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Home My WebLink AboutAU-11/19/2013 Fishers Island FISHERS ISLAND FERRYDISIRICT VENDOR 001327 AIRGAS EAST, INC 11/19/2013 CHECK 1535 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.000 9020636334 TAPE MEASURE 9.79 SM .5710.4.000.000 9020636565 (2)PROPANE-FORKLIFT FUEL 107.50 TOTAL 117.29 ' ar 4,-, a ro s -x _ xr' THE ORIGINAL CHECK HAS A COLORED BACKGROUND. A VOID COPY FEATURE AND WATERMARK PAPER UE, yk 3+ ':a c m m:; Cam- ~ ill " G.v,~~. ~f e~ e k i it, 40 hii, zi~ ~ ,tea o u~ s n R 6 u;. a 2* +cc" iF ui 'i BFI m 3il gi 0^a~^ T ff3i~Y ~3b ,o~H~ '~VA~I yyyt. i,, a a: m'., mi Poo 1535u- im ~ 14054641: 68 00 1 50 '2- Ins Vendor No. Check No. Town of Southold, New York - Payment Voucher 1327 15315 Vendor Tax ID Number or Social Security Number Vendor Address Entered by P.O. Box 827049 Vendor Name Philadelphia, PA 19182-7049 Audit Date Airgas East NOV 19 2013 Vendor Telephone Number 860444-3055 Town Clerk - - --L _ Vendor Contact l Invoice Invoice Invoice Net purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 9020636334 10/1112013 $9.79 $9.79 Tape Measure SM5710.2.000.000 9020636565 10/11/2013 $107.50 $107.50 Forklift Fuel o Y Qflf SM5710.4.000.000 I $117.29 $117.29 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exee/d/m7ptt,meeeexcluded. ~ or discrepancies noted, and payment is approved. Signature ~y Title • " Signature /J t Company Name y 4Y Date_ Title Date ' o {'mow TOE SURE PROPER CREDIT PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE. FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL'. 216.520-6000 IN 1,10101E TO NAME 1019160130 9020636334 10/11/2013 2576547 FISHERS ISLAND L 3F7IP YVi Y TTERMS ER DATE N329 CUPU NET 30 10/11/2013 DEU1+ERY J- CITY` CYUI# R UNIT PRICE DESC.`RF'T Nt 111ATEROL.NUMBER _ ^aMIP'{k ~UpM QTY810 sHpm iU6m AMOUNT 8021115267 S2930-305 1 EA 7.787 EA 9.79 N TAPE MEASURE 25' HI-VIZ Sale subtotal: 9.79 SHIP TO. 2576547 AMOUNT 9.79 A~rgry~~~ FISHERS ISLAND /u www.airgas.com FERRY DISTRICT Airgas USA, LLC Airgas USA, LLC PO BOX H Acct No 8606074318 6055 Rockside Woods Blvd FISHERS ISLAND NY 06390-0607 PNC Bank, ABA No 031000053 Independence, OH 44131 REV 1113 SEi-omoo° Page 1 of 1 FOR LOCATION NEAREST Y VISIT WWW.AIRGAS.COM Alm DELIVERY ORDER OU SHIPPER: SOLD BY: DELIVERY ORDER#8021115267 AIRGAS USA, LLC AIRGAS USA, LLC PAGE 1 OF 1 131 CROSS RD 130 CROSS RD ORDER DATE: 10/11/2013 WATERFORD, CT 06385-1204 WATERFORD, CT 06385-1204 SCH SHIP DATE: 10/11/2013 800-962-0285 PRINTED: 07:33 10/11/2013 SALES ORDER: 1019160130 SHIP TO: 2576547 SOLD TO: 2576547 FISHERS ISLAND COST PO # FERRY DISTRICT FISHERS ISLAND RELEASE # PO BOX H FERRY DISTRICT ORD BY FISHERS ISLAND, NY 06390-0607 US PO BOX H ENT BY DAVIESTEY 631-788-7463 FISHERS ISLAND, NY 06390-0607 US Order Type Payment Terms Incoterm Route Sales Plant Sales Total Containers Office Org Ship Return Acct Front NET 30 Customer Pick Up Customer Pick Up N329 N309 N000 Counter Qty UOM HM Description & Hazard Class Qty Qty Bin WT Shipped Type Order BID Loc 1 EA iri 10 terialit S2930- Stor. Loc. F001 1 0 C6 TAPE MEASURE 25' HI-VIZ 5c K. STANDARD TERMS AND CONDITIONS EMERGENCY CONTACT: 1-866-734-3438 PLACARDS OFFERED SEE THIS REVERSE AGREEMENT SIDE IS FOR SUBJECT TO IMPORTANT AIRGAS' SAFETY INFORMATION . PURCHASER AGREES i POINT OBTAIN MATERIALSAFETYDATA SHEETS IM503)FROMONE OF THE 1 LLE LI AIRGAS WEB SITE AT~ AAIRGASXO PORGY ? n i CALLING ING THE THE ABOVE LISTED EMERGENCY EMERGENCY CONTACT PHONE NUMBER BER AND ANO SELECTING ECTING OPTION tl] ACCEPTED FOR CA ACCEPT REJECT THE ABOVE THIS IS TO CERTIFY THAT THE ABOVE NAMED MATERIALS ARE PROPERLY CLASSIFIED, DESCRIBED. CUSTOMER ' PACKAGED, MARKED AND LABELED AND ARE IN PROPER CONDITION FOR TRANSPORTATION CUSTOMER MUST ! r] - ATL'Cr rvG To THE APPLICABLE REGULATIONS OF THE DEPARTMENT OF TRANSPORTATION INITIAL CHOICE NAME PLEASE PRINT J AIRGAS PERSONNEL DATE T.O.D. INTERNAL USE ONLY Delivery # 8021115267 Fllletl By Staging Area Toter PKGS Tracking / Pro Number - I Freight Charges III IIIIIIIIIIII IIIIIIIIIIIIIIIIIII II III TERMS AND CONDITIONS WARNING: TRANSPORT AND USE DECOMPRESSED GASES MAYBE EXTREMELYDANGEROUS. DO NOTTRANSPORTWITHOUT PROTECTIVE CAPS, IN CONFINED SPACES OR IN ANYOTHER IMPROPER MANNER. ALWAYS TRANSPORTCYLINDERS INA SECURED UPRIGHTPOSITION. BUYER ACKNOWLEDGES THATIT HAS RECEIVED A SAFETY INSTRUCTION SHEET FROM SELLER, SAFE HANDLING OF COMPRESSED GASES. 1. ANY AND ALL PRODUCTS AND SUPPLIES DEI IVERED TO BUYER BY SELLER OR SELLER'S REPRESENTATVE ARE COVERED BY THIS DELIVERY TICKET THE CYLINDERS, FITTINGS AND CAPS COVERED BY THIS DOCUMENT ARE RENTED OR LEASED BY SELLER TO BUYER, NOT SOLD. BUYER SHALL NOT PERMIT CYLINDERS OR OTHER STORAGE CONTAINERS FURNISHED HEREUNDER TO BE FILLED WITH ANY PRODUCT NOT FURNISHED BY SELLER OR SELLERS AUTHORIZED REPRESENTATIVE. ALL CYLINDERS (OTHER THAN THOSE SUBJECT TO AN ANNUAL LEASE) ARE RENTED AT CURRENT DAILY RATES. BEGINNING WITH THE DATE OF DELIVERY. RENTAL CHARGES ARE ASSESSED AS OF THE LAST DAY OF EACH MONTH OR AT THE START OF EACH ANNUAL LEASE PERIOD, AS APPLICABLE. BUYER SHALL RETURN. IN GOOD CONDITION, ALL CYLINDERS, COMPLETE WITH CAPS AND FITTINGS AND SHALL PAY SELLER UPON DEMAND THE REPLACEMENT VALUE OF (1) ANY LOST OR DAMAGED CYLINDERS. CAPS OR FITTINGS OR (IR THOSE CYLINDERS NOT RETURNED TO SELLER WITHIN THREE (3) MONTHS FROM DATE OF SHIPMENT TO THE BUYER (OTHER THAN THOSE SUBJECT TO AN ANNUAL LEASE) OR, IF DAMAGED AND THE DAMAGE CAN BE REPAIRED. THE COST OF MAKING SUCH REPAIR. PAYMENT BY THE BUYER OF CHARGES FOR DAMAGED. LOST OR DESTROYED CYLINDERS SHALL NOT GIVE ANY OWNERSHIP INTEREST IN THE CYLINDERS TO THE BUYER. UPON SUBSEQUENT RETURN OF ANY PURPORTEDLY LOST OR DESTROYED CYLINDERS SO PAID FOR, SELLER WILL REFUND THE AMOUNT PREVIOUSLY PAID WITH RESPECT TO ITS LOSS OR DESTRUCTION TO THE BUYER. LESS THE COST IF ANY OF PUTTING SUCH CYLINDERS IN REPAIR AND LESS CYLINDER RENTAL ACCRUED TO THE DATE OF RETURN. 2. ANY TAXES IMPOSED BY FEDERAL, STATE, OR OTHER GOVERNMENTAL AUTHORITY ON THE SALE, USE GR POSSESSION OF GOODS SHALL BE PAID BY BUYER IN ADDITION TO THE PURCHASE PRICE. 3. UNLESS OTHERWISE SPECIFIED IN A CONTRACT BUYER SHALL MAKE PAYMENT IN FULL WITHIN 33 DAYS AFTER THE DATE OF SELLER'S INVOICE. A LATE PAYMENT CHARGE OF 1.5% ON THE UNPAID, PAST DUE BALANCE, WILL BEI ASSESSED MONTHLY (MINIMUM TWO DOLLARS ($200). OR THE MAX,MUM LAWFUL RATE ALLOWABLE IN THE STATE WHERE THE GOODS ARE DELIVERED, WHICHEVER IS LESS. BUYER SHALL BE IN DEFAULT HEREUNDER UPON BUYERS FAILURE TO MAKE PAYMENT AS REQUIRED HEREIN OR UPON BUYER S FAILURE TO COMPLY WITH ANY OF THE TERMS AND CONDITIONS CONTAINED HEREIN OR UPON THE INSTITUTION OF ANY VOLUNTARY OR INVOLUNTARY BANKRUPTCY INSOLVENCY RECEIVERSHIP OR DEBTOR RELIEF PROCESSING BY OR AGAINST BUYER OR UPON BUYERS MAKING OF AN ASSIGNMENT FOR THE BENEFIT OF CREDITORS. IF SELLER EMPLOYS ANY COLLECTION AGENCY OR ATTORNEY TO COLLECT ANY AMOUNT DUE SELLER, ANDI TO REPOSSESS ANY GOODS, BUYER SHALL PAY ALL COLLECTION FEES, ATTORNEYS FEES. AND COURT COSTS. IN ADDITION TO THE AMOUNT OTHERWISE UNPAID. SELLER MAY BRING SUIT FOR THE COLLECTION OF ANY SUCH AMOUNT IN ANY JURISDICTION OR VENUE SELLER MAY SELECT. 4. NO GOODS SHALL BE RETURNED TO SELLER WITHOUT SELLER'S WRITTEN AUTHORIZATION. BUYER SHALL PAY A FIFTEEN PERCENT III RESTOCKING CHARGE ON ALL GOODS RETURNED TO SELLER, EXCEPT FOR RETURNS PPOVID[ U FOR UNDER SECTION 5 HEREOF S. SELLER SHALL BE LIABLE ONLY FOR ME REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS AND PRODUCTS, INCLUDING THE REPLACEMENT OF GASES THAT DO NOTMEETITS PURITY SPECIFICATIONS WITH GASES THATOO MEETSUCMSPECIFICATIONS. BUYER KNOWINGLYAND FULLYASSUMESTHE RISKS OFTRANSPORTINGAND USING COMPRESSED GASES. BUYER SHALL WARN AND PROTECTIVS EMPLOYEES AND OTHERS EXPOSEDTOTHE HAZARDS POSED BYBUYER'S STORAGEAND USE OFTHEPRODUCT. SELLER SMALL NOTES LIABLE FOR ANYDIRECT(EXCEPTAS EXPRESSLYPROVIDED HEREIN), INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL ANDA)R PUNITIVE DAMAGES, ARISING OR ALLEGED TO ARISE OUT OF OR IN CONNECTION WITH ITS OBLIGATIONS HEREUNDER OR WITH ANY PRODUCT, OTHER ITEMS OF SALE, OR EQUIPMENT SOLD OR LEASED HEREUNDER, WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT OR OMISSION OR IS RELATED TO STRICT LIABILITY, OR OTHERWISE. 6. ALL PRODUCTS. OTHER ITEMS OF SALE. CYLINDERS AND OTHER CONTAINERS FURNISHED HEREUNDER SHALL CONFORM TO THE DESCRIPTION THEREOF PUBLISHED BY THE MANUFACTURER AT THE TIME OF SALE AND WILL MEET SELLERS PURITY SPECIFICATIONS FOR ALL GAS PRODUCTS. SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED STANDARDS, GUARANTEES, OR WARRANTIES, INCLUDING ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENTAND ANY WARRANTIES THAT MAYBE ALLEGED TO ARISE ASA RESULT OF CUSTOM OR USAGE, ALL CLAIMS BY BUYER HAVING ANYTHING TO DO WITH ANY PRODUCT OR EQUIPMENT FURNISHED HEREUNDER BY SELLER SHALL BE MADE IN WRITING WITHIN TEN (10) DAYS AFTER THE DELIVERY THEREOF AND FAILURE OF BUYER TO GIVE SUCH NOTICE SHALL CONSTITUTE A COMPLETE WAIVER BY BUYER OF ANY SUCH CLAIMS AND DEFENSE FOR SELLER AGAINST ANY SUCH CLAIMS. 7. THE TOTAL AMOUNT DUE FROM BUYER MAY INCLUDE VARIOUS ITEMIZED CHARGES, INCLUDING CHARGES FOR THE HANDLED OF HAZARDOUS MATERIAL AND FOR COMPLIANCE WITH LAWS AND REGULATIONS CONCERNING HAZARDOUS MATER IALS, CHARGES FOR HANDLING, DELIVERY AND SHI PPI NO AND/OR CF ARSES FOR ENERGY OR FUEL. NONE OF THE CHARGES REPRESENT A TAX OR FEE PAID TO OR IMPOSED BY ANY GOVERNMENTAL AUTHORITY AND ALL OF THE CHARGES ARE RETAINED BY THE SELLER. SELLER HAS NOT SPECIFICALLY QUANTI f9 ED THE RE_ATIONSH IP BETWEEN THE CHARGES AND THE ACTUAL COSTS ASSOCIATED WITH THE CHARGES- WHICH CAN VARY BY PRODUCT. SERVICE. TIME AND PLACE, AMONG OTHER THINGS. R. CERTAIN AIRGAS COMPANIES ARE U.S GOV[ RNMENT CONTRACTORS AND SUBCONTRACTORS AND ARE SUBJECT TO AND ADHERE TO THE REQUIREMENTS OF FEDERAL LAWS. EXECUTIVE ORDERS. AND ATTENDANT RULES AND REGULATIONS, SPECIFICALLY EXECJTIVE ORDER NO 11246. THE REHABILITATION ACT OF 1973. AND THE VIETNAM ERA VETERANS READJUSTMENT ASSISTANCE ACT OF 1974. ALL AS AMENDED. 9. IF ANY TERM OR CONDITION OF THIS DELIVERY TICKET IS HELD INVALID, THEN SUCH INVALIDITY SHALL NOT AFFECT ANY OTHER TERM AND CONDITION OF THIS DELIVERY TICKET WHICH SHALL REMAIN IN FULL FORCE AND EFFECT. EMERGENCY RESPONSE INFORMATION PROPANE ACETYLENE AIR NITROUS OXIDE CO[ LIQUID CO, ARGON NITROGEN HYDROGEN MAPP OXYGEN LIQUID O[ LIQUID ARGON LIQUID Al HELIUM POTENTIAL HAZARDS POTENTIAL HAZARDS POTENTIAL HAZARDS POTENTIAL HAZARDS POTENTIAL HAZARDS RPEPFULAIOSION FIRE OP EXPLOSON ..doh O510N HE]LTI MEXLM EXTYLIFIFFLAMMABLE E 1 E E B a .moos n m .e ase M ets o a5P 1 11 11. 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FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL. 216-520.6000 T 1018919366 9020636565 10/11/2013 2576547 FISHERS ISLAND POMELEA' H SKIP VI = P Y ER DATIF N329 CUPU NET 30 10/11/2013 DELIVEAY NO, SGR tE)ri!t wTEFwNiL m"t SH QTY wm QTY W VNiT MIME, _ 'kYQM AMMNP 8021319600 PR 33A 2 CL 2 2 49.55 CL 99.10 N PROPANE INDUSTRIAL 33A CGA 510 (Vo1: 64 LES) Sale subtotal: 99.10 Hazmat Flat Rate 8.40 SHIP TO: 2576547 AMOUNT 107.50 FISHERS ISLAND Air98swwwairgas.com FERRY DISTRICT Airgas USA, LLC Airgas USA, LLC PO BOX H Acct No 8606074318 6055 Rockside Woods Blvd FISHERS ISLAND NY 06390-0607 PNC Bank, ABA No 031000053 Independence, OH 44131 REV 1 1 13 SEr-OOt000 Page 1 of 1 FOR LOCATION NEAREST YOU ligas DELIVERY ORDER VISIT WWW.AIRGAS.COM N SOLD BY: DELIVERY ORDER # 8021319600 SHIPPER: AIRGAS USA, LLC PAGE 1 OF 1 AIRGAS USA, LLC 130 CROSS RD ORDER DATE: 10/11/2013 131 CROSS RD WATERFORD, CT 06385-1204 WATERFORD, CT 06385-1204 SCH SHIP DATE: 19111/2013 800-962-0285 PRINTED: 07:30 10/1112013 SALES ORDER: 1018919366 SHIP TO: 2576547 SOLD TO: 2576547 CUST PO # FISHERS ISLAND FISHERS ISLAND RELEASE # FERRY DISTRICT FERRY DISTRICT ORD BY PO BOX H PO BOX H ENT BY DAVIESTEY FISHERS ISLAND, NY 06390-0607 US FISHERS ISLAND, NY 06390-0607 US 631-788-7463 Sales plant Sales Total Containers Order Type Payment Terms Incoterm Route Office Ong ip turn Acct Front NET 30 Customer Pick Up Customer Pick Up N329 N309 N000 Counter Qty Containers Vol Qty UOM HM Description & Hazard Class Order Ship Ret /Wt Shipped Type 2 0_ X UN1978 PROPANE 2.1 2 2 2 64 Llne# 10 Material# PR 33A Stor. Loc. F001 LB PROPANE 32LBS ALUMINUM eve THIS AGREEMENT IS SUBJEC AIR S' ST ARD T MS AND CONDITIONS EMERGENCY CONTACT: 1 -866-734-3438 PACARDS OFFERED SEE REVERSE SIDE FOR IMP NT FET~ H ORYA N PURCHASER AGREES TO OBTAIN MATERIAL SAFETY DATA SHEETS tMSOSI FROM ONE OF OR THE BY - FOLLOWING SOURCES; POINT OF PURCHASE, AIRGAS WEB SITE AT N'8ffl.~$,GO O ? ACCEPTED FOR CALLING THE ABOVE LISTED EMERGENCY CONTACT PHONE NUMBER AND SELECTING OPTION NS ACCEPT REJECT THE ABOVE / CUSTOMER -.'TH STOIC 7TH AT THE BOVENAMEOMATERIALSAREPROPERLY CLASSIFIER.DESCRIDE0. CUSTOMER MUST 1/ PACKAGF,D( A AND LABE D AND ARE IN PROPER CONDITION FOR.TRANSPORTATION INITIAL CHOICE NAME {q1^ }t ACCO)iDING TO IT APPLICAS REGULATIONS OF THE DEPARTMENT aF TRANSPORTATION PLEASE PRINT AI SPERSONNEL DATE T.O.D. INTERNAL USE ONLY Delivery # 8021319600 Flllea By Staging Area Total PKGS Tracking I Pro Number Freight Charges III 111111"IIIIIIIIIIIIIIIIIIIIIIIIII III TERMS AND CONDITIONS WARNING: TRANSPORTAND USE OF COMPRESSED GASES MAYBE EXTREMELYDANGEROUS. DO NOTTRANSFORTWITHOUT PROTECTIVE CAPS, IN CONFINED SPACES OR IN ANY OTHER IMPROPERMANNER. ALWAYS TRANSPORT CYLINDERS IN A SECURED UPRIGHT POSITION. BUYER ACKNOWLEDGES MAT IT HAS RECEIVEDA SAFETY INSTRUCTION SHEET FROM SELLER, SAFE HANDLING OF COMPRESSED GASES. 1. ANY AND ALL PRODUCTS AND SUPPLIES DELIVERED TO BUYER BY SELLER OR SELLER'S REPRESENTATIVE ARE COVERED BY THIS DELIVERY TICKET. THE CYLINDERS, FITTINGS AND CAPS COVERED BY THIS DOCUMENT ARE RENTED OR LEASED BY SELLER TO BUYER, NOT SOLD. BUYER SHALL NOT PERMIT CYLINDERS OR OTHER STORAGE CONTAINERS FURNISHED HEREUNDER TO BE FILLED WITH ANY PRODUCT NOT FURNISHED BY SELLER OR SELLER'S AUTHORIZED REPRESENTATIVE. ALL CYLINDERS (OTHER THAN THOSE SUBJECT TO AN ANNUAL LEASE) ARE RENTED AT CURRENT DAILY RATES, BEGINNING WITH THE DATE OF DELIVERY RENTAL CHARGES ARE ASSESSED AS OF THE LAST DAY OF EACH MONTH OR AT THE START OF EACH ANNUAL LEASE PERIOD, AS APPLICABLE. BUYER SHALL RETURN, IN GOOD CONDITION, ALL CYLINDERS. COMPLETE WITH CAPS AND FITTINGS AND SHALL PAY SELLER UPON DEMAND THE REPLACEMENT VALUE OF (B ANY LOST OR DAMAGED CYLINDERS, CAPS OR FITTINGS OR (10 THOSE CYLINDERS NOT RETURNED TO SELLER WITHIN THREE (3) MONTHS FROM DATE OF SHIPMENT TO THE BUYER (OTHER THAN THOSE SUBJECT TO AN ANNUAL LEASE) OR, IF DAMAGED AND THE DAMAGE CAN BE REPAIRED, THE COST OF MAKING SUCH REPAIR. PAYMENT BY fHE BUYER OF CHARGES FOR DAMAGED. LOST OR DESTROYED CYLINDERS SHALL NOT GIVE ANY OWNERSHIP INTEREST IN THE CYLINDERS TO THE BUYER. UPON SUBSEQUENT RETURN OF ANY PURPORTEDLY LOST OR DESTROYED CYLINDERS SO PAID FOR, SELLER WILL REFUND THE AMOUNT PREVIOUSLY PAID WITH RESPECT TO ITS LOSS OR DESTRUCTION TO THE BUYER, LESS THE COST, IF ANY OF PUTTING SUCH CYLINDERS IN REPAIR AND LESS CYLINDER RENTAL ACCRUED TO THE DATE OF RETURN. 2. ANY TAXES IMPOSED BY FEDERAL, STATE, OR OTHER GOVERNMENTAL AUTHORITY ON THE SALE, USE CR POSSESSION OF GOODS SHALL BE PAID BY BUYER IN ADDITION TO THE PURCHASE PRICE. 3. UNLESS OTHERWISE SPECIFIED IN A CONTRACT BUYER SHALL MAKE PAYMENT IN FULL WITHIN 30 DAYS AFTER THE DATE OF SELLER'S INVOICE. A LATE PAYMENT CHARGE OF 1.5% ON THE UNPAID, PAST DUE BALANCE, WILL BE ASSESSED MONTHLY (MINIMUM TWO DOLLARS ($2.00), OR THE MAXIMUM LAWFUL RATE ALLOWABLE IN THE STATE WHERE THE GOODS ARE DELIVERED. WHICHEVER IS LESS. BUYER SHALL BE IN DEFAULT HEREUNDER UPON BUYER'S FAILURE TO MAKE PAYMENT AS REQUIRED HEREIN OR UPON BUYER'S FAILURE TO COMPLY WITH ANY OF THE TERMS AND CONDITIONS CONTAINED HEREIN OR UPON THE INSTITUTION OF ANY VOLUNTARY OR INVOLUNTARY BANKRUPTCY, INSOLVENCY RECEIVERSHIP OR DEBTOR RELIEF PROCESSING BY OR AGAINST BUYER OR UPON BUYER'S MAKING OF AN ASSIGNMENT FOR THE BENEFIT OF CREDITORS. '.F SELLER EMPLOYS ANY COLLECTION AGENCY OR ATTORNEY TO COLLECT ANY AMOUNT DUE SELLER, AND/OR TO REPOSSESS ANY GOODS, BUYER SHALL PAY ALL COLLECTION FEES, ATTORNEYS' FEES. AND COURT COSTS, IN ADDITION TO THE AMOUNT OTHERWISE UNPAID. SELLER MAY BRING SUIT FOR THE COLLECTION OF ANY SUCH AMOUNT IN ANY JURISDICTION OR VENUE SELLER MAY SELECT 4. NO GOODS SHALL BE RETURNED TO SELLER WITHOUT SELLER'S WRITTEN AUTHORIZATION. BUYER SHALL PAY A FIFTEEN PERCENT (15%) RESTOCKING CHARGE ON ALL GOODS RETURNED TO SELLER, EXCEPT FOR RETURNS PROVIDED FOR UNDER SECTION 5 HEREOF 5. SELLER SHALL BE LIABLE ONLY FOR THE REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS AND PRODUCTS, INCLUDING THE REPLACEMENT OFGASES THATDO NOTMEET ITS PURITYSPECIFICATIONS WITH GASES MAT DO MEETSUCH SPECIFICATIONS. BUYER KNOWINGLYAND FULLYABSUMES THE RISKS OFTRANSPORTING AND USING COMPRESSED GASES. BUYER SHALL WARNAND PROTECTIVS EMPLOYEES AND OTHERS EXPOSEDTOTHEHAZARDS POSED BYBUYER'S STORAGEAND USE OFTHEPRODUCT. SELLERSHALL NOT BELIABLE FORANYDIRECT(EXCEPTAS EXPRESSLYPNOWDED HEREIN), INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL AND/OR PUNITIVE DAMAGES, ARISING OR ALLEGED TO ARISE OUT OF OR IN CONNECTION WITH ITS OBLIGATIONS HEREUNDER OR WITH ANY PRODUCT, OTHER ITEMS OF SALE, OR EQUIPMENT SOLD OR LEASED HEREUNDER, WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT OR OMISSION OR IS RELATED TO STRICT LIABILITY, OR OTHERWISE. 6. ALL PRODUCTS, OTHER ITEMS OF SALE, CYLINDERS AND OTHER CONTAINERS FURNISHED HEREUNDER SHALL CONFORM TO THE DESCRIPTION THEREOF PUBLISHED BY THE MANUFACTURER AT THE TIME OF SALE AND WILL MEET SELLER'S PURITY SPECIFICATIONS FOR ALL GAS PRODUCTS. SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED STANDARDS, GUARANTEES, OR WARRANTIES, INCLUDING ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT AND ANY WARRANTIES THAT MAYBE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE. ALL CLAIMS BY BUYER HAVING ANYTHING TO DO WITH ANY PRODUCT OR EQUIPMENT FURNISHED HEREUNDER BY SELLEi1 SHALL BE MADE IN WRITING WITHIN TEN (10) DAYS AFTER THE DELIVERY THEREOF AND FAILURE OF BUYER TO GIVE SUCH NOTICE SHALL CONSTITUTE A COMPLETE WAIVER BY BUYER OF ANY SUCH CLAIMS AND DEFENSE FOR SELLER AGAINST ANY SUCH CLAIMS. 7. THE TOTAL AMOUNT DUE FROM BUYER MAY INCLUDE VARIOUS ITEMIZED CHARGES. INCLUDING. CHARGES FOR THE HANDLING OF HAZARDOUS MATERIAL AND FOR COMPLIANCE WITH LAWS AND REGULATIONS CONCERNING HAZARDOUS MATERIALS, CHARGES FOR HANDLING, DELIVERY, AND SHIPPINGAND/OR CHARGES FOR ENERGY OR FUEL. NONE OF THE CHARGES REPRESENT A TAX OR FEE PAID TO OR IMPOSED BY ANY GOVERNMENTAL AUTHORITY AND ALL OF THE CHARGES ARE RETAINED BY THE SELLER. SELLER HAS NOT SPECIFICALLY QUANTA =AD THE RELATIONSHIP BETWEEN THE CHARGES AND THE ACTUAL COSTS ASSOCIATED WITH THE CHARGE'S, WHICH CAN VARY BY PRODUCT SERVICE, TIME AND PLACE, AMONG OTHER THINGS. 8. CERTAIN AIRGAS COMPANIES ARE U.S GOVERNMENT CONTRACTORS AND SUBCONTRACTORS AND ARE SUBJECT TO AND ADHERE TO THE REQUIREMENTS OF FEDERAL LAWS, EXECUTIVE ORDERS, AND ATTENDANT RULES AND REGULATIONS, SPECIFICALLY EXECUTIVE ORDER NO 11246, THE REHABILITATION ACT OF 1973, AND THE VIETNAM ERA VETERANS READJUSTMENT ASSISTANCE ACT OF 1974. ALL AS AMENDED. 9. IF ANY TERM OF? CONDITION OF THIS DELIVERY TICKET IS HELD INVALID, THEN SUCH INVALIDITY SHI NOT AFFECT ANY OTHER TERM AND CONDITION OF THIS DELIVERY TICKET. WHICH SHALL REMAIN IN FULL FORCE AND EFFECT. EMERGENCY RESPONSE INFORMATION PROPANE ACETYLENE AIR NITROUS OXIDE CO. LIQUID CO, ARGON NITROGEN HYDROGEN MAPP OXYGEN LIQUID O, LIQUIDARGON UQUIDN, HELIUM POTENTIAL HAZARDS POTENTIAL HALIRDS POTENTIAL HAZARDS POTENTIAL HAZARDS POTENTIAL HAZARDS INANESIREXPLOMIN XVLOSpN MERLIN fIINAMETENT LETREML.v ILAMMABL FMEONE PEOPEXPLOEION VIIIIIIIIIIII 'I of wai voppo'i mmousiion. case4umesssescy eLOnvil of rui cazo osp /wanon YETERNEFF-AMMIALF 4wnas del ame. sole Tdy "a Y. Y-Y, lot III mlf A w Sr eS.S I, Ill ASIA r Y er ee. ell m Smbe Sato w ~ w oe SarS Seaa Now .111 wIt"Antedlol 1, 111 Al I All ~ aro ee r1 r o, me ll np gmona colo A-9 ,I o Ili LANE, Iw cr heaoad o. Ed, ,I... C-Coll ,in 91, 11 Illf IF 91, ar .ra on 'glad pem ~orwoym"c on an aye e e.e an, lib. 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Ill , A Sn on opow s oa it ua.e . a on b lion melcz u 110) d 11 o I,owiors EMERGENCY RESPONSE FINE ~ 'IS do vONm EX SEDuanuuNING 4R5 nnE UNLESS EMERGENCY RESPONSE a~ MAY "Al III m~ l no e.a ar ar.,,..l ,e enoeao yo, LEaX Carv ss sronvea "nE y FINE OI EXNHOUISna LGNM'66aS pNEVNlE45 3m.NfXw cunoaloc1 .l,po of Ill e Ian NI 'I'd LM nenoiw c-y yol Fmrce.11 Int 'Ilk S,rvll Flna . Orv mcr;Nn co WN Urea nF OPOn. . yetl cliinl V AESroPPEO. grc "Sold, -11p, "I'll U ainq~uon ACSS O Id, MMa S'mlrCn LW N /nag"Ild AlSSo •mam a slwmo'ase.nnan-ul Cooiw o e es Illed-1111, on, 11 "ple" ol RN vC0 ed- Ip . q Fenin lei y.u an o, w. o ok D'Iff Oaneg 1.11d, lop w, f. III. 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SPILL Off LEaX S mno e v.baw onaeaa a IELLOLUNno J Izrs s. low V¢s e v - ba.onc. ATE, 9 ..v y w . spo u sp old a 11. M- Irded., uax] LAINLLSS~Idi era lousy. aewe... oa......... . ado ale 4Zoo-old ed, ol do Ill 1-1 be dou AN ELIMINATE A 1 91,111, or ",1 1 p eersn. Aide lee a ~i. aI-11 aknB m ^ 1. 1. P eo..apes ahe In I T.- 11 ofrocid. ago apoec h e macl SS to o0 N .p b eauSiae wig. ow.An wan mmy.,.eu Sell I a n IIIII 111 11 S ..ye .w It poll oil I I y Q a av rc S ods oleddea canon and 111e m Stop urygMS XpWaS If nMN4hboalx Mnb Yung I all,, in I 'told b omon.o con Sole FM AN, Nbry udukxYLlw.i w.nilnp. 0 _ Fll Clothing III,,, to 11-1 e aaa oe. awal 11 -kp- nl olon I oa - 01 en wpo cola _ S' mma H,, Idiel n,.IremsN• mvMN UwH m y. 11 C111 If 11TAT I I' "In IS "A e. mold '-we",doollp- Allil An "I'd Ill 11 .1 g aerab.e roNnre p%s er'woe, nunY^~h,bleodrcmrodlllb up en llMeN lOdeexWaw,n Ad,,, III IS,C 11 1 1111 dI life I o loop ,,I I'd wN MpxenUnyynile wming ,in" In" All H loold In the In, In,,, N441a, mFrrymMlYa 4 Eeenme e,HW .na.n llxNYro S r. A. e. oeremenaS FlN'd-I ba bm fe Indoed worms o 11 1,, to -All -1 d god. in- oalea a e o III-d" o .I A. I oppolp St. lalahas dope lea a p mre.a. rpm one H At Es I .-I A I'd to fle I". Ill oyge arig e ,I . 11 1.1 1 a. rg reded, 11 he 11 1 wood b, -A A' w wee g -I' ISIlle) aonaa p sopoc ~A ena sn de ryga b n eslI 'nq's Addlin 11 nneeap A, ITS, as ea Ill r rv ,I, hembevos of CC now Ibng to nlolno III Model ao, owed dNOIe being dello- old Ad 11 ling en or, 1, 11 cLAY of pIN- ,in I III lld Ed A SWAP I III All, Ill 'I'll I, Ill I Sell All, Iloe e, All meld poll, w. ivewl oa el a .vox -V . io p eves I'd on' III not led", I, I.- I " kid, -Ad .110 lon dollop" To PITIN't'delletv" FISHERS ISLAND FERRY DISTRICT VENDOR 001451 AMERICAN NATIONAL RED CROSS 11/19/2013 CHECK 1536 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.950 10244353 (12)ADLT CPR AED 6/17/13 960.00 SM .5710.4.000.950 10244353 (8)ADULT CPR AED 6/18/13 640.00 TOTAL 1,600.00 ii-ta M., ~iP THE ORIGINAL CHECK HAS A COLORED BACKGROUND A VOID COPY FEATURE AND WATERMARK PAPER 4 ea a°3 RA` v~ 4 i~++uY~6 '*m a iio- Mihm =0 i mi a~~Pm i ~roz ~w~ a iMTM M~ ta~ 3 TIN J s x !1~[#a 'arm 1 y~ *h 9 - . / o a~(4fq xCC~ .y.&sr o r ate/ 03 * <4'"W/di', a y y u•70~53~~~• 1:0 2 1 40 54 641: C8 D01502 1~~• :Vendor No. Check No. Town of Southold, New York - Payment Voucher 1451 5 Vendor Tax ID Number or Social Security Number Entered by i 53-0196605 Processing Center 100 West 10th Street Suite 501 Audit Date American National Red Cross Wilmington, DE 19801 NOV 19 2013 Vendor Telephone Number 888-284-0607 Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number escription of Goods or Services ` General Ledger Fund and Account Number -731 I 10244353 3 $960.00 $960.00 Ault CPR AED 6/17/13 SM5710.4.000.960 69SA20U $640.00 $640.00 Adult CPR AED 6/18/13 SM5710.4.000.950 !I $1,600.00 $1,600.00 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no pan has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt /arse/ excluded. or discrepancies noted. -payment is approved. Title Signa[urc Signature W Date Company Name / Date Title Nam it Page 1 of 1 AM cJ?n Red Cross Attn: Health and Safety Processing Center Invoice No.: 10244353 100 West 10th Street, Suite 501 Wilmington, DE 19801 1-888-284-0607 Invoice date: 7/31/2013 Customer PO Ref: Customer Number: 07038FISHISFE FISHERS ISLAND FERRY Invoice Total: $1,600.00 5 WATERFRONT PARK NEW LONDON CT 06320 American Red Cross Send Payment To: Health & Safety Services 25688 Network Place Chicago IL 60673-1256 Payment Terms: Net30 ORDER # CRSIOFFERING ID DESCRIPTION CLASS DATE INSTRUCTOR NAME TOTAL 11545918 3258414 Adult CPR/AED Review Item List Price 6/17/2013 Holland, Robert $960.00 12 Students x $80.00 fee per Students = $960.00 11548075 3260026 Adult CPR/AED Review Item List Price 6/18/2013 Holland, Robert $640.00 8 Students x $80.00 fee per Students = $640.00 Invoice Total: $1,600.00 Thank you for your support of the American Red Cross! If you have any questions about this invoice or want to make a credit card payment, please call 1-888-284-0607. You-may-also email your questons to billing/redcross.org Hr4 SecONd Clgss tvc ?7-13 American C K Red Cross Full Service Training Agreement This represents an agreement between the American Red Cross ("Red Cross") and the customer listed in the signature block below ("Customer") for Red Cross to provide training at the locations and on the dates listed below to Customer's employees or members. The Red Cross agrees to provide professional, high-quality instruction with certified instructors who will deliver training equipment to the site identified in this agreement. Customer Information Customer Name Fishers Island Ferry New ? Existing Org ID (if known) 07038FISHISFE Customer Contact steve burke Customer Contact Email sburke@Merry.com Customer (860) 442-0165 Customer Fax Contact Phone Customer 5 Waterfront Park Is this a new or ? Yes ? No Address New London, CT 06320 changed address? Billing Contact Name stove burke Billing Phone (860) 442-0165 Billing Contact Email sburke"ferry.com Is the above address the same as the billing address? Please fill in, if different. ? Yes ? No Customer Billing 5 Waterfront Park Address New London, CT 06320 Training Fee Summary #1 Course Name: First Aid #1 Start date: 10/22/2013 #1 Location: 5 Waterfront Park New London CT #1 Total: $900.00 TOTAL:_$900_ Method of Payment Red Cross-issued PO# 07038FISHISL Method of Payment: Invoice `NOTE: For all credit card and bank transfer payments, a Red Cross representative will contact you. Please do not include any credit card or bank transfer details on this agreement. Special Terms: Red Cross Representative Name Joseph Lodge Email joseph.lodge@redcross.org Phone 860-335-7502_ Updated: 02.05.2013 Page 1 American Refs Cross O_ E Spn' f" Class booking fees are non-refundable. A Customer must book a minimum of 8 unless otherwise noted. A Customer may reschedule a class without penalty if Red Cross is notified more than two (2) business days in advance of the scheduled class time. Red Cross is authorized to charge the Customer $120 if the Customer reschedules in less than two (2) business days. Payment terms are net 30 days. The parties, acting through their duly authorized officers, have executed this Agreement as of the dates specified below. Customer must return a signed copy of this Agreement at least seven (7) calendar days prior to the first training day to the designated Red Cross representative identified above or Red Cross will not be obligated to conduct the training courses as referenced in this Agreement. Customer Name: Fishers Island Ferry American Red Cross Customer Signature: Red Cross Signature: Electronic Signature: ? Electronic Signature: Name: Name: Joseph Lodge Title: Title: Corporate Solutions Account Executive Phone: Phone: 860-335-7502 Date: Date: 10/17/2013 Updated: 02.05.2013 Page 2 American Health and Safety Full Service Red Cross Training Agreement Addendum Account Name Fishers Island Ferry Prepared By Joseph Lodge LMS Ong ID 07038FISHISFE E-mail joseph.lodge@redcross.org Training Location Training Location 5 Waterfront Park New London L'T Training Contact (860) 442-0165 Training Contact Steve Burke Office Phone Training Contact sburke@fiferry.com Training Contact Steve Burke email Office Title Training Details Start Date 10/22/2013 End Date 10/22/2013 Start Time 0600 PM End Time 09.00 PM Equipment Instructor to provide AV equipment Materials Red Cross Provides Materials for In Class Use Drily Product Code Product Quantity Sales Price Total Pro HSSSFA101 First Aid 8.00 $100.00 $800.00 Delivery fee On site course delivery fee 1.00 $100.00 $100.00 Grand Total Amount $900.00 FISHERS ISLAND FERRY DISTRICT VENDOR 019500 AT&T 11/19/2013 CHECK 1537 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.100 86044201651113 NL TERM TEL-10/15-11/14 268.19 SM .5710.4.000.100 86044201651113 LATE PAYMENT 4.29 TOTAL 272.48 THE ORIGINAL CHECK HAS A COLORED BACKGROUND. A VOID .COPY FEATURE AND WATERMARK PAPER mt... r U i 4p ~ , r~ ,~ri I, 'rvl I al III p I Wp~ t f _ y J P 'ell SSlK[wwa~455 riz2_Qi' t - ra .r -".a. z'- /rX" ~r;~9 S„`.J~. rar' i~ a l9 r~LCr u '+4 r 'AN?Jr" t f .xe W e V, ly00 L53'ov r0 214054641 6A, 001502$ +1' Vendor No.Check No. Town of Southold, New York - Payment Voucher 19500 5 31 Vendor Tax ID Number or Social Security Number Vendor Address Entered by AT&T Vendor Name P.O. Box 5082 Audit Date AT&T Carol Stream, IL 60197- NOV 19 2013 Vendor Telephone Number 800-321-2000 To Clerk Vendor Contact ' a 1 Invoice Invoice Invoice Net purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Amount Number i 8604420165 10/15/2013 $268.191 $268.19 NL Terminal Tel SM5710.4.000.100 10/16113-11114/13 $4.29' $4.29 Late Payment SM5710.4.000.100 i j $272.481 $272.48 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes ~from ~ which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature Title 11011 Signature r Company Name Date !el ~~GV Title Date i FISHERS ISLAND FERRY DISI RICT Page 1017 PO BOXH Account Number 860442-0165078 FISHERS ISLE NY 00390-0007 Billing Date Oct 15, 2013 at&t Web Site att.COm Monthly Statement Bill-At-A-GlanCe AT&T Benefits Previous Bill 285.94 • Thank you for being alt ALL DISTANCE@ customer. Payment •00 Your ALL DISTANCE@ savings includes: Adjustments 419 Promotions and Discounts 2700 Past Due • Please Pay Immediately 290,23 Detail of Payments and Adjustments Current Charges 268.19 L -A Total Amount Due $558.42 * Rein _ No. Date Description Adiusnn eats Pa ents -yrn I. 10-15 Late Payment Charge 1.5% 4.29 Current Charges Due in Full by Nov 14, 2013 F- Plans and Services L Billing Summary L -A Promotions and Discounts Questions? Call: Page 2. Save Elite -S Cann-827 if -12mo tell" 27.0008 Plans and Services 1 268.19 Mouthly Service - Oct 15 that Nov 14- Oct 15 that Nov 14 1 800 321-2000 Charges for 860442-0165 Repair: 3. Monthly Charges 122.60 1 800 246-8464 Charges for 860443-6851 Internet Service 1 s: 877 722-3755 4. Monthly Charges 28.35 Charges for 860 444-0320 Total Current Charges 268.19 5. Monthly Charges 2835 Charges for 860 447-9371 ^ 6. M t Charges 28,35 Total Monthly hly Service 207.65 Call Charges Bits Block of Time 70011 MTM Summary 748 Minutes Used 700 Minutes Allowed Instate Long Distance 59 Out of State Long Distance 1,81 Call Plan Summary Total 2,40 7. Bus Block of Time 70011 MUM 35.00 Charges for 860 442-0165 Item You Can Use Summary No. Date Lane Place Number Code Min L News Itemized Calls • PREVENT DISCONNECT • CARRIER INFO 8. 9-14 1023A FISHERS IS NY 631788-5546 2 030+ 00 • KEEP YOUR DISCOUNT • UNIVERSAL SVC FEE •CHANGE IN TERMS • CENTRALINK 1100 See "News You Can Use" for additional information. Local Services provided by AT&T Connecticut. Services beyond *BASIC S306.47 NON BASIC S251.95 Connecticut provided by AT&T Lone Distance East. Return bottom portion with your check in the enclosed envelope. GO GREEN Enroll in papedesc billing. R FISHERS ISLAND FERRY DISTRICT Page 2 ol7 PO BOX IT Account Number 860 442-0165 018 at&t FISHERS ISLE NY 06390-0607 Billing Date Oct 15, 2013 \ Web Site att.com - - and SerViGes Call Charges - Continued Item No. Date The Place Number Dodg Min Call Chafes-ContinuedContinued 50. 9-191112A FISHERS IS NY 631788-7463 1 030+ .00 Item 51. 9-19 1145A FISHERS IS NY 631188-7345 1 0:30+ .00 NB. Date Time Place Number Coe Mill 52. 9-19 1150A FISHERS IS NY 631 788-7001 1 1:48+ .00 1. 9-14 1147A FISHERS IS NY 631 788-5550 1 0:30+ .00 53. 9-19 1239P NEW YORK NY 917620-7814 1 050+ .00 2. 9-141148A FISHERS IS NY 631788-5550 2 0:30+ .00 54. 9-19 442P HACKENSACK NJ 2014783975 1 0:30+ 00 3. 9-16 721A STAMFORD CT 203223-1328 N 117+ .00 55. 9-19 442P HACKENSACK NJ 201478-3975 1 333+ 00 4. 9-I6 910A FISHERS IS NY 631788-7345 1 1:34+ .00 56. 9-20 734A FISHERS IS NY 631788-7345 2 1:46+ W 5. 9-16 955A FISHERS IS NY 631 788-7744 1 0:34+ .00 57. 9-20 750A NEW YORK NY 917 747-0044 2 0:31+ .00 6. 9-I6 1110A NWYRCYZNOI NY 212327-1144 1 4:39+ .00 58. 9-20 918A FISHERS IS NY 631788-7345 1 1:18+ .00 7. 9-16 1124A FISHERS IS NY 631 788-7463 1 2:28+ .00 59. 9-20 921A FISHERS IS NY 631 788-7857 1 037+ .00 8. 9-16 219P FISHERS IS NY 631 766-7345 1 0:30+ .00 60. 9-20 924A FISHERS IS NY 631 788-5655 1 0:54+ .00 9. 9-I6 226P FISHERS IS NY 631 788-7463 1 104+ .00 61. 9-20 1040A NEW YORK NY 917 747-0044 1 0:30+ .00 10. 9-I6 306P PROVIDENCE RI 401 413-7302 1 8:29+ .00 62. 9-20 1042A FISHERS IS NY 631 788-7345 1 041+ .00 11. 9-17 814A CHESHIRE CT 203272-3077 D 238+ .00 63. 9-201115A FISHERS IS NY 631788-7345 1 0:30+ .00 12. 9-I7 905A FISHERS IS NY 631788-7224 1 0:31+ .00 64. 9-201136A FISHERS IS NY 631788-7463 1 0:47+ .00 13. 9-17 922A FISHERS IS NY 631788-7224 1 0:39+ .00 65. 9-201153A FISHERS IS NY 631788-7463 1 056+ .00 14. 9-17 931A FISHERS IS NY 631788-7463 1 0:52+ .00 66. 9-201216P SYRACUSE NY 315382-3902 1 033+ .00 15. 9-I7 938A WATERBURY CT 203754-5334 0 0:35+ .00 67. 9-20 1247P POUGHKEPSI NY 845656-1677 1 030+ .00 ¦ 16. 9-17 944A PROVIDENCE RI 401 4866759 1 2:42+ .00 68. 9-20 123P RUTLAND VT 802 262-6675 1 0:37+ .00 17. 9-17 1039A FISHERS IS NY 631788-7463 1 0:32+ .00 69. 9-20 150P FISHERS IS NY 631788-7345 1 045+ .00 ¦ 18. 9-17 1046A FISHERS IS NY 631 788-7224 1 5:57+ .00 70. 9-10 222P FISHERS IS NY 631 788-7255 1 033+ .00 19. 9-171106A FISHERS IS NY 631788-7224 1 1:27+ .00 71. 9-20 250P NWYRCYZNO1 NY 212873-1965 1 1:14+ .00 20. 9-17 1235P BALTIMORE MD 443615-0212 1 0:30+ .00 72. 9-20 252P MIAMI FL 305582-6707 1 0:32+ .00 21. 9-I7 1237P OLDGRNWICH CT 203277-3077 D 0:30+ .00 73. 9-20 306P FISHERS IS NY 631788-7345 1 048+ .00 12. 9-17 1237P CHESHIRE CT 203272-3077 D 0:30+ .00 74. 9-20 343P NEWYORK NY 917741-0044 1 0:30+ .00 23. 9-17 1242P FISHERS IS NY 631188-7928 1 2:19+ .00 75. 9-20 347P FISHERS IS NY 631 788-7345 1 030+ .00 24. 9-17 1251P CHESHIRE CT 203272-3077 D 0:30+ .00 76. 9-20 750P SOUTHINGTN CT 860620-4322 F 0:30+ .00 25. 9-171253P ESSEX CT 860 167-0660 D 0:30+ .00 77. 9-21 922A NEW YORK NY 917747-0044 2 044+ .00 26. 9-17 123P ESSEX CT 860767-0660 D 0:30+ .00 78. 9-21 104P NWYRCYZN01 NY 212873-1965 2 129+ .00 27. 9-17 124P CHESHIRE CT 203272-3077 D 1:14+ .00 79. 9-22 1234P ROANOKE VA 540520-6277 2 142+ .00 28. 9-17 142P ESSEX CT 860767-0660 D 0:32+ .00 80. 9-23 829A FISHERS IS NY 6317887221 1 1:42+ .00 29. 9-I7 150P PROVIDENCE HI 401413-7302 1 2:20+ .00 81. 9-23 832A FISHERS IS NY 631 788-7899 1 030+ .00 30. 9-17 153P HOPKINTON MA 508294-5556 1 0:58+ .00 82. 9-23 833A FISHERS IS NY 631 788-7444 1 144+ .00 31. 9-17 154P PROVIDENCE RI 401 413-7302 1 0:46+ DO 83. 9-23 836A FISHERS IS NY 631 788-7444 1 030+ .00 32. 9-17 200P NWYRCYZNOI NY 646431-8270 1 1:28+ .00 84. 9-23 923A FISHERS IS NY 631788-7345 1 030+ .00 33. 9-I7 304P HARTFORD CT 860250-0088 D 2:02+ .00 85. 9-23 950A BABYLON NY 631943-7487 1 0:30+ .00 34. 9-17 404P FISHERS IS NY 631788-7345 1 030+ .00 86. 9-23 956A BABYLON NY 631943-7487 1 0:30+ .00 35. 9-17 412P FISHERS IS NY 631788-7463 1 056+ .00 87. 9-23 957A BABYLON NY 631943-7487 1 0:41+ .00 36. 9-17 520P NWYRCYZN01 NY 2128731965 2 5:49+ .00 88. 9-231126A FISHERS IS NY 631788-5673 1 308+ .00 31. 9-18 817A CANONSBURG PA 724746-3700 1 1:55+ .00 89. 9-23 1143A HUNTINGTON CT 203924-4998 D 152+ .00 38. 9-18 855A FISHERS IS NY 631788-7345 1 058+ .00 90. 9-231MA HARTFORD CT 860614-2325 D 127+ .00 39. 9-18 923A FISHERS IS NY 631188-7345 1 1:10+ .00 91. 9-23 209P NWYRCYZNO1 NY 646745-6543 1 030+ .00 40. 9-181006A NWYRCYZNO1 NY 212327-1144 1 157+ .00 92. 9-23 306P FISHERS IS NY 631788-7857 1 0:30+ .00 41. 9-18 1040A FISHERS IS NY 631788-7444 1 0:43+ .00 93. 9-23 330P FISHERS IS NY 631788 7463 1 030+ DO 42. 9-18 115P FISHERS IS NY 631788-7345 1 0:30+ .00 94. 9-23 331P JEWETTCITY CT 860376-6242 D 2:52+ .00 43. 9-18 206P FISHERS IS NY 631788-7345 1 0:38+ .00 95. 9-24 BIOA FISHERS IS NY 631 788-7455 1 1:39+ .00 44. 9-18 337P FISHERS IS NY 631788-7444 1 0:47+ .00 96. 9-24 847A STAMFORD CT 203223-8160 D 036+ .00 45. 9-I8 41OP PROVIDENCE RI 401413-7302 1 030+ .00 97. 9-241006A PLAINFIELD CT 860564-2789 D 131+ .00 46. 9-18 422P NWYRCYZNO1 NY 212799-5555 1 0:30+ .00 98. 9-241110A FISHERS IS NY 6317887463 1 0:44+ .00 47. 9-19 747A FISHERS IS NY 6317887632 2 133+ .00 99. 9-24 1128A FISHERS IS NY 631 788-7463 1 1:14+ .00 48. 9-19 858A CRANFORD NJ 908377-4868 1 0:42+ .00 100. 9-241258P LENOX MA 413637-1282 1 0:32+ .00 49. 9-191103A FISHERS IS NY 631188-7345 1 0:34+ .00 101. 9-24 158P FISHERS IS NY 631788-7463 1 234+ .00 102. 924 256P DANBURY CT 203948-4226 D 557+ DO x+206 AT&T Knowledge Ventures. 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WI: r ~1 3243.006.063005.01.04.0000000 NNNNNNNY 70857.126113 FISHERS ISLAND FERRY DISTRICT Page 3o17 11 PO BOXH Account Number 860 442-0165 078 at& \ FISHERS ISLE NV 06390-0607 Bilking Date Oct 15, 2013 Call Charges - Continued L Plans and Services Item No. Date Time plape Number Code M' Cell Charges - Continued 50. 9-27 229P HARTFORD CT B60 289-7800 0 625+ .00 Itern 51. 9-27 252P GUILFORD CT 203458-4128 D 124+ .00 142 Date Time Place Number Code mill 52. 9-27 313P GUILFORD CT 203458-4128 D 0:39+ .00 1. 9-24 311P DANBURY CT 203948-4226 D 0:30+ 00 53. 9-281049A JEWETTCITY CT 860376-6242 E 503+ .00 2. 9-24 312P ROCKVILLE CT 860871-4966 D 254+ .00 54. 9-28 411P FISHERS IS NY 631788-7463 2 030+ .00 3. 9-25 822A NEW BOSTON NH 603325-2621 1 040+ .00 55. 9-30 807A FISHERS IS NY 631 788-7345 1 0:30+ .00 4. 9-25 918A FISHERS IS NY 631 788-7345 1 030+ .00 56. 9-30 844A FISHERS IS NY 631 788-7345 1 0:45+ .00 5. 9-25 920A FISHERS IS NY 631788-7345 1 047+ 00 51. 9-30 1119A FISHERS IS NY 631 788-7345 1 253+ .00 6. 9-25 938A FISHERS IS NY 631788-7632 1 030+ .00 58. 9-301147A GUILFORD CT 203453-1200 D 0:30+ .00 Z 9-25 945A GRAND RPDS MI 616262-0246 1 0:52+ .00 59. 9-301236P FISHERS IS NY 631788-7345 1 0:30+ .00 8. 9-251013A FISHERS IS NY 631788-7463 1 430+ .00 60. 9-30 110P MIDDLETOWN CT 860632-7338 D 103+ .00 9. 9-25 1032A FISHERS IS NY 631 788-7224 1 0:59+ 00 61. 9-30 320P FISHERS IS NY 631 788-5546 1 1:12+ .00 10. 9-251033A NEWHAVEN CT 203387-0810 0 7:03+ 00 62. 9-30 323P ESSEX CT 860662-6292 D 2:09+ .00 11. 9-25 1048A FISHERS IS NY 631766-7632 1 113+ .00 63. 9-30 335P FISHERS IS NY 631 788-5550 1 11:01+ .00 12. 9-25 1052A FISHERS IS NY 631 788-7463 1 0:30+ .00 64.10-01 850A FISHERS IS NY 631 788-7345 1 1:08+ .00 13. 9-251053A FISHERS IS NY 631788-7345 1 0.30+ .00 65.10-01 926A HARTFORD CT 860614-2325 D 0:52+ .00 14. 9-25 1146A NEWPORT RI 401841-3670 1 030+ 00 66.10-01 942A FISHERS IS NY 631 788-5673 1 633+ .00 15. 9-251MA NEWPORT RI 401832-5837 1 1:14+ 00 67.10-01 949A FISHERS IS NY 631788-7463 1 3:29+ .00 16, 9-25 1148A NEWPORT RI 401832-5166 1 0:32+ .00 68.10-01 1224P FISHERS IS NY 631 788-7029 1 1:06+ .00 17. 9-251150A RUTLAND VT 802282-6675 1 056+ .00 69.10-01 1250P FISHERS IS NY 631788-7463 1 3:45+ .00 18. 9-25 235P FISHERS IS NY 631788 7251 1 0.30+ .00 70.10-01 135P DEEP RIVER CT 860526-8082 0 0:30+ .00 19. 9-25 243P FISHERS IS NY 631788-7001 1 050+ .00 71.10-01 147P POUGHKEPSI NY 845485-4033 1 247+ .00 20. 9-25 345P ALBUOURGUE NM 505293-2669 1 045+ 00 72.10-01 156P WASHINGTON DC 202372-1563 1 0:30+ 00 21. 9-25 403P FISHERS IS NY 631 788-7345 1 238+ .00 73.10-01 200P ALEXANDRIA VA 703313-5800 1 128+ .00 22. 9-25 416P FISHERS IS NY 631788-7345 1 1.11+ .00 74.10-01 203P WASHINGTON DC 202372-1563 1 0:30+ .00 23. 9-25 505P ALBUOUROUE NM 505293-2889 2 0:34+ 00 75.10-01 219P NEWHAVEN CT 203468-4510 D 0:30+ .00 24, 9-26 837A FISHERS IS NY 631788-7345 1 230+ .00 76.10-01 231P NEWHAVEN CT 203468-4596 0 237+ .00 25. 9-26 842A FISHERS IS NY 631 788-7225 1 123+ .00 77.10-01 309P FISHERS IS NY 631788-7463 1 4:29+ .00 26. 9-26 912A FISHERS IS NY 631788-7921 1 0.35+ .00 78.10-01 420P FISHERS IS NY 631 788-7345 1 0:30+ .00 27. 9-26 933A BROOKLINE MA 617735-9325 1 349+ 00 79.10-01 420P FISHERS IS NY 631 788-7463 1 653+ .00 28. 9-261001A PROVIDENCE RI 401277-7472 1 030+ .00 80.10-02 820A HARTFORD CT 860883-2647 D 030+ .00 29. 9-26 1018A FISHERS IS NY 631 788-7345 1 030+ .00 81.10-02 922A FISHERS IS NY 631 788-5550 1 2:07+ 00 30. 9-26 1026A POUGHKEPSI NY 845485-4033 1 0'.30+ .00 82.10-02 943A FISHERS IS NY 631 788-7632 1 1:36+ .00 31. 9-261122A POUGHKEPSI NY 845485-4033 1 1:05+ 00 83.10-021025A FISHERS IS NY 631788-7463 1 0:30+ .00 32. 9-26 1133A PROVIDENCE RI 401277-7069 1 050+ 00 84.10-02 1027A FISHERS IS NY 631 788-7345 1 0:40+ .00 33. 9-26 1135A FISHERS IS NY 631 788-7345 1 0:30+ .00 85.10-02 1041A FISHERS IS NY 631788-7345 1 058+ .00 34. 9-261140A DESPLAINES IL 847299-1188 1 358+ .00 86.10-02 1102A FISHERS IS NY 631788-7311 1 146+ .00 35. 9-26 118P FISHERS IS NY 631 788-7919 1 6:10+ 00 BIT 10-02 1106A FISHERS IS NY 631 788-7463 1 049+ .00 36. 9-26 257P MOODUS CT 860873-1946 0 035+ .00 88.10-02 114P FISHERS IS NY 631788-7345 1 2:09+ 00 37, 9-26 259P FISHERS IS NY 631788-7632 1 211+ .00 89.10-02 124P POUGHKEPSI NY 845485-4033 1 1:05+ .00 38. 9-26 318P FISHERS IS NY 631 788-7345 1 0:30+ .00 90.10-02 153P POUGHKEPSI NY 845485-4033 1 0:34+ .00 39. 9-26 507P FISHERS IS NY 631 788-7463 2 202+ .00 91.10-02 218P FISHERS IS NY 631788 7345 1 0:30+ .00 40. 9-27 727A FISHERS IS NY 631788-7345 2 100+ 00 92.10-02 226P FISHERS IS NY 631 788-7455 1 030+ .00 41. 9-27 748A BROOKLYN NY 718628-8900 2 0:30+ .00 93.10-02 311P FISHERS IS NY 631788-7345 1 030+ .00 42. 9-27 755A LINDENHST NY 631 225-3060 2 0:39+ .00 94.10-02 311P FISHERS IS NY 631788-7463 1 056+ .00 41 9-27 825A POUGHKEPSI NY 845485-4033 1 115+ .00 95.10-02 349P WILLIMNTIC CT 860377-0789 D 0:47+ .00 44. 9-27 922A LINDENHST NY 631225-3060 1 0:30+ 00 96.10-02 804P WINDSORLKS CT 860668-0044 E 353+ .00 45. 9-27 923A BROOKLYN NY 718628-89W 1 1:03+ .00 91.10-03 722A FISHERS IS NY 631 788-7345 2 0:48+ .00 46. 9-27 1O01A LINDENHST NY 631 225-3060 1 1:12+ .00 98.10-03 732A FISHERS IS NY 631 788-7345 2 14:43+ .00 47. 9-27 1014A FISHERS IS NY 631788-5563 1 030+ .00 99.10-03 751A FISHERS IS NY 631 788-7345 2 8:37+ .00 48. 9-27 1014A FISHERS IS NY 631 788-5546 1 2:43+ 00 100.10-03 819A FISHERS IS NY 631788-7345 1 17:51+ .00 49. 9-27 1038A FISHERS IS NY 631 788-7345 1 041+ .00 101.10-03 853A PROVIDENCE RI 401 575-7689 1 0:54+ .00 102.10-03 1017A FISHERS IS NY 631788 7463 1 5:05+ .00 FISHERS ISLAND FERRY DISTRICT Page 4 of 7 PO BaXH Account Number 660442-01-65076 at&t FISHERS ISLE NY 063900607 Billing Date Oct 15, 2013 Plans and Services Call Charges - Continued Rein No. Date Time Place Number Code Ain Call Charges - Continued 50.10-10 940A NEWHAVEN CT 203799-2679 D 030+ .00 Item 51.10-10 941A NEW HAVEN CT 203795-5939 D 2:28+ .00 No. Date Time Lace Number Code Min 52.10-10 1011A FISHERS IS NY 631166-7144 1 1:51+ .00 1.10-03 1030A FISHERS IS NY 631 788-7345 1 0:55+ .00 53.10-10 1014A FISHERS IS NY 631786-7345 1 145+ .00 2. 