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Florida
Self-Insurers Guaranty Association, Inc.
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*** The following forms can now be completed prior to printing: SI-1, SI-5, SI-17, SI-19 and SI-20 ***
Order Approving Plan of Operation
Rule 69L-5, Florida Administrative Code - Effective March 9, 2010
Form SI-4F - Surety Bond for FSIGA Member
Form SI-5 - Payroll Report (includes instructions)
Form SI-6 - Letter of Credit (also in Word format)
Form SI-10 - Parental Guaranty (also in Word format)
Form SI-11 - Indemnity Agreement
Form SI-17 - Unit Statistical Report (includes instructions)
Form SI-17 - Electronic Reporting File Format Specifications
Form SI-19 - Certification of Servicing
Form SI-20 - Report of Outstanding WC Liabilities (includes instructions)
Compliance Guide for Self-Insurers
Continuing Self-Insurance Reporting Requirements for Terminated Self-Insurers
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