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AU-05/07/2013 Fishers Island
TOWN OF SOUTHOLD VENDOR 016545 HUNTINGTON POSTMASTER 04/30/2013 CHECK 117393 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT A .1330.4.600.400 043013 POSTAGE-2ND 1/2 REMINDER 2,395,67 TOTAL 2,395.67 Town of Southold, New York - Payment Voucher Vendor Name Vendor Telephone Number Vendor Contact /Vend°r N°' Vendor Addre$~~ Invoice Invoice Invoice Number Date Total Net Number or Services Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby cerfif~ that the foregoing claim is wac 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 ,a~--.~-O~ 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 thc exceptions or discrepancies noted, and payment is approved. ~ .Date Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address Vendor Name Postmaster Huntington Vendor Telepbone Number Vendor Contact Huntington, NY 11743 Vendor No. 16545 Invoice Invoice Invoice Number Date Total Discount 043013 4/30/2013 $2,395.67 Net Purchase Order Amount Claime( Number $2,395.67 $o.oo $0.00 $0.00 $2,395.67 $2,395.67 Payee Certification The undersigned (C!aimmn:) (Acting on behalf of the above named claimant) does hereby ceilify that the foregoing claim is true and correct, that no part has been pard, except as lherein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Signature Comp~my Name Date Title Check N°tl Entered by Audit Date 5/7/2013 Town Clerk Description of Goods or Services General Ledger Fund and Account Number Postage 2nd 1/2 Remind. A.1330.4.600.400 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 discrepm~cies noted, and pasxnent ts approved Signature Title Date Page I of 3 Whitecavage, Diana From: Cushmen, John Sent: Tuesday, April 30, 2013 10:36 AM To: Whitecavage, Diana Subject: FW: Town of Southold Reminder Notices Follow Up Flag: Follow up Flag Status: Red When can George get a check? From: sullygrs@aol.com [mailto:sullygrs@aol.com] Sent: Tuesday, April 30, 2013 10:30 AFl To: Cushman, John Subject: Fwd: Town of Southold Reminder Notices John, I will need a check in the amount of $2395.67 made payable to: Postmaster Huntington I will complete purchase order and please let me know when I can pick up the check. Thank you. ..... Original Message ..... From: Christine Sigel <christines~,printinqxpresns.com> To: George Sullivan <Sully.qrsC~,aoLcom> Cc: Iloyd.reisenberg <lloyd.reisenber,q~,town.southold.ny.us> Sent: Mon, Apr 29, 2013 9:28 pm Subject: Fw: Town of Southold Reminder Notices George, use this address for the check, and advise the date to US mail. Dennis Fatigati, Inc. 223 Wall Street #-412 Huntington, NY 11743 Please make postage check payable to POSTMASTER HUNTINGTON $2,395.67 PROVIDING THE BEC. ST QUALITY AND SERVICE AT THE LOWEST POSSIBLE PRICE SINCE 6/2 5/86 Christine Sigel 5 Dix Circle · Dix Hills, NY 11746 (631) 242-1992 · Fax (631) 254-8911 www. PrintinqXpresns.com ChristineS@PrintinqXpresns.com ..... Original Message ..... From: Dennis Fatiqati To: 'Reisenberq, Lloyd' Cc; christines~printinqxpresns.com Sent: Monday, April 29, 2013 8:50 PM 4/30/2013 Page 2 of 3 Subject: RE: Town of Southold Reminder Notices Please make postage check payable to POSTMASTER HUNTINGTON $2,395.67 What day would you like to mail the cards? Dennis Correspondence/Payments: Dennis Fatigati, Inc. 223 Wall Street #412 Huntington, NY 11743 Shipping/Receiving: DENNIS FATIGATI, INC. 9 GERARD STREET HUNTINGTON, NY 11743 PH 631-673-6974 FAX 631-223-2153 WEB www.faticlati.com EMAIL fati.qati~,optonlin e. net FTP ftp://fati~ati.hostcentric.com/ From: Reisenberg, Lloyd rmailto:Lloyd. Reisenberq@town.southold.ny.us] Sent: Monday, April 29, 2013 10:58 AH To: fatiaati{~ootonline.net Cc: christines@ printinqxpresns.com Subject: Town of Southold Reminder Notices Dennis, Attached is Southold Reminder Notice fife. Please contact me if you have any questions. Lloyd L/oyd H. Reisenberg Network and Systems Administrator Town of $outho/d, New York Email://ovd. reisenbero~town, southold, ny.u$ O: 63 f -XSE- f ggf C:63f-879-1554 CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. Information from ESET NOD32 Antivirus, version of virus signature database 8279 (20130429) The message was checked by ESET NOD32 Antivirus. http://www.eset.com 4/30/2013 Page 3 of 3 Information from ESET NOD32 Antivirus, version of virus signature database 8280 (20130429) The message was checked by ESET NOD32 Antivirus. http://www.eset.com 4/30/2013 Purchase Order # TOWN OF SOUTHOLD 25194 Tax Exempt # A163554 Date IDeliver and send billing to: Department / Z £ c- ~ ~ ~ ~ Addr~ ~' ~ ~;~ ~'~-~' ' ~ '~ I I VENDOR ** Return this copy and Town of Southold voucher itemized and signed for payment** ITEM/ I QUANTITY i UNIT COST THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SU~I~RvISOR TOTAL I CERTIFY THAT THERE ARE SUFFICIENT FUNDS AVAILABLE IN THE~PPROPRIATION CHAR.~ED , Dept. Head I CERTIFY THIS TO BE A JUST AND TRUE PURCHASE ORDER ~. -,/ '.~--. ~...~ / SupervLsor DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES I certify that the goods or services were received by this Departm/~t and all exceptions/~uly noted. Signed Title Date DEPARTMENT BILLING COPY TERMS AND CONDITIONS 1. The TOWN OF SOUTHOLD is not responsible for materials, supplies ot equipment delivered or services performed without authority of written order, Quantities specified are not to be exceeded. 2. No changes may be made in this order without written authority of the supervisor. 3. Inspection of delivery will be madb at delivery point unless otherwise speCified. Materials must be properly packaged. Damaged material will not be accepted. Include itemized packing lists with all shipments. Delivery indoors is required unless otherwise specified. All prices quoted must in- clude shipping, handling, packing and crating charges and be F.O.B. delivered, unless other terms are agreed to. 4. Substitutions of specified items will not be acceptable. The Town of Southold reserves the right to reject and return at shippers expense, materials delivered which do not conform to de- scription of item ordered. 5 If order cannot be filled in whole or in part i~n time specified, notify the town immediately. In case of delay in delivery, or in case of any default of the vendor, the town may procure the goods or services from other Sources and hold the vendor responsible for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby. 6. Upon acceptance of this order the vendor agrees to comply with all Federal, State or local taws relative thereto: a. The vendor shall defend actions or claims brought and hold the Town of Southold, its agents and its employees harmless from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are ~qot in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c. Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- ing hours ~nd minimum wages of employees and prohibiting ,discrimination on account of race, sex, color, creed or national origin in hiring employees within the State of New York involved in the manufacture of materials, equipment, or supplies specified in this order. d. The vendor shall comply with Sections 103a and 103b of the General Municipal Law pertaining to disqualifications of contractor for failure to waive immunity before Grand Jury. 7. INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. Claims for partial deliveries are not allowed unless indicated. Claims in question will constitute a condition precedent to the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. . ,. All RO./Claims must be audited and approved by the Town Board prior to actual payment. Purchase Order # Date /'"'"'2,/"~ '*'--/// TOWN OF SOUTHOLD 25194 Tax Exempt Account # IDeliver and send billing to: Department /~ Addr~ ~-~ I I I I I VENDOR ITEM / "'Return this copy and Town of Southold voucher itemized and signed for payment"* QUANTITY I DESCRIPTION UNIT COST TOTAL I THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFY THAT THERE ARE SUFFICIENT FUNDS AVAILABLE IN TH.~PPROPRIATION CHA~ED , Dept. Head I CERTIFY THIS TO BE A JUST TOWN OF SOUTHOLD VENDOR 001259 AFLAC NEW YORK 05/07/2013 CHECK 117400 FL~ND & ACCOUNT P.O.~ IA!VOICE DESCRIPTION ~2~OUNT T1 .023 514102 5/9/13 PA~fROLL DEDUCT 1,085.84 TOTAL 1,085.84 Town of Southold, New York - Pa',ment Voucher Vendor Tax ID Number or Social SecuriW Number Vendor Address Vendor Name AFLAC New York Vendor Telephone Number Vendor Contact Vendor No. 1259 Attn: Remittance Processing Services 1932 Wynnton Road Columbus, Georgia 31999-6005 Invoice Invoice Invoice Number Date Total Discount Nel 514102 4/27/2013 1,085.84 1,085.84 Purchase Order Number Description of Goods or Sen, ices 5/9/13 Payroll deductions Payee Certification The undersigned (C[ai:nant) (Acting on behalf of the above named claimmrt) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that fl~e balance therein stated is actually due and owing, gaud that taxes from which the Town is exempt are excluded (~1 ;Name Town of Southold Date ~J~'~/~ Department Certification I hereby certify that the materials above specified have been received by me tn good condition withoul substitution, the services properly performed and that the qumrtities thereof have been verified with the exceptmns or discrepm~cies noted, and payment is approved 'l~n Comptroller Date Account Number: NC595 Invoice Number: 514102 Af ac 514102 Premium Statement Town Of Southold Attn John Cushman PO Box ] 179 Southold NY 11971-0959 Date Prepared: 04/27/13 Billing Frequency: BI-WEEKLY IVR Pin; 318133 Premium Due Date: 05/12/13 Amount Billed: $1085.84 Total Amount Due: $1085.84 Page 1 ot 5 Thank you for your business. We are pleased to help protect and care for your employees. Follow these simple steps to process this statement: 1. Retrieve last month's statement to help with reconciliation. If this is your first statement, skip to step 2. 2. Match each employee's premium amount due to your payroll deduction amount. Check for any discrepancies or missing deductions. 3. Mark through any mismatched deduction on the respective policy line and write the correct amount in the adjusted premium column. Write the change request code in the CR column. 4. Total the adjusted premium and write in the space provided at the bottom of the page. Write the adjusted amount due and the amount enclosed on the payment coupon. 5. Return the portion below and copies of the pages with adjustments. Write the adjusted amount due and the amount enclosed in the space provided. Make the check payable to Aflac and note your account number on the check. Need help with this statement? Your Aflac agent is available to help. You may also contact Aflac's Customer Service Center, Monday through Friday from 8 a.m until 8 p.m. Eastern time at 1-800-99-AFLAC (1-800-992-3522). Detach Here Detach Here Account Name: Address: Town Of Southold Attn John Cushman PO Box 1179 Southold NY 11971-0959 Account Number: NC595 Invoice Number; 514102 Af .c Premium Statement Date Prepared: 04/27/13 Billing Frequency: BI-WEEKLY IVR Pin: 318133 Premium Due Date: 05/12/13 Amount Billed: $108584 Total Amount Due: $1085.84 Page 2 ol 5 If your payroll account information has changed, please indicate the changes below. Point of Contact: Phone Address Fax Email Account Number: NC595 Invoice Number: 514102 Page 3 of 5 Account Name: Address: Town Of Southold Attn John Cushman PO Box 1179 Southold NY 11971-0959 Date Prepared: o4/27/13 Billing Frequency: BI-WEEKLY IVR Pin: 318133 Premium Due Date: 05/12/13 Amount Billed: $108584 Total Amount Due: $1085.84 Expedite reconciliation with Wingspansm Online Services. Changes made on a paper statement may not appear on future statements for two billing cycles. To expedite reconciliation, you can make your changes online with Online Services. Online reconciliation allows faster processing of changes and provides the ability to pay electronically. Please contact Aflac's Customer Service Center at 1-800-99-AFLAC (1-800-992-3522) if you want to manage your account online. Instructions for Making Changes to Your Invoice: To make changes to your invoice, please indicate the Change Request (CR) letter code which represents the change that needs to occur. Input the CR letter code in the CR column on the billing invoice line which contains the respective employee's information. To expedite the request, additional information from your employees may be required. Encourage your employees to visit afiac.com for individuals and log in to Manage Your Aflac Policy to get applicable forms. Change Request Action Description (CR) A* Add person to pelicy The employee is adding another person to his/her existing Aflac policy. A completed change form is needed. C* Cancel coverage The employee would like to cancel his/her existing Aflac policy. The employee's signed request is needed, D Deceased The employee is deceased. If the date of death is provided, any remaining transactions will be expedited, E Not our employee The policyholder listed is not employed by your company and was mistakenly included in your invoice, F Family Medical Leave The employee is on Family and Medical Leave (FMLA). H* Name change The employee has changed his/her last name If the new last name is provided, we can update our records, I* Delete person from policy The employee is deleting a person from his/her existing Aflac policy A completed change form is needed. L Non-Family Medical Leave The employee is on a leave of absence other than Family and Medical Leave (FMLA). M Missed deduction The premium amount charged was not payroll deducted for this employee, O Other A change request that differs from the list provided. Please provide details to advise us of the change needed. R Retired The employee is retired and payroll deductions have ceased T No longer employed here The employee has terminated employment W Transfer to another account The employee is now employed at another location or business, *Change Request (CR) requires additional information from the employee. Submitting the employee's completed form along with your Premium Statement, will expedite the processing of the change requested. LGBPG TOWN OF SOUTHOLD VENDOR 001360 ALI CONSULTING GROUP, P.C. 05/07/2013 CHECK 117401 F~ND & ACCOI/NT P.O.# INVOICE DESCRIPTION A .1010.4.500.200 13-192 2/2/1929 WV COMPLAINT INVESTIGATN TOTAL AMOUNT 5,375.00 5,375.00 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address Vendor Name Ali Consulting Group, PC Vendor ] elephone Number Vendm Contact Vendor No. 1360 775 Park Avenue, Suite 255 Huntington, NY 11743 Check No_ Entered by Audit Date ,5/7/2013 Number 212/1929 Date 4/2412013 Invoice Net Total Discounl Amount Claimec 5,375.00 . 5,375.00 5,375.00 Payee Certification The undersigned (C!aimant) (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 Tdle Company Name Date Purchase Order Number 2013-192 Description of Goods or Services WV Complaint Investigation General Ledger Fund and Aceoun~ Number A,1010~4.500.200 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 or discrepancies noted, and payment l.~-~pr~.//// TrackMyHours.com I Invoice #10626 4/24/]3 7:05 AM Invoice Invoice # 20626 Date: 04/24/2013 Client: Town of Southold For Period: 03/20/2013 to 04/23/2013 Ali Consulting Group, P.C, 775 Park Avenue, Suite 255 Huntington, New York 11743 Sima Ali $2g0.00/hr Totals Southold - Investigation Totals 21.50 hrs $5,375.00 21.50 hrs $5,375.00 Date 03/20/2013 Wednesday 04/08/2013 Monday 04/10/2013 Wednesday 04/12/2013 Friday 04/15/2013 Monday 04/23/2013 Tuesday Total Hours TotalDue Start Finish Project Consultant Hours 7:15 AM 4:45 PM Southold - Investigation Sima Ali 9,S0 L~ $250.00/hr, Prepare for investigation, review policy, review notes, review complaint, conduct interviews of complainant, alleged harasser and three witnesses at Town Hall, 3:00 PM 5:00 PM Southold - Investigation Sima Ali 2.00 ~ $250.00/hr, Prepare summary of interviews and outline of report of investigation for client. 12:00 PM 3:00 PM Southold - Investigation Sima Ali 3.00 ~ ~250,O0/hr, Prepare summary of interviews (Scott russell) and continue draft of report on investigation, 2:00 PM 2:30 PM Southold - Investigation Sima Ali 0.S0 @ $2SO.O0/hr. Prepare summary of interview (Damon Rallis) 7:00AM 12:30 PM Southold Investigation Sima Ali 5,50 @ $250.00/hr. Finalize summary of interviews, prepare factual conclusions and recommendations, prepare exhibits to report, send draft report to RKZ. 4:00 PM 5:00 PM Southold - Investigation Sima Ali 1.00 @ ~250,00/hr, Finalize and submit report of investigation to client. $5,375.00 This invoice has NOT been paid Please make check for $5,375.00 payable to Ali Consulting Group, P.C. https //www.trackmyhours.com/secure/Invoice.aspxTID-3llO2&printable 1 Page 1 of 1 RESOLUTION 2013-192 ADOPTED DOC ID: 8611 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2013-192 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON FEBRUARY 26, 2013: RESOLVED, due to the unique circumstances involved in a Town employee's complaint, the Town Board of the Town of Southold hereby amends, for the purposes of this matter only, the Town's Workplace Violence Policy Statement item #5, which designates those conducting the investigation, and instead appoints Ali Consulting Group, LLC, at an hourly rate of $250 plus reasonable expenses incurred, to conduct a fact finding investigation and, amends item #6 to present his findings to the Town Board. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [5 TO 01 MOVER: Christopher Talbot, Councilman SECONDER: William Ruland, Councilman AYES: Dinizio Jr, Ruland, Doherty, Talbot, Evans ABSTAIN: Scott Russell TOWN OF SOUTHOLD VENDOR 001369 ALTEC-NUECO 05/07/2013 CHECK 117402 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT DB .5130.4.100,500 H7306 9552962 DB .5130.4.100.500 H7306 9553031 ~257-1 LINER,SHIPPING 555.76 i-TOOL HOLDER, SHIPPING 73.98 TOTAL 629.74 P Town of Southold, New York- Payment Voucher ALTECINUECO 1-800-$60-0183 9552962 9553031 4/3~2013 555.76. 41512013 73.98 ga ,e~ Cerdficarh, DEPT 3251 P.O. BOX 2153 1369 0.0O 555.76 0.n0 73.98 TOTAL 6~29.74 H7306 ~257- 1 LINER, SHIPPG - TOOL HOLDR, SHIPG DB.5130,4.1D0.500, NUECQ National Utility Equipment Company 3020 Commercial Road Fort Wayne Allen IN 46809 800-860-0183 SOLD TO: #29636 SOUTHOLD TOWN DEPT PUB WORKS 275 PECONIC LN PO BOX LONG ISLAND PECONIC NY 11968-0000 Part Sales Invoice Please Remit TO: Altec NUECO PO BOX 2153 DEPT 3251 Telephone Number: 1-800-860-0183 BIRMINGHAM AL 35287-3251 SHIP TO: #29636 SOUTHOLD TOWN DEPT PUB WORKS 275 PECONIC LN PO BOX LONG ISLAND PECONIC NY 11958-0000 Page 1 of I Customer Order No. Sales Order No. Order Date Terms Invoice Date Invoice NO. H7306 2561905 03-APR- 13 N ET 30 03-APR- 13 9552962 Shipping M¢thod Waybill Ne Date Shipped Sales Person Credit Card No. BEST METHOD 131757010 03-APR-13 0096 Bolton. Michael N/A GROUND Item I Quantit,j Part Number I Description I Unit Price Amount 1 1 981723266- LINER-50 KV AR1653 337.80 33780 4% State Tax 0.00 4.625% County Tax 0.00 0% City Tax 0.00 Special Instructions 337.80 Total Taxes 0.00 Total Freight 217.96 Total Amount Due 555.76 **THANK YOU FOR YOUR ORDER** **Please complete returns form and ship pads within 30 days Returns may be subject to a restock fee ** Payment Due by: 03-MAY-13 **Amount unpaid after this date is subject to ar1 interest charge of 1 5% per month** ** For any ~nquiries please contact 1-877-GO-ALTEC ** NUECO National Utiidy Equipment Company 3020 Commercial Road Fort Wayne Allen IN 46809 800 860 0183 SOLD TO: #29636 SOUTHOLD TOWN DEPT PUB WORKS 275 PECONIC LN PO BOX LONG ISLAND PECONIC NY 11958-0000 Part Sales Invoice Please Remit To: Altec NUECO PO BOX 2153 DEPT 3251 Telephone Number: 1-800-860-0183 BIRMINGHAM AL 35287-3251 SHIP TO: #29636 SOUTHOLD TOWN DEPT PUB WORKS 275 PECONIC LN PO BOX LONG ISLAND PECONIC NY 11958 0000 Page 1 of 1 Customer Order No. Sales Order No. Order Date Terms Invoice Date Invoice No H7306 2561905 03-APR 13 NET 30 05-APR-13 9553031 Shipping Method Waybill No Date Shipped Sales Person Credit Card No. REST METHOD lz 19986w0354840114 05-APR- 13 0096 Bolton, Michael N/A GROUND I Item I Quantity Part Number I Description / Unit Price Amount 1 1 981723703- SAW HOLDER POUCH AR2150 56.64 56.64 4% State Tax 000 4.625% County Tax 000 0% City Tax 0.00 Special Instructions Sub Total 56 64 Total Taxes 000 Total Freight 17 34 Total Amount Due 739R **THANK YOU FOR YOUR ORDER** "Please complete relur~s forrR and ship parts within 30 days Returns ;~lay be subject to a reslO~k fee '* Payment Due by: 05-MAY-13 "Amount unpaid alter this dale ,S su bract to an inlerest charge of I 5'% per fy onth*' ** For any inquiries please contact 1-877-GO-ALTEC ** ~~ Packing List 5-Apr-1 3 NUECO 096-2201388 Page: lofl Warehouse: NUECO Ft Wayne Address All Inquiries To: Ship To: Altec NUECO SOUTHOLD TOWN DEPT PUB WORKS 3020 Commercial Rd 275 PECONIC LN Ft, Wayne, IN 46809, United States PO BOX LONG iSLAND PECONIC, NY 11958-0000, United States Contact: Customer Order: Delivery Pack Date H7306 3469029 05-APR-13 A,tecorder IIIIrlllllllllllllllllllllllllllllllllllllll wa,b,,, 2561905 lz 19986w0354840114 Shipping Paint Sold By Shipping MethodFreight Terms 0096 Bolton, Michael Best Method Ground Prepay & Add with cost conversion Shipping Instructions: Packing Instructions: George 631-765-3140 Item Qty Part Number/ Cust Part Number Qty Qty Ordered Description / Serial Number BackOrd Packed 2 1 981723703 0 1 ;;*SPECIAL ORDER*SAW HOLDER POUCH AR2150; S/N~ **THANK YOU FOR YOUR ORDER** **Please comprete returns form and ship parts within 30 days** '* Call 1-800-850-0183 for return of *SPECIAL ORDER* items ** **Returns may be subiect to a restock fee** PURCHASEORDER No- ~ 7306 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · P. O. Box 178 · Peconic, L. I., N. Y. 11958 (631) 765-3140 · (631) 734-5211 / ADDRESS [ Plea~ Enter O~r Order For The Following item~ Quantity Description Unit Pric~ Amount Ordered By: ^ ~.~ Purchase Order Number Mus Appear On Invoice, Ac,knowled~ '~ m.~nt And APPROVED BY: TOWN OF SOUII-IOLD VENDOR 001015 AT & T MOBILITY 05/07/2013 CHECK 117403 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT A .2410.00 CN229/SOUTHOLD 1/1/06-4/31/13 REFUND 19,146.91 TOTAL 19,146.91 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securii), Number !Vendor Address Vendor Name AT & T Mobility Vendor Telephone Number Vendor No. Network Real Estate Administration Mail Stop 1395-A Check No. Enteredby ,~1(~ Audit Date 1-877-231-5447 Vendor Contact ATTN: ALLISON MUELLER Inyroice Number CN229/SOUTH OLD Date 4/2412013 Invoice 'I oral Discount 19,146.91 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant)does hereby certify that the foregoing claim is true and correct. thai 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 5405 Windward Parkway Alpharetta, GA 30004 Net Purchase Order Amounl Claimed Number 19,146.91 19,146.91 Description of Goods or Sen, ices Town Clerk General Ledger Fund and Account Number 111106-4131113 REFUND A.2410.00 Department Certification l hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, at&t 5405 Windward Pkwy 5te 1300 FA #:10074795 All/hafettar GA 3OOO~iT]~] NAMi~:: ('N229/SOUTH()LD MARKET NAME: NYC/NNJ AGREEMENT ID: 59038 Via Certified Mail - Return Receipt Request Number 7009 1680 0001 7341 0177 April 24, 2()[3 The Towu of Southold P.O. Box 1179 Southold, NY 11971-0959 Re: Request for Overpayment Rehmd; l.easc dated March 27. 1991, by and betx,.een The To',,~ n of Soutl-lold and cellular Telephone Company: Id: 10074795: Site Name: CN229/SOUI HOLD; Site Location: 414 05 Route 25, Peconic, NY 11958 Dear Ixmdlord, I)uring a recent audit, it was discovered that AT&~[ inadvertently made au overpayment on the above referenced agreement. Wc rcqutre that you pa), back the overpayment for the period of January 1, 2006 through April 30, 2013 in the aummfl of $19,146.91, which you received in error. Please refer to Exhibits A and B for detailed reconciliation, payment information and rent increase calculations. Please send thc reimbursement within thirty (30) day's to the following address: AT&T Mobility Network Real Estate Administration Attn: Allison Mueller Mail Stop 1395-A 5405 Windward Parkway Alphm'etta, GA 30004 With your payment please reference Site Name, Site Id Number and Site Location, in order tbr us to apply the refund properly. If you feel that you have received this letter in error, please led fl-ee to contact us at your earliest convenience. Thank you for your time and effort in resolving this matter quickly. Should you have any questions, please contact me at 1-877 23 1 5447 or email meareco\ crvl'eCOtl~(datl.coI!!. I,ease Payment Quality Manager AT&T Mobfln,, LLC. AM Ref Site Id: 10074795 Exhibit A Rent Reconciliation Jam06 Feb-06 Mar-06 Apr 06 May-06 Jun-06 July06 Aug-06 Sep-06 Oct-06 Nov 06 Dec 06 Jan-07 Feb-07 Mar 07 Apr-07 May-07 Jun-07 Jul-07 Aug 07 Sep-07 Oct 07 Nov-07 Dec-07 Jan-08 Feb-08 Mar-08 Apr-08 May 08 Jum08 Jul-08 Aug-08 Sep-08 Oct 08 Nov-08 Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jum09 Jul 09 Aug 09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 Abr-10 May-10 Jun 10 Aug-10 Sep-10 Oct 10 Nov-10 Dec-10 Due Paid 3,61486 $ 3.542.79 3,614.86 $ 3,542.79 3,614.86 $ 3,542.79 3,744.67 3,744,67 $ 3,66998 3,74467 $ 3,66998 3,74467 $ 3,66998 3,74467 $ 3,669.98 3,744~67 $ 3,669.98 3,744.67 $ 3,66998 3,744.67 $ 3,669.98 3,744.67 $ 3,669.98 3,744,67 $ 3,669.98 3,74467 $ 3,66998 3,744.67 $ 3,66998 3,85437 $ 3,66998 3,85437 $ 3,66998 3,854.37 $ 3,66998 3,854.37 $ 3,669.98 3,854.37 $ 3,669.98 3,854.37 $ 3,669.98 $ 827.04 3.85437 $ 3,80782 3,85437 $ 3,80782 3,85437 $ 3,807 82 3,854.37 $ 3,80782 3,854.37 $ 3,807.82 3,854.37 $ 3,807.82 4,005.69 $ 3,807.82 4,005.69 $ 3,80782 $ 4,005,69 $ 3,807,82 $ 4,00569 $ 3,80782 $ 4,00569 $ 3,80782 $ 4,00569 $ 3,80782 $ 4,005~69 $ 3,80782 $ 4,00569 $ 3,807 82 $ 4,005.69 $ 3,807.82 $ 4,005.69 $ 3,807.82 $ 4,005.69 $ 3,807.82 $ 4,005.69 $ 3,807.82 $ 4,065.61 $ 3,86630 $ 4,065.61 $ 3,866.30 $ 4,06561 $ 3,86630 $ 4,065,61 $ 3,86630 $ 4,06561 $ 3,86630 $ 4,06561 $ 3,86630 $ 4,065~61 $ 3,86630 $ 2,64255 $ 4,065.61 $ 3,991.67 $ 4,065.61 $ 3,991.67 $ 4,065.61 $ 3,991.67 $ 4,065.61 $ 3,991.67 $ 4,065.61 $ 3,991.67 $ 4,163.41 $ 3,991.67 $ 107.69 $ 4,16341 $ 3,991.67 $ 10769 $ 4,163.41 $ 4,09936 $ 4,163~41 $ 4,09936 $ 4,163.41 $ 4,09936 $ 4,163.41 $ 4,09936 $ 4J63.41 $ 4,09936 $ 4,163.41 $ 4,099~36 $ 4,163.41 $ 4,099.36 ,$ 4,163.41 $ 4,09936 I$ ck# 10203684 10303688 15037365 15242304 16315873 15388266 15438363 10506618 10620627 10736752 10834241 10950414 11064783 11158630 11253872 11353888 11477236 11568328 11655969 11795910 11811132 11883280 11991434 12095407 12212803 12320404 12420465 12525064 12679940 12800246 12881328 13005029 13147758 13324834 13450301 13566801 13678O96 13802628 13965997 14093920 14246321 14388902 14548451 14704756 14858936 15066070 14973054 15224982 15349387 15496019 15622707 15767614 15891781 16036289 16013994 16086566 16136231 16266771 16390000 16524173 16668211 3313567036 3313670427 3313793966 3313900220 ck date 12/29/2005 1/26/2006 2/23/2006 5/1/2006 5/25/2006 6/27/2006 7/25/2006 8/23/2006 9/22/2006 10/23/2006 11/21/2006 12/21/2006 1/23/2007 2/22/2007 3/22/2007 4/23/2007 5/23/2007 6/22/2007 7/20/2007 8/23/2007 8/27/2007 9/21/2007 10/23/2007 11/20/2007 12/20/2007 1/23/2008 2/22/2008 3/21/2008 4/23/2008 5/23/2008 6/23/2008 7/23/2008 8/22/2008 9/23/2008 10/23/2008 11/20/2008 12/23/2008 1/23/2009 2/23/2009 3/23/2009 4/23/2009 S/21/2009 6/23/2009 7/23/2009 8/21/2089 9/23/2009 9/8/2009 10/22/2009 11/20/2009 12/23/2009 1/22/2010 2/23/2010 3/23/2010 5/1/2010 4/23/2010 5/14/2010 5/21/2010 6/23/2010 7/23/2010 8/23/2010 9/23/2010 10/25/2010 11/23/2010 12/23/2010 1/24/2011 date 1/I/2006 2/1/2006 3/1/2006 5/1/2006 6/1/2006 7/1/2006 8/1/2006 9/1/2006 10/1/2006 12/1/2006 1/1/2007 3/1/2007 4/1/2007 5/1/2007 6/1/2007 7/1/2007 8/1/2007 9/1/2007 4/1/2007 10/1/2007 12/1/2007 1/1/2008 2/1/2008 3/1/2008 4/1/2008 5/1/2008 6/1/2008 7/1/2008 8/1/2008 9/1/2008 10/1/2008 12/1/2008 1/1/2009 2/1/2009 3/1/2009 4/1/2009 5/1/2009 6/1/2009 7/1/2009 8/1/2009 9/1/2009 10/1/2009 4/1/2008 12/1/2009 2/1/2010 3/1/2010 4/1/2010 4/1/2010 5/1/2010 5/1/2010 6/1/2010 7/1/2010 8/1/2010 9/1/2010 range 1/31/2006 2/28/2006 3/31/2006 5/31/2006 6/30/2006 7/31/2006 8/31/2006 9/30/2006 10/31/2006 11/30/2006 12/31/2006 1/31/2007 2/28/2007 3/31/2007 4/30/2007 5/31/2007 6/30/2007 7/31/2007 8/31/2007 9/30/2007 9/30/2007 10/31/2007 11/30/2007 12/31/2007 1/31/2008 2/29/2008 3/31/2008 4/30/2008 5/31/2008 6/30/2008 7/31/2008 8/31/2008 9/30/2008 10/31/2008 11/30/2008 12/31/2008 1/31/2009 2/28/2009 3/31/2009 4/30/2009 5/31/2009 6/30/2009 7/31/2009 8/31/2009 9/30/2009 10/31/2009 10/31/2009 11/30/2009 12/31/2009 1/31/2010 2/28/2010 3/31/2010 4/30/2010 4/30/2010 5/31/2010 5/31/2010 6/30/2010 7/31/2010 6/31/2010 9/30/2010 10/31/2010 11/30/2010 12/31/2010 1/31/2011 2/28/2011 May 11 Jan-12 Feb 12 Mar-12 Apr-12 May-12 Jun 12 Aug-12 Sep 12 Oct-12 Nov-12 Dec-12 Jan 13 Feb-13 Mar-13 Apr-13 Exhibit A Rent Reconciliation Due Paid 4,163.41 $ 4,099.36 3,200.00 $ 4,099.36 3,200.00 $ 4,09936 $ 22410 3,20000 $ 4,211.41 3,200.00 $ 4,211.41 3,200,00 $ 4,21141; 3,200.00 $ 4,21141 3,200,00 $ 4,21141 3,20000 $ 4,21141 3,200,00 $ 4,211.41 3,200.00 $ 4,211.41 3,200.00 $ 4,21141 3,200,00 $ 4,21141 3,200.00 $ 4,21141 $ 11293 3,20000 $ 4,211.41 $ 112.93 3,200.00 $ 4,324.34 3,200,00 $ 4,324.34 3,200.00 $ 4,324,34 3,200,00 $ 4,32434 3,200.00 $ 4,32434 3,200.00 $ 4,324.34 3,200.00 $ 4,324.34 3,200,00 $ 4,324.34 3,200,00 $ 4,324.34 3,200.00 $ 4,32434 3,20000 $ 4,32434 $ 328,849.58 $ 347,996.49 OVERPAID $ 19,146.91 ck# 3314010531 3314102954 3314219833 3314195625 3314326926 3314428212 3314508984 3314627522 3314738807 3314837013 3314938250 3315026015 3315130742 3315228269 3315332429 3315425461 3315450525 3315520834 3315552263 3315637081 3315718575 3315825648 3315923689 3316004827 3316102794 3316182407 3316278773 331637530! 3316454140 ck date 3/23/2011 4/22/2011 5/23/2011 6/23/2011 9/23/2011 10/24/2011 1/23/2012 3/23/2012 4/18/2012 4/23/2012 5/17/2012 5/23/2012 6/25/2012 7/17/2012 8/23/2012 9/24/2012 10/23/2012 11/23/2012 12/24/2012 1/23/2013 2/25/2013 3/25/2013 date 3/1/2011 4/1/2011 5/1/2011 4/1/2011 6/1/2011 7/1/2011 8/1/2011 9/1/2011 10/1/2011 11/1/2011 12/1/2011 1/1/2012 2/1/2012 3/1/2012 4/1/2012 4/1/2012 5/1/2012 5/1/2012 6/1/2812 7/1/2012 8/I/2012 9/1/2012 10/1/2012 11/1/2012 12/1/2012 1/1/2013 2/1/2013 3/1/2013 4/1/2013 range 3/31/2011 4/30/2011 5/31/2011 5/31/2011 6/30/2011 7/31/2011 8/31/2011 9/30/2011 10/31/2011 11/30/2011 12/31/2011 1/31/2012 2/29/2012 3/31/2012 4/30/2012 4/30/2012 5/31/2012 5/31/2012 6/30/2012 7/31/2012 8/31/2012 9/30/2012 10/31/2012 11/30/2012 12/31/2012 1/31/2013 2/28/2013 3/31/2013 4/30/2013 Site Id: 10074795 Exhibit B Rent Increase Calculations CPI-W; 1982; NYC; Feb (month Monthly Annual prior) Increase 4/1/1991 $2,500.00 $30,000.00 140.60 1992 $2,574.68 $30,896.16 144.80 2.99% 1993 $2,672.48 $32,069.70 150.30 3.80% 1994 $2,729.37 $32,752.49 163.50 2.13% 1995 $2,784.50 $33,413.94 156.60 2.02% 1996 $2,875.18 $34,502.13 161.70 3.26% 1997 $2,955.19 $35,462.30 166.20 2.78% 1998 $2,990.75 $35,889.05 168.20 1.20% 1999 $3,033.43 $36,401.14 170,60 1.43% 2000 $3,129.46 $37,553.34 176.00 3.17% 4/1/2001 $3,214.79 $38,577.52 180.80 2.73% 2002 $3,284.14 $39,409.67 184.70 2.16% 2003 $3,401.49 $40,817.92 191.30 3.57% 2004 $3,490.40 $41,884.78 196.30 2.61% 2005 $3,614.86 $43,378.38 203.30 3.57% 4/1/2006 $3,744.67 $44,935.99 210.60 3.59% 2007 $3,854.37 $46,252.49 216.77 2.93% 2008 $4,005.69 $48,068.28 225.28 3.93% 2009 $4,065.61 $48,787.34 228.65 1.50% 2010 $4,163.41 $49,960.88 234.15 2.41% 4/1/2011 $3,200.00 $38,400.00 Amendment 2012 $3,200.00 $38,400.00 2013 $3,200.00 $38,400.00 2014 $3,200.00 $38,400.00 2015 $3,200.00 $38,400.00 4/1/2016 $3,680.00 $44,160.00 15.00% 2017 $3,680.00 $44,160.00 2018 $3,680.00 $44,160.00 2019 $3,680.00 $44,160.00 2020 $3,680.00 $44,160.00 4/1/2021 $4,232.00 $50,784.00 15.00% 2022 $4,232.00 $50,784.00 2023 $4,23200 $50,784.00 2024 $4,232.00 $50,784.00 2025 $4,232.00 $50,784.00 4/1/2026 $4,866.80 $58,401.60 15.00% 2027 $4,866.80 $58,401.60 2028 $4,866.80 $58,401.60 2029 $4,866.80 $58,401.60 2030 $4,866.80 $58,401.60 4/1/2031 $5,596.82 $67,161.84 15.00% 2032 $5,596.82 $67,161.84 2033 $5,596.82 $67,161.84 2034 $5,596.82 $67,161.84 2035 $5,596.82 $67,161.84 4/1/2036 $6,436.34 $77,236.12 15.00% 2037 $6,436.34 $77,236.12 2038 $6,436.34 $77,236.12 2039 $6,436.34 $77,236.12 2040 $6,436.34 $77,236.12 Cushman, John From: Sent: To: Subject: Russell, Scott Tuesday, April 30, 2013 12:17 PM Cushman, John RE: A T & T request for refund Thanks. Boy, they could have been a little more polite in their letter of request. From: Cushman, John Sent: Tuesday, April 30, 2013 12:13 PM To: Russell, Scott Cc: William Ruland (rulandfarm@yahoo.com); Louisa Evans (IpevansO6390@qmail.com); Chris Talbot (christptal@yahoo.com); Jill DOHERTY (iilld927@optonline.net); .]ames Dinizio; Finnegan, Martin; Hulse, Lori Subject: A T & T request for refund Scott, The attached letter requesting a refund of $19,146.91 arrived from AT & T wireless yesterday. The lease agreement was renegotiated in 2009 and reduced the monthly rent amount substantially (from $4163 to $3200 per month). We never caught their overpayment error. It appears through my discussions with Lori Hulse that the claim is correct, so we will be processing the refund on the next audit (charged to revenue). This will result in a revenue shortfall in our Tower Rental Revenue line for 2013. John John Cushman Town Comptroller Town of Southold 631-765-4333 http://www.sout holdtownny.gov THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHOM IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED AND CONFIDENTIAL, OR THAT CONSTITUTES WORK PRODUCT AND IS EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF YOU ARE NOT THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY USE, DISSEMINATION, DISTRIBUTION, OR COPYING OF THE COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US BY TELEPHONE 631-765-4333 AND DESTROY THE DOCUMENT. THANK YOU. RESOLUTION 2009-107 ADOPTED DOC ID: 4678 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2009-107 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON FEBRUARY 3, 2009: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute the First Amendment to Lease and Memorandum of Lease between the Town of Southold and New Cingular Wireless PCS~ LLC~ successor in interest to Cellular Telephone Company, in connection with the renewal of the Lease regarding the Peconic Lane cell toxver site for a term of 60 months, commencing on April 1, 2011, subject to the approval of the Town Attorney. Elizabeth A. Neville Southoid Town Clerk RESULT: ADOPTED IUNANIMOUS] MOVER: William Ruland, Councilman SECONDER: Vincent Orlando, Councilman AYES: Ruland, Orlando, Krupski Jr., Wickham, Evans, Russell Cell Site No: N109717/CN229/SOUTHOLD_WS-28747 FA No: 10074795 Site Address: Peconic Lane, Peconic, NY 11958 FIRST AMENDMENT TO LEASE THIS FIRST AMENDMENT TO LEASE ("Amendment") dated as of the later date below is by and between the Town of Southold, having a mailing address at 53095 Main Road, PO Box 1179, Southold, NY 11971 (hereinafter referred to as "Landlord") and New Cingular Wireless PCS, LLC, a Delaware limited liability company, successor in interest to Cellular Telephone Company, having a mailing address at 12555 Cingular Way, Suite 300, Alpharetta, GA 30004 (hereinafter referred to as "Tenant"). WHEREAS, Landlord and Tenant entered into a Lease dated March 27, 1991, whereby Landlord leased to Tenant certain Leased Premises, therein described, that are a portion of the property located at Peconic Lane, Peconic, NY 11958 ("Agreement"); and WHEREAS, Landlord and Tenant desire to extend the term of the Agreement; and WHEREAS, Landlord and Tenant desire to modify, as set forth herein, the rent payable under the Agreement; and WHEREAS, Landlord and Tenant, in their mutual interest, further wish to amend the Agreement as set tbrth below. NOW THEREFORE, in consideration of the foregoing and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, Landlord and Tenant agree as follows: 1. Term. The Term of the Agreement shall be amended to provide that the Agreement has anew initial term of 60 months ("New Initial Term"), commencing on April 1,201 I. The Term will be automatically renewed for up to 5 additional 60 month terms (each a "Renewal Term") without further action by Tenant. Hereafter, the defined term "Term" shall include the New Initial Term and any applicable Renewal Term. 2. Termination. In addition to any rights that may exist in the Agreement, Tenant may terminate the Agreement at any time with 180 days prior written notice to Landlord for any or no reason. 3. Modification of Rent. Commencing on April 1,2011, the rent payable under the Agreement shall be $3,200.00 per month, and shall continue during the Term, subject to adjustment, if any, as provided below. 