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2012
ELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS OF MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hail, 53095 Main Road P.O. Box 1179 Southold, NewYork 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.nor thfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To~ From: Dated: Re: Martin Finnegan, Town Attorney Chief Flatley, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation Linda J. Cooper, Deputy Town Clerk May4,2012 Fireworks Permit sponsored by NF Country Club Transmitted herewith is an application for a Fireworks Permit for July 4, 2012 by North Fork Country Club to celebrate its 100th anniversary. Please advise if you have any objections to a permit being issued. Thank you. cc: Southold Town Board gL~ZABETIt A. N~vtt,LE, MMC TOWN CL~ru~c REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS OF MANAG~ OFFICER FI~E~.I~OM OF INFORMATION OFFICER Town Hall, 53095 Main P~ad P.O. Box 1179 Sot~lold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown-uor thfork.aet OFFICE OF THE TOWN CLI~RJ~ TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY FIREWORKS APPLICATION IS HEREBY MADE, pursuant to the provlsi6ns of Section 405.00 of the Penal Law of the State of New York, for a permit to display fireworks as hereinafter specified: DISPLAY IS TO BE SPONSORED BY North Fork Country Club PRI!NcII'AI, OIqqCEAT 26342 Main Road, Cutchogue, }C/ 11935 DATE&TIMEOF. DISPLAY 7/4[12 @ 9:15 pm approx~ately EXACT LOCATION'@F DISPLAY North Fork CC property (site map attached) SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAINDATE&TIMlg 7/6/12 @ 9:15 pm approximately The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition James Kelly 39 yrs. 3 yrs. plu.q Nomlrh_- l~.wo~llanr (Additional names and information may be submffted on ~n attached sheet Number and type of fireworks is as follows: 1.3G 2-3 inch= 1160, 4 inch=384 plus illuminations Manner and place of storage of fireworks prior to display: Delivery of product and equipment will be day of display. Attached hereto and made a part of hereof is a diagram of the grounds on which the display is to be held. Also attached is a certificate or policy of insurance coverage. NOTICE: Written permission~ with signature of the property Owner~ must be SUbmitted wit~ the FEE: $100 Name of O~anizatio~ . See policy.,for~ additional information By \. ,/C/Acc u zu> ¢3?? Si~Ap~licant Date of Application RESOLUTION 2010-474 ADOPTED DOC ID: 6016 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2010-474 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 29, 2010: RESOLVED that the Town Board of the Town of Southotd hereby adopts the following POLICY regarding the issuance of fireworks permits: The Town may grant a permit for the display of fireworks by municipalities, fair associations, amusement parks, persons or organizations of individuals. Penal Law Section 405.00(2). An "organization of individuals" is a religious, civic, or comparable organization. Op. Atty. Gert No. 2007-3. Fireworks permits shall indicate that the display must be concluded by 10:00 p.m. if held Sunday-Thursday, 11:00 p.m. if held Friday or Saturday, and there shall be no time restriction if held on July 4. No person shall engage in or allow the manufacture, assembly, storage or display of any fireworks or pyrotechnics display without first obtaining a permit issued by the Town Clerk. A completed application for display of fireworks must be received by the Town Clerk a minimum of 30 days prior to the date of display. The permit application for any fireworks or pyrotechnics display shall be accompanied by the following: (a) a copy of a valid certificate of competency asa pyrotechnician for the individual supervising the firing of the display; Certificate of Insurance naming the Town of Southold as additional insured with coverage limits of $2,000,000 for public liability and $2,000,000 for property damage; Detailed diagram showing location of fireworks discharge and minimum separation distances in accordance with the applicable requirements of Penal Law Section 405(2); (d) A copy of the contract with fireworks display company; and All applications shall require the approval of the Fire Chief of the District in which the display will take place and the Fire Marshal before being presented for approval by the Town Board. Resolution 2010-474 Board Meeting of June 29, 2010 5. All applications for a fireworks permit shall be subject to an application fee in an amount of $100.00, together with a processing fee in an amount to be determined by the Town Board to cover the Town's costs for monitoring and enforcing compliance with the Penal Law. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Albert Krupski Jr., Councilman SECONDER:Vincent Orlando, Councilman AYES: Ruland, Orlando, Talbot, Krupski Jr., Russell ABSENT: Louisa P. Evans Updated: 6/30/2010 10:43 AM by Lynda Rudder Page 2 Date: 5/I/12 SPONSOR: North Fork Country Club Fireworks Compag_Y pyro Engineering, Inc. 400 Broadhollow Rd. Suite 3 Farmingdale, NY 11735 Show Date(s): 7/4/12 Rain Date(s): 7/6/12 Location: North Fork Conntry Club, 26342 Main Road, Cutchogue, NY 1. Total number of Class B shells being used is 1544 plus illuminations. Sizes between: 2 inches and 4 inches in diameter. 2. All shells are DOT approved. 3. Display will be fired manually. 4. All displays will comply with all requirementS as set forth in NYS Penal Code 405 and NFPA 1123, 1124. 5. Pyro Engineering, Inc. has complete understanding of all roles and regulations governing public fireworks displays and this display will be in accordance with those roles and regulations. 6. Personnel representing firew°rks display company: Lead: James Kelly (License attached) 7. Technician(s): tba Signed___ Fireworks Company Representative ' E*';' USA , 0038~$38 KELLY JR ;' ,'~' JAMES P~ER lPUSACO38865~85<<lO<304BO~4869 7~01094~200804¢USA<<2404930606 KELLYKJRK<JA~ES(PETER<<<<<<<<< DN~J 3,6063.2556 E~S BLU HG'~ 6~ 0" NYSDOL - L&0 DNIT ROOM 161 BUILDING 12 ~ N~ 12240 CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THiS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES GELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the cedificate holder is an ADD[q-~ONAL INSURED. the policy(les) must be endorsed, ff SUBROGATION IS WAJVED, subject to the terms and conditions of the policy, ced. ain policies may require an endorsement. A statement on this cerUficaf~ does not confer rights to the certificate holde~ in lieu of such endorsement(s). PRODUCER Allied Specialty Insurance, Inc. 10451 Gulf Boulevard Treasure Island, FL 33766-4814 ~ma~ss: 1-860-237-3355 ~su~R^: T.H.E. Insurance Comp~ 12866 ~.su.~o Pyro Engineering, Inc. ~.SUR~RS: dba: Bay Fireworks 400 Broadhollow Road, Suite 3 Farmingdale, NY 11735 mSUR~ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR 3HE POLICY PERIOD iNDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THiS CERTIFICAT£ MAY BE iSSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN [S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDI~ON$ O~= SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. GENERAL ~Bal"F~Y O~A~: ~o .~rr~o I $100,000 I CLAIM~ArJ~Z~ [] OCCUR ~EDEXP(A~yo~epemc~l PERSONAL & ADV tN JURY 0~,L AC-~C~'m s2,000,000 SE.~. ~m.