Village of Amityville, New York

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What forms do you accept as Proof of Coverage for Workman’s Compensation and Disability?

 For Workman’s Compensation, we accept: C-105.21, C-105.2, U-26.3, SI-12, GSI-12. For Disability Insurance: C105.21, DB-120.1, DB-155.   No ACCORD forms will be accepted.

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Category: Building Department

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Village of Amityville, New York