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HomeMy WebLinkAboutCAST Mighty NF Triathlon Vendor No. keckN?:.'.'::` :.:::::: : Town of Southold, New York - Payment Voucher Vendor Name Vendor Address E31te3 ed'b}! .......... . ......... .... ..... ................ 2 .............................. Vendor Telephone Number 041 Vendor Contact 2 ::: rnor Dt0 :::::::::::::::.::::::::.:.:.:::::::.::::.::....:::: Invoicel Invoice Invoice Net Purchase Order Number Description of Goods or Services 5.`Gene"r'a1:I edgerEFiiri;fail Ntiiiiber"E:.: Number Date Total Discount Amount Claimedp ,y f ri U Gt d(5 15 oGo Payee Certification Department Certification The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing,and that taxes from which the Town is exempt are excluded. or discrepancies noted,and payment is approved. Signature Title Signatur �f V 1��1�Y� Company Name Date Title V 4 .r b'1AJ n 1 l�r,` Date t �� o�I Southold Town Board- Letter Board Meeting of June 4, 2024 RESOLUTION 2024-498 Item# 5.24 ADOPTED DOC ID: 20315 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2024-498 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON DUNE 4,2024: WHEREAS the'following groups have supplied the Town of Southold with a refundable Clean- up Deposit fee, for their events and WHEREAS the Southold Town Police Chief, Martin Flatley,has informed the Town Clerk's office that this fee may be refunded, now therefore be it RESOLVED that Town Board of the Town of Southold hereby authorizes a refund be issued in the amount of the deposit made to the following Name Date Received Amount of Deposit C.A.S.T. 2/07/2024 $1500.00 Attn: Cathy Demeroto PO Box 1566 Southold,NY 11971 Southold UFSD 4/11/2024 $250.00 Attn: Danielle Donohue PO Box 470 Southold,NY 11971 Orient Fire Dept. 3/22/2024 $250.00 Attn: Burke Liburt PO Box 37 Orient,NY 11957 Denis Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Anne H. Smith, Councilwoman SECONDER:Brian O. Mealy, Councilman AYES: Doroski, Mealy, Smith, Krupski Jr, Doherty ABSENT: Louisa P. Evans. Generated June 6, 2024 Page 46 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 02/07/24 Receipt#: 322474 Quantity Transactions Reference Subtotal 1 Clean-Up Deposit 5.26.2024 $1,500.00 Total Paid: $1,500.00 Notes: Payment Type Amount . Paid By CK#5265 $1,500.00 Event Power Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Event Power 98 Southdown Rd Huntington, NY 11743 Clerk ID: DENISN Internal ID:5.26.2024 �yUFFO(� RESOLUTION 2024-154 \vJ ADOPTED DOC ID: 19 67 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2024-154 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN•BOARD ON FEBRUARY 13,2024: RESOLVED that the Town Board of the_To_w,n_of FSouthold hezeby_grants permission for CAS to hold the 'kT-he_23rd An uual-Mighty_Nor_th_Fork Triathlon at Cedar Beach Park, Southold,New York, on(TSund May 26,20.2_'4;� 4 am to 12pm. (Set up Saturday May 25th from 9am to 3pm) using the following roads: Cedar Beach Road, Paradise Point Road,Bayview Road North, Anchor Lane,Pine Neck Road,Jacobs Lane and Main Bayview Road. and provided they file with the Town Clerk a Two Million Dollar Certificate of Insurance naming the Town of Southold as an additional insured; a$250.00 filing fee;$1500.00 deposit for clean-up (deposit to be returned after event upon recommendation of Chief Flatley, (Southold Town Police Department)provided they comply with the Town of Southold's Policy for Special events on Town Properties and Roads. Failure to comply with all provisions and conditions will result in the revocation of the permit. Denis Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Anne H. Smith, Councilwoman SECONDER:Brian O. Mealy, Councilman AYES: Doroski, Mealy, Smith, Krupski Jr, Doherty, Evans Ak •• LFE - 7 2024 yd MIGHTY NORTH FORS CO�' 500m swim-7mi bike-3.5mi run Date: January 29, 2024 To: Honorable Albert Krupski, Town Supervisor Town of Southold Board Members Denis Noncarrow, Town Clerk From: Cathy Demeroto, Executive Director, Community Action Southold Town Vicki Ventura, Race Director, EventPower Re: CAST Mighty North Fork Triathlon CAST and EventPower are partnering to launch the 24th Annual CAST Mighty North Fork Triathlon. Our collaborative goal is to: • Produce a safe and profitable event • Integrate community • Donate directly to the community In previous years the CAST Mighty North Fork Triathlon has raised money to help the residents of Southold. This year would mark the 24th Annual Triathlon. Enclosed please find the signed permit application for the 24th Annual CAST Mighty North Fork Triathlon for Sunday, May 26, 2024 at Cedar Beach in Southold, NY. The Triathlon begins at 6:50AM and is completed by 10:OOAM. The parking lot, beach and roads will be cleaned and the race site will be cleared by 11:OOAM. The race consists of a 500 meter swim, a 7 mile bike ride, and a 3.5 mile run. The course will be the same as it has been over the previous years. A map of the course is enclosed. Enclosed is a $250 check for the application fee, a $1500 check for the clean up deposit and a Certificate of Insurance for the Town of Southold. If you have any questions, please contact either Cathy Demeroto (631) 477-1717 or Vicki Ventura (516) 313-8329. n S 1' MIGHTx NORTH FORK 500m swim-7ml bike-3.5mi run January 29, 2024 Dear Town Supervisor, Members of the Town Board and Town Clerk, This letter is to explain the mission of the CAST Mighty North Fork Triathlon to be held on May 26, 202. This will be the 201 Annual CAST Mighty North Fork Triathlon. Our mission is to fight poor health through a culture of care on Long Island. Focusing on goal setting, health, fitness and wellbeing we want to promote and grow the competitive sport of triathlon through the safe and fair conduct of races. We are looking to educate the community about physical and mental health and generate funds for research and local community outreach. The race consists of a 500 meter swim, a 7 mile bike, and a 3.5 mile run. The triathlon would start at 6:50 AM and be complete by 10:00 AM. The site, including the parking lot, beach and roads will be cleaned up by 11:00 AM. EventPower is proud to produce triathlons across Long Island. We currently produce 11 adult events and 3 youth events per season. We encourage participation from every ability and are open to anyone interested in athletics. For more information, please visit us at EventPowerLl.com. Sincerely, Victoria Ventura Race Director I DENIS NONCARROW ,`�� ®Gy Town Hall,53095 Main Road TOWN CLERK 1 p P.O.Bog 1179 i Southold,New York 11971 REGISTRAR OF VITAL STATISTICS .Z: Fax(631)765-6145 MARRIAGE OFFICER 1 Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER l �+� vvvvw southoldto FREEDOM OF INFORMATION OFFICER �� I OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD i APPLICATION FOR A PERMIT TO HOLD A j SPECIAL EVENT Please Provide ALL of ti �infdrrnatihm requested below:Incomplete ap0lifttions WILL NOT be reviewed. Date of Submission 0D C OA Name of Event I � ` Name of Organization: C�A� Ces4ec- j�c 1�Qu- C—SA .Sv Is this a Not-For-Profit Event?Yes/No Contact's Name: c,� v, _. Mailing Address: Contact's Phone Number: �o k Contact's Email Address: �c�- o17`ck Event Location and Site Di I gram: ( (Use additional paper if necessary) Event Date(s): v Mc►. '. (Include set up andrhutdo times and dates) Nature of Event:—'�C\c��c\�\� — \-zs SK-e— C\— c-, (Please attach a detailed description to this application) Time Period(Hours)of Event: From "gxr n to 12c- s� Ito n.� Sati.— IOQ� Maximum Number of Expected Attendees: Specify any special requirements(i.e.road closure,police presence): mom 1 i i i If a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 \ Mailing Address to Send Event Permit to: i Event Fees: $250 for events with less than 1000 expected attendees $500 for events ith 1000 or more expected attendees 'e Clean-up Fees(Can NOT b waived): V $1,500.00 Cleanup for Bicycle and/or Running Special events(ONLY) $250 or more Clean-up deposit all other events CERTIFICATE,.OF INSU UNCE RE,OUI E'D: Not less than$2,000,000 naming the Town of Southold as an additional insured. f ***NOTE: PLEASE SEE ATTACHED REVISED,ADOPTED TOWN 3 .POLICY*** Additional information and requirements may be required as deemed necessary by the Town Board. Print name of A thorized Person filling out Signature o orized Person filling out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. J 2 CAST Mighty North Fork TRIATHLON INCIDENT ACTION PLAN i i The purpose of this Incident Action Plan (IAP)is to identify and mitigate any potential risks associated with the planning, implementation and