HomeMy WebLinkAboutCertificate of Insurance COUNTY OF SUFFOLK
STEVEN BELLONE
SUFFOLK COUNTY EXECUTIVE
DENNIS M.BROWN DEPARTMENT OF LAW
COUNTY ATTORNEY DIVISION OF RISK MANAGEMENT
August 7,'20,17h,
Town of Southold
PO Box 1179
Southold,NY 11971
Attn: Scott A Russell, Supervisor
Re: Certificate of Insurance
Dear Supervisor Russell:
Please find enclosed (on the opposite side of this letter) a Certificate of Insurance evidencing
coverage by Suffolk County for the use of your facilities as a Polling Place during the
September 12,2017 Primary Election.
If you have any questions,please do not hesitate to contact me at 631-853-5930.
Sincerely,
&"AAAI
Caroline Stolz
Insurance Contract Analyst
CC: Joseph Lombardi and Joseph Barone, Suffolk County Board of Elections
LOCATION: MAILING ADDRESS: Risk Management Phone (631)853-4700
H.LEE DENNISON BLDG—7"FLOOR P.O.BOX 6100 Risk Mgmt.&Liability Fax (631)853-4956
VETERANS MEMORIAL HIGHWAY HAUPPAUGE,NY 11788-0099
HAUPPAUGE,NY 11788
COUNTY OF SUFFOLK
STEVEN BELLONE
SUFFOLK COUNTY EXECUTIVE
DENNIS M.BROWN -DEPARTMENT OF LAW
COUNTY ATTORNEY DIVISION OF RISK MANAGEMENT
CERTIFICATE OF INSURANCE RECEIVED
Coverage Date: Tuesday,September 12,2017 from 5:00 am to 10:00 pm
AUG 1 6 2017
Issued To as Town of Southold
Additional Insured: PO Box 1179,Southold,NY 11971
Southold 7'ovvn CoErk
Location(s): Designated Polling Place(s):
Southold Town Recreation Center,970 Peconic Lane,Peconic,NY 11958
Purpose: Use of facilities as Polling Place for the September 12,2017 Primary Election
Amount of Coverage: $1,000,000 per occurrence combined single limit for Bodily Injury and Property Damage. This insurance
is excess over any other valid and collectible insurance except insurance that is written specifically as
excess over the limits of liability that apply in this policy.
This is to certify that coverage is afforded by:
Self Insured: County of Suffolk
Address: Risk Management&Benefits Division
P.O.Box 6100,H.Lee Dennison Building
Hauppauge,New York 11788-0099
Risks Covered: To the extent permitted by law,the COUNTY shall defend and indemnify and hold you harmless from and
against all claims, costs, losses and liabilities arising out of the acts or omissions or negligence of the
COUNTY,its agents or employees in connection with the use of the location at the time and for the purpose
described or referred to in this Certificate. This insurance is excess over any other valid and collectible
insurance except insurance that is written specifically as excess over the limits of liability that apply in
this policy.
COUNTY OF SUFFOL�K"-&
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Dated:August 7,2017 Leslie E.Baffa—Director of Risk Management
LOCATION: MAILING ADDRESS: Risk Management Phone (631)853-4700
H.LEE DENNISON BLDG—f's FLOOR P.O.BOX 6100 Risk Mgmt.&Liability Fax (631)853-4956
VETERANS MEMORIAL HIGHWAY HAUPPAUGE,NY 11788-0099
HAUPPAUGE,NY 11788