Iglesia Cristiana El Sembrador
Monday, March 21, 2011
Town Clerk
Town of Wappinger
Regarding our request to utilize the large meeting room at your Town Hall on Saturday, March 26th we
are now expecting more people than originally anticipating and we will need a larger room. For this
reason we will not be using the Town Hall after all.
We apologize for any inconvenience and we respectfully request if the $100 deposit could be refunded
to the church.
In appreciation,
Eddy De La Hoz, pastor
Iglesia Cristiana EI Sembrador
2568 South Avenue, Wappingers Falls, New York 12590
[R1~~~~~~[QJ
MAR 22 2011
TOWN OF WAPPINGER
TOWN CLERK
2010-01-19 JCM
I
FO Rl"{AL USE OlNL Y
I. I
Received bY~ Chris Mastersd;n 0
I' Christine Fulton 0
) 'je R/_os\e J !'~
Date Receiv : Jl
1 I: - In I " "j )01 r.
Serial #: ~ ' /.I c:r.
g{pplicatio, ~oo,oo #,ert, ofLl 13'r 'Iii" ,'c- } ,
CJ Notified R, creation (dale: ) 11.4 if" ! J
I,' t'. ---b(/Y
I: Agreement i'r the Use oftbe TowD Hall Facilities fDr Meeting!' "f-"
f d..- l-a.~ €e S~~~
Name ofOrg '.' aU n or Group
Ii
Name of p~o' I n::presenting the
7 EcJ...o/ "1;1" ]f/'1- )t~ - 'f 1'1>
Addres. I: Phone No,
This will confi' '. the mangement.C\ ~e;ng Teqlle5t.ed for your ,groups' use of the Wappinger Town Hill FaciLities. as
noted below: I \ \
, '
( ) Senior jtizens Room
(~Large 1 etingRoom
( ) Other: pecify: 'P'oOD woi./t... 0 (J,cr se;r..v'rrt::-. IJ..S ~ P~I?r- DF rtK (1I(;1~ ev~:
If I
The group is Jl~ expected t9 ace" , p~sons
Date(s): Stv..fv~;t4 IAf./'?;?t 2. .0 I{ Time: s- frt - 10 f'n
It should be un' I stood. that groupS Imngthe Buildings' Facilities far evening meetings must select dates when
Town Meetin~, e nonnally sched~ed (Le., Justice Court. Planning Board, etc.) S}lecial reques.ts will be
consjdered upo their O'\;litIl merit, anl1 arrangements can be made for access to, and closing, the building at the dose
of your meeting j
You ..,d your :: ganizatiOD hereby gree to adhere to the xules set forth on the attached page by signalme of an
authorized IDl j C!" of your Org~~tion or group.
The T OWl) of vJ ,ppinger re.erve. th~ right to suspend temporarily thi. agrccrneat should lbe Town have Deed of the
facility for its o;.~ purposes. Ad\lanc;:e notice v.;.ll be given as soon as possible on such occasions,
The T OW" CIa 'should be inform..! prompll y of any schedule change or canceDation of your group activiti os,
Arrangements ii,' access to specific tea to be used should be made with the Town Clerk at the time this form 15
submitted. I
No applic~tiun ,'I all be considered approved until it has been submitted to the Tov.:n Clerk :tor review and
Clearance,:\ \ jg-Itl ~ t y1laJ ~. kJ
L!)!J, _(),j q7 '3i1'G - 419 3 ~, ~,->C ~.JA"","
-'(, (lien >. 71 € - ?:'f -, 83t7~ i/h, f) f-o ~.v
[, )41L Dc:~A-~lnG@ cor>G'b ,COI"1 f"'V"" ~
~'d 6t899l6t~6
Town of Wappinger
Agreement for the Use of the Town
Hall Facilities for Meetillgs
UOS!P3 uO:)
96'17: ~ ~ ~ ~ ~OJelJ\J
I . ~
.,v......., ..,.... ..... - -
Terms of the a OlIleJlt must ba s ctIy adh=d to by !be contracting gJ."aup as any disregaId or abuse of the ",t<,
for use of the 'cilities will result' termination ofuse by the offending group, and they will not be grllIlted
reinstatOlIlen!.! ! I
I have read an' understand the rol.!. and regulations for the use of !be Paciliti ea in the Town of Wappinger Town
Hall, nnd will, ply 'U.,ith these r~uiremenu..
\:
,\
I
For:
~ i (I
.dt..~ E'L ~tNV\~
eN ame of Group or Organization)
Signed;
z_I\2
i
Approved:
\\
Date:
Date:
L
\1,
.1
1\
I
I
. ;
.\
I':
II
1\
J
I ._.-.,.....-...
6'\7t:99Z6i7~6
UOS1P3 u08
80g: ~ ~ ~ ~ ~o J8l/1
Z'd
Ua.~t:: .;)IL.IL.UJ.J.
845-896-'(834
Tl.lIlt;l: .;): 'i'i 1-'1"1 TO: TOWU 0.1 Wappl.ugt;ln::i I!!: J.O'iOL.~OJ.'i /0
Page: 003
t"'t'\"
ACORD'N CERTIFICATE OF LIABILITY INSURANCE r DATE (MM/DD/YYYYI
0310212011
THIS CERTIFICATE IS ISSUED AS A MATTER 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.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endollled. If SUBROGATION IS WAIVED, 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).
PRODUCER NAME:
Emery & Webb, Inc. Church I rllgNio Extl: 845896-6727 -, rli~, No): 866-279-1253
989 Main Street i ~~:~SS:
Fishkill, NY 12524 CUSTOMER ID':
845 896-6727 INSURER(S) AFFORDING COVERAGE NAIC.
INSURED INSURER A : Preferred Mutual Ins. Co. - Chu
EI Sembrador Church
CIO Eddie Delahoz INSURER B :
7 Echo Lane INSURER C :
Fishkill, NY 12524.2827 INSURER D :
INSURER E :
INSURER F :
Client#. 153650
50WAPPINGERS
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE. BEEN ISSUED TO THE 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 BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE. BEEN REDUCED BY PAID CLAIMS.
I~R TYPE OF INSURANCE ;.~L ~~ POLICY NUMBER ~~)g~/~~~YI P~~]g~'~~~YI LIMITS
A GENERAL LIABILITY BINDER537625 D3I1012011 0311 01201 ~ EACH OCCURRENCE $1.000000
I--
~ OMERCIAL GENERAL LIABILITY ~~~~~S lEa occurrancal $100,000
I-- CLAIMS-MADE [!] OCCUR MED EXP (Any ana parson) $5,000
PERSONAL &ADV INJURY $1,000,000
GENERAL AGGREGATE $3,000,000
~'L AGGREn LIMIT APPl PER: PRODUCTS. COMP/OP AGG $3,000,000
POLICY ~~~,: LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
f.--- lEa accldant)
I-- ANY AUTO BODILY INJURY (Par paraon) $
- ALL OWNED AUTOS ) BODILY INJURY (Per accident) $
- SCHEDULED AUTOS PROPERTY DAMAGE
HIRED AUTOS (Per accidenl) $
-
NON-OWNED AUTOS $
-
$
UMBRELLA LIAB H OCCUR EACH OCCURRENCE $
~
EXCESS LIAB CLAIMS-MADE AGGREGATE $
- DEDUCTIBLE $
RETENTION S $
WORKERS COMPENSATION l!'~D~}'~;.Y;'" l I~JH-
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVED E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? NIA
(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $
Ir YS6. describe under $
DESCRIPTION OF OPERATIONS balow E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (AttaCh ACORD 101, AddltiDnal Ramark. Schadula, If mora .pacal. ..qulrad)
Certificate is issued as proof of general liability, for insured's event on 3/26/2011.
