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Wildwood Manor Condo 2010-01-19 JCM FOR INTERNAL USE ONLY Town of Wappinger greement for the Use of the Town. Received by: Joseph P. PaolonLp „, Grace Robinson Fall Facilities for Meetings Date Received: 1 / MAY 0 • ”""8 4. Serial #: �, TO WN OF �`P�`°�mPT.NGER _ IJ Application ❑ $100.00 [1Cert.Tu ' LERK ❑ Notified Recreation (date:. Agreement for the Use of the Town Hall .Facilities for Meetings Name rganizatioor Group Name 9f person representing the Organization or Group / I_ ri 0"JS S`, ����u t q r1 Psr c1`f j X03 ��S y73-371 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 (V)' Large Meeting Room ( ) Other: Specify: The group is not elxp(,CtCA to exceed persons Date(s): 2! Time: /,l`1 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 Wappinger 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. 2010-01-19 JCM Terms 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 comply with these requirements. Signed: J / For: I � !G/� tld Oh / 1. 11��� ✓ �0r"' lAli wtf (Name of Group or Organization) Date: Approved: Town Clerk Date: Wildwood Manor 11 Raymond Avenue Suite 32 Poughkeepsie,NY 12603 Questions?Contact: Associa New York www,associa.com 420721 v.1 s Payor Name Payee Name Check Number Check Date Wildwood Manor Town Of Wappinger 1000748 04/24/2018 Payor Note: Invoice Paid: Account Number: Amount: Remittance Note: M4191 ai m $100,00 .• . .SECURITY FEATURE,AND OTHER 1foJIAEfEEt9F7AY5 Wi[dwood Manor - ryltitual ofbmahtNnk 75� _ - - 11 iiaymondAvenue.. = _ = 111W w 1liamicliDr Ste 101- Tamperi9ZQ528 i'oughkeill NY 12603- - ra - DATE. X12 I201$ 915751221R'" PAY TO TPWn Of Wd in of 10000 i i HE ORDER OF One Hundred:Ooliars and Zero Cents riaid 4 DOLLARS' dF momInv:E11041918100 Town Of Wappinger 20 Middiebush Rd Wapprogers Falfs NY 1.2590-4004 = 0L000 ?Il 1: L221057571: 2TP. 5LG42F. i'