Workers' Comp Audit
Client Info
Policy Info
Business Information
Payroll Snapshot
Upload Required Documents
Please upload your business tax filings for the audit period.
Depending on your entity type, this may include:
• Corporations/S-corps/Non-profits: IRS 1120/1120S/1120-H/990 + any referenced schedules (e.g. 1125-A, Statement #1).
• Sole Proprietors: IRS 1040 with Schedule C (business) or Schedule F (farming).
• Partnerships: IRS 1065 with 1125-A, K & K-1 schedules.
• LLCs: follow corporation/sole prop/partnership rules.
• Cooperatives: IRS 1120-C with 1125-A and referenced schedules.
• Farms: IRS 943 (Annual Agricultural) and/or 1040 Schedule F.
Also include quarterly 941s, annual 940, and state unemployment reports if applicable.
These documents verify payroll and gross wages with the government filings for your policy period
Upload your check register or bank statements for the audit period. These must show payroll checks or direct deposits issued to employees. The auditor uses this to confirm wages reported match actual disbursements.
Please upload at least one COI (PDF).
Upload all subcontractor documents for the audit period.
This may include:
• Certificates of Insurance (Workers’ Comp & General Liability)
• 1099s and 1096 summary forms
• Invoices, estimates, or bids for subcontracted work
If subcontractors are uninsured, their payments may be added to your payroll, so providing COIs is important.
Please upload at least one payroll document for the audit period.
Please upload your payroll report for the policy period.
This should show gross wages for all employees during the coverage dates. If possible, include a summary by class code or department. This verifies payroll against your quarterly filings
If you have more than 5 subcontractors, please call our office at 763-582-1888 to confirm acceptability before submitting this audit.
Review Your Information
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Disclaimer:
By submitting this audit request and payment, you acknowledge and agree to the following:
• Document responsibility: You are solely responsible for providing all required payroll records, tax filings, subcontractor information, and supporting documents necessary to complete your workers’ compensation audit.
• Audit cannot be completed without documents: If you fail to upload or provide the required documents, City Insurance & Financial Services cannot complete your audit and your insurance carrier may assess non-compliance penalties.
• Fee is non-refundable: Our audit assistance fee covers the review and handling of your submission. This fee is non-refundable once payment has been made, regardless of whether your audit is later deemed incomplete or non-compliant due to missing or inaccurate documents.
• No liability for your data: We are not responsible for errors, omissions, or inaccuracies in the information or documents you submit. Final audit determinations are made by your insurance carrier, not by City Insurance.
• Client notifications: We may send reminders if documents are missing; however, it remains your responsibility to ensure all required uploads are completed before deadlines.
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