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$OUT11$� <br />N City of South Bend <br />� :� M ,, s <br />IVA""`�' Request for Asset Disposal <br />x �' ■ <br />186E <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 <br />to 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 # _ Improvement # W0720088-0000 Acquisition Date 12/31/1988 <br />Description WELLS -- 4 WELLS <br />Serial Number <br />Tag/Reference Number <br />Asset Type 307 WELLS & SPRINGS <br />Purchase Cost $ 99,107.43 <br />(hisloncal acquisition value) <br />Net Book Value $ 11,591.19 <br />(purchase price minus depreciation) <br />Current Location Code WEDSN - WW - EDISON PLANT <br />Reason for Disposal: Partial asset disposal. Original asset value $132,143,25. Disposing of 3 wells at $33,035.82 each = $99,107.43 <br />Method of Disposal: <br />Approvals <br />Name <br />Signature <br />Date <br />Department Head <br />/ <br />Controller <br />Jennifer Hockenhull <br />Fixed Asset Form 1-13 Request for Asset Disposal 1 of 1 <br />