HomeMy WebLinkAboutRES 79-517 -LZRESOLUTIONNo.79-5
( To Accompany Application and Agreement
For Social Security Coverage)
WHEREAS,the City o f Apache Junction,Arizona •,hereinafter
(Name of Political Subdivision)
designated the Political Subdivision,through its City Council
(Governing Body)
desires to make formal application to the Arizona State Retirement System Board,
hereinafter designated the State Agency for inclusion of its eligible employees for
whom coverage is requested in the agreement dated June 29,1951 between the State
and the Federal Security Administrator for the coverage of Such eligible employees
under the insurance system established by Title II of the Federal Social Security Act,
as amended and implemented by Title 38,Chapter 5,A. R. S.; and
WHEREAS,the Political Subdivision desires to file such an application with
the Arizona State Retirement System Board and to enter into an agreement with the
State. Agency containing terms and conditions whereby the State Agency will take the
necessary steps to extend to such eligible employees coverage under the said
insurance system on behalf of the Political Subdivision;and
WHEREAS,a form of application and agreement between the State Agency, and
the Political Subdivision containing the terms and conditions for the inclusion by the
State Agency. of the said eligible employees for whom coverage is requested under the
coverage of said insurance system on behalf of the Political Subdivision has been
submitted to this body for consideration and action;
NOW,THEREFORE,BE IT RESOLVED that the Political Subdivision execute the
aforesaid application and that the State Agency be,and it is hereby requested to include
all said eligible employees of the Political Subdivision for whom coverage is requested
in the agreement between the State and the Federal Security Administrator for the coverage
of said employees under the insurance system established by Title II of the Federal
Social Security Act,as amended or as may hereafter be amended; and
BE IT FURTHER RESOLVED,that for the purpose of said application and
agreement the Mayor ,be,and he hereby is,
(Title of Authorized Agent)
• designated as the Authorized Agent of the Political Subdivision and is hereby authorized
and directed to execute said application and agreement,as submitted,on behalf of the
Political Subdivision and to forward the same to the State Agency for acceptance and
further action; and
BE IT FURTHER RESOLVED,that said Authorized Agent is further authorized
and directed as the representative of the Political Subdivision to conduct all negotiations,
conclude all arrangements and sign all agreements and instruments which may be
necessary to carry out the letter and intent of the aforesaid application and agreement
and in conformity with all applicable Federal and State laws,rules and regulations.
Isabel C.Ballard ,Clerk/Secretary of the
City o f Apache Junction ,State of Arizona,do hereby
certify the foregoing to be a full,true and correct copy of the resolution adopted by
the City Council of the City of Aparhp Junrtion
at a regular/special meeting held on the 21st day of February ,19 79 ,as the
same appears on record in my office:•_
IN WITNESS WHEREOF,i have hereunto set my hand and Affixed the seal of
said City of Apache Jct.at my office this 22nd day of February,
( Clerk/Secretary)
,is 79 ,
SUBMIT IN DUPLICATE Revised 1-15-71
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APPLICATION AND AGREEMENT
FOR SOCIAL SECURITY COVERAGE
The City o f Apache Junction,Arizona ,a political subdivision
(Name of Political Subdivision)
as defined in Article 13,Section 7,Constitution of Arizona,hereinafter called Applicant,
in accordance with a duly adopted resolution of its City Council
(Governing Body)
a certified copy of which is attached hereto and incorporated by reference herein,hereby
makes application to the Arizona State Retirement System Board,hereinafter called the
State Agency,to include all services performed by each of the eligible employees of
Applicant for whom coverage is requested hereinunder the old -age,survivor's,disability,
and health insurance system established by Title II of the Federal Social Security Act,a s
amended,in conformity with Section 218 thereof (42 U.S.C. A.,S 418)and implemented
by Title 38,Chapter 5,Article I.,A.R.S. ,and applicable Federal and State regulations
thereunder.
In order to carry into effect the common governmental duties -under Title 38,Applicant
agrees -to be bound by the following terms and conditions in consideration of the agreement
dated June 29,1951 between the Federal Security Administrator and the State of Arizona;
and the State Agency agrees to take the necessary steps to extend the old -age,survivors,
disability,and health insurance system to cover the said employees of the Applicant:
1.Applicant hereby requests that all services of each of its eligible employees
within the following coverage groups(s)as _defined in Section 218(b)(5)1 /of the said
Federal Social Security Act,be included in the saiil insurance system coverage:
Insert in the space provided below the appropriate coverage group,either A or B or
both,as desired.Use the exact language.Read attached "Definitions",Paragraph B.,
items 1 and 2,for an explanation of governmental and proprietary functions as used in
this agreement.
(A)employees other than those engaged in performing services in connection with
a proprietary function.-(Governmental)
p): employees engaged in performing services in connection with a proprietary
function..
la)employees Other than those engaged in performing services in *connection with_a proprietary function.(Governmental)
(B) employees engaged in performing sery,lces in connection with a proprietary
function.
2.Applicant will comply promptly and completely,throughout the terms of this
application and agreement,with the letter and intent of Title 38,Chapter 5,Article 1,
A. R. S.',and Section 218 -of the Federal Social Security Act and applicable Federal and
State regulations adopted pursuant thereto.
