HomeMy WebLinkAbout2001D Fideiit and Deposit Companyof Maryland Home Office
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Baltimore, MD 21203
[IColonial American Casualty and Surety Company
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CRIME POLICY DECLARATIONS
This policy consists of litia Declaratiuns Form, the Common Policy Conditions, the Crime General Provisions Form and the
Coverage Forms indicated as applicable.
Policy No_ CCP 005 14 26
Named Insured and Mailing Address (No., Street, Town or City, County, Slate, Zip Code)
Southold Fire District
Main Road, P.O. Box 908
Southold, New York 11971
Pulicy Peiivd. Frust January 3, 2001 to Until Date of Cancellation shown 8t1A.M Standard T1me at your mailing adrkacs
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH
YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
COVERAGE, LIMITS OF INSURANCE AND DEDUCTIBLE
Coverage Forms Forming a Part of this Policy
Limit of Insurance Deductible Amount
FORM A - Employee Dishonesty Coverage Form
FORM B - ForQery or Alteration Coverage Form
FORM C - Theft, Disappearance. and Destruction Coverage Form
Section 1. - Inside the Premises
Section 2 - Outside the Premises
FORM D - Robbery and Safe Burglary C—ornop Form
Section 1. - Inside the Premises
Section 2. - Outside the Premises
Additional Coverage Forms
FORM U - E'ubilc tmployee Dishonesty Coverage Form
$
NIL
$
NIL
$
NIL
$
NIL
$
NIL
$
NIL
$
NIL
$
NIL
$
NIL
$
NIL
$
NIL
$
NIL
+
Y. - -
$
100,000.00
$
NIL ✓
$
NIL
$
NIL
$
NIL
$
NIL
ENDORSEMENTS FORMING PART OF THIS POLICY WHEN ISSUED:
CR 10 00 06 95 CR 00 16 10 90 CR 10 37 0189 CR 10 50 0189 IL 0185 10 95 IL 02 68 04 98
Endorsement A
CANCELLATION OF PRIOR INSURANCE: By acceptance of this Policy you give use notice canceling prior policy or bond
Nos. the cancellation to be effective at the time this Policy becomes effective.
COUNTERSIGNED; By.
(Date) Authorized Representative
0
I of 2
CCC 6903a ED, 1/93
Includes coovnahted material of Insurance Services Office, Inc. with Is permission. Copyright, Insurance Services Office. Inc , 1993, 79 4
COMMERCIAL CRIME
POLICY NUMBER. CCP 005 14 26
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADD SCHEDULE EXCESS LIMIT OF INSURANCE
FOR SPECIFIED EMPLOYEES OR POSITIONS
FOR DISHONEST ACTS ONLY
This endorsement applies to EMPLOYEE DISHONESTY COVERAGE FORM A or PUBLIC EMPLOYEE
DISHONESTY COVERAGE FORM 0 or P.
A. SCHEDULE
B- PROVISIONS
1. The Excess Limit of Insurance shown in the SCHEDULE applies to each "employee" who is named or
who holds a position shown in the SCHEDULE opposite that limit.
2. The Excess Limit of Insurance applies only to that part of any covered loss that is excess of an amount
equal to the Limit of Insurance shown in the DECLARATIONS as applicable to the COVERAGE FORM
you purchase plus any applicable Deductible Amount.
g, The Excess Limit of Insurance applies only to loss caused by an identified "employee",
4. If tho Excess Limit of Insurance is scheduled on a position naris,, the most we will pay for an "employee"
holding more than one position Is the largest Excess Limit of insurance in effect and applicable to any one
of those positions at the time of loss.
5, The Excess Limit of insurance applies only to loss you susidin thiouyh "employee dishonesty".
CR 10 37 0189 init / date
Name -Schedule Position Schedule Coverage
Excess Limit j
No. of
Item
Names of Titles of
Location of
"Employees"
of Insurance
No.
"Employees" Positions
Covered Positions
Each
Position
Each
"Emplo ee"
Cynthia aprlse
ou o
ne
Karen A HeimSKi ✓
Southold, NY ✓
One
f.
