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Oct 29 10 02:45p Steve Rogers 8139649434 p.6 <br /> 12 -11 -2009 <br /> COG 1■16 <br /> ALEX SINK STATE OF FLORIDA <br /> CHIEF FI NlNCIAL.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 12/11/2009 EXPIRATION DATE: 12/11/2011 <br /> PERSON: ROGERS CHRISTOPHER S <br /> FEIN: 271106472 <br /> BUSINESS NAME AND ADDRESS: <br /> ALL FLORIDA PLUMBING CONTRACTORS INC <br /> 4407 ENDICOTT PLACE <br /> TAMPA FL 33624 <br /> SCOPES OF BUSINESS OR TRADE: <br /> 1- REPAIR SERVICE 2- CERTIFIED PLUMBING CONTRACTOR <br /> 3 - INSTALLATION SERVICES <br /> IMPORTANT: Pursuant to Chapter 440. 06(14), F.S., an elficer of s corporation who elects exemption from Ws chapter by filing s certificate of election ender this <br /> section may sot recover benefits or campnosstion wader this chapter. Pursuant to Chapter 440.05021. F.S., Certificates ol electiaa to be exempt... apply only within the <br /> scope of the business or trade listed os the notice of elect/ea to he exempt. Pursuant to Chapter 440.06(131. F.S.. Notices of election is be exempt ad cenilicaes al <br /> election to be exempt shall be subject to revocation i1, at any time atter the 'fling a1 the notice or the isausoce of the certificate. the persos named on the astice or <br /> certificate no longer meets the regniremems oI this sectios for issuance of a certificate. The department shell revoke a certificate et any time for Isilore of the person <br /> sealed on the certificate to meet Oro regeiremeets of this section. <br /> QUESTIONS? (850) 413 - 1609 <br /> DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 <br /> ;-3iT <br /> : - 12-11 -2009 <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: 12/11/2009 EXPIRATION DATE: 12/11/2011 <br /> PERSON: CARUCCI CHRISTOPHER <br /> FEIN: 271106472 <br /> BUSINESS NAME AND ADDRESS: <br /> ALL FLORIDA PLUMBING CONTRACTORS INC <br /> 4407 ENDICOTT PLACE <br /> TAMPA FL 33624 <br /> SCOPES OF BUSINESS OR TRADE <br /> 1- CERTIFIED PLUMBING CONTRACTOR <br /> IMPORTANT: Puissant to Chapter 440. 051141. F.S., an otllcer of a corporsNoa who elects eaetaptios from this chapter by HIfsg a certiltcate of election under this <br /> sorties may sot recover benefits or compsNoaUan enter Ibis chaplet. Peruses to Chapter 440.05112), F.S., Cerrilicetes of election to be exempt... apply only within the <br /> scope of the business or trade listed en the Notice of election to be exempt. Persona to Chapter 440.05(10, F.S., Notices of olectioe is be exempt sod certificates of <br /> election to be exempt shall be subject to revocation i1, st any time alter the lilieg of the notice or the issuance al the certificate. Iba person named on the satire 01 <br /> certificate AO longer meets tea tequiremeats of this sectios for issusace of a certificate. The dapentaeot shall revoke a certificate el say time ler !allure of the persos <br /> named on the certificate to meet the requirements of this section. <br /> QUESTIONS? (8501 413-1609 <br /> DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 <br />