04
USC8nSUSPOK~
.3~~IO ~0"" ~ '\J-llivclk' . ...
Q"hl2-b C <..)Lse-:'i
FOR INTERNAL USE ONLY W
Mar 2210 03:32p
.
1 845 878 3464
p.2
2010-01-19 JCM
Town of Wappinger
Agreement for the Use of the Town
Hall Facilities for Meetings
Chris Masterson C
Christine Fulton =:J
Su.e Rose (S'
Date Received: :], I:). '!7 I E
Serial #: ~
'J Application 0 $100.00 .;;Z.. cfLl
C Notified Recreation (date: )
Received by:
0" -.HAPPJ .
~~.-.:'.....~c.
~., "''':''~'
o c .,-..
!~i . .. ."
o ~~'.' .r>-,'
,.' '2: I
. ~' /:.. !
'C:.l. ...:...."
...~s'-"'. .' ,,,.....'
. _ _s co....
Agreement for the Use oftbe Town Ball Facilities for MeetingS
J ',' /'l /J
! ." L'- "1 <) . ~., . 17" , "{" .
. . ..- . . I t. ~ o_:',.;:-.t" J!"J~."~.
,.o' ,./ _ -(:'.. 1 ,_ - u~ .. . ,- ,
Name of Organization ~.-0ou~ ')'1 r' - .
/ \... :CFiV ~. e n / I c,: <..Lt't1.. 1
Name of person repr~~tingth~:f~~r.~tion o~ Grou~-;. , .J ._
-'J ,......... f ~?;;J- . f (Uf-j / /(l'j
Address - / . -
,IVy
.I
;"'..._ ;;.' --1 ,. ~...... .
,>slt') . ,'f ;S - )~ 1D
Phone No.
This will confirm the arrangements being requested for your groups' use of the Wappinger Town Hall Facilities, as
noted below:
~t\.t'>
( ) SemOT Citizens Room
() Large Meeting Room
( ) Other: Specify:
C 0.\ \~L \ C V\Q.Yl t\9--d -to
2z" o~o '--jU6
_ .''-t~;-'\, 15 ...-----
The group is Dot ex~ed to exceed ZD j>ersons
Date{s): <1 J 'Zc 2..: i 0 . Pl.-v c: ,(.\ i'h , Time: 8':;Cf+..,tC
, J
It should be understood that groups using the Buildings' Facilities for evening meetings must select dates when
Town Meetings are normally scbeduled (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 T O,",,'n 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 bas been submitted to the Town Clerk for review and
Clearance.
a'd,3'IO
c.oP(t +-v ~b "
Cfif t-v l~drJ
~ p~ ~9^/-f) +0 Us. ~.
Mar 22 10 03:32p
US Census POK LCO 2139
18458783464
p,3
2010-01-19 JCM
T enns of the agxeem.nt must be atrictly adhered to by the contracting group as any disregard or abuse of the rules
for use of the fucilities win resu\\ in termination ofuse by the offending group, and they win not be grmrted
reinstatement.
1 have ,ead and nnderstand the rules and regulationS fur the ..., of the Facilities in the Town of Wappinger Town
Hall, and will comply with these requirements.
For:
, ~
'\' /. (/ " ( !.
, , ,"'A., - ~ 1\, , ", I "
..~---.:),~'* \\.. "y",:, x\, .i.....fJ.:-'x:VJ~
. ~ /: " ./\-~
,I, ( . _ ,::----1/ . .' " -~.' .'
\ ) , ) ~,A''- '::> v ,:.. F-:) L, "~LL r '.
(}lame of Group or Organization)
..'
signed:
Approved:
31'2 LL2c\Q
c;rr~
Town Clerk
Date:
Date: :) 2.- "":J \ 0
I.... I............... .... ,.-
d
Vv Vt:'1 ~~U~ t '-"'I' L-V........ " I VV
UNITED STATES DEPARTMENT OF COMMERCE
Economics. and Statistics Administration
U.S. Census Bureau
poughkeepsie Local Census OffIce
31 Route 12 Suite 6
Pawling, NY 12564-3219
February 23,2010
Town of Wappinger
20 Middlebush Rd.
Wappinger, NY 12590
Dear Ms. Rose,
The Government is self-insured and does not maintain general liability insurance. Census agrees
to promptly consider and adjudicate any and all claims wllich may arise out of use of subject donator's
premises resulting from the actions of Census or duly authorized representatives or contractors of
CenSllS and to pay for any damage or injury as required OV Federal law. Such adjudication will be made
pursuant to the Federal Tort Claims .t\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.5.C. 8101 et.seq. or other such legal authority as may be
pertinent.
Si~
\ J,~
<, I - j'
\i "
<~ I~'-~.<
I
f
A~~
C--_//
David Fra::asso
Office 0 perations Su pervisor
U.S. Census Bureau, poughkeepsie N.Y. Office
Mar 2210 03:32p
US Census POK LCO 2139
1 845 878 3464
p.1
pough1<.eepsie LCO 2139
31 Route 22
Pawling. NY 1256-4-3219
845.878.8240
845 676.3464
US Census
Poughkeepsie 2139
Fax
To:
..<" C
'. lOV":{l
eAS-~'Lq
, 0,f7> So\.'"
IlL S ()-\'\\CJL'~ ~~ From:
1 C(: Pages:
Phone:
Date:
Fax:
~ ~J'X. 0 y ;-~C t \\tl Q~ &.9\J.eS'\ eel
o Urgent
o For Review 0 Please Comment 0 Please Reply 0 Please Recycle
. Comments:
TOWN CLERK
Chris Masterson
TOWN OF WAPPINGER
.,'
TOWN SUPERVISOR
Christopher J. Colsey
20 MIDDLEBUSH ROAD
WAPPINGERS FALLS. NY 12590
WWW.TOWNOFWAPPINGER.US
(845) 297...4158 - Main
(845) 297-5771 . Direct
(845) 298-1478 - Fax
TOWN BOARD
William H. Beale
Vincent Bettina
Ismay Czamiecki
Joseph P. Paoloni
Office of tbe Town Clerk
The Following Fax Message Consists of
Including Cover Sheet
3
Pages
FAX TELEPHONE NUMBER (845) 298-1478
DATE:
L~' ~ y I U
To:~hQo,^, YY1J~ - S,g-- ,)'11. -/
() f)
FROM: I.') lJJ.... ~ /:;V-'
REFERENCE: 0 ~ \\~ \ .Q 0 1 ~ - l..\ oiQ 1M l' a;yu
IF YOU DO NOT RECEIVE ALL THE PAGES, PLEASE CONTACT
SENDER IMMEDIATELY.
Sender:
Sending Confirm
Date MAR-23-2010 TUE 08:18AM
Name TOWN CLERK
Tel. (845)298-1478
---------------------------------------------------------------------------
Phone
Pages
Start Time
Elapsed Time
Mode
Resu It
8783464
3/3
03-23 08:16AM
01'04"
ECM
Ok
---------------------------------------------------------------------------