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CITY OF EUGENE <br /> SURPLUS PROPERTY DISPOSITION A9-111 , r <br /> P <br /> Use this form to document the donation, selling, or disposal of City owned property that has bee eemed as <br /> surplus. Refer to City Administrative Order 44-14-08F, City of Eugene Public Contracting Rules Exemption E- <br /> 16 (on back of form) or contact Eugene Purchasing for guidance. Fill in the form, attach the necessary <br /> documentation, and retain within the department for auditing purposes. If the item originally had a value over <br /> $5,000, and/or has a red asset tag attached, contact Kevin Vanderwall in Finance. <br /> Name: Keith Nicolson Dept.: Public Works Division: Maintenance <br /> Item Description: Surplus Gold Elite Parts <br /> Approximate Value: $ 1,100 Location of Item: 1820 Roosevelt Blvd, Eugene, Or <br /> The item above has been deemed as surplus and has been/will be removed from the department by the <br /> following method: <br /> °Donated to a non-profit organization or other government agency. <br /> Name of receiving entity: <br /> Attach a detailed receipt that includes receiver's signature, date, and item detail. <br /> Retain documentation in department file. <br /> ()Recycled or disposed of as waste. <br /> Name of employee overseeing disposal: <br /> Retain documentation in department file. <br /> ()Sold as a fixed price sale or at auction. <br /> Name of Buyer: Columbia 911 Communications District <br /> Minimum acceptable price: 1,100 Final sale price: 1 ,100 <br /> Detailed item description, including overall condition, manufacturer/model#, etc. <br /> Motorola Centracom Gold Elite Parts <br /> 1- Dual CEB Power Supply RECD 3($11 t7 PO# <br /> 2 - Single CEB Power Supplys CKW ACCT# <br /> INITIAL DATE <br /> Apply proceeds from sale & associated auction fees to account: <br /> Fund: 011 Org: 6840 Account: 47291 Project (optional) <br /> Send form, photos, and any other info that will help Purchasing sell the item(s)to Eugene Purchasing. <br /> Retain documentation, including outcome of sale, in department file. <br /> Today's date: 3/24/17 <br /> Division Supervisor authorizing Surplus of above item: <br /> W"'ci^^ 917f117 I CLEAR FORM <br />