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Home My WebLink AboutAU-01/31/2012 Fishers IslandFISHERS ISLAND FERRY DISTRICT VENDOR 001327 AIRGAS EAST, INC 01/31/2012 CHECK 296 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710,4.000.000 116406283 (2)PROPANE TANK RENTALS 67.96 TOTAL 67.96 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Name AIr~as East Vendor Telephone Number Vendor Contact Vendor Address P.O. Box 827049 Philadelphia, PA 19182-7049 Invoice Number Invoice Date Invoice Total Vendor No. 1327 Net Purchase Order Discount Amount Claimed Number ,1~. scription of Goods or Services Check No. Entered by Audit Date JAN 3 1 2012 116406283 $67.96 1/1112012 $67.96 67.96 Payee Certification 67.96 The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the lown is exempt are excluded Signature Title Company Name Date ank Rentals SM$710.4.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly peri'onned and that the quantities thereof have been verified with the exceptions or~ iscrepancies ote ~n ayment is approved Title ~t~' ' 'Date ] / _,~//,~'- PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE. FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL: 80~-562-3815 Ext 3800 892998-00 116406283 ] 02081 01/11/12 FISHERS ISLAND ] 465 2! ,I810 CUST PICKUP / NET 30 DAYS 1 ** LOCATION: B6 89299~ 31illPR 33A 2 0 PROPANE 32LBS ALUMINUM %1 29.977.~ 59.96 N 2 2 VOL: 64 89299 31!llHAZHAZMAT 1 0 HAZARDOUS MATERIAL CHARG EX 8.0( 8.00 N Suk total 67.96 TOTkL C%LIND[RS SHIPPED: 2 RETUR~EI TAX iD,: 900000006 TAX ESCRP CC~NI%TICU EXMPT CD: 0 EXMPT/CER~ MUNICIP~ ]ITY Alp]as sH,. , www.airgas.com FISHERS ISLAND ACT. NAME AIRGAS EAST Airgas East FERRY DISTRICT ACT. NO. 8606074799 17 Northwestern Drive FISHERS ISLAND NY 06390 PNC BANK -ABA NO. 031000053 Salem, NH 03079 REF. 116406283/02081 ORIGINAL INVOICE DELIVERY ORDER Airgas. For location nearest you visit www. airgas,com -- SOLD BY: AIRGAS EAST 130 CROSS RD WATERFORD CT 06385 -- SHIP TO: FISHERS ISLAND FERRY DISTRICT P/O I~ NO: I RELI~ NO: / -- SOLD TO: FISHERS ISLAND INTERNAL USE ONLY ~6~ 7 cu~, No: 0 20~ :: ORDER NO: 8 ~ 6:'00 PAGENO: 001-; ;OF 001- FISHERS ISLAND NY C6390 11-JAN-12 12:34PM CRT:TNA2902 I I I I;DI F~3UTING ISCHEDUmDS~IPDA~I~GION~.~_6 ENTEREDBY RH~r ~FI 84l 46~ BlO 0 CUST PICKUP 01/11/12 REA QTY UNIT HH .......... OESCRIPTIOH .......... ID LINE ...... ITEH ...... LOC QTY --~YLI~S,- VOl/ UHIT EXTE~DEO ~IP & HAZARD CLASS HUHBER HO HUHBER O~R SHIP ~TtMT AHOUflT RHOUflT CL X UH1978 PROPflHE Z PR ~3fl PB6 2 2 2 64 ] ER HAZARDOUS HRTERIAL CHARGE 3 HAZ HRZHRI PB6 O .0 Total ~i~: 50.0 ~ ~r pho~ ~numbe~: 631- 788*7463 ~HIP TO: FISHERS ISLAND r-SHIPPED BY: THIS AGREEMENT SUBJECTTO AIRGAS' STANDARD TERMS PLACAED~ OFFERED AND COND~IONS. SEE REVEESE S DE FO~ IMPORTANT III III Iu~ SHIPPER NO. I SAFETY INFORMATION. I ES~ 4 ^ CEPTEOFOR q'l /0/ PKG ID~ THE ABOVE /// ~ ~ /~' INmALCHOICE 892998-00 CUSTOMER X /J/=~,~l~.J~'3/// - NAME ~ ?Vyff' ~' ~ FERRY DISTRICT FISHERS ISLAND NY 06390 I~. ICu~t. lU~ 02081 O0 0 io;-G998_o°.ICKU -NO,E- PLEASE PRINT lmtlitl~/ ~onlo~1. ~1~.7 3~1,~1 (Intemoflor~l * coil: 1-703-527-3887) J TERMS AND CONDITIONS EMERGENCY RESPONSE INFORMATION FISHERS ISLAND FERRY DISTRICT VENDOR 002644 BRODEUR'S OIL SERVICE, INC. 