successful completion of the above referenced event. The parties that are planning and coordinating this event are committed to ensuring that all participants, sponsors, community members and emergency personnel are able to partake in the event in a safeiand organized manner.The procedural information contained herein will be strictly adhered to. Title of Event: The 241 h Annual CAST Mighty North Fork Triathlon Date of Event: May 26,2024- Start Time:6:50 AM(RAIN or SHINE) Event Description: Sprint Distance Triathlon:Swim:500 meters,Cycle:7 miles,Run 3.5 miles Location: 1) Swim:Cedar Beach, rectangle swim 2) Cycle- Exit Cedar Beach Rd heading North, Right turn onto Paradise Point Rd, Left turn onto N Bayview, Right turn at intersection of Bayview&Jacobs Lane continuing on Bayview Rd, Left turn at intersection of Bayview and Anchor Lane continue on Bayview, Left turn onto Pine Neck Rd, Left turn onto Main Bayview Rd,continue back to Cedar Beach 3) Run- Exit Cedar Beach Rd heading North, Right turn onto Paradise Point Rd, Left turn onto N Bayview, left turn at Jacobs Lane, Left Turn onto Main Bayview Rd,continue back to Cedar Beach. I Command Post Location: Town of Southold Police Captain Kruszeski:- fkruszeski@town.southold.ny.us 631-765-2600 Coordinator/Chairperson- Name: Vicki Ventura i Phone Number: 516-313-8329 Email Address: Vicki@eventpowerli.com Course Director- Name: Vicki Edwards Phone: 631-831-4333 I Email Address: info@eventpowerli.com Staff Coordinator- Name: Tara Hohlman I Phone: 516-840-7259 I Email Address: tara@eventpowerli.com Medical Emergencies Procedure All medical emergencies will be reported to the Command Post by use of Radios, cell phones or by verbal means. The Event Coordinator will call directly to the Command Post and report the incident/problem.The EMT(s)will report to the Command Post,as appropriate,when entering the event and notify the Command Post when leaving the event.The event coordinator will make sure an area is open to allow EMS personnel,vehicles and equipment access to the event grounds wherever emergency assistance is needed.The nearest hospital for receiving patients is East Long Island Hospital Police Emergencies Procedure For all police emergencies, Notification to the command post. Police enforcement will be provided by the Town of Southold Police with be station at position listed in the attached Course control document. Lost Child Procedure Police will be notified. In the event of a lost child, he/she should be taken to the Command Post. The child, if able, will be asked to provide parent/guardian information. Lost child announcements will be made from Stage, informing the crowd of the situation. The child will remain under the supervision of the Command Post who will ensure the child is comfortable and safe until his/her parent/guardian arrives. Police should be present to check identification of adult claiming to be the parent/guardian before release. Communication Plan: We will be using cell phones and a police radio if supplied Important Phone Numbers: Event Coordinator: Vicki Ventura 516-313-8329 vicki@eventpowerli.com Ambulance& Emergency Services: Southold Ambulance 631-765-3385 I C ASS T 0 MIG NORTH FORK 500m swim-7ml hike-ISM fun Swim Course—500 meters " The Swim will start in the water at the first buoy Keep all buoys on your left, except the final turn buoy Ix should be on your right as you head to the swim exit , c , folk County � - IirDn—mental_® *You must walk over the timing mat, through the swim chute, before entering the water. �. Start Bike Course—7 miles Start at Cedar Beach Turn right onto Paradise Point Road C­ A.a ,: Left onto N. Bayview Road Right to stay on N. Bayview Road �a Left to stay on N. Bayview Road ,x _ i ': Nnayvlpy Rd Eh_.. Left onto Pine Neck Road "'' , Left onto Main Bayview Road ., 0 f Left onto Cedar Beach Road ell _ if`r�',A:'a7�% "".�',F.:,r r.•{x•.n'Kt �. :�^�a°>;'?`""� -,T..,7: rti r.. Run Course—3.5 miles o _ water Start at Cedar Beach i stop I Rayvlp,v Rd6r.:_ Turn right onto Paradise Point Road Left onto N. Bayview Road �' y o Bed anN leeyfr ' Bed and Breakfast Left onto Jacobs Lane 4" �Hog aea ` - there will be a Water Stophere �� i QD a: � � - , t''� Suffalk,Gounty � Left onto Main Bayview Road , c e;Emirdmnental. j 8 ` p Nonh Fork Sign r r - merges with bike course Left onto Cedar Beach Road '$ ARC _ °,,; CAST Mighty North Fork Triathion Awards = Nutrition/ - 4 ® Water Bike 1n/ BBi ke Out a Results 10x10 Tent aBike Support Race \ Equipment '�•;-+_� - .