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AU-04/25/2017 Fishers Island
----- - --' -- --- -,r-' '-----------' ' ----------- ------------� FISHERS ISLAND-FERRY DISTRICT I ' VENDOR 001400 ALTERNATIVE SAFETY & TESTING 04/25/2017 CHECK 4003 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4°000.000 } 77415 DRUG TEST (4) RANDOM 160.00 r SM .5710.4.000.000 77415 LABCORP COLLECT SITE(4) 40.0,0 _ TOTAL �` 200.60 1 ' ' \ t :�,,� rz��F,ofw ^�.`>s.°x.'r -_ tea•„- ♦f _ •; "�,, e a ,.. •M.:J' .,roe:.- �' ,<%°,,"•' z,,, •.. `. `"�.::;•?,'`�:.t r. ,,;f;.• 1 l , f I � r- r_ FI'SHERS--"SLAAD,FERR-yD�STRIGT;�;� ;F� — } AUDIT,_ -- r - ,53095�MAIN ROAD�'PO'BOX:1179r' '`Rr'i';'aa ^,,, rt_, w�• 'ib 11. ZSOUTHOLD;;NY,1,197'1-9959 yj•* "i, CH'.CKt THE'SUFFOLK,CO,:,NAT,IONQL,�BANK r - _ CUT,CHOGUEr'NY.11935;.`I,J".'In! �AT�'=_ =' ',' ? 4/25,/,2,b - 11',114,111' ry;ul. p p• '__ b 4/'2'5./.`2'017 $'2'0 O 00 "':rE ? ) I '' .TWO�'HUNDRED�_fANDj• ,00` 10O,XDOLLARSz,• 's;,. ,fi• :�>,t -f- `;,"� °,' vt'>s — __ 7:.1','•1• __ __- - - .S 11 i£„ „I„i rl..°d4,d I�.',i�,dsa•'” __-" -_-s G' - _ - __ 1{' ,I,11'i,l ''d ';1',�I I '1'�J, - - -_ -fi°` - _ - - __ _— - - -_ zis' 1'Lp.'r "•1' o°s�' 1' ___-- -" - ',t" -a -'4C ..1. PT '1 ;r;' £--__t",-- -_" --” -_�-_ _ - -' "___ _= dI„1 1,1'(� il�i:' '• �.:_ -_ _ _ .__ .11 i itlt l' �'dli IUllfl d�3 .Y�- �S: _” _ - �'C .,. - v N,'i tEf.i .. `5< �1:r `.tl•, :� 'E, f r � . ��x°s:Z, ,1 �f, t, Iv r : _ ,bj,1.s¢"a/yv iHF .,•/i, ,'S, , AlY•'o,, ALTERNATIVE` SAFETY-=& _TESTING L-1•+i - - - --_ = zF 1:�„ ,;': 'i'1�1`'��`'4 '- rr. _-- - �'�'1'1�- nl� -', r,,r`.,t,' •!II' f"ZINC__ 6:,78';�FRONTr�AVE.:NW,x >SUITE.:256` . ,°r?=�,°`� ','` e4 a,��_;46'B`{: ((q :fr 'J��,t'1a<�p:4�> h r L>♦ .'tiF'�-'I' '{ , GRAND'` IDS. -:MI;'<4,9�5 0,4', „'`n-; ,�.,.•. ;;'£:': 53;;> :f; , ::Ir fll°'„'Y ".q: i,4 'f4. 'RAP, �,. _ =.•_' _ _ •�:;°_. ,,��,< _- r,�';':� _ _ , -__ - - -_____ 'wj�� !'Ilj ,`.I',. i' r;-' __ 't' - til'.• 'II.,I 'i� '�''-1 I�"'I1',•`f�;�^sfi:y.`a__',d~_ __ - '_ - __ __ -- - s„•, �'1'� f,;l,l"•t --, _ - - - �(, .Ir .an,� 111'dx Al lr,l•i1 'JI.1`•' fr - - - --'i• -'t, - _-- -- ,f `I 11 IS ,'t;il•'. {17, 7i'„L1U ,Ili t',' - _” -= - - - - i1��'-F'`I'a'l If I I;r;u�, :___ _ - - -- = __ __ _- _ p_ Z^ 'S 1 ..I 1, - - - - -_ � ______ •'£, 1 tl1�.' - 1'JI,7'.; 11 ,ry5" ___ __ __. __-i:_-_'- 't�. __- � ___ _ �-_.-/:- '„4,s � "'I ,-< `I,-, '•fV �.1°'e�”•�_�_ !;._ _ _ zz , r��400 AV i:0 2'L40 54'6r4<,:' !68 00 VS 2` ^Lii'_ - Vendor No. Check No. Town of Southold, New Fork - Payment Voucher 1400 00 Vendor Address Entered by 678 Front Avenue NW - Vendor Name Suite 256 Audit Date ALTERNATIVE SAFETY&TESTING SOLUTIONS Grand Rapids, MII 49504 p �o�i Vendor Telephone Number 800-477-3177 Town Clerk Vendor Contact /1' Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 77415 4/3/2017 $200.00 $160.00 Random 4) SM 6710.4.000.000 $40.00 Collection Fee (4) SM 6710.4.000.000 $200.00 $200.00 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 Signature Title Signature (�J Company Name Fishers Island Ferry District Date 4/12/2017 Title Date -( Remit Payment To. Invoice ® 678 Front Avenue NW EXCELLENCE Suite 256 Grand Rapids MI 49504 Date Invoice# Phone:800-477-3177 Alternative Safety&Testing Solutions Fax:616-534-5545 4/3/2017 77415 Bill To Fishers Island Ferry District Attn.Accounts Payable When submitting payment,please 261 Trumball Drive 607 26include the invoice number for Fishers Island,NY 06390 proper posting. Payments can now be made online at; Terms PO Number www.astscorp.com or www.astsmaritime.com. Due on receipt Quantity Description Rate Amount 4 Drug Test 4000 160.00 4 LabCorp Collection Site Fee 1000 40.00 J � U �l �5 e � Federal Tax ID#38-3510664 Total $200 I I I I i I I ' I• I 'I I 4 I I --' I , - I I I I FISHERS ISLAND FERRY DISTRICT } VENDOR 002437 ANTHEM BLUE CROSS BLUE SHIELD 04/25/2017 CHECK 4004 -- - - 1, FUND & ACCOUNT P.O.# INVOICE DESCRIPTION— ,\ AMOUNT SM .9060.8.00`0.0OI,O 444M81629-0517 N SCHMID 5/17 MEDICAL �', 1,270.48 TOTAL 1,270.48 - r- cli 1 ".3+r�.Mn_ ...x.e ..tl'x +,.r. ,-,�s."-,•`• <E .:•:J;?.';.`,::R.n:•. 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"I"ll , Vendor No. Check No. Town of Southold, New York - Payment Voucher 2437 Vendor Tax ID Number or Social Security Number Vendor Address Entered by _ P.O. Box 11792 vv- Vendor Name Newark, NJ 07101 Audit Date Anthem APR 2 5 2017 Vendor Telephone Number Town Clerk Vendor Contact 0 Invoice Invoice Invoice Net Purchase Order ' Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 444M81629-t5) 4/5/2017 1,270.48 1,270.48 Medical Insurance Premium SM9060.8.000.00 Nina J Schmid 5/1-31/17 1,270.48 1,270.48 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 Signature +0.n-*— A —"""'Title Signature v 5555,51� Company Name Fishers Island Ferry Date 4/12/20171 Title Date o, Page 1 of 2 4/5/2017 Member Anthem. Nina J Schmid Blue6oss B1ueShield a ID 444M81629 Plan Medical Please pay 11270111148 by due date May 1, 2017 Bill summary U 3l _ Coverage from 05/01/2017 to 05/2017 Previous balance $1,270.48 Payments received $1,270.48; Amount due from previous bill $0.00 Current premium charges $1,270.48; amountTotal • p;ay $1,270.48More ways to pay: Online at anthem.com or by phone. TRA1-0.0058551055281 ACUAA8 Si-ET-M7-C00002 4 t Please detach and return the bottom portion with your payment t _ FISHERS ISLAND FERRY DISTRICT VENDOR 001016 AT&T ! I 04/25/2017 CHECK 4005 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.4.000.200 03046865150317 FI LNG DSTNC-3/1-3/31 111.82 i J ( TOTAL 111.82 f l � t � I yt:? w r Vv4:•:. r- f 1 , c ��:4_ ��:- :,�•: 'v=-'�" :s���r4�':';°� b: 'FISHERS,ISLAND;°FERRYDISTRIC7'`,w.,. AuDZT�=04� 5'�;l`7. 'P,`='-� '- -- ':tt>,a ;t31 ;•, ,f',,. 3, ^:f,+``" „s,x„` -?� I"rr �/2. 3� t..,`' :".,; z's' ,�f•,r". 53095 MAIN•ROAD;PO BOX,1=179r §c i" V'- _'l- f• row';.i:r', ;i? _ •;` y,: i` ;SOUTHOLD;NY.11,971.0959je" a.` ;Fi= M,'cH,E,K,f a a'`,', i' '_ ✓ae' r., '.I Sr ki•.t'. ,'n.�,. _ __ --- -= - I;,aTNESFFOLK'GICO'N,ATI'O'N'. , '� ,O1UNTCUTCNOGUE;NY;;�`1$35,' 'd" I'i `gin:', -_-`__ -"=�•`-- ='=m`='-`- .e":. .r, .a"' -',p`;.�n,:c;'�" -- _, _ - - t,• .p nt "•r: '�Ir 1 `li'`. '! ",11',I„ :'r' -- - ---- - - _" t11' S ,I ay,�1'' 'al 11•a” ,'I-::- :_- _ `.S I ,u i ,I ' �04� _2`5 '2'01 •'$ .£1__`3 :/�, ct .§5- ;z: .•t< >t, S,E`. })£a'g" >t.s,f3 r li' + ;ONE<'T-IUNDRED.' ELEUE�µ ';AND'`,8'2 .10,0='DOI�I;ARS� .,k= ',; �,s` �t f, ita,4' '7�,�iR"1£'sYL •Po,t°•4 }4„ ''j,;�"-j� 'y,� •r�• _ , , .t ,N�.,,n,,,:,I,ra �ra„ • 'r.' _ � -_ - -T_ fv 1,,,5,,;,1.,n,.,=h,,,1{' ,1•,"S'' 1' "- -- `--_` - ---"_ - ",t',`'1{' 1',, - `�1•.--r'`�=f'"- _ =._ -- - _ = - - "': ,i:, --:}�� {I'- 3v It„' I, - - j -- `ii I`, 'i'n,;`' fp., •;Po"', - -_:�'_ _ _z4'- 3 :1' + _ _ _ _ i, „L'4, d•'.', -_ _ __ _- __ ___ _ __ -__ ,""v+";° __- - __ -- -_- - -`I„'4 ,1,">r•1::�.5,.°i•' ('1�,',. - >'k - -- __ -- ,k . ,.S fc - _ _ _ r`' - _ •d, �tR'� t x 'i i`„I'„'� -a�.. "n"' a.s' +'n(,',sh- _ r_ -,-f, r'1«"��, ,t.° - .•k°° 1't,a: _ ,"<: ,./"a:''.: ``s--at�j.`s. x"t" Y`t' sx' k>' '5,:,",f` 'S f.*i;4, i'£:,,` ••£�,.. '••., 's.r`-.y<,T> +.,i�. =,I `\` ,'g1 �', ne`s;` i{, sz;,`l.r, ate' 'itx •.r':x, _ '�� :'3' -`_ '`�.',&�_9 ;9 '.L> -- -,,3._--- _ - l:e� ',Ira'dl. 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'tf,<3 �!.'i 3'';, 3�;I , Y(t, - _" :: - i'Y.,r,i.sli ',Pd`,` „n. ul,, _ - 'fx.z..•, I,"" ,;:le ,i,l,`{;,,.flna'J11'1`'t` ,'s` _ '_=ryL I ,P:•'1 is ,I,'. ni''I "1 I'y' - _ - t - .r,�'�, ;l` :rl ilt,:l"' ---__ --_ {I ",l,•i, ii�0-_- - .L`t•^ ,"I' 'ili.'',yz•�l'u,f,':i __�'i - 0340^0'S`n:. ,��0-21,it;4,� 5;'4.6:4 • 6=8 :-0t0=1-50 '2:,'-i,u Vendor No. Check No. Town of Southold, New York - Payment Voucher 1016 4005 Vendor Address Entered by AT&T Vendor Name PO Box 105068 Audit Date AT&T Atlanta, GA 30348-5068 A P R 2 5 2017 Vendor Telephone Number 877-325-0445 Town Clerk Vendor Contact � PJ Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number r�17 030 4686515 U04. 3/31/2017 $111.82 $111.82 FI long distance SM5710.4.000.200 3/1-31/2017 $111.821 $111.82 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 Signature 13-_ Title Signature Company Name Fishers Island Ferry District Date_ 4/12/2017 Title Date -Kaebuftl Bill payfikent Due _ umbe7 Date - - DAA ���� FISHE_RS ISLAND FERRY DIST r P.O.FISHERS ISL NY 06390-0607 BOX 607 030 468 6515 001 MAR 31, 2017 APR 26, 2017 TELEPHONE NUMBER: 631 78 - 7463 For Fiodudt Imo:WWWu aft A-T&T=off b;ClBe- ervi =1i r, Cwwmi a 87Z SM0 AT&T All in One Service ACCOUNT STATUS AT&T LONG DISTANCE $59.69 PREVIOUS BALANCE $214.98 PAYMENT RECEIVED $105.29% TOTAL SERVICE CHARGES $59.69 ADJUSTMENTS- 0 TOTAL CURRENT CHARGES $111.82 SURCHARGES AND TAXES $52.13 - r TOTAL CURRENT CHARGES $111.82 TOTAL AMOUNT DUE21 See Summary of Charges page for details Pay online at www.att.com/paymybill * News From AT&T Just For Your Business Login now at http://www.att.com/loginnow to view your billing call details online. 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AT&T is not able to•reply,to inquiries writtin o6 this -i, _- r rn n 9en l�visit vu�,c r bcgpo_i€rranaaamerltfnr asstmijnqb. r AT&T ALL in One Service - Reference Guide AT&T ACCOUNT HIERARCHY * Account Number:The Main Billed AT&T account number for your All in One account. * Subaccount Number: Customers with toll free service, or those who have more than one location, will have their toll free/location level charges summarized under subaccounts. Multiple subaccounts can be associated with one. Example: * 030-555-1111 (Account Number) -Total Charges * 011-555-1234 (Subaccount) -Charges for Location #1 * 161-555-1235 (Subaccount) -Charges for toll free service SUMMARY OF MONTHLY CHARGES LONG DISTANCE SERVICE Monthly Charges * Toll-Free Service: A monthly charge, billed one month in advance, applies for Customers with AT&T Toll-Free Service. * Minimum Usage Charge:Assessed when the total AT&T Long Distance Usage charges are below the monthly minimum. 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I j FISHERS ISLAND FERRY DISTRICT - c ; VENDOR 014'223 BANK OF AMERICA 04/25/2017 CHECK 4006 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.000 7335-0317B NWSBRK(3)TIDE,PILOT BOOK 1. 50.84 r SM .5710.2.000.200 7335-0317B ENTERPRISE—RP VAN RENTAL 2, 027.35 SM .5709.2.000.200 7335-0317B AMAZON—SIGNS—NLT,RP ' ? 37.28 SM .5710.2.000.200 �~ 7335-0317B MOLECULAR—SUPER META,—RP 288.91 SM .5709.2.000.200 7335-0317B STAPLES—OFFICE CHAIR—NLT 168"36 SM :5709.2.000.200 7335,-0317B PK SFTY—GAS ALRT MICRCHP 779.00 �— -- TOTAL I 3,351.74 — .Y r- • e ® o e � ® o o - � __.a.,, -' `ra'- -'___�'; .°, „I+,; .I• - "I'"'"I"°a°',d' 4`.4t': Fv: {�`E-,__ c;f_:,'.P'"�t'J`,`.�,r', 'i`.--i"-:;^ry�;=•._`^'.F:'-;>i.a;`:3`•°�"(°:Fg OIUSTHFIOELDR'°SNN�11'97�.10959; ',;�,a"%n.i;"'.�x.,",�:�F.I'C.;�Tr.e`°;_�';1'!-i';nxsA„�=U' Y<D:'�IC°'.;,TT°piE;sYi`.°f'4;R°%2'kO5RRYDISRISI� VD 0 53095WAlN,R6A0:;Po-b0X•l179s" 0'0Ct`0 -°6"s- -$ -- '- _ NA I,• '1.. -s'� - "HE`SU�ALK'`CO: R'ON N CUTC}IOGUE;°'NY,'r1,1935°:Ir 'I;'i' -_ DATE_:` AMOUNT':'^I°'k ' "`4' 'e.ag ;st° •i� r�^'r 't. °ir`5 544 •x,`:5`<';' 62/ 1 T OUS 'TF3REEzr'HUNDRED:;`P I`F TY":ONE,rANDt;74 -'10,0; "DOLLAR'S „Y,; `'!= •;':: {�' THREE' H _ STD L. a'•',1. I,,, _ -- �_� "_- - - -- _ - ,.JS. rt .Pi.P - _ -_ ___ — __ _ ___ ,,,,~ i,41:',. 11''•.,'• ,1%'Ir,✓ - -:EY _ __ _ -_ - '•x.�F-- 4t= ''Ili%f��V A' '+n d�pl•'' ,F Yd`nl•d' = 3`'. - n: d;r;3.Is d !°''� 'm. .I s'1 _ - ___ - " , -�y 1-: - - --__= Pl ;&•- e'IP,r,y, ,3,',Pr^ `r' -- ^3 __ __ _ ____ ;�^p,'^� n�"'[p`t''P,-:i 1.f.°.tt - 'S}_ _ t. - sg`- -;y' f^I, �I+l�lq,a''PI, ',I',• _ _ _ _ -- _ L 11, ,a,t, ,d;l�}. ",:,ris e•(•_ - 7`-. 6,.4r„ i' 'Of`ik' it '3i iry {.< a§.' .�✓ ,ire - '•; f ,•�t ' Id'(3 .d'n - _ r•1. �i, azi'g" •ix`` `k''' r..! ♦z-µ t`ri t" �-J•: _ ,� t.5"sJ`M- '<,1�'li�x 'f' ✓!'4,, »7- •#x - '•i� 'xt" >'U iii ",Y`�' = - - - Nl,(,i�v ":;U`•.1 "Iliil' "PI, �E:'i,a � 41Y.. fx "..f n_ ,ef'. '15,,,.11r•:,t �f,� II t'I - __ Sr". I li '1 '{'r `„x°ri,X41,�:.+„ - - -- - - - -- `:,"r u,l,+''1•',i5,' =,`r-=;;._ -- - r - "a' ,."Iw A.j;"l. -<_ F0 D 1 '1 `• - --.r;- f,',. p 1;,'n' _ 1 - - I,r'f, i" ;1,I-1}t „d ,I I ".Y 'm,4'4'I' -'f": "._1. _-__- �'b'',y: 'I,^°' >E�'f,i:; __ V�'z' 'w 'y,•. ':IWI�LNlIINGTON;t'DE:�19886=57:3. 1: ';,;,t:=1si••;1''^�FI„ I"e'�;�."" ,�, � �I, f; ,F,,z:° - .f "''a�•'+>''>,�> x`?:+�',R Yll5` -`4"- ',t :1' '1,t gi qi -•t°. ,- ''Sl< '�t// }3: i't`<' ¢t E` •'1' 'I%'9 _ "r°'%• _i ul'IfIf ,I'li� �;,d - -vt'"= ____ -_- - r,{.1,17 7,1� .7�l7S ml'+>I, ,%�,III•:"�' - - _- - - `7I fl'IP' ^,�• 1{ 1��1Y�' _•<s` __ ___ �' - ___ "t�' �,.f,tr 'I'di d;Id did,j'd,,p i,;�'�,1',` _ _ - --�s-£ til'Itl�i4s ,I .d {lyu,1•,IS'y - - - = n'-0 0 t;-0 0�`6i`i■` I:0 2 L`4"0'`5 4`G`.4 t. .6.8 =0,.0.1.5"0''2 i;li'i Vendor No. Check No. Town of Southold, New York - Payment Voucher 14223 Vendor Name Vendor Address Entered by Bank of America PO Box 15731 Vendor Telephone Number Wilmington, DE 19886-5731 Audit Date 888-449-2273 FY17 APR- 2 5 2017 Town Clerk Vendor Contact Invoice Invoice Invoice Net General Ledger Fund Number Date Total Amount Claimed Description of Goods or Services and Account Number STATEMENT Apr 2017 4/2/2017 $3,351.74 $50.84 NEWSBREAK Eldridge Tide and Pilot Book(3) SM5710.2.000.000 $2,027.35 ENTERPRISE RENT A CAR Van rental 1.25 to 3.2.17 SM5710.2.000.200 3�— $ $37.28 AMAZON No smoking signs NLT RP SM5709.2:000.200 $288.91 MOLECULAR SYSTEMS Super metal 1 k9 R p SM5710.2.000.200 $168.36 STAPLES Office Chair NLT SM5709.2.000.200 $779.00 PK SAFETY SUPPLY Honeywell GasAlert MicroClip SM5709.2.000.200 $3,351.741 $3,351.74 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. Signature Title Signature Company Name Fishers Island Fenv District Date 4/14/2017 Title J Date � � J Bank®fAmerica ® FISHERS ISLAND FERRY DIST GORDON MURPHY XXXX-XXXX-XXXX-7335 Commercial Card March 02,2017-April 03,2017 Company Statement Mail Billing Inquiries to: Statement Date .......................................... 04/03/17 Previous Balance .................................... $2,87011 BANKCARD CENTER Payment Due Date .................................... 04/23/17 Payments .... .......... ....... ...... -$2,870.09 PO BOX 982238 EL PASO,TX 79998-2238 Days in Billing Cycle ............................ ........... 33 .Credits ................................................. .... $0.00 Customer Service: Credit Limit ......... . .................................. $40,000 Cash ....................................................... ..... $000 1.888.449.2273 24 Hours Cash Limit ........................................................ $0 Purchases ........................................... $16,041.50 Total Payment Due ............................... $16,041.52 Other Debits.................... ............................. $0.00 TTY Hearing Impaired: - 1.800.222.7365 24 Hours Overlimit Fee ................................................... $0.00 Late Payment Fee ............. ............................ $0.00 Outside the U.S.: Cash Fees .. $0.00 1.509.353.6656 24 Hours ••••• ••••••• ......••• •.......••••• OtherFees ..................................................... $0.00 For Lost or Stolen Card: Finance Charge ........... .......................... $0.00 1.888.449.2273 24 Hours Current Balance .................................... $16,041.52 Account Number Purchases and Credit Limit Credits Cash Other Debits Total Activity BURNS,RONALD J XXXX-XXXX-XXXX-2360 20,000 0.00 0.00 10,373.85 10,373.85 COOK,GEORGE B XXXX-XXXX-XXXX-6764 40,000 0.00 0.00 957.67 957.67 MURPHY,GORDON XXXX-XXXX-XXXX-4379 40,000 0.00 0.00 4,709.98 4,70998 E-M Posting payments: Payments received by mail at the remittance address shown on the Payment Coupon portion of the face of this statement on a banking day will be posted to your account on the day received If we receive your mailed payment on a non-banking day,we will post it to your account on the next banking day. There may be a delay of up to 5 banking days in posting payments made at a location other than the mailing address listed on the front of your payment coupon Service for the hearing impaired(TTY/TDD): Contact our.service for the hearing-impaired at 1 800 222.7365 Telephone monitoring: For the purposes of monitoring and improving the quality of service,Bank's supervisory personnel may listen to and/or N record telephone calls between Bank employees and any person acting on Company's behalf. o 0 Disclosure: We may furnish to your employer information concerning your use of your account. To read more about our information disclosure, o please visit www.bankofamenca com/corporatecarddisclosure or call the customer service number listed on your statement to request a copy e In case of errors or questions about your bill: Errors or questions about your bill must be received in writing no later than 60 days after we sent o you the first statement on which the error or problem appeared Please mad this information to BANKCARD CENTER, PO BOX 982238, EL PASO, TX 79998-2238 Your letter must include the following information m The company name,cardholder name and account number in question The dollar amount of the suspected error A written description of the error and why you believe there is an error. If you need more information,describe the item you are unsure about. Customer Service For questions regarding transactions,general assistance,and reporting lost and stolen cards,call Within the U S Outside the U S. 1 888 449 2273 1 509.353.6656 (collect calls accepted) 001000480707321860733520170403 Bank of America lop* FISHERS ISLAND FERRY DIST GORDON MURPHY XXXX-XXXX-XXXX-7335 March 02,2017-April 03,2017 Page 3 of 4 Transactions Posting Transaction Date Date Description Reference Number MCC Charge Credit FISHERS ISLAND FERRY DIST Total-Activity, Account Number_.,X_XXX-XXXX-XXXX-7335. -$2,870.09 03/20 03118 PAYMENT-THANK YOU 07715300000000555669170 0008 2,870.09 BURNS,RONALD J Total Activity, Account Number:XXXX-XX0(X-XXXX-2360 10,373.85_ 03102 02/28 NEWSBREAK-NEW BEDFORD NEW BEDFORD MA 24251387060980002793039 5994 5084 03/03 03102 ENTERPRISE RENT-A-CAR NEW LONDON CT 241640770610185.12144237 3405 2,027.35 BURNS RONA D082666 03108 03/07 DEFENDER INDUSTRIES INC WATERFORD CT 24431067066083713755796 4468 113.60 03/09 03/07 WEST MARINE#1318 MYSTIC CT 24692167067000420891780 5965 29.77 03/09 03/08 SQ`ALLEN WATROUS LLC gosq.com CT 24692167067000585144579 8999 450.00 03113 03/11 WATERPROOF CHARTS 239-313-0224 FL 24692167070000004428897 7338 86.85 03/13 03/10 DATA MGMT-TIMECLOCKPLUS 325-223-9500 TX 24493987069207953200277 5111 1,710.29 03/13 03/11 CRAIGSLIST.ORG 415-399-5200 CA 24493987070026903693374 7311 15.00 03/16 03/15 LOWES#02263' WATERFORD CT 24692167074000746453001 5200 30.53 03/17 03/16 CRAIGSLIST.ORG 415-399-5200 CA 24493987075026923576182 7311 15.00 03/17 03/16 MICHAELS STORES 3754 WATERFORD CT 24692167076000519975303 5970 120.68 03/17 03/16 HARBOR HYDRAULICS AND MAC508-9912433 MA 24755427076130760971107 7699 1,133.00 03/20 03117 SURFACEWORX 508-587-8877 MA 24431067077206838200011 5169 1,031.00 03/23 03/23 AMAZON MKTPLACE PMTS AMZN,COM/BILLWA 24692167082000139738737 5942 77.73 03/23 03/22 ATLANTIC EQUIP INSTALLER 203-284-0402 CT 24431067082200523400013 5085 1,760.09 03/24 03/23 LOWES#02263• WATERFORD CT 24692167062000577205223 5200 62.03 03/27 03123 STAPLES 00101873 NEW LONDON CT 24164077083105001056370 5943 492.34 03127 03/24 Signarama New London 860-443-9744 CT 24202987085980013567545 5099 324.37 03/28 03/27 DEFENDER INDUSTRIES INC WATERFORD CT 24431067086083753409151 4468 62.82 03/31 03/29 THE HOME DEPOT#6215 WATERFORD CT 24610437089010182049261 5200 73.31 03131 03/30 SQ*NEW LONDON COUNTY SEPgosq.com CT 24692167089000767831476 8999 212.70 04103, 03/31 AMAZON MKTPLACE PMTS AMZN,COM/BILLWA 24692167090000504942047 5942 37.28 04/03 03/31 MOLECULAR SYSTEMS OF NEW 978-8974300 MA 24639237092900018700028 5085 288.91 04103 04101 STAPLES DIRECT 800-3333330 MA 24164077092105313676385 5111 166.36 COOK,GEORGE B - - Total Activity Account Number.)XXX XXXX-XXXX-6764 957.67 03116 03/15 AMAZON MKTPLACE PMTS AMZN.COM/BILLWA 24692167074000720527739 5942 155.73 03/16 03/15 AMAZON.COM AMZN.COWBILL AMZN.COM/BILLWA 24431067074083361139996 5942 22.94 0_4/03 03/30 PK SAFETY SUPPLY 800-829-9580 CA 24110397090286535800760 5999 779.00 _✓ __ MURPHY,GORDON Total Activity Account Number:XXXX-XXXX-XXXX-4379 4,709.98 03/13 03/10 SMARTSIGN 7187971900 NY 24055227070206278008082 5399 149.85 03/22 03/20 PAPER ROLLS PLUS 913-492-7861 KS 24323007080754079405726 5111 164 85 03/23 03/22 SMARTSIGN 718-797-1900 NY 24055227082206278109159 5399 214.30 03/27 03/26 Intuit*QuickBooks 800-446-8848 CA 24692167085000299848141 5734 4,180.98 ChargeFinance • Your Annual Percentage Rate(APR)is the annual interest rate on your account. Annual Balance Subject Finance Charges by Percentage Rate to Interest Rate Transaction Type PURCHASES 10.00% V $0.00 $0.00 CASH 10.00% V $000 $000 V=Variable Rate(rate may vary),Promotional Balance=APR forlimited time on specified transactions. ���� �® FISHERS ISLAND FERRY DIST Bankof AmGORDON MURPHY XXXX-XXXX-XXXX-7335 March 02,2017-April 03,2017 Page 3 of 4 tr S. Posting Transaction Date Date Descnption Reference Number MCC Charge Credit F.I H R5^I P D F R S E SLAIV �E RY:DIST.=." - - �f� - 'TotaGActivit - - - --- - - - - - _ - - - - Acco _ _ =_ - _unt>Number:. _ _ _ XXXX-XXXX 335= XXXX=� - - - - - - - - - 87 :09 - - Z .0 03/20 03/18 PAYMENT-THANK YOU J Y 07715300000000555669170 0008 2,870.09 BURNS N tD,J: TotatActivit` c___ = Ac ount `umbe N r:XXXX=7(XXX-r 36 XXXX-Z 0" -- - 0 x'73.85 02 02/28 NEWSBREAK-NEW BEDFORD NEW F 24251387060980002793039 4 _ 3 9303 03/ EW BEDFORD MA 24251387060980002793039 5994~ 50.84 - 03/03 03/02 ENTERPRISE RENT-A-CAR NEW LONDON CT 24164077061018512144237 3405 2,02735 BURNS RONA D082666 03/08 03/07 DEFENDER INDUSTRIES INC WATERFORD CT 24431067066083713755796 4468 113.60 03/09 03/07 WEST MARINE#1318 MYSTIC CT 24692167067000420891780 5965 2977 03/09 03/08 SQ*ALLEN WATROUS LLC gosq.com CT 24692167067000585144579 8999 450.00 03/13 03/11 WATERPROOF CHARTS 239-313-0224 FL 24692167070000004428897 7338 8685 03/13 03/10 DATA MGMT-TIMECLOCKPLUS 325-223-9500 TX 24493987069207953200277 5111 1,710.29 03/13 03/11 CRAIGSLIST.ORG 415-399-5200 CA 24493987070026903693374 7311 1500 03/16 03/15 LOWES#02263* -WATERFORD CT 24692167074000746453001 5200 30.53 03/17 03/16 CRAIGSLIST.ORG 415-399-5200 CA 24493987075026923576182 7311 15.00 03/17 03/16 MICHAELS STORES 3754 WATERFORD CT 24692167076000519975303 5970 120.68 03/17 03/16 HARBOR HYDRAULICS AND MAC508-9912433 MA 24755427076130760971107 7699 1,133.00 03/20 03/17 SURFACEWORX 508-587-8877 MA 24431067077206838200011 5169 1,031.00 03/23 03/23 AMAZON MKTPLACE PMTS AMZN.COM/BILLWA 24692167082000139738737 5942 7773 03/23 03/22 ATLANTIC EQUIP INSTALLER 203-284-0402 CT 24431067082200523400013 5085 1,760.09 03/24 03/23 LOWES#02263* WATERFORD CT 24692167082000577205223 5200 62.03 03/27 03/23 STAPLES 00101873 NEW LONDON CT 24164077083105001056370 5943 492.34 03/27 03/24 Signarama New London 860-443-9744 CT 24202987085980013567545 5099 32437 03/28 03/27 DEFENDER INDUSTRIES INC WATERFORD CT 24431067086083753409151 4468 62.82 03/31 03/29 THE HOME DEPOT#6215 WATERFORD CT 24610437089010182049261 5200 7331 03/31 03/30 SQ*NEW LONDON COUNTY SEPgosq.com CT 24692167089000767831476 8999 21270 04/03 03/31 AMAZON MKTPLACE PMTS AMZN.COWBILLWA 24692167090000504942047 5942 37.28 04/03 03/31 MOLECULAR SYSTEMS OF NEW 978-8974300 MA 24639237092900018700028 5085 288.91 04/03 04/01 STAPLES DIRECT 800-3333330 MA 24164077092105313676385 5111 168.36 ;Total Activit - _ Account •er _ -- _-5=``='�=- Numb ,XXXX=- =6-6 -- XXXX=XXXX 7 4"` - 7, z 03/16 03/15 AMAZON MKTPLACE PMTS rAMZN COM/BILLWA 24692167074000720527739 5942 ' J 155.73 03/16 03/15 AMAZON COM AMZN.COM/BILL AMZN COM/BILLWA 24431067074083361139996 5942 22.94 04/03 03/30 PK SAFETY SUPPLY 800-829-9580 CA 241103970902865.35800760 5999 77900 MURPHY-GORDON� - �-- -- = - _ _ - - - -Total-Activit` ws c o n - A t•Nii tier:, - c u m -XXXX XXXXXXXX -- - :4`70 8 03/13 03/10 SMARTSIGN 7187971900 NY f 2405522707020627800808215399 149.85 03/22 03/20 PAPER ROLLS PLUS 913-492-7861 KS 24323007080754079405726 5111 164.85 03/23 03/22 SMARTSIGN 718-797-1900 NY 24055227082206278109159 5399 214.30 03/27 -03/26 _ Intuit*QuickBooks_ 800-446-8848 CA 24692167085000299848141 5734 4,18098 Your Annual Percentage Rate(APR)is the annual interest rate on your account Annual Balance Subject Finance Charges by Percentage Rate to Interest Rate Transaction Type PURCHASES 1000% v $0.00 $0.00 CASH 10.00% v $000 $0.00 V=Vanab/e Rate(rate may vary),Promotional Balance=APR for limited time on specified transachons. Bankof ��� �� FISHERS ISLAND FERRY DIST CORDON MURPHY XXXX-XXXX-XXXX-7335 March 02,2017-April 03,2017 Page 4 of 4 N N - O N O O ® O O W O O M O co M fry 5 NEWSBREAK f j / S3,POPES ISLAND NLW BEDFORD MA 02740 v 508-997 6:Ji Merchant ID 391406915 T,-11" ID. 6699 NEWSBREAK THE MAGAZINE SUPERSTORE Sa le NEW BEDFORD, MA. 02740 Application Labei VISA CREDIT j DATE. 02/28/2017 TUE TIME 08:45 VISA r L 1 BOOKS T1 ��DQ`�C XXXXXXXXXXXX2360 �ep BOOKS T1 PE<�g � $15.95 I AID: A0000000031010 yv"v ,� BOOKS T1 05 $15,95 Entry Method: Chip r T $2.99 TOTAL $50.84 Apprud: Online Bat&: 000002 I CHARGEI $50.84 02/28/17 06:49:06 WE HAVE THE Inua: 00000003 Appr Code: 096313 -LARGEST MAGAZINE SELECTION AROUND ! (508) 997-NEWS Total: $ 50.84 I VRI 00UU008U00 No.000010 sl FBae THANK YOU J, Cental Agreement#: 6SYY2K Bill Ref#: 7000-1903-7422 -- - Invoice Date: 03/02/2017 453 COLMAN ST Account M NEW LONDON, CT 06320-3740 BILLING DETAIL m- I Description Qty/Per Rate Amount TIME&DISTANCE 1 DAY 7998 7998 — — TIME&DISTANCE 5 WK 250.00 1,25000 BILL TOI DW 36 DAY 1899 683.64 RONALD J BURNS DISCOUNT TM 500% -66.50 22 PENNCOVE RD NIANTIC,CT-06357-2532 Subtotal 1,947.12 I2 NTAL INFORMATION--M - _ �� SALES TAX PCT 6.35 80.23 (Date/Time Out DateITime In Total Charges (USD) 2,027.35 5/2017 02.38 PM 03/02/2017 07.43 AM Renter Payment Visa -2,027.351 BURNS,RONALD J Total Payments(USD) Additional Driver FRANCO,MICHAEL t� RENTAL VEI�ICLES mount item�ep(sS®s renal rates dfc faime goddedSbntc�ecQrifmuliaoQe bares oa®be Miles/I(mS and/oe ouaPvo°Id reC lo^alv�o��scen{io e�s�re hat e c�argas equa�the actu 'Total Amount�llua Color License Model Unit Out In MAROON KFV6092 GCARAVA 7NHNYT 17,000 17,034 VIN:2C4RDGCGI HR557952 CLAIM INFORMATION' " 0 Claim#/PO#/RO# Insured Q Date of Loss Type of Loss Type of Vehicle Repair Shop J _Far Billing In uiries 1 Pa went Terms Tel#8606278080 GP48ADMINAR@EHI.COM Payment Due within days of invoice date Late payments are subject to a finance charge. Thank You For Choosing Enterprise ------------------------------------------------------------------------------------------------------------------------------------- Please Return This Portion With Remittance Amount Due(USD) 0 Remit To: Paid By: ENTERPRISE RENT-A-CAR RONALD J BURNS ` 8 ELLA GRASSO TURNPIKE 22 PENNCOVE RD WINDSOR LOCKS,CT 06096-1015 NIANTIC,CT 06357-2532 Fed Tax Id: 06-1299052 Account# Rental Agreement Amount GPBR 6SYY2K 0 4811 (Page 1 of 1) amazon.comm allazon.com- www.amazon.com/ your-account DDpmOKMm4/-3 of 3-/second/10254950 UPS- For detailed information about this and ISLNY-N other orders, please visit Your Account. You can also print invoices, change your e-mail address and payment settings, alter your communication preferences, and-much more - 24 hours a day - at http://www.amazon.com/your-account. Your order of March 29,2017(Order ID 113-4744241-7925841) Qty. 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Invoice Number: 18257 # yup tl "i"rvl ct«Ia:e 3t t ve Invoice Date: Isar 31,2017 Molecular Systema of New England, Inc. Page: � 2 Mgt&Main Place Suite$25 Maynard,MA 01754 V67Ce: 978-897-4300 i Fax: 978-897-4388 Bill E , � '� a w.n.nd>w,',:rsnro�wewronxa.+.a� ...uawr..,a�ua.+wa.»�......r- �raw:e:i m �v-�+m....»�4�+�-+.w.....«•_.. v�w..�wxuw�n"'"..."mxr.»m..v-:i»..d.....w.'.nr..w.. ..n'{ ..... FISHERS ISLAND FERRY FISHERS ISLANLI,FERRY 5 WATERFRONT DARK 5 WATERFRONT PARK NEW LONDON,OT 06320 NEW LONDON,CT 06320 3 I I � , FISHER001 _ VERBAL:MIKE VISA ZZ o 999 UPS Ground 3131117 =1117 www7wwcreaY-ay!w,y.,w.�n<�wy�.-gwpne�.[�-ynyn y� yyy�(.g+m,-.nrw-v - �}y�/-�-y+�.�.yt a. Qe�t3#xty •pp•_ a.....r ,•• Iter�r, � <3�•,--w-v�-.arn-r-r-m. � •« �iV�i3»' "�W�AF*tGiGi.�"»w-m�aA��` f4LIG y 1'Qtlk,yiAYiA. r.„.-v,.,..-..,-:uTM(„�n.�l'..i ,.,.e'. .,.a....w...-w ,.w........ .....awn.1 .• Ct.„Y.� ..- r. .a,w+�a,,...<....w.rnu..sw.a,�.,.'r-m.:..cH.+«+.u:...u.»...smw�.'+...M.&.«. wr.n .r,.+8.&6-.:......N.,t� �.__, 1.64 W01 1111 «Super fetal 1 KG 275.10 275.00 1 3 b , i t Subtotal { 275.40 Thank You For Sales Tax 'Your Business Freight M 13.x1 Total Invoice Amount 288,91 4 Check,Cxedit Merno No' 06575$ Faymcnt;Gredlt Agpled i � 21313,91 ES L �..;. >A .:. � .:. 0.00 A Service Charge of 1.5%per month will be charged on all outstanding balances over 15 days. STANCES Thank You for Your Order A confirmation email will be sent to you at PFORD@FIFERRY.COM with your complete order details If you have any questions about your order,please visit our Help Center. Order No 1 9753294479 You'll also find complete details of this order in the Order Status section of My Account You can Order date March 31,2017 view this information 15 minutes after your order is submitted. Deliver to: RJ Burns,261 TRUMBULL DR,FISHERS ISLAND,NY 06390 Expected Delivery By:2-8 Business Days Item No. Name Price Qty Coupons&Rewards Subtotal 642308 Office Star Faux Leather and Chrome Drafting Chairwith $154.99 Each 1.0 $0.00 Price: Teardrop Footrest,Black $154.99- Billing 954.99-Billing Address Order Subtotal: $154,99 ronald bums Shipping: Free 261 TRUMBULL DR Estimated tax' $12.79 FISHERS ISLAND,NY,06390 Remaining Balance- $167.78 (860)442-0165 Remaining Balance will be applied to following. Visa Credit Card ending in 2360 Hold on to your Staples Rebate Visa Cards and Prepaid Gift Cards until your order has been received If you have any quesilons or concerns about your order,please call 1-800STAPLES(1-800-782.7537)or email support@orlors,starles cam Important Information concerning coupons and sales tax can be found at,coupons and sales tax The tax shown is estimated Your Order Confirmation Email vnll include shipment details,product availability and estimated tax Important information concerning return policy can be found at retUrn oolicv For complete order details like sales tax,shipping info and Software Download instructions,keep an eye out for an email from Staples at the address abovp.You'll also find complete details of this order in the Order Status section of My Account You can view this information 15 minutes after your order is subrulted Sign up to receive Staples emails with great onlne and in-store offers and exclusive money-saving discounts This Web site is intended for use by US residents only.See Intemationel Sites.See our delivery policy for full details Copyright 1998-2016, Staples,Inc,All Rights Reserved Site Map l Privacy Policy I AdChoices Have a question? Chat with a Staples expert i$ v Geb Cook From: PK Safety <pks-store@pksafety.com> Sent: Thursday, March 30, 2017 2:49 PM To: Geb Cook Subject: Your Order Confirmation#581082 1 v Dear George Cook, We're delighted to confirm your order. We'll start working on it right away and email you when it ships. I If you have questions about your order please contact our product experts at.pks- store pksafety.com or call us at 800-829-9580 Monday - Friday, Gam - 5pm PST. Thank you again for shopping with us and enjoy your new PK Safety purchase. i Your Order #581082 (placed on March 30, 2017 11:49:23 AM PDT) Billing Information: Payment Method: George Cook Credit Card Fishers Island Ferry District 5 Waterfront Park Credit Card Type"" i New London, Connecticut, 06320 United States Visa T: 2034108156 Credit Card Number: xxxx-6764 1 Shipping Information: Shipping Method: - i -George Cook United Parcel Service - UPS Ground Fishers Island Ferry District 5 Waterfront Park j New London, Connecticut, 06320 United States j T: 2034108156 ? Item Sku Qty Each BW Honeywell GasAlert MicroClip X3 BW01-MCX3-XWHM- 1 $779.00 i 4-Gas Detector MCX3-XWHM-Y-NA Y-NA-BW0I-CG-Q34-4 Options i None Calibration Gas Yes - 34L j Subtotal $779.00 1 Shipping $6 8 Grand Total $779.00 Thank you, PK Safety 2 PK Safety Supply Packing Slip 1829 Clement Ave., Suite 200 Customer Order Date I Order# Alameda CA 94501 (510) 337-8880 Online : George 3/30/2017 1305134 pksafety.com Ship To Bill To George Cook George Cook Fishers Island Ferry District Fishers Island Ferry District 5 Waterfront Park 5 Waterfront Park New London CT 06320 New London CT 06320 Ship DateTracking # Ship Via PO # 3/30/2017 ZZX972400369792498 UPS Ground PKS-581082-Main Ordered By Item Number Description Options Qty. UM Ship Back Ordered BWOI-CG-Q34-4 Calibration gas for 4-gas BW/l00PPM 1 EA 1 CO,25ppm h2s,50%lel, 18%02 € I II -----_ FISHERS ISLAND FERRYDISTRICT 4 VENDOR 002945 CAPALBO ACCOUNTING SVCS, LLC 04/25/2017 CHECK 4007 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT • r- SM .1310.4.000:000 3075 ACCTNG CONSLTNG-3/9-3/10 412.50 TOTAL 412.50 � 1 :�ti'f •N� t. ' >,..- r '•.r::r"k :s'..:<`•" .>... ,::;x„s�c�,-i�"r.•: 'mow- .:3'� .,, - - cf i I • I II I -- - 1' ;_' :°` _•,., �; '= ISHERSj,ISL ApND=FERRpYDISTRIC7 AUDIT::04°/.'25/17 ='f•` .{ ` F ''53095 MAIN ROAD;PO.BOXt1.1'7,9j,'_i.,._:': 17 :/. :j"s f_ ;E %p•)': ,''eY;', ''' •''�C 'SOUTHOLD';NY',11971`-0959,',yv - r" i •I,• _ - "f'aTHEiOFFOI.K''CO�� •AT�ONAL�,N = _ `'. , +. 1��.;,t ,z, i ,,- s N Q DATE CUTEHO'GU�,"NY'1;1'935' 'I,;•'',1 ,, — yf;,' ,I"1 ".r •at - r'' - - - e;'+'->•.y'',.r .Y'r , � ut'A 1�p ,I I''Y•�.I' pi',i�,i� - ___ - _ - _ 'i'd�',r>i' 11'1 - _ 4'12.:'5'0;'z > 50=546/214',. ;> <`i•. 'I. FOUR'''HUNDREW'TW,ELVE ,AND -5'0' 10'0- :I _ `'1< tl , .'_ -_ ___ - - •'d' - __� __ - __ "__ -_ ,pl.l�l' •,4'�'>' „1",'I' '�1,"r^1,"p;''`.f�'P - -F ' , _ -_ ___ _ _ _ �itl.V j`;itl sdp,: ''"4j:' ---- - - --- -- -- �,I1, Ir- ,,,'L''e '9,t1! s•,i =_ :e_ _ "_`„ ,,'p - -- _.jv _#- 111, '`d�f a.i '1',dl •II�I,I',1 Ip`Itu'' __ - _ - _ __ - ,''d= �I "'.4 -_� - -_ �_ - �_�_- - -�� `c-. -= -'_ '_'=--'�' s 10i' "t�"'�,CI" n� -� - a--_ __-+'--__ - __ ,i.•+t''` •'I, •J „i'',`_1„ Iti>"�e^''i - _- - ,_ f;�» r- :';�: • ,i'� :i�``.'�.,` '•s+,y":f� �,,:'° ,s` r., "a;1,.y� i•.,CA `=rt1, - - ''' I tt' '1 - _ _ > _ •€' ;p. a�p611 11 Y,IV,N�I'I,`< P.ALBOI'''ACCOUNT_ING'�VCS;_ -_- ,/�'Y•' _ - _ -' i_✓_ _ „n.' 'I f _ = :-__.;�--:-1--j �1"a,�lt'�t.�, ,:y r'\f ldf�e;Mll' `_ - ___ -- - _- aR., t.i�^, - "_ i§_=/V__- - §.`.•r: ,I,1' '1`. II\41``i1,,111',1 1"1',4:i l�w - "j'�'I�', 'li;'• ''p':IP.Ir",IP•j,V.t,r�,d'o __ - _ <3 4, �' :i :I,p�;t,yi ipl, ORTi.nH"hLL�',ROAD`_= - _ ___ __ ,-__ .,;� ,,l,p•II"-rp;a••,.1�n. •�u'. __ - - - ./� -BOER u 'GRO�RON�:;C71';,.0"6'3:4:0,; ;k �"`_ E'}'' •>• ,. s' +h.• ,� .�,,�� ? _ .;1�z�,-y,'-f's `111;2 i f,. '.6`. .f�>' i. '4 - - n!" 1 .x`r<' .+>"1;.. _ - - _,`Y'_`-'ce e� _ c_�{'•-�'�.r.a _ - :il}A'V '�'`Y'I„ I'� .I"I _ _ - 'f' If;fi`1•Pii, l,i P `r' t'- _ - _ '.1",i `'i;` ,ro __ 1!1'•' I,Aii'•. 15 Ig np 'di,';-•"il�' ,x- - N_ - ',PI',,0, ,r ,d, p'lti1 fl l''',�,'lli;hp;,€of,ts'h' y>- _ I 1 ;A�IdI'!111',u'hl'•1,�:; :___ _ _yt_= _ _ _ �Ip'; 'd I', .'I __- �_ _-_ __ _�_ _ - ii 004"00`7ii� isp ,2,,` 5'4:6`4 68 ;OOS"L 50 2 1, Vendor No. Check No. Town of Southold, New York - Payment Voucher 2945H0077 Vendor Tax ID Number or Social Security Number Vendor Address Enteredyz�' 4 Fort Hill road Audit Date Capalbo Accounting Services Groton, CT 06340 APR 2 5 2017 . 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 General Ledger Fund'and Account Number 3075 3/31/2017 $412.50 $412.50 3/9-10/17 CPA consulting . SM1310.4.000.000 F $412.50 $412.50 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 Signature -`I Title Signature Company Name Fishers Island Ferry District Date 4/13/2017 Title _Date / /� Invoice CAPALBO ADate Invoice # Accounting Sell es 4 Fort Hill Road 3/31/2017 3075 Groton, CT 06340 Fisher's Island Ferry District PO Box 607 Fishers Island, NY 06390 Services Received Amount 3/9/17 - to NL terminal, working with Diane and Jeannine for AR 352.50 issues, rents showing up on manifest reports, security deposit issue, transferring security deposit from one person to another, memorize report for person who is inactive 3/10/17 - on phone with Diane about check clearing bank for more 60.00 than it is in QB, tracing payments and journal entries, fixing check Terms Total Due: $412.5 ! FISHERS ISLAND FERRY DISTRICT VENDOR 014693 COMMIS.OF TAXATION & FINANCE 04/25/2017 CHECK 4008 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION / AMOUNT SM .1980.4.000.000 033117 MTA TAX 1 QTR-1/1-3/31 870.53 TOTAL 870.53 , 1 cli �1 r ' S--�<Sa,r° ac <���,sx�. %..�.»,WS � vi.+t _.M r,-- - ..< ..i.{,ro... <.:// __•_ 33i^ -ice� sf•^��r .. M.,b... ..♦!;"^ ��'�'...•z."<' ...A'`• dit��<:nw,,,�;�'Ya'L.°�',,,••t,�'w,W. ...r:�. .: e ..x off`'•• � l • � I r- - 1 t i 1 tI i _- ':'I. ,i' s}1,'d'• _ - - - ,t .r I :'; _j'L.. e y� - a. ,•' ` FrSH RS ISI4NDf=FERRY.'DIS7RICTr I o'4V '5'/i7" -� r'� ;f•;; c , ,.,ALTO T�af.� /:: d� '<. �'�.," .t :�..',,i�w_ 53095'MAIN HOAo.iPO 80Xt1179r.• ;.i' ,.t ;•.r.�� ..:°;e.s:d^.._�;«�.:.'f,:.' "'�"• `,}°' ar•-="a;:• 't '•i,`' ='"v 4.=a c,' TH'O'd°1NY 1971=0959a r`.r 'ie. .3''ia,'11'•;u: "z`i;'' s i,�,a sou ,1 „ e'• "�_"''1" •e i _I'r1,• _ c HE UXFOL ICO?NAYIONALBANK "R - _ - -_ £,lT ,$ K 1 r' - t'•',. il,' ''" 1I CUTCHO'GUE;'NY..1';1935' 1, _ +:,DATEx'- •: ,, l AMQUN'T'- :i ••' _ J. I J'P,I'aP: ,pe�a,il,I. al l,.ky y'i<'= - - - !I. J' R11,,u 1 ;��� .t• _ - Il,a%t''n . 0. I. z 91, '"•s•. '��'� r�, �`'+,,,,.:�j4�: '•.r;�a; C`�<"' - .J'_' s s sv '0'4" 2`5`•2`017'':>': - C:87, :j53 ^ .50,546/21,4`:. yft`''.O"�LARS<,`-` _EIG_HT�'FiUNDR•HD,=;`S��J�4'�!NTY��:AND;;`5'3;/Y60,.,D L _ ,',f;_�s" _ ;�,°,, <; ,- ;,' 'J, _•:�_.``: _ ,h, ___ , c;�',�a`1• ,'p ,r;J„ ^a�d _ _ _ _ _ __ '`t"1,' i'I ;a+5•e V f. - - - - __ -.-ra{:, •I'' :1`. :I, "':+I;" "'4."•" 'q`:�:- _ "_ -. �'el',�i 'I'' rl'ur+i,�t ,�1` •'l�� l 3'.. ,_- - - "-'a,'--_ ,-i'w ,1, ,,�,1,`t d, a''''1 II_ ,.I,1 .I; -__" - -_ _ _ i�-_•�>,: „a`° , <d, °,,, q�l,,:�� _-- _ _ _-- - _ - /t.- --_ __ -"_ af'l• r'I,i J6''�. tf 11'- If aal 15 e,{r'a - - - - '-'1 gyp,,d�' ,°ar' '1'',%!,r Pf"' - t,`�,' `,cf`- - _ - _ A.K°ib.Xi[A'yT^_'L':!O?_t'N<_.,_-""&:s't✓t`-'i'1!^-_'�-�'-.,S,.-`,.k.!".x d_F ie<:Jx, `.,•�!-,4!y_•ypar,dy-!t:�:,•9•f'"_a--"f, -.}":._'..'rk s-i i,fStr„ _y��4h.g'la.�Rer�g';•”` 't ' 7_n ,ll, 'it8;,':=g.f ,cai�fNle,rJ^k"rie�1v�'i,'"Y°;F}ZNANCE,'-A,-, l.. qa„3°'' ",Ft ,ASS'' ."�: -�'_ -_ �'4 - _ ",7��•j,i W1;. I�,r, g£1,'ar� •-q� - =___ _--,�. 'p'.,�-r! ,...,f•I„i' +e;t,''` 1��,'�° - __ '1� -_ -_- 'Y. OI MCT MT.,iPRO'CESSING-=_CENTER= __-_ _- - -_ %a i, •!:{ ',3',f�s4�,. ,-1,eh:�.i 5-_ - a--_ _ _"-" -��,-,T;..� +.I tA• C, >;lnJ _g",}. -M0 a ati BoX'4i3'9 ;1 P1O, '4 .P'•'.++° ;lis,y, _ {a ,t„ _ .<y. `a\= _ ,3�a,�r- l a<�?. z,'` t',};�x'i 1' _ _ fty�d 7z,, +It •t, ;B•INGITP;Al'I'ON,'',NY.,1390=2„-4139F;+�` I _ - n In iY�.l a31' +°1�`9t f i -,i''__- _ __ _" _-_- :t, „t•`p'�t,4�1' £j':"°I'�i 11' 1� P`J.iif s:p �t`^` Y"' -__ _ _ = z ',�I ,'+`:, :s;°,._- _Ott~_= - - rt,rJ „1aJ. 11'ep ell..Igt il. igI11 ;•L, - - - Jrt•. A,. •f'1'J,A - - - - - - `•eJt yle,k,` £s tp'i{,lJl t,l.�e.,I --_ - y'= _ -- _ '4`. � 'e'I d,; IF.• ,al. it,I.,I,�a'11 a : �.;,•,, _ _- _ =f,_ _ _ ^_' n p p Li'O g u �.0 2 L'4 0'`.'S;'4,6 4`�• -6:8=::`=0 O: , 5 0`"2'i :Lnii , Vendor No. Check No. Town of Southold; New York - Payment Voucher 0 Vendor Tax ID Number or Social Security Number Vendor Address Entered by State of New York MCTMT Processing Center � arn .,.L�Q� Audit Date Com ssioner of Taaxation & Finance PO B ox 4139 APR 2 5 2017 Vendor Telephone Number Binghamton, NY 13902-4139 Town Clerk Vendor Contact Pete Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number X1331 17 4Q381�`fitirf 3/31/2017 $870.53 $870.53 1Q 2017 MTA Tax ` SM1980.4.000.000 $870.53 $870.53 Payee Certification Department Certification The undersigned(Cla;ffhvA)-(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. Signature] itle Signature Company Name FI Ferry District Date 4/12/2017 Title G%` Date / NEW Department of Taxation and Finance MTA-305 YORK Employer's Quarterly Metropolitan Commuter (12/16) STATE Transportation Mobility Tax Return Amended return For help completing your return,see instructions,Form MTA-305-I. Legal name Employer identification number(EIN) Fishers Island Ferry District 11-6003307 Mailing address(number and street or PO box) Address change2 Mark X Mark an X in only one box to indicate the quarter(a PO Box 1179, Route 25 (see instc)❑ separate return must be completed for each quarter) City,village,or post office State ZIP code and enter the last two digits of the tax year. Southold NY 11971-0959 Jan 1- Apr 1- July 1- Oct1- rax " Mar 31 S Jun 30 Sep 30— Dec 3. -. year Number of employees—Enter the number of covered employees whose wages are included in the i amount of payroll expense reported for the quarter............................................................................................... �._ _ 44_____ Enter your 2-character special condition code,if applicable(see instructions) ........................................................................... L____J If you permanently ceased paying wages subject to the metropolitan commuter transportation t mobility tax(MCTMT), enter the date(mmddyyyy) ................................................................................................ 1 Payroll expense subject to the MCTMT(see instructions).................................................................. 1.: 3784911 ,„23 2 MCTMT due for quarter(see instructions) ...................................... ................................................... 2. — -- -- -----870.,;53 3 Total prepayments including PrompTax payments and/or overpayments from previous quarter(see instructions) 3. 0 _00 4 MCTMT balance due(if line 2 is more than line 3,subtract line 3 from line 2;pay this amount) ............... 4. 1-- s . ?s Total MCTMT overpaid(if line 2 is less than line 3,subtract line 2 from line 3,enterhere and mark an X in box 6a or 6b) S. �iI 6a. Refund _,. or 6b. Credit to next quarter MCTMT _ Sign your return:I certify that the information on this return and any attachments is to the best of my knowledge and belief true,correct,and complete. Third-party Print designee's name Designee's phone number Personal identification designee?