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In response to the escalation in employment-related litigation, Insured Solutions, Inc. is pleased to provide you with the value added benifit of Employement Practices Liability Insurance. Protect your company against employment-related claims your General liability will not cover, including:
* Wrongful Termination
* Discrimination
* Sexual Harassment
* Work Place Torts
Would you like to add this coverage to your Pay As You Go Workers' Compensation for the low cost of $1.25 per employee, per week? Please note the coverage is voluntary and you may opt out anytime.
Payroll Frequency | Payroll Date: | ||||||
Enter your payroll amounts by Class Code Important: Please include the wages and class codes of the independent contractors paid this pay period below: |
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Enter Gross Regular Payroll Amount: | Rate: | Sub Total: | |||||
Enter Gross Overtime Payroll Amount: | Rate: | Sub Total: | |||||
Enter Gross Double-time Payroll Amount: | Rate: | Sub Total: |
Class Code | State | Payroll Type | Rate | Wages | Sub Total |
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Alternative Workers′ Compensation Coverage using Pay-as-You-Go or Traditional Payment Plans
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Risk Management Services Our loss control managers can provide the following services:
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Optional Payroll Administration Clients can keep their payroll processing in house, use the payroll provider of their choice, or use our payroll services. All of our packages keep the agent involved. Optional payroll processing, checks and distribution:
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How often do you pay your employees? |
Weekly - You pay your employees every week. (Example: Every Friday) |
ACH Terms In consideration of the services provided to me by Insured Solutions, its subsidiaries and/ or assigns (the company). I hereby authorize the company to initiate a debit entry to my account indicated below at the depository financial institution named below, hereinafter called DEPOSITORY, and to debit the same to such account for the amount and frequency listed below. I acknowledge that the origination of ACH transactions or preauthorized draft to my account must comply with the provisions of U.S. law. The specific debits to my account authorized herein may only post on or after today’s date, and in no event may the debit transaction post to my account prior to said date. This authorization is to remain in full force and effect until the company has received written notification from me of termination in such time and in such manner as to afford the cmpany and DEPOSITORY a reasonable opportunity to act. I may only revoke this authorization by contacting the company directly at the address listed above. |