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HomeMy WebLinkAbout2015 Vendor No. Check No. Town of Southold, New York - Payment Voucher I Check Made Payable To. Mail check to(mailing address): ! Entered by S ? cd O-Q k C 1t)b . nX 9-1(e7 Audit Date Contact Telephone Number ��yy(] Q ,( [� 6.3 I ® 1 CSS -5C0 Q 1 x1003t-in Q\SJ, 1 fl , Town Clerk Contact Name Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services :General Ledger Fund and Account Number Special Event Clean-up 8.5 p—15-- 250.00 250.00 Deposit Refund T1.030 `10.6,+ C'.1 u(o • ` � 7 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,be-n verified with the exceptions due and owing,and that taxes om which the Town is exempt are excluded. or discrepancies noted,and pay - t is approved ir Sign.t 1 ,LO Title VK} t(=,d Signature I 1: Company Name Date S',31'^JS Tit-1"•JA ��'v',�i � + �.. Date 1 s Southold Town Board - Letter Board Meeting of August 25, 2015 re) RESOLUTION 2015-750 Item# 5.12 ADOPTED DOC ID: 11117 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2015-750 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON AUGUST 25, 2015: WHEREAS the following groups have supplied the Town of Southold with a Clean-up Deposit fee in the amount of$250.00, for their events 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 the following: Name Date Received Southold Yacht Club 6/16/15 PO Box 546 Southold,NY 11971 The Old Town Arts Crafts Guild 7/31/15 PO Box 392 Cutchogue, NY 11935 Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Jill Doherty, Councilwoman SECONDER:William P. Ruland, Councilman AYES: Ghosio, Dinizio Jr, Ruland, Doherty, Russell EXCUSED: Louisa P. Evans Generated August 28, 2015 Page 20 y Rudder, Lynda From: Flatley, Martin Sent: Friday, August 21, 2015 9:25 AM To: Rudder, Lynda Subject: RE: clean ups Please do Martin Flatley,Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 631-765-3115 From: Rudder, Lynda Sent: Friday, August 21, 2015 9:09 AM To: Flatley, Martin <mflatley@town.southold.nv.us>; Blasko, Regina <rblasko@town.southold.nv.us> Subject: clean ups May I return the following clean up deposits: Old Town Arts&Crafts Guild 8/1/15 Southold Yacht Club 7/23-24, 8/8 a40Ot / aI Lynda M Rudder Deputy Town Clerk Principal Account Clerk Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold,NY 11971 631/765-1800 ext 210 631/765-6145 1 Southold Town Board - Letter Board Meeting of August 5, 2015 RESOLUTION 2015-707 Item# 5.3 o�a� ADOPTED DOC ID: 11078 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2015-707 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON AUGUST 5, 2015: RESOLVED that the Town Board of the Town of Southold hereby granted permission to the Old Town Arts & Crafts Guild to hold its annual Arts & Crafts Show on the Village Green in Cutchogue on August 1, 2015 from 9:00 AM to 4:00 PM, applicant has met all of the requirements as listed in the Town Policy on Special Events and Use of Recreation Areas and Town Roads. Failure to comply with policy procedures will result in forfeiture of clean up deposit. Support was for this year only. A ,Z7e.0/1.4.0Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Jill Doherty, Councilwoman SECONDER:William P. Ruland, Councilman AYES: Ghosio, Dinizio Jr, Ruland, Doherty, Evans, Russell Generated August 16, 2015 Page 5 // % ELIZABETH A.NEVILLE,MMC 10 .!''''''4' ' 8, .