Resolution No. 1979 R % - c /y ED
\ , : °, - Q AU
• R NO. / 7 7 G 6 197
(To Accompany Application and Agreement) S. T P v D •
WHEREAS, a majority of the eligible employees of the SOUTH TAHOE PUBLIC
(Public
UTILITY DISTRICT , hereinafter designated as "Public Agency," who are mem-
Agency)
bers of and in positions covered by the MANUFACTURER'S LIFE INSURANCE COMPANY
(Retirement System)
at a referendum conducted in accordance with the provisions of Part 4, Division 5, of
Title 2 of the California Government Code, Section 218 of the Federal Social Security
Act, and regulations promulgated by the Board of Administration of the Public Employ-
ees' Retirement System, hereinafter referred to as "State," voted in favor of coverage
under the provisions of the old -age survivors, disability and health insurance system
established by the Federal Social Security Act; and
WHEREAS, the Public Agency desires to file an application with the State and to
enter into an agreement with the State to extend to such retirement system members
and to other eligible employees of the Public Agency in the same coverage group, as
defined in Section 218(d)(4) of the Federal Social Security Act, coverage under the
said insurance system on behalf of the Public Agency; and
WHEREAS, official form "Application and Agreement, Ret. SS 32R" 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 offi-
cial form be executed on behalf of the Public Agency and submitted to the State to
provide coverage under the California State Social Security Agreement of March 9,
1951, of all services performed by employees of the Applicant in a coverage group
(as defined in Section 218(d)(4) of the Social Security Act) of the MANUFACTURER'S
(Name
LIFE INSURANCE COMPANY except the following:
of Retirement System)
4 11 , " SSD -33R (12/74) Resolution (Retirement System Coverage Group)
� y
-2-
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 Applicant as indicated in Resolution
No. 1955 adopted at a meeting of the HOARD OF DIRECTORS
the 15th day of MAY 1975 :
All services in any class or classes of elective
legislative positions
Effective date of coverage of services under said agreement to be: January 1
197
BE IT FURTHER RESOLVED, That DAVID W. CALLAHAN
(Name)
1275 MEADOW CREST
GENERAL MANAGER , SOUTH LAKE TAHOE. CA
(Title of Position) (Address of Public Agency)
be and he is hereby authorized and directed to execute said application and agree-
ment 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 appli-
cable Federal and State laws, rules and regulations, is vested in the position of
GENERAL MANAGER
(Title of Position)
ona H. ortes , re 1 ent
SUBMIT IN DUPLICATE SOUTH TAHOE PUBLIC UTILITY DISTRICT
David W. Callahan, Clerk & Ex- officio
Secretary of the Board
SSD -33R (lilp3I)TH TAHOE PUBLIC UTILITY DISTRICT
iheo RESOLUTION CERTIFICATION
PERS- SSD -33C Rev. 6 (3/75)
MARY D. PARSLEY Deputy Clerk
(Title)
of the SOUTH TAHOE PUBLIC UTILITY DISTRICT , State of California, do hereby certify
the foregoing to be a full, true, and correct copy of Resolution No. 777
adopted by the BOARD OF DIRECTORS
of the SOUTH TAHOE PUBLIC UrIL1TY DISTRICT at the regular /special meeting held on
the 18th day of September , 19 75 , as the same
appears of record in my office.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the Seal of said
South Tahoe Public Utility District at my office this 19th day of
September , 19 75 .
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; S gnature
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