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,.drIT',*t <br />'f;# <br />$1AT[ *F ]SA5HIN0T0N <br />Department of Labor & lndustries <br />certificate of workers' compensation coverage <br />JanuarY 30,2026 <br />WA UBI No. <br />L&l Account lD <br />Legal Business Name <br />Doing Business As <br />Workers' ComP Premium Status: <br />604 817 226 <br />185,334-00 <br />PEERS RISING <br />PEERS RISING <br />Account is in good standing' <br />A;;;;iy rePJrt received and is beins <br />processed. <br />Pending current quarter filing <br />Employer Services Help Line' (360) 902-4817 <br />No <br />Estimated Workers RePorted <br />(See DescriPtion Below) <br />Account RePresentative <br />Licensed Contractor? <br />What does "Estimated Workers Reported" <br />mean? <br />Estimated workers reported represents the number of <br />full time position requiring at least 480 hours of work' <br />per calendar quarter' A single 480 hour position may <br />be filled by one person, or several part time workers' <br />lndustrial lnsurance Information <br />Employers report and pay premiums each quarter <br />based on hours of employee work already performed' <br />and are liable for premiums found later to be due' <br />lndustrial insurance accounts have no policy periods' <br />cancellation dates' limitations of coverage or waiver of <br />subrogation (See RCW 5l ' L2'050 and 5I ' i 6' I 90)'