Signing this release allows the Building Industry Association of Washington (BIAW) to contact anyone at the above-listed company via mail, email, and phone for any BIAW-related matters.
I authorize L&I to provide my company’s premium, claims history, experience modification factor, and related industrial data, including all sub-accounts tied to the policy, whether inactive or active, to BIAW, along with access to L&I's online Claim & Account Center.
Your signature below verifies this authorization. Please sign the box using your mouse, finger, or stylus.