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Workers' Compensation

Certificate of Insurance

Certificates of Evidence of Coverage for Workers’ Compensation—can be issued on as needed basis on an Acord 25 and can be requested by emailing Eileen Massa When emailing your request, please include the following:

  • Certificate Holder Information

  • Name

  • Address

  • Contact for certificate delivery such as an email, fax, or mail.

  • Please indicate the need for the certificate and advise on event specific information for the certificate description or proof of coverage wording.

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