Si 21 form 2025

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This document is a Certificate of Excess Insurance Contract for a self-insurer, certifying that a Workers' Compensation Excess Insurance Policy has been issued. It outlines the responsibilities of the insurance carrier, including notification requirements for policy changes or cancellations, and confirms that the policy meets New York State regulations. The document includes spaces for details such as the self-insurer's name, policy number, effective dates, limits of liability, and retention amounts.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (69 Votes)
2017	4.4 Satisfied (43 Votes)
2015	4.3 Satisfied (138 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do you find certificate of insurance?

How to Get a Certificate of Insurance. If you are requesting a COI from a contractor or business, they should either be able to retrieve it from their insurance company or provide you with their insurance companys contact information, so you can ask for that proof to be sent to you directly.

How to get a certificate of health insurance?

You can call your insurance customer service department at any point during your coverage and ask for a written copy of your certificate of coverage. This should be provided free of charge. This document explains the health benefits you and your dependents have under the plan.

How do I get a certificate of insurance from Nysif?

Call us with your policy information at 888-875-5790 to have NYSIF email you a certificate within 48 hours.

How do I ask for a certificate of insurance?

To get a COI, simply send your client, hiring party, or other business partners a certificate of insurance request email, laying out the details of what youre requiring from their insurance coverage.

What is a NYSIF insurance certificate?

A certificate of insurance is a document issued by an insurance company that provides evidence of the existence and terms of your Workers Compensation insurance policy. You may be asked for a certificate of insurance when performing work at a job site, bidding on a contract or obtaining a work license.

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