(see instr) ( ) number(PIN) Yes❑ No❑ E-mail- ,V "Paidpreparertniistcomplete(seemstnrctions) ._.,u Date i< 'Tazp""" inust'sign,li Preparers signature ►Preparer's NYTPRIN Taxpayer's signature Firm's name(oryours,ifself-employed) • Preparer's PTIN or SSN Print sign ' Scott A. Russell Address • Employer identification number Title Supervisor Preparer's e-mail NYTPRIN Date Telephone number excl code 04-04-2017 ( 631 )765-4333 Payroll service's name Payroll service's EIN E-mail Scott.Russell@town.southold.ny.us Note: If you are using a paid preparer or a payroll service,the section above must be completed. Make your check or money order payable in U.S.funds to: Commissioner of Taxation and Finance Mail this return to: MCTMT PROCESSING CENTER PO BOX 4139 BINGHAMTON NY 13902-4139 0121160094 Department of Taxation and Finance /� ®� Y05 ORK Employer's Quarterly Metropolitan Commuter ��/� (12/16) STATE Transportation Mobility Tax Return Amended return For help completing your return,see instructions, Form MTA-305-1 Legal name Employer identification number(EIN) Fishers Island Ferry District 11-6003307 Mailing address(number and street or PO box) Mark Xress change? Mark an X In only one box to indicate the quarter(a PO Box 1179, Route 25 (see instr)❑ separate return must be completed for each quarter) City,village,or post office State ZIP code and enter the last two digits of the tax year. Southold NY 11971-0959 Mar31 X Jun 30 sep30 Dec 31 year Number of employees—Enter the number of covered employees whose wages are included in the 44 amount of payroll expense reported for the quarter............................................................................................... Enter your 2-character special condition code, if applicable(see Instructions) ........................................................................... If you permanently ceased paying wages subject to the metropolitan commuter transportation mobility tax(MCTMT), enter the date (mmddyyyy) ................................................................................................ 1 Payroll expense subject to the MCTMT(see Instructions) .................................................................. 1, 378491 , 23 2 MCTMT due for quarter(see Instructions) .......................................................................................... 2. 870 . 53 3 Total prepayments including PrompTax payments and/or overpayments from previous quarter(see Instructions) 3. 0 , 00 4 MCTMT balance due(if line 2 is more than line 3,subtract line 3 from line 2;pay this amount) ............... 4, 870 , 53� 5 Total MCTMT overpaid(if line 2 is less than line 3,subtract line 2 from line 3;enter here and mark an X In box 6a or 6b) 5. 6a. Refund or 6b. Credit to next quarter MCTMT Sign your return: I certify that the information on this return and any attachments is to the best of my knowledge and belief true, correct,and complete Third-party Print designee's name Designee's phone number Personal identification designee 7(see costo number(PIN) Yes❑ No❑ E- mail-0 Paid preparer must completevsee instructions) ♦ Date ♦ Taxpayer must sign here v Preparer's signature ► Preparer's NYTPRIN Taxpayer's signature Firm's name(or yours,If self-employed) • Preparer's PTIN or SSN Print signer's name Scott A. Russell Address • Employer identification number Title Supervisor Preparer's e-mail YT NPRIN Date Telephone number excl code 04-04-2017 ( 631 )765-4333 Payroll service's name Payroll service's EIN E-mail Scott.Russ ell@town.southol d.ny.us Note: If you are using a paid preparer or a payroll service, the section above must be completed. Make your check or money order payable In U.S,funds to: Commissioner of Taxation and Finance D� , Mail this return to: MCTMT PROCESSING CENTER PO BOX 4139 BINGHAMTON NY 13902-4139 0121160094 I , ' FISHERS ISLAND FERRY DISTRICT I � , VENDOR 003568 COOK CLAIMS SERVICES, INC. 04/25/2017 CHECK 4009 FUND & ACCOUNT, ( P.O'.# INVOICE DESCRIPTION AMOUNT SM .1930.4.000.000 j 040517 iFBO—C.BRIDGMAN-3/11 INJR 1,000:'00 r f TOTAL 1,000:00 1 - m � � r`'rb:M r- - - -- --•-- - -- --- —-- - it Ji ' h;:r'_- --` _ _.�,- >;L;4�4.,°+-"+x;18 'f 'u' ri��.: ^•`.;,.';,^ - :�= �,' 3 F7SHERISI1VD.uFERR'YDISTRIC7' _;,,- `AUDIx. T:.04' ,+2'5 '1171 t'` + :`,;' �.,<;'t;=',. - -- / / §,, s f' ^•J'.r :•yi,;, .y.?` ,n,.l.' .53095.MAIN ROAD:<PO:BOX'11J9,^� %-:�' .,��: '_i'S,'^;. ., : . ,!'r,`.;f.'�..`,:`r _•��,,,�,.� z s-• ;;' ! i' >•;. ',SOUTHOLD;NY>11971=0,959' 41111 '1 'SUPFOL GOP ATIONAL B,N +I 1a U7CHOGUE;'NYi.1i935''• - — _:.`•DATE`=" THE r , I' II's� tt'r P,�Ir, _- ;- ",>rt •p wts •'lP, 1, ''�I'r,, t'`'�."�.'-- -r„ _ _ -- _- - - I'Id'll'`,t'IP1ti'�III"5•"hOr""+,t' ''ta` r_, 20.17r't:YS- ,,-750-546/214' - - .i a .r� - �lr;: a: - e;�,,•,E - 'Ys,", "4i 1' i Y`"'r><Ei�i� ,t#= :P� - U :AND°AND' '0'0 10 0`�`DOL ONE;;T'HO S ;�, I•d. .r, --- .i - .$-� •rt' -"_ �- __ '" ___ "'I,d�1 '�" 'IL'�`f Illld �,'�- __- _ - :•{A t7„ IJ 1k ..1,1 'y1• - 'jT•, _ r-. i' .l,- .i, '>i ..4.'''>. ,V''`"t` r•:', - `.°7. ,'Ci sf I ;'' ' 1=,; ,.?` •,t 4- ,4• �, .,,i,.`r: .`. �r':,'" t� o;� .8_ ',1 Y g'.' -'.f r't.•r ''n fy tn' ty` s" , Ki CLilY> airvY;:',GOOA' MS.,SERUICES'_ `JINC:+`'i='"'r 'd r,s '1'p ~AT,ypG.-.,'1,I ;,1n';,'s -_ _ -4,' - •t 1:6,,r'a6;li' 'J'b1,.yne�1',a+,L;,j'q;+.`, a{r , t r ,I r� +: "I� _ _ - -"_ -_ - - �«� "h," �'Iv'« •!v+°d�1, �� __ - -_- - �- � ,.r" '�l"'n;,�•»+ >y,,V f_ ' - �'1u YY '1, t' -!=i7`-_ - - - ,£'i Y,,,l ruYi ''�:k's.N'ti 'I.StO ,{'i .S', _ - - - f•-F1'' Ni .ly S4.1 I�'i O,ITFIE:;,II a; "'BOX 60`4t6.1 ;tip ^,� 'M, III = _ _ _ - 'lu, �ly ,''f' -_- _�•r 'y^ As`�',YvIOBI'LE', ,13`6�616';'# .$ ,F o1, <i "51`ti #..:�`' •{• '',3- tli'�° ;t ,1} c t x5'fi'.i'Ad' t}s - - _ f, ^£'i> ^'d't:'-"r.,Z't a1'&' °3��s' •4 k, #t,' e+ M1 - - -- _ - �'.x�, 17` '';,•I dYs}�"P''C•I-d4 1. E'. - _ - -- L. "Pi. •p'yP ."ii'i 1'+e:':I Iii __ -i' - -_ - -_ -- _- - � "= - - -P +� "Y,•R, ''i' At' v _ - _ _ .''P;i',„7-",I'I I,_�i�'I'I-.I,'Y,i'u't 1.°•;.r°I'1�'� - 5�',�"- - __ - `�� _, _._ - -_ __- ,7FJn 'Sx,I'�.�” Aee ,1'�ti'•d ____ __ __ --" - N �!', i' � _ 'f-_ "_- - - - - --- _._-_ - ___ ':1�,° 1�11„1•,'M1'. ,,,' ;�" _r_ ____-_ - �',._ _ "y�+t�i'•4,,r',,,""Ir �,.- ul,r"'; . .-, :=:=, -'- = '. ". i'004009a;t ,i' 0 "2,,L<4't05;46,4 � =00"L,S,O`,L t Vendor No. Check No. Town of Southold, New York - Payment Voucher = 3568 Vendor Tax ID Number or Social Security Number Vendor Address Entered by , P.O.Box 160461 Vendor Name Mobile,AL 36616 Audit Date Cook Claims Services APR 2 5 2017 Vendor Telephone Number (251)470-0774 Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 040517 —�,, 4.7 4/5/2017 $1,000.00 $1,000.00 FBO C.Brid man March 11,2017 Injury SM1930.4.000.000 $1,000.00 $1,000.00 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 SignatTitle Signature Company Name Fishers Island Ferry District Date 4/13/2017 Title � Date 1 �� ` p Gordon Murphy From: David Cook <david@cookclaims.com> Sent: Wednesday,April 05, 2017 4:07 PM To: RJ Burns Cc: Gordon Murphy Subject: RE: Chris Bridgman Dear Mr. Burns and Mr. Murphy, good afternoon to you both. We have now had the pleasure of speaking with Chriss Bridgman concerning his illness of March 11, 2017. Based on our preliminary investigation it appears evident that Mr. Bridgman was working as a crewmember while in the service of the M/V Munnatawket at the time of his illness. In view of this, Mr. Bridgman will be entitled to certain benefits afforded under the vessel's insurance policy. Accordingly, it is our understanding that an ambulance was required to transfer Mr. Bridgman from the vessel to the hospital;following which he remained under doctors observation for 3 days, before being released. Because it is apparent that this claim will exceed the stated deductible of$1,000.00 for Fishers Island Ferry District, your insurance company has requesces, t that a check representing your deductible amount ($1,000.00)'be issued to Cook Claims Servi Inc. FBO Chriss Bridgman. You may mail the check to the address listed below: Cook Claims Services, Inc. Attn: David Cook U P.O. Box 160461 Mobile,AL 36616 Thank you in advance for your time and assistance. Please do not hesitate to call with any questions that you might have. David Cook, President Cook Claims Services, Inc. Maritime Adjusters,Surveyors&Investigators Serving The Gulf Of Mexico and Inland Waters 24/7 Call-Out Team On Duty Alabama,Mississippi&Florida www.cookclaims.com (251)470-0774 From: David Cook [mailto:davidCxbcookclaims.coml Sent: Thursday, March 30, 2017 9:33 AM To: 'rburns@fiferry.com' Cc: Gordon Murphy (gmurphy(JIfiferry.com) Subject: Chris Bridgeman Dear Mr. Burns,good morning. Cook Claims Services, Inc. has been assigned by the insurance company for Fishers Island Ferry District to handle and adjust the illness of Chris Bridgman on March 11, 2017. 1 have previously spoke with Mr. Murphy who was helpful in providing a cell phone of 860.908.7530; however,this number does not appear related to Mr. Bridgman. It is important that I complete our review of this matter as possible. With this said,your assistant is appreciated in provide us with Mr. Bridgman's cell phone number, necessary for us to communicate with him concerning this matter. 1 Gordon Murphy From: Scanlon, Lisa <lisa.scanlon@xlcatlin.com> Sent: Thursday, April 06, 2017 9:24 AM To: Gordon Murphy Cc: Diane Hansen; Carol Branch (cbranch@hilbgroup.com);Jeff Rosenthal Orosenthal@hilbgroup.com) Subject: RE: Chris Bridgman Gordon, You will need to provide your deductible to the adjuster and I will provide the balance for the bills due. Please let me know if you have any further questions. Thank you. Lisa M. Scanlon, AIC, SCLA Marine Claim Specialist .: �a, .. 2;,•. -uo,-.�? Irv.,: ,...3;�ia's r,�'"�!�.xJ'"1<�,,' ,iF. �i,V�„,h,..rk;e,'u3, (,F,3•nRp�..,"^• 505 Eagleview Blvd. Exton PA 19341, USA P. 610.968.2684 M:610.850.4390 E:Lisa.Scanlon(cDxlcatlin com FILENO: From: Gordon Murphy [mailto:gmurphy@fiferry.com] Sent: Wednesday, April 05, 2017 4:13 PM To: Scanlon, Lisa Cc: Diane Hansen; Carol Branch (cbranch(@hilbgroup.com); Jeff Rosenthal Orosenthal(ftilbgroup.com) Subject: FW: Chris Bridgman Lisa, Would you please confirm the below on behalf of the underwriter. Thanks, Gordon From: David Cook [mailto:david@cookclaims.com] Sent: Wednesday, April 05, 2017 4:07 PM To: RJ Burns Cc: Gordon Murphy Subject: RE: Chris Bridgman 1 --• I 1 1 1 1 1 1 - , 1 1 1 1 , `-` _>- -°-- -- 1 FISHERS ISLAND FERRY DISTRICT VENDOR 004277 DIME OIL COMPANY, LLC 04/25/2017 % CHECK 4011 FUND & ACCOUNT P.O.# —INVOICE DESCRIPTION AMOUNT _ 1 SM .5710.4.000.300 53561 RP 5237 GAL@$1.7138/GL 8, 975.'17 SM .5710.4.000.300 53561 CT EXCISE TAX—$.4170/GAL 2,183 .83 _ SM .5710.4.000.300 53561 S—F COST RECOVERY .0021 11.00 SM .5710.4.000.300 53561 LUST TAX—$.0010/GAL 5.24 - TOTAL 11, 175.24 r ,1 r �• 1 � n t $FY. .r , .. ... - w ..,.nom`` •'Y�"• 11 1 I ` t a • ;r l FIS ERSISLA—A, �FERRYDIS7RIC7'`' -- ',' ;,. `" . _ '� •`,_%�, <� 53095.MAIN ROAD;P,O 90Xr1179,';F �_ „'•y t', i s>.t, .,SOUTHOLD.,NY^11971=09.591;a ;'i._€j; w`CHECKf',N0. ss i f=,401`] -r= FF �L C•0' �TONAL 'NK ;THESE ,0 K A,�, E :CUTCHOGUE;NYa11935'';,,,;•;'.:"'�;" -. -_ DATE.'= _`1'_r,"^t.'. _ _AMD.U�1'•'�.`i, 1 --------d' - ;.4N �1° •,p"1'Iv„',,�i•f.; ''j,: - - - - - „•,.- it ,II"-= ',' 'W�;'U; '£�. �J ''1, 11'P•. ''P,du Jl d .,Iv ,nLnl `D~ --- ,.d". "-_ ,dP l a' ,I,' nl,,s" ;r„iG do;t` z 4}'` :"_-_ -- a - _ ;E>,'d,.<.,,�ih at":_ a;;l"1 -'a;!nl.,nra �I,.. �' �'E':`<" "z'• '4,'� ;c04/<25/2'0`TTry •.�,7''1,Y,17,5,r'2'4�,. .}' S q^• tl¢` 'i"-�.'$ '1: .•F- •4:'{'„`;,°<',•.', `50-548!214'. ``t.. 'x �`7"'" ;i a F a'.'n;r•s,� - x, .`9C yf,-” �-• Yd'J 4;�2•. ..y `"'• ' tid`p tom,dr q:c�'4: ��a:s . -' cY�-.`�•^ 'EL'EVEN'ieIHOIJSAND'' ','S +ONEF'HUNDRED �p'UENTY=F"FIVE.`>'P;ND°",2'4/1_;0'0:'-DOLT,P.RS;"' -t r a_c_ = i,l 'h'• '.'d, .'ID' ,•,"ida` _- __� - -- - -- "I .1,."I''I,'lis "1,. •1,;'1�.I,:''j _ - -- -- - "4�'V,<., 't,>"I;,s '4.V hrl,if - -' -' -.- _.�,,�'c<• _ - _ _-_ kl, �`,I I„ ,q,,'�u,,, Tpi'p°pit _" -- - "- xi i;,6.`' I njd ft�l„< 'i1."•' 9, - - --.5< :pd - B:<"� - - "" - <%, !< 't, 1i s'I a.111 '•s 7,i',3'- -_”- -_ � 1 Sli 1 I;'; - _ __ _ " - d 5I�= :t�' W 1'd ''d'�t li'.1' < ! d d' - - - - 't - _ "K'” •! �'�F',P'Jd n d•�d', :J d et5., - - __ _- d^ s. -` _ ".`- _ -_ _ �".* a,t; 1'`"• `71 "Ij Ot•' .'i','I,: �-P='=___-r -- _ -__ -�-_ L 4 - 'a"I!'^I•.:q'n,,.` .,;p'✓•a"°t`:--`-`' - __ '_ '� '""- - - " tr :'1Ti`d''ly;,' .iaie"-_= - _-'_ - _-:;.; s - rP 9r Y" 'Pa ;4'•. .Pi `g"S§_ = ;>__ "-_ - =-r°•P;'i flli it"' tl'i}I '#` _ -s ' -:_-_ "=aa', _ '!'lien <<$ ur`1 `x X11; �n x\`a4' C`E'`'Y• a:l< Ott `d '`Y�7:`i�` jl,", -.:9 qi�,:.•i�`'�r .;'.� -4.y''.r .fir R>�'' .1�"lgal:�:s i(. :F:a i✓l"•t'Yy „A�Y•� `'�:=d'DIME .OIL :COMPA-NYS_'=LIC`_ "nit ,INa �,y11•. '-z•d tY' 'n :111' 1Z ""i - _- _- __-1.._.: '•l' ,nl, J,4'h£'t- __ _ _ ___ _ _ pe.r•f� 'I:l,'y "1_' i �_ 1 �P' .s, °E 1��'.�„'I,r, m''1l"u 1' 4.1p P'II 1,, .,4 - _ _"i.l'�'gP,• I Ir 'll•1' OITI�C�'I,� ", 1. _ 'r'`e`P. 1� I' d ,l ur4i ,r',r': --- _ _';._ _ ,il,'',:P'• '.I,<Irl 1nt.'fy, I d93�^,7,,IDt7STRY•�'`.LANE'� '„3lv;,,r•.'',}ia' e81•, _ - - - --_ ___ - a%f' X51 '•�d•>.r - ula"a��' •JI. ,f`�"�ara.�__<•'s�' __ _ _ ,a �•'tl.rf' :.1, - „' _ ,#`;3`t•4'S !;ii _41BO�:BOX,<1'112.5'. '• t, .1. '(, rk;. ,t• .R'!i i 11,1.8, latrsi'' d><',°' .:€ n�?.„ :a `•xw ''1� _ 'f_ - 1" �111 •I'�ta t'i:'f. �'4r$"- _ __ _ e 1 •t IA1 'P'r _ _ _• __ " - - .11 °t I I n..1'7i`,' •'•,'`• - - - _- _ - ,nt`:xr' .I".: n - - -'s c' - 'i I V It •1t ftp"f :�(.`- ,1�e!� " qv - - _ '*r,=-__-_- _ '`f----- ,4 "'!11,1^4,. ei>y 1•:a<:a„ , i'i"i0040'i, in; . 1:'0 214'0`54 'L Vendor No. Check No., Town of Southold, New York - Payment Voucher 4277 '4011 Entered y P.O. Box 11125 Audit Date _ Dime Oil Company LLC Waterbury, CT 06703 Vendor Telephone Number APR 2 5 2017 203-754-5334 M 7 MTownerk Vendor Contact f Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 53561 4/10/2017 $11,175.24 $8,975.17 RP 5237.0 gal @$1.7138/gal SM5710.4.000.300 $2,183.83 CT Excise Tax-$0.4170/ al $11.00 S-F Cost Recovery.0021 $5.24 LUST Tax-$.0010/ al OPIS attached i Federal S-F tax increased on 1/1/2017 $11,175.241 1 $11,175.24 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 Signaturej4�..a_ ( dvr�— Title Signature Company Name Fishers Island Ferry District Date 4/12/2017 Title Date Dime Oil LLC Phone: 203-754-5334 PO Box 11125 Date 04/10/17 Waterbury, CT 06703 Page 1 Dime Oil LLC www.dimeoilco.com INVOICE ACCOUNT NUMBER : 4420165 Fishers Island Ferry District AMOUNT ENCLOSED: PO Box 607 (EMAIL) Attn Accounts Payable Fishers Island, NY 06390-0607 Re: Fishers Island Ferry Dist 5 Waterfront Park-Race Point, New London Terms: Net 30 Days From Invoice Date ------------------------------------------------------------------------------- Date Invoice Charge and Credits Amount ------------------------------------------------------------------------------- 04/10/17 53561 #20R Off Road Diesel 5237 . 0 GALS @ 1. 713800 8975. 17 Dyed Diesel Fuel for Off Road Use ONLY. S-F Cost Recovery 11.00 CT EXCISE TAX DSL 2183. 83 LUST TAX 5.24 04/10/17 53561 Fuel Invoice Total 11175.24 Amount Due 11175.24 Effective Jan 1st the Federal Spill Recovery Fee increased to . 0021 for Oil/Diesel & . 0019 for Gas Dime Oil LLC 203-754-5334 Account: 4420165 _�, � .,�-'�� �.:---er—�r-�_—.tj..,.—,..�—.�--•r—,yam,--_.�--._". .—__r�_�_..,—„�} TERMS:WE RESERVE THE RIGHT TO MAKE A FINANCE CHARGE COMPUTED BY A PERIODIC RATE OF,1.55%o PER MONTH WHICH IS AN ANNUAL PERCENTAGE-RATE OF'I S%ON AMOUNTS PAST DUE 30 DAYS OR MORE AND TO ADD'ALLf COLLECTION FEES. ORDER DATE 20 06 20 10 `� �gl /G 04/0 1201.7 �, r �, y DELIVERY DA E 3 c c F SYIe1and Ferry DiSt•, 4 4 � fir ;Er. 5 Watie3i f]:ont Park-trace Point , • • ;GALLONS, „/, � �`� m pID 1 , State,' Street. �FOR GPS : 4$60®44 0165 �< �`. �Ic_ {� New '1Q) d®lI C1'':Q632,0-� '$ ' ,b®�k97 FULL PRICE PER GALLON K 'ac't®� 21'a 1300 LaSt;.L�1�m 11/ 8/16V` 0 m 0072 o o 1 JOHN FiO 3 3m�3`11 ��,�I ® x6' I�- � 0E:t Ft A- o Cm _ DISCOUNT PRICE PER G`fON . ; agar _L ,State, Bt®®v :-RR o ;Farm, �` �,,.. f _ Nu v v,{ I « i T ° PAY DISCOUNT AMOUNT I r �` aOROI RE 5200,`G Fblki APAIL'10 '9,:00AIlY n - - : # � PAY THIS AMOUNT 1 _ makes= 0 0 0 21 9 ,0 0 4.17 0 0 a 0 010 i AFfTER DAYS {x C_.: t n� P � r ®IME ®IL: OMP� NY, LLV TRUCK ;TAX j ,C ; !DRIVER I ( RO.:BOX 11125-1TMST V1lATsERs�BUyRe'Yq, CT 06703 a TIME< gAM' ;PAYMENT RECEIVED, y `(LOa7),/J� m5,334_ •. TNIFI; oF,DE ��O PM, ❑CASH/❑C CK I.UST VOICE El CHAR ® mr .t t I Kascia Asmolov From: Accounting Department Sent: Wednesday,April 12, 2017 10:25 AM To: Kascia Asmolov Subject: FW: Fishers Island Invoice Attachments: Invoice.pdf From: Lori Waskowicz [mailto:lori@dimeoil.coml Sent: Tuesday, April 11, 2017 1:56 PM To: Accounting Department Subject: Fishers Island Invoice Attached is Fishers Island Invoice for delivery made on 4/10/17 NEW HAVEN, CT 2017-04-10 17:02:36 EDT **OPIS CLOSING BENCHMARK FILE** **OPIS GROSS ULTRA LOW SULFUR DISTILLATE PRICES** Move Terms No.2 Move No.1 Move Pre Move Date Time Global u N-10 168.80 + 1.40 195.00 + 1.50 171.55 + 1.51 04/07 18:00 Sprague u 1-10 169.00 + 1.25 -- -- -- -- -- -- -- -- 04/07 18:00 Shell u N-10 169.14 + 1.85 -- -- -- -- -- -- -- -- 04/07 18:00 NWENGLPTR u N-10 169.65 + 1.50 -- -- -- -- 172.15 + 1.50 04/07 18:00 S.R.& M. u 1-10 170.50 + 1.55 -- -- -- -- -- -- -- -- 04/07 18:00 Valero b 1-10 170.50 + 1.55 -- -- -- -- -- -- -- -- 04/07 18:00 XOM b 1-10 170.60 + 1.56 -- -- -- -- -- -- -- -- 04/07 19:00 Gulf b N-10 170.65 + 1.50 -- -- -- -- 173.15 + 1.50 04/07 18:00 GULF-GIE u Net 170.65 + 1.50 -- -- -- -- 173.15 + 1.50 04/07 18:00 Coastal b 125-3 170.85 + 1.50 -- -- -- -- -- -- -- -- 04/07 18:00 Shell b 125-3 170.85 + 1.87 -- -- -- -- -- -- -- -- 04/07 18:00 Sunoco b 125-3 170.85 + 1.50 -- -- -- -- -- -- -- -- 04/07 18:00 Citgo b 1-10 171.12 + 1.51 -- -- -- -- -- -- -- -- 04/07 18:00 Citgo u 1-10 171.12 + 1.51 -- -- -- -- -- -- -- -- 04/07 18:00 BP b 1-10 171.14 + 1.42 -- -- -- -- -- -- -- -- 04/07 18:00 Valero u N-10 171.15 + 1.55 -- -- -- -- -- -- -- -- 04/07 18:00 Irving u Net 171.67 + 1.62 -- -- -- -- -- -- -- -- 04/07 18:00 GlobalXOM b 1-10 173.71 + 1.50 -- -- -- -- -- -- -- -- 04/07 18:00 LOW RACK 168.80 195.00 171.55 HIGH RACK 173.71 195.00 173.15 RACK AVG 170.66 195.00 172.50 Plus vendor mark-up .72 Total 171.38 Convert to dollars $1.7138 Katarzyna Asmolov Fishers Island Ferry Disrict • P------------ P � P P i • � i :t FISHERS ISLAND FERRY DISTRICT „ \ VENDOR 005442 •EMPIRE DENTAL 04/25/2017 CHECK t 4012 FUND &' ACCOUNT/ P.O.# INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 6874419 DENTAL PkEM(25) -5/•17 2,070.92 ( TOTAL 2,070.92 � f t :•>„�;`. =µ ^N •:•"9�:b:z:�;i%r max"'' I/ y'nn x t .... a: "��t�nm�•,:.:� ar.: i t.,' r a K''' •'gib`•" _ c(' I I - 1 , r- i r- \. ------- __--- � t I i I t ' I FISHEIZS•:ISL�4IVD=FERRY.DrSTiZIC7:,., 53095,MAa : AUDIT ^(j %25,�, ',,� "J':P;f ,at'`ur;y t '•;�" :.1: gIfyROAD,PO BOX',1'T79�, f•,3;is°: x:r` `!. ?'e ,'€:' SOUT OCD. Y.Y7971=0959?.-:c' :'i.•f•' _ - r, ;t'p � ,^':;:'e� ,:,". `•>1:1.',� .kHr s.��' .n, ,1'';,�''w ,I} rt;'`-=.'<�t.'<'a't. _ .�CH�ECIC;iNO`,;,° k;I`,4s0�12:'' a dT 0 L"y '.3" THE•,SUJ rO'LK COb'N I �{.6 NK,.::' _ `3• y - - "`CU,TCHOGU5i^,NYA;1,935 •3.,;° _- '- iDATE 11' 1 a P - -- ;t-. -- .4` P P:,;" u't} V'.:iT�" b, - - - ,J"-- _ - - - z,•',tr'+ '.;" +' + >vr;"; ,r?` , ,a; _ _- ___ - ,!' d, .! J,lt „1,9;,J 1„df.Y..;;4;LpY ==g,,.•,- _ ,'p. - - - •`r F II, 1,11 ,'n n'''='i'. /214' ,s t, ,�ej; ;7� ., / ,/, s "ii'•a`�,a„ .I D �r> .,s :.':4: a.,;.r.°y`s t p.. d;,E:,1;Yi;.`„f ,�'�•t ,r, .at'r_.�....t,i�y>;�; :i`;?' '1�•', .'rt;'e= i' - °'t` ;. £_,^,✓'°::': ,,\r /,v+ 1e4• a'< 4M.•� .,tn iti1p,:e:. °jy...i,.n.2.;9 e t tir. 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"4 "_ - a't+dl'J,I •t 1".d p,lpp,,d ,i',l, p,!`i.>:�', - '`- ''1'` ! �I+, 1't' ,"+;+1 l:�) 'd°c qi-- it r - `- 'flu 0,.1 pe 40,:'.1•,6,2r'�'i,�:1"{'n 1"11. 2'r 40546:Y`,41` ■-_6 -' 012 'I4I•: , r Vendor No. Check No•.` Town of Southold, New York - Payment Voucher 5442 Q Vendor Tax ID Number or Social Security Number Entered b PO Box 202837 Department 83703 Audit Date Empire Dental Dallas,TX 75320-2837 APR 2 5 2017, Vendor Telephone Number 877-606-3409 Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 6874479 4/14/2017 2,070.92 2,070.92 May 2017 Dental Premiums (26) Stla'19060.8.000.000- 77 5/1-31/17 2,070.92 2,070.92 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. Signatures rtle Signature , ^ 2 Company Name Fishers Island Ferry Date 4/14/2017 Title- Date J �� EmpireO INVOICE PAGE 1 - BCUECBQSS EMPIRE ACCOUNT NAME FISHERS ISLAND FERRY DISTRICT PO BOX 856 ACCOUNT ENY4561251 INVOICE 6674479 MINNEAPOLIS MN 55440-0856 BILLING DATE 04/14/2017 SUBSCRIBER PERIOD 05/01/2017 - 05/31/2017 BILLING/PYMT INQUIRIES 877-606-3409 CLAIM PERIOD REMIT TO: FISHERS ISLAND FERRY DISTRICT EMPIRE DENTAL ATTN: ACCOUNTING SUPERVISOR DIANE HANSEN PO BOX 202837 261 TRUMBULL DR DEPARTMENT 83703 PO BOX 607 DALLAS TX 75320-2837 FISHERS ISLAND NY 06390 CUSTOMER NUMBER OF NUMBER OF CLAIM ADJUSTMENT RATE TOTAL REPORTING NUMBER CURRENT CLAIMS AMOUNT AMOUNT AMOUNT AMOUNT EMPLOYEES 456125-0001-0001-550 25 527.52 43.96/EE/MO 627.90 89.70/EE/MO 106.45 106.45/EE/MO 809.05 161.81/EE/MO 2,070.92 INVOICE TOTAL 25 0 $0.00 $0.00 $2,070.92 $2,070.92 YOUR BALANCE IS DUE-BY THE FIRST OF THE MONTH. PLEASE INCLUDE A STATEMENT COPY WITH YOUR PAYMENT. Services provided by Empire HealthChoice Assurance, Inc., a licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. , 1 1 1 ' ---' '----- -i i----'-------- , --------- ' 1' FISHERS ISLAND FERRY DISTRICT VENDOR 906155 FEDEX 04/25/2017 CHECK 4013 " FUND & ACCOUNT \`P.O.