Policy Materials

General Documents

• Accident Fund 2024 W-9
• Accident Fund 2025 W-9
• ACORD Cancellation
• AOR Form
• EMR-14 Form
• General Election Change Form
• Waiver of Subrogation Request Form

Georgia Policy Materials

• Georgia Exclusion Form

Indiana Policy Materials

• Indiana Election of Voluntary Coverage Form
  
• Indiana First Report of Injury
  
• Indiana Independent Contractor Clearance Certificate English | Spanish
  
• Indiana – Managing Exposure – Construction Industry and the use of Subcontractors
  
• Indiana State Form 36097

Iowa

• Iowa Exclusion Form

Michigan Policy Materials

• Michigan Employee Rights
• Michigan Exclusion Form
  
• Michigan First Report of Injury
  
• Michigan Independent Contractor Trucker Supplemental Worksheet
  
• Michigan Independent Contractor Worksheet
• Michigan – Managing Exposure – Construction Industry and the Use of Subcontractors
  
• Michigan Poster

South Carolina

• South Carolina Exclusion Form

Tennessee

• Tennessee Exclusion Form
• Tennessee Notice of Election

Virginia

• Virginia Exclusion Form