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Workers’ Comp Applications & Forms

All our forms are available for download. Just click the + to expand the section, then just click the document you’d like to download. You can also right-click the download button to get a link you can share with your customers or staff.

Applications & Forms

  • Applications & Forms
TitleSizeDate modifiedDownload
AmTrust EFT Form352.30 KB02-07-2023 DownloadPreview
Amerisafe Loss Control Agreement32.90 KB08-11-2024 DownloadPreview
Amerisafe Map1.63 MB07-24-2023 DownloadPreview
Binding-ACORD66.81 KB03-30-2022 DownloadPreview
Certificate Guide84.36 KB03-30-2022 DownloadPreview
Domestic WC: Why You Need It192.27 KB03-21-2024 DownloadPreview
Drug Free258.63 KB03-30-2022 DownloadPreview
ERM-14131.54 KB03-30-2022 DownloadPreview
Employers PayGo96.61 KB03-30-2022 DownloadPreview
FL Contracting Class Credit App162.63 KB03-30-2022 DownloadPreview
FL WC Appetite for Omega169.26 KB02-21-2024 DownloadPreview
Florida Contractor Credit Guide346.14 KB03-30-2022 DownloadPreview
Florida Drug-Free Credit Guide71.80 KB03-30-2022 DownloadPreview
Florida Exemption Rules 2024424.28 KB02-20-2024 DownloadPreview
Florida Officer Revocation Forms27.30 KB03-30-2022 DownloadPreview
Frank Crum Cert Request Form236.59 KB03-30-2022 DownloadPreview
KymberlyGroup Cert Request Form139.78 KB03-30-2022 DownloadPreview
Lost Policy Release for Cancellation6.11 KB03-30-2022 DownloadPreview
MCIM Classes253.76 KB03-30-2022 DownloadPreview
NCCI Construction Classes35.59 KB03-30-2022 DownloadPreview
No Loss Affidavit14.52 KB03-30-2022 DownloadPreview
Officer Inclusion17.96 KB03-30-2022 DownloadPreview
Officer Min-Max by State111.33 KB10-03-2024 DownloadPreview
Omega Binder – Things You Need to Know207.46 KB03-30-2022 DownloadPreview
PA Application for Executive Officer’s Declaration227.12 KB03-30-2022 DownloadPreview
PA Executive Officer’s Declaration222.13 KB03-30-2022 DownloadPreview
PEO Sample Proposal256.73 KB09-11-2024 DownloadPreview
PEO Sample Proposal Spanish158.91 KB09-11-2024 DownloadPreview
SUNZ Loss History Affidavit294.65 KB03-30-2022 DownloadPreview
Safety Credit256.87 KB03-30-2022 DownloadPreview
Sample Workplace Drug Free Policy100.73 KB03-30-2022 DownloadPreview
Southeast Cert Form104.91 KB08-25-2022 DownloadPreview
WC Class Codes617.92 KB03-30-2022 DownloadPreview
WC Rates Effective 1-1-25103.19 KB11-18-2024 DownloadPreview
What is a PEO vs Standalone117.95 KB09-06-2023 DownloadPreview
Wrap Ups120.97 KB03-30-2022 DownloadPreview

