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AU-05/08/2012 Fishers Island
FISHERS ISLAND FERR Y DISIR1CT VENDOR 001392 ADMIRAL CUSTOM EMBROIDERY, LLC 05/08/2012 CHECK 433 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710,4.000.000 1042 50 h~YLON TWILL CAPS 571.63 TOTAL 571,63 Town of Southold, New York - Pal Vendor Tax ID Number or Socth Secor tv Number Admiral Custom Embroidery, LLC Vendor Tclepbot~c N[~mber 104~ Vendor Contact invoice 'merit Voucher ~enddr Address ~9 Warren Street New London, CT 05520 Date $/23/2012 Total 571.63 571.63 Purchase Order Number Description of Goo~s or Servlc~S 50 Nylon Twill Caps Oheck No. £km~ral Lcd~ Funel and Account Number 8M5710.4:000.000 Payee Certification 'File undersigned (Claimant) (Acting on behalf of ibc abeve named claimant) Title Department Certification ~rfonned and that tbe quantities tha~f have been verified with fl~e ~ceptions Signature Signature Company Name__ '1 itle Town of Southold, New York - Payment Voucher Vendor T~x ID Number or Social Security Number Vendor Address Vendor Name Admiral Custom Embroider~, LLC Vendor Telephone Number Vendor Contact Invoice Number 1042 Invoice Invoice Date Total 3/23/2012 571.63 vendor No. 69 Warren Street New London, CT 06320 Net Discount !Amount Clalme~ 571.63 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 ts exempt are excluded co p ysame Date Purchase Order Number Description of Goods or Services $0 Nylon Twill Caps Eheck No. Entered by Audit Date ~IAY 0 $ 2012 Fown Clerk General Led[er Fund and Account Number SM1910.4.000.100 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 discrepancies noted, and payment is approved. Signature AdmTral Custom Embroidery, LLC 69 Warren Street New London, CT 06320 Phone: (860) 442-7519 Fax: (860) 437-0~1~.8 Invoice # 1042 Created: 3/23/2012 Invoiced: 3/23/2012 Bill To: F.I. Fern/District 5 Waterfront Park New London, CT 06320- Ship To: F.I. Fern/District 5 Waterfront Park New London, CT 06320* PO Number Terms Sales Rep Customer F.[. Fern/District (860) 442-0165 Contact Style £868 Description IColor ISizes IQuantity IPiece I Subtotal Production I PerformancePort Authority Cap Signature Nylon Twill Khaki One Size*50 50 $10.75 $537.50 IType IAm°unt IMeth°d IDate I Subtotal $537.50 Shipping $0.00 6.35%SalesTax $34.13 GrandTotal $571.63 Payments $0.00 Balance $571.63 Signature: Date: FISHERS ISLAND FERRY DISTRICT VENDOR 001327 AIRGAS EAST, INC 05/08/2012 CHECK 434 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 116284541 (2)PROPANE TA/qKS 67.96 TOTAL 67.96 Town of Southold, New York- Pa 'ment Vendor Tax ID Number or Social Securit3, Number Vendor Name AIr0as East Vendor Telephone Number Vendor Contact Vendor No. Voucher Vendor Address P.O. Box 827049 Philadelphia, PA 19182-7049 1327 Check No. Entered by ~e~ Audit Date Invoice Number 116284541 Date 4/1612012 Total Net Discount Number Services $67.961 $67.96 Tank Payee Certification The undersigned (C~aimant) (Acting on behalf of tbe above named claimant) does hereby certify that thc forcgning claim is txue 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. 67.96 Signature itle ~ Company Natae ~/~::~ Date /t~/~ ~'/.~..-~- General Ledser Fund and Account Number 8M6710.4.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Signature ~ P > - S} % NC; 8E ABE~ ?{}~ A ¥ DRECT (~XCEPf &S TO ENSURE PROPER CREDIT PLEASE RETURN THE UPPER PORTION WtTH YOUR REMITTANCE. FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL: 800-562-3815 ExL 3800 232246-00 116284541 I 02081 04/16/12 IFISHERS ISLAND 465 841 I 812 CUST PI~KUP L~ NET30 DAYS I 1 , ~* LOCATION: B6 .4 23224(04i1( ?R 33A PROPANE 32LBS ALUMINUM ~l 29.977.~ 59.96 N 2 2 VOL: 64 23224~04i1( {AZHAZMAT HAZARDOUS MATERIAL CHARG E~ 8.0( 8.00 N : Suk total 67.96 : TO] aL iYLIqDERS SHIPPED: 2 RETURNEE TAX Cd: )00000006 TAX ESCR} C( ~NEiTIiU EXMPT CD: 0 EXMPT/CER% ~UNICIP7 ]ITY , $67.96 $.o0 Airgas ~ www.airgas.com FISHERS ISLAND ACT. NAME AIRGAS EAST AJrgas East FERRY DISTRICT ACT. NO. 8606074799 17 Northwestern Drive FISHER ISLAND NY 06390 PNC BANK - ABA NO. 031000053 Salem, NH 03079 REF. 116284541/02081 s~- o~ooo ORIGINAL INVOICE FISHERS ISLAND FERRY DISTRICT VENDOR 019500 AT&T 05/08/2012 CHECK 435 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710,4.000.100 86044201650512 TEL/NL TERM 4/15-5/14/12 284.86 TOTAL 284.86 Town of Southold, New York - Pa~ Vendor Tax ID Number or Social Security Number Vendor Name AT&T Vendor Telephone Number Vendor Contact ,ment Voucher Vendor Address AT&T P,O. Box 5082 Vendor No. 19500 Check No. q55 Entered by ~ Audit Date ___ ~IAY fl 8 2012 Invoice Number 8604420165 0~ Invoice Invoice Date Total 4/t5120t2 284.86 Payee Certification Discount Carol Stream, IL 60197- Net Purchase Order Amount Claimed Number 284.86 284.86 The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~ that the foregoing claim is true and correct, that no pan h~s 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 Na Date Description of Goods or See/ices NL Terminal Tel 04/15-05/1 4/t2 General Led[er Fund and Accoum Number $M5710.4.000.100 Department Certification I hereby certify that the materials above specified have been received by me in go~d condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Title Date at&t FISHERS iSLAND FERRY DISTRICT Page 1 of 8 PO BOX H Account Number 860 442-0165 078 FISHERS ISLE NY 06390-0607 Billiog Date Apr 15, 2012 Web Site att.com Monthly Statement Previous Bill 551.79 Payment Received 3-19 268.34CR Adjustments 4,19 Past Due - Please Pay immediately 287.64 TotalAmount Due $568.31 * Current Charges Due in Full by May 14, 2012 · Thank you for being an ALL DISTANCE® customer. Your ALL DISTANCE® savings includes: Promobons and Discounts 27.00 No. Date Descriotion Adiustments Payments 1. 3-19 Payment 26834 2. 4-15 Late Payment Charge 15% 4.19 Totals 4.19 26834 Questions? Call: Plans and Services 1 800 321-2000 Repair: 1 800 246-8464 Internet Services: 1 877 722-3755 Total Current Charges Page 1 280.67 · PREVENT DISCONNECT · CARRIER INF0 · KEEP YOUR DISCOUNT · IMPORTANT LD CHANGES See "News You Can Use" for additional reformation. Promotions and Discounts 3. Save Elite-S Conn-S27 off -12mo term Monthly Sen/ice - Apr 15 thru May 14 Charges for 860 44Z-0165 4. Monthly Charges Charges for 860 443-6851 5. Monthly Charges Charges for 860 444-0320 6. Monthly Charges Charges for 860 447-9371 7, Monthly Charges Total Monthly Sen/ice Call Charqes 27,00CR 122.60 28.35 2835 28.35 Z07~5 Bus Block of Time 700 II 2Y Summary 1089 Minutes Used 100 Minutes Allowed Instate Long Distance Out of State Long Distance Call Plan Summary Total 8. Bus Block ol Time 700 II 2Y Charges for 860 442-0165 Item No. Date Time Place Itemized Calls 9. 3-15 812A FISHERSIS 3.21 13.54 16.75 Number Code Mi~ NY 631 788-7919 1 0:30+ 30.00 "BASIC $150.56 NON BASIC $417.75 Return bottom portion with your check in the enclosed envelope. at&t FISHERS ISLAND FERRY DISTRICT Page PO BOX H Account Nmaber FISHERS ISLE NY 06390-0607 Billing Date Web Site 2of8 860442-0165078 Apr 15, 2012 att.com Call Charges - Continued Item ~ Date Time Place Number 1. 3-15 849A FISHERSIS NY 631 788-7744 2. 3-15 905A FISHERSIS NY 631788-7311 3. 3-15 91lA POUGHKEPSI NY 845656-1677 4. 3-15 925A WlLUMNTIC CT 860234-9583 5. 3-15 1003A FISHERS iS NY 631 788-7463 6. 3-15 1038A FISHERS IS NY 631 788-7857 7. 3-15 1249P CAMBRIDGE MA 617 201-4375 8. 3-15 I10P FISHERSIS 9. 3-15 203P FISHERS IS 10. 3-15 222P OLD SAYBRK I1. 3-15 309P FISHERSIS 12. 3-15 409P FISHERSIS 13. 3-15 412P OLDSAYBRK 14. 3-15 554P FISHERSIS 15. 3-16 914A NEWRAVEN NY 631 788-7019 NY 631 788-7857 CT 860227-1660 NY 631 788 7919 NY 631 788-7444 CT 860388 7642 NY 631 78~-7463 CT 203 468-4509 16. 3-16 919A SANANGELO TX 325223-9500 17. 3-16 1012A FISHERS IS NY 631 788-7463 18. 3-16 1021A FISHERS IS NY 631 788-7463 19. 3-16 11~5A FISHERS IS NY 631 788-7463 20. 3-16 113P FISHERSIS NY 631788-7463 21. 3-16 131P MILFORD CT 203876-8606 22. 3-16 221P POUGHKEPSI NY 845656-1677 23. 3-17 1211P EISHERSIS NY 631788-7665 24. 3-18 1244P HUNTINGTON NY 631697-1013 25. 3-19 749A FISHERS IS NY 631 788-7463 26. 3-19 802A FISHERS IS NY 631788-7255 27. 3-19 842A WARREN RI 401 245-8300 28. 3-19 937A LEBANON CT 860642-4377 29. 3-19 943A WATERBURY CT 203754-5334 30. 3-19 946A FISHERS IS 31. 3-19 1044A FISHERS IS 32. 3-19 1141A FISHERSIS 33. 3-19 1147A WILLIMNTIC 34. 3-19 1148A PUTNAM 35. 3-19 1152A FISHEBSIS 36. 3-19 1158A FISRERSIS 37. 3-19 1224P FISHERS IS 38. 3-19 115P WARREN NY 631 788 7463 NY 631 788-7463 NY 631 788-7255 CT 860 234-9583 CT 060 963-0756 NY 631 788-7255 NY 631 788-7255 NY 631 788-7463 RI 401 245-8300 39. 3-19 146P NEWMILFORD CT 8603506410 40. 3-19 257P FISHERSIS NY 63178&7463 41. 3-20 73OA FISHERS IS NY 631 788-7632 42. 3-20 830A WlNDSORLKS CT 860623-8374 43. 3-20 84OA OLDSAYBRK CT 860388-9444 44. 3-20 855A FISHERS IS NY 631 788-7528 45. 3-20 905A FISHEBSIS NY 631788-7528 46. 3-20 911A FISHERSIS NY 63178~-7463 47. 3-20 959A FISHERSIS NY 631788-7345 48. 3-20 1207P FISHERS iS NY 631 788-5550 49. 3-20 1210P FISHERS IS NY 631 788-7919 Mi, 0:42+ 1 0:30+ 0:35+ 3:17+ 5:19+ 0:30+ 0:30+ 1:48+ 0:55+ 0:30+ 0:59+ 0:50+ 8:44+ 0:36+ 4:11+ 0:30+ 0:30+ 0:38+ 0:39+ 1:02+ 1:45+ 2:17+ 1:13+ 0:30+ 2:47+ 2:17+ 5:35+ 0:46+ 0:48+ 0:30+ 0:48+ 0:30+ 0:44+ 0:30+ 0:30+ 0:33+ 2:44+ 0:51+ 1:55+ 1:17+ 2:23+ 0:30+ 0:30+ 0:30+ 0:37+ 1:22+ 1:03+ 0:53+ .00 .00 .00 .00 .00 .00 .00 Call Cbar9es - Continued Item No. [~ Tim~ place Number 50. 3-20 1216P FISHERS IS NY 631 788-7528 51. 3-20 1251P FISHERS IS NY 631 783-7251 52. 3-20 122P NEWHAVEN CT 203410-6997 53. 3-20 127P TRENTON NJ 609462-3870 54. 3-20 132P FISHERS IS NY 631788-7144 55. 3-20 139P NORTHDADE FL 305621-7525 56. 3-20 203P FISHERS iS NY 631 788-7919 57. 3-20 308P FISHERS IS NY 631 788-7463 58. 3-20 344P FISHERS IS NY 631 788-7469 59. 3-20 345P FISHERS IS NY 631 788-7444 60. 3-20 347P FISHERS IS NY 631 788-7174 61. 3-20 418P GARDENCITY NY 516790-5820 62. 3-21 750A NARRAGNSTT RI 401 789-3964 63. 3-21 822A FISHERS IS NY 631 788-7463 64. 3-21 lOI4A FISHERS IS NY 631 788-7463 65. 3-21 1045A NEVVHAVEN CT 203710-4410 66. 3-21 1116A NEWHAVEN CT 203710-4410 67. 3-21 1119A FISHERSlS NY 631788-7343 68. 3-21 1126A FISHERSlS NY 631788-7463 69. 3-21 1128A FISHERSlS NY 631788-7345 70. 3-21 1149A FISHERSIS NY 631788-7463 71. 3-21 1217P FISHERS IS NY 631 788-5550 72. 3-21 123P NARRAGNSTT RI 401 789-3964 73. 3-21 134P LINBENHST NY 631225 3064 74. 3-21 145P UNBENRST NY 631225-2260 75. 3-21 309P FiSHERSIS NY 631788-7444 76. 3-21 329P NARRAGNSTT RI 401789-3964 77. 3-21 333P COLCHESTER CT 860537-8270 78. 3-21 405P PROVIDENCE RI 401 556-4196 79. 3-21 425P FISHERS IS NY 631 788-7463 80. 3-21 449P FISHERS IS NY 631 788 7463 81. 3-22 920A FISHERS IS NY 631788-7463 82. 3-22 923A HARTFORD CT 8605733957 83. 3-22 924A PTCHARLOTT FL 941 979-7607 84. 3-22 924A WlNDSORLKS CT 860668-0~44 85. 3-22 1001A FISHERS IS NY 631 788-74G3 86. 3-22 1033A ESSEX CT 868662-0839 87. 3-22 1045A SANANGELO TX 325223-9300 88. 3-22 1048A FISHERS IS NY 631 768-7463 89. 3-22 1113A FISHERS iS NY 631 788-5655 90. 3-22 1115A FISHERS IS NY 631 788-7857 91. 3-22 1116A POUGHKEPSl NY 845656-1677 92. 3-22 1121A POUGHKEPSI NY 845656-1677 93. 3-22 1148A FISHERS IS NY 631 788-5667 94. 3-22 1153A FISHERS IS NY 631 788-7345 95. 3-22 t224P POUGHKEPSl NY 845656 1677 96. 3-22 250P FISHERS iS NY 631 788-7857 97. 3-23 957A BELLOWSFLS VT 802376-6848 98. 3-23 1027A BALTIMORE MD 410804-2070 99. 3-23 1028A PIKESVILLE MD 410 205-2205 I00. 3-23 1132A FISHERS IS NY 631 788-7311 101. 3-23 1133A FISHERS IS NY 631 788-7345 102. 3-23 130P WlNDSORLKS CT 860668-0044 Code D Mien 1:22+ .00 0:51+ .00 0:53+ 0:43+ .00 0:49+ 2:34+ 0:30+ .00 1:12+ .00 0:43+ .00 0:59+ .OO 0:30+ .00 1:30+ .00 0:30+ .O0 4:28+ .00 10:40+ .00 0:39+ .00 0:30+ .00 0:39+ .00 0:34+ .00 0:30+ 0:30+ .00 0:39+ .00 4:06+ 0:30+ 0:30+ .00 0:30+ .00 1:33+ .00 0:32+ .00 5:13+ .00 10:14+ .0~ 0:30+ .00 0:43+ .O0 0:30+ .00 0:30+ .00 20:24+ .QO 5:42+ .00 7:45+ 2:35+ .00 0:30+ .00 0:30+ .00 0:36+ .00 2:50+ .00 0:35+ 0:30+ .00 0:34+ .00 3:49+ .00 0:39+ .00 0:58+ .00 0:32+ 0:31+ .00 0:30+ .00 0:30+ .00 1:39+ ,00 6187.007.081671.01.04.06e0000 NNNNNNNY 40939.163467 at&t F~SHERS ISLAND FERRY D~STRICT Page PO BOX H Account Number FISHERS ISLE NY 06390-0607 Billing Date 4of8 860 442-0165 078 Apr 15, 2012 Call Charges - Continued No. Date Time Place 1. 403 131P FISHERSIS 2. 403 133P FISHERSIS 3. 4 03 14OP FISHERS IS 4. 4 03 226P FISHERSIS 5. 4-03 320P FISHERS IS 6. 4-03 327P FISHERS IS 7. 403 443P NEWYORK 6. 4 04 709A NORFOLK Number NY 631 788 7463 NY 631 788 7632 NY 631 788-7463 NY 631 78&7463 NY 631 188-7857 NY 631 788-7343 NY 212 318-6426 VA 757 353-9842 9. 4-04 716A NEWBRNSWCKNJ 908227-1515 I0. 4-04 723A FISHERS IS 11. 4-04 731A FISHERSIS 12. 4-04 805A DEEP RIVER 13. 4-04 90~A FISRERSIS 14. 4-04 1125A FiSHERSIS 15. 404 1137A EISRERSI$ 16. 4 04 1145A FISHERS IS 17. 4-04 1212P FISHERS IS 18. 4 04 1233P COCOA 19. 4 04 1236P FISHERS IS 20. 4-04 145P FIStlERSIS 21. 404 325P FISRERStS 22. 4-04 329P PROVIDENCE 23. 4 04 342P FISHERS iS 24. 4-04 646P EARMINGDL NY 631 788-7463 NY 631 788-7345 CT 860526-9836 NY 631 788-7345 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 FL 321 482-3786 NY 631 788-7463 NY 631 788 7444 NY 631 788-7463 RI 4OI 225-2452 NY 631 788-7345 NY 631 414-5808 25. 4 05 833A MIDDLETOWN CT 860632-7338 26. 4-05 838A COLONIE NY 518452-0e00 21. 4-05 951A NORFOLK VA 7573539842 28 4-05 1010A FARMINGDL NY 631414-5808 29. 4-05 1012A FARMINGDL NY 631414 5808 30. 4-05 1012A FARMINGDL NY 631414-5808 31. 4-05 1034A NARRAGNSTT RI 401 789-3964 32. 4 05 1049A FISHERS IS 33 4 05 1057A FISHERS IS 34. 4 05 1114A WATERRURY 35. 4-05 112lA FISHERS IS 36 405 1123A FISHERSIS 37, 4-05 1136A FISHERSIS 38. 4-05 1235P FISHERSIS 39, 4 05 1242P FISHERS IS 40. 4-05 109P $OUTHOLD 41, 4-05 145P FISHERS IS 42. 4-05 205P FISHERSIS 43. 4 05 225P NEWARK 44, 4-05 241P SOUTHOLD 45, 4 05 257P NEWARK 46. 4-05 302P SOUTHOLB 47. 4-05 351P FISHERSIS 48. 4-05 405P COOPERSBG 49 4-05 544P FISHERSIS NY 631 788-7919 NY 631 788-7528 CT 203 754 5334 NY 631 788-7463 NY 631 788-7857 NY 631 788-7345 NY 631 788-7463 NY 631 788-7255 NY 631 765-4333 NY 631 788-7889 NY 631 788 7463 NJ 973 388-3565 NY 631 765-1283 NJ 923 388-3665 NY 631 765-1283 NY 631 788-7463 PA 610 214-0000 NY 631 788-7463 Code Min 0:31+ .00 0:49* .00 0:30+ 1:03+ .00 6:09+ .00 1:26+ .00 13:53+ .00 6:27+ ,00 1:16+ .00 3:44+ .00 0:51+ .00 2:21+ .00 1:29+ .0~ 4:30+ .06 1:41+ .0~ 0:43+ .06 9:44+ .00 0:35+ .00 0:30+ 1:55+ .0~ I:01+ .00 0:30+ .00 0:30+ 0:30+ 3:09+ .00 2:53+ 4:22+ .00 0:41+ ,00 0:30+ .00 1:03+ .00 1:50+ .00 0:30+ .00 0:36+ .00 2:45+ .00 0:30+ 1:14+ .00 0:37+ 0:30+ 0:30+ 0:30+ .00 0:42+ 1:30+ .00 2:32+ 0:42+ .00 2:36+ .00 1:02+ 0:40+ .00 53:43+ 3:08+ .00 Call Charqes - Continued Item No. Date Time Place Number 50. 4-06 826A FISHERS IS NY 631 788-7463 51. 4-06 934A DULUTH MN218722-1076 52. 4-06 949A NEWRAVEN CT 203468-4509 53. 4-06 954A WASHINGTON VA 703652-2500 54. 4-06 1000A COOPERSBG PA 610214-0000 55. 4-06 1033A FISHERS IS NY 631 788-7463 56. 4-06 1246P NORFOLK VA 757353-9842 57. 4-06 1251P FISHERS IS NY 631788-7714 58, 4-06 218P FISHERS IS NY 631 788-7463 59. 4-06 317P FISHERS IS NY 631 788-7463 60. 4-06 324P FISHERSIS NY 631788-7311 61. 4-06 4OOP WlNOSORLKS CT 860668-0044 62. 406 407P HSRERSIS NY 6317887311 63. 4-06 446P FISHERS IS NY 631 788-7345 64. 4 06 644P HUNTINGTON NY 631697-1013 65. 4 09 139A FISHERS IS NY 631 788 7463 66. 409 917A PUTNAM CT 860928-7848 67. 4 09 924A FISHERS IS NY 631 788 7851 68, 4 09 935A FISHERS IS NY 631 788-7463 69. 4 09 1022A FISHERS IS NY 631 788 7463 70. 4 09 1055A FISHERS IS NY 631 788-7463 71, 4 09 1105A ESSEX CT 860767 9917 72. 4-09 1138A ESSEX CT 860767-9917 73. 4-09 1158A FISHERS IS NY 631 788-7919 7¢ 4-89 1200P FISHERS IS NY 631 788 7345 7S. 4 09 1220P KILUNGWTH CT 860663 2759 76. 4-09 129P WlNDSORLKS CT 860668-0644 77. 409 129P W~NDSORLKS CZ 860668-0644 78. 4-09 145P FISHERS IS NY 631 788-7857 79. 4-09 250P FISHERS IS NY 631 788-7857 80. 4-09 256P FISHERS IS NY 631 788 7463 81. 4-09 301P FISHERSIS NY 6317887463 82. 4-09 409P FISHERS IS NY 631 788-7463 83. 4-09 459P C0OPERSBG PA 610214-0000 84. 4-10 855A FISHERS IS NY 631 188-7857 85. 4 10 955A NAUGATUCK CT 203723-7413 86. 4-10 119P RIVERREAD NY 631862-4561 87 4-10 120P RIVERHEAD NY 631852-4500 88 4 10 127P POUGHKEPSl NY 845656-1677 89. 4-10 310P OUEENS NY 718440-9257 90, 4 10 338P FISHERS IS NY 631 188-7919 91. 4-10 354P NORFOLK VA 757353-9~42 92 4 ll 736A NEWBRNSWCKNJ 9(~227-1515 93. 4-11 925A NWYRCYZNOI NY 212628-6070 94. 4 11 929A FISHERS IS NY 631 788-7919 95. 4-11 946A NWYRCYZN01 NY 2126286070 96. 4 I1 IO00A HARTFORD CT 860289-0267 97. 4-11 35OP FISRERSIS NY 631788-7463 98. 4-11 649R NATLDA 203411 99. 4-11 650P FISHERSIS NY 6317887416 100. 4 12 748A FISHERS IS NY 631788-7422 101. 4 12 750A MALDEN MA 781 322-7880 102. 4-12 802A FISHERSIS NY 6317887463 Code Min 1:33+ 0:55+ 0:41+ 0:32+ .0~ 26:58+ .00 0:30+ .00 2:12+ .00 0:32+ .00 0:44+ .00 0:55+ .00 0:47+ .00 D 2:56+ .00 I 5:57+ .00 I 0:30+ 2 5:11+ .00 2 1:22+ .00 D 0:37+ .0~ 1 0:51+ .00 1 4:33+ .oo 1 1:o3+ I 0:35+ .O0 O 5:19+ .00 D 2:32+ .00 I 1:42+ .00 1 0:30+ O 0:30+ .00 O 0:30+ 00 O 2:0(3+ .00 1 0:52+ .00 1 0:30+ .00 1 2:36+ 1 2:09+ .00 1 7:58+ .00 1M 4:07+ I 0:32+ .00 D 3:44+ .00 0:30+ .00 3:39+ .00 2:29+ 5:08+ 0:40+ .00 I:11+ .00 0:30+ ,00 1:49+ .00 9:26+ .19 0:30+ .02 5:15+ .23 0:30+ .02 1.99 2 2:50+ .12 2 0:30+ .02 2 0:30+ .02 1 3:27+ 15 6187.007.081671.02.04.0QX~0~6 NNNNNNNY 32417.124549 at&t FISHERS ISLAND FERRY DISTRICT PO BOX FI FISFIERSISLE NY 06390-0607 Page 3 of 8 Account Nmbof 860 442-0165 078 Billing Date Apr 15, 2012 Call Cha~es - Continued Item !~ Rate T~I~ Place Number I. 3-23 426P FISHERS IS NY 631788-7463 2. 3-23 43OP FISHERS IS NY 631788-7463 3. 3-26 888A FISHERS IS NY 631 788-5673 4. 3-26 813A FISHERS IS NY 631 788-8873 5. 3-26 822A BELLOWSELS VT 802376-6848 6. 3 26 832A BELLOWSFLS VT 802376-6848 7. 3-26 853A BELLOWSFLS VI 802 376-6848 8. 3 26 918A FISHERS IS 9. 3-26 1033A PEORIA 10. 3-26 1034A SOUTHOLD 11. 3-26 1088A IOWACITY 12. 3-26 1088A FISHERS IS 13. 3-26 1132A FISHERS IS 14. 3-26 1236P ESSEX 15. 3-26 1246P CORALSPG 16. 3-26 1248P CORALSPG 17. 3-26 104P FISHERSIS 18. 3-26 121P ESSEX 19. 3-26 127P NEWHAVEN 20. 3-26 207P MILFORD 21. 3 26 306P FISHERSiS 22. 3-26 347P HARTFORD 23. 3-27 803A LINDENRST 24. 3-27 805A LINDENHST 25. 3-27 814A ESSEX 26. 3 27 819A ESSEX 27. 3-27 851A FISHERSIS 28. 3-27 901A ESSEX 29. 3 27 905A ESSEX 30. 3-27 917A FISHERSIS 3t. 3-27 931A NEWHAVEN 32. 3 27 933A UNRENHST 33. 3-27 1023A FISHERS IS 34. 3-27 1123A FISHERS IS 35. 3 27 1129A NORWALK 36. 3-27 1188A POUGHKEPSI 37. 3-27 1251P HARTEORR ~8. 3 27 130P COLCHESTER 39. 3-27 209P FiSHERSIS 40. 3-27 214P FISHERSIS 41. 3 27 240P FISHERSIS 42. 3 27 400P FARMINGDL NY 631 788-7144 IL 309699-1116 NY 631 765-4333 IA 319354-5251 NY 631 788-7345 NY 631 788-7345 CT 860662-3013 FL 754 229-9594 FL 7542299594 NY 631 788-7144 CT 860662-3013 CT 203468-4503 CT 203876-8606 NY 631 788-7345 CT 860983-4444 NY 631 225-3064 NY 631 225-3060 CT 860767-1960 CT 880 662-De39 NY 631 788-7345 CT 860 662-0839 CT 860662-0839 NY 631 788-7345 CT 203641-9494 NY 631 225-3060 NY 631 78~-5673 NY 631 788-7528 CT 203943-3214 NY 845656-1677 CT 880 986-7634 CT 860537-3431 NY 631 788-7463 NY 631 788-7919 NY 631 788*7345 NY 631 414,8888 43. 3-27 436P SANANGELO TX 325223-9300 44. 3-27 5~5P WtNOSORLKS CT 860668-0044 45. 3-28 718A ASHTON RI 481 334,3444 46. 3-28 723A FISHERSIS NY 631788-7345 47. 3-28 733A FISHERSIS NY 631788-7463 48. 3-28 838A FISHERS IS NY 631 788-7345 49. 3-28 955A FISHERS IS NY 631788-7255 Code Call Charqes - Continued Item No. Date Time Place Number 88. 3-28 988A FISHERS I$ NY 631 788-7224 51. 3-28 1054A FISHERS IS NY 631 788 7221 Mien 52. 3-28 111 lA FISHERS IS NY 631 788-7463 0:30+ .88 53. 3-29 816A FISHERS IS NY 631 788-7807 9:03+ .00 54. 3-29 888A FISHERS IS NY 631 788-7343 4:16+ .88 55. 3-29 921A HARRISON NY 914462-2162 2:28+ .00 88. 3-29 1115A FISHERS IS NY 631 788-7463 0:51+ .00 57. 3-29 1134A FISHERS IS NY 631 788-7463 0:30+ .00 88. 3-29 1143A FISHERS IS NY 631 7Be-74&3 0:30+ ,00 59. 3-29 1244P FISHERS IS NY 631 788-7919 0:30+ .0~ 60. 3-29 115P FISHERS IS NY 631 788 7857 1:23+ .00 61. 3-29 132P FISHERSIS NY 631788-7857 1:29+ .00 62. 3-29 155P BRIDGEPORT CT 203913-2013 1:11+ .00 63. 3-30 935A ROCKVlI.LE CT 860870-2282 0:57+ .00 64. 3-30 988A MILFORD CT 2033060040 0:33+ .00 OS. 3-30 1039A POUGHKEPSI NY 845688-1677 3:53+ .08 66. 3-30 1109A FISHERS IS NY 631 788-7463 0:36+ .00 67. 3-30 1206P POUGHKEPSI NY 845656-1677 0:42+ .00 68. 3-30 1214P FISHERS IS NY 631 788-7919 0:30+ .88 69. 330 221P PI173BURGH PA 412454-2200 0:30+ .88 70. 330 225P NEWHAVEN CT 203784-7700 1:13+ .00 71. 3-30 244P FISHERS IS NY 631788-7857 0:37+ .00 72. 3-30 305P FISHERS I$ NY 631788-7463 0:43+ .00 73. 3-30 525P OLDSAYBRK CT 860388-1224 2:25+ .00 74. 3-31 1153A FISHERS IS NY 631 788-7919 0:30+ .00 75. 3-31 1188A FISHERSIS NY 631788-5884 0:43+ .00 76. 4,02 925A NEWHAVEN CT 203777-3601 3:19+ .88 77. 4-02 928A FISHERS IS NY 631 788-8873 0:30+ .00 78. 4-02 1002A FISHERS IS NY 631 788-7919 0:44+ .00 79. 4-02 1010A FISHERS IS NY 631 788-7463 0:59+ .00 80. 4-02 104OA NEWHAVEN CT 203468-4401 2:00+ .00 81. 4-02 317P WILLIMNTIC CT 888942-3685 2:29+ .00 82. 403 807A OLOSAYBRK CT 860399-5266 1:36+ .00 83. 403 814A OLDSAYBRK CT 860399-6544 10:27+ .GO 84. 4,03 815A OLDSAYBRK CT 8883995266 0:30+ .0~ 85. 4 03 816A FISHERSIS NY 631788-7857 0:33+ .00 86. 4,03 818A WATERBURY CT 203 754 5334 0:30+ .06 87. 4-03 832A OLD SAYBRK CT 860 399-5266 0:30+ .00 88. 4 03 988A FISHERS IS NY 631 788-7463 5:5t+ .00 89. 4-03 9§3A HARTFORD CT 888424,3019 2:10+ .00 90. 4-03 954A HARTFORD CT 860424-3034 1:23+ .88 91. 4,03 957A FISHERS IS NY 631788 7223 0:30+ .88 92. 4-03 988A FISHERS IS NY 631788q221 0:32+ .88 93. 4 03 1021A GARBENCITY NY 516790-1179 0:37+ .00 94. 