01/31/2012 CHECK 297 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.100 12983 281.9GAL HEATING FUEL 1,069.99 TOTAL 1,069.99 ~]~ Vendor No. .Town of Southold, New York - Payment Voucher ~ 2644 Vendor Tax ID Number or Social Security Number P.O. Box 602 Brodeur's Fuel Moosup, CT 06354 Check No. Entered by ~ Audit Date JAN 3 1 2012 Vendor Telephone Number Vendor Contact Invoice IBVOiCe Net Purchase Order Number Date 1/1112012 Total Discount 1,069.99 Amount Claime( 1,069.99 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Signature Title Company Name Date Number Heating FueI-NL General Led$¢r Fund and Account Number $M6710.4.000.100 Department Certification I hereby cerdfy that the materials above specified have been received by me in good condition without substitution, the services properly performed and t the quantities thereof have been verified with the exceptions o discrepancie note , payment is approved. Tit,e I- ' Date I · ROUTE FUEL DEL/H.W. D,D. NEXT DATE D,D. GALLONS K. FACTOR FUEL R TR ~ 012983 BRODEUR's OIL_SERVICE, INC. ~/~c~ ¢~ -._~ CED CS'.~ 28 STERLING ROAD, P.O. BOX 602, MOOSUP, CT 06354 !I~6~r27~89, , ~9,~8~ 0, *, 9 ,2~$2q ~ ~, ~ If Payment Received By PAY ~ ~ FISHERS ISLAND FERRY DISTRICT VENDOR 003891 CWPM, LLC 01/31/2012 CHECK 298 FI/ND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 21103835 REFUSE RMVL/NL-1/12 232.27 TOTAL 232.27 Town of Southold, New York - Payment Voucher Vendor ~o. Vendor Tax ID Number or Social Security Number Vendor Name CWPM, LLC Vendor Telephone Number Vendor Contact Invoice Number Invoice Date 21103835 1/1/2012 Invoice Total 232.27, Vendor Address dba Tlnnerello & Sons P.O. Box 418 Plainville, CT 06062 Net Discount 232.27 232.27 232.27 ~ I Purch~eOrder Number ervices Jan-2012 Ref Remvl NL Terminal Payee Certification Department Certification Check No. Entered by Audit Date JAN 3 1 2012 General Ledger Fund and Account Number 8M8710.4.000.000 The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Iowa is exempt are excluded Signature Title Company Name Date 1 hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or iscrepanci no payment is approved. Title f~ Date ~ I I I - ~' STATE ST PRIOR BALANCE 232.27 12/29/11 1C102265 PAYMENT RECEIVED (Thank you)214 <232.27> 01/01/12 CONTAINER SER 01/01/12-01/31/1 195.00 01/01/12 FUEL SURCHARGE 01/01/12 23.40 Tax 13.87 INV# 21103835 CURRENT $0 DAY 60 DAY 90 DAY DATE 01/01/12 ACCT# 1007831 232.27 PAGE 1 OF 1 CWPM. LLC RO. Box 415 Plainville, CT 06062 Phone (860) 747 1335 www cwpm.net New London County P6one (860) 447 1473 Rhode Island Phone (401) 348 3034 1 5% per month late charge assessed on past due amounts PLEASE PAY THIS AMOUNT 232.27 FISHERS ISLAND FERRY DISTRICT VENDOR 006155 FEDEX 01/31/2012 CHECK 299 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 7-752-19041 AIRBILLS-PAYROLL,W~LRRANT 104.44 TOTAL 104.44 Vendor No. Town of Southold, New York- Payment Voucher 616{~ Vendor Tax ID Number or Social Securily Number Vendor Address P.O. Box 371461 Vendor Name Pittsburgh, PA 15250-7461 Fedex Vendor Telephone Number Vendor Contact Invoice 7-762-19041 Date 11912012 Invoice Net Total Discount Amount Clai e( Purchase Order Number Description of Goods or Services $.irbill$-Payroll,Wa rrant Check No. Entered