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Home My WebLink About2005ALL NUNDERS IN THIS REPORT MUST BE ROUNDED TO THE NEAREST DOLLAR. METHOD OF ACCOUNTING (CHECK ONE) ~ SINGLE ENTRY CASH __ DOUBLE ENTRY MODIFIED ACCRUAL ANNUAL FINANCIAL REPORT UPDATE DOCUMENT RECEIVED FOR THE FEB 2 7 FISHERS ISLAND FIRE DISTRICT TOWN OF SOUTHOLD Southold Town Clef[ COUNTY OF SUFFOLK FOR THE FISCAL YEAR ENDED 2005 PLEASE CHECK HERE IF THE TREASURERtS NAME, ADDRESS, AND/OR TELEPHONE NUMBER IS DIFFERENT FROM LAST YEAR. q71179004000 NAUTHORIZATZON~ ARTICLE S, SECTION SO OF THE GENERAL MUNICIPAL LAW: I. ~ EVERY MUNICIPAL CORPORATION ~N SHALL ANNUALLY MAKE A REPORT OF ITS FINANCIAL CONDITION TO THE COMPTROLLER. SUCH REPORT SHALL DE MADE THE CHIEF FISCAL OFFICER OF SUCH MUNICIPAL CORPORATION ~ 5. ALL REPORTS SHALL DE CERTIFIED BY THE OFFICER MAKING THE SAME AND SHALL BE FILED WITH THE COMPTROLLER WITHIN SIXTY DAYS AFTER THE CLOSE OF THE FISCAL YEAR OF SUCH MUNICIPAL CORPORATION ~ IT SHALL BE THE DUTY OF THE INCUMBENT OFFICER AT THE TIME SUCH REPORTS ARE REQUIRED TO DE FILED WITH THE COMPTROLLER TO FILE SUCH REPORT ~ STATE OF NEW YORK OFFICE OF THE STATE COMPTROLLER DIVISION OF LOCAL GOVERNMENT SERVICES AND ECONOMIC DEVELOPMENT ALBANY, NEW YORK 1Z256 ~CERTIFICATION OF FISCAL OFFICER~ T,~-d~/:~'~l/)~<:-U~)$~r~ , CERTIFY THAT I AIq THE CHIEF FISCAL 0FF[CER AND THAT THE [NFORHAT[ON [NCLUDE~ HEREIN IS TRUE AND CORRECT TO THE 8EST OF HY KNOWLEDGE AND BELIEF. DATE ADDRESS ADDRESS TELEPHONE NUHBER / ~E CHAIRHAN OF THE BOARD ~ NAHE -- ADDRESS TELEPHONE NUNBER ADDRESS ~INQUIRY~ IF YOU HAVE ANY QUESTIONS RELATING TO THIS DOCUHENT PLEASE CALL: FILING REQUIRENENTS (518) 474-t014 ACCOUNTING REQUIRENENTS SEE LISTING OF REGIONAL SERVICE CENTERS. ~PLEASE HAIL CONPLETED DOCUHENT TO: STATE OF NEW YORK OFFICE DF THE STATE CONPTRDLLER DIVISION DF LOCAL 60VERNHENT SERVICES AND ECONDHIC OEVELOPHENT DATA HANAGEHENT UNIT 110 STATE STREET 11-8-C ALBANY, NEH YORK 122S& Z FINANCIAL INFORMATION FOR THE FOLLOWING FUNDS WAS INCLUDED IN THE ANNUAL FINANCIAL REPORT FILED BY YOUR GOVERNHENT FOR THE FISCAL YEAR ENDED 200~ AND HAS BEEN USED BY THE OSC AS THE BASIS FOR PREPARING THIS UPDATE DOCUMENT FOR YOUR FISCAL YEAR ENDED Z005= (A) GENERAL FUND (R) RESERVE ALL AMOUNTS INCLUDED IN THIS UPDATE DOCUMENT FOR 200~ REPRESENT THE DATA FILED DY YOUR GOVERNMENT WITH THE OSC AS REVIEWED AND ADJUSTED WHERE NECESSARY. IF ANY FUNDS WERE USED IN 2005 THAT WERE NOT USED IN ZO0~, PLEASE LIST BELOW. NOT SUPPLEMENTAL SECTION ~c-~ APPLICABLE THE SUPPLEMENTAL SECTION INCLUDES THE FOLLOWING SCHEDULES: I) STATEMENT DF INDEBTEDNESS Z) SCHEDULE FOR REPORTING VARIABLE RATE, DISCOUNTED, AND/OR NEGOTIATED BONDS AND NOTES ~) SCHEDULE OF SECURITIES FOR COLLATERALIZATION 4) SCHEDULE OF TIME DEPOSITS AND INVESTMENTS 5) INVESTMENT CERTIFICATION 6) BANK RECONCILIATION 7) LOCAL GOVERNMENT QUESTIONNAIRE IF SCHEDULES 1 AND/OR 2 ARE NOT APPLICABLE, PLEASE INITIAL IN THE APPROPRIATE