Forms

Insurance Requirements and Contracts Section
grey arrowSelf-Insurance Letter (PDF)

Sample Certificate of Insurance

Please submit documents to:
     
     Risk Management Division
     Insurance Requirements & Contracts Section
     115 South Andrews Ave, #210
     Ft Lauderdale, FL 33301
     Phone: 954-357-7210
     Fax: 954-357-5456

You may email the documents to the appropriate email address listed below:

Liability Section

Safety and Occupational Health Section

*Note - The above form must be completed for employment applications and Volunteer / Community Service Worker applications.

Workers’ Compensation Section

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