4-03 1022A FISHERS IS NY 631 788-7221 5:38+ .88 95. 4-03 1026A GARDENCITY NY 516790-1779 39:55+ .88 96. 4-03 1146A NORFOLK VA 757353-9842 1:54+ .00 97. 4-03 1149A FISHERS IS NY 631 788-7632 0:44+ .00 98. 4-03 1222P GARDENCITY NY 516790-1179 1:20+ .88 99. 4,03 1223P GARDENCITY NY 516790-1779 0:59+ .00 100. 4-03 1254P HARTFORD CT 860886-7634 1:07+ .88 101. 403 107P FISHERSIS NY 631788-5515 102. 4-03 119P FISRER31S NY 631788-7463 Code Min 1:11+ 0:52+ .0~ 41:43+ 0:41+ .00 1:51+ .00 I:11+ .00 0:30+ .00 0:42+ .00 0:30+ .00 2:38+ 2:07+ .00 0:88+ .OD 0:45+ .00 0:38+ 0:48+ 0:30+ .00 1:46+ ,OD 6:33+ 0:30+ 3:31+ .QO 1:26+ .00 4:06+ .00 0:30+ 1:16+ .00 0:36+ .00 2:26+ .00 0:52+ .00 0:30+ .00 0:39+ .00 11:01+ .00 1:58+ .88 0:33+ .00 0:30+ 0:30+ .00 0:32+ 0:32+ .00 1:47+ .00 0:30+ .00 1:21+ .00 1:18+ .00 1:46+ .QO 0:53+ 0:3g+ .00 0:30+ 3:36+ .00 0:55+ .00 0:30+ .ao 13:11+ .88 0:30+ .88 0:40+ .00 1:33+ .00 0:30+ .88 0:36+ .00 FISHERS ISLAND FERRY DISTRICT Page 6of8 PO BOX H Account Number 860 442-0165 028 FISHERS ISLE NY 06390 06O7 Billing Date Apr ~5, 2012 at&t Call Charges - Continued ~ Bate T~ Place 1. 3-23 408P FISHERSIS 2. 3-21 307P FISHERS IS 3. 3 28 828A FISHERS IS 4. 3 28 829A FISHERS IS 5. 3-30 1015A FISHERS IS 6. 4-03 12lIP FtSHERSIS 7. 4-03 1214P FISHERS IS 8. 4-03 1217P FISHERS IS 9. 4 03 1223P E~SHERS IS 10. 4 03 229P FISHERS IS 11. 403 246P FISRERSIS 12, 4-04 950A FISBERS IS 13. 4 06 549P FISHERS IS 14. 4-09 905A FISHERS IS 15. 4 10 349P FISDERSIS 16. 4 11 1244P FISHERSIS Total Itemized Calls Total Cbarges for 860 444-0320 CharGes lot 8~6 447-9371 Itemized Calls 17. 3-18 831A FISHERSIS Number NY 631 788 5523 NY 631 788-5523 NY 631 788-5523 NY 631 788-5523 NY 631 788-5523 NY 631 788-8552 NY 631 788-5523 NY 631 788-8552 NY 631 788-5523 NY 631 788-5523 NY 631 788-5523 NY 631 788-5523 NY 631 788-5523 NY 631 788-5523 NY 631 788-5523 NY 631 788-5523 NY 631 788-7857 18. 3-15 911A OLDSAYBRK CT 860304-3425 19. 3-15 600P OLDSAYBRK CT 860388-7642 20. 3-15 604P OLDSAYBRK CT 860388-2642 21. 3-16 922A FISHERS IS NY 631788-7019 22. 3-16 10G3A FISHERS IS NY 631 788-7463 23. 3-19 803A WATERBURY CT 203754-5334 24. 3-19 812A FtSHERSIS NY 631788-7463 25. 3-19 843A FISHERS IS NY 631788-7463 26. 3-19 9~A HUNTINGTON NY 631697-1013 27, 3-19 932A FISHERS IS NY 631788-5673 28. 3-19 1225P FISHERS IS NY 631 788-7463 29. 3-19 123P BRIDGEPORT CT 203913-2013 30. 3-20 841A OLDSAYBRK CT 860304-2195 31. 3-20 1258P FISHERSIS NY 631788-7463 32. 3 20 132P COLCHESTER CT 860537-9113 33. 3-20 208P FISHERSIS 34. 3-21 928A FISHERSIS 35. 3 21 943A FAflMINGDL 36. 3 21 1046A FISHERSIS 37. 3-21 1206P FISHEflSIS 38. 3-21 1207P FISHERSIS 39, 3 21 429P FARMINGDL 40. 3-21 631P HARTFORD NY 631 788-7463 NY 631 788-5545 NY 631 414-5808 NY 631 788-7345 NY 631 788-7463 NY 631 288-7345 NY 631 414-5808 CT 868 573-3957 41. 322 858A BRIDGEPORT CT 203913-2013 D 42. 3-22 1108A FISHERS IS NY 631 788-7857 43. 3-22 1116A WlNOSORLKS CT 860668-0044 D 44. 3-22 1124A FISHERS IS NY 631 788-1345 1 45. 3 22 406P FISHERS IS NY 631 788-7463 1 Call Charqes - Continued No. Date Time Place Number 46. 3-22 506P FISHERS IS NY 631788-7463 47. 3-23 934A FISHERS IS NY 631 788 7455 ~n 48. 3-23 934A FISHERS IS NY 631 788-7463 0:42+ .03 49. 3-23 1009A SEARSPORT ME 207 548-6302 0:30+ .02 50. 3-23 1144A FISHERS IS NY 631 788 7345 0:30+ .02 51. 3-23 1240P FISHERS IS NY 631 788-7463 2:31+ .11 52. 3-23 332P FISHERS IS NY 631 788-7345 0:32+ ,02 53. 3 23 355P NEW HAVEN CT 203 468-4503 0:32+ .02 54. 3-23 449P FISHERS IS NY 631 788-7463 1:01+ .04 55. 3-23 5~6P PROVIDENCE RI 401 556-4196 0:32+ .02 56, 3-25 222P OLOSAYBRK CT 86038~-1224 0:30+ .02 57. 3-26 1028A FISHERS tS NY 631 788 7463 1:49+ .0~ 58. 3-26 1052A FISHERS iS NY 631 788-7919 0:44+ .03 59. 3-26 1140A GREENWICH Ri 401884-2460 0:49+ ,04 60. 3-26 118P NEWHAVEN CT 2034684503 1:30+ ,06 61. 3-27 932A FISHERS IS NY 631 788 5673 0:30+ .02 62. 3-27 1231P BELLOWSFLS VT 802376-6848 0:44+ .03 63. 3-27 336P FISHERS IS NY 631 788 7311 0:30+ .02 64. 3-27 337P FISHERS IS NY 631 788 7716 .12 65. 3-27 349P RIVERHEAD NY 631871-2885 .72 66. 3-28 1138A FISHERS IS NY 631 788-7345 67. 3-28 115OA FISHERS IS NY 631 788-7221 68. 3-29 806A FISHERS IS NY 631788-7463 69. 3 29 111P FISHERS IS NY 631 788-7227 0:30+ .02 70. 3-29 588P FISHERS IS NY 631 788-7463 2:17+ .10 71. 3 30 1208P FISHERS IS NY 631 788-5550 0:30+ .02 72. 3-30 222P FISHERS IS NY 631 788-7463 1:18+ .06 73. 3-31 1148A FISHERS IS NY 631 788-7919 0:44+ .03 74. 3-31 1150A FISHERS IS NY 631 788-7919 2:25+ .10 75. 4-02 824A FISHERS IS NY 631 788-7345 0:30+ .02 76. 4-02 1132A NEWHAVEN CT 203777-3601 2:30+ .11 77. 4-02 11BP FISHERS IS NY 631 788-7463 5:47+ .25 78. 4-03 956A FISHERS IS NY 631 788-119~ 6:50+ 29 79 4-03 1022A HARTFORD CT 860424-3620 2:31+ .11 80. 4-03 1146A LINDENHST NY 631 225-3066 3:38+ .16 81. 4-03 1151A HARTFORD CT 8609~6-7634 0:30, .02 82 4-03 1259P FISHERS IS NY 631788-7463 1:28+ .06 83 4-03 159P SEAflSPORT ME 207 548 6302 1:20+ .06 84. 4-03 203P NARRAGNSTT RI 401 289-3964 0:32+ .02 85. 4 04 1107A FISHERS IS NY 631 788-7632 0:30+ .02 86. 4-04 100P FISHERS IS NY 631 788-2919 6:29+ .28 87. 4-04 644P FARMINGDL NY 631414-5844 0:30+ .02 88. 405 955A HARTFORD CT 8605944816 0:48+ .03 89. 4-05 957A FISHERS IS NY 631 188-7463 0:30+ .02 90. 4-05 1122A FARMiNGDL NY 631 414-5808 1:05+ .05 91. 4-05 1157A EARMINGDL NY 631414-5825 10:06+ .43 92. 4-05 1242P FISHERS IS NY 631 788-7463 16:40+ .72 93. 4-06 1138A NORFOLK VA 757 353-9~42 0:30+ .02 94. 4-06 1238P NEWHAVEN CT 203468-4509 0:45+ .03 95. 4-06 1240P FISHERS IS NY 631 788-1463 4:14+ .18 96. 4-06 1251P FISHERS IS NY 631 788-7716 0:40+ ,03 97. 4-06 1254P RUTLAND VT 802 773-8777 0:30+ .02 98. 4-09 1238P FARMINGDL NY 631 414-5825 Code Min 14:38+ .63 0:31+ .02 4:19+ .19 11:03+ .48 0:30+ 02 0:58+ .04 0:38+ .03 O 0:56+ .04 1:25+ .06 0:35+ 03 2:04+ ,09 1:33+ .07 0:41+ .03 2:31+ .11 D 5:40+ .24 0:30+ .02 0:30+ .02 0:30+ .02 0:44+ .03 3:55+ .17 0:46+ .03 1:05+ .05 2:00+ .09 0:46+ .03 11:55+ .51 2:29+ .11 7:40+ .33 0:47+ .03 0:30+ .02 0:30+ .02 D 4:16+ .18 I 1:14+ 1 0:30+ D 1:50+ .(~ 1 1:08+ .05 O 2:19+ .10 1 2:29+ .11 I 3:12+ .14 1 1:11+ .05 1 5:26+ .23 1 0:30+ .02 2 0:41+ .03 D 1:25+ .06 I 6:09+ .26 1 2:56+ ,13 1 0:43+ .03 1 0:30+ .02 t 0:30+ .02 B 0:33+ .02 1 0:39+ .03 1 2:11+ .09 1 1:09+ .05 I 2:25+ .10 6187.0~7.081671.03.04.~ NNNNNNNY 32419. t24551 FISHERS ISLAND FERRY DISTRICT Page 5 et 8 at&t ,o.x, ,_.,._, FISHERS ISLE NY ~6390-0607Billino Data Apr 15, 2012 Call Cha~es - Co.tinued Item No. Date Time Place I, 4-12 033A FISHERSIS 2, 4-12 85OA FISHERS IS 3. 4-12 936A FISHERSIS 4. 4-12 081A FISHERSIS 5. 4-12 1008A MALDEN Number NY 631 788-7463 NY 631 78~ 7422 NY 631 788-7483 NY 631 788-7422 MA 781 322-7880 6. 4-12 1053A ALLENTOWN NJ 6092598900 7. 4-12 II00A MALDEN MA 781322~7030 8. 4-12 III1A FISHERSIS NY 631788-7919 9. 4-12 1115A FISHERSIS NY 631788-7345 10. 4-12 1156A STAMFORD CT 2036740600 11. 4-12 102P FISHERSIS NY 631788-5655 12. 4-12 102P POUGHKEPSI NY 845656-1677 13. 4-12 104P CAMBRIDGE MA617806-1087 14. 4-12 138P STAMFORD CT 203674-0800 t5. 4-12 205P ALLENTOWN NJ 609259-8900 16. 4-12 513P SAIJGUS MA617529-0866 17. 4-12 516P MIDDLETOWN CT 860635-4125 18. 4-13 738A FISHERSIS 19. 4-13 018A ESSEX 20. 4-13 R26A FISHERSIS 21. 4-13 829A FISHERSIS 22. 4-13 831A FISHERSIS 23. 4-13 e46A FISHERS IS 24. 4-13 905A FISHERSIS 25. 4-13 027A COCOA 26. 4-13 943A FISHERS IS 27. 4-13 1014A BETHEL 28. 4-13 1041A FISHERSIS 29. 4-13 1081A FISHERSIS NY 631 7e8-7403 CT 860767-1768 NY 031 788-7326 NY 631 788-7311 NY 631 788-7249 NY 631 788-7463 NY 631 788-7345 FL 321 482-3786 NY 631 788-7463 VT 802 234-9300 NY 631 788-7463 NY ~1 788-7403 30. 4-13 1058A MORRISTOWN NJ 973214-1506 31. 4-13 1220P FISHERS IS 32. 4-13 1223P CHINO 33. 4-13 118P CAMBRIDGE 34. 4 13 212P FISHERSIS 35. 4-13 224P FiSHERSIS 36. 4-13 244P HARTFORD 37. 4-13 311P FISHERSIS 38. 4-13 324P HARTFORD NY 631 788-7453 CA gO9 591-7561 MA 617 806-1067 NY 631 788-7345 NY 631 788-7255 CT 860 986-7634 NY 631 78~-7345 CT 860 983-4444 39. 4-13 447P SOUTHINGTN CT 860620-4322 40. 4-13 450P HARTFORD CT 080883-2647 Total Itemized Calls Total Charges for 860 442-0165 Charges for 860 4434851 Itemized Calls 41. 3 15 1011A FISHER$1S 42. 3-16 1101A FISHERS IS 43. 3-16 327P FISHERSIS 44. 3-19 I012A FISHERS IS 45. 3-19 1039A FISHERS IS NY 031 788-5522 NY 631 788~5522 NY 031 788-5523 NY 0331 788-5572 NY 031 788-5522 Code 1 1 1 1 1 0:33+ 0:30+ 11:15+ 1:36+ 5:41+ 1:53+ 3:00+ 0:47+ 0:37+ 1:56+ 0:30+ 0:37+ 0:35+ 0:30+ 2:30+ 1:36+ 1:09+ 0:41+ 1:52+ 0:30+ 0:44+ 0:34+ 6:52+ 0:34+ 1:03+ 2:20+ 1:23+ 0:30+ 2:21+ 26:08+ 1:57+ 5:03+ 1:12+ 0:47+ 0:30+ 6:54+ 0:30+ 0:45+ 2:47+ 1:27+ 0:35+ 0:52+ 0:39+ 0:35+ 0:35+ .O2 .02 .48 .07 .24 .08 .13 .03 .03 .08 .02 .03 .03 .02 .II .07 .05 .03 .08 02 .03 .02 .30 02 .11 .08 02 .10 1.12 .08 .22 .05 .03 .02 .30 .02 .03 .12 .06 7.16 7.16 .03 .04 .03 .03 .03 Call Charges - Continued Item No. Oate Time Plac~ Number 46. 3 19 253P FISHERSIS NY 631 708~0822 47. 3-20 734A FISHERS IS NY 631 788~5523 48. 3-20 925A FISHERSIS NY 031788-7873 49. 3-20 953A FISHERS IS NY 631 788-5522 50. 3-20 235P FISHERS IS NY 631 788-5522 51, 3-21 1015A FISHERS IS NY 031 788-5522 52. 3-21 306P FISHERS IS NY 031788-5522 53. 3-22 1OOSA FISHERS IS NY 031 788-5522 54. 3-22 249P FISHERS IS NY 631 788-5600 55. 3-23 1011A FISHERS IS NY 631 788-0822 56. 3-23 1089A FISHERS IS NY 631 78~-0822 57. 3-23 1134A FISHERS IS NY 631 78~-0822 58. 3-26 1040A FISHERS IS NY 631 788-5522 59. 3-26 301P FISHERS IS NY 631 788 5522 60. 3 27 1050A FISHERS IS NY 631 788-5522 61. 3-27 1148A DARIEN CT 203621-2260 62. 3-27 224P FISHERS IS NY 631788-5522 63. 3-28 1043A FISHERS IS NY 631 788-5522 64. 3-28 256P FISHERS IS NY 631 788-5522 65, 3-29 1046A FISHERS IS NY 631 788-5522 66. 3 30 959A FISHERS IS NY 631 788-5522 67. 3-31 132P FISHERS IS NY 631788-5522 68. 4-02 956A FISHERS IS NY 631 788*5522 69, 4-02 314P FISHERS JS NY 031 788-5522 70. 4-03 1019A FISHERS IS NY 031 788-5522 71. 4-03 3lIP FISHERSIS NY 631788-5522 72. 4-04 1088A FISHERS IS NY 031 788-5522 73. 4-05 1037A FISHERS IS NY 031 78~-5522 74. 4-05 135P FISHERS IS NY 031 788-5522 75. 4-05 258P FISHERS IS NY 631 788-0822 76. 4-06 1053A FISHERS IS NY 631 788-5522 77. 4-06 251P FISHERS IS NY 631 78~-0822 78. 4 09 1048A FISHERS IS NY 631 788-5522 79. 4-09 252P FISHERSIS NY 631 788-0822 80. 4-10 950A FISHERS IS NY 631 788-5522 81. 4-10 251P FISHERS IS NY 631788-5522 82. 4-11 938A FISHERS IS NY 631 788-5522 83. 4-11 237P EISHERSIS NY 631788-5522 84. 4-12 11t3A FISHERS IS NY 631 788 5522 85. 4 12 208P FISHERSIS NY 631788-5522 8~, 4-12 308P FISHERS IS NY 631 788-5522 87. 4-13 1004A FISHERS IS NY 631 788-5522 88. 4-13 305P FISHERSIS NY 631788-5522 Total Itemized Calls Total Charges for 8~0 443-6851 Charges for 860 444-0320 Itemized Calls 89. 3 19 9~5A FISHERS IS NY 631 788-5523 90. 3-20 103P FISHERS IS NY 031 788-5523 91. 3-20 210P FISHERS IS NY 631788-5523 92. 3-21 312P FISHERS IS NY 631 788-5523 93. 3-23 1210P FISHERS IS NY 631 788-5523 Code Mien 0:32+ .02 0:30+ .02 1:52+ .08 0:35+ .O3 0:30+ .02 0:36+ .03 0:31+ .02 0:37+ .03 0:30+ .02 0:30+ .02 0:35+ .03 0:43+ .03 0:35+ .03 0:34+ .02 0:36+ .03 0:32+ .02 0:31+ .02 0:35+ .03 0:32+ .02 0:34+ .02 0:36+ .03 0:30+ .02 0:35+ .03 0:30+ .02 0:36+ .03 0:31+ .02 0:58+ .04 0:37+ .03 1:07+ .05 0:31+ .02 0:35+ .03 0:34+ .02 0:35+ .03 0:34+ .02 0:36+ .03 0:31+ .02 0:38+ .03 0:31+ .02 0:37+ .03 1:08+ .05 0:32+ .02 0:37+ .03 0:33+ .02 1.34 1.34 1 0:56+ .04 1 0:51+ .04 1 0:30+ .02 I 0:30+ .02 I 0:30+ .02 at&t FISHERS ISLAND FERRY DISTRICT Page 7 of 8 PO BOX H Accoant Number 860 442-0165 078 FISHERS ISLE NY 06390-0607 Billing Date Apr 15, 2012 Call Charges - Continued Item No. Date Time Place Number (;ode 1 409 503P COOPERSBG PA 610214-000e 2 f:03+ 2. 410 950A OLDSAYBRK CT 8603881224 O 1:15+ .05 3. 4 11 404P F~SHERS IS NY 631788q463 1 8:28+ .36 4. 4-12 1002A NWYRCYZN01 NY 9179456070 I 2:10+ .09 5. 4-12 159P HARTFORD CT 860289-0268 D 1:14+ .05 6 4-13 IO16A FISHERSIS NY 631 788-7919 I 1:03+ .05 7. 4-13 1202P DEEPRIVER CT 860526-9836 D 0:30+ .02 8. 4-13 1222P PROVIDENCE RI 401952-7554 I 0:41+ .03 9. 4 13 116P PROVIDENCE RI 4OI952-7554 I 0:49+ .04 10, 4 13 249P HARTFORD CT 860 9~9 6964 D 0:30+ .02 II. 4 13 250P HARTFORD CT 8609~9-6964 D 0:43+ .03 12. 4 13 452P MERIDEN CT 203537 3131 D 0:32+ .O2 Total Itemized Calls 9.52 Total Charges for 860 447 9371 9.52 + Optional Calling Plan Key to Calling Codes 1 Peak 2 Off Peak D Day E Evening M Multiple Rate Periods Total Call Charges 4&74 Surcharges and Other Fees AT&T Connecticut 13. Conuecticut F9-1-1 Surcharge-4Lines 14. Conuecticut Service Fund - 4 Lines 15. Universal Service Fund - Loc al(4 @ $1.32) 16. Federal Subscriber Line Charge - 4 Lines Total AT&T Connecticut ATET LD East 17. Federal Regulatary Fee 18. Universal Service Fund - Interstate Total AT&T Long Distance East Total Surcharges and O~er Fees 19. Federal 20. State Sales Tax Total Taxes Total Plans and Services 1.20 .20 5.28 23.0~ 29.76 .40 4.77 5.17 34.93 3.44 12.91 16.35 280.67 PREVENT DISCONNECT If your bill shows a past due amount, BOTH the Past Due amount and Current Charges are due IMMEBIATELY. All of your bill charges must be paid each month to keep your account current and avoid collection activities (See Terms and Conditions for further information). However, to avoid disconnection of local service, Basic Charges MUST be paid, For this account, that amount is: $150.56 for Current Basic Charges $0.00 for Past Due Basic Charges CARRIER INF0 Our records indicate that AT&T Connecbcut is your carrier for instate calls. AT&T Long Distance East is your carrier for interstate and international calls. KEEP YOUR DISCOUNT You receive any discounts, reduced rates, or promotional credits de scribed in the AT&T Benefits section of the bill because you subscribe to certain required services, for example, because you are an ALL DISTANCE® customer. If you remove any of the services required for a particular discount, reduced rate, or promobonal credit, your effective rate for the associated remaining service will change. Please call your AT&T service representative if you have any quesbons. IMPORTANT LB CHANGES Thank you for being a valued AT&T customer. Effective June 12, 2012, the minimum usage charge for customers who do not subscribe to a long distance plan will increase from $7.50 to $12.50. The minimum usage charge only applies to customers who have not chosen a long distance calling plan. For more inthrmation or to discuss available long distance plans, call the toll tree number on your bill or visit us online at www.attcom. BASIC CHARGES Basic Charges are charges for Basic Services. Basic Services include local service and in-state toll if you are an AT&T Connecticut local service customer, Basic Charges include: Monthly Charges for your local line and other services, such as Totalphone and Smartiink; in-state Calling Charges; in-state Directory Assistance Charges; the Connecticut E 91f Surcharge; the Connecticut Service Fund fee; the Federal Subscriber Uue Charge; and the Universal Service Fund - Local fee. NON GASIC CHARGES Non-Basic Charges are charges for Non-Basic Services. These charges include: Call Charges for out of state calls, 900 calls and calls placed through alternative services providers; Call Charges for in state long distance provided by a company other than AT&T Connecticut, out of state Directory Assistance Charges; charges for telephone equipment and inside wire maintenance, AT&T Voice Mail, AT&T Unified Messaging, AT&T High Speed Intarnet, Wireless, AT&T I DISH Network, AT&T I DIRECTV, Advertising iff the white page directories or other media; and tire Universal Service Fund - Interstate fee. FISHERS ISLAND FERRY DISTRICT Page g of 8 PO BOX H Account Number 860 442-0165 078 ' at t FISHERS ISLE NY 0639(3-0607 Billing Date Apr 15, 2012 CHARGES THAT MAY BE BASIC OR NON-BASIC Certain charges may be either Basic or Non-Basic, depending on the associated service. These include taxes, Late Payment Charges, Collection Charges. and Additions and Changes to your service. BILL PAYMENT, LATE PAYMENT CHARGES AND OTHER FEES Failure to pay any portion of your bill may result in additional collection action. Any partial payment made will first he applied to Basic Charges, then to Non-Basic Charges. Failure to pay your Basic Charges will result in interruption of your local service. If you fail to pay your Non-Basic Charges, your AT&T Connecticut local service will not be interrupted, but all of your Non-Basic services will be terminated. AT&T Connecticut may apply a late payment charge per month on any unpaid balance, excluding the previously assessed late payment charges. To avoid a late charge, we must receive payment for H~e total amount due no later than the date specified on your bill statement. AT&T Connecticut will apply a $20.00 Collection Charge on an account where a termination notice has been sent. An explanation of these charges may he obtained by calling AT&T Connecticut atthe number shown oa your bill or accessing our website: http://www, att.com/ctbillglossary AT&T SERVICES Local and in state long distance services, inside wire, rental sets, and voice mail services (except where shown as provided by AT&T Messaging) are provided by AT&T ConnecticuL Out of state long distance is provided by AT&T Long Distance East. brtemet services are provided by AT&T luternet Services. Wireless services are provided by AT&T Mobility. 61 g7.007.081671.04.04.0000(3(30 NNNNNNNY 32421.124553 FISHERS ISLAND FERRY DISTRICT VENDOR 002665 ROBERT R. BROOKS II 05/08/2012 CHECK 436 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5712.4.000.000 033112 '12 COMM.MTGS-6 @ $50 300.00 TOTAL 300.00 Town of Southold, New York - Pa, Vendor Tax ID Number or Social Security Number :VendorNol 'merit Voucher Vendor Address P.O. Box 306 Fishers island, NY 06390 Cheek No. Entered by ,,~ Robert R. Brooks, II Vendor Telephone Number Vendor Contact Number Date Not Amount Claimed ~r ¢)'~ I / C~ 3/31/2012 300.00 Invoice Total Discount 300.00 ] 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 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. Audit Date Purchase Order Number Description of Goods or Services Commission Meetin~l 6 Mt~ts ~ $50/mt~l General L~dg~' Fund mad Account Number 8M5712.4.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Signature Title FISHERS ISLAND FERRY DISTRICT VENDOR 002789 DAVID C BURNHAM II 05/08/2012 CHECK 437 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5712.4.000,000 033112 '12 COMM MTGS 7 @ $50 350,00 TOTAL 350.00 Town of Southold, New York - Pal ment Voucher Vendor Tax ID Number or Social Security Number David C. Burnham, II q Vendor Telephone Number Invoice Invoice Vendor Yendor Address P.O. 8ox 335 FI,h,ra Island, NY 05390 Purchase Order Vendor Contact invoice Net Check No. Entered by Audit Date HAY 0 8 2012 Number Date Total 313112012 350.00 Payee Certification Discount Amount Claimed Number 350.00 The undersigned (Claimant) (Acting on behalf of tbe above named claimant) does hereby certify that the foregoing claim is hue 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. Description of Goods or Services ¢ommia,qonsr Meetlno January-March 2012 7 Mtgs (~ $ 80 Mtg General Ledser Fund and Account Number 8M5712.4.000.000 Department Certification Title Date 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 discrepancies noted, and payment is approve& FISHERS ISLAND FERRY DISTRICT VENDOR 018554~ DIVERS COVE LLC 05/08/2012 CHECK 438 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.200 27179 RP-BOAT INSPECTION 106.35 TOTAL 106.35 Town of Southold, New York - Pa,~ Vendor Tax ID Number or Social Security Number Divers Cove Vendor Telephone Number Vendor No. ~ment Voucher /<~ ~q Vendor Address 7 Essex Plaza E~ex, CT 06426 Vendor Contact Invoice Net Purchase Order Number Total Discount Amount Claime¢ Number 106.35 106.35 Check No. Audit Date MAY 0 8 2012 106'35i I 106.35 Payee Certification The undersigned (Claimant) (Acting on bebolf 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 Description of Goods or Services RP-Boat Inspection General Ledser Fund and Account Number 8M5710.2.000.200 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 w~th the exceptions or discrepancies noted, and payment is approved Dive, rs Cove 7 Essex Plaza Essex CT 06426 P~one: 860-767-1960 Fax: 860-767-3356 Sales Person: 1 - ED R. COURSES & TRIPS - -CHECK OUT OUR WEBSITE: www.diverscove.com Invoice ~27179 4/6/2012 10:45:21 FISHERS ISLAND FERRY DISTRICT #4411 BOX H FISHERS ISLAND, NY 06390 Quantity unit Extended Ord. Del. Description PC Tax Price Price 1 1 LABOR-BOAT INSPECTION/REPAIR- FIRST HOUR R 1 $100.00 $100.00 BOAT/DC3763: NON TA-XABLE: $0.00 TAX3~BLE AMOUNT: $100.00 6.35% Sales Tax: $6.35 TOTAL DUE: $106.35 TOTAL PAID: $0.00 BALANCE DUE (This Invoice): $106.35 FOR FERRY WORK ON SUNDAY, APRIL 1, 2012, IN NEW LONDON. X THANK YOU FOR SUPPORTING OUR BUSINESS! Page: 1 FISHERS ISLAND FERRY DISTRICT VENDOR .02475 KENNETH EDWARDS JR. 05/08/2012 CHECK 439 FI/ND & ACCOUNT P.O.~ INVOICE DESCRIPTION A/~OUNT SM .1930.4.000.000 041812 REIMB.DAMAGED T~BLE 962.47 TOTAL 962.47 ~ T~wn of Southold, New York - Pa, Vendor Tax ID Number or Social Security Number Kenneth Edwards Jr. Vendor Telephone Number ~ment Voucher Fishers Island, NY 06390 [vendor No. Check No. Entered by Audit Date HAY 0 8 2012 Invoice Net Discount Amount Claime~ Invoice Invoice Date Total 4/1812012 962.47 962.47 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is trae 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 Purchase Order Number Dascription of Goods or Services Re-imburaament for damaged coffee table General Ledser Fund and Account Number 8M1930.4.