~E u~rr ~:'~UES ~: ~OOUCTS - CO~aP/OP AC~ $ 2,000,000 co~a~ S~N~U~ UO~r ,1,000,000 A ~c~mu~mLrr~ CPP0161284-02 0S/14/2012 05/14F2013 - U~RELLAUA~ ~OCC, U~ ELP0010296-02 05/14/2012 05114/2013 EAC~OCCU~E~CE $9,000,000 A ~' EXC~SSU~SI ~ C~J~ n~:mEC~.'m sg,000,000 A ANyANO ~J~PLOYEJ{S* ~LIT~pRopalErOPJp~m~jEX~CU~W~YIN WC~23842 ~5114/2012 05/1412013 I E L F~CH ~CC~[~m- S ~,000,000 CERTIFICATE HOLDER CANCELLATION North Fork Count~ Club 26342 Main Rd. Cutchogue, NY 11935 P-ERT #1654 Updated ACORD 25 © 1 88-2010 ACORD CORPORATION, All rights rese~ed. The ACORD name and logo are registered marks of ACORD ACORD AGENCY CUSTOMER Ilk B00425 LOC ~. ADDITIONAL REMARKS SCHEDULE Page 1 of 1 /Lllied Specialty Insurance CPE0101284-02 THE Insurance Company 12866 ~DDITIONAL REMARKS l NpyA~ ~o~S~ineering, Inc. 05/14/2012 ---05/14/2013 THiS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: ATTACHED TO D~ND MADE PART OF CERTIFICATE OF INSURANCE ISSUED ON ~{E DATE OF 05/01/2012 ON BEHALF OF: INSURED: PYRO ENGINEERING, INC. DBA: BAY FIREWORKS POLICY NO: CPP0101254-02 & ELP0010296-02 DISPI~%Y LOC: North Fork CoUntry Club, Cutcho~ue, NY DISPLAY ~ATE: 7/4/12 RAIN DATE: 7/6/12 RE: GENERAL LIABILITY, THE FOLLOWING ARE NAMED AS ADDITIONAL INSUR~EDS IN RESPECTS TO THE OPERATION OF THE NAMED INSURED ONLY: North Fork Country Club, their officers, directors, partners, representatives, agents and employees; Town of Southfold; Suffolk County; Chutchogue Fire Department; Cutchogue Fire District. Nold Harmless Agreement and Waiver of E~brogation per contract between the Named Insured and the Additional Insured applies_ This Insurance is Primary and Non-Contributory as respects to any loss or liability arisin~ directly or indirectly from the insured's operation. CO1 ~ 1654 Updated ACORD 101 (2Q08/01} © 2008 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 2fi 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Pemon~) Or O~nization(s): Location(s) Of Cove~d Operations North Fork Country Club, their 26342 Main Rd. officers,directors, partners, Cutchogue, NY 11935 representatives, agents and employees; Town of Southfold; Suffolk County; Cutchogue Fire District; Cutchogue Fire District. For Date: 07/04/12 Rain Date: 07/06/12 But only as respects to the operations of the Named Insured. In~rmafion requirad ~ complete this Schedule, if not shown above, wil~ be shown in the Declarations. A, Section Il - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only wffh respect to liability for "bodily injury", "property damage" or "personal and adve~sing injury" caused, in whole or in part, by: '1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. VV'¢¢, respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily inju~f or "property damage" occurring after:, 1. All work, including materials, parts er equip- ment fumished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage adses has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page '1 of I El U,S. Department of Transportation Eastern Service Center Operations Support Group AJV-E2 1701 Columbia Ave. College Park, GA 30337 February 6, 2012 Ms. Jo-Anne Triolo Pyro Engineering, INC. 400 Bmadhollow Road, Suite 3 Farmingdale, NY 11735 Dear Ms. Triolo: We r~ceived your letter regarding your proposed fireworks display for: North Fork CC 100th Date of the show: 7-4-2012 Rain Date: 7-6-2012 Approximate Start Time: 9:15 pm Duration ofleireworkDiaplay: 20 minutes Height of Fireworks: 500 feet Location of Show: North Fork CC, Cutchogue NY Step~ to be taken by Firework Company: O- Firewonks staffshould remain vigilant to easure that no aircraft are in the area priur to beginning the fireworks display. Our office has no objection to this event provided all the above notifications and precautions are met. This letter disposes of the Federal Aviation Administration's interest in this matter but should not be construed as superseding or invalidating any existing rules or regulations promulgated by any other federal, state, county, or municipal government, which may be required for this display. Please be sure to include on all future display request, longitude and latitudes for display. If you have any questions concerning this event, please contact David Phillips at 404-305-5574, Group Manager, Operations Support Eastern Service Area Air Traffic Organization America's World Class Fireworks Leader Display Date: July 4, 2012 FIREWORKS DISPLAY AGREEMENT AGREEMENT made April 20, 2011 by and between Pyro Engineering, Inc,, whose address is 400 Broadhollow Road, Suite 3, Farmingdale, NY '11735 (hereinafter "PEI"); and North Fork Country Club, 26342 Main Road, Cutchogue, NY 11935 (hereinafter =SPONSOR"). WHEREAS, PEI designs, produces, and conducts fireworks displays; and WHEREAS, SPONSOR wishes to engage PEI to design, produce and peri*otto a fireworks display on the terms and conditions hereinafter set forth; NOW, THEREFORE, in consideration of the terms, conditions and covenants hereinafter set forth, the parties hereto do m~ually agree as follows: f. FIREWORKS DISPLA Y: On, July 4, 20t 2 (hereinafter ~the Display Date'), PEI shall provide the fireworks and equipment for the display at the Fireworks Display location. 'Cna display will be under the supervision of a PEI trained technician. It is agreed that PEI shall be the sole fireworks supplier and producer for the event contracted for herein. (Note: The actual start and stop time of the display will be determined by the governmental abthorifies having jurisdiction over the display). AL TERNA TE DA TE: 2. COSTAND PAYMENTS: FIREWORKS DISPLAY PRICE: I $ 15,000.00 I The total (Fireworks Display Pdce plus all other applicable charges) sum of $15,000.00 shall be due and payable as follows: a. The sum of: $ 7,500.00 upon execution and der~very of this contract. b. The Balance of: $ 7,500.00 (which includes any taxes that may be applied to this sale) shall be paid by Official Bank Check made payable to Pyro Engineering, Inc. not later than f~esn (15) days prior to the Display Data. Please Note: SPONSOR is responsible for the payment of all governmental fees and taxes, including, but not limited to, sales, use, ex. sa, license, permit, entedainment, or other fees, tsxes or surcharges imposed or othenvisa applied to this exhibition. Atsu, please see SecUon 16(c) below. 3. POSTPONEMENT/RESCHEDULING: If the display of the fireworks is postponed/rescheduled by reason of inclement weather or by determination by the governmental author~.y having jurisdiction, or for any other meson beyond the control of PEI, same shall be re- scheduled [o the Alternate Date sat forth above_ In the event e postponement/rescheduling is necessary due to inclement weather or by determination by the governmental authority having jurisdiction, or for any other reason beyond the control of PEI a postponement/mscheduling fee will be based on the table below. IDesodption Jf notitied by 12:01 AM on 07/~31t2 If notitied after 12:01 AM on 07104/12 Once Bay Fireworks Techs An'ive on Site % of Fireworks Display Palco Addl§onal Costs 5% Any 3~" Party Vendor Expenses 15% Any 3m Pady Vendor Expenses 20% Any 3r= Party Vendor Expenses Any request made by SPONSOR for rescheduling/can coling shall be directed to help~beyflrewerks.com or by phone (516) 233- 4132. it is understood and agreed that PEI shall have no obligation to ne-schedule a display except as required by inclement weather or reasons beyond the control of PEI. 4. SPONSOR'S AGENT: Mr. John Collins CELL PHONE: shall be design~ed as SPONSOR'S agent to whom all questions and inquiries shall be relayed. Sponsor's agent shall be the only agent of SPONSOR authorized to make decisions on behalf of SPONSOR or to request rescheduling of the fireworks display on the part of SPONSOR~ Initial here: PE~ 5. EXHIBITION PLANNER CHECKLIST: It is understood and agreed by the parties hereto that the Fireworks Display shall be contingent upon the strict compliance by SPONSOR with all items specified on the Exhibition Planner Checklist (EPC) which is annexed hereto and made a part hereof. Failure on the part of SPONSOR to comply with all requirements set forth in the EPC to the satisfaction of PEI within the time limits therein set forth shall be deemed to be an event of default of SPONSOR'S obligations hereunder. 