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<br />AUG-28-01 01:09 AM <br />AUG-l~-el 0~:4~ PM u~ATZ ELECTRI~ <br /> <br />B13 'jiB" Ele4~ <br /> <br />P.02 <br />fJ&li!tl <br /> <br />07-11$-21:'01 <br /> <br />IT~TI OF rLORIDA. <br />DEPAATMENT 0' LABOA AND iMPI.OYMENT SECURITV <br />DIVISION or WORKI:"S' COMPENSA TIQN <br /> <br />CONSl AUCTION lNOU$TI\V ClltTIFleA TE Oil eXEMPTION <br />,.ROM FLORIDA WORKE~S' COMr~NS"" TION LAW <br /> <br />r.,:, clrtln.. thot the Individual 118tod b.,ow h.. tl.et.d te ... .~.",~t frOM 'Iorld. Welkels' <br />. ol'l'lpel'l..tIOf1 Law. <br /> <br />~FFeCTlVre DATI! 07/1e/'OOl <br />: ~PIA"'TION DATE 07/18/2003 <br /> <br />~ "( '!MPTEO INDIVIDUAL NAMa <br /> <br />GR^TZ <br /> <br />FtONA.tlO <br /> <br />c <br /> <br />.;,s, <br /> <br />27l-3S-2B61 <br /> <br />..,~ tt;/NE'SS NAME <br /> <br />ORIITZ RONALD C <br />271382861 <br /> <br />r'Sl~ <br /> <br />: '.JSINE:SS ADOR~SS <br /> <br />10507 PHLOX ClL^tlE r~A.f\f~ N <br />THONOTOSAS~ <br /> <br />Ft. :HS92 <br /> <br />~OTE: pu;-.iJa", to Ch.pt., 4AC:'O(1),(I).2 F,S., . .01, proprl.tor, p.rtnor, or .n "o;rioer ' 0;""- <br />~~~po,..t1o" WMl:' eleot$ elO(,.mptlon ftQm the Florlde Work.r.' Com~..nl5ilt:on Lew m.y not rr"r;over <br />-;.r,,'Rfits Of cornpenutlon under Chapter 440. <br /> <br />~L!AS! cur OUT T"C ~A.D efLOW ~g ~ITAIN 'OR 'UTU~I R[FI~tNCI <br />t, ~ r"Ofl!li)'A ..--.____ <br />.~.~I,'l r 01 l.~SOIl M~O EM"~::r~""[1I/ r m:UIlI IV <br />':.. r" WI'l"~~"S' r.OM"IN~411.)'" <br /> <br /> <br />:~I./C'.'ON l/IIlySTlh !:tnTIFleMr o~ ~1l:eI\llI'T(Ufll <br />. '.~ ".DPllnA WOIlk:e~~.. COMP;~JSMION L~\'V <br />: 'iVi. DATE ..~, ..._..o1.!..~8l,200 l . ._._'. <br />.,.tl(,'Ij U4T! ...:..... 01118/2003...-_ <br />.~-,:~ P~lls()t~ lAST NA.V.r-GaA.t Z <br />t:IR5 T NMt'E...ROIJAlD. .--.-.C <br />:," S~Cl;"1 rv IIIIMBE".... ....21..1..J&....2 a a 1.. .____... <br />.. ,m N""''''.. GRJ).Tl RONAlO C.. <br /> <br />"I~.. IOtfvflill:AHllr4 rl:J-;m'::.2.113.8.2.&8.i~.:~~--~" <br />"'~m A.OOqm_JU$07 PHlOX--Gu.o&...LANi...N <br />-T~lQSAn______._, _" 1:1 ~~r;9z.......__ <br /> <br />NO'~; I'ur'W1rl 10 ctll~lcr ".O,lOWW.1. F.S.. ~ l'l'f <br />"rap'I~lor. lI,rll;el. ar Dr/,ur of ~ CO'Il"" .1(1111 ~llll <br />elacll 1I.,mo!c/l" I rem ~Il. rtor IdOl W..r~~r!" ::;O":HI' :'J:'~II <br />Law ~jy no. r.~()"'Il'H' ~el~f!l1 ,!, "r e"tI'rtl"'l:.'u;'1 v"f.!f!. <br />Chlll~~r 410 <br /> <br />---."...... <br /> <br />H <br />E <br />R <br />! <br /> <br />"" .---...--.... ... -.-...............--- <br /> <br />---.------------ <br /> <br />CUT <br /> <br />HEAE <br /> <br />C.rry bottom Dartlol"l an th. Job, ac..p up,.er f:l6ttlon for your r.C10'~.. <br />. <br />