If the insurance carrier gave notice of cancellation or nonrenewal, did the district, prior to the effective date of the cancellation or nonrenewal of a policy, file a certificate with the Commission designating the new insurance carrier or other satisfactory proof of compliance?
If the district is self-insured, does the district on or before March 31 of each year, pay a tax of three percent of the premiums which would have been paid if the district had been fully insured under a plan available from the State Compensation Fund during the preceding calendar year? (Not less than $250.)
[ ] Yes [ ]No
Ars† 23-962 insurance by governmental units in state compensation fund; payment of premiums
If the school district insures its workers' compensation with the State Compensation Fund:
1. Does the district furnish quarterly to the State Compensation Fund a true payroll showing the total amount paid to employees segregated in accordance with the requirements of the State Compensation Fund?
2. Does the superintendent prepare and submit to the Governing Board for approval, a claim for the amount of premiums due the State Compensation Fund and are such premiums paid at once by the proper officer of the district?
[ ] Yes [ ]No
Ars† 23-964 posting notice of compliance with compensation law
Has the Governing Board posted in a conspicuous place typewritten or printed notices stating that the district has complied with the provisions of the Arizona Revised Statutes regarding workers' compensation and all rules and regulations of the Industrial Commission made in pursuance thereof and, if such is the fact, has been authorized by the Commission directly to compensate employees or their dependents?
[ ] Yes [ ]No
Ars† 23-967 deduction of premium from wages or salary; penalty
Any employer who deducts any portion of the premium (workers' compensation) except for accident benefits, which he is by law required to pay, from the wage or salary of an employee is guilty of a petty offense. Is the district in compliance?
[ ] Yes [ ]No
Ars† 23-1001 delivery of insurance contract or policy to employer
If the Governing Board insures for workers' compensation with an insurance carrier, has the district received from such insurance carrier a contract or policy of insurance?
[ ] Yes [ ]No
Ars† 23-1022 compensation as exclusive remedy; definition; exceptions
If an intergovernmental agreement or contract is in effect, does the Governing Board/district post a notice in substantially the following form?
"All employees are hereby further notified that they may be required to work under the jurisdiction or control of or within the jurisdictional boundaries of another public agency pursuant to an intergovernmental agreement or contract, and under such circumstances they are deemed by the laws of Arizona to be employees of both public agencies for the purposes of workers' compensation."
[ ] Yes [ ]No
Ars† 23-1047 procedure for determining cooperation for partial disability and permanent total disability in cases not enumerated; procedure for determining nonscheduled dependency and duration of compensation to partial dependents in death cases
A person receiving permanent compensation benefits must report annually on the anniversary date of the award all earnings for the prior 12-month period. Governing Board is a self-insured employer, does the district notify such person that such report has not been received, if such is the case, and that payment of further benefits will be suspended unless such report of earnings is filed within thirty days?
[ ] Yes [ ]No
Ars† 23-1061 for compensation; reopening; payment of compensation
Within ten days after receiving notice of an accident, does the Governing Board inform the insurance carrier and the Industrial Commission on such forms as may be prescribed by the Commission?
[ ] Yes [ ]No
Ars† 23-1361 blacklist defined; exceptions; privileged communications
A school district may lawfully provide information to a requesting employer concerning a person's education, training, experience, qualifications and job performance to be used for the purpose of evaluating the person for employment. Does the district send a copy of any such written communications to the former employee's last known address?
[ ] Yes [ ]No