CERTIFICATE HOLDER
CANCELLATION
Town Clerk, Town ofWappingers
20 Middlebush, Road
Wappingers Falls, NY 12590
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENT ATIVE
...-::" -1'988- 0
ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD
.uennAnt! II'nnn.A nc
'CORPORATION. All rights reserved.
hC:U
\l.
--
19lesia Cristiana El Sembrador
1.568 South Avenue
Wappingers Fall, NY 11.590
604
;3-7-20 II
_DiXfE
50-793612219
06
mTO 11IE
ORDEROF 1evUYl 0/ W~jU~~
~~MI~~ .
I
A HudsOn Valley
2iii;, federal Credit Union
,._~;::.;:;~~ 7(, '. ./. ~ t '. ...
MEMO ..' .. .. .~~_~~__1L-~_~-
.: ~2 ~ q? qlb :}.:00000 ~ bll.81 qOOIl-O bO l.
j $ /()?J d-
A ~;~:'~:~~
DOLLARS .. ill 0","" ".
God Bless America ,,,'
2010-01-19 JCM
FO
!.
Received by:
\
) Date Receiv ' :
\ I:
Serial #:
\
~AL USE ONLY
I
Chris Mastersd;n 0
Christine Fultdn 0
~~~ lL ~
!tA1'Plicatio ~oo,oo #,ert. ofU
~ Notified R. creation (date: . ~
I
I:' Agreement fJr the Us. of the To"'>> lIsll Fscilities for Meeting<
f ~-kfia.~ € e S~ ~~_.. .'
Name ofOrg '.'zati n or Group
\!
Name oIpCJ:$o'! Iq'resenting the
7 ..J.OI 1;- f.. J<r1- ,tG. - <{o 1'71>
AddreSS [' Phone No.
This will COnfi!, the 8II2Dllements\,.,;ng Tell',......d for yom groups' use of the Wappinger Town Hall Facilities, as
noted below: \ \ \
( ) senior '1tizens Room
(~ Large I eetingRoom
( ) other: peC1fy: YOOD woJ~ 0 (J1f S ="'Ct:J IJ. S "'" PFli1 r DF rtN" Cv'11fNJ<. WIfN'T
The group is 01 <l<pCcted ts> = \ p::rson.
Date(s): 51.),);'" fA<.-.A 2- .0' I Time: 'i' fr1- - \0 PM
It should be un, ood that groups bg the Buildings' Facilities for evening meetings must select dates when
Town Meetin~, e nolOlally sched~ed (t.c., Justice Court, Planning Board, etc.) Special requests will be
considered upo ,their own merit. anli arrangements can be mode for access to. and closing, the building aI the dose
of your meeting. L
You a,'Ill your ~ : ganization hereby ee to adhere to the rules set forth on the attached page by signatme of an
o.uthonz;ea mCIn cr of YOU! Org~~tion or group.
Ii \
The To"" ofW ,jlpinger rOS"",es th~ right to suspend temporarily this .grcemeut should are Town have need of tl1e
facility for its 0; en purposes. Ad~ notice will be given as soon as possible on such occasions,
The T 0"1'. Cler : should be inform) prompt! y of any schedule change or cancenation of your group activiti es.
AmmgCl)lents~' access to specificka to be used should be made with the Town Clerl<: at the time tllis fonn is
submitted. I \ .
No applicatiun., all be considered a~proved until it bas been S1lbIllitted to lb.e To"'" Clerk: for review and
ctearance.: \
f'J),fJ, _(~),3 q 7 . 38ro _\<.1193
i (~()j:'), '71 € - 79<f -,33{}CJ
8:.- .i ll.1L. :bBLA-~~r2G@ cOr-il3b ,com
~. d 6'\7t:99Z6'\7 ~6
Town of Wappinger
Agreement for the Use of the Town
Hall Facilities for Meetings
UOS!P3 uoc)
8St>: ~ ~ ~ ~ ~o J8V
\ . J .
