Michigan Workers Compensation Placement Facility Depopulation Report Page 1 Assigned Risk Renewals: April/May/June Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge AJVV INC ADA 6166083A 4,040 4/25/2021 9102 DANIEL EIZANS STRATEGIC SERVICES LLC ADA 5561051A 410 5/13/2021 8810 HARD WILLIAM C ADA 5277442A 307 6/6/2021 0908 JOBSON ROOFING ADA 5722586A 750 6/17/2021 5551 JOHNSON HOMES INC ADA 4417810A 750 5/25/2021 5645 LOYL HOMES LLC ADA 5861977A 240 5/3/2021 8810 LUONTO LLC ADA 4356209A 2,570 5/10/2021 9015 MERIDIAN CABLING SOLUTIONS LLC ADA 5862809A 470 5/8/2021 5190 PEAK PERFORMANCE ROOF CLEANING LLC ADA 5707269A 10,934 5/14/2021 5538 0.86 REIMERSMA BUILDERS ADA 2201550A 1,350 6/21/2021 5645 THREE SEASONS LAWN CARE & MAINTENANCE ADA 3657108A 2,057 5/15/2021 9102 0.95 LLC TIP TOP GRAVEL CO ADA 0824453A 9,333 5/10/2021 4000 1.41 13 % TRI ACOUSTIC CORPORATION ADA 0070602A 750 4/13/2021 5445 WMC SALES LLC ADA 4499743A 633 5/6/2021 3724 0.95 WYNN PAINTING ADA 4867777A 800 5/17/2021 5476 XERICK LOGISTICS GROUP INC ADA 6201008A 314 6/16/2021 8810 TOMMYS TEMP SERVICES LLC ADDISON 5722438A 752 6/8/2021 8017 ADRIAN FUELS LLC ADRIAN 4977289A 522 4/19/2021 8017 AKERS DAVID ADRIAN 0991112A 1,028 4/26/2021 5476 BROWN AND SONS ROOFING AND SIDING LLC ADRIAN 5715180A 24,532 5/11/2021 5552 0.87 DOWN UNDER TRENCHING LLC ADRIAN 2692562A 5,417 6/10/2021 7600 0.89 FASCO EMPLOYMENT INC ADRIAN 0943622A 14,879 5/18/2021 4558 1.33 GERRYS OUTDOOR SERVICES LLC ADRIAN 4971647A 2,220 4/23/2021 0106 0.95 HMS BUILDERS INC ADRIAN 3674606A 750 5/9/2021 5437 1.00 HOWELL HOLDINGS LLC ADRIAN 5735050A 18,456 5/21/2021 7720 0.95 IMAGINEERING AND MORE LLC ADRIAN 5720087A 348 6/12/2021 8810 JORDAN HOME SERVICES LLC ADRIAN 5995205A 710 6/12/2021 0042 LKN TRUCKING LLC ADRIAN 5591767A 750 5/8/2021 7208 O PATRIAM LLC ADRIAN 6198678A 751 6/12/2021 5437 SPAULDING AND SONS ADRIAN 5991080A 750 4/24/2021 5102 TWO HUNDRED 56 ROBOTICS LLC ADRIAN 5857619A 301 4/21/2021 5191 MAPLE HILL ADULT FOSTER CARE AFTON 5530318A 571 6/3/2021 9053 MIDWAY SPRING INC AFTON 3650634A 481 6/24/2021 8395 BAY FRONT PARK CAFE ALANSON 5865956A 330 6/25/2021 8017 1/4/2021 7:47:08 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 2 Assigned Risk Renewals: April/May/June Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BUILT RIGHT CONSTRUCTION AND REMODELING ALANSON 6000509A 1,894 6/16/2021 5645 LLC K COLFER SPORTHORSES LLC ALANSON 4745663A 2,293 5/4/2021 8279 0.95 MURPHY SCOTT ALANSON 5016916A 751 6/7/2021 7208 T D LEMIEUR ROOFING LLC ALANSON 5865050A 19,723 5/16/2021 5551 0.94 NELSON LARRY ALBION 1005200A 739 6/3/2021 6217 RUSTY 4 FARMS ALBION 0251267A 17,970 5/4/2021 2731 1.52 40 % YOUNGS GAS SERVICE LLC ALBION 0970263A 3,738 6/1/2021 8350 0.95 RAPID TEMPS INC ALBUQUERQUE, NM 2758083A 830 4/7/2021 8833 ABC SERVICES AND FOXFIRE FARM LLC ALGONAC 3792692A 16,031 4/17/2021 9015 1.53 13 % AHEE MASONRY LLC ALGONAC 3612392A 751 6/3/2021 5022 ALT VACANCY SOLUTIONS INC ALGONAC 5383455A 1,084 4/4/2021 9015 BLUE WATER MATERIALS LLC ALGONAC 3824993A 1,609 6/25/2021 4000 0.95 DEERBROOK BUILDERS LLC ALGONAC 3185494A 1,769 5/31/2021 5437 0.91 TNT CUSTOM CARPENTRY INC ALGONAC 5017459A 750 5/20/2021 5645 WHITENACK CONSTRUCTION LLC ALGONAC 5872928A 750 6/5/2021 5437 WINNERS CIRCLE BAR INC ALGONAC 0198986A 480 6/4/2021 9058 YOKOM JAMES ALGONAC 3597610A 750 5/6/2021 5437 ALLEGAN COUNTY AGRICULTURAL SOCIETY ALLEGAN 1602829A 6,216 5/1/2021 9015 0.88 ARM SERVICES INC ALLEGAN 5402360A 569 5/8/2021 9015 FIRST PLACEMENT EMPLOYMENT GROUP INC ALLEGAN 2162270A 56,501 5/25/2021 8059 MARK P JANKE CONSULTING FORESTER LLC ALLEGAN 5256852A 755 4/3/2021 8601 POPPEMA NATHAN ALLEGAN 5469279A 750 6/13/2021 5020 S AND T SEAMLESS GUTTERS AND COVERS ALLEGAN 5848245A 706 4/2/2021 5538 SKY TRAIL MANAGEMENT AND DEVELOPMENT ALLEGAN 4469941A 650 5/29/2021 8810 LLC STARS AND STRIPES ROOFING LLC ALLEGAN 5878454A 800 6/27/2021 5551 TJM SERVICES ALLEGAN 5007046A 898 5/12/2021 0042 BATT CHARLES B ALLEN 3522709A 750 5/31/2021 0106 SENSIBLE CONSTRUCTION LLC ALLEN 1527460A 750 4/9/2021 5551 BIG V LANDSCAPING ALLEN PARK 1829262A 760 6/30/2021 0042 COSTA ALLEN PARK INC ALLEN PARK 2625075B 741 4/9/2021 9058 0.95 FOURNIER HAL ALLEN PARK 5257239A 750 4/3/2021 5476 LIVIDINI LANDSCAPING LLC ALLEN PARK 5142440A 709 4/3/2021 0042 0.95 PHYSICIAN BILLING MANAGEMENT INC ALLEN PARK 3795950A 1,505 6/1/2021 9015 0.95 1/4/2021 7:47:08 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 3 Assigned Risk Renewals: April/May/June Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge ROBLES TREE SERVICE ALLEN PARK 5279941A 750 5/22/2021 0106 SLOAN AND SON HOME IMPROVEMENT ALLEN PARK 3206912A 1,375 6/7/2021 5645 STAR LYTE MANAGEMENT LLC ALLEN PARK 4991095A 751 5/30/2021 7380 T WIN SERVICES ALLEN PARK 0105236A 800 5/19/2021 5476 TUCCINI ORTHODONTIC LABORATORY INC ALLEN PARK 2498880A 593 5/26/2021 4692 DAVE BOSCH BUILDER INC ALLENDALE 4358163A 750 6/13/2021 5645 DAVIDSON SNOW & ICE LLC ALLENDALE 6176658A 657 5/7/2021 9102 JMB DEMOLITION LLC ALLENDALE 4445600A 9,023 4/26/2021 7380 0.97 KRUZEL BRIAN ALLENDALE 5983819A 750 4/10/2021 5445 LANGLAND JOSHUA ALLENDALE 5995000A 750 6/23/2021 5645 LJ HEINLEN TRANSPORTATION LLC ALLENDALE 3103714A 750 5/9/2021 7208 MATT PETERS CONSTRUCTION ALLENDALE 6003656A 750 6/12/2021 5645 NORTHSTAR CONSTRUCTION AND RENOVATION ALLENDALE 5409543A 750 6/30/2021 5645 LLC SHORELINE STAMPCRETE LLC ALLENDALE 5262941A 298 5/9/2021 8742 THOMPSON JUSTIN K ALLENDALE 6180833A 800 5/12/2021 5551 ULBERG BUILDERS LLC ALLENDALE 5269725A 1,554 5/25/2021 5437 0.95 VANGUARD CONSTRUCTION LLC ALLENDALE 6185266A 755 5/19/2021 5606 W S SERVICES ALLENDALE 2877716A 750 6/7/2021 5437 WIERSEMA JACOB ALLENDALE 5995078A 750 5/14/2021 5645 B M V TRANSPORT INC ALLENTON 2864576A 750 4/28/2021 7208 0.95 COMFORT CARE COMPANION LLC ALLENTON 5993261A 526 5/15/2021 8835 DIVINE FLOOR SERVICES LLC ALLENTON 4882733A 750 6/29/2021 5437 0.95 JC CONSTRUCTION ALLENTON 0908690A 825 5/5/2021 5645 ALL AMERICAN PEST CONTROL LLC ALMA 4988124A 3,358 5/23/2021 9015 0.95 DEVIN ENTERPRISES INC ALMA 5125243A 1,404 4/2/2021 9058 0.95 NEW HORIZONS REALTY INC ALMA 5877741A 355 6/16/2021 8742 RAMON ANTHONY ALMA 5697948A 471 4/4/2021 5190 MMH SOLUTIONS INC ALMONT 3021351A 750 5/11/2021 5403 0.95 ON POINT PROPERTY RESTORATION LLC ALMONT 1701061A 5,190 6/2/2021 5645 0.88 POLISH MANIA LLC ALMONT 5861837A 387 5/1/2021 9058 A 1 TREE SERVICE LLC ALPENA 5262720A 4,158 4/17/2021 0106 0.95 AARON OGG CONSTRUCTION ALPENA 6201717A 750 6/18/2021 5645 BELLA ROSE SKIN CARE PLLC ALPENA 5593425A 323 5/23/2021 9586 BIGGBEAN LLC ALPENA 5861691A 1,629 5/9/2021 8017 1/4/2021 7:47:08 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 4 Assigned Risk Renewals: April/May/June Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge CAMPERS COVE RV PARK & CANOE LIVERY INC ALPENA 4067908A 1,172 4/1/2021 9015 0.95 ENVIRONMENTAL AND ASBESTOS SERVICES INC ALPENA 4752880A 480 4/20/2021 8601 LEES MINITURE GOLF ALPENA 3365832A 568 6/5/2021 9015 MATUZAK CONCRETE CREATIONS LLC ALPENA 6198660A 880 6/12/2021 5022 MORGAN FOREST PRODUCTS ALPENA 4067436A 750 5/10/2021 2702 MURPHY CONTRACTING SERVICES LLC ALPENA 5985803A 750 4/16/2021 5645 BEAVER WOOD TREE SERVICE LLC ALTO 4864441A 7,379 6/30/2021 0106 0.87 BOVERHOF BUILDERS INC ALTO 2714221A 761 5/29/2021 8742 CUTLER JUSTIN ALTO 5856779A 709 4/20/2021 0042 DVB INC ALTO 3453987A 750 4/11/2021 5645 GROOT SERVICES LLC ALTO 5880360A 523 6/28/2021 9102 LEROUX CONSTRUCTION LLC ALTO 5596580A 750 5/9/2021 5645 VERBURG BUILDERS LLC ALTO 5272769A 750 5/23/2021 5645 0.95 FIRST CLASS CARPENTRY LLC ANCHORVILLE 5719399A 4,053 5/24/2021 5437 0.95 OARS COMPANIES INC ANGELS CAMP, CA 6004377A 263 6/14/2021 8810 A 2 SUPPLY CHAIN SERVICES LLC ANN ARBOR 5869951A 800 4/19/2021 5645 AARON HAMMER LLC ANN ARBOR 5555418A 1,363 5/11/2021 0042 0.95 ABRAMSON FRANCES ANN ARBOR 5983797A 530 4/16/2021 0913 ACKENHAUSEN THOMAS AND SHANNON ANN ARBOR 6182666A 307 5/14/2021 0908 AIS CONSTRUCTION INC ANN ARBOR 5732433A 750 4/26/2021 0106 ALLAN MARGARET ANN ARBOR 6197540A 382 6/22/2021 0908 ALLGOOD JASON ANN ARBOR 6186742A 530 5/21/2021 0913 ANTHONYS GOURMET PIZZA INC ANN ARBOR 0143049A 3,084 6/8/2021 9058 0.95 APPROPRIATE TECHNOLOGY COLLABORATIVE ANN ARBOR 6193463A 265 6/11/2021 8868 ASSISTED LIVING LLC ANN ARBOR 3671488A 7,681 5/8/2021 9053 ATLAS INSTALLERS LLC ANN ARBOR 5987903A 590 4/20/2021 9521 ATP PAINTING LLC ANN ARBOR 4395875A 751 4/24/2021 5476 B SQUARED PAINTING LLC ANN ARBOR 5547873A 4,236 4/19/2021 5437 0.95 BENDIT RACHEL ANN ARBOR 3925587A 663 5/18/2021 0908 0.95 BERGHOF SYSTEMS INC ANN ARBOR 5127270A 264 4/17/2021 8810 BIRD CENTER OF WASHTENAW COUNTY INC ANN ARBOR 4228863A 874 6/8/2021 8831 0.95 BLUE CHIP PLAYER DEVELOPMENT ANN ARBOR 6192173A 761 6/11/2021 9063 BOURNE TO MOW LLC ANN ARBOR 5263107A 1,754 6/27/2021 9102 CHECKMATE TACTICAL LLC ANN ARBOR 6193412A 2,710 6/4/2021 7720 CLOVERLY VILLAGE OWNERS ASSOCIATION ANN ARBOR 4235240A 568 4/17/2021 9015 1/4/2021 7:47:08 AM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 5 Assigned Risk Renewals: April/May/June Employer Name City RISK ID# Est.