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Home My WebLink AboutAU-11/07/2012 Fishers IslandFISHERS ISIMND FERRY DISTRICT VENDOR 001327 AIRGAS EAST, INC 11/07/2012 CHECK 804 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM ,5710.4.000.000 116555675 FINANCE CHARGES 2.04 SM .5710.4.000.000 116595513 (2)PROPANE FORKLIFT 74.88 TOTAL 76.92 ' SEVEnTY,SIX AND 92/100 DOLLARS 82 ~ 04,9 9182-7049 ~lq O0 ~ 50 2 &,' ~UDIT 11/7/12 CHECK NO. 804 [ t~TE 1 ^MOUNS ii/o7/~oi2 $?~.9~ Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securit~ Number Vendor Name Airgas East Vendor Telephone Number 860 ~. ~?. -3055 Vendor Contact Invoice Number 11655567 Date 9130/2012 Invoice Total $2.04i Discount Vendor Address P.O. Box 827049 Philadelphia, PA 19182-7049 Net Purchase Order Amount Claimed Number $2.04 $74.88 Vendor No. 1327 Description of Goods or Services Finance Charges Fork L ft Fuel Check No. g0q Entered by Audit Date NOV 0 7 2012. General Ledger Fund and Account Number SM57t0.4.000.000 116595513 10/9/2012 $74.88 SM5710.4.000.000 $76.92 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. $76.92 Signature ~'"'~ ~ Title Compan~Name~' f~ Date /$ ~----~ /~.... Department Certification I hereby certify that the materials above specified have be~n received by mc in good condition without substitation~ the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Signature ~'~~ '[itle ~ Date /0 ~ ,9 ./~ TO ENSURE PROPER CREDIT PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE. FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL: 888-757,.0030 555675 I 116555675 I 02081 09/30/12 FISHERS ISLAND , I 465 ,841 J 812 I I PAYABLE UPON RECEIPT 1 ~**' ?IN~NCE CHARGE INVOICE **** : : S~rvice charges base~: on pas dJe amount $135.92 $2.04 : $.00 II[, ~;: $2.04 Airn~ -.,.=... www.a,r9as.com ACT. NAME A,ROAS EAST Airgas East ACT. NO. 8606074799 17 Northwestern Ddve PNC BANK - ABA NO. 031000053 Salem, NH 030?9 REF. 116555675/02081 FINANCE CHARGES TO ENSURE PROPER PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE. FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL 860.444-3055 191525-00 116595513 I 02081 10/09/12 FISHERS ISLAND 1465 841 I 812 CUSTPICKUP I NET30DAYS 1 VOL: 64 uk oral 74.88 I .... $.0o OUNT TH S NVOICE $/'~ ' 88 Airnoe Airgas East FERRY DISTRICT 17 Northwestern Drive PO BOX H Salem, NH 03079 FISHERS ISLAND NY 06390-0607 ORIGINAL INVOICE ACT. NAME AIRGAS EAST ACT. NO. 8606074799 PNC BANK -ABA NO. 031000053 REF. 116595513/02081 Airgas DELIVERY ORDER For location nearest you visit nEMCOUNT BY FILLED REVIEWED STAGING ARE,~ TOTAL PKGS TsOHTpA. L CiNaDEETR. S FREIGHT CHARGES 5HIPPED: DELIVERED VIA ON ,BL# -- SOLD BY: AIRGAS EAST 130 CROSS RD WATERFORD CT 06385 -- SHIP TO: FISHERS ISLAND FERRY DISTRICT PO BOX H PlO REL NO: -- SOLD TO: FISHERS FISHERS ISLAND NY 06390-0607 09-0CT-12 09:27AM CRT:TNA179: INTERNAL USE ONLY 9857 OUST, NO: 02081 ORDER NO: 191525 - 00 ISLAND ORb DATE: 10/09/12 PAGE NO: 001 OF 001 TRAN TYPE SLSM C H R G S E L 841 BACH TEAR U~S 465 812 0 P~X -COL~ - 'SHl~Vl~cusT PICKUP ..... ROUTING ~S~HEDULEDSHIPDATE10/09/12 REGION116 ENTEREDBYNRs QTY UHIT HM ......... DESCRIPTION ......... ID LINE ...... ITEH ...... LOC QTY --CYLINDERS-, VOL/ UNIT EXTENOED SHIP& HAZARD CLASS i~UHDER NO NUMBER ORDER SHIP RETN WT AMOUNT AMOUNT Ct X UHlg78 PROPANE 2 PR 33R PB6 2 2 2 64 2.1 50.0 (PROPAHE 32LBS BLUNINUN) <<<<<<<Estimated del iuery:lO/lO>>>>>> >> ER HAZARDOUS HJtTERIAL CHARGE 3 HAZ HAZNAT PB6 1 0 .0 Total Weight: 50.0 Customer phone number: 631-788-7463 I SHIPPED BY: THIS AGREEMENT SUBJECT TO AIRGAS' STANDARD TERMS UPS SH~PPER NO. I AND CONDITIONS. SEE REVERSE SIDE FOR IMPORTANT SAFETY INFORMAT~ON~ PKG ID# 191525-00 HIP TO: FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLAND NY 06390-0607 JCUST. lUPS 02081 O0 0 PicKu ACCEPTED FOR THE ABOVE ~ - ' CUBTO E X Emergency Con~ 8~-7~-~8 I calhng ~ a~e Iis~ e~n~ co.ct FISHERS ISLAND FERRY DISTRICT VENDOR 003891 CWPM, LLC 11/07/2012 CHECK 805 FL~ND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 2A144545 REFUSE RMVL/NL-10/12 234.34 TOTAL 234.34 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address PO Box 415 Vendor Name [Plainvil e, CT 06062 CWPM, LLC Vendor Telephone Number 860-447-1473 Vendor Contact Number 2A144545 Invoice Date 10/tl20t2 Total $234.34 $234.341 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 Net Discount Amount Claimed $234.34 $234.34 Purchase Order I i Vendor No. !3891 Check No. Entered by Audit Date NOV 0 7 2012 Number Oct. Service Refuse NL Terminal General Ledger Fund and Account Number SM$710.4.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, thc services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Signature STATE ST PRIOR BALANCE 464.53 09/04./12 25137511 PAYMENT RECETVED (Thank you)659 <230.19> 10/0~/12 29102257 PAYMENT RECEIVED (Thank you)713 <234.34> 10/01/12 CONTAINER SER 10/01/12-10/31/1 195.00 10/01/12 FUEL SURCHARGE 10/01/12 25.35 For your convenience, we accept Visa, ~astercard, Amoriean fixpress, and ~iscovor. Tax 13.99 INV~ 2A144545 CURRENT 30 DAY 60 DAY 90 DAY DATE 10/01/12 ACCT~ 1007831 234,34 PAGE 1 OF 1 1 5% per month late charge assessed on past due amounts CWPM, LLC PO Box 418 Plainviile, CT 06062 Phone (860) 747 1335 www.cwpm net New London County Phone (860) 447-1473 Rhode Island Phone (401) 348 3034 PLEASE PAY THIS AMOUNT 234.34 FISHERS ISLAND FERRY DISTRICT VENDOR 018554 DIVERS COVE LLC 11/07/2012 CHECK 806 FUND & ACCOUNT P.O,# INVOICE DESCRIPTION AMOUNT SM .5710.2,000.000 29192 DIVER INSP-BOTH BOATS 106.35 TOTAL 106.35 · Vendor No. Town of Southoid, New York- Payment Voucher 18554 Vendor Tax ID Number or Social Security Number Vendor Address 7 Essex Plaza Essex, CT 06426 Divers Cove Vendor Telephone Number 860-767-t960 Vendor Contact Invoice Invoice Number Date 29192 101812012 Invoice Total Discount $106.35 $t06,35 Net Purchase Order Amount Claimed Number $t06.35 $t06.35 Payee Certification The undersigned (Claimant) (Acting on bebelf 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. Title Signature Company Name Check No. Entered by Audit Date Description of Goods or Services General Ledger Fund and Account Number Diver for both ferries SM$710.2.000.000 Department Certification Signature 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 approved. Divers Cove Invoice #29192 Page 1 of 1 Divers Cove 7 Es~x Plaza E~ex CT 0~26 860-767-1960 8~67~3~ COURSES & TRIPS - -CHECK OUT OUR WEBSITE: www,dlver~cove.com FISHERS ISLAND FERRY DISTRICT #441t BOX H FISHERS ISLAND, NY 06390 Quantity 1 ~ $100.00 Delivered Description I LABOR-BOAT INSPECTION/REPAIR- FIRST HOUR BOAT/DC3763: Invoice #29192 10/8/2012 3:17:20 PM Sales Person: I - ED R. PC TAX Amount R 1 $100.00 Taxabh~ Amount: $100.00 FERRY INSPECTION/SERVICE IN NEW LONDON, SUNDAY, OCT, 7, 2012 ol ' 6.35% Sales Tax: Total Due: Total Paid: Balance Due (This Invoice): $6.35 $106.35 $0,00 $106,35 THANK YOU FOR SUPPORTING OUR BUSINESSI file://C :\AJVPOS\HTML\Invoices~29192.html 10/8/2012 FISHERS ISLAND FERRY DISTRICT VENDOR 005442 EMPIRE DENTAL 11/07/2012 CHECK 807 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 4966082-11/12 DENTAL PREMIUM-ii/12 1,091.33 TOTAL 1,091.33 Vendor No. Town of Southold, New York - Payment Voucher 5442 Vendor Tax ID Number or Social Security Number P.O. Emp;r~ ~e0j~h~.c~0~'¢~ Iq~SU/CunC~. Box 202837 Empire Dental Department 83703 Vendor Telephone Number Dallas, TX 75320-2837 Vendor Contact Number 4966082 Invoice Invoice Date Total ~10/14/2012 $1,091.33 $1,091.33 Payee Certification Discount Net Purchase O~er Amount Claimed Number $1,091.33 $1,091.33 The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no pan has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the lown is exempt are excluded Signature~ Title ~ Company Name ~',~ Date Check No. Entered by Audit Date NOV 0 7 2012 Town Clerk Description of Goods or Services 11/1/12-11/30/12 ~O~+0& frerOl'0m- General Ledger Fund and Account Number SM9060.8.000.000 Department Certification I hereby cer[ify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities there&have been verified with the exceptions or discrepancies noted, and payment is approved Signature Title FIS]{ERS ISI~XND PERRY DISTRICT-BROKER ATTN: MARy C}~NTER 50 TRUMBULL ST ACCOUNT NAME FISHERS ISLA~ FERRY DISTRICT ACCOUNT ~Y4561251 INVOICE 4966082 BILLING DATE 10/14/2012 SLrBSCRIBER PERIOD 11/01/2012 - ~1/30/2012 BILLING/PY~ INQUIRIES 877-606-3409 CLJIIM PERIOD RE~IT TO: 37.58/HE/MO 76.68/EH/MO 91.89/EH/MO 139.67/EH/M0 YOUR BALANCE IS DUE BY THE FIRST OF THE MO~. PLEASE INCLUDE A STATE~5~NT COPY WITH YOUR PAYMENT. SUBSCRIBER LISTING PAGE i FISHERS ISLAND FERRY DIS~/RICT-BROKER ATTN: MARY CENTER 50 TRL%~BULL ST PO BOX B ACCOLSVT ~ FISUBRS ISLAND FERRY DISTRICT ACCOUNT F~IqY4561251 BILLING DATE ENROLLMENT INQUIRIES 800-928-6459 R~MIT ELIGIBILITY CHANGES TO: EMPIRE PO BOX 838 MINNEAPOLIS MN 55440-0838 II~;OICE 4966082 SUBSCRIBER PERIOD 11/01/2012 - 11/30/2012 SUBSCRIBER LISTING pAGE 2 EMPIRE PO BOX 856 MINNF~A~OL~$ MN 55440-Q85~ INVOICE 4966082 SUBSCRIBER PERIOD 11/01/2012 - 11/30/2012 FISHERS ISLAND FERRY DISTRICT VENDOR 005443 EMPLOYERS REFERENCE SOURCE,INC 11/07/2012 CHECK 808 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 131107 CRIMINAL BACKGRND-D.LAMB 120.00 SM .5710.4.000.000 131189 CRIMINAL BCKGRND-R.BURNS 119.00 TOTAL 239.00 Town of Southold, New York - Payment Voucher Vendor Tax iD Number or Social Secufib~ Number 06-1437099 Vendor Name EMPLOYERS REFERENCE SOURCE INC. Vendor Telephone Number 203-756-7878 Vendor Contact Vendor Address PO BOX 7019 PROSPECT, CT06712 Vendor No. 5443 Check No. Entered by ~.~ Audit Date NOV 0 7 2012 Invoice invoice Invoice Net Purchase Order Number Date Total Discount Amount Claime~ Number Description of Goods or Services General Ledger Fund and Account Number 131107 1011012012 $120.00 $120.00 Criminal background on 8M57t0.4.000.000 Donald Lewis Lamb 131189 10/18/2012 $119.0 $1t9.00 Criminal background on ; SM5710.4.000.000 Ronald Joseph Burns $239.00 $239.00 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~ litle ~ Company Name Date ~0 ~, ~ f ~, Department Certification Signature Title 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 beve been verified with the exceptions or discrepancies noted, and payment is approved. · EMPLOYERS REFERENCE SOURCE · PO BOX 7019 PROSPECT CT, 06712 Phone:203-755-7878 Fax:203-T55-7808 EmaJhinfo@employersreference.com Margo Larson Fishers Island Ferry District 261 Trumbull Dr. Fishers Island, NY 06390 Invoice 10/10/2012 INVOICE # 131107 Account 9107ny Page1 Please detach an~l return this i~rtion w~h your payment Net 30 days Amount Remitted Date Description Reference Tran Type Amount 10/10/201211nv:9107NY10102012 19107NY10101 Invoice 120.00 PLEASE PAY FROM TH'rs ~'NVOTCE I SALESTAX! NO STATEMENT WZLL FOLLOW i Am°untDue:i $120.00 Employer's Reference Source, Inc. SUBJECT BILLING LIST for FISHERS ISLAND FERRY DISTRICT -- Acct Nbr: 9107NY 10/01/12 through 10/06/12 Billing Date: 10/10/12 Completion Date Subject Name SS # 10/05/12 LAMB, DONALD LEWIS XXX-XX-4736 Extra Charges: NY/STATEWIDE criminal court fee (65.00) Requestor: MARGOT LARSON Reference # Billing Code ** BY ITEM Cdm VA ROANOKE Cdm NY STATEWIDE Crim VA CHESAPEAKE (CITY) Cdm VA BOTETOURT Social Security # Trace Page Fee Add'l Cha~es 55.00 65.00 Totals for FISHERS ISLAND FERRY DISTRICT $55.00 $65.00 $120.00 EMPLOYERS REFERENCE SOURCE , PO BOX 7019 · PROSPECT CT, 06712 Phone:203-755-7878 Fax:203-755-7808 Emaihinfo@employersreference,com Margo Larson Fishers Island Ferry District 261 Trumbull Dr. Fishers Island, NY 06390 :l:nvoice 10/18/2012 131189 9107ny Page1 Date Net 30 days Amount Remitted Reference Tmn Type Amount 10/18/201211nv:9107NY10182012 [9107NY10181 PLEASE PAY FROM THTS I'NVOTCE NO STATEMENT W'rLL FOLLOW Invoice 119.00 $119.00 Completion Date Subiact Name Employer's Reference Source, Inc. SUBJECT BILLING LIST for FISHERS ISLAND FERRY DISTRICT -Acct Nbr: 9107NY 10/08/12 through 10/13/12 Billing Date: 10/18/12 10/12/12 BURNS, RONALD JOSEPH Extra Charges: NY/STATEWIDE criminal court fee (65.00) Requeetor: MARGOT LARSON SS # Reference # Billing Code XXX-XX-1525 ** BY ITEM Crim CT STATEWIDE Federal CT ALL DISTRICTS Cdm NY STATEWIDE Federal NY ALL DISTRICTS Social Security # Trace Page I Fee Add'lCha~es 54.00 65.00 Totals for FISHERS ISLAND FERRY DISTRICT $54.00 $65.00 $119.00 FISHERS ISL4ND FERRY DISTRICT VENDOR 006155 FEDEX 11/07/2012 CHECK 809 FUND & ACCOUNT P. O. # INVOICE DESCRIPTION SM .5710.4.000.000 SM .5710.4.000.000 2-041-31052 2-042-24809 AMOUNT AIRBILLS-PAYROLL,WARRANT 33.62 AIRBILLS-PAYROLL,WARRANT 223.98 TOTAL 257.60 AND $0/lOO DOLLAR, S 0-7~61 · ' Check No. Town of Southoid, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address P.O. Box 371461 Vendor Name Pittsburgh, PA 15250-7461 Fedex Vendor Telephone Number 800-622-1147 Vendor Contact Vendor No. 6155 Entered by ._~ Audit Date NOV 0 7 2012 Invoice Invoice Da~e Total 101812012 $223.98 101812012 $33.62 $257.60[ Payee Certification Invoice Net Purchase Order Number Discount aanount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 2.642-24809 $223.98 Airbills-Pay roll,Wa rrant 8M6710.4.000.000 2-041-31062 $33.62 Airbills-Payroll,Warrant SM5710.4.000.000 $257.60! 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 ow/ng, and that taxes from which the Town is exempt are excluded Department Certification I hereby certify that the ma~erlals above specified have been received by me in good condition wtthota substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Company Name Date ~' ~" ~ ~ Title Invoice Number 2-042-24809 '~ Invoice Date '~ I Account Number '~ Page 0 ct 08, 2012 1206-0334-5 1 of 7 FedEx Tax ID: 71-0427007 Billin_o Address: FISHERS ISLAND FERRY DISTRICT DEB DOUCETTE PO BOX H FISHERS ISLAND NY 06390-0607 Invoice Summary Oct 08, 2012 FedEx Express Services Transportation Charges Base Discount Special Handling Charges Total Charges TOTAL THIS INVOICE You saved $27.14 in discounts this period! Other discounts may apply. Shippino Address: FISHERS ISLAND FERRY TERMINAL 5 WATERFRONT PARK 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 227.70 -27.14 23.42 USD $223.98 USD $223.98 Detailed descri tionsof surchar es can be located atfedex.com Invoice Number %~ Invoice Date ~ Account Number %I Page-, 2-042-24809 0 ct 08, 2012 1206-0334-5 2 of 7 Adjustment Request Fax to (800) 548-3020 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 vvww.fedex.com or calling 800.622.1147. Please use multiple forms for additional requests. Please complete all fields in black ink. a Phone I I I I*1 I I I-I I I I I Fax#1 I I I-I I I/-I I I I I E-mail Address r~lYes, I wantto update account contact wi~ tJqe above information. R Tracking Number Bill to Account $ 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 Io I I I IIIIIIII IIIIIII IIIiIIIII_1 IIIIIIo I II !1 il I iIILII IIIIIIII IIIII IIII~ IIIIII. I II ~1 I IIIIII IIIIIIII IIIII IiII/ I]IIIIo I II !iiili ICI ADR- Address Correctiou DVC- DeclaredValue lAN- InvalidAcct# I NW-lncorrect 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 ~t~,~.fedex.com or call (800) 622-1147 Tracking Number Code $ Amount Rotate information only (round to nearest inch) LBS L W H I I II I I Ixl I I Ixl I I I I I II I I Ixl I I Ixl I I I I II I I Ixl I I Ixl I 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/ Invoice Date 1 [ Account Number %] 2-042-24809 0 ct 08, 2012 1206-0334-5 Page 5of7 · EuelSurcharge EedExhasappliedafuelsurchargeofHS0%tothissgipment · Distance Based Pricing, Zone 2 Automation USAB Sender Tracking ID 875071430614 G S MURPHY Service Type FedEx Prior~ Overnight FISHERS ISLAND FERRY TERMINAL Package Type FedEx Envelope 5 WATERFRONT PARK Zone 02 NEW LONDON CT 06320 US Packages 1 Rated Weight N/A Transportation Charge Delivered Sop 14, 2012 O9:19 Discount Svc Area A4 Fuel Surcharge Signed by R.MALLEY Courier Pickup Charge FedEx Use 025704632/0000186/_ Total Charge Recioient TYLER VERTENISN HEALTHCONSULTANTSGROUP / 40 CORPORATE AVE ,~ PLAINVlLLECT86862 US USD 18.75 3.00 1.81 0.00 $17.