S 1,000,000.00
I
i
j I
I
B- PROVISIONS
1. The Excess Limit of Insurance shown in the SCHEDULE applies to each "employee" who is named or
who holds a position shown in the SCHEDULE opposite that limit.
2. The Excess Limit of Insurance applies only to that part of any covered loss that is excess of an amount
equal to the Limit of Insurance shown in the DECLARATIONS as applicable to the COVERAGE FORM
you purchase plus any applicable Deductible Amount.
g, The Excess Limit of Insurance applies only to loss caused by an identified "employee",
4. If tho Excess Limit of Insurance is scheduled on a position naris,, the most we will pay for an "employee"
holding more than one position Is the largest Excess Limit of insurance in effect and applicable to any one
of those positions at the time of loss.
5, The Excess Limit of insurance applies only to loss you susidin thiouyh "employee dishonesty".
CR 10 37 0189 init / date
RECEIVED
9 11001
Southold Town Clerl: SOUTHOLD FIRE DISTRICT
P.O. BOX 908. SOUTHOLD, N.Y. 11971
(631) 765-4305
FAX (631) 765-5076
December 15, 2001
Mrs. Elizabeth Neville, Town Clerk
Town of Southold
Main Road
Southold, NY 11971
Dear Betty:
Enclosed please find two (2) copies of the results of our most recent
election of Commissioner, held on December 11, 2001.
Kindly execute both documents, retain one for your files and return the
other one to me in the enclosed return envelope.
Thank you.
Sincerely,
Cynthia Caprise
Fire District Secretary
Southold Fire District in the
Town of Southold, Suffolk County, New York
The undersigned, ALICE KRAMFR, Chairperson of the Election,
SUSAN SEPENOSKI and MARY DEWEY, Ballot Clerks DO HEREBY
CERTIFY AS FOLLOWS:
1. That each of us is a resident elector of the Southold Fire District in the
Town of Southold, Suffolk County, New York, and that pursuant to a
resolution adopted by the Board of Fire commissioners of said Fire
District on the 13'bday of November, 2001 we were appointed to the
offices set forth hereinabove in connection with the election of said Fire
District held on the 11`x' day of December, 2001, between the hours of
6:00 PM and 9:00 PM, prevailing time, for the purpose of voting upon
the election of one (1) Fire District Commissioner for the term of office
which will commence on January 1, 2002 and expire on December 31,
2006.
2. After the polls had closed for said election, we immediately canvassed
the ballots cast. Inspection of such ballots disclosed the following
results:
For the election of Fire District Commissioner for the period of five (5)
years for the term of office which will commence on January 1, 2002 and
expire on December 31, 2006.
Total number of ballots cast 6"
Number
Number of votes for
George T Conway ,q
Number of void ballots
3. Upon completion of such canvass, the Chairman of the Election publicly
announced the result thereof.
4. A true, correct and complete copy of the official ballot used at said
election is attached hereto and made a part thereof.
5. On the 27`' day of November, 2001 at 9:00 AM, the Fire District
Secretary held a meeting to prepare the voter registration roll. This
register was prepared containing the names of all persons residing in said
Fire District and qualified to vote in said election whose names were on
the registration list certified and supplied to said Fire District by the
Suffolk County Board of Elections as of a date twenty-three (23) days
before date of said election. All of the votes described above were of
voters whose names appear on the register prepared at that time.
Dated: December 11, 2001
At: Southold, New York
Q+d4fd I a -(1-api/I &--
Cynthid-0-aprise, Fire District Secretary
Alice Kramer, ha rperson of the Election
Susan Sepenoski, Ballot Clerk
- )�
Mary Dewey, fQot Clerk
STATE OF NEW YORK)
ss: Southold Fire District
COUNTY OF SUFFOLK
I, the undersigned CLERK of the Town of Southold, Suffolk County, New
York DO HEREBY CERTIFY:
That I have compared the annexed copy of the CERTIFICATE OF RESULT
OF FIRE DISTRICT ELECTION, with the original thereof which was filed in
my office on the lh day of December, 2000, and that the same is true,
complete and correct copy of the whole of said original.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal
of said TOWN this day of December 2000.
(Corporate Seal)
OFFICIAL BALLOT
SOUTHOLD FIRE DISTRICT
DECEMBER 11, 2001
Instructions
1. Mark with a pencil or pen.
2. To vote for a candidate whose name is printed on this ballot,
place a cross (x) or a check mark (�) in the square to the left of
his/her name.
3. To vote for a person whose name is not printed on this ballot,
write his/her name in the blank space provided.
4. Any mark other than a cross (x) or a check mark (�) used for
the purpose of voting or any erasure made on this ballot will
void the ballot.
5. If you tear, or deface, or wrongly mark this ballot, return it and
obtain another.
Vote for only one
Fire District Commissioner — 5 years
commencing 1/1/2002 and expiring 12/31/06
George T. Conway
Robert T. McTague /
2795 South Harbor Road
Southold NY, 11971
The Town of Southold
P.O.Box 1179
Southold NY, 11971
Attn: Supervisor Jean W. Cochran
Tuesday Sept. 11, 2001
Dear Supervisor Cochran:
The following letter has been sent to the two local newspapers, The Chief
of the Southold Police Department, The Chief of the Southold Fire Department and each
of the Police Officers involved.
"On Sunday morning June 17, 2001 at approximately 2:00 AM I had
occasion to request the services of the Southold Police Department. My wife and I
arrived home at that time to find that our basement was filled to a level of roughly 4 %z
feet with water. There was water saturating the main floor of our home as well. We called
the Southold Police Department immediately and three police officers responded; P/O
. Peter Onufrak, P/O Peter Dicandia and P/O Steven Harned. The four of us got the water
feed to the washing machine on the main floor, where the problem existed, shut off.
Their assistance in solving our physical problem was invaluable. Equally important, to
my wife and I, was the calming effect that the officers had on the situation. Their counsel
on how to proceed from that point was invaluable. They advised us to ask the Southold
Fire Department to help us to remove the water from our basement.
My wife Joan called the fire department later that morning and they
promptly responded to our call. One of the fire fighters arrived and evaluated the
situation. He then notified the remainder of the department as to what was needed to
perform the task at hand. Two fire apparatus and many firefighters soon arrived and
began what seemed to be an impossible undertaking. Within three hours the basement
water level was down to inches and the work of restoring our home to a livable dwelling
could begin. These firepersons quietly and efficiently went about the task of helping us to
the degree that they could and for that we shall be eternally grateful. To Chief Thomas
Helinski, Chief Joe Pontino, John Pontino, Bill Byrnes, John Baker, Brian Conway, Keith
Cummings, Peggy Killian, Frank Locrotondo, Scott Latham, Mark Walters, Lou Walters
Sr. and Lou Walters Jr., along with the three Southold Police Officers, the McTagues
offer our undying gratitude for your help in our time of need."
Y rs ru
R ague
SEP 2 "
File: Commendations
"M" General
Police
Fire dept.- Southold
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
o�SOFfO�,�coG
o� y�
Go z
oy� • O��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Fire Department
Main Road
P O Box 908
Southold, NY 111971
Dear Firefighters:
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
September 20, 2001
The Southold Town Board, at its meeting held September 17, 2001, proclaimed
the week of October 7, 2001 to October 13, 2001 as FIRE PREVENTION
WEEK. A copy of the resolution is enclosed.
The Town Board wishes to thank you for efforts in educating and assisting the
members of our community in fire prevention.
Very truly yours,
?-'
Elizabeth A. Neville
Southold Town Clerk
Enc.
lj c
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 641 OF 2001
WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD
ON SEPTEMBER 17,2001:
WHEREAS, fire deaths due to smoke inhalation outnumber fire deaths due to burns by more
than two to one; and
WHEREAS, smoke detectors are our first line of defense against fire; and
WHEREAS, research shows that having a smoke detector cuts our risk of dying in a fire nearly
in half, and
WHEREAS, estimates show that about one-third of all homes that have fires have smoke
detectors that are not working, usually because of dead or missing batteries; and
WHEREAS, the National Fire Alarm Code requires smoke detectors outside each sleeping area
and on each level of the home and recommends testing smoke detectors at least once a month;
and
WHEREAS, a smoke detector that isn't working can't protect us from deadly smoke and fire;
and
WHEREAS, the FIRE SERVICE OF SOUTHOLD TOWN is dedicated to the safety of life and
property from the devastating effects of fire; and
WHEREAS, members of the fire service are joined by southold Town citizens, as well as
business, schools, service clubs and organizations in their fire safety efforts; and
WHEREAS, the local efforts of the fire service are supported by the American Burn
Association, American Red Cross, Congressional Fire Services Institute, Fire Marshals
Association of North America, International Association of Arson Investigators, International
Association of Fire Chiefs, International Association of Fire Fighters, International Association
of Black Professional Firefighters, National Association of State Fire Marshals, National Fire
Protection Association, National Volunteer Fire Council, and the United States Fire
Administration; now, therefore, be it
RESOLVED that the Town Board of the Town of southold hereby proclaims the week of
October 7-13, 2001, as FIRE PREVENTION WEEK. This week commemorates the great
Chicago Fire of 1871, which killed more than 250 persons, left 100,000 homeless and destroyed
more than 17,400 buildings; and be it further
RESOLVED that the Town Board calls upon the people of Southold Town to participate in fire
prevention activities at home, work, and school.
Elizabeth A. Neville
Southold Town Clerk
CERTIFICATE OF INSPECTORS OF ELECTION
SOUTHOLD FIRE DISTRICT
IN THE TOWN OF SOUTHOLD, NEW YORK
Canvass of Votes on Proposition at the
Special Election held August 15, 2001
WE, THE UNDERSIGNED, being Chairperson, Inspectors of
Election and Ballot Clerks, at the Special Election of the qualified
voters of the Southold Fire District, in the Town of Southold, in the
County of Suffolk, New York, held at the Main Firehouse, 55135 Main
Road, Southold, New York, on August 15, 2001, between the hours
of 6:00 o'clock P.M. (prevailing time) and 9:00 o'clock P.M. (prevailing
time), to vote upon Proposition contained in the ballot label used at
said Special Election; HEREBY CERTIFY that prior to said Special
Election we duly took and filed our oaths of office as required by law,
and we were otherwise duly qualified to act as Inspectors of Election
and Ballot Clerks; that the voting machines numbered 142750 and
142754 were checked by two inspectors and a representative from
the Suffolk County Board of Elections. We also found that the
Protective Counters registered 20126 (Machine # 142750) and 24084
(Machine # 142754). We also examined the ballot label on the face
of each machine, a true and complete copy of which is annexed
hereto and made a part hereof, and found each to be correctly placed
thereon. In addition, prior to the opening of the polls, we examined
every Counter in the machines and found that each registered (000)
and we examined the Public Counters and found that they registered
(000); and we further certify that during the examination and until the
opening of the polls no Inspector or any other person touched the
interior of the machines or any of their mechanisms; that we
conducted the voting at said Special Election in all respects in the
manner required by the law; that all persons who were qualified and
who presented themselves at the polls between 6:00 o'clock P.M.
(prevailing time) and 9:00 o'clock P.M. (prevailing time) on said day
were permitted to vote; that at 9:00 o'clock P.M. (prevailing time) the
doors of said polling place were closed and only such qualified voters
as were then within the polling place were permitted to vote
thereafter; that a Poll List containing the names and addresses of all
persons voting was kept by us and that immediately upon the close of
the polls, we found that the Protective Counters register 20196
(Machine # 142750) and 24152 (Machine # 142754) that one
Inspector, under the scrutiny of another Inspector, announced the
vote as shown on the Counters of each machine, and the same was
written down on the Certificates of Canvass by other Inspectors;
that after the vote was announced and written down, the
Certificates of Canvass were compared with the Counters in the
machines and found to agree; that the total number of votes as
shown by the Public Counters was:
Z C) On Machine No. / Z7�
6ef On Machine No. _/ �/ az=Lz�
and that the official return of votes cast at the Special
Election was:
Machine No. I Yes No
Blank Total
TOTALS
The Chairman thereupon publicly announced that the
Proposition has been approved.
