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2020-238A
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2020-238A
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Last modified
3/5/2021 1:53:44 PM
Creation date
12/23/2020 3:53:42 PM
Metadata
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Template:
Official Documents
Official Document Type
Contract
Approved Date
11/17/2020
Control Number
2020-238A
Agenda Item Number
8.D.
Entity Name
Kerns Constructionand Property Management Corp.
Subject
Roseland Community Center Building and Site Improvements
Project Number
IRC-1855
Bid Number
2020053
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Kems Construction & Property Management Cor <br />c� <br />... ,� <br />� once t,.. <br />JIMMY PATRONIS <br />CHIEF FINANICAL OFFICER STATE OF FLORIDA <br />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 />This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. <br />EFFECTIVE DATE: 11/15/2018 <br />PERSON: CHARLES D KERNS <br />FEIN: 300449688 <br />BUSINESS NAME AND ADDRESS: <br />EXPIRATION DATE: 11/14/2020 <br />EMAIL: CDCASS@COMCAST.NET <br />KERNS CONSTRUCTION AND PROPERTY MGMNT, CORP. <br />1674 PANCOAST ST. <br />PORT SAINT LUCIE, FL 34987 <br />SCOPE OF BUSINESS OR TRADE: <br />Liconsod Goncral Contractor <br />IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under <br />This section may not recover benefits orcompensalion under this chapter. Pursuant to Chapter 440.05(12), F,S., Certificates of cleclion to be oxempt... apply <br />only within the scope of the business or trade listed on the notice of election to be exempt, Pursuant to Chapter 440.05(13), F.S., Notices of election to be <br />exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issunnco of the cortifcale, the <br />pursuit named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a <br />certificate at any lime for failure of the person named on the certificate to meet the requirements of this section. <br />DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 <br />QUESTIONS? (850)413-1609 <br />
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