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4/29/21, 1:35 AM <br />Workers Compensation <br />Do you lease employees No <br />through Professional <br />Employer Organization <br />(PEO)?: <br />Please provide your <br />current workers <br />compensation insurance <br />information below: <br />PEO PEO PEO <br />PEO InformationName Phone Email <br />Insured by Carrier <br />Policy Holder Name:Servitek Electric IncInsurance Carrier:State Farm General Insurance Co <br />Policy Number:92-GWT-4912Inception date:3/31/2020Expiration Date:3/31/2021 <br />https://cadir.secure.force.com/ContractorSearch/PrintRegDetails Page 2 of 2 <br />