by ~ Audit Date Lf~J~.N 31 2012 General Ledger Fund and Account Number 8M6710.4.000.000 Payee Certification The undersigned (Claimant) (Acting on behaIf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which thc Town is exempt are excluded. Signature Title Company Name Date Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and thai the quantities thereof beve been verified with the exceptions Signature ~fi//°r iscrepancies noted, d payment_c)~ is ~appr°ved Billin. Address: FISHERS ISLAND FERRY DISTRICK NINA SCHMID/TOM DOHE PO BOX H FISHERS iSLAND NY 06390-0607 Invoice Summary Jan 09, 2012 Invoice Number '~ Invoice Date '~ I 7-752-19041 Jan 09, 2012 Shippiml Address: FISHERS ISLAND FERRY TERMINAL FERRY TERMINAL NEW LONDON 0T 06320 Account Number "% Page 1206-0334-5J 1 of 5 FedExTaxID: 71-0427007 Invoice Questions? Contact FedEx Revenue Services Phone: (800)622-1147 M-Sa 7-6 (CST) Fax: (800) 548-3020 Internet: www.fedex.corn FedEx Express Services Transportation 0harges 126.65 Base Discount -13.75 Special Handling Charges 29.93 Total Charges USD $142.83 TOTAL THIS INVOICE USD $142.83 You saved $13.15 in discounts this period! Other discounts may apply, Detailed descri tions of surcharges can be located at fedex.corn Adjustment Request Fax to (800) 548-3020 Invoice Number 7-752-19041 InvoiceDate ~[ Accountmumber ~ P.ge. 09, 2012 1206-0334-5 2 of'5 Use this form to fax requests for adjustments due to the reasons indicated below. Requests for adjustments due to other reasons, including service failures, should be submitted by going to vvw~v.fedex.com or calling 800.622.1147. Please use multiple forms for additional requests. Please complete all fields in black ink. ~Phone I I I I-I [ I I-I I I I I Fax#1 [ I I-III I-I I I I I E-mail Address [~ Yes, I wantto update account contact with the above inforrnatJon. Tracking Number Bill to Account $ Amount II- I. ADR-Address Correction ~.] DVC- Declared Value ; I° lAN - Invalid Acct # INW - Incorrect Weight INS - Incorrect Service OCF - Grd Pick-up Foe OCS - Exp Pick-up Fee OVS - Oversize Surcharge RSU- Residential Delivery PND - Pvvrshp Not Delivered SDR - Saturday Delivery For all Service failures or other surcharges please use our web site www.fedex.com or call (800) 622-1147 Tracking Number Code $ Amount Rerate information only (round to nearest inch) LBS L W H . II I I II I I Ixl I I Ixl I I I . II I I II I I Ixl I I Ixl I I I . II I I II I I Ixl I I Ixl I I I . II I I II I I Ixl I I Ixl I I I I I I II I I Ixl I I Ixl I I I Invoice Number 7-752-19041 FedEx Express Shipment Summary By Payor Type FedEx Express Shipments (Original) Shipper 3 7.0 Recipient 3 3.0 Invoice Date '~ [ Jan 09; 2012 66.30 22.33 60.35 7.60 Account Number "~ Page 1206-0334-5J 3 of 5 -7.71 80.92 -6.04 61.91 Total This Invoice USD $142.83 Account Number '~ P. age- 1206-0334-5! 