Current through Register Vol. 46, No. 50, December 11, 2024
Section 460.5 - Application for certificate of self-insuranceThe 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:(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: (3) identification number; and(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