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iL � �'Pr.Fi w t l64 i1*1p <br /> C 'C1 32S�A ® <br /> he �I � <br /> y� �rW�i7' °ar bo � c l <br /> �. <br /> e e <br /> 3 x <br /> r - <br /> 01-28 - 2009 <br /> SINK E <br /> ALX SIN <br /> AL SIN CIAL OFFICER STATE OF FLORIDA <br /> DEPARTMENT OF FINANCIAL SERVICES <br /> DIVISION OF WORKERS' COMPENSATION <br /> * * CERTIFICATE OF ELECTION 11) BE EXEMPT FROM FLORIDA WORKERS' COMPS * * <br /> CONSTRUCTION INDUSTRY EXEMPTION NSATION LAW <br /> This certifies that the individual listed below has elected to be exempt from Florida <br /> Workers' Compensation law. <br /> EFFECTIVE DATE: <br /> 01/28/2009 EXPIRATION DATE: 01/28/2011 <br /> PERSON: <br /> POMBO YOESLANDY <br /> FEIN: 205242427 <br /> BUSINESS NAME AND ADDRESS: <br /> POMBO'S CONTRACTING SERVICES INC <br /> 5004 LANDSMAN AVE <br /> TAMPA <br /> FL 33825 <br /> SCOPES OF BUSINESS OR TRADE: <br /> 1- CERTIFI RESIDENTIAL CONTRACT <br />