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Signature Title Page 1 of 2 M~in Identit~ To: Soar: Subject: "Restoration Hardware" <WebCS@RestorationHardware.com> <junebug~fishersisland net> Wednesday, April 18, 2012 3:00 PM Restoration Hardware Order Confirmation - Order #: 5088670 Order n5088670 Thank you I'br shopping at Restoration }lardxxare. Your order has been placed. Please save this order confirmation for your Jet,fence. l(.cnncth I dwards Fishers Island Fen3 5 Waterfront Park New London. CI 06320 United States Kenneth Edwards Po Box 67 Fishers lslaa& NY 06390 United States Del Mar Coffee Table Espresso Item #: 64250960 ESP You v, ill he contacted to schedule delivcD of this item on or before 05/01/12 Ihis item will ship with other Unlimited Furniture Delivt~D items in your order. We will schedule a delix er3. once all 5'our Unlimited Furniture DelixeD' items are a~.ailable. Price Quantity Total $780.00 I $780.00 Furniture Orders For your convenience, items eligible for / inlimited Farniture Deli,.¢D' are held for a single deli'~ e~. shipping x~hen all items on the order am ax ailabte. Custom orders are made especially for you and ship ,;cparately. Restorarion }lardxx are will retain a deposit for custom orders 24 gouts after order placement. With thc exceptmn or' mmttt[acturer defects or damages, this deposit cannot be Subtmal Handling & Monogram Sales Tax Total 4/24/2012 FISHERS ISLAND FERRY DISTRICT VENDOR 005289 CHRISTOPHER EDWARDS 05/08/2012 CHECK 440 FLrND & ACCOUNT P.O.~ INVOICE DESCRIPTION D24OUNT SM .5712.4.000.000 033112 '12 COMM MTGS-6 @ $50 300.00 TOTAL 300.00 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Add~ess Christopher I. Edwards P.O. Box 167 wnfior Fishers Island, NY 09390 Vendor Telephone Number Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number 0 %/23;31;2012 3oo.oo 300.00 Check No. Entered by Audit Date MAY Q.,8,,~IZ., Payee Certification The undersigned (Claimant) (Acting on behalf of tbe above named claimant) docs hereby certify that the foregoing claim is true and correct, that no part ha~ been paid, except ~s therein stated, that the balance therein stated is actually due and owing, and that taxes fi-om which the Tovm is exempt are excluded Signature Company Name Description of Goods or Services Commissioner Meetlnos /6 Mt~ls ~ $ $0/mtfll January - March 2012 General Ledser Fund and Account Number SM57t 2.4.000.000 Department Certification I hereby certify that the materials above specified have been received by mc in good condition without substitution, thc services properly performed and that thc quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Page 1 of 1 Whitecavage, Diana From: Gordon Murphy [GMurphy@fiferry.com] Sent: Thursday, May 03, 2012 12:05 PM To: Whitecavage, Diana Cc' Deb Doucette Subject: RE: Christopher Edwards voucher Diana, Strike "2". It should read "6 mtgs @ $50...." Gordon From: Whitecavage, Diana [mailto:diana.whitecavage@town.southold.ny.us] ~ent: Thursday, May 03, 2012 12:02 PM To: Gordon Murphy Cc: manager@fishersisland.net Subject: Christopher Edwards voucher Dear Gordon, Please see the attached voucher. The description has "26 mtgs @ $50/mtg" January-March 2012. The amount being charged on voucher is $300.00. The amount charged does not fit the description listed. Please advise how the voucher should read and which amount to charge. Thank you, Diana 5/3/2012 FISHERS ISLAND FERRY DISTRICT VENDOR 005414 ELECTRICAL WHOLESALERS, INC. 05/08/2012 CHECK 441 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710.2.000.000 S021710218 RP/MU LIGHT BULBS 93.35 TOTAL 93.35 Town of Southold, New York - Pa, Vendor Tax ID Number or Social Security Number Vendor Name Electrical Wholesalsm Inc. Vendor Telephone Number Vendor Contact Number S0217t0218 Invoice Date 4/1612012 Invoice Total 93.35! Discount 93.35 93.35 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is trae 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 ~ment Voucher Vendor Address Lockbox 9761 P.O. Box 8500 Philadelphia, PA 19178-9761 Net Purchase Order iAmount Claime¢ Number 93.35 Vendor No. 5414 Check No. , Entered by Audit Dute /.~_o MAY ~ ~ 2,D,~,2 . Description of Goods or Services RP/MU Li~lht Bulbs General Ledger Fund and Aecoum Number 8M67t 0.2.000.000 Department Certification I hereby certify that the materials above specified have been received by me m good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. ELECTRICAL WHOLESALERS INC. P.O. BOX 261797 HARTFORD, CT 06126-1797 1-800-522-3232 Branch: 163 STATE PIER ROAD NEW LONDON,CT 06320 860/443-4381 1971AB0.374 EO197X 104§6D46§708160P10456950001:0001 h",.,h.,,l"ql,.Ihhl",.ll, PpHIq.dd.thql., FISHERS ISLAND FERRY DI PO BOX H FISHERS ISLAND NY 06390-0607 INVOICE Invoice #: S021710218.000 Invoice Date: 04116/2012 Account #: 28370-SHOP Ticket #: B93265 Please Remit AII Payments To: Electrical Wholesalers, Inc Lockbox# 9761 PO Box 8500 Philadelphia, PA 19178-9761 VISIT US AT: www. usesi.com/ew SHIP TO FISHERS ISLAND FERRY TER Customer COUNTER P/U at: NEW LONDON, CT 06320 6 24 48 -120V-4478 QTZ 4-1/2" 3EL 100NRS-120V A21 RS LAMP *12PK* ~EL 60A-120V IF A19 MED LAMP+ 25.4z NEWI View, print, download and pay your invoices with ease using Electrical Wholesaler's new Invoice Gateway. Electrical Wholesalers continues to service our customers by now allowing easy online access to all your invoices and statements in one convenient location. Please visit the web address at the bottom of this page and use your unique enrollment token to begin experiencing the benefits of this great new service. I I I * PAYMENT IN FULL IS DUE BY MAY 25TH * L SUB-TOTAL 87.7~ TERMS OF SALE SPECIAL ORDERED NON-STOCK MERCHANDISE CANNOT BE RETURNED FOR CREDIT. NO MERCHANDISE CAN BE RETURNED FOR CREDIT WITHOUT AUTHORIZATION A M~NIMUM 30% RESTOCKING CHARGE DEDUCTED FROM ALL RETURNED MERCHANDISE ORIGINAL INVOICE NUMBER MUST ACCOMPANY ALL CLAIMS A SERVICE CHARGE OF 1-1i2% PER MONTH, WHICH IS THE EQUIVALENT OF 18% PER YEAR (OR AT SUCH A HIGHER RATE AS SHALL BE ALLOWED BY LAW) ON ALL PAST DUE BALANCES. REASONABLE ATTORNEY'S FEES, COURT FEES. AND OTHER COLLECTION COSTS MAY BE ADOED TO DELINQUENT ACCOUNTS. NO OISTRIBUTOR WARRANTIES UNLESS OTHERWISE SPECIFIED IN WRITING. AS VENDOR OF THIS ARTICLE(S), WE MAKE NO WARRANTIES OR REPRESENTATIONS, EXPRESSED OR iMPLIED, AS TO WORKMANSHIP, PERFORMANCE, QUALITY, DURABILITY, FITNESS, OR MERCHANTABILiTY, THE ONLY WARRANTIES APPLYING TO THE ARTICLE(S) SOLD HEREUNDER ARE THOSE SPECIFICALLY PROVIDED IN WRITING BY THE MANUFACTURER A USE~ Company 0001:0001u~'~''i~ ...... INVOICEGATEWAY:http:llewinc.billtrust.com WebEnrollmentToken: VMVDKXFVX Page 1 of 1 ORDER DATE CUSTOMER P O NUMBER SHIP VIA FREIGHT CHARGE TYpE FREIGHT 0a,/16/1?~ ~ i~AINT C['iUhWEF: P/Ii ,~ o~ 04,16.'12 10',1,~': ~h ':-"~3._t~"~"°.~., 0~0~-~ 0 I S604420165 28~70'-SHOF' 90I 65,1 CT 6 WhF',EHSi w~.~' .... ' ~' a ~ d o ~ ,,:% G: 14,o~ GEL i~.A, Rc-1 .... h2J. F;S Lr~HF' ~i2F'E: .... 0 N 04316818275 0EL zr,'~-~'O A ¢ :. L aHF'~ 4E ,, 0 ,5c =5,4.~ 043 ! 6 S 4 J. 0 '26 END OF ]R[IEF; , PACKING SLIP "''~ " TERMS OF SALE SPECIAL ORDERED NON-STOCK MERCHANDISE CANNOT BE RETURNED FOR CREDIT. NO MERCHANDISE CAN BE RETURNED FOR CREDIT WITHOUT AUTHORIZATION, 30% RESTOCKING CHARGE DEDUCTED FROM ALL RETURNED MERCHANDISE. ORIGINAL INVOICE NUMBER MUST ACCOMPANY ALL CLAIMS, A SERVICE CHARGE OF 1-1 1/2% PER MONTH, WHICH IS THE EQUIVALENT OF 18% PER YEAR. (OR AT SUCH A HIGHER RATE AS SHALL BE ALLOWED BY LAW) ON ALL PAST-DUE BALANCES. REASONABLE ATTORNEY'S FEES, COURT FEES, AND OTHER COLLECTION CO~]~ MAY t¢b ADDED I r~ DELINL~UbNI ACL;OUNtU. NO DISTRIBUTOR WARRANTIES UNLESS OTHERWISE SPECIFIED iN WRITING. AS VENDOR OF THIS ARTICLE(S), WE MAKE NO WARRANTIES OR REPRESENTATIONS, EXPRESSED OR IMPLIED, AS TO WORK- MANSHIP, PERFORMANCE, QUALITY, DURABILITY. FITNESS OR MERCHANTABILITY. THE ONLY WARRANTIES APPLYING TO THE ARTICLE(S) SOLD HEREUNDER ARE THOSE SPECIFICALLY PROVIDED IN WRITING BY ~'HE MANUFACTURER. ATTENTION: CASH RETURNS 1. ALL RETURNS MUST BE WITHIN 7 DAYS AND BE ACCOMPANIED BY THE INVOICE. 2. A 30% HANDLING CHARGE OR $300 WHICHEVER IS GREATER ON ALL MERCHANDISE. NO SPECIAL ORDERS OR CUT WIRE CAN BE RETtlRNED 3. MERCHANDISE REFUNDED ONLY - NO CASH. FISHERS ISLAND FERRY DISTRICT VENDOR 005442 EMPIRE DENTAL 05/08/2012 CHECK 442 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 4832995 DENTAL PREMIUM-5/12 1,263.48 TOTAL 1,263.48 Town of Southold, New York - Pal 'ment Voucher Vendor Tax ID Number or Social Security Number Empl'~e F/eoJ+h oho;ce ~ss~ rcmce Empire Dental Vendor Telephone Number Vendor Contact Number Date Invoice Total i Vendor No. P.O. Box 202837 Department 83703 Dallas, TX 75320-2837 Discount 4832998 4/14/2012 1,263.48 I ; 1,263.48 Net ~mount Claimed 1,263.48 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 par~ 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 Purchase Order Number Check No. Entered by Audit Date Description of Goods or Services May Dental General Led[er Fund and Account Number 8M9060.8.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Signature Title Emp. jre . . INVOICE PA -E 1 EMPIRE PO BOX 856 MINNEAPOLIS MN 55440-0856 ACCOUNT NAME ACCOUNT # BILLING DATE BILLING/PYMT FISHERS ISLAND FERRY DISTRICT ENY4561251 INVOICE# 4832995 04/14/2012 SUBSCRIBER PERIOD 05/01/2012 - 05/31/2012 877-606-3409 CLAIM PERIOD FISHERS ISLAND FERRY DISTRICT ATTN: ASSISTANT MANAGER DEBBIE DOMCETTE 50 TRUMBULL ST PO BOX H FISHERS ISLAND NY 06390 REMIT TO: EMPIRE DENTAL PO BOX 202837 DEPARTMENT 83703 DALLAS TX 75320-2837 CUSTOMER NUMBER OF NUMBER OF CLAIM ADJUSTMENT RATE TOTAL REPORTING NUMBER CURRENT EMPLOYEES CLAIMS AMOUNT AMOUNT AMOUNT AMOUNT 45B 125 -0001-0001 - 550 1B 300.64 37.58/EE/MO 460.08 76.68/EE/MO 91.89/EE/MO 139,67 139.67/ER/MO 271.20/R E TRO INVOICE TOTAL 16 0 $0.00 $0.00 $1,263.48 $1,263.48 YOUR BALANCE IS DUE BY THE FIRST Of THE MONTH. PLEASE INCLUDE A STATEMENT COPY WITH YOUR PAYMENT. SUBSCRIBER LISTING EMPIRE PO BOX 856 MINNEAPOLIS MN 55440-0856 ACCOUNT NAME ACCOUNT # BILLING DATE ENROLLMENT FISHERS ISLAND FERRY DISTRICT ENY4561251 INVOICE # 04/14/2012 SUBSCRIBER PERIOD 800-928-6459 4832995 05/01/2012 - 05/31/2012 FISHERS ISLAND FERRY DISTRICT ATTN: ASSISTANT MANAGER DEBBIE DOUCETTE 50 TRUMBULL ST PO BOX H FISHERS ISLAND NY 06390 REMIT ENROLLMENT CHANGES TO: EMPIRE PO BOX 838 MINNEAPOLIS MN 55440-0838 ATTN: ENROLLMENT DEPARTMENT CUSTOMER REPORTING NUMBER 456125-0001-0001 FISHERS ISLAND FERRY DISTRICT SUBSCRIBER EFFECTIVE COVERAGE CURRENT RETRO TOTAL LAST NAME FIRST NAME REF # ID DATE TYPE AMOUNT AMOUNT AMOUNT BARRETT FREDERICK N/A 883Ml1083 05/01/2011 EMPLOYEE 37,58 BRDWN DONALD N/A 895M11083 05/01/2011 EMPLOYEE+SPOUSE 76.68 DOHERTY THOMAS N/A 886Ml1083 05/01/2011 EMPLOYEE+SPOUSE 76.68 DUMOUCHEL ROBERT N/A 885Ml1083 05/01/2011 EMPLOYEE+SPOUSE 76.68 FIORA MICHAEL N/A 878M11083 05/01/2011 EMPLOYEE 37.58 FOLEY PAUL N/A 877M11083 05/01/2011 EMPLOYEE 37.58 HILLER dONATHAN N/A 262Ml1092 07/01/2011 EMPLOYEE 37.58 HOCH RICHARD N/A 882M11083 05/01/2011 EMPLOYEE 37.58 KNAUFF ROBERT N/A 884M11083 05/01/2011 EMPLOYEE+SPOUSE 79.88 LEFEVRE RAYMOND N/A 881Ml1083 05/01/2011 EMPLOYEE 37.58 LYNCH MATTHEW N/A 880M11083 05/01/2011 EMPLOYEE 37.58 MARSHALL dEBSE N/A 896M11083 05/01/2011 EMPLOYEE+SPOUSE 78.68 MOROAN dOHN N/A 897M11083 05/01/2011 EMPLOYEE+SPOUSE 76.68 MURPHY GORDON N/A 095M11203 03/01/2012 FAMILY 139.67 MAR12-APR12 271.20 SCHMID NINA N/A 898M11083 05/01/2011 EMP+CHI LD(REN) 91.89 TRAUB dAMES N/A 87BM11083 05/01/2011 EMPLOYEE 37.58 8 INDIVIDUAL 300.64 0.00 300.64 6 EMPLDYEE+SPOUSE 460.08 0.00 460.08 1 EMP+CHI LO(REN) 91.89 0.00 91.89 1 FAMILY 139.67 271.20 410.87 SUBSCRIBER TOTAL FOR HE ABOVE CUSTOMER RE ~ORTING NUMBIR 16 992.28 271.20 1,263.48 SUBSCRIBER LISTING PAcE 2 EMPIRE PD BOX 856 MINNEAPOLIS MN 55440-0856 ACCOUNT NAME ACCOUNT # BILLING DATE ENROLLMENT FISHERS ISLAND FERRY DISTRICT ENY4581251 INVOICE # 04/14/2012 SUBSCRIBER PERIOD 800-928-6459 4832995 05/01/2012 - 05/31/2012 CUSTOMER REPORTING NUMBER SUBSCRIBER EFFECTIVE COVERAGE CURRENT RETRO TOTAL LAST NAME F~RST NAME REF ~ ID DATE TYPE AMOUNT AMOUNT AMOUNT 8 INDIVIDUAL 300.64 0.00 300.84 6 EMPLOYEE+SPOUSE 480.08 0.00 460.08 1 EMP+CH[ LD(REN) 91.89 0.00 91.89 1 FAMILY 139.67 271.20 410.87 GRAND TDTAL FOR ALL TI CUSTOMER REPORTINE NUMBERS 16 992.28 271.20 1,263.48 ENROLLMENT CHANGES MUST BE RECEIVED AT LEAST 5 BUS[NESS DAYS PRIOR TO YOUR SCHEDULED BILL RUN DATE. STATEMENT PAGE I EMPIRE PO BOX 856 MINNEAPOLIS MN 55440-0856 ACCOUNT NAME ACCOUNT # BILLING DATE BILL/PYMT ENROLLMENT FISHERS ISLAND FERRY DISTRICT ENY456125i 04/14/2012 877-606-3409 800-928-6459 FISHERS ISLAND FERRY DISTRICT ATTN: ASSISTANT MANAGER DEBBIE DOUCE 50 TRUMBULL ST PO BOX H FISHERS ISLAND NY 06390 REMIT TO: EMPIRE DENTAL PO BOX 202837 DEPARTMENT 83703 DALLAS TX 75320-2837 TRANSACTION AMOUNT INVOICE TRANSACTION TRANSACTION DUE REFERENCE NUMBER DATE DATE AMOUNT DUE 4832995 04/14/2012 INVOICE 05/01/2012 01/MAY/12-31/MAY/12PREMI'U 1,263.48 1,263.48 CURRENT DUE PAST DUE TOTAL AMOUNT DUE I - 80 DAYS 31 - 60 DAYS 61 - 90 DAYS OVER 90 DAYS 1,288.48 0.00 0.00 0.00 0.00 I , 263.48 AMOUNT REMITTED YOUR BALANCE IS DUE BY THE FIRST OF THE MONTH. PLEASE INCLUDE A STATEMENT COPY WITH YOUR PAYMENT. $ FISHERS ISLAND FERRY DISTRICT VENDOR 005440 EMPIRE HEALTHCHOICE, INC. 05/08/2012 CHECK 443 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 SM .9060.8.000.000 598599-D2-0512 HEALTH INS.PREMIUM-5/12 598599H1S-0512 HEALTH SAV.ACCT-5/12 11,369.44 5,008.71 TOTAL 16,378.15 Town of Southold, New York - Pa, Vendor Tax ID Number or Social Security Number Empire HealthCholce, Inc. Vendor Telephone Number Vendor Contact Invoice Number Discount 598599 Date Total 4/14/2012 11,369.4~1 11,369.44 Payee Certification 'ment Voucher P.O. Box 11744 Newark, NJ 07101-4744 Net Purchase Order Amount Claimec Number 11,369.44 tl,369.44 The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby cerci fy that the foregoing claim is tree and correct, that no parr 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. Company Name Vendor No. 5 qO Entered by Audit Date MAY 0 8 2012 Description of Goods or Services June 1Haalth Ins Pr®mium D2-Emplre Prism EPO 8M9060.8.000.000 Department Certification i hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that thc quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Signature Title DATE BILLED BILLED PERIOD PAYMENT DUE DATE FROM TO 06/16/12 05/01/12 06/01/1~' 05/01/1~' COMMUNZTY RATED GROUP NUMBER SUB GRP, 598599 D2 BILLING TYPE REGULAR BXLL BILLING FREQUENCY MONTHLY BENEFITS CORSU~ANT COMMERCZAL ACCTS GORDON MURPHY FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLE, NY 06390 PAGE: I FOR BILLING INFORMATION: (866) 422-2583 PRIOR BILLING PERIOD PRIOR AMOUNT BILLED PAYMENTS I RECEIVED DATE STATUS ] CURRENT BILLING PERIOD CURRENT AMOUNT BILLED NET ADJUSTMENTS CURRENT DUE ] 05/01/12 - 06/01/12 11,369.44 0.00 11,369.64 THXS XNVOXCE REFLECTS ALL PAYMENTS AND ADJUSTMENTS PROCESSED THROUGH 06/16/12. ANY ADdUSTMENTS PROCESSED AFTER THXS DATE NXLL BE REFLECTED ON A SUBSEQUENT XNVOXCE. PLEASE SEE THE REVERSE SXDE OF THXS PAGE FOR MORE XMPORTANT NOTXCES. To receive proper creci~t, please return the BOTTOM PORTION of this page w;th your payment. NOTICE: AS required by Labor Law, Section 217, Insurance Law, Secbon 4235 and C~ies, Rules and Regulations of the State of New York, Title 11, Insurance, Section 55.2, Empire HealthChoice Assurance, Inc. hereby advises you of certain rights and obligations set forth in these sections. A. All covered members, subscribers and their covered dependents shall be afforded the following rights under the terminating policy: 1. Any claims incurred during the effective dates of the group contract will be processed and adjudicated in accordance with the terms, conditions and prows~ons of said group contract. 2. Additional benefits beyond the termination date of the contract may be available under the termination contract for conditions which result in a total disability, pursuant to the terms, conditions and prows~ons of the terminating group contract. 3. Rights to convert to a direct pay contract between Empire HealthChoice Assurance, Inc. and the covered member, subscriber or certificate holder, providing for coverage which ~s currently offered a direct pay basis, may be available provided the group does not obtain replacement coverage. B. Further, as required by the prows~ons cited above, you, as the policyholder, may be required to meet the following obligations: 1. The policyholder, must give written notice of the intended termination to each certificate holder resident in New York State insured under this group policy by hand-delivering of mailing to the certificate holder a copy of the nohce of termination and covering letter advising the certificate holders of the intended termination. 2. The policyholder's notice to the certificate holder shall be either: a) hand-delivered by the policyholder to the certificate holder at the certificate holder's place of employment (e.g. by including the notice in the certificate holder's pay envelope) at least nine days prior to intended date of termination; or: b) mailed by the policyholder to each certihcate holder at the certificate holder's last known residential address at least nine days prior to the intended date of termination. 3. The policyholder must also post a copy of this notice of intent to terminate and the required covering letter ~n conspicuous locations chosen as most likely to give not,ce to the certificate holders. The notice shall be posted at least nine days prior to the intended date of termination. 4. In accordance with the provisions of Labor Law, Section 217 (4), the prowsions of the Codes, Rules and Regulations of the State of New York, Title 11, Insurance Section 55.2 and Labor Law, Section 217 (3) shall not be deemed to apply if, at least 10 days prior to the date of the intended termination, as specified in the notice of intent to terminate, the policyholder has: a) taken necessary steps whereby the intended termination ~s rendered null and void; or: b) contracted with another insurer to replace the existing insurer for the providing of similar coverage for the same certificate holders, and filed an affidavit with the Commissioner of Labor and Superintendent of Insurance to that effect. Affidavits filed with the Commissioner of Labor shall refer to Labor Law, Section 217, and be addressed to: D~rector of Labor Standards-Department of Labor-Agency Building 12, State Office Bui~ing Campus-Albany, New York, 12240. Affidavits tiled with the Superintendent of Insurance shall refer to Labor Law, Section 217 and the Codes, Rules and Regulations of the State of New York, T~tle 11, Insurance, Section 55.2 Part, and shall be addressed to: Chief, Health and Life Policy Bureau New York State Insurance Department-Agency Building 1-AlOany, New York 12223. IMPORTANT NOTICES Ful._.~l payment of this invoice is required in order to avoid termination of your coverage. If you have any individual adjustments that require processing, please use the attached Adjustments Worksheet. Do NOT increase/reduce your payment of this invoice on the bails of the adjustments detailed on the worksheet. Your next invoice will show any credits allowed or additional charges due as a result of processing the adjustments. Payment of this invoice is due upon recdipt. Please pay promptly, as no reminder notice will be sent. If payment is not received within the 30-day grace period, your coverage will AUTOMATICAI,LY BE CANCEI,I,ED as of the date to which premiums have been paid. Empire is not fmancially responsible for claims incurred beyond the premium paid to date. In order to ensure proper crediting of your payment, you must mail your remittance to the address appearing on the face of this invoice. Sending payments to any other address may delay processing and cause your coverage to be tem'anated. Gr. oup Number: 598599 D2 Group Name: FISHERS ISLAND FERRY Sill Period: 05101112 To 06101/12 Payment Due Date: 05/01112 Prepared Date: 04/14112 INDIVIDUAL DETAIL EXPLANATION OF CHANGE TYPE CODES: PAGE: 2 SUB INDIVIDUAVS :ONT CHANGE INDIVIDUAL'S NAME GRP IDENTIFiCATiON NO)KG rYPE TYPE ADJUSTMENT PERIOD AMOUNT DUE Empire HealthChoice Assurance, Inc BARRETT FREDERICK 88886607 001 12 568.82 BRO#N DONALD 85377836 001 15 1,136.48 BURKE STEPHEN G 85515734 001 12 568.82 DOHERTY THOHA$ 88240378 00! 15 1,136.48 DUHOUCHEL ROBERT H 85785679 001 15 1,136.48 EASTER HARK B 88955198 001 12 568.82 HILLER JONATHAN ! 84838644 001 12 568.82 HOCH RICHARD 88742559 001 22 568.82 LEFEVRE RAYHOND 86638861 001 12 568.82 NARSHALL JESSE 89420041 001 15 1,136.48 NORGAN JOHN E 87023977 001 14 1,704.14 RICKER KENNETH H 88006302 001 12 568.82 SCHHID NXNA 89633561 001 12 568.82 TRAUB dAHES G 8?.517144 001 12 568.82 PAGE TOTAL: 11,369.44 TOTAL CURRENT ANOUNT PLUS CHANGES: 11,369.44 BALANCE DUE FROH PRXOR DXLL(S): 0.00 TOTAL AHOUNT DUE: 11,369.4& Group Number: 598599 D2 Group Name: FISHERS ISLAND FERRY Bill Period: 05/01112 To 06101/12 Payment Due Date: 05101112 Prepared Date: 04114112 PAGE: CONTRACT / RATES / COUNTS SUMMARY GROUP / PACKAGE CONTRACT TYPE RATE COUNT 598599 D2 / 001 12 5&8.82 8 14 1,704.14 1 15 1,136.48 22 568.82 1 PACKAGE SUB TOTAL GROUP TOTAL PLEASE SEE REVERSE OF THXS PAGE FOR A SUNNARY OF COVERAGE DESCRXPTIONS CONTRACT TYPE TOTALS CONTRACT TYPE S~NGLE THO PERSON FANZLY GRAND TOTAL NO. OF CONTRACTS 9 4 I 14 GROUP / PACKAGE DESCRXPTXON OF COVERAGE 598599 D2 / 001 EHPZRE PRZSfl EPO CARVEOUT EHPZRE PRZSH EPO HANAGED CARE DRUG AND VZSZON Town of Southold, New York - Pa; Vendor Tax ID Number or Social Security Number Empire HealthChoice Assurance, Inc. Vendor Telephone Number Vendor Contact ~ment Voucher !Vendor No. P.O. Box 11744 Newark, NJ 07101-4744 Check No. Number Net Discount Amount Claimed Invoice Invoice Date TotaI 4/14/2012 5,008.71 Payee Certification 598599 5,008.71 The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~ 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 ~xes from which the Town is exempt are excluded Signature ~.