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NOTICE FROM DOB TO ALL CONTRATORS
REGARDING INSURANCE REQUIREMENTS
Effective Monday, January 14, 2002
In order to comply with New York State regulations, the Department of Buildings will no longer be allowed to accept the ACORD form as proof or Worker's Compensation insurance. The ACORD form will be accepted only as proof of General Liability insurance.
Any request for a contractor's tracking number, initial permit or permit renewal will be rejected if the appropriate insurance forms/certificates are not submitted.
Following is a list of the official forms to submit as proof of, or exemption from, New York State Labor Department insurance requirements:
C 105.2
(9-01) | Certificate of NYS Workers' Compensation Insurance Coverage (NYS Workers' Compensation Board) |
C 105.21
(5-01) | Statement That Business Does Not Require Workers' Compensation and/or Disability Insurance |
| U 26.3 | Certificate of Worker's Compensation Insurance (NYS Insurance Fund) |
DB 120.1
(4-99) | Certificate of Compliance with Disability Benefits Law |
| ACORD | Certificate of Liability Insurance (required only for New Building and Alteration Type 1 applications |
Thank you for your cooperation.
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