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HomeMy WebLinkAboutKandic, Dana APPLICATION FOR FILMING/STILL PHOTOGRAPHY PERMIT NO: O y Please Print or Type APPLICATION DATE: 7'z( I aA 19 NAME OF APPLICANT: 'VAN P� 1!AN l7. ►C OA Ze HF l F OF 3(OSSOM - F-Y-PTSs�Y MAILING ADDRESS: W1 Z?-Oef�WEm -*110, new `AOC-K,(-I( 1 J012 PHONE: BUSINESS: 21 Z 2-07- ?V)l x 309 HOME: q1 S _70 ASG'? NAME OF ORGANIZATION/COMPANY: ATE 1.1 E'(L MAN A Com.N14--0-T MAILING ADDRESS: fo 6V-0 PrOl-)9M k' -710 , n- 0(-1C, 10 0 )Z PHONE: Z12 201- ?SA I x SOA FAX: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * DESCRIBE TYPE OF ACTIVITY (e.g. Motion Picture, Commercial, Television. Catalog, Magazine, etc.): Wi Woyo c(L!�'P�-w( T-c�s��a✓� S tl 00T -42;'a Cg-PrSt1 H A!d-r-i✓1 e DATE(S)AND TIME(S) OF PROPOSED FILMING/PHOTOGRAPHY: july 15 SW - (o IPM W PROPOSED LOCATION(S) OF FILMING/PHOTOGRAPHY: (attach additional sheet, if necessary) (-1 S+"5 J�eaCAJ CLna SufCouvICUA.,� Gley -4 wlkectV f,,r t A o(col NAME OF PERSON IN CHARGE AT SITE: VIOSSOM I FS " NUMBER OF PERSONS AT LOCATION (cast& crew included): B Cf-e-W t NUMBER AND TYPE OF VECHILES AT LOCATION: 1 M OTO RktaM E TYPE OF SPECIAL EQUIPMENT: M kAt ma I ANY SPECIAL REQUIREMENTS: tJ R S nature Return to: Southold Town Clerk Southold Town Hall 53095 Main Road P.O. Box 1179 Southold,NY 11971 INDEMNIFICATION AGREEMENT TOWN OF SOUTHOLD FILMING/STILL,.PHOTOGRAPHY PERMIT The Applicant shall indemnify and hold harmless the Town from and against all suits,claims,demands or actions for any damage and/or injury sustained or alleged. to be sustained by any party or parties in connection with the performance of filming or still photography by the Applicant,his employees or agents or any subcontractor and in case of any such action brought against the Town,the applicant shall immediately take charge of and defend the same at his own cost and expense. In addition,the Applicant will name the Town as an additional insured on, any applicable policies. �I,�► � -7 Int I wo�9 S ature Date Printed name � v cC 2 Title f 3 z AC�ffi DATE(MWDD/YYYY) �,,,,>- CERTIFICATE OF LIABILITY INSURANCE 7/21/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Tom C. Pickard&Co., Inc. NAME: 820 Pacific Coast Hwy PHONE 310-379-7788 FAC No: 310-318-9840 E M Hermosa Beach, CA 90254 ' AIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# License#0555411 INSURER A: Great American Insurance Company INSURED INSURER B: Great American Alliance Insurance Company Atelier Management A Plus Productions INSURER C: 453 S. Spring Street #1036 INSURER D: Los Angeles CA 90613 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 20945659 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MWDD/YYYY MWDDNYY LIMITS A �/ COMMERCIAL GENERAL LIABILITY SPP073847900 5/21/2014 5/21/2015 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE 7 DAMAGE RENTED OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 ✓ POLICY E PRO 4,000,000 JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ A AUTOMOBILE LIABILITY SPP073847900 5/21/2014 5/21/2015 CEOMaBIINBDSINGLELIMIT g 1,000000 ANY AUTO Physical Damage BODILY INJURY(Per person) $ ALL OWNED SCHEDULED Limit is$125,000/Auto AUTOS AUTOS BODILY INJURY(Per accident) $ ✓ HIRED AUTOS AUTOSWNED $250,000 Aggregate PROPERTY DAMAGE $ Ded=10/o Loss Subject to Per accident $1,000 Min $7,500 Max. $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B AND EMPLOYERSELIABILTY Y/N WORKERS COMPNSATNWC073848100 5/21/2014 5/21/2015 ,/ STATUTE 0RH OFFICER/MEM ER EXCLUDED ANY ECUTIVE FY] N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Miscellaneous Rented Equipment SPP073847900 5/21/2014 5/21/2015 $200,000 Limit/$1,000 Deductible A Props,Set,Wardrobe SPP073847900 5/21/2014 5/21/2015 $50,000 Limit/$1,000 Deductible A Third Party