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HomeMy WebLinkAbout210241 WEDOIT BUILDERS LLP - Waiver4' -• City of `�heatL jC1 Cye 9C or DEVEL+©PMENT 7500 W. 2911 Avenue * Wheat Ridge, CO 80033 * O: (303)235-2855 * F: (303)235-2857 Contractor Waiver for Workers' Compensation Insurance I, (print your name),��<fl Ns verify that I am the sole owner or partner of (company name): which has no employees and is not required by the State of Colorado to carry workers' compensation insurance. I further state that if I hire contractors/subcontractors, they are in compliance with the State of Colorado Workers' Compensation insurance requirements, have obtained the required contractor's license from the City of Wheat Ridge and I be listed on the permit. Signature: - Date: 2---