~V"'-"" --
Terms of the a eeIlI ent must be s . ctly adhered to by the contraeti1lg group as any rosregard or .buse of the ruks
for use of the : cilities will result i termination of use by the offending group, and they will uot be granted
reinstatement. \ ! 1
I have read an' . understand the ruI.l and regulations for the use of the Facilities in the Town of Wappinger "town
Holl, end will, ly with these r~1J1remenu.
\ '
i
For:
1\
z- ,\2
i
~ i ~
'r6"~ E.' L ftAN\~
(N' ame of Group or organization)
Signed:
Date:
Approved.:
Date:
\
1\
.,
I
1
I
I
\ :
II
\
J
\
\
I
Z:d
I ._..-......,--.
6t>~99Z6t>~6
UOS!P3 u08
B09:~~ ~~ ~OJ~
Date: 3/2/2011
845-896-7834
Time: 3:44 PM To: Town of Wappingers @ 18452981478
Page: 003
~f'\"
ACORD,. CERTIFICATE OF LIABILITY INSURANCE r DATE (MMIOO/YYYYI
03/0212011
THIS CERTIFICATE IS ISSUED AS A MATTER 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.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, 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).
PRODUCER I ~~:1~(;
Emery & Webb, Inc. Church I illgN:o Extl: 845896-6727 lr:,~, No): 866-279-1253
989 Main Street ~SS:
Fishkill, NY 12524 CUSTOMER ID':
845 896-6727 INSURER(S) AFFORDING COVERAGE NAIC.
INSURED INSURER A : Preferred Mutual Ins. Co.' Chu
EI Sembrador Church
INSURER B :
CIO Eddie Delahoz
7 Echo Lane INSURER C :
Fishkill, NY 12524-2827 INSURER D :
INSURER E :
INSURER F :
Client#. 153650
50WAPPINGERS
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE 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 MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
~~~R TYPE OF INSURANCE ~~'?L :;.';!,~R POLICY NUMBER r~~:g~I~~~Y' Ir~~:g~I~~~Y' LIMITS
A GENERAL LIABILITY BINDER537625 n3/1012011 03/101201~ EACH OCCURRENCE $1.000000
I--
~ OMERCIAL GENERAL LIABILITY ~~~~~is rEa o~;;;~ence\ $100,000
I-- CLAIMS.MADE [!] OCCUR MED EXP (Anyone pemon) $5,000
PERSONAL &ADV INJURY $1.000,000
I-- GENERAL AGGREGATE $3,000,000
n'L AGG~En LIMIT APn PER: PRODUCTS. COM PlOP AGG $3,000,000
POLICY ~~~T LOC $
AUTOMOBILE L1ABI L1TY COMBINED SINGLE LIMIT $
I-- (Ea accident)
I-- ANY AUTO BODILY INJURY (per person) $
- ALL OWNED AUTOS 1 $
BODILY INJURY (Per accodent)
I-- SCHEDULED AUTOS PROPERTY DAMAGE
$
I-- HIRED AUTOS (Per arodent)
I-- NON.OWNED AUTOS $
$
UMBRELLA LIAB R OCCUR EACH OCCURRENCE $
I--
EXCESS LIAB CLAIMS.MADE AGGREGATE $
I-- DEDUCTIBLE $
RETENTION ~ $
WORKERS COMPENSATION IWC STATU. I I~~H'
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVEO E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? NIA
(Mandetory In NH) E.L. DISEASE. EA EMPLOYEE $
If VB6, de5cribe under
DESCRIPTION OF OPERATIONS below E.l. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remark. Schedule, If more .pacel. required)
Certificate is issued as proof of general liability , for insured's event on 3/26/2011.
CERTIFICATE HOLDER
CANCELLATION
Town Clerk, Town of Wappingers
20 Middlebush, Road
Wappingers Falls, NY 12590
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENT ATIVE
ACORD 25 (2009109) 1 of 1
~~nnAnetallnnAnl!:
CORPORATION. All rights reserved.
ACU