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. , � ��p'swE�„�� <br /> � - � <br /> •��nwe�• � � <br /> �eFF A7WA7ER STATE OF FLORIDA ' <br /> CHIEF FINANCIAL OFFICER <br /> DEPARTMENT OF FINANCIAL SERVICES <br /> DMSION OF WORKERS'COMP.ENSATION � <br /> "CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW" <br /> CONSTRUCTION INDUSTRY EXEMPTION � <br /> This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. <br /> EFFECTIVE DATE: 3/3/2015 EXPIRATION DATE: 3/2/2017 <br /> PERSON: GILLIGAN TIM , J <br /> FEIN: 461033818 - <br /> BUSINESS NAME AND ADDRESS: <br /> NEW TAMPA FENCE INC <br /> � <br /> �• <br /> 31224 CRESTMONT CT. <br /> WESLEY CHAPEL FL 33543 <br /> SCOPES OF BUSINESS OR TRADE: <br /> FENCE INSTALLATION <br /> AND REPAIR- " <br /> Pursuant to Chapter440.05(14),F.S.,an officer of a corporation who elects exemptlon from this chapter by filing a certifirate of eledion under this sedion <br /> may not recover benefits or compensation under this chapter.Pursuant to Chapter440.05(12),F.S.,Certificates of eledion to be exempt...apply onty <br /> wifhin fhe 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 eiedion to be <br /> exempt and ceriificates of election to be exempt shall be subject to revocation"rf,at any time after the filing of the notice or the issuance of fhe ceAifipte, <br /> the person named on the notice or certficate no longer meets the requirements of this sec3ion far issuance of a certificate.The department shatl re�oke a <br /> DFS=F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT RE1/ISED OB-13 QUESTIONS?(850k{13-1609 <br /> l <br />