1/29/2021 8810 CROSSINGS OF OAKLAND PROPERTY OWNERS TROY 3428621A 568 3/3/2021 9015 ASSOCIATION DELTA STAR ELECTRICAL CONTRACTING LLC TROY 2062151A 1,173 3/22/2021 5190 DESIGN AND CONSTRUCTION GROUP INC TROY 2968401A 803 2/10/2021 5606 DETRAMS INC TROY 4361466A 516 1/22/2021 8017 0.92 DETROIT ACADEMY OF MARTIAL ARTS LLC TROY 5425735A 469 2/16/2021 9063 DROSTE GROUP LLC TROY 5221668A 215 1/1/2021 8810 0.95 EFEE INC TROY 5960940A 825 1/29/2021 5476 ENA CARE LLC TROY 5843871A 2,282 3/20/2021 9053 0.95 ETXE TAR USA CORPORATION TROY 3500403A 628 3/8/2021 9015 EVENT SOLUTIONS INTERNATIONAL INC TROY 2971151A 608 3/1/2021 8810 1.79 40 % EXPERT FLOORING & REMODELING TROY 3905357A 540 3/25/2021 9521 F AND P TOTAL REMODEL AND RENOVATION CO TROY 1652508B 750 2/26/2021 5645 0.94 FABRIC AFFAIR LLC TROY 5074428A 299 1/12/2021 8008 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 138 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge GBS ACQUISITION CORP TROY 1383329A 279 2/28/2021 8810 GIRL FRIDAY ASSOCIATES INC TROY 4823117A 4,338 1/25/2021 3146 1.29 13 % GLACIER CLUB THREE ASSOCIATION TROY 4317181A 568 2/27/2021 9015 GLEN EAGLES CONDOMINIUM ASSOCIATION TROY 3426459A 618 2/13/2021 9015 GLOEDE PARK SUBDIVISION HOMEOWNERS TROY 4853741A 568 1/14/2021 9015 ASSOCIATION GULASON ESTATES CONDOMINIUM ASSN TROY 3450015A 568 1/10/2021 9015 HMD PROPERTIES LLC TROY 5533627A 644 3/23/2021 8810 HR ALLIANCE INC TROY 4839706A 36,680 1/3/2021 8868 1.83 13 % HR MANAGEMENT LLC TROY 4017226A 150,877 1/1/2021 8395 1.46 HUMAN CAPITAL VENTURES INC TROY 5715598A 215 1/9/2021 8810 ISON SYSTEMS LLC TROY 5675855A 613 2/15/2021 9015 J POD LIMOS LLC TROY 5903912A 1,954 1/1/2021 7212 JEWELLS TOWING LLC TROY 5946336A 800 1/30/2021 7208 JKR LLC TROY 6108164A 750 1/25/2021 5437 JUNIOR LEAGUE OF BIRMINGHAM MICHIGAN INC TROY 1136054A 276 1/4/2021 8810 K VIAL CONSTRUCTION TROY 2661985A 2,091 3/8/2021 5645 0.95 KOCH CONTRACTING TROY 4865065A 573 1/16/2021 9102 L AND L FLOORING LLC TROY 5123852A 1,912 3/19/2021 9521 0.95 LAKE COMMUNITIES AT WATERSTONE TROY 4480538A 568 3/3/2021 9015 HOMEOWNERS ASSOCIATION LAKE EFFECT GROUP LLC TROY 5581699A 4,340 2/28/2021 8045 0.95 LAKEFRONT LAWN CARE INC TROY 5239230A 1,377 2/13/2021 9102 0.95 LEWIS DAVID TROY 1573217A 750 3/15/2021 5437 LLP SERVICES INC TROY 5530300A 2,225 3/17/2021 5606 0.95 MCGAUGHEY ELECTRIC TROY 0478652A 470 2/15/2021 5190 MEDMATCH PLUS TWO INC TROY 2808200A 478 1/23/2021 8832 MENTORS OF MICHIGAN INC TROY 4042948A 17,669 1/5/2021 9053 0.84 MHI PAINTING & RESTORATION LLC TROY 3090345A 800 2/20/2021 5476 MOUNTAIN TOP TREE SERVICE INC TROY 1210483A 4,767 1/1/2021 0106 0.89 MVP MANAGEMENT LLC TROY 6140858A 3,245 3/26/2021 7212 NADIA F ZAKI MD PC TROY 3201945A 240 1/15/2021 8832 OAK POINTE COMMUNITY ASSOCIATION TROY 3432378A 568 2/1/2021 9015 OAKLAND INDUSTRIAL PROPERTIES LLC TROY 3463400A 618 2/24/2021 9015 OFFICE EXPRESS INC TROY 1217240A 529 3/22/2021 8810 0.95

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ONE 800 RAPID 51 INC TROY 5722683A 825 2/23/2021 5551 ORSUS GROUP INC TROY 4454111A 2,091 3/22/2021 8810 0.95 PALAJ INC TROY 2211130A 1,659 3/17/2021 9058 1.05 10 % PARAGON ROOFING TECHNOLOGY INC TROY 2760118A 1,957 3/13/2021 8720 0.95 PINE RIVER LODGE LLC TROY 0593370A 357 2/28/2021 0908 POOCHPEOPLE INC TROY 3915379A 8,125 2/27/2021 8831 0.95 PORTAGE ACQUISITIONS INC TROY 6122655A 1,746 2/19/2021 0035 R F HOME IMPROVEMENT TROY 4865294A 750 2/8/2021 5183 RAY ADVERTISING INC TROY 4154380A 1,998 2/3/2021 7380 0.95 RAYBURN EZEKIEL TROY 5511976A 521 3/18/2021 0908 RELIANT HOME CARE SERVICES LLC TROY 5832195A 2,345 2/24/2021 8835 ROBINSON SECURITY SOLUTIONS LLC TROY 5424690A 1,168 1/4/2021 7720 0.93 ROYAL HILL APARTMENTS INC TROY 0082970A 351 3/1/2021 8810 ROYALTY AIR CARE INC TROY 4846583A 675 1/16/2021 5550 ROYALTY HOME BUILDERS INC TROY 4190599A 750 3/10/2021 9521 SHINY MARBLE RESTORATION LLC TROY 4844459A 750 3/8/2021 8810 SINALODI FLOORS TROY 6088015A 834 1/3/2021 5437 TB SOLUTIONS GROUP LLC TROY 5829070A 20,452 2/16/2021 3400 0.88 TED LINDSAY FOUNDATION TROY 4949471A 753 1/11/2021 8810 TRIPLE F FACILITY SERVICES INC TROY 4493150A 3,284 3/15/2021 9015 TROY JS CORPORATION TROY 5378591A 2,073 3/3/2021 8010 0.95 TROY PLUMBING LLC TROY 6138993A 611 3/24/2021 5183 TURTLE GROVE CONDOMINIUM ASSOCIATION TROY 5691680A 568 3/20/2021 9015 TUTHILL ERIC TROY 5968089A 307 3/24/2021 0908 UNITED DISTRIBUTING CO TROY 2077264A 824 3/17/2021 8017 UPSTON AIDEN TROY 5663016A 307 2/19/2021 0908 VIA REMODELING LLC TROY 5962145A 750 1/31/2021 5645 WISEMAN CARTER TROY 5302552A 307 3/25/2021 0908 WOODLAKE CONSTRUCTION LLC TROY 3474178A 1,046 3/31/2021 5606 0.95 WOODLYNNE CONSTRUCTION CO INC TROY 0497460A 750 1/9/2021 5437 WELLS LAWN CARE TRUFANT 5977894A 751 3/21/2021 0042 ADVANTAGE PAINTING & REMODELING INC TUCKER, GA 4339452A 5,050 1/27/2021 5476 INTERNATIONAL LAUNCH SOLUTIONS INC TUCSON, AZ 5811414A 5,772 1/18/2021 3400 0.95 BELCHERS MAPLE SYRUP LLC TUSTIN 4763920A 476 1/11/2021 0130 0.95 KAYL MATTSON CONSTRUCTION LLC TUSTIN 6130461A 750 3/5/2021 5645 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 140 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BELKNAP MATTHEW TWIN