*1 Town Hall,53095 Main Road TOWN CLERK = ; ..' +;!,:;.14:,;:-,,,- % P.O.Box 1179 co } 4.':-4.4,..; ms , Southold,New York 11971 REGISTRAR OF VITAL STATISTICS 1 w t,: �% ® ,, e C Fax(631)765-6145 MARRIAGE OFFICER °��'`'w,M •° ®� ,I' Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ' 9.1 `A°�,10' www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER .....-"--...,,•00 OFFICE OF THE TOWN CLERK RECEIVED TOWN OF SOUTHOLD J U L 3 1 2015 APPLICATION FOR A PERMIT TO HOLD A Southold Town Clerk SPECIAL EVENT Please provide ALL of the information requested below. Incomplete applications WILL NOT be reviewed. Date of Submission ItA / / S"f 1 Name of Event L - �" J a 4"..4..) Name of Organization: 0)L l) 0c,4i/ 1-721c 6 A-/::73 ('c/i LAS Is this a Not-For-Profit Event?Yes/No xit15' Contact's Name: 8 c O KiJ ,i - ))/?7-- 1 J Mailing Address: P1i /5 c y 3 2 Z Contact's Phone Number: /1--- 73X- ,? Z- C - 0 7 - ,_Z a Z 5---- Contact's Contact's Email Address: 0 L i) Z c-..-/,`/6--✓/e--4S ( /Q ' - c.e Event Location and Site Diagram: V/LL/17,-: C-oZ,J4J / g t--2 5--1" cAv`�' (Use additional paper if necessary) C u/ (--'61e- G--'//_ Event Date(s): �' , / j / ,2/f) 6 Z) C ac-4-1(4 ,� -- 7 c `� (Include set a d shutdown times and dates) / / P Nature of Event: /i-72-/— ci- ( 2A- ' /4+7 7 /Z- (Please attach a detailed description to this application) G G i ' ! Time Period (Hours) of Event: From 1 to `Ye'? Maximum Number of Expected Attendees:-7. I / G cv `' Specify any special requirements (i.e. road closure, police presence): _ ,)6 -/ j�,ZG�G,�,rc-r If a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 Mailing Address to Send Event Permit to: c � � � 3,7 r-/7 Fees: $250 for events with less than 1000 expected attendees )c' $350 for events with 1000 or more expected attendees $250 or more Clean-up deposit (Cannot be Waived) NOTE: Additional deposit may be required (see attached regulations)and shall be made in an amount determined prior to issuance of the permit based upon the estimated direct costs attributable to additional police, highway and cleanup costs associated with the event. The deposit will be used to cover such costs and any unused monies will be returned to applicant. CERTIFICATE OF INSURANCE REQUIRED: Not less than $2,000,000 naming the Town of Southold as an additional insured. Additional information and requirements may be required as deemed necessary by the Town Board. / (PP-Z.3/Y7J7- Print name of Authorized Person filling out Signature of Authorized Person filling out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. 2 UNIC tM Rt.v✓.... . AC I5* CERTIFICATE OF LIABILITY INSURANCE 7/31/2015 AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATENSUHOLDER. THIS CERTIFICATE THIS DOES NOT AFFIRMATIVELY OR NEGATIVELY BELOW. Tpi9 tltRTIKI IZED FtElilltSENTATIVE OR ��aUC� INSURANCE ������CE�T�FINOT CAZ`E HOLDER.CONSTITUTE A CONTRACT BETWEEN THE ISSUING Ythe tANi I If the tith holder,a on ADDITIONAL may requi a an eURED.the ndorsement. A statement on this certificatemust be endorsed. If fidoes not cconferWAIVED, righ s to the the terms and conditions of the policy,certainpolicies certificate holder In lieu of such endoraement(s) Dt+ ACT Lindsay Olsen PHON,,...