Property Damage SPP073847900 5/21/2014 5/21/2015 $1,000.000 Limit/$1,000 Deductible DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The Certificate Holder is named as Additional Insured and Loss Payee,but only with respect to claims arising out of the negligence of the Named Insured. CERTIFICATE HOLDER CANCELLATION Southold Town SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53095 Main Road THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Southold NY 11971 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Don Pickard 0", ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 20945659 CLIENT CODE: ATELMAI Lauren Nukes 7/21/2014 7:15:46 AM (PDT) Page 1 of 1 Rudder, Lynda From: Dana Kandic <danak@ateliermanagement.com> Sent: Monday,July 21, 2014 8:25 AM To: Rudder, Lynda Subject: Re:filming permit Fantastic thank you,will fill out and send via fedex as soon as I get to the office! Sent from my iPhone >On Jul 21, 2014, at 8:11 AM, "Rudder, Lynda" <Ivnda.rudder@town.southold.ny.us>wrote: >attached >-----Original Message----- > From: Dana Kandic [mailto:danak@ateliermanagement.com] >Sent: Sunday,July 20, 201410:19 PM >To: Rudder, Lynda >Cc: Neville, Elizabeth; Hydell, Carol >Subject: Re: filming permit > Hi Lynda, > Hope you had a great weekend! > Can you please send me all proper forms that need to be FedEx-ed to you tomorrow? > Many thanks ! >Sent from my iPhone >>On Jul 18, 2014, at 3:27 PM, "Rudder, Lynda" <Ivnda.rudder@town.southold.nv.us>wrote: >> If you Fed Ex the application, indemnification form, insurance binder and appropriate checks for delivery on Monday and the paperwork is in order, I have gotten an ok to issue the permit. Again provided ALL the paperwork and checks are in order. >> Checks payable to Southold Town Clerk >>application fee: $100 >> permit fee/day: $100 >> parking permit: $10/vehicle >>clean-up deposit: $250 ><Checklist for applicant.doc> ><APPLICATION FOR FILMING.doc> ><INDEMNIFICATION AGREEMENT.doc> 1 Rudder, Lynda From: Dana Kandic <danak@ateliermanagement.com> Sent: Monday, July 21, 2014 10:43 AM To: Rudder, Lynda Subject: Re: filming permit fantastic!just waiting on the check + i'll walk over to fedex to send this out im assuming it would be best to overnight the application correct? and to confirm, the forms + check should be mailed to: Southold Town 53095 Main Road Southold, NY 11971 631/765-1800 thanks again! Dana Kandic Atelier Management 611 Broadway, Suite 710 New York, NY 10012 T: 212 202 8341 x304 M: 973 714 4568 F: 646 349 5715 www.ateliermanagement.com Facebook I Twitter I Instagram I Blog On Jul 21, 2014, at 10:28 AM, Rudder, Lynda wrote: perfect From: Dana Kandic [mailto:danak abateliermanagement.com] Sent: Monday, July 21, 2014 10:16 AM To: Rudder, Lynda Subject: Re: filming permit Great, thank you - can you please verify this COI is OK or if any changes need to be made? i Dana Kandic Atelier Management 611 Broadway, Suite 710 New York, NY 10012 T: 212 202 8341 x304 M: 973 714 4568 F: 646 349 5715 www.ateliermanagement.com Facebook I Twitter ( Instagram Blog On Jul 21, 2014, at 10:10 AM, Rudder, Lynda wrote: Southold Town 53095 Main Road Southold, NY 11971 631/765-1800 From: Dana Kandic [mailto:danakCc-)ateliermanagement.com] Sent: Monday, July 21, 2014 10:00 AM To: Rudder, Lynda Subject: Re: filming permit Hi Lynda, Can you please tell me who should I address the COI to?Name + address please. Thank you! Dana Kandic Atelier Management 611 Broadway, Suite 710 New York, NY 10012 T: 212 202 8341 x304 M: 973 714 4568 z F: 646 349 5715 www.ateliermanagement.com Facebook I Twitter I Instagram Blog On Jul 21, 2014, at 8:11 AM, Rudder, Lynda wrote: attached -----Original Message----- From: Dana Kandic [mailto:danak cr,ateliermanagement.com] Sent: Sunday, July 20, 2014 10:19 PM To: Rudder, Lynda Cc: Neville, Elizabeth; Hydell, Carol Subject: Re: filming permit Hi Lynda, Hope you had a great weekend! Can you please send me all proper forms that need to be FedEx-ed to you tomorrow? Many thanks ! Sent from my iPhone On Jul 18, 2014, at 3:27 PM, "Rudder, Lynda" <Lynda.rudderntown.southold.ny.us> wrote: If you Fed Ex the application, indemnification form, insurance binder and appropriate checks for delivery on Monday and the paperwork is in order, I have gotten an ok to issue the permit. Again provided ALL the paperwork and checks are in order. Checks payable to Southold Town Clerk application fee: $100 permit fee/day: $100 3 parking permit: $10/vehicle clean-up deposit: $250 <Checklist for applicant.doc><APPLICATION FOR FILMING.doc><INDEMNIFICATION AGREEMENT.doc> 4 Rudder, Lynda From: Finnegan, Martin Sent: Monday, July 21, 2014 1:28 PM To: Rudder, Lynda Subject: RE: filming permit 7/25 No objection. From: Rudder, Lynda Sent: Monday, July 21, 2014 12:38 PM To: Flatley, Martin; Kruszeski, Frank; Finnegan, Martin Subject: filming permit 7/25 Importance: High Please approve/disapprove the attached filming permit. Heads up! Got another phone call from some location scout looking to shoot somewhere in Mattituck on 7/27. 1 Rudder, Lynda From: Flatley, Martin Sent: Monday, July 21, 2014 12:43 PM To: Rudder, Lynda; Kruszeski, Frank; Finnegan, Martin Subject: RE:filming permit 7/25 1 have no objections to this permit being approved, with the addendum that they use special parking placards for the parking at 67 Steps in Greenport mg%tGa Chief of Police Southold Town Police Department 41405 State Rt. 25 Peconic, N.Y. 11958 631-765-3115 From: Rudder, Lynda Sent: Monday, July 21, 2014 12:38 PM To: Flatley, Martin; Kruszeski, Frank; Finnegan, Martin Subject: filming permit 7/25 Importance: High Please approve/disapprove the attached filming permit. Heads up! Got another phone call from some location scout looking to shoot somewhere in Mattituck on 7/27. Rudder, Lynda From: Dana Kandic <danak@ateliermanagement.com> Sent: Friday, July 18, 2014 1:34 PM To: Rudder, Lynda Subject: Re: FILMING There is also like a block of wheat field the photographer is interested in, really simple shoot on Friday. Let me know Sent from my iPhone >On Jul 18, 2014, at 1:32 PM, Dana Kandic<danak@ateliermanagement.com>wrote: >Thanks Lynda. >The photographer+team are really set on shooting in North Fork. at 67 Steps Beach in Greenport West. > It's a small crew, only 1 model on the beach.very simple, shouldn't disrupt anyone's beach weekend. > Is there anyway we can expedite this process? Maybe pay extra for the permit to rush the process?The shoot date cannot be moved. > I look forward to hearing from you. > Best, > Dana >Sent from my iPhone >>On Jul 18, 2014, at 1:25 PM, "Rudder, Lynda" <Iynda.rudder@town.southold.ny.us>wrote: >> I sent you the special events application. Filming is separate. Please use the attached forms. Sorry for the confusion. >><Checklist for applicant.doc> >><APPLICATION FOR FILMING.doc> >><filming Local Law.doc> >><Filming permit docs for emailing.pdf><INDEMNIFICATION >>AGREEMENT.doc> 1 Rudder, Lynda From: Flatley, Martin Sent: Friday, July 18, 2014 3:22 PM To: Rudder, Lynda; Blasko, Regina Cc: Neville, Elizabeth; Finnegan, Martin Subject: RE: FILMING Hi Lyn, I have no objection to this filming taking place as long as their vehicles have a placard to avoid parking tickets. Please let me know if you approve this as I will need to pass this along to our Traffic Control for the weekend. Martin Flatley Chief of Police Southold Town Police Department 41405 State Rt. 25 Peconic, N.Y. 11958 631-765-3115 -----Original Message----- From: Rudder, Lynda Sent: Friday,July 18, 2014 1:47 PM To: 'Dana Kandic' Cc: Neville, Elizabeth; Finnegan, Martin; Flatley, Martin Subject: RE: FILMING I cannot guarantee that a permit will be issued. This office is supposed to receive the application, etc. at least seven (7) days before the filming. -----Original Message----- From: Dana Kandic [mailto:danak@ateliermanagement.com] Sent: Friday,July 18, 2014 1:34 PM To: Rudder, Lynda Subject: Re: FILMING There is also like a block of wheat field the photographer is interested in, really simple shoot on Friday. Let me know Sent from my iPhone >On Jul 18, 2014, at 1:32 PM, Dana Kandic<danak(a@ateliermanaeement.com>wrote: >Thanks Lynda. >The photographer+team are really set on shooting in North Fork. at 67 Steps Beach in Greenport West. > It's a small crew, only 1 model on the beach.very simple, shouldn't disrupt anyone's beach weekend. > Is there anyway we can expedite this process? Maybe pay extra for the permit to rush the process?The shoot date cannot be moved. > I look forward to hearing from you. 1 > Best, > Dana >Sent from my Whone >>On Jul 18, 2014, at 1:25 PM, "Rudder, Lynda" <I_ynda.rudder@town.southold.nv.us>wrote: >> I sent you the special events application. Filming is separate. Please use the attached forms. Sorry for the confusion. >><Checklist for applicant.doc> >><APPLICATION FOR FILMING.doc> >><filming Local Law.doc> >><Filming permit docs for emailing.pdf><INDEMNIFICATION >>AGREEMENT.doc> 2 * * * RECEIPT * * * Date: 07/22/14 Receipt#: 175339 Quantity Transactions Reference Subtotal 1 Application Fee - Non-Refund 042 app $100.00 1 Beach Permits 042 parking $10.00 1 Clean-Up Deposit 042 clean up $250.00 1 Daily Filming Permit 042 permit $100.00 Total Paid: $460.00 Notes: Payment Type Amount Paid By CK# $460.00 Atelier, Management Name: Atelier, Management 611 Broadway, #710 New York, NY 10012 Clerk ID: LYNDAR Internal ID:042 permit BLOSSOM BERKOFSKY DBA BLOSSOM BERKOFSKY SERVICES 1201 833 OCEAN AVE APT 103 SANTA MONICA,CA 90403-1012 1 16-24/1220 5584 ' 3216531974 PAY TO THE �•(., DATE ORDER OF I - ------------ Gt-----` ® Wells Fargo Bank.N.A. � C alifornia ellsfargo.com _ FOR_ � �✓��� --- �` � '� ,-� 1: l 2 2000 24 71: 3 21653 1974u * * * RECEIPT * * * Date: 07/22/14 Receipt#: 175339 Quantity Transactions Reference Subtotal 1 Application Fee- Non-Refund 042 app $100.00 1 Beach Permits 042 parking $10.00 1 Clean-Up Deposit 042 clean up $250.00 1 Daily Filming Permit 042 permit $100.00 Total Paid: $460.00 Notes: Payment Type Amount Paid By CK# $460.00 Atelier, Management Name: Atelier, Management 611 Broadway, #710 New York, NY 10012 Clerk ID: LYNDAR Internal ID:042 permit Vendor No. Check No. Town of Southold, New York - Payment Voucher Vendor Name Vendor Address Entered by Atelier Management 611 Broadway, #710 New York, NY 10012 Aud-if Date:: 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 Genecal:I;edgerFund:im Account Number:. 250.00 250.00 Clean-up Deposit Refund T1: 030 Total 250.00 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. Signat itle Signatu I 1 l Company Name Date l Tit] Date / i Southold Town Board - Letter Board Meeting of August 12, 2014 t RESOLUTION 2014-686 Item# 5.13 ice" ADOPTED DOC ID: 10030 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2014-686 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON AUGUST 12, 2014: WHEREAS Atelier Management has supplied the Town of Southold with a Clean-up Deposit fee in the amount of$250.00 for their Photo Shoot and WHEREAS the Southold Town Police Chief, Martin Flatley, has informed the Town Clerk's office that this fee may be refunded, now therefor be it RESOLVED that Town Board of the Town of Southold hereby authorizes a refund be issued in the amount of$250.00 to Atelier Management, 611 Broadway, #710, New York,NY 10012. F - Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: William P. Ruland, Councilman SECONDER:Louisa P. Evans, Justice AYES: Dinizio Jr, Ruland, Doherty, Evans, Russell ABSENT: Robert Ghosio Generated August 14, 2014 Page 19 Rudder, Lynda From: Flatley, Martin Sent: Wednesday, July 30, 2014 12:49 PM To: Rudder, Lynda Subject: RE: Clean-up deposits Yes Lyn Chief of Police Southold Town Police Department 41405 State Rt. 25 Peconic, N.Y. 11958 631-765-3115 From: Rudder, Lynda Sent: Wednesday, July 30, 2014 12:37 PM To: Flatley, Martin Subject: Clean-up deposits Can the following be released? Cutch-NS Historical Society—Antique Show 7/5 Atelier Management—filming 7/25 Henry Mazzoni -filming 6/30 1 TOWN CLERK'S CHECKLIST FOR FILMING PERMIT NOTE: All payments �must be cash or certified check Applicant: i e. 1 l Date Received: I ona I y Completed application $100 nonrefundable application fee Certificate of insurance that evidences a public liability insurance policy covering the town as an additional insured in the amount of$1,000,000 (one million dollars) per occurrence for the duration of the filming or still photography. Indemnification agreement stating the applicant agrees to assume all liability for and will indemnify and hold the town harmless of and free from any and all damages that occur to persons or property by reason of / said filming or still photography. ✓ Forward completed application to Chief of Police for approval or disapproval apd determination if Traffic Control Fee is required Approved Disapproved No Fee Required Fee in the amount of$ required V Forward certipeate of insurance and indemnification agreement to Town Attorney f approval Approved Disapproved COLLECT FEES AS FOLLOWS: Permit Fees (Prior to issuance of permit): Film Fee - $100 per day of each day covered by the permit Cleanup deposit: Separate certified check for $250 for each day covered by the permit. Traffic control fee - $1000 for each day covered by the permit if required by the Chief of Police. NOTE: Additional funds may be required by Police if it is determined that$1000 per day fee will be expended prior to the termination of the permit period. o\1 7 ✓ Beach Parking fee - $10 per vehicle, per day between May 1 and September 30. ISSUED PERMIT ✓ Countersign application Issue permit with name of applicant, locations(s), date(s), and time(s) NOTIFICATION of ISSUED PERMIT Chief of Police Chief Building Inspector Fire Marshal Code Enforcement Officer Superintendent of Highways Superintendent of Parks and Recreation REQUEST FOR EXTENSION OF PERMIT Forward extension permit request to Chief of Police If granted, collect additional $100 per day filming fee Amend permit to indicate granted extension period COMPLETION OF PERMIT PERIOD Chief of Police to provide applicant with statement of cost for providing Traffic Control and police coverage. (Refund overpayment or collect for additional costs within 30 days of termination of permit) Superintendent of Highways inspections locations listed on permit and determine if cleanup efforts by town personnel is required. *If cleanup is required, Superintendent will provide Town Clerk with a statement of actual costs. (Refund overpayment or collect for additional costs within 30 days of termination of permit) *If not cleanup is required, Superintendent of Highways will notify Town Clerk and Town Clerk will remit the $250 certified check to applicant. NEW Package FedEx8059 4 315 1417 r S Exps US A1rb/ll N�ber OEM :' • 1 From 4 Express Package Service 'reramrkxsoisse. ,eePl�ackagnaPro1581hL j WEE:somcsoorder bass cheoNei.Flrwsol.aeerduNy. F' re x` p y�ebsAsla Date Senders'/�'y�`4('�7 j/1 !t t 2 FedExFirstOvemi ht FedEx2DayA.M. ® Name '/` Ir'Vi r � �`—' Phone �' L � �'� ` ' ❑ iselies<n®ebusiessmomngdefaerymeelet ❑ Sacrday Dourarm07% �. 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