Lisa Smi le

From: Sent: To: Cc: Subject:

Dan, Pat and Lisa:

Young, Gail Tuesday, July 19, 2016 8:41 AM Dreimiller, Dan; Lisa Smigle New Hartford Supervisor FW: FOIL~ Oneida County Worker's Comp info

The following email was received today, July 19, 2016. If any of the requested documents exist, would you please deliver same to my attention so that I can make arrangements for Cathy to visit the Town Clerk's Office for document review and/or scanning.

Thank you!

Gail

From: Cathy [mailto:cathy@snsdolls.com] Sent: Monday, July 18, 2016 5:2.9 PM To: Young, Gail Subject: FOIL ~ Oneida County Worker's Comp info

Gail,

I would like to FOIL any signed paperwork or contracts for the 2015 & 2016 worker's compensation insurance coverage through the Oneida County Self Insurance Plan.

I would also like to FOIL any invoices, purchase orders, and cancelled checks for 2015 & 2016 for payment of the worker's compensation insurance through Oneida County.

1

Town of New I-Iartford 48 GENESEE ST. • NEW HARTFORD, NY JJ413

Phone 315/733-7508 Fed. ID 1115-100-1062

DEPARTMENT

CLAIMANT'S r;;neida County

NAME Workers' Compensation Department AND 800 Park Ave.

ADDRESS Utica, NY 13501 L ~

TERMS Vendor's Ref. No.

VOUCHER

DO NOT WRITE IN THIS SPACE

Date Voucher Received

FUND- APPROPRIATION AMOUNT

BP9040.08 12043 54 < 0 c

SF3410.43 1720 50 0 I

089040.08 m

158286 50 "' z 0

TOTAL $172050 54 Abstract No. I

Dates Quantity Description of Materials or Services Unit Price Amount

2016 Oneida County Self Insurance $17205 0 54

Plan -Workers' Compensation

(See Ins/rue/ions on Reverse Side) TOTAL $172050 54

CLAIMANT'S CERTIFICATION

1. , certify that the above account in the amount of $ is true and correct; that the items, services and disbursements charged were rendered to or for the municipality-o=-=n-clc-he:-:;-dac;le-:-s-s-cla"'t-ed7 ;-clh-a71-no-pa-rt77"ha-s"'b-e-e-n paid or satisfied; that taxes, from which the municipality is exempt, are not included; and that the amount claimed is actually due.

DATE

DEPARTMENT APPROVAL

CONTRACTUAL

SIGNATURE TITLE

(Space Balow for Municipal Usa)

er

APPROVAL FOR PAYMENT

This claim is approved and ordered paid from the appropriations indicated above.

DATE AUDITING BOARD

ONEIDA COUNTY WORKERS' COMPENSATION DEPARTMENT

Oneida County Board of Legislators

ONEIDA COUNTY OFFICE BUILDING, 800 PARK AVENUE, UTICA, NY 13501 PHONE: (315) 798-5688 FAX: (315) 798-5924

Gerald J. Fiorini, Chairman

January 19,2016

Supervisor Patrick Tyksinski Town of New Hartford Butler Hall, 48 Genesee St. New Hartford, New York 13413

Dear Supervisor Tyksinski:

Michael L. Lally mlally@ocgov.net

Workers' Compensation Committee

Norman Leach, Chairman

Your contribution as a participant of the Oneida County Self-Insurance Plan for the year 2016 is $172,050.54 which will be billed in 2016.

As always, should you have any concerns or questions, please feel free to call.

Thank you for your patience.

1.1£ !{ Michael L. La~ Oneida County Workers' Compensation 315-798-5688

· ;:,L\\0 t-f3 S'F I·' lo

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51 NEW HARTFORD

FIVE YEAR LOSS TOTAL NET LOSSES

337,641.94

5YEAR LOSS

PERCENTAGE

0.02721037

TOTAL ADMIN ALLOCATED EXPENSE CLAIM

(via finance) EXPENSE

50,143.78 113,906.76

ALLOCATED PREMIUM

2016

172,050.54

PURCHASE ORDER THIS NUMBER MUST APPEAR ON All CORRESPONDENCE, INVOICES, SHIPPING PAPERS AND PACKAGES.

TOWN OF NEW HARTFORD 48 Genesee Street

New Hartford, New York 13413

Fe<l. ID/1 15-100-1C62

PURPOSE OF PURCHASE:

BUDGETED ITEM: YES 0 NO

IF NO/EXPLAIN:

CONDITIONS GOODS ARE SUBJECT TO OUR INSPECTION AND APPROVAL. IF SHIPMENT WILL BE DELAYED FOR ANY REASON, ADVISE US IMMEDIATELY, STATING ALL THE NECESSARY FACTS. TO AVOID ERRORS, NOTE SPECIFICATIONS CAREFULLY AND If UNABLE TO COMPLETE ORDERS AS WRITTEN NOTIFY US PROMPTLY.

APPROVED BY COMPTROLLER 0

97697

pqa~o og /J.DLfJ. -------------------------------------------

SF 34/D.l/-3 11JD.50 --------------------------------------------

~~ ~ ~~ fti_Q~~Q~& ~ ~- ~- ~ ~ j fi~Q_ 0_~8'(p_:BJ ()50.9-/-

TOTAL

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#210

liWY/1'1 v,,ut .. ;r-,u.,,

Olli E~:l)Ct JIJIOI.>}ll 01'

~,,

02/H/~016

f>OWG A•,...,

SHUOG.~O,

a: llVIl!lnEo rlfH-ElGI!T l!IOUS;o,.~v r>l!l lliJI\tiRID ilfl!ln'·IIU 1:-IJJ.L.U.s MiD SO CU!J.'I

?OQt, \000 W>'

112216 02/19/16 $158,286.50

roucu , 1~l..Joi'>.'U•JI

OOI.Hl I' .

rm; UJ\CT N'.<:lUHT QT '

J\li:INE THOL'IlAJIO i'OI<T'i·TIIRRF. OOJJ.\lu:J_M'Il S~ Cl'.NTS

#1232 02/1.9/16 $12,043.54

FIRED!.~ OOClHO v,.u...,,..o~, ,.,. I

Hnu.!o

•'OtlOl\0,. >:Ot\lOH\8>!

02/19/1.6 $1,720.50

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Town of New Hartford VOUCHER \\ ~\ "'::::>

oiR GENESEE ST. • NEW HIIRTI'OIW, NY IJ•IIJ Phone JI517JJ-75UR

Fed.ID/115-100-1062

DEPARTMENT

CLAIMANT'S ~neida County

NAME Workers' Compensation Department

AND 800 Park Ave. Utica, NY 13501

ADDRESS L

TERMS

_j

Vendor's Ref. No.

DO NOT WRITE IN THIS SPACE

Date Voucher Received

FUND- APPROPRIATION AMOUNT

DB9040.08 197392 29 < 0 c () I m ;u z p

TOTAL $197392 29 Abstract No. I

Dates Quantity Description of Materials or Services Unit Price Amount

2015 Oneida County Self Insurance $197392 29

Plan- Workers' Compensation

(See lnstn!clions on Reverse Side) TOTAL $197392. 29

CLAIMANT'S CERTIFICATION

I, , certify that the above account in the amount of $ -:---c--ccc--:-:--:--:c-c---cc--:-­is true and couect; that the items, services and disbursements charged were rendered to or for the municipality on the datos stated; that no part has been paid or satisfied; that taxes, from which the municipality is exempt, are not included; and that the amount claimed is actually due.

DATE

CONTRACTUAL

SIGNATURE TITLE

(Space Below for Municipal Use)

DEPARTMENT APPROVAL

AUTHORIZED OFFICIAL

APPROVAL FOR PAYMENT

This claim is approved and ordered paid from the appropriations indicated above.

DATE AUDITING BOARD

''

ONEIDA COUNTY WORKERS' COMPENSATION DEPARTMENT

ONEIDA COUNTY OFFICE BUILDING, 800 I'AIUC AYENUE, UTICA, NY 13501 Oncidn County

Bonrd of Lcgislntors PHONE: (315) 798-5688 FAX: (315) 798-5924 Worl<m' Compensntion

Gemld J. Fiorini, Chninnnn

January 6, 2015

Supervisor Patrick Tyksinski Town of New Hartford Butler Hall, 48 Genesee St. New Hartford, New York 13413

Dear Supervisor Tylcsinski:

Michncl L. Lally Committee Michnel WntermnnJ Chnirmnn

Your premium as a participant of the Oneida County Self-Insurance Plan for the year 2015 is $197,392.29 which is due by February 6, 2015. Please make your check payable to "Workers' Compensation Department" and forward your payment to:

Oneida County Workers' Compensation Department 800 Park Avenue Utica, N.Y. 13501

As always, should you have any concerns or questions, please feel free to call.

~e~bEc Michael L. Lally ~ Oneida Count)' Workers' Compensation 315-798-5688

-r -- --------- -,- ------ --- ,---------- ---f -+-' ---+-------1----1----

_j_ ____ _L i TOWN OF NEW HARTFORD

FIREDEPTS WILLOWVALE VFD

±_-- -~ _ 2015 ': --- --f ----- --- -~:S- _LOSS CLAIMS

--- I - _ 2oosj-___ i01ol- 2011 -- 2012! 2013 ',!OT,O.L _ JP<::T:_ _ jAJ:.g:J<:;~_I_q!:l~ 0.00 0.001 O.OOj 2,383.00 117.00 _____ 2,500.00 . __ O.Q06734 _____ 908.02

------+-------11-----,------ 0_000000 0.00

TOWN OF NE_W_:~R-T-FORD h,166 60i 52,112.941 37,512.001 92,738.00 91,233.55 ·::_3ii~~,09_~=--~~9_~~~~~-:_-1~3,~~2~~ ! 95,121.00 91,350.55 ': 371,263.09 i 1.0000001 134,846.30 Total

-- 1 I

--1---- --------)- ;ADMIN. EXPENSE I 62,545.99 ----~ - I \LUMP SUM EXPENSE I 0.00

----------· , I ----- - - 1 THE ABOVE FIGURES ~D"'IS""TR"'I""'B\-cU'TE THE LOSS EXPENSE AMONG THE VARIOUS V.F.D.'S AND THE REMAINDER OF THE TOWN, BASED ON THE PERCENTAGE OF : •

THEIRRESPECTIVEPAIDLOSSESTOTHETOTAL. =t- ·- ', ~-- ~-1

ADMINISTRATION EXPENSES ARE LJSTED, BUT NOT ADDRESSED IN THE ABOVE 1 ----+--------+-----F()R~LJL-[1, ____ _ J _ __ __ _ _,____ ___ _ _ 1 _______ , _______ _

PURCHASE ORDER

TOWN OF NEW HARTFORD 48 Genesee Street

New Hartford, New York 13413

Fed. ID/1 15-100-HXi2

PURPOSE OF PURCHASE:

BUDGETED ITEM: YES 0 NO

IF NO/EXPLAIN:

CONDITIONS GOODS ARE SUBJECT TO OUR INSPECTION AND APPROVAL. IF SHIPMENT WILL BE DELAYED FOR ANY REASON, ADVISE US IMMEDIATELY, STATING AlL TUE NECESSARY FACTS. TO AVOID ERRORS, NOTE SPECIFICATIONS CAREFULLY AND IF UNABLE TO COMPLETE onDERS AS WRITTEN NOTIFY US PROMPTLY.

APPROVED BY COMPTROLLER 0

TOTAL

THIS NUMBER MUST APP AR ON All CORRESPONDENCE, INVOICES, SHIPPING PAPERS AND PACKAGES.

97531

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TOWN OF NEW HARTFORD 1--- -- - - -- ------·------FIRE DISTRICTS ·-----·----·------·····-·--··----------------·· ··-------- --- --- - - ---······· ·------ -. 2016-·BUDGE"'f _ _ ___ -----· ··--- --·-- ··---····------ -····· --- ------··· -------······--------- -----=c=.c ... _ .. ·---- ------···-----··------------

Flre Districts Expenditures Page 1 of 1 1116/2015 - 9:27AM

FIRE DISTRICTS ASSESSED ASSESSED

ACCOUNTS CODE VALUE BUDGET RATE VALUE BUDGET RATE 2015 2015 2015 2016 2016 2016

FD027 & FD028 SF 1 & 2 I NEW HARTFORD

Receipts: 0.7228,884,369.505 0.7676 1 Raised by Tax 881,791 .264 637,359.00 678,871 .50

Interest 0.00 0.00

UNEXPENDED BALANCE 0.00 0.00

TOTAL 637,359.00 678,871 .50

DISBURSEMENTS:

~~~~~~~~{~~~ Payment on Contract 637,359.00

Debt Service -Deficit 0.00 0.00

TOTAL 637,359.00 678,871.50

FD029 SF 3 NEW HARTFORD

Receipts: Raised by Tax 73,941.839 55,087.00 0.7450 73,945.962 55, 087.00 0.7450

Interest - -Unexpended Balance 0.00 0.00

TOTAL 55,087.00 55,087.00

DISBURSEMENTS: Payment on Contract 55,087.00 ~\~~§~~9,~k~9~B Deficit 0.00 0.00 -

TOTAL 55,087.00 55,087.00

FD030 SF4 WILLOWVALE Receipts: Raised by Tax 148,069.387 386,710.00 2.61 17 149,020.912 389,1 98.00 2.6117

Interest 0.00 0.00

Unexpended Balance 0.00 0.00 -TOTAL 386,710.00 389,198.00

DISBURSEMENTS:

·-Payment on Contract 315,710.00

Service Awards Program 71 ,000.00 '

Workers Comp -Defecit - -Repay Partial Loan toGen/PT - -

386,710.00 389,198.00

FD057 SF5

NEW YORK MILLS Receipts: Raised by Tax 163,011.808 138,625.00 0.8504 165,370.813 140,631.00 0.8504

Interest 0.00 0.00

Unexpended Balance 0.00 0.00

TOTAL 138,625.00 140,631.00

DISBURSEMENTS: Payment on Contract 138,625.00 ~11-"'""'~~"'~1! . Ji~ I ,~~11~~~ Deficit 0.00 0.00

TOTAL 138,625.00 140,631.00

Fira Page 1 of 1 11/612015 · 9:27AM