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HomeMy WebLinkAboutHaywaters Road Survey ,. . ` RESOLUTION 2024-668 ' - s ADOPTED DOC ID: 20501 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2024-668 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 30,2024: RESOLVED that the Town Board of the Town of Southold hereby accepts the proposal of L.K. McLean Associates, P.C. dated July 23, 2024 in the total amount of$5,175.00 for surveying work on Haywaters Road; and be it further RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Albert J. Krupski,Jr. to execute an Agreement between the Town of Southold and L.K. McLean Associates, P.C. in the total amount of$5,175.00,subject to the approval of the Town Attorney. Denis Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Louisa P. Evans,Justice SECONDER:Greg Doroski, Councilman AYES: Doroski,Mealy, Smith, Krupski Jr, Doherty, Evans AGREEMENT THIS AGREEMENT, entered into this:0 day of August, 2024, by and between the Town of Southold,New York ("the Town"), a municipal corporation organized and existing under the laws of the State of New York with offices at 53095 Main Road, Southold, New York, and L.K. McLean Associates Engineers and Surveyors, (the "Consultant") or ("MCLEAN"), with an address of 437 South Country Road, Brookhaven,New York 11719; WITNESSETH, that the Town and the Consultant, for the consideration hereinafter named, agree as follows: ARTICLE 1. WORK TO BE DONE AND CONSIDERATION THEREFOR The Consultant shall perform the professional surveying services, for a topographic boundary survey along approximately 400 l.f. of Haywaters Road in Cutchogue and subsequently set concrete monuments in five specific locations as outlined in its accepted proposal dated July 23. 2024. The Consultant shall receive a fee for said services as perthe accepted proposal submitted by the applicant, dated July 23. 2024,in the amount of$5,175. ARTICLE 2. TERM OF AGREEMENT The term of this agreement shall run from the full execution of this Contract and the work shall be completed within 6 months unless extended by mutual agreement of the parties. The Town agrees to cooperate with Consultant,as needed, and to provide Consultant with copies of any records, documents and other information needed for performance of this agreement on a timely basis.The Town further agrees to provide Consultant with access to all areas of the structure where work is performed and with all appropriate officials and/or employees of the Town, as may be needed in the performance of the agreement. Moreover,both parties understand and agree that mutual accountability and responsiveness is critical to the successful completion of the project, and therefore both shall always use their best faith efforts to be accountable and promptly responsive to each other. ARTICLE 3. ACCEPTANCE AND FINAL PAYMENT Upon receipt of written notice that the services required by this Agreement have been fully performed and an inspection to certify that the work has been completed to the satisfaction of the Town, the Consultant shall submit an itemized voucher to the Town Comptroller for payment. Such voucher shall be due and payable within forty-five (45) days after receipt of such voucher, but such sum shall not be due,and payable by the Town until the Town Board of the Town has received such a voucher and has audited and approved for payment the voucher to be submitted by Consultant in connection therewith. The Town Board shall process any voucher received from Consultant as expeditiously as possible. In the event that the Town disputes or objects to any portion of any voucher submitted by Consultant it shall notify Consultant in writing of such dispute or objection. Consultant acknowledges that Consultant is familiar with the requirements of Section 118 of the New York State Town Law which, in effect,prohibits payment of any claim against the Town unless an itemized voucher therefore shall have been presented to the Town Board or Town Comptroller and shall have been audited and allowed by the Town Board or Town Comptroller. The acceptance by the Consultant of the final payment shall be, and