HomeMy WebLinkAbout800042.tiff RESOLUTION
RE: SELF-INSURANCE WORKERS ' COMPENSATION
WHEREAS, the Board of County Commissioners of Weld County,
Colorado, pursuant to Colorado statute and the Weld County Home
Rule Charter, is vested with the authority of administering the
affairs of Weld County, Colorado, and
WHEREAS, the Board of County Commissioners, in acceptance
of the self-insured program on January 15 , 1980, indicated that
they wished to utilize the services of Arthur J. Gallagher and
Company to develop a self-insured workers ' compensation program
beginning January 1, 1981, and
WHEREAS, on April 7, 1980 , the Board of County Commissioners
authorized the submission of an application for the issuance of
a self-insurance permit under the Workers ' Compensation and
Occupational Disease Disability Act, and
WHEREAS, on December 16 , 1980 , the Industrial Commission
of Colorado authorized Weld County to self-insure its workers '
compensation liability for its operation within the State of
Colorado effective January 1, 1981, and
WHEREAS, the Director of Finance and Administration has
recommended to the Board of County Commissioners that protected
self-insurance of workers ' compensation will be in the best
interest of Weld County and be cost effective.
NOW, THEREFORE, BE IT RESOLVED that the Board of County
Commissioners of Weld County, Colorado hereby authorize and
direct the Director of Finance and Administration to implement
a self-insured worker compensation program for Weld County
effective January 1, 1981 in accordance with the terms and con-
ditions of the Resolution dated December 16 , 1980 passed by
the Industrial Commission of Colorado, and
BE IT FURTHER RESOLVED that the Board of County Commissioners
of Weld County, Colorado hereby authorizes the utilization of
Arthur J. Gallagher and Company to implement and administer the
self-insured workers ' compensation program as approved above.
804042
The above and foregoing Resolution was, on motion duly made
and seconded, adopted by the following vote on the 29th day of
December, A.D. , 1980.
i "f� °]e .yE.� BOARD OF COUNTY COMMISSIONERS
ATTEST: r C W T �Cf/64/EP .rv' WELD COUNTY, COLORADO
Weld County Clerk and Recorder ({,i Ql//z
and,Clerk to the Bo d C. W. Kiiirby, /nhairman
-€,R,„,,,,,_ . ,2_,
e__. / Deputy Count Clerk A. Leonard L. Roe,�ff Pro-Tem
APP OV D AS TO FORM: `/ Ct 4
Norman Carlson
"€tS1
County Attorney
L nn ar
ABSENT
June K. Steinmark
DATE PRESENTED: DECEMBER 29 , 1980
STATE OF COLORADO
INDUSTRIAL COMMISSION OF COLORADO Oe.Coto
Department of Labor and Employment y'S.�z=
itis
H
1525 Sherman * f * .
Denver,Colorado 80203 **.,,,s#
Phone (303) 839-2446 *ta76`
Richard D.Lamm,
Governor
December 16, 1980 COMMISSIONERS
Mike L.Baca,Chairman
Richard J.Wise
Harvey L.Rubinstein
Executive Secretary
Donald D. Warden, Director PaulH.leibowitz
Finance and Administration
County of Weld
P.O. Box 758
Greeley, CO 80632
Re: Self—Insurance Resolution and Permit
Colorado — Block No. 978
Dear Mr. Warden:
Enclosed please find sealed Resolution and Permit which
authorizes the County of Weld, State of Colorado, to self—insure
their workmen' s compensation liabilities.
If the Commission can be further assistance, please do
not hesitate to contact us.
inter
,(
Paul H. Leibowitz
Executive Secretar
PHL:mew
Enclosures.
INDUSTRIAL COMMISSION OF COLORADO
1525 Sherman St. •
DENVER, COLORADO 80203
SELF-INSURANCE PERMIT
In consideration of the filing of statements and financial showing satisfactory to the Commission,
made by COUNTY OF WELD, STATE OF COLORADO
of GREELEY,. COLORADO employer, said employer is hereby
granted permission by the Commission to he its own insurance carrier for the payment of the
compensation and benefits provided by the Workmen's Compensation Act of Colorado, Colorado
Occupational Disease Disability Act and Colorado Major Medical Insurance Fund Act, and any
amendments thereto, beginning with the 1st day of January
be continuous until cancelled or v.-reuokXdxXXxXXXXXXXXXXXx ,
19..x1-, and to Fc+YcD WAI*tititxxxXxx xXXxXxxxxxXx xx
DftXXXIc covering the entire operation of said employer within the State of Colorado, including farm
and ranch labor, and all employes not specifically rejecting the Act as provided therein.
This permit is granted subject to the provisions of the Colorado Workmen's Compensation Act,
Colorado Occupational Disease Disability Act, and Colorado Major Medical Insurance Fund Act,
as they now exist or as they may from time to time be amended, and also subject to the Rules,
Regulations and Orders of the Industrial Commission of Colorado as they now exist or may from time
to time be made, altered or amended.
THIS PERMIT IS SUBJECT 'fO REVOCATION OR CANCELLATION• BY TIlE COMMISSION
AT ANY TIME WITIIOU'I' NOTICE.
