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Monday, March 14, 2022

PACIF members received an email in February from "PACIF Self-Audit" listing the documents they need to assemble and send to PACIF underwriting staff for the 2021 workers' compensation payroll audits. The entire audit process this year is very similar to last year's. We ask members that if you have not yet done so, please collect and submit the necessary documents immediately! An underwriter may schedule a virtual meeting with you using Zoom or Microsoft Teams if necessary to complete your audit.

All the instructions are in the 2/2/22 email and listed on this webpage. You can also download a PDF of the instructions here or find it under the Attachments heading at the end of this page.

Please provide the following documents for Calendar Year 2021:

1.    Copies of the first page of all Quarterly 941s for calendar year 2021.

2.    Payroll records showing gross wages including overtime for each employee. Overtime must also be broken out. If you attach copies of W2s, you can conceal the Social Security numbers to protect your employees’ personal information.

  • If your payroll is on the NEMRC system, please generate the report called “Employee Wage Summary Report” that shows Detail by Name. Also generate a “PayTypes Report” with the following specifics: under Range, select  “All”; under Order, check “Name”;  and check the “All Pay” tab, then uncheck the bottom three boxes (“fringes, reimbursements and deductions”). (See a marked example here.) Either export each report to an Excel file or print the reports.
  • If you use Quickbooks, generate the report called “Payroll Expenses” or “Payroll Summary” report.
  • If you are using payroll cards or any type of manual system, please make sure that each person’s overtime and rate of pay are clearly marked and legible.

3.    List of elected and appointed officials for calendar year 2021.

4.    Documentation for every non-employee who is paid to do work for your municipality and paid on a 1099. For details, please visit Here is a short overview of key requirements:

  • Copies of 1099s that were issued for contractors for calendar year 2021. For each one, indicate the type of services rendered. 
  • A Certificate of Insurance showing proof of the contractor’s liability coverage naming the Named Member (your municipality) as an additional insured, and workers’ comp coverage (if applicable) during the time period the work was performed. 
  • A current and valid executed contract between the Named Member and the contractor.
  • A completed and executed copy of the most recent Non-Employee Work Agreement for the audit period.
  • A business card or marketing material that identifies the contractor as being in business.

Note that any contractor for whom you cannot provide all items listed under #4 may be charged as an employee on your audit.

Please compile the required documents within 30 days and submit them electronically via email to our secure address,

If necessary, you may mail paper records to:

Vermont League of Cities & Towns
Attn: Underwriting Dept.
89 Main Street, Suite 4
Montpelier, VT 05602-2948

or fax them to (802) 229-2211.

One of us might schedule a virtual meeting using Zoom or Microsoft Teams if necessary to complete your audit.

We truly appreciate your assistance in completing the audit in a timely manner. If you have any questions or concerns about this year's audit process, please email us at or call 800-649-7915. We always welcome your inquiries.

Your Workers’ Compensation Audit Team
Denise Ricker, Underwriting Assistant
Kelly Knotek, Senior Underwriter, Marketing Representative
Susan Benoit, Associate Underwriter
Vicky Abare, Senior Underwriter