6. SECURITY/SAFETY: SPONSOR shall provide and realatain sl.n~rlcient Security before, during and alter the Fireworks Display until the pyrotechnician in charge declares the area clear. Securibj shall be deemed to include, but not limited to, be all security Ithes, police protection, snow fencing, rope lines, barricades or any other item deemed necessary by the local government or by PEL SPONSOR shall also provide and maintain an area clear of any buildings cam and spectators with a minimum radius as specified by NFPA Code 1123, 2000 Edition as a Fire Safety Zone (FSZ) during the entire period commencing from the time the tir~3rks are delivered to the site until the area is declared clear by the pyratecbeician. It is understood and agreed that PEI will cease all fireworks discharge due to any security breach of the FSZ_ PEI shall nat be responsible for personal injury, vehicle or property damage occurring within the FSZ as a result of the SPONSOR's failure to maintain the FSZ in accordance with the standards of NFPA 1123 which, incidentally, are only minimum standards of distances. SPONSOR acknowledges and egress that PEI's respensibilities are limited to the Fireworks Display and that PEI is relying on SPONSOR to maintain the aforementioned FSZ and to comply with all Federal, State, municipal and laceJ laws, orders, regulations and ordinances pertaining to the implamectation of any and all security measures at the site of the Fireworks Display. Any site visits made during the display setup by or on behalf of SPONSOR shall be in accordance with NFPA 1123-1995, and under the direct supervision of the PEI technician in charge. Any such inspection shall not in any way interfere with the safety, setup or schedule of the preparation for and disassembly after the Fireworks Display. The PEI technician in charge may, at his discretion, cancel any thspectfen thai in his sole opinion may compromise the safety of the setup or the Fireworks Display or the setup scheds[e. The PEI technician may at any time temporarily discontinue the discharge of fireworks for any reason. 7, CREDITS: As a material inducement to PEI agreeing to enter into this Agreement, SPONSOR shall give PE! program credit as sole fireworks supplier and predueer in all press releases, advertising, and any other pregrern announcements, printed or otherwise. 8. INABILITY to DELIVER or CONDUCT FIREWORKS DISPLAY/FORCE MAJEURE. PEI shall not incur any liability for any less or for any failure to perform any obligation hereunder due to causes beyond its reasonable control including '~thsut limitation legal or regulatory resthctions, labor disputes of whatever nature, power loss, taiecernmonicatfuns taiJure, acts of God, or any other cause beyond its reasenable central, in the event PEI is unable to deliver the Fireworks Display on the Delivery Date this contract witl remain in full force and effect and the Fireworks Display will be performed on the Alternate Date or if no Alternate Date is stated then on such other date as may be agreed upon by the parties. 9. CONTRACT SUBJECT TO GOVERNMENT REGULA T/ON: This Agreement and PEI's obligations hereunder are subject to all applicable Federal, State, Municipal and local laws, rules, ordinances, regulations and codes, now or hereinafter in effect, and to the conditions and limitations contained in the permits required to be obtained by SPONSOR prior to the Fireworks Display. In the event any Federal, State, municipal or local law, rule, regulation ar ordinance shall be enacted which in anyway prohibits, limits or restricts the sale, performance or operation of the exhibition of the Fireworks Display or in the event SPONSOR'S permit in anyway limits or restricts the sale, performance or operation of said exhibition, PEI shall limit or restrict its performence or the Fireworks Display so as to comply with such law, rule, regulation or ordinance or lirnitatfen or resthction of SPONSOR'S permit. SPONSOR acknowledges that any such limit or restl~ction placed on the performance or operation of the Fireworks Display shall in no way result in or entitle SPONSOR to a reduction or abatement in the full contract price. 10, GENERAL PROVISIONS: a) This agreement constitutes the entire agreement between the parties relating to the subject matter hereof, and may not be changed, rnedifled, renewed or extended except by a written agreement, signed by both parties. SPONSOR acknowledges and agrees that PEI has not made any representations or warranties except these speddically set forth in this contract. Should any ctanse, section, or part of this agreement be held or declared to be void or illegal for any reason, all other clauses, sections, or parts of thla agreement which can be effected without such illegal clause, section, or part shall nevertheless cer~nue in full force and effect. b) SPONSOR is responsible fur removal of paper dabds associated with the Fireworks Display. c) PEI is not responsible for procuring any marine services associated with the production of SPONSOR'S event. Should SPONSOR require these services, PEI may, upon w~iffen request, assist SPONSOR in the location and contracting of such services. All additierlal costs and fees associated with marine services are the responsibility oftbe SPONSOR. It is specifically understood and agreed that PEI shall not be responsible in any way if any third party service w~h which SPONSOR has contracted for service tails to perform and the display cannot proceed as planned. d) SP~Ns~R is resp~nsibla fer any addi~onal merine costs and fees~ clty permit~escort fees~ c~unty /State~PD~FD~FM fees~ local towa permit fees, etc. e) In the event SPONSOR cancels the Fireworks Display the fell contract price as set forth herein shall become immediately due and paysble. SPONSOR w~ll have up to 30 days from the date of cancellation to request PEI to reschedule the Fireworks Display. Fireworks Display shall take place no later than six months from originally scheduled Fireworks Display f) PEI agrees to procure liability insurance on behalf of SPONSOR, and to indemnify SPONSOR, to the extent thereof, for all claims arising out of PEI's negligence. Any additional insurance that is required that incurs a cost, will be the SPONSOR'S respansibit[ty. Inr~al hem: Sponsor PEI t 1. SPONSOR'S DEFAULT; in the event SPONSOR shall fail to pay any sum when due under the terms of this contract, SPONSOR shall pay, in addition to such amount, interest at the rate of 1.5% per month on the unpaid amount from the original due date. SPONSOR does farther agree that it shalt pay PEI reaeanable attorney fees and other costs in the event PEI shall commence any proceeding (Arbitration or any other proceeding) or incur fees to compel SPONSOR to pay any sums due hereunder or otherwise as a result of SPONSOR'S default of any of the terms and previsions heroin contained. 12, UQUIDATED DAMAGF_~. it is agreed by and batweea the par~es hereto that in the event of SPONSOR'S defau:t hereunder PEI shall be entitled to receive the entire contract pdue and same shall be considered "liquidated damages" based upon an understanding between the pa~es hereto that PEI will have satfared damages due to Sponsors default. The damages suffered by PEI es a msuE of Sponsor's default wilt be substan'dal, but incapable of duterminalfan with mathamatlcal pmcisien. It is, therefore, agreed by the parties that the amount due PEI is not a ponal~, but rather a matua~y beeeltciaJ and reasonable estimate of the damages suffered by PEI. 13. SUBSTITUTIONS: PEI shall have the right, at its discretion, to substitute any fireworks it deems neceasap/provided same does not deb'aM from the aesthetic value or quality of the program. This includes, but is nat limited to, shell sizes, quantifies, types and brand names. Any substitutions shall in no way resuE in or entitle SPONSOR to a reduction or abatement of the fall contract price. 14. ARBITRATION; Any and all disputes, differences, or any other type of controversy arising out of or in relation to this Agreement, including as to the meaning or interpretation of any provision hereof, shall be resolved by arbitration in Nassau County, New York, pursuant to the comreercial rules then obtaining of the American Arbitration Association. Only ~ne (1) arbitrator shall be required, and the arbitrator may award attorneys' fees. The award of the arbitrator shall be final and binding and judgment may be entered thereon in any court of competent judsdictioe. The arbitrator sitting in such controversy shall have no power to alter or modify any express provision of this Agreement, nor to make any award which by its terms effects any such alteration or mod[ticatian. Either party may seek from the court of competent jurisdiction any previstouel remedy in aid of arbitration, including, but not limited to, injunction, attashment or repfavin, pending the determination of any claim or controversy in arbitration. Any and all disputes, contreversies, actions, claims, causes of action, or proceedings arising under, out of, or in connection with or relalt ng to the terms of this contract, and any amendment thereof, commenced by, between or against any of the pariies of this contract shall be deemed to have arisen from a transaction of business in New York, and shall be resolved by application of the substantive laws of the State of New York. 15. BINDING EFFECT: This conbact shall not be binding on PE] until executed by SPONSOR and PEI and PEI is in receipt of the dowspayment required hereunder. 16. EXHIBITION PLANNER CHECKLIST (EPC): a. FIREWORKS DISPLAY PERMIT: (Note: The actual start and stop time of the display will be determined by the goverereental authorities having jurisdiction over the display). SPONSOR'S RESPONSIBILITY: It is Sponsor's responsibility to call your State, City, County, Town, Borough, or Village Firs Mamhal or other apprepriate authority to file for and obtain the Fireworks Display permit. Upon receipt of your perm~ you must send the permit to our office for our records no later than 30 days prior to your display date. Failure to do so could seriously ieopardize your display. You must obtain information on: 1. Filing appliesrt'loe deadline and fees. 2, Local and state requirements for fireworks license for transportation and/or display. If a t/cease is required, fax all farms immediately to us. 3. Fire Marshal's requirements for secodty of fireworks truck upon arrival, and the security of the fire zone before and dudng the display. Federal regalaltons require that we carry an accurate route plan to the display site. Fax us a copy of the route instmotions from the nearest US Interstate to the display area (approved by the fire marshal or other authority, if necessary). Notify FAA on day of your display, according to the instractiens in the FAA Letter of Approval, which will be forwarded to you prior to your display. Please i~i~aleacti p~je. IrfitiaJ h~e: Sponsor PE~ b. COAST GUARD PERMITS (where required): 1. if the fireworks are to be displayed on or near the water, the following may be required: (Requests for permits must be filed at least 60 days prior to the Display Date (135 days prior for 4th of July events). 2. Coast Guard Application and Permit to Handle Hazardous Materials, 3. Coast Guard Marine Event Permit. c. SPONSOR RESPONSIBILITIES AND EXPENSES (The foltowinq services need to be provided and paid for by the SPONSOR in addition to the Fireworks Display Price. 1) SECURITY: MUST BE PROVIDED FOR FIREWORKS EQUIPMENT AND TO MAINTAIN THE FIRE SAFETY ZONE AT STAGING AREA FROM FIREWORKS TRUCK(S) ARRIVAL, UNTIL COMPLETION AND CLEAN-UP OF DISPLAY AREA AND TRUCK DEPARTURE, 2) Sand: Please provide 0 yards of sand. 3) Laborer(s): ~ laborers to arrive at fireworks site on (They will not handle fireworks). 4) Hotel Room(s): .__0 hotel rooms. 5) Vehicle(s): Four-wheel drive vehicle for movement on sand: Yes No XX__ If you have ordered a set piece(s), you are responsible for erecting the scaffolding and it must be ready when the crew an'ives d, RADIO SIMULCAST EXPENSES (if applicable): 1 ) Set up and staff a fireworks simalcast command center on site by 1:00 PM on the display date. 2)Provide broadcast relay to PEI Firing Center. Call our office for details. 3) Speaker system for VIP viewing stands. e. INSURANCE: Please list belowthe additional insured, as they should appear on the insurenca certificate: By: Signed by on behalf of Sponsor (Signature) Print Name Title of authorized representative of Sponsor Title State of County of_ On the__ day of , in the year before me, the undemigned, a Nolary Public in and for said State, personally appeared , personally known to me or proved to me on the basis of ~tovy evidence to be the individual(s) whose name(s) (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capaclt3~'es), and that by histher/their signature(s) on the h~amment, the individual(s), or the person upon behalf of which the individual(s) acted, executed the insi~mment. Signature and Office of individual t~ing acknowledgment [seal] Please in[~J sa~ page, In,rial here: Six.or FEI PYRO ENGINEERING, INC. DISPLAY SITE PLAN QUESTIONNAIRE All items Ibtad below am subject to all governing Federal. State, Municipal and bcal laws, rules, o~inances, regulations and codes, now or hereinafter in effect, and to the coed[tions and limitations contained in the permits required or to be obtained by Sponsor. SPONSOR: North Fork Country Club Display Date Display Location: Rain Date: Budget: Time of Display:. (Note: The actual start and stop time of the display will be determined by the governmental authorities having jurfsdiction over the display). IMPORTANT: PLEASE PROVIDE A SITE PLAN FOR YOUR EVENT LOCATION, INDICATING WITH AN X THE EXACT SPOT WHERE FIREWORKS ARE TO BE SET-UP, Local Fire Marshal: Telephone No: Pager NO: Crew Contact Person: Telephone No: Pager No: The Following information is necessary in order for us to provide your communfly or organization with a display that conforms with fireworks safet~ re~lulations and for the issuance of your insurance certificate. DISTANCES, IN PEET, FROM THE FIRING AREA TO THE FOLLOWING: FEET SPECTATORS, AUDIENCE OR PARKED CARS ................................................... OCCUPIED BUILDINGS (HOMES, APARTMENTS, ETC.) ..................................... PUBLIC BUILDINGS (SCHOOLS, HOSPITALS, CHURCHES, ETC.) ...................... TEMPORARY EVENT SET-UPS (CONCESSIONS, TENTS, ETC.) ........................... MAIN PARKING AREAS .................................................................................. HIGHWAYS OR ROADS .................................................................................. OVERHEAD OBJECTS (POWER LINES, LIGHT POLES, TREES, ETC ..................... FUEL STORAGE ............................................................................................. PLEASE PROVIDE DIRECTIONS FROM NEAREST INTERSTATE TO DISPLAY SITE. A MAP WOULD ALSO BE HELPFUl- Local Motels/Hotels: Telephone Nos. Signature Date Title: Please i~t~l e~cfl p~ge. Sponsor Pyro Engineering, Inc. Invoice No. 7005 400 Broadhollow Road; Suite 3 Farmingdale, NY 11735 631-390-8620 - phone---631-390-8621 fax Name __N_orth F0~_(~_nt_ry_c..l~b __ Address 26342 Main Road City Cutchogue State NY ZIP 11935 Attn: Mr. John Coltins Date 411812011 . Job. No. 12-0002 FOB Description Fireworks Display on July 4, 2012 Down Payment Due Upon Receipt of This invoice Balance Due 15 Days Prior to This Display Federal Tax ID No.: 7S-3044987 Unit Price TOTAL $15,000.00 $7,5OO.OO $7,500.00 $7,500.00, Payment Comments Tax Rate(s) SubTotal $7,500.00i TOTAL DUE? - $7,$00.001 Final Payment Must be Received Fifteen Business Days Prior to Show Date Page 1 of 1 0 0 0 0 0 https://uwc.webmail.optimum.net/attacbdNorth ¼20Fork ¼20CC ~20280 ¼20ft ¼20REVIS... 4/18/2012 ELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS OF MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, NewYork 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD PERMIT for PUBLIC DISPLAY OF FIREWORKS 1, ELIZABETH A. NEVILLE, Town Clerk of the Town of Southold, Suffolk County, New York, being an officer duly designated by the Town Board of the Town of Southold for this purpose, do hereby GRANT TO: NORTH FORK COUNTRY CLUB PERMIT FOR THE PUBLIC DISPLAY OF FIREWORKS by said organization in accordance with the provisions of Section 405.00 of the Penal Law of the State of New York on WEDNESDAY~ JULY 4~ 2012 AT 9:15 P.M.