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HomeMy WebLinkAbout80-001, - ,. ' Cafi!'orni~ Sta~c 1)ep:,rimcnt c~f l:ducation ~~ ' ' . Stale A~cney !'or Sur~lu~ Nrn;~crty • • 7Z1('aPi1~rlAfail.Sacr:nnrnt~i,CA 95814 • tiA5!' 1•nnn h<r. 2p2 f l~1-77) . ' , ~~~'~~~7~~~~~~~5.~~[~:'1 . - . . • ' R~50LUTION I30. 80-1 "BC IT Rf:SOI.VE?1~ hy t}ie Governing ~3oard, OR by the Ckticf rldministrati~~e Df~icc: of lf~osc oraanizations «~ich do not ha~~e a gover~Si»g board, and hcreby orc~crzd tft~t the oftici:~l(s) actd/or employec(s) wliose name(s), zitic(s), and • sign~tu~c(s) arc listed below slial] be :~:ic] is (ar~) }sereby autflc~rized as our regresentali~re(s) to acquire Ecderal surplus pro~,crty fa~orn t~ic Cali~ornia Statc Age3t~y Car Sur;alus 3'rogcs~fy uncier tl~e 'Ferms and Conditiasls listed on thc reverse side ' of this forn~." ~ , ~ . , , ' NAtitE TI'i'i.F: . ' SfG~l~TUEi~ . (Prirtt or type.} . • n /} ., , /1 ,. - Clifton C. Mickelson ~ Countv Administrat3v~,S~~ Tt~omas ~.~ 5truthers Purchasing Off'~Pr~ ~ ~L.'.~. B'rad~ield Bu er III - ~'J1SSt;~ f'~\~I~ 11D0~'T'F.i~ Ehis 8th day of Januar ,! 9~_ , t~Y th~ C~o'~CCI]][ln F3oa:-cI of_ ~ Butte Count California - by ih~ fo~lowif~~ voic: 11ycs:_~...__; \c~cs: 0•, AUscs~t:_.~_.._. . ~ /,_ CI~ARK A. NELSON ~ ~_ : C'!r•r~ r~J'!lrt~ (;u~~i~rlrilr,t l~uurd ~J " COUNTY OF Bi1TTE _cl~~ !rc-rcl~~• r•a~r~iJi~ !lrul rllr J'r,rc'~;u111~,~ i.c u J'rrll. lrrrr. urtc! cv~rrc~rl C'r3J3S~ r~J' cz rc~sultrfru:r udr,~~lrcl !~r 11rc 1lnurcl ul a zegular r~rrc•li»~ !lrrr~c•uJ~ l~c~lcl u~ i1s rc~,Srrfur ~~lrrcr uf rrrc~elrrig al 1hc~ clulc~ ulac! hy 11rc° i•r~1c~ a1,r~r<• slulrcl, titi•lrir•I1 rc.sr,ltrrir~ti is ~,1~ frfr rj~ thc~ r~JJtc•r r~f~ t!!c Isr~rtrd. • ,(aTTES'F:' CLARK A. NELSON, COUN~'Y CLERK- Coun.ty of• Butre ~ gECQRDE•R and ex-o£fi.cio Clerk of h:,,,~••~~~~~r~.~~~~~~~~~~° - the But Count Board of Supervisors ' . 25 County Centex Drive _ • 1[~3[in,; sJcSir>. . _ OrovilTe Butte 45965 l~~`~~~~~~1 ~ : ~.__. I C9ty Cuunsy 111' c~>d~ , , ~~ " ~ . . . AUTtIOKI'LCD this day of Nam<<~1 ~fii~'1 rc~minislsali~~cullic~r Namc ut ut~ani~.al'sun rlailin~ adJress ~ , ~ 9 , by: ~-~u~ ~ S1~,t]C(j ] ' Citp - ~ Cuunty -- Z1P codc ~ . . , lifornia S'tato Department of Educatian • . ` ~te R~en~' ~oi•Surplus Praperty - 3TATE OF CALIFORi~1IA ~ .' . 1 CaplitoE 11'lail, Sacramento, CA 95814 . . .+ ,sP Forni I~o. ial (laa7> APPI-iCATiON FOR ELIGiBiLITX .. . . FEDERAL SURPLUS PERSONAL PROPERTY PIt~GRAM ~ . fare preparing this apPlication, please read car~full}c the dsfinitions given under Part B. FiIl out all appiicable sections. . ~ ^ rtA. ~ County of B~t~e ' Telephone ~916)534-42b1 g59 5 ga! rsame of orgagixation Orovi3.le County $utte Z3P idress Adm~n~.stration Center City 25 Cou~ty Center Drive ppplication is being rr~ade as a(please check one) (a)1'ub~ic agency ~7 or (b) Private, nonprofit and tax~xempt educational or public hea~th arganizatioa ^. Please provide evidence t,hat the ore~nization is a public agency or enc~ase a copy of the letter or certificate fron the LTni#ed States Intemal Revenue Service evidencing tax-exempcion under Section SOI of the Internal Revenue Code of 1954. Check type of a~ertcy or organization and attach a supple ~4 ~ti nsis pe 1uLjeidn~a~sFa~ ~u ationalinstitut ons~ nc~deaa de crip ~o private, nanpro~t organizatians, the fotiewing addrrtoiral i q of the curriculum, tha number of days in the schaol year, arrd the number and qual,i#`ications af the faculty or staff; {b) If a public healt~ institutian or organization, include a descri~tion af the health services