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INDIAN RIVER COUNTY <br />FORM FOR DISPOSAL/TRANSFER OF EXCESS PROPERTY • <br />TO: <br />Raeanne Cone, Finance Department <br />DATE: <br />June 23, 2016 1 <br />SUBJECT: <br />Disposal/Transfer of Excess Property <br />FROM: <br />John Ankeny <br />Check One: Surplus Transfer Trade-in X <br />Asset Number: N/A <br />Non -Capital Missing/Stolen <br />Department. Public Works/Traffic Eng. Fleet Number: <br />Serial Number: 026676 032896 032754 324454 <br />Description: Iteris RZ3 & RZ4 Cameras and Processor <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: <br />Is the item functional/WORKING 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: John Ankeny Telephone Number: 772-226-1563 <br />Physical Location of asset: Traffic Operations - 4548 41 st 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;.tuber for Replacement: <br />Approval J/! <br />' <br />aptial Asset Custodian <br />App4/,a !� :� <br />Su rvisor ani <br />Approval <br />Director <br />If asset transfer, approval of department receiving asset: <br />Approval <br />Director <br />Additional Comments: <br />Date Replacement Received <br />To be completed by Budget Department: <br />Approved for: Surplus Transfer Trade -In Replacement <br />B udget <br />Director <br />Date <br />% / (o <br />Date / <br />Date <br />Date <br />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 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 />72 <br />