HomeMy WebLinkAboutAU-08/24/2021 Fishers Island r
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FISHERS ISLAND FERRY DISTRICT
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VENDOR 001409 ADVANTAGE TECH, INC.
08/24/20211, CHECK 7577
A FUND & ACCOUNT -
s P--O-# INVOICE DESCRIPTION AMOUNT
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SM .5710.4.000.500 967990 IT OUTSOURCING-8/21 4, 839.75
t TOTAL 4,839.75
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FISHERS ISLAND FERRY DISTRICT
53095 MAINROAD,POBOX 1179' DI ' 2;, _/202l.
50UTHOLD,NY 14 9710,959. 7,77
CTiECK,NO; ;,`75x771,S kyr
I THE SUFFbLK CO.NATIONAL BANK ` ^%
r (' CU_TCHOCUE;NY 11935, DATE° _ `AMOUNT • �;°' I U,
50'5467 i4;;'
I� `'FOUR' THO,U$AND EIGHT••HUNDRED'��THIRT •''\•NIN 4 75/100 y t ,'' " -- `,- c,;;re{�' ,,'`3 .s 'r�'`t •,`y I r;�
E' AND
DOyLAR5_ �`�. .'�_' ``�' '�, • `'� '`
oi4£ 5��i ,C{ "jam ,t'N�tl`• "t+`,i IY, i. ,
�y- �•o • ' "S e'+ yr nl''.1� .v'o i'
�.� i ,""� '^, •,,' �-,.' ,',I� ` - .!� � „t ,- -< �• 49944
;r I AY , ,:PD7ANTAGE TECH, INC;
�
THE _ �PO BOX
hlJhR` `SUFFIELD CT `06078
�71 7+
', ; 11500757 ?11 :0 2 140 54641: 68 00150 L �<
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Vendor No. Check No.
'down of Southold, New York - Payment Voucher 1409
Vendor Address Entered by
PO Box 951
Suffield,CT 06078 Audit Date
Advantage Tech, Inc2° = 2021
"AUG � 4
Vendor Telephone Number i
860-668-0044 Town Clerk
Vendor Contact �)
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger FundandAccount Number
967990 8/1/2021 $4,839.75 $4,839.75 IT outsourcing August 2021 SM5710.4.000.500
$4,839.75 $4,839.75
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
aaj�Signature Title Signatu
Company Name Fisherss and Ferry District Date 8/13/2021 Title Manager Da
r f�
;a Advantage Tech, Inc.
Invoice
P.O. Box 951
Suffield, CT 06078 Date Invoice#
8/1/2021 967990
Bill To
Fishers Island Ferry
P.O.Box 607
Fishers Island,NY 06390-0607
P.O.No. Terms Project
Due on receipt
Description Qty Rate Amount
Ticketing System Usage and Support-August 2021 2,135.00 2,135.00
IT Support-Ed-7/112021 thru 7/31/2021 7.25 165.00 1,196.25
AWS Hosting:July 2021 217.00 217.00
AWS VPN Tunnel:July 2021 50.00 50.00 /
AWS Hosting:June 2021 217.00 217.00
AWS VPN Tunnel:June 2021 50.00 50.00
AWS Hosting:May 2021 217.00 217.00
AWS VPN Tunnel.May 2021 50.00 50.00
DNS Hosting 2.50 2.50.,'
Cloud Backup.July 2021 45.00 45.0
Ticketing Web-Correct buffer process during reservation changes 4 165.00 660.00
Thank you for your business. •
Subtotal $4,839.75
Sales Tax (0.0%) $0.00
Total $4,839.75
Payments/Credits $0.00
Balance Due $4,839.7.5
Phone# E-mail
(860),980-0861 billing@advantech.biz
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FISHERS ISLAM FERRY DISTRICT
VENDOR 001318 AIRGAS USA, LLC -08/24/2021 CHECK 7578
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .5710;4.000.625 9115313974 PROP (5) NJT FORKLIFT 230.15
SM .5710.4 -000.625 9116030889 PROP (4) NLT FORKLIFT 184.45
SM .5710.4.000.625 ',9981308899 CYLINDER RENTAL (4) 105.24
TOTAL 519.84
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-, lSLAAVFERRYDlSTR
'FISHERS095 MAIN AOAD,'PO BGX'14�,79 AUDIT �b/�'4'/�2,021
SOUTHOLD,,NY 1,1971-0959
m,aI - CH -NQ,,, 75y8','
THE SUFFOLK CO.NATIONALBANK
I DATE, AMOUNT
CUTCHOGUE,NY 11935,
2 f 15'1'9.
`08/2�'/'20"'
Sv 6'12�4-
D-, 84 100 -DOLLARS
JND ED NINETEEN '
FIVE HT AN
Aff = AIRGAS-USA,, LfLc.,
T01 WE' -4 -4
BO '73 4'5
OIZD r X
', -CHICAGO IL; 60673^4445'OF
11'00 ? 5 ?113118 1:0-2 Llo S Ll 6 Lol: G]a oQ--1 50 2 L ul
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 1318 ---1 5-
Vendor Address Entered by
P.O. Box 734445 � L
Vendor Name Chicago, IL 60673-4445 Audit Date
Airgas USA, LLC J�1'r 2 4 2�2�
Vendor Telephone Number n U U
860-444-3055 800-962-0285 wn Clerk
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
9115313974 7/13/2021 $ 230.15 $ 230.15 Propane (5) NLT forklift SM.5710.4.000.625
9981308899 7/31/2021 $ 105.24 $ 105.24 Cylinder Rental 4) SM.5710.4.000.625
9116030889 8/2/2021 $ 184.45 $ 184.45 Propane(4) NLT forklift SM.5710.4.000.625
$519.841 1 $519.84
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved.
Signature Title Signature
Company Name Fishers Island Ferry District Date 8/13/2021 Title Mana erate 8/13/2021
TO ENSURE PROPER CREDIT,PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE.FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL. 216-520-6000
,T ORDER No., 7 v '�SOMTO'
5w I, NAME,
.AT,ff 7, �;" �- - ", I
1101779681 9115313974 07/13/2021, 2576547 FISHERS ISLAND FERRY DISTRICT
"T EN
,Q1,139LEASE', �A RED ERMS
NATE WHITE 860 442 0165 CUPU NET 30 07/13/2021
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8111834531 PR 33A 5 CL 5 5 41.00 CL 205.00 N
PROPANE INDUSTRIAL 33A CGA 790 (Vol: 160 LBS) (H)
Sale subtotal: 205.00
Airgas Hazmat Charge 25.15
Airgas Hazmat Charge (H) see Itemized Charges on reverse or visit www.Airgas.com/terms-of-sale
L/
230.15��
SHIP To 3878688 11
Airgas FISHERS ISLAND FERRY DISTRICT
an Air Liquide company 5 WATERFRONT PARK Airgas USA,LLC
Acct No 550372228
0"
AIRGAS USA LLC NEW LONDON CT 06320 JPMC Bank,ABA No 021000021
6055 Rocksld�Woods Blvd
Independence,OH 44131 For change of address
000535 email to NDIV.DI@Airgas.com
REV 6 1 16 0000658 Pa :
ge 1 of 1 or 216.520-6000
Disclosure
Terms of Sale• Each sale of Goods or services by an AirgasTm company is and shall be governed by the terms and conditions on this Disclosure,the Terns of Sale affixed to
the Account Application(if one has been completed),and the Terms of Sale found at http//www aimas com/terms-of-sale(collectively the"Terms of Sale") Each Contract for
the sale of Goods or services between Seller and Buyer("Contract")shall include these Terms of Sale,together with any other material describing the Goods or services being
sold,their price,delivery terms,and all other special provisions `Goods"refers to any items of tangible personal property described in any Contract or otherwise provided by
Seller to Buyer
Notice Regarding Cylinder Rentals/Leases and Responsibility This document shows the total number of cylinders charged to Buyer(i e,cylinders which Seller has rented or
leased to Buyer,and which Buyer has not returned)according to Seller's records as of the month ending date shown The number of cylinders thus charged to Buyer shall be
considered correct for all contractual purposes between Buyer and Seller,unless Buyer reports to Seller in writing any errors Buyer claims within 60 days after the date hereof
Buyer agrees to continue to pay rent on all cylinders charged to Buyer until Buyer has either(i)returned such cylinders to Seller in good working order or(ii)pays Seller the
replacement cost thereof
Refrigerant Cylinder Returns/Deposit Refillable refrigerant cylinders shall remain the property of Airgas or its third-party vendors. Such cylinders shall not be used by
Customer for purposes other than the storage of gas products purchased from Airgas or the return and reclamation of certain gases(e g,refrigerants) Each refillable
cylinder will be subject to a cylinder deposit fee,as established by Airgas from time to time Airgas will refund the deposit fee when the Customer returns the refrigerant
cylinder unless the cylinder's condition is deemed to be unfit for reuse,as determined by Airgas,which determination shall be irrefutable sixty days after the cylinder was
returned
Warranty All products, other items of sale, cylinders and other containers furnished by an Airgas company shall conform to the description thereof published by the
manufacturer at the time of sale and will meet Seller's purity specifications for all gas products SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED
STANDARDS, GUARANTEES, OR WARRANTIES, INCLUDING ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-
INFRINGEMENT AND ANY WARRANTIES THAT MAY BE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE.
Limitation of Liability: SELLER SHALL BE LIABLE ONLY FOR THE REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS AND PRODUCTS,INCLUDING
THE REPLACEMENT OF GASES THAT DO NOT MEET ITS PURITY SPECIFICATIONS WITH GASES,THAT DO MEET SUCH SPECIFICATIONS. BUYER KNOWINGLY
AND FULLY ASSUMES THE RISKS OF TRANSPORTING AND USING COMPRESSED GASES SELLER SHALL NOT BE LIABLE FOR ANY DIRECT(EXCEPT AS
EXPRESSLY PROVIDED HEREIN),INDIRECT,SPECIAL, INCIDENTAL,CONSEQUENTIAL AND/Oft PUNITIVE DAMAGES,ARISING OR ALLEGED TO ARISE OUT
OF OR IN CONNECTION WITH ITS PERFORMANCE OF ANY OBLIGATIONS ORANY PRODUCT,OTHER ITEMS OF SALE,OR EQUIPMENT SOLD OR LEASED BY
SELLER,WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT OR OMISSION OR IS RELATED TO STRICT LIABILITY,OR OTHERWISE
Terms of Payment Unless otherwise specified in a Contract,Buyer shall make payment in full within 30 days after the date of Seller's invoice Continued open account credit
is subject to Seller's assessment of Buyer's financial condition and ability to pay A,late payment charge of 1 5%on the unpaid,past due balance,will be assessed monthly
.(minimum two dollars(^$2.00),or the maximum lawful rate allowable in the state where the Goods ale deliyered,whichever is less _
Surcharges Upon notice and receipt of underlying documentation,Buyer shall pay to Seller a surcharge in the event of any extraordinary or emergency increases in the cost
of(a)power and/or raw materials used in the production of Products and/or(b)fuel
Title to Equipment, Title to all rental equipment shall remain in Seller's name Buyer shall not cover,modify,remove or otherwise disturb any identification or other indicia of
Seller's ownership on any rental equipment
Taxes Any taxes imposed by federal,state,or other governmental authority on the sale,use or possession of Goods or the sale or performance of services by an Airgas
company,shall be paid by Buyer in addition to the purchase price
Itemized Charges (a)The total amount due from the Buyer may include vanous itemized charges, including charges for the handling of hazardous materials and for
compliance with laws and regulations concerning hazardous materials,charges for handling,delivery and shipping,and/or charges for energy or fuel None of the charges
represent a tax or fee paid to or imposed by any government authority,and all of the charges are retained by the Seller The Seller has not specifically quantified the
relationship between the charges and the actual costs associated with the charges,which can vary by product,service,time and place,among other things (b)No such
charges not already provided for in a Rider will be imposed without mutual consent
Government Contracts. Certain Airgas companies are U S government contractors and subcontractors and are subject to and adhere to the requirements of federal laws,
executive orders,and attendant rules and regulations,specifically Executive Order No 11246,the Rehabilitation Act of 1973 and the Vietnam Era Veterans Readjustment
Assistance Act of 1974,all as amended
Airgas eBusiness
Now doing business with Airgas is easier than ever with our eBusiness website,http://www airgas.com Visit us online today to see how www.airgas.com can save you
time and money
® ®E L IVERY ORDER FOR LOCATION NEAREST YOU
-ah Air Ligtlide company VISIT WVWU.AIRGAS.COM
SHIPPER: SOLD BY: DELIVERY ORDER#81118345+31
AIRGAS USA,LLC AIRGAS USA, LLC PAGE 1 OF 1
130 CROSS RD 130 CROSS RD ORDER DATE: 07/13/2021
WATERFORD,CT 06385-1204 WATERFORD,CT 06385-1204 SCH SHIP DATE:07/13/2021
800-962-0285 800-962-0285 PRINTED: 13:57 , 07/13/2021
SALES ORDER: 1101779681.-
SHIP TO:3878688 SOLD TO:2576547
FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY DISTRICT CUST PO#
5 WATERFRONT PARK RELEASE#
NEW LONDON,CT 06320 FIS ERS ISLAND,
DR ORD BY NATE WHITE 860 442
860-442-0165 FISHERS ISLAND,NY 06390-8021 0165
ENT BY ERICCHASE
Order Type Payment Terms Incoterm Route Sales Office Plant Sales Total Containers
Org Ship— Return
Acct Front Customer Pick up Airgas r
Counter NET 30 Customer Pick Up N329 N309 N000
Qty UOM HM Description&Hazard Class Qty Containers Vol
Ship Type Order Ship Ret Mit
5 CL X UN1978 PROPANE 2.1
Line# 10 Materlal#PR 33A Stor.Loc.F001 5 5 5 160 LB
PROPANE 32LBS ALUMINUM 340.000 LB
u:-EMERGENCY CONTACT:1-866-734-3438 PLACARDS OFFERED THIS AGREEMENT IS SUBJECT TO Airgas'STANDARD TERMS AND CONDITIONS
SEE REVERSE SIDE FOR IMP ORTAN SAFETY INFORMATIO
PURCHASER AGREES TO OBTAIN SAFETY DATA SHEETS(SDS)FROM ONE OF THE FOLLOWING ❑ Ni
SOURCES;POINT OF PURCHASE,Airgas WEB SITE AT 4NWW.AIRGAS.COND OR BY CALLING THE ACCEPTED FOR
ABOVE LISTED EMERGENCY,CONTACT PHONE NUMBER AND SELECTING OPTION#3
ACCEPT REJECT THEABOVE
1" CUSTOMER
IBF
PACKAGED,MAA�2ICED AyyD,,LL��BBELED AND ARE IN PRQPE CON ITI N FORT TIO CUSTOMER MUST /
ACCORDING 1PI1EAPPLI A1F-1E.REGULATIONS OF THE DEPARTMENT OF TRANSPORTATI N INITIAL CHOICE NAME 0,-4- tJ
( '
PLEASE PRINT
Airgas PERSONNEL DATE T.0 D.
INTERNAL USE ONLY
w
Filled By Staging Area Total PKGS Tracking 1 Pro Number Freight Charges Total Weight' Delivery#8111834531'
340 LB _IIIlI�IIIIIIIIIII161911IIOIIIIiII�II
'Total weight for materials with weight displayed only
AIRGAS TERIVIS AND CONDITIONS OF SALE
WARNING TRANSPORT AND USE OF COMPRESSED GASES AMY BE EXTREMELY DANGEROUS DO NOT TRANSPORT IVITHOUT PROTECT/{E CAPS,IN CONFINED SPICES OR IN ANY OTHER IMPROPER AIANNER
ALWAYS TRANSPORT CYLINDERS INA SECURED UPRIGHT POSITION SAFETY DATA SHEETS("SDS')AREA KAILABLEAT AIRGAS COSI
EACH SALE OF PRODUCTS BY AIRGAS USA,LLC,OR ONE OF ITS AFFILIATES("SELLER"),SHALL BE GOVERNED BY THE TERMS AND CONDITIONS BELOW AND THE TERMS OF SALE FOUND AT HTTP H
1VWW AIRGAS COM/TERMS-OF-SALE(COLLECTIVELY,THE"TERMS") IF YOU DO NOT HAVE ACCESS TO THE INTERNET,YOU MAY REQUEST A COPY OF THE TERMS OF SALE FROM YOUR AIRGAS CUS-
TOMER SERVICE REPRESENTATIVE"BUYER"REFERS TO THE PURCHASER OF PRODUCTS FROM SELLER"PRODUCT(S)"REFERS TO ANY GOODS PROVIDED BY SELLER TO BUYER
1.CYLINDERS.UNLESS OTHERWISE SPECIFIED,CYLINDERS,FITTINGS AND CAPS COVERED BY THESE TERMS ARE RENTED TO BUYER AT SELLER'S CURRENT DAILY RATES,BEGINNING WITH THE DATE
OF DELIVERY RENTAL CHARGES ARE ASSESSED AS OF THE LAST DAY OF EACH MONTH OR AT THE START OF EACH ANNUAL LEASE PERIOD,AS APPLICABLE BUYER SHALL NOT PERMIT CYLINDERS OR
OTHER STORAGE CONTAINERS FURNISHED HEREUNDER TO BE FILLED WITH ANY PRODUCT NOT FURNISHED BY SELLER OR ITS AUTHORIZED AGENT BUYER SHALL RETURN,IN GOOD AND NON-CON-
TAMINATED CONDITION,ALL CYLINDERS,WITH VALVES CLOSED,COMPLETE WITH CAPS AND FITTINGS AND SHALL PAY SELLER THE REPLACEMENT VALUE OF ANY LOST OR DAMAGED CYLINDERS,
CAPS OR FITTINGS AND FOR ANY LOSS OR DAMAGE CAUSED BY BUYER CONTAMINATION UNLESS SUBJECT TO AN ANNUAL LEASE,ANY CYLINDER NOT RETURNED TO SELLER WITHIN THREE(3)
MONTHS OF ITS SHIPMENT DATE WILL BE CONSIDERED LOST PAYMENT BY THE BUYER OF CHARGES FOR DAMAGED,LOST OR DESTROYED CYLINDERS SHALL NOT GIVE ANY OWNERSHIP INTEREST
IN THE CYLINDERS TO THE BUYER
2 PAYMENT-UNLESS OTHERWISE SPECIFIED,BUYER SHALL MAKE PAYMENT IN FULL WITHIN THIRTY(30)DAYS AFTER THE DATE OF SELLER'S INVOICE IF BUYER FAILS TO MAKE ANY PAYMENT WHEN
AND AS DUE,SELLER MAY CHARGE BUYER MTERESTAT THE LESSER OF ONE-AND-ONE-HALF PERCENT(1 5%)PER MONTH(MIN[MUM TWO DOLLARS($2 00))OR THE HIGHEST RATE PERMITTED BYLAW
CALCULATED FROM AND EXCLUDING THE DUE DATE THEREOF TO AND INCLUDING THE DATE OF PAYMENT IF BUYER REQUESTS PAYMENT TERMS OTHER THAN CASH OR CASH ON DELIVERY(COD),
BUYER REPRESENTS THAT THE PURCHASES ARE MADE FOR BUSINESS,COMMERCIAL OR AGRICULTURAL PURPOSES AND NOT FOR PERSONAL,HOUSEHOLD,OR FAMILY USE IF BUYER HAS RECEIVED
CREDIT APPROVAL FROM SELLER,CONTINUED OPEN ACCOUNT CREDIT IS SUBJECT TO SELLER'S ASSESSMENT OF BUYER'S FINANCIAL CONDITION AND ABILITY TO PAY IF SELLER EMPLOYS ANY COL-
LECTION AGENCY OR ATTORNEY TO COLLECT ANY AMOUNT DUE SELLER,AND/OR TO REPOSSESS ANY PRODUCTS,BUYER SHALL PAY ALL COLLECTION FEES,ATTORNEYS'FEES,AND COURT COSTS,
IN ADDITION TO THE AMOUNT OTHERWISE UNPAID
3 TAXES.TAXES IMPOSED BY FEDERAL,STATE OR LOCAL GOVERNMENTS ON THE SALE,USE OR POSESSION OF PRODUCTS SHALL BE PAID BY BUYER IN ADDITION TO THE PURCHASE PRICE
4.RETURNS:NO PRODUCTS SHALL BE RETURNED WITHOUT SELLER'S WRITTEN AUTHORIZATION BUYER SHALL PAY FIFTEEN PERCENT(15%)RESTOCKING CHARGE ON ALL PRODUCTS RETURNED,
EXCEPT FOR RETURNS MADE UNDER SECTION 7 HEREOF
5 WARRANTYAND CLAIMS.SELLER WARRANTS THAT,AT THE TIME OF DELIVERY,ALL PRODUCTS FURNISHED HEREUNDER SHALL CONFORM TO THE MANUFACTURER'S OR SELLER'S SPECIFICATION
FOR THE PERIOD OF TIME SET FORTH IN SUCH SPECIFICATION OR,IF NONE,FOR A PERIOD OF NINETY(90)DAYS SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED STANDARDS,
GUARANTEES,OR WARRANTIES,INCLUDING ANY WARRANTIES OF MERCHANTABILITY,FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT AND ANY WARRANTIES THAT MAYBE
ALLEGED TO ARISE ASA RESULT OF CUSTOM OR USAGE.ALL CLAIMS BY BUYER HAVING ANYTHING TO DO WITH ANY PRODUCTS FURNISHED BY SELLER SHALL BE MADE IN WRITING WITHIN TEN
(10)DAYS AFTER THE DELIVERY OF THE PRODUCTS AND FAILURE OF BUYER TO GIVE SUCH NOTICE SHALL CONSTITUTE A COMPLETE WAIVER BY BUYER OF ANY SUCH CLAIMS AND DEFENSE FOR
SELLER AGAINST ANY SUCH CLAIMS
6 LIMITATION OF LIABILITY SELLER SHALL NOT BE LIABLE FOR ANY DIRECT(EXCEPT AS EXPRESSLY PROVIDED HEREIN),INDIRECT,SPECIAL,INCIDENTAL,CONSEQUENTIALAND/OR PUNI-
TIVE DAMAGES,ARISING OR ALLEGED TO ARISE OUT OF OR IN CONNECTION WITH ANY PRODUCT OR EQUIPMENT SOLD OR LEASED HEREUNDER,WHETHER SUCH DAMAGE RESULTS FROM
ANY NEGLIGENT ACT OR OMISSION OR IS RELATED TO STRICT LIABILITY,OR OTHERWISE.
7 REMEDY BUYER'S EXCLUSIVE REMEDY FOR EACH UNEXCUSED FAILURE OF PRODUCT TO MEET SPECIFICATION SHALL BE,AT SELLER'S OPTION,TO RECEIVE A REFUND OF THE PRICE
OF SUCH NON-CONFORMING PRODUCT OR REPLACEMENT THEREOF WITH PRODUCT THAT MEETS SUCH SPECIFICATION BUYER'S EXCLUSIVE REMEDY FOR THE UNEXCUSED FAILURE,BY
SELLER TO DELIVER PRODUCT AS SPECIFIED,REGARDLESS OF THE CAUSE OF SUCH FAILURE,INCLUDING NEGLIGENCE,SHALL BE TO RECOVER THE DIFFERENCE BETWEEN THE COST TO
BUYER OFANY SUBSTITUTE FOR PRODUCT NOT DELIVERED AND THE LESSER PRICE OF SUCH QUANTITY OF PRODUCT HEREUNDER.
8.COMPLIANCE/SDS:BUYER SHALL COMPLY WITH ALL APPLICABLE LAWS REGARDING THE SAFE HANDLING,TRANSPORTATION AND USE OF PRODUCTS BUYER ACKNOWLEDGES AND AGREES THAT
SELLER HAS PROVIDED RELEVANT SDS SDS ARE AVAILABLE(1)AT THE LOCAL AIRGAS BRANCH,(II)BY CALLING 1-866-734-3438,OR(111)ATAIRGAS COM
9.ITEMIZED CHARGES.THE TOTAL AMOUNT DUE FROM BUYER MAY INCLUDE VARIOUS ITEMIZED CHARGES,INCLUDING CHARGES FOR THE HANDLING OF HAZARDOUS MATERIALS AND FOR
COMPLIANCE WITH LAWS AND REGULATIONS CONCERNING HAZARDOUS MATERIALS,CHARGES FOR HANDLING,DELIVERY,AND SHIPPING,AND/OR CHARGES FOR ENERGY OR FUEL NONE OF THE
CHARGES REPRESENTS ATAX OR FEE PAID TO OR IMPOSED BY ANY GOVERNMENTAL AUTHORITY AND ALL OF THE CHARGES ARE RETAINED BY SELLER SELLER HAS NOT SPECIFICALLY QUANTIFIED
THE RELATIONSHIP BETWEEN THE CHARGES AND THE ACTUAL COSTS ASSOCIATED WITH THE CHARGES,WHICH CAN VARY BY PRODUCT,SERVICE,TIME AND PLACE,AMONG OTHER THINGS
EMERGENCY RESPONSE INFORMATION
CALL Emergency Response Telephone Number on Shipping Paper first
PROPANE METHANE ACETYLENE AIR NITROUS OXIDE CO, LIQUID CO, ARGON NITROGEN
HYDROGEN MAPP OXYGEN LIQUID Oa LIOUIDARGON LIQUID N, HELIUM
POTENTIAL HAZARDS POTENTIAL HAZARDS POTENTIAL HAZARDS POTENTIAL HAZARDS POTENTIAL HAZARDS
RREOR EXPLOSION FIRE OR EXPLOSION FlRE OR EXPLOSIONHEALTH HEALTH
•EXTREMELY FLAMMABLE •EXTREMELY FLAMMABLE Subelence does not burn but wan wppoa combuslon Vmoa may cause d11...a ssphy.uhonwMou: V.P..may cause dunress or asphy.lotlon
Will be moly,gn,letl by Mal sparks c,names Wil be eauiligmled by heal sparks or/lames Some may lees/lmlas,vy win Lots war w—I warning
•Wil fano e.plosw shmme.,th air WAltomeaplos hurb,rmwthar •May lgmle combusebtvs lwmtl paper aI staining etc) vapors from liquefied gas aro mnwlly heaner than ar 'Vepom from liquamtl gas ammaaly he.,cruan air
•Vapors from taunted gas we Imillly heaver tmn ll aprmtl along Slane mil,glum sponmnevusy m eu Vacant from bquelwd gas ere wmary heavier Nen an spread and spread along gmund end spread along ground
ground and rsy bawl m sorsa l Ig—arA mash back, .Those substances desgnaled wM a(P)may pdymmze along ground end may,awl to source of,glen end fled/back Contact war,gas a haunted gas may cause bums FIRE OR EXPLOSION
CAUTION Hyd g9n(UNINg),Me d,m(UN19M,HydmgoM exploswsly when healed a,molvedm a fire Runoll may create no or expioson hazard severelnlratrandrashoslb,le Noo-Aammeblagases.
mMgeretetl
liquid(UNISS end Northam(UN19T1)ere lighter then yemrs from hquatwtl gas are w,tlely hmncr plan e,r Conanorsayexplodewhennaiad FIREOREXPLOSION Comahere my oxpinds when hath
plrendwill rtes HyEmgemend Uemedam tons pre almcut m dot Y spremwa ,groun1rmdmyVavel to svurco of,gnAlan Rupluredcyhnaers may racket Rupturod cyl,,d,,,ay racket
slots theybumwithenlmismlpgame Umen altammemethod of antl flash beck HEALTH •Non-flammable gases
delactlon(thermal cvmem,broom handle,etc) Cylinders exposed to Ito may vent and reloass gammeons Vapors may cause dlznnose or asphywabon w,thout womng Ruptureds ay es may rocklodowhonet
healed PUBLIC SAFETY
•Cyltrawa aposad to lire may ventend release flammable gas Nrnh lel dances Conlec-In II Lad burns silvan •fluptoretl cyl,n PUBLIC
may rocket Isvlata spill fall)ir leak nuea,mmeaatoly total least 100
through pressur mill dewces go,
any pressure
Man heated and/or[,-bittesor qua gas may cause emlury PUBLICSAFETY •K�iem(330 Ian ell d,—.n,ewe
ry os Y Y W g smith mvc gale •Isolates al a Teak oa unmetl,ate la el Ieds1 1 W p um^d persome y
•ru Z maye.pladewhenheated Fuphaad lndeaa racket. Fre ma nduw vnlaan s p y
•flupmmetl cyd,adea may rocket HEALTH comers(no(ce)In 0 arstvme
•vepas ma a,u,nnaa a es Iron wlihnl waznw PUBLIC SAFETY Man stayprams are heaven Nan tie alp will spread
HEALTH y cause phy.s g Isolele spill or leak arca aanadately form least 100 meters(no Kmp pwand uetl mnsonnsl away aa,9 Around and tolled m low or confined areas
•Vapors may muse tl,umess or asphyualwn w,ihnl warning Same may be lo.lc,l inhaled w high cancenlmhom Imp mal mrevons Stay Pwtnd (seware bammonis Tanks)
•Soo may be Inial it Inhaled et high commmrawn. Cohlwd,YIth a or II uefetl use burl severe Marry gases are heaner than en mc!w iff spread,long
•Contac/with I, gas q gas may ce Kmp uneuNar,zetl pasonml away d antl tolls/m tax or calf cl areas Keep-d lower eas
gas or quel,ad gee may souse burns severe Injury Injury and/or lrosNlla Smyupwmd basun Isew,ra Venaala closed spaces bemrneanrin
and/or frostbite Fire ma oduce mawm and/or lo.w basp ous oflanks) g
•Fre may protium Irritating imalor wls gases Ypr gen Bases Many Bases are heaner than asaeatlaonglks) and .Keep pmdlox ams PROTECTIVE CLOTHING
PUBLIC SAFETY PUBLIC SAFETY caleans.11 tar eros, lea(sewers baseaas talks) PROTECTIVE
CLOTHING
bmlae emamg •amem nwopressure sencona,nod breatnmg
•Isomm spin or leak wan mmadwlely lm at bast 100 meters ino Isolae 9rll a mak ma Inanimately for et lC851 100 millers Kmp nt d mx areas PAOTECRVE CLOTHING anuct ps(SEBA)
3901ee1 m w1 dueclwm cep fear)man dr,ed pains • OTEC7 closed spasm bolos on:ermg Wear at"postinve,(S preswre Sellionm,rad bralh,rg Sauctursl fel prof Waslwe cbmmg will any
( I •Sap unsisprivad rzea pasnml away -Wow pTIV m,plop HG epparaus ralgho ACA ON protstron
•Keep P.hd rzod parsonml away Slay ugwmtl Wear,oases pressure acllcvnamad braining mparetta Structural firelighters pr,:ect,w ctpN,ng will only EVACUATION
•
Say upwlntl •Marry gases aro heaner than en end will spread along (SOBA) Aplonde limited pmtellog terga Split-Constler spies tlownwmtl evacuation lar
M rN gases tip he.vwr awn o,r end w+,l ca antl el,n0 oral and b d and celiac/In taw or conl,ned spam(smwm Waea themes/am-1 vs clothing wheh is ap,cllwany oya moor sperm,/pmtsctivo cbihe0 Mmn m leas:tgo mars(no Is.,)
•Nee conal-law
or ana9ad saws(sevmrs erns take) baaemena Anka) amommenaed by the manulec:urer Il may F—d.,ntlmorno handling minge marcrypg—,lqulas ar wild, FIOLAT nM rpm car ort ilk Wck nw,vad lnel,re
Keep •Keep out of low areas thermal protection EVACUATION IS for 800 memis(112 mae)Iln altlnall-re
PROTECnVECLOTHING PROTECTIVE CLOTHING Seuctural fMghlas Protmbvp cbN,ng,s remmmsntlea lar firm also mnardabr„Ipv......h for 600 mama
•Wwoprosive Plasmas seAmllemed buraWrlg aDpa2Ws(SC9A) Wmr,ovine or—.sell-conm,led bmalhm lue sluahwts ONLY tire mol stational IlvWausne noels does/ least 100 rsers(mo
ofast)al tlavmw,na evacuvuon rotor
•Swctua firelight—protsuw ctathmg will only pro..de Lnulea g appara p, ones:It t meters car or t p 112 onion)In all drsaas
(SOBA) coact wM the mal phnm a possible Flre-It auk ren car sh auk buck la)rs an issa../rte EMERGENCY RESPONSE
p.,cron •Samlaaifvebghlas protecLwcblhmg ell only provpe •Alwaysn.nurle Pmas:Ne cbNw9 whon handing mehgoenV ISOLATE for800ata,n1 miler uaIe(f/2rm also FIRE
•Always wear Ihgm,a,quids a clothing wino hantllm9 hummaEVACUATION
ION cryogenic bqup9 crosavr,.ml ewcahvn la 800 millers(12 nolo)m •Use eundingsh,rg agent aunaam la type of
r IngaanVcryogonlc I,qu,tls EVACUATION EVACUATION ell drsl,ons surrounding Iro
EVACuAVON Large sell/-Constlonn,ial tlownw,na amcuabon tar al leos[ Large Spilt-Cons,derinihaldowmandewcua:,onlaatlast500 EMERGENCYRESPONSE •Mora containers from fire areas 11 you can do It
Longasplit-Conapermbal downwind owcuaen fore leas:800 600 meters(tl2 mllal momm(amna) without risk
metas(1/2 moon Fire-It tank rail ser or ank lnckas T,md In,lue ISOLATE Fire-If tank ran car or lank mck,s invol Win a llro ISOLATE FIRE Dama do tlors ahoultl be hpntllod and b
Fim-ttaar,ra,I carorlmkh—lalmawambtim ISOIATE1. to,1600 melers(Imrd)Incl dirmem,also mns,der,naal nor 000 income(112 mre)m al anchone also c-.,d.r mmol Use e4,ngu,sh,ag agent sumblo for ypmol mhsl9ylln y y
1600 millers(1 mlo),n an d,rsirons also canons moa ewcuatwn amatmn tar h600 eters(1 mile)m an tlrtst,am achaWn lar 800 eters(1/2 mile)a all auectmm surrounding fire re w
Io 1®d otos Il moo)m en tlaerlrona eV Mow mummers from firs aces it you can old Fl In Iving Tank.
EMERGENCY RESPONSE EMERGENCY RESPONSE EMERGENCY RESPONSE Ii not, •Flim fie bbl a.,mum ducal or use unmanned
FlRE-DO NOTEXRHGUISHA LEAKING GAS FIRE UNLESS FIRE-UseexangwMrtg oBanl enable la typo of surrormtlugfro •Dao d Inders sluAld be handled onl hose homers or r'gamr mroIDs
FIRE-DO NOT EXTINGUISH A LEAKING GAS FlRE UNLESS LEAKCANBESTOPPED Smell R.,-Dry chermcala CO, ml.l.uas ybY •Cool contaznorp wkht Ibodng qual,1m 1water until
LEAK CAN BE STOPPED Smell Fires-Drychoure lorCOQ Large Flmaolving wait lire a out
CAUTION Hydrogen(UNIW9),Oeur.rlum(UN195T)and la Flma Wirer spray I F/re ht Lire fr,Tanks
H d refrigerated ll uid UN1966 burn with an Invisible age y ag or regumm Imm •Fight tae from mammum h-le,or........md m:sirs/nota al source of Irak or safely
y rogan, 4 ( ) •Wales spray or log •Damaged cylldeamlm,rm dyne mil do b without risk has,untaloa monitornoums devices icing may occur
Name Hyarlagme.11h hilvMethane m/iluro,cvmpasetl(UN2p]a) Move container,Talks Fire
lire elm,l you can tls,t wiNoui mk Damaged cyMnders Mould bo hantlletl only by spoclahsls Coslconm,mrs won flooding auant,pes of water iota/ WMtlaw mwooamlymmw of Io could Imm
leybumwithanherru6laarsons FlFInvolving mall Flm lnvolving Tnnke moll etandwout wnung silly away
sn arscoloretron sl milk
Smell Flma-Dry shalom/aCOz •Flim/nor Irom marlmum ausance or use urmlennetl time Fight fire Iran a.,mum dame a use nmannad baso holdees Do m:aril waver el source sl Ilk w solely dances ALWAYS sly spray hem ants engutlnl,n I,re
Large Flns hailers a rtwrina mules a nnn,lormzzlesmary SPILL OR LEAK
•Water away or log Cool conaulem wall loading ganhws of valor unto well Cool nnmmem will,loosing qualinku of water mel well.ter Window,mned,aty In most msng cound Iran Do lel inch or walk through started atonal
•Move mnamem from Jim small you mil calf wawa risk pryer Bre m out fire at out wnhng salary dances or d ualolomban of milk Stop leak d you can do it without risk alp d postale
Fire Involving i ka not Oils/water el source of leak a mlery tlev,ces ,no Do ml drsl water at sourco of look a salary den ace king ql-Way$stay away born ranks engulletl,n bre turn leaking mna,nere so that gas escapes rather
•
Fight fire from maximum dslante or use unannetl base holders mays may occur SPILL OR LEAK Than hauls
ammrnpules Wtada—mmeaately In case literal could from venimg W,thdrowurn—dalely In case olrls,ng sound lromvan:mg salary Donattnchorwa1111hrsughsp,lletlaleml Use water spray to reduce woore or d,val vapor
•Coal conlaners won fkradmg quanaha of meter unit well,tier safety devices or aacobml,on of lank deuces or tl5mlorel,omof lank •Slop leak If you can do l:mines nsk and if possible
cloud all Awpalowwg water runoff to coact
Ire rs vol •ALWAYS stay away Irom:he ends of No tank ALWAYS slay away Iron inks engulfed in Ire turn looking conlalnery m that gas escapes rather studied malarial
•De rid direct watera zoom of task a salary rJev,ms-M—Y— •Fa looses Ira,use twmannetl Mss holtlers a manna •For assns Ore use unmsnnntl time hWtlors or malaor mums d Nan 1, p •Do has d met wafer w spin or saucm of leak
•WiNamw urumaramy.m mss of nS,rg snap Iran varmg safety mules,I this at Impossible wnbtlraw Irom as and lel the m Impassible wthamw Iran aro slid ml fire ban Use wafer spray lo reduce epos or rima wpa Ravent envy mho waterways sawam,lawk mane or
dances o demmra:ron of rank. fire bum SPILL OR LEAK cloutl alit Amid anown cordmd arms
•ALWAYS say axay Irom the ends of he tank SPILL OR LEAK .K g water mrroR to conmci
•Fvrasswefine etaewzmadhmanddarcou non,los,l aLn-...h,r,(wtntl spilllel stand Iran sphW rsterW ap,notlamnal •Nmwaillur as ewmrata
this,s,m ELIMINATEenigmtron anrces(msmoking hares sparks or Donn:muchor walk Nraugh spilled materia Domnt envy,. w.—ya.ora,of leek FIRS AID poss,hle w,Ndraw from area lothueburn Ilamamlmt used area) $top lier,,that gao...onaaak dna llq,,dible turn leaking prevomenby,ntp waterways sewers basananma F/M,,
SPILL ORLEAK Allwdedenlusetlwhen M1nntlhng the product must be domainersor that gas mcepoaother Nan Ilqu,d mnfinetlareas Movevictimto mgoor
•holesELIMINATEalidem.maaces(m smoking Ilores sparks or groundsd Denddreslwamm aduc-peso Bleak Call 9ll oromergnncy meJcal services
Games N Immedala area) Slop leak,/yn mil do if w,Nnf risk mtl ill Allow substance Io ovapaele
•An e9uat��wlcn had,Ty Ne�t alis,he s,them tum on—mg rater nulfeducav==I spilled
tlrvertwpo cloutl tlr,t Avail CAUTION the arca Ad..,cwmlrmarehmnvwbm enotbreotmng
•
On
mltouch o warnWn hs Iled material �� making mummerslkNalgasescapes raid hqu,tl Glomal wales awaff mways nwallsalenal CAUTION When mconfect iwith nfa.Items Il Admwstero.yBandbreathl mtl,lfnit
•Slopleak II g u Dc ml Inch awalkWngh mtllsa 0look Prevent envy won waterways sewers basrrtmlm or awMetl amok rlcpillosneak mishmul HIn become bdR/e omit Keepethat warmantlgaet
yn mil tlo t wntwul risk and d posshle mm®lung Dc not mrst ay to m spin a snore d look eras am ak.l L break wllhovl hwm/n Fnwm that m wit pasonml ora aware t the
Use"lantrunso mat mduce,le apm rsthert,then Ill— Uwwanowng to reducowPasatmin wpaderal dam Allow substpme Uevamrmo FlRSTAID g maeral(e),nvNvad and take precautions to proles:
Use
water spray l0 nndece veer.or tlhonwmrclad tlnt gwid allowing wafer runoR tocnlacl opined material •Isolate sea unhlges has d,spvractl •Move vkam lO lreah air Namsolve9
Awp eilowng weer rmal moist,spilled material •Prmenl entry Into wamnwys sewers bas.m..1.or CAUTION When In vanfac!with reldgeremdvcryogenle liquids, Call 911 or emergency tical services
•Do no:drat/water el spill or sorsa of Ivek mntaed ems many,alwarrms halo..brills allow likely Io break wfha,i 9 acy ma
•Prevent sprsetlng vivapors through sewers ventlalon systems •Isclateara unul gm has dispersed —Ing Cnvenstero ge,,f oallncbm,s not breaN�ng
end canimed areas FlRSTAID FlRSTAID •Atlm,n¢ter oxygen,/bmeaN,ng Is d,ffwull
•Isdae sea anal gas has chmarsetl
uwCill Ili o Na skin—Id be hawetl belos
CAUTION WhnNmwihMr9rsle64ryogncLqmamay owvwmeor ea
Ca11911 or emergency makfull semcce Can 9v1lor=Zemeyrmoaml schloe bounghmnaved
Incaseofcomas w,Nh 1
mahataLabecgrtmbdmeap.re llkdymbrmkhvMMrraNng Give arawwl mspuomnd vrcam,sM broaN.g Gwe.rol—I rosammnd v,clrn is all breathing quemd gas taw fiostea
FlRSTAID Administer oxygen A breathings,dalwull gtlmm,sler o.ygen,l brawamgns da,cuft Pans wan hulk—wale
•Mwev,d,m tofresh eu Remme and Isolate contaminated clolhing and snow Ranwv fid solins camam,mled cl.h,ngand shoes E.epe,ctunvsrmsntlganl
•Ca119t l or emergency mmeel mmme In case of cantos/won lqumed gas new frosted pans with Clothng flown to Ns Nm shnitl be Vawea before bong rems,ed E�s that meotlwal personnel ore aware of/tion
•Give amfical resprahon 11 vision,s no:breath,ng lukewarm water In mseof contact with I,uefiad gas New lrmlod pans vnIn aerlel(s) Ived and lake prsaawns top tact
•Atl.mnaroxygen if breathmge difficult .Inmost burns martmotalycml affected slum lea as lukewam ester Nemaelves
•Remo..
and allato M
conmmal
med clothing and shins long as possible with rola wafer Do m:mmavu onammg d Keep nciun warm antl qu,nt
•Cbtnvg frozshm Uw tion' oatl be V b balsa bung mminad adhering m Sion •Ensure Nat hadml persoare
mel arewaol Nrrw ,a
e :als)
•In case of mnlacl w:h liquefied gm thew frosted peas with .Kap-ons wasp end goret Involvedend oke prswalve m protect thamalvm
lukewarm wets, Enwre Rat madeal pommel tie—real Ne mahmal(s)
•In—of bums ervreaatey man affected!Nil la as lay as possible Invdvad and mks prsaubons to protest duclul lees
win,cola v amr Do mr awn—co h'ng a sonamtq m ale.
•Keep vital wasp antl quiet
•Ensure Nat matl,c,l personnel ere aware of the masnalm)
wive,antl oke pmmuboas to protect Neaolvvs
. ,
'
TO ENSURE PROPER CREDIT P EASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE.FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL' 216-520-6000
99813088991 2576547 3 78688 07/31/2021 RENT NET 30
;NW SHI Le
BEG SALJ"�
CY-PR 33A - CYL PROPANE INDUSTRIAL 33 CGA 790
RRCYLILG-AR - Rent Cyl Ind Large Argon
RRCYLILG-OX - Rent Cyl Ind Large Oxygen
CY-OX 200 CYL OXYGEN INDUSTRIAL 200 CGA 540
RRCYLISM-FG - Rent Cyl Ind Small Fuel Gas
Airgas Hazmat Charge (H) see Itemized Charges on reverse or visit www.Airgas.com/terms-of-sale
Hazmat: 20.30
Important See the Notice Regarding Cylinder Rentals/Leases and Responsibility on the
Reverse side of this form You will be deemed to have accepted the provisions in the said 105.24
Notice as part of the contractual arrangements between you and us,unless you reject such all
provi sions by written advice to us within(15)days after the date of this document. Airgas USA,LLC
SHIP To 3878688 Acct No 550372228
Airgas FISHERS ISLAND FERRY DISTRICT JPIVIC Bank,ABA No 021000021
�W�N�NCTU�2
an Air Uquide company 5 WATERFRONT PARK
�GAGU LLC '
0ussRocuomoWoods Blvd For change of address
~~~~
Independence,OH44181 email to-NDIV.DI@Airgas c,m
nc����� 0017333 Page 1 of ~~^216-520-6000
1
Disclosure
Terms of Sale Each sale of Goods or services by an Airgas-,1-1 company is and shall be governed by the terms and conditions on this Disclosure,the Terms of Sale affixed to
the Account Application(if one ties been completed),and the Terms of Sale found at htto//www airgas com/terms-of-sale(collectively the"Terms of Sale") Each Contract for
the sale of Goods or services between Seller and Buyer("Contract")shall include these Terms of Sale,together with any other material describing the Goods or services being
sold,their price,delivery terms,and all other special provisions "Goods"refers to any items of tangible personal property described in any Contract or otherwise provided by
Seller to Buyer
Notice Regarding Cylinder Rentals/Leases and Responsibility. This document shows the total number of cylinders charged to Buyer(i.e,cylinders which Sellerhas rented or
leased to Buyer,and which Buyer has not returned)according to Seller's records as of the month ending date shown The number of cylinders thus charged to Buyer shall be
considered correct for all contractual purposes between Buyer and Seller,unless Buyer reports to Seller in writing any errors Buyer claims within 60 days after the date hereof
Buyer agrees to continue to pay rent on all cylinders chargea to Buyer until Buyer has either(i)returned such cylinders to Seiler in good working order or(it)pays Seiler the
replacement cost thereof
Refrigerant Cylinder Returns/Deposit Refillable refrigerant cylinders shall remain the property of Airgas or its third-r--,rty vendors Such cylinders shall not be used by
Customer for purposes other than the storage of gas products purchased from Airgas or the return and reclamation of certain gases(e g,refrigerants) Each refillable
cylinder will be subject to a cylinder deposit fee,as established by Airgas from time to time Airgas will refund the deposit fee when the Customer returns the refrigerant
cylinder unless the cylinder's condition is deemed to be unfit for reuse,as determined by Airgas which determination shall be irrefutable sixty days after the cylinder was
returned
Warm All products, other items of sale, cylinders and other containers furnished by an Airgas company shall conform to the description thereof published by the
manufacturer at the time of sale and will meet Seller's purity specifications for all gas products SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED
STANDARDS, GUARANTEES, OR WARRANTIES, INCLUDING ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-
INFRINGEMENT AND ANY WARRANTIES THAT MAY BE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE.
Limitation of Liat2 tv: SELLER SHALL BE LIABLE ONLY FOR THE REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS AND PRODUCTS,INCLUDING
THE REPLACEMENT OF GASES THAT DO NOT MEET ITS PURITY SPECIFICATIONS WITH GASES THAT DO MEET SUCH SPECIFICATIONS. BUYER KNOWINGLY
AND FULLY ASSUMES THE RISKS OF TRANSPORTING AND USiNG COMPRESSED GASES.SELLER SHALL NOT BE LIABLE FOR ANY DIRECT(EXCEPT AS
EXPRESSLY PROVIDED HEREIN), INDIRECT,SPECIAL,INCIDENTAL,CONSEQUENTIAL AND/OR PUNITIVE DAMAGES,ARISING OR ALLEGED TO ARISE OUT
OF OR IN CONNECTION WITH ITS PERFORMANCE OF ANY OBLIGATIONS ORANY PRODUCT,OTHER ITEMS OF SALE,OR EQUIPMENT SOLD OR i-EASED BY
SELLER,WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT OR OMISSION OR IS RELATED TO STRICT LIABILITY,OR OTHERWISE,
Terms of Payment Unless otherwise specified in a Contract,Buyer shall matte payment in full within 30 days after the date of Seller's invoice Continued open account credit
is subject to Seller's assessment of Buyer's financial condition and ability to pay A late payment charge of 1.5%on the unpaid,past due balance,will be assessed monthly
(minimum two dollars($2 00),or the maximum lawful rate allowable in the state where the Goods are delivered,whichever is less
Surcharges Upon notice and receipt of underlying documentation.Buyer shall pay to Seiler a surcharge in the event of any extraordinary or emergency increases in the cost
of(a)power and/or raw materials used in the production of Products and/or(b)fuel
Title to Equipment Title to all rental equipment shall remain in Seller's name Buyer shall not cover,modify,remove or otherwise disturb any identification or other indicia of
Seller's ownership on any rental equipment
Taxes Any taxes imposed by federal,state,or other governmental authority on the sale, use or possession of Goods,or the sale or performance of services by an Airgas
company,shall be paid by Buyer in addition to the purchase price
Itemized Charges (a)The total amount due from the Buyer may include various itemized charges, including charges for the handling of hazardous materials and for
compliance with laws and regulations concerning hazardous materials,charges for handling,delivery and shipping,and/or charges for energy or fuel.None of the charges
represent a tax or fee paid to or imposed by any government authority,and all of the charges are retained by the Seller The Seller has not specifically quantified the
relationship between the charges and the actual costs associated with the charges,which can vary by product,service,time and place,among other things (b)No such
charges not already provided for in a Rider will be imposed without mutual consent
Government Contracts Certain Airgas companies are U S government contractors and subcontractors and are subject to and adhere to the requirements of federal laws,
.executive orders,and attendant rules and regulations,specifically Executive Order No 11246,the Rehabilitation Act of 1973 and the Vietnam Era Veterans Readjustment
Assistance Act of 1974,all as amended
Airgas eBusiness
Now doing business with Airgas is easier than ever with our eBusiness website,http-//www.airgas com Visit us online today to see how www.airgas.com can save you
time and money
TO ENSURE PROPER CREDIT PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE.FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL 216-520-6000
R EI7>N IN, QI .AI INVOICE DATE
1102285426 9116030889 08/02/2021 2576547 FISHERS ISLAND FERRY DISTRICT
01RELEASF-4 ., YMENT>TF#�MS:�'"':: :•� ,ORQEI�.k7ATE
BOB AVIN 860-442-01651 CUPU NET 30 08/02/2021
'DELIVERY A1Q>f,.,,,
'MAY t•,
1 t 41S ?QTY Br(1 >s UNif FRIeE'r" (Jt M•', „ :AMC7Urd i?'? `•:';:
,.DESCFIJPTiC}lt=, ; • <r:.,,;
HipD �
8112449680 PR 33A 4 CL 4 4 41.00 CL 164.00 N
PROPANE INDUSTRIAL 33A CGA 790 (Vol: 128 LBS) (H)
Sale subtotal: 164.00
Airgas Hazmat Charge 20.45
Airgas Hazmat Charge (H) - see Itemized Charges on reverse or visit www.Airgas.com/terms-of-sale
L
.; ANiQIlNTry 184.45
SHIP TO-3878688 - -- _"'''
Airga& FISHERS ISLAND FERRY DISTRICT
an Air Liquide company 5 WATERFRONT PARK Airgas USA,LLC
NEW LONDON CT 06320 Acct No 550372228
♦ , AIRGAS USA,LLC JPMC Bank,ABA No 021000021
t 6055 Rockside Woods Blvd
Independence,OH 44131 For change of address
000431 email oto:
ND.Dl@, irga .com
REV 6 1 16 0000514 Page 1 of 1
Disclosure
Terms of Sale* Each sale of Goods or services by an AirgasTm company is and shall be governed by the terms and conditions on this Disclosure,the Terms of Sale affixed to
the Account Application(if one has been completed),and the Terms of Sale found at http 1/www airgas com/terms-of-safe(collectively the"Terms of Sale") Each Contract for
the sale of Goods or services between Seller and Buyer('Contract")shall Include these Terms of Sale,together with any other material describing the Goods or services being
sold,their price,delivery terms,and all other special provisions "Goods'refers to any Items of tangible personal property described in any Contract or otherwise provided by
Seller to Buyer
Notice Regarding Cylinder Rentals/Leases and Responsibility This document shows the total number of cylinders charged to Buyer(i e,cylinders which Seller has rented or
leased to Buyer,and which Buyer has not returned)according to Seller's records as of the month ending date shown The number of cylinders thus charged to Buyer shall be
considered correct for all contractual purposes between Buyer and Seller,unless Buyer reports to Seller in wilting any errors Buyer claims within 60 days after the date hereof
Buyer agrees to continue to pay,rent on all cylinders charged to Buyer until Buyer has either(i)returned such cylinders to Seller in good working order or(ii)pays Seller the
replacement cost thereof
Refrigerant Cylinder Returns/Deposit Refillable refrigerant cylinders shall remain the property of Airgas or Its third-party vendors Such cylinders shall not be used by
Customer for purposes other than the storage of gas products purchased from Airgas or the return and reclamation of certain gases(e g,refrigerants) Each refillable
cylinder will be subject to a cylinder deposit fee,as established by Airgas from time to time Airgas will refund the deposit fee when the Customer returns the refrigerant
cylinder unless the cylinder s condition Is deemed to be unfit for reuse,as determined by Airgas,which determination shall be irrefutable sixty days after the cylinder was -
returned
Warranty All products, other Items of sale cylinders and other containers furnished by an Airgas company shall conform to the description thereof published by the
manufacturer at the time of sale and will meet Seller's purity specifications for all gas products. SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED
STANDARDS, GUARANTEES, OR WARRANTIES, INCLUDING ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-
INFRINGEMENT AND ANY WARRANTIES THAT MAY BE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE.
Limitation of Liability: SELLER SHALL BE LIABLE ONLY FOR THE REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS AND PRODUCTS,INCLUDING
THE REPLACEMENT OF GASES THAT DO NOT MEET ITS PURITY SPECIFICATIONS WITH GASES THAT DO MEET SUCH SPECIFICATIONS. BUYER KNOWINGLY
AND FULLY ASSUMES THE RISKS OF TRANSPORTING AND USING COMPRESSED GASES.SELLER SHALL NOT BE LIABLE FOR ANY DIRECT(EXCEPT AS
EXPRESSLY PROVIDED HEREIN),INDIRECT,SPECIAL, INCIDENTAL,CONSEQUENTIAL AND/OR PUNITIVE DAMAGES,ARISING OR ALLEGED TO ARISE OUT
OF OR IN CONNECTION WITH ITS PERFORMANCE OF ANY OBLIGATIONS ORANY PRODUCT,OTHER ITEMS OF SALE,OR EQUIPMENT SOLD OR LEASED BY
SELLER,WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT OR OMISSION OR IS RELATED TO STRICT LIABILITY,OR OTHERWISE
Terms of Payment Unless otherwise specified in a Contract,Buyer shall make payment in full within 30 days after the date of Seller's invoice Continued open account credit
Is subject to Seller's assessment of Buyer's financial condition and ability to pay A late payment charge of 1 5%on the unpaid,past due balance,will be assessed monthly
(minimum two dollars(w2 00),or the maximum lawful rate allowable in the state where the Goods are delivered,whichever Is less ,
Surcharges Upon notice and receipt of underlying documentation,Buyer shall pay to Seller a surcharge in the event of any extraordinary or,emergency Increases in the cost
of(a)power and/or raw materials used in the production of Products and/or(b)fuel
Title to Equ�ment Title to all rental equipment shall remain in Seller's name Buyer shall not cover,modify,remove or otherwise disturb any identification or other Indicia of
Seller's ownership on any rental equipment
Taxes Any taxes Imposed by federal,state,or other governmental authority on the sale,use or possession of Goods,or the sale or performance of services by an Airgas
company,shall be paid by Buyer in addition to the purchase price.
Itemized Charges (a)The total amount due from the Buyer may include various Itemized charges, including charges for the handling of hazardous materials and for
compliance with laws and regulations concerning hazardous materials,charges for handling,delivery and shipping,and/or charges for energy or fuel.None of the charges
represent a tax or fee paid to or imposed by any government authority,and all of the charges are retained by the Seller The Seller has not specifically quantified the
relationship between the charges and the actual costs associated with the charges,which can vary by product,service,time and place,among other things (b)No such
charges not already provided for in a Rider will be imposed without mutual consent.
Government Contracts Certain Airgas companies are U S government contractors and subcontractors and are subject to and adhere to the requirements of federal laws,
executive orders,and attendant rules and regulations,specifically Executive Order No 11246,the Rehabilitation Act of 1973 and the Vietnam Era Veterans Readjustment
Assistance Act of 1974,all as amended
Airgas eBusiness
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gas
DELIVERY ORDER
FOR LOCATION NEAREST YOU
an Air Liquide Company VISIT-WWW.AIRGAS.COM
SHIPPER: SOLD BY: DELIVERY ORDER#•8112449680 .;
AIRGAS USA, LLC AIRGAS USA, LLC PAGE 1-OF 1 '
130 CROSS RD 130 CROSS RD ORDER DATE: 08/02/2021
WATERFORD,CT 06385-1204 WATERFORD,CT 06385-1204 SCH SHIP DATE:08/02/2021
800-962-0285 800-962-0285 PRINTED: 09:39 08/02%2021
SALES ORDER: 1102285426• ,
SHIP TO:3878688 SOLD TO:2576547
FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY DISTRICT CUST PO#
5 WATERFRONT PARK 261 TRUMBULL DR RELEASE#
NEW LONDON,CT 06320 FISHERS ISLAND,NY 06390-8021 ORD BY BOB LAVIN 860-442-0165
860-442-0165 ENT BY ERICCHASE
Order Type Payment Terms Incoterm Route Sales Office Plant Sales Total Containers
Org Ship Return
Acct vont NET 30 Customer Pick up Airgas
Counter Customer Pick Up N329 N309 N000
Qty UOM HM Description&Hazard Class Qty Containers Vol
Ship Type Order Ship Ret M/t
4 CL X UN1978 PROPANE 2 1
Line# 10 Materlal#PR 33A Stor.Loc.F001 4 4 4 128 LB
PROPANE 32LBS ALUMINUM 272.000 LB
EMERGENCY CONTACT:1-366-734-3433 PLACARDS OFFERED
THIS AGREEMENT IS SUBJECT TO Alrgas'STANDAR[ ERMS AND CONDITIONS
:i' SEE REVERSE SIDE FOR IMPORTA 1 T SAFETY INF RMATION
PURCHASER AGREES 70 OBTAIN SAFETY DATA SHEETS(SDS)FROM ONE OF THE FOLLOWING
SOURCES;POINT OF PURCHASE,Airgas WEB SITE AT 4%MN AIRGAACCEPTED FOR
S.COND OR BY CALLING THE ❑ ❑
ABOVELISTED EMERGENCY CONTACT PHONE NUMBER AND SELECTING OPTION#3 1
CUSACCEPT REJECT THE ABOVE
TOMER E
PACKAGED•MARKAND LABELED,•AND ARE IN PROPER CONDITION FOR TRANSPORTATION CUSTOMER MUST
AdCOR61NG 1'0,�HEED APPLICABLE qEGULATIONS OF THE DEPARTMENT OF TRANSPORTATION INITIAL CHOICE NAME `'� t7
��(p( �/'� g{ -
�``EPr L—( 1 3 y PLEASE PRINT �,/
Airgas PERSONNEL DATE T 0 D.
INTERNAL USE ONLY
Delivery
Filled By Staging Area Total PKGS Tracking/Pro Number Freight Charges Total Weight' #8112449680.,
272 LB III IIIIIIflllllllllllllllllll�llllllllI
'Total weight for m�tenals with weight displayed only
AIRGAS TERMS AND CONDITIONS OF SALE
(YARNING TRANSPORT AND USE OF COMPRESSED GASES ALLY BE EXTREMELY DANGEROUS DO NOT TRANSPORT WITHOUT PROTECTIVE CAPS IN CONFINED SPACES OR IN ANY OTHER IMPROPER MANNER
ALWAYS TRANSPORT CYLINDERS INA SECURED UPRIGHT POSITION SAFETY DATA SHEETS("SDS')ARE AI AILABLE AT AIRGAS COM
EACH SALE OF PRODUCTS BY AIRGAS USA,LLC,OR ONE OF ITS AFFILIATES("SELLER"),SHALL BE GOVERNED BY THE TERMS AND CONDITIONS BELOW AND THE TERIVIS OF SALE FOUND AT HTTP
WWW AIRGAS COM/TERMS-OF-SALE(COLLECTIVELY,THE"TERMS") IF YOU DO NOT HAVE ACCESS TO THE INTERNET,YOU MAY REQUEST A COPY OF THE TERMS OF SALE FROM YOUR AIRGAS CUS-
TOMER SERVICE REPRESENTATIVE"BUYER"REFERS TO THE PURCHASER OF PRODUCTS FROM SELLER"PRODUCT(S)"REFERS TO ANY GOODS PROVIDED BY SELLER TO BUYER
1 CYLINDERS UNLESS OTHERWISE SPECIFIED,CYLINDERS,FITTINGS AND CAPS COVERED BY THESE TERMS ARE RENTED TO BUYER AT SELLER'S CURRENT DAILY RATES,BEGINNING WITH THE DATE
OF DELIVERY RENTAL CHARGES ARE ASSESSED AS OF THE LAST DAY OF EACH MONTH OR AT THE START OF EACH ANNUAL LEASE PERIOD,AS APPLICABLE BUYER SHALL NOT PERMIT CYLINDERS OR
OTHER STORAGE CONTAINERS FURNISHED HEREUNDER TO BE FILLED WITH ANY PRODUCT NOT FURNISHED BY SELLER OR ITS AUTHORIZED AGENT BUYER SHALL RETURN,IN GOOD AND NON-CON-
TAMINATED CONDITION,ALL CYLINDERS,WITH VALVES CLOSED,COMPLETE WITH CAPS AND FITTINGS AND SHALL PAY SELLER THE REPLACEMENT VALUE OF ANY LOST OR DAMAGED CYLINDERS,
CAPS OR FITTINGS AND FOR ANY LOSS OR DAMAGE CAUSED BY BUYER CONTAMINATION UNLESS SUBJECT TO AN ANNUAL LEASE,ANY CYLINDER NOT RETURNED TO SELLER WITHIN THREE(3)
MONTHS OF ITS SHIPMENT DATE WILL BE CONSIDERED LOST PAYMENT BY THE BUYER OF CHARGES FOR DAMAGED,LOST OR DESTROYED CYLINDERS SHALL NOT GIVE ANY OWNERSHIP INTEREST
IN THE CYLINDERS TO THE BUYER
2.PAYMENT UNLESS OTHERWISE SPECIFIED,BUYER SHALL MAKE PAYMENT IN FULL WITHIN THIRTY(30)DAYS AFTER THE DATE OF SELLER'S INVOICE IF BUYER FAILS TO MAKE ANY PAYMENT WHEN
AND AS DUE,SELLER MAY CHARGE BUYER INTERESTAT THE LESSER OF ONE-AND-ONE-HALF PERCENT(15%)PER MONTH(MINIMUM TWO DOLLARS($2 00))OR THE HIGHEST RATE PERMITTED BYLAW
CALCULATED FROM AND EXCLUDING THE DUE DATE THEREOF TO AND INCLUDING THE DATE OF PAYMENT IF BUYER REQUESTS PAYMENT TERMS OTHER THAN CASH OR CASH ON DELIVERY(COD),
BUYER REPRESENTS THATTHE PURCHASES ARE MADE FOR BUSINESS,COMMERCIAL ORAGRICULTURAL PURPOSES AND NOT FOR PERSONAL,HOUSEHOLD,OR FAMILY USE IF BUYER HAS RECEIVED
CREDIT APPROVAL FROM SELLER,CONTINUED OPEN ACCOUNT CREDIT IS SUBJECT TO SELLER'S ASSESSM ENT OF BUYER'S FINANCIAL CONDITION AND ABILITY TO PAY IF SELLER EMPLOYS ANY COL-
LECTION AGENCY OR ATTORNEY TO COLLECT ANY AMOUNT DUE SELLER,AND/OR TO REPOSSESS ANY PRODUCTS,BUYER SHALL PAY ALL COLLECTION FEES,ATTORNEYS'FEES,AND COURT COSTS,
IN ADDITION TO THE AMOUNT OTHERWISE UNPAID
3.TAXES:TAXES IMPOSED BY FEDERAL,STATE OR LOCAL GOVERNMENTS ON THE SALE,USE OR POSESSION OF PRODUCTS SHALL BE PAID BY BUYER IN ADDITION TO THE PURCHASE PRICE
4.RETURNS'NO PRODUCTS SHALL BE RETURNED WITHOUT SELLER'S WRITTEN AUTHORIZATION BUYER SHALL PAY A FIFTEEN PERCENT(15%)RESTOCKING CHARGE ON ALL PRODUCTS RETURNED,
EXCEPT FOR RETURNS MADE UNDER SECTION 7 HEREOF
S.WARRANTY AND CLAIMS:SELLER WARRANTS THAT,AT THE TIME OF DELIVERY,ALL PRODUCTS FURNISHED HEREUNDER SHALL CONFORM TO THE MANUFACTURER'S OR SELLER'S SPECIFICATION
FOR THE PERIOD OF TIME SET FORTH IN SUCH SPECIFICATION OR,IF NONE,FOR A PERIOD OF NINETY(90)DAYS SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED STANDARDS,
GUARANTEES,OR WARRANTIES,INCLUDING ANY WARRANTIES OF MERCHANTABILITY,FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT AND ANY WARRANTIES THAT MAY BE
ALLEGED TO ARISE ASA RESULT OF CUSTOM OR USAGE.ALL CLAIMS BY BUYER HAVING ANYTHING TO DO WITH ANY PRODUCTS FURNISHED BY SELLER SHALL BE MADE IN WRITING WITHIN TEN
(10)DAYS AFTER THE DELIVERY OF THE PRODUCTS AND FAILURE OF BUYER TO GIVE SUCH NOTICE SHALL CONSTITUTE A COMPLETE WAIVER BY BUYER OF ANY SUCH CLAIMS AND DEFENSE FOR
SELLER AGAINST ANY SUCH CLAIMS
6.LIMITATION OF LIABILITY:SELLER SHALL NOT BE LIABLE FORANY DIRECT(EXCEPT AS EXPRESSLY PROVIDED HEREIN),INDIRECT,SPECIAL,INCIDENTAL,CONSEQUENTIALAND/OR PUNI-
TIVE DAMAGES,ARISING OR ALLEGED TO ARISE OUT OF OR IN CONNECTION WITH ANY PRODUCT OR EQUIPMENT SOLD OR LEASED HEREUNDER,WHETHER SUCH DAMAGE RESULTS FROM
ANY NEGLIGENT ACTOR OMISSION OR IS RELATED TO STRICT LIABILITY,OR OTHERWISE
7 REMEDY BUYER'S EXCLUSIVE REMEDY FOR EACH UNEXCUSED FAILURE OF PRODUCT TO MEET SPECIFICATION SHALL BE,AT SELLER'S OPTION,TO RECEIVE A REFUND OF THE PRICE
OF SUCH NON-CONFORMING PRODUCT OR REPLACEMENT THEREOF WITH PRODUCT THAT MEETS SUCH SPECIFICATION BUYER'S EXCLUSIVE REMEDY FOR THE UNEXCUSED FAILURE,BY
SELLER TO DELIVER PRODUCT AS SPECIFIED,REGARDLESS OFTHE CAUSE OF SUCH FAILURE,INCLUDING NEGLIGENCE,SHALL BE TO RECOVER THE DIFFERENCE BETWEEN THE COST TO
BUYER OFANY SUBSTITUTE FOR PRODUCT NOT DELIVERED AND THE LESSER PRICE OF SUCH QUANTITY OF PRODUCT HEREUNDER
8.COM PLIANCE/SDS:BUYER SHALL COMPLY WITH ALL APPLICABLE LAWS REGA RDING THE SAFE HANDLING,TRANSPORTATION AND USE OF PRODUCTS BUYER ACKNOWLEDGES ANDAGREES THAT
SELLER HAS PROVIDED RELEVANT SDS SDS ARE AVAILABLE(1)AT THE LOCAL AIRGAS BRANCH,(11)BY CALLING 1-866-734-3438,OR(III)AT AIRGAS COM
9.ITEMIZED CHARGES.THE TOTAL AMOUNT DUE FROM BUYER MAY INCLUDE VARIOUS ITEMIZED CHARGES,INCLUDING CHARGES FOR THE HANDLING OF HAZARDOUS MATERIALS AND FOR
COMPLIANCE WITH LAWS AND REGULATIONS CONCERNING HAZARDOUS MATERIALS,CHARGES FOR HANDLING,DELIVERY,AND SHIPPING,AND/OR CHARGES FOR ENERGY OR FUEL NONE OF THE
CHARGES REPRESENTS ATAX OR FEE PAID TO OR IMPOSED BYANY GOVERNMENTAL AUTHORITY AND ALL OF THE CHARGES ARE RETAINED BY SELLER SELLER I4AS NOT SPECIFICALLY QUANTIFIED
THE RELATIONSHIP BETWEEN THE CHARGES AND THE ACTUAL COSTS ASSOCIATED WITH THE CHARGES,WHICH CAN VARY BYPRODUCT,SERVICE,TIME AND PLACE,AMONG OTHER THINGS
EMERGENCY RESPONSE INFORMATION
CALL Emergency Response Telephone Number on Shipping Paper flrsf
PROPANE METHANE ACETYLENE AIR NITROUS OXIDEARGON NITROGEN
LIQ
HYDROGEN MAPP OXYGEN LIQUID Oa LIQUID HELIUM
LIQUID ARGON LIQUID NN,a
POTENTIAL HAZARDS POTENTIAL HAZARDS POTENTIAL HAZARDS POTENTIAL HAZARDS POTENTIAL HAZARDS
FlRE Ofl EXPLOSION FlREOR EXPLOSION FlRE OR EXPLOSION HEALTH HEALTH
•EXTREMELY FLAMMABLE EXTREMELY FLAMMABLE Subaa al does nor burn but-ll mppon canbualm Vapare my cause azzmess or esphyxaaon wo-1 Vapors may cause Cazmasx or asphyxallm
•Will be easdy lgnned by heal,sparks almmes WO by early,gmled by heal sparks or flames Some mayreactevpbslvdy with foals war wnnoul warning
•WJlfamexpI.r,..utureswl.x Wllformoxplo.I-mlxmreswMrt,
a. May ignas cob.debles(mad paper,oil cloning ale) VapomBroml ruclad II heavier Inane. Vapor,from equalled gas ar¢,nliolly hearer thane,,
•Vapors from fauetied ga.are l"leuly hottAW mama sprmtleang Slanew, nor sponleneouc Va from 11 god ere lonay
gronrd and my Vavel ro swam d,nmol antl naM back g^ Y,n e. pons euelletlg travel
to comneonathan ar spread wall o,hqund antl6ormtlelonBBrquntl
Y 9 •Those substances Bated Ca d,oIh a(P)may pdyma,za along launtl end may,a-I to space ol,Bnnwn end Gash back Came unm pas lo liquehmtl gas maycoos¢bums FIR OREXPLOSION
CAUPON Nytlmgan(IIN1019),Deuterium(UN195TJ,Nydmgm, expans,a whanhealetlat,m,nay melee •HumHx-ma,alosts meerwhanveausil rd. - FIRE
and/a lrosmno •Hort-nammablegloa
Dtrand will oHdrogenand
Mamoru Mesa1)m lighter Dan Vapors from Lquefmdgavcruyi,aelto werthanw •Captured anmya.mywhop hea[etl - Flfla OR=.PLOSION - Ruptured mwserlaewhen healttl---
.Ir.thyldmHy anlmllbooutee UwasalWd leulibdatect epdiflampng around and may lineal to source of igmuon •Rupluretl cyM1nders may rocket an mcrs°ble Ruplwatl ry,mPUBLIyrocket
slots ill burn wish sn invislblo game Use an almmala momod of gore¢
w ortl dash back HEALTH .Conlareal cmay explode when heabetl PUBLIC SAFETY
rtamNoars expel Camera,bmy yhandlv,an .Cylindersh prestlre Iremayvent arN rcmsoIlarvnabla •Vapae may cause I,,umessaasphyam,^nw,IhaNwaning .RupNrotl cylindersmayrocket Imlaesella leak oral unmedatolyfor el leas)tOB
•Cyl,ntlers eapaod Ip l,re may vim and release gammabb gas Bas through pressure reLa deuces Canbml unm Bas a l,quel,od paz may cause Dans same¢mryry PDBLIC SAFETY meters(330 leeO In e0 tluecmru
M cxgC r renal d,n m Containers may explode when healed arms aPlam .Iadate tall or leak orm,mmacralely lar at least too Keep mus"'uotl W—.1 away
•Co mvrs y plotlawhen heated Rupluretl cylmdos maymckel Fre may produce irnmamg and/or toxic gases metas(3301eeU,n all arechans Slay upwmtl
•Rupluretl cyl,ntlere may rocket HEALTH PUBLICSAFETY •Keep.naumonzetl personnel array •Marry gases ere heovler thenar and welom.d
HEALTH Vapwe may caum azz,ness or ssphyuatlon w,thout warn,np .Isolala a lion leak areata Conabd la at least too maters 330 eW re.m i t mal mllmt in Iowa confmad.reas
•Vapors may caum fICConsss or asphyxlaoon-Maul waning Some may be toxolnmaled al h,gn concenVatrorrs feet)In ell arecmns Y ( Stay upwmtl Isewms Desmcros mnMs)
•Some may be maa.g l amoad a h,gh cmtrenvooms Canmcl-m gas or Innerfistl gas may muse burns Camera Keep unsumanzetl I away •Many gams all hearer man at and,,11 son( along Keep ouI of now areas
•Contact mall gas or ufoaretl gas may anuso burns cams Inl.ry Injury entlior Instal. perinea w basements
antl mllec,lo Iwo or confined Geos lsevrens
antl/.,haunt¢ •Fire ma pmducsI torn cion-c •May gases basemenm tanks) •VOTECbVE CLO774INed belora emormB
•F�s may proeucernmbmg.mil.rloxc Bases Y gen ga..es Many are halo,¢,than a,rentlw,ll spreetlalonggrountl end Keep of lax areas PflOiECPVE CLOTH/NG
PUBLIC SAFETY collect in lox or conlmad-as(mwaa basemenle banks) yat,laedoseespaces before enenng Wear posmve pressure selfconlemed breammg
PUBLIC SAFETY Isolate split on lock area Immediately for at least 100 meters •Keep cold low areas PROTECTTVE CLOTHING apponeWs(SCEA)
•Iwlale spat a ea m
Ieat arm a y f ]oast 100,nines (030le d)m ell d.°cbo^s Ven,Wlp closed spaces before anlermg Wear poslaxe presale mllconlalnod br Cx g S,uclurN firergnlers pro,ecuum doming wel only
(3301-1)In all dreclone Keepun,mmanedpasonnalamy PROTECTIVE CLOTHING .,PC'...(SCMprov,tlseN Wole.ign
•Keepunaumonzed personnel away Stay upwmtl Weer postme pressure sell-c^nlanotl breamngepparalus Strucamllnefg,ters proleave clmhing will only EVACUATION
•Slayupwmtl •Many Bases aro heanerinen pirentl wilt cpreatl along (SCBM Large Split-Constlor initial tlo nd evacual,on for
•Many gases ore heavreu man ar ar,d wJl spread lana around aM ground and cdlocl m low or conimed areas(semen Wear chem,cal proi-m a cloth,n pmntlo anthers l pal
p whIt my anowdo by .Mvays sea menial Prange me un
rg when IF leas,100 maul ca 3U fact)
mega m bwa sodas an+,Ism ars bovsrnvnis,mina) bammenta tanks) mar
ancndetl by ma mamHmlurm It my PravNa Lille or ro EVACUATION
rcir,gmatetlkryogenm Inpoda a m1,tlp Fm-II tank nal car w tank Yuck n ervd-tl ra e fav,
•KeoP out of low areas KreP out of low seas pmrtnal prole LOn EVACUARON ISOLATE Iw 800 nCipr9112 inial,n WI arecfrans
PROTECTIVECLOTHING PROTECRVECLOTHiNG Smuclural Wall ar.act-clom,ng,s remmmentled for foe Large Spill-Cons,tlar,nsla down-d wticuaaon for at lm mnadc-maimcuordnl^,800-lists
Wear pose-pressure of Conned brect.goppaa]us(Sr-) .Wear now-pmssurecatcanlan,d br°atanBepparalus amouvne ONLY rla nololl¢cwemsoll alum-Cwlet.erect less,100 melas(330 fm1) (12 m110 In of dnocaone
•sma.hul fmfigmers pmmLa-.I.Mmg.1,only prwrow-ed (SCRA) contact mm me subaancoz pocsibm Flm-Ilmnk ralcarormnk Muck I,m,N,d I,,Gra EMERGENCY RESPONSE
Wotacaon Structural fvefgmers From ve cloutng vim only pronde Always wear Ihema]proleCave clothing when hanc hng ref^g-mil ISOLATE for 000 moans(12 mill)m a0 d. Loa also FIRE
AM-ayc wear Momal prolax-oca ug when haMlmg h mded au.n.on cryogenic Lgmda
• llgads EVACUATION EVACUATION ell tlreclipns co^acr ritual w
aleeastron la mho bas(12 ,x)at U� din
ex^ g in np agent 6u,m0mfor typal
refngerant/cryNamc
EVACUATION Large Split-Consid-n al domw1d av°Cuaaon for at feast Large Split-Conader lineal do nd wCuoc.total least 500 EMERGENCY RESPONSE
M^vo cont from lameas 11 you can dot
Largo Split-Conoacr,nmal downw,nd evncue401 f^r at least BOO BOO meters(1/T m,l°) ..,are(113m,le) w,moul nsk
ol
mars(t2 maol Flm-II Ls,Jt roll car a lank Wck a Invdvml,n°lull ISOLATE Flm-If lank rel ca a Wk,uck m imolwd In a lull ISOLATE FIRE Da-god uylmdem should be handlod only by
•Use extNuu mrg agml m,tabm la type of
Fila-II ma"'
1 I ca or tank b Jc,s vrvdved m a Ire ISOLATE la la Ifi00 melem(1 mole)m el]dueclwns elm conatler,ruual is 0p0 maers(12 mJa)mail nl,).na oL,r ans,da uulal =r specal,sls
1800Me hn(IImlmai sit or ane elm Cms,tla wisll evacuatlm acuatmn la lWOmeters(l milo)mell tlu¢abmnfi acaaavn for OOD meters(12m1e),n al tivpcapns ound,np etre Flm invvlving Tilde
Ipr lfiW meberall m,lelmalENCUMp am •Mame mnla,nersfrom firaeress,iyoucan do
EMERGENCY RESPONSE EMERGENCY RESPONSE v EMng ag,n YRESPONSE wuhoulask •Fghl lull tramcar ,roan-le ear lisp unmanned
FEAKCA NO STOPPGU1SNALEAKING GAS FIRE UNLESS FlRE-Use pximgosaucagent suitable for type of 6urrounOmg l.e .Damaged cyLntlersshoultl be handled only by Dose onfiholdnnent monflocomqu
FIRE-DO NOTEXTINGU/SNALEAKING GAS FIRE UNLESS LEAK CAN BE STOPPED Stall/Flora-Dry chemcalon CO, •Cool conmmns wJh llme,ng quanl,llas of wain u^LI
LEAK CAN BE STOPPED Small Flms- chm anal or CO, Le Fl., specmlcls wall after here out
�Y r9° F Iht fie fr Teeka
CAUTION Hydrogen dfululd Deuteriumlou fill .and Large Flree Wafer spray log fr m Ila linin right era from max,mum du^lance or use unmarred �^d erect water e,source of leak or mlery
Hydrogen,refrigerated daffism,N19.,burn wlesed lnvlslb/a Water spray orfogrfr Mwsmnmmerslro s lira else hypo can lyrt spectnsk hose hotlsmor monfbodng les tlwcas,ung may occur
It..Hydrogen end Methane mlrfure,compressed(UN2034) .Move containers from l,re area it you can do it wlnoul rink Damegatl cyLntlers should be hantlletl only by spec,el�sls .Cool cpnm,ners wnh llooanp quanl,aes of water anal Wnhaaw lmmetlataylncespolmmo of Wfrom
may bum with an Ildslb/e flame Fhe Involving Tanks Flm Involving Tanks well eller lull a out voming salary tlevlces a ascolaaaon of tank
Small Flms-Dry chem,ral a CO, Fgm to from maxvnum drsmnc.a um onmannad ham Fight fm frau m lint r,da once or use urmann al ham holders De not amIX wan a1 source of IaA or safety dances ALWAYS gay away Iron tanks¢,gulled,n fro
Large F/ma hod Is a mondor renlee or manta mulesIcing raw occur SPILL OR LEAK
•Wafer spray atag .Gaol Carla,c�t mm Ooalmpquanl,ues of v-lcr uralwe,l Cool mnle,ners wmh llauang quant,lasofwale,analwell cher Wmaaw,mydalelylncoseofrCIx:musnk Sop cak,gha wak oIt whop,llotl malarial
•Move containers tram l,reaee,lyvu can do,l wnhaa nsk elmrf.elsvut fireleout vq Stop lcok,l you can dolt wnhoN rusk and If possible
Flm lnvolvin Tanks nnng calory tlev,ced or tl¢colorab,on of tank gcpn gasomepes rather
H Do mol tivecl water el marcs pl leak ar Calory tlw,ces,c,np Do not enact wafer el source of leak or salary tlaiCas nc,ng ALWAYS rimy away from tanks°nulled m lull turn leekm banal so that
•
Fight lee from mortal d,stanco or ma unmannetl—holders Nan L uul
or Ion rmzzlas W"neur maYaxa SPILL OR g
•Coal cor m nce-m Ikwdm WaNmw-es;a dusu m ca ve of tamp sound Irom venW9 vic aw r anscoatety rt mss of,,strop bound Irpm venl,ng Clary Do not loath u wak ImoNh C,&salmd land If use water spray A.,la sauce orpo-1.,m 11 1.spa
g puanelas of water ami wall all¢, safety ALWAYS stays pr aecdaaeon d tank dwicoa,tamolvr I—of tank •t tap leak J you t do rt that g nsk and some, clout doh Aw,tl lapwing villa,runoff to tonlacl
are ns out -Fora ,e Irumm,madsef me tank •ALWAYS ore Irunmanne th a ice so notdred ealw
•Op not tluecb water et source of leak sale tlexces,c,n Yeway Yeway 0u turn leak,np conta,ners ev,hal gas esCapaz tamer
ry 9 row occur •For massive l,ro use wmannetl hose holders a moonier •Far mass,-l,re use unmanned hood tal0ers or monitor nvizles If man hgad •Do not tlnec,water at ep,ll a source of leak
•Wmtlrew,mmetlalely m ora of ns,ng muntl Iron wnimg salary nozrlss l Ws Is vnpmsbe wthaaw from ores and let ma a Impocable withdr-Iron lea end let Ive burn P,—,.mry,ao waerways some baseme^Is a
davkes or=oof Wk. •lisp was haw tv reduce w nor r w tlrvo vapor
aro Dom SPILL OR cloud drat Avatl alwnng-"ala mrell ro Cantata mmmotl seas
ALWAYS fi away hem meed Col thetank SPILL ORLE of Keep tO,Chbb(wootlomapd am)ew-ay from ea"ad rr,alaal AAvn stethe am to o-porale
•Fon mass,-1,re unmanned Doholders or mon,mr nonles a •ELIMINATE OIII nn�pn morcel lop srrak,n Imr¢s marks or Dona much or walk taro.ns,Iletl melena, sopl,ltb maleoli yenLmla the lea
this is rmposcb,euwandmw froman,and lot Ive bum IlarnomlsomBtllaeles g Slop leak it do Its h.mrCkond If D n laramwatera,ways rare-pi lock
SPILLORLEAK ) you poss,blo Turn leakng .preventanbry Iota wplewoys besomenmw FlRSTAID
•ELIMINATE all,gMron mortes(no smaxong Maes sparks a All untied ni umtl when hentllmg Dm product must be oo rat c,nons s^mal gas¢maps miner Iran l,gwd Alto.
c r aloes Mw°wNm to assn ort
heal In tamed so lee grounded it
Do not dnecl water ne spill a source ch leak .Allow n,meet¢to weporam •Call B11 a emesperey^a-h semcas
•Slap leak a you can do d-Mout r.A and,1 possmle turn Use weber spray to retluca wPora or a-n vial cloud tlryn A-,tl ypnlnlabe me area •Game emficW resp�relron,I vclan,s ml Dreathmp
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FISHERS ISLAND FERRY DISTRICT
VENDOR 001297 ALARM DESIGN, LLC 08/24/2021 CHEC4 7579
FUND & ACCOUNT P.O.# -INVOICE DESCRIPTION�� AMOUNT 3rd
SM '-.5709,2 .000.200 40104 ALARM REPORT-8/1 86.14
8
TOTAL 6.14
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THE SUFFOLK CO.NATIONAL BANK NL
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50.5461214 54/ `021 >,r 46,
EIGHTY
100 DOLLARS ,
",DESIGN LLC
0' 6,9,',,CASA'STRitT
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NORWICH CT 06360'
or,
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11900 ? 5 ?91im 1:0 2 1 Li,0 S L, P3 L,i: 68 00 L 5 0 2' L iis
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 1297 __ . : r
Vendor Address Entered by
69 Case Street
Norwich, CT 06360 Audit Date,
Alarm Design LLC AUG 2-4
Vendor Telephone Number
860-889-7576 TO k
Vendor Contact n . "
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services _General Ledger Fund and Account Number
40104 8/1/2021 $86.14 $86.14 Alarm report 8/1/21 SM5709.2;000.200
„
$86.14 $86.14
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has to good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Fishers s and Ferry District Date 8/11/2021 Title Manager Date 8/11/2021
r
1 ALARM DESIGN LLC Invoice
A 435 SALEM TURNPIKE
BOZRAH, CT 06334 DATE INVOICE#
CT LIC#105999 TEL 860 889-7576 40104
8/1/2021
BILL TO
FISHER ISLAND FERRY DISTRICT
PO BOX 607
FISHER ISLAND, NY 06390
TERMS DUE DATE ACCT NUMBER SERVICE DATE
Due on receipt 8/1/2021 107-3177&6W 908 JUNE
DESCRIPTION RATE AMOUNT
Alarm Report 81.00 81.00T
SALES TAX 6.35% 5.14
v�
REMEMBER TO TEST YOUR ALARM MONTHLY&CLEAN YOUR SMOKE DETECTORS
TWICE A YEAR Total $86.14
maw=== WOT F___77
Y,
FISHERS ISLAND FERRY DISTRICT
VENDOR 602437 ANTHEM BLUE CROSS BLUE SHIELD 08/24/2021 CHECK 7580
A
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15
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FUND & ACCOUNT P,.O.# INVOICE -- DESCRIPTION AMOUNT
0
SM .9060.8.000.000 0202108205965 VISION PLAN #A75986-:9/21 150.61
TOTAL 150.61
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'AUDI
53095 MAIN'ROAD,,'PO BOX 11797 T,,8/24/20
SOUTHOLD,-NY 1197,1-0959
CHECK`NO'., -7580,''
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11100 758011' 1:0 2 L 40 5 L, G Lil: 68 OOL502 lill
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 2437 5 �o
Vendor Tax ID Number or Social Security Number Vendor Address Entered by
P.O. Box 11792
cy-c—
Vendor Name Newark, NJ 07101 Audit Date
Anthem AUG 2 4 2021
Vendor Telephone Number
Me
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
0202108205965 8/1/2021 $150.61 $150.61 Vision Plan#A75986 September 2021 SM9060.8.000.000
150.61 150.61
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature - /j/
Company Name Fishers Island Ferry Date 8/13/2021 Title Manager Date 8/13/2021
I OF 4
` ANTHEM BLUE CROSS AND BLUE SHIELD
PO BOX 1049
NORTH HAVEN,CT 06473
Anthem. d
eII�II�Ie��IIIII'IIIIIII'II'II11°IIIIIIII"IIIIII'I'III'IIIIIIII
0330961 AB 0.425 002270/033096/004598 158 02 VG021 R
WPT132 SMGRP 08/02/202108/03/2021
FISHERS ISLAND FERRY DIST
PO BOX 607
- FISHERS ISLAND,NY 06390-0607
Your Premium Statement is Enclosed
Beginning May 1,2017, we are going PAPERLESS, Anthem's standard will be to issue bills (invoices) and accept
premium payment online via EmployerAccess.
Register or sign up now on EmployerAccess by logging onto ht!Rs://eMloyer.aiithem.com All it takes is a few
clicks!
It's free, secure and accessible 24/7! All you need is your group number, Tax ID number, and recent Invoice
number.
Just select the Billing Tab on the EmployerAccess overview screen to get started today! You will receive a monthly
email notification when your group invoice is available to view, download or print.
If you need to opt-out of online statements or payments, send an email with Opt-Out in the subject line to:
CT.ogb@a,anthem.com. Provide your group number, contact name, email address,phone number and reason for
opting out of the electronic billing and payment process
Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans,Inc.Independent licensee of the Blue Cross and Blue
Shield Association.®ANTHEM is a registered trademark of Anthem Insurance Companies,Inc.The Blue Cross and Blue Shield names
and symbols are registered marks of the Blue Cross and Blue Shield Association.
033096/004598 VG021R S1-ET-M1-C00009 4
-5 V1'4
Anthem.Y n s
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Billing Summary
Invoice No.: 0202108205965 Group Name" FISHERS ISLAND FERRY DIST
Group Number- A75986
Billing Period: 09/01/2021 to 10/01/2021
Date Billed: 08/02/2021
Due Date: 09/01/2021
Billing Summary
Prior Billing Net Amount Due Amount Paid Balancer
ANTHEM $344.84 $160.69 $184.15
SubTotal $184.15
Current Billing
—— _ANTHEM - -- $i 5n r,i $O.DO -- -$150,61 -- - —
SubTotal $150.61
Total Amount Due 4.76
Membership Detail
Contract No Rate* Subscriber Dep Premium
IID4 subs6lbea Product Volume T w Cos Chg Amount Amount Amount
EE 01 55-35 SOM 55.85
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Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans,Inc.Independent licensee of the Blue Cross and Blue
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aro and symbols are registered marks of the Blue Cross and Blue Shield Association.
op -
FISHERS ISLAND FERRY DISTRICT
VENDOR .03997 ANNE BORLAND 08/24/2021 CHECK 7581
A
NofA
FUND & ACCOUNT P.O'.# ' INVOICE DESCRIPTION AMOUNT
SM .1930.4.000.000- 073021 LOST FREIGHT-7/30/21, 119.43
TOTAL 119.43
-- - ----------------- - -- ----- - ------ --- ---- ---- -
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11100 7 58 Ill@ 1:0 2 L 4Q 54 6 4 1: 6 8 D'O I 5O L
Vendor No. Check No.'-
Town of Southold Payment New York - Pa Voucher �t�� `-==
Y 1jj` .=z
Vendor Tax ID Number or Social Security Number Vendor Address
66 E 83rd St Apr 4D � � � zz",I'Clt_111z '
New York,NY 10028-0875 Auditpate' E
Anne Borland
Vendor Telephone Number �UG'�1
Vendor Contact l� W \' ,``
4�
Invoice Invoice Invoice Net Purchase Order ?,; g
Number Date Total Discount Amount Claimed Number Description of Goods or Services `General Ledger Fund aout
and Accit-Number;._
r
7/30/2021 $119.43 $119.43 Lost freight ,7/30/21 SMI 930:4 0001,0 Q',
rg '";H�j"'" "• n,�,
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$119.43 $119.43
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been venfied with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Fisher env District Date TitleD e 4/9/2018
Fishers Island Ferry District
Freight Ineident/Lost Items Report
Date of Occurrence: ^1 �/c -1 - Time of Occurrence:
Freight Agent:
Supervisor: Date:
Was the item insured: Insurance Carrier:
Item(s)Description: Value*: _
Owner Details:
wvao
21(1
Provide detailed account of incident, including accurate description of the damage, burden of blame,
witnesses,etc,:
• Value: Claimant must ultimately provide proof of value. Ferry District will only pay to third-
parties.
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\\flservl\d$\fd network directory\general ops\accident damage mjury\masters\freight Incident report.docx
amazon 0,
Arfjie)
Detiver to.Atipe - New YoW,TOQ28
�j
< Your Orders
View order details
Order date Jul 26, 2021
Order# -49 -7910665
Order total --$119.43 (1 ite
(F7
View invoice
Shipment details
FREE Prime Delivery
Delivered
Delivery Estimate
Friday, July 30, 2021 by Spm
Cetestron -80mm Travel Scope - $109.95
Portable Refractor Telescope
PAM Qty: 1
PAM
Sold By:Amazon.com Services LLC
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https.//www.amazon com/gpilaNlya?ie=UTF8&ac=os&oid=111-4936955-7910665&ref_=pe_386300-440135490_TE_timp_c)d 8/.5/21,2-05 PM
Page 1 of 4
Payment Method
AmericanExpress ending in 9000
Billing Address
66 E 83RD ST APT 4D
NEW YORK, NY 10028-0875
Shipping address
Anne Borland
2091 BARLOW POND RD # 717
FISHERS ISLAND, NY 06390-7930
United States
Order Summary
Items: $109.95
Shipping & Handling: $0.00
Total Before Tax: $109.95
Estimated Tax Collected: $9.48
Order Total $119.4
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Your Account i, Your Orders ) Order Details ) Track Package
b&.Qbh.
Delivered July 30
Your package was delivered.It was handed directly to a resident.Signed by:WHITE
E] Delivered
Anne Borland
2091 BARLOW POND RD#717
FISHERS ISLAND,NY 06390-7930
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Tracking ID:1Z47VY660312803276
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E
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FISHERS ISLAND FERRY DISTRICT
VENDOR 002785 STEPHEN G. BURKE 08/24/2021 CHECK 7582,
A
FUND &-ACCOUNT' P.O. INVOICE DESCRIPTION AMOUNT
SM .9060.8 .000.000 072721 CIGNA MEDICAL-8/21 1,184.25
TOTAL 1,184.25
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'CUTCHOGUE,NY 11935 :AMOUNT,
08/24'/'2'02i, ""�",
56-5464i
THOUSAND'-ONE, UNDRED",',EiGHTY FOUR AND
:ONE t1fQDOLLARS"
R ,
xy PA Y STEPHEN G. -BURKE
SWTODDARDS- HARF ROA)D,,-
OAbER
or" LEDYARD CT 06339-1229
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11000 7 58 2us 1:0 2 L40 54641: 68 OPLS02 Lig'
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 2785 --�1_ , .
Vendor Tax ID Number or Social Security Number Vendor Address Entered by
40 Stoddard's Wharf Road
Kc—
Ledyard, CT 06339 Audit Date
Stephen G. Burke AUG 14 4 2021
Vendor Telephone Number
Towp�C,l
Vendor Contact � n erk�p��.D-eL-fL
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
MED REIMB 7/27/2021 $1,579.00 $1,184.25 August 2021 Medical reimb SM9060.8.000.000
-$394.75 75%of$1579
$1,184.251 1 $1,184.25
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name F Date 8/13/2021 Title Mana erDate
Nuera Benefits Agency Inc ® ELEVATE'
20 Madison Avenue NuEra WELLLNvESS hep/
' lBenefltS
Valhalla, NY 10595
Phone(914)428-6400
Fax(914)428-8080
INVOICE STATUS PAID
INVOICE# N356122244
Stephen Burke BILLING PERIOD 08/01/2021 to 08/31/2021
40 Stoddards Wharf Road DUE DATE 07/20/2021
Ledyard, CT, 06339 ENROLLMENT FEE $0.00
STATEMENT FEE $0.00
TOTAL PAID $1,579.00
TOTAL DUE $0.00
n V9
08/01/2021 to 08/31/2021 Stephen Burke Silver 3000 PPO $1,579.00
Previous Due $0.00
Statement Fee $0.00
Late Fee $0.00
Bounce Fee $0.00
Overall Amount $1,579.00
PAID[07/27/2021] +$1,579.00
Total Due $0.00
Please note:
-When you provide a check as payment,you authorize us either to use information from your check to make a
one-time electronic fund transfer from your account or to process the payment as a check transaction.
-Please make check payable to Nuera Benefits Agency Inc and include invoice#on the check
-A$25 late fee will apply if payment is not received on time.
-A$30 bounce fee will be apply for each bounced check
Please return this portion of the invoice and make check payable INVOICE# N356122244
to Nuera Benefits Agency Inc and include invoice#on the check DUE DATE 07/20/2021
TOTAL DUE $0.00
Nuera Benefits Agency Inc MEMBER Stephen Burke
20 Madison Avenue
Valhalla, NY 10595
,Z
FISHERS ISLAND FERRY DISTRICT I
VENDOR 002800 BURR'S YACHT HAVEN INC. 08/24/2021 CHECK 7583
FUND & ACCOUNT
P.O.# !INVOICE DESCRIPTION AMOUNT
SM .5710.4,.000.300\ D8'549 ' 129.2 GAL GAS 7/30 983.89
On SM .5710A .000,3001 D8560 155.2 GAL GAS-8/6 598 92, 1
y v: 711
SM .5710.4 .000'.300
D8568 250\"9 GAL GAS-8/9 968.;22
TOTAL 2,551.03 lk",
---- ------------- ---- ----------- --------------------- -------------- --------------------------------------------- -
4.5
."h
o'S
01
- - - ---- --- ----- ------
AN
p;11
M
FISHERS ISLAND FERRY DISTRICT AUDIT,--8� 24/20211',
E3095 MAIN'ROAD,PO,BOX,11,79-
fj
$OUT OLD,',NY,11971'0969,,,,,, ,'
rill 3,
THE SUFFOLK CO.OAtIONAL,BANK
CUTCHOGUE,NY 11935�� -'.,',DATE,
AMQUNT!', .
j
C' , 08/24,/,1�021X-,-t,
-A
"'j
X
6u,"s m,FIVE 'HUNDRED'
F, FTY ONE AND�'63/10 0,'bOt
191
Y - BURR'S,.YACIJT HAVEN INC-,
RA
AN
UE fE-;; 244 -�-PEWOT ,jl:0 U
Q,A
or"
"W' NEW�-"L6iI50N
CT -OdS�10 '1,
110007513311, 1:02L4054G4o: 68 001502 10
Check No: `
Town of Southold, New York - Payment Voucher 2800_, sa
Vendor Tax ID Number or Social Security Number Vendor Address En'ter'ed
Vendor Name 244 Pequot Ave Audit.Dat,e
Burr's Yacht Haven Inc New London,CT 06320
Vendor Telephone Number
Vendor Contact -n%d
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services ,-"(3eneral Ud`ger,Fund and 466 ounfNuinber� i
D8549 7/30/2021 $983.89 $983.89 129.2 gal 3.909& 122.5 gal 3.909 ,�a SM571O:4.000.3W,
D8560 8/6/2021 $598.92 $598.92 155.2 gal 3.859a SM5710.440O. � -�;�
D8568 8/9/2021 $968.22 $968.22 250.9 gal 3.859 , SM571O:40O0:36�='� �
ge
An> x i
3
a
€Y i
tZ A
Z e
$2,551.031 $2,551.03
Payee Certification Department Certification
nt)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
,in stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
axes from which the Town is exempt are excluded or discrepancies noted,and payment is approved I
Signature Title Signatur
s
Company Name Fishers Date 8/15/2021 Title_ Mana eger D
r
Invoice
,. na Date
244 Pequot Ave. 7/30/2021
New London, CT 06320
Invoice#
Bill To:
D8549
Fishers Island Ferry
Due Date
7/30/2021
Item Quantity Description Rate Amount
Gasoline 129.2 Gas Sales 3.909 505.04
Gasoline 122.5 Gas Sales 3.909 478.85
I
l
Subtotal $983 89
Sales Tax (6.35%) $000
Invoice Total $983.89
Customer Total Balance$4,209.93
BurrsManna1 @gmad.com
860-443-8457
r
BURR'SMARIRIA
244 Pequo€`Avenue
New London;=C'1 06320
(860)_443=8457
Fax (860)=443-8459
www.burrsm-aiina.com
CUSTOMER'S ORDER NO PHONE - -= DATE
NAME
ADDRESS
CITY STAGE Zip
SOLD BY CASH C 0 DI CHARGE ON ACCT YDS RET'D PAID OUT REPAIR
J
-10TY. PART NO. DESCRIPTION PRICE AMOUNT
-- TAX
RECEIVED BY -
TOTAL
B PRODUCT 3026 ® ® All claims and.teturned goods MUST be accompanied by this bill
�� 1� 9 =
�1 1Z Invoice
Date
244 Pequot Ave. 8/6/2021
New London,CT 06320
Invoice#
Bill To:
D8560
Fishers Island Ferry
Due Date
8/6/2021
Item Quantity Description Rate Amount
Gasoline 155.2 Gas Sales 3.859 598.92
Subtotal $598.92
Sales Tax (6.35%) $0.00
Invoice Total $598.92
Customer Total Balance$5,773.60
BurrsMarina1 @gmail.com
860-443-8457
f 7 I
BURWS-MARINA _
244 PequotAvenue S\v —,
New London-& 06320
(860)7443:8457 ��-
Fax (860):= 43-8459
www.burrsmarina.com
CUSTOMER'S ORDER NO PHONE
NAME
ADDRESS
=.t
CITY STATE ZIP
4
SOI�p�BY f CASH COD CH� ON ACCT-_c'WIDS REI"D PAID OUT REPAIR
-QTY- PART NO. DESCRIPTION PRICE AMOUNT
TAX
RECEIVED BY TOTAL
B PRODUCT 3026 ® ® All claims and"returned goods MUST be accompanied by this bill.
Do 8566
a
Invoice
mia eassyse� .�ae�i�t^"a-"
� arina. # Date
244 Pequot Ave. 8/9/2021
New London,CT 06320
Invoice#
Bill To.
D8568
Fishers Island Ferry 7
Due Date
8/9/2021
Item Quantity Description Rate Amount
Gasoline 250.9 Gas Sales 3.859 968.22
Subtotal $968.22 �(
Sales Tax (6.35%) $000
Invoice Total $968.22
Customer Total Balance$5,777.07
BurrsMarina1@gmad corn
860-443-8457
6
RURR'S-IIif�4RINA _
244 Pequot-Avenue <C�VQ e4—
New London==CT 06320
(860) 44-47$457
Fax (860):4-43-8459
www,bur-rsr arina-com
CUSTOMER'S ORDER NO PHONE -- --
__
NAME _f!-
ADDRESS
CITY
STA E ZIP
SBY� CASH COD CHARGE ON ACCT;
4 [�pS RET'D PAID OUT REPAIR
RECEIVED BY - TAX
== TOTAL
B PRODUCT 3026 - -
® All claims and returned goods MUST be accompanied by this bill
DO, 80 or- 8
I
4
FISHERS ISLAND FERRY DISTRICT
VENDOR 003274 CHA CONSULTING, INC. 08/24/2021
CHECK 7584
A
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .5610.2 .000.000 644027 SHRE PRTCTN PROJ-AIRPORT 409.30
TOTAL 409.30--
11K,
0
------ --- -- - ---------- --
-- - --------
61�
7v
®
gm,
'0
FISHERS ISLAAD
FEM Y DIST'RICT, 'AUDIT, 8/24/2,021.
53095 MAIN ROAD,PO 80X 1179'.
SOUTHOLD-,'NY 11971-0959,`
K',NO 4
0:
THE SUFFOLK C 'N ATIb'INA'L'BIANK
CUTCHOGUE,NY,11 935,
.,DATE, `AMOUNT,%fey ,
7 7
'54Qt214 81 4 2 4
�O
0
7POUR H6RED`, NINE AND '3 0/,10'0 DOLLARS
PAYCHA CONSULTING, INC.
,
IINN RS' "IRC
rPME' ', ZI ,W E ,LE
ORDER',
ALBANY' NY- 12205-
OF
e
he
11'00758411' 1:02,14054641: 68 OOL502 Ills
Vendor No. Check No,:
Town of Southold, New York - Payment Voucher 3274
Vendor Tax ID Number or Social Security Number Vendor Address Entered by,
PO Box 5269
Vendor Name Audit Date ,
CHA Consulting Inc lAlbany,NY 12205 -AUG'2, 4 ,21021 ,
Vendor Telephone Number
v►ni Clerk "
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
644027 8/6/2021 $409.30 $409.30 Elizabeth Airport Seawall-shore protection project SM5610.2.000.000
$409.30 $409.301 1
'ayee Certification Department Certification
t)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
n stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
xes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Fishers Islan Date 1/5/2018 Title ate
invoice CHA Consulting, Inc.
PO Box 5269
Albany, NY 12205
Phone:(518)453-4500
August 6,2021
Project No: 064402.000
Invoice No: 644027
Fishers Island Ferry District, NY
261 Trumball Drive
PO Box 607
Fishers Island, NY 06390
Project 064402.000 Fl Ferry DistrictShoreline Stabilization
Email invoices to:accounting@fiferry.com
Professional services provided.Survey,design plans and bidding assistance for shore protection project at Elizabeth Field.
Professional Services from July 31.2021 to August 27,2021
Phase 0001000 Sea Wall Repairs
Fee
Total Fee 8,825.00
Percent Complete 100.00 Total Earned 8,825.00
Previous Fee Billing 8,741.09
Current Fee Billing 83.91
Total Fee 83.91
Total this Phase $83.91
-- -- --- - - ----- - ---- - - ----- - - ---- - - - - - - - - - - - - - -
Phase 0002000 Bidding Assistance
Fee
Total Fee 6,000.00
Percent Complete 100.00 Total Earned 6,000.00
Previous Fee Billing 5,674.61
Current Fee Billing 325.39
Total Fee 325.39
Total this Phase $325.39
Total this Invoice $409.30
Billings to Date
Current Prior Total Received AR Balance
Fee 409.30 14,415.70 14,825.00
Totals 409.30 14,415.70 14,825.00 14,415.70 409.30
Authorized By. Date:
08-10-2021
Richard H Strouse, PE, LS
117,
FISHERS ISLAND FERRY DISTRICT
VENDOR 022580 CIS VENTURES 08/24/2021 CHECK 7585
A,
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION' AMOUNT
41,
SM .5709.2.000.200 0730210041 (1) PRCTCL AUTO PRINTER 321.43
TOTAL
321.43
mO,
A,
0
00
v
-sem-- -------- ------ - -------- - ---I -- - ------------- ------
------------ --- -------- -------------------
W
PV
'A)f
11v
_71
FISHERS ISLAND FERRY DISTRICT,, AUbI�%�P/24/2021
MAIN ROAD,PO BOX 1179,
SOUTHOLD,'-NY 11971-0959 . ... .
6HEC
THE S6FFbL'K,CO.NATIONAL BANK�,
DATE: AMOUNT� , ,o
CUTCHOGUE,NY 11935�
�:,08 24/20211
c-
',ttHREE JiUtbkED-TVENTY -,ONE AND -4 3 100 ,DOLS
PAY. ,, CIS VENTURES
i10' , 445',Ot3LETHORP9 .LANEl
ORDER' '
LUTH,GA 3009
OF'
7,4
1 1110'0 7 58 Slig 1:0 2 0.05464i: 68 00 L50.2 L V
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 22580 —15 R�s
Vendor Tax ID Number or Social Security Number Vendor Address Entered by
445 Oglethorpe Lane
Deluth,GA 30097 Audit Date
CIS Ventures 202
Vendor Telephone Number AUG 2 4
Town Clerk
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
073 '021004 7/30/2021 $321.43 $321.43 Practical Automation Printer(1) SM5709.2.000.200
$321.43 $321.43
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
SignatureTitle Signature
Company Name Fi District Date 8/13/2021 Title ate
CIS VENTURES
445 OGLETHORPE LANE, DULUTH, GA 30097 tel.678-584-0659
INVOICE
7 j
#073024-004
TO: Fishers Island Ferry District
Address: 5 Waterfront Park
New London, CT 06320 aft.Gordon Murphy tel.631 788 7463
CUSTOMER,ORDER SALESPERSON Te' F:rn� �,—JVIA F.O.B
PATE
,
Gordon Murphy' -Nei,10' 7/30/2021
-,_J�De-scriptibri;`�',
QUarititV,,"," ',"'P.O.' Price`--7 Total ',
1 Practical Automation Printer PM $ 299.00
kIT1200OG
2", cutter, USB
S/N W86458
Tax 7.5% $ 22.43
Shipping FedEx N/C
Total $ 321.43
AIVIPORTAN
Part Number B15-11078-3GR
Accounting Agent: Lili Shkolnik
ORIGINAL
aw
M
FISHERS ISLAND FERRY DISTRICT
VENDOR . 03998 CONNECTED SYSTEMS 08/24/2021 CHECK 7586
ase A
FUND & ACCOUNT P.,O.# INVOICE DESCRIPTION ; AMOUNT
SM .56101.4. 000.000 108-18274 AIRPORT-'REPLC RUNWAY,L,GH 1, 012 .60
Ifat TOTAL
1, 012 .60
M
-- - --------- ------------- - --------------
ik,
r
- ---- -- --
- ------ - - -------- ----- ----- - --- ---
-- Mr,
'T 0'21,
FISHERS ISLAND FERRY DISTRICT,
53095 MAM,ROAD,PO BOX 117 9 AUDIT• 8/,2 4,
SOUTHOLDAY 11971'- 959
. .... 75d'6
tHECK' No'.,
THE SUFFOLK CO.NATIONAL BANK
CUTCHOGUE,NY 11935 DATE AMOUNT
0 6'0
bp�5401214 $
0N '9ANb�' TWELVE AND 1'66 �
THOU 6 0/ ;DOLLARS
it
1Y CONNECTED SYSTEMS P,
tj T -RQAP
QN POST,
159' ,E�qST
9RDER:
-SUITE, D
OF
OLD LYME CT ,06371 ,
ts",
11100 7 Sa 6iim 11:0 2 1405L, 1: 68 00LS02 Lill
Vendor No. s Check No.
Town of Southold, New York - Payment Voucher one time
Vendor Tax ID Number or Social Security Number Vendor Address Entered by
169 Boston Post Road, Suite D
Old Lyme,CT 06371 Audit Date
Connected Systems AUG 2'-A 2021
Vendor Telephone Number
Town Clerk
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
08-18274 7/31/2021 1,012.60 1,012.60 Airport-replace runway lights SM6610.4.000.000
I
i
I
l
f
1,012.601 1,012.60 ,
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Date Title Date
CONNECTED Invoice
7Lt-ISYSTEMS
Date Invoice#
QUALITY ELECTRICAL CONTRACTING JASON ZELEK
159 Boston Post Road,Suite D 7/31/2021 08-18274
Old Lyme CT 06371-1348
Bill To Job Location
FISHERS ISLAND FERRY DISTRICT AIRPORT
DRAWER"H" FISHERS ISLAND LOCAL
FISHERS ISLAND,NY 06390 FISHERS ISLAND,NY 06390
Connecticut Licenses#ELC-0194718-E1,#HIC-0631443 Tax Exempt# Work Order# Terms
Suffolk County,NY Master Electrician#45453-ME
Rhode Island A-004969,B-013531 N/A Net 15
Date Qty Description Rate Amount
REPLACE OWNER SUPPLIED RUNWAY LIGHTS.
2 SOZ OXIDE INHIBITOR 36.26 7252
1 SPRAYS AND CLEANERS-16 OZ LECTRA SHIELD 4470 44.70
3 CONTRACTOR RTV SILICONE SEALANT CLEAR 13.54 4062
1 SUPPLIES AND HARDWARE 3.16 316
DISCOUNT-MATERIALS -36.30 -36.30
MATERIALS SUBTOTAL 12470
6/16/2021 1 DA 8500 8500
6/23/2021 25 DA 8500 21250
7/16/2021 3 DA 8500 25500
7/16/2021 3 DC 85.00 25500
LABOR SUBTOTAL 807.50
New York Sales Tax 8.625% 8040
860-434-1788 P 860-434-1538 F Total $1,012.60
www.conncctedsystemsct.com Payments/Credits $0.00
Retuned Checks subject to a$30.00 Charge. Balance Due $L012.60
ThaufUm foryou business!
um wz_�_
.0�
je,
FISHERS ISLAND FERRY DISTRICT
08/24/2021 CHECK 7587 VENDOR O'03891 CWPM, LLC
FUND , ACCOUNT
ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .5709.2.000.200 2307090 REFUSE/RECYCLING-'8/21 5-2,9.34
77
TOTAL 529.34
7t4
---- ----- --- ------- -------
-----------
---- ------- -------------------------- ---- ---
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_o 3
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- ----- ----- - - - ---- - -------I-
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o
- ----- ------- -
FISHERS ISLAND FERRY DISTRICT- AUDIT' 5"24/20-2,1'
53095 MAWROAD;PO BOX 7,179,
SOUTHOLD,NY 11971-0959
5'CHE.CK`JqO'.-, `:,�'-75PV�
THE SUFFbkK'cb_.NATIONAL BANK'
Ra
CUTCHO NY
DAT 'AMOUNT
�,qUE, ,1 IS E'21
O / 4
� �
.6 , 2 202f,
DOL
'i
`-71VR, HUNDRED .TWENTY N:,NE''AND 34/1,60
'j
.,ICWPM,,,,,,LLC
-BOX `4"l 5
IE
0
,
OF .:PLAINVI
E CT 06x62
1 7111,
1110075137110 11:0214051,641: 68 001502 111,
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 3891
Vendor Address Entered by
PO Box 415
Vendor Name Plainville, CT 06062 Audit Date
CWPM, LLC ` AUG' 2,4 2021 °
Vendor Telephone Number
860-447-1473oven Clerk
Vendor Contact �)
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number General Ledger Fund and Account Number
2307090 8/1/2021 $529.34 $529.34 August 2021 Refuse and Recycling SM5709.1000.200
$529.34 $529.34
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name_Fi Ferry District Date 8/11/2021 Title Manager Date 8/11/2021
Commercial Einvoice August
1 ?0#: Descri tion: units: $/Unit: Subtotal:
ActNbr•12761300 SiteNan:e.FISHERSISLAND FERRYDIST.
STATE ST NEW LONDON,CT 06320
7/27/2021 628157 MONTHLY SERVICES 1.00 $000 $000
8/1/2021 MONTHLY SERVICES 1.00 $259 17 $259.17
8/1/2021 RCY MONTHLY SERVICES 100 $99.68 $9968
8/1/2021 MONTHLY SERVICES 2.00 $53 16 $10633
Co
CWPM,LLC Charges. $465.18
PO Box 415 Taxes. $3160
Plainville,CT 06062 $3256
Phone: 1-888-966-CWPM Fuel Surcharges.
Finance charge: $000
Fax:860-793-2624
Total This Invoice• $529.34
�,
VYi�
FISHERS ISLAND FERRYDISTRICT
VENDOR 004277 DIME OIL COMPANY, LLC 08/24/2021 CHECK 7588
A
FUND & ACCOUNT P.0-.4 INVOICE DESCRIPTION AMOUNT
SM .5710.4 .'000.300 93105 RP 5455. 1 GAL@$' 1760/G 11,870 .30//
SM .5710.4.000.300 93105 S-F RECOVERY COST . 0021 11.46
SM .5710.4.000.300 _9/3105 LUST TAX - $.0010/GAL 5.46
TOTAL 11, 887.22
'---- ---- ----- ---- --- ------- -- -- --- --- ------11,
`i------ -- ------- - - ------ ------------- -
1�77
-n
"ilo
_�77,
- ---- -- ---- -- ------ - ------ --------------------------- ------ -
X
FISHERsJSLAAb FERRY L)is7Rj4C-T 'j-, AUDIT,',-I
53095'MAIN IROAD,MBOX 1179 3 2 4/2b'-2',,1
SOUTHOLD,�NY 11971 r.
THE SbF'F T16N'AL 84Nk
CUTCHOGUE,NY 11935 DATE,
�,AMOIJ NT
8%2 4)-2 0 2 1'� 88
IT 50,54,01214,,
1�0
ELEVEN' TAOTjSAND EIGHT,-HUNDRED EIGHTY 'S�EVE9_-AND 22�100, DO,1,;,LARS
1 .Ay DIME OIL ,COMPANY, LLC
rqXffE,-`.93 INDUSTRY LAI
?TE
OF
WATERBURY CT 067,04
11800 7 58811'_' 1:0 2 440 54641: P=8 004502 1
Vendor No. Clieck No.
Town of Southold, New York - Payment Voucher 4277
Entered by_
P.O. Box 11125 Audit—Date-
Dime
ateDime Oil Company LLC Waterbury, CT 06703
AUG 2'.4-2021-,
A
Vendor Telephone Number
203-754-5334 Town Clerk
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger,Fund and Account Number, „
93105 8/13/2021 $11,887.22 $11,870.30 RP 5455.1 gal $2.1760/gal SM5710.4.000.300
$11.46 S-F Cost Recovery.0021 SM5710.4.000.300
$5.46 LUST Tax-$.0010/gal ,7--SM5710:4.000.300
OPIS attached
$11,887.22 $11,887.22
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excludedo discrepancies noted,and payment is approved
Signature 0 ure
Title Sign
Company Name Fi and Ferry District Date 8/17/2021 Title Manager Date
Dime Oil LLC Phone: 203-754-5334
PO Box 11125 Date 08/13/21
Waterbury, CT 06703 Page 1
'Dime Oil LLC
r� www.dimeoilco.com
`fes
INVOICE
ACCOUNT NUMBER : 4420165
Fishers Island Ferry District AMOUNT ENCLOSED:
PO Box 607 (EMAIL)
Attn Accounts Payable
Fishers Island, NY 06390-0607
Re. Fishers Island Ferry Dist
5 Waterfront Park-Race Point, New London
Terms: Net 30 Days From Invoice Date
---------------------------------------------------------------------
Date Invoice Charge and Credits Amount
-------------------------------------------------------------------------
08/13/21 93105 #6 #2 ULSD Dyed 5455.1 GALS @ 2.176000 11870.30
Pickup No: TM FULL
#2 Dyed Diesel Fuel NonTaxable Use ONLY Penalty For Taxable Use
S-F Cost Recovery 11.46
LUST TAX 5.46
08/13/21 93105 Fuel Invoice Total 11887.22
Amount Due 11887.22
*** Please include account number with payment ***
Dime Oil LLC
203-754-5334
Account:4420165
TERMS:-WE RESERVE THE RIGHT TO MAKE kFINANCE CHARGE COMPUTED BY A PERIODIC RATE OF 1.5%PER MONTH WHICH S. <3 ®'5 I
CAN ANNUAL PERCENTAGE,RATE OF 18%ON AMOUNTS PAST DUE 30 DAYS OR MORE AND TO ADD ALL COLLECTION FEES. p�
t u u
-y _. OIna o iflDER DAT
�
/ /C 08%11/2021
0 063 10000 tn
� .� -- 7 _��_. - :� <E' •-I !DELI Y DATE � m
t� FisYiers` island Ferry, Dist ,44Z0165v��'�
5 5 Water'front Park=Race Point,',:.'-
�
tate Street
]�e� London CT 06320— 115%7 8' = 'FULL PRICE PER GALLON
K Factor _21 000 _Last. D6Iv07/2T/21U '0 '0'123'' -
�` JQHN 860-303-8311*i95ra-ex83-strait—f0llW i iDISCOUNT`PRIPER GALLON,
o �- apt.
o, .signs-L •State St-ovr RR tracks to' -term-,-LL,,
,` ?' �• ^PAYhDISCOUNT AMOUNT
(B)5400 FRI 8/13 -9AM ��`
PAY_THISAMOUNL
_ ! •i AFTERz.- DAYS.`
Taxes=$ 0.0021 $ 0_,0010
®�� ®�fr ANY L ;TRUCK TAX
®IM .D E �' �
P.O. BOX 1,1125 , T ,• _� ; I,�y'� RE � ,LL,'
PAYMENT RECEIVED I
WAT,ERBURY, CT 06703 TQM AM m
TMF OFD M t" }' D
(203)'754-5334
CASH ❑CHECK �, I
HARGE
M
Kasia Asmolov
From: Kasia Asmolov
Sent: Tuesday,August 17, 2021 9:28 AM
To: Kasia Asmolov
Subject: FW: 8/13 Delivery
Attachments: FISHER ISLAND.PDF
From: Beth Skojec [mailto:beth@dimeoil.com]
Sent:Tuesday,August 17,20216:42 AM
To: Kasia Asmolov<kasmolov@fiferry.com>
Subject:8/13 Delivery
**OPIS GROSS ULTRA LOW SULFUR DISTILLATE PRICES**
Move
Terms No.2 Move No.1 Move Pre Move Date Time
Gulf u Net 212.35 - .50 -- -- -- -- 214.85 - .50 08/12 18:00
SaratogaE u N-10 213.60 - .30 -- -- -- -- -- -- -- -- 08/12 18:00
NWENGLPTR u N-10 213.95 + 2.55 -- -- -- -- 216.45 + 2.55 08/11 18:00
Shell u N-10 214.00 - .80 -- -- -- -- -- -- -- -- 08/12 18:00
Valero u N-10 215.17 - .07 -- -- -- -- -- -- -- -- 08/12 18:00
Shell b 125-3 216.16 - .81 -- -- -- -- -- -- -- -- 08/12 18:00
Irving u N-10 217.07 - .13 -- -- -- -- -- -- -- -- 08/12 18:00
Sprague u 1-10 217.18 + 2.52 -- -- -- -- 219.20 + 2.52 08/11 18:00
Citgo b 1-10 217.19 - .20 --'-- -- -- -- -- -- -- 08/12 18:00
Citgo u 1-10 217.19 - .20 -- -- -- -- -- -- -- -- 08/12 18:00
Gulf b N-10 217.40 - .55 -- -- -- -- 219.90 - .55 08/12 18:00
S.R.& M. u 1-10 217.47 - .09 -- -- -- -- -- -- -- -- 08/12 18:00
Valero b 1-10 217.62 - .17 -- -- -- -- -- -- -- -- 08/12 18:00
Sunoco b 125-3 217.64 - .15 -- -- -- -- -- -- -- -- 08/12 18:00
XOM b 125-3 217.81 - .09 -- -- -- -- -- -- -- -- 08/12 19:00
BP b 125-3 218.21 + .19 -- -- -- -- -- -- -- -- 08/12 18:00
Irving b 1-10 218.29 + .28 -- -- -- -- -- -- -- -- 08/13 00:01
LOW RACK 212.35 -- -- 214.85
HIGH RACK 218.29 -- -- 219.90
RACK AVG 216.37
Plus vendor mark-up 1.23
Total 217.60
Convert to dollars $ 2.1760
Kasia Asmolov
Fishers Island Ferry District
Beth slzojec- befli9dimeoil.com
6ofi'ice: (203)754-5334 6direct: (203)437-6864 6www.dimeoilco.com
IL COMPANY LLC
Id ul Y4Mr.)au
1
FISHERS ISLAND FERRY DISTRICT
VENDOR 004443 DOCKSIDE ELECTRONICS SVC LLC 08/24/2021 CHECr, 7589
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .5710.2.000.200 14742 RP-REPAIR GARMIN SYSTEM 379.59
TOTAL
379.59
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FISHERS ISLAN 'AUDIT 'S/24•/26211
)FE�RYPISTRRICT
53095 MAIN ROAD;PO80X 1119
'
,SOUTHOLDMYJ,1971'-0969,
-CHEC NO'- ',758'9
THE SUFFOLK CO.`NXTIONAL BANK',
CUT9HOGUE,NY 11936,
DATE AMOUNT,. ,"
3 7 9'.,5 4
546/214.,
Li
9 10 0,
!YkRih SEVENTY NINE-'•AND 5 -DOLLAR8.
