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Who needs a Form CE 200?
To establish proof that a company is exempt from the payment of workers' compensation and/or disability insurance coverage the CE 200 is provided by the NYS Worker’s Compensation Board. The CE 200 may only be completed by businesses with no employees or out-of-state entities working on contracts for which all work is performed outside New York state. In case of disability benefits exemption, the CE 200 should be completed by those entities without employees working in New York state for less than 30 days a year.
What is Form CE 200 for?
This form should be completed in order to obtain a certificate of attestation of exemption. You should be aware that this form is to be filled only in the case of hazardous employment as defined under article 1, section 3 of the New York State Worker’s Compensation law.
Is Form CE 200 accompanied by other forms?
This form does not require the support of other documents.
When is Form CE 200 due?
This certificate is issued for a limited period and can be associated with a particular contract for work. This means that a new certificate may be required for each new project to be done by contractor.
How do I fill out Form CE 200?
You should provide the following: 1) Applicant personal Information and title; 2) Legal entity information; 3) Contract information; 4) Job site location information; 5) Partners or members information; 6) The reasons for not obtaining of the compensation or disability benefits;
Where do I send Form CE 200?
Completed and signed this form should be sent to the following address: Bureau of Compliance — CE-200; 100 Broadway, Albany, NY 12241-0005, FAX: 518-486-7145
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