HomeMy WebLinkAboutRES 85-429No Text
RESOLUTION APPROVING THE ISSUANCE OF
BEAUMONT HEALTH FACILITIES DEVELOPMENT CORPORATION
$4,200,000 MULTIPLE MODE DEMAND HEALTH FACILITY
DEVELOPMENT REVENUE BONDS ,
SERIES 1985
(PARK MEDICAL ASSOCIATES HEALTH FACILITY)
WHEREAS , by a duly adopted resolution of the City
Council (the "Governing Body" ) of the City of Beaumont ,
Texas (the "Sponsoring Entity") , the Governing Body
authorized and approved the creation of the Beaumont Health
Facilities Development Corporation (the "Corporation") as a
nonprofit corporation under the provisions of the Health
Facilities Development Corporation Act , as amended,
Art . 1528] of Vernon' s Annotated Texas Civil Statutes (the
"Act") ; and
WHEREAS , the Corporation on behalf of the Sponsoring
Entity is empowered to finance certain costs associated with
acquisition, construction, improvement , repair, renovation
and remodeling of certain health facilities in order to
improve the adequacy, cost and accessibility of health care,
research and education within the State of Texas and to
assist in the maintenance of the public health; and
WHEREAS , the definition of "health facility" in the Act
includes any real , personal or mixed property, or any
interest therein, the financing, refinancing, acquiring,
providing, constructing, enlarging, remodeling, renovating,
improvement , furnishing or equipping of which is found by
the Board of Directors of the Corporation to be required,
necessary or convenient for health care, research and
education regardless of whether such property is in
existence or is to be provided after the making of such
finding; and
WHEREAS, Park Medical Associates (the "User") has made
application for approval of a specific health facility to be
constructed within the boundaries of the Sponsoring Entity
and to consist , among other things , of the site and
facilities described in the Health Facility Description
attached hereto as Exhibit "A" (the "Health Facility") ; and
WHEREAS , the Corporation desires to sell and to provide
for the issuance and sale of its $4,200,000 Multiple Mode
Demand Health Facility Development Revenue Bonds , Series
1985 (Park Medical Associates Health Facility) (the "Bonds")
by adopting a Resolution in a form to be prescribed by the
Corporation (the "Resolution") ; and
, WHEREAS, Section 4. 03 of the Act requires that at least
fourteen (14) days prior to issuance of the Bonds , the
Corporation shall file with the Governing Body of the
Sponsoring Entity a full and complete description of the
Health Facility, including an explanation of the projected
costs of the Health Facility, the necessity for the Health
Facility, and the name of the User; and
WHEREAS , as a prerequisite to the exemption from
federal income tax of interest on obligations issued
pursuant to Section 103 (b) (6) of the Internal Revenue Code
of 1954, as amended (the "Code" ) , Section 103 (k) of the Code
provides that such issue may be approved by the applicable
elected representative of the governmental unit on whose
behalf such obligations are issued and by each governmental
jurisdiction over the area in which any facility to be
financed from the proceeds of such issue is located (except
that if more than one governmental unit has jurisdiction
over the entire area in which such facility is located, only
one governmental unit need approve the issue) , only after a
public hearing has been held; and
WHEREAS , the Sponsoring Entity is a "governmental unit"
within the meaning of the Code; and
WHEREAS, as the elected legislative body of the
governmental unit within which the entire Health Facility is
located, the Governing Body is an "applicable elected
representative" of the governmental unit with specific
authority within the meaning of Section 103 (k) of the Code;
and
WHEREAS , the Health Facility is located entirely within
the geographic jurisdiction of the Sponsoring Entity, thus
necessitating only one public hearing and approval pursuant
to Section 103 (k) of the Code; and
WHEREAS , in compliance with Section 103 (k) of the Code
and the Open Meetings Law, as amended, Art . 6252-17 of
Vernon' s Annotated Texas Civil Statutes , notice in writing
of a public hearing to approve issuance of the Bonds has
been published in a newspaper of general circulation in the
Sponsoring Entity on November 24, 1985 , and written notice
has also been posted continuously at City Hall since
December 6 , 1985 , and pursuant to such notice , the Governing
Body has this day held a public hearing for the purpose of
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considering the authorization and approval of the proposed
Health Facility and the issuance of the Bonds ; and
WHEREAS, this public hearing has been conducted in
order to provide an opportunity for persons with differing
views on both the authorization and issuance of the Bonds
and the location and nature of the Health Facility to be
heard, and in order to comply with Section 103 (k) of the
Code and the Act ;
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF
THE CITY OF BEAUMONT, TEXAS , THAT:
Section 1. The Governing Body hereby finds and
determines that the Health Facility proposed by the User
conforms with the overall objectives , authorizations , and
limitations specified in the Act .
