Florida Regulations 69H-1.003: Certificate and Other Forms Adopted
Current as of: 2020 |
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(1) The Department hereby adopts and incorporates by reference a Certificate of Coverage and the other forms in paragraphs (a) through (i), below, for use in the State Risk Management Trust Fund, State Property Claims.
(a) Form DFS-D0-850, Coverage Request Form, rev. 7/10.
(b) Form DFS-D0-851, Replacement Value Computation: Building Contents, rev. 8/09.
(c) Form DFS-D0-852, Certificate of Property Coverage, rev. 11/05.
(d) Form DFS-D0-853, Certificate of Rental Value Coverage, rev. 11/05.
(e) Form DFS-D0-854, Notice of Property Loss, rev. 8/09.
(f) Form DFS-D0-855, Statement — Lightning Losses, rev. 11/05.
(g) Form DFS-D0-856, Certificate of Proof of Loss, rev. 11/05.
(h) Form DFS-D0-857, Building Values Worksheet, rev. 8/09.
(i) Form DFS-D0-1391, Total Loss Contents — ACV Worksheet, rev. 11/05.
(2) Copies of each of the forms incorporated by reference in this rule are available from the Division of Risk Management, Department of Financial Services, Larson Building, Tallahassee, Florida 32399-0336.
Rulemaking Authority 284.17 FS. Law Implemented 255.03(1), 284.01 FS. History—New 7-29-72, Formerly 4-29.04, 4-29.004, Amended 1-7-92, 10-3-94, 12-27-95, 6-21-01, Formerly 4H-1.003, Amended 7-23-06, 1-9-11.
(a) Form DFS-D0-850, Coverage Request Form, rev. 7/10.
(b) Form DFS-D0-851, Replacement Value Computation: Building Contents, rev. 8/09.
(c) Form DFS-D0-852, Certificate of Property Coverage, rev. 11/05.
(d) Form DFS-D0-853, Certificate of Rental Value Coverage, rev. 11/05.
(e) Form DFS-D0-854, Notice of Property Loss, rev. 8/09.
(f) Form DFS-D0-855, Statement — Lightning Losses, rev. 11/05.
(g) Form DFS-D0-856, Certificate of Proof of Loss, rev. 11/05.
(h) Form DFS-D0-857, Building Values Worksheet, rev. 8/09.
(i) Form DFS-D0-1391, Total Loss Contents — ACV Worksheet, rev. 11/05.
(2) Copies of each of the forms incorporated by reference in this rule are available from the Division of Risk Management, Department of Financial Services, Larson Building, Tallahassee, Florida 32399-0336.
Rulemaking Authority 284.17 FS. Law Implemented 255.03(1), 284.01 FS. History—New 7-29-72, Formerly 4-29.04, 4-29.004, Amended 1-7-92, 10-3-94, 12-27-95, 6-21-01, Formerly 4H-1.003, Amended 7-23-06, 1-9-11.