| Entity Name: | FRSA SELF INSURERS FUND, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 26 Mar 2014 (11 years ago) |
| Document Number: | P14000027822 |
| FEI/EIN Number | 46-5263150 |
| Address: | 4099 METRIC DRIVE, WINTER PARK, FL, 32792, US |
| Mail Address: | 4099 METRIC DRIVE, WINTER PARK, FL, 32792, US |
| ZIP code: | 32792 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SAFE-HARBOR 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF FRSA SELF INSURERS FUND, INC. | 2023 | 465263150 | 2024-10-14 | FRSA SELF INSURERS FUND, INC. | 17 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-14 |
| Name of individual signing | MICHAEL RICKER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-11-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 4076713772 |
| Plan sponsor’s address | 4099 METRIC DR, WINTER PARK, FL, 327926804 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-05 |
| Name of individual signing | MICHAEL RICKER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-11-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 4076713772 |
| Plan sponsor’s address | 4099 METRIC DR, WINTER PARK, FL, 327926804 |
Signature of
| Role | Plan administrator |
| Date | 2022-04-18 |
| Name of individual signing | MICHAEL RICKER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-11-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 4076713772 |
| Plan sponsor’s address | 4099 METRIC DR, WINTER PARK, FL, 327926804 |
Signature of
| Role | Plan administrator |
| Date | 2021-02-24 |
| Name of individual signing | MICHAEL RICKER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-11-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 4076713772 |
| Plan sponsor’s address | 4099 METRIC DR, WINTER PARK, FL, 327926804 |
Signature of
| Role | Plan administrator |
| Date | 2020-07-17 |
| Name of individual signing | MICHAEL RICKER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-11-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 4076713772 |
| Plan sponsor’s address | 4099 METRIC DR, WINTER PARK, FL, 327926804 |
Signature of
| Role | Plan administrator |
| Date | 2019-10-07 |
| Name of individual signing | MICHAEL RICKER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-11-01 |
| Business code | 524290 |
| Sponsor’s telephone number | 4076713772 |
| Plan sponsor’s address | 4099 METRIC DR, WINTER PARK, FL, 327926804 |
Signature of
| Role | Plan administrator |
| Date | 2018-04-25 |
| Name of individual signing | MICHAEL RICKER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-11-01 |
| Business code | 524290 |
| Sponsor’s telephone number | 4076713772 |
| Plan sponsor’s address | 4099 METRIC DR, WINTER PARK, FL, 327926804 |
Signature of
| Role | Plan administrator |
| Date | 2017-07-24 |
| Name of individual signing | MIKE RICKER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-11-01 |
| Business code | 524290 |
| Sponsor’s telephone number | 4076713772 |
| Plan sponsor’s address | 4099 METRIC DR, WINTER PARK, FL, 327926804 |
Signature of
| Role | Plan administrator |
| Date | 2016-07-06 |
| Name of individual signing | MIKE RICKER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ROBINSON JOHN DESQ | Agent | 201 E PINE ST, ORLANDO, FL, 32801 |
| Name | Role | Address |
|---|---|---|
| GUIDRY DEBBIE | President | 4099 METRIC DR, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| RICKER MICHAEL | Secretary | 4099 METRIC DR, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| RICKER MICHAEL | Treasurer | 4099 METRIC DR, WINTER PARK, FL, 32792 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000022568 | FLORIDA ROOFING & SHEET METAL ASSOCIATION SIF | ACTIVE | 2022-02-23 | 2027-12-31 | No data | 4099 METRIC DR, WINTER PARK, FL, 32792 |
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| Travis Lamone Benjamin, Appellant(s) v. FRSA Self Insurers Fund, Inc., Sheet Metal Masters, Appellee(s). | 1D2022-3843 | 2022-12-01 | Closed | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Name | Travis Lamone Benjamin |