10-03 1203P FISHERS IS NY 631 788-7455 1 030+ .00 54.10-10 1020A FISHERS IS NY 631 788-7345 1 0:33+ .00 3.10-03 108P PROVIDENCE RI 401177-7069 1 042+ .00 55.10-10 1033A FISHERS IS NY 631788-7463 1 2:12+ .00 4.10-03 317P FISHERS IS NY 631788-7463 1 2:00+ .00 56.10-101036A PLAINVILLE CT 860351-0100 0 2:09+ .00 5.10-03 328P POUGHKEPSI NY 845485-4033 1 0:51+ .00 57.10-10 213P FISHERS IS NY 631788-7345 1 8:12+ .00 6.10-03 330P FISHERS IS NY 631788-7251 1 0:50+ .00 58.10-10 319P FISHERS IS NY 631 7BB-7345 1 0:34+ .00 7.10-03 339P FISHERS IS NY 631788-7345 1 0:35+ .00 59.10-10 321P MIDDLETOWN CT 860347-2189 D 0:30+ .00 8.10-04 849A FISHERS IS NY 631788-7345 1 302+ .00 60.10-10 352P FISHERS IS NY 631 788-7345 1 2:51+ .00 9.10-04 931A ROANOKE VA 540520-6277 1 2:06+ .00 61.10-11 855A HARTFORD CT 860289-8433 0 3:34+ .00 10.10-041027A NEW YORK NY 917620-7814 1 044+ .00 62.10-11 928A LINOENHST NY 631225-3060 1 4:20+ .00 11.10-041135A MANSFIELD OF 419755-1011 1 342+ .00 6110-11 937A BEVERLY MA 978927-8098 1 0:30+ .00 11.10-04 130P FISHERS IS NY 631 788-7345 1 0:30+ .00 64.10-11 937A WALPOLE MA 508641-8611 1 2651+ .00 13.10-04 132P FISHERS IS NY 631 788-5655 1 0:35+ .00 65.10-11 1020A FISHERS IS NY 631 788-7345 1 0:30+ .00 14.10-04 142P FISHERS IS NY 631 788-7433 1 0:30+ .00 66.10-11 1037A HARTFORD CT 860666-0555 D 312+ .00 15.10-04 325P CHELSEA MA 617270-8238 1 0:30+ .00 67.10-11 1053A HARTFORD CT 860666-0555 D 538+ .00 16.10-07 803A WATERBURY CT 203754-5334 D 030+ .00 68.10-11 1059A TRUMBULL CT 203268-8688 D 1:17+ .00 17.10-07 933A POUGHKEPSI NY 845485-4033 1 3:03+ .00 69.10-111104A FISHERS IS NY 631788-7345 1 344+ .00 18.10-07 937A FISHERS IS NY 631 788-7744 1 0:30+ .00 70.10-11 1151A FISHERS IS NY 631788-7919 1 1:13+ .00 19.10-07 938A FISHERS IS NY 631 788-7744 1 108+ .00 71.10-11 1200P FISHERS IS NY 631 788-7463 1 4:45+ .00 20.10-07 1214P FISHERS IS NY 631788-7345 1 1:45+ .00 72.10-11 1205P FISHERS IS NY 631 788-7345 1 18:43+ .00 21.10-07 139P FISHERS IS NY 631788-7345 1 036+ .00 73.10-11 1240P FISHERS IS NY 631 7BB-7744 1 0:53+ .00 22.10-07 213P FISHERS IS NY 631768-7345 1 0:41+ .00 74.10-11 1245P WINDSORLKS CT 860668-0044 D 3:44+ .00 2110-07 219P FISHERS IS NY 631788-7345 1 0:30+ .00 75.10-11 129P NEW YORK NY 917319-3024 1 0:43+ .00 24.10-07 302P FISHERS IS NY 631 788-5550 1 1:02+ .00 76.10-11 138P FISHERS IS NY 631 788-7345 1 0:30+ .00 25.10-07 536P NEWYORK NY 917686-0201 2 0:33+ .00 77.10-11 241P FISHERS IS NY 631788-7345 1 0:39+ .00 26.10-08 713A BRIDGEPORT CT 203556-2964 N 0:36+ .00 78.10-11 254P HARTFORD CT 860666-0555 D 1:53+ .00 27.10-08 742A FISHERS IS NY 631 788-5673 2 030+ .00 79.10-11 302P FISHERS IS NY 631 788-7345 1 0:30+ .00 28.10-08 924A KILLINGWTH CT 860663-3005 D 0:30+ .170 80.10-11 350P FISHERS IS NY 631788-7345 1 042+ .00 29.10-081029A LINDENHST NY 631225-3060 1 123+ .00 OF 10-11 714P PROVIDENCE RI 401339-9566 2 0:48+ DO 30.10-08 1207P FISHERS IS NY 631 788-7463 1 326+ .00 82.10-12 955A FISHERS IS NY 631 788-5550 2 547+ .00 31.10-08 149P FISHERS IS NY 631 788-7019 1 0:30+ .00 83.10-14 857A OLD SAYBRK CT 860391-1444 D 100+ .00 32.10-08 150P FISHERS IS NY 631 786-7345 1 0:44+ .00 84.10-14 935A FISHERS IS NY 631 788-7857 1 059+ .00 33.10-08 151P FISHERS IS NY 631 788-7001 1 1:35+ .00 85.10-14 632P FISHERS IS NY 631768-7742 2 030+ .00 34.10-08 332P MCLEAN VA 703893-9533 1 1:52+ .00 Total Itemized Calls .00 35.10-08 345P FISHERS IS NY 631768-7463 1 1:44+ .00 Total Charges for 860442-0165 .00 36.10-09 934A WHARTFORD CT 860335-7502 D 4:51+ .00 37.10-091117A MCLEAN VA 703893-9533 1 3:21+ ,00 Charges for 860443-6851 38.10-091153A FISHERS IS NY 631788-7345 1 0:30+ ,00 Itemized Calls 39.10-09 1231P MIDDLETOWN CT 860632-7338 D 2:48+ DO 86. 9-16 1121A FISHERS IS NY 631 788-5522 1 1:09+ .00 40.10-09 1245P MIDDLETOWN CT 860347-2189 D 0:45+ .00 87. 9-161130A FISHERS IS NY 631788-5522 1 030+ .00 41.10-09 1259P NEWPORT RI 401 841-3670 1 6:36+ .00 88. 9-17 1035A FISHERS IS NY 631 788-5522 1 1:20+ .00 42.10-09 136P FISHERS IS NY 631788-5673 1 037+ .00 89. 9-I7 1129A FISHERS IS NY 631 788-5522 1 0:30+ .00 43.10-09 235P BRIDGEPORT CT 203556-2964 D 0:30+ .00 90. 9-17 312P FISHERS IS NY 631788-5512 1 030+ .00 44.10-09 244P FISHERS IS NY 631788-7463 1 2:21+ .00 91. 9-18 635A FISHERS IS NY 631 788-5522 2 0:30+ .00 45.10-10 840A FISHERS IS NY 631 788-7345 1 030+ OD 92. 8-18 1016A FISHERS IS NY 631788-5522 1 116+ .00 46.10-10 855A FISHERS IS NY 631788-7919 1 0:44+ ,00 93. 9-18 256P FISHERS IS NY 631788-5522 1 0:30+ .00 47.10-10 917A BRIDGEPORT CT 203556-2%4 D 030+ .00 94. 9-191105A FISHERS IS NY 631788-5522 1 139+ .00 48.10-10 921A BRIDGEPORT CT 203556-2964 D 0:38+ .00 95. 9-19 255P FISHERS IS NY 631788-5522 1 1:52+ .00 49.10-10 932A BRIDGEPORT CT 203556-2964 D 0:49+ .00 96. 9-19 306P FISHERS IS NY 631788-5522 1 038+ .00 97. 9-19 314P FISHERS IS NY 631788-5522 1 0:32+ .00 3243.006.063005.02.04.0000000 NNNNNNNY 48217.81453 FISHERS ISLAND FERRY DISTRICT Page 5 of 7 PO BOXH Account Number 860 442-0165 078 at&1 \ FISHERS ISLE NY 063900607 Billing Date Oct 15, 2013 Plans and Services Call Chafes - Continued- Continued L -A Item No. Date Time Place Number Code Miri Call Charges - Continued 50.10-05 206P FISHERS IS NY 631788-5522 2 030+ .00 Item 51, 10-07 1043A FISHERS IS NY 631 788-5522 1 111+ .00 No. Date Time Place Number Code mill 52.10-07 310P FISHERS IS NY 631788-5522 1 0:30+ .00 -1--i-19 318P FISHERS IS NY 631 788-5522 1 0:51+ .00 53.10.08 1026A FISHERS IS NY 631 788-5522 1 031+ .00 2. 9-20 955A FISHERS IS NY 631 788-5522 1 0:36+ .00 54.10-08 1201P FISHERS IS NY 631 788-5523 1 0:30+ .00 3. 9-20 1016A FISHERS IS NY 631 788-5522 1 108+ .00 55.10-08 1208P FISHERS IS NY 631788-5522 1 0:52+ .00 4. 9-20 308P FISHERS IS NY 631 788-5522 1 0:48+ .00 56.10-08 251P FISHERS IS NY 631788-5522 1 0:42+ .00 5. 9-21 146P FISHERS IS NY 631 788-5522 2 0:34+ .00 57.10-09 1004A FISHERS IS NY 631786-5522 1 0:32+ .00 6. 9-23 925A FISHERS IS NY 631788-5522 1 0:35+ .00 58.10-09 1048A FISHERS IS NY 631 788-5522 1 0:54+ .00 Z 9-23 1110A FISHERS IS NY 631 788-5522 1 041+ .00 59.10-09 315P FISHERS IS NY 631788-5522 1 0:30+ .00 B. 9-23 303P FISHERS IS NY 631 788-5522 1 033+ .00 60.10-09 325P FISHERS IS NY 631788-5522 1 030+ .00 9. 9-24 1044A FISHERS IS NY 631788-5522 1 1:21+ .00 61.10-10 1021A FISHERS IS NY 631788-5522 1 0:36+ .00 10. 9-24 305P FISHERS IS NY 631 788-5522 1 030+ .00 62.10-10 I110A FISHERS IS NY 631 788-5522 1 1:01+ .00 11. 9-25 730A FISHERS IS NY 631 788-5522 2 030+ .00 63.10-10 204P FISHERS IS NY 631 788-5522 1 031+ .00 12. 9-25 1116A FISHERS IS NY 631 788-5522 1 1:07+ .00 64.10-10 311P FISHERS IS NY 631 788-5522 1 0:31+ DO 13. 9-25 312P FISHERS IS NY 631788.5522 1 030+ .00 65.10-10 313P BLOOMFIELD CT 060331-8348 D 0:30+ .00 14. 9-26 1021A FISHERS IS NY 631 788-5522 1 0:36+ .00 66.10-11 1105A FISHERS IS NY 631 788-5522 1 1:13+ .00 15. 9-26 IIODA FISHERS IS NY 631 788-5522 1 032+ .00 67.10-11 322P FISHERS IS NY 631 788-5522 1 0:32+ 00 16. 9-26 1122A FISHERS IS NY 631 788-5522 1 053+ 00 Total Itemized Calls .00 11. 9-26 242P FISHERS IS NY 631 788-5522 1 143+ .00 Total Charges for 660443-6851 00 18. 9-26 247P FISHERS IS NY 631 788-5522 1 032+ 00 19. 9-271059A BOSTON MA 617723-7400 1 030+ .00 Chargesfor060444-0320 20. 9-27 1101A BOSTON MA 611123-7400 1 0:30+ 00 Itemized Calls 21. 9-271105A BOSTON MA 617723-7400 1 0:30+ 00 68. 9-17 1150A EPROVIDNCE RI 401228-0183 1 118+ .00 22. 9-271107A BOSTON MA 617723-4200 1 0:30+ DO 69. 9-17 246P EPROVIDNCE RI 401228-0183 1 1:19+ .00 23. 9-271108A BOSTON MA 617723-7400 1 030+ .00 70. 9-19 346P NEWBRITAIN CT 860229-5091 D 030+ .00 24. 9-2711IOA BOSTON MA 617723-4200 1 036+ Do 71. 8-24 938A EPROVIDNCE RI 401228-0183 1 1:07+ .00 25. 9-271112A BOSTON MA 617723-4200 1 0:38+ .00 72.10-091030A LINDENHST NY 631225-3064 1 0:35+ .00 26. 9-27 1114A FISHERS IS NY 631 788-5522 1 108+ DO 73.10-09 1036A LINDENHST NY 631 225-3064 1 042+ .00 27. 9-27 306P FISHERS IS NY 631788-5522 1 030+ 00 74.10-11 945A BEVERLY MA 978927-5388 1 0:30+ .00 2B. 9-28 128P FISHERS IS NY 631 788-5522 2 031+ .00 75.10-11 949A BEVERLY MA 978927-5388 1 030+ .00 29. 9-30 926A FISHERS IS NY 631 788-5522 1 031+ .00 76.10-11 1042A BEVERLY MA 978927-5388 1 0:37+ .00 30. 9-30 1057A FISHERS IS NY 631 788-5522 1 0:54+ ,00 Total Itemized Calls .00 31. 9-30 313P FISHERS IS NY 631788-5522 1 030+ .00 Total Charges for 860444-0320 00 32.10-011106A FISHERS IS NY 631788-5522 1 032+ .00 Chargesfor060447-%71 33.10-011119A FISHERS IS NY 631788-5522 1 0:54+ .00 Itemized Calls 34.10-01 213P FISHERS IS NY 631788-5682 1 0:32+ .00 77. 9-161102A NWYRCYZN01 NY 212327-1144 1 0:30+ .00 35.10-01 214P FISHERS IS NY 631 788-5523 1 0:59+ .00 78. 9-16 123P FISHERS IS NY 631788-7224 1 1:21+ .00 36.10-01 253P FISHERS IS NY 631 788-5522 1 0:30+ .00 79. 9-16 144P FISHERS IS NY 631788-7224 1 0:30+ .00 37.10-01 313P FISHERS IS NY 631788-5523 1 032+ .00 80. 9-16 144P GARDENCITY NY 516807-8732 1 1:18+ .00 38.10-021109A FISHERS IS NY 631788-5522 1 0:50+ .00 81. 9-16 207P DELMAR DE 302462-0222 1 1545+ .00 39.10-02 306P FISHERS IS NY 631 788-5522 1 0:30+ .00 82. 9-17 1224P FISHERS IS NY 631 788-7463 1 0:30+ .00 40.10-03 709A FISHERS IS NY 631788-5522 2 0:30+ .00 83. 9-17 1225P CHESHIRE CT 203272.3077 D 208+ .00 41.10-03 1116A FISHERS IS NY 631 788-5522 1 1:11+ .00 84. 9-17 1232P NWYRCYZN01 NY 212873-1965 1 526+ .00 42.10-03 223P FISHERS IS NY 631 788-5522 1 0:30+ .00 85. 9-17 1244P FISHERS IS NY 631 788-7857 1 211+ .00 43.10-03 246P FISHERS IS NY 631 788-5522 1 0:30+ .00 86. 9-17 202P OLD SAYBRK CT 860227-1925 D 5:06+ .00 44.10-03 258P FISHERS IS NY 631788-5522 1 031+ .00 87. 9-17 255P NWYRCYZN01 NY 212327-1144 1 1:31+ .00 45.10-04 652A FISHERS IS NY 631788-5522 2 0:30+ .00 88. 9-18 929A FISHERS IS NY 631 788-5550 1 010+ 00 46.10-04 848A FISHERS IS NY 631788-5523 1 030+ .00 89. 9-18 931A JEWETTCITY CT 860376-4277 D 2:24+ .00 47.10-04 1104A FISHERS IS NY 631788-5522 1 110+ .00 90. 9-18 1055A FISHERS IS NY 631788-5550 1 1:40+ .00 48.10-04 310P FISHERS IS NY 631788-5522 1 0:33+ .00 91. 9-18 1133A FISHERS IS NY 631 788-7345 1 133+ 00 49.10-05 1052A FISHERS IS NY 631 768-5522 2 0.41+ .00 92. 9-18 250P FISHERS IS NY 631 788-7345 1 0.30+ 00 i FISHERS ISLAND FERRY DISTRICT Page 6 of 7 at&t PO BOX IT Account Number 660442-0165078 FISHERS ISLE NY 06390-0607 Billing Date Date Oct 15, 2013 Plans and Services 7 Call Cherries - Continued Item No. Date Time Place Number Code Min Call Charges - Continued 50.10-10 942A WATERBURY CT 203754-5334 D 1:34+ .38 Item 51,10-10 955A FISHERS IS NY 631 788-7663 1 106+ .05 No. Date Time Place Number Code Min 52.10-10 IOOOA FISHERS IS NY 631188-7744 1 6:55+ .35 1. 9-18 451P HOPKINTON MA 508294-5556 1 1:10+ .00 53.10-10 1036A FISHERS IS NY 631788-7345 1 0:30+ .02 2. 9-20 835A SIMSBURY CT 860653-5095 D 338+ .00 54.10-101201P FISHERS IS NY 631788-7744 1 2:38+ .13 3. 9-20 928A ALLENTOWN NJ 609259-8900 1 1:19+ .00 55.10-10 418P FISHERS IS NY 631788-7345 1 0:30+ .02 4. 9-20 1MA FISHERS IS NY 631788-7345 1 153+ .00 56.10-11 117P FISHERS IS NY 631 788-7036 1 228+ .12 5. 9-20 345P FISHERS IS NY 631788-5550 1 1:18+ .00 57.10-14 926A HARTFORD CT 860594-4816 D 055+ .05 6. 9-23 950A NEWPORT RI 401841-3042 1 1:55+ .00 58.10-14 931A MORRISTOWN NJ 973214-1506 1 0:37+ .03 7. 9-23 1243P FISHERS IS NY 631 788-7562 1 1:03+ .00 Total Itemized Calls 2.40 8. 9-23 116P WILMINGTON DE 302530-7009 1 6:05+ DO Total Charges for 860447-9371 2.40 9. 9-23 149P FISHERS IS NY 631 788-7345 1 0:30+ .00 + - Optional Calling Plan 10. 9-23 254P FISHERS IS NY 631 788-7632 1 0:58+ .00 11. 9-23 256P FISHERS IS NY 631788-7463 1 0:30+ .00 Keyto Calling Codes 12. 9-24 242P DANBURY CT 203948-4226 D 0:30+ .00 1 Peak 2 Off Peak D Day 13. 9.24 243P FISHERS IS NY 631 788-7433 1 0:30+ .00 E Evening N Night(Weekend 14. 9-24 243P FISHERS IS NY 631788 7463 1 0:30+ .00 15. 9-25 1023A FISHERS IS NY 631 788-7487 1 3:02+ .00 Total Call Charges 37.40 16. 9-25 236P FISHERS IS NY 631 788-7001 1 4:08+ .00 17. 9-26 900A WESTPORT CT 203226-3010 D 0:30+ .00 Surcharges and Other Fees 18. 9-26 1124A FISHERS IS NY 631 788-7255 1 1:39+ .00 AT&T Connecticut 19. 9-261136A POUGHKEPSI NY 845485-4033 1 0:30+ .00 59. Connecticut E 9-1-1 Surcharge -4Lines 1.6B 20. 9-30 845A MTVIEW CA 650210-5182 1 144+ .00 60. Connecticut Service Fund -4Lines .20 21. 9-301257P WESTPORT CT 203226-3010 D 3:59+ .00 61. Universal Service Fund -LocaR4®51.26) 5.04 22. 9-30 202P REDWOOD CY CA 650454-6667 1 0:49+ .00 62. Federal Subscriber Line Charge -4Lines 24.44 23. 9-30 251P FISHERS IS NY 631 788-7463 1 21:40+ .00 Total AT&T Connecticut 31.36 24.10-01 941A FISHERS IS NY 631 788-5522 1 0:30+ .00 25.10-01 1252P FISHERS IS NY 631 7BB-5550 1 0:41+ .00 AT&T ED East 26.10-01 149P WASHINGTON OC 202372-1563 1 0:30+ .00 63. Federal Regulatory Fee .37 27.10-02 855A WESTPORT CT 203 226-3010 D 0:30+ .00 64. Universal Service Fund - Interstate 2.80 28.10-02 855A SIMSBURY CT 860653-5095 D 253+ 00 Total AT&T Long Distance East 311 29.10-02 1233P FISHERS IS NY 631 788-7857 1 220+ .00 Total Surcharges and Other Fees 34.53 30.10-02 118P FISHERS IS NY 631 788-7345 1 1:00+ .00 31.10-02 320P FISHERS IS NY 631 788-7345 1 2:32+ .07 Taxes 32.10-03 115P FISHERS IS NY 631 788-7345 1 1:04+ .05 65. Federal 3.48 33.10-03 315P POUGHKEPSI NY 845485-4033 1 039+ .03 66. State Sales Tax 12.13 34.10-03 316P HONEOYEFLS NY 585624-9390 1 219+ .12 Total Taxes 15.61 35.10-03 332P FISHERS IS NY 631 788-7422 1 0:43+ .04 36.10-04 933A FISHERS IS NY 631 788-7345 1 2:44+ .14 Total Plans and Services 268.19 37.10-041025A NEW YORK NY 917620-7814 1 0:30+ .02 38.10-04 140P POUGHKEPSI NY 845656-1677 1 0:30+ .02 39.10-05 607P FISHERS IS NY 631 788-7402 2 0:30+ .02 40.10-07 1013A SIMSBURY CT 860653-5095 0 2:42+ .13 News You Can Use 41.10-081038A BRIDGEPORT CT 203556-2964 0 0:32+ .03 42.10-08 1130A FISHERS IS NY 631 788-7345 1 1:35+ .08 43.10-08 246P FISHERS IS NY 631788-7345 1 0:58+ .05 PREVENT DISCONNECT 44.10-08 327P GARDENCITY NY 516790-5813 1 0:51+ .04 Ryour bill shows a pastdue amount BOTH the Past Due amomnand 45.10-09 1148A BOSTON MA 617 723-2292 1 0:30+ .02 Current Charges are due IMMEDIATELY. All of your bill charges must be 46.10-09 118P FISHERS IS NY 631788-7463 1 030+ .02 paid each month to keep your accountcurrent and avoid collection 47.10-09 146P FISHERS IS NY 631 788-7463 1 0:30+ .02 activities (See Terms and Conditions for further information). However, 48.10-09 147P FISHERS IS NY 631 788-7463 1 0:30+ .02 to avoid disconnection of local service, Basic Charges MUST be paid. For 49.10-09 148P NEWPORT RI 401841-3670 1 632+ .33 this account that amountis: 5152.41 for Current Basic Charges $154.06 for Past Due Basic Charges 3243.006.063005.03.04.0000000 NNNNNNNY 48219.81455 FISHERS ISLAND FERRY DISTRICT Page 7 of 7 \ I A PO BOXH Account Number 860 442-0165 078 t &t FISHERS ISLE NY 06990-0607 Billing Date Oct 15, 2013 U News ' NON-BASIC CHARGES Non-Basic Charges are charges for Non-Basic Services. These charges include: Call Charges for outof state calls, 900 calls and calls placed CARRIER INFO through alternative services providers; Call Charges for in state long Our records indicate that AT&T Connecticut is your carrier for instate distance provided by a company other than AT&T Connecticut out of state calls. AT&T Long Distance Eastis your carrier for interstate and Directory Assistance Charges; charges fortelephone equipment and inside international calls, wire maintenance, AT&T Voice Mail, AT&T Unified Messaging, AT&T High KEEP YOUR DISCOUNT Speed Internet Wireless, AT&T I DISH Network, AT&T I DIRECTV, You receive any discounts, reduced rates, or promotional credits de- Advertising in the white page directories or other media; and the scribed in the AT&T Benefits section of tlfie bill because you subscribe Universal Service Fund - Interstate fee. to certain required services, for example, because you are an CHARGES THAT MAY BE BASIC OR NON-BASIC ALL DISTANCE@ customer. If you remove any of the services required for a Certain charges may be either Basic or Non-Basic, depending on the particular discomfit reduced rate, or promotional credit, your associated service. These include taxes, Late Payment Charges, effective rate for the associated remaining service will change. Please Collection Charges, and Additions and Changes to your service. call your AT&T service representative if you have any questions. BILL PAYMENT, LATE PAYMENT CHARGES AND OTHER FEES UNIVERSAL SVC FEE Failure to pay any portion of your bill may result in additional collection action. Any partial payment made will first be applied to The Federal Universal Service Fee increased on 10/1/2013. This fee Basic Charges, then to Non-Basic Charges. Failure to pay your Basic supports telecommunication needs of low-income households, consumers Charges will resultin interruption of your local service. If you fail living in high-cost areas, schools, libraries and rural hospitals. Your to pay your Non-Basic Charges, your AT&T Connecticutlocal service will current bill reflects the change. For more information, please contact not be interrupted, but all of your Non-Basic services will be an AT&T Service Representative at the phone number listed on the front terminated. AT&T Connecticut may apply a late payment charge per month of your bill. on any unpaid balance, excluding the previously assessed late payment CHANGE IN TERMS charges. To avoid a late charge, we mustreceive payment for die total Effective 11/12/2013, AT&T Long Distance Toll Free Service Optional Call amount due no later than die date specified on your bill statement. AT&T Routing features will no longer be available to new Customers or to Connecticut will apply a 520.00 Collection Charge on an accountwhere a existing customers at new locations or on new toll free numbers. termination notice has been sent. An explanation of these charges may be Existing customers may retain die call routing arrangement butmoves, obtained by calling AT&T Connecticut at the number shown on your bill or adds or changes will not be permitted. For more information, please accessing our website: http://www.attcom/etbillglossary contact us at the number on die front of your bill or visitour website AT&T SERVICES atwww. att.com. Thank you for choosing AT&T Long Distance East. Local and in state long distance services, inside wire, rental sets, and CENTRALINK 1100 voice (nail services (except where shown as provided by AT&T Messaging) are provided by AT&T Connecticut. Out of state long distance is provided Effective 12/1/2013, the Month to Month prices in lie tariff for by AT&T Long Distance East. Internet services are provided by AT&T Central-ink 1100 services will increase by 510,00 per line. Central-ink Internet Services. Wireless services are provided by AT&T Mobility. 1100 customers under term plans will not be affected until their term plan expires. If you have any questions or wish to consider ogler price plans for your business, please contact your AT&T account executive or call AT&T atthe toll-free number on your bill. F_ Terms and Conditions k -A BASIC CHARGES Basic Charges are charges for Basic Services. Basic Services include local service and in-state toll if you are an AT&T Connecticut local service customer. Basic Charges include: Monthly Charges for your local line and other services, such as Totalphone and Smardink; in-state Calling Charges; in-state Directory Assistance Charges; tie Connecticut E-911 Surcharge; the Connecticut Service Fund fee; the Federal Subscriber Line Charge; and the Universal Service Fund - Local fee. 3243.006.063005.04.04.0000000 NNNNNNNY 48221.61457 FISHERS ISLAND FERRY DISTRICT VENDOR 002776 CHARLES BURGESS 11/19/2013 CHECK 1538 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 080113 PRESCRIPT ARREARS-8/13 90.63 SM .9060.8.000.000 090113 PRESCRIPT ARREARS-9/13 90.63 SM .9060.8.000.000 100113 PRESCRIPT ARREARS-10/13 90.63 SM .9060.8.000.000 110113 PRESCRIPT ARREARS-11/13 90.63 SM .9060.8.000.000 5324402871 4TH QTR 2013 REIMB. 436.94 TOTAL 799.46 w Ile, , ftw q** 9v 4 a m: • • f; 3 y. ...gyn.: _ ,,.ai _tle._... rv ~µy i?" THE .v' ? miV ~ ~~Jt^• viR... „f~ u:?r~i v^S`.... ORIGINAL COLORED BACKGROUND. A VOID COPY FEATURE ADD WATERMARK PAPER 211 o ° `x ^sy+" gel va i r °a a .eP 4v ova ~c.w vv@x` "n- "W,\ v m k~ ,04 a~ ~ Y„ a a mYe Jil v i"i ~ pol I a as ~ 9 dA3#" S Zr *uRS `~O~°" Offer Iroo 5 3h p• 1:0 2 i4054641: 58 OD i 5C7 2 1 ~i• Vendor No. Check No. Town of Southold, New York - Payment Voucher 2776 Vendor Tax ID Number or Social Security Number Vendor Address Entered by 4 Hamel Court Waterford, CT 06385 Audit Date Burgess, Charles 1' f Vendor Telephone Number NO V 19 2013 To Clerk Vendor Contact t~C Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number pg O l I' (e--u Arrears- 8 / 3 60280329901 8/1/2013 $90.63 $90.63 Anthem Retiree SM9060.8.000.000 NO I I 3 9/1/2013 $90.63 ' $90.63 Prescription Plan 9/13 7j 10/1/2013 $90.63 $90.63 90% Reimbursement f/)/ 11/1/2013 $90.63 $90.63 $100.70 less 10% ($90.63) 'f / Charles Burgess Ck#'s 3180,3185,3194,3202 Reimbursement of payments 5324402871 10/1/2013 $436.94 $436.94 Anthem BC/BS SM9060.8.000.000 Retiree Stand Alone 90% Rei bu $486.49 less $48.55 Charles Burgess Ck#3196 Quarterly 10/1/13.12}1,31113 $799.46 $799.46 y`th AC(,j 1`el~b_ Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved Signature - Title A - \ Signature c:~~ Company Name /e Date l Title - Date Anthem*V Customer Cara 1-888-620-1747 MW Macff""P) AT 01 042414 83121B140 A**306T CHARLES W BURGESS Payments received after 7/2 will appear on 4 HAMEL CT your next invoice. WATERFORD CT 06385-2008 $100.70 08/01/2013 G0230329901 Payment For check payment or automatic withdrawal from your bank account (ACH), use the form below. - For credit card payment or withholding from your SSA/RRB check, call 1-888-620-1747. - For one time credit card payment through our automated system, call 1-877-358-6M. Previous Balance $100.70 Payment Aedvky Siuoe Last Invoice -$100.70 - Pkyment Tvce Date Received Amount = Check Payment 00003173 06/28/2013 -$100.70 Activity Detail $100.70 Transaction Tvoe Premium Month Amount Premium AUGUST 2013 $100.70 Amoo*)We $100.70 - Please retain the top portion for yeurrasords BILLING FOR: CHARLES W BURGESS DUE DATE: 08/01/2013 CT I01 ° 602303299 $100.70 Please include your Payment ID on your check or money order. Do mot send east. ElIf yea wooid we to chow your payment to automatic withdrawal from your hank Blue MedicareRx - CT ~Fpomnt (ACHE ph ow check this box, P.O. Box 505171 endow yoer creek paymenit, and we the St Louis, MO 63150-5171 reverse side- v/ 51-7011/2111 318 0 KAREN C. BURGESS CHARLES W. BURGESS 4 HAMEL CT. OwlE/ as 3 WATERFORD, CT 0066985-2008 PAY TO ORDER O AJ4..