# INVOICE DESCRIPTION . AMOUNT r7 8M .5710.4.000.000 5-765-10680 AP(4) ,PAYROLL(2) 174.'38 TOTAL 114.38 1 ......... r t }�:nV `.1^s 1 , 1, ,1 1 � 1 -_ --•l'--__"h.a -d4R: am14.X11•. -:-_- - __ - 'ilk _'\I,�':'ul.:hil�',•' .I' Fl�4LRn zy'SG_' tip.:i`-'- �_ - 1n,�. _ ,�; ;s„s'�,. ERRYDISTRIC mr. .�” FFy- ttE gtA ,° _ FISHER =7SNEgF `, AUDZT,.Eo4%a'S°%rl�?°£; R�,a ',i`.y`.:x:>5;, }r ' ,yr„F`a, b,F'4;k;;s,•.�k'�'. 'Tp ,�FO r:.,. ` ' 'A "PO BOX,,1179,n:ay'•a"•-, «f,' i ':r•,, '"?.,f, _ z,:;' ai•,; :ti` .t,..,� >�;_ 53095-MAN d•AD..' r,_ _ O � ,1:e.�*t, ',5�_ ,a?1. ��: _ Y`;_'' ___ J.`p, tl ,a: ,I 'c,,II s,',�'� .5• �s.' 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F• z'lPZT,T'SB'URGH.:PP,,al=52'50. x7,461"•,'i °.; 6'.q;,';:,,:,, ,f_,{,.rE;;,'e „�`i'• kR,i ,h` st: OF,'J". xt` f.i°'i 6.s1•"-: •:i'.a,'a i"` 'Yt Y:. t Y7:FI:<S pay,`° ',a7:,..:. 4'n}1,>. Y 3•t',`<.'1'�1'1'.:,°`'�� ,a q• t,l, qtr;, ,;'£,'.t`- •<�:s �'a5',E.pit, ., '�5:`it51�• ':;,f '.i'; ik� .t'/i:,r. 'i.'- _ `i•. -'?x't a.;j'gx '.t �ti`,t :; ,h., - .f: :ft;:.t•<. ,4`RK.Y.n�«s:,:, _ �',•••y'S„',4e,.-` °,.1 1t: Ln¢r. ['�i�ji _ _ � - ,�'.. 'tr 'pS s.,;'\"' � '"fw- ia,(:♦ '.,,td a'y .s in x> °I. .r..�` - -`_ ,f;:,ka,',`I°r=,"a;Ihli='aa^"9t'i,tir@.^ _s° -t, •- --c4.'} ,f 3 - �',_,-•_ -- - I' 7•il '"' 1,,,'I',�,1;£,pYl 11r+�9.t,it., --- -- '`s"-___:;l -_ >f_ dal t;a,1,da a=I,"°ddf71 FI;' 11•dt- - _- -_ -_ _ - tr_ = _ -- --�3`Y_ _ °al'd'A,,x I,:a,l:t7 �l�`„ r,,1,i,k :�} s� _ -_ - - _ .''},<•n. ,r:,t -- _ _ __ _ - _ - Pi' ,e•t I. Ali,.�! ,I,�>,ti - - - - - `3- :_ --- _ -s,_ - _ - ,n' r', a-:,, - - -•cam ,,�,'--..:a,,ly::ti n`�_y .,14 .,1:. e,a•'--- "`�-- - -_."--- ,. 5,'4`6,`4� ;8\ .0.0:�5,0:.2; 51 n■ Vendor No. Check No. Town of Southold, New York- Payment Voucher 6155 Ll 013 Vendor Address Entered by P.O. Box 371461 Vendor Name Pittsburgh, PA 15250-7461 Audit Date Fedex APR 2 5 2017 Vendor Telephone Number 800-622-1147 Town Clerk Vendor Contact /. ! Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number. 5-765-10680 4/10/2017 $174.38 $174.38 AP 4 PR 2) SM5710.4.000.000 . i 3 i _ F 1 . i i $174.38 $174.38 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 Signature C�n��iNr—� Title Signature Company Name Fishers Island Fe District Date 4/14/2017 Title ate �r�/� Fed, QD Invoice Number Invoice Date Account Number loge 5-765-10680 Apr 10,2017 1206-0334-5 of 5 Billing Address: Shipping Address: FISHERS ISLAND FERRY DISTRICT FISHERS ISLAND FERRY TERMINAL Invoice Questions? ACCOUNT PAYABLE 5 WATERFRONT PARK Contact FedEx Revenue Services PO BOX 607 NEW LONDON CT 06320 Phone:- (800)622-1147 FISHERS ISLAND NY 06390-0607 M-F7 AM to 8 PM CST Sa 7 AM to 6 PM CST Fax: (800)548-3020 Invoice Summary Apr 10,2017 Internet: www.fedex.com FedEx Express Services Transportation Charges 183.49 Base Discount -14.56 Special Handling Charges 5.45 Total Charges USD $174.38 TOTAL THIS INVOICE USD $174.38 You saved$14 56 in discounts this period! Other discounts may apply. Detailed descriptions of surcharoes can be located atfedex.com Invoice Number Invoice Date _ Account Number Page 5-765-10680 Apr 10 2017 1206-0334-5 2 of 5 Adjustment Request Fax to (800) 540-3020 Use this form to fax requests for adjustments due to the reasons indicated below. Requests for adjustments due to other reasons,including service failures,should be submitted'by going to www.fedex.com or calling 800.622.1147. Please use multiple forms for additional requests. C Please complete all fields in black ink. 4 Requestor Name 1 1 1 1 1 1 ` 1 I I I I I I I I I I " I ( I I I" 1 1 1 1 1 1 Date W/ W/ W t ar Phone WWW -I I I I -WWW_ J Fax# WWW -WWJ -�WWJ t E-mail Address OYes,I wantto update account contact with the above•mformation. Tracking Number Bill to Account $Amount 101111111111111111 IIIIIIIIII IIIIII• W hllllllllllllllll IIIIIIIIII IIIIII• W jllllllllllllllll IIIIIIIIII IIIIII• W 11111111111111111 IIIIIIIIII IIIIII• W � IIIIIIIIIIIIIIII Itllllllll IIII � II• W ADR-Address Correction INW-Incorrect Weight OVS- Oversize Surcharge For all Service failures or other o DVC-Declared Value INS- Incorrect Service RSU- Residential Delivery surcharges please use our web e IAN- Invalid Acct# OCF- Gird Pick-up Fee PND- Pwrshp Not Delivered site www.fedox.com or call OCS-Exp Pick-up Fee SDR- Saturday Delivery (800)622-1147 Rerate information only (round to nearest inch) C Tracking Number Code $Amount LBS L W H ( I I I I I I I I I I I I I I I I I I I I I I I I I• W WWWWWWXI XI I I I IIIIIIIIIIIIIIIIIIIIIIIIII• W IIIIIIIIXI X 111 tIIIIIIIIIIIIIIIIIIIIIIIII• W IIIIIIIIxWWWxllll S l I I I I I I I I I I I I I I I I I I I I I I I I I• W I I I IWWWX I I IX I I I I l l l l l l l l l l l l l l l l l l l l l f l l l• W I I I II I I IX I I IX I I I Invoice Number Invoice Date EAccount Number Page 5-765-10680 AW r 10 2017 1206-0334-5 3 of 5 FedEx Express Shipment Summary By Payor Type FedEx Express Shipments(original) Rated- Special Might, TranspuMilon Hodiing Ret ChgtTax -N or Type shipments lbs Charges Charges CredblOther t fzddoots- -Totat-Cltarges Shipper 1 51.28 1.67 52.95 Recipient 4 3.0 102.05 3.03 -11.54 93.54 Third Parry 1 3.0 30.16 0.75 -3.02 27.89 Total FsdrxExpress 6 60 $183A9 $SAS 4t4 G $117436 TOTAL THIS INVOICE USD- $174.38 1098-01-00-0015991-0002-0041806 InvoiceNumber Invoice Date Account Number Page ` 5-765-10680 Apr 102017 1206-0334-5 4of5 FedEx Express Shipment Detail By Payor Type(Original) Ship Date M r20,2017 Gust.Ref.NO REFERENCE INFORMA7IOI4 W12- Panyon Shipper ReL _ • Fuel Surcharge-Fed Exhas applied a fuel surcharge of 25%to this shipment • Distance Based Pricing,Zone 2 Automation AWB - Sender Recipient Tracking ID 810997039700 G MURGY Q LARZ ARENA Service Type FedEx First Overnight FISHERS ISLAND FERRY TERMINAL TOWN AT SOVTHALD FINANCE Package Type FedEx Envelope 5 WATERFRONT PARK 54375 MAIN RD Zone 02 NEW LONDON CT 06320 US SOUTHOLD NY 11971 US Packages 1 Rated Weight N/A - Declared Value USD 10000 Transportation Charge 51.28 Delivered Mar 21;2017 10 38 Declared Value Charge 000 Svc Area A8 Fuel Surcharge 167 Signed by R RALLIS Courier Pickup Charge 0.00 FedEx Use 007941654/3/_ Total Charge USD $52.95 Shipper Subtotal USD $52.95 Ship Date.Mar 40,2017- Cost.Ref.:NO REFERENCE INFORMATION, -Ref#2: Payer:Recipient fief Al. • Fuel Surcharge-FedEx has applied a fuel surcharge of3.75%to this shipment • Distance Based Pricing,Zone 2 • FedEx has audited this shipment for correct packages,weight,and service Any changes made are reflected in the invoice amount • The package weight exceeds the maximum for the packaging type,therefore,FedEx Envelope was rated as FedEx Pak Automation AWB Sender Recipient Tracking ID 810602182667 JANICE LFOULIA GORDON MURPHY Service Type FedEx Priority Overnight TOWN OF SOUTHOLD FISHERS ISLAND FERRY DISTIRCT� Package Type FedEx Pak 53095 ROUTE 25 FISHERS ISLAND NY 06390 US Zone 02 SOUTHOLD NY 11971-4642 US Packages 1 Rated Weight 10 lbs,0.5 kgs Delivered Mar 13,2017 0936 Transportation Charge 26.59 Svc Area A9 Discount -2.66 Signed by R.KELLY Fuel Surcharge 090 FedEx Use 006975114/1486/_ Total Charge USD $24.83 Ship DatwMarI5,2017 Cast.Rei:NO REFERENCE INFORMATION beta Payor;Recipient • Fuel Surcharge-FedEx has applied a fuel surcharge of 3 50%to this shipment • Weather delay-Snow • Distance Based Pricing,Zone 2 • FedEx has audited this shipmentfor correct packages,weight,and service.Any changes made are reflected in the invoice amount. • The package weight exceeds the maximum for the packaging type,therefore,FedEx Envelope was rated as FedEx Pak Automation AWB Sender Recipient Tracking ID 810602182678 LAURA ARENA GORDON MURPHY ------- Service Type FedEx Priority Overnight TOWN OF SOUTHOLD 1' FI FERRY DISTRICT Package Type FedEx Pak 53095 ROUTE 25 11 5 WATERFRONT PK Zone 02 SOUTHOLD NY 11971-4642 US NEW LONDON CT 06320 US Packages 1 Rated Weight 1.0 lbs,0 5 kgs Delivered Mar 16,2017 11:10 Transportation Charge 2659 Svc Area A4 Discount -2.66 Signed by R.FORD Fuel Surcharge 0.84 FedEx Use 007460466/1486/_ Total Charge USD 524.77 1098-01-00-0015991-0002-0041806 ° Invoice Number Invoice Date Account Number Page 5-765-10680 Apr 10,2017 1 1206-0334-5 5 of 5 Ship DOWN S03,2017 Cust Rot.:NOr-REFERENCO NFORMATI ON Ref#2: FayQr:Recipietlt 001113: • Fuel Surcharge-Fed Ex has applied a fuel surcharge of 3 25%to this shipment • Distance Based Pricing,Zone 2 • FedEx has audited this shipmentfor correct packages,weight,and serwce.Any changes made are reflected in the invoice amount • The package weight exceeds the maximum forthe packaging type,therefore,FedEx Envelope was rated as FedEx Pak. Automation AWB Sender pD Recipient Tracking ID 810602182689 JANICE LFOGLIA GORDON MURPHY Service Type FedEx Priority Overnight TOWN OF SOUTHOLD FISHERS ISLAND TERRY DISTRICT Package Type FedEx Pak 53095 ROUTE 25 FISHERS ISLAND NY 06390 US Zone 02 - SOUTHOLD NY 11971-4642 US Packages 1 Rated Weight 1.0 lbs,0.5 kgs Delivered Mar 24,2017 10.55 Transportation Charge 2659 Svc Area A9 Discount -266 Signed by J MOORE Fuel Surcharge 078 FedEx Use 008282330/1486/ Total Charge USD $24.71 Ship Date:Mar 29,2017 Cust,Ret.:NO REFERENCE INFORMATI ON Ret12: payor:Recipient Ret,#3 • Fuel Surcharge-FedEx has applied a fuel surcharge of 2.75%to this shipment • Distance Based Pricing,Zone 2 Automation AWB Sender Recipient Tracking ID 806434365108 LAURA ARENA P GORDON MURPHY Service Type FedEx Priority Overnight TOWN OF SOUTHOLD f` EI FERRY DISTRICT Package Type FedEx Envelope 53095 ROUTE 25 5 WATERFRONT PK Zone 02 SOUTHOLD NY 11971-4642 US NEW LONDON CT 06320 US Packages 1 Rated Weight N/A Delivered Mar 30,201710.01 Transportation Charge 22.28 Svc Area -A4 Discount -3 56 Signed by T KELLY Fuel Surcharge 0 51 FedEx Use 008879233/186/ Total Charge USD $19.23 Recipient Subtotal USD $93.54 Ship Date:Apr 44,2417 Cust,Ref:AP Rot.#Q. Mayor,Third Party ReLft • Fuel Surcharge-FedEx has applied a fuel surcharge of 275%to this shipment. Distance Based Pricing,Zone 2 FedEx has audited this shipment for correct packages,weight,and service.Any changes made are reflected in the invoice amount The package weight exceeds the maximum for the packaging type,therefore,FedEx Envelope was rated as Customer Packaging Automation AWB Sender Recipient Tracking ID 875071426110 DIANE HANSEN (J LAURAARENA Service Type FedEx Priority Overnight FISHERS ISLAND FERRY DISTRI TOWN OF SOUTHOLD-ACCOUNTING Package Type Customer Packaging 201 TRUMBULL DR 54375 MAIN RD TOWN HALL ANNEX Zone 02 NORWICH CT 06360 US SOUTHOLD NY 11971 US Packages 1 Rated Weight 3 0lbs,1.4 kgs Transportation Charge 3016 Delivered Apr 05,201711.10 Discount -302 Svc Area A8 Courier Pickup Charge, 000 Signed by J ARENA Fuel Surcharge 0.75 FedEx Use 009476570/1486/ Total Charge USD $27.89 Third Parry Subtotal USD $27.89 Total FedEx Express USD $174.38 1098-01-00-0015991-0001-0041805 I I , rl 6 I I. •a 1 I I I _ , , I I i - I I 6 r ;FISHERS ISLAND FERRY DISTRICT VENDOR 006373 FISHERS ISLAND FERRY DISTRICT 04/25/2017 CHECK 4014 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5710.,2.000.200 041717 CVS-FRST AID SUPPLIES-RP 28.29 SM .5710'2•.000.100 041717 WALGREENS-DISTLLD WTR-MU 10.00 SM .5710.2.000.100 041717 CVS,-DISTILLED WATER-MU SM .5710.2.000.100 041717 TRUE VALUE-KEY-MUNN 10.05 ; SM .5710.2.000.100 041717 WALGREENS-DISTLLD WTR-MU 1.29 SM` .57.10.2.000.200 041717 HOME DEPOT-SPRAY FOAM-RP `\ 14.83 ;- SM .5710.2.000.000 041717 HOME DEPOT-VELCRO-RP,MU 61.63 TOTAL 127.66 - - '' �� ', FAQ r. .. ... r. ....:.. "r aM,�',.•sl<.";.q N. 'it=g I ' - t I _ ._ - __ __-___ - 1 +,J"� � ___-NaI-_ - _-fi., ttl'„lz°' �rb yl.A ��:r,:'"• - 1'E79R:=R` =YDIS7:�.. k 2 5- 0xIFERSISIAD. _ >v •;�', �.r;.+',';.,' =t✓'�' '`y;ti" e"'- �>u ,i,•. ',�„_ ,fe. ;v Y-:11971= 959t r >i:'< r;r •”t '•,r' ,'°F;_' - ,z4,j,' ,�; �y`SOUTHOLD;N ,Q« ,r• =h`+;'<;�"_','' _ - ;`CIiECIC .NO`.�, �a4`0`14"•<=, r `.i'� 'ra°li'.'.I =,%• - =��- -- ESUFFOLK'C0.IIATIONAC'BANK: 'CUTCHOGUE;,NY'11935'�;r,,,�:, _ — - ;DATEa`.—_ .aS`'n '` -_ _ - - - •`r(" i 'I':a ',,I I�'' In' n q"�t'dt' 1� �. _"-- -_-__' _- -,"_- �{,... 1'dl "i�,da`9du}?`, 'd••3,1�;o,. _ _-w t„ '8-._ .,a.F'. ;I' >' 's.tY�:I�"ns. ,li `It,;, `_ +'ul `d'. o'I'Ir st+� >I �1, -_-- - '•t-_'_':ac't.r...r ,I'<G"'. ' � ;a'" __ _ _ _ f• __ .t',, a.�i' __ — .,r'i„l,j.'��':,' '<'%'.1 n•� ls'4 L •i. t. 'd: �`J :0.4" 25 .20.17:` `.: ;e » l2'7'•:`6'6E:t„ 50-54812.14 ._� � D `6'6` ]OOf��DOI�LARS::° OEE• .HUNDRED'Y'TWENTY^,'SEVEN AN A' ,/,, }, _t,lt1, ,^I -- __ - '__ __ .:1'-- _ "i._<' _ _ - 'ki,,N r� �p,•�h,l �ul,t, ;-f�'_ ___ ___ - - - __ ,:'1; .,Ik•L.;It,�'„:y ,`-i;t,.�Y -- '_- -_-_- -- - ___- -_-_ r,5 •t;,.'. c'” -_ `-- - =:a`__ - -- ar�•i;t�"r1..r,, ':rs. -- .a-= -.a'_=`'i`"=== '`+, - - - - - +11'd- ''I't 'tl�a ri'74t�4�:• k' '3 - ___ - - =�r• �y? �'i I�''p ;t.'1,}I Id'.,•1d ,'r,• _ Fa.: r •_ __ f.: ';'1• - -3,i:^�•.N',.;t� �S; •�,..tt.hJ ,F,,�,:�6:-!x:^>,..J' a. 4�•, n.� n..l�ir J"v;.:l •,/:i „'L r te:. ;s; •,' � _$., �,� :�. Ham?., f,;;:d'., '.2'P., �E� Ip ,Yia :I� a'7rr � _ '§(- - •'t�-_ `4k y,1�1:•E1 �"G vlf',1 sl 11}11.t;l illi+�i(f``.' `;'FS$HE h�+t.: +". ,,r..,„r."h', _ -_�_ - �- __ _- I«I,1's >.y;l„I •'1,, .v. "L:k,...i__ _ _ __-_ --*�� �r x��'J,,: �'„y�' ,Y;n,,'y,° _ .11 s{'•I =_,'}- :`rf - ` '•I'r 1, t `qi°lt`.I', I,i _ 1 t O�ITHE9•d' a ;'a1., 'al 1'„6''•;4 9',, rl'r' '`u; ,'I;PE 14.; GASH ';`_ u, :, I ,,, ,b• __ � !,q':•tJ,l ;,ri,� :eY 'd. �y1v.'-.c' __ _' -_�-_ - _- - __- _� A §'til Y•6;{ lilIEIF`.1r •''�' }.� �}yy II'` P'V,•`13'0X,d6`07�°:,} tl'fs �=a-:}'' '�/; -;� t•' a:l, ,ti t§`ar ,t� ;;{'=:t,v y/;�},t`,°� ,➢aS'. t Yy.yv r, FISHERSj„ISLAND t, ?rNY"';06>3'9.0` Y'1.,'',: , , • :;,= '< F;,;•,;.�_ _ - _- k'`r;."A ,11, n l� 1:,'I,,I+� �"f? - - iuj,•�:,"'1'-'�Ppd,�'n 4i'' !ti"1'r,l'fi�t' F�=` - -f'i"r ',1"a- °� = - 1','�u r•" I."I'll`„".1 ..l'r� ,1 - -"�)'� d F,'ll lt.. .p� Irllt;.,Ioi@'r' rll {I I. ;'k�' _ - _- _ r _-off:.=1;:_,.' '>,..:a•___-'°_ ',y51 'r•'p,r _ c[ir -- - -- _ "- _ „li, - - - --' -: " - -`6= .k<_- - = '.k 4r, r'llii'll:,'3lrllt villr'.'ll ;.I 11� .}".r - -" -"- _"' __- _ _ 'j•Pj�i"f•�,P I "II teat}'�.i .I' t.q.te' - - __- ,. o 0 '4.0 1 4 iii. ',;i '..0 I'2,,�i4;�=5,1'i;,6`4 f: ° 6`8' -D 0` 5 0 2 'i' Vendor No. Check No. 'down of Southold, New York - Payment Voucher 6373 4014 Vendor Address Entered by P.O. Box 607 Vendor Name Fishers Island, NY 06390 Audit Date Fishers Island Ferry District PettyCash APR" 2 2017 Vendor Telephone Number wn Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number E REPLENISH 4/17/2017 $127.66 $28.29 CVS 1st Aid RP SM5710.2.000.200 $10.00 WALGREENS Distilled Water for batteries MU SM5710.2.000.100 $1.57 CVS Distilled Water for batteries MU SM5710.2.000.100 $10.05 TRUE VALUE Key for MU SM5710.2.000.100 $1.29 WALGREENS Distilled Water for batteries MU SM5710.2.000.100 [ $14.83 HOME DEPOT Spray Foam RP SM5710.2.000.200 $61.63 HOME DEPOT Velcro for Signs RP,MU SM5710.2.000.000 f ° E $127.66 $127.66 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 venfied with the exceptions due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and payment is approved. Signature ! � tle Signature (� 7 Company Name Fishers Island Ferry District Date 4/13/2017 Title Date ( / x, 13,l� 2`� ➢ 2 r � _ � ► 5 r� 3- 3,P f >� 1 y 3 tvC, - -Lq, 83 33 3 r e o,--- D . m.• t 6• d � R . 3-g t i 4 I I - ( j I (I I I!I 1 VS/pharmacy� i 817 BANK STREET NEW LONDON, CT 06320 860.443.5359 I !: REG#06 TRN#6558 CSHR#1176213 STR#1080 Helped by; KATHERINE F 1 CVS INSTNT COLD PK 2PK 4,99T 4.99 EACH 2/OR MORE 0 4.50 EACH I 1 CVS EYE OINTMENT ,125 11 ,49N 1 i 1 DERMOPLASTiSPRAY 2.75 11 .99N / i ! I 3 ITEMS G�j SUBTOTAL 27.97 CT 6.35% TAX - .32 TOTAL 28.29 CASH, , 40.00 CHANGE 11.71 1 - I Illillllll IIII III IIIIII IIIA IIIIII III , i 2501 0807 0416 5580 68 j RETURNS WITH RECEIPT THRU 04/11/2017 FEBRUARY 10, 2017 10;06 AM F=FLEXIBLE SPENDING ACCT SUMMARY' (FSA) Health Care Eligible Total 5 31 FSA summary above includes items (and tax) that may be eligible for Plan reimbursement. Restrictions may ar+}ly. i GET YOUR CVS EXTRACARE CARD THANK YOU. SHOP 24 HOURS AT CVS,COM 1 I r cvs/pharmacy"' #10483 698 BANK ST 817 BANK STREET NEW LONDON CT 06320 NEW LONDON, CT 06320 860-446-3566 - 860.443.5359 232 0123 0022 03/03/2017 10:13 AM REG#02 TRN#8590 CSHR40922136 STR#1080 NICE DISTILLED "WATER 1GL ++� 04902251745/ 10.00 Helped by' GAYLE Jr 10,-@ 1.29-or 2/2!00 �7 RETURN VALUE 1..00' ea ; 1 CVS DSTLD WTR 1GL 1,57F _ - - r� 3N „TOTAL )� ,10.00, TOTAL 1.57 CASH :,10.00 ! CHANGE - , - = -00. CASH 20,00 CHANGE i8,93 THANK,YOU FOR SHOPPING AT WAL ' TO ' .` TB WIIIIIIIIIIIIIiiIIIIIIIIII�IIIIIII GE M RE WI H, ALANCE RE ARDSGREENS REDEEM POINTS,•FOR'SOMETHING EXTRA IN'A,,,FUTURE;;RURCHASE:,,RESTRICTIONS Y 2501 0807 0628 5900 23 APPLY. 'FOR TERMS AND CONDITIONS, • RETURNS WITH RECEIPT' THRU 05/02/2017 VISIT WALGREENS, COM/BALANCE. , ; MARCH 3, 2017 10;04 AM i RFN# 1048-3220-1231-1703-0303 IIII IIIlillll II Iillllllllllillll III Illiil IIllillllllllllli IIIIIIII GET YOUR CVS EXTRACARE CARD THANK YOU. SHOP 24 HOURS AT CVS,C O M balance' " award ,-_, POINT BALANCE 2050 - POINTS TO $5 REWARD 2950 { BALANCE REWARDS ACCT # *********5755 OPENING'BALANCE 1950 EVERYDAY POINTS - RETAIL 100 :;,"ING BALANCE 2050 THANK YOU FOR SHOPPING AT CASH TRUE VAL:U[}MYSTIC (860) 536-,960) STORE HOURS MON-FRI 8--7 SAT-SUN 8-5 03/04/17 12:14PM HFHR 567 SAIF KEY-S-- ---- --- - 5---FA__ +-1 .89 EA � SINGLE 5IDID KEY 9,415 i SUB-TOTAL:9: 9.45 TAX: $ ESU TOTAL: � i'.� I CASH TEND: 10.05 70.i j �I ISI! I I�IIII�IIIiIII�lii IS�iI : ==>> JRNL.#G52396 «_ I CUST NO:*5 CLISt'omer Copy NO RFEURNS AFTER 90 DAYS NO RETURNS WITHOUT VALID RECEIP'i �j '410483 698 BANK ST,�O �ES C� NEW LONDON, CT 06320 `M V`1-1 860-440-3566 r2 2.62 8017 0021 03/027 10;07 AN ore saving. NICE DISTILLED WATER 1GL A More doing," ki 04902251745 1 .29 RETURN VALUE 1 .29 f 816 HAP.TFORD TPKE -WATT-WATERFORD, CT 06385 TI)TAL. 1 .29 RICH%BRhDLEY, , TORI: MGR 860)437-1900 CASH 2.00 // CI�ANC,k: 0.71 621)15 00007 03207 03/24 ]7 08 10 AM CASHIER KAREN �/� THANK YOU FOR SHOPPING AT WALGREEN5 1 07t �8188365 DAPTE�'(F?VUS<A> DApTE-X�P_L-U�_FGAM'�HITE 12 OZ CID YOU KNON THAJ YOU CAN EARN- POINTS 2Q6:97-. 13.94 ON TH6USAIiDS O': 1101Q 1 (N-STORE AND MSUBTOTAL 13.94 ONLIN!-9 SFE OUR '4Ek KI'.' AD FOR (MORE I SALES°TAX INFORIiAT_16`' ITEMS "�Isti,IGE WEEKLY RESTR(CTlfDNS_A.P,'?; r!; TER111S -AND �,�7y TOTAL ,_ $14.83 � iU, VISI r ���� GRI 1jn 1 r �� CASH 20.OD CUIN71 i ION(), VISI (;til GRI Lt-6 (.0 /BALANCE. CHANGE DUE 5.17 - - RF1dt, 1048-3i 1E-01 1 73-- 703-0203 �� �����i$►�����j •�a��►i����,���►i ���i►����� IIS�I Iii 1 If II II IIIlilllll IIIIIIIIIIIIIIIIIIIII IIIIIIillllllllllll III 6215 07 03207 03/24/2017 1132 I RETURN POLTCY DEFINITTONS 'bal,erlce -v POLICY ID DAYS POLICY EXPIRES c�PJ A 1 90 06/22/2017 THE HOME DEPOT RESERVES THE RIGHT i0 Gec the flu shot tkat hers provide LIMIT / DENY RETURNS. PLEASE SEE THE ' a lifesavin .vaccine to,a c�!ild in need. RETURN POLICY• SIGN IN SORES FOR Get. a Shot. Give a Shot, It's that easy. DETAILS. Learn more at the pharmacy, - BUY ONLINE`�IGK=UP�IN-STORE F��39*� ��� 4�� � r AVAILABLE>NOW ON HOMEDEPOT-C M. Enter our monthly sweepstakes 0r CONVENIENT, EASY AND MOST OC cash - WWRERUIWIN LESS THAN 2 HOURS! =� Visit -WOPW.WALGREENSLISTENSIOM 1, 0 Cl 0 Cco CD MCCDCCD _n Cn �CV) X,1- 1-� rvvC-) r-f nCD• C7 CD C7 CD 20 WD OCJJO�pO fll0 SIS) i +J CJ CG F CSI O �� w CD+-4 00 CD r O p�\ 7J r_ xN)=�l Cl MS) o I o c <C �� ym mX z cerci - -1- 3__4Cn0 CD Cnv C7(7707-I Cn Cn NSl S:0 1RT SIC OD C)M D.ODC =0 It 3:KMM �m cn Cn(f)cr,---i r w c'====Dm-1 __q_V rx MC-) 17� 33 = r—cn o F1 Z7 n --i: 3 D 0 0 D -10 u>D=c o 9)--(v• :;0rn m s7 D r z n M n iTi X c y � H D C .Z_7 C in C 3 Cn Z \ Cb M -C C CD M x -4 CF) �. N [A v v, v C31 , • w c N� 01 � NT.l -iN µ j�p CDF)OOO t- .Cl)__j CnwCn - 00 µO w0000a7cD COO 2CD oa -4o OOO CJWCn (3) oUl 3 I I - t I I • ` - , ___________I I_v_u_______I 1_---_ _____1 k______._____I ____I J__________rl I__ u-u .-I tu_ - I it I ,I FISHERS ISLAND FERRY DISTRICT J VENDOR 007237 GILBERT ASSOCIATES, INC. 04/25/2017 JCHECK 4015 FUND & ACCOUNT P.O.# INVOICE( DESCRIPTION AMOUNT SM +.5710.4.400.1001, 2017-351 PROF.SVC-3/1-3/17 2-,700.00 SM .5710.4.400'.10'0 2017-360 PROF.SVC-3/20=3/31/17 380.00 TOTAL 3,0`80.00 ' r I ` 'V•-............ ,..ice "y= .... ...`�.'..:�4. :e rr"y, } I t j f � r - 4: ,°' ISHR: iSLA1VD RERR'Y'D S'TR7CT'1 __ A' Jiq•.; z' �r' rs< .. �P.i7DIT:.'© /`25`/1-'7 ,.. t453095,A(IAIN•AOAD;.PO ,. _ ' �.. .SOU7HOLp;NY 1,1971=0959.` - �'�O� - •,i •v t. .I• 1 - -- - °TH�"SU�FO'C CO AT��ON L�t}ANK`s _ i AATE,�_ AMOU ; ,' _ T .I,p' `al ,I, ,11,1,i- - -- -- _ i{I'I S > Jd'�r1�`.„ ,,�-v 1,•u _-_ :� = s - _ _ d nl"J' '{°3'frid fl yllc:.l lal, L',+ - - -- >'.-- ;ii`. !'F ate• - ',;:�'.'