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.