| Name | Form Title |
|---|---|
| Florida Workers' Compensation Application | ACORD 130 FL |
| Addendum to ACORD 130 FL | ACORD 133 FL |
| Instructions for Completing ACORD 130 FL | ACORD |
| Instructions for Completing ACORD 133 FL | ACORD 134 FL |
| Confidential Request for Information | ERM-14 |
| Instructions for Completing the ERM-14 | NCCI |
| Applicant's Affidavit | FWCJUA |
| Assessable Policy Endorsement | Custom |
| Bankruptcy Questionnaire | Custom |
| Employee Leasing Questionnaire | Custom |
| Employer's Affidavit | FWCJUA |
| Employment and Wage Information Release Agreement | FWCJUA |
| "If Any" Acknowledgment form | FWCJUA |
| Subcontracted Labor Statement | Custom |
| UCT-6 Questionnaire | Custom |
| Workplace Safety Program Premium Credit Application | Safety 09-3 |
| Cancellation Request Form | ACORD 35 |
| Certificate of Insurance | ACORD 25 |
| Certificate of Insurance St Paul Travelers Request Procedure | Custom |
| Certificate of Insurance WC Compare | Custom |
| Consent to Rate | Custom |
| Credit Card Payment Authorization Form | Custom |
| Deductible Application $2,500 | FWCJUA |
| Deductible Credit Election | Custom |
| Drug-Free Premium Credit Application | 09-01 |
| Employee Definition | Florida Statutes |
| FCCPAP Credit | FCCPAP |
| First Report of Injury or Illness | DWC-1 |
| Florida Standard Market Rates 10/1/03 | NCCI |
| Foreign Corporation Registration | Division of Corporations |
| FWCJUA Commission Schedule | FWCJUA |
| FWCJUA Rating Tiers 7\1\04 | Custom |
| FWCJUA St Paul Travelers Contact Information | Custom |
| Important Workers' Compensation Information for Claimants | |
| Independent Contractors 6 point test | Custom |
| Legal Structure Types | Custom |
| Monthly Change Report | Custom |
| Monthly Change Sheet | ACORD 175 FL |
| NCCI Physical Inspection Order Form | NCCI |
| NCCI Workers' Compensation States | Custom |
| Policy Cancellation Procedures | Custom |
| Safety Program Acknowldgement | Custom |
| Sample Stock Certificate | Custom |
| St Paul Travelers Claims Reporting | St Paul Travelers |
| Workers Compensation Application | ACORD 130 |
| Acknowldgment by Client of Continued Coverage Under MCP (PEO) | FWCJUA |
| Acknowldgment of Multiple Coordinated Policy (PEO) | FWCJUA |
| Supplemental Employee Leasing Application (PEO) | FWCJUA |
| Notice of Election to be Exempt | DWC 250 |
| Notice of Revocation of Election to be Exempt | DWC 250-R |
| Notice of Election of Coverage | DWC 251 |
| Revocation of Election of Coverage | DWC 251-R |
| Instructions for Completing Construction Industry Application | |
| Instructions for Completing Non-Construction Industry Application | |
| Rules of Exclusion from a Florida Policy | Custom |
| Insurance Premium Credit Card Payment Authorization | Custom |
| FWCJUA Class Code Premiums by Tier | |
| Non-Compliance Penalty Worksheet | Custom |
| Exemption Application Problem Reference | DFS |
| FWCJUA Renewal Proceedure | Custom |