WORKERS COMPENSATION REQUIREMENT
FOR CONSTRUCTION COMPANIES

Worker's compensation insurance is required for all construction companies who employ one or more persons (S.B. 251 and City Ordinance 3394).

A certificate of insurance must be submitted with your application or renewal of a business license if you are a construction company and employ one or more persons.

If you do not employ one or more persons, you must sign and return this exemption certificate with your application for a business license or renewal.

EXEMPTION
I hereby certify that I own or represent a construction company and do not employ one or more persons and therefore am not required to provide proof of worker's compensation.

Signature_________________________________________________  Date___________________