Woodhill Green Condo (3)
2010-01-19 JCM
Date Received:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
19-/~/~
Town of Wappinger
Agreement for the Use of the Town
Hall Facilities for Meetings
FOR INTERNAL USE ONLY
Received by:
Serial #: ~
~pplication ~-t($100.00 ~Cert. ofLl
o Notified RecreatIon (date: )
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Agreement for the Use of the Town Hall Facilities for Meetings
~ '.
This will confirm the arrangements being requested for your groups' use of the Wappinger Town Hall Facilities, as
noted below:
v
( )
Senior Citizens Room
Large Meeting Room
Other: Specify:
The group is not expected to exceed
Date(s):
Time: 7fJ- 7J1
q Ll '7r)
,
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 11
Clearance.
~~CC~~~~[5)
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SEP 3 0 2DI1
TOWN OF WAPPINGER
TOWN CLERK
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:
(Name of Group or Organization)
For:
Date:
qJ~qJ//
, ,
Approved:
Town Clerk
Date:
.: oct. 4, 2011 8:24AM
, .....
TRAVELERS]
No. 0305 p, 2
One Tower Square, Hartford, Connecticut 06183
POLlCY NO.: I-G80-3A873647-PHX-11
ISSUE DATE: 07-14-11
COMMON POLICY DECLARATIONS
,- CONDOMI NI UM PAC
BUSINESS: CONDO 1-4
INSURING COMPANY:
THE PHOENIX INSURANCE COMPANY
1. NAMED INSURED AND MAILING ADDRESS:
WOODHILL GREEN CONDOMINIUM
1 6Ga ROUTE 9 BUI LDI NG 1
WAPPINGERS FALLS NY 12590-7400
2. POLICY PERIOD: From 07-06-11 to 07-06-12 12:01 A.M. Standard Time at your mailing address.
3. DESCRIPTION OF PREMISES:
01
ALL
COND,O 1~4
ADDRESS
(same as Mailing Address unless speoified otherwise)
1668 ROUTE 9 BUILDING 1
WAPPINGERS FALLS NY 12590
PREM. LOC. NO. BLDG. NO. OCCUPANCY
4. COVERAGE PARTS AND SUPPLEMENTS FORMING PART OF THIS POLICY AND INSURING
COMPANIES
. ---..
COVERAGE PARTS and SUPPLEMENTS
Businessowners Coverage Part
Directors &. Officers Coverage Supplement
INSURING COMPANY
PHX
PHX
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The COMPLETE POLICY consists of this declarations and all other declarations, and the forms and endorse-
ments for whIch symbol numbers ar!3 attached on a separate listing.
6. SUPPLEMENTAL POLICIES: Each of the following is a separate policy containing its complete provisions.
POLICY POLICY NUMBER INSURING COMPANY
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~ 7. PREMIUM SUMMARY:
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Provisional Premium
Due at Inoeptlon
Due at Each
NAME AND ADDRESS OF AGENT OR BROKER
$
$
$
26,301 .00
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, NACCARATO INS AGENCY INC EM094
PO BOX 283
SAUGERTIES NY 12477
IL TO 190205 (Page 1 of 02)
Office: ALBANY DOWN
CO~E~
AuthorIzed Represpntatlve
DATE: "7~/!-/f
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O~t. 4, 2011 8:24AM
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TRAVELERSJ .
No. 0305 P. 3
One Tower Square, Hartford, Connecticut 06'83
BUSINESSOWNERS COVERAGE PART DECLARATIONS
CONDOMINIUM PAC POLICY NO,: I-SSO-3A873647-PHX-11
ISSUE DATE: 07-14-11
INSURING COMPANY:
THE PHOENIX INSURANCE COMPANY
POLICY PERIoD:
From 07-06-11 to 07-06-12 12:01 A.M. Standard Time at yoU~ mailing add~e5s.
FORM OF BUSINESS: ASSOCIATION
COVERAGES AND LIMITS OF INSURANCE; In5urance appli~ only to an item for which a
"limit" or the word "included" is shown.
COMMERCIAL GENERAL LIABILITY COVERAGE
OCCURRENCE FORM
General Aggregate (except Product~-Completed Operations Limit)
Products-Completed Operations Aggregate Limit
Personal and Advertising Injury Limit
Each OCcu~~ence Limit
Damage to Premises Rented to You
Medical Payments Limit (anyone persQ")
LIMITS
$
$
$
$
$
$
BUSINESSOWNERS PROPERTY COVERAGE
DEDUCTIBLE AMOUNT:
Businessowners Property Coverage:
Building Glass:
$ 5,000 pe~ occurrence.
$ 250 per occurrence.
BUSINESS INCOME/EXTRA EXPENSE LIMIT:
OF INSURANCE
2,000,000
2,000,000
1,000,000
1 ,000,000
300,000
5,000
Actual loss for 12 consecutive months
Period of Restoration-Time Period:
Immediately
Other additional coverages apply and may be changed by an endorsement.
read the policy.
SPECIAL PROVISIONS;
COMMERCIAL GENERAL LIABILITY COVERAGE
IS SUBJECT TO A GENERAL AGGREGATE LIMIT
MP TO 01 02 05 (Page 1 of 02)
Please
Od, 4. 2011 8:24AM
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CONFIDENTIAL
Wooot11tlL C;reeV\- COV\-clOVlA.LlI\.tUVlA-S
1668 Route 9
Building 1/Office
Wappingers Falls, NY 12590
Office 845-623-2300
Fax 845-623-2244
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FAX TR.ANSMITT'AL FO'R.JVl
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Phone: 11/0'-1# J 2 - ~317J
Fax: Ills- ~3t?- A~ if'!
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-Oft, 5. 2011- 2:31PM-...
No, 0316 JP, 2/31/
~ 7Q - -r ( tf
2010-01.19 JCM
FOR INTERNAL USE ONLY
I
Town of Wappinger
Agreement for the Use of the Town
Hall Facilities for Meetings
Received by: Chris Masterson 0
Christine Fulton 0
Sue Rose 0
Date Received: / /
Serial #:
~ VoJAP"P ,-
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o Application 0 $100.00 0 eert. ofL!
o Notified Recreation (date: ~
Agreement for the Use of the Town Hall Facilities for Meetings
1tJ~ Pu//A-< ~
N.m.~~ /~ mtl4&. __
~trm7l,tl1.LtI~.M cJ~ h1/~ /t/:J-b3,J-;aP1J
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
~ ~~::~=Room ~ ,(l~~-J '-J1L I-f'
ted to exceed ?5" _ persons ,-t /J
- Time: r / /J ?n .,. "::LJ2 m
It should be un!, I ""~. ".!.g ~ BuIldings' Facilities fur ev~ meetings must select dale. when
Town Meetin are normally scheduled (ie., Justice Court, Pltuming 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 pUIposes. Advance notice will be given as soon as possible on such occasions.
The Town Clerk should be informed promptly of any schedule change Ot cancellation of your group activities.
Arrangements for access to specific liU'ea to beused should be made with the Town Clerk at the time this fann is
submitted.
No application shall be considered approved until it has been submitted to the Town Clerk for review and
Clearance.
-9.co.t. 5, 2011. 2: 31 PM
No.0316 p, 3/3
2010-01-19 JCM
Terms oftbe 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.
Siil'ed:
(Name of Group or Organization)
For:
Date: ~
Approved: - . ( ~rx-
Town Clerk
)//7/11
Date:
2011 i
2:29PM\1 r~aLcarato No,03170
CERTIFICATE OF LIABILITY INSURANCE
P, 11
DATI! (IIM111Dr<<fY)
10/4/2011
HIS eE~'I'I~ICATE IS ISSUED AS A MATTeR OF INPORMATlON ONLY AND CONFERS NO 1Il10HTS UPON THE CERTIFICATE HOLDER. THIS
'::ERTIFICATE DOES NOT AFFIRMATIVEl.Y OR NEGATIV&LY AMEND, I:.XTEND OR ALTER THe C:OVERAGI AFFORDEO BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE OOES NOT CONSTITUTE A CONTRACT BElWEEN THE ISSUINClINSURER($). AUTHORIZI!O
REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDEIl.
IMPORTANTI If lhl! cerlltlcate holder II .n ADDITIONAL INSURED. the polley(I"J must be InClorsed. tr SUIlIROOATlON la WAIVED, lIubJeot to
th. terms &I'ld conditIons of the poncy. certain policies m.y r.qulte In endora.mlllt. A .tatem.nt on this certlRcate does not canrer rights to the
certlfk:ale hold., In lieu of sueh IIndora.ment(s .
PRODUOI"
Naoca~ato I~su~anoe
100 Ul$~e: Avenue
PO Box 263
Saugs%,'tie.
