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B/23f221 7:33 AM <br />Registrations <br />Contractor Information <br />. Legal Entity Name <br />HARDY & HARPER, INC, <br />Legal Entity Type <br />Corporation <br />SIAM <br />Active <br />Registration Number <br />1000000076 <br />Registration effective date <br />07/01/22 <br />Registration expiration date <br />06/30/23 <br />Mailing Address <br />32 Rancho Circle Lake Forest 92630 CA United Stat.., <br />Physical Address <br />32 Rancho Circle Lake Forest 92630 CA United Stat... <br />Email Address <br />cicamem@hat(iyandhasper.com <br />Trade Name/DEIA <br />License Number (s) <br />C5LB215952 <br />CSLB215952 <br />Legal Entity Information <br />Corporation Entity Number: <br />Federal Employment Identification Number: <br />President Name: <br />Vice President Name: <br />Treasurer Name: <br />Secretary Name: <br />CEO Name: <br />A9QL1GXf?l ervice <br />Agent of Service Name. <br />Agent of Service Mailing Address: <br />Worker's Compensation <br />Registration History <br />Effective Date <br />Expiration Date <br />06/15/16 <br />06/30/19 <br />D5/09/17 <br />06/30/18 <br />06MR/16 <br />06/30/17 <br />... ......... ..... ............ <br />06/19/15 <br />06/30/16 <br />07/02/14 <br />06/30/15 <br />07AI/19 <br />06/30/20 <br />07/01/20 <br />06/30/21 <br />07/01/21 <br />06/30/22 <br />07/01/22 <br />06/30/23 <br />C0443071 <br />952251022 <br />Dan T. Maas <br />Michael Murray <br />Kristen Paulino <br />Dan T Maas <br />32 Rancho Circle Lake Forest 92630 CA United States of America <br />Do you lease employees through Professional Employer Organisation (PEO)?: <br />Please provide your current worker's compensation insurance information below: <br />PEO RED PEO <br />PEO lnformationName Phone Email <br />Insured by Carrier <br />Policy Holder Name: <br />Insurance Carrier: <br />Policy Number: <br />Inception date: <br />Expiration Date: <br />No <br />HARDY & HARPER, INC. <br />OLD REPUBLIC GENERAL INSURANCE CORF <br />AICWAD013900 <br />04/15/22 <br />04/15/23 <br />ht(ps:Itcadir.secure.force.com/ContractorSearch(registrallonSearchOetails?id=a1Rt00000048rbiEAA ill <br />