2018 Annual Member Assessment

Please complete the 2018 Annual Assessment Form & return to Amber Pusatere. Forms can be returned by email, fax, or mail.

Please also be sure to attach either the Annual Statement or the Exhibit of Premiums and Losses for each company to be covered.


Fax: 518.463.8656

230 Washington Avenue Ext., Suite 101
Albany, NY 12203