HomeMy WebLinkAboutCouncil Resolution 901CITY C®iJ1VTY Il®iSiJRAIVCE SERVICES
GROUP SELF-INSURANCE RESOLUTION
As required by the State of Oregon Workers' Compensation Division
This Resolution must be passed by each City or County governing body (including districts,
agencies, arzd instrumentalities which are `public bodies" as defined in ORS 30.260 and which are
created by a city or county under statutory or borne rule charter authority) as a prerequisite to
becoming a Member of the CIS Workers' Compensation Self-Insured Group.
lies®luti®n N®a ! D I
City of Central Point (hereinafter called "the City") agrees to be liable for the payment of any
compensation due subject workers of the City or other amounts due to the Oregon Workers'
Compensation Division under ORS Chapter 656 incurred by the City. Further, the City understands
and agrees that should the City terminate from the group that the City will continue to be liable for
the payment of any compensation due its subject workers and other amounts due the Workers'
Compensation Division when such compensation and other amounts. arise out of a period when the
City was a Member of the group. The signature dates below notwithstanding, the effective date of
coverage shall be October 1, 2000.
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This Resolution was passed by City of Central Point on~~,~ ~ ~ ,.2001 for coverage
to be effective as of October 1, 2000..
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Signe ~ Date: ~ P~ ~
~.~ _ (Name and Title
Attested by:
(Name and Title)
Date:
Attested by: ~~~d~Date: ~t~ ~~~~
(Name an Titl
This resolution has the same force and effect as if signed on or before the effective date of coverage.