Montclair Condo / Townhouse ..l~'OR INTRIriAL USE OivTL
Town of Wappinger 2010-ol-lg jCM
Received by: Joseph P. Paoloni Agreement OI1
Grace Robinson k � Use Off'the Town
Date Received: / 1 � 7z � SC
- - Meetings
Serial #:U016OCT 14 2016
Application o $100,00 � Cert. o �PPIN E
0 Notified Recreation(dater CLERK
Agreement for the Use of the Town Hall Facilities for Meetings
Na e f Or ration or Group
Name of p rson represe ting t rganization or Gro p
l l Phone No.
This will confirm the arrangements being requested for your groups' use of the Wappinger Town Hall Facilities, as
noted below:
( Senior Citizens loom
Large Meeting Room
( ) Other: Specify:
The group is not expected to exceed ® persons
Time: � ,�
� '�.._,�
It should be understood that groups using the Buildings' Facilities for evening meetings must select dates when
Town Meetings are normally 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 Wappiner reserves the right to suspend temporarily this agreement should the Town have need of the
facility for its own purposes. Advance notice will be given as soon as possible on such occasions.
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 used should be made with the Town Clerk at the time this form, is
submitted.
No application shall be considered approved until it has been submitted to the Town.Clerk for review and
Clearance.
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To: Town of Wappingers From. Heidi M Brogan
-------------- --------------------------- ----------- ----------- -.---------------------------_ ----------
A.ttention: Grape Date: 10-18-2016
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Fax k 845-298-1478 CC:
------------------ ................. .............LL------------------------------------- -------------------------------
Re: 'r&
---------- ----------Re: '', ,C lnsurance/Montclair/Armua1 Meeting Pages: 2+cover
Please feel free to contact the office witli any questions or concerns.
Thanks yvu,
Adtrliniwative Assistant
Town Country Properly l�bmt,Inc. ���C Q��D
Managing Agent t'ar
The Park ] Condominiums
3 Neptune Rood, STF,A.19A
Poughkeepsie, NY 12601 OCT 18 2016
545,462,2270(p) TOWN OF WAPPINGER
845.462,2272 (0 TOWN CLERK
9 Neptune Pond,5n.ita A19A, paughkeepsio, NY 12601 tel. 845.462.2270 Fax 843,467..2272
e-mail totivngnJcotintr)rpropertymgmt@;itt.nct
,
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THIS CERTIFICATE IS ISSUED AS q 14hATTE4 OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTInCATE HOLLER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NPOATIVELY AMEND, EXTEND OR ALTER THE COVERA06 AFFORDED BY THE POLICIES
RIFLOW. Ttils CFRTIFICATF OF INSt144NCE OOES NOT CONSTI°i'UTE A CONTRACT BETWEEN THE" ISSUING INSURER(S), AU-rI'!0RIZF0
REPRE=SENTATIVE OR Pk()LIUCER,AND THE CERTIFICATE HOLLER.
IMPORTANT. it the certifpcate holder Is SIt AObITIONAL INSURED,the PoilcY(leS)must he ondors0 - If SUBROGATION IS WAIVED,subject to
the terms and condition%of the pollCy,curtain Policies may require an endorsement. A stataMent on this certfttitu does riot Canfor rights Ga the
cartlflwte hnidsr In lieu of such andorsemanys).
PRODUCER DNTA AYIInfjesoje
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COVERAGES CERTIFIC:ATENUMS 11*lASTER Tia RERP:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 6ELOW HAVE BEEN ISSU TO THE INSURED RIENAMIEED AgOvE FOR THE POLICY PERIOD
INDICATED, NOTWITN�TANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHIOH THIS
CFRTIFICATE MAY E� ISSUED ON MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CCNDJION3 OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCCD BY PAID CLAIMS.
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TYPE OF INSURANCE NUMB 10DY EXP LIMITS
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DESCRIPTION OP OPERATIONS!LOQAWN5 i VEHICLES (ACOR01'0'I,AddtdoRNl ReMUIRrA$chOdUtA,MSAy ba Rttvchod IF Morn"nee is F6WuWO
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vnlly. This Qerti!�IcBtn hae been iasued as a matter of in£ormAtion only.
Coverage is Prould0d fOr thirtY-seven two-story brick veneer condc5minium huildinga contaiui,n,g two bvndred
nlnet-.-si,x residential units. The p,CeJmisos is located at bu:,Idinga 1.-37 Alpine. Drava, Wappingers rally,
Dutche ss County, New 'Zork 1590.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED Pbt WffS OF CANCELLED BEFORE
EVIDENCE OF COt1ERP,GE 4 TLY THIF EXPIRATION DATE THEREOF, NOTICE 9I LL BE DFI.IVEREn. IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZED AEPRE9ENTATIVE 1
Al,ana ii2aa;f,e/MC
GT 1988-2014 ACORD CORPORATION. All rights reserved.
ACORE)25(201410 1) The ACORD Isamu and logo are registered marks of ACORD
INS028ipni4n-i
CERTIFICATE OF PROPERTY INSURANCE D10/7nroDIYYYYI
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THIS CERTIFICATE I5 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOFR. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENb, FXTEND OR A4T0 THE COVERAGE AFFORDED BY THF'POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN TOV ISSUING INSURED($), AUTHORIZEDRFPRESFNTATI r O€�NRODUCER,AND THE CERTIFICATE HOLDER.
If this r-ortificata fa boijig prepared for a party who has an Insurable In#prwt In.the Propertyr da nlot use this form. Use ACORD 27 or ACORD 28,
PRODUCER NAME: T�•.1arMa ,7essie
DGNLT GF7ELT,T ASOCIi:7E8
PHONE (91a 21i-66a0
IN15UB,FNV-F', AorNCY INC � leia1z73-scall
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Craton-�on--Eudnon NY 10520 FRID: 00000030
INSURED — -- - INSURER(S) FFORDNO COMAOE NAIC 9
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COVI=RAGES CERTIFICATE NUMBERMSTER Prop REVISION NUMBER:
LOCATION OF PREMISES!DESCRIPTION Or PROPERTY(AHeeh ACQRq in9,Addlllohel RoMerk 5d�■dy>A,Ir more epeco h foquksdl
LQ0# 00001: 1-:17:17 I+ rine Drive Wappingers Valla NY 11$90
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THIS IS TQ 07RTIF'Y THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 1$8UED TO THEE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY HE ISSUED QR MAY PERTAIN, THE INSURANCE AFFORDED 9Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND C0NnI71QN$OF SUCH POLICIES,OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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INLAN6 MAMK rYPE OF POLICY S .
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NAMED PERII,S POLICY NUMBER
S
A X I CRIMP PHPR15b"S52R 10/1/2016 10/1/2017 X E vyeeDWIGNe4y, s .
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TYPE OF POLICY _ '' CompWet Proud d� Y
X Farpry d Ah9ratlons F 3 9D4 67
BOILER&MACHINERY I 1?HPPU353620 10/1/2016 10/1/2017 X Limll �.._.
RGIUIF'MENT BREAKDOWN 39,545.13
X Daduagpin S
SPECIAL CONDITIONS l OTHER COVERAGES (Aiknch AGORD 709,Addklbreal"RAs SehedWe,i!R101b space Is required) Y�
The coverages rnfnrred to on this certxfioata are in. fotce for the Protection of th6 above
naited inmtred only. This certificate has been issued as a matter of informatiwi only.
The PrL:)PartZ Managing ent Rider ;Lainp
pluded on Crime.
CERTIFICATE HOLDER CANCELLATION
SWULD ANY OF THE ASOYE DESORIBED POLICIES BE CANCELLED BEFORE.
THE EXPIRATION DATE THEREOF, NOTICE WILL RO 09UVERED IN
EVZDENCE OF COVAPAwM, ONLY, ACCORDANCE WITH THIS POLICY PROVISIONS.
AUTWRrd=REPRESENTATIVE
Aland Jessie/MC
ACORD 24(2009109) (D 1995-2089 ACORD CORPORATION, All rights resolved.
INS024(2aaenol The ACORD name and logo etre registered marks of ACORD