HomeMy WebLinkAboutAgenda Report - November 2, 1983 (24)r
{ -CITY COUNCIL MEETING
_ r
NOVEMBER T, 1983 ,
DESIGNATION OF Following introduction of the matter by City Manager Glaves,
CITY Come iI, on motion of Council Kimber Pinkerton, Reid second,
REPRESENTATIVES adopted Resolution No. 83-128 designating the Public Nbrks
TO MAKE PCIECWES Director Jack Ronsko, Equipment and Building Maintenance
OF FEDERAL Supervisor Richard Wiech, and Assistant City Manager Jerry
SURPLUS PROPEHIY Glenn, as the City's representatives to acquire federal
surplus property from the California State Agency for
RFS ND. 83-128 Surplus Property.
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CITY COUNCIL
EVELYN M. OLSON. Mayor
JOHN R. (Randy) SNIDER
Mayor Pro Tempore
ROBERT C. MURPHY
JAMES W. PINKERTON. Jr.
FRED M. RE ID
OW
CITY OF LODI
CITY HALL. 221 WEST PINE STREET
POST OFFICE BOX 320
LODI. CALKORN1A 95241
(209) 334-5634
November 7, 1983
R. W. Swans, Chief
Surplus Property Section
State of California
Department of Education
721 C.Rpital Mall
Sacramento. CA 9814
Ree 39-9-210-2-4-G
2H 39 K 924
Gentlemen:
HENRY A. CLAVES, Jr.
City Manaim
ALICE M. REIMCHE
City Geek
RONALD M. STEIN
City Attorney
Pursuant to your recent letter, enclosed please find property docunerutation
to insure continuing eligibility for the City of Lodi to acquire federal
surplus personal property; namely
Executed copy of State of California Application for
Eligibility Federal Surplus Personnel Property Program.
Executed copy of Assurance of CImpliance with CSA Regulations.
Certified copy of Resolution No. 83-128 designating certain
city mployees as the City's representatives to acquire federal
surplus property from the California State Agency for Surplus
Property.
If you have any questions regarding this matter, please do not hesitate to
call.
Very truly yours,
Alice M. Reimche
City Clerk
AMR: ii
i�nc.
CalirprZ '.State Department of Fducation
r "ire of Surplus Property
121 Capitol N11". Sacramento, CA 95814 STATE OF CALIFORNIA
OSP Form No, 201 (9.82) APPLICATION FOR ELIGIBILITY
s FEDERAL SURPLUS PERSONAL PROPERTY PROGRAM
Before prepaying this application, please read carefully the definitions given under Part B. Fill out all applicable sections.
Part A.
Legal name of organization City of Lodi Telephon9209) 334-5634
Address 22� West Pine Street City._ Lodi .,County Sa Joaguin zi 9S240-
1. Application is being made as a (please check one) (a) Public agency X3 or (b) Private, nonprofit and tax-exempt educational or public
health organization O. Please provide evidence that the organization is a public agency or enclose a copy of the letter.of certificate from
the United States Interns! Revenue Service evidencing tax -exemption under Section 501 of the Internal Revenue Code of 1954.
2. Check type of agency or organization and attach a supplement to this application describing the program operations and activities. For
private. nonprofit organizations, the following additional information is required: (a) For educational institutions, include a description
of the curriculum. the number of days in the school year, and the number and qualifications of the faculty or staff;(b) If a public health
institution or organization, include a description of the health services offered, qualifications of staff and, if applicable. the number of
beds, number of resident physicians. and number of registered nurses on the staff.
PUBLIC AGENCIES: Check either state C1 or local lit NONPROFIT INSTI' UT10N OR ORGANIZATION:
O ,Conservation O Education
O Economic development Grade level
O Education (Preschool, oniwrsiry)
Grade level Enrollment
(Preschool. university) No. of school sites
Enrollment O School for the mentally or physically handicapped
No. of school sites_ O Educational radio or television station
O Parks and recreation O Museum
O Public health O Library
O Public safety O Medical institution
O Two or more of above O Hospital
O Other (specify) O Health center
O Clinic
O Other (specify)
3. Check if the applicant program is approved O : accredited O or licensed O. Enclose evidence of such approval, accreditation. of
licensing. If the applicant lacks evidence of formal approval, accreditation. or licensing, check here O and refer to the endured
Instructions.
4.. Are the applicant's services available to the public at large? . If only a specified group of people is served, please indicate who
. comprises this group.
5. Checklist of attachments submitted with this application:
O Evidence that applicant's program is a public agency or exempt from paying taxes under Section 501 of the IRS Code of 1954
O Description of program operations and activities
O Evidence of approval, accreditation, or licensing or information submitted in lieu thereof
O SASP Form No. 202. "Resolution," properly signed. designating representatives authorized to bind the applicant to the terms and
conditions governing the transfer of federal surplus personal property
O SASP Form No. 203. nondiscrimination compliance assurance
O Statement concerning applicant's Reeds, resources. aV ability to utilize the property
O Othef statements or documentation required. ass fled in thyinstr�ctigns, for certain categories of applicants.
Date: November 2, 1983
Application approved:
Comments or additional information:
FOR STATE AGENCY USE
Application disapproved:
Title: City Manager
Date: Signed:
Director
it
Part B.
DEFINITIONS
Accredited: Approval by a recognized accrediting board of
association on a regional, state, or national levet, such as state bond
of education or health; the American Hospital Association; a
regional or nationa! accrediting association for universiti^s, colleges,
or secondary schools; or another recognized accrediting association.
Appro.ed: Recognition and approval by the State Department of
Ld,,cation, Stat: Department of health, or 00141 appropriate
as.thotity. With respect to an educational institution, approval must
reh;e to academic or instructional standards. An educational
institution may be considered as appfwed if its credits are accepttd
by accredited or stats -approve: institutions of if it meets the
eeadrrr,ec or instructional stands, is prescribed for public schools in
the st a te.
Child care center: A public or nonprofit facility where day care
services such as educational, social, health, and nutritional services
are provided to children through age 14 and which is approved or
licensed by the state or other appropriate authority.
Cimic: An approved public or nonprofit facility organized and
operated for the primary purpose of providing outpatient public
health services Including customary related services such as labors-
lories and treatment room&
College: An approved or accredited public or nonprofit institu-
tion of higher learning offering organized study courws and credits
Its -ling to a baccalaureate or higher degree.
Corssenvtion: A program or program! carried out or promoted by
a public agency for public purposes involving.direcily or indirectly.
the protection, maintenanr+, development. and restoration of the
natural resources of a given political area. These resources incEide
but are not limited to the sir. land, forests, water. rivers, streams.
lakes and ponds, minerals, and animals, fish, and other wildlife.
F.co+sonsic dewhW~nf: A program or programs c•aried out or
promoted by a public agency for public purposes wnich involver
directly or Indirectly,efforts to improve the opportunities of a given
political area for the successt-4 establishment or expansion of
industrial, commercial. of agricultural plants or facilities and which
otherwise assist in the creation of long term employment gpportun-
-hies in the area or primarily 6nefit the unemployed of those with
low incomes.
Edorcotio nal Institution: An otherwise eligible public or nonprofit
institution, facility, entity, or orpabation conducting educational
programs. Including research fest any such programs, such is a child
core center, school. college. university. school for the mentally or
physically handicapped, educational radio or television station.
museum. or library.
Ed ucedonel rudlo actions: A radio station licensed by the
Federal Communications Commission and operated exclusively for
noncommercial educational purposes and which is public or
nonprofit and tax exempt under Section 301 of the Internal
Revenue Code of 1934.
Edbsedonef televbion sti d". A television station licensed by the
Federal Communications Commission and operated exclusively for
noncommercial educational putposo and which is public or
nonprofit and tax exempt under Section 301 of the Internal
Revenue Code of I?".
Moolth center. An approved public or nonprofit facility utilized
by a health unit for the provision of public health services. including
related facilities such as diag"stic and laboratory facilities and
clink&
Motpitof: An approved or accredited public or nonprofit institu.
tion providing public health services primarily for inpatient medial
or surgical cats of the sick and injured. including related facilities
such as laboratofies, outpatient departments, training facilities, and
Staff offke&
Libaary: A public or nonprofit facility providing library services
free to all residents of a community, district, state, or region.
Mediad Institution: An otherwise eligible public or nonp.ofit
institution, facility, entity. of organization the primary function of
which is the furnishing of health end medical services to the public
at fangs or promoting public health through the conduct of research
for any such purposes. experiments. trailing, or demonstrations
wtated to the cause. prevention. and rmthods of diagnosis and
treatment of diseases and injuries. The term includes but Is, not
limited to hospitals, clinics. alcoholic and drug abuse treatment
centers, public healtit or treatment centers, r -starch and health
centers, geriatric anter laboratories, medical schools, dental
f
schools, nursing schools, and similar institutions. The term does not
include institutions pnmarily engaged in domicilury care although a
separate medical facility within such a domicitury institution may
qualify as a "medical institution.
Museum: A public or nonprofit facility which is attended by the
public free or at a nominal charge and which provides museum
services including the preservation and exhibition of artistic.
cultural, historical, or scientific objects.
Nonprofit Institution: An educational or public health Institution
of organization, no part of the net earnings of which inures or may
lawfully inure to the benefit of any private shareholder or individual
and which has been held to be tax exempt under the provisions of
Section SOI of the Interrul Revenue Code of 1934.
Part: and recreation: A program or proluams carried not or
promoted by a public agency for public purposes which involve
directly or Hduectly the acquisition, development, insprsvement.
rrtaintemnee. and protection of park and recreational facilities for
the residents of a given political area. These facilities include but are
not limited to parks playgrounds and athletic fields. swimming
pools, golf courses, nature facilities, and nature trails.
Public egency: Any state; any political subdivision thereof.
including any unit of local government or-cono.nic development
district; any department, agency, instrumer,.ality thereof, IncWding
instrumentalities created by compact or other agre►ment Setween a
c.tate and another state, a political subdividisotl, a mutt jjssrudictfonal
substate district established by or pursuant to state law, or any
Indian tribe, band, group, pueblo, or community located on a state
reservation.
Public health: A program or programs to promote, maintain, and
conserve the public's h!alth by , -oviding health services to
individuals and by the conduct of research, investigations, estamina-
tion. training, and demonstrations. Public health services may
include but ate not limited to immunization, muernal and child
health prepams, sanitary engineering, sewage treatment and
disposal. sanitation inspection and supervision. water purification
and distribution, air pollution control, !asbags and trash disposal.
the control and elimination of discs setstrying animals and insects,
and the control of communicable diseases.
Public wfirty: A program or programs carried out or ptomoled by
a public agency for public purposes involving, directly or indirectly.
the protection, safety. and law enforcement activities and the
criminal justice system of a given political area. Public safety
programs may include but are not :.rotted to thou carried out by
public police departments, sheriffs' offices. the c )attic penal and
eortecf!onal Institutions including juvenile facilities. state and civil
defense organtzationt, and fire departments and rescue squads
including volunteer fire departments and rescue equals supported In
whole or in past with public funds.