�OTA Y,,,E �POCKSIDE ELECTRONICS, SVC'LLC
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1140075139iia 1:0 2 L4054641: C38 00LS02 Lill
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 4443
Vendor Address Entered by
18 Stafford Street
Vendor Name Audit Date
Dockside Electronics Service LLC Mystic, CT 06355 AUG' 2 4 ZO2
Vendor Telephone Number
860-536-1919 TPIWM Clerk ;
Vendor Contact9 �r
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
14742 8/5/2021 $379.59 $379.59 RP repair on garmin system SM6710.2.000.200
i
$379.59 $319.59
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved.
Signature Title Signature /-Z—
Company Name Fishers s and Ferry District Date 8/12/2021 Title Manager Date $/12/2021
cCxslo DOCKSIDE ELECTRONICS Invoice o SERVICE LLC
y
18 Stafford Street DATE INVOICE#
Mystic, CT 06355
860.536.1919 8/5/2021 14742
BILL TO SHIP TO
FISHERS ISLAND FERRY DISTRICT
BOX H
FISHERS ISLAND,N.Y. 06390
Boat Name P.O. NO. TERWIS SHIP VIA FOB
Race Point NET 30
ITEM QTY DESCRIPTION SERIAL NO. RATE TOTAL
SERVICE 2.5 troubleshoot no position on Garmin system,drop cable 130.00 325.00
pinched/caught in overhead,had to replace drop cable.update all
software
INSTALL KIT 1 Drop Cable 45.00 45.00
MILEAGE F... 1 Mileage Fee 9.59 9.59
9 (I o
Fax# E-mail Subtotal $379.59
860-536-9272 tiro@dockside-electronics.com Sales Tax (6.35%) $0.00
All service calls are subject to a minimum charge of$130.A 50%deposit is required on
all new installations. If final payment has not been received after 30 days of completion Total
of services,the credit card we have on file for you will be billed the invoice total in $379.59
addition to a 3%service fee.
FISHERS ISLANDFERRY-DISTRICT
f. 71,
VENDOR 004552 MEREDITH S. DOYEN 08/24/2021 CHECK 7590
10" A
FUND & ACCOUNT P.OA INVOICE DESCRIPTION AMOUNT
S
SM .5710.4.000. 000 081621 ELECTION INSPCTR-7-4 .5 HRS 90.0,0
TOTAL 90 .00
I MEN"
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FISHERS,ISLAND FERRY DISTRICT-, AUDIT '824/,262-1......
53095 MAIN ROAD,PO,BOX 1179
_SOUTHpLD,NYlj,971-0959
;CHECK ATO. ,7590
Eq THE§UIiFbCK,C'O.;NATIONAL BANK
CUTCHOGUE,NY,l 19,35 D�ATE, AMOUNT,",
'08/24' /2 02 f'�
50-5461'21'4
'IN 'DOLLARS,
?-0
:NINETY AND,,66/100"
Yq,
a
PAY-, ":MEREDITH S. , DOYEN
B �51',"'
Tq TEH OX
R
FISHERS ISLAND NY '06-3'9 0,
0 0 ? S 9 0 1:0 2 1 L,0 5 1.G Lo: G 8 OOLS02 III*
a, 5.
fd �'
Vendor No. Check No:
'o Town of Southold, New York - Payment Voucher 4552 '1. R�
Vendor Tax ID Number or Social Security Number Vendor Address Entered by t j
PO Box 351 \1
Fishers Island, NY 06390 Audit Date
Do en Meredith
Vendor Telephone Number gg ��� �s
i •
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
c''-�+R)- 8/16/2021 $90.00 $90.00 2021 Election Inspectors SM5710.4.000.000
4.5 hours @$20.00
e
$90.001 1 $90.00
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Fishers and Fenn District Date 8/12/2021 Title Date
2020 Election Inspectors Rate: $ 20.00
,17 10-Aug Total Payment
Meredith Doyen 4.5 $ 90.00 $ 90.00
PO Box 351
Fishers Island
NY 06390
Deanna Ross 5 $ 100.00 $ 100.00
PO Box 161
Fishers Island
NY 06390
tota 1 $ 190.00
FISHERS ISLAND FERRY DISTRICT
August 2,2021
' Election Inspectors
Resolution 2021-125
The Board of Commissioners hereby appoints Meredith Doyen and Deanna Ross to be Election
Inspectors for the August 10th Fishers Island Ferry District Board of Commissioners election at a
rate of$20.00 per hour.
Moved by:Commissioner Burnham
Seconded by: Commissioner Cashel
Ayes:A.Ahrens, H. Burnham,T. Cashel and J. Reid
Nays: None
FISHERS ISLAND FERRY DISTRICT
VENDOR 00-5738 EVERSOURCE-ELECTRIC 08/24/2021 CHECK 7591
A ;N
FUND & ACCOUNT P.O.# INVOICE
DESCRIPTION AMOUNT
SM .5710.4.000.100 51981034010721 NLT ELEC SVC-7/1-8/2 ) 1,269.36
TOTAL 1,269.36
co
%
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10 :11 11)
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'ISLAAD FERRY DISMICT .24 2 0 2 t 1
FISHERS, ,` AUbIT"6/
63095 MAIN ROAD,PO BOX 1179
-0959 NO'
SOUTHOLD,NY 11971 t CHECK' 5
+Hi'SUFF'O'LK CO.NATIONAL BANK
CUTCHOGUE,NY 11935,.',.
1 � ' AMOUNT DATE
7ll 2,71-7. 5 Z,�7- ,�- -V,
,r I0 24 "'4
50-546/214.1-�; , "1"."
"SANb' 'TWO"'HUNDRED'.SIXTY NINE A"kb" 191-16DOLLAR8�',-
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$10
q
m4y, EVERS.OURCE-ELECTRIC.
7P TffE PO ,'BOx 56002,
R!
ORDE 141
,
ON' MA 02155-��dG02j`
OF'
11300759 Ili, 1:0 2 140 54 640: 68 001502 Ills
A ,
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 5738q 1
Vendor Address Entered by
PO Box 56002
Boston,MA 02155-6002 Audit Date
Eversource A'U� 2 4 2021
Vendor Telephone Number
888-783-6617 0 1
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
51981034010 8/1/2021 $1,269.36 $1,269.36 NLT elec sery 7/1-8/2/21 SM5710.4.000.100'
� T E
f
t
k
$1,269.36 $1,269.36
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name and Ferry District Date 8/11/2021 Title Mana er Date 8/11/2021
EVERS'.'.�.URCE
.Account Number: 5198103 4010
Statement Date: 08/02/21` Amount Due On 07%29/21 $2,097.31' i
Service Provided To: :Last Payment Received On 07/07/21 -$1,007.15
FISHER ISLAND FERRY DISTRICT I°Balance Forward $1X090.16
Total Current Charges
,r'-ror�,. - '' _ -`„�'s' arti:"�` 'y -�,.rz` ng
Q'- h <;'"'';; `3'?°,LD1
"•'^;�sns g >�� .;w, rro,:y:,,„,.,a•,.,y;
'r•.b'h�a -.�. .♦ �,. ='^: .,,,fi• ', 6 '+�-�.ir'
kWh/Day supoly Delivery
400
$567.28 $702.0
Cost of electricity from Cost to deliver electricity
300 � Eversource from Eversource
200 '
100
- - `” � - - a'•xu., .��_.rte<,,, �,
$0, $255 . $510 - $765 $1,020 $1,275
O Aug Sep Oct Nov Dee Jan Feb Mar Apr May, Jun Jul Aug
72° 824 52° 48° 33° 28° 28° 42° 510 590 71' 73° 05° Your electric supplier is
Average Temperature Eversource
PO Box 270 ;
r. ;. Hartford,CT,06141-0270
04",0,
This month your This month you used
'average daily -_28.5%less
28
electric,use was than at the
V
y USAGE
256.0'kWh
same time last ear
News For You
While summer may be winding down,the hotter temperatures can linger through September.On average,customers use'about 35%more energy during hot
weather,to stay cool,so your overall bill may be higher because more energy is being used.We're here to help you manage your energy costs all year long,Visit
eversource.com/home-savings to see tips to help you save.
Remit PaymentTo;Eversource,PO Box 56002,Boston,MA 02205-6002
-- - - - - -- _ 0802PR0 1
CE 21 D,TXT--159705-90000277-
EVERS"URCE
Account Number: . 5198103 4010
Customer name key:FISH
Statement Date: . 08/02/21
Service Provided To'- Electric Account Summary
FISHER ISLAND FERRY DISTRICT Amount Due on 07/29/21 $2,097.31,
Last,Payment Received On 07/07/21 -$1,007.15
s a u q o o Balance Forward, $1,090.16
o o o ( o e v Current Charges/Credits
o a o Electric Supply Services $567.28
Delivery Services $702.08
Total Current Charges $1,269.36
'Meter _ Current Previous Current Reading Total Amount Due $2,359.52
Number Read Read Usage Type Q '
892582072 89494 88674' 820 Actual 5,7'37
Total Demand Use=23.10 kW
820 x Meter Constant of 10=8,200 Billed Usage, Supplier
Eversource
Aug Sep Oct- _ Nov. 'Dec •Jan - Feb, . , Service`Reference:952682001
11820 9680 9200 7300 8350'- 10160, 8270 Generation Srvc Chrg** 8200.00kWh X$0.06918 $567.28
Mar Apr May Jun Jul Aug- Subtotal Supplier Services' $567.28
8890 7260 7160 6060 6,100 8200 Delivery
Contact Information (DISTRIBUTION RATE:030)
Emergency:800-286-2000 Service Reference:952682001
www.eversource.com Transmission Drnd Chrg 21.1 OKW X$7,92000 $167.11
BusinessCenterCTQeversource.com Distr Cust Srvc Chrg $44.00
Pay by Phone:888-783-6618 Distribution Dmd Chrg 21.1 OKW X$14.22000 $300.04
Customer Service:888-783-6617 -
Electric Sys Improvements*** '21.1 OKW X$1.08000 $22.79
CTA Demand Chrg 21.1 OKW X$434000 -$7.17
FMCC Delivery Chrg 8200.00kWh X$0.01412 $115.78
Comb Public Benefit Chrg* 8200.00kWh X$0.00726 $59.53
Subtotal Delivery Services $702,08
Total Cost of Electricity $1,269.36
Total Current Charges $1,269.36
CE-210802PROD,TXr-159706-000002737
EVERS.A,-.-" URCE Total1 e Que
Account Number: 5198103 401.0 by !I $2,359.52
CLstomer name key:FISH
Statement Date: 08/02/21
Service Provided To:
FISHER ISLAND FERRY DISTRICT
Continued from previous page...
Supply Rate
Dollars/kWh
01
0 08
0 06
0 04
0 02
Aug Sep Oct Nov Dec Jan FebMar Apr May Jun Jul Aug
Demand Profile
Max Demand
53025 35-
30-
25-
20-
15-
10-
5
015 105 T a„
0
Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug
p
23
CE 210802PROD,TXT-159707-000002737
FISHERS ISLAND FERRY DISTRICT
7
VENDOR 006155 FEDEX 08/24/'2021CHECK 7592
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .5710.4 ' 000.000- 7-454-08334 AP (1) PR (1) 70.54
rte) SM .5710.4.000.000 7-461-43212 AP (1) IT (1) 101.88,
'g,
"N?
TOTAL 172.42 ;M
f:
----------------------------- -- ----------------- - ---------
r i
10
i'g
Z!
----- ----- ------- --
Ilk,
,FISHERS ISLAND FERRYDIST)?ICT �,
7 AUD T, 4
53095 MAIN ROAD,PO BOX 1179 J -., - ,, ,, � 11",\,""If - , , I
SOUTHOLD'L E K 4 J, 77,
NY,11971-0959 5 9�
'No
THE SUFFOLK C07.NATIONA BANK
CUTCHOGUE,NY DATE, j 'AMOUNT
- J,
pi? 11935
7
56-54/214. °x08,/'2'4/20.21 :2
�
.2�.4
��N HUNDRED--'SEVENTY F -HbNE&Eb---SEVENTY.'TWO AND '42/100' �-'D' S,
l (5 lak
"j,
P,4Y .,FEDEX 7
T HE0461'T -- PbPb,BOX--3,7(
-PITTSBURGH PA 15250t'7 461
�X541 11,007592115 1:02140S4641: 68 OOL502 I
Vendor No. Check_ No.
Town of Southold, New York- Payment Voucher 6155
Vendor Address Entered by
P.O. Box 371461
Vendor Name Pittsburgh, PA 15250-7461 Audit Date
Fedexw�,
Vendor Telephone Number AUG 2 t 202
800-622-1147 MEerja
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
7-454-08334 8/2/2021 $70.54 $70.54 AP(1)PR(1) SM5710.4.000.000
7-461-43212 8/9/2021 $101.88 $101.88 AP(1) IT(1) SM5710.4.000.000'
E
r
A
$172.42 $172.42
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been pard,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature �ande
Title Signature
Company Name Fistrict Date 8/13/2021 Title Manager D
recum
o Invoice Number Invoice-Date Account Number Page
7-454-08334 J Aug02,2021 1206-0334-5 1 of 3
Billing Address: Shipping Address: Invoice Questions?
FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY TERMINAL Contact FedEx Revenue Services
ACCOUNT PAYABLE 5 WATERFRONT PARK Phone: 800.622.1147
PO BOX 607 NEW LONDON CT 06320 M-F7 AM to 8 PM CST
FISHERS ISLAND NY 06390-0607 Sa 7 AM to 6 PM CST
Internet: fedex.com
Invoice Summary Account Summary as of Aug 02,2021
FedEx Express Services
Total Charges USD $70.54 Previous Balance 216.63
Payments 0.00
TOTAL THIS INVOICE USD $70.54 Adjustments .00
You saved$6.36 in discounts this periods New Charges 70.54
Other discounts may apply. New Account Balance $287.17
To pay your FedEx invoice,please go to www.fedex.com/payment.Thank
you for using FedEx. Payments not received by Aug 17,2021 are subject to a late fee.
0 0
r
Detailed-descriptions of surcharges can be located atfedex.com -
Invoice Number Invoice Date Account Number Page
7-454-08334 Aug02,2021 1206-0334-5 2 of 3
FedEx Express Shipment Summary By Payor Type
FedEx Express Shipments(Original)
Rated Special:
Weight Transpottatian- Handling Ret Chgn'ax
Payor Type Shipments lbs Charges Charges CreditObther Discounts Total Charges
Recipient 2 2.0 63.52 13.38 -6.36 70.54
Total FedEx Patpress 2 2A $63,52' $13M 4636 $70.64
TOTAL THIS INVOICE USD $70.54 —
FedEx Express Shipment Detail By Payor Type (Original)
Ship Elate;Ju126,2021 Cust,Rel.,NO REFERENCE INFORMATION Ref.#2.
Payor:Recipient Ref.#3;
• Fuel Surcharge-Fed Ex has applied a fuel surcharge of 8 75%to this shipment
• Distance Based Pricing,Zone 2
• FedEx has audited this shipment for correct packages,weight,and service.Any changes made are reflected in the invoice amount
• The package weight exceeds the maximum for the packaging type,therefore,FedEx Envelope was rated as FedEx Pak
Automation AWB Sender Recipient
Tracking ID 816377478318 DIANA WHITECAVAGE GORDON MURPHY
Service Type FedEx Priority Overnight TOWN OF SOUTHOLD FISHERS ISLAND FERRY DIST
Package Type FedEx Pak 53095 MAIN RD 261 TRUMBULLOR
Zone 02 SOUTHOLD NY 11971 US FISHERS ISLAND NY 06390 US
Packages 1
Rated Weight 1.O lbs,0.5 kgs Transportation Charge 31.76
Delivered Jul 27,202110 24 Discount -318
Svc Area A9 Fuel Surcharge 284
Signed by N WHITE DAS Extended Comm 3 85
FedEx Use 020753702/1486/ Total Charge USD $35.27
r�� Invoice Number Invoice Date Account Number Page
7-454-08334 Aug02 2021 11 1206-0334-5 3 of 3
Skip Dale:J028,20211 Cust.Ref NO REFERENCE INFORMATION ROW,
Payer:Recipient RefJ3;
• Fuel Surcharge-FedEx has applied a fuel surcharge of 815%to this shipment
• Distance Based Pricing,Zone 2
• FedExhas audited this shipmentfor correct packages,weight,and service Any changes made are reflected in the invoice amount
• The package weightexceeds the maximum for the packaging type,therefore,FedEx Envelope was rated as FedEx Pak
Automation AWB Sender Recipient
Tracking ID 816377478307 KARIANE CHEW GORDON MURPHY /
Service Type FedEx Priority Overnight TOWN OF SOUTHOLD FL FERRY DISTRICT
Package Type FedEx Pak 53095 MAIN RD 261 TRUMBELL DR
Zone 02 SOUTHOLD NY 11971 US FISHERS ISLAND NY 06390 US
Packages 1
Rated Weight 10 lbs,0 5 kgs Transportation Charge 3176
Delivered Ju129,20210946 Discount -3.18
Svc Area A9 Fuel Surcharge 284
Signed by N WHITE DAS Extended Comm 3 85
FedEx Use 020967880/1486/_ Total Charge USD $35.27
Recipient Subtotal USD $70.54
Total FedEx Express USD $70.54
1212-01-00-0010710-0001-0021686
FecL.K
® Invoice Number Invoice Date FAccount Number Page
• 7-461-43212 Aug09 2021 1206-0334-5 1of3
Billing Address: Shipping Address: Invoice Questions?
FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRYTERMINAL Contact FedEx Revenue Services
ACCOUNT PAYABLE 5 WATERFRONT PARK Phone: 800.622.1147
PO BOX 607 NEW LONDON CT 06320 M-F7 AM to 8 PM CST
FISHERS ISLAND NY 06390-0607 Sa 7 AM to 6 PM CST
Internet: fedex.com
Invoice Summary Account Summary as of Aug 09,2021
FedEx Express Services
Previous Balance 174.34
Total Charges USD $97.66
- Payments 0.00
Other Charges USD Adjustments 0.0
New Charges 101.88-
TOTAL
01.88
TOTAL THIS INVOICE USD C $101.88
New Account Balance $276.22
You saved$8.18 in discounts this periods
Other discounts may apply. Payments not received byAug 24,2021are subject roaWefee.
To pay your FedEx invoice,please go to www.fedex.com/payment.Thank
you for using FedEx.
r - -
Detailed descriptions of surcharges can be located atfedex.com
Invoice Number Invoice Date Account Number Page
7-461-43212 Aug09 2021 1206-0334-5 2of3
FedEx Express Shipment Summary By Payor Type
FedEx Express Shipments(Original)
Rated Special
Weight Transportation Handling RetChgffax
PaporType Sldpments -lbs Cbarges `charges Credits/other Discounts Total Charges
Shipper 1 2.0 30.98 5.90 -3.10 33.78
Recipient 1 8.0 50.81 18.15 -5.08 63.88
Total FedEx Express 2 10-0 $81.79 $2405 $8.18 $97.66
Other Charges Summary
Invoice Invoice Original Payments Pastllue
(Number Date Amount Applied/Credit Amount Rate tbarges —
Late Fee 7-424-90163 07/05/21 70.38 70.38 6% 422
Total 870,38 $4.22
TOTAL THIS INVOICE USD $101.88 —
FedEx Express Shipment Detail By Payor Type (Original)
Ship Bate:Aug 02,2021 Cust.Refs NO REFERENCE INFORMATION Ref.#2i -
Payor:Shipper Ref.#3:
• Fuel Surcharge-FedEx has applied a fuel surcharge of 8.50%to this shipment
• Distance Based Pricmg,Zone 2
• FedEx has audited this shipmentfor correct packages,weight,and service Any changes made are reflected in the invoice amount
• The package weight exceeds the maximum for the packaging type,therefore,FedEx Envelope was rated as FedEx Pak
Automation AWB Sender Recipient
Tracking ID 810997040699 KASIAASMOLOV KARIANE CHEW
Service Type FedEx Standard Overnight FISHERS ISLAND FERRY TERMINAL TOWN OF SOUTHOLD-ACCT DEPT
Package Type FedEx Pak 5 WATERFRONT PARK 54375 MAIN RD TOWN HALL ANNEX
Zone 02 NEW LONDON CT 06320 US SOUTHOLD NY 11971 US
Packages 1
Rated Weight 2.0 lbs,09 kgs Transportation Charge 3098
Declared Value USD 10000 Discount -310
Delivered Aug 03,2021 1148 Fuel Surcharge 2.65
Continued on next page
FacFm Invoice Number Invoice Date Account Number Page
7-461-43212 Aug09,2021 1206-0334-5 3 of 3
Tracking ID:810997040699 continued
Svc Area A8 DAS Comm 325
Signed by K HANSEN Declared Value Charge 0.00
FedEx Use 021490278/1283/_ Total Charge USD $33.78
Shipper Subtotal USD $33.78
Ship I?ate. 1f2,20 1 " - stat.Refs Practical AutomatJi
Payor:Recipient Refer:'
Fuel Surcharge-Fed Ex has applied a fuel surcharge of 8.50%to this shipment
• Distance Based Pricing,Zone 5
Automation INET Sender Recipient
Tracking ID 774417960729 Anatoly Voronov Gordon Murphy
Service Type FedEx 2Day CIS Ventures Fishers Island Ferry District
Package Type Customer Packaging 445 Oglethorpe Lane 261 Trumbull Dr,#607
Zone 05 DULUTH GA 30097 US FISHERS ISLAND NY 06390 US
Packages 1
Rated Weight 8.0 lbs,3.6 kgs Transportation Charge 50.81
Declared Value USD 500.00 Discount -5.08
Delivered Aug 04,2021 09.48 Fuel Surcharge 4.55
Svc Area A9 Direct Signature 0.00
Signed by N WHITE Declared Value Charge 5.75
FedEx Use 000000000/6046/ Courier Pickup Charge 4.00
DAS Extended Comm 3.85
Total Charge USD $63.88
Recipient Subtotal USD $63.88
Total FedEx Express USD $97.66
1219-01-00.0009560-0001-0019785
FISHERS ISLAND FERRY DISTRICT
VENDOR 006412 FISHERS: ISLAND (.iJTILITY CO 08/24/2021 CHECK 7593
A
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT 44
SM .5710.4 .000.200 1100130721 TELEPHONE-FIT-7/21 262�*90
llo6130721 INTERNET-FIT-7/21 204.23
SM .5710.4 .000.200
1�j , I "�: U
SM .5710.4.000.200 1100130721 ELECTRIC-FIT-7/21 \297.09
�!`* - 9
SM .5710.4.000.200 1100130721 WATER-FIT-7/21 41.55 1"A
SM .7155.4.000.000 1100130721 TELEPHONE-THEATRE-7/21 44 .71
Riga SM .7155.4,,000.000 1100130721 INTERNET-THEATRE-7/21 146.99 m
SM .7155.4.000.000 1100130721 ELECTRIC-THEATRE-7/21 194 .30
SM'', .7155.4.000.000 1100130721 WATER-THEATRE-7/21 285.97
fs SM .5709.2.000.100 1100130721 TELEPHONE-WHISTLER-, 7/21 33.05
to
SM .5709.2.000.100 1100130721 . -,INTER
NET-WHISTLER-7/21 68 .00
SM .5709.2 . 000,100 1100130721 6*k�tt=IC-WHISTLER-7/ .
SM -57-092 -00-0-100- --------- , 2 , --. vA 10 -0 -. W AT FR�WRIS_TLER--7/21
SM .5610.4 .000.000 110013Q72�],' �j,ECTR-XC-AIRPORT-7/21 173 .91
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ERRY
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Vendor No. Check No.
Town of Southold, New York - Payment Voucher 6412 CD-
Vendor Tax ID Number or Social Security Number Vendor Address Entered by �
PO BOX 604
Vendor Name Fishers Island, NY 06390 Audit Date
FISHER ISLAND UTILITY COMPANY AUG 2 4 2021
Vendor Telephone Number
631-188-0023 T C1 rk
Vendor Contact �.
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
1100130 8/1/2021 $ 2,062.85 $ 262.90 Telephone July 2021 FIT SM.5710.4.000.200
$ 204.23 Internet July 2021 FIT SM.5710.4.000.200
$ 297.09 Electric July 2021 FIT SM.5710.4.000.200
$ 41.55 Water July 2021 -FIT SM5710.4.000.200
$ 44.71 Telephone July 2021 -Theatre SM.7155.4.000.000
$ 146.99 Internet July 2021-Theatre SM.7155.4.000.000
$ 194.30 Electric July 2021 -Theatre SM.7155.4.000.000
$ 285.97 Water July 2021 -Theatre SM.7155.4.000.000
-
$ 33.05 Telephone July 2021-357 Whistler SM5709.2.000.100
$ 68.00 Internet July 2021-357 Whistler SM5709.2.000.100
$ 203.80 Electric July 2021-357 Whistler SM5709.2.000.100
$ 106.35 Water July 2021-357 Whistler SM5709.2.000.100
$ 173.91 Electric July 2021-Airport SM5610.4.000.000
$ 2,062.85 $ 2,062.85
3ayee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name_Fi Ferry Date 8/13/2021 Title Manager Date
Page: 1 of 14
Account: 1100130
P.O. Box 604 Bill Date: Aug 012021
Fishers Island, NY 06390 Name: F I FERRY DISTRICT
UTILITY Co.
CST 1913
Questions about your bill?
Account Summary Contact our office by phone(631)788-7251
press 4 for Telephone;press 5 Electric or Water
Previous Balance Due $3,532.34 Monday-Friday 8 am-Noon&1 pm-4:30pm
Payment-Jul 08 $1,976.13CR Email:Phone,Electric&Water-billing@fiuc.net
Unpaid Balance as of Jul 27 $1,556.21 If you pay by check,this is notification that
(Unpaid Balance Due Immediately) the check may be converted to an electronic
deposit. Please detach and return below
portion with your payment.
Fishers Island Telephone Corporation $284.83
Fishers Island LD $55.83 Register for ECare to view your bill and make
Fishers Island-ISP $419.22 payments online.
Fishers Island Electric Corporation $869.10 -Go to www.fiuc.net Select ECare:View/Pay My Bill.
Fishers Island Water Works Corporation 433.87 -Select Register and follow the step instructions.
Total Current Charges $2,062.8 -In Step 3 Click on(Show Me)to locate your
account code on your bill.
Total Amount Due by Aug 25 $3,619.06
Page: 2 of 14
Account: 1100130
Bill Date: Aug 012021
Name: F I FERRY DISTRICT
How toq Reach FISHERS ISLAND UTILITY CO.
For In--By Phone: 631-788-7251 press 4 for Telephone, press 5 for ElectricMater
By Mail: PO BOX 604 FISHERS ISLAND NY 06390-0604
--Website: www.fiuc.net
For Payments by Mail
--FISHERS ISLAND UTILITY CO. PO BOX 604 FISHERS ISLAND NY 06390-0604
For Payments Online
--www.fiuc.net
Consumer Complaints
If you have a complaint or question about your utility service, please contact
The Fishers Island Utility Company first. If your complaint or dispute cannot
be resolved with mutual satisfaction,you may file a customer complaint by
contacting the New York State Department or Public Service(DPS) by any
of the methods listed below.
DPS complaint webpage: www.dps.ny.gov/complaints
DPS Helpline: 1-800-342-3377
1-800-662-1220 (Hearing/Speech Impaired,TDD)
1-518-486-7868 Fax
DPS Mailing Address: NYS Department of Public Services
Office of Consumer Services
3 Empire State Plaza
Albany, NY 12223-7350
Page: 3 of 14
^l P.O. Box 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 01 2021
Name: F I FERRY DISTRICT
Preferred Service Providers
The following service(s)use Fishers Island LD for intraLATA long distance:
631 788-7463 631 788-7580 631 788-7744
The following service(s)use AT&T Communications for intraLATA long distance:
631 788-5523 631 788-7031 631 788-7345 631 788-7655
The following service(s)use Fishers Island LD for interLATA long distance:
631 788-7463 631 788-7580 631 788-7744
The following service(s)use AT&T Communications for interLATA long distance.
631 788-5523 631 788-7031 631 788-7345 631 788-7655
Fishers Island Telephone
Monthly Service
Monthly Service from Aug 01 through Aug 31
631788-5523(FAX/DSUMAINOFFICE)
Business Local Service ** 23.00
Access Recovery Charge ML Bus ** 3.00
End User Charge-Multi Line ** 920
Total for 631 788-5523 35.20
Total Monthly Service Charges 35.20
** Indicates an item for which non-payment will result in disconnection of basic service.
Taxes and Surcharges
Landline
E-911 Surcharge 35
Federal Universal Service Charge 3.88
NY State Surcharge 1.16
Total Taxes and Surcharges 5.39
Monthly Service
Monthly Service from Aug 01 through Aug 31
631 788-7031 (MOVIE THEATER)
Business Local Service ** 2300
Access Recovery Charge ML Bus ** 3.00
End User Charge-Multi Line ** 9.20
Toll Restriction-Business `* 4.00
Total for 631788-7031 39.20
Total Monthly Service Charges 39.20
** Indicates an item for which non-payment will result in disconnection of basic service.
Page: 4 of 14
P.O. Box 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 012021
Name: F I FERRY DISTRICT
Taxes and Surcharges
Landline
E-911 Surcharge .35
Federal Universal Service Charge 3.88
NY State Surcharge 1.28
Total Taxes and Surcharges 5.51
Monthly Service
Monthly Service from Aug 01 through Aug 31
631788-7345(FREIGHT OFFICE)
Business Local Service ** 23.00
Access Recovery Charge ML Bus ** 3.00
End User Charge-Multi Line ** 9.20
Toll Restriction-Business ** 400
Total for 631 788-7345 39.20
Total Monthly Service Charges 39.20
** Indicates an item for which non-payment will result in disconnection of basic service.
Taxes and Surcharges
Landline
E-911 Surcharge .35
Federal Universal Service Charge 3.88
NY State Surcharge 1.28
Total Taxes and Surcharges 5.51
Monthly Service
Monthly Service from Aug 01 through Aug 31
631788-7463(MANAGERS OFFICE)
Business Local Service ** 23.00
Access Recovery Charge ML Bus ** 3.00
End User Charge-Multi Line ** 9.20
Total for 631788-7463 35.20
Total Monthly Service Charges 35.20
** Indicates an item for which non-payment will result in disconnection of basic service
Taxes and Surcharges
Landline
E-911 Surcharge .35
Federal Universal Service Charge 3.88
NY State Surcharge 1.16
Total Taxes and Surcharges 5.39
Monthly Service
Monthly Service from Aug 01 through Aug 31
631 788-7580(FIO ROLLOVER)
Business Local,Service ** 23.00
Access Recovery Charge ML Bus ** 3.00
Page: 5 of 14
P.O. Box 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 01 2021
Name: F I FERRY DISTRICT
Monthly Service
Monthly Service from Aug 01 through Aug 31 (continued)
End User Charge-Multi Line *' 9.20
Total for 631 788-7580 35.20
Total Monthly Service Charges 35.20
*" Indicates an item for which non-payment will result in disconnection of basic service
Taxes and Surcharges
Landline
E-911 Surcharge .35
Federal Universal Seance Charge 3.88
NY State Surcharge 1.16
Total Taxes and Surcharges 5.39
Monthly Service
Monthly Service from Aug 01 through Aug 31
631788-7655(F I FERRY DISTRICT-RESIDENCE)
Access Recovery Charge SL Res ** .15
Residential Local Service ** 23.00
End User Charge-Single Line Res 6.50
Total for 631 788-7655 29.65
Total Monthly Service Charges 29.65
** Indicates an item for which non-payment will result in disconnection of basic service.
Taxes and Surcharges
Landline
E-911 Surcharge .35
Federal Universal Service Charge 2.11
NY State Surcharge .94
Total Taxes and Surcharges 3.40
Monthly Service
Monthly Service from Aug 01 through Aug 31
631 788-7744(FI TICKETING)
Business Local Service ** 23.00
Access Recovery Charge ML Bus *' 300
End User Charge-Multi Line ** 9.20
Total for 631788-7744 35.20
Total Monthly Service Charges 35.20
** Indicates an item for which non-payment will result in disconnection of basic service.
Page: 6 of 14
P.O. Box 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 01 2021
Name: F I FERRY DISTRICT
Taxes and Surcharges
Landline
E-911 Surcharge .35
Federal Universal Service Charge 3.88
NY State Surcharge 1.16
Total Taxes and Surcharges 5.39
Total Fishers Island Telephone Corporation Charges, 284.83
1
1
If you have any questions concerning the below charges, please call 631-788-7001, option 4.
Monthly Service
Monthly Service from Aug 01 through Aug 31
631788-7463(MANAGERS OFFICE)
Carrier Cost Recovery Fee .99
FILD National Plan 17.00
Total for 631 788-7463 17.99
Total Monthly Service Charges 17.99
Usage Summary
500 National Plan
Allotment 500:00 minutes
Used 12 00 minutes
Total Usage Charges .00
Usage Detail
Toll Detail
Item Date Time Place Called Number Called Type Plan(s) Minutes Charge
631788-7463(MANAGERS OFFICE)
1 Jul 02 1.07:49pm Riverhead NY 631566-5539 Direct 500 2.00 .00
2 Jul 03 12:38-43pm New London CT 860 442-0165 Direct 500 2.00 .00
3 Jul 03 12:43-47pm New London CT 860 442-0165 Direct 500 1.00 .00
4 Jul 03 12:54.08pm New London CT 860 442-0165 Direct 500 2.00 .00
5 Jul 09 12:04:23pm Lynn MA 781771-0239 Direct 500 1:00 .00
6 Jul 09 2:24:24pm Boston MA 617 818-5090 Direct 500 1.00 .00
7 Jul 12 4.03:10pm Norwalk CT 203 644-5561 Direct 500 1:00 .00
8 Jul 23 3:47:15pm Norwood MA 781929-6661 Direct 500 2:00 .00
Total of 8 calls for 631 788-7463 12:00 .00
Total Usage Detail Charges .00
Taxes and Surcharges
Landline
NY State Surcharge .62
Total Taxes and Surcharges .62
t Page: 7 of 14
P.O. Box 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 01 2021
i
Name: F I FERRY DISTRICT
Monthly Service
Monthly Service from Aug 01 through Aug 31
631788-7580(FIO ROLLOVER)
Carrier Cost Recovery Fee ,99
FILD National Plan 17.00
Total for 631 788-7580 17.99
Total Monthly Service Charges 17.99
Usage Summary
500 National Plan
Allotment 500.00 minutes
Used 109:00 minutes
Total Usage Charges .00
Usage Detail
Toll Detail
Item Date Time Place Called Number Called Type Plan(s) Minutes Charge
631788-7580(FIO ROLLOVER)
1 Jun 30 4:14:18pm Glastonby CT 860 368-8368 Direct 500 200 00
2 Jul 01 9.54:54am Milford CT 203 951-4171 Direct 500 1:00 .00
3 Jul 06 8:47.34am Grandprari TX 214 738-7190 Direct 500 1 00 .00
4 Jul 06 11 29:46am New London CT 860 442-0615 Direct 500 1.00 .00
5 Jul 07 11.13:31 am New Haven CT 203 410-8156 Direct 500 1.00 .00
6 Jul 08 2:07:49pm Glastonby CT 860 368-8368 Direct 500 1:00 .00
7 JUI 09 2:31.38pm Old Saybrk CT 860 399-3630 Direct 500 5:00 .00
8 JUI 09 3:03:29pm New London CT 860 271-9737 Direct 500 1:00 00
9. Jul 12 10 43:45am Providence RI 401 741-5736 Direct 500 3:00 .00
10 Jul 13 2:00.45pm Willimntic CT 860 428-2562 Direct 500 1:00 .00
11 Jul 15 10.05:57am Glastonby CT 860 368-8368 Direct 500 1:00 .00
12 Ju116 10:36:46am Riverhead NY 631852-4554 Direct 500 6:00 00
13 Jul-16 10:52:14am Southold NY 631765-1937 Direct 500 4:00 00
14 Jul 16 10:57 09am Riverhead NY 631 852-5280 Direct 500 1:00 .00
15 Jul 16 12:02:00pm Glastonby CT 860 368-8368 Direct 500 1.00 .00
16 JUI 19 9:35:06am Glastonby CT 860 368-8368 Direct 500 1.00 - .00
17 JU1 19 10.03 54am Glastonby CT 860368-8368 Direct 500 1:00 .00
18 JU119 11.08.24am Southold NY 631765-1937 Direct 500 2:00 .00
19 JUI 19 11:11.54am Chicago IL 312 416-1518 Direct 500 5:00 .00
20 JUI 19 11.19:09am Chicago IL 312 416-1518 Direct 500 6:00 .00
21 Jul 19 11 57:00am Chicago IL 312 416-1518 Direct 500 3:00 .00
22 Jul 21 11:10:19am Waterbury CT 203 598-1706 Direct 500 2:00 .00
23 Ju122 2:29:06pm Memphis TN 901671-6654 Direct 500 3:00 .00
24 Ju122 2:41:19pm Patchogue NY 631289-1097 Direct 500 1:00 .00
25 Ju122 3:21:31 pm Atlanta Ne GA 678 634-3281 Direct 500 1.00 .00
26 Jul 23 9:29.27am New London CT 860 447-8304 Direct 500 2:00 '.00
27 Jul 23 9.30 51 am New London CT 860 443-8720 Direct 500 1:00 .00
28 Jul 23 9:31.09am New London CT 860 447-8304 Direct 500 1:00 00
29 Jul 23 9:31:49am New London CT 860 447-8304 Direct 500 1:00 .00
30 Jul 23 9:33.00am New London CT 860 447-8304 Direct 500 2.00 .00
31 Jul 23 9 34.33am New London CT 860 447-8304 Direct 500 2.00 .00
32 Jul 23 9 36.17am New London CT 860 447-8304 Direct 500 25:00 .00
33 Jul 23 10:38:13am New London CT 860 447-8304 Direct 500 2:00 00
34 Jul 23 10:43:59am New London CT 860 447-8304 Direct 500 13.00 .00
35 Jul 23 10:58,10am Middletown CT 860 347-6971 Direct 500 1:00 .00
36 Jul 23 1.53:41 pm Snfc Cntrl CA 415 516-1076 Direct 500 3:00 .00
37 Jul 26 9.23:54am Washington DC 202 302-5411 Direct 500 1.00 .00
Total of 37 calls for 631788-7580 109:00 .00
Total Usage Detail Charges .00
Page: 8 of 14
P.O. Box 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 01 2021
Name: F I FERRY DISTRICT
Taxes and Surcharges
Landline
NY State Surcharge •62
Total Taxes and Surcharges •62
Monthly Service
Monthly Service from Aug 01 through Aug 31
631788-7744(FI TICKETING)
Carrier Cost Recovery Fee 99
FILD National Plan 17.00
Total for 631 788-7744 17.99
Total Monthly Service Charges 17.99
Usage Summary
500 National Plan
Allotment 500:00 minutes
Used 22.00 minutes
Total Usage Charges .00
Usage Detail
Toll Detail
Item Date Time Place Called Number Called Type Plan(s) Minutes Charge
631 788-7744(FI TICKETING)
1 Jul 06 9:00:18am Humboldt IA 515 604-9776 Direct 500 14:00 .00
2 Jul 08 9 02:56am Nwyrcyzn01 NY 917 517-7495 Direct 500 1:00 .00
3 Jul 08 11:48 51 am Portsmouth VA 757 485-4260 Direct 500 3.00 .00
4 Jul 09 9:40:26am New York NY 917 903-3516 Direct 500 4:00 .00
Total of 4 calls for 631788-7744 22:00 .00
Total Usage Detail Charges .00
Taxes and Surcharges
Landline
NY State Surcharge .62
Total Taxes and Surcharges .62
Total Fishers Island LD Charges 55.83
• Page: 9 of 14
P.O. Box 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 01 2021
Name: F I FERRY DISTRICT
UTILITY CO..
