HomeMy WebLinkAboutCity Council Resolution 50 RESOLUTIOI~ NO
(To Accoeapany )
WI~, a majority of the eligible employees for whom coverage is requested by the
, herein-
after designated "Public Agency," indicated at an election or elections, or by petition
filed with the Public Agency that they favor the Public ASency making a forms_el applica-
tion to the ]~oard of Administration of the State Employees' Retirement System, hereinafter
called "State", for inclusion of the said eligible employees of said Public Agency in the
California ~tate Social Security Agreement of b~arch 9, 1951~ providing for the coverage
of said eligible employees under the insurance system established by Title II of the
Federal Social Security Act; and
WNtRFAS, the Public Agency desires to file such an application with the State and to
enter into an agreement with the State for inclusion of said eligible employees in said
Oaltfon~ta State Social Security Agreement; and
WHIIRFAS, official form "Application and Agreement, Ret.-0ASI 32A" containing the
terms and conditions under which the State will effect such inclusion has been ex~_ned
by this body:
NOW, THEREFORE, BE IT RESOLVE that an Application and Agreement on said official
form be executed on behalf of the Public Agency and submitted to the State to provide
coverage under said California State Social Security Agreement as follows:
A. ~.ver~.e G~upS: ((1~eck only one part):
1. XiZ All coverage groups, i.e., all eligible employees.
~et,-OASI B3A Rev. 6 (9-57) 200 RESOLUTION (Other than Retirement System Members)
B. Exceed Services:
1. All services excluded from coverage under the agreement by Section 218
of the Social S~curity' Act; and
2. Services excluded by option of the Public Agency IC~.eck only one part):
~ a. No' optional exclusions desired
~m eslr sloes o~. shesos of 0%00 %re lofts-
alive elolsive eseeutLve, ssd/®~. eXooeSvo JudgelaX poettLom~
ill ~i1~1 ,ef,el~e, &m me ele. e, or ohmsms of pms, l-t~me p, Dm$~IDM~
mefvtees &m msm~ elmms ms. elmmmem of 1peru& &o~m S:l~e ~osm-
mtll. tl fee, elkioN I. II II m fle 1NMIt. m | (e ) P$ouli~uPll labor
C. Effective Date of Coverage ~maer Agreement: ~tllY !, ~ 19~;
-:: -: =i ':i ................. ' ................
BE' IT FURTHER RESOLVED, that
~ttr 4:D, ost ' , t~S& smmtofes-.rde ~m M.,
(Ti~l'e'Sf Position) ........... (Address of Public Agency)
be and he is hereby authorized and directed to execute said application ~.nd agreement on
behalf of and as Authorized Agent of the Public Agency and to forward same to the
for acceptance and further action; and
BE IT FUt~THER RE~oOLVED, that authority hereafter to act as Authorized Agent, and ~;o
to conduct all negotiations, conclude all arrangements, submit all reports, and sign all
a~reements and instruments which my be necessary to carry out the letter' and intent of the
aforesaid application and agreement, in conformity with all applicable Fedeml and State
laws, rules and regulations, is vested in the position of ..... O[~]P' Gllrtt ·
Ret.-OASI 33A Roy, 6 (9-57)
.... , State of California~ do hersby certify
the foregoing to be & full, true, and correct copy of Resolution No. ~ adopted by
of
the m ..... .. .......... . ..... ~ the regular/~ meeting held on
IN WITNESS ~_FAEOF, I have hereunto set my hand affixed the Seal of said
... ~a_*= =.~ e---~--- , at my office this ~ day of
-., ...., ~ , ~.
SUBMIT IN DELICATE
Rot. OASI 33C ~Y'. 1 (7-57) 200 Certification
For the parposes of this application and agreement~ any reference made herein to any
State or Federal statute or statutest or regtulations~ or part thereof~ applies to all
amendments thereto nov, heretofore, or hereafter made.
For the purposes of this application and agreement, "Federal system" means the Old-
Age, Survivors, and Disability Insurance system established by Title II of the
Federal Social Security Act,, "Federal agency" means the Secretary of Heal'th~ Education,
and Welfare~ or the predecessor or successor in f'~mtion to such officer, "Board"
means the Board of Administration of the State Employees' Retirement System~
The , a Frolic
Name of Public Agency7
agency as defined in Section ~2OO9 of the Government Code -%/hereinafter called Appl'!.cant~
in accordance with a dally adopted resolution or ordinance of its ]egis].ative or governing
bo~y~ a certified colyy of which I.$ attached. hereto and incorporated by reference herein,
hereby makes application to the Board~ hereinafter called State~ to in~:lude all services
performed by each of the eligible employees of applicant for whom coverage is requested
herein within the coverage of the Federal system in conformity with ,5e.-ction ~18 of the
Social Sectu-:ity Act and statutes of the State of California, and applicable Federal and
State regulations thereunder.
22009
Ia) 'Public AgenoT" means the ,Itate, any city, county, city and county, district, municipal or public
corporation or any ixmtrumcntal!ty thereof, or bo~,ds and o~ittee~ establia[hed ~der ~a~er iO of
Division 6 of the A~=icultural Code, ~apter 75h of Statutes of 1933, as ~ended, or C~pt~ 30T of
the ~tutes of 1935, as eraended, the mplo~e~ of ~ioh co~stitu%e one or more coverage ~eups, or
~e~irment S~St~ oov~age &roupz,
Ret. OA~I 32A Rev. 5 (9/}7) Appliosti0n-Agreement (Other th~n Retirement )yst~rn Menbars)
In order to carry into effect the cc~non governmental dut. ies under such statutes
Applicant agrees to be bollnd by the following terms and conditions in constoleration of
an agreement between the Federal agency and the State~ and the State agrees to take the
necessary steps to extend. the provisions cf the Federal system to cover the said emploU~ee~
of the Alyplicant:
1. Applicant hereby requests that all services of each of ~ts eligible emp]_oy~.e~
within the follo~.;ing coverage group(s), as defined by Section 218 of sa~d Social Security
Act~ or~ if so stated., all services of all employees eligible for coverage under the
Federal systen, be i~cluded under the Federal system:
(Fill in approFtate coverage group(s) from designations in (A) and/or (Bt of i otn~tf
using ENTIRE PHRASE. If coverage group (B) is used, identify the prot~rietary reception(s)
to be included. If all employees of the Applicant are to receive coveraids under the
Federal system e_xcept those exclu.dLed b_Z la~; cr at the option of the A~ under
~p~h ~ be!ow~ endtar "All Eligible Employees.")
t:'cz~issible designations of coverage groups for local public a~enci~;s are:
(A) Fmployeea of a political subdivision of a State other than those en~a~ed in perfom]in~
settees in connection with a pro~iet~y f~otion~
(B~; ~pl~ee~ of a political subdivision of a State engaEed in perfomin~ service in
oonnec%ion ~%h a single proprieta~
If an employee would be included in more %han one coverage group be,~u~e he performs service in
connection with two or more proprie~y f~ctions or in co~eotion ~th both a prop~iet~y funerich
~nd a nonproprie%a~%~ func~tion, he shall be included in only one such coverage group.
2. Applicant will comply promptly znd c~pletely, tkrou~.~hout the ter~n of this
~pplication ~d s~e~ent~ with the letter ~d in~ent of all statute~ of the State .:f
California, ~d Sscti~ 218 of the Federal ~cial Secttry Act., m~d applicable Fedenral
~d S~te regulations adopted p~su~t thereto.
