div class=ts-pagebutton class=gotoPage data-page=1Page 1button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=1 data-page=1 class=ts-thumb lazyload alt=Page 1: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails1jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=2Page 2button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=2 data-page=2 class=ts-thumb lazyload alt=Page 2: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails2jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=3Page 3button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=3 data-page=3 class=ts-thumb lazyload alt=Page 3: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails3jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=4Page 4button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=4 data-page=4 class=ts-thumb lazyload alt=Page 4: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails4jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=5Page 5button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=5 data-page=5 class=ts-thumb lazyload alt=Page 5: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails5jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=6Page 6button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=6 data-page=6 class=ts-thumb lazyload alt=Page 6: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails6jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=7Page 7button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=7 data-page=7 class=ts-thumb lazyload alt=Page 7: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails7jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=8Page 8button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=8 data-page=8 class=ts-thumb lazyload alt=Page 8: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails8jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=9Page 9button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=9 data-page=9 class=ts-thumb lazyload alt=Page 9: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails9jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=10Page 10button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=10 data-page=10 class=ts-thumb lazyload alt=Page 10: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails10jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=11Page 11button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=11 data-page=11 class=ts-thumb lazyload alt=Page 11: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails11jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=12Page 12button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=12 data-page=12 class=ts-thumb lazyload alt=Page 12: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails12jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=13Page 13button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=13 data-page=13 class=ts-thumb lazyload alt=Page 13: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails13jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=14Page 14button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=14 data-page=14 class=ts-thumb lazyload alt=Page 14: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails14jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=15Page 15button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=15 data-page=15 class=ts-thumb lazyload alt=Page 15: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails15jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=16Page 16button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=16 data-page=16 class=ts-thumb lazyload alt=Page 16: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails16jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=17Page 17button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=17 data-page=17 class=ts-thumb lazyload alt=Page 17: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails17jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=18Page 18button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=18 data-page=18 class=ts-thumb lazyload alt=Page 18: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails18jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=19Page 19button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=19 data-page=19 class=ts-thumb lazyload alt=Page 19: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails19jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=20Page 20button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=20 data-page=20 class=ts-thumb lazyload alt=Page 20: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails20jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=21Page 21button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=21 data-page=21 class=ts-thumb lazyload alt=Page 21: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails21jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=22Page 22button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=22 data-page=22 class=ts-thumb lazyload alt=Page 22: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails22jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=23Page 23button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=23 data-page=23 class=ts-thumb lazyload alt=Page 23: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails23jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=24Page 24button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=24 data-page=24 class=ts-thumb lazyload alt=Page 24: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails24jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=25Page 25button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=25 data-page=25 class=ts-thumb lazyload alt=Page 25: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails25jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=26Page 26button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=26 data-page=26 class=ts-thumb lazyload alt=Page 26: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails26jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=27Page 27button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=27 data-page=27 class=ts-thumb lazyload alt=Page 27: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails27jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=28Page 28button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=28 data-page=28 class=ts-thumb lazyload alt=Page 28: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails28jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=29Page 29button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=29 data-page=29 class=ts-thumb lazyload alt=Page 29: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails29jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=30Page 30button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=30 data-page=30 class=ts-thumb lazyload alt=Page 30: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails30jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=31Page 31button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=31 data-page=31 class=ts-thumb lazyload alt=Page 31: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails31jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=32Page 32button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=32 data-page=32 class=ts-thumb lazyload alt=Page 32: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails32jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=33Page 33button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=33 data-page=33 class=ts-thumb lazyload alt=Page 33: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails33jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=34Page 34button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=34 data-page=34 class=ts-thumb lazyload alt=Page 34: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails34jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=35Page 35button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=35 data-page=35 class=ts-thumb lazyload alt=Page 35: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails35jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=36Page 36button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=36 data-page=36 class=ts-thumb lazyload alt=Page 36: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails36jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=37Page 37button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=37 data-page=37 class=ts-thumb lazyload alt=Page 37: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails37jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=38Page 38button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=38 data-page=38 class=ts-thumb lazyload alt=Page 38: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails38jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=39Page 39button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=39 data-page=39 class=ts-thumb lazyload alt=Page 39: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails39jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=40Page 40button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=40 data-page=40 class=ts-thumb lazyload alt=Page 40: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails40jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=41Page 41button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=41 data-page=41 class=ts-thumb lazyload alt=Page 41: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails41jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=42Page 42button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=42 data-page=42 class=ts-thumb lazyload alt=Page 42: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails42jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=43Page 43button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=43 data-page=43 class=ts-thumb lazyload alt=Page 43: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails43jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=44Page 44button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=44 data-page=44 class=ts-thumb lazyload alt=Page 44: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails44jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=45Page 45button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=45 data-page=45 class=ts-thumb lazyload alt=Page 45: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails45jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=46Page 46button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=46 data-page=46 class=ts-thumb lazyload alt=Page 46: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails46jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=47Page 47button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=47 data-page=47 class=ts-thumb lazyload alt=Page 47: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails47jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=48Page 48button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=48 data-page=48 class=ts-thumb lazyload alt=Page 48: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails48jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=49Page 49button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=49 data-page=49 class=ts-thumb lazyload alt=Page 49: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails49jpg width=140 height=200 divdivdiv class=ts-pagebutton class=gotoPage data-page=50Page 50button div class=ts-imageimg data-url=st4752-workers-compensation-declaration-i-hereby-affirm-that-i-have-a-certificatehtmlpage=50 data-page=50 class=ts-thumb lazyload alt=Page 50: St4752WORKERS COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selfi ure certificate ot Workers Compensation Insurance or a c ified thereof Sec loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAIAAAACCAQAAADYv8WvAAAAD0lEQVR42mP8X8AwAgiABKBAv+vAXklAAAAAElFTkSuQmCC data-src=https:reader033vdocumentssitereader033viewer20220421105e8b207a36460f7d7b21089ehtml5thumbnails50jpg width=140 height=200 divdiv