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Get Affidavit Of Compliance For Worker's Compensation I ...

He building permit application form, instead of the license holder) I do hereby swear and affirm that I am in full compliance with Florida s Worker s Compensation Law, and that coverage has been secured or a valid certificate of exemption has been obtained. Licensed Contractor s Signature Only I hereby certify that on this day, before me, as an officer duly authorized in the state and county aforesaid to take acknowledgements, personally appeared who is per.

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