IN WITNESS WHEREOF, we have hereunto set our hands this
day of August, 2001
Inspectors of Election and
Ballot Clerks
372097.1 001092 RES
OATH OF INSPECTORS OF ELECTION
STATE OF NEW YORK )
.ss.
COUNTY OF SUFFOLK )
WE, THE UNDERSIGNED, having been designated to act as
Chairman, Inspectors of Election and Ballot Clerks, for the
purpose of conducting a Special Election of the qualified voters
of Southold Fire District, in the Town of Southold, New York,
held at the Main Firehouse, 55135 Main Road, Southold, New York,
on August 15, 2001, at 6:00 P.M. (Prevailing Time), DO SOLEMNLY
SWEAR that we will support the Constitution of the United States
of America and the Constitution of the State of New York, and
that we shall faithfully discharge the duties of the offices of
Chairman, I spectors of Election and Ballot Clerks at such
Special Election called to vote on the Proposition set forth and
described in the Notice calling the Special Election.
Subscribe and swo to before me
this ay of 2001.
No ary Public, -Stat-T of New York
SANDFA L BERRY
-my Pubic, Oft d Now Yak
No.01BE400M
Qaftsd in &** 04urt/
ovni m E*m Dooe tv 91,19
Inspectors of Election
and Ballot Clerks
372097.1 001092 RES
PROPOSITION
SHALL the bond resolution of Southold Fire District, in the Town of
Southold, New York, entitled: `Bond Resolution of the Southold Fire District,
in the Town of Southold, New York, adopted June 12, 2001, authorizing the
construction of an addition and improvements to the main firehouse, located at
55135 Main Road, in Southold; stating the estimated maximum cost thereof is
$1,100,000; appropriating said amount therefore; authorizing the issuance of
$1,100,000 serial bonds of said Fire District to finance said appropriation;
STATING that it has been determined that the project will not result in any
significant adverse environmental impact for purposes of the State
Environmental Quality Review Act ("SEQRA") and that a negative declaration
has been issued; determining that the period of probable usefulness of the
specific object or purpose for which said $1,100,000 serial bonds are authorized
to be issued is 20 years; and providing for the levy of taxes to be collected to
pay the principal of and interest on said bonds" BE APPROVED?
CERTIFICATE OF THE FIRE DISTRICT SECRETARY
I, Cynthia Caprise, Fire District Secretary of Southold Fire District, in
the Town of Southold, Suffolk County, New York, HEREBY CERTIFY
that I have compared the annexed copy of the Certificate of
Inspectors of Election as to the results of the voting at the Special
Election duly called and held in said Fire District on August 15, 2001,
with the original thereof, which was filed with the Board of Fire
Commissioners in my office as Fire District Secretary, following said
Special Election, and the same is a true copy of said original
Certificate and of the whole thereof so far as the same relates to the
vote on the Proposition submitted at such Special Election.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed
the corporate seal of said Fire District this 16th day of August, 2001.
(SEAL) eqd4la 0(*Obe--
Fire
District Secretary
CERTIFICATE OF TOWN CLERK
I, Elizabeth A. Neville, Town Clerk of the Town of Southold, Suffolk
County, New York, HEREBY CERTIFY that after the Special Election
of the qualified voters of Southold Fire District, in the Town of
Southold, Suffolk County, New York held on August 15, 2001, the
Certificate of Inspectors of Election, executed by the Chairperson,
Inspectors of the Election and Ballot Clerks, showing the results of
the canvass of votes on the Proposition submitted to the qualified
voters at said Special Election, a full and complete copy of which is
annexed hereto and made a part hereof, was filed in the office of the
Town Clerk of the Town of Southold.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed
the corporate seal of said Town this day of August, 2001.
(SEAL)
Town Qlerk