Common Contracts

2 similar Assessment Contractual Agreement contracts

IN THE MATTER OF
Assessment Contractual Agreement • January 26th, 2016 • New York

THIS DEFICIT ASSESSMENT CONTRACTUAL AGREEMENT (“Agreement”) is entered into by and between the New York State Workers’ Compensation Board (“State” or “WCB”), with offices located at 328 State Street, Schenectady, New York, 12305 and the above-named Member (“Member”) of the above-named Trust (“Trust”), said New York State Workers’ Compensation Board and Member to be collectively referred to herein as the “Parties.”

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IN THE MATTER OF
Assessment Contractual Agreement • July 27th, 2015 • New York

THIS DEFICIT ASSESSMENT CONTRACTUAL AGREEMENT (“Agreement”) is entered into by and between the New York State Workers’ Compensation Board (“State” or “WCB”), with offices located at 328 State Street, Schenectady, New York, 12305 and the above-named Member (“Member”) of the above-named Trust (“Trust”), said New York State Workers’ Compensation Board and Member to be collectively referred to herein as the “Parties.”

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