3.This application and agreement includes all services performed by each of the
eligible employees of the Applicant -for whom coverage i s requested,except the following:
(a)Any service performed by an employee in a position,which,on the effective date
of this agreement,is covered by a retirement system,
(b)Service performed by an employee who is employed to relieve him from
unemployment,
(c)Service performed in a home,hospital or other institution by a patient or an
inmate thereof,
(d)Covered transportation service (as defined in Section 210(a)of the Social Security
Act,as amended),
(e)Service (other than agricultural labor or service performed by a student) which
Is excluded from employment by any provision of Section 210(a) of the Social Security
Act,as amended,other than paragraph 8 of such section,and
(f)Service of an emergency nature performed on and after January 1,1968.
Provided,however,that in addition to the above exceptions as enumerated herein,the,
.following shall also be excepted from the inclusion of services performed by employees
of the Applicant:
Please write in full in the space provided below any one or more of the following
exceptions you wish to make.Read attached "Definitions",Paragraph C.,items 1
through 6,for explanation of these exceptions.If no exceptions,write in the words
"No exceptions".
•(A)all work in any class or classes of elective positions,
(B)all work in any class or classes of part-time positions,
(C)all Work in any class or classes of positions the compensation for Which is on
fee basis,i.e..,employees compensated in part by salary and in part by fees,
(D)agricultural labor if the -work would be excluded if done for a private. employer,
(E)work done by a student if the work would be excluded if done for a private employer.
r13)all work in any class or classes of part-time positions.
(C) all work in any class or classes of positions the compensation for which is on
ft fee basis,i.e. ,employees compensated in part by salary and in part -by fees.
(D) agricultural labor if the work would be excluded if done for a private employer,
(E) work done by a student if the work would be excluded if done for a private employer.
(F) services performed by election officials or election workers if remuneration paid-
in a calendar quarter is less than $50.41)7
4.That Applicant will pay. the Arizona State Retirement 'System Board amounts
equivalent to the sums of taxes (employer -employee contributions) imposed by Sections
*3101 and 311'l of the Internal Revenue -Code of 1954 with 'respect to all the services of
each of the eligible employees covered by this application and agreement,such further sums
a s shall cover Applicant's pro rata share of the cost of administering the provisions of
Title 38,Chapter 5,Article 1,A. R.S. ,in such amounts and at such times as -shall be
--determined by the regulations of the •Arizona -State Retirement System Board.••--•-
:....That Applicant .shall prepare and submit such wage and other reports to the .•-.:.
Arizona State Retirement System Board as may be required from time to time by the.•
,State Agency.•
.6..That Applicant, shall pay to the Arizona State Retirement System Board any sums ._.
ormoney that the State may be obligated.tapay or forfeit to the Federal Government by
reason of any delinquency or default of the Applicant in paying the contributions a s
required herein w.hen due.or.in making such wage reports as required pursuant to this ,.
application and agreement.•
7.That the_ coverage as herein :provided for all services of each of the eligible
employees of the Applicant shall be effective as of Februay ,19 7%and this
agreement shall continue until terminated as provided herein.
8.That the State Agency or the Applicant,in conformity with the rules and
regulations of the State Agency and the Secretary of Health,Education,and Welfare,
shall have the right to terminate this application and agreement upon giving at least two
years'advance notice in writing to the other party,effective at the end of a calendar
quarter specified in the notice,provided,however,that the application and agreement
must have been in effect not less than five years prior to receipt of such notice,and
provided further,that if. the Secretary of Health,Education,and Welfare should
terminate the agreement between the Secretary of Health,Education,and Welfare and
the State for the administration by the State of Section 218 of the Social Security Act,as
amended,the State shall have the right to terminate this application and agreement in
accordance with the same rights and -powers as the Secretary of Health,Education,and
Welfare exercises in terminating the agreement between him and the State.
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•9.That,subject to the aforesaid provisions and applicable law,this application and
agreement may be terminated or amended by the mutual consent of the parties in writing..
10.After filing of this application,its acceptance and execution by the AriEona State
Retirement System Board shall constitute a binding agreement between the Applicant and
the Arizona State .Retirement System Board with respect to the matters herein set forth.
11.That for.the purpose of this agreement the Ma,yoi
(Title of Authorized Agent),
P.O. Box 829, Apache Junction, Arizona 85220 ,i s hereby designated
(Address)
as the duly authorized representative of the political subdivision,and is authorized and
directed to conduct all negotiations,conclude all arrangements,sign all supplemental
agreements and instruments which may be necessary to carry out the letter and intent of
the agreement in conformity with all applicable Federal and State laws,rules and
regulations.
This agreement is to apply,upon being entered into,to approximately 4 employees:
(Number)•
ACCEPTED .a /9q/
,(Dale ).
Arizona State Retirement System Board
B y
Signed City Of Apache Junction,Arizona
(Official Name of Political Subdivision)
B y
Title
AdminOtrator,:-AriZona State Retirement System
Social Security Division
7 (Signature)
Mayor
Revised 11.-1-74
Submit in Duplicate.Both copies of this agreement should be signed by the authorized
agent designated in the resolution.,