1988-11
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ELIGIBILITY APPLICATION FOR PUBLIC AGEN:IES
FEDERAL SURPIlJS POOPERI'Y t1I'ILIZATION PR(X;RAM
88 - 0 II
legal NaIre of Applicant
City of Clermont'
1\ddres s
P.O. Box 219, #1 Westgate Plaza, Clermont, Florida
ZIP 32711
County
Lake
Area Cede 9 0 4
'!'ele¡:hone 394-3350
Date Agency began Operation
1884
1. 01eck Type of Açency:
(See defini tians on reverse side)
a . Conservation
b . Ec:onani.c Develq;I!elt -
c. Parks & Recreation -
d. Public Safety
e . Museun .
f . State Agency
2. AttaC.~ a narrative which describes the programs and services offered. Also
attach evidence that the é1IXJlicant is a public a<JP..ncy.
g . County Govt.
h. City GoverrIœnt
i . Indian Tril:e, Group , Band ,
(State Reservation Only)
j . Other
x
Pueblo
6
3 . ~1 is the activity funded :
(Please indicate percentages)
a. Tax sup£X)rteå (other than a grant)
b. By grant and/or contributions
c. Ot.'1er (please be specific)
4 . Cœp1ete the attached Assurance of Cœpliance with GSA Regulations under Ti-
. tle VI of the Civil, Rights Act of 1964, Section 606 of Title VI of the Fed-
eral Property and Adr:ri.nistrative ServiceS Act of 1949, as arœnded, and Sec-
tion 504 of the Rehabilitation Act of 1973, as arrended, Title IX of the Edu-
cation AIændments of 1972, as amended, and Section 303 of the Age Disc:riIn.i-
nation Act of 1975.
100%
5. Cœplete the attached Authorization J:)ocŒent by the Governing Board or Body
designating one or IrDre representatives to act for the applicant acquiring
property fran the State Agency, to ca:mit the experrliture of fuOOs, and to
execute the State Agency's invoice/issue sheet, including tems, cxmditions,
reservations, and restrictions that the State Agency or <;SA may establish on
the property.
DATE :
4/14/88
~:~~
s~gnature)
City Manager
TITI..E :
FOR STATE AGEt cr USE
/'
CJ APPROVED r7 DISAPPROVED
/7 roIDITICNAL ELIGmILITY DATE
CJ UPDATED
DIREX:TOR
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DEFINITIONS - PUBLIC AGENCIES
, -.
1. Conservation: Means a program or programs carried out or promoted by a
public agency for public purposes involving directly or indirectly the
protection, maintenance, development, and restoration of the n~tural
resources of a given political area. These resources include but are not
limited to the air, land, forests, water, rivers, streams, lakes and ponds,
minera~s, and animals, fish, and other wildlife.
2. Econonic Development: Means a program or programs carried out or promoted
by a.public agency for public purposes which involve directly or indirectly
efforts to improve the opportunities of a given political area for the
successful establishment or expansion of industrial, commercial, or agri-
cultural plants or facilities and which otherwise assists in the creation
of long term employment opportunities in the area or primarily benefit the
unemployed or those with low incomes.
3. Parks and Recreation: Means a program or programs carried out or promoted
by a public agency for public purposes which involve directly or indirectly
the acquisition, development, improvement, maintenance, and protection of
park and recreational facilities for the residents of a given political
area. Such facilities include but are not limited to parks, playgrounds
and athletic fièlds, swimming pools, golf courses, nature facilities, and
nature trails.
4. Public Safety: :1eans a program or programs carried out or promoted by a
public agency for public purposes involving, directly or indirectly, the
protection, safety, law enforcement activities; and criminal justice system
of a given political area. Public safety programs may include but are not
limited to those carried out by public police departments, sheriff's
offices, the courts, penal and correctional institutions including juvenile
facilities, state and civil d~fense organizations, and fire departments
and rescue squads including volunteer fire departments and rescue squads
supported in whole or in part with public funds.
5. Museum: Means a public or nonprofit facili~y.w~iph j~,_~ttended by the
public free or at a nominal charge and which provides museum services in-
cluding the preservation and exhibition of artistic, cultural, historical
or scientific objects.
6. State, County and City Governmental Agencies: Surplus personal property
acquired through the State Agency must be used by ~~e public agency to
carry out or to promote for the residents of a given political area one or
more public purposes. While the Act lists certain specific public purposes
such as conservation, economic development, education, parks and recreation,
public safety, this enumeration is not exclusive and is not intended to
preclude the acquisition of donable surplus personal property by a public
agency for other public purposes. Each public program is conducted by
designated departments, ~gen~i~s, or other instrumentalities of the State
and/or local governments. .
