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Certificate of Insurance ISSUING A CERTIFICATE OF INSURANCE '0 MATRI 4neSource A Vensure Employer Services Compare 1. MatrixOneSource does NOT release a Certificate of Insurance until you pick up your first payroll from us. For example, if you call in your payroll on Wednesday, and pick up the payroll on Friday, MatrixOneSource sends the Certificate out on Friday, not Wednesday. 2. If you need a certificate sent out prior to picking up your first payroll, the only way we can make this happen is to collect a non-refundable, pre -payment on your fifth scheduled payroll; we will need the pre -payment to be certified funds. When you run your fifth scheduled payroll the pre -payment depos it will be applied, if you do not run your fifth scheduled payroll the deposit is non-refundable. 3. Even with a pre -payment on payroll, we need 72 hours to process the request and send the Certificate out; we also limit the initial number of Certificates to one, additional Certificates can be requested as soon as you start running your payroll. 4. After you are in our system and running payroll, Certificates can be requested by faxing in the request form, or by calling your payroll representative. CANCELLATION OF YOUR CERTIFICATE OF INSURANCE 1. If you stop running payroll through MatrixOneSource, we will cancel any outstanding Certificates retroactive to the last date that your company ran payroll through us. 2. All companies that you are working with are notified of the cancellation immediately. 3. Remember, MatrixOneSource covers your employees, NOT your company for Workers Compensation Insurance, coverage is only in place on employees that are leased back from MatrixOneSource. If you are not running payroll, you are not leasing your employees, as a result there is no coverage and the Certificate will be cancelled. Client Signature: Sales Rep Signature: MOSFORM-FULLPEOENROLLMENTPACK 19 02020 MatrixOneSource