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Home My WebLink AboutAU-01/15/2013 Fishers IslandFISHERS ISLAND FERRY DISTRICT VENDOR 001327 AIRGAS EAST, INC 01/15/2013 CHECK 919 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 SM .5710.4.000.000 SM .5710.4.000.000 9010767714 9011105169 9906250813 (2)FORKLIFT FUEL 86.49 (2)FORKLIFT FUEL 86.49 (1)YR LEASE RNW-TRCH NL 105.00 TOTAL 277.98 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securiiy Number Vendor Address P.O. Box 827049 Vendor Name Philadelphia, PA 19182-7049 Vendor No. 1327 Check No. Entered by Audit Date Airgas East Vendor Telephone Number 860-444-3055 Vendor Contact Invoice Invoice I Net JAN 1 5 2013 Town Clerk Purchase Order Number Discount Amount Claimed 9010767714 i $86.49 Date Total 121512012 $86.49 12/712012 $106.00! 1211712012 $86.49 $277.98 $105.00 9906250813 9011105169 $86.49 $277.98 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that thc foregoing claim is true and correct, that no par[ has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which thc Town is exempt arc excluded, Number Description of Goods or Services Forklift Fuel Torch NL Shop (I)¥~ Fork,ft Fue (' General Ledger Fund and Account Number SM5710.4.000.000 ~q~ SM5710.4.000.000 SM5710.4,000.000 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 Company Nmme Date Signature Title Date ORDER NO. , INV01¢E NC},, INVOIC~ DATE ! SOLD TO NO. 1009762943 9010767714 12/05/2012 2576547 ! N. 320 ! ~UPU --~1 DELIVERY NO:~ T; R QTY 0 CYLINDER 8010973633 ~R 33A 2 CI, 2 2 PROPANE INDUSTRIA% 33 CGA 510 (Vol: 64.000 LBS) SOLD TO NAME FISHERS ISLAND PAYMENT TERMS [ ORDER DATE NET 30 [ 12/05/2012 39.37 CL 78.74 N Hazmat Fiat Rate Sale subtotal: 78.74 7.75 SHIP TO: 2576547 · r~as FISHERS ISLAND www.a~rgas.com FERRY DISTRICT PO BOX H Airgas USA, LLC FISHERS ISLAND NY 06390-0607 6055 Rockside Woods Blvd Independence, OH 44131 Page 1 of 1 J ABOUNT J ____ 86.49 Airgas USA, LLC ACT. NO. 8606074318 PNC BANK, ABA NO. 031000053 Airgas SHIPPER: AIRGAS USA, LLC 131 CROSS RD WATERFORD, CT 06385-1204 SHIP TO: 2576547 FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLAND, NY 06390-0607 US 631-788-7463 DELIVERY ORDER SOLD BY: AIRGAS USA, LLC 130 CROSS RD WATERFORD, CT 06385-1204 800-962-0285 SOLD TO: 2576547 FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLAND, NY 06390-0607 US FOR LOCATION NEAREST YOU l VISIT VWVVV.AIRGAS.COM DELIVERY ORDER # 8010973633 PAGE 1 OF 1 ORDER DATE: 12/05/2012 SCH SHIP DATE: 12/05/2012 PRINTED: 12:32 12/05/2012 SALES ORDER: 1009762943 CUST PO # RELEASE# ORD BY ENT BY RANZARMSTR Order Type Acct Front Counter Payment Terms NET 30 Incoterm Customer Pick Up Route Up Office Sales Plant Customer Pick N329 N309 Sales Total Containers erg Ship Return NO00 Qty UOM HM Description & Hazard Class Qty Containers Vol Unit Exten Shipped Type Order Ship Ret NVt Price Pric 2 EL X UN1978 PROPANE 2.] Llne~ 10 Material# PR 38A Stor, Loc. F001 2 2 2 64 39.37 78.7 PROPANE 32L65 ALUMINUM LB /CL Hazmat Flat Rate 7.7 Subtotal 86.4 Total SaFes 86.4 EMERGENCY C,ONTACT:I-866-734-3438 P~C^RDS OFFERED J PURCHASER AGREES TO OBTAIN ~J~IAL SAFETY OATA SHEETS (MSD$)FROM ONE OF THE Jl FOLLOWING SO RCES~ POINT PURCHASE, AIRGAS WEB SITE AT ~.AIRGA~ CO~ OR By CALL,NG THE ~VE LISTE:~:~:~ CONTACT PHONE NUMBER AND ,ELECTING OPTION ,3 ~ ~ I I ¢ i / m ACCEPT TNIS IS TO G~TIFY THAT/HE ASOV~~AMED MATERiAgS ARE PROPERLy C~SSIFIEB, DESCRIBED, i REJECT PAC~GED/~ARKEB BE B ~ARE IN PROPER 60NDITION FOR T~NSPORTATION INITIAL CHOICE AIRGAS PERSONNEL DATE T.O.D, THIS AGREEMENT IS SUBJECT TO AIR AS' STANDARD TERMS AND CONDITIONS SEE REVERSE SIDE FOR IMPORTANT ,~FET~ INF~I~J~,ATION / ACCEPTED FOR X ' ~ INTERNAL USE ONLY Delivery # 8010973633 Filled By SlagingArea TOtaIPKGS Tracking/Pro Number Freighteh,rg. IIIIIIIIIIIllllllllllllllllllllllllllll TERMS AND CONDITIONS WARNING: TRANSPORT AND USE OF COMPRESSED GASES MAY BE EXTREMELY DANGEROUS. DO NOT TRANSPORT WITHOUT PROTECTIVE CAPS, IN CONFINED SPACES OR IN ANY OTHER IMPROPER MANliER. ALWAYS TRANSPORT CYLINDERS IN A SECURED UPRIGHT POSITION. BUYER ACKNOWLEDGES THAT IT HAS RECEIVED A SAFETY INSTRUCTION SHEET FROM SELLER, SAFE HANDLING OF COMPRESSED GASES. I ANY AND AL [ PRODUCTS AND SUPPLIES DELIVERED TO BUYER BY SELLER OR SEt [ fRS REPRESENTATIVE ARE COVERED By THIS DELIVERY ]ICKET THE CYLINDERS FIT rINGS AN[) CApS COVERED By THIS 'D©CUMEN[ ARE RENTED OR LEASED BY SELLER TO BUYER NOT SOLD BUYER SHALL NOT PERMIT CYLINDERS OR OTHER STORAGE CONTAINERS FLJRNISHED HEREUNDER TO BE FILLED WiTH ANY PRODUC f NGT FURNISHED By SEE L ER (IN Sb[ I bH S AU f H©RIZED REPRESENTATIVE ALL CYLINDERS (OTHER THAN THOSE SUBJECT TO AN ANNUAL L bASE) ARE RENTED AT CURRENT DAILY RAT ES BEGINNING WiTH THE DATE OF DELIVERY RENIAI CHARGES aRE ASSESSED AS OF file LAST DAY OF EACH MONTH OR AT THE START OF EACH ANNUAL LEASE PERIOD AS APPLICABLE BJYER SHALL RETURN IN GOOD CONDfTION ALL CYLINDERS COMPLETE WITH CAPS AND FITTINGS AND SI]ALL PAY SELLER LJPON DEMAND l HE REPLACEMENT VALUE OF (~) ANY LOST OR DAMAGED CYLINDERS QAPS OR FITTINGS OR (11) THOSE CYLINDERS NOT RETURNED TO SELLER WITHIN THREE (3) MONTHS CYLINDERS SO PAID FOR SELLER WILL REFUND THE AMOUNT PREVIOUS[v PAID WI fH RESPECT TO ITS I DSS OR DESTRUCTION TO THE BUYER LESS THE COS% IF ANY OF PU YTING SUCH CYLINDERS IN REPAIR AND LESS CYLINDER RENTAL ACCRUED TO yHE DATE OF RETURN 2 ANY TAXES IMPOSED BY FEDERAL STATF OR OTHER GOVERNMENTAL Ad] HORITv ON THE SALE USE 32 POSSESSION OF GOODS SHALL BE PAID BY BUYER IN ADDITION ¥O f HE PURCHASE PRICE :~ UNLESS OTHERWISE SPECIFIED IN a CONTRACT BUYER SHAI L MAKE pAYMENT IN FULL WITHIN 30 [}AYS AFTER THE DATE OF SEI LERS INVOICE A LATE PAYMENT CHARGE OF I 5% ON THE UNPAID PAST DtJF BALANCE WILL BE ASSESSED MONTHLY (MINIMUM TWO DOt t ARS (S2 00) OR THE MAXIMUM LAWFUL RATE ALLOWABLE IN THE STATE WHERE THE GOODS ARE DELIVERED WHICHEVER IS LESS BUYER SHALL BE IN DEFAUI T HEREUNDER UPON BUY£ R S FAILURE TO MAKE PAYMENT AS REQUIRED HEREN OR UPON BUYERS FAILURE TO COMPLY WITH ANY OF THE TERMS AND CONDITIONS CONTAINED HEREIN OR UPON THE INSTITUTION OF ANY VOLUNTARY OR INVO[UNTARY BANKRUPTCY INSOLVENCY RECEIVFRSHIP Ol~ DEBTOR RELIEF PROCESSING BY OR AGAINST BUYER OR dPON BUYERS MAKING OF AN aSSIGNMENT FOR THE BENEFIT OF CREDITORS IF SE LLER EMPI OYS ANY COLLEC r~ON AGENCY OR ATTO RN EY TO COl L ECT ANY AMOUNT DUE SE LL£R AND/OR TO REPOSSESS ANY GOODS BUYER SHALL PAY ALL COLLECTION FEES AT-ORN EYS FEES AND COdRT COSTS IN ADDITION TO THE AMOUNT OTHERWISE UNPAID SELLER MAY BRING SUIr f OR THE COLLECTION OF ANY SUCH AMOUNT IN ANY JdRISDICTION OR VENUE SELLER MAY SELEC, 4 NO GOODS SHALL BE RETURNE[~ lO SELLER WITHOUT SELLERS WRI%TEN AUTHOHIZATION 8LJYER ~HAI [ PAY A FIFTEEN PERCENT f1~%) RESTOCKING CHARGE ON ALL GOODS RETURNED TO SELLER EXCEPT FOR RETURNS PROVIDED FOR UNDER SECTION 5 HEREO~ & SELLER SHALL BE LIABLE ONLY FOR THE REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS AND PRODUCTS~ INCLUDING THE REPLACEMENT OF GASES THAT DO NOT MEET ITS PURITY SPECIFICATIONS WITH GASES THAT DO MEET SUCH SPECIFICATIONS. BUYER KNOWINGLY AND FULLY ASSUMES THE RISKS OF TRANSPORTING AND USING COMPRESSED GASES. BUYER SHALL WARN AND PROTECT ITS EMPLOYEES A ND OTHERS EXPOSED TO THE HAZARDS POSED B Y BUYER'S STORAGE AND USE OF THE pRODUC~ SELLER SHALL NOT BE L IA BLE FOR A N Y DIRECT (EXCEPT A S EXPRESSLY PROVIDED HEREIN), INDIRECT, SPECIA L, INCIDENTAL, CONSEQUENTIAL AN~/OR PUNITIVE DAMAGES, ARISING OR ALLEGED TO ARISE OUT OF OR IN CONNECTION WITH ITS OBLIGATIONS HEREUNDER OR WITH ANY PRODUCT, OTHER ITEMS OF SALE, OR EQUIPMENT SOLD OR LEASED HEREUNDER, WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT OR OMISSION OR IS RELATED TO STRICT LIABILITy, OR OTHERWISE. 6 ALL PRODUCTS OTHER ITEMS OF SALE CYLINDERS AND OTHER CONTAINERS EU~NISHED HEREUNDER SHALL CONFORM TO THE DESCRIPTION THEREOF PUBLISHED BY THE MANUFACTU[tER AT THE TIME OF SAt F AND WILL MEET SELLERS PURITY SPECIFICATIONS FOR ALL GAS PRODUCTS SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR ~MPLIED STANDARDS, GUARANTEES, OR WARRANTIES, INCLUDING ANY WARRANTIES OF MERCHANTABILIT~ FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT AND ANY WARRANTIES THAT MAY BE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE. ALL CLAIM$ ~Y BUYER HAVING ANYTHING TO DO WITH ANY PRODUCT OR EQUIPMENT FURNISHED HEREUNDER BY SELL ER SHALL BE MADE JN WRITING WITHIN TEN { lO) DAYS AFTER THE DELIVERY T~EREOF AND FAILURE OF BUYER TO GIVE SUCll NOTICE SHALL CONSTITUTE A COMPLETE WAIVER BY OUYER OF ANY SUCH CLAIMS aND DEFENSE FOR SELLER AGAINST aNY SUCH C[ AIMS 7 THE TOTAL AMOUNT DUE FROM BUYER MAY INC[UDE VARIOUS ITEMIZED CHARGES INCLUDING CHARGES FOR THE HANDLING OF HAZARDO~JS MATERIAL AND FOR COMPLIANCE WITH t AWS AN[) HbGULATIONS CONCERNING HAZARDOUS MATERIALS CHARGES FOR HANDI lNG DELIVERY AND SHIPPING; AND/OR CHARGES FOR ENERGY OR FUEL NONE OF THE CHARGES REPRESENT A T&X OR FEE PAID TO OR IMPOSED BY ANY G©VERNMENTA[ AUI HORIT~ AND ALL OF T~IE CHARGES ARE RETAINED BY YHE SELLER SELLER HAS NOT SPECIFICALLY QUANTIFIED ~HE RELATIONSHIP BETWEEN THE CHARGES AND THE ACTUAL C©S~ S ASSOCIATED WITH THE CHARGES WHICH CAN VARy BY PRODUCT SERVICE TIME AND PLACE AMONG OTHER THINGS 8 CERT&IN AIRGAS COMPANIES ARE U S GOVERNMENT CONTRACTOPS AND SUBCONTRACTORS AND AHE SUBJECT TO AND ADHERE TO YHE REQUIREMENTS OF FEDERAL LAWS EXECUTIVE ORDERS AND AT TENDANT R[JLES AND REGt Jl ATIONS SPECIFICALLY EXECUTIVE ORDER NO I 1246 THE REI~ABILITATION ACT OF 1073 AND THE VIETNAM ERA VETERANS READJUSTMENT ASSISTANCE ACT OF 1r474 ALL AS ,~MENDE D 9 IF ANY TERM OR CONDITION OF THIS DE[ IVERY f ICKET IS I]ELD INVALID THEN SUCH INVALIDITY SHALL NOT AFFECT ANY OTHER TERM AND CONDITION OF THIS DELIVERY TICKET WHICH SHALL REMAIN IN I ULL FORCE AND EFFECT EMERGENCYRESPONSEINFORMA~ON PROPANE HYDROGEN POTENTIAL HAZARDS AIR NITROUS OXIDE OXYGEN POTENTIAL HAZARDS LIQUID CO~ LIQUid) ARGON LIQUID N ¢ ARGON NITROGEN HELIUM ENSURE PROPER CREDIT, pLEA~E RETURN THE UppER PORTION WITH YOUR REMITTANCE FOR OUESTIONS ON YOUR ACCOUNT PLEASE CALL 216-642-1500 ORDER NQi I~V~I~ NO: :.,, , 7006560032 I 9906250813 ] 12/07/2012 ] 2576547 I FISHERS ISLAND I ~ REEEASE B~NCPt ~ ~ Lease Renewal N329 ........ ~ ....... NET"~0 ........... 112/0~/~012 I 70065~ECYL 3 CL 35.00 YR 105.00 N ~~ 01/0~/20~3 ?0 ~2/3~/20~3 105.00 Sale subtotal: -Fo h SHIP TO: 2576547 lirgas FISHERS ISLAND www.airgas.com FERRY DISTRICT PO BOX H Airgas USA, LLC FISHERS ISLAND NY 06390-0607 6055 Rockside Woods Bird Independence, OH 44131 Airgas USA, LLC ACT. NO. 8606074318 PNC BANK, ABA NO. 031000053 Page 1 of 1 TO ENSURE PROPER CRED T PLEASE RETURN THE UPPER PORT ON W TH YOUR REMITTANCE FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL 216-642-1500 ORDER NO [[INVOICE ~AT~ )SOlDTM ~ ~0~TO NAME, 1010073932 I 9011105169 /12/17/2012 2576547 FISHERS ISLAND PO; REdE ;, ~R~NCH ;; SH PVIA p^yMENT ~E~MS ORDER DATE| ...... N329 I CUPU NET 30 112/17/2012/ SHIP TO: 2576547 AMOUNT I 8 6.4 9 Aim.e FISHERS ISLAND I! UU~,,~ www.airgas,comFERRY DISTRICT PO BOX H Airgas USA, LLC FISHERS ISLAND NY 06390-0607 6055 Rockside Woods Blvd Independence, OH 44131 Page 1 of 1 Airgas USA, LLC ACT. NO. 8606074318 PNC BANK, ABA NO. 031000053 Airgas SHIP~E~: AIRGAS USA, LLC 131 CROSS RD WATERFORD, CT 06385-1204 SHIP TO: 2576547 FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS iSLAND, NY 06390-0607 US 631-788-7463 DELIVERY ORDER SOLD BY: AIRGAS USA, LLC 130 CROSS RD WATERFORD, CT 06385-1204 800-962-0285 SOLD TO: 2576547 FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLAND, NY 06390-0607 US FOR LOCATION NEAREST YOU ~ VISIT ~.AIRGAS.COM DELIVERY ORDER # 8011322259 PAGE 1 OF 1 ORDER DATE: 12/17/2012 SCH SHIP DATE: 12/17/2012 PRINTED: 08:36 12/17/2012 SALES ORDER: 1010073932 CUST PO # RELEASE # ORD BY ENT BY GARYDUBATO I Sales Plant Order Type Payment Terms Incoterm Route Office Acct Front Customer Pick Up J Counter NET 30 I Customer P ck Up N329 N309 Sales Total Containers Or9 Ship Return NO00 I Qty UOM HM Description & Hazard Class Qty Containers Vol Shipped Type Order Ship Ret /~Nt 2 CL X UN1978 PROPANE 2.1 Line// 10 Materlal#PR33A Stor. Loc, FO01 2 2 2 64 PROPANE 32LBS ALUMINUM LB ·II P~CARD FFERED THISAGREEMENTISSUBJECTTOAIRGAS'STANDARDTE:~MSAND CONDITIONS · ' ' ' H SE SIDE FOR IMPORTANT SAFETY ,NFORMATI~)N. EMERGENCY CONTACT 1 866 734 3438 so PURCHASER AGREES TO OBTAIN MATERIAL SAFETY DATA SHEETS MSDS FROM ONE OF THE FOLLOW,Ne SOURCES,POI.T O, ,U.C.ASE, A,.G^S WE. S,TE A, ~.^,.e^S.CO. O.., II CALLING THE ABOVE LISTED EMERGENCY CONTACT PHONE NUMBER AND SELECTING OPTION .......... INTERNAL USE ONLY Delivery # 8011322259 TERMS AND CONDITIONS WARNING: TRANSPORT AND USE OF COMPRESSED GASES MAY BE EXTREMELY DANGEROUS. DO NOT TRANSPORT WITHOUT PROTECTIVE CAPS, IN CONFINED SPACES OR IN ANY OTHER IMPROPER MANliER. ALWAYS TRANSPORT CYLINDERS IN A SECURED UPRIGHT POSITION. BUYER ACKNOWLEDGES THAT IT HAS RECEIVED A SAFETY INSTRUCTION SHEET FROM SELLER, SAFE HANDLING OF COMPRESSED GASES. I ANY AND ALL PRODUCTS AND SUPPLIES DELIVERED TO BUYER BY SELLER OR SELLER S REPRESENTATIVE ARE COVERED BY THIS DELIVERY TICKET THE CYLINDERS FITTINGS AND CAPS COVERED BY I HIS DOCUMENT ARb ~EN1 ED OR LEASED BY SELLER TO BUYER NOT SOLD BUYER SHALL NOT PERMIT OYL INDERS OR O'¢HE R STORAGE CONTAINERS FURNISHED HEREUNDER TO BE FILLED WITH ANY PRODUCT NOT FURNISHED BY SELLER OR SELLERS AUTHORIZED REPRESENTATIVE ALL CYLINDERS(OTHER THAN THOSE SUBJECT TO AN ANNUAL LEASE)ARE RENTED AT CURRENT DAILY RATES BEGINNING WITH THE Da,TE OF DELIVERY RENTAt CHARGES ARE ASSESSED AS OF THE LAST DAY OF EACH MONTH OR AT THE START OF EACH ANNUAL [EASE PERIOD AS APPLICABLE BUYER SHALL RETURN IN GOOD CONDITION ALL CYLINDERS COMPLETE WITH CAPS AND FI%[ INGS AND SHALL PAY SELLER UPON DEMAND THE REPLACEMENT VALUE OF (I) ANY LOST OR DAMAGEB CYLINDERS CAPS OR FITTINGS OR (fi) THOSE CYLINDERS NOI RET[JRNED TO SELLER WITHIN THREE (3) MONTHS FROM DATE OF SHIPMENT /O THE BUYER (OTHER THAN THOSE SUBJECT TO AN ANNUAL LEASE} OR IF DAMAGED AND THE DAMAGE CAN BE REPAIRED IHE COST OF MAKING SUCH REPAIR PAYMENT B'Y TF~E BUYER OF CHARGES FOR DAMAGED LOST OR DESTROYED CYLINDERS SHALL NOT GIVE ANY OWNERSHIP INTEREST IN THE CYLINDERS TO THE BUYER UPON SUBSEQUENT RETURN OF ANY PURPORTEDLY LOST OR DESTROYED CYLINDERS SO PAID FOR SELER WILL REFUND THE AMOUNT PREVIOUSLY PAID WITH RESPECT TO ITS 2OSS OR DESTRUCTION TO THE BUYER LESS THE COST IF ANY OF pUTTING SUCH CYLINDERS IN REPAIR AND LESS CYLINDER RENTAL ACCRUED TO THE DATE OF RETURN 2 ANY ]AXES IbIPOSED BY FEDERA[ STATE OR OTHER GOVERNMENTAL AUTHORITY ON THE SALE USE OR POSSESSION OF GOODS SHALL BE PAID BY BUYER IN ADDITION TO THE PURCHASE PRICE 3 UNLESS OIHERyV[SE SPECIFIED IN A CONTRACT BUYER SHALL MAKE PAYMENT IN LULL WITHIN 30 DAyS AFTER file DArE OF SELLERS iNVOICE A t. ATF PAYMENT CHARGE OF I 5% ON THE UNPAID PAST DUE BALANCE WILL BE ASSESSED ~,~ONTH LY (MINIMUM ln¢]O DOLt ARS {S2 00) OR THE MAXIMUM LAWFUL RAPE ALLOWABLE IN THE STATE WHERE THE GOODS ARE DELIVERED WHICHEVER IS LESS BUYER SHALL BE IN DEFAULT HEREUNDER UPON BUYERS FAILURE TO MAKE PAYMENT AS REQUIRED HEREIN OR UPON BUYER S FAILiJR E TO COMPLY WITH ANY OF THE TERMS AND CONDITIONS CONTAINED HEREIN OR UPON THE INSTITUTION OF ANY VOLUNTARY OR INVOLUNTARY BANKRUPTCY INSOLVENCY RECEIVERSHIP OR DEBTOR RELIEF PROCESSING BY OR AGAINST BUYER OR UPON BUYERS MAKING OF AN ASSIGNMENT FOR THE BENEFIT OF CREDITORS IF SELLER EIvIPLOYS ANY COLLECTION AGENCY OR ATTORNEY TO COLLECT ANY AMOUNT DUE SELLER Ar~ D~OR TO REPOSSESS ANY GOODS BUYER SHALL PAY ALL COLLECTION FEES &~fORNEYS FEES AND COURT COSTS IN ADDITION TO THE AMOUNT OTHERWISE UNPAID SELLER MAY BRING SUIT FOR THE COLLECTION OF AfkJY SLJCH AMOUNT IN ANY ~URISDICTION OR VENUE SELLER MAY SELECT 4 NO GO©DS SHALL BE RETLJRNED TO SELLER WITHOUT SELLER S WRITTEN AU ~HORIZATI©N BUYER SHAt L pay A FIFTEEN PERCENT {15%~ RESTOCKING CHARGE ©N ALE G©OL1S R~ !LJ~NED fO SFI [ FR EXCEPT F©R RE TURNS PROVIDED FOR UNDER SECTION 5 HEREOF 5. SELLER SHALL BE LIABLEONLYFORTHE REPAIR OR REPLACEMENTOFDEFECTiVE GAS CYLINDERS AND PRODUCTS, INCLUDING THE REpLACEMENT OFGASESTHATDO NOT MEETITS pURITY SPECIFICATIONS WITH GA SES THAT DO MEET SUCH SPECIFICATIONS. BUYER KNOWINGLY AND FULL Y ASSUMES THE RISKS OF TRANSPORTING A ND USING COMPRESSED GASES. BUYER SHALL WA RNA NE) PROTECT ITS EMPLOYEES AND OTHERS EXPOSED TO THE HAZARDS POSED BY BUYER'S STORAGE AND USE OF THE PRODUCT; SELLER SHALL NOT BE LIABLE FOR ANY DIRECT (EXCEPT AS EXPRESSLY PROVIDED HEREIN), INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL AND/OR PUNITIVE DAMAGES, ARISING OR ALLEGED TO ARISE OUT OF OR IN CONNECTION WITH ITS OBLIGATIONS HEREUNDER OR WITH ANY PRODUCT, OTHER ITEMS OF SALE, OR EQUIPMENT SOLD OR LEASED HEREUNDER, WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT OR OMISSION OR IS RELATED TO STRICT LIABILITy, OR OTHERWISE. 6 ALL PRODUCTS OTHER I]EMS OF SALE CYt INDERS AND OTHER CONTAINERS FURNISHED HEREUNDER SHALL CONFORr~4 TO THE DESCRIPTION THEREOF P,JBLISHED BY THE MANUFACTURER AT THE TIME OF SALE AND WILL MEET SELLERS PURl fY SPECIFICATIONS FOR ALL GAS PRODUCTS SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED STANDARDS, GUARANTEES, OR WARRANTIES, INCLUDING ANY WARRANTIES OF MERCHANTABILITy, FITNESS FOR A PARTICULAR PURPOSE OR NON.INFRINGEMENT AND ANY WARRANTIES THAT MAY BE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE. ALL CLAIh,~S BY BUYER HAVING ANYTHING TO DO WI~ H ANY PRODUCT OR EQUIPMENT F[iRNISHED HEREUNDER BY SE[ LER SHALL BE MADE IN WRITING WITHIN TEN (101 DAYS AFTER THE DELIVERY THEREOF AND FAILURE OF BUYER TO GIVE SUCH NOTICE SHALL CONSTITUTE A COMPLETE WAIVER BY BUYER OF ANY SUCH CLAIMS AND DEFENSE FOR SELLER AGAINST ANY SUCH CLAIMS 7 THE TOTAL AMOUNT DUE FROM BUYER MAY INCLUDE VARIOUS ITEMIZED CHARGES INCLUDING CHARGES FOR THE HANDLING OF; HAZARDOUS MATERIAL AND FOR COMPUANCF WITH LAWS AND REGUL~,TIONS CONCERNING HAZARDOUS HATERIALS; CHARGES FOR HANDLING DELIVERY AND SHIPP,NG AND~OR 3HaRGES FOR ENERGY OR FUEL NONE OF file CHARGES REPRESENT A TAX OR FEE PAID TO OR IMPOSED BY ANY GOVERNMENTAL AUTHORITY AND ALL Of THE CHARGES ARE RETAINED BY THE SELLER SELLER HAS NOT SPECIFICALLY Q(JANTIFIED THE RELATIONSHIp ~¢ETWEEN THE CHARGES AND THE ACTUAL COSTS ASSOCIATFB WITH THE CHARGES WHICH CAN VARY BY PRODUCT SERVICE TIME AND PLACE AMONG OTHER THINGS 8 CERTAIN AIRGAS COMPANIES ARE U S GOVERNMENT CONTRACTORS AND SUBCONTRACTORS AND ARE SUBJECT TO AND ADHERE TO THE REQUIREMENTS OF FED[RAL LAWS EXECUTIVE ORDERS AND ATTFNDANT RULES AND REGULATIONS SPECIFICALLY EXECUTIVE ORDER NO 11246 THE REHABILITATION ACT OF 1973 AND THE VIETNAM ERA ¢'ETERANS READJUSTMENT ASSISTANCE ACT OF 1974 ALL AS A[vtENDED 9 IFANY [ER~.aORCONDITIONQFTHISDELVERYTICKETISHELD NVALD THENSUCHINVA[ DTYSHA~ NOTAFFECTANYOTHERTERMANDCONDTONOFT4SDELVERYTCKET 'HICHSHALLREMAININFU FORCE AND EFFECT EMERGENCYRESPONSEINFORMA~ON PROPANE HYDROGEN POTENTIAL HAZARDS ACETYLENE MAPP POTENTIAL HAZARDS AIR NITROUS OXIDE OXYGEN LIQUIDO~ pOTENTIAL HAZARDS CO¢ LIQUID CO¢ LIQUID ARGON LIQUID N, POTENTIAL HAZARDS FISHERS ISLAND FERRY DISTRICT VENDOR 001481 ANCHOR INSULATION CO., INC. 01/15/2013 CHECK 920 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.200 0047287-IN RP-INSUL.MTRLS-ENG ROOM 2,400.00 TOT~iL 2,400.00 II iii· Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number 05-0390251 Anchor insulation Company, Inc. Vendor No. Vendor Telephone Number 401438-6720 VendorContact Invoice Invoice Invoice I P Di 1438 Narragansett ark rve ~Pawtucket, RI 02861 Net Purchase Order 1481 Check No. Entered by Audit Date JAN 1 5 2013 General Ledger Fund and Account Number 0047287-1N Date 11/1612012 Total Discount $2,400.00 Amount Claimed $2,400.00 $2,400.00 $2,400.00 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby cer.d~' that the Ibregoing claim is true and correct, that no par' has been paid, except as therein statcd, that thc balance ~hcrcin stated is actually Number Description of Goods or Services RP- Insulating materials in engine room SM5710.2.000.200 Department Certification hereby certifi~ 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 due and owing, and that taxes from which the Fo,a~ is exempt are excluded Signature or discrepancies noted, and payment is approved Signature ANCHOR INBULATION industrial, Commercial and Marine Insulator:, Heating and Cooling · Noise Control Residential Insulation · Gutters · Fireplaces · Shelving 435 Narragansett Park Dr · Pawtucket, Rhode Island 02861-4321 401-438-6720 Fax: 401~,38-6480 www anchorinsulation.com INVOICE INVOICE NUMBER: INVOICE DATE: SALESPERSON: SALES TAX CODE: 91300 Fisher Island Ferry Box H Fishers Island, NY 06390 CONTACT For measuring fabricating and installing custom blankets for the engine room overhead of the Race Point Ail as directed by Steve Burke Agreed Contract Price JOB NO: CUSTOMER NO: CUSTOMER PO: TERMS: FAX NO: 1.000 PAGE: 0047287-1N 11/16/2012 CT OFFICE Connecticut Exempt 0005972 FISHER Net 30 Days 2,400.000 2,400.00 Carrying charge at the rate of 1-1/2% per month will be charged on invoices unpaid after 45 days from date of invoice Delinquent accounts will have attorneys fees added thereto if placed for collection. NET INVOICE FREIGHT SALES TAX 2,400.00 0.00 0.00 2,400.00 I IM ~= U I. ~? I 0 IM Industrial, Residential, Comrae~cial and Marine Insulators, Noise Control, Heating and Cooling, Fireplaces, Guttc.