Michigan Workers Compensation Placement Facility Depopulation Report Page 1 Assigned Risk Renewals: July/August/September Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BOB LEVERING ROOFING ADA 2257017A 750 7/6/2016 5551 LA ISLA FOUNDATION INC ADA 5300797A 514 8/7/2016 8742 R J DEVRIES CONSTRUCTION INC ADA 2458160A 1,231 9/25/2016 5445 STAFFING SOLUTIONS INC ADA 4535219A 73,828 9/26/2016 5102 0.92 THREE D PROSCAPES LLC ADA 5422094A 787 7/9/2016 9102 BURKE DOUG ADDISON 5447801A 750 9/14/2016 7208 LEE GROUP LLC ADDISON 5114098A 753 8/19/2016 5606 0.95 MCAULIFFES PROCESSING INC ADDISON 3724638A 5,111 9/18/2016 2081 0.90 AC 3 LLC ADRIAN 4899571A 383 8/13/2016 8045 ANNAS ADULT NOVELTIES LLC ADRIAN 5447674A 447 9/17/2016 8017 LENAWEE EMERGENCY AND AFFORDABLE ADRIAN 1991728A 1,084 7/16/2016 9015 0.95 HOUSING CORPORATION SAFEWAY MOVING & STORAGE INC ADRIAN 4662890A 2,084 9/9/2016 7214 0.95 SANDY PEBBLES GOLF COURSE LLC AHMEEK 5428556A 941 7/29/2016 9060 JERRY PESARCYK BUILDERS LLC ALANSON 0620300A 750 8/25/2016 5645 0.95 KRE TRUCKING ALANSON 5422655A 750 7/11/2016 7208 DLC ENTERPRISES INC ALBION 0375268A 800 7/21/2016 9015 1.23 WASHINGTON AND ASSOCIATES HOME HEALTH ALBION 2977125A 2,247 8/22/2016 8835 0.95 SYSTEMS INC ANCHOR BAY PAINTING ALGONAC 5426502A 750 7/22/2016 5476 CHRISS CUSTOM CUTS ALGONAC 4792742A 1,007 7/21/2016 9102 COMPLETE MAINTENANCE & CABINETRY LLC ALGONAC 3702260A 750 7/11/2016 5221 E J SIDING INC ALGONAC 2725690A 750 7/2/2016 5403 0.95 ENTERPRISE FACILITY SERVICES LLC ALGONAC 5001072A 750 9/13/2016 9015 SOLAR VIEW ALGONAC 1513400A 750 7/3/2016 5645 0.95 SUPERIOR HOME BUILDING ALGONAC 5430437A 750 8/3/2016 5645 FRESH TOUCH LLC ALLEGAN 5420393A 750 7/3/2016 9015 SAFE HARBOR CHILDRENS ADVOCACY CENTER ALLEGAN 2371340A 635 7/13/2016 8832 WINGS HOME ALLEGAN 4797043A 2,264 8/26/2016 8835 0.95 ALL POINT CONSTRUCTION LLC ALLEN PARK 5420334A 7,477 7/2/2016 5437 BOVE CONSTRUCTION CO ALLEN PARK 1776070A 750 9/9/2016 5645 COMPADRES INC ALLEN PARK 5425344A 951 7/21/2016 8387 CUSTOM HOLIDAYS LLC ALLEN PARK 5276659A 753 9/1/2016 9015 D AND J HOME ALLEN PARK 3592880A 750 8/2/2016 5645 E CREW LLC ALLEN PARK 4384890A 978 9/1/2016 9058 0.95 3/31/2016 1:19:10 PM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 2 Assigned Risk Renewals: July/August/September Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge K DAWG PROPERTIES LLC ALLEN PARK 5191858A 751 9/24/2016 3365 REALTY TRANSITION LLC ALLEN PARK 5435749A 750 8/14/2016 5645 S A EXPRESS INC ALLEN PARK 5300827A 802 8/7/2016 8810 STAR LYTE MANAGEMENT LLC ALLEN PARK 4991095A 419 8/1/2016 8748 STAY AT HOME CARE LLC ALLEN PARK 4883896A 7,698 7/6/2016 8835 0.89 SUNRISE 2 SUNSET CONTRACTORS INC ALLEN PARK 5427312A 750 7/31/2016 5645 U S CONSTRUCTION INC ALLEN PARK 4190017A 750 7/24/2016 5645 VAIL GEORGE ALLEN PARK 4779142A 750 8/4/2016 5476 Y G AND L CORPORATION ALLEN PARK 3063593A 868 9/16/2016 8017 0.95 BJS MASONRY INC ALLENDALE 2120178A 750 9/14/2016 5022 0.95 DEVOS PRUNING ALLENDALE 1802550A 750 9/25/2016 0106 DUTTON CALEB ALLENDALE 5449685A 750 9/15/2016 5437 KOOISTRA DURK ALLENDALE 5230047A 750 9/22/2016 7208 KUZEE