Sample Forms and Documents
As a resource to subscribers, NYMIR offers the following sample forms and documents in MS Word format.

• Sample General Release
• Sample Insurance Requirements - Asbestos Removal
• Sample Insurance Requirements - Consultants
• Sample Insurance Requirements - General Construction
• Sample Use of Facilities Application
• Sample Volunteer Application

NYMIR 12 Metro Park Rd. Suite 208 Colonie, NY 12205-1139 Tel: 518-437-1171 Fax: 518-437-1182

NYMIR 333 Earle Ovington Blvd Suite 505 Uniondale, NY 11553-3624 Tel: 516-227-2120 Fax: 516-227-2352

Toll-free number in New York State:
1-800-NYMIR05

Emergency After Hours Number: 516-692-3983