STAFFING
SUPPLEMENTAL

Please provide a breakdown of Hazard Groups based on class codes utilized during the year prior to this submission:

Hours of operation:

It is a crime to knowingly provide false, incomplete or misleading information to any party to a workers’ compensation transaction for the purpose of committing fraud. Penalties include imprisonment, fines, and denial of insurance benefits. Any person who knowingly, and with intent to defraud any insurance company or another person, files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects the person to criminal and civil penalties.

By signing this document you are authorizing Diamond PEO Company to request and be furnished Experience Modification Worksheet(s)/Risk Snapshot(s), from NCCI, relating to the entity named above.

LOCATION DETAILS CLICK HERE

Los Angeles Office
1701 South Figueroa 1094
Los Angeles, CA 90015

New York Office
1145 1280 Lexington Ave STE 2
New York, NY 10028

Florida Office
6421 N. Florida Ave D-1537
Tampa, FL 33604

North Carolina Office
801 E Morehead St Ste 105 3647
Charlotte, NC 28202

North Carolina Office
4214 West Wendover Ave. 1205
Greensboro, NC 27407

Working with a Professional Employer Organization (PEO) brings expert value to your business in the areas of Human Resources, Payroll, Employee Benefits, and Risk Management. Diamond PEO takes on the administrative responsibilities of your company for you.

ADDRESS

27442 Calle Arroyo, Cottage 45
San Juan Capistrano, CA 92675

PHONE

SOCIAL MEDIA


Working with a Professional Employer Organization (PEO) brings expert value to your business in the areas of Human Resources, Payroll, Employee Benefits, and Risk Management. Diamond PEO takes on the administrative responsibilities of your company for you.

ADDRESS

27442 Calle Arroyo,
Cottage 45
San Juan Capistrano,
CA 92675

PHONE

SOCIAL MEDIA