LAKE 5505402A 750 2/8/2021 5645 0.92 CROWN CONSTRUCTION SERVICES LLC TWIN LAKE 5834627A 750 3/3/2021 5403 JELINEK TREE SERVICE LLC TWIN LAKE 5829666A 752 3/1/2021 0106 GENES HARDWARE AND LP GAS LLC TWINING 0266850A 2,057 2/8/2021 8010 PSI COLLEGIUM LLC TWINSBURG, OH 4169476A 947 1/11/2021 8868 0.95 B AND P TRANSPORT LLC UBLY 5134951A 3,079 3/13/2021 7219 0.95 PAUL BUNYAN SAWMILL UBLY 4193563A 3,248 3/17/2021 2759 0.95 ROOSTER RANCH LLC UBLY 1973738A 569 2/12/2021 9015 FOUR LAKES RV LLC UNION 5715920A 309 2/26/2021 8748 TURTLE LAKE RESORT LLC UNION CITY 2023806A 1,246 1/7/2021 9015 0.95 A AND Q PAINTING LLC UTICA 5949823A 750 1/4/2021 5476 AZDECK ONE LLC UTICA 6133860A 800 3/10/2021 5645 CAMPO DISPOSAL INC UTICA 5955300A 750 1/19/2021 7208 LENINGER ENTERPRISES INC UTICA 1970720A 4,853 1/8/2021 9015 1.05 PREVAIL BUILDING SERVICES INC UTICA 5644747A 750 2/14/2021 5437 RADIANT WINDOWS INC UTICA 5952611A 887 2/5/2021 9015 TONI CONSTRUCTION LLC UTICA 6125875A 800 2/26/2021 5348 XTREME SERVICES INC UTICA 4289552A 3,652 3/9/2021 9015 1.00 SAMS TILE AND MARBLE VAN BUREN 6136532A 750 3/18/2021 5348 BLACK MONT LLC VAN BUREN TWP 5047943A 1,497 1/25/2021 5348 S I COMPLETE SERVICES LLC VAN BUREN TWP 6090974A 1,430 1/10/2021 7212 CREEKSTONE INVESTMENTS INC VANDALIA 5961475A 324 1/30/2021 8810 BURNETTE LOGGING VANDERBILT 4311515A 750 1/5/2021 2702 CORK PINE BUILDERS LLC VASSAR 3525333A 2,086 3/28/2021 5645 0.95 VASSAR CHAMBER OF COMMERCE VASSAR 2410060A 283 1/8/2021 8810 SHARP IMAGE PROPERTY MAINTENANCE LLC VERMONTVILLE 5687349A 663 3/7/2021 9102 BISSELL LINERS AND MORE LLC VESTABURG 6096441A 438 1/11/2021 4484 DUCKIN TRUCKIN EXPRESS LLC VICKSBURG 5720656A 806 2/23/2021 8810 0.95 GENEROUS HANDS INC VICKSBURG 5490049A 306 1/1/2021 8742 HAAS ANDREA VICKSBURG 4399552A 1,319 1/11/2021 0913 0.95 VICKSBURG ROOFING & SIDING CO VICKSBURG 3292886A 752 1/1/2021 8810 1.45 13 % VICKSBURG TOWING LLC VICKSBURG 5409705A 800 2/28/2021 7208 HUMMEL LOGGING VULCAN 3874664A 750 1/16/2021 2709 KL CUSTOM WOODWORKS LLC VULCAN 6091261A 1,468 1/3/2021 5437 LAFRENIERE CONSTRUCTION LLC VULCAN 5424887A 3,459 3/10/2021 5479 0.95 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 141 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WINDGATE TRANSPORTATION INC W BLOOMFIELD 6122361A 10,353 3/18/2021 7202 WRIGHT WALDRON FIRE & RESCUE WALDRON 3621880A 1,904 2/21/2021 7904 0.95 ASSOCIATION PETRA CONSTRUCTION INC WALES 1085867A 1,847 1/1/2021 5645 0.95 UITVLUGT PAINTING WALKER 3529614A 750 2/12/2021 5476 ZENDER JOSH WALKER 6097812A 750 1/14/2021 5437 T RAKS LLC WALLACE 5666406A 750 2/23/2021 7208 CHUMACK CONSTRUCTION LLC WALLED LAKE 5733111A 1,210 1/9/2021 5437 FOUR HM INC WALLED LAKE 3014061A 750 3/19/2021 5437 HAMAKATSU CORP WALLED LAKE 5264723A 401 1/28/2021 9058 JCH BUILDERS WALLED LAKE 4240332A 750 3/3/2021 5645 LADD ROAD COLLISION INC WALLED LAKE 3556891A 846 1/4/2021 8393 LAKE O WOODS CONDOMINIUM ASSOCIATION WALLED LAKE 2097737A 568 3/4/2021 9102 ANGELIC FOSTER CARE INC WARREN 5338166B 1,531 1/9/2021 9053 0.95 ARK GRANITE & CONSTRUCTION LLC WARREN 5957761A 750 1/23/2021 5348 BEC CONSTRUCTION INC WARREN 5477751A 750 2/25/2021 5437 BEN CONSTRUCTION LLC WARREN 5443571A 1,519 1/10/2021 5403 BENS MOBIL SERVICE WARREN 5511399A 481 3/4/2021 8395 BLUE WATER SPORTS MANAGEMENT LLC WARREN 4426495A 7,562 2/9/2021 9015 0.95 BM PAINTING INC WARREN 4258010A 750 2/3/2021 5476 BUILDING DECOMMISSION SERVICES LLC WARREN 4419553A 422 2/11/2021 8742 1.26 13 % BULLDOG RECOVERY & TOWING LLC WARREN 5959217A 11,404 1/25/2021 7208 CAN LAB LLC WARREN 5237777B 1,823 2/15/2021 4511 1.09 13 % CITY ABATEMENT SERVICES LLC WARREN 5947685A 42,405 1/15/2021 5183 CURB ENVY CONSTRUCTION WARREN 6125115A 750 2/25/2021 5348 CWC SMART HOME SPECIALISTS LLC WARREN 4548280A 1,577 3/23/2021 5190 EMB SOLUTIONS LLC WARREN 5016959A 15,584 3/4/2021 3400 0.80 FAS DESIGN WARREN 5405530A 750 1/16/2021 5348 FOURACRE CONSTRUCTION LLC WARREN 3664392A 2,392 2/15/2021 5403 FRANKIES ROOFING AND SIDING LLC WARREN 6122906A 1,525 2/19/2021 5645 GILBERT HOME LLC WARREN 5692326A 894 3/17/2021 9053 GM CONTRACTING WARREN 3795209A 2,078 3/31/2021 5437 0.95 GREEN LINE CONSTRUCTION LLC WARREN 5681510A 1,090 2/25/2021 5551 GROUNDSMEN LAWNSCAPE WARREN 1835335A 709 3/22/2021 0042 I HEART DOGS RESCUE AND ANIMAL HAVEN WARREN 5488850A 1,749 1/6/2021 8831 1.00

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge INSPECT IT RIGHT LLC WARREN 5686601A 444 3/24/2021 8720 INTERNATIONAL UNION OF PAINTERS & ALLIED WARREN 0087653A 2,309 1/18/2021 8755 0.95 TRADES DISTRICT COUNCIL 1M JB CLEANING SERVICES INC WARREN 3436535A 984 3/8/2021 9015 0.95 JCS HEATING & COOLING LLC WARREN 4800010A 675 3/11/2021 5550 0.95 JFB CONSTRUCTION LLC WARREN 5053382A 3,572 3/23/2021 5645 0.95 KADO CLEANING SERVICE LLC WARREN 5838851A 568 3/13/2021 9015 KEVIN OLOWNIUK PRO SERVICES WARREN 2268396A 674 2/24/2021 5550 KINNIE DRIVERS SERVICES INC WARREN 3941973A 7,528 2/26/2021 7380 0.85 KNAPP SCHOOL OF DANCE WARREN 4152069A 547 1/25/2021 9063 L AND M FLOORING SERVICES LLC WARREN 6115357A 850 2/10/2021 9521 LAST MINUTE HAULING WARREN 1567861A 764 1/22/2021 5610 LCA CONCEPTS INC WARREN 4073363A 463 3/15/2021 9058 M AND