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1963/08/05 City Council Resolution 105MOLUTIOi? NO. /D.. (To Accompany Application an cement) U TIE EAS, a majority of the eligible employees for whom coverage is requested by the Mtv of 80p art ftrk herein - (Official Name of Public Agency) after designated "Public Agency," indicated at an election or elections, or by petition filed with. the Public Agency that they favor the Public Agency malting a formal applica- tion to the Board 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 State Social Security Agreement of March 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 WHEREAS, 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 California State Social Security Agreement; and WHEREAS, official form "Application and Agreement, Ret. -OASDI 32A" containing the terms and conditions under which the State will effect such inclusion has been examined by this body: NOW, THEREFORE, BE IT RESOLVED 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. Coverage Groups: (Check only one part): 1. Z]y All coverage groups, i.e., all eligible employees. 2. Ret. —OASDI 33A Rev. 7 (11 -58) 400 RESOLUTION (Other than Retirement System Members) -2- B. Excluded Services: 1. All services excluded from coverage under the agreement by Section 218 of the Social Security Act; and 2. Services excluded by option of the Public Agency (Check only one part): a. No optional exclusions desired L4I b. Service performed: Air service of aaa emergeaaey natures All services in any class or claws of elective legislative and/or elective judicial pwitionsg e All services in any class or class" tv -time positions; .d All services in any class or c2asses of positions the compensation tor vhi.ch Is on a fts bsridx (e) Agricultarel labor if ooh work ift1d be excluded if per; onned. for a private employer; (f) tSe�rvicee�Bertbzmed by a student if such , �d be excluded ii p+e1 i'Vxmed for a private employer. C. Effective Date of Covers e under Agreement: acts"r I , 19 62; BE IT FURTHER RESOLVED, That (Name) (title of Position (Address of Public Agency) be and he is hereby authorized and directed to execute said application and agreement on behalf of and as Authorized Agent of the Public Agency and to forward same to the State for acceptance and further action; and BE IT FURTHER RESOLVED, That authority hereafter to act as Authorized Agent, and so to conduct all negotiations, conclude all arrangements, submit all reports, and sign all agreements and instruments which may be necessary to carry out the letter and intent of the aforesaid application and agreement, in conformity with all applicable Federal and State laws, rules, and regulations, is vested in the position of -"(Title of Position) SUBMIT IN DUPLICATE Ret. -OASDI 33A Rev. 7 (11 -58) I, Clerk/ry of the State of California, do hereby certify the foregoing to be a full, true, and correct copy of Resolution No. adopted by the f ©f the at the regulars meeting held on the 5( day of , 19A�Lz, as the same appears of record in imy office. IN WITNESS WHEREOF, I have hereunto set my hand affixed. the Seal of said x:= , at my office this day of Clerk Seerety Ret. OASDI 33C Rev. 3 (10 -62) RESOLUTION CERTIFICATION 200