4 of 5 InvoiceNumber ~I 7-752-19041 FedEx Express Shipment Detail By Payor Type (Original) Invoice Date Jan 09, 2012 · Fuel Surcharge - FedEx has applied a fuel surcharge of 1400% to this shipment Sender N SCHMIO FISHERS ISLAND FERRY TERMINAL FERRY TERMINAL NEW LONDON CT 06320 US Automation USAB Tracking l0 875071430051 Service Type FedEx Priority Overnight Package Type FedEx Pak Zone 02 Packages 1 Rated Weight 2.0 lbs, 0.0 kgs Delivered Dec 14, 2011 10:45 Svc Area AM Signed by C.EOSTER FedEx Use 034703109/0001486/_ Recipient JOHNC TOUN OF SOUTHOLD 54375 MAIN RD 2ND FL S FORK BA SOUTHOL0 NY 11971 US Transportation Charge 21.75 Discount -2.10 Fuel Surcharge 2.74 Courier Pickup Charge 0.00 Total Charge USD $2231 · Fuel Surcharge - FedEx has applied a fuel surcharge of 14.00% to this shipment Sender N SCHIMID FISHERS ISLAND FERRY TERMINAL FERRYTERMINAL NEW LONDON CT 06320 US RecinienI MS LUCINAA J HERRICK 1158 FIFTH AVE N EWYORK CITY NY 10029 US · Distance Based Pricing, Zone 2 Automation USAB Tracking ID 875071430062 Service Type FedEx Priority Overnight Package Type FedEx Envelope Zone 02 Packages 1 Rated Weight N/A Delivered Dec 20, 2011 09:53 Svc Area A1 Signed by M.MACK FedEx Use 035304079/0000186/_ Transportation Charge 17.85 Courier Pickup Charge 0.00 Discount -2.86 Fuel Surcharge 2.48 Residential Delivery 2.75 Total Charge USD $20.22 ~ Fuel SurcharGe - FedE× has applied a fuel surcharge of 1400% to this shipment Distance Based Pricing, Zone 2 Automation USAB Sender ReciDient ~ ' Tracking ID 875818170744 FISHERS ISLAND FERRYTERMINAL / HZM LABS./[NC Service Type FedEx Priority Overnight FERRY TERMINAL / 575 B..EG'AD HOLLOW RD Package Type Dustomer Packaging NEWLONDONCT 06320 US / M/EL~ILLE NY 11747 US I .on.. Packages 1 Transportation Charge 26.70 Rated Weight 5.0 lbs, 2.3 kcs Account Number Correction 1 Delivered Jan 03, 2012 08:59 Discount 2.67 Svc Area A2 Courier Pickup Charge ~. ~ 0.00 Signed by R.ZAOBIA Fuel Surcharge ~ ~ FedEx Use 030402474/0001486/ Total Ctiarge ~ ~USD $3839 Shipper Subtotal USD $80.92 1008-01 -oe-oo 1254y-0002-0052052 Invoice Number 7-752-19041 Invoice Date Jan 09, 2012 Account Number '~ Page 1206-0334-5] s of 5 Fu~lSurcharge FedExhasappliedafuelsurchargeofl4C(~%tothisshipment. gistance Based Pricing,Zone 2 FedExhas audited this shipment for correct packages,weJDht, and service Any changes made are reflected in the invoice amount The package weight exceeds the maximum for the packagiag b/pe, therefore, FedEx Enwlope was rated as FedEx Pak Automation USAO Sender Tracking ID 874181231314 JANICE LFOGLIA Service TyRe FedEx Priority Overnight TOWN OF SOUTHOLD Package TyRe FedEx Pak 53095 ROUTE 25 Zone 02 SOUTHOLD NY 11971-4642 US Packages Rated Weight 1.0 lbs, 0.5 kcs Delivered Dec 17, 2011 10:50 TransporIatJon Charge Svc Area PM Discount Signed by R.SURELE Fuel Surcharge FedEx Use 035003194/0001486/_ Total Charge Recieient RANDY WYROSKY FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND NY 06390 US 21.30 2,13 2.68 USD $2135 Fuel Surcharge - FedEx has applied a fuel surcharge of 14.00% to this shipment. Distance Dased Prlcing, Zone 2 FedExhas audited this shipment for correct packages, weight, and service Any changes made are reflected in the invoice amount. The package weight exceeds the maximum for the packaging type, therefore, FedEx Envelope was rated as FedEx Pak. Automation USAB Sender Tracking ID 875366961053 DIANA WHITECAVAGE Service Type FedEx Standard Overnight TOWN OF SOUTHOLD Package Type FedEx Pak 53695 ROUTE 25 Zone 02 SOUTHOLD NY 11971-4642 US Packages 1 Rated Weigl~t 1.0 lbs, 05 kgs Delivered Dec 22, 2011 12:11 Transportation Charge Svc Area A4 Discount Signed