COLUMN. ALL OTHER SCHEDULES MUST BE COMPLETED. ALL NUMBERS IN THIS REPORT MUST BE ROUNDED TO THE NEAREST DOLLAR. FINANCIAL SECTION (A) GENERAL FUND BALANCE SHEET DESCRIPTION ASSETS FISHERS ISLAND FIRE DISTRICT ANNUAL UPDATE DOCUMENT FOR THE FISCAL YEAR ENDED 2005 FOR THE FISCAL EDP YEAR ENDED 2004 CODE FOR THE FISCAL YEAR ENDED 2005 CASH TOTAL CASH $0 AZ00 A A 0 TOTAL ASSETS (A) GENERAL FUND BALANCE SHEET DESCRIPTION LIABILITIES AND FUND EQUITY FISHERS ISLAND FIRE DISTRICT ANNUAL UPDATE DOCUMENT FOR THE FISCAL YEAR ENDED 2005 FOR THE FZSCAL EDP YEAR ENDED 2004 CODE FOR THE FISCAL YEAR ENDED 2005 ACCOUNTS PAYADLE TOTAL ACCOUNTS PAYABLE $0 A600 A A 0 TOTAL TOTAL LIABILITIES UNRESERVED FUND BALANCE UNAPPROPRIATED TOTAL UNRESERVED FUND BALANCE - UNAPPROPRIATED AgZ1 A A TOTAL TOTAL FUND EQUITY TOTAL LIABILITIES AND FUND EQUITY (A) 6ENERAL FUND RESULTS OF OPERATIONS DESCRIPTION FISHERS ISLAND FIRE DISTRICT ANNUAL UPDATE DOCUHENT FOR THE FISCAL YEAR ENDED 2005 FOR THE FISCAL YEAR ENDED ZOOq DETAIL REVENUES AND OTHER SOURCES REAL PROPERTY TAXES TOTAL REAL PROPERTY TAXES INTEREST AND EARNINGS TOTAL USE OF MONEY AND PROPERTY $$32,047 $S2,0~7 1,450 1,450 A]O0! A A A240! A A EDP FOR THE FISCAL CODE YEAR ENDED 2005 TOTAL TOTAL REVENUES 333,q97 TOTAL DETAIL REVENUES AND OTHER SOURCES 333,497 (A) GENERAL FUND RESULTS OF OPERATIONS DESCRIPTION FISHERS ISLAND FIRE DISTRICT ANNUAL UPDATE DOCUMENT FOR THE FISCAL YEAR ENDED 2005 FOR THE FISCAL YEAR ENDED 200q DETAIL EXPENDITURES AND OTHER USES FIRE, PERS SERV FIRE, EQUIP B CAP OUTLAY FIRE, CONTR EXPEND TOTAL FIRE TOTAL PUBLIC SAFETY EDP FOR THE FZSCAL CODE YEAR ENDED 2005 $20,23q A3~IO.1 20,$86 A3410.2 81,257 A$~10.~ A 121,879 A$~10.0 LOCAL PENSION FUND, EMPL BNFTS SOCIAL SECURITY, EMPLOYER CONT WGRKER~S CGMPENSATIONj EMPL BNFTS LZFE INSURANCE, EHPL BNFTS TOTAL EMPLOYEE BENEFITS TOTAL EXPENDITURES 121,879 A9025.8 A9030.8 AgO~Q.8 A904S.8 TRANSFERS, OTHER FUNDS TOTAL TRANSFERS TOTAL OTHER USES TOTAL DETAIL EXPENDITURES AND OTHER USES 77,075 1S~366 97,372 219,251 56,000 56,000 56,000 A9901.9 275,Z5! /?o. ¢ ;/, ¢¢¢. (A) GENERAL FUND RESULTS OF OPERATIONS DESCRIPTION FISHERS ISLAND FIRE DISTRICT ANNUAL UPDATE DOCUMENT FOR THE FISCAL YEAR ENDED 2005 FOR THE FISCAL YEAR ENDED 200q ANALYSIS OF CHANGES IN FUND EQUITY EDP FOR THE FISCAL CODE YEAR ENDED 2005 FUND EQUITY-BEGINNING OF YEAR~ PRIOR PERIOD ADJ-INCREASE TO FUND EQUITY PRIOR PERIOD ADJ - DECREASE IN FUND EQUITY RESTATED FUND EQUITY - BEG OF YEAR ADD - REVENUES AND OTHER SOURCES DEDUCT - EXPENDITURES AND OTHER USES FUND EQUITY-END OF YEAR~ $SS2,119 A8021 $S90,S65 0 A8012 0 A8015 $9o,36s A8O29 ¢/% * TOTAL INCLUDES RESERVED AND UNRESERVED FUND BALANCE IN GOVERNMENTAL FUNDS, NET ASSETS FOR PROPRIETARY FUNDS. ADJUSTMENTS TO BEGINNING FUND EQUITY RESULTING FROM A CORRECTION OF A PRIOR YEAR'S ACCOUNTING ERROR SHOULD BE REPORTED AS A PRIOR PERIOD ADJUSTMENT. PLEASE EXPLAIN ALL PRIOR PERIOD ADJUSTMENTS BELOW. DOUBLE ENTRY UNITS ~ FUND EQUITY-END OF YEAR MUST AGREE WITH TOTAL FUND EQUITY AS SHOWN ON THE BALANCE SHEET. SINGLE ENTRY FIRE DISTRICTS ~a FUND EQUITY-BEGINNING OF YEAR PLUS TOTAL REVENUES MUST AGREE WITH FUND EQUITY-END OF YEAR PLUS TOTAL EXPENDITURES. IO (R) RESERVE RESULTS OF OPERATIONS DESCRIPTION FISHERS ISLAND FIRE DISTRICT ANNUAL UPDATE DOCUNENT FOR THE FISCAL YEAR ENDED 2005 FOR THE FISCAL YEAR ENDED 2004 DETAIL REVENUES AND OTHER SOURCES INTEREST & EARNINGS TOTAL USE OF MONEY AND PROPERTY $1,000 1,000 EDP FOR THE FISCAL CODE YEAR ENDED 2005 RZ40! R R TOTAL TOTAL REVENUES INTERFUNO TRANSFERS TOTAL INTERFUND TRANSFERS 1,000 56,000 56,000 R5031 R R TOTAL TOTAL OTHER SOURCES 56,000 TOTAL DETAIL REVENUES AND OTHER SOURCES 57,000 11 (R) RESERVE RESULTS OF OPERATIONS DESCRIPTION FISHERS ISLAND FIRE DISTRICT ANNUAL UPDATE DOCUMENT FOR THE FISCAL YEAR ENDED 2005 FOR THE FZSCAL YEAR ENDED 2004 ANALYSIS OF CHANGES IN FUND EQUITY EDP FOR THE FISCAL CODE YEAR ENDED 2005 FUND EQUITY - BEGINNING OF YEAR~ PRIOR PERIOD ADJ - INC TO FUND EQUITY PRIOR PERIOD ADJ - DEC TO FUND EQUITY RESTATED FUND EQUITY - BEG OF YEAR ADD - REVENUES AND OTHER SOURCES DEDUCT - EXPENDITURES AND OTHER USES FUND EQUITY - END OF YEAR~ $199,656 R8021 $256,656 0 R8012 0 R8015 99,656 .022 5 ,ooo 0 TOTAL ZNCLUDES RESERVED AND UNRESERVED FUND BALANCE IN GOVERNMENTAL FUNDS, NET ASSETS FOR PROPRIETARY FUNDS. ADJUSTMENTS TO BEGINNING FUND EQUITY RESULTING FROM A CORRECTION OF A PRIOR YEARtS ACCOUNTING ERROR SHOULD BE REPORTED AS A PRIOR PERIOD ADJUSTMENT. PLEASE EXPLAIN ALL PRIOR PERIOD ADJUSTMENTS BELOW. DOUBLE ENTRY UNITS ~ FUND EQUITY-END OF YEAR MUST AGREE WITH TOTAL FUND EQUITY AS SHOWN ON THE BALANCE SHEET. SINGLE ENTRY FIRE DISTRICTS ~ FUND EQUITY-BEGINNING OF YEAR PLUS TOTAL REVENUES MUST AGREE WITH FUND EQUITY-END OF YEAR PLUS TOTAL EXPENDITURES. 12 ~ SUPPLEHENTAL SECTZON ~ 13 STATEMENT OF INDEBTEDNESS TAX ANTICIPATION NOTES ILIST SEPARATELY BY DATE OF ISSUE ITAX ANTICIPATION NOTE NO. 1 IMONTH AND YEAR OF ISSUE ICURRENT INTEREST RATE IOUTSTANOIN6 BEGINNING OF YEAR IISSUED DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) IPAZD DURING FISCAL YEAR (DO NOT INCLUDE RENEgALS HERE) IOUTSTANDING ENO OF FISCAL YEAR FINAL MATURITY DATE TAX ANTICIPATION NOTE NO. 2 MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) PAID DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) OUTSTANDING END OF FISCAL YEAR FINAL MATURITY DATE TAX ANTICIPATION NOTE NO. $ MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING DEGINNING OF YEAR ISSUED DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) PAID DURING FISCAL YEAR (00 NOT INCLUDE RENEgALS HERE) OUTSTANDING END OF FISCAL YEAR IFINAL MATURITY DATE I TOTAL TAX ANTICIPATION NOTES OUTSTANDING DEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR 14 EDPCODE 2P18611 2P18613 2PLO615 2PLO617 2P18&11 2PID61~ 2P18617 2PLO611 2P18&15 2PLO615 2P18617 AMOUNT I I I I / I r._l AMOUNT STATEMENT OF INDEBTEDNESS REVENUE ANTICIPATION NOTES LIST SEPARATELY BY DATE OF ISSUE REVENUE ANTICIPATION NOTE NO. I MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING DEGZNNZNG OF YEAR ISSUED DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) PAID DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) OUTSTANDING END OF F~SCAL YEAR FINAL MATURITY DATE REVENUE ANTICIPATION NOTE NO. 2 MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR (DO NOT ~NCLUDE RENEWALS HERE) PAID DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) OUTSTANDING END OF FISCAL YEAR FINAL MATURITY DATE REVENUE ANTICIPATION NOTE NO. 3 MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) PAID DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) OUTSTANDING END OF FISCAL YEAR IF~NAL MATURITY DATE I TOTAL REVENUE ANTICIPATION NOTES OUTSTANOXN$ BE6XNNIN$ OF YEAR ISSUED DURING FISCAL YEAR PAXD DURING FXSCAL YEAR OUTSTANDXNG END OF FISCAL YEAR 15 EDPCODE 2P186ZZ 2P1862S 2P18625 2P18627 ZP18&21 ZPZS&2$ 2PIB625 2PIB627 2PIB621 2P18625 2P18625 2PIB&27 AMOUNT AMOUNT STATEMENT OF INDEBTEDNESS BUDGET NOTES LIST SEPARATELY BY DATE OF ISSUE BUDGET NOTE NO. ! MONTH AND YEAR OF ZSSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FZSCAL YEAR (DO NOT INCLUDE RENEWALS HERE) PAID DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) OUTSTANDING END OF FISCAL YEAR FINAL MATURITY DATE DUDGET NOTE NO. 2 MONTH AND YEAR OF ZSSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) PAID DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) OUTSTANDZNG END OF FISCAL YEAR FINAL MATURITY DATE BUDGET NOTE NO. $ MONTH AND YEAR OF ISSUE CURRENT ZNTEREST RATE OUTSTANDING BEGZNNZNG OF YEAR ISSUED DURZNG FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) PAID DURING FZSCAL YEAR (DO NOT ZNCLUDE RENEWALS HERE) OUTSTANDING END OF FZSCAL YEAR IFINAL MATURITY DATE I TOTAL BUDGET NOTES OUTSTANDZNG BEGZNNING OF YEAR ZSSUED DURZNG FZSCAL YEAR PAZD DURING FISCAL YEAR OUTSTANDING END OF FZSCAL YEAR 16 EDPCODE 2P18651 2P1865S 2P18655 2P186S7 2P18651 2P186S$ 2P18635 ZP18&37 2P18651 2P18633 2P18&35 2P18&37 AMOUNT / AMOUNT I I I I I ~,_1 I I I I I I I I I I r._l STATENENT OF INDEBTEDNESS CAPITAL NOTES LIST SEPARATELY BY DATE OF ISSUE CAPZTAL NOTE NO. ! MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDIN$ BEGINNZN6 OF YEAR ZSSUED DURZNG FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) PAID DURING FZSCAL YEAR (DO NOT INCLUDE RENEWALS HERE) OUTSTANDING END OF FISCAL YEAR FINAL MATURITY DATE CAPZTAL NOTE NO. 2 MONTH AND YEAR OF ZSSUE CURRENT INTEREST RATE OUTSTANDZNG BEGINNING OF YEAR ISSUED DURING FISCAL YEAR (DO NOT ZNCLUDE RENEWALS HERE) PAID DURING FZSCAL YEAR (DO NOT INCLUDE RENEWALS HERE) OUTSTANDZNG END OF FZSCAL YEAR FZNAL MATURZTY DATE CAPITAL NOTE NO. $ MONTH AND YEAR OF 1SSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ZSSUED DURZNG FZSCAL YEAR (DO NOT INCLUDE RENEWALS HERE) PAZD DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) OUTSTANDING END OF FISCAL YEAR IFZNAL MATURZTY DATE I TOTAL CAPITAL NOTES OUTSTANDZNG BEGZNNING OF YEAR ZSSUED DURING FISCAL YEAR PAZD DURZNG FISCAL YEAR OUTSTANDZNG END OF FISCAL YEAR EDPCODE 2P18751 2P18755 2P18755 2P18757 2P18751 2P18753 2PZ8755 2PZ8757 2PZ8751 2P18753 2P18755 2P18757 I AMOUNT I I I I /__1 Z_I $ AMOUNT 17 STATEMENT OF INDEDTEDNESS BOND ANTICIPATION NOTES LIST SEPARATELY BY DATE OF ISSUE EDPCODE AMOUNT BOND ANTICIPATION NOTE NO. 1 MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNIN6 OF YEAR ISSUED DURIN$ FISCAL YEAR (DO NOT INCLUDE RENEgALS HERE) PAID DURING FISCAL YEAR (DO NOT INCLUDE RENEgALS HERE) OUTSTANDING END OF FISCAL YEAR 2P18761 2P1876~ 2P187&5 2P18767 FINAL MATURITY DATE BOND ANTICIPAT/ON NOTE NO. Z MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR (DO NOT INCLUDE RENEWALS HERE) PAID DURING FISCAL YEAR (DO NOT INCLUDE RENEgALS HERE) OUTSTANDING END DF FISCAL YEAR 2P18761 2P1876S 2P18765 2P187&7 FINAL MATURITY DATE BOND ANTICIPATION NOTE NO. $ MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE iOUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR (DO NOT INCLUDE RENEgALS HERE) PAID DURING FISCAL YEAR (DO NOT INCLUDE RENE#ALS HERE) :OUTSTANDING END OF FISCAL YEAR 2P16761 2P18765 2P18765 2P18767 IFTNAL MATURTTY DATE I TOTAL BOND ANT]*CTPATTON NOTES AMOUNT OUTSTANDING BEGZNNIN6 OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR ~K~ DOND ANTICIPATION NOTES REDEEMED FROM BOND PROCEEDS DURZNG FISCAL YEAR 2P18885 $ $ $ 18 STATEMENT OF INDEBTEDNESS BONDS LIST SEPARATELY BY DATE OF ISSUE BOND NO. ! MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING DEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR FINAL MATURITY DATE BOND NO. 2 MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR FINAL MATURITY DATE BOND NO. $ MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR IFZNAL MATURITY DATE I TOTAL BONDS OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR EDPCODE 2P1877Z 2P18773 2PZ8775 2PZ8777 2P1877! ZP18775 2P16775 2P18777 2P1877! 2P18775 2PZ8775 2PZ8777 I AMOUNT I I I I /l__.l ~._I $ I I I I AMOUNT 19 STATEMENT OF INDEBTEDNESS INSTALLNENT PURCHASE CONTRACTS LIST SEPARATELY BY DATE OF ISSUE IPC NO. ! MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR FINAL MATURITY DATE IPC NO. Z MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR FINAL MATURITY DATE IPC NO. $ MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR IFINAL MATURITY DATE I TOTAL INSTALLMENT PURCHASE CONTRACTS OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR EDPCDDE SPI SP$ $P5 SP7 3P1 3P3 $P5 3P7 3PI $P3 3P5 3P7 AMOUNT I I I I ~_1 I I I I AMOUNT 20 STATEMENT OF INDEBTEDNESS STATE OR AUTHORITY LOANS STATE OR AUTHORITY LOANS MONTH AND YEAR OF ISSUE CURRENT INTEREST RATE OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR EDPCODE AMOUNT ZP18791 $ 2P18795 2P18795 $ 2P18797 IFZNAL MATURITY DATE I I TOTAL OF ALL INDEBTEDNESS INCLUDES TOTAL OF ALL BONDS, NOTES, INSTALLMENT PURCHASE CONTRACTS AND LOANS OUTSTANDING BEGINNING OF YEAR ISSUED DURING FISCAL YEAR PAID DURING FISCAL YEAR OUTSTANDING END OF FISCAL YEAR 21 FISHERS ISLAND FIRE DISTRICT STATEMENT OF INDEBTEDNESS SCHEDULE FOR REPORTING VARIABLE RATE, DISCOUNTED, AND/OR NEGOTIATED BONDS & NOTES (PLEASE COMPLETE A SEPARATE SCHEDULE FOR EACH NEW DEBT ISSUE) FISCAL YEAR ENDED 2005 ONLY TYPE OF DEBT INSTRUMENT: PLEASE ENTER 1 FOR A BOND, 2 FOR A BOND ANTICIPATION NOTE, OR $ FOR OTHER NOTES. AMOUNT OF ISSUE WAS THZS ISSUE SOLD COMPETITIVELY OR THROUGH NEGOTIATED SALE? PLEASE ENTER I IF SOLD COMPETITIVELY, 2 ZF NEGOTIATED SALE. DATE OF ISSUE MONTH, DAY AND YEAR OF FINAL MATURITY TYPE OF INTEREST RATE: PLEASE ENTER 1 IF FIXED, 2 IF VARIABLE, $ IF SOLD AT DISCOUNT. EDP CODE RESPONSE 6PKOD 6PPR 6PTOS 6PDT __/ /__ 6PON __/ /._.. &PTIR 22 SCHEDULE OF SECURITIES FOR COLLATERALZZATION GENERAL MUNICIPAL LAW SECTION 10 LISTS ELEVEN TYPES OF SECURITIES WHICH MAY BE PLEDGED FOR COLLATERALIZATION AND AUTHORIZES THE ACCEPTANCE OF LETTERS OF CREDIT AND SURETY BONDS IN LIEU OF COLLATERAL. PLEASE ENTER I IN THE RESPONSE COLUMN ON THE LINE(S) NEXT TO THE TYPE(S) OF SECURITIES USED BY BANKS AS COLLATERAL FOR YOUR DEPOSITS. ELIGIBLE SECURITIES EDPCODE RESPONSE OBLIGATIONS ISSUED BY THE UNITED STATES OF 9ZSECO1 AMERICA, AN AGENCY THEREOF OR A UNITED STATES SPONSORED CORPORATION OR OBLIGATIONS FULLY INSURED OR GUARANTEED AS TO THE PAYMENT OF PRINCIPAL AND INTEREST BY THE UNITED STATES OF AMERICA, AN AGENCY THEREOF OR A UNITED STATES GOVERNMENT SPONSORED CORPORATION. 2. OBLIGATIONS ISSUED OR FULLY GUARANTEED BY THE 9ZSEC02 INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT, THE INTER-AMERICAN DEVELOPMENT BANK, THE ASIAN DEVELOPMENT BANK, AND THE AFRICAN DEVELOPMENT BANK. $. OBLIGATIONS PARTIALLY INSURED OR GUARANTEED BY 9ZSECO$ ANY AGENCV OF THE UNITED STATES OF AMERICA, AT A PROPORTION OF THE MARKET VALUE OF THE OBLIGATION THAT REPRESENTS THE AMOUNT OF THE INSURANCE OR GUARANTY. OBLIGATIONS ISSUED OR FULLY INSURED OR 9ZSEC04 GUARANTEED BY THIS STATE, OBLIGATIONS BY A MUNICIPAL CORPORATION, SCHOOL DISTRICT OR DISTRICT CORPORATION OF THIS STATE OR OBLIGATIONS OF ANY PUBLIC BENEFIT CORPORATION WHICH UNDER A SPECIFIC STATE STATUTE MAY BE ACCEPTED AS SECURITY FOR DEPOSIT OF PUBLIC MONEYS. 5. OBLZGATIONS ISSUED BY STATES (OTHER THAN THIS 9ZSECOS STATE) OF THE UNITED STATES RATED IN ONE OF THE THREE HIGHEST RATZNG CATEGORIES BY AT LEAST ONE NATIONALLY RECOGNIZED STATZSTICAL RATING ORGANIZATION. OBLIGATIONS OF PUERTO RICO RATED IN ONE OF 9ZSECO& THREE HIGHEST RATINGS CATEGORIES BY AT LEAST ONE NATIONALLY RECOGNZZED STATISTZCAL RATING ORGANIZATZON. SCHEDULE OF SECURITIES FOR COLLATERALZZATZON ELIGIBLE SECURITIES EDPCODE RESPONSE 10. 11. 12. 15. OBLIGATIONS OF COUNTIES, CITIES, AND OTHER GOVERNMENTAL ENTITIES OF ANOTHER STATE HAVING THE POWER TO LEVY TAXES THAT ARE BACKED BY THE FULL FAITH AND CREDIT OF SUCH GOVERNMENTAL ENTITY AND RATED ZN ONE OF THE THREE HIGHEST RATING CATEGORIES DY AT LEAST ONE NATIONALLY RECOGNZZED STATZSTICAL RATZNG ORGANIZATION. OBLIGATIONS OF DOMESTIC CORPORATIONS RATED IN ONE OF THE TWO HIGHEST RATING CATEGORIES BY AT LEAST ONE NATIONALLY RECOGNIZED STATISTICAL RATING ORGANIZATION. ANY MORTGAGE RELATED SECURITZES, AS DEFINED ZN THE SECURZTZES EXCHANGE ACT OF ~9S4, AS AMENDED, WHICH MAY BE PURCHASED BY BANKS UNDER THE LIMITATZONS ESTABLISHED DY FEDERAL BANK REGULATORY AGENCZES. COMMERCZAL PAPER AND BANKERSw ACCEPTANCES ISSUED DY A BANK (OTHER THAN THE BANK WITH WHZCH THE MONEY ZS BEING DEPOSITED OR ZNVESTED) RATED ZN THE HZGHEST SHORT-TERM CATEGORY BY AT LEAST ONE NATIONALLY RECOGNZZED STATISTZCAL RATING ORGANZZAT~ON AND HAVING MATURZTZES OF NOT LONGER THAN SZXTY DAYS FROM THE DATE THEY ARE PLEDGED. ZERO-COUPON OBLIGATIONS OF THE UNZTED STATES GOVERNMENT MARKETED AS "TREASURY STRIPS." LETTERS OF CREDZT SURETY BONDS 9ZSEC07 9ZSEC08 9ZSEC09 9ZSEC/O 9ZSEC11 9ZSEC12 9ZSEC1S 24 SCHEDULE OF TIME DEPOSITS AND INVESTMENTS EDPCODE AMOUNT CASH= ON HAND 9ZZOOZ DEMAND DEPOSITS 9Z202! TIME DEPOSITS 9Z2011 TOTAL - FDIC INSURANCE 9Z2OZq - COLLATERALZZED NITH SECURITIES HELD IN POSSESSION OF MUNICIPALITY OR ITS AGENT 9Z2OZqA TOTAL INVESTMENTS: - SECURITIES ~BOOK VALUE (COST) 9Z~501 ~MARKET VALUE AT BALANCE SHEET DATE 9Z4S02 ~COLLATERALIZED WITH SECURITIES HELD IN POSSESSION OF MUNICIPALITY OR ITS AGENT 9Z4SOqA - REPURCHASE AGREEMENTS ~BOOK VALUE (COST) ~MARKET VALUE AT DALANCE SHEET DATE 9Z~512 NCOLLATERALIZED WITH SECURITIES HELD ZN POSSESSION OF MUNICIPALITY OR ITS AGENT 9Zq51~A 25 SCHEDULE OF TINE DEPOSITS AND INVESTHENTS RESERVE FUNDS EDPCODE CASH (ALL RESERVE FUNDS): ON HAND 9Z2501 DENAND DEPOSITS 9Z2~Z1 TINE DEPOSITS 9Z2521 TOTAL COLLATERAL: - FDIC INSURANCE 9Z2524 - SECURITIES LOCATED: (1) IN POSSESSION OF HUNZCIPALZTY 9Z252~A (2) HELD BY THIRD PARTY CUSTODIAL BANK 9ZZ524B (5) HELD BY TRADING COUNTER PARTNER 9Z2524C INVESTHENTS (ALL RESERVE FUNDS) - SECURITIES (450) ~DDOK VALUE (COST) 9Z4521 ~HARKET VALUE AT BALANCE SHEET DATE 9Z4522 ~SECURITIES LOCATED: (1) IN POSSESSION OF MUNICIPALITY 9Z4524A (2) HELD BY THIRD PARTY CUSTODIAL DANK 9Z4524D (5) HELD DY TRADING COUNTER PARTNER 9Z4524C - REPURCHASE AGREEHENTS (ALL RESERVE FUNDS) (451) ~BOOK VALUE (COST) 9Z455! ~NARKET VALUE AT DALANCE SHEET DATE 9Z455Z ~SECURITIES LOCATED: (1) POSSESSION OF HUNICIPALITY 9Z4554A (Z) HELD BY THIRD PARTY CUSTODIAL BANK 9Z4554B ($) HELD BY TRADING COUNTER PARTNER 9Z4554C AHOUNT FISHERS ISLAND FIRE DISTRICT INVESTMENT CERTIFICATION DEFINITIONS REPURCHASE AGREEMENT - A GENERIC TERM FOR AN AGREEMENT IN WHICH A GOVERNMENT ENTITY (DUYER-LENDER) TRANSFERS CASH TO A BROKER-DEALER OR FINANCIAL INSTITUTION (SELLER-BORROgER); THE BROKER-DEALER OR FINANCIAL INSTITUTION TRANSFERS SECURITIES TO THE ENTITY AND PROMISES TO REPAY THE CASH PLUS INTEREST IN EXCHANGE FOR THE SAME SECURITIES OR FOR DIFFERENT SECURITIES. REVERSE REPURCHASE AGREEMENT - AN AGREEMENT IN gHICH R BROKER-DEALER OR FINANCIAL INSTITUTION (BUYER-LENDER) TRANSFERS CASH TO A GOVERNMENT ENTITY (SELLER-BORROgER); THE ENTITY TRANSFERS SECURITIES TO THE BROKER-DEALER OR FINANCIAL INSTITUTION AND PROMISES TO REPAY THE CASH PLUS INTEREST IN EXCHANGE FOR THE SAME SECURITIES OR DIFFERENT SECURITIES. INSTRUCTIONS PLEASE PUT I IN THE RESPONSE COLUMN NEXT TO THE APPROPRIATE ANSWERS IN QUESTIONS 1, 2, AND $ FOR THE INVESTMENT CERTIFICATION SCHEDULE. EDPCODE RESPONSE 1) HAS YOUR LOCAL GOVERNMENT ADOPTED AN INVESTMENT POLICY AS REQUIRED BY GENERAL MUNICIPAL LAg, SECTION $9? YES 9ZPOLY NO 9ZPOLN IF THE ANSgER TO NUMBER 1 IS YES, PLEASE INDICATE WHICH OF THE FOLLOWING INVESTMENTS ARE PERMITTED BY YOUR INVESTMENT POLICY. OBLIGATIONS OF THE UNITED STATES 9ZINV! ODLIGATIONS OF U.S. GOVERNMENT AGENCIES, GUARANTEED BY THE UNITED STATES GOVERNMENT. 9ZINV2 OBLIGATIONS OF THE STATE OF NEW YORK 9ZINVS ODLIGATIDNS OF OTHER NEg YORK STATE LOCAL GOVERNMENTS 9ZINV~ OTHERS (SPECIFY) 9ZINV5 Z7 FISHERS ISLAND FIRE DISTRICT INVESTMENT CERTIFICATION ARE REPURCHASE AGREEMENTS AUTHORIZED BY YOUR INVESTMENT POLICY? DO YOU ENGAGE IN REVERSE REPURCHASE AGREEMENTS? EDPCODE YES 9ZREPOY NO 9ZREPON YES 9ZRVREY NO 9ZRVREN RESPONSE SIGNATURE TITLE PHONE NUMBER 28 BANK RECONCILIATION INCLUDE ALL CHECKING, SAVINOS AND C.D, ACCOUNTS BANK ACCOUNT NUMBER BANK BALANCE ADD: LESS: DEPOSITS OUTSTANDING IN TRANSIT CHECKS ADJUSTED BANK BALANCE 9lq, IO, TOTAL ADJUSTED DANK DALANCE PETTY CASH ADJUSTMENTS (SPECIFY) EDP CODE TOTAL CASH TOTAL CASH DALANCE ALL FUNDS ~ MUST BE EQUAL 9ZCASH gZCASHB 29 FISHERS ISLAND FIRE DISTRICT LOCAL GOVERNMENT QUESTIONNAIRE PLEASE ENTER 1 FOR ALL YES RESPONSES PLEASE ENTER 2 FOR ALL NO RESPONSES EDP CODE RESPONSE 1) DOES YOUR MUNICIPALITY HAVE A WRITTEN PROCUREMENT POLICY? 9ZPRP Z) HAVE THE FINANCIAL STATEMENTS FOR YOUR MUNICIPALITY ~-~ BEEN IDEPENDENTLY AUDITED? 9ZACO IF NOT, ARE YOU PLANNING ON HAVING AN AUDIT CONDUCTED? 9ZACC 3) DOES YOUR LOCAL GOVERNMENT PARTICIPATE IN AN INSURANCE POOL WITH OTHER LOCAL GOVERNMENTS? 9ZLY3! 4) DOES YOUR LOCAL GOVERNMENT PARTICIPATE IN AN INVESTMENT POOL WITH OTHER LOCAL GOVERNMENTS? 9ZLYSO 5) DOES YOUR MUNICIPALITY HAVE A LENGTH OF SERVICE AWARD PROGRAM (LOSAP) FOR VOLUNTEER FIREFIGHTERS? 9ZLOSAP 6) DOES YOUR MUNICIPALITY HAVE A CAPITAL PLAN? 9ZCAP 7) HAS YOUR MUNICIPALITY PREPARED A DOCUMENTED RISK ~'~ ASSESSMENT? 9ZDRA IF YES, HAS YOUR MUNICIPALITY USED THE RESULTS TO DESIGN THE SYSTEM OF INTERNAL CONTROLS? 9ZINC HAVE YOU HAD A CHANGE IN CHIEF EXECUTIVE OR CHIEF FISCAL OFFICER DURING THE LAST YEAR? 9ZMAML 9) DOES YOUR MUNICIPALITY HAVE ACCESS TO THE ZNTERNET? 9ZINTE YOUR MUNICIPALITY HAVE AN OFFICIAL E-MAIL DOES ADDRESS? 9ZEMAZL ZF YES, WHAT ZS IT? DOES THE CHIEF FISCAL OFFICER HAVE A SEPARATE E-MAIL ADDRESS? 9ZCFOE IF YES, WHAT IS IT? ~.~ DO YOU HAVE A WEB SITE? 9ZWEB IF YES, WHAT IS THE OFFICIAL WED SITE ADDRESS FOR YOUR MUNICIPALITY?