Riofrio Jr., HectorFOR INTERNAL USE ONLY
LA
Received by: Joseph P. Paoloni
,,
'e -
Date Received:
Serial #:
N
The undersigned does hereby apply to the Tow r mini
NEW RENEWAL
J, W&k�,ffd7 ohiyy-
License for Hawking and Peddling pursuant to Town of Wappinger Local Law No. 10 of 1992,
regulating Hawkers and Peddlers in the Town of Wappinger, and in
application, does state the following:
1) Applicant:
Y
NAME: r �/,7 a AGE: 2,
CURRENT ADDRESS:
. cron
e Al
(St #) (Street) (City) (State) (ZIP)
PHONE ##
20 7 6
PERMANENT ADDRESS (if different):
(St #) (Street) (City) (State) (ZIP)
If Applicant is an Agent or Employer:
Applicant's Employer_ TE;,,+tj Gc)lct(-, L-& N
Address of Employer 22- Gow11 ever P"-dfk-me 1
(St. #) (Street) (City) (State) (ZIP)
Proof of Employment (attach to application)
2) Nature of Business:
S 2fo%r
Tape a 2"X 211
color photo (less
than 60 days Old)
0 Motor Vehicle (circle one): (—car) truck van
11 On Foot &/or with vehicle drawn by han or animal
Vehicle Info: Vehicle Make Ma--Z4-i- Vehicle Model AA
License Plate # Ld L— HZ 3 State of Registration t4 Y
Operator's License Number
11 Weights & Measures Certificate Certificate #
1.1 Dutchess County Health Dept Permit Permit #
202105-13 JPP
3) Veteran Status
❑ Veteran Applicant -Exempt from license fee (attach certificate from Dutchess County)
Names of all other municipalities in which the applicant has been a vendor in the preceding 6
months:
4) Compliance
That the applicant, if the License requested hereby is granted, consents and agrees to conduct the
aforesaid business or activity pursuant to all of the terms and regulations of the Local Law above
specified, and all other rules, regulations and Laws governing ones activities in the Town of
Wappinger as a Peddler or Hawker.
Dated: 'I / 9
Wappingers Falls, N.Y.
Sworn to before me this
day of , 20_
Notary Public
202-5
nature of Applicant
Application must be accompanied by a fee of Two Hundred Dollars ($200.00) plus $50 for
each addition to the original license per year, payable to the Town of Wappinger. This is a
nonrefundable fee.
Applicants possessing a valid Dutchess County Veterans Vendors License are exempt from
the $200.00 fee, provided that a copy of said license is attached to the application.
SOLAR
Town of Wappiffier., IN
Town Clerk
20 Middlebush Road
Wappingers Falls NY 12590
(845)297-5772
Application Location:
- Located in Packet.
Background Check/Fingerprinting Required? (instructions):
- Background check may be done through the town, though they did not mention
fingerprinting.
Special Notes About Township/Application Process:
- The permit process could take up to a month to receive.
Salesperson is required to provide the following items:
- Valid Driver's License
- Company ID
- 2 Passport Photos
- All checks and documents provided in this packet, please complete application fully.
ONCE YOU' TURN IN APPLICATION:
-Get the name of the person you are turning the application into and a contact phone number. This
is the information you will use to follow up on your permit/license.
-Make sure ALL the information is filled out completely on the application.
-if you are unsure about a question on the application, contact your DM or call the town and ask.
Do not leave it blank.
-if you find out the town is not accepting applications for any reason, please email licensing and let
them know. Include the name of the person who gave you this information.
-Once you receive your permit/license take a photo of it and email it to licensing.
-Anyone who does not send licensing a copy of their permit/license will be considered non-
compliant and managers will be notified.
Best of Luck!
Licensi�ng@trinity-solar.com
SOLAR
WHEN FILLING OUT ANY APPLICATION FOR SOLICITIATION, USE THE
• AS SOON AS YOUR LICENSE OR PERMIT IS ISSUED BY THE TOWN, CITY OR
STATE, YOU ARE RE+QUIREDTO SEND A COPY TO THE LICENSING DEPARTMENT
AT LICENSING TRINITY-SOLAR.COM
• ANY LICENSE NOT RECEIVED WITHIN 60 DAYS OF BEING REQUESTED WILL BE
CONSIDERED INACTIVE AND NON-COMPLIANT.
• IF YOU NEED SUPPORT FOLLOWING OF WITH ATOWNSHIP OR STATE
PERMITTING AUTHORITY TO OBTAIN YOUR PERMIT, PLEASE CONTACT
LICENSING AND WE WILL PLACE A FOLLOW-UP CALL ON YOUR BEHALF.
• IF YOU LOSE ANY CHECKTHATTRINITY HAS SUPPLIED YOU WITH THIS PACKET,
YOU WILL BE RESPOSIBLE TO PAYOUT OF POCKET FOR THE REQUIRED
TOWNSHIP/CITY FEE.