EST 1918
Fishers Island Internet
Monthly Service
Monthly Service from Aug 01 through Aug 31
isp-1001000075(F 1 FERRY DISTRICT-RESIDENCE)
12 Month"BASIC"Internet 65.00
Internet Infrastructure Fee 3.00
Total for isp-1001000075 68.00
Total Monthly Service Charges 68.00
Monthly Service
Monthly Service from Aug 01 through Aug 31
isp-1001010114(FERRY MAIN OFFICE)
12 Month"Best"Internet New 160.00
Internet Infrastructure Fee 3.00
Total for isp-1001010114 163.00
Total Monthly Service Charges 163.00
NEW Indicates an item that is being charged for the first time.
Other Charges and Credits
isp-1001010114(FERRY MAIN OFFICE)
12 Month"BETTER"Business Internet (07/03/21 -07/31/21) 114.13CR
12 Month"Best"Internet (07/02/21 -07/31/21) 154.84
Total for isp-1001010114 40.71
Total Other Charges and Credits 40.71
Monthly Service
Monthly Service from Aug 01 through Aug 31
isp-B8M-Theatre
8 Month"Better"Business Internet 138.00
8m-Internet Reconnect Fee .00
Internet Infrastructure Fee 3.00
Internet Modem Lease Fee 5.99
Total for isp-B8M-Theatre 146.99
Total Monthly Service Charges 146.99
Taxes and Surcharges
Internet Service
Suffolk County .28
NY Sales Tax .24
Total Taxes and Surcharges .52
Total Fishers Island-ISP Charges 419.22
9
Page: 10 of 14
P.O. Box 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 01 2021
Name: F I FERRY DISTRICT
Fishers Island Electric
RENTAL HOUSE
Current Charges
Residential Electric Rates Class 7 2646
Energy Charge(See detail below) 155.10
Demand Charge 00
Fuel Adjustment Fuel Adjustment Factor.03315 Per KWH 17.27
NY State Tax 4.97
Current Previous Energy Used Charges
MASTER 22730 22209 REG. 521 KWH 155.10
DEMAND 0.00 DMD. 0 00 KWH .00
DATE 07/19/21 06/21/21 DMD MIN. 000
Meter Multiplier 1.00
Total Energy Charges for RENTAL HOUSE 203.80
FREIGHT SHED, BLDG 208
Current Charges
Commercial Electric Rates Class 5 1820
Energy Charge(See detail below) 79.80
Demand Charge 29.31
Fuel Adjustment Fuel Adjustment Factor.01232 Per KWH 4.73
Current Previous Energy Used Charges
MASTER 8575 8191 REG 384 KWH 79.80
DEMAND 231 DMD. 2.31 KWH 29.31
DATE 07/19/21 06/21/21 DMD.MIN 2.31
Meter Multiplier 1.00
Total Energy Charges for FREIGHT SHED, BLDG 208 132.04
THEATRE
Current Charges
Commercial Electric Rates Class 5 18.20
Energy Charge(See detail below) 166.24
Demand Charge 00
Fuel Adjustment Fuel Adjustment Factor.01232 Per KWH 986
Current Previous Energy Used Charges
MASTER 1163 1153 REG. 800 KWH 16624
DEMAND 0.00 DMD 0.00 KWH .00
DATE 07/19/21 06/21/21 DMD MIN 0.00
Meter Multiplier 80.00
Total Energy Charges for THEATRE 194.30
AIRPORT
Current Charges
Commercial Electric Rates Class 5 18.20
Energy Charge(See detail below) 107.22
Demand Charge 4213
Fuel Adjustment Fuel Adjustment Factor 01232 Per KWH 636
Page: 11 of 14
P.O. Box 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 01 2021
Name: F I FERRY DISTRICT
Current Previous Energy Used Charges
MASTER 32215 31699 REG. 516 KWH 107.22
DEMAND 3.32 DMD. 3 32 KWH 42.13
DATE 07/19/21 06/21/21 DMD.MIN. 000
Meter Multiplier 100
Total Energy Charges for AIRPORT 173.91
BUSINESS OFFICE
Current Charges
Commercial Electric Rates Class 5 18.20
Energy Charge(See detail below) 114.91
Demand Charge 25.13
Fuel Adjustment Fuel Adjustment Factor.01232 Per KWH 6.81
Current Previous Energy Used Charges
MASTER 8622 8069 REG. 553 KWH 114.91
DEMAND 1.98 DMD. 1 98 KWH 2513
DATE 07/19/21 06/21/21 DMD.MIN. 1.98
Meter Multiplier 1.00
Total Energy Charges for BUSINESS OFFICE 165.05
Total.Fishers Island Electric Corporation Charges 869.10_
UNDERSTANDING YOUR ELECTRIC BILL
Your contract is on a non-transferable annual basis.Federal and State Taxes are trilled when applicable.A complete copy of our
rate schedule can be obtained at the offices of the Fishers Island Utility Company office budding.
BASIC MINIMUM CHARGE: Covers maintenance of electric lines,meters and other costs.This charge will be billed
whether or not you use energy.
KWH(KILOWATTHOUR): A KWH equals 1,00Dwatt-hours of electricity use.One KWH equals the energy needed
to run a 100 watt tight bulb for 10 hours.
FU EL AD1 USTMENT: A charge that reflects changes in the actual cost of fuel purchased by the utility.
RESIDENTIAL ELECTRIC RATES
CLASS 1 CLASS 2 CLASS 7
Minimum Charge $12.13 Minimum Charge $37.05 Minimum Charge $26.46
First 1,000 KWH $0.21% All KWH 50.4101 All KWH S02977
Over 1,000 KWH $0.2503
COMMERCIAL ELECTRIC RATES
CLASS 5
Minimum Charge $18.20
Demand Charge $12.69 per KWH
Energy Charge 50.2078 per KWH
e � Page: 12 of 14
P.O. Box 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 01 2021
Name: F I FERRY DISTRICT
Fishers Island Water
RENTAL HOUSE
Current Charges
System Improvement Charge 7.81
Water Class 2,Meter 5/8 49.40
06/21/21 -07/26/21 Water Usage Detail
Meter#1564430356
Current Meter Reading 7216
Previous Meter Reading 6419
Cubic Feet Used 797
Gallons(Cubic Feet x 7.5) 5978
Total Water Usage Charge 49.14
Total for RENTAL HOUSE 106.35
THEATRE
Current Charges
System Improvement Charge 21.00
Water Class 2,Meter 5/8 49.40
06/21/21 -07/26/21 Water Usage Detail
Meter#1564600656
Current Meter Reading 2232
Previous Meter Reading 90
Cubic Feet Used 2142
Gallons(Cubic Feet x 7 5) 16065
Total Water Usage Charge 215.57
Total for THEATRE 285.97
BUSINESS OFFICE
Current Charges
System Improvement Charge 3.05
Water Class 1,Meter 5/8 3850
06/21/21 -07/26/21 Water Usage Detail
Meter#1564573058
Current Meter Reading 4415
Previous Meter Reading 4061
Cubic Feet Used 354
Gallons(Cubic Feet x 7.5) 2655
Total Water Usage Charge .00
Total for BUSINESS OFFICE 41.55
Total Fishers Island Water Works Corporation Charges 433.87
!s Page: 13 of 14
P.O. BOX 604 Account: 1100130
Fishers Island, NY 06390 Bill Date: Aug 01 2021
Name: F I FERRY DISTRICT
UNDERSTANDING YOUR WATER BILL
Water usage is billed monthly.Your contact is on a non-transferable basis.Monthly minimum charges are based on meter
size and class.Federal and State taxes are billed where applicable.A complete copy of our rate schedule can be obtained at
the offices of Fishers Island Utility Company office building.
CLASS 1 Meter Size Minimum Charge Minimum Usage
(inch) (Gallons)
5/8 $38.50 31000
3/4 $57.80 4,500
1 $96.20 7,500
11/4 $134.70 10,500
11/2 $19250 15,000
2 $308.00 24,000
3 $615.90 48,000
4 $96240 75,000
6 $1,924.80 M,000
Water usage over the minimum is billed at$12.80 per thousand gallons.
CLASS 2 Meter Size Minimum Charge Minimum Usage
(inch) (Gallons)
5/8 549.40 3,000
3/4 $74.20 4,500
1 5123.60 7,500
11/4 5173.10 10,500
11/2 $247.20 15,000
2 $395.60 24,000
3 $791.10 48,000
4 $1,236.10 75,000
6 $2,47230 150,000
Water usage over the minimum is billed at$16.50 per thousand gallons.
Page: 14 of 14
P.O. Box 604 Account: 1100130
t Fishers Island, NY 06390 Bill Date: Aug 01 2021
Name: F I FERRY DISTRICT
******************** This page intentionally left blank********************
"M
' FISHERS ISLAND FERRY DISTRICT v
VENDOR .03999 GREAT AMERICAN INSURANCE GROUP 08/24/2021 CHECK 7594
FUNDi& ACCOUNT P.O.# INVOICE DESCRIPTION
AMOUNT
'SM .193,0.4.000.000 062121 CLAIM-A00371405-6/21/21 1,000.00"
4" TOTAL 1,000.00
N
-- ----------- --- - --- -------------- --
----------- - ----- -
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IVILI�
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FIS)lk!kS,ISLAND FERRY DISTWICT AbDIT' '8/24),2'02-1
53095MAIN ROAD,PO BOX'1179
POUTHOLD,,NY 11971.0959CHECK',-N ,,-7 5 94,
0,
THE SUFFOLK CO.NATIONAL BANK
CyTqH0,GuE,NY 11935 DATE AMOUNT,'
50-5461214
ONE THbUSAi&'AND';-b o/io 0 DO LAR
.DIY, , ,GREAT.AMERICAN INSURANCE GROUP, Y
,
LIE
PO BOX2468.
4 6 8im,
OW-Eff
NCiNN—Ti bA 4�201 '
OF
"'A 112007594118 1:0 2 L4054641: 68 00 I50 2 1
Vendor No. Check No.
Town of Southold, New York - Payment Voucher ® q9 D-
Vendor Tax ID Number or Social Security Number Vendor Address Entered by
CL
One-time vendor PO Box 2468 Audit Date t
Great American Insurance GroupCincinnati3OH 45201 z AUG 2 4 2021
Vendor Telephone Number
Clerk
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General`Ledger Fund and Account Number
etW 6/21/2021 $1,000.00 $1,000.00 Deductible for Claim-Todd Gurveremout SM1930.4.000.000
r
Date of loss 6/21/21
A00371405
$1,000.00 $1,000.00
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signatu
Company Namei and Ferry District Date 8/15/2021 Title Date
4 OCEAN MARINE DIVISION
28 LIBERTY STRIIE.T,36 FLPgR
NEW YORK,NY 10005
►�+
TEL: (212)510-0128
G- REATAmERICAN FAX:(212)422-1108
INSURANCE GROUP JOAMVE'MARZA$IO
, SENIOR yCLAIMS,SPECIALIST
July 29, 2021
Fishers Island Ferry District
P.O. Box 607
Fishers Island, NY 06390
Attention: Gordon Murphy
Insured : Fishers Island Ferry,District
Claimant : Todd Gurveremout
Date/Loss : 06121/2021
File No. : A00371405
Deductible : $1,000.00
Dear Mr. Murphy:
We are writing to advise you that we have settled the above captioned claim in the
amount of $2,247.59, which is in excess of your$1,000 policy deductible.
At this time, we ask that you send us a check in the amount of $1,000.00, to satisfy your
policy deductible.
The check should be made payable to the Great American Insurance Company and
mailed to us at the following address:
Great American Insurance Company
Ocean Marine Claims
Post Office Box 2468
Cincinnati, Ohio 45201
Attn: Millie Melendez
We appreciate your cooperation in this regard.
Very truly yours,
Joanne Marzario
1-800-426-9697 ext 0128
imarzario@gaiq.cora
JM/mm
cc: The Hilb Group of New England, LLC
-2000 Chapel View Blvd. 240
Cranston, RI"02920-3051
Attention: Claims Department
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FISHERS ISLAND FERRY DISTRICT
Al
VENDOR 012705 LOWE'S 08/24/2021 CHECK 7595
A 1 "'14
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT i Asa
SM .5710'.4,000.625 901057A NLT TERMINAL SUPPLIES 7.56
SM .5709.2.000.100 918150 WHISTLER AVE-WASHER 756.19
SM .5709.2.000.100 935779 WHISTLER AVE-DRYER 760.16
TOTAL 1,523.91
TT
4 IN
------------
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9MIC ME
7,
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FISHERS.ISLAND FERRY DISTRICT, AUPIT"�6/24/2'02,1-
•53095,MAIWROAD,PO BOX 1,179,
-•0959 tHEC
_§OUTHOL iW11971'
THE SUFFOLK C6.,"TiO'NAL BANK
-DATE
CU TtHOGUE,NY'l 1935' OUNL,'
T,
`p8/24/202,�:,
6ki"THOUSAND FIVE 'HUNDRED,TW'ENTY
s
AY LOWE S
PO BO ,30954x
dRDER
ATLANTk-GA 30353`-0954
11NOO 7 5 9 �118 0 2 1 0-5 L, G L,1: 613 00150 2 L v
Check No.
Town of Southold, New York - Payment Voucher 12705 e.
Vendor Tax ID Number or Social Security Number Vendor Address Entered by L�
Vendor Name 1000 Lowe's Blvd Audit Date
Lowes Mooresville, NC 28117 202
Vendor Telephone Number AUG 2 4
Town Clem,
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
918150 7/5/2021 $756.19 $756.19 357 Whistler Ave washer SM5709.2.000.100
935779 7/5/2021 $760.16 $760.16 357 Whistler Ave dryer SM5709.2.000.100
901057 7/26/2021 $7.56 $7.56 NLT terminal supplies SM5710.4.000.625
$1,523.91 $1,523.91
Payee Certification Department Certification
nt)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
;in stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
axes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Fishers Islan Date 8/11/2021 Title Mana er Date
41PIM
Account: 9800 295465 3 Statement Date:08/02/21 Page: 1 of 5
Learn how Lowe's Commercial Accounts can get
Extended Terms as a Lowe's For Pros Loyalty
Member (not required for accounts opened on or
before 3/31/21 .) For details, visit
lowes.com/procreditoffer.
I�r��lllllll��"'I��Irr�IIIIII�iIIrIiIrI�III�IIrIlllilllli�ll��ll
FISHERS ISLAND FERRY DIST 65287
ATTN: ACCOUNTS PAYABLE K107
PO BOX 607
FISHERS ISLAND, NY 06390-0607
Customer Service Online at www.lowescredit.com
This account is already registered.
See Your Online Admin to get a User ID & Password
a,
AccouritBalance Sbmrmalij, -z]
_
Current l voices&!ReturnsI ,$'1,52391
1-30 Days Past Due $,684j09
°s
31`-60 Days Past=Due � " �° ��" � $,0'00
Over 60 Days Past Due $0.00
Unapplied Payments&Adjustments $0.00
Statement Balance $2,208.00
a
0
Send payments to: o� Send Billing/General Inquiries
Lowe's I '-- 1 to:
P 0 Box 530954 P.O.Box 965054
Atlanta GA 30353-0954 Orlando FL 32896-5054
For Customer Service:call 1-866-232-7443
Purchases,returns,and payments made just prior to the statement date may not appear
until the next month's statement.Any payments received after 5pm on any business day or
on any day other than a business day,at the address above,will be credited on the next
business day.If the payment Is made at a location other than such address,credit may be
delayed
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COLR649A 5379 5005 A79 07 210803 PAGE 00001 OF 00005 6528;
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Definitions
i,
Payments' Ricewed: Money received'-and posted-to
the account since the previous billing period.
Current Invoices & Returns: New purchases and _.
credits given for merchandise returned` since' the
previous billing period. -rt
Past . Due Invoices & Returns: Previously billed
in ppes that have not been closed,(by;a payment_or:a
credit) ..or merchandise returns that have. not been
applied to8i specific invoice.
Unapplied Payments & Adjustments: Payments or,-
non-merchandise credits that have been applied to the
account, but not applied to a specific invoice.
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4113510S Page 2 of 5
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Account: 9800 295465 3 Statement Date:08/02/21 Page:2 of 5 Account:9800 295465 3
ACCOUNT ACTIVITY
Amos Account Number : 9800 295465 3
Current Invoices & Returns
Date Invoice Original Due Date Store/City Reference Invoice Date&
Amount Amount Due
Please Indicate by Invoices You re Paying
07/05/21 918150 $756.19 09/20/21 2938 COOK 918150 �/0 07/05/21
-HEEDFO $756 19
LISBON,CT
07/05/21 935779 $760.16 09/20/21 2263 COOK 935779 07/05/21
-HEEDAC $760.16
WATERFORD,CT
07/26/21 901057 $7.56 09/20/21 2263 NA 901057 07/26/21
-HHEMNF $756
WATERFORD,CT
i
Subtotal $1,523-91 ��A Subtotal $1,523.91
Past Due Invoices & Returns (
DateInvoice------sOriginal Due-Date--Store/City-Reference I Invoice Date&
j ! Amount ( �� Amount Due
1 1 @ Please Indicate b
1
y Invoices You are Paying
05/04/21 902362 $56.24 07/20/21 2263��RACEIPOI NT 902362 ❑ 05/04/21
_ 1 i_ _� __ . .__, -�..-.... $56.24
GVHKKR
WATERFORD,CT s I
J
05/11/21 923493 $20,82 07/20/21 2263 NLT 923493 ❑ 05/11/21
GWHNMN $20.82 P
WATERFORD,CT
05/17/21 902991 $25.94 07/20/21 2263 RACE PT 902991 ❑ 05/17/21 a
-GXDCPR $25.94
C WATERFORD,CT
05/18/21 902195 $92.23 07/20/21 2263 RACE POINT 902195 ❑ 05/18/21
- -GXHZWP $92.23
WATERFORD,CT
05/18/21 902192 $163.13 07/20/21 2263 COOK 902192 ❑ 05/18/21
-GXHZWN i $163.13 n
WATERFORD,CT
05/18/21 902305 $26.90 07/20/21 2263 RACE PT 902305 ❑ 05/18/21
-GXHZWV $26 90
WATERFORD,CT
05/20/21 923549 $38,94 07/20/21 2263 COOK -123549 ❑ 05/20/21
e -GXRXZN $38.94 O
e WATERFORD,CT
05/24/21 901829 $25.96 07/20/21 2263 FISHERS ISLAND 901829 ❑ 05/24/21
-GYDXXS $25.960
WATERFORD,CT
05/24/21 902957 $86.13 07/20/21 2263 RACE POINT 902957 ❑ 05/24/21
-GYDXXA $86.13 10
WATERFORD,CT >9
05/26/21 901934 $56.95 07/20/21 2263 RACEPOINT 901934 ❑ 05/26/21
-GYODRW $56.95
WATERFORD,CT
05/27/21 903247 $23.00 07/20/21 2263 COOK 903247 ❑ 05/27/21
-GYTAGD $23 00
WATERFORD,CT
05/28/21 902299 $67.85 07/20/21 2263 COOK 902299 ❑ 05/28/21 r
-GYXEWJ $67 85
WATERFORD,CT
Subtotal $684.09 i Subtotal $684.09
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COLR649A 5879 5005 A7G 07 210803 PAGE 00002 OF 00005 65257
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Definitions _ ..
Payments Received: Money received and posted to
the account since the'previous`•billing period.
Current Invoices & Returns: New purchases and
_ ; o credits given for merchandise returned since, the
previous billing period.
Bust Due invoices & Returns: Previously billed
- invoices,that have not-been closed (by a payment or a.3_
credit) or, merchandise returns that have not been
applied to a specific invoice.
}. Unapplied Payments & Adjustments: Payments-or-==
non-merchandise,credits that have been applied to the
account; but not applied'to a specific invoice.
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PAYMENT STUB
408 Page 3 of 5
Account: 9800 295465 3 Statement Date: 08/02/21 Page:3 of 5 ; Account: 9800 295465 3
Li
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Account Balance
Summary
9800 295465 3
ETotal
$2,208.00
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COLR649A 5879 5005 A7G 07 210803 PAGE 00003 OF 00005 652871
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Definitions
Payments Received: Money received and posted to
the account since the previous billing period.
Current Invoices & Returns: New purchases and
credits given for merchandise returned since the
previous billing period. ry
Past Due Invoices & Returns: Previously billed
invoices that have not been closed (by a payment or a
credit) or merchandise returns that have not been
applied to a specific invoice.
Unapplied Payments & Adjustments: Payments or =
non-merchandise credits that have been applied to the
I
account, but not applied to a specific invoice.
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Account: 9800 295465 3 Statement Date:08/02/21 Page:4 of 5
Current Invoice Details
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Mail Payments to: LOWE'S
P.O. BOX 530954
ATLANTA, GA 30353-0954
FISHERS ISLAND FERRY DIST Date of Sale: 07/05121
Account: 9800 295465 3 Invoice: 918150 -HEEDFO
Store/City: 2938/LISBON,CT P.O./JOB: COOK
Buyer: COOK GEB
SHIP TO:
5 Waterfront Park
NEW LONDON,CT 06320
S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE
000000001639522 ,-LG FC WASHERWM3400CW 1.00 EA 725.81 725.81
000000000246995 '� 2-CT 6-FT SS WM•FILLLL HOSE 1.00 EA 30.38 30.38
000000000155670""' PROMOTIONAL DISCOUNT APPL- 1.00 EA 0.00 000
0000!)0000000002 DELIVERY FEE, 1.00 EA 0.00 0.00
_ I
Subtotal: 756.19 (�� -� Tax 1000i=3 ; Balance Due: 756.19
Mail Payments t°: t L�jLOWE'S
BOX 530954
ATLANTA;G'A-30353=0954`
FISHERS ISLAND FERRY DIST Date of Sale: 07/05/21
Account: 9800 295465 3 Invoice: ; 935779 -HEEDAC
Store/City: 2263/WATERFORD,CT P.O./JOB,I COOK
Buyer: COOK GEB
SHIP TO:
5 Waterfront Park
NEW LONDON,CT 06320
S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE
I
000000001639523 LG ELEC DRYER DLE340OW 1.00 EA 725.81 725.81
000000000148708 3-WIRE DRYER CORD 6-FT 1.00 EA 18.40 18.40
0
000000000040529 4-INX8-FT FOIL TRNSTN DCT 1.00 EA 11.89 11.89
000000000433261 44N METAL WORM GEAR CLAM ! 2.00 EA 2.03 4.06
000000000155670 PROMOTIONAL DISCOUNT APPL 100 EA 0.00 0.00
000000000155670 PROMOTIONAL DISCOUNT APPL 1.00 EA 0.00 0.00
000000000000002 DELIVERY FEE 1.00 EA 0.00 0,00
I
Subtotal: 760.16 Tax: 0.00 Balance Due: 760.16
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COLR649A 5879 5005 A76 07 210803 PAGE 00004 OF 00005 65287
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.;t Definitions
Payments-'Received Money received arid posted to
the account since the'previo'us billing period.
I '
. ._ _ Current Invoices ,&_Re'tu'rhso_ New purchases and '
_ credits given for merchandise returned since the
previous billing period.
Past Due Invoices & Returns: Previously billed
f invoices that have not been closed (by a payment or'a
credit) or merchandise returns that have not been ,.-,;
I
applied to a specific'invoice. '
Unappliied Paoyments,& Adjustments: Payments or
non-merchandise credits that have=been applied to the
account, but not apblied to°a-'specific invoice.
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Account: 9800 295465 3 Statement Date:08/02/21 Page:5 of 5
Mail Payments to: LOWE'S
P.O. BOX 530954
ATLANTA, GA 30353-0954
FISHERS ISLAND FERRY DIST Date of Sale:, 07/26/21
Account: 9800 295465 3 Invoice: i 901057 -HHEMNF
Store/City: 2263/WATERFORD,CT P.O./JOB: NA
Buyer: FRANCO MICHAEL
S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT.PRICE
000000000036908 YS 10-CT HOSE WASHERS 4.00 EA 1.31 5.24
000000000137348 5116-IN-18 BRAD HL N TEE 2.00 EA 1.16 2.32
000000000155670 PROMOTIONAL DISCOUNT APPL 1.00 EA 0.00 0.00
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Subtotal: 7.56 Tax- 0.00 Balance Due: 7.56
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COLR649A 5879 5D05 A7G 07 210803 PAGE 00005 OF 00005 65287T
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Definitions
Payments Received: Money received and posted to ,
the account since the previous billing period.
Current Invoices & Returns: New purchases and
credits given for merchandise returned since the
previous billing period.
Past Due Invoices & Returns: Previously billed
invoices that have not been closed (by a payment or a _
credit) or merchandise returns that have not been
applied to a specific invoice.
a.r
Unapplied Payments & Adjustments: Payments or Y
non-merchandise credits that have been applied to the
account, but not applied to a specific invoice.
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DELIVERY D . � ❑
�( T= A.M. AVAILABLE
Customer Name:
Phone#: Fishers �—P•M• DRIVER:
(203) 410- Island Ferr
III voice#: 18150 8156 LAR:XXX4653 Y Distr 2938 LOWE'S HO
Date: Pp—COOK DELIVE y CENTERS, LLC
07/06/2021 � ADDRESSSS; 1 of 1
Salesman#: 2557764 1:00 AM - 8'00 5 Waterfront Park
SUE O'CONNOR PM
NEW LONDON CO NEW LONDON, CT 06320
Delivery Instructions: ALT PHN: (203) 410-8156
DELIVERY TO THE FERRY FOR TRANSPORT TO FISHERS ISLAND
I I IAL ITEM# ITEM DESCRIPTION MODEL ATY I UNIT UNIT PRICE
1639522 LG FL WASHER WM3400Cn1 WM3400CW
1 EA 725.81
246995 2—CT 6—FT SS WM FILL HOSE 98506
1` EA 30.38
2938 07/05/2021 ORIG IVO: 18150 756.19 0.00 756.19
PRINT ID; S2938AH1 FULL PRINTING INVOICE DELIVERY MERCHANDISE TOTAL
************4653 LAR
TOTAL CHARGE
INITIAL & CHECK ALL APPLICABLE TASKS BELOW ACCORDING TO MERCHANDISE DELIVERED:
( ) INSPECT UNIT FOR DAMAGE, REMOVE ALL PACKING MATERIALS AND SHIPPING PINS
( ) INSTALL LEVELING LEGS, LOCK NUTS, SHELVING, DRIP PANS, LEVEL THE UNIT/S
( ) SET TEMPERATURE AND TIME CONTROLS--REFRIGERATORS AND RANGES ONLY
( ) CONNECTED, TIGHTENED, AND CHECKED ALL WATER LINE CONNECTIONS FOR LEAKS
( ) ATTACH RETENTION SPRING/CLAMP, INSTALL NEW 220V ELECTRICAL CONNECTIONS
( ) TESTED UNIT/S OPERATION AND GAVE CUSTOMER OWNER'S MANUAL
( ) MFR RECOMMENDS SEMI—RIGID DUCT BUT USED FOIL DUE TO SPACE CONSTRAINTS
AND CUSTOMER CONSENTS TO U.L. METAL FOIL DUCT BY SIGNING BELOW
lease check the merchandise to ensure a items are received. Lowe's is
of responsible for Pick-up shortages after you leave Lowe's warehouse.
our signature acknowledges the completion of all initialed and checked
pplicable tasks above, as well as signifies receipt of all Delivered
erchandise/items listed above. Your not signing acknowledgement of
eceipt, however, does not mean that such merchandise was not delivered.
:ECEIVED AND ACKNOWLEDGED BY:
o k `
s
NOT
III�IllllllrlllIIIIII�IIIIIIIIIIIIIIIIIIIIII�IIIIIIII DELIVERY DATE: � / lR / � TIME AVAILABLE
A.M.
P.M. DRIVER:
-
Customer Name: Fishers Island Ferry Distr 2263 LOWE'S HOME CENTERS, LLC 1 of 1
Phone#: (203) 410-8156 LAR:XXX4653 PO-COOK DELIVERY ADDRESS:
Invoice#: 35779 Date: 07/06/20'21 5 Waterfront Park
8:00 AM - 8:00 PM
Salesman#: 2189937 CHRISTOPH RO O NEW LONDON, CT 06320
NEW LONDON COQ�/. ALT PHN: (203) 410-8156 I '
Delivery Instructions:
Eyo 641
FISHERS ISLAND FERRY
V/ kv,���\\\ �
INITIAL ITEM# ITEM DESCRIPTION MODEL QTY UNIT UNIT PRICE
1639523 LG ELEC DRYER DLE3400W DLE340OW 1 EA 725.81
148708 3-WIRE DRYER CORD 6-FT UTD100306 1 EA 18.40
40529 4-INX8-FT FOIL TRNSTN DCT UL L498UL 1 EA 11.89
433261 4-IN METAL WORM GEAR CLAMP C 433261 2 EA 2.03
2263 07/05/2021 ORIG IVO: 35779 760.16 0.00 760.16
*************4654653 LAR
PRINT ID: 3JM1 FULL PRINTING INVOICE DELIVERY MERCHANDISE TOTAL
TOTAL CHARGE
INITIAL & CHECK ALL APPLICABLE TASKS BELOW ACCORDING TO ,MERCHANDISE DELIVERED:
( ) INSPECT UNIT FOR DAMAGE, REMOVE ALL PACKING MATERIALS AND SHIPPING PINS
( ) INSTALL LEVELING LEGS, LOCK NUTS, SHELVING, DRIP PANS, LEVEL THE UNIT/S
( ) SET TEMPERATURE AND TIME CONTROLS--REFRIGERATORS AND RANGES ONLY
( ) CONNECTED, TIGHTENED, AND CHECKED ALL WATER LINE CONNECTIONS FOR LEAKS
( ) ATTACH RETENTION SPRING/CLAMP, INSTALL NEW 220V ELECTRICAL CONNECTIONS
( ) TESTED UNIT/S OPERATION AND GAVE CUSTOMER OWNER'S MANUAL
( ) MFR RECOMMENDS SEMI-RIGID DUCT BUT USED FOIL DUE TO SPACE CONSTRAINTS
AND CUSTOMER CONSENTS TO U.L. METAL FOIL DUCT BY SIGNING BELOW
Please check the merchandise to ensure all items are received. Lowe's is
zoo responsible for Pick-up shortages after you leave Lowe's warehouse.
four signature acknowledges the completion of all initialed and checked
applicable tasks above, as well as signifies receipt of all Deli ered
aerchandise/items listed above. Your not signing acknowledgem t of
receipt, however, does not mean that such merchandise was no delivered.
W EIVED AND ACKNOWLEDGED ✓ /,�'� '�
BY:
0
EV
_ OW E
LOWE'S HOME CENTERS, LLCW n^/1�fiv�� {� S
167 WATERFORD PARKWAY NORI C t LOWE'S HOME CENTERS, LLC
WATERFORD, CT 06385 (860) 701-2000
����'` 167 WATERFORD PARKWAY NORT
w SALE _ Vv-v `o-��� WAfERF'ORD, CT 06385 (660) 701-2000
ESN: S2263CR2 2169931 TRANSN: 55496981 07-05 _ SALE
1639523 LO ELEC DRYER OLE340OW 725.61 :SN: 52263181 1251107 TRANSN: 88322170 07-2
764.00 DISCOUNT EACH -36.19 ^ /
*MINIMUM RETAIL PRICE APPLIED TO THIS ITEMS V ab908 YS 1D-CT N05E MASHERS 5.24
1.38 DISCOUNT EACH -0.07
[DELIVERY - 07106/20211 4 9 1.31
148108 3-WIRE DRYER CORD 6-FT 18.40 157348 5116-IN-18 BRAG HL N TEE 2.32
19.78 DISCOUNT EACH .1.38 1.22 DISCOUNT EACH 0.06
[DELIVERY - 0710612021I C� 2 O 1.16
40529 4•INXB-FT FOIL TRNSTII OCT 11.89 I_
12.78 DISCOUNT EACH -0.89 SUBTOTAL: 7.56
[DELIVERY - 07106/20211 TOTAL TAX: 0.00
433261 4-I11 METAL WORN GEAR CLAM 4.06 INVOICE 01057 TOTAL: 7.56
2.18 DISCOUNT EACH -0.15 1 pp; 7.56
2 (4 2.03
[DELIVERY - 07/0612021) ����A�- f]IS�:OLihI1 : 0.4.:
2 DELIVERY FEE 0.00 �� LAR:XXXXXXXXXXXX4653 AMOUNT:7.56 AUIHCD:00061
(� 1 SWIPED REFID:626155 07/26/21 13:56:46
SUBTOTAL: 760.16 v^" LAR P0: NA
TOTAL TAX: 0.00 ACCOUNT NAME:
INVOICE 35779 TOTAL: 760.16 FISHERS ISLAND FERRY DISTR LAR: 760.16 RUTH BUYER: FRANCO MICHAEL
0 T A L O I S O OU N T: 4 O-71 COUNT WILL BE BILLED UPON MERCHANDISE THANSAC
LAR:XXXXXXXXXXXX4653 AMOUNT:760.16 AUTHCD:0014
SWIPED REFID:932925 07/05121 11:29.511'E FOR STOCK MERCHANDISE AND NO LAfER THAN 90
� FROM TRANSACTION RATE FOR SOS ON DIRECT DELTU•
LAR P0: COOK
MERCHANDISE.
ACCOUNT NAME:
FISHERS ISLAND FERRY DISTR STORE: 2263 TERMINAL: 01 07/26121 19:56:
AUTH BUYER: COOK OEB OF IYEMS PURCHASED
EXCLUDES FEb. ShlUiij S AND SPFCIAL ORDER ITE
COUNT WILL BE BILLED UPON MERCHANDISE TRANSACI I1111i31131111111111111i11111111111111111 11111111lp111111111111111111111111111111111111�111111111111111!1111 ,11I
TE FOR STOCK MERCHANDISE AND NO LATER THAN 90 1', ,
FROM 1RANSACfION DATE FOR SOS OR DIRECT DELIUV
MERCHANDISE.
1u
5TOIlE: 2263 fERMiNAL: 35 07!05/21 11:29:; '
OF I.1"EMS PURCVIASED:
axrl uDEs FEES. SERVICES AND SPECIAL ORDER ITE
m ISI o„ i
'm4 'I ' pjfoli
JP
FISHERS ISLAND FERRY DISTRICT
`„
VENDOR 012810 M.J. BRADLEY ASSOCIATES, LLC 08/24/2021 CHECK 7596
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
H7 .5989.2 .400.400 251 RP PROF SVC-7/21 2,310.00
SM .5709.2.000.200 268 PROF SVC-7/21
16, 685.00
TOTAL 18,995.00�
co
co
8
Xfl.
va,
A
%
FISHERS ISLAND F)FRP Y DISTRICT
53096 MAIN ROAD;PO BOX 1179 AUDIT
SOUTHOLD,NY 11971-0959 CHECK
NO. 61
7`�
JFFOL'K'CQ.NATIONAL ALBANK
I , , AMOUNT'-
CUTCHOGILIE,NY 11935+ DATE
-18:,,995.7
'0
50-546/214,
-D6)�LARS,'lildHTEEN',,THOUSAND,NINE' HUNDRED N'INETY, FIVE ARb 60/160
pxy— RAD
M.J, B LEY,& ASSOCIATES,
LLC,
47, JUNCTION,',SQUARE,PRTVE:,
''cbNc6Ab MA' 0 17 4 2-
ORb—PR-
OF,
7
111007596115 40214051, 644 68 00 150 2 1 I'm
Vendor No. Check'No:_,' �
Town of Southold, New York - Payment Voucher 12810 7n.
Vendor Tax ID Number or Social Security Number Entered by
47 Junction Square Dr. r%
Concord, MA 01742 Audit,Date `
M.J. Bradley&Associates �,� ��
Vendor Telephone Number �"��( ," "
;" d(['2077 1,
a
Tdi n'Clerk"
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services �� General Ledgei Fund'and�Account-Number'
251 8/3/2021 $2,310.00 $2,310.00 Professional services -Race Point H7.5989.,2.400.400 '
through July 31,2021
"
FIF CT DEEP VW Grant Technical Support
268 8/3/2021 $16,685.00 $16,685.00 Professional services -Port Infrastructure Grant SM5709.2.000.200
July 1 through July 31,2021 � �°
156MB01 FIFD PIDP Grant Application
$18,995.00 $18,995.00 '
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
ndlSignature Title Signature
Company Name Fisher Ferry District Date 8/15/2021 Title Date
a
( Please Remit to NEW ADDRESS
�f7'�)
�g r- Wrong Instructions Check Payments ACH Transfers
6 ``-'J? Well Fargo Bank,N A Box No 2691 Wells Fargo Bank,N A
MJBI %��:-tea aA 420 Montgomery Street P O Box 8500 420 Montgomery Street
I I San Francisco,CA 94104 Philadelphia,PA 19178-2691 San Francisco,CA 94104
an ERM Group company ABANo 121000248 ABA 121000248
Credit to:ERM,Inc Creditto ERM,Inc
Account No 2000031445506 Account No 2000031445506
Swift Code WFBIUS6S
Attn: Geb Cook; Kasia Asmolov Invoice Date:03-August-2021
Fishers Island Ferry District Invoice#:251
261 Trumbull Drive Project#:0593767
Fishers Island, NY 06390 ERM Proiect Mananer:
Dept:MB01
For Professional Services rendered through July 31,2021
Project Name. 156MB01 FlFD04 CT DEEP VW Grant
gcook@fiferry.com;kasmolov@fiferry corn
Professional Personnel
Rate Schedule Labor Hours Rate Amount
Dave Seamonds 1350 145.00 1,95750
Paul Moynihan 150 23500 35250
--------------------
ERM Rate Schedule Labor 2,310.00
Total ERM Labor 2,310.00
Amount Due This Invoice ' (USD) 2,310.00
e
� ^I
M.J Bradley&Associates, LLC(an ERM Group Co)-Tax Id#26-2840513
i
Project: 0593767 -- 166MB01 FIFD04 CT DEEP VW Grant Invoice#: 251
Phase:, " " -- Default ,
ERM Rate Schedule Labor
Employee Name Date Hours Rate Amount
Paul Moynihan 07/07/2021 1.50 23500 352.50
update for GC,DS
-------------
------------------------------------ -------------- ---------------------
Paul Moynihan 1.50 352 50
Dave Seamonds 07/08/2021 150 14500 217.50
07/28/2021 5.00 14500 725.00
07/29/2021 3.00 145.00 435.00
07/30/2021 400 145.00 58000
------------------------------------------------- -------------- ---------------------
Dave Seamonds 13 50 1,95750
Rate Schedule Labor 15.00 2,310.00
Total Phase:**** -- Default Labor : 2,310.00
Expense 0.00
Phase Total a 2,310.00
Total Project:0593767 -- 156MB01 FIFD04 CT DEEP VW Grant 2,310.00
Page 1
Please Remit to. NEWADDRESS
MJWiring Instructions. Check Payments ACH Transfers
I.�; Well Fargo Bank,N A Box No 2691 Wells Fargo Bank,N A
i _- 420 Montgomery Street P O Box 8500 420 Montgomery Street B
San Francisco,CA 94104 Philadelphia,PA 19178-2691 San Francisco,CA 94104
an ERIC Group company ABA No 121000248 ABA 121000248
Credit to ERM,Inc Credit to..ERM,Inc.
Account No 2000031445506 Account No 2000031445506
Swift Code WFBIUS6S
Attn: Geb Cook Invoice Date:03-August-2021
Fishers Island Ferry District Invoice#:268
P.O. Box 607 Project#:0608227
Fishers Island, NY 06390 ERM Proiect Manaaer:
Dept:MB01
For Professional Services rendered from July 01,2021 thresh July 31,2021
Project Name: 156MB01 FIFD PIDP Grant
Professional Personnel
Rate Schedule Labor Hours Rate Amount
Paul Moynihan 71 00 235.00 16,685.00
--------------------
ERM Rate Schedule Labor 16,685.00
Total ERM Labor 16,685.00
Amount Due This Invoice (USD) 16,685.00
I f C..S
I �I
M.J Bradley&Associates, LLC(an ERM Group Co)-Tax Id#26-2840513
Project: 0608227 -- 156MB01 FIFD PIDP Grant Invoice#: 268
Phases Default - .