``=� D 4"- f5 2' TT°• � 3' :0$0'<d D'd; "f I "ZGIi� �'s'00�.1'0.0':DOItLARS':�° + �.THR$E`='THO�7SAND.:E TY 9:AND , c1 - - I''P., ",d`" - __ _- - - __ _ ,tl,'A�• :°J.,,,r,a P':�"�1�"<;'0;'i 1`�w`� - -i - - __ - -a; II .a{d fll'„i'll:I;,;•ir,Ui„ - _ _ __ I}I ,Ila, ,I at.• 1� - - - - - - - - - '�tl'' +I !J A{I .,I '{,II',ri,l, - _ - _._d-= - d tll ,',•-x , 3 I iA d'3 - _ - _ _ _ �'I•, i;k i' I. 'll' .,- -- '1 'V�1Y It 11�I�u' f,n - _ _- _ i, 4.• `i�.`t• '�GILBERITt� TTSSOCIATES_- -INCr.. I• ">,,','r�'�I _- -- - = II 3, { �i;i',,.1,.t. „I,,;I?"+ r:_ IW4���:i,ir,;1'0"1h��,G�2:1SS�MAN�-D1ZIVE -`=�UIT�`-r�9`<,05•.�;1+,1',',h,;',I,�;�.,i;;ll" ,,I, ',II' ;,�i"+. - - -- = I�,�,ib- I,I ',��,1'+,, ,,III+ RbER:: - -- :_- "l"l3'RAINT LEEN:MA`.02'184,, ,t' s Y " - - ,, _ -_ - III,• r,{j<J III'r ir„ -.1„I - - __ - - -_ -_ - - - vl IbV x+7'8' 'rel{'1� - - 'I n t' ,Iiia„�� lyll's•L``� a` - '3` - - - - - 1. -- _- __- - - ia'•;' '�1' dl's' �_ - _- - - � - - - - - i1' ',1'•' I,�;�;�,I;,I,,P al''ii,.. - - .t=_ •1 ill ,'i ',I'.141 iPr 4,+t�- - - - - - - - -_ - ��^ P��Y -1 .rlt "�i - -- - _ �i''., 'la, i irr'•� - - ..=-p” Sill,!1:021.40„ 1n;+°`�."n`,i'.' �`a8-aE___o0; -^.0:. ,':` :14- Vendor No. Check No. Town of Southold, New York - Payment Voucher 7237 LA01 5 Vendor Tax ID Number or Social Security Number Vendor Address Entered by 100 Grossman Drive, Suite 205 Braintree, MA 02184 Audit Date Gilbert Associates, Inc. Vendor Telephone Number --- 781-740-8193 Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 1.7 2017-351 3/21/2017 $2,700.00 $2,700.00 3/1-4f/17 Race Point DWS& LCG plus expenses SM5710.4.400.100 - -$2,700.001 1 $2,700.00 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 Signature Title Signature /r I Company Name Fishers Island Ferry District Date 3/28/2017 Title V p Date 6 ' Gilbert Associates,Inc. x , 100 Grossman Drive Suite 205 Braintree, MA 02184 Invoice T Bill To Date Invoice# Fisher's Island Ferry District PO Box 607 3/21/2017 2017-351 Fisher Island,NY 06390 P.O. No. Project No. Due Upon Receipt C-1147 Race Point 3/21/2017 Description Hours/Days Rate Amount For professional services rendered from March 1,2017 through March 17,2017 including:deadweight survey and stability submission,review fbds,draft,weight from deadweight survey, check regulations and stability calculations for deadweight survey Time: Karyn Cox 19 90.00 11710.00 Gerald E.Gilligan 9 110.00 990.00 pz W Total $2,700.00 Vendor No Check No. Town of Southold, New York - Payment Voucher 7237 L1015 Vendor Tax ID Number or Social Security Number Vendor Address Entered by � 100 Grossman Drive, Suite 205 Braintree, MA 02184 Audit Date Gilbert Associates, Inc. APR 2 5 2017 Vendor Telephone Number 781-740-8193 Town Clerk Vendor Contact �, ��,)2 •/J/J Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledgei Fund and Account Number 2017-360 4/4/2017 $380.00 $380.00 3/20-31/17 Race Point stability, conf and emails SM5710.4.400.100 $380.00 $380.00 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 Signature / Title Signature Company Name Fis tens Island Ferry District Date 4/19/2017 Title Gilbert Associates, Inc. 100 Grossman Drive Suite 205 Braintree,MA 02184 Invoice Bill To Date Invoice# Fisher's Island Ferry District PO Box 607 4/4/2017 2017-360 Fisher Island,NY 06390 P.O. No. Project No. Due Upon Receipt C-1147 Race Point 4/4/2017 Description Hours/Days Rate Amount For professional services rendered from March 20,2017 through March 31,2017 including:stability,telephone conferences and emails Time: Karyn Cox 2 80.00 160.00 John W.Gilbert 2 110.00 220.00 i Total $380.00 Cr• , FISHERS ISLAND'FERRY DISTRICT VENDOR 008081 HARVARD PILGRIM HEALTH CARE 04/25/2017 CHECK 4016 I FUND &' ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 74705109817 MEDICAL PREM(21) —MAY'17 18,591.51 , TOTAL 18,591.51 _ I 1 1111111111 B ___ `.L.``v r.•>s.- =" .«r ...i --2tb .'..XS'.:;.::";'.,.(a":..'T..:.,`T" —cx 7 i I I I , I I r- _-__ '%'f`-•`;; ; '.`.4t:.7t+2''FISHERS3 . ', N`D=FERR•Y',DISTRIGTr:° ,IS I, ;'53095•M'AIN•ROAD,PO•BOX':1 .r ySOU,TFiOLD'°NY 1`1.971=0959` .,r; _ .t.•.<' I b `THE' ' F rtLkOi N T ON L' K" ,S 1,,0 G A A: A, -_ - - - = I I'i ,III` TC GU "'N 1,1935 AT - "AMO,UNT.;,,;t',',=.y I' `dn It 11. '1° '°'• - --_ - -e - -- ''°4 r,1+' u y, 1 k 1p„y.9."' - _- - -_ _ - - ,i'. ..,'. `'8I„I .I '' .h .S k,111"' 14'4f f§: -ry. "' ° - __ EI q [``ql.,I, II,•,II. =,1'a _-_ - '1 •4 dI" aI'1'1'dI 4; ''PIS 'Ilii `- ;' `>=3,'sn04x;/.2St'-5n't,/<2 917 $-1'8,-,';5 8;;5,t<9,1'--5 5iDOEINILARN .TLfANiE 'rN „JE:. 1 ` ,. ''. J,_F n,,1,a, rk7;J _ _'•`_ .`5_ 3' - - .__ _ _ _- '” -_-_ :'1,11„ nI" il' .,I,. r'r:F f -n=- -- __ - n - -_ I „ II .,{ :'I: .i•'"C.. '.P, - r _ - - - ' ` - _ _- 'I'+ 'P 1'I "I"''I'li iilri hll't 1 - '1'll €'ll'J ,'gin,8 IJ ,'s - _, •__ '__- ,'.a.` 4• 0',4'` -'C,.tiJRt - e 1' •33 +j °,Y, it F,w H I 't 'i' ,a .fi:.l ,l 11 a t.`(' I'HARUAR'D`''PILGRIM .HEALTH..,CAREi I"rN ,, ,i,-ir b': '.;: .i;yl,llr,; _ ,a__ _ ,, ___ =_"t {, 'a„ ;`4" b,illi ah __ I i„ '- __ :__ __ ___ _ , 4"'r], 1 Ute' d "J`SI k','; ______ __ __ ____ _'_ "fl'cP J' II','1%'Pi',P,1• 170,0`50 yRLR NF , - - ,- _-.; '--.` =f r 1,:">s< ;Ili',}li' ',r• yn„, "L,.- A9 0050 - ? '?' :`• i,hn.i ,,;1 ':,;'r ` ' ic` ;,,,.7,4 - 1 " 1 I ''1''I t •'1 I 11 'k Iq - _ - _- -- t.11l' ,1, ,Qj.._ - ,I z`n a 'illl"•I„il rl• - -- _ =A -__ - __ _ .I a II'.r 1, ' ',",,; !,r•.(i ,4” : ' _ _ ____ _ •I'a.be .q'i r,il•4 G __ _ _ _ _ I`x'.:e' _ _ -- _ - :'`?' .•'f,,', I, {',i.,'ll Iii,,iu,l'> 1 - _ _ - ,y;x -01 0 '2 .y ^E:"•M..^I," _ __ =_=__r.,,01F31" 'it0''2"L 4'0 5'464 :' 6`8 .00 L 5'0 2'. u•'. Vendor No. Check No. Town of Southold, New Fork- Payment Voucher 8081 o1 r. Vendor Address Entered by PO Box 970050 it Datd Harvard Pilgrim Health Care Boston, Mao 02297-0050 _ APR 2 5 201 7 Vendor Telephone Number Tciwn Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and'Aecount Number 74705109817 4/8/2017 $18,591.51 $18,591.51 May 17 Medical Premium (21) 5M9060:$.000.000 dv . $18,591.51 $18,591.51 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. Signature V �p Title Signature Company Name Fishers Island Ferry District Date 4/14/2017 Title Date Z�L 20 /--7 Harvard Pilgrim 4 .. Healthcare 000607 IMPORTANT:INVOICE ENCLOSED ATTN:DIANE HANSEN INVOICE#: 074705109817 FISHERS ISLAND FERRY DIS INVOICE DATE : 04/08/17 261 TRUMBULL DR BILL PERIOD : 05/01/17-05/31/17 PO BOX 607 PAYMENT DUE ON/BEFORE : 05/01/2017 FISHERS ISLAND,NY 06390 TOTAL CONTRACTS 40 CUSTOMER ACCOUNT#: 0150930000 TOTAL MEMBERS 40 PREVIOUS BALANCE $ 37,690.53 MEMOS $ 0.00 ADJUSTMENTS $ 0.00 AMOUNT PAID $ -18.387.14 BALANCE FORWARD $ 19,303.39 1L CURRENT PREMIUMS $ 8,591.51 TOTAL AMOUNT DUE $ 37,894.90 Any enrollment transactions or payments applied after the 5th will be reflected on the following months invoice. For questions regarding your invoice please call Account Services at 1-800-637-4751. HPHConnect allows you to perform transactions online"real time",please go to www.harvardpilgrim.org to logon. Including Harvard Pilgrim Health Care of New England,Harvard Pilgrim Health Care of Connecticut and HPHC Insurance Company FOLD AND DETACH AT PERFORATION ' ,, I I , I I I I I I I __-_-___I I I i FISHERS ISLAND FERRY DISTRICT VENDOR 011637 KROP, ENVIRON,CONTRACTORS, INC 04/25/2017 CHECK 4017 ; FUND & ACCOUNT ^P.O.# INVOICE DESCRIPTION AMOUNT SM .5`710.2.000.200 17 (S),138 RP—TANK CLEANING SVC-4/3 1,499.54 r TOTAL 1,499.54 i 1 l v:•:• s;. •d'n' . j r , S tl t 1 I i i t r- I ,'__ FISHERS:ISLA'10=F.ERIZ=Y,&YMCT,£, ' ; . Army";0`4. 2'5 17 •a+,. -t "ter rcJ.-,.":t`r"-,:.;T:. y,! >,Y. '' "• x . ' ?7tSO JTHOLD,,NY;:11197,1-0959' ,`1,ds P..FI";',,=•'F < s #e THE,BU 000L CO NATI6N7iL A _ "r ,•,,; DATEAMOUNT'':;;;'",;`, j CUTCHdGUE;°iN,Y' 11935:f; _ a, n n llr d,l' 4<,t = - - t,t• „IrrL , , • 4 „Ph, •-- ^,C ~t -_ - --''.- af:',em•P 'a " >t•:Pnw4+t1-`•e`<';k'" 4 '•Y :'J`•:••,.-'„ a,. r. ✓' - :>. 5,a }-..,04`)'25` 20171'•;t,, - 99,::54£,' i' F I7"s+s;- Sg••.,; .j- ,,'; kar tt' I"s <7,4a•: s'4 <i'sS„3•t',s -t£ -;, 't 50-546%2m :;,,#,r rt;, hs,?• :tj= ;ni' ° ,::.i =`;E`. '~P d,,r.f+< -,,1;" - 'c .- `4.l^``3"f::1"A.m`•.R R /• h. i ^ f '1 ,'l..' 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'E'8 =0 0 150 2",..L<1ie— Vendor No. Check No. Town of Southold, New York - Payment Voucher 1.l 637 Vendor Tax ID Number or Social Security Number Vendor Address - Entered by PO Box 258 32 Exeter Road Audit Date Kropp Environmental Contractors Lebanon,CT 06249 APR 2 5 2017 Vendor Telephone Number 860-642-9952 Town Clerk Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General hedger Fund and Account Number 17(S)138 4/3/2017 $1,499.54 $1,499.54 Tank Cleaning Services 4.3.17 P SM5710.2.000.200 2-4 u o�t� $1,499.54 $149954 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 Signature Title Signature Company Name Fishers Island Ferry District Date 4/14/2017 Title Date .< PO Box 258 Invoice 32 Exeter Road Lebanon,CT 06249 Date Invoice# ENlltft0NMMTAL CONTRACTORS. PH:860-642-9952 FAX:860-642-9953 4/3/2017 17(S)138 Bill To Job Site Location Fishers Island Ferry 5 Waterfront Park 5 Waterfront Park New London,CT New London,CT 06320 Terms Description Qty Rate Amount KEC Project Location:5 Waterfront Park New London,CT KEC Project Number:17(S)138 Monday,April 3,2017(Tank Cleaning Services) Scope of Work I(Provide waste water tank cleaning service,Perform OSHA 1 1,095.00 1,05.00T confined space entry,Disposal on site) Field Technician,A.Deschamps,per hour 3 55.00 165.00T Utility Truck,per day 1 75.00 75.00T Power Washer Rental 1 75.00 75.00T Sales Tax/9429978-000 6.35% 89.54 /J Total $1,499.54 A finance charge of 1.5%per month will be charged on Payments/Credits any invoice that is 30 days past due.All accounts are $0.00 subject to&ornery and colledtion fees. Balance Due $1,499.54 :, ENVIRONMENTAL CONTRACTORS, INC. P.O.Box 258 Phone:(860)642-9952 32 Exeter Road Fax:(860)642-9953 Lebanon,Connecticut 06249 www.kroppenvironmental eom March 29, 2017 Mr. Geb Cook District Manager Fishers Island Ferry District 5 Waterfront Park New London, CT 06320 RE: Quotation for Sanitary Tank Cleaning Services 5 Waterfront Park New London, CT 06320 Dear Mr. Cook, Kropp Environmental Contractors, Inc. (KEC) is pleased to provide this quotation for wastewater tank cleaning services at the above referenced address in New London, Connecticut. Scope of Work Provide onsite all labor and equipment required to perform the following tasks: A. Perform OSHA certified confined space entry into the bilge to get to the sanitary tank. B. Provide onsite one (1) foreman and one (1) skilled laborer to unbolt side manway and remove solids without entry by shovel; C. Spray the tank with bleach and clean the tank with simple'green. The cost for this Scope of Work is One Thousand and Ninety-Five Dollars per day ($1,095.00)portal to portal.This quote as written provides for the following stipulations: ® Waste remaining in the tank will be pumped down prior to job commencement. e All liquids waste will be disposed of onsite as directed and pumped by others. Payment is due upon job completion. The owner is responsible for providing electricity and water to the work area(s). All work will be done in a workmanlike manner, in a reasonable length of time, and according to state and federal regulations. A finance charge of 1 1/2% per month (18% Annual Percentage r� Quotation for Sanitary Tank Cleaning Services 5 Waterfront Park New London,CT 06320 Page 2 Rate) will be charged on all invoices 30 days past due. All accounts are subject to attorney and collection fees. KEC is a Connecticut permitted Emergency Spill Clean-Up Contractor and licensed Hazardous Waste Hauler(CT-HW-690); a Rhode Island licensed Emergency Spill Clean-Up Contractor and licensed Hazardous Waste Hauler (RI-804); a New York licensed Hazardous Waste Hauler(CT- 138); Asbestos Removal Contractor (CT-000302); and, a Tank and Pump Contractor (P9- 00279287).KEC also has a Licensed Environmental Professional on staff(License No. 576). Please feel free to contact me at 860-642-9952 with any questions. Sincerely, Ai Sally W. Kropp President APPROVED: DATE: I - KROPP-2 OP ID:MS ,d►coR®� DATE / Y)CERTIFICATE OF LIABILITY INSURANCE 03/30/2017 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(ies) 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 Brown&Brown of CT,Inc. NAME Mallory Penney POE 55 Capital Blvd.,Ste.102 AHCNNo. Ext 860-665-8416 FAX No): 203-639-0031 Rocky Hill,CT 06067 ADDRE Tom Stahl SS:MPenney@bbhartford.com INSURER(S)AFFORDING COVERAGE NAIC i INSURER Homeland Insurance Co of NY 34452 INSURED Kropp Environmental INSURER B.Atlantic Specialty Ins.Co. 27154 Contractors,Incorporated Shire Environmental INSURERC:AmGUARD Insurance Co Corporation INSURER D: 32 Exeter RD Lebanon,CT 06249-1317 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. INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS LTR NSD POLICYNUMBER MM/DD/YYYY MMIDD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FYI OCCUR 793-00-54-89-0000 11/22/2016 11/22/2017 DAMAGE TO RENTED 100OO PREMISES Ea ocanence $ MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,00 X POLICY PR - ECT F—]LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaacad.ra $ 1,000,00 B X ANY AUTO 793-00-54-90-0000 11/22/2016 11/22/2017 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Peraccdent) $ NON-OWNED PROPERTY eOrac dent DAMAGE $ HIREDAUTOS L I $ AUTOS UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,00 A X EXCESS LIAB CLAIMS-MADE 793-00-54-91-0000 11/22/2016 11/22/2017 AGGREGATE $ 3,000,000 DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN C ANY PROPRIETOR/PARTNER/EXECUTIVE R2WC873007 01/04/2017 01/04/2018 EL EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 1,000,000 If DESCdescribe under RIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT 1$ 1,000,000 A Pollution Lialti 793-00-54-89-0000 11/22/2016 11/22/2017 Pollution 1,000,00 A Professional Liab 793-00-54-89-0000 11/22/2016 11/22/2017 Prof Liab 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION FISHERS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Fishers Island Ferry THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN rY ACCORDANCE WITH THE POLICY PROVISIONS. 5 Waterfront Park New London,CT 06320 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD luleanHarbn LT Clean Harbors Environmental Services,Inc. , q 770 Derby Ave l� Seymour,CT 06483 www.cleanharbors.com March 29, 2017 Attn: Mr. Geb Cook Fishers Island Ferry District Po Box H Fishers Island,NY 06390 Quote#2632423,Fishers Island Ferry District,New London,CT Dear Mr. Geb Cook: Thank you for considering Clean Harbors Environmental Services, Inc. for your environmental service needs. We provide a,•broad range of environmental services including hazardous and non-hazardous waste-transportation and disposal, laboratory chemical packing, emergency response, field services and industrial maintenance. We are pleased to provide-this proposal based on the scope of work outlined below. We offer our clients a broad spectrum of environmental services and the ability to dispose of hazardous material at or through a Clean Harbors' owned and operated facility. In addition to managing your waste streams, a Clean Harbors',professional can assist you with: • Waste Transportation&Disposal 24-Hour Environmental Emergency Response • Laboratory Chemical Packing Industrial Services • Field Services InSite Services I look forward to servicing your environmental needs. When you are ready to place an order, please contact our Customer Service group at 800.444.4244. If you have any questions or need further assistance,you may reach me at the number below. Sincerely, Todd J Vasiliou Field Service Supervisor Phone: 860.583.8917 r0"People and Technology Creating a.Safer. Cleaner Eni,ironrnent" leanHarbor March 29,2017 Page 2 of 8 Clean Harbors Quote#2632423 QUOTE CONDITIONS The proposal is based on the following assumptions and site conditions. Any work which falls outside of the assumptions will constitute work beyond the intended scope and be completed upon mutually satisfactory terms. Fisher Island Ferry will provide the vacuum truck to remove the waste. CHES will,set up for a confined space entry to enter the bildge. CUES will remove the side cover of the sewer holding tank and vacuum out contents. CHES will follow the scope out work that was provided'to us by Fisher Island Ferry. Procedure of cleanout of 1400g Sanitary holding,tank on Race.Point. 1.Pump out tank down to residual solids(estimate 4"or-65g solids remaining) 2. Set up for Confined space entry including:', a.Ventilation of space b. Tripod extraction device " c.Monitoring of space with 4 gas meter s. d.Level C ppe w/-respirator(Tyvek suit, latex'gloves, pvc gloves,) 3. Enter space and approach side manway of.8'L x 5' W x 4' deep holding tank. a.Entrant to remove all bolts from manway and place in bucket. b.Remove manway—product/solids is expected to be below manway. 4. Solids removal. a. Insert hose from sanitation truck and/or wet dry vac, into manway. b. Vacuum out solids c. Spray bleach into tank and all surfaces— 1 to 2 gallons. d.Utilize shovel/garden hoe/squeegee to pull solids to manway e. Once solids are removed rinse out tank interior using floor mop and rags to wipe all surfaces with simple green. f. Pad tank-dry. i 0"People and Technolegv Creating a Sq fer. Cleaner Environinenl" CleanHarbor5 March 29, 2017 Page 3 of 8 Clean Harbors Quote#2632423 QUOTE CONDITIONS g. Vent space overnight until dry. CHES will not be entering the actual sewer tank. All work will be done from out side the manway. This quote is based on the information given. Any additional work out side,the scope.provided will constitute a change order,Example entering sewer tank scraping and pressure washing. 0"People and Technology Creating a Safer. Cleaner Environment" lleadarbg March 29,2017 Page 4 of 8 Clean Harbors Quote#2632423 SANITARY HOLDING TANK CLEANOUT TOTAL LABOR,EQUIPMENT,AND MATERIAL $3,000.00 $3,000.00 per day,estimated 1 day GENERAL CONDITIONS • Except where superseded by an existing services agreement the following terms and conditions apply to this quoted business. • The customer hereby acknowledges that the estimated cost is based upon a preliminary appraisal by a Clean Harbors Field Representative, and that the amount invoiced by Clean Harbors will be based upon labor and materials actually expended in performing the scope of work. Any changes in the scope will be billed on a time and materials basis. • Clean Harbors guarantees to hold these prices firm for 60 days. • Terms:Net 30 Days • For work to begin we ask that you acknowledge the quotation with a signature and provide the appropriate purchase order number. Where modifications to the scope of services become necessary, Clean Harbors will notify the customer promptly,and obtain customer authorization for such modifications and a revised contract price will be established in order to finish the proj ect. • This proposal is contingent on the customer providing full and complete access to the site. Customer represents and warrants to Clean Harbors that the customer has the legal right,title and interest necessary to provide access to the site. In addition, customer warrants that it has supplied Clean Harbors complete and accurate information regarding the site, subsurface conditions, utility locations, site ownership, hazardous materials or wastes and other substances or hazards likely to be present and any other reports, documentation or information concerning the scope of work. • Interest will be charged at 1.5% per month or the maximum allowed by law for all past due amounts. • Disposal will be managed within the Clean Harbors Network of Approved Facilities. • Local, state and federal fees/taxes applying to the generating location/receiving facilities are not included in disposal pricing and will be added to each invoice as applicable. • Materials subject to additional charges if they do not conform to the listed specifications. • Electronically submitted profiles will be approved at no charge. Paper profiles will be charged at $75.00 each. • Clean Harbors supports many invoice delivery options (E-mail, Electronic Invoicing, EDI, Etc.). Pricing is based on Clean Harbors' standard invoice delivery method of E-mail. If another delivery method is required there could be an additional service fee per invoice. Any alternate delivery methods must be reviewed and approved by Clean Harbors prior to acceptance and implementation. �1"Pevi31e and Technologv Cmatnz a Sgfer. Cleaner Eni ronrrrent" Cleanftbor5 March 29,2017 Page 5 of 8 Clean Harbors Quote#2632423 GENERAL CONDITIONS • A variable Recovery Fee (that fluctuates with the DOE national average,diesel price), currently at 10.0%, is included in our quoted pricing. For more information regarding our recovery fee calculation please go to: www.cleanharbors.com/recoveryfee. • Pickups that require same day or next day service may be subject to additional charges. • Pickups cancelled within 72 hours of scheduling will be subject to cancellation charges. • Transportation charges to the final disposal facility will be` charged in addition to local transportation Ito our truck to truck hub/local facility and will vary with logistics and routing. • Time over