C105 2 Form - For forms or general questions, contact the. Web if you maintain workers' compensation and disability insurance coverage. Web the only forms that are accepted as proof of workers’ compensation insurance are: Name and address of the entity requesting proof of coverage (entity being listed as the certificate holder) the city. The following forms must be submitted with each permit.
For forms or general questions, contact the. Web the only forms that are accepted as proof of workers’ compensation insurance are: Name and address of the entity requesting proof of coverage (entity being listed as the certificate holder) the city. The following forms must be submitted with each permit. Web if you maintain workers' compensation and disability insurance coverage.