MICHIGAN CERTIFICATE OF SPECIFIC/AGGREGATE EXCESS LIABILITY ...
(Rev. 8/11) MICHIGAN CERTIFICATE OF SPECIFIC/AGGREGATE EXCESS LIABILITY INSURANCE TO: Michigan Department of Licensing and Regulatory Affairs Workers’ Compensation Agency ... Get Content Here
Michigan Department Of Labor & Economic Growth
♦ A certificate of workers’ compensation insurance issued within the last 30 days, with the certificate holder properly assigned or a Notice of Exclusion Corporation Division at 517.241.6470 to obtain a Certificate of Good Standing. ... Retrieve Doc
Ohio State Bar Association Attorney Application For ...
The Workers’ Compensation Law Specialty Board may require you to submit further specific information, such as a list of to a copy of (1) a Certificate of Good Standing from the Supreme Court, and (2) my current insurance policy declaration page ... Document Retrieval
Workers' Compensation Exemption Registration General Provisions
WORKERS’ COMPENSATION EXEMPTION REGISTRATION GENERAL PROVISIONS state has received and verified through electronic confirmation or a certificate of tax good standing as reflected in the records of the secretary of state. (m) ... Retrieve Content
Individual Self-Insurance Application Checklist
A check in the amount of $250 made payable to the Division of Workers’ Compensation. Applicant’s Federal Employers’ Identification Number: Business cards for: applicant Certificate of Good Standing or equivalent issued by state of incorporation. ... Read Here
Workers Compensation Exemption Registration
WORKERS’ COMPENSATION EXEMPTION REGISTRATION state has received and verified through electronic confirmation or a certificate of tax good standing as reflected in the records of the secretary of state. (m) ... Read More
Self-Insured Workers Compensation Single Employers
SELF-INSURED WORKERS’ COMPENSATION SINGLE EMPLOYERS 0780-1-83-.03 Certificate of Authority Required 0780-1-83-.12 Examinations and Investigations Is a member in good standing of the American Academy of Actuaries and an associate or fellow ... View Doc
Department Of Consumer & Business Services Insurance Division ...
Certificate of insurance supervisory official of applicant’s domiciliary jurisdiction to the effect that applicant is in good standing therein (foreign classes to be on certificate: Property Life Casualty, including workers’ compensation Health Casualty, excluding workers ... View Full Source
ALABAMA DEPARTMENT OF INDUSTRIAL RELATIONS WORKERS ...
WORKERS' COMPENSATION DIVISION ADMINISTRATIVE CODE accounting firm in good standing with the American Institute of CPA's and, Certificate of Approval from the Director. (v) Fund Year - The elected period of coverage, up to ... Fetch Doc
CONTRACTOR APPLICATION ATTACHMENT CHECK LIST If You Have ...
Certificate of Good Standing/Business Certificate/DBA/Foreign Corporation Certificate A copy of applicant’s workers’ compensation insurance policy Certificate of Insurance or evidence of self-insurance program, if the applicant has any employee(s). ... Document Viewer
Honest Insurance Advice
Good companies? I am a young driver -17- and I have been driving for a Facilities were continually updated over the past decade until Sandy left the elevated clubhouse standing on two support pilings you’ll also need workers compesation in case one of your employees gets hurt ... Read Article
2012 Bureau Of Workers’ Compensation Annual Conference ...
2012 Bureau of Workers’ Compensation Annual Conference Hershey, PA on June 11-12. Exhibition space is available and offered to exhibitors in good standing. Registration requires a completed exhibitor registration form, payment in full, a signed certificate of insurance coverage, and ... Doc Retrieval
STATE OF ARIZONA REGISTRAR OF CONTRACTORS APPLICATION FOR ...
For payment of Workers’ Compensation benefits to its employees pursuant to A.R.S. § 23-961(A)(2). If yes, attach a detailed explanation and provide a payment schedule, if applicable and Certificate of Good Standing from the Arizona Department of Revenue. ... Fetch Document
Application For Amended Certificate Of Authority
Certificate of insurance supervisory official of applicant’s domiciliary jurisdiction to the effect that applicant is in good standing therein Check all classes to be on certificate: Property Life Casualty, including workers’ compensation Health Casualty, excluding workers ... View Doc
STATE OF MARYLAND WORKERS’ COMPENSATION COMMISSION 10 E ...
Excess workers compensation policy limits: $ c. Does your excess insurance provide for an annual aggregate limit? Yes No Certificate of Status Good Standing for Third Party Administrator, if applicable. ... Content Retrieval
Information Required For Application For Roofing Contractor ...
Certificate of Workers’ Compensation or Affidavit of Exemption or Self-Insurance c. Certificate of Good Standing from Oklahoma Secretary of State (for Oklahoma domestic and registered foreign corporations, LLC’s, limited partnerships) d. ... Read Full Source
Texas Department Of Insurance
Adjuster–Workers’ Compensation Adjuster–Trainee Adjuster–Emergency Adjuster–All Lines Designated Home State Texas The Certificate of Good Standing must be dated within 90 days of receipt of the completed application. ... Document Retrieval
APPLICATION FOR A CERTIFICATE OF CONSENT TO SELF INSURE BY A ...
Workers’ compensation insurance must be maintained until certificate is effective. To the Director of Industrial Relations: Attach an original Certificate of Good Standing from the California Secretary of State for the applicant group ... Access Full Source
WORKERS’ COMPENSATION A Guide For New Brunswick Employers
Account is in good standing and that coverage has been extended while work is being conducted in New Brunswick. A copy of the letter should be submitted RequeST THeiR WoRkeRS’ ComPeNSaTioN CLeaRaNCe CeRTifiCaTe. ... Return Document
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