ERM Rate Schedule Labor
Employee Name Date Hours Rate Amount
Paul Moynihan 07/12/2021 4.00 235.00 940.00
emails,grant application needs,narrative outline
07/13/2021 200 235.00 47000
grant application
07/14/2021 2.00 235.00 470.00
grant application
07/15/2021 2.00 235.00 470.00
grant application
07/16/2021 2.00 23500 470.00
grant application
07/19/2021 3.00 235.00 705.00
grant application
07/20/2021 3.00 235.00 705.00
grant application
07/21/2021 4.00 235.00 940.00
grant application
07/22/2021 2.00 235.00 470.00
grant application
07/23/2021 5.00 235.00 1,175.00
grant application
07/24/2021 2.00 235.00 470.00
grant application
07/25/2021 5.50 235.00 1,292.50
grant application
07/26/2021 6.00 235.00 1,410.00
grant application
07/27/2021 6.00 235.00 1,410.00
grant application,coordinate grants.gov submittal w/Jon Haney
07/28/2021 8.00 23500 1,880.00
grant application,benefits analysis,EJ&sustainability impact
07/29/2021 6.50 23500 1,527.50
draft to GC for review,assemble appendices,GC comments
07/30/2021 8.00 235.00 1,880.00
finalize application,grants.gov submittal,post-submittal project
close-out
------------------------------------------------- --------------Paul Moynihan Moynihan 71.00 16,685.00
Rate Schedule Labor 71.00 16,685.00
Total',Phase,*' Default Labor 16,685.00
" , Expense , 0.00
Phase-Total 16,685.00
Total Project:0608227 -- 156MB01FIFD PIDP Grant 16,685.00
Page 1
FISHERS ISLAND FERRY DISTRICT
June 21,2021
Consultant/Legal/Professional Service
RESOLUTION 2021-102
WHEREAS, M.J. Bradley and Associates, LLC(MJB&A) is a transportation engineering firm
providing technical and strategic advisory services to government agencies and environmental
groups throughout New York and New England; and
WHEREAS MJB&A specializes in drafting and administration of grants for marine vessels and
port facilities; and
WHEREAS the FIFD is interested in applying for US Department of Transportation Maritime
Administration (MARAD) Port Infrastructure Development Program (PIDP)grant funding to
replace aging infrastructure including the north ramp, and ferry terminal building upgrade at
Fishers Island, New York as well as the replacement of thirteen (13) dolphin structures at the
New London,CT terminal.
WHEREAS, MJB&A has presented a proposal to the BOC for the provision of professional grant
writing services dated June 11, 2020,for a maximum cost total project budget not to exceed
$25,000; and
WHEREAS the BOC of the FIFD has determined that it would not be in the best interests of the
taxpayers of the FIFD to seek alternative proposals or quotations from other engineering firms
who do not possess MJBXs technical expertise in this field; and
Now,therefore be it RESOLVED that the BOC waives the requirement of a second quote in
Guideline 8 of the FIFD Procurement Policy; and
be it further RESOLVED that the BOC of the FIFD hereby accept the proposal of MJB&A for
professional grant administration services dated June 11,2021, not to exceed$25,000,subject
to the approval of District counsel.
Moved by: Commissioner Shillo
Seconded by: Commissioner Reid
Ayes:Ayes:A.Ahrens, H. Burnham,T. Cashel, J. Reid and D.Shillo
Nays: None
Southold Town Board - Letter Board Meeting of June 29, 2021
RESOLUTION 2021-549 Item R 5.28
ADOPTED
DOC ID: 17197
THIS IS TO CERTIFY.'THAT THE FOLLOWING RESOLUTION NO.2021-549 WAS
ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON
JUNE 29,2021:
RESOLVED that the Town Board of the Town of Southold hereby ratifies and approves the
resolutions of the Fishers Island Ferry District Board of Commissioners dated June 21, 2021
meetings, as follows:
FIFD
Resolution{ Regarding
2021 - 101 Accounting
2021 - 102 Legal/Pro Services
2021 - 103 Settlement
Elizabeth A. Neville
Southold Town Clerk
RESULT: ADOPTED [UNANIMOUS]
MOVER: Jill Doherty, Councilwoman
SECONDER:Louisa P. Evans, Justice
AYES: Nappa, Doherty, Ghosio, Evans, Russell
ABSENT: James Dinizio Jr
Generated June 30, 2021 Page 43
T'd
FISHERS ISLAND PERRYDISTRICT
ax, VENDOR 013564 MCMASTER-CARR SUPPLY COr 08/24/2021
CHECK 7597
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .5710.4.000.625 61653039 NLT SUPPLIES 22.87
SM .5710.2.000.200 61731202 RP SUPPLIES
228.58
.......... SM .5710.2.000.200 62184506 RP SUPPLIES 143 .34
SM .5710.2,000,200 62192515 RP SUPPLIES
50.53
TOTAL 445.32
-a=te-- --------- --- - -- ---- ---- - ----------
------ ----------- -----------
---------- ----- --- ------------------- -
W
g4�
1•0
2A 2 0 2
HUNDRED FORTY FIVE AND-"'32/1'06"D6Li!ARS'
7p
a; I
PAY,-- S
MCMA TER-CARR-, SUPPLY, CO.
rO
INE
THE: P,0 J�j CloUNty t �R AD
996ER
or EtMkURgT IL 6012
11500 7 S 9 Wo 1:0 2 11,0 5L, GLI: 68 OOL502 III-
' Vendor No. Check No:
Town of Southold, New York - Payment Voucher 13564 � " y
Vendor Address Entered`by
P.O. Box 7690
Vendor Name Chicago, IL 60680-7690 Aud_ii Date
McMaster-Carr Supply Co. y��g "
Vendor Telephone Number PLUG ° 4�"-20
21
609-689-3000 orpiiC e` '
Vendor Contact ..
3 '<
Invoice Invoice Invoice Net Purchase Order p
Number Date Total Discount Amount Claimed Number Description of Goods or Services Generdficdger Fund a'n&Accouut Number
61653039 7/15/2021 $ 22.87 $22.87 NLT supplies SIVI5710.4:000.626 `
61731202 7/16/2021 $ 228.58 $228.58 RP supplies � 'SM5710.2.000:200.�°
62184506 7/26/2021 $ 143.34 $ 143.34 RP supplies "i"W5710" .000.260
62192515 7/26/2021 $ 50.53 $50.53 RP supplies
50.53 `�
. _ z
$ 445.32 $445.32
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signatur
Company Name Fishers Island Fermi District Date 8/12/2021 Title ager Date 8/12/2021
-
Invoice
609-689-3000
609-259-3575(fax)
nj.sales@mcmaster.com
Purchase Order JOHN P
Tota 1 $22.87
1 nvo ice 61653039
Billed to I nvo ice Date 7/15/21
FISHERS ISLAND FERRY DISTRICT
P O BOX 607 PaY ment Terms 2% 10, Net 30
FISHERS ISLAND NY 06390-0607 Deduct$0 30 on merchandise and tax if paid by 725/21
Shipped to Mail Payment to McMaster-Carr
Fishers Island Ferry District PO Box 7690
5 Waterfront Park Chicago IL 60680-7690
New London CT 06320 Your Account 260910000
John Paradis placed this order.
Line Product Ordered Shipped Balance Price Total
1 44615K456 Standard-Wall Steel Pipe Nipple,Threaded on 1 1 0 2.76 2.76
Both Ends, 1 NPT,3" Long Each Each
2 44605K625 Low-Pressure Pipe Fitting,Steel,Bushing Adapter 1 1 0 11.55 11.55
with Hex Body,2 Male x 1 Female NPT Each Each
Merchandise 14.31
Sales Tax 1.37
Shipping 7.19
Total $22.87
Packing List Shipped Weight Carrier Tracking
2104816-01 7/15/21 2 Ib UPS 1Z0835200332712103
1 /
Federal ID 36-1458720 McMaster-Carr Supply Company Page 1 of 1
CD 7d7
L
• I
_ I
.� =MTA TER• ARR.
F S Packing List
200 New Canton Way Fishers Island Ferry District Purchase Order Page 1 of 1
Robbinsville NJ 08691-2343 5 Waterfront Park JOHN P
609-689-3000 New London CT 06320 07/15/2021
nj.sales@mcmaster.com Order Placed By f_
John Paradis
McMaster-Carr Number
2104816-01
Line Product �i, _ i Or'lred Shipped
-
1 '44615K456 Standard-Wall Steel Pipe Nipple, Threaded on Both E lfds, 1 NPT, 3"Long 1 1
Each
2 44605K625 Low-Pressure Pipe Fitting, Steel, Bushing Adapter with Hex Body, 2 Male x 1 Female NPT 1- 1
- Each
L. T
I
I
I
I
I ,
I
I
I
l
l '
478
,Fi:" MMASTERcCARR. Invoice
609-689-3000
609-259-3575(fax)
nj.sales@mcmaster.com
Purchase Order JOHN P
Total $228.58
Invoice 61731202
Billed to Invoice Date 7/16/21
FISHERS ISLAND FERRY DISTRICT Y
P O BOX 607 Pa meat Terms 2% 10, Net 30
FISHERS ISLAND NY 06390-0607 Deduct$4 26 on merchandise and tax if paid by 7/26/21
Shipped to Mail Payment to McMaster-Carr
Fishers Island Ferry District PO Box 7690
5 Waterfront Park Chicago IL 60680-7690
New London CT 06320 Your Account 260910000
John Paradis placed this order.
Line Product Ordered Shipped Balance Price Total
1 1798T11 Vibration-Resistant Pressure Gauge,304 2 2 0 3438 68.76
Stainless Steel Case, 1/4 NPT Male Bottom Each Each
Connection,0 to 1500 PSI
2 1798T11 Vibration-Resistant Pressure Gauge,304 2 2 0 34.38 68.76
Stainless Steel Case, 1/4 NPT Male Bottom Each Each
Connection,0 to 3000 PSI
3 3935K37 Vacuum Gauge with ABS Plastic Case, Dual 2 2 0 26.63 53.26
Scale,2-1/2"Dial, 1/4 NPT Male Bottom Each Each
Connection
4 3474A44 Cobalt Steel Left-Hand Drill Bit,Titanium 1 1 0 9.50 9.50
Aluminum Nitride Coated,7/32"Size Each Each
Merchandise 200.28
Sales Tax 13.65
Shipping 14.65
Total $228.58
Packing ppList Shipped Weight Carrier Tracking
2145999-02 7/16/21 3 Ib UPS 1Z0835200332747344
2145999-01 7/16/21 1l FedEx 524336955218
Federal ID 36-1458720 McMaster-Carr Supply Company Page 1 of 1
CP 1A5
i
b � MAASTERmCARR. Packing List
200 New Canton Way Fishers Island Ferry District Purchase Order Page 1"of 1
Robbinsville NJ 08691-2343 5 Waterfront Park JOHN P
609-689-3000 New London CT 06320 07/16/2021
Order Placed By
nj.sales@mcmaster.com John Paradis
McMaster-Carr Number
2145999-01
Line Product ; Ordered Shipped
3 3935K37 Vacuum Gauge with ABS Plastic Case, Dual Scale, 2-1/2" Dial, 1/4 NPT Male Bottom 2 2
Connection Each
i
i
Shipped separately from our New Jersey warehouse on 07/16
a
1 1798T11 Vibration-Resistant Pressure Gauge, 304 Stainless Steel Case, 1/4 NPT Male Bottom 2 2
Connection, 0 to 1500 PSI ; Each
2 1798T11 Vibration-Resistant Pressure Gauge, 304 Stainless Steel Case, 1/4 NPT Male Bottom 2 2
Connection, 0 to 3000 PSI Each
4 3474A44 Cobalt Steel Left-Hand Drill Bit, Titanium Aluminum Nitride Coated, 7/32"Size 1 1
Each
i
(COPY
r
852
i
fr_- McMASTER.CARR. Packing List
200 New Canton Way Fishers Island Ferry District! Purchase Order Page 1 of 1
Robbinsville NJ 08691-2343 5 Waterfront Park JOHN P
609-689-3000 New London CT 06320 07/16/2021
Order Placed By
nj sales@mcmaster.com John Paradis
McMaster-Carr Number
2145999-02
Line Product Ordered Shipped
1 1798T11 Vibration-Resistant Pressure Gauge, 304 Stainless Steel Case, 1/4 NPT Male Bottom 2 2
Connection, 0 to 1500 PSI Each
2 1798T11 Vibration-Resistant Pressure Gauge, 304 Stainless Steiel Case, 1/4 NPT Male Bottom 2 2
Connection, 0 to 3000 PSI Each
4 3474A44 Cobalt Steel Left-Hand Drill Bit, Titanium Aluminum Nitride Coated, 7/32" Size 1 1
Each
i
i
Shipped separately from our Chicago warehouse on 07/16
!
3 39356(37 Vacuum Gauge with ABS Plastic Case, Dual Scale, 2-1�/2" Dial, 1/4 NPT Male Bottom 2 2
Connection ! Each
!
!
727
McMASTERmCA
` � Invoice
609-689-3000
609-259-3575(fax)
nj.sales@mcmaster.com
a� LL Purchase Order JOHN P
Total $143.34
I nvo ice 62184506
r
Billed to I nvo ice Date 7/26/21
FISHERS ISLAND FERRY DISTRICT Y
P O BOX 607 Pa ment Terms 2% 10, Net 30
FISHERS ISLAND NY 06390-0607 Deduct$2 69 on merchandise and tax if paid by 8/5/21
Shipped to Mail Payment to McMaster-Carr
Fishers Island Ferry District PO Box 7690
5 Waterfront Park Chicago IL 60680-7690
New London CT 06320 Your Account 260910000
John Paradis placed this order.
Line Product Ordered Shipped Balance Price Total
1 4638K135 Low-Pressure Pipe Fitting,Galvanized Iron,90 1 1 0 6.96 6.96
Degree Elbow Connector, 1 NPT Female Each Each
2 4638K549 Low-Pressure Pipe Fitting,Galvanized Iron, 1 1 0 11.21 11.21
Bushing Adapter, 1 NPT Male x 3/4 NPT Female Each Each
3 4549K611 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 5.46 5.46
Nipple, Fully Threaded, 1 NPT, 1-1/2" Long Each Each
4 4549K612 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 6.51 6.51
Nipple,Threaded on Both Ends, 1 NPT,2"Long Each Each
5 4549K613 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 6.91 6.91
Nipple,Threaded on Both Ends, 1 NPT,2-1/2" Each Each
Long
6 4549K614 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 7.39 7.39
Nipple,Threaded on Both Ends, 1 NPT,3"Long Each Each
7 4549K597 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 6.29 6.29
Nipple,Threaded on Both Ends,3/4 NPT,4"Long Each Each
8 4549K9 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 7.06 7.06
Nipple,Threaded on Both Ends,3/4 NPT,4-1/2" Each Each
Long
9 45491<599 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 7.80 7.80
Nipple,Threaded on Both Ends,3/4 NPT,5"Long Each Each
10 4549K602 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 9.39 9.39
Nipple,Threaded on Both Ends,3/4 NPT,5'Long Each Each
11 4549K745 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 14.79 14.79
Nipple,Threaded on Both Ends,3/4 NPT,7"Long Each Each
12 4549K591 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 3.94 3.94
Nipple, Fully Threaded,3/4 NPT, 1=3/8"Long Each Each
13 45491<592 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 4.18 4.18
Nipple,Threaded on Both Ends,3/4 NPT, 1-1/2" Each Each
Long
Federal ID36-1458720 McMaster-Carr Supply Company Page 1 of
rn ++s
MAASTERnCARR.
Invoke
609-689-3000
609-259-3575(fax)
nj.sales@mcmaster.com
Purchase Order JOHN P
I nvo ice 62184506
1 nvo ice Date 7/26/21
Line Product Ordered Shipped Balance Price Total
14 4549K745 Standard-Wall Galvanized Steel Threaded Pipe 1 1 0 14.79 14.79
Nipple,Threaded on Both Ends,3/4 NPT,7"Long Each Each
15 4638K234 Low-Pressure Pipe Fitting,Galvanized Iron,45 2 2 0 6.96 13.92
Degree Elbow Connector,3/4 NPT Female Each Each
Merchandise 126.60
Sales Tax 8.56
Shipping 8.18
Total $143.34
Packing List Shipped Weight Carrier Tracking
2596809-01 7/26/21 6 Ib UPS 1 ZO835200333152912
06-1 ill ®I �1
Federal ID 36-1458720 McMaster-Carr Supply Company Page 2 of 2
rn +ta
i
cMASTER•CARR®� Packing List
200 New Canton Way Fishers Is Ferry,District -Purchase Order Page 1 of 1
Robbinsville NJ_' 08691-2343 5 Waterfront Park. _- JOHN P
07/26/2021
609-689-3000 New London CT 06320 Order Placed By
nj.sales aQmcmaster.com John Paradis
McMaster-Carr Number
2596809-01
Line Product - Ordered Shipped /
1 4638K135 Low-Pressure Pipe Fitting, Galvanized Iron, 90 Degree',Elbow Connector, 1 NPT Female 1 1
Each
2 4638K549 Low-Pressure Pipe Fitting, Galvanized Iron, Bushing Adapter, 1 NPT Male x 3/4 NPT 1 1
Female Each
3 45491<611 Standard-Wall Galvanized Steel Threaded Pipe Nipples Fully Threaded, 1 NPT, 1-1/2 1 1 6%
Lon '
Long Each ,
4 4549K612 Standard-Wall Galvanized Steel Threaded Pipe Nipple', Threaded on Both Ends, 1 NPT, -1 1
2"Long Each
5 4549K613 Standard-Wall Galvanized Steel Threaded Pipe Nipple;Threaded on Both Ends, 1 NPT, 1 1
2-1/2"Long Each
I `
6 45491<614 Standard-Wall Galvanized Steel Threaded Pipe Nipple{, Threaded on Both Ends, 1 NPT, 1 1
3" Long Each �
7 4549K597 Standard-Wall Galvanized Steel Threaded Pipe Nipple, Threaded on Both Ends, 3/4 NPT, 1 1 ;/,,,''•3`:
4"Long } Each
8 4549K9 StandarAall Galvanized Steel Threaded Pipe Nipple, Threaded on Both Ends 3/4 NPT, 1 1 !
-- 4-1/2"=Lcng ----- -- - -- --
9 4549K599 Standard-Wall Galvanized Steel Threaded Pipe Nipple, Threaded,on Both Ends, 3/4 NPT, 1 1
5"Long _ Each
10 4549K602 Standard-Wall Galvanized Steel Threaded Pipe Nipple,, Threaded on Both Ends, 3/4 NPT, 1 1
6"Long Each
11 4549K745 Standard-Wall Galvanized Steel Threaded Pipe Nipple, Threaded on Both Ends, 3/4 NPT,, 1 1 "
7"Long Each
12 4549K591 Standard-Wall Galvanized Steel Threaded Pipe Nipple, Fully Threaded, 3/4 NPT, 1-3/8" 1 1
Long Each f
13 4549K592 Standard-Wall Galvanized Steel Threaded Pipe Nipple,, Threaded on Both Ends, 3/4 NPT, 1 1 J
1-1/2"Long Each
14 4549K745 Standard-Wall Galvanized Steel Threaded Pipe Nipple, Threaded on Both Ends, 3/4 NPT, 1 1
7"Long Each
15 4638K234 Low-Pressure Pipe Fitting, Galvanized Iron,45 Degree Elbow Connector, 3/4 NPT Female 2 2
--Each
Ac
JD
I
174
MMASTERmCARR. Invoice
609-689-3000
609-259-3575(fax)
nj.sales@mcmaster.com
Purchase Order JOHN P
Total $50.53
1 nvo ice 62192515
Billed to I nvo ice Date 7/26/21
FISHERS ISLAND FERRY DISTRICT Y
P O BOX 607 Pa ment Terms 2% 10, Net 30
FISHERS ISLAND NY 06390-0607 Deduct$0 87 on merchandise and tax if paid by 8/5/21
Shipped to Mail Payment to McMaster-Carr
Fishers Island Ferry District PO Box 7690
5 Waterfront Park Chicago IL 60680=7690
New London CT 06320 Your Account 260910000
John Paradis placed this order.
Line Product Ordered Shipped Balance Price Total
1 90465A215 Brass Coupling Nut,5/16"-18 Thread Size,7/8" 4 4 0 6.44 25.76
Long Each Each
2 92941A578 Brass Hex Head Screw,5/16"-18 Thread Size, 1 1 0 6.16 6.16
1/2"Long,Packs of 10 Pack Per Pack
3 92941A583 Brass Hex Head Screw,5/16"-18 Thread Size, 1" 1 1 0 8.74 8.74
Long, Packs of 10 Pack Per Pack
Merchandise 40.66
Sales Tax 3.02
Shipping 6.85
Total $50.53
Vff
Packing List Shipped Weight Carrier Tracking
2575293-01 7/26/21 2 Ib UPS 1 ZO835200333134192
Federal ID 36-1458720 McMaster-Carr Supply Company Page 1 of 1
rn 117
FISHERS ISLAND FERRYDISTRICT
VENDOR 014505 NORTH ATLANTIC POWER PRODUCTS 08/24/2021 CHECK 7598
A
FUND & ACCOUNT P.i 0.# INVOICE DESCRIPTION AMOUNT
,SM .5710.2.000.100 CQ210638158 MU SPEED SENSOR 258.57
TOTAL 258.57
jf
OD
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FISHERS I&AADFERRY DISMICT -AUDIT, - -Z021,
63095 MAIN 140AM PQ BOX 1179 4,/
�
Ny
7S 8 C ECK,,,NO'.
SOUTHGLD,: 1971'-0959
THE SUFFOLK-CO.NATIONAL BANK
CUTCHOGUE,NY 11936 DATE 'AMOUNT'
jo� 2
TWO'HARED' FIFTY EIGHT ANIS '�7/100 DO'LiLAR91
"o"
,P?i
PAY NORTH ATLANTIC POWER PRODUCTS,-
A
'ADM3;N
�0*g' '-,ACC'0U'N'TS'RECEIVABLE� • 0
ZZ
ORDE
TYLER LVD-
4 T
71 R
OF
MENTOR .OH 44060 -
All
"M
0 0 7 5 9 8no 1:02L4054641: 68 00 L S 0 2 111V
Il- +.. .
Vendor No. Check No.'
Town of Southold, New Fork - Payment Voucher 14505
Vendor Tax ID Number or Social Security Number Vendor Address Entered by.
Exeter Branch
Vendor Name 15 Continental Drive Audit Date,
North Atlantic Power Products Exeter, NH 03833
Vendor Telephone Number
AUG
2'A 2021- .
603-418-0470 Clerk
Vendor Contact ��)f
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Furid'and Account Number
CQ210638158 6/2/2021 $258.57 $258.57 MU speed sensor SM5710.,2.000.100
$258.57 $258.57
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Date Title Date
North Atlantic Power Products REPRINT INVOICE
Exeter Branch
' 15 Continental Drive
Exeter, NH 03833
Invoice ' Date Customer
CQ210638158 06/02/2021 101065
- lJ7g63
UP:(603)418-0470
F:(603)418-0471 �� 7
Sold to: Shipped to: Y
FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY
EMAILACCOUNT 5 WATERFRONT PARK
261 TRUMBULL DR P O BOX 607 NEW LONDON,CT 06320
FISHERS ISLAND, NY 06390-0607
Salesperson: Exeter Salesman
Registration
Notes
Quantity Product Id Description Unit Price Total Price
Delivery: CQ54855-1 Entered by: Paul Walsh Shipping Method: Will Call
Order: CQ54855 06/02/2021
Cust PO#: John P
1 TD 1020552 OUTPUT SPEED SENSOR 237.00 237.00
HC Handling Charge 7.11
FO Outbound Freight 14.46
258.57
Tracking#: 1ZA8X6030340700888 � )
Due Date Payment Amount Paid Tax Basis Tax Rate Tax Amount
06/12/21 On Account 258.57 Non-Taxable 258.57 0.0000% 0.00
__ DeteUl at line antl return wrtti payment -- - - — _ - -• - -
LIKE US ON FACEBOOK Total Amount: 258.57
@GreatLakesPower Sales Tax:
Total : 258.57
AmountAftei 07/03/2021 Pay: 262.45
REMIT TO: North Atlantic Power Products Invoice CQ210638168
Accounts Receivable-Admin Date 06/02/2021
7455 Tyler Blvd.
Mentor,OH 44060 Customer 101065
All amounts are in US Dollars($)
TERMS NET 10 DAYS
Accounts over 30 days are subject to a 15%semce charge lannual rate 18%1 and an
costs d1 collection mctudmg reasonable altomito led
Al manuf.&W—Y names.mr.b,s•symbols and dr—phone are used for m1c.ortm
purposes only and 4I not implied any pan listed is the pmdutt of mese manufacturers
Seller makes no warranties which extend beyond the description on the lace hereof Title
to the items is retained by the setter unlit fug payment is recened
9)L_lrrtpwmvt(}wpaaro+nW_vu Rclnrt tCd l_ot_lmxnsd_xyt_aat20t7 rin Page 1 of 1 8/1012021 113124AN
ag"
FISHERS ISLAND FERRY DISTRICT
VENDOR 014022 RING'S END LUMBER, INC. 08/24/2021 CHECK 7599
A
'W
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .5710.2.000.000 751549 RP/MU, SUPPLIEP 95.90
/TOTAL 95.90
------------- -------------- -------------- ----------
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FISHERS J&LAAD,F6RR'YbIS!RltT-,`- /-2'i-/,2 0'21'-:1
J 53095 MAIN ROAD;PO 80X-1179
.sOUTHOLD, 11 97,1-0959'
;CHEC— NTHE� SUFF6Lk.c6.NATIONAL BANK
CUTCHOGU5;NY 11935 MOUNT
k
said --tO8/24
0-
IIINETY,'FIVE, AND 9'0/100' DOILLAkg"
*77,
LU�IB R, INC—,
RING'S 'END,"
E, PC,
)"i6i -14
RDER NIAXTIC, CT 0,635,7 ,
OF
ii000 ? 5 9 9110 40 2 L4054641: G 8 00L502 I'll
L
t Vendor No. Check No:
77-1
y
Town of Southold, New York - Payment Voucher 14022 ; ]
Vendor Address Entered-by',_ r
PO BOX 714
Niantic, CT 06357 Audit Date
RING'S END
Vendor Telephone Number '
860-739-5441 Clerk "'
Vendor Contact
Invoice Invoice Invoice Net Purchase Ordera'
Number Date Total Discount Amount Claimed Number Description of Goods or Services General-Ledger'Fund and Account Number'-
751649
umber-751549 5/18/2021 $95.90 $95.90 RP/MU supplies SM57.10.2A00.006,%"
$95.90 $95.90 `
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signatur Title Signature
Company Name FRd Ferry District Date 8/11/2021 Title Managc Date 8/11/2021
��®f 10
RINGS END
Since 19®2
Bethel, CT Branford, CT Darien, CT Lewisboro, NY
(203)797-1212 (203)488-3551 (203)655-2525 (914)533-2517
308 South Frontae Road (800)797-6511 (866)758-3551 (800)390-1000 (888)533-2517
New London cT 6385
T: 860-439-015
F: 860-439-1369 New London, CT New Milford, CT Niantic, CT Wilton, CT
(860)439-0155 (860)355-5566 (860)739-5441 (203)761-1000
(866)439-0155 (888)350-8966 (800)303-6526 (866)842-7883
TRANSACTION
TYPE STORE
Charge Invoice New Londonr CT
BILL TO: SHIP TO:
FISHERS ISLAND FERRY DIS
P.O. BOX 607
FISHERS ISLAND NY 06390
Phone 860-442-0165
CUSTOMER TRANSACTION CUSTOMER
CODE DATE NUMBER TIME PURCHASE ORDER NUMBER SALESPERSON
EFISHIS 051821 1 751549 08:14 RACE POINT 104 Bob Thomas
APPLY TO ORDER DATE ORD/QTE NO. 1 TERMS TAX JURISDICTION
0 RI I 1 1 2% 15th, Net 25 Days 6.35% - CT SALES TAX
ITEM ORDER QTY SHIP QTY LOC DESCRIPTION PRICING UNIT PRICING PER UOM NET AMOUNT
V50090Q 1 1 COROTECH ALI/ACR/UR CATALYST QT 1.000 30.190 EACH 30.19
V50088 1 1 COROTECH ALI/ACR/UR CLEAR BASE 1.000 59.980 EACH 59.98
imperial blue
RECEIVED IN GOOD CONDITION BY:
NICK ESPOSITO
TELEPHONE ORDER MISC SAT.FS REMAINING INVOICE
NET AMT CHARGE FREIGHT TAX DEPOSIT TOTAL
X 90.17 0.00 5.73 95.90
CUSTOMER COPY Page: 1
^ � `,"<" r r^ -y ,�,&•;^r�!�Oi79//9141�a »«s,_-arFa'�>✓crf.,.� ��s .
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FISHERS ISLAND FERRY DISTRICT -
{¢
I I
VENDOR 018571 DEANNA L ROSS 08/24/2021 CHECK 7600
A I Al
I I
r, FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
I ��
I I
I
SM .5710.4:000.000 08162,1 ELECTION INSPECTOR-5 HRS 100 .00
TOTAL loo.00
I ,
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1 .,+fibp;?`:r.;.,;a +r>rgLL;,,:^^>Pti:* . ;.*,.s4."�, ''§'^"�"' '^:F:%`.`r ""'^r"`:'». ;:"'v:•h#"^,.+2:;" '`` ;e'y.';�/':x;✓,«`x;,"`�. I�ffn
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FISHERS ISLAND FERRY DISTRICT ' AUDTT``:aF/24%2'o�2a;
53095 MAIN ROAD,PO BOX 1179 "
711Y q' r SOUTHOLD,,NY 11977-0959 ;CH qK^"NQ,
Ip f THE,SUPFOLK CO.-NATIONAL BANK
CUTCHOGUE,NY,11935, 'DATE, AMOUNT;'
;,a , I.,
24
O � j so•SaB�ztd � c f 2
':HUNDRED, AND 00/1'00--,DOLLARS
y•.• DEANNA L ROSS'.,
Y,?T'HE�
; , �;•� ,
g` 714.Q0 MANSION'HOUSE' DR #341ro
OF; �P�'"BOXY"'341,
,FISHERS ISLAND NY-, 06390
`' 11500 760011' 1:0 2 140 54641: 613 00 ISO 2 111
~ Vendor No. Check No.
Town of Southold, New York - Payment Voucher 18571 �C:`��
Vendor Tax ID Number or Social Security Number Vendor Address Entered by
PO Box 341
Fishers Island, NY 06390 Audit Date
DEANNA L. ROSS
AUG, 2p4 2021
Vendor Telephone Number
Town Cl rk� %PX:('.('�
Vendor Contact ;
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
&TWE-No 8/16/2021 $100.00 $100.00 2021 Election InspectorS �` SM5710.4.000.000 `
C r6 V"p
f
$100.00 $100.00
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name i d Ferry District Date 8/12/2021 Title Date
• 202f Election Inspectors Rate: $ 20.00
10-Aug Total Payment
Meredith Doyen 4.5 $ 90.00 $ 90.00
PO Box 351
Fishers Island
NY 06390
Deanna Ross 5 $ 100.00 $ 100.00
PO Box 161
Fishers Island
NY 06390
total $ 190.00
f
FISHERS ISLAND FERRY DISTRICT
August 2,2021
Election Inspectors
Resolution 2021-125
The Board of Commissioners hereby appoints Meredith Doyen and Deanna Ross to be Election
Inspectors for the August 101h Fishers Island Ferry District Board of Commissioners election at a
rate of$20.00 per hour.
Moved by: Commissioner Burnham
Seconded by: Commissioner Cashel
Ayes:A.Ahrens, H. Burnham,T.Cashel and J. Reid
Nays: None
FISHERS ISLAND FERRY DISTRICT
VENDOR 012315 SHELTERPOINT LIFE INS,CO. 08/24/2021 CHECK 7601
A
FUND &'ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .9060.8.000.000 080321 LIFE INS PREM (22),--9/21 58.155
7 7'
7
TOTAL _ 58.155
P
- - ------------- --- ----------'--'- --------------- - -----
- - ---------r--------'--------------------------
-- -------- -- __-___ i__°.®_
FISHERS-IS LA AD FERRY.DISTRICT AUDIT" 4
'53095 MAIN ROAD,PO SOX 117,9;l,
SOUTHOLD,'NY 1197170959 CHECK,N -7
THE,St)FFOLK CO
NATIONAL BANK
'N"
CUTCHOPUE,NY 11935 1 .'_`,'DATE A
MOUNT
a -'v
5
/2 02 81.116l
Q-5461,214-
-DOLLAkS
FIFTY
10 0
PAY" l,.lSHELTERPOINT LIFE INS.rCO'
1;225 'FR IWKLIWAVE'.,STif TF
4 7
ORDER
GARDEWCttY`NY 11530,'OF r,
7c
(Z
11500 760 Lill 1:0 2 140 5L. GL, :
68 00 150 2 Lill
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 12315 _ 0
Vendor Address Entered by
600 Northern Blvd Suite 310I ,r
Great Neck, NY 11021 Audit Date . a
ShelterPoint Life Insurance Company -AUG 2
Vendor Telephone Number
800-365-4999 - wri-Clerk° -
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number`
41515 8/3/2021 $58.65 $58.65 Sept 2021 Life,AD&D Ins Premiums(22) `SM9060.8.000.000
$58.65 $58.65
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name FQi§1TQand Ferry District Date 8/13/2021 Title Manager Date 8/13/2021
Shelter Point Life Insurance Co Monthly Billing for 9/1/2021 MPBR0003 OperNo 10
Run 08/03/2021 05 30 PM Page 75
Premium* 41515 FINAL
FISHERS ISLAND FERRY DISTRICT(Grp 41515/Loc 10)
PO BOX 607
261 TRUMBULL DRIVE
FISHERS ISLAND,NY 06390
Location Totals Total Due
New Eligs Medical. 0 Dental 0 Vision: 0 Drug 0 Misc 0 Life. 1 LTD 0 STD 0
Insureds Billed 22
Balance Forward $10710
New 1
Termed 0 Payments - $10710
Adjustments + $000
Make Check Payable To. Shelter Point Life Insurance Co
Beginning Balance $000
1225 Franklin Avenue,Ste 475
Garden City,NY 11530 Current Amount Due* + $56.10
4��L Current Adjustments* +
Total Amount Due $58 65
This is a premium invoice for the above mentioned policy Please remit payment by the 25th of this month to avoid a lapse in coverage. It is very important that you remit your
premium as shown on this billing statement. Any enrollment/roster changes should be reported to us under separate cover,and will be credited accordingly on the next months'
billing statement. Delinquent payments and outstanding balances may result in the suspension of claim payments to your employees If you have any questions regarding this
invoice or your insurance coverage,please call our customer service department at 1-800-365-4999 or email us at customerservice@shelterpoint com Please return this entire
form with your payment in the envelope provided
FISHERS ISLAND FERRY DISTRICT
'7'
VENDOR .04000 LESLIE SIWAKOSKI 08/24/2021 CHECK 7602
.14, FUND & ACCOUNT #P.O. INVOICE DESCRIPTION AMOUNT , "Al
,hit
SM .1930.4.000.000 072121 VEHICLE DAMAGE-7/21/21 1,795.52
TOTAL 1,795.52
— - ---- --- -- -------
- ------ - --- --------- -
V l
W,
42,
"V
"Alt,
71
------------------ -------- -- ----------- ----- - --
-------- - - - -
°,FISHERS&AM', FERRY DISTRICT
'
63095 MAIN.ROAD,PVBOX1179AUl "J,
SOUTHOLD,NY 1-1971'-095s
THE SUFFOLK CO..NATIONAL BANK AMOUNT:
CYTPHOGVE,NY,l 1 R35 DATE
71
o 8:/ 2021
ONE .VHousA9b,,,SEVEN HUNDRED=N"I' NETY FIVE AND 52 10b DOLLARS' !Og
"o
-,,LESLIE, SIWAKOSKI,,,, ,
T
LATEAU O THE" 7 A
ORDER- "BRID6EP'bkT'CT,0666"'
6
or,
39
'A
u500 760 2v 1:0 2 140 SLGLl: 68 00L502 L
Vendor N: ® Check Na � ., • • . r
Town of Southold, New York - Payment Voucher one time ; ,e
Vendor Tax ID Number or Social Security Number Vendor Address Entered by
57 Plateau Avenue
Bridgeport,CT 06606-3215 Audit Date
Siwakoski Leslie
Vendor Telephone Number 2 Q 2J
Clerk
Vendor Contact ,
Invoice Invoice Invoice Net Purchase Order1g
Number Date Total Discount Amount Claimed Number Description of Goods or Services General hedger Fund and Account Number
CLAIM 7/21/2021 $1,795.52 $1,795.52 Damage to vehicle 7/21/21 SM1930.4.000.000
a
•
$1,795.52 $1,795.52
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved.
Signature0Title Signature
Company Name and Fem Distnct Date Title Date 4/9/2018
Fishers Island Ferry District
Vehicle Incident Report
Date of Occurrence: 11-t-1 � Time of Occurrence: 7 o e �---
Vessel: V.6-0— FGA jr Trip: ;) ",( --
Captain: A (n� Crew Involved:,a
Weather and sea conditions:
Vehicle Descriptions: Manufacturer: 4-;"�C—^,
Year:
Model:
Color:
Owner Identification: Name: 401'1—
Address: Iirt-Address:
Phone:
Email: I,t j i rA�a�fk
Provide a detailed account of the incident including an accurate description of damage,how the
accident occurred, burden of blame,witnesses,etc.
s,4 ir Gr c
(�eu—f r liveea,f V✓2.17 u r "-4—rte. .• ��- U' (f� e-,,—
e o, �- t,�4, ,/, V�o / ;,-e,v /V
Supervisor: Date:
Incident Report Review Date: Name: je) �•-
\\flservl\d$\fd network directory\general ops\accident damage injury\masters\vehicle incident report docx
NOTICE OF CLAIM
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF Suffolk
x
In the Matter of the Claim of
Leslie A.Siwakoski
-against-
0 Fishers Island Ferry District
TO: Fishers Island Ferry District
PLEASE TAKE NOTICE that the claimant herein hereby makes claim and demand against
you as follows:
1. The name and post-office address of the claimant and of his/her attorney is:
Claimant Claimant's Attorney
Leslie A.Siwakoski Robert Josovitz
57 Plateau Avenue 400 Stillson Road
Bridgeport, CT 06606-3215 Fairfield, CT 06824
2. The nature of the claim:
i
Car damage
3. The time when,the place where and the manner in which the claim arose. The incident
occurred on 07/21 2021 at or about 3:20 PM
Car was backed onto Race Point ferry, into a fixed appendage,thereby damaging
my car.
4. The items of damage or injuries claimed are:
Left front bumper, left fender,fog light
That said claim and demand is hereby presented for adjustment and payment. You are
hereby notified that unless it is adjusted and paid within the time provided by law from the
date of presentation to you,the claimant intends to commence an action on this claim.
NOTICE OF CLAIM
Dated: n� , 20;�Q
CT
Signature
Leslie A.Siwakoski
Print Name
STATE OF/VV/9 }
Q )ss.:
COUNTY OF 3LK )
I, Leslie A. Siwakoski ,am the Claimant in the above-entitled action. I
have read the foregoing complaint and know the contents thereof. The contents are true to my
own knowledge except as to matters therein stated to be alleged upon information and belief, and
as to those matters, I believe them to be true.
Signature
Sworn to before me on this Pn
day of U5p- , 202 t
Q)Ld/ —
Nota Publi can 05:2_y` 2_2
aiE•t�l�zZ� 67P3
CITIZEN'S AUTO BODY
1475 KINGS HIGHWAY EAST
FAIRFIELD,,CT 06824
(P)203-336-2169
(F)203-333-5315
***
PRELIMINARY ESTIMATE***
06/2212020 10:06 AM
L.Owner
Owner: Leslie Siwakoski
Work/Day: (203)414-6740
Address:
Inspection Date: 07/2712021 10:06 AM Inspection Type:
Repairer �__ --..--.-.�--- �
Contact: Mike
Repairer: Citizens Auto Body Inc
Address: 1475 Kings Highway East Work/Day: (203)336-2169
City State Zip: Fairfield, CT 06824 FAX: (203)333-5315
Email: nygjs@optonline.net
Target Complete Date/Time: Days To Repair: 4
CVehicle ---
2012 Subaru Outback 2.5i Premium 4 DR Wagon
4cyl Gasoline 2.5
Continuously Variable Tr
L-ic Expire: VIN: 4S4BRBCC9C3301378
Veh Insp#: Mileage Type: Actual
Condition: Code: F2284A
Ext.Refinish: Two-Stage Int.Refinish: Two-Stage
Options
2nd Row Head Airbags AM/FM CD Player Air Conditioning
Alarm System Aluminum/Alloy Wheels Anti-Lock Brakes
Auto Headlamp-Control Bodyside Cladding Bucket Seats
Cargo/Trunk Mat Center Console Cruise Control
Daytime Running Lights Dual Airbags Floor Mats
Fog Lights Halogen Headlights Head Airbags
Heated Rear Window Wiper IPOD Control Illuminated Visor Mirror
Intermittent Wipers Keyless Entry System Leather Steering Wheel
Lighted Entry System MP3 Decoder Overhead Console
Pelvic Airbags Power Brakes Power Door Locks
Power Drivers Seat Power Mirrors Power Steering
Power Windows Privacy Glass Pwr Driver Lumbar Supp
Rear Spoiler Rear Window Defroster Rear Window Wiper/Washer
Rem Trunk-L/Gate Release Roof/Luggage Rack Side Airbags
Split Folding Rear Seat Stability Cntri Suspensn Strg Wheel Radio Control
Tachometer Theft Deterrent System Tilt&Telescopic Steer
Tonneau/Cargo Cover Traction Control System Trip Computer
USB Audio Input(s)
Velour/Cloth Seats Wireless Audio Streaming
Page 1 of 3
0712712021 10'38 AM
0612212020 10:06 AM
2012 Subaru C Aback 2.51 PrernluM d DR Wagon
Claim#.
