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INDIAN RIVER COUNTY INTER -OFFICE MEMORANDUM `wow CO: DATE: SUBJECT: FROM: Raeanne Cone, Fixed Assets Management Disposal of Excess Property Check One: Surplus Transfer Trade -lift x Non -Capital Missing/Stolen Asset Number: 21094 Fleet Number: Asset Description: ATSI based monitor tester Ca f li ct- mon br tesftr Serial Number: 2501-0190 Do you have possession of the asset? Yes x No If Lost/Missing has a police report been filed? Yes No x If Yes, Please attach a copy of the police report. If No, state reason: Is the item functional? Yes x No Description of problems with item: Reason why item is excess: this item can not be calibrated anymore by ATSI Does OMB need to review the transfer? Yes No x (maintenance impact) Department transferred to: Contact Person: Ms. Maya Miller Telephone Number: 226-1637 (The above contact information will aid Purchasing and Facilities Management in the process of equipment removal from departments) If asset will be replaced, please answer the following: Requisition or Purchase Order Num der for r -placement: Date Replacement Received Date *Oar'Approval 3 .2 $ Approval Approval OMB Director / Assistant Director Date Controller Date Manag Approved for: Disposition Recorded: Additional Comments: rplus Transfer Trade -In 1 Replacement Date Date Fixed Assets Department Date It is the disposing department's responsibility to keep the item until Facilities Management can pick it up. DO NOT REMOVE PROPERTY FROM YOUR LOCATION WITHOUT PROPER AUTHORIZATION FOR DISPOSAL This form to be used for all property with or without an asset number assigned. Please attach a copy of this form securely to the item being disposed of. All other forms for transfer/disposal of property now obsolete. Revised: January 2010 85