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Prorated Fee Amount 2017
Acceptable as proof of WC/DB insurance coverage. Form CE-200 Certificate of Attestation of Exemption from NYS Workers Compensation and/or Disability Benefits Coverage. NEW FOOD SERVICE ESTABLISHMENT Prorated Fee amount For minus Site Eval fee paid Office Balance Due Use Only Date Paid Recpt PERMIT APPLICATION Environmental Health Services Phone 607 737-2019 Fax 607 737-2059 CHEMUNG COUNTY HEALTH DEPARTMENT 103 Washington Street Post Office Box 588 Elmira New York 14902 Approved by www....
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