84-302 WHITE - CITV CLERK
PINK - FINANCE GITY OF SAINT PAUL Council
CANARV - DEPARTMENT JJ��,
BLUE - MAVOR File �O• � �� "
1
Counci esolution
Presented By �
Referred To Committee: Date
Out of Committee By Date
BE IT RESOLVED, That the City of Saint Paul enter into an
agreement with the State of Minnesota, Department of Public Safety
for the following purpose :
To receive from the State of Minnesota, Department of
Public Safety, an Intoxilyzer 5000 breath test instrument
and breath alcohol simulator on a loan basis . The
instruments are to be used by law enforcement officers
to assist them in the detection of motorists who may be
in violation of Minnesota Statutes Section 169. 121 , or
other Minnesota laws or local ordinances or other law
enforcement purposes .
BE IT FURTHER RESOLVED, That the Ma.yor and Director of Finance
be and they hereby are authorized to execute such agreement .
COUNCILMEN Requested by Department of:
Yeas Nays ��
Fletcher
Galles In Favor
Masanz
Nicosia L�i, � /�-u/1�t/
eetie�� _�__ A gai n s t BY �'r��
Tedesco
W ilson
� "6 1984 For Approved y C' ey
Adopted by Council: Date
c
Certified a-s d y Council et BY �
By
A�ppro d y Mavor: Date � 7 �� p►pprove Mayor for Submission to C uncil
� By �� � �
�
pUBL{SHED MAR 17 1984
'� � . Gr/= �'y 30�
Police DEPARTh1ENT
Lt. Thomas L. Redina r.ONTACT
2g2-3500 PHONE ���� �(� ,
February 22, 1984 DATE �
(Routing and Explanation Sheet)
Assign Number for Routin Order (Clip Al1 Locations for Maydral Signature):
1 Department Director
Ci ty Attorney RECEtVED
2 Director of Management/Mayor ,
3 Fi nanEe and Management Servi ces Di rector �EB Z 3 19a4
Ci ty Cl erk MAYOR'S OFFICE
Budget Director
What Will be Achieved by iaking Action on the Attached Materials? (Purpose/Rationale):
Agreement for the loan of Intoxilyzer 5000 evidentiai breath alcohol test instruments
from the State of Minnesota.
Financial , Budgetary and Personnel Ir�acts Anticipated:
Instrument purchased by State of Minnesota, Department of Public Safety, with money
from a federal highway and traffic safety grant and from a State of Minnesota Legis-
lative appropriation of matching funds.
Funding Source and Fund Activity Nun�er Charged or Credited:
Naintain instrument in proper operating condition and supply all disposable components.
Attachments (List and Nur�er all Attachments1 :
Four (4) Copies of Agreement
Council Resolution
UEPARTMENT REVIEW CITY ATTORNEY REVIEW
X Yes No Council Resolution Required? Resolution Required? Yes No
Yes X No Insurance Required? Insurance Sufficient? Yes _ No
Yes No Insurance Attached?
Revision of October, 1982
(See Reverse Side for �Instructions)
. �
• • . , �
HOW TO USE THE GREEN SHEET �
The GREEN SHEET has several purposes:
1. To assist in routin documents and in securing
required signatures
2 . To brief the reviewers of documents on the impacts
of approval
3. To help ensure that r.ecessary supportinQ materials
are prepared and, if required, attached.
ROUTING . .
�ost GREEV SHE�T acti�ns must �e rev_e�aea Sy a Je�ar::�eat
�irec�or, �;�e City �z�orney, t:�e Director o* i�ianageme:�t, �he
Director of Finance and Management Services. Other possible
reviewers/signatures are listed.
BRIEFING �
. N1�st of the GREEN SHEET headings are designed to assist in
developing a precis of the decision which the attachments
represent. The headings are offered to remind users of some
of the more critical elements of this brief. .
The Financial, Budqetary and Personnel ImAacts heading provides
a space to explain the cost/benef it aspects of the decision.
Costs and benefits relate both to City budget (General Fund and/or
Special Funds) and to broader financial impacts (cost to users,
homeowners or other groups affect�d by the action) . The personnel
impact is a description of change or shift of Full-Time Equivalent
(FTE) positions. �
SJPPORTING MATERIALS
In the Attachments section, list all attachments. If the GREEN
SHEET is well done, no letter of transmittal need be included
(unless signing such a letter is one of the requested actions) .
Note: Actions which require Citx Council resolutions include:
a. Contractual relationship with another government unit.
b. Collective bargaining.
c. Purchase or sale of land, or lease of land. "
d. Issuance of bonds by City.
e. Eminent domain.
f. Assumption of liability by City, or granting
by City of indemnification.
g. Agreements with State or Federal Government
under which they are providing funding.
Note also: If an agreement requires evidence of insurance/co-
insurance, a Certificate of Insurance should be one
� • of the attachments at time of routing.
