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HomeMy WebLinkAboutDeparture Films Vendor No. Check Nd Town of Southold, New York - Payment Voucher Vendor Name Vendor Address Entered by..:: 'Pi 1(- ayo �I3 " 2�J1 s Atzdtt Date Vern�dor1 phone Number n �J Q- q(� " "[�o ..own Clerk Vendor Contact �� IF Ty%*1% M Invoice Invoice Invoice Net Purchase Order Number Date Total i Discount Amount ClaimedNumber Description of Goods or Services General.UdgerFund and Account Number i 8 �w 250.00 250.00 Clean-upDeposit Refund T'k 030 I I i i i 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 fro which the Town is exempt are excluded. or discrepancies noted,and paymen approved. Si tur itle ' Signatur Company Name Date Title Date o� Southold Town Board - Letter Board Meeting of July 15, 2014 le.Su"a```° RESOLUTION 2014-610 Item 4 5.12 �oQE ADOPTED DOC ID: 9959 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2014-610 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 157 2014: WHEREAS Departure Films has supplied the Town of Southold with a Clean-up Deposit fee in the amount of$250.00 for their television series 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 Departure Films, 240 West 37th Street, Ste 501, New York NY 10018. c ,404�& Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Louisa P. Evans, Justice SECONDER:Robert Ghosio, Councilman AYES: Ghosio, Dinizio Jr, Ruland, Doherty, Evans, Russell Generated July 17, 2014 Page 17 * * * RECEIPT * * * Date: 06/25/14 Receipt#: 172902 Quantity Transactions Reference Subtotal 1 Clean-Up Deposit 039 $250.00 Total Paid: $250.00 Notes: Payment Type Amount Paid By CK#3330 $250.00 Departure, Films Name: Departure, Films 240 West 37th St Suite 501 New York, NY 10018 Clerk ID: CAROLH Internal ID:039 DEPARTURE FILMS 3330 .4 -Southold Town Clerk 6/24/2014 Date Type Reference Original Amt. Balance Due Discount Payment 6/23/2014 Bill deposit 250.00 250.00 250.00 Check Amount 250.00 City National Checkin deposit 250.00 * * * RECEIPT * * * Date: 06/25/14 Receipt#: 172903 Quantity Transactions Reference Subtotal 5 Beach Permits 039B $50.00 3 Daily Filming Permit 039FP $300.00 Total Paid: $350.00 Notes: Payment Type Amount Paid By CK#3325 $350.00 Departure, Films Name: Departure, Films 240 West 37th St Suite 501 New York, NY 10018 Clerk ID: CAROLH Internal ID:039FP DEPARTURE FILMS 3325 Southold Town Clerk 6/24/2014 Date , , Type Reference Original Amt. Balance Due Discount Payment 6/23/2014 Bill permits 350.00 350.00 350.00 Check Amount 350.00 City National Checkin 350.00 Southold Locations: Southold Town Beach Goose Creek Beach Corey Creek Goldsmith inlet/Beach Hashamomuck Pond Kenney's Beach Gull Pond East End Lighthouse from end of road McCabe's Beach Downs Farm Preserve Arshamomaque Preserve 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 dates and time(s) NOTTIFICATION of ISSUED PERMIT Chief of Police - Chief Building Inspector ire Marshal /Code Enforcement Officer ✓ Superintendent of Highways Y Superintendent of Parks and Recreation ecreation 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. Hydell, Carol From: Flatley, Martin Sent: Thursday,July 03, 2014 11:46 AM To: Hydell, Carol Subject: RE: Departure Filming Permit Hi Carol, Since I won't be able to check all locations, I would approve them to have their deposit returned. U41 Chief of Police Southold Town Police Department 41405 State Rt. 25 Peconic, N.Y. 11958 631-765-3115 From: Hydell, Carol Sent: Wednesday, July 02, 2014 1:54 PM To: Flatley, Martin; Blasko, Regina Subject: Departure Filming Permit Hi Chief: Sorry I haven't got back to you (Busy with beach permit). Attached are the places that Departure Films were, please let me know about clean-up fee. Thanks again carol 1 Hydell, Carol From: Emily English <emily@departure-films.com> Sent: Wednesday,June 25, 2014 2:03 PM To: Hydell, Carol Subject: Cedar Beach Road Hi Carol, I spoke with Michelle Stark at Suffolk County office and she said that Cedar Beach Road(beach at end of road) is town-owned. Can you please confirm so that we know we are covered there in case we decide to shoot? This shoot would fall under one of the days we have already paid for. It would not be an additional day. Below is a link to a map of the area I am speaking of. Thanks much! Best, Emily https://www.google.com/maps/Tlace/3535+Cedar+Beach+Rd/g-)41.037536,- 72.39045.19,140m/data=!3m2!1 e3!4b 1!4m2!3m 1!1 sOx89e899dOO6e79a91.Oxc3d l 5058aa459253 Emily English Associate Producer Departure Films New York,NY P. 212-629-9666 ext. 34 C. 917-647-0799 F. 212-629-6788 1 Hydell, Carol From: Finnegan, Martin Sent: Friday,June 20, 2014 11:01 AM To: Hydell, Carol; Krauza, Lynne Subject: RE: Sorry—no objection. From: Hydell, Carol Sent: Friday, June 20, 2014 10:58 AM To: Finnegan, Martin; Krauza, Lynne Subject: Please let me know about this permit? Take Care Carol 1 Hydell, Carol From: Flatley, Martin Sent: Thursday,June 19, 2014 2:57 PM To: Hydell, Carol Cc: Blasko, Regina; Finnegan, Martin; Krauza, Lynne Subject: Re:filming permit I have no objections to this permit being issued. I'm assuming there will be no known actors/actresses with this group that will necessitate crowd control since these locations are very open to the public? If not,then just placards for the cars associated with the shoot for parking at theses sites. If they need a officer attached for security, I will need to add a cost analysis. Sent from my Wad, Chief M. Flatley On Jun 19, 2014, at 1:26 PM, "Hydell, Carol"<carol.hydell@town.southold.ny.us>wrote: <FILMING_20140619121453.pdf5 i Hydell, Carol From: Flatley, Martin Sent: Monday,June 23, 2014 4:41 PM To: Hydell, Carol Cc: Blasko, Regina; Finnegan, Martin; Krauza, Lynne Subject: RE:filming permit Carol, Do you still have me last response on this permit? If not, my only question was whether the group needed any security around their shoots to keep the public away since they are shooting in some very public beaches that could be crowded if the weekend turns out to be nice. If this is not a concern,then as longs as their vehicles are carrying a placard for parking, our Traffic Control Officers will not summons them. Chief of Police Southold Town Police Department 41405 State Rt. 25 Peconic, N.Y. 11958 631-765-3115 �M _ �.. _ _._. _..... ...... _ _. _.. .a .. ,. ... ._ a� �. m.a.� ........ From: Hydell, Carol Sent: Thursday, June 19, 2014 1:27 PM To: Flatley, Martin; Blasko, Regina; Finnegan, Martin; Krauza, Lynne Subject: filming permit 1 • 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. 61� Signa re Date Printed name Frz, � ss� Title • APPLICATION FOR FILMING/STILL PHOTOGRAPHY PERMIT NO: Please Print or Type APPLICATION DATE: 6/16/14 NAME OF APPLICANT: Emily English MAILING ADDRESS: 240 W. 37"' Street,New York,NY 10018 PHONE: BUSINESS: 212.629.9666 ext. 34 HOME: 917.647.0799 NAME OF ORGANIZATION/COMPANY: Departure Films MAILING ADDRESS: 240 W. 37`h Street,New York,NY 10018 PHONE: 212.629.9666 FAX: 212.629.6788 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * DESCRIBE TYPE OF ACTIVITY(e.g. Motion Picture, Commercial, Television. Catalog, Magazine, etc.): Television Series DATE(S)AND TIME(S) OF PROPOSED FILMING/PHOTOGRAPHY: June 27 2014 - June 29 2014 PROPOSED LOCATION(S) OF FILMING/PHOTOGRAPHY: (attach additional sheet, if necessary) Please see attached NAME OF PERSON IN CHARGE AT SITE: 2 NUMBER OF PERSONS AT LOCATION (cast& crew included): 14 NUMBER AND TYPE OF VECHILES AT LOCATION: 5 TYPE OF SPECIAL EQUIPMENT: Cameras, hand-held lights, microphones ANY SPECIAL REQUIREMENTS: No Signature Return to: Southold Town Clerk Southold Town Hall 53095 Main Road P.O. Box 1179 Southold,NY 11971 INDEMNIFICATION AGREEMENT TOWN OF SOUTTIOLD FIL.