HomeMy WebLinkAbout2013-359 IGA - OR Federal & State Surplus Program
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, Oregon Federal and State Surplus Property Program
1655 Salem Industrial Dr. NE, Salem, OR 97301
503-378-6020 www.oregonsurplus.com
About the Surplus Property Program
The Federal Surplus Property Donation program enables certain nonfederal organizations to
obtain property the Federal government no longer needs. The Oregon State Agency for Surplus
Property (ORSASP) obtains this surplus property from the Federal government and donates it to
eligible entities, and charges a service fee. Eligible entities include:
• Public agencies (State agencies, cities, counties, school districts, fire protection districts, etc.)
• Not-for-profit educational and public health activities (these must be licensed or accredited
by a recognized authority)
• Agencies that primarily serve the homeless
• Agencies that provide assistance to the needy
• Agencies that receive funds from the Older Americans Act`
To become eligible, forms must be completed by the chief administrative officer or executive
head of the agency and ORSASP must make an eligibility determination. Once an agency is
approved to receive property, the agency is called a donee. At that point, authorized
representatives can visit the ORSASP facility and select property needed by the donee. Property
is received on a daily basis so the inventory changes on a daily basis.
Service Educational Activities
Service Educational Activities (SEAS) are eligible to receive Department of Defense (DOD)
property. Although their eligibility is determined by the DOD, they should contact ORSASP for
requirements. Property obtained by the SEA can only be used in their eligible program and must
be put into use within one year of receipt, and used for at least one year.
Small Business Administration Participants
Participants in the Small Business Administration's (SBA's) 8(a) Business Development Program
may be eligible to receive surplus property. The SBA will be responsible for determining eligibility
and enforcing compliance.
Want List
To request property that is needed but not currently available, donees can place their name and
the needed item on the want list. When property is received, staff will call and notify the donee
that it is available.
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[Return of Property
• If at any time during the period of restriction the property is no longer suitable, usable or
further needed by the donee, the donee must return the property to ORSASP.
• If property cannot be-used and is returned within 30 days from receipt, full credit will be
given. If property is returned 31 to 60 days-from receipt, half credit will be given. After 60
days, no credit will be given.
Restrictions
The Federal government requires that ORSASP place restrictions on property transferred through
the donation program. Title to the property does not pass to the donee until it has been used for
the period of the restriction. A summary of these restrictions is as follows:
• Property can only be used by the eligible donee.
• Property obtained must be put into use within one year of receipt and remain in use for at
least one year.
• Passenger motor vehicles and items with an original acquisition cost of $5,000 or more
must be used for a minimum of 18 months.
• Gas masks, body armor, aircraft, vessel and foreign gifts have an additional period of
restriction.
• Personal use, unauthorized sale, disposal, cannibalization or destruction of property during
the restriction period is considered noncompliance.
• Property cannot be stored at a personal residence without the prior written approval of
ORSASP.
Compliance
ORSASP is required to verify compliance with federal regulations. This is done by mailing
utilization report forms and by making random unannounced compliance visits. During the
compliance visits, we ask to see the property in use.
State Surplus Property
In addition to the federal donation program, ORSASP operates the State Surplus Property
Program. This provides an opportunity for the same donees to obtain surplus property from state
agencies. State Surplus Property must be obtained for use by the eligible donee.
Fixed Price Vehicle Program
Under the fixed price sale program, ORSASP brokers direct purchases of vehicles from the
Federal government. These vehicles are then resold to eligible donees. The vehicles are typically
lower mileage and later model years than those found through the donation program. These
vehicles must be obtained for use by only the eligible donee.
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Instructions for Completing Eligibility Forms
Please complete all blanks requiring information. If you fail to do this, it will result in delays for
establishing your eligibility. If you have questions or need assistance in filling out the forms, contact
Nora Leahy at 503-378-2753 or email her at nora.leahv(cbstate.or.us.
1. The Chief Administrative Office or executive head must sign all forms (i.e. mayor, presiding
commissioner, superintendent, chairman/president of the board, director, etc.).
2. Only one of the above officials should sign the eligibility forms. (All forms must be signed by the same
individual).
3. Signatures must be original, not stamped.
4. On the Application for Eligibility:
• if you are a Public Agency, complete Sections I and II only and sign.
• if you are a non-profit organization, complete Sections I and III only and sign.
5. If your mailing address is a P.O. Box, a geographic location must be documented in the street address
section on the Donee Authorization form. This information is required to satisfy Federal accountability
and compliance regulations.
6. On the Donee Authorization form, list the names and contact information of the people who are
authorized to come in and sign for property for your agency.
7. If you are applying as a non-profit organization, a copy of the IRS tax-exempt ruling must accompany
the application. The ruling must have the correct name and address of the applicant organization. If it
does not, a name and/or address correction should be requested from the Internal Revenue Service,
EP/EO Division, P.O. Box 192, Covington, KY 41012-0192 (Tel. # 877-829-5500). A copy of this
correspondence may be included with the application packet, since confirmation by the IRS generally
may not be received for a long period of time.
8. If you are licensed, accredited, certified and/or have received approval for your health or educational
activity by a nationally recognized accrediting agency, please provide current copies of the
documentation. We are required to keep this information current at all times.
9. A narrative description of services your organization provides is required by Federal regulations. For
non-profit agencies, a more detailed description is necessary. Include brochures, pamphlets, etc.
Political subdivisions, such as cities, may include a brief summary of services such as police
department, sewer, water, street, etc.
10. Make a copy of the application to keep for your records.
11. Mail your paperwork to:
Oregon Federal and State Surplus Property Program
1655 Salem Industrial Dr. NE
Salem, OR 97301
Attn: Nora Leahy
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Department of Administrative Services
_ regOn Enterprise Asset Management - Surplus Property Distribution Center
1655 Salem Industrial Drive NE
John A. Kitzhaber, MD, Governor Salem, Oregon 97301
'g PHONE: 503-378-6020
APPLICATION FOR ELIGIBILITY FAX: 503-378-8558
Section I
Legal Name of Applicant Organization: City of Ashland
Address (Street Address AND applicable P.O. Box); 90 N. Mountain Avenue
Street Address
Ashland OR 97520 541-488-5354
P.O. Box City State Zip Code Phone
Has the institution been approved, accredited, or licensed? (Attach evidence)
If yes, by what authority?
Narrative description of program or services offered (Attach)
Public Agencies - Fill out Section II and sign below.
Non-profit Institutions -Fill out Section III and sign.
Section II Public Tax Supported Agencies
Check type of agency:
❑ State Government ❑ Health ❑ Education
8 City Government ❑ County Government ❑ Other
Section III. Non-Profit Institution
Check type of institution:
❑ College ❑ Child Care Center ❑ Health Center/Clinic
❑ Secondary School ❑ Radio/TV Station ❑ Provider of Assistance to the Needy
❑ Elementary School ❑ Library ❑ Provider of Assistant to the Homeless
❑ School for Disabled ❑ Museum ❑ Older American Act Funding
❑ Nursing Hone ❑ Hospital ❑ Other
How is the institution funded? (Show percentages)
1. Tax supported (other than grant)
2. By grant and/or contributions
3. Other (specify)
Has the institution been determined non-profit and tax-exempt under section 501 of the US Internal Revenue
Code? ❑ Yes (Attach IRS Ruling Letter) ❑ No
Articles of Incorporation and Bylaws (Attach)
Chief Administrative Officer or Executi a Head
Date e Title
October 3, 2013 t Cx--%'-z'~ ~w-~` ~l~y 71W~1It15'R~1 br
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Terms and Conditions of Distribution
You AGREE to the following when signing your name to a Distribution Document/ Invoice:
• To use the surplus property only in the official program you represent
• To use the surplus property for its intended purpose
• To put the surplus property into use within one year and to use it for at least one year
• To use certain items for 18 months or longer *
• To not sell the property, lend it, trade it, or tear it down for parts unless given prior written permission
• To not permanently remove the property for use outside the state
• To not store property at a personal residence without prior written authorization
• To return property that is still under restriction but is no longer needed
• To pay the U.S. Government for the property if not used according to the terms and conditions specified on the
distribution document
In short, the surplus property must be used in an authorized program. Personal or non-use of surplus property
is prohibited. Permission must be received before selling, trading or cannibalizing the property. Understand
your obligations by reading the back of your Distribution Document/Invoice.
*Property that has an original acquisition cost of $5,000 or more and passenger motor vehicles regardless of
acquisition cost are items that would fall under this restriction. Utilization reports will be mailed to you for
completion every six months until the use requirement is met. Any authorized representative can complete this
form if they have the necessary information. If you need assistance with thesd reports, contact Steve Smith at
503-378-6051.
RETURN POLICY:
Property returned within 30 days from acquisition = Full Credit
Property returned 31-60 days from acquisition = Half Credit
No credit will be given for property returned after 60 days
1 agree to abide by the terms and conditions on the back of the distribution document and understand that
failure to do so could render my organization ineligible to receive property.
