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JENNIFER BACKHAUS DBA BACKHAUS DANCE
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JENNIFER BACKHAUS DBA BACKHAUS DANCE
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Last modified
12/17/2021 11:06:22 AM
Creation date
12/16/2021 4:53:10 PM
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Contracts
Company Name
JENNIFER BACKHAUS DBA BACKHAUS DANCE
Contract #
N-2021-250
Agency
Parks, Recreation, & Community Services
Expiration Date
12/31/2022
Insurance Exp Date
6/3/2022
Destruction Year
2027
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Page 4 <br />Named InsuredBACKHAUS DANCE <br />Customer ID <br />Policy NumberWC80946 <br />Transaction TypeNew BusinessEffective9/7/2021 <br /> <br />XPSLFST!DPNQ!QPMJDZ!JOGPSNBUJPO!SFDBQ <br />Predominant State:CA <br />Employers Liability:Each Accident:1,000,000 <br />Policy Limit:1,000,000 <br />Each Employee:1,000,000 <br />Admiralty Limit:Per Accident:N/A <br />Program Type:N/A <br />FELA Limit:Per Accident:N/A <br />Program Type:N/A <br />Retro Plan:No <br />Interstate Exper Mod ID: <br />Effective Date: <br />Exper Mod: <br />Njojnvn!QsfnjvnUfsn0UsbotIjhiftu!Qfs!Qpmjdz <br />Policy:15901590 <br />Empl Liab:120120 <br />Admiralty: <br />FELA: <br />Combined Policy Premium: <br />NJ Premium: <br />Executive Officers:No <br />Employee Leasing:No <br />Deposit Factor: <br />Installment Plan:11 <br /> <br />
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