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HomeMy WebLinkAboutL.K. McLean - Mason Dr RESOLUTION 2023-78 ADOPTED DOC ID: 18722 THIS.IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2023-78 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JANUARY 3,2023: RESOLVED that the Town Board of the Town of Southold hereby accepts the proposal of L.K. McLean Associates, P.C. dated December 29, 2022 in the total amount of$2,955.00 for surveying work on Mason Drive; and be it further RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute an Agreement between the Town of Southold and L.K. McLean Associates, P.C. in the total amount of$2,955.00, subject to the approval of the Town Attorney. Denis Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Brian O. Mealy, Councilman SECONDER:'Sarah E.Nappa, Councilwoman AYES: Nappa, Doroski, Mealy,Doherty, Evans, Russell O��S�1rf0L��® a� Gym Q Office of the Town Attorney Town of Southold Town Hall Annex, 54375 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone : 631-765-1939 Facsimile: 631-765-6639 MEMORANDUM To: Denis Noncarrow, Town Clerk From: Missy Mirabelli Secretary to the Town Attorney Date: February 2, 2023 Subject: Mason Drive Survey Agreement w/ LKMA With respect to the above-referenced matter, I am enclosing the original Agreement together with the Resolution. If you have any questions regarding the enclosed, please do not hesitate to call me. Thank you. /mm Enclosures cc: Accounting Engineering THIS AGREEMENT made and entered into this of January 2023, by and between Town of Southold (hereinafter referred to as "Town"), a municipal corporation organized and existing under and by virtue of the laws of the State of New York (mailing address: c/o Dennis Noncarrow, Town Clerk, P.O. Box 1179, Southold, New York 11971-0959), party of the first part, and Louis K McLean & Associates Engineers & Surveyors PC (hereinafter referred to as "Consultant") with an address at 437 South Country Road, Brookhaven New York 11719, party of the second part. WITNESSETH: That the Town and Consultant, for the consideration named,hereby agree as follows: 1. PURPOSE. The Consultant shall provide professional land surveying services for Mason Drive in the Town of Southold. 2. SPECIFIC SERVICES. The Consultant shall perform all the tasks set forth in the Proposal submitted to the Town dated December 291h 2022, a copy of which is attached hereto as Appendix A and made a part hereof. 3. TIME AND ATTENDANCE; COOPERATION BY THE TOWN. The services to be rendered under this Contract shall be completed within two (2) months of execution of the contract. The Town agrees to cooperate with Consultant, as needed, and to provide Consultant with copies of any records, documents and other information needed for performance of this agreement on a timely basis. The Town further agrees to provide Consultant with access to appropriate officials and/or employees of the Town, as may be needed in the performance of the agreement Moreover, both parties understand and agree that mutual accountability and responsiveness is critical to the successful completion of the project, and therefore both shall always use their best faith efforts to be accountable and promptly responsive to each other. 4. COMPENSATION. In payment for the services to be performed hereunder by Consultant, the Town shall make payments to Consultant as follows: (a) For the services to be performed by Consultant pursuant to paragraph 2 hereof, the Town shall pay Consultant as set forth in the Proposals. Consultant shall submit an itemized voucher for work actually completed on a monthly basis with the Town Comptroller and the Town will pay. Such voucher shall be due and payable within 45 days after receipt of such voucher, but such sum shall not be due and payable by the Town until the Town Board of the Town has received such a voucher and has audited and approved for payment the signed voucher to be submitted by Consultant in connection therewith. (b) The Town Board shall process any vouchers received from Consultant as expeditiously as possible. (c) In the event that the Town disputes or objects to any portion of any voucher submitted by Consultant pursuant to this paragraph,the Town shall,within 30 days of the receipt of such voucher, notify Consultant in writing of such dispute or objection. (d) Consultant acknowledges that Consultant is familiar with the requirements of section 118 of the Town Law which, in effect, prohibit payment of any of Consultant's claims against the Town unless an itemized voucher therefore shall have been presented to the Town Board or Town Comptroller and shall have been audited and allowed by the Town Board or Town Comptroller. 5. TERM OF AGREEMENT; TERMINATION. This agreement shall commence on the Agreement being fully executed and shall terminate upon completion of, and payment for, all the tasks outlined in the Proposal, provided, however, that this agreement shall terminate immediately in the event that (a) Consultant dies; (b) Consultant incurs a disability which makes Consultant unable to perform the services which Consultant is required to perform hereunder; (c) Consultant files a Petition in Bankruptcy Court or a Petition is filed against Consultant in Bankruptcy Court, or Consultant is adjudged bankrupt or makes an assignment for the benefit of creditors; or (d) a Receiver or Liquidator is appointed for Consultant and/or Consultant's property and is not dismissed within 20 days after such appointment or the proceedings in connection therewith are not stayed on appeal within the said 20 days. In the event that Consultant refuses or fails to provide the services required hereunder with due diligence, or fails to make prompt payment to persons supplying labor for Consultant's services hereunder, or refuses or fails to comply with applicable statutes, laws or ordinances, or is guilty of a substantial violation of any provision of this agreement,the Town shall send Consultant written notice that Consultant has 20 days to cure said default;and if,at the"end of said 20-day period, Consultant has not cured said default, the Town may then terminate this agreement on 7 days' prior written notice to Consultant. Except as prohibited by law, the Town and Consultant hereby waive trial by jury in any litigation arising out of, or connected with, or relating to this Agreement. 6. SKILLS OF CONSULTANT; CONFLICTS OF INTEREST. Consultant represents that Consultant has the requisite skills and experience to perform the services hereunder. 7. INDEPENDENT CONSULTANT STATUS OF CONSULTANT. Consultant and the Town agree that in the performance of Consultant's services hereunder, Consultant is an independent consultant and shall not be deemed to be an employee or agent of the Town for any purpose whatsoever. The Consultant shall assume all blame, loss and responsibility of any nature by reason of neglect or violation of any federal, state, county or local laws, regulations or ordinances. 8. CONSULTANT'S INSURANCE The Consultant shall not commence work under this Contract until it has obtained all insurance required under this paragraph and such insurance has been approved by the Town. (a) Compensation Insurance: The Consultant shall take out and maintain during the life of this Contract Workers' Compensation Insurance for its employees to be assigned to the work hereunder. (b) Liability Insurance: The Consultant shall take out and maintain during the life of this Contract such general liability, property damage, and commercial auto liability insurance as shall protect it from claims for damages for personal injury, including accidental death, as well as from claims for property damage which may arise from operations under this Contract. The amounts of such insurance shall be as follows: 1. General liability insurance in an amount not less than $1,000,000 for injuries, including wrongful death to any one person and subject to the same limit for each person, in an amount not less than $2,000,000 on account of any one occurrence. 2. Property damage insurance in an amount not less than $300,000 for damage on account of all occurrences. The Consultant shall furnish the above insurances to the Town and shall also name the Town as an additional named insured in said policies. (c) Any accident shall be reported to the office of the Town Clerk as soon as possible and not later than twenty-four (24) hours from the time of such accident. A detailed written report must be submitted to the Town as soon thereafter as possible, but not later than three (3) days after the date of such accident. 9. INDEMNIFICATION Consultant shall release, indemnify,defend and hold harmless the TOWN,its officers, employees, and representatives from and against any and all demands, liabilities,losses, damages,expenses (including attorney's fees)and judgments for any personal injuries,death,or property damage in any way relating to or arising from this Contract and the services to be performed under this contract. 10. PROHIBITION AGAINST ASSIGNMENT. Consultant is hereby prohibited from assigning, transferring, conveying, subletting or otherwise disposing of this agreement or his right, title or interest in this agreement without prior written consent of the Town. 11. COMPLIANCE WITH STATUTES. Consultant agrees that Consultant will comply with all statutes, ordinances, local laws, codes,rules i and regulations which are or may be applicable to Consultant's services, activities and duties set forth in this agreement. 12. NOTICES. Any and all notices and payments required hereunder shall be addressed as follows, or to such other address as may hereafter be designated in writing by either party hereto: To Town: Dennis Noncarrow Town Clerk Town of Southold PO Box 1 179 Southold, NY 11971-0959 To Consultant: Christopher F. Dwyer L.K. McLean Associates, P.C. 437 South Country Road, Brookhaven New York 11719 13. WAIVER. No waiver of any breach of any condition of the Agreement shall be binding unless in writing and signed by the party waiving said breach. No such waiver shall in any way affect any other term or condition of this Agreement or constitute a cause or excuse for a repetition of such or any other breach unless the waiver shall include the same. 14. APPLICABLE LAW. This Agreement and the rights and obligations of parties hereunder shall be construed in accordance with and be governed by the laws of the State of New York without regard to conflicts of laws and principles. Consultant hereby submits to the jurisdiction of the Courts of the State of New York for all disputes relating to this Agreement and agrees that venue for all disputes shall be in Suffolk County. 15. COMPLETE AGREEMENT; MODIFICATION. This Agreement constitutes the complete understanding of the parties. No modification of any provisions thereof shall be valid unless in writing and signed by both parties. 1 IN WITNESS WHEREOF, the Town of Southold has caused its corporate seal to be affixed hereto and these presents to be signed by Scott A. Russell, its Supervisor, duly authorized to do so, and to be attested to by Dennis Noncarrow, Town Clerk, and the Consultant has caused its corporate seal to be affixed hereto and these presents to be signed by its President, the day and year first above written. Town of Southold By: , Scott A. Russell, Supervisor Louis K. McLean & Associates Engineers &Surveyors PC By: Raymond G. DiBiase, PE. PTOE STATE OF NEW YORK) ) ss.: COUNTY OF SUFFOLK) On the,, of January in the year 2023 before me, the undersigned, personally appeared Scott A. Russell, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity and that by his signature on the instrument, the individual or the person upon whose behalf of which the individual acted, executed the instrument. p h� N�f PIL�lE TOMASZEWSKI NOTARY PUBLIC-STATE OF NEW YORK No. 01 TO6156671 Qualified in Suffolk County My Commission Expires 11-27-2026 STATE OF NEW YORK) ) ss.. COUNTY OF SUFFOLK) On the of the year 2023 before me, the undersigned, personally appeared Raymond G. DiaBiase P.E., P.T.O.E., personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity and that by his signature on the instrument, the individual or the person upon whose behalf of which the indivicted, executed the instrument. _ r Notary Public CHRISTINE WIEGAND NOTARY PUBLIC,State of New York No.01 W16210359,Suffolk County Commission Expires August 17�Q�S °� 63 RESOLUTION 2023-78 ADOPTED } DOC ID: 18722 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2023-78 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JANUARY 3,2023: RESOLVED that the Town Board of the Town of Southold hereby accepts the proposal of L.K. McLean Associates, P.C. dated December 29, 2022 in the total amount of$2,955.00 for surveying work on Mason Drive; and be it further RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute an Agreement between the Town of Southold and L.K. McLean Associates, P.C. in the total amount of$2,955.00, subject to the approval of the Town Attorney. Denis Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Brian O. Mealy, Councilman SECONDER:Sarah E.Nappa, Councilwoman AYES: Nappa, Doroski,Mealy, Doherty, Evans, Russell 1L I I A A L. K McLean Associates IA C. 9 •3 437 South Country Road . Brookhaven V New fork o 11719 (631)286-8668 • FAX(631)286-6314 25 Newbridge Road - Suite 304 . Hicksville • New York e 11801 hitPs:i/www.lk-rna.com RAYMOND G.DiBIASE.P.E.,PTOE,PTP.PRESIDENT and CEO Associates ROBERT A.STEELE,P.E,.EXECUTIVE VICE PRESIDENT JAMES L.DeKONING.P.E.. /ICE PRESIDENT CHRISTOPHER F.DWYER STEVEN W.EISENBERG,P.E. ANDREW B.SPEISER MATTHEW C.JEDLICKA,LEED AP KEITH J.MASSERIA.P.E. VINCENT A.CORRADO,P.E. TAMARA L.STILLMAN,P.L.S. December 29, 2022 Town of Southold Engineering Department 53095 Main Rd P.O. Box 1171 Southold, NY 11971 Attn: Michael Collins P.E, Town Engineer Re: Survey and Monuments for Mason Drive Road End in Cutchogue Proposal for Professional Surveying Services Dear Mr. Collins: Pursuant to your email dated December 19, 2022 with attached tax map (marked) and scope of services, L.K. McLean Associates (LKMA) is pleased to submit this cost estimate for professional services (Surveying) associated with the property determination and field services associated with the physical delineation of Mason Drive's east right of way (south/west terminus) in Broadwater's Cove Community(Cutchogue). Based upon your scope of services and reviewing the tax map we understand that our office is responsible for the following services; Task I- Survey ROW Four (4) hours to pickup property markers of lots in the vicinity of the road ending. Obtain any physical features located within the right-of-way. Office Surveyor to perform deed compilation required in order to identify the east side of Mason Drive's south terminus. We estimate a lump sum fee of$2,975.00 for the field &office survey services. Task II- Install two (2) monuments Install two (2) concrete monuments along the east side of Mason Drive's west/south terminus. We estimate four(2) hours of a two-man survey crew(labor)+ $40 per/monument(material cost)for a per monument cost of$490/monument set or an extended cost of$980.00. We want to thank you for giving us an opportunity to submit a proposal for the above referenced professional services. TODAY sSZWAUBNCr l.dT,oMORROW'S SOLLTT'IONS Page 1 oft Sinccj 19.50 La K. McLean Associates PC 9 Should you have any questions or comments regarding this proposal please do not hesitate in contacting me. Very truly yours, Christopher F. Dwyer, Associate L.K. McLean Associates CFD:cfd CC: LKMA Comptroller Copy LKMA Project Manager Copy Mason Drive- LKMA Proposal.doc Page 2 of 2 ACORO0 DATE(MM/DD/YYYY) `� CERTIFICATE OF LIABILITY INSURANCE 4/28/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: UNFCU Financial Services LLC d/b/a Industrial Coverage H(AIO"N Ext:631 736-7500 F,Avc No):631-736-7619 62 S Ocean Ave Ste 1 E-MAIL Patchogue NY 11772 ADDRESS: certs@industrialcoverage.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Travelers Indemnity Company 25658 INSURED LOUIKMC-01 INSURER B:Travelers Indemnity Company of America 25666 Louis K. McLean Associates Engineers&Surveyors P.C. 437 South Country Road INSURER C: Brookhaven NY 11719-9773 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2046860402 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR POLICYNUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y P6303T8314531ND22 5/1/2022 5/1/2023 EACH OCCURRENCE $1,000,000 � OCCUR DAMAGES(RENTED CLAIMS-MADE PREMISES Ea occurrence) $100,000 X Contractual Liab MED EXP(Any one person) $15,000 -PERSONAL BADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY 1 PE0 F—] LOCPRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY BA3T8337472243G 5/1/2022 5/1/2023 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIREDX NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ A X UMBRELLALIAB X OCCUR CUP3T8361592243 5/1/2022 5/1/2023 EACH OCCURRENCE $8,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $8,000,000 DED X RETENTION$1 n nnn $ WORKERS COMPENSATION PER 10TH- UTEAND EMPLOYERS'LIABILITY Y/N STATER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) All Projects Certificate holder is included as additional insured for General Liability if required by written contract in accordance with the terms and conditions of the policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Route 25 PO Box 1179 Southold NY 11791 AUTHORIZED REPRESENTATIVE USA —( ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD A�" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)a/z7/2o2z THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: ALYSON GRAZIOSI PG Genatt Group LLC PHONE FAX 3333 NEW HYDE PARK RD A/c No Ext):516-869-8788 'JC.No):516-470-0338 SUITE 409 ADDRESS: agraziosi@crpgrp.com NEW HYDE PARK NY 11042 INSURERS AFFORDING COVERAGE NAIC# INSURERA:Berkshire Hathaway Specialty Insurance Company 22276 INSURED LOUIS INSURER B: Louis K. McLean Associates Engineers& Surveyors PC INSURERC: 437 S. Country Road INSURER D: Brookhaven NY 11719 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:48994123 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR D POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE ToRENTED CLAIMS-MADE D OCCUR PREMISES(E.occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ JECT POLICY 0 PRO ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident F $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N STATUTE I ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A PROFESSIONAL LIABILITY 47-EPP-305170-05 5/1/2022 5/1/2023 EACH CLAIM $5,000,000 AGGREAGATE $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:All Projects CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Route 25 P.O. Box 1179 AUTHORIZED REPRESENTATIVE Southold NY 11791 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 01/26/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT:if the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements s. PRODUCER Keystone Risk Partners LLC CONTACT NAME: 604 East Baltimore Pike PHONE A/C No Ext):888-473-6398 FAX A/C No): Media,PA 19063 E-MAIL ADDRESS:Risk@ExtensisGroup.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: Indemnity Insurance Company of North 43575 INSURED INSURER B: Philadelphia Indemnity Insurance Company 18058 Extensis,Inc.L/C/F INSURER C: Louis K McLean Associates Engineers&Surveyors PC(Louis K McLean Associates Engineers&Surveyors PC) INSURER D: 900 US HWY 9 North,3rd Floor INSURER E: Woodbridge;NJ 07095 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSRD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY Not Applicable EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES(E.= CLAIMS MADE 1-1 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICYPROJECT LOC $ COMB AUTOMOBILE LIABILITY Not Applicable Ea acc dentSINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident X UMBRELLA LIAB X OCCUR PHUB833392 09/30/2022 09/30/2023 EACH OCCURRENCE $ 10,000,000.00 B EXCESS LIAB CLAIMS MADE AGGREGATE $ 10,000,000.00 X DED I X RETENTION $ 10,000 $ WORKERS COMPENSATION WC STATU- 0T'_ AND EMPLOYERS'LIABILITY 051424098 09/30/2022 09/30/2023 X TORY LIMITS ER A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000.00 OFFICER/MEMBER EXCLUDED? Y/N N/A [MandatoryinNH) ❑ E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 f yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks,Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION 206744 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Southland ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Route 25 PO Box 1179 AUTHORIZED REPRESENTATIVE Southold,NY 11791 Jay Peichel ' ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD