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Davidson, RyanFOR INTERNAL USE ONLY Received by: Joseph P. Paoloni -- - Received Lynn O'Dell 7 Cooper Leatherwood J �AR 0 5 2026 Date Received Serial #: �6;LC, - 3 2021-05-13 JPP Town of Wappinger Application for Hawkers & Peddler's License of Wappinger mri Clerk The undersigned does hereby apply to the Town of Wappinger Town Clerk for a NEW RENEWAL TEMPORARY (1 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 conri�--- application, does state the following: 1) Applicant: 0 NAME, , a v, AC�F- CURRENT ADDRESS: (St (Street) (City) (State) (ZIP) A RA PHONE# cp PERMANENT ADDRESS (if different): (St -4) (Street) (City) (State) (ZIP) If Applicant is an Agent or Employer: Applicant's Employer "k-+'nj,i Address of Employer )-, S12 ki ii (St. #) (Street) (City) (State) (ZIP) Proof of Employment (attach to application) 2) Nature of Business: :1 Motor Vehicle (circle one): car truck van -J On Foot &/or with vehicle drawn by hand or animal Vehicle Info: Vehicle Make 4 Vehicle Model Cx-c License Plate# (�O'; State of Registration Operator's License Number 07'151LLjzti, .1 Weights & Measures Certificate Certificate # I Dutchess. County Health Dept Permit Permit # 2021-05-13 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: n.� z..� �,^ , 20 'fit,. Wappingers balls, N.Y. Sworn to before me this Signature of Applicant dayofh(6) 20a MEGAN K SQUARZINI �-- > - NOTARY PUBLIC, STATE OF NEW YORK Registration No. 01 LA6394276 fffyxt_�� Qualified in Dutchess County Notary Pu lic Commission Expires July 1, 203—ri 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. k E 4iJ;1 �G4yJr1#F}YnG.}/ r�j�,,'a�J" :x 1 � t '`R " CERTIFICATE OF LIABILITY INSURANCE DAT513012025YYi 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(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 endorsements . PRODUCER Arthur J. Gallagher Risk Management Services, Li 300 Fellowship Road Suite 200 CONTACT Ni Alex Gillikin PHONE Fax A C N Ex : 856 482-9900 Ara No)'. 856-482-1888 Aan"le�ss: CharryHill.BSD.CertM_@AJG.com Mount Laurel NJ 08054 INSURERS AFFORDING COVERAGE NAIC# INSURI~RA: National Union Fire Insurance Company of Pittsbur 19445 INSURED TRINHEA-03 Trinity Solar LLC 62 Leone Lane INSURERB: Evanston Insurance Company 35378 INSURERC: Navigators Secialt Insurance Company 36056 INSURERD: Endurance American Specialty Ins Co 1 41718 Chester, NY 10918 INSURERS: Lli Insurance Underwriters Inc 19917 INSURER F : COVERAGES CERTIFICATE NUMBER: 1901 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. INSR LTR TYPE OF INSURANCE ADDL SUER POLICYNUMBER POLICY EFF MMlDDIYYYY POLICY EXP MMIDDIYYYY LIMITS B X COMMERCIAL GENERAL LIABILITY Y MKLV7ENV106507 6/112025 6/1/2026 EACH OCCURRENCE $ 3,000,400 CLAIMS MADE � PREMOCCUR DAMAGE RENTED REM]SES Ea occurrence $ 300,000 MED EXP {Any one person) $ 25,000 PERSONAL & ADV INJURY $ 3,000,000 GHN'h AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGO $ 3,D00,000 $ OTHER: A AUTOMOBILE LIABILITY 2960145 611I2025 6/1/2026 COMBINED SINGLE LIMIT Ea accident $ 6,000,000 BODILY INJURY (Per p®rson) $ ANYAUTO 1X OWNED SCHEDULED AUTOS ONLY AUTOS ) BODILY INJURY (Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per acddent) $ C D E UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE NY25EXCZOLOHKIC NY25EXCZOLOHKIC Ei-030006989103 1 D00231834-09 6/112025 6/112025 611I2025 6/112025 8/1/2026 8/1/2026 6/1/2026 6/1/2026 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 6,000,000 DED RETENTION $ LIMIT X OF $5,000,000 $ 16,000,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFE[CERIMEMBEREXCLUDED? FN NIA 13188225 611I2025 6/1/2026 X PER EIR STATUTE ER E.L. EACH ACCIDENT $ 5,000,000 E.L. DISEASE • EA EMPi.QYEF $ 5,000,000 (Mandatory In NH) Ifyes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POUCYLIM IT $ 5,000,000 A AUTOMOBILE COMP. I COLLISION DEDUCT. 2960145 6/112025 6/1121 ALL OTHER UNITS TRUCK -TRACTORS AND $2501$500 SEMI -TRAILERS $2501$500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) EXCESS LIABILITY- CONT. Carrier: Columbia Casualty Company Policy* 7039650582 Policy Period: 6/1/2025 - 6/1/2026 Limit: $5,000,000 xs $21,000,000 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 IST Workers' Compensation Board CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a. Legal Name & Address of Insured (use street address only) 1 b. Business Telephone Number of Insured Trinity Solar LLC 631-319-7233 62 Leone Lane Chester, NY 10918 1c. NYS Unemployment Insurance Employer Registration Number of Insured 49-230977 1d. Federal Employer Identification Number of Insured or Social Security Work Location of Insured (Only required if coverage is specifically limited Number to certain locations in New York State, i.e., a Wrap -Up Policy) 22-3292324 2. Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Town of Wa pp� 9 to er National Union Fire Insurance Company 20 Middlebush Road 3b. Policy Number of Entity Listed in Box "Ila" Wappingers Falls, NY 12590 13188225 USA 3c, Policy effective period 6/1/2026 to 6/1/2026 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 this 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: _ i ',��r�f"2+„2 6i112025 (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.wcb.ny.gov Wor YOU Conn inkers' sation CERTIFICATE OF INSURANCE COVERAGE �r Boar PY 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 1 a, 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 1 c. Federal Employer Identification Number of Insured or Social Security Number Work Location of insured {only required if coverage is specifically limited to certain locations in N9w York State, i.e., Wrap-up Policy) 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 3b. Policy Number of Entity Listed in Box 1 a Wappingers Falls, NY 12590 R71757-0,02 USA 3c. Policy Effective Period 8/1/2017 to 6/1/2026 4. Policy provides the following benefits: f-K-1 A. Both disability and Paid Family Leave benefits. B. Disability benefits only. C. Paid Family Leave benefits only. 5. Policy covers: A. All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law, 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 andlor Paid Family Leave benefits insurance coverage as descrfid above. Date Signed 6/212025 By (Signature of insurance carrier's author3ed representative or NYS licensed insurance agent of that insurance carrier) Telephone Number (212) 355-4141 Name and Title SUPERVISOR-DBL/POLICY SERVICES I MPORTANT: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. Mall it directly to the certificate holder. If Box 413, 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, PC Box 5200, Binghamton, NY 13902-5200. PART 2. To be completed by the NYS Workers' Compensation Board (Only if Box4B, 4C or 5B of Part I 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 (Sigrature of Authorized NYS WDrkers'Compemation Board Employee) Telephone Number Name and Title Please Note: Only insurance carriers licensed to write NYS disability and Paid Fainfly Leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form OB-120. 1. Insurance brokers are NOT authorized to issue this form. DS-120.1 (12-21) 111111111111111111111111111111I11I111tI111I 1 DB-120.] �12-21,) Additional Instructions for Form DE3-120.1 By signing this form, the insurance carrier identified in Box 3 on this form is certifying that it is insuring the business referenced in Box 1a for disability and/or Paid Family Leave benefits under the NYS Disability and Paid Family Leave Benefits Law. The insurance carrier or its licensed agent will send this Certificate of Insurance Coverage (Certificate)to the entity listed 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 cancelled 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 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 NYS disability and/or Paid Family Leave benefits contract of insurance only while the underlying policy is in effect. Please Dote: Upon the cancellation of the disability and/or Paid Family Leave benefits 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 Insurance Coverage for NYS disability and/ or Paid Family Leave Benefits or other authorized proof that the business is complying with the mandatory coverage requirements of the NYS Disability and Paid Family Leave Benefits Law. NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAVA §220. Subd. 8 (a) 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 employment as defined in this article, and not withstanding any general or special statute requiring or 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 the payment of disability benefits and after January first, two thousand and twenty-one, the payment of family leave benefits for all employees has been secured as provided by this article. 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 disability benefits to any such employee if so employed. (b) 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 employment as defined in this article and notwithstanding any general or special statute 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 the payment of disability benefits and after January first, two thousand eighteen, the payment of family leave benefits for all employees has been secured as provided by this article. DB-120.1 (12-21) Reverse WM9 Request for Taxpayer Give Form Form (Rev, October 2018) Identification Number and Certification to the requester. Do not Department Of the a Treasury send to the IRS. .t.m.1 Raven.. Service 11, Go to WWW.Irs.gov/FormW9 for instructions and the latest information. 