Affidavit - This form is stating that you will release your Financial statement to our CPA for approval in joining the CompTrust program.
SI-12 application – This application is the application that we are required to file with the Arkansas’ Workers’ Compensation Commission.
Safety & Drug agreement – This form simply states that upon joining the CompTrust program that you will drug test before hiring, post accident and random drug testing. In signing this form you are also stating that you have a Safety program in place that meet the requirements of CompTrust.
Joint & Several Liability – When signing this form before coming into the program you are acknowledging that you are legally liable like each member in the CompTrust program, if a claim arises from the Group itself or any of its members to obtain recovery on that claim.
Acord application – Standard information collected such as physical address, number of employees, class codes, losses, prior carrier information, experience mod worksheet.
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