~-~Title. ~ Purchase Order Number Entered by ~ Audit Date ~IAY 0 8 201/. Description of Goods or Services Health Savings Accounts Ma¥12012 Premium Hsl General Led[er Fund and Account Number $M9060.8.000.000 Department Certification 1 hereby certi~ 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 discrepancies noted, and payment is approved. Title Date COMHUNXTY RATED 3ROUP NUMBER SUB GRP. 598599 HIS BILLING TYPE REGULAR BXLL BILLING FREQUENCY MONTHLY BENEFITS CONSU~ANT COMMERCXAL ACCTS 05/01/1:* 06/01/12 GORDON MURPHY FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLE, NY 06390 PAGE: I FOR BILLING INFORMATION: (866) 422-2583 PRIOR BILLING PERIOD PRIOR AMOUNT BILLED PAYMENTS I RECEIVED DATE STATUS CURRENT BILLING PERIOD CURRENT AMOUNT BILLED NET ADJUSTMENTS I CURRENT DUE ~ ~ 05/01/1:* - 06/01/12 :*,:*77.53 2,731.18 5,008.71 THZS ZNVOZCE REFLECTS ALL PAYMENTS AND ADJUSTMENTS PROCESSED THROUGH 04/1&/12. ANY ADJUSTMENTS PROCESSED AFTER THZS DATE #ZLL BE REFLECTED ON A SUBSEQUENT ZNVOZCE. RATES ZNCLUDE AN EMPZRE TOTAL BLUE(SM) ADMZNZSTRATZON FEE FOR ALTERNATE FUNDXNG ARRANGEMENTS (HRA/HSA). THE COST OF PROVXD~NG THE MENTAL HEALTH BENEFZTS REqUiRED BY "TZMOTHY~S LAH", STARTING ZN 2007, ZS ESTXMATED TO BE ~:*.68 PER MEMBER PER NONTH. "MEMBER" MEANS EACH COVERED EMPLOYEE, SPOUSE AND DEPENDENTS. THZS AMOUNT ZS FULLY SUSS~DZZED BY N.Y. STATE AND ~S EXCLUDED FROM THE AMOUNT BZLLED TO YOU. THE SUBSZDY AMOUNT REFLECTED ON YOUR DXLL [S SUBJECT TO ANNUAL REV~EN BY THE NEM YORK STATE ~NSURANCE DEPARTMENT BEGiNNiNG EACH YEAR ON MARCH 31ST. THE NEM RATE NXLL BE REFLECTED ONCE APPROVED. PLEASE SEE THE REVERSE SXDE OF THXS PAGE FOR MORE XMPORTANT NOTXCES. To receive proper cr~t, please return the BOTTOM PORTION of this page with your payment. I~OTICE: As required by Labor Law, Section 217, Insurance Law, Section 4235 and Codes, Ru~es and Regulations of the State · of New York, Title 11, Insurance, Section 55.2, Empire HealthChoice Assurance, Inc. hereby advises you of certain r~ghts and obligations set forth in these sections. A. All covered members, subscribers and their covered dependents shall be afforded the following rights under the terminating policy; 1. Any claims incurred during the effective dates of the group contract will be processed and adjudicated in accordance with the terms, conditions and provisions of said group contract. 2. Additional benefits beyond the termination date of the contract may be available under the termination contract for conditions which result in a total disability, pursuant to the terms, conditions and provisions of the terminating group contract. 3. Rights to convert to a direct pay contract between Empire HealthChoico Assurance, Inc. and the covered member, subscriber or certificate holder, providing for coverage which is currently offered a direct pay basis, may be available provided the group does not obtain replacement coverage. B. Further, as required by the prowsions cited above, you, as the policyholder, may be required to meet the following obligations: 1. The policyholder, must give written notice of the intended termination to each certificate holder resident in New York State insured under th~s group policy by hand-delivering of mailing to the certificate holder a copy of the notice of termination and covering letter advising the certificate holders of the intended termination. 2. The policyhoIder's notice to the certificate holder shall be either: a) hand-delivered by the policyholder to the certihcate holder at the certificate holder's place of employment (e.g. by including the notice in the certificate holder's pay envelope) at least nine days prior to intended da~e of termination; or: b) mailed by the policyholder to each certificate. holder at the corttficato holder's last known residential address at least nine days prior to the intended date of termination. 3. The policyholder must also post a copy of this notice of intent to terminate and the required covering letter in conspmuous locations chosen as most likely to give notice to the certificate holders. The notice shall be pasted at least nine days prior to the intended date of termination. 4. In accordance with the prows~ons of Labor Law, Section 217 {4), the provisions Of the Codes, Rules and Regulations ot the State of New York, Title 11, Insurance Section 55.2 and Labor Law, Section 217 (3) shall not be deemed to apply if, at least 10 days prior to the date of the intended termination, as specified in the notice of intent to terminate, the policyholder has: a) taken necessary steps whereby the intended termination is rendered null and void; or; b) contracted with another insurer to replace the existing insurer for the providing of similar coverage for the same certihcate holders, and filed an affidavit with the Commissioner of Labor and Superintendent of Insurance to that effect. Affidavits hied with the Commissioner of Labor shall refer to Labor Law, Section 217, and be addressed to: Director of LaOor Standards-Department of Labor-Agency Building 12, 5tare Office Building Campus-Albany, New York, 12240. Affidavits filed with the Superintendent of Insurance shall refer to Labor Law, Section 217 and the Codes, Rules and Regulations of the State of New York, Title 11, Insurance, Section 55.2 Part, and shall be addressed to; Chief, Health and Life Policy Bureau New York State Insurance Department-Agency Building f-Albany, New York 12223. IMPORTANT NOTICES Fall payment of this invoice is required in order to avoid termination of your coverage. If you have any individual adjustments that require processmg, please use the attached Adjustments Worksheet. Do NOT increase/reduce your payment of this invoice on the basis of the adjustments detailed on the worksheet. Your next invoice will show any credits allowed or additional charges due as a result of processing the adjustments. Payment of this invoice is due upon receipt. Please pay promptly, as no reminder notice will be sent. If payment is not received within the 30-day grace period, your coverage will AUTOMATICALLY BE CANCELLED as of the date to which premiums have been paid. Empire is not financially responsible for claims incurred beyond the premium paid to date. In order to ensure proper crediting of your payment, you must mail your remittance to the address appearing on the face of this invoice. Sendmg payments to any other address may delay processing and cause your coverage to be terminated. Group Number: 598599 H1S Group Name: FISHERS ISLAND FERRY INDIVIDUAL DETAIL Bill Period: 05/01112 To 06101112 Payment Due Date: 05/01112 ADD EXPLANATION OF CHANGE TYPE CODES: PAGE: 2 SUB INDIVIDUAL'S CONT CHANGE INDIVIDUAL'S NAME GRP IDENTIFICATION Nc~KG I~PE TYPE ADJUSTMENT PERIOD AMOUNT DUE Empire HealthChoice Assurance, ]nc FZORA HZCHAEL 83054186 001 12 455.97 LYNCH HATTHEg B 88138034 001 12 455.97 HURPHY GORDON 89539930 002 14 ADD 03/01/12 - 05/01/12 E,731.18 89539930 002 14 1,365.59 PAGE TOTAL: 5,008.71 TOTAL CURRENT AHOUNT PLUS CHANGES: 5,008.71 BALANCE DUE FROH PRXOR BXLL(S): 0.00 TOTAL AHOUNT DUE: 5,008.7! Group Number: 598599 HIS Group Name: FISHERS ISLAND FERRY Bill Period: 05101/12 To 06101112 Payment Due Date: 05101112 Prepared Date: 04/14112 PAGE: CONTRACT I RATES I COUNTS SUMMARY GROUP / PACKAGE CONTRACT TYPE RATE COUNT 598599 HXS / OOX 12 455.97 2 PACKAGE SU~ TOTAL 2 598599 H1S / 002 l& 1,365.59 1 PACKAGE SUB TOTAL 1 GROUP TOTAL 3 PLEASE SEE REVERSE OF THXS PAGE FOR A SUNNARY OF COVERAGE DESCRZPTZONS CONTRACT TYPE TOTALS CONTRACT TYPE SZNGLE FANXLY GRAND TOTAL NO. OF CONTRACTS 2 I 3 ALL PACKAGES CONTAZN HSA PARTZCZPATZON GROUP / PACKAGE OESCRZPTZON OF COVERAGE 598599 HXS / 00! COHP PPO SG CARVEOUT CDHP PPO SG HANAGED CARE DRUG AND VZSZON 598599 H1S / 002 CDHP PPO SG CARVEOUT CDHP PPO SG HANAGED CARE DRUG AND VZSZOH FISHERS ISLAND FERRY DISTRICT VENDOR 006155 FEDEX 05/08/2012 CHECK 444 FUND & ACCOUNT P.O.O INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 7-849-40686 AIRBILL-PAYROLL,W~kRR3tNT 115.01 TOTAL 115.01 Town of Southoid, New York - Pai ment Voucher Vendor Tax ID Number or Social Securily Number Vendor Name Fedex Vendor Telephone Number Vendor Contact Vendor No. 6155 Vendor Address P.O. Box 371461 Pittsburgh, PA 15250-746~ -I 2heck No. qqq Entered by a~udit Date '~ M~AY..O Invoice Date Invoice Net Total Discount :Amount Claimed Purchase Order Number Description of Goods or Services 7-849-40686 419/2012 1t5.01 115.01 Airbills-Payroll,Warrant Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby cerd fy that the foregoing claim is trae 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. Company .amc / 8M6710.4.000.000 Department Certification 1 hereby certify that the materials above specified have been received by me in goal condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and paymem is approved Invoice Number 7-849-40§86 Invoice Date Apr09,2012 '~1 Account Number 1206-03:]4-5 %~ ~a°~a5 Fed£xTaxlD: 7%0427007 Billino Address: FISHERS ISLAND FERRY DISTRICK NINA SCHMID/TOM DOHE PO BOX H FISHERS ISLAND NY 06390-0607 Invoice Summary Apr 09, 2012 Shippin§ Address: FISHERS ISLAND FERRY TERMINAL FERRY TERMINAL NEW LONDON CT 06320 Invoice Questions? Contact FedEx Revenue Services Phone: (800) 622-1147 M-Sa 7-6 (CST) Fax: (800) 548-3020 Internet: www.fedex.com FedEx Express Services Transportation Charges Base Discount Special Handling Charges Total Charges TOTAL THIS INVOICE You saved $13.88 in discounts this period Other discounts may apply. USD USD 138.65 -13.88 27.42 $152.19 $152.19 Detailed descriptions of surcharges can be located at fedex.corn Adjustment Request Fax to (800) 548-3020 Invoice Number 7-849-40686 ~ I Invoice Date %I Account Number ~ Page Apr 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 vvvvvv.fedex.com or calling 800.622.1147. P ease use mu t p e forms for add t ona requests. Please complete all fields in black ink. ~ RequestorNamel I I I I I I I I I I I I I I I I I I I I I I I I I I I Datel I I/I I I/I I I~ Phone IIII-I I I I-I I I I I Fax#1 I I I-III I-I I I I I E-mail Address [] Yes, I wantto update account contact with the above information. Tracking Number I I I I I I I I I I I I I I I ~1 I I III I I I I I II Ill Bill to Account Illlllllll Illlllllll Illlllllll IIIIIIIIII $ Amount I I I I I I.I I I I I I I I I,I I I I I I I I I-I I I I I I I I I.I I I I I I I I I,I I I ADR - Address Correction DVC - Declared Value lAN - Invalid Acct # INW -incorrect Weight INS - Incorrect Service OCF - Grd Pick-up Fee OCS - Exp Pick-up Fee OVS - Oversize Surcharge RSU- Residential Delivery PND - Pwrshp Not Delivered SDR - Saturday Delivery For all Service failures or other surcharges please use our web site wv~v.fedex.com or call (800) 622-1147 Tracking Number Code $ Amount i!~!il I I I I I I I I I I I I I I I I I I I I I I I I Iol I I Rerate information only (round to nearest inch) LBS L W H i I II I I Ixl I I Ixl I I i I II I I Ix1 I I Ixl I I I I II I I Ixl I I Ixl I I I I II I I Ixl I I Ixl I I Invoice Number 7-849-40686 FedEx Express Shipment Summary By Payor Type FedEx Express Shipments (Original) InvoiceDate'~ AccountNumber '~ Apr 09, 2012 1206-0334-5 Page 3of5 Shipper 3 7.0 Recipient 3 3.0 71.45 19.56 -7.16 67,20 7.86 -6,72 83.85 68.34 Total This Invoice USD $152.19 Account Number '~ Page 1206-0334-5/ 4 of 5 Invoice Number 7-849-40686 FedEx Express Shipment Detail By Payor Type (Original) invoice Date Apr 09, 2012 PuelSurcharge FedExhasappliedafuelsurchargeof1300%tothisshipment. Distance Based Pricing, Zone 2 PedExhas 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 Pek. Sentier DEBBIE DOUCETTE FISHERS ISLAND FERRY TERMINAL FERRY TERMINAL NEW LONDON CT 06320 US Automation USAB Tracking ID 899364278010 Service Type FedEx Priority Overnight Package Type FedEx Pek Zone 02 Packages 1 Rated Weight 2.0 lbs, 0.9 kgs Delivered Mar 21, 2012 10:44 Svc Area AM Si0ned by C.FOSTER FedEx Use 008002654/0001486/_ Recioient ATT ACCOUNTING DEPT '[OWN OF SOUTHALD 54375 MAIN ST SOUTHOLD NY 11971 OS Transporta0on Charge 22.85 ~ Courier Pickup Charge 0.00 ~' Fuel Surcharge 2.67 ~ Discount 4.29 -- Total Charge USD $23.23 ~ · Fuel Surcharge - Fod[x has applied a ~ud surcharge ~1 ~3 ~% to this shipment · Distance Based Pdclng, Zone 2 · Package sent from:06390 zip code Recipient HRM LABS INC 575 BROAD HOLBO RD MELVILLE NY 11747 US 25.75 11,00 0.00 2,58 3.01 USD ~37.18 Automation USAB Sender Tracking ID 875818176825 FISHERS ISLAND FERRY TERMINAL Service Type FedEx Priorib/Overnight FERRY TERMINAL Package Type Customer Packaging NEW LONDON CT 06320 US Zone 02 Packages 1 TransporLation Charge Rated Weight 3.0 lbs, 1,4 kgs Account Number Correction Delivered Mar 27, 2012 10:09 Courier Pickup Charge Svc Area A2 Discount Signed by .SAAGER Fuel Surcharge FedEx Use 008603167/0001486/_ Total Charge Fuel Surcharge - FedEx has applied a fuel surcharge of 1400% to this shipment Distance Based Pricing, 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 Pek Automation USAB Sender Tracking ID 872893382190 PEBBLE DOUCETTE Service Type FedEx Priority Overnight FISHERS ISLAND FERRY TERMINAL Package Type EedEx Pek FERRY TERMINAL Zone 02 NEW LONDON CT 06320 US Packages 1 Rated Weight 2.0 lbs, 0.9 kgs Delivered Apr 05, 2012 11:03 Transportation Charge Svc Area AM Fuel Surcharge Signed by A. DIANA W Discount FedEx Use 009502312/0001486/ Total Cha~Je Recipient ATT ACCOUNTING DEPT TOWN OF SOUTHOLD 54375 MAIN RD SOUTHOLD NY 11971 US USD 22.85 2.88 -2.29 $23.44 Shipper Subtotal USD $83.85 1099 01-00-0014306-0002-0037272 Invoice Number 7-849-40686 Invoice Date /I Apr 09, 2012 /I Account Number 1206-0334-5 Page 5of5 EuelSurcharge FedExhasappgedafuelsurchargeofl3OO%tothisshipment Oistance 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 maximum for the packaging type, therefore, FedEx Envelope was rated as FedEx Pek Automation USAB Sender Tracking ID 875366961156 DIANA WHITECAVAGE Service Type FedEx Priority Overnight TOWN OF SOUTHOLD Package Type FedEx Pek 53095 ROUTE 28 Zone 02 SOUTHOLD NY 11971-4642 US Packages 1 Rated Weight 1.0 lbs, 05 kgs Delivered Mar 16, 2012 09:54 Transportation Charge Svc Area A4 Fuel Surcharge Signed by H,LEFERVE Discount FedEx Use 007502175/0001486/_ Total Charge Recioient RANDYWYDOFSKY FIFERRY DISTRICT 5WATERFRONT PK NEW LONDON CT06320 US USD 22.40 2.62 224 $22.78 Fue[Surcharge FedExhasappriedaft~elsurchargeofl3OO%tothisshipment Distance Based Pricing, Zone g FedExhas audited this shipment for correct packages, weight, and service Any changes msde are reflected in the invoice amount The package weight exceeds the maximum for the packaging type, therefore, FedEx Envelope was rated as FedEx pek Automation USAB Sender Tracking ID 875366961167 JANICE L FOGLIA Service Type FedEx Priority Overnight TOWN OF SOUTHOLD Package Type FedEx Pek 53095 ROUTE 25 Zone 02 SOUTHOLD NY 11971 4642 US Packages 1 Rated Weight 10 lbs, 0.5 kgs Delivered Mar 23, 2012 09:52 Transportation Charge Svc Area PM Discount Signed by R.RILEY Fuel Surcharge FedEx Use 008202850/0001486/_ Total Charge Recioient RANDY WYROFSKY FISHERS ISLAND FERRY DISTRICT FISDEDS ISLAND NY 06390 US 2240 224 262 USD $22.78 Fuel Surcharge FedEx has applied a fuel surcharge of 1300% to this shipment eistance Based Pricing, Zone 2 FedEx has audited this shipmentforcorrectpackages, weight, and serviceAn¥ changes made are reflected gn the invoice amount The package weight exceeds the maximum for the packaging type, therefore, FedEx Envelope was rated as FedExPak Automation USAB Sender Tracking ID 875366961178 DIANA WHITECAVAGE Service Type FedEx Priority Overnight TOWN OF SOUTHOLD Package Type FedEx Pek 53095 ROUTE 25 Zone 02 SOUTDOLD NY 11971-4642 US Packages 1 Rated Weight 1.0 lbs, 05 kgs Delivered Mar 29, 2012 09:45 Transportation Charge Svc Area A4 Fuel Surcharge Signed by R.LEFEVflE Discount FedEx Use 008801874/0001486/ Recipient RANDY WYROFSKY E I FERRY DISTRICT 5 WATERFRONT PK NEW LONDON CT 06320 US 22.40 2.62 2.24 Total Charge USD $22.78 Recipient Subtotal USD $68.34 Total FedEx Express USD $152.19 10~9 01-00-0014106 0001 0037271 FISHERS ISLAND FERRY DISTRICT VENDOR 006339 FISHERS ISLAND ELECTRIC CORP. 05/08/2012 CHECK 445 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710.2.000.200 445 RP-LIFE RAFT BACK IN RAK 215.00 TOTAL 215.00 Town of Southold, New York - Pm Vendor Tax ID Number or Social Security Number Vendor Name FI Electric Co. Vendor Telephone Number Vendor Contact rment Voucher Vendor Address P.O. Drawer E Fishers Island, NY 06390 Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Number vendor No. 6339 4/1112012 215.00 i 215.00 Into the rack Check No. Entered by Audit Date 2012 Description of Goods or Services RP-Return life raft back General Ledfer Fund and Account Number 8M5710.2.000.200 2t5.00i 215.00 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 pan 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 /~tle f~/~ CompanyName 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 that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Signature Title Date Fishers Island Electric Corp. Drawer E Fishers Island, NY 06390 Invoice Date Invoice # 4/11/2012 445 Bill To Fishers Island Ferry Dislrict Drawer H Fish~rs Island, NY 06390 P.O. No. Terms Project Quantity Description Rate Amount 2 Labor April 9, 2012 Assist crew on~..~e Point - Place life rat~ back into rock ( 2 65.00 130.00 I Digger Derrick use on April 9, 2012 85.00 85.00 Total $215.oo FISHERS ISLAND FERRY DISTRICT VENDOR 006406 FISHERS ISLAND SEWER DISTRICT 05/08/2012 CHECK 446 Fl/ND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .1950.4.000.000 041612 SEWER DIST.RENT-5/1/12 1,800.00 TOTAL 1,800.00 Town of Southold, New York - Pa~yment Voucher Vendor Tax 1D Number or Social Security Number Vendor Address Town Hall Ve.dorN..e' ~'~'shexs ~sl~n~ .¢~ex r>is4r,'c4. P.o..ox 1179 ~bOffice of the Town Clerk Southold, NY 11971 Vendor Telephone Number Invoice Invoice Net Purchase Order Vendor Contact Invoice Vendor No. Cq0~ Entered by ~udit Date ~ ~IAY 0 $ 2012 I Number Date 4/16/2012 Total Discount Amount Chimed 1,800.00 i . 1,800.00 1,800.00 i 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 t~xes from which the Town is exempt are excluded. 1,800.00 Number Description of Goods or Services Sewer District Rent Due May 1, 2012 Genend L~ds*r Fund and Account Number SM1950.4.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substil'ation, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. 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 April 16, 2012 FISHERS ISLAND SEWER DISTRICT User No. 2 Fishers Island Ferry District Fishers Island NY 06390 This installment is due May 15, 2012 (Number of units 4__ ~ $225.00 per unit) Make check payable to: Town of Southold (FISD) Please remit to: Elizabeth A. Neville, Town Clerk Southold Town Hall P O Box 1179 Southold NY 11971 5% penaltF on rents not paid by due date. $ 900.00 For your information: Total Rent: $ 1800.00 PLEASE RETURN THE DUPLICATE OF THIS NOTICE WITH YOUR PAYMENT Thank you FISHERS ISLAND FERRY DISTRICT VENDOR 006398 FISHERS ISLAND TELEPHONE CO 06/08/2012 CHECK 447 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710,4.000.200 1965 REPLACE ALARM BATTERIES 88,90 TOTAL 88.90 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address Fishers Island Telephone Corp. Vendor Telephone Number Vendor Contact Invoice Invoice Drawer E Fishers Island, NY 06390 Net Purchase Order Vendor No. 6398 Check No. Entered by ~ Audit Date ~AY 0 8 2012 Number 1965 3131/2012 Total Discount Amount Claimed 88.90 88.90 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 Number Description of Goods or Services Replace Alarm Batteries Cr~eral Ledger Fund and Account Number 8M6710.4.000.200 Department Certification I hereby certify that the materials above specified have been received by me m good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Signature Title Fishers Island Telephone Corp. Drawer E Fishers Island, NY 06390 (631) 788-7001 Invoice Date Invoice # 3/31/2012 1965 Bill To F.I. Ferry District Drawer H Fishers Island, NY 06390 J P.O. No. 212056 Terms Due Date 30 days 4/30/2012 Quantity Description Rate Amount 3/26/12; replace alarm system battery 70.00 70.00 4 amp battery 18.90 18.90 PLEASE MAY CHECKS PAYABLE TO "F.I. TELEPHONE" ....... THANK YOU! Total $88.90 I fitelephone@fishersisland.net FISHERS ISLAND FERRY DISTRICT VENDOR 006482 PAUL J. FOLEY 05/08/2012 CHECK 448 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 041612 REIMB.RX-APR'12 94.41 TOTAL 94.41 Town of Southold, New York - Pa'~ Vendor Tax ID Number or Social Security Number Paul J. Foley Vendor Telephone Number Vendor Contact Number Date 4/1612012 vendor $~i ,men, Voucher ~q~:~ N~w L~ndon, (gl' 06320 Invoice i Net Total i Discount i Amount Claimel 94.41 ! 94.41 Purchase Order Number Description of Goods or Services Antham Retiree Prescription Plan 90% Reimbursement ;104.90 less 10% ($94.4t) Paul Foley Ck #1538 611/2012 Check No. Entered by Audit Date MAY 0 8 201 General Ledger Fund and Account Number 8M9060.8.000.000 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 _/4~-~ Company Name ~--.~ff:::r~) 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 that the quantities thereof bave been verified with the exceptions or discrepancies noted, and payment is approved. Blue MedicareRx' (PO P) 902640731 G0230330801 IIh,,,Ih,,,Ih,,I,IIl.,.h,h,,IMh,,hlhh,lh.ll-,I PAUL J FOLEY 690 WILLIAMS ST NEW LONDON CT 06320-4132 Balance Due 05/01/2012 $104.90 Please return the top portion qf this fotw~ with your payment. See reverse ,side for payment option.