Organization Signature
r ll~ l 3 -Dave. kayme-r
Date Printed Name
5
State of Oregon Federal and State Surplus Property Program •
1655 Salem Industrial Dr. NE des
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Salem, OR 97301(tik
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Donee Authorized Signers
Use this form to add/delete authorized signers to/from your account
if more names must be added, make a co of this sheet and add numbers to signers
Name of Donee Institution: Date:
City of Ashland October 3, 2013
Department (if College, University, or applicable): Address (Street and Number):
90 N. Mountain Avenue Ashland 97520
Mailing Address/ P.O. Box: City: ZIP Code:
County: Telephone Number (include extension): Website Address:
Jackson 541-488-5354 ashland.or. us
Send Invoices to:
Jamie Snow I Authorize Purchases By Anyone In My Agency That Holds:
job Tide and Phone Number: - Business Credit Card El
Purchase Order Either❑
Accounts Payable, 541-552-2028 or SPOTS Card
ame Add Delete Email Address
Kari Olson kari.olson@ashland.or.us
Title Phone Number
Purchasing Representative 541-488-5354
Add
Name #2 Delete Email Address
Dale Peters Z dale.peters@ashland.or.us
Title Phone Number
Facilities Maintenance 541-552-2292
Name #3 A De Email Address
Stu Wilkie 0 stu.wilkie@ashland.or.us
Title Phone Number
Fleet/Safety Supervisor 541-552-2355
Name #4 A De ete Email Address
Scott Hollingsworth F V1
Title Phone Number
Battalion Chief EMT-P 541-482-2770
Name #5 A Deete Email Address
Gail Rosenberg ✓ gail.rosenberg@ashland.or.us
Title Phone Number
Administrative Assistant 541-552-2117
Authorized By (Please Print) Title:
Daue Kanner ~i~y ~rvtinisk r
Chief Administrative Office or Executive Head
Signature (s
Signature of Chief Administrative Olliceo Ex oAppointed Hired Elected (Term expires Hired by Contract (expires_/_J_)
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NONDISCRIMINATION ASSURANCE
Name of Applicarff Organization
The applicant, herein after called the "donee", assures compliance with all requirements by or
pursuant to the regulations of the General Services Administration (41 CFR 101-6.2 and 101-8) issued
under the provisions of Title VI of the Civil Rights Act of 1964, as amended; Section 504 of the.
Rehabilitation Act of 1973, as amended; Title IX of the Education Amendments of 1972, as amended;
and Civil Rights Restoration Act of 1987.
No person shall be excluded from program participation or denied benefits on the basis of race, color,
national origin, sex, education, age or disability.
Further, the donee agrees that this agreement obligates the donee for the period which it retains
ownership or possession of property, that the United States shall have the right to seek judicial
enforcement of this agreement and that this agreement is binding upon the donee and its successors,
transferees and assignees.
By signing below, I agree to the nondiscriminatio assurance and certify that my representations are
true and correct.
to 1173
Date Signature of Authoriz Official for Organization
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR
LOWER TIER COVERED TRANSACTIONS
The Applicant Organization certifies, by submission of this application, that neither it nor its principals is presently
debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from
Participation in this transaction by any Federal department agency
Q The Applicant Or nization is unable to certify any of the statements in this certification and shall attach an
explanation to thiaproposal. n r
Signature of Chief Admini rative Officer/Executive Head Title
till, It 3
Date
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CERTIFICATIONS AND AGREEMENTS
THE DONEE CERTIFIES THAT:
1. (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.
If. 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 Slate 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.
III. THE DONEE AGREES TO THE FOLLOWING CONDITIONS IMPOSED BY THE STATE AGENCY, APPLICABLE TO ITEMS WITH A UNIT
ACQUISITION COST OF $5,000 (PUBLIC LAW 99.386, SEC. 207) OR MORE AND PASSENGER MOTOR VEHICLES, REGARDLESS OF
ACQUISITION COST, EXCEPT VESSELS 50 FEET IN LENGTH AND AIRCRAFT:
(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.
IV. 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 Slate 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 Slate 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 Slate agency.
(5) Al 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.
V. 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.
VI. TERMS AND CONDITIONS APPLICABLE TO THE DONATION OF AIRCRAFT AND VESSELS (50 FEET OR MORE IN LENGTH) HAVING AN
ACQUISITION COST OF $5,000 (PUBLIC LAW 99-386, SEC. 207) OR MORE, REGARDLESS OF THE PURPOSE FOR WHICH ACQUIRED:
(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 AND CONDITIONS IMPOSED BY THE STATE AGENCY APPLICABLE TO ITEMS WITH
A UNIT ACQUISITION COST OF UNDER $5,000 (PUBLIC LAW 99-386, SEC. 207):
(1) Title to items with an acquisition cost of less than $5,000. (Public Law 99-386, Sec. 207) shall pass to the donee when the terms and conditions
imposed by (b) (1) and (2) have been met.
(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 Slate 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.