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Home My WebLink About2009NORTH FORK ANIMAL WELFARE LEAGUE, INC. P.O. ~ox 297, SouthoM, New York 11971 Supervisor Scott Rus~ Town of Southold Town H. II~ 53095 Main Road P.O. Box 1179 Southold, New York 11971 September 1, 20O9 RECEIVED SEP 11 ~uthold Tow~ Cle~ SUP~t~?tSO t S OFF,uE TOWN OF $OUTHOLD Dear Supervisor Russell, I am in receipt of a certified letter from your Town Clerk of August 25, 2009 requesting information regarding our duties in accordance with New York State A/picuiture and Markets Article 7 and Town Law Article 8 and our latest contract with the Town. Our Certificate of Liability Insurance and Workers~ Compensation Insurance have both been renewed but copies have not been requested by the Town prior to this letter. Enclosed please find the copies. DI- 18 forms do contain important informatio~ Ple~e advise which spec/ftc forms the Town Clerk cannot read. Please be advised eu~h,ni~ion cerfificat~ do not exist. Please have the clerk clarify her request. The Town has rec~ved all edoption documents and fees in accordan~ with New York State Agriculture and Markets Article 7 and as required in our contra~t with the Town of Southold. per 6ur contract of Apr~ 2008, monthly r~ports arc not required. Wo ero in shiet accorden~ with all the requirements of New York State Agriculture and Market~ Article 7 and our extremely proud of our DL-89 Impo~ion Rel0orts. If you have further questioes regardln~ the above please feel free to call me personally. Tberese McCjuinne~ Pr~ident/NPAWL "HELP US TO HELP THOSE WHO CANNOT HELP THEMSELVES" New York State Insurance Fund Worl~m~ Compmzv~on & ~ B~nefl~s SpedMi~s Since 1914 1~ CM~CH ~, N~ ~, N.Y. 1~-11~ P~ (~) ~ CERTIFICATE OF WORKERS' COMPENSATION INSURANCE NORTH FORK ANIMAL WELFARE LEAGUE INC PO BOX 297 SOUTHOI.D NY 11971 POLICYHOLDER NORTH FORK ANIMAL WELFARE LEAGUE INC PO BOX 297 SOI. H'HOLD NY 11971 CERTIFICATE HOLDER TOWN OF BOUTHOLD TOWN CLERK PO BOX t179 SOUTHOLD NY 11971 POLICY NUMBER CERtiFICATE NUMBER Z 673 415-6 628764 PERIOD COVERED BYTHIE C,t:~ii/-ICATE DATE 08/23/2006 TO 06/01/2010 9/1/2009 THIS 18 TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE 18 INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POi.iCY NO. 673415-6 UNTIL 06/01/2010, COVERING THE ENTIRE OBLIGATION OF THIS PC~.ICYHCLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT A~ INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHCLDER"S REGULAR NE'W YORK STATE EMPLOYEES ONLY. IF SAID POUCY IS CANCELLED, OR CHANGED PRIOR TO 06/01/2010 IN SUCH MANNER AB TO AFFECT THIS CERTIFICATE, t0 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL BO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOESNOTASSUME ANYLIABILITYIN THE EVENT OF FAILURE TOGNE SUCH NOTICE. THIB CERTIFICATE IS ISSUED AB A MAI-rER OF INFORMATIONONLYANDCONPERS NO RIGHTS NOR INSURANCE COVERAGE uPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR, INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https-.//www.nysif, comlcerl/certval.asp or by ceiling (888) 8755790 VALIDATION NUMBER: 291985507 ACORD CERTIFICATE OF LI, ~omcee (516)82Z-6550 FAX (~1b~822-6~64 PHnca AssociateS, Inc. 1B3 Broadway 'dicksvTlle, K,'Y 1.180/ ~ Nol~t o An ma ~e are: ague TI1C PO Box 297 Southho16, NY 11971 BILITY INSURANCE os/o3/'zoo~ ONLY ~ CONFERS NO RtGHT~ UPON THE Ce~ r a-SCa ~ = RLT~RT~E ~;OV~-~-ee AFFORDED ~ THe P~3Li~t~ D~d.V . ~UR~Ra AFFORDIN~ COVERAGE NAIC ~ MAy pERTAIN. THEiNStJRANCE AFFOrdED By THE pQUCtE~ _~_ _~ HEREIN ~ 5UBJEOT TO~JJ- THE ~. ~U~ ~ ~ ~ ~H POLIGIES. A~GREGATE UMIT8 SHOlaffl MAY HA~ ~ REIN3OED BY pAID ~cate