S REMODELING LLC WARREN 5962161A 750 1/31/2021 5645 MEXICO CITY RESTAURANT CO WARREN 5192749A 780 3/10/2021 9058 MICHAIL INC WARREN 5363446A 330 1/20/2021 8017 MICHIGAN ASPIRE II LLC WARREN 6093787A 444 1/8/2021 0035 MUSIC FACTORY EAST LLC WARREN 5685249A 1,539 3/3/2021 9015 0.95 NERMINS PAINTING INC WARREN 4836006A 750 2/28/2021 5476 PANTHERS TOWING AND RECOVERY LLC WARREN 6108130A 750 1/25/2021 7208 PAUL AND CO INC WARREN 6123716A 707 2/21/2021 5538 PRESTIGE BUILDING PERFORMANCE LLC WARREN 5662109A 450 3/24/2021 8720 PRO COMM CABLING LLC WARREN 5214564A 332 1/17/2021 5191 PW CONTRACTING LLC WARREN 5818761A 1,260 2/1/2021 5221 RAPID RECOVERY SERVICE INC WARREN 3596974A 10,989 1/1/2021 9015 1.60 13 % SAS SERVICES INC WARREN 4548493A 14,480 1/3/2021 5476 0.87 SAWAS MECHANICAL LLC WARREN 5968160A 750 2/18/2021 5550 SHOWALTER MICHAEL WARREN 5840058A 568 3/19/2021 9015 SIGN EMPORIUM INC WARREN 5462592A 825 2/20/2021 3064 0.95 SMART ROOF LLC WARREN 3928497A 852 2/3/2021 8810 SNAPPY SERVICES INC WARREN 2431874A 1,892 2/20/2021 9102 0.95 STRAIGHTLINE HOME IMPROVEMENT WARREN 3639142A 751 1/7/2021 5645 SURYA ASSOCIATES INC WARREN 3688097B 1,287 1/30/2021 8017 0.95 UNIQUE ONE AUTO SALES LLC WARREN 4982312A 856 1/18/2021 8395 VB CONSTRUCTION LLC WARREN 6100155A 750 1/16/2021 5551

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge VILLA DORO ASSOCIATION WARREN 0025518A 750 1/25/2021 5645 WARREN TERRACE ASSOCIATION WARREN 3790428A 750 2/23/2021 5022 WORLDWIDE INDUSTRIAL CONTRACTING LLC WARREN 3968804A 371 3/29/2021 8742 WR AMERICA LOGISTICS INC WARREN 4655044A 858 2/20/2021 8010 0.87 ANYTIME HOISTING INC WASHINGTON 4331397A 6,189 2/1/2021 9530 0.89 B AND M SPECIALIZED INC WASHINGTON 6122582A 304 2/19/2021 8810 CEG CONTRACTING INC WASHINGTON 6089658A 6,540 1/1/2021 5437 CLASSIC FINISH CARPENTRY LLC WASHINGTON 4998766A 800 2/16/2021 5437 CM MANAGEMENT SERVICES INC WASHINGTON 6135242A 568 3/13/2021 9015 D M HOMES OAKLAND HUNT CORP WASHINGTON 4966511A 750 2/28/2021 5645 EASTERN BUILDERS LLC WASHINGTON 3076822A 800 2/27/2021 5645 0.95 G I ZARMAKOUPIS & SON CORPORATION WASHINGTON 0141879A 2,494 3/26/2021 9058 1.00 G WOODBURY AND ASSOCIATES INC WASHINGTON, DC 4842766A 4,607 1/1/2021 7720 0.90 GREAT LAKES CARPENTRY AND REMODELING WASHINGTON 4271807A 750 1/7/2021 5403 LLC J AND J TILE & MARBLE WASHINGTON 1809067A 750 3/12/2021 5348 KATIES KORNER SALON & GIFT SHOPPE LLC WASHINGTON 5280745A 399 3/17/2021 9586 KIRIOS ROOFING AND PAINTING INC WASHINGTON 5937515A 10,889 2/21/2021 5403 LIN CORP WASHINGTON 0491527A 750 1/4/2021 5645 MASERATI TILE & MARBLE INC WASHINGTON 0509132A 1,281 2/16/2021 5348 0.95 MERIDIAN CONTRACTING GROUP LLC WASHINGTON 3271269A 800 2/22/2021 5437 0.95 MICHIGAN WASTEWATER LLC WASHINGTON 6093795A 722 2/1/2021 7520 POND BIOLOGICS LLC WASHINGTON 5971063A 933 2/28/2021 4828 PROSTALL FLOOR COVERING WASHINGTON 4092643A 750 3/6/2021 5437 R B D LLC WASHINGTON 4675800A 750 1/1/2021 5437 RS 3 COMPANIES INC WASHINGTON 5789648A 712 1/15/2021 9402 SYNERGY CONSTRUCTION MANAGEMENT LLC WASHINGTON 4236491A 750 3/29/2021 5645 TOUCHETTE GROUP LLC WASHINGTON 5802547A 2,341 1/3/2021 9015 WIDE EYE CREATIVE LLC WASHINGTON, DC 5967686A 215 2/15/2021 8810 F D INCORPORATED WASHINGTON TWP 2908204A 5,770 2/22/2021 9058 0.88 G AND G CONTRACTORS INC WASHINGTON TWP 3749371A 750 3/1/2021 3030 G C SERVICES LLC WASHINGTON TWP 5362741A 752 1/17/2021 8810 GEORGE LINI INC WASHINGTON TWP 2160161A 1,478 1/23/2021 5645 MDM FLOORS LLC WASHINGTON TWP 5936608A 750 1/16/2021 5437 MPM CONSTRUCTION LLC WASHINGTON TWP 3473988A 750 2/21/2021 5348 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 144 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge RANCILIO CONSTRUCTION SERVICES I NC WASHINGTON TWP 1228757A 1,815 3/17/2021 5437 0.95 SOMMERSET HOMES & DEVELOPMENT INC WASHINGTON TWP 3790797A 3,000 1/8/2021 5606 TIMBERLAND BRICK PAVING LLC WASHINGTON TWP 2999927A 750 1/29/2021 5221 ADREIS DESIGN STONE INC WATERFORD 5968216A 750 2/17/2021 5348 ALLIED TOWING & RECOVERY LLC WATERFORD 5700680A 3,967 1/4/2021 7208 0.95 ANGEL DRYWALL INC WATERFORD 3541630A 7,116 2/28/2021 5445 0.95 B AND B CUSTOM MASONRY INC WATERFORD 2717891A 752 1/25/2021 8810 BAYSIDE MARINA INC WATERFORD 0681954A 808 3/2/2021 6836 BCM HOME IMPROVEMENT LLC WATERFORD 4347250A 765 2/3/2021 8810 BIG WORM TRUCKING INC WATERFORD 5381150A 10,306 3/3/2021 7208 0.92 BRIXNSTONE LLC WATERFORD 4069978A 1,180 1/30/2021 5022 0.95 C S MAINTENANCE INC WATERFORD 3253473A 1,248 3/6/2021 9015 0.95 CARING 4 LOVE ONES INC WATERFORD 5283000A 8,883 1/19/2021 8835 0.86 CERVANTES DRYWALL WATERFORD 6124690A 750 2/22/2021 5445 CHELSEA ROOFING WATERFORD 4188934A 750 3/6/2021 5551 CONNORS CHIMNEY AND MASONRY SVS WATERFORD 6135200A 750 3/13/2021 5022 DES CLEANING SERVICE INC WATERFORD 5034604A 569 2/13/2021 9015 DIRECT EXTERIORS WATERFORD 5696224A 750 3/29/2021 5437 DOUBLE PANE WINDOW CLEANING LLC WATERFORD 5538033A 1,673 2/22/2021 9015 0.95 ENTERPRISE ESTATES AND CONSTRUCTION INC WATERFORD 3599833A 6,935 2/21/2021 9015 0.85 GMS CONSTRUCTION WATERFORD 5524040A 750 3/24/2021 5645 GRIFFIN THOMAS M WATERFORD 5966396A 307 2/9/2021 0908 H AND S CONSTRUCTION COMPANY INC WATERFORD 5249430A 