1 Name (as shown on your income tax return), Name Is required on this line; do not leave this line blank. Trinity Solar, LLC 2 Business nameMisregarcled entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name Is entered on line 1. Check only one of the 4 Exemptions (codes apply only to foliowing seven boxes. certain entitles, not individuals; see CL cc D Individual/sole proprietor or El C Corporation EJ S Corporation El Partnership El Trust/estate Instructions on page 3): M C single -member LLC Exempt payee code (if any) Limited fi.bifity company, Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) * P Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting U) LLC If the LLC is ciassifled as a single -member LLC that Is disregarded from the owner unless the owner of the LLC Is LLC that is disregarded from code (if any) CL a another not the owner for U.S, federal tax purposes. Otherwise, a single -member LLC that Is disregarded from the owner should check the appropriate box for the tax classification of its owner. a) ❑to Other (see instructions) O� (Apotw ac.-Is ­hfW..d ­Oid. the U5.) CL 5 Address (number, street, and apt. or suite no.) See Instm'ellions. Requester`s name and address (optional) Z 2211 Allenwood Road 6 City, state, and ZIP code Wall, NJ 07719 I 7 List account number(s) here (optional) ffM Ma Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Soeial security number backup withholding. For Individuals, this is generally your social security number (SSN). However, fora resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, later. For other entities, it Is your employer identification number (EIN). If vou do not have a number, see Now to cat a TIN, later. or Note: If the account is in more than one name, see the instructions for line 1. Also see What lVame and Employer identification number Number To, Give the Requester for guidelines on whose number to enter. F—T-7 I I I I I MMMMMUMMMM Under penalties of perjury, I certify that: 1. The number shown on this form 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 l am no longer subject to backup withholding; and 3. I am a U.S, citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) Indicating that I am exempt from FATCA reporting is correct. Certification 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 Part 11, later. Sign Here Signature of U.S. person No. 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.irs.gov/FormW9. Purpose of Form 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 MN) which may be your social security number (SSN), individual taxpayer identification number (IT11N), adoption taxpayer identification number (ATIN), or employer identification number (EIIN), 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 1099-INT (interest earned or paid) Date ► 08/01/2023 a Form 1 099-DIV (dividends, including those from stocks or mutual funds) - Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) s Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) Form 1 099-S (procoods from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (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 alien), to provide your correct TIN. it 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) SOLAR To Whom It May Concern: NY Putnam County Home Improvement Contractor # PC6987 NY Putnam County Electrical License # R23713 NY Westchester County Home Improvement Contractor #WC-27944-HI5 NY Westchester County Electrical License # 599 NY Rockland County Home Improvement Contractor #H-12313-40 NY Rockland County Electrical License # 402 NY Orange County Electrical License # 198 NY Sullivan County Electrical License # 442 NY Greene County Electrical License # 502 NY, jurisdictions, license or registration informatior furnished upon request. For other jurisdictions, please visit: http://www.trinity-solar,,com/about-u,5/locatiors-and-locerses February 16, 2026 Ryan Davidson is a Trinity Sales employee seeking approval to solicit in the Town of Wappinger. We are a local solar company specializing in residential financing options, and they are a part of the division that generates leads by going door-to-door. The most prominent product we offer is a power purchase agreement for homeowners to supplement their current utility bills by using solar energy produced on their home. Please contact me if you should have any questions Sincerely, M a* -Cal N Maria Nuzzi Licensing Administrator 0: 732-780-3779 E: Licensing@trinity-solar.com Hudson Valley Office 1-8'77-SUN -SAVES 62 Leone Lane Ph: 845-572-0060 Chester, New York 10918 Fax: 845-576-0068 www.trinity-solar.com