School (except schools for the mentally or physically, handi-
capped): A public or nonprofit, approved or accredited organisa-
tional entity devoted primarily to approved acadcmic, vocational. of
professional study and instruction, which operates primarily lot
educational purposes on a full-time bads for a minimum school rest
and employs a full-time staff of qualified Instructom
School for the mentally hendicapped: A facility or Institution
operated primarily to provide specialized instruction to students of
limited mental capacity. It must be public or nonprofit and mast
overate on a full-time basis for the equivalent of a mininstam sehool
year prescribed for public school Instruciion of the mentally
handicapped. have a staff of qualified instructor. and demonstrate
that the facility meets state and local health and safety standard,.
School for the physicaDv hendlcappett: A school organized
primarily to provide specialized Instruction to students whose
physical handicaps necessitate individual of group instruction. no
schools nwst be public or nonprofit and operate on a full-time bash
for the equivalent of a m+nimum school year proscribed for public
school instruction for the physically handicapped. have a staff of
qualified lrrstructors, and demonstrate that the facility molts state
and local health and safety standards.
Taxrarpported orrvniserlon: One which receives a majew portion
of its financial support from moneys derived from state or local
government revenues.
University: A public or nonprofit, approved or amfedited
institution of higher education empowered to confer degrees In
special departments or colleges.
"2-13 DE 12767 5-62 .M
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Of fide' of Surplus PropAIM
WT y
OSP Form No. 203
(3-82)
om
ASSURANCE OF COMPLIANCE WITH GSA REGULATIONS UNDER
TITLE VI OF THE CIVIL RIGHTS ACT OF 1964, SECTION 606
OF TITLE VI OF THE FEDERAL PROPERTY AND ADMINISTRATIVE
SERVICES ACT OF 1949, AS AMENDED, SECTION 504 OF
THE REHABILITATION ACT OF 1973, AS ARENDED,
TITLE IX OF THE EDUCATION AMENDMENTS OF 1972, AS AMENDED
AND SECTION 303 OF THE AGE DISCRIMINATION ACT OF 1975
City of Lodi (hereinafter called the "donee") ,
Name of donee organization)
HEREBY AGREES THAT the program for or in connection with which any
property is donated to the donee will be conducted in compliance with,
and the donee will comply with and will require any other person (any
legal entity) who through contractual or other arrangements with the
donee is authorized to provide services or benefits under said program
to comply with, all requirements imposed by or pursuant to the regulations
of the General Services Administration (41 CRF 101-6.2) issued under the
provisions of Title VI. of the Civil Rights Act of 1964, Section 606 of
Title V1 of. the Federal Property and Administrative Services Act of 1949,
as amended, Section 504 of the Rehabilitation Act of 1973, as amended,
Title IX of the•Education Amendments of 1972, as amended, and Section 303
of the Age Discrimination Act of 1975, to the end that no person in the
United States shall on the ground of race, color, national origin, sex,
or age, or that no otherwise qualified handicapped person shall solely by
reason of the handicap, be excluded from participation in, be denied the
benefits of, or be subjected to discrimination under any prograin or
activity for which the donee received Federal assistance from the
General Services Administration; and HEREBY GIVES ASSURANCE THAT it will
immediately take any measures necessary to effectuate this agreement.
The donee further agrees that this agreement shall be subject in all
respects to the provisions of said regulations; that this agreement
shall obligate the donee for the period during which it retains ownership
or possess).gn of any such property; that the United States shall have the
right to seek judicial enforcement of this agreement; and, this agreement
shall be binding upon any successor in interest of the donee and the
word "donee" as used herein includes any such successor in interest.
d
Date November 2, 1983 City of Lodi, California
Donee Organization
BY
-- resi3 nt airm4n o the Boarif
or compakable authorized official)
Henry A. Glaves, City Manager
221 West Pine Street
Lodi, CA 95240 .
Donee Mailing Address
-
RE90Wr1CN No. 83-128
BE IT RE9CU D that the City CDuncil of the City of Lodi does hereby
order that the following employees whose name(s), title(s), and signPture(s)
are listed below shall be and are hereby authorized as our represent ative(s)
to acquire federal surplus property from the California Siete Agency for
Surplus Property under the Terms and Conditions listed on the reverse -side of
this form.
NME TITLE
Jack Ronsko Public Works Director
Richard Wiech Equipment a Building
Maintenance Supervisor
Jerry Glenn Assistant City Manager
PASSED AND AD011MM this 2nd day of Novenbe
of the City of Lodi by the following vote:
Ayes: Council Mwbers - Reid, Snider, Murphy,
Pinkerton a Olson (Wkyor)
Noes: Council Mwbers - None
Absent: Council Meabers - None
I, Alice M. Relmebe, City Clerk of the City of Lodi do hereby
certify that the foregoing is a full, true, and correct copy of a
resolution adopted by the City Council at a regular meeting thereof
held at its regular place of meeting at the date and by the vote
above stated, which resolution is on file in the office of the
City Clerk.
City of Lodi
221 West Pine Street
Lodi, Seth Joaquin, 95240 .
Signed
Alice M. fiffimche
�i
City Clerk
11
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TERMS AND CONDITIONS
tA1"fltE t,ONEE. CERTIFIES THAT:
(1) It is a periotic agency; or a nonprofit i:t.tiorul or public health in,ti:u;ion of organitaiun, c..e:npt t;om taxation under Section 501 ,
et tht lnternA Itcvenue Code of 1954; within the meaning of Section 203(j) of the Federal Property and Administutive Services Act oC 1939,
as amended, and the regulations of the Administrator of General Services.
(2) If a public agency, the property is needed and will be used by the recipient for carryinj out o: promoting for the residents of a given
ro!ifical area ons or more public purposes, or, if a nonprofit tax-exempt institution or organization, the property is needed for and will be used
by the recipient for educational or public health purposes, and including research (or such purpose. The property is not beins acquired Cor any
other use or purpisse. or for sale or other distribution; or for permanent use outside the state, except with prior approval of the state agency.
(3) Funds are available to pay all cots and charges Incident to Conation.
(4) This transaction shat( be subject to the nondiscrimination regulations governinS the donation of surplus pttsonat property issued
unicf Title VI of the Civil Rights Act of 1964; Title VI. Section 606, of the Federal Propeity ant Administrative Services Act of 1939. as
arnendcd; Section 504 of the Rehabilitation Act of 1973. as amended; Title IX of the Education .amendments of 1972, as arneoded. and Section
303 of the Ale DiscrImtiution Act of 1975.
(it) THE DONEE AGREES TO THE FOLLOWING FEDERAL CO%DITIONS:
(I1 All items of proper:j �hsll be placed in use for the purpos:(s) for which acqu(red within one gest of receipt and shall be continued In
use fur srch purpose(r) for one year from the date the property was placed in use, in the event the property is not so placed In use. or
continued in cue. th•_ alone shill immediately notify the state agency and, at the donee's expense, return such property to the state agency. cc
otherwise make the property available for transfer or other disposal by the state agency, provided the property is still usable as determined by
the state agency.
(2) Such special handling or use limitations as are imposed by General Services Administration (GSA) on any itemis) of property listed
hereon.
(3) In the event the property is not so used of handled as requited by (B)(i) and (2). title and right to the posussion of such property
shalt at the option of GSA revert to the United States of America and upon demand the donee shag release such property to such person as
GSA or its des(gnee shall direct.
(C) THE DONEE AGREES TO THE FOLLOWING CONDITIONS IM POSED BY THE STATE AGENCY. APPLICABLE TO ITEMS WITH A
UNIT ACQUISITION COST OF $3.000 OR MORE AND PASSENGER MOTOR VEHICLES. REGARDLESS OF ACQUISITION COST,
EXCEPT VESSELS 50 FEET OR MORE iN LENGTH AND AIRCRAFT:
(1) The property shall be used only for the purpose(s) for which acquired and for no other purpose(%).
(2) Thele shall be a period of restriction which will expire after such property has been used for the purpose(:) for which acquired rot a
period of IS months from the date the property Is placed in use, exmpt for such items of major equipment. listed hereon. on which the state
agency designates a further period of restriction.
(3) In the event the property is not so used as required by (C)1.1) and (2) and federal restrictions (e)(1) sndj?) have expired then title
and right to the possession of such property shall at the option of the state agency revert to the State of California and the donee shag release
such property to such person as the state agency shall direct.
(D) THE DONEE AGREES TO THE FOLLOWING TERMS. RESERVATIONS. AND RESTRICTIONS:
(1) From the date it receives the property lifted hereon and through the period(s) of time the conditions Imposed by (B) and (q above
remain in effect. the donee shall not sett, trade, lease. lend. ball. cannibalise. encumber, or otherwise dispose of such property. of remove it
permanently. for use outside the state, without the prior approval of GSA under (B) or the state agency under (C). The proceeds from any Pala.
trade, lease. loan. bailment, encumbrance. of other disposal of the property. when such action is authorized by GSA or by the state agency,
shall be remitted promptly by the donee to GSA or the state agency. as the case may be.
(2) to the event any of the property listed hereon Is sold, traded. lased. loaned, bailed, cannibalised. encumbered, or otherwise disposed
of by the donee from the date it receives the property through the pertod(s) of time the conditions imposed by (B) and (C) 1011131111'% effect,
without the prior appront of GSA or the shte agency, the donee. at the option of GSA of the state agency, shall pay to GSA or the state
a;,eney, as the case may be. Ow proceeds of the disposal or the fair market value or the fair rental value or the property at the time of suds
disposal, as determined bGSA or the stare agency.
.(3) if at any -time�rom the date it receives the property through the period(s) of time the conditions imposed by (B) and (C) remain los,
effect, any of the property listed hereon is no longer suitable. usable, or further needed by the donee for the purpose(s) for which aequtred, the
donee shall promptly notify the state agency. and shall, as directed by the state agency. return the property to the state speney. setease the
property to crsother donee or another state agency or a department or agency of the United States. self, or otherwise dispose of the property.
77na proceeds from any We shall be remitted promptly by the donee to the state agency.
(4) The donee shall make reports to the state agency on the use. condition. and location of the property listed hereon. and on other
pertinent matters as may be required from time to time by the state agency. / -
(5) At the option of the state agency. the donee may abrogate the conditions set forth to (C) and the terms, reservations, and testrictiorns
pertinent thereto in (D) by payment of an amount as determined by the state agency.
(E) THE DONEE AGREES TO THE FOLLOWING CONDITIONS. APPLICABLE TO ALL ITEMS OF PROPERTY LISTED HEREON:
(1) 'The property acquired by th4 donee is on an "as is," —whom is" bask without warranty of any kind.
(2) Where a donee carries insunoce against damages to or lou of property due to fire or other hazards and where loss of or daraage to
donated property with unexpired tgrms, conditions, reservations~ or restrictions occur„ the state agency will be entitled to reimbursement from
the donee out of the insurance proceeds. of an amount equal to the unamortired portion of the fair value of the damaged or destroyed donated
Items.
