Loading...
HomeMy WebLinkAboutLIRR RESOLUTION 2023-205. ADOPTED DOC ID: 18918 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2023-205 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON FEBRUARY 14,2023: WHEREAS,the Town Board of the Town of Southold has determined it necessary to demolish three (3) buildings and a concrete silo at the parcel known as Sills Farm Property located at 70282 Main Road, Greenport,New York (SCTM# 1000-045.00-05.00-004.000); WHEREAS, in order to take such action,the Town Board has been advised that it will be necessary to enter upon and cross over lands owned by the Long Island Rail Road; and WHEREAS,the Long Island Rail Road is willing to grant a non-exclusive, revocable Entry Permit to the Town of Southold, its officers, employees, agents, contractors, subcontractors and consultants, to enter onto the property of the Long Island Rail Road for the purpose of performing the scope of work at the location described, under certain written terns and conditions; and be it finther, RESOLVED,that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott Russell to execute said non-exclusive,revocable Entry Permit Agreement, dated January 23, 2023 between the'Town of Southold and Long Island Rail Road, subject to the approval of the Town Attorney. Denis Nonearrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] ]MOVER: Louisa P. Evans, Justice SECONDER:Brian O.Mealy, Councilman AYES: Nappa,Doroski,Mealy, Doherty, Evans,Russell 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 RE To: Denis Noncarrow, Town Clerk CEIVED From: Missy Mirabelli F E 8 2 7 2023 Secretary to the Town Attorney Date: February 24, 2023 ` uthold Town, C°3P-rk Subject: Entry Permit URR 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: Michael Collins- Engineering i Long Island Rail Road January 23,2023 Town of Southold 53095 Main Road Southold,NY 11971 A'TTN: Scott Russell,Town Supervisor Subject: kl'-1444—Entry Permit to enter upon Long Island Rail Road (LIRR) property for the purpose of demolishing three buildings and a concrete silo located at the Sills Farm Property at 70282 Main Road in Greenport. To Whom It May Concern: D,ie,to',t17e COVID-19aeniergericy;;the.palties'are:agrpeing;ahattttiis.Ag�,eement,may-be,e ecuted and deiiveredbj,any party;by deliveryyof a;,fac"simtie ar other electronic signature or by electronic mai ljrn-portalile°document,faiil at?,(;pdf};;wliicli"sibh nature shall haveitesaine force°aiid effect:as an griginal"wet'ink"`sigriatur'e and which dehyer 'shall constitute effective del the eof til' such t ..>.;. ,.. . tin eas the.pariies are ableao and=do deliver"wet ink'=oiiginal'signatu a pages.Anylpa"t .which ,�..: y b s'4, acsimile del veror pdf s gnatureasliall: promptlyaahereafter (taking into corisider'ation:ahe COVIDr1 ;emergencjr);deliver ab originally executed;,sign9ture`td hl ,:other,party(ies);;pio;�ided; howeve;;that the failure to i3elver"an original signature'page�shall notaffect,,th�validi}i{J/'of ally si iiafure�'deliveredttor<facsimite 'LJ on;t, _,. ;subse went_'=delive ` 'Ii' "eactiY" arty .of the -.. .: .,.,.., r., ; originally,executed:lsigiiatu"r`es such hardscopy,.;ori�gals:sha11=:6e treated 3as.;ttie' origiiiais.in iepl'aceiii-hVfbr the..`elect'rori Cally signed2and delivered counterparts`' The Long Island Rail Road(Railroad) is willing to grant a non-exclusive,revocable Entry Permit (the "Entry Permit") to Town of Southold ("Permittee"), its officers, employees, agents, contractors, subcontractors and consultants (collectively "Permittee Parties") to enter onto the property of the Railroad for the purpose of performing the work("Work") described in the Scope of Work (attached hereto and made a part of this Entry Permit) at the above captioned location. The terms and conditions of the Entry Permit are as follows: 1. If Permittee determines to do additional work above and beyond the Work described herein, or that it requires entry upon,access to or fouling of the elevated Railroad ROW or any other property of Railroad, it shall notify and make application to the Chief Engineer of the Railroad,who must approve,in writing,the time,place and manner of such additional work or such entry before Permittee may commence such additional work or make such entry. 2. Any Work shall be conducted in such manner and at such time, so that it shall in no way interfere with the traffic of the Railroad. Permittee shall, at all times, comply with the instructions of Railroad personnel at the site. 3. Upon execution of this Entry Permit,Permittee will pay Railroad a permit fee of$2,000(made payable to "The Long Island Rail Road Company" at the address listed below) as compensation for the preparation and issuance of this Permit,and any approved right of entry to Railroad property at the subject location,in connection with the work that is the subject of this Permit. MTA Long Island Railroad Mr.Michael Reilly,Controller 146-01 Archer Avenue Jamaica,NY 11435 4. Permittee shall reimburse the Railroad for all costs of any kind whatsoever; which.Railroad may incur in connection with Permittee's Permittee activities which are the subject of this Permit. Such costs may include (but not necessarily be limited to) engineering cost (both field and office)and the cost of providing inspectors,watchmen,flagmen and/or trainmen for the protection of Permittee. Cost means all direct labor, materials and equipment costs, plus such percentage thereof as represents the Railroad's overhead costs at the time the work is performed.A rough order of magnitude (ROM) estimate of such costs (hereafter referred to as "LIRR Force Account Costs")is provided as follows: Daily Rate: $ 6,158.00 Mark-out(if required): $10,579.00 ** * Daily Rate includes Transportation Department costs for flagmen and Engineering Department support costs. It should be noted, however,that the daily rate includes overtime rates for various departments. Due to limited staffing and/or contractual agreements, some of this work would be identified as overtime on the LIRR invoice. ** Mark-outs by the Power, Signal, Communications and Structures Departments will be required when the scope of work covered by this Entry Permit shall consist of any form of excavation within the limits of the LIRR ROW and within six(6) feet of the LIRR ROW. Mark-outs performed by the LIRR are valid for a two-week period. If the Permittee's work does not commence within that two-week period, an additional set of mark-outs shall be required,at the Permittee's expense.Prior to Permittee's scheduled start date,Permittee shall provide a two-week notice to the LIRR Project Engineer assigned to this Entry Permit,so that the LIRR Project Engineer can request the mark-outs,if required. It is understood that the ROM estimate of LIRR Force Account Costs to support Permittee's work,as the same may be updated from time to time, is subject to change based on the scope and nature of the work actually performed, and/or costs incurred by Railroad. Permittee's obligation to pay or reimburse Railroad for LIRR Force Account Costs shall not be affected by the estimation process, including Railroad's failure to identify or otherwise accurately estimate any such costs and expenses. 