750 1/25/2021 5022 HOWLAND SCOTT WATERFORD 1695592A 471 2/23/2021 5190 HUGHES DUANE WATERFORD 3735060A 750 2/15/2021 5445 HUGHES DUANE JR WATERFORD 5967716A 750 2/15/2021 5445 HUTCHINSON BUILDING CO INC WATERFORD 5970679A 800 2/23/2021 9521 HYDE CONSTRUCTION WATERFORD 4707702A 750 1/16/2021 5645 IVANOV ROOFING LLC WATERFORD 3901254A 826 3/27/2021 8810 JUNIORS MASONRY LLC WATERFORD 6135390A 750 3/13/2021 5022 KEVIN MOLITOR LANDSCAPING LLC WATERFORD 5500699A 709 1/9/2021 0042 KLVWOODWORKS LLC WATERFORD 6113842A 750 2/6/2021 5437 KUHN PROPERTY MANAGEMENT INC WATERFORD 5951445A 915 1/10/2021 9015 MARTIN MECHANICAL HVAC LLC WATERFORD 5858178A 771 2/1/2021 5550 MASTER CARPENTRY LLC WATERFORD 5808006A 750 1/18/2021 5437 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 145 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge MATTHEW W ROSS CONSTRUCTION LLC WATERFORD 4306457A 750 1/23/2021 5645 METROPOLITAN LAND SERVICES INC WATERFORD 6121403A 750 2/18/2021 6216 MICHIGAN QUALITY PAINTERS LLC WATERFORD 3351157A 750 3/1/2021 5476 MONSTER LANDSCAPING WATERFORD 5501415A 1,170 1/12/2021 0042 0.95 MOTOR CITY HOT TUBS AND OUTDOOR LIVING WATERFORD 5599857A 807 2/23/2021 8742 INC MVP CONCRETE LLC WATERFORD 5807220A 750 1/10/2021 5221 RAYKOV HOME IMPROVEMENT & REMODELING WATERFORD 3901157A 750 3/30/2021 5437 RAYSEN CARE SERVICES LLC WATERFORD 5400066A 521 1/17/2021 8835 0.95 REVIVE CONSTRUCTION GROUP LLC WATERFORD 5283914A 3,747 2/22/2021 5437 0.95 RJD CLEANING SERVICE WATERFORD 3905195A 568 3/30/2021 9015 SKYLIFT CRANE LLC WATERFORD 6112234A 476 2/1/2021 9530 STORM ROOFING SOLUTIONS LLC WATERFORD 5692903A 800 3/18/2021 5551 T ROWS LLC WATERFORD 5376289A 800 2/21/2021 0106 TOMS MASONRY REPAIR LLC WATERFORD 5727405A 800 1/4/2021 5022 UNIQUE DESIGNED HOMES INC WATERFORD 2281112A 800 3/18/2021 5645 0.95 VJM DESIGN & BUILD CORPORATION WATERFORD 4405579A 850 3/9/2021 5606 WRIGHT JACK WATERFORD 6101240A 750 1/17/2021 5445 FORRESTER RESTORATIONS INC WATERVLIET 5210135A 3,818 3/18/2021 9015 1.00 SCOTTS AUTO SALES LLC WATERVLIET 5058902A 959 2/22/2021 8395 0.95 TOTAL TREE CARE LLC WATERVLIET 5688655A 10,272 3/18/2021 0106 0.94 WATERVLIET JOINT FIRE BOARD WATERVLIET 0295078A 5,386 1/12/2021 7704 0.94 SUITE STAFFING INC WAUCONDA, IL 2837986A 11,923 3/20/2021 9052 0.75 MPD NORTHWOODS PALLET & CUTSTOCK LLC WAUPACA, WI 6133207A 10,671 3/7/2021 2759 CORNERSTONE AG MANAGEMENT LLC WAYLAND 5966973A 3,543 3/1/2021 0129 D AND K DIVERSIFIED SERVICES LLC WAYLAND 0799327A 719 1/10/2021 9519 EXCELLENT EXTERIORS INC WAYLAND 3187560A 4,369 3/30/2021 5538 0.95 GOLD LINE TRANSPORT LLC WAYLAND 5810043A 13,409 1/17/2021 7208 0.92 GREEN SERVICES LLC WAYLAND 5979757A 709 3/27/2021 9402 KM NEWHOUSE & SONS TRUCKING WAYLAND 3658295A 12,656 2/1/2021 7208 LAKE TRADES LLC WAYLAND 6123422A 13,352 2/21/2021 6217 RK HOMES AND CONSTRUCTION LLC WAYLAND 6135870A 750 3/14/2021 5645 TEMPORARY PERSONNEL SERVICES LLC WAYLAND 1656244A 14,041 1/1/2021 8102 0.79 AR SERVICES LLC WAYNE 4814746A 516 1/17/2021 8387 ARB CONSTRUCTION INC WAYNE 5658152A 12,844 1/11/2021 5645 0.89

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge B T S CARRIER INC WAYNE 5214254B 9,330 1/18/2021 7208 BRADFORD PLAYGROUNDS WAYNE 6100970A 413 1/23/2021 5606 COSHER TIMOTHY F WAYNE 5962170A 937 1/31/2021 9015 DANS ENTERPRISES LLC WAYNE 1797298A 1,386 1/23/2021 8017 0.95 ED ROWE ELECTRIC LLC WAYNE 5367425A 470 1/30/2021 5190 ELLIS SLOAN INC WAYNE 0515825A 1,093 1/1/2021 9058 EMPLOYMENT AND TRAINING DESIGNS INC WAYNE 3584364A 7,088 1/1/2021 8868 0.88 EVEN FLO PAINTING CORP WAYNE 3923541A 2,023 1/22/2021 5476 0.95 MOSSY OAK LANDSCAPING AND IRRIGATION WAYNE 5558379A 561 1/5/2021 9102 SERVICES LLC OFFICE CUBICLE INSTALLATION LLC WAYNE 6119271A 825 2/14/2021 5146 R AND V DRYWALL INC WAYNE 2911728A 1,557 1/16/2021 5445 0.95 WALLACE RESTORATION LLC WAYNE 4720067A 2,776 2/10/2021 9015 WALKER CONTRACTING SERVICES WEBBERVILLE 5254124A 800 3/26/2021 5215 PEGGY KAROLAK INS AGENCY INC WELLINGTON, OH 5958776A 235 2/1/2021 8810 JOHN RIAN CONTRACTING INC WELLS 2543079A 739 3/28/2021 6217 HELPING HANDS WELLSTON 5380243A 568 3/4/2021 9015 ACTION BUILDING & CONSTRUCTION COMPANY WEST BLOOMFIELD 5952387A 750 2/27/2021 5445 LLC ADCO CONSTRUCTION SERVICES LLC WEST BLOOMFIELD 4866304A 752 2/11/2021 5610 ALMOST HOME ANIMAL RESCUE LEAGUE WEST BLOOMFIELD 4604253A 1,337 1/29/2021 8831 0.95 AMERICAN PRESTIGE MARBLE & GRANITE INC WEST BLOOMFIELD 4169646A 825 1/24/2021 5348 APEX CONSTRUCTION SOLUTIONS LLC WEST BLOOMFIELD 6088198A 997 1/16/2021 5606 APPLEFIELD MICHAEL & LIEBERMAN APPLEFIELD WEST BLOOMFIELD 3283402A 530 2/17/2021 0913 LAURA BETH AR CONSTRUCTION LLC WEST BLOOMFIELD 5749956A 3,238 1/7/2021 5445 ASHBY PRESERVE CONDO ASSOCIATION WEST BLOOMFIELD 4738160A 568 3/23/2021 9015 ASSAAD FAMILY LLC WEST BLOOMFIELD 5223229A 345 2/1/2021 8868 ASSOCIATION SERVICES WEST BLOOMFIELD 2817535A 380 1/1/2021 8810 B AND R INTERIOR FINISHING CO WEST BLOOMFIELD 2980940A 826 3/13/2021 8810 BREAKPOINT WARREN LLC WEST BLOOMFIELD 5954037A 618 1/17/2021 9015 BROOKFIELD ESTATES VISTAS CONDOMINIUM WEST BLOOMFIELD 4315600A 568 3/12/2021 9015 ASSOCIATION CASSAR CONSTRUCTION SERVICES WEST BLOOMFIELD 3523217A 3,782 3/11/2021 5645 0.93 CORPORATION COMMUNITY FIRST HOMECARE LLC WEST BLOOMFIELD 4831241A 4,139 3/6/2021 8835 0.85