~ Fuel Surcharge - FedEx has applied a fuel surcharge of T1 50% to this shipment Distance Based Pricing, Zone g FedEx has audited this shipment for correctpackages, weight, and service Any changes made are reflected in the invoice amount The package weight exceeds the maximum for the packaging b/po, therefore, FedEx Envelope was rated as FedEx pak Automa0on USAB Sender Tracking ID 875071430588 DEBBIE DOUOTTE Service Type FedEx Priority Overnight FISHERS iSLAND FERRY TERMINAL Package Type FedEx Pak 5 WATERFRONT PARK Zone 02 NEW LONDON CT 06320 US Packages Rated Weight 2.0 lbs, 0.9 kgs Delivered Sop 19, 2012 10:24 Transportation Charge Svc Area AM Fuel Surcharge Signed by D WHITECAVAGE Discount FedEx Use 026201142/0001486/_ Total Charge ReciDient / ATTN ACCOUNTING DEPT TOWN OF~' 54375MAIN RD SOUTHOLD NY 11971 US USD 22,85 2.36 229 $22.92 Fuel Surcharge - FedEx has applied a fuel surcharge of 1350% to this shipment Distance Based Pricing, Zone 2 FedEx hasaudited this shipmentforcorrectpackages, weight, and service Anychangesmade are reflected in theinvo[ce amount The package weight exceeds the maximum for the packaging Wpe, therefore, FedEx Envelope was rated as FedEx pak Automation USAB Sender Tracking ID 875071430647 GORDAN MURPHY Service Type FedEx Standard Overnight FISHERS ISLAND FERRY TERMINAL Package Type FedEx Pak 5 WATERFRONT PARK Zone 02 NEW LONDON CT 06320 US Packages 1 Rated Weight 2.0 lbs, 0.9 kgs Delivered Oct 04, 2012 14:44 Transportation Charge Svc Area AM Fuel Surcharge Signed by D WHITECAVAGE Discount FedEx Use 027704570/0001283/_ Total Charge Recinient DW TOWN OF SOUTHOLD 54375 MAIN RD SOUTHOLD NY 11971 US USD 20.10 2.44 $20.93 Shipper Subtotal USO $116.50 FuelSurcharge FedExhasappliedafuelsurchargeofllS0%tothisshipment 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 b/po, therefore, FedEx Envelope was rated as FedEx pak Automation USA8 Sender Tracking iD 875366961465 JANICE L FOGLIA Service Type FedEx Priority Overnight TOWN OF SOUTHOLD Package Type FedEx Pak 53095 ROUTE 25 Zone 02 SOUTHOLD NY 11971-4642 US Packages 1 Continued on next page RecipieRt GORDON MURPHY FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND NY 06390 US Invoice Number Tracking ID: 875366961465 continued 2-042-24809 ~ I Invoice Date '~ Account Number ) Page; 0 ct 08, 2012 1206-0334-5 6 of 7 Rated Weight 1.0 lbs, 0.5 kgs Delivered Sop 10, 2012 09:05 Transpedation Charge 22.40 Svc Area PM Discount 2.24 Signed by M.NICK Fuel Surcharge 2.32 FedEx Use 025102491/0001486/_ Total Chmge USO ~22.48 · FuelSurcharge FedExhasappliedafuelsurchar~eofl150%tothisshipment · Distant e Based Pricing, Zone 2 Automation USAB Sender Recioient Tracking ID 875366961454 DIANA WHITECAVAGE GORDON MURPHY Service Type FedEx Priority Overnight TOWN OF SOUTHOLD FI FERRY DISTRICT Package Type FedEx Envelope 53095 ROUTE 25 5 WATERFRONT PK Zone 02 SOUTHOLD NY 11971 4642 US NEWLONDON CT 06320 US Packages 1 Rated Weight N/A Delivered Sop 13, 21)12 09:35 Transportation Charge Svc Area A4 Fuel Surcharge Signed by M JIM Discount FedEx Use 025603365/0000186/_ Total Charge USD 1835 __ $17.56 FuelS~rcharge FedExhasappliedafuelsurchargeofDS0%toth[sshipment. Distance Based Pricing,Zone Z FedExhas audited this shipment for correct packages, welght, and servlce Any changes made are reflected in the invcice amount 7he package weight exceeds the maximum for the packaging type, therefore, FedEx Envelope was rated as FedEx Pak. Automation USAB Sender Tracking ID 875366961421 JANICE L FOGLIA Service Type FedEx Priority Overnight TOWN OF SOUTHOLD Package Type FedEx Pak 53095 ROUTE 25 Zone 02 SOUTHOLD NY 11971-4642 US Packages Rated Weight L0 lbs, 0,5 kgs Delivered Sop 21, 2012 09:47 Transporta6on Charge Svc Area PM Discount Signed by P. FORD Fue~ Surcharge FedEx Use 026403038/0001486/_ Total Charge Recioient GORDON MURPHY FISHERS iSLAND FERRY DISTRICT FISHERS iSLAND NY 06390 US USD 22.40 2.32 $22.48 Fuel Surcharge - FedEx has applied a furl surcharge of 11 50% to this shipment Distance Based Pricing, Zone 2 FedEx has ~udited this shipmeq~for correct packages,weight, and service Any changes made are reflected in the invcice amount The package weight exceeds ~he maximum for the packaging type, therefore, FedEx Envelope was rated as FedEx Pak Automation USAB Sender Tracking ID 875366961416 DIANAWHITECAYAGE Service Type FedEx Priority Overnight TOWN OF SOUTHOLD Package Type FedEx Pak 53095 ROUTE 25 Zone 02 SOUTHOLD NY 11971-4642 US Packages 1 Rated Weight 1,0 lbs, 0.5 kgs Delivered Sop 27, 2012 09:50 Eransportation Charge Svc Area A4 Discount Signed by M.RAY Fuel Surcharge FedEx Use 027001891/0001486/_ Total Charge Recioient GORDON MURPHY / FI FERRY DISTRICT 5 WATERFRONT PK NEW LONDON CT 06320 US USO 22.40 2.24 2.32 $22.48 Recipient Subtotal USD $85.00 1280-02-00 000440~ 0004 f]()36407 Invoice Number 2-042-24809 FedEx Express Shipment Detail By Payor Type (Original) Invoice Date Oct 08, 2012 Account Number 1206-0334-5 Page 4of7 Fuel Surcharge - FedEx has ap¢ied a fuel surcharge ofll 50% to this shipraent Distance Based Pricing, Zone 2 FedEx has audited this shipment for correct packRges, weight, and service Any changes made are reflected in the invoice amount The package weight exceeds the maximum for the packaging type, therefore, FedEx Envelope was rated as FedEx Pak Sender GORDON MURPHY FISHERS ISLAND FERRY TERMINAL 5WATERFRONT PARK NEW LONDON CT 06320 US Automation USAB Tracking ID 875071430202 Service Type FedEx Priority Overnight Package Type FedEx Pak Zone 02 Packages 1 Rated Weight 1.0 lbs, 0.5 kgs Delivered Sop 10, 2012 11:06 Svc Area AM Signed by C.FOSTER FedEx Use 025103212/0001486, Recipient ATT ACCOUNTING DEPT TOWN OF SOUTHOLD 54375 MAIN RD SOUTHOLD NY 11971 US ./ Transportation Charge 2240 Discount 2.24 Fuel Surcharge 2.32 Total Charge USD SZZ,~ Fuel Surcharge -FedExhas applied a fuel surcharge ofll 50% to this shipment Distance Based PricingrZone 2 Package sent from: 11933 zip code 16.50 -264 1.59 Recipient JOSEMORENO FAA 600 OLD COUNTRY RD STE 464 GARDEN CITYNY 11530 US Automation USAB Sender Tracking ID 875071430603 G S MURPHY Service Type FedEx Standard Overnight FISHERS ISLAND FERRY TERMINAL Package Type FedEx Envelope 5 WATERFRONT PARK Zone 02 NEW LONDON CT 06320 US Packages 1 Rated Weight N/A Delivere6 Sop 13, 2012 11:44 Transportation Charge Svc Area A1 Discount Signed by .PALMANTO Fuel Surcharge FedEx Use 025603365/0000200/_ Total Charge USD $15.45 Fuel Surcharge - FedEx has applied a fuel surcharge of 11 50% to tgis shipment Distance Based Pricing, Zone 2 Packrge sent from: 11933 zip code Automation USAB Tracking ID 875071430636 Service Type FedEx Priority Overnight Package Type FedEx Envelope Zone 02 Packages 1 Rated Weigh! N/A Delivered Sop 13, 2012 09:35 Svc Area PM Signed by M.JIM FedEx Use 025603365/0000186/_ Sender GS MURPHY FISHERS ISLAND FERRY TERMINAL 5 WATERFRONT PARK NEWLONDONCT 06320 OS Transportation Charge Discount Fuel Surcharge Total Charge Recipient G S MURPHY FISHERS ISLAND FERRY 261 TRUMBULL DR FISHERS ISLAND NY 06390 US USD 18.75 300 1.81 $17.56 1280-02-00-0(×)4108 0005 0e36108 Invoice Number "~ 2-042-24809 FedEx Express Shipment Summary By Payor Type FedEx Express Shipments (Original) Invoice Date 0 ct 08, 2012 Account Number "~ Page 1206-0334-5J 3 of 7 Shipper 6 5,0 119.35 12,33 -15,18 116.50 Recipient 4 3.0 85.95 837 -9.72 85.00 Third Party 1 1.0 22.40 2.32 -2.24 22.48 ~.t~ ~.9~ Total This Invoice USD $223.98 2-042-24809 0 ct 08, 2012 1206-0334-5 7 of 7 FuelSurcharge Fed£xhesappliedafueIsurchargeof11~0%tothisshipment Incorrect recipient address Distance Based Pricing, Zone 2 1st at~empt Sep 10, 2012 at 11:05 AM FedExhas audited this shipment for correct packages, weight, and se~ce Any changes made are reflected in the lnvoice amount The package weight exceeds the maximum for the packaging ~pe, therefore, FedEx Envelope was rated as FedEx Pak Automation USAB Tracking ID 875071430625 Service Type FedEx Priorii¥ Overnight Package Type FedEx Pak Zone 02 Packages 1 Rated Weight 10 lbs, 0,5 kgs Delivered Sep 10, 2012 15:28 Svc Area AM Signed by B.DOROSKI FedEx Use 025103210/0001486, Sender Recioient G S MURPHY SCOTT RUSSELL FLOBAS ISLAD FERRY TOWN OF SOUTHOLD j 261 TRUMBELL DR 54375 MAIN RD FISHERS ISLAND NY 06390 US SOUTHOLD NY 11971 US Transpo~adon Charge Discount FuelSurcharge TotalCharge 22.40 2~24 2.32 USD $22.~ Third Party Subtotal USD $22.48 Total FedEx Express USD $2..23.98 Invoice Number 2-041-3t052 Invoice Date '~ [ Account Number "~ Page Oct 08, 2012 1206-0334-5 1 of 4 FedEx Tax ID: 71-0427007 Billinq Address: FISHERS ISLAND FERRY DISTRICT DEB D0UCETTE PO BOX H FISHERS ISLAND NY 06390-0607 Invoice Summary Oct 08, 2012 Shippin~j Address: FISHERS ISLAND FERRY TERMINAL 5 WATERFRONT PARK NEW LONDON CT 06320 Invoice Questions? Contact FedEx Revenue Services Phone: (800) 622-1147 M-Sa 7-6 (CST) Fax: (800) 548-3020 Internet: wvvvv.fedex.corn FedEx Exnress Services Transportation Charges Base Discount Special Handling Charges Total Charges TOTAL THIS INVOICE You saved $2.29 in discounts this period! Other discounts may apply. 22,85 -2.29 13.06 USD $33.62 USD $33.62 surcharges can be located at fedex.corn Adjustment Request Fax to (800) 548-3020 Invoice Number 2-041-31052 Invoice Date 1 Account Number ~ Page Oct 08, 2012 1206-0334-5 2of4 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 ~wv.fedex.com or calling 800.622.1147. Please use multiple forms for additional 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 Datel I [/[ I I I I ~Phone I I I I-I I I I-I I I I I Fax#1 I I I-I J I/-I I I I I E-mail Address [] Yes, I want to update account contact with the above information. R Tracking Number I I I II Ill I Illl II t111111 II I I I Ill II ~llllllll t Ill I I I I Bill to Account I I I I I I I I I~ I I I I I I I I I~ IIIIIIII1~ I I I I I I I I I~ I I I I I I I I I~ $ 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 ADR -Address Correction RI DVC- Declared Value F iA.-luva.dAcct 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 Servicefailures or other surcharges please use ourweb sitewww.fedex.com or call (800)622-1147 Tracking Number Code $ 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 Io[_b ~1 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'LL 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,// Rerate information only (round to nearest inch) LBS L W H I I I II I I Ixl I I Ixl I I I I I II I I Ixl I I Jxl I I I I I II I I Ixl I I Ixl I I I I I II I I Ixl I I Ixl I I I I I I II I I Ixl I I Ixl I I I Invoice Number '~ Invoice Date '~ Account Number '~ Page 2-041-31052 0 ct 08, 2012 1206-0334-5 3 of 4 FedEx Express Shipment Summary By Payor Type FedEx Express Shipments (Rebill) Shipper 1 2.0 22.85 13.06 -2.29 33.62 Total This Invoice USD $33.62 Invoice Number 2-041-31052 FedEx Express Shipmeet Detail By Payor Type (Rebill) Invoice Date 0ct08,2012 Account Number "~ Page 1206-0334-5/ 4 of 4 · Fuel Surcharge - FedEx has applied ~ fuel surcharge of 10.00% to this shipment. · Distance Based Pricing, Zone 2 Automation Tracking ID Se~ice Type Package Type Zone Packages Rated Weight Delivered Svc Area Signed by FedEx Use USAB 875071430599 FedEx Priority Overnight FedEx Pak 02 2 0lbs, 09 kgs Aug 30, 2012 10:41 AM D.WHITECAVADGE 000000000/0001486/ Sender D£BBIE DOUCETTE FISHERS ISLAND FERRY PO BOX H FISHERS ISLAND NY 06390-0607 US Transpo~afien Charge AccountNumb~r Corr~c~on FuelSurcharge Discount TotalCharge Recipient ATT ACCOUNTING DEPT TOWN OF SOUTHOLD 54375 MAIN RD SOUTHOLD NY 11911 US 22.85 11.00 2.06 -2.29 USD $33.62 ~ Shipper Subtotal USD $33.62 ~-- Total FedEx Express USO $33.62 ~ 1280-O2-OO-OOO4408-OOO1-OO36404 FISHERS ISLAND FERRY DISTRICT VENDOR 006412 FISHERS ISLAND UTILITY CO 11/07/2012 CHECK 810 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT SM SM SM SM SM SM SM SM SM SM SM SM SM SM SM SM SM SM · 5710.4.000.200 027700-9/12 ELECTR~C-FRSHT SHE~-9/~2 138.53 · 5710.4.000.200 027750-~/12 EL~CTR~C-~S~-9/~2 ~.30 5710.4.000.200 027750-9/12 WATER-WHISTLER-9/12 23.10 5710.~.000.200 027800-~/~2 ~F~UN~-~-9/12 ~6.~0 5710.4.000.200 027800-9/12 wazER~zH~T~-9/~2 2~.67 5710.4.000.200 027900-9/~2 z~c~c-a~o~-~/12 123.~7 57~0.4.000.200 028000-~/12 ~ZP~UNE-~R~ O~C-~/Z2 ~13.43 ~7~0.4.000.200 0~8000-~/12 ~, EL~OTR~C-~Z 0~C-9/12 280.74 57~0.4.000.200 02~000-~/12 ~5~-~Z OF~0-9/1~ 23.~0 57~0.4.000.200 0~8100-~/12 ~P~UNZ-~S~ 0~C-9/12 266.11 5710.~.000.200 02%p?.p~ff O~Z-~O~ CO~-S/~2 36.~ 57~0.4. 000.2OO ~f~/~ ~-~X- 9/~2 5710,4. 000.2oo ~ ,~S ~ ~/~ .... ~h~,~ ~9/12 33. oo 5710.4.000.z~O~ ...... ~ 028135_9/12.:~ WATER~ANNEX_9/i2 5710 4 0~Q >' . ~ . .~ ~ 29.67 ~710.4.000 '%~z-~/1~ 86.o8 .~710.4.000.200 02~150-~/~2 T~EF~UNE-~X ~C~-5/12 148.67 TOTAL 1,627.58 ONI9 THOUSAND SIX HUNDRI~D TWENTY SEVF~ AND 58/108 DOLLARS OF ) ~Uf 06390-0604 "OOOS;,O,' i:O~?iLOSL,~,L,: &a 001,50~? Vendor No. 6412 Town of Southold, New York - Payment Voucher Vendor T0x ID Number or Social Securit~ Number Vendor Address PO BOX E Vendor Name FISHERS ISLAND UTILITY COMPANY Vendor Telephone Number 631-788-7744 Vendor Contact Fishers Island, NY 06390 Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 028136 913012012 $54.28 $54.28 Tel Annex-9112 SM6710.4.000.200 028136 9130/2012' $33.00 $33.00 Elec Annex-9/12 SM5710.4.000.200 028135 9130/2012 $29.67 $29.67 Water Annex-9112 SM6710.4.000.200 028145 9/3012012 $93.06 $93.06 Tel Freight DSL 9/12 SM6710.4.000.200 028146 9/30/2012 $86.08~* $86.08 Tel UPS Line 9/12 SM6710.4.000.200 028150 9/30/2012 $148.67 $148.67 Tel Fax Line 9112 SM$710.4.000.200 027700 9/3012012 $138.53 $138.53 Frt Shed Elec 9/12 SM5710.4.000.200 027800 9/3012012 $36.10 $36.10 Theater Tel 9112 SM6710.4.000.200 027800 9/3012012 $93.16 $93.16 Theater Elec-9/12 SM5710.4.000.200 027800 9/30/2012 $29.67 $29.67 Theater Water-9112 SM6710.4.000.200 027900 9/30/2012 $123.47 $t23.47 Airport Elec-9112 SM5710.4.000.200 028000 9/30/201: $113.43 $113.43 Frt Shed Tel - 9112 SM$710.4.000.200 028000 9130/20t2 $280.74 $280.74 Frt Shed Elec-9/12 SM5710.4.000.200 028000 9/30/2012 $23.10 $23.10 Frt Shed Water-9/12 SM67t0.4.000.200 028100 9/30/2012 $266.11 $266.11 FI Office Tel-9112 SM67t0.4.000.200 028101 9130/2012 $36.11 $36.11 FI Off Computer Tel-9/12 SM5710.4.000.200 027750 9130/2012 $42.40 Whistler Ave House 9/12 SM$710.4.000.200 $42.40 $1,627.58 $1,627.58 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing alaim 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 Department Certification 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 Check No. N0¥ 0 7 2012 Compeny Name Oat~ ~- ~ 2 Title FISHERS ISLAND UTILITY - VENDOR #6412 INVOICE# SUFFIX DATE AMOUNT DESCRIPTION FUND/ACCT# 027700- 9/12 9/30/12 138.53 Electrfc-Frght Shed- 9/12 SM.5710.4.000.200 027750- 9/12 9/30/12 19.30 Electric- t~t.~,J~.~/~ 9/12 SM.5710.4.000.200 027750- 9/12 9/30/12 23.10 Water- [k~{~J~,~A. 9/12 SM.5710.4.000.200 Total-42.40 027800- 9/12 9/30/12 36.10 Telephone-Theatre- 9/12 SM.5710.4.000.200 027800- 9/12 9/30/12 93.16 Electric-Theatre- 9/12 SM.5710.4.000.200 027800- 9/12 9/30/12 29.67 Water-Theatre- 9/12 SM.5710.4.000.200 total-158.93 027900- 9/12 ;)/30/12 123.47 Electric-Airport- ;)/12 SM.5710.4.000.200 027950- 9/12 ;)/30/12 0.00 Electric-Annex #2 ;)/12 SM;5709.2.000.100 028000- 9/12 9/30/12 113.43 Telephone-Frght Offc- 9/12 SM.5710.4.000.200 928000- 9/12 9/30/12 280.741 Electdc-Frght Offc- 9/12 SM.5710.4.000.200 928000- 9/12 9/30/12 23.1£~ ~Vater-Frght Offc- 9/12 SM.5710.4.000.200 Iotal-417.27 328100- 9/12 9/30112 266.11 Telephone-Mgr Offc- 9/12 SM.5710.4.000.200 328101- ;)/12 9/30/12 36.11 Yelephone-Mgr Comp- 9/12 SM.5710.4.000.200 ;)28102- ;)/12 9/30/12 0.00 l'elephone-ATM Line- 9/12 SM.5710.4.000.200 028135- 3/12 9/30112 54.2; Telephone-Annex- 9/12 SM.5710.4.000.200 028135- 9/12 9/30/12 33.00 Electric-Annex- 9/12 SM.5710.4.000.200 028135- 9/12 9/30/12 29.67 Water-Annex- 9/12 SM.5710.4.000.200 total-116.95 028145- 9/12 9/30/12 93.06 Telephone-Computer- 9/12 SM5710.4.000.200 028146- 9/12 9/30/12 86.08 Telephone-UPS Line- 9/12 SM.5710.4.000.200 028150- 9/12 9/30/12 148.67 Telephone-Fax Mach- 9/12 SM.5710.4.000.200 TOTAL 1,627.58 BILLING SUMMAEY TELEPHONE Balance From Previous Month Total Payments . Total AdjustmenTs ELECTRIC Balance From Previous Month Total Payments Total Adjustments WATER Balance From Previous Month Total Payments Total Adjustments Current Account Activity ...... Current Balance ......... ...... Current Balance ......... ...... Current Balance ......... * DUE IMMEDIATELY .... OUTSTANDING BALANCE *** Current Telephone Charges ...... Current Amount Due by 10125112 Total Amount Due 504.38 166.99 .00 337.39 .00 .00 .00 .00 .00 .00 .00 .00 337.39 148.67 486.06 11001000 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788-7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For: The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p.m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERSlSLANDTELEPHONECORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERSISLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-7422 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 . FIE~I~IL~ IMAM) bTILITY FI,.~I~RS I,~tND, ~ BILLING DETAIL Fishers Island PAGE 3 TELEPHONE NUMBER 631-788-5523 ACCOUNT NUMBER 028150 BILL DATE 09/30/12 Detail of Current Basic Charges Equipment for Period: 10101112 - 10131112 Descriotion BUS. LOCAL SERVICE ANNUA ENDUSER CHARGE ANNUAL (M 1 E-911 SURCHARGE 1 ~otal Equipment And Service Charges ederal Universal Service Charge Total Basic Charges 9.20 .35 Total 9.20 .35 31.51 31.51 1.60 33.11 Detail of Current Non-Basic Charges Equipment for Period: 10/01/12 - 10/31112 Descriotion Ouant ltv ADSL+ 12 MOS.SERVICE Total Equipment And Service Charges Total Non-Basic Charges Total 59.95 59.95 59.95 110O1001 at&t BILLING DETAIL AT&T PAGE 4 TELEPHONE NUMBER 631-788-5523 ACCOUNT NUMBER 028150 BILL DATE 09/30/12 Detail of Current AT&T Long Distance Charges Detail of Itemized Calls Originating # 631-788-5523 No uaze Time Min Loc Called 1 8/30/12 1:30PM 2 Lyme CT 9/06/12 9:18AM 1 ~ystic CT 9/06/12 9:21AM 2 mystic . CT 9/07/12 3:48PM 1 New London CT 5 9/11/12 12:27PM 1 Danielson CT 6 9/14/12 9:24AM 1 Portland ME 7 9/18/12 1:56PM 2 Trumbuli CT 8 9/20/12 10:41AM 2 TrumbuII CT 9 9/20/12 10:43AM 2 Trumbull CT Detail of Other Charges and Credits Descrimtion Federal Carrier Line Assessment @ Single Line Total AT&T Total Itemized Calls the.r Charges And Credits ctoDer Acc~ Chg ~ _ nterstate uross Heceipts /ax 4.44% Universal Connectivity Charge Total AT&T Long Distance Charges P-Rate Period Applied D-Day T-Call Type 1-Direct Dial Area-Number P T Amount 860-434-3800 D 1 2.78 860-396-6891 D 1 1.39 860-396-7013 D 1 2.78 860-443-6851 D 1 1.39 860-774-8952 D 1 1.39 207-552-2478 D 1 1.39 203-459-7372 D 1 2.78 203-459-7372 D 1 2.78 203-459-7372 D 1 2.78 Subtotal 19.46 For 631-788-5523 19.46 Total Occ's 4.95 19.46 4.95 20.95 2.36 7.89 55.61 BILLING SUMMARY TELEPHOME -Balance From Previous Month Total ~ymeots . Total ~ojuszmen[s ELECTRIC Balance From Previous Month Total ~¥ments . Total ~ojustmen[s WATER Balance From Previous Month Total ~yme0ts . Total Aojuszmenzs Current Account Activity ...... Current Balance ......... ...... Current Balance ......... ...... Current Balance ......... * DUE IMMEDIATELY .... OUTSTANDING BALANCE *** Current Electric Charges · See Page 3 ...... Current Amount Oue by 10/25/12 Total Amount Due .00 .00 .00 .00 339.47 175.55 .00 163.92 .00 .00 .00 .00 163.92 302.45 11000975 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788-7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For: The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p.m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERSISLANDTELEPHONECORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERSlSLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-7422 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 PAGE 3 TELEPHONE NUMBER 631-188-0023 ACCOUNT NUMBER 027700 BILL DATE 09/30/12 THE FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE (631) 788-7251 Detail of Current Electric Charges Electric Class - 5 CURRENT CHARGE: ~nergy Charge uel Adiustment New York State Tax Total Current Charges $132.05 6.48 0.00 $138.53 Meter Readings Energy used Current ~revious MASTER 16342 15889 REG. 453 KWH DEMAND 3.10 .01 DMD. 3.52 ~ DATE 9/26 8/27 DMD. MIN. 3.52 METER MULT. 1 NY SURCHARGE FUEL ADJUSTMENT FACTOR .0143 PER KWH TOTAL ENERGY CHARGE Amount 92.73 39.32 .00 $132.05 1100097§ BILLING SUtlMARY TELEPHONE Balance From Previous Month ~otal ~yments . Total Aojustmen~s ELECTRIC Balance From Previous Month Total ~¥ments Total Aojustments WATER Balance From Previous Month Total ~yme~ts . Total Aejuszmen~s Current Account Activity *** OUTSTANDING BALANCE *** Current ~lectric Charges - S~e Page 3 ...... Current water Charges - See Page u ...... Current Amount Due by 10125112 Total Amount Due .