workers’ E-COMP – Payroll and Workers’ Compensation ... · (f Heartland OVATION PAYROLL ....
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Company Name Address City State Zip Phone Fax Contact Name email Years in Business FEIN Entity Type (Corp/Partnership/Individual) Type of Business/Description of Operations Current Workers Comp Insurance Carrier Renewal Date Payroll Client # Payroll Rep Phone Number/email Number of Employees (Full Time/Part Time) Any losses during the last 5 years? Class Code Estimated Annual Payroll Class Code Estimated Annual Payroll Payroll Frequency 1st Check Date 25% Minimum No Deposit/No Down Payment Estimated, based on projected payroll (usually underestimated Monthly/quarterly audit reports to complete Year-end on site or phone audit, documentation required, additional premium due or refund Deposit/ Down Payment Premium Reports Audit multiple carriers, expertise and exceptional service all in one place. www.ecomp.us 888-493-2667 License #OC41366 audit adjustment and no additional paperwork (unless state or carrier mandated) E-COMP – Payroll and Workers’ Compensation In One Integrated, Pay-As-You-Go Program workers’ compensation Traditional Workers' Comp. (The Old Way) Pay-As-You-Go Workers' Comp. (The New Way) Fax to 888-738-9097 or E-mail to [email protected]
Transcript of workers’ E-COMP – Payroll and Workers’ Compensation ... · (f Heartland OVATION PAYROLL ....
Company Name
Address
City State Zip
Phone Fax
Contact Name email
Years in Business FEIN
Entity Type (Corp/Partnership/Individual)
Type of Business/Description of Operations
Current Workers Comp Insurance Carrier
Renewal Date Payroll Client #
Payroll Rep Phone Number/email
Number of Employees (Full Time/Part Time)
Any losses during the last 5 years?
Class Code Estimated Annual Payroll
Class Code Estimated Annual Payroll
Payroll Frequency 1st Check Date
25% Minimum No Deposit/No Down Payment
Estimated, based on projected payroll(usually underestimated
Monthly/quarterly audit reports to complete
Year-end on site or phone audit, documentation required, additional premium due or refund
Deposit/Down Payment
Premium
Reports
Audit
multiple carriers, expertise and exceptional service all in one place.
www.ecomp.us888-493-2667
License #OC41366
audit adjustment and no additional paperwork (unless state or carrier mandated)
E-COMP – Payroll and Workers’ Compensation In One Integrated, Pay-As-You-Go Program
workers’compensation
Traditional Workers' Comp.(The Old Way)
Pay-As-You-Go Workers' Comp.(The New Way)
Fax to 888-738-9097or
E-mail to [email protected]