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 147 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CRANBROOK HOMES INC WEST BLOOMFIELD 3284875A 805 1/24/2021 8810 CYMEX LLC WEST BLOOMFIELD 4990676A 800 3/28/2021 5645 DAN COMBS CONSULTING INC WEST BLOOMFIELD 2715511C 41,272 2/10/2021 5191 1.34 13 % DEALER CONCEPTS LLC WEST BLOOMFIELD 3416402A 227 1/30/2021 8810 DETROIT WELDING & FABRICATING INC WEST BLOOMFIELD 4116798A 913 1/8/2021 5057 DM HOMES OF METRO DETROIT LLC WEST BLOOMFIELD 5088283A 800 3/17/2021 5437 0.95 DUNSKY ROBERT & HARRIET WEST BLOOMFIELD 0900532A 307 2/28/2021 0908 EXTERIOR PROS LLC WEST BLOOMFIELD 3132552A 800 2/6/2021 5645 FOREST EDGE BUILDERS LLC WEST BLOOMFIELD 5644119A 825 1/20/2021 5645 FRIENDS OF CHILDRENS ONCOLOGY CAMP WEST BLOOMFIELD 3741265A 333 3/4/2021 8810 FOUNDATION FRITZ ZS LAWN CARE LLC WEST BLOOMFIELD 5697018A 524 3/30/2021 9102 GAMARRA JESSICA WEST BLOOMFIELD 5354358A 530 1/5/2021 0913 GRANT STEVEN DR WEST BLOOMFIELD 1881213A 307 1/9/2021 0908 GREGORY ROBERTSON C M T INC WEST BLOOMFIELD 4430476A 800 1/10/2021 0042 HANDY ANDY REMODELING LLC WEST BLOOMFIELD 5658802A 4,045 1/13/2021 5645 0.95 HUMAN BODY REHAB SERVICES PLLC WEST BLOOMFIELD 4196473A 226 2/9/2021 8810 K AND K DEVELOPERS LIMITED PARTNERSHIP WEST BLOOMFIELD 4451538A 568 3/19/2021 9015 KARP MARTIN & DEBORAH WEST BLOOMFIELD 2453266A 382 3/30/2021 0908 KMJA LLC WEST BLOOMFIELD 6111378A 1,625 1/30/2021 7208 KS WEST BLOOMFIELD 5222044A 750 3/9/2021 5476 MARIYA CONSTRUCTION LLC WEST BLOOMFIELD 4423801A 800 3/23/2021 5645 MICHAEL KNIGHT AOS LLC WEST BLOOMFIELD 4725387A 353 2/24/2021 8810 0.95 MILLENNIUM HOMES LLC WEST BLOOMFIELD 2983176A 750 3/17/2021 5645 MONICA MAE LLC WEST BLOOMFIELD 4584813A 230 1/30/2021 8832 NORTH POINTE PAINTING AND CARPENTRY INC WEST BLOOMFIELD 4176723A 790 3/11/2021 5476 0.95 NYX CONSTRUCTION WEST BLOOMFIELD 3255565A 800 2/21/2021 5476 OHANA FAMILY CONSTRUCTION LLC WEST BLOOMFIELD 5968720A 847 2/20/2021 5437 PENSLER ROBERT WEST BLOOMFIELD 5392756A 530 2/28/2021 0913 PIONEER REHAB SERVICES WEST BLOOMFIELD 3986098A 521 3/28/2021 8835 PLAY 4 FUN SPORTS LLC WEST BLOOMFIELD 4536932A 458 3/1/2021 9063 PTH MANAGEMENT LLC WEST BLOOMFIELD 4835921A 840 2/4/2021 0912 REID ASHTON PHOTOGRAPHY INC WEST BLOOMFIELD 2982374A 588 1/30/2021 4361 RELATIVITY PRODUCTIONS LLC WEST BLOOMFIELD 5958733A 546 1/24/2021 7610 SILVERMAN CAROL WEST BLOOMFIELD 0506354A 309 2/12/2021 0908

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge SIMON DONALD R WEST BLOOMFIELD 1435493A 860 1/14/2021 0913 0.95 SIMPLIFY IT LLC WEST BLOOMFIELD 4025520A 569 2/7/2021 9015 SQUARE ANGLE CONSTRUCTION LLC WEST BLOOMFIELD 5662230A 1,879 1/18/2021 5403 0.95 STAR MAINTENANCE INC WEST BLOOMFIELD 2610302A 850 1/20/2021 5476 STATEWIDE BUILDING SERVICES LLC WEST BLOOMFIELD 4920260A 568 3/21/2021 9015 T M H SECURITY SERVICE INC WEST BLOOMFIELD 0260240A 37,115 1/24/2021 7720 1.51 13 % TEMPLE CONSTRUCTION INC WEST BLOOMFIELD 4491416B 541 2/13/2021 5606 0.95 TOWNSEND HOMES LLC WEST BLOOMFIELD 3983706A 800 1/11/2021 5190 TRIUNE IRON & METAL INC WEST BLOOMFIELD 3401499A 1,659 2/1/2021 7218 0.95 TWO GUYS AND A BUCKET LLC WEST BLOOMFIELD 5833515A 1,047 2/28/2021 9015 URBAN TILE SOLUTIONS LLC WEST BLOOMFIELD 5950775A 800 1/9/2021 5348 VIDHI INNS INC WEST BLOOMFIELD 5951135A 1,051 1/10/2021 9052 0.96 WATER TREATMENT ASSOCIATES LLC WEST BLOOMFIELD 4436415A 358 1/29/2021 8010 WHITE OWL MAINTENANCE CO INC WEST BLOOMFIELD 1641034A 1,167 3/9/2021 9015 WINDMILL ESTATES WEST BLOOMFIELD 2154951A 584 1/15/2021 9015 WOODLYNNE DRIVE HOMEOWNERS WEST BLOOMFIELD 3313140A 568 2/1/2021 9015 ASSOCIATION ZETTERHOLM TIMOTHY C WEST BLOOMFIELD 4313020A 304 2/10/2021 8742 CENTRAL MICHIGAN AUTO GLASS INC WEST BRANCH 4588231A 518 2/10/2021 8387 CHARLIES OVERHEAD DOORS INC WEST BRANCH 4541090A 750 1/20/2021 3724 RALPH M NELSON ENTERPRISES INC WEST BRANCH 1991647A 952 3/27/2021 1320 0.95 REM NATION PLLC WEST BRANCH 5576512A 477 2/24/2021 8832 SOLUTIONS PHYSICAL THERAPY PLLC WEST BRANCH 5684153A 344 3/14/2021 8832 TIMBER BUILDING & REMODELING WEST BRANCH 3791033A 750 1/23/2021 5645 VICTORIAN MANOR CONDOMINIUMS WEST BRANCH 5949050A 759 1/3/2021 0042 ASSOCIATION INC R RIVETER LLC WEST END, NC 6144209A 238 3/31/2021 8810 ACTON ACCESS LLC WEST KNOLLWOOD 2539080A 325 1/8/2021 8742 INDIANA STATE DAIRY ASSOCIATION INC WEST LAFAYETTE, IN 3427765A 448 1/1/2021 4511 ADVANCED PAVEMENT MARKING LLC WEST OLIVE 4645553A 3,864 1/14/2021 5476 0.94 NORTHLAND HARDWOOD FLOORS LLC WEST OLIVE 3180948A 825 1/9/2021 5437 TOP LINE ENGINEERING LLC WEST OLIVE 6120288A 1,918 2/17/2021 8601 A AND Q AUTO REPAIR CENTER INC WESTLAND 3627101A 2,522 1/7/2021 8748 0.95 ABL COMMUNICATIONS LLC WESTLAND 6132146A 417 3/6/2021 8601 AIRTECH MECHANICAL LLC WESTLAND 5968666A 725 2/20/2021 5550

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 149 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ALERT PROPERTY INSPECTIONS LLC WESTLAND 6128130A 539 2/28/2021 8720 ASH CONSTRUCTION LLC WESTLAND 5998190A 3,203 2/26/2021 5645 BISHOP DESIGN & DISPLAY INC WESTLAND 1939300A 2,086 3/4/2021 9521 1.00 BLITZ TRUCKS INC WESTLAND 6122639A 481 2/21/2021 8395 BOICE MICHAEL WESTLAND 4950950A 307 1/14/2021 0908 BRYAN AND DUKES CLEANING SERVICE LLC WESTLAND 5503299A 618 2/17/2021 8835 CAMILLERI A 1 PAINTING CO LLC WESTLAND 1417568A 750 2/16/2021 5476 CATALANO RICHARD WESTLAND 3464970A 929 3/27/2021 0913 0.95 CDS SPECIALTY COATINGS LLC WESTLAND 4281721A 750 2/7/2021 5038 0.95 CRAIG MITCHELL GRANITE PLATE RESURFACING WESTLAND 1994786A 1,693 3/29/2021 3685 1.00 INC D E L CARPENTRY & FRAMING LLC WESTLAND 2395860A 1,885 3/6/2021 5437 DAVID M OSIWALA TRUST WESTLAND 3735508A 967 3/2/2021 0913 0.95 FERGUSON FLOORING WESTLAND 3087751A 540 3/28/2021 9521 H AND A PAINTING AND DRYWALL INC WESTLAND 5969697A 750 2/23/2021 5445 HARVEST ROOFING LLC WESTLAND 5961939A 826 2/1/2021 5552 HAZELWOOD ROBERTO WESTLAND 4732480A 307 3/25/2021 0908 INDEPENDENT CONSTRUCTION INC WESTLAND 1044222A 750 1/20/2021 5437 J FENCE LLC WESTLAND 5834236A 4,711 3/2/2021 5645 0.95 JPC SERVICES LLC WESTLAND 4192044A 800 2/21/2021 5437 JR CLEANING LLC WESTLAND 3996409A 618 2/7/2021 9015 LUTFY MARGAUX WESTLAND 4787676A 530 3/23/2021 0913 MALOSH PAUL LAWRENCE WESTLAND 3255336A 628 3/3/2021 0908 MOTORCITY INTERIORS LLC WESTLAND 3917088A 800 3/7/2021 5445 MOTZ PAUL WESTLAND 4158679A 665 1/1/2021 8832 MOVING ON INVESTMENTS INC WESTLAND 1088319A 750 2/18/2021 5645 NORPLEX ASSOCIATES LLC WESTLAND 1543644A 620 2/19/2021 8810 RANGEMASTERS INC WESTLAND 3596206A 4,161 2/12/2021 8017 0.90 ROBB CHRISTINE WESTLAND 5381134A 307 3/5/2021 0908 ROQUE PAINTING WESTLAND 5592348A 750 1/23/2021 5476 ROYALTY CLEANING INC WESTLAND 4826582A 1,041 2/28/2021 9015 0.95 SCHMITT AMY WESTLAND 6130984A 530 3/5/2021 0913 SUNFLOWER CLEANING COMPANY LLC WESTLAND 6114458A 569 2/10/2021 9015 SURE CARE ENTERPRISES LLC WESTLAND 5322910A 350 1/30/2021 9063 ULTRA GREEN HYDRO INC WESTLAND 6182550B 866 1/8/2021 8010 0.95

9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 150 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge WAFER LATRICE WESTLAND 4706994A 307 1/23/2021 0908 ZALESCHI TILE INC WESTLAND 6131123A 750 3/5/2021 8810 RODRIGUEZ CONSTRUCTION SERVICE WHITE CLOUD 4997212A 3,978 3/26/2021 5645 0.92 SPEEDY CLEAN QUALITY PRESSURE WASHING WHITE CLOUD 5522226A 706 3/2/2021 8387 STALHOOD CONSTRUCTION LLC WHITE CLOUD 5609569A 750 2/7/2021 5645 SWOISH CONSTRUCTION LLC WHITE CLOUD 4776151A 750 2/16/2021 5645 WHITE CLOUD AREA FIRE DEPARTMENT WHITE CLOUD 1028561A 1,718 2/7/2021 7904 0.95 A AND B ENTERPRISES WHITE LAKE 6120326A 750 2/15/2021 5403 ALPINE VALLEY SKI AREA LEASING COMPANY WHITE LAKE 0035637A 12,887 2/16/2021 9015 0.78 B AND B CONSTRUCTIONS INC WHITE LAKE 2850265A 3,546 3/21/2021 9015 0.95 B H I ROOFING INC WHITE LAKE 1530011A 1,740 2/25/2021 5551 0.95 CK PROPERTY & DEVELOPMENT COMPANY OF WHITE LAKE 2967588A 750 2/22/2021 5645 MICHIGAN INC CONWAY CONSTRUCTION WHITE LAKE 1046993A 750 2/12/2021 5437 CPC HOMES WHITE LAKE 5508002A 750 3/25/2021 5645 CUSTOM SHEET METAL & DUCT WORK WHITE LAKE 3194370A 674 3/11/2021 5550 CUTTING EDGE OUTDOOR SERVICES INC WHITE LAKE 4953126A 716 1/18/2021 9102 0.95 FORTE FARM LLC WHITE LAKE 5463106A 750 1/3/2021 8279 G Z PAINTING & DECORATING WHITE LAKE 5815355A 825 1/24/2021 5476 KUZA CONSTRUCTION LLC WHITE LAKE 0982423A 414 1/16/2021 5606 LYNK FINANCIAL INC WHITE LAKE 3768384A 215 1/27/2021 8810 MICHIGAN INTERIOR RESTORATION LLC WHITE LAKE 5623278A 1,064 2/11/2021 9521 MIDWEST ACOUSTICAL LLC WHITE LAKE 3336433A 750 1/9/2021 5020 MINTZER BUILDING COMPANY LLC WHITE LAKE 5390737A 750 3/26/2021 5190 PREFERRED PAINTING WHITE LAKE 2063808A 1,754 3/30/2021 5476 0.95 ROC IT DRYWALL INC WHITE LAKE 1558234A 11,481 1/19/2021 5445 1.85 27 % ROCO SUPPLY INC WHITE LAKE 4971027A 431 3/15/2021 8742 TNT MARBLE AND STONE INC WHITE LAKE 1855743A 5,730 2/27/2021 1624 1.33 VOSS CONSTRUCTION AND HOME WHITE LAKE 5299489A 2,120 3/20/2021 5437 IMPROVEMENT INC J AND D MILLWRIGHT AND MAINTENANCE LLC WHITE PIGEON 4984366A 4,947 1/24/2021 3724 0.92 GLOBAL WOOD STICKS LLC WHITE PINE 5174830A 5,311 3/3/2021 2841 0.95 TAMIS TOTS LLC WHITEHALL 5600200A 371 2/10/2021 8869 ENZOS CATERING LLC WHITMORE LAKE 4334388A 628 2/7/2021 9058 JOHN R KINSTLER LLC WHITMORE LAKE 3732673A 361 1/11/2021 8601

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge PRO GREEN LAWN SPRAY INC WHITMORE LAKE 5848202A 624 3/31/2021 0005 S M A R T AUTO REPAIR LLC WHITMORE LAKE 6112110A 1,172 2/1/2021 8395 UPPER PENINSULA CLUB WHITMORE LAKE 1550896A 538 1/31/2021 9061 JC CONSTRUCTION LLC WHITTAKER 6117015A 3,500 2/12/2021 5645 BURLEIGH RENO WHITTEMORE FIRE WHITTEMORE 3141560A 1,133 3/6/2021 7704 0.95 DEPARTMENT CONRAD CONSTRUCTION MANAGEMENT LLC WILLIAMSBURG 6058949A 800 1/7/2021 5437 FARMER WHITES WILLIAMSBURG 3893057A 1,154 3/1/2021 0130 0.95 STEELMAN BROTHERS CONSTRUCTION LLC WILLIAMSBURG 5480680A 1,895 1/1/2021 5645 0.95 STIEBER MELANIE WILLIAMSBURG 5950546A 215 1/8/2021 8810 TEAM THORNE LLC WILLIAMSBURG 5803195A 5,485 1/9/2021 2709 DANS GLASS & SCREEN LLC WILLIAMSTON 5535271A 750 3/25/2021 5462 DLS INCORPORATED WILLIAMSTON 0233404A 949 1/31/2021 9058 0.95 JACOKES FINANCIAL GROUP LLC WILLIAMSTON 5912504A 283 1/22/2021 8810 KWR HOME SERVICES LLC WILLIAMSTON 6095364A 2,485 1/29/2021 6325 LARKIN ENGINEERING LLC WILLIAMSTON 5499054A 343 1/7/2021 8601 MORAWSKIS 2ND GENERATION ROOFING & WILLIS 3312364A 750 1/28/2021 5551 RESTORATION REDWOOD FORESTRY SERVICES LLC WILLIS 6108059A 4,026 1/25/2021 0106 TIBNAN LLC WILLIS 4988604A 853 2/15/2021 8017 0.95 PACE DRIVERS INC WILLOUGHBY, OH 5656028A 3,148 1/10/2021 8292 0.95 KLEE LOGGING & TREE SERVICE INC WILSON 5507324A 1,938 1/26/2021 2709 0.95 RYAN PAVLAT TRUCKING WILSON 6122370A 750 2/19/2021 7208 AMERICAN MASTER PRODUCTS INC WIXOM 1140973A 580 1/20/2021 9015 CRISANA VALLEY INC WIXOM 4839285A 750 2/16/2021 7208 GARCIA ANALLELI WIXOM 5838479A 491 3/14/2021 3681 H V PAINTING INC WIXOM 4502396A 2,908 2/1/2021 5476 0.95 INCORE RESTORATION GROUP LLC WIXOM 4643283A 3,234 3/6/2021 5606 0.93 JANES OF ALL TRADES LLC WIXOM 5972400A 1,577 3/2/2021 5476 JR INSULATION INC WIXOM 1393316A 2,229 3/19/2021 5479 0.95 MADE PAINTING LLC WIXOM 4973445A 2,605 3/31/2021 5476 0.95 PISTONS ROOFING WIXOM 4357485A 750 1/1/2021 5551 PRECISION KARTING TECHNOLOGIES LLC WIXOM 5365686A 561 1/24/2021 3632 QTS INTERNATIONAL LLC WIXOM 4871685A 226 1/16/2021 8810 R AND G PAINTING HOME AND IMPROVEMENT WIXOM 5570611A 1,000 1/30/2021 5476 LLC 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 152 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge S AND B BUILDING LLC WIXOM 4388666A 800 3/14/2021 5645 SAAVEDRA FERMIN WIXOM 4854764A 750 3/29/2021 5437 TRAFFIC AND SAFETY CONTROL SYSTEMS INC WIXOM 0105961A 631 3/1/2021 3179 0.90 AMERICAN MAILBOX SERVICES INC WOLVERINE LAKE 4134184A 750 2/7/2021 6400 IGY SERVICES LLC WOLVERINE LAKE 3649202A 1,124 2/6/2021 5610 0.95 KMK CARPENTRY LLC WOLVERINE LAKE 2743167A 1,431 3/30/2021 5645 0.95 D AND W TRANSPORT LLC WOODHAVEN 5272815A 750 1/16/2021 7208 0.95 FOCUS HOMES LLC WOODHAVEN 4841280A 750 2/25/2021 0042 M AND S LAWN AND LANDSCAPE CORP WOODHAVEN 5779790A 859 1/25/2021 9015 MIDWESTHR BENEFITS SOLUTIONS LLC WOODRIDGE, IL 4835905A 78,104 1/1/2021 7208 0.94 L D M RETAIL ASSOCIATES INC WORTHINGTON, OH 3145751A 5,899 1/17/2021 8017 0.86 D AND R HOME IMPROVEMENT LLC WYANDOTTE 3320146A 800 2/16/2021 5445 0.95 DBC AMERICA LLC WYANDOTTE 5831024A 1,770 3/2/2021 8742 DMN SERVICES WYANDOTTE 5950805A 3,720 2/17/2021 5645 DO GO MOVING SERVICES WYANDOTTE 0896713A 750 1/21/2021 8293 0.95 EZELL DANIEL WYANDOTTE 5957583A 750 3/10/2021 5645 HARRISON SEWER AND DRAIN CLEANING INC WYANDOTTE 5515629A 561 2/11/2021 5183 HERITAGE HARBOUR CONDOMINIUM WYANDOTTE 4126033A 618 3/1/2021 9015 ASSOCIATION ISLAND LAKE WOODS ASSOCIATION WYANDOTTE 4230922A 618 1/1/2021 9015 JOHNS HOME IMPROVEMENT INC WYANDOTTE 3339190A 802 3/22/2021 8810 NORTHVILLE HOLLOW CONDOMINIUM WYANDOTTE 4308689A 580 1/27/2021 9015 ASSOCIATION PROCESS TECHNOLOGIES INC WYANDOTTE 3735494A 471 2/3/2021 4361 R M S HEATING COOLING & REFRIGERATION INC WYANDOTTE 3583317A 750 1/18/2021 5550 RJS SERVICE INC WYANDOTTE 4023684A 750 1/29/2021 5445 SANDBOX PROPERTY MANAGEMENT LLC WYANDOTTE 5811309A 523 1/18/2021 9102 TIMBER RIDGE HOMEOWNERS ASSOCIATION WYANDOTTE 4308654A 568 1/27/2021 9015 TONGUES PROCESS HEATING LLC WYANDOTTE 5505909A 1,555 3/21/2021 3724 0.95 AR PAINTING LLC WYOMING 5689570A 13,790 3/11/2021 5476 1.33 13 % AURORA INVESTMENTS LLC WYOMING 3559815A 3,281 1/5/2021 8293 BRAND WELL LLC WYOMING 6113800A 252 2/6/2021 8810 BROTHERS ASSOCIATES LLC WYOMING 6070752A 750 2/15/2021 5645 COBRA CABLING SYSTEMS LLC WYOMING 5912164A 520 3/7/2021 5190 CONCIERGE HOME HEALTH COMPANY WYOMING 6088961A 1,028 1/28/2021 8835

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CUSTOM DRYWALL CONSTRUCTION LLC WYOMING 3747000A 6,507 2/22/2021 5445 0.94 DIAZ POWER WASH LLC WYOMING 5848644A 1,275 3/31/2021 8387 E AND J CARPENTRY LLC WYOMING 6144152A 750 3/28/2021 5403 E AND L CONSTRUCTION LLC WYOMING 5735912A 13,668 1/9/2021 5551 0.86 FOERSTER RICHARD WYOMING 5980330A 800 3/29/2021 5476 GONZAR CONSTRUCTION LLC WYOMING 5823498A 2,508 2/10/2021 5146 0.95 HELDER HOME SERVICES LLC WYOMING 5835631A 750 3/7/2021 5645 0.95 J VITALS CONSTRUCTION LLC WYOMING 5818206A 10,671 1/31/2021 5403 0.95 JS TOWING LLC WYOMING 5760135A 2,866 2/12/2021 7208 KENT COUNTY DISPATCH AUTHORITY WYOMING 5848415A 291 3/29/2021 8810 MANNYS DRYWALL LLC WYOMING 3933148A 825 3/23/2021 5445 0.95 MT CONSTRUCTION WYOMING 3899888A 750 2/1/2021 5645 MTZ QUALITY CONSTRUCTION LLC WYOMING 5827884A 8,797 2/22/2021 5445 0.95 PERRY SHAINE WYOMING 5955505A 750 2/18/2021 5645 PRO CLASSIC PAINTING LLC WYOMING 4684192A 750 2/13/2021 5476 PROFESSIONAL SECURITY SERVICES LLC WYOMING 5364051A 7,685 1/20/2021 7720 0.91 REYES BUILDING & EXTERIORS LLC WYOMING 5973228A 825 3/6/2021 5645 RG DRYWALL LLC WYOMING 5967066A 4,315 2/23/2021 5445 RYAN SCHOLMA INC WYOMING 2202832A 750 1/6/2021 5645 0.95 SARMIENTO CONSTRUCTION WYOMING 6127827A 2,801 2/28/2021 5445 TITAN EXTERIORS LLC WYOMING 5495172A 750 2/1/2021 5645 0.89 TOP QUALITY CONSTRUCTION GROUP WYOMING 6006108A 5,563 1/31/2021 5403 UNITED AUTO WORKERS CIO UNITED AIRCRAFT WYOMING 2489392A 298 2/17/2021 8755 & AGRI IMPL WORKERS OF AMERICA UNLIMITED AUTO GROUP USED CAR SALES LLC WYOMING 6120261A 8,477 2/15/2021 8393 VAPEJOOSE INC WYOMING 5374693A 4,639 3/14/2021 4828 0.90 VASQUEZ ROOFING WYOMING 6126839A 800 2/28/2021 5551 BLUE LAKE GROUP INC YALE 3746160A 387 2/19/2021 8742 COMPLETE FLOOR YALE 4102860A 750 2/16/2021 5437 DUDLEYS FLOOR COVERING YALE 5100470A 821 3/18/2021 9521 KERBER CARYL M YORKTOWN HEIGHTS, NY 5655960A 744 1/18/2021 0908 REGIONAL SUPPLEMENTAL SERVICES INC YORKTOWN HTS, NY 6132944A 9,330 3/7/2021 7208 ABODE COUTURE LLC YPSILANTI 5947901A 751 1/9/2021 5476 ALLIANCE SERVICES YPSILANTI 5821134A 750 2/9/2021 5476 ANN ARBOR LEARNING COMMUNITY YPSILANTI 3081001A 315 1/12/2021 8868

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Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BRIAN TILE AND STONE YPSILANTI 6136869A 750 3/18/2021 5348 BROTHERS CONSTRUCTIONS LLC YPSILANTI 5690340A 11,355 3/14/2021 5645 0.92 CLASSIC LAWN CARE & BUILDING MAINTENANCE YPSILANTI 4623991A 1,636 3/23/2021 9015 0.95 DKS SERVICES LLC YPSILANTI 5985153A 569 1/8/2021 9015 DREMARCUS LANDSCAPE LLC YPSILANTI 6107710A 523 1/25/2021 9102 ENERGY EQUIPMENT AND RESOURCES YPSILANTI 4947797A 609 1/4/2021 5191 EUCEDAS CONSTRUCTION LLC YPSILANTI 6019153A 3,500 3/3/2021 5645 FAWZI AND ASSOCIATES INC YPSILANTI 1073982A 616 3/19/2021 9058 FRIENDS IN DEED YPSILANTI 2951959A 449 3/27/2021 8742 GO GREEN WITH NATURAL CLEAN INC YPSILANTI 4845730A 1,860 3/21/2021 9015 0.95 GORDON L PANK EXPEDITING INC YPSILANTI 4856996A 751 1/24/2021 7208 GREENE HOMES YPSILANTI 6104304A 825 1/22/2021 5551 GUEVARA CONSTRUCTION YPSILANTI 5968747A 761 2/20/2021 5645 HEALTH PLUS SERVICES INC YPSILANTI 4076052A 8,388 1/11/2021 7212 1.37 13 % J AND D LANDSCAPING LLC YPSILANTI 5953278A 656 1/18/2021 9402 J O J CONSTRUCTION LLC YPSILANTI 5979218A 2,400 3/26/2021 5645 JAYCAR WELLNESS GROUP LLC YPSILANTI 5657300A 237 2/21/2021 8742 JON HAVRY CUSTOM HOMES INC YPSILANTI 6098029A 750 1/21/2021 5348 JRS GENERAL CONSTRUCTION YPSILANTI 5976065A 750 3/15/2021 5645 LIGHTHOUSE ENTERPRISES LLC YPSILANTI 3661407A 1,959 1/15/2021 9102 0.95 LOPEZ EXTERIORS LLC YPSILANTI 5980003A 750 3/28/2021 5102 M AND M INTERIORS LLC YPSILANTI 5803209A 2,541 1/1/2021 5476 NASH AND BROTHERS SERVICES LLC YPSILANTI 5855675A 1,375 2/13/2021 5645 NOEMI CLEANING SERVICE LLC YPSILANTI 6110320A 618 1/29/2021 9015 PERFECT HELP HOUSE SERVICES LLC YPSILANTI 5282659A 643 3/20/2021 9015 0.95 PNP HANDYMAN SERVICES LLC YPSILANTI 6135552A 800 3/16/2021 5645 RICER SUSAN YPSILANTI 5810698A 619 1/18/2021 9015 ROCKWOOD HOUSE INC YPSILANTI 4992237A 789 1/24/2021 9053 1.00 ROOFS AND EXTERIOR CLEANERS LLC YPSILANTI 5696330A 750 3/29/2021 5476 S AND J FAITH TRANSPORT LLC YPSILANTI 5783720A 3,556 1/4/2021 7208 S AND S CONCRETE AND SNOW REMOVAL YPSILANTI 2778122A 4,716 1/7/2021 5221 0.95 SECURITY AND PROTECTIVE SERVICES LLC YPSILANTI 0860816A 5,232 3/3/2021 7720 0.95 SENIOR SUPPORT NET LLC YPSILANTI 5076145A 1,740 3/4/2021 8835 0.95 SENTINEL LAWN CARE YPSILANTI 4739426A 1,286 3/24/2021 9102 SEQUENCE CARE MANAGEMENT INC YPSILANTI 5518644A 285 3/20/2021 8742 9/29/2020 8:54:51 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 155 Assigned Risk Renewals: January/February/March

Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge STANLEY GENERAL CONSTRUCTION LLC YPSILANTI 6124755A 750 2/22/2021 5645 T JS SERVICES INC YPSILANTI 5302897A 3,606 3/30/2021 9102 0.90 TAYYAB MUHAMMAD MD YPSILANTI 2159082A 285 2/22/2021 8832 TRU TURF LAWN FERTILIZING YPSILANTI 3608255A 709 3/23/2021 0042 UNITED WEB TECHNOLOGY INC YPSILANTI 0722103A 358 1/20/2021 8601 OZOTECH INC YREKA, CA 5680301A 355 2/23/2021 8742 ADDINK BUILDERS LLC ZEELAND 5239460A 750 1/10/2021 5437 ANDREW ULBERG BUILDER LLC ZEELAND 4606213A 752 3/28/2021 5190 B AND H DRYWALL LLC ZEELAND 5389712A 750 3/24/2021 5445 0.95 BATTERIES NOT INCLUDED LLC ZEELAND 5950244A 1,030 1/5/2021 8017 BLAUKAMP BUILDERS INC ZEELAND 3667146A 750 3/7/2021 5645 0.95 DE ROO ROOFING INC ZEELAND 0824640A 750 3/15/2021 5551 0.88 DEYOUNG SIDING ZEELAND 5944414A 2,444 1/1/2021 5645 DOUGLAS L BROWER BUILDER ZEELAND 3590895A 750 1/18/2021 5645 DTB SERVICES LLC ZEELAND 4890175A 1,851 1/1/2021 5146 0.95 FRAAZA SERVICES LLC ZEELAND 5326893A 750 1/21/2021 5645 GUIDE MKTG LLC ZEELAND 6089577A 343 1/1/2021 8810 JOHNS BATTERY & ELECTRIC INC ZEELAND 2174898A 482 3/9/2021 8010 JUNIPER LLC ZEELAND 5811406A 1,854 1/18/2021 0042 0.95 LIGHTHOUSE PROPERTY SERVICES LLC ZEELAND 4847555A 709 1/15/2021 0042 LUNSFORD BUILDERS LLC ZEELAND 4510259A 933 1/5/2021 5645 0.95 MACATAWA DRIVING SCHOOL LLC ZEELAND 5454980A 676 2/7/2021 8868 MLS ROOFING LLC ZEELAND 6093426A 750 1/7/2021 5551 MVO CONSTRUCTION LLC ZEELAND 6096476A 750 1/11/2021 5645 PARAGON CONSTRUCTION LLC ZEELAND 5981050A 750 3/28/2021 5645 PAULS ROOFING & REPAIR INC ZEELAND 0338745A 750 3/27/2021 5551 0.95 RANDALL BURRI BUILDER ZEELAND 1398083A 750 3/30/2021 5645 SHINE N GO LLC ZEELAND 5655480A 2,468 1/5/2021 8387 0.95 SNS BUILDING CORP ZEELAND 5671485A 750 2/13/2021 5645 TIMBER FLOORING LLC ZEELAND 5775450A 750 3/13/2021 5437 VANDENBURG LEONE G ZEELAND 5958709A 2,171 1/24/2021 0913 VANDERVEEN MARC ZEELAND 4195752A 750 3/23/2021 5221 VERPLANK CONSTRUCTION LLC ZEELAND 6137784A 1,559 3/20/2021 5022 WEST OTTAWA DOOR LLC ZEELAND 0199303A 631 2/6/2021 3724

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