Affidavit of Exempt Status definition

Affidavit of Exempt Status means an affidavit authorized by 85A O.S., §36 which any individual or business entity that is not required to secure compensation pursuant to the AWCA may execute and file with the Oklahoma Workers' Compensation Commission.
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Examples of Affidavit of Exempt Status in a sentence

  • Ten-day cancellation clause **Required Coverage:1) Worker’s Compensation and Employer’s Liability or Affidavit of Exempt Status Filed with the State of Oklahoma for everyone listed on the core crew list: Limits of Liability:Bodily Injury by Accident: $100,000 each accident Bodily Injury by Disease: $500,000 policy limit Bodily Injury by Disease: $100,000 each employeeOklahoma Statute requires Worker’s Compensation coverage for anyone with one (1) or more employees.

  • Ten-day cancellation clause **Required Coverage:1) Worker’s Compensation and Employer’s Liability or Affidavit of Exempt Status Filed with the State of Oklahoma for everyone listed on the core crew list:Limits of Liability:Bodily Injury by Accident: $100,000 each accident Bodily Injury by Disease: $500,000 policy limit Bodily Injury by Disease: $100,000 each employeeOklahoma Statute requires Worker’s Compensation coverage for anyone with one (1) or more employees.

  • If at least six of the statements below do not describe your business, you should not sign the attached Affidavit of Exempt Status Under the Workers’ Compensation Act.

  • I understand that based upon the representations in this Affidavit of Exempt Status, I am requesting that(Insert contractor’s name) consider my business to be that of an independent contractor; that I am not an employee under the Workers’ Compensation Act and the policy issued by (Insurance Carrier).

  • I understand that knowingly providing false information on an Affidavit of Exempt Status Under the Workers’ Compensation Act shall constitute a misdemeanor punishable by a fine not to exceed One Thousand Dollars ($1,000.00) per violation.

  • I understand that based upon the representations in this Affidavit of Exempt Status, I am requesting(Insert contractor’s name) to consider my business to be that of an independent contractor; that I am not an employee under the Workers’ Compensation Act and the policy issued by(Insurance Carrier); and that no premium be charged for the services performed by my business during the policy year.

  • The Affidavit of Exempt Status is not dispositive of the issue, and only creates a rebuttable presumption that Davison County is not required to provide Workers’ Compensation insurance for the individual signing the Affidavit.

  • In the event changed circumstances make securing compensation pursuant to the requirements of the Administrative Workers' Compensation Act necessary, I will execute and file a Cancellation of Affidavit of Exempt Status with the Workers' Compensation Commission.

  • I understand that knowingly providing false information on an executed Affidavit of Exempt Status shall constitute a misdemeanor punishable by a fine not to exceed One Thousand Dollars ($1,000.00).

  • SDCL 62-1-19 through 62-1-22 allows some independent contractors the option to provide an Affidavit of Exempt Status to Davison County in lieu of carrying Workers’ Compensation coverage.

Related to Affidavit of Exempt Status

  • certificate of exemption means any document evidencing that the entity is exempt from

  • Affidavit means the affidavit certifying eligibility under section 29A of IBC provided by the Bidder substantially in form and manner as set out in Annexure 3 of this Process Memorandum;

  • Cooperative Stock Certificate With respect to a Cooperative Loan, the stock certificate or other instrument evidencing the related Cooperative Stock.

  • Continuing Disclosure Certificate means that certain Continuing Disclosure Certificate executed by the District and dated the date of issuance and delivery of the Bonds, as originally executed and as it may be amended from time to time in accordance with the terms thereof.

  • Tax Exemption Certificate means the Tax Exemption Certificate approved under the terms of this Resolution and to be executed by the Treasurer and delivered at the time of issuance and delivery of the Notes.

  • Disclosure Certificate means this Continuing Disclosure Certificate.

  • certificate of competency means a certificate issued by the Washington state board of boiler rules to a person who has passed the tests as set forth in WAC 296-104-050.

  • Affidavit of Small Business Enterprise Certification means the fully completed, signed, and notarized affidavit that must be submitted with an application for SBE certification. Representations and certifications made by the applicant in this Affidavit are made under penalty of perjury and will be used and relied upon by City to verify SBE eligibility and compliance with SBE certification and documentation requirements.

  • Delaware Certificate is defined in Section 2.1.

  • Transfer Affidavit As defined in Section 5.02(c).

  • Stock Certificate With respect to a Cooperative Loan, a certificate evidencing ownership of the Cooperative Shares issued by the Cooperative.

  • Certificate of eligibility means a document issued by the bureau stating that the criminal record and all records of arrest, investigation, and detention associated with a case that is the subject of a petition for expungement is eligible for expungement.

  • Company Stock Certificate shall have the meaning set forth in Section 1.6.

  • Buyer Certificate means a certificate to the effect that each of the conditions specified in clauses (a) through (c) (insofar as clause (c) relates to Legal Proceedings involving the Buyer) of Section 5.2 is satisfied in all respects.

  • Independent Certificate means a certificate or opinion to be delivered to the Indenture Trustee under the circumstances described in, and otherwise complying with, the applicable requirements of Section 11.1 of the Indenture, made by an independent appraiser or other expert appointed by an Issuer Order, and such opinion or certificate shall state that the signer has read the definition of “Independent” in this Appendix A and that the signer is Independent within the meaning thereof.

  • Exemption Certificate is defined in clause (e) of Section 4.6.

  • Certificate of Conversion means the certificate of conversion converting the Company’s prior partnership into the Company filed with the office of the Secretary of State of the State of Delaware on March 2, 2000.

  • Transferee Affidavit As defined in Section 5.03(n).

  • Certificate re Non-Bank Status means a certificate substantially in the form of Exhibit F.

  • Tax Certificate means the Federal Tax Certificate executed and delivered by the City on the Date of Original Issue of any Bond issued as a Tax-Exempt Bond, as the same may be amended or supplemented in accordance with its provisions.

  • FIRPTA Affidavit means the Foreign Investment in Real Property Tax Act Certification and Affidavit, substantially in the form of Exhibit D hereto.

  • Certificate of Beneficial Ownership means, for each Borrower, a certificate in form and substance acceptable to Agent (as amended or modified by Agent from time to time in its sole discretion), certifying, among other things, the Beneficial Owner of such Borrower.

  • Non-Bank Certificate has the meaning specified in Section 3.01(b).

  • FIRPTA Certificate an affidavit from the Annual Conference pursuant to Section 1445(b)(2) of the Code in the form attached hereto as Exhibit D, and on which Buyer is entitled to rely, that Seller is not a “foreign person” within the meaning of Section 1445(f)(3) of the Code

  • Claim Certificate shall have the meaning set forth in Section 8.6(a).

  • certificate of fitness means a certificate issued by the Department to a contract bus carrier.