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<br />]-., <br /> <br />--. <br /> <br /> <br />05-08-2007 <br /> <br />ALEX SINK STATE OF FLORIDA <br />CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES <br />DIVISION OF WORKERS' COMPENSATION <br />* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * <br />CONSTRUCTION INDUSTRY EXEMPTION <br /> <br />-:- <br /> <br />"fhis certifies that the individual I isted below has elected to be exemp~from Florida Workers' Compensation law. <br /> <br />EFFECTIVE DATE: <br /> <br />05/08/2007 <br /> <br />EXPIRATION DATE: 05/07/2009 <br /> <br />PERSON: RUIZ <br /> <br />FEIN: 205405629 <br /> <br />BUSINESS NAME AND ADDRESS: <br />B & G FENCES CORP <br />9905 NW 116 WAY <br />#109 <br />MIAMI FL 33178 <br /> <br />RIGOBERTO <br /> <br />JR <br /> <br />SCOPES OF BUSINESS OR TRADE: <br />1- FENCE ERECTION <br /> <br />IMPORTANT: Pursuant to Chapler 440 . 05(14). F.S., an officer of a corporation who elects exemption from this chapter by filing II terlificate of election under Ihis <br />section may nol recover benefits or compensation under this chapter. Pursuant to Chapler 440.05(12), F.S., Certificates of election to be exempt... apply only withir. the <br />scope 01 the business or Hade listed on the nolice of election to be exempt. Pursuant to Chapter 440.05(3), F.S., Notices of election 10 be exempt and certificates of <br />eleclion to be exempt shall be sub jett to revocation if, at any time after the filing of the notice or the issUllnce of the certificate, the person named on the notice or <br />certificate no longer meets the requirements of this section lor issuance of a cerlifitate. The department shill revoke a certlflclle at IOY time for 'ailure of the person <br />named on Ihe cerrifica.e to meet the requirements of this section. <br /> <br />QUESTIONS? (850) 413-16 <br /> <br />DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 <br />