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Effective 11- 1 -2010 <br />CITY OF SOUTH BEND <br />Request for Asset Disposal <br />Fixed Asset Disposal Procedure Statement <br />U T rf—h� k-*" <br />-A <br />I <br />All city departments are required to submit asset disposal requests to the Board of Public Works for approval prior to <br />disposal of an asset. Asset disposal requests must include the following information: <br />Asset description <br />Asset identification number <br />Year of acquisition <br />Historical acquisition value <br />Net book value <br />Reason for disposal <br />Method of disposal (offer for sale, scrap, etc.) <br />The asset disposal request must be signed by the Controller before submittal to the Board of Public Works. <br />Asset Description <br />Asset#5519, 2003 Genie towable boom lift 50' platform trailer <br />Asset Tag Number <br />Vehicle number 317A <br />Department of Ownership <br />Park Department <br />Year of Acquisition <br />2003 <br />Historical Acquisition $ Value <br />$28,151 <br />Net Book Value <br />0 <br />Reason for Disposal <br />no longer functions properly for the usage it is needed for. Doesn't reach down far <br />enough. <br />Method of Disposal <br />Trading in for new <br />Approval(s) Name Signature Date <br />Department Head &Q , <br />Controller 7 <br />AF Policy 2.5.1 Fixed Asset Form 1 -13 Request for Asset Disposal.doc Rev. 020810a <br />Page 1 of 1 <br />