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Firm Name By Title Date SUBCONTRACTOR S WAIVER OF WORKERS COMPENSATION COVERAGE I certify that I am a subcontractor that I am a sole proprietor or a partner and that I have no employees. Name of Contractor Subletting the Contract Name of Subcontractor Subcontractor s Signature Date NOTICE This Waiver shall be effective from the date it is signed until the expiration date of the subletting contractor s current workers compensation insurance policy. It is understood that the Inspections...

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What is officeragent of form contractor?

Officer/agent of form contractor refers to the individual who is authorized to represent and act on behalf of the contracting company.

Who is required to file officeragent of form contractor?

The contracting company is required to file officer/agent of form contractor.

How to fill out officeragent of form contractor?

To fill out officer/agent of form contractor, the contracting company must provide the necessary information about the authorized individual and their role in the company.

What is the purpose of officeragent of form contractor?

The purpose of officer/agent of form contractor is to officially designate the authorized individual who can act on behalf of the contracting company.

What information must be reported on officeragent of form contractor?

The officer/agent of form contractor must report the name, title, contact information, and authorization details of the authorized individual.

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