Membership

Becoming a new member and renewals

New Membership

LGLP invites you to participate in its liability protection program. In order to become a member of the Local Government Liability Pool, an entity will be required to complete:

A membership application and any applicable supplemental applications which request information about your operations and insurance history. Please be sure to answer every question, even if the answer is “not applicable”.
Complete and sign the Joint Powers Agreement.
When LGLP notifies you of the contribution due, submit your check, payable to the Local Government Liability Pool, to:
Local Government Liability Pool
6844 Yellowtail Road
Cheyenne, WY 82009

Some entities may not be able to issue a check without a voucher. Please submit a voucher with the enrollment forms and it will be signed and returned to you.

Please read the instructions before you fill out the applications.

New Membership Applications

Please read the instructions before you fill out the applications.

Need Assitance?

Contact us for questions, comments or any assistance needed.

Renewal Information

It is important that you follow these instructions carefully, as improper reporting may affect your contribution. Please fill out the application that is appropriate for your entity. If an item on the form does not apply to your entity, fill in “N/A”.

Deductible: Please remember, each organization pay the deductible for each separate claim, and should budget funds each year to pay deductibles. A deductible is only necessary if LGLP makes a claim payment. Defense costs (attorney fees, adjuster fees, etc.) are not part of the deductible, and LGLP picks up these costs.
Payroll Expenditures: LGLP uses your organizations total payroll to calculate your annual contribution assessment. Total payroll is based on your “Employer’s Quarterly Federal Tax Return – Employers Form W3, Form 941” or annual Form 943 or Form 944. Please attach all forms for the preceding calendar year. That means if you submit Form 941s to the IRS, you will need to submit a copy of the first page of all four Form 941s that were submitted for the past year.
Questions: If you have any questions regarding your application, please do not hesitate to give us a call – we are here to assist you with the renewal process.
Phone: 307-638-1911
Email: lglp@lglp.net

Renewal Applications

Please choose the application that is appropriate for your entity:

Application Form

Google Account Users

If you have a Google account for your business, please select this application form.

Application Form

Non-Google Account Users

If you do not have a Google account for your business, please select this application form.