by R.LEFERVER Fuel Surcharge FedEx Use 035503297/0001283/_ Total Charge Recioient RANDY WYROFSKY FISHERS ISLAND FERRY DISTRICT 5 WATER FRONT PARK NEW LONDON CT 06320 US 17.75 2.24 USD $18.21 Fuei Surcharge - FedEx has applied a fuel surcharge of 1400% to this shipment Dista~ce Based Pricing, Zone 2 FedEx has audited this shipment for correct packages, weight, and service. Any changes made are reflected in the invoice amount The package weight exceeds the maxirnum for the packaging type,therefore, FedEx Envelope was rated as FedEx Pak Automation USAB Tracking ID 874181231325 Service TyRe FedEx Priority Overnight Package Type FedEx Pak Zone 02 Packages 1 Rated Weight 1.0 lbs, 0.5 kcs Delivered Dec 30, 2Oll 09:50 Svc Area PM Signed by R.SALGER FedEx Use 036301660/0001486/ JANICE L FOGLIA TOWN OF SOUTHOLD 53095 ROUTE 25 SOUTHOLD NY 11971-4642 US Recieie~l RANDY WYROFKSY FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND NY 06390 US Transpor[ation Charge 21.30 Discount -2.13 Fuel Surcharge 268 Total Charge USD $21.85 Recipient Subtotal [lSD $61.91 Total FedEx Express USD $142.83 Invoice Number 7-752-19041 FedEx Express Shipment Detail By Payor Type (Original) Invoice Date Jan 09~ 2012 Account Number '~ 1206-0334-5 4, Fuel Surcharge - FedEx has applied a f~Jel surcharge of 14.~% to fhis shipment. Distance Based Pricing, Zone 2 FedEx has audited ~i$ shipment for correct packages, weight, and service. Any chang Thepackagewaightexceedsthemaximumfor~epackagingtype, therefore, FedExEnvelo Automation USAB Sender Tracking ID 875071430051 N SCHMIO Service Type FedEx Priority Overnight FISHERS ISLAND FERRY TERMINAL Package Type FedEx Pak FERRY TERMINAL Zone 02 NEW LONOON CT 06320 US Packages 1 Dated Weight 2.0 lbs, 0.9 kgs Transportation Charge Delivered Dec 14, 2011 10:45 Discount Svc Area AM Fuel Surcharge Signed by C.FOSTER FedEx Use 034703199/0001486/_ Total Charge · Fuel Surcharge - FedEx has applied e flJel surcharge of 14,00% to tflis shipment. · Distance Based Pricing, Zone 2 Automation USAB Sender Tracking ID 875071430062 N SCHIMID Service Type FedEx Priority Overnight FISHERS ISLAND FERRY TERMINAL Package Type FedEx Envelope FERRY TERMINAL Zone 02 NEW LONDON CT 06320 US Packages 1 Rated Weight N/A Transportation Charge Delivered Dec 20, 2011 09:53 Courier Pickup Charge Svc Area A1 Discount Signed by MMACK Fuel Surcharge FedEx Use 035304079~)0(X)186/_ Residential Delivery Total Charge Recinient MS LUCINAA J HERRICK 1158 FIFTH AVE NEW YORK CITY NY 10029 US 21.75 2.74 17.85 0.00 -2.86 2.48 2.75 USD $20.22 Automation USAD Sender Recipient ~ '~ Tracking 10 875818176744 FISHERSIS~ND FERRYTERMINAL ~ HZM'~B~ ~ Sewice Type Fed~ Priori~ ~ernight FERRY TERMINAL / 575 B~D HOLLOW RD ~ Package TyRe Cus~mer Packaging N~ LONDON CT ~320 US / M~ILLE NY 11747 US ] Zone 02 ~ / Deliwred Jan 03, 2012 ~:59 Discount ~ / -2.67 Svc Area ~ Courier Pickup Charge ~ ~ 0.