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. 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Annual Expire Date Class Exp. Mod Pool Premium Code Surcharge P S STONE AND CONSTRUCTION LLC ALBION 5726069A 753 6/21/2018 5348 RUSTY 4 FARMS ALBION 0251267A 9,921 5/4/2018 2731 1.00 YOUNGS GAS SERVICE LLC ALBION 0970263A 2,561 6/1/2018 8350 0.95 GREENWORLD MAINTENANCE LLC ALDEN 2249200A 750 5/4/2018 0042 0.92 NORTHERN SKYLIGHTS LLC ALDEN 4340051A 750 6/27/2018 5550 REBELLION ROCK WORKS ALDEN 5725607A 1,029 6/20/2018 5022 THEISEN BUILDERS LLC ALGER 2129167A 1,474 4/6/2018 5437 ABC SERVICES AND FOXFIRE FARM LLC ALGONAC 3792692A 9,186 4/17/2018 9015 0.84 AHEE MASONRY LLC ALGONAC 3612392A 751 6/3/2018 5022 ALT VACANCY SOLUTIONS INC ALGONAC 5383455A 646 4/4/2018 9015 BLUE WATER MATERIALS LLC ALGONAC 3824993A 4,414 6/25/2018 4000 0.95 CATENACCI ANDY ALGONAC 1834509A 2,614 6/9/2018 5645 POLITO A ALGONAC 3204855A 750 5/16/2018 5645 S AND M PAINTING ALGONAC 5695198A 750 4/5/2018 5476 SKARBEK PROPERTY MAINTENANCE LLC ALGONAC 5715547A 750 5/12/2018 0042 TILTON CONSTRUCTION LLC ALGONAC 5260752A 825 4/12/2018 5506 YOKOM JAMES ALGONAC 3597610A 750 5/6/2018 5437 ALLEGAN COUNTY AGRICULTURAL SOCIETY ALLEGAN 1602829A 9,878 5/1/2018 9015 1.26 ARM SERVICES INC ALLEGAN 5402360A 647 5/8/2018 9015 BIG REDS WRECKER LLC ALLEGAN 5694000A 7,236 4/6/2018 7208 MARK P JANKE CONSULTING FORESTER LLC ALLEGAN 5256852A 755 4/3/2018 8601 SKY TRAIL MANAGEMENT AND DEVELOPMENT ALLEGAN 4469941A 921 5/4/2018 8810 LLC T AND L SERVICES ALLEGAN 4956761A 1,084 5/28/2018 9015 0.95 TJM SERVICES ALLEGAN 5007046A 750 5/12/2018 0042 BATT CHARLES B ALLEN 3522709A 750 5/31/2018 0106 ALLEN PARK CEMENT GUYZ INC ALLEN PARK 4367103A 750 5/28/2018 5221 BIG V LANDSCAPING ALLEN PARK 1829262A 801 6/30/2018 0042 0.95 COSTA ALLEN PARK INC ALLEN PARK 2625075B 897 4/9/2018 9058 0.95 FAMILIA TUCCINI ORTHODONTIC LABORATORY ALLEN PARK 2498880A 473 5/26/2018 4692 INC FAST TIME TOWING LLC ALLEN PARK 5464471A 750 4/14/2018 7208 FOURNIER HAL ALLEN PARK 5257239A 750 4/3/2018 5476 GUTIERREZ CARPENTRY LTD INC ALLEN PARK 5555159A 750 4/22/2018 5645 HAMMERTIME LLC ALLEN PARK 5395747A 750 5/26/2018 5437 1/2/2018 8:13:07 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. 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Mod Pool Premium Code Surcharge LIVIDINI LANDSCAPING LLC ALLEN PARK 5142440A 750 4/3/2018 0042 0.95 MITTEN CONTRACTING LLC ALLEN PARK 4875214A 9,549 4/5/2018 5645 0.95 NILE CONSTRUCTION LLC ALLEN PARK 5280982A 750 6/14/2018 5221 SKYHORSE STEEL CORPORATION ALLEN PARK 5563143A 7,497 5/17/2018 5102 STAY AT HOME CARE LLC ALLEN PARK 4883896A 25,154 4/12/2018 8835 1.58 13 % T P ASSOCIATES LLC ALLEN PARK 4494113C 2,848 6/14/2018 9060 1.29 13 % TWIN SERVICES ALLEN PARK 0105236A 800 5/19/2018 5476 DAVE BOSCH BUILDER INC ALLENDALE 4358163A 750 6/13/2018 5645 HARWOOD MACHINE REPAIR & DIAGNOSTIC INC ALLENDALE 5409039A 750 5/30/2018 3724 HIGH BAR PLUMBING LLC ALLENDALE 5721369A 704 6/2/2018 5183 JMB DEMOLITION LLC ALLENDALE 4445600A 4,787 4/26/2018 7380 0.95 KOOISTRA DURK ALLENDALE 5230047A 750 5/20/2018 7208 MILES ULBERG BUILDERS LLC ALLENDALE 5269725A 1,525 5/25/2018 5437 NORTHSTAR CONSTRUCTION AND RENOVATION ALLENDALE 5409543A 750 6/30/2018 5645 LLC VICTORY CHEERLEADING COMPANY LLC ALLENDALE 3508269A 798 6/5/2018 9063 W S SERVICES ALLENDALE 2877716A 750 6/7/2018 5437 DIVINE FLOOR SERVICES LLC ALLENTON 4882733A 2,371 6/29/2018 5437 0.95 GENERAL MAINTENANCE WORKS INC ALLENTON 5025010A 2,336 4/24/2018 5221 