HomeMy Public PortalAboutRES-CC-1990-03Utah Division of Surplus Property
522 South 700 west
Salt lake Cry, Utah 84104
Tel. 533.5885 FPS 588-5029
UDSP Form No. 101 (3-86)
. ,PE
`*\�i
William A. Arseneau
Director
RESOLUTION 03-90
BE IT RESOLVED THAT Thomas A. Stocks
Name of Representative
Mayor/Administrator
Title of Representative
Moab City Corporation
shall be and is hereby designated as the representative of
Full Legal Name of Applicant
to secure the transfer to said Applicant of surplus Federal property through the UTAH DIVISION OF SURPLUS
PROPERTY, under the provisions of Section 203 (j) of the Federal Property & Administrative Services Act of 1949, as
amended, to obligate the applicant and its funds to the extent necessary to comply with the Terms and Conditions
listed ont he reverse side of this form.
BE IT FURTHER RESOLVED THAT acertified copy of this resolution shall be submitted to the Utah Division of
Surplus Proper* and that the same shall remain in full force and effect until written notice to the contrary is
submitted to the said Utah Division of Surplus Property.
I, Thomas A. Stocks
Name
Mayor
Title
of Moab City Corporation
Full Legal Name of Applicant
CERTIFICATION
of the
, hereby certify that I am the
Moab City Council
Full Legal Name of Governing Board
and that the foregoing is (1) a true and correct copy of the resolution adopted by the vote of a majority of said board
present at a duly -convened meeting of said board on the ? 0 t h day of March
at which a quorum was present, OR (2) an executive action taken by me on the
March , 19 90
kTTEST:
4CrA/1,eL
Signature of Designated Representative
Sandra E. Beauregard
Acting Temporary City Recorder
Signature.
19 90
20th day of
Chairman of the Board or
Chief Administrative Officer
Thomas A. Stocks
Mayor
Utah Otvtnoa of Surplus Property
522 South 700 west
Salt Lake club Utah 84104
TeL 533.3883 FTS 388-5029
UDSP Form :la L02 (3-883
AUTHOR= AGENTS AND THEIR SIGNATURES
Date- 3/20/90
The following persons, whose signatures appear below, are authorized to acquire surplus Federal personal
property through the Federal Property Assistance Program for:
Moab City Corporation
Full Legal Name of Applicant or Donee
TYPED OR PRINTED NAME CORRES NDING SIGN TURF
i. Thomas A. Stocks I
2, William D. McDougald 2. ,/d/la�--7-/- X , %�
5, Larry S . Johnson 3, ;, c 'I J ,- , 4-/1-` .—
v/
4, Holly R. Walden ;1 , `J r ` `( ./ _-.
5. Timmy Sheets
6. Alan West
5
5.
7. T ynn 7.11fel t �.
g_ M. David Olsen
9. Sandra E, Be_auregard
9.
L0. 10.
•
Submitted By: Thomas A. Stocks. Mayor/Administrator
Typed or printed name of designated representative
(See UDSP Form No. I01)
ATTEST: �l(A/n)
Signature of designated representative
andra E. Beauregard g
Acting Temporary City Recorder
Additional agents and their signatures may be added on the back of this page.
Other agents may be authorized to shop at the Utah DS? Distriburion Canter on one-time basis by su.bmitring a
letter of Authorization signed by the duly designated representative. Only the person designated by resolution on
UDS? Form No. 101 may authorize Donee agents.
Utah Division of Surplus Property
5M South 700 west
Salt take City. Utah 84104
TeL a"i�. -5885 E75 588-5029
UDSP Forth No. 100 (Rev. 3-883
STATE OF UTAH
APPLICATION FOR ELIGIBILITY
FEDERAL PROPERTY ASSISTANCE PROGRAM
Before preparing this application, please read carefully the instructions.
Part A.
Legal Name of Applicant:
Mailing Address.
Moab City Corporation
150 E. Center Street
WW1= A. Arseneau
Director
Telephone: (801) 259-5121
City: Moab County: Grand zip. 84532
PART A.
I.
Complete Only if the Applicant is a Public Agency
Check Only One: ❑ State Public Agency a Local Public Agency.
2. Check the One Which Best Describes
❑ Conservation
❑ Economic Development
❑ Education
❑ Parks & Recreation
how Surplus Property will be Used:
❑ Public Health
❑ Public Safety
® Two or More of the Above
❑ Other:
PART B. Complete Only if the Applicant is a Nonprofit a Tax-exempt Organization
1. Attach a copy of the letter or certificate from the U.S. Internal Revenue Service evidencing tax -
exemption under Section 501 of the Internal Revneue Code of 1.954.
2. Check the One Which Best Describes how Surplus Property will be Used: •
❑ Education ❑ Medical Institution
❑ School for the Mentally Retarded ❑ Hospital
❑ School for the Physically Handicapped ❑ Health Center
❑ Museum ❑ Clinic
❑ Library ❑ Other-
3. Check One:
❑ Evidence of approval is attached.
❑ Evidence of accreditation is attached.
❑ Evidence of licensing is attached.
(Note: If such evidence is lacking, refer to Instruction B.Z. or B.6.)
4. Are the applicant's services .available to the public at large') If only a specified group is
served, indicate who comprises this group.
5. Attach the following information: (a) For educational institutions, include a description of the
curriculum, the grades taught, enrollment, length of school day, week and year, the number and
qualifications of the full-time and part-time staff, and the facilities operated; (b) For public health
applicants, include a description of the health services offered, the number of beds where applicable.
the number of resident physicians, the number of registered nurses, the number and qualifications of
the other professional staff, and the facilities operated.
itc h Dtpiston of Surplus ? operty
522 South 700 west
Salt Lake an/. Utah 84104
TeL 533.5885 FtS 588-3029
UDSP Form No. 104 (3-8e)
STATEMENT OF NEEDS & RESOURCES
Moab City Corporation
(Type or Print Legal Name of Applicant Agency or Institution)
Federal law requires that surplus property be distributed in a fair and equitable manner based on the relative
needs and resources of interested eligible agencies and organizations and their abilities to utilize the property.
The information provided on this form will assist the Utah DSP in complying with this requirement.
I. Source of funds:
a. Tax Revenues ao 95
b. Federal or State Grants a 5
c. Tuition or Service Charges cti 0
d. Donations or Contributions % 0 ,
e. Other % 0 (specify)
2. Economic condition of the applicant. Mark one:
() () O
5 4 3
Excellent
( x) ( )
2 1
Poor
3. Describe any extraordinary problems below. If none, mark here: (
Depressed economy
4. Does the applicant agency or insititution have sufficient funds and facilities to acquire, repair or renovate,
and maintain surplus personal property in use?
(X ) Yes ( ) No
Exceptions:
5. Glve a general description of the nature and types of property needed for the applicants program:
vehicles, hardware, tools, office equipment
Date:
'TEST :
3/20/90
G
ra :eaur gar
Acting Temporary City
Submitted By:
ecorder
ident. Chairman of the Board
or other comparable official
Thomas A. Stocks
Mayor
Uta..h•Otviston of Surplus Etoperri
322 South 700 west
Salt Lake City. Utah 84t04
Tet. a"ar5885 FTS 588-5029
UDS2 Form No. t03 (3-86)
ASSURANCE OF COMPLIANCE WITH GSA REGULATIONS UNDER TITLE VI OF THE
CIVIL RIGHTS ACT OF 1964, AS AA/ENDED, SECTION 606 OF TITLE VI OF
THE FEDERAL PROPERTY AND ADMLNISTRATIVE SERVICES ACT OF 1949,
AS AMENDED. SECTION 504 OF THE REHABILITATION ACT OF 1973,
AS AMENDED, AND SECTION 303 OF THE AGE DISCRLMINATION
ACT OF 1975, AS AMENDED
Moab City Corporation
(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 CFR 101-6.2) issued under the provisions of Title VI of the Civil Rights Act of 1964, as amended,
Section 606 of Title VI of the Federal Property and Administrtive 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, as amended. 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 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 S tates 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.
Dated March 20th 1990
TTEST :
•
By
dra Beauregard
Acting Temporary City Recorder
(President/Chairman of the Board or
comparable authorized official)
Thomas A. Stocks
Mayor
Utah Division of Surplus Property
522 South 700 West
Salt Lake City. Utah 84104
Tel. 533.5885 FTS 588-5029
UDS? Form No. 100(A) (Rev. 3/86)
Instructions For Eligibility Applications
A. Instructions Applicable to All Applicants
1.
Before preparing this application, please read the definitions on the back of this
instruction page carefully.
2. Attached are UDSP Form No's. 100, 101, 102,
appropriate signatures where required.
3. If you have any questions, please call us.
588-5029.
103 and 104. Complete all forms and provide
Our telephone number is 533-5885 or FTS
4. Return completed applications to the Utah Division of Surplus Property, 522 South 700
West, Salt Lake City, Utah 84104.
B. Instructions Applicable Only to Nonprofit & Tax-exempt Applicants
1. Nonprofit and tax-exempt applicants must be either educational or public health
organizations and must provide evidence of tax -exemption under Section 501 of the
Internal Revenue Code of 1954 and evidence of formal approval, accreditation or
licensing.
2. If the applicant is a school, college, or university lacking evidence of formal approval or
accreditation. the following type of information may be accepted in lieu thereof: A letter
from a school district governing board or chief administratinve officer, or the State
Board of Education or similar authority, stating that the institution meets the academic
or instructional standards prescribed for public schools, colleges, or universities in the
state or that students will be accepted for transfer to accredited or approved institutions
at the same academic level; OR a minimum of three letters from accredited or approved
institutions to the effect that students from the applicant institution have been and are
accepted as if coming from an accredited or approved institution.
3. If the applicant is a school for the mentally or physically handicapped, the application
must include a copy of a certificate or other evidence that the facility meets the state and
local health and safety standards. Give data on length of school day, week, and year and
the number and qualifications of the staff.
4. If the applicant is an educational radio or educational television station, the application
must be accompanied by a copy of the FCC license to operate exclusively for non-
commercial educational purposes.
5. If the applicant is a private, nonprofit library, the application must include a statement
from the governing body that the library serves free all residents of the community.
6. If the applicant is a medical institution lacking evidence of formal approval, accredi-
tation, or licensing, the application must include a letter from a city, county, state, or
federal health authority stating that the institution is approved by that authority. A
licensing authority will be accepted as evidence of approval only when the licensing
authority prescribes the medical requirements and standards for the professional and
technical services of the institution.