N.Y. Comp. Codes R. & Regs. tit. 9 § 460.5

Current through Register Vol. 46, No. 50, December 11, 2024
Section 460.5 - Application for certificate of self-insurance

The application for a certificate of self-insurance shall contain:

(a) The following information concerning the applicant:
(1) name of the applicant;
(2) Federal employer's number;
(3) coverage for which self-insurance is requested:
(i) property damage;
(ii) bodily injury;
(4) amount of reserves set aside to meet future claims;
(5) manner in which claims are investigated and adjusted;
(6) number of accidents in last two years;
(7) number of claims and amounts;
(8) number of settlements and amounts;
(9) number of judgments open and unsatisfied; and
(10) period of time covered by certificate of self-insurance.
(b) The following information concerning each snowmobile to be covered by self-insurance:
(1) year of manufacture;
(2) make of snowmobile;
(3) identification number; and
(4) registration number.
(c) An affidavit attesting to the truth of the above information, signed by the chief fiscal officer of the applicant and acknowledged by a notary public.

N.Y. Comp. Codes R. & Regs. Tit. 9 § 460.5