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[A <br />4 <br />i Bureau of Workers' 30 W. Spring St. <br />Ohio j Compensation Columbus, OH 43215 <br />i <br />Certificate of Ohio Workers' Compensation <br />This certifies that the employer listed below participates in the Ohio State Insurance Fund as required by law. <br />Therefore, the employer is entitled to the rights and benefits of the fund for the period specified. This certificate <br />is only valid if premiums and assessments, including installments, are paid by the applicable due date. To <br />verify coverage, visit www.bwc.ohio.gov, or call 1-800-644-6292. <br />This certificate must be conspicuously posted. <br />Policy number and employer Period Specified Below <br />01123710 07/01/2019 to 07/01/2020 <br />LICURSI GARDEN CNETER INC <br />8265 CHARDON RD <br />KIRTLAND, OH 44094 <br />wL <br />www.bwc.ohio.gov z <br />Issued by: BWC: <br />Administrator/CEO <br />You can reproduce this certificate as needed. <br />Ohio Bureau of Workers' Compensation <br />Required Posting <br />Section 4123.54 of the Ohio Revised Code requires notice of <br />rebuttable presumption. Rebuttable presumption means an <br />employee may dispute or prove untrue the presumption (or <br />belief) that alcohol, marihuana or a controlled substance not <br />prescribed by the employee's physician is the proximate cause <br />(main reason) of the work-related injury. <br />The burden of proof is on the employee to prove the presence of <br />alcohol, marihuana or a controlled substance was not the <br />proximate cause of the work-related injury. An employee who <br />tests positive or refuses to submit --to chemical testing may be <br />disqualified for compensation and benefits under the Workers' <br />Compensation Act. <br />Bureau of Workers' <br />Ghia iCompensation You must post this language with the <br />Certificate of Ohio Workers' Compensation. <br />DP -29 BWC-1629 (Rev. Jan. 10, 2019) <br />