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Registrations <br />Pagel of 2 <br />State of California <br />Department <br />(hops 11,'r.ca.govl) <br />Contractor Information <br />Back to DIR— (https.11www dir ca gov4 <br />of Industrial Relations <br />Legal Entity Name <br />Corporation <br />Active <br />1000008336 <br />07/01119 <br />06130,2I <br />592 E. State Street Ontario 91761 CA United States of America <br />592E.5tateStreet Ontario 91761 CA United $tales ofAmerica <br />klondi keconst ruction9gma Il. com <br />KLONDIKE CONSTRUCTION SERVICES INC <br />Llcanse Number (s) <br />Other110B <br />CSOL990645 <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 />Agent of Service Name: <br />Agent of Service Mailing Address: <br />Worker's Compensation <br />KU3M1lK4 CONSIRjCnON5ERVIC.E3iNC <br />3600667 <br />463632937 <br />DAVID B. BOORSTEIN <br />DAVID B. BOORSTEIN <br />DAVID B. BOORSTEIN <br />DAVID B BOORSfEIN <br />592 E. State Street Ontario 91761 CA United States of America <br />Do you lease employees through Professional Employer Organization (PED)7: <br />Please provide your current worker's compensation insurance information below.- <br />PEO PEO PEO <br />PEO Informationhame Phone Ema I <br />Insured by Carrier <br />Policy Helder Name; <br />Insurance Carrier. <br />Policy Number: <br />Inception date: <br />Expiration Date: <br />no <br />KLONDIKE CONSTRUCTION SERVICES INC <br />STATE COMPENSATION INSURANCE FUND <br />9087198-2019 <br />01/25119 <br />01/25120 <br />About Dllt <br />Who we are (https.lAvww dir.ca.govlaboutd r html) <br />DIR Divisions, Boards & Commissions (https-11www.dir ca govldivisions_and_programs html) <br />Contact DIR (https.thvww dtr ca.gov/Contactus.htmi) <br />Work with Us <br />Jobs at DIR (https.lAvww dir ca govldidobsldiriobs him) <br />Licensing, registrations, certifications & permits (https lAvww dir.ra.govlpermits-licenses-certiflcabons.htm i <br />Required Notifications (https-lAvww dir ra gov/dosh/Required•Notifications himl) <br />Public Records Requests (https./Mww dir ca.gov/prajequest-thtmi) <br />Learn More <br />Acceso al idioma (http Ilwww dir ca govllBilingual-Services-Actldefault.html) <br />Frequently Asked Questions (httpsJAvww dir ca govlfagslist.html) <br />https://cadir.secure.force.com/ContractorSearch/registrationSearchDetails?id=a1 Rt0000O... 12/16/2020 <br />