19
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2010-01-19 JCM
Received by:
Chris Masterson D
Christine Fulton D
Sue Rose ~.
~1J6/~
Town of Wappinger
Agreement for the Use of the Town
Hall FaCi~itie.s for MeetingS~
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FOR INTERNAL USE ONLY
Date Received:
Serial #:
~pplication ~ 00.00 ~rt. of LI
C Notified Recreation (date: Q/,<;7/o )
Agreement for the Use of the Town Hall Facilities for Meetings
. I:' I
!d4-6)t L.-{,
\ ),s-r D
'64f ~ ~--/rfD
Phone No.
This will confirm the arrangements being requested for your groups' use ofthe Wappinger Town Hall Facilities, as
noted below:
( ) Senior Citizens Room
( ) Large Meeting Roof} f} ~;J'~. \
() other:specify:JL>~ -.r /~ 0 for:iJdLl=:. htJilw(j-)
The group is not expected to exceed -~~ -ersons
Date(s): Sept ,:;;...G,;) 20l 0 ~) Time:-' pM ~-'~7Wl
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.
... L I \
2010-01-19 JCM
Terms ofthe 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.
,--.I /) \ (
Signed: Jl\~,-~ "-) - -4---\~
For: fO..A rv'&.4.CCH CLcGtl('\;\
(N
Date:~. \ 0 I ).OlO
Approved: ~_ L-1J[Q~"'~
\ Town Clerk
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Date: q.. l \ - ~l D
~
~R CERTIFICATE OF LIABILITY INSURANCE I DATE~
OP IDMP
09/13/10
THIS CERTIFICATE IS ISSUED AS A MA TIER 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.
: If the certificate holder IS an AUUlllUnAl. , the pollcy{leS) must De endorsed. liS ..~.. --, 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).
PROOlJCOR 0'''''''''' Maria B. Perez, CIC
MOody & Associates, Inc. NA.:
PHOIE I FAX
www.moodyinsurance.com c.u:. No, ....' c.u:.I.",
.......
22601 Gateway Center Drive AIIDAESS, mperez@moodyinsurance.com
C1arksburg NO 20871-2002 PROOlJCOR FORMAS1
CUSTOIER II) t:
Phone: 301-417-0001 Fax: 301-417-0040 INSURERCSJ AFFORDING COVERAGE IWC'
IN8UftED INSURER A : Alllanoe or ~ Ear IhaIIRO
Formosan Association For INSURER 8 :
Public Affairs
552 7th Street, S.E. INSURER C :
Washington DC 20003
IN8UIER 0 :
INSURER E :
INSURER F:
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY TliAT THE POlICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POlICY PERIOD
INDICATED. NOlVtmiSTAJrDNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONlRACT OR OTHER DOCUMENT \MTH RESPECT TO 'lI\HICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AU THE TERMS,
EXCLUSIONS AND CONOmONS OF SUCH POLICIES. LIMITS SHQNN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
..... ADDl sueR POUCV EFF POUCY EllP
LTR lYPEOf_ IHSR WVD POUCY MJJiBER l-.v'tl l-.vv) UWTS
GENERAL l.IAIaITY . 1000000
- EACH OCCURRENCE
A X COMMERCIAL GENERAL LIABILITY 2010-13703 09/03/10 09/03/11 DAMAGE TO RENTED
PREMISES (E. ot'IlUT'8f1Ce) . 500000
I ClAIMS-MADE ~OCCUR MED EXP (Any one perw:Jfl) . 20000
f-- PERSOfoW. & ADV INJURY . 1000000
~ Liq Liab-1,000,00 GENERAL AGGREGATE . 2000000
GEN'l AGGREGATE LNIT APPlIES PER: PRODUCTS - COMPIOP AGG . 2000000
Ii poucy n ~ n LOC .
AIJ1OOIllM.E l.IAIaITY COMBINED SINGlE LIMIT
f-- (EallCCidenl:) . 1,000,000.
A _ AUTO 2010-13703 09/03/10 09/03/11
- BOOtlY INJURY (Perpel'K'ln) .
AU O\MiED AUTOS
~ BODILY INJURY (Pet acddent) .
SCHEDUlED AUTOS
'-- PROPERTY DAMAGE
~ HIRED AUTOS (PefllCCidenl:) .
~ ~EDAUTOS .
.
-.... UAII H OCCUR
- EACH OCCURRENCE .
EllCESS UAII CL.AJMS-MADE
AGGREGATE .
f-- DEDUCTIBlE .
RETENT1Ot< . .
""""'""" COOI'ENllAllON I. V\C STATU- I 10:
AND EIlPLOYERS' LIABIJTY v,. TORY LIMITS
ANY PROPRtETORIPARTNERlEXECUllVE D E.l. EACH AOODEHT
OfFICERlUEMBER EXClUDED? 'A .
(MMId*Ny In,,)
tf.,.., dMcribe lrldef E.L otSEASE - EA EMPLOYEE .
DESCRIPTION Of OPERATIONS below E.l. DISEASE - POUCY LIMIT .
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (MIKIt ACORD 101, AddIioNI ~~. if..... apM:e..........
RE: Taiwan Democratic Development Seminar being held at Wappingers Town
Ba11 , 20 MidcUebush Road, Wappingerss Fa11s, NY 12590, on Sunday, September
26, 2010.
CERTIFICATE HOLDER
CANCELLATION
SItOULD MY OF TtE ABOVE DESCRIBED POI.JCIES BE CANCa.l.ED BEFORE
FAPANY1 THE EXPIRA110N DATE 1HEREOF, N011CE WI.!. BE DEL.NERED..
ACCORDANCE WITH 11tE POlICY PROVISIONS.
FAPA NY Mid-Budson Chapter
c/o Thomas Bwang AU1HORIZED REPRESENTATIVE
68 Sherwood Beights
Wappingers Falls NY 12590 ~~
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ACORD 25 (2009/09)
@1988-2009ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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FAPA MID-HUDSON CHAPTER 166
PH. 914-298-1590 ~ S
WA~I~~~~~~~~~~~90 DATE~.~~__)~ [D 50-7936/2219
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Fotplosan Association for Public Affairs - Wikipedia, the free encyclopedia
Page 1 of 1
The Formosan Association for Public Affairs (FAPA) is a Washington, D.C.-based nonprofit
organization that seeks to build worldwide support for Taiwan independence. Its 52 chapters also seek to
advance the interests of Taiwanese people and communities around the world. Currently, the President
ofFAPA is Dr. Bob Yang.
Established in 1982 in Los Angeles, California, F AP A subsequently moved its headquarters to
Washington, D.C. The organization provides U.S. policy makers, the media, scholars and the general
public with information on issues related to Taiwan.
Contents
http://en.wikipedia.org/wiki/Formosan_Association_for _Public_Affairs
9/10/2010