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WORKERS COMP
CERTIFICATE
FORM
Require a fresh Workers Comp Certificate? Obtain one by completing the form below for a workers’ compensation certificate request.
We have sent a text message to your phone number. Please enter the code you have received.
To protect your account, we require you to authenticate using a phone number. Please enter your phone number.
For assistance, please contact your agent, you may call (754) 287-7313 for support.
Please select your company.
Don’t see your company? Contact (754) 287-7313 for support.
We didn’t find a company under the provided phone number.
Please contact our customer support team at (754) 287-7313 to resolve this issue.
I acknowledge that the information entered here is true and correct. I understand that once submitted, the cert can not be changed or modified unless I request a change. I understand that if I request a waiver of subrogation, there will be a $200 fee for each waiver of subrogation. I also agree to the OCMI Workers Comp & Professional Services, LLC. terms & conditions.