• AFTER YOU ARE ISSUED THE PERMIT, PLEASE ASIC IF THE TOWN HAS A"NO
KNOW LIST. IF THEY PROVIDE YOU WITH ONE, PLEASE SEND IT TO THE
LICENSING 'DEPARTMENT ASAP 'SO WE CAN UPLOAD THE ADDRESSES TO BE
SYNCED TO'THE SPOTIO APP.
• IF YOU ARE NOT APPLYING TO THIS TERRITORY, PLEASE RETURN PACKETAI" D
CHECKS TO DM OR TRAINING MANAGER ASAP.
THANK YOU,
LICENSING DEPARTMENT
Licensing@trinity-solar.com_
�
NY/Ll, Nassau County Home Improvement Contractor #H2409780000
mY/Ll,Suffolk County Home Improvement contracto,#H-5aazt
uOL~`'^ NY, jurisdictions, license o,registration information furnished upon request.
For other jurisdictions, please visit: http://www.trinity-so�ar.com/about-us/�ocations-and-Ecenses
April 21, 2025
To Whom It May Concern:
Hector Riofrio is a Trinity Sales employee seeking approval to solicit in the Town of Wappinger,
NY. We are a local solar company specializing in residentiail financing options, and they are a part of the
division that generates leads bvgoing door-to-doocThe, most prominent product vveoffer is apuvver
purchase agreement for homeowners to supplement their current utility biHs by using solar energy
produced ontheir home.
Please contact me if you should have any questions.
Maria Nuzzi
Licensing Administrator
Phone: (732)780-3779 ex 9809
EO1ai[Ucensng@trnitV-solar.com
Long Island, NYOffice 1 -877 -SUN -SAVES
2180 9fthAvenue, Unit Y Ph: 631-319-7233
Rmnkonkumo'New York ll779 Fox: 631-285-3428
_1
NEW Workers'
YORK
STATE =nsation CERTIFICATE OF INSURANCE COVERAGE
NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW
PART 1. To be completed by NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrier
Ia. Legal Name & Address of Insured (use street address only)
1b. Business Telephone Number of Insured
TRINITY SOLAR, LLC
62 LEONE LANE
8003733765
CHESTER, NY 10918
Work Location of Insured (Only required if coverage is specifically iirniledlo
1 c. Federal Employer Identification Number of Insured
certain iocalions in New York State, ke, Wrap -Up Policy)
or Social Security Number
22-3292324
2. Name and Address of Entity Requesting Proof of Coverage
3a. Name of Insurance Carrier
(Entity Being Listed as the Certificate Holder)
Standard Security Life Insurance Company of New York
Town of Wappinger
20 Middlebush Road
31b. Policy Number of Entity Listed in Box Ia
Wappingers Falls, NY 12590
871757-002
USA
3c. Policy Effective Period
8/1/2017 to 6/1/2025
4. Policy provides the following benefits:
[X-] A. Both disability and Paid Family Leave benefits.
[] B. Disability benefits only.
E] C. Paid Family Leave benefits only.
5, Policy covers!
RX A. All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law.
F] B. Only the following class or classes of employer's employees:
Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named
insured has NYS disability and/or Paid Family Leave benefits insurance coverage as de:sc dabove.
Date Signed 6/2/2024 By
(Signature of Insurance carrier's authDrIed representative or NYS licensed insurance agent of that insurance carrier)
Telephone Number (212) 355-4141 Name and Title SUPERVISOR-DBL/POLICY SERVICES
IMPORTANT:lf Boxes 4A and 5A are checked, and this form is signed by the insurance carrier's authorized representative or NYS
Licensed Insurance Agent of that carrier, this certificate is COMPLETE. Mail it directly to the certificate holder.
If Box 4B, 4C or 5B is checked, this certificate is NOT COMPLETE for purposes of Section 220, Subd. 8 of the NYS
Disability and Paid Family Leave Benefits Law. It must be emailed to PAU@wcb,ny.gov or it can be mailed for
completion to the Workers' Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200,
PART 2. To be completed by the NYS Workers' Compensation Board (Only if Box 413, 4C or 5B of Part 1 has been checked)
State of New York
Workers' Compensation Board
According to information maintained by the NYS Workers' Compensation Board, the above-named employer has complied
with the NYS Disability and Paid Family Leave Benefits Law(Article 9 of the Workers' Compensation Law) with respect to all of
their employees.
Date Signed By
(Signature of Authorized NYS Workers' Compensation Board Empbyee)
Telephone Number Name and Title
Please Note: Only insurance carriers licensed to write NYS disability and Paid FamPy Leave benefits insurance policies and NYS licensed
insurance agents of those insurance carriers are authorized to issue Form DB -120, I. Insurance brokers are NOT authorized to issue this form.
