Self-Insured Construction Project Application {BWC-7250}

BWC-7250 / SI-50 - SELF-INSURED CONSTRUCTION PROJECT APPLICATION. This form is used by a self-insured employer to apply for approval from the Bureau of Workers' Compensation (BWC) to administer workers' compensation coverage for a specific construction project under a self-insured wrap-up program. The application requires details about the project, including its scope, estimated cost, contractor and subcontractor participation, claims administration process, safety plan, and payroll tracking method. The self-insured employer must also certify the accuracy of the information provided and comply with reporting requirements. www.FormsWorkflow.com