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HomeMy WebLinkAboutSurplus Request - Public WorksGrant County Public Works Property Transaction Form Action: Deletion Person Submitting Form: Ed Lowry Date Submitted: 3/18/2019 Dept. Submitting Form: Public Works DESCRIPTION OF PROPERTY/ASSET Asset ID: 11097 _ Description: jTwo Air 50' hose reels Dept. Assigned Vehicle #, if used: Manufacturer: INapa Serial #: Model #: ME/EX/XA Model Year: Department: jPublic Works Dept. Purchased By: ISelect One Physical Location: IRD1 Hartline I Purchase Date: 11/29/07 Custodian: I 7Vendor: lEphrata Auto Parts —71 Cost: 1287.44 —� Account Expense #: Transfer of Property/Asset Dept. Transferred From: ISelect One Dept. Approval: Dept. Transferred To: Iselect One Dept. Approval: Date Transferred: New Physical Location: Iseiect One New Custodian:F— — Surplus Request Surplus Date: 3/18/2019 Commissioner Ap roval Manner of Disposal: IDES Auction Dist #1: Current cost of Asset: 125.00 Dist #2: ! Dist #3: W COMPLETED FORMS ARE TO BE FORWARDED TO THE PUBLIC WORKS ACCOUNTING DEPT t GRANT COUNT JBLIC WORKS f EFFECTIVE: JULY IST, 2004 INVENTORY FORM DEPARTMENT COMPONENT: AM "iia k.. ASSET ID:� 'h�lh�iY'4', °dna r ,U DESCRIPTION:_., "ti,$ _ h1:1W *A1 Try Y .. CONDITION: (CIRCLE ONE) NE USED LEASED ASST A -'COU1T tUilA2;, MODEL NUMBER: DONATED CONSTRUCTED r { T ACCUMUt�ATED DEPRECIATI a as a .' MANUFACTURER: SERIAL NUMBER: ('r It-YYIk1'id� ' LICENSE NUMBER: 'W G'h QUANTITY: WARRANTY VENDOR: PRICE: (, % / �l TAXES: TOTAL COST: WARRANTY EXPIRATION: S&H: r - _ J TOTAL UNIT PRICE: LIFE: TYPE: (CHOOSE FROM LIST) SALVAGE VALUE FUND: CLASS: (CHOOSE FROM LIST) f LOCATION: (CHOOSE FROM LIST) DEPARTMENT: RETIRIgfT T�I]E _- ;! ///I r ;, CUSTODIAN: (CHOOSE FROM LIST) REVENUE SOURCE: mzr,4 . (1 Q 6 E?I� rADDITlO TRANSFER ACTIVITY: (CIRCLE ONE) GRANT: " SURPLUS JUNK E " Z } ' VENDOR: INVOICE NUMBER: DATE PURCHASED: ASSET RETIRED: OLD ASSET NUMBER: DATE IN SERVICE: EXPANDED DESCRIPTION LAST INVENTORY: r JOL,n^< a �"�� ,5 (4 TRANS OF EQUIP. TO WHICH DEPT: >° ry JUNKED: DATE OF TRANSFER: SURPLUS: �iITODAY'S DATE:SGNATURE: Z'! J- •_ _ ovFRrCU1IN IMSE ONLY CONTROL NO,­'; ' EPHRATA AUTO PARTS PHONE 754-4895 P.O. BOX 758 1050 BASIN ST., S.W. EPHRATA, WASHINGTON 98823 p��ll FEDERAL ID # 91-0499597 TERMS: Due and discountable 2% 10th of month following date of purchase, (unless otherwise noted.) 1'V2% per month service charge on past due accounts. Minimum service charge $1.00 per month. DISCLAIMER OF WARRANTIES - Any Warranties of the products sold hereby, are the warrantee of the manufacturer of those products. The seller hereby expresslyy disclaims all warranties, express or Implied, - - including any implied warranty of merchantability or fitness for a particular purpose, and neither assumes {{{I nor authorizes any other person to assume for it any liability In connection with the. sale of the products. PARTS MUST BE CHECKED OUT BY INSTALLER BEFORE INSTALLING. IMPROPER LISTING OR APPLICATION IS NOT THE RESPONSIBILITY OF EPHRATA AUTO PARTS, INC. . RECO BY X ALL GOODS RETURNED MUST BE ACCOMPANIED BY THIS INVOICE NO RETURN ON ELECTRICAL PARTS S -- 3 s'WQ� Hit, e. RteV, ACCT, 146: SOLD TO DATE INVOICE NO, STORE NO. CM SLS TIME PURCHASE ORDER NO. ATTENTION INVOICE TYPE--> QUANTITY PART NUMBER LINE DESCRIPTION PRICE • NET TOTAL CODE Ifo i susTcyrAL-,r °°=?^x� TOTAL ' 7, It P; It