IN WITNESS WIIEItFOE, The Industrial Commission of Colorado has caused these presents to
be signed by its Chairman and its official seal to he hereunto affixed by its Secretary, this ..14-th
day of December 10 80
INDUSTRIAL COMMISSION OF COLORADO
By GG���
PIES . 1. In/A�� , C Make L. Baca, Chairman
•
Paul H. Leibowitz, Ex Secretary
BLOCK NO. 978 •
RESOLUTION
In a meeting of the Industrial Commission of Colorado held in
its offices at 1525 Sherman Street, Denver, Colorado, on December 16,
1980, Commissioners Baca and Rubinstein being present, the follow—
ing resolution was introduced and its adoption duly moved and
seconded :
WHEREAS, the County of Weld, State of Colorado has filed an
application for self—insurance to insure its workmen ' s compensation
liabilities, and
WHEREAS, the Industrial Commission has reviewed the application
and supporting material and finds that the same appears to comply
with the Commission' s regulations and requirements;
IT IS , THEREFORE, RESOLVED: That the County of Weld, State of
Colorado be hereby . authorized to self—insure its workmen' s compen—
sation liability for its operation within the State of Colorado
effective January 1 , 1981 .
BE IT FURTHER RESOLVED: That the statistical block #978 be
assigned to the said County of Weld and that this number be imprinted
upon all required forms to be used in the administration of its work—
men' s compensation claims program.
BE IT FURTHER RESOLVED: That all the above is and shall con—
tinue to be conditional upon the following:
1 . That the County of Weld, State of Colorado continues to
keep on file with the Industrial Commission an irrevocable letter
of credit in the amount of $150, 000 for the purpose of securing
awards and claims presented to the Division of Labor against the
County of Weld . The Commission is presently in possession of said
letter of credit issued by the Greeley National Bank, number 76, in
favor of the Industrial Commission;
2. That the County of Weld shall obtain and maintain insurance
coverage to cover said liabilities which occur or accrue over and
above the amount guaranteed by said letter of credit; proof of said
excess insurance coverage shall be filed with the Commission.
3. That the County of Weld shall furnish to the Commission an
updated annual report showing financial statements within 60 days
of the end of the fiscal year;
4. That said self—insurer shall also supply the Commission
with a report within 60 days of the end of the fiscal year present—
ing claims experience for that year including the following :
a. The total number of reported accidents including the number
of temporary total disability instances, permanent partial
disability instances, permanent total disability instances,
and deaths;
b. The amount estimated for costs of future liabilities for
all open and unpaid claims as of the end of the fiscal
year;
c. The amount paid on current year claims for each medical,
temporary total disability, permanent total disability,
permanent partial disability, vocational rehabilitation
and dependent benefits;
5. The Industrial Commission reserves the right and option to
revoke the self—insurance permit or to adjust the required amount or
form of guaranty reserves against such liabilities.
The roll being called by the Executive Secretary, the vote
resulted in the following:
AYES: Commissioners Baca and Rubinstein
NAYS: None
WHEREUPON, the Chairman declared said resolution duly and
regularly adopted .
INDUSTRIAL COMMISSION OF COLORADO
—
� BaC-111a
Harvey L . Rubinstein
Commissioners
st:
VQ,L ttkl,
Paul H. Leibowitz
Executive Secretar
Block No . 978
RESOLUTION
RE: APPLICATION- FOR SELF-INSURANCE OF WORKER'S COMPENSATION.
WHEREAS, the Board of County Commissioners of Weld County, Colorado,
pursuant to Colorado Statutes and the Weld County Home Rule Charter, is
vested with the authority of administering the affairs of Weld County,
Colorado, and
WHEREAS, the Board of County Commissioners , in acceptance of the self-
insured program on January 15, 1980, indicated that they wished to utilize
the services of Arthur J. Gallagher & Company to develop a self-insured
worker's compensation program, beginning January 1 , 1981 , and
WHEREAS, the Industrial Commission of Colorado requires the submission
of a formal application for the issuance of a self-insurance permit under
the Worker's Compensation and Occupational Disease Disability Act, and
WHEREAS, the Director of Finance and Administration has completed the
required application and developed the required data associated with the
application.
NOW, THEREFORE, BE IT RESOLVED that the Board of County Commissioners of
Weld County, Colorado hereby authorize the Chairman of the Board to sign and
execute the self-insurance worker compensation application on behalf of
Weld County.
The above and foregoing resolution was , on motion duly made and seconded,
adopted by the following vote on. the 7th day of April , A.D. , 1980.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
pct/1�//
C. W. Kirby, Chai,fman
•
lato . lite. wCI-i.:1-+eu.LE:.7‘) Q-., c AL- 2 ia-s-
ATTEST: D Leonard Roe, Chairman Pro-tem
Weld County Clerk and Recorder � �---
and Clerk to Board Norman Car son
0 3.y: < f - .oL
eputy County erl ' t Dunbar
APR ICED AS TO FORM: vn')wzi ��
\ / J e K. Steinmar
/ County Attorney
800041
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