7. Indian Tribe, Band, Group, Pueblo, or Community: May be certified for
participation in the Federal Surplus Property Donation Program only if
located on a State Reservation. ' , ---,
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1,
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AUTHORIZATION DOCU' ~NT
8
WHEREAS, the Florida State Agency known as the Department of
General Services, Division of Surplus Property, by authority of the Federal
Property and Administrative Services Act of 1949 as amended, makes available
Federal surplus personal property to public agencies for public purposes,
and to nonprofit tax-exempt health and educational institutions, and
WHEREAS ,
City of Clermont
(applicant organization)
hereafter referred to as the Applicant, is desirous of utilizing the ser-
vices and resources of this Agency, and
WHEREAS, the Applicant further certifies that 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 and for no
other purposes, and
WHEREAS, the Applicant further certifies that property is needed
and will be used by the recipient for educational or health purposes includ-
ing research and for no other purpose, and
WHEREAs. the~~pp}icàRt agrees that all items of property shall be
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placed in use for the purposes for which acquired within one year of receipt
and shall be continually in use for such purposes for one year from the date
the property was placed in use, and in the event the property is not so
placed in use, or continued in use, the donee shall immediately notify the
State Agency, and return said property to the State Agency as directed, and
WHEREAS, the Applicant further agrées to abide by all additional
periods of restriction placed on property by; the State Agency; that is, 18
months on all passenger motor vehicles and other items of property with a
unit acquisition cost of $5000.00 or more, except for such items of major
equipment on which the State Agency designates a further period of restric-
tion as indicated on the distribution document, and
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('..:
-------, -----
WHEREAS, the Applicant further agrees that during the period of
f'. /".,
restriction, it wil~ not sell, trade, lease, lend, ba4_' encumber, or other-
wise dispose of such property without prior approval of the General Services
:Administration or the State Agency, and in the event property is so disposed
of without prior approval of the General Services Administration or the
State Agency the Applicant will be liable for the fair market value or the
fair rental value of such property as determined by the General Services
Administration or the State Agency, and
WHEREAS, the Applicant further agrees to remit promptly to the
State Agency for all fees assessed on all property acquired for service
and handling expenses, and
WHEREAS, BE IT RESOLVED, that the Applicant requests that eligi-
bi1ity be established to participate in the Federal Surplus Property Utili-
zation Program, and
BE IT FURTHER RESOLVED, that the
City of Clermont
(Applicant Organization)
hereby certifies that he has read
and understands the above.
4/14/88
(Date)
P.O. Box 219
(Mailing Address)
S undet~ignature)City anager
hief Administrative Officer or
Executive Head
Clermont, FL 32711
(City, State, ZIP)
( 904
394 - 3350
(Telephone)
)
EXT:
Persons authorized to sign for and receive property and commit the expendi-
ture of funds:
Robert E. Smythe
(print name)
Wayne Saunders
~~
Joe Van Zile
e
Nor ID ISCRn -ITNAT I ΠJ ASSUIW ICE
8
Assurance to be executed by autOOrized representative of donee activity pr:i:,Qr
to receiving donations of surplus personal property fran the State Surplus
Property Agency on arrl after October 17, 1977.
Assurance of Cœ1pliance with GSA Regula-
tions under Title VI of the Civil Rights
Act of 1964, Section 606 of Title VI of
the Federal Property arrl Administrative
Services Act of 1949, as arænded, Section
504 of the Rehabilitation Act of 1973, as
arænded, Title IX of the Education Arænd-
rœnts of 1972, as amended, and Section
303 of the Age Discrimination Act of 1975.
City of Clermont
(nææ of donee)
agrees that the program for or in connection with which any property is donated
to the donee \'rill be conducted in canpliance with, arrl the donee will cx:rnply
with arrl will re::JUÍre aIr:! other person (any legal entity) who through contrac-
tual or other arrangaœnts with the donee is authorized to provide services or
benefi ts under said program to cCItlpl y with, all requiranents :imposed by or pur-
suant to the regulations of the General Services Administration (41 Œ'R 101-6.2)
issued under the provisions of Title VI of the Civil Ric;:rhts Act of 1964, Section
606 of Title VI of the Federal Property and Administrative Services Act of 1949,
as axœnded, Section 504 of the Rehabilitation Act of 1973, as amended, Title IX
0 f the Ed uca ti on AIœndrœn ts 0 f 19 7 2, as amended , and Section 3 0 3 0 f the Age D i s -
crimination Act of 1975, to the end that no person in the United States shall on
the grrn.md of race, color, national origin, sex, or age, or that no othervåse
qualified handic~ person shall solely by reason of the handicap, be excluded
fran participation in, be denied the benefits of, or be subjected to discrimina-
tion under aIr:! program or activity for which the àonee received Federal assis-
tance fran the General Services Administration; and Hereby Gives Assurance That
it will irrrædiately take any Iœasures necessæ:y to effectuate this agreement.
, hereinafter called the "donee", hereby
The donee further agrees that this agreaœnt shall be subject in all respects to
the provisions of said regulations; that this agreaænt shall obligate the donee
for the period during which it retains ~ship or possession of any such prop-
erty; that the United States shall have the right to seek judicial enforcaænt
of this agreaœnt; arrl, this agreerœnt shall be binding upon any successor in
interest of the donee and the word "donee" as used herein includes any such suc-
cessor in interest.
Dated
4/14/88
City of Clermont
Donee
P.O. Box 219
or
Clermont, FL 32711
Donee n:riling address
t.
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fA7Ey OF PROPERI'Y NEEDS, AJ~
~ tmLIZATlOO CAPABIL.l:r:æS
The State Agency for Federal Property Assistance, to nore equitably serve the needs of all
participants, requests the below infonnation and stipulates that the data subni tted will be
used only for the purp.JSe of facilitating the fair and equitable distribution of pxoperty
and for no other purposes. Public Law 94-519, October 17, 1977., mrends the Federal Properly
arrl Administrative Services Act of 1949 and mandates that the State 'Agency will provide for.
fair and equitable distributicn of property within the State ~ up:m relative needs,
resources and ability to utilize available personal surpl~ p~~ '!his survey will be
used to make those detenninations. Your cooperation in S\.JPP:LyiÌ1g ~ ~ted data will œ
appreciated. - -
I . GENERAL DATA
A. Type of Agency:
[::Jl Public Agency
CJ Private Nonprofit Institution-
B.
Resources Available:
1. Funding source
[::J Tax appropriated ftmds
[::J Tuition or charge for se1:VÌces
t:::J Federal or State Grant (contract)
[::J D:>nations or contributions
2. Statarent of relative financial ability (budget limitations, inability to pur
chase fran ccmrercial sources, extraordinaJ:y econanic problems, etc.):
Note: Other factors may be considered in the distribution of available property such
as, per capita incane of residents of area, assessed property values, econanic
ranking, and other data as published in the Statistical Report of the Departrrent of
Revenue and other similar reports.
c.
Population served:
6400
D.
Capability for repair and naintenance of property:
"~
E. Ability to utilize requested property (statement of utilization potential, ongoing
need, temporary need, reserve backup, etc.):
On going need
(con I t. on reverse side)
II.
SPOCIFIC NEEDS
~ ,~
Indicate major itans not' ~Æerally available in the agen~ Jistribution centers such
as, but not limited to, aircraft and cx::IfP)I1el1ts: vessels and caIlpOIlents: vehicles and
u..allt~J.uents: oonstruction equiprent and carponents: heavy construction materials:
material handling equipœnt and L:Ulll--ULleIlts: generators: carpressors: nusical j nstru-
ne:nts: machine tcx:>ls and CCJt1?O11el1ts: scientific equiprent: photographic equipœnt:
printing equitJY1eI1t¡ refrigeration equipœnt: transportation equipnent: shop equipnent:
carputers and u.JIllJ:-'UlleIlts: reproduction equipnent: major itans of electronics: and
other specialized i terns of property.
rrL.\1
DESCRIPTION
NARRATIVE JUSTIFICATION (
)
Vehicles & Components
Cúnstruction Equip &
Componen s
Materials, Handling Eq.
& Component-
Generators
Compressors
Transportation Equip.
Shop Equip
Major items of Electronics
Other Specialized items
of property
, [II.
SHIPprnG rnSTRUCTIONS
l:.7 Direct pick-up at federal holding agency
fY7 Pick-up at agency distribution center
CJ Ship directly by cx::mron carrier
Date:
4/14/88
City of Clermont
Eligible Organization
Signed:
If~~fy' ff" 1
Certi 1ng 0 :LC:La
hi
Wayne Saunders, City Manager
(type or print narre and title)
STATE OF FLORIDA
~EPARTMENT OF GENERAL SERV.S
BOB MARTINEZ
GOVE./>NOR
LARSON BUILDING, 200 E, GAINI'.S ST,
TALLAHASSEE. FLORIDA 323'J!l-O!J50
GEORGE FIRESTONE
SECRETARY OF STATE
ROBERT A BUTTERWORTH
ATTORNEY GENERAL
GERALD LEWIS
STATE COMPTROLLER
January 27. 1988
BILL GUNTER
STATE TREASURER
DOYLE CONNER
COMMISSIONER OF AGRICULTURE
RONALD W THOMAS
EXECUTIVE DIRECTOR
BETTY CASTOR
COMMISSIONER OF EDUCATION
I'I.FA~E A ) )HE~S HEP!.Y ' ()
813-A Lake Bradford Rd.
Tallahassee. Fl 32304
Mr. Robert Smythe.
Public Works
City of Clermont
P. O. Box 219
Clermont. Florida
Director
r-
3271 L
Dear Mr. Smythe:
Thank you for your interest concerning the Federal Surplus Property
Utilization Program.
The program can provide valuable support in obtaining good used feder 11
property at remarkable savings and we are anxious to include your organiza-
tion as an eligible recipient.
A brochure is enclosed which describes the eligibility requirements
and provides information about the program's history. In addition, a copy
of the most recent newsletter is included which depicts a small sample of
our inventory.
After reviewing the information. complete the enclosed application.
attach any necessary supporting documents and return them to us as soon as
possible. Your application will be processed immediately.
If you have questions or need assistance in completing the forms.
please call us at (904) 488-3524 or Suncom 278-3524. We look forward to
your participation in a very worthwhile program.
Sincerely.
Ollie L. Evans. Jr.. Director
Division of Surplus Property
'-- ~l --ð /7/ó l
~~aff. Chie~
Bureau of Federal Surplus Property
JAN/gw
0O3F
Enclosures - Application
Brochure
Newsletter
()IVI~I()NS
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