Common use of Proof of Compliance with Disability Benefits Coverage Requirements Clause in Contracts

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 (▇▇▇.▇▇▇.▇▇.▇▇▇); (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 ▇▇▇-▇▇▇-▇▇▇▇ 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- ▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇.

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 contractor shall: aA) Be legally exempt from obtaining disability benefits coverage; or bB) Obtain such coverage from an insurance carrier; or cC) Be a Board-approved self-insured employer. A Vendor Contractor seeking to enter into a Contract contract with the State of New York shall provide one of the following forms to OGS the Office of General Services at the time of Vendor Submission and thereafter, within three (3) days bid submission or shortly after the opening of requestbids: aA) 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 (▇▇▇.▇▇▇.▇▇▇▇▇.▇▇.▇▇); (Reference applicable Solicitation RFP and Group #s on the form.); bB) Form DB-120.1, Certificate of Disability Benefits Insurance. The Vendor/Contractor must request that its business insurance carrier to send this form to OGSthe New York State Office of General Services; or cC) Form DB-155, Certificate of Disability Benefits Self-Insurance. The Vendor/Contractor must call the Board’s Self-Insurance Office at ▇▇▇-▇▇▇-▇▇▇▇ 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- ▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇.