HomeMy WebLinkAbout06.a.02 Asset Disposal AGENDA ITEM 6-a.2.a
REQUEST FOR SURPLUS DECLARATION AND/OR
ASSET DISPOSAL AUTHORIZATION
10/07/25
ASSET# DESCRIPTION SERIAL#
14723 Caterpillar 305E2 Excavator (2/2016) (D&C) H5M01484
13477 John Deere 50D Excavator (3/2012) (D&C) 1 FF050OXCBG27&696
9120 Bobcat 331 (10/04) (D&C) 234311688
Clay County Utility Authority
Equipment Update Form
Disposal/Surplus Section :
U Dispose Li Surplus Placement 0 Surplus Removal
Placement Location:
(If Requesting Disposal, please indicate reason below)
❑ Lost ❑Obsolete Date Ag.enda Approved
❑ Cannibalized ❑Stolen I Vandalizes
Damaged ❑ Returned to Vendor
• If Stolen / Vandalized, please provide a copy of the police report.
Asset # Item Description (Make/Model) Serial #
14723 CaterprIla► 305E2 Excavator (2/2016) IDBC) H5M01484
13477 John Deere 50D Excavator (3'2012) (D&C) 1FFOSCDXCBG276696
9120 Bobcat 331 (10!04) (D&C) 234311688
Dept Name: D&C quested by: David Rawlins
Dept Head Approval: ) �� '' `-e Date: 09!30/25
Final Disposal Detai
Method of Disposal: Trade-In on new 305CFG14A Date:
Details/Comments: Ring Power Transport Pick-up
Person Disposing: Date:
Witness: Date:
Transfer/Loan Section (Between departmental offices):
Transfer U 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: