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INDIAN RIVER COUNTY <br />FORM FOR DISPOSAUI RANSFER OF EXCESS PROPERTY • <br />TO: Raeanne Cone, Finance Department <br />DATE: January 14, 2016 <br />SUBJECT: Disposal/Transfer of Excess Property <br />FROM: Kenny Jordan <br />Check One: Surplus Transfer Trade -In X Non -Capital Missing/Stolen <br />Asset Number N/A Department: Public Works/Traffic Eng. Fleet Number. N/A <br />Serial Number: RZ3 #1\'06040838687 AND RZ4 #K03032315217 <br />Description: Iteris RZ3 & RZ4 Traffic Video Detection Cameras <br />Do you have possession of the asset? Yes X No <br />If lost/Missing has a police report been filed? Yes N/A NO <br />If yes, please attach a copy of the police report. If no, state reason: N/A <br />Is the item functionaUR'ORKING CONDITION and could be used by another department? Yes No X <br />If not in working condition, description of problems with item: Cameras are not detecting vehicles <br />If transfer, department transferred to: N/A <br />Contact Person: Kenny Jordan Telephone Number: (772) 633-0302 <br />Physical Location of asset: Traffic Operations - 4548 41st Street <br />(The above information will aid Purchasing and Facilities Management in the process of equipment removal from department). ^ <br />If asset will be replaced, please answer the following: <br />Purchase Order Number for Replacement: Date Replacement Received <br />Approval <br />Director <br />If asset transfer, approval of department receiving asset <br />Approval <br />Director <br />Additional Comments: <br />To be completed by Budget Department: <br />Approved for: Srlus I <br />Budget 1 <br />Director <br />i <br />Trade -In Replacement <br />IVB <br />/ f <br />B e <br />Date <br />Date <br />Date <br />IT IS THE DISPOSIN DEP RTME.N 1-S RESPONSIBILITY TO KEEP THE ITEM UNTIL FACILITIES MANAGEMENT CAN PICK UP. <br />DO NO'f RFM <br />§WE PROPERTY FROM YOUR LOCATION WITHOUT PROPER AUTHORIZATION FOR DISPOSAL. <br />This form is to be used for all property with or without an asset number assigned. <br />Please attach a copy of this form securely to the item being disposed of. <br />All other forms for disposal/transfer of property now obsolete. <br />Revised: August 2015 <br />98 <br />