shall operate as a release to the Town from all claims and all liabilities to the Consultant for all the things done or furnished in connection with this work and for every act and neglect of the Town and others relating to or arising out of, this Agreement, except Consultant's claim for interest upon the final payment, if this payment be improperly delayed. No payment, however final or otherwise, shall operate to release the Consultant or its sureties from any obligations under this Agreement. ARTICLE 4. CONSULATANT'S OBLIGATIONS (a)The Consultant shall be responsible for the full and correct performance of the Work required w i t h i n the time specified herein and any errors therein shall be corrected at the Consultant's own cost and expense. In addition, the Consultant shall indemnify the Town for any costs or expenses attributable to negligent errors in the performance the work of the Consultant. (b)The Consultant is retained to utilize its expertise in the performance of the work as outlined in its accepted Proposal dated July 23. 2024. (c) The Consultant shall be solely responsible for all labor and services provided for under this contract. ARTICLE 5. CONSULTANT'S INSURANCE The Consultant shall not commence work under this Agreement until it has obtained all insurance required under this paragraph and such insurance has been approved by the Town. (a) Compensation Insurance: The Consultant shall take out and maintain during the life of this Contract Workers' Compensation Insurance for its employees to be assigned to the work hereunder. (b)Liability Insurance: The Consultant shall take out and maintain during the life of this Contract general liability and professional liability (E& O) insurance. The amounts of such insurance shall be as follows: 1. General liability insurance in an amount not less than$2,000,000 for injuries, including wrongful death to any one person and subject to the same limit for each person, in an amount not less than $4,000,000 on account of any one occurrence. 2.Professional liability (E& O) insurance in an amount not less than$2,000,000 per occurrence or claim and $4,000,000 aggregate. The Consultant shall furnish the above insurances to the Town and shall also name the Town as an additional named insured and certificate holder in said policies with respect to liability arising out of services provided by consultant. ARTICLE 6. DAMAGES It is hereby mutually covenanted and agreed that the relation of the Consultant to the work to be performed by it under this Agreement shall be that of an independent contractor. As an independent contractor, it will be responsible for all damage, loss or injury to persons or property that may arise in or be incurred during the conduct and progress of said work, to the extent caused by the negligence of the Consultant, its agents, or employees. The Consultant shall hold and keep the Town free and discharged of and from any and all responsibility and liability of any sort or kind to the extent caused by Consultant's negligence. ARTICLE 7. INDEMNITY AND SAVE HARMLESS AGREEMENT With respect to professional services,MCLEAN shall,to the fullest extent permitted by law, indemnify and hold harmless the TOWN, its officers, employees, and representatives against damages, liabilities or costs, including reasonable attorneys' fees and defense costs, to the extent caused by MCLEAN's negligent performance of professional services,misconduct, and/or omissions under this Agreement and that of its subconsultants or anyone for whom MCCLEAN is legally liable. MCLEAN's obligation to indemnify and hold harmless the TOWN, its officers, employees, and representatives does not include a duty to defend. With respect to liability other than that arising out of professional services, MCLEAN shall defend, indemnify and hold harmless the TOWN, its officers, employees, and representatives from and against any and all damages, liability,judgments, losses, and expenses, including but not limited to attorney's fees, including damages arising from injuries or death of persons and damage to property which arise from or are connected with, or caused by the negligent performance of professional services, misconduct, and/or omissions under this Agreement and that of its subconsultants or anyone for whom MCLEAN is legally liable. ARTICLE 8. NO ASSIGNMENT In accordance with the provisions of section 109 of the General Municipal Law, the Contractor is hereby prohibited from assigning,transferring, conveying, subletting or otherwise disposing of this Agreement, or of its right,title or interest in this Agreement, or its power to execute this Agreement, to any other person or corporation without the previous consent in writing of the Town. ARTICLE 9. AUTHORITY FOR EXECUTION This Agreement has been executed in accordance with a Resolution 2024-668, attached hereto and made a part hereof, adopted by the Town Board of the Town of Southold, at a meeting thereof held on July 30, 2024 and its execution on behalf of the Town is duly authorized. A copy of this instrument shall be executed in duplicate. At least one copy shall be permanently filed, after execution thereof, in the office of the Town Clerk,Denis Noncarrow. The individual executing this Agreement on behalf of the Consultant hereby represents and warrants that he/she has the full right,power and authority to execute this contract and is authorized by the Consultant to do so. ARTICLE 10. NOTICES Any and all notices and payments required hereunder shall be addressed as follows, or to such other address as may hereafter be designated in writing by either party hereto: To Southold Town: Denis Noncarrow Southold Town Clerk 53095 Route 25 Southold,NY 11971 To Consultant: L.K. McLean Associates Engineers and Surveyors 437 South Country Road, Brookhaven,New York 11719 ARTICLE 11. WAIVER No waiver of any breach of any condition of the Agreement shall be binding unless in writing and signed by the party waiving said breach.No such waiver shall in any way affect any other term or condition of this Agreement or constitute a cause or excuse for a repetition of such or any other breach unless the waiver shall include the same. ARTICLE 12. MODIFICATION This Agreement constitutes the complete understanding of the parties.No modification of any provisions thereof shall be valid unless in writing and signed by both parties. ARTICLE 13. APPLICABLE LAW This Agreement is governed by the laws of the State of New York. In the event of any controversy or claim arising out of or relating to this Application for Service contract, or the breach thereof, the parties specifically consent to the Supreme Court, State of New York, County of Suffolk. IN WITNESS WHEREOF, the Town of Southold has caused these presents to be duly executed and the Consultant has caused these presents to be signed by its President, the day and year first above written. Town of Southold By: �2 � � Albert J. Krupski,Jr. Supervisor Town of Southold L.K. McLean&Associates, ngineers and Surveyors DPC By: STATE OF NEW YORK) ) ss.. COUNTY OF SUFFOLK) On the aoday of August in the year 2024 before me,personally came Albert J Krupski,Jr., to me known, who, being by me duly sworn, deposes and says that he is the Supervisor of the Town of Southold,the municipal corporation described herein and which executed the above instrument; that the action taken was duly authorized, and that he signed his name thereto by like authority. a MICHELLE L TOMASZEWSKI Signature ind office of indivQphl taking a owledgment NOTARY PUBLIC-STATE OF NEW YORK. No. 01 T06156671 Qualified in Suffolk County My STATE OF NEW YORK) Commission Expires 11-27.2026 ) SS.: COUNTY OF SUFFOLK) On they day of August in the year 2024 before me,personally came ► Cl P te to me known, who, being by me duly sworn, deposes and says that he/she/they is (are)the p resident or other officer or director or attorney in fact duly appointed) of the .4 . f /� ,�.�,I gl)c-[name of corporation], the corporation described herein and which executed the above instrument; that the action taken was duly authorized, and that he/she/they signed his/her/their name(s)thereto by like autho, CHRISTINE wIEGAND York _ statestto k Countr 25 Signature and office of in ividual taking acknowledgment NOTARY W1621pI3 9, commission Expires August 17 Appendix A i AKA A L. K. McLean Associates, D.P.C. i :• 437 South Country Road • Brookhaven • Neis York • 11719 (631)286-866R - FAX(631)286.6314 4- 25 Newbridge Road • Suite 212 • Hicksville New York 1.1801 https://ww%%,.Ikma.com i ! ROBERT A STEELE,P.E.PRESIDENT and CEO Associates i JAMES L.DQKONING,P.E.,ViCE PRESIDENT W.EISENBERG,P.E. CHRISTOPHER F.DWYER,VICE PRESIDENT STEVEN ISER p 3 B. E KEITH J.MASSERIA.P.E.,VICE PRESIDENT EW B. P.E. MATTHEW JEDLICKA,LEED AR PRINCIPAL VINCENT ANDREW i TAMARA STILLMAN,P.L.S.,PRINCIPAL-DIRECTOR OF SURVEY KEVIN J.PETERMAN,P,E CHRISTINE L.BELSON,MBA,SHRM-SCP,PRINCIPAI.•CONTROLLER KARA M.O'NEILL,LISP,MBA i 1 f Town of Southold July 23,2024 Engineering Department i 53095 Route 25,P.O. Box 1179 Southold,NY 11971 Attn: Michael Collins,P.E.,Civil Engineer RE: Haywaters Road,Cutchogue—Topographic Boundary Survey Dear Mr.Collins, L.K. McLean Associates, P.C. (LKMA) is pleased to submit a cost proposal for professional survey services pertaining to performing a topographic boundary survey along approximately 400 I.f. of Haywaters Road in Cutchogue and subsequently setting concrete monuments in five (5) specific locations as depicted on a goggle Image provided with the RFP dated July 16,2024. LKMA has identified the following tasks associated with this work: • Topoeraphic Boundary Survey— Office Surveyor will go to the Suffolk County Clerk's Office to perform research for deed and file map compilation in the vicinity of the survey limits to generate reference points for the survey crew in the field.Two-man survey crew will search for and locate existing boundary evidence along Haywaters Road in the area utilizing Trimble R10 GPS unit, collecting data in the New York State Plane Coordinate ! System, NAD83, Long Island Zone. They will proceed to locate the visible topographic ! features In the vicinity. Survey Manager will review topographic survey and boundary solution.LKMA estimates eight(8)hours for a two-man survey crew,twelve(12)hours for I office surveyor and one(1)hour for Survey Manager. i • Set Monuments—Two-man survey crew will setup to five(5)concrete monuments at the locations marked by red squares on the google image. The lump sum fee for the Topographic Boundary Survey is$3,850.00. The price to Install concrete monuments as necessary at the selected locations is $265.00 per monument. Fees include LKMA's operational costs, consumable Items, and travel costs on Long Island associated with the work and will be due and invoiced upon completion of the work. 1 Established 1950 L. IC. .111cLean Associates, D.P.C. Our current work load will enable us to initiate work within two(2)weeks upon the issuance of an approved contract. The Client accepts that the actions of the federal, state, county and local governments, other regulatory agencies, consultants and adverse weather are beyond our control. We will strive to cope with these factors but cannot be held responsible for delays,losses,or other adverse effects that the Client may suffer as a result of them. { Upon receipt of a proper invoice the Client will pay LKMA monthly for work performed up to the total fee indicated. If you are in agreement with this proposal, kindly sign one copy and return it to our office, This will constitute your authorization for LKMA to begin the work. Thank you for the opportunity to provide these professional services. Should you have any questions regarding the Information presented, please feel free to contact me at 631-286-8668, ext.250 or via email at tstillmaq@ kma.com. Sincerely, -limt�a Tamara Stillman, PLS Principal,Director of Survey TLS:tIs Cc:Christine Belson,Principal and Comptroller LKMA File Copy Accepted by: Date: i t CERTIFICATE OF LIABILITY INSURANCE DATE 09/20/2022023 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 be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements s . PRODUCER Keystone Risk Partners LLC CONTACT NAME: 604 East Baltimore Pike PHONE A/C,No,Ext:888-473-6398 FAX A/C No): Media,PA 19063 E-MAIL ADDRESS:Risk ExtensisGrou .com INSURER(S)AFFORDING COVERAGE NAIL# INSURER A: Indemnity Insurance Company of North 43575 INSURED INSURER B: Philadelphia Indemnity Insurance Company 18058 Extensis,Inc.L/C/F INSURER C: Louis K McLean Associates Engineers&Surveyors PC(Louis K McLean Associates Engineers&Surveyors PC) INSURER D: 900 US HWY 9 North,3rd Floor INSURER E. Woodbridge,NJ 07095 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSRD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY Not Applicable EACH OCCURRENCE $ CLAIMS-MADE❑OCCUR DAMAGE TO RENTED $ PREMISES Ea occurrence MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- El PRODUCTS-COMP/OPAGG $ JECT OTHER: $ AUTOMOBILE LIABILITY Not Applicable COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR PHUB882213 09/30/2023 09/30/2024 EACH OCCURRENCE $ 10,000,000.00 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000.00 X DED I X RETENTION $ 10,000 $ WORKERS COMPENSATION X PER STATUTE OTH- AND EMPLOYERS'LIABILITY C55681879 09/30/2023 09/30/2024 ER A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000.00 OFFICER/MEMBER EXCLUDED? Y/N N/A (Mandatory in NH) ❑ E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 f yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks,Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION 206744 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Route 25 PO Box 1179 AUTHORIZED REPRESENTATIVE Y, Southold,NY 11791 I Jay Peichel I ACORD 25(2016/03) 51988-2015 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) �® CERTIFICATE OF LIABILITY INSURANCE $/13/2024 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). CONTACT PRODUCER NAME, Certificate Department Risk Strategies Company PHONE 212 867-3550 a No 750 Third Avenue 15th Floor E-MAIL Suite 2700 ADDRESS: certificates2 risk-Strate IeS.COm New York, NY 10017 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Travelers Indemnity Company 25658 INSURED INSURER B: Travelers Indemnity Co of America 25666 L.K. McLean Associates Engineering &Surveying, INSURERC: Continental Casualty Company 20443 D.P.C. Robert Steele, President&CEO INSURERD: 437 S.Country Road INSURER E: Brookhaven NY,, 11719 INSURER F COVERAGES CERTIFICATE NUMBER: 81393562 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 ADDLSUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDY EFF MM/DD OLICY EXP LTR / LIMITS A �/ COMMERCIAL GENERAL LIABILITY ✓ 630-6W323314 5/1/2024 5/1/2025 EACH OCCURRENCE $1000000 DAMAGE TO CLAIMS-MADE �✓ OCCUR PREM SES EaEED nce $300 000 ✓ Contractual Liability Included MED EXP(Any one person) $5 000 ,/ Valuable Papers$50,000 PERSONAL&ADV INJURY $1 00O 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $2 000 000 OTHER: $ B AUTOMOBILE LIABILITY BA-6W733364 5/1/2024 5/1/2025 C(EaOMBINED SINGLE $1000000 ✓ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED IPROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A �/ UMBRELLALIAB ✓ OCCUR CUP-6W735517 5/1/2024 5/1/2025 1 EACH OCCURRENCE $8000000 EXCESS LIAB CLAIMS-MADE AGGREGATE $$00O 000 DED I ✓I RETENTION$10,000 $ WORKERS COMPENSATIONOTH- AND EMPLOYERS'LIABILITY Y/N STATUTE F ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Professional&Pollution Liability AEH591963888 5/1/2024 5/1/2025 $5,000,000 Per Claim $5,000,000 Annual Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Description: Professional surveying services for a topographic boundary survey of Haywaters Rd.Avenue in Cutchogue. The Town of Southold is additional insured for general liability,as required by contract as respects to work performed by the insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 53095 Main Rd. ACCORDANCE WITH THE POLICY PROVISIONS. Southold NY 11971 AUTHORIZED REPRESENTATIVE RSC Insurance Brokerage ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 81393562 � 24-25 GL AUTO UMB PL Rafael Aznar 8/13/2024 3:31:39 PM (EDT) I Page 1 of 1 This certificate cancels and supersedes ALL previously issued certificates. COVER SHEET FOR DOCUMENT Sent To: (ra Sent By: TOWN ATTORNEY, PAUL M. DECHANCE DEPUTY T/A, JACK SQUICCIARINI ASSISTANT T/A, JULIE M. MCGIVNEY ASSISTANT T/A, BENJAMIN JOHNSON CONFIDENTIAL SECRETARY, AMY SCHLACHTER RECEIVED Type Of Agreement: A U G 2 2 2024 Southold Town Clerk Nature Of Contract/Agreement c J �/ 0-4 dW`-'1