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SAMPLE ACORD-855 - NYS Construction Certificate of ...
ogs.ny.govSample Page 2 of 2 AUTHORIZED REPRESENTATIVE SIGNATURE DATE (MM/DD/YYYY) Yes, by specific policy provision Yes, by endorsement No and no other option is available with this insurer ... SAMPLE ACORD-855 - NYS Construction Certificate of Liability Insurance Addendum (Reuired as of 10/2016)