New Mexico Administrative Code
Title 1 - GENERAL GOVERNMENT ADMINISTRATION
Chapter 5 - PUBLIC PROPERTY PROCUREMENT AND MANAGEMENT
Part 22 - CHARITABLE USE OF REAL PROPERTY REGULATION: USE OF PROPERTY CONTROL DIVISION, REQUIREMENTS FOR CHARITABLE USE OF REAL PROPERTY
Section 1.5.22.10 - APPLICATION FORM
Current through Register Vol. 35, No. 6, March 26, 2024
Charitable Use of Property Control Division Land and Buildings
Name of Applicant: ___________________________________ (include names of all Professional Fundraisers to be used by applicant***)
Address: _________________________ Telephone: _________________
Town: ___________________________ Zip:______________
Name of Applicant's Agent or Representative: __________________________
Town: ___________________________ Zip: ______________
Telephone: _______________________
Applicant requests the Property Control Division, GSD, State of New Mexico authorize applicant's use of Division buildings and/or land, as follows:
1. Address of building(s) or land to be used*:
Street address: ____________________________________
City: _______________________________
2. Location(s)within the building to be used*:______________________________________________
3. Dates of use (not to exceed 30 consecutive calendar days): ___________________________________
___________________________________________________________________________________________
4. Time of day for the activities listed below: __________________________________________
5. Activities of Applicant (describe activities to be conducted in Division Buildings and/or land in detail)*:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
6. Purpose of activities (describe nature of applicant, if funds are raised or solicitations requested, list how funds are to be used, list non-profit incorporations, if any, IRS status, etc.)*: _____________________________
___________________________________________________________________________________________
7. If sales of product or service are involved in case of Division and/or Buildings, describe product** including origin and price*:
_____________________________________________________________________________________
_____________________________________________________________________________________
8. The requirements of the Charitable Organization and Solicitation Act:
____ do not apply to Applicant
____ do apply to Applicant, proof of compliance is attached***
Applicant hereby certifies that the foregoing information is correct, and agrees that the Property Control Division Director or his designee may, by advanced written notice, cancel this permission to conduct the above-listed activities or modify the times and places allowed for such activities.
Applicant further agrees to defend, indemnify and hold the Property Control Division and the State of New Mexico harmless from all actions, proceedings, claims, demands, costs, damages, attorney's fees and all other liabilities and expenses of any kind from any source which may arise out of applicant's use of the buildings or land described heretofore, unless caused by the tortuous act or omission of the State of New Mexico, its officials, employees or servants.
Applicant agrees to not interfere with the work functions of any (state) Agency in the buildings or on land in which applicant's activities are conducted, agrees to comply with all provisions of Regulation GSD 86-503 [now 1.5.22 NMAC], and further agrees that any such interference or violation of said regulation may result in immediate termination of the permission granted herein, at the option of the Director of the Property Control Division.
This application shall become the registration required under Regulation GSD 86-503, Section 6.2 [now Subsection B of 1.5.22.10 NMAC], only upon approval of the Property Control Division Director or his designee.
Applicant's Name: __________________________________________
By: __________________________________________
Name of Authorized Agent
Approved: Property Control Division
By: __________________________________________
* Continue on separate sheet if necessary and attach.
** If the product is food, the Director of the Property Control Division shall require proof of compliance with applicable Health Standards and may require proof of food purveyors and product liability insurance coverage in an amount acceptable to the Director.
*** Proof of compliance shall consist of a showing of filing and current compliance with the Act. Proof of compliance is required for each Professional Fundraiser (as defined in GSD 86-503, Section 4.9 [now Subsection I of 1.5.22.7 NMAC]) to be used by Applicant.