DB -120.1 (12-21)I III
DB -1,20 .1 (12-2-1
NEW Workers'Y ATC Compensation
Board
CERTIFICATE OF
NYS WORKERS' COMPENSATION INSURANCE COVERAGE
la. Legal Name & Address of Insured (use street address only)
1b. Business Telephone Number of Insurectl,
Trinity Solar, LLC
631-319-7233
62 Leone Lane
Chester, NY 14918
1c. NYS Unemployment Insurance Employer Registration Number of
Insured
49-230977
Work Location of Insured (Onlyrequired if coverage Is specifically limited to
1d, Federal Employer Identification Number of Insured or Social Security
certain locations in New York State, i.e., a Wrap -Up Policy)
Number
22-3292324
2. Name and Address of Entity Requesting Proof of Coverage
3a. Name of Insurance Carrier
(Entity Being Listed as the Certificate Holder)
National Union Fire Insurance Company
Town of Wappinger
3b, Policy Number of Entity Listed in Box "1 a"
20 Middlebush Road
Wappingers Falls, NY 12590
WC 013588107
USA
3c. Policy effective period
6/1/2024 to 6/1/2025
3d. The Proprietor, Partners or Executive Officers are
❑ included, (Only check box if all partners/officers included)
all excluded or certain partners/officers excluded.
This certifies that the insurance carrier indicated above in box "3" insures the business referenced above in box "1 a" for workers'
compensation under the New York State Workers' Compensation Law. (To use this form, New York (NY) must be listed under Item 3A
on the INFORMATION PAGE of the workers' compensation insurance policy). The Insurance Carrier or its licensed agent will send
thls Certificate of Insurance to the entity listed above as the certificate holder in box "2".
The insurance carrier must notify the above certificate holder and the Workers' Compensation Board within 10 days IF a policy is canceled
due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or
eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this
Certificate is valid for one year after this form is approved by the insurance carrier or Its licensed agent, or until the policy
expiration date listed in box "3c", whichever is earlier.
This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend,
extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the
referenced policy,
This certificate may be used as evidence of a Workers' Compensation contract of insurance only while the underlying policy is in effect.
Please Note: Upon cancellation of the workers' compensation policy indicated on this form, if the business continues.to be
named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a
new Certificate of Workers' Compensation Coverage or other authorized proof that 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 or licensed agent of the insurance carrier referenced
above and that the named insured has the coverage as depicted on this form.
Approved by: Michael Price
(Print name of authorized representative or licensed agent of insurance carrier)
Approved by: .Z, 61112024
(Signature) (Date)
Title: C.E.O. North America
Telephone Number of authorized representative or licensed agent of insurance carrier:
Please Note: Only Insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT
authorized to issue It.
C-105.2 (9-17) www.wob.ny.gov
,a�►ac�� CERTIFICATE OF LIABILITY INSURANCE
E 1
DAT 512812D1YYYY)
i2sizo24
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 INSUREII AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provisions or 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
Arthur J. Gallagher Risk Management Services, LLC
300 Fellowship Road
Suite 200
CONTACT
NAME:
PHO NN Ext: 856 482-9900 nlc No): 856-482-1888
E-MAIL
ADDREss; Cherr HiII,BSD.CertM AJG.com
INSURER(S) AFFORDING COVERAGE MAIC#
Mount Laurel NJ 08054
INSURERA: Gotham Insurance Company 25569
INSURED TRINHEA-03
Trinity Solar LLC
62 Leone Lane
INSURER B: National Union Fire Insurance Company of Pittsbur 19445
sURERc; Endurance American Specialty Ins Co 41718
INSURER
INSURER D: Liberty Insurance Underwriters Inc 19917
Chester, NY 10918
INSURER E: Columbia Casualty Company 31127
INSURER F:
COVERAGES CERTIFICATE NUMBER, 2087486737 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.
ILTR.
TYPE OF INSURANCE
ADDL
I
SUBR
POLICY NUMBER
POLICY EFF
MMIDDNYYY
POLICY EXP
MMIDDYYY
IY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
GLL202100013376
6/1/2023
6/1/2025
EACH OCCURRENCE $ 2,000,000
CLAIMS -MADE � OCCUR
DAMAGE TO
PREMISES Ea occurrence $ 100,000
MED EXP Any one person) $ 0
PERSONAL & ADV INJURY $1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $2,000,000
PRODUCTS - COMPIOP AGO $ 2,000,000
PO -
POLICY FILOC
1E JE
$
OTHER:
S
AUTOMOBILE LIABILITY
CA 2960145
6/112024
61112025
COMBINED SINGLE LIMIT $ 2,000,000
Ea acoident
BODILY INJURY (Per person) $
X ANY AUTO
OWNFDSCHEDULED
AUT080NLY AUTOS
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
Per accident
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
A
D
E
X
UMBRELLA LIAB IX
EXCESS LIAR
OCCUR
CLAIMS -MADE
EX202300001871
ELD30006989102
1000231834-08
7089650582
61112023
61112024
611/2024
61112024
6/1/2025
6/1/2025
6/112025
6/1/2025
EACH OCCURRENCE $ 5,000,000
AGGREGATE $ 5,000,000
DED RETENTION $
Limit x of $5,000,000 $19,000,000
B
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY Y 1 N
ANYPROPRIETORIPARTNERIEXECUTIVE
OFFICERIMEMBEREXCLUDED?
(Mandatory in NH)
NIA
WC 013588107
611/2024
6/1/2025
X PER H-
STATUTE ER
E.L. EACH ACCIDFNT $1,000,000
E,L. DISEASE- EA EMPLOYEE $ 1,000,000
E.L. DISEASE- POLICY LIMIT $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
R
AUtornolAle
Comp! Collusion Ded.
CA 2960145
6/1/2024
6/112025
All Other Units $2501$500
Truck -Tractors and
Semi -Trailers $2501$500
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
The Certificate Holder is named as additional insured with respect to the above General Liability Policy, if required by written contract executed prior to services
performed.
Town of Wappinger
20 Middlebush Road
Wappingers Falls NY 12590
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Farm W009
(Rev. October 2618)
pepart lent of the Treasury
internal Revenue Service
ri
M
D
1 Name (as shown on your Inc
trinity Solar, LLC
2 Business name/disregarded
Request for Taxpayer
Identification Number and Certification
b Go to
e tax retu
name, If different from
W9 for instructions and the latest Information,
on this line; do not
3 Check appropriate box for federal tax classification of the person whose name Is entered on I€ne 1. Check only one of the
following seven boxes.
❑ Indlvldualisole proprietor or ❑ C Corporation ❑ 3 Corporatlon ❑ Partnership ❑ Trust/estate
single -member LLC
Limited liability company. Enter the tax classification (C=C corporation, SwS corporation, P=partnership) ► P
Notes Check the appropriate box In the line above for the tax classification of the single -member owner. Do not check
LLC If the LLC Is classified as a single -member LLC that Is disregarded from the owner unless the owner of the LLC Is
another LLC that Is not disregarded from the owner for US, federal tax purposes. Otherwise, a single -member LLC thz
Is disregarded from the owner should check the appropriate box for the tax classification of Its owner,
Other (see Instructions) ►
dress (number, street, and WE or
2211 Allenwoo
B City, state, and ZIP of
Wall, NJ 07719
7 List account numbers
Road
here
Give Form to the
requester. Do not
send to the IRS.
4 Exemptions (codas apply only to
certain entities, not Individuals; see
Instructions on page 3);
Exempt payee code (If any)
Exemption from FATCA reporting
code (if any) .
1 (App!lostoautnuntematnitttnedautaldethe V.B.)
name and address footional)
Enter your TIN In the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding, For individuals, this is generally your social security number (SSN), However, for a — —
resident alien, sole proprietor, or disregarded entity, see the Instructions for Part I, later. For, other
entities, it is your employer Identifioation number (EW). If you do not have a number, see Now to get a
TIN, later. or
Nota: If the account Is in more than one name, see the Instructions for line 1. Also see What Name .and I employer Identification number
Number To Give the Requester for guidelines on whose number to enter. � �� rr r
2 2- 3 12 1 9 12 `13 ^I 2 1j
4
Under penalties of perjury, I certify that;
1. The number shown on this farm Is my correct taxpayer identification number (or I am waiting for a number to be Issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S, citizen or other U.S. person (deflned below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting Is correct.
Certifioation instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage Interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual .retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the Instructions for Dart 11, later.
Wof
e i signature ► �r� �;, r Date 0108/01/2023
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and Its Instructions, such as legislation enacted
after they were published, go to www.lrs.gov1F6rmW9.
Purpose of Farm
An Individual or entity (Form W-9 requester) who Is required to file an
Information return with the IRS must obtain your correct taxpayer
Identification number (TIN) which may be your social security number
(SSN), Individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer Identification number
(EIN), to report on an Information return the amount paid to you, or other
amount reportable on an Information return. Examples of Information
returns Include, but are not limited to, the following.
• Form 1098 -INT (interest earned or paid)
• Form 1099 -DIV (dividends, including those from.stocks or mutual
funds)
• Form 1099-MISO (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
Form 1089-S (proceeds from real estate transaotions)
• Form 1099-K (merchant card and third parry network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan Interest),
1098-T (tuition)
• Form 1099-0 (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
allen), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No, 10231X Form W.9 (Rev. 10-2018)
� f