~. Retain the bottom portion of this jbrm.fi)r ytmr records' Per your Evidence of Coverage booklet, if you and your spouse are both enrolled in the plan, your monthly premium payments must be paid separately. _We require one remittance advice and one payment oer account. The remittance advice is located on the reverse side of this statement This will ensure each member account is credited appropriately and timely to prevent disenrollment from the plan, which will result in a lapse of coverage~ If you are disenrolled from the plan, you may only re-enroll during a valid election period. Anthem . Participant ID: G0230330801 Date: 04/04/2012 I Blue MedicareRx' (PO P) Transaction Date Description Amount Premium 04/01/2012 April 2012 104.90 - Balance Due 104.90 Plea., 51-7218/2211 i 548 PAUL d. FOLEY 1630902~28 NEW LONDON, CT 06320 DATE_ ~ ~ _ people~ bank I011 01.O04YOlggq841O01-0010717 Page 1 of l FISHERS ISLAND FERRY DISTRICT VENDOR 009682 GOOSE ISLAND CORP 05/08/2012 CHECK 449 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 26305 111.6 GAL HTG OIL 545.72 TOTAL 545.72 Vendor No. Town of Southold, New York - Payment Voucher i 9682 Vendor Tax ID Numbor or Social Securiiy Number Vendor Address . . ! P.O. Box 49 VendorName 00~ ~O Fishers Island, NY 06390 Island Service Vendor Telephone Number Invoice Net Purchase Order Vendor Contact Susan Invoice invoice Check No. Entered by Audit Date ~IAY 0 8 2012 Number 26305 Date Total 4/13/2012 646.72 , 546.72 i Payee Certification Discount Amount Claime¢ 645.72 545.72 The undersigned (Claimant) (Acting on behalf of the above named claimant) docs hereby certify that the foregoing claim is true and correct, that no part has boen 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 Number Description of Goods or Services Fuel Oil 111.6 ~lal (~ 4.89 gal General Ledser Fund lind Account Number SM6710.4.000.000 Signature ~ Title__ Date Department Certification I hereby certi~ that the materials above specified have boen received by me in good condition without substitution, the services properly performed and that thc quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. GOOSE I~J..AND CORP. P.O. Bo~49 (S31) 788.7311 [] Dyed unmarked Heating Oil: Not for use in highway or non-highway, locomotive or marine engines. END OF GALLONS TENTHS DELIVERY ~ METER READING END OF DELIVERY METER READING START OF DE IVERY DATE ~/C;~-- ' - 26305 PRODUCT GALLONS PRICE AMOUNT $ ~ c^s. [] C.ECK TAX X toTAL DELIVERY RECEIVED PER ABOVE METER READING FISHERS ISLAND FERRY DISTRICT VENDOR 008100 HAWKINS, DELAFIELD & WOOD 05/08/2012 CHECK 450 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .1420.4.000.000 041912 $715K BAN 4/12/12 1,063.74 TOTAL 1,063.74 Town of Southold, New York - Pa, Vendor Tax ID Number or Social Security Number Vendor Name Hawkins Delaflsld & Wood LLP Vendor Telephone Number Vendor No. 'merit Voucher 8100 Vendor Address One Chase Mahattan Plaza Vendor Contact Invoice New York~NY 10005 Numbor 118526 Date 4/13/2012 Total 1,063.74 Dis~ount Net Purchase Order Amount Claimed Number Description of Goods or Services 1,063.74 71SKBAN- 4/t 2112 Check No. Entered by Audit Date General Ledger Ftmd and Account Number $M1420.4.000.000 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 t~xes from which the Town is exempt are excluded. Signature Title Company Name ~/~ Date Department Certification I hereby certify that the matefiais above specified have been received by me m good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Signature Title Town of Southold, New York - Payment Voucher Hawkins Delafield & Wood LLP Ven31or Telephone Number (212) 820-9400 Vendor Contact Vendor No. Vendor Address One Chase Manhattan Plaza New York, NY 10005 Gerard Fernandez, Jr. Invoice Invoice Invoice Number Date Total See 382.87 Net Purchase Order Discount Number Cheek No. Entered bY AUdit Date HAY 0 8 2012 Town Clerk Payee Certification The undersigned (Claimant) (Acting on behalf of the above n~med claimant) docs hereby ceni fy that the foregoing claim is t~ue and correct, that no part has been paid, except as therein stated, that the balance therein slated s actually due and owing, a~d that t~0~s from which the Town is exemp are ex¢ uded. Signatu~~T,~le Of Counsel HaC~s~a~lafxe~;Ja' i Wood iL ate 4/19/2012 -- 1~ Departnnent Certification ONE CHASE MANHATTAN PLAZA NEW YORK, NY 10005 ~ HAW~IN S.CO M TOWN OF SOUTHOLD, NEW YORK (Our File Designation: 2615/31455, 30200 and 19513) April 19, 2012 Hawkins Delafield & Wood LLP TO professional services rendered the Town of Southold (the "Town"), in the County of Suffolk, New York, in the matter of the authorization, sale, preparation and issuance of the $715,000 Various Purposes Bond Anticipation Note-2012 (the "Note"), dated April 12, 2012 maturing April ll, 2013, including preparation of drafts of the requisite authorizing, sale and closing documents, the Bordered Note in readiness for execution and delivery; telephone conversations and correspondence with the Town Comptroller as to the details of the Note and its sale and issuance and the rendering of the final written approving opinion of Hawkins Delafield & Wood LLP at the time of delivery. SUBTOTAL $1,300.00 Disbursements: Duplication of Documents, Postage, Federal Express Delivery, Word Processing and Computer Financial Analysis (re: IRS Form 8038-G) 82.87 TOTAL 1149223.1 034513 CLD TOWN OF SOUTHOLD - BAN FEE BREAKDOWN Account Principal Number Amount 31455 $ 21,000.00 19513 $ 550,000.00 34513 _$ 144,000.00 Totals $ 715,000.00 _Purpose Acquisition of a Dump Truck Fishers Island Ferry Dock Fuel Management Systemt Fee $ 38.18 $ $ 1,000.00 $ .$ 261.82 $ 1,3oo.oo Disbursement Total 2.43 $ 40.62 63.75 $ 1,063.7~,//~ 16.69 $ 278.51 82.87 .$ 1,382.87 ,~shman, John From: Sent: To: Cc: Subject: Attachments: Cushman, John Wednesday, April 25, 2012 2:18 PM Randy Wyrofsky; Craig Gilbert; GSMurphy (gmurphy@fiferry.com) Finnegan, Martin Bond Counsel invoice HAW~NS_20120425141740.pdf All, Attached please find the invoice from bond counsel for the recent BAN renewal. Note that the District's portion of this invoice is $1063.74. Please process this for payment on your next warrant. John John Cushman Town Comptroller Town of Southold 631-765-4333 http:[[southoldtown.northfork.net[Acct-Fin.htm THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHOM IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED AND CONFIDENTIAL, OR THAT CONSTITUTES WORK PRODUCT AND IS EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF YOU ARE NOTTHE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY USE, DISSEMINATION, DISTRIBUTION, OR COPYING OF THE COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US BY TELEPHONE 633.-765~4333 AND DESTROY THE DOCUMENT. THANK YOU. FISHERS ISLAND FERRY DISTRICT VENDOR 008370 LUCINDA J. HERRICK 05/08/2012 CHECK 451 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5712.4.000.000 033112 '12 COMM MTG-2 @ $50 100.00 TOTAL 100.00 Town of Southold, New York - Vendor Tax ID Number or Social Security Number ment Voucher 1t58 Fifth Avenue Vendor No. Lucinda Herrick New York, NY 10029 Check No. Entered by Audit Date Vendor Telephone Number Vendor Contact Number Invoice Date Discount Invoice Total 100.00 Net Amount Claimed 100.00 i Purchase Order Number Description of Goods or Services Commissioner Meeting January - March 2012 2 Mt~s (~ $ $0.00 Mt9 General Ledser Fund and Account Number $M5712.4.000.000 Payee Certification The undersigned (Claimant) (Acting on behal£of tbe 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 lowa is exempt are excluded. Signature ~ Title ~'~'~ Company Name ~r~'~ Date ~,~/'~Z~-- 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 thc quantities thereof have been verified w/th the exceptions or discrepancies noted, and payment is approved Title Date FISHERS ISLAND FERRY DISTRICT VENDOR 011069 KELLOGG MARINE INC 05/08/2012 CHECK 452 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 SM .5710.4.000.000 13086884-00N 13086884-00N RP-24"LIFE RING,BUOY BKT 59.71 MU-ICE RESCUE SUIT 808.40 TOTAL 868.11 Town of Southold, New York - Payment Voucher Kellogg Marine Supply Nulnpar Date 13086884-00N 3/13/2012 3/13/2012 Total Discount 59.71 11069 8 Ente~rise_Dri~ve Old Lyme, CT 06371 Net 59.71 808.40 808.40 868.11i ~ 868.11 Payee Certification The undecsigne~! (Claimam) (Acting on behalf of the above named claimant) does hereby cerlif) that the foregoing claim is true and cermet, t}mt no part bas been paid, except as tb~min stated, ?aat the balance therein stated is acaually duo and owing, and that taxes From which the Town is exempt are e~cteded. RP-24" Life Ring and Buoy Bracket MU-ice Rescue Suit Check No. Entered by Audit Date 0 8 2012 Oeneral l ~'~Fuad and Accc~am Number SM6710A, 000.000 SM57t 0.4.000,000 Department Certification 01:31:59 5 ENTERPRISE DRIVE OLD LYME, CT 06371 BILL TO: FISHERS ISLAND FERRY DISTRICT BOX 4 FISHERS ISI2~ND, NY 06390 SALES PHONE #: (800) 243-9303 FAX #: (800) 628-1304 SHIP TO: FISHERS ISLAND FERRY DISTRICT FOOT OF STATE STREET NEW LONDON, CT 06320 * =FEDERAL EXCISE TAX iNCLUDED IN COST INV # 13086884-00N ACCT. # 021275 ROUTE # 600/25 (631)788-7463 ORDER DATE OUST, P.O. # LOC. SLM. TAKEN BY FILL CHK. # PKG. WE. SHIP DATE SHIP VIA OOR TRUCK PAGE 163 1 3/13/12 STEVE 163 610 SVANEP 3 16 3/14/12 TERMS NET 45 DAYS /1 HM NO. o~. ow. s~,(3w. U/M PART NUMBER DESCRIPTION PRICE DISC. COST TOT~ 1 1 EA * 58-HS240 24IN O~GE ~ SHELL RING BU 67.89 50.23 50.23 C~ HS240 ~ ~ 1 1 EA *354-491240 SS RING BUOY B~CKET ~o( ~%~ 8.95 6.03 6.03 S~ 491240 S~ 491240 1 1 EA '693-IC9001 ICE RESC~ SUIT GO~ ~T ~I 917.19 808.40 808.40 ~S IC9001 DELI~RY F~L S~C~GE ~ 3.45 V]EW ~PECI~S, CHECK STOCK, ~CE ORDERS ~D VIEW ACCT HISTO~ 24/7 ON ~.~LLOGG~I~.COM ~C~GE POUCY-uPTOA2%~LY~C~YaE~DTOm~E WE CEmI~mEABOVETO BE TRUE TO THE ~ ~~RABiL~Y NO~RCA3~ON 0~ ANY DISCREPANCIES REQUIRED ~THIN 48 H(~JRS ORIGINAL SIGNATURE RECEIVEDB¥: REMIT TO: P.O. *ons.~,~Jo, con~m~ou.s.~ PAYABLE IN U.S. DOLLARS ONLY -DRAWN ON U.S. BANK ONLY BOX 11909, NEWARK, NJ 07101-4909 FISHERS ISLAND FERRY DISTRICT VENDOR 011564 THOMAS KRAFT 05/08/2012 CHECK 453 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 SM .5710.4.000,300 SM .5710.4.000.300 SM .5710.4.000.300 SM .5710.4.000.300 53593 53593 53593 53593 54354 54354 54354 54354 RP-4000 GAL @ 3.3673 13,469.20 S-F COST RECOVERY .0019 7.60 CT EXCISE TAX-$.04620/GA 1,848.00 LUST TAX - $.0010/GAL 4.00 RP-5218 GAL @ 3.313600 17,290.36 CT EXCISE TAX-$.04620/GA 2,410.72 S-F COST RECOVERY .0019 9.91 LUST TAX-$.0010/GAL 5.22 TOTAL 35,045.01 Town of Southold, New York - Pa~ Vendor Tax ID Number or Social Secmity Number Thomas Kraft dba Dime OII Company Vendor Telephone Number Vendor Contact Invoice Invoice Number Date Total 54354 4/1912012 9.9t 5.22 4/612012 7.60 4.00 ]~nndor No. 11564 'ment Voucher P.O. Box 11125 Waterbury, CT 06703 Net Purchase Order Amount Claimed Number n of Goods or Services 17,290.36 RP -52t8 gal (~ 3.313600 2,410.72 Excise Tax - 9.9t Cost 5.22 LUST Tax - RP-4000 gal ~ 3.3673 CT Excise Tax - ~ 7.60 1,848.00 4.00 LUST Tax - Check No. Entered by~ ¢ Audit Date MAY 0 8 2012 General Led~r Fund and Account Number 8M5710.4.000.300 35,045.01 Payee Certification Tbe undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~ 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 t~xes from which the Town is exempt are excluded. 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 discrepancies noted, and payment is approved. Signature Title DZHE OZL COMPANY P,,~, BOX 11125 ,WATERBURY, CT 06703 Phone: (203)75~-533~ Date: 0b/20/2012 Re: Fishers Zsland Ferry District PO Box H Attn Accounts Payable Fishers Zsland, NY 06390- Fishers Zsland Ferry Dist 5 Waterfront Park-Race Point, New London ACCOUNT NUMBER: AMOUNT ENCLOSED: ~20165 P,age : 1 Terms: NET 30 Days From Invoice Date Date Znvoice charges and Credits Amount 04/20/12 5~35~ Fuel Invoice Total 04/20/12 5t~35t~ ff2OR Off Road Diesel 5218.0 GALS 9 3.313600 17290,36 Oyed Oiesel Fuel for Off Road Use ONLY, S-F Cost Recovery @ 0.0019 9.91 State Excise Tax DSL 8 0,b620 2~10,72 LUST TAX ~ 0,0010 5,22 19716,21 19716,21 Amount Due *** Please include *Fed ZD~ 060967353 account number' with paymemt *** DIME OIL COMPANY (203)75b-533b Account: ~20165 .DIME OIL COMPANY · P00. BOX 11125 WATERBURY, CT 06703 Phone: (203)75~-533~ Date: 0~/05/2012 Re: ACCOUNT NUNBER: Fishers Island Ferry District PO Box H Attn Accounts Payable Fishers Island, NY 06390- - AMOUNT ENCLOSED: Fishers Island Ferry Dist 5 Waterfront Park-Race Point, New London 6~20165 Page : 1 Terms: NET 30 Days From Invoice Date Date Invoice Charges and Credits Amount 0~/05/12 53593 Fuel Invoice Total 0~/05/12 53593 #20R Off Road Diesel ~000.0 GALS @ 3.367300 13~69.20 Dyed Diesel Fuel for Off Road Use ONLY, S-F Cost Recovery @ 0.0019 7.60 State Excise Tax DSL @ 0.~620 18~8.00 LUST TAX @ 0.0010 ~.00 15328.80 15328.80 Amount Due *** Please include *Fed ID# 060967353 account number' with paymemt DIME OIL COMPANY (203)75~-533~ Account: ~20165 FULL PRICE PER GALLON DtS~,COUNT PRICE PER G~ON ~ ~UCK ~. DIME OIL. COMPANY~.~s. 47 SADDLE ROAD OF DEL~5 ~PM ' *' - WOLCO~, CT 06716 TMFI TI~ * AM (203) 754L'~53~ 879~504 - State St~t ~w Lond~, CT 0632~- K Factor: 0.000 La~ DeIv:04/05/l~ sJgns-L State St,ov~ RR - . ' 4 ~0 Taxes- $0 47 SADDLE ROm . WOLCO~, CT 0~1, 6 (203) 754-5334 OR 879-6504 FISHERS ISLAND FERRY DISTRICT VENDOR 011745 LdkND, SEA & AIR CONSULT & TEST 05/08/2012 CHECK 454 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 SM .5710.4.000.000 237-030912 DRUG TEST-R.DUMOUCHEL 57.00 237-030912 DRUG TEST-N,ESPINOSA 57.00 TOTAL 114.00 ~oWn of Southold, New York ~' Ve~hdor T~x ID Number or Social Security Number Vendor N~me Land Sea and Air Consultin~l & Testln~l Vendor Telephone Number VendorContuct Number Date - Pa' Vendor No, ~ment Voucher 1174{5 Vendor Address M0 Route 109 Mo~th Undenhurat, NY t t ?fi? Net Purchase Order Check No. Entered by q ~ Audit Date HAY 0 8 2012 Invoice Total :3/9/2012 $t14.00 Discount Amount Claimed Number Description of Goods or Services RP-24" Cd~ K~i.lll Icc P.c=~:-~ Su;~ Dumouchel, E-spiraea Testi~ General Ledser Fund and Account Number $0~. 5'~10. q.o00,O00 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimam) does hereby eenif~ 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 Company Name /~t~ Date Department Certification I hereby certi~, 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 discrepancies noted, and payment is approved. Signature Title 04/~5A12 Page: 1 IRS ~ FISHER'S, ATT; NINA SCHMIDT PO BOX H FISHER'S ISLAND, CT 06390 LAND SEA P~qD AIR CONSULTING &TESTN It4vOtC-~ ~o ~OUT~ ~o~ 27-1482752 LINDENHURST, NY 11757 Tel: 6312253060 ISLAND FERRY Acct: 20000328 /CO Tel: 631/442-0165 Date Diag Ref C.P.T Qt Patient name AR Pi Amt Bal 03/09/12 RANDOMDS1 77-ESPINOSA, NICHOLAS O 57.00 03/09/12 RRNDOMDS1 5-DUMOUCHEL, ROBERT O 57.00 57.00 Regular Tetal: $ 114.00 Provider: OFFSITE Operator: PP Page 1 of I Whitecavage, Diana From: Gordon Murphy [GMurphy@fiferry.com] Sent: Thursday, May 03, 2012 3:29 PM To: Whitecavage, Diana Subject: RE: Land, Sea and Air I agree to the change and we will note that for future payments. Thanks From: Whitecavage, Diana [mailto:diana.whitecavage@town.southold.ny.us] ~ent: Thursday, May 03, 2012 3:07 PM To: Gordon Murphy Cc: Debbie Subject: Land, Sea and Air Hi Gordon, Upon entering this voucher for the drug testing Account# SM.1910.4.000.100 (Insurance Ferry Operation) is being charged, however drug testing has always been charged to SM.5710.4.000.000 (Ferry Ops) - FYI Please advise if it is OK for me to correct on voucher. Also, please make note for future invoices. Thank you, Diana 5/3/2012 FISHERS ISLAND FERRY DISTRICT VENDOR 013510 MCM~2qN-PRICE AGENCY, INC. 05/08/2012 CHECK 455 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5610.4.000.000 118526 GEN LI~-~.RENEW TO 5/13 6,785.00 TOTAL 6,785.00 Vendor No. T~own of Southoid, New York - Pa,~ ~ment Voucher i 13510 Vendor Tax ID Number or Social Security Number Vendor Address 828 Front Street Vendor Name P.O. BOX 2065 Eheck No. Entered by .~ Audit Date McMann PHce Agency, Inc. Vendor Telephone Number Vendor Contact Greenport, NY 11944-0876 Number Total Discount 6,786.oo! Net ;Amount Claime¢ , 6,785.00 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) docs hereby certify that the foregoing claim is tree 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 ~ Purchase Order Number RAY 0 8 2012 Description of Goods or Services ~en Liability Renewal :)6102120t2-05102120t3 General Led$er Fund and Account Number 8M5610.4.000.000 Department Certification I hereby certify that thc 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 discrepancies holed, and payment is approved. Signature Title - ! ! - :lient: Town of Southold and Fishers Is. Fen~ Di.~ 118'526 05/02/2012 Renewa] quote Po]icy #PR86315 05/02/2012-05/02/2013 O]d Repub]ic Insurance. Company General Liability - Renewal quote Policy Fee 6,585.00 200.00 6,785.00 Thank you McMann Price Agency, Inc. 631.477.1680 04/13/2012 FISHERS ISLAND FERRY DISTRICT VENDOR 014021 NATIONAL AUTO PARTS SVCE,INC. 05/08/2012 CHECK 456 FUND & ACCOUNT P.O, # INVOICE DESCRIPTION AMOUNT SM .5710.2,000.200 SM .5710.2.000,200 901942 RP-OIL FILTER 94.36 902285 RP FILTERS 211.91 TOTAL 306.27 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Secud~y Number Vendor Name NAPA Vendor Telephone Number Vendor Contact Vendor Address Vendor No. t06 Boston Post Road Waterford, CT 06385 14021 Check No. Entered by Audit Date NAY 0 8 2012 Invoice Number Net Discount Amount Claimec Description of Goods or Services R.P.- Oi! Filter 901942 41312012 94.36 94.36 90228 415/2012 211.91 211.91 RP Filters SM5710.2.000.200 $306.27 306.27 Payee Certification The undersigned (Clatmant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true ~nd correct, that no part 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. SM5710.2.000,200 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed mad that the quantities thereof have been verified with the exceptions or discrel~mcies noted, and payment is approved Sig~atare 200001180 National Parts Service Inc. 150 Bridge Street Groton, Ct. 03640, CT 06340 (860) 445-8181 Time: 09:05 Date: 04/03/2012 Page: 1/1 Invoice Number 901942 1297 Fishers Island Ferry District PO Box 4H Fishers Island, NY 06390 Employee: 33 Forte, Joe Sales Rep: 0 0, Salesman Accounting Day: 2 1970 3209 FIL NAPAGOLD OIL FILTER FIL NAPAGOLD FUEL FILTER Tax Exempt:on:: X ' Terms: Net 20th Customer Signature ~L GOODS RETURNED MUST BE ACCOMPANIED BY MIS INVOICE NAPA AUTO PARTS 150 BRIDGE STREET GROTON, CT. 06340 STORE COPY 2.00 54.82 31.4900! 62~98 2.00 28.22 15.6900! 31.38 Subtotal 94.36 TABLE 1 6.3500% 0.00 Charge Sale 94.36 Fishers Island Ferry District PO Box 4H Fishers Island, NY 06390 Time: 11:28 Date: 04/05/2012 200001180 National Parts Service Inc. 150 Bridge Street Groton, Ct. 03640, CT 06340 (860) 445-8181 Invoice Number 902285 Page: 1/1 Employee: 35 CLARK, ERIK Sales Rep: 0 0, Salesman Accounting Day: 4 1792 FIL NAPAGOLD OIL FILTER ~A~ ~- 4.00 52.27 28.9900 115.96 3210 FIL NAPAGOLD FUEL FILTER ~- 4.00 33.36 18.4900 73.96 3384 FIL NAPAGOLD FUEL FILTER~ ~ ~ % 1.00 37.56 21.9900 21.99 Delivery: Attention: Tax Exemption: Terms: Net 20th Customer Signature ALL GOODS RETURNED MUST 8E ACCOMPANIED BY THIS INVOICE NAPA AUTO PARTS 150 BRIDGE STREET GROTON, CT. 06340 CUSTOMER COPY Subtotal 211.91 TABLE 1 6.3500% 0.00 Charge Sale 211.91 FISHERS ISLAND FERRY DISTRICT VENDOR 014505 NORTH ATLANTIC POWER PRODUCTS 05/08/2012 CHECK 457 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.100 WQ120403281 MU-REBUILD REDUCT.GE~LR 10,041.61 TOTAL 10,041.61 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Se~uri~ Number Vendor Address Portsmouth Branch Vendor ~ame 225 Heritage Avenue WhdorNo. 