Pedicab Business Insurance Affirmation - Nyc Department Of Consumer Affairs printable pdf download

Pedicab Business Insurance Affirmation - Nyc Department Of Consumer Affairs

42 Broadway

PEDICAB BUSINESS

5th Floor

INSURANCE AFFIRMATION

New York, NY 10004

Dial 311

Business Name: _________________________________________________

(212-NEW-YORK)

Business Address: _______________________________________________

nyc.gov/consumers

I, _____________________________________, am an/the (circle one) owner of

(Owner Name)

______________________________________________________ and I am

(Company Name, hereafter Company)

authorized to execute this affirmation on behalf of Company and all owners of the

Company.

Please read carefully. Initial each paragraph and sign the affirmation.

_______ I have read section 20-253 of the New York City Administrative Code

(“the Code”) and I understand that I am required to maintain liability insurance

coverage during the full term of my pedicab business license for the amounts

stated in the Code. I understand that it is my responsibility to read my

insurance policy to make sure that it complies with section 20-253 of the Code.

_______ I understand that my insurance policy must cover all drivers

authorized to operate my pedicabs including, if applicable, pedicab drivers who

lease or rent my pedicabs, pedicab drivers engaged as independent

contractors, pedicab drivers under age 21, pedicab drivers who possess a

foreign motor vehicle driver license, and pedicab drivers with moving vehicle

violations.

_______ I have submitted to the Department a copy of my insurance policy

that is and will be in full force and effect during this license period and that

meets all the requirements under the pedicab law. If my insurance policy is not

available when I submit my application, I will submit it as soon as I receive it

from my insurance company, but no later than 90 days after submitting my

license renewal application. I understand that failure to timely submit my

insurance policy may result in the voiding of my pedicab business license and

registration plates.

_______ I understand that my pedicab business license and registration plates

will become void if my insurance lapses for any reason. I also understand that

operation of my pedicab(s) without the required insurance may result in seizure

of my pedicab(s), revocation of my license, and fines.

Pedicab Business Insurance Affirmation - Nyc Department Of Consumer Affairs