4. Future Rent Increase / Renewal Term Increase. The Agreement is amended to provide that commencing on April I, 2016, rent shall increase by fifteen percent (15.00%) and at the beginning of each Renewal Term, as applicable. A -FMaser Templae vO0 BDWv2 Cell Site No: N109717/CN229/SOUTHOLD_WS-28747 FA No: 10074795 Site Add tess: Peconic Lane, Peconic, NY 11958 5. Taxes. Landlord shall be responsible for payment of all ad valorem taxes levied upon the lands, improvements and other property of Landlord. Tenant shall be responsible for all taxes levied upon Tenant's leasehold improvements (including Tenant's equipment building and towar) on the Premises. Landlord shall provide Tenant with copies of all assessment notices on or including the Premises immediately upon receipt, but in no event later than thirty (30) days after receipt by Landlord. If Landlord fails to provide such notice within such time frame, Landlord shall be responsible for all increases in taxes for the year covered by the assessment. Tenant shall have the right to contest, in good faith, the validity or the amount of any tax or assessment levied against the Premises by such appellate or other proceedings as may be appropriate in the jurisdiction, and may defer payment of such obligations, pay same under protest, or take such other steps as Tenant may deem appropriate. This right shall include the ability to institute any legal, regulatory or informal action in the name of Landlord, Tenant, or both, with respect to the valuation of the Premises. Landlord shall cooperate in the institution and prosecution of any such proceedings and will execute any documents required therefore. The expense of any such proceedings shall be borne by Tenant and any refunds or rebates secured as a result of Tenant's action shall belong to Tenant. 6. Memorandum of Lease. Either party will, at any time upon fifteen (15) days prior written notice from the other, execute, acknowledge and deliver to the other a recordable Memorandum of Lease substantially in the form of the Attachment 1. Either party may record this memorandum at any time, in its absolute discretion. 7. Acknowledgement. Landlord acknowledges that: 1) this Amendment is entered into of the Landlord's free will and volition; 2) Landlord has read and understands this Amendment and the underlying Agreement and, prior to execution of the Amendment, was free to consult with counsel of its choosing regarding I.andlord's decision to enter into this Amendment and to have counsel review the terms and conditions of the Amendment; 3) Landlord has been advised and is informed that should Landlord not enter into this Amendment, the underlying Agreement between Landlord and Tenant, including any termination or non- renewal provision therein, would remain in full force and effect. 8. Notices. Section 15 of the Agreement is hereby deleted in its entirety and replaced with the following: NOTICES. All notices, requests, demands and communications hereunder will be given by first class certified or registered mail, return receipt requested, or by a nationally recognized overnight, courier,. postage prepaid, to be effective when properly sent and received, refused or returned undelivered. Notices will be addressed to the parties as follows: Tenant: New Cingular Wireless PCS, LLC c/o Network Real Estate Administration Cell Site # N 109717, Cell Site Name CN229/SOUTHOLD (NY) Fixed Asset No. 10074795 12555 Cingular Way, Suite 1300 Alpharetta, GA 30004 ATr Master Template v20 BDW v.2 ~2- Cell SiteNo: NI09717/CN229/SOUTHOLD_WS-28747 FA No: 10074795 Site Address: Peconic Lane, Peconic, NY 11958 With a required copy of the notice sent to AT&T Legal at: New Cingular Wireless PCS, LLC Attn: AT&T Legal Department Cell Site # N 109717, Cell Site Name CN229/SOUTHOLD (NY) Fixed Asset No. 10074795 340 Mt. Kemble Avenue Morristown, NJ 07960 Landlord: Town of Southold 53095 Main Road PO Box 1179 Southold, NY 11971 Either party hereto may change the place for the giving of notice to it by thirty (30) days prior written notice to the other as provided herein. 9. Other Terms and Conditions Remain. In the event of any inconsistencies between the Agreement and this Amendment, the terms of this Amendment shall control. Except as expressly set forth in this Amendment, the Agreement otherwise is unmodified and remains in full force and effect. Each reference in the Agreement to itself shall be deemed also to refer to this Amendment. 10. Capitalized Terms. All capitalized terms used but not defined herein shall have the same meanings as defined in the Agreement. [Signatures on Following PageJ Mas er Temp a e_v.20_BDW v2 Cell Site No: N109717/CN229/SOUTHOLD_WS-28747 FA No: 10074795 Site Address: Peconic Lane, Peconic, NY 11958 IN WITNESS WHEREOF, the parties have caused their properly authorized representatives to execute and seal this Amendment on the date and year below. LANDLORD: TENANT: Town of Southold New Cingular Wireless PCS, LLC By: AT&T Mobility Corporation Its: Manager Name: Title: Date: Name: Title: ~ Date: WITNESSED BY: By: _~(~ ~ Name: ~.(~Q,J~t53.- ~/~,/j~ Title: , ATT Master Template_v,20_BDW v. I Cell Site No: N109717/CN229/SOUTHOLD_WS-28747 FA No: 10074795 Site Address: Peconic Lane, Peconic, NY 11958 LANDLORD ACKNOWLEDGEMENT REPRESENTATIVE CAPACITY STATE OF ~-.~-0 Y 0//-./~' ) COUNTY OF 5e'.~ .'~(r/d SS. 'I ce~i~ that I know or have satisfacto~ evidence that 5~ ~- ~~fis ~e ~rson who app~ed before me, ~d said person aeknowl~ged that said person sign~ this i~s~fie~), on oath stated ~at said ~rson w~ puthorized to execute the instrument and acknowledged it as the ~ ~ ~/~ ~ ~ p ~J~oq of ~t ~,~¢ ~ ~ ~ e~ ~ ~e~o be the f~e and vo Un(a~ ac~ 0f s~ch' pa~y f~ ihe uses ~d pu~oses ~entioned in the instrument.- ' ' DATED: Notary Seal LINDA d COOPER NOTARY PUBLIC, State of New York NO. 01C04822~563, Suffolk Coun. t_v Term Expires December 31, 20 ",~ (Signature ~)ff~otal/y) / (Legibly Print or Strop Name of No~) Nota~ Public in ~d for the State of ~ ~ My appoin~ent expires: /2- 3/-/0 ATT Master Template_v.20_BDW v.I -5~ Cell Site No: N109717/CN229/SOUTHOLD_WS-28747 FA No: 10074795 Site Address: Peconic Lane, Peconic, NY 11958 TENANT ACKNOWLEDGEMENT STATE OF [/)~J.) ~/'£~t ) ) ss. COUNTY OF ) ! certify that I know or have satisfactory evidence that '~/o"~ ~.fa £ i.¢'~/tz'~t,L, is the person who appeared before me, and said person acknowledged that he si~ned this instrument, on oath stated that he was authorized to execute the instrument and acknowledged it as the/) ~C.~,J~ to be the flee and voluntary act of such part~ for the uses and purposes mentioned in the instrument. O^TED: Notary Seal (Legibly Print or Stamp Name of Notary) Notary Public in and for the State of My appointment expires: ][ Notary Public, State of New Jersey I1 ][ My Commission Expires ATT Master Template_v 20_BDW v.I Cell Site No: N109717/CN229/SOUTHOLD_WS-28747 FA No: 10074795 Site Address: Peconic Lane, Peconic, NY 11958 ATTACHMENT I Prepared by: BlackDot IFireless 320 Commerce, Suite 200 lrvine, CA 92602 MEMORANDUM OF LEASE Return to: New Cingular Wireless PCS, LLC 12555 Cingular Way, Suite 1300, Alpharetta, GA 30004 Attn: AT&T Network Real Estate Administration Re: Market: New York City/Northern NJ Cell Site Number: N109717 Cell Site Name: CN229/SOUTHOLD FA Number: 10074795 Address: Peconic Lane, Peconic, NY 11958 County: Suffolk MEMORANDUM OF LEASE This Memorandum of Lease is entered into on this __ day of ,200~, by and between the Town of Southold, having a mailing address at 53095 Main Road, PO Box 1179, Southold, NY 11971 (hereinafter referred to as "Landlord") and New Cingular Wireless PCS, LLC, a Delaware limited liability company; having a mailing address of 12555 Cingular Way, Suite 1300, Alpharetta, GA 30004 (hereinafter referred to as "Tenant"). Landlord and Tenant entered into a certain Lease ("Agreement") on the 27th day of March, 1991, as amended by that certain First Amendment to Lease for the purpose of installing, operating and maintaining a communications facility and other improvements. All oftbe foregoing is set forth in the Agreement. The initial lease term was ten (10) years ("Initial Term") commencing on the Effective Date of the Agreement, with two (2) successive five (5) year options to renew, which was extended by the First Amendment which commenced a new five (5) year Initial Term on April 1,201 I with five (5) successive five (5) year options to renew. 3. The land upon which the premises being leased to Tenant is located is described in Exhibit 1 annexed hereto. 4. This Memorandum of Lease is not intended to amend or modify, and shall not be deemed or construed as amending or modifying, any of the terms, conditions or provisions of the Agreement, all of which are hereby ratified and affirmed. In the event of a conflict between the provisions of this Memorandum of Lease and the ATT Masler Template v 20_BDW v I -7. Cell Site No: N109717/CN229/SOUTHOLD_WS-28747 FA No: 10074795 Site Address: Peconic Lane, Peconic, NY 11958 provisions of the Agreement, the provisions of the Agreement shall control. The Agreement shall be binding upon and inure to the benefit of the parties and their respective heirs, successors, and assigns, subject to the provisions of the Agreement. IN WITNESS WHEREOF, the parties have executed this Memorandum of Lease as of the day and year first above written. WITNESSES: Print Name: Print Name: "LANDLORD" Town of Southold By: Print Name: Its: Date: Print Name: Print Name: "TENANT" New Cingular Wireless PCS, LLC, a Delaware limited liability company By: AT&T Mobility Corporation Its: Manager By: Print Name: Its: Date: ATT Master Template_v.20_BDW vA .8- Cell SiteNo: N109717/CN229/SOUTHOLD_WS-28747 FA No: 10074795 Site Address: Peconic Lane, Peconic, NY 11958 LANDLORD ACKNOWLEDGEMENT REPRESENTATIVE CAPACITY STATE OF ) ) SS. COUNTY OF ), I certify that I know or have satisfactory evidence that is the person who appeared before me, and said person acknowledged that said person signed this instrument, on oath stated that said person was authorized to execute the instrument and acknowledged it as the of , to be the free and voluntary act of such party for the uses and purposes mentioned in the instrument. DATED: Notary Seal (Signature of Notary) (Legibly Print or Stamp Name of Notary) Notary Public in and for the State of My appointment expires: ATT Master Templatev.20_BDW v. I Cell Site No: N109717/CN229/SOUTHOLD WS-28747 FA No: 10074795 Site Address: Peconic Lane, Peconic, NY 11958 TENANT ACKNOWLEDGEMENT STATE OF ) ) ss. COUNTY OF ) I certify that I know or have satisfactory evidence that is the person who appeared before me, and said person acknowledged that he signed this instrument, on oath stated that he was authorized to execute the instrument and acknowledged it as the of New Cineular Wireless PCS. LLC, to be the free and voluntary act of such party for the uses and purposes mentioned in the instrument. DATED: Notary Seal (Signature of Notary) (Legibly Print or Stamp Name of Notary) Notary Public in and for the State of My appointment expires: ATT Master Template v 20_BDW v.I -10- Cell Site No: N109717/CN229/SOUTHOLD WS-28747 FA No: 10074795 Site Address: Peconic Lane, Peconic, NY 11958 EXHIBIT 1 DESCRIPTION OF PROPERTY Page of __ to the Memorandum of Lease dated __, 200~, by and between the Town of Southold, as Landlord, and New Cingular Wireless PCS, LLC, a Delaware liability company, as Tenant. The Property is described and/or depicted as follows: All' Master Template_v.20_BDW v.l -11- TOWN OF SOUTHOLD VENDOR 001760 AUTO-CHLOR SYSTEM 05/07/2013 CHECK 117404 FLeD & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .6772.4.400.675 25065 610619432 DISHWASHER SVC-2/13 366.40 A .6772.4.400.675 25065 610731340 DISHWASHER SVC-2/26/13 221.95 TOTAL 588.35 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Auto Chlor Vendor Telephone Number 293-0222 Vendor Contact Vendor Address 1530 Old Country Rd. Plainview, NY 11803 Date Invoice Net Total Discount Amount Claimed Purchase Order Number 610619432 1/30/2013 366.40 366.40 25065 366.40 I'OTAL Vendor No. 1760 Description of Goods or Services HRC dishwasher svce :ebruary service Payee Certification The undersigned (Claimant) (Acting on behalf of the above named clmmant) does hereby certify that the foregoing claim is true and correct, that no part has been prod, except as therein stated, thai the balance therein stated is actually due and owing, a~d that taxes from which the Town is exempt are excluded Signature '1 itle Company Name Date :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ~:".iiiilili?'i!:!::'!"i:" 'i!i!'" ........ ,:/...; ........ ; ..... l .......... .................... : :,: ::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Department Certification here§v 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 h ave,.10e~'~n verified with the exceptions or d,~epancies notedffa~d p~ment is approved 84 2Li 2813 03:33PI,1 5162938242: i5.;0 OLD COSTly ~ PL~NVIEW N~ 11803-!803 (516) 2oy 0222 TOWN t.)l-' SOUTHC LD HIJMAN P() BOX 85 MATTiTUCK NY ~1952-0000 Al ITO C:HLCIR Invoice No: Invoice Date: Route Sales R.:p: Customer No: Ten:Is: DOC No P;~GE INVOICE COPY 611)619432 01/30/I3 3 KEN WILLIAMS 610 13928 Charge T)W &'4 19275 Unused ~5x. 8 ~ t Prcv Met=r: 252872 qllo,.,efl 0 Extra: 1 x SO 0000 Qty Drily. Description Mi, Chg: $215.00 Rack C'hil: $0.00 Sub-%tal aW Cu~t: $215,00 Tota!DW Cost: $215.00 ! mit Price A~nount 3 3 3 0 5 2 0 1 1 1339 DW-MD3X DW-SUPER 8 - I&5 GAL DW-RINSATE FLOOR BREAK POT AND PAN SOLUTION QA-2.5L CONTAIN-ERS PRE RINSE PARTS ENYERGY/ENWIRN SUR. CHG LATE FEE $0.00000 $0.00 $0.00000 $0.00 $0 00000 $0 O0 S20,95000 $0.00 $I8~5~000 $92.7~ $25.85000 $51.70 $3.35000 $0.00 $0.00000 $0.00 $6 9sO00 $6.95 $0.02000 $0 O0 *Tolal S~]e $366.40 *s~l~ w× ~ 8.625% $0.00 *TotalDue $366.40 TOWN OF SOUTHOL~ Purchase Order Tax Exempt # A163554 A~ou.t # A.6:,"I'I,:3.4..4oo. Lo-fS. IDeliver and send billing to: I Department Address -To.On o-? ,..~O'~OIC~ f"~C Pc,. 13~x ~ I I V~dor I-/~0 VENDOR Return this copy and Town of Southold voucher itemized and signed for payment'" ITEM QUANTITY DESCRIPTION UNIT COST TOTAL ~OO,OC THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFY THAT THERE ARE SUFFICI6fqT FUNDS AVAILABLE I CERTIFY T~IIS TO BE A JUST AND TRUE,~URCHASE,~DER Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securfiy Number Auto Chlor VendorFelephone Number 293-0222 VendorCont~t Vendor Address 1530 Old Country Rd. Plainview, NY 11803 Vendor No. 1760 Invoice Number 610731340 31112013 Total 221.95 Discount ?OTAL Net Amount Claimed 221.95 221.95 Purchase Order Number 25065 DescriptionofGoodsorServices HRC dishwashersvce servicedate:2/26/13 ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Department Certification Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby ceffti~ 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 AUTO ~EIL OR ~Y~I EM 1BSO OLD CDUNINV RD HLAINVIEW · N¥tlDD3 (516)2~3-0222 INVOICE INVOICE ND 610721340 INVUICL DAlE 03/01/2013 DRIVER 3 KWN WILLIAM'~ TOWN OF SOUTHOLD HUMAN PO BOX 85 MATTITUCK NYllg52-OOOD CUSTOMER NO 610 13925 TERMS CRAHGE CHECK# DWA4 19275 RACXS 00001 UNUSED 3 0 DELIV PROD# B 122 tS3 56O 58O 1 800 0 B14 0 980 DESCRIPTION UNIT PRICE '~ UW MDSX 0 0000 0 UO DW SUPER 8 l&5 GAL 0 0000 0 O0 THANK YOU FOR YOUR BUSINESS YOUR NEXT SERVICE DATE IS ON 03/25/2013 *IOTAL SALE : 221.95' *SALES TAX § O.OOO: 0 00' *FREiGHI : ~) ~[OTAL DUE : 221 95* DISHWASHER SERVICE REPORT RESULTS ROUND SCREEN COND/FIT SPRAYARM JETS & BEARINGS NAIL, PAN/LEG BOLTS FILL & START BUTTONS FILL LINE CHECK MOTOR VENTS/FIllINGS WATER TEMPERATURE WATER LEVEL OPERATING PROCEDURES INSIDE HOOD/PAN COMPRESSION FITTINGS CHEMICAL WUMPS & TUBING STOP SEAT, CHAIN SOLENOID SANITIZER CC S DISPENSED TOLD EDMADE A CHEMICAL DELIEVERY NOT TO LONG AGU CLEANED AND POLISHED DW EXIERIOR TIMESTAMP: 03/01/2013 23 31 12 CUSTOMER SERVICE REPORT Customer Address SYSTEM Emergency Service Time Installation Setup Other Machine Model Other Equipment Dish, Glass & Flatware Results Operating Procedures Round Screen-Fit, StoppeflChain Inside Hood/Pan Condition Comp Fittings/Tray Rail-Nuts Vacuum Breaker Lower Arm, Spray Tee, A5 Baffle Fill & Start Button Chemical Pumps & Tubing Detergent Dispensed Check Valve Test Motor Vents/Fittings Drain Line/Hose Clear Mid Cycle/Upper Arm Rinse Aid Dispensed Lower Fill Line Check Sanitizer Test Water Temperature ...... .~,4~'~ _ Macmne Left?a_ . Scraptrap Screens Exterior Condition/Labels Product Levels. Straws & Screens Dispensers & Other Equipment Pre-soak Floor Cleaner Pot & Pan Glass Kleen D-Grease Bio-Flow Oven Clean Ali-Purpose Han-Gel Air Freshener D-Scale Disinfectant SS Polish Sol QA Bar Detergent Laundry Soap Prepared by:,l~ t; ! Your Comments & Suggestions are very important to us. crusHoAmNe rKsi~nO U FORatur~l US~~ Purchase Order # 2 5 0 6 5 Tax Exempt # A163554 Account # A. a,4.4oo, D~ver and send billing to: I rtment Address 'To~L.~I~ O-')C ..~L)'~OIC~ t-~ IVendor I-7'(~O I Aofo- Ch~or' I 'Pl~invieW, ~V ,,g'0:3 I VENDOR ITEM Return this copy and Town of Southold voucher itemized and signed for payment'' QUANTITY DESCRIPTION UNIT COST TOTAL -700, cc THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFY THAT THERE ARE SUFFICI~:~IT FUNDS~AFLABLE II~b-T~l F-/A P P R O.~/[AT I O N/C~ ARGED [~;~.' ~ead ~_~ /~Y CERTIFY T~IIS TO BE A JUST AND TRU~tURCHASE/O~DER... TOWN OF SOUTHOLD VENDOR 001003 AVAYA, INC. 05/07/2013 CHECK 117405 FLrND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT DB .5140.4.200.100 2732478430 MERLIN MTC 3/20-4/19/13 72.15 TOTAL 72.15 Town of Southold, New York Vendor Tax ID N umb*r or Social S~¢urily Number AVAYAr INC. - Payment Voucher PO BOX 5332 NEW YORK, NY [~-~d0°rN°' 1003 10087-5332 t:.r?~?' /"'i "; '/" ;" ""i ~ i.,.::i ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Number Date To~t DIs~ounl' N ,t- ?urchu¢ Order Amount Chimed Numb*r of Good~ or Servlc,~ MONTHLY MERLIN SYSTEM Payee Certification The undersigned (C~aim;.nt} (Actini: on beh~.)fof thc ;,Bow named cla(m~t) ............. ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Department Certification /,-l~it~cr ~p~,a¢l~ r/o~d. ~nd paym~n~.i~ approve. Customer Care Center 14400 Hertz Quail Sprir~g Pkwy Oklahoma City, OK 73134 SUMMARYINVOICE ~IB 01 000097 75902 B 7 A SOUTHOLD HNY DEPT PO BOX 178 P£CON[C NY 11958-0178 Account Number: 0101528928 Summary Invoice Number: 2732478430 Summary Invoice Date: 03-24-13 For ordering, balance or inquiries: call t-800-328-7833 For repair servtces: call 1-800-242-2121 New Charges Purchase Agreements/Milestone Billing Product 0.00 Service 0.00 Software 0.00 License 0.00 Freight 0.00 Total Purchase Agreement/Milestone Billing Service Agreements Hardware 72.15 Software 0.00 License 0.00 Total Service Agreement Miscellaneous Services Total New Charges Federal Excise Tax 0,00 State/Local Taxes 0.00 Total Taxes on New Charges Total New Charges and Taxes Late Fee Total New Charges 0,00 72,15 0.00 72,15 0.00 72.15 0.00 72.15 Payment is Due lmmediatel): Upon Receipt - For outstanding balance, call number above ~,,~'~ AVAYA. INC Payment is due immediately upon ,-__-~..__-~. receipt of the summary invoice. Delinquent payments are subject to a late payment charge of one and one half percent (1.5%) per month, or portion thereof, of any undisputed balance. To ensure proper credit, please indicate your account number on your check. IMPORTANT CORRESPONDENCE INFORMATION: CORRESPONDENCE Please do not send correspondence with your payment, Direst any correspondence to: 14400 Hertz Quail Springs Parkway, Oklahoma City, OK, 73134. Cancellations to service contracts must be in writing and should be sent to mycontract@avaya.com QUESTIONS REGARDING YOUR BILL if you disagree with the amount on this summary invoice, please notify us at the number liated on the front within 60 days of the original summary invoice date. Delays in notification may cause you additional expense and the reconcilition of any questioned amounts may be delayed. ISERVICE AGREEMENT ] CHANGES Any changes to your service agreement need to be in writing and should be sent to mycontract@avaya.com IPAYMENT LOCATIONS Please remit payment to the address as noted on the remittance document. ADDRESS CORRECTION If you relocate, please notify us by either telephone or in writing, using the phone number or address listed on the front of this summary invoice. Manage your Avaya account online Account Number: 0101528928 Page Number2 Suramary Invoice Number:2732478430 Sunaaary I'nvoice Date: 03-24-13 SERVICE AGREEMENTS Pumhase Order: Orig ZBWV - 40691088 Order Number/Service Contract Number: In.ice Date: 03-20-13 I Invoice Number: 2214705799 I Total this invoice 48.25 Continued AVAyA- Account Number: 0101528928 Sumary Invoice Number:2732478430 Summary [nvo~ce Date: 03-24-13 Page Number3 SERVICE AGREEMENTS (Continued) Purchase Order: Orig ZBWV - 40691088 Order NL~nber/Serv~e Contracl Nu~nber: ~nvoice Dale: 03-23-13 ! Invoice Number: 2214721292 0050485862 ~olciTo: 0004088223 Tax Ccde: 3310366041 EOUTHOLD HWY DEPT PECONIC LANE Value Added Tax: PECONIC NY 11958 Clar~y Contract ID: Remarks: MER MDL 410 ESSENTL PLUS OPT WIRE COVERG - MONTHLY MONTHLY BRIDGES PARTNER SPIRI~ MERLIN HORZ KEY - MONTHLY MONTHLY 104158 158542 Service Charge 8.38 15.52 23.90 Purchase Price/ License Fees SuMotal Shipping Freight Taxes I Federal Excise Tap O. O0 S~ate/Local Tap O, 00 Total this invoice 23,90 BULLETIN BOARD Please visit survey.walkednfo.com/SurveyAvayaUS to let us know about your purchase experience. TOWN OF SOUTHOLD VENDOR 001979 BAR BOY PRODUCTS 05/07/2013 CHECK 117406 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT A .6772.2.500.700 25403 AN9553 A .6772.2.500.700 25403 AP0217 pADDLES,SHELVES,RACKS, 400.80 EPOXY SHELVES 83.70 TOTAL 484.50 Town of Southold, New York - Payment Voucher Vend 'ax D Number or Social SpcuHty Number ~r Address Bar Boy 516-293-71S5 218 W. Montauk Hwy. Hampton Bays NY 11946 Vcndor No. 1979 Invoice Invoice invoice Ne( Purchase Order an9553 41512013 400.80 lap02'17 4112/2013 400.80 25403 83.70I [ 83.70 TOTAL 484.50 f 25403 liswasher racks/knife , shelves Payee Certification properly Date SI~..C'T: Request- for Author!~tion for B~ Pa~t- I.~y ~u~ yo~ a~o~on for ~ent of~e ~ch~ b~of ~biB'ex~ &6-~Pmv~ ~e ~ mo~t of ~'~, ~ ~ attachedbill as described above: Fax: 'x~ g/~la-Tg~4 Fax: 131/716-7103 I SOU~H6LD TOWN ~UMAN SERVICES P.O. BOX 85 750 PACIFIC STREET MAT~ ITUCK~ NY 11952--0085 ATTN: TERRY ~.,~- PG 298~-44S0 I s OUTHOLD TOWN HUMAN SERVICES 750 PACIFIC STREET MATTITUCK, NY 11~52-'0085 [mm ~8 .00 .00 400.80 ~e-monm( .'*l~llr, Um)wil~c~clonputdue*ccGur~,z~,meysms .e~cltoilow(~c(~t'fa~iced~celK~. ON REVEILSE SIDE P,O. BOX 85 750 PACIFIC STREET MATTITUCK, NY 11952-0085 ATTN: TERRY I SOUTHOLD TOWN ~UMAN SERVICES ~P.O. BOX 85 750 PACIFIC STREET MATTITUCK, NY .~11952-0085 ~0U0021631 298-4460 TRUCK*¥ 50 DAYS* A17472 1424~ 14x~4 EPOXY 15. D5 G~. 70 6 8~. 70 .00 .00 83.70 MADE. -~LL BE APPL!~ D FO S ~c ?,. - 50% RESTOCKING CHAI~( Ilurcha~e Order # 2 5 4 0 3 TOWN OF SOUTHOLD Tax Exempt Account # IDeliver and send billing Department Address r:-t'~ ~ VENDOR **Return this copy and Town of Southold voucher itemized and signed for payment** ITEM QUANTITY DESCRIPTION JN IT COST TOTAL THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFY THAT THERE ARE SUFFICIENT FUNDS AVAILABLE IN THE APPROPRIATION CHARGED ,:' (/~ ,, , "-, :/, , / Dept. Head I CERTIFY THIS TO BE A JUST AND TRUE PURCHASE ORDER Sup~i*or DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES I certify that tJ~ie~oods or/~ 7 le received by this 7:itle~/~~ Date ' / ' / DEPARTMENT BILLING COPY TERMS AND CONDITIONS I. The TOWN OF SOUTHOLD is not respon.~ible fo~ materials, supplies or equipment delivered or services performed without authority o~ written order. C)uantities specified are not to be exceeded. 2 No changes :nay b( msde in this,)rdur with,:ut zvritLen authority of the supervisor. 3, Inspection o/delivery will be made at [!elivery point unless otherwise specified. Materials must be properly packag,~d. Damaged mat(-ria! will no~ be accepted. Include itemized packing lists with ~I! sh[pr:~e~',ts. ~elivery indoor.,; is *equire~' u~:fles:; otherwise sp~,cified. All prices quoted must in. dude sl',ipl.', r~g, ~ar~dlir~g, t:ack ng and cr~:,'.in~; charges and be FiO.B deliver'ed, unless other terms are agreed ~o. 4 S~.:b,;tit~,:ilo~; of sp,.cifi,~.d i:em~; wdl ¢~ot ~e ,'.~,cceptable, The Town of Southold reserves the ..iht ~o ej~,:t ~,d :¢tu;~ [,t sh?,p,' rs expcnr,_*, materials delivered which do not conform to de* scription of item 5 Ircrder can 'et he fhed in whc!e c,'i~ pa~t in time sl'ec;','ied, notify the town immediately. In c;~se of .d'cl~y ir de',;ver¥, o~ in case of an,,/def3uit of the ~rendol; the town rnay procure the goods or se.~'vices fro:~ o!he! source,s ;."~d hold the v..,ndor responsible fog ar:y EXCESS COST, EX- PENSE OR DAMAGES occasioned therei:y. ,8 !?po~'~ accep*an,?-,, cf this oder th~ v6r'~d~:;¢' agrees to comply with all Federal, State or local iaws relative thereto: a. Th(~ w- ;,d,':,r shah defend actior s of cl ~ims brought and hold the Town el' Southold, its agents ahd its en,ployees harm!;~ss frot~ loss, suits, costs, rk3hts, patent or patent rights of any invention or any other cause. b The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maxirnum p~ices pt.-'rmitted, and are not in excess of those currently charged to other governmental, institutior~ ~1 or commercial users for similar items, quantities and deliveries. c Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 22(}-d, 220-e and 222 of the Labor Law of [he State of New York relating to maximum work- ing hours and minimum wages of employees arrd prohibiting discrimination on account of race, sex, color, c~;-ed or n-~ti.nal origin n h;rin ~ employees with;n the State of New 'Cork involved ir thr m~mufacture of m3teriah¥ equiFme ~t, or supplies specified in this order. d, T?e ve~d,~r ~-?~ali comply with Settle ~s 103.] and 103b of the General Municipal Law p,~t.;ta rfir ~; t~ disqu~!ific,:~tions t)f conti ~ct~,r for failure to wa;ye immurdty before Grand Jury. 7 INVC'iCES f',EI, OERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED tN DETAIL. Claims r:;r !~arti?.i d liv,- rie~ ar~ not. allowf-'.d unless ir dicated. Claims in question will constitute a conditic~: p~ec.de~t to thc· right o¢ the vendor or r.%eive any payment and ma[rets of dispute must be adjust~ d before final ~ccept~nce by the Town of Southold. 8 Biliing shall allow for exemption f~-om taxes under Federal Excise Tax Exemption Certificate No. A 163554 held by the Town o[ Southold. 9. Cash discount terms mdst be indicated on claim voucher; discount period will be computed from date of acceptance of de!ivery o,' receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. All RO./Claims 'nus~ b(~ audited and ~ pp~oved by the Tow~ Board prior to actual payment. TOWN OF SOUTHOLD VENDOR 002113 BARNWELL HOUSE OF TIRES, INC. 05/07/2013 CHECK 117407 FLrND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT DB .5130.4.100.550 H7320 819974 #273,296-TIRE,TUBE,WHEEL 410.00 TOTAL 410.00 Town of Southold, New York - Payment Voucher BARNWELL HOUSE OF TIRES, INC. Vendor Address 65 JETSON LANE 631-648-7t21 CENTRAL ISLIP NY 11722 JUSTINE DEROGATIS Net Purchase Order Check NO [ Invoice Invoice Invoice Number Date Total Discount Amount~ CJaimed Description of Goods or Services General Leager Fund and Account Numbe~ Payee Certification The undersigned IClaimant) (Acting on behalf of the above named claimant) docs hereby certil}, that thc lbregoing claim is true and correct that no part has been paid except as therein stated that the balance therein stated is actualb due and o~ing, and Ihal taxes Ii'om v, hlch Iht Toxkn i~ exempt are excluded Department Certification [ hereb5 certi(v that the materials above specified have been received b} me in good condition without substitution, the services properl5 perlbrmed and that tbe quantities lhcrcof have been verified with the exceptions INVOICE 819974 PAGE i BARNWELL HOUSE OF TIRES, INC. COMMERCIAL TIRE SERVICE 2020 LAKELAND AVEUNE RONKONKOMA NY 11779 (631) 737 6008 S/O: 361021-000 WHOLESALE Time In 4/09/13 10:12 Time Out: 4/10/i3 07:24 NYS FACILITY ID~ 7052033 B]I: I0 tOWN OF SOUINOiD HTGMWAY DE PECONiC FANE PO BOX 178 PECONiE NY 11958 SHIP TO PHONE 631 765 3140 CONTACT NONE CUSTOMER NO. 02322 CJSTOMER PO 7320 SERV ADVISOR IN: JF OUT: JCB WORK ORDER SHIP TO: tOWN OF SOUTHOLD H1GHWA PECONIC LANE PO BOX 178 PECONIC. NY 11958 VEH YEAR/MAKE. VEHICLE MODEL. VEHICLE COLOR. LICENSE/STATE. ODOMETR IN/OUT. VEHICLE # .... VIN # TEE PRODUCT CODE SHIPPED B/O DESCRIPTION REMIT NAYMEN1 TO~ 65 JETSON LANk CENTRAL !SLIP NY 11722 OlIO 0C1!3259i057 1 0 !O00R15 J RT500 AP RIB 000 !97407175 1 0 i000R15 TUBE TR444 000 040221000 1 0 15X8 OPEN TRUCK WHEEl 063 9402 i 0 MED TRUCK MOUNT/DISMOUNT 16 PARTS LABOR 335.00 2500 5000 LINE TOTAL 335.00 2500 5000 O0 FOR TOTAL ikRMS NET 30 CASH CHECK AMEX MASTFR VISA OISCOVER GOOOYEAR OTHER PARTS TOTAL LABOR TOTAL FREIGHT CHARGE. SUB TOTAL TAXABLE AMOUNT SA[ES TAX TIRE TAX INVOICE TOTAL ...... TOTAL DUE 41000 410 O0 410.00 410.00 PURCHASE ORDER N-~ ~ 7320 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · P. O. Box 178 · Peconic, L. I., N. Y. 11958 (631) 765-3140 · (631) 734-5211 /////~, ADD~ ~0 ~/~'~TAX EXEMPT Please Enter Our Order Fei' The Following Items (~tJty ' ' Unit Price Amount / Ordered By: ~ ~ ~der N~ M~ ~ A~F ~ In~, A~wl~ APPROVED BY: TOWN OF SOUTHOLD VENDOR 002116 LESLIE J. BAUER 05/07/2013 CHECK 117408 FI/ND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT CS .1910.4.500.300 042913 CLAIM STTLMNT-WINDSHIELD 295.00 TOTAL 295.00 iii Town of-Southold, New York - Payment Voucher Vendor Name Vend~or Telephone Number · Vendo~'~ontact - Vendor Address Invoice Invoice Invoice Number Total Vendor No. Dla~ount Pu,mhase Order Number ::::::::::::::::::::::::::::::::::::::::::::::::::::: 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 acWally due and owing, and that taxes fi~om which the Town is exempt are excluded. Signatum~ Title_ _.~ Company~ame t' CC_ )~ 5 Date Department Certification I hereby eevtlfy that the materials above specified have bee~ received by me in good eondltion without substitution, the s~wloes properly performed and that the quantitla~ thereof have b~en verified'with the exceptions or discrepancies noted, and payment is approved. lllll lllll lllll~ r-- TOWN OF SOUTHOLD 750 PACIFIC ST ..._..J~A.T TJ~U CK, NY ATLANTIC AUTO GLASS INC PO BOX 228 HOLBROOK, NY 11741 (631) 395-3500 / Fax (631) 395-3533 Fed. ID# 204109333 ~"~'~ WO A003'1973 bt. 04122/~'013 C.-~, # 2984460 I~mcode CAS H F.O. # Sold By ~e.,~axa EX-A 16356 InstIBy L (63t) 298-4.460 2012 GRAND CHEROKEE / Fax (63t) 268.4462 ~laK~ JEEP 4 DOOR UTILITY (631) 298-4460 (631) 298-4462 0 '*'-- LESLIE BAUER'S CAR - PLATE#JAZ-354 1 DW01839GBYN Windshield (sir contr)(W/Third Visor Frit) 1 LABOR Labor 2,60 hours 1 HAH000448 20 Fast-Cure Urethane, Dam, Primer 04/22/2013 0.00 0.00 0 0O 456.05 295,00 295.00 0.00 0.00 0.00 0.00 0.00 36,5 x 60,5 RECEIVE[) APR ~ 9 2013 Town Attorney's Office SPECIAL INSTRUCTION~ '~" DO NOT TA~(E TAPE OFF FOR 24hm,Do NOT DRIVE FOR 5-8 hl~,Do NOT SLAM DOORS FOR 24hm'~ ,Under p ~lally ~f perJu~,lhat: I h~e made ~pa{m to my a~omobile and I have a~ched a copy o[ my invoice as Inc. ~ ~ 228, Holbrook, NY ~1741 Labor Subtotal Tax Total Balance 0.00 295.00 0.00 295,00 295OO RECEIVED BY 4/22/13 4:08pm by ADMIN Updated 4/22/13 4:O8@m by ADMIN GENERAL RELEASE KNOW ALL PERSONS BY THESE PRESENTS, that Leslie J. Bauer, currently residing at 44335 Main Road, Peconic, New York 11958 (hereinafter referred to as the "Releasor"), in consideration of the sum of Two Hundred Ninety-Five and 00/100 Dollars ($295.00) and other good and valuable consideration, the receipt of which is hereby acknowledged, releases and discharges the Town of Southold, a municipal corporation (hereinafter referred to as the "Releasee"), Releasee's heirs, executors, administrators, successors, assigns, q[ficers, directors, shareholders' and employees of and from all and in all manner of any existing actions, causes of action, suits, debts, dues, sums of money, accounts, reckonings, bonds, bills, specialties, covenants, contracts, controversies, agreements, promises, variances, trespasses, damages, judgments, extents, executions, claims and demands whatsoever, in law, admiralty or equity, which against the Releasee, the Releasor, Releasor's heirs, executors, administrators, successors and assigns ever had, now have or hereafter can, shall or may have for, upon, or by reason of any matter, cause or thing whatsoever from the beginning of the world to the day of the date of this Release. The words "Releasor" and "Releasee" include all Releasors and all Releasees under this Release. This Release may not be changed orally. IN WITNESS WHEREOF and intending to be legally bound hereby, the Releasor has hereunto set Releasor's hand and seal on the 29th day of April, 2013. STATE OF NEW YORK COUNTY OF SUFFOLK Acknowledgment SS. On the 29th day of April in the year 2013, before me, the undersigned, personally appeared Leslie J. Bauer, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her capacity and that by her signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed this instrument. Ngtar~ Public xk,) J~NNIFER ANDALORO Notary puff/,c, 8~ate of New York No. O~ANeO~46 ELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, NewYork 11971 Fax (631) 765-6145 Telephone (631) 765-1800 www. southoldtownny, gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD From: Re: Southold Town Board Southold Town Attorney Chief of Police CR~ ~Rg ;re~' 'ee~ Jg; hn cny,A i nCc~ s h ma n ~-~'~ Elizabeth A. Neville, Town Cler~ Notice of Claim in the Matter of Leslie Bauer regarding windsheild damage to her vehicle from a Highway Department Truck Date: April 19, 2013 Transmitted is the above reference notice of claim received from the Town Comptroller's Office through the inter-office mail on this date. RECEIVE~) town Attorney'S Office RECEIVED 4/I6/2013 Leshc L Bauer PO Box 1727 Southold, NY 11971 APR lq , 013 ~outhobl Town Cle~ Southold Town Highway Department At'm: Curtis Davids, D~puty Superintendent- 275 Poconic Ln. P.O. Box 178 Peconic, NY 11958 FAX: 765-1750 Incident of 11/13/2012 Kenney's Road, Southold. NY Damage to windshield of my 2012 Jeep Grand Cherokee from debris off Town of Southold Truck. Dear Mr. Davids, I appreciate your time today to speak with me regarding thc damage to my windshield from your town truck on 11/13/2012. As loan said you requested, I filed apolice report on 11/15/2012. It follows for your review. When speaking with Joan, I advised that if possible, I would rather have the windshield replaced in warmer weather so the gaskets mad adhesives seal better. It was a cold winter. Now is a good time to have it replaced. The photos I supplied evidencing the truck, its load and the damage to my windshield was famished to your department in November, upon notification of the in¢ideat. If you would be so kind as to set up a time for the windshield replacement of my 2012 Seep Grand Cherokee, I would be most appreciative. Please call me at 516-527-7783 when an appointment mn be arranged. Be advised that I work Monday - Friday, so if it could be done at my employment in Grecnport, that would be most helpful. I look forward to hearing from you soon. Att: Incident report: 01-12-009784 National Standard Incident Incident Report Neville, Elizabeth To: Subject: Neville, Elizabeth Friday, April 19, 2013 1:03 PM Andaloro, Jennife~ Christopher Talbot; Doherty, Jilt James Dinizio; Krauza, Lynne; 'Lauren Standish'; louisa P. Evans; Neville, Elizabeth; 'Phillip Belt='; Russell, Scott; Tomaszewski, MicheBe; William Ruland 6arbara Dammers; Cushman, John; D. $imicich; Finnegan, Martin; John Shearin; Krauza, Lynne; Norklun, Stacey; Flatley, Martin (mflatley@town.southold.ny.us); Harris, Peter; Davids, Curt Notice of Claim L. Bauer Notice of Claim-L BaueL201304.. Please find the claim of Leslie Bauer for damaged windshield by Highway Department truck. Elizabeth A. Neville, MMC Southold Town Clerk PO Box 1179 Southold, NY 11971 Tel. 631 765-1800, Ext. 228 Fax 631 765-6145 Cell 631 466-6064 DRAFT FOR 5/7/13 TB MEETING RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs the payment of the sum of $295.00 to Leslie J. Bauer for property damage stemming from an incident on November 13,2012, subject to the approval of the Town Attorney. TOWN OF SOUTHOLD VENDOR 002126 ANTOINETTE BECK-WITT 05/07/2013 CHECK 117409 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .7020.4.500.420 043013 PAINTING/DRAWING-5 HRS 150.00 TOTAL 150.00 Town of Southold~ New York - Payment Voucher Vendor Address Vendor Name AntoinetteBeek-Wltt Vendor Telephone Number 1710 Gull Pond Lane Greenport NY 11944 477.5973 Vendor Contact Invoice Invoice Number Date Invoice Total Invoice Total Discount Net Amount Claimed Payee Certification Purchase Order Number Vendor No. 002126 Check No. Entered by Audit Date Clerk . Description of Goods or Services Painting & Drawing Class -~- HOURS General Ledger Fund and Account Number A7020.4.500.420 Department Certification hereby certify that lbo ma~dals above ~pe~ificd hav~ be~ r~ red by ma TOWN OF SOUTHOLD VENDOR 002281 CAROL BETTY 05/07/2013 CHECK 117410 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT MS .1989.4.000.000 10/1/12-REIS 2011-12 MEDICARE REIMB. 1,229.80 TOTAL 1,229.80 Town of Southold, New York - Payment Voucher Vendor Tax iD Number or So~ial Security Number Vendor Hame Carol Betty Vendor No. ! Vendor Address ~72 Vendor Telephone Number Vendor Contac~ Invoice Total Discount Payee Certification Invoice Number 1011112- 101t112 The undersigned (C! ~m---.'.) (Acling On behalf of thc above named claimant) does hereby certify that thc foregoing claim is true and correct, fltat no part has Check No. Entered by Audit Date HAY 0 7 2013 Company Name TownofSouthold Datc I ! performed and the the quantities tbeteof have been verified with he exceptions ot discrepancies not~d, and payment is approved. Department Certification l hereby certify tha~ the m~teriais above specified have been received by me in good condition without substit~.ioa, the services properly l~scription of Goods or Services General Ledger Fund and Account Number 2011-t2 Medicare Reimbursement MS.1989.4.000.000 TOWN OF SOUTHOLD VENDOR 002436 S~dRA BLOOM 05/07/2013 CHECK 117411 FUND & ACCOUNT P.O.