| Role | Appellant |
| Status | Active |
| Name | FRSA SELF INSURERS FUND, INC. |
| Role | Appellee |
| Status | Active |
| Name | SHEET METAL MASTERS, LLC |
| Role | Appellee |
| Status | Active |
| Representations | Barbara E. Fox, Barbara J. Glas |
| Name | Jonathan E. Walker |
| Role | Judge of Compensation Claims |
| Status | Active |
| Name | Hon. David W. Langham |
| Role | Judge of Compensation Claims |
| Status | Active |
| Name | Julie Hunsaker WC |
| Role | Lower Tribunal Clerk |
| Status | Active |
Docket Entries
| Docket Date | 2023-07-05 |
| Type | Misc. Events |
| Subtype | Miscellaneous Docket Entry |
| Description | Miscellaneous Docket Entry |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2023-05-10 |
| Type | Disposition by Order |
| Subtype | Dismissed |
| Description | Pursuant to Appellant's notices of voluntary dismissal, the Court dismisses the case pursuant to Florida Rule of Appellate Procedure 9.350(b). The Court denies all pending motions as moot. RAY, KELSEY, and M.K. THOMAS, JJ., concur. |
| View | View File |
| Docket Date | 2023-03-24 |
| Type | Motions Other |
| Subtype | Motion/Notice Voluntary Dismissal |
| Description | Motion/Notice Voluntary Dismissal |
| On Behalf Of | Jonathan E. Walker |
| Docket Date | 2023-03-08 |
| Type | Motions Other |
| Subtype | Motion/Notice Voluntary Dismissal |
| Description | Motion/Notice Voluntary Dismissal |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2023-02-21 |
| Type | Motions Other |
| Subtype | Motion/Notice Voluntary Dismissal |
| Description | Motion For Voluntary Dismissal |
| On Behalf Of | Jonathan E. Walker |
| Docket Date | 2023-02-21 |
| Type | Misc. Events |
| Subtype | Miscellaneous Docket Entry |
| Description | Miscellaneous Docket Entry ~ filed with motion for voluntary dismissal |
| On Behalf Of | Jonathan E. Walker |
| Docket Date | 2023-02-13 |
| Type | Record |
| Subtype | Record on Appeal |
| Description | Received Records ~ 233 pages |
| Docket Date | 2023-02-03 |
| Type | Misc. Events |
| Subtype | Miscellaneous Docket Entry |
| Description | Miscellaneous Docket Entry |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2023-02-03 |
| Type | Motions Relating to Oral Argument |
| Subtype | Motion/Request for Oral Argument |
| Description | Motion For Oral Argument |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2023-02-01 |
| Type | Motions Other |
| Subtype | Miscellaneous Motion |
| Description | Motion (Other) |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2023-02-01 |
| Type | Order |
| Subtype | Order Striking Filing |
| Description | Strike Motion Because . . . ~ The Court strikes Appellant’s January 9, 2023, motion. This cause will proceed. |
| Docket Date | 2023-01-30 |
| Type | Misc. Events |
| Subtype | Certificate of Service |
| Description | Supplemental Certificate of Service |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2023-01-10 |
| Type | Order |
| Subtype | Order Directing Service of Filing |
| Description | AA/PT Serve Filing/File Supp Cert of Svc 10 days-Rule Att ~ Appellant is directed to serve a copy of the motion docketed January 9, 2023, on counsel for Appellee, and to file a supplemental certificate of service within 10 days of this order which demonstrates that service. A copy of Florida Rule of Appellate Procedure 9.420, which governs certificates of service, is attached to Appellant's copy of this order. The failure of Appellant to timely comply with this order will result in striking of the motion, as authorized by Florida Rule of Appellate Procedure 9.410(a). |
| Docket Date | 2023-01-09 |
| Type | Motions Other |
| Subtype | Miscellaneous Motion |
| Description | Motion (Other) |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2022-12-22 |
| Type | Notice |
| Subtype | Amended Notice of Appeal |
| Description | Amended Notice of Appeal |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2022-12-21 |
| Type | Misc. Events |
| Subtype | Determination of Indigency/LT Order Insolvency |
