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INDIAN RIVER COUNTY <br /> INTER-OFFICE MEMORANDUM <br /> TO: Meow Cane,Fixed Assets Manogement <br /> DATE: 5/9/2013 <br /> SUBJECT: Disposal of Excess Property <br /> FROM: Debbie Clemenzi <br /> Check One: Surplus Transfer Trade-In X Non-Capital Missing/Stolen <br /> Asset Number. 21922 Fleet Number. 629 r <br /> Asset Description: 2004 Chevy Blazer <br /> Serial Number. iGNDT13X54K153188 Do you have possession of the asset? Yes X No <br /> If Lost/Missing has a police report been filed? Yes No <br /> If Yes, Please attach a copy of the police report. If No,state reason: <br /> Is the item functional? Yes X No <br /> Description of problems with item: <br /> Reason why item is excess: High Maintenance due to age <br /> Does OMS need to review the transfer? Yes No (maintenance impact) <br /> Department transferred to: <br /> Contact Person: Telephone Number. <br /> (The above contact information will aid Purchasing and FocHtties Management in the process of equipment removal from departments) <br /> If asset will be replaced,please answer the following: <br /> Requisition or Purchape Order Number for repiacement: Date Replacement Received <br /> ,approval <br /> Date <br /> Superv( pt Personnel <br /> Approval <br /> Director/Assistant Director Date <br /> Approval <br /> Controller Date <br /> Approval <br /> Oth Date <br /> OMB Date <br /> Manag C� <br /> Approved for: rplus Transfer Trade-inReplacement <br /> Disposition Recorded: <br /> Fixed Assets Department Date <br /> Additional Comments: <br /> N k"dkpoftdepad"WWs reqxxw#Ady to k*"iM Mem uM Facgras M0n09*ment can pick N UP, <br /> DO NOT REMOVE PROPERTY FROM YOUR LowiON wr Mohr PROPER AuTHOP=ATION FOR DISPOSAL <br /> This form to be used for all property With or without on onset number assigned. <br /> Please attach o copy of this form securely to the item being disposed of. <br /> All other forms for transfer/disposal of property now obsolete. <br />