Section 2 . The Governing Body finds that the proposed
Health Facility to be financed will significantly contribute
to the fulfillment of the overall development objectives of
the Sponsoring Entity , and that it is in furtherance of the
public purposes of the Act to assist in the maintenance of
the public health.
Section 3 . The Governing Body hereby finds and
determines that the Corporation has filed and deposited with
the Governing Body all of the information required by
Section 4. 03 of the Act , and on such basis hereby approves
the Health Facility after having made the determinations and
findings required by the Act .
Section 4. The issuance of the Bonds and the form of
Resolution to be adopted by the Corporation, pursuant to
which the Bonds are to be sold and issued, are hereby -
approved by the Governing Body on behalf of the Sponsoring
Entity as required by the Act and the Code.
Section 5 . As a part of and within the scope of the
approvals granted herein, the Governing Body hereby finds
and determines that (i) the initial owner and user of the
Health Facility is Park Medical Associates , a Texas general
partnership, (ii) the maximum aggregate face amount of the
Bonds to be issued with respect to the Health Facility is
$4,200 ,000 and (iii) the Health Facility Description
attached hereto as Exhibit "A" includes a general,
functional description and a general description of the
location of the Health Facility as required by the Code and
the regulations promulgated thereunder.
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Section 6 . This resolution is adopted for the purpose
of satisfying the conditions and requirements of the Act .
This resolution is also adopted for the purpose of
satisfying the conditions and requirements of Section 103 of
the Code, the regulations promulgated thereunder, and any
requirements for a public hearing and approval by an elected
official or legislature which may be imposed by applicable
law prior to the issuance of the Bonds , and for the benefit
of the Corporation, the Sponsoring Entity, the Governing
Body, and the owners or holders from time to time of the
obligations of the Corporation and all other interested
persons .
Section 7 . The Governing Body hereby finds and
determines that the issuance of the Bonds to finance the
Health Facility will accomplish the specific public purpose
for which the Corporation was created.
Section 8 . The approvals of the Governing Body as set
forth herein shall be applicable only if, as and to the
extent that the Bonds are issued not more than one year from
the date hereof.
Section 9 . There is hereby assigned and transferred to
the Corporation the amount of ceiling of private activity
bonds which is allocated to the Sponsoring Entity for the
Bonds and the Health Facility pursuant to the laws of the
State of Texas (including without limitation Art . 5190. 9 ,
House Bill 690, Acts of the 69th Legislature, Regular
Session, 1985) .
Section 10 . The Governing Body has considered evidence
of the publication and posting of notice of this meeting and
public hearing and officially finds , determines , recites ,
and declares that sufficient written and reasonable public
notice of the date, hour and place of this meeting and
public hearing and of the subject matter of this resolution,
including the general, functional description of the Health
Facility and the general description of its location, was
published in a newspaper of general circulation in the
Sponsoring Entity not less than fourteen (14) days prior to
this meeting and public hearing, and was also posted on a
bulletin board at a place convenient to the public in the
City Hall of the Governmental Unit (within the meaning of
Section 103 of the Code) not less than seventy-two (72)
hours preceding the convening of this meeting and public
hearing; that such place of posting was readily accessible
to the general public at all times from the time of posting
until the convening of such meeting and public hearing; that
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such meeting and public hearing were open to the public as
required by law at all times during which this resolution
and the subject matter hereof were discussed, considered,
and formally acted upon; that the giving of notice in the
manner provided above was reasonably designed to apprise
residents of the Sponsoring Entity of the proposed
authorization and issuance of the Bonds and approval of the
Health Facility; that the meeting and public hearing were
conducted in a manner that provided a reasonable opportunity
for persons with differing views on the issuance of the
Bonds and the nature and location of the Health Facility to
be heard; and that this meeting and public hearing were held
at a time and place convenient for persons affected by the
financing of the Health Facility and issuance of the Bonds ;
and that the foregoing notice and hearing complied with the
Open Meeting Law, as amended, Art . 6252-17 of Vernon' s
Annotated Texas Civil Statutes , and Section 103 (k) of the
Code and the regulations thereunder.