Holder as Landlord of pre~flses CZ$9 peconlc Land, Pecon~c, NY) ~s Additional Tnsm"ed. ~I::K ! ir;CATE HOLDER Town of' Southold fi) Box 1179 Southold, NY 11971 ~ ~9B8.200~ ACORD CORPORATION. At; i;~;;-- ~served. *CORD ~ 1~o~ol ) The ACORD name and Io9o ara regL~temd marks of ACORD ' DL-90 (9/07) NYS DEPARTMENT OF AGRICULTURE & MARKETS DIVISION OF ANIMAL INDUSTRY REVIEWED BY: JOB AIRLINE DRIVE, ALBANY, NY 12235 I 518-457-3502 MUNICIPAL' SHELTER INSPECTION REPORT ~INSPECTION DATE [] RE INSPECTION TIME INFO CHANGE SHELTER NAME ISHELTER MANAGER/OWNE" IPR~{E,~S ADDRE$.S (911) c.. MAIL ADDRESS EMAIL ADDR, F~,S ou.w o v LONGITUDE: W.4)? I LATITUDE: N+4 A. STANDARDS OF CARE S U B. RECORDS S/ U 1. STRUCTURE SOUNDNESS J~./' 1. DL-18 ON FILE 2'. SANITATION ~. / 2. HOLDING PERIOD 4. ANIMAL SAFETY;".~ · 4, IMPOUND FEE PAID 5. SPACE ~'j" 5. CONTRACT/LEASE L,,,,' 6. LIGHT ~ 6. BOND UP TO DATE ~ ~ 7. VENTILATION i/~ - ~" 8. TEI~P~,TURE ~/'/~ C. OTHER 9. FOOD/WATER ~/,~ 10. VETERINARY CARE J/', ~ 1 I. EUTHANASIA ~,,/ -- 12. OUTDOOR ENcLosuRES ~'// _ COMMENTS DATE SF;CONO COPY - INSPECTOR DL-89 (9/07) . ~ ..~.. '- HYS DEPARTMENT OF AGRICULTURE & MARKETS DIVISION OF ANIMAL INDUSTRY ,. DOG CONTROLOPFi~i~" ;NsPECTION REPORT, ?" DATE TIME INSPECTION ~ [] RE NsPECT!ON [] NFO CrinGE NEXT INSPECTION DUE [] SAflt6FACTORY [] UNSATISFACTORY TCV CODES A. $;J;'URES ~. U B. RECORDS S U 1. ~ ~EI~CES . 1. DL-18 COMPLETE L2. EQUIPMENT. , ~" 2. HOLDING PERIOD 3. TRANSPORT VEHICLE , t / 3, LICENSE BEFORE RELEASE I/. 4---~I~ITATION ~ 4' IMPOUND FEE PAID ' i/ .. 5. vETERINARY CARE . / 5. PENALTY ACTIONS L,,,'/ 6. EUTHANASIA V'"' 6. DANGEROUS,DOG PROCEDURES 7. NUMBER OF DOGS SI=ITI=D . ..~ _. -~ ~) [ C. OTHER COMMENTS T DATE SECOND COPY - INSPECTOR EI.IZ&BETH A. NEVII.LR, RMC, CMC TOWN CL~.RK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Ma/n Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-61~ Telephone (631) 765-1800 southoldtown.nor thforl~net OFFICE OF THE. TOWN CLERK TOWN OF SOUTHOLD August 25, 2009 CERTIFIED MAIL RETURN RECEIPT REQUESTED Tberese McGuiness, President North Fork Animal Welfare League, Inc. Animal Shelter Post Office Box 297 Peconic, New York 11958 Dear Ms. McGuiness, Your Certificate of Liability Insurance aad Certificate of Workers' Compensation Insurance have both expired in June and July 2009. These documents should be sent to me upon their · n renewal. Please PWvide me with current copies of these documents at your earliest convenie ce. The completion of the DL- 18 forms, Dog Seizure and Disposition/Redemption/Adoption by your staff are not acceptable. These forms are sometimes missing important information and are illegible. Signatures must have printed name underneath. We have not received euthanizafion certificates from you. Please forward all of these certificates th~ you have. I don't believe we are receiving all oftbe adoption doeumeats and fees. In 2006 we received 171, in 2007 -121; 2008-72; 2009 only $. To date, you have only generated 72 dog licenses from the shelter in un eight (8) month period. According to our reeords there are currently one hundred fifteen (115) case numbers listed which are unaccounted for. The new 2008 conUact did not remove any of your reporting obligations to the town. The last monthly report we received from you is March 2008. You are still responsible for providing my office with monthly reports, and maintaining the shelter and performing your duties in accordance with NYS Aigiculture & Markets Law, Article 7 and Town Law, Article 8. Yours truly, Southold Town Clerk cc: Supervisor & Town Board Members Town Attorney Town ComPtroller.