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Contractor Information <br />Legal Entity Name <br />CALIFORNIA BARRICADE RENTALS, INC. <br />Legal Entity Type <br />Carparefan <br />Status <br />Active <br />Registration Number <br />1000017487 <br />Registration effective date <br />6/30/2019 <br />Registration expiration date <br />6/29/2020 <br />Mailing Address <br />1550 E SAINT GERTRUDE PLACE SANTA ANA 927D5 CA Unit_._ <br />Physical Address <br />1550 E SAINT GERTRUDE PLACE SANTA ANA 92705 CA Unit_ <br />Email Address <br />Trade Name/DBA <br />CALIFORNIA BARRICADE, INC. <br />License Number(s) <br />CSLB735733 <br />Legal Entity Information <br />Corporation Number: <br />C2035262 <br />Federal Employment Identification Number: <br />President Name: <br />MARK HURST <br />Vice President Name: <br />KELLIE HURST <br />Treasurer Name: <br />KELLIE HURST <br />Secretary Name: <br />KELLIE HURST <br />CEO Name: <br />KELLIE HURST <br />Agent of Service Name: <br />NANCY DOWD <br />Agent of Service Mailing Address: <br />9921 CARMEL MOUNTAIN ROAD STE. 382 SAN DIEGO 92129 CA United States of America <br />Workers Compensation <br />Do you lease employees No <br />through Professional Employer <br />Organization (PEO)?: <br />Please provide your current <br />workers compensation <br />insurance information below: <br />PEO PEO PEO <br />PEO Information Name Phone Email <br />Registration History <br />Effective Date Expiration Date <br />6/11/2018 6/29/2019 <br />5/8/2017 6/29/2018 <br />6/15/2016 6/29/2017 <br />9/22/2015 6/29/2016 <br />3/30/2015 6/29/2015 <br />6/30/2019 6/29/2020 <br />Insured by Carrier <br />Policy Holder Name:CALIFORNIA BARRICADE RENTALS, INC.Insurance Carrier: <br />25E42"ion date:6/30I701RExniration Date: <br />