HomeMy WebLinkAboutDEPARTMENT OF FINANCIAL SERVICESJEFF ATWATER
CHIEF FINANCIAL OFFICER
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
• CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 10/28/2015
PERSON: LOUIS
FEIN: 463638106
BUSINESS NAME AND ADDRESS:
Al ELEVATORS LLC
3502 DUFFER RD
SEBRING
EXPIRATION DATE: 10/27/2017
RONEL
FL 33872
SCOPES OF BUSINESS OR TRADE:
ELEVATOR ERECTION OR
REPAIR
SGANNEU
BY
St. Lucie Countv
LAW --
Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section
may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only
vriNin the scope of the business or trade listed on the notice of election to be exempt Pursuant to Chapter 440.05(13), F.S., Notices of election to be
exempt and certflicates of election to be exempt shall be subject to revocation If, at any time aflerthe filing of the notice or the Issuance of the certificate,
the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (650)413-1609