Department of Labor and Industries Home Modification Acknowledgement of Responsibilities
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
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| Title |
 Department of Labor and Industries Home Modification Acknowledgement of Responsibilities (64 KB DOC)
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| Description | Used by both workers and bidding contractors to read, sign and submit to L&I to verify that they have read, understand and accept their respective responsibilities in the home modification process. | |
| Detail | ||
| Form number | F247-003-000 | |
| Availability | Online only. See document above to download. |
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| Keywords | activities, activity, bid, bond, claims, construction, daily, funding, industrial insurance, inspection, license, lien, living, mobility, permit, proof, register, release, responsibility, safety, volunteer, worker's compensation, workers compensation, workers' compensation | |
| Languages | English | |
| Valid dates | 12-2006 | |
| Contact information |
Vocational Resources
Sarah Martin - 360-902-4480 - masa235@LNI.wa.gov |
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