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Home My WebLink AboutStrawberry Fields MARTIN D.FINNEGAN SCOTT A.RUSSELL TOWN ATTORNEY Supervisor martin.finnegan@town.southold.ny.us Of SO(/jy� JENNIFER ANDALORO Town Hall Annex, 54375 Route 25 ASSISTANT TOWN ATTORNEY J�[ P.O.Box 1179 jennifer.andaloro@town.southold.ny.us Southold,New York 11971-0959 CA LORI M.HULSE '.�0 �� Telephone(631) 765-1939 ASSISTANT TOWN ATTORNEY 'COU Facsimile(631) 765-6639 lori.hulse@town.southold.ny.us OFFICE OF THE TOWN ATTORNEY RECEIVED TOWN OF SOUTHOLD FEB 1 g 2014 Southold Town Clerk February 18, 2014 Suffolk County Department of Parks, Recreation & Conservation P.O. Box 144 West Sayville, NY 11796-0144 Attention: Ms. Tracy Seeba, Contracts Unit Re: Strawberry Fields (Greenways Agreement), Inlet Pond County Park, Laurel Lake Preserve Dear Ms. Seeba: Pursuant to your letter dated January 28, 2014, 1 am enclosing the completed and executed Lawful Hiring Forms in connection with the referenced matter. We will retain copies in our file. If you have any questions regarding the enclosed, please do not hesitate to call me. Thank you for your attention. Very truly yours, Lynne Krauza Secretary to the Town Attorney /Ik Enclosures cc: Elizabeth A. Neville, Town Clerk Steven Bellone Samuel Chu Suffolk County Executive Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING, & CONSUMER AFFAIRS NOTICE OF APPLICATION TO CERTIFY COMPLIANCE WITH FEDERAL LAW (8 U.S.C. SECTION 1324A) WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES Suffolk County Code,Chapter 353 (2006) To Be Completed By Applicant/Covered Employer/Owner EMPLOYER/CORP/ BUSINESS/COMPANY NAME: /t O ADDRESS: NOT-FOR-PROFIT: YES NO_ (Submit Proof of IRS Not for-Profit Status) VENDOR# (If known): CONTRACT ID (Ifknown): CONTACT: TELEPHONE#: TERM OF CONTRACT OR EXTENSION(PROVIDE DATES): _ ('t/-3 6)�2A — n7 a V �S- B1.IEF DESCRIPTION OF %COMPENSATION,PROJECT OR SERVICE /r• L G SUBCONTRACTOR: ADDRESS: VENDOR#: TELEPHONE#: CONTACT: DESCRIPTION OF COMPENSATION,PROJECT OR SERVICE: EVIDENCE OF COMPLIANCE: Copies of the following must be maintained by covered employers or the owners thereof for each employee for the time periods set forth in Suffolk County Code, Section 353-14 (A): A. United States passport; or B. Resident alien card or alien registration card;or C. Birth certificate indicating that person was born in the United States; or D. (1)A driver's license, if it contains a photograph of the individual;and (2) A social security account number card(other than such a card which specifies on its face that the issuance of the card does not authorize employment in the United States);or E. Employment authorization documents such as an H-1B visa, H-2B visa, and L-1 visa, or other work visa as may be authorized by the United States Government at the time the County contract is awarded for all covered employees. DOL: LHE-1 (revised 4/13) LHE-2 Form jWJ Steven Bellone Samuel Chu Suffolk County Executive Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING &CONSUMER AFFAIRS AFFIDAVIT OF COMPLIANCE WITH THE REQUIREMENTS OF 8 U.S.C. SECTION 1324a WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES State of New York ) / ss: County of S��/�01/ ) -5e,e2�A P,4A sem, being duly sworn, deposed and says: (Print Name of Deponent) 1. I am owner uthorized representative f :7�—O W A O'F -5014 (Circle one) (Name of Corp.,Business,Company) 2. I certify that I have complied, in good faith, with the requirements of Title 8 of the United States Code (U.S.C.) section 1324a(Aliens and Nationality)with respect to the hiring of covered employees and with respect to the alien and nationality status of the owners thereof, as set forth in Suffolk County Code Chapter 234(2006). ( ' ature of Deponent) Sworn to before me this a day �6 LAUREN M. teofN w of e. 20L� Notary public, State of New York No.OIST6164008 lCn CY1 �f�✓ ((!f �i in Suffolk cue, I:xpirea Nrru 9.gotia tary Public) DOL:LHE-2(rovised 1/13) LHE-2 Form Steven Bellone Samuel Chu Suffolk County Executive Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING &CONSUMER AFFAIRS AFFIDAVIT OF COMPLIANCE WITH THE REQUIREMENTS OF 8 U.S.C. SECTION 1324a WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES State of New York ) County of �S[A-M-)( K )ss: s:12-t+ /9. 0g(/SSB //being duly sworn, deposed and says: (Print Name of Deponent) 1. I am owner authorized representative of :o W/1 � ic�al —So -e (Circ one (Name of Corp.,Business,Company) 2. 1 certify that I have complied, in good faith, with the requirements of Title 8 of the United States Code (U.S.C.) section 1324a(Aliens and Nationality)with respect to the hiring of covered employees and with respect to the alien and nationality status of the owners thereof, as set forth in Suffolk County Code Chapter 234 (2006). Signature of Deponent) Sworn to before me this I$� day 6 LAUREN public, sate of DNe wyclill of r( 20 No OIST6164008 (LL2• t �Y (Oh in Suffolk COU* commeafio Expfrss April 9,2015 (Nona y Public) DOL:LH&2(revised 1/13) Steven Bellone Samuel Chu Suffolk County Executive Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING, &CONSUMER AFFAIRS NOTICE OF APPLICATION TO CERTIFY COMPLIANCE WITH FEDERAL LAW (8 U.S.C. SECTION 1324A) WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES Suffolk County Code, Chapter 353 (2006) To Be Completed By Applicant/Covered Employer/Owner EMPLOYER/CORP/ BUSINESS/COWANY NAME: O ADDRESS: T ` Y/- zlOX 1L7I 56 = -6d. y I (91L09.57 NOT-FOR-PROFIT: YES NO (Submit Proof ofI.RS Nor for-Profit Status) VENDOR#(If known): CONTRACT ED (If known): CONTACT: TELEPHONE#: TERM OF CONTRACT OR EXTENSION(PROVIDE DATES): BRIEF DESCRIPTION OF COMPEN/SATION,PROJECT C'R SERVICE / cc( n�Lin c, r'ou.�tC OaAl4dla a req 9— �(G I Ls SUBCONTRACTOR: ADDRESS: VENDOR#: TELEPHONE#: CONTACT: DESCRIPTION OF COMPENSATION,PROJECT OR SERVICE: EVIDENCE OF COMPLL4,NCE: Copies of the following must be maintained by covered employers or the owners thereof for each employee for the time periods set forth in Suffolk County Code, Section 353-14 (A): A. United States passport; or B. Resident alien card or alien registration card; or C. Birth certificate indicating that person was bom in the United States; or D. (1)A driver's license, if it contains a photograph of the individual; and (2) A social security account number card(other than such a card which specifies on its face that the issuance of the card does not authorize employment in the United States); or E. Employment authorization documents such as an H-1B visa,H-2B visa,and L-1 visa, or other work visa as may be authorized by the United States Government at the time the County contract is awarded for all covered employees. DOL: LHE-1 (revised 4/13) Ict L4 re--/ 1�a Ke f�ese^ve Steven Bellone Samuel Chu Suffolk County Executive Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING, & CONSUMER AFFAIRS NOTICE OF APPLICATION TO CERTIFY COMPLIANCE WITH FEDERAL LAW (8 U.S.C. SECTION 1324A) WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES Suffolk County Code, Chapter 353 (2006) To Be Completed By Applicant/Covered Employer/Owner EMPLOYER/CORP/ �//� f BUSINESS/COMPANY NAME: OT �/1 0 q c—q ADDRESS: O_ jo-A 1 LZ 9, So t&t/i o A) l l g 7/ O [ / NOT-FOR-PROFIT: YES NO (Submit Proof of IRS Not for-Profit Status) VENDOR# (If known): CONTRACT ID (Ifknown): CONTACT: TELEPHONE#: TERM OF CONTRACTOR EXTENSION(PROVIDE DATES): �S- BRIEF DESCRIPTION OF COM`PENSATION,PROJECT R SERVICE _/ T '� lr i1 r ✓Vl a%r1 t P�/I at/1 0.n q rc Sf/Q A . M 42CO(16-MCA 43- SUBCO CTOR: A ADDRESS: VENDOR#: TELEPHONE#: CONTACT: DESCRIPTION OF COMPENSATION,PROJECT OR SERVICE: EVIDENCE OF COMPLIANCE: Copies of the following must be maintained by covered employers or the owners thereof for each employee for the time periods set forth in Suffolk County Code, Section 353-14 (A): A. United States passport; or B. Resident alien card or alien registration card; or C. Birth certificate indicating that person was born in the United States; or D. (1)A driver's license, if it contains a photograph of the individual;and (2) A social security account number card (other than such a card which specifies on its face that the issuance of the card does not authorize employment in the United States); or E. Employment authorization documents such as an H-1B visa,H-2B visa, and L-1 visa, or other work visa as may be authorized by the United States Government at the time the County contract is awarded for all covered employees. DOL: LHE-1 (revised 4/13) .L-HE-2 Form 191.fl-de Steven Bellone ` Samuel Chu Suffolk County Executive Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING &CONSUMER AFFAIRS AFFIDAVIT OF COMPLIANCE WITH THE REQUIREMENTS OF 8 U.S.C. SECTION 1324a WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES State of New York ) c ss: County of �J (.( 0�K ) rTC'r lQ_ a Cfe, �/ , being duly sworn, deposed and says: (Print Name of Deponent) 1. I am ownerauthorized representative f iyl1 e4 Sn r f'iVOI . (Circle one) (Name of Corp., Business, Company) 2. I certify that I have complied, in good faith, with the requirements of Title 8 of the United States Code (U.S.C.) section 1324a(Aliens and Nationality) with respect to the hiring of covered employees and with respect to the alien and nationality status of the owners thereof, as set forth in Suffolk County Code Chapter 234 (2006). p ignature of eponent) Sworn to before me this I0 day of��20 �AAIIREN M. t. f SH Y Publk;Stale o/New Yo* ,S Qus filed 00 in u$o�lk /1 l Al/I '{h . t(�h cam'"k ron E)q*n Mrg g. is otary Public) DOL:LH&2(rcviud 1113)