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of� <br /> JIMMY PATRONIS <br /> CHIEF FINANCIAL OFFICER STATE OF FLORIDA <br /> DEPARTMENT OF FINANCIAL SERVICES <br /> DIVISION OF WORKERS' COMPENSATION <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: 7/16/2019 EXPIRATION DATE: 7/15/2021 <br /> PERSON: MATTHEW W ZAPPE EMAIL: ALADDINELECTRICINC@YAHOO.COM <br /> FEIN: 591596484 <br /> BUSINESS NAME AND ADDRESS: <br /> ALADDIN ELECTRIC INC <br /> 2602 SHOREWOOD LN <br /> LAND O LAKES, FL 34639 <br /> SCOPE OF BUSINESS OR TRADE: <br /> Electrical Wiring Within <br /> Buildings and Drivers <br /> IMPORTANT:Pursuant to subsection 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under <br /> this section may not recover benefits or compensation under this chapter.Pursuant to subsection 440.05(12),F.S.,Certificates of election to be exempt issued <br /> under subsection(3)shall apply only to the corporate officer named on the notice of election to be exempt and apply only within the scope of the business or <br /> trade listed on the notice of election to be exempt.Pursuant to subsection 440.05(13),F.S.,notices of election to be exempt and certificates of election to be <br /> exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate <br /> no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at anytime for failure of the person <br /> named on the certificate to meet the requirements of this section. <br /> DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 E01019153 QUESTIONS?(850)413-1609 <br />