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INDIAN RIVER COUNTY <br />FORM FOR DISPOSAL/TRANSFER OF EXCESS PROPERTY <br />TO: <br />DATE: <br />SUBJ ECT: <br />FROM: <br />R eanne Cone, Finance Department <br />Disposals rat s er pf Excess Property <br />Asn hb -h <br />Check One Surplus Transfer Trade -In V Non -Capital Missing/Stolen <br />Asset Number <br />Serial Number <br />Description <br />6314 Department <br />�}ybal"?b - LNDP�9 <br />Fleet Number <br />NIA <br />}41 d r) s (Zu Jve d 6L 1. Nle <br />Do you hat e possession of the asset' Yes ✓ <br />If Lost/Missing has a police report been tiled? <br />r' lL.4Lr <br />No <br />1'es No <br />If yes, please attach a copy of the police report. If no, state reason <br />Is the item functional/WORK/11G CONDITION and could be used by another department'' <br />If not in working condition, description of problems with item <br />If transfer, department transferred to <br />Utirudirx <br />Yes No <br />Contact Person ROl,J'2 'telephone Number 3/)q5€ <br />Des LJGreh os2 <br />(The above information will aid Purcha. ing and Facilities Management in the process of equipment removal from department). <br />Physical Location of asset. <br />Basset will be replaced, please answer the following <br />Purchase Ord % jumber for Re Date Date Replacement Received <br />Approv <br />Approval <br />Approval <br />aptial st'dian <br />n 'p <br />Director <br />If asset transfer, approval of department receiving asset <br />Appro‘ al <br />Director <br />Additional Comments: <br />Date <br />II -3-i5 <br />Date <br />11/515— <br />Date <br />Date <br />To be completed by Budget Department <br />Approved for Surplus Transfer Trade -In Replacement <br />I3udget <br />Director Date <br />IT IS THE DISPOSING DEPARTMENT'S RESPONSIBILITY TO KEEP THE ITEM UNTIL FACILITIES MANAGEMENT CAN PICK UP. <br />DO NOT REMOVE PROPERTY FROM YOUR LOCATION WITHOUT PROPER AUTHORIZATION FOR DISPOSAL <br />This form is to he used for all property with or tvithout an asset number assigned. <br />Please attach a copy of this form secure') to the item heing disposed of <br />All other forms for disposal/transfer of property now obsolete <br />Revised. August 2015 <br />32 <br />