BUILDERS LLC ALLENDALE 4125169A 750 9/29/2016 5437 0.95 MARTIN DRYWALL INC ALLENDALE 2749009A 750 7/11/2016 5445 ROUTE 45 BREWING COMPANY LLC ALLENDALE 5445540A 791 9/5/2016 2121 SKYLINE SYSTEMS LLC ALLENDALE 5229499A 836 9/8/2016 8601 STONE CREEK PROPERTIES LLC ALLENDALE 4874013A 750 7/6/2016 9015 WES KNOPER BUILDER ALLENDALE 3330133A 750 8/3/2016 5645 ROGAN JUSTIN P ALLOUEZ 5421314A 750 7/7/2016 2702 C AND M FENCE ALMA 5435587A 750 8/13/2016 5403 DUHADWAY DANCE DIMENSIONS LLC ALMA 3892603A 711 9/14/2016 9063 ENERGYFIRST HOME IMPROVEMENTS LLC ALMA 5420075A 13,773 7/1/2016 5645 JG ANESTHESIA SERVICES PC ALMA 3207811A 750 8/25/2016 8833 BUSH CONTRACTING INC ALMONT 3367037A 750 8/7/2016 6217 0.95 CLEVER CARPENTRY ALMONT 4106440A 825 7/29/2016 5403 DEBMAR INC ALMONT 4782712A 637 8/13/2016 8810 K AND R GARAGE DOOR SERVICE LLC ALMONT 2899728A 750 8/1/2016 3724 DGI ROOFING & BUILDING INC ALPENA 4996518A 4,492 7/3/2016 5403 0.95 NOWAKOWSKI BENJAMIN ALPENA 4487575A 750 9/23/2016 2702 PHELPS COLLINS AVIATION INC ALPENA 0797170A 3,291 9/16/2016 7422 0.95 ROMEL TRUCKING INC ALPENA 0719765A 750 7/16/2016 2702 X TREME TIMBER CUTTING LLC ALPENA 5305780A 750 8/20/2016 2709 BAIRDS FLOORING LLC ALTO 5297222A 750 7/29/2016 5437 BOULDER RIDGE RANCH LLC ALTO 2731509B 5,016 9/1/2016 9015 0.95 3/31/2016 1:19:10 PM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 3 Assigned Risk Renewals: July/August/September Employer Name City RISK ID# Est. Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge BOWMAN MICHAEL ALTO 0030490A 749 9/5/2016 0129 JACKSON AVIATION SERVICES LLC ALTO 4113349A 2,079 8/26/2016 7422 0.95 CARE TEAM SOLUTIONS LLC AMHERST, NY 5454123A 324 9/23/2016 8832 VERMILION TREE AND LANDCLEARING SERVICE AMHERST, OH 5454611A 8,075 9/28/2016 2709 INC ADAMS TREE SERVICE LLC ANN ARBOR 3063801A 1,099 9/1/2016 0042 0.95 AJ NIMER LLC ANN ARBOR 5295386A 3,950 8/11/2016 5445 ALL PHASES PAINTING INTERIOR & EXTERIOR ANN ARBOR 4661338A 942 9/1/2016 5476 0.95 INC ALL WAYS PAINT & DRYWALL ANN ARBOR 2807939A 750 8/1/2016 5476 ALPINE CONDOMINIUM ASSOCIATION ANN ARBOR 3792790A 750 9/15/2016 9015 0.95 ARBOR LANDSCAPING AND LAWN CARE INC ANN ARBOR 4752937A 801 8/25/2016 0042 ARBORSIDE CONSUMER PROTECTION SERVICES ANN ARBOR 4893166A 717 8/24/2016 8045 L3C AUSTIN COMMONS CONDOMINIUM ASSOCIATION ANN ARBOR 4022076A 750 9/12/2016 9015 B R STOUFFER LLC ANN ARBOR 4806778A 750 8/28/2016 5437 BABY SENIOR CARE SERVICES ANN ARBOR 5442311A 1,367 8/29/2016 8835 BACKYARD BRAINS INCORPORATED ANN ARBOR 4889215A 2,895 7/26/2016 3179 0.95 BLACKSHEAR BOOKS INC ANN ARBOR 5167213A 405 7/17/2016 8017 BUILDING ARTS AND CONSERVATION LLC ANN ARBOR 3996913A 1,831 8/18/2016 8720 0.95 CAMERON COTTAGE LLC ANN ARBOR 5420938A 7,168 7/3/2016 3726 CLAIMS INC ANN ARBOR 0151394A 755 8/7/2016 8742 CLASS REUNION CREATOR LLC ANN ARBOR 4709632A 295 8/29/2016 8810 D AND E PLUMBING ANN ARBOR 5441854A 3,350 8/28/2016 5183 DONALD J WURTZEL DDS PLLC ANN ARBOR 1724355A 6,132 7/15/2016 8832 1.39 27 % DOUGHTY MONTESSORI SCHOOL LTD ANN ARBOR 1204769A 1,060 7/17/2016 8869 0.95 ECO HOUSE PAINTERS ANN ARBOR 2519925A 750 9/10/2016 5476 ENVIRONMENTAL