HomeMy WebLinkAbout5-a.2.a Asset Disposal AGENDA ITEM 5-a.2.a
REQUEST FOR SURPLUS DECLARATION AND/OR
ASSET DISPOSAL AUTHORIZATION
09/06/22
Asset Number Description Cost Per Unit Acquired Date Book Value
8911 ENCLOSED CARGO TRAILER $ 3,160.00 7/13/2004 $ -
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Clay County Utility Authority
Equipment Update Form
Disposal/Surplus Section:
0 Dispose ❑ Surplus Placement ❑ Surplus Removal
Placement Location:
(If Requesting Disposal, please indicate reason below)
❑ Lost ❑Obsolete Date Agenda Approved
❑ Cannibalized ❑Stolen / Vandalized
0 Damaged ❑ Returned to Vendor
* If Stolen / Vandalized, please provide a copy of the police report.
Asset # Item Description (Make/Model) Serial #
08911 2004 C&S A-Ok Enclosed Trailer
VIN: 5C7EE12174D000736
Dept Name: Fleet Maint Requested by: Jim Moore
Dept Head Approval: Date: 9/29/2022
Final Disposal Details
to Method of Disposal: Gov Deals- c
Date:
Details/Comments: Broken Frame
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: