HomeMy WebLinkAbout1966
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'POs 11LiERT N. d2ClHKi~. ?dix Cim~C. lOMM Q i0~!'SOLD
IVtI.IGS'IGN ii Il~iY WIDS, possuant to the psavisiaas of
Nction lifMa of the tarsal Law o! the hats of flw 7Mek• !or a psrait
to display ilsswaslu a• hsssinattsr spscitisdt
'ilia display la to ba sponsored by Tine ~9~i e.vY ~~iR ~
De,~~'/,~rMCN,r. with pcins~pal ot!!as at ~ildiff.4.9,~ ST. /9Ri PN/
few Ybrk, and will bs held en ~ , 7 ,196
(day) (swath)
at S'' ~ 3 o t.M..
ro~~
~'~-iiY Dy T~ - r~~ r - c~rti ~ c ~
S'hs o ing persons-ar. to a'haris of the aatnal
shooting of the Lirewarksr
~~e~rT d 1~o~,c_LA-ss ~
~. ~ o S S ~(~/n A /r ,L N.hl ~Y
.,L~. o YD TeRR r ~
1;_ss! " -- ~_. .
~ /t^ o D Q~
e/~~~- ~ ~,~~ ~TaRr ?
--~-j~ lr O a ,~
Clvi~ ! JI-'~fq /~r~7inG /~
'3 ~1~raw~S' lr- O ~ A
~tabs~s' and type o! lirewosks is a. tollawst
r~1iJLiA~rr~ri~1~r~w~i~Y./+/i.~- o • /)YC r~/fbf~i~lfr(~r~ ~ ~' ..(S
rrNrrrWrrr-~/~r~ ~ r.. r1Af~f~l~~fi-=..~ ~' ~ ~ L~rr~iL.7rr.~r,~~
rrrrrrrrwrrrr~{w(Q~(r~Mrrr rrrrrrrrrrw~rrrrrrrrrrrrrw
Rbe lirewoeks will bs stored in a Dowsed trbek pziar to
the shooting on the groWnds.
1-ttachsd hsre~o and sails a past hsreo! is a disgrss o! the
grounds oa wAleb the display is to be bald. 1-lso attad-ad is the osrti!-
scats or poiioy of insararas oowrags.
~~~~
ltsspscttully shitted,
~~~~ ~~~
(nw or organisation)
..
OYSTER PONDS CHEMICAL CO.
ORIENT FIRE DEPARTMENT
ORIENT, NEW YORK
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- CERTIFICATE OF INSURANCE
B [j].I-Iartford Fire Insurance Company ° ®New York Underwriters Insurance Compwy
THE II~RTFORD ~ lfl Hartford Accident and Indemnity Company ~ ®Northwestem Underwriters of Citizens Insurance Company of New Jersey
INSURANCE GROUP c' ®Citiz<ns Insurance Company of New Jersey ~ m Twin City Fire Insurance Company
This is to certify that the company designated Ca Gda
herein by Co. Code has issued to the named insured ~.__
the policies enumerated below.
Named Insured and Address
Orient Fire District & Oysterponda
16-0175 Chemical Co. & Town of Southold
Floyd F. King Jr. Orchard Stree~
Orient, New York
The policies indicated herein apply with respect to the hazards and for the coverages and limits of liability indicated by
specific entry herein, subject to all the terms of such policies.
Coverages and Limits of Liability
Hazaide POlicy
Number Effective
Date E%pifatiOn
Date Fadily Injury Liability Property Damage Liability
riGpSOtBa4 erLarid.vt we~ardda.a aggregate
General Liability
Premises-Operations
Elevators
10RMP101~6._20
~ LT66
7-LET66
$ 300000
$ ,000
$ ,000
$ ,000
$ ,000
$ ,000
$ _300000
XXXX
Independent Contractors $ ,000 $ ,000 $ ,000 $ ,000
Products-Completed $ ,000 S ,000 $ ,000 $ ,000
Operations Aggregate: $ ,000 XXXX XXXX
Contractual-as
described below _
$ ,000
$ ,000
$ ,000
$ ,000
Automobile Liability
Owned Automobiles
$ ,000
$ ,000
$ ,000
XXXX
Hired Automobiles $ ,000 $ ,000 $ ,000 XXXX
Non-Owned Automobiles $ ,000 $ ,000 $ ,000 XXXX
Workmen's Compensation
and
Employers' Liability Compensation -Statutory
Employers' Liability - $ ,000
Umbrella Liability $ ,000,000
Location and description of operations, automobiles, contracts, etc. (For contracts, indicate type of agreement, party and
- date.) -
Coverage is afforded for setting off afire works display on Village Wharf.
Main St., Orient, D?.Y. If by chance this anent is rained out coverage will
be afforded for July 9, 1966.
If policy is canceled, 10 days
written notice will be given to:
Date 6_21-66
Form G-2106-3 Printed iv U. 5. A. 6 '64
Town of Southold
Southold, N.Y,
By........~ ~ ....... .................................
~~~~~~~~~~~~~~~~ Atdhorised Reprerentntdve
ABa„red......Orient _Fire ..Distri.c.t....&...Oysterp.ands....Chemical....C.a.. ................._......_.........
Attached to and forming part of Policy Nd,.OSMPlOl~.62O..... _.......of the...Aar..tf.Ord.. Flj11"..B....Ina......ri.O.w ..........................................
.................._..........................._...................................Insurance.Company, issued at its......Ur.idTlt......N...Y................ _...................................Agency.
1, (~ity or 7owe) (State)
Effective Date...._..'7.-4,.- ............................._....._...................__._l9.(](~. ................F10.3!d...F.. _..Z{iI]g....Jr.w............................Agent
In consideration of an additional premium it is agreed that coverage
under Section II Liability is afforded for afire works display by the
Fire Dept. on Village Wharf, Main St., Orient, N.Y, in behalf of the
town of Southold.
As respects this event, the town of Southold is an additional
named insured. In the event of rain on this date, coverage will be
afforded for the rain date July 9s 1966.
This endorsement provides coverage under Su'odivision 5 of ~
Section 1894-.A Penal Law oP the 5tatd of New Yor3~.
ADDITIONAL PREMIUM 0
DUE HEREWITH $ 73.15
196 INSTALLMENT
196 INSTALLMENT
TOTAL $ 73.1
RETURN PREMIUM Q
PREVIOUs
INSTALLMENTS
REVISED
INSTALLMENTS
All other terms and con Ntione of this policy remain unchanged.
M-2979
FLOYD F. KING, Jx.
ROUTE 25, ORIENT, LONG ISLAND, NEW YORK 11957
Telephones: OR 2-1750 -Res. OR 2-0813
June 27, 1960
dir. Albert liichmond
Southold Town Clerk
Southold, iV . Y .
1{e; Orient Fire llistrict a Oysterponds
Chemical Co. :Town of aouthold
Policy r~l OSiYiP1 04620
Uear Mr. 1{ichmond:
I have checked with l~lr. I{obert 1'asker and he has approved
the enclosed endorsement in reference to the above policy.
If there are any questions, please do not hesitate to call.
Very truly youlrs,
%r ~„ ,,~'
b'Fl:~mk Flogd 1~ . Ding, Jr.~
l;nc.
av Heprerru/niy ilAK'CFORll ACCTDE NT A3D 1PnCMNITY COMPANY of the
~~ 1IA12T1~ORU hnzi: Ivsuun~*cc Cor2t~ns~• Gizour
f HARTFORD 15. CONNECTICUT