1987-23552-Resolution Recorded 11/13/1987AUTHORIZATION OF PARTICIPANTS
8"7— 235 2 0089_0624
RESOLUTION
67 ?,'yav 13 Pi /2:Oi
"BE IT RESOLVED by the Governing Board, OR by the Chief Administratra pith v bse organiza-
tions which do not have a governing board, and hereby ordered that the official(s) id/ r employee(s)
whose name(s), title(s), and signature(s) is (are) listed below shall be and is (are) hereby authorized
as our representative (s) to acquire federal surplus property from the Oregon State Agency for Surplus
Property under the-Terms and Conditions listed on the reverse side of this form."
NAME
(Print or type)
Dennis Roberts
Roger Graham
Lee Landers
Dick Maudlin
TITLE SIGNATURE
Road Superintendent
Equipment Services Manager
Trans. Division Manager
County Commissioner
PASSED AND ADOPTED this —r "- day of
of
/
9 2lLLL (CL Z
aZ
�`, do hereby certify that the foregoing is a full, true and
correct copy of a resolution "adopted by the Board at a 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
Board.
Board of Commissioners
Name of organization
Administration Building
Mailing address
Bend, Deschutes 97701 [Signe
City County ZIP Code ( j1y Al thorized •fficial)
/,14-(/) ° L6
19 f (, by the Governing Board
Clerk of the Governing Board of
OR
AUTHORIZED this_ 10th day of November 19 87 _, by:
Chair,
County Commissi9n_erv.
Title
Lois Bristow Prante
Name of chief administrative officer
Deschutes County
Name of organization
Administration Building
Mailing address
Bend Deschutes 97701
City County ZIP Code
an �'
[ Signe• / NL�� /�1�i_ /�i�
(L y thorized Official)
008 CERTIFICATIONS AND AGREEMENTS �-,s5
(a) THE DONEE CERTIFIES THAT:
(1) It is a public agency; or a nonprofit educational or public health institution or organization, exempt from taxation 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 or promoting for the residents of a given political area one 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 for such purpose. The property is not being acquired for any other use or purpose, 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 costs and charges incident to donation, and these charges will be paid promptly.
(4) This transaction shall be subject to the nondiscrimination regulations governing the donation of surplus personal property issued 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.
(b) THE DONEE AGREES TO THE FOLLOWING FEDERAL CONDITIONS:
(1) All items of property shall be placed in use for the purposes for which acquired within one year of receipt and shall be continued in use for such purposes
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 use, the donee shall immediately
notify the State agency, and at the donee's expense, return such property to the State agency, or 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 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 right 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 or its designee shall direct.
(c) THE DONEE AGREES TO THE FOLLOWING CONDITIONS IMPOSED BY THE STATE AGENCY, APPLICABLE TO ITEMS WITH A UNIT
ACQUISITION COST OF FOR MORE AND PASSENGER MOTOR VEHICLES, REGARDLESS OF ACQUISITION COST, EXCEPT VESSELS
50 FEET IN LENGTH AND AIRCRAFT., o D /°iL q 9 3 R'(o S e e 7
(1) The property shall be used only for the purpose(s) for which acquired and for no other purpose(s).
(2) There shall be a period of restriction which will expire after such property has been used for the purpose(s) for which acquired for a period of 18 months
from the date the property is placed in use.
(3) In the event the property is not so used as required by (c) (1) and (2) and Federal restrictions (b) (1) and (2) have expired then the right to the possession
of such property shall at the option of the State agency revert to the State of Oregon 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 listed hereon and through the period(s) 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 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 sale, trade, lease, loan, bailment, encumbrance or 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) In the event any of the property listed hereon is sold, traded, leased, loaned, bailed, cannibalized, encumbered, or otherwise disposed of by the donee
from the date it receives the property through the period(s) of time the conditions imposed by (b) and (c) remain in effect, without prior approval of GSA or the
State agency, the donee, at the option of GSA or the State agency shall pay to GSA or the State agency, as the case may be, the proceeds of the disposal or the
fair 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, from the date it receives the property through the period(s) of time the conditions imposed by (b) and (c) remain in effect, 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,
a department or agency of the United States, sell or otherwise dispose 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 time by the State agency.
(5) 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 DONEE AGREES TO THE FOLLOWING CONDITIONS, APPLICABLE TO ALL ITEMS OF PROPERTY LISTED HEREON:
(1) The property acquired by the donee is on an "as is ", "where is" basis, without warranty of any kind.
