Florida insurance license
[DOC File]STATE OF FLORIDA
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Attachment 3: Insurance verification: A copy of an insurance policy, a self insurance policy or certificate of insurance is acceptable. Documentation must include a schedule of vehicles covered, if the policy is not blanket coverage or self-insurance. ... Attachment 6: The medical director must be a Florida license physician. A copy of his/her ...
[DOCX File]Health Care Licensing Application
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include the following attachments as stated in Chapters 408, Part II and 395, Florida Statutes (F.S.), and Chapters 59A-35, 59A-3 and 59A-10, Florida Administrative Code (F.A.C). Applications must be received . at least 60 days prior to. the expiration of the current license or effective date of a change of ownership to avoid a late fee.
[DOC File]ANNUAL VOLUME COMMITMENT
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Copy of insurance license issued by state of residence or agency domicile. Certificate of insurance for your current professional liability (E&O) insurance. IRS Form W-9. 2010 Hull & Company, Inc. 2010 Hull & Company, Inc. 4/7/2010. 4/7/2010. Page 2 of 6. Page 3 of 6. Page 4 of 6. Page 5 of 6. Page 6 of 6
[DOC File]ANNUAL REPORT - Florida Office of Insurance Regulation
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AMOUNT TYPE/CLASS FEE FUND ACCOUNT $50.00 1300 L Renewal License Fee Office of Insurance Regulation. Life & Health Financial Oversight. OIR-A1-1671 (6/08) OIR-A3-975 (rev. 03/03) Name of Administrator: _____ Annual Report of Insurance Administrator to the Florida Office of Insurance Regulation
[DOCX File]License & Appointment Requirements for Non-Admitted
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Westchester Surplus Lines Insurance Company – WSL: “Admitted Company” in Georgia. If a policy is issued in Georgia agent must hold a regular P&C license and appointment. “Non-Admitted Company” in all other states except: Minnesota. Company is not authorized in this state.
[DOCX File]Health Care Licensing Application
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A person who knowingly submits a false, misleading, or fraudulent application or other document when applying for licensure as a health care clinic, seeking an exemption from licensure as a health care clinic, or demonstrating compliance with part X of chapter 400, Florida Statutes, with the intent to use the license, exemption from licensure ...
Application for Licensure to Provide Substance Abuse Services
An application without the applicable licensure fee as required under Section 397.407, Florida Statutes and Section 65D-30.003, Florida Administrative Code, will be returned to the applicant. An application for renewal of a regular license must be submitted to the department at least 60 days before the license …
[DOC File]DEPARTMENT OF INSURANCE
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69B-232.130 Penalties for Violations of Other Specific Provisions of the Florida Insurance Code. The following stated penalties shall apply for violations of the following provisions of the Florida Insurance Code: (1) Section 634.095(1), F.S. – suspension for 6 months. (2) …
69B-220
(a) “Adjuster,” when used without further specification, includes all types and classes of insurance adjusters, (company employee, independent, and public), subject to chapter 626, F.S., regardless of whether permanent, temporary, apprentice, or emergency licensees. (b) “Department” means the Florida Department of Financial Services.
[DOC File]SAMPLE REQUEST LETTER - Orchard Park
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ACORD 25 certificates of insurance are required from all contractors, sub-contractors, vendors, tenants, and any organization utilizing facilities. Your ACORD certificate of insurance must conform to the coverage and language on the attached sample certificate. Your ACORD 25 …
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