Membership Application & Indemnity AgreementMembership Application & Indemnity Agreement • November 11th, 2011
THIS APPLICATION AND INDEMNITY AGREEMENT (the “Agreement”), dated effective as of the date of acceptance by the administrator as set forth below, is made by and between Massachusetts Trade Self-Insurance Group, Inc., a Massachusetts nonprofit corporation, (the “Group”), and the undersigned employer located in the Commonwealth of Massachusetts, (the “Member”).
Massachusetts Retail MerchantsMembership Application & Indemnity Agreement • December 7th, 2017
for your workers’ compensation coverage. Enclosed you will find the information and forms necessary to complete your application.
BEWBCMembership Application & Indemnity Agreement • January 7th, 2015
