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<br />DEPARTMENT OF GENERAL SERVICES <br />INTERAGENCY SUPPORT DIVISION <br />FEDERAL AND STATE SURPLUS <br />PROPERTY PROGRAMS. <br />28 CIVIC CENTER PLAZA, SUITE 538 <br />SANTA ANA, CA 92701 <br />(114) 558-6796 <br /> <br />A. Name of Organization _Redwood City Fire Department Telephone_650-780-7400 <br />Address_755 Marshall Street City_Redwood City County San Mateo_Zip_ 64063 <br />Fax Number 650-780-7461 E-mail Address_mschutt@redwoodCity.org <br /> <br />Organization is a: PUBLIC GOVERNMENTAL AGENCY PRIVATE AGENCY/ORGANIZATION <br />_A. Conservation ~ Homeless Program <br />_B. Economic Development _B. Private Education - ADA <br />C. Education - ADA C. Private Health <br />-D. Parks & Recreation -D. Older Americans Act for Sr. Citizens <br />=E. Public Health = E. Other, Explain <br />_X_F. Public Safety <br />_G.Other (includes library/museums) <br /> <br />SASP Form 201-A (0312~~A <br />Page 4 <br /> <br />ELIGIBILITY RENEWAL APPLICATION <br />STATE & FEDERAL SURPLUS PROPERTY PROGRAM <br /> <br />Number of Service Sites <br />Total Number of Clients Served Each Day <br /> <br />RESOLUTION <br />B. -BE IT RESOLVED by the Goveming Board hereby ordered that the official(s) and/or employee(s) whose name(s), title(s), <br />signature(s) are listed below is (are) hereby authorized as our represen1ative(s) to acquire state or federal surplus property <br />from the California Slate Agency for Surplus Property and approve incidental fees under the Terms and Conditions listed on the reverse <br />side of this form.. <br /> <br />NAME (Print or type) TITLE E..MAIL ADDRESS <br />Steve Cavallero Battalion Chief scavallero@redwoodcity.ora <br />Geoff Balton Battalion Chief abalton@redwoodcitv.org. <br />Stan Maupin Battalion Chief smauoin@redwoodcitv.ora <br />Dave Pucci Battalion Chief doucci@redwoodcitv.org <br />Martin Schutt Captain mschutt@redwoodcitv.org <br /> <br /> <br />*Note. all slanatures must be In oriainal form. No cODIed r stamDed' slanature. <br /> <br />PASSED AND ADOPTED on <br /> <br />20_by the Governing Board of the: <br /> <br />by the following vote: AYES <br /> <br />NOES <br /> <br />ABSENT <br /> <br />I, <br /> <br />Clerk of the <br /> <br />subject Governing Board, hereby certify that the foregoing is a fun, true, and correct copy of a resolution adopted by the Board at a <br /> <br />meeting on <br /> <br />20_ meeting thereof held at its regular place of meeting at the date and by the vote above <br /> <br />stated, which resolution is on file in the office of the Governing Board. <br />Signed by <br /> <br />NOTE: ALL LOCAL GOVERNMENT & NON-PROFIT INCORPORATED ORGANIZATIONS ~ A GOVERNING BOARD, <br />THEREFORE COMPLETE ONLY SECnONS "Aft & "B". THE FOLLOWING SECTION alC" IS FOR STATE AGENCIES ONLY <br /> <br />C. AUTHORIZED BY: <br /> <br />Printed Name and Title of Chief Administrative Officer <br /> <br />Signature of Chief Administrative Officer <br /> <br />Date <br /> <br />STATE OFCAUFORNIA AGENCIES ARE REQUIRED TO PRO.VlDE THEIR STATE BILUNG CODE# <br />FOR STATE SURPLUS AGENCY USE ONLY <br /> <br />.~A"''''''' "Ill A A." Ill...." '''All IU ,I. a "."_.A:A.***",,,...AA loA "A.U "" ..111"""* A*a ***...*111 .*.*._&". .AAA I.At.'. III "11* .***........11.. AI. 11... A." _.*... ..._.Ir,...III.* .*........ <br /> <br />Renewal Application Approved <br />Date: <br /> <br />Renewal Application Disapproved <br /> <br />Signed: <br />