Nys workers compensation exemption certificate

    • [DOCX File]its.ny.gov

      https://info.5y1.org/nys-workers-compensation-exemption-certificate_1_fcc3ae.html

      WC/DB CE-200, Certificate of Attestation of Exemption from New York State Workers Compensation and/or Disability Benefits Coverage. Request through the Workers’ Compensation Board website. Attachment 17, Disability Benefits Requirements under WCL § …

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    • [DOCX File]Please have your carrier or licensed NYS agent submit each ...

      https://info.5y1.org/nys-workers-compensation-exemption-certificate_1_26282c.html

      (Certificate of Affidavit of Exemption from NYS Worker’ Compensation and/or Disability Benefits Coverage). For Disability coverage, the only acceptable forms are the: DB120.1

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    • [DOC File]ARCHITECT/CONSULTANT/ENGINEER

      https://info.5y1.org/nys-workers-compensation-exemption-certificate_1_b80039.html

      DB-155- Certificate of Disability Self Insurance. The NYS Workers’ Compensation Board’s Self Insurance Office will provide a completed form. Exemptions. DASNY will no longer accept WC/DB 101 for Out of State or Foreign Employers working in New York State. Effective September 9, 2007 this form is obsolete. For institutions claiming exemption ...

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    • [DOCX File]Request for Proposals (RFP) New York State Mentor Teacher ...

      https://info.5y1.org/nys-workers-compensation-exemption-certificate_1_73e0c0.html

      – Certificate of Attestation of Exemption from NYS Workers’ Compensation and/or Disability Benefits Coverage. Proof of Disability Benefits Coverage. To comply with coverage provisions of the WCL regarding disability benefits, the Workers’ Compensation Board requires that a business seeking to enter into a State contract must submit ...

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    • [DOC File]ARCHITECT/CONSULTANT/ENGINEER

      https://info.5y1.org/nys-workers-compensation-exemption-certificate_1_772a48.html

      DB-120.1 (May 2006, or most current version) – Certificate of Insurance Coverage under the NYS Disability Benefits Law. The insurance carrier will provide a completed form as evidence of in-force coverage. DB-155-Certificate of Disability Self Insurance. The NYS Workers’ Compensation Board’s Self Insurance Office will provide a completed form. CE-200-Certificate of Attestation of Exemption.

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    • [DOCX File]NYS OFFICE OF GENERAL SERVICES

      https://info.5y1.org/nys-workers-compensation-exemption-certificate_1_ae4424.html

      Per New York State Workers’ Compensation Law §57 & §220, a business entity applying for a state contract, license or permit must provide proof of coverage or exemption for both Workers’ Compensation AND Disability Benefits. (Please see the “Workers’ Compensation Board Agency Contract Requirements" chart.)

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