–_. FAX (631)063-1145 PRODUCER PHHONE (631,)360-3737 tg Noo t Os �CJP�riG�� IY)C! ++AIG MsI..fi O 'E•MAIL O1senL@optonline.net 159 Terry Road pa.DfzE�s; � NAICII INSURER{St AFFORDING COVERAGE ._ � 11045 Smithtown NY 11787 _._ INSURER A:Excel.sior INSURERS• INSURED _._._ OLD TOWN ARTS & CRAFTS GUILD INC. INSURER C: PO Box 392 INSURER D: -- ----- INSURER –._ INSURER E:INSURER F: ---- NY 11935 cvTcxoGUE COVERAGES CERTIFICATE NUMBER:CL1573112913 REVISION NUMBER: THIS IS TO CERTIFY OWHTHAT THE STANDING ANYIREQUIREMEN, TERM OR CONDITION NCE LISTED HAVE OFBEEN ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOPOLICY WHICH THISPERIOD INDICATED. NMWI CERTIFICATE MAY DCONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVEE6EEN REDUCED POLICIES PAID CLAIMED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AN `ADDLISUBRI 1 POLICY EFF POLICY EXP I LIMITS INSR I TYPE OF INSURANCE tS tNSD ff WVO` POLICY NUMBER (MM,DD/YYYY1 IMMIDD/YYYY1 1,000,000 EACH OCCURRENCE , S ][ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100,000 �REEM�SE,SSEaoccurrenca_L_ S 5,000 A CLAIMS MADE X l OCCUR 2 2/15/2015 2/15/2016 MED EXP(Any one person) ,$ CHP800423 PERSONAL&ADV INJURY 5 1,000,000 - GENERAL AGGREGATE $ 2,000,000 { 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER' PRODUCTS-COMP/OP AGG $ PRO. LOC $ X POLICY� JECT ...�. S I COMBINED SINGLE LIMIT OTHER. _ce accident) AUTOMOBILE AUTOABILITY BODILY INJURY(Per person) $ _ ANY BODILY INJURY{Por accident) $ ALL OWNED — SCHEDULED PROPERTY DAMAGE $ AUTOS AUTOS�— NON-OWNED J,Per a I amt) HIRED AUTOS T AUTOS $ EACH OCCURRENCE S UMBRELLA LIAH — OCCUR I $ EXCESS UAB CLAIMS-MADE AGGREGATE I DED I 1 RETENTIONS PER .2E I I R 0TH- S WORKERS COMPENSATION 1 ST�iTt AND EMPLOYERS'UABIUTY V I N EL EACH ACCIDENT .5 _ ANY PROPRIETOWPARTNERIEXECUTIVE N!A E L DISEASE-EA EMPLOYEE ✓ (OFFICER/MEMBER(Mandatory In N )EXCLUDED? $ (Mandatary In NN) It yes,describe under E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS below I I I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Additional insured includes: Cutchogue/New Suffolk Historical Council and Town of Southold. • CERTIFICATE HOLDER CANCELLATION 1 SHOULD}{E EXPIRATION DATEF THE ABOVE THEREOFBED NOTOICE POLICIES WIaL BE CANCELLED DELIVEREDBEFORE IN Rechogue/ New Suffolk Historical Council ACCORDANCE WITH THE POLICY PROVISIONS. Rte 25 Cutchogue, NY 11935 AUTHO s' ED REP ESENTATIVE tit , - ( �r ©198 .014 ACORD'CORPORATION.;AII•righfs_r served. The ACORD name and logo are registered marks of ACORD -;: - F:,;1 ACORD 25(2014!01) ;+„; - INSQ2"�t201601) 4.0 ' r A ' ,, THE OLD TOWN ARTS:CRAFTS GUILD ' (, P.O.,,BOX362 1 CUTCHOGUE,NY 11p35-09i - 5901 50-791814 :'' , pYto'.---ti ' -77—',/, . )-- - (- — .:'''— ' _-, .. Boilers M Foaluro, Wck 'Capital Orie'NA/. / b <:0'��2.'14 ,9 2i.1.111:1',L X26 . - - � 0.-?, i' 0000.? 20 90:`Z - . • - -`•�-_ __.. _. ` - r i COLON44LCL0.5S�Ci a • • s * * * RECEIPT * * * Date: 07/31/15 Receipt#: 191555 Quantity Transactions Reference Subtotal 1 Clean-Up Deposit 8/1/15 $250.00 Total Paid: $250.00 Notes: Payment Type Amount Paid By CK#5901 $250.00 Old, Town Arts Crafts Guild Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Old, Town Arts Crafts Guild Po Box 392 Cutchogue, NY 11935 Clerk ID: LYNDAR Internal ID 8/1/15