Wireless Phone Connect
Line Op Guide MC Description MFR.Part No. Price ADA B% Hours R
Front Bumper 1.8 SM
1 E 6 46 Cover,Front Bumper 57704AJ09A $258.77 3.5 RF
2 L 6 13 Cover,Front Bumper Refinish
2.4 Surface
0.6 Two-stage setup
0.5 Two-stage 0.5 RF
3 L 27 Prep Raw Frt Bmpr Cvr Refinish
0.5 Surface
4 E 126 46 Filler,Front Bumper LT 57731AJ43A $95.12 INC SM
5 E 561 Brkt,Front Bumper Mtg LT 57707AJ53A $8.42 0.1 SM
Front Body And Windshield 1.0* SM
6 1 103 Fender,Front LT Repair 2.8 RF
7 L 103 Fender,Front LT Refinish
2.3 Surface
0.5 Two-stage
Manual Entries
8 SB HAZARD.WSTE. REM. Sublet Repair $3.00* SM
9 N COVER CAR EXTERIOR Additional Labor $2.00'- 0.2* SM
10 L COLOR TINT Refinish 0.5* RF
11 EC FLEX ADDITIVE Replace Economy $10.00* SM
12 EC SHOP MATERIALS Replace Economy $20.00* SM
13 N MASK&BACK TAPE Additional Labor 0.2* RF
14 N DENIB&BUFF Additional Labor 0.5* SM
15 RI Bill kolb trim R&I Assembly 1.0* SM*
>> Including reback time/material
15 Items
MC Message
13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE
46 PRINTABLE ALTERNATE PARTS COMPARE l
Estimate Total &Entries
OEM Parts $362.31
Other Parts $3200
Paint&Materials 7.5 Hours @ $35.00 $262.50
Parts&Material Total $656.81
Tax on Parts&Material @ 6.350% $41.71
Labor Rate Replace Repair Hrs Total Hrs
Hrs
Sheet Metal(SM) $85.00 2.9 1.7 4.6 $391.00
Mech/Elec(ME) $95.00
Frame(FR) $95.00
Refinish(RF) $85.00 7.3 0.2 7.5 $637.50
Labor Total 12.1 Hours $1,028.50
Tax on Labor @ 6.350% $65.31
Sublet Repairs $3.00
0712712021 10 38 AM Page 2 of 3
2012 SLbaru Oulback 2.51 Premium 4 DR Wagon 06122/2020 10.06 AM
Claim#
Tax on Sublet @ 6.350% $0.19
Gross Total $1
Net Total
Alternate Parts Y/02/00/00/02/02 Cumulative 02/00/00/02/02 Zip Code:06824 Audatex Host
Rate Name Default
Audatex Estimating 8.0.911 Update 5 ES 07/27/2021 10:38 AM REL 8.0.911 Update 5 DT 08/01/2021
State Disclosure:CT
@ 2021 Audatex North America,Inc.
1.6 HRS WERE ADDED TO THIS ESTIMATE BASED ON AUDATEWS TWO-STAGE REFINISH FORMULA.
NOTICE: THIS REPAIR ESTIMATE IS BASED IN PART ON THE USE OF REPLACEMENT
PARTS WHICH ARE NOT MADE BY THE ORIGINAL MANUFACTURER OF THE DAMAGED PARTS
IN YOUR MOTOR VEHICLE.
NOTICE: YOU HAVE THE RIGHT TO CHOOSE THE LICENSED REPAIR SHOP WHERE
THE DAMAGE TO YOUR MOTOR VEHICLE 'WILL BE REPAIRED.
Op Codes
= User-Entered Value A = Labor Matches System Assigned Rates E = Replace OEM
NG= Replace NAGS EC= Replace Economy OE= Replace PXN OE Srpls
UE= Replace OE Surplus ET= Partial Replace Labor EP= Replace PXN
EU= Replace Recycled TE= Partial Replace Price PM= Replace PXN Reman/Reblt
UM= Replace Reman/Rebuilt L = Refinish PC= Replace PXN Reconditioned
UC= Replace Reconditioned TT = Two-Tone SB= Sublet Repair
N = Additional Labor BR= Blend Refinish I = Repair
IT = Partial Repair CG= Chipguard RI = R&I Assembly
P Check AA= Appearance Allowance RP= Related Prior Damage
This report contains proprietary information of Audatex and may not be disclosed to any third party
(other than the insured,claimant and others on a need to know basis in order to effectuate the claims
r^ process)without Audatex's prior written consent.
oLeFca i A uda-tex
*....{ @ 2621 Audatex North America, Inc. SoLefo
AUDATEX is a trademark owned by Audatex �...�
North America, Inc.All rights reserved.
Page 3 of 3
0712712021 10.38 AM
CQ
L -,0 it;
41
; FISHERS ISLAND FERRY DISTRICT
VENDOR 019711 STAPLES CONTRACT & COMMERCIAL, 08/24f2021 CHECK 7603
• A
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .5710.4.000.625 3482125983 FIT SUPPLIES' 138.29
SM .5711.4 .00 1 0.000 3484044220 OFFICESUPPLIES 136.56
TOTAL 174.85
4,
---------- -- ------------------- ---- --- -- -- ----------------- -
------- - --- ---------
jis ,
-----------
® 14F
% FISHERS'ISLAAD FERRY DISTPiet -AUD17 8,/,2,4/2,0,2,1- --,
X53095 MAIN ROAD,'FO'BOX 1,175 ,`
SOUT
HO,W,-NY 11971"-'0959
CHECK' NO.,. 6,0 3
THE SUFFOLK c6.NATIONAL BANK
CUTPHOGUE,tNY 11935 ',.',,DATE, AMOUNTV,
-,q
/08. •2,4/2021`,
4 1l 0
'6NE`:HDNDAED` b EVVThr' F&U-R.4&b''8 5 1,,d 0 'VOLLARf
V4,
X,
STAPLES CONTRACT-,& COM
if.,' ov
T0,THR- Pb,iiok ,7
OF Z,
`PkILAbELPHIAPA-19176-0242
'iY
11r00 7 60 3111 1:0 2 X40 54641: C3 B 001,502,, Ino
F
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 19711
Vendor Tax ID Number or Social Security Number Vendor Address Entered by
Dept NY Y--�L
PO Box 415256 Audit Date
STAPLES CONTRACT&COMMERCIAL Boston, MA 02241-5256 AUG d ���,
Vendor Telephone Number
888-753-4107
Vendor Contact Mr9
Invoice Invoice Invoice Net Purchase Order
Number Date Total Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
3482125983 7/17/2021 $138.29 $ 138.29 FIT supplies SM5710.4.000.625
3484044220 8/7/2021 $36.56 $ 36.56 Office Supplies SM5711.4.000.000
$174.85 $174.85
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title I Signature
Company Name Fis er erry District Date 8/15/2021 Title Manager Date
M Staple$_ INVOICE DATE, CUSTOMER'"?' `•- ° ` �"�`""� SUMMARY-INVOICE
7/17/21 NYC 1032952 8062907610
PLEASE PAY"BY TERMS"' AMOUNTDUE" " '
8/16/21 Net 30 Days 138.29
INVOICEDETAm
staples Federal ID #:04-3390816
Bill to Account: 1017907 Ship to Account: FIFERRY
FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY DISTRICT
ATTN: ACCOUNTS PAYABLE ATTN: GORDON MURPHY
PO BOX 607 261 TRUMBULL DR
#PC67296 FISHERS ISLAND, NY 06390
FISHERS ISLAND, NY 06390-0607
Budget Ctr : 1010 Invoice Number: 3482125983
Budget Ctr Desc: Order 7334949273-000-001
P 0 Number FI TERMINAL Ordered By GORDON MURPHY
P 0 Desc Order Date 7/14/21
Release
Release Desc
order order B/o unit Ship unit Extended
Line Item Number Description Qty QtyMeas Qty Price Price
1 356348 BROTHER DR720 DRUM UNIT 1 0 EA 1 88.79 88.79
2 356338 BROTHER TN750 BLACK TONER HY 1 0 EA 1 49.50 49.50
Freight: .00 Tax:( .0000 %) .00 sub-Total: 138.29
Total: 138.29
V
1
c
wag
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customer service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4107 Page: 1
Make checks a able to st les contract&commercial, PO Box 70242, Philadel hia PA 19176-0242
To reach Customer Service, REFER TO THIS ORDER NO. FOR ALL INQUIRIES
Staples. Please dial (877)285-8852. ti,k<°„CIISTOMERtirNO., l-SHIP DATW,- ,,=u,
0001032952 7/15/21 7334949273-000001
PIIliCHASE,_ORDER NOS. �k F,a•u. RELEASE".NO.
FI TERMINAL
','POST,' - End;;Cust�xPO# '
Staples SHIPPING LOCATION:Putnam, CT FC
CARRIER ROUTE: SP1/UPS /U2
�S FISHERS ISLAND FERRY DISTRICT S
`H GORDON MURPHY p FISHERS ISLAND FERRY DISTRICT TOTAL PACKAGES: 1
2 261 TRUMBULL DR L PO BOX 607
P FISHERS ISLAND, NY 06390 #PC67296
Contact: (631) 788-7463 EXT. 20100 - GORDONMU , FISHERS ISLAND, NY 063900607
O O
`<, c
PAGE: 1
SPECIAL INSTRUCTIONS
Line'< "a'yt,,."y";'�k°,�:�'aa'iITEwM`aNU6IDx-ER'� •'... �;a:'M'`,-`,,te ", ESCR�I;P
�"•''^R,=:"t'7,a,r�`,�[;":�.°`17,x' 'Asp ," ' D,i,�,�NoIf,_
.t"
0.ITEMA MODEL �D+ w OREKD '
SIPPED - -
a
�oaNl$r,�'�t�c;aE.1 356348 BROTHER DR720 DRUM UNIT /DR720 ./ EA 1 1 0
2 356338 BROTHER TN750 BLACK TONER HY /TN750 c/ EA 1 1 0
Safety Data Sheet (SDS) may be found by visiting http://sds. ,talles.com/msds/35638.pdf
ri stapler-," 7, 7 _77 - 7 77, 77777777,
r
_,,NOTICE,NEW `PACKAGING;`& NEW ; ,� £
-PRODUCT OPTIONS-TO BETTER 'SERVE .s" - -- - - - '
8_Previems' - ,YOUR'`BUSINESS,",NEEDS. _ - - - _ "' _ - -
.'.�`
001 Thank You For Your Order! Staples, Inc.
SCS
4
r
rl Staples. INVOICEDATE--' CUSTOMER' ' SUMMARY INVOICE-
8/07/21 NYC 1032952 8063145971
PLEASE PAY BY TERMS AMOUNT DUE
9/06/21 Net 30 Days 36.56
INVOICEDEmuL
Staples Federal XD #:04-3390816
Bill to Account: 1017907 Ship to Account: FIFERRY
FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY DISTRICT
ATTN: ACCOUNTS PAYABLE ATTN: GORDON MURPHY
PO BOX 607 261 TRUMBULL DR
#PC67296 FISHERS ISLAND, NY 06390
FISHERS ISLAND, NY 06390-0607
Budget Ctr 1010 Invoice Number: 3484044220
Budget Ctr Desc: order : 7336287864-000-001
P 0 Number FI TERMINAL Ordered By GORDON MURPHY
P 0 Desc Order Date 8/03/21
Release
Release Desc
Order order B/o unit Ship unit Extended
Line Item Number Description Qty Qty Meas Price Price
1 219306 STPLS ONE TOUCH PLUS BLK 2 0 EA 2 8.39 16.78
2 036619 MARKER 15001 PERMANENT BLACK 2 0 DZ 2 9.89 19.78
Freight: .00 Tax:( .0000 %) .00 Sub-Total: 36.56
Total: 36.56
1
customer service inquiries # 877-826-7755 Invoice Payment Inquiries 888-753-4107 Page: 1
Make checks a able to St les contract &commercial, Po Box 70242, Philadelphia PA 19176-0242
IJ '�J`,'�`✓i�...� r--�- v��i������ RELEAS$ No. �
PURCHASE" ORDER NO.,
FI TERMINAL
COST CENTER' End,--Gust PO# ' -
SHIPPING LOCATION:Putnam, CT FC CARRIER ROUTE: SP1/FDX /F2
Staples
S FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY DISTRICT
TOTAL PACKAGES:
O
Ii GORDON MURPHY LPO BOX 607
I 261 TRUMBULL DR D #PC67296
PFISHERS ISLAND, NY 06390 NY 063900607
Contact: (631) 788-7463 EXT. 20100 - GORDON T
FISHERS ISLAND,
T Q PAGE: 1
`O
SPECIAL INSTRUCTIONS-
_ UNI _,a _ QTY E
TY
ITEM /'MODEL _ Of - 8/O"HtY
, o ORDERED �SAIPPED
Liae ITEM,.NONIDER DESCRIPTION =NQIIDER„
„ EA 2 2 0
1 219306 STPLS ONE TOUCH PLUS BLK /TR58483-CC DZ 2 2 0
2 036619 MARKER 15001 PERMANENT BLACK /15001
Safety Data Sheet (SDS) may
be found by visiting http://sds. to les.com msds/036 19.pdf
17771 Staples
NOTICE NEW PACKAGING & NEW
NeWS , PRODUCT OPTIONS TO BETTER SERVE
& nrevie S YOUR BUSINESS NEEDS.
001
Thank You For Your Order! Staples, Inc. SCS
FISHERS ISLAND FERRY DISTRICT
VENDOR 019708 STAR COMPUTERS, LLC 08/24/2021 CHECK 7604
A
FUND & ACCOUNT P,.O.# INVOICE DESCRIPTION AMOUNT
SM ,.5710.4 .000.500 2021455 IT SERVICES 3, 901.50
.;,4
TOTAL-- 3, 9/01.50
01
Y",
- - - --------- ---------- IN -- ------ --
xw,
m K
v,
Flof lw` R."A'
,7 g
,tj
7
"41r,
6
--------- -------- ----
ImamYid
FISHERS ISLAND FERR kbiSiRid-f'
53095 MAIN'ROAD,PO,'BOX'I 179-
SOUTHOLD,'NY'11971'-0959,' CHECK, 0-: 6 -4
THE SUFFOLK CO,NATIONAL BANK'
CUTCHOGUE,NY,11935 DATE
MOUNT,--
,
5bt,546i214-
08/24.202,1-THREE 'THOUSAND-NI9E HUkbRE6.-!6:NE AND0 /idd'bkLAi
S
p,4y,"', y_STAR COMPUTERS, ,-LLC ,,
7 -T 'BLACK POINT,•R0,A.D ,,.,,
'0 HE',
;PO BOX,`6 18
OF NIANTIC CT 06357r , ,
115007604o 1:02L4054641: 68 00LS02 &III
Check Na.
Town of Southold, New York - Payment Voucher 19708 = Q0 0
Vendor Tax ID Number or Social Security Number Vendor Address Entered,by
Vendor Name P.O. Box 618 Audit Date
Star Computers Niantic,CT 06357 AUG :2 4--201
Vendor Telephone Number
TownClerk "
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
2021455 7/26/2021 $3,901.50 $3,901.50 IT services SM5710.4.000.500
$3,901.50 1 $3,901.50
r---i
Payee Certification Department Certification
nt)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
;in stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
axes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Fishers Is Date 8/11/2021 Title Maria er Date
, 94M
At' INVOICE
— - RS* "3a k f4�r
Empla f8spR8{8p..Wols WASP
Niantic, CT 06357 DATE INVOICE#
860-691-0044 fax 877-890-0014 _ `----
www.starcomputers.com 7/26/2021 2021455
Fishers Island Ferry District
P.O. Box 607
261 Trumbull Dr.
Fishers Island,NY 06390 I
PO NO TERMS ; DUE DATE TECHi NOTES - SHIP DATE SHIP V;A
Due on receipt ` 7/26/2021 LLS 7/26/2021
;
QTY j DESCRIPTION RATE AMOUNT i
18.5 1 Computer Technician-LLS
153001 2,83050
I Date 5/07-7/15/2021 - Ticket # 12742
I i
Location.Remote&Onsite-UPS Trackpad Project i
T- !Computer Technician-LLS 153.00 i 1,071.00
Date'6/15/2021 - Ticket-# 13434- ! i
Location Remote-Carol can't�log into quickbooks admin
Date 6/16/2021 - Ticket # 13453
i 'Location* Remote-Atlantic Broadband down
Date 6/16/2021 - Ticket # 13458
Location:Remote-Firewall FW Updates
Date 6/24/2021 - Ticket # 13659 v A
i Location:Remote-Change public wifi password �✓� i I j
I Date 6/29/2021 - Ticket # 13738 j
Location Remote-Reconfigure old NL AP for FI Freight
i
i
j Date 6/29/2021 - Ticket # 13750 !
j Location Remote-Add FIBilling to Airport Users
j Date 5/27-7/16/2021 - Ticket # 13079
Location Remote-Access Database for Traffic Tracking j I
Date 7/16/2021 - Ticket # 14232 i ! f
1 Location:Remote-Add Carol to Intuit Desktop
j � I
i
Date 7/16/2021 - Ticket # 14233
Location-Remote-Server Updates and Quickbooks Maintenance
Date 7/23/2621 - Ticket #"14437 j
I
Thank you for your businessl
Sales Tax (0.0%)
(--------—-----------------------------------
lotal
Page 1
F
STA R C 0 R S
- luw, U INVOICE
complex technology...simple solution
Niantic, CT 06357 DATE INVOICE#
860-,691-0044 fax 877-890-0014
7/26/2021 2021455
www.starcoi-nputers.com
Fishers Island Ferry District
P.O. Box 607
261 Trumbull Dr.
Fishers Island,NY 06390
PO NO TERMS I DUE DATE TECH NOTES SHIP DATE SHIP VIA
----------- ------------- ----------------------- ......11-------------------------------- ------------
-------------------------------_...... ---------------------- ---------------------------
Due on receipt i 7/26/2021 LLS i i 7/26/2021
QTY DESCRIPTION RATE AMOUNT
Location:Remote-Reset Jasmin's ticketing credentials
Date 7/23/2021 - Ticket 4 14442
Location.Remote-Geb-Question about secure/insecure links
Date 7/23/2021 - Ticket # 14443
i Location-Remote-Add Jon Haney to SilverEel
Ii I
---------------------------------- --------
Fhanl you for your business'
Sales Tax (0.0%) $0.00
In an eff0f t to Cut down on paper waste,Star Computers is now offering the option ------------------------------------------___-._---_-_------------i
to
----------_--------------
to have invoice,;electronically submitted to you via e-mail If you are interested please include Your
1 pretbired c-inad address with YOU payment or submit via e-mail to-Nffirirzelh @starcomputers corn Total $3,901.50
Thank yowl
.. ........ --- ----- ------------------------ ----- ----- ------------------ ----- --------- --- ------ -------
Page 2 A
q
,yq
FISHERS ISLAND FER, YDISMICT
VENDOR 019554 STATE OF CONNECTICUT, 08/24/2021 CHECK 7605
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .5709.2.000.200 100851 088274 BURNHAM-2004 80.00
ay SM .5709.2.000.200 100851 0882U5-HUBBELL
-2004 80.00
di IN
TOTAL 160.00
all!
co
%
—---------- - - ----- ------ ------- -------------- --- ----- ------------------------- -------- - ---
$ g
.5,
•W
M
%
gr
-F
7SRERS;l&Ab F'WRRYDIS `7 :24'/,2V4'X--, r
53095 MAIN,ROAD;PO'BOX 1179.
-1971-0959
POUTHOLD,',NY 1
'CH :7.6 0 t
THE SUFFOLK CO.NATIONAL BANK',
CLITPHOPUE,NY 119W' ,.,,DATE AMOUNT
'-4
V,
-00-Y24J-202- • 0
SIXTY'-'AN
ONE HUNDRED, P
"o
Ify, Si'
R
PAY,,,- -,,STATE,,OF CONNECtlqtT,
T HE,; ,CONS,-BUREAU='bF I_ %
OTBO L R
165 'CAPITOL",AVE
000, : ROOM 266
0 1
HARTFORD CT 66106716-20
11000 ? P30 511, 1:02 L L,0 S Le 6 4 1: IS 00L502 I ul
clt
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 19554
Vendor Tax ID Number or Social Security Number Vendor Address Entered by
State of Connecticut
450 Columbus Blvd-Suite 1303 Audit Date
Dept. of Administrative Services, Bureau of Boilers Hartford,CT 06103 AUG ,2 4 202=1
Vendor Telephone Number
860-713-5880 Town Clerk
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General-Ledger Fund and Account Number
100851 8/6/2021 $160.00 $80.00 088274-Burnham-2004 "SM5709.2.000.206 '
$80.001 088275-Hubbell-2004 SM57091.000.200,
Boiler Inspection/Certification
NL Terminal Bldg
-
$160.00 $160.00
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and paymen is approved
Signature Title Signature
—4t - -1...........................
Company Name Date Title Date
Page 1
STATE OF CONNECTICUT
CT Department of Administrative Services OSBI-Bureau of Boilers
y, 450 Columbus Blvd-Suite 1303
Hartford, CT 06103
Phone:(860)713-5880
Boiler/Water Heater Invoice
ATTN: R.J. Burns
Fishers Island Ferry District/Attn. R.J. Burns Pay This Amount $160.00
PO Box 607
Fishers Island NY, 06390-0607
INVOICE NUMBER: 100851 DATE PRINTED: 08/06/2021
TERMS:Payable upon receipt of invoice.Please keep this copy for your records.
The operating certificate required for legal operation may be issued only after amounts specified herein have been paid.
INSP DATE FEE TYPE DESCRIPTION LOCATION AMOUNT
8/5/2021 INSP/CERT FEE 088274-Burnham-2004 Fishers Island Ferry 5 Waterfront Park,New London $8000
District CT,06320
8/5/2021 INSP/CERT FEE 088275-Hubbell-2004 Fishers Island Ferry 5 Waterfront Park,New London $80.00
District CT,06320
Please include invoice number or remittance form with payment when mailing.
FISHERS ISLAND FERR Y DISTRICT
VENDOR 012312 THE HILB GROUP OF 08/24/2021 CHECK 7606
A
j
FUND-& ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM . 1910.4 .000.100 1569554 POL-#CA:P140224604-RENWL 2, 639.00
SM .1910.4 .000.100 1569560 POL-#CAP206215304-RENWL 604.00
ty SM . 1910.4 ,000.100 1569630`.e; POL-#MAC140224504-RENWL 9,380. 07
1569638 POL-#OMkl85440904-RENWL 4,297.
SM .1910.4 .000.100 00
is
SM .1•,910.4 .600.200 1569639 POL-#AP04582315510-RENWL 4,350. 00
SM .1'910,4 .000.100 1569640 POL-#OMH1854,35104-RENWL
9, 125.00
SM :1910.4 .000.100 1569 41 POL-#OMH185438004-RENWL 35, 994 .00
SM .1910.4. 000.100 1569645 POL-#OMH350068504-RENWL 1, 866.00
sm .1910.4 .0b0.100 1569646 POL-#OMH429792904-RENWL 822.00
SM .1910.4. 000.100 1569787 " , PL-#MASILBN0003121-RENWL 24, 000.00
-- ----------- -- ----- 3f TOTAL-- --- ----------- ---93,07-7 0_7
m
t V*X,
YX
---- ---- ------ -- --------- - ----------- ------ ---- - ----
pmm a 1 ! !p l ; :;
1'2
-,FISHERS ISLAAD,FERRYDISYRICT
I — 1 , . ,w,
53095 MAIN'ROAG,PO BOX 1179.,' AUDI
SOLITHOLI),NY -Oq59
CHECK, , 7 60
— I NP"11,11"
THE SUFFOLK CO.NATIONAL BANK I ... I
DATE k ,:AMOUNT.- ,
qTCHQGUE,NY11935' 1-
$9'ar 3'lf,4'0 3-7, b-7-,
ids I ' 0 2, ,-
50=540(214,
,I , , 11— 1 1 6
Tli 1,'e- eE
NIN TY- 4k!'E-9 THOUSAND 0"US' A N D S E V E&TY' SEVEN AND" G T/1 b 0' DOLLARS',' ,
v J
'4")" PAY THE H,TLB GROUP OF
TO,THE
NEW ENGLAND, LLC
-R
op, 16 MAIN STREET
EASTGREENWICHRI 02818
0 0 716 0 1:0 2 L L,0 54641: C38 00LS02 IV
Check No.
Town of Southold, New York - Payment Vouche 12312 71 ��1,0
Vendor Tax ID Number or Social Security Number Vendor Address Entered by
Vendor Name 2000 Chapel View Bldv Audit Date
The Hilb Group of New England LLC Cranston RI 02920 AUG 2 .4 2021
Vendor Telephone Number
Town CI rk
Vendor Contact V
�,, n"
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
1569641 8/3/2021 $35,994.00 $35,994.00 Hull/P&1 Policy OMH185438004 8/1/21-8/1/2022 SM1910.4.000.100
1569645 8/3/2021 $1,866.00 $1,866.00 Primary Pollution Policy OMH360068504 8/1/21-8/1/2022 SM1910.4.000.100
1569646 8/3/2021 $ 822.00 $ 822.00 Excess Pollution Policy OMH429792904 8/1/21-8/1/2022 SM1910.4.000.100
1569640 8/3/2021 $ 9,125.00 $ 9,125.00 Marine Package Policy OMH185435104 8/1/21-8/1/2022 SM1910.4.000.100
1569638 8/3/2021 $4,297.00 $4,297.00 Piers&Docks Policy OMH186440904 8/1/21-8/1/2022 SM1910.4.000.100
1569630 8/3/2021 $9,380. $9,380;C)) Property/Fire-MAC140224504 8/1/21-8/1/2022 SM1910.4.000.100
1569560 8/3/2021 $604.00 $604.00 CT Garagekeepers Policy CAP206215304 8/1/21-8/1/2022 SM1910.4.000.100
1569554 8/3/2021 $2,639.00 $2,639.00 NY Automobile Policy CAP140224604 8/1/21-8/1/2022 SM1910.4.000.100
1569639 8/3/2021 $4,350.00 $4,350.00 Airport Liability Policy AP04682315510 8/1/21-8/1/2022 SM1910.4.000.200
1569787 8/3/2021 $24,000.00 $24,000.00 Bumbershoot Policy MASILBN0003121 8/1/21-8/1/2022 SM1910.4.000.100
$93,077.(' $93,077,10-4
tyee Certification Department Certification
(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
iregomg claim is true and correct,that no part has in good condition without substitution,the services properly
stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
es from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Fishers Date 7/19/2019 Title Manager Date
INVOICE
NEW
iGtlStlt10 xa. Fishers Island Ferry District
G R O tJ ENGLAND
15677
08/03/2021
l`C[isfciner ..1' Randall Carnahan
'Service er. " Carol Branch
1 of 1
iric�oice�Sumritaryr 35,99400
?PaymentAM6go nY
Fishers Island
Ferry District ,
P.O. Box 607 P ymeptfdlwInvoice#1569641
Fishers Island,NY 06390-0607 OMH185438004
Thank You
Please detach and return with payment
— — — — — — — — — — — — — — — — — — — — — —
Customer Fishers Island Ferry District
=xIr1YOIC8=""� �;�Effective��>3'r '�"'"";YTtsfn&1CtiOn2,• �r. >�ta;.>��_"`-=c�,a.' 4,a>.<`":x`'"��'�?-;"bCSCC,i�?�it)�l'":>.� .'�`> .;�.�ra _�,>r","; ",;" r< =
Policy#OMH185438004 08/01/2021-08/01/2022
American Financial Group/Great American Insurance
Company
1569641 08/01/2021 Renew policy
Hull/P&I-Renew policy 35,994 00
PLEASE MAKE YOUR CHECK PAYABLE TO THE HILB
GROUP OF NEW ENGLAND THANK YOU
Now accepting Credit Card and ACH payments online at https//hilbgroup epaypolicy com
$35,994.00
yo I
Thank You
The Hilb Group New England,LLC (800)232-0582 ` 'x;
2000 Chapel View Blvd Suite 240
Cranston,RI 02920 08/03/2021
'
—_—___----- INVOICE
� . '' � N EW
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C ishers Island Ferry District
ENGLAND
�� 8#=� � �. Q� � 0��
��O �p � X� N���� �a�.�`� ��
15677
08/03/2021
Randall Carnahan
,v, Carol Branch
$1,86600-
pioxem|o|anuronyommot '
P.O. Box 607
Fishers Island,mYooxoo*oor
'
Thank You
�
Please detach and return with payment
�- -- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ —
Customer Fishers Island Ferry District
Policy#OMH350068504 08/01/2021-08/01/2022
American Financial Group/Great American Insurance
Company
1569645 08/01/2021 Renew policy
Primary Pollution-Renew policy 1,866.00
PLEASE MAKE YOUR CHECK PAYABLE TO THE HILB
GROUP OF NEW ENGLAND THANKYOU.
Now accepting Credit Card and ACH payments online at https Hhjlbgroup epaypolicy corn t
Thank You 'WIPC
The Hilb Group New England,LLC (800)232-0582
ff
2000 Chapel View Blvd Suite 240 08/03/2021
Cranston,RI 02920
'
INVOICE
NEW
u0 r> Fishers Island Ferry District
'
15677
CYR 0 to ENGLAND
T
p� 08/03/2021
Randall Carnahan
Carol Branch
Pagef I of 1
P;zt
Mary" $822.00
,rAi4nen0*'n-otL 4
Fishers Island Ferry DistrictInvoice#1569646
R 0. Box 607
Fishers Island,NY 06390-0607 OMH429792904
Thank You
— —
Please detach and return with payment
— — —
— — -- — — — — — — — — — — — — — — — — — — — — — — -- — -
Customer Fishers Island Ferry District
V,
77'7� Amount
jn ""77 1�40
74.
Policy#OMH429792904 08101/2021-08/01/2022
American Financial Group/GreatAmerican Insurance
Company
1569646 08/01/2021 Renew policy
Excess Pollution-Renew policy 82200
PLEASE MAKE YOUR CHECK PAYABLE TO THE HILB
GROUP OF NEW ENGLAND. THANK YOU
Now accepting Credit Card and ACH payments online at-https,//hilbgroup epaypolicy com
$822 00
Thank You
&
The Hilb Group New England,LLC (800)232-0582 U?
2000 Chapel View Blvd Suite 240 08/0312021
Cranston,RI 02920
INVOICE
NEW
'CwpiiYlqr Fishers Island Ferry District
GROUP ENGLAND
WAI# 1 15677
Batey;
08/03/2021
Randall Carnahan
$eTYiCr ;3 2 Carol Branch
I of 1
-7
!,pentj imailoiii'�i 7"=-
0
jnvof urarltle `Z' $9,12500
Fishers Island Ferry District
PaMy invoice#1569640
R 0. Box 607 1 11
Fishers Island,NY 06390-0607 OMH185435104
Thank You
Please detach and return with payment
— — — — — — — — — — — — — — — — — — — — — — — — — — — -
Customer*Fishers Island Ferry District
7 7
mot,
lldlf-.1760 4010 7041.1
"i if IY�I EW k
Policy#OMH 185435104 08/01/2021-08/01/2022
American Financial Group/Great American Insurance
Company
1569640 08101/2021 Renew policy
Package -Renew policy 8,97500
Program Fee-Renew policy 150.00
PLEASE MAKE YOUR CHECK PAYABLE TO THE HILB
GROUP OF NEW ENGLAND THANK YOU.
Now accepting Credit Card and ACH payments online at https//hilbgroup epaypolicy com
qqp
grTky(f
$9,125 00
Thank You
The Hilb Group New England,LLC (800)232-0582V"'�'.'-4
2000 Chapel View Blvd Suite 240 0810312021
Cranston, RI 02920
NEW INVOICE
sC0tplfl@I ? Fishers Island Ferry District
CROUP (q
Ac A#' 315677
Date ,, 08/03/2021
CiStotteC Randall Carnahan
Service Carol Branch
Page``` x� ....s 1 of 1
Payment,`iaformation <T
ETavoice`S"amina i. ''r $4,29700
TC' jrrneii �tim0,iint pry,"
Fishers Island Ferry District Invoice#1569638
P.O. Box 607
P„8ytTletttfor €i :y
Fishers Island,NY 06390-0607 OMH185440904
Thank You
Please detach and return with payment
Customer Fishers Island Ferry District Irivotpep, Effective � ° ",Tr'ansact9d u,.3' F-<`rK;' ""',;. °' '
- �, ,��
�•�-ay�-r :. °.,���:"
Policy#OMH185440904 08/01/2021-08/01/2022
American Financial Group/Great American Insurance
Company
1569638 08/01/2021 Renew policy
Piers&Docks-Renew policy 4,29700
PLEASE MAKE YOUR CHECK PAYABLE TO THE HILB
GROUP OF NEW ENGLAND. THANK YOU
Now accepting Credit Card and ACH payments online at htt s//hilbgroup e aYPolic corn -otai•
$4,297.00
Thank You
The Hilb Group New England,LLC (800)232-0582 r3wa�'� a '' �”
2000 Chapel View Blvd Suite 240
8/03/2021
Cranston,RI 02920 0
INVOICE
NEWeVj�'4 Fishers island Ferry District
GROUP ENGLAND
15677
08/03/2021
Randall Carnahan
.iervil Carol Branch
1 Of 1
7777`7
invoiCe95uinmary'r < ; $9,380.07
Fishers Island Ferry District
0,,j�yn q:"�f or. Invoice#1569630
P.O. Box 607
Fishers Island,NY 06390-0607 MAC 140224504
Thank You
X Please detach and return with payment
- - -- - - - - - - - — — — — -- - - –
Customer
–Customer Fishers Island Ferry District
's"r
Toil
!P!s
Policy#MAC140224504 08/01/2021-08/01/2022
American Financial Group/Great American Insurance
Company
1569630 08/01/2021 Renew policy
Commercial Property-Renew policy 9,35900
Policy Fee-NY Fire Insurance-Renew policy 21 07
PLEASE MAKE YOUR CHECK PAYABLE TO THE HILB
GROUP OF NEW ENGLAND. THANK YOU
Now accepting Credit Card and ACH payments online at.https//hilbgroup epaypolicy com
$9,38007
Thank You
The Hilb Group New England,LLC (800)232-0582
2000 Chapel View Blvd Suite 240 08/03/2021
Cranston,RI 02920
NEW
INVOICE
i-? 111111111 Gcsoine,.¢ Fishers Island Ferry Distract
GROUP ENGLAND
Acct#` ,, ., 15677
rDate`F "j 08/03/2021
Cugtciners-g ' Randall Carnahan
Carol Branch
°s " `f;yiijont l`iifdrt►iat[on y�V,
Invoice5iimtriary " $604 00
-
Fishers Island Ferry District aIT)@r,tf0j ?-,, Invoice#1569560
P.0. Box 607
Fishers Island,NY 06390-0607 CAP206215304
Thank You
- Please detach and return with payment
- — — — — — — — — — — — — — — — — — — -
Customer Fishers Island Ferry District
ttivotG@, Efeativew .." ld1lS, GA,t1; ,..s.�. . `.D@5�� �tUrk `moi , .E . a >ra' .:vvAil7Qtitlt ;.,
Policy#CAP206215304 08/01/2021-08/01/2022
American Financial Group/Great American Alliance
Insurance Company
1569560 08/01/2Q21 Renew policy
Business Auto-Renew policy 60400
PLEASE MAKE YOUR CHECK PAYABLE TO THE HILB
GROUP OF NEW ENGLAND. THANK YOU
Now accepting Credit Card and ACH payments online at*https//hilbgroup epaypolicy com =�` � Total�w;' .,� -
$604 00 �
Thank You
The Hilb Group New England,LLC (800)232-0582 `"VY�',9A to z z`
2000 Chapel View Blvd Suite 240
08/03/2021
Cranston,RI 02920
INVOICE
NEW Fishers Island Ferry District
(11 R 0 TIP ENGLAND
1:it'_1; 15677
08/0312021
Randall Carnahan
ServI
Carol Branch
i of i
,jjrqe#tnVoice�`'ummary.ry" �" 11,6 $2,639.00
Fishers Island Ferry District
Invoice#1569554
P.O. Box 607
Fishers Island,NY 06390-0607 CAP140224604
Thank You
Please detach and return with payment
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — -- — — –
Customer,Fishers Island Ferry District
aon
unt
Policy#CAP140224604 08/01/2021-08/01/2022
American Financial Group/Great American Insurance
Company
1569554 08/01/2021 Renew policy
Business Auto-Renew policy 2,62900
Policy Fee-NY Law Enforcement-Renew policy 1000
PLEASE MAKE YOUR CHECK PAYABLE TO THE HILB
GROUP OF NEW ENGLAND THANK YOU.
Now accepting Credit Card and ACH payments online at https-//hilbgroup epaypolicy com 77777�;wjmvn
$2,639 00
Thank You
The Hilb Group New England,LLC (800)232-0582
2000 Chapel View Blvd Suite 240 08/03/2021
Cransrton, RI 02920
INVOICE
N
EW
duko Dist
F Ferry District
Fishers Island Fer'
-Aa
CYR 0 UP ENGLAND
15677
08/03/2021
Tlstomei Randall Carnahan
Carol Branch
Of 1
'P yiriertiliifor
140 c�ii'rri �'"'- $4,350.00
,Yrn RMY"
PAY f,
Fishers Island Ferry District Invoice#1569639
R 0. Box 607 1
Fishers Island,NY 06390-0607 AP04582315510
Thank You
Please detach and return with p6-yrnent
Customer Fishers Island Ferry District
'rr On
ro
'D
rnouq
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t"'§
Policy#AP0458231551 0 08/01/2021-08/01/2022
American International Group/National Union Fire Ins
Co of Pittsburg
1569639 08/0112021 Renew policy
Airport General Liability-Renew policy 4,350.00
PLEASE MAKE YOUR CHECK PAYABLE TO THE HILB
GROUP OF NEW ENGLAND
THANK YOU.
Now accepting Credit Card and ACH payments online at,https//hilbgroup epaypolicy com
$4,35000
Thank You
The Hilb Group New England,LLC (800)232-0582
2000 Chapel View Blvd Suite 240 08103/2021
Cranston,RI 02920
INVOICE
NEWFishers Island Ferry District
CYRO UPENGLAND 15677
08/03/2021
CwstomeK "`3 Randall Carnahan
Carol Branch
1 of 1
ZPW,nenf Infoiiiiiiao
$24,00000
JR 'UnfFVQ
-IiiiiO4 AC6 e
Fishers Island Ferry District '0,;Jynij� Invoice#1569787
,t f4D ,j
P.O. Box 607
Fishers Island,NY 0090-0607 MASILBN0003121
Thank You
Please detach and return with payment
-- — — — — — — — — — — — — — — — — -
Customer Fishers Island Ferry District
701-1—460 W' ;R'11�11-,-""
Policy#MASILBN0003121 08/01/2021-08/01/2022
Subscription
1569787 08/01/2021 Renew policy
Bumbershoot-Renew policy-50% 24,00000
PLEASE MAKE YOUR CHECK PAYABLE TO THE HILB
GROUP OF NEW ENGLAND THANK YOU
Now accepting Credit Card and ACH payments online at*https//hilbgroup.epaypolicy comp;.
$24,00000
Thank You
Dot*- -z
The Hilb Group New England,LLC (800)232-0582
2000 Chapel View Blvd Suite 240 08/03/2021
Cranston,RI 02920
3
FISHERS ISLAND FERRY DISTRICT
VENDOR )015921 UHS PREMIUM BILLING 08/24/2021 CHECK 7607
A
\
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .9060.8.000.000 647673795014 MEDICAL PREM (18) -9/21 19, 168.13
IrA
TOTAL 191, 168.13
-77
77
IN,
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FISHERS ISLAND FERRY DISTRICT,, Aupj,, 021
53095 MAIN ROAD;PO BOX 1179'
SOUTHOLD,NY 11971-0959
, aKN ."