# INA/OICE DESCRIPTION AMOUNT A .7020.4.500.420 043013 MEMOIR WRITING-4 HRS 120.0( TOTAL 120.00 Town of Southold, New York - Payment Voucher Vendor Name Sara Bloom Vendor Telephone Number 765.3539 Vendor Contact Invoice Number Invoice Date Invoice Total Discount Vendor Address Payee Certification Thc undorsigued (Claimant) (Acting on behaif of the above named claimant) do~ hcrcby ccrti~at th~/.f~rcgoing cia~ is tmc and correct, that no par~ has been paid, e.x~.~ ?/~ff,~fi stated,~ balance therein stated is actually Company Namc Date 240 Christopher Street Southold NY 11971 Net Amount Claimed Vendor No. 2436 Check No. Entered by Audit Date y/7/ Town Clerk Purchase Order Number Description of Goods or Services Memoir Writing Classes hours ~ / Hour General Ledger Fund and Account Number A7020.4.500.420 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 exc~i~s or discrepancies noted, and payment is approved. Signature T.le . CREATIONSUP RVlSOR Date TOWN OF SOUTHOLD VENDOR 002557 THOMAS BOUCHER 05/07/2013 CHECK 117412 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .7020.4.500.420 043013 GUITAR LESSONS-4 HRS 120.00 TOTAL 120.00 Town of Southold, New York - Payment Voucher Vendor Name Thomas Boucher Vendor Telephone Number 734.5787 Vendor Contact Invoice Invoice Number Date Invoice Total PaTM Invoice Total ,ce Certification Discount Vendor Address 1080 Fairway Drive Cutchogue NY 11935 Net Amount Claimed 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 owi]lg,.3m~ d that tagt~ fro~ which the Town is exempt are excluded. Company Name Date Vendor No. 2557 Check No. tt'tq Entered by Audit Date Purchase Order Number Description of Goods or Services Guitar Lessons ~ hours ~ $ ~ /hour General Ledger Fund and Account Number A7020.4.500.420 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 exc~.~ discrepancies noted, and payment is approved. Signature Title RECREATION SUPERVISOR Date. TOWN OF SOUTHOLD VENDOR .02614 CH3kRLOTTE & WILLIAM BURKARD 05/07/2013 CHECK 117413 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .2590.40 032013 REFUND WETLAND APP. TOTAL 50.00 50.00 Town of Southold, New York - Payment Voucher Vendor Name Charlotte & William Burkjard Vendor Telephone Number 298-4823 Vendor Contact Vendor Address PO Box 334 Mattituck, NY 11952 Vendor No. Ch~k NO: Entered by Audit Date (/ Invoice Number Invoice Date Invoice Net Total Discount Amount Claimed O 32013 3/20/201: $50.00 $50.00 Total: $50.00 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certii~ that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Company Name Date Purchase Order Number Description of Goods or Services ¢/etland Application Refund for BurkJlard; SCTM# 128-2-16 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly perlbrmed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. General Led~e~ Fund and Account Number James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 TO: FROM: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Supervisor Scott Russell Southold Town Board ~ James F. King, President :~,. ~ Southold Town Board of Trust'e-¢~ DATE: April 23, 2013 RE: Storm Related Reimbursement Requests The following actions were taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, March 20,2013: RESOLVED, that the Board of Trustees resolved to fully refund the following applications that involved a project that is storm related pursuant to Town Board Resolutions 2013-60, 2013-111,2013-189, and Town Code §111-22: · Amendment to Wetland Permit #6661 - Charlotte C. Burkard; SCTM# 128-2-16 Refund recommended: $50.00 Please send the check to: Charlotte C. Burkard PO Box 334 F/ Mattituck, NY 11952 Amendment to Wetland Permit #7978 - Chades & Janice Bovino; SCTM# 119-1- 6.1 Payable to: Suffolk Environmental Consulting, Inc. as agent Refund recommended: $50.00 Please send check to: Suffolk Environmental Consulting, Inc. PO Box 2003 Bridgehampton, NY 11932-2003 Wetland Permit #8012 - John Abbott; SCTM# 126-5-1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8011 - James Abbott; SCTM# 126-5-3.1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8035 -John Congdon & Others; SCTM#128-4-6 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7995 - Patricia Congdon O'Brien; SCTM# 128-4-1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8064 - Stephen & Elizabeth O'Shaughnessy; SCTM# 128-2-9.2 Payable to: Eh~Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit # 8063 - Mary McFeely; SCTM# 128-2-9.1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8071 - Matthew D. Volpe; SCTM# 80-5-1.1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8057- Mark Miller; SCTM# 81-3-24.2 Payable to: Costello Marine Contracting Corp. as agent Refund recommended: $250.00 Please send check to: Costello Marine Contracting Corp. PO Box 2124 Greenport, NY 11944 Wetland Permit #8067 - Peter & Dina Masso; SCTM# 111-13-4 Refund recommended: $250.00 Please send check to: Peter & Dina Masso 5705 Nassau Point Road Cutchogue, NY 11935 Wetland Permit #8070 - Philip & Carolyn Manning; SCTM# 117-10-11 Refund recommended: $250.00 Please send check to: Philip & Carolyn Manning 2 Quarry Lane Irvington, NY 10533 Wetland Permit #8023 - Dean Blaikie; SCTM# 111-15-9 Payable to: Suffolk Environmental Consulting, Inc. as agent Refund recommended: $250.00 Please send check to: Suffolk Environmental Consulting, Inc. PO Box 2003 Bridgehampton, NY 11932-2003 Wetland Permit #8047 & CEHA Permit #8047C - Soundfront Holdings, LLC; SCTM# 51-4~8 Payable to: Eh-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7998 & CEHA Permit #7998C - Peter & Madsa Patinella; SCTM# 38-6-12 Payable to: En-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7997 & CEHA Permit #7997C - Jonathan & Christine Meyer & Josephine Cippitelli; SCTM# 38-6-13 Payable to: Eh-Consultants as agent Refund recommended: $500.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7996 & CEHA Permit #7996C - Edward & Rachel Flannigan; SCTM# 38-6-14 Payable to: Eh-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8046 & CEHA Permit #8046C - Kirk O'Farrell & Denise Cerasani; SCTM# 31-13-9.1 Payable to: Eh-Consultants Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit~8044 & CEHA Permit #8044C - Norton & Wesley Davidson; SCTM# 12-2-5.3 Refund recommended: $500.00 Please send check to: Norton & Wesley Davidson 1515 Gracewood Lane Vero Beach, FL 32963 Wetland Permit #8043 & CEHA Permit #8043C - Ralph Carbone; SCTM# 1-2-5 Payable to: Glenn E. Just as agent Refund recommended: $500.00 Please send check to: Glenn E. Just PO Box 447 Quogue, NY 11959-0447 Wetland Permit #8050 & CEHA Permit #8050C - Suzanne Moyse, Mary Guerriera & Jennifer Blackhall; SCTM# 31-18-5 Payable to: Jeffrey Patanjo as agent Refund recommended: $500.00 Please send check to: Jeffrey Patanjo 106 Hewitt Boulevard Center Moriches, NY 11934 RESOLVED, that the Board of Trustees resolve to refund Linton I. Duell $150.00 in application fees as an Amendment was only required for the proposed project in lieu of a Wetland Permit: Please send check to: Linton I. Duell PO Box 387 Orient, NY 11957 cc: John Cushman - Town Comptroller Attachments TOWN OF SOUTHOLD VENDOR 002797 BURT'S RELIABLE 05/07/2013 CHECK 117414 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT DB .5110.4.100.200 DB .5110.4.100.200 DB .5110.4.100.200 DB .5110.4.100.200 DB .5110.4.100.200 DB .5110.4.100.200 A .1620.4.100.250 H7314 10653V-31351 518.2 GAL DIESEL H7323 10653V-31800 311.7 GAL DIESEL H7339 10653V-31888 385.8 GAL DIESEL H7346 10653V-31918 402.3 GAL DIESEL H7352 10653V-32169 555.5 GAL DIESEL H7358~/;~V~.~_. ~344.3 GAL DIESEL 255~,~£-'~ ~-~000 GALS #2 FUEL OIL 1,747.63 1,063.68 1,277.96 1,304.46 1,790.10 1,109.51 3,312.50 11,605.84 Town of Southold,' New York - payment Voucher va"t'~ )'k"'~ ~ { v,~,.,,-. ,,~ · V .en~,~ Tck'i~ ~ ; ' ' From: NIC Holding Corp To: Burrs- John Romanelli Page: 1/1 Date: 4/5/2013 4:36:35 PM ' Northville Prices Effective April 5, 2013 18:00 hrs Northville (Holtsville) ope. 24/7 '¢/2 Non-Hwy Diesel Motor Fuel .................. $ 3.2225 *** see change notice below Clear 15ppm Hw.~y Diesel ~otor Fuel ......... ~.~-~$. 3.2225 Dyed 15ppm Non-Hwy Diesel Motor Fuel $ 3.2325 Clear Prem 15ppm Hwy Diesel Motor Fuel.. _: ~. $ 3.2425 Dyed Prem 15ppm Non-Hwy Diesel Motor Fuel.. $ 3.2525 Dyed Kerosene (Bottom Load only) ....... $ 3.8495 Vehicle Refueling MV Diesel ...... $ 4, 1 000 (Before taxes 3.35486) Ethanol Regular Gas ........ $ 2.7205 Ethanol Premium Gas ...... $ 3.0175 Ethanol Midgrade Gas ...... $ 2.8125 E-85 (70%) ..................... $ 2.6750 3.2225 0.1500 002 3.3725 Inland Terminals Frank Bros. (Bay Shore) General Term ofW. Islip Romanelli (Lindenhurst) (EZ-Access number REQUIRED - Go to www. northville, corn) 631-665-3300 # 2 Non-Hwy Diesel Motor Fuel- $ 3.2225 631-422-5746 # 2 Non-Hwy Diesel Motor Fuel- $ 3.2225 63f-956-f20f # 2 Non-Hwy Diesel Motor Fuel- $ 3.2225 # 2 Non-~qwy Diesel Motor Fuel- $ 3.2225 Romanelli open Saturdays 7'am to f2pm Oswego (Hempstead) 516-485-3900 Prices do not include taxes -Tom Mag no 04/03/13 - #2 Non-Hwy Diesel Motor Fuel (1602) NOW contains bio diesel. PURCHASE ORDER N~- H 7314 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · P. O. Box 178 · Peconic, L. I., N. Y. 11958 (631) 765-3140 · (631) 734-5211 ~ ~ ~ ~/~ ~o/,~ ADDRK~ DATE REF # DESCRIPTION Ensure Proof Cr~it P(ease Oetach Up ~rtion And ~turn With ~yment 4/06/13 31351 DIESEL-TAX FR 518.2 < TOTAL AMOUNT > DELIVERED TO: AMOUNT GAL@3. 3725 1747.63 1747.63 SOUTHOLD TOWN HIGHWAY DEPT/PECONIC LANE/( BURTPS RELIABLE We'll Take Cam of It~ HEATING · AIR CONDITIONING · PLUMBING Home Heating Oil · Kerosene · Diesel Tel: (631) 765-3767 · Fax: (631) 765-1744 · wwmburts.com Town o£ Southold,'New $ork - ~'ayment Voucher [Vc~dor No. ' DATE REF # DESCRIPTION ~EnsureProperCreditP[easeDetach~p~ionAndRetumWithPayment ./ / 4/09/13 31800 DIESEL-TAX FR 311.7 GAL@3.4125 AMOUNT DELIVERED TO: 1063.68 < TOTAL AMOUNT > 1063.68 SOUTHOLD TOWN HIGHWAY DEPT/PECONIC LANE/( BURTIIS ____.. RELIABLr. We'll Take Care of ItTM HEATING · AIR CONDITIONING ° PLUMBING Home Heating Oil · Kerosene · Diesel Tel: (631) 765-3767. Fax: (631) 765-1744 · ww~burt$.com ,. From: NIC Holding Corp To: Burrs- John Romanelli Page: 1/1 Date: 4/8/2013 4:38:08 PM - Northville Prices Effective April 8, 2013 18:00 hrs No~hville (Holtsville) open 24/7 # 2 Non-Hwy Diesel Motor Fuel ...................... $ 3,2825 ~ Hwy Diesel Motor Fuel ............... $ 3.262~5 _/ Dyed 15ppm Clear Prem 15ppm Hwy Diesel Motor Fuel ........ $ 3.2825 Dyed Prem 15ppm Non-Hwy Diesel Motor Fuel.. $ 3.2925 Dyed Kerosene (Bottom Load only) ........ $ 3.8895 Vehicle Refueling MV Diesel ............... $ 4,1000 (Before taxe.~ 3.35486) Ethanol 'Regular Gas ........ $ 2.7705 Ethanol Premium Gas ...... $ 3.0675 Ethanol Midgrade Gas ...... $ 2.8625 E-85 (70%) ..................... $ 2.6750 3. 2625 + 0.1500 + lteaH0.: 002 10bi: 3.4125 * Inland Terminals Frank Bros. (Bay Shore) General Term of W. Islip Romanelli (Lindenhurst) (EZ-Access number REQUIRED - Go to www. norfhville, com.) 631-665-3300 # 2 Non-Hwy Diesel Motor Fuel- $ 3.2625 631-422-5746 # 2 Non-Hwy Diesel Motor Fuel- $ 3.2625 63f-956-120f # 2 Non-Hwy Diesel Motor Fuel- $ 3.2625 # 2 Non-'Hwy Diesel Motor Fuel- $ 3.2625 Romanelli open Saturdays 7am to f 2pm Oswego (Hempstead) 536-485-3900 Prices do not include taxes -Tom Magno PURCHASE ORDER No H 7323 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · P. O. Box 178 · Peconic, L. I., N. Y. 11958 (631 ) 765-3140 · (631) 734-5211 20 13 ~DDRF~ Pka~ nter Our Order Fa The Followia8 Items APPROVED BY: Towno£Southold, ew ork- Vendor Comzct !.-.'~e- '--. · 'Tot~ N~m~er Pnyee Cerfific~on Thc tmdctsif~.d (Cl~mant) (Actin~ On Ix:~lf of t~ abevc doc3 I~rcby certify t~at the fo~e~oin~ cb:~n ~s ~ and cor~ct, bccn Ixikt, Ip~cep! Is ~hcrcin statc(~ t~l b~'~l~ncc tl~rci~ s~tcd ~ ~l~ ~ ~ ~L ~ ~t ~ from ~h ~ T~ h cx~ ~c DATE REF # DESCRIPTION Ensure Proper Credit Please Detach Up ~rtion And Return With Payment 4/12/13 31888 DIESEL-TAX FR 385.8 AMOUNT GAL@3.3125 1277.96 < TOTAL AMOUNT > 1277.96 SOUTHOLD TOWN HIGHWAY DEPT/PECONIC LANE/( DELIVERED TO: BURTPS RELIABLE We'll Take Care of It.TM HEATING · AIR CONDITIONING · PLUMBING Home Heating Oil · Kerosene · Diesel Tel: (65 I) 765-3767 · Fax: (63 I) 765-1744 · www. buds. com From: NIC Holding Corp To: Burrs- John Romanelli Page: 1/1 Date: 4/11/2013 4:37:39 PM o hville Prices Effective April 11, 2013 Cb.. 18:00 hrs Northville (Holtsville) open 24/7 ' 'Ct 2 Non-Hwy Diesel Motor Fuel ...................... $ 3.1625 Clear 15ppm Hwy Diesel Motor F~uel ......... $ 3.1625 Clear Prem 15ppm Hwy Diesel Motor Fuel ....... $ 3.1825 Dyed Prem 15ppm Non-Hwy Diesel Motor Fuel.. $ 3.1925 Dyed Kerosene (Bottom Load only) ....... $ 3.7895 Vehicle Refueling MV Diesel ............... $ 4.1 000 Co,ore ¢~x~ ,3.35486) Ethan'c~l Regular Gas ........ $ 2.7005 Ethanol Premium Gas ...... $ 3.0075 Ethanol Midgrade Gas ...... $ 2.8125 E-85 (70%) ..................... $ 2.6750 3.1625 0.1500 002 3.3125 Inland Terminals Frank Bros. (Bay Shore) General Term ofW. Islip Romanelli (Lindenhurst) (EZ-Access n umber REQUIRED - Go to www. noHhville, corn) 631-665-3300 # 2 Non-Hwy Diesel Motor Fuel- $ 3.1 625 631-422-5746 # 2 Non-Hwy Diesel Motor Fuel- $ 3.1625 631-956-1201 # 2 Non-Hwy Diesel Motor Fuel- $ 3.1 625 Ct 2 Non-Hwy Diesel Motor Fuel- $ 3.1625 Romanelli open Saturdays 7am to 12pm Oswego (Hempstead) 516-485-3900 Prices do not include taxes -Tom Magno [TJEntered & Sent PURCHASE ORDER NO H 7339 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · E O. Box 178 · Peconic, L. I., N. Y. 11958 ADDRE~ - Please I~ate* Our Order For The Followin8 Items I~antity Desc~p~ion Unit Price Amount Ordered By: ~ ' ,~ Purchase Order Number Mus . m-ent And Par. kases. APPROVED BY: Town of Southold, New Fork- ~ayment Voucher v~ 1,1-.~ne / Vender ~ - No. ' Department Cettificalion ccnif~ that t~e mJl~:bJ$ ~b~v~ sl~:~l'~J:l h~ve ~n r~:~ivcd by m~ good condi6on v~ut s~. ~ ~s ~o~r~ From: NIC Holding Corp To: Burts- John Romanelli Page: 1/1 Date: 4/15/2013 4:38:21 PM Northville Prices Effective April 15, 2013 ¢~. 18:00 hrs ' Northville (Holtsville) ope~ 24~7 # 2 Non-Hwy Diesel Motor Fuel ................... $ 3.0925 - Dye~'~FSp-~m Non-HWy Di-~sel M~or Fuel ...... Clear Prem 15ppm Hwy Diesel Motor Fuel ........ $ 3.1 125 Dyed Prem 15ppm Non-Hwy Diesel Motor Fuel $ 3.1225 Dyed Kerosene (Bottom Load only) ...... $ 3.7195 3.0925 0.1500 002 Total: 3.2425 Vehicle Refueling MV Diesel ........... $ 4.0500 (Before taxes 3.30690) Ethanol Regular Gas ........ $ 2.6605 Ethanol Premium Gas ...... $ 2.9675 Ethanol Midgrade Gas ...... $ 2.7725 E-85 (70%) ..................... $ 2.6750 (changing from 70% to 74% 4/16 O0:OOhrs) Inland Terminals Frank Bros. (Bay Shore) General Term ofW. Islip Romanelli (Lindenhurst) (EZ-Access number REQUIRED - Go to www. northville com) 631-665-3300 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0925 631-422-5746 # 2 Non-Hwy Oiesel Motor Fuel- $ 3.0925 63f-956-f20f # 2 Non-Hwy Diesel Motor Fuel- $ 3.0925 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0925 Romanelfi open Saturdays 7am to 12pm Oswego (Hempstead) 5'16-485-3900 Prices do not include taxes -Tom Magno DATE REF # DESCRIPTION ~EnsureProperCr~itP[easeDetach~p~rtio~AndReturnWithPayment / / 4/16/13 31918 DIESEL-TAX FR 402.3 GAL@3.2425 < TOTAL AMOUNT > DELIVERED TO: AMOUNT SOUTHOLD TOWN HIGHWAY DEPT/PECONIC 1304.46 1304.46 LANE/( BURTPS RELIABLE We'll Take Care of It~ HEATING · AIR CONDITIONING · PLUMBING Home Heating Oil · Kerosene · Diesel Tel: (631) 765-3767 · Fax; (631) 765-1744 · www. burts.com PURCHASE ORDER ., N9 734.6 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · E O. Box 178 · Peconic, L. I., N. '~ 11958 (631 ) 765-3140 · (631) 734-5211 ,, ADDRE~ ~ ~nter Our Order For The Followins Items Quantity Description Unit ~ Amount /)~' .,a .,,,, Ordered By: Pumhaae Order Number Mm Appear 0n Invite. Acknowled~ ment And APPROVED BY: Town of Southold, New York - Payment Voucher Ven~tor Telephone Number Vendor Con[act Invoice invoice Number Date To[al Discount Vendor No. Vendor Address Net Purchase Order ~.mount Claim Number Description of Goods or Services Check No. Entered by ~ Audit Date ~.-._. Ledger F~md a~ Payee Certification Thc undersigned (Cla~manl) (Acting on behalf of the above named claimant) docs hereby ccrii~ thal the £orcgoing claim is tnie and correct, thai no pari has Department Certification I hereby certit~ that thc materials above specified have been received by mc in good condition without substitution, the services properly performed and that thc quantities thereof have been verified with the excepttons or c,es noTted, and p~,nt ts approved S ,gnatur~)~ ~, . [ ,~ DATE REF # DESCRIPTION ~ Ensur~ P~per Credit Please Detach Up ~rtion And Return With ~yment / / 4/19/13 32169 DIESEL-TAX FR 555.5/GAL@3.222~' < TOTAL AMOUNT > DELIVERED TO: AMOUNT 1790.10 1790.10 SOUTHOLD TOWN HIGHWAY DEPT/PECONIC LANE/( BURTPS RELIABLE We'll Taka Care of It.'~ HEATING · AIR CONDITIONING · PLUMBING Home Heating Oil · Kerosene · Diesel Tel: (631) 765-3767 ·/:ax' (631) 765-1744 · www. burts.com From: NIC Holding Corp To: Buffs- John Romanelli Page: 1/1 Date: 4/18/2013 4:37:59 PM Northville Pdces Effective April 18, 2013 18:00 hrs Northville (Holtsville) o~=n 24/7 · # 2 Non-Hwy Diesel Motor Fuel ...................... $ 3.0725 Clear 15ppm Hwy Diesel Motor Fuel .............. ~ , ~ Clear Prem 15ppm Hwy Diesel Motor Fuel ........ $ 3.0925 Dyed Pram 15ppm Non-Hwy Diesel Motor Fuel.. $ 3.1025 Dyed Kerosene (Bottom Load only) ..... $ 3.6995 Vehicle Refueling MV Diesel ........... $ 4.0000 (Before taxes 3.25894) Etha~)l Regular Gas ........ $ 2.8105 Ethanol Premium Gas ...... $ 3.1175 Ethanol Midgrade Gas ...... $ 2.9225 E-85 (74%) ..................... $ 2.7250 3.0725 0.1500 ltemHo.: 002 ToLoI: 3. 2225 Inland Terminals Frank Bros. (Bay Shore) General Term ofW. Islip Romanelli (Lindenhurst) (EX-Access n umber REQUIRED - Go to www. northville, corn) 631-665-3300 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0725 631~422-5746 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0725 631-956-1201 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0725 # 2 Non-Hwy Diesel Motor Fuel- $ 3,0725 Romanelli open Saturdays 7am to 12pm Oswego (Hempstead) 546-485-3900 Prices do not include taxes -Tom Magne PURCHASE ORDER N-~ ~ 7352 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · P. O. Box 178 · Peconic, L. I., N. Y. 11958 (631) 765-3140 · (631) 734-5211 / Plea~ Enter Our Order For The Followini item~ quantity Description Unit Pri~e Amount OrderedlBy: By' ~ ment And P~ APPROVED BY: ,,Town of Southold, New York - ~'ayment Voucher Number IVcndor No. Vendo~ Addrcs~ lnvoic~ Invoice Discount Numar CheckNo. Illqlq Entered by __ ~--A_~< Payee Certification The undersig~d (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has Department Certification :-~_~ ~t,~ ~,~-/~ DATE REF # DESCRIPTION AMOUNT ~[nsureProperCreditP(easeOetach~p~ionAndReturnWithPayment /' 4/23/13 32299 DIESEL-TAX FR 344.3 GAL@3.2225 1109.51 < TOTAL AMOUNT > 1109.51 DELIVERED TO: SOUTHOLD TOWN HIGHWAY DEPT/PECONIC LANE/( BURTPS RELIABLE We'll Take Care of It'~ HEATING · AIR CONDITIONING o PLUMBING Home Heating Oil · Kerosene · Diesel Tel: (631) 765-3767 · Fax: (631) 765-1744 · wwvzburls.com From: NIC Holding Corp To: Burts- John Romanel~i Page: 1/1 Date: 4/22/2013 4:0818 PM Northville Prices Effective April 22, 2013 18:00 hrs NO CHANGE Northville (Holtsville) op~ 24/7 # 2 Non-Hwy Diesel Motor Fuel ...... $ 3.0725 Clear 15ppm Hwy Diesel Motor Fuel ....... ~.0725 ~.~ '~q~d~5'~m Non-Hwy Diesel Motor Fuel $ 3.0825 Clear Prem 15ppm Hwy Diesel Motor Fuel ...... $ 3.0925 Dyed Prem 15ppm Non-Hwy Diesel Motor Fuel_ $ 3.1 025 3.0725 + 0.1500 + ]temHo.: 002 ~tal: 3.2225 * Dyed Kerosene (Bottom Load only) $ 3.6995 Vehicle Refueling MV Diesel .... $ 4.0000 (Before taxes 3.25894) Ethan(~i Regular Gas ........ $ 2.7905 Ethanol Premium Gas ...... $ 3.0975 Ethanol Midgrade Gas ...... $ 2.9025 E-85 (74%) ..................... $ 2.7250 Inland Terminals Frank Bros· (Bay Shore) General Term of W. Islip Romanelli (Lindenhurst) (EZ-Access number REQUIRED - Go to www northvi//e com) 637-665-3300 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0725 631-422-5746 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0725 63f-956-f201 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0725 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0725 Romanelli open Saturdays 7am to ¢2pm Oswego (Hempstead) 5?6-485-3900 Prices do not include taxes -Tom Magno PURCHASE ORDER No t~ 7358 $OUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · R O. Box 178 · Peconic, L. I., N. Y. 11958 (631) 765-3140 · (631) 734-5211,,~/,/ ,/-//,: ADDR.F_,.q~ ~r Our Order For The Followin~ Items Qu~ntlty Description Unit Price Amount Ordered B~~=. APPROVED BY: DATE REF # DESCRIPTION Ensure Pr6per Credit Please Detach Up ~rtion And ~turn With Payment 4/17/13 32051 ~2 FUEL OIL 1000.0 GAL@3.3125 AMOUNT DELIVERED TO: 3312.50 < TOTAL AMOUNT > 3312.50 SOUTHOLD DEPT OF PUBLIC WORKS/PECONIC LAN BURTPS RELIABLE We'll Take Care of It~' HEATING ° AIR CONDITIONING ° PLUMBING Home Heating Oil · Kerosene · Diesel Tel: (631) 765-3767, Fax: (63 I) 765-1744 · www. burts,com From: NIC Holding Corp To: Burts- John Romanelli Page: 1/1 Date: 4/16/2013 4:39:01 PM /'~No~hville Prices Effective April 16, 2013 ~ 18:00 hrs Northville (Holtsville) open 24/7 # 2 Non-Hwy Diesel Motor Fuel ............. $ 3.0625 Clear 15ppm Hwy Diesel Motor Fuel ............ $ 3.0625 Dyed 15ppm Non-Hwy Diesel Motor Fuel ......... $ 3.0725 Clear Prem 15ppm Hwy Diesel Motor Fuel ........ $ 3.0825 Dyed Prem 15ppm Non-Hwy Diesel Motor Fuel.. $ 3.0925 Dyed Kerosene (Bottom Load only) ...... $ 3.6895 Vehicle Refueling MV Diesel ........... $ 4,0000 (seCure tax.~ 3.25694) Ethanol Regular Gas ........ $ 2.8105 Ethanol Premium Gas ...... $ 3.1175 Ethanol Midgrade Gas ...... $ 2.9225 E-85 (74%) ..................... $ 2.7250 · .0.. CA 3. 0625 0.2500 002 Total: 3. 3125 Inland Terminals Frank Bros. (Bay Shore) General Term ofW. Islip Romanelli (Lindenhurst) (EZ-Access number f~EQUIRED - Go to www northvfl/e corr¢ 63¢-665~3300 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0625 63f-422-5746 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0625 631-956-720f # 2 Non-Hwy Diesel Motor Fuel- $ 3.0625 # 2 Non-Hwy Diesel Motor Fuel- $ 3.0625 F~omanelli open Saturdays 7am to f 2pm Oswego (Hempstead) 516-485-3900 Pdces do not include taxes -Tom Magno TOWN OF SOUTHOLD JI~liwr ~11 J~l billlq I I I I ITEM VENDOR **Return this copy and Town of'Southold voucher itemized and si~ed for payment** QUANTITY UNIT COST TOTAL THIS PURCHASE ORDER IS 'NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFY THAT THERE ARE S U FFI C~Ilfl't~J~RI*~LE I CERTIFY THIS TO BE A JUST AND TRUE PU,~CHASE ORDER Supewb~r DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES TERMS AND CONDITIONS 1. The TOWN OF SOUTHOLD is not responsible for materials, supplies or equipment delivered or services performed without authority of written order. Quantities specified are not to be exceeded. 2. No changes may be made in this order without written authority of the supervisor. 3. Inspection of delivery will be made at delivery point unless otherwise specified. Materials must be properly packaged. Damaged material will not be accepted. Include itemized packing lists with all shipments. Delivery indoors is required unless otherwise specified. All prices quoted must in- clude sh;pping, handling, packing and cratin9 charges and be FO.B delivered, unless other terms are agreed to. 4 Substitutions of specified item. s will not be acceptable. The Town of Southold reserves the right to reject a~d return at shipp~-~rs exp~nse, materials deliw, red 'which do not conform to de- scription of item ordered. 5, If order cannot be filled in whole or in part in time specified, notify the town immediately. In case of delay in deliver,/, or in case of any default of the vendor, the town may procure the goods or services fror;; other sources aqd hold the vendor responsible for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby. fi. Upon acceptance of this o~-der th~~, vendor agrees to comply with all Federal, State or local laws relative thereto: a. The vendor shall defend actions or claims brought and hold the Town of Southold, its agents arid its employees harmless from loss, suits, costs, ri~chts, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c. Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- lng hours and minimum wages of employees and prohibiting discrimination on account of race, sex, color, creed or national origin in hiring employees within the State of New York involved in the manufacture of materials, equipment, or supplies specified in this order. d. The vendor shall comply with Sections 103a and 103b of the General Municipal Law pertaining to disqualifications of contractor for failure to waive immunity before Grand Jury. 7. INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. Claims for partial deliveries are not allowed unless indicated. Claims in question will constitute a condition precedent to the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. 1 !i All P.O./Claims must be audited and approved by the Town Board prior to actual payment. TOWN OF SOUTHOLD VENDOR 043541 C.MARTIN AUTOMOTIVE ~806 05/07/2013 CHECK 117415 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT A .1620.4.100.500 25442 389769 FILTER KIT, FILTER 151.96 A .1620.4.100.500 25442 389771 ATF FLUID,BULBS 221.40 DB .5130.4.100.500 H7294 389957 OIL FLTR,BULB,FLSHR,SCKT 138.31 A .1620.4.100.500 25442 390308 CREDIT-LED BRAKE LIGHT 20.28- DB .5130.4.100.500 H7312 390830 #245,251,F/M-FLTRS,BLBS, 679.80 A .1620.4.100.500 25489 .,.~9~-<.~£~ ?~ UJOINT FILTER FLTR KIT 243.70 DB .5130.4.100.500 H733~i~..~ ....... -~i!~.l~ FILTERS,BULBS,HRDWR 581.43 DB .5130.4.100.500 H~f~ !2~8~251-UJOINT,BAR LINK 331.94 ~ .1620.4.100.550 ,~'~ !~.~TER,~I~E SRA,~LG lS0.39 A .1620.4.100.550 ~i)~ ,$ILTERS 57.63 DB .5130.4.100.500 [I~.ERS OIL,H3%RDW/MRE 576.07 3,112.35 C. MARTIN AUTOMOTIVE 31097 RT. 25 CUTCHOGUE, NY 11935 ~ PHONE: (631) 734-9000 FAX: (631) 734-5318 ~J~® NOTICE TO CUSTOMER AFTER 20 DAYS -OPEN ACCOUNTS DUE AND PAYABLE 10TH OF EACH MONTH WITH NO CREDIT EXTENDS TO UN-PAID ACCOUNTS AFTER THE 20TH OF MONTH FOLLOWING PURCHASES 4 ~ PER MONTH SERV C C UN.pAID I~AEANCE. ~T # ~D TO DATE TIME STORE # CM # '74.~':'~1 (Z~l:;q,J- DE]::'T) SOUTHOL. 1) 'I'OLJN Ht,J'~' 03/27/1314:26 200007[306 4 "' ' ~" SM ~ J::q~]]X]N1;f;;: i f::d.lE PURC~ ORDER ~ A~N~ON AD ~R~: '?h <,~ 'c ri e Sa I e ':~ DELIVERY: :i of PART NU~ ~ ~SC~ ~ Pfl~E N~ TOTAL ....... ~ { 3,,.J~O 43.08 AFTER 20 DAYS A CHARGE OF 20% WILL BE MADE ON ALL ITEMS RETURNED FOR CREDIT OR EXCHANGE NO REFUNDS ON ELECTRICAL ~ TOTAL :=-=> [.ha'~,ge Sale ' "' '...,t~ '-/ SIGNATURE ALL GOODS RF_T,I~RNED MUST BE ACCOMPANIED BY THIS INVOICE C. MARTIN AUTOMOTIVE 31097 RT. 25 P.O. BOX 761 CUTCHOGUE, NY 11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 NOTICE TO C[I~IrOMER PLEASE EXAMINE THESE PARTS AT ONCE. NO REFUND ON ELECTRICAL PARTS SPECIAL ORDERS OR ANY MERCHANDISE THAT HAS BEEN USED OR INSTALLED 20% HANDLING CHARGE ON UN-USED MERCHANDISE RETURNED AFTER 20 DAYS -OPEN ACCOUNTS OUE AND PAYABLE 10TH OF EACH MONTH WITH NO CREDIT EXTENDS TO UN.PAID ACCOUNTS AFTER THE 20TH OF MONTH FOLLOWING PURCHASES. 4% PER MONTH SERVICE CHARGE ON DN.PAIO BALANCE ACCT # SOLD TO DATE TIME STORE # CM # I~;t, ze]r#::a;[e]~ '74/:';1 ();)l::q,,J... :OEI::'"{') S[)I]TH(]L]) TOWI.I HWY C, 3/2'7/:1,:i!t:1.4'.'28 I 2000078061 4 389'7';?~ SM ~ I::'E:~':(')I,I]:C I..AI,IE PURCHA~ O~R ~ A~ENTION x.x..x. {..If)l.. I) :l: t".l~J[:):]: CE: :,,:..x..x-.x-.x- : .. ~ ~.. .:i: DELI~: :1. of" " PART ~ER ~ D~CRI~ QU~ ~ICE NET TOTAL ...... I., o NC; R/INNE]:~' T'I~E B'O[) E;ND ~.. O0 93,, 5L, ~:l.,, 9500 81.95 ~:~'~)1 1 ] 56[.dH BK I.J~[;D RF;hC~d<F" '¥'~'::tIt )})I.]L }~:: i. OO ~. OC. 20. 6900 .'-.:. ~.). n? -...,. / ATI I::'L.ATII.ILIM I .I. 1... I I.l~ K.]Tl' 1. O0 60,, 54 48,. 4700 48.4'7 ;:4~: U~I ATF" + 4 I:L [.1:1:):) 8. O0 ')., OC 9. 3500 74,, 80 RETURNED FOR CREDIT OR EXC~IANGE' NO REFUNDS ON ELECTRICAL SC~ btota ]. 225 ,, 9 :l. 'TAXTABI...E 1 8.62o0%" '"' 0,. O0 ~ % 0,, ()0 'FO'/AL ==) Char te ,:ale ,:x:~,. 9:i ~ '-"'"-~'" .,,~NATURE ALL GOODS RETUR~rO MUST BE ACCOMPANIED BY THIS INVOICE C. MARTIN AUTOMOTIVE 31097 RT. 25 P.O. BOX 761 CUTCHOGUE, NY 11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 NO~CE TO CUSTOMER pLEASE EXAMINE THESE PARTS AT ONCE NO REFUND ON ELECTRICAL PARTS, SPECIAL ORDERS OR ANy MERCHANDISE TI,AT HAS BEEN USED OR ~NSTALLED. 20% HANDLING CHARGE ON UN-USED MERCHANDISE RETURNED AFTER 20 DAYS OPEN ACCOUNTS DUI AND PAYAOLE 1O~d OF EACH MONTH WITH NO CREDIT EXTENDS TO UN-PAID ACCOUNTS AFTER THE 20T~ OF MONTH FOLLOWING PURCHASES 4% PER MONTH SERVICE CHARG~ ON UN-PAID BALANCE ACCT # SOLD TO DATE TIME STORE # CM # SM ~ PEC:OhN;E I r::d.~l: PURCHASE ORDER ~ A~E~ION PART N~R LN DE~R~ QUA~ PRI~ N~ TOTAL I I % (),, O0 'f'C)TPiL =:=.~ C'r'(.~d :[ 'b I"l,:{.m~c:, ;:.!0 ,, f:,%" SIGNATURE iODS RETURN~:D MUST BE ACCOMPANIED BY THIS INVOICE TOWN OF SOUTqOLD L ' I * *!;1~ thit (~:N)Y a~l Ta~m of Southotd voui~er itemizlKI ~td ~ for payment'* ITEM QUANTITY DESCRIPTION TOTAL TH I~I~RCHilI~E ORDER IS NOT VALID WItHOUT'ricE SIGNA~IflES OF THE DEPT. HEADAND THE SUPERVISOR DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES Date TERMS AND CONDITIONS 1. The .TOWN OF SOUTHOLD is not responsible for materials, supplies or equipment delivered or services performed without authority of written order. Quantities specified are not to be exceeded. .,. 2. No changes may be made in this order without written authority of the supervisor, 3, Inspection of delivery will be made at delivery point unless otherwise specified: Materialsmust be properly packaged. Damaged material will not be accepted. Include itemized packing lists with at! shipments, Delivery indoors is required unless otherwise specified. All prices quoted must in- clude shipping, handling, packing and crating charees and be F.O.B delivered, unless other terms are agreed to. 4. Substitutions of specified items will not be acoeptable. The Town of Southold reserves the right to reject and return at shippers expense, materials delivered which do not conform to de- scription of item ordered. 5, If order cam~ot be filled in whole cr in pa~ in time specified, notify the town immediately. In case of delay in delivery, ol in case of any default of the vendor, the town may procur~the goods or services from other sources and hold the vendor responsible for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby. 6. Upon acceptance of this order the vendo,' agrees to comply with all Federal, State or local laws relative thereto: a. The vendor shall defend actions or claims brought and hold the Town of Southold, its agents and its employees harmless from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c. Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- ing hours and minimum wages of employees and prohibiting discrimination on account of race, sex, color, creed or national origin in hiring employees within the State of New York involved in the manufacture of materials, equipment, or supplies specified in this order. d. The vendor shall comply with Sections 103a and 103b of the General Municipal Law pertaining to disqualifications of contractor for failure to waive immunity before,Grand Jury. 7. INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. Claims for partial deliveries are not atlowed unless indicated. Claims in question will constitute a condition precedent to the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; cliscount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. 1!. Alt PO./Claims must be audited and approved by the Town Board prior to actual payment. C. MARTIN AUTOMOTIVE i 31097 RT, 25 P,O, BOX 761 CUTCHOGUE, NY '11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 PLEASE EXAMINE THESE PARTS AT ONCE NO REFUND ON ELECTRICAL PARTS, SPECIAL ORDERS OR ANY MERCHANDISE THAT HAS BEEN USED OR INSTALLED 20% HANDLING CHARGE ON UN-USED MERCHANDISE RETURNED AFTER 20 DAYS -OPEN ACCOUNTS OUE AND PAYABLE 10TH OF EACH MONTH WITH NO CREDIT EXTENDS TO UN-PAID ACCOUNTS AFTER THE 20TH OF MONTH FOLLOWING PURCHASES 4% PER MONTH SERVICE CHARGE ON ACCT # SOLD TO DATE TIME STORE # CM # SM # F'~i (:h::)H:I:E ~ Fd,H: PURCHASE ORDER ~ A~ENTION AD TERMS: FJ .:~ ~<-., ~1~.:.:. ;'~= '~ DELIVERY: PART NUMBER LN DESCRIP~ON QUAN~ PRICE NET TOTAL AFTER 20 DAYS A CHARGE OF 20% W~LL BE MADE ON ALL ITEMS 'f'~::lX'f'f:'~:~l...ll; :1. 8 ........ ).~ C,,, O0 //"~..~ -/'~--~--~ ¢'""'-/'/.,/~ I G N AT U R E ALL GOODS RETU~]~ED MUST BE ACCOMPANIED BY THIS INVOICE I I 31097 RT. 25 P.O. BOX 761 CUTCHOGUE, NY 11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 NOTICE TO C~STOMER pLEASE EXAMINE THESE PARTS AT O~NCE NO REFUND ON ELECTRICAL PARTS, SPECIAL ORDERS OR ANY MERCHANDISE THAT HAS BEEN USED OR INSTALLED 20% HANDLING CI4ARGE ON UN-USED MERCHANDISE RETURNEF~ AFTER 20 DAYS -OPEN ACCOUNTS DUE AND pAyABEE lOTH OF EACH MONTH WITH NO CREDIT EXTENDS TO UN-PAID ACCOUNTS AFTER THE 20TH OF MONTH FOLLOWING PURCHASES 4% PER MONTH SERVICE CHARGE ON UN PAID B~I~NCE ACCT # ~tll_l~ TO DATE TIME STORE # CM # SM · PA~ ~ bN D~ : ~N~ P~E N~ TOTAL ,,,~8 55. '7900 ..... SU b'b(:.)ts a 1 ~,::: ,':~ ~"i!.., 'T'~%X'T'~::~BLE: :[ 8.. 6,2',50% O,. C, 0 % O ,..:::, 0 ,Sale ':" '; / :: ":' AFTER 20 DAYS A CHARGE OF 20% WILL BE MADE ON ALL ITEMS RETURNED FOR CREDIT OR EXCHANGE NO REFUNDS ON ELECTRICAL PARTS OR SPECIAL ORDERS ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE C. MARTIN AUTOMOTIVE 31097 RT. 25 P.O. BOX 761 CUTCHOGUE, NY 11935 PHONE: {631) 734-9000 FAX: (631) 734-5318 I PLEASE EXAMINE THESE pAF~S AT ONCE. NO REFUND ON ELECTRICAL PARTS, SPECIAL ORDERS OR ANY MERCHANO~SE THAT HAS BEEN USED OR INSTALLED 23% HANDLING CHARGE ON UN-USED MERCHANDISE RETURNED A~TER 20 DAYS -OPEN ACCOUNTS DUE AND PAYABLE 10TH OF EACH MONTH W~TH NO CREDIT EXTENDS TO UN-PAID ACCOUNTS AFTER THE 20TH OF MONTH FOLLOWING PURCHASES 4% PER MONTH SERVICE CHARGE ON UN PAID BALANCE ACCT # SOLD TO DATE TIME STORE # CM # SM ~ I:'l:h;%)l, KIh;;; I. ¢fl-,-II;; PURCHASE ORDER ~ A~EN~ON PART NUMBER LN DE~RIP~ QUAN~ PRICE NET TOTAL AFTER 20 DAYS A CHARGE OF 20% WILL BE MADE ON ALL ITEMS PARTSRETURNEDOR SPEClALFOR CREDIToRDERSOR EXCHANGE NO REFUNDS ON ELECTRICAL ~ v- ~ SIGNATURE ALL GOODS'RETURNED MUST BE ACCOMPANIED BY THIS INVOICE Or,er # 2 5 4 8 9 ~/ ver billing to: end rtment TOWN OF SOUTHOLD VENDOR FTEM "Return this copy end Town of Southold voucher iter~ized and signed for payment'' QUANTITY DESCRIPTION THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF I CERTIF'~ THAT~.'rHERE ARE S U F F I~,~~?~.~.BLE/ IN T~,fE A~PROPRIATIOI~,~ED I CERTIF'~, THIS T~O BE A JUST ~ AND TRLI~'PURCIqASE ORDER! Supervisor UNIT COST THE / were received by this Title Date '~ "'" TOTAL DEPARTMENT BILLING TERMS AND CONDITIONS 1, 'l'he TOWN OF SOUTHOLD is not responsible for materials, supplies or equipment delivered or services performed without authority of written order. Quantities specified are not to be exceeded. ;t, No changes may be made in this order without written authority of the supervisor. 3. Inspection of delivery will be made at delivery point unless otherwise specified. Materials must be properly packaged. Damaged material will not be accepted. Include itemized packing lists with all shipments. Delivery indoors is required unless otherwise specified. All prices quoted must in- clude sl~ipping, handling, packing and crating charges and be EO.B. delivered, unless other terms are agreed to. 4. Substitutions of specified items will not be acceptable. The Town of Southold reserves the ~ight to reject and return at shippers expense, materials delivered which do not conform to de- scription of item ordered. 5. If order cannot be filled in whole or in part in time s[~ecified, notify the town immediately. In case of delay in delivery, or in case of any default of the vendor, the town may procure the goods or services from other sources and hold the vendor responsible fo~ any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby. 6 Upon acceptance of this order the vendor agrees to comply with all Federal, State or local laws relative thereto: a. The vendor shall defend actions or claims brought and hold the Town of Southold, its agents and its employees harmless from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c, Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- lng hours and minimum wages of employees and prohibiting discrimination on account of race, sex, color, creed or national origin in hiring employees within the State of New York involved in the manufacture of materials, equipment, or supplies specified:in this order. ? d. The vendor shall comply with Sections 103a and 103b of the General Municipal Law pertaining to disqualifications of contractor for failure to waive immunity before Grand Jury. 7. INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. Claims for partial deliveries are not allowed unless indicated. Claims in question will constitute a condition precedent to the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for exempt~0n from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by :the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. 11. All P.O./Claims must be audited and approved by the Town Board prior to actual payment. 1~8.g ~957~6Z ~ 11,'7'(:, 5'76,o7 C. MARTIN AUTOMOTIVE 31097 RT. 25 P.O. BOX 761 CUTCHOGUE, NY 11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 ACCT # SOLD TO DATE TIME STORE # CM # 748' Southr_~l d Town Hi mhwa~¢ 03/29/13JtO: ~ 0 1 6;oooo-78o61 4 SM ¢ P e c o n ~ c ' a n e ,,PU~HASE ORDER ¢ A~N~ON ~ HOL. D INVOICE******* h7294 4 iNVOiCE MUST BE SIGNED DE~ERY: of 1 P~T N~MB~R ~ ~~ ~ P~I~ ~ TOTAL t791 FIL OzL FILT 3. O0 27. 23 13. 9000 b.--c, NF EL_ECT-ME:CH FLASHER 1.00; 3-. 76 ~:7. 190(: E:¥'.. 19 IEP-. S(5 NF ELECT--MECH FLASHER 1. 001 ....... ':.z =.~ 2t. 4906 755'.'5048 B~ TRAILER CONN SOCKET 2,0( I5.38 9.990C I9,.98 '?~S- 5(-)FIE' B~~ BOOT ¢..'~' 0.¢ 0.0C 4. ~/ v SIGNATURE ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE Subtotal 14t. I3 TAXTABLE 1 8. 6250% % O. 00 TOTC~L ==) Charge Sale C. MARTIN AUTOMOTIVE 31097 RT. 25 P.O. BOX 761 CUTCHOGUE, NY 11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 e AFTER 20 DAYS A CHARGE OF 20% WILL BE MADE ON ALL ITEMS / / SIGNATURE -- ALL GOO[~'~ETURNED MUST BE ACCOMPANIED BY THIS INVOICE 31097 RT. 25 P.O. BOX 761 CUTCHOGUE, NY 11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 ~~ P~:.~,::: <::, n :i ~:: L an~::, PURCHASE ORDER # ATTENTION P~ NU~ AFTER 20 DAYS A CHARGE OF 20% WILL BE MADE ON ALL ITEMS RETURNED FOR CREDIT OR EXCHANGE NO R[FUNDS ON [LECTRICAL PARTS OR SPECIAL ORDERS '~' SIGNATURE ALL GOODS~ETURNED MUST BE ACCOMPANIED BY THIS INVOICE PURCHASE ORDER Ne H 7312 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · P. O. Box 178 · Peconic, L. I., N. Y. 11958 (631) 765-3140, (631) 73~5211 20/~ Ordered By: a~ Pmrd~ O~der Number Ma C. MARTIN AUTOMOTIVE 31097 RT. 25 P.O. BOX 761 CUTCHOGUE, NY 11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 NO'I]CE TO CUSTOI4~R pLEA~ EXAMINE THESE pARTS AT ONCE NO REFUND ON ELECTRICAL PARTS, SPECIAL ORDERS OR ANY M EFICHANDISE THAT HAS BEEN USED OR INSTALLED 2(3% HANDL}NG CHARGE ON UN-USED MERCHANDISE RETURNED AFTER 20 DAYS ~)~EN ACCO~JNTS DUE AND pAyABLE ~OTH O{c EACH MONTH WITH NO CREDIT EXTENDS TO UN-PAID ACCOUNTS AFTER T~E 20TH OF MONTH FOLLOWING PURCHABES 4% PER MONTH SERVICE CHARGE ON DATE TIME STORE # CM # ~A~ PRICE ~ TOTAL -I- ! RETURNED FOR CREDIT OR EXCHANGE NO REFUNDS ON ELECI~ilCAL PARTS OR SPECI~ ORDERS ALL GOODS~PANIED BY TH~S INVOICE C. MARTIN AUTOMOTIVE 31097 RT. 25 CUTCHOGUE, NY 11935 PHONE· (631) 734-9000 FAX: (631) 734-5318 ACC# SOLD TO : DATE TIME STORE # CM # , '*' . ~:~(* C, OC,":~c,(~(: .... i 'e,:: ,:::,~'/:i. ,::: h ::~ ,",(:, , PURCHASE ~DER ~ A~EN~ON SM '~ ' :,~ :,,: i .'.(31..D INUO;DZ:i~;.x.x..),:..~,:.~,>*-x. I '~':':~c ..... 3 I::' ',* '-.-: ~' ~': ,, NY :t. :i ?:~5~?...-0C, 0C, T~ ~EMP~ON: ~: ~-?~,k ;I. '/ C "~ .~ ~~ :~A~ PRI~ NET TOTAL i { :;7 L.i~ ~t I{ ';:: 10. O0 ,,,:::' ..,,.,':: ':' ,::.. 3 :~OO ,:'"':',, ":"¢ '7,::::,:":, ; ;-:'6'7 BK ,..~, ,r" ,~:: '¢":: ':;,(::, ..., i. O0 1 :: , ¢:' :: :1.4. 9900 :i. 4,, :; RETURNED FOR CREDIT OR EXCHANGE NO REFUNDS ON ELECTRICAL PARTS OR SPECIAL ORDERS · ~URE ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE TAXTABLIE .1. 8. 6250% TOTAU :==~ PURCHASE ORDER NE H 7294 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · P. O. Box 178 · Peconic, L. I., N. Y. 11958 (631) 765-3140 · (631) 734-5211 APPROVED BY: PURCHASE ORDER N-~ H 7338 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · R O. Box 178 · Peconic, L. I., N. Y. 11958 (631) 765-3140 · (631) 734-5211 ! Ordered By: '~ ~ Order Numt~r Mm APPROVED BY: ~ C. MARTIN AUTOMOTIVE 31097 RT. 25 P.O. BOX 761 CUTCHOGUE, NY 11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 PLEASE EXAMINE THESE PARTS AT ONCE NO REFUND ON ELECTRICAL PARTS, SPECIAL ORDERS OR ANy MERCHANDISE THAT HAS BEEN USEO OR INSTALLED 20% HANDLING CHARGE ON UN-USED MERCHANDISE RETURNED AFTER 20 DAYS ~OPEN ACCOUNTS DUE AND PAYABLE 10TH OF EACH MONTH WITH NO CREDIT EXTENDS TO UN-PAID ACCOUNTS AFTER THE 20TH OF MONTH FOLLOWING PURCHASES 4% PER MON1~ SERVICE CHARGE ON ACCT # SOLD TO DATE TIME STORE # CM # ~ ~: ,~:~ c [..':, ~ ,<: PURCHASE ORDER ~ A~ENTION 5M ~ :: F',".,::',.:~:~,:,, hlY 1 :~ ":':q':[~ ,::':.:::,,:':..:'~ T~ EXEMPTION: AD TERMS: ~J ,:~,::,i.: :l '~' E: h ~:~,.'~- q ~.::. ::~'F :EHUO:I:r:TE~ jq[P~[~"¢ ;:'dT ~;:D:~HE:~::~ DELIVERY: :i or :i PART NU~ER LN DESCRIPTION QUANTI~ PRICE NET TOTAL ~::~:'r~:~ ~ I'iF':~ U---.'r~:'~:NT :1.. 00~ (::,,, OO 3~3.. 8900 ~ iF/:,.':~::~C,~,,~.~::'~ )3RG '~:~:;h'", I.~l..l:J' 'Y :[ ,, OO, :[ (:)~.:~,, ';:'C~ '70.. ~300 Lh~, I b.%l I'.iCP ~;I,d¢:~Y '~.:.:~:;~ ~.:i:hiK :1.,, OC :1.:3'7,, 04 .:1.~,:.,,, 4800 AFTER 2O DAYS A CHARGE OF 20% WILL BE MAOE ON ALL ITEMS RETURNED FOR CRED~I OR EXCHANGE NO REFUNDS ON ELECTRICAL ALL GOODS RET SIGNATURE · ' MUST BE ACCOMPANIED BY THIS INVOICE T~qX'f'~::d3l .[i; :1. ~,,, f. .... O..g 0,, O0 % 0,, OC, TO ADDRF~ PURCHASE ORDER No H 7356 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · P. O. Box 178 · Peconic, L. I., N. Y. 11958 ~(631) 765-3140 .DA~(631) 734-521 31097 RT. 25 P.O. BOX 761 CUTCHOGUE. NY 11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 ACCT # SOLD TO DATE TIME STORE # CM # ';;'~:~0 ~;c)tL'bl'~c):l. cl Town Higl'l~y ] 0000'780 ,I 4 i:,(~(::.on :i. c I...~ne PURCHASE ORDER ~ A~ENTION SM ~ ~. ~.l..If:)l...i) 3: NUO ];CE*..~***.*-* h'73E, 1 · 3 I:'e(~(:)n:L(z~ NY 119~:58..-0000 T~EXEM~ION: AD TERMS: weel.:.].7 C;h~t'r ~e) 30 ]:NUO]:CE I'IUST [{{E S:[6NED DELIVERY: J. (:)f 2 PART HUMBER LN ~SCRI~ION GUA~I~ PRICE NET TOTAL [:~1:{;3z, 8 E~}~ [{L.D~E:R FIOTC)R RES]:~TC) 1. O0 3:1.. ~ :L~. 0400 18. OZ, I::CZ~ EC~ COIqNI:::CTOR ~.. O0 23.99 ~.3. 5700 ~.~. ~7 ~+()'7~. FZL COOL CON ~. O0 30.30 :LS. 4~00 30. :1.307005 ~[J~ I~EYER L.O~ TI::~I::' O:I:L ~;:~. O0 O, O0 ~2. 4900 J. 49.88 ~,0~--"2039 9K E:NG]:NE HOUI,IT ~. O0 98.1~ (:,9.3"900 69. '['(:-;6045 ECb 'FOGGI..E S~ :[ TCH ~. O0 ~.{~. 09 1 J.. 9300 J. 1 .. 93 '725.--.:1.653 t)K PRESTO F']:N 3 J.~:, J.. O0 O. O0 3. 7900 3.79 3:1.:1.8 F[L FUEl.. F[I.. 1.O0 24,0~ ~.~700 3377 F':L FUEL F:[I.. ~.00 32.59 J.G,.G~400 :1.791 F[L 0:[I.. F]:LT ~.00 27.23 ~3.9000 13.90 :1.74/:~ F:L O]:L F:ZL.. J.. O0 :1.04.30 53. ~300 53. ~3 3739 FIL NAF'A[3[)I...D I::'UI[::I... F:ELTE:R 1. CO 46.59 ~3.78,00 23. '7~:$ 775OS FIL I'IRF'AGOL[) O]:1... FIL.TE:F~ $.. OO ~. 60 ~O. 3~00 ~0.3~ ~',:5~,9 FI{ RIRF:[I... 2. O0 53.57 27. 3500 54.70 65~,2 FIL ~:[R F]:L 1. O0 95.34 48. E~700 48. AFTER 20 DAyS A CHARGE OF 20% WILL BE MADE ON ALL ITEMS SIGNATURE ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE C. MARTIN AUTOMOTIVE CUTCHOGUE, NY 11935 PHONE: (631) 734-9000 FAX: (631) 734-5318 ACCT # SOLD TO DATE TIME STORE # CM # Town H:i. ghway l e0000780 ,1 4 3932.62 7480 Southolcl Peconic l_~1'1~ PURCHASE ORDER ~ A~EN~ON SM ~ ~HOL]) ZNg0~CE~*.x-**.x..x.* h7361 3 Pecon:Lc~ NY [~958.-..0OO0 T~ EXEMPTION: AD TERMS: ~eek[~ Charge 30 INgO~CE MUST BE SIGNED DEEVERY: ~ of 2 PART NUMBER LN DE~RI~ION QUANTI~ PRICE NET TOTAL '285135 NW BATTERY ACCE:SSORIES 4. O0 21.08 1J.. 7000 46.80 AFTER 20 DAYS A CHARGE OF 20% WtLL BE MADE ON ALL ITEMS RETURNED FOR CREDIT OR EXCHANGE NO REFUNDS ON ELECTRICAL PARTS OR SPECIAL ORDERS iLL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE St~btotal 587.83 TAXTABI_E 1 8.68.50% 0,. O0 % 0. O0 TOTAL. =-'=) Charge Sale 587.83 PURCHASE ORDER N-~ H 7361 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · R O. Box 178 · Peconic, L. I., N. Y. 11958 (631) 765-3140. (631) 734-521/ /,//,..~ ~...____ /_ ADDRESS TOWN OF SOUTHOLD VENDOR 002915 CABLEVISION 05/07/2013 CHECK 117416 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION ~J~OUNT A .1680.4.200.100 A .1680,4.200.100 A ,1680.4.200.300 A .1680.4.200.100 391317029-0513 MNTHLY MTC-HWY-5/13 84.06 397990019-0513 MNTHLY MTC-REC-5/13 79.90 398620011-0513 MTHLY MTC-MEDIATRAQ-5/13 54.95 403953018-0513 MNTHLY MTC-HRC-5/13 79.90 298.81 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securiiy Number Vendor Name Cablevision Vendor Telephone Number Vendor Contact Vendor Address PO Box 9202 Uniofidale, NY 11555-9202 Vendor No. Check No. Entered by ~(~ Audit Date 14AY 0 7 2013 ~F. qown Clerk Number .0-78-39-391317-02-9 07-839-397990-01-9 Discount Invoice Invoice Date Total 5/15/2013 $84.06 5/15/2013 $79.90 5/15/2013 $79.90 $0.00 Net Amount Claimer $84.06 $79.90 65~5 · -7C$~403953-01-8 $79.90 07~,.~$-403986-01-9 $0.00 Payee Certification $243.86 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 X Signature Title Company Name Date Purchase Order Number Description of Goods or Services Monthly Maint. - Highway Month y Maint. - Rec D/~ 3 Monthly Maint. - HR(:. ~ Monthly Maint. - Landfill General Ledger Fund and Account Number A.1680.4.200.100 A.1680.4.200.100 A. 1680.4.200.100 A.1680.4.200.100 Department Certification l hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Title Account Number Service for 07839-391317-02-9 TOWN OF SOUTHOLD H.D 275 PECONIC LN PECONIC NY 11958 Billing Period 05/01/13-05/31/13 Includes Payments Received By 04/24/13 Last Bill Balance $168.12 Payments - Thank You! $168.12 cr Remaining Balance $0.00 Current Charges - Due By 05/15/13 $84.06 Total Amount Due $84.06 Payments 04/16 payment-Thank You $168.12 cr Total Payments $168.12 or TV 05/01 -05/31 Optimum Value $0.00 05/01 -05/31 Box Discount $3.00 cr Special Promotion 05/01 -05/31 1 Cable Box(es) $695 (At $671 each and remote(s) at $0 24 each) 05/01 -05/31 10able Box(es) $0.00 (At $671 each and remote(s) at $024 each) Tota~l ~V ~.95 Internet 05/01 - 05/31 05/01 - 05/31 05/01 -05/31 Optimum Online $54.95 Static IP $10.00 (5 usable IP addresses) (Requires Boost Plus or Ultra) Boost $14,95 Total Internet $79.90 Taxes & Fees 05/01 - 05/31 TV Taxes and Fees $~0.2J Total Taxes & Fees $0.21 Subtotal of Current Charges Remaining Balenee $0.00 Current Chargea $84.06 Total Amount Due $84.06 Online Pmduct~ & euppert Online bill pay, www optimum net/myaccount Ohannelline up, www opitmum net/supporl Live chat, www optimum f~et/WeChat For help, www twitter com/optimumhelp Follow us, ~ twilter corn/optimum Like us, www facebook com/opitmum Ll~et Vulsngm~? ke it easy. Visit www optimum corn/moving You're open for business with fast, bee WiFi. It's never been easier to check emil, piece orders end manage your day to day trom virtually anywhere. In addition to saving on data chmges, you and your smart phone, laptop or tablet can enjoy unlimited access to aver 75,000 Optimum hotspots ail at your favorite Ioca~ons acress ~he bi-state area, including hundreds of commutm rail stations. Went a Toll Free number, or transfer your current phone number? A Toll Free number isn't simply a bee call for your customers, it's an effective marketing tool. Adding our Toll Free service will give you the beadem to add multiple toll bee phone lines, ail for less than t~e phone company. Optimum is the way to go, when you're going Toll Free. optimum.net ] facebook.com/optimum twitter.com/optimum Your FCC Community ID# is NY 0188. 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Sunrise Highway, Freeport, NY 11520 595 South Broadway, Hicksville, NY 11801 Suffolk County: 1144 Route 109, Lindenhurst, NY 11757 254 Old Country Road, Riverhead, NY 11901 32 Hill Street, Southampton, NY 11968 11 Industrial Road, Port Jefferson Station, NY 11776 1600 Motor Parkway, Hauppauge, NY 11788 1070 E, Jericho Turnpike, Huntington, NY 11743 To find other locations where you can make a payment to your Cablevision account, contact any of the following: IPP - 877-PAY-AT-IPP (877-729-2847) Western Union (800)-354-0005, Option 5 or www.westernunion corn Pay-O-Matic- 888-PAY-3773 (888-729-3773) Checkfree Pay 1-855-578-6415 or www.pheckfrespay corn Boxing: Mayweather vs. Guerrero: Sat, May 4 Pre-Show 7pm, Event 9pm on Pay-Per-View, only $59.95. Order with your remote 15 minutes before event start. HD: channel 550; SD; channel 551. Programming subject to change. Digital cable box required, Don't miss May's new Movies On Demand on channel 500. Premiering 5/'/- Jack Reacher, 5/7 - Stand Up Guys, 5/14 - Cloud Atlas and 5/21 - The Lost Stand. Watch them in HD at the same great price. A digital cable box is required. WWE: Extreme Rules: Sun., May 19 Pre-Show 7:30pm, Event 8pm on Pay-Per-View, only $44.95. Order with your remote 15 minutes before event start. HD: Ch. 550; SD: Ch. 551. Programming subject to change. Digital cable box required. Get the best selection of international programming from around the world in your language. Choose from over 45 Spanish-language channels featuring a wide variety of your favorite telanoveles and shows, as well es Chinese, Russian, South Asian channels and more. Call 1-888-947-1870 for details. Did you know that unless you secure your wireless router others can see your home or business network and use your signal? Protect your important files, identity and prevent unauthorized access to your PC. Check the settings on your wireless router to be sure it is secure by referring to the manual or Wedsita for your router. Aisc visit www.optimum net/SupportFrutorials for a helpful video on Wireless Security. Mail above portion with your payment. --- ~ag-e 2 of-2 PAYMENT INFORMATION: Authorization To Convert Your Check To An Electronic Funds Transfer: By sending your chuck to us as payment, you authorize us either to j~se [nlormation from your check to make a one time electronic funds transfer lrom your account or to process the payment as a check transaction - Payment is due by the due date indicated on the front of your Payments not received within 30 days may be sent to collections within 60 days will incur a $8 late tee YOU will receive written notice of service interruption lor non payment Payments can be made at no charge through our Automated Phone System by calling Customer Support Follow the phone prompts to set up an automated poyment by check or credit card Entering your Optimum account number and zip code authorizes an ACH habit entry to your bank account that can only be revoked by calling Customer Support - If your service is interrupted for non-payment, payment o1 the past due amoun~ and applicable reconnection charges is required before service is restored Any service interruption will affect TV, iO TV, Phone, and Internet serwces Reconnection of service will be done on the next available appointment - You are responsible for lost, damaged or unreturned ~quipment and will be charged the full replacement lee (Digital Video Recorder - $265, Cable Box - $120, Tuning Adapter $f40, Remote Control $3.00, Smart Card - $75, CableCARD - $40, Cable Modem -$100, Wheless Router - $50, Static IP Router-$29g, Voice Enabled Medem 4 pod Sf 00; 12 port $750, SIP Trunk Interface Device - $750.00) - If your bank returns your check unpaid, you will incur a $20 lee BILLING INFORMATION: - Billing errors must be reported within 30 days, in writing, detailing the error, and sent to the Customer Suppo~ address on the front of your bill. We wJJt investigate and reply within 10 days To avoid service interruption, you should pay the undisputed porpon of the bill, If you are not satisfied with our reply, you may write to The New York State Department of Public Service, Three Empire State Ptaza, Albany, NY 12223- 1350 or call 1 800-342-3377 - You are billed each month in advance for the next month's services Charges for On Demand/Pay Per View will appear on the next billing statement following your order On Demand/Fay Per View purchases are not subject to refund or credit. Use parental control features to avoid unwanted purchases if your monthly account balance for On Demand/Pay Pe¢ View selections exceeds $55 ($175 for customers in good standing after 90 days), we reserve the right to limit additional On Demand/Pay Per View orders If any changes are made to your account during the month, partial month charges may apply - There is an additional monthly charge for equipment, including cable boxes and remote controls There is also a monthly lee to access premium or digital programming on additional TV sets in your home Your monthly bill includes all government fees These fees are a percentage of your total monthly cable bill paid ~o your state and local governments under the terms and agreements with them to provide cable service In addition, the Federal Communications Commission (FCC) collects a small fee from every cable customer to cover the administrative costs relatad to cable regulation SERVICE INFORMATION: Technical: If you are having trouble w0h service: 1 ) Ensure your equipment (TV and cable bex, or cable modem) is correctly plugged in 2) For cabte problems, check that your TV (and VCR, if at,ac he~) is tuned to Channel 3 3) CheCk all cable connections for a secure lit If you still have a problem, call Customer Support and we Will troubleshoot or send a techn~;ian Il no cable-rotated problems are found, you may incur a cbalge for the technician visit Il you have a cable related outage that lasls for more than three consecutive hours, you will receive full credit on your bill for the lime lost provided you call or write us withi~ 30 days ol the outage Parental Control: Your cable box allows you to block one or more channels and On Demand/Pay Per View purchases For information, refer to your Optimum Reference Guide, visit optimum net/parentalcontrpa or call Customer Support B37 Account Number Service for 07839-397990-01-9 TOWN OF SOUTHOLD REC 970 PECONIC LN PECONIC NY 11958 Billing Period 05/01/13-05/31/13 Includes Payments Received By 04/24/13 Last Bill Balance $159.80 Payments - Thank You l $159.80 cr Remaining Balance $0.00 Current Charges - Due By 05/15/13 $79.90 Total Amount Due $79.90 Payments 04/16 05/01 - 05/31 05/01 -05/31 05/01 - 05/31 ~a~LmffntrTh~n_ k Yqu Total Paymenta $159.80cr $159.80cr Optimum Online Static IP (5 usable IP addresses) (Requires Boost Plus or Ultra) Boost Total Intarnat $54.95 $10.00 $!4.95 $79.90 Subtotal of Current Charges Remaining Balance Current Charges Total Amount Due $79.90 $79.90 $79.90 Online Ptoducta & Support Online bill pay, www optimum net/myaccount O Channel line up, www optimum net/support Live chat, www op[imum net/livec ~at For help, www twitter com/optimumhelp Follow us, www twitter com/optimum Uke us, www f~cebook corn/optimum ~ 6A~G~r~rmateCr~eianler'~aD~e, Melville, NY 11747 The O~limum Bu~lnen~ Aenount Center: N~ y~ ~ ~ ~ ~ ~1 y~r sew~ in ~ pl~ wi~ a ~w ~ ~y to ~ ~h~d, i~i~ ~ ~r~ like ~ ~ Day ~1 f~di~ ~d ~r ~ ~s f~re ~ ~ ~t of y~r sew~ ~ mu~ ~. For a qu~ ~ur, ~ ~ ~.OptimumBusiness.com/ac ~ ~ I~ in ~ y~r Op~mum ID ~ ~ ~.Optimum.ne~busmess. You're ~n ~r ~si~s wi~ ~t, ~ ~Fi. I~s ~er ~ ~ ~ ~ ~1, ~ ~rs ~ m~e y~r ~y ~ day ~om vi~y ~e. In ~i~ to savi~ ~ ~ ch~, y~ ~ your s~ p~, I~p ~ ~t ~ ~y unam~ ~s ~ over 75,~ Op~mum ~ ~1 ~ y~r fav~ ~ ~r~s ~e ~i-s~ m~, i~l~i~ hu~r~ of ~mm~r r~l s~. W~t a Toll Fr~ nu~, ~ ~sf~ y~r curr~t ~ num~ A T~I Fr~ numar ~n~ sim~y a ff~ ~1 ~r y~r c~t~, Irs ~ eff~e m~ t~l. ~di~ ~r T~I Fr~ sew~ will gna you ~ ~ to add mul~ t~l ff~ ~ li~, NJ f~ ~s ~ ~ ~ ~y. Optimum ~ ~ way ~ go, wh~ you're g~ T~I Fr~. optimum.net ] tacebook.com/optimunq twitter.corn/optimum Your FCC Community ID# is NY 0188. Optimum Storee: You may choose to pay your bill online at www.optimum.net/MyAooount or at any of our Optimum Stores. To find your nearest Optimum Store and for store hours go to www.optimum.net/stores. To make changes to your account or pick up new equipment, you need to be an authorized user. This means that your name must be listed on the account, and to ensure account security, you will need to present a photo ID. Optimum Store Locations: Naaea__u_~_o~nty: 1072 Old Northern Boulevard, Roslyn, NY 11576 160 E. Sunrise Highway, Freeport, NY 11520 595 South Broadway, Hicksvilte, NY 11801 Suffolk County:.' 1144 Route 109, Lindenhurst, NY 11757 254 Cid Country Road, Riverhead, NY 11901 32 Hill Street, Southampton, NY 11968 11 Industrial Road, Port Jefferson Station, NY 11776 1600 Mo~3r Parkway, Hauppauge, NY 11788 1070 E. Jericho Turnpike, Huntington, NY 11743 To find other locations where you can make a payment to your Cablevisian account, contact any of the following: IPP - 877-PAY-ATqPP (877-729-2847) Western Union (800)-354-0005, Option 5 or www.westa[nunian.com Pay-O-Matic* 888-PAY-3773 (888-729-3773 Checkfree Pay 1-855~578-6415 or www.checkfreepa~v corn Did you know that unless you secure your wireless router others can see your home or business network and use your signal? Protect your important files, identity and prevent unauthorized access to your PC. Check the settings on your wireless router to be sure it is secure by referring to the manual or Website for your router. Aisc visit www.optimum,net~SupbertjTutorials for a helpful video on Wireless Security. Mail above portion with your payment. Page 2 of 2 PAYMENT INFORMATION: Authorizati(m To Convert Your Check To An Electronic Funds Transfer By sending your check to us as payment, you authorize us either to,se information from your check to make a one-time electronic funds ~ransfer from your account or to process the payment as a check transaction Payment is due by lhe due date indicafed on the front of your bill. - Payments not received within 30 days may ba sent to collechens ang within 60 days will incur a $8 late fee You will receive written notice of service interruption for non-payment. Payments can be made at no charge through our Automated Phone System by calling Customer Support Follow the phone prompts 1o set up an automated payment by check or credit card Entering your Optimum account number and zip code authorizes an ACH debit entry to your bank account that can only be revoked by calling Customer Support - If your service Is interrupted for non*payment, payment of the past due amount and applicable reconnection charges is required before service is restored Any service interrupt~n will affect TV, iO TV, Phone, and Internet services Reconnec0on of service will be done on the next available appointmenf - You are responsible for lost, damaged or unreturned equipment and will be charged the full replacement fee (Digital Video Recorder - $265, Cable Sex - $120, Tuning Abapter - $140, Remote Control- $3.00, Smad Card $75, CableCARD $40, Cable Modem -$100, Wireless Router - $50, Static Ip Router $299, Voice Enabled Modem - 4 port $100; t 2 port $750, SIP Trunk interface Device - $750.00) - if your bank returns your check unpaid, you will incur a $20 fee BILLING INFORMATION: - Billing errors must be repoded within 30 days, in writing, detailing the error, and sent to the Customer Support address on the front of your bill We investigate and reply within 10 days. To avoid service interruption, you should pay the undisputed portion of ~ba bill It you are not satisfied with our reply, you may write fo The New York State Department of Public Service, Three Empire State Plaza, Albany, NY 12223- 1350 or call t-800-342-3377. - You are b[Ired each month in advance for the next month's services Charges for On Demand/Pay Per View will appear on ~he next billing statement following your order - On Demand/Pay Per View purchases are not subject to refund or credit Use parental con~rol features to avoid unwanted purchases, - II your monthly account balance for On Demand/Pay Per View selections exceeds $55 ($175 for customers in good standing after 90 days), we reserve the right to limit additional On Demand/Pay Per View orders If any changes are made to your account during the monlh, partial month charges may apply - There is an additional monthly charge for equipment, including cable boxes and remote controls There is also a monthly fee to access premium or digital programming on additional TV sets in your home. ~ Your monthly b[Ir includes all government fees These fees are a percentage ol your ~otal monthly cable bill paid to your state and local governments under the terms and agreements with them to provide cabre service In addi~ion, the Federal Communications Commission (FCC) collects a small fee lrom every cable customer to cover the administrative SERVICE INFORMATION: Technlcah if you are heving trouble with service: 1 ) Ensure your equipment (TV and cable box, or cable modem) is correctly plugged in 2) For cable provided you call or write us within 30 days of the outage and On Demand/Pay Per View paredases For information, refer to your Customer Suppad .I Page 1 of 2 Account Number Service for 07839-403983.01-8 TWN OF SOUTHOLD HR 750 PACIFIC ST COMM MATTITUCK NY 11952 Billing Period 05/01/13- 05/31/13 Includes Payments Received By 04/24/13 Last Bill Balance $159.80 Payments - Thank You! $159.80 cr Remaining Balance $0.00 Current Charges - Due By 05/15/13 $79.90 Total Amount Due $79.~0 Payments 04/16 Payment-Thank You $159.80 cr Total Payments $159.80 cr Internet 05/01 -05/31 Optimum Online $54.95 05/01 -05/31 Static IP $10.00 (5 usable IP addresses) (Requires Boost Plus or Ultra) 05/0.1 -05/31 Boost $14.95 Total Intemet $79.90 Subtotal of Current Charges $79.90 Remaining Balance $0.00 Current Charges $79.90 Total Amount Due $79.90 Online Pmduct~ & Support Online bill pay, www optimum.nel/myaccount Channel line up, WWw ppiimunl.nei/suPport Live chat, www optimum net/l!vec ha~ For help, www twitter com/optimumh~lp Foltow us, www twitter.corn/optimum LiKe us, www tacebcok corn/optimum Impoltant Phone Numbers For Technical Support, Sales and ~ Customer Service Please call: 1-866-575-8000 WHnen Correspondence 6Al~rl(~rfC~°r~t~e~nalersa~eriSve, Melville, NY 11747 Moving? O or call us/or special offers for movers Let us make it easy Visit www optirnum corn/moving The Optimum Business Account Cente~: Now you can access and manage all your services in one place with a new and easy to use deshbeard, including new features like Time of Day Call forwarding and our new users feature to delegate management of your services to multiple people. For a quick tour, go to www:OptimumBusi0ess:com/ac or to log in with your Optimum ID go to www Optimum,net/busbess. You're open for business with fast, free WiFL It's never been easier to check emall, place orders and manage your day to day from virtually anywhere. In addition to saving on data charges, you and your smart phone, laptop or tablet can enjoy unllmilad access to over 75,000 Optimum hotspots all at your favorite locations across the tri-state area, including hundreds of commuter rail stations. Want a Toll Free number, or transfer your current phone number? A Toll Free number isn't simply a free call for your customers, it's an effective marketing tool. Adding our Toll Free service will give you the freedom to add multiple tall free phone lines, ali for less than tt~ phone company. Optimum is the way to go, when you're going Toll Free. optimum.net ] tacebool~.com/opt~mum twitter.corn/optimum Ycur FCC Community ID# is NY 0188. Optimum Stores: You may choose te pay your bill online at ~optim~m~yAsp~unt or at any of our Optimum Stores. To find your nearest Optimum Store and for stere hours, go to www.optimum net/stores. To make changes to your account or pick up new equipment, you need te be an authorized user. This means ~hat your name must be listed on the account, and to ensure account security, you will need to present a photo ID. Optimum Store Locations: Nassau Countyl 1072 Old Northern Boulevard, Roslyn, NY 11576 160 E. Sunrise Highway, Freeport, NY 11520 595 South Broadway, Hicksville, NY 11801 Suff~_.!k c o u_n&~:' 1144 Route 109, Undanhurst, NY 11757 254 Old Coun~'y Road, Riverhead, NY 11901 32 Hill Sb'eet, Southampton, NY 11968 11 Industrial Road, Port Jefferson Station, NY 11776 1600 Motor Parkway, Hauppauge, NY 11788 1070 E. Jericho Turnpike, Huntington, NY 11743 To find other locations where you can make a payment to your Cablevision account, contact any of the following: IPP - 877-PAY-AT-IPP (877-729-2847) Western Union (800)-354-0005, Option 5 or Www .w~es~f n u~ior~.cpm Pay-O-Matic- 888-PAY-3773 (88~729-3773) Checkfree Pay 1-855-578-6415 or www.checkfreepay.com Did you know that unless you secure your wireless router others can s~e your home or business network and use your signal? Pro,oct your important tiles, identity and prevent unauthorized accees to your PC. Check the se~ngs on your wireless router te be sure it is secure by referring to ~ manual or Webuite for your router. Aisc visit www.op~Imum.net./Support/l'~torials for a helpful video on Wireless Security. Mail above portion with your payment. Page 2 of 2 PAYMENT INFORMATION: Authori~aticn TO Convert Your Check To An Electronic Funds Transfer: By sending your check to us as payment, you authorize us eilber to u,,se inlormation from your check 1o make a one time electronic funds transfer from your account or lo process the payment as a check transaction - Payment is due by the due date indicated on the front of your bill - Payments not received within 30 days may be sent to collections and, w h n 60 days w II ncur a $8 ]ate fee You will receive wnen no ~ce o service interruption for non-payment - Payments can be made at no charge through our Automated Phone System by calling Customer Support Follow the phone prompts fo set up an automated payment by check or credit card Entering your Optimum account number and zip code authorizes an ACH debit entry to your bank account that can only be revoked by calling Customer Supporf - if your service is interrupted for non payment, payment oi the past due amount and applicable reconnection charges is required before service is restored Any sen/ice interruplion will affect TV, iO TV, Phone, and Internet services Reconnection ol service will be done on the next available appointment You are responsible for lost, damaged or unreturned equipment and will be charged the full replacement fee (Digital Video Recorder - $265, Cable Box - $120, Tuning Adapter - $140, Remote Control - $3 00, Smad Card $75, CableCARD $40, Cable Modem -$100, Wireless Router $50, Static IP Router $299, Voice EnabledModem-4 portS100; 12port$750, SIP Trunk interface Device - $75000) - If your bank returns youl check unpaid, you will incur a $20 fee BILLING INFORMATION: - Billing ero s taus be epo ed w h n 30 days, in w iting, detailing the error, and sent to the Customer Support address on the front ct your bill We will investigate and reply within 10 days To avoid service interruption, you should pay the undisputed portion of the bill. If you are not satisfied with our reply, you may write to The New York Stare Department oi Public Service, Three Empire State Plaza, Albany, NY 12223- 1350 or call 1 800 342 3377 - You are billed each month in advance for the next month's services Charges for On Demand/Pay Per View will appear on the next billing statement tollowing your order. - On Demand/Pay Per View purchases are not subject to refund or credit Use parental control features to avoid unwanted purchases. - If your monthly accounl balance for On Demand/Pay Per View selections exceeds $55 ($175 for customers in good standing after 90 days), we reserve the right to limit additional On Demand/Pay Per View orders - If any changes are made to your account during the month, partial month charges may apply - There is an additional monthly charge for equipment, including cable boxes and remote controls. There is also a monthly fee to access premium or digital programming on addi0onal TV sets in your home. - Your monthly bill includes all government fees. These fees are a percentage of your total monthly cable bill paid to your state and local governments under the terms and agreements with them lo provide cable service In addition, the Federal Communications Commission (FCC) collects a small fee from every cable customer to cover the administrative costs related to cable regulation. SERVICE INFORMATION: Technical: If you are having trouble with service: 1 ) Ensure your equipment (TV and cable poX, or cable modem) is correctly plugoed in 2) For cable problems, check that your TV (and VCR, i~ attached) is tuned to Channel 3 3) Check all cable connections lot a secure fit. If you still have a problem, call Customer Support and we will troubleshoot or send a technician 0 no cable related problems are found, you may incur a charge for the lechnlci~n visit If you have a cable relafed outage that lasts for more than three consecutive hours, you will receive lull credit on your bill for the time lost provided you call or write us within 30 days of the outage Parental Control: Your cable poX allows you ~o bJock one or more channels and On Demand/Pay Per View purchases For information, refer to your Optimum Reference Guide, visit optimum net/parentalcontrol, or call Customer Support B37 Town of Southoid, New York - Payment Voucher Vendor Tax ID Number or Social Secudty Number Vendor Name Cablevision Vendor Telephone Number Vendor Contact Vendor Address PO Box 9202 Uniondale, NY 11555-9202 Vendor No. Invoice Invoice Invoice Net Purchase Order Check No, Entered by ~ Audit Date MAY 0 ? 2013 Town Clerk Number Date Total $54.95 $o.oo $o.oo 05~3 4~-39-398620-01-1 5/7/2013 07839406610-01-1 07839-407644-01-9 Payee Certification Discount Amount Claimec $54.95 0.00 $54.95 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. ~tle Number X Signature Company Name Date Descdpbon of Goods or Services Town Hall General Ledger Fund and Account Number A.1680.4.200,300 Communicty Center Katinka House A,1680.4.200,300 0.00 A.1680.4.200.300 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services propedy performed and that the quantities thereof have been verified with the exceptions or discrepandes noted, and payment is approved. lifle Date Page 1 ol 2 Account Number Sac, ice for 07839-398620-01-1 TOWNHALL SOUTH HOLD 53095 MAiN RD COMM SOUTHOLD NY 11971-4642 Billing Period 04/23/13-05/22/13 Includes Payments Received By 04/17/13 Last Bill Balance $54.95 Payments - Thank You! $54.95 cr Remaining Balance $0.00 Current Charges - Due By 05/07/13 $54.95 Total Amount Due $54,95 Payments 04/16 Payment-Thank You $54.95 cr Total Payments $54.95 cr TV 04/23 -05/22 Optimum Value $000 04/23 -05/22 2 Cable Box(es $000 A $67 each and remote(s) at $0 24 each) Total TV $0.00 Internet 04/2~ :_~5/22 Optimum Online $54.95 Total Internet $54.95 Subtotal of Current Charges Remaining Balance Current Charges Total Amount Due $54.95 $0.00 $54.95 $54.96 ~ Online Pmduma & Suppolt Online bill pay, www.optimum net/myaccount You're open far business with fast, free WiFi. It's never been easier to check em-il, place orders end manage your day to day from virtually anywhere. )n addition to saving on data charges, you and your smart phone, laptop or tablet can enjoy unlimited access to over 75,000 Optimum hotspets ail at your favodte locations across the tri-state area, including hundreds of commuter rail stations. Want a Toll Free number, or transfer your current phone number? A Toil Frae number isn~ simply a free call for your customers, it's an effective marketing tool. Addiag our Toll Free service will give you the freedom to add mallJple toll free phone lines, all for less than the phone company. Optimum is the way to go, when you're going Toll Free. optimum.net ] facebook.com/optirnum twitter.corn/optimum Your FCC Community ID# is NY 0188. Clo~d Captioning: For immediate closed captioning issues, please contact os: 888-420-0777 (phone), 631-846-5349 (fax), optimum@mailoa.custhalp,com (em~il). Written closed captioning complaints should be sent to the address on the fi'ant of your bill, attention Marian O'Hagan, Manager, Shared Services, 631-846-5360 (phone), 516-803-2040 (fax), MOHA_GAN~ab!evisio_n com. optimum Storee: You may choose to pay your bill online at ~ww.optiroqm:l?etJMYAcpaun_t or at any of our Optimum Steres. To find your nearest Optimum Store and for store hours, go to www~oj~tJm~ ~t/~t0~es. To make changes to your account or pick up new equipment, you need to be an authorized user. This means that your name must be listed on the account, and to ensure account security, you will need to present a photo ID. Optimum Store Locations: Naeeau County: 1072 Cid Northern Boulevard, Roslyn, NY 11576 160 E. Sunrise Highway, Freeport, NY 11520 595 South Broadway, Hicksville, NY 11801 Suffolk County: 1144 Route 109, Lindanhurst, NY 11757 254 Old Country Road, Rivarhead, NY 11901 32 Hill Street, Southampton, NY 11968 11 Industrial Road, Port Jefferson Station, NY 11776 1600 Motor Parkway, Hauppauge, NY 11788 1070 E. Jericho Turnpike, Huntington, NY t 1743 To lind other locations where you can make a payment to your Cabievision account, contact any of the following: IPP - 877-PAY-AT-IPP (877-729-2847) Western Union (800)-354-0005, Option 5 or www.we_s ts; n U pi(?n .c0m Pay*O-Mafic- 886-PAY-3773 (888-729-3773) Chackfi'ee Pay 1-855-578-6415 or WWw.gheqkfi'eePay:p0m New Channels: CTS America (channel 1156) and KBS World (channel 1155) are available in the Optimum Korean package. For mare information an the Optimum Korean package, cell 1-888-947-1870. A digital cable box or CableCARD is required. A new Optimum Premier South Asian package with exciting new channels is now available. Life OK ( channel 1170), Star India Plus ( channel 1174), Star India Gold (channel 1175) are ~ available for $9.95/mo each or as part of the new Optimum Premiar South Asian package for $39.95/mo. Call 1-888-947-1870 to order now. Dont miss April's new Movies On Demand on channel 500. Premiering 4/23 - A Haunted House, 4/30 - Guilt Trip, 4/30 - Silver Linings Playbook, 4/30 - Django Unchained and 4/30 - Gangster Squad. Watch them in HD at the same great price. A digital cable box is required. Get the best selection of international programming from around the world in your language. Choose fi'om over 45 Spanish-language channels featuring a wide variety of your favorite telanovelas and shows, as well ac Chinese, Russian, South Asian channels and mare. Call 1-886-947-1870 for details. Mail above portion with your payment. Page 2 of 2 PAYMENT INFORMATION: Authorization To Convert Your Check To An Electronic Funds ~l ransler : By sending your check to us as payment, you authorize us either to use information from your check to make a one-time electronic funds transfer from your account or to process the payment as a check transaction - Payment is due by the due date indicated on the front of your bil~ Payments no~ received within 30 days may be sent to collections and within 60 days will incur a $8 late fee. You will receive written notice of service interruption for non-payment. - Paymenls can be made at no charge through our Automated Phone System by calling Customer Support. Follow the phone prompts to set up an automated payment by check or credit card Entering your Optimum account number and zip code authorizes an ACH debit entry to your bank account that can only be revoked by calling Customer Support - If your service is interrupted for non-payment, payment of the past due amount and applicable reconnection charges is required before service is restored. Any service interruption will affect TV, iO TV, Phone, and Internet services Reconneotion of service will be done on the r~xt available appolelment. You are responsible for lost, damaged or unreturned equipment and will be charged the fult replacement fee (Digital Video Recorder $265, Cable Box $120, Tuning Adapter $140, Remote Control - $3,00, Smart Card - $75, CableCARD - $40, Cable Modem -$100, Wireless Router $50, Static IP Router - $299, Voice Enabled Modem 4 port $100; 12 port $750, SIP Trunk Interface Device - $75000) If your bank returns your check unpaid, you will incur a $20 fee BILLING INFORMATION: - Billing errors must be reported within 30 days, in writing, detailing the error, and sent to the Customer Support address on the front of your bill We will investigate and reply within 10 days To avoid service interruption, you should pay the undisputed portion el the bill If you are not satisfied with our reply, you may write to The New York State Department of Public Service, Three Empire State Plaza, Albany, NY 12223- 1350 or call 1 800 342 3377 You are billed each month in advance for the next month's services Charges for On Demand/Pay Per View will appear on the next billing statement following your order - On Demand/Pay Per View purchases are not subject to refund or credit Use parental control features to avokJ unwanted purchases - If your monthry account balance lor On Demand/Pay Per View selec0ons exceeds $55 ($175 for customers in good standing after 90 days), we reserve the right to limit additional On Demand/Pay Per View orders - If any changes are made to your account during the month, partial month charges may apply - There is an additional monthly charge lor equipment, including cable boxes and remote controls There is also a monthly fee to access premium or digital programming on additional TV sets in your home - Your monthly bill includes all government fees These fees are a percentage of your total monthly cable bill paid to your state and local governments under the terms and agreements with them to provide cable serwce In addition, the Federal Communications Commission (FCC) collects a small fee from every cable customer to cover the administrative costs related to cable regulation SER¥1CE INFORMATION: Technical: 0 you are having trouble with service; 1 ) Ensure your equipment (TV and cable box, or cable modem) is correctly plugged in 2) For cable problems, check that your TV (and VCR, if attached) is tuned to Channel 3 3) Check all cable connections for a secure fit Il you still have a problem, call Customer Support and we will troubleshoot er send a technician If no cable-related problems are found, you may incur a charge for the technician visit If you have a cable-related outage that lasts for more than three consecutive hours, you will receive full credit on your bill for the time lost provided you call or write us within 30 days ol the outage Parental Control: Your cable box allows you to block one or more channels and On Demand/Pay Per View purchases For information, refer to your Optimum Reference Guide, visit optimum.r~t/parentalcontroL or call Customer Support B37 TOWN OF SOUTHOLD VENDOR 018308 CANON FINANCIAL SERVICES,INC 05/07/2013 CHECK 117417 FLrND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT A .1670.2.200.500 DB .5140.4.400.600 SR .8160.4.400.700 A .1670.2.200.500 A .1670.2.200.500 A .1670.2.200.500 A .1670.2.200.500 A .1670.2.200.500 A .1670.2.200.500 .1670.2.200.500 08-927 12665632 5 COPY MACHINES-4/13 2,459.67 09-543 12665632 HWY-IR3225-4/13 107.61 10-221 12665632 LNDFILL-IR1025-4/13 70.13 10-710 12665632 TWN ATTY IR3245I-4/13 195.00 10-711 12665632 HRC-IR3225-4/13 185.00 10-711,.