~l S~v~ng, Waterproofing Mr. Steve Burke Fishers Island Ferry District (, Drawer ) J/l Fishers Island, NY 06390-0607 Ph: 860-287-0517 Re: MV Race Point Insulation Stcve, We are pleased to provide our proposal to furnish all labor and supervision required for the removal of insulating materials on the engine room overhead of the Race Point. Scope of Work: Remove perforated aluminum, 2-inch thick mineral wool board, and cut offinsulation pins close to plate from the forward bulkhead to 16 feet aft, approximately 480 square feet and 60 square feet from the bay at the afl bulkhead. Price: Two thousand four hundred dollars ($2,400.00) plus any applicable tax. Notes: -Based on performance of work during first shift hours, Monday - Friday. -Pins will be snipped of approximately 1/8" from plate surface. Docs not include removal of pin stubs. -Waste will be deposed of in an on-site dumpster provided by others. We thank you fbr the opportunity to provide our proposal and trust Anchor may be of future service. Please feel fi'ce to contact me at any time if you have questions. Sincerely, William T. Eekhoff Anchor Insulation Company, Inc. 435 Narragansett Park Drive Pawtucket, RI 02861 Ph: 401438-6720 Fax: 4014384480 34 Industrial Park Road Niantic, CT 06357 Ph: 860-739-3111 Fax: 860-739-2090 1500 Shawsheen Street, Unit 5 Tewksbury, MA 01876 Ph: 978-658-9592 Fax: 9784584158 FISHERS ISLAND FERRY DISTRICT VENDOR 019500 AT&T 01/15/2013 CHECK 921 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.100 86044201650113 NL TERM TEL 12/15-1/14 259.79 TOTAL 259.79 Town of Southold, New York- Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address AT&T Vendor Name AT&T Vendor Tclepbone Numbor 800-32t-2000 Vendor Contact P.O. Box 5082 Carol Stream, IL 60197- [Vendor No ' 19500 Check No. Entered by Audit Date Invoice Invoice Invoice J Net Purchase Order Number Date Total Discount Amount Claimed Number Descri )tion or'Goods or Services 8604420165 12/1512012 $259.79 $259.79 NLTerminaITel ; 12116/12-1/14/13 $259.79 $259.79 Payee Certification I he undersigned (Claimant) (Acting on behalf of the above named c[aimant) does hereby certit~ that the foregoing claim is true and correct, that no part has been paid, except as therein stated that thc balance therein stated is actually due and owing, and that taxes from which the '['o~ ~s exempt are excluded JAN 1 5 2013 T~.wn Clerk General I,edger Fund and Account Number SM5710.4.000.t00 Department Certification I hereby cer[i(w that the materials above specified have been received by me in good condition without substitution, the services property performed and that the quantities thereof have been verified with the cxce?tmns or discrepancies noted and payment ~s approved Signature at&t FISHERS ISLAND FERRY OISTRICT Page 1 ol 6 P0 BOXH AccouRt Number 860442-0165078 FISHEgS ISLE NY 06390 0601 Billing Date Dec 16, 2012 Web Sile att.com : ,, onthly Statement Previous Bill 529.38 Payment Received 11-29 264.15 CR Adjustments ,00 Past Due- Please Pay Immediately ~ (~ 265.23 Current Charges ~ ~ Total Amount Due $525.02 * Current Charges Due in Full by Jan 14, 2013 Questions7 Call: Plans and Services 1 800 321-2000 Repair: 1 800 246-8464 Internet Services: 1 877 722-3755 Total Current Charges Page 1 259.79 259.79 · PREVENT DISCONNECP · CARRIER INFO · KEEP YOUR DISCOUNT · PRICE INCREASE · PRICE CHANGE · APL PRICE CHANGE See "News You Can Use" for additional information. · Thank you for being an ALL DISTANCE® customer. Your ALL DISTANCE® savings includes: 27.00 Promotions and Discounts I. Save Elite SConn-$27oif-12moterm 27.66CR Monthly Service - Dec lgthru Jan 14 Charges for 860 442-0165 2 Monthly Charges 12260 Charges for 8~0 443~851 3. MontlRy Charges 2835 Charges for 860 44d-O3Z0 4 Monthly CImrges 28.35 Charges for 860 447-9371 5 Monthly Charges 2835 Total Monthly Service Z07.65 Call Charqes Bus Block of Time 700 II ZY Summary 610 Minutes Used ?00 Minutes Allowed 6 Bus Block of Time 70(3 II 2Y Charges for 860 4~2.-0168 Item No. Date Time Place Itemized Calls 7 11-15 1126A FISHERS IS NY 8.11-15 1133A LINDFNHST NY 9 11 15 1169A FISHERS I$ NY 10.11 15 1223P FISHERSIS NY 11.11-15 1224P FISHERSIS NY 1211-15 180P FISHERSIS NY 13 Ild5 745P FISHERSIS NY 1411 15 319P FISHERSIS NY 15. 11-16 1004A FISHERS IS NY 16.11 16 1018A FISHERSIS NY 1711-16 1034A EISHERSIS NY 18.11 16 1107A FISHERSIS NY Number Code Mtn 631 788-7251 0:30+ 631 225-3060 7:52+ 631 788-5673 0:31+ 631 788-7345 0:38+ 631 788-7520 0:50+ 631 780 7463 0:41+ 631 788-7463 1:06+ 631 788-7463 1:51+ 631 788-5673 1:57+ 631 788-7345 0:30+ 631 788-2919 0:40+ 631 788 7463 0:49+ 3000 Locar Services provided by AT&T Connecticut Services beyond Connecticut provided by AT&T Long Distance East. 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I~ *BASIC $187.28 NON BASIC $337,74 Return bottom portion with you~ check in the enclosed envelope at&t FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLE NY 06390 0607 Page 2 of 6 Acco..t Number 860 442-OI65 078 Billing Date Dec 15, 20~2 Web Site art.corn Call Charges - Coutinued lien& No Date Thne Place 1.11 16 lllOA FISHERS IS 2.11 16 1239P FISHERS IS 3.11 16 239P FISREHSIS 411 16 328P UXBRIDGE 511 16 335P UXBRIDBE 6.11 16 337P UXBRIDOE 1.11 16 344P UXBRIBGE 81141 /0SA MOODUS 911-19 144A FISHERS IS 10.11 19 842A FISHERS~S 11 11-19 10DNA OLD SAYBRK 1211 19 1149A FISHERSIS 1311 19 ll55A FISttERSIS 1411 19 103P FISRERSIS 1511 19 139P NEWYORK 1611 19 217P EISHERSIS 1711 19 244P FISHERSIS 1811-19 252P FISHERSIS 1911 19 253P FISHERSIS 20 II 19 316P FISHERSIS NY 631 788 7345 NY 631 788 7345 NY 631 788 56~3 MA 508 779 0052 MA 508 179 0052 MA 508 779 0052 MA 508 779 0052 CT 860873-8488 NY 631 788-5546 NY 631 788-5550 CT 860 227-2335 NY 631 288 7463 NY 63l 788 5673 NY 631 788 7345 NY 646 298 8698 NY 631 788 7345 NY 631 788 7919 NY 631 788-7343 NY 631 188-7857 NY 631 188 7857 8! II 20 946A COLCItESTER CT 860537 22~A 2211 20 947A COLCHESTER CT 860537-2344 23 11 20 954A FISHERSIS 2411 20 1248P FISHERSIS 25.11 20 2COP FISHERSIS 26.11-20 319P CAMBRIDGE 27 I1 20 357P FISHERS IS 261121 156P PUTNAM 2911 26 1050A FISttERS IS 3011 26 1224P FISHERSIS 31.11 26 1225P FISHERSIS 32 11 26 120P FISHERSIS 33.11-26 125P FISHERS IS 34 1126 141P EISHERSIS NY 631 788 5682 NY 631 788 7867 NY 631 788 7463 MA 617 201-4375 NY COl 788-7463 CT 860963 0756 NY 631 788 7255 NY 631 788-1455 NY 631 188 7249 NY 631 188-5573 NY 631 788-7857 NY 63~ 788 7463 35 11-27 DO6A COLCHESTER CT 860537 2344 3611-27 1025A FISHERS IS 37 11 27 1026A FISHERS IS 38.11-27 103lA FISHERS IS 39 11-27 llcoA FISHERSIS 40 11 27 1145A SEALS CITY 41.11 27 254P FISHERS 18 42.1L27 349P FISHERS IS 43 11 27 427P FISHERS IS 4411 21 431P FISHERS IS 45.11 27 445P EISHERSIS 46.11-28 924A EISHERS iS 47.ll-28 1043A UNDENHSr 48. ll-28 1113A FISHERS IS 49 11~28 1157A FISHERS IS NY 631 788 7345 NY 631 788-7345 NY 631 788-5550 NY 631 188 7463 NJ 609624 3100 NY 631 788-7463 NY 631 788 7463 NY 631 788-7345 NY 831 788 5515 NY 631 788 56/3 NY 631 188 7463 NY 631 225 3060 NY 631 788 7251 NY 631 788 5550 Code Call Charges - Continued Item No, Date Time Place 50.11-28 204P WILLIMNTIC 61 11-29 818A SEAISCITY Mi~ 52.11 29 911A FISHERS IS 0:30+ DO 53.11 29 951A FISHERSIS 4:21+ DO 5411 29 ICOgA BELLOWSFLS 1:16+ .DO 55.11 29 101lA FISHERSIS 0:37+ .DO 56 11~29 1055A FISHERS IS 0:30+ .00 5711-29 1115A FISHERSIS 2:25+ .00 58 11 29 1147A FISHERS IS 1:00+ .00 5911 29 1DOP SEAISCITY 0:30+ CO 6011 29 116P FISRERSIS 3:52+ .DO 61 11 29 202P FISHERS IS 0:38+ ,DO 6211 29 218P FISHERSIS 1:14+ .CO 63.11-29 333P FISHERSIS 1:00+ .00 64.11-30 649A FISHERS IS 0:52+ .00 65.1D30 737A FISHERSIS 7:04+ .00 66.11 30 753A FISHERSIS 0:30+ CO 67.11 30 836A FISHERS IS 2:17+ .DO 68.11 30 844A FISHERS IS 1:48+ DO 69 11 30 846A FISHERS IS 0:30+ ,D0 70 I1 30 908A FISHERS IS 3:54+ .DO 71.11 30 914A NEWYORK 0:49+ .CO 72. 11 30 927A FISHERS IS 0:30+ .00 13.11-30 952A F!SHERS!S 1:44+ DO 74.11-30 955A HARTFORD 0:30+ CO 15. 11 30 1124A FISHERS IS 1:19+ DO 76 11-30 1145A FISHERSIS 0:50+ DO 7711 30 1220P FISHEflSIS 1:34+ .DO 1811 30 313P HARTFORD 1:11+ ,CO 79.11 30 400P FISHERSiS 0:56+ .DO 80.11 30 405P FISHERS IS 1:21+ .00 81.11-30 417P FISHERSIS 0:30+ DO 82 11 30 615P FISHERS IS 0:30+ DO 83.12-02 151P FISHERSIS 0:39+ .00 841203 725A FISHEHSIS 2:01+ .DO 85.12 03 739A FISHERS IS 0:30+ O0 86. 12-03 103lA FISHERS IS 3:26+ .00 81. 12 03 1033A FISHERS IS 0:45+ .DO 88. 12-03 1110A HARTFORD 0:30+ .DO 89.1203 1258P FISHERSIS 2:30+ .DO 901203 105P FISHERSiS 0:59+ .CO 91.12 03 123P FISHERS IS 11:44+ .DO 92.12 03 125P PUTNAM 6:08+ .CO 93.12 03 145P FISHERS IS 3:20+ DO 94.12 03 257P FISHERS IS 2:55+ .DO 9512-04 705A NEWHAVEN 0:41+ .DO 96,12-04 849A WATERBURY 1:33+ .CO 97.12 04 858A FISHERS IS 0:30+ .00 98.12-04 932A NEW HAVEN 2:42+ .DO 99. 12 04 945A FISRERS IS 0:41+ .DO 100.1204 lll6A FISHERSIS 7:34+ .DO 101.12-04 1117A FISHERSIS 102 12 04 1136A FISHERS IS Number Code Mill CT 860 234 9583 D 0:40+ .DO NJ 609 624 3700 1:06+ .DO NY 631 188 7463 0:30+ .DO NY 631 788 7463 7:25+ .DO VT 802 460 1300 1:18+ .DO NY 631 788 7463 0:30+ .DO NY COl 788 7463 1:06+ .DO NY 631 788 7444 1:24+ DO NY 631 788 7463 0:30+ DO NJ 609 624 3700 6:36+ DO NY 631 788 7463 2:29+ .00 NY 631 788 7463 6:57+ .DO NY 631 788-5686 0:43+ .DO NY 631 788-7463 1:50+ .00 NY 631 788-5507 0:30+ .CO NY 631 788 7343 0:30+ .DO NY 631 788 7919 1:49+ .DO NY 631 788 7919 0:30+ DO NY 63i 788 5550 1:06+ .DO NY 631 288-5550 0:30+ .DO NY 631 788 7326 LDO+ .DO NY 917686-O201 2:47+ .DO NY 631 788-7326 0:30+ .DO NY 63! 788-7857 0:41+ .DO CT 860883-9499 0:30+ .DO NY 631 788-7455 0:53+ .DO NY 631 788-7857 0:56+ .CO NY 631 788 7463 0:30+ 00 CT 860 883 9499 3:10+ .CO NY 631 788 1919 0:40+ .DO NY 631 788-7919 0:30+ .DO NY 631 788-7852 1:28+ .DO NY 631 788 7463 1:36+ .DO NY 631 788-5682 0:30+ .DO NY 631 788 5550 4:52+ .DO NY 631 788-7345 0:30+ DO NY 631 788-7848 0:39+ .DO NY 631 788q919 3:02+ .DO CT 8DO 841-6860 3:41+ .00 NY 631 188 7345 2:05+ 00 NY 631 788 7345 3:52+ .DO NY 631 788-5515 1:07+ .DO CT 860 963 0756 0:52+ .DO NY 631 788 7345 1:22+ .CO NY 631 788 7345 0:45+ .00 CT 203 710-44i0 N 5:02+ .DO CT 203754-5334 D 1:14+ .CO NY 631 788-55DO 1 1:25+ CT 203710-4410 D 3:44+ .DO NY 631 788 7463 1 1:33+ .CO NY 631 788 7343 I 0:41+ .CO NY 631 788-7857 I 1:41+ .CO NY 631 788 5573 I 0:30+ ,CO © 2006 AT&T Knowledge Ventures. All rights reserved 4013 CO8.072319.01.83 DODO000 NNYNNNNY 4~116.144779 at&t FISHERS ISLAND FERRY OI$TRICF PO BOX H FISHERS ISLE NY 06390-0607 Page Account Number Billing Date 3of6 860 442-01aR 078 Dec 15, 2012 Call Charges - Cont nued No O~ Time Place I. 12-04 1138A FISHERS IS 2 12-04 1260P FISHERS IS 3 12-04 1257P FISHERS IS 4 12-04 105R FISHERSIS 5.12-04 l16P FISHERSlS 6.12-O4 151P EISRERSIS 1.12-04 202P FISHERS IS 8.12-04 216P FISHERS IS 9.12-04 242R FISHERS IS 10 12-04 442P FISHERS IS 11.12-05 815A EISRERSIS 12.12-05 850A FISHERS IS 13.12-05 956A RALEIGH 14.12-05 11OIA UNDENRST Number NY 631 788-5573 NY 631 788-7463 NY 631 788-7463 NY 631 788-7919 NY 631 788-1463 NY 631 188-7348 NY 631 788-7463 NY 631 788-7311 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 NY 631 188-7463 NC 919801-0463 NY 631 225-3060 15 12 05 1216P BURLINGTON VT 802363-3816 16 12-05 1220P FISHERS IS 1712-05 147P FISHERSIS 18 12-05 303P FISRERSIS 19 12-06 721A FISHERS IS 20.12-06 745A FISHERS IS 2112-06 815A NEWHAVEN 22.12-06 931A FISHERS IS 23.12-06 956A FISHERS IS 24.12 06 1046A FISHERS IS 25 12-06 1134A MILFORD 26. 12-061138A FISHERS IS 27.12-06 1146A BOSTON NY 631 788-7919 NY 631 788-7345 NY 631 788-7463 NY 631 788-7463 NY 631 768-7463 CT 203 710-4410 NY 631 788-7919 NY 631 788-7463 NY 631 708-7463 CT 2O3 876-8606 NY 631 788-7463 MA 857 321-9719 28.12-06 1156A NEWBRITAIN CT 860229-1631 29.12-06 1157A HARTFORD 30 12-06 1229P SEATTLE 31 12-06 1257P FISHERS IS 32 12-06 124P FISHERS IS 33.12 06 147P STAMFORD 34 12-DO 148P INDIANAPLS 35.12-06 159P FISRERSIS 36 12 06 302P OLD SAYDRK 37 12 06 429P FISHERS IS 38.12-06 434P FISHERS IS 39 12-O7 1016A FISHERS iS CT 860992-2253 WA 206 390-1965 NY 631 788-7463 NY 631 788-7251 CT 203322-1902 IN 317299-3401 NY 631 788 7528 CT 860 227-2335 NY 631 788-7463 NY 631 788-7345 NY 631 788-7632 40.12-07 1231P NEWMILF0flD CT 860350-9449 41.12-07 104P FISHERS IS 42 12-07 140P FISHERS IS 43 12-07 144P FISHERS IS 44 12-07 240P WORCESTER 45,1207 306P FISHERS IS 46 12 07 359P FISHERS IS 47 12 07 359P FISHERS IS 48,12-07 410P FISHERSIS 49 12-08 733A FISHERS IS NY 631 788-7255 NY 631 788-7463 NY 631 788-5673 MA 508 304-2184 NY 631 788-7345 NY 631 788-1463 NY 631 788-7345 NY 631 788-7345 NY 631 788-7463 Code 0:30+ .DO 3:40+ .DO 0:40+ .(JO 0:38+ .(JO 0:30+ .DO 1:08+ .00 0:34+ .DO 0:47+ O0 0:57+ .DO 0:31+ .(JO 2:49+ .DO 3:38+ .DO 4:28+ .DO 6:57+ .DO 1:46+ 2:43+ .DO 4:12+ ,DO 3:08+ .DO 0:30+ .DO 0:59+ 0:39~ 2:46+ ,0~ 2:37+ .DO 0:42+ .DO 1:04+ .DO 1:15+ .DO 6:04+ .DO 1:01+ .DO 2:52+ .DO I:00+ ,DO 0:39+ DO 2:38+ .DO 0:55+ .DO 1:23+ .DO 0:30+ .DO 1:06+ .DO 0:30+ .DO 0:30+ .DO 2:12+ .DO 5:23+ .DO 1:04+ .DO 1:24+ 0:37+ .DO 2:09+ .DO 0:30+ .DO 0:30+ .DO 0:30+ .DO 0:30+ .DO 0:30+ .DO Calf Char~es - Cont hued No. ~ Time Place 50.12-08 737A FISHERS IS 51.12-08 DOBA FISHERS IS 52.12-O8 946A FISHERS IS 53.12-08 947A FISHERS IS 54.12-08 957A ROANOKE 65. 12-08 1034A FISHERS IS 56. 12-08 1127A FISHERS IS 57. 12-08 1142A FISHERS IS 58.12-10 715A HARTFORD 59.12-10 789A FISHERS IS 60,12-10 817A FISHERSIS 6112-10 938A FISHERS IS 6Z 12-10 IOIOA FISHERS IS 63. 12-10 1015A FISHERS IS 64. 12-10 1052A WlNOSORLKS 65. 12-10 IIDOA FISHERS IS 66.12-10 1112A FISHERS IS 67.12-10 1135A FISHERS IS 68 12-10 1139A FISHERS IS 69. 12-10 1145A FISHERS IS 70. 12-10 1151A FISHERS IS 71.12-10 1246P FISHERS IS 72. 12-10 1255P EISRERS IS 73.12-10 3lOP FISHERS iS 74,12-10 352P WlNDSORLKS 75 12-10 358P FISHERS IS 7&12-10 405R FISHERS IS 77.12-10 410R FISHERS IS 78.12-10 411P FISHERSlS 79.12-10 432P EISHERS IS 80.12-10 445P FISHERS IS 81.12-10 502P FISHERSlS 82.12-11 759A FISRERSlS 83.12-11 817A FISHERS IS 84.12-11 838A FISHERSlS 85.12-11 850A WINDSORLKS 68 12-11 851A FISHERSIS 87.12-11 916A RSHERSIS 8812-11 920A WINOSORLKS 89.12-11 94OA ESSEX 90 12-11 IOIOA GUILFORD 91.12-11 1026A FISHERS IS 92. 12-11 1031A FISHERS IS 93. 12-11 1122A FISHERS IS 94. 12-11 1123A FISHERS fS Number NY 631 788-7744 NY 631 788-7744 NY 631 788-7744 NY 631 788-7463 VA 540 520-6277 NY 631 788-7744 NY 631 788-7744 NY 631 788-7744 CT 8DO 550-0081 NY 631 788-7345 NY 631 788-5550 NY 631 788q744 NY 631 788-7463 NY 631 788-7744 CT 860 668-0044 NY 631 788-7744 NY 631 788-7744 NY 631 788-7744 NY 631788-7744 NY 631 788-7744 NY 631 788-7463 NY 63! 788-7463 NY 631 788-7744 NY 631 768-7345 CT 86O668-0044 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 NY 631 788-7857 CT 8DO 668-0~44 NY 631 788-7463 NY 631 788-7463 CT 8DO DO8-DO44 CT 860662-3013 CT 203458-4128 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 NY 631 788-7345 95.12-11 243P MIDDLETOWN CT 8DO632*7338 96 12-11 336P FISHERS IS 97.12-12 910A FISHERS IS 98.12-12 953A FISHERS IS 99. 12-121041A FISHERS IS 100. 12-12 1107A FISHERS IS 101.12-12 1156A WlLLIMNTIC 102 12-12 1239P WlLLIMNTIC NY 631 788-7463 NY 631 788-5673 NY 631 788-7463 NY 631 788-7444 NY 631 788-5546 CT 860 933-6964 CT 860 933-6964 0:30+ 1:50+ 0:41+ 0:30+ 0:45+ 7:47+ 1:53+ 0:30+ 0:32+ 0:54+ 3:03+ 8:42+ 1:44+ 0:43+ 8:43+ 0:30+ 1:07+ 0:30+ 1:40+ 1:17+ 0:30+ 1:26+ 10:59+ 0:30+ 4:42+ 0:30+ 0:30+ 0:38+ 20:35+ 6:28+ 0:30+ 7:54+ 2M 3:14+ 1 0:30+ 1 0:86+ D 6:38+ I 2:48+ I 0:30+ D 6:09+ D 2:00+ D 1:17+ 1 0:30+ 1 1:40+ 1 0:30+ 1 0:30+ D 4:22+ I 1:25+ I 0:30+ 1 0:59+ I 1:33+ 1 1:58+ D 3:16+ D 0:35+ at&t FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS~SLE NY 06390-0607 Page Account Number Billing Date 4 of 6 860442-0165078 Dec 15,2012 Call Charges - Continued Item No. Date Time place 1.12 12 248P FISHERSIS 2.12-13 DOgA FISHERS IS 3 12-13 834A FISHERS IS 412-13 851A FISHERSIS 5.12-13 917A FISHERS IS 612 13 920A FISHERSiS 7.12-13 921A FISHERSIS 8.12-13 954A FISHERSIS 9. 12-13 10~3A FISHERS IS IO. 12-13 IO17A FISHERS IS I1.12-13 1107A FISHERS IS 12. 12-13 1114A FISHERS IS 13.12 13 1128A E]SHERSIS 14.12-13 1138A HARTFORD 15.12-13 1205P GUILFORD 10.12-13 1208P GUILFORD 17.12-13 1218P FISHERS IS 18 12-13 1221P FISHERS IS 19.12-13 1229P GUILFORD 2012 13 221P FiSHERS[S 21.12-13 222P FISHERSIS 22 12-13 223P FISHERS IS 23.12-13 228P FISHERS IS 24.12 13 245P FISHERSIS 2512 13 329P FISHERSIS 26 12 14 847A ESSEX 27.12 14 851A FISHERSIS 28. 12-14 1018A FISHERS IS 29. 12-14 1105A FISHERS IS 3OI2 14 1129A FISHERSIS 3112-14 133P FISHERSIS 32.12-14 214P ESSEX 33.12-14 238P FISHERS IS 34.12-14 251P FISHERSIS 35.12 14 338P DOPKINTON Total Itemized Calls Total Charges for 860 442-O165 Charges for 860 443-6851 Ilemized Calls Number NY 631 788-1345 NY 631 788-5550 NY 631 788-5673 NY 631 788 7311 NY 631 788 5673 NY 631 788-7463 NY 631 788-7744 NY 631 788-7744 NY 631 700q744 NY 631 788 7744 NY 631 788-7857 NY 631 788-7463 NY 631 708-5673 CT 860883-1239 CT 203458-4128 CT 203 458-4128 NY 631 788q311 NY 631 788 7343 CT 203458-4128 NY 631 188-5673 NY 631 788-7233 NY 631 788 7919 NY 631 788-7463 NY 631 788-7463 NY 631 788-7463 CT 860767-1768 NY 631 798-7345 NY 631 788-7227 NY 631 788-7444 NY 631 788-7444 NY 631 788-7463 CT 860 662 7550 NY 631 788 5673 NY 631 788-7463 MA 774 248-0098 36.11-15 732A PROVIDENCE BI 4012756581 37.11-15 1018A FISHERS IS 38.11 15 1021A FISHERS IS 39.11 15 253P FISHERSIS 40. I1-15302P FISHERSlS 41.11-16 1013A FISHERS IS 42.11-16 301P FISHERSIS 43.11 17 DOIA FISHERSIS 44.11-17 242P FISHERS IS 45.11-19 917A FISHERS IS NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788 5522 NY 631 788 5522 NY 631 788-5522 NY 631 788-5522 NY 631 780 5522 Code Mien 0:30+ 0:30+ 3:03+ 1:29+ 0:30+ 0:48+ 10:32+ 1:02+ 1:26+ 6:17+ 0:59+ 0:30+ 0:57+ 1:24+ 1:24+ 1:11+ 1:57+ 1:14+ 5:16+ 0:43+ 0:34+ 1:09+ 6:24+ 2:43+ 0:30+ 0:53+ 0:30+ 0:30+ 1:43+ 0:30+ 0:30+ 0:46+ 3:43+ 0:30+ 2:33+ 0:31+ 0:38+ 0:31+ 0:32+ 0:30+ 0:41+ 0:31+ 0:30+ 0:31+ 0:41+ .OO .00 .DO .DO .DO .00 .00 .DO .00 Call Charges - Continued Item No. Date Time Place 46.11 19 945A FISHERSIS 47. 11-19 1054A FISHERS IS 48.11-19 3lIP FISHERSIS 49. 11 20 1035A FISHERS IS 50.11-20 254P FISHERS IS 51.11-20 541P FISHERSIS 52.11 21 1012A FISHERSIS 53.11 21 1040A FISHERSIS 54.11-21 309P FISHERS IS 55. 11-23 1248P FISHERS IS 56.11-23 308P FISHERSIS 57,11-23 312P FISHERSIS 58. 11 26 1105A FISHERS IS 59.1126 310P FISHERSIS 60.11-27 1117A FISHERS IS 61.11-27 311P FISHERSIS 62, 11-28 1081A FISHERS IS 63,11-28 247P FISHERSIS 64.11-29 933A FISHERSIS 65. 11-29 1141A FISHERS IS 66.11 29 215P FISHERSIS 67.11 29 310P FISHERSIS 68. 11-30 1102A FISHERS IS 6g 11-~8 !114A FISHERS IS 70.12 01 DeeP FISHERS IS 71.12-03 902A FISHERS IS 72.12-03 255P FISHERS IS 73.12-03 300P FISHERS IS 74.12-04 958A FISHERS IS 75.12-05 848A FISHERS IS 76. 12-05 1038A FISHERS IS 77.12 05 254P FISHERS IS 78 12 06 1117A FISHERS IS 79. 12 06 1154A FISHERS IS 80.12 06 1257P FISHERS IS 81.12 06 258P FISHERS IS 82. 12-07 1021A FISHERS IS 83 12-07 127P FISHERSIS 84 12 07 305P FISHERS IS 85.12-08 254P FISHERS IS 86.12-10 948A FISHERS IS Number NY 631 288 5522 NY 631 788-5522 NY 631 788-5522 NY 631 788 5522 NY 631 788-5522 NY 631 788-5523 NY 631 788-5522 NY 631 288 5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788 5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5523 NY 631 788-5522 NY 631 788-5522 NY 631 788 5522 NY 631 288 5522 NY 631 788 5522 NY 631 788 5522 NY 631 788-5522 NY 631 708-5522 NY 631 788-5522 NY 631 788 5522 NY 631 788 5523 NY 631 788 5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788 5522 NY 631 788-5522 NY 631 788-5522 NY 631 788 5522 87. 12 10 141P WESTHAMPTN NY 631 288-5161 88 12-10 345P FISHERSIS 89.12-11 817A FISHERSJS 90 12-11 836A GREATNECK 91,12 11 1003A FISHERSIS 9212 11 1026A FISHERSIS 93. 12-11 1048A FISRERS IS 94 12-11 1245P FISHERS IS 95. 12 112SIP FISHERS IS 96. 12-121030A FISHERS IS 97.12-12 301P FISHERSIS 98. 12 131045A FISHERS IS NY 631 788-5522 NY 631 788-5549 NY 516829-8213 NY 631 780-5522 NY 631 798-5522 NY 631 788-5523 NY 631 788-5523 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 NY 631 788-5522 ~od~ 0:41+ .DO 0:32+ .DO 0:32+ .00 0:55+ .00 0:30+ .00 0:30+ .00 0:53+ 0:35+ .00 0:30+ .00 0:31+ .00 0:32+ .00 0:32+ .00 0:44+ .00 0:31+ .00 0:55+ 0:30+ 0:56+ .0~ 0:30+ .DO 0:30+ 1:16+ .DO 1:28+ .DO 0:32+ .DO 0:59+ .00 0:31+ .DO 0:30+ 0:59+ .00 0:30+ 0:31+ DO 0:56+ .00 0:30+ .DO 1:03+ .DO 0:32+ .OO 1:15+ .O0 1:54+ 1:02+ ,00 0:32+ .00 0:49+ .DO 1:06+ .DO 0:34+ .00 0:30+ .DO 0:59+ .00 0:36+ .00 0:32+ .00 0:52+ .00 0:33+ .DO 0:31+ 1:07+ .DO 0:30+ .00 1:30+ .DO 0:30+ .DO 0:57+ .DO O:31+ .O0 1:20+ 00 4OI3.008.072319,02.O3.0OOOO0e NNYNNNNY 3396398119 II · at&t EISHERS ISLANO FERRY OlSTRICT PO BOX R FISHERS ISLE NY 06390-0607 Page 5 of 6 Account Number 860 442-0165 078 Billing Date Dec 15, 2012 Call Charges - Continued Item No. ~ Tim~ Place Number 1.12-13 1129A FISHERS IS NY 631 788-5522 2.12-13 314P FISHERS IS NY 631 788-5522 3. T2-13 326P FISHERS IS NY 631 788-5523 4.12-14 1038A FISHERSIS NY 631788-5522 5 12d4 258P FISHERS IS NY 631 788-5522 Total Itemized Calls Total Charges for 860 443-6851 Charges for 860 444-6320 Itemizeg Calls 6.11-15 938A UNDENHST NY 631 225-3064 7.11-15 941A LINDENHST NY 631 225-3064 8.11-15 1130A LINDENHST NY 631225-3064 9.11-19 312P FISHERSIS NY 631788-5523 10 11-19 315P FISHERS IS NY 631 788-5523 11.12-06 929A CARY-RTP NC 919443-2416 12.12-06 932A CARY-RTP NC 919443-2416 13. 12-60 1043A CARY-RTP NC 919 443-2416 14.12-60 1208P CARY-RTP NC 919443-1467 15.12-11 1139A FALLNGWTRS WV 30427F2541 16 12-11 114OA FALLNGWTRS WV 304271 2541 17.12-11 1144A FALLNGWTRS WV 304271-2541 18.12-11 1145A FALLNGWTRS WV 304271-2541 19,12-11 1200P FALLNGWTRS WV 304271-254l 20,12-11 225P NEWBRITAIN CT 860 225-4762 Total Itemized Calls Total Charges for 860 444-0320 Charges for 860 447-9371 Itemized Cells 21 11-15 222P FISHERS IS NY 63l 788-7520 22.11-26 1252P OLDSAYBRK CT 860227-2335 23.11-21 737A FISHERSIS NY 631788-7345 24.11-27 858A COLCHESTER CT 860537-2344 2511-27 914A FISHER61S NY 631788-5673 26.11 27 915A COLCHESTER CT 860537-2344 27, 11-27 1600A FISHERS IS NY 631 758-7463 28.11-28 IOISA FISHERS IS NY 631 788-7463 29,11-29 1015A BELLOWSELS VT 802460-1300 30.11-29 104P FISHERSIS NY 631788-7463 3111-30 915A FISHERSIS NY 631788-7345 32.11-30 938A FISHERS IS NY 631788-7345 33.11 30 223P FISHERSIS NY 631788-7444 3411-30 338P FISHERSIS NY 631788-7345 35. 12-04 1221P HARTFORD CT 860 240-3152 36.12-04 104P FISHERS [S NY 631 788-7345 37.12-05 260P FISHERS IS NY 631788-7444 38.12-05 235P EISHERSI8 NY 631788-7345 3912-06 605A FISHERSIS NY 631788-7463 4012-60 1023A NEWFIAVEN CT 203710-4410 Code Mien 0:36+ .60 0:31+ .60 0:30+ .00 1:11+ .00 0:31+ ~ .60 0:30+ 60 0:59+ ,60 0:37+ ,60 1:05+ .60 1:04+ ,00 0:30+ .60 0:30+ ,60 0:30+ .00 0:30+ .00 0:30+ ,60 0:30+ .60 0:30+ 60 0:30+ 60 0:30+ .60 0:30+ .00 .00 .00 1:10+ .00 0:43+ .60 0:38+ .00 1:10+ .60 0:30+ .o0 1:57+ .00 1:51+ .00 0:30+ ,00 0:53+ .00 2:50+ ,OC 2:40+ .O0 0:30+ .60 2:23+ .00 0:30+ .00 5:39+ .00 0:40+ 00 3:30+ .00 0:55+ .00 5:00+ .00 0:30+ .00 Call Cherpes - Continued Item No~ Date Tim~ Plow 41.12-06 1129A FISHERS IS 42 12-10 357P FISHERSIS 43.12-11 803A FISHERSIS 44.12-11 808A FISHERS IS 45.12-11 924A MILFORD 46. 12-111120A FISHERS IS 47.12-11 1245P FISHERS IS 481211 II1P FISHERSIS 49.12-12 756A HARTFORD 50.12-13 804A HARTFORD 51.12-13 836A FISHERSIS 52.12-13 1036A FISHERS IS 53 12-13 1228P HARTFORD Total Itemized Calls Total Charges for 860 447-9371 + - Optional Calling Plan Key to CoRing Codes 1 Peak M Multiple Rate Periods Totel Call Charges Number [L~L~ Mi~ NY 631 788-5673 I 0:30+ .60 NY 631 788-7345 I 0:30+ .00 NY 631 788-7463 1 0:51+ .00 NY 631 788-7463 1 5:34+ .60 CT 203 306-0040 O 1:O0+ .00 NY 631 788-7463 1 3:02+ NY 631 788-7463 1 2:33+ NY 631 788-7463 I 1:12+ ,60 CT 860883-3990 N I:11+ .60 CT 860240-3162 O 2:48+ .60 NY 631 788-7463 1 1:23+ .00 NY 631 788-7744 1 0:30+ .00 CT 860639-2488 D 1:09+ .00 2 Off Peak D Day N Night/Weekend Surcharges and Other Fees AT&T Connecticut 54. Connechcut E9-1-1Surcharge-4Lines 55. Connecticut Service Fund - 4 Lines 56. Universal Service Fund - Local(4 @ $L43) 57. Federal Subscriber Line Charge - 4 Lines Total AT&T Connecticut AT&T LD East 58. Federal Regulatory Fee 59. Universal Service Fund - Interstate Total AT&T Long Distance East Total Surcharges and Other Fees 60. Federal 61, State Sales Tax Total Taxes Total Plans and Services 36.00 1.60 .20 5.72 2384 3136 .28 2.5 2.~ 34.04 3,47 11.63 15.16 259.79 at&t FISHERS ISLAND FERRY DISTRICT Page 6 of 6 PO BO× H Account Number 860 442-0165 078 FISHERS ISLE NY 06390 06O7 Billing Date Dec 15, 2012 PREVENT DISCONNECT Il your bill shows a past due amount, BOTH the Past Due am ount and Current Charges are due IMMEDIAEELY. All of your bill charges must be paid each month to keep your account current and avoid collection activities (See Terms and Conditions for further information). However, to avoid disconnection of local service, Basic Charges MUSP be paid. For this account, that amount is: $148.85 for Current Basic Charges $38.43 for Past Due Basic Charges CARRIER INFO Our records indicate that AT&T Connecticut is your carrier for instate calls. AT&T Long Distance East is your carrier for interstate and international calls. KEEP YOUR DISCOUNT You receive any discounts, reduced rates, or promotional credits de- scribed in the AT&T Benefits section of tire bill because you subscribe to certain required services, for example, because you are an ALL DISEANCE® customer. If you remove any of the services required for a particular discount, reduced fate, or promotional credit, your effective rate for gte associated remaining service will change. Please call your AT&T service representative if you bare any questions. PRICE INCREASE Effective February 12, 2013, the out of term prices for High Volume Calling Plan II, Business Flat Rate Plan and Customized Select Plan (including out of term rates for customized term contracts based on those plans) long distance service will increase by 35% over the curren'~y published guidebook/tariff prices. If you are currently under term agreement, you will not experience this price increase until your term agreement expires. Please call your Account Manager or the number on your bill tel more information PRICE CHANGE Elfecdve February 1, 2013, monthly prices for Flat Business Lines and Trunks on Month-to-Month (MTM) service will increase from $57.00 to $64.50 in Exchange Classes (ECl 1 thru 5, Monthly prices for Business Per Call MTM service will increase from $37.00 to $44.00 in ECl tbru ECS Monthly prices for Message Rate Service (Grandfathered) will increase from $48.00 to $56.00 in ECl thru 5. Toll Restriction will increase from $6.00 to $7.00, PBX Outward Dialing Trunks will increase from $1300 to $14.00 and PBX Telephone Number Reservation Blocks of 20 and Local Exchange will increase from $0.50 to $0.60. Term plans will not be affected For questions, please call the toll free number on your bill. Thank you for choosing AT&T Connecticut, APL PRICE CHANGE Effective February 15, 2013, the Analog Private Line month-to-month prices in Connecticut will increase approximately 20%. The amouot of the increase will depend on the specific circuit type. If you have any questions, please contact an AT&T Service Representative at the toll-free *)umber on your bill. Thank you for choosing AE&T Connecticut. BASIC CHARGES Basic Charges are charges for Basic Services. Basic Services include local service and in-state toll if you are an At&T Connecticut local service customer. Basic Charges include: Monthly Charges for your local line and other services, such as Totalphone and Smartlink; in-state Calling Charges; in-state O/rectory Assistance Charges; the Connecticut E-9! 1 Surcharge; the Connecticut Service Fund fee; the Federal Subscriber Line Charge; and the Universal Service Fund - Local fee, NON-BASIC CHARGES Non-Basic Charges are charges for Non-Basic Services. These charges include: Cult Charges for out o! state calls, 9~ calls and calls placed through alternative services providers; Call Charges for in state long distance provided by a company ether than AT&T Connecticut; out of state Directory Assistance Charges; charges for telephone equipment and inside wire maintenance, AT&E Voice Mail. AT&T Unified Messaging, AT&T High Speed luternet; Wireless, AT&T I DISB Network, AT&T I DIRECTV. Advertising in the white page directories or other media; and the Universal Service Fund - Interstate fee. CHARGES THAT MAY BI: BASIC OR NON-BASIC Certain charges may be either Basic or Non-Basic, depending on the associated service. These include taxes, Late Payment Charges, Collection Charges, and Additions and Changes to your service. BILL PAYMENT, LATE PAYMENT CHARGES AND OTIIER FEES Failure to pay any portion of your hill may result in additional collection action. Any partial payment made will first be applied to Basic Charges, then to Non Basic Charges. Failure to pay your Basic Charges will result in interruption of your local service. If you fail to pay your Non-Basic Charges, your AT&T Connecticut local service will not be interrupted, but all of your Non Basic services will be terminated. AT&T Connecticut may apply a late payment charge per month on any unpaid balance, excluding the previously assessed late payment charges To avoid a late charge, we must receive payment for the total amount due no later than the date specified on your bill statement, AT&T Connecticut will apply a $20.00 Collection Charge on an account where a termination notice has been sent, An explanation of these charges may be obtained by calling AT&T Connecticut at the number shown on your bill or accessing our webs/re: http://wvvw.attcom/ctbillglossary AT&T SERVICES Local and in state long distance services, inside wire, rental sets, and voice mail services (except wbere sbown as provided by AT&T Messaging) are provided by AI'&T Connecticut, Out of state Ions distance is provided by AT&T Long Distance East thternet services are provided by AT&T Intemet Services. Wireless services are provided by AF&T Mobility. 4013.008.072319.03.03.0000000 NNYNNNNY 33965.98121 IIIlllm I1~ I FISHERS ISLAND FERRY DISTRICT VENDOR 001781 ATLANTIC DETROIT DIESEL- 01/15/2013 CHECK 922 FI/ND & ACCOUNT P.O,# INVOICE DESCRIPTION A~OUNT SM .5710.2.000,100 2220423 M~-BLOCK HEATER 136.53 TOTAL 136.53 Town of Southold, New York - Payment Voucher Vendor Tax D Number or Social Security Number Vendor Address PO Box 950 Vendor Name Lodi, NJ O~644 Atlantic Detroit Diesel Allison, LLC Vendor Telephone Number 201-489-5800 Vendor Contact Vendor No. 1781 Check No. Entered by Audit Date JAN ! 5 2013 i Town Clerk Invoice I Invoice Number Date 2220423 12/12/2012 Fotal $136.53, Discount t iet ~ Purchase Order Amount Claimed] Number 3 .53 $136.531 $136.53 Description of Goods or Services Munn-Block heater General Ledger Fund and Account Number SM5710.2.000.100 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~ that the foregoing claim is true and correct, that no par~ has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Department Certification l hereby certi[x that the materials above specified have been received by me in good condition without substitution, the services properly pertbnned and that the quantities thereof have been verified with the exceptmns or discrepancies noted, and pevmcnt Is approved Signature Title ~eTfiOIT ~IeleL-AU. ISON '~ N' ~ATLANTIC IKRNeR mMI Atlantic Power Systems is a Division of Atlantic Detroit Diesel-Allison, LLC Please make all checks payable and remit to: ATLANTIC DETROIT DIESEL-ALLISON, LLC P.O. Box 950 · Lodi, New Jemey 07644 Phone: (201) 489-5800 I~LED TO F:'~!~F~IZRS ISLAND F'ISF~I::,'Y ~:I:STF~ICT '×'SANE: F'. 0. I:~(:)× I"i Invoice ~dlSp[D 'fO f .I. CI-.UF NET DUE c,O DAY,<:: DATE: ~.2/12712 TIME: 15:14:54 ~F'T: PARTS CUSTOMER COPY AI'LANT IC DDA 562 E[..bl UNII' .L .,.. DSCUMENT# = I MARLBOROLJGH HA 01752 (508)460-6277 8F(DER TYPE: STSCK SHIF' ]O.*SAME 05010 SOLD TO:FISHERS I,SLAND FERRY DISTRIC][ P.O. BOX H FISHERS ISLAND. NY 0~5~0 ORIGINAl... PAGE :L * P I C K T I C K E T * LIMITE~ C~EDI'I CU`STOMER F'O# = ROIJl' ING: F' I CKUF' B/L NUMBER." UNIT SERIAL#-PRIMARY: CUSTOMER CONTACT: ,TOHN C/C ........... CHI: ........... CASH .........COD ..... FILLFD F'I='D .......... COl.... .......... F'U ......... EN'I'EFRED BY: ****** /1 =.~ 1N/COD DATE SHIH::'ED: 0/00/00 CHARLES TUR[; I 0 M I DDTCF' 14/ PHC)NE (65:L) 788-7465 F'C ITEM I'E:CI-I# GRSUF' BIN ~.li" Y QI'Y QTY UNIT EX'¥ENDED NLJMBER DE,SCRIPT ION L.8C ORD SHP B/8 PRICE F'R:[CE TF751 002 750W 120V DIR IMM 0000 KIM I 1 89.75 89.75 ATLANTIC I'S NOW THE: 8NE STOP SHOF' FOR ALL~,OF YOLJR TRLJC:K ., BUS GENIERAI'OR AND MARINE: .... ' ' ~ ~AIR CONDITISNING F'ARI'S AND ,.>E.F~V.[CE... F'ARI'`S AND SERVICE NEEI)S .... HOT DEALS ON .L ASK ABOUI' OUR F'REON SI::f':CIAL ....... FOR MC)RE [NI::8 VISIT WWW.ATI,..ANFI(]I)DA.COH P 6,~.,J~. ]. ~,.M KEC, I::.IVE. D BY ." FISHERS ISLAND FERRY DISTRICT VENDOR 002125 THE BEACH PLUM, LLC 01/15/2013 CHECK 923 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.800 121512 UNIFORMS/CLOTHES 536.00 TOTAL 536.00 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Name The Beach Plum Vendor Telephone Number 631-788-7731 Vendor Contact 2125 Vendor Address Entered by \ , .~'-~ PO Box 664 Fishers Island, NY 06390 Audit Date JAN i 5 2013 Invoice Invoice Invoice i Net Purchase Order ~ Number Date Total Discount iAmoun C aimed Number Description of Goods or Services General Ledger Fund and Account Number I.~ / 12115/2012 $536.00 ~ $536.00 Uniforms/Cloth~- )' SM5710.4.000.800 $536.00! $536.00 Payee Certification lhe undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the ~I oual is exempt are excluded Signature ~Title Company Name Department Certification I hereby certi~ that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Title Date ~PO Box 664 788 7731 ~ I~1 I"~ 57 O0 $9~1 On FISHERS ISLAND FERRY DISTRICT VENDOR 002644 BRODEUR'S OIL SERVICE, INC. 01/15/2013 CHECK 924 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.100 22578 387.9 GAL #2 HTG 0IL-NL 1,480.57 TOTAL 1,480.57 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number P.O. Box 602 Brodeur's Fuel i Moosup, CT 06354 Vendor Telephone Number 860-564-2789 Vendor Contact Vendor No. 2644 Check No. Entered by & Audit Date ~ JAN 1 5 2013 Clerk Invoice Invoice Number Date 22578i 12/2712012 Invoice Total Net Discount IAmount Claimed $1'480'57i $1,480.57 i $1,480.57; $1,480.57 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi(v that the foregoing claim is true and con-cci, 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 ~s exempt are excluded Signature ~ Compan> Name T't,e Date Purchase Order Number Description of Goods or Services 387.9 gal Heating Oil New London Terminal General Ledger Fund and Account Number SM5710.4.000.100 Department Certification I hereby certd~ 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 ~s approved Signature ~/ Td~e ~ Date '022578 ~ I ~l I I (tN ~ I I ~Y (~RN Iii [)(~ CT. LIC.~96 i' (,~ $;AI 1 ~; 'lAX CTHOD846 BRODEUR's OIL_SERVICE, INC. 28 STERLING ROAD, P.O. BOX 602, MOOSUP, CT 06354 564-2789 · 859-5840 · 923-9528 If Payment Received Ry PAY l)Vt~d tlnmel t'ked FISHERS ISLAND FERRY DISTRICT VENDOR 002785 STEPHEN G. BURKE 01/15/2013 CHECK 925 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 121912 REIM 263MI@.555/MI 145,96 TOTAL 145.96 Town of Southold, New York - Payment Voucher Vendor No. 2785 Vendor Tax 1D Number or Social Security Number Stephen G. Burke Vendor Telephone Number Vendor Contact Invoice Number Discount Invoice Invoice Date Total 12/19/2012 $145.96 $145.96 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~: that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Vendor Address 40 Stoddard'e Wharf Road Ledyard, CT 06339 Net Purchase Order Amount Claimed Number $145.96 $145.96 263.00 mi. x $.66.$1mi Signature ~'"~.~t~ Title ~ Company NameJ ~'""~ Date Check No. Audit Date JAN 1 5 2013 town Clerk 1 General Ledger Fund and Account Number SM6710.4.000.000 Department Certification I hereby certi~ 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 is approved. Signature Title Mileage Reimbursement Form Date Miles Destination Purpose 5-8 7 Home Depot/Arrow paper Concrete grinder/wax ring 5-9 13 Home DepoffDefender?EWH Tarps/Vests 5-I 1 I I Airgas Forklift Fuel* 5-23 15 Ct Scrap Scrap metal 5-24 11 Airgas Forklif~ fuel 5-24 7 Defender Life vests 5-29 5 Staples 6-6 11 Lowes/Airgas * 6-28 t 1 Airgas * 7-6 11 * 7-18 II * 7-26 I 1 * 8-21 11 * 8-29 11 * 9-14 11 * 9-25 t t * 9-28 5 Staples 10-9 I I Airgas * 10-31 11 * I I-1 10 Hillery Steel Plates Total miles ~7(~_~ X 5-5'.5~- per mile = iNS-. q '7 ~ ~ ~ -iq- I~ I signature date www. BusinessFormTemplate.com dX ~ Mileage Reimbursement Form Date Miles Destination Purpose I 1-15 11 Airgas Fork lift fuel 11-20 8 Defender Float coat 12-3 13 Home Depot/Defender Christmas lrees 12-17 1 I Airgas Forklift fuel 12-19 15 Defender/Radacks/Ringsend MOB clips/keys/paint Total miles ;7r~?~3 X 5-52 5' per mile = I0 S-. q '7 date www. B usiness FormTemplate.com FISHERS ISLAND FERRY DISTRICT VENDOR 003370 CITY OF NEW LONDON 01/15/2013 CHECK 926 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT SM .1950.4.000.000 SM .1950.4.000.000 40404A 6614A REAL ESTATE TAX ADDT'L 30.65 REAL ESTATE TAX ADDT'L 2,125.39 TOTAL 2,156.04 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number City of New London-Tax Dept. Vendor Telephone Number 860-447-5208 Vendor Contact Invoice ~ Invoice Number i Date 6614 1t/212012 40404 /> 11/2/20t 2 [B¥oice Total Discount $2,125.39 $30.651 $2,156.04 Vendor Address P.O. Box 1305 New London, CT 06320-1305 Net Amount Claimed $2,125.39 $30.66 $2,166.04 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 thc Town is exempt are excluded. Signature~ Title Compan~ Name /C'~ Vendor No. ] 3370 Check No. Entered by Audit Date JAN 1 5 2013 Purchase Order Number Description of Goods or Services Real Estate Tax t'!dd't Real Estate Tax Additional tax due to mlllincrease General Ledger Fund and Account Number $M1960.4.000.000 SMt950.4.000.000 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 there&have been verified with the exceptions or discrepancies noted, and payment is approved Signature ~,1,.~~ Title Date City of New London Tax Collector P.O. Box 1305 New London CT 063201305 Phone: (860) 447-5208 12/13/12 Map/Block/Lot Gl2 0108 0002 SOUTHOLD TOWN OF PO BOX H FISHERS ISLAND NY 06390 6614 006614 Legal Description STATE ST REVISED ACCOUNT STATEMENT REAL ESTATE TAX YEAR BASE TAX PENALTY/INT OTHER +/- 11 2 RVRE 2,125.39 .00 .00 11-2 21,789.38 - ~ .00 .00 Total Due 23,914.77 .00 .00 TOTAL DUE 2,125.39 21,789.38 23,914.77 The mill rate has been changed to 26.6 mills as a result of the City's adopted budget of October 11, 2012. Your bill has been revised to reflect this rate. No interest penalty will be added to the INCREASE if your taxes are paid in full by 02/01/2013. *Additional owner(s): C/O R T KNAUFF City of New London Tax Collector P.O. Box 1305 New London CT 063201305 Phone: (860) 447-5208 12/18/12 Account description NON REGMV FISHERS ISLAND FERRY DIST PO BOX H FISHERS ISLAND NY 06390 40404 040404 Legal Description WATER ST REVISED ACCOUNT PERSONAL PROPERTY TAX YEAR BASE TAX 11 2 RVPP 30.65 1 -2 3oo.66 Total Due 331.31 STATEMENT PENALTY/INT OTHER +/- TOTAL DUE .00 .00 30.65 .00 .00 300.66 .00 .00 331.31 The mill rate has been changed to 26.6 mills as a result of he City's adopted budget of October 11, 2012. Your bill has been revised to reflect this rate. No interest penalty will be added to the INCREASE if your taxes are paid in full by 02/01/2013. Any prior years tax balances must be paid in full before payments can be applied to this bill. FISHERS ISLAND FERRY DISTRICT IrENDOR 003371 CITY OF NEW LONDON 01/15/2013 CHECK 927 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.100 27360-0912A QTRLY WATER USG-9/12 B/~L 139.11 TOTAL 139.11 Town of Southold, New York - Payment Voucher [Vendor No. 3371 Check No. Vendor Tax ID Number or Social Securib' Number Vendor Name City of New London/Dept. of Public Otilitia$ Vendor Telephone Number 860-447-5222 Vendor Conlact Number Date ~'~'1 ~5~C .-~( 11/6/2012 Total Discount $139.11 i $139.111 Payee Certification The undersigned (Claimam) (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 Towm is exempt are excluded. Vendor Address P.O. Box 4127 Woburn, MA 01888-4127 Net Purchase Order ~mount Claimed Number $139.11 $139.11 Entered by Audit Date JAN 1 5 2013 Town Clerk -- Descriplion of Goods or Ser~4ccs Quarterly Water Usage NL Terrnlnal 6126/12 to 9/24/12 We shorted this payment on 12/41t2 check #842 should have Been $404.43 General Ledger Fund and Account Number SM$710.4.000.100 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities there&have been verified with the exceptions or discrepancies noted, and payracnt is approved Signature ~"~- Title Compan5 Name /~'/ Date Title Date STATE ST, FOOT OF Last Bill Amount $277.45 Payments $-277 45 Adjustments $0.00 Balance Forward $0.00 7360 06-01 11/06/12 12/06/12 Last Payment Amount $277.45 Last Payment Date 9/04/12 Service Period Meter Reads - From To Days Meter Number Multiplier Units Current Previous Usage 6/26/12 9/24112 90 60421510 1.000 CF 138300 132600 ~700 Service Description Consumption Charge Total Water CUST FACILITY CHARGE 2.02 Water CUBIC FEET 5,700.00 95.36 Water REPLACEMNT FUND SURC 5,700.00 15.68 TOTAL WATER SERVICE 113.06 CUST FACILITY CHARGE 14.12 CUBIC FEET 5,700.00 178.77 TOTAL SEWER SERVICE Sewer Sewer Fire Service FIRE SERVICE 4" 10/01/12 1/01/13 Total Current Charges Balance Forward Total Amount Due 98.48 192.89 9848 404.43 .00 404.43 PLEASE DETACH AND RETURN BOTTOM PORT ON W TH YOUR PAYMENT City of New London Department of Public Utilities 120 Broad Street New London, CT 06320 TEMP-RETURN SERVICE REQUESTED Phone: (860) 447-5222 Make checks payable to: City of New London FISHERS ISLAND FERRY DISTRICT PO BOX H 'l~J~'~ FISHERS ISLAND NY 06390-0607 39337-27360 STATE ST, FOOT OF TOTAL CURRENT CHARGES $404.43 BALANCE FORWARD $0.00 TOTAL AMOUNT DUE $404.43 000039337000027360000000404430 Remit to: hl,, l,lpl,mlCU hlhlllmP,lll,llllqllql,lll,Ull,lll,,I CITY OF NEW LONDON DEPARTMENT OF PUBLIC UTILITIES PO BOX 4127 WOBURN MA 01888-4127 Vendor No. Tow of Southold, Ney York - Payment Voucher 3371 Vendor Tax"lD Number or Social Security Nut,ocr Venl/or Address P.O. Box 4127 Vendor Name Woburn, MA 01888-4t27 City of New London/Dept. of Public Utilities Vendor Telephone Number 860-447-5222 Entered by Audit Date Vendor Contact Invoice Invoic~ lnvoic~ I Net Purchase Order Number Data Total i Discount offnouat Claimed Number D~scription of Goods or Services 111612012 $277.45~I $277.45 Quarterly Water Usage NL Terminal 6/26/12 to 9124/12 i $277.451 $277.45 Town Clerk General Ledger Fund and Account Number 8M5710.4,000.100 Payee Certification 'Uae undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is h*ue and correct, that no part has been paid, except as therdn stated, that the balance therein stated is actually due and owing, and that taxes from which the To,va is exempt are exclud, ed. Signature Title Company Name Date Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have ~ verified with the exceptions or discrepancies noted, and payment is approved. Signature Title Date 't New London Public Utilities Proudly operated by 120 Broad St ~ New London, CT 06320 860-447-5222 V~OUA December 18, 2012 FISHERS ISLAND FERRY DISTRICT PO BOX 607 FISHERS ISLAND NY 06390 DELINQUENT BALANCE: $139.11 Service Location: 5 WATERFRONT PARK Account Number (numero de la cuenta): 39337-27360 REMINDER NOTICE This is a reminder that your account is overdue. If we do not receive payment within ten (10) business days, we xvill be fomed to apply additional collection procedures. Payments may be made in person at 120 Broad Street in New London or mailed to: City of New London Department of Public Utilities P.O. Box 4127 Woburn, MA 01888-4127 If you have already mailed your payment, please disregard this notice. Thank you. City of New London Department of Public Utilities .UT4J, a~L~ 201~ 1:24PM CITY OF NEW LONDON Account History - Combined Inquiry No. 1795 11/03/13 13:04:03 Customer ID: 39337 Name: FISHERS ISLAND FERRY DISTRICT L~cation ID: 27360 Addr: 5 WATERFRONT PARK Cycle/route . . : 06 01 Amount due Initiation date . : 4/21/05 Pending ......... Termination date : Customer/location status Type options, press Enter. 