CA #1049832 Active

Form & Function Landscape

Ontario, CA

Business Information

Address
1044 Hollowell St, Ontario, CA 91762
Phone
(909) 525 7878
Type
Sole Owner

License Status

Status
Active
Issued
Feb 6, 2019
Expires
Feb 28, 2027
Classifications
C27 Landscaping

Workers Compensation

Insurer
Employers Preferred Insurance Company
Effective
Mar 14, 2026
Expires
Mar 14, 2027

Contractor's Bond

Bond #
100426346
Amount
$25,000
Effective
Jan 1, 2023
Surety
American Contractors Indemnity Company

License History

Workers' comp coverage obtained

Mar 17, 2026

Workers Comp Policy Number: EIG585463101

Workers Comp Effective Date: 2025-04-01 2026-03-14

Workers Comp Expiration Date: 2027-03-14

Workers Comp Insurance Company: EMPLOYERS PREFERRED INSURANCE COMPANY

Workers Comp Coverage Type: Exempt Workers' Compensation Insurance

Contractor's bond reinstated

Feb 7, 2026

Contractor's Bond Cancellation Date: 2026-02-27 cleared

License data updated

Jan 30, 2026
Contractor's Bond Cancellation Date
2026-02-27

Changed to workers' comp exempt

Apr 2, 2025
Workers Comp Policy Number
EIG585463100 → —
Workers Comp Effective Date
2025-03-14 → 2025-04-01
Workers Comp Expiration Date
2026-03-14 → —
Workers Comp Insurance Company
EMPLOYERS COMPENSATION INSURANCE COMPANY → —
Workers Comp Coverage Type
Workers' Compensation Insurance → Exempt

Workers' comp renewed

Mar 18, 2025
Workers Comp Policy Number
CWC01755701 → EIG585463100
Workers Comp Effective Date
2024-03-14 → 2025-03-14
Workers Comp Expiration Date
2025-03-14 → 2026-03-14
Workers Comp Insurance Company
CLEAR SPRING PROPERTY AND CASUALTY COMPANY → EMPLOYERS COMPENSATION INSURANCE COMPANY

License renewed

Feb 13, 2025

City: POMONA ONTARIO

County: Los Angeles San Bernardino

Mailing Address: 1467 DENSMORE ST 1044 HOLLOWELL ST

ZIP Code: 91767 91762

Expiration Date: 2025-02-28 2027-02-28

Workers' comp renewed

Mar 15, 2024
Workers Comp Policy Number
CWC01755700 → CWC01755701
Workers Comp Effective Date
2023-03-14 → 2024-03-14
Workers Comp Expiration Date
2024-03-14 → 2025-03-14

License issued

Feb 6, 2019