Brochures / Forms / Posters: General

Anti-Fraud Reward Program Notice

Poster

State of Florida - Division of Workers' Compensation

Broken Arm - Poster - English

Poster - March 2010

State of Florida - Division of Workers' Compensation

Broken Arm - Poster - Spanish

Poster - March 2010

State of Florida - Division of Workers' Compensation

Comparing the Premium Cost of Workers’ Compensation

Brochure- March 2015

David W. Langham

Emergency Phone Numbers - English/Spanish

Poster - May 2014

Summit Holdings

Employee Earnings Report

Form - March 2009

State of Florida - Division of Workers' Compensation

ERM-14 - Confidential Request for Ownership Information

Form - December 2003

NCCI

Experience Rating for Former Clients of Labor Contractors

Form - August 2004

NCCI

First Report of Injury or Illness

Form - March 2009

State of Florida - Division of Workers' Compensation

Florida Contracting Classification Premium Adjustment Program - FCCPAP

Form - 2010

NCCI

FL WC Uniform Medical Treatment/Status Reporting Form

Form - May 2005

State of Florida - Division of Workers' Compensation

Fraud - English/Spanish

Poster - May 2014

Summit Holdings

Fraud Brochure - English

Brochure - July 2011

State of Florida - Division of Workers' Compensation

Fraud Brochure - Spanish

Brochure - July 2011

State of Florida - Division of Workers' Compensation

In Case of an Accident - English/Spanish

Poster - May 2014

Summit Holdings

Key Coverage and Exemption Eligibility Requirements

Brochure - August 2014

State of Florida - Division of Workers' Compensation

Notice of Election of Coverage

Form - December 2008

State of Florida - Division of Workers' Compensation

Notice of Election to be Exempt

Form

State of Florida - Division of Workers' Compensation

Revocation of Election of Coverage

Form

State of Florida - Division of Workers' Compensation

Revocation of Election to be Exempt

Form - August 2013

State of Florida - Division of Workers' Compensation

Wage Statement

Form - March 2009

State of Florida - Division of Workers' Compensation

Workers' Compensation Information for Employers - English

Brochure - March 2010

State of Florida - Division of Workers' Compensation

Workers' Compensation Information for Employers - Spanish

State of Florida - Division of Workers' Compensation

Workers' Compensation Information for Florida's Workers' - English

Brochure - March 2010

State of Florida - Division of Workers' Compensation

Workers' Compensation Information for Florida's Workers' - Spanish

Brochure - March 2010

State of Florida - Division of Workers' Compensation

Workers' Compensation Reemployment Services Brochure

Brochure

State of Florida - Division of Workers' Compensation

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Roy E. Disney

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