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To complete an FWCJUA APPLICATION FOR COVERAGE, follow this link: Online Application for Coverage
For more information about application forms or to review FWCJUA procedures, follow this link: FWCJUA Operations Manual
Below are various application packages for FWCJUA coverage:
FWCJUA Application Package http  (updated 2010/01)
ACORD 130 FL (2002/07)
ACORD 133 FL (2010/01)
Employment and Wage Information Release Agreement (2007/06)
Supplemental Applications:
Employee Leasing/PEO Package http (updated 2010/01)
FWCJUA Supplemental Employee Leasing Application
Acknowledgement by Labor Contractor and Client of Terms and Conditions of the
Multiple Coordinated Policy
Acknowledgement by Client of the Terms and Conditions of Continued Coverage under
the Multiple Coordinated Policy
Employee Leasing Consent To The Release Of Client Initiation Or Termination Information
Construction Industry Package http (updated 2008/08)
Contractors Supplemental Application
"If Any" Acknowledgement Form
All forms are in Acrobat PDF
If the forms are being displayed blank then you probably need to update your Adobe Acrobat.
All Forms and Applications:
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