BWC_July_2025_to_June_2026__1_.pdf
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- Attached to
- Agency Administered OH|429-26-3365
- Contract number
- 429-26-3365
- Issued by
- Ohio
About this file
This document is a Certificate of Ohio Workers' Compensation issued by the Ohio Bureau of Workers' Compensation (BWC) located in Columbus, Ohio. The certificate is for an individual employer, Jamal Naiyer from Dublin, Ohio, with policy number 01622329, and validates the employer's participation in the Ohio State Insurance Fund for the period from 07/01/2025 to 07/01/2026.
The certificate confirms the employer's compliance with state workers' compensation requirements, providing rights and benefits under the fund, contingent upon timely premium and assessment payments. The document includes a required posting that explains the legal concept of "rebuttable presumption" regarding work-related injuries, specifically addressing situations involving alcohol, marijuana, or controlled substances. The certificate is valid for verification of coverage and must be conspicuously posted, with the option to reproduce as needed. Verification of coverage can be done online at www.bwc.ohio.gov or by calling 1-800-644-6292.
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Text version
Bureau ofWorkers Compensation
Certificate of Ohio Workers' Compensation
30 W. Spring St.
Columbus, OH 43215
This certifies that the employer listed below participates in the Ohio State Insurance Fund as required by law.
Therefore, the employer is entitled to the rights and benefits of the fund for the period specified. This certificate is only valid if premiums and assessments, including installments, are paid by the applicable due date. To verify coverage, visit www.bwc.ohio.gov, or call 1-800-644-6292.
This certificate must be conspicuously posted.
Policy number and employer 01622329
JAMAL NAIYER
4924 STERLING VWOODS CT.
DUBLIN OH 43016
www.bwc.ohio.gov Issued by: BWC
Period Specified Below 07/01/2025 to 07/01/2026
Skghani ttloud Administrator/CEO
You cen reproduce this certificate as needed.
Ohio Bureau of Workers' Compensation
Required Posting Section 4123.54 of the Ohio Revised Code requires notice of rebuttable presumption. Rebuttable presumption means an employee may dispute or prove untrue the presumption (or belief) that alcohol, marihuana or a controlled substance not prescribed by the employee's physician is the proximate cause (main reason) of the work-related injury.
The burden of proof is on the employee to prove the presence of alcohol, marihuana or a controlled substance was not the proximate cause of the work-related injury. An employee who tests positive or refuses to submit to chemical testing may be disqualified for compensation and benefits under the Workers' Compensation Act.
Bureau ofWorkers' Compensation
DP-29 BWC-1629 (Rev. Jan. 10, 2019)
You must post this language with the Certificate of Ohio Workers' Compensation.
File details come from the government source that posted it. Updated .