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"All employees are hereby notified that in the event they do not specifically reject the provisions of the compulsory compensation law they are deemed by the laws of Arizona to have accepted the provisions of such law and to have elected to accept compensation under the terms of such law and that under the terms thereof, employees have the right to reject the same by written notice thereof prior to any injury sustained and that blanks and forms for such notice are available to all employees at the office of this company?"
If an employee rejects the compulsory compensation law by a notice in writing, given to the district in duplicate, signed and dated, does the district within five days file with the insurance carrier the notice so served by the employee?
[ ] Yes [ ]No
Does the Governing Board file with the Industrial Commission and the district's insurance carrier at the time and in the form and detail the Commission prescribes, a full and complete report of every known injury to an employee arising out of or in the course of employment and resulting in injury or loss of life?
Within ten days after receiving notice of an accident, did the Governing Board inform the district insurance carrier and the Industrial Commission on such forms and in such manner as may be prescribed by the Commission?
Does the district immediately upon notice of an accident resulting in an injury to an employee provide the employee with the name and address of the district's insurance carrier, the policy number and expiration date?
[ ] Yes [ ]No
Does the Governing Board ensure that all books, records and payrolls showing or reflecting the wage expenditure of the district are always open for inspection by the Industrial Commission or its assistants to ascertain information necessary for its administration of the law?
[ ] Yes [ ]No
Has the district secured workers' compensation for the employees in one of the following ways:
1. By ensuring and keeping insured the payment of such compensation with the State Compensation Fund or an insurance carrier authorized to write workers' compensation insurance in this state?
2. By furnishing satisfactory proof of financial ability to pay direct the compensation in the amount and manner and when due, as required?
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