~ on the property of The North Fork Country Club, 26342 Main Road, Cutchogue, New York ON CONDITION THAT the bond (indemnity insurance) required shall continue in full force and effect in favor of the Town of Southdld, and PROVIDED that the actual point at which the fireworks are to be fired shall be at least two hundred feet from the nearest building, public highway or railroad, or other means of travel, and at least fifty feet from the nearest above ground telephone or telegraph line, trees or other overhead obstruction; that the audience at such display shall be restrained behind lines at least one hundred and fif~' feet from the point at which the fireworks are discharged and only persons in active charge of the display shall be allowed inside these lines; that all fireworks that fire a projectile shall be so set up that the projectile will go in the air as nearby as possible in a vertical direction unless such fireworks are to be fired from the shore or a lake or other large body of water, then they may be directed in such manner that the falling residue from the deflagration will fall into such lake or body of water; that any fireworks that remain unfired after the display is conducted shall be immediately disposed of in a way safe for the particular type of fireworks remaining; that no fireworks display shall beheld during any wind storm in which the wind reaches a velocity of more than thirty miles per hour; that all persons in actual charge of firing the fireworks shall be over the age of eighteen years, competent and physically fit for the tusk, that there shall be at least two such operators constantly on duty during the discharge and that at last two soda acid or other approved type fire extinguishers of at least two and one-half gallons capacity each shall be kept at such widely separated points as possible within the actual area of the display. Elizabeth A. Neville, Town Clerk (Town Seal) Town of Southold Dated: June 5, 2012 Suffolk County, New York THIS PERMIT IS NOT TRANSFERABLE RESOLUTION 2012-466 ADOPTED DOC ID: 7899 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2012-466 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 5, 2012: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a fireworks permit by the Town Clerk to the North Fork Country Club, for a fireworks display on July 4, 2012, on the Country Club's property at 26342 Main Road, Cutchogue, New York, to celebrate its 100th Anniversary, upon the payment of a single fee of $100 and subject to the applicant's compliance with the requirements of the Town's policy regarding the issuance of fireworks permits and subject to the approval of the Town Attorney. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Louisa P. Evans, Justice SECONDER: Jill Doherty, Councilwoman AYES: Ruland, Talbot, Doherty, Krupski Jr., Evans, Russell ELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS OF MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.nor thfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To~ From: Dated: Re: Martin Finnegan, Town Attorney Chief Flatley, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation Linda J. Cooper, Deputy Town Clerk May 4, 2012 Fireworks Permit sponsored by NF Country Club Transmitted herewith is an application for a Fireworks Permit for July 4, 2012 by North Fork Country Club to celebrate its 100th anniversary. Please advise if you have any objections to a permit being issued. Thank you. cc: Southold Town Board RF~IffFRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORI~ OF MANAGEMENT OFFICER FF~r~OM OF ~'FORMATION OFFICER Tawn Ha~, ~95 Mah~ P~ad P.O. Bc~ 1179 So~ N~York 11971 F~ (6~1) ~ep~ne (~1) 7~1~0 ~d~ ~ork.net OFFICE OF THE. TOWN CI.ERK TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY IqREWORKS APPLICATION IS HEREBY MADE, pursuant to bhe pro~d~6ns of Section 405.00 of fl~e Pen~ Law of Stat~ of New York, for a permit to display fireworks as hereinat~r specified: DISPLAY IS TO BE SPONSORED BY North Fork Country Club PIUI~C[PAL OFFICE AT 26342 Main Road, Cutchogue, ~P/ 11935 DATE & Tll~IE OF DISPLAY 7/4/12 @ 9:15 pm approxL, nately EXACT LOCATION'OF DISPLAY North Fork CC property (site map attached) SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAINDATE&TIM~ 7/6/12 @ 9:15 pm approximately Thc following per~ons are to be in charge of the set. hi shooting of the fireworks: Name Age Experience Physieal Condition James Kelly ~q yrs. ] yrs. ?]u~ 14pnlrh~ (Additional names and information may b~ submitted on an attached sheet Number and lype of fireworks is as follows: 1.3G 2-3 inch- 1160, 4 inch=384 plus illuminations Manner and phce of storage of fireworks p~or ~ dbpiay: Delivery of product and equipment will be day of display. Attached hereto and made a part of hereof is a diagram of the grounds on which the display is to be held. Also attached is a certificate or policy of insurance coverage. NOTICE: Written pemission, with sigs~re of the Preoertv Owner. must be subm~ ~t~ ~e FEE: $100 N~ of~fio~ S~ ~licy~fof additional info~ation ~. /- . ~ / /f~ - _ Date of Applimfion Date: 5/1/12 SPONSOR: North Fork Couutry Club Fireworks Company Pyro Engineering, Inc. 400 Broadhollow Rd. Suite 3 Farmingdale, NY 11735 Show Date(s): 7/4/12 Rain Date(s): 7/6/12 Location: North Fork Country Club, 26342 Main Road, Cutchogue, NY I. Total number of Class B shells being used is 1544 plus illuminations. Sizes between: 2 inches and 4 inches in diameter. 2. All shells are DOT approved. 3. Display will be fired manually. 4. All displays will comply with all requirements as set forth in NYS Penal Code 405 and NFPA 1123, 1124. 5. Pyro Engineering, Inc. has complete understanding of all roles and regulations governing public fireworks displays and this display will be in accordance with those rules and regulations. 6. Personnel representing fireworks display company: Lead: James Kelly (License attached) 7. Technician(s): tba CERTIFICATE OF LIABILITY INSURANCE [05/01/2012 certificate hok~w in lieu of such encinrsemm~s). PROO¢JCER Allied Specialty Insurance, Inc. 10451 Gulf Boulevard Treasure Island, FL 33706-48t4 1-800-237-3355 Pyro Engineering, Inc. dba: Bay Fireworks 400 Bmadhollow Road, Suite 3 Farmingdale, NY 11735 ~ ^: T.H.E. Insurance Com pa_~y_ COVERAGES CER~FICATE NUMBER: REVISION NUMBER: t2888 THIS IS TO CERTiFY THAT THE POLICIES OF INSURANCE LISTED aELOW HAVE BEEN ISSUED TO THE INSURED NAMED ~ FOR 'IHE POLICY PERIOD INDICATEO. NOT1MTHSTAND~NG ANY REQUIREMENT, TERM OR CONDITION OF ANY CON1PP. ACT OR OTHER DOCUMENT ~*q'H RESPECT TO V~IICH THIS A ~E~.~u~a~r~ i CPP0101284-02 105/142012;105/14/2013 EACHOCC~RRENCE ~ COMUERCJAL I:~ENE;,~L UA~UTY ! I PR£mSES ~R~soH~u._ ~.~ ,1,000,000 -- ~' I I ~HE~,A~ AO~,;~C~*~ s 2,000,000 _ c~ ~- ~-~-c~ u~ ~P~U~s ~n: i t p~oeuc?s - ce~A~ s 2,000,000 A __~r°a~unmu~ CPP0101284-02 5/14/2012 05/14r2013 - [ I~c~'s-u'~D~ ELP0010296-02 ~5/14~2012 05/14~2013 EAC~CCCUI~ENCE ~c~: s9,000~000 A ~OF~U~ v/, WC123842 )5rl4~2012 0S/14r~013 X ~p~o. o~ o~o.s ~0~. E L ~SE ~E-mU~U~ S 1,000,000 DISPLAY DATE: 714/12 RAIN DATE: ?~6/12 LOCATION: Nor~ Fol~ Country Club, Cutchogue, NY. ;~E: GENERAL LIABILITY, ThE FOLLOWING ARE NAMED AS ADDITIONAL II~UREO IN RESPECTS TO ]TIE OPERATION OF 1TIE NAMED INSUI~.D ONLY: SEE ATTACHED ACORD 101. Tit e above Co~tt~r clal General Llatsfity pcdlcy affords bodily injury & p~o~er ty damage BmbiS(y COVerage ir~ing dire~fy fTom a fir~*~l~ d~piny, howe~, no Marlite, Hull & Mm~hinm~j, P&I o~ Polkdion Liability coverage is afforded under this CGL poUc~ arising from Ihs use of any ba~e, docks, pin~, wharves o~ floaUng platforms. :ERT1FICATE HOLDER CANCELLATION North Fork Coun~ Club 26342 Main Rd. Cutchogue, NY 11935 CERT #1654 Updated ACORD 25 (2010/05) 0 1988-2010 ACORD CORPORATION. Alt rights re~erved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:. B00425 LOC #: ADDITIONAL REMARKS SCHEDULE Allied Specialty Insurance CPP0101284-02 THE Insurance Company Pyro Engineering, Inc. dba: Bay Fireworks ER~C/IVEOATE: 05/14/2012 - 05/14/2013 %DDITIONAL REMARKS THIS ADDITIONAL REMARKS FO~J~ IS A SCHEDULE TO ACORD FORM, FORM t~' ~".: FORM TITLE: Page 1 of I ATTAC~qED TO AND NADE PART OF CERTIFICATE OF INSUP~%NCE ISSUED ON THE DATE OF 05/01/2012 ON BE}IALF OF: INSURED: PYRO ENGINEERING, INC. DBA: BAY FIREWORKS POLICY NO: CPP0101284-02 & ELP0010296-02 DISPLAY LOC: North Fork Country Club, Cutcho~ue, NY DISPLAY DATE: 7/4/12 P~AIN DA~: 7/6/12 RE: GF~ERAL LIABILITY, THE FOLLOWING ARE NAMED AS ADDITIONAL INSUREDS IN RESPECTS TO THE OPERATION OF T~E NAMED INSUP~ED ONLY: North Fork Country Club, their officers, directors, partners, representatives, agents and employees; Town of Southfold; Suffolk County; Chutchogue Fire Department; Cutcho~ue Fire District. ~old Harmless Agreement and Waiver of Subrogation per contract between the Named Insured and the Additional Insured applies. This Insurance is Primary and Non-Contributory as respects to any loss or liability arising directly or indirectly from the insured's operation. COI# 1654 Updatsd ACORD 101 (2008~1) © 2008 ACORD CCXRPORATION, All ~ghts reserved. The ACORD n~me and logo am registered marks of ACORD POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 1007 04 THIS ENDORSEMENT CHANGES THE POMCY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the follOWing: COMMERCIAL GENERAL LIABILITY COVERAGE PART BCHEDULE Name Of Addi~onal Insured Perao~s) Or Orcjanizafion{s): Location(s) Of Covered Opera§ohs North Fork Country Club, their 26342 Main Rd. officers,directors, partners, Cutcho~u~, NY 11935 represemtatives, agents and employees; To~n of Southfold; Suffolk County; Cutchogue Fire District; Cutchogue Fire District. For Date: 07/04/12 Rain Date: 07/06/12 But only as respects to the operations of the Named Insured. Information ~quired to compete this Schedule, if not shown above, will be shown in the Declarations. A, Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or '*personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the periormance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. W'P,h respect to the insurance afforded to these additional insureds, the follovdng additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after~. 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage adses has been put to its in- tended use by any person or organization other than another conb'actor or subcontractor gaged in performing operations for a principal as a part of the same project CG 20 10 07 04 © ISO Properties, Inc., 2004 Page I of I [] U.S. Deparlanent of Trnnsporlation Eastern Service Center Operations Support Group AJV-E2 1701 Columbia Ave. College Park, GA 30337 February 6, 2012 Ms. Jo-Anne Trinlo Pyro Engineering, INC. 400 Broadhollow Road, Suite 3 Farmingdale, NY I 1735 Dear Ms, Triolo: We received your letter regarding your prolm~ed fireworks displny for: North Fork CC 100th Date of the show: 7-4-2012 Rain Date: 7-6-2012 Approximate S~art Time: 9:15 pm Duration of Firework Display: 20 minutes Height of Fireworks: 500 feet Location of Show: North Fork CC, Cutchoguc NY Stef~ to be taken by Firt~m4t Company: Fireworks stnffshould remain vigilant to ensure that no aircrnfl are in the area prior to beginning the fireworks display. Our office has no objection to this event provided all the above n~ifications and precautions are met. This letter disposes of the Federal Aviation Administration's interest in this matter but should not be construed as superseding or invalidating any existing rules or regulations promulgated by any other f~lesal, state, county, or municipal government, whic~ may be required for this display. Please be sure to include on all future display request, longitude and latitudes for display_ If you have any questions concerning this event, please comact David Phillips at 404-305-5574. in F/r/fi// Group Manager, Operations Support Eastern Service Area Air Traffic Organization Amerfca's World Class Fireworks Leader Display Date: July 4, 2012 FIREWORKS DISPLAY AGREEMENT AGREEMENT made April 20, 2011 by and between Pyro Engineering, Ine., whose address is 400 Broadhollow Road, Suite 3, Farmlngdele, NY 11735 (hereinafter 'PEr'); and No~h Fo~ Country Club, 26342 Main Road, Cutehogue, NY 11935 (hereinafter 'SPONSOR"). WHEREAS, PEI designs, pmducas, and conducts fireworks displays; and WHEREAS, SPONSOR wishes to engage PEI to design, produce and perform a fireworks display en the terms and conditions hereinafter sat forth; NOW, THEREFORE, in consideration of the terms, conditions and covenants hereinafter set forth, the padles hereto do mutually agree as follows: f. FIREWORKS DISPLAY: On, July 4, 2012 (hereinafter 'lhe Display Date'), PEI shall provide the fireworks and equipment for the display at the Fireworks Display location. The display will be under the supen~ision of a PEI trained technician. It is agreed that PEI shall he the SOll §reworks supplier and producer for the event contracted for herein. (Note: The actual start and stop time of the display will be determined by lite govemmentel authorities having ju~tsdiction over the display). ALTERNATE DA TE: 2. COSTAND PAYMENTS: I FIREWORKS DISPLAY PRICE: I $ 15~000.00 The total (Fireworks Display Pdce plus all other applicable charges) sum of $15,000.00 a. The sum of: $ 7,500.00 upon execution and delh,m.*ry of this contract. t shall be due and payable as follows: b. The Balance of: $ 7,500.00 (which ledudes any taxes that may he applied to this sa!e) sha# be paid by ~ Bank Check made payable to Pyro Engineering, Inc. nat later than fifteen (15) days mior to the Oisdiav Dote. Please Note: SPONSOR is responsible for the payment of all governmental fees and taxes, including, but not limited to, sales, use, excise, license, permit, entertainment, or other fees, taxes or surcharges imposed or otheneise applied to this exhibition. Also, please see Section 16(c) below. 3. POSTPONEMENT/RESCHEDULING: If the display of the fireworks is pestpaned/reschaduled by mason of inclemant weather er by determination by the governmental authority having juK~licUon, or for any other mason beyond the control of PEI, same shall be re- scheduled to the Altemate Date set fodh above. In the event a postponement/mschnduiing is necessary due to inclement weather or by determination by the govemmantel authority having jurisdicl!or), or f~ any other reason beyond the control of PEI a postponemeot/rescheduling fee will he based on the table below. IDescription If notified by 12:01 AM on 07/03/12 If notifiad alter 12:01 AM on 07/04/12 Once Say Fireworks Techs Arrive on Site i % of Fi~rks Dislflay Prise 2O% Addifioriat Costs Any 3r" Pady Vendor Expenses Any 3m Parly Vendor Expenses Any 3~" Party Vendor Expenses Any request made by SPONSOR for raschaduling/cencalthg shall be directed to hel~bayfirewof~.~,.c~rn or by phone (5t6) 233- 4i32. It is undemteod and agreed that PEI shall have no obligation to reschaduil a display except as required by inclement weather or masons beyond the control of PEI. 4. SPONSOR~S AGENT: Mr. John Collins CELL PHONE: shall be designatad es SPONSOR'S agent to whom all questions and inquiries shall be relayed. Sponsor's agent shall be the only agent of SPONSOR author~-.nd to make decisions on behalf of SPONSOR or to request rescheduling of the fireworks display on the p~t of SPONSOR. Ini~al here; 5. EXHIBITION PLANNER CHECKLIST: it is undemtood and agreed by the perties hereto Ihat the Fireworks Display shall be contingent upon the strict compliance by SPONSOR with all items specified on the Exhibition Planner Checldist (EPC) which is annexed hem{o and made a part hereof. Failure on the part of SPONSOR to comply with ell requirements se~ forth in the EPC to the satisfaction of PEI within the time limits therein set forth shait be deemed to be an event of default of SPONSORS obligatfons hereunder. 