HomeMy WebLinkAboutRecreationTHIS AGREEMENT made this 26th dayof Augus~ ,2003, between
the TOWN .OF SOUTHOI~D, 'a'munic pality of the state of New York, having its principal
office at 53095 Main Road (Route 25), P.O. Box 1179, Southo d, New York l1971 (the
'-row~") and Lisa Bagli~i
residi~t '1295~ Cawd~nal Drive Mattituck -NY
HOME PHONE: 29.8-2067
~M~IL A~ORESS
WORK I
11952
(The Instructor")
1. T~he Town does hereby agree to hire th~ln/~s,an in~ependel~t,contracter,
and the Instructor does hereby agree.to progltie'~ir~f~u~or~{[ services to the Town.for
the program(s) hereinafter descnbed~ subjecf~to tbe?~ter~nd~co?d,fions .hereinafter set
forth.
2. ' The Instructor shall provide instructional ~ervices fo~ the following program~ to
wit:
Introduction ~o Drawing
3. The Instructor agrees to commence the rendering of services on
Sep, tember 24~ 2003 .and to render instructional .services~ during the following
time period: Sept 24 - Oct 29 7:00-9':O0,PM Wednesdays MHS Room 109
4. The Town agrees to pay the Instructor and the Instructor agrees to, accept for
such services? the compensation of $30.0~ pe~,'~hour/~.~3'<f6 to be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
to be performed and the hours for which it will be performed.
6. It is agreed that the Instructor shall be responsib(e for the establishment of the
program, to assist with the solicitation of parfic pants therein, and the completion of all
the classes planned for such program.
7. In the event of the temporary illness or inability of the Instructor to conduct
classes as and when scheduled, the Instructor shall immediately notify the Recreation
Supervisor. The Instructor will assist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors.
8. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter .set fort~, the Town shall have the right to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment 9 Maximum Enrollment 12
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contracfl3r and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
13. The Town of Southold shall, as part of the Instructor's compensation, cover the
individual Instructor from claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
Joshua Y. Horton, Supervisor
Instructor
Business Name (if applicable)
Instructor's Social Security Number
Federal ID Number (if applicable)
t
i THISAGREEMENTmadethis ~- ~:h~, dayof Au.qus
,2003, between
ofrme at, 53095 Main Road (Route 25), P.O. Box 1179, Southold, New York 11971 (the
"Town") and [uqenia Cherouski (The Instructor")
res~d,i gat P'h BOX '109 ~lamesD0rt NY 11947
,~ ~ : (MAI~LING ADDRESS)
HOME PHONE: 72_2-3855 WORK PHONE:
"' WITNESSETH:
1 ;:Th'~ T~V~does hereby agree to hire the Instructor as an independent contractor,
! :~af~d 'tfl~;t0¥~t~r d0~ hereby agree to proulde'~nstructlonal services to the Town for
/fie prOgr~tl~(~J I~,r~ina~er: descr boO, subject to the terms and cond~ons hereinafter set
forth.
The 'Instructor Sl~all provide instructional serv ces for the f¢l owing program to
International Folk Dancin~
· 3: ~h~ Instructor agrees to commence the rendering of services on
SeDteraber 23. 2003 and to render instructional services during the following
time period: ~Sept 23'- Nov 25 Tursdays 3:00-4:30 PM Recreation Center
NO CLASS 11/4 and 11/11
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such se~ce§;:th~e compensation of $~5.00 per ~Ya~lhour/l~g~3Xto be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5, It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
to be pel~ormed and the hours for which it will be performed.
6. It is agreed that the Instructor shall be responsible for the establishment of the
program', to assist with the solicitation of participants therein, and the completion of all
the classes planned for such program.
7. In the event of the temporary illness or inability of the Instructor to conduct
classes as and When scheduled, the Instructor shall immediately notify the Recreation
Supervisor. The Instructor will assist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors.
8. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment 8 Maximum Enrollment. 40
10. The Instructor agrees to prepare accurate attendance records of al! persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold Shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
13. The Town of Southold shall, as part of the Instructor's Compensation, cover the
individual Instructor from claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
$t~000,000. and $2,000,000 aggregate liability for bodily injury and proper~y damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
Joshua Y. Horton, Supervisor
Instructor
Business Name (if applicable)
Instructor's Social Security Number
Federal ID Number (if applicable)
THIS AGREEMENT made this 26th ,day,of . August ,2003, between
the TOWN OF SOUTHOLD, a raunicipality of,the State of. New York, having its principal
office at 53095 Main Road (Route 25), P.O. Box ii79, Southold, New York i197i (the
"TownP) ahd Steven DeLaney (The Instructor")
residingat 3'65~'J~mine Lane Southold NY 11971
£el~i' b~;~ne ~ (MAILINGADDRESS)
I~I~;PHOI~E: 631-786-5915 WORK PHONE:
WITNESSETH:
1. ?~ Town.does hereby agree to hire the Instructor as an independent contractor,
ahd:~ I~s~u~c,tOr iJoes hereby agree to provide instructional services to the Town for
fl~e'~r~m(s) he~6inafter described, subject to the terms and conditions hereinafter set
forth.
The Instructor shall provide instructional services for the following program, to
v~it:
Teen Nights
The Instructor agrees to commence the rendering of services on
Sep_tember 12. 2003 and to render instructional services during the following
timepeHod: See. Attached
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such services, the compensation of $20°00 per ~FaTs~/hour/l~,~s~Cto be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
to be performed and the hours for which it will be performed.
6. It is agreed that the Instructor shall be responsible for the establishment of the
program, to assist with the solicitation of participants therein, and the completion of all
the classes planned for such program.
7. I~ the event of the temporary illness or inability of the Instructor to conduct
classes as and when scheduled, the Instructor shall immediately notify the Recreation
Supervisor. The Instructor will assist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors.
8. In the event that the enrollment in the program ~s less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment
Maximum Enrollment
10. The Instructor agrees to prepare accurate attendance records of ail persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
13. The Town of Southold shall, as part of the Instructor's compensation, cover the
individual instructor from claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
Joshua Y. Horton, Supervisor
Instructor
Business Name (if applicable)
Instructor's Social Security Number
Federal ID Number [if applicable)
FRIDAY TEEN NIGHTS
NEW! ! !
Youth in grades 6-9 are welcome to attend these youth nights scheduled on Friday
evenings at the recreation center. Activities include pool, ping-pong, and foosball. The
program is scheduled as follows:
FRIDAYS, 6:30 -9:00 P.M.
SEPTEMBER 12, OCTOBER 10 & 24
NOVEMBER 7 & 14~ DECEMBER 12
COST:
LOCATION:
Free to resident youth
Southold Town Recreation Center
We trust that all participants will exercise the utmost care of the equipment at the
recreation center and behave in an appropriate and mature manner so that we may
be able to offer more of these programs in the future.
THIs,AGREEMENT madethis 26th .~ day 0f August _, 2003. between
.the TOWN OF SOUTHOLD, a municipality of~the State of New York, having,its principal
office at 53095 Main Road (Route 25), P.O. Box 1179, Southold, New York 11971 (the
'~rown')and Easi; End Kids, Inc, (The"Instructor")
doing business at
HOME PHONE:
E-MAIL ADDRESS:
PO Box 314 East rq~arion NY 11939'
(MAILING ADDRESS): ,..
WORKPI~(~NE: _ z~77-1413
WITNESSETH:
1. The Town does hereby agree to hire th~ Instructor as an independent contractor,
and the Instructor does hereby agree to p~ovlde instructional services to the Town for
the program(s) hereinafter described, subject~[o the terms and conditions hereinafter set
forth.
2. The Instructor shall provide instructional services for the following program, to
wib
Crime Stoppers Course
3. The Instructor agrees to commence the rendering of services on
September 25, 2003 and to render instructional services during the following
time period: Sept 25 - OCt 16 Thursdays 7:00-8:00 SHS Room =
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such services, the compensation of $50.00 per ~lperson to be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Depar[rnent of the Town. The Instructor shall determine that scope and manner of work
to be performed and the hours for which it will be performed.
6. It is agreed' that the Instructor shall be responsible for the establishment of the
program, to assist with the solicitation of participants therein, and the completion of all
the classes planned for such program.
7. In the event of the temporary illness or inability of the Instructor to conduct
classes as and when scheduled, the Instructor shall immediately notify the Recreation
Supervisor. The Instructor will assist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors.
8. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement, In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment
Maximum Enrollment
'10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement, There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
13. The Instructor agrees to carry appropriate insurance coverage from claims for
bodily injury, death or property damage which may arise from the performance of their
services under the Agreement in limits of $'1,000,000 and $2,000,000 aggregate liability
for bodily injury and property damage.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
Joshua Y. Horton, SuperVisor
Instructor
Instructor's Social Security Number
Federal ID Number (if applicable)
Business Name (if applicable)
26th day of August _,'2003, between
~..~ ~the TOWN OF SOUTHOLD, a municipality cf the State of New York~ having its principal
office at 53095 Main Road (Route 25), P.O. Box 1179, Southcid, New York i1971 (the
"Town") and Fox Run Farm
' doihgbusinessat 330 Tasker Lane
Virginia Ross
Greenport NY 11944
(The "Instructor")
~.~ ~ (MAlUNG ADDRESS).:
HOME PHONE: 477-218! WORK PHONE:
E-MAIL:ADDRESS: ?r0s$89100@aol. com
WITNESSETH:
734-6434
The Town does hereby agree to hire the Instructor as an independentcontractor,
bnd the. Instructor does hereby agree to provide nstrucfional services to the Town for
the program(s) hereinafter described, subject to the terms and conditions hereinafter set
forth.
2. ' The Instructor shall provide instrucfiona services for the following program, to
wit:
Eall Horseback Riding
3. ~The Instructor agrees to commence the rendering of services on
Sep,t~ember 21, 2003 and to render instructional services during the following
Session. I Session II
timeperiod¢ Sept 21, 28, .Oct 5 Nov 2, 9, 16 Sundays 12:00-2:00 PM
Fox Run ka~?. Cox Lane Cutchogue
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such services, the compensation of $]40/sessi0rper mlass~l~pel~r~ to be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
to be performed' and the hoUrs for which it will be performed.
6. It is agreed that the Instructor shall be responsible for the establishment of the
program, to assist with the solicitation of participants therein, and the completion of all
the classes planned for such program.
7. In the event of the temporary illness or inability of the Instructor to conduct
classes as and when scheduled, the Instructor shall immediately notify the Recreation
Supervisor. The Instructor will assist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors.
8. In the event that the enrollment in the program is less than the minimum
.enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrol!ment :3 Maximum Enrollment 4
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will prOvide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he Or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment~n fulfilling his/her Instructor~sks.
'12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
13. The Instructor agrees to carry appropriate insurance coverage from claims for
bodily injury, death or property damage which may arise from the performance of their
services under the Agreement in limits of $'1,000,000 and $2,000,000 aggregate liability
for bodily injury and property damage.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first abov~ written.
TOWN OF SOUTHOLD
Joshua Y. Horton, Supervisor
Instructor
Instructor's Social Security Number
Federal ID Number (if applicable)
BUsiness Name (if applicable)~
THIS
26th dayof August ,2003, between
TOWN OF SOUTHOLD, a municipality of the State of New York, having: its principal
office at 53095 Main Road (Route 25), P.O. Box 1179, Southold, New York 11971 (the
'q'own") and, Steve Smith (The Instructor')
residing~t 12D0 S venth Sl~reet Greenport NJ 11944
~, . ~ - (~AILING~>ADDRESS)
HOMEPHONE: 477-9597 WORKPHONE: Z65-5400
WITNESSETH:
1 * The Town does hereby agree to hire the Instructor as an independent contractor,
~d the instructor does hereby agree to provide instructional services to the Town for
the program(s~ hereinafter described, subject to the terms and conditions hereinafter set
forth.
"2. The instructor shall provide instructional services for the following program, to
Wit:
Weight Training Course
3. The Instructor agrees to commence the rendering of services on
September 22, 2003 and to render instructional services during the following
time period: Sept 22 - Dec 12 Mon & Thurs 7:00-8:30-PM SHS Weight Roo~,
NO CLASS'IU/b, IU/I~, ~±/17, and 11/27
4. The Town agrees to pay the Instructor and the I~structor agrees to accept for
such services, the compensation of $25.00 per c~/hour/l~yVs~ to be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report tO the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
to be performed and the hours for which it will be performed.
6. It is agreed that the Instructor shall be responsible for the establishment of the
program, to assist with the solicitafio~ of participants therein, and the completion of all
the classes planned for such program,
7. In the event of the temporary illness or inability of the Instructor to conduct
classes as and when scheduled, the Instructor shall immediately notify the Recreation
Supervisor. The Instructor will assist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors.
8. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement. In the event that the Instructor failsor neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event~ the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment 9
Maximum Enrollment 15
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is Solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independentjudgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered unfit this
contract is signed and returned to the town clerk, s office prior to the beginning of said
program.
13. The Town of Southold shall, as part of the Instructor's compensation, cover the
individual Instructor from claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the Agreement in'limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and property damage,
This coverage dqes not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN V¥1TNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
Joshua Y. Horton, Supervisor
Instructor
Business Name (if applicable)
Instructor's Social Security Number
Federal ID Number (if applicable)
~ :THIS AGREEMENTmade this 26th ~day'0f August
,2003, be[Ween
.~;the TOWN OF SOUTHOLD; a municipality Of the State of New York, haVing its principal
;office at 55096 Main Road (Route 2~, P.O. Box 1,179, Southold, New York 11971 (the
"Town") and Chr~st0pher Vedder (The Instructor")
residi'ngat' PO' BO~ 2066 Gre~nport NY 1['944
HOME PHONE: 477-1846 WORK PHONE:
E-MAIL ADi~RESS '
477-0777
WITNESSETH '
1. The Town does hereby agree to hire the Instructor as an independent contractor,
a?d t~e In, Structor does h~ereby ~gree to pro'ida iQ~trubf~onal services to the Town for
the pt'ogram(s) hereinafter described, subject to the;term~ and conditions hereinafter set
forth.
2; The Instructor shall provide instructional services for the following program,
wit:
Beginner/Intermediate Golf Lessons
3. The Instructor agrees to commence the rendering of servi'ces on
September 16, 2003. and to render instructional services during the follow!ng
time period: Sept 16 - Oct 14 Tuesdays 3:00-5:15 PM Islands End Golf
and Country club
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such services, the compensation of $38.00 per ~l~:N~Eperson to be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
to be performed and the hours for which it will be performed.
6. It is agreed that the Instructor shall be responsible for the establishment of the
program, to assist with the solicitation of participants therein, and the completion of all
the classes planned for such program.
7. In the event .of the temporary illness or inability of the Instructor to conduct
classes as and when scheduled, the Instructor shall immediately notify the Recreation
Supervisor. The Instructor will assist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors.
8. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment ? Maximum Enrollment
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
expermnce to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor repFesents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shalt not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
13. The Town of Southold shall, as part of the Instructor's compensation, cover the
Jndiviciuai instructor from claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liabili~ for bodily injury and property damage.
· This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
~Josfiua Y. Horton, Supervisor
Instructor
Business Name (if applicable)
Inetructor's Social Security Number
Federal ~ID Number (if applicable)
TOWN'CO Y
26th dayof August ,2003, between
Zthe TOWN OF SOUTHOLD, a municipality of the State of New York, having ts pr nc pa
office at 53095 Main Read (Route 25), P.O. Box 1179, Southold, New York 11971 (the
"Town")and Hidden La,ke Farms Riding School (The"lnstructar")
doing busines~ at
HOME PHONE:
~ E-_NIAIL .~D~O.P~E S S;
PO Box 269 Peconic NY 11958
(MAILING ADDRESS):
765-4661 WORK PHONE:
WITNESSETH:
765-9896
t. The Town does hereby agree to hire the Instructor as. an independent contractor,
and the Instructor does hereby agree to provide instructiorial services to the Town for
the program(s) hereinafter described, subject to the terms and conditions hereinafter set
forth.
2. The Instrubtoi' shall provide instrdctional ~erVices for the following program, to
'' ~ d]i g~ Ees on
cHorseback i. ,n ~., S s t, ~ ,~.., .... t~ '
3. The' Insffuctor agrees~-'~[o commence ~he" rendering '6f~ :se~i~':0n
September 26~ 2003and to render ins~uc~onal se~mes during the following
tim, p~riod: Sept26 - Nov i4 Fr~daTs 4:0¢-~:00 PH H~dden _ake [ar~s
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such services, the compensation of $215.00 per 6Ya~person to be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town The Instructor shall determine that scope and manner of,work
to be performed and the hours for which it will be per[ormed.' '
6. It is agreed .that the Instructor shall, be responsible for the establishment of the
program, to assist with thee solicitation of participants therein, and the completion .of all
the classes planned for such program~
7. in the, event~of the temporary illness or inability -of' the' Instructor to- conduct
classes as and whe~ scheduled, the Instructor sba mm~d ate y ~otify~e_Recr. eafio~
Super;iS'01:.' ¥1i~' Insti;uctor ~vill assist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors.
. n the event that the enrollment in the program is less than the minimum
enrollment as~hereinafter set. fo~th~ the',~ToWn ~-shall have the right to terminate.this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, .then and-in such event,; the
Town inthe exercise of discretion, shall have the right to terminate thisagreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment 4 Maximum Enrollment 5
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services ~n a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract,is signed and returned to the town clerk's office prior-to the beginning of said
program.
13. ,The Instructor agrees to,carry appropriate insurance coverage fram Claims for
bodily injury, death or property damage which may arise from the performance of their
services under the Agreement in limits of $~1,000,000 and $2,000,000 aggregate liability
for bodily injury and property damage.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
JoCund. H~)rto~, SupervisOr
. Business Name (if apPliCable)
Instructor's Social SeCurity Number
Federal ID NUmber(lapp ~ble)
COPY
THIS AGREEMENT made,this 26th ' day of Auqust ,2003~ between
theTOWN OF SOUTHOLD, a municipality of the State of New'York, havfng its principal
office at'53095 Main Road (Route 25), P.O. Box 117g, Southold, New York 11971 (the
'~rown") an~' M~'rtha Eagle (The Instructor")
residing~t ~1785 Seawood Dr~ve $ou~ho~d NY 1197~
(MAILING ADDRESS)
HOME PHONE: . 765-557[9 WORK PHONE: 298-4884
E-MAIL ADDRESS
1:i . .The T6~wn does hereby agree to hire the Instructor as an independent contractor,
arid ~e InstruO:°r does hereby agrae to provide instructional services to the Town ~for
the program(s)hereinafter Described, subject te the terms and conditions hereinafter set
2. The InstruCtor shall provide instructional services for the following program, to
wit:
Classic Body Scu]ptin§/Aer0bics
The instructor agrees to commence the repderJnG of se.wices on
Septe~mbe~ 29~ 2~}03 and to render instructional services daring the following
timeperiod: ,Sept 29 - Dec 17 Mon & Wed 5:30-6:30 PN Recreation Center
NO~CLASS 10/13, 1I/5, 11/26, AND 12/3
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such seP~ices, the compensation of $30.00 per ~l{¥s~/hourl~FsVdhXte be paid at
semi-rnonthly intervals by the submissioh ofvouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of Work
te De performed and the hours for which it will be performed.
6. It is agreed that the Instructor shall be responsible for the esteblisfimen[ of the
program, to assist with~the solicitation of participants therein, and the completion of all
the classes plannedfor such program.
7. In the event of. the temporary illness or inability of the InStructor to conduct
classes as and when scheduled, the Instructor shal[ immediately notify the Recreation
Supervisor. The Instructor will assist and/or cooperate with the ~up~rvis~r tO p~0vide for
makeup classes and/or substitute qualified instructors.
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment
Maximum Enrollment 3 5
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agroes
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not De liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor witJ not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
!3. The Town of Scuthoid shall, as 9a~. of the Instructar's compensation, cover [he
individuai ~ns~ruc.o, from ~laims for bodily injury, death ar property damage which may
arise from the performance of his/her servmes under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
J o~ ~~r
Instructor's Social Security Number
Business Name (if applicable) Federal ID Number [if applicable)
CERTIFICATE OF
INC.
PHONE:
FAX:
~t~URERS ~N~tNG COVERAGE
NAtC~
Amedc~m Pm~cUon Ars C~
/
25..$.
COVERAGES
~ACHOCCUa~mC~_ _ I~
OTHER:
DESCRIPTIO~ OF OPERAT~)NS/LOGATION~VEHICLES~EXCLUSIONS A~IE~ ENDORSEMENTi' SPECIAL
R~$P~$ ECT TO U~E OF GYM IN GRIEENPORT ~.HO OE FOR CO, ED VOL~.~flBALL PROGRAM TO ~E HELD ON
2003 TO JUNE 9, 2004. FROM ~ -
GREENPORT PtS~UC SCHOOLS
720 FRONT S'tT, E~ [
~PORT NY ~:~
Atterd~on:" ': PUP~ C.~PONE'4??~2164(FAX)
CANCC-~LLAT}ON
\
2977 l~tom~.~
FRIDAY TEEN NIGHTS
NEW!!!
Youth in ~g~es 6-9 are welcome to attend these youth nights scheduled on Friday
evenings a~,ihe recreation center. Activities include pool, ping-pong, and foosball. The
program is scheduled as follows:
FRIDAYS, 6:30 - 9:00 P.M.
SEPTEMBER 12, OCTOBER 10 & 24
NOvE~vm~:R 7 & ~4, DEC~mFm 12
COST:
LO~ ~T~O~'~
Free to resident youth
_ Somhold Tom Recreation Center
We trust that all participants will exercise the utmost care of the equipment at the
recreation center and behave in an appropriate and mature manner so that we may
beable,:to offer more of these programs in the future.
SE? I I 200
TOWN COPY
Southa?d Town Clerk-
THIS AGREEMENT made this 26th day of &ugu s~; ,2003, between
the TOWN OF SOUTHOLDi a municipality of the State of N~ew,.York, having its. principal
office at 53095~ Main Road (Route 25)~ P.O. Box 1179, Southold, New York it971 (the
'q'own") and Steven DeLane.y (The Instructor~')
residingat 365 Jasm~ne',Lane South01d NY 11971
~ ",. :,,~ ,~ .'r~ , (MAILING ADDRESS)~
Phone #
. WITNESSETH;
the Instructor as an independent contractor,
to provide instructional servibes to the Town for
trip.' r~..m(~) hereinafter described,:subject to the terms and Conditions hereinafter set
forth.
Z-~:; ~ ;~The Instructo~ shal provide instructional services for the following program, to
Teen Ni,gh,~s '
3~.,,~ :~.The tnstructer agrees to commence the rendering of services on
,~S~0~ember i.2.. ~003 and to render instructional services during the following
time ~riod See~ Attached
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such services; the compensation of $20.00 per &Fav~/hour/t~cZrYsYe~to be paid at
semi:rhonthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner.of work
to be performed and the hours for which it will be performed.
6. It is agreed that the Instructor shall be responsible for the'estat~lishment (~f the
program, to assist with the solicitation of participants therein, and the completion of all
the classes planned for such program
7. In {he e~en~ 0~ the temporary illness or inability of the Instructor to conduct
classes as and when scheduled, the Instructor shall immediately notify the Recreation
Supervisor. The Instructor will assist and/or cooperate with the supervisor to provide for
makeup ~lasses and/or substitute qualified instructors.
. In the e~eh~t t~a[ ~th~ep~ollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement~ then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment
Maximum Enrollment
t0. The Instructor agrees to prepare accur~e attendance records of ail persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional 'manne~; The instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
~13. The Town of Southoid shall, as part of the Instructor's compensation, cover the
individual Instructor from claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does not inure any other benefits uDon the independent contractor nor
does it alter or modify the Instructor's status es an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
Instructor s Social Security Nut'bet
Business Name (if applicable) Federal ID Number lif applicable)
TO VN COPY
THIS AGREEMENT m;ade this 26th dayof ' August
· 2003, between
~theTOWN OF SOUTHOLD, a municipality-of the State of New, York, having its prin. c[pal
~0ffice at 5~095. ~ain Road ~Route 25), P.O. Box 1179, SoUthold, New y.,ork~~ 11971 (the
"Town") and T?lc]a~ Graffagnlno (The Instructor'')
'resid~nga~ 7~5 0r'fo'~e Drive Southold NY 11971
::~+ .~; :~,~; '~ ·, ~ (MAILING ADDREB8)
HOM£PHONE: T6S-5296
WORR ~HONE:
WITNESSETH:
the Instructor as an independent contractor,
ant ,e ,?'str~ctor does hereby agree to provide instructional services to the Town for
the prog:-n~n(s) hereinafter described, subject to the termsand conditions hereinafter set
~, mJ~ I'n~[ru.c~t0r ~hall provide ihstrucfional services for the following program, to
3:~. to. commence the. rendering of '.services on
2003 ~nd to render instructional services during the following
t~"n~e period: See', a~tached
4. · The Town agrees to pay the Instructor and the Instructor agrees to accept for
such services, the compensation of ~;20.00 per ~,.~hourll~ave~ to.be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed' that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
to be~ performed and the hours for which it will be performed.
:6. It is agreed that the Instructor shall be responsible for the establishment of the
program, to assist with the solicitation of participants therein, and the completion of all
~he classes planned for such program.
7. In the even~, of the temporary, illness or inability of the Instructor to conduct
classes as and whe~ scheduled· the Instructor shall immediately notify the Recreation
Supervisor. The'Instructor w~! 'assist and/or cooperate with the supervisor to providefor
~akeup classes and/or substitute qualified instructors,
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the Hght to terminate this
agreement. In the event that the Instructor fails or neglects to perform such 'instructional
services in adcordance with provisions of this agreement, then and in such event,~the
Town in the exercise of discretion, shall have the dght to terminate this agreement_
9. '~The r~i~-imbm and maximum enrollment of the ~lass for the p~ogram is as follows:
Minimum Enrollment
Maximum Enrollment.
10. The Instructor agrees to prepare accurate attendance records of ail persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
~11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected [o utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
13. Th~ Town of S~uthold shali, as part of the Instructor's compensation, 'cover the
individual ~nstruntor from claims for bodily injury, death or property damage which may
arise from the performance* of his/her services under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injur~ and property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it.atter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and. seals the
day and year first above written.
TOWN OF SOUTHOLD
shua Y:/Ho~rton, ~upervisor .--"~----.---.~.~
Business Name (if applicable)
26th day o~ August
,2003, between
~the TOWN OF SOUTHOLD, a municipality of the State of New York,,having its principal
office at 53'095 Main Road (Route 25), P.O. Box 1179, Southold, New York 11971 (the
'~;T6wn") and Custer Institut~
.... ~lbingl~usinessat "_Box [204 Sbuthold NY 11971
~'.~. ~.' ,~ !~, (MAILING ADDRESS);
HOME PHON E: WORK PHONE:
(The Instructor")
765-2'626
DAY - 722-3850
WITNESSETH:
, '1. ,~ ~rtie ~OWn does hereby agree to hire the Instructor as an mdependent contractor
~': .~ ~t~~ ~ lri~-t~ct0r does hereby agree to pr~o~ide in,tractional services to the To~, for
' [b~pr~o~ra~h.{S); hereinafter described, subje,ct to the terms and conditions hereinafter set
The InStructor shall provide instructional services for the following program, to
· .. Chi, l~lrens Astronomy Class '
The ~nstruct°r agrees to commence the. rendering of services on
0~R~> ~.[ ~nn~ and;to render instruct[omal ~[c~s ~rin~ ~e fol~ina
..... ~c~-1 - ~ov ~ wednesdays /:~u-~:uu Pr~ cus~r ~ns~ u~
fimeperiod: ,Oct 2 - 30 Thursdays 7:00-8:30 PR Custer Institute
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such services~ the compensation of $45 & $30 per ~lperson to be paid at
semi.m0nthly intervals by the submission of vouchers therefore to the Town
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The' Instructor shall determine that scope and manner of work
to be performed and the hours for which it will be performed.
6. It is a~reed that the Instructor shall be responsible for the'establishment of the
program, to assist with the solicitation of partic pants therein, and the complet on of al
the classes panned for such program.
7. In the event of the temporary illness or inability of the Instructor to conduct
classes{as an~ when scheduled, the Instructor shall immediately notify the Recreation
SuperviSor Th~ instructor, wi ass St and/or cooperate w th the superv sot to provide for
makeup classes and/or substitute qua ~f ed mstructors.
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town- shall have the right to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services~in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the r ght to terminate th s agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
$ 20
Minimum Enrollment 6 Maximum Enrollment 15
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the .Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
t2. The Instructor will not receive payment for any services rende?d until this
contract is signed and returned to the town clerk's office prior to the begmr{ing of said
program.
13~ The Instructor agrees to carry appropriate insurance coverage from claims for
bodily injury, death or property damage which may arise from the performance of their
services under the Agreement in limits of $1,000,000 and $2,000,000 aggregate liability
for bodily injury and property damage·
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
Jfu~Y. Hol:to~ Supervisor
Instructor
Business Name (if applicable)/
Instructor's Social Security Number,
Federal ID Number, (if app~ca//b~, ~,
THIS AGREEMENT made this
~ 26th da~o~ Augus% _,2003;between
the TOW,:N~ OF SOUTHOLD,_ ',~ a municipality. . of the State of New York, having its' principal
office at 55095 Main Road (Route 25), P.O. Box ii79, Southold, New York 1~97fl (the
"Town~) {The Instructor")
r~s:~in~at O0'Bo~ 1639 S~uthold ItY 11971
~'~ ~ ~,~ ~*~ ~[MAIEINGADDRESS)
7~ 5-146~
HOME PHONE: WORK PHONE:
,J~i~w~0~Sr~hereby agree ~to hire the Instructor as an independent contractor,
[~.~C~'~i~'es h~ra~by: ~g~'~, to ProVide instructional Services to the Town for
~(~s) ~li~r~iJ~affe~'de~Cribe~f~ subject to the terms and conditions hereinafter set
provide instructional services for the following program, to
and ~o
- Oct~ g5
commence the rendering of service§ on
render instructional services during the following
Saturdass 12:00-5:00 PM TasKer Park Courts
4... ~e Town, agrees to pay the Instructor and the Instructor agrees to accept for
suc~ s~!V. ices,. ~ compensation of - $25.00 per class/t~OLYr~ to be paid at
semi;m~hthly intervals by the submission of vouchers therefore to the Town.
5. It is 'agreed that the Instructor shall report to the Supervisor for the Recreation
Departmen~ of the Town. The Instructor shall determine that scope and manner of work
to be p~=~-~ormed and the hours for which it will be performed.
6. 1t: is agreed that the Instructor shall be responsible for the establishment'of the
program, to assist with the solicitation of participants therein, and the completion of all
the classes planned for such program~
7. Inthe evenf~ of the temporary illness or inability et the Instructor to conduct
classes As and wheh scheduled, the Ing-~b'uctor she mmediately 'notify the Recreat on
Super~is..o£. ~he Ins ~[~..ctor w II asmst and/or cooperate with the supervisor to provide for
makeup c~asses and/or subsfitd[e qua fled nstructors.
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the dght to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the e~(ercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Midirhum Enrollment 6 -Max mum Enro Iment.
10. The Instructor agrees to prepare accurate attendance records of alt persons
enrolled in the program and to file the same with the Recreation SuPervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes artsing out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor-will not receive payment for any services' rendered until this
conb~act is signed and returned to the town clerk's office prior to the beginning of said
program.
'13. The Town of Southold shall, as part of the Instructor's compensation, cover the
individual instr~uctor from claims for bodily !njury, death or property damage which may
artse from the performance of his/her services under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does not inure any other benefits upon the independent: contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTI~OLD
Hol on, upervJsor
Instructor's Social Security Number
Federal ID Number (if applicable)
Business Name (if applicable)
TOWN'COPY
THIS AGREEMENT made this 26th dayof August ,2003, between
11952
(The Instructor")
2gg-~5~2 WORK PHONE;
an independent, contractor,
ervices to the Town for
conditions hereinafter set
instructional services for the following program, to
a~eeB to commence ~he~ ' re~dering of services on
such
render instructional services during the following
Tuesdays 6:00-7:30 PM Recreation Cen~er
SS 11/4 and 11/11
,the Instructor and the Instructor agrees to accept for
of $25.00 per class/F~L~fl~Y~a~rt~ to: be paid at
the submission of vouchers'.therefors to the Town.
5. It is agrepd ithat the Instructor shall report to the Supervisor for the Recreation
Department 'b]: theLT0wrL The Instructor shall determine that scope and manner of work
to be per~o~:rded,a~ the h~urs for which it will be performed. ,
6. It is,agreed ,~..at the Instructor shall be responsible for the establishment of tt~e
program, to ~sis~ ~ith the solicitation of participants therein, and the complefionof all
the classes p!anned~er~su~h program~
7. In. the~,~vent~ of. the, temporary ~llness or inability of the Instructor to conduct
c asses as an~l ~en sch~uled, the Instructor shall m~nediately notify, the Recreation
Supe, rvlsot?: ~THe?h3s~uctor ~wdl assist and/or cooperate w~th the supervisor to prowde for
makeup classes and/or subsfif~te qualified instructors ., :
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set ,forth,~ ,the Town ~ha, II have ~e right to, ter~minate, this
agreement. In the event that the Instru(~t0r'f~s'or n~glects to perform such ~nstrdctional
services in accordance with provisions of this agreement, then and in such event, the
T~n-in-the exercise of discretion, shall have the dght to terminate this agr, eemer~t. '
9. The m~mmt~m and maximum enrol{ment of the class for the program~ is as follows".'
Minimum Enrollment
Maximum Enrollment
10, The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in. this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered te the Instructor. The Instructor is expected to utilize
his/her inde~3endent judgment in fulfilling his/her Instructor tasks.
12. The Instructor Will not'receive payment~f6r any services rendered until this
contract is signed and returned to ~he town clerk's office prior to the beginning, of said
~3, The Town of $outhold shall, as
individual {nstru¢~or from claims for bodJty injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
$1,000,000. and $2,000;000 aggregate liability for bodily injury and property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter er modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
f:nstr~'~ter ' ~ - ' Ins~uctor's Social Security Number
Business Name (if applicable)
Federal ID Number (if applicable)
TOWN COPY
THIS AGREEMENT ma~le this 26t~ .day of August
,2003, between
ti3e,TO~N OF SOUTHOLD~ ~ municipality of the State of ,New York, having~ its priocipai¥
office aL ~09~Main Road ~(R0ute 25)~ P.O. Box 1179, South01d, New y.;Ork 119,,7,1' (the
"Town';) and Thomas McBunni§le (The _lnst~.uctor")
residinn ' 4 ...... ,
at. 30~,95 C0untV Road 48, Pecon~c hY 11958
HOME PHONE: 765:-5974 WORKPNONE:
' WITNESSETH:
J. ~ :~ <~h~o~n,~dee~-~her~by~agree to h~re the nstru~to~ as an independent contractor
a~fl ~'~!lns~ruei:o~~ dee, s hereby agree to provide mstruc~onal servmes to tha Town for
~f~i~g~n~h~rei~lafter ~le~-cribed, subject to the termsland conditions hereinafter set
s for the following program, to
· ; agrees to commence the .rendering of services on
and to render instructional services during the following
fimep'eriod: S'~pt 20'-~0¢I~.25 Saturdays 9:00-11:00 AM McGunn~gle Farm
~[ &8, Peconic
4, Thee: Town agrees to pay the Instructor and the Instructor agrees to accept for
such sbrvices, the compensaton of $45.00 per ~person to be paid at
semi-monthiyinterval~ by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the:Town. The Instructor shall determine that scope and manner of work
to be performed and the hours for which it will be performed. -.
6. It is agreed that the Instructor shall be responsible for the establishment of the
program, to assis~With the solicitation of participants therein, and the completion of all
the cla~ses plannedfor.such pr. ogram.
7. In the e~/ent of the te~mporary illness or inability of the Instructor to conduct
classes! as ~nd when Scheduled, the Instructor shall immediately notify the Recreation
SHpe, r~iSor. ,The Instructor will assist and/or cooperate with the supervisor to provide for
' makeup.clas~es~nd/or,subsfltute qualified instructors. ' . ,
. In the event that the enrollment in the program is less than the minimum
enrollment as~ hereinafter set forth, the:Town shall 'have the_right to ,terminate, this~
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with prov!sions of this agreement, then- and in ~uch event~ the
T0wn fn~th~ exercise of discretion, shall have the Hght to terminate this agreement.
9. The minimum and maximum enrollmentof the Class for ~he program is as follows:
Minimum Enrollment 10 Maximum Enrollment [ 5
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
'11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
servmes in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor wilt no[ receive payment for any services rendered until this
contract~is signed and .'returned to the toWn clerk's Office prior tothe beginning of said
program~ ~ .- -- , -.
The Town of Southold shall, ~ ....
as, part eT .,he Instructor s compensatior{, cover the
individual Instructor from cia~ms for boc~iiy injury, death a~ proper'~] ~amage.which may
arise from the performance of his/her services under, the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and prOperfy damage,
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
clay and year first above written.
TOWN OF SOUTHOLD
Instructor's Social Security-Number
Business Name (if applicable) Federal ID Number (if applicable)
THIS AGREEMENT made this 26I:h dayof
TOWN COPY
August
,2003, between
the TOWN OF SOUTHO.LD; a municipality of the State of. New York, having ifs prod/pal
office at 53095
"Town")
resldm
HOME PHONE:
477 -308?
25), P.O. Box lI79, S~uthold, New.~ork '~-,i971 (f_he.
(The Instructor")
Greenp0r~ '~Y 11944
C~MAILING ADDRESS)',
WORK PHONE:
'WITNESSETH:
hire the 10structor as an independent contractor,
hereby agree to provide instructional services to the Town for
p~ocjremls~ hereinafter dnscribod~ subjectto [he terms and conditions hereinafter set
The Instructor shall~prov~de instructional serwces for the following .prog£am, to
~C.a~d.~o Cgnd&~] o'n~gi, t-01-. -and. ' ._
· ~iStrenqthen, ,Sd~l~t~ and.Stretch '
~. ]n§:truc~r,. agrees to commence the rendedn~ of services on
to render instructional services during the following
Her & Thurs 7:00-9:20 PV GHS Cafeteria
N9 CLASS ~0/6, 10/13, and 11/27
4-. ,.' ~The Town ~agrees to pay the Instructor and the Instructor agrees to- accept for
such 'servicds, th;e COmpensation, of · $22.00 per ;Ct~'slhour/~/~lis'~ to be paid at
semi-monthly in[ervals by the Submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Towm The Instructor shall determine that scope and manner of work
to be pe~ormed and. the hours for which it will be performed. . ~
6. It i~ agreed that the Instructor shall be responsible for the e~blishment o(the
program, to solicitation of participants therein, and the completion of alt~
7. , In orary illness or inability Ofrthe lnstructoF to conduct
classes as the Instructor shall immediately notify the Recreation
Supervisor. TheJnstructo~ will assist and/or cooperate with the supervisor .to provi, de ,for
ma keup&classes ,and~or~.ubsflflJie quahfied instructors.
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate,this
agreement.' ~ the event that the instructor fails or neglects to perform such [~tru~ti0~al
services in aqcardance With .prov!sions of fl3is agreement,, then and in such event, the
Town m the ex6rcise of d~scr~tion, shall have the Hght t0 terminate this agreement~'' '
The minimum and maximum enrollment of the class for the program is ~s foll~WSi
10 25
Minimum Enrollment. 10 Maximum Enrollment 25+
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
ii. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There Shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks,
12. The Instructo[ will-not receive payment for .any services rendered until this
conb;act~[S S g~ed and returned to the town clerk's Office pf~r tO the,beglnn ng of said
,program.
13. The T~wn of Southoid shall, as .oar[ 6flhe |nslructer's compensation; ..... ~ '
cover bhe
individual Instructor from claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the. Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and propecty damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
S{lua Y., Horton, Supervisor
Business Name (E applicable)
0¢ 6 7
Instructor's Social Security Number
F~leral ID Number (if applicable)
TOWN COPY
THIS AGREEMENT made,his
26th' . day of A~i~us~ ,2002, betwee~
the TOWN OF SOUTHOL_D, a municipality of the State of New York, having, it?'.p~rirlCipal,
(Route 25), P.O~ Box t179, Southold, New York 1197~t (the
"Town") ~and Do¥oth,¥ ~o'~f (The Instructor~)
residfngat' 2055 Ancho~ Lane Southold NY 11971
,',~: ~.(MAILINGADDRESS)
HOME F;HONE'' 765.4770 WORK PHONF:
, '. _ WITNESSETH:
agree to hire the !nstructor as an independent contractor,
to provide instructional services t(~ the Town for
to the terms;~nd conditions hereinafter se[
'~he tnstru~'~or~hall~provde nstructicna[ services for the following program, to
~ commence ~e ;rendering of services on
to render inst~onal, se~ic~ during ~e. following
t~ep~r~f'$ep~ ~ ;- Nov 25 Tuesdays 12:45--~:r45 ~M Recreation Center
N0~,CL~SS 11/4 and 11/11
~.. ~he~ ~o~, ag~s to pay ~e Instruc~r and ~e Instructor agrees ~ accept for
such s?yi~S,' ~e ~mpensafion of $25.00 per ~/hour/~6~ be paid at
semi-~on~l~ inte~ala b~ ~e submissi~m ~erefore to ~e Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
. to be performed and the hours for which it will be performed.
6. It is agreed that the Instructor shall be responsible for the establishment of the
program, to ~assist with the solicitation .of participants therein, and the completion of all
the classes ptanned for such.program.
7. In, th~ event of, th~ 'temporary illness or inability of the Instructor to conduct
classes aS, ahd. when scheduled, the Instructor shall immediately notify the' Recreation
supervisor: 2~he.lnstructor will assist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors. ...- ~.
. In the event that the enrollment in the program is -less than the minimum
enrollment as hereinafter set forth, the "~own. shall have the right to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as fellows:
Minimum Enrollment 1(} Maximum Enrollment 14
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she ~s an
independent contractor and that [he Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the ,Instructor. The Instructor is expected 'to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
~12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk'S office prior to the beginning of said
program.
13. The Town.cf Southold sha~l,=as pa~ of the Instructor's compensation, cov~r the
ndividuai instructor ~om claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
$1,000,000. and $2,000~000 aggregate- liability for bodily injury arid property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's Status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
J~u'a Y. Hort~l,-Sul~ervisor
~ 'ty umber
Business Name (if applicable)
Federal ID Number (if applicable)
'RECEIVED
TOWN COPY
8FP 200;3
THiS AGREEMENT made this 26~l~i; :~;~ay,~f~ ~lql~.st ,2003, between
the TOWN. OF 6OUTHOLD,, a municipality of ~e S~e of New York, hav ng its prin~ipa
office at 53095 Main Road (Route 25), P.O. Box ~79, Southold, New York 1~971 (the
~own") and EaS~ End Insu ca,ce S. ecv ~ cas (The "Instructor')
doingbus ness at P0 ~Sx 1406 S0u~h01d NY [~97~
(MAILING ADDEESS}:
WORK PHONE:
765-2811
WITNESSETH:
HOME PHONE:
E-MAIL ADDRESS:
i. The Town does hereby agree to hire the Instructor as an independent contractor,
and the Instructor does hereby agree to provide instructional services to the Town for
the program(s) hereinafter described, subject to the terms and conditions hereinafter set
forth.
'2. The Instructor shall provide instructional services for the following program, to
wit:
NTSI Defensive Driving Cours~
8. The Instructor agrees to commence the rendering of services on
November 8, 2003 and to render instructional services during the following
time period: Nov 8 9:00-3:30PM Saturday Recreation Center
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such services, the compensation of $30.00 per ~t~person to be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that ~cope ar)d manner of work
to be performed end the hours for which it will be performed.
6. It is agreed that the Instructor shall be responsible for the establishment of ttie
program, to assist with the solicitation of participants therein, and the completion of all
the classes pta.nned for.such program.
7. In the event of the temporary illness or inability of the Instructor to conduct
classes as and when scheduled, the Instructor shall immediately notify the Recreation
Supe,.rv~o~.~ Th~ Instructor will assist and/or cooperate with the supervisor to provide for
makeup cl~Lsse~ and/or substitute qualified instructors.
, In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter s~.t. ~0tth,,~the .Tow~n shall have the right to terminate this
agreement. In the event that ~'inst~actor ~failE or neglects to perform such instructional
services in accordance with proVisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment ~[ 5 Maximum Enrollment 40
'10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginmng of said
program.
13. The Instructor agrees to carry appropriate insurance coverage from claims for
bodily injury, death or property damage which may arise from the performance of their
services under the Agreement in limits of $1,000,000 and $2,000,000 aggregate liability
for bodily injury and property damage.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
.~H~'rton, Supervisor
Business Name (if applicable)
Instructor's Social Securit~ Number
Federal ID Number (ifapplicable)
~ACORD
TM
PRODUCER
ROY H REEV~ AGE[',]CY~ [NC.
PO BOX 54. 13408 MAIN RD,
MATTITUCK NY ~ ~1952
PHONE: ~1-29&4700
FAX: 631-2984850
DATE (MM/DD/YY)
CERTIFICATE OF L/~ INSURANCE sEP 4 03
INSURED
TOWN OF SOUTHOLD
P.O. BOX 1179
S399~ MAiN ~
SOLq'HOLD NY 1!971-0959
INSUlt"RS AFFORDING COVERAGE
INSURER iD:
COVERAGES
Amedca~ IP~t~:f~on,[as Co
NNC #
~PLO~' [I~Y ~E.L
SOU~ ~ ~C~N DE~. & ~ORT ~DN F~ SCH~L DIS~CT ~ USTED AS ~O~ ~S~ ~TH
RESPECT TO USE ~ GYM~E~ IN G~RT ~ F~ ~ROB~ ~S TO ~ ~ ON MORAYS & ~U~DAYS FROM
sEPT. lS, 2~ TO JU~ 14, 2~04 F~
CERTIFICATE HOLOER I J ~Dm~,~mt. msu~; ~RSUR~ L--~q~ CANCELLATION
GREENPORT PUBUC SCHOOLS
728 FRONT STREET
GREENDORT NY 119~
A. enti~ ' ':C~~ KOzo~47i~I~ .....
2sg9 Thomas A. D[ckerson
IMPORTANT
If the ,c, ertiflc.~ te holderisan ADDIq'IONAL INSURED, the policy~ies) must be end, orsed. A statement
on this certificate does not conifer tights to the certif'm_,ate holder in lieu of such endorsement(s).
If SUBROGA;TION IS WAIVED, subject to the terms and co~dit[oes of the policy, ceCtain policies may
require an endorsement. A sta~ment on this certificate does not confer r~hts to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate o~ Ipsurance on the reverse side of this form does not constitute a contra,ct between
the issuiJ~g insurer(s}I, authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-S (2001/08)
;~G~rtific~te ~t28~17
COPY
THISAGREEMENT:madethis 26th ~dayof August ,2003, between
the. TOWN OF SOUTHOLD, a mun c~paiity df the State of New York, having itS~prin.cipai~
office at 53095 Main Road (Route 25), P.O. Box 1~179~ ~thold~ New York 1197,5 (the
~'Town") and Thomas 'B0ucher (The Instructor")
re~idingat PO Box '}260 Cu~ch(~que [IY 11935
~ ~: ~ ~ *~:~'~ , ' (MAILING ADDRESS):
HOMEPHONE: ' 734:5,787 WORKPHONE: 344-4030
' WITNESSETH:
I ' The'Town'does hereby agren to h re ~he nstructor es an nde endent contractor
a'rid t~ Instructor does hereby agree to prey de instructional se~rvices to the Town for
the program(s hereinafter described, subject to the terms and conditions hereinafter set
forth.
instructional services for the following program~ to
?.. mi ........ ~.C .
The Instructor agrees lo commence the rendering of services on
to render instructional services during the following
bm~Pedod:i Se~:,LT,,~N~v12 .. ~ednesdays 6:45-9:00 PM Recreation Sender
NO C~SS ~1/5
4. 'r' Tl~e,~ '[o,w,,p~grees,,to pay, the Instructor and the nstructor agrees to accept for
sUclt ,s,,er~i~Ces, i tIi~]compensati0n of ' $25.00 per ~i'~s/hour/~Y~, to be paid at
semi-mor~thl¥ inte~als by the submission of vouchers therefore to the Town.
5. Iris. agreed that the Instructor shall report to the Supervisor for the Recreation
Departmenl~0~ thin,own The Instructor sha determ ne that scope and manner of work
to I~ perfoi~med ant~ the hours for which it will be performed..
6. It is agree(~:~hat the Instructor shall be responsible for the establishment of the
program, to,assist;with the solicitation of participants therein, and the' completion of all
the class~ ~i~pJann~ for such program
classes a:
Su~pe~i~a
mak~J~.~
;~he ev,e, nt:~of the,temporary illness or 'nability df the Instructor to conduct
~a,nd .W-h~ ~c~eduled, the In-~tructor shall im~nediately notify the Recreation
~., The,ln~iJctoi~ will assist and/or cooperate with the supervisor to provide for
Asses and/or substitute qualified instructors.
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement. In'the event that the Instructor Yaits or r~glect~'to perform such
services in accordance with provisions of this agreement, then and .in such event, the
Tow~q in the'exercise of discretion, shall have the right to terminate this agreement.
9. The rriihimum and maximum enrollment;of the class for the progra~ i~'ias f°iiow~:
Minimum Enrollment 4 Maximum Enrollment 5
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction proyided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment, The Instructor agrees that he or she is an
indepenctent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment.f~r any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program. ~
13. The Town of Southold shall, a~ part 0fthe Instructor's cdmlSehsafion,"~
individual Instructor from claims for bodily injury, death or property damage which may
arise from the performance of h~s/her services under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does not inure any. other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
Instructor's Social Security Number
Business Name (if applicable) Federal ID Number (if applicable)
TOWiSI COPY
THIS AGREEMENT made this -26th tray of August ,2003,~between
the TOWN. OF $OIITHOLD, a municipality ?f the State of.New York, h~ting it.~r~acipal
office (Route 2~, P~O~ Box 1179, South01~l, New York~llg71 (the
"Town~3 and Dan Gebbi.a
res~di~g'~t~i''~ I065 Ha,~or,s Path
HOME PHONE:
Sout ha~,lpton NY 11968
, (MAILING ADDRESS)
287-z~460 WORK PHONE:
WITNESSETH:
(The Instructor")
2. - 4 .~hc Instrt~ctor.shall provide instrud~fl~nal:services for the following progra .m,, to
wit: ' '". ·
agrees to commence the rendering of services on
.~ ....i..:~ .' .... ~.;,'.~3 and to render instructional~ services during the following
time ~0~ 22 Wednesdays 6:45-8:00 P~ Recreation Cen~er
4. ,, ~ ~h~e Tpwn agrees to pay the Instructor and the Instructor agrees to accept for
such: ~erv!(~es, the compensation of _~gF;./d()9 per ]class~lxo:a~l~egsorgta be paid at
semi-monthly intervals by:the Submission of vouchers therefore to the Town
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Departmeot of the Town. The Instructor shall determine that scope and manner of work
to be performed and the hours for which it will be performed.
6. It is agreed:that the Instructor shall be responsible f~r the esta~list{/n;~t'of the
program, tc assist with the solicitation of participants therein, and the completion of all
the classes planned,forsuch program.
7: IP,,~he~. ev~,e~,~ Of ~h.e~ ,~emP0rary ,illness or inability of the Instructor,to,~cenduct
~assesi:as an'd When scheduled, the Instructor shall immediately notify the Recreation
Sup~e~v~py%The InStructor will assist and/or cooperate with the supervisor tq. prov!de for
makbul~ classes and/or substitute'qualified instructOrS. '-.~
. In the event that the enrollment in the program is less than the minimum
enrollm~nt~as hereinafter set forth, the Town shall have the right to terminate~this
agreement. In the event that the Instructor fails or neglects to perform such instructional
se.~vi~ces in~ accordance with provisi0ns of ~this agreement, then and in such:ev~ent; the
Town in the exercise of discretion, shall have the rightto terminate this agreement_
9. The minimum and maximum enrollment of the class for the program is as folroWS:
Minimum Enrollment l~_ Maximum Enrollment
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instructio~ provided for in this contract, and will provide sucti
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southotd shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered te the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independentjudgmentJn fulfilling his/her Instructor tesks.
12. The lnstructor~ will not receive.payment' for any services rendered until this
contrac~t is ~signed and returned to the town clerk,s office prior to the beginning, of said
program.
13. The Town of Southold shall, as pa~t ~of ~he Ihstructer's compensafion~'c0ver the
individual Instructor from claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liabilify for bodily injury and property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above w~itten.
TOWN OF SOUTHOLD
.~shua Y. I-~rt~r[, Supervisor
Instructor
Business Name (if applicable)
In~ruc~or's Social Security Number
Fc,~eral ID Number (if applicable)
THIS AGREEMENT made,his_ 26iff day of
TOWI COPY
August ,2003, between
office at5~095 I~lain ROad(Route 25);P O. Box 1179; Seuthold, New York i197~ (the
Town'~ and 3,~h]3 D~ H~uru,s (The Inductor')
~ ?~ '~" 0~: Cutchogue NY 11935
residing~t~', P0~ox I ~ r
HO~PHONE: 734-6860 WORK PHONE: 477-0777
the Instructor asan independent contractor,
services to the Town for
escrthed, subject to the terms and conditions hereinafter set
_~._~,~[~,, Tt~e' nstrug-'tor~ ~hall:~prowde mstructonal services for the following program, to
'!~t(~uc~0~ i'a~rees lo commando' the rendering of' ~services on
render instructional services during the following
3:00-5:1.5 PI~ Wednesdays Islands End,Golf
and Country Club
s4. iThe Town.agrees to pay [he Instructor and the Instructor agrees to accept for
[!ch s~rvices; ,the compensation of $38_. 00 per ~la;~/fli:Y~/pers0n to be paid at
semi-monthly intervals by [he, submission of vouchers therefore to the TOWn,
5, ,It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner~f work
'to be performed and the hours for which it will be performed. , -
6, It is agreed that the Instructor shall be responsible for. the establishment of the
prograq~, to assist with the solicitation of participants therein, and the completion of all
the classes431anned for such program~ .
7. ., 'l~ ~he e~fi~ of' the 'temporary illness O¢ inability of the Instr~ctoi' to conduct
cl~ass~,S~s a0.d wh. en .schedpled,.~the.'lrtst~uctor~ shall jmmediately~natify the~Recreation
supe~v~'gr,~The Instructor will assist and/or cooperate with the supervisor to provide for
m~keup classes and/or substitute qualified instructors,
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate .this
agreement. In the event that the Instructor fails~ or h~eglects to perform such instructional
services i~ ad~ordan~ce with provisions of this agreement, then and in such event, the
T0~n !nthe ~rcise'0f discretion, shall have the right to terminate th s agreement.
The 'n~i~i~um ~nd n~ax m~-m enr011ment'ofthe class for the program is as fellows:
Minimum Enrollment ~ Maximum Enrollment t0
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of.f. raining and
experience to provide the instruction provided for in this contract, and will provide such
services in a compe[ent and professional mann'er. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive, payment for any. services rendered unUi this
contract is signed and returned to the town clerk's office prior to the beginning of said
program. ~ ....
~ 3. The Town of Southold shall, as part of the ~nst~Jctor's compen~at c~. 'co,er ;-,~e
individual instructor from cia/ms.for bodily/injury, death or property damage which may
arise from .the performance of his/her services under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN7 SOUTHOLD
Infi~ruotor
Business Name (if applicable)
/o 3 -3 ,'
Instructor's Social Security Number
Federal ID N~mber (if applicable)
ToWN COP
THIS AGREEMENT made'this
26th day0f' Augus't
,2003, between
office at 53095 Main Road .(Routa 25),
"Town") a~d Mar~y Hewitt
residingat 245 LOng C~eek Driv~
76'5~3599
Box i179, Southold, New York 11971 (the
S~uthold NY
WORK PHC NE~;
(The Instructor~')
11971
: the Instructor as an independent contractor,
hereby agree to provide instructional services to the Town for
subject to the terms and conditions hereinafter set
2.~ ~ T~e Instrudtor ~haJl provide instructional services for the following program, to
C~eat ive Sc~pboo k~ n9
8.~.~ . ~The I~S~Ctonr agrees to commence the rendering of services on
,~ p~?b;er~,~4,~ 2003 .'and to r, ender instructional services during the following
time~pe~d: ~pt~24.- r~OV,19 W~dnesdays 6.30~8:~0 PM SHS Cafeteria
' a d /
NO CkASS 10/15 n~ I1 5
4. ~ .~The ToWn agrees to pay the nstructor and the Instructor agrees to accept for
such s~vices, the compensation of $20.00 per )~eV~slhourl~, to be paid at
se~m -monthly ifiter~als by the submission of vouchers therefore to the Town.
5. I~ is agreed that the Instructor shall report to the Supervisor for {he Recreation
Department of the, Town. The Instructor shall determine that scope and manne~ of work
to be performed and the hours for which it will be performed.
t is agreed that the Instructor shall be responsible for the establishment of the
program, to assis~ with the solicitation of participants therein, and the completion of all
the classes~ planned for sach p~ogram.
7. . tn the;,'event of the temPorary illness or inability of the Instructor to conduct
classes as and when scheduled, tie Instructor shall immediately notify the Recreation
Supervi,Sor. Th~lnstructor will assist and/or cooperate with the supervisor to provide for
mal~upl, classes ar~lor substitute qualified instructors.
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement. In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment 7 Maximum Enrollment 10
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor-and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
The Town of Southold shall, as part of the Instructor's compensation, cover the
individual Instructor from claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
,$1,000,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does no[ inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
tN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
J~a Y. I~or~3n, Supervisor
in(~-ruct~ r
Instructor's Social Security Number
Business Name (if applicable) Federal ID Number (if applicable)
THIS AGREEMENT made this
26th day of August
· 2003, between
office at 53095 Main R0ad (Rou~e 25), P.O.
'"~°Wn"). a~d RoSer~ar, y Martilot~a
reSidlnga~ - PO Box
Cutchoque NY 11935
~ , .~ ,., -~,*~ <~ ~{MAILING ADDRESS),
ipality of the State of New York. having its pr~pa!
Box 117g~ Southold, New Yore 119.71 (the
(The Instructor")
WORK PHONE:
NESSETH:
the instructor as an independent contractor,
ant ;;ructor, does hereby agree to provide instructional, services to the Town for
Ihe pEog'arn(s) ' ':~ ......
t~oremaf[er described, subject .to the terms and cond~bons hereinafter set
fo~h~
2'-~. . , The. !~st ll~;p~oyide, instructional services for the following program, to
3,4 ~!e Jcnstrut:~or agrees to commence the renoermg of services on
· ~~,e~mb:er' ~2,, ~003,< , ' · ' the following
' ~ ',~ ,;,~, ,;.; . and to render Instructional services during
time,or,Od; _~..~_. __ 17 Honda.vs 8:30-10:00 AH Rec~es~ion Cen~e~
N0 EbASS 10/13-
4. Thej~T~own,~g,rees,to,pay the Instructor and the Instructor agrees to accept for
such serv~&e~s, the¢,&ompensation of $55.00 per class/tyo~'~ to be paid at
semi-monthlydntei'v~{Is by the submission of vouchers therefore to the Town.
5. It is' agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
[o be performed and the hours for which it will be performed.
6. It is agreed,-that the InstructoF. shall be responsible for the establishment of the
program, to-assist With the solicitation of participants therein, and the completion of all
the classes~planned for such program.
7, 'In the. even[ ;bf the temporary illness Or inability ~of th~ Instructo~ '{o~conduct
classes ashland when schedu!ed, the Instructor shatl-immediatety, nofif~ the Recreation
Supervisor¢',The,t,: lns~ctor will assist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors,
. In the event that the enrollment in the program ts less than the minimum
enrollment as hereinafter set forth, the, Town shal! t~ave the right to. terminate this
a{Ireement- n~the event that the InstruCtor fails'~'rieglects to perform such instructional
Services ~ accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. '~ ~' ~ ':TI~ ~inim~m'and maxi'mum enro~Imen;~of the class for the program is as follows:
Minimum Enrollment Maximum Enrollment
10~ The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered' to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgmect in fulfilling his/her lnstructar tasks.
12. The Instructor will not receive payment for any services rendered until this
contract'is signed and returned to the town clerk's office prior to the'beginning of said
program.
~ 3. The '~wr~ of Southold shall, as part ~f the Inst~uctar's compensation, cover the
ihdividual Instructor from claims for bodily.injurY, aeath or property dar~age which may
arise from the performance of his/her services under the Agreement in limits of
$~ ,000,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above writtem
TOWN OF SOUTHOLD
,~roshua Y. Herren, Super~isor . .~/
Instructor's Social Security Number
Business Name (if applicable) Federal ID Number (if applicable)
TOWi COPY
ENT made this 26th dayof August ' ,2003, between
the TOWN- OF SOUTHOLD, a municipality of the State of New York; having its: principal
~ffice at $$095 Main R ~oad, (Route, 25), P~O. Box 117.9~ Southotd~ New York 1'I971 '(the
~Town~) and ' j~les ~qikelSank (T~e Instructor")
~lattituck NY 11952
~ME PHONE::
:(MAIUNG ADDRESS)
WORK PHONE:
,, WITN ESSETH:
~ the Instructor,as an independent contractor,
to provide instructional services to the Town for
, subject to the termsr and conditions hereinafter set
2~ ~.~The nstru~tor st]alt provide mstrucflonal services for the following program, to
$..: to commence the rendering :; of~, ~'~services or~
render instructional services during the following
time~per~o,d: SeD,2~[,3',~-Dec 6 Saturdays 7.30-9.30 AM SES Gym
NO' PROGRAM '1Q/25, 11/1, and 11/29 '
4, , TheT(~Wn a, gr~es to, pay the Instructor and the Instructor agrees to accept for
such services, .fll~ co~ilpensation of $25.00 per c¢~hourlI~g<~'l~ to be p~id at
semi-monthly intervals'by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
to be performed and the hours for which it wilt be performed.
6. .It is agreed that,the Instructor shall be responsible for the establishment of the
program, to assist with the solicitation of participants therein, and the completion of ail
the ctasses.plaoned~or such program.
In the 9veqt of the temporary illness, or nability of the Instructo~ to conduct
classes as and when scheduled, the Instructor shall ~mmedlately notify t.h.,e ~e, creatto~n
Superyispr;;The' Instructor will assist andlor cooperate v~/ith thb sU~ervisoi' to provide for
~akeup, cla~se$ and/or substitute qualified instructors.
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement. In.' the eVent that the Instrtictor fails Or neglects to perform such instructional
services !r~ accordance with. provisions of this agreement, then and. n suc~h event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9 .... The mlmmum and maximum enrol menthol the class for the program is asfdllows:
Minimum Enrollment 10 Maximum Enrollment 25
10. The Instructor agrees to prepare accurate attendance records of alt persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The nstructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructo~ will not receive payment,f~r any services rendered until this
i;ontract is signed And returned to the town' ~lerk s office prior'to the'be'ginning of said
program
13. The Towh of Southold shall, as part of the' lnstr~Ct0~'s comperfs~t:io~, :[he
~ndividual instructor from claims for bodily njury, d~ath or property damage which may
arise from-the performance of his/her services under the Agreement in limits of
$1,000,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOW~ SOUTHOLD
uc~r ~ ~ ~ ~ Ins~ctor's Social Security Number
Business Name (E applicable) Federal ID Number (if applicable)
TOWN COPY
THIS AGREEMENT madethis 26th day of AuguSt ., 2003, between
the TOWN OF SOUTHOLD, a municipa ity of the State of New York. having its, princ Pa
office at 53095. Main Road (Route 25), P.O. Box 1179, Southold, New York llg71 (the
~'Town")and Pain~'Webbe~, Inc. Steve Guglielmoni
doing bfi~iness at ~5 Br'~dhollow Ro~d Melville NY
HOME PHONE:
E~MAIIS;A~DD~ESS: ~.
(MAILING ADDRESS):
WORK PHONE:
(The "Instructor")
11747-4896
1-800-654-6162 Ext 46~
WITNESSETH:
7' The Town does hereby agree to hire the nstructor as an independent contractor,
~nd the ihsfracto~ does hereby agree 'tO provide instrucflona ' serv ces to the Town for
~the,proG~am(~} hereinafte~ descr bed, subject to the terms and conditions hereinafter set
fo~h.
~2o ~ r~T~,h~e !~3structor s~all p'rovjde~4nstruct onal services fei~ the following program, to
The,~C~mpl~ter,:Elt3a~nc~a] Na~agemen~ Workshop ~-, ,~., ~,
$. T' he ,~lnstr~ctor agrees to commence the rendering of services on
0ctoDer 30, 2003 and to render instructional services during the following
time period: Oct 30 - h0v 20 Thursdays 7:00-9:00 PM HHS Room 212
4. The Town agrees to pay the Instructor and the Instructor agrees to accept for
such services, the compensation of $20.00 per ~t~/~l{t~l~person to be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town,
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope arid manner, o'fwork
to be performed and the hours for which it,will be performed. ' ~' '- ', ~ , '"
6. It is agreed that the Instructor shall be responsible for the establishment ol; the'~
program, to assist with the solicitation ,of participants therein, and the comp et On of all
the classes planhed~f~r such p!;ogr~m.
7. In the event of the temporary illness or inability of the Instructor to conduct
classes as~and"Wl~en Sctfed[lled, the Idstructor shall imme~liat~ly noti~ the R~creation
Supervis0~r. The Instructor will assist and/or cooperate with the superviso, r to.provide for
makeul~i~ss~ a~!prsub~tj~tut~ q_ua! fled nstructors~, c r ~ ~ ~' ' ~ ' '~ '' '~
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter..~et forth, the Town shall have the right to. terminate this
agreement. In the event that the Instructor fails-or neglects toperform such instructional
services, in .accordance with provisions of this agreement, then and?in' such~e~vent,.;the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the' program is as follows:
Minimum Enrollment 8 Maximum Enrollment. 30
t0. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town Clerk's office prior to'the beginning of Said
program.
15. The Instructor agrees to carry appropriate insurance coverage from claims for
bodily injury, death or property damage which may arise from the pe~ormance of their
services under the Agreement in limits of $1,000,000 and $2,000,000 aggregate liability
for bodily injury and property damage.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
s~3[a Y. Ho~on, S~pervisor
I
BUsiness:Name (if applicable)
Instructor's Social SecuritY Number
THIS AGREEMENT madethis N '- 26th day of :' August ,2003, between
the TOWN OF SOUTHOLD,, a muriicipali[y:of the State of New York, having its prin~ipat
P.O. Box 1179, Southold, New York 11971 (the
"Town"} an~ l~h~resa~ Press ler
res~d~ngat -510 Tuchll Roa Ext
S0uthold NY
(The Instructor")
11971
~ , . Instructor as an independent contractor,
and ;th'e In~J. ructo~: d(Ses hereby agree to provide instructional ~services to the Town for
the progr~rn(s) horeiha~ter d..oscribed, subject to the terms~and conditions hereinafter se[
torth.
T~'~struc[[o~', sna l [~revide instructional services for the following program~ to
Story,& Cr~t ' ' '
3. i~.,~The~'{nstYuF, tor~ agrees to commence the rendering of servces on
i F.lriZeTaFe~'i-'~00.~'. and to render instructional services during the following
time.nod: ~geo/c ~6,~ ~v ]4, Fr~da. vs 8:30-9:45 PM Recreation Center
4. . ~ The Town.agrees to pay the Instructor and the Instructor agrees to accept for
such.s~ervmes, the compensation of $2500 _ per.~aVs/hour/~h to be paid at
semi-mOnthly intervals by the submissipn of vouchers therefore to the Town. .
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
to be performed and the hours for which it will be performed.
6. It is agreed that the Instructor shall be responsible for 'the establishment of the
program, to assist with the solicitation of participants therein, and the completion of all
the classes planned,for such program.
7. In the event 'of the temporary illness or inability of the Instructor to conduct
classes as and when scheduled, the Instructor shall immediately notify [he Recreation
SuperVisor, The Insfl~btOr will ~ssist and/or cooperate with the supervisor to provide for
makeup classes and/or substitute qualified instructors.
. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set forth, the Town shall have the right to terminate this
agreement, In the event that the Instructor fails or neglects to perform such instructional
services in accordance with provisions of this agreement, then and in such event, the
Town in the exercise of discretion, shall have the right to terminate this agreement.
9. The minimum and maximum enrollment of the class for the program is as follows:
Minimum Enrollment 9 Maximum Enrollment [ §
10. The Instructor agrees to prepare accurate attendam=e records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
l~l. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner. The instructor represents and agrees
that he or she is an independent contractor and is sclely responsible for payment of
taxes arising out of this employment. The instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensatio~ benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and returned to the town clerk's office prior to the beginning of said
program.
13. The Town of Southold shall, as par of the Instructor's compensation, cover the
individual Instructor from claims for bodily injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
$~,000,000. and $2,000,000 aggregate liability for bodily injury and properbj damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands andseals the
day and year firs[above wriff, en.
TOWN OF SOUTHOLD
Instructor
Business Name (if applicable)
Instructor's Social Security Number
FederallD Number if applicable)
OW! COPY
THIS AGREEMENT made this 26th day of August . ; 2003~between
office at 53095
'.New York, having its~prihcipa~
P.O~ Box 1179, So,uthold, New. York 11971 (the
[The Instructor")
WITNESSETH:
%- ~ -T~e,}To~n~loes hereby agree to h~ra the Instructar as an independent contractor,
~n~e Ihstruct~r ~es hereby a~rae ~ prowde m~onai se~mes to ~e Town for.
the 0rog ~am(s} hereinafter described, subject to ~e ~ms~d condifionshereina~r set
forths;
~?~;A~he~nsffu~r~$hal4provide ns~uctlona ,se~ c~ for ~e following program, to
agrees [o commence the rendering of se~ice8 on
to render instructional services during the following
,,~-~: ~ Oct~ ~ -}~Nov 13 Thursdays 7:00-9:00 ?M Recreation Cen~er
l~lO bLAb~ .LU/Ib and .L0/'23
4 The TowB ~a~re~s to pay the InstruCtor and the Instructor agrees [o accept for
such ,services, ¢~h~oomPensation of $20. O0 per ~[,~,lhourl~ to be paid at
semi;.~on~hly integrals by the submission of vouchers thoro[ore to the .Town.
5. It is.agreed.that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope and manner of work
to be performed and [he hours for which it will be perl:ormed.
6. It is agreed,that the Instructor shall be~ responsible for the estabfishmeht: of the
program, to assist. With the solicitation of participants therein, and the completion of ail
the classes~plannect for sbch program.
7. Ih the evL~n?of, the temporary illness or inability of the Instructor to conduct
classes.as and when scheduled, the Instructor shall immediately notify the. Recreation
Supervi~or. The ;Instructor Will assist and/or cooperate with the supervisor to provide for
makeup classes and/orsubsfi~te qualified instructors., . :.~;~ ~, . ,
8. In the event that the enrollment in the program is less than the minimum
enrollment as hereinafter set. forth,t the Towr~;shall' have the right to_terminate this
agreement. In'~he event that the InstructOr ~ail~ ~ neglects to perform such i~strUctional
se~ice~ in accordance with provisions of this agreement, then and in such event, the
Town !n the exercise of discretion shall haVe th~ right.to terminate this agreemenf,
9. The minimum and m~ximum enrollment of the class for the program is as folloWs!
Minimum Enrollment ' 6 Maximum Enrollment 12
10. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
e~.perience to provide the instruction provided for in this con~_ract, and will pro¥ide such
services in a competent and professional manner. The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement. There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor will not receive payment for any services rendered until this
contract is signed and retarned to the town-clerk's office prior to the beginning of said
~)¢ogram. ,,, ~
13. The ~own of Southold shall,~as p~r~ of the Instructor's compehs~'0n, cover the
individual Instructor from claims for bodily Injury, death or property damage which may
arise from the performance of his/her services under the Agreement in limits of
$1,O00,000. and $2,000,000 aggregate liability for bodily injury and property damage.
This coverage does not inure any other benefits upon the independent contractor nor
does it alter or modify the Instructor's status as an independent contractor.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands ~and Seals the
clay and year first above written.
TOWN OF SOUTHOLD
~;~h~'~ ~. H0rton, Sul~)ervisor
Instructor
Business Name (if applicable)
Instructor's Social Security Number
Federal ID Number (if applicable}
TOWN COPY
26th day0f August - ,2003, between
the TOWN OF SOUTHOLD, a municipality of the State of New York, having its~principal
office at 53095 Main Road (Route 25), P.O. Box 1179, Southold, New York 11971 (the
"Town") and Touch Dance Studios
doing business at BOX 1382 'West, hamPton Beach NY
HOME PHONE: _
~E~MAI.L A, DD~RESS:
(MA ~L NG ADDRESS):
. WORK PHONE:
alfonso~touchdancin9. com
(The "Instructor")
11978
288-5659
i: The Town.does hereby agree to Hire the Instructor as an independent contractor,
and the Instructor~ does' hereb~y agree to Provide ins,trucflonal services to the Town for
th~ pr°gram(s)~ hel~einaffer described, subje'ctte the terms and conditions hereinafter set
forth.
2. The Instrubtor shall pYovide' instructional services for the following program, to
wit:
3. The ~ Instructor. agrees ~. to commence, the rendering,, of: services 'on
b
0cte e'r 11~ 2003 and to render instructional services during the following
time period: Oct 11'-'N~v 22 6~00-9:00 P~f Saturdays Recreation Center
N0 CLASS 11/8
4. The Town agrees to pay the Instructor and the Instrueter agrees to accept for
such services, the compensation of $8.00 per class/tt6t4~peraon to be paid at
semi-monthly intervals by the submission of vouchers therefore to the Town.
5. It is agreed that the Instructor shall report to the Supervisor for the Recreation
Department of the Town. The Instructor shall determine that scope apd '..rnan'her of work
to be performed and the hours for which it will be performed .... -
6. It is agreed that the Instructor shall be responsible for the establishmeht of the
program, to assist with the solicitation of participants therein, and the completion of all
the classes planned, for such program;
7 In ~the. even~ of the ,temporary ness oF-inab ty of the nstructor to conduct
classes as and .when sche u ed, the nstructo sha mmed ate y noti~ the Recreat on
Supervisor; The4nstructor will assist and/or cooperate with~the'~'upervi~or to pr0{/ide*fo~'
makeup Cias~es and/or substitute qualified instructors.
. In the event that the enrollment in the program is !ess than the minimum
enrollment as hereinafte~ set ferth, the Town shall~have the right to terminate this
agreement. In thei~eVent that the Instructor fa Is-or neg ects to perform such instruct ona
services in accordancewith provisions of this agreement, then and in such event, the
TO~n' inthe exerCise bf discreti0n, Shall havethe right to terrnihate this agreem~ht~
9. 'TI~e mi~imum and ~a~i~um ~nr°li~ent 6fthe ~las$ f~r the. pr~ra'm~'is a~
Minimum Enrollment ~0"~,~ O Maximum Enrollment
fO. The Instructor agrees to prepare accurate attendance records of all persons
enrolled in the program and to file the same with the Recreation Supervisor within one
week after the last class of the program.
11. The Instructor represents that he or she is competent by reason of training and
experience to provide the instruction provided for in this contract, and will provide such
services in a competent and professional manner~ The Instructor represents and agrees
that he or she is an independent contractor and is solely responsible for payment of
taxes arising out of this employment. The Instructor agrees that he or she is an
independent contractor and that the Town of Southold shall not be liable for any taxes or
withholding. There shall be no fringe benefits associated with this Agreement, There
shall be no health benefits offered to the Instructor. There shall be no workers
compensation benefits offered to the Instructor. The Instructor is expected to utilize
his/her independent judgment in fulfilling his/her Instructor tasks.
12. The Instructor ~will :not receive:payment, for any services .rendered un:Iii this
.contract is signed and returned to the town cleFk's office prior to the beginning of said
program; ~
~TI~sin r tor r e t ~ ry - . . ' ~ ~ ~ ~.
13. st uc ag e s o ar appropnate ~nsurance coverage fromcla~ms for
bodily injury, death or property .damage which may arise from the performance of their
services under the Agreement in limits of Sf,000,000 and $2,000,000 aggregate liability
for bodily injury and prOperty damage.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals the
day and year first above written.
TOWN OF SOUTHOLD
JO~L~a Y. Horton, Su[oervisor~
Business Name (if applicable)
Instructor's Social Security Number
Federal I O Number (if applica/bl~)