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Brochures / Forms / Posters: General

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Anti-Fraud Reward Program Notice

Poster

State of Florida - Division of Workers' Compensation

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Broken Arm - Poster - English

Poster - March 2010

State of Florida - Division of Workers' Compensation

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Broken Arm - Poster - Spanish

Poster - March 2010

State of Florida - Division of Workers' Compensation

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Comparing the Premium Cost of Workers’ Compensation

Brochure- March 2015

David W. Langham

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Employee Earnings Report

Form - March 2009

State of Florida - Division of Workers' Compensation

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ERM-14 - Confidential Request for Ownership Information

Form - December 2003

NCCI

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Experience Rating for Former Clients of Labor Contractors

Form - August 2004

NCCI

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First Report of Injury or Illness

Form - March 2009

State of Florida - Division of Workers' Compensation

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Florida Contracting Classification Premium Adjustment Program - FCCPAP

Form - 2010

NCCI

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FL WC Uniform Medical Treatment/Status Reporting Form

Form - May 2005

State of Florida - Division of Workers' Compensation

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Fraud - English/Spanish

Poster - May 2014

Summit Holdings

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Fraud Brochure - English

Brochure - July 2011

State of Florida - Division of Workers' Compensation

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Fraud Brochure - Spanish

Brochure - July 2011

State of Florida - Division of Workers' Compensation

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In Case of an Accident - English/Spanish

Poster - May 2014

Summit Holdings

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Key Coverage and Exemption Eligibility Requirements

Brochure - August 2014

State of Florida - Division of Workers' Compensation

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Notice of Election of Coverage

Form - December 2008

State of Florida - Division of Workers' Compensation

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Notice of Election to be Exempt

Form

State of Florida - Division of Workers' Compensation

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Revocation of Election of Coverage

Form

State of Florida - Division of Workers' Compensation

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Revocation of Election to be Exempt

Form - August 2013

State of Florida - Division of Workers' Compensation

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Wage Statement

Form - March 2009

State of Florida - Division of Workers' Compensation

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Workers' Compensation Information for Employers - English

Brochure - March 2010

State of Florida - Division of Workers' Compensation

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Workers' Compensation Information for Employers - Spanish

Brochure - March 2010

State of Florida - Division of Workers' Compensation

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

Brochure - March 2010

State of Florida - Division of Workers' Compensation

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

Brochure - March 2010

State of Florida - Division of Workers' Compensation

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Workers' Compensation Reemployment Services Brochure

Brochure

State of Florida - Division of Workers' Compensation

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