6. SECURITY/SAFETY: SPONSOR shall provide and maintain sufficient Secuitty before, during and after the Fireworks Display until the pymtechniclan in charge declares the area dear. Secu~ty shall be deemed to include, but not limited to, be all security lines, police protection, ~ow fendng, rope lines, barricades or any other item deemed necessary by the local government or by PEI, SPONSOR shall also provide and maintain an area dear of any buildings cars and spectators with a minimum radius as specified by NFPA Code 1123, 2000 Edition as a Fire Safety Zone (FSZ) du~ng the entire period commencing from the time the fireworks ere delivered to the site untit the area is daclemd Clear by the pymtechniclan. It is understood and agreed that PEI will cease all fireworks discharge due to any security breach of the FSZ_ PEI shall not be responsible for personal injury, vehicle or property damage oc~uning within the FSZ as a result of the SPONSOR's failure to maintain the FSZ. in accordance with the standards of NFPA 1123 which, incidantally, are only minimum standarda of distances. SPONSOR acknowledges and agrees that PB's responsibilities are limited to the Fireworks Display and that PE! is relying on SPONSOR to maintain the aforementioned FSZ and to comlY~' with all Federal, State, municipal and local laws, ordem, regulations and ordinances pertaining to the implementation of any and all security measures at the site of the Fireworks Display. Any site visits made dudng the display setup by or on behalf of SPONSOR shall ha in accordance with NFPA 1123-1995, and under the direct supervision of the PEI technician in charge. Any such inspection shall nat in any way interfere with the safoty, setup er schedule of the preparation for and disassembly after the Fireworks Display. The PEI technician in charge may, at his discretion, cancel any inspection that in his sole opinion may compromise the safety oftbe setup or the Fir~.~,vorks Display or the setup schedule. The PEI technician may at any time temporarily discontinue the d[scharge of fireworks for any mason. CREDITS: As a material inducement to PEI agreeing to enter into this ~,~reemont, SPONSOR shall give PEI program credit es sole tireworks supplier and producer in all press releases, advertising, and any other program announcements, printed or othenvisa. 8.1NABIIJTY~oDELIVERorCONDUCTRREWORKSDISPLAY/I=ORCEI~AJEURE. PEI shell not incur any liability for any lesa or for any failure to perform any obligation hemundor due to causes beyond its reasonable control including without limitation legal or mgulelo~y restrictions, labor disputes of whatever nature, power less, telecommunications failure, ac~s of C-od, er any other cause beyond its reasonable control. In the event PEI is unable to deliver the Fireworks Display on the Delivery Date this contract will remain in full force and effect and the Ffrev~rks Display will be parrormed on the Alternate Date or If no Alternate Date is stated then on such other data as may be agreed upon by the parties. 9. CONTRACT SUBJECT TO GOVERNMENT REGUt_ATION: This Agreement and PEI's obligations hereunder are subject to all applicable Federal, State, Municipal and local laws, roles, ordinances, regulations and codes, now or hereinafter in effect, and to the condiitoPa and limitations contained in the permits required to be obtained by SPONSOR prior to the Fireworks Display. In the event any Federal, State, municipal er local law, rule, regulation or ordinance shall be enacted whish in any way prohibits, limits or restricts the sale, pe~ormance or operation of the exhibition of the Firewo~s Display or in ~ event SPONSOR'S permit in any way limits or restricts the sale, performance or operetion of said exhibi~on, PEI shall limit or restrict its performance er the Fireworks Display so es to comply with such law, rule, regulation or ordinance er limitetkm or restriction of SPONSOR*S permit. SPONSOR acknowledges that any such limit or restriction placed on the performance or operation of the Fireworks Display shall in no way result in or entitle SPONSOR to a raducllen or aba{emant in the full contract price. 10. GENERAl. a) This agreement constitutes the entire agreement between the perlJes relating to the subject matter hereof, and may not be changed, modified, rene~ed or extended except by a ~,;~ agreement, signed by both parties. SPONSOR acknowledges and agrees that PEI has not made any mpresentatiuns or warranties except those specifically sat forth in this contract. Should any clause, section, or pert of this agreement be held or declared to be void or illegal for any reason, all other clauses, sections, or pads of this agreement which can be effected without such illegal clause, section, or pert shall naverthetess continue in full force and effe~. b) SPONSOR is responsible for removal of paper debds associated wffh the Fireworks Display. c) PEI is not mspensible for procuring any marine selvices associated with the production of SPONSOR'S event. Should SPONSOR require these services, PEI may, upon w~ten request, assist SPONSOR in the location and contracting of such se~inas. A~I additional c~ts and fces associated with madse services are the responsibility of the SPONSOR. it is speckr'~ally understood and agreed that PEI shatl not be responsible in any way if any third party sennce with which SPONSOR has contmctnd for service tails to perform and the display cannot proceed as planned. d} SPONSOR is responsible for any additional madne costs and fees, city permit/escort fees, County/State/PD/FD/FM fees, local tow~ permit fees, eto. e) In the event SPONSOR cancels the Fireworks Display the full contract price as set forth herein shall become immedietaiy due and payable. SPONSOR will have up to 30 days bom the date of cancaila~on to request PEI to reschedule the Fireworks Display. Fireworks Display shall take place no later than six months fi'om originally scheduled Fireworks Display t) PEI agreea te procure liability insurance on behalf of SPONSOR, and to indemnify SPONSOR, to the extant thereof, for ali claims arising out of PEI'e nagligonce. Any additional insurance that is required that incurs a cost, will be Ihe SPONSOR'S responsibility. Ini~l he~: Sponsor 11. SPONSOR'S DEFAULT: In the event SPONSOR shall fail to pay any sum when due under the terms of this contract, SPONSOR shall pay, in addition to such amount, interest at the rote of 1.5% per month on the unpaid amount from the original due date. SPONSOR does further agree that it shall pay PEI reasonable attorney fees and uther costs in the event PEI shall commence any proceeding (A~o~b,Gon or any other proceeding) or incur fees to compel SPONSOR to pay any sums due hereunder or othensise as a result of SPONSOR'S default of any of the terms and provisions herein contained. 12. UQUIDATEDDAMAGES: It is agnsed by and bat'.~.'m~, the pa~es hereto that in the event of SPONSOR'S default hereunder PE1 shall be padlashe~Em~t PEt will have suttemd damages due to ~s dofaulL The damages suflered by PElasamsuit of Sponso~sdeleult will be substa~ bet incepebie of dntendina~on wlih mathematicel pradsion, it is, therefore, agraed by the parties that the ~ ~ ~1 is ~ a panalty, but ~ a mutualy banef~d, al and masonabis sslimate of the damages suffered by PEI. 13. SUBSTITUTIONS: PFJ shall have the right, at its discretion, to substitute any fireworks it deems necessary provided same does not detract from the aesthetic value or quality of the pm{Imm. This indudea, but is not limited to, shell sizes, quantrdes, types and brand names. Any substitutions shall in no way result in or entitle SPONSOR to a mducben or abatement of the full contract price. 