CertMonster

Subcontractor Coverage Audit Packet

Prepared for your workers' comp premium audit

SAMPLE

ContractorHarbor Point Builders LLC

Audit period03/01/2025 to 03/01/2026

Contractor's WC policyWC-000-1234567

StateFlorida

Packet prepared03/09/2026

Reviewed byJ. Rivera, policy admin

Summary

4Covered the whole period

1Valid exemption

1Gap in coverage

1No coverage found

7 subcontractors paid during the audit period. Payment totals come from the contractor's records. Coverage was confirmed against each sub's certificate and the state's proof of coverage records.

Subcontractor list

Subcontractor	Trade (class)	Paid in period	Coverage in period	Status
Bayline Plumbing LLC	Plumbing (5183)	$84,200	Full period	Covered
Coastal Air Pros Inc	HVAC (5537)	$61,750	Full period	Covered
Greenway Landscape Co	Landscaping (0042)	$22,400	Full period	Covered
Keystone Roofing LLC	Roofing (5551)	$47,900	Full period	Covered
R&J Electric LLC	Electrical (5190)	$18,300	Officer exemption, no employees	Exempt
Tri-County Concrete Inc	Concrete (5221)	$39,600	Lapsed 08/14 to 09/02/2025	Gap
Sunstate Drywall	Drywall (5445)	$27,500	None found	Not covered

Proof for each subcontractor

Bayline Plumbing LLCCovered

InsurerExample Mutual Insurance Co. Policy numberWC-555-0192 Policy dates01/15/2025 to 01/15/2026, renewed to 01/15/2027 CertificateACORD 25 received 03/03/2025 and 01/20/2026 (Appendix A-1, A-2) State record checkFlorida proof of coverage records: active policy found, checked 03/09/2026 9:42 AM ET (Appendix A-3) NotesNamed insured and FEIN on the certificate match the state record.

R&J Electric LLCExempt

ExemptionConstruction officer exemption for R. Jimenez, valid 05/2024 to 05/2026 State record checkFlorida exemption records: active, checked 03/09/2026 9:44 AM ET (Appendix E-1) EmployeesSub signed a statement of no employees on 03/05/2025 (Appendix E-2) NotesAn exemption covers the officer only. If this sub had employees, the auditor may charge their payroll.

Tri-County Concrete IncGap

InsurerExample Casualty Co. Policy numberWC-777-4410 What happenedCancelled for non-payment 08/14/2025, reinstated 09/02/2025 State record checkFlorida proof of coverage records show the cancellation and reinstatement, checked 03/09/2026 9:47 AM ET (Appendix G-1) Paid during the gap$6,200 (invoices 1182 and 1190, from contractor records) NotesThe auditor may treat payments made during the gap as uninsured labor.

Sunstate DrywallNot covered

CertificateRequested 3 times (02/10, 02/17 and 02/24/2026). None received. State record checkNo policy or exemption found under the business name or FEIN, checked 03/09/2026 9:51 AM ET (Appendix N-1) NotesExpect the auditor to include these payments in your payroll unless proof of coverage turns up.

The full packet has one section like this for every subcontractor, plus an appendix with each certificate and a dated screenshot of each state record.

How this packet was prepared

Certificates came from the subcontractors, by upload, text or email. Each one was checked against the state's public proof of coverage and exemption records on the date and time shown. Payment amounts come from the contractor's own records. A CertMonster reviewer checked every entry before the packet was issued.

Reviewed by (CertMonster)

Date

This packet is a record of the certificates and public records we reviewed. It is not an insurance policy, does not change any coverage, and does not guarantee the result of an audit. Your insurance company's auditor decides what proof to accept. State records can be delayed or incomplete. CertMonster is a service of Vesper Risk.