Transportation Carrier Information

The information below reflects the content of the TMIS
information system as of the close of the previous business day.
Carrier ID PSG0021004
Carrier Name SIMI VALLEY RETIREMENT RESIDENCE LIMITED PARTNERSHIP
Primary DBA SIMI HILLS

Authorities Transportation Charter Party Specialized Permit - Revoked - 03/18/08

INSURANCE POLICIES
Policy Type Policy Number Insurance Company Address
PL and PD Policy AS266100418420 LIBERTY MUTUAL FIRE INSR CO
P O BOX 4600
LEWISTON, ME 04243-9977
Workers Compensation Coverage WA766D00418401 LIBERTY INSR CORP
1333 EAST SHAW
FRESNO, CA 93784