offered, quali#"icatiorts oF staff and, if applicable, the r~umbcr a heds, number af resident physicians, and numi~er of re~stered nurses an the s#aff. . _ PUBLIC AGEI~rCIES: Check either state ~ or lacal ~ ~ ^ Conservatioa ~ ^ Ecanomic development . ^ Educaiioa • - Grade level ~ ~ ~ . (Pccsci~aa~, univc.r.atY) Enroilment . • ' Na: of schaol site5 . ~. _ - ~ ^ Parks and recreation , ~ ~ ~ ~ ^ Public health • ' ~ . • . ~ ^ Public safecy " ~ .' ' C~ Two or more of abo~e .p Other (specify) . T1pI~Ip~tQFIT IN5'FITU'TI~I~T OR ORGANIZATIaN: ^ Education _. Grade Ievel ~ (Yreschooi, university) Enro~lmes~t . Na. of school sites ~ C3 5chool far the mentally or p~ysicaliy haadicapped . ^ Educational xadio or televisian station - ~ Muse~sm. ' ~ ~ ~ ~ • • ' ~ ~ ~ Library . ~ ~ ~ p Medical institutioa . ^ HospitaI . ~ . ~ . ^ Hea~th center , • ~ Clinic ~ ^ Other {specafy} 3. Check if #he applicant pragram is approved ^; aceredited ^~ ; or licensed ^. ~nctase eviden.ce of such approvai, accreditaiion, c Iicensiag. If the applicant Iaclcs evidence of forrnsl appcoval, accreditation, or licensing, et~eck heie ^ and refer ta the enctase instxuctions. ~ 4. Are the app~icant's senrices available to the pub~ic at iarge? Y~s . I#' anly a specified gzoup of peopte is sezved, p~ease indicate wt camprises this group. ~ 5_ Checklist of attachments submitted with ii~is application: , ~ ° ^ Evidence that applicant's program is a public a~ency or exempt from paYing taxes under Section 501 of the 1RS Code of I~54 0 Description of pragram operations and activities ^ Evidence of approval, accreditation, ar Iicensing or information subrrutted in Iieu ihereof . [~ SASP Farrt No. 202, "Resolution," prflperly signe~~ onal~roliertrepresentatives aushorized to bind ihe agplicant to tf~e terms a canditians ga~erning the transfer of federai surplus pers p p Y . ~ SASP Fosm No. 203, nondiscriminatian cojnpli3nce assurance ~ . . ~l Statement coneerning agQiicani's needs,~resources, and abzlity to utilize the propezty ^ Other stacerr~ents or documentation required, as specii'~d in the instructions, fo ~ertain categorzes of applicants. Date:~~ $0 FOR STAT~ ~ AGENCY USE , purchasing Officer AppIicatian appraved• ~ - _ Application ciisapproved: , Commencs or additional information: . ~ r,_._. Signed: .,:__..«,.. ~ri B•- DEFINI'FIOPt5 ~~~pt~; Approval by a recognized accsediting board or ,s~oeiation on a regional, state, or aationai level. such as staLe baard • rf education or heafth; the Amesican Hospital Associa~tion; a ~giattal ar naiional accrediting association ~or universitics, colleees, ~t secon~ary scE~oots: or another ~ecoitnized 'accrediti~g assoc~cion. i[pproved: Rccognitioa and approval by [iee St~te Depaitment of E3ucatian. State Dep~rtrnent oC Hea[tt~, or other approQria~e tuthosiry. 1Vith respect to an educatianal insti~ution, approval must eelate w academic or instructional standards. Ar~ edacacionai iestitution may be considered as approved if ets credits are accepted by acciedited or state-agQroved institucions or if it mests the a~adamic oz irutructional standatds prescribed tor public schools in the state. Child ccre eenter: A gublic or nonpro~t facitity whece day case secvices such as educationai, social, heilth, and nutritiaaal services aie provided ta childeen throueh age I4 and which is approved ar licensed by the state or other appropriate authocity. Cl~nic: An apptovcd pubiic or nongroi3t facility o~ganized and opesated for lite pzicnarY purpase ot providing autpatient public heai[is ser+ricas including eustomary reEated services such as labara- tocies