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11 <br />C; <br />54 <br />Bureau of Workers' 30 W. Spring St. <br />Ohio Compensation Columbus, OH 43215 <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 />01457498 07/01/2020 to 07/01/2021 <br />KOVACHY SALES INC <br />CITY WIDE MAINTENANCE OF CLEVELAND a <br />711 W BAGLEY RD <br />BEREA, OH 44017-2952 # <br />:e <br />www.bwc.ohio.gov <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 />OhioBureau of Workers' <br />Compensation You must post this language with the Certificate of Ohio Workers' Compensation. <br />DP -29 BWC-1629 (Rev. Jan. 10, 2019) <br />