1. (1) Applicants for a certificate of authority as a commercial self-insurance fund pursuant to section 624.462, F.S., shall comply with the directions on, or otherwise submit, the following applicable forms:

   1. (a) Form OIR-C1-845, “Application for Certificate of Authority Commercial Self-Insurance Fund,” incorporated by reference in Rule 69O-136.100, F.A.C.;
   2. (b) Form OIR-C1-144, “Service of Process Consent & Agreement,” incorporated by reference in Rule 69O-136.100, F.A.C.;
   3. (c) Form OIR-C1-1416, “Uniform Certificate of Authority Application (UCAA) Lines of Insurance,” incorporated by reference in Rule 69O-136.100, F.A.C.;
   4. (d) The biographical information package as defined in subsection 69O-136.100(3), F.A.C.; and
   5. (e) Form OIR-C1-2221, “Management Information Form,” incorporated by reference in Rule 69O-136.100, F.A.C.
2. (2) All the forms listed in subsection (1) above may be obtained from the Office’s website at floir.gov and shall be submitted electronically via the Office’s iApply system at floir.gov/iportal. Forms relating to specific kinds of insurance are to be submitted only by companies issuing policies relating to the kind of insurance specified.

Rulemaking Authority 624.308 FS. Law Implemented 624.307(1), 624.34, 624.401, 624.404, 624.407, 624.411, 624.413, 624.414(1), 624.422, 624.466, 624.501, 625.306, 628.041, 628.6011, 628.051, 628.061, 628.071, 628.081, 628.091, 628.121, 628.151, 628.161, 628.171, 628.221, 628.231, 628.251, 628.261, 628.451, 628.461, 628.4615, 628.471, 629.071, 629.081, 629.091, 629.101, 629.121, 629.131, 629.181 FS. History–New 2-26-92, Amended 9-19-00, 11-18-02, Formerly 4-136.011, Amended 1-7-24, 3-31-25, Technical Change 4-15-26.