View the City of Richmond Sample Insurance Certificate & Endorsements documents (pdf).
View the ACCORD Certificate 25-S Sample Insurance w/ Instructions.
Contractors or vendors can fill out the Contractor's Release of Liability Form.
Workers' Compensation Information and Forms
- Employers Report of Occupational Injury or Illness Form 5020
- Ergonomic Workstation Request Form
- Supervisors Report of Employee Injury Form
- Workers' Compensation Claim Form (DWC 1)
- Instructions for filling out DWC 1
City of Richmond Insurance Requirements
- Consultants and Contractors - Type 1
- Professional Services - Type 2
- Environmental Risk/Hazardous Waste Material - Type 3
- Lease of City Property - Type 4
- Vendors, Suppliers, Small Grant Recipients, & Nonprofit Organizations - Type 5
- Transportation Providers - Type 6
International Association of Fire Fighters (IAFF) LOCAL 188
- Workers' Compensation Alternative Dispute Prevention and Resolution Program Agreement - IAFF Local 188
- Evaluating Physicians List
- Treating Physicians List