~ Signed by R.ZABBtA Fuel Surcharge ~ ~ 3.36 Shipper Subtotal USD $80.92 FISHERS ISLAND FERRY DISTRICT VENDOR 011564 THOMAS KRAFT 01/31/2012 CHECK 300 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.300 SM .5710.4.000.300 SM .5710.4.000.300 SM .5710.4.000.300 46418 46418 46418 46418 MU-5210~ $3.193400 16,637.61 CT EXCISE TA~X-$.04620/GA 2,407.02 S-F COST RECOVERY .0019 9.90 LUST TAX-$.0010/GAL 5.21 TOTAL 19,059.74 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor No. 11564 Thomas Kraft dba I~ime Oil Company Vendor Telephone Number Vendor Contact Invoice Date Number 46418 1/13/2012 P.O. Box 11125 Waterbury, CT 06703 Invoice Net Purchase Order Total Discount mount Claimed Number 16,637.61 16,637.61 2,407.02 , 2,407.02 9.90i 9.90 5.21 i 5.21 19,059.74 19,059.74i Payee Certification Thc undersigned (Claimant) (Acting on bebalf of thc above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Signature Title Company Name Date Check No. Entered by Audit Date Description of Goods or Services MU - 5210 ~ $3.193400 CT Excise Tax - $.04620/[I; I-F Cost Recovery .0019 LUST Tax - $.00101~1al _JAN 3 1 2012 Department 'ertification I hereby certify that the materials above ! ~ecified have been received by me in good condition without substitution, the services properly performed and tohrat st hcer eqpU~nr ct: t e: Sn ~ t her i ,]~ ~ ;Va; m eb a ennt ~ser~ pP~rdo v'~h the exceptions General Ledger Fund and Account Number 8M5710.4.000.300 o~)~ ~^~ 01/12/12 ~ate 8t;eet 442 0165 ~ '~ ~ndon, ~ 06320- 0 I95 e~3 strait follow sl~s L State ovr ~ ~ Trac~ to Te~ ~de~ed 5200gal o~ 1/13 ~ 9~ I1 SADDLE BOAD -- - ~ WOLCO~ ~T ~"71"" ~F _ _~ ~ ~ CHAn~e DIME OIL COMPANY PlO. BOX 11125 WATERBURY, CT 06703 Phone; (203)754-5334 Date; 01/13/2012 Re-" Fishers Island Ferry District PO Box H Attn Accounts Payable Fishers Island, NY 06390- Fishers Island Ferry Dist 5 Waterfront Park-Race Point, New London ACCOUNT NUMBEE: AMOUNT ENCLOSED: ~,~.20165 Pa,~ : 1 Terms: NET 30 Days From Invoice Date Date Invoice Charges and Credits Amount 01/13/12 ~6~18 01/13/12 I~20165-A Fishers Island Ferry 51aterfront rk-Nunnatawket ~2OR Off Road Diesel 5210.0 GALS @ 3.193~00 Dyed Diese] Fuel for Off Road Use ONLY, S-F Cost Recovery @ 0.0019 State Excise Tax DSL @ 0.b620 LUST TAX @ 0.0010 b6618 Fuel Invoice Total Amount Due 16637,61 9.90 2&07,02 5.21 19059,7~ 19059.7b *** Please include account number' with paymemt *Fed ID# 060967353 DIME C~IL 'COMPANY (203) 75b-5334 Account; 4420165 FISHERS ISLAND FERRY DISTRICT VENDOR 012011 LIBERTY MUTUAL INSURANCE GROUP 01/31/2012 CHECK 301 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .1910.4.000.300 1364305-122711 CT WC 1/16/12-1/16/13 17,924.00 TOTkL 17,924.00 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address Liberty Mutual Insurance Group Vendor Telephone Number VendorContact P.O. Box 7247-0329 Vendor No. Philadelphia, PA 19170-0329 Check No. Audit Date JAN 3 1 2012 Invoice Invoice Net Number Total Discount Amount Claimed 17,924.00 17,924.00 17,924.00 17,924.00 Payee Certification The undersigned (Claimant) (Acting on behalf of thc above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Signature Title Company Name Date Purchase Order Number Description of Goods or Services CT WC Pollc)' Renewal Premium Quote # 493488-01 General Ledger Fund and Account Number SM1910.4.000.300 Department Certification I bercby certify that the materials above specified have been received by me in good condition without substitution, thc setwices properly performed and that the quantities thereof have been vcdfiod with the exceptions o ~ir~di crepan¢i~s no~, and payment is approved Signature //i~ 1.. litle ~ //~-/ Date / Liberty Mutu51. LM INSURANCE CORPORATION P.O. Box 8090 Wausau Wl 54402-8090 Telephone: (800) 653-7893 Fax: (715) 843-2649 Email: IMS@LibertyMutual.com December 27, 2011 FISHERS ISLAND FERRY DISTRICT BOX H FISHERS ISLAND NY 06390 RE: Reminder Notice Workers Compensation Renewal Quote Quote Number: 493488-01 Dear Insured: WE HAVE NOT RECEIVED YOUR PAYMENT We value your business and would like to continue your coverage. That's why we are writing to inform you that your current workers compensation policy is about to expire. We are required by law to notify the applicable bureau in your state that your coverage will terminate on January 16, 2012. Your policy WC5-31S-364305-011 is set to expire on January 16, 2012 at 12:01 a.m. If continued coverage is needed, a quote was mailed to you on November 9, 2011. You can renew your policy now by sending a deposit of $17,924 along with the bottom portion of this letter in the enclosed envelope. A renewal policy will not be issued and all coverage will cease on the expiration date noted above if the deposit premium is not postmarked or eleclxonically submitted to Liberty Mutual at the address below before January 16, 2012. If you send your premium postmarked (not metered) within 60 days following the proposed renewal policy effective date, this will result in a policy issued with a lapse of coverage. If you send your premium postmarked (not metered) 61, or more days from the proposed renewal policy effective date it will be returned and will require reapplication to the Plan. To Allow For Timely Processing of Your Payment, Carefully Detach and Return Original with Payment in the Enclosed Envelope If your premium is financed, please send a signed copy of the finance agreement and power of attorney to us by , email at IMS@LibertyMutual.com or by fax at (715) 843-2649. If you need to overnight your payment, please use the overnight address below. Please include your policy number and corresponding LOCKBOX# on your check. Overnight Mailing Address: For the states of - AK, AL, AZ, CA, CO, ID, HI, IL, IN, IA, KS, LA, MI, MN, MO, NE, NV, NM, ND, OH, OK, OR, SD, TN, TX, UT, WA, WI, send to: Liberty Mutual Group/LOCKBOX g0992 c/o Citibank Lockbox Operations 8430 W. Bryn Mawr Avenue, 3rd Floor Chicago, IL 60631 Telephone: (312) 236-3187 For the states of - AR, CT, DE, DC, FL, GA, KY, ME, MD, MA, MS, MT, NH, NJ, NY, NC, PA, RI, SC, VT, VA, WV, WY, send to: Liberty Mutual Group/LOCKBOX g0329 c/o Citibank Lockbox Operations 1615 Brett Road New Castle, DE 19720-2425 Telephone: (302) 325-6043 Questions? We're here to help. Please call (800) 653-7893 or email us at IMS@IZtbertyMutual.com. Thank you for your business. We hope to continue to provide you coverage in the years to come. Sincerely, Valerie Hankes Manager, Commercial Service Operations cc: GF_aNCORP INSURANCE BROKERAGE OF MASSACHUSETTS INC FISHERS ISLAND FERRY DISTRICT VENDOR 013554 MONTVILLE HARDWARE & SUPPLY 01/31/2012 CHECK 302 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 J006364-REIS MISC HARDWARE 32.29 TOTAL 32,29 Town of Southold, New York - Payment Voucher Montvllle Hardware_ ~$~,ppl¥ Vendor Telephone Number V~ndor Contact :~.O. Box 507 