5. The Permittee shall notify the Railroad or its designee,Chief Engineer,at least two weeks in advance before entering upon or starting any work upon the property and keep the Railroad or said designee fully advised of all activities. No entry or use of the property will be permitted until this permit is fully executed and Permittee shall have received Railroad's approval for specific entry. 6. if flagmen have been ordered through the Project Engineer,cancellations must occur no later than 12:00 pm the day prior to the flagman reporting for duty. The request to cancel flagmen must be made through the Project Engineer. For flagging assignments cancelled after 12:00 pm, the contractor will be responsible to compensate the LIRR in full,for the cost of the flagmen ordered. 7. Periodically,during the term of this Entry Permit,Railroad shall render to Permittee a detailed statement of the costs incurred by Railroad, with respect to Permittee's activities during the term of this Entry Permit. Permittee's obligation to reimburse Railroad shall survive the expiration or.termination of this agreement.Permittee shall reimburse Railroad for these costs within thirty(30)days of receipt of the statement. 8. To the fullest extent permitted by law, the Permittee shall defend, indemnify and hold harmless the Metropolitan Transportation Authority(MTA)and the Railroad,their respective officers, agents and employees from any and all claims, suits, loss or liability, including reasonable attorneys' fees and disbursements, on account of injury or death of any person(s) whatsoever (including, but not limited to, Permittee and employees of Railroad, MTA or Permittee)or damage to any property owned by or in the care,custody or control of Railroad, MTA or Permittee arising in whole or in part, directly or indirectly, by reason of or in connection with the activities of Permittee Parties hereunder or presence of the Permittee Parties, or equipment on or about the premises of the Railroad,regardless of whether or not such personal injury, death or property damage is caused in whole or in part, directly or indirectly, by any fault, failure or negligence of Pennittee, Railroad or MTA, or their respective officers, agents,employees or otherwise. 9. Permittee shall not cause or permit any Hazardous Substance to be used,stored,generated,or disposed of on or in the property of the Railroad by Permittee,or its officers,employees,and contractors,without first obtaining Railroad's prior written consent,which may be withheld at Railroad's sole and absolute discretion. In addition, if Permittee uses, stores, generates, treats, or disposes of any Hazardous Substance, or permits the presence of any Hazardous Substance not already present on the property of the Railroad and such actions result in contamination,Permittee shall promptly,at its sole expense,take any and all necessary action to return the property of the Railroad to the condition existing before the presence of any such Hazardous Substances on the property of the Railroad;provided,however,that Permittee shall first obtain Railroad's approval for any such remedial action."Hazardous Substances,"for the purpose of this Agreement is defined by Chapter 4 Part 371 of the Department of Environmental Conservation's Regulations. Under no circumstances shall Permittee's obligation to perform any remediation include remediation of Hazardous Substances already existing on the Railroad property prior to the performance of the Work, except to the extent that such remediation is required as a result of Permittee's activities at the site. 10. This Entry Permit is not assignable and the rights and privileges herein granted shall extend solely to Permittee and agents of Permittee (e.g. contractors, etc.) while performing work hereunder or on or about the Railroad's property. 11. This Entry Permit shall expire upon the earlier of A.) the completion of the work, or B.) October 27,2023. LIRR reserves the right to terminate this Entry Permit at its sole discretion by giving Permittee notice in writing of its intention to so terminate this Entry Permit,which notice shall specify the effective date of the termination. 12. Insurance SECTION A. INSURANCE REQUIREMENTS The Permittee,at its sole cost and expense,shall obtain and'Maintain at al l times during the term of this agreement such policies of insurance as set forth below: i. Workers' Compensation Insurance as required by statute in the State in which the work will be performed. Employer's Liability Insurance with limits of not less than $1,000,000 bodily injury per accident; $1,000,000 bodily injury per disease; and $1,000,000 annual aggregate. For work conducted outside the State of New York, Employer's Liability Insurance requires limits of not less than$2,000,000 bodily injury per accident;$2,000,000 bodily injury per disease;and$2,000,000 annual aggregate and must provide proof that its Workers' Compensation Insurance policy has been endorsed to include"Other States Coverage." If Permittee leases one or more employees through the use of a payroll, employee management, or other similar company, then Permittee must procure worker's compensation insurance written on an "if any" policy form, including an endorsement providing coverage for alternate employer/leased employee liability. I Commercial General Liability(11CGL11)Insurance covering claims for personal and advertising injury, bodily injury (including death) and property damage arising out of the Work and in a form providing coverage no less broad than that of the current ISO Commercial General Liability Insurance policy(Occurrence Form,number CG 00 01). Such insurance shall provide coverage for all operations including the products- completed operations hazard and shall be maintained for a period of at least three (3) years after final completion,subject to the limitation of any applicable statute. The limits of such insurance shall renew annually and not be less than$2,000,000 each occurrence; $4,000,000 products and completed operations aggregate; and $4,000,000 per project general aggregate.This requirement may be satisfied by a combination of a primary CGL policy coverage with limits of not less than$1,000,000 per occurrence and follow-farm Excess or Umbrella liability insurance policy(ies) which equal the total limits required above and for excess or umbrella liability insurance in item `iv' below. The CGL and excess or umbrella liability insurance policies must be written on an occurrence basis form,and must comply with the following provisions: • The policy shall include independent contractor and contractual liability coverages • The policy shall not contain any contractual exclusion relative to Labor Laws or any other exclusions or limitations directed toward any types of projects,materials or processes involved in the Work • The policy shall not contain any of the following exclusions: subcontractor's exclusion; construction defect exclusion; leased worker exclusion; cross liability exclusion; crane exclusion; and demolition exclusion or"explosion, collapse and underground"exclusion. • Construction work taking place within 50 feet of a railroad must include: - Contractual Liability—Railroads CG 24 17 listing the Scheduled Railroad and Designated Job Site. - Coverage for claims for bodily injury asserted by a railroad employee of an additional insured and any Employer's Liability Exclusion which may otherwise operate to exclude such coverage shall be removed. iii. Business Automobile Liability Insurance covering any owned,non-owned,and hired vehicles on and off-site for claims arising out of the ownership,maintenance or use of any such vehicle.Such insurance shall provide coverage at least as broad as the standard ISO Comprehensive Automobile Liability policy(CA 00 01,CA 00 05,CA 00 12, CA 0020), with limits not less than $2,000,000. If the Work involves transportation of hazardous or regulated substances, hazardous or regulated wastes and/or hazardous or regulated materials, Permittee shall provide pollution auto coverage equivalent to that provided under the ISO pollution liability-broadened coverage for covered autos endorsement (CA 99 48), and the Motor Carrier Act endorsement (MCS 90). Any statutorily required"No-Fault" benefits and uninsured/underinsured motorist coverage shall be included. iv. Umbrella/Excess Liability Insurance,with limits of not less than$3,000,000 written on an occurrence basis in excess of the limits indicated for Commercial General Liability, Employer's Liability, and Business Automobile Liability Insurance which is at least as broad as each underlying policies.The umbrella/excess liability policies shall be written on a "drop-down" and "follow form" basis, with only such exceptions expressly approved in writing by Permittor/MTA. v. Railroad Protective Liability Insurance(ISO/RIMA CG 0035 or equivalent form),if any Work will be taking place within 50 feet of a railroad, subway or similar tracked conveyance or requires flag or protective measures by the Permittor/MTA or its affiliates or their respective employees, covering the work to be performed at the designated job site and affording protection for damages arising out of bodily injury or death,physical damage to or destruction of property, including damage to the Insured's own property and conforming to the following: • The policy shall name as"Named Insureds"each of the Indemnified Parties listed under Section D. • The limit of liability shall be not less than$2,000,000 per occurrence,subject to a $6,000,000 annual aggregate; • Policy must be endorsed to provide coverage for claims arising from injury to employees covered by Federal Employer's Liability Act(FELA),when applicable. • Indicate the Name and address of the designated Permittee, project location and description of work,and permit number if applicable. A. Contractor's Pollution Liability Insurance (if disposal of hazardous materials from the designated job site is undertaken or if the Work being performed in the Impact Area involves environmental orpollution exposures) with limits not less than$2,000,000 per occurrence and general aggregate on a per project basis including completed operations coverage to be maintained for at least three (3) years after final completion of the work. Policy shall cover environmental damage resulting.from pollution conditions that arise from the operations of the Permittee/Contractor,as applicable,and described under the scope of services of this contract. Coverage must apply to sudden and non-sudden pollution conditions including the discharge, dispersal, release or escape of smoke, vapors, soot, fumes, acids, alkalis, toxic chemicals, liquids or gases,waste materials or other irritants, contaminants or pollutants, silt or sediment into or upon land, the atmosphere or any watercourse or body of water, provided such conditions are not naturally present in the environment in the concentration or amounts discovered,unless such natural condition(s) are released or dispersed as a result of the performance of Covered Operations. Such insurance shall include but not be limited to: • Bodily injury,sickness,disease,mental anguish or shock sustained by any person, including death;medical monitoring s Physical injury to or destruction of tangible property of parties other than the Insured including the resulting loss of use and diminution in value thereof;Loss of use, but not diminution in value, of tangible property of parties other than the Insured that has not been physically injured or destroyed • Natural Resource Damages; • Cleanup Costs P Transportation and Non-Owned Disposal Site coverage (with no sunset clause/restricted coverage term) if the Requesting Party or the Project Contractor is disposing of contaminated material(s) • No exclusions for asbestos,lead paint, silica or mold/fungus/legionella • Defense including costs, charges and expenses incurred in the investigation, adjustment or defense of claims for such compensatory damages SECTION B. GENERAL.INSURANCE REQUIREMENTS The following requirements are applicable to all insurance coverages required under this agreement,except to the extent otherwise indicated. i. Insurer Requirements. All policies of insurance shall be placed with insurers acceptable to Permittor/MTA. The insurance underwriter(s) must be duly licensed or approved Surplus Lines insurer to do business in the state where the Work is to be performed and must have a financial ratings of A-/VII or better in the most recent edition of Best's Key Rating Guide or otherwise satisfactory to Permittor/MTA. ii. Insurance Policies.The Perinittee sliall furnish cel tified copies of all insurance policies required to be maintained under this agreement within ten (10) business days after receiving Permittor/MTA's request. iii. Breadth of Coverage. All policies (except for Workers' Compensation and Professional Liability, unless otherwise noted)shall provide coverage to the Additional Insureds,as defined below,that is at least as broad as that provided to the first named insured to each policy. In the event that any policy provided in compliance with this agreement states that the coverage provided to an additional insured shall be no broader than that required by agreement,or words of similar meaning,the parties agree that nothing in this agreement is intended to restrict or limit the breadth of such coverage. The limits of insurance stated for each type of insurance are minimum limits only. If the Permittee's policy provides greater limits, then the Additional Insureds shall be entitled to,or to share in,the full limits of such policy,and this agreement shall be deemed to require such full limits. iv. Right to Request Additional Insurance. Permittee further agrees to provide, at Permittee's sole cost and expense,such increased or expanded insurance coverage as Permittor/MTA may from time to time as deem reasonable and appropriate. V. Additional Insureds. All insurance required (except Workers' Compensation and Professional liability or otherwise noted), shall name the parties listed in Section D as Additional Insureds, and shall include their respective subsidiary and affiliated companies, and their Boards of Directors, officers, employees, representatives, and agents (hereinafter, collectively the "Additional Insureds"). For the Commercial General Liability insurance,additional insured coverage must be provided on ISO form or its equivalent at least as broad as CG 20 26.No other endorsement will be accepted unless approved by the Permittor/MTA. vi. Primary and Non-Contributory. Each policy required, including primary, excess, and/or umbrella, shall provide that the insurance provided to the Additional Insureds is primary and non-contributory,such that no other insurance or self-insured retention carried or held by Permittor/MTA shall be called upon to contribute to a loss covered by insurance for the named insured. vii. Waiver of Subrogation.To the fullest extent permitted by law,Permittee will require all insurance policies required to include clauses stating each insurer will waive all rights of recovery.All waivers provided herein shall be effective as to any individual or entity even if such individual or entity (a) would otherwise have a duty of indemnification, contractual or otherwise, or (b) did not pay the insurance premium directly or indirectly, and whether or not such individual or entity has an insurable interest in any property damaged. viii. Self-Insured Retentions.None of the insurance required shall be subject to any self- insured retention greater than$500,000 without Permittor/MTA's written approval. ix. Subcontract Agreements. Permittee shall by appropriate written agreements flow down the requirements for i)the waiver of subrogation ii)additional insured coverage and iii)other requirements of this Section to all tiers of subcontractors,for all insurance required of such subcontractors by Permittee for the Work. X. No Limitation.Nothing in the Insurance Requirements shall be construed as limiting in any way the extentto which Permittee may be held responsible for payment of damages resulting from their operations. Permittee's obligations to procure insurance are separate and independent of and shall not limit Permittee's contractual indemnity and defense obligations. Permittor/MTA does not represent that coverages and limits required in this agreement will necessarily be adequate to protect Permittee. xi. Notice of Cancellation or Nan-Renewal. The Permittee agrees to notify Permittor/MTA thirty days prior to any cancellation, non-renewal or change to any insurance policies required.Notice shall be sent electronically to the `rlmignaeel email artdi-,ess'provided.to.Permittee via MTA Certificate of Insurance Management System (CIIWIS),Compliatlz� xii. Notice of Occurrence.The Permittee shall file the following with the Long Island Rail Road Claims Department,Attention: Director of Claims(with a copy to the Engineer), 93-02 Sutphin Blvd—4"Fl,Jamaica,NY 11435 :(1)a notice of any occurrence likely to result in a claim against the LIRR, which shall be filed immediately; and (2) a detailed,sworn proof of interest and loss, which shall be filed within sixty (60)days from the date of loss. xiii. Insurance Not in Effect.If,at any time during the period of this Agreement,insurance as required is not in effect, or proof thereof is not provided to the Permittor, the Permittor shall have the options to:(i)direct the Permittee to suspend work or operation with no additional cost or extension of time due on account thereof; or(ii)treat such failure as an Event of Default. xiv. Conformance to Law. If applicable law limits the enforceability of any of the foregoing requirements,then Permittee shall be required to comply with the foregoing requirements to the fullest extent of coverage and limits allowed by applicable law and the provisions of insurance shall be limited only to the extent required to conform to applicable law. SECTION C. EVIDENCE OFINSURANCE 1. Insurance Submission. The Permittee must submit initial evidence of all required insurance to: Agency Name: MTA Long Island Railroad Agency Address: Hillside Maintenance Facility 93-59 1831 Street,Dept.3146 Hollis,NY 11423 Attention: Joseph Holzapfel,Manager—Engineering Compliance Email Address: iltolZ4t.1 fitT.or14­. 2. Insurance Compliance.After the Permittee's insurance has been approved,a"compliant message"will be sent to the Permittee via the MTA Certificate of Insurance Management System (CIMS),the Complianz:rm. This message will also include a"designated" email address for submission of all insurancerenewals,specific to this agreement.The Permittee shall endeavor to provide renewal or replacement policies of insurance two(2)weeks from the policy expiration date with terms and conditions no less favorable than expiring. 3. Insurance Confirmation. Permittor/MTA's acceptance of any certificate of insurance evidencing the required coverages and limits does not constitute approval or agreement by Permittor/MTA that the insurance requirements have been met or that the insurance policies shown in the certificate of insurance are compliant with these requirements.Failure of the Permittor/MTA to demand such certificates of insurance or other evidence of full compliance with these insurance requirements, or failure of Permittor/MTA to identify a deficiency from evidence provided, will not be construed as a waiver of the Permittee's obligation to maintain such insurance. 4. Non-Compliant Insurance. Permittor/MTA has the right, but not the obligation, of prohibiting the Permittee from entering the Permittor/MTA Property until Permittor/MTA receives all certificates of insurance or other evidence that insurance is compliant. 5. Proof of Insurance: a. Acceptable Forms • ACORD 25: Certificate of Insurance: • ACORD 855:NY Construction Certificate of Liability Addendum • ACORD 28: Certificate of Commercial Property Insurance • ACORD Binder or Insurance Policy • Workers' Compensation(alternative forms): o C-105.2:Certificate of Workers' Compensation Insurance; or o U-26.3:Certificate of Workers' Compensation from the State Insurance Fund; or o GSI-105/SI-12—Certificate of Workers' Compensation Self Insurance; or o CE-200 — Attestation of Exemption when.Contractor meets the requirements (e.g.)Sole Proprietor b. Certificate of Insurance-The following minimum details must be referenced on the certificate: • Policy coverage details (e.g.) policy term, per occurrence/per project; limits/sub- limits, aggregate limits, deductibles, self-insured retentions, insurance carrier name and corresponding NAIC# • Contract Identifier(e.g.)Contract#,RFP#,or Entry Permit# • Location and Description of Work • Additional Insureds listed in Section D including primary and noncontributory coverage and waiver of subrogation in favor of Permittor/MTA • Certificate Holder must list Permittor/MTA • Certificate of Insurance must be signed by an authorized insurance representative c. Endorsements(where applicable): • General Liability Additional Insured(CG 20 26) • General Liability-Primary and Non-Contributory CG 2001 or equivalent • General Liability-Per Project Aggregate(CG 25 03 or equivalent) • Business Automobile Liability-Additional Insured,MCS 90 and CA 99 48 • Contractor's Pollution Liability-Additional Insured,Non-Owned Disposal Site and Transportation Coverage • Waiver of Subrogation(most recent NCCI/ISO or equivalent as applicable) • Primary and Non-Contributory d. Insurance Binder/Policy(Applicable to Railroad Protective Liability and Builder's RisklInstallation Floater) An insurance binder must include the following minimum details: • Policy coverages and details(e.g.)policy term,limits/sub-limits,aggregate limits, deductibles,self-insured retentions,insurance carrier name and applicable NAIC • Contract number or entry permit number; designated contractor; location and description of Work • Indemnified Parties listed must be listed as Named Insureds. • Binder must be issued and signed by the authorized insurance company or their authorized insurance agent • Binder may be accepted pending issuance of the policy. Policy must be submitted within 30 days from binder effective date. e. Joint Venture: Evidence of General Liability and Umbrella/Excess Liability insurance must be submitted in the name of the Joint Venture.Alternatively,each Joint Venture Party may submit separate insurance covering the Joint Venture as a Named Insured. SECTION D. ADDITIONAL INSUREDS/INDEMNIFIED PARTIES (By Location of Work) ® All LIRR Agreements: Long Island Rail Road (LIRR), MTA Grand Central Madison Concourse Operating Company (GCMCOC), Metropolitan Transportation Authority (MTA) and its subsidiaries and affiliates and New York & Atlantic Railway Company (when applicable) Anacostia Rail Holdings and the respective affiliates and subsidiaries existing currently or in the future of and successors to each Indemnified Parties listed herein. ❑ Penn Station: Long Island Rail Road (LIRR), MTA Grand Central Madison Concourse Operating Company (GCMCOC), MTA Grand Central Madison Concourse Operating Company(GCMCOC),Metropolitan Transportation Authority(MTA)and its subsidiaries and affiliates and New York&Atlantic Railway Company (when applicable) Anacostia Rail Holdings and the respective affiliates and subsidiaries existing currently or in the future of and successors to each Indemnified Parties listed herein, National Railroad Passenger Corp.(Amtrak),NJ Transit Corporation,and NJ Transit Rail Operations,Inc. ❑ West Side Yard:Long Island Rail Road(LIRR),MTA Grand Central Madison Concourse Operating Company (GCMCOC), Metropolitan Transportation Authority (MTA) and its subsidiaries and affiliates and New York&Atlantic Railway Company(when applicable) Anacostia Rail Holdings and the respective affiliates and subsidiaries existing currently or in the future of and successors to each Indemnified Parties listed herein,National Railroad Passenger Corp. (Amtrak), NJ Transit Corporation, NJ Transit Rail Operations, Inc., Consolidated Rail Corporation and CSX Transportation Inc. and Triborough Bridge & Tunnel Authority(B&T). ❑ Sunnyside Yard:Long Island Rail Road(LIRR),MTA Grand Central Madison Concourse Operating Company (GCMCOC), Metropolitan Transportation Authority (MTA) and its subsidiaries and affiliates and New York&Atlantic Railway Company(when applicable) Anacostia Rail Holdings and the respective affiliates and subsidiaries existing currently or in the future of and successors to each Indemnified Parties listed herein,National Railroad Passenger Corp. (Amtrak), NJ Transit Corporation, NJ Transit Rail Operations, Inc. and New York&Atlantic Railway Company(when applicable). ❑ Jamaica Station:Long Island Rail Road(LIRR),MTA Grand Central Madison Concourse Operating Company (GCMCOC), Metropolitan Transportation Authority (MTA) and its subsidiaries and affiliates and New York&Atlantic Railway Company(when applicable) Anacostia Rail Holdings and the respective affiliates and subsidiaries existing currently or in the future of and successors to each Indemnified Parties listed herein,and Port Authority of NY&NJ. ❑ Other: 13. In the event any article,section,subarticle, paragraph,sentence,clause or phrase contained in this Entry Permit shall be determined,declared or adjudged invalid,illegal,unconstitutional or otherwise unenforceable, such determination, declaration, or adjudication shall in no manner affect the other articles,sections,subarticles,paragraphs, sentences, clauses or phrases of this Entry Permits, which shall remain in full force and effect as if the article, section, subarticle, paragraph, sentence, clause or phrase declared, determined or adjudged invalid, illegal, unconstitutional or otherwise unenforceable was not originally a part thereof. Please find the proposed Entry Permit in duplicate, and arrange for both of the agreements to be signed by the appropriate officer of your Company,and return both copies to my attention. Upon receipt of the signed agreements, the permit fee and Insurance approval from the MTA- Risk & Insurance Management (see Step 3 of the LIRR Entry Permit Guidelines), we will affect execution on behalf of the Railroad,and a fully executed agreement will be returned to you. Thank you for your cooperation. Sincerely, Joseph Holzapfel Manager-Engineering Compliance ACCEPTED and AGREED: Town of Southold 53095 Main Road Southold,NY 11971 BYE Date: .21�t0 Scott Riissel ,Town Supervisor D.Varley (MC 3143) D.Olson (MC 3143) M.Reilly (MC 1955) S.Chandra (MC 3146) J.Serina (MC 3146) U.Arteaga (MC 3143) D.Holley .(2 Broadway—21St Floor—Manhattan-MTA Pouch) File MUM,` A ' - - , ° L. K McLean Associates, P..C. 4'+ 437 South Country Road Brookhaven New York 11719 (631)286-8668 - FAX(631)256-6314 25 Newbridge Road • Suite 212 • Hicksville • New Fork • 11801 https://www.lkma.com RAYMOND G.DIBIASE,P,.E.,PTOE,PTP,PRESIDENT and CEO Associates ROBERT A,STEELE,P,E.,EXECUTIVE VICE PRESIDENT CHRISTOPHER F.DWYER JAMES L DeKONING,P-E.,VICE PRESIDENT 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. October 26,2022 Long Island Rail Road,Hillside Maintenance Complex 93-59 183'Street,Department 3146 Hollis,New York 11423 Attn: Joseph Holzapfel,Manager—Engineering Compliance—Engineering Department Re: Town of Southold:Sills Farm Buildings(3) & Concrete Silo Demolition Letter Obtaining Approval for a LIRR Entry Permit LKMA No.22162.000 Dear Mr.Holzapfel: In accordance with your agency's guidelines for obtaining a LIRR entry permit on behalf of the Town of Southold Engineering Department, L.K. McLean Associates PC has prepared this cover letter providing the information requested by your office; 1) Agent for Project: L.K.McLean Associates PC 437 South Country Road Brookhaven,NY 11719 Principal of Company:Robert A.Steele PE,Executive Vice President Contact Person:Christopher F.Dwyer,Associate(516)779-4776 e ei`�glkma:doin 2) Project Sponsor(authority for whom work is being performed): Town of Southold Engineering Department 53095 Main Road Southold,NY 11971 Contact Person: Michael Collins PE;Southold Town Engineer 631-765-1560 .Itticliae:l:e;oftins.��to�tn.sottthol`d.ny:us 3) Construction Contract#:TBD upon Municipal Bid Phase,LKIv1A Project#:22162.000 4) Full Description of Work: The Town of Southold would like to demolish three (3) dilapidated buildings and a concrete silo Iocated at the SiII's Farm Property at 70282 Main Road in Greenport, NY (across from the intersection of Main Road (NY-25) & Chapel Lane. The structures are located east of the railroad tracks that run through the property. In order to complete the demolition project,an access plan must be prepared for and approved by the Long Island Rail Road to ensure that the tracks are protected during the course of the project and that demolition operations do not interfere with the operation of the trains. c: r U,,: 1=,r 803LUTIONS _ _ .. r,:•: �ir�ce 1. 5 - Tan-i '�s��l:��,�,�1� ., �--T����,�,��� •*x r �.„ s* �.0 1 , Z,l. 3 t o :� " �� � ,»_�T �� <a• est +M��, ." �r�hw���+ � � *.�'r � *• * ,Yw•r '�iix, fir. '«. z'a..,7w• ��. • � � *• #�wt. 40 f 4 Mr 'WlWdry] '-•ts • •, 3 $".Y SITE Lw. yx,,.Y�a .�• � _ ' aW, "d , '�W ''�x„';y'x,jrM. � •} '+{' r s..� - x. .. .•"u'. � .y r ice`", >r yy y." y� • •�' � ,�� ." �� .� � '� � . .,�. "may' ,j. • _w� r.lf # is s+ A.N w 'r {+ ,.+•r" - �;p4'k'"rk�, y+l'.. •' +. ' M y�-r •wsA".��`w '4 � µ...' y ,J{ bSTs+ w il w"'t•-t'",y""�"�.vw:rt`�, •�Y�`'��� �"s�'��.y7P'N" �.� �y'r�,:wk�� ''X..^���''�'„r�� �°��' d • L. K. t�lc�ear$ A"�s�ciates, P C. 6) The Town of Southold and LKMA estimates that the project will take approximately 10 to 12 weeks to properly demolish the structures. The construction activity will include but not be limited to the following; 1) Site Mobilization, 2) Erosion & Sediment Control Measures, 3) Site & Access Preparation, 4) Demolition of Structures, 5). Loading of Demolition Material, 6) Off Site Transportation & Disposal of Demolition Material, 7) Environmental Controls and 8) Site Restoration & De-Mobilizition. All work would be conducted between the hours of 7:OOAM and 4:OOPM(Monday through Friday). Our office appreciates the guidance your office has provided in preparing this request for a Long Island Rail Road Entry Permit. If you should have any questions relative to this request/submission please do not hesitate to contact this office directly. Very truly yours, CFD:cfd Christopher F.Dwyer Associate Enc.(1)Demolition&Removal Plan Cc: Michael Collins PE,Southold Town Engineer w/enc. LKMA File w/enc. Cover setter-URR Entry Permit_Silts Farm Structure Demolition 'z rro Yl Lg :J7 W �x �yr -t"T' v% Z_0 e; �ell�il APPROY, 3a d '9 5�k A&;7 ? M r 'y 'Y- LOCATION MAP g4 scm W"'t ".t�. P .}Znrilir'° e'�*:•}�'�}•�' ''' h +;$ • k ,.Wl �lj too �`;,`".;« +:i .`.}+" �IX�. t .:,w 4.':Ae�'N.4,:�,� amkA:' <4, 'X ��. .:�,r qy;.�.,. �?-CY�+- 'P' r�4° •' h "5T r.S 'Oki, -"4_� �V�r;4'x� Rli�l 'z_ m*s- WN S SITE PLAN SILLS FAR44 DEMOLITION S—E!­W IT ,77 jP, SITE ACCESS PLkN McLEAN ASSOCIATES, An. .F�/CFD A$Vl�!ED RW Guidelines for Obtaining a LIRR Entry Permit Step 1: Is this an_LIRR Pir6iect: If no,Peocecd to Step 2 If Yes,:Contik LIRR Project Manager Step 2: Rcgaest f6t Entry P&mit: Contact: Mr.Joseph Holzapfel Tele: (347)494-6487 Manager-Engineering Compliance,Engineering Dept. Email:jholzap@lirr.org Long Island Rail Road,Hillside Maintenance Complex 93-59 183rd Street,Dept.3146 Hollis,NY 11423 Provide: 1) On`Cgm >any,letterhead;:CoinpanyName;, dciress,Principal of Company(President or VP),Contact I'ersiiii's ne;-Title,&Telep one, address, Auihor!tyy'forvvhom the work,ts being performed(NYC or NYS DOT,County,Utility Company,etc.),if ap.plicable,: 3 Contract Number-:assigned byfftic aGope Authority,for flre:wotk to be performed, :4� F tiil::Descript'ran of i�a`rk'(detailed sro.p ;of work),aii lgcatiori of'i#here414;;wi11 be performed(street aaar�ss; Cr[iSS streets;,t(7�vn,couniy;etc) 5). 1 dclifioiiiil ii%formatioiY tliat..tny clai .Cy.tlie:vt©eking limits and any interference to LIRR operation(i.e. drawings,surveys;:cranecalculatiQns;_etc:) .. ) Amoiiiati oftiirie:iiecessazy to complefe tlie,work and anticipated period of performance. After reviewing.th Enir."y­Pbi i .tt request.1submitt4l pacicage.for.colilo.leteness,a copy of the ARREntry Permit wi11,be prepared,-scaiuied and fbhgaTdddAo th6t6que"stor for signature.Upbri receipts the requestor must revie�v; ;sign,sc:Irii.and return.the permit and.all;.requxrecl insurance documents,to the Manager-Engineering Coiiipliance. Step 3: Initial Insurance Review: Upou.receipf; riAiieiv;,.aiid,apptoval ofall insurance docunlents,by the,-1!+1:111 Risk &.insuraance-Management Dci�vi trriert#;tlte;M lagger Fngin&e sng;Com�P-16 e will contact tlic. IRR Ctiiitinllers r6gardi'r4;1he receipt status of the arrtry.Pern it Fee.iiomthe requestor. Step 4 Entry Rtrs'nitFee Upon corifirn ation from the LIRRC-biArdllers Office- that the Entry Permit.. Fee has been' received from the requpgor,,the Manager-Engineering Compl ianee will execute and forward a copy of_the executed agreement to the requestor,and the requestor shall proceed to Step 5 Step 6: 11;W .Civil Desibri&,Uspeoti6n Contact: Mr.Ulises Arteaga,PE Tele:(718)558-3351 LIRR Civil Design&Inspection Fax:(718)558-3298 Engineer of Structures-Civil Inspection,Engineering Department Email:uarteag@lirr.org Long Island Rail Road,Hillside Support Facility 93-59 183rd Street,Dept.3143,Hollis,NY 11423 Provide: 1) A Eiitry:wmiit(signed 'by LIRR:apd,,requestor) 2) Orf.1hrd�;16 al:.signd..coppies of l vidence of lnsurance-.submitted:in the groper format 3 Ife ,°rt'ri trt Step:2 Uiicin ieiet of.all:documents;ani!cib`tainirig:appr'opriate.conCiiiiation frori.MTARIM that`all iriscirrtiices Piave beecr:rev,iewed randapprgved,antitlkat the larit�Perttrit agxee�netit lzas liecu frilly.exec�tted;:�l field Inspector 4�±i11' be assigni 4 to coordinate activities nssoci tecl;wiih:d�e project;sucli:as arrangiiag,for.appcojiriaie flag.protecCion, R WP'Training anrequestfor mark�oiit of:LI1iR assets. *It should be noted that the requestor must not;alterthe documents or take exception to the ORR.Entry PermitTerms and Conditions.Failure-to follow th"e Guidelines described hereinmay result in the cancellation of ttie;6htiy l'ermitAgreement. Long Island Rail Road GENERAL REQUIREMENTS FOR PROJECTS ADJACENT TO LIRR PROPERTY WITH POTENTIAL TO IMPACT LIRR SAFETY AND OPERATIONS • Attached are "General Requirements for Outside Contractors Working on LIRR Property". These requirements apply to this project. Entry Permit requires an outside agency or contractor to reimburse the LIRR for all project costs (i.e. Flag Protection, Project engineers, Inspectors, etc.) • Shop drawings and calculations detailing sheeting must be submitted prior to excavation, which may impact the stability of adjacent embankment supporting our tracks. Shop drawings and calculations to include the original seal and signature of a NYS Licensed Professional Engineer. Sheeting to be designed for Cooper E- 80 Axel Loading as per the American Railway Engineering Associates. • Fouling of LIRR Track includes work within 15 ft. of or along LIRR tracks. This also includes operation of equipment or any part of equipment (i.e. crane booms) which could fall onto or within six (6) feet of LIRR tracks. • All parties are notified that fouling LIRR track without LIRR flag protection being present is a violation of Federal Law.. CRANES o Crane operation must maintain at least fifteen (15) feet vertical and horizontal separation from overhead LIRR High Tension Lines. If overhead power lines from outside agencies are supported from LIRR High tension poles, a letter from that agency must be submitted- to the LIRR stating their vertical and horizontal separation requirements. o The following conditions apply for operating cranes with booms of sufficient length to fall onto or within six (6) feet of LIRR tracks. Crane information must be submitted to the LIRR for review, including proposed location of crane, proposed boom angle and loading diagram indicating that the crane is capable of supporting 150% of load to be lifted. Loading diagram to include original seal and signature of NYS Licensed Professional engineer. . LIRR flag protection must be on site. Crane operations will generally be restricted to 10:00 am to 3:00 pm daily. Crane operator or one (1) construction supervisor who will be on the site full time must be trained and verified in Roadway Worker Protection. Crane operations must follow the direction of LIRR flagmen and face boom parallel to our track when ordered to do so. Procedure Number: 3`d Party—3- Title:Adjacent Revision:2 Date:03113/12 Saved Location: H:\Structures\3rd Party Contracting\Procedures\Projects Adjacent to LIRR Property.doc Page 1 of 1 Long Island Rail Road GENERAL REQUIREMENTS FOR OUTSIDE CONTRACTORS WORKING ON LIRR PROPERTY • Obtain Entry Permits. Call LIRR Manager — Engineering Compliance at 347-494-6487. • Obtain required Railroad Protective Liability Insurance and submit original signed insurance documents to the MTA Risk and Insurance Management, call 646-252-1429. • All contractor personnel whose duties include working on, within fifteen (15) feet of or above railroad tracks or operating equipment (i.e. cranes) on or near railroad tracks shall attend annual Roadway Worker Protection (RWP). Call LIRR Training Department at 718-558-3100 to schedule. • Two (2) weeks prior to start of construction call Managing Engineer — Civil Inspection at 718-558-3351. Procedure Number: 3`d Party—3 Title:General Revision:2 Date:03/13/12 Saved Location: H:\Structures\3rd Party Contracting\Procedures\Outside Contractors Working on LIRR Property.doc Page 1 of 1 GUYS AND SIGNAL CABLE LINES NOTES: ` (AT 60-R.NO WIND) 1.ST1l1JCiUR[S,NIy3f,H0T BE>�OCAtfp-NIjR,e,R'TO TRACT:7HAU Vam OTHER THAN TROLLEY TTyyEE fARIiltDM.-cLEAtTANCE UNT(3'PR4'CRIBED'BY T}i15=1+U,N: OVER HEAD BRIOCES 8 OTHER WRiROSSiNO RAIL ROAD APb"TLL?SE�BIStANCES' .... CLLEEDCD'WHEf£,p�SStBtf,_ SHOULD.$E STFT UCTURES IN ELECTRIFIED - TRACK MINIMUM CLEARANCES- ' SIGNAL OPEN WIRES FOR TANGENT TRACK TERRRORY 70 ALLOW FOR - - (AT 60•F.,NO WIND) SHALL BE SHOWN ON THIS PLAN. '-0'TROtlLY WIRE HfIOHT. , i FOR CURVED TRACK ARE THE SAME AS SHOWN FOR ABOVE 70P OF RAIL TANGENT TRACK MEAS RED VERTr RAIL EXCEPT ALLY PASSENGER ANID 'THRU'yR VUDUCtSr. - .. - - OFE EWFRIGHICH PLATFORMS. BE MEASURED ftl6tTSj': 'GA'ITQY.�C•RAik_$;5T (AL'Y,YRP•ES' _ _ I FROM TOP OF NEAREST RAIL. ND,.P,F 7RQLLLY%:h'IRES;"- 'OUfSIGT[ ON THE OUTSIDE OF CURVED TRACK. ! (geM�A%S1S41UM;MJ�:.TFFiRCfOjLY� -. ''• _ SIDE CLEARANCES SHALL HE s AA;C,07HER MEASURED HORROWALLY FROM THE ... SIGNAL BRIDGE INCREASED OF NEAREST RAIL AND BE INCREASED CURVATURE;1 INCH PER BEREE OF f RANGENTTRACK.THAT SHOWN _ BE ` 1NSIDEI ON THE INSIDE OF CURVSHALLED TRACK ENGINE HOUSE,SHOP AND _ - -- --- - .. MIERSURto HO 2Ri ONTALLY FROM THE _w. .. WAREHOUSE DOORS GAGE OF NEAREST RAIL AND BE TOTALLY WIRED,(MIN. STANDARD SIDE RiCREASED BY 1 INCH PER DEGREE LARANCE ON ALL ELECT.7ERRITORY.) - oF PERMANENT OBSTRUCTIONS OF CTANGENTRE,OVERTT WHICH SHOWY MU57 ALSO BE ADDED TO THE _ - AMOUNT OF SUPER ELEVATION OF THE HIGH RAIL ABOVE THE ', --- LOW RAIL ! - - `• 2.PLATFORM CANOPY CLEARANCE OF 4'-6'MAY BE USED ONLY 11 RESTRICTIONS AOAINST RIDING ON THE SIDE OR TOP OF CARS AT FlATi;OIW;,CANOPI';' _ THE LOCATION OF THE CANOPY ARE LISTED IN THE CURRENT TrE- i TABLE UNDER SPEG1Al INSTRUCTIONS. &CLEARANCE REQUIREMENTS SET FORTH ON THIS PLN SHALL 4.MINIMUM YARD CLEARANCE REQUIREMENTS SHALL BE AS .1E6AL'S9E: E;ON•°ALL SHRU;R.RI - SPECIFIED ON MESOP IA.B.F OPERATING PROCEDURE AHP•tbNNELS.- £'ORiB(DO$:,.ENOINE ' , HOUSE D ALVrOT14ER BLDG.OOORY?AYS; - t:f; eAPpLY'FOR:TRA4N?ALMIITENAHCE`ONLY MIN.LEGALESE CLEARANCE, ��.. (roR'KEw,;CQTFSFRUCf1,ON';T`tEf CA7E5T',-URR MW2DOO) ON OBSTRUCTIONS OTHER �: 'STRtlCTURSS'AIfA TFAC(Efp^C4NSTRi1CT2D PRIOR TO APRIL 1'1'1961. THAN THOSE LASTED FOR 8'-0' 4. MAYBE M A1NED"AND EKIENDEO Ai 7HE E%ISNNC CLEARANCE FOR YARDS YIN.IECAJ,SIDE CLEARANCE I THE FOLLOWING SIDE CLEARANCE ARE INCLU 0 IN SECTION SI-A SEE NOTE 4• - - OF THE RAR ROAD LAW EFFECTIVE APRIL 1 1961. ''2 ! •'rA. a ,i':."'r MIN.C TO C DISTANCE FOR PARALLEL MAIN TRACKS-13'-6'C TO C s' ,D'. - 1i0 LT .' •p ,,L C TO C DISTANCE YARD AND SIDE PACKS--13'-6'C TO C ALL PACKS PARALLEL TO MAIN OR PASSING'TRACKS-1$'-0'C t0 C .N N `,N "ION UDDER TRACKS TO ADJACENT TRACKS -18'-0'C TO C PARALLEL LA - t_J: PARALLEL TEAM ET TRACKS AND HWSE'TRACKS=.-_-13'-6'C TO C ®CLEARANCE IS MEASURED FROM THE BOTTOM OF TIE RUBBING BOARD _--- "$=$'� `OR, ':� 90 .1G0 Q3RD Q.TRACK •$.r�,. RAIL HIGH Lr.0 PASSENGER -- _ -•$�-3 3 S dN I l - -'3�"'�T - PLATFORM INTERTRACK FENCE _.A�-5:.3.4{.a '_1S'-3':3 :4'-' •PlAI(OTDL• � 1 WHERE REQUIRED SHALL BE LOCATED ,RLIATiQNSIL'P ON CENTER BETWEEN r ! 'WEICHri.+'OF;-RRUUryTLNiNO`• TRACKS. '� r: FJK5.3Q;LU!UTO;,RF,GS COVER BOARD AND —,. .• -. •-. :- g� - . _ .. LOW PASSENGER , . 2 +e'u PLATFORM FOR 3RD '''. '9•'1 . '`L:, SRO'- RAIL TERRITORY ONLY .. - �� t '0:123 L{ .._.. .. _ - -• - ".... .` ®GAGE AS:MCAStR 8 £EEITLk A PLANE iT�EB BARS n i T , AT,RiGCStN-AN9 RAf 5 - T ,: , - - .— PASSENGER PLATFORM BELOW:.tHE T4F`.OF:7NC RAD;HFAC TRVN21 it ©RUBBING BOARDS(STUB END TERMINALS ONL T^ D "ipP-Df ilE NOTE Ll A RUBBING BOARDS ALL OTHER PLATFORMS .. mAyJ U DIMENSION SHOWN FOR VARIATIONS SEE CONTACT LAND COVER BOARD iA%If-ROAD,SIOHAL CABLES.AIR UNES QO. '-. _ ._,_.-_ ._. _ '&(THIRD)RAIL SUPPORT k PROTECTION ASSEMBLY DRAWING. REFERENCES: S_D F... R' FACE OF TOP OF'COHDLR74:':`PLPES'.51£6'VES'ETC:.- FAACE VK ®REVISED TITLE BLOCK THIS DRAWING IS A REDRAFTR70 OF ONTO.80.820-1D. DATED-.6-30-72 JACK PTI t3' _�_ �a•-s" NG ISLAND R LO - RAILROAD SEE NOTE 4 SEE NOTE 4 - - . uNIVILIM RAILWAY CLFARANCEES Meum d a 1 DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCEF_ 02/24/2023 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(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 Barbara Dammers - NAME: Roy H Reeve Agency,Inc. PHONE. (631)298-4700 FAX (631)298-3850 AIC No.Ext), AIC:No): PO Box 54E-MAIL. bdammers@royreeve.com ADORESS: 13400 Main Road INSURER(S)AFFORDING COVERAGE NAILIf Mattituck NY 11952 INSURERA: New York Municipal Insurance Reciprocal INSURED INSURER 8: _ Town of Southold INSURER C,,. PO BOX 1179 INSURER D INSURER E: Southold NY 11971 INSURER F. COVERAGES CERTIFICATE NUMBER: CL22122218289 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. SR TYPE OF INSURANCEAQUIL FOLIC F - POL CY E P LIMITS LTR INSD WVD POLICYNUMBER MMIDD MMIDDtYYYY ><'COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE. $ 1,000,000 CLAIMS-MADE ®OCCUR r OEMISES=. $ 50,000 $:24,000 deductibleMED EXP(Anv one person) $ 5,000 A Y MPLTHOLD001 01/01/2023 01/01/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 3,000,000 Q PRO- 'n 1,000,000 POLICY JECT L_t LOC PRODUCTS-COMPIOPAGG $ vrHER Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COM6tNLD(Eajcdjent"NGLt LIMIT $ 1,000,000 ,^ ANYAUTO BODILY INJURY(Perperson) $ A OWNED SCHEDULED AUTOS ONLY AUTOS MCATHOLD001 01/01/2023 01101/2024 BODILY INJURY(Per accident) $ HIREDNON-OWNED PROP,ERiY:DAMAGE $ AUTOS ONLY AUTOS ONLY Per.acc dent UMBRELLA LIAR I X OCCUR EACH OCCURRENCE $ 10,000,000 A EXCESS LIAB CLAIMS-MADE. MECTHOLD001 01/01/2023 01/01/2024 AGGREGATE $ 20,000,000 DEDRETENTION'S'10,000 $ WORKERS COMPENSATION PER 0TH- YINEMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNER/EXECUTIVENIA E.L.EACHACCIDENT $ - OFFICERIMEMBER EXCLUDED? Q (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space Is required) LIRR,GCMCOC,MTA and its subsidiaries and affiliates&NY&Atlantic Railway Company Anacostia Rail Holdings and the respective affiliates and subsidiaries existing currently or in the future&successors to each indemnified parties listed herein,their board of directors,officers,employees, representatives and agents are listed as additional insureds with respect to general liability as per the terms and conditions of form#MPL-216(03/06)- Generai Liability New York Municipal Special Additional Insured Endorsement,or form#CG2013(11/85)-Additional Insured-State or Political Subdivision-permits relating to premises, as required by written contract or agreement. Civerage is primary&non-contributory&a waiver of subrogation applies. CERTIFICATE.HOLDER — CANCELLATION,_, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN MTA Long Island Railroad ACCORDANCE WITH THE POLICY PROVISIONS. Hillside Maintenance Facility AUTHORIZED REPRESENTATIVE 93-59 183rd St,Dept 3146 , Hollis NY 11423 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD STATE OF NEW YORK WORKERS'COMPENSATION BOARD CERTIFICATE OF PARTICIPATION IN WORKERS' COMPENSATION GROUP SELF-INSURANCE Ia.Legal Name and Address of Business Participating in Group Self- Id.Business Telephone Number of Business referenced in box Insurance(Use Street Address Only) "la" Town of Southold 631-7654333 54375 Main Road,PO Box 1179 Southold,NY 11971 I e.NYS Unemployment Insurance Employer Registration 1b.Effective Date of Membership in the Group: :01/602006 Number of Business referenced in box"la" I c.The Proprietor,Partners or Executive Officers are if.Federal Employer Identification Number of Business referenced in Box"Ia" ❑ included(only check box if all partnersloffecers included) ❑ all excluded or certain partners/officers excluded 2.Name and Address of the Entity Requesting Proof of Coverage 3.Name and Address of Group Self-Insurer (Entity Being Listed as Certificate Holder) NEW YORK STATE MUNICIPAL WORKERS' MTA Long Island Railroad COMPENSATION ALLIANCE 93-59 1831 St,Dept 3146 CLAIMS ADMINISTERED BY: Hollis,NY 11423 WRIGHT RISK MANAGEMENT 900 STEWART AVENUE,SUITE 600 GARDEN CITY,NY 11530 This certifies that the business referenced above in box"1 a"is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law as a participating member of the Group Self-Insurer listed above in box"3"and participation in such group self-insurance is still in force.The Group Self-Insurer's Administrator will send this Certificate of Participation to the entity listed above as the certificate holder in box "2".The Group Self-.Insurer's Administrator will notify the above certificate holder within 10 days IF the membership of the participant listed in box "W'is terminated.(These notices may be sent by regular mail.)Otherwise,this Certificate is valid for a maximum of one year from the date certified by the group self-insurer. If this certificate is no longer valid according to the above guidelines and the business referenced in box"1 a"continues to be named on a permit, license or contract issued by the certificate holder,the business must provide the certificate holder either with a new certificate or other authorized proof the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative of the Group Self-Insurer referenced above and that the business referenced in box"la" has the coverage as depicted on this form. Certified by: Eric ffft tcofd 01/01/2023—�1'2131/2023 (Print name of authorized representative of the Group Self-Insurer) Date Certified by: (Signature) Title: -Pko(! AyI.MANAGER. Telephone Number __.516-750940.9 GSI-105,2 WORKERS'COMPENSATION LAW,. Section 57 Restriction on issue of permits and the entering into contracts unless compensation is secured. 1.The head of a state or municipal department,board,commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter,and notwithstanding any general or special statute requiring or authorizing the issue of such permits,shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that compensation for all employees has been secured as provided by this chapter.Nothing herein,however,shall be construed as creating any liability on the part of such state or municipal department,board,commission or office to pay any compensation to any such employee if so employed. 2.The head of a state or municipal department,board,commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter,notwithstanding any general or special statute requiring or authorizing any such contract,shall not enter into any such contract unless proof duly subscribed by an insurance carver is produced in a form satisfactory to the chair,that compensation for all employees has been secured as provided by this chapter. Please Note: This Certificate is valid only through the policy dates indicated above, OR a maximum of one year after this form is approved by the authorized representatives of the Group Self-Insurer. At the expiration of those dates, if the business continues to be named on a permit or contract issued by the above government entity, the business must provide that government entity with a new Certificate.The business must also provide a new Certificate upon notice of cancellation or change in status of the policy. GSI-105.2(2-02)Reverse