Okaloosa County BOCC — January 19, 2016 — Electric Motor Repair WCI exemption
Electric Motor Repair WCI exemption in the January 19, 2016 Okaloosa County BOCC meeting materials. Preserved county-portal original with machine-generated OCR reading text.
Preserved among the January 19, 2016 Okaloosa County Board of County Commissioners meeting materials (IQM2 meeting 1320). The date shown is the verified meeting context, not an independently established creation date for every attachment. The download catalog used Nov 17, 2015; the meeting date was corrected using the agenda/minutes heading and matching source filename.
Original publication
Electric Motor Repair WCI exemption
Date
January 19, 2016
Publisher
Okaloosa County Board of County Commissioners
Where to find it
1
Reference collection
Okaloosa County Board of County Commissioners (IQM2 public portal)
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Electric Motor Repair WCI exemption — extracted reading text
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Electric Motor Repair WCI exemption — extracted reading text
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09-22-201M
JEFF ATWATER STATE OF FLORIDA
CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS" COMPENSATION
% x CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * %
NON-CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Waorkers’ Compensation law.
EFFECTIVE DATE: 09/22/20M1 EXPIRATION DATE: N/A
PERSON: OGLESBY LESLIE N
FEIN: 592185118
BUSINESS NAME AND ADDRESS:
ELECTRIC MOTOR REPAIR SERVICE OF FORT WALTON BEACH INC
80 SKIPPER AVE
FORT WALTON BEACH FL. 32547
SCOPES OF BUSINESS OR TRADE:
1- REPAIR SERVICE
IMPORTANT: Pursuant to Chapter 448 . 05{14}, F.S., an officer of a cerparation who elects exemption from this chapter by filing a certificate of eiection under this
section may not recover bemefits or compensation under this chapter. Pursnamt te Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the
scope of the basiness or irade listed on the notite of election to be sxempL Pursuant to Chapter 440.05{13), F.S., Notices of election to be exempt and certificates of
election to be exempt shall be subject to revecation if, at any time after the filing of the notice or the issuance of the certificate, the persom named on the motice or
certificate no longer meets the requirements of this section for issuasce of 3 certificate. The department shsall revoke 2 certificate at amy time for failare of the person
amed ertifi t tie requireme: i ion.
n an the ¢ cate to mee! s mts of this section QUESTIONS? (850) 413-1509
¥BWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11
=
09-26-2011
JEFF ATWATER STATE OF FLORIDA
CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS® COMPENSATION
* % CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW = x
NON-CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers’” Compensation law.
EFFECTIVE DATE: 09/26/2011 EXPIRATION DATE: N/A
PERSON: BROXSON GRADY
FEIN: 592185119
BUSINESS NAME AND ADDRESS:
ELECTRIC MOTOR REPAIR SERVICE OF FORT WALTON, INC.
80 SKIPPER AVE
FORT WALTON BEACH FL 32547
SCOPES OF BUSINESS OR TRADE:
1- REPAIR SERVICE
IMPORTANT: Pursuant to Chapter 440 . 05{14), F.S., an afficer of a corporaticn who elects exemptisn from this chapter by filing a certificate of electiun umder this
section may not recover benefits or compessation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certiticates of election o be exempl... apply ealy within the
scepe of the business or trade listed o the notice of eiection to be exempl. Pursuant to Chepter 440.05(13), F.S., Notices of election to be exempt amd certificates of
election to be exempt shail be subject ts revocation if, at any time after the filing of the netice or the isswance of the certificate, the person named on the notice or
certificate ne longer meets the requirements of this section for isswance of a certificate. The department shall revoke a cestificate at any time for failure of the person
named on the certificate to meet the requirements of this section.
) QUESTIONS? {850} 413-1609
MAr-969 CFRTIFICATE NE FILECTIAN TN RE CYEMDT REVICER N1-179
Okaloosa County Board of County Commissioners. “Okaloosa County BOCC — January 19, 2016 — Electric Motor Repair WCI exemption.” January 19, 2016. Electric Motor Repair WCI exemption. Crypt of Echoes evidence ID LED-2026-67d3c34b35724362a9869f9a3ad2d22d. http://127.0.0.1:58097/evidence/LED-2026-67d3c34b35724362a9869f9a3ad2d22d. Accessed [date].
Catalogue citation: Okaloosa County Board of County Commissioners, Electric Motor Repair WCI exemption, meeting materials for January 19, 2016. https://okaloosacountyfl.iqm2.com/Citizens/FileOpen.aspx?Type=4&ID=10428&MeetingID=1320
Preserved county public-record source. Third-party attachments may retain their original rights.
