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PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE <br /> STATE OF FLORIDA <br /> DEPARTMENT OF FINANCIAt SERVICES � IMPORTANT <br /> DIVISION OF WORKERS' COMPENSATION Pursuant to Chapter 440.05�14�, F.S., an officer of a corporation who <br /> CONSTRUCTION INDUSTRY � elects exemption from this chapter by filing a certificate of election <br /> CERTIFICATE OF ELECTION T08E EXEMPT FROM FLORIDA . L under this sectien may no# reeover benefits or compensation under this <br /> WORKERS' COMPENSATION LAW `"°"'� D chapter <br /> EFFEGTIVE: 06/22/2010 EXPIRATION DATE: �8/21/2Al2 pursuant to Chapter 440.051121, F.S., Certificates of election to be <br /> PERSON: WALTER CRAMfFORD JR H exempt... apply only within the scope of the business or trade listed on <br /> FEIN: 450516387 R the natice of election to be exempt <br /> BUSINESS IVAME AND ADDRESS. E Pursuant to Chapter 440.05113►, F.S., Notices of election to 6e exempt <br /> WAVNE CR4WFORD CONSTRUCTION iHC aiid �ertificates of election to be exempt shall be subject to revocation <br /> a�sz e Hicriwnv ee N if, at any time after the filing of the notice or the issuance of the <br /> IAKELAND, FL 33H09 certificate, the person named on the notice or certificate no longer meets <br /> the requirements of this section for issuance af a certificate. The <br /> department shall revoke a certificate at any time for failure of the <br /> SCOPE OF B!JSINESS OR �fiADc: person named on the certificate to meet the requirements of this <br /> 1- POOLS/SPAS CONSTRUCTION section. <br /> QUESTIONS? (850) 413-1609 <br /> CUT HERE <br /> * Carry bottom portion on the job, ke�p upper p�rrtion for your records. <br /> � � �� . � � <br /> � , ,��� <br /> DWC-252 CERTIFICATE OF ELECTaiMi.TQ 8E .EXEMPT REVISED 09-06 <br /> ��Q,�a �� � <br /> � <br /> ------- ---- <br /> AC# � � 4 � � -� 4 STATE OF FLORIDA ^�--------------- --- --- -------� <br /> � <br /> DEPARTMCONSTRUCTION�INDUSTRYRLIGENS�INGLBOA �LATION � <br /> SEQ# Lioo�i9oio2a � <br /> • � : • : - LICENSE NBR I <br /> 07/19/2010 100035025 CPC1457664 � <br /> The COMMERCIAL POOL/SPA CONTR.ACTOR � <br /> Named below IS CERTIFIED ' <br /> Under the provisions of Chapter 489 FS. <br /> Expiration date: AUG 31, 2012 <br /> CRAWFORD, WALTER WAYNE JR <br /> WAYNE CRAWFORD CONSTRUCTION INC � <br /> 4732 US HWY 98 N � <br /> LAKELAND FL 33809 I <br /> � <br /> CHARLIE CRIST CIiARLIE LIEM � <br /> GOVERNOR INTERIM SECRETARY I <br /> -- ----- -- ----- --- .--- --.__-----__ ._---------- DISPLAY_AS_REQUIRED BY _ LAW ---____��_________ i <br />