Skip Navigation
This table is used for column layout.
  • Citizen Action Center
  • Community Choice Aggregation
  • Freedom of Information
  • Online Payments
  • Online Forms
  • Subscribe to News
  • Send Us Comments
  • Contacts Directory
  • Projects & Initiatives
  • Community Links
  • Village Code
 
 
Insurance Forms
Document
Description
Insurance Forms:
Document
Description
All applicants requesting a permit must show proof of insurance coverage. This document explains the required coverage and documentation that must be submitted with every permit application.
This form may be used (under certain conditions, see form) by homeowners of 1, 2, 3 or 4-family owner-occupied residences (including condominiums) listed on the permit application, to document they are not required to show specific proof of worker's compensaiton insurance coverage. This form must be notarized.
This form is used to document those New York entities and any out of state entities with no employees, that New York State workers' compensation and/or disability benefits insurance coverage is not required. This form must be notarized and stamped as received by the NYS Workers' Compensation Board for it it be accepted
This form is used to document an OUT-OF-STATE OR FOREIGN EMPLOYER working in New York State does not require specific New York State Workers' Compensation and/or disability benefits insurance coverage. This form must be notarized and stamped as received by the NYS Workers' Compensation Board for it to be accepted.