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11/02/2010 17:14 FAX 8139737297 ALCA PLUMING COMPANY In003 /004 <br /> d ry <br /> f 04 -10 -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 hes elected to be exempt from Florida Workers' Compensation law. <br /> EFFECTIVE DATE: 06/18/2009 EXPIRATION DATE: 06/18/2011 <br /> PERSON: DANG ANTHONY L <br /> FEIN: 161727545 <br /> BUSINESS NAME AND ADDRESS: <br /> ALCA PLUMBING INC <br /> 1126 BAYCREST DR <br /> WESLEY CHAPEL FL 33543 <br /> SCOPES OF BUSINESS OR TRADE: <br /> 1- CERTIFIED PLUMBING CONTRACTOR <br /> a— <br /> Ib1P0RTANTs Peanut to Chapter 440 . 05114), r.s., en officer of a corporation wbo elects exemptloa from this ebepter by filing a cerllflcete o1 election under this <br /> sectlon may not recover benefits or compensation under this chapter. Punnet to Chapter 440.05(12), F.S., Cartlflee's el eleelloo to be exempt... eppty only within Iho <br /> scope of the business or trade listed on tb aotIc. of election to ba exempt. Pereolat lo Chapter 440.05113), F.S., Notices of election to be exempt ant certificates el <br /> election to he exemut •!tall be subject to revocation If, it ley base lifter the filing of _the notice or the isabance 01 Om canfliest& the person aimed on the natice or <br /> certificate so longer meets the rnquitements of this seetiae for !emote of a tend ieele, The department .hell revoke a certiifceta at any time for failure of IN p <br /> ACCOUNT NO; 062771 TYPE OF BUSINESS: <br /> SIC CODE: 1711.03 PLUMBING CONTRACTOR <br /> LOCATION ADDRESS: <br /> ALCA PLUMBING INC 1126 BAYCREST DR <br /> 1126 BAYCREST DR WESLEY CHAPEL <br /> WESLEY CHAPEL FL 33544 -7674 <br /> DATE RECEIPT AMOUNT <br /> 07/09/10 586680 31.25 <br /> s 114pal hh01144hll sla1111a114pliduph.Ihpl.e hp <br />