PASSED AND APPROVED this 10th day of December, 1985 .
r
Mayor, City of Beaumont , Texas
Exhibit "A" - Health Facility Description
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EXHIBIT "A"
Health Facility
The Health Facility to be financed with the proceeds of the
Bonds will involve (i) acquisition, construction and
improvement of a medical office building which will consist
of approximately 51,000 square feet , (ii) the lease of a
site for the Health Facility, and (iii) acquisition,
construction and installment of various items of equipment ,
facilities and furnishings which are functionally related
and subordinate to the foregoing.
Site of Health Facility
TRACT ONE
All of User' s leasehold interest in and to that certain
31,019 square foot tract located at the corner of Harrison
and 14th Streets in the City of Beaumont , Texas , and being
within Lot 30 of the J. B. Langham Estate Subdivision as
recorded in Volume 1, Page 200 of the Civil Minutes of the
Jefferson County' s 60th District Court ; said 31,019 square
foot tract being within a 5 . 0885 acre tract as described in
a deed recorded under Film Code No. 101-12-1384 of the
Jefferson County Deed Records ; and said 31,019 square foot
tract being within the Thomas H. Lewis Survey Abstract 16
and the D. J. 0. Millard Survey, Abstract 179 , and being
more particularly described by metes and bounds as follows :
COMMENCING AT AN "x-mark" in concrete found at the
southeast corner of the said 5 .0885 acre tract ;
THENCE South 88°37 '05" West along the south line of the
said 5 . 0885 acre tract , a distance of 65 . 00 feet to a
point for corner;
THENCE North 00°56 ' 10" West , a distance of 68 . 00 feet
to the southeast corner of the said 31 ,019 square foot
tract and the POINT OF BEGINNING:
THENCE South 88°37 ' 05" West , a distance of 35 . 00 feet
to an interior point for corner on the south line of
the said 31 ,019 square foot tract ;
THENCE South 01°22 ' 55" East , a distance of 18 . 00 feet
to a point for corner on the south line of the said
31 ,019 square foot tract ;
THENCE South 88 037 ' 05" West , a distance of 38 . 00 feet
to a point for corner on the south line of the said
31 ,019 square foot tract ;
THENCE North 01 022 ' 55" West , a distance of 18 . 00 feet
to an interior point on the south line of the said
31 ,019 square foot tract ;
THENCE South 88°37 ' 05" West , a distance of 122 .00 feet
to a point for the southwest corner of the said 31 ,019
square foot tract ;
THENCE North 01°22 ' 55" West , a distance of 150 . 00 feet
to a point for the northwest corner of the said 31 ,019
square foot tract ;
THENCE North 88°37 ' 05" East , a distance of 37 . 24 feet
to a point for corner on the north line of the said
31 ,019 square foot tract ;
THENCE North 58°37 ' 05" East , a distance of 15 . 99 feet
to a point for corner on the north line of the said
31 ,019 square foot tract ;
THENCE North 88°37 ' 05" East , a distance of 95 . 00 feet
to a point for corner on the north line of the said
31 ,019 square foot tract ;
THENCE South 01 022 ' 55" East , a distance of 18 . 00 feet
to an interior corner on the north line of the said
31 ,019 square foot tract ;
THENCE North 88 037 ' 05" East , a distance of 50 . 00 feet
to a point for the northeast corner of the said 31 ,019
square foot tract ;
THENCE South 00°56 ' 10" East , a distance of 60. 00 feet
to a point for interior corner on the east line of the
said 31 ,019 square foot tract ;
THENCE North 89°03 ' 50 East , a distance of 18 .00 feet
to a point for corner on the east line of the said
31 ,019 square foot tract ;
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THENCE South 00°56 ' 10" East , a distance of 38 .00 feet
to a point for corner on the east line of the said
31 ,019 square foot tract ;
THENCE South 89°03 '50" West , a distance of 18 . 00 feet
to an interior point for corner on the east line of the
said 31 ,019 square foot tract ;
THENCE South 00°56 ' 10" East , a distance of 42. 00 feet
to the POINT OF BEGINNING, and containing 31 ,019 square
feet of land.
