SUBCONTRACTOR MASTER LIST FOR POSTING ON JOBSITE AND STATE WEBSITE (RSA 21-I:81-a and 21-I:81-b) Revision Date: 07/01/16 Project Name: State Military Reservation Site Improvements Project Number: Concord 80844R Contract A General Contractor: Busby Construction Co., Inc. 71 Route 111 Atkinson, NH CEO: Paul Busby, President 71 Route 111 Atkinson, NH 03811 CFO: Virginia Busby, Treasurer 71 Route 111 Atkinson, NH 03811 NAME OF GENERAL ENTITY WITH WHOM ENTITY PROVIDING NAME & ADDRESS OF CONTRACTOR, SUBCONTRACTOR OR WORKERS INSURANCE CARRIER SUBCONTRACTOR, OR INDEPENDENT IS COMPENSATION INDEPENDENT CONTRACTED COVERAGE Busby Construction Co., Inc. 71 State of New Hampshire Bureau Acadia Insurance Company 4 Bedford Farms Drive Route 111 of Public Works Suite 400 Atkinson, NH 03811 Bedford, NH 03110 Wolcott Construction Busby Construction Acadia Insurance Company 4 Bedford Farms Drive 309 Sawtooth Road Suite 400 Gilmanton, NH 03237 Bedford, NH 03110 JCB Busby Construction Cincinnati Insurance Company 10485 Reading Road 748 Bobbin Road Cincinnati, OH 45241 P.O. Box 123 Lunenburg, VT 05906
SUBCONTRACTOR MASTER LIST FOR POSTING ON JOBSITE AND STATE WEBSITE (RSA 21-I:81-a and 21-I:81-b) Revision Date: 07/01/16 Project Name: State Military Reservation Site Improvements Project Number: Concord 80844R Contract A General Contractor: Busby Construction Co., Inc. 71 Route 111 Atkinson, NH CEO: Paul Busby, President 71 Route 111 Atkinson, NH 03811 CFO: Virginia Busby, Treasurer 71 Route 111 Atkinson, NH 03811 NAME OF GENERAL CONTRACTOR, SUBCONTRACTOR, OR INDEPENDENT ENTITY WITH WHOM SUBCONTRACTOR OR INDEPENDENT IS CONTRACTED ENTITY PROVIDING WORKERS COMPENSATION COVERAGE NAME & ADDRESS OF INSURANCE CARRIER Busby Construction Co., Inc. 71 Route 111 Atkinson, NH 03811 State of New Hampshire Bureau of Public Works Acadia Insurance Company 4 Bedford Farms Drive Suite 400 Bedford, NH 03110 Wolcott Construction 309 Sawtooth Road Gilmanton, NH 03237 Busby Construction Acadia Insurance Company 4 Bedford Farms Drive Suite 400 Bedford, NH 03110 JCB 748 Bobbin Road P.O. Box 123 Lunenburg, VT 05906 Busby Construction Cincinnati Insurance Company 10485 Reading Road Cincinnati, OH 45241
Concord_SMR%20Site%20Improvements_80844R_July%202016.docx