3. This aI~licati~: ~d a~eement includes all services perforated by each of' ~n, fm
eligible ~ployees sf the Applic~t for wh~ coverage is requc. sted~ exceirt the foli~nnwing~
(a) ~y semite perfo~d by an employee who~ on the effective ~h~te of this agreem~mt~ is
a m~ber of a retir~ent syst~, (b) servica ~rfomed by an individual who is empl. oya~. to
relieve h~ from ~emplo~ent~ (c) service ~rfomed in a hospital, home~ cr other institu-
tion by $ patient or i~,.ats thereof, (d) covered transportation ~;ervi~e (as de-F:Lne5 ~n
~cticn ~lO(1) of the Social ~c~ity Act,, as ~ended), and (e) s~n~rvice (other than agricul.-
rural labor or service performed 'by a student) whish is exclud~d f'ro~. emplo~m'~t by any
provision of ~ction 210(a) of the Social Sec~'ity Act~ other thorn paragraph 7 cff such
section.
Provided, h~ever~ that in addition to the above excep~.iona~ as e~srate~ heroin, the
following services perf creed by employees of the Applicant shall alsc~ b<~ excluded f'rom
coverage ~der the Federal system p~s~t tc Section 2kS(e) of the Social Security Aci.:~/
(m) mw tem mf
~2/ if n¢ exolUaion~ write in the ~ord.~ "No ~lu~l.on~.' The lpplle~nt ~aY e2.sc~ to ,:~xo2ude from
cov~::yage settees perfccme~ b~ ~pl~ee~ in ~y one or more of the follo'.in~ o]$,,sse$: [a) ~y service
of' an emm-gency ~ure~ (b) ~.ll services tn ~y clans or slashes of elftire le~islatiw~ t~lect~ve
e~cr. ti'~e, ~nd,,/or el~tive .iudio~al po.~iti~; (c) ~1 services in any cla~s or classes of pastime
positiorl~ (d) ~]. servi,3es i,n any ola~s or cla,.ses of pc~sjtic. nsthe c<xnpensa. tion for which is Dn a
fee basis; (e) ~r:icult~al labor i~ ;!~oh__ wor2 would be excjudej ii ~,fo~aed for a pry. rate
(f) Se~wice p~formed b:~ ~ ~tudent if suc~woj! would b~ excluded if }~erf,.',rmed for a ~ivat. e
Applicant ~ist f~ll in above ~y of these e~clusions it wi~bes to ~n~e. ~s2 e~ti~.
:}a~.:!~ s~j.o~ ~clu,-t. on. Exol~5,.ons indicated ,nu~t a~ee with it~ns on i~esolut!.on Fore
l~. That applicant shall pay to the State amomnts equi'~.raiLent t:~, the sums of taxes
(employer-employee contributiox~s) imposed by Section 310] anal 3!tl of the Imtern. al.
Code with resFst to remuneration for a].i services of each of the el:~?;ible emp].,:n>yees ~::over~'~d
by this application and a~:reement. That Applicant shall keep or ca, us~,~ t,o be ke?t
records of all remuneration for such ~r, ervices, said records to be maint, ained as requj. red
Fe~.eral or State re6~atJ ons, and said records shall he avaj. lab]Le for inspection or audit
by the Board or its dez.i~ated representative.
5. That Applicant shall prepare and submit such wage rand on;her reports to tt~e State
as may be required from t~e to %~e by the State.
~,. That the Applicant shall pay To the S'::ate any s~s of money that the' State may
be ,:::,bligated tc F,Y or forfeit to the Fe~eral Government by reas,::m c~f' a~y faii]_ure :: !'
Applicant, for any cause or reason, tc: pay the ::ontributior~s, penalties, :br int~.re~z~".
quired by the agreement between the Federal a~:~ency and the Sta~:,e at such time ~:,r fin
~o~mts as required by the $a,J,'t agreement and r~y ',~tate or F~t~e~'~l re:.?llatic:,n~. a'Z,:~?~:.~:z<.
suaI~t 'thereto. Tha'b applicant s:hal~. pay its pro:[,ort:j. onate sha:r,:~: of the ~tat.~ 's
a~inistrative costs as determined by the Sta~,e.
