Agreement of Assumption and Guarantee of Workers' Compensation Liabilities (Certified Self-Insurer)

Agreement of Assumption and Guarantee of Workers'' Compensation Liabilities (Certified Self-Insurer) - (Forms/Publications)
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Title Agreement of Assumption and Guarantee of Workers'' Compensation Liabilities (Certified Self-Insurer) (A fillable form - 80 KB PDF)
Description

Used by certified self-insured companies when they are acquired by another organization. New parent organization guarantees the self-insured workers' compensation liabilities of its new subsidiary.

Detail
Form number F207-040-001
Availability
Online only. See document above to download.
Keywords certificate, certification, claims, industrial insurance, liability, parental, parents, self insurance, self insurer, self-insurance, worker's compensation, workers compensation
Languages English
Valid dates 11-2000
Contact information Self-Insurance
Web pages Self-Insured Employers

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