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Form: A-2 (1-2016) Page 1

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4.8 out of 5

112 votes

The document is an application form submitted by Monrovia Unified School District to the California Department of Industrial Relations for a Certificate of Consent to Self-Insure workers' compensation liabilities. It includes details about the agency, contact information, current workers' compensation program status, claims administration, and safety programs. The application seeks approval for self-insurance under California Labor Code Section 3700.

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Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (112 Votes)

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