~6~6~%'~7.~37~_ HRC-COPY OVERAGE-4/13 25.32 /13 185.00 CRT-IR6055-4/13 401.00 /13 369.00 OVERAGE-4/13 98.70 4,096.43 Vendor No. Town of Southold, New York-Payment Voucher 18308 Vendor Tax ID Number or Social Securi~ Number 14904 Collection Centers Drive Check No. Entered by Vendor Name Canon Financial Services, Inc. Chicago, IL 60693-0149 Vendor Contact Audit Date 5/7/2013 /Town Clerk ~ .~d' Invoice Date Total Net Amount Claimed Purchase Order Number Discount Description of Goods or Services 12665632 4/12/2013 $2,459.67 $2,459.67 2008-927 5 COPY MACHINES4/13 A.1670.2.200.500 107.61 $107.61 2009-543 HWY-IR3225~4/13 DB.5140.4.400.600 $70.13 $70.13 2010-221 LNDFILL-IR1025-4/13 $185.00 $185.00 2010-711 HRC-IR3225-4/13 $25.32 $25.32 2010-711 HRC-copy overage-4/13 TWN ATTY IR32451-4/13 SR.8160.4A00.700 ] $195.00 $195.00 2010-710 A.1670.2.200.500 $185.00 $185.00 2011-207 REC IR3225-4/13 A. 1670.2.200.500 2011-207 $0.00 REC- Copy Overage- JUST CRT-IR60554/13 $0.00 A. 1670.2.200.500 $401.00 $401.00 2011-595 A.1670.2.200.500 $369.01] $369.00 2012-157 PD-IRC 5051-4/13 A.1670.2.200.500 $98.70 2012-157 2012-157 $98.70 $0.00 $4,096.43 PD-Color Overage-4/13 PD-BW overage- $0.00 $4,096.43 A.1670.2.200.500 A.1670.2.200.500 Payee Certification The undersigned ~C!aim~'::) (Acting on behalf of the a~ove named claimant) does hereby certi~ that the foregoing claim is Irue and CO~Tect. that no parI hms been paid, except as therein stated, that the balance thereto stated is actually due and o~ing and that taxes from which the Town is exelllpt are excluded Department Certification l hereb', cerid~ that the materials above spemfied have been received b~ me m good condition without substitution, Ihe services properly perforated and that the quantities thereof have been verified wdh the exceptions Southold New York Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address Entered by 18308 Audit Date Vendor Name Canon Financial Services, In, inc. PO Box 7247-0322 Philadelphia, PA 19170-0322 Town Clerk Vendor Contact Invoice Invoice Invoice Net ~umhase Order Number Date Discount Amount Claimed Number General Ledger Fund and Account Number 12665632 4/1212013 2,459.67 Copier IR5075 CXA00698 A. 1670.2.200.500 Copier IR5050 CHE Copier IR5050CHE0 Copier IR5050 CHE( Copier [R32351 DGA01892 107.61 Copier IR3225 DFHI0224 DB.$140.4.400.600 70.13 Copier IR1025IFDRL23083 SR.8160.4.400.700 185.00 + 25.32 usalse Copier DFH22448 A. 1670.200.500 195.00 Copier DHK10854 A.1670.2.200.500 185.00 Copier DFH27133 A. 1670.2.200.500 401.00 CopierHTT16729 A.1670.2.200.500 369.00+98.70 usaage Copier GQM60176 A.31244 TOTAL 4,096.43 Payee Certification Department Certification The unde~igned (Claimant) (Acting on behalf of the above named claimant) [ hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is ~rue and c~rmct, ~hat ~0 part ha? in good condition withou~ ~bstitu[!0n, the ~ervices properl~ been paid, except as therein statedz [hat the b~lan? th~ ~tated is ~cma!ly performed and that the quantities thereof have been verified w![l~ the excepOons due and owing, and that taxes from which the Town is exempt are excluded, or discrepancies noted, and payment is approved. ' Signature Invoice Attached : :: ~ ~' -- i ~ -- 4/25/2013 ~,~HO'~ 14904 Collections Center Drive Invoice Number 12665632 Chicago, IL 60693-0149 Customer Number 545927 CANON FINANCIAL SERVICES, INC. Total Due $4,096.43 .Important Messages Invoice Date 04/12/13 Past Due After 05/01/13 In certain states, taxing authorities require CFS to pay upfront sales/use tax for leased equipment. If CFS has paid upfront sales/use tax for your leased equipment, your "Contract Charge" has been adjusted to include repayment of this cost to CFS. Please remit your PAYMENTS ONLY to: 14904 Collections Center Drive Chicago, Illinois 60693-0149 (envelope enclosed) Please send all CORRESPONDENCE to: Via e-mail to: cfscustserv@cfs.canon.com Via fax to: 856-813-5122 P.O. Box 5008, Mt. Laurel, NJ 08054 Please reference INVOICE number on your remittance. You may notice a change to the format of the Model Number on this invoice as we improve the descriptions in our records. There is no action required on },our par[. No chan~e has been made to )/our contract or equipment. Itemized Charge Detail and Equipment Schedule Contract Number 001-0545927-001 Detailed Charges Due Date Payment Amount Sales Tax Total Due CONTRACT CHARGE 05/01/13 2.459.67 0.00 2,45967 Make / Model Number Location Address Serial Number City / State / ZIP COPIER/IR5075 53095 MAIN ROAD CXA00698 SOU~HOLD, NY 11971 COPIeR/IR0060 5~095 MAIN RO RECEIYED CHE09331 SOUTHOLD, NY 11971 COPIER/IR5050 53095 MAIN RD CH~O9632 SOO~HO~O, NY tt67t APR 1 8 ~B CHE09330 SOUTHOLD. NY 11971 ~uthold Town Cle~[ COPIER/IR32351 53095 MAIN RD DGA01892 SOUTHOLD. NY 11971 Contract Number 001-0545927-002 Detailed Charges Due Date Payment Amount Sales Tax CONTRACT CHARGE 05/01/13 107~61 0.00 Total Due 107.61 NOTE: Please contact Customer Service with ANY CHANGES to the equipment location(s) listed above. L 0004 L $4,°96'431[ $o.oo] L $o.ool I $o.ooJ L so.cci CONTRACTS CURRENT PAST DUE 1-30 PAST DUE 31-60 PAST DUE 61-90 PAST DUE 91 + Customer Service hours are M-F 8:30 am to 7:30 pm, Eastern Time page 1 of 6 Phone: 800-220-0330 Fax: 856-813-5122 E-mail: cfscustserv@cfs,canon,com $4,096'431 TOTAL DUE Thank you for choosing Canon! Customer Service hours are M-F 8:30 am to 7:30 pm, Eastern Time. · Contact us by Phone: · Correspondence: · Payments by Check: · E-mail Requests: · Insurance inquiries: Phone: 800-220-0330 Fax: 856-813-5122 Canon Financial Services Inc., PO Box 5008, Mt. Laurel, NJ 08054 Canon Financial Services Inc., 14904 Collections Center Drive, Chicago, rllinois 60693-0149 cfscustserv @ cfs.canon.com Phone: 800-877-2416 Fax: 866-747-3899 Email: cs-seattle@gaic.com HOW TO READ YOUR INVOICE Remittance Section Invoice Number 1234567 123 AMERICAN WAY Important Messages Thank you for choosing Canon! We appreciate your business and look forward to serving all your needs! Customer/Invoice Number - It will be helpful to have both numbers when calling or e-mailing Customer Service. Past Due After - Invoice must be paid before the Due Date to avoid a late charge. Amount Paid - Please indicate the payment amount included with your remittance. Remittance Address - Send your payment to this address with your remittance coupon for proper credit to your account. Important Messages - Important information concerning your account will be displayed here. Itemized Charge Detail and Equipment Schedule - A description of the equipment covered by the agreement follows the charge list, and includes specific equipment references. Account Aging - Aging of your account is at the bottom of the first page of the invoice. page 2 of 6 cfs-110336 14904 Collections Center Drive Invoice Number 12665632 Invoice Date 04/12/13 Chicago, IL 60693-0149 Customer Number 545927 Past Due After 05/01/13 Total Due $4,096.43 CANON FINANCIAL SERVICES, INC. Itemized Charge Detail and Equipment Schedule continue0 Make / Model Number Location Address Serial Number City / State ! ZIP COPIER/IR3225 275 PECONIC LN DFH10224 PO8 178 WASTE MAIN PECONIC, NY 11958 Contract Number 001-0545927-003 Detai~ed Charges Due Date Payment Amount CONTRACT CHARGE 05/01/13 70.13 Make / Model Number Location Address Serial Number City / State / ZIP COPIER/IR10251F 6155 COX LANE DRL23083 CUTCHOGUE, NY 11935 Sales Tax 0.00 Total Due 7013 Contract Number 001-0545927-004 Detailed Charges Due Date Payment Amount 8W METER USAGE 05/01/13 2532 CONTRACT CHARGE 05/01/13 18509 Make / Model Number Location Address Serial Number City / State / ZiP COPIEROR3225 750 PACIFIC STREET DFH22448 MATTITUCK, NY 11952 Sales Tax 0 00 000 Total Due 2532 18500 Contract Number 001-0545927-005 Detailed Charges Due Date Payment Amount CONTRACT CHARGE 05/01/13 195.00 Make / Model Number Location Address Serial Number City / State / ZIP COPIER/IR32451 54375 ROUTE 25 DHK10854 TOWN HALL ANNEX BLDG SOUTHOLD, NY 11971 Sales Tax 000 Total Due 195.00 Contract Number 001-0545927-006 Detailed Charges Due Date Payment Amount CONTRACT CHARGE 05/01/13 18500 Make / Model Number Location Address Serial Number City / State ! ZIP COPIER/IR3225 970 PECONIC LANE DFH27133 RECREATION 1ST FLR PECONIC, NY 11958 Sales Tax 0.00 Total Due -- Contract Number 001-0545927-007 Detailed Charges Due Date Payment Amount CONTRACT CHARGE 05/01/13 401.00 Make / Model Number Location Address Serial Number City / State / ZIP COPIER/IR6055 53095 MAIN ROAD HTT16729 SOUTHOLD, NY 11971-4642 Sales Tax 0.00 Contract Number 001-0545927-008 Detailed Charges Due Date Payment Amount CLR METER USAGE 05/01/13 9870 CONTRACT CHARGE 05/01/13 369.00 Make / Model Number Location Address Serial Number City / State / ZIP GRAPHICS EQUIPMENT/IRC5051 41405 ROUTE 25 A GQM60176 PECONIC, NY 11959 Sales Tax 0.00 0 O0 Total Due 9870 36900 page 3 of 6 "U 14904 Collections Center Drive Invoice Date 04/12/13 Invoice Number 1 2665632 Chicago, IL 60693-0149 Customer Number 545927 Past Due After 05/01/13 CANON FINANCIAL SERVICES, INC. Total Due $4,096.43 Copy Usage Detail (***last 3 readings: Activity Summary**' Contract Number/Meter Type Model Number Serial Number Copl Reference 1 Period Starting. Ending Allow Billable @ Overag; Reference 2 End Date Reacting Reading Copies Copy Charge Charg; 001-0545927-001 BW METER USAGE 01/31/13 769,495 793,800 54,044 AGGREGATE:0001 IR5075 10/31/12 724,573 769,495 54,030 AGGREGATE:0001 0XA00698 07/31/12 686,741 724,573 54,035 AGGREGATE:0001 001-0545927-001 BW METER USAGE 01/31/13 488,656 506,504 54,000 AGGREGATE:0001 IRS050 10/31/12 440,155 488,656 54,050 AGGREGATE:0001 CHE09331 07/31/12 413,929 440,155 54,000 AGGREGATE:0001 001-0545927-001 BW METER USAGE 01/31/13 391,237 400,730 54,000 AGGREGATE:0001 IR5050 10/31/12 370,329 391,237 54,010 AGGREGATE:0001 CHE09332 07/31/12 350,450 370,329 54,015 AGGREGATE:0001 00!-0545927-001 BW METER USAGE 01!3 ,/,3 482,490 510,427 54,000 AGGREGATE:0001 I IR5050 10/31/12 453,018 482,490 54,000 AGGREGATE:0001 CHE09330 07/31/12 413,905 453,018 54,020 AGGREGATE:0001 001-0545927-001 BW METER USAGE 01/31/13 212,605 218.309 54,020 AGGREGATE:0001 IR32351 10/31/12 212,605 212,605 54,000 AGGREGATE:0001 DGA01892 07/31/12 201,144 212,605 54.241 AGGREGATE:0001 001-0545927-002 BW METER USAGE 01/31/13 55,738 61,346 6,009 0@0,01470 0.00 IR3225 10/31/12 52,158 55,738: 6,000 0@0,01470 0.00 DFH10224 07/31/12 47,798 52,158I 6,020 0@0.01471 000 001-0545927-003 BW METER USAGE 02/28/13 16,307 18,041 3,000 0@0.02160 0.00 IR10251F 11/30/12 14,743 16,307 3,000 0@0.02160 0.00 DRL23083 08/31/12 13,179 14,743 3,000 0@0.02160 0.00 001-0545927-004 BW METER USAGE 03/31/13 127,663 141,459 12,000 1,796@0.01410 25.32 IR3225 12/31/12 110,746 127,663 12,000 4,917@0.0141( 69.33 DFH22448 09/30/12 97,629 110,746 12,010 1,107@0.01410 15.61 001-0545927-005 BW METER USAGE 03/31/13 63,021 68,692 15,000 0@0.01220 000 IR32451 12/31/12 56,662 63,021 15,002 0@00122[ 000 DHK10854 09/30/12 49,028 56,662 15,000 0@0.01220 0.00 001-0545927-006 BW METER USAGE 03/31/13 50,051 52,449 3,500 0@0.01410 0.00 IR3225 02/28/13 48,196 50,051 3,500 0@0.01410 0.00 DFH27133 01/31/13 46.443 48,196 3,500 0@0.01410 0.00 001-0545927-007 BW METER USAGE 01/31/13 81,309 101,915 22,500 0@0.00954 0.00 IR6055 10131/12 58,997 81,309 22,510 0@0.00954 0.00 H~16729 07/31/12 37,980 58,997 22,500 0@0.00954 0.00 001-0545927-006 BW METER USAGE 03/31/13 92,821 101.281 10.020 0@0.00972 0.00 IR05051 02/28/13 83,922 92,821 10.000 0@0.00972 0.00 GQM60176 01/31/13 75,658 83.922 10,004 0@0.00972 0.00 001-0545927-008 CLR METER USAGE 03/31/13 9,889 11,332 0 1.443@0.06840 98.70 IRC5051 02/28/13 9,066 9,889 0 823@0.0684 56.29 GQM60176 01/31/13 8,000 9,066 0 1,066@0.0684 72.91 page 4 of 6 _'~ 14904 Collections Center Drive Invoice Number 12665632 Invoice Date 04/12/13 Chicago, IL 60693-0149 Customer Number 545927 Past Due After 05/01/13 CANON FINANCIAL SERVICES, INC. Total Due $4,096.43 Aggregate Usage Detail(***last 3 readings: Activity Summary***) Aggregate CPC Code/Meter Type Cop'~ Period Starting Ending Allow Billable @ Overage End Date Reading Reading Copies Copy Charge Charge 0001/BW METER USAGE 01/31/13 2.344.483 2,429,770 270,064 0@0.00830 00£ 0001/BW METER USAGE 10/31/12 2.200,680 2,344,483 270,090 0@0.00830 00C O001/BW METER USAGE 07/31/12 2068169 2,200,680 270,311 0@0.00830 00£ page 5 of 6 TOWN OF SOUTHOLD VENDOR 012318 CARQUEST AUTO PD,qTS 05/07/2013 CHECK 117418 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT A .1620.4.100.500 25443 959856292 PW7 BALL JOINTS 323.68 A .1620.4.100.500 25443 959856933 PW7 ROTOR,BRAKE PAD 358.67 TOTAL 682.35 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Sccurit) Number Vendor Address Vendor Name Carquest of Mattituck 298-5700 19625 Main Road Mattituck, NY 11952 959856292 Invoice Invoice Date I oral 3/27/13 $323.68 4121'13 $358.67 Net $323.68 25443 Vendor No. 12318 Description of Goods or Ser~ ices al~joints toter, brake pad ~:heck No. I:l'lqlg Entered by Audit Date ~/7/2013 J./o~w n CLerk ...,~ o A.1620.4.100.500 Signature Fitle (ompa% Name [)ate The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~ that the foregoing claim is true and correct, lhat no part has been paid, except as therein stated, that the balance therein stated is actually duc and owing, and that taxes from which the Town is exempt are excluded Department Certification [ hereby certi[~ that the materials above specified have been received by mc in good condition v, ithout substitution, thc services properly performed and that the quantities thereof have been ve ' with thc exceptions ar discrepancies noted, and payment is approved Signatur _ _ Payee Certification $682.35 959856933 $358.67 25443 A.1620.4.100.500 C IRQUEST AUTO PARTS Great people, great products, great prices? CARQUEST OF HATTITUCK 19625 HAIN ROAD HATTiTUCK, NY 11952 (631) 298-5700 OPEN H - ~ 7:30 - 6 SAT 8 - 4 ~'~;UUJJCTRETEIRNED FOR CREDIT I"~USTBE ACCO"PANIED BY THIS RECEIPT. SOUTHOLD TOWN DPW PO BOX 178 PECONiC, NY 11958 CUSTOMER ][NVOZCE NO. DATE NO, HFG. PART NUHBER ORDERED THIS TICKET CONTAINS PARTS A: PCH 500-1108 2 PCH 505-1288 2 PAGE i OF ! REF~ 62734 SEE CARQUES¥ STORE FOR DETAILS OF THE COAST TO COAST GUARANTEE SOUTNOLD TOWN DPW PO BOX 178 PECONIC, NY 11958 CUST, P.O. NO, SALESzD J COUNTERzD DF3220 LZST PRZCE NET NET CORE 160.99 80.92 0.00 160.99 80.92; 0.00 FORM OFPYMT, CHARGE 161.8~ N/N SHZP VZA )2:08 PM DELV. ZD FREZGHT TAXABLE AMT. SALES TAX TOTAL CORE PREV. DEPOSZT RECEt'VED PAY THZS BY X CUSTOMER C07¥l AMOUNT 323.68 AUTO Fir'ARTS Great PeDple, gr~at products, great prices!s" CARQUEST OF HATTITUCK 19625 HAIN ROAD HATTITUCK, NY 11952 (631) 298-5700 OPEN H - F 712~13 04020959800000569330000063438652 ' J SOUTHOLD TOWN DPW PO BOX 178 PECONIC, NY 11958 ' INVOICE NO. CUSTOMER DATE NO. 9Rqs-~6q~3 4118~ 04/02~1~ THIS TICKET CONTAINS PARTS FOt 200! DODCE R}~ 3500 5.9£ 360 r BDR 5393 DISC 8~KE ROTOR FRI BMD821H ~PAKE PAD SET 3 BRG R515063 HUB ASSEMBLY PAGE 1 O~, 1 REF# 61438 7:30 6 SAT 8 - 4 SEECARqUESTSTOREFORDETAIL$OFTHECOASTTOCOASTGUA~NTEE SOUTHOLD TOWN DPW FORM OF PYMT. CHARGE ~ PO BOX 178 PECONIC, NY 11958 SALES COUNTER cOST. P.O. NO. ZO XD ?~44~ PL33~1 91.19 58. 61 0.00 68.37 0.00 108.99 EXT, AMOUNT TAX 173'01 N/R 286.16 173.08 0.00 SHIP VXA~ TOTAL CORE PREV. DEPOSIT DELV. T~ME DELV. ZD FREIGHT TAXABLE AMT. SALES TAX "ECEXVED_ I. /'J ~.~.-.-~..-~- , 0.00 0.0 PAYTH~'$ 08:40 AH BY CUSTO~,~ C02:{[ AHOUNT 358.67 TOWN OF SOUTHOLD eu,ch.. O,d.r, 2 5 4 4 3 Tax Exempt # A163554 Account # IDeliver and ~end billing to: Department I I I I VENDOR **Return this copy and Town of Southold voucher itemized and signed for payment** ITEM QUANTITY DESCRIPTION UNIT COST TOTAL THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I C E RTl FY~24Aff'~A~- - - SUFFI~NT FUNDS AVAIt~ABLE IN T~;~ APPROPRIATION C~~ Dept.,Headv ,' I ~ I CERTIFY THIS TO BE A JUST AND TRUE PURCHASE ORDER Supervisor DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES Date DEPARTMENT BILLING COPY TERMS AND CONDITIONS 1. The TOWN OF SOUTHOLD is not responsible for materials, ,supplies or equipmeht delivered or services performed without authority of written order. Quantities specified are not to be exceeded. , , 2, No changes may be made in this order without written authority of the supervisor. 3. Inspection of delivery will be made at delivery point unless otherwise specified. Materials must be properly packaged. Damaged material will not be accepted. Include itemized packing lists with all shipments. Delivery indoors is required unless otherwise specified. All prices quoted must in- c!ude shipping, handling, packing and crating charges and be F.O.B delivered, unless other terms are agreed to. 4. Substitutions of specified items will not be acceptable. The, Town of Southold reserves the right to reject and return at shippers expense, materials delivered which do not conform to de- scription of item ordered. 5 If order cannot be filled in whole or in part in tirne specified, notify the town immediately. In case of delay in delivery, or in case of any default of the vendor, the town may procure the goods or services from other sources and hold the vendor responsible for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby. 6. Upon acceptance of this order the vendor agrees to comply with all Federal, State or local laws relative thereto: a. The vendor shall defend actions or claims brought and hold the Town of Southold, its agents and its employees harmless from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c, Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e ~ind 222 of the Labor Law of the State of New York relating to maximum work- ing hours and minimum wages of employees and prohibiting discrimination on account of race, sex, color, creed or national origin in hiring employees within the State of New York involved in the manufacture of materials, equipment, or suppties specified in this order. d. The vendor shall comply with Sections 103a and 103b of the General Municipal Law pertaining to disqualifications of contractor for failure to waive immunity before Grand Jury. 7. INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. Claims for partial deliveries are not allowed unless indicated. Claims in question will constitute a condition precedent to the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. 1!. All EO./Claims must be audited and approved by the Town Board prior to actual payment. TOWN OF SOUTHOLD VENDOR 003092 CONSTANCE CASE 05/07/2013 CHECK 117419 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .7020.4.500.420 043013 QUILTING CLASSES-4 HRS 120.00 TOTAL 120.00 000001~ Town of Southold, New York - Payment Vendor Name CONSTANCE CASE Vendor Telephone Number 765.1658 Vendor Contact Invoice Number Invoice Invoice Date Total Discount Invoice Total Voucher Vendor Address 505 Cedar Point West Southold NY 11971 Net Amount Claimed 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 ~S-L~ ~.~ Title Company Name Date Vendor No. 3092 Purchase Order Number Description of Goods or Services QUILTING CLASSES HOURS /HOUR General Ledger Fund and Account Number 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 excep[~T di~repancies noted, and payment is approved. Signature Title RECREATION SUPERVISOR Date A7020;4.500.420 TOWN OF SOUTHOLD VENDOR 003053 CDW GOVERNMENT, INC. 05/07/2013 CHECK 117420 FI/ND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT H .1680.2.600.100 25184 BP32421 H .1680.2.600.100 25184 BR44442 A .1410.4.100.100 25346 BS88289 (36)MS OFFICE 6,756.48 CREDIT (36)MS OFFICE 6,756.48- INTUIT QUICKEN 103.73 TOTAL 103.73 Vendor No. Check No. 'Town of Southold, New York-Payment Voucher 3053 Vendor Tax [D Number or Social Secuni~ Number Vendor Address Entered-- by' ~]5~ CDW Government 75 Remmittance Dr. Suite 1515 Chicago, IE 60675 BP32421 ~/11/2013 $6,7~ $6,756 ~ 25184 (~ MS Offife ".t680.2.6~.100 BR44442 4/16/2013 66,756.~ 66,756.~ ) 25184 ~fiS g~ee H. t680a.6~.100 $0.00 $0.00 H.1680.2.6~.100 $0.00 $0.00 ~1680.2.6~.100 $0.00 $0.00 H,1680.2,600.1~ $0.00 $0.00 H.16~.2.6~.100 $0.00 ~ ~0.~ Payee Certification Department Certification INVOICE DATE INVOICE NUMBER I PAYMENT TERMS DUE DAI~ O~)./11/13 BP32421 I Net 30 Days 05/11/13 ORDER DATE SHIP VIA PURCHASE ORDER NUMBER CUSTOMER NUMBER 04/11/13 UPS Next Day 10:30, most areas 25184 3172402 ITE~ NUMBER DESCRIPTION QTY I QTY I QTY UNIT PRICE TOTAL {;)RDI ]SHIP B~O 2116653 MS OFFICE HOME & BUS 2010 PKC 36 36 187.68 6,756.4~ Manufacturer Part Number: T5D-00295 GO GREEN! CDW is happy to announce that paperless billing is now available! If you would like to start receiving your invoices as an emailed PDF, please email CDW at paperlessbilling@cdw.com, Please include your Customer number or an Invoice number in your email for faster processing, REDUCE PROCESSING COSTS AND ELIMINATE THE HASSLE OF PAPER CHECKSl Begin transmitting your payments electronically via ACH using CDW's bank and remittance information located at the top of the attached payment coupon. Email credit@cdw.com with any questions. ACCOUNT MANAGER SHIPPING ADDRESS: SUBTOTAL $6,756.4E VICTORIA PALMIERI TOWN OF SOUTHOLD - DATA PROCESSING 203-851-7050 LLOYD REISENBER SHIPPING $0.0( victpal@cdw.com 53095 ROUTE 25 SOUTHOLD NY 11971-4642 SALES TAX $0.0( SALES ORDER NUMBER DKBN817 AMOUNT DUE $6,756.4~ 0001:0001 Cage Code Number IKH72 DUNS Number 02-615-7235 ISO 9001 and ISO 14001 Certified CDW GOVERNMENT FEIN 36-4230110 HAVE QUESTIONS ABOUT YOUR ACCOUNT? PLEASE EMAIL US AT credlt@cdw.com VISIT US ON THE INTERNET AT www.cdwg.com Page 1 of 1 CREDIT DATE CREDn' MEMO NUMBER ORIGINAL INVOICE NUMBER · 04//6/13 BR44442 BD98174 ORDER DATE PURCHASE ORDER NUMBER CUSTOMER NUMBER 03/21/13 25184 3172402 ITEM NUMBER DESCRi~IO" QTYI QTY I QTY TOTAL ORD. SHIP. B/O 2933542 VIS OFFICE HOME AND BUS 2013 32/64 36 -36 187.68 (6,756.48) VIanufacturer Part Number: T5D-01575 GO GREEN! CDW is happy to announce that paperless billing is now available! If you would like to start receiving your invoices as an ernailed PDF, please email CDW at paperlessbilling@cdw.com. Please include your Customer number or an Invoice number in your email for faster processing. REDUCE PROCESSING COSTS AND ELIMINATE THE HASSLE OF PAPER CHECKS! Begin transmitting your payments electronically via ACH using CDW's bank and remittance information located at the top of the attached payment coupon. Email credit@cdw.com with any questions. ACCOUNT MANAGER SHIPPING ADDRESS: SUSTOTAL $ (6,756.48' TOWN OF SOUTHOLD - DATA PROCESSING VICTORIA PALMIERI LLOYD REISENBER SHIPPING $0.0( 203-851-7050 53095 ROUTE 25 I victpal@cdw.com SOUTHOLD NY 11971-4642 SALES TAX $0.0( CREDIT AMOUNT $ (6,756.48) 0001:0001 Cage Code Number 1KH72 DUNS Number 02-6t5-7235 CDW GOVERNMENT FEIN 36-4230110 HAVE QUESTIONS ABOUT YOUR ACCOUNT? PLEASE EMAIL US AT credit@cdw, com VISIT US ON THE INTERNET AT www.cdwg.com Page 1 of 1 O urchase Order # Date 25184 TOWN Cl..F__SOUT-HO LD IDeliver and send billing Department ~r~, -r/,-~,~ Address ~ ~-,/=' ~ I I Tax Exempt # A163554 '~. /~o. z. ~o~. A~oun! # IVendor I C ~ -0 , '1 VENDOR · ' Return this copy and Town of Southold voucher itemized and signed for payment'' ITEM QUANTITY ? DESCRIPTION UNIT COST TOTAL THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT, HEAD AND THE SUPERVISOR I CERTIFY THAT THERE ARE SUFFICIENT FUNDS~VAILABLE OTIFY THIS TO BE A JUST AND TRU E//~U RCHAS~-(~ RD E R ,/ /...' / Superior ACCOUNTING Town of Southold, New York - Payment Voucher Vendor Name CDW Government Vendor Telephone Number Vendor Contact Victoria Palmieri Invoice Number Vendor No. Vendor Address 75 Remittance Drive, Suite 1515 Chicago, IL 60675-1515 Dale Invoice Net Total Discount Amount Claimed Number 3O53 Description of Goods or Services BS88289 4/1912013 103.73 103.73 25346 Intuit Quicken ( Total 103.73 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify 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 Town is exempt are excluded Check No. ] Audit Date MAY 0 7 2.013 Town Clerk Signature Tttle Company Nanre Date General Le0ger Fund and Account'Number A.1410~4,100.100 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly perforated and that the quantities thereof have been verified with the exceptions or discrepancies noted, and paymenl is approved INVOICE DATE INVOICE NUMBER I PAYMENT TERMS DUE DATE ORDER DATE BS88289 I Net 30 Days SHIP ViA 0'4/19/13 FEDEX Ground ITEM NUMBER DESCRIPTION 2852098 INTUIT QUICKEN HOME & BUSINESS 2013 Manufacturer Part Number: 419323 PURCHASE ORDER NUMBER 25346 ORD SHIP BIO 1 UNiT PRICE 103.73 CUSTOMER 3172402 TOTAL 103.73 GO GREEN! CDW is happy to announce that paperless billing is now available! If you would like to start receiving your invoices as an emailed PDF, please email CDW at paperlessbilling~cdw.com. Please include your Customer number or an Invoice number in your email for faster processing. REDUCE PROCESSING COSTS AND ELIMINATE THE HASSLE OF PAPER CHECKS! Begin transmitting your payments electronically via ACH using CDW's bank and remittance information located at the top of the attached payment coupon. Email credit@cdw.com with any questions. ACCOUNT MANAGER SHIPPING ADDRESS: SUBTOTAL VICTORIA PALMIERI TOWN OF SOUTHOLD - DATA PROCESSING 203-851-7050 LLOYD REISENBER SHIPPING victpai@cdw.com 53095 ROUTE 25 SALES ORDER NUMBER SOUTHOLD NY 11971-4642 SALES TAX DKLH515 AMOUNT DUE $103.7~ $o.o( $0.0( $103.7.' 000h0002 Cage Code Number 1KH72 DUNS Number 02-615-7235 ISO 9001 and ISO 14001 Certified CDW GOVERNMENT FEIN 36-4230110 HAVE QUESTIONS ABOUT YOUR ACCOUNT? PLEASE EMAIL US AT credit@cdw.com VISIT US ON THE INTERNET AT www.cdwg.com Page 1 of 1 Purchase Order # Date 25346 TOWN OF SOUTHOLD IDeliver and send billing to: .' ~ [ I Department _~,~o~, ~ -~u~r~ L_. ~ gL Addres~ -~ VENDOR ITEM **Return this copy and Town of Southold voucher itemized and signed for payment** QUANTITY DESCRIPTION I UN IT COST I TOTAL to3 THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFY THAT THERE ARE SUFFICIENT FUNDS AVAILABLE IN THE APPROPRIATION CHARGED D;pt. He~ .... I CERTIFY THIS TO BE A JUST AND TRU~/PURCHAS. E ORDER Sup~isor DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES I certify that the goods or services were received by this Depa~ment and all exc?p' ns duly noted. '~'~mgn~d ~ Title I 0" Date DEPARTMENT BILLING COPY TERMS AND CONDITIONS i. The TOWN OF SOUTHOLD is not responsible fo.,' materials, supplies or equipment delivered or services perforined without authority of written order. Quantities specified are not to be oxceeded. 2 No changes may be made in this order without written authority of the supervisor. 3 Inspection of delivery will be made at delivery point unless otherwise specified. Materials must be properly packaged. Damaged material will not be accepted. Include itemized packing lists with ~il shipr~,ents. Delivery indoors is required unless otherwise specified. All prices quoted must in- clude shipping, hacdling, packing and cr~tincj charges and be EO.B. delivered, unless other terms are agreed to. 4 S,.~bs~itutions of specified items will not be acceptable. The Town of Southold reserves the ~'igh~ ~o :eject and return at shipp~.rs expense, materials delivered which do not conform to de- scription of item ordered. 5 I[order cannot be filled in whole cr in part in time sFecified, notify the town immediately. In case of delay in delivery, o~ in case of any default of the vendor, the town may procure the goods or services from other sources and hold the vendor responsible for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby. 6. Upon acceptance of this orde~ the vendor agrees to comply with all Federal, State or local laws relative thereto: a. The vendor shall defend actions or claims brought and hold the Town of Southold, its agents and its employees harmless from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governme[}tal, institutional or commercial users for similar items, quantities and deliveries. c. Insofar as applicable, the Vendor shall comply with Sections 220, 220~a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- lng hours and minimum wages of employees and prohibiting discrimination on account of race, sex, color, creed or national origin in hiring employees within the State of New York involved in the manufacture of materials, equipme~t, or supplies specified in this order. d. The vendor shai', comply with Sections 103a and 103b of the General Municipal Law pertaining to disqualifications of contractor for failure to waive immunity before Grand Jury. 7 INVOICES F[E~DERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. ~laims for partial deliw~ries are not allowed unless indicated. Claims in question will constitute a condition preceder~t to the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. 1!. All P.O./Claims must be audited and approved by the Town Board prior to actual payment. TOWN OF SOUTHOLD VENDOR 007662 CHARLES GREENBL~TT, INC. 05/07/2013 CHECK 117421 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT A .3120.4.100.600 25553 34395 (2)BATONS-RECRUITS ACAD. 159.90 TOTAL 159.90 Town of ~outhold, New York - Payment Voucher Vendor Name Ch=ties G~bl~tt 3zr4'6. Cain Dr~e Vendor Telephone N~VOOQ ~ .i 4~i 7 IVendor No. Vendor Address Invoice Invoice Invoice Net P=~se 'Order Number Total Number Payee Certification The undersigned (Clahnan0 (Acting on behalf of the above named claimant) doe~ hereby certify that the foregoing claim is lrue and cermet, that no part has Department Certification I hereby certify ~ the materials above specified have been received by me- in good cOndition without substitution, the service~ properly CHARLES GREENBLA TT INC. (631) 231-4010 FAX (631) 231-4024 34-36 CAIN DRIVE BRENTWOOD, NY 11717-1261 Invoice DATE INVOICE # 4/23/2013 34395 BILL TO TOWN OF SOUTHOLD POLICE DEPT. P.O. BOX 911 41405 ROUTE 25 PECONIC, NY 11958 Al'IN: LT. SAWICKI SHIP TO PICKED UP BY SPO RECRUITS P.O. NUMBER TERMS REP SHIP VIA F.O.B. NET 30 DAYS MG 4/23/2013 PICKED UP QUANTITY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 2 52411 ASP F21B Black Chrome Baton 79.95 159.90 TOTAL $159.90 Purchase Order # Date April 'TOWN OF SOUTHOLD 25553 29, 2013 Tax Exempt # Al~[~,;~.d., ,~ Account # IDeliver and send billing to: Department Southold Police Dept. 41405 Route 25 Address PO BOX 91 1 Peconic, NY 11958 IVendor # 7662 Charles Greenblatb, Inc. 34-36 Cain Drive Brentwood, NY 11717 631-231-4010 631-231-4024 (fax) VENDOR **Return this copy and Town of Southold voucher itemized and signed for payment** ITEM 1. QUANTITY 2 DESCRIPTION ASP F21B Recruits THIS PURCHASE ORDER IS NOT I CERTIFY THAT THERE ARE SUFFICIENI FU~B~pI~VAILABLE IN THE A~'R(~=J~ION CHA~j~ED Dept. Head . , ~' - I CERTIFY THIS TO BE A JUST AND TRUE PURCHASE ORDER L,Supervisbr for UNIT COST TOTAL 79.95 $159.90 PT. HEAD AND THE SUPERVISOR '?~ DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES I certify that the [jp~eds/;~ services were received by this Departmest, an~l~ll.e~eptior,~ duly noted. ~ .~ S~gned- (~ ,.(/ "~itle Date TOWN OF SOUTHOLD VENDOR 003373 CITYSCAPE CONSULTANTS, INC. 05/07/2013 CHECK 117422 FLrND & ACCOUNT P.O. # IN%~OTCE DESCRIPTION ANOUNT B .691 2550 WIRELESS RVW 31-3-11.31 4,000.00 B .2115.40 2550 WIRELESS RVW 31-3-11.31 4,000.00~ B .8020.4.500.350 25339 2550 WIRELESS RVW 31-3-11.31 4,000.00 TOTAL 4,000.00 Town of Southold, New York - Payment Voucher Vendor Name "CityScape Vendor Telephone Number Vendor Contact Vendor Address Vendor No. 3373 Number 2550 4/19/13 Invoice Total Discount 7050 W. Palmetto Park Rd. #15-652 Boca Raton, FL 33433 Net Amount Claimed $4,600. ~ $4,000. !$4,000. ;(4,000. ) Payee Certification ~'~ Thc undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is tree and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes fiom which the Town is exempt are excluded. Signature Title Company Name Date Purchase Order Number 25339 Description of Goods or Services site application review New Cingular Wireless at E. Marion FD SCTM#1000-31-3-11.31 Department Certification I hereby ce~ify that the materials above specified have been received by me in good condition without substitution, the services pmperfy performed and that the quantifies thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Title Planning Director _Date ~//-)[,,/),'3 c 3,'sca 705(~ W. Palmetto Park Rd #15-652 Boca Raton, FL 33433 Tel: (877)438-2851 Fax: (877) 220-4593 INVOICE DATE ! INVOICE # 4/19/2013i 2550 BILL TO Town O~-~[1~0~' ; Heather Lanza, AICP, Planning Dir P.O. Box 1179 Southold, NY 11971 APR 2 37_~3 Project Ref/PO: ATT NYCENY1017 9245 Main Rd Description Rate Site Application Review and Analysis: ATT NYCENY1017 4,000.00 Site Application submitted by New Cingular Wireless PCS, LLC (AT&T Mobility) to modify/upgrade existing facilities located at 9245 Main Road, East Marion Review completed 04/17/2013 PO Ref#25339 SCTM~ 1000-31-3-11.31 Total Amount 4,000.00 $4,000.00 CityScape Consultants, Inc Purchase Order # 2 5 3 3 9 Date March 22, 20[3 TOWN OF SOUTHOLD Tax Exempt # A163554 B 8020 4 500 350 Account # IDeliver and ~cl billing t°: Deflartmeflt PLA~NNING BOARD Addres~ Vendor ~ ~ ~'~ ~ CityScape Consulta-~ts, Inc. ?050 W. Palmetto Park Road #[5-652 Boca Raton, FL 33433 VENDOR **Return this copy and Town of Southold voucher itemized and signed for payment** ITEM QUANTITY DESCRIPTION Consulting services re W~reless Appl~c. modify New Clngular Wlrelesm telecom facility at E. ~arion ~D; SCTM#1000-31~3-11.31 UNIT COST TOTAL NOT TO EXCEED $4,000. THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFY THAT THERE ARE SUFFICIENT FU NDS~S~VAILABL E IN THE APPROP~ATI~)N CHARGED Dept. Head I CERTIFY THIS TO BE A JUST AND TRUE PURCHASE ORDER Supervisor DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES I certify that the goods or services were received by this Departme~d. Signed Title DEPARTMENT BILLING COPY Date TERMS AND CONDITIONS 1, The TOWN OF SOUTHOLD is not responsible [or materials, supplies or equipment delivered or services performed without authority of written order. Quantities specified are not to be exceeded, 2 No changes may be made in this order without written authority of the supervisor. 3. Inspectio,~ of delivery will be made at deiivery point unless otherwise specified. Materials must be properly packaged. Damaged material will not be accepted, h~clude itemized packing lists with all shipn~ems. Delivery indoors is required un~ess otherwise specified. All prices quoted must im clude shipping, handling, packing and crating charges and be F.O.B delivered, unless other terms are agreed to. 4. Substitutions of specified items will not be acceptable. The Town of South~ld reserves the ~igh.'. ~o ~e.j~.¢t and r~turn at shippers exp~nse, materials delivered which do not conform to de- scription of item ordered. 5 If order c3n;"~ot be filled in whole ~r in part in tirr~e specified, notify the town immediately~ In case of ~9~a¥ in delivery, o~ in case of any default of the vendor, the town may procure the goods or services from other sources and hold the vendor responsible for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby. 6. Upon acceptance of this o,der the vendor agrees to comply with all Federal, State or local laws relative thereto: a. Th~ w~dor shatl defend actions or claims brought and hold the Town of Southold, its agents and its employees h~rmless from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c. insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- lng hours and minimum wages of employees and prohibiting discrimination on account of race, sex, color, creed or national origin in hiring employees within the State of New York involved in the manufacture of materials, equipme~t, or supplies specified in this order. d. The vendor shall comply with Sections 103a and 103b of the General Municipal Law pertaining to disqualifications of contractor for failure to waive immunity before Grand Jury. 7. INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. ~[aims ~'c.r partial dgliveries are not allowed L~nless indicated. Claims in question will constitute a condition precedent to the right of the vendor or receive any payment and matters of dispute must be adjusted before f!nal acceptance by the Town of Southold. 8. Billing shall allow for exemption from taxes under Federal Excise Tax Exemption Certificate No. A~163554 held by the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptanc9 of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York 5,,.,~ fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. 11. All P.O./Claims mus~ be audited and approved by the Town Board prior to actual payment. TOWN OF SOUTHOLD VENDOR 003442 ROBERT CLEVELAND 05/07/2013 CHECK 117423 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT A .1010.4,600.200 2179 V/TAPE TB MTG 4/23/13 261.00 TOTAL 261.00 !Vendor No. Town of Southold, New York - Payment Voucher; Vendor Tax [D Number or Social Security Number 1 [-2927335 Vendor Name Robert Cleveland - Allen Video Vendor Telephone Number 957-0908 Vendor Contact Robert Number Invoice Date [nvoic~ Total Discount Vendor Address 344ii Payee Certification The undersigned (Clmmant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is trae and correct, that no part bas been paid, except as therein stared, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Signature Title 35 Plane Tree Ln St. James, NY 11780 Net Purchase Order JAmount Claime, Number Description of Goods or Services Check No. Entered by ~ Audit Date lqAY 0 ? 2013 Town Clerk Genera[ Ledgex Fund and Account Number A.1010.4.600.200 Deparh'nent Certification I hereby certify thai the materials above specified have been received by me in good condition without substitution, the se~ices properly performed and that the quantities thereof have been verified with the exceptmns or discrepancies noted, and payment is approved Tide ~ Date ALLEN VIDEO PRODUCTIONS INC 35 Plane Tree Lane Saint James, N.Y, 11780 Invoice Bill To: Town of Southold 53095 Route 25 P.O. Box 1179 Southhold, N.Y. 11971 ~,ttn: Town Clerk Date Invoice No. 04/23/13 2179 P,O. Number Terms Project Net 15 I Item Description Quantity Rate Amount Meeting Tape Video Tape Board Meeting Southold Town Board 1 250.00 250.00 Meeting Apd123, 2013 Tape 1 -Tape I 8.00 8.00 DVD 1-DVD 1 3.00 3.00 / i Thank you for your business. Total $261.00 TOWN OF SOUTHOLD VENDOR 003543 COMPASS GROUP USA, INC. 05/07/2013 CHECK 117424 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT A .6772.4.100.700 25068 700952 MNTHLY SVC-4/13 69.00 A .6772.4.100.700 25068 704114 COFFEE PURCHASE 53.95 TOTAL 122.95 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Securi~ Number Compass Group USA, Inc. DBA Coffee Solutions Group Vendor Telephone Number 773-4400 Vendor Contact Vendor Address 990 Smith Street Farmingdale, NY 11735 Invoice Invoice Net Purchase Order Vendor No. 3543 flAY 0 7 20]3 ] Check No. Entered by Audit Date ~v~ Clerk ~ Date 700952 4/1120t3 704114 4129/2013 Total ~ Discount Amount Clalme~ 69.00 69.00 53.95 i 53.95 TOTAL 122.95 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby ceaify 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 25068 25068 Description of Goods or Services 4RC mthl¥ svce Apr 20t3 HRC coffee purchases General Ledger Fund and Account Number A.6772.4.100.700 A.6772.4.100.700 Department Certification COFFEE SOLUTIONS G R O U P ~ Acct# 2111 SOUTHOLD SENIOR CENTER 750 PACIFIC STREET PO BOX 85 MATTITUCK, NY 11952 (Z) SAME 1 04/29/13 I~'~'-Mo~-B II 631-298-44~0 RRY INVOICE BREAKTIME REFRESHMENT~ 59O SMITH ST. FARMINGDALE, NY 11735 TEL: 631-T/3-4400 FAX:631-773-6660 www. Coffeesg.com INet 30 Days 704114 II IIIIallllllllllllllll I~ Il IIIllllllllllllllll Ill Ill 04/25/13 09: 24am maureen RIDDSC EACH 1 DS EACH 1 RI-SWP FIREFLY DECAF(SC) NYS-DELIVERY CHARGE # : 163554 49.00 4.95 SUB tOTAL : NYS FEE : Sales : DUE : 49.00 4.95 53.95 0.00 53.95 Proud Distributorsof MGR. MONEY RECEIVED [] CASH $ [] CHECK $ [] CHECK · SiGN NAME PRINT NAME TiME RECEIVED COFFEE SOLUTIONS G R 0 U P INVOICE BREAKTIME REFRESHMENTS 590 SMITH ST. FARMINGDALE, NY 11735 TEL: 631-773-4400 FAX:631-773-6660 www. Coffeesg,com ~ Acct# 2111 ~ 700952 SOUTHOLD SENIOR CENTER (Z) SAME 750 PACIFIC STREET MATTITUCK, NY 11952 2 1 1 1 '~="~=:~"'~""~"'~"~ II IIIIIIIIIIIIIIIIIIIIIII Ill 700952 04/01/13 LE-MON-B 631-298-4460 I Net 30 Days 04/01/13 6:02pm I I I 0 ~o~¥/~¥ I ~o~ H~-2~l-1 EACH 1 H©N?H~¥ ~F_~G[/~F3 ~9.00 69.00 H©N?H~¥ ~[]r?EACH 0 04/01/~3--04/30/13 0.00 0.00 NYS RECYCLE FEE : 0.00 T~ ID # : Sales 'ax : - 0 - TO~.L DUE : 69.00 Proud Distributorsof MGR. SIGN MONEY RECEIVED NAME [] CASH $ PRINT NAME [] CHECK $ TiME DATE PIECES WATEF [] CHECK #. RECEIVED Purchase Order # Date TOWN OF SOUTHOLD''-'---~' 25068 O~ver and send billing to: rtment ~~' ~ iiq~ I Tax Exempt # A163554 Account # A.(~-/?~./4. /~D,-/O~ VENDOR **Return this copy and Town of Southold voucher itemized and signed for payment** ITEM QUANTITY DESCRIPTION UNIT COST TOTAL TH IS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFYTHAT~T/HER~AR/E ~ S U FFICl ENT F~[DS AVAI/I~AI .~ INfO__THE P TIO CH,~,~ DepX~ad '~ ~ I CERTIFY T~IS TO BE A JUST Supe~r - ' TOWN OF SOUTHOLD VENDOR 003613 COSTELLO MARINE CONTRACT.CORP 05/07/2013 CHECK 117425 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .2590.40 032013 REFND WTLND APP-M.MILLER 250.00 TOTAL 250.00 Il" Town of Southold, New York - Payment Voucher Vendor Name Costello Maline Contracting Corp. Vendor Telephone Number 477-1199 Vendor Contact Jarie Costello Vendor Address PO Box 2124 Greenport, NY 11944 Vendor No. 3613 Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number (~2013 3/20/2013 $250.00 $250.00 Total: $250.00 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. Entered by ~ Audit~. 0 7 2013 Town Clerk Description of Goods or Services Wetland Application Refund fl Mark Miller; SCTM# 81-3-24.2 General Ledl~er Fund and Account Number Department Certification I hereby certi6j 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 ~ ~~ James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 TO: FROM: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Supervisor Scott Russell Southold Town Board ~,~'~ '" ) JamesF. King, President ~~ Southold Town Board of Trustb"e~ DATE: April 23, 2013 RE: Storm Related Reimbursement Requests The following actions were taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, March 20, 2013: RESOLVED, that the Board of Trustees resolved to fully refund the following applications that involved a project that is storm related pursuant to Town Board Resolutions 2013-60, 2013-111,2013-189, and Town Code §111-22: · Amendment to Wetland Permit #6661 - Charlotte C. Burkard; SCTM# 128-2-16 Refund recommended: $50.00 Please send the check to: Charlotte C. Burkard PO Box 334 Mattituck, NY 11952 Amendment to Wetland Permit #7978 - Charles & Janice Bovino; SCTM# 119-1- 6.1 Payable to: Suffolk Environmental Consulting, Inc. as agent Refund recommended: $50.00 Please send check to: Suffolk Environmental Consulting, Inc. PO Box 2003 Bddgehampton, NY 11932-2003 Wetland Permit #8012 -John Abbott; SCTM# 126-5-1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8011 - James Abbott; SCTM# 126-5-3.1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8035-John Congdon & Others; SCTM#128-4-6 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7995 - Patricia Congdon O'Brien; SCTM# 128-4-1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #-8064- Stephen & Elizabeth O'Shaughnessy; SCTM# 128-2-9.2 Payable to.' En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit # 8063 - Mary McFeely; SCTM# 128-2-9.1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8071 - Matthew D. Volpe; SCTM# 80-5-1.1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8057 - Mark Miller; SCTM# 81-3-24.2 Payable to: Costello Madne Contracting Corp. as agent Refund recommended: $250.00 Please send check to: Costello Madne Contracting Corp. PO Box 2124 Greenport, NY 11944 Wetland Permit fl8067- Peter & Dina Masso; SCTM# 111-13-4 Refund recommended: $250.00 Please send check to: Peter & Dina Masso 5705 Nassau Point Road Cutchogue, NY 11935 Wetland Permit #8070 - Philip & Carolyn Manning; SCTM# 117-10-11 Refund recommended: $250.00 Please send check to: Philip & Carolyn Manning 2 Quarry Lane Irvington, NY 10533 Wetland Permit #8023 - Dean Blaikie; SCTM# 111-15-9 Payable to: Suffolk Environmental Consulting, Inc. as agent Refund recommended: $250.00 Please send check to: Suffolk Environmental Consulting, Inc. PO Box 2003 Bridgehampton, NY 11932-2003 Wetland Permit #8047 & CEHA Permit #8047C - Soundfront Holdings, LLC; SCTM# 51-4-8 Payable to: En-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7998 & CEHA Permit #7998C - Peter & Madsa Patinella; SCTM# 38-6-12 Payable to.' Eh-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7997 & CEHA Permit #7997C - Jonathan & Christine Meyer & Josephine Cippitelli; SCTM# 38-6-13 Payable to: En-Consultants as agent Refund recommended: $500.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7996 & CEHA Permit #7996C - Edward & Rachel Flannigan; SCTM# 38-6-14 Payable to: Eh-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8046 & CEHA Permit #8046C - Kirk O'Farrell & Denise Cerasani; SCTM# 31-13-9.1 Payable to: Eh-Consultants Refund recommended: $500.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit~8044 & CEHA Permit #8044C - Norton & Wesley Davidson; SCTM# 12-2-5.3 Refund recommended: $500.00 Please send check to: Norton & Wesley Davidson 1515 Gracewood Lane Vero Beach, FL 32963 Wetland Permit #8043 & CEHA Permit ~8043C - Ralph Carbone; SCTM# 1-2-5 Payable to: Glenn E. Just as agent Refund recommended: $500.00 Please send check to: Glenn E. Just PO Box 447 Quogue, NY 11959-0447 Wetland Permit #8050 & CEHA Permit #8050C - Suzanne Moyse, Mary Guerriera & Jennifer Blackhall; SCTM# 31-18-5 Payable to: Jeffrey Patanjo as agent Refund recommended: $500.00 Please send check to: Jeffrey Patanjo 106 Hewitt Boulevard Center Moriches, NY 11934 RESOLVED, that the Board of Trustees resolve to refund Linton I. Duell $150.00 in application fees as an Amendment was only required for the proposed project in lieu of a Wetland Permit: Please send check to: Linton I. Duell PO Box 387 Odent, NY 11957 cc: John Cushman - Town Comptroller Attachments TOWN OF SOUTHOLD VENDOR 003789 CUTCHOGUE HARDWARE, INC. 05/07/2013 CHECK 117426 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT DB .5130.4.100.500 H7259 0765 (1)90 PIPE ELBOW TOTAL 2.83 2.83 Town of Southold, New York - Payment Voucher Vendor Name Vendor Address Vendor Telephone Number Num~ Date Total Net Purchase Order Number Check No. Entered by ~/~ Audit Date .... ~r~: / . . ~ ~,, Department Certification I hereby certd? that the material~ above specified have been received by me m good condition withou: substdution, the services properly performed and that the quantities tberco~ have been verified with the exceptions ayment ~s approved Payee Certific~ztion The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the tbregoing claim is true and correct, that no part has been paid, except as therein stated, thai the balance therein stated is actually :~ate ,b--/ I5 CUTCHOGUE HARDWARE, INC. 28970 Main Road P,O. Box 998 CUTCHOGUE, NEW YORK 11935-0998 (~31) C PRODUCT 6~0 All claims a~d returned goods must be accompanied by this bill. PURCHASEORDER N~ ~ ?259 SOUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · R O. Box 178 · Peconic, L, L, N. Y. 11958 (631) 765-3140 .. (631) 734-5211 ADDRK~ Q~antity De~'ilnio~ Unit Pri~e Amount Ordered By: ~ ~r Nm~r Mm ment ~ P~ APPROVED BY: ~ TOWN OF SOUTHOLD VENDOR .02616 NORTON & WESLEY DAVIDSON 05/07/2013 CHECK 117427 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .2590.40 032013 REFUND WETLAND/CEHA APPS 500.00 TOTAL 500.00 Town of Southold, New York - Payment Voucher Norton & Wesley Davidson 1515 Gr~cewood Lane Vero Beach, FL 32963 Ve~der T=lephone Num~gt 7'/2-231-0750 Vendor Co~a~r ........ 052015 3/20/20~3 $500.00 $500.00 total: $500.00 Ve'ador No. Norton & Wesley Davidson SCTM# 12-2-5.3 ".'- --."-.' .-..-."-." '.'. " I)q~r ~mem Cerlfficafiee I h~hy cem~ ~a[ ~kc ~tcna~ ab~ ~ifi~ ~vc b~ ~v~ by ~ ~0~ ReceiVed From __ Address Dollars AMT PAID 049067 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 TO: FROM: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Supervisor Scott Russell Southold Town Board ~ James F. King, President /'~ ~ Southold Town Board of Tru~ DATE: April 23, 2013 RE: Storm Related Reimbursement Requests The following actions were taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, March 20, 2013: RESOLVED, that the Board of Trustees resolved to fully refund the following applications that involved a project that is storm related pursuant to Town Board Resolutions 2013-60, 2013-111,2013-189, and Town Code {]111-22: · Amendment to Wetland Permit #6661 - Charlotte C. Burkard; SCTM# 128-2-16 Refund recommended: $50.00 Please send the check to: Charlotte C. Burkard PO Box 334 Mattituck, NY 11952 Amendment to Wetland Permit #7978 - Charles & Janice Bovino; SCTM# 119-1- 6.1 Payable to: Suffolk Environmental Consulting, Inc. as agent Refund recommended: $50.00 Please send check to: Suffolk Environmental Consulting, Inc. PO Box 2003 Bridgehampton, NY 11932-2003 Wetland Permit #8012- John Abbott; SCTM# 126-5-1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #-8011 - James Abbott; SCTM# 126-5-3.1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8035 -John Congdon & Others; SCTM#128-4-6 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7995- Patricia Congdon O'Brien; SCTM# 128-4-1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8064 - Stephen & Elizabeth O'Shaughnessy; SCTM# 128-2-9.2 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit # 8063- Mary McFeely; SCTM# 128-2-9.1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8071 - Matthew D. Volpe; SCTM# 80-5-1.1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8057 - Mark Miller; SCTM# 81-3-24.2 Payable to: Costello Marine Contracting Corp. as agent Refund recommended: $250.00 Please send check to: Costello Marine Contracting Corp. PO Box 2124 Greenport, NY 11944 Wetland Permit #8067- Peter & Dina Masso; SCTM# 111-13-4 Refund recommended: $250.00 Please send check to: Peter & Dina Masso 5705 Nassau Point Road Cutchogue, NY 11935 Wetland Permit #-8070 - Philip & Carolyn Manning; SCTM# 117-10-11 Refund recommended: $250.00 Please send check to: Philip & Carolyn Manning 2 Quarry Lane Irvington, NY 10533 Wetland Permit #8023 - Dean Blaikie; SCTM# 111-15-9 Payable to: Suffolk Environmental Consulting, Inc. as agent Refund recommended: $250.00 Please send check to: Suffolk Environmental Consulting, Inc. PO Box 2003 Bridgehampton, NY 11932-2003 Wetland Permit #8047 & CEHA Permit #8047C - Soundfront Holdings, LLC; SCTM# 51-4-8 Payable to: Eh-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7998 & CEHA Permit #7998C - Peter & Madsa Patinella; SCTM# 38-6-12 Payable to: En-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7997 & CEHA Permit #7997C - Jonathan & Christine Meyer & Josephine Cippitelli; SCTM# 38-6-13 Payable to: Eh-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7996 & CEHA Permit #7996C - Edward & Rachel Flannigan; SCTM# 38-6-14 Payable to: Eh-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8046 & CEHA Permit #8046C - Kirk O'Farrell & Denise Cerasani; SCTM# 31-13-9.1 Payable to: Eh-Consultants Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit8044 & CEHA Permit #8044C - Norton & Wesley Davidson; SCTM# 12-2-5.3 Refund recommended: $500.00 Please send check to: / Notion & Wesley Davidson 1515 Gracewood Lane Vero Beach, FL 32963 Wetland Permit #8043 & CEHA Permit #8043C - Ralph Carbone; SCTM# 1-2-5 Payable to: Glenn E. Just as agent Refund recommended: $500.00 Please send check to: Glenn E. Just PO Box 447 Quogue, NY 11959-0447 Wetland Permit #8050 & CEHA Permit #8050C - Suzanne Moyse, Mary Guerriera & Jennifer Blackhall; SCTM# 31-18-5 Payable to: Jeffrey Patanjo as agent Refund recommended: $500.00 Please send check to: Jeffrey Patanjo 106 Hewitt Boulevard Center Moriches, NY 11934 RESOLVED, that the Board of Trustees resolve to refund Linton I. Duell $150.00 in application fees as an Amendment was only required for the proposed project in lieu of a Wetland Permit: Please send check to: Linton I. Duell PO Box 387 Orient, NY 11957 cc: John Cushman - Town Comptroller Attachments TOWN OF SOUTHOLD VENDOR 004034 DELTA COMPUTER SERVICES, INC. 05/07/2013 CHECK 117428 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT A .1680.4.400.353 A .1680.4.400.350 A .1680.4.400.351 A .1680.4.400.352 A .1680.4.400.353 A .1680.4.400.410 A .1680.4.400.353 INV-282434 8MM SERVICE CALL 1,353.00 INV-284383 AS/400/SERVER MTC-5/13 176.30 INV-284383 DISPLAY STATION MTC-5/13 13.50 INV-284383 PRINTER MAINT-5/13 266.60 INV-284383 8~4 MAINTENANCE-5/13 55.80 _~ ~.~.~7~?~ SCANNER MAINTENANCE-5/13 140.40 ~'~' ' ~REDIT 8MM SERVICE CALL 1,353.00- "~TOTAL 652.60 :Town of Southold, New York-Payment Voucher Vendor Tax ID Number or Social S~curity Number Delta Computer Services VendorCon~ 4 Dubon Ct. Farmingdale, NY 11735 Invoice Number TNV-282434 SCR-57918 212812013 4/25/2013 $0.00 $0.00 $0.00 ,1t353.00 (,1,353.00) $0.00 Net Discount Amount Claimed $0,00 $0.00 $0.00 ,1~353.00 (,~3s3.oo) $0.00 n/a n/a n/a n/a n/a Vendor No. 4034 AS/4OO/Server Mainter Display Station Maint. Printer Maintenance 8MM~ Entered by Audit Date HAY 0 '7 2013 l A.1880.4.400.350 A.1680.4.400.351 A.1680.4.400.352 A.1680.4.400.353 A.1680.4.400.353 n/a PC Maintenance A.1680.4.400.355 $0.00 $0.00 n/a UPS Maintenance A.1680.4.400.356 n/a $0.00 $0.00 $0,00 Police AS/400 Maint. Network Eq. Maint. $0.00 $o.oo $0.00 n/a n/a A.1680.4.400.357 A.1680.4.400.410 A,1680,4.400.420 $0.00 Payee Certification Department CerUficaUon or disCrel~au~i~ ~ot~d./a~ ~ay~e~t is al~proved. Signature~/~//~~'~/~ ; ~-~'(-~'Y' 1~,~,~ ~"~,, INVOICE Invoice Number: INV-282434 Invoice Date: 02/28/13 Page: 1 Bill To: Town Of Southold Town Hall, 53095 Main Road P.O. Box 1179 Southold, NY 11971-0959 Town Of Southold Ship To I Service To: Town Of Southold Town Hall, 53095 Main Road P.O. Box 1179 Southold, NY 11971-0959 ZACARY TOMASZEWSKI Customer No: M7360 Payment Terms: NET 30 Payment Due Date: 03/30/13 Salesperson: Matthew Sullivan Your Reference No: Service Call Date: Service Call No: Contact Phone No: 02119113 021913-036 631.766.18911631-879-155 Quantity Item No. Description Price Each Amount .......... Billable Service Call .......... 2 RLA Robert Accomando 125.00 250.00 1 TRAVEL TRAVEL CHARGE 60.00 60.00 1 YC945 DELL PV122T LTO2 W/BARCODE READ 1,043.00 1,043.00 SERVICE DATE: 2/21/13 DELL 122T-ERRORS WHEN BACKING UP-VERIFY PER RLA REPLACED 122T SIN - 95NR391 NEW SIN - 7NVZN11 Subtotal: 1,353.00 Sales Tax: 0.00 Invoice Total: 1,353.00 IF THIS INVOICE IS NOT DISPUTED, IN WRITING, WITHIN 30 DAYS OF RECEIPT, IT IS DEEMED VALID FOR PAYMENT. All Invoices Not Paid Within The Payment Terms Will Be Subject To A I 112 % Late Charge. Please Remit Your Payment To: DELTA COMPUTER SERVICES, INC. 4 Dubon Court, Farmingdale, NY 11735 Website: www.deltacomputergroup.com Phone 631.845.0400, Fax 631.845.7225 Billing: billing(~deltacomputergroup.com CREDIT MEMO Credit To: Town Of Southold Town Hall, 53095 Main Ro~d P.O. Box 1179 Southold, NY 11971-0959 Town Of Southo~d Credit Memo Number: SCR-57918 Credit Memo Date: 04/25/13 Applied to Invoice Number: INV-282434 Page: 1 Ship To / Service To: Town Of Southold Town Hall, 53095 Main Road P.O. BOX 1179 Southo~d, NY 11971-0959 ZACARY TOMASZEWSKI Customer No: M7360 Payment Terms: SalesPerson: Matthew Sullivan Your Reference No.: Service Call No: 021913-036 Quantity Item No. Description Price Each **'~**COVERED UNDER CONTRACT***** 2 RLA Robert Accomando 125,00 250.00 1 TRAVEL TRAVEL CHARGE 60.00 60.00 I YC.945 DELL PV122T LTO2 W/BARCODE READ 1,043.00 1,043.00 SERVICE DATE: 2121/13 DELL 122T-ERRORS WHEN BACKING UP-VER PER RLA REPLACED 122T Total Price NEW S/N - 7NVZN11 Subtotal: 1,353.00 Sales Tax:. 0.00 Credit Total: '1,353.00 IF THIS INVOICE IS NOT DISPUTED, IN WRITING, WITH 30 DAYS OF RECEIPT, IT IS DEEMED VALID FOR PAYMENT. NI Involoe~ Not Paid Within The Payment Terma Will Be Subjected To A t 1/2% Late Charge. PJease Remit Your Payment To: DELTA COMPUTER SERVlCES, INC. Phone $31.845.0400, Fax $31.84S.7225 Billing: billing~deltacompute~mup.com 4 Dubon Court, Farmingdale, NY 11735 Website: www-deltacomputergroup.com Town of Southoldr New York-Payment Delta Computer Services Voucher /endor Address ~ Dubon Ct. Farmingdale, NY 11735 Vendor No. 4034 Check No. Entered by Audit Date MAY 0 '7 2013 Town Clerk ., -- , INV-284383 INV-284383 INV-284383 4/21/2013 4121/2013 4/21/2013 INV-284383 4/21/2013 INV-284383 4/21/2013 INV-284383 INV-284383 [NV-284383 INV-284383 INV-284383 4/21/2013 4/21/2013 412112013 4/2112013 4/2112013 9176.30 $13.50 $266.60 955.80 90.00 90.00 $0.00 90.00 $140,40 $0.00 $176,30 $13,50 9266.60 955.8o $0.00 90.00 90.00 $0.00 9140.40 90.00 n/a n/a n/a n/a n/a Description of Goods or S~rvice~ ~l ~3 AS/400/Server Mainten Display Station Maint. Printer Maintenance B MM Maintenance~) 3 Decollator Maint. A.1680.4.400.350 A. 1680.4.400.351 A.1680.4,400.352 A.1680.4.400.353 A.1680.4.400.354 n/a PC Maintenance A.1680.4,400.355 UPS Maintenance A.1680.4.400.356 Police AS/400 Maint. Scanner Maintenance n/a n/a A.1680.4.400.357 A,1680,4.400.410 n/a n/a Network Eq. Maint. A.1680.4.400.420 J .............. LL. $652.60 $652.60 Payee CerUficaUon Department CertificaUon or discrepa~cies,noled,/a~)/ment is apl~oved, INVOICE Invoice Number: INV-284383 Invoice Date: 04/21/13 Page: 1 Bill To: TOWN OF SOUTHOLD TOWN HALL, 53095 MAIN ROAD P.O. BOX 1179 SOUTHOLD, NY 11971-0959 MR. LLOYD REISENBERG Ship To I Service To: TOWN OF SOUTHOLD TOWN HALL, 53095 MAIN ROAD P.O. BOX 1179 SOUTHOLD, NY 11971-0959 MR. LLOYD REISENBERG Customer No: Payment Terms: Payment Due Date: Salesperson: M7360 Your Reference No: NET 30 Service Call Date: 04121/13 05/21/13 Service Call No: Matthew Sullivan Contact Phone No: 516-765-1800 Quantity Item No. Description Price Each Amount 1 123 COMPUTER MAINTENANCE 652.60 652.60 05/01/13 - 05/31/13 Subtotal: 652.60 Sales Tax: 0.00 Invoice Total: 652.60 IF THIS INVOICE IS NOT DISPUTED, IN WRITING, WITHIN 30 DAYS OF RECEIPT, IT IS DEEMED VALID FOR PAYMENT. All Invoices Not Paid Within The Payment Terms Will Be Subject To A 1 112 % Late Charge. Please Remit Your Payment To: DELTA COMPUTER SERVICES, INC. 4 Dubon Court, Farmingdale, NY 11735 Website: www.deltacomputergroup.com Phone 631.845.0400, Fax 631.845.7228 Billing: billing@deltacomputergroup.com TOWN OF SOUTHOLD VENDOR 004070 CHARMAINE DEROSA 05/07/2013 CHECK 117429 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT A .1110.4,500.200 041013 A .1110.4,500.200 042213 A .1110.4.500.200 042613 CRT RPTR-PROB CAUSE-PRIC 250.00 CRT RPTR-BRUER-4/22/13 250.00 CRT RPTR-BRUER-4/26/13 250.00 TOT~ 750.00 Town of Southold, New' York - Payment Voucher V*ndor Nam, Charmain¢.DeRosa Vondor Tolophono Number V~ndor Contact 16 Carnegie Drive Smlthtown, NY 11787 V~ador. NO. 4070 · Invoice Invoioo lnvoiao Numbor Data Total Discount Number CA,ok No. ~,iiditna~ MAY O? 2013 services A11t0.4.500.200 Payee Certification Th* undersigned (Claimant) (Acting on bohalfof thc above named don herdoy o~tlf~ that tho forogoing claim is lruo and carrot, that no been paid, exoopt as therain stat-~t, that tho balaaoo therein stated is actually duo and owing, and that tax~ from which tho~own is exempt ar~ *xaluded.. Department Certffication I h/a',b7 o~tiflt that tho martials abovc*p*uified h~vc b~n mo~/ved by mo in good uondil/on wiltmat cub*t/ration, tho serdoe~ properly performed and that tho q.~.-~l*ka the~'~of havo been w~ifled with th~ except/ohs Tifl~ Dam Town of Southold, New York Vendor Name Charmaine DeRosa Vender Telephone Number - Payment Voucher Vendor Addre~ 16 Carnegie Drive Smlthtown, NY 11787 Vendor No. 4070 · l~voice Invoice Invoic~ Not Purol~so Onl~' Number Date Total Discount Number · 0oo~ or Services EntereA by Audit Date , MAY 0 7 2013 services Al110.4.500.200 Payee Certification The undexsign*d (Claimant) (Acting on behalf of the abovo named claimant) does h~roby c~lify that the foregoing claim is u-un and correct, that no p~rt has been paid, except as thee'cia statud, that the balance thm'~in stated is aotually du~ and owing, and tha/t~ from which tho T~fl~ is exezapt are excluded. Compal:~¥ Nam~ Dal:~ Department Certification I hcrchy ccrt/fy tha~ the m~t,'rialS above spccificd have bccn reco~ved by me in good condition without schsfitution, th~ services properly pcrformed and that th~ ClUaUl/fiea thm~f hav~ b~n vcrificd with the cxm,-ptioms or disct cjla?ci~s noted, and payment is approvcd, Sigonture ~f/ J Titl~ .Date Town of Southold, New York - Payment Voucher V~ndor Name Charmaine DeRosa Vendor Telephone Numhar Vendor Contact ' invoioo In¥oioe Invoioe N~ Pumha~e Order Nmnber Dam Total Discount Number Vendor No. . 4070 V~ador Addm~ 16 Carnegie Drive Sm thrown, NY 11787 n of Oeo& or S eawiccs tt'tq q. 1 Che~k No, ]~.tered by ~ Audit Date MAY 0 ? 2013 Tokyo Clerk ;Number services A1110.4.501).200 Payee Certification Th~ undc~ignc, d (Cislmant) (Acting on behalf of tho above named claimanO does h~reby certify that thc foregoing claim is true and corr~t, that no pa*l has been paid, except as th~'cin stated, that the balanoe th*r,in stated is actually duo and owing, and tho Town is exempt am ~x*ludexl. Department Certification [ hereby ~ that tho matedals above spccified have be~a r~ceived by mc in good ;ondition without substitu~.oI~ the services prop~ly p~formecl and that th~ qua~titi~ th~cof havo been wrified with the ~ptions or disoropanci*s noted, and paymmt is approved. Company Name TOWN OF SOUTHOLD VENDOR 004077 DEVITT SPELLMAN BARRETT, LLP 05/07/2013 CHECK 117430 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .1420.4.500.100 032913 LEGAL SVCS RE:MTA TAX 101.75 TOTAL 101.75 Town-of Southold, New York Vendor Name - Payment Voucher Vendor No. oo~o77 Vendor Contact Invoice Invoice Invoice Number Date Total Nurab~r t--'/C C_c- ==================================== :i:::~::: i!?:!iiiii::i:' t4A¥ 0 7 2013 ::: i Payee Certification The undersigned (Claimant) (Acting on behalf of the above named ¢lairrmat) does hereby ceaif,7 that the forrtgoing claim is hue and correct, that no part has been paid, except as therein slated, that the balance thu-r~in stated is actually due and owing, and that taxes from which the Town is exempt are exclude. Signatum/5~ ~Title ._~ C~k/. Department Certification I hereby, cettl fy that the matetitls above specified have been received by me m good condition without substitution, the sen4ee? properly lxa'fon-ned and that the quantiti~a th~eof have be*n v~fied with the exertions Title ~31 ~ Date ~_ { ~'/D_ . DEVITT SPELLMAN BARRETT, LI ATTORNEYS AND COUNSELLORS AT LAW 50 Route 111 Smithtown, New York 11787 Phone: (631 ) 724-8833 Fax: (631) 724-8010 Email: in IWa~devitt spellmanlaw.c om I'ItOMAS J. SPELl,MAN. JR. WILLIAM J. BARRETT KF, VIN M. SPELLMAN JELTJE de JONG FRANCIS J. TIERNEY DAVID S. PALl. Al JOHN M, DENBY DAVID II. ARNTSEN KENNETH M. SEll)El,l, ANDRE N. POULIS JOHN M. SHIELDS ANNE C. LEAHEY STEPIIAN D. TRACE KELLY E. WRIGHI' NICHOLAS M. BRINe CHARLES W. BORGHARDT JOSHUA S. SHTEIERMAN Retired JO'qEPII P DEVITT Martin D. Finnegan, Esq. Southhold Town Attorney P.O. Box 1179 Southhold, NY 11971 April 15, 2015 Of Counsel THOMAS SICA S~I EFANIE AFFRONTI I)EBORAIt C. ZACItARY Tiffany Scarlato, Esq. Southampton Town Attorney 116 Hampton Road Southampton, NY 11968 Re: Town of Southhold v. Metropolitan Transit Authority Our File No. SD5910JD Town of Southampton v. Metropolitan Transit Authority Our File: SO5910JD RECEIVED APR 1 8 2013 'fbwn Attorney's Office Dear Mr. Finnegan and Ms. Scarlato: In connection with the above matter, enclosed herewith please lind our interim invoice for services rendered dated March 29, 2013 in the amount of $203.50 Pursuant to your agreement that the Town of Southold and the Town of Southampton will each pay 50% of the invoice, please be advised that each Town is responsible for $101.75 of the total amount due. Should you have any questions, please feel free to contact the undersigned. JDJ/vs Enclosure Very truly yours, ~)~V'~T SPELLMAN B~..~TT,~LLP\ ,eltje de JSng ~ / Devitt Spellman Barrett, LLP 50 Route 111 Smithtown, New York 11787 (631) 724-8833 Tax iD No. 11-2396397 Town of Southold P.O. Box 1179 Southold, New York 11971-0959 Attn: Martin Finnegan, Esq. RE: Town of Southampton/Town of Southold v. MTA PREVIOUS BALANCE: $4,144.00 DATE PROFESSIONAL SERVICES RENDERED 03/13/13 Telephone conference with court re: Nassau County appeal 03/14/13 Letter to Town Atty re: telephone conference 03/19/13 R&R of correspondence from the Court of Claims; update our file Total of New Services: DATE 02/14/13 02/14/13 03/01/13 Total of New PAYMENT Southampton payment Southampton payment Southold payment Payments: ACCOUNT SUMMARY INDIV JMD JMD JMD PAGE 1 BILLING DATE: ACC'T NO.: TIME 0.70 0.20 0.20 1.10 03/29/13 000-SD5910JD AMOUNT 129.50 37.00 37.00 203.50 AMOUNT 27.75 989.75 1,554.00 2,571.50 PREVIOUS BALANCE: NEW SERVICES: NEW EXPENSES: NEW PAYMENTS: TOT. CURRENT PERIOD: CURRENT BALANCE: $4,144.00 $203.50 $0.00 $2,571.50 $203.50 $1,776.00 TOWN OF SOUTHOLD VENDOR 004558 LENOP~A DOME 05/07/2013 CHECK 117431 FUND & ACCOUNT P,O.~ INVOICE DESCRIPTION AMOUNT A .7020,4.500.420 043013 BELLY DANCING CLASS-3 HR 90.00 TOTAL 90.00 Vendor No. Check No. Town of Southold, New York - Payment Voucher Vendor Name Lenora Dome Vendor Telephone Number 878.5946 Vendor Contact Invoice Number Invoice Date Invoice Total Total Discount Vendor Address PO Box 236 Sayville NY 11782-0236 Net Amount Claimed 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 Signature Company Nam~2~ Date Purchase Order Number 4558 Entered by Audit Date Description of Goods or Services Belly Dancing Classes .L~ hours ~ $30/hour General Ledger Fund and Account Number A7020.4.500.420 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 exce~ .~~ancies noted, and payment is approved. Signature Title RECREATION SUPERVISOR Date TOWN OF SOUTHOLD VENDOR 004554 MICHAEL DOMINO 05/07/2013 CHECK 117432 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .8090.4.600.350 042913 REIM 15MI@.565/MI-INSP. 8.48 TOTAL 8.48 Town of Southold, New York - Payment Voucher Vendor Name Michael J. Domino Vendor Telephone Number 834-0727 Vendor Contact Vendor Address P.O. Box 75 Southold, NY 11971 Vendor No. Invoice Number 042913 4554 Invoice Date 4/29/2013 Invoice Net Total Discount Amount Claimed $8.48 $8.48 PumhaseOrder Number Description of Goods or Services Mileage Reimbursement 15 mi. @ .5651mi beck No. Audit Date MAY 0 '/2013 Town Clerk General Leda[er Fund and Account Number ~8090.4.600;$50 Payee Certification The undersigned (Claimant) (Acting on behalf of thc above named claimant) does hereby certify that thc foregoing claim is tree and correct, that no pa~t has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Department Certification I hereby certify that the materials above specified have been received by me in go~d condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. MILEAGE Date Beginning From-To-Return Ending Total Miles TOWN OF SOUTHOLD VENDOR .02618 LINTON I. DUELL 05/07/2013 CHECK 117433 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .2590.40 032013 PAMT.REFUND WETLJ~ND APP. 150.00 TOTAL 150.00 Town of Southold, New York - Payment Voucher Vendor Name Linton I. Duell Vendor Telephone Number 375-3693 Vendor Contact Vendor Address PO Box 387 Orient, NY 11957 Vendor No. Audit Dat~ MAYO Number 032013 3/20/2013 Invoice Net Total Discount Amount Claimed $150.00 $150.00 Total: $150.00 Payee Certification Thc undclsigned (Claimant) (Acting on behalf of thc above named claimant) docs hereby certify that thc 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 Town is exempt arc excluded. Signatu~ Company Name Date Purchase Order Number Description of Goods or Services Partial Wetland Application Refund for Linton I. Duell SCTM# 24-2-12 General Ledger Ftmd and Account Number Department Certification I hereby certi~ that thc materials above specified have been received by mc in good condition without substitution, the services properly performed and that thc quantities thereof have been verified with thc exceptions or discrepancies noted, and payment is approved Title I Y/¥~f/~F ) D'lte James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 TO: FROM: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Supervisor Scott Russell Southold Town Board James F. King, President ,.~ Southold Town Board of Truste"e~ DATE: April 23, 2013 RE: Storm Related Reimbursement Requests The following actions were taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, March 20, 2013: RESOLVED, that the Board of Trustees resolved to fully refund the following applications that involved a project that is storm related pursuant to Town Board Resolutions 2013-60, 2013-111, 2013-189, and Town Code §111-22: · Amendment to Wetland Permit #6661 - Charlotte C. Burkard; SCTM# 128-2-16 Refund recommended: $50.00 Please send the check to: Charlotte C. Burkard PO Box 334 Mattituck, NY 11952 Amendment to Wetland Permit #7978 - Chades & Janice Bovino; SCTM# 119-1- 6.1 Payable to: Suffolk Environmental Consulting, Inc. as agent Refund recommended: $50.00 Please send check to: Suffolk Environmental Consulting, Inc. PO Box 2003 Bddgehampton, NY 11932-2003 Wetland Permit #8012 - John Abbott; SCTM# 126-5-1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8011 - James Abbott; SCTM# 126-5-3.1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8035-John Congdon & Others; SCTM#128-4-6 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7995 - Patricia Congdon O'Brien; SCTM# 128-4-1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8064 - Stephen & Elizabeth O'Shaughnessy; SCTM# 128-2-9.2 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit # 8063 - Mary McFeely; SCTM# 128-2-9.1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8071 - Matthew D. Volpe; SCTM# 80-5-1.1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8057 - Mark Miller; SCTM# 81-3-24.2 Payable to: Costello Marine Contracting Corp. as agent Refund recommended: $250.00 Please send check to: Costello Marine Contracting Corp. PO Box 2124 Greenport, NY 11944 Wetland Permit #-8067 - Peter & Dina Masso; SCTM# 111-13-4 Refund recommended: $250.00 Please send check to: Peter & Dina Masso 5705 Nassau Point Road Cutchogue, NY 11935 Wetland Permit #8070 - Philip & Carolyn Manning; SCTM# 117-10-11 Refund recommended: $250.00 Please send check to: Philip & Carolyn Manning 2 Quarry Lane Irvington, NY 10533 Wetland Permit #8023- Dean Blaikie; SCTM# 111-15-9 Payable to: Suffolk Environmental Consulting, Inc. as agent Refund recommended: $250.00 Please send check to: Suffolk Environmental Consulting, Inc. PO Box 2003 Bridgehampton, NY 11932-2003 Wetland Permit #8047 & CEHA Permit #8047C - Soundfront Holdings, LLC; SCTM# 51-4-8 Payable to: En-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7998 & CEHA Permit ¢7998C - Peter & Marisa Patinella; SCTM¢ 38-6-12 Payable to: En-Consultants as agent Refund recommended: $500.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit ¢7997 & CEHA Permit ¢7997C - Jonathan & Christine Meyer & Josephine Cippitelli; SCTM¢ 38-6-13 Payable to: En-Consultants as agent Refund recommended: $500.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit ¢7996 & CEHA Permit ¢7996C - Edward & Rachel Flannigan; S CTM¢ 38-6-14 Payable to: En-Consultants as agent Refund recommended: $500.