and treatrnent roams. " College: An appro~ed or accredite~ public ar nonprottt inst'siu- ts~n of hi~er learning o(fcring organ~ed study courses and credits leading to a baccalauseate oc hi~h~t cEc~ree. "~ Conservati~n: A Program ur programs carcied oat ar promoted by" = public apency far public purposes invotvinc,directly or indirectly; She ptatecEion, maint~nartce, deveiopmenc. and cestoration ai t[~e statura! resources of a given poiitical arc:a. These xesources includ+: but ace iiot limited ta tt~e ai[, land, forests, water, iivcrs, sire:cros, •Ia9ces ancf ponds, mi~eraEs, and animals, fish, and otlt~i w'ildlife. ~ca:oenic development: ~ pro~rarrt or pro,rams cariied out oc pcomoEed by a public agency for public purposes Khich ir-voi~e~ dircetly ot ind'uectiy,eifor~s to improve the opportuniiies oF ~ Givon poiitical area fo~ the successi'uf establishment or exQansion of industrial, commerci3l, or agricultutal p~ants or faci~i[ies and wE~ich ~otherwise assist in the ereation of long term;rnpEoyment o~portun- iiies in the area nr primarity benefiE the unemployed or those with - IOW 1riCO7F]l:5. ' ' ~ -~ Edurdtfonal ir~srin~tion: Ar+ otherwise;aligible pubtic~ot~onPro~t •... •• <~ .institutian, facility, enticy, ar organization conducting educatianaE ~programs, [ncluding rescarch far any such pro^ran~s, suc~ as a chilr! care center, school. colleye, univeisity, school for the asentalky or physically hand'ec:~pped, educationai I~~iO or television statinn, muse~nt, or library. -- ~ - - - ~ Educalioncd ~adio staTions: r~ radio station licenscd by the ~ederal Communirations Comntission and op~taEed e~ciusiveEy far noncommerciai educatianal p~rposes and w~ich is public or nonprofiE and tax exarnpt uadcz 5ection 501 of the lnccrnat Revcnuc Code o!' 195~F. .. ... - •-~ - - ' ~'ducQfrarra! televisron statioir: A televisio~ st~Uon ]icensed by the redera! Communicatinns Comrnission and operated exdctsivrly for nonco~nmercial educacional purposas and whi~h is public or nos~pzofit and ta~ exempt under Scction 501 of thc In[cinal Revenue Code of 1954. fleafth center: An a~proved public ar nnnorofit Facitity utilizrd - by a health uniE fot• tlie ptotision of pub~ic hzuitki services, inciudin~ ielated faeifities suci~ as diagnostic and laboratbry facilities ~nd clinics. flaspitul: An approved ar accredited public or nonprofit institu- ~. tioe providing pubiic health services primaci[y tor iR~atient inedical nr surg9cai care of the sic~: and injured, including. relaced facilities such as labotatories, outpaiient departrnents, training facilities, and staff ofCices. Lpbrvey; A pubiic or nonprofit facility praviding libs~ry services free to a!1 residents oC a comntunily, district, s[ate, or ~ecian. hlediea! insiitWron: An otheiwise eli2ible publi~ or r-onprofic institutian, faci[ity, ea[ity, oc or~anization the primary Fu~tction of ~~which is the•furnashing of h~ai~h and' incdica~ scrvices ta tha public at large or pcomotinc puhlic hcaiti- ttirou~h the conduct of rese~rch for any such purposes, e~~~~simcnts, tsaining, or demonstz:~tions ~elated to the cause, prevencion, and methods ol' dia~nosis and treatment of diseases and irtjuries. Thc te~rrt in¢tudcs but is not limited -to hospitats, clinics. aEcaholic aad druL abuse treatment ' centecs, public heatth or treatment cencers: reseazch ~ and• health oenters, geriatsic center labot~tories, medic:sl sc3coois, denta! ~ ~y schoois, nursing s~hoois, and similar institutians. '~he term daes ~ot . inciuda institutions primariiy engaged in domiciiiary care a.ithougha separaie medical facility withirs such a domitiliarY instiiution may qualify as a "medicai institncion." t~fuseum: A pablic or nonprof t Caciiity which is attended by ttie public free or at a nomina.~ charge and u•hich provides museum services inciudirtg the preservation aad exhibition of ariistic, . ce~l;uxal, hisiorical, ai scien[iFc objects. Nonprofit irrstitutio~: An edncaEionai ac public health institution ar organ~atios~, no par~ of the net earnings of which inures or may lawfulfy inure to the lxnetit of any prrr'ate shaxeho[der or individual aad which hxs been held to be ta.~c exempt c+nder the provisions oC 5cction SOl oF the Intzrnal Reve~ue Code of 1954. pdrk and recreation: A program or pio~rams carried aut or . prornoEed by a public agency for public purposes which invnlve d'uecciy or ind'uectly the acquisitian, deveEopmcnt, improvemes-t, snaintenance, and protection oF patk and reereational Cacilities fos t3~e residen[s oC a given pal's~icaE asea. "fhese facilities incEude but are not Eimited to parks, playgrounds and achletic tieids~ swimming pools, goif courses, nature faciiities. and nature traiis. ' F~blir agericy: Any state• any poEiticaI subdivisian thereof, including any unit ot ~ocal eavernment or economic development • dist~ict; any departmcnt, avency, instrumentality chereof, inciuding instrumcacaiities create~i by compacL oc otf-er aeieesnent hetween a state and another state, a political~s` b~lisuaht to ~state1 law,1or any ~ substate .districE estableshed 6y p Indian tribe, band, group, puebla, or community located on d.state . , ieservatiar-. • Pu6lic litafth: A pro~sam or proera~ns co promote, maintain, and conserve the publ'sc's hea[th by providing health services to individuals and by the conduct of reseaicti, inr•estigatiuns, axamina- - -. tian, training. and dzmonstsations. Pubiic heaith services ~ztay . inciude but are not limited to irnmunezation, rnaterna! and child he•rith psoerams, senitary engincerin~, sew•a~e treatmen[ and disposal. sanitation inspection and supesvision. ti~•ater p~rificatian °. and distributiaa, air po[lution conEinl, ~arbage and lrash dispossi, the cantml :irvr~ eEimin~+'te~n nf disFa~e-carsy~ng anjmals and insects, ~- and the contral of cumrnunica~le diseases. :' ~ •~~ ~. •~f'ublir safetv: r1'progr;IFn o~ ~+roprams carried out•or:~xomated by -•.~ ~•_-~~ a publit ages,cy for public purposes irtvolvine. dire~tly or indirecily, ~. the grotc:cUOn, safety, and la~v eni'o~cemcnt activi[ie~ and the criminaI justice system of a sivcn polit[cal area. Public safety .... , programs may include buc are not [irnited to those carried out by - public poli~e d4p~r[n~ents., slicriifs' oifices, shc covrts, pcnai ancE. correctionaE institutions including ju~•enile laciliti:s, state and ci~•il defe3isc orcanizations, ~nd fiee d~parCments and ~cscuc squads iricludino vohinteer Eiee dc~srtnients and reseue squads suppoTted in whoEc or in parc ~vith pul~Eic funds. . Schnol (e~cept schools for tkie mentafty or pt~ysicauy h3ndi- . . capped): A public or nonprotit, approved or accrec~ieed or~:~nixa- ti~~nal entity devoted prin~~riiy !o appFO~'ecS academic, ~•oc~tional, or ~• professional siudy sncE instruction. ~~hich operases p:imari~y For educationak pur~oses on a Fuil-time basis Eor a minimun~ scliaol year and employs a full-time siaif of Q~alitiee~ns~[~r Fac~ility oz institution Schoof for 1he mentafly handicapp operated psim~rily to provide specialized instruct9on ta sse~dents ot' limited mcntal capacity. !t must bc public ar nunprot~t anrl mast aperale on r full-tinzc basis lor thc equir•a[en[ of a mir.i~num schooi ycar prescribcd foi public schno! insuuction of the mentaiiy handicapped, h:~~'c a stali oC qua[iCed instrucrors, and demonstrace that th~ facility maets stat~ a~d locai heaith an~ safety s:2ndards. 5~laool for thc playsicall~• harrdrea~ped: :~ school orcanized, primarily to - pro~'id~ specialized insirucsion to studcnts ~~•hose physical handicaps necessetata individual or group in~truction. The ' schools must b~ public or r~onpcofic ~nd operate on a tu31-[imc basis for the equi~•~lr.ni oF a minisriurri schooE yeai p:~scribzd fai pu4Eic scE-ooi instruction for ~he physically handicarped, r~4e a stuft af qualified instrucEors, and demonstrs~e zEias the facility:meecs-stxte;~ ,r: i and local health and satety startdards. Tax•supAorted argarrrzation: One u~hich recci~es a ma7or portion of its firz~nciat support from moneys derived from state or iocal government reven~es. Unie•enity: A pablic or nonpraf t, apQIOVCd or aeeseditcd institu~ion of.•hicher educatian empa~vered to confer degrees in : spcciai drpar[ments at col[eges. ~ ~taCe Agency for Surplus Property SASP Form No. 203 (~a77) ~. A'SSUkt~.NCE OF COMPL7ANCE WITH GSA REGT3LA'~ZONS UNDER T~'1'~E V~ 0~ ~fiE CIVIL R~GHTS ACT OF 1464, SECTION 60b dF TzT~E V~ OF TH~ ~'EI]ERAI, PROPERTY AND ADMIN~STRATTVE S~RVICES ~1CT Ok' 7.94~9, AS .AMENDEA, AND SEG~~ON 504 Q~` ~HE REHA3~L~TATION AC~ ~r 1473, AS AMENDED Caunty of But~e ,{hereir.after ca~~.ed the "donee"}, (Nar~e a~ donee arganiza~i.cn} . , H~R~~3Y AGR~ES ~AT the program for or i.n connection with which any property is donated to ~he rlaitiee wi11 t~a conduc~ed in. cor~pliance witi~, and ehe do~.ee wi.11 comp:y with and wi.J.~ require any other perspn (ar_y i ega], en.~ity) who t.~rou;h contractua~ ox athe: arrangeme~.ts w~~h ~he donee is authorized tc p~ovide ser- • vices or bene~its under said pragra:~ ta comply w~.~h, a~ 1 requirer~er_ts Lm~osed by or puxs~ant to ~he regu~at~ ons of ~he General. ServicPs Administ~a±-~c;~ (41 CFR 3.OI-b.2) issued under thc prov~ sion~ of Ti~-e tJ~ o: the Civi.l ?Za.g31~s Ace of 1.954, Section 606 0~ ~i~'!c V?' of rhe Federa3~ P~opert~> ar_d Admirc=s~ra~.ive ServLce€~ Ac~ a~ 1949, ~~ amendec?, a~.~ Sec~ian 5~4 of th~ ~~e;~ab~.~.i~G~io: Act of 1973, as am~.raded, to t~c e:id t'Ra~ no persoa ~.n the Unit~c: 5~a~es s~~al.~. an `~~e grau~cl o~ xac~, co3oy, natioral. arigzr., or sex, o~ ~l-:ar na other~~t~se qua?i~ie~ , handic7pped ~ersan sha~.1 sole?y by reason. af tl~e har:c3zc~p, be excluaed ~rom ~artic,~~a~ian in, be deni.e~ t?--e bene£iLs of, or be s~abjer,t:.ec~ ~o di.scx~.r~i_na~ic~ undex any pragram o~ act:~v~~y ~or ~•,:~~ch the donee receiv~~ ~ ed~~'a1 assisCar.ce fzon~ ~t:~e Gene,:aZ •Serv~.ces Admiaistration; and H~Rk:~Y GIVES ASS~J,.~t'~?rC~ Tf3~4"' it wi~~. i.~mediateAy talce any ~ea~ures n.ecessary i.o efiec~Late ~h.ti s a~;~eY;~ent. Tn~ c~~~~ee ~urt~e~ agrees Lhat tY~is. agreeme~.~ shz7.~ b~ subjeci.: i~: a'sl sesrects to ~ize provisiar~s af said re~u~atzons; ~1~aC t;~:.s a;reemeni sa~~l o~liga~e ~he dor_eF: ~or ~he peri~d dur~~g ~aizich it :etai.~.s owne~ship or poss~ssior. of any such praper~.y; tha~ t~~e Un~,~ed Sta~es shal.~. have ~;~~ r~gtz~ to seek jud~cia~ anforcemen~ o~ this agreemen~; and, tl~is agreemer:t sha13. be ~inciikzg u~o:z ~ny successor ir, in~e~es~ of the don.ee an.d ~l~e word "cionee" as used 'n~~e~r. inc?udes ary such successor in in~eres~, January S, ~.980 ~T Caunty of Be~tte ,~ .--- Da~ed Donee Qr a..' a4;.or~ ~ . ~~~ I _ ~ ~~ (~~/ ~a_rman ok tt~~e ~oarci of Superviso ~ ~~~ County of Bu~te 25 Caunty Cen.~er Drive Orovil].e, CA 95965 Donee Mai.l.zng ~ddress