~~ $/00 A rT_ Cl Citizens Bank• MEMO ~ ~ 2 i i 170 1 14~: 3180 S.~ ~IanD Qe :II It#edicar>etRlt~"Pt (POP) Anthemoij Customer Care: 1-888-620-1747 Blue MedicareRx°(PDP) AT 01 042328 967898140 A••3DGT IIIIr-III 1Ill. 11u1111PI-TIII11111uuP11I1r1 -III 1III Ih1 CHARLES W BURGESS Payments received after 8/5 will appear on 4 HAMEL CT your next invoice. WATERFORD CT 06385-2008 A 4OUNT 51-7011/2111 3185 $100.70 KAREN C. BURGESS ° CHARLES W. BURGESS-~3 4 HAMEL CT. Payment Options WATERFORD, CT 06305-2008 • For check paymer j $ l d b 7 ~8~ PAY TO TH€'/JP 07~~7 ~QPC For credit card pal ORDER OF 7h 0 oouARS 4 T j For onetime credi 4CitizensBank• Previous Balance Payment Activity Sinn MEM_ 3185 Payment Type 1: 21100 11'.': Check Payment 000( _ -$100.70 Activity Detail $100.70 Transaction Type Premium Month Amount Premium SEPTEMBER 2013 $100.70 Amount Due $100.70 Please retain the top portion for your records BILLING FOR: CHARLES W BURGESS DUE DATE: 09/01/2013 CT 101 PxXl~1V`l' IZ;t ; AMt4U1~1T;~YUI~° ' ' ~OU~T.~I~TA~~A 602303299 $100.70 /0 7 Please include your Payment ID on your check or money order. Do not send cash. ?If you would like to change your payment to automatic withdrawal from your bank Blue MedicareRx - CT account (ACH), please check this box, P.O. Box 505171 enclose your check payment, and see the St. Louis, MO 63150-5171 reverse side. ~nnn 7A1'1'1 •/n-J-J 1'1»CCTnI Al YIn7n7 :>P~ Anthem Customer Care: 1-888-620-1747 Blue MedicareRx°(PDP) AT 01 043013 092238145 A"3DGT Im6°udlhllh11i1111111^h11d1p11ppii1i1up1i CHARLES W BURGESS Payments received after 9/4 will appear on 4 HAMEL CT your next invoice. WATERFORD CT 06385-2008 A OOI** DM DIM DATE ~b $100.70 10/01/2013 G0230329901 Payment Options ° For check payment or automatic withdrawal from your bank account (ACH), use the form below. ° For credit card payment or withholding from your SSA/RRB check, call 1-888-620-1747. ° For . ,An 'ted system. call 1-877-358-6792. KAREN C. BURGESS 51-7011/2111 CHARLES W. BURGESS 3194 Previous 4 HAMEL CT. $100.70 WATERFORD, CT 063852008 "TE 13 Paymen 10 PAY RDER OHn Paten O 7 Chet 70 $ ©d 8 Activity C ~"P 0 DOLLARS 8 70 Ta° 101 Citizens Bank' Pren Amoun MEMO $100.70 1:211IMIi41: 3194 Please retain the top portion for your records BILLING FOR: CMARLES W BURGESS DUE DATE: 10/01/2013 CT 1101 PA 11lfC1l'P.ID " A1tiI0UNT>AUE AMOUNT G02303299 $100.70 Please include your Payment ID on your check or money order. Do not send cash. UIf you would like to change your payment to automatic withdrawal from your bank Blue MedicareRx - CT account (ACH), please check this bog, P.O. Box 505171 enclose your check payment, and see the St. Louis, MO 63150-5171 reverse side. ; #remle'r (IPDPj Anthem Customer Care: 1-888-620-1747 Blue MedicareRx'(PDP) AT 01 042951 235188142 A"3DGT Irru~•I^•n•ud•lu•II^~9dh•hq•dli~P•~9^hlii.p.~ CHARLES W BURGESS Payments received after 10/2 will appear on 4 HAMEL CT your next invoice. WATERFORD CT 06385-2008 ;A~T DUE DUE DATE 01 $100.70 11/01/2013 G02303299 Payment Options • For check n-- • s,-ronizn, 3202 v. For cn For on KAREN C. BURGESS C,.©a 3C 3-Q'7'? CHARLES W. BURGESS DATE 4 HAMEL CT. WATERFORD, CT 08385-2008 6/ C y/\~ Previous Bb PAV TO THE ` ( ORDER OF DOLLARS $10U.70 I 'I Payment A< zc~ Payment Check Pa Activity Der, Citizens Bank° Transactic I!~ 3202 Premium = $100.70 Please retain the top portion for your records BILLING FOR: CHARLES W BURGESS DUE DATE: 11/01/2013 CT 101 ° 1'ANAMNIT"ID F AMOUNTDIIE AIVi(}iF1+iT 181~Ci.O~ " 602303299 ?/00, 70 Please include your Payment ID on your check or money order. Do not send cash. ?U you would like to change your payment to automatic withdrawal from your bank Blue MedicareRx - CT account (ACI), please check this box, P.O. Box 505171 enclose your check payment, and see the St. Louis, MO 63150-5171 reverse side. nnnnnnnl Arn»njnam Tni n, nnnnn 100221 rev 0113 1of 1 Anthem. ~ 108 Leigus Road 03941 Wallingford, CT 06492 le Connectiwt, Anthem Blue Cmss and Blue Shhad is a smile name of Amhem Heaton Plans, Inc, a0 independent Ilumsee of the Blue C. and Blue Shied Association, RelZaanind masks of the Bone Cross and Blue Shield Assodauon. INDIVIDUAL MARKET INVOICE Is' '11.11•• II'II I'Id1"Ilh I 1 I 'di' 111 III 1'1'111 Si nl Casita ayuda an espaRol Para entender 09630/009452/012224 34 1 AGWOS 006 1 este documento, puede solicitana sin costo BCTBSA004RCT38 003941 090213 090313 adicional, llamando al n6mero de servicio at CHARLES N BURGESS cliente que aparece at dorso de su tarjeta 4 RA14EL CT de identificact6n o en el folleto de inscripci6n. WATERFORD CT 06385-2008 MEMBER NO: 08421"120101 MEMBER: CHARLES W BURGESS INVOICE NO: 5324402871 BILLING ACCT NO: 7010842920101 PRODUCT CLASS PERIOD COVERED AMOUNT MEDIGAP PLAN N,COPAY 520. 1 10/01/2013 - 12/31/21113 + 8485.49 KARENC.BURGESS 51-7011/2111 3196 CHARLES W. BURGESS 4 HAMEL CT. DATE e? -d5 / 3 WATERFORD, CT 06305-200088 ORDER THE? "1L`~ " $ Y~~ tJfi~ PAY TO OF C,8 TOTAL AMOI 5.49 If you have a 12 Citizens Bank" ,hue Shield, pleas AP through Fridl MEMO 1:2LLi701i4~: 3L96 001187943135030500400007010842920101100532440287109021300109500000485496 DETACH AND RETURN THIS PORTION WITH PAYMENT MAKE CHECK PAYABLE TO "ANTHEM BCBS" 009452/012225 AO0P05 ETM10005 4 2 CHARLES W BURGESS 7 4 HAMEL CT TOTAL AMOUNT DUE BY: WATERFORD, CT 06385-2008 OCTOBER 1, 2013 9 $485.49 5 MEMBER NUMBER: 0842M20101 INVOICE NUMBER: 5324402871 1 BILLINGACCOUNT: 7010842920101 PERIOD COVERED: 10/01/2013 - 12/31/2013 INDICATE ADDRESS CHANGE BELOW: It•II'•dhlrh'•'•'hldr'u1'I'll••'h•II•il••Ilydd'1'1111 001187943135 ANTHEM BLUE CROSS AND BLUE SHIELD PO BOX 1166 NEWARK NJ 07101-1168f PLEASE WRITE HI LI FISHERS ISLAND FERRYDISTRICT VENDOR 002769 DAVID C BURNHAM II 11/19/2013 CHECK 1539 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5712.4.000.000 093013 '13 COMM MTG JUL-SEP 100.00 TOTAL 100.00 aB „ m THE °nS c'.~ah'kx:.~7 OR[GINAL CHECK HAS A COLORED BACKGROUND PAPER A VOID COPY FEATURE AND WATERMARK ~~,g 'm'-goi@60,J7 No o"r'•' O:~ ~ ~G s,. tea. iv ~ \ b ~ ~ 'IF r »P s*vt aw4u ra*- '40~ °inU~ _ci IVA fit V. U 44- Apo eaE~~ ~'i05340. ~02L4C]5464~ 6A doi50i its' Vendor No. 1 Check No. Town of Southold, New York - Payment Voucher 2789 Vendor Tax ID Number or Social Security Number Vendor Address Entered by P.O. Box 335 Vendor Name Fishers Island, NY 06390 Audit Date David C. Burnham, II NOV 19 2013 Vendor Telephone Number Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount '.Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number Qq~ 9/30/2013 $100.00 $100.00 Commissioner Meeting SM5712.4.000.000 July-September 2013 2 Mtgs @ $ 50 Mtg i i $100.00 $100.00 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signaturev~ Title Signature n ,q' ^ Company Name_ ~f~ Date - G~~ Title Date ~ 1 Sheet1 $50.00 a meeting Meeting Date Brooks, Robert Edwards, Christopher Rafferty, Christopher Rugg, Peter Wall, Robert Burnham, D Cook, Harold 07/01/13 1 1 1 07/15/13 1 1 1 08/06/13 1 1 1 08/16/13 1 1 1 1 08/26/13 1 09/03/13 1 1 09/23/13 1 1 1 1 Total Meetings 0 7 6 3 0 2 2 3rd Quarter 0 350 300 150 0 100 100 Page 1 FISHERS ISLAND FERRY DISTRICT VENDOR 018554 DIVERS COVE LLC 11/19/2013 CHECK 1540 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.000 32103 DIVER-INSPECT BOTH BOATS 159.53 TOTAL 159.53 THE N^s 9~~} WATERMARK PAPER ORIGINAL CHECK HAS A COLOECD BACKGROUND AND A VOID COPY FEATURE v 3 a m•I T~D `n a t »d 1~ CH as Z _V~ 11W • a e 1382113 z _ ONE HUNDRED FIFTY 'NINH 53 f 14Dt3" . ~ 7-40-- -no Vp, 7 'WSW 210= prl.•,, ~y v004 st,Oil' 1:0 2 1 40 5464iC 68 OO i 50 2'/ L~~' t Vendor No. Check No. Town of Southold, New York - Payment Voucher 18554 1540 Vendor Tax ID Number or Social Security Number Vendor Address Entered by 7 Essex Plaza Essex, CT 06426 Audit Date Divers Cove NOV 19 2013 Vendor Telephone Number 860-767-1960 To~y'q?Flerk Vendor Contact l.Ld,~y~ Q,f Invoice Invoice Invoice Net Purchase Order Number Dace Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 32103 10/7/2013 $159.53, $159.53 Diver for both SM5710.2.000.000 ferries $159.53 $169.53 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature Title Signature Date 5 Company Name Date yU Title i~O - ~vv ~J Divers Cove Invoice #32103 7 Essex Plaza 10/7/2013 9:56:48 AM Essex CT 06426 Phone: 860-767-1960 Fax: 860-767-3356 Sales Person: 1 - ED R. COURSES & TRIPS - -CHECK OUT OUR WEBSITE: www.diverscove.com FISHERS ISLAND FERRY DISTRICT #4411 BOX H FISHERS ISLAND, NY 06390 Quantity Unit Extended Ord. Del. Description PC Tax Price Price 1 1 LABOR-BOAT INSPECTION/REPAIR- PER HOUR M 1 $150.00 $150.00 BOAT/DC3763: NON TAXABLE: $0.00 TAXABLE AMOUNT: $150.00 6.358 Sales Tax: $9.53 TOTAL DUE: $159.53 TOTAL PAID: $O.CO BALANCE DUE (This Invoice): $159.53 SERVICE PERFORMED 8/6/13 X THANK YOU FOR SUPPORTING OUR BUSINESS! Page: 1 FISHERS ISLAND FERRY DISTRICT VENDOR 004533 DEBORAH A DOUCETTE 11/19/2013 CHECK 1541 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.950 310409128 REIM.FIRST AID COURSE 62.10 TOTAL 62.10 ~KK a ~ > >P THE • COLORED BACKGROUND. A VOID COPY FEATURE AND WATERMARK PAPER 017,1 Affl ` crw i "s 1e a er«c L w a~µ. ~u~d o ~Il11 HQ i .:+„CH6"3C 25Q' . Tf* SIM TWO AM 10/1-60 DOWAAS y MAP NY i66196, "400 154'lun 1:0 2 i405464o: 6A db 1 50 2' iii' Vendor No. Check No. Town of Southold, New York - Payment Voucher 4533 5 4' Vendor Tax ID Number or Social Security Number Vendor Address Entered by P.O. Box 77 Fishers Island, NY 06390 Audit Date Deborah A. Doucette NOV 19 2013 Vendor Telephone Number Town Clerk Vendor Contact ~ u1 L _ Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 310409128 10/24/2013 $62.10 $62.10 First Aid Course SM5710.4.000.950 reimbursement I I $62.10 $62.10! Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature Title 1001r~ Signature Company Name Date T ~w Title Date ~'Uy ~7 Account: 310409128 Clarion Inn (CT149) Date: 10/24/13 269 North Frontage Road Room: 204 SaA Arrival Date: 10/23/13 1 New London, CT 06320 Departure Date: 10/24/13 ® (860) 442-0631 BY CHOICE H 0 T E L 5 GM.CT149@choicehotels.com Check In Time: 10/23/13 5:51 PM Check Out Time, Rewards Program ID: DOUCETTE, DEBORAH You were checked out by: P.O. BOX 77,606 ALPINE AVENUE You were checked in by: jgreen.ct149 FISHERS ISLAND, NY 06390 Total Balance Due: 62.10 Post Date r" Description Comment Amount 10/23/13 Room Charge #204 DOUCETTE, DEBORAH 54.00 10/23113 Occupancy Tax 8.10 10/24/13 Master Card (62.10) XXXXXXXXXXXX8075 Folio Summary 10/23/13 -10/24/13 Room Charge 54.00 Occupancy Tax 8.10 Master Card (62.10) Balance Due: 0.00 This rate is eligible for partner rewards. If this rate is changed, you may no longer be entitled to partner rewards. Debit Card funds are on hold immediately from your account and may remain on hold for up to 15 days. ONLY your financial institution (i.e. your bank) can release these funds. For your convenience, we have prepared this zero-balance folio indicating a 0.00 balance on your account. Please be advised that any charges not reflected on this folio will be charged to the credit card on file with the hotel. While this folio reflects a 0.00 balance, your credit card may not be charged until after your departure. You are ultimately responsible for paying all of your folio charges in full. CHOICE privileges X You could be earning free nights and other great rewards. Join Choice Privileges today, at www.choiceprivileges.com. D D~,D 201 FISHERS ISLAND FERRY DISTRICT VENDOR 005289 CHRISTOPHER EDWARDS 11/19/2013 CHECK 1542 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5712.4.000.000 093013 '13 COMM MTG JUL-SEP 350.00 TOTAL 350.00 rwh Yaf$ y$y i t n E THE ORIGiNAL CHECK HAS A COLORED BACKGROUND, A VOID COPY FEATURE AND WATERMARK PAPER a so m o aro /qb 11. 'FrIE , * Q0.: 'Plfit$g fItR3l9AND'f''IFTY AND 00/1" DQLt+l~ t l/rc'i' CMUT" a F1980-m ISLAND w 90390., d e qtr \4 ~G ` m~~.. 'is00 15 4 211• 1:0 2 1405464~o 613 00 150 2 1i~' Vendor No. I, Check No. Town of Southold, New York- Payment Voucher 5289 ' Vendor Tax ID Number or Social Security Number Vendor Address Entered by P.O. Box 167 Vendor Name Fishers Island, NY 06390 Audit Date Edwards, Christopher NOV 19 2013 Vendor Telephone Number Town Clerk Vendor Contact Invoice Invoice Invoice Net purchase Order Number Date Total Discount (Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 30 3 9/30/2013 $350.00, $350.00 Commission Meeting SM5712.4.000.000 July-September 2013 7 Mtgs @ $50/mtg $350.00 $350.00 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature - Title Signature Company Name "O~ Date ~av Title Date Sheetl $50.00 a meeting Meeting Date Brooks, Robert Edwards, Christopher Rafferty, Christopher Rugg, Peter Wall, Robert Burnham, D Cook, Harold 07/01/13 1 1 1 07/15/13 1 1 1 08/06/13 1 1 1 08/16/13 1 1 1 1 08/26/13 1 09/03/13 1 1 09/23/13 1 1 1 1 Total Meetings 0 7 6 3 0 2 2 3rd Quarter 0 350 300 150 0 100 100 Page 1 FISHERS ISLAND FERRY DISTRICT VENDOR 006155 FEDEX 11/19/2013 CHECK 1543 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 2-431-89768 AIRBILLS-PAYROLL,WARRANT 135.49 TOTAL 135.49 °a C. aJ-'m~_ fit. 5`_:. r^YJR _.,+Mn` • THE P # fY'. ORIGINAL Pill S E .p # 1 'AY lav •y~F'9 a.IYV:., ]t {yamJq``wG a 0 HUMUT! Tk1I1tT'Y' Mm AND 99t1~fl© "7"tWMA~ R - . sue,. „?s,. ia~~„ 0060t5tolno 1:02LL.0St.E4i 6$ C1OE LIs 02 i~i• Vendor No. Check No. Town of Southold, New York - Payment Voucher 6155 4 Vendor Tax ID Number or Social Security Number Vendor Address Entered by P.O. Box 371461 Vendor Name Pittsburgh, PA 15250-7461 Audit Date Feclex NOV 1 9 20 3 Vendor Telephone Number 800-622-1147 Town Clerk Vendor Confect Invoice Invoice Invoice Net purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 2-431-89768 10/14/2013 $135.491 $135.49 Airbills-Payroll,Warrant SM5710.4.000.000 i i $135.49 $135.49 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no parr has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature _ Title Signature Company Name/ Date /vy~ Title Date FocL.i4, Invoice Number Invoice Date Account Number Page 2-431-89768 Oct 14, 2013 1206-0334-5 1 of 5 FedEx Tax ID: 71-0427007 Billing Address: Shipping Address: FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY TERMINAL DEB DOUCETTE 5 WATERFRONT PARK PO BOX H NEW LONDON CT 06320 Invoice Questions? Contact FedEx Revenue Services FISHERS ISLAND NY 06390-0607 Phone: (800) 622-1147 M-Sa 7-6 (CST) Fax: (800) 548-3020 Invoice Summary Oct 14, 2013 Internet: www.fedex.com FedEx Express Services Transportation Charges 138.45 Base Discount -15.05 Special Handling Charges 12.09 Total Charges USD $135.49 TOTAL THIS INVOICE LISD $135.49 You saved $15.05 in discounts this period! Other discounts may apply. Detailed descriptions of surcharges can be located atfedex.com Invoice Number Invoice Date Account Number Page 2-431-89768 Oct 14 2013 1206-0334-5 2of5 Adjustment Request Fax to (800) 548-3020 Use this form to fax requests for adjustments due to the reasons indicated below. Requests for adjustments due to other reasons, including service failures, should be submitted by going to www.fedex.com or calling 800.622.1147. Please use multiple forms for additional requests. CPlease complete all fields in black ink. n Requestor NameI I I I I I I I I I I I I I I I I I I I I I I I I I Date W/ W/ W ti - 8 Phone L I I I WJ -I I I I I Fax# IWW W-I -I I I I I c t' E-mail Address ElYes, I wantto update account contact with the above information. RTracking Number Bill to Account $Amount 'IIIIIIIIIIIIIIII IIIIIIIIII 111111-W bIIIIIIIIIIIIIIII IIIIIIIIII 111111• W ,j,IIIIIIIIIIIIIIII IIIIIIIIII IIIIII•W IIIIIIIIIIIIIIIIII IIIIIIIIII IIIIII•W srlllllllllllllllll IIIIIIIIII IIIIII•W ADR -Address Correction INW -Incorrect Weight OVS - Oversize Surcharge For all Service failures or other c DVC - Declared Value INS - Incorrect Service RSU - Residential Delivery surcharges please use our web IAN - Invalid Acct # OCF - Gird Pick-up Fee PND - Pwrshp Not Delivered site www.fedex.com or call OCS - Exp Pick-up Fee SDR - Saturday Delivery (800) 622-1147 Rerate information only (round to nearest inch) C: Tracking Number Code $Amount LBS L W H r'i 0 1 1 1 1 1 1 1 1 I 1 1 1 I I I I I I I I I I I I I• W I I I II I I IxI I I Ix WW i;I I I I I I I I I I I I I I I I I I I I I I I I I I• W I I I I I I IxI I I Ixl I I t' I I I 1 1 1 1 1 1 I I I I 1 1 1 1 1 1 • W I I I I LWJ X1 I I J x WJ a I I I I I I I I WJ I I I• W I I I II I I 1x1 1 1 1x1 I I J I I I I I I I I I I I I I I I I I• W I I I II I I IxWWxl I I recitx Invoice Number Invoice Date Account Number Page 2-431-89768 Oct 14 2013 1206-0334-5 3of5 FedEx Express Shipment Summary By Payor Type FedEx Express Shipments (Original) Rated Spacial Weight Transportation Hamill" Rat chwTax Payer Type Shipments lhs' Charges Charges credit /Olhor Discounts Total Chagos Shipper 2 3.0 47.55 4.27 -4.76 47.06 Recipient 4 4.0 90.90 7.82 -10.29 88.43 Total FedEx Express 6 7.0 $138.45 $t2A9 -$ism $1350 Total This Invoice USD $135.49 1285-01 0(0012037 0002-0041 762 Invoice Number Invoice Date Account Number Page 2-431-89768 Oct 14 2013 1206-0334-5 4of5 FedEx Express Shipment Detail By Payor Type (Original) Picked W.Sepi24,2013 Cust Ill NO REFERENCE INFORMATION Ref.#2: Payer: Shipper Reti3: •Fuel Surcharge FedExhas applied a fuel surcharge of9.50% to this shipment • Distance Based Pricing, Zone 2 Automation CAFE Sender Recipient Tracking ID 564523215247 Jim Traub Diana Whitecavage Service Type FedEx Priority Overnight FISHERS ISLAND FERRY TERMINAL Town of Southold Package Type FedEx Pak 5 WATERFRONT PARK Town of Southold-Annex-Acctg Zone 02 NEW LONDON CT 06320 US SOUTHOLD NY 11971 US Packages 1 Rated Weight 2.0 Its, 0.9 kgs Declared Value USD 20.00 Transportation Charge 24.00 Delivered Sep 25, 201311:06 Declared Value Charge 0.00 Svc Area A8 Fuel Surcharge 2.05 Signed by C.FOSTER Discount -2.40 FedEx Use 000000000/0001486/_ Total Charge USD - 523.65 Picked up:Det08, 2013 Gust. Ref.: No REFERENCE INFORMATION Ref.#2: Payer: Shipper; 111111131 • Fuel Surcharge FedEx has applied a fuel surcharge of 1050% to this shipment. • Distance Based Pricing, Zone 2 Automation CAFE Sender Recipient Tracking ID 564523215269 Jim Traub Diana Whitecavage Service Type FedEx Priority Overnight FISHERS ISLAND FERRY TERMINAL Town of Southold Package Type FedEx Pak 5 WATERFRONT PARK Town of Southold-Annex-Acctg Zone 02 NEW LONDON CT 06320 US SOUTHOLD NY 11971 US Packages 1 Rated Weight 1.0 lbs, 0.5 logs Declared Value USD 10.00 Transportation Charge 23.55 Delivered Oct09, 201310:31 Discount -2.36 Svc Area AS Fuel Surcharge 2.22 Signed by O.WHITECAVAGE Declared Value Charge 0.00 FedEx Use 000000000/0001486/_ Total Charge USD 523.41 Shipper Subtotal USD $47.06 Dropped off: Sep 11, 2013 Cast. Ref.: Warrant Refer: Fill Recipient ReE.#3: Fuel Surcharge- FedEx has applied a fuel surcharge of950% to this shipment • Distance Based Pricing, Zone 2 • FedEx has audited this shipment for correct packages, weight, and service. Any changes made are reflected in the invoice amount. • The package weight exceeds the maximum for the packaging type, therefore, Fed Ex Envelope was rated as Fed Ex Pak. Automation INET Sender Recipient Tracking ID 796659214153 John Cushman Gordon Murphy Service Type FedEx Priority Overnight TOWN OF SOUTHOLD Fishers Island Ferry District Package Type FedEx Pak 54375 Route 25 Fishers Island Ferry Terminal Zone 02 SOUTHOLD NY 11971 US FISHERS ISLAND NY 06390 US Packages 1 Rated Weight 2.0 Its, 0.9 kgs Delivered Sep 12, 2013 09:32 Transportation Charge 24.00 Svc Area A9 Discount -2.40 Signed by M.JIM Fuel Surcharge _ 2.05 FedEx Use 000000000/0001486/_ Total Charge USD 523.65 1)85.0[-00-001201i (i On 11762 Invoice Number Invoice Date Account Number s of e 2-431-89768 0 ct 14 2013 1206-0334-5 Dropped on: Sep 10, 2013 cult. Ref.: NO REFERENCE INFORMATION Roi Pryor: Recipient 111e113 • Fuel Surcharge- FedEx has applied a fuel surcharge of 950% to this shipment. • Distance Based Pricing, Zone2 • FedEx has audited this shipment for correct packages,weight,on, therefore, FedEx Envelope was ratedces FedEx Pak ice amount • The package weight exceeds the maximum for the packaging type Sender Recipient Automation USAB JANICE L FOGLIA DONALD IAMB Tracking ID 801403333800 FISHERS ISUANO FERRY DISTRICT Service Type FedEx Priority Overnight TOWN OF SOUTHOLD FISHERS ISLAND NY 06390 US Package Type FedEx Pak 53095 ROUTE 25 Zone 02 SOUTHOLD NY 11971-4642 US Packages I Rated Weight 10 lbs, 0.5 kgs 2155 Delivered Sep 19, 2013 09:43 Transportation Charge 236 Svc Area A9 Discount _ 2.01 Signed by MAIM Fuel Surcharge USD $23.20 FedEx Use 026166957/0001486/ Total Charge Dropped oft. Oct 03, 2013 Cul not.: NO REFERENCE INFORMATION ROM. Payer: Recipient Ref.#3: • Fuel Surcharge- FedExhas applied a fuel surcharge of 9,50% to this shipment. • Distance Based Pricing, Zone 2 as in invoice amount. • Fed Ex has audited this shipment for correct packages, weight, and service. Any changeslomade pe are reflected • The package weight exceeds the maximum for the packaging type therefore, FedEx Envelope was rated as FedEx Pak. Sender Recipient Automation USAB JANICE L POGLIA MR DONALD LAMB Tracking ID 876921840071 N OF SOUTHOLD FISHERS ISLAND FERRY DISTRICT Service Type FedEx Priority Overnight TOWN ROUTE 25 FISHERS ISLAND NY 06390 US Package Type FedEx Pak S53095 OUTHOLD NY 11971-4642 US Zone 02 Packages 1 Rated Weight 1.0 Ibs,05 kgs 23.55 Delivered Oct 04, 201309: 55 Transportation Charge 401 Svc Area A9 Fuel Surcharge _ -2.36 Signed by P.RIED Discount USD 52:4.20 FedEx Use 027693914/0001486/ Total Charge Dropped off:. Oct 09, 2013 Cull Al NO REFERENCE INFORMATION RofA2: pal Recipient Rel • Full Surcharge Fed Ex has applied a fuel surcharge of 10.50% to this shipment • fllstance Based Pricing, Zone2 Sender Recipient Automation USAB DIANA WHITECAVAGA DONALD LAMB Tracking ID 801403333796 OF SOUTHOLD FISHERS ISLAND FERRY DISTRICT Service Type Fail Priority Overnight TOWN 5 WATER FRONT PARK Package Type FedEx Envelope 53095 ROUTE NY 25 119714642 US NEW LONDON CT 06320 US lone 02 Packages 1 Rated Weight N/A 1930 Delivered Oct 10, 2013 09:33 Transportation Charge 3,17 Svc Area A4 Discount 175 Signed by MJIM Fuel Surcharge USD $1838 FedEx Use 028250243/0000186/_ Total Charge Recipient Subtotal USD $88•43 Total FedEx Express USD $135.49 1295-f)1-0p-0p, AAJ-nOO l 00 176 L9u1, 00-L000 ztozio0-00-1o-svzl After printing this label: 1. Use the 'Pont' bullon on this page to print your label to your laser or inkier pnnler 2. Fold the printed page along the hor¢ontal line. 3. Place label in shipping pouch and aft it to your shipment so that the bemode podion of the label can be read and scanned. Warning: Use only the purled onginat label for shipping. Using a photocopy of the label for shWg purposes is freuoLlenl and cadd res4( addilional Wing charges, along with the cancellation of your FedEx account number Fran: (860) 442-0165 Origin 10: SKKA ~ Ship Data: 24SEP13 JIM TRAUB FeCIEL Ac1Wgt 2.0 LB MAN FISHERS ISLAND FERRY TERMINAL ? CAD: 0175165/CAFE2608 5 WATERFRONT PARK _ Bar CoT. NEW LONDON. CT 08320 E Delivery Address III IIIII~I~I~INIIIH III6HI II IIH~NNI J121312fOrdV3 IIIIIIII I IIIIIIIIIIIIN SHIP T0: (631) 7651333 BILL SENDER 8I II 11 DIANA WHITECAVAGE Invoice # TOWN OF SOUTHOLD PON TOWN OF SOUTHOLD-ANNEX-ACCT'G D°Pt# 54375 MAIN RD. SOUTHOLD, NY 11971 WED - 25 SEP 12:OOP 11M N... w# 5645 23215247 PRIORITY OVERNIGHT 11971 NY-Ll E L WS HA J F K S 111111111111111 11 512CI6256CM After pdn6ng this label 1 Use the 'Print' button on this page to pool your label to your laser or inkjet printer 2 Fold the printed page along the horwontal line 3. Place label in shipping porch and all it to your shipment so that the barcode portion Of the label can be read and scanned. Warning: Use orgy the panted odginel label for shipping. Using a photocopy of eus label (pr shipping purposes is fraudulent and coup result in additional billing charges, along with the cancellation of your Fedj account number Fran: (860) 442-0165 Origin ID: SKKA f> Ship D e: 08OCT13 JIM TRAUB S• AcNY 2.0 LB MAN FISHERS ISLAND FERRY TERMINAL CAD: 75165/CAFE2608 5 WATERFRONT PARK al l9 Delivaq Address Bar Code NEW LONDON, CT 08320 ` I III ~ II IIII III VIII III I II III IIIIIII'I II I II IIU (VIII I II III II I I IIII I II III II I III I I SHIP TO: (631) 7654333 BILL SENDER Ref# DIANA WHITECAVAGE Invoice# TOWN OF SOUTHOLD PO# TOWN OF SOUTHOLD-ANNEX-ACCT'G Dept If 54375 MAIN RD. SOUTHOLD, NY 11971 WED - 09 OCT 12:OOP PRIORITY OVERNIGHT j 5645 2321 5269 F0201 I r + ) 11971 NY-US r K ( EL WS HA JF 51X1/~I~~ raau 8769 2184 0071 0200 x lox Express USAirbill nmo -ONO WEx ReWeval Copy r•. 1 From 4 Express Package Service •n~.laes PocA,eesaprol5atba. Senders FadEx Dam Account Number 1046/'.7,0..19 O rmesw.iw.raras~.an.vewsrar.uh. =^wc rar.rrar. ao~aw.rusaa'a Senders Name Jnr ,wcb ~ti1J.9- phone I V 7G_5-y35:3 06? FeddExA lrOvemigMe.merymw.n 46? EWoe Ex 2n 0a 0.M. FeawenmI raxx.m.n s.wmrvpar..rvrim..mi.w. I v.nbnsnliromnroea,.n.s.x.rea. Compam /041:vv df •JOU771011) D FdE Prom? 0vemigM 03? s e ~::.mm~,•m.ree ncm,w CIS ~ m e.mmecn M.:awawo.aun~onroll rr wimoxer.ea,MOnmv..i.ss7iuaonr ~ a.a.me. oxc.iymssleme. n AddressSyJ'75 /;V'7/A/ /Y %)A/) -/-b OJQX //79 05 FedEx SmndaNOvemigM FetlFx Express Saver xmE,oundamn mLb'e. C a'Jt,,n 0}• /7•~7DapulMaxauaeq n ? s•uiawoeY.arxormbda. S wrNY OeV-'Nor m ciM Ovr t/ 5 Packaging •p.rrw.ras (T sham Nom/ zip M/ / a ro 06 FedExEnvelope' 02? FedExPak* 03[ 2'Your htrerrtel Billing Reference BFedEx ox ?TFed ube Ol?Other 3 c°a. 3 To 6 Special Handling and Delivery Signaatre Options W NaP ienra7&~//> ~it/IJQ Phone /~3l 716 7ylo3 03? SATURDAY DEWERY i 4f ? 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Third Party 40 Coedit Card 50 CasMCheck MINIMUM[ Tola1Packages Total Weigh r e.uc.aaen. i =nrewaq rmammm~nr.rW~,...lres~e..,mmr.a~sem~.n~m.mra°M. 612 r 8769 2184 OD71 nna•nnnma•mr°Fmmreeu•mlxrtorxesx. ssi 00052 Fm:Ex ® Package :t Ex ress U$Arbill 8014 0333 3800 1; 1 1 faem /P 4 Express Package Service •w.r Dam Peeaepnapro,Setba xpre s.a..rrrracraaw. n...wwc.l.rns wnwinwa. P gm, urfwarmsm~ Sande Namers 1~1p/03/ 7b-5- 5/333 Fed Ex Fret Overnight FedEx2D!y0.M. Phone ? Ire' .iw v h me,mw wm w ? sewb vo r rvrvar _ ^ "Z sFrUxnnro r rv' xrorna. TOWN OF S17UTf-IOLD ed.&Pnorlry Ovemlght ? s~eddEaxb2DaY am m.-OW Comperrv x.' O'e. va'' melt M exxi.xaa Wwlsyunx. MADAevoew.ry oa!Mry i e ar.v.en - smolm M 53095 ROUTE - FedEx Standard Overnight Fed Ex Ex press Saver Ili Address ? xwb .rm..n• ? mw e~ av oegmoorrsermc.m se.wrvo w.rvrvarm~uu.. s.mra.vo i rvr?o*...a.bi.. ~ ~ m Cftv SOUTHOI D Stare NY zip 11971-..4642 5 aging •owmww s.mm ~ x UEnvelope' ? FedEx Pak' ? FedEx ? FedEx ? 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Cargo Aircraft Only CM1y Stan, zip A( 39~ 7 PeyIFlerlt Sells, ~ xe.utiwrc.rexo.b.a.. Otter No. ? Sander ? waeien°'~ Reent ? Third Party ? Credft Card ? CasMCheckI 0457762087 3 L I,I I 'I I I'I II 1111 I' 111 I~'I I Tonal Packages Taal We9M cw . am ' l IN' IgBll 'INUI'Ill IIfN'II N '''rylll rc.. W =Pmn.eshximwmusnme~.o-,eeswnsry,wreu.s.m.ammras.smr.a.m.mrama. 611 _ 8014 0333 3800 ~y~• - e...o.re vlx•v.nnssui•mieamlxreex.•mixnoix usn. sas J I I I I _I J =1 1 a FISHERS ISLAND FERRYDISTRICT VENDOR 006376 FIFD-CAPITAL PROJECTS 11/19/2013 CHECK 1544 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .9901.9.000.000 102413 H7.5031.00 N.RAMP PROJEC 2,969.00 TOTAL 2,969.00 e T t- 14 ` THE ORIGINAL CHECK HAS A COLORED BACKGROUND. A VOID COPY FEATURE AND WATERMARK PAPER as aE` o W-,• A~l ~v~`~• x 0 so Ho \\E.•~, ~o-5se2zK# -a ~-A~9~ Two Tm&j"ND PFINB P R46vow SIXTY Wift W 8 ¢ i#d LFS~ 00 P•11`'#vF G#Y!Tr 8~ r~ \'z i t d/ 7z 'rr TOWN som"m e l lit 0151.1.11, 1C02i405464i: m boiso2~ in, ~ Vendor No. Check No. Town of Southold, New York - Payment Voucher 6376 5,4q Vendor Tax ID Number or Social Security Number Vendor Address Entered by ? , t \ PO Box 1179 T~[A_Av/ Vendor Name Southold, NY 11971-0959 Audit Date Fishers Island Ferry District-Capital Projects NOV 19 2013 Vendor Telephone Number 631-765.4333 To y~JeQrkyp-"/~`j~ Vendor Contact - (6NCy' John Cushman i Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number ball 13 10/2412013 $2,969.00; $2,969.00 H7.5031.00-North Ramp Project SM.9901.9.000.000 i i $2,969.00 $2,969.00 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby cenify that the materials above specified have been received by me does hereby certify that the foregoing claim is one and correct, that no pan has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt we excluded. or discrepancies noted, and payment is approved. Signature Title '4xe' v Signature Company Name rl~ Date title Date ~UV FISHERS ISLAND FERRY DISTRICT VENDOR 009615 FISHERS ISLAND COMMUNITY CENTR 11/19/2013 CHECK 1545 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .7155.4.000.000 102513 WARNER BROS BILL 647.19 TOTAL 647.19 to s,-_ THE ORIGINAL CHECK HAS A f1 COLORED BACKGROUND, a CGwk`~fl I"+S you DGU ~iv` y ea.ssertat l1 39ZD13' -3 ¢ , . SIX HUN# D FORTY SWEN ACID DOWUt9- _ ~ - a i A/P PAY TliE C TCENTR rs » x ORD68 PCl ~ ~ff?~ ~ ~,.ui»p HJrs ~rrll~,~~`~. ~Y~ FTSM !--LAND NY 063-50-06'07 r.a 6 POO 1545110 1:0 2 i405464i: 68 X10 150 2 Iu- Vendor No. Check No. Town of Southold, New York - Payment Voucher 9615 1545 Vendor Tax ID Number or Social Security Number Vendor Address Entered by PO Box 464 Vendor Name Fisher's Island, NY 06390-0607 Audit Date Fislyf5 island Community Center- NOV 19 2013 Vendor Telephone Number Town Clerk `r'te) • f Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 10/2512013 $647.19 $647.19 Warner Bros Bill SM7155.4.000.000 $647.19 $647.19 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature Title 14~ Signature Company Name~~ Date ~ ~~a~ Title Date _ ~ ~ Remit Payment to: Fed Id: 81-0597220 Bank Wire Transfer To FISHERS ISLAND FERRY DISTRICT WARNER BROS. Bank of America Fax: 631-788-5523 DISTRIBUTING INC. Warner Bros Main Concentration Phone: 609477-1776 Accet: 12577-00439 ABA: 0260-0959-3 P.O. BOX 2910, Fax (818)9S4-3911 1655 GRANT STREET 261 TRUMBALL DR TOLUCA LAKE, CA 91610 Concord, CA 94520 FISHER ISLAND,NY 06390 Theatre city Release Type WK Date Gross ST H.E. Deduct (s) Tonne ST Amount(s) Local Tx Paymeatis) %Paid Ballsl Comments Fishers Island Fishers Is Argo Film Rental 1 8127113 216.00 B 4,000 0.00 35.00% S 250.00 0.00 0.00 250.00 Fishers Is Darkknight Film Rental 1 8126/12 638.00 B 4,000 0.00 40.00% S 255.20 0.00 282.40 44.26% -27.20 Fishers Is Hangover £ Film Rental 1 8/16113 106.0C'T" : 4,000 0.00 35.00% 37.10 0.00 0.00 37.10 Fishers Is Pacific RI Film Rental 1 8120113 208.00 B 4,000 0.00 35.000/6 S 250.00 0.00 0.00 250.00 Fishers Is VVWRe The Film Rental 1 9/29/13 392.26 ~T 4,000 0.00 35.00% 137.29 0.00 0100 137.29 Totals: 1,560.26 0.00 929.59 0.00 282A0 647.19 F C Post Dui of Please remit Balance 9s9 x L Box Office Reports Are Needed Please fax to 818-977-9063 u Or e-mail to:'filtrcer.•frcere:;r;nr, iw;:rner;;ro.>. enc q Please include Theatre name, city, fdm name & playdate in subject ifineof e-mail i n FISHERS ISLAND COMMUNITY CENTER, INC. 1083 FRIENDS OF THE FI THEATER PO Box 464 FISHERS ISLAND NYP08390-0464 e625 I st-57/n935 C PAYTOTHE DATE l / n ORDER OF 1Y~ LI' ~N S 1~ Y 1`l is 6y~ ~ Q ( p S n1 I / ~?G~ ~l~ DOLLARS 8 R ti < BankofAmerica ' ACK B?a1190a5/1 1~1 A/LL I/1L"-n ,~~Di,./ Date: 10/23/13 4:21 FOR `P IL -11~' ! - Page l of t 11'00108311' 1: 38S0L2360S761I' FISHERS ISLAND FERRY DISTRICT VENDOR 010002 JAN ELECTRONIC SUPPLIES, INC. 11/19/2013 CHECK 1546 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.100 73440 MU CONDUIT 16.00 TOTAL 16.00 THE r ORIGINAL COLORED BACKGROUND. A VOID COPY FEATURE AND WATERMARK PAPER ~ n x -DP ° Y u ffi wv m; m. Vvl E 53 fiB 1 tax 6~awryo rand`/ ,S~p cm C& M ar~+nvekAii~ 6D540ffj4 1 9 211 3- _ ~-.v SIXTEEN AND 08J1100 M?LIA2S . - ¢.5 c s 3m a. bfi 7 P,4Y L Jut 1 T1{ Of/he S01?4i, as, INC OFtt R NEW I+CMIM CT 0632-0 OF ~s ( fJN: o~~~$s xyAy9~~ WYrf Its 00154611• 1: 02i405464l: 68 001502 1 ip Vendor No. j Check No. Town of Southold, New York- Payment Voucher 10002 Vendor Tax ID Number or Social Security Number Vendor Address Entered by Vendor Name 6 Truman Street Audit Date Jan Electronic Supplies, Inc. New London, CT 06320 _ NOV ] 9 2013 Vendor Telephone Number 860-442-4386 Town Clerk Vendor Contact ~4a Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 73440 10/17/2013 $16.00 $16.00 MUNN Conduit SM5710.2.000.100 - i 1 i $16.00 $16.00 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me dues hereby certify, that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature Title Signature ~Ak al," Company Name Date Title Date ~~r= Vendor No. Check No. Town of Southold, New York - Payment Voucher 10002 vcnd, T. IDNmnberar SocW Sewity Nvmber vendorAddress by a 6 Truman Street Audit DAu vaodorNone London, CT 06320 NOV 1 9 ?~j3 Jan Electronic SUPPRO5, inc. New London, CT 05320 Vendor Telcph"c Kwriber Town Clerk 860-442.4386 M Vendor Contact N LD OD r- (nvoioe ]man IDwice Net Purchase Order M Nmobw DOE Tom! Duoou~l Amount Claimed Number Description of Goods Sere ices Gmud Lodger Fwd and A,=an Number 73440 10!17(2013 $16.00 I 576.00 MUNNConduit SM6770.2.000.100 I 1 I I - m [I ~ $1 6.00:i c ~ Payee Certification Deportment Ceriifntlon w I bmby ,Mfy drat d¢ materials abore3pemfwd hve been mmvral bg me w The wdetsipoed (Clamserre) (Ac'Ims o0 oeLalf,rfthc onawe named chdma~n! d wwitiao aidtom sulavaIDOn Vtcxmca properly jwd dRS lrachy rtrlify tlml thefaregoiaedaim is wearul r..raCs Wafno pets has mined and that the grssrwd Uh fbave been verified soh the cxr<ynars t ban yard, escort x therein slater Uwt the ba6mce draein: is aMlsl .rrrsrdis appi0tkd '16'0' m or discrepancies rem d, and pa, dry and oxiny, and din! terse from r'hich d,e To- is exm,rpt are eaclude0_ Sipiznnc Tide San''R- a r ire ~ NUS 4/ ~ [;amDam Nsme / Doge 7 / - Tida _ - O M (fl INVOICE N 73440 JAN ELECTRONIC SUPPLIES, INC. 6 TRUMAN STREET NEW LONDON, CT 06320 /tw EDGE (860) 442-4386 FAX # (860) 447-8164 DATE ~ D ~ 17 -)3 TGltti YY~ P6 60 X N i S LAtO Y Ulo Flo C STOMER'S RDER NO. CHARG MDSE RET'D SHIP VIA SALES REP. vuNa3uw IL UNIT PRICE 7, 07 QTY. SHP'D O I C6 Oo C7 ' ann 04 CLTSON-IC ALL i and turned goods ST be accompanied by this bill. TAX SHIPPING A,f ECEIVE Y TOTAL DO CUSTOMER FISHERS ISLAND FERRYDISTRICT VENDOR 011564 THOMAS KRAFT 11/19/2013 CHECK 1547 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT j SM .5710.4.000.300 3684 RP 4539.4 GALQ$3.001500 13,625.01 SM .5710.4.000.300 3684 CT EXCISE TAX-$.5490/GAL 2,492.13 SM .5710.4.000.300 3684 S-F COST RECOVERY.0019 8.62 SM .5710.4.000.300 3684 LUST TAX-$.0010/GAL 4.54 TOTAL 16,130.30 i 3- - ~ ~ d~ .xac ~sra aia k. ` Sl1E'fZEN T7i0U8ANII ,Oi3E THE OR~GINAL CHECK HAS A COLORED BACKGROUND A VOID COPY FEATURE AND WATERMARK PAPER PAYI(f y'' T~1A 3l yam, % spy i d ,l= 2FCIX '~~~gqilyq+Jb®b P:. IAJKLa'.~W.t s! Y9~ ~YRk'E'".z: 0r alas OF, w kC 13t CT tS6a <s ' >x It'O01St.?"' 1:02i405464o: 68 00IS02 Ill' ' Vendor No. Check No. Town of Southold, New York - Payment Voucher 11564 Vendor Tax ID Number or Social Security Number Entered by 45-4111778 P.O. Box 11125 Audit Date Thomas Kraft db ime Oil Company Waterbury, CT 06703 NOV 19 2013 Vendor Telephone Number 203-764-5334 Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 3684 1012512013 $13,625.01 $13,625.01 RP 4539.4 Gals @ $3.001500 SM6710.4.000.300 $2,492.13 $2,492.13 CT Excise Tax - $.5490/gal $8.62 $8.62' S-F Cost Recovery .0019 $4.54 $4.64! LUST Tax - $.0010/gal $16,130.30 $16,130.30 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature Title Signature Company Named Date Title Date Dime Oil LLC Phone: 203-754-5334 PO Box 11125 4aterbury,CT 06703 Date: 10/25/2013 C) i FYI+=" c) "x ..b IL.. N.... C:: :C N. V C.> J.". C:. E ACCOUNT NUMBER: 4420165 Fishers Island Ferry District AMOUNT ENCLOSED: PO Box H Attn Accounts Payable Fishers Island, NY 06390- - Re: Fishers Island Ferry Dist 5 Waterfront Park-Race Point, New London Page 1 Terms: NET 30 Days From Invoice Date - Date Invoice Charges and Credits Amount 10/25/13 3684 #20R Off Road Diesel 4539.4 GALS @ 3.001500 13625.01 Dyed Diesel Fuel for Off Road Use ONLY. S-F Cost Recovery @ 0.0019 8.62 CT EXCISE TAX DIESEL @ 0.5490 2492.13 LUST TAX @ 0.0010 4.54 10/25/13 3684 Fuel Invoice Total 16130.30 Amount Due 16130.30 **Please include account number, with payment*** Fed ID# 454111778 IV Dime Oil LLC 203-754-5334 Account: 4420165 - FISHERS ISLAND FERRYDISTRICT VENDOR 013120 MATTERN CONSTRUCTION, INC. 11/19/2013 CHECK 1548 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT H7 .5720.2.400.100 102413 MODIFICATNS TO HANDRAIL 2,969.00 TOTAL 2,969.00 phi' kw ~ t ws a 4i. rA~ r ~:s M117D p N1MffU4 cv. giAL 9iWK ' O(ilE. NY 1 0-54$R13, 11/19r20X3 TWO THOUSAND NINE HUNDRED SIXTY NINE AND 90/100 9QLLA]RS~ PAY MAT'S` CONSTRVCTI43N,: INC. TOME 26M BUSHNELL+ HOLLOW, RD. ORDER'. BALTIC CT 06330:. x 9 0 11600 L 548ti' 1:0 2 140 54640: 68 00 1 50 2 L11' Vendor No. Check No. Town of Southold, New York - Payment Voucher 113120 1549 Vendor Tax ID Number or Social Security Number Vendor Address Entered by 26M Bushnell Hollow Road 40 Baltic, CT 06330 Audit Date Mattern Construction, Inc. NOV 19 2013 Vendor Telephone Number Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 10/24/2013 $2,969.00 $2,969.00 Cutting of the existing railing H7.6720.2.400.100 Fabrication/Attachment of the new railing ends, Cold galvanizing I I $2,969.00 $2,969.00 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature Title Signature V Company Name Date y Title Date / , MATTERN CONSTRUCTION INC. GENERAL CONTRACTING/CONSTRUCTION MANAGEMENT 26M BUSHNELL HOLLOW ROAD • BALTIC. CT 06330 (860) 887-1998 FAX (860) 886-8091 October 24, 2013 FISHERS ISLAND FERRY DISTRICT P.O. Box H Fishers Island, NY 06390 ATTN: MR. GORDON MURPHY Subject: Fishers Island Ferry Ramp Restoration Handrail Modifications Proposed Change Order #6 Dear Mr. Murphy, Following is our proposal for the modification to the handrail to create a swing away section of rail on both sides. Included in our proposed scope of work are the following items. • Cutting of the existing railing • Fabrication/attachment of the new railing ends • Cold galvaniang of all bare metal Labor $2,100.00 Equipment and Material 482.00 Subtotal $2,582.00 Mattem Construction Inc. OH&P 387.00 TOTAL PROPOSED CHANGE ORDER #6 $2,969.00 Sincerely, George J. Mattttem President GJM:alygm3308 Job #5905 AN EQUAL OPPORTUNITY EMPLOYER FISHERS ISLAND FERRY DISTRICT VENDOR 013564 MCMASTER-CARR SUPPLY CO. 11/19/2013 CHECK 1549 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.000 62259624 FITTING-OIL CHANGE PUMP 404.77 TOTAL 404.77 .y. a. 4 4 4 THE ORIGINAL CHECK . _ +'NCi Wrr r a: HAS A COLORED BACKGROUND. A VOID COPY FEATURE AND WATERMARK PAPER ~s \ pus'..: F' -0 . i I "N40 CHECK 1' S^' 44 FOCM HUNDRED FOUR AND 77/100 DOLEAR„S. - - a - wCLd"~ '"'ice' i -°UO MCK53 7C R „ PLP M. t .ter/zs~' ~ ^ ~1 d ` PO BOX "7,6 0 Qf. 11100 1 5491'• 1:0 2 i40S464o: 6$ OO i 50 2 Lill Vendor No. Check No. Town of Southold, New York - Payment Voucher 13564 5 Vendor Tax ID Number or Social Security Number Vendor Address Entered by P.O. Box 7690 Vendor Name Chicago, IL 60680-7690 Audit Date McMaster-Carr Supply Co. q 9 Vendor Telephone Number NOV 19 2013 609.689-3000 Town Clerk Vendor Contact r Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number i 62259624 10115/2013 $404.77 $404.77 Fittings for oil change SM5710.2.000.000 Pump it $404.77 $404.77 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature - Title Signature Company Name r~ Date / Gv Title ~ Date /C/UI/ r: MAMMON. Invoice 609-689-3000 609-259-3575 (fax) nj.sales@mcmaster.com Purchase Order MIKE Total $404.77 Invoice 62259624 Billedto Invoice Date 10115/13 FISHERS ISLAND FERRY DISTRICT PODRAWERH Payment Terms 2% 10, Net 30 FISHERS ISLAND NY 06390-0607 Deduct 87.60 on merchandise if paid by 1025/13. Shipped to Mail Payment to McMaster-Carr Fishers Island Ferry District PO Box 7690 5 Waterfront Park Chicago IL 60680-7690 New London CT 06320 Your Account 260910000 Mike placed this order. Line Product Ordered Shipped Balance Price Total 1 5341 K94 Pioneer-Shape Hydraulic Hose Coupling, Plug 16 16 0 1114 210.24 with O Ring Seal, 112 Coupling, 3/4" NPTF Female Each Each Pipe 2 5341 K49 Pioneer-Shape Hydraulic Hose Coupling, 4 4 0 24.49 97.96 Push-to-Connct Socket, 1/2 Coupling, 3/4" NPTF Each Each Female Pipe 3 1852K69 Thermostat Guard, Steel with Ring Base, 6-518" H 2 2 0 25.69 51.38 X 4-112" W X 3-3/8"D Each Each 4 85955K23 Ultra High Temperature Mica, Flexible Film, .012" 1 1 0 20.66 20.66 Thick, 39" X 23" Each Each Merchandise 380.24 Shipping 24.53 Total $404.77 Packing List Shipped Weight Carrier Tracking 1192105-01 10/15/13 12 lb UPS Ground 1ZO835200368658212 1192105-02 10/15113 12 lb UPS Ground 120835200368658221 Federal ID 36-1458720 McMaster-Carr Supply Company Page 1 of i SP 1064 FISHERS ISLAND FERRY DISTRICT VENDOR 016170 H.O. PENN MACHINERY,INC. 11/19/2013 CHECK 1550 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.200 PSCE4650280 RP-SOLENOID,FILTERS 698.05 TOTAL 698.05 s~sero eke ~#i&#r:o * o xr ...7 77 F a~ PFi'` THE ORIGINAL CHECK HAS A COLORED BACKGROUND. A VOID COPY FEATURE AND WATERMARK PAPER a o . ~r CHECK Ni3. 1S S... _ ME S k 6 NAk BIfNK - z SIC HUNM-kb NINETY RIGHT Al-W 05/100 ~LkrtRR - ~ . Pd' H:Q..P M71. Tt~C: o~ ~xt POAD, o¢ - PDII4'}MMPSI8 NY 12603-22940 - ,.a l -rev vin, 11•00i5501i• 402i405464l: 68 b0 502 in• Vendor No. Check No. Town of Southold, New York - Payment Voucher 16170 1550 Vendor Tax ID Number or Social Security Number Vendor Address Entered by 122 Noxon Road vend pyr~ ame Poughkeepsie, NY 12603-2940 Audit Date H.O. Penn Machinery Co. NOV 19 2013 Vendor Telephone Number 846-462-1200 Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order ~C Number Date Total Discount ;Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number PSCE4660280 10/17/2013 $698.05 $698.06 RP PA-3-ME- SM5710.2.000.200 S $698.06 $698.06 Payee Certification Department Certification She undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature - Title Signature C / Company Name ~j~ Date / Title Date H. O. PENN MACHINERY COMPANY, INC. BLOOMINGBURG. NY 783 BLOOMINGBURG RD 845-733-6400 H.O.PENN BRONX,NY 699 BRUSH AVENUE 718-863-3800 PACKING LIST - s~_e ^szs HOLTSVILLE, LI 660 UNION AVENUE 631-758-7500 NEWINGTON. CT 225 RICHARD STREET 860-666-8401 POUGHKEEPSIE. NY 122 NOXON ROAD 845-452-1200 FOR INQUIRIES PLEASE CUSTOMER SHIPPING LIST *CHARGE* REFERENCE THIS NUMBER SOLD TO CUSTOMER NO. SHIP TO DOCUMENT NO. 04C760203 FISHERS ISLAND FERRY DISTRIC 18697 5 WATERFRONT PARK FILLED BY PO BOX H NEW LONDON, CT. 06 FISHERS ISLAND NY 06390 STORE WICLOC 04 WIS PCIS ORDERED BY TELEPHONE CUST. ORDER NO. INSTRUCTIONS DELIVERY LOCATION SHIP VIA 631-788-7463 JOHN UPS DIRECT UPS GROUND MAKE PIC MODEL SERIAL NUMBER EQUIP. NO ARRANGEMENT NO DATE TIME ENT BY REFERENCE NO. AA Y UNKN 099200001 10/14/13 9:30:07 MXB ITEM ----QUANTITY--- PART NUMBER/ GROSS NO. ORDER SHIP B/O DESCRIPTION LOCATION N/R TR SOS WEIGHT UNIT PRICE EXTD PRICE PARTS SALES PERSON: MARK BARANSKI ~ccf ?yi;z1 ~ 3 1 1 9X-1413 BE 164A * 000 4.3 155.25 155.25 SOLENOID A 1 4 4 6L-4714 HA lA * 000 10.2 95.48 381 921 FILTER-- AIR 11 ~F ZN~003 ~F - .5 5S- 55.96 j FILTER-SOOT -TOTAL GROSS WEIGHT OF SHIPPED ITEMS 47.1 - SAVN-MONEY ON--FREIGHT-_PI -STOCK ORDERS?-CALL-PAl= Pf CONN SALES TAX - 39.57 ~ ITEMS MARKED "'"ARE NOT-RETURNABLE **SIGNATURE REQUIRED** B37FPBC w/o 04/11111 PERMISSION MUST BE OBTAINED TO RETURN PARTS AFTER 15 DAYS. 15% HANDLING CHARE DEDUCTED - INVOICE NUMBER COVERING BILLING OF PARTS MUST BE GIVEN. CUSTOMER OR HIS AGENT ACKNOWLEDGES RECDPT OF THE ITEMS INDICATED AS SHIPPED ABOVE AND AGREES THAT THE TERMS. CONDITIONS AND LIMITATIONS PRINTED ON THIS DOCUMENT WILL APPLY TO ALL ITEMS USTED HEREON. RECEIVED BY DATE CUSTOMER INVOICE HAPENN M3 H. O. PENN MACHINERY COMPANY, INC. slllCE ~s2a BLOOMINGBURG, NY 783 BLOOMINGBURG RD, 12721 845-733-6400 BRONX, NY 699 BRUSH AVENUE, 10465 718-863-3800 HOLTSVILLE, NY 660 UNION AVENUE, 11742 631-758-7500 NEWINGTON, CT 225 RICHARD STREET, 06111 860.666.8401 POUGHKEEPSIE, NY 122 NOXON ROAD, 12603 845.452.1200 SOLD TO: 000064 * 000064 001 SHIP TO: FISHERS ISLAND FERRY DISTRIC 5 WATERFRONT PARK PO BOX H NEW LONDON, CT. 06 FISHERS ISLAND NY 06390 MIMOIGE'. NUM INVOICE DATE USTUMp k^ ZUWDMgR PUMMAEE. ORMHR'NUMMEM ORS MV '.Zw K MAN T060 I PAM¦ : PSCE4650280 10-17-13 18697 JOHN 09 C 2 1 PaDR.M N Doc. MATE PC rM EfUPYIA 1 040760203 10-19-13 10 10 UPS GROUND 3995882 '/4ANE EERW..... ER E"Iwmwv NUMMER METE1t R"al"o Iklt NO. AA UNKN 099200001 -0ummTY ITMNL.. 'NR DESCRIPTION UNR PIDCE EXTpiE1014 PARTS SALES PERSON: MARK BARANSKI 4 6L-4714 'FILTER-- AIR 95.48 381.92 4 2N-7003 FILTER-S00'] s 13.99 55.96 1 9X-1413 'SOLENOID A .,I 185.25 185.25 TOTAL PAR'.- 623.13 T 1 FREIGHT OUT 33.24 TOTAI, MISC CHARGES 33.24 T CONN SALES 'TA-X 41.68 T g o NOT RETURNABLE FISHERS ISLAND FERRY DISTRICT VENDOR 016200 PIELA ELECTRIC, INC. 11/19/2013 CHECK 1551 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5709.2.000.000 140145 CIRC PUMP NL TERMINAL 247.10 TOTAL 247.10 ~ .r 4 ; ~R A THE ORIGINAL CHECK HAS A COLORED BACKGROUND. A VOID COPY FEATURE AND WATERMARK PAPER AftV ~ OHO' 0~tf ~ CHCk ~R,= 1552,.... 'kKS90HKC eh~gK°' TWO HUNDRtD ftflY SUV99 AND 10/200 DGI;t^~ Pal` PIwi*,hv ` *Y&, INS. "o ifi YSOlYD- omm OF pMT rT 06365- ' ff, 1180OLSSIna 402i40546 4i: 6g OOLS02 1118 i~ Vendor No. Check No. Town of Southold, New York - Payment Voucher 16200 5 51 Vendor Tax ID Number or Social Security Number Vendor Address Entered by 16 Halls Mill Road Vendor Name Preston, CT 06366 Audit Date Plela Electric Inc Vendor Telephone Number NOV 1 g 2013 Town Clerk, Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 1401461 10/16/2013 $247.10 $247.10 Circ Pump NL Terminal SM6709.2.000.000 I I $247.10 - $247.10 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature - Title Signature ( ~1 Company Name Date Title Date / y y ? Piela Electric, Inc Page:1 16 Halls Mill Road INVOICE "Preston, CT 06365 Phone 860.889.8476 140145 Fax 860.886.2757 CUSTOMER NO FISHE01 SOLD TO SHIP TO Fishers Island Ferry Fishers Island Ferry Attn: Accounts Payable Attn: Accounts Payable Box H Box H Fishers Island, NY 06390 Fishers Island, NY 06390 USA USA INVOICE DATE SHIP VIA F.O.B. PAYMENTTERMS 10/16/13 Balance Due in 30 Days PURCHASE ORDER NUMBER ORDER DATE SALESPERSON OUR ORDER NUMBER Mtr, Shop QTY ERED SHIP ED 60 NUM ER DESCRIPTION PRICE DISC % EXTENDED D [ORD 1.00 1.00 L Motor Shop Labor Repair Ticket 36.00 36.00 G368318 Rotom 1/3 HP Motor, 1725 Pump Motor 1.00 1.00 RP Motor Shop Repair Parts 196.35 196.35 G 1 CC, Po m) 0 1UL rrmyjq ~ © K 54-Pvc 101 b -13 Fisher's Island Ferry Subtotal 232.35 Taxable 232.35 CT tax 14.75 Non-Taxable 0.00 Total 247.10 0.00 247.10 FISHERS ISLAND FERRY DISTRICT VENDOR 014156 POLAND SPRING DIRECT 11/19/2013 CHECK 1552 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.000 03JO441584661 BOTTLE WATER IN NLT 63.54 TOTAL 63.54 ab: y m THE kwJ%f G d ORIGINAL COLORED g~ v~W e 4 \ 1~' < F Aimv sirNYi1i71~ CUT _ iD6483Zb z lj1n9 D 2 SrXTY THREE AND 54/2flt1 DOLLARS _ F - e ~ m L hre O Po Sox t56,192, . or LOUISVILLE KY 402SS-6192 11000i5S2,1' ":021405464i: 68 OOL502 i'i' * Vendor No. Check No. ^ Town of Southold, New York - Payment Voucher 14156 1 55 d Vendor Tax ID Number or Social Security Number Vendor Address Entered by e4-3027237 PO Box 856192 Vendor Name IQ~~ S p t YlG jre Louisville, KY 40285$192 Audit Date Nestle Waters of North America Inc. J q q Vendor Telephone Number NOV 19 2013 ' 800-950-9396 To Clerk - - Vendor -Comact Invoice Invoice Invoice Net Purchase Order ~C. Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 03JO441584661 10/10/2013 $63.54 $63.54 Bottle Water in NLT SM5710.4.000.000 $63.54 $63.54 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify, that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that tttaxes , from which the Town is exempt are eexxcluded. or discrepancies noted, and payment is approved Signature Title Signature Company Name / Date Y ~~(/v ~ Title ~4~ Date _ / - v/~ "m1m.polandspring.mm BILLING PERIOD INVOICE NUMBER • 215 6661 DIXIE HWY, SUITE 4 i LOUISVILLE KY 40256 09/11/13 -10/10/13 03J0441584661 ADDRESS SERVICE REQUESTED UPCOMING DELIVERIES ACCOUNT NUMBER 'I'II I I I III III II I II I I I I I I II I II I III THU- OCT 24 0441584661 FRI- NOV NOV 22 THU- DEC 26 TUE- JAN 28 FISHERS ISLAND FERRY DISTRICT Customer Service: 1-800-950-9396 GORDON MURPHY BOX H Did you forget about us? Kindly pay upon receipt. FISHERS ISLAND NY 06390-0607 Remember, past due accounts are subject to a late fee. Your prompt payment Is appreciated. For your ""'11i~~II~I'III~III""I'II'r~III~~IrIr~~1~I~IJr1'lll'lll~l' convenience, pay online: servlce.polandspring.com. If payment has been made, we thank you. ACCOUNT ACTIVITY For uestionsor ar rtonwater uali and information cell/-600-950.9396 ordsitsgrvica. lands rin .com. DATE REFERENCE # • DESCRIPTION AMOUNT Delivery address: FISHERS ISLAND FERRY, 5 WATERFRONT PARK, FERRY OFFICE, NEW LONDON CT 06320 PREVIOUS BALANCE 124.04 9/17 663432 PAYMENT-THANK YOU -37.56 9126 4077157073 8 5 GAL PS HANDLE SPILL PROOF 47.92 BOTTLE DEPOSIT: 8 CHARGED, 8 CREDITED .00 10/10 4086533660 1 OIL/FUEL SURCHARGE 2.88 J3476193 RENT 11.98 SALES TAX .76 TOTAL 150.02 ACCOUNTSUMMARY PREVIOUSBALANCE PAYMENT/ADJUSTMENT CURRENT ACTIVITY PAYTHISAMOUNT Subject to terms on reverse side. 124.04 37.56 + 63.54 = 150.02 BILLING RIGHTS SUMMARY YOUR INVOICE - 4 WAYS TO HELP US SERVE YOU BETTER 1. Please remember payment is due by the "pay by" date noted to ensure the smoothest service. IN CASE OP ERRORS OR QUESTIONS ABOUT YOCR BILL, OR FOR 2. Remember, if you are renting equipment, your equipment rental is charged one month in advance. That means A REPORT ON WATER QUAIITY AND INFORMATION, PLEASE your first invoice "Ill include a pro-rated fee for the current month, plus the next month's rental. CALL 1-800-950-9396 OR WRITE US AT. 3. Kindly fill in the amount enclosed, include your account number on your check and do not send cash. POLAND SPRING WATER CO. If you prefer, you can pay your bill online at service.polandspring.com. 4216 4. Never hesitate to call us with comments, questions, or concerns. 6661 DIXIE HWY., SUITE 4 LOUISVILLE. KY 40258 If van think your hit) is wrong, or Ifyou need mom information about a transaction on your bill, write is ot; a sopens, sheet of paper SAMPLE INVOICE We must hear from you in writing no later than thirty (30) days after we sent Our the first bill an which the error or problem appeared You can telephone us, but doing so will not preserve your rights. In your Farm, give us the following informadem Date range of this invoice Your name, address, telephone and account numbers. A The dollars mnunt of the suspected error_ Describe the corm and explain if you can, why yon believe there is ~ tnnsnasv Your Account Number air voloolvv vvrvalav 1 - You are obligated to pay the parts of your bill that arc not in function. You do not have to pay the disputed amount while it is being nvsnasv/ investigated_ During the investigation, we cannot repel your unl Watch here for a as delinquent er take any action w collect the oracular question ter ooc,F s L se personalized account GENERAL INFORMATION Important an.aa sl,mpa.nn,usn„aas..nsane e,.om=...r'R 11 so mmanme, message Pay-teens received after the billin (INVOICG7 date willsp o oew9 and n°rm~ utur dated '","""av"~•"e g days of offers ivm, s `"p e arwa° Four next invoice Past due invoices rat p 1 30 dn ys within may be assessed a late te fee as allowed d by law not to to bda1, t.e.. a.,a^n..n-LAt4n+.a exceed S20 pct month_ Additionally. thin I parry c.have .Naworse, Pay electronically ,a,,a.e.. may he a......d at a rate not in caused 100% of the unpaid halarec or the maximum allowed by law. 2_ Fach returned check is subject to a service charge subject to the Make sure this maximum check return charge allowable in your State Activity amount has been your eaoua* ernvnv 3. All bottle and combiners deposits are shown as CURRENT since y paid in full to A( IIVIFY last invoice avoid late fees 4. Escipis t replacement assts will be charged hat bottles lost -xs stolen, damaged or not returned. s,,,,m Monthly Oil 1-11 -1 1 5_ In accordance with NWNA Term, and Cord i mu ("T&C'), your s= Surcharge, Fuel Equipment Lease and/or Service Agreement account may be subject to minimum monthly purchases and/or early cancellation Surcharge or Delivery Sides. (A complete vension of the current me,beviewelonthe Fee (see #6 under website listed below) Upon service discontinuation, rent for the "General Leased Turbaned is charged through the end of the billing cycle . E - F=~~ Information") in which service discontinued a r ( - _ _ - - Payment stub c tar - 6 You will be charged a monthly Oil Sumha ge, Fuel Surcharge or _ 'A' 11 1 .r co-am Mcoimr uai -'s s Dehrery rem as described in your r&c. only .at of mean Re, onfo.11 will ii or each me...I The fee hat ppl t yt cconunt socarai as s;. I- - --n is stated the front ofthe Invoice F Francs xmstion gleam more v visit the bsits listed below or contact our customer service _ x... x . vvavvvssm vsz 1=.°n=. Amount due enter 7 As a foot product, heated at is :ubleLt to the rules and o nut regulations promulgated by the Federal Food and Drug r u s,o ns Administration (FDA). aJ Submit your ,e 8 Your first invoice indicates the products delivered ed on your first .act t.a. ` a t e c-,µw , A delivery, along with my applicable bottle and ,count deposits, payment by this redemption foes, and a v dispenser charges. All furore invoices date will reflect charges far ester delivered and JrPamer rental, hurtle deposits and credits phis charges for any additional products crderidbyyor Deliveries are made wary three or four weeks, for a total of I6-17 deliveries per year You will only receive invoices 12 times per year. so approximately 5 of those invoices will reflect two deliveries_ y © 2008 Poland Spring Water Company, a Division of Nestle Waters North America Inc. Form No. NW 715 11/08 service.polandspring.com OA FISHERS ISLAND FERRY DISTRICT VENDOR 016659 PRINCIPAL LIFE GROUP 11/19/2013 CHECK 1553 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 H19730-1-11/13 LIFE PREM 11/1-11/30/13 272.58 TOTAL 272.58 e n S+t,.n T 4 '_o- ~bY C YFfi :o nr t~.g ~1hT D++-.:;d5ia. ~4;II ~a ORIGINAL COLORED g„ y s A tl~fH9l¢.Ok1 •i ~~a aa\~x~c n\~a~ 50-940t21'4 TWO KMREb 6_WA WTY TWO AbM 581100 DOLIA" Y~ x -Kw 'Pst3' Wl`L,'`'~ s Llft GAQUP 4 e~ as).,~ To - - sav ~s - tME OItTJFdi , ~ 13" 1451.3 OP M Dig bb iEg IA 54306-a(433 11o00L553118 1:02L405461.~: 68 00L50Z Lilo Vendor No. Check No. Town of Southold, New York - Payment Voucher 16659 15503 Vendor Tax ID Number or Social Security Number Vendor Address Entered by P.O. Box 14513 Des Moines, IA 50306-3513 Audit Date Principal Life Group '1 1I y 19 p Vendor Telephone Number NOV 2013 800-843-1371 Cler Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number M-130 1 -11 10/1712013 $272.58 $272.58 Life Prent SM9060.6.000.000 14 11/1/13-11/30/13 I $272.58 $272.58 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) 1 hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature Title 10 1 A Signature Company Name / Date"`~ Title Date_ r PREMIUM STATEMENT a FFF117 ncial Principal Financial Group I Principal Lite I This statement in no way changes the Group Des Moines, IA 50392-0001 Insurance Company contract or waives any overdue payment Account Number H19730-1 Lb.No. 0819730 00001 93 000136 Due Date 11/01/13 Stmt Date 10/17/13 Billing Period 11/01/13 - 11/30/13 FISHERS ISLAND FERRY ATTN J MILLER 261 TRUMBULL DR BOX 607 Please Pay Balance Due FISHERS ISLAND NY 06390 $ 272.58 PLEASE REVIEW ALL MESSAGES BELOW. THEY CONTAIN INFORMATION RELATED TO YOUR PREMIUM PAYMENTS AND THE ADMINISTRATION OF YOUR PLAN. IF YOU HAVE QUESTIONS REGARDING ANY OF THESE MESSAGES, PLEASE CONTACT US AT THE NUMBER LISTED BELOW. IT IS IMPORTANT TO REPORT NEW ENROLLMENTS, TERMINATIONS, AND CHANGES IN DEPENDENT STATUS PROMPTLY TO OUR WEBSITE AT WWW.PRINCIPAL.COM OR NOTIFY OUR ADMINISTRATION AREA. WEB REPORTING REQUIRES A PIN. IF YOU DO NOT HAVE A PIN, PLEASE CALL 800-621-6280. REPORTING CHANGES PROMPTLY WILL RESULT IN A MORE ACCURATE PREMIUM STATEMENT. CHANGES SHOULD NOT BE SENT WITH YOUR PAYMENT. FOR ASSISTANCE, PLEASE CALL TOLL FREE: 1-800-843-1371 NOTICE--TO AVOID DISCONTINUANCE OF YOUR PLAN, PLEASE BE SURE YOUR $136.29 BALANCE IS PAID AND RECEIVED IN THIS OFFICE BEFORE THE GRACE PERIOD ENDS ON 10/31/13. IF YOU HAVE PAID, PLEASE DISREGARD THIS NOTICE. PROVIDING YOU WITH GOOD SERVICE IS IMPORTANT. PLEASE REVIEW YOUR STATEMENT EACH MONTH TO ENSURE PROMPT AND ACCURATE CLAIM PAYMENT. - - - - fina~ia/ Principal Financial Group Principal Life PREMIUM STATEMENT This statement in no way changes the Croup Des Moines, IA 50392-0002 Insurance Company contract or waives any overdue payment THIS IS YOUR COPY. PLEASE KEEP FOR YOUR RECORDS. ACCOUNT NO. H19730-1 FISHERS ISLAND FERRY Le. NO. 0819730 00001 93 DUE DATE: 11/01/13 STMT DATE: 10/17/13 A CHARGE/ ID G BILL LIFE/AD6D CREDIT NUMBER NAME E MONTH BNFT PREM 97t2673tt BROWNi DONA 52 1'.1Oft3 44000 6149 6.49 9755tOO34 BURKE<STEP 53 ttO1t3 (0000 8,49 6,49 9t2050289 BARNS§RONA 53 [tO113 to000 6,49 6,49 93444$811 DOUCETTE C BO t'f Oft3 ItOO00 8.49 8.49 904919399 EAOAN-RANI 24 110tt3 10000 6,49 6,49 945736524 ESPINOSA N 30 110113 10000 6,49 5.49 980255278 FENTON SCO 27 110113 10000 6.49 6.49 56558752 FIORA MICH 32 110113 10000 6,49 6,49 97750897 FORD POLLY 44 110113 10000 6.49 6.49 38317938 FRANCO MIC 57 110113 10000 6.49 6.49 996223868 HANEY: ODRA 311.10113 10000 8149 5.49 965391736 HILLER JON 55 1tOtt3 tO000 5,49 6.49 901458613 LAMB DONAL 57 110t1S 10000 6.49 i 6.49 9661t$534 LAVIN4 OR A 58 t.10113 40000 8.49 6,49 927278449 LE FE:VR£ R 50 ftO113 tp000 6,49 6.49 935118920 MARKS JASO 25 110113 10000 6.49 6.49 966377308 MARSHALL J 38 110113 10000 6.49 6.49 57847586 MORGAN JOH 33 110113 10000 6.49 8.49 70433972 MURPHY GOR 56 110113 10000 6.49 6,49 982693982 PARADIS JO 47 110113 10000 6.49 6.49 20099292 TRAUBJAME 5B 1310113 (0000 8149 5,49 SUMMARY TOTALS - TOTAL COVERED 2t LIFE / AD6D 210,000 BAL DUE LAST 135.29 PMT SINCE LAST .00 NET CREDITS .00 SAL FORWARD 135.29 CHARGES THIS STMT 136.29 'TOTAL AMT DUE 272.59 LIFE / AD6D PREMIUM TOTALS 8138,29 FOR ASSISTANCE, PLEASE CALL TOLL FREE: 1-800-843-1371 F396GP-4 ACCOUNT NO. H19730-1 11/01/2013 000 000000 000000 CGS631832901172455001001 0000335 002 OF 002 FISHERS ISLAND FERRY DISTRICT VENDOR 018011 CHRISTOPHER L. RAFFERTY 11/19/2013 CHECK 1554 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5712.4.000.000 093013 '13 COMM MTG JUL-SEP 300.00 TOTAL 300.00 s "WNW THE ORIGINAL CHECK HAS A COLORED BACKGROUND. A VOID COPY FEATURE AND WATERMARK PAPER soit~aSlGO"nr1~~~°ASSS1~ MESA" THE C 6UPFOLK,QD~{'I~FI0NAL 6MNIF ~ , C1Y4'omoem, NY 41339 S{fS461214 1 3900 THREE HUNDRED AND 00/100 D014L ARS PAY C -qTg?~ R L. RAFFERTY" _ % PO B(>X 311 or, FISHSR Z9t AND NY 063+10-01183 H'%%l/d%',/'' W "v wms_ - 1 0H` raa 11'001554110 1:0 2 140 54641: 66 001502 1110 Vendor No. Check No. Town of Southold, New York - Payment Voucher 118011 Vendor Tax ID Number or Social Security Number Entered by Vendor Name P.O. Box 393 Audit Date Christopher L. Rafferty Fishers Island, NY 06390 ~O, 3 - NOV 19 Vendor Telephone Number Vendor Contact Invoice Invoice Invoice Net Purchase Order AA Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number UaJ~~3 9130/2013 $300.00', $300.00 Commissioner Meetings SM5712.4.000.000 July-September 2013 6 Mtgs @ $ 50.00 I i $300.00 $300.00 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no pan has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt ayre(excluded . or discrepancies noted, and payment is approved. Signature Title 144A-11 r / Signature y% r- Company Name Date / / vGV Title Date / ~j Sheetl $50.00 a meeting Meeting Date Brooks, Robert Edwards, Christopher Rafferty, Christopher Rugg, Peter Wall, Robert Burnham, D Cook, Harold 07/01/13 1 1 1 07/15/13 1 1 1 08/06/13 1 1 1 08/16/13 1 1 1 1 08/26/13 1 09/03/13 1 1 09/23/13 1 1 1 1 Total Meetings 0 7 6 3 0 2 2 3rd Quarter 0 350 300 150 0 100 100 i i Page 1 FISHERS ISLAND FERRY DISTRICT VENDOR 018752 PETER RUGG 11/19/2013 CHECK 1555 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5712.4.000.000 093013 '13 COMM MTG JUL-SEP 150.00 TOTAL 150.00 ° z :r- * y, ew THE ORIGINAL CHECK HAS A COLORED BACKGROUND A VOID COPY FEATURE AND WATERMARK PAPER - hex 3~0.• , ~ ~t Cu ~Mp ertrcaa®ue *as "£"~~N ea?raerats 1~~~9~1~.. _ ©Ng HUNDmb FZFTY AND OQ/100... DOW.Ikk$: _ ' Syr v cZp~ #s s;jpx v~Yag „fw - - ~tA mil, f 'a~~ PWT9$t RV ;;ice v S srf-~ air yut $T. ` 5A z4 OF mw YORK NY 10021 ia~ r a2 P6yP py % n•00ISSSill 1:02i40546ix 68 001502 in• Vendor No. Check No. Town of Southold, New York - Payment Voucher 18752 1555 Vendor Tax ID Number or Social Security Number Entered by 102-36-3439 Vendor Name 136 E. 76TH STREET, APT SA Audit Date Rugg, Peter NEW YORK, NY 10021 NOV 19 2013 Vendor Telephone Number Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number Qq 509/30/2013 $150.00 $150.00 Commission Meeting SM5712.4.000.000 July-September 2013 3 Mtgs @ $50/mtg I I $150.00 $150.00 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature r~ Title Signature e ~ Company Name Date Title Date Sheet1 $50.00 a meeting Meeting Date Brooks, Robert Edwards, Christopher Rafferty, Christopher Rugg, Peter Wall, Robert Burnham, D Cook, Harold 07/01/13 1 1 1 07/15/13 1 1 1 08/06/13 1 1 1 08116/13 1 1 1 1 08/26/13 1 09/03/13 1 1 09/23/13 1 1 1 1 Total Meetings 0 7 6 3 / 0 2 2 3rd Quarter 0 350 300 150 / 0 100 100 Page 1 FISHERS ISLAND FERRY DISTRICT VENDOR 019719 STAPLES CREDIT PLAN 11/19/2013 CHECK 1556 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5711.4.000.000 4341561001 FI OFFICE SUPPLIES 109.06 SM .5711.4.000.000 4925716001 FI OFFICE SUPPLIES 74.14 SM .5711.4.000.000 8345689001 FI OFFICE SUPPLIES 24.94 TOTAL 208.14 r b THE ORIGINAL CHECK HAS A X COLORED BACKGROUND A VOID COPY FEATURE AND WATERMARK PAPER a e' VW'~ ui 'H ',~I**.m r yc pp~C HOIC~NY 71Q07rg96e ItD9 - a vmo~°' ~CK 15r,.t. CUiC ix ¢N°riNKSxf®s"iL °,iwK' TE - __T 53.545/214 11-~.92fl= TWO HU9MED BIGHT AND 14/190'DOLLAkS d PAY S'P"LEB CREDIT PLAN - TO 714H DEVT! 31-5 000307773 ORM OF .F17 BOk 689020 OF -BEB HgS IA 50366-9020 - - r~ asrT- a. 11200155611' 1:02i4054B4,: 68 001502 iii' Vendor No. Check No. Town of Southold, New York - Payment Voucher 19719 1556 Vendor Tax ID Number or Social Security Number Vendor Address Entered by PO Box 414524 Pip Vendor Name Boston, MA 022414524 Audit Date Staples Contract & Commercial, Inc. NOV 19 2013 Vendor Telephone Number 866-996-8103 Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services 4341561001 9/24/2013 $109.06 $109.06 Fl Office Supplies SM5711.4.000.000 4925716001 9/10/2013 $74.14 $74.14 FI Office Supplies SM5711.4.000.000 I 8345689001 9/1012013 $24.94 $24.94 Fl Office Supplies SM5711.4.000.000 $208.14 $208.14 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved Signature ~i Title :o r ~ Signature Company Name ~.v Date 14- ~G~~ Title Date 1,3 Account Statement Commercial Account 6 Customer Service: FISHER ISLAND FERRY DIST stapies.accountoniine.com Account Inquiries: that was easy.- ® 1-800-767-1291 Fax 1-601-779-7425 Account Number: 8035 5178 2065 7673 Summary of Account Activity Payment Information Previous Balance $1,321.98 Current Due $31.00 Payments -$79642 Past Due Amount + $0.00 Credits -$0.00 Minimum Payment Due $31.00 Purchases +$208.14 Debits +$0.00 Payment Due Date 11/03/13 FINANCE CHARGES +$0.00 Late Fees +$0.00 Credit Line $10,500 New Balance $733.70 Credit Available $9,766 Closing Date 10/09/13 Send Notice of Billing Errors and Customer Service Inquiries to. Next Closing Date 11/08/13 STAPLES CREDIT PLAN 9 PO Box 790449, St. Louis, MO 63179-0449 Days in Billing Period 31 TRANSACTIONS Trans Date Location/Description Reference # Amount 09/10 #6823645689-000-001 PUTNAM CT $ 24.94 0 09/10 #9243925716-000-001 PUTNAM CT $ 74.14 U- ,l 09/24 49244341561-000-001 PUTNAM CT $ 109.06 W PAYMENTS, CREDITS, FEES AND ADJUSTMENTS r 09/15 PAYMENT - THANK YOU P9194008209K15SRV $ 796.42- FINANCE CHARGE SUMMARY Your Annual Percentage Rate (APR) is the annual interest rate on your account. Annual Percentage Dally Periodic Balance Subject to Type of Balance Rate (APR) Rate Finance Charge Finance Charge PURCHASES REGULAR REVOLVING CREDIT PLAN 0.00% 0.00000% $0.DO $0.00 NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION Page 1 of 8 This Account Is Issued by Citibank, N.A. Information About Your Account. Proper Form. For a payment sent by mail or courier to be in proper form, Grace Period on Purchases. You can avoid periodic finance charges you must: on purchases, but not on cash advances. This is called a grace period Enclose a valid check or money order. No cash, gift cards, on purchases. You can get a grace period of at least 20 days. To do or foreign currency please. so, pay the following amounts by the due date every billing period: Include your name and the last four digits of your account number. the New Balance (subject to the Promotional Balance Exceptions), Copy Fee. We charge S5 for each copy of a billing statement that dates plus the minimum monthly payments required for your No Interest and 0% balances. If you do not, you will not get a grace period unless halahack 3ncemonths more. e If add the fee the regular revolve credit plan you pay those amounts by the due date for two billing periods Ina . We waive the fee your request t for the copy relates to a billing row. The two Promotional Balance Exceptions are: (1) You do not have en or or disputed purchase. to pay any No Interest or 0% balances that do riot expire by the Next Payment Other Than By Mail. Closing Date shown on the billing statement. (2) You can pay any No Online. Go to the URL on Page 1 of your statement to make a Interest or 0% balances that do expire by the Next Closing Date shown payment. For security reasons, you may not be able to pay your on the statement by the later of the promotion's expiration date or the entire New Balance the first time you make a payment online. The statement's payment due date. payment cutoff time for Online Bill Payments is midnight Eastern Certain promotional offers may take away the grace period on purchases. time. This means that we will credit your account as of the calendar Other promotional offers may allow you to have a grace period on day, based on Easton; time, that we receive your payment request. purchases without having to pay all or a portion of the promotional Phone. Call the phone number on Page 1 of your statement to make a balance by the due date. If either is the case, the promotional offer payment. We may process your payment electronically after we verify will describe what happens. your identity. You will be charged $14.95 to use this service. The Balance Subject to Finance Charge. We calculate periodic finance payment cutoff time for Phone Payments is midnight Eastern time. charges separately for each balance. Balances include regular purchases, This means that we will credit your account as of the calendar day, regular cash advances, and different promotional balances, based on Eastern time, that we receive your payment request_ To get a daily balance, we start with the balance as of the end of the Express Mali. Send payment by courier or express mail to: Customer S IA 50.l23. 5 ervice day. We add any new charges. We then subtract any new credits Center, Dept. CCS 3n per form 1st Street, Urbandale, e by 5 time be t received be credit it ped rroo as per ssthat at the proper address s or payments and make other adjustments. A credit balance is treated as Central must v a balance of zero. if the rate on a balance is a dally rate we include in the In proper i day. All payments received daily balance any periodic finance charge on the previous day's balance. In poper format the proper address after that time will be credited G^ (This results in daily compounding of finance charges.) as of the next day. -J If you send an eligible check with this payment coupon, you authorize W If the rate on a balance is a daily rate we use an average daily balance us to complete your payment by electronic debit. If we do, the checking C3 method (including new transactions). We figure the periodic finance account will be debited in the amount on the check. We may do this as h- charge by multiplying the daily balance by its daily periodic rate. We do soon as the day we receive the check. Also, the check will be destroyed. this for each day in the billing period. The Balance Subject to Finance Charge is the average of the daily balances during the billing period. If Report a Lost or Stolen Card Immediately. Yoo may cal! Customer you multiply this figure for each balance by its daily periodic rate and ny Service 24 hours a day, 7 days a week, the number of days in the billing period, the result is the total periodic Notify Us In Case of Errors or questions About Your Bill. If you think finance charge on that balance. Rounding may cause a small difference. your bill is wrong, or if you need more information about a transaction Other Account and Payment Information. on your bill, write us (on a separate sheet) at the Billing Errors address When Your Payment WIII Be Credited. If we receive your payment in on this statement as soon as possible. We must hear from you in writing proper form at our processing facility by 5 p.m. local time there, it will no later than 6C days after we send you the first bill on which the error be credited as of that day. A payment received there in proper form or pronlem appeared. In your letter, give is the following Information: after that time will be credited as of the next day. Allow 5 to 7 days for Your name and account number, payments by regular mail to reach us. There may be a delay of up to 5 The doliar amount of the suspected error. days in crediting a payment we receive that is not in proper form or is Describe the error and explain, if you can, why you believe there is not sent to the correct address. The correct address for regular mail is an error. If you need more information, describe the item you are the address on the front of the payment coupon. The correct address unsure about. for courier or express mail is the Express Mail Address shown in the Express Mai section. 1`03936.9164-1560-0002--0---04/01/02-96-000-P--0--0-0-0--12131/99-ST09-September8, 2013-0- N--- F-0 ST-OS CHC JUL13 Remit payment and make checkspayable to STAPLESES CR CREDITDIT PLAN INVOICE DETAIL DEPT. 51 7820657673 that was easy.- PO BOX 68o20 DES MOINES IA 50368-9020 BILL TO SHIP TO: Acct: 6035 5178 2065 7673 DEB DOUCETTE Amount Due: Trans Date: Invoice FISHERS ISLAND FERRY 4341561001 261 TRUMBULL DR $109.06 09/24/13 FISHERS ISLAND, NY 00000-0000 PO: Store: 100066887, PUTNAM PRODUCT SKU # QUANTITY UNIT PRICE TOTAL PRICE Staples 8.5x11 copy cs 000135848 1.0000 CT $37.79 $3719 SPLS STNDRD TAPE 48MMX100 000380107 1.0000 PK $17.79 $17.79 SIMPLY NOTES 3X3 YELLOW 1 000486955 1.0000 PK $14.99 $14.99 BROTHER TZE-2312PK 12MM B 000917881 1.0000 PK $38.49 $38.49 Purchased by: GORDON MURPHY SUBTOTAL $109.06 TAX $0.00 SHIPPING $0.00 TOTAL $109.06 BILL TO SHIP TO Acct: 6035 5178 2065 7673 DEB DOUCETTE Amount Due: Trans Date: Invoice FISHERS ISLAND FERRY 4925716001 261 TRUMBULL DR $74.14 09/10/13 FISHERS ISLAND, NV 00000-0000 0 PO; Store: 100088887, PUTNAM v w PRODUCT SKU # QUANTITY UNIT PRICE TOTAL PRICE 0 WITE OUT SHAKE & SQUZE CO 000450852 2.0000 EA $2.99 $5.98 HP 940XL YEL INK 000772997 1.0000 EA $25.19 $25.19 HP 940XL MAG 000772998 1.0000 EA $25.19 $25.19 OF 6X9 CLEARCLASP ENVE 000812457 1.0000 BX $13.79 $13.79 CLIPS BINDER MED 24CT 831 000831602 1.0000 PK $3.99 $3.99 Purchased by: GORDON MURPHY SUBTOTAL $74.14 TAX $0.00 SHIPPING $0.00 TOTAL $74.14 BILL TO: SHIP TO: Acct: 6035 5178 2065 7673 DEBBIE DOUCETTE Amount Due: Trans Date: Invoice FISHERS ISLAND FERRY ~1 260 TRUMBULL DR $24.94 09/10113 FISHERS ISLAND, NV 00000-0000 PO; Store: 100088887, PUTNAM PRODUCT SKU # QUANTITY UNIT PRICE TOTAL PRICE STAMP SELF-INK 3/8 X 2-3/ 000836318 1.0000 EA $14.99 $14.99 SHIPPING SKU 1 000364187 1.0000 EA $9.95 $9.95 Purchased by: DEBBIE DOUCETTE SUBTOTAL $24.94 TAX $0.00 SHIPPING $0.00 TOTAL $24.94 Page 7 of 8 1-800-767-1291 staples.accountonline.com This page intentionally left blank. cr w w 0 r Page 8 of 8 1-800-767-1291 staples.accountonline.com Staples.com® I Printable Order Summary hays://www.stapies.com/office/supplies/orderconfprnt?catalogld=l0... • M goommmmom that was easy ;t Printable Order Summary Thank You for Your Order For complete order details like sales tax, shipping info and Software Download instructions, keep an eye out for an email from Staples at the address below. Order confirmation will be sent to: ddoucette@fiferry.com Order No 1: 9244341561 Order date: September 24, 2013 You'll also find complete details of this order in the Order Status section of My Account. You can view this information 15 minutes after your order is submitted. Shipping Address Deb Doucette Fishers Island Ferry District 261 Trumbull Dr Box 607 Fishers Island, NY, 06390-8021 (631) 788-7463 Not going to be around to receive or sign for your order? Please fill out a Driver Release Agreement: http://www.staples.com/sbd/content/help/shipping/nothome_popup.htmI Billing Address Gordon Murphy Fishers Island Ferry District 261 Trumbull Dr Fishers Island, NY, 06390-0607 (631) 788-7463 Your order may be sent in different shipments. If it is, no additional charges will apply.For Software Download, an email containing download instructions, software link(s) and activation code(s) will be sent following the email confirmation of your order. !Order No: 9244341561 Item 135848 Staples@ Copy Paper, 8 112" x 11", Expected business-day !Qty: 1 Price: Case delivery: Thu 09/26 at $37.79 5,000/Case 1$37.79 Item 380107 Staples@ Standard-Grade Packaging Expect ed business-day Qty: 1 !Price: Tape, Clear, 1.89" x 110 yds, 6 Rolls delivery: Thu 09/26 at $17.79 6/Pack I$17.79 Item 917881 Brother@ TZe-2312PK P-Touchy Expected business-day Qty: I Price: Label Tape, 1/2" Black on White, delivery: Thu 09/26 at $38.49 2/Pack ;.$38.49! 2/Pack Item 486955 SimplyTm 3" x 3" Yellow Notes, Expected business-day !Qty: 1 Price: 18/Pack delivery: Thu 09/26 at $14.99 18/Pack :$14.99': I of 2 9/24/2013 1 1:25 AM Staples.com©~ Printable Order Summary https://www.stapies.com/office/supplies/orderconfpmt?catalogld=l0... Subtotal $109.06 Coupons: $0.00 Estimated Tax: Tax Exempt - Delivery: Free Total: $109.06 Remaining Balance: $109.06 Remaining Balance will be applied to following: Staples Credit Card ending in 7673 Hold on to your Staples Rebate Visa Cards and Prepaid Gift Cards until your order has been received If you have any questions or concerns about your order, please call 1-800-STAPLES (1-800-782-7537) or email support@o rdem.staples.co m Important information concerning coupons and sales tax can be found at: coupons and sales tax The tax shown is estimated. Your Order Confirmation Email will include shipment details, product availability and estimated tax. Important information concerning return policy can be found at: return policy. For complete order details like sales tax, shipping info and Software Download instructions, keep an eye out for an email from Staples at the address above.You'II also find complete details of this order in the Order Status section of My Account. You can view this information 15 minutes after your order is submitted. Sign up to receive Staples emails with great online and in-store offers and exclusive money-saving discounts. This Web site is intended for use by US residents only. See International Sites. See our delivery policy for full details. Copyright 2012, Staples, Inc., All Rights Reserved. Questions? Call 1-800-333-3330 or email us. Site Map I I AdChoices 2 of 2 9/24/2013 11:25 AM For Customer Service, call. REFER TOSEIP THIS ORDER NO. FOR ALL INQUIRIES. 1-800-333-3330, 'or email at CUSTOMER NO... DATE -ORDER 00. support`orders.staples.ccrp. Order 4051825224 .9/24 13 9244341561-000001 online, by phone o'r•by fax 24 PURCHASE ORDER NO. RELEASE 90'.. hours a day, 7 days a week' that was easy. COST CENTER REQUISITIONER STAPLES that was easy SHIPPING LOCATION: Pptnam• CT FC ' CARRIER ROUTE:UPS/UPS /U2 FISHERS ISLAND FERRY DISTRICT ° H'. DEB DOUCETTE ' 0TOTAL PACKAGES: 2 X' Floor: 1 L P 261 TRUMBULL DR 11'. T BOX 607, i0 FISHERS ISLAND, NY '063908021 - Q Contact: (631) 788-7463 - DEB DOUCETTE PAGE: 1 t • SPeCIAL INSTR9CfIONS ' Order Date: 09/24/2013 i Line ITEM WOMO8 ITWd MODEL LpP QTY QW Stegkea ' Extended • % IIi$CYiFPTIOIa + f JiDMeER OR7IEREF? : $NFPg$4: Pz~.a® Aidouat Coupons and other adju tments are deducted after the Merchandise Total. On large orders some boxes may be arriving,in Separate shipments. 1 135848 Staples 8.5x11 copy cs' /135848-WH IT 1 1 37.79 37.79 Material Safety Data Sleets (MSDS) may be found by visiting http'://sds. to les. com/nsds/Sta lesMSDS_ xempt.pdf 2 380107 SPLS STNDRD TAPE 48MMX100M 6PK/380107-CC , PK' 1 1 17.79 17.79 3 486955 SIMPLY NOTES 3X3 YELLOW 18PK /S-33-YW-18 PK 1 1 / 14.99 14.99 4 917861 BROTHER TZE-2312PK 12M.M BKWHT /TZe-2312PK PK 1 ~1 ? 38.49 38.49 ' M= andise Total... 109.06 D li ery.... ...00 T ix . .00 Check your order statu online by going-Lo www. Staples.com and clicking on 'my Ord rs:'. ® Need to return something? Please that waz easy' News call Customer Service to process ' TOTAL P[eview. a return. VALUE, P ' OF ORDER; 109.06 ool Thank You For Your Order! Staples, Inc. THIS IS NOT AN INVOICE Staples.comCR I Printable Order Summary Page 1 of 3 rat was egay~ k Printable Order Summary Thank You for Your Order For complete order details like sales tax, shipping info and Software Download instructions, keep an eye out for an email from Staples at the address below. Order confirmation will be sent to: ddoucette@fiferry.com Order No 1: 9243925716 Order date: September 10, 2013 You'll also find complete details of this order in the Order Status section of My Account. You can view this information 15 minutes after your order is submitted. Shipping Address Deb Doucette Fishers Island Ferry District 261 Trumbull Dr Box 607 Fishers Island, NY, 06390-8021 (631) 788-7463 Not going to be around to receive or sign for your order? Please fill out a Driver Release Agreement: http://www.staples.com/sbd/content/help/shipping/nothome_popup.html Billing Address Gordon Murphy Fishers Island Ferry District 261 Trumbull Or Fishers Island, NY, 06390-0607 (631) 788-7463 Your order may be sent in different shipments. If it is, no additional charges will apply.For Software Download, an email containing download instructions, software link(s) and activation code(s) will be sent following the email confirmation of your order. Order No: 9243925716 Item 812457 ; Quality Park@ Clear-ClaspT' 6' x 9" &pected business-day j Qty: 1 ' Price: Catalog Envelopes 100/Box delivery: Thu 09/12 !at $13.79 100/Box $13.79 . x Item 772998! HP 940XL Magenta Ink Cartridge Expected business day Qty: 1 Price: (C4908AN), High Yield delivery: Thu 09/12 at $25.19 Each $25.19 Item 772997 HP 940XL Yellow Ink Cartridge Expected business-day { Qty: 1 Price: (C4909AN), High Yield delivery: Thu 09/12 at $25.19 Each $25.19 Item 4508521BIC& Wite-Out@ Brand Correction jExpected business-day Qty: 2 Price: Pen Shake N Squeeze' 8ml )delivery Thu 09/12 at $2.99 Each `.$5.98 Item 831602;Staples Medium Metal Binder Expected business day iQty: 1 Price: https://www.staples.com/office/supplies/orderconfpmt?catalogld=10051 &orderld=185040... 10-Sep-13 Staples.com©~ Printable Order Summary Page 2 of 2 Clips, Black, 1 1/4" Size with delivery: Thu 09/12 at $3.99 24/Pack , $3.99 5/8"Capacity 1 Hold on to your Staples Rebate Visa Cards - and Prepaid Gift Cards until your order has Subtotal: $74.14 been received ti If you have any questions or concerns about Coupons: $0.00 your order, please call 1-800-STAPLES (1- Estimated Tax: Tax Exempt i 800-782-7537) or email support@orders.staples.com Delivery: Free Important information concerning coupons and sales tax can be found at: coupons and Total: $74.14 sales tax Remaining Balance: $74.14 I The tax shown is estimated. Your Order - Confirmation Email will include shipment details, product availability and estimated tax. Remaining Balance will be applied to following: Important information concerning return ---v-^-•-----_--°•^°-•-°--°°°-°--_.____..w. policy can be found at: return policy. Staples Credit Card ending in 7673 For complete order details like sales tax, shipping info and Software Download instructions, keep an eye out for an email from Staples at the address above.You'll also find complete details of this order in the Order Status section of My Account. You can view this information 15 minutes after your order is submitted. Sign up to receive Staples emails with great online and in-store offers and exclusive money-saving discounts. This Web site is intended for use by US residents only. See International Sites. See our delivery policy for full details. Copyright 2012, Staples, Inc., All Rights Reserved. Questions? Call 1-800-333-3330 or email us. Site Map I I AdChoices https://www.staples.com/office/supplies/orderconfprnt?catalogld=10051 &orderld=185040... 10-Sep-13 For Customer Service, call REFER T THIS ORDER NO. FOR ALL INQUIRIES 1-800-333-3330, or email at CVSTON= SSO. 88IF p,;y, ORDER 3N0. supportQorders.staples.com. Order 4051825224 9/10/13 9243925716-000001 online, by phone or by fax 24 P$E ORD 2Tp. REtEAOE NO.'i hours a day, 7 days a week. that was easy. cxssfi caNTax REQUISITIONER STAPLES that was easy SHIPPING LOCATION: Putnam, CT PC CARRIER ROUTE:UPS/UPS /U2 FISHERS ISLAND FERRY DISTRICT DEB DOUCETTE tf TOTAL PACKAGES: 1 Floor: 1 L 7: 261 TRUMBULL DR T BOX 607 U; FISHERS ISLAND, NY 063908021 Contact: (631) 788-7463 - DEB DOUCETTE PAGE: 1 Snzczx INSMU ONO Order Date: 09/10/2013 of ITEN . 1 NODET. tl ~ RT"I pTx StaPl ea izC6ndsd L3,ae 22Edd N[tll9, R43GEkFRIDN f N7RIEER OY ORDBEEO SRIPPEEF FKie® Am6utit Coupons and other adju tments are deducted after the merchandise Total. on large orders some boxes may be arriving in separate shipments. 1 450852 WITE OUT SHAKE & SQUZE COR PEN/50694/WOSQPPII EA 2 2.99 5.98 Material Safety Data Sleets (MSDS) may be found by visiting http://sds. to les.com/psds/450852. pdf 2 772997 HP 940XL YEL INK /C4909AN#140 EA .1 1 25.19 25.19 3 772998 HP 940XL MAG /C4908AN#140 EA 1 1 25.19 25.19 4 812457 QP 6X9 CLEARCLASP ENVE /43468 BX 1 1 13.79 13.79 5 831602 CLIPS BINDER MED 24CT 831602 /10668-CC PK 1 1 3.99 3.99 M rc andise Total... 74.14 D li ery .00 T x . .00 Check your order statu online by going to www.Staples.com and clicking on "My Or rs". ® Need to return something? Please that was east call Customer Service to process TOTAL vrwOE c ereviere a return. OF ORDER: 74.14 .01 Thank You For Your Order! Staples, Inc. THIS IS NOTAN INVOICE Order Confirmation Page I of 1 Welcome, ddourette I Shop staples com® I Questions? 1 888 333 3199 I * Can I LOgout Design Center Home Order Status I Help I My Account Ci~?+++ that was easy: Search pysprnnt, W Check-Out Complete (pending payment) Order Checkout yrp Billing Address v Payment Information tip Review and Submit Tel OMer ConOrmadon Order Confirmation Your order has been processed. and will be delivered according to your specifications to niece another order. please click here Order Number 55M5B-D2A09-BC2 Print Order Summary Shipping Address: Debbie Doucette I Fishers Island Ferry . 260 Trumbull Or. Fishers Island, NY 06390. United States of America Billing Address: Debbie Doucette I Fishers Island Ferry . 260 Trumbull Dr, Fishers Island. NY 06390. United States of America Delivered Products Quantity Price Subtotal Self-Inking Stamp - 3/8" x 2-3/4" - T4916 $24. 9 1 $14 ctSi iSlANOGERRY taS1RtQ .99 roil Saved 40°/° Blue INCLUDED $14.99' Original Price You Pay Product Total: $24,99 $14.99 Shipping & Processing (Priority 7 Business Days): $9.95 Estimated Sales Tax: $2.15 Total: $37109 $27.09 You Saved $10.001 Stale sales tax is required on this item services Support Policies Design Uploads I Customer Service Privacy 8 Security Help Terms of Use Artwork SR§Lclf cations Product Pricing I Copyright 2011 Staples Inc All rights reserved. Duectiora~ Cell 1 888 333.3199 or email us. https://print.staples.com/vp/ns/cart/confirmed.aspx?alt order_id=55M5B-MA09-OC2 I0-Sep-13 FISHERS ISLAND FERRY DISTRICT VENDOR 019621 STEWART & STEVENSON PWR PROD. 11/19/2013 CHECK 1557 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.000 2269220 SPARE FOR RP/MU GENS 210.90 TOTAL 210.90 vi; .may 4Y7S4A'+?t ~~j, THE ORIGINAL CHECK HAS A COLORED BACKGROUND. A VOID COPY FEATURE AND WATERMARK PAPER ~a :o a# 9Pf 5174 ~ ~x,~e U&T ouirc NY 1 s t cac i~ ~ 7 ' , Fiaxwitafeywc - 9W$4W 4 - 117 9~ i1 .3-,: ~ - Twa HUN13MD T AND 90/100 DOLLA" PAk STMT,, ' -:5'1tVZNL§oN iWWR !'ROD. = "Y' 0 vo say e 9 , LODI W 07544 11100L5SWs 1:0 2 140 5464e: 613 00 1502 L~i• Vendor No. Check No. Town of Southold, New York - Payment Voucher 19621 Vendor Tax ID Number or Social Security Number Vendor Address Entered by PO Box 950 Vendor Name Lod!,NJ 07644 Audit Date Stewart & Stevenson Power Products - NOV 1 9 203 BA Atlantic Detroit Diesel Allison Vendor Telephone Number V~0. 201.489-5800 Vendor Contact Invoice Invoice Invoice Net urchase Orde Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 2269220 10114/2013 $210.90 $210.90 Spare for RP & Munn Gans SM5710.2.000.000 j i I $210.90 $210.90 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. ! or discrepancies noted, and payment is approved. Signature Title- Signature Company Name / ! Date Title Date IWO Stewart & Stevenson ATLANTIC DETROIT DIESEL-ALLISON_ (9 ® • • • Power Products LLC ATLANTIC POWER SYSTEMS ®,°ns9y i i' ~'.2e.) 9 ' C. p! ener Please make all checks payable and remit to: STEWART& STEVENSON POWER PRODUCTS LLC Invoice P.O. Box 950 • Lodi, New Jersey 07644 Phone: (201) 489-5800 'C 014 1. T F BILLED TO SHIPPED TO F'2£ii-EF: S TSLAND FERNY DT" 11'1(2f *SAME i ,[Sl IE1<Eii 1:i 1.-r'iN'r.)., NY 062-90 DATE INVOICED DATE SHIPPED PURCHASE ORDER NO. BILL OF LADING NO. REFERENCE NO. SERIAL NO. MODEL NO. CUSTOMER IM. NO. FREIGHT VIA TERMS UPS NFET DUE 3"0 DAYS DESCRIPTION UNIT PRICE EXTENSION :.'.;:SO4:L9EN k::(11..JE:Nia7T: 1. 7`?.•-~:1. 1.i5'..~;-:I. 1, 4.75 14 7F5 'OR i'iC;P'{I: :f.P•lP i:7 ASia]i.iT' (JL.1Pi t'PC(II?IJC: L`i ,F FINE i^iND f:iE::E{U7: F_;:i V:C:ii:F'T ld W.:ATL_AN'T':I:r I)i}A :.ti(.i i S T EJ:JI'4 :'T' & i E::.... NI ON) FfiiLIER PRODL _'T S PA). FIO) 950 L-OD T , NO 07F)44 ;L. 1.31ITT r'A. 1.70., 4 L I Fi. L 6 v i31-:TFIFI)M[ : J. .7.:: FORM NO. 005 CE CERTIFY THAT THESE GOODS ONPLUANCB wTN ALL APPUDASLC REQUIREMENTS OF SECTIONS 5, 7 n THE FAIR LABOR STANDARDS ACT AS AMENDED AND OF REGULATIONS AND ORDERS OF THE UNITED STATES DEPARTMENT OF IASDR ISSUED UNDER SECTION 14 THEREOF SEE TERMS AND CONDITIONS OF REVERSE SIDE 1 CUSTOMER COPY f son Stewart & Stevenson ATLANTIC DETROIT DIESEL-ALLISON v Power Products LLC iit~ ATLANTIC POWER SYSTEMS lit AOW energy X)AT'E::::LO%:L=dial): 11-1._AiVl'"TC X)X)r>+ OR:f.LITNAi.- F":lGl: 1 T I MIL. 4 v') Sc) I H Sl A.Ot11Ail"N f #i P6 9 0 /r)YM X)I' I T E'tal T ti UN T T 12 O,OL,) Mr3ILTt(lli(J{hGhl MA (A 71:.;2 (800)'51A, ;499 (aP,X)Ih fYII `>1.Oi.l S01 1) .ffil.flNT) FERRY X).IEiTItIC;'T' ',:)1.111-' f[.l::x;,fSML.: +,xx)eatxxxxxuxatacxxttxoexaeeae•n f'«O,. BOX H )i I :1: C: L: I T t: V. I..: f P`lSiF.IF..:RS 1GI._AND. NY 06::,90 5e8H4ti~jF.r~.x.~i.~ri..x..x.arac.ae.x..xap.)e.x..x.n.ae~)edP I...:I:M:I: TT:::I) C:RIii:X).1I f.:[i°iT(.)Mf::h I'(.1l8::S'T'ilt'4 U/f.: C:1°Il, CASHC:OD 1)hII 1.1:1:1'F'Ii:D:: ( UV-'Oi) FF:LI L.F.::X) BY: . NGi::t.ll'Ei ROUT'[ Xit/I_. Nt.R4Xitp;R. I`I N-Mil:.[) X;f:, CJi~ir l~l 1::ci ftJtti::l.(:) h1 J:1)Uli.;I A 4 ex.,i,<xx I IN/COD CJtd.1 SiE.:Ra.(il_.t:-F'I•..LMFaF;'f:: CU S T OMEER C:ON"T raC l J 01 IG)N I'l{ONI:i. (63:1.) _ . L.iTl)t:.U I TF:M ih(.:I O lim.)(4, Xt)N OTY QI Y (!II f U I I 1:..x I J RA.:L NUMXiE.R X)I.13CiRTI,I.CON ORD lit/U 301...ii::NO11) C+OOO O:.'<I':S:LY 1. Y., 41. :'r',.•aa. 1.4 11.1,`04196 Afl.-AN'T Lt; 11,,3 NOW (Ill... ONIS: `..:TUI 31I(.1)' EY.JF: 01..1_. OF' Y(J(.Jfi II,Ui.;I::.X31.1.i LL:.Nt:tiitYClli fdNl) hillh.LNlS. FIAR TS AND SER'V:LC:fi: DEEAl..4 (:)N F11_.I_. Al R, (:OND:1: f :C(.)NI.NO F-AR 16 AND #rF. F)E's(°4J'f tJtJF; i E'{I:EON °.I I C:I:ftl ..............I`OR hOIA:: :C NFCl VIS1.1 WWW.t~il._iaill.tl l:J!6i,.4::Oht SPAR I' Fd )2 R. P. ~ M Gem S., C*1 G I ~ I AAA 10 Gal...a Y., flax.:: F'690 Y09M (4 OY,: drl tlhltic! kiia GENER 1i.. FERNIS %7ND (I)\DIT'IONS L DYYIAIf IONS. 1, n e in Now Ge;nanI berms and (ondinons, the term' (mods"' P AU mean the Products, part, and acce,sonci (indtdmg lhiids) of ci,ri tor.; iI, st Silber I he tun? -Sec-two, 1 oath the boi thr , rcn ocd mamtenanee to i ht I s end othu x uipm, pros rdy! by S,I'er. " S (ter" shall moan Stem art & Stevenson Ponver Products I IA. (also HOW Atlantic Pooca sssterns)a c.,Bu,a ,.!1 mc4n toss cw0.nncr (pcixm, ~ntt~t)to h„tn Good,o Sc'c teas i, ,old or ofit rcd. + %(I EPTAN(A Lppor ccptanc by Seders Bu u4 request for cu smin and a purcha,e order ht (Wods or St w is cspi my cond Owned anon Buser , a>:n r ru to the Ihs'iog t ri t and. of uions n ,i no other tern„ antes, authorized ur o"u"Be suppdcmcn el m s+rituig b} Schr. 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J, m nor,, r(, run "thou Jrt fiOWN O A li= WHY 0141W , P"aYMn Wa AY nr „ .ms Jr r44101:15 's ,arc C'mu st,rrti to ,Iatc. tad . `e-oa,, ,,s,cia,br Ft<%5m d 'aRlic, wt Bw( I<r„<NO r,,trs.rL,n»mr 0m1 1F(JACi At F„DIS(i tI11I IL Ib tot , id.'ot t a uw a).,ie.e i'ra` 3e1 tr and Salley i uct,n a nts, opre:, n ms and e pl nxa , I of he i , , x t J •tp. n t o r. r col ,,..,.c w „ I abil.. t r t (Owl Hicony of ,m h n•iht}. hn on. action or fni!u:,° lit act m respect to the rc;pat a n.,t,,atent of pattz c, .a, rFmnnslud nn o~ +a e . s S,.ru, era In DASCR.A IMI.R 01 IN IDEVT kI OR f (>SSCQI,ENTIAL I.IABILITI Die linuud tt arrantg of Seller and tole. rnanafr, otter.' linuird xatrantrc dw..nbad h~ , Brn o, irsea any arm wl .sonar .t ,I iyi,c . a by ow, ,s is Or" of any kw d , t...t,cc., n d i i.r; vwww hirchkin cost. a t.ca tin caps ,s n.c'!l r 1 ding, to" of „ i ,a cots. lox, o, nine, d,•un t,n,. „t, rcniua..s.a un.. LTI:,,ttatele,-icortry oth,.cos.of _sh..scrcuunr_ionid..~cainciitaiby the Applicable yrarnuo~ I 1 1 INII IAl ION Qt I I %BI I A I I _ In r s and a ll+c ent fthe Drinawn ln }3Arr A ! rr tool ti "Ity , matins, or d inieg" rvai ,uy: Al ,1 ~e use N It a , no or Service, wick of Ka L al of ScHor the i pcagnis a lnd c ensphojecs 01 IIIR. PANILDdLS 0 Sd IAAR Me lint c d ,tan-units lit d d here" ,hall not I orne alceuse unlr the (Kuper p y, `cellar IN One (oaf , s t iri• Ina. l'I In c, d w at „t. t .ut in n, K p !cu a stir fiat rails to pas as mfr rd. K AG AT La<e all the n t le, proe ,dui idea ti to, of Ae .trot, Akio h ,,td, o Ski, &C, n,,. r ,.c.,. ON N .a It, I.. to hiT , u, .ire sir w , Whisk. In >e or 1 r per month (I 3°a per annum). 1!quip ana no m,ked up he Huyr uWin 5 harness cars oCwnW au,m > wMac:.o a Y On per a a , ,,i, s Ovirgo to ..e t, i ti, Pau „ A-.3 . rl e, &M 1.n, iii t the Collection d f nut amutt _ due fro, Itute to Selcen lb ver ac n,e, to pay YeL,r , va-, . tilt eritor e . , 112 .i d "to •e, i„ a w kA , FISHERS ISLAND FERRY DISTRICT VENDOR 020729 TRAVELERS 11/19/2013 CHECK 1558 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .1910.4.000.100 4709X1135-1013 COMM VEH POL 11/13-11/14 2,329.00 TOTAL 2,329.00 r : z "Im MEMO THE ORIGINAL CHECK HAS A COLORED BACKGROUND. A VOID COPY FEATURE AND WATERMARK PAPER . M NY 71 .09 Cf CK NO. 1 DIR W - , s~ss4a, TWO TNT THREE H[RdDRW Ti48NTY 1Qi- _@4 f 24f iLL9 RAC TRAVtLE#A 70T~6 CL 3irA:rTTmcz cm= ORDER ~0 -4OX 45,60317 _ d OP D LAS TX 75266-0317 x =xa • a 1,8001558n' 1:0211.05t.F.Lx 66 d0L502 in' Vendor No. Check No. Town of Southold, New York - Payment Voucher 20729 ' 5 V. Vendor Tax ID Number or Social Security Number Vendor Address Entered by CL Remittance Center Vendor Name PO Box 660317 Audit Date The Travelers Dallas, TX 75266-0317 NOV 19 2013 Vendor Telephone Number 877-307-4202 T Jerk Vendor Contact (pl%lit . Z~A C Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 4709X1135 0/14/2013 $2,329.00 $2,329.00 Comm. Vehicle Policy SM1910.4.000.100 1013 11/1/13-11/1/14 Ford F-350 Truck I i i $2,329.00 $2,329.00 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) 1 hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and roving, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature Title Signature Company Name Date Title Date TRAVELERS Jw. 07365-L4 Page I of 2 GLOVER-PADULA INS INC Account Bill 16 MAIN ST EAST GREENWICH RI 02818 Account No. 4709X1135 Date of This Bill 10/14/13 TOTAL BALANCE - $2,329.00 CP 01 6640 G6640LKS 13284 07365 P1 MINIMUM DUE $226.30 FISHERS ISLAND FERRY DISTRICT TOWN OF SOUTHOLD P.O. BOX H FISHERS ISLAND NY 06390 PAYMENT MUST BE RECEIVED BY: NOVEMBER 01, 2013 ACCOUNT BILLING SUMMARY POLICY TYPE POLICY PERIOD MIN. DUE ALANCE 808OM715 BA Business Auto Pol 11/01/13 To 11/01/14 $220.30 $2,329.00 Current Installment Charge 6.00 TOTAL BALANCE $226.30 $2,329.00 TRANSACTIONS SINCE LAST STATEMENT Payment Received - Thank You -24.00 Total Transactions (See Transaction Detail Section) +2,353.00 TOTAL BALANCE $2,329.00 CONTINUED ON NEXT PAGE mail e enclosed TRAVELERS Please NTER,aPO B XW660317, ymentALLASin,thTX 75266-0317. to: Customer Service Contacts Billing Questions MONDAY-FRIDAY, 7:00 A.M. - 8:00 P.M. EST 800-252-2268 Your Account Number: 4709X1135 Automated lnyuir y: 24 hrs a day, 7days a week 800-252-2268 Polic V Ouestions GLOVER-PADULA INS INC 401-884-2460 Claim Ouestions BUSINESS INSURANCE 800-238-6225 CONSTRUCTION 800-828-4132 NATIONAL ACCOUNTS 800-832-7839 Policy Information Insuring Company 808OM715 BA THE TRAVELERS INDEMNITY COMPANY Policyholder FISHERS ISLAND FERRY DISTRICT Page 2 of 2 Account No. 4709X1135 Date of This Bill; 10/14/13 TRANSACTION DETAIL POLICY NUMBER 808OM715 BA Business Auto Pol 11/01/13 Renewal 2,343.00 11/01/13 NY Motor Ve Fee 10.00 TOTAL TRANSACTIONS x,353 00 SPECIAL MESSAGES Hassle Free Payments - Call 877-307-4202 to make a quick and simple payment. For all other customer service inquiries (other than making a payment) Please call 800-252-2268. You must pay at least the minimum due or up to the total balance due. If at any time you pay us more than the minimum due, and it covers your future installments, you will not receive a bill or be charged an installment charge. If you pay by installments, a $6.00 charge will be added to each installment bill. If your payment is not received by the due date WE HAVE THE RIGHT, WITHOUT ADVANCE NOTICE TO YOU, TO TERMINATE YOUR OPTION TO PAY IN INSTALLMENTS AND TO REQUIRE FULL PAYMENT OF THE OUTSTANDING BALANCE ON YOUR POLICY. WE ALSO HAVE THE RIGHT TO ASSESS A LATE FEE OF $10.00. Make payments on-line! With our on-line payment options you can make single payments or you can schedule Automatic Recurring Payments. It's fast and easy, enroll today! To learn more visit our website - www.travelersepay.com. If you are paying with a check from a Personal Checking Account, you authorize us to either use information from your check to make a one-time electronic funds transfer from your account or to process the payment as a check. If you are paying with a check from a Business Checking account, we will process the payment as a check. 648842H 2013287 7978 853 032964 CLDBILL2 PLq837 FISHERS ISLAND FERRYDISMICT VENDOR 020735 TRI-TOWN ENTERPRISES, INC. 11/19/2013 CHECK 1559 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.000 1210-121 BOILER SERVICE-BOTH BOAT 586.00 TOTAL 586.00 e. ^F"r..., THE I ORIGINAL CHECK HAS A • • BACKGROUND, A VOID COPY FEATURE AND WATERMARK PAPER PVI tip sourmo DN AQ~77-p~6 1t 4 n+E rtROLiwOe<;vTw~+k[sAr+ic'` . CUITCHIl so-54a73*d 11 19/2-0 _Wu FIVI3 HMMRED EIGHTY _SIX ANb 00/100 DOLf,R,dL$ a NAY tG* Ewb ppISES , ,Ift . " _4^ P/1111- e ~rt p/~~ f. py~e 70 ¢Vr 41ttA 441 6aF Ems). w'3, f'=° OFF JMM CITY CT 06351 Q ono. as ~~1190015591r i:0 2 140 54641: M 001502 iii• Vendor No. Check No. Town of Southold, New York - Payment Voucher 20735 113 5ci Vendor Tax ID Number or Social Security Number Vendor Address Entered by P.O. Box W"q I Vendor Name Jewett City, CT 06351 Audit Date Tri-Town Mechanical NOV 1 9 203 Vendor Telephone Number 860-376-0277 Town Clerk Vendor Contact Invoice Invoice Invoice Net purchase Order , Number Date Total Discount 'Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 1210-121 10/8/2013 $586.00 $586.00 Boiler Service SM5710.2.000.000 Both Boats I j I $586.00 $586.00 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf ofthe above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated, that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded. or discrepancies noted, and payment is approved. Signature Title Signature Company Name 459 Date "u~ Title Date t WEEK (7) Page 2 Invoice 'C1i-Town Mechanical, LLC October 20, 2013 PO Box 247 Summary: SERVICE Jewett City, Ct. 06351 Invoice 1210-121 (860) 376-4277 / 1-800-286-4833 Tech: ERIC Due Date: 11/19/2013 Job Date: 10/8/2013 Bill To: Job Name: Fishers Isl. Ferry Fishers Isl. Fenys / office PO Box H Fishers Island, NY 06390-0607 New london, CT 06 860-442-0165 Item Code . Hrs/Qty Price Amount Annual tune-up on boilers on ferries and office L-COMANTLIN Annual tune-up on commercial boiler 3.00 175.00 EA 525.00 M-NOZZLE 3.00 8.00 EA 24.00 M-GARBERCART GARBER FILTER CART. 2.00 15.00 EA 30.00 M-4FO 4" Filter Cart. 1.00 7.00 EA 7.00 ~C)Jer 5crol ct 30-4 boat NL T-PfMbuGl OK to-29-13 Material Labor Subtotal Total 61.00 525.00 586.00 $586.00 All material is guaranteed for one year, unless otherwises specified. All work to be completed in a professional manner according to standard practices. Due to varying differences in oil quality, nozzles, fitter cartridges and labor are guaranteed for 30 days. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon delays beyond our control. Purchaser agrees to pay all costs of collection, including attorney's fees. Terms: Net 30 THANK YOU FOR YOUR BUSINESS Lic.# 0385728 S1 FISHERS ISLAND FERRY DISTRICT VENDOR 021506 UNITED PARCEL SERVICE 11/19/2013 CHECK 1560 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.700 26639423 W/E 10/19/13-(4)PKGS 77.44 SM .5710.4.000.700 26639433 W/E 10/26/13-(3)PKGS 221.16 TOTAL 296.60 ,ffirct ;•i; r 8.:. v n A~ Y y ~'c •.rXW s ~~N ~kt~ THE e ~ ORIGINAL CHECK HAS A COLORED BACKGROUND A VOID COPY FEATURE AND WATERMARK PAPER ma, a (ITl10 , I+r f f f-0~ a CHECK Xwo 15 'Dr ` 0@FlE, N1 f3435 a StY5a8t?tg ,1$19D 3 Two HUNDRED NIWETY NIQHR AND 60-fio tX6 3,LA'[tS-c. , R31Y UNI' ' C19L SERVICE e o~ r v PC) BOX 7241-02t4l, ORDG7t PHILADMIMIA PA 19170-0002 - - z , u'00IS 60m ':0 2 1405464E 68 001S02 in' Vendor No. Check No. Town of Southold, New York -Payment Voucher 21506 115b0 Vendor Tax ID Number or Social Security Number Vendor Address Entered by P.O. Box 7247-0244 Vendor Name Philadelphia, PA 19170-0001 Audit Date United Parcel Service NOV 19 2013 Vendor Telephone Number 800-811-1648 ~QCI(~~JJ ky{y~ Vendor Contact /I C ~C Invoice Invoice Invoice Net Purchase Order Cl Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 26639423 10/19/2013 $77.44 $77.44 W/E 10/19/13 4, P SM5710.4.000.700 26639433; 10/26/2013 $221.16 $221.161 W/E 10/26113 SM5710.4.000.700 i $298.60 $298.60 Payee Certification Department Certification The undersigned (Claimant) (Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct, that no part has in good condition without substitution, the services properly been paid, except as therein stated that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing, and that taxes from which the Town is exempt are excluded, or discrepancies noted, and payment is approved Signature Title--, N~ Signature-- - Company Name Date 7 av Title Date ,J Delivery Service Invoice Invoice date October 19, 2013 ' Shipped from: Invoice number 0000026639423 FISHERS ISLAND FERRY Shipper number 026639 1 STATE ST Control ID 535Q NEW LONDON, CT 06320 Page I of 3 Sign up for electronic billing today! 0736A00000266394 77366300035058 Visit ups.com/billing FP 01 089406 2684BG294 A"3DGT For questions about your invoice, call: IIIIIIIIIII'll'lllll'1111111'1111'I'I"I'lllllllll'llllllll°l,l, (800) 811-1648 FISHER ISLAND FERRY MondayFriday - 8:00 am.. - 9:00 p.m. E.T. PO BOX 607 FISHERS ISLAND, NY 06390 or write: UPS P.O. Box 7247-0244 Philadelphia, PA 19170-0001 Account Status Summary Weekly Payment Plan Thank you for using UPS. Amount Due This Period $ 77.44 Summary Charges Amount Outstanding (prior invoices) $1,118.83 age arge Total Amount Outstanding $1,196.27 Outbound Please include the Return Portion of each outstanding invoice with 3 UPS WorldShip $ 50.89 your payment See Account Status for details. 3 Adjustments & Other Charges $ 2.00 Paying too much to accept credit cards? 3 Fees $ 2.55 Have you heard about the UPS Capital Merchant Services Service Charges $ 22.00 B program? Our best-in-class credit card processing features Amount due this period $ 7744 great rates, next day funding and mobile payment options. For = details, visit upscaoital.com/merchantservices or call UPS payment terms require payment of this invoice by October 1-855-597-4387. We also offer sign-up incentives of up to 30, 2013. $1,500 and don't forget about the Meet or Beat Rate Guarantee available through UPS Capital Merchant Services. Payments not received by November 13, 2013 are subject to a late fee of 6% of the Amount Due This Period. (Details in UPS Tariff, available at ups.com) c Note: This invoice may contain a )al surcharge as described ups.com. The pub/fished fuel surcharge is 7.0% for UPS Ground d Services and 1 I.W. for UPS Air Services, UPS 3 Day Select and International services. For more information, visit ups.com. r Delivery Service Invoice Invoice date October 19, 2013 Invoice number 0000026639423 Shipper number 026639 n Page 2 of 3 Account Status Weekly Payment Plan Payments Applied Amount Invoice Number Invoice Date Paid 0000026639353 08/31/2013 $ 371.71 0000026639363 09/07/2013 $ 13199 0000026639373 09/14/2013 $ 236.68 Account Status Weekly Payment Plan Amount Outstanding (prior invoices): Please include the Return Portion of each outstanding invoice with your payment. Balance Invoice Number Invoice Date Due 0000026639383 09/21/2013 $ 42.58 0000026639393 09/28/2013 $ 478.44 0000026639403 10/05/2013 $ 240.17 0000026639413 10/12/2013 $ 357.64 Total $ 1,118.83 Outstanding balances reflect any payments received as of 10/1812013. Please ignore this message if a recent payment has been made for any outstanding invoices. Delivery Service Invoice Invoice date October 19, 2013 1 Invoice number 0000026639423 Shipper number 026639 n Page 3 of 3 Outbound UPS WorldShip Pickup Pickup Number of Billed Date Record Message Codes Packages Charge 10/15 9121174871 1 25.36 10/16 9121174882 1 6.79 10/18 9121174893 2 18.74 Total UPS WorldShip 4 Package(s) 50.89 Total Outbound 4 Package(s) 50.89 Adjustments & Other Charges Miscellaneous Billed Explanation Charge WEEKLY PRINTER SERVICE FEE 2.00 FOR 1 PRINTERS AT $2.00 EACH FOR 18-OCT-2013 Total Miscellaneous 200 Total Adjustments & Other Charges 200 Fees - WeekEnding Unpaid Billed Date Balance Rate Charge 09/21 Late Payment Fee 42.58 6,00% 2.55 Pursuant to the UPS Tariff, a late payment tee has been assessed. _ Total Fees 2.55 - 089406 212 i Delivery Service Invoice Invoice date October 26, 2013 ' Shipped from: Invoice number 0000026639433 FISHERS ISLAND FERRY Shipper number 026639 1 STATE ST Control ID S827 NEW LONDON, CT 06320 Page 1 of 4 Sign up for electronic billing today! 0736A00000266394 77366400035449 Visit ups.com/billing FP 01 088683 297981294 A*"3DGT For questions about your invoice, call: 1.lll..ll.1.lll'IIIIILIIItII'L.IIJ1111111111.1111111111,1111,1 (800) 811-1646 Monday - Friday FISHER ISLAND FERRY 8:00 a.m.-9:00 p.m. E.T. PO BOX 607 FISHERS ISLAND, NY 06390 or write: UPS _ P.O. Box 7247-0244 Philadelphia, PA 19170-0001 Account Status Summary Weekly Payment Plan Thank you for using UPS. Amount Due This Period $ 221.16 ank you tor Summary Charges Amount Outstanding (prior invoices) $ 1.19627 age arge Total Amount Outstanding $1,417.43 Outbound Please include the Return Portion of each outstanding invoice with 3 UPS WorldShip $ 90 90 your payment See Account Status for details. 3 Adjustments & Other Charges $ 90.55 Pa q too much to accent credit cards? 4 Fay $ z8?1 = Have you heard about the UPS Capital Merchant Services Service Charges $ 11 00 program? Our best-in-class credit card processing features Amount due this period $ 721.16 great rates, next day funding and mobile payment options. For - details, visit uoscapital.corNmerchantseryices or call UPS payment terms require payment of this invoice by November - 1-855-597-4387. We also offer sign-up incentives of up to 6, 2013. $1.500 and don't forget about the Meet or Beat Rate Guarantee available through UPS Capital Merchant Services. Payments not received by November 20, 2013 are subject to a late fee of 6% of the Amount Due This Period. (Details in UPS Tariff, available at ups.com) Note: This invoice may contain a fuel surcharge as described at ups.com. The published fuel surcharge is 7.031. for UPS Ground Services and 11.0% for UPS Air Services, UPS 3 Day Select, and International services. For more information, visit ups.com. F Delivery Service Invoice Invoice date October 26, 2013 1 Invoice number 0000026639433 Shipper number 026639 Page 2 of 4 Account Status Weekly Payment Plan Amount Outstanding (prior invoices): Please include the Return Portion of each outstanding invoice with your payment Balance Invoice Number Invoice Date Due 0000026639383 09/21/2013 $42.58 0000026639393 09/28/2013 $ 478.44 0000026639403 10/05/2013 $ 240.17 0000026639413 10/12/2013 $ 357.64 0000026639423 10/19/2013 $ 77.44 Total $ 1,196.27 Outstanding balances reflect any payments received as of 10/25/2013. Please ignore this message if a recent payment has been made for any outstanding invoices. Delivery Service Invoice Invoice date October 26, 2013 ' Invoice number 0000026639433 Shipper number 026639 n Page 3 of 4 Outbound UPS WorldShip Pickup Pickup Number of Billed Date Record Message Codes Packages Charge 10/23 9121174904 1 6.25 10,24 9121174915 1 54.33 10/25 9121174926 1 30.32 Total UPS WorldShip 3 Package(s) 90.90 Total Outbound 3 Package(s) 90.90 Adjustments & Other Charges Packages Delivered but not Previously Billed Delivery Billed Date Tracking Number Service Zone Weight Charge 09,16 1Z0266390341252403 Ground Residential 7 44 3678 Residential Surcharge 2 80 Fuel Surcharge 2 77 Total 42.35 Receiver: Sender : FISHERS ISLAND FERRY 112 RIVULET 1 STATE ST AUSTIN TX 78738 NEW LONDON CT 06320 Message Codes : w Total Packages Delivered but not Previously Billed 1 Package(s) 4235 Residential/Commercial Adjustments UPS WorldShip Shipped Pickup Recorded Billed Adjustment Date Record Entry Tracking Number Corrected Charge Amount _ 10/25 9121174926 1 IZO266390341231855 Commercial -10.45 Residential 10.45 Residential Surcharge 2.80 Delivery Area Surcharge 0.75 Fuel Surcharge 0.25 3 80 1st ref: Larry Horn FINY 06390 2nd ref : 631 788 7828 Total UPS WorldShip _ 1 Package(s) 3.80 Total Residential/Commercial Adjustments 1 Package(s) 3.80 Shipping Charge Corrections Learn how to avoid future shipping charge corrections. Visit www_ups_com/avoidcharges Pickup Tracking Original5e11cei ZIP Billed Adjustment Date Number Corrected Service Code Zone Weight Charge Amount 10/24 1Z0266391342308841 Next Day Air Saver 28390 134 3 45.75 Next Day Air Saver 28390 134 128 85 75 Audited Dimensions = 19 x 16 x 7 in Customer Entered Dimensions = 12 x 12 x 2 in Fuel Surcharge 440 4440 1st ref: Don Lamb FINY 06390 2nd ref : 631 788 7416 Sender : FISHERS ISLAND FERRY Receiver: Katie Simmons NEW LONDON CT 06320 Spring Lake NC 28390 Total Shipping Charge Corrections 1 Package(s) 44.40 Total Adjustments & Other Charges 90.55 088683 2I2 Delivery Service Invoice ' Invoice date October 26, 2013 Invoice number 0000026639433 Shipper number 026639 n Page 4 of 4 Fees WeekEnding Unpaid Billed Date Balance Rate Charge 09/28 Late Payment Fee 478.44 6.00% 28.71 Pursuant to the UPS Tariff, a late payment fee has been assessed. Total Fees 2831 Invoice Messaging Code Message w Dimensional Weight adjustment based upon UPS audit 6