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(8'15)298-1478
1 8458783476
TO: 8783476
p.2
Jui 0610 02:58p US Census POK LCO 2139
JUL-6-2010 02:36P FROM:TOWN CLERK
P.2/4
2010-01-19 JCM
FOR INTERNAL USE ONLY
Town of Wappinger
Agreement for the Use of the Town
Hall Facilities for Meetings
Chris Masterson q
Christine Fulton 'tJ
Sue Rose 0 :J
Date Received: 01 101! L
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Serial #: / 3
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~ Application ~OO.OO _~: ofB
I Y; Notified Recreation (date":1.1:J.p.QJ
Received by;
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Agreement for the Use of the Town HaB Facilities for Meetings
_ US CeM~t^-J Dl,t(-">a~
Nr; o~or.ani1f;pr ar;J} .
rti;, of (:-0<-, ,
Name ofp~so, ~representing th
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This wi]] confirm the arrangements being requested for your groups' use of the Wappinger Town Hall Facilities, as
noted below:
(V Senior Citizens Room
(0 Large Meeting Room
( ) Other: Specify:
Tne gro~ ~t t:Xpected to aceed t 'L persons L1 L:J
Date(S):~~ I L) "1-0c 0 Time: ~:]c riP?~ Vdo r~
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 meeti1'1.g.
You and your Organization hereby agree to adhere to the rules set forth on the attached page by signatm"e of an
authorized member of your Organization or group.
The Town of Wappinger reserves the right to suspend tempomrily 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 ()(:casions.
The Town Clerk should be infonned 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 TO",ll Clerk: for review and
Clearance.
Jul 0610 02:59p US Census POK LCO 2139
JUL-6-2010 02:36P FRDM:TOWN CLERK
(845)298-1478
1 8458783476
TO: 8783476
p.;;
P.3/Q
2010-01.19 JCM
Terms of t..he agrc:erncnt must ~ strictly adhered to by the oont:rDcting group as any disregard or abuse of the rules
for use of the facilities 'win result in termination of use by the offending group, and they wiU not be granted
reinstatement
I have read and understand the roles and regulations for the use of the Facilities in the Town of Wappinger Town
Hall, and will comply with these requirements.
Signed:
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(Name of Group or Or~)
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For:
Date:
Jul 0610 02:58p
US Census POK LCO 2139
18458783476
p.i
Poughkeepsie lCa 2139
31 Route 22
Pawling, NY 12564-3219
345-878-8240
845-878-3464
US Census
Poughkeepsie 2139
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I UNITED STATES DEPARTMENT OF COM MERCE
Economic; and Statistics Administration
U.S. Census Bureau
poughKeepsie Local Census Office
31 Route 22 Suite 6
Pawling, NY 1256a-3219
February 23,2010
TOvvn of VJapping-er
20 Middiebush Rd.
Wa ppinger, NY 12590
Dear Ms. Rose,
The Government is self-insured and does not maintain general liability insLJrance. Cens.us agrees
to promptly consider" and adjudicate any and all claims wllieh may arise out of use of subject donator's
.
premises resulting from the actions of Census or duly authorized representatives or contractors of
Census and to pay for an~' damage or injury as required OV Federal law. Such adjudication will be made
pursuant to the Federal Tort Claims .A.ct, 28 U.S.c. 2671 et. seq. or such other legal authority as may be
pertinent.
CensuS also agrees to consider and adjudicate any claims for damage or inj ury sustained by
Census personnel in the performance of their official duties. Such Adjudication will be made pursuant to
the Federal Employees Compensation Act, 5 U.S.c. 8101 et.seq. or other such legal authority as may be
pertinent.
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David Fracasso
Office Oper<lTions Supervisor
U.S. Census Bureau, poughkeepsie NY Office