(2) The State agency requires the donee to carry 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 fair value of the damaged or destroyed donated items.
(f) TERMS AND CONDITIONS APPLICABLE TO THE DONATION OF AIRCRAFT AND VESSELS (50 FEET OR MORE IN LENGTH) HAVING
AN ACQUISITION COST OF OR MORE, RE GARDLESS OFTHE PURPOSE FOR WHICH ACQUIRED:
�'��000 IOL 9- �8� o ec--- -L O 7
(1) The donation shall be subject to the terms, conditions, reservations, and restrictions set forth in the Conditional Transfer Document executed by the
authorized donee representative.
THE DONEE AGREES TO THE FOLLOWING TERMS ND CONDITIONS IMPOSED BY THE STATE AGENCY APPLICABLE TO ITEMS
WITH A UNIT ACQUISITION COST OF UNDER $389:- OP — 38'6 -. c_ ,;2a 7
(1) Title to items with an acquisition cost of less than $3;110(T-shall pass lo the donee when the terms and conditions imposed by (b) (1) and (2) have been
met. 0 0 /`-',1- " 5'6 .j e 0 7
(2) All clothing, upholstered furniture, and bedding materials acquired from the SURPLUS PROPERTY DIVISION will be sterilized as required by State
Law before being used.
(3) In addition to any other remedies available to the Department or to the State agency, said agency shall have the right and authority to withhold further
transfers of Government Surplus Property to our institution if we fail at anytime.
(a) abide by the above terms and conditions and (b) promptly pay just service and handling charge fees assessed by the state agency.
Debt. of General Services
Federal Surplus Property
- 1655 Salem Industrial Dr. N.E.
• Salem, OR 97310
378 -4714
Legal Name of Applicant:
APPLICATION FOR ELIGIBILITY
FEDERAL PROPERTY UTILIZATION PROGRAM
UNDER P.L. 94 -519
Deschutes County Department of Public Works
Mailing Address:
61150 S.E. 27th Street
Location:
camp, ac ahn-ITp,
Bend, OR.
Zip Code
County
1. Application is made: a. XX as a Public Agency Phone:
b as a Nonprofit Educational or Public Health Institution (attach copy of Tax -
exempt determination under Section 501 of the Internal Revenue Code of 1954)
Executive No Coca)
/
97702
Deschutes
(503)388 -6581
2. Applicant is a: (See definitions)
a. State Agency g School for the Physi- 1 Child Care Center
b XX Local Government tally Handicapped m Hospital
c. School h. Educational Radio n Health Center
d. College Station o Clinic
e. University i. Educational TV Station P. Other (Specify):
f. School for the j. Library
Mentally Retarded k Museum
3. Source of funds: a Taxes or Public Funds b.
c. Other (Describe) U.S. Forest Receipts
Grants and /or Contributions
4. Applicant is: a Accredited b. Approved c - Licensed
(Attach documentary evidence substantiating Approval or Licensing)
5. When not obvious from institution's name, attach a narrative to provide:
a. If a Public Agency, details of public program functions, activities, and /or facilities.
b. If Nonprofit Educational, details to include grades taught, enrollment, length of school day, weeks, and year;
number and qualifications of full -time and part -time staff, and facilities operated or programs conducted.
c. If Nonprofit Public Health, details of services offered, number of beds where applicable, number of resident
physicians, number of registered nurses, other professional staff, an cilities op +-d, or programs conducted.
Date November 4. 1987
Attachments:
1
2
3
4
5
(As required)
Signe
Chair, Deschutes County Commissioners
Title
(Legally Authorized Official)
Assurance of Compliance with Nondiscrimination
Authorization of participants
Narrative program description (if required)
IRS determination (if nonprofit under Section 501 of IRS Code)
Evidence of approval, accreditation or licensing (if required)
1. Applicant is approved as a•
FOR STATE AGENCY USE
Public Agency
Nonprofit Educational Institution
Nonprofit Public Health Institution
2. Applicant is not approved Comment:
Date
State Agency Approving Officer
Kenneth R. Jones Manager
DEFINITIONS
0089 °0627
Public Agency: means any State; political subdivision thereof, including any unit of local government or economic de-
velopment district; or any department, agency, instrumentality thereof, including instrumentalities created by compact
or other agreement between states or political subdivisions, multijurisdictional substate districts established by or pur-
suant to state law, or any Indian tribe, band, group, pueblo, or community located on a state reservation.