CONSULTING GROUP INC ANN ARBOR 4890469A 284 7/27/2016 8601 GENDRON CATHY ANN ARBOR 5418089A 811 7/1/2016 5476 GREAT LAKES PERFORMING ARTIST ASSOCIATES ANN ARBOR 2334747A 244 7/16/2016 8810 GREENSTREET INC ANN ARBOR 0138126A 27,510 9/20/2016 0106 1.27 HARRIS HOMES CARPENTRY INC ANN ARBOR 0345687A 800 8/20/2016 5645 HEALTHCARE DURABLE MEDICAL EQUIPMENTS ANN ARBOR 4446127A 1,082 8/23/2016 8810 0.91 LLC I AND I CONSTRUCTION ANN ARBOR 3131297A 750 8/28/2016 5645 J WEIL GOLDSMITH & ASSOC LLC ANN ARBOR 3028453A 441 7/7/2016 0908 3/31/2016 1:19:10 PM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 4 Assigned Risk Renewals: July/August/September Employer Name City RISK ID# Est. 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Mod Pool Premium Code Surcharge JOHN E ROBBINS THE ROBBINS TRUST ANN ARBOR 5443008A 756 9/1/2016 0913 JOHNSON JEREMIAH ANN ARBOR 5239311A 706 8/4/2016 0913 KITE NETWORK ANN ARBOR 5443830A 284 9/23/2016 8810 LAKE IMPROVEMENT ASSOCIATION ANN ARBOR 0597244A 750 7/3/2016 9015 LEGACY FINANCIAL INC ANN ARBOR 3817598A 405 7/15/2016 8810 LENSKI SHOSHANNAH ANN ARBOR 4893646A 706 8/3/2016 0913 LIBERTY HEIGHTS CONDOMINIUM ASSOCIATION ANN ARBOR 5316260A 750 9/15/2016 9015 MAVEN DEVELOPMENT LLC ANN ARBOR 3763919A 800 8/28/2016 5645 MR ROOF ANN ARBOR LLC ANN ARBOR 3974090A 10,547 7/1/2016 8227 0.81 NAZARIO JOSE ANN ARBOR 5012970A 706 8/20/2016 0913 OAK MEADOWS ASSOCIATION ANN ARBOR 2016176A 800 8/8/2016 9015 ONE THOUSAND 316 S WESTERN LLC ANN ARBOR 0818852A 1,483 7/1/2016 9015 0.95 PHI RHO SIGMA MEDICAL ASSN ANN ARBOR 1355139A 563 9/15/2016 9061 RICHARD THOMPSON LLC ANN ARBOR 4796691A 605 8/27/2016 8742 SCHULTZ LINDSAY ANN ARBOR 5430240A 706 8/3/2016 0913 SKG CONSULTING LLC ANN ARBOR 5285593A 226 7/2/2016 8810 SMG SERVICES LLC ANN ARBOR 5286743A 750 7/4/2016 9015 SNOW X INC ANN ARBOR 0277983A 5,418 8/15/2016 9402 0.94 SUNTECH INDUSTRIALS LLC ANN ARBOR 5452350A 1,699 9/18/2016 8018 TONYS ROOF REPAIR LLC ANN ARBOR 2906287A 750 9/4/2016 5551 URBAN FORESTERS INC ANN ARBOR 2192047A 47,728 9/14/2016 0042 1.56 13 % VECTOR ELECTRIC INC ANN ARBOR 2033151A 1,804 8/6/2016 5190 0.95 VINCENT RE PLLC ANN ARBOR 5319102A 225 9/20/2016 8810 WATSON HEALTH CARE INC ANN ARBOR 2305437A 88,060 8/17/2016 8835 1.61 27 % WHITMAN MARINA & ROBERT ANN ARBOR 2493667A 1,014 8/1/2016 0908 0.95 WOODS AND WATER ECOTOURS LLC ANN ARBOR 4356209A 751 7/21/2016 9015 ZAMPERLA BROTHERS LLC ANN ARBOR 4703014A 772 9/22/2016 5437 ZEEB INC ANN ARBOR 2785340B 889 7/2/2016 8017 0.89 COMFORT IN HOME CARE LLC APPLEGATE 3951189A 2,928 7/20/2016 8835 0.95 ARMADA CONTROLS LLC ARMADA 4774035A 300 7/27/2016 8810 CROWN CONSTRUCTION INC ARMADA 0052760A 2,051 7/10/2016 5221 0.95 MICHIGAN MILLWORKS ARMADA 5422167A 750 7/10/2016 5437 P AND V MASONRY LLC ARMADA 0037478A 1,226 7/25/2016 5022 0.95 SANDRA N MICHAEL INC ARMADA 5022851A 800 9/11/2016 7208 0.95 TREE GUYS ARMADA 5435765A 1,234 9/30/2016 0106 3/31/2016 1:19:10 PM /CaomReports/QuarterlyAR Depopulation Report Michigan Workers Compensation Placement Facility Depopulation Report Page 5 Assigned Risk Renewals: July/August/September Employer Name City RISK ID# Est.