Tautfest, Bryce2021-05-13 .IPP
Town of Wappinger
Applo, tion for Hawkers
e4veddler's License
The undersigned does hereby apply to the Town of Wappinger Town Clerk for a
NEW RENEWAL TEMPORARY
(I weekend only)
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 conn
application, does state the following:
1) Applicant:
NAME: Bryce Tautfest AGE:
CURRENT ADDRESS:
7 W Cross St. Ste 7E Hawthorne NY 10532
(St #) (Street) (City) (State) (ZIP)
PHONE#
3609492862
PERMANENT ADDRESS (if different):
7517 ne 165th ave Vancouver WA 98692
(St #) (Street) (City) (State) (ZIP)
If Applicant is an Agent or Employer:
Applicant's Employer APTIVE ENVIRONMENTAL LLC
Address of Employer .5132 N 100 W Ste 150 Provo . . ...... LJT 84804
(St. #) (Street) (City) (State) (ZIP)
Proof of Employment (attach to applicationj_
2) Nature of Business:
••• 1 4.1
MIN"
L Motor Vehicle (circle one): car truck van
L On Foot &/or with vehicle drawn by hand or animal
Vehicle Info: Vehicle Make Lens Vehicle Model
License Plate # CAV'5620 State of Registration -wA
Operator's License Number WDL77Z91B53B
L Weights & Measures Certificate Certificate 9 N/A
L Dutchess County Health Dept Permit Permit 9:N/A
2021-05-13 JPP
3) Veteran Status
1.. 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: While Plains, Mount Pleasant, Clarkstown
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: 0(Ob"Z[_tO7,L7)' 20
Wappingers Falls, N.Y.
A'Uci�n�ti- o—
Si ature of Applicant
Sworn to before me this
d of
c'
Not Public
. Lee A. Freno
No tary Public, State of New YO*
No. OIFR6327313
Qualified in Outchess County.
Commission Expires 716i
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
non-refundable fee.
Applicants possessing a valid Dutchess County Veterans Vendors License are exempt from
the $200.00 fee, provided that a copy of said license is attached to the application.
CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
6/4/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT, If the certificate holder is an ADDITIONAL INSURED, the pollcy(tes) must have ADDITIONAL INSURED provisions or be endorsed.
It 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
Graham Com an
p y.
a Marsh & McLennan Agency, LLC company
30 S 15th Street, 20th Floor
Philadelphia PA 19102
CONT
NAME:
PHONE FAX
AIG No 215-567-6300 A No): 215-569-3025
ADDRIESS: MMAEastGrahamHold enUnit marshmma.corn
INSURER(S) AFFORDING COVERAGE NAIC#
INSURERA: Safety National Casualty Corporation 15105
MML��IYYYY
INSURED APTIENV-01 APTIINSURERS:
5132 N 300 W. Ste 150 ENVIRONMENTAL, LLC
5132 N
Evanston Insurance Company 35378
wsunmc: Lexington Insurance Company 19437
INSURER D: Steadfast Insurance Company 26387
Provo, UT $4604
INSURER E
11/1/2024
INSURER F
EACH OCCURRENCE $1,000,000
_D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVEFORTHE 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.
INSR
LTR
TYPE OF INSURANCE
I
UBR
POLICY NUMBER
POLICY EFF
MML��IYYYY
LIMITS
C
X COMMERCIAL GENERAL LIABILITY
Y
27734516
11/1/2024
11/112025
EACH OCCURRENCE $1,000,000
_D
CLAIMS -MADE OCCUR
DAMAGE T57721,TTE
PREM SE5 Ea occurrence) $ 300,000
MED EXP (Any one person) $
PERSONAL &Al INJURY $1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
0 PRO-
GENERAL AGGREGATE $2,000,000
PRODUCTS - COMPIOP AGG $ 2,000,000
POLICY JECT LOC
$
OTHER:
A
AUTOMOBILE
LIABILITY
CA 8676643
11/1/2024
1111/2025
COMBINED SINGLE LIMIT $ 3,000,000
Ea accldeni
X
ANY AUTO
BODILY INJURY (Por persnn) $
OWNER SCHEDULED
BODILY INJURY (Per accident) $
1AUT05
AUTOS ONLY AUTOS
HIRED NON-pWNEQ
ONLY AUTOS ONLY
PROPERTY DAMAGE
Per ac ]don,)
D
UMBRELLA LIAB
X
OCCUR
SXS 6439974.00
11/1/2024
11/1/2025
EACH OCCURRENCE $ 2,000,000
X
EXCESS LIAR
CLAIMS -MADE
AGGREGATE $
DED RETENTION $ .
$
q
WORKERS COMPENSATION
LDS 4066513
11/1/2024
11/112025
X STATUTE �RH
A
AND EMPLOYERS` LIABILITY YIN
PS 4068512
11/1/2024
11/112025
E.L. EACH ACGIIJENT $ 1,000,000
ANYPROPRIETOPJPARTNERIEXECUTIVE
OFFICERIMEMBEREXCLUDED?
NIA
DISEASE - EA EMPLOYEE $ 1,000,000
(Mandatory d cry be un)E.L.
If yes, describe under
E.L, DISEASE - POLICY LIMIT $ 1,000,000
DESCRIPTION OF CPI=RATIONS below
B
C
Contractor's Pollution
MKLVI ENV104535
11/1/2024
11/1/2025
Each Pollution
Excess Liability
52114892
11/1/2024
11/1/2025
Coodllion LinnitlAgg: $5,000,000
Limit: $3,000,000
DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The Excess Liability policy referenced above with Steadfast Insurance Company provides limits in excess of the Auto Liability only.
The Excess Liability coverage referenced above with Lexington Insurance Company provides limits in excess of the primary General Liability and Excess Auto
Liability policies,
The Town Of Wappinger, NY is an additional Insured on the above General Liability policy if required bywritten contract.
Town of Wappinger, NY
20 Mlddlebush Road
Wappingers Falls NY 12590
ACORD 25 (2016103)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ArORITED PRESENTATIVE
1019UU-21795 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD