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Approved Certificates of Insurance

The certificates of insurance listed below may contain or incorporate material that is protected by U.S. or foreign copyright laws, and no person may reproduce, redistribute, or make commercial use of any such material in violation of those laws. ACORD has advised that its certificates of insurance are for ACORD member use only.

Entity Name Form Number Form Name Approval Date

ACORD

ACORD 20 (2009/12)

Certificate of Aviation Liability Insurance

June 25, 2015

ACORD

ACORD 20 (2016/03)

Certificate of Aviation Liability Insurance

June 25, 2015

ACORD

ACORD 21 (2009/12)

Certificate of Aircraft Insurance

June 25, 2015

ACORD

ACORD 21 (2016/03)

Certificate of Aircraft Insurance

June 25, 2015

ACORD

ACORD 22 (2012/04)

Intermodal Interchange Certificate of Insurance

June 25, 2015

ACORD

ACORD 22 (2016/03)

Intermodal Interchange Certificate of Insurance

June 25, 2015

ACORD

ACORD 23 (2010/05)

Vehicle or Equipment Certificate of Insurance

June 25, 2015

ACORD

ACORD 23 (2016/03)

Vehicle or Equipment Certificate of Insurance

June 25, 2015

ACORD

ACORD 24 (2009/09)

Certificate of Property Insurance

June 25, 2015

ACORD

ACORD 24 (2016/03)

Certificate of Property Insurance

June 25, 2015

ACORD

ACORD 25 (2014/01)

Certificate of Liability Insurance

June 25, 2015

ACORD

ACORD 25 (2016/03)

Certificate of Liability Insurance

June 25, 2015

ACORD

ACORD 27 (2009/12)

Evidence of Property Insurance

June 25, 2015

ACORD

ACORD 27 (2016/03)

Evidence of Property Insurance

June 25, 2015

ACORD

ACORD 28 (2014/01)

Evidence of Commercial Property Insurance

June 25, 2015

ACORD

ACORD 28 (2016/03)

Evidence of Commercial Property Insurance

June 25, 2015

ACORD

ACORD 29 (2013/10)

Evidence of Flood Insurance

June 25, 2015

ACORD

ACORD 29 (2016/03)

Evidence of Flood Insurance

June 25, 2015

ACORD

ACORD 30 (2014/01)

Certificate of Garage Insurance

June 25, 2015

ACORD

ACORD 30 (2016/03)

Certificate of Garage Insurance

June 25, 2015

ACORD

ACORD 31 (2014/01)

Certificate of Marine/Energy Insurance

June 25, 2015

ACORD

ACORD 31 (2016/03)

Certificate of Marine/Energy Insurance

June 25, 2015

ACORD

ACORD 855 NY (2014/05)

New York Construction Certificate of
Liability Insurance Addendum

June 25, 2015

BNC Insurance Agency, Inc.

S02-SPQ (1/2017)

BNC Subshield Subcontractor Prequalification Form

February 10, 2017

District Attorney's Office, Bronx County

NA

Certificates of Insurance

July 28, 2015

District Attorney's Office, Kings County

NA

Certificates of Insurance

July 28, 2015

District Attorney's Office, New York County

NA

Certificates of Insurance

July 28, 2015

District Attorney's Office, Queens County

NA

Certificates of Insurance

July 28, 2015

District Attorney's Office, Richmond County

NA

Certificates of Insurance

July 28, 2015

Insurance Services Office, Inc.

IL C 001 11 11

Certificate of Commercial Liability Insurance

October 6, 2015

Insurance Services Office, Inc.

IL C 006 12 11

Certificate of Property Insurance (Commercial Risks)

October 6, 2015

Mayor's Fund to Advance New York City

NA

Certificates of Insurance

June 25, 2015

Metropolitan Transportation Authority

NA

Long Island Rail Road Certificate of Insurance

October 13, 2015

Metropolitan Transportation Authority

NA

Long Island Rail Road Certificate of Insurance (Capital Contract - OCIP)

October 13, 2015

Metropolitan Transportation Authority

NA

Metro-North Railroad Certificate of Insurance

October 13, 2015

Metropolitan Transportation Authority

NA

Metro-North Railroad Certificate of Insurance (Capital Contract - OCIP)

October 13, 2015

Metropolitan Transportation Authority

NA

Metropolitan Transportation Authority Certificate of Insurance Headquarters Agreements

October 13, 2015

Metropolitan Transportation Authority

NA

Metropolitan Transportation Authority Certificate of Insurance (for Joint Agency Agreements)

October 13, 2015

Metropolitan Transportation Authority

NA

MTA Bus Company Certificate of Insurance

October 13, 2015

Metropolitan Transportation Authority

NA

MTA Capital Construction Company Certificate of Insurance

October 13, 2015

Metropolitan Transportation Authority

NA

MTA Capital Construction Company Certificate of Insurance (Capital Contract - OCIP)

October 13, 2015

Metropolitan Transportation Authority

NA

New York City Transit Certificate of Insurance

October 13, 2015

Metropolitan Transportation Authority

NA

New York City Transit Certificate of Insurance (Capital Contract - OCIP)

October 13, 2015

Metropolitan Transportation Authority

NA

Triborough Bridge & Tunnel Authority Certificate of Insurance

October 13, 2015

Metropolitan Transportation Authority

NA

Triborough Bridge & Tunnel Authority Certificate of Insurance (Capital Contract - OCIP)

October 13, 2015

New York City

NA

Certificates of Insurance

May 7, 2015

New York City Board of Education

NA

Certificates of Insurance

June 25, 2015

New York City Housing Authority

NA

RiskWorks rm.Compliance Insurance Questionnaire Forms

August 18, 2017

New York State Thruway Authority
New York State Canal Corporation

TA-W51343-9 (12/2015)

Supplemental Insurance Certificate

December 11, 2015

SecureInsight

NA

Insurance Authorization & Verification Form

May 11, 2016

SecureInsight

NA

Fidelity Bond (Employee Dishonesty/Crime Coverage) Authorization & Verification Form

May 11, 2016

SecureInsight

NA

Professional Liability Coverage (Errors & Omissions) Authorization & Verification Form

May 11, 2016

Sullivan & Strauss Agency, Inc.

NA

Certificate of SkiSafe Boat Insurance

August 24, 2015

Sullivan & Strauss Agency, Inc.

NA

Evidence of Ski-Safe Boat Insurance

August 24, 2015

Town of Islip

NA

Affirmation of Insurance Coverage

May 9, 2016

USI Insurance Services, LLC

USI-AFFIRMOFC (12/15)

Affirmation of Coverage by Subcontractor's Broker/Agent

December 03, 2015

Updated 08/18/2017

 

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