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 42.40 11000977 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788- 7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For: The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p.m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERSlSLANDTELEPHONECORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERSlSLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-7422 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 PAGE 3 TELEPHONE NUMBER 631-188-0122 ACCOUNT NUMBER 027750 BILL DATE 09130112 THE FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE (631) 788-7251 Detail of Current Electric Charges Electric Class - 1 CURRENT CHARGE: ~nergy Charge uel Adjustment New York State Tax Total Current Charges $18.66 0.64 0.00 $19.30 Meter Readings Energy used Current Previous MASTER 58484 58439 REG. 45 KWH DEMAND .00 .00 DMD. .00 KW DATE 9/26 8/27 DMD. MIN. .00 METER MULT. NY SURCHARGE FUEL ADJUSTMENT FACTOR .0143 PER KWH TOTAL ENERGY CHARGE Amount 18.66 0.00 .00 $18.66 FISHERS ISLAND WATER WORKS CORP. BUSINESS OFFICE (631) 788-7251 Detail of Current Water Charges Water Class - 11 CURRENT CHARGE: METER READING/DATE CURRENT 77000 9/26 PREVIOUS 76990 8/27 CUBIC FEET 10 (GU FT x 7,5 = GALLONS) 75 ~urrent Water Charg~ ross Receipts Tax uredit (per PSC) Total Current Charges 23.10 0.00 $23.10 11000978 BILLING SUMMAgY TELEPHONE *Balance From Previous Month Total ~yments Total ~ojustments 'ELECTRIC Balance From Previous Month Total ~yments Total Aojustments WATER Balance From Previous Month Total ~yments . Total Aajustmenzs Current Account Activity * DUE IMMEDIATELY .... OUTSTANDING BALANCE *** Current Telephone Charges _ - . ..... Current [lectric Charges - $§e Fage 5 ...... Current water Charges - See Fage = ...... Current Amount Due by 1012§/12 Total Amount Due 71.40 35.70 .00 35.70 506.43 206.34 .00 300.09 59.34 29.67 11.02CR 18.65'- 354.44 513.37 11000979 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788-7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For: The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p.m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERS ISLAND TELEPHONE CORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERS ISLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-7422 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 FI,.~I~IL~ IMAM) UTILITY OOI~AHY · FI,.q~I~P~ I,..~4M), IVY 06390 BILLING DETAIL Fishers Island PAGE 3 TELEPHONE NUMBER 631-788-7031 ACCOUNT NUMBER 027800 BILL DATE 09/30/12 Detail of Current Basic Charges Equipment for Period: 10/01112 - 10/31/12 Descrietion Ouant itv BUS. LOCAL SERVICE ANNUA ~ TOLL RESTRICTION 1 ENDUSER CHARGE ANNUAL (M 1 E-911 SURCHARGE 1 Detail of Other Charges and Credits Descriotion ~ LINE GRANGE RECORD ORDER BUS. Total Equipment And Sgrvice Charges ~t~er Charges An~ ~reeits ~. ~eoeral Universal bervice unarge Total Basic Charges 21. 2.00 9.20 .35 Total Total Oco's 1.00 4.60 .35 16.93 10.00 18.00 16.93 18.00 .80 35.73 Detail of Current Non-Basic Charges Equipment for Period: 10/01/12 - 10131112 ~ACK MAINT. BU ~ ~ Total Total Equipment And Service Charges Total Non-Basic Charges .37 .37 .37 11000980 PAGE 5 TELEPHONE NUMBER 631-788-7031 ACCOUNT NUMBER 027800 BILL DATE 09/30/12 THE FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE (631) 788-7251 Detail of Current Electric Charges Electric Class - 5 CURRENT CHARGE: ~nerg¥ Charge uel Adjustment New York State Tax Total Current Charges $92.02 1.14 0.00 $93.16 Meter Readings Energy used Current Previous MASTER 310 309 REG. 80 KWH DEMAND .08 .01 DMD. 5.60 KW DATE 9/26 8/27 DMD. MIN. 5.40 METER MULT. 80 NY SURCHARGE FUEL ADJUSTMENT FACTOR .0143 PER KWH TOTAL ENERGY CHARGE Amount 29.47 62.55 .00 $92.02 FISHERS ISLAND WATER WORKS CORP. BUSINESS OFFICE (631) 788-7251 Detail of Current Water Charges Water Class - 21 CURRENT CHARGE: METER READING/DATE CURRENT PREVIOUS CUBIC FEET (CU FT x 7.5 = GALLONS) 97178 9/26 97170 8/27 8 60 ~urren~ Water Cbarg~ . ross Keceipts /ax ureait (per PSC) Total Current Charges 29.67 0.00 $29.67 11000981 BASIC MINIMUM CHARGE: KWH (KILOWATTHOUR): FUEL ADJUSTMENT: UNDERSTANDING YOUR ELECTRIC BILL Your contract is on a non-transferable annual basis. Federal and State Taxes am billed where applicabie. A complete copy of our rate schedule can be obtained at the offices of the Fishers Island Utility Company office building. Covers maintenance of electric lines, meters and other costs. This charge will be billed whether or not you use any energy. A KVVH equals 1000 watt-hours of electricity use. One KWH equals the energy needed to run a 100 watt light bulb for 10 hours. A charge that reflects changes in the actual cost of fuel pumhased by the utility. RESIDENTIAL ELECTRIC RATES CLASS 1. CLASS 2. CLASS 7. Minimum Charge $10.60 Minimum Charge $32.37 Minimum Charge $23.12 First 1,000 KWH $ 0.1790 All KWH $ 0.3237 All KWH $ 0.2255 Over 1,000 KWH $ 0.2067 COMMERCIAL ELECTRIC RATES CLASS 5. Minimum Charge $15.90 Demand charge $11.17 per KWH Energy charge $0.1696 per KWH UNDERSTANDING YOUR WATER BILL Water usage is billed monthly. Your contract is on a nomtransferable basis. Monthly minimum charges are based on meter size and class. Federal and State taxes are billed where applicable. A complete copy of our rate schedule can be obtained at the offices of the Fishers Island Utility Company office building. CLASS 1. Meter Size Minimum Charge Minimurn Usage (Inch) (Gallons/ 5/8 $23.10 3,000 3/4 $30.80 4,000 1 $53.90 7,000 I 1/4 $77.00 10,000 1 1/2 $100.10 13,000 2 $161.70 21,000 3 $308.00 40,000 4 $508.20 66,000 6 $1001.00 130,000 Water usage over the minimum is billed at $7.70 per thousand gallons. CLASS 2. Meter Size Minimum Charge Minimurn Usage (inch) (Gallons) 5/8 $29.67 3,000 3/4 $39.56 4,000 1 $69.24 7,000 1 1/4 $98.91 10,000 1 1/2 $128.58 13,000 2 $207.71 21,000 3 $395.63 40,000 4 $652.80 66,000 6 $1,285.81 130,000 Water usage over the minimum is billed at $9.89 per thousand gallons. BILLING SUMM Y TELEPHONE Balance From Previous Month 'Total ~yments . Total aojustmenzs ELECTRIC 'Balance From Previous Month Total Payments Total Adjustments WATER Balance From Previous Month Total Payments Total Adjustments Current Account Activity * DUE IMMEDIATELY .... OUTSTANDING BALANCE *** Current Electric Charges . See Page 3 ...... Current Amount Due by 10125/12 Total Amount Due .00 .00 .00 .00 277.70 143.18 .00 134.52 .00 .00 .00 .00 134.52 257.99 11000982 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788-7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For: The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p.m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERS ISLAND TELEPHONE CORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERS ISLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-7422 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 PAGE 3 TELEPHONE NUMBER 631-188-0576 ACCOUNT NUMBER 027900 BILL DATE 09/30/12 THE FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE (631) 788-7251 Detail of Current Electric Charges Electric Class - 5 CURRENT CHARGE: Energy Charge Fuel Adiustment New York State Tax Total Current Charges $120.24 3.23 0.00 $123.47 Meter Readings Energy used Current Previous MASTER 4763 4537 REG. 226 KWH DEMAND 5.92 .01 DMD. 5.91 KW DATE 9/26 8/28 DMD. MIN. 5.16 METER MULT. 1 NY SURCHARGE FUEL ADJUSTMENT FACTOR .0143 PER KWH TOTAL ENERGY CHARGE Amount 54.23 66.01 .00 $120.24 11000983 BILLING *TELEPHONE Balance From Previous Month Total Payments . ,Total Adjustments ELECTRIC Balance From Previous Month Total ~yments . Total Aejustmen[s WATER Balance From Previous Month Total Payments . Total AdjustmenTs Current Account Activity ...... Current Balance ......... ...... Current Balance ......... ...... Current Balance ......... * DUE IMMEDIATELY .... OUTSTANDING BALANCE *** Current Telephone Charges - . ..... Current Electric Charges_- aee Page 7 ...... Current Water Charges - ~ee Page / ...... Current Amount Due by 10125112 Total Amount Due 243.64 171.98 .00 71.66 603.64 301.76 .00 301.88 47.36 23.10 5.79CR 18.47 392.01 809.28 11000985 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788-7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For: The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p.m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERS ISLAND TELEPHONE CORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERS ISLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-7422 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 FI,.~IERS ISLAM) OTILITY COII~AIVY · FI.CNR'~t,S ISLAND, NY 06390 BILLING DETAIL Fishers Island PAGE 3 TELEPHONE NUMBER 631-788-7345 ACCOUNT NUMBER 028000 BILL DATE 09/30/12 Detail of Current Basic Charges Equipment for Period: 10/01/12 - 10131112 Descriotion Quant itv BUS. LOCAL SERVICE ANNUA ~ ENDUSER CHARGE ANNUAL (M 1 E-911 SURCHARGE 1 ~o~al Equipment And Service Charges eaeral Universal Service Charge Total Basic Charges 9.20 .35 Total 9.20 .35 31.51 31.51 1.60 33.11 Detail of Current Non-Basic Charges Equipment for Period: 10101112 - 10131/12 Descriotion Quant ltv INS. WIRE/JACK MAINT. BU ~ ALARM SVC MONTHLY CHARGE 1 ,Total Equipment And Service Charges Total Non-Basic Charges 30.00 Total 30.00 33.75 33.75 33.75 11000988 at&t BILLING DETAIL AT&T PAGE 4 TELEPHONE NUMBER 631-788-7345 ACCOUNT NUMBER 028000 BILL DATE 09/30/12 Detail of Current AT&T Long Distance Charges Detail of Itemized Calls Originat!ng # 631-788-7345 No uate Time Min Loc Called 1 8/21/12 11:04AM 2 New London CT 2 8/21/12 11:23AM 1 New London CT 3 8/21/12 1:48PM 1 Queens NY 4 8/21/12 1:53PM 1 Norwich CT 5 8/21/12 2:03PM 1 Brooklyn NY 6 8/21/12 3:22PM 1 New London CT 7 8/22/12 1:57PM 1 Norwich CT 8 8/22/12 2:28PM 1 New London CT 9 8/23/12 8:21AM 1 Queens NY 10 8/23/12 8:53AM 2 New London CT 11 8/23/12 1:43PM 1 Norwich CT 12 8/24/12 8:35AM 2 New London CT 13 8/24/12 12:10PM 1 New London CT 14 8/24/12 12:49PM 1 New London CT 15 8/24/12 2:49PM 1 Brooklyn NY 16 8/27/12 12:20PM 1 New London CT 17 8/27/12 1:28PM 3 New London CT 18 8/27/12 2:23PM 1 Queens NY 19 8/27/12 2:29PM 1 Queens NY 20 8/27/12 3:36PM 1 Norwich CT 21 8/28/12 9:02AM 1 New London CT 22 8/29/12 2:23PM 1 New London CT 23 8/30/12 11:lOAM 1 New London CT 24 8/30/12 12:09PM 1 New London CT 25 8/31/12 12:14PM 1 New London CT 26 8/31/12 12:14PM 1 New London CT 27 8/31/12 2:40PM 1 Brentwood NY 28 9/01/12 8:05AM 3 New London CT 29 9/04/12 8:50AM 1 New London CT 30 9/04/12 8:57AM 1 Queens NY 31 9/04/12 11:59AM 1 New London CT 32 9/04/12 12:06PM 1 New London CT 33 9/04/12 12:09PM 2 New London CT 34 9/04/12 2:16PM 1 Norwich CT 35 9/05/12 8:20AM 3 New London CT 36 9/05/12 10:24AM 1 New London CT 37 9/05/12 11:38AM 2 New London CT 38 9/06/12 11:07AM 1 New London CT 39 9/06/12 11:07AM 1 New London CT 40 9/06/12 2:35PM 1 Queens NY 41 9/07/12 8:18AM 1 New London CT 42 9/07/12 2:23PM 1 Norwich CT 43 9/10/12 10:26AM 1 New London CT 44 9/10/12 11:05AM 1 New London CT 45 9/10/12 11:09AM 1 Norwich CT 46 9/10/12 11:20AM 1 New London CT 47 9/11/12 8:17AM 1 New London CT 48 9/11/12 8:22AM 1 New London CT 49 9/11/12 10:39AM 1 New London CT 50 9/11/12 2:52PM 1 New London CT 51 9/12/12 8:41AM 1 New London CT 52 9/12/12 2:23PM 1 Queens NY 53 9/13/12 9:51AM 1 New London CT 54 9/13/12 11:13AM 1 New London CT 55 9/13/12 11:41AM 1 New London CT 56 9/13/12 2:43PM 1 Queens NY 57 9/14/12 8:16AM 1 New London CT 58 9/14/12 11:31Aa 1 New London CT 59 9/14/12 11:36Aa 2 New London CT 60 9/14/12 2:16PM 8 New London CT 61 9/17/12 8:29AM 1 New London CT 62 9/17/12 8:43AM 2 New London CT 63 9/17/12 10:54AM 1 Deep River CT 64 9/17/12 2:37PM 1 New London CT 65 9/18/12 8:04AM 1 New London CT Area-Number P T 860-442-0165 D 1 860-442-0165 D 1 347-730-2913 D 1 860-303-2960 D 1 917-589-8890 D 1 860-442-0165 D 1 860-303-2960 D 1 860-460-9903 D 1 347-730-2913 D 1 860-442-0165 D 1 860-303-2960 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 917-589-8890 D 1 860-442-0165 D 1 860-442-0165 D 1 347-730-2913 D 1 347-730-2913 D 1 860-303-2960 D 1 860-460-9903 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 631-767-7181 D 1 860-442-0165 N 1 860-442-0165 D 1 347-730-2913 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 860-303-2960 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 347-730-2913 D 1 860-389-4471 D 1 860-303-2960 D 1 860-442-0165 D 1 860-442-0165 D 1 860-303-2960 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 347-730-2913 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 347-730-2913 D 1 860-442-0165 D 1 860-442-0165 D 1 860-442-0165 D 1 660-442-0165 D 1 860-912-2277 D 1 860-442-0165 D 1 860-790-5514 D 1 860-442-0165 D 1 860-442-0165 D 1 Amount .80 .40 .36 .40 .36 .40 .40 .40 .36 .80 .40 .80 .40 .40 .36 .40 1.20 .36 .36 .40 .40 .40 .40 .40 .40 .40 .36 .75 .40 .36 .40 .40 .80 .40 1.20 .40 .80 .40 .40 .36 .40 .40 .40 .40 .40 .40 .40 .40 .40 .40 .40 .36 .40 .40 .40 .36 .40 .40 .80 3.20 .40 .80 .40 .40 .40 at&t BILLING DETAIL AT&T PAGE 5 TELEPHONE NUMBER 631-788-7345 ACCOUNT NUMBER 028000 BILL DATE 09/30/12 Detail of Current AT&T Long Distance Charges Detail of Itemized Calls ~riginat~ng # 631-788.7345 o uate Time Min Loc Called Area-Number P T 1 9/18/12 10:52AM 1 New London CT 860-442-0165 D 1 2 9/18/12 12:00PM 1 New London CT 860-442-0165 D 1 3 9/18/12 2:17PM 1 Norwich CT 860-303-2960 D 1 4 9/19/12 7:58AM 1 New London CT 860-442-0165 D 1 5 9/19/12 8:01AM 1 New London CT 860-442-0165 D 1 6 9/19/12 8:01AM 1 New London CT 860-442-0165 D 1 7 9/19/12 11:07AM 1 New London CT 860-442-0165 D 1 8 9/19/12 2:11PM 1 Norwich CT 860-303-2960 D 1 9 9/20/12 8:17AM 1 New London CT 860-442-0165 D 1 10 9/20/12 IO:05AM 1 New London CT 860-501-2351 D 1 11 9/20/12 IO:30AM 1 New London CT 860-442-0165 D 1 12 9/20/12 IO:50AM 1 New London CT 860-442-0165 D 1 13 9/20/12 12:46PM 1 New London CT 860-442-0165 D 1 14 9/20/12 2:1OPM 1 New London CT 860-460-9903 D 1 Subtotal Total For 631-788-7345 AT&T Total Itemized Calls blnterstate Gross Receipts Tax 4.44% niversal Connectivity Charge Total AT&T Long Distance Charges P-Rate Period Applied D-Day N-Night T-Call Type 1-Direct Dia Amount .40 .40 .40 .40 .40 .40 .40 .40 .40 .40 .40 .40 .40 .40 38.71 38.71 38.71 1.81 6.05 46.57 11000987 PAGE 7 TELEPHONE NUMBER 631-788-7345 ACCOUNT NUMBER 028000 BILL DATE 09/30/12 THE FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE (631) 788-7251 Detail of Current Electric Charges Electric Class - 5 CURRENT CHARGE: ~nergv Charge uel Adiustment New York State Tax Total Current Charges $263.84 16.90 0.00 $280.74 Meter Readiggs Energy used Current ~revious MASTER 39656 38474 REG. 1182 KWH DEMAND 4.26 .01 DMD. 4.25 KW DATE 9126 8/27 DMD. MIN. 3.68 METER MULT. 1 NY SURCHARGE FUEL ADJUSTMENT FACTOR .0143 PER ~ TOTAL ENERGY CHARGE Amount 216;37 47.47 .00 $263.84 FISHERS ISLAND WATER WORKS COI~P. BUSINESS OFFICE (631) 768-7251 Detail of Current Water Charges Water Class - 11 CURRENT CHARGE: METER READING/DATE CURRENT PREVIOUS CUBIC FEET (CU FT x 7.5 = GALLONS) 69660 9/26 69260 8/27 400 3,000 ~urren! Water Cbarg~ , ross ~eceipts /ax ureoit (per PSC) Total Current Charges 23.10 0.00 $23.10 UNDERSTANDING YOUR ELECTRIC BILL Your contract is on a non-transferable annual basis. Federal and State Taxes ara billed whera applicable. A complete copy of our rate schedule can be obtained at the offices of the Fishers Island Utility Company office building. BASIC MINIMUM CHARGE: KWH (KILOWATTHOUR): FUEL ADJUSTMENT: Covers maintenance of electric lines, meters and other costs. This charge will be billed whether or not you use any energy. A KWH equals 1000 watt-hours of electricity use. One KVVH equals the energy needed to run a 100 watt light bulb for 10 hours. A charge that reflects changes in the actual cost of fuel pumhased by the utility. RESIDENTIAL ELECTRIC RATES CLASS 1. CLASS 2. CLASS 7. Minimum Charge $10.60 Minimum Charge $32.37 Minimum Charge $23.12 First 1,000 KWH $ 0.1790 All KWH $ 0.3237 All KWH $ 0.2255 Over 1,0OO KWH $ 0.2067 COMMERCIAL ELECTRIC RATES CLASS 5. Minimum Charge $15.90 Demand charge $11.17 per KVVH Energy charge $ 0.1696 per K'VVH UNDERSTANDING YOUR WATER BILL Water usage is billed monthly. Your contract is on a non-transferable basis. Monthly minimum charges ara based on meter size and class. Federal and State taxes are billed where applicable. A complete copy of our rate schedule can be obtained at the offices of the Fishers Island Utility Company office building. CLASS 1. Meter Size Minimum Charge Minimum Usage (Inch) (Gallons) 5/8 $23.10 3,000 3/4 $30.80 4,000 1 $53.90 7,000 1 1/4 $77.00 10,000 1 1/2 $100.10 13,000 2 $161.70 21 ,OO0 3 $308.00 40,000 4 $508.20 66,000 6 $1001.00 130,000 Water usage over the minimum is billed at $7.70 per thousand gallons. CLASS 2. Meter Size Minimum Charge Minimum Usage (Inch) (Gallons) 5/8 $29.67 3,000 3/4 $39.56 4,000 1 $69.24 7,OOO 1 1/4 $98.91 10,000 1 1/2 $128.58 13,000 2 $207.71 21,000 3 $395.63 40,000 4 $652.80 66,000 6 $1,285.81 130,000 Water usage over the minimum is billed at $9.89 per thousand gallons. BILLING SUMMARY TELEPHONE * Balance From Previous Month Total Payments Total Adjustments · ELECTRIC Balance From Previous Month Total Payments . Total Adjustments WATER Balance From Previous Month Total ~yme0ts . Total Aojuszmenzs Current Account Activity ...... Current Balance ......... ...... Current Balance ......... ...... Current Balance ......... * DUE IMMEDIATELY .... OUTSTANDING BALANCE *** Current Telephone Charges ...... Current Amount Due by 10/25/12 Total Amount Due 6O3.34 279.01 .00 324.33 .00 .00 .00 .00 .00 .00 .00 .00 324.33 266.11 §§0.44 11000988 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788-7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For; The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p.m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERS ISLAND TELEPHONE CORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERS ISLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-7422 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 FI.~L~ I2V~.M) UTILITY COliP~ ' FI~ I,~AM), ~ 06390 BILLING DETAIL Fishers Island PAGE 3 TELEPHONE NUMBER 831-788-7463 ACCOUNT NUMBER 028100 BILL DATE 09/30/12 Detail of Current Basic Charges Equipment for Period: 10/01112 - 10131112 Description 0uant ltv BUS. LOCAL SERVICE ANNUA ENDUSER CHARGE ANNUAL (M 1 E-911 SURCHARGE 1 ~o[al Equipment And Service Charges eaeral Universal Service Charge Total Basic Charges 9.20 .35 Total 9.20 .35 31.51 31.51 1.60 33.11 Detail of Current Non-Basic Charges Equipment for Period: 10/01/12 - 10/31/12 Descriotion Quant ltv BUSINESS ~ULTI HUNT SRVC ~ Total Equipment And Service Charges Total Non-Basic Charges Total 3.00 3.00 3.00 11000989 at&t BILLIN DETAIL AT&T PAGE 4 TELEPHONE NUMBER 631-788-7463 ACCOUNT NUMBER 028100 BILL DATE 09/30/12 Detail of Current AT&T Long Distance Charges Originating # 631-788-7463 No DaTe Time 1 8/21/12 8:02AM 2 8/21/12 9:46AM 3 8/21/12 10:25AM 4 8/21/12 10:51AM 5 8/21/12 1:27PM 6 8/21/12 2:04PM 7 8/21/12 2:09PM 8 8/22/12 IO:03AM 9 8/22/12 10:32AM 10 8/22/12 12:53PM 11 8/22/12 1:58PM 12 8/22/12 2:05PM 13 8/22/12 3:20PM 14 8/23/12 10:22AM 15 8/23/12 10:58AM 16 8/23/12 1:09PM 17 8/23/12 3:02PM 18 8/24/12 8:55AM 19 8/24/12 9:59AM 20 8/24/12 IO:OOAM 21 8/24/12 10:1lAM 22 8/24/12 10:39AM 23 8/24/12 12:19PM 24 8/27/12 8:31AM 25 8/27/12 9:15AM 26 8/27/12 12:30PM 27 8/27/12 4:35PM 28 8/27/12 4:36PM 29 8/28/12 8:19AM 30 8/28/12 8:39AM 31 8/28/12 8:48AM 32 8/28/12 8:57AM 33 8/28/12 11:04AM 34 8/28/12 12:47PM 35 8/28/12 12:48PM 36 8/28/12 2:03PM 37 8/28/12 3:52PM 38 8/28/12 3:57PM 39 8/28/12 4:11PM 40 8/29/12 IO:OOAM 41 8/29/12 10:57AM 42 8/29/12 11:05AM 43 8/29/12 11:23AM 44 8/29/12 11:24AM 45 8/29/12 11:39AM 46 8/29/12 11:55AM 47 8/29/12 12:38PM 48 8/29/12 12:39PM 49 8/29/12 1:22PM 50 8/29/12 1:55PM 51 8/29/12 1:56PM 52 8/29/12 2:15PM 53 8/29/12 2:24PM 54 8/29/12 2:25PM 55 8/29/12 2:55PM 56 8/29/12 3:14PM 57 8/29/12 3:15PM 58 8/29/12 4:02PM 59 8/30/12 8:26AM 60 8/30/12 8:27AM 61 8/30/12 8:37AM 62 8/30/12 1:18PM 63 8/30/12 1:23PM 64 8/30/12 2:13PM 65 8/30/12 2:34PM Detail of Itemized Calls Min Loc Called 2 New London CT 2 New London CT 2 Southold NY 3 Southold NY 4 Westbury NY 2 New London CT 1 Providence RI 2 New London CT 1 New London CT 1 Culvercity CA 1 Norwich CT 2 New London CT 4 Southold NY 5 New London CT 2 New London CT 1 New Haven CT 3 Deerfldbch FL 33 New York NY 1 Southold NY 11 Hartford CT 1 New London CT 2 Boston MA 1 New London CT 4 Southold NY 3 New London CT 10 Plainville CT 1 New Haven CT 2 New Haven CT 1 New London CT 1 New London CT 1 New London CT 6 New York NY 4 Plainville CT 1 Albany NY 1 Albany NY 7 ~lba~y , NY 5 New London CT 1 Searsport ME Searsport ME ~ Hartford CT 6 Plainville CT Lyme CT Boston MA Lyme CT 7 Plainville CT 1 New London CT 1 ~earsport ME ~ ~earsport ME ~y~e CT 1 uu[ncy MA S~ugus MA ~ P~a~nville CT 1 Plainville CT 5 Riverhead NY ~u!vercity CA ~ ~u~verc~ty CA 9 Martforo CT 4 New London CT 1 New London CT 6 New London CT 2 New London CT ~ulvercity CA uu~vercl~y CA ~y~e .. CT 1 Albany NY Area-Number P T Amount 860-442-0165 D 1 .80 860-442-0165 D 1 .80 631-765-4333 D 1 .72 631-765-1800 D 1 1.08 516-984-2998 D 1 1.44 860-442-0165 D 1 .80 401-447-5134 D 1 .40 860-442-0165 D 1 .80 860-442-0165 D 1 .40 310-244-2332 D 1 .40 860-705-0105 D 1 .40 860-460-8864 D 1 .80 631-765-4333 D 1 1.44 860-442-0165 D 1 2.00 860-442-0165 D 1 .80 203-314-5860 D 1 .40 954-426-5754 D 1 1.20 646-216-7111 D 1 11.88 631-765-4333 D 1 .36 860-402-7461 D 1 4.40 860-235-8335 D 1 .40 617-434-3297 D 1 .80 860-442-0165 D 1 .40 631-765-4333 D 1 1.44 860-442-0165 D 1 1.20 860-351-0100 D 1 4.00 203-996-4492 D 1 .40 203-996-4492 D 1 .80 860-442-0165 D 1 .40 860-442-0165 D 1 .40 860-442-0165 D 1 .40 212-476-1000 D 1 2.16 860-351-0100 D 1 1.60 518-457-1090 D 1 .36 518-457-1090 D 1 .36 518-457-1090 D 1 2.52 860-445-9706 D 1 2.00 207-548-6302 D 1 .40 207-548-6302 D 1 .80 860-539-0440 D 1 .40 860-351-0129 D 1 2.40 860-434-3610 D 1 1.20 860-434-3610 D 1 .40 617-434-3297 D 1 .40 860-351-0129 D 1 2.80 860-442-0165 D 1 .40 207-548-0424 D 1 .40 207-548-0424 D 1 .80 860-434-7224 D 1 1.60 617-770-8115 D 1 .40 617-529-9666 D 1 1.20 860-351-0129 D 1 .40 860-351-0100 D 1 .40 631-852-4555 D 1 1.80 310-244-8790 D 1 1.20 310-244-8790 D 1 .40 860-257-1870 D 1 3.60 860-442-0165 D 1 1.60 860-442-0165 D 1 .40 860-442-0165 D 1 2.40 860-442-0165 D 1 .80 310-244-8790 D 1 1.20 860-434-0052 D 1 .40 310-244-8790 D 1 .40 518-457-2722 D 1 .36 at&t BILLING DETAIL AT&T PAGE 5 TELEPHONE NUMBER 631-788-7463 ACCOUNT NUMBER 028100 BILL DATE 09/30/12 Detail of Current AT&T Long Distance Charges Originating # 631-788-7463 No DaTe Time 1 8/31/12 8:30AM 2 8/31/12 8:43AM 3 8/31/12 8:44AM 4 8/31/12 8:48AM 5 8/31/12 10:05AM 6 8/31/12 10:06AM 7 8/31/12 12:01PM 8 8/31/12 2:03PM 9 8/31/12 2:03PM 10 9/04/12 8:22AM 11 9/04/12 8:53AM 12 9/04/12 8:54AM 13 9/04/12 9:26AM 14 9/04/12 9:31AM 15 9/04/12 9:32AM 16 9/04/12 9:34AM 17 9/04/12 10:45AM 18 9/04/12 11:28AM 19 9/04/12 2:32PM 20 9/04/12 3:39PM 21 9/05/12 7:09AM 22 9/05/12 9:16AM 23 9/05/12 9:55AM -24 9/05/12 1:54PM 25 9/05/12 2:55PM 26 9/05/12 3:08PM 27 9/05/12 3:30PM 28 9/06/12 8:08AM 29 9/06/12 12:36PM 30 9/06/12 1:49PM 31 9/06/12 1:57PM 32 9/06/12 1:58PM 33 9/06/12 2:34PM 34 9/06/12 3:52PM 35 9/07/12 6:32AM 36 9/07/12 9:19AM 37 9/07/12 9:25AM 38 9/07/12 9:30AM 39 9/07/12 10:18AM 40 9/07/12 IO:20AM 41 9/10/12 9:34AM 42 9/11/12 8:22AM 43 9/11/12 9:44AM 44 9/11/12 10:37AM 45 9/11/12 12:02PM 46 9/11/12 12:05PM 47 9/11/12 4:00PM 48 9/11/12 5:04PM 49 9/11/12 5:05PM 50 9/12/12 9:30AM 51 9/12/12 12:27PM 52 9/13/12 8:17AM 53 9/13/12 8:20AM 54 9/13/12 8:45AM 55 9/13/12 9:00AM 56 9/13/12 9:01AM 57 9/13/12 9:07AM 58 9/13/12 9:07AM 59 9/13/12 1:1OPM 60 9/13/12 1:46PM 61 9/13/12 2:44PM 62 9/13/12 3:16PM 63 9/13/12 3:39PM 64 9/13/12 4:02PM 65 9/13/12 4:07PM Detail of Itemized Calls Min Loc Called Area-Number 2 New London CT 860-442-0165 3 New London CT 860-442-0165 2 ~entrais,lp NY 631-853-6416 1 ~reenwicn RI 401-884-2460 1 ~ard~nci. ty NY 516-247-3412 6 New LOnDon CT 860-442-0165 2 Hartford CT 860-257-1870 1 New London CT 860-442-0165 3 Southold NY 631-765-4333 1 New London CT 860-442-0165 1 Plainville CT 860-351-0129 2 Plainville CT 860-351-0100 1 New London CT 860-442-0165 1 New London CT 860-442-0165 2 Van Nuys CA 818-756-2400 ~an Nuys, CA 818-756-2410 ~ ~reenw~cn RI 401-884-7800 2 New London CT 860-442-0165 ~opewltjct NY 845-227-9815 12 ~outhold NY 631-765-1939 1 New London CT 860-442-0165 2 New London CT 860-442-0165 2 Southold NY 631-765-1939 1 Southold NY 631-765-1939 5 Gardencity NY 516-227-3802 16 Hartford CT 860-986-7634 1 Stamford CT 203-977-7421 1 New London CT 860-442-0165 1 Norwich CT 860-705-0105 1 Hartford CT 860-257-1870 1 Wells ME 207-646-4546 4 Wells ME 207-251-2941 1 Greenwich RI 401-336-2182 1 New London CT 860-442-0165 1 New London CT 860-442-0165 2 Southold NY 631-765-4333 1 ~ardenc~ty NY 516-247-3412 5 Martfora CT 860-257-1870 1 New London CT 860-442-0165 3 Southold NY 631-765-4333 3 New London CT 860-442-0165 3 New London CT 860-442-0165 3 New London CT 860-442-0165 12 Plainville CT 860-351-0129 3 New London CT 860-625-3796 1 New London CT 860-442-0165 1 Plainville CT 860-351-0100 1 Lenape PA 610-793-1688 2 Wells ME 207-251-2941 1 Southold NY 631-765-4333 2 New London CT 860-442-0165 2 New London CT 860-442-0165 1 Lyme CT 860-434-1788 1 Southold NY 631-765-1889 1 Bridgeport CT 203-650-0327 6 Mancnester NH 603-644-6659 2 Southold NY 631-765-4333 1 Southold NY 631-765-1939 4 New London CT 860-442-0165 1 Lyme. . CT 860-484-1788 1 New Lonaon CT 860-514-7346 3 Poughkepsi NY 845-452-1200 6 New London CT 860-442-0165 2 New London CT 860-442-7519 1 New London CT 860-442-0165 P T Amount D 1 .80 D 1 1.20 D 1 .72 D 1 .40 D 1 .36 D 1 2.40 D 1 .80 D 1 .40 D 1 1.08 D 1 .40 D 1 .40 D 1 .80 D 1 .40 D t .40 D 1 .80 D 1 .80 D 1 .40 D 1 .80 D 1 3.60 D 1 .72 D 1 .40 D 1 .80 D 1 .72 D 1 .36 D 1 1.80 D 1 6.40 D 1 .40 D 1 .40 D 1 .40 D 1 .40 D 1 .40 D 1 1.60 D 1 .40 D 1 .40 E 1 .40 D 1 .72 D 1 .36 D 1 2.00 D 1 .40 D 1 1.08 D 1 1.20 D 1 1.20 D 1 1.20 D 1 4.80 D 1 1.20 D 1 40 D 1 40 D 1 40 D 1 80 D 1 36 D 1 80 D 1 80 D 1 40 D 1 36 D 1 .40 D 1 2.40 D 1 .72 D 1 .36 D 1 1.60 D 1 .40 D 1 .40 D 1 1.08 D 1 2.40 D 1 .80 D 1 .40 11000990 at&t BILLING DETAIL AT&T PAGE 6 TELEPHONE NUMBER 631-788-7463 ACCOUNT NUMBER 028100 BILL DATE 09/30/12 Detail of Current AT&T Long Distance Charges Detail of Itemized Calls Originating # 631-788-7463 No Daze Time Min Loc Called 1 9/13/12 4:09PM 1 Boston MA 2 9/14/12 8:27AM 1 Southold NY 3 9/14/12 8:38AM 6 New London CT 4 9/14/12 8:52AM 1 New London CT 5 9/14/12 IO:04AM 3 New London CT 6 9/14/12 10:16AM 1 New London CT 7 9/14/12 2:40PM 2 New London CT 8 9/14/12 3:14PM 2 New London CT 9 9/14/12 4:02PM 7 Niantic CT 10 9/14/12 4:08PM 6 New London CT 11 9/17/12 7:54AM 1 New London CT 12 9/17/12 8:21AM 1 Southold NY 13 9/17/12 8:22AM 2 Southold NY 14 9/17/12 8:29AM 3 ~ardencity NY 15 9/17/12 8:36AM 1 bouthold NY 16 9/17/12 9:40AM 2 New London CT 17 9/17/12 10:45AM 1 New London CT 18 9/17/12 11:13AM 15 Pla/nv/lie CT 19 9/17/12 11:28AM 6 Southold NY 20 9/17/12 12:09PM 1 Southold NY 21 9/17/12 12:14PM 5 Pla/nv/lie CT 22 9/17/12 3:27PM 2 New London CT 23 9/18/12 9:09AM 4 Pla/nv/lie CT 24 9/18/12 9:15AM 1 Lynn MA 25 9/18/12 9:20AM 1 New London CT 26 9/18/12 9:21AM 1 New London CT 27 9/18/12 10:39AM 3 N/antic CT 28 9/18/12 1:28PM 5 Pla/nv/lie CT 29 9/18/12 2:47PM 2 New London CT 30 9/19/12 8:14AM 1 New London CT 31 9/19/12 8:19AM 3 New London CT 32 9/19/12 8:37AM 1 Riverhead NY 33 9/19/12 9:55AM 1 Riverhead NY 34 9/19/12 10:17AM 1 New London CT 35 9/19/12 10:54AM 1 New London CT 36 9/19/12 2:16PM 12 New York NY 37 9/19/12 3:1OPM 2 Southold NY 38 9/19/12 3:51PM 1 New London CT 39 9/20/12 9:16AM 1 New London CT 40 9/20/12 9:18AM 1 New London CT 41 9/20/12 9:57AM 1 New London CT 42 9/20/12 10:23AM 1 New London CT 43 9/20/12 10:24AM 2 Lyme CT 44 9/20/12 10:33AM 2 Hartford CT 45 9/20/12 11:19AM 1 New London CT 46 9/20/12 2:00PM 4 New London CT 47 9/20/12 3:20PM 6 New London CT 48 9/20/12 3:48PM 8 New London CT 49 9/20/12 4:18PM 2 New London CT AT&T Total Itemized Calls Interstate Gross Receipts Tax 4.44% Universal Connectivity Charge Total AT&T Long Distance Charges P-Rate Period Applied D-Day E-Evening T-Call Type l-Direct Dial Total Area-Number P T Amount 617-434-3297 D 1 .40 631-765-1939 D 1 .36 860-442-0165 D 1 2.40 860-442-0165 D 1 .40 860-442-0165 D 1 1.20 860-442-0165 D 1 .40 860-442-0165 D 1 .80 860-442-0165 D 1 .80 860-691-0044 D 1 2.80 860-442-0165 D 1 2.40 860-442-0165 D 1 .40 631-765-1959 D 1 .36 631-765-1939 D 1 .72 516-227-3802 D 1 1.08 631-765-1939 D 1 .36 860-442-0165 D 1 .80 860-235-9233 D 1 .40 860-351-0129 D 1 6.00 631-765-4333 D 1 2.16 631-765-4333 D 1 .36 860-351-0129 D 1 2.00 860-442-0165 D 1 .80 860-351-0100 D 1 1.60 781-771-6891 D 1 .40 860-625-4836 D 1 .40 860-442-0165 D 1 .40 860-691-0044 D 1 1.20 860-351-0129 D 1 2.00 860-961-9116 D 1 .80 860-442-0165 D 1 .40 860-442-0165 D 1 1.20 631-852-4538 D 1 .36 631-852-4538 D 1 .36 860-442-0165 D 1 .40 860-442-0165 D 1 .40 212-734-1376 D 1 4.32 631-765-1802 D 1 .72 860-442-0165 D 1 .40 860-442-0165 D 1 .40 860-442-7819 D 1 .40 860-442-0165 D 1 .40 860-442-0165 D 1 .40 860-434-9481 D 1 .80 860-838-4095 D 1 .80 860-442-0165 D 1 .40 860-912-1027 D 1 1.60 860-442-0165 D 1 2.40 860-442-0165 D 1 3.20 860-442-0165 D 1 .80 Subtotal 197.08 For 631-788-7463 197.08 197.08 7.59 25.33 230.00 BILLING SUMMARY TELEPHONE Balance From Previous Month Total Payments Total Adjustments ELECTRIC Balance From Previous Month Total Payments Total Adjustments WATER Balance From Previous Month Total Payments Total Adjustments Current Account Activity ...... Current Balance ......... ...... Current Balance ......... ...... Current Balance ......... * DUE IMMEDIATELY .... OUTSTANDING BALANCE *** Current Telephone Charges ...... Current Amount Due by 10125112 Total Amount Due 11.99 35.95 59.91 35.95 .00 .00 .00 .00 .00 .00 .00 .00 35.95 36.11 72.06 11000991 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788-7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For: The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p,m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERS ISLAND TELEPHONE CORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERS ISLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-74.22 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 FIY~i~N~ IMAM) UTILIT~ I~liM~ ' FI,~d~g~ I,.~AM), ~ 0~90 BILLING DETAIL Fishers Island PAGE 3 TELEPHONE NUMBER 631-788-7580 ACCOUNT NUMBER 028101 BILL DATE 09/30/12 Detail of Current Basic Charges ~quipment for Period: 1010111[- 10131/12 escriBtion Quag/JJLv BUS. LOCAL SERVICE ANNUA ~ ENDUSER CHARGE ANNUAL (M 1 E-911 SURCHARGE 1 ~otal Equipment And Service Charges ederal Universal Service Charge Total Basic Charges 9.20 .35 Total 9.20 .35 31.51 31.51 1.60 33.11 Detail of Current Non-Basic Charges Equipment for Period: 10101112 - 10/31/12 Description Ouant itv 6USINE$~ MULTI HUNT SRVC ~ Total Equipment And Service Charges Total Non-Basic Charges Total 3.00 3.00 3.00 11000992 BILLING SUMMARY TELEPHONE '-Balance From Previous Month Total Payments Total Adjustments ~LECTRIC Balance From Previous Month Total Payments . Total AdjustmenTs WATER Balance From Previous Month Total Payments Total Adjustments Current Account Activity ...... Current Balance ......... ...... Current Balance ......... ...... Current Balance ......... * DUE IMMEDIATELY .... OUTSTANDING BALANCE *** Current Telephone Charges - - . ..... Current Electric Charges - ~ee Page 5 ...... Current Water Charges - See Page ~ ...... Current Amount Due by 10/25/12 Total Amount Due 170.38 64.46 .00 105.92 54.30 30.87 .00 23.43 59.34 29.67 7.97CR 21.70 151.05 268.00 11000993 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788-7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For: The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p.m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERS ISLAND TELEPHONE CORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERS ISLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-7422 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 ,-FI,.~I~iL~ I,..~EAb'D [~I'ILI~Y (llIPAI~ FI~I~iL~ IS~_AND, NY 06390 BILLING DETAIL Fishers Island PAGE 3 TELEPHONE NUMBER §31-788-7744 ACCOUNT NUMBER 028135 BILL DATE 09/30/12 Detail of Current Basic Charges Equipment for Period: 10101112 - 10131/12 Descriotion Ouant itv BUS. LOCAL SERVICE ANNUA ~ ENDUSER CHARGE ANNUAL (M 1 E-911 SURCHARGE 1 ~o[al Equipment And Service Charges eaeral Universal Service Charge Total Basic Charges 9.20 .35 Total 9.20 .35 31.51 31.51 1.60 33.11 Detail of Current Non-Basic Charges Equip;ent for Period: 10/01112 - 10/31112 Description Ouant ltv iNS. WIRE/JACK MAINT. BU ~ OFF PREMISE CHARGE 1 OFF PREMISE 1/4 MiLE BUS 4 Total Equipment And Service Charges Total Non-Basic Charges .50 1.30 Total .50 5.20 6.45 6.45 6.45 11000994 at&t BILLING DETAIL AT&T PAGE 4 TELEPHONE NUMBER 631-788-7744 ACCOUNT NUMBER 028135 BILL DATE 09/30/12 Detail of Current AT&T Long Distance Charges Detail of Itemized Calls ~riginat~ng # 631-788-7744 o uate Time Min Loc Called 1 8/21/12 10:12AM 1 New London CT 2 8/21/12 10:52AM 1 New London CT 3 8/21/12 10:52AM 1 New London CT 4 8/22/12 11:17AM 1 New London CT 5 8/28/12 12:13PM 6 New London CT 6 8/30/12 9:52AM 2 Darien CT 7 8/31/12 10:40AM 2 New Canaan CT 8 9/04/12 10:21AM 1 Danbury CT 9 9/05/12 10:14AM 1 New London CT 10 9/12/12 10:04AM 5 New London CT 11 9/14/12 9:31AM 1 New London CT 12 9/14/12 11:15AM 5 New London CT 13 9/18/12 10:47AM 2 New London CT 14 9/19/12 12:59PM 1 New London CT Total AT&T Total Itemized Calls Interstate Gross Receipts Tax 4.44% Universal Connectivity Charge Total AT&T Long Distance Charges P-Rate Period Applied D-Day T-Call Type 1-Direct Dial Area-Number P T Amount 860-442-0165 D 1 .40 860-460-5562 D 1 .40 860-442-0165 D 1 .40 860-442-0165 D 1 .40 860-442-0165 D 1 2.40 203-655-4724 D 1 .80 203-966-5885 D 1 .80 203-948-5072 D 1 .40 860-442-0165 D 1 .40 860-442-0165 D 1 2.00 860-442-0165 D 1 .40 860-442-0165 D 1 2.00 860-442-0165 D 1 .80 860-389-2277 D 1 .40 Subtotal 12.00 For 631-788-7744 12.00 12.00 .63 2.09 14.72 PAGE 5 TELEPHONE NUMBER 631-788-7744 ACCOUNT NUMBER 028135 BILL DATE 09/30/12 THE FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE (631) 788-7251 Detail of Current Electric Charges Electric Class - 5 CURRENT CHARGE: ~nergv Charge uel Adiustment New York State Tax Total Current Charges $31.67 1.33 0.00 $33.00 Meter Readings . Energy used Current ~rewous MASTER 34263 34170 REG. 93 KWH DEMAND .00 .00 DMD. .00 KW DATE 9/26 8/27 DMD. MIN. .00 METER MULT. 1 NY SURCHARGE FUEL ADJUSTMENT FACTOR .0143 PER kWH TOTAL ENERGY CHARGE Amount 31.67 0.00 .00 $31.67 FISHERS ISLAND ~ATER WORKS CORP. BUSINESS OFFICE (631) 788-7251 Detail of Current Water Charges Water Class - 21 CURRENT OHARGE: METER READING/DATE CURRENT PREVIOUS CUBIC FEET (CU FT x 7.5 = GALLONS) 330 9/26 320 8/27 10 75 ~urren~ Water CQarg~ . ross ~eceipts ~ax ~reait (per PSC) Total Current Charges 29.67 0.00 $29.67 11000995 UNDERSTANDING YOUR ELECTRIC BILL Your contract is on a non-transferable annual basis. Federal and State Taxes are billed where applicable· A complete copy of our rate schedule can be obtained at the offices of the Fishers Island Utility Company office building. BASIC MINIMUM CHARGE: Covers maintenance of electric lines, metem and other costs. This charge will be billed whether or not you use any energy. KWH (KILOWATTHOUR): A KWH equals 1000 watt~hours of electricity use. One KWH equals the energy needed to run a 100 watt light bulb for 10 hours. FUEL ADJUSTMENT: A charge that reflects changes in the actual cost of fuel pumhased by the utility. RESIDENTIAL ELECTRIC RATES CLASS 1. CLASS 2. CLASS 7. Minimum Charge $10.60 Minimum Charge $32.37 Minimum Charge $23.12 First 1,000 KWH $ 0.1790 All KWH $ 0.3237 All KWH $ 0.2255 Over 1,000 KWH $ 0.2067 COMMERCIAL ELECTRIC RATES CLASS 5. Minimum Charge $15.90 Demand charge $11.17 per KWH Energy charge $ 0.1696 per KWH UNDERSTANDING YOUR WATER BILL Water usage is billed monthly. Your contract is on a non-transferable basis. Monthly minimum charges are based on meter size and class. Federal and State taxes ara billed where applicable. A complete copy of our rate schedule can be obtained at the offices of the Fishem Island Utility Company office building. CLASS1. Meter Size Minimum Charge Minimum Usage (Inch) (Gallons) 5/8 $23.10 3,000 3/4 $30.80 4,000 1 $53.90 7,000 1 1/4 $77.00 10,000 I 1/2 $100.10 13,000 2 $161.70 21,000 3 $308.00 40,000 4 $508.20 66,000 6 $1001.00 130,000 Water usage over the minimum is billed at $7.70 per thousand gallons. CLASS 2. Meter Size Minimum Charge Minimum Usage (Inch) (Gallons) 5/8 $29.67 3,000 3/4 $39.56 4,000 1 $69.24 7,000 1 1/4 $98.91 10,000 1 1/2 $128.58 13,000 2 $207.71 21,000 3 $395.63 40,000 4 $652.80 66,000 6 $1,285.81 130,000 Water usage over the minimum is billed at $9.89 per thousand gallons. BILLING SUMMARY TELEPHONE Balance From Previous Month Total Payments Total Adjustments ELECTRIC Balance From Previous Month Total Payments Total Adjustments WATER Balance From Previous Month Total Payments Total Adjustments Current Account Activity ...... Current Balance ......... ...... Current Balance ......... ...... Current Balance ......... * DUE IMMEDIATELY .... OUTSTANDING BALANCE *** Current Telephone Charges ...... Current Amount Due by 10/25/12 Total Amount Due ,185.80 92.90 .00 92.90 .00 .00 .00 .00 .00 .00 .00 .00 92.90 93.06 185.96 11000996 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788- 7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For: The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p.m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERS ISLAND TELEPHONE CORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERS ISLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-7422 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 06390 BILLING DETAIL Fishers Island PAGE 3 TELEPHONE NUMBER 631-788-5522 ACCOUNT NUMBER 028145 BILL DATE 09/30/12 Detail of Current Basic Charges Equipment for Period: 10101112 - 10131/12 Descriotion Quant itv BUS. LOCAL SERVICE /~J~NUA ~ ENDUSER CHARGE ANNUAL (M 1 E-911 SURCHARGE 1 ~o~al Equipment And Service Charges eaeral Universal Service Charge Total Basic Charges 9.20 .35 Total 9.20 .35 31.51 31.51 1.60 33.11 Detail of Current Non-Basic Charges Equipment for Period: 10101112 - 10131112 Descriotion Ouant ltv ADSL+ 12 MOS.SERVICE ----'-'f"' Total Equipment And Service Charges Total Non-Basic Charges Total 59.95 59.95 59.95 11000997 BILLIN6 SU~6~Y TELEPHONE Balance From Previous Month .Total Payments . Total AdjustmenTs ELECTRIC ~Balance From Previous Month Total ~yments . Total ~olustmenTs WATER Balance From Previous Month Total ~yments . Total ~ojustmenTs Current Account Activity ...... Current Balance ......... ...... Current Balance ......... ...... Current Balance ......... * DUE IMMEDIATELY .... OUTSTANDING BALANCE *** Current Telephone Charges ...... Current .Amount Due by 10125112 Total Amount Due 140.26 71.11 .00 69.15 .00 .00 .00 .00 .00 .00 .00 .00 86.08 155.23 11000998 CONSUMER COMPLAINTS Fishers Island Telephone, Electric and Water If the Fishers Island Telephone, Electric or Water Company fails to "Satisfactorily" resolve a service or billing complaint within a reasonable period of time, customers may refer their problems to the Consumer Services Division of the New York State Public Service Commission by writing to: Consumer Services Division Three Empire State Plaza Albany, New York 12223 Or by calling 1-800-342-3377 If, however, you feel that your problems may be handled at the local level, please ask to speak with the President of The Utility Company, Robert Wall, who may be reached at 788-7251 during business hours. Fishers Island Utility Co., Inc. Since 1918 Management For: The Fishers Island Electric Corporation The Fishers Island Telephone Corporation The Fishers Island Water Works Corporation General Office -- 788-7251 Office Hours: (Monday - Friday) 8:00 a.m. - 12 noon & 1:00 p.m. - 5:00 p.m. FISHERS ISLAND ELECTRIC CORPORATION BUSINESS OFFICE .............. 788-7543 POWER PLANT ................. 788-7520 ELECTRIC EMERGENCY AFTER BUSINESS HOURS For Emergency Assistance ...... 788-7815 FISHERS ISLAND TELEPHONE CORPORATION DURING BUSINESS HOURS: Information & Assistance ....... 788-7001 Repair Service ............... 788-7001 AFTER BUSINESS HOURS Emergency ................. 788-7815 FISHERSlSLAND WATER WORKS BUSINESS OFFICE .............. 788-7251 SUPERINTENDENT Water Plant ................. 788-7422 Emergency .................. 788-7815 UTILITY COMPANY President's Office ............... 788-7251 Residence ..................... 788-7710 FIS~i'P~ I,~.ND UTILITY Ca.ANY FIEltll~ IMAM), NY O639O BILLING DETAIL Fishers Island PAGE 3 TELEPHONE NUMBER 631-788-5673 ACCOUNT NUMBER 028146 BILL DATE 09/30/12 Detail of Current Basic Charges Equipaent for Period: 10101112 - 10131/12 Description Quant itv BUS. LOCAL SERVICE ANNUA ~ ENDUSER CHARGE ANNUAL (M 1 E-911 SURCHARGE 1 Total Equipment And Service Charges Federal Universal Service Charge Total Basic Charges 9.20 .35 Total 9.20 .35 31.51 31.51 1.60 33.11 11000999 at&t BILLING DETAIL AT&T PAGE 4 TELEPHONE NUMBER 631-788-5673 ACCOUNT NUMBER 028146 BILL DATE 09/30/12 Detail of Current AT&T Long Distance Charges Detail of Itemized Calls Originating # 631-788-5673 No Daze Time Min Loc Called 1 8/21/12 3:17PM 1 New London CT 2 8/22/12 12:57PM 1 New London CT 3 8/22/12 3:24PM 1 Dallas TX 4 8/23/12 2:19PM 1 Grandprari TX ~ 8/23/12 2:21PM 7 Tampacntrl FL 8/23/12 2:33PM 2 Dallas TX 7 8/27/12 1:46PM 6 New London CT 8 8/28/12 12:57PM 3 New London CT 9 8/29/12 9:41AM 1 New London CT 10 8/29/12 9:44AM 3 New London CT 11 8/29/12 10:23AM 1 New London CT 12 8/30/12 9:13AM 13 New London CT 13 8/30/12 9:26AM 2 Niantic CT 14 8/30/12 9:42AM 1 New London CT 15 8/30/12 11:33AM 1 New London CT 16 8/30/12 11:36AM 1 New London CT 17 8/31/12 1:01PM 2 New London CT 18 9/04/12 12:59PM 1 New London CT 19 9/05/12 8:22AM 3 New London CT 20 9/05/12 10:28AM 1 Norwich CT 21 9/05/12 11:21AM 2 New London CT 22 9/05/12 11:22AM 1 New London CT 23 9/07/12 2:00PM 2 New London CT 24 9/10/12 9:59AM 1 New London CT 25 9/10/12 2:02PM 2 New London CT 26 9/12/12 8:30AM 3 New London CT 27 9/12/12 11:18AM 9 New London CT 28 9/12/12 11:49AM 2 New London CT 29 9/12/12 11:52AM 3 New London CT 30 9/12/12 1:49PM 3 New London CT 31 9/12/12 4:50PM 1 New London CT 32 9/14/12 8:25AM 1 New London CT 33 9/14/12 8:51AM 8 New London CT 34 9/14/12 12:44PM 5 New London CT 35 9/14/12 12:50PM 2 New London CT 36 9/18/12 8:44AM 2 New London CT 37 9/18/12 12:48PM 1 New London CT 38 9/18/12 1:01PM 2 New London CT 39 9/19/12 12:38PM 5 New London CT 40 9/20/12 12:42PM 1 New London CT Total AT&T Total Itemized Calls Interstate Gross Receipts Tax 4.44% Universal Connectivity Charge Total AT&T Long Distance Charges P-Rate Period Applied D-Day T-Call Type 1*Direct Dial Area-Number P T Amount 860-442-0165 D 1 .40 860-442-0165 D 1 .40 214-528-1499 D 1 .40 214-315-4134 D 1 ,40 813-289-6262 D 1 2.80 214-217~9104 D 1 .80 860-442-0165 D 1 2.40 860-442-0165 D 1 1.20 860-442-0165 D 1 .40 860-442-0165 D 1 1.20 860-442-0669 D 1 .40 860-442-0165 D 1 5.20 860-739-5441 D 1 .80 860-442-0165 D 1 .40 860-442-0669 D 1 .40 860-442-0165 D 1 .40 860-442-0165 D 1 .80 860-442-0165 D 1 .40 860-442-0165 D 1 1.20 860-303-5736 D 1 .40 860-442-0165 D 1 .80 860-442-0165 D 1 .40 860-442-0165 D 1 .80 860-442-0165 D 1 .40 860-442-1201 D 1 .80 860-442-1201 D 1 1.20 860-442-1201 D 1 3.60 860-442-1201 D 1 .80 860-442-0165 D 1 1,20 860-442-0165 D 1 1.20 860-442-0165 D 1 .40 860-442-0165 D 1 .40 860-442-0165 D 1 3.20 860-442-0165 D 1 2.00 860-442-0165 D 1 .80 860-442-0165 D 1 .80 860-912-2533 D 1 .40 860-442-0165 D 1 .80 860-442-0165 D 1 2.00 860-442-0165 D 1 .40 Subtotal 43.20 For 631-788-5673 43.20 43.20 2.25 7.52 52,97 FISHERS ISLAND FERRY DISTRICT VENDOR 006482 PAUL J. FOLEY 11/07/2012 CHECK 811 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 100112 REIMB.RX-OCT'12 94.41 TOTAL 94.41 "'000~,,' ,:02~h05h~h. Vendor No. Town of Southold, New York - Payment Voucher 6482 Vendor Tax ID Number or Social Security Number Vendor Address 690 Williams Street New London, CT 06320 Paul J. Foley Vendor Telephone Number Vendor Contact Invoice Number IO0llO Invoice Date 10/112012 Invoice Total Discount Net Amount Claimed $94.4t i $94.41 $94.41 $94.41 Payee Certification Thc underalgned (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 To~,m is exempt are excluded Signature ~ Title s~ Company Name ~'~ Date Purchase Order Number Check No. Entered by Audit Date NOV 0 7 2012 Town Clerk Description of Goods or Services General Ledger Fund and Account Number Anthem Retiree 8M9060.8.000.000 Prescription Plan 90% Reimbursement ~104.90 less 10% ($94.41) Paul Foley ( # 2185 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 Signatare Title Ih,¢,,,I,H,,hhlq..d~qM,,.Md,l,,d,mh,hllh~ PAUL J FOLEY 690 WILLIAMS ST NEW LONDON CT 06320-4132 902640731 G0230330801 Balance Due 11/01/2012 $104.90 Please return the top portion of this form with your payment. See reverse side fi~r pco,men! options. Retain the bottom portion qf this fi~rm./or your 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 per account The remittance advice is located on the reverse side of tl'us statement, riffs 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: 10/06/2012 Blue MedicareRx'(PD P) Transaction Date Description Amount Premium 10/01/2012 October 2012 104.90 Balance Due / ~ ..... ~ 104.90 NEW LONDON, CT 06320 22 15 peoples,corn FISHERS ISLAND FERRY DISTRICT VENDOR 009682 GOOSE ISLAND CORP 11/07/2012 CHECK 812 FUND & ACCOUNT P,O.~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000,200 24093 45.6 GAL ~2 FUEL OIL 227.54 TOTAL 227.54 TWO R~/NI)RED ,TWENTY SEV~N AND 54/100 DOLI~m, RS lt/Q7 f2012 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number ! Vendor Address !1633 Central Avenu Island Service Station Vendor Telephone Number 631-788-73tl Vendor Contact Box 49 e~ island, NY 06390 Vendor No. 9682 Check No. Entered by ~ Audit Date NOV 0 7 2012 Invoice Invoice Invoice Purchase Order Number Date Total Number Description of Goods or Services General Ledger Fund and Account Number 24093 I011012012 $22?.$4 45.6 gal ~ $M$710.4.000.200 #2 Fuel Oil ~$4.99 ~scoum Amount Claimed $227.54 $221.84 $227.54 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 Company Name f ~'~ Date Town Clerk Department Certification 1 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 Vendor No. Town of Southold, New York - Payment Voucher 9682 Vendor Tax ID Number or Social Security Number Vendor Address 1633 Central Avert u Vendor Name Island Sentlce Station Vendor Telephone Number 631-788-7311 VendorContact Susan Invoice ! Invoice Number Date 24093 t011012012 P.O. Box 49 Fishers Island, NY 06390 Invoice Net Purchase Order Total Number Description of Goods $227.54 Check No. Entered by Audit Date 2012 General Ledger Fund and Account Number SM5710,4.000.000 $227.54 $227.54 Payee Certification on bebalf 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 ta~xes from which the Town is exempt are excluded Signature~ Company Name Title I hereby certify that the materials above s 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 ~s approved. tare Date o ~ ¥© o ~ r~24094 .Island Service Station ; 1633 Central Ave #49 Fishers Island, NY 06390-0049 Invoice 10/10/2012 24093 Bill To FI Ferry District P.O. Box H Fishers Island, NY 06390 Description Qty Rate Amount #2 Fuel Oil 45.6 4.99 227.54T Sales Tax (0.0%) $o.oo Total $227.54 Balance Due $227.54 FISHERS ISLAND FERRY DISTRICT VENDOR 019216 GR3%NITE GROUP WHOLESALERS, LLC 11/07/2012 CHECK 813 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.100 6337290-00 MU-GREY WATER DRAIN 42.75 TOTAL 42.75 ~DRT~ TW~ A~D '7~11~'8 11/07/20t2 813 S42.7~ 30g-2004 00&50~ ~1~' Town of Southold, New York - Payment Voucher Vendor No. 19216 Vendor Tax ID Number or Social Security Number The Granite Group Vendor Address P. O. Box 2004 Concord, NH 03302-2004 Check No. Entered by Audit Date Vendor Telephone Number 860-442-4348 Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 6337290-00 1014/2WI 2 $42.75 $42.75 Munn-Women's Head SM5710.2,000.100 Grey Water Drain $42.75[ $42.75 The undersigned (Claimant) (Acting on behalf&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 ,~,~ Date NOV 0 7 ~012 To'~ Clerk Department Certification I hereby cerg fly that the materials above specified have been received by me in good condition without substg-dtion, the services properly performed a~d that the quantities thereof have been verified w~th the exceptions or discrepancies noted, and paymem is approved Title ~ Date INVOICE (860)442-4348 CUSTOMER #: 27698 maint 290 gginv_100512txt_395140 FISHERS ISLAND FERRY DISTRICT POBOXH FISHERS ISLAND NY 06390 THE GRANITE GROUP PO BOX 2004 CONCORD NH 03302-2004 IIh,,,,Ih,,ll,lh,,,,hl,,I,IIh,,Ih,,,h,llh,,,h,h,l,II SHIP TO: CT PICK UP - DELIVERIES FISHERS ISLAND FERRY DISTRICT P O BOX H FISHERS ISLAND, NY 06390 GRANITE INDUSTRIAL BR 44 ONLY STEVE TO CHRG 1 112dbmiu 1-1/2" BLACK MI 150# BR UNION 2 112dbmicap 1-1/2" BLACK MI CAP 3 112.5BN 1-1/2X5 BLK STEEL NIPPLE 4 IPS80310 R5155 1/2" X 520" TEFLON TAPE WHI 2 2 0 each 1 1 0 each 1 1 0 EACH 1 1 0 EACH 16.49000 32.98 4.24000 4.24 4.48000 4.48 1.05000 1.05 Total 42.75 Page 1 of 1 5 $42.75 INTERNAL USE ONLY: Page 1 of 1 Pick i ~ci~et/Pac!~ing List C,.~s~ ~: 27698 FISHERS iSLAN Cust PO~: ma~rit Phone ~ : ~860)44~-0165/ Order ~ 6337290-00 PO Date Page ~ i0/04/12 1 Printed By 44c3 on i0/04/12 i0:09 F:ISHERS ISLAND FERR'~ DISIRIC] P O BOX H FISHERS ISLAND, NY 06390 Ship From: GRANITE INDUSTRIAL BR 44 SHETUCKE} INDUS[RIAL SUP-BRe4 NEW LONDON, CT 06320 (860)442-4348 CF PiCK UI-' - DELiVERiES FISHERS iSLAND FERRY D1SiRIC-F P G BOX H FISHERS ISLAND, N~ 06390 L~T~O Producl; QLy Q~y Instructions: ONLY SfEVE Ti] CHRG Quobed 1'o: Via: Written By: )ps Promised: 10/0ZW12 Requested: 10,.04/ic~ Sh~pped: 10/04/12 Reference: Qby Qtv Unit :¢ /ql,d D?cript ion D,d Ship 8.0. UI'I Sh i p pe_d_/ Price~ ~ '- : '. . I ~. EACH ~ 1.05 x~l.:o i/d",.¥ ~c~, TEFLON TAPE WHI ~2/2C/E02/ ili. 5BN i-~,;EX5 BLR SI~EEL NIPPLE :[ i~dbmicap ~l,c: BLACg. MI CAP EACH~ ~/~ each, 4.24 i2/3L/B2~7~-~2/3L/A23/ each / i6.49 [2,3L/C33/ [i~/3L/B33/ Bi. ACK ltlI i5~ BR UI'4?Li]N INVOIE:E TO]AL: / 5 42. -" - ~ uf L1c~es Not Printed: 0 Weight: 5.41 F'ickeo By: Packed By: Checked By: Freight Chgs: i b~,gs I Bundles i Cartons I Lengths i Pieces I Coils I Total Packages iA ~B iC ID ~E ~F .. Cusgomer Signature: Date: _asr k'a!~ e ( ) Lessor ( ) Other (specify) ] Itle Date TERMS & CONDITIONS OF SALE ~'~ · FISHERS ISLAND FERRY DISTRICT VENDOR 014421 O'CONNOR DAVIES, LLP 11/07/2012 CHECK 815 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .1310.4.000.000 153620 SVCS 9/21-9/28/12 2,335.00 TOTAL 2,335.00 11/07/2012 p~¥ ~'CONN~R DAVIES, FO TH~ I00 ~R~iT~E~%DOW RD. SUITE 4~1 ORDF~ OF WETHERSFIEL~ CT 06109 $2,33S~0Q "'000t51, 5"' " " Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number O'Connor Davies, LLP Vendor Telephone Number 860-257-1870 Vendor Contact 100 Great Neck Road Suite 401 Wethersfield, CT 06109 Vendor No. 14421 Check No. Entered by ~ Audit Date NOV 0 7 2012 invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number $2,335.001 9130120t2 $2,335.00 $2,335.00 153620 $2,335.00 Payee Certification The undersigned (Claimant) (Acting on behalf oftbe 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 Services 9/21-9/2812012 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 have been verified with the exceptions or discrepancies noted, and payment is approved Signature Title Date O'CONNOR DAVIES PKF Date 09/30/2012 Fishers Island Ferry District P.O. Drawer H Fishers Island, NY 06390 For Professional Services Rendered DATE SERVICE STAFF 09/21/2012 Special (describe) Marien T Updated budget package and revesions 09/26/2012 Special (describe) Marien T get ready for budget discussion, speak with Chris Raferty 09/27/2012 Special (describe) budget and forecast E.I.N. 27-1728945 HOURS AMOUNT 1.00 $ 285.00 09/27/2012 Special (describe) final budget review 1.00 285.00 09/28/2012 Lathrop 1.00 55.00 Marien T 3.00 855.00 Special (describe) Marien T budget analysis, review with Grodon payroll and fuel oil expenses, prepare schedules and send e-mall to client Client No. 475764.000 Invoice No. 153620 3.00 855.00 $ 2.335.00 Please make your check payable to "O'Connor Davies, LLP" Putnam Park - I O0 Great Meadow Road - Suite 401 - Wethersfield - Connecticut - 06109 ph. 860-257-1870 - fax 860-257-1875 FISHERS ISLAND FERRY DISTRICT VENDOR 015887 OXFORD HEALTH PLANS 11/07/2012 CHECK 816 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION SM .9060.8.000.000 SM .9060.8.000.000 AMOUNT 42342652 MEDICAL PREM HIGH-ii/12 8,888.04 42342653 MEDICAL PREM LOW-ii/12 5,047.68 TOTAL 13,935.72 11/07/2012 THIRTEEN TH~;SAND N'I~E HUNIA%ED TNIRTY ~IV~ AND 72/i00 DOLLARS ?~¥ OXFORD HEALTM PLANS TO THE PO BO~ 1697 ORDER OF N~WANK NJ 07101-1697 £ ;Vendor No. Town of Southold, New York - Payment Voucher 15887 Vendor Tax ID Number or Social Security Number Vendor Address 06-1181200 Check No. Oxford Health Plans Vendor Telephone Number 888-20t-4216 Vendor Contact Invoice invoice Number Date 42342653 10/I/2012 Invoice Total $5,047.68 Discount PO Box1697 Newark, NJ 0710%1697 Net Purchase Order Amount Claimed Number $8,047.68 $8,888.04 Entered by Audit Date NOV 0 ? 2012 Town~~, ~A~ Clerk . Description of Goods or Services Lod Medical Premium for 11/12 Medical Premium for 11112 General Ledger Fund and Account Number SM9060.8.000.000 42342652 10/1/2012 $8,888.04 SM9060.8.000.000 S13,935.72 $13,935.72 Payee Certification The undersigned (Claimant) (Acting on behalf of tbe above named claimant) does hereby certil~ 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 ~ Company Name w ,~I~ Date Department Certification l hereby celti~ 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 exceptmns or discrepancies noted, and payment is approved. Signature ~ Ti,lc ~ Date Unitedltealthcare' Oxford INVOICE SUMMARY Fishers Island Ferry District We encourage you to contact your Dedicated Client Service Manager (DCSM) at 888-201-4216 with any questions regarding this invoice. Group Number Billing Group FI9458 BG02 Previous Balance Payments Received Debit Memos (See Memo Details on last page of this invoice Credit Memos (See Memo Details on last page of th~s invoice Total Balance Forward ............. Coverage Period 11/0112012 - 1113012012 Invoice Number 42342653 Due Date of Payment November 01, 2012 $ 9,20306 4,60153 000 000 $ 4,601.53 Adjustments to Prior Bills .......... Totals by Contract Type - Currant Premium 6 Single 1 Couple 1 Family 8 Total Healthcare Contracts Current Premium ............... $ 446.15 2,67690 98153 1,389 25 5,047 68 $ 5,047.68 Total Balance Forward ......... Adjustments to Prior Bills ....... + Current Premium ............ Total Amount Due ......... $ 4,601.53 $ 446.15 $ 5,047.68 $ 10,095.36 284GBILLL21651901 JOBINA MILLER FISHERS iSLAND FERRY DISTRICT P O BOX 607 FISHERS ISLAND NY 06390 THIS STATEMENT REFLECTS PAYMENTS RECEIVED BY OXFORD ON OR BEFORE 10/05/2012. Please write your account number on your check when submitting payment. MS-12-139 Thank you for choosing Oxford. the total due. Any financial adjustment for Membership activity not displayed in this invoice summary will be reflected in a future invoice. If you would like your payment applied to a specific plan design, you must send the Remittance Advice for that plan design and indicate the amount to be paid in the Amount Remitted field of the Advice. NOTICE Failure to remit payment by the end of the grace period may result in termination of coverage by Oxford.* According to the terms of your Group Policy and Group Enrollment Agreement with Oxford, premium payments are due on the first of the month. The purpose of this notice is to advise you that your group coverage may terminate on the last day of the coverage period indicated on page one of this bill (the "Coverage Period") if we do not receive the required premium payment by the end of the grace period specified in your Group Policy and Oroup Enrollment Agreement. For New York groups, if we do not receive any payment by the end of the grace period, the termination date of coverage will be retroactive to the last paid date of coverage. If we receive a partial payment, the termination process described in the prior paragraph will apply. For all groups, if termination occurs, your employees and their dependents will receive coverage for all claims incurred on or before the last day of the Coverage Period or, in the case ora New York employer who has made no payment before the end oftbe grace period, the last paid date of coverage. No coverage will be provided for cl~mas incurred thereal~er. Any employee or dependent who has access to no other health insurance may be able to convert to an individual policy with Oxford. More information about this conversion option can be obtained by contacting your Oxford group representative directly. FOR NEW YORK EMPLOYERS ONLY In addition to the above, pursuant to section 217 of the New York Labor Law, you are required to inform your employees of the intended termination of their health coverage. This law requires that you do so by either hand-delivering or mailing to each of your employees, and by posting at conspicuous locations chosen as most likely to give notice to your employees, at least nine days prior to the intended termination date, a copy of this notice along with your own cover letter advising as to the intended termination of coverage. However, if your premium payment is sent to Oxford on or before the 20th day of the Coverage Period, or if you have arranged for similar replacement coverage for your employees provided by a different carrier (and filed affidavits to that effect with the Commission of Labor and Superintendent of Insurance), the law does not require that you provide your employees with notification as described above. The Contract Type on the Invoice Details list refers to the Contract Type of the core health care benefit, unless no such benefit exists for the Subscriber. Please refer to the Legend For Invoice Details above for an explanation of Contract Type, Benefit, and Code abbreviations. *Oxford HMO products are underwritten by Oxford Health Plans (NY), Inc., Oxford Health Plans (NJ), Inc. and Oxford Health Plans (CT), Inc. Oxford insurance products are underwritten by Oxford Health Insurance, Inc. Invoice DetaiLs may be continued on the other side. OUR GOAL IS HELPING PEOPLE LIVE HEALTHIER LIVES How do we do this? Better information. Beetler decisions. Better health. We're committed to providing better information to support better decisions that help drive better health for our members. A leading physician network, 24-hour health care guidance with Oxford On-Call®, a wealth of wellness resources, and online access at oxfordhealth.com, are just a few examples of our ongoing efforts to help our members live healthier lives. ~I]} Hnii~,dgloal~ht~vo' Thank you for choosing Oxford. P.ge of 1 INVOICE DETAILS Fishers Island Ferry District HSA SINGLE - LOW PLAN / HSA FAMILY - LOW PLAN Coverage Period: 11/01/2012 to 11/30/2012 CURRENT PERIOD ADJUSTMENTS TO PRIOR BILLS TOTALS Social Subscriber Contract # of Coverage Current Subscriber Security# Name Type Members Type Benefit Premium Period Code Premium TOTAL 1121103501 Brown, Donald C 2 CS02F HEALTHCR 98153 1121083801 BurKe Stephen S 1 CSPO2 HEALTHCR 446 15 1121090301 Fiora Michael S 1 CSP02 HEALTHCR 44615 1125766701 Gli0ewell, Logan S 1 CSP02 HEALTHCR 446 15 1121734601 Hoch, Richarp S 1 CSP02 HEALTHCR 44615 1121093501 Lynch, Matthew S 1 CSP02 HEALTHCR 44615 1121094501 MarKs Jason S 1 CSP02 HEALTHCR 446 15 1121096001 Murphy, Gordon F 3 CS02F HEALTHCR 1389 25 10~1~012-10~1~012 SUBA 44615 981 53 446 15 446 15 89230 446 15 446 15 446 15 1389 25 Total .................................... $ 5,047.68 ........... $ 446.15 $ 5,493.83 The Contract Type on the Invoice Details list refers to the Contract Type or the core healthcare benefit, unless no such Penefit exists for the SuPscfiber Please refer to the Legend For Invoice Details on the back of the Invoice Summary for an explanation of Contract Type, Benefit, and Code abbreviations Invoice Details may be continued on the other side. UnitedHealthcare' Oxford INVOICE SUMMARY Fishers Island Ferry District We encourage you to contact your Dedicated Client Service Manager (DCSM) at 888-201-4216 with any questions regarding this invoice. Group Number Billing Group Coverage Period i Invoice Number Due Date of Payment FI9458 BG01 1110112012.1113012012 ! 42342652 November 01, 2012 Previous Balance $ 3.609 52 Adjustments to Prior Bills .......... $ 1,152.68 Payments Received -4.601 53 Totals by Contract Type - Current Premium Debit Memos 0 00 7 Single 4.034 38 (See Memo Details on last page of th~s invoice) 1 Couple 1.26796 Credit Memos 0 O0 2 Family 3,585 70 (See Memo Details on last page of this ~nvoice.) 10 Total Healthcare Contracts 8,888 04 Total Balance Forward ............. $ 8,2tl.05 Current Premium ............... $ 8,868.04 Total Balance Forward ......... Adjustments to Prior Bills ....... + Current Premium ............ Total Amount Due ......... $ 8,211.05 $ 1,152.68 $ 8,888.04 $ 18,251.77 JOBINA MILLER FISHERS iSLAND FERRY DISTRICT P O BOX 607 FISHERS ISLAND, NY 06390 I THIS STATEMENT REFLECTS PAYMENTS i RECEIVED BY OXFORD ON OR BEFORE LUI 10/05/2012. Please write your account I ~1 number on your check when submitting payment. MS-12-139 Thank you for choosing Oxford. the total due. Any financial adjustment for Membership activity not displayed in this invoice summary will be reflected in a future invoice. If you would like your payment applied to a specific plan design, you must send the Remittance Advice for that plan design and indicate the amount to be paid in the Amount Remitted field of the Advice. NOTICE Failure to remit payment by the end of the grace period may result in termination of coverage by Oxford.* According to the terms of your Group Policy and Group Enrollment Agreement with Oxford, premium payments are due on the first of the month. The purpose of this notice is to advise you that your group coverage may terminate on the last day of the coverage period indicated on page one of this bill (the "Coverage Period") if we do not receive the required premium payment by the end of the grace period specified in your Group Policy and Group Enrollment Agreement. For New York groups, if we do not receive any payment by the end of the grace period, the termination date of coverage will be retroactive to the last paid date of coverage. If we receive a partial payment, the termination process described in the prior paragraph will apply. For all groups, if termination occurs, your employees and their dependents will receive coverage for all claims incurred on or before the last day of the Coverage Period or, in the case of a New York employer who has made no payment before the end of the grace period, the last paid date of coverage. No coverage will be provided for claims incurred thereafter. Any employee or dependent who has access to no other health insurance ma3, be able to convert to an individual policy with Oxford. More information about this conversion option can be obtained by contacting your Oxford group representative directly. FOR NEW YORK EMPLOYERS ONLY In addition to the above, pursuant to section 217 of the New York Labor Law, you are required to inform your employees of the intended termination of their health coverage. This law requires that you do so by either hand-delivering or mailing to each of your employees, and by posting at conspicuous locations chosen as most likely to give notice to your employees, at least nine days prior to the intended termination date, a copy of this notice along with your own cover letter advising as to the intended termination of coverage. However, if your premium payment is sent to Oxford on or before the 20th day of the Coverage Period, or if you have arranged for similar replacement coverage for your employees provided by a different carrier (and filed affidavits to that effect with the Commission of Labor and Superintendent of Insurance), the law does not require that you provide your employees with notification as described above. The Contract Type on the Invoice Details list refers to the Contract Type of the core health care benefit, unless no such benefit exists for the Subscriber. Please refer to the Legend For Invoice Details above for an explanation of Contract Type, Benefit, and Code abbreviations. *Oxford HMO products are underwritten by Oxford Health Plans (NY), Inc., Oxford Health Plans (NJ), Inc. end Oxford Health Plans (CT), Inc. Oxford insurance products are underwritten by Oxford Health Insurance, Inc. Invoice Details may be continued on the other side. OUR GOAL IS HELPING PEOPLE LIVE HEALTHIER LIVES How do we do this? Better information. Better decisions. Better health. We're committed to providing better information to support better decisions that help drive better health for our members. A leading physician network, 24-hour health care guidance with Oxford On-Call®, a wealth of wellness resources, and online access at oxfordhealth.com, are just a few examples of our ongoing efforts to help our members live healthier lives, m~[ llnilhatllt'~lfh~' Thank you for choosing Oxford. INVOICE DETAILS Fishers Island Ferry District HIGH PLAN Coverage Period: 11/01/2012 to 11/30/2012 Page 1 of 1 CURRENT PERIOD ADJUSTMENTS TO PRIOR BILLS TOTALS Socia~ Subscriber Contract #of Coverage Current Subscriber Security# Name Type Members Type Benefit Premium Period Code Premium TOTAL 1121732001 Barrett, Frederick S 1 CSP01S HEALTHCR 57634 1121732601 Easter Mark S 1 CSP01S HEALTHCR 57634 1121007601 Ford, Polly F 3 CSP01 HEALTHCR 1792 85 1121010001 Hiller Jonathan S 1 CSP01 HEALTHCR 576 34 1121013701 Le Fevre, Raymond S 1 CSP01 HEALTHCR 576 34 1121011301 Marshall, Jesse C 2 CSP01 HEALTHCR 1267 96 1121078601 Morgan, John F 3 CSP01 HEALTHCR 179285 1123283101 F~icker, Kenneth S 1 CSP01S HEALTHCR 57634 1121733601 Schmid, Nina S 1 CSP01S HEALTHCR 576 34 1121075501 Traub James S 1 CSP01 HEALTHCR 576 34 Total .................................... $ 8,888.04 09~1D012-09~0~012 SUBA 57634 10~1D012-10~1~012 SUBA 57634 $ 1,152.68 57634 576 34 1792 85 576 34 57634 1267 96 179285 172902 576 34 576 34 $ 10,040.72 The Contract Type on the Invoice Details list refers to the Contract Type of the core healthcare benefit, unless no such benefit exists for the Subscriber Please refer to the Legend For Invoice Details on the back of the Invoice Summary for an explanation of Contract Type, Benefit, and Code abbreviations Invoice Details may be continued on the other side, FISHERS ISLAND FERRY DISTRICT VENDOR 016659 PRINCIPAL LIFE GROUP 11/07/2012 CHECK 817 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .9060,8.000.000 H19730-1-11/12 LIFE PREM-11/12 6.49 TOTAL 6.49 TH SUFFOLKCO. NAT$ONALBANK CU~*CHOGU~, NY 11935 PAY PRINCIPAL LIPE CROUP ng~HH GRAND ISLED ORDER OF PO BOX 14513 DES MOINES IA 50305-3513 AUDIT 11/7/12 CHECK Nb 81~7 Vendor No. Town of Southold, New York - Payment Voucher 16659 Vendor Tax ID Number or Social Security Number Vendor Address P.O. Box 14513 Des Molnes, IA 50306-3513 Principal Life Group Vendor Telephone Number 800-843-1371 Vendor Contact Number Date ,10/17/2012 Invoice Total Discount $6.49 H19730-1- Net Purchase Order Amount Claimed Number $6.46 $6.49 $6.49~. Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and cmrect, 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 S,gnatu, T,fie Company NameDa e Check No. Entered by Audit Date NOV 0 7 2012 Town Clerk Description of Goods or Services Life Prem General Ledger Fund and Account Number SM9060.8.000.000 11 I1/12-11/30/12 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 Signature ~ litle Date ~'~ ~' ~ "~ Group Principal Financial Group Des Moines, IA 50392-0001 IPrincipal Life insurance Company IPREMIUM STATEMENT This statement in no way changes the contract or waives any overdue payment Account Number 000283 FISHERS ISLAND FERRY ATTN J MILLER 261 TRUMBELL DR BOX 607 FISHERS ISLAND NY 06390 H19730-1 Lb, No, 0819730 00001 93 Due Date 11/01/12 StmtOate 10/17/12 Billing Period 11/01/12 - 11/30/12 Please Pay Balance Due $ 6.49 PLEASE REVIEW ALL MESSAGES BELOW. THEY CONTAIN INFORMATION RELATED TO YOUR PREMIUM PAYMENTS AND THE ADMINISTRATION QF 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.COM OR NOTIFY OUR ADMINISTRATION AREA. WEB REPORTING REQUIRES A PIN. IF YOU DO NOT HAVE A PIN, PLEASE CALL 800-621-8280. REPORTING CHANGES PROMPTLY WILL RESULT IN A MORE ACCURATE PREMIUM STATEMENT. CHANGES SHOULD NOT BE SENT WITH YOUR PAYMENT. FOR ASSISTANCE, PLEASE CALL TOLL FREE: 1-8OO-843-1371 PROVIDING YOU WITH GOOD SERVICE IS IMPORTANT. PLEASE REVIEW YOUR STATEMENT EACH MDNTH TO ENSURE PROMPT AND ACCURATE CLAIM PAYMENT. ~nancial Group THZS TS YOUR COPY. Principal Financial Group Principal Life Des Moines, A 50392-0002 Insurance Company PLEASE KEEP FOR YOUR RECORDS. I PREMIUM STATEMENT ACCOUNT NO. H19730-1 FZSHERS ZSLAND FERRY LB. NO. 0819730 00001 93 DUE DATE: 11/01/12 STMT DATE: 10/17/12 lUMBER NAME ~D~?50897 FORD POLLY 930347664 GILBERT CR D95119919 GLIDEWELL 957647586 MORGAN dOH 970433672 MURPHY GOR 982693982 PARAD[$ dO 920098292 TRAUB dAME L[FE/AD&D BNFT PREM CHARGE/ CREDIT EE CHANGE SUMMARY : NEW ENROLLMENT 11/01/2012 6.49 6.49 6.49 6.49 6.49 NET CRED]T$ .00 BAL FORWARD 108.06- CHARGES TH[S STMT t14.55 TOTAL AMT DUE 6,49 FOR ASSISTANCE, PLEASE CALL TOLL FREE: 1-800-843-1371 F396GP-4 ACCOUNT NO. H19730-1 I 1/01/2012 000 000000 oooooo CGS631822911137197001002 0000696 002 OF 002 FISHERS ISLAND FERRY DISTRICT VENDOR 009673 SCALES INDUSTRIAL TECH, INC. 11/07/2012 CHECK 818 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710.2.000.200 3331011-00 RP-AIR COMP-SWITCH,VALVE 206.51 TOTAL 206.51 THE SUFFOLK CO. NATIONAL BANK CUTCHO'GUE. NY t 1935 TWO ,MUNDRED SIX ;%ND S1/100 DOLLARS PA~ SCAL~S INDUSTRIAL TECR; INC. TO THE 339 CLARK STREET ORDE~ POBOX 820 OF M~SLD;%~'CT 06467 00;,508 AUDIT 11/7/12 CHECK NO. 818 il/07/20i2 ~206.5~,i : Vendor No. Town of Southold, New York - Payment Voucher 9673 Vendor Tax ID Number or Social Security Number Vendor Address 339 Clark Street PO Box 820 Scales Industrial Technologies, Inc. M I dale, CT 06467 Vendor Telephone Number 203-630-5555 Vendor Contact iCheck No. Entered by ~ Audit Date NOV 0 7 2012 Invoice Number 3331011-00 Invoice Date 1011012012 Invoice Total Discount $206.51J $206.51 l Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and co~rect, 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 Net Amount Claimed $206.51 $206.51 Signature ~ Title Company Name a~ Date Purchase Order Number Description o f ;o~ si ~; ~_~;~ VI~' General Ledger Fund and Account Number RP-Air Compressors 8M6710.2.000.200 Department Certification I hereby certify that the materials above specified have been received by mc tn 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 Phone: NY (516) 248-9096 Ct. (203) 630-5555 SCALES INDUSTRIAL TECHNOLOGIES, INC, AN EMPLOYEE OWNED COMPANY Invoice Cust. #: Ship To: Bill To: 70015417 FISHERS ISLAND FERRY 5 WATERFRONT PARK ATTN: JOHN NEW LONDON, CT 06320 BO. Date 10/10/12 Remit To: FISHERS ISLAND FERRY ATTENTION: ACCOUNTS PAYABLE P.O. BOX H FISHERS ISLAND, NY 06390 Ship Point Att:Accts. Payable ** Drop Ship ** Instructions 1Z3380120365049652 Inv. Date Invoice # 10/10/t2 3331011-00 P.O.