Agency Workers Comp Docs

New York Documents

Some of the documents you might need to successfully submit and bind in the state of New York.

Officer Exclusion Forms

New York Corp Exclusion (C105.51)

New York Revocation (C105.55)

New York LLC, Partner, Sole Prop Inclusion (C105.32)

New York Not-for-Profit Exclusion (C105.52)

New York Not-for-Profit Revocation (C105.53)

Terms and Conditions

Pie Terms and Conditions

No Loss Statement

Pie No Loss Statement

BOR Letter

Pie BOR Letter Template

Proposal Cover Page

Why Pie Proposal Cover Page

Required Notices

New York Required Notices

Other Documents

C105.2 Template

If you have questions about how to use these documents, please contact your underwriter.