� , _ � `' � Run Out - - Port-O-Johns Finish Line ,{ ! � naer,%Exit; * SW11, 1 1,il l N 4� , AC OR ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/26/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Insurance Office of America, Inc. PHONE FAX 1855 West State Road 434 A/c o Ext: A/C No): Longwood FL 32750 ADDARESS: INSURERS AFFORDING COVERAGE NAIC# License#:OE67768 INSURER A:United States Fire Insurance Company 21113 INSURED USATRIA-01 INSURERB:Accredited Surety&Cas Co Inc 26379 USA Triathlon of Colorado 5825 Delmonico Dr INsuRERc:HDI Global Specialty SE Colorado Springs CO 80919 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:615193555 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLITYPE OF INSURANCE INSD SUER POLICY NUMBER POLICY EFF MMIDPOLID EXP LTR LIMITS B X COMMERCIAL GENERAL LIABILITY Y Y 1-TRE-CO-17-01338730-00 1/1/2024 1/1/2025 EACH OCCURRENCE $2,000,000 DAMAGE CLAIMS-MADE OCCUR PREM SES Ea occurrence) $2,000,000 X Participant LL MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 HX POLICY JEQLOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: Event $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident 4077887933 1 1 $ e X OCCUR Y Y 1-TRE-CO-17-01338731-00 1/1/2024 1/1/2025 EACH OCCURRENCE $3,000,000 IUMBRELLALIAB EXCESS LIAB CLAIMS-MADE AGGREGATE $3,000,000 DED RETENTION$ $ WORKERS COMPENSATIONPER OTH AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ ❑ OFFICERIMEMBEREXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Participant Accident US1929881 1/1/2024 1/1/2025 Accident Medical 25,000 C Excess Liability(xo$3mm Lead) Y Y HDHX003701136 1/1/2024 1/1/2025 Occ/Agg 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Coverage applies to the USA Triathlon sanctioned or approved event specified on this certificate. The certificate holder is an additional insured,where required by written contract or agreement,but only with respect to the operations of the named insured, and subject to the provisions and limitations of form RSCG0303-Additional Insured-Blanket when required by written contract,but only with respect to the USAT sanctioned or approved event specified on this certificate. The General Liability policy is primary as per Form CG2001 and the General Liability policy contains CG2404:Waiver of Transfer of Rights of Recovery Against others to US,but only as required by written contract or agreement executed by the named insured prior to an occurrence resulting in a loss or a claim. Mighty North Fork Triathlon 1 2024-05-26 1 2024-05-26 1 Southold,NY 11971 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold Town Hall,53095 Main Road Southold NY 11971 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 1-TRE-CO-17-01338730-00 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. 1. Additional Insured Paragraph 2.of Section II—Who Is An Insured is amended by the addition of the following: e. Any person or organization is included as an additional insured, but only to the extent such person or organization is held liable for "bodily injury", "property damage" or "personal and advertising injury" caused by your acts or omissions. With respect to the insurance afforded to such insured, all of the following additional provisions apply: (1) You and such person or organization have agreed in a written"insured contract"that such person or organization be added as an additional insured under this policy; (2) The "bodily injury", "property damage" or"personal and advertising injury"for which said person or organization is held liable occurs subsequent to the execution of such"insured contract'; (3) The most we will pay is the lesser of either the Limits of Insurance shown in the Declarations or the Limits of Insurance required by the"insured contract'; (4) Such person or organization is an insured only with respect to: (a) Their ownership, maintenance, or use of that part of the premises, or land, owned by, rented to, or leased to you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (b) Your ongoing operations performed for that insured; (c) Their financial control of you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (d) The