Incasvllle, CT 06382 Vendor No. 13554 Invoice Invoice Net Number Da~e Total Discount Number J006364 32.29 32.29 ,n of Goods or Scr~ces C Hardware 32.29 32.29 Payee Certification $,gnatur~'-~'~' Titlc v. Department Certification I hereby certify that the materials above specified have been received by me (~%~or discrel~mm(_~noted, and payment is appr°vcd' MONTVILLE HARDWARE AND SUPPLY, INc. 907A ROUTE 32 * P. Oi BOX 507 · UNCASViLLE, CT 06382 PHONE (860) 848-3616 FAX (860) 848-0858 lustomer's rder No. ddress Phone; CHARGE Received J906364 ", PRINTED IN U S A FISHERS ISL~,,VD FERRY DISTRICT VENDOR 019202 SEAPORT COMMUNICATIONS CO, 01/31/2012 CHECK 303 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000,200 20351 USB EXT-RP,RADAR/PLOTTER 122,00 TOTAL 122.00 ~ndor No. Town of Southold, New York - Payment Voucher i 19202 Vendor Tax ID Number or Social Security Number Vendor Address 304 Point .Judith Road ~e;2:~rn;o~2mu~n~n 'F~~ Narrafansett, R, 02882 Vendor Telephone Number Vendor Contact Uheck No. $05 Entered by Audit Date Number 20351 Invoice Date 1/512012 Invoice Net Total ; Discount Amount Claimed $122.001 $122.00 $122.00 $122.00 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no per~ has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Signature Title Company Name Date Purchase Order Number Description of Goods or Services USB Ext-RP RayMark Radar/Plotter Cr~n~ral Ledl~er Fund and Account Number SM87t0.2.000.200 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or 'serepancies o , d payment is approved Title yl a ~/ Date SEAPORT COMMUNICATIONS CO. '304 POINT JUDITH RD NARRAGANSETT, RI 02882 401 783 4778 Invoice # 1/5/2012 20351 Bill To M/V Munnatawket Fishers Island Ferry District Box H Fishers Island NY 06390 Ship To P.O. Number Terms Rep Ship Via F.O.B. Project Due on receipt I/5/2012 Quantity Item Code Description Pdce Each Amount I usb adapter 3Oft usb extension 60.00 60.00T 0.5 SERVICE TECHNICAL SUPPLIED SERVICE 100.00 50.00 moved moose added extension for dvr control 1.25 SERVICE TECHNICAL SUPPLIED SERVICE 0.00 0.00 camera 6 out(reseated lens plug realigned tested no charge warranty 1.25 SERVICE TECHNICAL SUPPLIED SERVICE 0_00 0.00 Race Point removed shipped reinstalled batte~ charger no charge warranty Freight ups Freight battery charger to Charles Industries 12.00 12.00 Sales Tax 0.00% 0.00 Totsl $122.00 Payments/Credits $o.oo - Balance Due $122.oo SEAPORT COMMUNICATIONS CO. 304 POINT JUDITH RD NARRAGANSETT, RI 02882 401 783 4778 Invoice # 1/5/2012 20351 Bill To M/V Munnatawket Fishers lsland Ferry District Box H Fishers Island NY 06390 Ship To P.O. Number Terms Rep Ship Via F.O.B. Project Due on receipt 1/5/2012 Quantity Item Code Description Price Each Amount 1 usb adapter 30ff usb extension 60.00 60.00T 0.5 SERV1CE TECHNICAL SUPPLIED SERVICE 100.00 50.00 moved mouse added extension for dvr control 1.25 SERVICE TECHNICAL SUPPLIED SERVICE 0.00 0.00 camera 6 out(reseated lens plug realigned tested no charge warranty 1.25 SERVICE TECHNICAL SUPPLIED SERVICE 0.00 0.00 Race Point removed shipped reinstalled battery charger no charge warranty Freight ups Freight battery charger to Charles Industries 12.00 12.00 Sales Tax 0.00% 0.00 Total $122.00 Payments/Credits $o.oo Balance Due $i22.o0