(F) TERMS AND CONDMONS APPLICABLE TO TILE DONATION OF AIRCRAFT AND VESSELS (50 FEET OR MORE 1N LENGTH)
IIAViNG AN ACQUISITION COST OF $3,000 OR i`IORE. REGARDLESS OF THE PURPOSE FOR WHICH ACQUIRED:
The donation shell be subject to the terms, conditions, reservations, and restrictions set forth in the Conditional Tbarsfer Dociamert .
executed by the suthorited donee representative
• FBI -197 DE 12667 4-82 3M
CalitorMa State Department of Education
0frke of Surplus Property
721 Capitol MA Sacramento. CA 95824
OSP Form No. 202 (4-82)
RESOLUTION
il
"BE IT RESOLVED by the Governing Bond, OR by the Chief Administrative Officer of those organizations which do not
have a governing board, and hereby ordered that the official(s) and/or employee(s) whose name(s), title(s), and
signatures) are listed below shall be and is (are) hereby authorized as our representative(s) to acquire federal surplus
property from t<rte California State Agency for Surplus Property under the Terms and Conditions listed o -a the reverse side
of this form."
NAME TIME SIGNATURE
(Print or type.)
PASSED AND ADOPTED this_ day of 19 , by the Governini Board of
by the following vote: Ayes: ; Noes: ; Absent:
1. . Clerk of the GoPon ms Board of
do hereby certify that the foregoing is a full. true. and
toned copy of a molutlon adopted by the Board ate meetinir thereof held at its re uhr plact of
nseeting at the date and by the rote above stated, which resolution is on jilt In the office of the Board
tSigned 1
Cur C—Sty str oob
OR
AtJTl;tOR1ZED this day of , 19 , by: '
: 1 ERAIS AND CONDITIONS
(A) THE DONEE CERTIFIES THAT:
(1) It is a public agency, or a nonprofit educational or public health institution or organization, exempt from taXalion under Section 501
of the Internal Revenue Code of 1954; within the meaning of Section 203(j) of the Federal Property and Administrative Services Act of 1949,
as amended, and the regulations of the Administrator of General Services.
(2) If a public agency, the property is needed and will be used by the recipient for carrying out of promoting for the residents of a given
political area one or more public purposes, or, if a nonprofit tax-exempt institution or otgrnizatton, the property is needed Tot and will be used
by the recipient for educational or public health purposes, and including research for such purpose. The property is not being acquired for any
other use or purposa, or for sale or other distribution: or for permanent use outside the state, except with prior approval of the state agency.
(3) f=unds are available to pay all costs and charges incident to donation.
(4) This transactions shall Ic subject to the nondiscrimination regulations governing the donation of surplus personal property issued
under Tat It VI of the Civil Rights Act of 1964; Title VI, Section 606, of the Federal Property and Administrative Services Act of 1939, as
amended; Section 504 of the Rehabilitation Act of 1973, as amended; Title IX of the Education Amendments of 1972, as amended; and Section
303 of the Age Discrimination Act of 1975.
IR) THE DONEE AGREES TO THE FOLLOWING FEDERAL CONDITIONS:
(1) All items of property shall be placed in use for the purpose(%) for which acquired within one year of receipt and shall be Continued in
use for such purpose(%) for one year from the date the property was placed in use. In the event the property is not to placed in use, of
continued in use, the donee shall immediately notify the state agency and, at the donee's expense, return such property to the state astency, or
otherwise make the property available for transfer or other disposal by the state agency, pro-ided the property is still usable as determined by
the state agency.
(2) Such spa(xl handling or use limitations as ate imposed by General Services Administration (GSA) on any item(s) of property listed
hereon.
(3) In the event the property is not so used or handled as required by (B)(1) and (2), title and tight to the possession of such property
shall at the option of GSA revert to the United States of America and upon demand the donee shall release such property to such person as
GSA of its designee shall direct.
IC) THE DONEE AGREES TO THE FOLLOWING CONDITIONS IMPOSED BY THE STATE AGENCY, APPLICABLE TO ITEMS WITH A
UNIT ACQUISITION COST OF 53,000 OR MORE AND PASSENGER 1610TOR VEHICLES, REGARDLESS DF ACQUISITION COST,
EXCEPT VESSELS 30 FEET OR MORE IN LENGTH AND AIRCRAFT:
(1) The property shall be used only for the purposes) for which acquired and for no other purpose(t)
(2) There shall be a period of resitiction which will expire after rich property has been used for the purposes) for which acquired for a
period of 18 months from the dais the property is placed in use; except for such items of major equipment, listed hereon, on which the state
agency designates a further period of restriction.
(3) In the event the property is not so used as required by (C)(1) and (2) and federal restrictions (0)(1) and (2) have expired then title
and tight to the possession of such propetty shall at the option of the state agency revert to the State of California and the donee shall release
such property to such person as the state agency shall direct.
(D) THE DONEE AGREES TO THE FOLLOWING TERMS, RESERVATIONS. AND RESTRICTIONS:
(1) From the date it receives the property Ibted hereon and through the period(&) of time the conditions imposed by (B) and (C) above
remain in effect, the donee shall not sell, trade, lease, lend, bail, cannibalize, encumber, or otherwise dispose of such property, or femove it
permanently. for use outside the state, without the prior approval of GSA under (B) or the state agency under (C). The proceeds from any sale.
trade. Tease, loan. bailment, encumbrance, or other disposal of the property, when such action is authorized by GSA or by the : tate apecy,
shall be remitted promptly by the donee to GSA of the state agency, as the ase may be.
(2) In the event any of the property listed hereon is sold, traded. Waged, loaned, baited, cannibalized. encumbered, or otherwise disposed
of by the donee frons the data it receives the property through the period(s) of time the conditions imposed by (B) and (C) remain in effect,
without the prior apprvvs: of GSA or the state agency, the donee, at the option of GSA of the state agency. shall par to GSA or the state
agency, as the can may be, the proceeds of the disposal or the fait market value or the fair rental value of the property at the time of such
disposal, as determined by GSA or the state agency.
