HomeMy WebLinkAbout6-a.2.a Asset Disposal AGENDA ITEM 6-a.2.a
REQUEST FOR SURPLUS DECLARATION AND/OR
ASSET DISPOSAL AUTHORIZATION
03/15/22
;Asset NumberT ;�
Description Acquired Date Cost Per Unit Book Valuel
{
i 6804 ICARRYALL ELECTRIC MAINTENANCE CART 06/24/2002 ? $ 4,855.50 I $ -
13439 Canon Imager Runner Color Printer/Copier Skyrim t 12/08/2011 $ 5;913.00 $ -
L 13508 Canon Imagerunner Advance 6500 SN HTT24997 06/01/2012 ..__ 1 $ 8,300.00 i $
ro
a)
a
0
z
Na)
I.f�
Clay County Utility Authority
Equipment Update Form
Disposal/Surplus Section: ,�/
❑ Dispose ❑Surplus Placement LE Surplus Removal
Placement Location:
(If Requesting Disposal, please indicate reason below)
❑ Lost ❑Obsolete Date Agenda Approved
❑ Cannibalized ❑Stolen /Vandalized * -
▪ Damaged El Returned to Vendor
*If Stolen/ Vandalized, please provide a copy of the police report.
Asset # Item Description (Make/Model) Serial #
6804 Carryall Electric Maintenance Cart
Dept Name: Wastewater Requested by: Philip Hendrix
to Dept Head Approval: Date: 3/1/2022
Final Disposal Details
Method of Disposal: Date:
Details/Comments:
Person Disposing: Date:
Witness: Date:
Transfer/Loan Section (Between departmental offices):
❑ Transfer ❑ Loan
Asset # Item Description (Make/Model) Serial # Est Rtrn Date
I acknowledge receipt of the above referenced equipment. I will return this equipment
when it is no longer required in the same condition, or better than I received it.
Grantor (from) Grantee (to)
Dept Name: Dept Name:
Custodian: Custodian:
Today's Date: Today's Date:
Clay County Utility Authority
Equipment Update Form
Disposal/Surplus Section:
r'...4 Dispose ['Surplus Placement El Surplus Removal
•
Placement Location: ,,........ , _' RA „...,,,,...........,-- :, '
yi ftratiOttolit007011016:11tingicateerfaSi 71;,;below)
0 Lost Xi Obsolete Date Agenda Approved
El Cannibalized 0 Stolen / Vandalized ••
El Damaged El Returned to Vendor
*If Stolen/Vandalized, please provide a copy of the police report.
.
Asset?"'"v: i''''''"f,:f7-4 v-474zilittif'ilailietianitialieittii#4104,: ,-,2 ,,,i,i-etiL, , :si.,A
13508 Canon iR-ADV 6055 (6/1/2012) BV: $0.0 , !HTT24997
13439 Canon ImageRunner C5035 Adv (12/8/2011) BV: $0,0.. : G NW59816
. ;
. . ,
..,
Dept Name: Admin (IT) _,,-7-- Requested by: Andrew Robertson
.4,.,i.e1,.( 1--N__,- - Date: 3/3/2022 '.
• Dept Head Approval: --.......- -,;---.,...,,:.......-----;-,,
oiiia :Details „ i ;„:z.„,.„:-.1.„,
Method of Disposal: GovDeals Date:
. ,
Details/Comments: - .
.. .
Person Disposing:, Date:,
Witness: Date::
.:.
Transfer/Loan Section (Between departmental offices):
, .
El Transfer El Loan
.--wititigi itralitiikoatoni610 ,,. Serial ,
.•,-__ - .
- .
I :•,i/.. -
I acknowledge receipt of the above referenced equipment. I will return this equipment
when it is no longer required in the same condition, or better than I received it.
Gran (from) r' r?,rfi:ilitg;Ii-;„01-..,ifirreik-c,
Dept Name: Admin (IT) Dept Name: 1
, .
•!: Custodian: . Custodian:
i.h
Today's Date: Today's Date: "
I i
1 I