. . . � �r- ��`30�
BUREAU OF CRIMINAL APPREHENSION ��,�
1246 UNIVERSITY AVENUE
ST. PAUL, MINNESOTA 55104-4197 �
T E L E P H O N E: 296-2882
� '
STATE OF MINNESOTA
DEPARTMENT OF PUBLIC SAFETY
February 14, 1984
William McCutcheon, Chief
St. Paul Police Department
101 East Tenth Street
St. Paul , MN 55101
Dear Chief McCutcheon,
Enclosed you will find five copies of the agreement for the lend-lease of an
Intoxilyzer 5000, copies of a sample resolution, and if applicable forms and
information relating to old Breathalyzer equipment. This agreement is the
mechanism through which we will be able to place a new infrared breath testing
instrument and simulator with your law enforcement agency.
These instruments have been purchased with money from a federal highway and
traffic safety grant and from a State of Minnesota Legislative appropriation
of matching funds. We are distributing the testing instruments in a manner
similar to the program under which we have in the past distributed preliminary
breath test instruments.
To complete this paperwork, your county board or city council will first
need to pass a resolution similar to the sample resolution provided. Once
this is done the remainder of the agreement can be completed. Instructions
on the sample resolution and agreement are also enclosed.
It is our hope that you will find this approach to providing breath testing
equipment agreeable. If you have questions about the paperwork or the
equipment, please contact our 6reath Testing Section at 612-296-7940. We
are prepared to assist you in any manner necessary to complete the process.
Sincerely,
C,���� �
���-�
Lowell C. Van Berkom
Forensic Laboratory Director
AN EQUAL OPPORTUNITY EMPLOYER
, . • �,e ��-:30�
MINNESOTA DEPARTMENT ADMINISTRATION
OF PUBLIC SAFETY Transportation Building
PHONE:
�
AN EQUAL OPPORTUNITY EMPLOVER
SAINT PAUL ■ 55155
February 8, 1984
A1 Olson
City Clerk
101 E. Tenth St.
St. Paul, MN 55101
Dear Mr. Olson:
The equipment described on the Status Change Form has been declared
obsolete for the following reasons: 1.) Breathalyzers will be de-
certified for use in Minnesota upon delivery of new infra-red equip-
ment; 2.) the equipment has no further use value in this state; 3.)
the current market value of the equipment is less than $1,000.
In order to close our file on the equipment, we have prepared two (2)
copies of the Status Change Form. Please sign both copies of the
attached forms. RETAIN ONE COPY FOR YOUR RECORDS. Since these records
are subject to audit, it is required that they be retained for a period •
of three (3) years after disposal of any equipment to which they pertain.
Return the second copy to:
Office of Traffic Safety
Department of Public Safety
Room 207 Transportation Bldg.
St. Paul, MN 55155
Attn: Sally Bly
Upon receipt of this signed form we will remove the equipment from the
Federal Inventory. This procedure is necessary to effect compliance
with Federal Management Regulation criteria.
Any questions concerning this correspondence may be directed to Sally Bly,
Office of Traffic Safety, State Transportation Bldg. , St. Paul, MN 55155 -
Phone 612/296-6953.
We appreciate your continued cooperation and involvement in the traffic
safety area.
Sincere ,
.
Thomas A. Boerner
Director, Traffic Safety
cc: Lowell Van Berkom - CAD
_ . . . _ __ . .... _ ._ .. ._ ..._....
_._.._... . _. . ... .... . .... . _ ._
� • � ' . STATUS CHAI�GE FOR FEDERAL_LY FUNDED PROPrER�T`1 �� �y`30�
Retum to: Minnesota Department of Public Safety Reference:
, Office of Traffic Safety Equipment: Breathalyzer
207 Transpoztation Building 0920303
St. Paul, I�IIJ, 55155 Serial No.
Phone: (612) 296-6953 Make or Model: Stephenson Model 900A
Governmental Agency Address:
Inventory No.
City of St. Paul 12-11-72
Date Acquired:
101 E. Tenth St.
St. Paul, MN 55101 Federal Fuads: $387.50 or 50 �
Recipient Contribution: $387.50 or 50 � '
Total Acquisition Cost $��5.00
Check item or fill in appropriate blank. 842
1. Property status: File No. �
�Status chan�e occurzed Complete 7 through 10 below only if
❑ Request fcr status chanRe disposition or exchange has taken place.
Also furnish relevant. documentation.
2. Are you currently in possession of :the property
7. Date of Transactioa: N/A
�Yes ❑No g. Amount •Received:
3. Di�osition or recoimnended dispositfon: Cash $ N/A
❑Sold
p Trade-in Trade-In Allowance
Q Reassigned to new highway safety azea S N/A
p Transferred to a different agency g. New Owner of E ui ment:
O Lost or abandoned 9 P
p Stolen N/A
p Destroyed
❑Damaged
j�Obsolete, surplus or junked 10. Give details of property disposition
p Other below (use zeverse side if necessary) :
�. Condition of Property:
�Poor NOTE: Thi s equipment wi l_1 be
p Fair removed by BCA.
❑ Good - Also, the federal interest
❑ Excellent has ceased and no further
obligation exists.
�. Value of Property:
$ -0- Current Market Value
' -0- Salvage Value
. How was value determined?
The state of the art_is such, that the above mentioned eQUipment
is obsolete and has �no further use value.
CERTIFICATION
hereby certify to the above propertp disposition or proposed disposition.
�thozized Custodian Authorized Agency Signature
:ficial Title Official Title
3te Date '
. . . .. . _ ,_._ . . .:.. _... ......._.... _._.......
. .., .... _ _ .:.
`" ! ' . STATUS CHAICGE FOR FEDERALLY FUNDED PROPE T�"� �r �� `3�a
Return to: Minnesota Department of Public Safety Reference:
, Office of Traffic Safety Equipment: Breathalyzer
207 Transportation Building Serial No. 0920303
St. Paul, I�W, 55155
Phone: (612) 296-6953 Make or Model: Stephenson Model 900A
Governmental Agency Address:
Inventory No.
City of St. Paul 12-11-72
101 E. Tenth St. Date Acquired:
St. Paul, MN 55101 Federal Funds: $387.50 or 50 �
Recipieat Contribution: $387.50 or 50 � '
Total Acquisition Cost $��5.00
�heck item or fill in appropriate blank. >
File No. • 842
l. Property status: t
�Status chan�e occurred Complete 7 through 10 below only if
❑ Request for status chanRe disposition or exchange has taken place.
Also furnish relevant. documentation.
�. Are you currently in possession of :the property
7. Date of Transaction: N/A
�Yes ❑No
8. Amount •Received:
3. Di�ositfon or recoaanended dispositfon: �sh $ N/A
❑Sold
Q Trade-in Trade-In Allowaace
p Reassigned to new highway safety area S N/A
Q Transferred to a different agency 9. New O�mer of Equipment•
p Lost or abandoned N/A •
p Stolen
p Destroyed
❑Damaged
�Obsolete, surplus or junked 10. Give details of property disposition
Q Other below (use reverse �ide if necessary) :
�. Condition of Pro�erty:
�Poor NOTE: This equipment wil_1 be
p Fair removed by BCT�.
Q Good Also, the federal interest
❑ Excellent has ceased and no further
obligation exists.
. Value of Property:
S -0- Current Market Value
' -0- Salvage Value
. How was value determined?
The state of the art is such, that the above mentioned eQUipmen
is obsolete and has no further use value.
CERTIFICATION
hereby certify to the above pzoperty disposition or proposed disposition.
�thorized Custodian Authorized Agency Signature
:ficial Title Official Title
3te Date �
_ _::_ .. . ..... ._ .. . . . . . ..� ..... _ _ . _:.:.. _.:
. . _ . .. :: . .. _. . . . .: . . .
• �� �- • . STATUS CHAI6GE FOR FEDERALLY FUNDED �PE� �F �� `3��
Return �to: Minnesata Department of Public Safety Reference:
_ Office of Traffic Safety Equipment: Breathalyzer
207 Transportation Building Serial No. 0920259
St. Paul, I�1, 55155
Phone: (612) 296-6953 Make or Model: Stephenson Model 900A
GcKernaental Agency Address:
Inventory No.
City of St. Paul
101 E. Tenth St. Date Acquired: 12-11-72
St. Paul, IrIN 55101 Federal Funds: $387.50 or 50 �
Recipient Contribution: $387.50 or 50 �
Total Acquisition Cost $��5.00
�heck item oz fill in appropriate blank.
1. Property status: File No. � 843
�Status chan�e occurred Complete 7 through 10 below only if
disposition or exchange has taken place.
❑ Request for status chanRe Also furnish relevant. documentation.
2. Are you currently in possession of :the preperty
7. Date of Transaction: N/A
�Yes ❑No g. Amount .Received:
3. Disposition or recoffinended dispositfon: �sh $ N/A
❑Sold
p Trade-ia Trade-In Allowance
p Reassigned to new highway safety area S N/A
p Transferred to a different agency 9. New Owner of Equipment:
17 Lost oz abandoned
O Stolen N/A
❑Destroyed
p Damaged
�Obsolete, surplus or junked 10. Give details of property disposition
p Other below (use reverse side if necessary) :
+. Condition of Property:
Q�Poor NOTE: Thi s equipment F�i].1 be
Q Fair removed by BCA.
Q Good Also, the federal interest
p Excellent has ceased and no further
obligation exists.
