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5 <br />N. <br />CITY OF SOUTH BEND <br />U <br />:E <br />Request for Asset Disposal P. A:C. <br />- R <br />Effective 1-1-2010 <br />Fixed Asset Disposal Procedure Statement <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, em) <br />The asset disposal request must be signed by the Controller before submittal to the Board of Public Works, <br />Asset Description . car 19, 2002 Chevy Cargo Van <br />AssetTag Number asset # 00005981 <br />Department of Ownership Community Investment <br />Year of Acquisition 2002 <br />Historical Acquisition Value $17,301 <br />Net BoakValue 0 <br />Reason for Disposal past useful life <br />Method of Disposal Auction 2017 <br />Approval(s) Name Signature Date <br />Department Head 3APw Mtkollv <br />Controller KAA —7-4) -1 t <br />AF Palky 25.1 Fixed Asset Form 1-8 Request for Asset D[sposal.doc Rev. 0208 1 Oa <br />Page I of I <br />