CA State Fund Protects People Who Make California Work 

Workers Compensation Product

• Guaranteed Cost

Announcements

Recent marketing or articles shared with our retail agents.

If you are interested in reading some of the latest safety news, covering a wide range of safety topics to help prevent injuries, please visit the State Fund website.

Class or Industry Specific Questionnaires

• Agriculture/Farming Industry –Questionnaire 
• Automotive Services Industry –Questionnaire
• Construction Industry –Questionnaire
• Health & Human Services Industry – Questionnaire
• Hotel/Motel Industry – Questionnaire 
• Janitorial Industry – Questionnaire
• Landscape Industry – Questionnaire
• Manufacturing Industry – Questionnaire
• Marijuana/Cannabis – Questionnaire
• Rental Property Owner/Operator – Questionnaire
• Restaurant Industry – Questionnaire
• Roofing - Questionnaire
• Towing Industry – Questionnaire
• Trucking No Subhauler Industry – Questionnaire
• Trucking Industry - Questionnaire
• Private Residence Employees - Pre-Coverage Questionnaire

Submission Requirements

• Workers’ Comp Application - ACORD 130
• Access State Fund Supplemental Application
• Accurate payroll estimates per location
• Detailed description of operations
• Prior 4 years payroll and premium totals
• 4 years of loss runs (valued within 100 days of proposed inception date)
• Complete ownership (officer name, title, stock percentages if applicable)
• Licensing information (CSLB, DMV/MCP, PUC, FLC, ICC)

Submit completed applications to asfnewbusiness@amwins.com

Have a Question?

Get in touch at 1-888-693-7892.