�. Value of Property:
S -0- Curreat Market Value
" -0- Salvage Value
�. How was value determined?
The state of the art is such, that the above mentioned eauipment
is obsolete and has no further use value.
� -CERTIFICATION
hereby certify to the above property disposition or proposed disposition.
�thorized Custodian Authorized Agency Signature
ficial Title Official Title
�t� Date �
. .. ..._. .<... . .... ,:.., ..... _::. _
_. . _ . . .:.. . _. .... . . ..:. . .. .. ._. .. .. . . .
� .� � � • . STAT�JS CHAhGE FOR FEDERAL.I„�,�Y Fl7NDED PROPE� �� �� 3�
Return to: Minnesota Department of Public Safety Reference:
, Office of Traffic Safety Equipment: Breathalyzer
207 Transportation Buildiag 0920259
St. Paul, l�T, 55155 Serial No.
Phone: (612) 296-6953 Make or Model: Stephenson Model 900A
Gc�ernmental Agency Address:
City of St. Paul
Inventory No.
101 E. Tenth St.
Date Acquired: 12-11-72
St. Paul, MN 55101 Federal Funds: $387.50 or 50 �
Recipient Contribution: $387.50 or 50 � '
Total Acquisition Cost $��5.00
�heck item or fill in appropriate blank. ,
L. Property status: File No. • 843 �
� Status chan�e occurred Complete 7 through 10 below only if
❑ Request for status chanRe disposition or exchange has taken place.
Also furnish relevant. documentation.
?. Aze you currently in possession of :the property �. Date of Transactioa: N/A
�Yes ❑No
8. Amount .Received:
3. Disposition or recommended dispositfon• '
Cash $ N/A
p Sold
p Tzade-in Trade-In Allowance
Q Reassigned to new highway safety area S N/A
p Transferred to a different agency 9. New Owner of E ui ment•
O Lost or abandoned 9 P •
p Stolen N/A
�Destroyed
Q Damaged
�Obsolete, surplus or junked 10. Give details of property disposition
O Other below (use reverse side if aecessary) :
. Condition of Property:
�Poor NOTE: Thi s equipment wi].1 be
❑Fair removed by BC�,.
Q Good Also, the federal interest
p Excellent has ceased and no further
obligation exists.
. Value of Property:
S -0- Current Market Value
� -0- Salvage Value
. �iow was value determined?
The state of the art is such, that the above mentioned ecruipment
is obsolete and has no further use value.
� -CERTIFICATION
hereby certify to the above propertp disvosition or proposed dieposition.
�thorized Custodian Authorized Agency Signature
�ficial Title Official Title
�te Date �
. � � ' � � �.� �1L3o�
INSTRUCTIONS FOR INTOXILYZER 5000 LEND-LEASE AGREEMENT
The agreement must be completed in quintuplicate (5 copies). Five certified
copies of the resolution passed by the governing body of the local government
must be included.
THE RESOLUTION: there are two forms of sample resolution, one for cities and
one for counties. Other types of local jurisdiction such as a joint police
commission will have to devise a resolution based on the wording of these
two samples. The essential points that must be contained in the resolution
are:
1 ) to empower the local government to enter into agreement with the
State according to the terms of the agreement.
2) to designate at least one and preferably two officials to execute
the agreement. More than two may be designated if desired.
Lines nine and ten of the sample resolution contain two blank lines which
should be filled with the titles of the officials designated to execute the
agreement. Names of specific individuals should be avoided. For a city
government recipient it would be most practical if the officials designated
were the city clerk and the chief of police. For a county government recipient
the county auditor and sheriff would be most practical. These officials are
suggested because the annual certification statements are usually sent to
a city clerk or county auditor and because the instruments will usually be
sited in a police department or sheriff's office.
THE AGREEMENT: once the resolution has been passed, the designated officials
titles should be entered on the "title" lines of the RECIPIENT sign-off section
on the left hand column of page three and again on the blanks in the next �
to the last line of page three. These officials may sign the "BY" lines
of the sign-off section.
FEDERAL GRANT EQUIPMENT: if equipment is to be ceded to the state that was
purchased with federal grant money, this agreement will be accompanied by a
packet of information and forms which must be executed. These documents
should be returned with the signed agreements and certified copies of the
resolution.
Once the State of Minnesota officials have signed off the applicable sections
of the agreement, a copy of the completed document will be returned to the
city clerk or county auditor or in the case of other jurisdictions, the
appropriate official designated to maintain the jurisdiction' s records and
a second copy will be sent to the law enforcement agency where the instrument
is located.
The completed documents should be returned to:
Bureau of Criminal Apprehension Laboratory
Breath Test Section
1246 University Avenue
St. Paul , Minnesota 55104
Questions about the agreement or requests for assistance may be directed to
the Breath Test Section at the above address or by phone at 612-296-7940.