• (3) If at any time;Yrom the date it receives the property through the period(s) of time the conditions imposed by (B) and (C) remain )n
effoct, any of the property listed hereon is no longer suitable, usable, or further needed by the donee for the purpose(s) for which acquired, the
donee shall promptly notify the state agency. and shall, as directed by the state agency, return the property to the state agency, release the
property to another donee or another state agency at a department or agency of the United States, sell, or otherwise dispaae of the property.
The proceeds from any sale shall be remitted promptly by the donee to the state agency.
(4) The donee shall make reports to the state agency on the use, condition, and location of the property listed hereon, and on other
pertinent matters as may be required from time to Sime by the state agency.
(3) At the option of the state agency, the donee may abrogate the conditions set forth in (C) and the terms. reservations, and restrictions
pertinent thereto in (D) by payment of an amount as determined by the state agency.
(E) THE DONFE AGREES TO THE FOLLOWING, CON D11 IONS. APPLICABLE TO ALL ITEMS OF PROPERTY LISTED HEREON:
(1) The property acquired by thl dance is on an "as is." "where is" basis, without warranty of any kind.
(2) Where a donee castles insurance against damages to or loss of property due to fire or other hazards and where loss of or damage to
donated property with unexpired terms conditions, reservations, or restrictions occurs, the state agency will be entitled to reimbursement from
the donee out of the insurance proceeds, of an amount equal to the unamortized portion of the fait value of the damaged of destroyed donated
Items.
(F) TERMS AND CONDITIONS APPLICABLE TO THE DONATION OF AIRCRAFT AND VESSELS (50 FEET OR MORE 1N LENGTH)
HAVING AN ACQUISITION COST OF $3,000 OR MORE, REGARDLESS OF THE PURPOSE FOR WHICH ACQUIRED:
The donation shall be subject to the terms, conditions, reservations, and restricticits set forth in the Conditional Transfer Document
executed by the authorized donee representative. F81.197 DE 12"7 4132 ,aA
I& .
Office of Surplus PropJly
OSP Form No. 203
(3-82)
kl
ASSURANCE OF COMPLIANCE WITH GSA REGULATIONS UNDER
TITLE VI OF THE CIVIL RIGHTS ACT OF 1964, SECTION 606
OF TITLE VI OF THE FEDERAL PROPERTY AND ADMINISTRATIVE
SERVICES ACT OF 1949, AS AMENDED, SECTION 504 OF
THE REHABILITATION ACT OF 1973, AS AMENDED,
TITLE IX OF THE EDUCATION AMENDMENTS OF 1972, AS AMENDED
AND SECTION 303 OF THE AGE DISCRIMINATION ACT OF 1975
(hereinafter called the "donee"),
Name o once organization)
HEREBY AGREES THAT the program for or in connection with which any
property is donated to the donee will be conducted in compliance with,
and the donee will comply with and will require any other person (any
legal entity) who through contractual or other arrangements with the
donee is authorized to provide services or benefits under said program
to comply with, all requirements imposed by or pursuant to the regu?ations
of the General Services Administration (41 CRP 101-6.2) issued under the
provisions of Title VI of the Civil Rights Act of 1964, Section 606 of
Title VI of the Federal Property and Administrative Services Act of 1949,
as amended, Section 504 of the Rehabilitation Act of 1973, as amended,
Title IX of the Education Amendments of 1972, as amended, and Section 303
of the Age Discrimination Act of 1975, to the end that no person in the
United States shall on the ground of race, color, national origin, sex,
or age, or that no otherwise qualified handicapped person shall solely by
reason of the handicap, be excluded from participation in, be denied the
benefits of, or be subjected to discrimination under arty program or
activity for which the donee received Federal assistance from the
General Services Administration; and HEREBY GIVES ASSURANCE THAT it will
immediately take any measures necessary to effectuate this agreement.
The donee further agrees that this agreement shall be subject in all
respects to the provisions of said regulations; that this agreement
shall obligate the donee for the period during which it retains ownership
or possession of any such property; that the United States shall have the
right to silk judicial enforcement of this agreement; and, this agreement
shall be binding upon any successor in interest of the donee and the
word "donee" as used herein includes any such successor in interest.
Date
Donee Organization
BY
(President/Chairman of the Boar
or comparable authorized official)
Donee Mailing Address
e
California State Department of Education
Office of Surplus property
721 Capitol Mail, Sacramento, CA 95614
OSP Fosm No. 202 (4-52)
RESOLUTLON
"BE IT RESOLVED by the Governing Board, OR by the Chief Administrative Officer of those organizations which do not
have a governing board, and hereby ordered that the official(s) and/or employee(s) whose name(s), title(s), and
signature(:) are listed below shall be and is (are) hereby authorized as our representative(s) to acquire federal surplus
property from the California State Agency for Surplus Propeity und..r the Terms and Conditions listed on the reverse side
of this form."
NAME TITLE SIGNATURE
(Print or type.)
Jack Ronsko Public Works Director
Wiech EQuipinent and Building Maintenance Supervisor
PASSED AND AD(*TED this 2n(Iday of November 19_13_ . by the Governing Board of
by the following vote: Ayes: ; Noes: ; Absent:
Alice M. Reimche . Clerk of the Governing Board of
the City of Lodi do hereby certify that the joreaolnt is a full, true. and
correct copy of a resolution adopted by the Board at a. r4cp i I a r meeting thereof held at its regular place of
meeting at the date and by the rote above stated. which resolution is on file in the office of the Board
City of Lodi, California
liame pubstion
221 W. Pine Street
MIAMI 8""M
Lode San Joaquin 95240 [Signer!)
City cowty zip two
ILL NONIO
6.perM AcM dlrelia b 4nic"M
Md Diriela of EArecNow
RE C r..! ..3D
STATE OF CALIFORNIA I- OLS 31 ~=
DEPARTMENT OF EDUCATION kL{CE 1>1.
STATE EDUCATION 9M0010, 721 CAPITOL MALI. SACRAMENTO. CA ossi. CITY CL;"fiX
C:, r, Y OF Lr:"
19-`.'-21^-2-4-G 2 H 39 X924
CITU OF LOCI
HENRY ,L SVCS
?21 WrST PTN*' STpFET
LODI CA 9524_
Federal regulations require State agencies for surplus property to
update the eligibility records of donee organizations on a periodic
basis, but not less than once every three years, to ensure
continuing eligibility.
Forms for use in updating your eligibility status were sent to you
in September or October, 1982 and again in April 1983; however,
we have received no response from you. Another set of forms for
this purpose is enclosed with this letter.
Please be advised that if we do not hear from you within thirty (30)
days concerning the updating of your eligibility, your eligibility
to acquire federal surplus personal property will be terminated.
In the event your eligibility is terminated, all property in your
possession remaining under federal or State use restrictions must
be returned to this agency at your expense.
Please give this matter your immediate attention.
Sincerely yours,
R. W. Evans, Chief
Surplus Property Section
Office of Surplus Property
(916) 323-8521
cc: O. W. Wilson
G. E. Smith
Glifprnu� a Department of Education
Offiec of'�urplus Property
121 Capitol Mall, Sacramento, CA 95814
OSP Form No. 201 (842)
. . I
C)
STATE OF CALIFORNIA
APPLICATION FOR ELIGIBILITY
FEDERAL SURPLUS PERSONAL PROPERTY PROGRAM
Before preparir;; this application. please read carefully the definitions given under Part B. Fill out all applicable sections.
Part A.
Legal name of organization Telephone
Address city County ZIP
1. Application is being made as a (please check one) (a) Public agency O or (b) Private, nonprofit and tax-exempt educational or public
health organization O. Please provide evidence that the organization is a public agency or enclose a copy of the letter.or Certificate from
the United States Internal Revenue Service evidencing tax -exemption under Section 501 of the Internal Revenue Code of 1954.
2. Check type of agency or organization and attach a supplement to this application describing the program operations and activities. For
private, nonprofit organizations. the following additiond information is required: (a) For educational institutions, include a deacdption
of the curriculum, the number of days In the school year. and the number and qualifications of the faculty or staff; (b) If a public health
institution or organization. include•& description of the health services offered. qualifications of staff and. if applicable. the number of
beds number of residentsicianseyed nurses on the sta.
!�Y . and number of re � ff.
PUBLIC AGENCIES: Check either state Dor local Q
O Conservation
O Economic development
O irducation
Grade level
(V"fthoot. Wnirarslty)
Enrollment
No. of school sites
O Parks and recreation
O Public health
O Public safety
O Two or more of above
O Other (specify)
NONPROFIT INSTITUTION OR ORGANIZATION:
D Education
Grade level
(he"hoot. Wotvarsity)
Enrollment
No. of school sites
O School for the mentally or physically handicapped
0 Educational radio or television station
O Museum
O Library
O Medical institution
O Hospital
O Health center
O Clink
O Other (specify)
3. Check if the applicant program is approved O ; accredited O ; or licensed O. Enclose evidence of such approval. accreditation. or
licensing. if the applicant lacks evidence of formal approval, accreditation. or licensing. check here O and refer to the enclosed
instructions.
4. Are the applicant's services available to the public at large?-. if only a specified group of people is served. please indicate who
compriaca this group.
5. Checklist of attachments submitted with this application:
O Evidence that apoWant's program is a public agency or exempt from paying taxes under Section 501 of the IRS Code of 1934
O Description of program operations and activities
O Evidence of approval. accreditation, or licensing or Information submitted in lieu thereof
O SASP Form No. 202. "Resolution." properly signed, designating representatives authorised to bind the applicant to the terms and
conditions governing the transfer of federal surplus personal property
O SASP Form No. 203. nondiscrimination compliance assurance
O Statement concerning applicant's needs. resources. and ability to utilize the property
O Other statements or documentation required, as specified in the instructions, for certain categories of applicants.
Date: Signed: _ Title:
FOP. STATE AGENCY USE
Application approved: Application disapproved:
Comments or additional information:
Date: Signed:
Director
Ur
Part B.
DEFINITIONS
Accredited: Approval by a recognized accrediting board or
association on a regional, state, or national level, such as state board
of education or health; the American Hospital Association: a
regional or national accrediting association rot universities, colkses,
or secondary schools; or another recognized accrediting sssrciation.
Apprtived. Recognition and approval by the State Department of
Education, State Department of Health, or other appropriate
authority. With respect to an educational institution, approval must
relate to academic of instructional standards. An educational
institution may be considered as approved if its credits are accepted
by accredited or state -approved institutions of if it meets the
academic or instructional standards prescribed for public schools in
the slate.
ChUd cent center. A public or nonprofit facility where day tare
services such as educationai, social, health, and nutritional services
are provided to children through age 14 and which is approved or
licensed by the state or other appropriate authority.
Clink: An approved public or nonprofit facility organized and
operated for the primary purpose of providing outpatient public
health services including customary related services such as labors-
totics anJ treatment rooms.
College: An approved of accredited public or nonprofit institu-
tion of higher learnirsf offering organized study courses and credits
kr-ling to a baccalaureate or higher degree.
Consermdon. A program of programs carried out or promoted by
a public agency for public purposes invotving,directiy or tnuirectlx
the protection, maintenance, development, and restoration of the
natural resources of a &en political area. These resources Include
but ate not limited to the sit, land, forests, water, riven, streams,
lakes and ponds, minerals, and animals, risk, and other wildlife.