eight (8) hours in the normal workday and,all day Saturday is considered overtime and will be billed at 1.5 times the applicable straight time rate for all billable personnel unless otherwise quoted. Sunday and Holidays are considered premium time and will be billed at 2.0 times the applicable straight time rate for all billable personnel unless otherwise quoted. • This proposal is submitted contingent upon the right to negotiate mutually acceptable contract terms and conditions, which are reflective of the work contemplated, and an equitable distribution of the risks involved therein. In the event that such agreement cannot be reached, Clean Harbors reserves the right to decline to enter into such an agreement without prejudice or penalty. • In the event that legal or other action is required.to�collect unpaid invoice balances, Customer agrees to pay,all costs of collection, including reasonable attorneys' fees, and agrees to the jurisdiction of the Commonwealth of Massachusetts. t "Peolde and Technologv Crealing a.Safer. Cleaner Em,irontnenl > Cleanftbg5 March 29, 2017 Page 6 of 8 Clean Harbors Quote 42632423 ACKNOWLEDGEMENT Your signature below indicates your acceptance of the pricing and terms detailed in the quote above, and the Field Services Agreement in the following pages. Thank you for the opportunity to be of service. CUSTOMER'S AUTHORIZED Clean Harbors Environmental Services,Inc. REPRESENTATIVE OR AGENT Signature Signature Print Name Print Name Date Date' , Phone Purchase Order Number Customer Insurance Carrier ,r4"People and Techn01ogf Ci-eating a Safer-. Cleaner-Eni4i-t mint„ Cleadarbor5 March 29,2017 Page 7 of 8 Clean Harbors Quote#2632423 FIELD SERVICES AGREEMENT The Customer acknowledges that the estimated cost is based on a preliminary on-site appraisal by the Clean Harbors Environmental Services,Inc ("Clean Harbors")field representative and that the amount invoiced by Clean Harbors will be based on labor and materials actually expended in performing the Scope of Work Any changes in the Scope of Work will be billed in addition to the estimated cost specified above Customer hereby assigns to Clean Harbors all rights to any insurance payments that Customer may be entitled to receive to pay for the Services provided under this Field Services Agreement and hereby authorizes its insurance company or agent to pay Clean Harbors directly Customer agrees that all charges that are not paid to Clean Harbors by its insurance company will be paid by the Customer This Field Services Agreement establishes the terms and conditions under which Clean Harbors agrees to provide,and Customer agrees to pay for,Services In consideration of the mutual covenants contained herein,and for other good consideration,the receipt and sufficiency of which is hereby acknowledged, the parties have caused this Agreement to be executed by their duly authorized representative as of the date first written below STANDARD TERMS AND CONDITIONS 1. Clean Harbors shall provide all labor,materials,tools,equipment and subcontracted items necessary to perform the Services described in the Scope of Work Clean Harbors represents that it is properly licensed,possesses the requisite skills and shall perform the work in a professional and workmanlike manner 2 Customer shall provide full and complete information regarding the site,surface and subsurface conditions, utility locations, site ownership, contractor access,hazardous materials or wastes and other substances or hazards likely to be present and any other reports,documentation or information concerning the site or Scope of Work which may reasonably be provided to Clean Harbors Customer represents and warrants to Clean Harbors that Customer has the requisite legal right,title,and interest necessary to provide access to the job site 3 Clean Harbors shall procure and maintain at its own expense during the term of this Agreement the following insurance coverages Worker's Compensation Statutory Employer's Liability $2,000,000 General Commercial Liability $2 million per occurrence $4 million aggregate Automobile $5 million combined single limit Contractors Pollution Liability, $10 million each Claim $10 million all Claims The Customer agrees that Clean Harbors,liability under this Agreement and Scope of Work shall not exceed the value of this contract,or the amount paid to Clean Harbors by Customer,whichever is less.' 4 The payment terms set forth herein are contingent upon the approval of Clean Harbors' Credit Department In the event of a change in Customer's financial condition,Clean Harbors reserves the right to alter,change,or modify payment terms,and to immediately stop work The failure of Clean Harbors to exercise its rights under this article at any time shall not constitute a waiver of Clean Harbors'continuing right to do so Payment of the total estimated cost is required prior to performance of any service by Clean Harbors unless other payment terns have been established by the parties Clean Harbors'standard terms of payment to approved accounts are net fifteen(15)days from the date of invoice Interest shall accrue at the rate of one and one half(1 5%)percent per month,or at the maximum rate allowed by law,after fifteen(15)days In the event that legal or other action is required to collect unpaid balances or invoices,Customer agrees to pay all costs of collection, including reasonable attorneys' fees, which may be incurred by Clean Harbors "Legal or other action"as used above shall include bankruptcy and insolvency proceedings Customer's obligation to pay the amounts due pursuant to this Agreement shall not be conditioned upon or limited by the types,amounts or availability of Customer's insurance Customer agrees to pay Clean Harbors in accordance with Clean Harbors' published Rate Schedule ("Rates") for any litigation support or testimony provided by Clean Harbors in connection with,or arising out of,the work performed by Clean Harbors hereunder 5 In the event that work is suspended or terminated for any reason prior to the completion of the Scope of Work,Customer agrees to pay for labor, equipment,materials,disposal and other costs incurred by Clean Harbors at the Rates and for reasonable demobilization costs 6 Customer agrees that Clean Harbors shall not be responsible for pre-existing contamination at the fob location,natural resource damage,or for indirect,incidental,consequential or special damages,including loss of use or lost profits,resulting from or arising out of the performance of the Scope of Work by Clean Harbors,its employees,agents and/or subcontractors 7 The performance of this Agreement,except for the payment of money for Services already rendered,may be suspended by either party in the event performance of this Agreement is prevented by a cause or causes beyond the reasonable control of such parties Such causes shall include but not be limited to acts of God,acts of war,riot,fire,explosion,accidents,inclement weather or sabotage,lack of adequate fuel,power,raw materials,labor or transportation facilities,changes in government laws,regulations,orders,or defense requirements,restraining orders,labor disputes,strike,lock-out or inunction(provided that neither party shall be required to settle a labor dispute against its own best judgment) The party which is prevented from performing by a cause beyond its reasonable control shall use its best efforts to eliminate such cause or event ,'I"People antiTP.chnoloinv Cj-ea1`h1 q_ axSal'i". Cleaner Environment � Cleadarbo'rk March 29, 2017 Page 8 of 8 Clean Harbors Quote#2632423 STANDARD TERMS AND CONDITIONS 8. Clean Harbors agrees to indemnify,save harmless and defend the Customer,its parent,subsidiary and affiliated companies and their respective directors,officers,employees,agents and assigns from and against any and all losses,liabilities,claims,penalties,forfeitures,suits,and the cost and expenses incident thereto(including cost of defense,settlement and reasonable attorneys,fees)which Customer may hereafter incur,become responsible for or pay out as a result of death or bodily injuries to any person,destruction or damage to any property,contamination of or adverse effects on the environment or any violation of applicable federal,state and local laws,regulations,by-laws or ordinances to the extent caused by (1) Clean Harbors' breach of any term or provision of this Agreement, or(2) the negligence or willful misconduct of•Clean Harbors, its employees or agents in the performance of this Agreement Customer agrees to indemnify,save harmless and defend Clean Harbors, its parent,subsidiary and affiliated companies and their respective directors,officers,employees,agents and assigns from and against any and all losses liabilities,claims,penalties,forfeitures,suits,and the costs and expenses incident thereto(including costs of defense,settlement and reasonable attorneys'fees)which Clean Harbors may hereafter incur, become responsible for or pay out as a result of death or bodily injuries to any person,destruction or damage to any property,contamination or adverse effects on the environment,or any violation of applicable federal,state and local laws,regulations,by-laws or ordinances to the extent caused by (1)Customer's breach of any term or provision of this Agreement,or(2)the negligence or willful misconduct of the Customer,its employees or agents in the performance of this Agreement Neither party shall be liable to the other for indirect,incidental,consequential,or special damages,including loss of use or lost profits 9 The terms and conditions of this Agreement and Scope of Work and any CIean Harbors change orders or Clean Harbors'daily work sheets signed by both parties constitute the entire agreement,between the parties Additional,conflicting or different terms on any Purchase Order or other preprinted documents issued by Customer,shall be void and are hereby expressly refected by Clean Harbors In the event that any portion of this Agreement is invalidated for any reason,the parties agree that all other provisions of this Agreement shall remain in force and effect 10. Customer's representative or agent represents and wazrants to Clean Harbors that it is duly authorizedto execute this Agreement on Customer's behalf 11 The validity, interpretation and performance of this Agreement shall be governed and construed m.accordance with the Laws of the Commonwealth of Massachusetts and the parties agree to submit to the jurisdiction of the courts of the Commonwealth of Massachusetts for any disputes arising under this Agreement ,0"People and Technology Creating a Sofer. Cleaner Environment„ i t __ ___ _ ___ ________ f FISHERS ISLAND FERRY DISTRICT VENDOR 013564 MCMAS TER—CARR SUPPLY CO. 0'4/25/2017 CHECK ' 4018 - r FUND & ACCOUNT P.O.`# INVOICE DESCRIPTION AMOUNT SM .5710.2.000.200 ) 21497687 RP—BILGE MANIFOLD REPAIR t 1,070.95 -SM .5709'.2.000.200 21665610 NLT—SCREWS,HANGING .BRCKT 44.88 `SM .5710.2.000.200 22053464 RP—BILGE SYSTM RPR—PIPES 527.21 SM .5710.2.000.200 22403214 RP—BILGE SYSTM RPR—PARTS 310.57 SM .5710'.2.000.200 22404157 RP—BILGE. SYSTM RPR—PIPES 76.99 _ r- -` TOTAL 2,030.60 ?Yv k v.•rSo• ' \ I } -- t r r I a 1 ___ , 3 „Ili. -_ _ FIS S1sR _8LANi ;°HERR DIS7RI H AUjDTT •.0;4.%e_5"/ F ,. ',f`; a''•,. .,^ 53095 MAIN ROAD:.PO,BOX i;l'79;' ' r` ''_S^-_O-U-"T= OLD N:.StYr'aV-l,tO''i l S74G'9 'U7E1=r0 a9,5a 19 d K FOL CONATAONAC6 NJDAT CUTGHJIt, lio, 04 2- 5/- `f2_-- A 0 HIRTYA ;;=60 10 0DOLLARJ1'04,,, 1 0 8; '.„,.' - - '1,;,. • 9: ; ,r,l„t '1 ',, _ - _ -- __ =- -_ _ _.__ L'1''l1 °ti' - J. -_' - - - ___-- "1 - 714„ 'd l''4•,ti - __ _-' _'_ - -- fr - - ^,1MCNlA$'TER'-CA12R -' _- '' - - _ 1+ 5i I "`''4'r'i•• i l`xP af;'In _ _ - J'' - 1'r. OBIT E. '.P, -- _” - _ , ,•,:• „L 6 ;6` ,l,1 '11, ,1 r,i, -” J_i,•,- __ _ "s rtV °1 l >',+ul; ,H „n POI B' uX. 7i1rr .90. _- -' --' _- „a-.1 ` ,,,. ,, i r,t, Tait _- - - — , ';n`;.,,,,', r': ;:``. — — - s`• ,!''" < •, ;,r 1:' `'- - CTiIC'P,GI Ar`II;.:'=` '06.80=7.69Q•- " - - __ SII'3,,rd.,I rf', I'lr''i I f II 4 •t: - ll 11'f, '`1 = - - - - - -"_ _ __ __ - 11' '1'.• 'p., ply„`.' _' "__ _ _ _ 'P `i'il'i.:. 1. 1 ,'!• "_ _ _" _ __ _ — n 0`p 4: tF 1-8,61'-,'_;., im,. :''i2,,, ;4 ,4 ,"4 .` _ 8 0 CJ 5 0? 2`t' im Vendor No. Check No. Town of Southold, New York - Payment Voucher 13564 Vendor Address Entered by P.O.,Box 7690 Vendor Name Chicago, IL 60680-7690 Audit Dat McMaster-Carr Supp!y Co. APR 2 5 Vendor Telephone Number 609-689-3000 Town Clerk Vendor Contact ` Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 21497687 3/29/2017 $1,070.95 $1,070.95 RP bilge manifold repair SM5710.2.000.200 21665610 3/30/2017 $44.88 $44.88 NLT supplies SM5709.2.000.200 22053464 4/3/2017 $527.21 1 $527.21 RP'bil e system repair SM5710.2.000.200 22404157 4/4/2017 $76.99 $76.99 RP bilge system repair SM5710.2.000.200 22403214 4/4/2017 $310.57 . $310.57 RP bilge system repair SM5710.2.000,200 $2,030.60 $2,030.60 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. Signature Title Signature Company Name Fishers Island Ferry District Date 4/12/2017 Title �� — Date % �� { C� MAASTERmCARR® Invoice 609-689-3000 609-259-3575(fax) nj.sales@mcmaster.com Purchase Order JOHNP Total $1,070.95 Invoice 21497687 Billed to Invoice Date 3129117 FISHERS ISLAND FERRY DISTRICT Y P O BOX 607 Payment Terms 2% 10, Net 30 FISHERS ISLAND NY 06390-0607 Deduct$20 64 on merchandise if paid by 4/8/17 Shipped to Mail Payment to McMaster-Carr Fishers Island FerryDist_ric_tPO Box 7690 5 Waterfront Park l - Chicago IL 60680-7690 New London CT 06320 Your Account 260910000 John Paradis placed this order. Line Product Ordered Shipped Balance Price Total 1 4549K613 Standard-Wall Galvanized Steel Pipe Nipple 2 2 0 3.22 6.44 Threaded on Both Ends, 1 Pipe Size, 2-1/2"Long Each Each 2 4549K631 Standard-Wall Galvanized Steel Pipe Nipple Fully 3 3 0 3.36 10.08 Threaded, 1-1/4 Pipe Size Each Each 3 4549K651 Standard-Wall Galvanized Steel Pipe Nipple Fully 3 3 0 4.01 12.03 Threaded, 1-1/2 Pipe Size Each Each 4 4549K636 Standard-Wall Galvanized Steel Pipe Nipple 2 2 0 5.08 10.16 Threaded on Both Ends, 1-1/4 Pipe Size,4"Long Each Each 5 4549K641 Standard-Wall Galvanized Steel Pipe Nipple 2 2 0 7.32 14.64 Threaded on Both Ends, 1-1/4 Pipe Size,6"Long Each Each 6 463SK135 Low-Pressure Pipe Fitting Galvanized Iron,90 2 2 0 5.46 10.92 Degree Elbow Connector, 1 NPT Female Each Each 7 4708K57 High-Flow Backflow-Prevention Valve Brass Seal, 2 2 0 85.87 171.74 1-1/2 NPT Female,4"End-to-End Length Each Each 8 - 4819K17 Bronze Gradual On/Off Valve Pressure Class 125,- 2 2 0 63.24 126.48 Nonrising Stem, 1-1/2 NPT Female Each Each 9 4549K652 Standard-Wall Galvanized Steel Pipe Nipple 3 3 0 4.37 13.11 Threaded on Both Ends, 1-112 Pipe Size,2"Long Each Each 10 4549K653 Standard-Wall Galvanized Steel Pipe Nipple 3 3 0 4.94 14.82 Threaded on Both Ends, 1-1/2 Pipe Size, 2-1/2" Each Each Long 11 45491<654 Standard-Wall Galvanized Steel Pipe Nipple 3 3 0 5.06 15.18 Threaded on Both Ends, 1-1/2 Pipe Size, 3"Long Each Each 12 4549K665 Standard-Wall Galvanized Steel Pipe Nipple 2 2 0 18.09 36.18 Threaded on Both Ends, 1-1/2 Pipe Size, 12"Long Each Each 13 4638K137 Low-Pressure Pipe Fitting Galvanized Iron, 90 4 4 0 11.27 45.08 Degree Elbow Connector, 1-1/2 NPT Female Each Each 14 4638K335 Low-Pressure Pipe Fitting Galvanized Iron, Hex 2 2 0 7.36 14.72 Bushing Adapter, 1-1/4 NPT x 1 NPT Each Each Federal ID 36-1458720 McMaster-Carr Supply Company Page 1 of 2 MP 66 MMASTERmCARR. Invoice 609-689-3000 609-259-3575(fax) nj.sales@mcmaster.com Purchase Order JOHNP Invoice 21497687 Invoice Date 3129117 Line Product Ordered Shipped Balance Price Total 15 43245K367 Medium-Pressure Pipe Connector with 3 3 0 25.27 75.81 Easy-Alignment Threads,Galvanized Steel, 1-1/4 Each Each NPT Female 16 43245K368 Medium-Pressure Pipe Connector with 3 3 0 25.27 7581 Easy-Alignment Threads,Galvanized Steel, 1-1/2 Each Each - _ - - - -NPT Female _ 17 7739K148 High-Pressure Galvanized Steel Pipe Fitting 2 2 0 10.92 21.84 Straight Connector, 1-112 NPT Female Each Each 18 4638K737 Low-Pressure Pipe Fitting Galvanized Iron, Union 4 4 0 29.18 116.72 Straight Connector, 1-1/2 NPT Female Each Each 19 463SK736 Low-Pressure Pipe Fitting Galvanized Iron, Union 4 4 0 24.08 96.32 Straight Connector, 1-1/4 NPT Female Each Each 20 4549K658 Standard-Wall Galvanized Steel Pipe Nipple 2 2 0 7.84 15.68 Threaded on Both Ends, 1-1/2 Pipe Size,5"Long Each Each 21 4549K16 Standard-Wall Galvanized Steel Pipe Nipple 2 2 0 7.03 14.06 Threaded on Both Ends, 1-1/2 Pipe Size,4-1/2" Each Each Long 22 4549K656 Standard-Wall Galvanized Steel Pipe Nipple 2 2 0 6.43 12.86 Threaded on Both Ends, 1-1/2 Pipe Size,4"Long Each Each 23 4549K218 Standard-Wall Galvanized Steel Pipe Nipple 2 2 0 5.63 11.26 Threaded on Both Ends, 1-1/2 Pipe Size, 3-1/2" Each Each Long 24 4499K75 Standard-Wall Galvanized Steel Pipe Threaded on 1 1 0 89.98 89.98 Both Ends, 1-1/2 Pipe Size,72"Long Each Each Merchandise 1,031.92 Shipping 39.03 Total $1'QZ0.95 Packing List, Shipped Weight Carrier Tracking 1187258-01 3/29/17 1 Ib FedEx Priority 728665941560 1187258-02 3/29/17 181b UPS Ground 1 ZO835200353853832 1187258-03 3/29/17 521b UPS Ground 1 ZO835200353853841 1187258-04 3/29/17 14 Ib UPS Ground 1Z0835200353853850 Federal ID 36-1458720 McMaster-Carr Supply Company Page 2 of 2 MP 67 i u VIAASTERmCARR® Packing List 200 New Canton Way Fishers Island Ferry Districts Purchase Order Page 1 of Robbinsville NJ 08691-2343 5 Waterfront Park JOHNP 609-689-3000 New London CT 06320 d, 03/29/2017 Order Placed By nj.sales@mcmaster.com John Paradis 4 McMaster-Carr Number 1 1187258-01 Line Product ''` Ordered Shipped 15 43245K367 Medium-Pressure Pipe Connector with Easy-Aligriment;Th'reads, Galvanized Steel, 1-1/4 3 3 NPT Female y Each ]e Shipped 'separately from our New Jersey warehouse on 03/29 n' 1 4549K613 Standard-Wall Galvanized Steel Pipe Nipple Threaded orkBoth Ends, 1 Pipe Size, 2-1/2" 2 2 .z Long Each 2 4549K631 Standard-Wall Galvanized Steel Pipe Nipple Fully Threaded, 1-1/4 Pipe Size 3 3 Each i 3 4549K651 Standard-Wall Galvanized Steel Pipe Nipple Fully Threaded, 1-1/2 Pipe Size 3 3 Each 4 4549K636 Standard-Wall Galvanized Steel Pipe Nipple Threaded ion Both Ends, 1-1/4 Pipe Size, 4" 2 2 Long Each 5 4549K641 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/4 Pipe Size, 6" 2 2 Long Each �6 4638K135 Low-Pressure Pipe Fitting Galvanized Iron, 90 Degree Elbow Connector, 1 NPT Female 2 2 Each 7 4708K57 High-Flow Backflow-Prevention Valve Brass Seal, 1-1/2 NPT Female, 4"End-to-End 2 2 Length ; Each 8 4619K17 Bronze Gradual On/Off Valve Pressure Class 125, Nonnsing Stem, 1-1/2 NPT Female 2 2 Each 9 4549K652 Standard-Wall Galvanized Steel Pipe Nipple Threadedaon,Both Ends, 1-1/2 Pipe Size, 2" 3 3 Long Each i 10 4549K653 Standard-Wall Galvanized Steel Pipe Nipple Threaded ion Both Ends, 1-1/2 Pipe Size, 3 3 2-1/2" Long Each 11 4549K654 Standard-Wall Galvanized Steel Pipe Nipple Threaded ion Both Ends, 1-1/2 Pipe Size, 3" 3 3 Long Each 12 4549K665 Standard-Wall Galvanized Steel Pipe Nipple Threaded or, Both Ends, 1-1/2 Pipe Size, 12" 2 2 Long Each 307 Packing List 200 New Canton Way Fishers Island Ferry District Purchase Order Page 2 of 2 Robbinsville NJ 08691-2343 5 Waterfront Park JOHNP 609-689-3000 New London CT 06320 03/29/2017 nj sales@mcmaster.com Order Placed By John Paradis McMaster-Carr Number 1187258-01 Line Description Ordered Shipped 13 4'638K137 Low-Pressure Pipe Fitting Galvanized Iron, 90 Degree Elbow Connector, 1-1/2 NPT 4 4 Female Each 14 463BK335 Low-Pressure Pipe Fitting Galvanized Iron, Hex Bushing Adapter, 1-1/4 NPT x 1 NPT 2 2 Each V/16 43245K368 Medium-Pressure Pipe Connector with Easy-Alignment Threads, Galvanized Steel, 1-1/2 3 3 NPT Female Each 17 7739K148 High-Pressure Galvanized Steel Pipe Fitting Straight Connector, 1-1/2 NPT Female 2 2 Each 18 4638K737 Low-Pressure Pipe Fitting Galvanized Iron, Union Straight Connector, 1-1/2 NPT Female 4 4 Each 19 4638K736 Low-Pressure Pipe Fitting Galvanized Iron, Union Straight Connector, 1-1/4 NPT Female 4 4 Each 20 4549K658 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 5" 2 2 Long Each 21 4549K16 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 2 2 4-1/2"Long _ Each 22 4549K656 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 4" 2 2 Long Each 23 4549K218 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 2 2 3-1/2"Long Each ✓24 4499K75 Standard-Wall Galvanized Steel Pipe Threaded on Both Ends, 1-1/2 Pipe Size, 72"Long 1 1 Each AW rOct) 2� 308 t i -IR MASTERmCARR. Packing List I 200 New Canton Way Fishers Island Ferry District/ Purchase Order Page 1 of t; Robbinsvdle NJ 08691-2343 5 Waterfront Park JOHNP 609-689-3000 New London CT 06320 03/29/2017 r mcmaster corn Order Placed By nJ sales @ John Paradis `J McMaster-Carr Number ,G 1187258-03 _Q �>�l _,. Line Product Ordered Shipped I 4549K613 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1 Pipe Size, 2-1/2" 2 2 �} Long Each 4549K631 Standard-Wall Galvanized Steel Pipe Nipple Fully Threaded, 1-1/4 Pipe Size 3 3 _ Each I V3 4549K651 Standard-Wall Galvanized Steel Pipe Nipple Fully Threaded, 1-1/2 Pipe Size 3 3 Each I I Y4 4549K636 Standard-Wall Galvanized Steel Pipe Nipple Threaded;on Both Ends, 1-1/4 Pipe Size, 4" 2 2 r4•' Long Each 5 4549K641 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/4 Pipe Size, 6 2 2 Long Each I :,.,1/6 4638K135 Low-Pressure Pipe Fitting Galvanized Iron, 90 DegreeElbow Connector, 1 NPT Female 2 2 Each i9 4549K652 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 2 3 3 r..1, Long Each ,µ21" i., 10 4549K653 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 3 3 - -- - - ------ -Each---- -- - -- :y 11 4549K654 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 3 3 3 '/ Long Each 1 12 4549K665 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 12 2 2 ` Long Each f� 13 4638K137 Low-Pressure Pipe Fitting Galvanized Iron, 90 Degree Elbow Connector, 1-1/2 NPT 4 4 ,1/ Female 1 Each " 14 4638K335 Low-Pressure Pipe Fitting Galvanized Iron, Hex Bushing Adapter, 1-1/4 NPT x 1 NPT 2 2 Each 'r 6 43245K368 Medium-Pressure Pipe Connector with Easy-Alignment Threads, Galvanized Steel, 1-1/2 3 3 NPT Female Each `V17 7739K148 High-Pressure Galvanized Steel Pipe Fitting Straight Connector, 1-1/2 NPT Female 2 2 Each $" 18 4638K737 Low-Pressure Pipe Fitting Galvanized Iron, Union Straight Connector, 1-1/2 NPT Female 4 4 Each �19 463BK736 Low-Pressure Pipe Fitting Galvanized Iron, Union Straight Connector, 1-1/4 NPT Feale 4 4 m Each ✓20 4549K658 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 5" 2 2 Long Each .V21 4549K16 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 2 2 4-1/2" Long Each C'. `_`'" 378 Packing List 200 New Canton Way Fishers Island Ferry District Purchase Order Page 2 of 2 Robbinsville NJ 08691-2343 5 Waterfront Park JOHNP 03/29/2017 609-689-3000 New London CT 06320 Order Placed By nj sales@mcmaster.com John Paradis McMaster-Carr Number 1187258-03 Line Product Ordered Shipped �a }� V12 4549K656 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 4" 2 2 91i Long Each f 3 4549K218 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, I-1/2 Pipe Size, 2 2 ,r. 3-1/2"Long Each Q „ 'Shipped separately from our Chicago warehouse on 03/29 15 43245K367 Medium-Pressure Pipe Connector with Easy-Alignment Threads, Galvanized Steel, 1-1/4 3 3 NPT Female Each KA Y' SFr ii tel\ /'ASV }at\ti 4,t J 'trr 379 ,r JM, " McMASTERmCARR. Invoice . 609-689-3000 609-259-3575(fax) nj.sales@mcmaster.com Purchase Order MIKE Total $44.88 Invoice 21665610 Billed to Invoice Date 3/30/17 FISHERS ISLAND FERRY DISTRICT Y P O BOX 607 Payment Terms 2% 10, Net 30 FISHERS ISLAND NY 06390-0607 Deduct$0.51 on merchandise if paid by 4/9/17 Shipped to Mail Payment to McMaster-Carr Fishers Island Ferry District PO Box 7690 5 Waterfront Park Chicago IL 6068077690 Ne _w London CT 06320 Your Account 260910000 Mike Franco placed this order. Line Product ' Ordered Shipped Balance Price Total 1 90031 Al 96 Phillips Flat Head Screws for Wood Zinc-Plated 1 1 0 4.47 447 Steel, Number 8 Size,5/8"Long, Packs of 100 Pack Per Pack 2 1201A38 Cut-to-Size Lift-Off Panel-Hanging Bracket 1 1 0 14.04 14.04 Each Each 3 66615A92 Nylon Hammer-in Screw Anchor, Number 8 Size,_ 1 1 0 6.77 6.77 Packs of 10 Pack Per Pack Merchandise 25.28 O Shipping 19.60 �`— Total $4 Packing List Shipped Weight Carrier Tracking 1248109-01 3/30/17 4 Ib UPS Ground 1 ZO835200353948196 1248109-02 3/30/17 1 Ib UPS Ground 1Z0835200353948203 Federal ID 36-1458720 McMaster-Carr Supply Company Page 1 of 1 SP 519 MMASTER•CARR® Invoice, 609-689-3000 609-259-3575(fax) nj.sales@mcmaster corn Purchase Order JOHN P Total $527.21 Invoice 22053464 Billed to Invoice Date 4/3117 FISHERS BOX 607LAND FERRY DISTRICT PPayment Terms 2% 10, Net 30 FISHERS ISLAND NY 06390-0607 Deduct$9 99 on merchandise if paid by 4/13/17 Shipped to Mail Payment to McMaster-Carr Fishers Island Ferry District PO Box 7690 5 Waterfront Park Chicago IL 60680-7690 New London CT 06320 Your Account 260910000 John Paradis placed this order. Line Product Ordered Shipped Balance Price Total 1 4549K17 Standard-Wall Galvanized Steel Pipe Nipple 3 3 0 7.88 23.64 Threaded on Both Ends, 1-1/2 Pipe Size,5-1/2" Each Each Long 2 4549K658 Standard-Wall Galvanized Steel Pipe Nipple 3 3 0 7.84 23.52 Threaded on Both Ends, 1-1/2 Pipe Size, 5"Long Each Each 3 4549K16 Standard-Wall Galvanized Steel Pipe Nipple 3 3 0 7.03 21.09 Threaded on Both Ends, 1-1/2 Pipe Size,4-1/2" Each Each Long . 4 4549K653 Standard-Wall Galvanized Steel Pipe Nipple 4 4 0 4.94 19.76 Threaded on Both Ends, 1-1/2 Pipe Size, 2-1/2" Each Each Long 5 4549K656 Standard-Wall Galvanized Steel Pipe Nipple 4 4 0 6.43, 2572 Threaded on Both Ends, 1-1/2 Pipe Size,4"Long Each Each 6 4549K661 Standard-Wall Galvanized Steel Pipe Nipple 4 4 0 8.77 35.08 Threaded on Both Ends, 1-1/2 Pipe Size, 6"Long Each Each 7 4499K75 Standard-Wall Galvanized Steel Pipe Threaded on _ 3 '_3 0 -89.98--- 269.94 - - — Both-Ends','i-1/2 Pipe Size,72"Long^ - Each Each 8 4638K737 Low-Pressure Pipe Fitting Galvanized Iron, Union 2 2 0 29.18 58.36 Straight Connector, 1-1/2 NPT Female Each Each 9 4638K137 Low-Pressure Pipe Fitting Galvanized Iron, 90 2 2 0 11.27 22 54 Degree Elbow Connector, 1-1/2 NPT Female Each Each Merchandise 499.65 Shipping 27.56 Total $527.21 Packing List Shipped Weight Carrier Tracking 1373802-01 4/3/17 361b UPS Ground 1ZO835200354145588 1373802-02 4/3/17 271b UPS Ground 1 ZO835200354145597 Federal ID 36-1458720 McMaster-Carr Supply Company Page 1 of 1 SP Soo r '°`��MMASTERmCARR. Packing List 200 New Canton Way Fishers Island Ferry District Purchase Order Page 1 of 1 Robbinsville NJ 08691-2343 5 Waterfront Park JOHN P 609-689-3000 New London CT 06320 04/03/2017 nj sales@mcmaster com Order Placed By John Paradis McMaster-Carr Number 1373802-01 Line Product 'Ordered Shipped 7 4499K75 Standard-Wall Galvanized Steel Pipe Threaded on Both Ends, 1-1/2 Pipe Size, 72" Long 3 3 Each /C) / - - 4 I , 1 458 I "FIAMASTERoCARR. Parking dist 200 New Canton Way Fishers Island Ferry District Purchase Order Page 1 of 1 Robbinsville NJ 08691-2343 5 Waterfront Park JOHN P 609-689-3000 New London CT 06320 04/03/2017 ; nJ b sales' mcmaster com Order Placed By John Paradis 4 McMaster-Carr Number ' 1373802-02 Product Ordered Shipped +fW 1 'v;`4549K17 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1=1/2 Pipe Size, 3 3 5-1/2"Long Each 2 4549K658 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1%2 Pipe Size,-5" 3 3 Long Each 3 4549K16 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 3 3 4-1/2"Long Each 4 4549K653 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 4 4 2-1/2"Long Each 5 4549K656 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 4" 4 4 Long Each 6 4549K661 Standard-Wall Galvanized Steel Pipe Nipple Threaded on Both Ends, 1-1/2 Pipe Size, 6" 4 4 , Long Each 8 4638K737 Low-Pressure Pipe Fitting Galvanized Iron, Union Straight Connector, 1-1/2 NPT Female 2 2 Each 9 4638K137 Low-Pressure Pipe Fitting Galvanized Iron, 90 Degree Elbow Connector, 1-1/2 NPT 2 2 --- - -- -- — _— - - ------- ------- - -- - - - - Each-- - - --- - �- Fema� - - - t 593 WMASTERmCARR. Invoice 609-689-3000 609-259-3575(fax) nj.sales@mcmaster.com Purchase Order ,! JOHN P Tota 1 $76.99 Invoice 22404157 Billed to Invoice Date 414117 FISHERS ISLAND FERRY DISTRICT Y P O BOX 607 Payment Terms 2% 10, Net 30 FISHERS ISLAND NY 06390-0607 beduct$142 on merchandise if paid by 4/14/17 Shipped to Mail Payment to McMaster-Carr Fishers Island Ferry District PO Box 7690 _ 5 Waterfront Park Chicago IL 60680-7690 New London CT 06320 Your Account 260910000 John Paradis placed this order. Line Product Ordered Shipped Balance Price Total 1 4549K651 Standard-Wall Galvanized Steel Pipe Nipple Fully 8 8 0 4.01 32.08 Threaded, 1-1/2 Pipe Size Each Each 2 4549K652 Standard-Wall Galvanized Steel Pipe Nipple 3 3 0 4.37 13.11 Threaded on Both Ends, 1-1/2 Pipe Size, 2"Long Each Each 3 4549K656 Standard-Wall Galvanized Steel Pipe Nipple 4 4 0 6.43 25.72 Threaded on Both Ends, 1-1/2 Pipe Size,4"Long Each Each Merchandise 70.91 Shipping 608 Total M19-9 Packing List Shipped Weight Carrier Tracking 1429379-01 4/4/17 7 Ib UPS Ground 1 ZO835200354228293 Federal ID 36-1458720 McMaster-Carr Supply Company Page 1 of 1 co 305 y4 F `MASTE •CAR ® Packing List . 00 New Canton Way Fishers Island Ferry District, Purchase Order Page 1 of 1 obbinsville NJ 08691-2343 5 Waterfront JOHN P 04/04/2017 „609-689-3000 New London CT 06320 Order Placed By n�sales@mcmaster com John Paradis McMaster-Carr Number 1429379-01 " y.Line Product Ordered Shipped >: .;1 4549K651 Standard-Wall Galvanized Steel Pipe Nipple Fully Threaded, 1-1/2 Pipe Size 6 S Each 4549K652 Standard-Wall Galvanized Steel Pipe Nipple Threaded,on Both Ends, 1-1/2 Pipe Size, 2 3 3 11 S_.t • ,K Each ".�_. Long a . �3 4549K656 Standard-Wall Galvanized Steel Pipe Nipple Threadedl on Both Ends, 1-1/2 Pipe Size, 4" 4 4 Each Long }fig;,• I, a. I I I ' I - I I n ' I I I ` I -St;Y"�• I A l I I 1 I I I I 3SI � I I i _ I I I M eeuvuw° MAASTERmCARR® Invoice 609-689-3000 609-259-3575(fax) nj.sales@mcmaster.com Purchase Order JOHN P Tota 1 $310.57 Invoice 22403214 Billed to Invoice Date 414117 FISHERS ISLAND FERRY DISTRICT Y P O BOX 607 Payment Terms 2% 10, Net 30 FISHERS ISLAND NY 06390-0607 Deduct$5 96 on,merchandise if paid by 4/14/17 Shipped to Mail Payment to McMaster-Carr Fishers Island Ferry District PO Box 7690 5 Waterfront Park - Chicago IL 60680-7690 New London CT 06320 Your Account 260910000 John Paradis placed this order. - Line Product Ordered Shipped Balance Price Total 1 470BK57 High-Flow Backflow-Prevention Valve Brass Seal, 2 2 0 85.87 171 74 1-1/2 NPT Female,4"End-to-End Length Each Each 2 4619K17 Bronze Gradual On/Off Valve Pressure Class 125, 2 2 0 63.24 126.48 Nonrising Stem, 1-1/2 NPT Female Each Each Merchandise 298.22 Shipping, 12.35 Total $3 Packing List Shipped Weight Carrier Tracking 1424939-01 4/4/17 7 Ib FedEx Priority 729495438232 1424939-02 4/4/17 91b UPS Ground 1ZO835200354221325 Federal ID 36-1458720 McMaster-Carr Supply Company Page 1 of 1 co 305 McMASTER'CARR, Packing List 200 New Canton Way Fishers,Island Ferry District Purchase Order Page 1 of 1 Robbinsville NJ 08691-2343 5 Watertront Park '� '` JOHN P _ 609=689-3000 New London CT 06320 04/04/2017 Order Placed By nj sales@mcmaster.com John Paradis McMaster-Carr Number 1424939-01 Line Product Ordered Shipped 1 4708K57 High-Flow Backflow-Prevention Valve Brass Seal, l-,1/2 NPT Female, 4"End-to-End 2 2 Length Each fs' hipped separately from our New Jersey,warehouse on 04/04 4619K17 Bronze Gradual On/Off Valve Pressure Class 125, Nionrising Stem, 1-1/2 NPT Female 2 2 Each d k i 661 i 1 I'diMONN�F�" II T ERmCARRe Packing List 200 New Canton Way Fishers Island Ferry District Purchase Order Page 1 of 1 Robbinsvdle NJ 08691-2343 5 Waterfront Park JOHN P 609-689-3000 New London CT 06320 04/04/2017 n sales@mcmaster.com Order Placed By J @ � John Paradis McMaster-Carr Number 1424939-02 Line Product Ordered Shipped 2 4619K17 Bronze Gradual On/Off Valve Pressure Class 125, Nonnsing Stem, 1-1/2 NP.T Female 2 2 Each Shipped separately from our Chicago warehouse on 04/04 1 4708K57 High-Flow Backflow-Prevention Valve Brass Seal, 1-1/2 NPT Female, 4" End-to-End 2 2 Length Each d < act i ate; 128 I I • , I' _' , I I ,I 1I - Ir I. I •I I I .FISHERS ISLAND FERRY DISTRICT VENDOR 014232 NYS DEPT OF LABOR.-UI DIV 04/25/2,017 CHECK 4019 • 1 FUND &ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT 71. SM .9050.8.000.000 04-643094-0317 1ST QTR-AC RICKER 22,6.50 -- TOTAL 226.50 1 1 1 r- I < 4 - ` I r-- 1 'r- p 0 • ' B • B • B • B IS£ FERRO D7S.TRIG7'.-; > FISNE LA1VD AUDI—,, 4/•2;5•/j'17 :'53095MAW ROAD,PD BOX 71'7,9'n;{', ,;'; „\„% r j.r< }' §:151 :) 3 OUTHOID>. Y.11971 959?< -- `.'1 _ _ "CHECK: •i - K " AT ON'I BA, F L + J^, ..J' 'nr' - - `•THE SUF C5 N• -' -- Y','1 .DATES '-_- -- 5 - 1, 1 ,P`A,i - ___ _ - ?,•,I, +,z '11, '.111 1 --- - _ "° _" "5, 'lllp',1, ,Gd'i,,l,, 5l'111'I'i `?I1'd^,11'' ,1, ,, d1 - -- - - - - „1 d'..: '` I d •d';';"' - - __ 2`26 r5 =s 50L946)214"' , i' w f TWE "1T'WO'`Fii7NDR.ED" : ;S j 7 ', ' - - _ _ .q. I' "" ,gyp , . .)... r- - ='•g` _ _"_ 'd' '7p" ''`d 'P, 'fd' ,'J `1 aid' - a}, i ja , .i Ij t;' PT•`:pF '`LAHdR=fUI ,°DSV = 1.1,; 1'I.. ,} r;, „r: - - - - - 11,;-di l at ,I;1P, R I L,IaC`a - -- -- - 1 'h -_ __ - _-_ 'r _ _ "•..t"' ,;II'i 'd8 .g 'sl.dl•,:'Il ,dl '' "§' "i - 'f' ,lal, l'„•`t I,V 2-_' - ”- - i'ie'•',I;, 1.1 - - '3`_ - '11 ,1 Id"::°,d 5 'd.i 1 _ _ _ __ __ i, 1 •d II II I','u ;l" __" _ , __- -' -_ '" ;1' 1"".4;'......, ':i,' _ _ _ __ _ _ __ '''li", Il, 1.1''1 _ _,J•_._:- '_ -" -- - -_ --`'t'. ."111.1>: 1,,, ; :.'",•'",y`'"'"' - - e-0, = <91n <;^,1 :0 '2"14'"0 546:4, :u ;g-__0.o_L SFo,.2 ii i Vendor No. Check No. Town of Southold, New York - Payment Voucher 14232 Vendor Tax ID Number or Social Security Number Vendor Address Entered by P.O. Box 4301 Vendor Name Binghamton, NY 13902-4301 Audit Date New York State Unemployment Insurance ,SPR 2 5 2017 Vendor Telephone Number : M 7 Town Clerk Vendor Contact 0,, Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 04-643094- 4/3/2017 $226.50 $226.50 Ricker 1st Qtr 2017 SM9050.8.000.000 0917 $226.50 $226.50 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 n Signature O,r —" Title Signature /�, 9 Company Name Fishers Island Ferry District Date 4/13/2017 Trtle d%!' - Date DEPARTMENT OF LABOR NEW UNEMPLOYMENT INSURANCE YORK PO BOX 4301 For Office Use Only STATE BINGHAMTON NY 13902-4301 WWW.LAB 0 R.NY.GOV Dist Ind. Assign.Type FormType X U Received Date cl Al FISHERS ISLAND Employer Reg. No. Account Status as of FERRY DISTRICT 04-64309 4 04/03/17 PO BOX 1179 SOUTHOLD NY 11971-0959 For Completion by Employer Enter Payment Amount Enclosed Return this form to the return address shown above. Notice of Reimbursable Billing Any amount now due for Unemployment Insurance Benefit Reimbursement charges, Interest or Penalty is'shown below,as "Current Balance"preceded by.th,e word"Underpaid." A check for this amount plus'any,additlonal interest should be mailed promptly. Enter the payment amount in the employer box above and return this form with your payment. If the amount shown as "Current Balance" is preceded by the word "Overpaid"you will be receiving a refund of this overpayment. Payment on current quarter charges shown as IBR"is due by the end of the month following the end of the quarter or 15 days from the billing date, whichever is later. This notice does not include amounts assessed for Failure to File Penalties or Benefit Claim Penalties. If you have penalties due you will be advised by separate notice. Interest is assessed on late-payment of benefit reimbursement charges at the rate of 12 percent per year. Charge Notices, IA 96R, included in`billing are dated: 1Q17 02/03/17 through 04/07/17 2Q17 05/05117 through 07/07/17 Your Previous Balance Was 3Q17 08/04/17 through 10/06/17 4Q17 11/03/17 through 01/05/18 NONE *0.00 E The symbols in Transaction � Col 1 Column 1 show Claimant Date Period Type Column 2 Column 3 the type of S S.Acct# of Amount Due Amount Paid joj Mo. Day Yr. Qtr. Year Liab, BR- 04 01 17 1 17 BR *226.50 Benefit Reimbursement IN- interest PE- C/ Penalty Enter your Employer Registration Number _ ._.__ - ---- -- ---- -------as shown above on your remittance CarrenLala[ payable to New York State Unemployment Insurance. Keep a copy of this notice for your records. UNDERPAID $226.50 Use this form for payments only. If you have questions,please call(518)457-1090 for assistance. Carl N. Boorn, Director, IA 4')RD 171471 I Inomnln/menf Inci,r�nno rli/ieinn NEW YORK STATE DEPARTMENT OF LABOR Unemployment Insurance Division PO Box 15122 ALBANY,N.Y. 12212.5122 www.labor.ny.gov NOTICE OF BENEFIT REIMBURSEMENT CHARGES DATE MAILED EMPLOYER REG. NO. FISHERS ISLAND 02/03/17 04-64309 4 FERRY DISTRICT PO BOX 1179 SOUTHOLD NY 11971-0959 THIS IS NOT A BILL PLEASE REVIEW PROMPTLY BENEFIT PAYMENTS MADE TO THE CLAIMANTS LISTED HAVE'BEEN,CHARGED TO YOUR ACCOUNT EACH PAYMENT IS FOR FOUR EFFECTIVE DAYS(ONE WEElq UNLESS OTHERWISE INDICATED., TO HELP PROTECT YOUR ACCOUNT AND THE UNEMPLOYMENT INSURANCE FUND; 1.Verify that each claimant was employed by you. 2. If,you failed to respond to information requested In the Notice of Potential Charges(FORM LO 400)or any other subsequent request for Information about a claim in a timely or adequate manner, the law prohibits the.relief of charges under most circumstances. 3. If you,have any information you were not aware of when you received the Notice,&Poi6ntiai't6ar'ges that mightaffect the claimant's benefit rights, we'must receive your response within ten calendar days of the date of this notice in order tq be re_lieved of charges. Please write to the NYS Department of Labor, PO Box 15122,Albany, NY 12212-5122 or fax to(518)485-6172, 4. If you have work available, please contact the claimant directly. Should the claimant refuse.the job or not•report to work, please write to the NYS Department of Labor, P0,13ox 15130, Albany, NY 12212-5130 or"fax to(518)485-7377, If°.you are-unable to contact the claimant or would like assistance in meeting-your hiring,needs, contact'the DOL Employment Service-nearest you. 5.A;(P.),printed,text to the amount of,ben-efits Paid shows that a pension reduction is already being made, if you are aware that a claimant is receiving a,pehsion to-which you contributed and no reduction is shown, please write to,tiie address in#4 above or fax to(51 a)485-7377. 6. If you object to any of these charges for other reasons, write to the Liability and Determination Section at the address in the header or fax to; (518)485.6172. Provide the claimant's name, SS#,,week,ended dates, and'reason s)you believe the charges are Incorrect. IF YOU DISAGREE WITH THIS D.I»TERMINATION,YOU MAY R QtTEST A HEARING WITHIN 30 DAYS FROM THE MAILING DATE OF'THIS NOTICE, PAGE 1 SOCIAL SEC. WK ENDED EFF DOL SOCIAL SEC. WK ENDED EFF DOL ACCOUNT # NAME NO DY YR AMOUNT DAY OFF ACCOUNT # NAME NO DY YR . AMOUNT DAY OFF 089-34-4524 A RICKER 1101.17 25,00 1 801 08'9-34-4524 A RICKER 110817 75.00 3' 801 089-34-4524 A RICKER 111517 50,00 2 801 089-34-4524 A RICKER 1,12217 25,00 1 801 i i r r � 1 i w i r i 1 ) i t � � t A t ! 1 i I 1 M I 1 f Y 1 1 1 1 1 E 1 1 1 k i t 1 WE WILL SEND A BILL AT THE END OF $175.00 TOTAL THE QUARTER FOR THE TOTAL AMOUNT DUE. , A CR SYMBOL CANCELS A PREVIOUS CHARGE. AN ASTERISK (m) IS AN ADJUSTMENT. IA 96R(12-13) CARL BOORN,DIRECTOR UNEMPLOYMENT INSURANCE DIVISION FOR THE COMMISSIONER OF LABOR t ' (i NEW YORK STATE DEPARTMENT OF LABOR Unemployment Insurance Division PO Box 15122 ALBANY,N.Y. 12212-5122 www.labor.ny.gov NOTICE OF BENEFIT REIMBURSEMENT CHARGES DATE MAILED EMPLOYER REG. NO. FISHERS ISLAND 04/07/17 04-64309 4 FERRY DISTRICT PO BOX 1179 SOUTHOLD NY 11971-0959 THIS IS NOT A BILL PLEASE REVIEW PROMPTLY BENEFIT PAYMENTS MADE TO THE CLAIMANTS LISTED HAVE BEEN CHARGED TO YOUR ACCOUNT EACH PAYMENT IS FOR FOUR EFFECTIVE DAYS(ONE WEEK) UNLESS OTHERWISE INDICATED. TO HELP PROTECT YOUR ACCOUNT AND THE UNEMPLOYMENT INSURANCE FUND: 1. Verify that each claimant was employed by you. 2. If you failed to respond to information requested in the Notice of Potential Charges(FORM LO 400) or any other subsequent request for information about a claim in a timely or adequate manner, the law prohibits the relief of charges under most circumstances 3. If you have any information you were not aware of when you received the Notice of Potential Charges that might affect the claimant's benefit rights, we must receive your response within ten calendar days of the date of this notice in order to be relieved of charges. Please write to the NYS Department of Labor, PO Box 15122, Albany, NY 12212-5122 or fax to (518) 485-6172. 4 If you have work available, please contact the claimant directly. Should the claimant refuse the job or not report to work, please write to the NYS Department of Labor, PO Box 15130, Albany, NY 12212-5130 or fax to (518)485-7377. If you are unable to contact the claimant or would like assistance in meeting your hiring needs, contact the DOL Employment Service nearest you. 5. A(P) printed next to the amount of benefits paid shows that a pension reduction is already being made. If you are aware that a claimant is receiving a pension to which you contributed and no reduction is shown, please write to the address in##4 above or fax to (518)485-7377. 6. If you object to any of these charges for other reasons, write to the Liability and Determination Section at the address in the header or fax to: (518)485-6172. Provide the claimant's name, SS#, week ended dates, and reason s)' ou believe the charges are incorrect. IF YOU DISAGREE WITH THIS DETERMINATION,YOU MAY R�QUYEST A PAGE 1 HEARING WITHIN 30 DAYS FROM THE MAILING DATE OF THIS NOTICE. SOCIAL SEC. WK ENDED EFF DOL SOCIAL SEC. WK ENDED EFF DOL ACCOUNT # NAME MO DY YR AMOUNT DAY OFF ACCOUNT # NAME MO DY YR AMOUNT DAY OFF 089-34-4524 AC RICKER 311917 25.75 1 801 089-34-4524 AC RICKER 312617 25.75 1 801 It 11 i Y ! i Y i i t r i EACCOUNTiN !� Q 1J (r 1 l_ 1 i rE 1 0 2017 11 1 1 1 1 >+SC7UTNOt_�D It i &FINANCE D-pT.i '1 t F 1 1 1 I 1 I 1 t Y Y I f ' 1 1 1 1 I f ( ( I t 1 t 1 t Y Y I 1 S i 1 1 1 ! $51.50 TOTAL WE WILL SEND A BILL AT THE END OF THE QUARTER FOR THE TOTAL AMOUNT DUE. A CR SYMBOL CANCELS A PREVIOUS CHARGE. AN ASTERISK (*) IS AN,ADJUSTMENT. � IA 96R(12-13) CARL BOORN, DIRECTOR UNEMPLOYMENT INSURANCE DIVISION FOR THE COMMISSIONER OF LABOR ----------' --------- --• '---------- -----, I I ._ I FISHERS ISLAND FERRY-DISTRICT VENDOR 016723 PROGRESSIVE BENEFIT SOLUT. ,LLC 04/25/2017 CHECK 4020 FUND & ACCOUNT P.O.