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y <br /> OH <br /> to <br /> i A • .,-.,„ <br /> .. <br /> , , <br /> li' ' <br /> rr. <br /> .1 -07 -3009 . <br /> - �,-) .;f <br /> ALEX SINK STATE OF FLORIDA <br /> CHIEF FINANCIAL. OFFICER DEPARTMENT OF FINANCIAL SERVICES <br /> DIVISION OF WO COMPENSATION <br /> * * CERTIFICATE OF ELECTION TO OE 1901MIPT EIOM FILMR COMPENSATION LAW * * <br /> CONSTRUCTION INDUSTRY EXEMPTION <br /> This certifies that the individual listed below has elected iv be exempt from Ronda Workers' Compensation law. <br /> EFFECTIVE DATE: 03/01/2009 EXPIRATION DATE 031011308 <br /> PERSON: KENNEDY DAVID F <br /> FEIN: 593970767 <br /> BUSINESS NAME AND ADDRESS: <br /> GUARANTEE ELECTRIC INC <br /> 10646 FAWN DRIVE <br /> NEW PORT RICHEY FL 34854 <br /> OGOrbi OF fUSINISS OR TRAD I <br /> 1- REGISTERED ELECTRICAL CONTRACT <br /> IMPORTAIIT: Noncom to Chapter 440 . 06(14), 1.5., an Ohm et s carpnties ado darts ramtpelss Linn Si e>Mpeer by fillet a certificate et election under this Y <br /> section may sat mere, benefits or campnseriee odor lids or. Purses* In amply 44Lef11V. 1.5., Caldicoles *4 etedios to be exempt... apply only within the <br /> scope el the basis's; or trace listed as roe notice et Omits' to be eregit ltirttsutt is tided 445.11611* F_S, Marius of Mambo* to he exempt sad certificates of <br /> etection to be exempt shall be subject to revocation il, et any time fifer do tilup of Sr site er tbn tommece d Ile certificate, the person muted on the notice or <br /> certiticale no longer moots the regoireaeets et this sorties for isseaece of s coedicea. The ifmtesrtmsst tint rude: a anteing* et any time for failure of the person <br /> nomad ea Ow twitrtieare to swift 16. regaireseatt al Ibis xttiiea. <br /> DWC - 252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 QUESTIONS? 11501 473 -1609 <br />