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INDIAN RIVER COUNTY INTER -OFFICE MEMORANDUM �... TO: DATE: SUBJECT: FROM: Raeanne Cone, Fixed Assets Management Disposal of Excess Property Check One: Surplus Transfer Trade -I x Non -Capital Missing/Stolen Asset Number: 18523 Fleet Number: Asset Description: inductive loop tester Serial Number: 1250-10093 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: trade in Reason why item is excess: we don't use loops any more(all video Does OMB need to review the transfer? Yes Nb (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 Number for replacement: Date Replacement Received Date Approval Approval Approval Approval OMB Supervisor/ s-zs'—ly Director r / Assistant Director Date Controller Other Date Date Manager Date Approved for: Surplus Transfer Trade -In Replacement Disposition Recorded: Additional Comments: 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 88