# INVOICE DESCRIPTION=S AMOUNT (M .'9060.8%-000.000 38308 (21)MNTLY,CRD ADMN—'3/17 94'.50 TOTAL , 94.50 1 r 1 1 - - Fri-'•: ;3^> , _ t ' 1 L 1 - a r- =— TVR _ -'; '; '` rya,.,«s,,'i,;;y, gy;:;:<.-•`: :_ , _- ;. v ^ '^'.; :FRRI ,DISTRICT ,'FISHERSrISLA1VD, '.. rt p "— =s`Y :P:L7DIT,.O.4/`2'5'/1 _ ,"53095MAINROADiP.Oi80Xr1r179,/;:{`.: :r,.S,;il.;..,ra •u.','.:._^,•t..rm mutt `• pa' W'ts>t 1' {;. `tS0UTHOL''D.'NY'tttr97;1'-0959,`,t„ r `'j' °CHECICx: Q, f; ',02.0. at, w" ..it =t - 'L O.NATIOIJAL=6 'NK" ',p•bt'I - _ - - _ THE,,SUFFO K C , A _r:CUTCH0GUEi`N 'T;1935'x"•h „'. 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WY, i 'li;, t. - - ,.5. , . ,I, I `I, ;,'+ li, Pp OGRIE'S'S`IUE'"BEN_EFIT'="SOIUT.,,'LT C; . 'irY - -- _ _ --- - L-,:-_ ;"t,,.: - ' '''1':` .a\e,.__ ___ __ __- _ &?:•-.id',er 'r` n. IJ',i•a_ __ 'al ,11=,1u`. 'Y;- - - - - -_a`, ".0"1 jfr, rl' 4 s1';'6 a?d",Y,xu;,g- n,;? _- - _ - _ -.i• .,4Y io:' t\,; Yl.lq f. O, I,'HE, „1'4€•' 4'BL7S'"INESS"fPARK: DR:IU_E"-#.8.==1' '- " ,1 I.;a+'aL`•a•„ I Gl'',u 11,.,: .,\;,,1^t rc ="s: 'r= __ _;-„L_ "'t ,N" ,tiy l ';t' Nla,,. :: `, ''1 yr n+'`- .,,i'v•• -" - ae"`.,'°__ -y;` `,)r,", '.f` - ,'I.e..i,wr `w"'r-` -_r= ;, _-_- -_--/' RDR rs'?CT' ' _ _ — "f;." ::';;'P;r ss I,,.•;"r lf:,re,9 -_ u2, Al {IBZAIdF0127 ^f; i06 '05, -rG, _ :Y,i'''•``?_ ,, F" ° 5, ry ;t,. t,;i 't' ' .•: . ,,ria„`.;-' r, `,,, °:!:✓w° %:. . `,i” t,', r'{.. `.i" u. !f°+'-•Yi' i Y ,•t,3.•o, ,`t• ;f 'J, ,s` .q'•'7 f:t i`e'a ' .'r"rr`.`. "tt°• ;`!.,",,,•: ,4` s b• - ,r6,`,,f,',,, wai,.fir•, -a.). - _ - I dl r^,II P11,` G ;,,IP, t 'js _ _a•} _ __ _ e l'1• r 11',4-, 11114 i,.`r. _ _ _ 1• 'G - __ _- - _ - '•r--' '; IY flit, - - „• •I.-=iii p p 1;`0'2`0 iii,. i.0 2 L 4''0 5'4 6 4 . 6 8 "`0 0"L 5`0' Pl ` Vendor No ' Check No.. - Town of Southold, New York - Payment Voucher 16723 Vendor Address Entered by 14 Business Park Dr#8 (:�7 - Branford, CT 06405 Audit Date Progressive Benefit Solutions (PBS) APR 2 5 2017 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 General Ledger Fund and Account Number 38308 3/31/2017 $94.50 $94.501 Monthly card administration(21)Mar 2017 SM9060.8.000.000 i $94.50 $94.50 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 pant 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 Rom which the Town is exempt are excluded or discrepancies noted,and payment is approved. Signature Title Signature Company Name Fishers Island Ferry District Date 4/19/2017 Title `%� Date C l j G� n 1 Progressive Benefit Solutions LLC Invoice 14 Business Park, #8 Date Invoke# Branford, CT 06405 3/31/2017 38308 Bill To Fishers Island Ferry District Attn: Gordon Murphy P.O.Box 607 Fishers Isle,NY 06390 P.O. No. Terms Project Upon Receipt Quantity Description Rate Amount 21 Monthly Benny Card Administration 450 9450 April 2017 Invoice(Active Participants thin 03/31/2017) - Total $94.5 r - r r r k FISHERS ISLAND FERRY DISTRICT' VENDOR 012315 SHELTERPOINT LIFE INS.CO. 04/25/2017 CHECK 4021 r - - FUND & ACCOUNT P.iO.-# _INVOICE DESCRIPTION AMOUNT SM .9060.8.000.000 23817-0517 (24)LIFE INS PREM-5/17 67.2'0 NOTAL 67.20 r- , 1 ti,r t J r ! .ib •c ...,ro ,',x' > .><.< ...<:: ' .;i. >y,•.. :rod.-rr "` „ r f- , 1 t 1 -- 'y a'fsr`,L,<aa.-,;,"s. :r:, ,-,^ <i`; ``%qs.'``g-- e-v'-_g:,rt`1'y,,,..;.2^'°v;"•rw,af.''"<s„'L ip§: Yt;tIs",'f.r"P:,_a.rI„ DA S_ i'bF4SlERSISLAIVD°FRRYx 3095WANBOAD> TR,y^IN•C,`a.:TT4i,+a:U4.q t!'q.','m°,q y;A<n,'.FilUod--D,',^,Iq'v TNf<_t;_,'.•40<R'y4%s':'` zYe•fu G,5=='..`j,]i':`7--?,"s€„=t_'-t'qtrrt.'rY"(= .;d.,:;":_`;,s,_yy,:; , r P.O'BOXr,1,179..: :,!':11. ., .. F>`•:. :,^c,,`+:t r`..` ,!',rr:[^,f;:r--t .r -0",`;,,:r,., ..'l:" 1 ;4 1 71"0959P-"t',4r' :';P"Il,ydt,',. 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"ta',,c q, i "v, t.t• GT2EA'T:}TEC :NY;.b1'1'021 „>:-, ,.._ , s,4 ;It;,t;,i°rt 11,71'„ ,0 1 Ilstfl', 4;1:#s`,: .I,,.,-.., t .,R ,B;,,nr k,'r„ v,Y•k. k', "t;€ ,rv-- OFr'y`,r y3” ,e",r°s' "e:- ,4' !, °`t:'c<o-` ^' ; ';f 5;• s s ,rx i, ig;•"t`"^ <'t k,,' 1 .'ia:• r ik .,a 'ro a', lir t ,I' ,' '',' •'3 'l "2 § q;,.. . ! 4 1>;' 'b'< cll;T, .tr° `h`sly"rP .-ta'4( `.d, k rl'.'-: n 11'= „s•'c,'`,C.•i"' .ri'fy ha„-"1.,-R' ;-':' t 'i„^x•^, v; r a.•__ - _ __ _ -_ - - - I. _ "__•:d:-"' "' _"', _” __=___ __ 4i-_---',t'; igr x i'F I'- .,1I1,$.r i Idr•'IVrli.`'C'rI,r",,4':iVk'I1,"1I,', :F`!">1-:"t••___` -_= ->. = -_ -'!'tt"t°'T,lrJ1P N> _hr,,ili i•.rl 1'C rP"lr `4'h st.'4 f. ",3;'r- -`'4'r -" _ `> _ t_,lal r 'PI,i. ,I r,Iq ra+' 'tl ' /d'a'sr°}r-• _ -_ ;'a '; - -- - __ _ -- ",n`w`r t 1, _ -- -- _-= I,r,r a,;al"1 ,;I. "i4"s''p,•+:>> :r:s`--='.,:v'.' - - - _ _ -- _ _ _ _ i3E"' ::•d, '11, ,P ,W 4,P+'t"t 4,111°:Td'r>` "v` _I _ _ _ _ _ _" r#,; P-6 11, •ti.4 -- s. _ _ _ _ _ -_.€__ _:ar'--_ - c%k,'^q•'. ,tl °Id"':,^, .A' 1 Ir'fl' d,`✓_: - ""_ __°.t;'` '`t---_ - . _-_ - - " >,-zi ^<, "_,i_i''_•0".=0_ '40_L"2"a1rr`::• 2 I"1` .tM S I Gt'.gAp. w''--"-s68' _'_-__O0_-"'15'O,• _?3`. -'..n'P rW'z,',`,"l.ii lv`i'r.; ..,I„Im.••q1 .",, "4....., ...4!eiw - r -'.._'x.. _.- ,-_ -;5. >, I Vendor No. Check No. Town of Southold, New York - Payment Voucher 12315 4019 1 Vendor Address Entered by 600 Northern Blvd Suite 310 Great Neck, IVY 11021 Audit Date ShelterPoint Life Insurance Company APR 2 5 2017 Vendor Telephone Number 800-365-4999 Town Clerk Vendor Contact0, ' Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number 5S1 7-09 7 23817 4/3/2017 $67.20 $67.20 IIIIIAY 2017 Life,AD&D Ins Premiums SM9060.8.000.000 24 participants $67.20 $67.20 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 SignatTitle Signature Company Name Fishers Island Ferry District Date 4/13/2017 Title / p Date r 7 r Shelter Point Life Insurance Co. Monthly Billing for 5/1/2017 MPBR0003 OperNo:2 Run:04/03/2017 02.50 PM Page.6 Premium: 23817 FINAL FISHERS ISLAND FERRY DISTRICT(Grp:23817) PO BOX 607 261 TRUMBULL DRIVE FISHERS ISLAND,NY 06390-0607 Group Totals Total Due Volume Totals for Group Life: $240,000 Sup Life: AD&D: Sup AD&D: Salary: Sps Life, Dep Life: STD: LTD: Misc Vol 1 Misc Vol 2 Misc Vol 3: Misc Vol 4: Misc Vol 5. Insureds Billed- 24 Balance Forward. $123.20 New 0 Payments: - $53.20 Termed 0 Adjustments: + $0.00 Make Check Payable To: Shelter Point Life Insurance Co. Beginning Balance $70.00- 600 70.00600 Northern Boulevard,STE#310 Great Neck,NY 11021 Current Amount Due: + $67 20,-, I Current Adjustments: + 0:60 U' — Total Amount Due. $137.20 This is a premium invoice for the above mentioned policy. Please remit payment by the 25th of this month to avoid a lapse in coverage. It is very important that you remit your premium as shown on this billing statement Any enrollment/roster changes should be reported to us under separate cover,and will be credited accordingly on the next months' billing statement Delinquent payments and outstanding balances may result in the suspension of claim payments to your employees. If you have any questions regarding this invoice or your insurance coverage,please call our customer service department at 1-800-365-4999 or email us at custamerservice@shelterpoint corn Please return this entire form with your payment in the envelope provided ---- — — -- •, ————-— 1 , \ 1 , , FISHERS ISLAND FERRY DISTRICT VENDOR 019719 STAPLES CREDIT PLAN 04/25/2017 CHECK 4022 -FUND & ACCOUNT P.O.# INVOICE DESCRIPTION AMOUNT SM .5709.2.000.200 1794898281 W BINDER8-FREIGHT AGNTS 19.99 -- SM .5711.4.000.000 1795266591 STAPLE REMOVER-ACT 2.49 ; . 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':i F§',,,,, ai' ao,v` 'tf 'r<{'.F:"'~`,1 r1•",'. 6. `(,r s` z'i{, 'i,.si PHOEhTIX':'•AZ' '•8;5e06 2 V8 0`04.>7b, _ ,r - " 4- 1,' PI '1'i•`"d)`i•?'dl't'4kr". -•s- - -- - - ',_.> ,n 1,. i,fl i,S''i`„ (•,°,.`ilr:'ia .S' -- _ -f,`n _ F; "tel•-- - __ _ ,j'`,,L,I 't`,',+'_"I :f 11,Y.IJ':v( - __ - ;_ f:nl Ia,.F!al,: ,a,. `,1' _ r•i= - _ "- F°' _ _ _- _ _ _ _ 'ir'.:5h•r I_ -'_l'-. .:' `_-_`__ -__ r. .,I,p4,a' r`vj _ _-__ _ _'.S_=: ii'O;Ot40 0102'2 112' '"i:OR`2'`L4''0 L' i Vendor No. Check No. Town of Southold, New York - Payment Voucher 19719 H001 a Vendor Tax ID Number or Social Security Number Vendor Address Entered by Dept 51-7820657673 PO Box 78004 Audit Date' STAPLES CREDIT PLAN Phoenix,AZ 85062-8004 � �� Vendor Telephone Number 800-767-1291 FY 17 Town Clerk Vendor Contact r Invoice Invoice Invoice Net Purchase Order Number Date Total Amount Claimed Number Description of Goods or Services General,Ledger Fund and Account Number 1794898281 4/6/2017 $19.99 $19.99 Binders (4)for freight agents SM5709.2.000.200 1795266591 4/7/2017 $2.49 $2.49 staple remover for ACT SM6711.4.000.000 $22.48 $22.48 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 Signatur o Title Signature � C� I Company Name Fishers Island Ferry Date 4/14/2017 Title Date Account Statement 0Commercial Account staples.accontonl _ Customer untonl Service. Commercial FISHER ISLAND FERRY DIST ®� ^®���„ Account Inquiries: J� (� � 1-800-767-1291 Fax 1-801-779-7425 Account-Number: 6035 5178i 2065 7673 SQAmPip'ary of Account Activity Payment§nformat6®n Previous Balance_ $93.95_ Current Due _ $25.00 , moments �— -$0.00 Past Due Amount —+�_ $25.00 Credits -$0.00 Minimum Payment Due V = $50.00 — Purchases +$22.48 Debits �— +$0.00 Payment Due Date 05/02/17 FINANCE CHARGES +$0.00 Credit Line $10,500 Late Fees +$0.00 --- New Balance $116.43 Credit Available $10,361 Closing Date 04/07/17 Send Notice of Billing Errors and Customer Service Inquiries to: PILES CREDIT PLAN Next ClosingDate 05/09/17 STA PO Box 790449,St Louis,MO 63179-0449 Days in Billing Period 29 Your account is 1 month past due This is a courtesy reminder that we did not receive payment for last month.We're here for you and would like to help you bring your account current.»For assistance call us today at 1-877-740-2971.For the hearing impaired,call our TDD line at 1-800-995-9305.Hours of operation:Monday-Thursday 6.30 a m.to 11.00 p m CT•Friday.6 30 a.m.to 9 00 p m CT Saturday and Sunday,8,00 a.m.to 5:00 p.m.CT. Please update your phone number,including cell phone number on the back of the payment coupon,or call customer service at 1-800-767-1.291 to update. -_a By giving us your phone and/or cell number or a number later converted to a cell number,you agree that Citibank or its service providers can contact w you at the number by autodialer,recorded or artificial voice,or text Your phone plan charges may apply. C t-' Please note that if we received your pay by phone or online payment between 5 p m ET and midnight ET on the last day of your billing period,your payment will not be reflected until your next statement. Reminder Payments can be made by mad,online or by calling 1-800-767-1291 Note:in-store payments are not accepted. (/ TRANSACTIONS Trans Date Location/Description PO# Order# _ Amount _ 04/06 PUTNAM CT 9753573540 $ 19.99_ 04/07 PUTNAM CT 9753573540 $ 249 FINANCE CHARGE SUMMARY Your Annual Percentage Rate(APR)is the annual interest rate on your account. Annual Percentage Daily Periodic- Balance Subject to T Type of Balance Rate(APR) Rate Finance Charge Finance Charge PURCHASES REGULAR REVOLVING CREDIT PLAN 000% 0.00000% $0.00 $0.00 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION Page 1 of 4 This Account is Issued by Citibank,N.A.- 4- .A.4- Please detach and return lower portion with your payment to insure orooer credit. Retain uDDer portion for your records y Information About Your Account. sent to the correct address.The correct address for regular mail is the Grace Period on Purchases.You can avoid periodic finance charges on address listed on the front of the payment coupon.The correct address purchases but not on cash advances(if available on your account) This is for courier or express mail is the Express Mail Address shown in the called a grace period on purchases.The grace period is at least 20 days. Express Mail section. To get a grace period on purchases,you must pay the New Balance by Proper Form.For a payment sent by mail or courier to be in proper form, the payment due date every billing period.If you do not,you will not get a you must: grace period until you pay the New Balance for two billing periods in a row. Enclose a valid check or money order.No cash,gift cards,or foreign If you have a balance subject to a No Interest promotion or a 0% currency please. promotion and that promotion does not expire before the payment due Include your name and the last four digits of your account number. date,that balance(an"excluded balance")is excluded from the amount Copy Fee.We charge$5 for each copy of a billing statement that dates you must pay in full to get a grace period on a purchase balance other back 3 months or more.We add the fee to the regular revolve credit plan than an excluded balance.In addition,if you have a major purchase balance.We waive the fee if your request for the copy relates to a billing plan balance,that balance(an"excluded balance")is excluded from error or disputed purchase. the amount you must pay in full to get a grace period on a purchase balance other than an excluded balance.However,you must still pay any Payment Other Than By Mail. N separately required payment on the excluded balance.In billing periods Online.Go to the URL on Page 1 of your statement to make a payment. in which payments are allocated to No Interest balances first,the No For security reasons,you may not be able to pay your entire New v Interest balance will be reduced before any other balance on the account. Balance the first time you make a payment online.The payment cutoff Ln However,you will continue to get a grace period on purchases,other time for Online Bill Payments is midnight Eastern time.This means that M than an excluded balance,so long as you pay the New Balance(less any we will credit your account as of the calendar day,based on Eastern excluded balance,plus any separately required payment on an excluded time,that we receive your payment request. balance)in full by the payment due date each billing period. Phone.Call the phone number on Page 1 of your statement to make a In addition,certain promotional offers may take away the grace period on payment.We may process your payment electronically after we verify purchases.Other promotional offers not described above may also allow your identity.There is no fee for this service.The payment cutoff time m you to have a grace period on purchases without having to pay all or a for Phone Payments is midnight Eastern time.This means that we will N portion of the promotional balance by the payment due date.If either is credit your account as of the calendar day,based on Eastern time,that the case,the promotional offer will describe what happens. we receive your payment request. Balance Subject to Finance Charge.We calculate periodic finance Express Mail.Send payment by courier or express mail to: _J charges separately for each balance.Balances include regular purchases, Attn.Commercial Payment Dept.,1820 E.Sky Harbor Circle South, Er regular cash advances(if available on your account),and different STE 150,Phoenix,AZ 85034.Payment must be received in proper form _J promotional balances. at the proper address by 5 p.m.Central time to be credited as of that OTo get a daily balance,we start with the balance as of the end of the day.All payments received in proper form at the proper address after L✓ previous day.We add any new charges.We then subtract any new credits that time will li credited k of the next day. or payments and make other adjustments A credit balance is treated as u you send et eligible check with this payment coupon,you authorize a balance of zero.If the rate on a balance is a daily rate we include in the us c complete your payment by electronic debit.If we hedo,the daily balance any periodic finance charge on the previous day's balance. checking account will be debited in the amount on the check.check may (This results in daily compounding of finance charges.), do this as soon as the day we receive the check.Also,the check will be destroyed. If the rate on a balance is a daily rate we use an average daily balance Report a Lost or Stolen Card Immediately.You may call Customer method(including new transactions).We figure the periodic finance Service 24 hours a day,7 days a week. charge by multiplying the daily balance by its daily periodic rate.We do N this for each day in the billing period.The Balance Subject to Finance Notify Us In Case of Errors or Ouestions About Your Bill.If you think o Charge is the average of the daily balances during the billing period.If you your bill is wrong,or if you need more information about a transaction on multiply this figure for each balance by its daily periodic rate and by the your bill,write us(on a separate sheet)at the Billing Errors address on this a number of days in the billing period,the result is the total periodic finance statement as soon as possible.We must hear from you in writing no later charge on that balance.Rounding may cause a small difference. than 60 days after we send you the first bill on which the error or problem appeared.In your letter,give us the following information: Other Account and Payment information. When Your Payment Will Be Credited.If we receive your payment in Your name and account number. N proper form at our processing facility by 5 p.m.local time there,it will be The dollar amount of the suspected error. " credited as of that day.A payment received there in proper form after Describe the error and explain,if you can,why you believe there is an that time will be credited as of the next day.Allow 5 to 7 days for error If you need more information,describe the item you are unsure payments by regular mail to reach us.There may be a delay of up to 5 about. N days in crediting a payment we receive that is not in proper form or is not ST OS CRC JUN16 v c ST-9194-1550-0002-//-N-00-6035517100088887- -//- -0-D-96-/1-P-B-0-N-//-1- - 0-/1-04/01/02-180-March 9,2017-//-0- - ST09-//- -0- -//- w Page 2 of 4 Remit payment and make checks payable to:, i STAPLES CREDIT PLAN INVOICE DETAIL �\ DEPT.51-7820657673 m®re���®u im PO BOX 78004 PHOENIX,A 8 5062-8004 BILL TO: SHIP TO Acct 6035 5178 2065 7673 DIANE HANSEN Amount Due: Trans'Date: 811'99/®9Ce#e FISHES ISLAND FERRY 1794898281 261 TRUMBULL DR $1999 04/06/17 FISHERS ISLAND,NY 06390-8021 PO: Store: 100088887,PUTNAM,CT PRODUCT SKU# QUANTITY. UNIT PRICE TOTAL PRICE JAM PAPER ASSORTED 75 INC -2329747 1.0000 EA $19.99 $19.99 Purchased by: GORDON MURPHY SUBTOTAL $19.99 Order#: 9753573540 TAX $000 SHIPPING $0.00 TOTAL $1999 BILL TO: SHIP TO: Acct: 6035 5178 2065 7673 DIANE HANSEN Amount Due: Trans Date: DnvoOCe#o - FISHES-ISLAND FERRY 17955266591 261 TRUMBULL DR $249 04/07/17 FISHERS ISLAND,NY 06390-8021 PO: Store: 100088887,PUTNAM,CT PRODUCT SKU# QUANTITY UNIT PRICE TOTAL PRICE STAPLESREG FLAT STAPLE RE 317313 1 0000 EA $249 _$249 C3 Purchased by: GORDON MURPHY SUBTOTAL $2.49 ru Order#: 9753573540 TAX $0.00 SHIPPING $000 TOTAL, 1249 -/ �' Page_3 of 4 1-800-767-1291 staples.accountonline.com This page intentionally left blank. N e n M N i P P N tU m M N W 0 ru N W O N ' O a P v n N L 0 N V J O W , Page 4 of 4 1-800-767-1291 staples accountonline com Order by phone: 1-800-333-3330 Order: 1381746 M—F: 7am—Mid Sat: 9am-10pm Placed:4/6/2017 Sun: 11 am-9pm Eastern Time MAKE rnoreHAppEN Email: support@orders.staples.com Ship To ' Order Information Diane Hansen Fishes Island Ferry Purchase Order No. : ZYFKS7 261 Trumbull Dr Fishers Island, New York06390 Customer No.:2733095012 8604450165 accounting@fiferry.com Item# Model# Name Quantity Quantity Ordered Shipped 2329747 750T1 RGBOR JAM Paper@ Binders - Plastic- Glass Twill - 1 1 0.75 inch -Assorted -4 per Pack Order Information ` Shipping Shipped on 4/6/2017 using UPS Ground: 1Z1X8X60394494856 Need to return something? Please visit www.staples.com/returns. If returning to a Staples store, please bring this document. Questions about your order? REFER TO THIS ORDER NO. FOR ALL INQUIRIES Visit our Help Center at CUSTO=k NO. SHIP DA-rR I pADM xa' www.staples.com/help-center 4051825224 4/06117 1 9753573540-000001 1 PURL=99 ORDER MO. N0 MAKE rnOfe HAPPEN COST CXbl'J BR Rk'QVISI'. IO xM Staples Make More Happen SHIPPING LOCATION:Putnam, CT FC CARRIER ROUTE:UPS/UPS /U2 FISHES ISLAND FERRY :H DIANE HANSEN 0 TOTAL PACKAGES: 1 261 TRUMBULL DR FISHERS ISLAND, NY 063908021 T Contact: (860)445-0165 - DIANE HANSEN T {5 D PAGE: 1 1 SPECIAL INSTRUCTIONS XTWU�i RA I Q1Y Wim $tapIQs &Yc� ci�s� rid A4° 'C i'�TUMJ3F. D xk�m pN t� N M�E01m $dTTP-� P e3�e luctazint 1 317313 Staplesreg Flat Staple Remover/24567-CC EA 1 1 2.49 2.49 p M rc andise Total. . . . . . . . 2.49 d\ D alivery. . . . . . . . . . . . .00 T x. . . . . . . . . . . . . . . . . . . .00 Check your order statuE online by going to www.Staples.com and clicking on "Track rder" . I ,Ylr�aw Need to return something? Visit ;News www.staples.com/returns. For store TOTAL VALUE 1& Previews returns, bring this pack slip. PAYMENT METHOD: 2.49 OF ORDER: 001 Thank You For Your Order! Staples, Inc. THIS IS NOT ANINVOICE