Colorado

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  Accident Report

  COGCC22 $69.00
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  Application for a Division Independent Medical Examination

  COWC77 $89.00
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  Average Weekly Wage Worksheet

  COWC1A $89.00
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  Bottom Hole Pressure

  COGCC13 $69.00
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  Certificate of Clearance/Change of Operator

  COGCC10 $89.00
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  Clearance/Change Multiple Locations

  COGCC10A $89.00
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  Completed Interval Report

  COGCC05A $89.00
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  Completion Report for Seismic Operations

  COGCC20A $69.00
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  Dependent’s Notice and Claim for Compensation

  COWC18 $89.00
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  Drilling Completion Report

  COGCC05 $89.00
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  Employer’s First Report of Injury

  COWC1 $89.00
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  Fatal Case – Final Admission

  COWC153 $89.00
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  Fatal Case – General Admission

  COWC151 $89.00
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  Final Admission of Liability (For Injuries On or After Aug. 5, 1998)

  COWC145 $89.00
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  Final Admission of Liability (Prior to Aug. 5, 1998)

  COWC4 $89.00
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  Final Payment Notice

  COWC25 $89.00