\,IINGI!STILL PHOTOGRAPHY PERMIT The Applicant shall indemnify and hold harmless the Town from and against all suits,claims,demands or actions for any damage andlor 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. Signa s e Date .......... Printed name Title ACORD, CERTIFICATE OF LIABILITY INSURANCEDate(MM/DD/YYYY) 6/16/14 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). PRODUCER Contact Name: James Pedrick Laura Comerford Aon/Albert G. Ruben Co.of NY, Inc. Phone: 212-337-4356 212-337-4354 171 Madison Avenue,Suite 401 New York, NY 10016 Insurers Affording Coverage NAIC# INSURED INSURER A: Great Divide Insurance Company INSURER B:ACE America Insurance Company 39th Street Productions LLC INSURER C: 240 West 37 Street, 501 INSURER D: New York, NY 10018 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MM/DDIVYYY) (MWDD/YYYY) A GENERAL LIABILITY CNA 1000703 06/01/14 06/01/15 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES $1 000 000 (Ea occurrence) CLAIMS MADE ❑X OCCUR X PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OP AGG $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PROJECT MEDICAL EXPENSE EXCLUDED A AUTOMOBILE LIABILITY CNA 1000703 06/01/14 06/01/15 COMBINED SINGLE LIMIT $1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED X 'AUTO PHYSICAL BODILY INJURY(Per accident) AUTOS AUTOS DAMAGE DEDUCTIBLE: X HIRED AUTOS X NON-OWNED $2,500 PROPERTY DAMAGE AUTOS Per accident X AUTO PHYS.DAM.' Ind.in Miscellaneous AUTO PHYSICAL DAMAGE Equipment A X Umbrella Liab X OCCUR CUA 1000704 06/01/14 06/01/15 EACH OCCURRENCE $5,000,000 Excess Liab CLAIMS-MADE X AGGREGATE $5,000,000 DEDUCTIBLE WORKERS COMPENSATION AND WC Statutory Other EMPLOYERS'LIABILITY Limits ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N NOT COVERED E.L.Each Accident OFFICERIMEMBER EXCLUDED? HEREUNDER (Mandatory in NH) N/A E.L.Disease-EA Employee If yes,describe under DESCRIPTION OF OPERATIONS below E.L.Disease-Policy Lima A WORLDWIDE PRODUCTION PACKAGE CNA 1000703 06/01/14 06/01/15 LIMIT DEDUCTIBLE MISCELLANEOUS EQUIPMENT $3,000,000 $3,500 PROPERTY OF OTHERS $1,000,000 $2,500 PROPS,SETS&WARDROBE $1,000,000 $2,500 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Scripps Networks Interactive—Home&Garden Television-Vacation House for Free 200 Casting Certificate Holder is Additional Insured(by"Blanket"Endorsement)under General/Auto Liability but only with regard to claims arising from the negligence of Named Insured and as required by written contract. Certificate Holder is Loss Payee with regard to Production Package.All coverage is subject to terms and conditions of policies of insurance.This Certificate does not amend,extend or alter the coverage afforded by the policies above. CERTIFICATE HOLDER Cancellation Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 53095 Main Rd DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE Aon/Albert G.Ruben Insurance Services,Inc. ACORD 26(2010/05) 1988—2010©ACORD CORPORATION All rights reserved. * * * RECEIPT * * * Date: 06/19/14 Receipt#: 172363 Quantity Transactions Reference Subtotal 1 Application Fee- Non-Refund 039 $100.00 Total Paid: $100.00 Notes: Payment Type Amount Paid By CK#3299 $100.00 Departure, Films Name: Departure, Films 240 West 37th St Suite 501 New York, NY 10018 Clerk ID: CAROLH Internal ID:039 DEPARTURE FILMS 3299 Southold Town Clerk 6/17/2014 Date Type Reference Original Amt. Balance Due Discount Payment 6/17/2014 Bill permit fee 100.00 100.00 100.00 Check Amount 100.00 City National Checkin permit fee 100.00 C (-"4 CAIVL C(c,S i C, _l-4ih CJp CtoS � an� ISSUES WUe. lUok -fc�wG�� -Fa bjuri tV) TOWN CLERK'S CHECKLIST FOR FILMING PERMIT NOTE: All payments must be cash or certified check Applicant: Qo-rfu r Date Received: (0 71 Completed application v $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$1,000,000 (one million dollars)per occurrence for the duration of the filming or still ` photography. Y Indemnification agreement stating the applicant agrees to assume all liability for and will indemnify and hold the town harmless of and free from any and all damages that occur to persons or property by reason of said filming or still photography. Forward completed application to Chief of Police for approval or disapproval d determination if Traffic Control Fee is required Approved Disapproved No Fee Required / Fee in the amount of$ required V Forward certificate of insurance and indemnification agreement to Town Attorney fgr approval ✓ Approved Disapproved COLLECT FEES AS FOLLOWS: Permit Fees (Prior to issuance of permit): -Z Film Fee - $100 per day of each day covered by the permit ZCleanup, 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. From: (212)629-9666 Origin ID:MTPAShip Date:24JUN14 Aileen Wong m ActWgt:1.0 LB Express Departure Fills CAD:4030833ANET3490 240 W 37th Street Suite 501 Delivery Address Bar Code New York,NY 10018 J14101402070326 III VIII IIII IIIIII VIII I III II I I I III VI II IIII I I I II III SHIP TO: (631)765.1800 BILL SENDER Ref# Vacation House For Free Carol Hydell Invoice# Southold Town Clerk Po# 53095 Main Rd Dept# SOUTHOLD, NY 11971 WED - 25 JUN 12:OOP TRK# 7704 0157 0746 PRIORITY OVERNIGHT 0201 11971 EL W J K JFK I 522G519BC41F220 After printing this label: 1. Use the'Print'button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning: Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges, along w ith the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on f edex.com.FedEx w ill not be responsible for any claim in excess of$100 per package,w hether the result of loss, damage, delay, non-delivery,rrisdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees, costs, and other forms of damage w hether direct, incidental,cons equential,or special is limited to the greater of$100 or the authorized declared value. Recovery cannot exceed actual documented loss.Maximum for items of extraordinary value is$1,000, e.g.jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits, see current FedEx Service Guide. From: (212)629-9666 Origin ID:MTPA Ship Date:17JUN14 Aileen Wong m ActWgt:1.0 LB Departure Fills Express CAD:4030833ANET3490 240 W 37th Street Suite 501 Delivery Address Bar Code New York,NY 10018 J14101402070326 II I IIIII II II I II I II(I I II I III II I I I III III I(III III)I II I II I I III SHIP TO: (631)765.1800 BILL SENDER Ref# Vacation House For Free Carol Hydell Invoice# Southold Town Clerk PO# 53095 Main Road Dept# SOUTHOLDS, NY 11971 WED - 18 JUN 12:OOP TRK 7703 2857 2570 PRIORITY OVERNIGHT 11971 ELWSHA JFK FK � 522G519BC4/F220 After printing this label: 1. Use the'Print'button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning: Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges, along w ith the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx w ill not be responsible for any claim in excess of$100 per package,w hether the result of loss, damage, delay, non-delivery,mis delivery,or misinformation, unless you declare a higher value, pay an additional charge,document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply.Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees, costs,and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of$100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Wximum for items of extraordinary value is$1,000, e.g.jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide.Written claims must be filed within strict time limits, see current FedEx Service Guide.