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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 />(714) 558 -6796 <br />SASP Form 201 -A (03/2006) <br />ELIGIBILITY RENEWAL APPLICATION <br />STATE & FEDERAL SURPLUS PROPERTY PROGRAM <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 />Organization is a: PUBLIC GOVERNMENTAL AGENCY <br />A. Conservation <br />B. Economic Development <br />C. Education – ADA <br />D. Parks & Recreation <br />E. Public Health <br />_X—F. Public Safety <br />G.Other (includes library/museums) <br />PRIVATE AGENCY /ORGANIZATION <br />A. Homeless Program <br />B. Private Education – ADA <br />C. Private Health <br />D. Older Americans Act for Sr. Citizens <br />E. Other, Explain <br />Number of Service Sites <br />Total Number of Clients Served Each Day <br />RESOLUTION <br />B. "BE IT RESOLVED by the Governing 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 representative(s) to acquire state or federal surplus property <br />from the California State Agency for Surplus Property and approve incidental fees under the Terms and Conditions listed on the reverse <br />side of this form." <br />NAME (Print or type) TITLE --- A <br />Steve Cavallero Battalion Chief <br />Geoff Balton Battalion Chief ' <br />Stan Maupin Battalion Chief <br />Dave Pucci Battalion Chief <br />Martin Schutt Captain <br />*Note, all signatures must be in original form. No coaled r stamped sianat <br />PASSED AND ADOPTED on 20 by the Governing Board of the: <br />by the following vote: AYES NOES ABSENT I, <br />E -MAIL ADDRESS <br />scava Ile ro(ab redwood citv.orc <br />gba Ito n @ redwood city orq <br />smaupin(o)redwoodcity. orq <br />dpucci(a)redwoodcity. <br />mschutt(aD- redwood city. orq <br />Clerk of the <br />subject Governing Board, hereby certify that the foregoing is a full, true, and correct copy of a resolution adopted by the Board at a <br />meeting on 20 meeting thereof held at its regular place of meeting at the date and by the vote above <br />stated, which resolution is on file in the office of the Governing Board. <br />Signed by <br />NOTE: ALL LOCAL GOVERNMENT & NON - PROFIT INCORPORATED ORGANIZATIONS HAVE A GOVERNING BOARD, <br />THEREFORE COMPLETE ONLY SECTIONS "A" &' THE FOLLOWING SECTION "C" IS FOR STATE AGENCIES ONLY <br />C. AUTHORIZED BY: <br />Printed Name and Title of Chief Administrative Officer <br />Signature of Chief Administrative Officer Date <br />STATE OF CALIFORNIA AGENCIES ARE REQUIRED TO PROVIDE THEIR STATE BILLING CODE# <br />FOR STATE SURPLUS AGENCY USE ONLY <br />Renewal Application Approved Renewal Application Disapproved, <br />Date: Signed: <br />