5=Display Trn Opt Xl~e LB PMT - 30 ADJ 29 ADJ - 28 ADJ BL BILL LB PMT BL BILL LB PMT Tzn/Due Description Da~e Cancel Comment 12/10/12 DSHORT 12101299 12/08/12 3% FIRE INT. INSIDE 12/08/12 .3% SW INT. INSIDE 12/08/12 3% WA INT, INSIDE 11/05/12 .CYCLE BILL 9/04/12 CFOSTER 09041299 8/01/12CYCLE BILL 5/29/12 DSHORT 05291299 A 139.11 .00 F3=Exit F§=Adjustments F10=Ch&nge view FT=Pending FiX=Payments Tm/Pry Reference Running Amount Date/Num Balance 277.45- 139,11 2.95 11/06/12 416.56 5.79 11/06/12 413.61 3.39 11/06/12 407.82 404.43 11/06/12 404.43 277.45- .00 277.45 8/02/12 277.45 196.10- .00 More... FS=Charges F9=Print history F12=Cancel F14=More keys FISItERS ISLAND FERRY DISTRICT VENDOR 003441 CME ASSOCIATES ENGINEERING 01/15/2013 CHECK 928 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5709.2.000.200 876 ASSESSMENT OF STORM DMG 543.75 TOTAL 543.75 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social SccuriV/Number Vendor Address P.O. Box 849 Vendor Name Woodstock, CT 06281 CME Assoc. Eng. & Land Surveying PLLC Vendor Telephone Number 860-928-7848 Vendor Contact Check No. Entered by Audit Date JAN 1 5 2013 Invoice 876 Number Date Total Discount Tow'P. C erk ~ · $843.78 Net Amount Claimed $843.78 General Ledger Fund and Account Number Purchase Order IAssessment of Storm Damage Number Description of Goods or Services 11/30/20t 2 SM5709.2.000.200 $843.?s $543.78 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby ceftin, that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Signature ~' Title Company Name Date Department Certification I hereby ceftin/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 Invoice The Fishers Island Ferry District AU.n: Tom Doherty PO Box H Fishers Island, NY 06390 CME Assoc., Eng, Land Surveying & Arch PO Box 849 Woodstock, CT 06281 Tel: 860-928-7848 ~ Fax: 860-928-7846 www.cmeengineering.com November 30, 2012 Project No: 2012863.002 Invoice No: 000000000876 Project 2012863.002 FI Ferry District - Damage Assmt, Airpor Professional services provided for airpor~ site review and inspection with Ocean and Coastal Consultants of damage caused by Hurricane Sandy 11/20/2012. Profession.al Services from November 01. 2012 to November 30. 2017 Phase 01 Fee TERMS: NET 15 DAYS Assessment of Storm Damage Total this Phase Total this Invoice 543.75 $543.75 $543.75 FISHERS ISLAND FERRY DISTRICT VENDOR 006155 FEDEX 01/15/2013 CHECK 929 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 SM .5610.4.000.000 SM .5710.4.000.000 2-107-67877 2-107-67877 2-107-67877 AIRBILLS-PAYROLL,WARRANT 195.71 AIRPORT PAC~3~GE 26.30 CREDIT-PKG NOT FIFD 51.21- TOTAL 170.80 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Name Fedex Vendor Telephone Number 800422-1147 Vendor Co~tact Vendor Address P.O. Box 371461 Pittsburgh, PA t 5250-7461 Vendor No. 6155 Check No. Entered by Audit Date JAN 1 5 2013 Town Clerk C~ Invoice Invoice Invoice Number Dale Total Discount Description of Goods or Seivices General Ledger Fund and Account Number 2-107.07877 1211012012 $195.71 Airbil|s-Payroll,Wa rrant $M67t0.4.000.000 $26.30 2-107-67877 2-107-67877 t 211012012 Net Purchase Order Amount Claimed Number $195.71 $26,30 -$51.21 1~1012012 -$61,21) Airport package Package not FIFD $170.80 $170.80 Payee Certification ~ The under slgned (Claimant) (Ataing on behalf o f tbe above named claimantl does hereby cecil fy 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 ovnng, and that taxes from which the Town is exempt are excluded. Signature Compan5. Name SM5610.4.000.000 SM5710.4.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition w~thout substitution, the seivices properly performed and that the quantities lhereof have been verified with Ibe exceptions or discrepancies noted, and payment is approved Title Date Invoice Number 2-107-67877 Invoice Date '~ Account Number '~ PaBe Dec 10~ 2012 1206-0334-5 1 oi 6 FedExTax iD: 71-0427007 Billinu Address: FISHERS ISLAND FERRY DISTRICT DEB DOUCETTE PO BOX H FISHERS ISLAND NY 06390-0607 Invoice Summary Dec 10, 2012 Shiooinu 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: wwvv,fedex.com FedEx Express Services Transportation Charges 202.60 Base Discount -22.52 Special Handling Char~]es 41.93 Total Charges USD $222,0! TOTAL THIS INVOICE USD $2Z2.01 You saved $22 52 in discounts tJ~is period! Other discounts may apply. Detailed descriptions of surcharges can be located at fedex.corn Invoice Number Adjustment Request Fax to (800) 548-3020 2-107-67877 Invoice Date '~ Account Number %~ Page Dec 10~ 2012 1206-0334-5 2of6 Use this form to fax requests for adjustments due to the reasons indicated below. Requests for adjustments due to other reasons, including service failures, should be submitted by going to www.fedex.com or calling 800.622.1147. Please use multiple forms for additional requests. C Please complete all fields in black ink. o n RequestorUamel III III I IIIIII I I I II I I I I I I I I I Datel I I/I I I/I I I t a Phone I I I I-I I I I-I I I I I Fax#Il1 I-I I I I-I I I I I c t E-mail Address [~ Yes, I want to update account contact with the above ii,formation Tracking Number II I I I I I I I I I I I I I I I ~$il I I I I I I I I I I I I I I I Bill to Account I I I I I I I I I I IIIIIIIIII II I II IIIII IIIII I IIII IIIIIIIIII SAmount I I I I I Iol I I I I I I I Iol 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'11 I I I ADR -Address Correction ~J DVC- Declared Valae FIAN- Invalid Acct# INW - Incorrect Weight INS - Incorrect Service OCF - Grd Pick-up Fee OCS - Exp Pick-up Fee OV$ - Oversize Surcharge RSU- Residential Delivery PND - Pvvrshp Not Delivered SDR - Saturday Deliver C Tracking Number Code $ Amount r For all Service failures or other surcharges please use our web site www.fedex.com or call (800) 622-1147 Rerate information only (round to nearest inch) LBS L W H . I_L~I I I Ixl I I Ixl 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 II I I Ixl I I Ixl I I I . I I I II I I rxl I i ixl I i 2-107-67877 Dec 10, 2012 FedEx Express Shipment Summary By Payor Type Account Number ~ Page 1206-0334-5J 3 of 6 FedEx Express Shipments (Original) Shipper 5 16.0 116,65 31.36 -1280 135.21 Recipient 4 3.0 05.95 10.57 -9,72 86,80 Tota!;FedEx Express 9 19~0 $20Z.60 $4t.93 -$22.5z $222.01 Total This Invoice USD $222.01 Invoice Number 2-107 -67877 FedEx Express Shipment Detail By Payor Type (Original) Invoice Date Dec 10, 2012 Account Number 1206-0334-5 Page 40f6 · Fuel Surcharge FedEx has appJied a fuel surcharge of ~4C~% to this shipment · Distance Based Pricing, Zone 2 · Package sent trom: 06390 zip code Automation USAB Sender Tracking ID 875818177008 FISHERS ISLAND FERRY TERMINAL Service TyRe FedEx Priority Overnight 5 WATERFRONT PARK Package Type Customer Packaging NEW LONDON CT 06320 US Zone 02 Packages 1 Rated Weighl 10.O lbs, 4.5 kgs Fransportation Charge Delivered Nov 10, 20]2 IO:33 Fuel Surcharge Svc Area A2 Saturday Delivery Signed by C OTT[RDERG Oiscoun~ FedEx Use 031402949/0001486/ Total Charge Recipient HAM LABS INC 575 BREAD HOLLOW RD MELVILLE NY 11747 US 33.25 6.29 1500 -- USD $5121 -- Fuel Surcharge - FedEx has applied a fuel surcharge of 14 CO% to this shipment Distance Based Pricing, Zone 2 1st atternpt Nov 23, 2012 at 09:01 AM FedExhas audited this shipment for correct packages, weight, and service Any changes made are reflected in the invoice amount Automation USAB Sender Recioient Tracking ID 825071430691 G S MURPHY D WHITERENGE ATTN ACCOUNTS Service Type FedEx Standard Overnight FISHERS ISLAND FERRY TERMINAL TOWN OF SODTH OLD Package Type FedEx Pak § WATERFRONT PARK 54375 MAIN ST Zone 02 NEWIONDONCT 06320 US SOUTHOLD NY 11921 US Packages I Rated Weight 2.0 lbs, 0.9 kgs Delivered Nov 26, 2012 10:52 Transportation Cl~arge Svc Area AM Fuel Surcharge Signed by D.WHITECAVAGE Discount FedEx Use 032604022/00~1283/_ Total Charge USO 293 201 $20.62 FuelSurcharge FedExhasappliedafuelsurchargeof1350%tothisshipment Distance Based Pricing, Z~ne ? FedEx has audited this shipmentthr correctpackages, weigi~t, and service Any changes made are reflected m the invoice amount The package weighl ~xeeeds the maximum for the packagin9 ~pe, therefore, FedEx Pak was rated as Customer Packaging Automation USAB Sender Tracking IO 875071430106 G S MURPY Service Type FedEx Priority Overnight FISHERS ISLAND FERRY TERMINAL Package Type Customer Packaging 5 WATERFRONT PARK Zone 02 NEW LONDON CT 06320 US Packages 1 Rated Weight 3.0 lbs, 1.4 kgs Delivered Dec 05, 2012 11:22 Transporta6on Charge Svc Area AM Fuel Surcharge Signed by L KRUAZA Discount FedEx Use 033903430/0001486/ Total Charge Recipient MAR FIN F TOWN OF SOOTH LD 54 375 RT 25 SOUTHOLD NY 11971 US USD 25.75 313 258 Invoice Number 2-107-67877 kj Invoice Date ~j I Dec 10, 2012 Account Number "% Page 1206-0334-5J 5 o~ 6 Fuel Surcharge - FedEx has applied a fuel suroherge of 13 50% to this shipment Distance 6~sed Pricing, Zone 2 FedEx has audited this shipment for correct packages, weight, and servlce Any chm~ges made are reflected in the i~voice amount The package weight exceeds the maximum tor the packaging Wpe, therefore, FedEx Envelope w@s rated as FedEx pak Sender G S MURPHY FISHERS ISLAND FERRY TERMINAL 8 WATERFRONT PARK NEW LONDON CT 06320 US USAB 875071430717 FedEx Standard Overnight FedEx Pak 02 1.0 lbs, 0.5 kgs Dec 06, 2012 15:38 AM C.BUNCH 034001005/0001283/_ AutomaRo, Tracking ID Service Type Package Type Zone Packages Rated Weight Delivered Svc Area Signed by FedEx Use Hecinienl D WHITERANAGE TOWN OF SOUTHOLD 54375MAIN OD SOUTHOLD NY 11971 US Transportation Charge Discount Fuel Surcharge Total Charge USD · Payor: Sb!PP~ ; · Fuel Surcharge EedExhasappliedafuelsurchargeof1350%tothisshipment 18 80 188 2 28 $19.20 Automation USAB Sender Recinien! Tracking ID 875071430213 G MURPHY JOHN PWRONOWSKI Service Type FedEx Priority Overnight FISHERS ISLAND FERRY TERMINAL THOMAS SHIPYARD & REPAIR CO Package Type FedEx Envelope 5 WATERFRONT PARK 2 PERRY STREET Zone 02 NEW LONDON CT 06320 US NEW LONDON CT 06320 US Packages 1 Rated Weight N/A Delivered Dec 07, 2012 09:08 l ransportaDon Charge Svc Area A4 Fuel Surcharge Signed by M ASHI FY Discmml FedEx Use 034104717/0000186/ Total Charge USD 1875 2 13 -300 $17.88 Shipper Subtotal USD Dropped off: NOV i6, 2012 CusL ReL: NO REFERENCE ~NFOFiMATION Refit2: Automation USAD Sender Recinient Tracki~g ID 875366961373 JANICF I FOOl IA GREDON MURPHY Service Type FedEx Priori~ Overnight TOWN OF SOUTHOLD FISHERS ISLAND FERRY DISTRICT Package Type FedEx Pak 53095 ROUTE 25 FISHERS ISLAND NY 06390 US Zone 02 SOUTHOLD NY 11991 4642 US Packages 1 Rated Weight 1.0 lbs, 0.5 kgs Delivered Nov 19, 2012 09:51 Transportation Charge Svc Area PM Discount Signed by MNICK Fuel Surcharge FedEx Use 03210218~/0DR1486/_ Total Charge USD Automa0on USAB Tracking ID 875366961384 Service Type FedEx Priority Overnight Package Type FedEx Envelope Zone 02 Packages 1 Rated W~ight N/A Continaed on next page Sender DIANA WHITECAVAGE TOWN OF SOUTHOLD 53095 ROUTE 25 SOUTHOLD NY 11971 4642 US Recipient GORDON MURPHY FI FERRY DISTRICT 5 WATERFRONT PK NEW LONDON CT 06320 US $135.21 22,40 2.24 282 $ZZ.98 Invoice Number 2-107-67877 Tracking ID:875366961384 continued Invoice Date ~ Dec 10, 2012 Account Number ~ Page 1206-0334-5/ 6 of 6 Delivered Nov 23, 20T2 09:48 Transportation Charge 18.75 Svc Area A4 Fuel Surcharge 2.21 Signed by M.SEARLE Discount 3.oo __ FedEx Use 032603193/0000186/. TotaICharge USD $17-96 -- FuelSurcharge FedExhasappliedafuelsurchargeof1400%tottiisshipment Distance Based Pricing, Zone 2 FedEx has audited [his shipme.t for correct packages, weight, earl so.ice Any Changes made 8re reflected m the invmc~ amount lhe package weight exceeds ~e maximum for ~e packaging ~pe, ~erefore, F~dEx Envelope was rated as FedEx Pak. Automation USAB Se~de~r Recioient Tracking ID 801403333395 JANIC£ L FOGLIA DONALD LAMB Service Type FedEx Priority Overnight [OWN OF SOUTHOLD FISHERS ISLAND FERRY DISTRIC1 Package Type FedEx Pak 53095 ROUTE 25 FISHERS ISLAND NY 06390 US Zone 02 SOUTHOLD NY 11911-4642 US Packages 1 Rated Weight 1.0 lbs, 05 kgs Delivered Dec 03, 2012 08:50 TransportalJon Charge Svc Area PM Discount Signed by P. POLLY Fuel Surcharge FedEx Use 033502R03/0001466/_ Total Charge USD 22.40 -- 224 2.82 FueISurcharge Fed£xhasappliedafuelsurchargeoflBS0%tothisshipment Distance Based Pricing, Zone 2 J edExhas audKed this shipment for correct packages, weight, and service Any changes made are reflected in the invoice amount The package weight exceeds the maximum for the packaging type, therefore, FedEx Envelope was rated as FedEx Pak. Automa0en USAB Sender Tracki~rg ID 801403333421 DIANA WHITECAVAGE 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.O IDs, O.8 kgs Delivered Dec 06, 2012 09:23 TransporLatien Charge Svc Area A4 Discount Sig]]ed by M.RAY Fuel Surcharge FedEx Use 034002055/0001486/_ Total Charge Recipient DONALDLAMB EIFERRY DISTRICT 5WATERFRONT PK NEW LONDON CT 06320 US 22.40 2.24 272 USD $22~8 Recipient Subtotal USD ~6.80 Total FedEx Express USD $222.01 '~X NEWPackage ,o.. E×press' USAirbill '::::~, 8758 1817 7008 Date J[ *~' Account Number Your Internal Billing Reference Recipient'$ Name HOLD Weekday 4 Express Package Service rt(JT~ So.ice order has oi~agGea Please ~elect C a r elu~l¥ FedEx Rr~t Overnight dEX Pfior~y Overnight FedEx Standard 0vemight 6 Special Handling and Deliver/Signnture Options ATURDAY Deliver/ No Signature Required Direct Signature [] DP/ice 7 Payment Billm: [] ,~ [] Recipient [] 1bird Piny [~reditCar~ [] Cash/Check ~ USAirbN .... ~,.", 8750 7143 0717 Express ~"~' ~= , '~ :=N~'.~e. /?.db e .~ ~ 9'~ Sender's Name Address s,, .,%-/z,,.._ OLeamtO, '~k like p pm at fedex.com/packaging r Envelope* ~ FedEx Pak* ~ FedEx ~ FedEx ~ O~her G Special Handling and Delivmy Signature Options r.e~x ~ us Airbill Express . ..... 8750 7143 0213 ~FedEx ~] FedExPak* ~ FedEx L~ FedEx L~ Othel 6 Special Hm~ling ~d Delivery $ign~tu~ Oplio~ December 18, 2012 FISI IERS ISLAND FERRY DISTRICT PO BOX I I FISIIERS ISLAND, NY 063900607 Dear Customer: Thank you for your inquiry of December 19, 2012. Your invoice adjustment request has been proccsscd. Below is the list of invoice(s)/tracking number(s) that have been credited along with an updated balance. I[iveice Nb± Ai£bill Nb~ C£edlted B~I ~llce 2-10'/-67~77 875818177008 ~ ul.21 $0.00 Thank you for choosing FedEx. We appreciate your business and look forward to meeting your future shipping needs. Sincerely, Fedex Billim, Department Fax: 1-800-548-3020 ATTN: FROM: IJMILLERQFIFERR¥.COM Admin DATE: December 18, 2012 SUBJECT: JOB: 1599 ATTACH: Seagate_Crgstal_Reports_ActiveX_6.tif This Fax Originated From a Biscom 'Faxcom'. MEMO: ........................................................................ FISHERS ISLAND FERRY DISTRICT VENDOR 006373 FISHERS ISLAND FERRY DIST 01/15/2013 CHECK 930 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 122112 PETTY CASH 9/13-12/21/12 395.18 TOTAL 395.18 Town of Southold, New York - Payment Voucher Vendor Tdx ID Number or Social Security. Number i Vendor No. Fishem Island Ferry District -Petty Cash Account Vendor Telephone Number Vendor Contact Invoice Number Date 12121/2012 Invoice $395.18 Discount Vendor Address P.O. Box H $395.18 $395.18 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~ that the foregoing claim is true and correct, that no part bas been paid. except as therein stated, that the balance therein stated is actually Fishem Island, NY 06390 Net Purchase Order ~,mount Claimed Number $395.18 6373 I Check No. ~Audit Date JAN 1 5 2013 Clerk ~ .) · Description of Goods or Services Petty Cash Receipts 9113112-12/2 t I12 General Ledger Fund and Account Number SM5710.4.000.000 Department Certification ] hereby certi~ 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 **ith the exceptions due and owing, and that taxes from which the Town is exempt are excluded. Signature Title Company Name Date Signature Title or discrepancies noted, and payment is approved FISHERS ISLAND FERRY DISTRICT VENDOR 006374 FISHERS ISLAND WASTE F~NAGEMNT 01/15/2013 CHECK 931 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.925 3429 .75CCJYD CONSTRUCT.DEBRIS 30.00 TOTAL 30.00 Town of Southold, New York - Payment Voucher Vendor No. 6374 Vendor Tax ID Number or Social Securi~ Number FI Waste Management District Vendor Telephone Number 631-788-7456 Vendor Contact Beth Stem Invoice Invoice Number Date 3429 12/18/20 t 2 Invoice Total $30.00 Discount Vendor Address 2760 Whistler Avenue PO Box 22 Fishers Island, NY 06390-0022 $30.00 Purchase Order Number Description of Goods or Services .76 cubic yard of Construction debris $30.00 $30.00 Payee Certification Department Certification Check No. Entered by Audit Date JAN 1 5 2013 Clerk · ' "t General Ledger Fund and Account Number SMfi710.4.000.926 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 ] hereby cenif}/that thc materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved FI WASTE MANAGEMENT DISTRICT PO BOX 22 FISHERS ISLAND, NY 06390-0022 Invoice Date Invoice # 12/18/20! 2 3429 Bill To FI FERRY DRAWER H FISItERS ISLAND, NY 06360 Item Description Qty Rate Disposal date Amount CD YARD OF CD 0.75 40.00 30.00 Total 3o.oo Customer Total Balance $205.00 FISHERS ISLAND FERRY DISTRICT VENDOR 006482 PAUL J. FOLEY 01/15/2013 CHECK 932 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT SM -9060.8.000.000 SM .9060.8.000.000 SM .9060,8.000.000 G02303308 G02303308A 3234601334 REIMB RX-DEC'12 94.41 REIMB RX-JAN'13 90.63 REIM 1ST QTR STND ALONE 459.95 TOTAL 644.99 Town of Southoid, New York - Payment Voucher Vendor Tax ID Number or Social Security. Number Vendor Address 690 Williams Street New London, CT 06320 Paul J. Foley Vendor Telephone Number Vendor No. 6482 Check No. Entered by ~ Audit Date JAN 1 5 2013 Town Clerk , Invoice Invoice Invoice Net Purchase Order Number Date Total Discount ~mount Claimed Number Description of Goods or Sev,-ices General Ledger Fund and Account Number 002303308 12/t/2012 $94.41 $94.41 Anthem Retiree 8M9060.8.000.000 Prescription Plan 90% Reimbursement $104.90 less 10% ($94.4t) I Paul Foley Ck #2231 --x 90% Re. lm~rsement Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby ceni~ that the £oregoing 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 ~ ompa Name ,/ ?? Date g / Department Certification I hereby ceftin, that the materials above specified have been received by me 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 ign ture Tide Date Customer Care: 1-888-620-1747 AT 01 '001352 85306 B 7 A**3DGT PAUL J FOLEY 690 WILLIAMS ST NEW LONDON CI 06320-4132 Anthem . . Blue MedicareRx' (PDP) $205.60 01/01/2013 G0230330801 -- Payment Options For check payment or automatic withdrawal from your bank account (ACH), use the form below. For credit card payment or withholding from your SSA/RRB check, call 1-888-620-1747. Previous Balance $104.90 Payment Activity Since Last Invoice as of 11/13/2012 -$104.90 Payment. Type Date Received Amount Check Payment 11/26/2012 -$104.90 Activity Detail Transaction Type Premium Premium Amount Due . premium Month Amount JANUARY 2013 $100.70 DECEMBER 2012 $104.90 $205.60 $205.60 /'lease retain the tqp portion for your records BILLING FOR: PAUL J FOLEY DUE DATE: 01/01/2013 CT I01 Please include your Payment ID on your check or money order. Do not send cash. ~]If you would like to change your payment to automatic withdrawal from your bank account (ACH), please check this box, enclose your check payment, and see the reverse side. Blue MedicareRx-CT P.O. Box 505171 St. Louis, MO63150-5171 I I h,,,lll ,hi, II IIIIII I II Ih,I ,,I mi d, mi.hi m l II I II. I. I.Im I 20002001AG023033081010205600 Customer Care: 1-888-620-1747 AT 01 001352 85306 8 7 A**3DGT PAUL J FOLEY 690 WILLIAMS ST NEW LONDON CT 063204132 Anthem . . Blue MedicareRx' (PDP) b 205.60 I Ol/Ol/2O13 / c 23o33o8ol Payment Options For Cheek payment or automatic withdrawal from your bank account (ACH), use the form below. For credit card payment or withholding from your SSA/RRB check, call 1-888-620-1747. Previous Balance $104.90 Payment Activity Since Last Invoice as of 11/13/2012 -$104.90 Payment Type Date Received Amount Cheek Payment 11/26/2012 -$104.90 Activity De, ail $205.60 Transaction Type Premium Month_ Amount Premium JANUARY 20t3 $100.70 Premium DECEMBER 2012 $104.90 Amount Due $205.60 BE[,IJlNG FOR: PAUL G02303308 Please inclu~ ~If you would like to cha automatic withdrawal 2231 690 WILMAMS ST. 5~ 7218/2211 NEW LONDON, CT 06320 account (ACH), please ~ ..... .,~ ..~, - - - enclose your check payment, and see the St. Louis, MO 63150-5171 reverse side. ,,,111 ,hi,II I!111! I II Ih,I ,,I d d l I I~hl !1 II I II. h! 1.1~ I 20002001AGO23033081010205600 Anthem Blue MedicareRx (PDP) December 10, 2012 PREMIUM BILLING CHANGE NOTICE We previously sent a courtesy letter notifying you of some changes that you will see on your Blue MedicareRxTM (PDP) premium invoices for 2013. Enclosed is your new-look Premium Invoice for the Medicare Part D Plan year that starts on January 1, 20 / 3, and with it, we wanted to give you a friendly reminder of these changes. Beginning in December 2012, you will receive your monthly premium invoice about 15 days prior to the month of coverage. The due date will be the first of the month for each month of coverage, and is also noted on your monthly invoice. For example, your January 2013 premium invoice will be mailed to you in mid-December and will be due January 1, 2013. See the chart below for additional examples. The new schedule will continue through the entire plan year. Monthly Premium Invoice Mailed to you Payment Due to Blue Month of _ MedicareRx _ Coverage December 2012 Mid Dccember January 1, 2013 December 2012 January 2013 Mid December January 1, 2013' January 2013 February 2013 Mid January February 1,2013 February 2013 March 2013 Mid February March 1,2013 March 2013 April 2013 Mid Ma_rch April 1, 2013 April 2013 May 2013 Mid April May l, 20i3 ~May 2013 June 2013 Mid May June 1, 2013 June 2013 July 2013 Mid June July I, 2013 July 2013 August 2013 Mid July August 1,2013 August 2013 September 2013 Mid August September 1,2013 September 2013 October 2013 Mid September October 1, 2013 October 2013 November 2013 Mid October Novembcr 1,2013 November 2013 December ~5~)13 Mid November December 1, 2013 December 201'~ *Please note: Your first 2013 premium invoice will include your December 2012 premium amount and your January 2013 premium amount both qf which are due on January 1, 2013 (in addition to any unpaid balances or other activity). S2893 12102 00090291 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securg3 Number Vendor Address Vendor No. 6482 Check No. Entered by $90 Williams Street New London, CT 06320 Audit Date Paul J. Foley Vendor Tetephone Number ~! 52013 Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 3234601334 1211/2012 $459.95 $459.95 Anthem BCIBS SM9060.8.000.000 ~ Retiree Stand Alone 90% Reimbumement $511.05 Less $5t.10 , Paul Foley Ck # 2230 Quarterly 1/1/13-3/3t/13 $459.95 $459.95 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereb> cerfi~ that the materials above specified have been received by me does hereby certif~ that the foregoing claim is true and correct, that no part has m good condition without substitution, the services properl~ been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded or discrepancies noted, and payment ~s approved Company Name Date '/~'~/f~ Title ate / ~ b ~ Anthem 370 Bassctt Road INDIVIDUAL MARKET INVOICE hlllril..uIMlllllHllHrlllillq.lhlhllqli.n.l.dl BCTBSAOO~RCT1B 000132 121112 121312 PAUL d FOLEY 690 WILLIAHS ST Si necesita ayuda en espafiol para entender este documento, puede solicitarla Sill costo adicional, Bamando al nfimero de Servicio al cliente que aparece al dorso de su tarjeta de identificaci6n o en el folleto de inscrlpcibn. MEMBER NO: MEMBER; INVOICE NO: BILLING ACCT NO: 0864M20101 PAUL J FOLEY 323460153~ 7010864920101 I PRODUCT IcLAss I PERIOD COVERED I AMOUNT I MEDIGAP PLAN N,COPAY $20. 1 01/01/2015 05/51/2015 + $511;05 For plans renewing 111113, this bill reflects your rate change. TOTAL AMOUNT DUE BY JANUARY 1, 2013 ~511.05 If you have any questions regarding this invoice or your coverage with Anthem Blue Cross and Blue Shield, please call our dedicated Customer Service Unit during normal business hours, Monday through Friday. The toll free number is 1-800-633-6673 . 000999584499030500400007010864920101300323460133412121200109500000511051 DETACH AND RETURN THIS PORTION WITH PAYMENT MAKE CHECK PAYABLE TO "ANTHEM BCBS" PAUL J FOLEY 690 WILLIAMS ST NEW LONDON, CT 06320 iNVOICE NUMBER: PERIOD COVERED: MEMBER NUMBER: 0864M20101 BILLING ACCOUNT: 7010864920101 7 TOTAL AMOUNT DUE BY: JANUARY 1, 20t3 ~ $511.05 5 5234601534 01/01/2013 - 03/51/2013 INDICATE ADDRESS CHANGE BELOW: .ll..,I.r..irrlllll.lllhlHlml.mr.".lrll..llr.l.llll"l 00099958q~99 ANTHEH BLUE CROSS AND BLUE SHIELD PO BOX 1168 NENARK NJ 07101-1168 PLEASE DO NOT WR TE BELOW TH S L NE 000999584499030500400007010864920101300323460133412121200109500000511;}51 Town of Southold, New York - Payment Voucher Vendor No. 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 Invoice Invoice Net Purchase Order Number Date Total Discount Number Description of Goods or Services Check No. Entered by ~,,~ Audit Date JAN 1 5 2013 Town Clerk General Ledger Fund and Account Number G02303308 ~ 12/1/2012 $90.63 Payee Certification The undersigned (Claimant) (Acting on behalf of tbe above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded. $90.63 Signature Company Name ? .~C% ~ement Anthem Retiree Prescription Plan 90% Reimbursement $100.70 less 10% ($90.63) £ Paul Foley ~k #2231 SM9060.8.000.000 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified w/th the exceptions or discrepancies noted, and payment is approved. Signature ~ T,.e ~stomer Care: 1-888-620-1747 AT bl 001352 85306 B 7 ^**3DGT PAUL I FOLEY 690 WILLIAMS ST NEW LONDON CT 06320-4132 Anthem . Blue MedicareRx'(PDP) 01/01/2013 [ C~230330801 Payment Options For check payment or automatic withdrawal from your bank account (ACH), usc the form below. For credit card payment or withholding from your SSA/RRB check, call 1-888-620-1747. Previous Balance $104.90 Payment Activity Since Last Invoice as of 11/13/2012 -$104.90 Payment Type Date Received Amount Check Payment 11/26/2012 -$104.90 Activity Detail $205.60 ~ Premium Month Amount Premium JANUARY 2013 $100.70 Premium DECEMBER 2012 $104.90 Amount Due $205.60 m PAl.IL J. FOLEY 2231 6go WIEMAMS ST. NEW LONDON. CT 06320 f5/'~ ~'//~ $1-7z181~.11 ' Dart BILLING FOR: PAUL J 1 G02303308 Please inclu& [~lf you would like to cha automatic withdrawal g account (ACH), please ~,.~.,. ,,,~-uox, - enclose your check payment, and see the reverse side. Pay tq the ,//~ ~ .~ · ,,~ __ Order/of £1~.4x.-~l~?,~:J~lf ~. ~ [ { ~&~ ~ 0 'DoH~s ~ m: 2 2 & &? 2 k~F.m: ~.?. 30qo 2 s 2~.· 2'23s St. Louis, MO 63150-5171 II I I ,hi . II II IIII I iii I1,,I I ' ,I d~ ~lfhl fl III II, I. I I I 20002001AG023033081010205600 FISHERS ISLAND FERRY DISTRICT VENDOR .02572 JOHN FOSTER 01/15/2013 CHECK 933 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .1930.4.000.000 121712 REIM GRILLE-DMGD ON BOAT 246.55 TOTAL 246.55 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number I Vendor Address PO Box 634 Fishers Island, NY 06390 John Foster Vendor Telephone Number Vendor Contact Vendor No, Check No. Entered by Audit Date JAN 1 5 2013 Town Clerk Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Serx, ices General Ledger Fund and Account Number $246.55 $246.55 12 I~ [,:¢ 12/17/2012! $246.66i I $246.66 Payee Certification The undersigned (Claimant) (Acting on behalfo£the above named claimant) does hereby certif'z that the foregoing claim is true and correct, that no part has been paid, except as therein stated, thal the balance therein stated is actually Accident on the boat that damaged his grill SMt930.4.000.000 Department Certification I hereby certi~' that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Tow:~ is exempt are excluded /./ or discrepancies noted, and payment is approved Signature ,it,e Customer: 1371 JOHN FOSTER PO BOX 634 FISHERS ISLAND NY 06390 Home: 860-884-7725 Work: N/A Advisor: 007631-MICHAEL CANOVA Hat: RO: B260124 Cashier: 11:09-2 Date Out: 12/19/2012 OPEN TAG:K34082 IN:0923~T:l109 VIN:IFTWF31515EC61717 2005 FORD RED Est. Mileage: 33162 Delivered: 09/13/2007 Date In: 12/17/2012 OP Acct Tech Hours Complaint/Cause/Correction [ CUSTOMER PAY ] A FOCB 007631 CUSTOMER STATES: ORDER NEW GRILL. REPACED THE GRILL AS NEEDED. Parts: 1 SO 5C3Z8200BAA GRILLE ASSY - P~ADIATOR Per Unit Ext~ded Price 231.83 231.83 Total Parts: 231.83 Operation Total: 231.83 SO = Special Order Parts ................ £'OP. IPLETE ,<;ATISFACTION* * ............... Customer Pay Parts: 231.83 Customer Pay subtotal: 231.83 Customer Pay Sales Tax: 14.72 Customer Total Due: 246.55 THANI< YOU FOR YOUR BU$IiNE,%~ WE APPRECIATE YOUR PATRON.~GE AND WELCOME YOUR QUESTIONS AND SUGGESTIONS FISHERS ISLAND FERRY DISTRICT VENDOR 011557 ~ KOWALCZYK-BANKS 01/15/2013 CHECK 934 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.600 SM .5710~4.000.600 113012 JANITORIAL-NOV'12 250.00 123112 JANITORIAL-DEC'12 250.00 TOTAL 500.00 Town of Southold, New York- Pa~ucher I Vendor No 11557 Vendor Tax ID Number or Social Security Number Vendor Address P.O. Box 384 Vendor Name Fishers Island, NY 06390 Ann Kowalczyk Banks Vendor Telephone Number Vendor Contact Number Invoice $250.00 Invoice Date To!al 11/30/2012 12/31/20'12 $250.00 $500.00 Discount Net Purchase Order Amount Claimed Number $250.00! Check No. Entered by Audit Date JAN 1 5 2013 Town Clerk Deseriplion of Goods or Services Janitorial/November General Ledger Fund and Account Number SM5710.4.000.600 $250.00 Janitorial/December SM5710.4.000.600 $500.00 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~ that the foregoing claim is true and correct, that no pan has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Tow~ is exempt are excluded Department Certification I hereby certi~ that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Signature ~le ~ Signature FISHERS ISLAND FERRY DISTRICT VENDOR 011564 THOMAS KRAFT 01/15/2013 CHECK 935 FUND & ACCOUNT P.O. $ INVOICE DESCRIPTION AMOUNT SM .5710.4.000.300 SM .5710.4.000.300 SM .5710.4.000.300 SM .5710.4.000.300 10907 10907 10907 10907 MU-5210.0 GAL @3.270400 17,038.78 CT EXCISE TAX-$.5120/GAL 2,667.52 S-F COST RECOVERY .0019 9.90 LUST TA=X-$.0010/GAL 5.21 TOTAL 19,721.41 Town of Southold, New York - Paymen~'-V~her Vendor No. 11564 Vendor Tax ID Number or Social Security Number 4541 t 1778 P.O. Box 11125 Thomas Kraft dba Dime Oil Company Waterbury, CT 06703 Vendor Telephone Number 203-754-5334 Vendor Contact Invoice Invoice Net Purchase Order Date Total Discount Amount Claimed Number Description of Goods or Services Check No. q$5 Entered by Audit Date JAN 1 5 2013 General Ledger Fund and Account Number SM5710.4.000.300 lnv°ic10907 Number 12/2812012: $17,038.78 $2,667.52 $9.901 $5.21 $t7,038.78 $2,667.52 $9,90 $5.21 $19,721.41 $19,721.4t 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 Tow~ is exempt are excluded Signature ~__~'~'~ Title ~'~----- Compa% Name ,,~,~ Date MUNN-5210,0 Gals~3.270400 CT Excise Tax - $.5120/gal S-F Cost Recovery .0019 LUST Tax - $.00101gal 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 10907 Fishers Island F~rr¥ ' ~.5 Waterfront Pk-~unnataWket State ~treet New London, CT 06320- K Factor: 0.000 Last Delv:08/~8/~ Ig5-ex83-strait-follow signe~St· RR Tracks to Term · ,~* ---- Taxes~ $o.~0019 $0.~120 $o.oolo DIME OIL COMPANY, LLC P.O. BOX 11125 TMST WATERBURY, CT 06703 (203) 754-5334 .~/22/12 GALLONS ,o C~ C, fL Ch, FISHERS ISLAND FERRY DISTRICT VENDOR 011738 DONALD LAMB 01/15/2013 CHECK 936 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT SM .5710,4.000.000 9040530 REIMB.CROSS SOUND FERRY 108.12 TOTAL 108.12 Town of Southold, New York - Payment Voucher Vendor Tax D Number or Social Securdy Number Vendor Address PO Box 73 Fishem Island, NY 06390 Donald Lamb Vendor Telephone Number Vendor Contact Number 0040530 Invoice Invoice Date Total Discount $108.12 1t/20/20t2 $108.12i $108.12 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is tree and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually Vendor No. 11738 Net Purchase Order Amount Claimed Number Description of Goods or Services I~cI m [P- $108.12 Cross Sound Ferry Check No. Entered by Audit Date JAN 1 5 2013 Town Clerk General Ledger Fund and Account Number SM5710.4.000.000 Department Certification ] hereby certi~ that the materials above specified have been received b5 me in good condition without substitution~ the services properly performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. Signature Title Company Name Date Signature Title or discrepancies noted, and payment is approved ,/th Reservation Check In Document hups://www.longislandferry, com/Common/ReservationChecldnDoc.a... e-Ticket Confirmation This is NOT a Boarding Pass. This document with transaction number and barcode(s) must be printed and presented at the ferry terminal upon check in. Cross Sound Ferry Transaction Number is: 9040530 7ontact Information 3ONALD LAMB ~.O. BOX 73 FISHERS ISLAND NY 06390 Payment Type: 1. Visa Departure Info: 9040530 Qty. Ticket Length I MD AUTO 18 F 9040530 Qty. Ticket Length 1 MD AUTO 18 F terms and Conditions: Ferry service provided by Cross Sound is subject to the following terms and :onditions, in addition to any terms and conditions printed on any ticket, or specified an Cross Sound's website. To the extent there is a conflict between the Terms and Conditions and information printed on the ticket or posted on Cross Sound's website, Iht following Terms and Conditions shall govern. By purchasing a ticket or accepting ferry transportation, thc customer agrees to be bound by all of the following Terms and Conditions: Arrive Early: It is strongly recommended that you arrive at our ferry dock at least thirty (30) mintues in advance of scheduled departure time. Please allow ample time for unanticipated traffic delays, parking, issuance of tickets and boarding the ferry. rickets are not sold or issued on any of the ferries. I of 3 11/20/2012 6:46 AM Rcscrvat.;-on Check In Document https://www.longislandferry, confCommon/ReservationChccklnDoc.a... 30 Minute Rule: All vehicles over 20 feet in lenght or 7 feet in width or any vehicle :owing a trailer and motorcycles must arrive and have boarding passes in hand at least 30 minutes prior to departure time or your reservation will be cancelled and you will >e placed on standby. 15 Minute Rule: Standard size vchicles less than 20 feet in length and 7 feet in width must arrive and have boarding passes in hand at least 15 minutes prior to departure ;ime or your reservation will be cancelled and you will be placed on standby. 10 Minute Rule: Tickets for individuals not traveling with vehicles must be issued ten qO) minutes prior to your scheduled sailing time or your space will be forfeited. Priority Service: Priority service reservations arriving at least 20 minutes prior to ~eparture time will be loaded onto the vessel and depart the vessel upon arrival as :arly as possible. Priority service reservations will be permitted to arrive at the ferry Ierminal until 10 minutes before departure time but will lose priority boarding/departing status. Reservations: Your reservation conlLrmation, along with a photo ID, must be presented upon arrival in order for tickets to be issued. Reservation availability is based on the length and width provided when booking a reservation. Cross Sound reserves the right to deny passage or place on a different ferry any vehicle that is :eater in size than what was specified on the reservation. 'naccompanied Minors: Cross Sound reserves the right not to accept any passenger under the age of 18 years, unless accompanied by an adult. Pets: Pets are allowed in approved pet carriers or on leashes in designated areas on our auto ferries. Pets are not permitted on the passenger seats. Pets must be in approved pet carriers on the Sea Jet (high speed ferry). Security: All passengers, vehicles, baggage, personal items and freight may be subject to search and inspection prior to boarding and at any time while onboard the vessel. Passengers who refuse to consent to a search may be denied passage. In accordance with Department of Homeland Security Regulations, intoxicated or disorderly persons are considered security risks and w'dl be denied passage and/or arrested. Cross Sound reserves the right to deny passage to anyone it deems a safety or security risk. Customer Cancellation Policy: All cancellations will be assessed a $5 processing fee }er vehicle, per direction. Same day cancellations made prior to departure times will ~e assessed $15 late cancellation fee per vehicle per direction. Unused reservations or those not cancelled prior to departure time will be subject to forfeiture of the entire amount. Customers must contact the Cross Sound ticket office before their reservation departure time for changes, refunds, or credits. Change Policy: Changes to departure dates or times should be made at least two hours prior to sailing and are subject to availability and other restrictions. Unused reservations or those not cancelled prior to departure time will be subject to forfeiture 2 of 3 11/20/2012 6:46 AM Reservation Check In Document https://www.longislandferry, com/Con~non/ReservationChecklnDoc.a... )fthe entire amount. Reservations are non-transferable. Fares are subject to change md Cross Sound reserves the right to re-price a reservation that is changed after it was )riginally booked. Dangerous Cargo: No dangerous goods/cargo or firearms may be brought on board Mthout the permission of Cross Sound. Dangerous goods must bc declared at the time )f booking and upon arrival at the ferry terminal and can only be transported in a gehicle. No dangerous goods or firearms may be carried by a foot-passenger. If in toubt as to whether items qualify as dangerous goods, please ask us before travel or >oarding may be refused. If you are carrying these items with our permission, you nust report such to a Cross Sound Ferry employee at check in. ~ustomer Safety: Customers shall at all times follow and carry out all lawful directions of the Captain, the Mate andor crew members of the vessel, particularly in relation to (but not limited to) personal sal~ty of themselves, the crew, or other passengers. Delays or Cancellation: Cross Sound does not guarantee that its ferries will depart or arrive at the time stated on the schedule and crossing times may vary. Cross Sound at its sole and absolute discretion, reserves the right to change or cancel any scheduled trip and/or substitute a vessel without notice or liability. If a trip is cancelled by Cross Sound, tickets may be fully refunded or exchanged for a different trip, subject to availability. Cross Sound Ferry will not be responsible for any addkional expenses incurred by a customer as a result of any change, delay or cancellation. Please call the Cross Sound office at 860-443-5281 or 631-323-2525 for changes, cancellations, group sales and general information. Forum Selection: Any suit or action arising out of or relating to this agreement shall only be instituted in the state court of Suffolk County, New York or in the U. S. District Court for the Eastem District of New York. Each customer agrees to personal urisdiction of either such court and waives any objection he/she may have to venue herein. Limitations: Cross Sound's liability for loss or damage to vehicle or personal property is limited to $1,000. Cross Sound shall not liable for any loss or damage to vehicles or ~ersonal property, or for personal injuries, illness or death, unless written notice is ~ven to Cross Sound within 6 months of the date of the occurrence, and suits on all Isuch claims shall not be maintainable unless filed within 1 year after the date of the injury, event, illness or death Severability: If any provision herein shall be held to be invalid, illegal or unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby and shall remain valid, legal and 2nforceable to the fullest extent permitted by law. l'hank you for choosing Eross Sound Ferry Services 3 of 3 11/20/2012 6:46 AM FISHERS ISLAND FERRY DISTRICT VENDOR 011745 LAND, SEA & AIR CONSULT & TEST 01/15/2013 CHECK 937 FI/ND & ACCOUNT P, O. # IA~VOICE DESCRIPTION AMOUNT SM .5710.4.000.000 SM .5710.4.000.000 SM .5710.4.000.000 237-1112 237-1112 237-1212 DRUG TEST-J.HANEY 11/1 57.00 DRUG TEST-R,BURNS 11/6 57.00 SUPERVISORY DRUG TRAINNG 210.00 TOTAL 324.00 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address 2%1482752 510 Route 109 Vendor Name North Lindenhurst, NY 11757 Land Sea and Air Consulting & Testing Vendor Telephone Number 631-225-3060 Vendor Contact Invoice Number Date Vendor No. 11 ?45 Check No. Entered by Audit Date JAN 1 5 ~013 Invoice Total Discount $57.00 $57.00 Net Purchase Order Amount$5?.00Claimed Number $57.00 Description of Goods or Services Predrug Haney Jonathan itl Predrug Burns Ronald il]W General Ledger Fund and Account Number 8M5710.4.000,000 SM5710.4.000.000 12/6120t2 $210.00 $210.00 Supervisory Drug Training SM5710.4.000.000 $324.00 $324.00! Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~/that the foregoing claim is true and correcL 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 Tom is exempt are excluded Department Certification I hereb~r cer~ifi: 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 Corn pan.'. Name Date Signature Title ! / - 12/06/12 IRS # 112966699 FISHER'S, ISLAND FERRY ATT; NINA SCHMIDT PO BOX H FISHER'S ISL~dYD,CT 06390 ~-S~%~nt Page: ~u~ SEA & AIR MEDIC~ REVIEW 910 RO~E 109 LINDE~ST, NY 11757 Tel: 6312253060 Acct: 10000328 /CO Tel: 860/442-0165 1 Date Diag Ref C.P.T Qt Patient name AR P1 Amt Bal 11/15/12 SUPTRAIN6 20-FISHER'S ISL~R~D, F 0 210.00 210~00 Regular Total: $ 210.00 Provider: OFFSITE Operator: PP 12/06/12 IRS # 27-1482752 Itemized Statement Page: 1 LAND SEA AND AIR CONSULTING &TES[ 910 ROUTE 109 LINDENHURST, NY 11757 Tel: 6312253060 FISHER'S, ISLAND FERRY ATT; NINA SCHMIDT PO BOX H FISHER'S ISLAND,CT 06390 Acct: 20000328 /CO Tel: 860/442-0165 Date Diag Ref C.P.T Qt Patient name AR P1 Amt Bal 11/06/12 PREDRUGT1 139-BURNS, RONALD O 57.00 57.00 11/01/12 PREDRUGT1 140-HANEY, JONATHAN 0 57.00 57.00 Regular Total: $ 114.00 Provider: OFFSITE Operator: PP FISHERS ISLAND FERRY DISTRICT VENDOR 013054 MAPLE PRINT SERVICES, INC. 01/15/2013 CHECK 938 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5711.4.000.000 1827 (1000)NO DRIVER TAGS 158.00 TOTAL 158.00 Town of Southoid, New York - Payment Voucher Vendor No 13054 Vendor Tax ID Number or Social Securies Number 286 Rt. 12, Suite 699 Groton, CT 06340 Maple Print Services, Inc. Vendor Telephone Number 860-381-6470 Vendor Contact Invoice Total $188.00 Invoice Invoice Number Date t827 12/27/2012 Net ~mount Claimed $158.00 Purchase Order Number Description of Goods or Services .o Driver Tags (i 6(4~ $158.00 $158.00 Check No, Entered by Audit Date JAN ! 5 2013 Payee Certification The undersigned (Claimant) (Acting on behalf oftbe above named claimant) does hereby certifi:, that the foregoing claim is true and correct, that no parr has been paid. except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the To~n is exempt are excluded Signature ~ Title Company' Name ~'.p Date ? / ~'~///~'~ Town Clerk Title Date. Department Certification [ hereby certi$ tbat lhe 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. SM6711.4.000.000 General Ledger Fund and Account Number M~ple Print Services Inc. 25,5 Rt. 12 Suite 699 Groton, CT 06340 Invoice Invoice No. 1827 Bill To: Fishers Island Ferry Fishers Island, N.Y. 06390 Date 12/27/12 - - REP P.O. Number I Terms I DUel 2/27/1Date2 Item Description Quantity Amount Printing No Driver Tags (Yellow) 1,000 158.00 Thank You!!! - Total $158.00 Date: 12-7-12 Services, lnc. PROOF APPROVAL Order #:. 1827 Customer Name: FI Ferry Job Description: no driver tags yellow no slits Proof#: I827-1 PLEASE READ CAREFULLY BEFORE REVIEWING PROOF This proof is submitted for careful review and inspection for cuts, spelling, dates, ruling placement and text. CHECK ENTIRE FORM CAREFULLY, NOT JUST AREAS CHANGED, especially names, addresses and technical terms. Kindly make notes below of errors, if any, that exist. Corrections due to our errors will be made at no charge and another proof sent. Changes made from original copy will be charged as customer alterations on a time and material basis and will appear as a separate charge on your invoice. This w~l becolne our copy from which to print. The proof is made on paper suitable (or proofing purposes and not necessarily on stock or sizes to be used on your order. Occasionally, electronic files will output differently on various equipment. Colors here may therefore be simulated. Please verify order specifications and consult a Pantone color book, if necessary. ,//Please check appropriate box, sign, date, and fax to: 866.822.3663 ~' as Submitted [] OK with Changes Noted [] Send a Revised Proof Your Signature: ~e~_~_~ .-~'~'~"'"'-~ Date: ~'~ ///&-- Note: We, the printers, re-g3-~ that may occur tbrc, ugt'~ production undetected, but cam-lot be held responsible if work i,~inted per customer's proof approval, or changes are communicated verball~ Your signature relieves the printer of ANY and ALL prepress error liability. Changes (if needed to be made): OK APPLIES TO ENTIRE FORM, NOT rUST CHANGED AREAS mapleprintservices(Ocomcast.net 860.381.5470 866.822.3663 ~x FISItERS ISLAND FERRY D1S1R1CT VENDOR 013567 JOHN MORGAN 01/15/2013 CHECK 939 FI/ND & ACCOLVNT P.O. # INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 SM .5710.4.000.000 120512 REIM 301.2MI@.555/MI 167.16 120512 REIM TOLL-CONFERENCE 16.00 TOTAL 183.16 Town of Southold, New York - Pa~ ~ment Voucher Vendor Tax ID Number or Social Security Number Vendor Address Total John Morgan Vendor Telephone Number Vendor Contact Number Date $t67.16 88 Spicer Avenue, Rear Groton, CT 06340 Net Purchase Order Amount$167.t6ClaimedN umber $16.001 Vendor No. Check No. ~ Entered by .~ Audit Date JAN 1 15 2013 Town Clerk ~ Description of Goods or Services 301.2 miles * .566 Tollto conference General Ledger Fund and Account Number SM5710.4.000.000 $16.00 SM5710.4.000.000 $183.16 $183.16 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named c~nn~ does hereby certify that the foregoing claim is tree and correct, that no part has 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 been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes thom which the Town is exempt are excluded Compan:~ Name ~' p~ Date Mileage Reimbursement Form Name: , Date Miles Destination Purpose ~ %'1 .... Total miles per mile = I~,'-1.0(,, × date www,BusinessFormTemplate.com FISHERS ISLAND FERRY DISTRICT VENDOR 013945 GORDON MURPHY 01/15/2013 CHECK 940 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT SM ,5709.2.000.200 SM .5709.2.000.200 SM .5711.4.000.000 121712 121712 121712 REIM SHELVING NLT 53.16 REIMB BLUE TRACK FI 1.98 REIMB OFFICE SUPPLIES FI 21.26 TOTAL 76.40 · Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securdy Number Gordon Murphy Vendor Telephone Number Vendor Address P.O, Box 607 Fishers Island, NY 06390 Vendor Contact Invoice I Invoice ~ Invoice Number Date Total $53.16 $1.98 $21.261 Discount Net Purchase Order ~.mount Claimed Number $53.16 $1.98 $21.26 -- -- CheckNo. qq0 , Vendor No. 13945 Description of Goods or Services Shelving NLT BlueTrack FI ce Supplies FI Entered by Audit Date JAN 1 5 2013 General Ledger Fund and Account Number SM6709.2.000.200 SM5709.2.000.200 SM5711.4.000.000 $76.40 $76.40 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 t~~ I'itle Company Name Department Certification 1 hereby certi~ that the materials above specified have been received by me or discrepancies noted, and payment is approved 7igt ~;ture~~ GSMurphy F; FD Expense Reimbursement 12/17/2012 Office Equipment Sheliving(NLT) $ 53.16 Home Depot BlueTack (FIO) ~; 1,98 Home Depot USBcable(FIO) $ 21.26 Staples Total $ 76.40 Gordon S~U~phy /~ Dor~a'l'd L Lamb Low prices. Every item. Every day. 292 US ROUTE 1 New London, CT 06320 (860) 439-1872 SALE1352894 4 002 63453 0187 12/15/12 03:08 YOUlt OPINION COUNTS AND (JILL BF REVIEWED BY THIS STORE'S MANAGER! Please take a short survey and be entered into a montq]y drawing for a $5,000 Stap]es gif[ card. NO PURCHASE NECESSARY, Log on to ~wmStapleeCares.com or call 1--800-881-1123 Your survey code: OlO1 4859 5402 1716 See store for rules. Survey code expires 12/22/2012, ***Tome nuestra encuesta eq Espa~o) en ]a Pcgina de Internet o pot telefono. Consiga las reglas eR la tienda.,m, QTY SKU PRICE REWARDS NUMBER 1998025421 SPLS 6Fl USB EXTEN 718103124560 SUBTOTAL Standard Tax 6.35% ~ TOTAL 19.99 19~99 1.27 $21.28 Debit Tender: Card No.: XXXXXXXXXXXg028 [SI Auth No.: 182244 21.26 I"OTA L ITEMS 1 816 HARTI:ORi:, rl'K 'f:di JOHN COURNO'FEIL 6215 000sa 2012~ (;i./1%/t2 f)2,]4 PM OASHIER SEI.F CHh)]K ,)II 'jI OIb~ 7360190011327 COl,Il.all4 ;: MINI DEC,DI;A r {./F , ;)~1~ l IMm k 259.97 0716912211)]:3 Sl.tl].l ~.~. 10"X48" '~H]:rl ;lIE ~0 2~,7.76 Ih.b2 716~1181125 XI41 I'l,t.~m'. -;, 06~2.95 17.70 71691220466 25' ',71ir mill 25" WHITE I'kfiN Ub~,h, 'IH:lin]Ill 3~4.76 i.I 2;'. 05~15036835 20")Z' SCOTCH I~I_UE ):~3' :FiNItR¢ 2t)gO ~6.58 077027005004 GE Yt) ~ ~ .:,~ A- 3 GE SILIm;QNE Il ~.)FI. EAR ~0 TOSS-IN CI:;:Em):i;OiE ~;~lv~ 70798~120tl el_d{~ H [;4 ,~ 0226240641i.q SI?J. I~[iil =A 800 DEGREE I.All X {[I I:';I VI:W{ 5iAI 07239700346:9 5" ROUI{) IHE .-:A> ACURZTE RI) hEItl4 ~/ M,]UNT[NG ~K{ AUTH CODE 6215 53 21)[?} 12/{':,/2(11;? 9Z42 REPJRN P,:~I. ICY ],1 F INIT IONS POLICY Fl;, IFA'/; I::01 If;Y EXPI]RES (~N A I )1 ) ()3/15/20] 3 THE HOME OEPOi Rl:;.>q!3 IHE R:~GHI lfJ LIMIT / {){~IW I.:}:l'lJN,j] PII]ASE SEE IliL BUY ONLZIAI: I{D:~ ;~1:: [I,I ::.TONE AVAILABLE 1'Auw ON -IorEDl'Pof.ceM CONVENIENT. I:&s/ %1[, HiisI ORDI:R: READY [N I.E;S I-IAi'] 2 tim)tJRf;f COMPAFtl-J~, S;~II <;IF>]iNiON FISHERS ISLAND FERRY DISTRICT VENDOR 016659 PRINCIPAL LIFE GROUP 01/15/2013 CHECK 941 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 H19730-1-01/13 LIFE PREM 1/1/13-1/31/13 121.04 TOTAL 121.04 ~05hh~,: ha 00~50~ ii,' Town of Southold, New York - Payment Voucher Vendor No. 16659 Entered by ~) Audit Date JAN 1 5 2013 Town Clerk ~ Vendor Tax ID Number or Social Security Number Principal Life Group Vendor Telephone Number 800-lN3-1371 Vendor Address P.O. Box 14,513 Des Moines, IA 50306-3513 Vendor Contact Number Invoice Date Invoice Total Purchase Order Number Discount Description of Goods or Sen, ices General Ledger Fund and Account Number H19730-1 ~12/17/2012 $121.04 Life Prem SM9060.8.000.000 } 111113-1131113 Net Amount Claimed $121.04 i $121.041 , $121.04 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~r 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 Compan5 Name ff Date Department Certification I hereby certi~' that tbe 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 ~J £inancia/ Group Principal Financial Group Des Moines, IA 50392-0001 Principal Life Insurance Company PREMIUM STATEMENT Account Number 001417 FISHERS ISLAND FERRY ATTN J MILLER 261 TRUMBELL DR BOX 607 FISHERS ISLAND NY 06390 H19730-1 Lb. No. 0819730 00001 93 Due Date 01/01/13 ~mtDate 12/17/12 Billing Period 01/01/13 - 01/31/13 $ 235.59 PLEASE REVIEW ALL MESSAGES BELOW. THEY CONTAIN INFORMATION RELATED TO YOUR PREMIUM PAYMENTS AND THE ADMINISTRATION OF YOUR PLAN. IF YOU HAVE QUESTIONS REGARDING ANY CF THESE MESSAGES, PLEASE CONTACi US AT THE NUMBER LIbTED BELUW. IT IS IMPORTANT TO REPORT NEW ENROLLMENTS, TERMINATIONS, AND CHANGES IN DEPENDENT STATUS PROMPTLY TO OUR WEBSITE AT WWW.PRINCIPAL.CDM OR NOTIFY OUR ADMINISTRATION AREA. WEB REPORTING REOUIRES A PIN. IF YOU DO NOT HAVE A PIN, PLEASE CALL 800-821-6280. 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: 1-800-843-1371 NOTICE--TO AVOID DISCONTINUANCE DF YOUR PLAN. PLEASE BE SURE YOUR $114.55 BALANCE IS PAID AND RECEIVED IN THIS OFFICE BEFORE THE GRACE PERIOD ENDS ON 12/31/12. IF YOU HAVE PAID, PLEASE DISREGARD THIS NOTICE. PROVIDING YOU WITH GOOD SERVICE IS IMPORTANT. PLEASE REVIEW YOUR STATEMENT EACH MONTH TO ENSURE PROMPT AND ACCURATE CLAIM PAYMENT. IMPORTANT NOTICE: PLEASE REVIEW THE STATUS OF CURRENT DISABLEDS AND DETERMINE IF THERE IS A NEED TD FILE FOR WAIVER OF PREMIUM. FILING MUST BE COMPLETED WITHIN 12 MONTHS OF THE DATE DF DISABILITY OR CLAIM PAYMENT COULD BE IMPACTED. Group THZS tS YOUR COPY. Principal Financial Group Principal Life Des Moines, IA 50392-0002 Insurance Company PLEASE KEEP FOR YOUR RECORDS. PREMZUM STATEMENT This statement in r~o way changes the contract or waives any overdue payment ACCOUNT NO. H19730-1 FISHERS I!;LAND FERRY LB. NO. 0819730 OOOO1 93 DUE DATE: O1/O1/13 STMT DATE: 12/17/12 CHARGE/ ID NUMBER NANE LIFE/AD&D BNFT PEEN CRED[T 6,49 TOTAL ANT DUE 235,59 FOR ASSISTANCE, PLEASE CALL TOLL FREE: 1-8OO-843-1371 F396GP-4 O1/O1/2013 000 000000 O00000 C6S631623521148082001002 0003598 002 OF 002 ACCOUNT NO, FISHERS ISLAND FERRY DISTRICT VENDOR 016735 JAMES PRZYBOROWSKI 01/15/2013 CHECK 942 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5709.2.000.200 010213 SOUTH RAMP-EMRGCY RPR 4,410.00 TOTAL 4,410.00 Town of Southold, New York - Payment Voucher Vendor No. 16735 Vendor Tax ID Number or Social Securi~ Number 31 Chestnut Hill Road Przyborowski/James DBA Jim Ski Construction Colchester, CT 06416 Vendor Telephone Number 860-334-3974 Vendor Contact Invoice Invoice invoice Net Purchase Order Number Date lotat Discount Amount Claime( Number {~ t {.~) 5 1/2/20t3 $4,410.00 $4,410.00 South Ramp Repair $4,410.00 $4,410.00 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does herebjr ceftin, that the foregoing claim is true and correct, that no part has been paid, except as therein staled, that the balance therein stated is actually Check No. Entered by ~,~ Audit Date JAN 1 5 2013 Description of Goods or Services General Ledger Fund and Account Number SM6709.2.000.200 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. Company Name ~'~/,~ Date or discrepancies noted, and payment is approved Title Date From the desk of'. Jim ski Construction chestnut h~] rd. Colchester ct. 06413 Call (860)3~4-3974 Fax (860) 5~7-8~00 Complete Site Work/Road Work/Land Clearing/General Contracting 1/2/2013 Bill to: Fishers Island Ferry Scope of work; south ramp repair 12/28q2/29/2012 1. Cut asphalt outline to be excavated and remove 2. Exploratory excavate 3. Line excavated area with geotextfle fabric 4. Backfill with stone and compact, wrap stone completely with fabric 5. Top dressing with 6" procc. Gravel 6. Topped side area with cold patch Scope of work has been completed amount due= $2,500.00 Materials used; 10 yds stone3 yds processed 13 yds total @ $120.00 py ~ $1,560.00 Fabric $350.00 Scope of work : $2,500.00 Total amount due: $4,410.00 Jimskiconstruction. com FISHERS ISLAND FERRY DISTRICT VENDOR 019275 RADACK'S RAPID LOCK & DOOR SVC 01/15/2013 CHECK 943 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.000 122495 (3)KEYS 8.25 TOTAL 8.25 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number 57-1206216 Vendor Name -Radaek~ Rapid Lock & Door Service Incorporated Vendor Telephone Number 860-443.6143 Vendor Contact Vendor Address 82 Boston Post Road Waterford, CT 06385 I Vendor No. 19275 Check No. ~ Entered by .~ Audit Date JAN 1 5 2013 invoice Invoice Invoice Net ] Purchase Order Number Date Total Discount Amount Claimed] Number Description of Goods or Services General Ledger Fund and Account Number $8.25 $8.28: $8.25 122495 1212612012; $8.25 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby ceftin, that the foregoing claim is true and correct, that no pan has been paid, except as therein stated, that the balance therein stated is act ual]y due and owing, and that taxes from which the Town is exempt are excluded SM57t0.2.000.000 Department Certification [ hereby certif~r that the materials above specified have been received by me ~n 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 i~.1~ 82 Boston Post Rd. Fisher's Island Ferry Box H Fishers Island, NY 06390 VENDOR # I 019275 CONTRACTOR LICENSE #: 611218 I:I~;I)ERAI, E[N #: 57-1206216 PO NO. I Phone 860 442 0165 Fax 860 443 6851 Invoice # 122495 DATE 12/26/12 DUE DAIE I/5/13 TERMS Net 10 days Serviced Description 12/19/12 WORK ORDERED BY STEVE Cost 2.75 Total 8.25 82 Boston Post Rd. Suite 3 PHONE: 860-443-6143 TOTAL Waterford, CT 06385 FAX: 860-444-8723 E-MAIL: Rapidlock@rocketmail.com Balance Due Finance charges will be added to all overdue balances at 1.5% per momh $8.25 Sales Tax (6.35%) $o.oo $8.25 $8.25 F1SIfERS ISLAND FERRY DISTRICT VENDOR 014022 RING'S END, INC 01/15/2013 CHECK 944 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.000 443245 PAINT 135.96 TOTAL 135.96 Town of Southold, New York - Payment Voucher Vendor No. 14022 Vendor Tax ID Number or Social SecuriW Number Vendor Address PO BOX 714 Niantic, CT 06357 RING'S END Vendor Telephone Number Check No. Entered by ~ Audit Date JAN 1 5 2013 860-739-5441 Invoice i Invoice invoice Net: Purchase Order I Number Date Total Discount ~,mount Claimed! Number Description of Goods or Services] General Ledger Fund and Account Number 443245 t2/t9/2012 $135.96 $135.96 iPaint I SM5710.2.000.000 I $t 35.96 $135.96 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~ that the foregoing claim is true and correct, that no par[ has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Department Certification I hereby cer[i fy that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quanfifies thereo£have been verified with the exceptions or discrepancies noted, and paymen! is approved Title Date . Page # 1 Bethel, CT Branford, CT Darien, CT Lewisboro, NY (203) 797-1212 (203) 488-3551 (203) 655-2525 (914) 533-2517 308 South Frontage Road (800) 797-6511 (866) 758-3551 (800) 390-1000 (888) 533-2517 New London CT 06385 New London, CT New Milford, CT N~antic, CT Wilton, CT T: 860-439-0155 (860) 439-0155 (860) 355-5566 (860) 739-5441 (203) 761-1000 F; 860-439-1368 (866) 439-0155 (888) 350-8966 (800) 303-6526 (866) 842-7883 STO. Charge Invoice * * * THANK YOU FOR SHOPPING RING'S END * * * New London, CT B~LL TO: BM~ TO: FISH~RS ISLJLND FERRY DIS P.O. BOX H FISHERS ISLAND NY 06390 860-442-0165 CUSTOMER TRANSACTION CODE DATE NUMB~ I ~ME PUR~ASE ORDER NUMBER SALESPERSON EFISHIS 12/19/2012 ~3~4~ 1~:i6 STEVE 275 - Matthew Davis ORIGINAL APPLY TO ORDER DA~E ORDIQ~E NO~ TERMS TAX JURisDiCTION 0 443245 2% Date Based Discount 6.35% - CT SALES TAX ITEM O~FROT¥ SHIP OTY LOC ~i~iNG UNIT PRICING PER UOM NE~AM~NT P22080i 4 4 URETHANE ALKYD GLOSS SAFETY'' NH G 4,001 33.990/EACH 135,96 RECEIVED IN GOOD CONDITION ~yi SEE REVERSE SIDE FOR TERMS AND CONDITIONS MISC SALES REMAINING INVOICE NET AMT CHARGE FREIOHT TAX DEPOSIT , TOTAL X 135.9( 0.0( 0.00 135.9( CUSTOMER COPY The following terms and conditions govern the sales of The Seller, whether pursuant to oral or written orders to its representatives or saJespeople. RETURNED GOODS Stock items, in original units or full packages, will be accepted for credit or exchange when returned in good condition. Within 30 days of I~.'chase, AND ACCOMPANIED BY ORIGINAL SALES TICKET. A restocking charge will be assessed by the Seller on all returned goods. No special orders~will be accepted for return or credit. TAXES Buyer shall pay to Seller the amount of any and all taxes, excises or other charges which Seller may be required to pay or to collect for any government, national, state or local, upon, or measured by the production, sale transportation, delivery or use of the merchandise sold hereunder. FORCE MAJEURE Delay in delivery or non-delivery in whole or in part by Seller shall not be a breach of this sale if performance is made impracticable by the occurrence of any one or more of the following contingencies, the non-occurrence of which is a basic assumption on which the agreement is made: la) Fires, Floods, or other casualties; lb) Wars, Riots, Civil Commotion, Embargoes, governmental regulations or martial law; (c) Seller's inability to obtain necessary materials (finished or otherwise) from its usual sources of Supply; (d) Shortage of cars or trucks or delays in transit; (e) Existing or future strikes or other labor troubles affecting production or shipment, whether involving employees of Seller or employees of others and regardless of responsibility or fault on the part of the employer; and {f) Other contingencies of manufacture or shipment, whether or not of a class or kind mentioned herein and not reasonably within Seller's control. WARRANTY Seller agrees that any merchandise delivered hereunder found to be defective in material or workmanship will be repaired or replaced by the Seller without additional charge for the merchandise. This warranty is made in lieu of any other warranties or conditions including merchantability or f tness for a part cu ar purpose. The remedies under this warranty are exclusive and by accepting this merchandise the Buyer agree~s to these conditions and waives any other warranties conditions expressed or implied. All claims for damaged or defective material must be made w th n 5 days and we are limited to the purchase price of the materials sold or the replacement thereof at our option. We are not responsible for extra costs, indirect damages or consequential damages. Buyer assumes all risk and liability with respect to results obtained by the use of such merchandise whether used alone or in a combination with other products. No claims of any kind whatsoever, whether based on breach of warranty, the alleged negligence of seller, or otherwise, with respect to merchandise delivered or for failure to deliver any merchandise shall be greater in amount than the purchase price hereunder of the merchandise in respect of which damages are claimed; and failure of buyer to give written notice claim within 30 days after delivery of merchandise shall constitute a waiver of buyer of all claims with respect to such merchandise. TERMS AND CONDITIONS TO GOVERN THIS INVOICE CONSTITUTES THE ENTIRE CONTRACT WTH RESPECT TO THE SALE AND PURCHASE OF THE MERCHANDISE SPECIFIED HEREIN. No modification of this sale shal~ be effected by the acceptance or acknowledgement of purchase order forms specifying different conditions, and no modifications shall be effective unless in writing signed by the party claimed to be bound thereby. STATE OF JURISDICTION This sale shall be deemed to have been made in, and shall be construed in accordance with the laws of the State shown in the Seller's address. DELIVERY AND ACCEPTANCE OF TITLE OF GOODS Title to the materials shall pass from the Seller to Buyer upon delivery thereof to Buyer or his agent and thereafter shall be Buyer's [isk. Claims for shortages, breakages or for any nonconformance with the terms and conditions of the order shall be noted on the Seller's delivery receipt by the Buyer at the time of delivery, otherwise, the Seller shall not be responsible for any such claims. If delivery is by common carrier, delivery by the Seller to the carrier at point of origin shall constitute delivery to the Buyer and thereafter the shipment shall be at Buyer's risk, and claims for loss or damage must be filed by the Buyer against the carrier. Title to goods loaded onto Buyer's conveyance at Seller's warehouse passes to the buyer at the Seller's loading dock. If upon delivery at job site, there is not present at the job site an employee of the Buyer authorized to accept delivery and sign a delivery document evidencing delivery of materials as listed on this invoice document, then the Seller reserves the right to deposit the material at the delivery area previously designated by the Buyer without obtaining a signed receipt therefore, and the Buyer agrees to liability for payment of this invoice as if it were signed by an authorized employee of the Buyer, unless the Buyer has previously instructed the Seller not to deposit material at the designated delivery area without obtaining a signed delivery receipt from an authorized employee of the Buyer. FINANCE All bills are payable on the 15th of the month following billing date and are past due after 30 days. Past due accounts are subject to a FINANCE CHARGE of I 114% PER MONTH on the past due unpaid balance (which is an ANNUAL PERCENTAGE of 15%). MATERIALS SAFETY DATA SHEETS (MSDS) The occupational safety and Health Administration Hazard Communication Standard, the Superfund Amendments and Reauthorizatipn Act of 1986 and many state right-to-know laws require that a material safety data sheet (MSDS) be provided with products containing ~azardous chemicals. As a manufacturer, importer or distributor, you are required by law to ascertain which of your products require an accompanying MSDS and provide such. As a condition of this sale, you expressly warrant that you will comply with the provisions of the foregoing right-to-know-laws. HAZARD COMMUNICATION LABEL Alkaline Copper Quaternary (ACQ) Pressure Treated Wood Hazard warnings for treated wood are similar to those for untreated woQd. Airborne wood dust can cause respiratory eye, and skin irritation. Breathing excessive amounts of treated or untreated wood dust pr mar y hardwood) has been associated with nasal cancer in some industries. · Handling may cause splinters. · High airborne levels of wood dust may burn rapidly in the air when exposed to an ignition source. · Some forms of components of the liquid preservative used to manufacture this product (arsenic and chromium) have caused lung, skin, and possibly other cancers in humans occupationally or environmentally overexposed. SUCH EXPOSURES HAVE NOT OCCURRED WITH TREATED WOOD. NOTE: Consult the Material Safety Data Sheet for additional information on this product. This Information is designed to address the label requirements of the OSHA Hazard Communication Standard with respect to treated lumber. DELIVERY All deliveries are priced and understood to be on a first floor/tailboard delivery basis. ~,RING'S END) o\< 5e~ X i REMIT TO: P. O. BOX 714 Niantic, CT 06357 PAYMENTS AJqD CREDITS RECEIVED ON OR AFTER THE 25TH MAY BE SHOWN ON YOUR NEXT STATEMENT CUSTOMER CODE STATEMENT DATE EFISHIS / 114742 12/31/2012 FISHERS ISLJ~ND FERRY DIS P.O. BOX H FISHERS ISLAND, NY 06390 FOR BILLING INQUIRIES PLEASE CALL: 860-739-5441 MAKE CHECKS PAYABLE TO: RING'S END, INC. THE NEXT CLOSING WILL BE ON: JANUARY 31, 2013 TRANS DATE 12/07/2012 12/19/2012 12/27/2012 12/27/2012 859 PAYMENT 443245 INVOICE 882 PAYMENT 122712 FIN CHRG ORIG. TRA~S AMT -12.74 135.96 -120.79 -0.16 0.00 135.96 0.00 0.00 CUST PO/JOB N~4E STEVE PREVIOUS BAI,ANCE ] CURRENT CHARGES 133.69[ 135.96 C~RRENT 96 135 . 