TRACT TWO
All of the User' s right , title and interest in and to
that certain Parking Easement from Sisters of Charity of the
Incarnate Word, Houston, Texas , providing for up to 250
parking spaces incident to usage of the Health Facility .
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RESOLUTION OF BEAUMONT HEALTH FACILITIES DEVELOPMENT
CORPORATION AUTHORIZING ISSUANCE OF BONDS
AND APPROVAL OF DOCUMENTS
WHEREAS , the Health Facilities Development Act, Art.
1528] of Vernon' s Annotated Texas Civil Statutes , as amended
(the "Act") , authorizes and empowers the Beaumont Health
Facilities Development Corporation (the "Corporation") to
issue revenue bonds on behalf of the City of Beaumont, Texas
(the "Sponsoring Entity") , to finance certain costs asso-
ciated with the acquisition, construction, improvement ,
repair , renovation and remodeling of certain health
facilities determined by the Board of Directors of the
Corporation (the "Board") to be needed for the purpose of
improving the adequacy, cost and accessibility of health
care, research and education within the State of Texas and
to assist in the maintenance of the public health; and
WHEREAS, in accordance with the provisions of the Act,
on October 8 , 1985 , the Board adopted a certain Resolution
concerning Issuance of Bonds to Finance a Health Facility
for Park Medical Associates , a Texas general partnership
(the "User") , whereby the Corporation agreed to provide for
the financing of the cost of the User ' s health facility (the
"Health Facility") which is described in Exhibit "A" to said
Resolution; and
WHEREAS, for purposes of financing the cost of the
Health Facility, the Corporation now desires (i) to
authorize the issuance of its Multiple Mode Demand Health
Facility Development Revenue Bonds , Series 1985 (Park
Medical Associates Health Facility) (the "Bonds") , in the
maximum aggregate principal amount of $4 ,200 , 000 , pursuant
to the terms and provisions of a trust indenture, (ii) to
provide for the sale of the Bonds to the purchaser described
herein, (iii) to approve any placement memoranda, official
statements and any other documents used to market and
remarket the Bonds , (iv) to provide for the payment of the
principal of and premium, if any , and interest on the Bonds
with revenues derived from the loan of the proceeds of sale
of the Bonds to the User to finance the cost of the Health
Facility pursuant to the terms and provisions of a loan
agreement and from a letter of credit if one is obtained by
the User , and (v) to take and authorize certain other
actions in connection with the foregoing; and
WHEREAS , the Board is willing to adopt this resolution
and authorize the actions to be taken hereby in reliance
upon representations by the User that if the Bonds bear
interest at a variable or fixed rate , the User will (i)
enter into a remarketing and interest rate services
agreement with a bank or other financial institution whereby
the bank or institution will attempt to remarket any Bonds
which are put by the holders thereof and will establish
interest rates on the Bonds during variable rate periods ,
(ii) cause a bank or other institution to issue a letter of
credit or other credit enhancement facility to provide
additional security for payment of the Bonds and to enter
into a reimbursement agreement with respect thereto , and
(iii) if necessary, enter into a collateralization and loan
agreement with a bank or other financial institution whereby
the bank or institution will provide collateral security for
the letter of credit or other credit enhancement facility
and the User will agree to repay the bank or institution any
amounts which it advances with respect to the letter of
credit or other credit enhancement facility; and
WHEREAS , the Board has been presented with and has
examined proposed forms of a trust indenture , a loan
agreement, a note and a letter of representation, and the
Board finds that the form and substance of such documents
are satisfactory and the recitals and findings contained
therein are true , correct and complete and hereby adopts and
incorporates by reference such recitals and findings as if
set forth in full in this resolution, and finds that it is
in the best interest of the public and the Corporation and
assists in carrying out the public purposes of the
Corporation and of the Act to authorize the execution and
delivery of such documents ; and
WHEREAS , the Board has also been presented with and has
examined the proposed form of a guarantee agreement pursuant
to which each general partner of the User (collectively the
"Guarantors") will irrevocably and unconditionally guarantee
on a several , limited basis the prompt payment of all of the
User' s obligations under the proposed form of a loan
