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09/11/2009 11:39 8137889189 ABSOLUTE AIR SYSTEMS PAGE 03/04 <br /> • <br /> • <br /> ,•; 11 ^17 -2008 <br /> ALEX SINK STATE OF FLORIDA <br /> CHIEF FINANCIAL OFFICER 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: 11/17/2008 EXPIRATION DATE: 11/17/2010 <br /> PERSON: DEROLF STEVEN C <br /> FEIN: 181880168 <br /> BUSINESS NAME AND ADDRESS: <br /> ABSOLUTE AIR SYSTEMS /NC <br /> 37325 KOSSIK RD <br /> ZEPHYRHILLS FL 33641 -7041 <br /> SCOPES OF BUSINESS OR TRADE: <br /> 1— CERTIFIED AC CONTRACTOR <br /> IMPORTANT: normal to Chapter 440. 06(14), F.S., •n •slier (11 n corporation who elects exemption from this chapter by !map a cacti/teeth of electi•o under this <br /> seetlon may net recover benefit: or cenpeesation Wader this copier. Puissant to Chapter 440.05(121, P.S., Certificates of election to be exempt.. apply ally within the <br /> scope of the business or (rode listed oe the notice of election to be eanotpt. PWrseam to Chapter 440.06113), F.S., Notices of el.ctl.o to be exempt mod certificates el <br /> election to be exempt shall be subject to revoeoue, i1, el any time after Me filing el the notice or Me issu•ace of the certificate, the person awned en the notice or <br /> certflicote no Ionger meets the requirements of this sestina for Isswence of e certificate. The deportment shell revoke a certificate et eey time lot faller. el the person <br /> 0x14 on the certificate to meet the) regeir•mgnt: of MI section. <br /> QUESTIONS? 0150) 413-1609 <br /> DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 <br /> • <br /> • <br />