HomeMy WebLinkAbout05.a.02 Asset Disposal AGENDA ITEM 5-a.2.a
REQUEST FOR SURPLUS DECLARATION AND/OR
ASSET DISPOSAL AUTHORIZATION
06/18/24
ASSET# DESCRIPTION
09618 2006 International 7400 VAC-CON
Clay County Utility Authority
Equipment Update Form
Disposal/Surplus Section:
❑■ Dispose ❑Surplus Placement ❑ Surplus Removal
Placement Location:
(If Requesting Disposal, please indicate reason below)
El Lost El Obsolete Date Agenda Approved
El Cannibalized El Stolen / Vandalized *
ElDamaged ❑ Returned to Vendor 18 Jun 2024
* If Stolen/ Vandalized, please provide a copy of the police report.
Asset # Item Description (Make/Model) Serial #
09618 2006 International 7400 VAC-CON VIN: 1 HTWHAAT86J238301 1HTWHAAT.86J238301
Dept Name: Fleet Ma t Requested by: Jim Moore
Dept Head Approval: Date: 13 Jun 2024
Final Disposal Details /
Method of Disposal: T mpa M hin ry Auction Date: 13 July 2024
Details/Comments: AssefDtsposal
Person Disposing: Jim Moore Date:
Witness: Doug Schutter 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: