|NAME||OOPS WORKERS COMP|
The Supervisor signed the CA1/CA2 for the following incident on |4|: Date of Incident: |3| Case #: |2| Note to Supervisor: The CA1/CA2 must be electronically signed by the employee and supervisor. Then a copy of the CA1/CA2 must be printed out, hand-signed and dated in blue ink, and sent to the Worker's Compensation Manager's Office.
|SUBJECT||Worker's Comp Notification|
This bulletin will be sent to the Workers Comp personnel when the Supervisor has signed the CA1/CA2 claim.