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R orRRRr,y Y <br />FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION <br />WON B - Property Reporting Form <br />yrNrtR <br />Agreement Number: CV003 <br />GRANTEE: In order to comply with applicable state and/or federal regulations, list non -expendable equipment/personal property costing $10,000 or more purchased directly or indirectly under the above Agreement. Complete: <br />1) a description of the property, 2) the serial number or other identification number, 3) the source, 4) who holds title/ownership, 5) purchase date, 6) cost, 7) DEP's percent share of that cost, 8) location/address of the <br />property, 9) use and condition, 10) any ultimate disposition data, including date of disposal and sale price. <br />Description <br />P <br />Serial No./ <br />ID No. <br />Source <br />Owner <br />Purchase <br />Date <br />Cost <br />% Charged to <br />DEP Grant <br />Location <br />Use and Condition Disposition <br />Grantee: <br />Date: <br />Grantee Grant Manager: <br />BELOW IS FOR DEP USE ONLY <br />Date: <br />DEP GRANT MANAGER: Send invoices supporting the cost of the items to Finance and Accounting for the processing of the Grantee's invoice for payment. Maintain a copy of the invoices supporting the cost of each <br />item identified above in your grant agreement file. Refer to Administrative Policy 320 for Property Guidelines. <br />DEP Grant Manager: <br />DEP 55-211 <br />Rev. 10-01-2024 <br />Date: <br />1of1 <br />