"
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THE SUFFOLK CO.NATIONAUBANK
CUTPHOGPE,NX 11 DA AgMOUNT-' '
" os 419-16 8 13-',
NINEfiEEN HOUSAND-ONE 'HUNDRED 'SIXTY EIGHT, ' 13/10Q 'DOLLARS
4 I
PAY-- -,UH$,PREMIUM BILLING
ro,
THE',' Pb 130.k-,94017 ,
O
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WE PALTI 'E IL .4
OF
llv00 ? F30 ?ilv 1:0 20,05LPAi: 613 001SO 2 L 0
Check No.,r s
Town of Southold, New York - Payment Voucher 15921
Vendor Tax ID Number or Social Security Number Vendor Address Entered'by
Vendor Name PO Box 94017 AOdit•Date
United Healthcare Palatine,IL 60094-4017
Vendor Telephone Number
,..,,n L'9rK"
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
647673795014 8/8/2021 $19,168.13 $19,168.13 September 2021 Medical Premiums (18) SM9060.8.000.000,
$19,168.13 $19,168.13
Payee Certification Department Certification
cant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
he foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
;rein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
t taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature k*(-1 IL,--
Company Name Fishers Date 8/17/2021 Title Manager Date
Unitefflia'thcW'
uHs Premium Billing : Manage=your',-Acpount:, ..,
PO BOX 94017 ' `k'y W'" " "6hceservicescom
Palatine,IL 600944017 InvoiceeNo- 647673795014
Invoice Date. 08/08/2021
Customer No: 1320205
Bill Group No* 209981
Coverage Period, 09/01/2021 -09/30/2021
Due Date: 09/01/2021
2212DREGU LARBW0003004-07467-01
FISHERS ISLAND FERRY DISTRICT
GORDON MURPHY
PO BOX 607
FISHERS ISLAND NY 06390-0607
Account Summary Thank you for your business.
Previous Balance $19,168.13
Payments(-) -$19,168.13 About Your Payment
Account Adjustments(+%-) 000 We offer several payment options to help you-manage your account:
Current Charges(+) 19,168.1 pay Online. Go to uhceservices.com to make a one-time payment or schedule
/ monthly payments directly from your bank account.
Total Balance Due $19,168.113 pay By Phone. Call 1-888-201-4216,TTY 711,24 hours a day, 7 days a week,
to make a payment directly from your bank account.
Pay By Check. Use the enclosed envelope to send us your payment:Your
payment must be,sent to the address on the form below to ensure it is applied to
vyour account. Checks returned for lack of funds or checks that can't be cashed for
any reason are not considered payment.
f1 - Payment is due'in full on or before the due date above.If full payment is not
received by the end of your grace period,your coverage may be terminated
as stated in your policy requirements.If a premium payment is deposited
late,it does not automatically mean we will accept the premium.
�-
Please detach and return,with your payment.
Customer Name Customer Number Payment Due Date Invoice #
FISHERS ISLAND FERRY DISTRICT 1320205 09/01/2021 647673795014
Send payment to:
Minimum Amount Due, $19,168.13
UHS Premium Billing
PO BOX 94017
Palatine, IL 60094-4017' Amount Enclosed
Illll�i�ill'�I�I��Inill�ul��l��l�l��lli�l�llll�lllll'll'�1'I'I'
6476'750765001000000191681364767'37950147
2212 DREGULARBW0003004-07467-02
FISHERS ISLAND FERRY DISTRICT Page 2 of 5
Customer No: 1320205
Invoice No: 647673795014
Invoice Date: 08/08/2021
Bill Group: 209981
Coverage Period, 09/01/2021 -09/30/2021
Due Date: 09/01/2021
Summary
Description Employee Net Amount
Count
282348-Default Billing Pref
CT B FRDM NG 6700/100 PPO HSA 21
Employee 11 $6,683.17
Employee & Family 4 $7,549.24
Employee &Spouse _ 3_. _$4 935,.72-
Subtota/, CT B FRDM NG 6700/100 PPO HSA 21 18 $19,168.13
Subtotal 282348-Default Billing Pref T$19,168.13
282348-Default Billing Pref
Adjustments
Account Adjustments $0.00
Current Adjustments $0.00
Subtotal,Adjustments �_ $0.00
TOTAL _ _ __. _ 18 _.� _ . $19,168.13
Questions?We're here to help
Toll free 1-888-201-4216 uhceseivices com
FISHERS ISLAND FERRY DISTRICT
VENDOR 021304 ULINE 08/24/2021 CHECK 7608
A '
FUND & ACCOUNT P.OA INVOICE DESCRIPTION AMOUNT
SM .5710.4. 000.625 136388508 NLT MASKS/BLOWN WRAP 412.62
TOTAL 412 .62
M
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FISHERS ISLAND '-kEERR YPISTRICT' AUDIT,, lA
2 4 2 0`2 1 t
53095 MAIN,ROAD,PO BOX 1179,'
o ,SOUTHOLD,NYI 19711--0959 0 ?¢
N.
THE SUFFOLK CO:,NAT16N4 BANK'
CUTCHOGUE,NY 11935 ,','AMOUNT;
-4
v
OUR ''HUNDRED HUN R
'b
ED TWELVE AND 6 '/idO ,DO
Y •• 'T
AY ULINE-
P
ATT 'AbC06ftV- ,!X
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,THE
OF, Po Box, .$_8741'
CHICAGO IL 6089071741
0A
11300 7 608ill 1:0 2 L40 54641: C313 00L502 L11
Vendor No. Check No.
Town of Southold, New York - Payment Voucher 21304
Vendor Address Entered by,-,
Attn: Accounts Receivable
PO Box 88741 Audit Date
ULINE Chicago, IL 60680-1741 !' :�
Vendor Telephone Number , AUG 4` 202 1
800-296-6610 To erk s`. d ,
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services "General'I:edger Fund and Account Number
136238608 7/21/2021 $412.62 $412.62 NLT masks, blown wrap 12 RLSM5710.4.006.625.°
I
$412.62 $412.62
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Fishers Island Ferry District Date 8/13/2021 Title Manager Date 8/13/2021
INVOICE NO.
1-800-295-5510 **
uline.com 136388508
PO Box 88741 •Chicago IL 60680-1741 INVOICE
SHIFTING SUPPLY SPECIALISTS ULINE FED ID#:36-3684738
r
THANK YOU FOR YOUR ORDER. ULINE CUSTOMER SINCE 2005
YOUR ORDER# 53874964
SOLD TO: SHIP TO:
MDG2017 00004357 1 AB 042 8' 2461167
FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY DISTRICT
PO BOX 607 5 WATERFRONT PARK
FISHERS ISLAND NY 06390-0607 ' NEW LONDON CT 06320
U 100-9-2013
CUSTOMER NO. PURCHASE ORDER NO.
2461167 NICK UPS GROUND 7/21/21• 7/21/21- NET 30 DAYS-- 7/21/21- --
ITEM NUMBER DESCRIPTION
During these unprecedented times,the earlier in the day you order fro Wine,the
better equippe we are to handle your order. We so appreciate your usiness.
6 BX S-22137 ULINE DELUXE SURGICAL MASK 50/BX 19.00 114.00
12 ' RL S-642 18X1500 80GA ULINE BLOWN WRAP 17.00 204.00
.1 , EA S-22555BOS-X MLB T-SHIRT- RED SOX XL .00 .00
THIS ITEM AT NO CHARGE
ORDER PLACED BY: NICK ESPINOSA SUB TOTAL SALES TAX FRT/HNDLING AMOUNT DUE
EGIERNOTH/1 318.00 24.64 69.98 412.62
FISHERS ISLAND FERRY DISYRICT
771
VENDOR 021506 UPS 08/24/2021 CHECK 7609
A
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
SM .5710.4.000.700 26639311 W/E 7/30/21 36.00
SM .5710.4.000.700 26639321 W/E 8/6/21 722 .75
44
TOTAL 758.75
std- '°a-"I- ----------
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FISHERS ISLAND FERRY DIRRICT" AUDIT, 8' 24/'20'2'1"- ,"""1'-"'-
, i
53095'MAIN ROAD,PO BOX"I 179
SOUTHOLD,NY 11974-0969
"CHECK'
NATIONAL BANK
THE SU14DI DATE '., AMOUNT
CUTCHOGUE,NY 11935 v
-20"20a1/2X,
", 1 VOW
417
9EViWhUNDPED, FIFTY EIGHT
P,4Y UPS
rO 77iE,"
PO BOX '8094`!]I' '
9RDER CHIc'AGO"IL 0680-§488''
0'
114 0 0 7 6 0 9118 1:0 2 1 L,O'S L, 1: 68 00LS02 Lill
Vendor No. Check No. -
Town of Southold, New York - Payment Voucher 21506 °` � C,7 ,
Vendor Address Entered bye ;
P.O. Box 809488
Vendor Name UPS Chicago IL 60680-9488
United Parcel Service ygtvy 2��=
Vendor Telephone Number
800-811-1648 C1
Vendor Contact
3 �
Invoice Invoice Invoice Net Purchase Order _ - H-u
a
Date Total Discount Amount Claime Number Description of Goode or Services .1,'.`Gen$ral"Ledger Vundzand Account Number
26639311 7/31/2021 $36.00 $36.00 WE 7/30/21 : r`.rSM5710.4:D00.760,
26639321 8/7/2021 $722.75 $722.75 WE 8/6/21 a '" iSM5770:4:000700
y '/A
$758.75 $758.75
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Nameand Ferry District Date 8/13/2021 Title Manager Date 8/13/2021
= ,M Delivery Service Invoice _
Invoice Date July 31, 2021 Z
Shipped from: Invoice Number 0000026639311
FISHERS ISLAND FERRY Shipper Number 026639
5 WATERFRONT PARK Control ID 187U
NEW LONDON,CT 06320 Page 1 of 3
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0736A00000266394 77366050014153 Visit ups.com/billing
AB 01 018332 70500 H 59 E For questions about your invoice,call:
-1648
'I�I��lll�l'I�III�I�IIIII�III�II��I�II�I����II����I���������I��� (Monday800) s-Friday
FISHERS ISLAND FERRY s:oo a.m.-6:00 p.m.E.T.
ACCTS PAYABLE or write:
® PO BOX 607 UPS
FISHERS ISLAND, NY 06390.0607 P.O.BOX 809488
CHICAGO,IL 60680-9488
Account Status Summary Thank you for using UPS.
Weekly Payment Plan Summary of Charges
Amount Due This Period $36.00 Page Charge
Amount Outstanding(prior Invoices) $1,638.41 3 Adjustments&Other Charges $3.00
Total Amount Outstanding $1,674.41 3 Service Charges $33.00
Please Include the Return Portion of each outstanding invoice with Amount due this period $36.00
your payment.See Account Status for details. UPS payment terms require payment of this invoice by August 22,
Questions about your charges? 2021.
To get abetter understanding of the charges on your invoice,
visit our invoice guide and glossary of billing charges at Payments received late are subject to a late payment fee of 6%of
ups.com/invoiceguide, the Amount Due This Period.(see Tariff/Terms and Conditions of
Service at ups.com for details) ' 'I
Note:This invoice may contain a fuel surcharge as described at
ups.com.For more information,please visit ups.com.
— — — — — — — — — — -- — — — — — — — — — — — — — — — — — — — — — — — — — — — —
Delivery Service Invoice
Invoice Date July 31, 2021
' Invoice Number 0000026639311
Shipper Number 026639 g
Page 2 of 3
Account Status
Weekly Payment Plan
Amount Outstanding(prior invoices):
Please include the Return Portion of each outstanding invoice with
your payment
Invoice Number Invoice Date Balance Due
0000026639271 07/03/2021 $1,502.08
0000026639281 07/10/2021 $64.33
0000026639291 07/17/2021 $36 00
0000026639301 07/24/2021 $36 00
Total $1,638.41
Outstanding balances reflect any payments received as of
07/30/2021.Please ignore this message if a recent payment has
been made for any outstanding invoices.
- 4
Delivery Service Invoice
Invoice Date July 31, 2021
OT.M
Invoice Number 0000026639311
Shipper Number 026639
Adjustments & Other Charges Page 3 of 3
Miscellaneous
Billed
Explanation Charge
WEEKLY PRINTER SERVICE FEE 3.00
FOR 1 PRINTERS AT$3 00 EACH
FOR 30-JUL-2021
Total Miscellaneous 3.00
Total Adjustments&Other Charges 3.00
Service Charges
Week Ending Billed
Date Explanation Charge
07/31 Weekly Service Charge 33.00
Total Service Charges 33.00
` alder
-- -'-- '-- - - - - ---- -- -- -- ---- - - - - - - -- -- ----- -'-`--------------------
018332 2/2
o
0
M
Delivery Service Invoice
Invoice Date August 7, 2021
1 Shipped from: Invoice Number 0000026639321
FISHERS ISLAND FERRY Shipper Number 026639
5 WATERFRONT PARK Control ID 422Q
NEW LONDON,CT 06320 Page 1 of 7
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0736A00000266394 77366010015638 Visit ups.com/billing
AB 02 019374 77518 H 61 A For questions about your invoice,call:
(800)811-1648
Monday-Friday
FISHERS ISLAND FERRY - 8:00 a.m.-6:00 p.m.E.T.
ACCTS PAYABLE or write:
® PO BOX 607 UPS
FISHERS ISLAND, NY 06390.0607 P.O.BOx 809488
CHICAGO,IL 60680.9488
Thank you for using UPS.
Incentive Savings Summary of Charges
Total incentive savings this period $11.40 page Charge
Your amount due this period Includes these savings. Outbound
See incentive summary section for details. 3 UPS WorldShip $632.45
Account Status Summary 5 Adjustments&Other Charges $73.80
Weekly Payment Plan 7 Service Charges $16.50
Amount Due This Period $722.75 Amount due this period
Amount Outstanding(prior Invoices) $108.00
Total Amount Outstanding $830.75 UPS payment terms require payment of this invoice by August 29,
Please Include the Return Portion of each outstanding Invoice with 2021.
your payment.See Account Status for details.
Payments received lace are subject to a late payment fee of 6%of ,,,.•�
Questions about vour charges? the Amount Due This Period.(see Tariff/Terms and Conditions of
To get a better understanding of the charges on your invoice, Service at ups.com for details)
visit our invoice guide and glossary of billing charges at
ups.com/invoiceguide. Note:This invoice may contain a fuel surcharge as described at
ups.com.For more information,please visit ups.com.
0
0
a
Delivery Service In voice f
Invoice Date August 7, 2021
CTM Invoice Number 0000026639321
Shipper Number 026639
Page 2 of 7
Incentives Account Status
Outbound Weekly Payment Plan
Service Date Incentive Plan Payments Applied
Published Incentive Invoice Number Invoice Date Amount Paid
Incentive Level Count Charges Credit 0000026639271 07/03/2021 $1,502.08
Fuel Surcharge 0000026639281 07/10/2021 $64.33
08/07/2021
-0.90 Account Status
Peak Surcharge-Additional Handling Weekly Payment Plan
08/07/2021 ERMVWMP Amount Outstanding(prior invoices):
Basle 3 10.50 -10.50 Please include the Return Portion of each outstanding invoice with
Total Outbound -11.40 your payment.
Total Incentives -11.40 Invoice Number Invoice Date Balance Due
0000026639291 07/17/2021 $36.00
0000026639301 07/24/2021 $36.00
0000026639311 07/31/2021 $36.00
Total $108.00
Outstanding balances reflect any payments received as of
08/06/2021.Please ignore this message if a recent payment has
been made for any outstanding invoices.
Delivery Service Invoice
Invoice Date August 7, 2021
Invoice Number 0000026639321
Shipper Number 026639
Page 3 of 7
Outbound
UPS WorldShip
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit ChargIe
08/05 9739067074 1 1 ZO266390341975249 Ground Residential 02554 2 19, 14.19 14.19
Customer Weight 3
Residential Surcharge 4.45 4.45
Fuel Surcharge 1.58 1.58
Customer Entered Dimensions,= 17 x 17 x 9 In
Total 20.22 20.22
Sender Receiver:Marria Kane
Michael Kane Llghtship Baskets
38 Vestal St.
NANTUCKET MA 02554
Message Codes:r
2 1Z0266390341426252 Ground Residential 76107 7 6 15.19 15.19
Customer Weight , 1
Residential Surcharge 4.45 4.45
Fuel Surcharge 1.67 1.67
Customer Entered Dimensions= 13 x 8 x 7 In
Total 21.31 21.31
Sender Receiver:Robert Ginsberg
1305 Shady Oaks lane
FT WORTH TX 76107
Message Codes:r
3 120266390341065679 Ground Residential 37215 5 49 39.33 39.33
Customer Weight 20
Residential Surcharge 4.45 4.45
Additional Handling -Length+Girth 18.00 18.00
Peak Surcharge-Additional Handling 3.50 -3.50 0.00
Fuel Surcharge 5.55 -0.30 5.25
Customer Entered Dimensions= 36 x 31 x 6 In •a
Total 70.83 -3.80 67.03 1:1�
:!
Sender Receiver:Alex Sargent Capps
6105 Stonehaven Dr.
NASHVILLE TN 37215
Message Codes:r KD
4 1Z0266390342385723 Ground Commercial 02908 2 39 20.13 20.13
Fuel Surcharge 1.71 1.71
Total 21.84 21.84
Sender Receiver:Don's Auto Electric
40 Pleasant Valley Pky
- ----- -- - ------------ -- - -------- -- - -------------- ----- -- -
- ----- ------ ---- ----------- ----- ------ -- -- --- ---
PROVIDENCE Ri 02908-------- ----- --------- ---- ••-----••-------
5 IZO266390342576358 Ground Commercial 33898 6 15 19.41 - 19.41
Delivery Area Surcharge 3.10 3.10
Fuel Surcharge 1.91 1.91
Total 24.42 24.42
Sender Receiver:Sue Horn
HENRY MCCANCE
#124 2300 NORTH SCENIC HIGHWAY
LAKE WALES FL 33898
6 1Z0266390342046116 Ground Residential 76107 7 60 59.31 59.31
Residential Surcharge 4.45 4.45
Additional Handling-Weight 27.00 27.00
Peak Surcharge-Additional Handling 3.50 -3,50 0.00
Fuel Surcharge 8.01 -0.30 7.71
Total 102.27 -3.80 98.47
Sender Receiver:Dana Porter
1110 Broad Ave.
FT WORTH TX 76107
Message Codes:KD
019374 2/4
Delivery Service Invoice
Invoice Date August 7, 2021
VTM
Invoice Number 0000026639321
Shipper Number 026639
Page 4 of 7
Outbound
UPS WorldShip(continued)
Pickup Pickup ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code Zone Weight Charge Credit Charge
08/05 9739067074 7 IZO266390340028309 Ground Residential 76107 7 57 58.94 58.94
Customer Weight 40
Residential Surcharge 4.45 4.45
Fuel Surcharge 5.39 5.39
Customer Entered Dimensions= 33 x 17 x 14 in
Total 68.78 68.78
Sender Receiver:Dana Porter
1110 Broad Ave.
FT WORTH TX 76107
Message Codes:r
8 IZO266390340448294 Ground Residential 76107 7 57 58.94 58.94
Customer Weight 25
Residential Surcharge 4.45 4.45
Fuel Surcharge 5.39 5.39
Customer Entered Dimensions= 33 x 17 x 14 In
Total 68.78 68.78
Sender Receiver:Dana Porter
1110 Broad Ave.
FT WORTH TX 76107
Message Codes:r
9 IZO266390340342086 Ground Residential 76107 7 57 58.94 58.94
Customer Weight 53 -
Residential Surcharge 4.45 4.45
_ Additional Handling-Weight 27.00 27.00
Peak Surcharge-Additional Handling 3.50 -3.50 0.00
Fuel Surcharge 7.98 -0.30 7.68
Customer Entered Dimensions= 33 x 17 x 14 In
Total 101.87 -3.80 98.07
Sender Receiver:Dana Porter
1110 Broad Ave.
FT WORTH TX 76107
Message Codes:r KD
10 1Z0266390340766342 Ground Residential 75205 7 21 29.44 29.44
Residential Surcharge 4.45 4.45
Fuel Surcharge 2.88 2.88
Total 36.77 36.77
Sender Receiver:Gretchen Flanagan
------------------------ ----- --------------------------- ---------------- 4437 Beverly Drive-
DALLAS TX 75205
11 1Z0266390342451133 Ground Residential 75205 7 38 47.07 47.07
Customer Weight 25
Residential Surcharge 4.45 4.45
Fuel Surcharge 4.38 4.38
Customer Entered Dimensions= 18 x 17 x 17 in
Total 55.90 55.90
Sender Receiver:Gretchen Flanagan
4437 Beverly Drive
DALLAS TX 75205
Message Codes:r
N
-� Delivery Service Invoice
Invoice Date August 7, 2021
' Invoice Number 0000026639321
Shipper Number 026639
Page 5 of 7
Outbound
UPS WorldShip(continued)
Pickup Pickup • ZIP Published Incentive Billed
Date Record Entry Tracking Number Service Code, Zone Weight Charge Credit Charge
08/05 9739067074 , 12 IZO266390341695060 Ground Residential ,` 75205 - 7 34 42.43 42.43
Customer Weight 33
Residential Surcharge 4.45 4.45
Fuel Surcharge 3.98 3.98
Customer Entered Dimensions= 18 x 17 x 15 in
Total 50.86 50.86
Sender Receiver:Gretchen Flanagan
4437 Beverly Drive
DALLAS TX 75205
Message Codes:r
Total for Pickup Number: 9739067074 12 Package(s) 643.85 -11.40 632.45
Total UPS WorldShip 12 Package(s) 643.85 -11.40 632.45
Total Outbound 12 Package(s) 643.85 -11.40 632.45
Adjustments & Other Charges
Address Corrections
Number of Published Incentive Billed
Tracking Number Service Packages Charge Credit Charge
120266390342385723 Ground 1 18.00 18.00
Recorded:DON'S AUTO ELECTRIC Corrected:DON'S AUTO ELECTRIC
40 PLEASANT VALLEY PKY 516 BROAD ST
PROVIDENCE RI 02908 PROVIDENCE RI 02907
Total for Reference Number: 18.00 18.00
Total Address Corrections 1 18.00 18.00
Packages Delivered but not Previously Billed
Delivery Published Incentive Billed
Date Tracking Number Service Zone Weight Charge Credit Charge
07/30 IZO266390340028309 Missing PLD Fee 2.00 2.00
Total 2.00 2.00
Receiver: Sender :FISHERS ISLAND FERRY
1110 BROAD 5 WATERFRONT PARK
FORT WORTH TX 76107 NEW LONDON CT 06320
1Z0266390340342086 Missing PLD Fee 2.00 2.00
' Total 2:00 '2.00
-Receiver: Sender-- FISHERS ISLAND FERRY-
1110 BROAD 5 WATERFRONT PARK
FORT WORTH TX 76107 NEW LONDON CT 06320
1Z0266390340448294 Missing PLD Fee 2.00 2.00
Total 2.00 2.00
Receiver: Sender :FISHERS ISLAND FERRY
1110 BROAD 5 WATERFRONT PARK
FORT WORTH TX 76107 NEW LONDON CT 06320
07/29 IZO266390341065679 Missing PLD Fee 2.00 2.00
Total 2.00 2.00
Receiver: Sender ;FISHERS ISLAND FERRY
6105 STONEHAVEN 5 WATERFRONT PARK
NASHVILLE TN 37215 NEW LONDON CT 06320
07/27 1Z0266390341426252 'Missing PLD Fee 2.00 2.00
Total 2.00 2.00
Receiver: Sender :FISHERS ISLAND FERRY
1305 SHADY OAKS 5 WATERFRONT PARK
FORT WORTH TX 76107 NEW LONDON CT 06320
019374 3/4
Delivery Service In voice r
Invoice Date August 7, 2021
OTM Invoice Number 0000026639321
Shipper Number 026639
Page 6 of 7
Adjustments & Other Charges
Packages Delivered but not Previously Billed(continued)
Delivery Published Incentive Billed
Date Tracking Number Service Zone Weight Charge Credit Charge
07/27 IZO266390341695060 Missing PLD Fee 2.00 200
Total 200 200
Receiver: Sender :FISHERS ISLAND FERRY
4437 BEVERLY 5 WATERFRONT PARK
DALLAS TX 75205 NEW LONDON CT 06320
07/30 120266390342046116 Missing PLD Fee 200 200
Total 200 2.00
Receiver: Sender :FISHERS ISLAND FERRY
1110 BROAD 5 WATERFRONT PARK
FORT WORTH TX 76107 NEW LONDON CT 06320
07/29 120266390342385723 Missing PLD Fee 2.00 2.00
Total 2.00 200
Receiver: Sender :FISHERS ISLAND FERRY
40 PLEASANT VALLEY 5 WATERFRONT PARK
PROVIDENCE RI 02908 NEW LONDON CT 06320
Total Packages Delivered but not Previously Billed 8 Package(s) 16.00 16.00
Miscellaneous
Published Incentive Billed
Explanation Charge Credit Charge
WEEKLY PRINTER SERVICE FEE 300 3.00
FOR 1 PRINTERS AT$3.00 EACH
_ FOR 06-AUG-2021
Total Miscellaneous 300 300
Adjustments
Number of Published Incentive Billed
Explanation Packages Charge Credit Charge
BILLING ADJUSTMENT FOR W/E 08/07/2021 208 2.08
SHIPPING CHARGE CORRECTION AUDIT FEE
FEE BASED ON 2 PACKAGES
AND$34.72 CORRECTION AMOUNT
Total Adjustments 2.08 2.08
Shipping Charge Corrections Learn how to avoid future shipping charge corrections.Visit www.ups.com/avoidcharges.
Pickup _ _. . ____ Original_$ervlce/ _-. ZIP_. --_.............. .. ...Published Incentive - --_.Billed Adjustment
Date Tracking Number Corrected Service Code Zone Weight Charge Credit Charge Amount
08/05 120266390340028309 Ground 76107 7
Additional Handling-Packaging/Other 7 16.00 1600
Peak Surcharge-Additional Handling 3.50 -3.50 0.00
Fuel Surcharge 1.66 -0.30 1.36 17.36
Sender-:FISHERS ISLAND FERRY Receiver:Dana Porter
WATERFRONT 1110 Broad Ave
NEW LONDON CT 06320 FT WORTH TX 76107
1Z0266390340448294 Ground 76107 7
Additional Handling-Packaging/Other 7 1600 1600
Peak Surcharge-Additional Handling 350 -350 0.00
Fuel Surcharge 1.66 -0.30 1 36 1736
Sender :FISHERS ISLAND FERRY Receiver:Dana Porter
WATERFRONT 1110 Broad Ave.
NEW LONDON,CT 06320 FT WORTH TX 76107
Total Shipping Charge Corrections 2 Package(s) 3472
Total Adjustments&Other Charges 7380
d
00
Delivery Service In voice
Invoice Date August 7, 2021
' Invoice Number 0000026639321
Shipper Number 026639
Page 7 of 7
Service Charges
Week Ending Published Incentive Billed
Date Explanation Charge Credit Charge
08/07 Weekly Service Charge 16.50 16.50
Total Service Charges 16.50 16.50
Invoice Messaging
Code Message
r Dimensional weight applied
KD Charges based on Customer-provided information
:urn.
-- - ----------------- -....... ----- -------- --........-------- ------ ---------...........................
019374 4/4
al5N" - V7-,-1,7- IIA7;_,-,,L7,yr -, -,"r,,-
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FISHERS ISLAND FERRY DISTRICT
VENDOR 005414 US ELECTRICAL SERVICES,INC. 08/24/2021 CHECK 7610
ii,l A
FUND & ACCOUNTP.O.# INVOICE DESCRIPTION AMOUNT /
,SSM .5716.4 .000.625 S118569108.001 NLT ELECTRICAL SUPPLIES 90.78
TOTAL 90.78
41
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53095 MAIN,ROAD;PO'BOX 1479 1: 4/
SOUTHOLD,,NY-11971,0959 CK',!,Nb,:,,i 7
1"Z I
THE SUFFOLK CO" NATIONAL BANK
CLITCHOGUE,NY 11935
DATE=wIII -, ,AMOUNT'.,,
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54621'4 $90 '-7,Bl At
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78/100 0 DOLLARS
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1110076 10,11 1:0 2 1 L,0 54 641: 6 8 00 L 50 2 1118
1 Vendor No. Check No,.'.,'
Town of Southold, New York- Payment Voucher 5414 (0
Vendor Address Entered by
Vendor Name P.O. BOX 412485 Audit Date
Electrical Wholesalers Inc. Boston, MA 02241-24852 ���_�
Vendor Telephone Number A G.
800-522-3232 Jown 1 r
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number',
S118569108.001 7/22/2021 $90.78 $90.78 NLT electrical supplies SM5710.4.000.625
E
J
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$90.78 1 $90.78
Payee Certification Department Certification
The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
OdJJSignature Title Signature
Company Name Fish erry District Date 8/13/2021 Title Manager Date
INVOICE
®Electlical wh olesulers Inc.
4, nUSF7nad..l9eni—C.. CUSTgMER NUMBER, ;x SUBeACCOUNT41:
EW-NEW LONDON 27352 27352
163 STATE PIER ROAD
NEW LONDON CT 06320-5817 �',INV,OICE NUM$ER` . ,',`!NV,OICEsDATE,,:;'
860-443-4381 Fax 860-443-4570 S118569108.001 07/22/21
REMIT TO:
US ELECTRICAL SERVICES,INC.
PO BOX 412485
BOSTON MA 02241-2485
BILL TO:
4059 1 AB 0 428 E0398X 10654 D7879260053 S2 P8411305 0001.0001 SHIP TO:
IIIIIIIIIIIIIIIIIIIIIIIII.-IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
FISHERS ISLAND FERRY DI FISHERS ISLAND FERRY DI
PO BOX 607 PO BOX 607
FISHERS ISLAND NY 06390-0607 FISHERS ISLAND NY 06390-0607
CUSTOMER'PO# ° JOB NAME I RELEASE# �ORDERED,B`�-'� - SALESPERSON
RACE POINT RACE POINT JOHN HILLER HORSE ACCOUNT
" WRITER. ,- " SHIP.VIA TERMS - aSHIP DATE ORDERFDAT,E'
NICHOLAS GRESSLER PICK UP MFG DISC 10TH, NET 15TH 07/22/21 07/22/21
ORDER,QTY �SHIP,QTY •,DESCRIPTION' `,' -UNIT PRICE ..� EXTyPRICE
ORDER PICKED UP IN NEW LONDON, CT-06320-5817
6ea 6ea PHI 550442 3 560 ea 21 36
8.8A19/PER/930/P/E26/DIM6/1 FB A19
LED 8.8W 60EQ 3000K 80OLM E26
80CRI
10ea 10ea MMM 33-3/4X76FT-1 SCOTCH SUPER33+ 6 400 ea 64.00
VINYL ELECTRICAL TAPE 3/41NX76FT
11N CORE BLACK
Try®rdering ®nline or on the go!
• Visit www.ew-ct.com or download our app on the App Store or Google Play store
• Order until 7 PM for next day pickup or delivery
• Live account pricing
• Check stock in nearby branches
• Contact SolutionsR22ACcousesi.com for more information
• Pay your bills online at usesi.billtrust.com(enrollment token at the bottom of this invoice)
PROOF OF DELIVERY SIGNATURE Subtotal 85.36
2021107!22 10 25 26 F+M S1185BO108 1
Invoice is due by 08/15/21. Shipping Chgs 0.00
Tax 5.42
For complete Terms&Conditions go to Payments 0.00
https//tlnyurl com/EWCT-Customer-TC
A Electrical Company Visit us at www.usesi.com ,
Arnount:�Due.` 90.78
r=te,5.>rases;is
TO VIEW ONLINE GO TO: HTTP://USESI BILLTRUST.COM USE THIS ENROLLMENT TOKEN: LMR LDP GZR Pager, f 1
0001.0001
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FISHERS ISLAND FERRY DISTRICT
I I
VENDOR 002240 VERIZON WIRELESS 08/24/2021 CHECK 7611
; ; , A =e
FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT
qt' ?
SM .5710.4.000.100 ` 9885178430 SE HOT SPOT27/21 97.78
7 '
TOTAL 97.78
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Vendor Tax ID Number or Social Security Number Vendor Address Entered by
Vendor Name PO Box 408 Audit Date
Verizon Newark,NJ 07101-0408
Vendor Telephone Number ���
T wn Clerk
Vendor Contact
Invoice Invoice Invoice Net Purchase Order
Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number
9885178430 7/30/2021 $97.78 $97.78 SE hot spot July 2021 SM5710.4:000.100
$97.78 $97.78
Payee Certification Department Certification
nt)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me
foregoing claim is true and correct,that no part has in good condition without substitution,the services properly
,in stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions
axes from which the Town is exempt are excluded or discrepancies noted,and payment is approved
Signature Title Signature
Company Name Fishers 11S�Mtny Date 8/11/2021 Title Mana Date
verizon u ,
PO BOX 489 Manage Your Account Account Number Date Due
NEWARK,NJ 07101-0489
a e : Fj=1101 MORIN
Change your address at Invoice Number 9885178430
http://sso.verizonenterprise.com
Quick Bli! Summary Jul 01--Jul 30
FISHERS ISLAND FERRY DISTRICT 00006424 Previous Balance(see back for details) $155.54
ACCOUNTS PAYABLE KI07 Payment—Thank You —$77.77
261 TRUMBULL DR Balance Forward Due Immediately $77,77
PO BOX 607
FISHERS ISLAND,NY 06390-8021 Monthly Charges $77.00
Usage and Purchase Charges_
Voice $,00
Messaging $.02
Data $20.00
Surcharges
and Other Charges&Credits '$.76
Taxes,Governmental Surcharges&Fees $.00
Total Current Charges Due by August 22,2021 rfif78
Total Amount Due $175.55
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Our records indicate your account is past due.Please send payment now to avoid service disruption.
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Overview Of Shared Usage
Participating Lines Lines Exceeding Shared Shared Shared
as of 07/30/21 Allowance after Share Allowance Usage Billable Cost
Data–Flexible Business Share 1 1 2.000GB 3.334GB 2.000GB $20.00
Overview of Lines
Usage Surcharges Taxes,
and and Other Governmental Third–Party Voice
Page Monthly Purchase Equipment Chargesand• Surcharges Charges Total .Plan Messaging Data Voice Messaging Data
Lines Charges Number Charges Charges Charges Credits and Fees (includes Tax)- Charges Usage Usage Usage Roaming Roaming Roaming
631-372-0263 Ferry Jeipack 5 $26.95 $20.02 -- $.02 $.00 -- $46.99 -- 1 3.334GB -- — --
631-466-5153 Gordon Gordon 6 $50.05 -- -- -$.74 $.00 -- $50.79 69 9 483GB -- -- --
Total Current Charges $77.00 $20.02 $.00 $.76 $M $0O $97.78
verizon /
Invoice Number Account Number Date Due Page
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Shared Usage Overage Details
Current Usage
DATA—FLEXIBLE BUSINESS SHARE
Shared Usage Overage Details Allowance Used Billable Cost
2GB ACCT SHR$10/GB$0 631-372-0263 FERRY JEFPACK 2.000G13 3,334GB 2.000G6 $20.00
Have more questions about your charges?Get details for all your Usage Charges at vzw.com/mybusinessaccount.
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Invoice Number Account Number Date Due Page
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Summary for Ferry Jetpack: 631-372-0263
Your Plan Monthly Charges
Flex Business Data Device 2GB 07/31 —08/30 35.00
Flex Business Data Device 2GB 23%Access Discount 07/31 —08/30 —8.05
$35.00 monthly charge $26.95
$,25 per minute
2GB Acct share$10/GB Usage and Purchase Charges .
2 monthly gigabyte allowance Messaging Allowance Used I Billable I Cost
$10,00 per GB after allowance Text—Rcv'd messages -- 1 1 .02
Beginning on 06/07/19: Total Messaging $,02
23%Access Discount Data Allowance Used Billable Cost
Gigabyte Usage gigabytes 2.000 3.334 1.334 20.00
(shared)
Have more questions about your charges? Total Data $20.00
Get details for usage charges at Total Usage and Purchase Charges $20.02
b2b.verizonwireless.com.
Surcharges
Regulatory Charge .02-
$.02
Total Current Charges for 631-372-0263 $46.99
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Invoice Number Account Number Date Due Page
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Summary for Gordon Gordon: 631-466-5153
Your Plan Monthly Charges ;
4G NW UNL Min&MSG+Email&Data 07/31 —08/30 65.00
4G NW UNL Mln&MSG+Email&Data 23%AccessDiscount 07/31 —08/30 —14.95
$65,00 monthly charge $50.05
Unlimited monthly minutes
UNL Text Messaging Usage and Purchase Charges
Unlimited M2M Text Voice Allowance Used Billable Cost
Unlimited Text Message Calling Plan minutes unlimited 69 -- --
Mobile to Mobile minutes unlimited 34 -- •
Email&Web Unlimited Night/Weekend minutes unlimited 1 -- --
Unlimited monthly gigabyte Total Voice $,00
Beginning on 05/31/19: Messaging Allowance Used Billable Cost
23%Access Discount Text messages unlimited 1 -- --
M2M National Unlimited Unlimited M2M Text messages unlimited 8 -- --
Unlimited monthly Mobile to Mobile Total Messaging $,00
Data Allowance Used Billable Cost
UNL Night&Weekend Min Gigabyte Usage gigabytes unlimited ,483 -- --
Unlimited monthly OFFPEAK Total Data $.00
UNL Picture/Video MSG Total Usage and Purchase Charges $.00
Unlimited monthly Picture&Video,
Surcharges ;
Fed Universal Service Charge .36
Have more questions about your charges? Regulatory Charge .21
Get details for usage charges at Gross Receipts Surchg .17
b2b.verizonwireless,com. $,74
Total Current Charges for 631-466-5153 $50.79
verizonv � � • � • •
Invoice Number Account Number Date Due Page
Need-to-Know hf®rmati®n
Explanation of Surcharges Introducing Plan Manager
Surcharges include(i)a Regulatory Charge(which helps defray Now you can see everything your plan has to offer at a glance,like
various government charges we pay including government number your entertainment bundles and ways to keep your phone safer.
administration and license fees);(ii)a Federal Universal Service Check out all your perks and benefits-all in one place-online or in
Charge(and,if applicable,a State Universal Service Charge)to the My Verizon app.
recover charges imposed on us by the government to support
universal service;and(iii)an Administrative Charge,which'helps
defray certain expenses we incur,including:charges we,or our
agents,pay local telephone companies for delivering calls from our
customers to their customers;fees and assessments on our
network facilities and services;property taxes;and the costs we
incur responding to regulatory obligations.'Please note that,these
are Verizon Wireless charges,not taxes.These charges,and
what's Included,are subject to change from time to time.
Bankruptcy Information
If you are or were in'bankruptcy,this bill may include amounts for
pre-bankruptcy charges.You should not pay pre-bankruptcy
amounts;they are for your information only.In the event Verizon
receives notice of a bankruptcy filing,pre-bankruptcy charges will
be adjusted in future invoices.Mail bankruptcy-related
correspondence to 500 Technology Drive,Suite 550,Weldon
Spring,MO 63304.
Returned Payments
In the event your'check for payment of your wireless bill is returned
by your bank for insufficient or uncollected funds,Verizon Wireless
may resubmit your check electronically to your bank for payment
from your checking account,
Late Payment Information
A late payment applies for unpaid balances.The charge is the
greater of$5 or 1.5%,per month,or as permitted by law.Failure to
pay bills on time may result in negative credit reporting.
More On Wireless Taxes And Surcharges
Your total charges for this month's bill cycle are$175.55.
This includes charges for one or more bundled Verizon service
plans that include voice,messaging,data,_or other services for
which you pay a monthly plan charge.
This bill cycle,your fixed monthly plan charges were$100.00
(before applying any discounts or credits,and excluding other
charges such as overage,late payment,taxes,Verizon surcharges,
and equipment).
To accurately bill taxes and Verizon surcharges,we regularly look at
past network usage by you and other customers with similar plans
to allocate this fixed monthly plan charge among the services
included in the bundle.
In this bill cycle,we have allocated this amount as follows:$4.17 for
voice,$0.84 for messaging,$94.99 for data,and$0.00 for other
services.
For more information,please go to vzw.com/taxesandsurcharges.
FUSC Change
The Federal Universal Service Charge(FUSC)is a Verizon Wireless
charge that is subject to change each calendar quarter based on
contribution rates prescribed by the FCC.On July 1,the FUSC
decreased to 10.06%percent of assessable wireless charges,other
than separately billed interstate and international telecom charges.
The FUSC on separately billed interstate and international telecom
charges decreased to 31.8%percent.For more details,please call
1-888-684-1888