14. ARBITRATION: Any and all disputes, difremncos, or any other type of controversy a~sing OUt of or in mlafJon to this Agreement, including as to the meaning or intel'pretation of any provision hereof, shall be resolved by arbitration in Nassau County, New York, pumuant to the commercial rules then obtaining of the Amedcan Arbitration Association. Only one (1) arbitrator shall be requirerl, and the arbitrator may award attorneys' fees. The award of the arbitrator shall be final and binding and judgment may be entered thereon in any court of competent jurisdiction. The arbitrator sitting in such controversy shall have no power to alter or modify any express provision of this Agreemant, nor to make any award which by its temls effects any such alteration or modification. Either party may seek from the court of competent jurisdiction any provisional remedy in aid of arbitration, including, but not limited to, injunction, attachment or replevin, pending the determination of any claim or controversy in arbitration. Any and all disputes, contmversiss, actions, claims, causes of action, or proceedings edsing under, out of, or in connection with or relating to the terms of this contract, and any amendment therec~f, cemmenced by, betwean or against any of the parties of this cantmct shall be deemed to have arisen from a transaction of business in New York, and shall be msulved by application of the substantive laws of the State of New York. t5. BINDING ;..; ; ;_CT: This ccotmct shall nut he bieding on PB until e~ecuted by SPONSOR and PB and PEI is in mceip~ of the 16. EXHIBITION PLANNER CHECKLIST (EPC): a. FIREWORKS DISPLAY PERMIT: (Note: The ac~al start and stop time of the display will be defarained by the governmental authorities having jurisdiction over the display). SPONSOR'S RESPONSIBILITY: It is Sponsor's responsibility to cell your State, City, County, Town, Borough, or Village Fire Marshal or other appropriate authority to ~e for and obtain the Fireworks Display permit. Upon recatot of your permit, you must send the uentfit to our office for our mcord~ no teter than 30 days prior to your display date. Failure to do could eaHocelv ieo~ardize your display. You must obtain inform~on on: 1. Filing application deadline and fees. Local and state mquiremente for firew~n'(s license for transportation and/or display. If a license is required, fax all forms immediately to us. 3. Fire Marshal's requirements for security of fireworks track upue arrival, and the security of the fire zone before and dudng the display. Federal regulations require that we sam/an accurate route plan to the display site. Fax us a copy of the route instructions from the nearest US Interstate to/he display area (approved by the fire mamhat or other authority, if necessary). Notify FAA on day of your display, according to the instructions in the FAA Letter of Approval, which will be fonearded lo you pdor to your display. b, COAST GUARD PERMITS (where required): 1. Ifthefireworksaretobedlsplayedonornearthewater, the following may be required: (Requests for penaits must be filed at least 60 days prior Io the Display Date (135 days prior for 4th of July events). 2. Coast Guard Application and Permit to Handle Hazardous Materials. 3. Coast Guard Madne Event Permit. c. SPONSOR RESPONSlBIETIES AND EXPENSES (The fntlowinR services need to be provided ap~l paid for by the SPONSOR in ad~NJon to the Flre~orks Disolav Price. 1) SECURITY: MUST BE PROVIDED FOR FIREWORKS EQUIPMENT AND TO MAINTAIN THE FIRE SAFETY ZONE AT STAGING AREA FROM FIREWORKS TRUCK(S) ARRIVAL, UNTIL COMPLETION AND CLEAN-UP OF DISPLAY AREA AND TRUCK DEPARTURE. 2) Sand: Please provide__0 yards of sand. 3) Laborer{e): __0 laborers to arrive at firewoH(s site on (They will nol handle fireworks). 4) Hotel Room(s): ._0 hotel rooms. 5) Vehicts(s): Four-wheeldrivevehicleformovementonsand:Yes No XX__ 6) If you have ordered a set piece(s), you am responsible for erecting the scaffolding and it must be resdy when the cl. RADIO SIMULCAST EXPENSES (if applicable): 1) Set up and stsff a fireworks simulcast command ce~tsr on site by 1:00 PM on the display date. 2}Provide bn:~adcast relay to PEI Firing Center. Call o~r office for details. 3) Speaker system for VIP viewing stands. e. INSURANCE: Please list below the additional insured, as they should appear on the insurance certificate: Signed by on behalf of Sponsor (Signature) Print Name Title of authorized representative of Sponsor Title S~eof Coun~of. On thc __ day of _, in the year before mc, the undersigned, a Notmy Public in and for said State, lx:tsonally appeared , pe~onally known to me; or proved to roe on the basis of satisfantor7 evidence to be the individual(s) whose name(s) is (are) subsefibed to thc within instrument and acknowledged to me that be/sh~dthey executed thc same in his/h~/thcir capacity(i=s), and that by his/her/their signature(s) on the instrument, thc individual(s), or thc poison upon bebaJ f of which thc individual(s) anted, executed the instrument. Signaturc and Ot~c~ ofindividuaJ taking acknowledgment [seal] PYRO ENGINEERING, INC. DISPLAY SITE PLAN QUESTIONNAIRE All items I~sted below am sure, ct to all govemlag Federal. State. Municipal and local laws. rules, ordinances, regula~ons and c~es. now or hereina~er in effect, and to ~ conditions and limitations containnd in the pem~tis required or to be obtaim~ by Sponsor. SPONSOR: North Fork Country Club Display Data Display Location: Rain Date: Budget: TIme of Display: (Note: The actual start and stop time of the display will be determined by the governmental authorities having jurisdiction over the display). IMPORTANT: PLEASE PROVIDE A SITE PLAN FOR YOUR EVENT LOCATION, INDICATING WITH AN X THE EXACT SPOT WHERE FIREWORKS ARE TO BE SET-UP. Local Fire Matshel: Telephone No: Pager No: Crew Contact Person: Telephone No: Pager No: The Following Informa#on Is necessary in order for us to provide your community or organization with a display that conforms wflh fireworks safety re~ulations and for the issuance of }~our insurence certificate. DISTANCES, IN FEET, FROM THE FIRING AREA TO THE FOLLOWING: FEET SPECTATORS, AUDIENCE OR PARKED CARS ................................................... OCCUPIED BUILDINGS (HOMES, APARTMENTS, ETC.) ..................................... PUBLIC BUILDINGS (SCHOOLS, HOSPITALS, CHURCHES, ETC.) ...................... TEMPORARY EVENT SET-UPS (CONCESSIONS, TENTS, ETC.) ........................... MAIN PARKING AREAS .................................................................................. HIGHWAYS OR ROADS .................................................................................. OVERHEAD OBJECTS (POWER LINES, LIGHT POLES, TREES, ETC ..................... FUEL STORAGE ............................................................................................. PLEASE PROVIDE DIRECTIONS FROM NEAREST INTERSTATE TO DISPLAY SITE. A MAP WOULD ALSO BE HELPFUL. Local Motels/Hotels: Telephone Nos. Signature Data Title: Pyro Engin~ring, Inc. 400 B~dhollow Road; Sui~ 3 Fa~ing~le, NY 11735 631-390-8620 - phon~-631-390-8621 f~ Invoice No. 7005 IINVOICE Cml Name .N?th Fp~_ Cp_u?t~_Club Add~ 26342 Main Road Ci~ Cutch~ue S~e NY ZIP 11935 Affn: Mr. J~n Collins ~ Paint Due Upon R~ipt MTh~ Invoke ~lan~ Due 15 Days P~or to This Display Misc ~ Date 4/18/2011 Job. No..12-0002 FOB . Unit Price '~ __TOTAL__ ~ $15,ooo.ooi $7,500.00 $7,500.00 $7,500.00 I ~ Federal Tax ID No.: 75-3044987 Payment I I Comments SubTotal $7,500.00! Tax Rate(s) - ~ 'ro~A~)U E~- $7,500.001 (oa~ u=, ~- ..... Final Payment Must be Received Fifteen Business Days Prior to Show Date Page 1 of 1 0 0 0 0 0 https://uwc.webmail.optimum.net/attach/North¼20Fork¼20CCVo20280¼20fi~20REVIS... 4/18/2012 CONCEPT OE$1GN pROOUCT~OId Corporate lioedqu~rters: 40D Bmodhollow Rd., Suite Farmingdala, N.Y, 11736 TEl: 631.39O.8620 FIK: 631.390.862-1 Intematanel Syrnpos~um on F~r~r~s ~t WaR O~s~y W=~d Am~fca's 40O~h Anniversa~ C~ines · Bafly'=, C~er's, Claridge A~eusar Busch Th~me p~rks Un{v~sai QdBndo Rased Hard RDCk Th~a Major League Baseball LLS. Olympic Commilt,o Sta~e Games Of America Na~ioflal Football League (;hie prl:llllll~ iM Ilhmllflltlglla Now Ye~'s Eve Celebrations The 8reekers & Roseclifl CeMonnido Stadhee, Stoo~, Coecens Th~rrm Park D~ign * Consldlaliofl FAX:631-734-'5427 PHONE: 631-734-6907 Date: ~Iay 1, 2012 Cutchogue Fire Department/Fire District 260NewSuffolkKoad Cutchogue, l~' 11935 Dcar Chief, Please be advised that pyro Engineering Iuc, dba Bay Fireworks will be conducting a firework8 display at the following location: Sponsor: North Fork Country Club Location: 26342 Main Road, Cutchogue, NY Date: 7/4/12 Rain Date: 7/6/12 Time: 9:15 pm We are respectfully requesting that a "pumper" be on site during the display time for this event, The Town of Southold Clerks Off~ce has been notified of this event as well. Please call this office to confirm receipt of this information, Sincerely, nne Triolo CC: Linda Coop*r Town of Southold Town Clerks Office Fax: 631-765-6145