Economic development: A program or programs carried out or
promoted by a public agency for public purposes which involve,
directly or indisectly.efforts to improve the opportunitks of a given
political area for the successful establiskment of expansion of
industrial, commercial, of isficultural plants or facilities and which
otherwise assist in the creation of long term employment gpportun-
ities in the area of primarily benefit the unemployed or thole with
low incomes.
E&caotimurl institution. An otherwise eligible public or nonprofit
institution, facility, entity, of organization conducting educational
programs, Including research for any such programs, such its a child
un center, school, college, university, school for the mentally or
physically handicapped, educational radio or television station,
museum. or library.
Ednatfo+ri nano Nations: A radio station licensed by the
Federal Communications Commission and operated exclusively for
noncommercial educational purposes and which is public of
nonprofit and tax exempt under Section 301 of the internal
Revenue Code of 1934.
Ukaortiorsol relerblon sariem: A television station licensed by the
Fedetal Communications Commission and operated exclusively for
noncommercial educational purposes and which is public or
nnonptoftt and tax exempt under Section 501 of the Internal
Revenue Code of 1934.
Health Crater. Aw approved public or nonprofit facility utilized
by a health unit for the provision of public health services, including
related facilities such as diagnostic and laboratory facilities and
tunics.
MoVial: An approved or accredited public or nonprofit institu-
tion providing p Abtic health services primarily rot inpatient toodical
or surgical can of the sick and injured, including telsted facilities
such as lsborstofie% outpatient departments, training facilities, and
staff offices.
LArwr: A public or nonprofit facility providing library services
free to all residents of a communit; , district, state, of region.
Medical butinrr.ow: An otherwise eligible putdic or nonprofit
institution, facility, entity. or organization the primary function of
which b the furnishing of health and medical services to the public
at large or promoting public health through the conduct of research
for any such purposes, experiments, trainini, of demonstrations
related to the cause, prevention, and methods of diagnosis and
treatment of diseases and injuries. The term Includes but I not
limited to hospitals. clinics. aloolulic and drug abuse treatment
centers, public health of treatment centers, research and health
Centers, geriatric center laboratories, medical schools, dental
+-1
schools, nursing schools, and similar institutions. The term does not
include institutions primarily engaged in domiciliary care although a
separate medical facility within such a domiciliary institution may
qualify as a "medical institution."
Museum: A public or nonprofit facility which is attended by the
public free or at a nominal charge and which provides museum
services including the preservation and exhibition of artistic,
cultural, historical, or scientific objects.
Nompro/it institution: An educational or public health Institution
or organization, no part of the net earnings of which inures or may
lawfully inure to the benefit of any private shareholder or individual
and which has been held to be tax exempt under the provisions of
Section SOI of the Internal Revenue Code of 1954.
Pmt and recreation: A program or programs carried out or
promoted by a public afency for public purposes which involve
directly or indirectly the acquisition, development, improvement,
mainte lance, and protection of park and r• creational facilities for
the residents of a given political area. These facilities include but as
not limited to parks, playgrounds and athletic fields, swimming
Fools. golf courses, nature facilities, and nature trails.
.Molle ergemcr: Any state; arty political subdivision thereof.
Including any unit of local government or ocoramic 4"opment
district; any department, agency, instrumentality thereof, including
lnstrnmentalitin created by compact or other agreement between a
state and another state, a political subdividisot), a multijurisdictional
substate district established by or pursuant to state law, of any
Indian tribe, band, group, pueblo, of community locatel on a stab
reservation.
Prblk health: A program of programs to promote, maintain, and
conserve the public's health by providing health semices to
individuals and by the conduct of research, investigations, examina-
tion, training, and demonstrations. Public health services may
Include but are not limited to immunization, maternal and child
health programs, sanitary engineering, sewage treatment and
disposal. sanitation inspection and supervision. water purification
and distribution, tit pollution control, garbage and trash disposal,
the control and elimination of disease -carrying aNmais and insects.
aad the control of communicable diseases.
Public is/etc: A program or programs carried out or promoted by
a public agency for public purposes involving, directly or indirectly,
the protection, safety, and law enforcement activities and the
criminal justice system of a given political area. Public safety
programs may include but am not limited to those carried out by
public police departments. sheriffs' *Meet. the courts. penal and
cosrectiemal institutions including juvenile facilities. state and civil
defense organizations, and fire deptttn»nti and rescue squads
including volunteer fire departments and rescue squads supported in
whole or In put with public funds.
School (except schools rot the mentally or physically handi-
capped): A public or nonprofit, approved of accredited organisa-
tional entity devoted primarily to approved academic, vocationak or
professional study and instruction. which operates primarily foe
educational pvtposn on a full-time basis for a minimum sebool year
and employs a full tims staff of qualified instructor.
School Jo► the mensal herrsdicepped: A facility at institution
operated primarily to provide specialized Instruction to students of
lirnited mental capacity. It must be public or nonprofit end nest
operate on a full-time basis for the equivalent of a mininsem school
year prescribed for public school instruction of the mentally
handicapped, have a staff of qualifad lnstrsctoa, and demonstrate
that the facility meets state and local health and safety standards.
School Jnr the physicso handlnpped. A school orgaink--ed
primarily to provide specisUed instruction to students whose
pbystkal handicaps necessitate Individual or group instruction. The
schools must be public or nonprofit and operate on a fuu4ime basis
for the equivalent of a minimum achoul you prescribed for pubilie
school instroction for t1a physically handicapped, haus a staff of
qualified instructors, and demonstrate that the facility riosts state
and local Ittalth and sarety standards.
71xr.wrpporred ogvrnisarim: One which receives a major portion
of its financial support from moneys derived from state or local
government revenues.
Umlrersiry: A public or nonprofit, approved or acetedited
institution of higher education empowered to confer degrees in
special departments or colleges.
"2.13 DF 12767 5-62 IM