0.95 STC FLEET SERVICE INC ALLENTON 4329821A 589 5/2/2018 8395 AFFORDABLE DRYWALL ALMA 5266700A 750 5/1/2018 5445 ALL AMERICAN PEST CONTROL LLC ALMA 4988124A 2,524 5/23/2018 9015 0.95 GUIETT PORTAJOHN RENTALS & SERVICE LLC ALMA 5547130A 843 4/18/2018 9402 LOTT BUILDERS LLC ALMA 3851354B 2,969 5/19/2018 5645 0.95 RAMON ANTHONY ALMA 5697948A 545 4/4/2018 5190 TJ AND K TOWING & RECOVERY LLC ALMA 5330122A 4,108 6/12/2018 7208 0.95 FRESH AIRE MECHANICAL INC ALMONT 4058771A 5,212 4/10/2018 5550 0.91 JT POWER INC ALMONT 4550897A 3,461 5/18/2018 5190 0.95 MMH SOLUTIONS INC ALMONT 3021351A 750 6/10/2018 5645 0.95 ORLANDOS MASONRY & CONSTRUCTION LLC ALMONT 5341787A 1,207 4/23/2018 5022 0.95 SCOTTS LAWN MAINTENANCE INC ALMONT 3170446A 1,453 6/22/2018 0042 0.95 SIRCO SCAPE LLC ALMONT 3948706A 5,689 4/20/2018 9102 0.86 A 1 TREE SERVICE LLC ALPENA 5262720A 1,896 4/17/2018 0106 0.95 CAMPERS COVE RV PARK & CANOE LIVERY INC ALPENA 4067908A 913 5/3/2018 6836 0.95 ENVIRONMENTAL AND ASBESTOS SERVICES INC ALPENA 4752880A 639 4/20/2018 8601 1/2/2018 8:13:07 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. 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Mod Pool Premium Code Surcharge SAMPLE AND SONS INC BAY CITY 0990876A 971 6/21/2018 8387 0.95 SHIP SHAPE AND SUDS INC BAY CITY 4049659A 1,548 4/13/2018 6826 0.95 SHORKEY HEATING & COOLING LLC BAY CITY 4521463A 801 6/19/2018 5550 SMITH STREET HOME ASSISTED LIVING LLC BAY CITY 3295885A 1,079 6/28/2018 9053 SUNSET SHORES YACHT CLUB INC BAY CITY 1499360A 647 6/6/2018 9015 THAT GUYS LLC BAY CITY 3345300A 1,723 5/31/2018 9058 TWIN FLOWER LLC BAY CITY 5553580A 755 6/9/2018 7212 UPTOWN MARATHON LLC BAY CITY 3827437A 500 5/15/2018 8017 0.95 WHATS POPPIN BAY CITY 5551234A 365 4/27/2018 8017 WHEELER LANDING INC BAY CITY 1191500A 929 4/13/2018 6836 0.95 XSCAPEQUEST LLC BAY CITY 5710715A 1,489 4/29/2018 9015 BAY PORT FISH CO BAY PORT 0553140A 568 4/28/2018 8021 1.00 NORTHERN CONSTRUCTION LLC BEAR LAKE 5714931A 5,828 5/11/2018 5403 G AND B FARMS BEAVER ISLAND 5705444A 1,215 4/18/2018 0106 SCHWARTZFISHER DAVID BEAVER ISLAND 3517977A 750 4/20/2018 6217 0.95 BDL TESTING & DRIVING SCHOOL LLC BEAVERTON 3936910A 471 6/12/2018 8868 BEAVERTON AREA FIRE DISTRICT BEAVERTON 0680907A 1,908 5/1/2018 7704 1.00 COMPLETE COATINGS LLC BEAVERTON 4053958A 750 4/8/2018 5476 MID MICHIGAN TREE SERVICE BEAVERTON 3610535A 1,425 4/2/2018 0106 0.95 MID STATE SEAWALL INC BEAVERTON 3985105A 2,093 5/1/2018 6217 0.95 WILD PUMPKIN INC BEAVERTON 5406501A 682 5/20/2018 2003 KASSOUNI MANUFACTURING INC BELDING 2528657A 14,407 6/28/2018 4828 0.86 PRECISION WELDING LLC BELDING 5717736A 825 5/19/2018 3365 CYMAN GARDENS LLC BELLAIRE 3781631A 1,562 5/16/2018 0042 0.95 DAVE ROBB CONSTRUCTION LLC BELLAIRE 3056414A 2,030 4/20/2018 5221 0.95 OTHERSIDE IRRIGATION SERVICES BELLAIRE 5708699A 1,288 4/26/2018 6229 TORCH LAKE TREE PRO LLC BELLAIRE 5270634A 2,611 6/1/2018 0106 0.95 TRIBUTARY BUILDERS LLC BELLAIRE 5123399A 750 4/29/2018 5645 A AND S SEALCOATING LLC BELLEVILLE 4901100A 825 5/24/2018 5221 BELLEVILLE TRUCKING LLC BELLEVILLE 0178241A 2,453 4/14/2018 7208 0.95 CAL PLUMBING BELLEVILLE 1224760A 858 6/1/2018 5183 CHARLEBOIS MASONRY BELLEVILLE 2467674A 800 4/28/2018 5022 CHIPPEWA TREE SERVICE INC BELLEVILLE 2134829A 915 4/2/2018 0106 0.95 CONTINENTAL FENCE LLC BELLEVILLE 5544831A 800 4/13/2018 5645 CU 29 SHINE LLC BELLEVILLE 3240096A 750 5/22/2018 5476 1/2/2018 8:13:07 AM /CaomReports/QuarterlyAR Depopulation Report
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