Proof of Compliance with Disability Benefits Coverage Requirements. In order to provide proof of compliance with the requirements of the Workers’ Compensation Law pertaining to disability benefits, a Vendor/Contractor shall:
a) Be legally exempt from obtaining disability benefits coverage; or
b) Obtain such coverage from an insurance carrier; or
c) Be a Board-approved self-insured employer. A Vendor seeking to enter into a Contract with the State of New York shall provide one of the following forms to OGS at the time of Vendor Submission and thereafter, within three (3) days of request:
a) Form CE-200, Certificate of Attestation for New York Entities With No Employees and Certain Out of State Entities, That New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage is Not Required, which is available on the Workers’ Compensation Board’s website (xxx.xxx.xx.xxx); (Reference applicable Solicitation and Group #s on the form.);
b) Form DB-120.1, Certificate of Disability Benefits Insurance. The Vendor/Contractor must request that its insurance carrier send this form to OGS; or
c) Form DB-155, Certificate of Disability Benefits Self-Insurance. The Vendor/Contractor must call the Board’s Self-Insurance Office at 000-000-0000 to obtain this form. Proof of coverage or an exemption shall be submitted to The New York State Office of General Services, New York State Procurement, Corning Tower- 00xx Xxxxx, Xxxxxx Xxxxx Xxxxx, Xxxxxx, XX 00000.
Proof of Compliance with Disability Benefits Coverage Requirements. In order to provide proof of compliance with the requirements of the Workers’ Compensation Law pertaining to disability benefits, a Bidder/Contractor shall:
A) Be legally exempt from obtaining disability benefits coverage; or
B) Obtain such coverage from an insurance carrier; or
Proof of Compliance with Disability Benefits Coverage Requirements. 1. In order to provide proof of compliance with the requirements of the New York State Workers’ Compensation Law pertaining to disability benefits, a contractor shall:
a. Be legally exempt from obtaining disability benefits coverage; or
b. Obtain such coverage from an insurance carrier; or
c. Be a Board-approved self-insured employer.
2. A Contractor seeking to enter into a contract with the State of New York shall provide one of the following forms to the Office of General Services before this Piggyback Contract can be executed by the Commissioner.
a. Form CE-200, Certificate of Attestation for New York Entities With No Employees and Certain Out of State Entities, That New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage is Not Required, which is available on the Workers’ Compensation Board’s website (xxx.xxx.xx.xxx).
b. Form DB-120.1, Certificate of Disability Benefits Insurance. Contractor must request its business insurance carrier to send this form to the New York State Office of General Services; or
c. Form DB-155, Certificate of Disability Benefits Self-Insurance. The Contractor must call the Board’s Self-Insurance Office at 000-000-0000 to obtain this form.
Proof of Compliance with Disability Benefits Coverage Requirements. In order to provide proof of compliance with the requirements of the Workers’ Compensation Law pertaining to disability benefits, a contractor shall:
A) Be legally exempt from obtaining disability benefits coverage; or
B) Obtain such coverage from an insurance carrier; or
C) Be a Board-approved self-insured employer. A Contractor seeking to enter into a contract with the State of New York shall provide one of the following forms to the Office of General Services at the time of bid submission:
A) Form CE-200, Certificate of Attestation for New York Entities With No Employees and Certain Out of State Entities, That New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage is Not Required, which is available on the Workers’ Compensation Board’s website (xxx.xxx.xxxxx.xx.xx); (Reference applicable RFP and Group #s on the form.)
B) Form DB-120.1, Certificate of Disability Benefits Insurance. Contractor must request its business insurance carrier to send this form to the New York State Office of General Services; or
C) Form DB-155, Certificate of Disability Benefits Self-Insurance. The Contractor must call the Board’s Self-Insurance Office at 000-000-0000 to obtain this form.
Proof of Compliance with Disability Benefits Coverage Requirements. In order to provide proof of compliance with the requirements of the Workers’ Compensation Law pertaining to disability benefits, a Vendor/Contractor shall:
Proof of Compliance with Disability Benefits Coverage Requirements. In order to provide proof of compliance with the requirements of the Workers’ Compensation Law pertaining to disability benefits, a contractor shall:
1. Be legally exempt from obtaining disability benefits coverage; or
2. Obtain such coverage from an insurance carrier; or
3. Be a Board-approved self-insured employer. A Contractor seeking to enter into a contract with the State of New York shall provide one of the following forms to the Office of General Services at the time of bid submission or shortly after the opening of bids:
Proof of Compliance with Disability Benefits Coverage Requirements. In order to provide proof of compliance with the requirements of the New York State Workers’ Compensation Law pertaining to disability benefits, a contractor shall:
Proof of Compliance with Disability Benefits Coverage Requirements. In order to provide proof of compliance with the requirements of the Workers’ Compensation Law pertaining to disability benefits, a contractor shall:
A) Be legally exempt from obtaining disability benefits coverage; or
B) Obtain such coverage from an insurance carrier; or
C) Be a Board-approved self-insured employer. A Contractor seeking to enter into a contract with the State of New York shall provide one of the following forms to the Office of General Services at the time of bid submission or shortly after the opening of bids:
A) Form CE-200, Certificate of Attestation for New York Entities With No Employees and Certain Out of State Entities, That New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage is Not Required, which is available on the Workers’ Compensation Board’s website (xxx.xxx.xxxxx.xx.xx); (Reference applicable IFB/RFP and Group #s on the form.) B) Form DB-120.1, Certificate of Disability Benefits Insurance. Contractor must request its business insurance carrier to send this form to the New York State Office of General Services; or
Proof of Compliance with Disability Benefits Coverage Requirements. 1. In order to provide proof of compliance with the requirements of the New York State Workers’ Compensation Law pertaining to disability benefits, a contractor shall:
a. Be legally exempt from obtaining disability benefits coverage; or
b. Obtain such coverage from an insurance carrier; or
c. Be a Board-approved self-insured employer.
2. A Contractor seeking to enter into a contract with the State of New York shall provide one of the following forms to the Office of General Services before this Piggyback Contract can be executed by the Commissioner.
a. Form CE-200, Certificate of Attestation for New York Entities With No Employees and Certain Out of State Entities, That New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage is Not Required, which is available on the Workers’ Compensation Board’s website (xxx.xxx.xx.xxx).
b. Form DB-120.1, Certificate of Disability Benefits Insurance. Contractor must request its business insurance carrier to send this form to the New York State Office of General Services; or
Proof of Compliance with Disability Benefits Coverage Requirements. In order to provide proof of compliance with the requirements of the Workers’ Compensation Law pertaining to disability benefits, a contractor shall:
1) Be legally exempt from obtaining disability benefits coverage; or
2) Obtain such coverage from an insurance carrier; or
3) Be a Board-approved self-insured employer.
4) Form DB-120.1, Certificate of Disability Benefits Insurance. Contractor must request its business insurance carrier to send this form to the New York State Office of General Services; or
5) Form DB-155, Certificate of Disability Benefits Self-Insurance. The Contractor must call the Board’s Self-Insurance Office at 000-000-0000 to obtain this form.
