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HomeMy WebLinkAbout05.a.02 Asset Disposal AGENDA ITEM 5-a.2.a REQUEST FOR SURPLUS DECLARATION AND/OR ASSET DISPOSAL AUTHORIZATION 11/04/25 Asset# Description Serial# 13948 Canon Image Runner NMU08359 14076 Canon Image Runner NMU08258 14175 Canon Image Runner NMU12016 14762 OCE Plotter 875003110 Clay County U ility Authority Equipment Update Form Disposal/Surplus Section: Dispose ❑Surplus Placement ❑Surplus Removal Placement Location: a�� � _.: •�-.4 7 .s'e , z a ) ��:.:'7.;e �ra ) !:s-•-E, �4 M�� } °x'r� 7 ^ f = �'F °dF s •- f rr - ,.� .:..17......_..s..u...�:......s,.e....e....4�r,.r_.. .•.... _.�,.,.,.:_..n.xu..s..w.:3 i... ,...,,ci .,..�1i_: ��c.�.r. ...ti........:: ❑ Lost ®Obsolete Date Agenda Approved ❑Cannibalized ❑Stolen / Vandalized * ❑ Damaged ❑ Returned to Vendor * If Stolen/ Vandalized, please provide a copy of the police report. •1rq�'� t4 �➢ k Y .� :t a'ix.7."�'"4 - 4 +,;�•r J T'', r4 :- 6N• aTM.r.""-)ou .? - y ow;Jfi a .Ji xc =e4�.. seq.=.-�SA`r hak -,�•- n° ?ter . r �.tti xl y_"R t i i}2' 11��a ~ ��� UX ll� ,. y3,k a • `.`:.#� �., .�: �..............�?;v,��...x...:_..:c.t k�,...:.�.,...5.:�.,..,,u..�.L�Jds......._..�.��.�x..-..:;.,,.a--_..i,s......__.�._w::..L... _�-__x,.._>._.....H.�:...•._,_- ,:.'J 13948 Canon Ima•eRunner Adv 6255 9/23/2013 BV: $0.0 NMU08359 14076 Canon Ima•eRunner Adv 62551 11/26/2013 BV: $0.0 NMU08258 14175 Canon ImageRunner Adv 6255 5/12/2014) BV: $0.0 NMU12016 Dept Name: Admin (IT- Requested by: Jacob Rutkowski Dept Head Approval: Date: 10/27/2025 gyp,':. n "x^ri i' � H t:^> t?�MI? �^v'c-� ^u42 4�y) '^ s. 'aa�+r C y 7�.. ,r y�'°,�- :. 2� rl"F •°�, y 2� �'x,Y,. _a r('!' r ',z` ,�j! �,� 3uYri '�Y4Y� {"t ray'. '}7 3e'x k' '�j''* x: i "4��L3• ,g''. j tom?" .yzr ,(y r - s•W._'� -:e:rd c. �' .__ '�� 9.._� ..5.._u'7uw _...�L...W,�e.,_r.�_..�:..+_.-,,..�.......i•....e.__�...... •�..✓_ .�e;.a...�_..�.ya<..�... ..__�.. �"''-- .v�.z '.�.:..__f.�., _..Method of Disposal: Sensible Recycling Date: 11/06/2025 Details/Comments: Person Disposing: Jacob & J.D. Date: Witness: Date: Transfer/Loan Section (Between departmental offices): ❑Transfer ❑ Loan ,�.' • - .�a,;a„ w:, ar:._. k s.• �S "� £ a _ F, . `r •:' � -s rt` r tit s .ss ya `f "` $ t 36..t rr r B r '�•. S< a 3fr klrJ Y3 Fib aar 15 r # r f 1�d 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. �t< 7x4 y �+f a.Al, .+ r-•{'lr c'w',+,.fix - �3.i1 ."! ��x r iJ tq "'=rl 3 fed -'1A S Wytr �1tS L4�. (i,x y,Si ie f<C.'1' �... �;A � p7 p (6 {© J { �1'�'. 'µk?> �� f z ib v ..-!,.j�I I ,r ,k 7.. �! 's'�'d 4hi'R.: ,....4.: vr,..sn � .ar. i��,.3.i.' .' r-+;}d »�i=: r fr. ...,x Dept Name: Admin (IT) Dept Name: Custodian: Custodian: Today's Date: Today's Date: Clay County Utility Authority Equipment Update Form Disposal/Surplus Section: Surplus removal Dispose Surplus placement (location) Lost Cannibalized Stolen/Vandalized E:.' Obsolete Returned to Vendor Damaged Date Agenda Approved * If StolenNandalized, please provide a copy of the police report. toR • •31 ltEkli I�I _. �i pi/i//� h�o;q I y�'V31'�' Aai&s,K 14762 OCE PW750 875003110 Dept Name: Engineering Requested by: Darrell Damrow Igned by Darrell Damrow s e✓� 'x_ �,_ w m illnn:nlu rl'av ,n _ CE—dd,i amr.=om..a..sNt.e=r,D OeUrre=lUl.Sme ersn Date: 10/29/2025DaeI Method of Disposal: Date: Details/Comments: • Person Disposing: Date: #' Witness: Date: Transfer/Loan Section (between departmental offices): Transfer Loan i Wyss-hvr YE� H* } d R t• 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. r — y w !„Iv, Dept Name: Dept Name: Custodian: Custodian: oday's Date: Today's Date: Y��