agreement , and the Board finds the form and substance of
such document is satisfactory, and that the agreements of
each Guarantor contained therein constitute a material
inducement to the Corporation to issue and sell the Bonds
and in reliance upon such agreements of the Guarantors , the
Board is willing to adopt this resolution and authorize the
actions to be taken hereby; and
WHEREAS, the Board has also been presented with and has
examined the proposed form of a deed of trust, security
agreement and assignment of rents and leasehold rights from
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the User to a mortgage trustee for the benefit of the
Corporation and the bank or other institution to be named
therein, and the Board finds the form and substance of such
document to be satisfactory; and
WHEREAS , on December 10 , 1985 , after a public hearing
as required by Section 103(k) of the Internal Revenue Code
of 1954 , as amended, and the applicable regulations
promulgated thereunder and in compliance with the Act , the
governing body of the Sponsoring Entity adopted a written
resolution specifically approving the Health Facility and
this resolution of the Corporation providing for issuance of
the Bonds ; and
WHEREAS , the Board finds that it is in the best
interest of the public and the Corporation and that it will
assist in carrying out the public purposes of the
Corporation and of the Act to authorize the execution and
delivery of the documents herein described;
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF
DIRECTORS OF THE BEAUMONT HEALTH FACILITIES DEVELOPMENT
CORPORATION THAT:
1 . The Corporation hereby authorizes and directs the
issuance of the Bonds in the maximum aggregate principal
amount of $4 ,200 ,000 , in accordance with a trust indenture
dated as of December 1 , 1985 (the "Indenture") , by and
between the Corporation and the trustee named therein (the
"Trustee") , and the President and any Vice-President of the
Corporation are hereby severally authorized and directed to
execute and deliver the Indenture and the Bonds on behalf of
the Corporation, and the Secretary or Assistant Secretary of
the Corporation is hereby authorized to attest and affix the
Corporation' s seal thereto , in such final form as may be
agreed upon by any such authorized officer , such execution,
duly attested by the Secretary or Assistant Secretary of the
Corporation to be conclusive evidence of the approval and
acceptance by the Corporation of the form and content
thereof.
2. The loan of the proceeds of the sale of the Bonds
by the Corporation to the User to provide financing for the
costs of acquiring and constructing the Health Facility
shall be effected pursuant to the terms and provisions of a
loan agreement dated as of December 1 , 1985 (the "Loan
Agreement") , by and between the Corporation and the User ,
and the President and any Vice-President of the Corporation
are hereby severally authorized and directed to execute and
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deliver the Loan Agreement on behalf of the Corporation, and
the Secretary or Assistant Secretary of the Corporation is
hereby authorized to attest and affix the Corporation' s seal
thereto in such final form as may be agreed upon by any such
authorized officer , such execution, duly attested by the
Secretary or Assistant Secretary of the Corporation to be
conclusive evidence of the approval and acceptance by the
Corporation of the form and content thereof.
3 . As a condition to the actions authorized in
paragraphs 1 and 2 of this resolution, the Guarantors shall
have each executed and delivered to the Trustee a guarantee
agreement substantially in the form of the Guarantee
Agreement dated as of December 1 , 1985 (collectively the
"Guarantee Agreements") , between each Guarantor and the
Trustee , and the User shall execute (or cause to be
executed) and there shall be in full force and effect at the
time of sale and delivery of the Bonds a Deed of Trust ,
Security Agreement and Assignment of Rents and Leasehold
Rights dated as of December 1 , 1985 (the "Mortgage") , from
the User to the mortgage trustee named therein, providing
further security for the payment of amounts due under the
Loan Agreement for the benefit of the Corporation, the
registered owners of the Bonds and the bank or other
institution to be named therein, all of which documents were
presented to the Board and the form, terms and provisions
thereof being hereby authorized and approved, and the
President and any Vice-President of the Corporation are
hereby authorized to approve and accept the final form of
such documents on behalf of the Corporation.
4 . The sale and delivery of the Bonds by the
Corporation to First City National Bank of Beaumont (the
"Initial Purchaser") is hereby authorized and approved.