I,.'UREO
NY 12477
Inau~an~e Nacc~rato
(845)216"7134
114512d6~1l'1U
WOODHILL GUEN CONDOMINIUM Associtaion
1669 ROUTE 9 BUILDING 1
UREft C :
D'
I...." I'
NY 12590-1400 INSURE ,:
OERTlFICA.TE NUMBER:To"n ot ".ppingQ~.
REVISION NUMBER:
WAPPINGERS SALLS
COVERAGES
THIS IS 'TO CElnJPV THAT THE POUCIE8 OF INSURANCE LISTeD BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVf FO~ lHE POUC"f PERIOD
INDICATED. HOl"Vv1Tt1STANDING AtlY REQUIRatENT. TERM OR CONDITION OF Nf( CONTRACT OR OTHER DOCUMENt ~'rH ReSPECT TO 'MilCH THIS
~RT\F1CATE MAY BE ISSUED OFl MAV PlRTNN, 1HE INSURANCE AFFORDED IV THe POLICIES DESORIIl!O HEREIN IS SUBJECT TO ALL T1ie TEFtMS.
EXCLUSIONS AND CONDITIONS OF SUCH POlIOIES. UMITS SH~ MAY HAVE 8EEN ReOUCED II'( ~s.
I~l: rtI'IOl'IHSURANCE ..oucY NUAUlM 'OUOY UI' ~ Ul.lJ18
GEJiERAL wall.lT'l' EACH OC:CURREtolQI! $
X COfMtERClAL GENERAL u.BllllY l1NAAQIl TO RI:NTI::~1 S
I C~s.MADE [i] OOQUFl IIO.3AB'7364'1 16/20U '1"a012 MeDEXfI/AIW~""1 $
PSt80NAL & 1J)V INJURY II
nHlAA&. AGGREGA'r'E I
PROOUCTS. (:(I/!lPIOP ~ $
I
~LJIIl\II'!
BODL Y INJURY ('<<1*'<<11 S
IODl.Y INJuRY lPnQ;ldctlll II
~R~ $
$
EACH OC:CUAAiHCi I a
oAGGRliGATr .
$
r~JT~WiT m
Eo!. I:iot'JoI Allt.:lOI1Hr :it
EL OISEASE - EA al,I"OYEI .
!.l,. DIIWE - POLICY LIMIT r
~l..AOOR~ LIMIT APf.!:!!.&PEA:
IXlpoueyl IP,~,; I ILOC
AUTOMOBILE ~alurr
'--
AN( AUTO
- AU. OWlED ...-- 8C"IDULIiD
_ AIJTOS '-- ~,~
_ HIAEO AUTOS f-- "UTOS
1.0001000
300,000
5/000
l,OOO,OO~
:2 000,000
2 000 000
A
UMBRELLA lIAs I I OCCUR
- IiICE" L1AIl n Cl.AoIlofIU\D!i
DEI) I I RETENTION $
WORKEIU COIilP"NlAnOIl
AND E..,.LOVIlRS' ~"UT't' Y I N
ANY ~OPRIETORIPAATNEASC;CUTMl 0 HI ~
O~jlJC!!NMI!M8E1\ ElCCLUDED? ..
IMaIlllalOIf In "HI
If yea, deIdlt U'lW
DESCRlPnoN CF1 OPlAATlONl: lleIoW
OIlS<lNI"YlOH OF OPI;MllON./I.OC:IA \10N8/ VlEIIICl.E6 (Alti"h AC:DIID .0'\, AoIcIlhnal Rtmlrke S'.4uIo, II....... .pl" It...l\VImII
CERTIFICATE HOLDE~
1632-2244
Town of Wappingere
20 Hicldl-.ush Road
Wapp1nqera !'aU.., NY
CANCELLATION
SHOUlD ANY OF THI! AIIOVI DSSCRIIED POLICIES !'IE CANOI!LlED BEFORE
THe elfPIAt.TION DATE THEJ{EOF, NOTlCI! WILL liIi DElIVIRfD IN
ACCORDANCE WITH THE poueY PROVISION'.
12590
Ann Bruno
.
ACORD 26 (2010/08)
,..1."".,........_.. ......
Town of Wappinger
20 Middlebush Rd
Wappingers Falls, NY 12590
(845) 297-5771
RECEIPT
#46030
10/06/2011
Association, Woodhill Green Condo
Received $ 100.00 for Building Use Fee, on 10/06/2011. Thank you for stopping by the Town
Clerk's office.
As always, it is our pleasure to serve you.
John C. Masterson
Town Clerk