Supplemental Forms

  • Supplemental Forms
TitleSizeDate modifiedDownload
Ambulance Questionnaire91.51 KB03-30-2022 DownloadPreview
Any CC Questionnaire123.57 KB03-30-2022 DownloadPreview
Assisted Living Questionnaire102.01 KB03-30-2022 DownloadPreview
Auto Dealers Supplemental122.12 KB03-30-2022 DownloadPreview
Auto Repair21.11 KB03-30-2022 DownloadPreview
Bar Supplemental94.36 KB08-12-2022 DownloadPreview
Blank USLH572.03 KB03-30-2022 DownloadPreview
Brewery Supplemental2.88 MB03-30-2022 DownloadPreview
Cable Installation Supplemental108.19 KB03-30-2022 DownloadPreview
Catering Supplemental18.52 KB03-30-2022 DownloadPreview
Cert Issuance Guide84.36 KB03-30-2022 DownloadPreview
Construction Supplemental312.94 KB04-06-2022 DownloadPreview
Day Care Center Supplemental22.25 KB03-30-2022 DownloadPreview
Delivery Supplemental202.98 KB03-30-2022 DownloadPreview
Distributors Supplemental72.76 KB03-30-2022 DownloadPreview
Domestic Brochure1.23 MB02-07-2024 DownloadPreview
Domestic Supplemental1.33 MB01-17-2023 DownloadPreview
Dump Truck Supplemental433.93 KB11-19-2024 DownloadPreview
Dump Truck Supplemental433.93 KB11-18-2024 DownloadPreview
Engineering Firm Supplemental92.80 KB03-30-2022 DownloadPreview
Equine Questionnaire93.19 KB07-14-2022 DownloadPreview
Excavation Supplemental310.11 KB03-30-2022 DownloadPreview
Farm Supplemental10.47 KB03-30-2022 DownloadPreview
Freight Forwarding Supplemental93.60 KB03-30-2022 DownloadPreview
Health Care Supplemental150.48 KB03-30-2022 DownloadPreview
Home Health Care111.97 KB03-30-2022 DownloadPreview
Home Health Care Professional Services113.87 KB03-30-2022 DownloadPreview
Hotel & Motel26.50 KB03-30-2022 DownloadPreview
Janitorial Supplemental189.01 KB03-30-2022 DownloadPreview
Landscaping Supplemental149.68 KB03-30-2022 DownloadPreview
Logging Supplemental58.43 KB03-30-2022 DownloadPreview
Manufacturing Rep Supplemental88.03 KB03-30-2022 DownloadPreview
New Agents to WC87.17 KB03-30-2022 DownloadPreview
Pawn Brokers Supplemental108.79 KB03-30-2022 DownloadPreview
Pest Control Supplemental80.49 KB03-30-2022 DownloadPreview
Pizza & Restaurant Delivery Supplemental202.65 KB03-30-2022 DownloadPreview
Property Management Supplemental131.64 KB03-30-2022 DownloadPreview
Recycling Waste Dism-Scr Questionnaire157.11 KB03-30-2022 DownloadPreview
Restaurant Supplemental26.70 KB03-30-2022 DownloadPreview
Retail-Wholesale Supplemental Application27.08 KB03-30-2022 DownloadPreview
Schools Supplemental Application135.46 KB03-30-2022 DownloadPreview
Scrap Operations573.71 KB03-30-2022 DownloadPreview
Security Guards234.11 KB02-15-2023 DownloadPreview
Social Services Supplemental29.66 KB03-30-2022 DownloadPreview
Tow Truck Supplemental369.74 KB03-30-2022 DownloadPreview
Trav Supplemental – Construction56.33 KB03-30-2022 DownloadPreview
Tree Pruning Supplemental1.75 MB03-30-2022 DownloadPreview
Trucking Supplemental Application87.59 KB03-30-2022 DownloadPreview
USL&H Supplemental572.07 KB03-30-2022 DownloadPreview
Wholesalers38.16 KB03-30-2022 DownloadPreview

Unrated Carrier Financials

  • Unrated Carrier Financials
TitleSizeDate modifiedDownload
Ascendant Financials9.81 MB08-11-2024 DownloadPreview
FCBI Financials518.26 KB08-11-2024 DownloadPreview
Financial Ratings for Cimarron Insurance Company5.68 MB05-01-2024 DownloadPreview
MCIM Financials139.64 KB08-11-2024 DownloadPreview
Normandy Financials9.89 MB08-11-2024 DownloadPreview

Workers' Comp Tips & Best Practices

  • Workers' Comp Tips & Best Practices
TitleSizeDate modifiedDownload
6 construction accidents that may lead to personal injury compensation61.58 KB07-28-2022 DownloadPreview
10 Quick Tips for WC66.13 KB07-21-2022 DownloadPreview
10 WC Best Practices115.79 KB07-21-2022 DownloadPreview
The employer’s guide to Florida workers’ comp insurance174.45 KB07-21-2022 DownloadPreview
Three Tips to Prevent a Massive Workers Comp Audit134.85 KB07-21-2022 DownloadPreview
Top 10 Things to Know About Writing Workers' Comp114.25 KB07-28-2022 DownloadPreview