Resolution No. 82-50 AUTHORIZATION OF PARTICIPANTS
CITY OF TIGARD, OREGON
RESOLUTION i
¢� No. 82-50
icer of
se
aniza-
IT RESOLVED
do not have a governing board,OR
and by the Chief hereby ordered that thetoFfici0al(s) and/or oemployee(s) i.
tion title(sj, and signature(s) is (are) listed below shall be and is (are) hereby authorized
whose representative
as our Propertypundertthe Terto ms and Conn federal
s listed olus nrthe reverse side off tm the his form."on to Agency for Surplus
NAME
TITLE SIGNA RE
(Print or type) i
,ty a r ator
—C—
Doris HartiP Finance Director/City R'e/corder o
Walt Zielinski
Crew Chief
Loreen Wilson Office Manager
da _ N/1 -, 19 82 by the Governing Board
PASSED AND ADOPTED this_�L` — Y of
of the City of Tigard. Oregon. _—
Clerk of the Governing Board of
I,
the Ci do hereby certify that the foregoing is a full,true and
y the Boar
p s resolution adopted bd ata ggU ar meeting thereof held at its regular
correct copy o,
ve ^toted,which resolution is on file in the office oft e
place of meeting at the date and by the vote abo
Board.
Name of organization
PO Box 23397,--Ti ard Oregon 97223
Malting address _
,,--,,n ton
[Signed)
City
County ZIP Code (Legally Authorized official)
OR
AUTHORIZED this da Y of 19 ,by.
Title
Name of chief administrative officer
3 Name of organization
Malting address
(Signed
City County ZIP CoAe (Legally Authorized Official)
APPLICATION FOR ELIGIBILITY
FEDERAL PRO UNDER PTL. 94 SI90N PROGRAM
Legal Name of Applicant: CITY OF TIGA [) OREGON
Zip Code 97223
p0 Box 23397 Tigard, Ore on __--
Mailing Address: County ldashi
{
Location: 12755 SW Ash AvenuenoL'On
PHONE aoJ int
1. Application is made: a•
XXXX as a Public Agency
bas a Nonprofit Educationa
. l or Public Health Institution (attach copy o ax-
under Section 501 of the Internal Revenue Code of 1954)
exempt determination
2, Applicant is a: (See definitions) 1. _Child Care Center
a•__ g.
Agency g.—School for the
cally,Handicapped
m.--Hospital
b XXX Local Government n,__Health Center
h,__Educational Radio —_Clinic
C._School Station o
d, CollegeOther(Specify):
1, __Educational TV Station P•
e, University _Library
School for the 1•
Mentally Retarded g, Museum
XXX Taxes or Public Funds b. --Grants and/or Contributions
3. Source of funds: a._— .
C. Other (Describe)
Approved c.--Licensed
4. Applicant is: a._—Accredited b• Approval or Licensing)
(Attach documentary evidence substantiating
(not needed)
l•. institution's name,attach a narrative to provide:
5. When not obvious from
ubil_ ALency,details of public program functions,activities,and/or facilities.
a.
a. If a Pth of weeln, and year;
b. If Nonprofit Educational,details to include grades taught,aff and facilities operated or programs conducted. ',
number and qualifications of full-time and part-time st ,
ams where applicable,number of resident
C. If Nonprofit Public Health. details of services offered, number of beds ered nurses, other professional staff,and faci
physicians, number of registlities operated,or programs conducted.
Date
-fid-YX Signed
rde
Title
(Legally Authorized Official)
Attachments: (As required)
1, Assurance of Compliance with Nondiscrimination
2,__Authorization of participants
3 __Narrative program description(if required)
4,___IRS determination (if nonprofit under Section 501 of IRS Code)
5, Evidence of approval, accreditation or licensing(if required)
FOR SLATE AGENCY USE
1. Applicant is approved as a: --Public Agency
Nonprofit Educational Institution
Nonprofit Public Health Institution
C,
2• Applicant is not approved _—Comment:
fficer
Date —SWte Agency ApProvinR O
rs
4
,1
l
RECEIVED
/:PR 2 2 1982
' •. : Department of Genera/ Services �_ _CITY DF TIGARD I
wcrownrer 1230 STATE STREET, SE.,SALEM,OREGON 97310 PHONE(503)378-4642
i
April 21, 1982
TO: All Federal Surplus Property Donee's
FROM: Kenneth R. Jones, Coordinator �QJ
State Surplus Property
SUBJECT: Eligibility Re-Certification
Under Public Law 94-519, the Federal Property Management Regulations
(FPMR) requires the State agency administering the Federal Surplus
Program to update a donee's eligibility record on a periodic basis, not
less than once every 3 years, to insure continued eligibility.
Our records reveal your agency as one due for the process.
Please prepare the enclosed documents and return to this office by
June 30, 1982, to maintain your eligibility status.
Thank you for your time and cooperation in this matter.
Enclosures:
KJ:db
C
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 (k
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 i
accepted ,s 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:
e
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
r
G