The Workers Compensation Certificates Of Insurance Form

Standard certificates are produced on an acord form number 25 s a form provided to the insurance industry by acord the association for cooperative operations research and development.

The workers compensation certificates of insurance form. Florida division of workers compensation. Click here to complete the form and receive your acknowledgement of compliance. A workers compensation certificate of insurance is a form showing proof that a company has workers compensation insurance coverage. Welcome to the division of workers compensation.

Workers compensation insurance is required by law for florida employers. The nys state insurance fund uses the u 26 3 form as its certificate of nys workers comp insurance. Securing a valid certificate of workers compensation insurance is critical for managing workers comp coverage and cost. The acord 125 form is the standard document used to issue certificates of insurance coverage.

Certificate of workers compensation insurance form 61a certificate of workers compensation insurance form 61a electronic filing of the contractor certification form 61a is now available. We assist injured workers employers health care providers and insurers in following the florida workers compensation rules and laws. Certificate of workers compensation insurance form 61a online the contractor s certificate of workers compensation insurance form 61a is a form issued by commissioners of revenue all over the commonwealth in conjunction with contractor s business license filings. The acord form includes information about the insured including coverage type policy numbers expiration dates limits of coverage and key details.

Our goal is to ensure that anyone interested or involved in the florida workers compensation system has the tools and resources they need to participate. 2012 capitol circle se hartman building tallahassee florida 32399 0680 850 921 6966 fl division of workers compensation. Florida forms and applications such as owners inclusion or exclusion forms are sometimes updated by the state. The certificate of insurance is issued by an insurance provider and it lists details including the names of the insurer and the policyholder policy period type of insurance policy number and effective dates.

For assistance in creating an online account please contact nysif s contact center at 888 875 5790. Standard certificate of insurance forms.