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<br />~JA FLORIDA WORKERS' COMPENSATION <br />. .~; ..llIKT UNlERWRmNG ASSOC~TIIlII. INC. <br /> <br />P.o. Box 3556 Customer service: <br />Orlando, FL 32802-3556 <br /> <br />Fax: <br /> <br />1-800-247-7218 (FL only) <br />1-800-443-4404 (all other states) <br />(407) 388-7839 <br /> <br />September 27,2007 <br /> <br />Insurer: Florida W.C. JUA <br /> <br />SANDY DEVELOPMENT COMPANY INC <br />12303 US HWY 301 <br />DADE CITY FL 33525 <br /> <br />Policy No: 6FR13UB 4184B18907 <br />Effective Date: 09/08/07 <br /> <br />Dear Customer: <br /> <br />The Florida Workers' Compensation Joint Underwriting Association Inc., who provides coverage for your Assigned <br />Risk Workers' Compensation Insurance, has appointed St. Paul Travelers as your service provider. We have <br />received your application, or renewal payment, and we will be issuing this policy on behalf of the Florida Workers' <br />Compensation Joint Underwriting Association Inc., within the next 20 days. <br /> <br />In the meantime, if you fmd it necessary to file a claim, obtain Managed Care infonnation, or communicate with our <br />Orlando Service Center, please note the following: <br /> <br />For Managed Care Reporting: <br />1-800-832- 7839 <br /> <br />For Policy Services: <br />St. Paul Travelers <br />P.O. Box 3556 <br />Orlando, FL 32802-3556 <br />(800) 247-7218 (FL only) <br />(800) 443-4404 (all other states) <br /> <br />For Managed Care Infonnation: <br />1-800-422-9958 <br /> <br />Safety and Loss Prevention are critical concerns to any business. We have long been a pioneer in the field of <br />accident prevention, having the experience, resources and capabilities to provide a complete range of safety services. <br />Your policy will include more details regarding these services. <br /> <br />A state authorized $2,500 Deductible Plan is available. Please contact St. Paul Travelers for an application and <br />infonnation regarding how to qualify. There is no premium credit associated with this option. <br /> <br />Please make a record of the above policy number and include it on all your correspondence. <br /> <br />WELCOME to the St. Paul Travelers! Ifwe can be of service, please call. <br /> <br />Sincerely, <br /> <br />AMY GILLAND, Ext. 83166 <br />Account Manager Underwriter <br /> <br />cc: L.G. EDWARDS INSUR.-\NCE <br />P. O. BOX 1548 <br />DADE CITY FL 33526 <br />