# Page # VERBAL JOHN 10-09-12 1 SCALES INDUSTRIAL TECHNOLOGIES 339 CLARK STREET PO BOX 820 MILLDALE, CT 06467 Via UPS GROUND Shipped Terms i0/10/12 NET 30 DAYS Product QTY QTY QTY Unit Ln# and Description Ordered B.O. Shipped UM Price 1 QU1855 6 0 6 EA 5.60 DIAPHRAGM, VALVE, INLET 2 SQ9013GHG2J57 2 0 2 EA 75.00 PRESSURE SWITCH 120-150 2 Lines Total Qty Shipped Total 8 Amount (Net) 33.60 150.00 Total 183.60 Freight Out 11.25 Taxes 11.66 Invoice Total 206.51 Last Page THIS INVOICE MAY BE SUBJECT TO A SERVICE CHARGE OF 1~12% PER MONTH IF NOT PAID WITHIN 30 DAYS OF INVOICE DATE. ANY TAXES BILLED ON THIS INVOICE MAY BE DEDUCTED ONLY IF APPROPRIATE EXEMPTION CERTIFICATE IS INCLUDED WITH YOUR PAYMENT. D~cument: Transfer/Packing List Order ~ Transfer # 3331011-00 312840-00 brder Dt Page 10/10/12 ~ill To: Ship To: Correspondence To: SCALES INDUSTRIAL TECHNOLOGIES 339 CLARK STREET PO BOX 828 ~ILLDALE, CT ~34~7 FISHERS ISLAND FERRY Instructions Cust PO8 5 ~TERFRONT PARK VERI~ J~N 10-09-12 ATTN: JOt~ Ship Point Via Request Shipped Terms NEW LONDON, CT 06320 SCALES INDUSTRIAL TECHNOLOGIES L~S ORO~D 10/10/12 NET 30 DAYS Line ~oduct UPC Bin Quantity Quantity Quantity Qty # # And Description Item# Location Ordered B,O. Shipped UM Received Cartons *** For Original OE Order#: 3331811-88 Customer PO: VERBAL JOHN 18-89-18 PLEASE SHIP OUT TODAY 18-89-18. THANK YOU 1 ICD;4-E-~Q 88888 811181805/806 6.80 8.88 6,88 EA DIAPHRA~ OUIS~ OR Tie - Order #: 3331011-00 Line # 1 Customer: FISHERS IOLAND FERRY 2 SO9813GHG2J57 08888 81/85/886/883 2.88 8.80 2.80 EA PREBSURE SWITCH 120-150 OG Tie - Order 8: 333101t-0~ Line # 2 Customer: FISHERS ISLED FERRY 2 Lines Total ** # of Lines Not Printed 8 Picked By: Packed By: Checked By: Cube: Qty Shipped Total 8.08 Total Weight: Freight Charges: Received By: Last Page Date Received: FISHERS ISLAND FERRY DISTRICT VENDOR 019267 DEBORAH S. SHILLO 11/07/2012 CHECK 819 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4,000.000 100312 RECORD MINUTES-9/12 243.75 SM .5710.4.000,000 101412 RECORD MINUTES-10/12 125.00 TOTAL 368.75 ~DF~RRYDtSTB/CT aUDIT 11/7/12 CHECK NO 819 11935 j DATE' I A~NT ?AY DEBORA~ S. S~ILLO FO~H~ 26 HI~WOOD RD. ORDER OF ~LOOM~IELD CT 06002 Vendor No. Town of Southold, New York- Payment Voucher 19267 Vendor Tax ID Number or Social Security Number 26 High Wood Road Deborah Shillo Bloomfield, CT 06002 Vendor Telephone Number 860-242-2514 Vendor Contact Check No. Entered by Audit Date NOV 0 7 2012 Invoice Invoice Invoice Purchase Order Number Date Total Number Description of Goeds or Services General Ledger Fund and Account Number Net Discount Amount Claimed $243.75 $125.00 101312012 $368.79 $243.75 Recorder of minutes Comm. Mtgs 9.75 hrs ~ $ 25.00 $128.00 September 10/t4/2012 Record of minutes Comm. Mtgs 6 hfs ~ $25.00 October 3-14 $368.75I 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 /~1 Date SM57t0.4.000.000 Department Certification I hereby certify that the materials above speciliod have been received by me in good condition w~tbout substitution, the services properly peffo~mod and that thc quantities thereof have been verified with tbe exceptions or discrepancies noted, and payment is approved Deborah Shillo 26 High Wood Rd. Bloomfield, CT 06002 860 242 2514 $25.00 Hr. 20 l 2 September $243.75 Date Description Hours TL 6-Sep meeting 1.5 $37.50 7-Sep resolu minut 2.5 $62.50 10-Sep sent minutes 0.5 $12.50 17-Sep minutes 2 550.00 27-5ep adj to 9/6 1 525.00 3-Oct final 9/6 0.25 56.25 3-Oct 9/17minutes 2 550.00 $o.oo $o.oo O-C 1 .50 + 2'50 + 0-50 + 2'00 + 1 '00 + 0'25 + 2-00 + 9'75G+ 9-75 x 25-00 243-75 Deborah Shillo 26 High Wood Rd. Bloomfield, CT 06002 860 242 2514 $25.00 Hr. 2012 October Date Description Hours 3-Oct 10/2 minute., 14-Oct ~2 special & 14-Oct oct 15 set up $~25.00 TL 3 $75.00 S2s.oo $25.00 $o.oo So.oo SO.OO So.oo SO.OO So.oo O'OOG+ 5'00 + 1 '00 + 1 '00 + 5'00G+ 5'00 x 25 ' O0 = 125'00 FISHERS ISLAND FERRY DISTRICT VENDOR 019719 STAPLES CREDIT PLAN 11/07/2012 CHECK 820 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5711.4 .000.000 16440 FI OFFICE SUPPLIES SM .5711.4 .000.000 73.34 3309671001 FI OFFICE SUPPLIES 88 .87 SM .5711.4 .000.000 3387639001 FI OFFICE SUPPLIES 125.95 SM .5711.4 .000.000 3651728001 FI OFFICE SUPPLIES SM .5711.4 .000.000 22.86 3679429001 FI OFFICE SUPPLIES 60.74 SM .5711.4 .000. 000 3679429011 FI OFFICE SUPPLIES SM .5711.4. 000. 000 34.99- 3881069001 FI OFFICE SUPPLIES 134 . 99 TOTAL 446.01 m g� & fit°"'' .. , 5 # s � .,, °4 THE ORIGINAL CHECK HAS A COLORED BACKGROUND, A VOID COPY FEATURE AND WATERMARK PAPER Fabiff SotKcI F YDIS7RICT AUDIT 11/7/12 SO MAIN OAp PO B so zHDLo,Nr i r45�o CH,GK NO. 820 rr„ O NATIGNAL$ANK " b11/0ATE i AktOl1N1 6WTCH©GDE.NM 11 B35 FoT3R flt1NDR A r 7/ 412'. 46; y' PAY STAPLE'S CREDIT PLAN Od FR 79 # ( ORDER EPT 31 60003077 D Pb BOX 689020 P fl't0tal00 u 0'a 11 0 5't.541: 66 DO 150 2 LH' Town of Southold, New York - Payment Voucher Vendor Tax iD Number or Social Security Number Vendor Address Dept 51-7820657673 PO Box 689020 STAPLES CREDIT PLAN Des Molnes, IA 50368-9020 Vendor Telephone Number 800-767-1291 Vendor Contact Invoice lnvoi~ Numb~ Date 3679429001 9/1112012 3651728001 9/1t/2012 3881069001 9/17/2012 3679429011 9/19/2012 16440 9/28/2012 3309671001 1011/2012 3387639001 1013/2012 IVendor No. 19719 Check No. Entered by Audit Date NOV 0 ? 2012 Invoice Purchase Order Total Number Description of Go.is or Services General Ledger Fund and Account Number $60.74! $22.86 Net Amount Claimed $80.74 $22.86 $134.99 $73.34 $88.87 $126.96 $134.99 -$60.74 $73.34 $88.87 FI Office Supplies FI Office Supplies FI Office Supplies FI Office Supplies FI Office Supplies FI Office Supplies $126.96 FI Office Supplies $446.01 $446.0t Payee Certification Department 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, excepl as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded. SM571t.4.000.000 ~'/ 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 that was easy: (~ Customer Sewice: staples.accountonline.com M Account Inquid~s: 1~800-767-1291 Fax 1-801-779-7425 Account Statement Summary of Account Activity Previous Balance $475.81 Payments -$197.47 Credits -$60.74 Pumhases +$506.75 Debits +$0,00 FINANCE CHARGES +$0.00 Late Fees +$0,00 New Balance $724.35 Send No'ce of Billing Errom ~1 Customer Sen~e Inqui~ies to: STAPLES CREDIT PLAN PO Box 790449, St. Louis, MO 63179-0449 Payment Information Current Due Past Due Amount Minimum Payment Due Payment Due Date I Credit Line J Credit Available I Clo~ing Date JI Next Closing Date J Days in Billing Period $31.00 $0.00 $31.00 11/03/12 $10,500 $9,775 10/09/12 11/08/12 32 __ TRANSACTIONS Trans Date Locatlon~Oescription O9117 09/19 10/03 f~¢23165i728-000-o91 PUTNAM CT f~-/231679429-000-O91 PUTNAM CT ~f'9231881069-O90-O91 MONROE TOWNSH NJ ~'9231679429-d01-O91 PUTNAM CT CREDrr OFFICE SUPPLIES NEW LONDON CT ~'232309671-0G0-001 PUTNAM CT ~232387639-000-O91 PUTNAM CT PAYMENTS, CREDIT~, FEES AND ADJUSTMENTS 09117 PAYMENT - THANK YOU $ 60.74 P9194OgLMOgTRNSS3 $ 197.47- FINANCE CHARGE SUMMARY PURCHASES REGULAR REVOLVING CREDIT PLAN Annual Pe~'~ntage Rato (AP~) Your Annual Pementage Rate (APR) is the annualinterest rate on your account. J 0.00000% $0.00 $0 O0 ;- ~ NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION Page I of 6 This Account I~ I~lued by Citibank, N.A. that was eas~ INVOICE DETAIL BILL TO: Acc't: 6035 5178 2065 7673 SHiP TO: DEB DOUCE~rE FISHERS iSLAND FERRY 261 TRUMSULL DR FISHERS iSLAND, NY 00000-00(30 PRODUCT SKU # SES TONER BROTHER TN620 R 000894709 Purchased by: DEB DOUCETTE BILL TO: Ac. ct: 6035 5178 2065 7673 SHIP TO: DEB DOUCETrE FISHEP~ ISLAND FERRY 261 TRUMBULL DR FISHERS ISLAND, NY PRODUCT SKU # 3-TAB FLDR LTR MANILA 100 000116657 BATTERY AAA 4PK 0OO3i8949 ONE STEP MORE INDX 15-TAB 000400853 SILL TO: Acc't: 6035 5178 2065 7673 PO $60.74 09/11/12 11~3/i2 Invoice #: 3679~29001 I Store: 100088887, PUTNAM QUANTITY UNIT PRICE TOTAL PRICE Purchased by: DEB DOUCETTE 1.0OOO EA $60.74 $60~74 SUBTOTAL $60.74 TAX $43.00 SHIPPING $5.OO TOTAL $60.74 SHIP TO: DEB DOUCET~E FISHERS ISLAND FERRY 261 TRUMBULL DR FISHERS ISLAND, NY 00000-0000 PRODUCT SKU # Trina Dale: ' 09/~ 1/12 DUE DA 11/03/12 $22.86 I Store: 100009412, CHAMBERSBURG Invoice #: 36517280O1 QUANTITY UNIT PRICE TOTAL PRICE SEB REMAN TONER CANON 261 000920646 Purchased by: DEB DOUCE~rE BILL TO: Acct: 6035 5178 2065 7673 1.0000 BX $6.99 $6.99 2.0000 PK $5.29 $10.58 1.0000 EA $5.29 $5.29 SUBTOTAL $22.86 TAX $0.00 SHIPPING $0.00 TOTAL $22.86 SHIP TO: GORDON MURPHY FISHERS ISLAND FERRY 5 WATERFRON~ PARK NEW LONDON, CT PRODUCT SKU # Am°unt ~ Tran" Dat"~' DU£ DA11=: Invoice #: 1O0O88887, PUTNAM QUANTITY UNIT PRICE TOTAL PRICE SEB TONER BROTHER TN620 R 000894709 1.0000 EA $13~.99 $134.99 SUBTOTAL $134.99 TAX $O.OO SHIPPING $0.00 TOTAL $134.99 Purchased by: GORDON MURPHY 09/19/12 I 11 ~3/12 Invoice #: 3679429011 t Store: lo3088887, PUTNAM QUANTITY UNIT PRICE TOTAL PRICE 1.O3OOEA $60.7~ $60.7~ SUBTOTAL $60.7~ TAX $0.O3 SHIPPING $5.OO TOTAL $60.7~ Page 3 of 6 1-800-767-1291 staptes.accountonline.com This page intentionally left blank. Page 4 of 6 1-800-767-1291 staples.accountonline,com J that was easy~. INVOICE DETAIL BILL TO: Acct: 6035517820657673 SHIP TO: FISHER ISLAND FERRY DIST PO BOX H FISHERS iSLAND, NY 06390-0607 PRODUCT SKU # FALCON DUST DESTOYER 7OZ 326196 BROTHER LC71YS YELLOW INK 324017 iNVISIBLE TAPE 3PK-DISPEN 518724 STAPLES COpy SELECT 20~34 897802 BROTHER LC71CS CYAN INK 324015 STAPLES FUNDED COUPON 558100 STAPLES FUNDED COUPON 558100 $73.34' 09/28/12 11/03/12 16440 I Store: 100(X)1872, NEW LONDON QUANTITY UNIT PRICE TOTAL PRICE BILL TO: Acct: 6035 5178 2065 7673 1.0000 EA $10.00 $10.00 1.0000 EA $3~99 $9.99 1.0000 EA $4.99 $4.99 1.0000 EA $48.99 $48.99 1.0000 EA $9.99 $9.99 1.0000 EA $5.01- $5.01- 1.0000 EA $9.99- $9.99- SUBTOTAL $68.96 TAX $4.38 SHIPPING $0.00 TOTAL $73.34 SHIP TO: DEB DOUCHE FISHERS ISLAND FERRY 261 TRUMBULL DR FISHERS ISLAND, NY PRODUCT SKU# I PO: $88.87 Trmm Date: J DUE DATE: Invoice #: lO/Ol/12! [ 11~3i12 3309671001 I Store: 100088887, PUTNAM QUANTITY UNIT PRICE TOTAL PRICE SPLS 8.5X11 COPY CS 000135848 FOLDER 1/3 cUT PASTEL LTR 000459684 HP 940XL SLK INK 000772995 Purchased by: GORDON MURPHY 1.0000 CT $37.79 $37.79 1.0000 BX $15.99 $15.99 1.0000 EA $35.09 $35.09 SUBTOTAL $88.87 TAX $0.00 SHIPPING TOTAL $88.87 SILL TO: SHIP TO: Acct: 6035 5178 2065 7673 DES DOUCE~TE FISHERS ISLAND FERRY 261 TRUMBULL DR FISHERS ISLAND, NY PRODUCT SKU# Amount Due: PO: $125.95 TranS Datm DUE DATE: 10/03/12 11/03/12 Invoice #: I Store: 100088887, PUTNAM QUANllTY UNIT PRICE TOTAL PRICE HP 940XL CYAN INK 000772994 HP 940XL YEL iNK 000772997 HP 940XL MAG 000772998 Purchased by: GORDON MURPHY 2.00O0 EA $25.19 $50.38 2.0000 EA $25.19 $50.38 1 0000 EA $25.19 $25.19 SUBTOTAL $125.95 TAX $0.00 SHIPPING $O.00 TOTAL $125.95 Pege 5 of 6 1-800-767-1291 staples .accountonline.com This page intentionally left blank. Pege 6 of 6 1-800-767-1291 staples .accountonline.com 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 FISHERS ISLA/qD FERRY DISTRICT 1 DEB DOUCETTE Floor: 1 261 TRUMBULL DR FISHERS ISLAND, NY 063908021 Contact: (631) 788-7463 - DEB DOUCETTE REFER TO THIS ORDER NO. FOR ALL INOUIRIES 4051828224 9/11~/12 I 9231651728-00000:' SHIPPINO LOCATION: Putnam, CT FC CARRIER ROUTE:UPS/UPS /U2 TOTAL PACKAOES: PAGE: 1 Coupons and other adjustments are deducted after the Merchandise Total. On large ~rders some bcxes may be arriving in separate shipments. 116657 ~j 3-TA_B FLDR LTR MA/qILA 100 /116657 BX 1 1 6.99 6.99 318949~/ BATTERY ~ 4PK /MN2400B4Z PK 2 2 5.29 10.58 400853 ONE STEP MORE INDX 15 TAB CLR /67318 EA 1 1 5.29 5.29 M ~rc :andise total ....... 22.86 D ~.li zery ................. 00 T~x ...................... O0 Check your order statu~ online by going to www. Staples.com and clicking on "My Orders". ~ Need to return something? Please call Customer Service to process TOTAL VALUE 00: Thank You For Your Order! Staples, Inc. THIS IS NOT~4N INVOICE For Customer Serv,ce, 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. that was easy: ' STAPLES that was easy FISHERS ISL~LND FERRY DISTRICT DEB DOUCETTE Floor: 1 261 TRUMBULL DR FISHERS ISLAND, NY 063908021 Contact: (631) 788-7463 - DEB DOUCETTE SHIPPING LOCATION: putnam, CT PC CARRIER ROUTE:UPS/UPS /U2 TOTAL PACKAGES: 1 Order Date: 09/11/2012 Coupons and other adjus On large or,ers some be 894709 ~ Check your order statu~ tments are deducted after the Merchandise Total. xes may be arriving in separate shipments. SEB TONER BROTHER TN620 REMA_N /SEBTN620R online by going to www. Staples.com and clickin( "My Fotal 60.74 60.74 60.74 .00 .00 Need to return something? Please call Customer Service to process a return. TOTAL VALUE OF ORDER: 60. 74 Thank You For Your Order! Staple. s, Inc. THIS IS NOT~4N INVOICE 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. REFER ORDER STAPLES that was easy is FISHERS ISLAND FERRY DISTRICT DEB DOUCETTE Floor: 1 261 TRUMBULL DR FISHERS ISLAND, NY 063908021 Contact: (631) 788 7463 DEB DOUCETTE SHIPPING LOCATION:Monroe FC CARRIER ROUTE:UPS/UPS TOTAL PACKAGES: PAGE: 1 COUPONS AND OTHER ADJU~ FMENTS ARE DEDUCTED AFTER THE MERCHANDISE TOTAL. The following are shi -=d from an alternate warehouse via UPS. They should arrive no later than 09/18/12 920646 SEB REMAN TONER CANON 2617B001/SEB2617R CC M D Total 134.99 134.99 134.99 .00 .00 Check your order online by going to ww~.Staples.com and clickin( "My Need to return something? Please call Customer Service to process a return. TOTAL VALUE OF OP~DER: 134 . 99 Thank You For Your Order! Staples, Inc. THIS IS NOT AN INVOICE 001 scs 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. that was easy: REFER ~ ~HIS 9RD~R NO. FOR A~L ~N9 RIES 4051825224 I10/01 '12 I 9232309671-000001 STAPLES that was easy FISHERS ISLA/~D FERRY DISTRICT 1 DEB DOUCETTE Floor: 1 261 TRUMBULL DR DRAWER E FISHERS ISLAND, NY 063908021 Contact: (631) 788-7463 - DEB DOUCETTE SHIPPING LOCATION:Putnam, CT FC CARRIER ROUTE:UPS/UPS /U2 Order Date: 10/01/2012 Coupons and other adju: 5ments are deducted after the Merchandise Total. On large o~rs some b~ xes may be arriving in separate shipments. 1 135848~,~ S~LS ~.5Xll COPY CS /135848-WH CT 1 1 37.79 37.79 2 459684 / FOLDER 1/3 CUT PASTEL LTR AST /459684 BX 1 1 15.99 15.99 3 772995 HP 940XL BLK INK /C4906A-N#140 EA 1 1 35.09 35.09 M ~rc landise total ....... 88.87 D ~li ~ery ................. 00 T~X ..................... 00 Check your order status online by going to www. Staples.com and clicking on "My Orders". ~ Need to return something? Please ~a~.~s~ call Customer Service to process TOTAL V;tLUE Thank You For Your Order! Staples, Inc. THIS IS NOT.4N INVOICE 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 FISHERS ISLJkND FERRY DISTRICT 1 DEB DOUCETTE Floor: 1 261 TRUMBULL DR FISHERS ISLAND, NY 063908021 Contact: (631) 788-7463 - DEB DOUCETTE REFER TO THIS ORD~ ~ N0. FOR AL~. INOUIRIES 4051825224 10/03 '12 9232387639-000001' ~:i :. :.: ~ :~ ~:~..~ ~: gHIPPING LOCATION: Putnam, CT FC CARRIER ROUTE:UPS/UPS /U2 TOTAL PACKAGES: 1 PAGE: 1 Order Date: 10/03/2012 Coupons and other adjuetments are deducted after the Merchandise Total. On large orders some bcxes may be arriving in separate shipments. / 772994 HP 940XL CYAN INK /C4907AN#140 EA ~ 2 25.19 50.38 Please tell us how we're doing for a chance to win $2500! To participate co to WWW.SURVEY4STAPLES.COM and enter Survey Code 9232387639 For rules visit www.survey4staples.com. 772997 HP 940XL YEL INK /C49092kN#140 EA 27/ 2 25.19 50.38 772998 HP 940XL MAG /C4908A~#140 EA~ 1 25.19 25.19 M ~rc landise rotal ....... 125.95 D ;li rery ................. 00 T~x ..................... O0 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 FISHERS ISLAArD FERRY DISTRICT 1 DEB DOUCETTE Floor: 1 261 TRUMBULL DR D~AWER H FISHERS ISLA/qD, NY 063908021 Contact: (631) 788-7463 - DEB DOUCETTE REFER TO THIS ORDER Ng~ FOR ALL INOUIRIES 4051825224 10/03 r12 9232387639 000001' ' SHIPPING LOCATION: Putnam, CT FC CA~RIEH HOUTE:UPS/UPS /U2 TOTAL PACKAGES: 1 Order Date: 10/03/2012 Check your order status online by going to www. Staples.com and clicking on "My Orders". ~ Need to return something? Please News call Customer Service to process TOTAL VALUE oo~ Thank You For Your Order! Staples, Inc. THIS IS NOT,4NINVOICE FISHERS ISLAND FERRY DISTRICT VENDOR 020167 TERMINIX PROCESSING CENTER 11/07/2012 CHECK 821 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM ,5709.2.000.200 11091127464 PEST CONTROL-NL-9/27/12 TOTAL 49.98 49.98 PAY TERMINIX PROCESSING CHNTER TO'HE PO BOX 74~592 ORDER ~F CINCIN~&TI OH 4~274-2~9~2 AUDIT 11/7/12 C~E~ NO. 821 11/07/2012 $49.98 Vendor No. Town of Southoid, New York - Payment Voucher 20167 Vendor Tax ID Number or Social Security Number Vendor Address P.O. Box 742592 Vendor Name Cincinnati, OH 45274-2592 Terminix Processing Center Vendor Telephone Number 860-683-0012 Vendor Contact Check No. Entered by Audit Date NOV 0 7 2012 ITown C er~ '~ ~.. .... ~,.~,,, l I Total Description of Goods or Services Genexal Ledger Fund and Account Number 11091127464 101212012 $49.98 Pest ControI-NL 9/27/12 8M$709.2.000.200 $49.98 Net Discount a. mount Claimed $49.98 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certif~ that the foregoing claim is true and correct, that no part has been imi& except as therein stated, that the balance therein stated is actually due and owing, and that tmxes from which the Town is exempt are excluded. Department Certification I hereby certify that thc materials above specified have been received by me m good condition without substitution, the setvlces properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Signature - P.O. BOX 17167 .MEMPHIS, TN ~B187 11606 t MB 0.401 FISHER'S ISLAND FERRY* ATTN: DEBRA DOUCETTE PO BOX H FISHERS ISLAND NY 06390-0607 EASY WAYS TO PAY YOUR TERMINIX® INVOICE Paying your bill is easy. especially online Just visit the "Manage My Account" portal at TerminixCommercial.com and sign up with your Customer Number: 406732'~ and phone number to start paying bills online. ACCOUNT INVOICE Please Pay By: Total Due: 10/22/2012 $49.98 PAYONLINE Ter minixCommerciel.com OPAY BY PHONE 1.800.TERMINIX QUESTIONS · Local Office: 860.685.0012 · Toll Free: 1.800,TERMINIX · Online: TerminixCommercial.com 10/02/2012 Pest Control Work Order 11091127464 Tax Charge Location: 5 STATE ST/DOCK OFFICE, NEW LONDON CT 06320 318661124 $47.00 $298 $49.98 DUE DATE: 10/22/2012 TOTAL DUE: $49.98 Business License; 0151, #B-0219 REFER COLLEAGUES AND FRIENDS. SAVE ON YOUR TERPlINIX SERVICE. For each person or business you recommend who purchases an annual Terminix commercial or residenl~ial service, you'll Sere $150 or more, To learn more abouL Business Refer & Save, visit TermlnlxCommerclel.com or ask your Termlnix Commercial representative. OPERATOR'S NAME & CERTIFICATION # ~if~ *~ ~, ;Fiji i,.,!;:, ;¢ TEIIMI IlX TERMITE and PEST CONTROL [ 0 - i 2 SERVICE PROPERTY AT P~oouc'noN TIME IN TIME OUT SERVICE CENTER TARGET PEST: SERVICE INSTRUCTIONS ~ASEMENT - RESI 92~ii.-C OFFICES 024~;-.C 022~3-C !5028-S PUBLIC AR_Ao !RASH AREA 02263-C 02~!I-C ~ 5928-S U~NDi~G AREA~ 02aH-C 02~3-C ~sO~8-S ,)3332-C 02263 5A5 PLUS ~tO 023~[! M~c~ FC S~l~ct R~ch ~e~ F!D~ONI{_ ,Ot~ ~?-~25V BAYER CTEES05 ~?Kick CS ,05~ CT~UTi~i~i ~,05~ 4~y-304 TRFJkTED INSPECI~ED [ ] c_! E _I £- ~w"'_ [] [ _] [ _] AdOUNT EQUIP SUPERVIS(~'S C(~,h~F_.