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SERFS Tracking Number: NCCI-125516405 State: Arkansas Filing Company: CCI State Tracking Number: EFT $100 Company Tracking Number: RM-W-8031-AR TO: 16.0 Workers Compensation Subtle: 16.0004 Standard
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2008 2009 Arkansas Florida LPS nal RM-W-8031 RM-W-8031ASSIGNED NCCI classication qualies WCIP SERFF PPA specic notication compensability NCCIs rst ve dened timeliness qualication noncompliant EFT RM-W-8031-AR Terri veriable NCCI-125516405 4-A-4-a 4-A-3-b

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