C 218 Form - Fill Out the NY Certificate of Insurance

C 218 Form PDF Details

The C 218 form is a Certificate of Insurance issued by a subscribing insurance company on behalf of a New York State contractor. The New York State Department of Transportation (NYSDOT) requires this certificate from all contractors before project work begins. Last revised February 9, 2010, the two-page document certifies that all required coverage types are active and comply with the terms of the specific NYSDOT contract.

Who Needs to File the C 218 Form

Any contractor or subcontractor entering into a project agreement with NYSDOT must provide a completed C 218 form before work begins. Insurance companies must be authorized to operate in New York State, and an authorized representative must sign and notarize the certificate. Project sponsors, third-party administrators, and companies providing professional services such as engineering or design under a NYSDOT contract also require this certificate on file with the Office of Contract Management.

Insurance Coverages Listed on the C 218 Form

The C 218 form documents all required insurance coverages for an NYSDOT contract. Each coverage type must list the policy number, effective date, expiration date, limits of liability, and any deductibles or self-insured retentions (SIR):

• Workers' Compensation - Covers all employees engaged in contract work for injuries or illness sustained during the project.
• Commercial General Liability - Covers third-party bodily injury and property damage claims arising from contract activities.
• Professional Liability - Required for contractors providing design, engineering, or consulting services. Covers errors and omissions in professional work.
• Umbrella or Excess Liability - Provides additional limits above primary policies when a claim exceeds the base coverage amount.
• Special Protective and Highway Liability - Required for work performed on or adjacent to public highways in New York State.
• Railroad Protective Liability Insurance - Mandatory when contract work occurs within a railroad right-of-way or near railroad tracks.
• Builders Risk Insurance - Covers loss or damage to structures under construction during the contract period.

Policy Requirements and Legal Obligations

Policy coverage stated on the C 218 form must exactly match the actual coverage provided by the insurance company. Any discrepancy is subject to legal penalties under Section 2110 of the New York State Insurance Law. The form also requires disclosure of procedures for policy changes, cancellations, and advance notification requirements to NYSDOT. The notarization section must be completed by an authorized representative of the insurer and stamped by a licensed notary public in New York State.

Related Insurance Certificate Forms

Contractors working across multiple project types or jurisdictions may need additional certificate forms. The general Certificate of Insurance form covers documentation needs for non-NYSDOT projects. For commercial coverage documentation, the Commercial Liability Insurance Certificate provides a format recognized across multiple jurisdictions. Workers' Compensation coverage is also tracked using the Workers Compensation C-4 Form when a New York contractor employee is injured on the job.