7. That the cca~..raf~e as hereln [:rc:.~idecl for all services cff ca:'fi~ c;f' the ~]ai[~it:..t~.
ployees of the applicant shall be effective ~s of . J~l[ 1 ., l']i~; 8 ~.-' ,:m,j~. thi~::
a~reement shall ccntinue ~.mt:i.:] terminf. Red as provi,led. heretic.
~3. That the S'at.e or the .~pp]icar,~: shall have the right. t.c, terminate ~:.~is
tion and agreement ui.~on giv:in~ at lea~'~::. 't:~,~o years' ,s.d~,:';nce noti.:rcs. :[.n ,,.~r:iti~ ~'o tb,~ :.~h,:~::.r
part. y~ effective at the end off a aalendar quarter specified in t?'.o no'::.ice;
h~7~.~arver, that the sai~ ap:p].ication an,i. a(Creement mus. t have b~na~:: ]i'~. ,z..ffe,'~t no't i.e~:s~z ~:.~,~:~':
five years prior to receipt off such netice, and provide,~ f~'~:h~m~.:r, that if the
a~ncy should t'c.m~mle t.~e a(~r.eement i~e~:ween ~:,h,,~2 Federal. agen::::y ~nd. the Stat. e ~2:,r
Public a~enoie~ includ~!~d in ~ae a~reement between tj~e State ~nd b]~ F~i. de~'~t agenc?~ ~n ,'~r before
December } 1, 1959, may r~ :;i' i~ s~ an ef fec~ fve .;fat e o f c :r~era~[c ,:, f ~amls. ry ]l , i 956, n,r a~y :}at e the.re-
aft. er ~
a~inis~ratiofi by the State of the Federal system, the State shall have the right to. terml-
hate this a~plication and agreement in accordance with the s~e rights sad pc~ers as the
Federal ~ncy ~erci~es i~ teminating the agre~ent between him and the Sis%e.
9. ~t, subject to the .aforesaid provisions and applicable law~ this application ~id
a~e~nt m~y Be teminated or ~ende.1 by the mutual consent of the ~rties in ~ritln~.
(T~ rOLLiNG FIi~lO~ TO BE M~E ONLY BY P~LIC AG~CIES WITH hMPLO~]ES IN P~ITiONS
CO~ BY A ~~ SY~, W~,RE .'SUCH ~O~ES ~E NOT TO RE E(CL~)ED ~ C,U,VFRAGF
~ T~ ~~ SY~ ~SU~ TO T~ T~ OF THIS ~PL~C~ION ~ AG~E~P: )
t0., That employees in positions cove:red by a retir~ent. system not excluded from
coverage ~der the Feleral system pursu~.t to the terns of this app!icat:ion and ag:reemertt
(shall)(shall not) continue to be covere:l ~mder the Federal sy::~'tem if t.hey become el:t[::k~]e
to be members o~ s~ch retirement system after the execution o;, this application anti ngy:~:,~::-
merit, subject to all provisions of Sec'tior~ 21b of the Social Securit::.y Act and FederaEk and
S+Ate re~lations adopted p~suant thereto.
11. ~ter the filing of this application, its acceptance ~',l e::~,cut, ion by the :Dtate
s~ll, constitute a binding agreement. between the Applicant and the S~.at,e of Calif'orr:xia
with respect to the mtters heroin set forth.
Si~ed ef ~~
~Officia! Name of t:~blic .~/.enq:y~
By
KAuth.::::,;:~ z ed Agent ~~e~k
ad By
(Tit.~e) MaWr
ST~E OF C~I~RNIA
BO~D OF ~INISTR.~ION {'$~IT fUN DUPLiZ~ATE)
BY
E~I~ OFFIC~
Rot, O~I 32n Rev, j (.9/57)