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8046 & CEHA Permit #8046C - Kirk O'Farrell & Denise Cerasani; SCTM# 31-13-9.1 Payable to: Eh-Consultants Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit8044 & CEHA Permit #8044C - Norton & Wesley Davidson; SCTM# 12-2-5.3 Refund recommended: $500.00 Please send check to: Norton & Wesley Davidson 1515 Gracewood Lane Vero Beach, FL 32963 Wetland Permit #8043 & CEHA Permit #8043C - Ralph Carbone; SCTM# 1-2-5 Payable to: Glenn E. Just as agent Refund recommended: $500.00 Please send check to: Glenn E. Just PO Box 447 Quogue, NY 11959-0447 Wetland Permit #8050 & CEHA Permit #8050C - Suzanne Moyse, Mary Guerriera & Jennifer Blackhall; SCTM# 31-18-5 Payable to: Jeffrey Patanjo as agent Refund recommended: $500.00 Please send check to: Jeffrey Patanjo 106 Hewitt Boulevard Center Modches, NY 11934 RESOLVED, that the Board of Trustees resolve to refund Linton I. Duel $15~.~_~O. in application fees as an Amendment was only required for the proposed project in lieu of a Wetland Permit: Please send check to: Linton I. Duell PO Box 387 Odent, NY 11957 cc: John Cushman - Town Comptroller Attachments TOWN OF SOUTHOLD VENDOR 006550 E-SERVICES 05/07/2013 CHECK 117434 FUND & ACCOUNT P.O,# INVOICE DESCRIPTION AMOUNT A .7020.4,500.420 043013 IPAD CLASSES-4 HRS 120.00 TOTAL 120.00 Town of Southold, New York - Payment Voucher VendorName E. Forte, S. Forte - E-Services Vendor Telephone Number 734-6468 Vendor Contact Vendor Address 1400 Evergreen Drive Cutchogue NY 11935 Vendor No. 6550 Cheek No. ]l't'43q Entered by Audit Date Invoice Number Invoice Invoice Net Date Total Discount Amount Claimed Invoice Total 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 ~f~ Title Company Name Date Purchase Order Number Services Classes hours /hour General Ledger Fund and Account Number A7020.4.500.420 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 ~L~/~tiofs or discrepancies noted, and payment is approved. Signature Title RECREATION SUPERVISOR Date 2~ 1~/I.~ TOWN OF SOUTHOLD VENDOR 005032 EAST MARION CEMETERY ASSOC. 05/07/2013 CHECK 117435 FLrND & ACCOLrNT P.O.# INVOICE DESCRIPTION AMOUNT A .8810.4.400.200 101-104-107-13 2013 MAINT-LEGION PLOT TOT/~L 6.00 6.00 Town of Southold, New York - Payment Voucher Vendor Name Vendor Address East Marion Cemetery Association O Box $34 Marion, NY 11939 Vendor Telephone Number Vendor Contact vendor No. 5032 £heck N0. Emeredhy ~ Audit DA 20'13 Invoice Number Invoice Date Discount 101-104-10Z. ja) 412412013 6.00 6.00 Total I Payee Certification Invoice Net Total Amount Claime~ Description of Goods or Services Ge~ra~ Ledger Fund and Account Number Department Certification 1 hereby certify that the materials above specified have been received by me in good condition withoul 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 Name Date The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certif)' that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded Purchase Order Number 2~.2 .'.',aint - Le~lion Plot Annual Assessment Fee , , , , ,A'8810'4' ~/o~',, Z~o, EAST MARION CEMETERY ASSOCIATION Box 534, East Marion, N.Y. 11939 Assassment on P~ot .o. ,?&l-- I ~ ?- Id'/ Care Other Charges: Balance Still Due Special Services Total Amount Due at this time "In so far as we receive, so shall we be able to do." East Marion Cemetery Association Box534, East Marion, N.Y. 11939 °ate Plot Amount Due ~, ~ EAST MARION CEMETERY ASSOCIATION Box 534, East Marion, N.Y. 11939 Assessment on Plot Care Other Charges: Balance Still Due Special Services Total Amount Due at this time "In so far as we receive, so shall we be able to do." TOWN OF SOUTHOLD VENDOR 005403 EN-CONSULTANTS, LLC 05/07/2013 CHECK 117436 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .2590,40 A .2590.40 A .2590.40 A .2590.40 A ,2590.40 A .2590.40 A .2590.40 A .2590.40 A .2590.40 A .2590.40 A .2590.40 032013 RFND APP-JOHN ABBOTT 250.00 032013 RFND APP-JAMES ABBOTT 250.00 032013 RFND APP-J.CONGDON & ORS 250.00 032013 RFND APP-P.CONGDON OBRIE 250.00 032013 RFND APP-O ' SHAUGHNESSY 250.00 .Q3~i~37~? i~79'- RFND APP-MARY MCFEELY 250.00 <,'~ £':0'i APP-SOUNDFRONT HLDG 500.00 APP- PATINELLA 500.00 500. O0 ~pp- FLANNIGAN 500.00 )FARRELL/CERASA 500.00 4,000.00 Town of Southold, New York - Payment Voucher En-Consultants Vendor Telephone Number 631-283-6360 Vendor Contact Mary Egan-Accotmtant Robert Herrmann - Owner Invoice Invoice Number Date ~32013 3/20/2013 032013 3/20/2013 ~32013 3/20/2013 [~32013 3/20/2013 l; 32013 3/20/2013 Total Discount $250.00 $250.00 $250.O0 $250.00 $250.00 Total: Payee Certification Vendor Address 1319 North Sea Road Southampton, NY 11968 Purchase Ord~ ' Amount Claimed Number $250.00 '"-/ $250.00'%/ $250.00 Jf $250.00 $250.00 ~'~.' The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the fbregoing claim is tree and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and t~q taxcs from which the Town is exempt are excluded. Signature. ~ ~ Tide_ Company NamJ Vendor No. Description of Goods or Services Wetland Application Refund for John Abbott; SCTM# 126-5-1 Wetland Application Refund for ,q- 5q:O, qO James Abbott; SCTM# 126-5-3A Wetland Application Refund for John Congdon & Ors; SCTM# 128-4-6 Wetland Application Refund for P. Congdon O'Brien; SCTM# 128-4-1 Wetland Application Refund for )'Shaughnessy; SCTM# 128-2-9.2 Department Certification I hereby ce~ify that the materials above specified have been received by me in good condition without substitution, the services properly ped'onned and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved. Vendor No. ICheck NO: I 'Town of Southold, New York - Payment Voucher Vendor Name En-Consultants Vendor Telephone Number 631-283-6360 Vendor Contact Ma~y Egan-Accotmtant Robert Herrmann - Owner invoice Number Invoice Date Invoice Total Discount Vendor Address 1319 North Sea Road Southampton, NY 11968 Net Purchase Order Amount Claimed Number Description of Goods or Services C32013 ,(~2013 3/20/2013 3/20/2013 $250.00 $250.00 $500.00, $500.00 Wetland Application Refund for Mary McFeely; SCTM# 128-2-9.1 Wetland & CEHA Applic. Refund for General Ledger Fund and Account Nmnber /q, O 5qo~ q:o t-~, o 5qo, q 0 CB2013 3/20/2013 $500.00 $500.00 Soundfront Ho d ngs LLC SCTM# 51 Wetland & CEHA Applic, Refund for Patinella; SCTM# 38-6-12 (~32013 3/20/2013 $500.00 $500.00 ,// NeUand & CEHA Applic. Refund for Meyer & Cippitelli; SCTM# 38-6-13 Total: Payee Certification The undersigned (Claimant) (Acting on behalf of thc above named claimant) do~s hereby certify that t~e foregning claim is true and corccct, that no part has been paid, except as therein stated, that thc balance therein stated is actually duc and owing, and t~t taxes from which the Town is exempt are exc[uded. Signature~' }~r~ ~'x.- Title Company Name ~-~_O~.U/~'d~'~ Date Department Certification I hereby certil~ that the materials above specified have been received by me in good condition without substitution, thc services properly performed and that the quantities therco£ have been verified with the exceptions or discrepancies noted, and payment is approved. Signature ~ ~" J~'~ Vendor No. ICh~ck N0 I Town of Southold, New York - Payment Voucher Vendor Name En-Consultants Vendor Telephone Number 651-283-6360 Vendor Contacl Mary Egan-Accountant Robert Hen'mann - Owner Invoice Vendor Address 1319 North Sea Road Southampton, NY 11968 Net Purchase Order Number 32013 032013 Date 3/20/2013 3/20/2013 Total Discount Amount Claimed $500.00 $500.00 $500.00 $500.00 Total: Pa ;ee Certification Number Description of Goods or Services Wetland & CEHA Applic. Refund for Flannigan; SCTM# 38-6-14 Wetland & CEHA Applic, Refund for O'Farrell & Cerasani; SCTM# 31-13-9.1 The undc~sigmed (Claimant) (Acting on behalf oftbc above named claimant) does hereby certity that thc foregoing claim is tree and correct, that no part has been paid, except as therein stated, that the balance therein stat~l is actually dUesignatureand owing, and~a~.~Titlc_ (~r~~t at taxes from which the Town is exempt are excluded. Company Nam; Date. General Ledger Fund ,and Account Number C R Department Certification I hereby certil~ that thc mat~nials above specified have been received by mc in good condition without substitution, the services properly pcrlbrmed and that thc quantities thereof have been verified with thc exceptions or discrepancies noted, and payment is approved. EN-CONSULTANTS 1319 North Sea Road, Southampton, NY11968 Office (631) 283~360 Fax (631)283~136 Email: encon@encensultants.com Memo 1'o: Attn: Elizabeth Cantrell Town of Southold Board of Trustees PO Box 1179 Southold, NY 11971 From.' Mary Egan, Accounts Manager Date= April 5, 2013 Re: Wetland Application Refunds ECEiVE APt{ - 6 20t3 Enclosed are the signed payment vouchers for the Wetland Application Refunds we are due (Inv 32013). I have also enclosed a completed W-9 Form for your records. Please contact me if you have any questions. · Page 1 uJ Address 050084 DUE ./ - oa,e t ~-- I.S~//?' 050068 '" 1~4_-~_~= ~ ' ~ '! [ ~°] ~ I:ddress _ Received Frbm :lzo~ Io::o L 050051 Address Dollars $ ~--'~ ~ Received From Address Date 04905 Dollars AMT OF ACCOUNT AMT PAID BALANCE DUE '~ .e,e I17-¢ 1¢ 049055 Address James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 TO: FROM: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Supervisor Scott Russell Southold Town Board James F. King, President /q~ Southold Town Board of Trust'-e~ DATE: April 23, 2013 RE: Storm Related Reimbursement Requests The following actions were taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, March 20, 2013: RESOLVED, that the Board of Trustees resolved to fully refund the following applications that involved a project that is storm related pursuant to Town Board Resolutions 2013-60, 2013-111,2013-189, and Town Code §111-22: Amendment to Wetland Permit #6661 - Charlotte C. Burkard; SCTM# 128-2-16 Refund recommended: $50.00 Please send the check to: Charlotte C. Burkard PO Box 334 Mattituck, NY 11952 Amendment to Wetland Permit #7978 - Chades & Janice Bovino; SCTM# 119-1- 6.1 Payable to: Suffolk Environmental Consulting, Inc. as agent Refund recommended: $50.00 Please send check to: Suffolk Environmental Consulting, Inc. PO Box 2003 Bridgehampton, NY 11932-2003 Wetland Permit #8012 - John Abbott; SCTM# 126-5-1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8011 -James Abbott; SCTM# 126-5-3.1 Payable to: En-Consultants as agent Refund recommended: $250.00 J Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8035-John Congdon & Others; SCTM#128-4-6 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7995- Patricia Congdon O'Brien; SCTM# 128-4-1 Payable to: Eh-Consultants as agent Refund recommended: $250.00 Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8064 - Stephen & Elizabeth O'Shaughnessy; SCTM# 128-2-9.2 Payable to: En-Consultants as agent Refund recommended: $250.00 ,,/' Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit # 8063- Mary McFeely; SCTM# 128-2-9.1 Payable to: Eh~Consultants as agent Refund recommended: $250.00 L// Please send check to: Eh-Consultants 1319 North Sea Road Southampton, NY 11968 · Wetland Permit #8071 - Matthew D. Volpe; SCTM# 80-5-1.1 Payable to: En-Consultants as agent Refund recommended: $250.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #8057 - Mark Miller; SCTM# 81-3-24.2 Payable to: Costello Marine Contracting Corp. as agent Refund recommended: $250.00 Please send checkto: Costello Marine Contra~ing Corp. PO Box 2124 Greenport, NY 11944 Wetland Permit #8067 - Peter & Dina Masso; SCTM# 111-13-4 Refund recommended: $250.00 Please send check to: Peter & Dina Masso 5705 Nassau Point Road Cutchogue, NY 11935 Wetland Permit #8070 - Philip & Carolyn Manning; SCTM# 117-10-11 Refund recommended: $250.00 Please send check to: Philip & Carolyn Manning 2 Quarry Lane Irvington, NY 10533 Wetland Permit #8023 - Dean Blaikie; SCTM# 111-15-9 Payable to: Suffolk Environmental Consulting, Inc. as agent Refund recommended: $250.00 Please send check to: Suffolk Environmental Consulting, Inc. PO Box 2003 Bridgehampton, NY 11932-2003 Wetland Permit #8047 & CEHA Permit #8047C - Soundfmnt Holdings, LLC; SCTM# 51-4-8 Payable to: En-Consultants as agent Refund recommended: $500,00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7998 & CEHA Permit #7998C - Peter & Madsa Patinella; SCTM# 38-6-12 Payable to: En-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7997 & CEHA Permit #7997C - Jonathan & Christine Meyer & Josephine Cippitelli; SCTM# 38-6-13 j Payable to: En-Consultants as agent Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #7996 & CEHA Permit #7996C - Edward & Rachel Flannigan; SCTM# 38-6-14 Payable to: En-Consultants as agent ~' Refund recommended: $500.00 Please send check to: En-Consultants 1319 North Sea Road Southampton, NY 11968 Wetland Permit #-8046 & CEHA Permit #8046C - Kirk O'Farrell & Denise Cerasani; SCTM# 31-13-9.1 Payable to: Eh-Consultants Refund recommended: $500.00 Please send check to: Eh-Consultants 1319 Nodh Sea Road Southampton, NY 11968 Wetland Permit~8044 & CEHA Permit #8044C - Norton & Wesley Davidson; SCTM# 12-2-5.3 Refund recommended: $500.00 Please send check to: Norton & Wesley Davidson 1515 Gracewood Lane Vero Beach, FL 32963 Wetland Permit #8043 & CEHA Permit #8043C - Ralph Carbone; SCTM# 1-2-5 Payable to: Glenn E. Just as agent Refund recommended: $500.00 Please send check to: Glenn E. Just PO Box 447 Quogue, NY 11959-0447 Wetland Permit #8050 & CEHA Permit ~050C - Suzanne Moyse, Mary Guerriera & Jennifer Blackhall; SCTM# 31-18-5 Payable to: Jeffrey Patanjo as agent Refund recommended: $500.00 Please send check to: Jeffrey Patanjo 106 Hewitt Boulevard Center Moriches, NY 11934 RESOLVED, that the Board of Trustees resolve to refund Linton I. Duell $150.00 in application fees as an Amendment was only required for the proposed project in lieu of a Wetland Permit: Please send check to: Linton I. Duell PO Box 387 Orient, NY 11957 cc: John Cushman - Town Comptroller Attachments TOWN OF SOUTHOLD VENDOR 005506 JOSEPH ESPINOSA, LLC 05/07/2013 CHECK 117437 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT B .691 042913 REIM.ESCROW 75-5-14.1 4,500.00 TOTAL 4,500.00 Town of Southold, New York - Payment Voucher Vendor Name ~ Vendor Address Jose ~inosa-LtC ~ Vendor No. · Alcatel-Lucena'-L42106 2640 Netherland Drive - Apt. 205 Vendor T¢lephone N.m~ Beaver Creek, OH 45431-7742 Vendor Contact Invoice Invoice Invoice11 [ Net Pmehase Order Number Date Total ! Dlaeount ! Amonnt Claimed Number Description of Gonds or Services , :onsulting review re [ ,ireless applicat ion I 4,500. at Police Sta. Peconic I SCTM#1000-75-5-14.1 I I Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) doc~ hereby certify that the foregoing claim is true and correct, that no pa~ has been paid, except as therein stated, that the balance therein stated is actually due and owing, and flint rexes from which the Town is exempt are excluded. Signature Title Company Nam~ 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 quantifies thereof have been vetified with the exceptions or discrepancies noted, and payment is approved. Ti~ePlanning DirectOr Date TOWN OF SOUTHOLD VENDOR 005733 JOHN M. EVANS 05/07/2013 CHECK 117438 FUND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT A .3130.4.500.400 TBR406 123112 YR 2012 BAY PATROL P/T 1,296.88 TOTAL 1,296.88 Town of Southoid, New York - Payment Voucher Vmdor Tax ID Numb~ ~' ,~cial ~coffty Nural~r Vec~do~ T~I~I~ Numb~ No. i.!.i-: '.:;~'; !:!.!.!.: '.F :.::¢-:., ~i;~.< i:i: :-:. :!:!:!:i:i': :i:i "':"/":""." ."'~!:!~!:i:!:i:!: ::::::::::::::::::::::::::::::::::::::::::::::::::~." ~' ~.'.'. Payee Cer~fleaflon rl~ undmi~n~d. (Claimant) (.~-tin~ ~ b~hsdf of ~e above named claimanO doea Imray certi~ t~t ~e f~s~oing claim is m~e and con--t, that no P~t has ~) RESOLUTION 2012-406 ADOPTED DOC ID: 7834 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2012-406 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MAY 8, 2012: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute an Agreement between the Town of Southold and Matthew Sklnner~ Fishers Island~ to pert'om services as a Fishers Island Bay Patrol, effective May 8, 2012 through December 31, 2012, at a compensation rate of $2,576.56, plus approved expenses, subject to the approval of the Town Attorney; and be it further RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute an Agreement between the Town of Southold and John Evans~ Fishers Island~ to perform services as a Fishers Island Bay Patrol~ effective May 8, 2012 through December 31, 2012, at a compensation rate of $1,296.88, plus approved expenses, 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: Ruland, Talbot, Doherty, Kmpski Jr., Evans, Russell ORIGINAL FISHERS ISLAND BAY PATROL AGREEMENT THIS AGREEMENT made this 8th day of May, 2012, by and between the TOWN OF SOUTHOLD, a municipal corporation of the State of New York, having its principal office at 53095 Main Road, P.O. Box 1179, Southold, New York 11971-0959 (hereinafter the "Town") and JOHN EVANS, Fishers Island Bay Patrol, with an address at P.O. Box 475, Old Mystic, Connecticut 06372 (hereinafter "Evans"). WHEREAS, pursuant to Town Board Resolution No. 2012-406, adopted on May 8, 2012, the Town agrees to contract for Evans' services as a Fishers Island Bay Patrolman; and WHEREAS, the term of such service shall be effective on May 8, 2012 through December 31,2012; and WHEREAS, the duties of Bay Patrol shall be completely performed by Evans to the satisfaction of the Fishers Island Harbor Committee and the Town Board of the Town of Southold and Evans shall be assigned specifically to the areas in and around the Town at Fishers Island; and WHEREAS, these duties include patrolling the waters in and around Fishers Island, making reports as necessary, assisting law enforcement personnel in a civilian capacity, assisting the residents and visitors of Fishers Island in maintaining the peace and safety of the waters and contiguous areas in and around Fishers Island. -]- NOW, THEREFORE, IT IS AGREED AS FOLLOWS: The Town will pay Evans at the prorated amount of $1296.88 per annum effective May 8, 2012 through December 31, 2012. 1. Evans will provide a boat for the purpose of performing the duties of Bay Patrolman. 2. The Town will reimburse fuel required for the operation of the boat up to fifty (50) gallons per year while performing services for the Town, provided timely proof of mileage and fuel usage is submitted for the Town's review. Any amount in excess of fifty (50) gallons may be reimbursed at the sole discretion of the Town Board only upon good cause shown and provided the request for reimbursement is made in a timely manner and accompanied by proof of mileage and fuel usage. 3. The Town will pay reasonable costs for servicing the motor of the boat actually used while performing services for the Town. Proof of servicing must be provided before reimbursement will be made by the Town. In no event shall the Town pay more than $250.00 per annum for servicing costs. 4. The Town will NOT reimburse Evans the cost of dock space, dockage fees, registration, insurance, or any other expense not specifically addressed herein. 5. Evans agrees to comply with all stated standards of performance, policies, rules and regulations of Bay Patrolman, as specified by the -:2- Fishers Island Harbor Committee and the Town Board of the Town of Southold. 6. This Agreement may terminate upon the occurrence of any of the following events: (a) failure to perform duties satisfactorily to the Town Board or the Fishers Island Harbor Committee after notice thereof; (b) for just cause based upon non-performance of duties by Evans; or (c) upon four (4) weeks written notice by either party. IN WITNESS WHEREOF. the parties hereto have caused this Agreement to be executed on the day and year first above written. TOWN OF SO, OLD By: ~-'~~ Scott A~. Russell, Supervisor FISHERS ISLAND BAY PATROL TOWN OF SOUTHOLD VENDOR 013535 VIVIAN EYRE 05/07/2013 CHECK 117439 FI/ND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .7020.4.500.420 0430~3 POETRY CLASSES-3 HRS 90.00 TOTAL 90.00 Town of Southoid, New York - Payment Voucher Vendor Name Vivian Eyre Vendor Address PO Box 1055 VendorTelephoneNumber Southold NY 11971 765.3463 Vendor Contact Invoice Number Date Invoice Total Invoice Total Discount Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded. Signature Title Company Name Date Net Amount Claimed Purchase Order Number Vendor No. Check No. Entered by Audit Date y/7/, Description of Goods or Services Poetry Classes .__.~hours ~$ .~:} /hour General Ledger Fund and Account Number A7020.4.500.420 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 exc~j~_r~epancies noted, and payment is approved. Signature T,tle ECREATIONSUP RVISO Date q/ O//3 TOWN OF SOUTHOLD VENDOR 006330 FIRST MOBILE TECHNOLOGIES 05/07/2013 CHECK 117440 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .1680.2.400.450 25523 36297 LAPTOP POWER SUPPLY 262.90 TOTAL 262.90 Town of Southold, New York - Payment Voucher Vendor Tax ID Number or Social Security Number Vendor Address Vendor Name First Mobile Technologies Vendor Telephone Number Vendor Contact 1013 Conshohocken Rd. Conshohocken, PA 19428~978 Vendor No. 6330 Check No. 11_3_ qO Entered by ~ Audit Date MAY 0 ? 2013 Town Clerk Invoice Number Net Discount Amount Claimed Invoice Invoice Date Total 4/1512013 $262.90 36297 $262.90 Payee Certification $262.90i The undersigned (Claimant) (Acting on behalfof the above named claimant) does hereby certify that the foregoing claim is true and correct, that no part has been paid, except as therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded X Signature Title Company Name Date Purchase Order Laptop Power Supply Number Description of Goods or Services 25523 General Ledger Fund and Account Number A.1680.2.400.450 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution, the services properly performed and that the quantities thereof have been verified with the exceptions or discrepancies noted, and payment is approved Signature Title Date ~ff F, rst*' Mobile Technologies 1013 Conshohocken Road, Suite 312 Conshohocken, PA 19428-0978 Tel 610-828-1492 Fax 610-828-1195 208459 TOWN OF SOUTHOLD AIWN: LLOYD REISENBERG 53095 MAIN RD IT Dept, SOUTHOLD NY 11971 USA SHIP VIA JPS GROUND ITERMS Date: 04/15/13 Due Date: 05/15/13 INVOICE Inv No 36297 Page No: 1 Ship To/Remarks TOWN OF SOUTHOLD A]q-N: LLOYD REISENBERG 53095 MAIN RD IT Dept. SOUTHOLD NY 11971 USA SALES RE 3OHND P'DELL "D" SERIES PWR SP, HW Item #: FM-PWR-DLH SHIPPING/HANDLING CHARGE THANK YOU FOR YOUR ORDER. Shipped on 4/15/2013 Ship Via: UPS Ground Trk #: 1Z197E190300025731 End Shipment ea Days SUB-TOTAL FREIGHT TAX TOTAL NET TO PAY 238.00 24.90 262.90 CERTIFICATE OF CONFORMANCE" FMT CERTI- :IES THAT THE MATERIALS ARE IN COMPLI- 3Eipiiient"$h'b-~a'~l~S-'M/,~i'Bi~'Reported In 15 PLEASE REMIT PAYMENT TO: P.O. Box 906009 Charlotte, NC 28290-6009 1-1/2% Per month will be charged on all overdue accounts Returns over 30 days are not valid unless warranted Returns within 30 days may be subject to a 20% charge 2.0 2.0 119.0000 262.90 0.00 0.00 262.90 Purchase Order # Da~e TOWN OF SOUTHOLD 25523 Tax Exempt # A163554 /-~ Account # //~' 660'~. ~/OV. ,~"~ VENDOR **Return this copy and TOwn of Southold voucher itemized and signed for payment** QUANTITY ITEM D, t~ DESCRIPTION UNIT COST I! ~. o o TOTAL 2??. ..2 ~2. '7,0 THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR CERTIFY THAT THERE ARE SUFFICIENT FUNDS AVAILABLE IN T~ E:~O P R~:~P RIA~O~.~ARG ~;) Dept. He~d , I CERTIFY THIS TO BE A JUST AND TRUE PURCHASE ORDER Supervisor DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES I certify that the goods or services were received by this Depertme, nt a~d all ~,~eptions.cluly noted. Date DEPARTMENT BILLING COPY TERMS AND CONDITIONS I. The TOWN OF SOUTHOLD is not responsible for materials, supplies or equipment delivered or services performed without authority of written order. Quantities specified are not to be exceeded. 2 No changes may be m~de in this order without written authority of the supervisor. 3, Inspection of delivery will be made at delivery point unless otherwise specified: Materials must ~)e properly [~ackaged. Damaged material will not be accepted. Include itemized packing lists with all shipments. Delivery indoors is required unless otherwise specified. All prices quoted must in- .:tude shipph~g, handling, packing and cratin(3 charges and be F.O.B. delivered, unless other terr~s are agreed to. 4. S~bstitutions of specilied iteq~,s w~ill not be acceptable. The Town of Southold reserves the ight ~:o :¢~.ject ~-ed return at shippers expense, materials delivered which do not conform to de- scription of item ordered. 5 If order c,~nnot be filled in ~vhole c-r ir~ part in time s~,,eci¢ied, notify the town immediately. In case of ~elay in delivery; eL in case of any default of the vendor, the town may procure the goods or services fron~ other sources and hold the vendor responsible for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby, 6, Upon acceptance of this order the vendo~ agrees to comply with all Federal, State or local laws relative thereto: a. The ve.~.dor shall defend actions or claims brought and hold the Town of Southold, its agents and its employees harmless from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor,represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c. Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- ing ho~rs and minimum wages of employees and prohibiting discrimination on account of race, sex, color, creed or na~Iional origin in hiring employees within the State of New York involved in the manufacture of m:aterials, equipmeqt, or supplies specified in this order. d. The vendor shall comply with Sectior, s 103a and 103b of the General Municipal Law pertaining to disqualifications of contracto,. for failure to waive immunity before Grand Jury. 7. INVOICES RENDERIED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. Claims f¢,r partial deliveries are not allowed unless indicated. Claims in question will constitute a condition precedent to the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. 1!. All I~O./Claims must be audited and approved by the Town Board prior tO actual payment. F, rst Mobile Technologies 1013 Conshohocken Road, Suite 312 Conshohocken, PA 19428-0978 Tel 610-828-1492 Fax 610-828-1195 QUOTE Date: 04/08/13 Quote No.: 3087 Due Date: 04/08/13 Page No.: i SOUTHOLD TOWN OF SOUTHOLD AI-I'N: LLOYD REISENBERG 53095 MAIN RD SOUTHOLD NY 11971 USA (631) 765-1891 Ship to/Remark TOWN OF SOUTHOLD ATTN: LLOYD REISENBERG 53095 MAIN RD SOUTHOLD NY 11971 USA SHIPVIA ]FOB ITERMS ] YOUR# IOUR# NET 30 DAYS ~~ ~*DELL "D" SERIES PWR SP, HW 2.0 2.0 119.0000 Item #: FM-PWR-DLH ea SALES RE 238.0( ~HIPPING/HANDLING CHARGE 24.9( SUB-TOTAL TAX TOTAL 262.90 0.00 262.9(] NET TO PAY 262.9(] TOWN OF SOUTHOLD VENDOR 013966 FIRST SOUTHOLD REAL EST. CORP 05/07/2013 CHECK 117441 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .1640.4.100.500 25496 46172 B15 225/70R15 TIRE 132.00 TOTAL 132.00 Note: Check with (X) the statement above which apl needing attention should be checked in the list beloxn a separate sheet. Driver's Motor Veh. ~ ~l/~10L'~_~f~'~ __ Vehicle is in good operating condition. Items checked below require attention. Ammeter/Voltmeter Battery Water Lights-headlights Body Parts Lights-body Brakes-foot Lights-stop Brakes-parking Lights-tail Bumpers Lubrication Chains Engine Compartment Clutch Oil Pressure Defroster Radiator Door Latches/Locks Rearview Mirrors Exhaust System Side Mirrors 'Fan Belt Directional Signals Fender/Quarter Panel Speedometer Fire Extinguisher 'Springs/Shocks Flags/Flares/Reflectors Starter Gearshift Steering Gear Generator/Alternator ~.. T.T_ires Heater Windshield Wipers Horn Wiper Fluid Jack Ending Mi~'~/~e~ ~.i ~t~ Starting Mileage Signed by ~~ (Driver) Date 5/2~'"' [ ~ Vehicle Tag No. ~'- EASTERN TIRE & NASSAU POINT S.S. 15 EUGENE'S RD. CUTCHOGUE, NY 11935 REPAIR LICENSE # 7083283 Invoice Date Invoice # 4/Y2013 46172 Sold to SOU FItOLD TOWN ACCOUNTING AND I:INANC [ PO BX 1!79 SOUTHOLD NY 11971 VIN # YEAR, MODEL Meth*d of. Tech Odometer FORI) RANGER t70 25496 ZAK Item Description Qty Price Amount CON I [NEN'FA[, 225/70R15 CONTINENTAl. ri I>~/XC I 132.00 132.00 I' MOUNT. BALAN£ E, VALVE & DISP. I hereby authorize the above repair work to be done along with the necessary materials. Subtotal $132.00 I You and 3'our employees may operate above vehicle for purposes of testing, inspection, or delivery at my risk. An express mechanics lcin is acknowledged on above vehicle to secure Sales Tax (0.0%) $0.00 thc amount ofrcpairs thereto. It is also understood that an) vehiclc Iclt here for more than I day without prior arrangement will be assest an $ [0.00 a da.~ $132.00 storage t'~e. Phone # Fax # 734-7395 / 734-66 0 734-7301 Total Payments/Credits $o.oo Balance Due $m.00 Order # 2 5 4 9 6 TOWN OF $OUTHOLD Tax Exempt # A163554 ~/~/~ J,/~ ~,_~ Account # v~_r and send billing to: Department ,,~ .D~:, ~'7~/~ Addres~ ~ ~ 2 /" ,//,~ IVendor VENDOR Return this copy and Town of Southold voucher itemized and signed for payment** ITEM QUANTITY DESCRIPTION UNIT COST TOTAL THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFY THAT THERE ARE SUFFICIENT FUNDS AVAILABLE Dep~:, ~lead I CERTIFY THIS TO BE A JUST AND TRUE PURCHASEORDER SuperVisor DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES I certify that the goo~r services were received by this Depa r t me_~![~,D~a~e~ptio, p~d uly noted. Date DEPARTMENT BILLING COPY TERMS AND CONDITIONS 1. The TOWN OF SOUTHOLD is not responsible for materials, supplies or equipment delivered or services performed wi:thout authority of written order. Quantities specified are not to be exceeded. 2 No changes may be made in this order without writter~ authority of the supervisor. 3. Inspection of delivery will be made at deliveqf point unless otherwise specified. Materials must be properly packaged. Damaged material will not be accepted. Include itemized packing lists with all shipments. Delivery indoors is required u~nless otherwise specified. All prices quoted must in* c~ude shipping, handling, pack;ng and cr~tin(j charges and be F.Q.B, delivered, unless other terms are agreed to. 4, Substitu~,ions of specified terns will not be acceptable. The Town of Southold reserves the right to reject and return at shippers expense, ~a~aterials delivered which do not conform to de- scription of item ordered. 5, If order cannot be filled in whole c~' in part in time s~ecified, notify the town immediately. In case of delay in delivery, o~ in case of any de[ault of the vendor, the town may procure the goods or services from other sources a~d hold the vendor responsible for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby, 6, Upon acceptance of this order the vendor agrees to comply with all Federal, State or local laws relative thereto: a. The vendor shall defend actions or claims brought and hold the Town of Southold, its agents and its employees harmless from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c. Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- lng hours and minimum wages of employees and prohibiting discrimination on account of race, sex, color, creed or national origin in hirir~g employees within the State of New York involved in the manufacture of materials, equipment, or supplies specified in this order. d. The vendor shall comply with Sections 103a and 103b of the General Municipal Law pertaining to disqualifications of contractor for failure to waive immunity before Grand Jury. 7. INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. Claims for partial de!iveries are not allowed unless indicated. Claims in question will constitute a condition precedent to the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold. 9. Cash discount terms rr~ust be indicated on claim voucher; discount period will be computed from date of acceptance of dc'.ivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. 11. All RO./Claims must be audited and approved by the Town Board prior to actual payment. TOWN OF SOUTHOLD VENDOR 006844 FUNDAMENTAL BUSINESS SVCE,INC. 05/07/2013 CHECK 117442 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .1110.4.400.500 03312013 30% COF~4 PRKNG TKT-3/13 1,020.00 TOTAL 1,020.00 Town of Southold, New York - Payment Voucher Vendor Telephone Number (516) 486 - 3120 DENNIS J. FARRELL VendorAddr~ MGMT SERVICE MARC}{ 2013 Check No. I J'"JJ.Jq Audit MAY 0 ? 20]3 }'OWn Clerk INVOICE TOTAL $1,020.0( $1,020. Payee Certification ~s~ ~c. ~ o3/31/2o1~ Fundamental Business Service, Inc. ~.4 Front Street, Suite ~.00 · Hempstead, NY t~_550 Toll-free 800-272-1635 · Local 516-486-3120 · Fax 516-486-256~. www.fbsnet.com Jus~ceSolutions March 31, 2013 To: STATEMENT Town of Southold 53095 Route 25 PO Box 11971 Southold, NY 11971 Attention: Ms. Christine Stulsky Court Clerk FOR SERVICES RENDERED: CLIENT # 2306 RECEIVABLES Period Ending 03/31/2013 Gross Receipts Commissionable Receipts Fee Due $ 3,400.00 $ 3,400.00 $1,020.00 Total Due $1,020.00 TOWN OF SOUTHOLD VENDOR 007028 WAYNE GAJ-J~NTE 05/07/2013 CHECK 117443 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT A .8090.4.500.600 042313 A .8090.4.500.600 042913 MINUTES-2/20/13-TRST MTG 850,00 MINUTES-4/17/13 TRST MTG 850.00 TOTAL 1,700.00 Town of Southold, New York - Payment Voucher Vendor No. 7oJ <12 Descriplien of G'ood$ or Services Payee Cer(ifica tion Thc uademigncd (Claimant) (Aaing o~ I~half of ~e abo~ ~ cravat) ~0o Trustees, April 23, 2013 Please remit at your ea~llest convenience a cheek for $850 for the transcription of Minutes of the Trustee meeting held on February 20, 2013, at Southold Town Hall to: Wayne Galante 14 Calico Court Riv~rhead, New York 11901 yoU, Wayne Gala~te ~ 'd 99L'ON ~VL[:8 gLO~'~C'~d¥ Town of Southold, New York - Payment Voucher Payee Certification ~ustces, April 29, 2013 Please remit at your earliest convenience a check for $$50 for the transcription of Minutes of tho Trustee meet/rig held on April 17, 2013, at Southold Town H~ll to: Wayne Galante 14 Cal/eo Court Riverheafl, New York 11901 you, wayM Gamete TOWN OF SOU'IT-IOLD VENDOR 007029 GALETON GLOVES 05/07/2013 CHECK 117444 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT D~ .5140.4.100.700 H7298 1102335-00 SAFETY,VINYL GLOVES TOT~ 96.01 96.01 Town of Southold, New York ~ Payment Voucher ~ o-'-/q ~"-/g 7~5 33(0 oo~o~e 100 Foxborough Boulevard Foxborough, MA 02035 CUSTOMER NUMBER INVOICE DATE 359289 INVOICE NUMBER 1102335-00 04/01/i3 SOUTHOLD HIGHWAY DEPT BOX 178 PECONIC, NY 11958 Thank You For Ordering From Galeton Ph: (800)221-0570 Fax: (800)322-2003 INVOICE in US Dollars Oderedby ~ SOUTHOLD HIGHWAY DEPT P 0 BOX 178 PECONIC, NY 11958 Ship~ ~ TOWN OF SOUTHHOLD HWY DEPT 275 PECONIC LN UOPHNOCD, NY 11958 Invoice Processing CUSTOMER ORDER D~E SHIPPED VIA DATE SHIPPED PAGE TERMS PURCHASE ORDER NUMBER Net 30 days H7298 04/01/12 UPSGRND COMM 04/01/1: 1 QUANTI~ QUANTITY QUANTITY LiNE ITEM/DESCRIPTION ORDERED SHIPPED BACKORDERED UNIT PRICE TOTAL DIVERSION CONTR3~RY TO U S. LAW If PROHIBITED 2112-XL ] 1 0 41.95 41.95 TIGER CAT LTHR PLM GLVS SZ XL SFTY CUFF 12PR/PK( 7506-XL 4 4 0 10.25 41.00 HVY-DTY GLVS 6.5 MIL SZ XL LTLY PWDRD 100/BA( SUB TO~AL 82.95 Freight Out 13.06 TOTAL ES Dollars 96.01 REMIT IN US Dollars Galeton PO Box 336 Mansfield, NDX 02048-181~ (800)221-0570 Thank you for your busiJtess with Galeton. PURCHASE ORDER N-° [4 7298 $OUTHOLD TOWN HIGHWAY DEPARTMENT 275 Peconic Lane · R O. Box 178 · Peconic, L. I., N. '~ 11958 (631) 765-3140 · (631) 734-5211,/ Please Enter Our Or'der For T'ne Followinsr Items Quantity De~.,rit~ioa Unit Price Amou~ ' '~'- '(/~ Ordered By: APPROVED BY: (~(~ (~..~ TOWN OF SOUTHOLD VENDOR 007413 DENISE GILLIES 05/07/2013 CHECK 117445 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .7020.4.500.420 043013 TAI CHI CLASSES-1.25 HRS 37.50 TOTAL 37.50 Town of Southold, New York - Payment Voucher Vendor Name Denise Gillies Vendor Address PO Box 1280 Vendor Telephone Number Cutchogue NY 11935 734.6762 Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Invoice Total 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/o~g, and that taxes f~9~ xvl~e~ tho Town is exempt are excluded. Company Name Date Vendor No. - 7413 Cheek No. Entered by Audit Date T,o~v~ Clerk Description of Goods or Services Tai Chi Classes hours ~ $30/hour General Ledger Fund and Account Number A7020.4.500.420 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 exce~'b~s or.discrePancies noted, and payment is approved. Signature ~ Title RECREATION SUPERVISOR Date TOWN OF SOUTHOLD VENDOR 007310 LEANDER GLOVER,JR. 05/07/2013 CHECK 117446 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .1620.4.400.700 25082 050113 BAR/~ RENTAL-5/13 500.00 TOTAL 500.00 Town of Southold, New York - Payment VOucher Vendor 'Fax ID Number or Social Securily Number Vendor Name I_oander GIover, Jr Vendor Telephone Number 631-734-6366 Vendor Contact Vendor Address 815 Cox Lane Cutchogue, NY 11935 ,Vendor No. Invoice Number hwoice Date Invoice '[otal Net Amount Claimed Purchase Order Number 7310 ] Check No: 5/7/2013 ~5~/~ 5/1/2013 $500.00 $500.00 25082 A.1620.4.400.700 $500.00 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certd} that the tbregoing claim is true and correct, that no part has been paid, except as thereto stated, that the balance therein stated is aclually due and owing, and that taxcs l¥om which the Town is exempl are excluded Signature litle Compan5 Name [)ate Department Certification I hcrcb5 certil}' ha he n a er a s above specified have been received by me in good conditio tion. the services properb pertbrmed and that t ' 'ed with the exceptions or red. TOWN OF soUTHoL~ ~Po~iJ~Iib Purchase Order # . 