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CONNECTICUT DEPARTMENT OF LABOR

WAGE AND WORKPLACE STANDARDS DIVISION

SWOI (11/07)

STOP,II\/ORK Ql;lOFH NO.:

EMPLOYER NAME:

ISSUANCE DATE:
FEIN:

..

EMPLOYER ADORES~:
CITY:
WORK~ITE

----.

--

--.

POSTING ADDRESS:

STATE:
.

-.

CITY:

k ....

ZIP:

STATE:

ZIP:

INDUSTRY OF EMPLOYER:

Construction

IJ

Non-construction

Agriculture

STOP-WORK ORDER
Pursuant to Connectic,.t General Statute$ Section 31266 as amended, the above-referenced Employer Is
hereby ORDERED TO CEASE ALL BUSINESS OPERATIONS FOR THIS WORKSITE based on the following
virllation(s);
'
Failure to secure the payment of worker's compensation in violation of sections 31284 subsection (b) by:
Failing to obtain coverage that meets the requirements of section 31-284
Misrepresenting employees as independent contractors- Section 31288
Materially understating or concealing payroll;
Materially m'srepresenting or concealing employees duties so as to avoid proper classification for
calculations.



Materially misrepresenting or concealing lnfonnation pertinent to the computation and application of
an experience rating modification factor.
Failure to produce required payroll and other records within a reasonable time as designated by an
authori2:ed representative of the Labor Commissioner pursuant to section 31-76a of C.G.S.

THIS STOP-WORK ORDER MAY BE AMENDED TO INCLUDE ADDITIONAL VIOLATIONS AND SHALL REMAIN
IN EFFECT UNTIL THE DIVISION ISSUES AN ORDER RELEASING THE STOP-WORK ORDER.
IF THE EMPLOYER CONDUCTS BUSINESS OPERATIONS IN VIOLATION OF THIS STOP-WORK ORDER, A
PENALTY OF $1000.00 PER DAY OF VIOLATION SHALL BE ASSESSED AND EACH DAY OF SUCH
VIOLATION SHAlL CONSTITUTE A SEPARATE OFFENSE.
CERTIFICATEIOF SERVICB

Pursuant to section 31-76a as amended--~=======;;--------~-~.,.---.~---(P'RINT ~Al.lE AND TITLE OF SERVER)


seJVed a true copy of this Stop-Work Order:

By posting at the Worksite:

Date:------

Time: _ _ _ __

D
0

By hand delivery:

Date: _ _ _ _ __

Time: _ _ _ __

By certified mail:

Date: _ _ _ _ __

Time: _ _ _ __

White copy - Ernployet

SeJVer: - - - - - - - SeJVer: - - - - - - - SeJVer: - - - - - - - -

SW0-2 (11107)

NOTICE OF APPEAL RIGHTS


You, the employer, have a right under section 31-76a as amended to initiate proceedings by
filing a written petition for hearing not more than ten days after the issuance of such order.
If you dispute a material fact contained in this Stop-Work Order, you are entitled to a hearing
under section 4-177 at which you may be represented by counsel, present evidence and
argument on the issue(s), examine witnesses, submit a proposed recommended order, and
file exceptions to the recommended order of the designated hearing officer.
A petition for a hearing under section 4-177 must conform to the rules of Chapter 54 of the
Uniform Administrative Procedure Act. Any request for hearing must concisely state the
reason(s) for such request, including the facts to demonstrate that no viofation(s) has
occurred.
You must file a petition for hearing so that it is received by the Division at the address
identified below, within ten (iO) days of the receipt of this Stop-Work Order. FAILURE TO
FILE A PETITION FOR HEARING WITHIN THE TEN (10) DAYS OF RECEIPT OF THIS
STOP-WORK ORDER CONSTITUTES A WAIVER OF YOUR RIGHT TO REQUEST A
HEARING.

ISSUING AGENCY NAME AND ADDRESS


Connecticut Department of Labor, Wage and Workplace Standards Division, 200 Folly Brook BI vd.,
Wethersfield, CT. 06109

Attn: Gary Pechie, Director