HomeMy WebLinkAbout20220327.tiffJARED POLIS
Governor
JOE BARELA
Executive Director
PAUL TAURIELLO
Director
DEPARTMENT OF LABOR AND EMPLOYMENT
DIVISION OF WORKERS' COMPENSATION
INSURANCE COMPLIANCE - SELF-INSURANCE UNIT
633 17TH STREET, SUITE 400
DENVER CO 80202-3660
(303) 318-8639 FAX (303) 318-8651
CANCELLATION OF SELF-INSURANCE PERMIT
WELD COUNTY, BLOCK NO. 0846
Weld County, self -insured for workers' compensation since January 1, 1992, has furnished its
letter of December 17, 2021, informing the Department of Labor and Employment that it no
longer wishes to be self -insured for workers' compensation and is acquiring workers'
compensation coverage through Pinnacol Assurance effective January 1, 2022.
In consideration of the above, the Executive Directorfinds that coverage under Self -Insurance
Block Number 0846 is cancelled and of no further force or effect, as of 12:01 a.m. on January
1, 2022.
DEPARTMENT OF LA OR AND EMPLOYMENT
1/11/2022
By:
JOE BA ELA, Executive Director
Date
IQiiu
2022-0327
1-2y-ZoZZ
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