~TS:-- [~Treat for Infestation/Prevention or Inspect areas indicated. TR~TME~ cODEs: C = Crack & Crevice S = Spot B = 3' Band G = General ~ = SpaceTreatmen~ A = Aerosol B&G = Comp. Air [,~ ~pge~==,~_~and Dust T =Trap B = Bait Stat. EQUIPMENT CODES: SPECIAL SERVICE INSTRUCTIONS CUSTOMER'S SIGNATURE . I AMOUNT PAiD FISHERS ISLAND FERRY DISTRICT VENDOR 020729 TRAVELERS 11/07/2012 CHECK 822 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .1910.4.000.100 4709Xl135-1012 COMM VEH POL-11/12-11/13 1,719.00 TOTAL 1,719.00 ONE THOUSAND SEV~N '}U3NDRED NINETEEN AND 00/100 DOLLARS P~IY TRAVELERS TOTNB CL REMITTANCE CENTER ORDER OF PO, 11/07/2012 Town of Southold, New York- Payment Voucher Vendor Tax iD Number or Social Security Number Vendor Name The Travelers Vendor Telephone Number 877-307-4202 Vendor Contact Number Date 4709X113~ 101121201' Total t,719.00 1,719.0{) Payee Certification Discount Vendor Address CL Remittance Center PO Box 660317 Dallas, TX 75266-0317 Vendor No. 20729 Description of Goods or Services Net Purchase Order ~mount Claimed Number 1,7t9.00 Comm. Vehicle Policy 1111112.1111113 Ford F-380 Truck Check No. Entered by Audit Date NOV 0 7 2012 1,719.00 The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~ that the foregoing claim is true and correct, that no pa~t 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~ ~P Date General Ledger Fund and Account Number SM1910.4.000.100 Department Certification I hereby certify that the materials above specified have been received by me in g~od condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment ~s approved Signature ~ Title Date TRAV£LER ' GLOVER-PADULA INS ZNC 16 MAZN ST EAST GREENWICH RZ 02818 08649-L4 Page 1 of 2 Account Bill Account No. q709Xl135 Date of This Bill 10/12/12 CP 01 6640 G6640LKS 12285 08649 P1 FISHERS ISLAND FERRY DISTRICT P.O. BOX H FISHERS ISLAND NY 06390 TOTAL BALANCE I $1,~19.00~ MINIMUM DUE { $186.9o/ PAYMENT MUST BE RECEIVED BY: NOVEMBER 01~ 2012 ACCOUNT BILLING SUMMARY POLICY TYPE 8080M715 BA Business Auto Pol TOTAL BALANCE POLICY PERIOD 11/01/12 To 11/01/13 Current Installment Charge MIN. DUE BALANCE $180.90 $1,719.00 6.00 $186.90 $1,719.00 TRANSACTIONS SINCE LAST STATEMENT Total Transactions (See Transaction Detail Section) TOTAL BALANCE +1/719.00 $1,719.00 TRANSACTION DETAIL POLICY NUMBER 8080M715 BA Business Auto Pul 11/01/12 Renewal 11/01/12 NY Motor Ve Fee TOTAL TRANSACTIONS ~__?iL ~/'~'~'~- CONTINUED ON NEXT PAGE 1,709.00 10.00 $1,719.00 Please de~ch~e paymentcoupon and ma# with yourpayment~ ~e enclosed enve~pe TRAVELERS CL REMITTANCE CENTER, PO BOX 660317, DALLAS, TX 75266-0317. Customer ,¥ervice Contacts Billin ~ Questions Your Account Number: Automated Inquiry: MONDAY-FRIDAY, 7:00 A.M. - 8:00 P.M. EST q709X1135 24hrsada.~ 7day~aweek 800-252-2268 800-252-2268 Policy Ou estion s Claim Ouestions GLOVER-PAOULA INS INC BUSINESS INSURANCE CONSTRUCTION NATIONAL ACCOUNTS ~01-88~-2460 800-238-6225 800-828-4132 800-832-7839 Policylnformation Insuring Company 8080M715 8A THE CHARTER OAK FIRE INSURANCE COMPANY Page 2 of 2 Policyholder FISHERS ISLAND FERRY DISTRICT Account No. ~709X[:[$-~ Date of This Bill: SPECIAL MESSAGES Hassle Free Payments - Call 877-507-q202 to make a quick and simple payment. For all other customer service inquiries (other than making a payment) please call 800-252-2268. You must pay at least the minimum due or up to the total balance due. If at any time you pay us more than the minimum due, and it covers your future installments, you will not receive a bill or be charged an installment charge. If you pay by installments, a $6.00 charge will be added to each installment bill. If your payment is not received by the due date WE NAVE THE RIGHT, WITHOUT ADVANCE NOTICE TO YOU, TO TERMINATE YOUR OPTION TO PAY IN INSTALLMENTS AND TO REQUIRE FULL PAYMENT OF THE OUTSTANDING BALANCE ON YOUR POLICY. WE ALSO NAVE THE RIGHT TO ASSESS A LATE FEE OF $10.00. Make payments on-line! With our on-line payment options you can make single payments or you can schedule Automatic Recurring Payments. It's fast and easy, enroll today! To learn more visit our website - www.travelersepay.com. If you are paying with a check from a Personal Checking Account, you authorize us to either use information from your check to make a one-time electronic funds transfer from your account or to process the payment as a check. If you are paying with a check from a Business Checking account, we will process the payment as a check. 6fi88fi2H 2012286 7725 855 052964 CLOBILL2 PL-9837 FISHERS ISLAND FERRY DISTRICT VENDOR 021304 ULINE 11/07/2012 CHECK 823 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 46850782 SHRINK WRAP-NL 157.31 TOTA~ 157.31 11/07/2012 PAY OPd3~ OF ULINE ATTN:'~CCOUNTS RECEIVABLE ~ D ~'OOO88:~"' ':081,~,OSt, r=~,: r:8 OO~,SO8 ~,~' Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor No. 21304 Vendor Address Attn: Accounts Receivable 2200 S. Lakeside Drive ULINE Waukegan, IL 60085 Vendor Telephone Number 800-295-5510 Vendor Contact Invoice Total Discount $157.31 $157.31 Net Purchase Order Amount Claimer Number $167.31 Invoice Number $157.31 Invoice Date 46850782 10/10/2012 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 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 Title ~ Date Company Name Description of Goods or Services hrlnk Wrap-NL CheckNo.~~J Entered by ~ Audit Date NOV 0 7 20!2 Town Clerk General Ledger Fund and Account Number SM5710.4.000.000 Department Certification I hereby certify that the materials abeve 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 Ti.e Date 1-800-295-5510 uline.com 2200 S, Lakeside Drive · Waukegan, IL 60085 SHIP~ING SUPPLY SPECIALISTS THANK YOU FOR YOUR ORDER. ULINE CUSTOMER SINCE 2005 SOLD TO: INVOICE NO. 46850782 INVOICE ULINE FED ID#: 36-3684738 YOUR ORDER # 50401569 SHIP TO: MDG2010 00007505 1 AB 0374 ~'H¢."h"HMHqhlqq'h""ql.'llll~'"h~"h~ll FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY DISTRICT 5 WATERFRONT PARK Po Box H ~:~-.. NEW LONDON CT 06320 FISHERS ISLAND NY 06390-0607 2461167 PAY UPS G ROUND 10/10/12 10/10/12 N ET 30 DAYS 10/10/12 --- iflLii,, ,-.-, ~. I IIII mi '1 tl, 8 RL S-642 18X1500 80GA ULINE BLOWN WRAP 16.00 128.00 ORDER PLACED BY: RAY LEFEVRE DIONNE /I SUB-TOTAL 128.00 SALES TAX .00 FRWHNDLING 29.31 AMOUNT DUE 157.31 FISHERS ISLAND FERRY DISTRICT VENDOR 021506 UNITED PARCEL SERVICE 11/07/2012 CHECK 824 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT SM .5710.4.000.700 SM ,5710.4.000.700 SM .5710,4.000.700 26639402 W/E 10/6/12 (8)PKGS 136.12 26639412 W/E 10/13/12 (10)PKGS 250.51 26639422 W/E 10/20/12 (32)PKGS 603.16 TOTAL 989.79 AUDIT 11/7/1~ CHECK NO. PAY UNITE~ PARCEL S~RVICE ORD~ OF PHILADELPMIA PA 19170-0001 ·, ' Vendor No. Check No. ,: 21506 Town of Southold, New York - Payment Voucher Vendor Tax ID N~rnber or Social Security Number Vendor Address P,O. Box 7247-0244 Vendor Name Philadelphia, PA 19170-0001 United Parcel Service Vendor Telephone Number 800-811-1648 Vendor Contact Entered by Audit Date NOV 0 ? 2012 Invoice Number Discount Description of Goods or Services General Ledger Fund and Account Number Invoice Invoice i Date Total I 101612012 $136.12i t0/13/2012 $250.5t 10/20/2012 $603.16 $989.79 w/e 10/13/12 10/20/12 Net Pumhase Order Amour Cwim~ Number $136,12 $250.51 $603.16 $989.79 26639402 26639412 26639422 SM5710.4.000.700 SM5710.4.000.700 SM5710.4.000.700 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 ouang, and that taxes from which the Town is exempt a~e excluded Signature ~ Title ~''~l~'- Company Name Date Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services propafly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Signature Title ~ Date Shipped from: FISHERS ISLAND FERRY 1 STATE ST NEW LONDON, CT 06320 Delivery Service Invoice Invoice date October 6, 2012 Invoice number 0000026639402 Shipper number 026639 Control ID 55S6 Page 1 of 3 0720A00000266392 77366100011248 FP 01 073901 49891Z241A**3DGT FISHER ISLAND FERRY PO BOX 607 FISHERS ISLAND, NY Account Status Summary Weekly Payment Plan Amount Due This Period $136.12 Amount Outstanding (prior invoices) $ 520.43 Total Amount Outstanding $ 656.55 Please inctude the Return Portion of each outstanding invoice with your payment. See Account Status for details. Questions about your charges? To get a better understanding of the charges on your invoice, visit our invoice guide and glossary of billing charges at ups.com/invoiceguide. Sign up for electronic billing today! Visit ups.com/billing For questions about your invoice, call: (800) 811-1648 Monday - Friday 8:69 a.m. - 9:00 p.m.E.T. or write: UPS P.O. Box 7247-0244 Philadelphia, PA 19170-0001 Thank you for using UPS. Summary of Charges Page Charge Outbound 3 UPS WoHdShip $113 12 3 Adjustments & Other Charges $13.00 Service Charges $10.00 Amount due this period $136.12 UPS payment terms require payment of this invoice by October 17, 2012. Payments flor received by October 31, 2012 are subject to a late tee 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 13.5% for UPS Air Services, UPS 3 Day Select, and International services. For more information, visit ups.com. Delivery Service Invoice Invoice date October 6, 2012 invoice number 0000026639402 Shipper number 026639 Page 2 of 3 Account Statue Weekly Payment Plan Payments Applied Invoice Number Invoice Date 0000026639342 08/25/2012 0000026639352 09/01/2012 0000026639362 09/08/2012 Account Status Weekly Payment Plan Amount Paid $ 734.85 $108.38 $ 330.99 Amount Outstanding (prior invoices): Please include the Return Portion of each outstanding invoice with your payment. Balance Invoice Number Invoice Date Due 0000026639372 09/15/2012 $118.93 0000026639382 09/22/2012 $ 206.82 0000026639392 09/29/2012 $194.68 Total $ 520.43 Outstanding balances reflect any payments received as of 10/05/2012. Please ignore this message if a recent payment has been made for any outstanding invoices. Delivery Service Invoice Invoice date October 6, 2012 Invoice number 0000026639402 Shipper number 026639 Page 3 of 3 Outbound UPS WorldShip Pickup Pickup Nurcber of Billed Date Record Message Codes Packages Charge 09/28 912117364~ 3 41.64 10/04 9121173655 2 1884 9121173666 2 41.94 10/05 9121173670 1 10.70 Total UPS WorldShip 8 Package(s) 113.12 Total Outbound 8 Package(e) 113.12 Adjustments & Other Charges Address Corrections Number of Billed Tracking Number Service Packages Charge 1Z0266390341297802 Ground 1 11.00 1st ret: THE BEACH PLUM FINY 06390 2nd ret: 631 788 7731 Recorded: MRS HOMER TESSIER Corrected: TESSIER,MRS HOMER 24 COOLIDGE AVENUE 24 COOLIDGE AVE GLENS FALLS NY 12081 GLENS FALLS NY 12801 Total Address Corrections 1 Package(s) 11.00 Miscellaneous Explanation WEEKLY PRINTER SERVICE FEE FOR 1 PRINTERS AT $2.00 EACH FOR 05-OCT-2012 Total Miscellaneous Billed Charge 2.00 Residential/Commercial Adjustments UPS WorldShip Shipped Pickup Recorded Billed Adjuslment Date Record Entity Tracking Number Corrected Charge Amount 09/27 9121173633 I 1Z0266390340719974 Corcmercial -9.54 Residential 9.54 Residential Surcharge 2.55 Fuel Sumharge O. 18 2.73 1st ret: Mason Horn FINY 06390 2nd ret: 631 788 7047 09/28 9121173644 3 1Z0266390340955218 Residential -8.96 Residential Surcharge -2.55 Commercial 8.96 Fuel Sumharge ~.18 -2.73 1st ret: The Beach Plurc FINY 06390 2nd ret: 631 788 7731 Total UPS WorldShip 2 Package(s) 0.00 Total Residential/Commercial Adjustments 2 Package(s) 0.00 Total Adjustments & Other Charges 13.00 073901 2/2 Shipped from: FISHERS ISLAND FERRY 1 STATE ST NEW LONDON, CT 06320 Delivery Service Invoice Invoice date October 13, 2012 Invoice number 0000026639412 Shipper number 026639 Control ID N024 Page 1 of 3 0720A00000266392 77366200011483 FP 01 071194 53553Z231A**3DGT ,[h,,,ihllllhHIHIlll~h,ll,llIHl,l,il'[,,,iNH,] FZSHER ZSLAND FERRY PO BOX 607 FISHERS ISLAND, NY 06590 Account Status Summary Weekly Payment Plan Amount Due This Period $ 250.51 Amount Outstanding (prior invoices) $ 656.55 Total Amount Outstanding $ 907.06 Pleace include ~s Return Portion of each outstanding invoice with your payment. See Account Status for details. Questions about your charges? To get a better understanding of the charges on your invoice, visit our invoice guide and glossary of billing charges at ups.com/invoiceguide. ISign up for electronic billing todayl Visit ups.com/billing For questions about your invoice, call: (800) 8~1-1648 Monday - Friday 8.00 a.m. - 9:00 p.m.E.T. UPS P.O. Box 7247-0244 Philadelphia, PA 191700001 Thank you for using UPS. Summary of Charges Page Charge Outbound 3 UPS WorldShip $ 220.37 3 Adjustments & Other Charges $13.00 3 Fees $ 7.14 Service Charges $10.00 Amount due this period $ 250.51 UPS payment terms require payment of thla invoice by October 24, 2012. Payments not raceivad by November 7, 2012 ars subject to a late fee o! 6% of the Amount Due This Period. (Details in UPS Tariff, available at ups~oum) Note: This invoice may contain s fuel surcharge as described at ups.com. The published fuel surcharge is 8.0% for UPS Ground Services and 13.5% for UPS Air Servi~s, UPS 3 Day Select, and International services. For more information, visit ups.rom. Delivery Service Invoice Invoice date October 13, 2012 Invoice number 0000026639412 Shipper number 026639 Page 2 of 3 Account Status Weekly Payment Plan Amount Outstanding (prior invoices): Please include the Return Portion of each outstanding invoice with your payment. Balance Invoice Number Invoice Date Due 0000026639372 09/15/2012 $118.93 0000026639382 09/22/2012 $ 206.82 0000026639392 09/29/2012 $194.68 0000026639402 10/06/2012 $136.12 Total $ 656.55 Outstanding baleace~ reflect any payments received as of 10/12/2012. Please ignore this message if a recent payment ban been made for any outstanding invoicea. Outbound UPS WorldShip Delivery Service Invoice Invoice date October 13, 2012 Invoice number 0000026639412 Shipper number 026639 Page 3of3 Pickup Pickup Number of Billed Date Record Message Codes Packages Charge 10/09 9121173681 2 41~74 10/10 9121173692 r 6 82.13 10/11 9121173703 1 9.76 10/12 9121173714 r 1 86.74 Total UPS WorldShip 10 Packa~a) 220.37 Total Outbound lO Package(s) 220.37 Adjustments & Other Charges Address Corrections Number of Billed Tracldng Number Service Packages Charge 1ZO2663g0341783232 Ground 1 11.00 15t ref: PIRATES COVE MARINE FINY 06390 2nd ref: 631 788 7528 Recorded: WARRANTY RETURNS Corrected: BRP US INC BRP US INC 10101 SCIENCE DRIVE 10101 SCIENCE DR WAUKEGAN IL 60085 STURTEVANT WI 53177 Total Address Corrections 1 Package(s) 11.00 Miscellaneous Explanation Charge WEEKLY PRINTER SERVICE FEE 2.00 FOR 1 PRINTERS AT $2.00 EACH FOR 12-OCT-2012 Total Miscellaneous 2.00 Total Adjustments & Other Charges 13.00 Fees WeekEnding Unpaid Billed Date Balance Rate Charge 09/15 Late Payment Fee 118.93 6.00 % 7.14 Pursuant to the UPS Tariff, a late payment fee has been assessed. Total Fees 7.14 Invoice Messagin9 Code Message r Dimensional weight applied 071194 2/2 Shipped from: FISHERS ISLAND FERRY 1 STATE ST NEW LONDON, CT 06320 Delivery Service Invoice invoice date October 20, 201 2 invoice number 0000026639422 Shipper number 026639 Control ID 6L79 Page 1 of 3 0720A00000266392 77366300012190 FP 01 076050 56963[242 A**3DGT FISHER ZSLAND FERRY PO BOX 607 FZSHERS ZSLAND, NY 06590 Account Status Summary Weekly Payment Plan Amount Due This Period $ 603.16 Amount Outstanding (prior invoices) $ 386.63 Total Amount Outstanding $ 989.79 Please include the Retsm Portion of each outstanding invoice with your payment. See Account Status for details. Questions about your char_~es? To get a better understanding of the charges on your invoice, visit our invoice guide and glossary of billing charges at ups.com/invoiceguide. ~c~ S~n up for electronic billing todayl Visit ups.corn/billing I For questions about your invoice, call: (800) 811-1648 Monday - Friday 8:00 a.m. - 9.'00 p.m.E.T. or write: UPS P.O. Box 7247-0244 Philadelphia, PA 19170-0001 Thank you for using UPS. Summary of Charges Page Charge Outbound 3 UPS WorldShip $ 574.54 Inbound 3 Collect $15.52 3 Adjustments & Other Cherge~ $ 3.10 Service Charges $10.00 Amount due this period $ 603.16 UPS payment terms require payment of this invoice by October 31, 2012. Payments not received by November 14, 2012 ate 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 ~s described at ups.com. The published fue~ surcharge is ~0% for UPS Ground Services and 13.5% for UPS Air Services, UPS 3 Day Select and International services. For more information, ~fsit ups.com. Delivery Service Invoice invoice date October 20, 2012 invoice number 0000026639422 Shipper number 026639 Page 2 of 3 Account Status Weekly Payment Plan Payments Applied Invoice Number Invoice Date 0000026639372 09/15/2012 0000026639382 09/22/2012 0000026639392 09/29/2012 Account Status Weekly Payment Plan Paid $118.93 $ 206.82 $194.68 Amoum Outstandin~l (prior invoices): Please include the Return Porlion of each outstanding invoice with your payment. Balance Invoice Number Invoice Date Due 0000026639402 10/06/2012 $136.12 0000026639412 10/13/2012 $ 250.51 Total $ 386.63 Outstanding balances reflect any payments received an of 10/19/2012. Please ignore this meseage if a recent payment has been mede for any outstanding invoices. Outbound uPS WorldShip Delivery Service Invoice Invoice date October 20, 2012 Invoice number 0000026639422 Shipper number 026639 Page 3of3 Pickup Pickup Number of Billed Date Record Message Codes Packages Charge 10/15 9121173725 12 183.73 10/16 9121173736 r 10 188.93 10/18 9121173740 r 9 188.36 10/19 9121173751 1 13.52 Total UPS WorldShip 32 Package(s) 574.54 Total Outbound 32 Package(e) 574.54 Inbound Collect Pickup Pickup ZIP Billed Date Record Entry Tracking Number Service Cede Zone Weight Charge 10/17 7392877181 7 1Z0275250340333596 Ground Commercial Collect 06320 2 51 14.37 Fuel Surcharge 1 15 Total 15.52 Sender : Receiver: REF 46 BLASTITE B C S COMPANY INC FISHER ISLAND FERRY DI STRICT 763 THOMPSON RD 5 WATERFRONT PARK THOMPSON CT 06277-1939 NEW LONDON CT 06320 Total for Shipper: 0000027525 Total Collect 1 Package(s) Total Inbound 1 Package(s) Adjustments & Other Charges Miscellaneous Billod Explanation Charge WEEKLY PRINTER SERVICE FEE 2.0o FOR 1 PRINTERS AT $2.00 EACH FOR 19~OCT-2012 Total Miscellaneous 2.0o Shipping Char~le Corrections Learn how to avoid future shipping charge corrections. Visit www. ups.com/avoidcharges. Pickup Tracking Original Service/ ZIP Billed Adjustment Date Number Corrected Service Code Zone Weight Charge Amount 10/16 1Z0266390341080376 Ground 33455 6 47 30~70 Ground 33455 6 49~4 31 72 Dimensions = 24 x 19 x 18 in Fuel Surcharge 0.08 1.10 1si ref: CB Hall FINY 06390 Sender : FISHERS iSLAND FERRY Receiver: CB Hall NEW LONDON CT 06320 HOBE SOUND FL 33455 Total Shipping Charge Corrections 1 Package(s) 1.10 Total Adjustments & Other Charges 3. I 0 Invoice Messa~lin~ Code Messa~le r Dimensional weight applied 15 52 15.52 1552 076050 2/2