Workers comp exemption------------------------------------
JIMMY PATRONIS
CHIEF ANAHICAI. OfRCER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
• • CERTIACATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW• •
CONSTRUCTION INDUSTRY EXEMPTION
This certiies that 1he indMdual lisled below has eff!Cled to be exempt lrom Florida Workers' Con,,ensation law.
EFFECTIVE DATE: 7/10/2019
PERSON: ADNER A SANTOS
FEfll : 821462121
BUSINESS NAME AND ADDRESS:
AIR CONDITIONING PROTECH CORP
3960 W 16TH AVE I 206
HIALEAH. FL33012
SCOPE OF BUSINESS OR TRADE:
HNtn;.~Jw.
Co, -Rel,.... • S,S.-.ns ...,.11a1n.,s.,. • ..o
Rao•. SiPw:G. Y..S & ()nw.,.
EXPIRATION! DATE: 71912021
EMAIL: ADNER64@GMAILCOM
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OFS-F2•DWC•2S2CER11FICATE Of ELECTION TO BE EXEMPT REVISED 08 •13 QUESTIONS? (850)'413-11109