maintenance, operation or use by you of equipment leased to you by such person or organization; (e) Operations performed by you or on your behalf and for which a state or political subdivision has issued a permit, provided such operations are not performed for such state or political subdivision, and are not included within the"products-completed operations hazard'; (5) This insurance does not apply to "bodily injury", "property damage", "personal and advertising injury", "occurrence"or offense: (a) Which takes place at a particular premise after you cease to be a tenant of that premises; (b) Which takes place after all work, including materials, parts or equipment furnished in connection with such work to be performed by or on behalf of the additional insured at the site of the covered operations, has been completed; (c) Which takes place after that portion of"your work" out of which the injury or damage arises has been put to its intended use by any other person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project; (d) Which takes place after the expiration of any equipment lease to which(4)(d)above applies; RSCG 03 03 09 21 Includes copyrighted material of Insurance Services Office, Inc.,with Page 1 of 2 its permission (6) With respect to architects, engineers or surveyors, coverage does not apply to "bodily injury', "property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional services by or for you,including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports,surveys,field orders, change orders, or drawings and specifications; (b) Supervisory, inspection,architectural or engineering services. However, if an Additional Insured endorsement is attached to this policy that specifically names a person or organization as an insured, then this subsection 2.e. does not apply to such person or organization. RSCG 03 03 09 21 Includes copyrighted material of Insurance Services Office, Inc.,with Page 2 of 2 its permission POLICY NUMBER: 1-TRE-CO-17-01338730-00 COMMERCIAL GENERAL LIABILITY CG24041219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER;OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART, LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s)Or Organization(s): ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s)shown in the Schedule above. CG 24 04 12 19 ©Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: 1-TRE-CO-17-01338730-00 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance;and CG 20 01 1219 ©Insurance Services Office, Inc.,2018 Page 1 of 1 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 02/07/24 Receipt#: 322475 Quantity Transactions Reference Subtotal 1 Event Fee 5.26.2024 $250.00 Total Paid: $250.00 Notes: Payment Type Amount Paid By CK#5264 $250.00 Event, Power Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Event, Power 162 Long Island Avenue, #179 Holtsville, NY 11742 Clerk ID: DENISN Internal ID:5.26.2024 Noncarrow, Denis From: Flatley, Martin Sent: Wednesday, February 7, 2024 4:31 PM To: Noncarrow, Denis; Blasko, Regina; DeChance, Paul; Goodwin, Dan; Grattan, Steven; Mudd,Jennifer; Mirabelli, Melissa; Norklun, Stacey; Orientale, Michael; Born, Sabrina; Spiro, Melissa Subject: RE: CAST Mighty Triathlon " Attachments: NF Triathalon Cost Analysis, 2024A.xls I have no objections to this event being approved. My cost analysis report is attached. Martin Flatley, Chief of Police Town of Southold Police Department 41405 State Route 25 Peconic, N.Y. 11958 Tel: 631-765-3115 The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s)and may contain information that is privileged,confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient,you are hereby notified that any review,retransmission,conversion to hard copy,copying,reproduction,circulation,publication, dissemination or other use of, or taking of any action,or omission to take action,in reliance upon this communication by persons or entities other than the intended recipient is strictly prohibited. If you have received this communication in error,please(i)notify us immediately by telephone at 631.765.2600, (h)return the original message and all copies to us at the address above via the U.S.Postal Service,and(iii)delete the message and any material attached thereto from any computer,disk drive,diskette, or other storage device or media. From: Noncarrow, Denis<denisn@southoldtownny.gov> Sent:Wednesday, February 7, 20241:28 PM To: Blasko, Regina <rblasko@town.southold.ny.us>; DeChance, Paul<pauld@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Goodwin, Dan <dang@southoldtownny.gov>; Grattan,Steven <sgrattan@southoldtownny.gov>; Mudd,Jennifer<jennifer.mudd@town.southold.ny.us>; Mirabelli, Melissa <melissa.mirabelli@town.southold.ny.us>; Noncarrow, Denis<denisn@southoldtownny.gov>; Norklun, Stacey <Stacey.Norklun@town.southold.ny.us>; Orientale, Michael<michaelo@southoldtownny.gov>; Born, Sabrina <sabrina.born @town.southo Id.ny.us>; Spiro, Melissa<Melissa.Spiro@town.southold.ny.us> Subject:CAST Mighty Triathlon Please see attached for CAST event. 5/26/2024 Please respond with your information. Thank you Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southoldtownny.gov denisn @southoldtownn v.gov 631-765-1800 CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is 1 w Town of Southold Police Department Special Event Cost Analysis Event: Mighty North Fork Triathalon Date(s): May 26,2024 Location: I Bayview Area, Southold Patrol18RO ation for Event. R Reg Hours OT Hrs Hrly Wage Total Comments �Police�Officers�: Sgt. Garcia 2 $182.80 PO Barszczewski 2 $103.80 Special Patrol Reg Hours OT Hrs Hrly Wage Comments PO Chenche 2 $145.04 PO Sanders 2 $145.04 Bic'„c1e P,,atrol. ° w,j :K=9AUnit' Highrivay�Patrol��_�_��-..h HP-2 Flatley 2 $155.82 HP-1 Onufrak $154.40 B.C. Kirincic 2 $91.56 BC Dimon 2 $77.64 Traff c Control ''` `� �ReMgHours OT Hrs Hrly Wage Total Comments TC-1 2 $19.11 $38.22 TC-2 2 $19.11 $38.22 TC-3 2 $19.11 $38.22 T Equipment.Costs�. a., •:3'. `u 'pI .t '. � .fE+a ,�+. �"•'4'i. ;C"e'',ro.'•, .l*"' ia. A+,a.�,c -s...+m m.,...........o. S Fuel for Police Boat $90/hr boat= $180.001 $180.00� PD Vehicles= $10/hr 10 vehicles foi r 20 hrs $200.00 Total Department Cost for Event= $ $1,213.56 Prepared by Capt.M. Flatley 2/8/2024 Pagel ' Denis From McCullough, Lillian Sent: Friday, February 9, 2O241(l13AK4 To: Noncarnovv Denis Subject: RE: [AST Mighty Triathlon Hi Dennis, This not preserved by the Town, but it is a County Park, so I defer to any comments from the County. Acreage 59.05 Land Use Recreation&Open Space Protected County Park Community Facilities Class County Owned Public Parks Ag District Info Zoning Primary R-80 Zoning Secondary Zoning acres in 0.00 Secondary Zone I Freshwater Wetlands 0.00 Lilly From: Noncarrom, Denis<denisn@smutho|dtovvnny.gov> Sent:Wednesday, February 7, 2O341:38PK4 To: B|asko, Regina <rb|msho@toxxn.southo|d.ny.us>; DmChanca, Paul<pau|d@southo|d1ovvnny.gov>; F|at|ey, Martin <mflatley@town.southold.ny.us>; Goodwin, Dan<dang@southoldtownny.gov>; Grattan,Steven sgrattan@southo|dtovvnny.gov>; Mudd,Jennifer"jennifer.nnudd@1oxxn.southo|d.ny.uo>; Mirabelli, Melissa <nne|issa.nnirabe||i@1oxvn.southo|d.ny.us>; Nonrarrow, Denis<denisn@southo|d1oxvnny.gov>; NorNun,8tacey <6tacey.NmrNun@toxxn.southo|d.ny.us>;Orienta|e, Michael<nnichae|o0Dsoutho|dtoxvnny.gov>; Born,Sabrina <sabrina.born@tovvn.southo|d.ny.us>; Spiro, K4e|issa«W1e|issa.Spiro@tovvn.southo|d.ny.us> Subject: CAST Mighty Triathlon Please see attached for CAST event.5/36/2O24 Please respond with your information. Thank you 1 - DENIS NONCARROW o~� G.y� Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 cc Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p .F Fax(631)765-6145 MARRIAGE OFFICER y RECORDS MANAGEMENT OFFICER �0,( .�O Telephone oldt nny.gov FREEDOM OF INFORMATION OFFICER www.southoldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD February 13, 2024 Cathy Demeroto CAST P.O.B. 1566 Southold,New York 11971 Dear Cathy, The Southold Town Board, at its regular meeting held February 13th, 2024, granted permission to CAST to hold its Might North Fork Triathlon on May 261h 2024 from 4am to 12pm. Set up May 251h 2024 9am to 3pm. A certified copy of the resolution is enclosed. An insurance policy naming the Town of Southold as additionally insured has been filed with this office. Please contact Captain Grattan at the Southold Town Police Department as soon as possible,to coordinate traffic control. If you have any further questions, please do not hesitate to contact the Town Clerk's office at (631) 765-1800. B?'s c with your event. Sily, Doncarrow, Town Clerk Enc.