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�/ ' �( )� '�./ `� SASP Fortn 201-A(01Y2011) <br /> 4 \\ ll u <br /> ;�A�!�s�'+ :_ �n`�'�'�F . <br /> L„_.7 '\.�/ <br /> �E N�R�� �E R V I�E 5 �������������� � ����� ��. <br /> ELIGIBILITY RENEWAL APPLICATION STATE �FEDERAL SURPLUS PROPERTY PROGRAM <br /> A. Name of the Organization Port of R�dwood City Telephone 650-306-4150 <br /> Address (75 Seaport Boulevard CityRedwood City Zip 94063 <br /> FaxNumber 650-369-7636 E-mailAddress Portofrc@redwoodcityport.com <br /> Organization is a: PUBLIC GOVERNMENTAL AGENCY PRIVATE AGENCY/ORGANIZATION <br /> A.Conservation A. 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 /> F. Public Safety <br /> �G.Other, Explain Department <br /> of City Number of Service Sites <br /> Total Number of Clients Served Each Day <br /> RESOLUTION N0. P-2192 <br /> B. "BE IT RESOLVED by the Goveming Board,and hereby ordered that the offical(s)and/or employee(s)whose name(s),title(s),and signature(s)are listed <br /> below shall be and is(are)hereby authorized as our representative(s)to acquire surplus property through the auspices of the Cal'rfomia State Agency for <br /> Surplus Property and accept responsibility for payment of incidental fees by the surplus property agency under the Terms and Conditions accompanying <br /> this form or listed on the reverse side of this form." <br /> NAME(Print or type) TITLE N T RE* � E-MAIL ADDRESS <br /> Michael J. Giari Executive Director � � mgiari@redwoodcityport.com <br /> o � ; <br /> Cynthia D. Hampton Dir.Finance & Admin. � champton@redwoodcityport.com <br /> Donald K. Snaman Mgr of Operations dsnaman re woo cityport.com <br /> "Note:All siqnatures must be in oripinal form. No coaied or stamaed siqnatures. <br /> The above resolution was PASSED AND ADOPTED this 13th day of February Zp 13 by the Governing Board of the:Port of <br /> Redwood City by the following vote: AYES: 3 NOES: � ABSENT: 2 <br /> � Richard A. Dodge Port Co�issioners of the City <br /> Clerk of the Governing Board known as of Redwood Cit <br /> Do hereby certify that the foregoing is a full,true,and correct resolution adopted by the governing boy rd of e above na e organization at <br /> the meeting thereof held at its regular place of ineeting on the date and by the vote above stated,�copy f s � resolution s on file in the <br /> principal office of the Governing Board. r <br /> Signed by: / `' ��� <br /> NOTE:ALL LOCAL GOVERNMENT&NON-PROFIT INCORPORATED ORGANIZATIONS HAVE A GOVERNING BOARD,THEREFORE <br /> COMPLETE ONLY SECTIONS"A"8�"B". 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 Appliption Disapproved <br /> Date: Signed: <br /> OFFiCE QF FlEE7 AND ASSETMANACi EfifiENT :: Str�fe o#C:skF���aaa ;5tcr��:mU�vrarssurm-r Sc�vices A�errcy <br /> 7 li�L��?uf�rxrs��r�v� ; S�aza�rna�•�rf� �>4 9�4 ' f 9d����.2a5t3 f 4 P ci.�'2°.9v��a <br /> RE50 P-2192 ��Q'� <br /> � <br />