30 DAYS 0.00 CURRENT CREDITS 0.00 If-you pay by 01/15/13, Deduct 60 DAYS 0.00 CURRENT PAYMENTS FINANCE CHARGE AMOUNT DUE -133.53 ~0,16 135.96 / 2.72 Page 1 All bills are payable on the 10Lb o£ the month roi [owing billing date and are past due after 30 days. Past due accounts are subject to a FIN~3NCE CHftRGE //£ 1 1/4% i~ER MON'[N orl the past duc unpaid balance ANNUAL PERCENTAGE }lATE OF 15%. FISHERS ISLAND FERRY DISTRICT VENDOR 019794 JOHN STANFORD 01/15/2013 CHECK 945 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5709.2.000.200 12 PLOWING-NL 12/29,12/30 600.00 TOTAL 600.00 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number John S. Stanford Vendor Address 8 Burdick Road Preston, CT 06366 Vendor No. 19794 Vendor Telephone Number 860-908-2194 Vendor Contact Invoice Number Description of Goods or Services Net Purchase Order Amount Claimer Number $600.00 $600.00 Invoice Invoice $600.00 Date Total Discount t/t/2013 $600.00 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded. Signature ~~ Title / t Plowing/Clean up NL 12/29/12 & t2/30112 Check No. Entered by Audit Date JAN 1 5 2013 Town Clerk General Ledger Fund and Account Number SM6709.2.000.200 Department Certification I hereby certify that the materials above specified have been received by me tn good condition without substitution, the services properly performed and that the quantities thereof have been verified with the excepnons or discrepancies noted, and payment ~s approved Title Date . ohn S Stanford 8 Burdick Rd Preston Phone: 860 908 2194 Fax: 860 859 1/// Emaih js32ryder~sbo]lobal,net Ct 06365 Date: ~nvoice Number: PO Number: Due Date: Shipping Method: 1/1/2013 12 1/31/2013 Billing Address Fishers Lsland Ferry District 5 Waterfront Par~ New London, Ct 06320 Shipping Address Fishers Island Ferry District 5 Waterfront Park New London, Ct 06320 Snow Removal Plowing of lot on 12,/2912 of 3 in. and plowing of lot on 12j30/of 2in. 2 300 600.00 Customer Note: SubTo~l: Tax: Totel: 600.00 0.00 600.00 FISHERS ISLAND FERRY DISTRICT VENDOR 019719 STAPLES CREDIT PI~%N 01/15/2013 CHECK 946 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT SM SM SM SM SM SM SM 5710.4.000.500 5711.4.000.000 5711.4.000.000 5711.4.000.000 5711.4.000.000 5711.4.000.000 5711.4.000.000 16930 HARD DRIVE 74.99 16930 NL OFFICE SUPPLIES 95.31 29874 NL OFFICE SUPPLIES 273.34 3624575001 FI OFFICE SUPPLIES 48.94 3624575002 FI OFFICE SUPPLIES 15.98 3751615001 FI OFFICE SUPPLIES 110.66 3751615002 FI OFFICE SUPPLIES 34.99 TOTAL 654.21 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securiiy Number Vendor Address PO Box 414524 Vendor Name Boston, MA 02241-4524 Staples Contract & Commercial, Inc. Vendor Telephone Number 866-996-8103 Vendor Contact Invoice Number i Vendor No. 19719 Invoice Date Total Net Amount Claim Purchase Order Number Check No. Entered by x~ Audit Date JAN 1 5 2013 (,~- :fown Clerk 16930 11/1512012 $95.31 NL Office Supplies SM5711.4.000.000 j 29874 11/2012012 $273.34; $273.34 NL Office Supplies SM5711.4.000.000 ,-/ 3751615002 12/7/2012 $3,4.99 $34.99 FI Office Supplies SM5711.4.000.000 3751615001 12/712012 $110.66 $110.66 FI Office Supplies SM5711.4.000.000 j $654.21~ $654.21 $74.99 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify, that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing and that taxes from which the Towm is exempt are excluded Signature ~ _ Title ~'~ /? $74.99 $95.3t Hard Drive SM5710.4.000.500 .~ Department Certification hereby certi~ 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 ~s approved Signature Title Discount 3624575002 11/9/2012 $15.98 $15.98 Office Supplies 8M5711.4.000.000 ,,,/ 3624575001 t119/2012 $48.94 $48.94 FI Office Supplies SM6711.4,000.000 J 16930 11/1512012 Description of Goods or Services 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 ISLJ~ND FERRY DISTRICT I~1 DEB DOUCETTE Floor: 1 261 TRUMBULL DR FISHERS ISLA/qD, NY 063908021 Contact: (631) 788-7463 - DEB DOUCETTE REFER ~O TRIg ORDER NO. FOR ALL INQUIRIES 4051825224 112/07 '12 I 9234751615-000001 SHIPPING LOCATION:Putnam, CT FC CARRISR ROUTE:UPS/UPS /U2 Coupons and other adju~ 2ments are deducted after the Merchandise Total. On large orders some b~ xes may be arriving in separate shipments. 772994 HP 940XL CYAN INK J /C4907AN#140 772995 HP 940XL BLK INK ~ /C4906A~#140 772997 HP 940XL YEL INK / /C4909AN#140 772998 HP 940XL MAG~/ /C4908Alq~140 The following are shi ed from an alternate warehouse via UPS. They should arrive no later than 12/12/12 ~ 950846 MEDIUM ROAST VARIetY PACK KCUP/15727-048 D Check your order online by going to www. Staples.com and clickinc "My 25.19 25.19 35.09 35.09 25.19 25..19 25.19 25.19 total 34.99 .00 110.66 .00 .00 Need to return something? Please call Customer Service to process a return. OF ORDER: 110.66 Thank You For Your Order! Staples, Inc. THIS IS NOT AN 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 ISLAND FERRY DISTRICT tSl DEB DOUCETTE Floor: 1 261 TRUMBULL DR FISHERS ISLA~rD~ NY 063908021 Contact: (631) 788-7463 DEB DOUCETTE Order Date: 12/07/2012 SHIPPING LOCATION: Florida Fulfilment Center CARRIER ROUTE:UPS/UPS TOT3J~ PACKAGES: /U2 Coupons and other adjustments are deducted after the Merchandise Tota¢ 950846 MEDIUM ROAST VARIETY PACK KCUP/15727-048/ EA 1 1 M -=rc] .andise Total ....... E~li, ery ................ Check your order status online by going to www. Staples.com and clicking on "My Orders". ~ Need to return something? Please 34 . 99 34 . 99 33.99 .00 .00 oo: Thank You For Your Order.' Staples, Inc. THIS IS ?[JOF AN INVOICE that was easy~ ACcount Statemen( ~ Customer Service: staples,accountonline, com []Account Inquiries: 1~800-767-1291 Fax 1-801-779-7425 iAccount Number: 6035517820657673 Summary of Account Activity Previous Balance $772.76 Payments -$446.01 Credits -$0.00 Pumhases +$654.21 Debits +$0.00 FINANCE CHARGES +$0.00 Late Fees +$0.00 New Balance $980.96 Sera:l NoSce et' Bliqg Errors and Customer Sewlce Inc~ries to: STAPLES CREDIT PLAN no Box 790449, St. Louis, MO 63179-o449 -- ~ : ANb4.JrlONS Payment tnformatior~ Current Due Past Due Amount Minimum Payment Due Payment Due Date $41.00 + $0.00 = $41.00 01/03~3 Credit Line Credit Available Closing Date Next Closing Date Days in B ng Period $10,500 $9,374 12/09/12 01/09/13 31 Trans Date Location,~.cription PAYMENTS, CREDITS, FEES AND ADJUSTMENTS $ 4894 $ 15.98 $ 170.30 $ 273.34 $ 110.66 $ 34g9 P919400NKOgMZ3GSV $ 446.01 ; ,~iI,NC ~ CHARG'. ~UMMAP. Y -- Type of Bale~ce PURCHASES REGULAR REVOLVING CREDIT PLAN Annual Percentage Rate (APR) Your Annual Percentage Rare (APR) is the annual interest rate on your accounl. Daily Periodic Balance Subject to Rate Finance Charge Finance Charge 0.00% 0.00000% $0.00 $0.00 NOTICE: SEE REVERSE SIDE FOR IMPORTANT rNFORMATION Page 1 of 6 This Account is Issued by Citibank, N.A. that was easy: INVOICE DETAIL BILL TO: AccE 6035 5178 2065 7673 SHIP TO: DEB DOUCETTE FISHERS ISLAND FERRY 261 TRUMBULL DR FISHERS ISLAND, NY 0O000 0000 PRODUCT SKU # Amount Due: Trans Date: $15.98 11/09/12 invoice #: 3624575002 PO: l Store: 100088887, PUTNAM QUANTITY UNIT PRICE TOTAL PRICE 13 MINI MNTH WALL/ERASE 6 000755772 Purchased by: GORDON MURPHY 2 0000 EA $7.99 $15 98 SUBTOTAL $15.98 TAX $0.00 SHIPPING $0 (30 TOTAL $15.98 BILL TO: Acct: 6035 5176 2065 7673 SHIP TO: DES DOUCETTE FISHERS ISLAND FERRY 261 TRUMBULL DR F~SHERS ISLAND, NY o0~00~0000 PRODUCT SKU # Amount Due: Trans Date: $48.94 11/o9/12 IRvoice #: PO: I Store: 100088887, PUTNAM QUAN'RTY UNIT PRICE TOTAL PRICE STAPLES WRE LETTER TRAY B 000119909 STAPLES ECON GRD TP 6PK C 000467431 13 DESK PAD CALENDAR 22X1 000645491 Purchased by: GORDON MURPHY 20000 EA $5.49 $10.98 1.0000 PK $7.99 $7.99 3.0000 EA $9.99 $29.97 SUBTOTAL $48.94 TAX $8.00 SHIPPING $0.00 TOTAL $48.94 BILL TO: Accl: 6035 5178 20~5 7673 SHIP TO: FISHER ISLAND FERRY DIST PO BOX H FISHERS ISLAND, NY 0639~0607 f p~n~nt Due: $17030 11/15/12 I Store: NEW LONDON 100001872, PRODUCT SKU# QUANTITY SEAGATE INT 500GB SATA HA 678927 IRVOiCe #: 16930 2013 ATAGLNC BUSINESS 15x 446675 SONY 5OPK DVD+R SPINDLE 564107 2013 MNTH ATAGLNC WALL 15 922302 #t0 ENV P&S SEC 20LB 25PK 862858 5TAB HANG FLDR LTR ASST 2 875411 1 YREXT REPLACEMENT $60-99 423435 5TAB HANG FLDR LTR ASST 2 875411 UNIT PRICE TOTAL PRICE 1.0000EA $74.99 $74.99 1.0000EA $1699 $16.99 1.0000EA $19.99 $19.99 1.0000EA $1&99 $1599 I O000EA $1.99 $199 1.0000EA $10.79 $1079 1.0000EA $18.00 $18.00 I O000EA $10.79 $1079 SUBTOTAL $159.53 TAX $10.77 SHIPPING $0.00 TOTAL $17030 BILL TO: Acct: 603551782065 7673 SHIP TO: FISHER ISLAND FERRY DIST PO BOX H FISHERS ISLAND, NY 06390~O607 PRODUCT SKU # mount Due: $273.34 Trans Date: 11/20/12 Invoice #: 29874 I Store: 100001872, NEW LONDON QUAN'nTY UNIT PRICE TOTAL PRICE BROTHER TN620 BLACK TONER 782504 STAPLES FLAT STACK STPLR 648234 121N BEVELED WOOD RULER 164566 BROTHER LC71BKS BLACK INK 324013 8IN RECYCLED SCISSORS 384326 BROTHER LC71YS YELLOW INK 324017 INK RECYCLING LIMIT 10/MO 725137 STAPLES FUNDED COUPON 558100 3~0000 EA $85.99 $257 97 I 0000 EA $1479 $14.79 1 0000 EA $1 99 $1.99 1.0000 EA $14.99 $14.99 1.0000 EA $5.99 $5.99 1.0000 EA $9.99 $9..99 3 0000 EA $0.01 $0.03 1 0000 EA $8.0O- $8 00- ~onl~nued ~ ~. This page intentionally left blank. Page 4 of 6 1-800-767-1291 staples.accountoaline~com that was eas~ INVOICE DETAIL PRODUCT SKU # Invoice #: 29874 continued QUAN11TY UNIT PRICE TOTAL PRICE STAPLES FUNDED COUPON STAPLESFUNDEDCOUPON STAPLESFUNDEDCOUPON STAPLES FUNDED COUPON 558100 558100 558100 558100 IO000EA $40.70- $40.70- 1.CX)OOEA $0.01- $0.01- 1.0000EA $0.01- $001- 1.000OEA $001- $001- SUBTOTAL $25702 TAX $16.32 SHIPPING $000 TOTAL $273.34 BILL TO: Acer: 6035 5178 2065 7673 SHiP TO: DEB DOUCETTE FISHERS ISLAND FERRY 261 IFRUMBULL DR FISHERS ISLAND, NY 00o00-(xA30 PRODUCT SKU # Amount Due: Trans Dale: $3499 12J07/12 ~RVOJCe #; 3751615002 PO: t Store: 100088887, PUTNAM QUANTITY UNIT PRICE TOTAL PRICE MEDIUM ROAST VARIETY PACK 000950846 Purchased by: GORDON MURPHY 1 0000 EA $34.99 $34.99 SUBTOTAL $3499 TAX $0.00 SHIPPING $0.00 TOTAL $34.99 BiLL TO: AC~,I: 6035 5176 2065 7673 SHIP TO: DEB DOUCEFI E FISHERS ISLAND FERRY 261 TRUMBUI.L DR FISHERS ISLAND, NY 0000~0000 PRODUCT SKU # Amount Due: Trans Date: Invoice #: 3751615001 PO: I Store: 100088887, PUTNAM QUAN11TY UNIT PRICE TOTAL PRICE HP 94OXL CYAN INK 000772994 HP 940XL BLK INK 000772995 HP 940XL YEL INK 000772997 HP 940XL MAG 000772998 Purchased by: GORDON MURPHY 1.0000 EA $25.19 $25.19 1.0000 EA $35.09 $35 09 1 0000 EA $25.19 $25.19 1 0000 EA $25 19 $25.19 SUBTOTAL $110.66 TAX $0.00 SHIPPING $o.00 TOTAL $110.66 This page intentionally left blank. Page 6 of 6 1-80(}-767-1291 staples.accountonline.com Deb Douce~e From: Sent: To: Subject: su pport@orders.staples.com Friday, November 09, 2012 5:22 PM Deb Doucette We Received Staples Order # 9233624575 Hello, and thanks for shopping Staples. This is to confirm that your order has been received and is being processed. Order NO.: 9233624575 Customer No.: 4051825:224 Method of Payment: ST ending in 7673 Track order: Track your order Delivery address GORDON MURPHY FISHERS iSLAND FERRY DISTRICT 261 TRUMBULL DR FISHERS iSLAND, NY 06390-8021 Item 1 13 DESK PAD CALENDAR 22X1 Billing Address GORDON MURPHY FISHERS ISLAND FERRY DISTRICT 261 TRUMBULL DR FISHERS ISLAND, NY 06390- 0607 Qty. Subtotal 3 $29.97 item No.: 645491 Price: $9.99/each Expected Delivery: 11113/2012 by UPS Item 2 STAPLES ECON GRD TP 6PK C Item No.: 467431 Price: $7.99/each Expected Delivery: 11/13/2012 by UPS Item 3 13 MiNI MNTH WALL/ERASE 6 item No.: 755772 Price: $7.99/each Expected Delivery: 11/13/2012 by UPS Item 4 STAPLES WRE L~II ER TRAY B item No.: 119909 Price: $5.49/each Expected Delivery: 11/13/2012 by UPS Subtotal $7.99 Qty. Subtotal 2 $15.98 Qty. Subtotal 2 $10.98 Pentel® WO,,¥TM Retractable Ballpoint Pen, 1 mm Uedium, Black. Dozen 21~' ~22C7 I,~aski~_c -age Subtotal: Delivery: Tax: Total: $64.92 FREE Tax Exempt $64.92 Staples.corn® I Printable Order Summary Page I of 2 that was oasy~ Printable Order Summary Thank You for Your Order For complete order details like sales tax, shipping info and Software Download instructions, keep an eye out for an email from Staples at the address below. Order confirmation will be sent to: ddoucette@fiferry.com Order number 1:9233624575 ~ Order date: November 9, 2012 You'll also find complete details of this order in the Order Status section of My Account on Staples.com®. Shipping Address Gordon Murphy Fishers Island ferry District 261 Trumbull Dr Fishers Island, NY, 06390-8021 ~ (631) 788-7463 Not going to be around to receive or sign for your order? Please fill out a Driver Release Agreement: http://www.staples.com/sbd/content/help/shipping/nothome popup.html Billing Address Gordon Murphy Fishers Island ferry District 261 Trumbull Dr ~a, Fishers Island, NY, 06390-0607 (631) 788-7463 Your order may be sent in different shipments. Tf it is, no additional charges will apply. For Software Downloadf an email containing download instructions, software link(s) and activation code(s) will be sent following the email confirmation of your order. "~ Order number: 9233624575 Item [2013 House of Doolittle® Desk Pad Expected business-day iQty: 3 Price 645491 Calendar, 22" x 17" delivery: Wed 11/14 fat $9.99 $29.97 i Each Item Simply'" Economy-Grade Packaging Tape, Expected business-day Qty: 1 Price: 467431 Clear, 1.89" x 54.7 yds, 6 Roils delivery: Wed 11/14 at $7.99 $7.99 6/Pack ~ Item 2013 AT-A-GLANCE® Mini Monthly Wall Expected business-day Qty: 2 Price: 755772 Calendar, 6-1/2" x 15" delivery: Wed 11/14 !at $7.99 $15.98 I Each Item Staples® Wire-Formed Letter-Size Tray, Expected business-day !Qty: 2 Price: .119909 i Black delivery: Wed 11/14 !at $5.49 $10.98 i Letter Tray https://www.stap~es~c~m~~~ce/supp~ies/~rderc~nfPmt?cata~~g~d=~~~5~&~rderId=~6~337... 11/9/2012 Staples.corn® I Printable Order Summary Page 2 of 2 Subtotal: i $64.92 i$o.oo [Coupons: Estimated Tax: Tax Exempt Total: ! $64.92 Remaining Balance: i $64.92 Remaining Balance will be applied to following: Staples Credit Card ending in 7673 Hold on to your Staples Rebate Visa Cards and Prepaid Gift Cards until your order has been received If you have any questions or concerns about your order, please call 1-ao0-STAPLES (1-800-782-7537) or email su pport@orders.sta pies.corn Important information concerning coupons and sales tax can be found at; http://www.staples.com/salestax The tax shown is estimated. Your Order Confirmation Email will include shipment details, product availability and estimated tax. l~portant information concerning return policy can be found at'. http://www.staples.com/sbd/content/help/using/retums_policy_popup.html For complete order details like sales tax, shipping info and Software Download instructions, keep an eye out for an email from Staples at the address above. You'll also find complete details of this order in the Order Status section of My Account on Staples.corn@. Sign up to receive Staples emails with great online and in-store offers and exclusive money-saving discounts. This Web site is intended for use by US residents only. See International Sites. See our delivery policy for full details. Copyright 2012, Staples, Inc., All Rights Reserved. Questions? Call 1-800-333-3330 or email us. Site Nap I RSS Feed I AdChoices htt~s://www.stap~es.c~n~ce/supp~ies/~rderc~nfprnt?cata~gId=~5~&~rderId=~6~337... 11/9/2012 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 easyr, STAPLES that was easy FISHERS ISLAND FERRY DISTRICT 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 111/12 '12 I 9233624575-000001 SHIPPINg LOCATION:Putnam, CT FC CARRIER ROUTE:UPS/UPS /U2 TOTAL PACF~AGES: 1 PAGE: 1 Order Date: 11/09/2012 Coupons and other adju~5ments are deducted after the Merchandise Total On large orders some xes may be arriving in separate shipments. 119909 STAPLES WRE LETTER TRAY BLACK /104~5-CC 467431 STAPLES ECON GRD TP 6PK CLEAR /467431-CC 645491 13 DESK PAD CALENDAR 22X17 /HOD150HD The following are shi sd ~rom an alternate warehouse via UPS. They should arrive no later than 11/13/12 755772 13 MINE MNTH WALL/ERASE 6.tXlt/PMEt-26 Check your order status online by going to w~w. Staples.ccm and clickin( 2~ "My Ord, 2 5.49 10.98 1 7.99 7.99 3 9.99 29.97 0 7.99 .00 'otai.. 48.94 .00 .0C Need to return something? Please call Customer Service to process a return. TOTAL VALUE OF ORDER: 48 . 94 Thank You For Your Order! Staples, Inc. THIS IS NOT AN INVOICE Deb Doucette From: Sent: To: Subject: support@orders.staples.com Friday, December 07, 2012 9:47 AM Deb Doucette We Received Staples Order # 9234751615 Hello, and thanks for shopping Staples. This is to confirm that your order has been received and is being processed. Order No.: 9234751615 Customer No.: 4051525224 Method of Payment: ST ending in 7673 Track order: Track your order Delivery address GORDON MURPHY FISHERS ISLAND FERRY DISTRICT 261 TRUMBULL DR FISHERS ISLAND, NY 06390-8021 Item 1 HP 940XL CYAN INK Billing Address GORDON MURPHY FISHERS ISLAND FERRY DISTRICT 261 TRUMBULL DR FISHERS ISLAND, NY 06390- 0607 Qty. Subtotal 1 $25.19 Item No.: 772994 Price: $25.19/each Expected Delivery: 12/10/2012 by UPS Item 2 HP 940XL BLK INK Item NO,: 772995 Price: $35.09/each Expected Delivery: 12/10/2012 by UPS Item 3 HP 940XL YEL INK Item No.: 772997 Price: $25.19/each Expected Delivery: 12/10/2012 by UPS Item 4 HP 940XL MAG Item No.: 772998 Price: $25.19/each Expected Delivery: 12/10/2012 by UPS Item 5 MEDIUM ROAST VARIETY PACK Item No.: 950846 Price: $34.99/each Expected Delivery: 12/12/2012 by UPS Qty. Subtotal I $35.09 Qty. Subtotal i $25.19 Qty. Subtotal 1 $25.19 Qty. Subtotal I $34.99 · ;;&'/; Two '.',"ay Ra~ic Battery for U;A-COU PCS and others Disney Fur an... Skills Subtotal: $145.65 Delivery: FREE Tax: Tax Exempt Total: $145.65 · Your order is subject to review and the expected delivery date(s) noted above are pending credit or check approval. · Won't be there to sign for your order from 9 am to 5 pm, Iqonday Friday. Print our D~ive~ Release. Some residential orders may be delivered by UPS as late as 7 pm. · Questions about your order? Call us at 1-800 3STAPLE (1-800- 378-2753) or email us at - j.~ :. , r t t ': .... . You can also fax us at 1-800-333-3199. Our prices vary from store prices. Not responsible for typographical errors. Not all items are available. We reserve the right to limit quantities, including the right to prohibit sales to resellers. · Jif your order contains a Software Download, you will be sent an additional email with download instructions, software link(s) and activation code(s). · Thanks for Shopping Staples. Bush Westfield Right L-Bow Front Desk, Auburn Uaple/Graphite Gray Infectious waste Begs. 25 qt. Fcrk Black IOC6;Cartc¢ FISHERS ISLAND FERRY DISTRICT VENDOR 020167 TERMINIX PROCESSING CENTER 01/15/2013 CHECK 947 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5709.2.000.200 320291376 PEST CONTROL-NL 12/3/12 TOT]kL 52.11 52.11 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security. Number Vendor Name Terminix Processing Center Vendor Telephone Number 860-683-0012 Vendor Contact Number Vendor Address P.O. Box 742592 Invoice Invoice Date Tmal 1213/2012 $52.11 $52.11 Payee Certification Cincinnati, OH 45274-2592 Net Purchase Order ~,rnount Claimed Number $52.11 Check No. qq"l Vendor No. 20167 Entered by ~ Audit Date Signature Company Name Department Certification I hereby certify that the malerials above SFecifled have been received by me m good condition without substitution, the services properly performed and that the quantities thereof have been vet/fled with the exceptions or discrepancies noted, and payment is approved Title Date 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 $52.11 Discount Description of Goods or Sop, ices General Ledger Fund and Account Number 320291376 Pest ControI-NL 12/3/12 $M5709.2.000.200 JAN 1 5 2013 TEIIMII~IX · PO SOX 17167 .HEMPHIS, TN 38187 F[SHER'S ISLAND FERRY* · '~ ATTN: DEBRA DOUCETTE P0 BOX H FISHERS ISLAND NY 06390-0607 lUd,h Hdl,lhl,llll,,imlllll,u,,ImUIlU,i,M,,lllhCu EASY WAYS TO PAY YOUR TERMINIX!' INVOICE ACCOUNT INVOICE Please pay By: 12/24/2012 Total Due: $52.11 OPAY ONLINE TermimxCommercial corn PAY BY PHONE I BO0 TERMINIX i~ QUESTIONS · Local Office: 860 683 0012 · roll Free: 1800 TERMINIX your bill Is easy, especially online Just visit the "Nlanage ~ly Account" !2/[)3/2012 Work Order 11213054953 Fax Charge Location 5STATE ST/DOCK OFFICE, NEW LONDON CT 06320 320291576 $4900 DUE DATE: 12/24/2012 TOTAL DUE: $52.11 BUSINESS ~ F R SAVE REFER COLLEAGUES AND FRIENDS. SAVE ON YOUR TERI~INIX SERVICE. For each person or business you recommend who purchases an annual Terminix commercial or resJderltjaJ service, you'll Save $150 or more To learn more about Business Refer & Save, visit TermlnlxCommerclel.com or ask your Termlnlx Commercial representative. OPERATOR'S NAME & CERTIFICATION # OYL~ C 'YOST 0-41939 TEIIIWI/ilZ,, , TERMITE and PEST CONTROlr 12-12 1860)442-0165 FIS~R'5 ISLANO FERRY* STATE ST/OOC~ UFFICE NEU L~OON ,~T TARGET PES~ ~ TERNINIX INTERNATIONAl. 8-0219 42§-A HAYOE.N XI'ATI~ J~OAD WINOSOR,CT 06095 (860)&a~Ot2 ~]ILER RO,.