14505 Chock No. Entered by Audit Date North Atlantic Power Products Vendor Telephone Number Portsmouth, NH 03801 Vendor Contact ~nvoice Number Date Invoice Total Discount Net Amount Claime~ WQ120403281 411012012 10,041.61 ~ 10,04t.61 10,041.6t 10,041.61 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is tree 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 fi.om which the Town is exempt are excluded. Purchase Order Number MAYO 8 2012 Description of Goods or Services MO - Rebuild Reduction Oear General Ledger Fund and Account Number 8Mfi710.2.000.t00 Department Certification I hereby certil~ 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 discrepancies noted, and payment is approved. Signature ~ Title Date Sold to: North Atlantic Power Products Exeter Branch 15 Continental Drive Exeter, NH 03833 (603) 418-0470 (603) 418-0471 FISHERS ISLAND FERRY DISTRICT P.O. BOX H FISHERS ISLAND, NY 06390 INVOICE Invoice Date Customer WQt 2040328t 04/10120t2 101065 Shipped to: FISHERS ISLAND FERRY DISTRICT P.O. BOX H FISHERS ISLAND, NY 06390 Page 1 of 2 Branch Invoiced: 71NP Exeter Dept invoiced: 40-Service Registration: Notcs: Quanfit~ Product Id Cust PO#: Verbal - John Work Order: WQ4704 Segment: Evaluate/overhaul 1 MISC OP TD K495 TD XA6853A TD XA7058A 1 FRL EF SS Description 1 MG514 Entered by: Dan Jones Outside Parts KIT MG514 OH SIN 3H3010 & UF DR SPIDER ASSY MG514 ++SEE SHAFT ASSY FWD ++SEE RE++ Total Parts Flat Rate Labor Flat Rate Labor Environmental Fee Shop Supplies Charges inbound Freight Outbound Freight Misc Unit Price 03/16/2012 WO Shop 165.62 5,084.54 1,016.86 11313.67 2,156.00 Total Price 165.62 5,084.54 1,016.86 1,313.67 7,580.69 2,156.00 2,156.00 15.00 50.00 65.0C 135.92 104.0C 239.92 North Atlantic Power Products INVOICE Exeter Branch 15 Continental Drive Exeter, NH 03833 (603) 418-0470 (603) 418-0471 FISHERS ISLAND FERRY DISTRICT P.O. BOX H FISHERS ISLAND, NY 06390 Sold to: Invoice Date Customer WQ120403281 04110/2012 101065 Shipped to: FISHERS ISLAND FERRY DISTRICT P,O. BOX H FISHERS ISLAND, NY 06390 Page 2 of 2 Branch Invoiced: 71NP Exeter Dept Invoiced: 40-Service Re~listration: Notes: Quantity Product Id Descriotlon Unit Price Total Price Due Date Payment Amount Paid Tax Basis Tax Rate Tax Amount 04/10/2012 On Account 10,041.61 FISHERS ISLAND FERRY DISTRICT VENDOR 016170 H.O. PENN MACHINERY, INC. 05/08/2012 CHECK 458 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT SM .5710.2.000.200 SM .5710.2.000.200 PSCE4596071 RP-WATER PUMP SENSOR 79.05 PSCE4596457 RP-WATER PUMP SENSOR 95.82 TOTAL 174.87 iSO Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securiiy Number H.O. Penn Machinery Co. hwoice Vendor No. 16170 Vendor Address 122 Noxon Road Poughkeepsie, NY i~603~2940 Purchase Order Vendor Telephone Number Invoice Vendor Contact Invoice Number PSCE4596071 PSCE4596457 Date 41812012 41t 0/2012 Total 79.05 95.82 Discount Net Amount Claimed Number 79.05 95.82 174.87 i Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) docs hereby ceftin/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 ' 174.87 Description of Goeds or Services RP-Water Pump Sensor RP-Water Pump Sensor Check No. Entered by ~ Audit Date IqAY 0 8 2012 C~neral Ledger Fund and Account Number 8M$710.2.000.200 SM57t 0.2.000.200 Department Certification i hereby certi~ that the materials above specified have been received by me in good condition without substiiution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Title Date ! / CUSTOMER INVOICE H. O. PENN MACHINERY COMPANY, INC. BLOOMINGBURG, NY 783 BLOOMINGBURG RD, 12721 845-733-6400 BRONX, NY 699 BRUSH AVENUE, 10465 718-863-3800 HOLTSVILLE, NY 660 UNION AVENUE, 11742 631-758-7500 NEWINGTON, CT 220 RICHARD STREET, 06111 860-666-8401 POUGHKEEPSIE, NY 122 NOXON ROAD, 12603 845-452-t200 SOLD TO: O0005R '~ 000056 FISHERS ISLAND FERRY DISTRIC PO BOX H FISHERS ISLAND NY 06390 SHIP TO: 5 WATERFRONT PARK NEWLONDON CT 06320 04C684381A 04-05-12 10 [ 10[ []PS COMPLETE 3576899 AA UNKN 099Z00001 PARTS SALES PERSON: MEL J. FENN 1 2W-8916 CONTACTOR A S 74.33 74.33 TOTAL PARTS 74.33 T 1 FREIGHT OUT 11.31 TOTAL MISC CHARGES 11,31 T FRT IN 4.46 T CONN SALES TAX 5.72 T NOT RETURNABLE CUSTOMER INVOICE H. O. PENN MACHINERY COMPANY, INC. BLOOMINGBURG, NY 783 BLOOMINGBURG RD, t 272t 845-733-6400 BRONX, NY 699 BRUSH AVENUE, 10465 7t8-863-3800 HOLTSVlLLE, NY 660 UNION AVENUE, 11742 631-758-7500 NEWlNGTON1 CT 225 RICHARD STREET, 06111 860-666-8401 POUGHKEEPSIE, NY t22 NOXON ROAD, 12603 845-452-1200 SOLD TO: 000041 * 000041 FISHERS ISLAND FERRY DISTRIC PO BOX H FISHERS ISLAND NY 06390 001 SHIP TO: 5 WATERFRONT PARK NEWLONDON CT 06320 PSCE4596071 04-05-12 18697 JOHN 04 C 2 1 04C684381 04-05-12 10/ [ 10I UPS COMPLETE I 3574324 , ,, M~K~ PARTS SALES PERSON: MEL J. FENN i 2W-8916 CONTACTOR A S 74.33 74.33 TOTAL PARTS 74.33 T CONN SALES TAX 4.72 T ' - NOT RETURNABLE FISHERS ISLAND FERRY DISTRICT VENDOR 016659 PRINCIPAL LIFE GROUP 05/08/2012 CHECK 459 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 H19730-1-0512 LIFE PREM-5/12 157.71 TOTAL 157.71 Town of Southold, New York - Pa~ Vendor Tax ID Number or S~cial Security Number Vendor No. 'ment Voucher 16659 Vendor Address P.O. Box 14513 Des Moines, IA 50306-3513 Check No. Entered, by Audit Date Principal Life Group Vendor Telephone Number Vendor Contact Invoice Invoice Number Date H19730-1 4/t7120'1~ Invoice Net Total : Discount Amount Claime¢ $t 67.71 $187.71 Purchase Order Number IqAY 0 $ 2012 Town Clerk Description of Goods or Services Life Prem-5/2012 General Led~r Fund ~nd Account Number 5M9060.8.000.000 157.71 157.71 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is tree and correct, that no pert 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. Department Certification l 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 discrepencies noted, and payment is approved Signature Date Group Principal Financial Group Des Moines, IA 50392-0001 Principal Life Insurance Company PREMIUM STATEMENT This slatement in no way changes the conlract or waives any overdue payment Account Number 001798 FISHERS ISLAND FERRY ATTN NINA SCHMID PO BOX H FISHERS ISLAND NY 06390 H19730-1 Lb. No. 0819730 00001 93 DueDa~ 05/01/12 ~mtDa~ 04/17/12 Billing Period 05/01/12 - 05/31/12 Please Pay Balance Due $ 157.71 PLEASE REVIEW ALL MESSAGES BELOW. THEY CONTAIN INFORMATION RELATED TO YOUR PREMIUM PAYMENTS AND THE ADMINISTRATION OF YOUR PLAN. IF YOU HAVE QUESTIONS REGARDING ANY OF THESE MESSAGES, PLEASE CONTACT US AT THE NUMBER LISTED BELOW. IT IS IMPORTANT TO REPORT NEW ENROLLMENTS, TERMINATIONS, AND CHANGES IN DEPENDENT STATUS PROMPTLY TO OUR WEBSITE AT WWW.PRINCIPAL.CDM OR NOTIFY OUR ADMINISTRATION AREA. WEB REPORTING REQUIRES A PIN. IF YOU DO NOT HAVE A PIN, PLEASE CALL 800-621-6280. REPORTING CHANGES PROMPTLY WILL RESULT IN A MORE ACCURATE PREMIUM STATEMENT. CHANGES SHOULD NDT BE SENT WITH YOUR PAYMENT. FOR ASSISTANCE, PLEASE CALL TOLL FREE: 1-800-843-1371 NOTICE--TO AVOID DISCONTINUANCE OF YOUR PLAN, PLEASE BE SURE YOUR $56.14 BALANCE IS PAID AND RECEIVED IN THIS OFFICE BEFORE THE GRACE PERIOD ENDS ON 04/30/12. IF YOU HAVE PAID, PLEASE DISREGARD THIS NOTICE. PROVIDING YOU WITH GOOD SERVICE IS IMPORTANT. PLEASE REVIEW YOUR STATEMENT EACH MONTH TO ENSURE PROMPT AND ACCURATE CLAIM PAYMENT. Group TH'rS TS YOUR COPY. Principal Financial Group Principal Life Des Moines, IA 50392-0002 Insurance Company PLEASE KEEP FOR YOUR RECORDS. PREMZUM STATEMENT This st atemen~ in no way changes the contract or waives any overdue payment ACCOUNT NO. H19730-1 FISHERS ISLAND FERRY lID LIFE/AD&D NUMBER NAME BNFT PREM LB. NO. 0819730 00001 93 DUE DATE: 05/01/12 STMT DATE: 04/17/12 CHARGE/ CREDIT 040112 10000 6,49 030112 10000 6,49 99?613206 DUMOUCHEL 050112 lO000 6.49 944416981 EASTER MAR EE CHANGE SUMMARY : TERMINATION 0~/3~/2012 g29355154 SCHMID NIN EE CHANGE SUMMARY : TERMINATION 01/31/2012 6.46 FOR ASSISTANCE, PLEASE CALL TOLL FREE: 1-800-843-1371 F396GP-4 ACCOUNT ND. H19730-1 05/01/2012 000 000000 000000 CG$631821081148080001002 0004580 002 OF 003 Financial Group THES TS YOUR COPY. Principal Financial Group Principal Life Des Moines, IA 50392-0002 Insurance Company PLEASE KEEP FOR YOUR RECORDS. PREM'r UM STATEMENT This statement in no way changes the contract or waives any overdue payment ACCOUNT NO. H19730-1 FISHERS ISLAND FERRY LB. NO. 0819730 00001 93 DUE DATE: 05/01/12 STMT DATE: 04/17/12 CHARGE/ CREDIT PMT SINCE LAST 108.06 NET CREDITS 51,92- BAL FORWARD 56. 14 CHARGES THIS STMT I01.57 TOTAL AMT DUE 157.71 FOR ASSTSTANCE, PLEASE CALL TOLL FREE: 1-800-843-1371 F396OP-4 ACCOUNT NO. H19730-1 O5/O1/2012 000 000000 000000 CGS631821081145060001002 0004581 003 OF 003 FISHERS ISLAND FERRY DISTRICT VENDOR 016734 PROPET DISTRIBUTORS, INC. 05/08/2012 CHECK 460 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 86783 DOGIPOT TRASH REC.AND BG 258.00 TOTAL 258.00 Vendor No. Town of Southold, New York - Pa~'ment Voucher , J (o~7~ Vendor Tax ID Number or Social Security Number Vendor Address 2100 Principal Row, Suite 405 VendorName ~)rlando, FL 32837 ProPet Distributors, Inc. Cheek No. Entered by Audit Date Vendor Telephone Number Vendor Contact Invoice Number Date Invoice Net Purchase Order Total Discount Amount Claim Number 86783 4/1112012 258.00 258.00 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 / f-.r~'"-/~"~ Date MAY 0 8 2012 Description of Goods or Se~ices Dogipot trash mesptleal and bags SM8710.4.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified w/th the exceptions or discrepancies noted, and payment is approved Signature Title PROPET DISTRIBUTORS, INC. 2100 PRINCIPAL ROW, SUITE 405 ORLANDO, FL 32837 PHONE: 866.DOGIPOT {866.364.4768) FAX: 407.888.8526 WWW. PROPET. ORG INVOICE Fishors Island Ferry District Accounts Payable PO Box H Fishers Island, NY 06390 Fishers Island Ferry District Jesse Marshall 5 Waterfront Park New London, CT 06320 860-608-0481 1208-L 1402-20 10 Gallon Poly DOGIPOT Trash Receptacle with Lid, with one (1) box of 50 count DOGIPOT Liner Trash Bags DOGIPOT Litter Pick Up Bags, 200 Opaque Green, OXO-BIODEGRADABLE 8"x 13" bags per boxed roll- 20 Roll Case 75.00 152.00 75.00 I52,00 S&H Shipping & Handling 31.00 31.00 TERMS: A late charge of 1 5q~ per month will be added on all overdue an oun s Fed TID# 20 4635153 Please Make Checl~s Payable to ProPer Distributors, Inc. Thankyou for your business! $258.00 $O,% $258.OO FISHERS ISLAND FERRY DISTRICT VENDOR 017991 P~ACE ROCK GARDEN CO. 05/08/2012 CHECK 461 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5709.2.000.200 14444 RMV SNOW BLOWER-TP~ACTOR 37.50 TOTAL 37.50 Town of $outhold, New York - Payment Voucher Vendor Tax ID Number or Social S~curity Number Vendor Name Race Rock Garden Co.- Vendor Telephone Number Vendor Contact Invoice Invoice Vendor Address P.O. Box 517 Fishers i~i~d, NY 06390 Net Purchase Order :Vendor No. 17991 Check No. Audit Date ~AY 0 8 2012 Number Date 3/311201 Total i Discount 37.50 4mount Claimed 37.50 37.50 37.50 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does bereby certify that the foregoing claim is truc and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded. Company Name .~.~.~ Date Number Description of Goods or Services Remove the snow blower from the tractor General Led$cr Fund and Account Number 8M5709.2.000.200 Department Certification I hereby ceni fy 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 discrepancies noted, and payment is approved Title Date Race Rock Garden Company, Inc. PO Box 517 Fishers Island, NY 06390 Invoice Date Invoice # 3/31/2012 14444 Bill To FI Ferry District Drawer H Fishers Island, NY 06390 Project Terms Account # Net 30 23 Quantity Serviced Description Rate Amount 0.5 3/27/2012 Mechanic- remove snow blower off tractor 75.00 37.50 Phone # Fax # E-mail Total $37.50 631-788-7632 631-788-7634 rrgarden~fi shersisland.net FISHERS ISLAND FERRY DISTRICT VENDOR 019275 R3%DACK'S RAPID LOCK & DOOR SVC 05/08/2012 CHECK 462 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710.2.000.200 32923 RP-PURSERS OFFICE KEYS 28.50 TOTAL 28.50 Town of Southoid, New York - Pa' Vendor Tax ID Number or Social S~cuhty Number Vendor Name Radack's Rapid Lock & Door Service Incorporated Vendor Telephone Number Vendor Contact Invoice Number 32923 Invoice Date 4/4/20t2 Total Discount 28.50 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby ceftin, that the foregoing claim is tree and correct, that no par~ 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 ;ment Voucher Vendor Address 82 Boston Post Road Waterford, CT 06385 Net Purchase Order Amount Claime, Number 28.$0 28.50 Signature ~'"~/~'~ Title Company Name /e~, ~ '/~"~9 Dat Vendor No, 19275 Check No. Audit Date [~AY 0 8 2012 Description of Goods or Services RP -Pumers Office Keys General Le~ Fund and Account Number 8M5710.2.000.200 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitation, the services properly performed and that the quantities thereof have been verified with the excepuons or discrepancies norad, and payment is approved. Signature ~ Title Date ,~/~'/f~ / ! · · Wednesday, April 04, 2012 12;15 PM Rapid Lock & Door Service 860-444-8723 p.01 VENDOR # 019:275 Fisher's Island Fen.~ Box H Fishers Island, NY 06390 Phone Fax COI',FfKACTOR LICENSE ~; 011218 FEDERAL EiN #: 5%1206216 PO NO, · ~2 0165 443 6851 Invoice 032923 DATE ,~/4/12 DUE DATE 4/14/12 TERMS inet 10 days 4/4/12 Description Cost Total KEY COPIES. IN SHOP. (STEVE) SPECIALTY KEY 4.75 28,50 Subtotal $28.50 Sales Tax (6.35%) $o oo $28.50 $28.50 82 Boston Post Rd. Suite 3PHONE: 860-443-6143 TOTAL Waterford, CT 06385 FAX: 860-444-8723 E-MAIL: Rapidlock@rocketmaiLcom Balance Due Finance clmrges will be added to all overdue balances at 1.5% per month FISHERS ISLAND FERRY DISTRICT VENDOR 018011 CHRISTOPHER L. RAFFERTY 05/08/2012 CHECK 463 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5712.4.000.000 033112 '12 COMM.MTG-5 @ $50 250.00 TOTAL 250.00 Town of Southold, New York - Pal ~ment Voucher Vendor T~x ID Number or Social Security Number Christopher L. Rafferty Vendor Telephone Number Vendor Contact Invoice Invoice Invoice Vendor No. P.O. Box 393 Flshem Island, NY 06390 Net Purchase Order Check No. Entered by ~ Audit Date MAY 0 8 2012 Numar Date Total 3131/2012 250.00 , Payee Certification Discount ~mount Claimed 250.00 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 fi-om which the Town is exempt are excluded. Company Name /e~.~t~/~ ~.~ Number Description of Goods or Services Commissioner Meetin~ls January - March Mtos ~ $ 60.00 General Ledger Fund and Account Numbex 8M5712.4.000.000 Department Certification I hereby certify that the materials above specified have been received by mc in good con&tion without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Signature Title~ Date FISHERS ISLAND FERRY DISTRICT VENDOR 018458 ROBERT HALF M3%NAGEMENT 05/08/2012 CHECK 464 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .1310.4.000.000 35298863 R.WYROFSKY-W/E 4/6/12 844.20 TOTAJ~ 844.20 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Robert Half Mana0ement Resources Vendor Telephone Number Vendor No. ! 2400 Collections Center Drive Chicago, IL 60693 Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total = Discount Amount Claime~ Number Cheek No. Entered by Audit Date ~AY 0 8 2012 35298863 4/1012012 $844.20 $844.2C 844.20 I 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 844.20 Description of Goods or Services Rwyrofsky-w/e 04/0612012 General Ledser Fund and Account Number SM1310.4.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof bare been verified with the exceptions or discrepancies noted, and payment is approved Robert Half International A Global Leader in Professional Services Since 1948 Page: 1 Invoice Date: 04/10/2012 Invoice Number: 35298863 Customer Number: 00700-101844000 Fed Tax ID: 94-1648752 Personal & Confidential Chds Raffedy FISHERS ISLAND FERRY PO DRAWER H FISHERS ISLAND NY 06390 Labor Invoice - DUE UPON RECEIPT Please Remit To: Robert Half Management Resources 12400 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 Line Employee Name Wk End Dt "Report-To" Supervisor Qty UOM Bill Rate Amount I Wyrofsky,Randy 04106201? Brook~,Bob 10.50 HRS REG $ 80.40 $ 044.20 Subtotal for Week-Ended: 04/06/2012 10,50 HRS $ 844.20 Invoice Subtotal: $ 844.20 r TOTAL AMOUNT DUE: $ 844.20 Any questions regarding this invoice please call: (800) 533-8435 For senior accounting and finance project professionals prdase call: (888) 400-7474 Please detach and return this remittance stub with your payment. Robert Half® Management Resources Week Ending Date: 4/6/12 Online Timesheet fEmployee ID 0500160010 fJob Order Number ~0700-113382 Name (Last, First Middle) Wyrofsky, Randy Client Company Name Fishers Island Ferry Repo~To Brooks, Bob f~T~me worked for one week onl Day I Date In Out In Out In Out Total Sat I 3/31/12 Sun 4/1/12 Mon 4/2/12 2:00 PM 4:00 PM 2.00 Tue 4/3/12 9:00 AM 11:30 AM 2.50 Wed 4/4/12 9:00 AM 11:30 AM 2.50 i 1.50 Thu__ 4/5/12 10:00 AM 11:30 AM Fri 4/6112 2:00 PM 4:00 PM I I ! I 2.00 TotaIWeekly Hours: 10.50 Employee Authorization ours entered by employee were submitted electronically. lectronically Submitted on 4/9/12 5:22:02 AM PDT y Randy VWrofsky Client Approval The Total Hours as shown on this timesheet were approved electronically. ElectronicallyApproved on 4/9/12 1:14:51 PM PDT by Bob Brooks An Equal Opportunity Employer © Robert Half International Inc. 2010, All Rights Reserved. OP02V3 FISHERS ISLAND FERRY DISTRICT VENDOR 019719 STAPLES CREDIT PLAN 05/08/2012 CHECK 465 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT SM .5711.4.000.000 SM .5711.4.000.000 SM .5711.4.000.000 SM .5711.4.000.000 SM .5711.4.000.000 2164145001 FI OFFICE SUPPLIES 320.53 60069 FI OFFICE SUPPLIES 170.10 66768 FI OFFICE SUPPLIES 12.75 67265 FI OFFICE SUPPLIES 87.69 67267 FI OFFICE SUPPLIES 9.56- TOTAL 581.51 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Socia[ Security Number Vendor Address Dept 31-00~0~_307779 P.O. Box 689020 Vendor No. 19719 Check No. Entered by ~ ~.udit Date MAY 0 8 2012 Staples Vendor Telephone Number Vendor Contact Number Des Molnes, IA 50368-9020 Invoice Invoice Net Date Total Number t'~0.10 Payee Certification 1,163.02 The undersigned (Claimant) (Acting on behalf of tbe 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 me~~::::.~ itle Company Na Date FI Office Supplies General Led ~r Fund and Account Number 8M5711.4.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Signature Title that was easy: mm m Previous Baian~e ~ 726.58 Oloeing Date 04/08/12 Paymente -$ 510.08 Next CIo~ing Date 05/09/1Z RSHER ISLAND FERRY [NST Oredit. -$ 9.56 Payment Due Date 05/03/12 THOMAS DOHARTY OR NIHA Pumhases +$ 591.07 PO BOX H Debit~ ~ 0.00 Current Due $ 34.00 FISHERS ISLAND, NY 0~3~0-0607 FINANCE CHARGES +$ 0.00 Pant Due Amount +$ 0.00 Credit Line $ 10,500 Late Fees +~ 0.00 Minimum Payment Due =$ 34.00 Oredit Available $ 9,701 New Balanoe =$ 796.01 CURRENT ACTIVITY View, Manage and Pay online ~ hltp://www.staples.a~untenline.~om NAR g OFFICE SUPPLIES NEN LONDON CT 170.10 NAR 1Z OFFICE SUPPLIES NEH LONDON CT 1Z.75 NAR 1ff. #9ZZ61641~.5-000-001 PUTNAN CT $Z0.55 NAR 1~. OFFICE SUPPLIES NEH LONDON CT 87.69 NAR Iff. OFFICE SUPPLIES NEN LONDON CT CREDIT g.56- PAYHENTS, CREDITS, FEES, and ADJUSTHENTS NAR 18 PAYNENT - REF # Pglgff.OOEZOOPgNP12 510.08 FINANCE CHARGE SUMMARY Current Billing Pedod Previous Billing Pednd ' PERC~ITAG E Sub)~t to Period~ E/~in~ ~ERCIE]4TAG E REGULAR REVOLVE CREDIT PLAN Z ~z ~ Tn~Accountlssued by Citibank, N.A CUSTOMER SERVICE 1- 800 767-1291 FAX NUMBER 1-801-779-7425 Information About Your Account Grace Period for Purchases, You can avoid periodic finance charges on purchases but not on cash advances. This is called a grac~ period onpurchases. The grace period is at least 20 days, To get the grace period on purchases, pay the following amounts by the due date every billing period: the New Balance (subject to the Promotional Balance E×cep[tions), plus the mtn mum monthly payments required for your NO Interest and 0% balances d you do not, you will not get a grace period unless you pay those amounts by the due date for two billinqpenods in a row. The two Promotional Balance Exceptions are: d) You do not have to pay any No Interest or 0% balances that do not expire by !he Next Closing Date shown on the billing statement. (2 You can pay any NO Interest or 0% balances that do expire by the Next CIosinq Date shown on the statement by the later of the promobon's expiraBon date or the statement's payment due date, In addition, certain promotional offers maty take away the grace period on purchases. Other promotional offers in addition to No Interest and 0% offers may also allow you to have a grace period on Furchases without having to pay all or a portion of the promotional balance by the due date. If either is the case the promotional offer will describe what happens. Balance Subject to Finance Charge: We calculate periodic finance charges separately for each balance. Balances include regular purchases, regular cash advances, and different promotional balances. Toget a daily balance, we star[ with the balance as of the end of the previous day. We add any new charges. We [hen subtract any new credds orpayments and make other ad ustments. A credit balance is treated as a balance of zero. If the rate on a balance is a daily rate we include in the daily balance any periodic finance charge on the previous day's balance. (This results in daily compounding of finance charges.) If the rate on a balance is a daily rate we use an average daily balance me[hod (includingnew transactions). We hgure thev~eeriodic finance charge by mulBplying the dailybalance by its daily periodic rate. 1o this for each day in the billing period. The Balance Subiect to Finance Charqe is the averaq(e of the daily balances durin(] the billing period. If you multiply this figure for each~alance by its daily periooic rate and by the number of days in the billing period, the resuq is the total periodic finance charge on that balance. Rounning Inay cause a small difference. · Alternate Balance Subiect to Finance Charae Calculation Method. If the front of your statement has a message stating this a~count is subject to the Alternate Balance Subject to Finance Charge Calculadorl Method we use a two-cycle average gaily balance method (including new transactions) for purchases and an average daily balance method (including new transactions) for cash advances. -If a periodic rate is a daily periodic rate, we use the following calculation method. For each balance we multiply the daily balance by the applicable- 0ally eriodic rate. We do this for each da in the billing period includln the Closing each day of the previous blllinqperiod by the applicable dailyperiodic rate, unless your account was credited for the full New Balance, plus ti~e minim_~lm monthly payments required for your No Interest and 0% balances, on your- previous billing s~atement by that statement's payment due date (subject the Promotional Balance Exceptions described above in the Grace Period fo~ Purchases) or a periodic finance charge was already billed on that balance. To et the daily balance we take the beginning balance for each balance every ~ay, add any new charges and any periodic finance charge on the previous day's balance, subtracfany creditsorpaymentscrediteoasofthatday, and make other adjustments, A credit balance is treated as a balance of zero. For each balance, the Balance Sub oct to Finance Charge is the average of the daily balances during fha applicable billing period. For eachpLurchase balance, if you multiply the current billing period Balance Sub eot to Finance Charge by the number of days in the bilhng period and by the applicable dailyperiodic rate and you multiply the previous billing period Balance Sub oct to Finance Charge (if currently subject to a finance charge) by the number of days in that billing eriod and by the applicable daily periodic rate, and add those two fiqures together, the result is the periodic finance charges assessed for that balance, except for minor variations caused by rounding. -If a periodic rate is a monthly periodic rate, we use the following calculation method. We take the beginning balance for each balance every day (including periodic finance charges imposed in previous billing periods) add any new charges, subtract any credits or payments credited as of that day and make other ad us[men[s, A credit balance is treated as a balance of zero. This gives us the daily balance. We add up all the daily balances for the billin~q period ([ncludinc~ the balances on the Closing Date) and divide by the totaq number of days in the bgling[period. This gives us the Balance Sub'ectl( to Finance Charge for that balance.We figure the periodic finance charge by multiplying the Balance Subject to Finance Charqe for that balance 5y the appbcable monthly ~eriodic rate. In addition, for each purchase balance, we multiply the Balance ~ublect to Finance Charge for that balance for the previous billing period b)~ the applicable monthly periodic rate, unless your account wa5 credited for the al- New Balance, plus the minimum monthly payments required for your No Interest and 0% balances, onMour previous billing statement by that statement's payment due date (subject to the Promobonal Balance Exceptions described above in the Grace Period for Purchases) or a periodic finance charge was already billed on that balance. Notify Us in Case of Errors or Questions About Your Bill If you think your billing statement is wrong o' if you need more information abouf a transaction on your billin~q statement write to us (on a separate sheet) as soon as possible at the billing ~rrors address on this statement as soon as possbe We must hear from you in wr[ting nc la er han60da~saf er we sent you the first statement on which the error or problem appeared. In your letter, give us the forlowing information: · Your name and account number. · _ The dollar amount of the suspected error. Describe the error and explain if,~ou can, achy you believe there is an error. If you need more information, describe the i em you are unsure about. Important Payment Instructions Crediting Payments: We must receive your payment in proper form at our processing facility by 5 p.m. local time there. If we do it wilIbe credited as of day. A payment received at the processin~q facility tnproper form after that time will be credited as of the next day. Allow 5to 7 dags tot payments by regular mail to reach us. There may be a delay of up to 5 days in trod[tin a pa men[ we receive that is not in proper form or is not sen~t to the correct adagress, Ylhe correct address for a payment sent by regular mail is ,he address listed on the return envelope or on the front of [he payment coupan. A payment made in-store is not sent to the correct address. The correct addr?s for a payment sent bV courier or express mail is the Express Payments Addres, shown below. Proper Form: EoF a payment sent b~y mail or caurier to be inprroper fOrmr you must: · Enclose a valid check or money order. No cash, gift cards, or foreign currency please. · Include your name and account number on the front of your check or money ordec If you send an eligible check with thispi ayment coupon you authorize us to complete your payment by electronic del~it. If we do, the checking account will De delfited in ~he amount on the check. We may do this as soon as the day we receive the check. Also, the check will be destroyed. Copv Fee: We charge $5 for each copy of a billing statement that dates back 3 months or more. We add the fee to the regular revolve credit plan balance. We waive the fee if your request for the copy relates to a billing error or disputed purchase. Payment Options Other Than Regular Mail: iOnline Payments. Visd www.staples.accountonline.com and sign up for online payments. Enrollment may take a few days. If we receive your request to make an online payment by 5 p,m. Eastern time. we will credit your payment as of [hat day. If we receive your request to make an online payment after that time, we wil/credd your payment on the next day. For security reasons, you may be unable to pay your entire New Balance with your firs[online payment. Pa'/ by Phone Service. You may use this service any time to make a payment by phone. You will be charged $t4.95 to use this service, Call by 5p.m, Eastern rime to haveyourpayment credited as of that day..If you call after that tired, your payment will be credited as of the next day. We may process your payment electronically upon verification of your identity. · Express Payments. You can send payment by courier or express mail to the Express Payments address: Customer Service Center, Dept, CCS 922 4740121st Street, Urbandale, IA 50323, Payment must be received inprroper form, at the prope~ address by 5 p.m. Central time in order to be credited as of that day. Alt payments received inproper form, at the proper address, after that time will be credded as of the nextday. Report a Lost or Stolen Card Immediately: Customer Service is available 24 hours a day, 7 days a week, This Account is Issued by Citibank, N.A. Staples CRC S~04ST00000711 Re,/. 07/11 Retail To: STAPLES CREDIT PLAN DEPT.51 - 7820255882 PO' BOX 689020* DES MOINES IA 50368-9020 Payment Due Date: 05/03/12 Bill To: page 2 of 3 ACCOUNT: 6035517820255882 FISHER ISLAND FERRY DIST PO BOX H Please make che~ks payable to STAPLES CREDIT PLAN that was easy: SHIP TO= INVOICE: 60069 AMOUNT DUE: 170.10 iNVOICE DATE: 03/09/12 SHIp TO= INVOICE: 66768 AMOUNT DUE: 12.75 INVOICE DATE: 03/12/12 INVOICE: 67265 AMOUNT DUE: 87.69 INVOICE DATE: 03/14/12 TOTAL 12.75 INVOICE: 67267 AMOUNT DUE: 9.56- INVOICE DATE: 03/14/12 PleaseDireetlnquiriesto: Phone:800-767-1291 Fax: 801-779-7425 Information About Your Account Grace Period for Purchases. You can avoid periodic finance charges on purchaseSr but not on cash advances. This is called a grace period onpurchases. The grace period is at least 20 days. To get the grace period on purchases pay the following amounts by the due date every billing period: [he New Balance (sub ecl to the Promotional Balance Exceptions plus the minimum monthly payments required for your No interest and 0% balances. If you do not you will not get a grace period unless you pay those amounts by the due date for two billinqpenods in a row. The two Promotional Balance Exceptions are: d You do nothave to pay any No Interest or 0% balances that do not expire by :he Next Closing Date shown on the billing statement. (2) You can pay any No Interest or 0% balances that do expire byfheNextCIosing Date shown on the statemenf by the later of the promoBon's expiration date or the statement's payment due date. In addition, certain promotional offers ma]y ta~e awaa¥ the grace period on purchases. Other promotional offers in addition to No Interest and 0% offers, may also allow you to have a grace period on )urchases without having to pay all or a portion of the promotional balance by the due date. If either is the case the promotional offer will describe what happens. charge on the previous dayrs balance. (This re~,uds in daily compounding of finance charges.) (indudingnew transactions). We Bgure the. j? iodic finance charge by multiplying the dail~Balance by its daily periodic rate. vve Jo this for each day inthe billing period. The Balance Sub ectfo Finance Charge is the average of the daily balances durfn thebillin eriod, lfyoumuqi lythisficlureforeachbalanceb itsdaily periodic rate an~ ~y the ,lumber of ~ays in the billing period, the result is the total -if a periodic rate is a daily periodic rate we use the followinq calculation method. For each balance we multiply the daily balanc~ by tbe applicable daily eriodic rate. We do this for each da in the bilHng period indudm the C-losing ~)ate. In addition, for each purchase ~alance, we multiply ~he daily ~)alanee for each day of the previous bdlingperiod by the applicable dailvpe,riodic rate, unless your account was credited for the full New Balance, plus the minimum monthly pa merits required for your No Interest and 0% balances, on your previous bil~ing statement by that statement's payment due date (subject the Promotional Balance Exceptions described above in the Grace Period for Purchases) or a periodic finance charge was already billed on that balance. To et the da~ly balance, we take the beginning balance for each balance every. ~ay, add any new charges and any periodic finance charge on the previous day's balance, subtract any credits or payments creditedas of thatday, and make other adjustments. A credit balance is treated as a balance of zero. For each balance the Balance Sub ect to Finance Charge is the average of the ,aily balances during the applicable billing period. For eachpLurchase balance if you multiply the current billing period Balance Sub ecl to Finance Charge by the numberofdaysinthebillmqperiodandbytheapplicabledailyper~odicrate and you multiply the previous billing period Balance Subject to Finance Charge (if currently subiect to a finance charge) by the number of days in that billing p~ eriod and by the applicable daily periodic rate and add those two fiqures together, the result is the periodic finance charges assessed for that balance except for minor w~riations caused by rounding. -If a periodic rate is a monthly periodic rate, we use the following calculation method. We take the beginning balance for each balance every day including periodic finance charges imposed in previous billing periods) add any new charges, subtract any credits or payments credited as of that day and make other adjustments. A credit balance is treated as a balance of zero. This gi~es us the daily balance. We add up all the daily balances for the billing period (incJudinq the balances on the Closing Dale) and divide by the total number of days in the billing period. This gives us the Balance $ub'ect to Finance Charge for that balance. We figure the periodic finance charge ~y multiplying the Balance Sub ecl to Finance Charge for that balance by the apphcable monthly periodic rate. In addition, for each purchase balance, we multiply the Balance Sub ectj to Finance Charge for that balan:e for the previous bdgng period bythe applicable monthly periodic rate, unless your account was credited for the full New Balance, plus the minimum monthly payments required for your NO Interest and O% balances, onyourpreviousbillingstatementbythatstatement's payment due date (subject to the Promofional Balance Exceptions described above in the Grace Period for Purchases) or a periodic finance charge was already biped on that balance, Notify Us in Case of Errors or Questions About Your Bill If you think your billing statement is wrong, o if you need more information about a transaction on your billin~ sta omen wr e o us on a separa e sheet as soon as possible at the billing ~rrors addre,ss on th s s a ement as soon as possible. We must hear from you in writing n( later than 60 day5 after we sent you the first s atement on which he er o or p oblem appeared n your e er, gveus he fo owng ntorma on: · Your name and account numbeL · The dollar amount of the suspected error. · Describe the error and explain if ~/ou can, why you believe there is an error, If you need more information, describe the item you are unsure abou, Important Payment Instructions Crediting Payments: We must receive youl payment in proper form at our processing facility by 5 p.m. local time there. P we do it wil/be credited as of that day. Apaymentreceivedattheprocessin~q fadlity inproper form after that time wil/be credited as of the next day. Allow 5to i~ da~s lor payments by regular mail to reach us. There may be a delay of up to 5 days in creditinq a payment we receive that is not in proper form or is not serd to the correct address The correct address for a payment sent by regular mail is the address listed on the return enverope or on the front of the payment coupon. A payment made in-store is not sent fo the correct address. The correct address for a payment sent by courier or express mail is the Express Payments Address shown below. Proper Form: For a payment sent by mail or courier to be in proper form, you taus(: · Enclose a valid check or money ordeE No casll, gift cardsr or foreign currency please. · Include your name and account number on t he front of your check or money order, If you send an eligible check with thisp~ ayment coupon, you authorize us to complete your peyment by electronic de,it. If we do, the checking account will be de~ited m the amount on the check. We may do this as soon as the day we receive the check. Also, the check will be destroyed. Copy Fee: We charge $5 for each copy of a billing statement that dates back 3 monlhs or more. We add the fee to the regular revolve cred t p an ba anco We wa ve the fee if your request for the copy relates to a billing error or disputed purchase Payment Options Other Than Regular Mail: iOnline Payments. Visit www. staples.accountonline.com and sign up for online payments. Enrollment may take a few days. If we receive your request to make an online payment by 5 p.m. Eastern time. we will credit your payment as of that day. If we receive your request to make an online pay~ment after that time we willcredit your payment on the next day. For security ~easons, you may be unable to pay your entire New Balance with your first online payment. Pay by Phone Service. You may use this service any time to make a payrm(.nt by phone. You will be charged $14.95 to use this service. Call by Bp.m. Eastern time to haveyour payment credited as of that day.. If you call after that time. your payment will be credited as of the next day. We may process your pay~ent electronically upon verification of your identify. · Express Payments. YOU can send payment by courier or express mail to the Express Payments address: Customer Service Center. Dept. CCS 922, 4740121st Street. Urbandale, IA 50323. Payment must be received inplroper form. at the proper addresSr by 5 p.m. Central time in order to be credited as of that day. All payments received inproper form, at the proper address, after that time will be credited as of the nextday. Report a Lost or Stolen Card Immediately: Customer Service is available 2A hours a da% 7 days a week This Account is Issued by Citibank, N.A. Stap[es CRC S604ST00000711 Rev. 07/11 F~emll TO: STAPLES CREDIT PLAN DEPT.S1 - 7820255882 PO BOX 689020 DEs MOINES IA 50368-9020 Payment Due Date: 05/03/12 BIll To: pago ACCOUNT: 603551?820255882 FISHER ISLAND FERRY DIST PO BOX N Please make checks payable lo STAPLES CREDIT PLAN that was easy: INVOICE: 2164145001 AMOUNT DUE: 320.53 INVOICE DATE: 03/14/12 Please Direct Inquiriesto: Phone: 800-767-1291 Fax: 801-779-7425 information About Your Account Grace Period for Purchases. You can avoid ~eriodic finance charges on purchases, but not on cash advances. This is called a grace period on purchases. The grace period is at least 20 days. TO get the grace period on purchases, pay the following amounts by the due date every billing period: the New Balance (sub act to the Promotional Balance Exceptions plus the minimum monthly payments required for your No Interest and 0% balances. If you do not, you will not get a grace period unless you pay those amounts by the due date for two billingpenods in a row. The two Promotional Balance Exceptions are: (1) You do nothave to pay any No Interest or 0% balances that do not expire by the Next Closing Date shown on the billing statement. 2 You can pay any NO Interest or 0% balances that do expire by the Next Closing Date shown on the statement by the later of the promotion's expiration date orthe statementrs payment due date. In addi ion certain promotional offers ma]y take away the grace period on purchases. Other promotional offers in addition to No Interest and 0% offers may also allow you to have a grace period on purchases without having to pay all or a portion of the promotional balance by the due date. If either is the caser the promotional offer will describe what happens Balance Subject to Finance Charge: We cak ulate periodic finance charges separately for each balance, Balances include regular purchases, regular cash advances, and different promotional balances To et a daily balance, we start with the balance as of the end of the prewous day. V~e add any new charcjes, We then subtract any new credits orpayments and make other ad ustments. A credit balance is treated as a balance of zero. If the rate on a balance is a daily ~ate we include in ~he daily balance any periodic finance charge on the previous day's balance. (This results in daily compounding of finance charges.) If the rate on a balance is a daily rate we use an average daily balance method includinnq new transactions. We figure theperiodic finance charge by multiplying the daily balance by its daily periodic rate. We do this for each day in the billing period. The Balance Subject to Finance Charge is the average of the daily balances during the billing period, if you multiply this figure for each balance by [ts daily periodic rate and by the number of days in the billing period the result is the total periodic finance charge on that balance. Rounding may cause a small d ference. · Alternate Balance Subiect to Finance Charae Calculation Method. If the front of your statement has a message statin~ this a~count is sub act to the Alternate Balance Sub eot to Finance Charge Ca[culatd n Method we use a two cvcle average daily balance method (including new transactions) for purchases and an average daily balance method (including new transactions) for cash advances. -If a periodic rate is a daily periodic rate we use the following calculation method. For each balance we multipl~ the daily balance by the applicable daily eriodic rate. We do this for each dayin the billing perio~ including the C~osing Date. In addition for each [~urchase balance we multiply the daily balance, for each day of the previous blllingperiod by the applicable dailyperiodic rate, unless your account was credited for the full New Balance, pus the minimum monthly payments required for your No Interest and 0% balances, on your. previous billing statement by that statement's payment due date subecttO the PromoBonal Balance Bxceptions described above in the Grace Period fo~ Purchases oraperiodicfinancechargewasalreadybdledonthatbalance. To et the daily balance we take the beginning balance for each balance every. ay add any new charges and any periodic finance charge on the previous day's balance, subtract any credits or payments credite~as of thatday, and make other adjustments. A credit balance is treated as a balance of zero. For each balance the Balance Subiect to Finance Charge is the average of the daily balancesduringtheapplicab]ebill[ngperiod. Foreachpurchase balance, dyou multiply the current billing period Balance Subject to ~nance Charge by the number of days in the billing period and by the applicable dailyperiodic rate. and you multiply the previous billing period Balance Sub ect to Finance Charge if currenfly sub ect to a finance charge by the number of days in that billing eriod and by the applicable daily periodic rate, and add those two figures together, the result is the periodic finance charges assessed for thatbalance, except for minor variations caused by rounding. If a periodic rate is a monthly periodic rate we use the following calculation method. We take the beginning balance for each balance every bay (including periodic finance charges imposed in previous billing periods) add any new charges subtract any credits or payments credited as of that day and make other adjustments. A credit balance is treated as a balance of zero. This gives us the daily balance. We add up ali the daily balances for the billin[g period including~hebalancesontheCIosingDate and divide by the total number of days in the billing period. This gives us the Balance Sub'ectl~ to Finance Charge for that balance. We figure the periodic finance charge by multiplying the Balance Subject to Finance Charge for that balance by the applicable monthly ~eriodic rate. In addition for each purchase balance we multiply the Balance bubecttoFinanceChargeforthatbalanceforthepreviousbll[ingperiodb] ythe applicable monthly periodic rate unless your account was credited for the tull New Balance plus the minimum monthly payments required for your NO Interest and 0% balances ony~our previous billing s~atement by that statement's payment due date subject to the PromoBonal Balance Exceptions described above in the Grace Per~od for Purchases) or a per od c f nance charge was already billed on that balance. Notify Us in Case of Errors or Questions About Your Bill abou a ransaction on your billin~ statement, wr~tetous on a separate sheet) as soon as possible at the billing hrrors pddress on this statement as soon as poss ble We must hear from ,/ou in writing no later than 60 da~s after we sent you the first statement on which the error or problem appeared. In your letterr give us the following information: i Your name and acco ntnumber. Describe the error and explain ii,Quean why you believe there is an error. If Important Payment Instructions Cred t nq Payments We must race ve yo ~r payment in roper form at our processng ac yb,/Sp ~ ocal me here. lfwedo itwil~becreditedasofthat da . A payment leceived at the processin facility in roper form after that time wYbeced ed asp he next day Allow~ o T days iPor payments by regular ma oreachus TheremaybeadelayofuptoS~aysincreditin apa mentwe race ve ha is not in proper form or is not sent to the correct adogress, Yrhe correct address orapa men sen by regular mail i ~ the address listed on the return If you send an eliqible check with this ayment coupon, you authorize us to complete your payment by e ectronic o~§it. If we do, the checkincJ account w be deli ted in ~he amount on the check. We may do this as soon as the day we receive the check. Also, the check will be destroyed. Cop,/Fee We charge $5 for each copy of a billing statement that dates back 3 mon'ths or more We add the fee to the regular revolve credit plan balance. We waive the fee if your request for the copy relates to a billing error or disputed purchase. Payment Options Other Than Regular Mail: · Online Payments. Visit www.staples.accountonline.com and sign up for online paymen s. Enrollment may take a few days. If we receive your request to make an online paymenl by 5 p.m, Eastern time we will credit your payment as of that day. If we receive your request to make an online payrment after that timer we wil]credit your payment on the next day. For security reasons, you may be unable to pay your entire New Balance with your first online payment. · Pay by Phone Service. Youyma use this service any time to make a payrment by phone. You will be charged $14.95 to use this service. Call by 5p,m. Eastern hme o haveyourpayment credited as of that day.. If you call after that time your payment will be credited as of the next day. We may process your payment electronically upon verification of your identity. · Express Payments. You can send payment by courier or express mail to lhe Express Payments address: Customer Service Centerr Dept. CCS 922, 4740 121st S rea Urbandale IA 50323, Payment must be received mprroper form at the proper address by S p.m. Central time in order to be credited as of that day, All This Account is issued by Citibank. N.A Staples CRC S604STOOOOO711 Rev. 07/11 that was easy: For Customer Service, call 1-800-333-3330, or email at support@orders.staples.com. Order online, by phone or by fax 24 hours a day, 7 days a week. STAPLES that was easy NINA SCHMID Fleer: 1 C/O FISHERS ISL~2~D FERRY 5 WATERFRONT PARK NEW LONDON, CT 06320 Contact: (631) 788-7463 NINA SCHMID SHIPPINg LOCATION:PUtnam, CT FC CARRIER NOUTE:MCH/COU /44 TOT~-L PACKAGES: 1 PAGE: 1 Order Date: 03/14/2012 Coupons and other ad~u~.tment$ are deducted a~ter the Merchand±se Total. 491789 HARDWOOD 36X48 CHAIR MAT /STP-15987 EA 2 2 34.99 69.98 Please tell us how wt 're doing for a chance to win $2500! To participate o to WWW.SURVEY4STAPLES.COM and enter urvey Code 9226164145 For rules vis~ t www.survey4staples.com. 716522 SPLS 1SUB 8X10.5 QUAD 4SQ/IN /11625M-CC EA 5 5 3.29 16.45 744154 K-CUP SPECIAL BLEND 18/BX /15555/0050 BX 1 1 11.99 11.9~9 772994 HP 940XL CYAN INK /C4907~N#140 EA 2 2 23.39 46.78 772995 HP 940XL BLK INK /C4906~2q#140 EA 2 2 32.39 64.78 772997 HP 940XL YEL INK /C4909D2q#140 EA 2 2 23.39 46.78 772998 HP 940XL MAG /C4908~N#140 EA 2 2 23.39 46.78 852242 3X3 VAL PK 12 CANARY 6 BRIGHT /654144YWB PK 1 1 16.99 16.99 Thank You For Your Order! Staples, Inc. that was easy: For Customer Service, call 1-800 333-3330, or email at support@orders.staples.com. Order online, by phone or by fax 24 hours a day, 7 days a week. STAPLES that was easy Floor: 1 C/O FISHERS ISIJ~ND FERRY 5 WATERFRONT PARK NEW LONDON, CT 06320 Contact: (631) 788-7463 - NINA SCHMID SHIPPING LOCATION:Putnam, CT FC CARRIER EOUTE:MCH/COU /44 TOTAL PACF~A~ES: 1 PAGE: 2 Order Date: 03/14/2012 Check your order status online by going to w~ww. Staples.com and clicking "Order total 320.53 .00 .00 Need to return something? Please call Customer Service to process a return. TOTA~ VJtLUE OF ORDER: 320.53 ' oo~ Thank You For Your Order! Staples, Inc. THIS IS NOT AN INVOICE FISHERS ISLAND FERRY DISTRICT VENDOR 020554 TORRINGTON BRUSH WORKS, INC, 05/08/2012 CHECK 466 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMO~/NT SM .5710.2.000.200 297833 RP-BROOM & DUSTP~N 56.30 TOTAL 56.30 Town of Southoid, New York - Pal 'ment Voucher Vendor Tax [D Number or Social Security Number Vendor Address 4377 Independence Ct. Vendor Name Sarasota, FL 34234 vends,- No. 20554 Uheck No. Entered by Audit Date Torrington Brush Works, Inc. Vendor Telephone Number Vendor Contact Invoice Invoice Net Purchase:Order MAY 0 8 2012 CI k ~. . Number 297833 Date Total 3/2612012 56.30 $56.30 Payee Certification Discount i Amount Claimed 66.30 $56.30 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 Number Description of Goods or Services RP-Broom & Dustpan SM5710.2.000.200 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 w/th the exceptmns or discrepancies noted, and payment is approved. Signature Title__ Date Page: 1 Torrington Brush Works, lnc. 4377Independence Ct. Sarasota, FL 34234 9413551499 Sold To: FISHERS ISLAND FERRY DIS BOX H FERRY ISLAND, NY 06390 Invoice Invoice Number: 0297833qN Invoice Date: 3/26/2012 Order Number: 0271598 Order Date 3/23/2012 Salesperson: PHON Customer Number: 0010040 Ship To: FISHER ISLAND FERRY DIS 5 WATERFRONT PARK NEW LONDON, CT 06320 Confirm To: JESSIE Customer P.O. Ship VIA F.O.B. Terms VERBAL UPSGROUND 1% 15 Days - Net 30 Item Number Unit Ordered Shipped Back Ordered Price Amount 14009 EACH 5 5 0 6.6400 134 STEEL DUST PAN Whae: 002 03035 EACH 2 2 0 11.5500 WARREN 16"FLOOR BRUSH Whse: 002 33,20 23.10 Net Invoice: Less Discount; Freight: Sales Tax: Invoice Total USD: 5630 0.00 0,00 0.00 56,30 FISHERS ISLAND FERRY DISTRICT VENDOR 020730 TP~AWLWORKS, INC. 05/08/2012 CHECK 467 FI/ND & ACCOLVNT P.O. ~ INVOICE DESCRIPTION AMOUNT SM .5710.2.000.000 SM .5710.2.000.200 34165 34653 RP/MU-LINES FOR LIFE FLT 62.91 RP-HAMMERS,SCRAPERS 90.60 TOTAL 153.51 00;,508 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Name Trawlworks, Inc. Vendor Telephone Number Vendor Contact Vendor Address P.O. Box 342 Narragansett, RI 02882 Vendor No. 20730 Check No. Audit Date MAY 0 8 Z012 Invoice Invoice Invoice Number Date Total Discount 34653 415/2012 $90.60 3416~ $62.91; 90.60 62.91 153.51 153.51 Payee Certification lhe undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is acmalfy due and owing and that taxes from which the Town is exempt are excluded Signature ~ Tide Company Name ~:::~'-.~,~ Date Purchase Order Number Description of Goods or Services RP- Hammers and Scrapers for chipping RPIMU Lines for Life Floats General Ledser Fund and Account Number SMfi710.2.000.200 SM5710.2.000.000 Department Certification I hereby certify that the materials above specified have been received by me m good condition without substimfion, the services properly performed and that tbe quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Signature TRAWLWORKS, INC. 30 Waits Way, P.O. Box 342 3 46 5 3 NARRAGANSE'I-r RI 02882 (401) 789-3964 FAX (401) 789-8534 ~f C'~. TO 04/25/2012 10:02 4817898534 TRA~/LWORK$, ~NC. 30 Wa~ ~.'ay, P.O. Box 342 NARRAGANS[~ r, ~ 02882. (401) 789-3~ F~ (~1) 759~5~ TRAWLWORKS INC PAGE 01/01 34165 FISHERS ISLAND FERRY DISTRICT VENDOR 021503 UNITED OIL RECOVERY, INC. 05/08/2012 CHECK 468 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.925 98507 HAZARDOUS WASTE DISPOSAL 1,709.26 TOTAL 1,709.26 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address P.O. Box 845033 Vendor No. 21503 United Industrial Services Vendor Telephone Number Vendor Contact Invoice Invoice Invoice BostOn, MA 02284-~033 Net Purchase Order Check No. Entered by ~[~ Audit Date MAY 0 8 2012 Number 98507 Date Total 3129/20t2 1,709.26 Discount Amount Claimed 1,709.26 1,709.26, j 1,709.26 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is 'flue 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. Number Description of Goods or Services Hazardous Waste Disposal General Ledser Fund and Account Number SM87'10.4.000.925 Department Certification I hereby certify that the materials above specified have been received by mc in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Invoice TI ADEBE TM Remit To: Uniled Oil Recovery, Inc, P,O, Box 845033 Benton, MA 02284-5033 Ii;SHERS ISLAND FERRY DISTRICT O BOX H ISHERS ISLAND, NY 06390 ontact: ACCOUNTS PAYABLE FISHER"S ISLAND FERRY 5 WATERFRONT PARK NEW LONDON, CT 06320 Page: 1 Number: 98507 Date: 3/29/2012 UNITED INDUSTRIAL SERVICES 4/28/2012 11:34:00 AM 004FIS 98507 Net 30 Oil Based Paint Loose Pack (P122911002PSBYPT15) - Man# 009522141JJK Zinc containing paint (P011612001H3LP) - Man# 009522141JJK Lead Paint Chips (P061807071H4LTDPB) - Man# 009522141JJK MANIFEST PREPARATION FEE Transportation bi#ed on JO229120074-101 Recovery & Secudty Surcharge LAST ITEM Y 1 55 gallon drum $275.000 $275~00 Y 1 16 ga,on drum $750.000 $750.00 Y 2 16 gallon drum $195.000 $390.00 Y 1 EACH $20.000 $20.00 1 Surcharge $172.200 $172.20 Subtotal $1,607.20 Sales Tax $102.06 Pa~'ments __-- ............. $1,709.26 TERMS: INTEREST SHALL ACCRUE AT THE RATE OF1 1/2Y~PERMONTHONALLAMOUNTSNOTPAIDIN3ODAY$. CUSTOMERAGREESTOPAYALLCOSTSOF COLLECTION INCLUDING A REASONABLE ATFORN EY'S FEE IN THE EVENT THIS ACCOUNT IS TURNED OVER TO AN A'~'ORNEY FOR COLLECTION. CONTACT INFO: UNITED OIL RECOVERY, INC. 47 GRACEY AVENUE, MERIDEN, CT 06451 PHONE: (203) 238-6757 FAX: (203) 238-6778 FISHERS ISLAND FERRY DISTRICT VENDOR 021506 D-NITED PARCEL SERVICE 05/08/2012 CHECK 469 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.700 SM .5710.4.000.700 SM .5710.4.000.700 26639142 W/E 4/6/12-(4)PKG 74.19 26639152 W/E 4/13/12-(1)PKG 32.67 26639162 W/E 4/20/12-(2)PKG 44.34 151.20 Town of Southold, New York - Pal United Parcel Service Vendor Telephone Number Vendor Comact Invoice Invoice Date 26639152 4/t4/2012 26639142 4/712012 74.19 26639162 4/2112012 $44.34 $32.67 Vendor No. ~ment Voucher ' 21506 Vendor Address P.O. Box 7247-0244 Philadelphia, PA 19170-0001 :heck No. Entered by ~ Audit Date MAY 0 8 2012 $32.67 $74.19 w/e 04/06/2012 .34 w,e o4/20,2012 $151.20[ $151.20 Payee Certification The undersigned (Claln~nt) (Acting on behalf of the above named claimant) Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the serv/ces properly performed and that the quantifies thereof have been verified with the exce~ions or discrepancies noted, and payment is approved Title Date Shipped from: FISHERS iSLAND FERRY 1 STATE ST NEW LONDON, CT 06320 Defivery Service Invoice Invoice date April 14, 2012 Invoice number 0000026639152 Shipper number 026639 Control ID 17S3 Page 1 of 3 ~ 0720A00000266392 77366200011433 ~-- AB 01 058708 626811175 B**3DGT ~ FISHER ISLAND FERRY ~--- PO BOX H = FISHER ISLAND, NY 0639g-g607 Sign up for electronic billing today! Visit ups.com/billing For questions about your invoice, call: (8OO) 811-1648 Monday - Friday 8:00 a.m. - 9:00 p.m.E.T. UPS P.O. Box 650580 Dallas, TX 75265-0580 Account Status Summary Weekly Payment Plan Amount Due This Period $ 32.67 Amount Outstanding (prior invoices) $196.69 Total Amount Outstanding $ 229.36 Pierce include the Return Portion of each outstanding invoice with your payment. See Account Status for details. A paper alternative Choose a UPS electronic billing solution as an alternative to receiving a paper bill. You can view, manage and pay your UPS bills electronically. Choose the format that best suits your company's needs. Learn more at www.ups.com/billing Thank you for using UPS. Summary of Charges Page Charge Outbound 3 UPS WoddShip $ 9.72 3 Adjnstments & Other Charges $ 2.00 3 Fees Service Charges $ 0.95 $ 20.00 $ 32.67 Amount due this period UPS payment terms require payment of this invoice by April 25, 2012. Pay ed by May 9 bj manta not receiv ,2012 are sa act to a lats fee of 6% of the Amount Due This Period (Details in UPS Tariff, available at ups. com) Note: This invoice may contain a fuel Surcharge as described at ups.com. The published fuel surcharge is 8. 0% for UPS Ground Services and lZLO% for UPS Air Services, UPS 3 D~y Select, and Intsrnationsl services. For more information, visit upa.com. Delivery Service Invoice Invoice date April 14, 2012 Invoice number 0000026639152 Shipper number 026639 Page 2 of 3 Account Status Weekly Payment Plan Amount Outatandin~l (prior invoices): Please include the Return Portion of each outstanding invoice with your payment. Betance Invoice Number Invoice Date Due 0000026639092 03/03/2012 $ 23,40 0000026639102 03/10/2012 $ 25.14 0000026639112 03/17/2012 $15,91 0000026639122 03/24/2012 $13,00 0000026639132 03/31/2012 $ 45.05 0000026639142 04/07/2012 $ 74.19 Total $196.69 Outstanding balances reflect any payments received as of 04/13/2012. Please ignore this message if a recent payment has been made for any outstanding invoices. Outbound UPS WorldShip Delivery Service Invoice Invoice date April 14, 2012 Invoice number 0000026639152 Shipper number 026639 Page 3 of 3 Pickup Pickup Number of Billed Date Record Message Codes Packages Charge 04/10 9121173014 1 9.72 Total UPS WorldShip 1 Package(s) 9.72 Total Outbound 1 Package(s) 9.72 Adjustments & Other Charges Miscellaneous Billed Explanation Charge WEEKLY PRINTER SERVICE FEE 2.00 FOR 1 PRINTERS AT $2.00 EACH FOR 13-APR*2012 Total Miscellaneous 2.00 Total Adjustments & Other Charges 200 Fees WeekEnding Unpaid Billed Date Balance Rate Charge 03/17 Late Payment Fee 15.91 6.00 % 0.95 Pursuant to the UPS Tariff, a late payment fee has been assessed. Total Fees 095 m Shipped from: FISHERS ISLAND FERRY 1 STATE ST NEW LONDON, CT 06320 Delivery Service Invoice Invoice date April 7, 2012 Invoice number 0000026639142 Shipper number 026639 Control ID Q051 Page 1 of 3 ~---- 0720A00000266392 77366100011701 ~ AB 01 063943 590481187 B**3DGT ISign up for electronic billing today! Visit ups.com/billing For questions about your invoice, cell: (800) 811-1648 Monday - Friday 8:00 a.m. - 9:00 p.m.E.T. or write: UPS P.O. Box 650580 Dallas, TX 75265-0580 Account Status Summary Weekly Payment Plan Amount Due 'l~tis Period $ 74.19 Amount Outstanding (prior invoices) $122.50 Total Amount Outstanding $196.69 Please include t~u Return Portion of each outstanding invoice with your payment~ See Account Status for details. A paper alternative Choose a UPS electronic billing solution as an alternative to receiving a paper bill. You can view, manage and pay your UPS bills electronically. Choose the format that best suits your company's needs. Learn more at www.ups.com/billing Thank you for using UPS. Summary of Charges Page Cherge Outbound 3 UPS WorldShip $ 50.68 3 Adjustments & Other Chmges $ 2.00 3 Fees $1.51 Service Charges $ 20.00 Amount due this period $ 74.19 UPS payment terms require payment of this invoice by April 18, 2012. Payments not received by May 2, 2012 ere subject to a late fee of 6% of the Amount Due This Period. (Details in UPS Tariff, available at ups.corn) Note: This invoice may contain a fuel surcharge as described at ups.com. The published fuel surcharge is 8.0% for UPS Ground Services and 14.0% for UPS Air Services, UPS 3 Day Select, and International services. For more information, visit upa.com. Delivery Service Invoice Invoice date April 7, 2012 Invoice number 0000026639142 Shipper number 026639 Page 2of3 Account Status Weekly Payment Plan Amount Outstandin~l (prior invoices): Pleace include the Return Portion of each outstanding invoice with your payment. Balance Invoice Number Invoice Date Due 0000026639092 03/03/2012 $ 23,40 0000026639102 03/10/2012 $ 25.14 0000026639112 03/17/2012 $15~91 0000026639122 03/24/2012 $13.00 0000026639132 03/31/2012 $ 45.05 Total $122.50 Outstanding balances reflect any paymanta received as of 04/06/2012. Please ignore this message if a recent payment has been made for any outstanding invoices. Delivery Service Invoice Invoice date Apdl 7', 2012 Invoice number 0000026639142 Shipper number 026639 Page 3 of 3 Outbound UPS WorldShip Pickup Pickup Number of Billed Date Record Message Cedes Packages Charge 04/06 9121173003 4 5068 Total UPS WorldShip 4 Package(s) 50.68 Total Outbound 4 Package(s) 50.68 Adjustments & Other Charges Miscellaneous Billed Explanation Charge WEEKLY PRINTER SERVICE FEE 2.00 FOR 1 PRINTERS AT $2.00 EACH FOR 06-APR-2012 Total Miscellaneous 2.00 Total Adjustments & Other Charges 2.00 Fees WeekEnding Unpaid Billed Date Balance Rate Charge 03/10 Late Payment Fee 25.14 6.00 % 1.51 Pursuant to the UPS Tariff, a late payment fee has been assessed. Total Fees 1.51 m 063943 2/2 Shipped from: FISHERS ISLAND FERRY 1 STATE ST NEW LONDON, CT 06320 Delivery Service Invoice Invoice date April 21,2012 Invoice number 0000026639162 Shipper number 026639 Control ID 3K36 Page 1 of 3 ---- 0720A00000266392 77366300012015 ~ AB 01 063232 660961186 B**3DGT ~ I'l' '1' ' , , ,, ,111 I ' I "1111 __-- FTSHER ZSLAND FERRY ~ PO BOX H __-- FZSHER 'rSLAND, NY 06590-0607 Account Status Summary Weekly Payment Plan Amount Due This Period $ 44.34 Amount Outstanding (prior invoices) $151.91 Total Amount Outstanding $196.25 Please include the Return Portion of each outstanding invoice with your payment. See Account Status for details. A paper alternative Cho~e a UPS electronic billing solution as an alternative to recelwng a paper bill. You can view, manage and pay your UPS bills electronically. Choose the format that best suits your company's needs. Learn more at www.ups.com/billing JSign up for e ectronic billing today! Visit ups.com/billing For questions about your invoice, call: (800) 811-t 648 Monday - Friday 8:00 a.m. - 9:00 p.m.E.T. or write: UPS P.O. Box 650580 Dallas, TX 75265-0580 Thank you for using UPS. Summary of Charges Page Char"~ Outbound 3 UPS WoridShip $ 2234 3 Adjustments & Other Charges $ 200 Service Charges $ 2300 Amount due this period $ 44.34 UPS payment lerms require payment of this invoice by May 2, 2012. Payments nol received by May 16, 2012 are subject to a late las of 6% of the Amount Due This Period. (Details in UPS Tariff, available at ups. cam) Note: This invoice may coutain a fuel surcharge ss described at ups.com. The published fuel surcharge is 8.0% for UPS Ground Services end 14.0% for UPS Air Services, UPS 3 Day Select, and International services. For more information, visit ups. com. Delivery Service Invoice Invoice date April 21, 2012 Invoice number 0000026639162 Shipper number 026639 Page 2 of 3 Account Status Weekly Payment Plan Payments Applied Invoice Number Invoice Date 0000026639092 03/03/2012 0000026639102 03/10/2012 0000026639112 03/17/2012 0000026639122 03/24/2012 Account Status Weekly Payment Plan Amount Paid $ 23.4O $ 2514 $15.91 $1300 Amount Outstandin~l (prior invoices): Please include the Return Portion of each outstanding invoice with your payment. Balance Invoice Number Invoice Date Due 0000026639132 03/31/2012 $ 45.05 0000026639142 04/07/2012 $ 74.19 0000026639152 04/14/2012 $ 32.67 Total $151.91 Outstanding balances reflect any payments received as of 04/20/2012. Please ignore this message if a recent payment has been made for any outstanding invoices. Delivery Service Invoice rnvoice date April 21,2012 Invoice number 0000026639162 Shipper number 026639 Page 3 of 3 Outbound UPS WorldShip Pickup Pickup Number of Billed Date Record Message Codes Packages Charge 04/18 9121173025 2 22.34 Total UPS WorldShip 2 Package(s) 22.34 Total Outbound 2 Package(s) 22,34 Adjustments & Other Charges Miscellaneous Billed Explanation Charge WEEKLY PRINTER SERVICE FEE 2.00 FOR 1 PRINTERS AT $2.00 EACH FOR 20-APR-2012 Total Miscellaneous 200 Total Adjustments & Other Charges ;Loo 063232 2/2 FISHERS ISLAND FERRY DISTRICT VENDOR 025038 Z & S FUEL & SERVICE, INC. 05/08/2012 CHECK 470 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 SM .5710.4.000.000 SM .5710.4.000.000 SM .5710.4.000.000 17241 17251 17274 17279 10.806 GAL GAS-FORKLIFT 47.10 10.526 GAL GAS-FORKLIFT 45.88 10.~16 GAL GAS-FORKLIFT 44.97 5.007 GAL GAS FORKLIFT 21.83 TOTAL 159.78 Vendor No. Check No. Town of Southoid, New York- Pa:;ment Voucher 25038 Vendor Tax ID Number or Social Securi~ Number Vendor Address Entered by P.O. Drawer B Vendor Name Fis~hers Island; NY 0~390 Audit Da~A Z&S Fuel&Service, Inc. Y O 8 2012 Vendor Telephone Number Vendor Contact Invoice Invoice Invoice Net Purchase Order 10.008 Number Date Total Discount I Amount Claime~ Number Description of Goods or Services General Ledser Fund and Account Number I 47.10 Gal Gas-Fork Lift 8M5710.4.000.000 17241 316112 47.10 I t725;I 3/14/12 45.88 i 45.88 10.526 Gal Gas-Fork Lift SM6710.4.000.000 17274 3/26/12 44.97 44.97 10.316 Gal Gas-Fork Lift Sbl8710.4.000.000 17279 3/29112 21.83 21.83 5.007 Gal Gas-Fork Lift SM$710.4.000.000 159.78 159.78 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 ~..~F~ 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 that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Signature ~ Title f ~'~'~ Date Z & S FUEL & SERVICE, DRAWER B FISHERS iSLAND, NY 06390 (631) 788-7343 NAME /~A?2~ Liters/Gals. Liters/Qts. Oil Lubrication Oil Filter C PRODUCT 60e All oods MUST be accompanied by this biff Z & $ FUEL & SERVICE, iNC. DRAWER B ;tSHERS ISLAND, NY 0639r.) (631) 788.7343 Liters/Qts. Oil Lubrication Oil Filter Z & S FUEL & SERVICE, INCr. DRAWER B FISHERS ~SL.AND, NY 06390 (631} 788-7343 Liters/Gals. Gasoline~ ~ ~ J/C3 Liters/Qts. Oil Lubrication Oil Filter C PRODUCT 608 All claims and returned goods MUST be accompanied by this bill 17 2 41 Z & S FUlL & SERVICE, !NC. DRAWER B FISHERS ISLAND. NY 06390 (631) 788-7343 ._. Liters/Gals, Gasoline/~]p ,~ ~,~ Liters/Qts. Oil Lubrication Oil Filter C PRODUCT 608 this biff I 70-//I ~, /-]~Z Z & S FUEL & SERVICE, INC. Drawer B Fishers Island, NY 06390 Statement Date I 3/31/2012 To: FISHERS ISLAND FERRY DISTRICT P.O. BOX H FISHERS ISLAND, NY 06390 Amount Due Amount Enc. $203.82 Date Transaction Amount Balance 02/29/2012 ;Balance forward 478.00 03/06/2012 GAS 47.10 525.10 03/14/2012 i GAS 45.88-' 570.98 03/26/2012 GAS 44.97- 615.95 03/29/2012 GAS 21.83- 637.78 03/30/2012 PMT #387. -433.96 203.82 CURRENT 1-30 DAYS PAST 31-60 DAYS PAST 61-90 DAYS PAST OVER 90 DAYS Amount Due DUE DUE DUE PAST DUE 159.78 0.00 44.04 0.00 0.00 $203.82