Loading...
HomeMy WebLinkAboutGoldsmith Inlet RestorationRESOLUTION 2013-324 ADOPTED DOC ID: 8738 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2013-324 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON APRIL 23, 2013: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute the Modification Agreement Form between the Town of Southold and the New York State Department of State in connection with a no-cost extension of time extending the term of Contract #C007079 (Restoration of Goldsmith Inlet) to December 31, 2014, subject to the approval of the Town Attorney. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Louisa P. Evans, Justice SECONDER: Christopher Talbot, Councilman AYES: Dinizio Jr, Ruland, Doherty, Talbot, Evans, Russell APPENDIX X MODIFICATION AGREEMENT FORM Agency Code: 19000/DOS01 Contract No.: C007079 Contract Period: 4/1/2010 to 12/31/2014 Funding for Period: $0.00 This is an AGREEMENT between THE STATE OF NEW YORK, acting by and through thc New York State Department of State, having its principal office in Albany, New York (hereinafter referred to as the STATE), and the Town of Southold (hereinafter referred to as thc CONTRACTOR), for modification o£tbe contract number noted above, as amended herein and noted below. Type of contract modification: [] Renewal: Revised total contract value: $ .(renewals only) [] No cost time extension [] Amendment: [] Attached Appendices: All other provisions of said AGREEMENT shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this AGREEMENT as of the dates appearing under their signatures. Signature: Name:  TOR SIGNATURE ~ Signature: NYS DEPARTMENT OF STATE Title: ~,~ /~5~'/._F O ~ Title: Date: ~/ V.~. q/..~ Date: State Aeencv Ce~ifi~ti90: 'la ~ition to the acute of~is c~tmct, I al~ ceni~ that origi~l copi~ of~is signa~ ~e ~11 ~ a~ch~ to ~1 other exact ~i~ of&is c~tmct ~ State of New York ) Countyof ~ C4PP~>/~/~ )ss: On this 3q day of ~ Ci ~ , in the year 20 [~ , before me ~nally appear~ 5 fl, , to me known and known to me to be the ~n who is ~e ~ f~Or of ~ ~ ~ ~o/~ , the orga~i~tio~ descri~ th and which execumd ~e a~ve &ument; and ~at has the authority to sign on ~halfofsaid organi~tion; and that he/~ ex~ated the foregoing agreement for ~d on behalf &said organi~tion. ~UREN M. STANDISH ' No. 018T61~0~ NOTARY PUBLIC _ ATTORNEY GENERAL SIGNATURE STATE COMPTROLLER SIGNATURE Signature: Signature: Name: Name: Date: Date: DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 01/02/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT Phone: (631) 298-4700 Fax: (631) 298-3850 PRODUCER Barbara Dammers NAME: ROY H REEVE AGENCY, INC. PHONEFAX (631) 298-3850 (631) 298-4700 (A/C, No, Ext):(A/C, No): PO BOX 54 E-MAIL bdammers@royreeve.com ADDRESS: 13400 MAIN ROAD INSURER(S) AFFORDING COVERAGENAIC # MATTITUCK NY 11952 US Specialty Ins. Co. INSURER A : INSURED US Specialty Ins. Co. INSURER B : TOWN OF SOUTHOLD C/O SOUTHOLD TOWN HALL US Specialty Ins. Co. INSURER C : P.O. BOX 1179 INSURER D: SOUTHOLD NY 11971 INSURER E : INSURER F : 56559 COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDLSUBR POLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTRINSDWVD (MM/DD/YYYY)(MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY CPKG8062010901/01/1501/01/161,000,000 EACH OCCURRENCE$ A DAMAGE TO RENTED X OCCUR 1,000,000 CLAIMS-MADE $ PREMISES (Ea occurence) X $50,000. Deductible 10,000 MED. EXP (Any one person)$ Public Officials Liability X 1,000,000 PERSONAL & ADV INJURY$ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ 5,000,000 PRO- POLICYLOC 5,000,000 PRODUCTS - COMP/OP AGG$ JECT 1,000,000 OTHER:Pub Officials Liab$ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY CPKG8062010901/01/1501/01/161,000,000 C $ (Ea accident) ANY AUTOBODILY INJURY (Per person)$ X SCHEDULED ALL OWNED BODILY INJURY (Per accident)$ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS$ (per accident) AUTOS $ OCCUREACH OCCURRENCE$ XCPKG8062010901/01/1501/01/1610,000,000 UMBRELLA LIAB B 10,000,000 CLAIMS-MADEAGGREGATE$ EXCESS LIAB DEDRETENTION $$ X10,000 PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT$ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE-EA EMPLOYEE$ (Mandatory in NH) If yes, describe under E.L. DISEASE-POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re : IMA between Town of Southold & SC DPW for improvement to Goldsmith Inlet CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE County of Suffolk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Dept. of Public Works 335 Yaphank Avenue AUTHORIZED REPRESENTATIVE Yaphank, N Y 11980-9744 Attention: Barbara J. Dammers © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD