Form F207-095-000 Self-insured Employer Certificate of Excess Insurance - Washington

What Is Form F207-095-000?

This is a legal form that was released by the Washington State Department of Labor and Industries - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form F207-095-000?A: Form F207-095-000 is the Self-insured Employer Certificate of Excess Insurance specific to Washington.

Q: Who is required to fill out this form?A: This form is required to be filled out by self-insured employers in Washington.

Q: What is the purpose of this form?A: The purpose of this form is to provide proof of excess insurance coverage for self-insured employers in Washington.

Q: Is this form specific to Washington State?A: Yes, this form is specific to Washington State self-insured employers.

Q: What information is required on this form?A: This form requires information such as the employer's name, self-insured claim number, excess insurance carrier information, and policy details.

Q: Are there any filing fees associated with this form?A: There are no filing fees associated with this form.