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2008 (2)ACORDrM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/24/2007 PRODUCER 845-928-7000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION RICHARD A AGOSTINONI ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 219 ROUTE 32, SUITE 102 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO BOX 297 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CENTRAL VALLEY NY 10917 , INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: FARM FAMILY CASUALTY INSURANCE _ ANDSCAPE & SITE DEVELOPING CO. INC. INSURER B: _ 12 TREE LINE DRIVE INSURER C: __ I -- -.- WAPPINGERS FALLS, NY 12590 - -- INSURER D: - _ -__ nnv~ewn~~ INSURER E: 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRTADD LL - -- ---- - -- -- --- --- TR POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY i EACH OCCURRENCE $ 1,000,000 i I COMMERCIAL GENERAL LIABILITY 3114X0173 4/1/07 4/1/08 DRENTED P I 50 000 REMISES~Eaoccurence~ , _ 4 $ I I _ CLAIMS MADE ~ X I OCCUR ~~ ~ ~ MC-D EXP (Any one person) ~ ~ $ j,000 X CONTRACTORS ADV PERSONAL&ADVINJURY $ INCL IN AGG - - - _ _ _ GENERALAGGREGATE ~$ 2 000 000 GEN'LAGGREGATELIMITAPPLIESPER: PRO' PRODUCTS>COMP/OP AGG , , $ 1,000,000 X POLICY LOC AUT OMOBILE LIABILITY ~ A i , ~ ANY AUTO 311400703 4/1 /07 4/1 /08 COMBINEDSINGLELIMIT (Ea accdent) $ 1,000,000 ~ I~ ALLOWNEDAUTOS BODILY INJURY , /l ' SCHEDULED AUTOS (Per person) $ X HIRED AUTOS X BODILY INJURY P id $ I NON>OWNEDAUTOS er acc ent) ( I - ----- ----- - PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY --- AUTO ONLV > EA ACCIDENT $ ANY AUTO - --_ OTHER THAN EA ACC _._._- $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 2,000,000 A ~ X OCCUR CLAIMS MADE 3114E1103 4/1/07 4/1/08 AGGREGATE -- - _ $ .2,000 000 I, ~ $ _ DEDUCTIBLE i - _ _-- $ --- I RETENTION $ $ WORKERS COMPENSATION AND VvCSTATU~ OTH> EMPLOYERS' LIABILITY ___.._TORY LIMITS .___ ER ___ __ _ j ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT ~$ _- - __._.__...._ _ _ -_-_ -. ~ OFFICER/MEMBER EXCLUDE09 If es describe under E.L. DISEASE > EA EMPLOYEE $ - - --------r-_-- __-- ---- , y SPECIAL PROVISIONS below ~ E.L. DISEASE > POLICY LIMIT $ 07HER A INLAND MARINE 311410093 4/1/07 4/1/08 MACHINERY DESCRIPTION OF OPERATIONS (LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS LANDSCAPE GARDENING (INCL. XCU), EXCAVATION, PESTICIDE/HERBICIDE, STREET CLEANING/SNOW REMOVAL REFERENCE: DCH TOYOTA CERTIFICATE HOLDER ceurt~l I eTlnu SHOULD ANY OF 7HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRI7TEN TOWN OF WAPPINGERS FALLS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 20 MIDDLEBUSH RD IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR WAPPINGERS FALLS NY 12590 REPRESENTATIVES. , AUTHORIZED REPR NTATIVE n A ~/ ia~.vr~u ca (tvv uva- ' ACORD CORPORATION 1988 Date; 8/24/2007 Time: 11;20 AM To: @ 18459288958 e Flanders Group Page: 002-002 New York State Insurance Fund Workers' Compensation 8 DLsahilitp Benefits Specialists Since 1914 199 CHURCH STREET, NEW YORK, N.Y. 10007-1100 Phone: (888)997-3863 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ~~~~~~ J A C LANDSCAPE & SITE DEVELOPMENT INC A DEBTOR IN POSSESSION 12 TREE LINE DR WAPPINGERS FALLS NY 12590 POLICYHOLDER CERTIFICATE HOLDER J A C LANDSCAPE & SITE DEVELOPMENT TOWN OF WAPPINGER INCA DEBTOR IN POSSESSION 20 MIDDLEBUSH ROAD 12 TREE LINE DR WAPPINGER FALLS NY 12590 WAPPINGERS FALLS NY 12590 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE Z 1025 151-0 899133 04!01/2007 TO 04/01/2008 8!2412007 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1025151-0 UNTIL 04/0112008, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 04/01/2008 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE 8Y REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS CERTIFICATE DOES NOT APPLY TO BUILDING DEMOLITION. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 8Y THE POLICY. NEW YORK STATE INSURANCE FUND U-26.3 ~~ ~~ DIRECTOR,INSURANCE FUND UNDERWRITING This cert~cate can be validated on our web site at https://www.nysff.comlcert/certval.asp or by calling (888) 875-5790 VALIDATION NUMBER: 795245662 Th I" ACORD CERTIFICATE OF LIABILITY INSURANCE csR F~ DATE (MM/DD/YYYY) DKVIN-1 08 10 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Marshall & Sterling, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 110 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Poughkeepsie NY 12601 Phone: 845-454-0800 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: NGM InsuranC@ CCItt 8n 226 D . K. Vinyl Industries Ina. INSURER B: Tha ei rat R~habili tatiot, Li Pa DBA: Vinyyl Tech INSURER C: 668 DutCFless Turnpike INSURER D: Poughkeepsie NY 12603 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM~DMf DATE MM~D I LIMITS GENERAL LIABILITY EACH OCCURRENCE $ l O Q Q Q Q Q A X COMMERCIAL GENERAL LIABILITY ~V72915 ~ 04/26/07 04/26/08 PREMISES Eaoecurenee) $ 1000Q0 CLAIMS MADE a OCCUR MED EXP (Any one person) $ 10000 PERSONALBADVINJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'LAGGREGATELIMITAPPLIESPER: PRO- PRODUCTS•COMP/OPAGG $ 2000000 POLICY JECT LOC AU TOMOBILE LUIBILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON-OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY • EA ACCIDENT $ ANY AUTO OTHER THAN ~ ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLALUU3ILITY ~ EACH OCCURRENCE $ lOOOOOO A X OCCUR ~ CLAIMSMADE CW72915 04/26/07 04/2=' X08 AGGREGATE $ 1000000 $ DEDUCTIBLE $ )( RETENTION $ ZOOOO $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? tf yes describe under E.L. DISEASE - EA EMPLOYEE $ , SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ B OTHER Disability DBL276013 04/24/07 12/31/09 Stat DESCRIPTION OF OPERATK)NS /LOCATIONS / VEHK:LES I EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS ~ ~ ~ ~ t' / 1~ rM S AUG ~ ~ 2~~7 CERTIFICATE HOLDER CANCELLATION Town Of Wappingers Falls PO Box 324 20 Middlebush Road Wappingers Falls NY 12590 ACORD 25 (2001108) TOWNO2 4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 O DAYS WRITTEN NOTK:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. r~vvt\Y iJ ,iVV IIVV~ STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF PARTICIPATION IN WORKERS' COMPENSATION GROUP SELF-INSURANCE 1a. Legal Name and Address of Business Participating in Group Self- Insurance (Use Street Address Only) 1d. Business Telephone Number of Business referenced in box "1a" D.K. Vinyl Industries Inc. 845-454-0037 668 Dutchess Turnpike 1e. NYS Unemployment Insurance Employer Registration Number of Poughkeepsie, NY 12603 Business referenced in box "1 a" 1b. Effective Date of Membership in the Group 04/26/07 - 04/01/08 1c. The Proprietor, Partners or Executive Officers are: 1f. Federal Employer Ident~cation Number of Business included. (Only check box if all partners/officer incuded) referenced in Box "1a" x[~ all excluded or certain partners/officers excluded 20-8292921 2. Name and address of the Entity Requesting Proof of 3. Name and address of Group Self-Insurer Coverage (Entity Being Listed as Certlficate Holder) Town of Wappinger Falls Elite Contractors Trust Of New York PO Box 324 386 Violet Ave 20 Middlebush Road Poughkeepsie, NY 12601 Wappinger Falls; NY 12590 Trust Member # ECT04072127 This certifies that the business referenced above in box "la" is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law as a participating member of the Group Self-Insurer listed above in box "3" and participation in such group self-insurance is still in force. The Group Self-Insurer's Administrator will send this Certificate of Participation to the entity listed above as the certificate holder in box " 2". The Group Self-Insurer's Administrator will notify the above certificate holder within 10 days IF the membership of the participant listed in box "1 a" is terminated. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for a maximum of one year from the date certified by the group self-insurer. If this certificate is no longer valid according to the above guidelines and the business referenced in box "la "continues to be named on a permit, license or contract issued by the certificate holder, the business must provide the certificate holder either with a new certificate or other authorized proof the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under Penalty of perjury, I certify that I am an authorized representative of the Group Self-Insurer referenced above and that the business referenced in box "la" has the coverage as depicted on this form. Certified by: John P O'Shea (Print name of authorized representative of the Group Self-Insurer) Certified by: ~/ n ~ ~ . ~, ~ir~y„ ~jr.s,,,,. 06/14/07 (Date) Title: Authorized Representative Telephone: 845-454-0800 GSI-105.2 (2-02) WORKERS' COMPENSATION LAW Section 57 Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring of authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statue requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Please Note: This Certificate is valid only for a maximum of one year after this form is approved by the authorized representative of the Group Self-Insurer. At the expiration of that date, if the business continues to be named on a permit, license or contract issued by the above government entity, the business must provide that govemment entity with a new Certificate. The business must also provide a new Certificate upon notice of cance{lation or change in status of such participation in group self-insurance. GSI-105.2 (2-02) Reverse -:~caRO CERTIFICATE OF LIABILITY INSURANCE CSR SK DATE (MM/DD/YYYY) DUTCH-4 07 20 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Marshall & Sterling, Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 103 Executive Drive, Suite 300 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. New Windsor NY 12553-5531 Phone: 845-567-1000 Fax: 845-567-1030 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Ar Onaut Insurance Com an INSURER B: County Of Dutchess Office of Risk Management INSURER C: 22 Market Str@et INSURER D: Poughkeepsie NY 12601 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ lOOOOOO A X X COMMERCIAL GENERAL LIABILITY 4611579 10/01/06 10/01/07 PREMISES (Eaoccurence) $ 100000 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ X Law Enforcement PERSONALBADVINJURY $ 1000000 1000000/2000000 GENERAL AGGREGATE $ 2000000 GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $2000000 POLICY PRO LOC JECT AU TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A ][ ANY AUTO 4611579 10~01~06 10~01~07 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) ~( HIRED AUTOS BODILY INJURY $ ]~ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10000000 A X OCCUR ~ CLAIMSMADE 4611579 10/01/06 10/01/07 AGGREGATE $ 10000000 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND ' TORY LIMITS ER EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Town of Wappingers is provided Additional Insured status, when required by _ ~ ~. . 4~ "+~ a , written contract or agreement, with respect to Dutchess County Department of ~ Public Works to hold an informational meeting regarding the Dutchess Rail Trail at the Town Hall on Monday, July 23, 2007 at 7:00 pm. ~~~ ~~. ~a$ CERTIFICATE HOLDER CANCELLATION 1# 1VIif~! [:L[r~tS WAPPI-7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 O DAYS WRITTEN Town of Wappingers NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn : C . Masterson ,Town Clerk 20 Middlebush Road IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Wappingers Falls, NY 12590 REPRESENTATIVES. AUTH ORIZEDT,REBB£ SENTATaVE ~'~' r/bD~~~--u~~ ACORD 25 (2001108) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108)