| Description | Insolvency/Indigency Order from Lower Tribunal ~ order granting relief from paying costs |
| On Behalf Of | Jonathan E. Walker |
| Docket Date | 2022-12-19 |
| Type | Misc. Events |
| Subtype | Docketing Statement |
| Description | Docketing Statement |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2022-12-19 |
| Type | Notice |
| Subtype | Notice of Appeal |
| Description | Notice of Appeal Filed ~ paper/copy of order appealed attached |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2022-12-09 |
| Type | Brief |
| Subtype | Initial Brief |
| Description | Initial Brief on Merits |
| On Behalf Of | Travis Lamone Benjamin |
| Docket Date | 2022-12-07 |
| Type | Order |
| Subtype | Order to Register/Update eDCA |
| Description | Acknowledgment of Service List ~ The Notice of Appearance and Designation of E-Mail Address filed by counsel for the Appellee, Sheet Metal Masters/FRSA Self Insurers Fund, Inc., on December 6, 2022, providing e-mail addresses, is acknowledged. However, in addition to filing such notice, counsel of record are responsible for ensuring their primary and/or secondary e-mail addresses under their profile in the Florida Courts E-Filing Portal and eDCA are consistent with the filed notice in order to receive e-mailed notification (Casemail) from the court. Profiles for eDCA users may be updated by clicking on the “My Profile” link and clicking the “Submit” button after making the desired changes. |
| Docket Date | 2022-12-06 |
| Type | Notice |
| Subtype | Notice of Appearance |
| Description | Notice of Appearance ~ and designation of email address |
| On Behalf Of | Sheet Metal Masters |
| Docket Date | 2022-12-02 |
| Type | Letter |
| Subtype | Acknowledgment Letter |
| Description | Worker's Compensation / Acknowledgement letter ~ The First District Court of Appeal has received the Notice of Appeal in this Workers’ Compensation action, filed in this Court on December 1, 2022, and in the lower tribunal on November 30, 2022. |
| Docket Date | 2022-12-02 |
| Type | Order |
| Subtype | Order on Filing Fee |
| Description | Appeal-Pay Fee/Submit LT Ord of Insolv ($300) ~ Appellant has filed a notice of appeal in the lower tribunal without the entry of an order of insolvency or deposit of the statutory filing fee. Accordingly, Appellant shall, within 30 days from the date of this order, either file a certified copy of the lower tribunal's order of insolvency for appellate purposes as required by Florida Rule of Appellate Procedure 9.430 or pay to the clerk of this Court the sum of $300.00 as the appellate filing fee required by the applicable rule of procedure and Section 35.22(2)(a), Florida Statutes (2018). If Appellant seeks a waiver of the filing fee on the grounds of indigency, Appellant shall file a motion and affidavit of indigency with the clerk of the lower tribunal (the court, agency, officer, board, commission, or body whose order is to be reviewed) for a determination by the lower tribunal of whether an order of insolvency should be issued pursuant to Rule 9.430 and Section 57.081(1) or 57.085(2), Florida Statutes (2018), as applicable.This appeal shall not proceed until the order of insolvency is filed or the fee is paid. Failure to comply with this order will result in the dismissal of this case without further opportunity to be heard. Florida Rule of Appellate Procedure 9.410. |
| Docket Date | 2022-12-01 |
| Type | Notice |
| Subtype | Notice of Appeal Transmittal Form |
| Description | Notice of Appeal Transmittal Form |
| On Behalf Of | Jonathan E. Walker |
| Docket Date | 2022-12-01 |
| Type | Misc. Events |
| Subtype | Order Appealed |
| Description | Order Appealed |
| On Behalf Of | Jonathan E. Walker |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-01-28 |
| AMENDED ANNUAL REPORT | 2021-12-17 |
| ANNUAL REPORT | 2021-01-15 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-02-05 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-03-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