Nonprofit Institution: means 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 Jr individual, and which has been held to
be tax - exempt under the provisions of Section 501 of the Internal Revenue Code of 1954.
Local Government: means a government, or administration of a locality, within a state or a possession of the United
States.
School: (except for schools for the mentally retarded and schools for the physically handicapped) means a public or non-
profit approved or accredited organizational entity devoted primarily to approved academic, vocational, or professional
study and instruction, which operates primarily for educational purposes on a full -time basis for a minimum school
year and employs a full -time staff of qualified instructors.
College: means an approved or accredited public or nonprofit institution of higher learning offering organized study
courses and credits leading to the baccalaureate or higher degrees.
University: means a public or nonprofit approved or accredited institution for instruction and study in the higher
branches of learning and empowered to confer degrees in special departments or colleges.
School for the mentally retarded: means a facility or institution operated primarily to provide specialized instruction to
students of limited mental capacity. It must be public or nonprofit and must operate on a full -time basis for the equiva-
lent of a minimum school year prescribed for public school instruction of the mentally retarded, have a staff of quali-
fied instructors, and demonstrate that the facility meets the health and safety standards of the state or local govern-
mental body.
School for the physically handicapped: means a school organized primarily to provide specialized instruction to students
whose physical handicaps necessitate individual or group instruction. The school must be public or nonprofit and operate
on a full -time basis for the equivalent of a minimum school year prescribed for public school instruction for the physi-
cally handicapped, with a staff of qualified instructors, and demonstrate that the facility meets the health and safety
standards of the state or local governmental body.
Educational Radio: means 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 501 of the
Internal Revenue Code of 1954.
Educational Television: means a television 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
501 of the Internal Revenue Code of 1954.
Library: means a public or nonprofit facility providing library services free to all residents of a community, district,
state or region.
Museum: means 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.
Child Care Center: means 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.
Hospital: means an approved or accredited public or nonprofit institution providing public health services primarily for
inpatient medical or surgical care of the sick and injured and includes related facilities such as laboratories, outpatient
departments, training facilities, and staff offices.
Health Center: means an 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 clinics.
Clinic: means an approved public or nonprofit facility organized and operated for the primary purpose of providing
outpatient public health services and includes customary related services such as laboratories and treatment rooms.
i
0089 --0628
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 AMEND-
MENTS OF 1972, AS AMENDED, AND SECTION 303 OF THE AGE DISCRIMINATION ACT OF
1975.
DESCHUTES COUNTY
(Name of donee)
(hereinafter called the "donee ")
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, 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 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 of possession 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.
Dated
November 10, 1987
Deschutes County Board of Commissioners
County Administration Building
Bend, Oregon 97701
Donee Mailing Address
84- 125 -FSPO1
BY
Deschutes County
nee
(President /Chairman of the Board
or comparable authorized official)
Lois Bristow Prante, Chair
Deschutes County Commission
t1089 --e629
Instructions for Eligibility Applications
A. Instructions Applicable Only to Certain Specified Applicants
1. If the applicant is a school, college, or university lacking evidence of formal approval or accred-
itation, the following type of information may be accepted in lieu thereof: a letter from a school
district governing board or the State Board of Education or similar authority stating that the in-
stitution 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 ap-
proved institutions to the effect that students from the applicant institution have been and are
accepted as if coming from an accredited or approved institution.
2. If the applicant is a school for the mentally or physically handicapped, the application must in-
clude 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 staff.
3. 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 noncommercial educational
purposes.
4. 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.
5. If the applicant is a medical institution lacking evidence of formal approval, accreditation, or
licensing, the application must include a letter from a city, county, state, or federal health au-
thority 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 re-
quirements and standards for the professional and technical services of the institution.
B. Instructions Applicable to All Applicants
1. Public Law 94 -519 mandates that surplus personal property be distributed in a fair and equit-
able manner based on the relative needs and resources of interested eligible agencies and orga-
nizations and their abilities to utilize the property. To assist the state agency in complying with
this requirement, enclose a statement with the application providing information relating to the
following:
a. Source of funds, such as tax revenues, federal or state grants, tuition or service charges, and
donations or contributions
b. Economic condition of the agency or organization, including any extraordinary economic
problems
c. Availability of funds and facilities to repair or renovate the property and maintain the prop-
erty in use
d. General description of the nature and types of property needed for use in the program or
activities