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How to fill out the SAMPLE -855 - NYS Construction Certificate Of Liability Insurance Addendum online
The SAMPLE -855 - NYS Construction Certificate Of Liability Insurance Addendum is a crucial document that outlines the insurance policy provisions relevant to construction projects in New York State. This guide will provide you with clear, step-by-step instructions to successfully complete the form online.
Follow the steps to fill out the form accurately.
- Click ‘Get Form’ button to obtain the form and open it for online completion.
- Begin by entering the agency customer ID at the top of the form to identify the insurance agency involved.
- Fill in the date (MM/DD/YYYY) to indicate when this addendum is being completed.
- Provide the details of the named insured(s), including their full legal names as covered under the policy.
- Input the policy number, effective date, and carrier's information to ensure accurate reference to the insurance coverage.
- Detail any specific operations excluded or restricted under the general liability (GL) policy by specifying locations, types of construction, and building height.
- Select the appropriate additional insured endorsements that apply to your policy and include any specific endorsement numbers.
- Indicate whether the additional insured has primary and noncontributory coverage by selecting 'Yes' or 'No' as appropriate.
- Complete sections regarding earth movement, excavation, and other specified exclusions as they relate to the GL policy.
- Once all fields are filled out accurately, review the information for any errors or omissions before finalization.
- Save changes made to the form, and proceed to download, print, or share the completed addendum as necessary.
Complete your documents online by following these instructions to ensure you meet all requirements.
For Foreign Corporations: Agency:New York Department of State - Division of Corporations, State Records and Uniform Commercial CodeForm:Application for AuthorityAgency Fee:$225Law:NY Bus Corp L § 1301Certified Copy Requirement:Certified copies not required.1 more row