The Fairway Agency, Inc.

HELPFUL LINKS AND RESOURCES

Forms

ACORD 130 Application
Sample No-Loss Letter
Sample Opt-In letter for Sole Proprietors
DIA Form 153 (Corporate Officer Opt-Out)

Useful Websites and resources

MA Workers Compensation Bureau
(617) 439-9030
https://www.wcribma.org/mass/

MA Division of Insurance
(617) 521-7794
www.state.ma.us/doi.home.html

Department of Industrial Accidents (DIA)
(800) 323-3249
www.mass.gov/dia/

Massachusetts Independent Agent Association
(800) 870-7091
www.massagent.com

National Council on Compensation Insurance, Inc.
800-688-4123
www.ncci.com

Independent Insurance Agents & Brokers of New Hampshire
800-559-3373
www.iiaba.net

New Hampshire Insurance Department
800-852-3416
www.nh.gov/insurance

New Hampshire Department of Labor
603-271-3176
www.labor.state.nh.us

AIM Mutual Insurance Company
800-876-2765
www.aimmutual.com