warehouse workers with clipboard

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

TitleSizeDate modifiedDownload
ACORD 130-FL Tips for Completing206.96 KB04-16-2024 DownloadPreview
Acord 130120.08 KB03-30-2022 DownloadPreview
Acord 130 Tips for Completing69.05 KB07-18-2022 DownloadPreview
Acord 130-FL160.77 KB09-06-2023 DownloadPreview
AmTrust EFT Form352.30 KB02-07-2023 DownloadPreview
Amerisafe Loss Control Agreement23.80 KB04-05-2024 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
Financial Ratings for Cimarron Insurance Company5.68 MB05-01-2024 DownloadPreview
Florida Contractor Credit Guide346.14 KB03-30-2022 DownloadPreview
Florida Drug-Free Credit Guide71.80 KB03-30-2022 DownloadPreview
Florida Exemption Rules 2023369.38 KB11-14-2022 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 State191.21 KB08-28-2023 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
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 1-1-24766.93 KB11-15-2023 DownloadPreview
What is a PEO vs Standalone117.95 KB09-06-2023 DownloadPreview
Wrap Ups120.97 KB03-30-2022 DownloadPreview

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
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

TitleSizeDate modifiedDownload
Ascendant Financials1.17 MB04-05-2024 DownloadPreview
FCBI Financials10.46 KB11-14-2022 DownloadPreview
MCIM Financials2.66 MB12-15-2022 DownloadPreview
Normandy Financials112.08 KB11-28-2022 DownloadPreview

Workers' Comp Tips & Best Practices