~H 02411-C ~ ESI ~2411-¢ FOOD A~AS 024[1-C PERIflETER 02411-C REST ROO~ ~TORAt:L/UTILITY ~4ll-~ ! [..1 cd' 02411 Tri-Oie Bulk Oust ~ P,.U~ XLO FO~.II Ita~ferce FC Select hKh hi CYKCS0~ Cy-~ick cs ,~x PYRETHRI~I~ ,PBOIOX,S[LIC 499-429 C~LUTHRIN O.05X 499-304 SUPERVISOR'S COMMENTS: rlTreat for Infestation/Prevention or Inspect areas indicated. 8A~OCK, ORIAN $-§805 ~ I-- "1 ...... 0 2012 I~IETERMINIX I~r~ER~ll~PU~L COMPANY Pri~ Oala~ce,~ 49,98 Cha~ge ........ : + 47,00 Total O~e ..... = 99,96 FISHERS ISLAND FERRY DISTRICT VENDOR 020554 TORRINGTON BRUSH WORKS, INC. 01/15/2013 CHECK 948 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5709.2.000.000 0309697-IN PAINTING TOTtkL 63.20 63.20 i Vendor No. Town of Southold, New York- Paymen-m-~K~Y0-dcher 20554 Vendor Tax ID Number or Social Security Number Vendor Address 4377 Independence Ct. Vendor Name Sarasota, FL 34234 Torrington Brush Works, Inc. Vendor Telephone Number 941455-1499 Check No. Entered by .~ Audit Date JAN 1 5 2013 Town Clerk Invoice Invoice Invoice Net : Purchase Order Number Date Total Discount Amount Claimer Number Description of Goods or Services i General Ledger Fund and Accounl Number 0309697-1N 12118/2012 $63.20 $63.20 Painting SM6709.2.000.000 ; ! $63.20 i $63.20 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of tbe above named claimant) I hereby ceftin, that the materials above specified have been received by me does hereby certi~ that the foregoing claim is true and correct, that no part has m good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded, or discrepancies noted, and payment Is approved Signature ~ Title Compan.~ Name /' Date Signature Title Date Page: 1 Torrington Brush Works, Inc. 4377 InUependence Ct. Sarasota, FL 34234 9413551499 Sold To: FISHERS ISLAND FERRY DIS BOX H FERRY ISLAND, NY 06390 Invoice Invoice Number: 0309697-1N Invoice I)ate: 12/18/2012 Order Number: 0283230 Order Date 12/18/2012 Salesperson: PHON Customer Number: 0010040 Ship To: FISHER ISLAND FERRY DIS 5 WATERFRONT PARK NEW LONDON, CT 06320 Confirm To: ,3ESSIE Customer P.O. Ship VIA F.O.B. Terms UPSGROUND 1% 15 Days- Net 30 Item Number Unit Ordered Shipped Back Ordered Pdce Amount 01036 EACH 24 24 0 0.8300 303 2" CHIP BRUSH Whse: 001 01890 EACH 24 24 0 1.2300 2"WHITE BRISTLE PAINT BRUSH Whse: 001 o,,,< S-k-c- 19.92 29.52 www.facebook,¢om/torringtonbrushworks Net Invoice: Less Discount: Freight: Sales Tax: Invoice Total USD: 49.44 0.00 9.99 3.77 63,20 FISHERS ISLAND FERRY DISTRICT VENDOR 020735 TRI-TOWN ENTERPRISES, INC. 01/15/2013 CHECK 949 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5709.2.000.200 1210-120 NL TERM-SERVICE BOILERS 611.00 TOTAL 611.00 Town of Southoid, New York - Payment Voucher Vendor Tax iD Number or Social Security Number Vendor Name Tri-Town Mechanical Vendor Telephone Number 860-376-4277 Vendor Contact Vendor Address P.O. Box 427 Jewett City, CT 06351 Vendor No. 20735 Net Purchase Order Amount Claimed Number $611.00 Check No. Entered by Audit Date JAN 1 5 2013 Town Clerk Invoice ! Invoice Invoice Number Date Total Discount Description of Goods or Services General Ledger Fund and Account Number 1210-120 12/12/2012 $61t.00 NL Terminal Boiler Svc & I~ 8M6709.2.000.200 / $611.00 $611.00 Payee Certification The undersigned (Claimant) (Acting on bebolf of thc above named claimant) does hereby cerfi~ 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 o~ing, and that taxes from v, hich the Tow~ is exempt are excluded Department Certification in good condition without substitution, the services properly performed and that the quantities lhcrcof have been verified with the exceptions or discrepancies noted, and payment is approved Signature Title Tri-¥own Mechanical, LLC PO Box 247 Jewett City, Ct. 06351 (860) 376-4277 1 1-800-286-4833 Invoice December 12, 2012 Summary: SERVICE Invoice #: 1210-120 Tech: ERIC Due Date: 1/11/2013 Job Date: 12/5/2012 Bill To: Fishers Isl. Ferry PO Box H Fishers Island, NY 06390-0607 860-442-0165 Job Name: Fishers Isl. Ferrys / office New london, CT 06 L-COMANTUN M-NOZZLE M-GARBERCART M-4FO M-38FUSIBLEVLV Annual tune-up on boilers Install a oil line firomatic on ferry - per inspection Annual tune-up on commercial boiler GARBER FILTER CART. 4" Filter Cart. 3/8" STR.FIROMATIC 3.00 175.00 EA 525.00 3.00 8.00 EA 24.00 2.00 15.00 EA 30.00 1.00 7.00 EA 7.00 1.00 25.00 EA 25.00 86.00 525.00 611.00 $611.00 All material is guaranteed for one year, unless otherwises specified. All work to be completed in a professional manner according to standard practices, Due to varying differences in oil quality, nozzles, filter cartridges and labor are guaranteed for 30 days. Any alteration or deviation from above specifications involving extra costs wltl be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon delays beyond our control. Purchaser agrees to pay all costs of collection, including attorney's fees. Terms: Net 30 THANK YOU FOR YOUR BUSINESS Lic.# 0395728 Sl FISHERS ISLAND FERRY DISTRICT VENDOR 021304 ULINE 01/15/2013 CHECK 950 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4,000.000 SM .5710.4.000.000 SM .5710.4,000.000 48308762 NL SHOP 280.59 48346956 NL SHOP 68.80 51787141 EYE WASH STATIONS 977.79 1,327.18 Town of Southold, New York - Payment Voucher Vendor No. 21304 Vendor Tax ID Number or Social Security Number Vendor Address Attn: Accounts Receivable 2200 S. Lakeside Drive ULINE Waukegan, IL 60085 Vendor Telephone Number 800-295-5510 Vendor Contact Number Date Total Net Amount Claimed 51787141 12/18/2012 $977.79 $977.79 Purchase Order Number Description of Goods or Services Eye Wash Stations [NL Shop NL Shop Check No. q,50 Entered by ~.~ Audit Date JAN 1 5 2013 Town Clerk General Ledger Fund and Account Number 8M5710.4.000.000 ~" 48308762 12/24/2012 $280.59 $280.59 SM5710.4.000.000 48346956 12/2812012 $68.801 $68.80 SM5710.4.000.000 ' $1,327.18 $1,327.18 Department Certification I hereb) cert fy ha he ma trials above specified have been received by me m good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptmns or discrepancies noted, and payment is approved Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Signature Title Company Name Date Signature ~ Title ~ Date SHIPPING SUPPLY SPECIALISTS 1-800-295-5510 uline.com 2200 S Lakeside Dnve- Waukegan, IL 60085 INVOICE NO 48211751 INVOICE ULINE FED ID#: 36-3684738 THANK ¥C;U FOR YOUR ORDER ULINE CUSTOMER SINCE 2005 YOUR ORDER # 51787141 SOLD TO: SHIP TO: MDG201000020164 '~ AB 0374 Ihl,UUlllqlhl,l,h,,,l ,,ih,I,Hl, SiHI,m,h,,¢,ll,l,, FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLAND NY 06390-0607 FISHERS ISLAND FERRY DISTRICT 5 WATERFRONT PARK NEW LONDON CT 06320 U 1O082010 2461167 12/18/12 12/18/12 12/18/12 7 4 EA 2 EA 2 !EA 3 E^ H-1846 iH-2388 H-2387 S-15383 ORDER PLACED BY: RJ BURNS PAGET /I OILY WASTE CAN 6 GALLON i SECONDARY EYE WASH STATION iSINGLE EYE WASH STATION 32 0Z ~S NGLE EYE WASH STATION 16 OZ STANDARD MSDS COMPLIANCE CENTER oK I-3- 3 59.00 45.00 31.00 2600 70.o0 413.00 180,00 62.00 52.00 210.00 SUBZOTALi! SALES TAX Iir~I FRT/HNDLING AMOUNT DUE 917.00~,, .00 il 60.79 977.79 SHIPPING SLtPPLY SPECIAI. I$i'$ 1-800-295-5510 2200S. L~keside Drive Woukegc~, iL ~0085 $O~ TO: FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLAND NY 06390 YOgRORDER # 0051787141 SHIPTO: FISHERS ISLAND FERRY DISTRICT 5 WATERFRONT PD2RK NEW LONDON CT 06320 Shipment 1 of 1 2461167 RJ J.P. EXPRESS 12/18/1: 12/18/12 NET 30 DAYS 7 H-1846 4 H-1174 2 H-2388 2 H-2387 3 S-15383 your orders OILY WASTE CAN 6 GALLON SECONDARY EYE WASH STATION SINGLE EYE WASH STATION 32 0Z SINGLE EYE WASH STATION 16 OZ STAATDARD MSDS COMPLIANCE CENTE on www.uline.com/MyAccount/MyU 59.00 45.00 31.00 26.00 70.00 ine.aspx iSUB-TOTAL I SALES TA)( ] J TOIAL 917. O0 . oo/[ EXCLUDES SHIttiNG CFi~S 413.00 180.00 62.00 52.00 210.00 917.00 To: RJ BURNS From: PAGET F. ~(I/ID/ Thank you for your order. Page 1 of 1 SUPPLY SPECIALISTS 1-800-295-5510 uline corr~ INVOICE NO. ? 48308762 L INVOICE ULINE FED ID#: 36 3684738 YOUR ORDER ULINE CUSTOMER S!NC!E 2005 YOUR ORDER # 51885288 SC)LD TO MDG201000013168 1 AB 0374 FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLAND NY 06390-0~07 I~:~ FISHERS ISLAND FERRY DISTRICT 5 WATERFRONT PARK NEW LONDON CT 06320 2461167 NET 30 DAYS 12/26/12 4 EA 3 EA 5 ;EA H-1294 H-1292 H-1384BLU ULINE 50 PERSON FIRST AID KIT ULINE 10 PERSON FIRST AID KIT 28QT BLUE OFFICE RECYCLING CONT 13QT BLUE RECYCLING CONTAINER 64.00 128.00 22.00 88.00 6.75 20.25 6.50 32.50 ORDER PLACED BY: RJ BURNS : ":7:"-'% : --£:- :': ~:~::; : ':-:%?; ~; SUB-TOTAl. SALES TAX FRT/HNDLING AMOUNT DUE CSYDELL /I 268.75 .00i 11.84~ ' 280.59 SHIPPING SUPPLY SPECIALISTS 1-800-295-5510 INVOICE NO. [ DUPLICATE uline.com J 48308762 2200:5. Lal~esJde Dflve WaukeG~n, tL 6908,5 INVOICE UUNE FED ID#: 36,-36a4738 IHANK YOU FOR YOUR ORDER. UUNE CUSI'OMER rdNC;E 2005 51885288 SOLD TO: SHIP TO: FISHERS ISLA~ND FERRY DISTRICT PO BOX H FISHERS ISI~ANI) NY 06390 0607 FISHERS ISLAND FERRY DISTRICT 5 WATERFRONT PARK NEW LONDON CT 06320 2461167 RJ GROUND 12/24/12 12/26/12 NET 30 DAYS 12/26/12 2 H 1294 4 H-1292 3 H 1384BLU 5 H 1858BLU ULINE 50 PERSON FIRST AID KIT ULINE 10 PERSON FIRST AID KIT 28QT BLUE OFFICE RECYCLING CONT 13QT BLUE RECYCLING CONTAINER j' dc' · ~). ~'" 64.00 128.00 22.00 88.00 6.75 20.25 6.50 32.50 268.75 .00 11.84 280.59I ORDER PLACED BY: RJ BURNS CSYDELL MAKE CHECK PAY. A~LE AND MA~L JO: DATE: 12/28/12 ULINE Altn: Accoun~Receivable TO: RJ BURNS 2200S. Lake~cleDrive Waukegan, lL 60085 FROM: ANGIE B. SH!PC'IN~-' SUPPLY SPECIALISTS 1-800-295-5510 iNVOICE NO 48346956 INVOICE UL!NE FED ID¢~: 36-3684738 SOt D TO: 2005 YOUR ORDER # ~HiP !C 51924173 MDG201000005444 1 MB 0404 I' H,, ,qllllll.,h,qHMI.h.H,, Hm ,,ll.l,.. FISHERS ISLAND FERRY DISTRICT PO BOX H FISHERS ISLAND NY 06390-0607 FISHERS ISLAND FERRY DISTRICT 5 WATERFRONT PARK NEW LONDON CT 06320 12/28/12 12/28/12 NET 30 DAYS 12/28/12 2 H-1552 BUNG WRENCH 30.00 60.00 oF: £ ORDER PLACED BY: RJ BURNS ABYERS /I F~ ~B ~':::r~ SALES TAX FRT/HNDLING ! i AMOUN? DI~E 60.00 . ..... .00_ .... ~:80j 68.80 FISHERS ISLAND FERRY DISTRICT VENDOR 021506 UNITED PARCEL SERVICE 01/15/2013 CHECK 951 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT SM .5710,4,000,700 SM .5710.4.000.700 SM .5710~4,000.700 26639502 W/E 12/15/12(6)PKGS 114.88 26639512 W/E 12/22/12(9)PKGS 167.05 26639522 W/E 12/29/12(1)PKG 50.45 TOTAL 332.38 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securi~ Number Vendor Address Vendor Name United Parcel Service Vendor Telephone Number 800-811-1648 P.O. Box 7247-0244 Vendor No. 21506 Philadelphia, PA 19170-0001 Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number 26639502 12115/2012 $114.88 $114.88 26639512 12122/2012 $167.05 $167.05 26639522 1212912012 $50.45 $50.45 Check No. Entered by Audit Date JAN I 5 2013 Town Clerk Description &Goods or Services Genera] Ledger Fund and Account Number 12,15,12( ) cq sM5,1o.4.ooo.,oo w, 12,22,12 ,) s,,,6,1o.4.ooo.,oo w,E,2,,9,12 (,) C% s,5,1o.4.ooo.,oo Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that thc foregoing claim is true and corrcct, 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 $332.38 $332.38 Department Certification [ 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 ~s approved Signature ~'~,.~Tit]e ~ Signature ~ Compeny Name ~ ~ Date ///~/Z/? Title Date Shipped from: FISHERS ISLAND FERRY 1 STATE ST NEW LONDON, CT 06320 Delivery Service Invoice Invoice date December 15. 2012 invoice number 0000026639502 Shipper number 026639 Control ID Q179 Page 1 of 3 m 0720A00000266392 77366300012301 FP 01 076944 847781240 A**3DGT .lllll.lvl.l.qll.lql.~.lll..dlll.'llllv..~l.h,h'l.l..l. FISHER ISLAND FERRY PO BOX 607 FISHERS ISLAND, NY 0~$90 ISign up for electronic billing today! Visit ups.com/billing 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 Account Status Summary Weekly Payment Plan Amount Due This Period $114.88 Amount Outstanding (prior invoices) $ 545.64 Total Amount Outstanding $ 660.52 P~ease include the Return Portion of each outstanding invoice with your paymem. See Account Status for details. New Rates Information Effective December 31,2012, UPS Rates will change as follows: UPS Air and International Services will increase an average net 4.5% and UPS Ground Se~'ices wilt increase an average net 4.9%. To view these new rates, as well as changes to accessorial rates, visit ups.corn/rates. Thank you for using UPS. Summary of Charges Page Charge Outbound 3 UPS WorldShip $ 86.40 3 Adjustments & Other Charges $13.00 3 Fees $548 Service Charges $10.00 Amount due this period $114.88 UPS payment terms require payment of this invoice by December 26, 2012. Payments not received by January 9, 2013 me subject to a late fee of 6% of the Amount Due This Period. (Details in UPS Tariff, available at ups.corn) Note: This invoice may contain a fuel surcharge as described at ups.com. The published fuel surcharge is 8.5% for UPS Ground Services and 13.5% for UPS Air Services, UPS 3 Day Select, and International services. For more information, vfsit ups.com. Delivery Service Invoice Invoice date December 15, 2012 Invoice number 0000026639502 Shipper number 026639 Page 2 of 3 Account Status Weekly Payment Plan Payments Applied Amount Invoice Number Invoice Date Paid 0000026639442 11/03/2012 $ 52.97 0000026639452 11/10/2012 $ 49 52 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 0000026639462 11/17/2012 $ 91.34 0000026639472 11/24/2012 $ 115.76 0000026639482 12/01/2012 $ 252.55 0000026639492 12/08/2012 $ 85.99 Total $ 545.64 Outstanding balances reflect any payments received as of 12/14/2012. Please ignore this message if a recent payment has been made for any outstanding invoices. Defivery Service Invoice invoice date December 15, 2012 Invoice number 0000026639502 Shipper number 026639 Page 3 of 3 Outbound UPS WorldShi@ Pickup Pickup Number of Billed Date Record Message Codes Packages Charge 12/10 9121173891 1 21 01 12/11 9121173902 2 25.36 12/13 9121173913 2 25.76 12/14 9121173924 1 14.27 Total UPS WorldShip 6 Package(s) 8640 Total Outbound 6 Package(s) 86 40 Adjustments & Other Charges Address Corrections Number of Billed Tracking Number Service Packages Charge 1Z0266390342971938 Ground 1 11 O0 1st ret: THE BEACH PLUM FiNY 06390 2nd ret: JAMMIE 631 788 7731 Recorded: ROBIN OWEN Corrected: OWEN 8269 CHAPMAN ROAD 8289 CHAPMAN RD BOZEMAN MT 59718 BOZEMAN MT 59718 Total Address Corrections 1 Package(s) 11.00 Miscellaneous Explanation Charge WEEKLY PRINTER SERVICE FEE 200 FOR 1 PRINTERS AT $2 00 EACH FOR 14-DEC-2012 Total Miscellaneous 2.00 Total Adjustments & Other Charges 13.00 Fees WeekEnding Unpaid Billed Date Balance Hate Charge 11/17 Late Payment Fee 91.34 6.00 % 548 Pursuant to the UPS Tariff, a late payment fee has been assessed. Total Fees 5.48 076944 2/2 Shipped from: FISHERS ISLAND FERRY 1 STATE ST NEW LONDON, CT 06320 Delivery Service Invoice Invoice date December 22, 2012 Invoice number 0000026639512 Shipper number 026639 Control ID 36R0 Page 1 of 4 0720A00000266392 77366400012003 FP 01 073514 884321232 A**3DGT h,,,ll,hhl~h,hi~i,ll,llilh,,Ihi,,Iqill,~.l,hh,,Hl,! FISHER ISLAND FERRY PO BOX 607 FISHERS ISLAND, NY 06590 Sign up for electronic billing today! Visit ups.com/billing 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 7247~244 Philadelphia, PA 19170-0001 Account Status Summary Weekly Payment Plan Amount Due This Period $167.05 Amount Outstanding (prior invoices) $ 660.52 Total Amount Outstanding $ 827.57 Please include the Return Portion of each outstanding invoice with your payment See Account Status for details. New Rates Information Effective December 31,2012, UPS Rates will change as follows: UPS Air and International Services will increase an average net 4.5% and UPS Ground Services will increase an average net 4.9%. To view these new rates, as well as changes to accessorial rates, visit ups.corn/rates. Thank you for using UPS. Summary of Charges Page Charge Outbound 3 UPS WorldShip $125.83 3 Adjustments & Othar Charges $ 24.27 4 Fees $ 6.95 Service Charges $10.00 Amount due this period $167.05 UPS payment terms require payment of this invoice by January 2, 2013. Payments not received by January 16, 2013 are subject to a late fee of 6% ot the Amount Due This Period. (DelaJls in UPS Tariff, available at ups. corn) Note: This invoice may contain a fuel surcharge as described at ups.com, ine pub:?~;~d ~uet surcharge is 8.5% for UPS Ground Services and 13.5% tot UPS ~ir Services, UPS 3 Day Select, and International services. For more ;. ~torrnation, visit ups.corn. Delivery Service Invoice Invoice date December 22, 2012 invoice number 0000026639512 Shipper number 026639 Page 2 of 4 Account Status Weekly Payment Plan Amount Outstanding (prior invoices): Please include the Relum Portion of each ouLstanding invoice with your payment Balance Invoice Number Invoice Date Due 0000026639462 11/17/2012 $ 91.34 0000026639472 11/24/2012 $115.76 0000026639482 12/01/2012 $ 252.55 0000026639492 12/08/2012 $ 85.99 0000026639502 12/15/2012 $114~88 Total $ 660.52 Outstanding balances reflect any payments received as ol 12/21/2012. Please ignore this message if a recent payment has been made for any oulstanding invoices. Outbound ups WorldShilP Delivery Service Invoice Invoice date December 22, 2012 Invoice number 0000026639512 Shipper number 026639 Page 3 of 4 Pickup Pickup Date Record Message Codes Number of Packages Billed Charge 1~17 9121173935 25.46 1~18 9121173946 8O 8O 1~21 9121173950 19.57 Total UPS WorldShip 9 Package(s) 125 83 Total Outbound 9 Package(s) 125 83 Adjustments & Other Charges Address Corrections Tracking Number Service Number of Packages 1 Z0266390342925827 Ground 1st ref: KAREN LAMB FINY 06390 Recorded: KATIE SIMMONS 260 BONITA GLENN DR CHULA VISTA CA 91910 2nd ref: 631 788 7416 Corrected: KATIE SIMMONS 260 BONITA GLEN DR Floor:APT Suite:X13 CHULA VISTA CA 91910 Billed Charge 11 O0 Total Address Corrections Miscellaneous 1 package(s) 11.00 m m m m m m m m Explanation Billed Charge WEEKLY PRINTER SERVICE FEE FOR 1 PRINTERS AT $2 O0 EACH FOR 21-DEC-2012 Total Miscellaneous Residential/Commercial Adjustments UPS WorldShip 2.00 Shipped Pickup Date Record Entry Tracking Number Recorded Corrected Billed Adjustment Charge Amount 1~18 9121173946 1 1Z0266390341616038 Commercial -9.08 Residential 9 08 Residential Surcharge 255 Fuel Surcharge 0.22 1st ref: Tim Patterson FINY 06390 2nd ref: 631 788 7562 2.77 Total UPS WorldShip 1 Package(s) 2.77 Total Residential/Commercial Adjustments 1 Package(s) 2 77 Shipping Charge Corrections Learn how to avoid future shipping charge corrections Visit www ups.conVavoideharges Pickup Tracking Original Service/ ZIP Billed Adjustment Date Number Corrected Service Code Zone Weight Charge Amount 12/13 1Z0266390342488989 Ground 94941 8 Additional Handling - Not encased in cardboard 850 8.50 1st reft The Beack Plum FINY 06390 2nd ref: 631 788 7731 Sender : FISHERS ISLAND FERRY Receiver: Josh & Elizabeth Keman NEW LONDON CT 06320 MILL VALLEY CA 94941 Total Shipping Charge Corrections 1 Package(s) 8 50 Total Adjustments & Other Charges 24.27 073514 2/2 Fees Delivery Service Invoice Invoice date December 22, 2012 Invoice number 0000026639512 Shipper number 026639 Page 4 of 4 WeekEnding Unpaid Billed Date Balance Rate Charge 11/24 Late Payment Fee 115.76 6.00 % 6.95 Pursuant to the UPS Tariff, a late payment fee has been assessed. Total Fees 6.95 Shipped from: FISHERS iSLAND FERRY 1 STATE ST NEW LONDON, CT 06320 Delivery Service Invoice Invoice date December 29, 2012 Invoice number 0000026639522 Shipper number 026639 Control ID 6N00 Page 1 of 3 m 0720A00000266392 77366500009461 FP 01 056685 90618Z190 A**3DGT FZSHER ZSLAND FERRY PO BOX 607 FISHERS ZSLAND, NY 06590 ISign up for electronic billing today! Visit ups.corn/billing 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 7247~244 Philadelphia, PA 19170-0001 Account Status Summary Weekly Payment Plan Amount Due This Period $ 50.45 Amount Outstanding (prior invoices) $ 827.57 Total Amount Outstanding $ 878.02 Please include the Return Porlion of each outstanding invoice with your payment. See Account Status for details. New Rates Information Effective December 31,2012, UPS Rates will change as follows: UPS Air and International Services will increase an average net 4.5% and UPS Ground Se~ices will increase an average net 4.9%. To view these new rates, as well as changes to accessorial rates, visit ups.corn/rates. Thank you for using UPS. Summary of Charges page Charge Outbound 3 UPS WorldShip $1330 3 Adjustments & Other Charges $ 2 00 3 Fees $15.15 Service Charges $ 20.00 Amount due this period UPS payment terms require payment of this invoice by January 9, 2013. Payments not received by January 23, 2013 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 8.5% 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 December 29, 2012 invoice number 0000026639522 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 0000026639462 11/17/2012 $ 91.34 0000026639472 11/24/2012 $11576 0000026639482 12/01/2012 $ 252.55 0000026639492 12/08/2012 $ 85 99 0000026639502 12/15/2012 $114,88 0000026639512 12/22/2012 $167.05 Total $ 827.57 Outstanding balances reflect any payments received as of 12/28/2012. Please ignore this message if a recent payment has been made for any outstanding invoices. Outbound ups WorldShip Delivery Service Invoice Invoice date December 29, 2012 Invoice number 0000026639522 Shipper number 026639 Page 3of3 Pickup Pickup Number of Billed Date Record Message Codes Packages Charge 12/28 9121173961 1 1330 Total UPS WorldShip 1 Package(s) 13.30 Total Outbound 1 Package(s) 13 30 Adjustments & Other Charges Miscellaneous Billed Explanation Charge WEEKLY PRINTER SERVICE FEE 2.00 FOR 1 PRINTERS AT $2.00 EACH FOR 28-DEC~2012 Total Miscellaneous 2 O0 Total Adjustments & Other Charges 2.00 Fees WeekEnding Unpaid Billed Date Balance Rate Charge 12/01 Late Paymenl Fee 25255 6.O0 % 15 15 Pursuant to the UPS TariA a late payment fee has been assessed Total Fees 15.15 m m m m