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WORKERS COMPENSATION INSURANCE APPLICATION Program available through: CALICO Insurance Services Tel: 800.652.1772 Workers Compensation General Information 1. Firm Name: 2. Contact Person: (Person
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Start by gathering all the necessary information and documents required to fill out the CIS - WC rev1210 form.
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Provide accurate details about the injury or illness that occurred, including the date, time, location, and a thorough description of what happened.
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