Little League CE: �WE ED
DEC 3 0 2015 2010-01-191cm
FOR INTERNAL USE ON
WiN F WAPPTIW� of Wappinger
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7'r)�
Received Lay: Joseph P. Paoloni U 7n� e-q r-Agreement for the Use of the Town
Grace Robinson Hall Facilities for Meetings
Date Received:
Serial#:
1") Application J $100.00 11 Cert. of LI
J Notified Recreation (date:_.....
Agreement for the Use of the Town Hall Facilities for Meetings
'7
7.
Name of Organization or GrOLI
12
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Name of person representing the Organization or Group
Address
Phone No.
This will confirm the arrangements being,requested for your groups' use of the Wappinger Town Hall Facilities, as
noted below:
Senior Citizens Room
Large Meeting Room
7;
(11K Other Specify:
The group is not expected to ed &2 Persons
a e
16P Time:
It should be understood that groups, using the Buildings' Facilities for evening meetings Must select dates when
Town.Meetings are norin.ally scheduled (i.e., Justice Court, Planning Board, etc.)Special requests will be
considered upon their own merit, and arrangements can be made for access to, and closing, the building at the close
of your meeting.
You and your Organization hereby agree to adhere to the rules set forth on the attached page by signature of an
authorized member of your Organization or group.
The Town of Wappinger reserves the right to Suspend temporarily this agreement should the'rown have need of the
facility for its own purposes. Advance notice will be given as soon as possible on such occasions.
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The Town Clerk should be informed promptly of any schedule change or cancellation of your group activities.
Arrangements for access to specific area to be LISed should be made with the Town Clerk at the time this foram is
Submitted.
No application shall be considered approved until it has, been Submitted to the Town Clerk for review and
Clearance.
2.010-01-19 JCM
Tenns of the agreement must be strictly adhered to by the contracting group as any disregard or abuse of the rules
for use of the facilities will result in termination of use by the offending group,and they will not be granted
reinstatement.
I have read and understand the rules and regulations for the use of the Facilities in the Town of Wappinger Town
Hall, and will corn ly with these x irements.
0
Signed:
For: � ��
(Name of Group or Organization)
Date:
Approved: —�—
Town Clerk
Date:
CERTIFICATE OF LIABILITY INSURANCE DATE It/23/1 F-'�
Keystone Risk Managers,LLC, CERTIFICATE# a ; ,._
1995 Point Township Drive
Northumberland,PA 17867 2 32 17
APtATIONAL NAMED INSURED: INSURERS AFFORDING COVERAGE:
TOWN OF WAP 3<I*+!GEN A1"HER I CAN LL.. INSURER A: LEXINGTON INSURANCE COMPAn
PETER KOOW01
1.4 [-•1AM I L.TON IRV INSURER B. NATIONAL UNION FIRE INSURANC
(Non-Liability) COMPANY OF PITTSBURGH, PA
INSURER C: AIG SPECIALTY
INSURANCE COMPANY
COVERAGES
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 RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAIi
PERTAIN, THE INSURANCE AFPORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSION$AND CONDITIONS OF SUGF
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
in ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
N iNsnD DATE MWDDNYYY DATE MWDDNYYY
GENERAL LIABILITY EA1'H000t1HRENCE ;.{,, y;}�
3" X X OCCURRENCE 011225814 .1..�,O1/2; 1.6 .&1 .+'0.I,'20.1 7 GENERALAGGRFGATE ,421 O"Di0i 000
X INCL. PARTICIPANTS Property Damage Deductible:$250 AGGREGATlaRnOUC'T9rcoTE OPs 41, s 000' 000E
X SEXUALABUSE OCCURRENCE
SAGG EGATE C
OO��r ��0BUSS µpi 0
MEDICAL PAYMENTS ANYONE
pER50
EACH LOSS $1,000,000
DIE�ECTORS&OFFICERS
A X1171,3 309 FiS 1/01/124016 1.A'£.f:1./210 17 AGGREGATE $1,000,000
A EACH LOSS $35,000
GRIME COVERAGE
Crime Deductible:$250 Property/$1,000 Money AGGREGATE NONE
As in Master Poky As in Master
SPORTS EXCESS ACCIDENT �� r�� R y D Med.Max. Policy Excess
aR1.1?I0_�-43. °1 .[.! Olr20 i6 �,�/0.1., 2017 Ded.$50
"X"INDICATES COVERAGE SELECTED FOR ADDITIONAL NAMED INSURED
, ADDITIONAL INSURED
Who is an insured(SECTIOW11)of the General Liability policy is amended to include as an insured the person or organization shown in the schedule,but only with respect ti
liability arising out of the above named Little League's maintenance or use of ball fields, or other premises loaned, donated, or rented to that Little League by such person o
organizations and subject to the following additional exclusions:
t. Structural alterations,new construction,maintenance,repair or demolition operations performed by or on behalf of the person or organization designated In the Schefte unless
performed by the above named Little League and
2. That part of the ball field or other premises not being used by the above named Little League
NAME AND ADDRESS OF PERSON OR ORGANIZATION:
TOW 0 F k,,J1A P1i\[G ul"•r' V WAPPINGERS CF-_N RAI_ t C.Qi•-@COL. D3', TRIC'r
INSURED CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES TO THE ABOVE NAMED LITTLE LEAGUE BE CANCELED BEFORE THI
Little League Baseball Risk Purchasing Group, Inc. EXPIRATION GATE THEREOF,THE ISSUING INSURER OR THE{R REPRESENTATIVE WILL MA?L30 DAYS WRITTEN NOTICI
TO THE DESIGNATED PERSON OR ORGANIZATION AT THEIrLKN ADDRESS TO U .
539 U.S.RT. 15 HIGHWAY
South Williamsport, PA 17702 AUTHORIZED RE RESENTATiVE
i 1
Peter McGowan, League President
Town of Wappinger Little League
14 Hamilton Rd Wappingers Fails, NY 12590
December 30,2015
Members of the Board for the Town of Wappinger,
Hello, My name is Peter McGowan and I am the new President of the Town of
Wappinger Little League. I am writing to request the Town Board waive the fee for the
Little League to use the courtroom in the town hall on January 30th and February 20th
2016 for Little League registration. I understand that you have extended this courtesy in
the past. Any way that the league could save money would be a help. I appreciate you
time and consideration with this matter.
Respectfully,
Peter McGowan
15)
IVE0
DEC 30Z015
TOWN OF WAPPINGEr'
1
Peter McGowan, League President
Town of Wappinger Little League
14 Hamilton Rd Wappingers Falls, NY 12590
December 30,2015
Members of the Board for the Town of Wappinger,
Hello, My name is Peter McGowan and I am the new President of the Town of
Wappinger Little League. I am rri mg to request the Town Board waive the fee for the
�oo
Little League to use the iiNe town�hall on January 30th and February 20th
2015 for Little League registration. I understand that you have extended this courtesy in
the past. Any way that the league could save money would be a help. I appreciate you
time and consideration with this matter.
Respectfully,
Peter McGowan
RE�W E
j DEC 3 0 2015
TOWN OF WAPPINGFI'