2 5 0 8 2 o., )/ ~/1~ D~= and send billing to: rtment Address ~ I Tax Exempt # A163554 Account # A~ I iVend°r I I VENDOR ITEM ** Return this copy and Town of Southold voucher itemized and signed for payment** QUANTITY DESCRIPTION UNIT COST ~c. g013 TOTAL THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATU~ SUPERVISOR I CERTIFY THIS TO BE A JUST AND TRU_~RCHA~ORDER_ TOWN OF SOUTHOLD VENDOR 009682 GOOSE ISLAND CORP 05/07/2013 CHECK 117447 FUND & ACCOUNT P.O. ~ INVOICE DESCRIPTION AMOUNT DB .5110.4,100.200 DB .5110.4.100.200 231991 11.907 GAL REG-4/5 56.55 232835 12.561 GAL REG-3/18 59.65 TOTAL 116.20 I n'~ o'ice Invoice Nef- Purchase Orde~ Numbe~ Dale ?Otal Discounl Number ICheck No. Entered by Audff Da~ Town Clerk Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) docs hereby ce~lil~ that the }bregoing claim is frae and con'ect, that no par~ has been paid, except as tllerein stated, that the b~lance therein sta~ed is actually due and owing, and that taxes fi'om whicb the Town ts exempt are excluded Department Certifibation I hereby ce~lify that tbe materials above specified have been received by me m good condition without substitution, the services properly pe~ tbnned and that the quantities thereof have been verified with the exceptions Ol disc · ncles iloted, and payment is approved Goose Island Corporation ;1633 Central Ave #49 Fishers Island, NY 06390-0049 Invoice Date Invoice # 3/18/2013 232835 Bill To Highway Dept/Town of Southold 275 Peconie Lane P.O. Box178 Peconic, NY 11958 Description Qty Rate Amount 87 Octane Gasohol 12.561 4.749 59.65 Sales Tax (8.625%) $o.oo Total $59.65 Balance Due $59.65 (631) 785-7311 Invoice Date Invoice # 4/5/2013 231991 RECEIVED BY TAX ~oto~Y TOTAL : /, ; Qty Rate Amount RECEIVED BY -- TAX i 11.907 4.749 56.55 TOTAL :' /, DUCT 609T · All claims and returned goods MUST be accompanied by this :3 2 8 3 5 THANK YOU Sales Tax (8.625%) $o.oo Total $56.55 Balance Due $56.55 CUSTOMER'SORDERNO NAME ADDRESS GOOSE ISLAND CORP. P,O, BOX 49 FISHERS'ISLAND, NEW YORK 06390 (631) 788-7311 i~o~ I~.~rr_/~ PRODUCT 609T · All claims and returned goods MUST be a~ompanied by this bill. 2 3 ~. 9 9 ~. THANK YOU TOWN OF SOUTHOLD VENDOR 007638 GRAINGER 05/07/2013 CHECK 117448 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .1620.2.500.250 25542 9123016785 DRILL HAMMER 100.69 TOTAL 100.69 Town of Southold, New York - Pa' Veudor 'lax ID Ntnnhcr or Social Securit3 Numbcr Vendor Name Grainger Vendor Telephone Number Vendor Contact ye,dOt No. ,men/Voucher Vendor Address Division of W.W. Grainger 199 Orville Drive Bohemia, NY 11716-2507 7638 Check Enlered by ~ Audit Date 5/7/2 013 Town Clerk Nunlber 9123016785 [)ate 412212013 Invoice Net Total Discount Amount Claimed $100.69 $100.69 $100.69 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 exentpt are excluded Purchase Order drill hammer Number Description ot Goods or Set,rices 25542 General Ledger Fund and Account Number A.1620.2.500.250 Department Certification I hereby certify that the materials above specified have been received by me in good condition ~ithout substitution, the services properb pertbrmed and tohrat the u ' ye been ,{erified with the exceptk>ns rERNIS AND CONDITIONS % The TOWN OF SOUTHOLD is ,not responsible for materials, supplies or equipment delivered ~r serwces perfo~ed witho~t duth :)rh~' of written order. Quantities specified are not to be exceeded. ? No char,',d, es ne, b,, m;,:de in Ibis )rd~;~ without written authority of the supervisor. 3 l~spe::tior~ of delive~., wi;I b~ made at delivery point unless off, er'wise specified. Materials must ~.~e p-ope;'ly ~ac',.ag :,d. ~.)amaged r'~aterial will not be accepted. !nch~de itemized packing lists with ¢i! sh pr~-ent:,, Delix. ery ;ndoor~ is required unles:; otherwise specified. All prices quoted must in- ;-!,jd~, s;' ~p;:tg har~ Jlir :.~,; act< ng ~nd crF, fincj charges and be F.O.B delivered, unless other terms a~e agreed !o. ,' [~ b::m:io~;.;of sp, eif;~d te,t ~v'ill;~ot beacceptab[e Th~,Tt,wn of Southold reserves the ;jht o , ,~j,~. :t a~id :3tu ~ 6t si' 'pp ;~s ~xp,¢nse, materials deliwred which do not conform to de~ scriFmon of item ordered. ': tf~:rEerc,n;r',ttef'ied z;~vhcle:', ir: part in timeslecified, nctify the town immediately, ln ::,,se of dela~ in deliver;, o~ in cas~ of any default of the vendor, the town may procure the goods ~,;' s.-,:vic~*.s rror~ othe source s r;'~d hold the w-tudor responsible for any EXCESS COST, EX- ¢'ENSE OR DAMAGES occasi~med th ~reby. I!por~ acceptance o' thi~; o"de? th(, v£r~dor agrees to comp',y with all Federal, State or local ;aws ~elative thereto: a. 'rhn ve~,dor s!'ali defend ac!ior soi claims brought and hold the Town of Southold, its agents arid its employees hermless from loss, suits, costs, rights, patent or patent fights of any invention or any other cause. b The vendor represents and warrants that the unit prices charged herein are not higher than any epplicable legal maximum prices permitted, and are not in excess of those currently cha~ged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c Insofar as applic'~ble, the V,,n6or shali comply with Sections 220. 220-a, 220-b, 220-c, 220-d, 220-e and 222 of !he Labor Law of the State of New York relating to maximum work- ir, g h,~urs and mi~dm~m wa{jes cf employees and prohibiting discrimination on account of race, sex, ~.o!o~, c~eed ~r oationa! ori~¢in n hiring employees within the State of New York involved h' t!~ manufacture of m ~te~ia!s equipment, or supplies specified in this order. d. Tfe v: ~dor sbail comp y with Sections 103a and t03b of the General Municipal Law p~:;'t~:,:il:,S t,- disqualific;-tir'ns of contractor for failure to waive ;mmunity before Grand Jury, INVOICES REN..)ERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. :',aims "ct pr. fl ;'-.I d,.:liweries ar, n~)~ allowed unless indicated Claims in question will constitute a :',onditirm p~'ecede~t to the right o,¢ the vendor or receive any payment and matters of dispute nust be adjusted before final acceptance by the Town of Southold. S Billing shall allow for exempticn flora taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. ~0. 'The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. : ~. A',! PO./Claims must be audited and approved by the Town Board prior to actual payment. 25542 TOWN OF $OUTHOLD Tax Exempt # A1~1.~4 IDeliver and send billing to: Department I · ~'r ITEM VENDOR **Return this copy and Town of Southold voucher itemized and signed for payment** QUANTITY DESCRIPTION UNIT COST TOTAL THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERT~ SU F/~CIENT FU ND~WAILABL_E~ __ AND TRUE PURCHASE ORDER ., . , / / ..../ S~ewi~r DEPARTMENT BILL_lNG COPY GRAINGER IIIIl 18 APPLEG TE DRIVE NORTH ROBBINSUJ~LLE, NI 08691-2342 www.grainger.com Ship to information is listed below in the description section BILL TO MDG2013 00025759 I MB 0405 TOWN OF SOUTHOLD DPW PO BOX :[78 PECON]C, NY 11958-0178 The following items were shipped to: TOWN OF SOUTHOLD DPW 53095 ROUTE 25 MAIN RD SOUTHOLD NY 11971-0000 5VC48 DRILL, HAMMER, I/2 IN,2700 RPM,7.8 A MANUFACTURER # DW511 GRAINGER ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE DUE DATE AMOUNT DUE 856468335 9123016785 04/22/2013 05/22/2013 100.69 PO NUMBER: 25542 CALLER: NANCY FOOTE CUSTOMER PHONE: (631)765-1283 ORDE~/DEUVERY#:6226171190 INCO TERMS: FOB DESTINATION Interested in receiving invoices via email? Sign up for paperless invoicing at: www.graing er.cum/pa perlessinvoicin g THANK YOU ! FEi HUMBER 36-11502~0 FOR ANY QUESTIONS ABOUT THIS INVOICE OR ACCOUNT CALL 1-877-202-2594 I 100.69 100.69 NUMBER OF PKGS: 0 WEIGHT 5 50 DATE SHIPPED: 04/'22/2013 CARRIER UPS GROUND TRACKING NO: 1Z20251W0378384489 These items are sold for domestic consumption in Ihe United Stales If expoded, purchaser assumes M~ responsibilify for compliance with IlS expod controls [ PAYMENT TERMS NET 30 DAYS PAY THIS INVOICE NO STATEMENT SENT PAYADI~E ~N U S DOLLARS i INVOICE SUB TOTAL 100 69 AMOUNT DUE f00.69 TOWN OF SOUTHOLD VENDOR 009531 STEPHEN GRZESIK 05/07/2013 CHECK 117449 FI/ND & ACCOUNT P.O.~ INVOICE DESCRIPTION AMOUNT A .1310.4.100.100 25551 0767 (1500)FRANKED WIND.ENVS. 130.00 TOTAL 130.00 Town of Southold, New York - Payment Voucher Vendor Tele~one Numar N~r Discount ~mounl Claimec Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certify that the foregoing claim is true and correct, ~hat no part has been paid, except a~ therein stated, that the balance therein stated is actually duc and owing, ami that taxes from which the Town is exempt are e×cluded X Signature Title The Ink Spot Printing 175 Boisseau Ave. PO Box 665 C...,iLc, ld, I';~! 119."I Purchase Order Number Description of Goods or Services Entered by &udit Date 5-? Department Certification I hereby certify that thc nmterials 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 yment is approved. qty. 1500 item #lOW p.o. number 25551 terms Upon Receipt date 4/15/13 job 0767 description Window Envelopes total price 130.00 the ink spot printing & copy center · p.o. box 665 · southold, ny 11971 · (631) 765-3625 · fax (631) 765-1769 $130.00 Purchase Order # IDeliver and send billing to: Department / ~ ~ C,' [ Address TOWN OF SOUTHOLD 25551 /f, 2¢./~ Tax Exempt # A163554 ,4 SiC' cf ICO Account # ti k I I I VENDOR **Return this copy and Town of Southold voucher itemized and signed for payment** ITEM QUANTITY DESCRIPTION / UNIT COST TOTAL THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFY THAT THERE ARE SUFFICIENT FUNDS AVAILABLE IN ~P.~N CHARGED · D. epf. Head I CERTIFY THIS TO BE A JUST AND TRUE PURCHASE ORDER Supervisor DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES I certify that the goods or services were received by this ~ and all ~$ duly noted. _ ._ _D E PAR'~M ENT B_ILLIN G C Q _P_¥ .... TERMS AND CONDITIONS 1. The TOWN OF SOUTHOLD is not responsible for materials, supplies or equipment delivered or services performed without authority of written order. Quantities specified are not to be exceeded. 2. No changes may be made in this order without written authority of the supervisor. 3. Inspection of delivery will be made at delivery point unless otherwise specified: Materials must be properly packaged. Damaged material willl not be accepted. Include itemized packing lists with a shipments. De wery mc oors ~s required unless otherwise specd~ed. All pr c ,s quoted must n- elude shipping, handling, packing and crating charges and be F:.O.B, delivered, unless other terms are agreed to. 4. Substitutions of sl:>ecified ;terns will not be acceptable. The Town of Southold reserves the right to rej~,ct and return at shippers expense, materials delivered which do not conform to de- scription of item ordered. 5, If order csnr:ot be filled in vvho!e or in part in tirre specified, notify the town immediately. In case of delay in deliver,,', o~ in case of any default of the vendor, the town may procure the goods ~,r services from other sources and hold the vendor responsible for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby. 6, Upon acceptance of this order the vendor agrees to comply witl~ all Federal, State or local laws relative thereto: a. The vender shall defend actions or claims brought and hold the Town of Southold, its agents and its employees harmless from loss, suits, costs, rights, patent or patent rights of any invention or a~ny other ,cause. b The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c. Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- ing hours and minimum wages of employees and prohibiting discrimination on account of race, sex, color, creed or natiional origin in hiring employees within the State of New York involved in the manufacture of materials, equipment, or supplies specified in this order. d. The vendor shall comply with Sections 103a and 103b of the General Municipal Law pertaining to disqualifications of contractor for failure to waive immunity before Grand Jury. 7. INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. Claims for partia! deliveries are not allowed unless indicated. Claims in question will constitute a condition preceden, t lo the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8, Billing shall allow for exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. 1!. All I~O./Claims must be audited and approved by the Town Board prior to actual payment. TOWN OF SOUTHOLD VENDOR 007313 HARRY GOLDMAN WATER TESTING 05/07/2013 CHECK 117450 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .1620.4.400.100 25494 86893 WATER TEST-TASKER 55.00 TOTAL 55.00 Town of Southoid, New York - Payment Voucher Vendor Name Vendor Address Vendor Teleph6ne Number Invoice knvoice Invoice i Vendor No. ' 7313 Net i Purchase Order Check No Date Total Discount Description of Goods or Services Amount Claime( Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certif~ that the foregoing claim is true and correct, that no part has been paid, except ~s therein stated, that the balance therein stated is actually due and owing, and that taxes from which the Town ~s exempl are excluded Number General Ledger Fund and Account Numoer Department :ertJfication I hereby certify that the materials above s ec~fied have been received by me m good condfllon without substltutloI1, the services properly TERMS AND CONDITIONS · The TOWN OF SOUTHOLD is not responsible fo~ materials, supplies or equipment delivered ~r services performed without authority of written order. Quantities specified are not to be (',xceeded. : No changes ma~, b~, m~de in tbs )rd,,,,~ without written authority of the supervisor· 3, Inspection of de!i,very will be made at delivery point urdess otherwise specified. Materials must ~e properly package, d. ,r},amaged material wil! not be accepted. !nclude itemized packing lists with ~!l shipments· Delivery indoors is reqkdred unless otherwise specified. All prices quoted must in- ~!ude shippir~g, hanJlir~9, ~, r~ck n9 a,qd crcdn9 charges a~d be EO.B delivered, unless other terms are agreed to. '~ Sub;dt~t on:; oi sp(_~cif[,,d .te~'~ will not be 8cceptable. Th,:~ Town of Southold reserves the ;ght ~.o reject ~,~-;d ;'e[ur~ ~,t shpp? s ,~xp~ns~, materials delivered which do not conform to de- scription of item ordered. ': Ir order c:~nrtot be filed i~} ~vho!e c ~' ir pad in time specified, notify the town immediately. In rase ¢4 delay ir, delivery, o~ in case of any detault of the vendor, the town may procure the goods ,r s*:rvices fro;';~ ethel sourc¢!s ~;~d hold the vendor responsible for any EXCESS COST, EX- I'ENSE OR DAMAGES occasioned thereby. ¢ t,~pon acceptance of this o,der the vendor agrees to comply with all Federal, State or local laws relative thereto; a The w. r, dor shali de~end actions o~ claims brought and hold the Town of Southold, its agents arid its employees hsrmless from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c. Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- ing hours and minimum ,~ages of employees and prohibiting discrimination on account of race, sex, color, creed or ~ationa! origin in hiring employees within the State of New York involved in the manufacture of mate.dal:¥ equipment, or supplies specified in this order. d. The vendor shaii comp!y with Sections 103a and 103b of the General Municipal Law perta nir~: t~ disqualific,-~tio~m ~)f o~ntractor for failure to wave immunity before Grand Jury. ;~ INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. Claims for partial deliw;ries ar~; not allowed unless indicated. Claims in question will constitute a ~.ondition precedent to the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold. 9, Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of de;ivery or receipt of a correct claim voucher, whichever is later. 'i0. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. ~, !. AIl P.O./Claims must be audited and approved by the Town Board prior to actual payment. Purchase Order # Dete TOWN OF SOUTHOLD ~ 25494 AccountTax Exempt # ~1635~ IDeliver and send billing to: Department ~ .Address / I I I I VENDOR "R turn this ~ ~'5~1~ e ' copy and Town of Southold voucher itemized and signed for payment** ITEM QUANTITY DESCRIPTION UNIT COST TOTAL THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. I CERTIFY THAT THERE ARE SU FF~;~=~'P~'~BLE~. I CERTIFY THIS TO BE A JUST AND TRUE PUBCHASE OBDER Supervisor DEPARTMENTS SERVICES Iced~tl S~n~ DEPARTMENT BILLING COPY Title Date thi~ ACCOUNT SALES PURCHASE ORDER NUMBER SHIPVIA tERMS NET DUE UPON RECEIPT NUMBER iD ORDER NUMBER INVOICE INVOICE ) A LATE PAYMENT FINANCE CHARGE OF ~ ~ER MONTH TOTAL ~. MAY BE APPLIED ON BALANCES AFTER ~ DAYS. SALES TAX HRRRY GDLDHRN NRTER TEST~[NG FRBGHT/DELIVERYCHARGES PO BOX 859 MATTITUCK NY 1~9oc (631) 298-4640 $55. ORIGINAL INVOICE RETAIN BOTTOM PORTION FOR YOUR RECORDS TOWN OF SOUTHOLD VENDOR 008100 HAWKINS, DELAFIELD & WOOD 05/07/2013 CHECK 117451 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .1310.4.500.100 041813 $1058K BA~-4/ll/13 195.78 TOTAL 195.78 Town of Southold, New York - Payment Voucher Vendor Name Hawkins Delafield & Wood LLP Vendor Telephone Number (212) 820-9416 Vendor Contact Gerard Fernandez, Jr., Of Counsel Number Date Total 4/18/13 Vendor Address [Vendor No. One Chase Manhattan Plaza 4?nd Floor, NY, NY 10005 D*scoant Net Purchase Order Number Description of Goods or Services See Attached Check No. ivIqSI General Ledger Fund and Account l%mbot Payee Certification The undersigned {Claimant) {Acting on behalf of the above named clniman[) does hereby certify that the foregoing claim is true and correct, thai no pa~t has been pald, except as ther stated, that thc balance therein stated Is ac ually due and o o hich the Tom is exempt are excluded 9'J~ret'~'t'grt~'"--'"~'~n'' Ti Of Counsel Hae ; ; Oem e,d &'Wood co~.p~.y Name Date 4/18/13 Department Certification I hereby certify that the material, 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 discrepanmes noted, and payment is approved. ONE CHASE MANHATTAN PLAZA NEW YORK, NY 10005 WWW HAWKINS COM April 18, 2013 TOWN OF SOUTHOLD, NEW YORK (Our File Designation:: 2615/19513 and 34513) Hawkins Delafidd & Wood LLP TO professional services rendered the Town of Southold (the "Town"), in the County of Suffolk, New York, in the matter of the authorization, sale, preparation and issuance of the $1,058,000 Various Purposes Bond Anticipation Note-2013 (the "Note"), dated April I 1,2013 maturing April I 0, 20I 4, including preparation of drafts of the requisite authorizing, sale and closing documents, the Bordered Note in readiness for execution and delivery; telephone conversations and correspondence with the Town Comptroller as to the details of the Note and its sale and issuance and the rendering of the final written approving opinion of Hawkins Delafield & Wood LLP at the time of delivery. FEE: Disbursements: (including attention to the proceedings pursuant to the Town Law, §202-b and the adoption of the bond resolution by the Town Board on December 4, 2012, authorizing the issuance of $500,000 serial bonds, to provide for and finance the increase and improvement of facilities of the Fishers Island Ferry District pursuant to Town Law, Section 202-b) Duplication of Documents, Postage, Federal Express Delivery, Telephone Toils, Word Processing and Computer Financial Analysis (re: IRS Form 8038-G) $2,655.00 218.15 TOTAL $2.873.1~55 1254008.1 034513 CLD Cushman, John From: Sent: To: Cc: Subject: Attachments: Cushman, John Monday, April 22, 2013 9:56 AM Don Lamb (dlamb@fiferry.com); GSMurphy (gmurphy@fiferry.com) J Miller {jmiller@fiferry.com); Whitecavage, Diana Invoice for Bond Counsel HDW.pdf Dear Don and Gordon, The attached invoice from Hawkins, Delafield & Wood for bond counsel fees relatin§ to the April 11, 2013 BAN arrived this morning. Note that $2,677.37 related to the Ferry District, which is bein§ charged as follows: SM.1420.4.000.000 H7.5720.4.400.:100 $391.65 For renewal of the New London Terminal BAN $2285,72 For issuance of the North Ramp project BAN I will be putting this on for payment on the May 7 audit. Please process accordingly. John John Cushman Town Comptroller Town of Southold 631-765-4333 http://www.sout holdtownny.gov THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHOM IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED AND CONFIDENTIAL, OR THAT CONSTITUTES WORK PRODUCT AND IS EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF YOU ARE NOT THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY USE, DISSEMINATION, DISTRIBUTION, OR COPYING OF THE COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US BY TELEPHONE 631-765-4333 AND DESTROY THE DOCUMENT. THANK YOU. DELAFIELD &WOOD LLP PHONE: 212-820-9300 FAX 212-514-8425 (212) 820-9416 ONE CHASE MANHATTAN PLAZA NEW YORK, NY 10005 VV~NW HAWKINS COM April 18, 2013 NEW YORK . WASHINGTON NEWARK HARTFORD LOS ANGELES SACRAMENTO SAN FRANCISCO PORTLAND TOWN OF SOUTHOLD, NEW YORK (Our File Designations: 2615/19513 and 34513) Mr. John Cushman Town Comptroller Town of Southold P.O. Box 1179 Southold, New York 11971 Dear John: We have prepared and enclose herewith our statement for professional services rendered in connection with the authorization, sale and issuance of the $1,058,000 Various Purposes Bond Anticipation Note-2013 which was delivered on April 11, 2013. If you find our statement to be in order, may I ask that you submit it to the attention of the proper officials for payment. As always, it has been our privilege and pleasure to serve as Bond Counsel to the Town and to work with you; we look forward to the continuance of our most cordial relationship. Thanking you and with kind regards, I remain Si~l~rs, Gerard Fernandez, Jr. GFjr/cfc Enclosure 12540081 034513 CLD Matter Number Principal Amount Purpose Fee Disbursement Total 19513 19513 34513 Totals $ 450,000.00 Fisher Island Ferry Dock Fisher Island Ferry District 500,000.00 Increase & Improvement 108,000.00 Fuel Management System $1.058.000~)(! $ 342.13 2,230.76 82.11 $2.6~555.00 $ 49.52 54.96 113.67 $218.15 $ 391.65 2,285.72 195.78 $~873A5 1256567.1 034513 FiLE TOWN OF SOUTHOLD VENDOR 007717 HOME DEPOT CREDIT SERVICES 05/07/2013 CHECK 117452 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .1620.4.100.100 25543 6112-0413 (2)DEHUNIDIFIERS 396.00 TOTAL 396.00 °To&n of Southold, New York - Payment Voucher Vendor'fax ID Number or Social Sccuri~, Number Vendor Address Home Depot Credit Services Yendor [elephone Number Dept 32-2540606112 PO Box 9055 Des Moines, IA 50368-9055 Vendor No. 7717 Check No. Entered by ~,~ Audit Date 5/7/2 013 Number Date 412412013 ;396.00 L)iscount $396.00 $396.00 Payee Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) does hereby certi~ that thc foregoing claim is true and correct, that no part has been paid, except as therein state& that the balance therein staled is aclualb due and owing~ and that taxes from which the Town is exempt are excluded Signature Title Purchase Order 25543 Description of Goods or Serx ices dehumidifiers General Ledger [und and Account Number A.1620.4.100.100 Department Certification I hereby certify that the materials above specified have been received by me in good condition without substitution the services properl ' pertbrmed and that the n ities t ' i e exccpl~ons proved. Signature~ RETURN MAIL AODRESS PO BOX 790420 Sr LOUIS, MO 63179 TOWN OF SOUTHOLD PO BOX 11 79 ATTN: CHRISTINE FOSTER SOUTHOLD, NY 11971-0959 ACCOUNT ACTIVITY STATEMENT Commercial Account: Statement Date Credit Line Credit Available IAccount Balance Account Information xxxx xxxx xxxx 6112 04/28/13 $5,500 $5,104 $396.001 Please see Payment Page(s) for Amount Due and Payment Due Date(s) Current Payments and Unapplied Payments -$530.96 Current Purchases and Debits $396.00 Current Returns, Exchanges and Adjustments $0.00 Previously Billed Invoices $0.00 INSTANT SAVINGS ON THE PRODUC'rS YOU USE MOST The Home Depot® is here to help you leverage your buying power with bulk pricing on over hundreds of items. Plus, items that qualify are clearly marked in stores and online for easy shopping. Stop by the Pro Desk and save right away! PRO iCURRENT AND UNAPPLIED PAYMENTS PAYM , ..~= co,tact~ us with your instructiOns on how to apply to sPecific invoices. Payments recelved since t he last staioment period, Date Amount 04/04/13 $530.96- Total $530.96- CURRENT PURCHASES AND DEBITS Customer Date Purchase Location/Description Invoice # Purchase Order/Job Name Agreement # Amount Due Date 04/24/13 THE HOME DEPOT RIVERHEAD, NY 282330 25543 $396.00 05/18/!3 TOTAL $396.00 Questions ACCT MCR HOME DEPOT CREDIT SERVICES Send Billin9 Inquiries to: PHONE 1-800-395 7363 HOME DEPOT CREDIT S[RVICES About Your FAX 1-877-969 6751 PO Box 790340 Account GO TO MYHOMEDEPOTACCOUN~ COM St Louis, MO 63179 0340 NCTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION Page 1 of 4 8 HP 28 This Account is Issued by Citibank. N A Commercial Account I RETURN MAIL ADDRESS PO BOX 79O420 ST LOUIS, MO 63179 TOWN OF SOUTHOLD PO BOX 1179 ATTN: CHRISTINE FOSTER SOUTHOLD, NY 11971-0959 ACCOUNT ACTIVITY STATEMENT Commercial Account: xxxx xxxx xxxx 6112 Statement Date 04/28/13 Credit Line $5,500 Credit Available $5,104 Account Balance $396.00 Account Information Please see Payment Page(s) for Amount Due and PaFment Due Date(s) Current Payments and Unapplied Payments -$530.96 Current Purchases and Debits $396.00 Current Returns, Exchanges and Adjustments $0.00 Previously Billed invoices $0.00 INSTANT SAVINGS ON THE PRODUCTS YOU USE MOST The Home Depot® is here to help you leverage your buying power with bulk pricing on over hundreds of items. Plus, items that qualify are clearly marked in stores and online for easy shopping. Stop by the Pro Desk and save right away! PRO Date Amount 04/04/13 $530.96- Total $530.96- Customer :~te Purchase Order/Job Name # Amount Due Date Purchase Location/Description Invoice # Agreement b4i24/13 THE HOME DEPOT RIVERHEAD, NY 282330 25543 $39600 05/18/!3 TOTAL $396.00 More saving. More doing: 1550 OLD COUNTRY RD RIVERHEAD NV 11901 STORE MANAGER PAT IAQUINTA 631-284-2530 1222 00028 23862 04/24/13 11:23 AM CASHIER ROBERT - RBKSVS 048231364577 30PINT DEHUM LG 30PT ENERGY STAR DEHUMIDIFIER 396.00N 2B198.00 SUBTOTAL 396.00 SALES TAX 0.00 TAX EXEMPT TOTAL $396.00 XXXXXXXXXXXX~112 HOME DEPOT 396.00 AUTH CODE 024243/0282330 TA p.O.#/DOB NAME: 25543 TOWN OF SOUTHOLD STANDISH JEFF 1222 28 23862 04/24/2013 9795 RETURN POLICY DEFINITIONS POLICY ID DAYS POLICY EXPIRES ON A 1 go 07/23/2013 THE HOME DEPOT RESERVES lHE RIGHT TO LIMIT / DENY RETURNS. PLEASE SEE THE RETURN POLICY SIGN IN STORES FOR DETAILS. BUY ONLINE PICK-UP IN STORE AVAILABLE NOW ON HONEDEPOT.COM. CONVENIENT, EASY AND MOST ORDERS READY IN LESS THAN 2 HOURS~ ENTER FOR A CHANCE TO W~N A $5.000 ii¢')MF r~FPOT GTFT TOWN OF SOUTHOLD P~r~ 0~ ,~ 2 5 5 4 3 ~.~. Tax Exempt # A163554 ~t~ O~aver and send billing to: rtment Addre~ ~ I Vendor I I ~f/ 771 ? ITEM VENDOR **Return this copy and Town of Southold voucher itemized and signed.for payment** QUANTITY DESCRIPTION UNIT COST TOTAL THIS PURCHASE ORDER IS NOel' VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERT~E ARE SU F.F'fCIENT FL/RD~BLE I CERTIFY THIS TO BE A JUST AND TRUE PURCHASE ORD,ER Supervisor ~ DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES DEPARTMENT BILLING COPY TERMS AND CONDITIONS 1. The TOWN OF SOUTHOLD is not responsible for materials, supplies or equipment delivered or services performed without authority of written order. Quantities specified are not to be exceeded. ;?. No changes may be made in this orde~r without written authority of the supervisor. 3. Inspection of delivery will be made at delivery point unless otherwise specified. Materials must be properly packaged. Damaged material will not be accepted. Include itemized packing lists with all shipments. Delivery indoors is required unless otherwise specified. All prices quoted must in- clude shipping, handling,, packing and crating charges an.d be F.O.B. delivered, unless other terms are agreed to. 4. Sub,~titutions of specified items will not be acceptable. The Town of Southold reserves the right to ;'eject and return at shippers expens¢~, materials delivered which do not conform to de- scription of item ordered. 5 If order cannot be filled in whole or in part in time specified, notify the town immediately. In case of delay in delivery, or in case of any default of the vendor, the town may procure the goods or services fro.~ other sources and hold the vendor responsible for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby. 6. Upon acceptance of this order the vendor agrees to comply with all Federal, State or local laws relative thereto: a. The vendor shall defend actions or claims brought and hold the Town of Southold, its agents and its employees harmless from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c. Insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- lng hours and minimum wages of employees and prohibiting discrimination on account of race, sex, color, creed or national origin in hiring employees within the State of New York involved in the manufacture of materials, equipment, or supplies specified in this order. d. The vendor shall comply with Sections 103a and 103b of the General Municipal Law perta!ning to disqualifications of contractor for failure to waive immunity before Grand Jury. 7. INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. CIaims for partial deliveries are not allowed unless indicated. Claims in question will constitute a condition precedent to the right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for ,exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held by the Town of Southold, 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld~Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do not apply to purchases made by the Town of Southold. 11. All RO./Claims must be audited and approved by the Town Board prior to actual payment. TOWN OF SOUTHOLD VENDOR 008656 RONDA OF RIVERHEAD 05/07/2013 CHECK 117453 FI/ND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT A .1620.4.100.550 25544 189116 DRIVE SHAFT 359.99 TOTAL 359.99 Town of Southold, New York - PaymentVoucher Vendor 'lax ID Number or Social Security Number Vendor Address Vendor Name Honda of Riverhead Vendor Telephone Number 631-727-5510 Vendor Contact 1407 Pulaski Street Riverhead, NY 11901 Vendor No. 8656 ~Check No. Entered by Audit Date 5/7/2013 Invoice Number 189116 Date 4~24~2013 Invoice Net Tolal Discount Amount Claimed $359.99 $359.99 Payee Certification '1 he undersigned IClaimant) (Acting on behalf of the above named claimant) does hereby certil}, that the ~(~regoing claim is true and correct, that no paCt has been paid, except as therein stated, that thc balance therein stated is actually due and owing, and that taxes from which the Town is exempt are excluded $359.99 Signature Title Company Name Date Purchase Order Number 25544 Description of Goods or Services driveshafl General Ledger Fund and Account Number A.1620.4.100.550 Department Certification l hereby certif)that the materials above specified have b~ by me n good condition without substitution, the set,rices ,erlbrmcd and that the quantities there ave I~een ions ,r discrepancies noted, and paymen s approved Signature ' ~ Honda of Riverhead 1407 PulaskiStreet River~ead, NY 11901 631-727-5510 Phone: 631-765-1283 i TOWN OF SOUTHOLD, SCO]-[ 53095 NAIN ROAD SOUTHOLD NY 11971 516-359-9098C Status: Parts Sale Make Type Invoice Number 189116 Date 04/24/2013 P.O. # 25544 Ref. Number Item Number Description PO1332285 DRIVESHAFIASM,REAR,RH Qty Unit Price Ext. Price WSO x 1 $359.99 $359.99 ALL RETURNS SUBJECT TO A15% RESTOCK FEE ELECTRICAL PARTS ARE NOT RETURNABLE THANK YOU FOR ALLOWING US TO SERVICE ALL YOUR PARTS NEEDS. ALL SPECIAL ORDER DEPOSITS WILL BE FORFETED IF PARTS NOT PICKED UP WITH 45 DAYS Shipping Charges Ship Via Labor Pickup & Detivery Shop Materials EPA Charge Restocking Fee $o.oo $o.oo $359.9~ S/O Items $359.99 S/O Shipping S/O Tax $0.00 S/O Total $359.99 S/O Deposit Amt $0.OO Taxable Items $0.OO Non Taxable Items $0.00 Tax $0.00 Total $0.00 S/O Balance Due: 359.99 Printed: 04/30/2013 12:06:19 PMSales Rep VICTOR SofiFek Sof~ware Int'l [nc Transaction Total Payment Method Balance Due $0.00 Signature 1 of 1 TOWN OF $OUTHOLD P..:h.. Ordor # 2 5 5 4 4 o,,o q/~z///~ Tax Exempt # A163554 Account # JDeliver and ~ billing to: Department ., ~ I I I VENDOR **Return this copy and Town of Southold voucher itemized and signed for payment** ITEM QUANTITY DESCRIPTION UNIT COST TOTAL THIS PURCHASE ORDER IS NOT VALID WITHOUT THE SIGNATURES OF THE DEPT. HEAD AND THE SUPERVISOR I CERTIFY THAT THER~r.~ SUFFIC.~-~NT FUNDS~V~AILABI--~ / IN THI~ APPROPRIA~I~ ~ Dept Head - ~ ~ J. / I CERTIFY THI,~O BE A JUST AND TRUE PI~CHASE ORDER Supervisor DEPARTMENT'S CERTIFICATION OF GOODS OR SERVICES I cert'.~{"~e ~~.~.~ved by this DEPARTMENT BILLING COPY TERMS AND CONDITIONS 1. The TOWN OF SOUTHOLD is not responsible for materials, supplies or equipment delivered or services performed without authority cf written order. Quantities specified are not to be exceeded. 2. No changes may be made in this order without written authority of the supervisor. 3. inspection of delivery will be made at delivery point unless otherwise specified. Materials must be properly packaged. Damaged material will not be accepted. Include itemized packing lists with all shipments. Delivery indoors is required unless otherwise specified. All prices quoted must in- clude sl~ipping, handling, packing and crating charges and be F.Q.B. delivered, unless other terms are agreed to. 4. Sl~bstitutions of specified items will not be acceptable. The Town of Southold reserves the right *~o reject and return at shippers expens¢~', materials delivered which do not conform to de- scription of item ordered. 5 If order canr:ot be fi!led in whole cr in part in time specified, notify the town immediately. In case of de ay in delivery )' n case of any default of the vendor, the town may procure the goods or services fron~ other sources and ho d the vendor respons ble for any EXCESS COST, EX- PENSE OR DAMAGES occasioned thereby. 6. Upon acceptance of this order the vendor agrees to comply with all Federal, State, or local laws relative thereto: a. The vendor shall defend actions or claims brought and hold the Town of Southold, its agents and its employees harm!ess from loss, suits, costs, rights, patent or patent rights of any invention or any other cause. b. The vendor represents and warrants that the unit prices charged herein are not higher than any applicable legal maximum prices permitted, and are not in excess of those currently charged to other governmental, institutional or commercial users for similar items, quantities and deliveries. c. insofar as applicable, the Vendor shall comply with Sections 220, 220-a, 220-b, 220-c, 220-d, 220-e and 222 of the Labor Law of the State of New York relating to maximum work- ng ho ~rs and minimu ~ wages of employees and prohi'.~iting discrimination on account of r. ace,. sex, color, creed or national or g n n hiring employeesw thin tte State of New Yorkinvo~veo in the manufacture of materials, equipment, or supplies specified in this order. d. The vendor shall comply with Sections 103a and 103b of the General Municipal Law pertaining to disqualifications of contractor for failure to waive immunity before Grand Jury. 7. INVOICES RENDERED ON ENCLOSED CLAIM FORM MUST BE ITEMIZED IN DETAIL. Claims for partial deliveries are not allowed unless indicated. Claims in question will constitute a condition precedent to ~:he right of the vendor or receive any payment and matters of dispute must be adjusted before final acceptance by the Town of Southold. 8. Billing shall allow for' exemption from taxes under Federal Excise Tax Exemption Certificate No. A-163554 held hy the Town of Southold. 9. Cash discount terms must be indicated on claim voucher; discount period will be computed from date of acceptance of delivery or receipt of a correct claim voucher, whichever is later. 10. The provisions of the New York State Fair Trade Law (Feld-Crawford Act) and the Federal Price Discrimination Law (Robinson-Patman Act) do no'[ apply to purchases made by the Town of Southold. 1!. All P.O./Claims must be audited and approved by the Town Board prior to actual payment. TOWN OF SOUTHOLD VENDOR 013556 LORI HULSE 05/07/2013 CHECK 117454 FUND & ACCOUNT P.O. # INVOICE DESCRIPTION AMOUNT A .1420.4.600.300 A .1420.4.600.300 032013 REIM 35.8MI@.565/MI-TRST 20.23 041713 REIM 35.8MI@.565/MI-TRST 20.23 TOTAL 40.46 Town of Southold, New York - Payment Voucher Vendor Name Vendor Address Vendor Telephone Number IVendorNo. Vendor Contact Invoice Invoice Invoice Number Date Total ]5. ~a~,'lcs e~tt~ 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 therem stated, that the balance therein stated is actually due and owing, and that taxc~ from wInch the Town is exempt are excluded. Company Name --~-~ Date Department Certification ! hereby cer~i~ that the~materials above specified have been received by me in good condition without subsfi~tion, the servlacs properly performed and that the quantities thereof have been verified vath the exceptions /- or ~ncies noted, and payment is approved. mapquest Trip to: 54375 Route 25 Southold, NY 11971-4646 17.90 miles / 25 minutes Notes ~ Riverhead, NY 11901-6300 1. Start out going southeast on--toward Sound Ave. 2. Turn left onto Sound Ave. t 3. Staystralllht to go onto CR-48 El Middle Rd. 4. Turn right onto Youngs Ave. ~:~ 5. Turn rlghtontoRT.251MainRd. 6. 54375 ROUTE 25. 0.6 MI 0.6 Mi Total 7.9 MI &5 Mi Tote/ 8.9 Mi ~ 7,3 Mi Total 0.6 MI ~ 7.9 Mi Total 0.02 Mi 17.9 Mi Total 54375 Route 25, Southold, NY 11971-4646 Total Travel Estimate: 17.90 miles - about 25 minutes ~2013 MapQuest, Inc. Um of directions and maps is subject to the MapQuest Tenms of Use. We make no guarantee of the accuracy of their content, road ~ondltions or mute usebllity. You amume all dakof u~e.