HomeMy WebLinkAbout1991FEB ~& lCjCjZ
~? 2~ 7900 OlOO
ORIENT leO$OUITD DISIRIC~
COUNIY OF SUFFOLK
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List ~rotely ~ ~te of ll~ ~ ~ ~ce~it bii~J~ Of l~. ~t~ Pm~d ~ ~d Of ~turfty
Ta MttCipac~
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Tocat R~ ~ttci~tton ~ces
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To~l ~d~c ~cea
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STAI~qT oir IN~SI~3f4KSS
Hncc~ Current Outscandin$ Do ~ot Include ReneWals He~e OucatandinS Final
List Separatal~ EI)PCOf~ and - Interest B~innir~ of la~ncd DO~in~ Paid ~t~ ~ of ~ricy
~pital ~ces
~tal ~pitat ~tes ~1885
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~tal ~ ~ttc~tt~ ~tee ~
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~AL IMPS
'TCr'l~AL AMOLl~r ~ CLAIJ~ TOTAL AHO~h'~ PAID t~ff CLAIHS
EDp ~ AHOUNT EDP COOB AHQUNT
Cl&ius Pem~- Be~tm~.nW o! Year
Involvin8 Codefend~t~hird Part3r Defendant ~PTWIO
Other Cl&tm~ 7PTRI5
2
Rotlcem Filed Durin~ th~ Year
InvolvtnS Codmfendant/l~trd Pert~ Defendant 71~R20
Other Claim 7PTR25
7ffl121 3
7PT~2& 4
ClaLB~ dtml~mm4 of durtn$ the year
°By Unit
7J~R30
7t~l. 7Pill32 5
71vX1~1 7P'Z'~&2 6
Claims disposed of during the ymar
o~ Unit 7FrRSO
*By Insurance C~rrier 7~
0~ J~c 7~
*olaf ( ) 7~
.7P'IItSX 7PTR52 7
7FI~6L 7PT~62 8
7P'llt71. 7P'rR72
7JfI2W1L 7PTR82
Kqumla:
Claims Pmndin~ - ~nd of Year
Iflvolvtns Codefend~c/Third Party Defendant 7PTRgO
Other Claims 7PTR95
7t'Xlt91 -
7PTR96
AUTRORTZATION
COLLA11~AL
~h in l'ime Oe~o~tca 7~299!
UUU
Collateral - Insurance (Iq)lC, eec.) and securities.
A - Securtt~ ie ~mmim~ o~ local SovernBeflcal unLC
B - Secur~y held by third party custodial b~nk.
C - Security held b~ cradln[ partner.
~ ~ ~IIT (~JL~I~OI~AIR!
* Audl~ Gov~r~e Surve~ *~
L Ia ~m mmual financial ret)ore prepared ~ot~ yom~ ~ove~m~e&l unlz!
the anmmr to q~es~ton ~ fa ~pmo, ple~ae enter ! if ymar rt~ort tm Pre~mred tnternmlly o~ 2 f.f ~our repoFt lo prepared by an
/ndependene mdttor.
If your annual report ts presred by a tn~eflden~ auditor please provide th~ follovinK J. nforu~tLofl.
FOR STA~ CCIWTROLLneS USE O~Ly
lqmn~ of F,Irm
Addre~e of Firm
6;
~d~dt£fed Accz~utl. 2
~ll! or ~ tho official s~t.entu for your unit ~ ~t~ ~ ~ i~t ~tt~ (~lk ~t~t or certified ~blic ~c~tant) for
~he final ~r ~4 ~ l~
~ter 2 if ~
the ~M to question t f~ve fo ~s, please l~tc~te ~olt~ tnf~t~ for ~e p~m~l ~ttoF:
i~! STATK ~i~0LI~R,S lJSE OWLY
D.crtpzton I~qulred Information E~PCO~
Nm of k~dltln! Firs: 7P2IAC
Auditor rode
Address of Auditin$ Fire:
Cl~y
Zip Code
Telephone Nu.ber ( )
Pleese list the ssooeiltioas t~t y~J or your mUnicipsl entity beloos to ubicb ore relav~nt ~o the duties ymt mi/or other
lnRFucte~ belo~. Yo~ reply to ~l~ request util e~o~re that mil mallin6~ and inquiries ~tll be dl£octed to ~e proper individual and address.
~ of Individuml
(3~lef Fioce! Officer
Official J~ilinS Address
Telephone No. (Ares Code)
later Inforuettoe liars
(~fef rlscul Officer
~mue of Individual
C*ntef Esecutive Officer
Official N~il;niiddress
Telephone ~. (Area Code)
A t8
(3~ief ~xecuttve Officer
( I