Common Contracts

THIS DEFICIT ASSESSMENT CONTRACTUAL AGREEMENT (“Agreement”) is

Member Of • September 21st, 2010 • New York

• Contract Type
  Member Of
• Filed
  September 21st, 2010
• Jurisdiction
  New York

entered into by and between the New York State Workers’ Compensation Board (“State” or “WCB”), with offices located at 20 Park Street, Albany, New York, 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.”