How to Complete and Post NYS Workers’ Comp Form C-105.1

New York State Workers’ Comp Form C-105.1 is a posting notice, not a certificate. Under Section 51 of the Workers’ Compensation Law, employers who operate vehicles must display this notice inside each automotive or horse-drawn vehicle to inform workers that compensation coverage is in effect. Your insurance carrier fills it in with your policy information and gives it to you to post. It is not filed with the state, and it is not the document a permit office, general contractor, or licensing agency wants when they ask for “proof of workers’ comp.” That form is C-105.2, and the number similarity causes constant confusion.

What C-105.1 Is For

The full title of the form is “Notice to Be Posted by Employers Under WCL for Automotive or Horse-Drawn Vehicles.” Its only job is to sit inside the vehicle so that any worker riding in it can see that the employer carries workers’ compensation coverage, as required by Section 51 of the Workers’ Compensation Law.

Because it is a posting notice, there is nothing for you to submit. You obtain it, complete it with your carrier’s help, and post it in the vehicle. That is the entire compliance step.

How to Obtain the Form

You cannot download C-105.1 from the Workers’ Compensation Board website. Contact your insurance carrier or a licensed New York insurance agent to request it.¹ The carrier prints your policy details on the notice before delivering it to you.

When your policy renews, you do not need to replace the entire poster. Ask your carrier for Form C-105.10, a gummed label with the updated policy dates and number that sticks over the expired information on your existing C-105 notice.²

If You Were Asked to Provide Proof of Coverage

If a state agency, municipal building department, general contractor, or licensing body told you to produce workers’ compensation documentation, they are not asking for C-105.1. They want C-105.2, the Certificate of NYS Workers’ Compensation Insurance Coverage.

Sections 57 and 220(8) of the Workers’ Compensation Law bar state and municipal agencies from issuing any permit, license, or contract until the applicant proves workers’ compensation coverage is in place.³ The rule applies to both original issuances and renewals. C-105.2 is the form most private-carrier policyholders use to satisfy that requirement.

Different forms apply if you hold a different type of coverage:

Employers insured through the New York State Insurance Fund receive form U-26.3.
Self-insured employers use form SI-12.
Participants in group self-insurance plans use form SIG-105.2.⁴

How to Get the C-105.2

You do not fill out or download the C-105.2 yourself. Only private insurance carriers licensed to write New York workers’ compensation policies, and their licensed agents, are authorized to issue it. Insurance brokers are not authorized to issue this form, even if your broker placed the policy. Go through the carrier or a licensed agent directly.⁴

Many carriers offer an online portal that generates the certificate immediately. Others handle requests by phone or email, usually within the same business day. The Workers’ Compensation Board itself does not stock or distribute certificates and directs employers to their carrier or agent.

Before you request the certificate, have the name and mailing address of the entity that requires proof of coverage ready. That entity becomes the “certificate holder” and will receive notice from your carrier if the policy is later cancelled. One other detail matters: New York must be listed under Item 3A on the Information Page of your workers’ compensation policy, or the certificate is not valid.⁵

How Long the C-105.2 Stays Valid

The certificate is valid for one year from the date the carrier approves it, or until the policy expiration date, whichever comes first. When your policy renews, request a fresh certificate for every active permit, license, or contract that still requires proof.

If your policy is cancelled, the carrier must notify the certificate holder within 10 days for cancellation due to nonpayment, or within 30 days for cancellation for any other reason. Once that notice goes out, you have to provide a new certificate to keep the permit or contract active.⁵

If You Have No Employees: Form CE-200

If you do not carry workers’ compensation coverage because you are legally exempt, no carrier can produce a C-105.2 or a C-105.1 for you. The form you need is CE-200, the Certificate of Attestation of Exemption. Two categories qualify:

Entities operating in New York with no employees, such as a sole proprietor working alone.
Out-of-state entities holding a contract or license where all work is performed outside New York.

Apply for the CE-200 online through New York Business Express. It is not issued through your carrier.⁶ A permit office that asks for workers’ compensation proof will accept the CE-200 in place of the C-105.2 when you have no employees.

Penalties for Operating Without Coverage

Whether you are posting C-105.1 in a vehicle or handing over C-105.2 for a permit, the underlying obligation is real coverage. Section 52(5) of the Workers’ Compensation Law authorizes a penalty of up to $2,000 for every 10-day period of non-compliance, or up to twice the cost of compensation for your payroll during the gap, whichever is greater.⁷ The Board tiers the amounts by company size:

5 or fewer employees: up to $500 per 10-day period.
6 to 10 employees: up to $750 per 10-day period.
11 to 24 employees: up to $1,000 per 10-day period.
25 or more employees: up to $2,000 per 10-day period.⁸

If you cannot produce payroll records, the Board imputes weekly payroll at 1.5 times the New York State average weekly wage for each worker, officer, sole proprietor, or partner. For corporate employers, the president, secretary, and treasurer are personally liable for the penalty. Under Section 141-a, the Board can also issue a stop-work order that shuts operations down entirely until coverage is restored.

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New York State Workers’ Compensation Board. Workers’ Compensation Forms Employers
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New York State Workers’ Compensation Board. Insurers Workers’ Compensation Forms
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New York State Workers’ Compensation Board. Workers’ Compensation Requirements for Government Issued Permits, Licenses and Contracts
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New York State Workers’ Compensation Board. Certificate of NYS Workers’ Compensation Insurance
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New York State Workers’ Compensation Board. Certificate of NYS Workers’ Compensation Insurance Coverage
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New York State Workers’ Compensation Board. Request Certificate of Attestation of Exemption (CE-200)
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New York State Senate. New York Workers’ Compensation Code 52 – Effect of Failure to Secure Compensation
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Workers’ Compensation Board. Employer Penalty Calculation Help