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Brochures, Forms & Posters

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Florida Experience Rating Modification Factor Endorsement

Document#:

WC 09 04 02 A

Edition:

05-01-2017

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Forms

Florida Foreign Voluntary Compensation and Employers Liability Coverage Endorsement

Document#:

WC 09 04 06 A

Edition:

07-01-2015

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Forms

Florida Insufficient Funds Endorsement

Document#:

WC 09 04 08 A

Edition:

07-01-2019

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Forms

Florida Maritime Coverage Endorsement

Document#:

WC 09 02 01

Edition:

01-01-2015

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Forms

Florida Multiple Coordinated Policy Endorsement

Document#:

WC 09 03 13

Edition:

07-01-2007

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Forms

Florida Non-Cooperation with Premium Endorsement

Document#:

WC 09 04 07

Edition:

07-01-2013

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Forms

Florida Notice of Cancellation and Nonrenewal to Others Endorsement

Document#:

WC 09 06 08

Edition:

01-01-2024

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Forms

Florida Retrospective Rating Plan Premium Endorsement One-Year Plan

Document#:

WC 09 05 03 B

Edition:

01-01-2019

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Forms

Florida Retrospective Rating Plan Premium Endorsement One-Year Plan – Multiple Lines

Document#:

WC 09 05 04 B

Edition:

01-01-2019

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Forms

Florida Retrospective Rating Plan Premium Endorsement – Large Risk Alternative Rating Option (LRARO)

Document#:

WC 09 05 05 A

Edition:

01-01-2019

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Forms

Florida Rural Utilities Service Endorsement

Document#:

WC 09 03 09

Edition:

01-01-2006

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Forms

Florida Terrorism Risk Insurance Program Reauthorization Act Endorsement

Document#:

WC 09 04 03 C

Edition:

01-01-2021

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Forms

Florida Workers Compensation Insurance Guaranty Association Surcharge Endorsement

Document#:

WC 09 06 07 A

Edition:

07-01-2019

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Forms

Florida Workers Compensation Joint Underwriting Association, INC. Addendum to ACORD 130 FL

Document#:

133-FL

Edition:

01-20

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Forms

Florida Workers Compensation Monthly Change Sheet

Document#:

175-FL

Edition:

03-97

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Forms

Important Workers Compensation Information for Florida's Workers - English

Document#:

DFS-F2-DWC-60

Edition:

03-2010

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Brochures

Important Workers Compensation Information for Florida's Workers - Spanish

Document#:

DFS-F2-DWC-61

Edition:

03-2010

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Brochures

Important Workers' Compensation Information for Employers - English

Document#:

DFS-F2-DWC-65

Edition:

03-2010

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Brochures

Important Workers' Compensation Information for Employers - Spanish

Document#:

DFS-F2-DWC-66

Edition:

03-2010

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Brochures

Information Page

Document#:

WC 00 00 01 A

Edition:

05-01-1988

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Forms

Injured Worker Informational Brochure - English

Document#:

DFS-F2-DWC-60

Edition:

11-30-2014

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Brochures

Injured Worker Informational Brochure - Spanish

Document#:

DFS-F2-DWC-61

Edition:

02-2014

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Brochures

Insurance Company As Insured Endorsement

Document#:

WC 00 03 04

Edition:

04-01-1984

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Forms

Insurance Supplement - Workers' Compensation Only

Document#:

64-US

Edition:

09-20

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Forms

Join the Battle Against Workers' Compensation Fraud - English

Document#:

​

Edition:

10-2020

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Brochures
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Roy E. Disney

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