5 . The actions and obligations authorized in para-
graphs 1 through 4 of this resolution shall be subject to
and conditioned upon receipt by the Corporation , on the date
of delivery of and payment for the Bonds (the "Closing
Date") , of (i) a Letter of Representation dated the Closing
Date (the "Letter of Representation") duly authorized and
executed by the User , and the President and any
Vice-President of the Corporation are hereby severally
authorized to signify the Corporation' s acceptance and
confirmation of such Letter of Representation by executing
the same on behalf of the Corporation in multiple
counterparts in such final form as may be agreed upon by any
such authorized officer , such execution to be conclusive
evidence of the approval and acceptance by the Corporation
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of the form and content thereof, (ii) an Investment Letter
dated the Closing Date (the "Investment Letter") duly
authorized and executed by the Initial Purchaser , and the
President and any Vice-President of the Corporation are
hereby severally authorized to approve the form, terms and
provisions of such Investment Letter on behalf of the
Corporation, such execution to be conclusive evidence of the
approval and acceptance by the Corporation of the form and
content thereof, (iii) the purchase price for the Bonds , and
(iv) such opinions , evidences , certificates , instruments or
other documents as shall be requested by the Corporation' s
counsel or by Bond Counsel to evidence due performance or
satisfaction by the User at or prior to such time of all
agreements then to be performed and all conditions then to
be satisfied.
6 . As a condition to the Bonds bearing interest at a
variable or fixed rate , the User will be required to (i)
enter into a remarketing and interest rate services rate
agreement with a bank or other financial institution whereby
the bank or institution will attempt to remarket any Bonds
which are put by the holders thereof and will establish
interest rates on the Bonds during variable rate periods ,
(ii) cause a bank or other institution to issue a letter of
credit or other credit enhancement facility to provide
additional security for payment of the Bonds and to enter
into a reimbursement agreement with respect thereto , and
(iii) if necessary , enter into a collateralization and loan
agreement with a bank or other financial institution whereby
the bank or institution will provide collateral security for
the letter of credit or other credit enhancement facility
and the User will agree to repay the bank or institution any
amount which it advances with respect to the Letter of
Credit or other credit enhancement facility, and the
President and any Vice-President of the Corporation are
hereby severally authorized to approve on behalf of the
Corporation any such remarketing and interest rate service
agreement , any such letter of credit or other credit
enhancement facility, any such reimbursement agreement , and
any such collateral ization and loan agreement, and the
President and any Vice-President of the Corporation are
further authorized to approve on behalf of the Corporation
any preliminary private placement memoranda, preliminary
official statements , final official statements , or other
offering documents , if any, presented to them or either of
them for use in connection with the marketing or remarketing
of the Bonds , and any person so authorized by the President
or any Vice-President may distribute such documents on
behalf of the Corporation.
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7 . The officers , employees and agents of the Corpor-
ation, and each of them, shall be and each is expressly
authorized, empowered and directed from time to time and at
any time to do and perform all acts and things and to
execute, acknowledge and deliver in the name and under the
corporate seal and on behalf of the Corporation all
certificates , financing statements , instruments and other
papers , whether or not herein mentioned, as they may
determine to be necessary or desirable in order to carry out
the terms and provisions of this resolution and of the Bonds
to be issued hereunder , as well as the terms and provisions
of the Indenture, the Loan Agreement , the Guarantee
Agreements , the Mortgage, the Letter of Representation, and
all other documents approved and authorized hereby, such
determination to be conclusively evidenced by the
performance of such acts and things and the execution of any
such certificate, financing statement, instrument or other
paper or document.
8 . Based upon representations made by the User to the
Board, the Board hereby affirmatively finds that the Health
Facility is needed to improve the adequacy, cost and
accessibility of health care in the City of Beaumont, Texas
and the surrounding areas and will assist in the maintenance
of the public heath.
9. This resolution shall take effect and be in full
force and effect upon and after its passage.
PASSED AND APPROVED this 10th day of December , 1985.
ATTEST: BEAUMONT HE H FACT IES
DEVEL P T RP
AA A.40
By:
Secretary Pr ent
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AFFIDAVIT
STATE OF TEXAS
COUNTY OF JEFFERSON
BEFORE ME, the undersigned authority, on this day
personally appeared 1]c.� who,
after being first duly sworn according to law , stated on oath
the following:
d
my
/�1/�•
(name) (relationship)
has a substantial interest, as defined by S.B. 1044 , ins
( name and description of busin ss entity)
a business entity that will be peculiarly affected by official
action of the City Council of the 11City of Beaumont in
connection with
escribe matter)
The nature and extent of his/her interest is as
follows: j� -- d-i✓ --e�c—e- �- --�
(describe interest)
ffiant
SWORD? TO,AND SUBSCRIBED before me this AW day of
,l @ e�rna ,'✓ , 19 8/ .
oz
?`• a` ,« 5". Notary Public, State of Texas