Important notice for visitors to the Courthouse in Duluth: effective Monday, March 30, the 2nd Street entrance will be closed to the public. Visitors may enter the building through the main entrance off the Civic Center/Priley Drive or via the skywalk from the 3rd Street ramp.  
CERTIFICATE OF COMPLIANCE WITH MINNESOTA WORKERS' COMPENSATIONLAW Minn. Stat. § 176.182
 
 
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  • MN Worker's Comp Form

    This information is required by law, and licenses and permits to operate a business may not be issued or renewed if it is not provided and/or is falsely reported. In addition, the County shall not enter into a contract for the doing of any public work before receiving acceptable evidence of compliance with workers' compensation insurance coverage requirements. Furthermore, if this information is not provided or is falsely stated; it may result in a $2,000 penalty assessed against the applicant by the Commissioner of the Department of Labor and Industry.

  • Dates of Coverage:

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  • OR

  • Applicant is not required to have worker's compensation liability coverage because:

  • OR

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    • Grantee/Contractor:



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