�;\.Public u I­Schools '\J SURPLUS PROPERTY DISPOSAL JUSTIFICATION FORM

The School Board requires an explanation as to why an item is determined to be surplus when it falls into one of

the following categories:

1. Less than 5 Years old 2.0riginal cost was more than $5,000 3. Has not yet met its life cycle

When disposing of an item that applies to any of the these three areas, this form must be completed in

its entirety, signed by the appropriate department head{s), and returned to Distribution Services (attention

Sandy Kimple) before a pick-up date will be scheduled.

SECTION A: TO BE COMPLETED BY DISTRIBUTION SERVICES

Asset #: 007020934 Description of Item: HYBRID MERCHANDISER, FEDERAL --------

Acquisition Date: 08/22/14 Original Cost: $12,221.00 Current Book Value: 1745.86 life Cycle: 7 ----- ---

SECTION 8: TO BE COMPLETED BY THE SITE ADMINISTRATOR

1. Check (v) one of the following boxes:

IZ] ltem(s) are uneconomical to repair or ll] ltem(s) obsolete & no longer usable

2. It is required to attach supporting documentation or complete the details section below. Your items will not be

picked up if this information isn't provided.

3• Details: The unit continues to fail and is no longer usable usable within the kitchen operation.

Ke · Th t O.g,tally sigood by Kevin Thornton

Kevin Thornton, Director of Food & Nutrition Services Vin orn on Dato: 2020.091810:44:25-04'00' 9/18/2020 -------Administrator Name (print)/ Title Administrator Signature Date

1---------------------�----------------------

L

SECTION C: TO BE COMPLETED BY THE APPROPRIATE DIVISION HEAD AND CABINET MEMBER

Robin Novelli, Chief Operating Of ficer Administrator Name (print)/ Title

Administrator Name (print)/ Title

Novelli Robin@Operati Digltauy signed by · Novelll,Robin@Operatlons

OnS Date: 2020.09.1811:50:07-04·00·

Administrator Signature

Administrator Signature

SECTION D: TO BE COMPLETED BY SANDY KIMPLE, SUPERVISOR DISTRI

Kristine Rodriguez, MBA, CPPO, CPPB, Director

Procurement & Distribution Services

Phone: (321) 633-1000, ext. 11645 Fax: (321) 633-3618

Distribution: (321) 633-3680, ext. 14100 Fax: (321) 633-3698

- .. , -

-

Date

Date

�-;\. Publi�

u

lt Schools \j SURPLUS PROPERTY DISPOSAL JUSTIFICATION FORM

The School Board requires an explanation as to why an item is determined to be surplus when it falls into one of

the following categories:

1. Less than 5 Years old 2. Original cost was more than $5,000 3. Has not yet met its life cycle

When disposing of an item that applies to any of the these three areas, this form must be completed in

its entirety, signed by the appropriate department head(s), and returned to Distribution Services (attention

Sandy Kimple) before a pick-up date will be scheduled.

Please complete all areas below, giving as much detail as possible:

SECTION A: TO BE COMPLETED BY DISTRIBUTION SERVICES

Asset #: 007020936 Description of Item: HYBRID MERCHANDISER, FEDERAL

I Acquisition Date: 8/22/14 Original Cost: $17,623.00 Current Book Value: $2,517.57 Life Cycle: 7

SECTION B: TO BE COMPLETED BY THE SITE ADMINISTRATOR

1. Check (v) one of the following boxes:

[Z] ltem(s) are uneconomical to repair or

---

[l] ltem(s) obsolete & no longer usable

2. It is required to attach supporting documentation or complete the details section below. Your items will not bepicked up if this information isn't provided.

3• Details: The unit continues to fail and is no longer usable usable within the kitchen operation.

Kev.In Thornton Digitally signed by Kevin Thornton

Kevin Thornton, Director of Food & Nutrition Services Date: 2020.09.1e 10:46:29-04·00· 9/18/2020 -------

Administrator Name (print)/ Title Administrator Signature Date

I---------------------�----------------------SECTION C: TO BE COMPLETED BY THE APPROPRIATE DIVISION HEAD AND CABINET MEMBER

Robin Novelli, Chief Operating Officer Administrator Name (print)/ Title

Administrator Name (print)/ Title

Novelli. Robin@Operati Digitally signed by NoveHi.Robin@Operations

OnS Date: 2020.09.1811.49:46-04'00'

Administrator Signature

Administrator Signature

Date

Date

SECTION D: TO BE COMPLETED BY SANDY KIMPLE, SUPERVISOR DISTRIBU�

TI N SERVICES � / ,

I 'f'<....,, ""' ,.., ;; - /Ofr'� f2_o Documentation Reviewed/ Submit Request to Board for Approval: ---+-l:;.,---;,,<-""'""��-+----�'� ''-�----------

Sandy Kimple, Supervisor, Distribution Services / Date

Kristine Rodriguez, MBA, CPPO, CPPB, Director

Procurement & Distribution Services

Phone: (321) 633-1000, ext. 11645 Fax: (321) 633-3618

Distribution: (321) 633-3680, ext. 14100 Fax: (321) 633-3698

'

c__,.- ,.,--------------------'

1�,. Public

1

u lt­Schools \J SURPLUS PROPERTY DISPOSAL JUSTIFICATION FORM

The School Board requires an explanation as to why an item is determined to be surplus when it falls into one of

the following categories:

1. Less than 5 Years old 2. Original cost was more than $5,000 3. Has not yet met its life cycle

When disposing of an item that applies to any of the these three areas, this form must be completed in

its entirety, signed by the appropriate department head(s), and returned to Distribution Services (attention

Sandy Kimple) before a pick-up date will be scheduled.

SECTION A: TO BE COMPLETED BY DISTRIBUTION SERVICES

Description of Item: HYBRID MERCHANDISER, FEDERAL Asset #: 007021138

Acquisition Date: 10/20/14 Original Cost: $17,623.00 Current Book Value: $2,517.57 Life Cycle: 7

SECTION B: TO BE COMPLETED BY THE SITE ADMINISTRATOR

1. Check (v) one of the following boxes:

[Z] ltem(s) are uneconomical to repair Q[_

---

ll] ltem(s) obsolete & no longer usable

2. It is required to attach supporting documentation or complete the details section below. Your items will not be

picked up if this information isn't provided.

3. Details: The unit continues to fail and is no longer usable usable within the kitchen operation.

Ke · Th t O.g,tally signed by Kevon Thomtoo

Vin orn on Date· 202009.1810:47 43-04'00' 9/18/2020 -------

Kevin Thornton, Director of Food & Nutrition Services Administrator Name (print)/ Title Administrator Signature Date

I---------------------�----------------------SECTION C: TO BE COMPLETED BY THE APPROPRIATE DIVISION HEAD AND CABINET MEMBER

Robin Novelli, Chief Operating Officer Administrator Name (print)/ Title

Administrator Name (print)/ Title

Novelli. Robin@Operati D,gnally s;gned by Novell1.Robon@Operaoons

OnS Date: 2020.09.18 11 49:13 -04'00'

Administrator Signature

Administrator Signature

SECTION D: TO BE COMPLETED BY SANDY KIMPLE, SUPERVISOR DIST.

Procurement & Distribution Services Phone: (321) 633-1000, ext. 11645 Fax: (321) 633-3618

Distribution: (321) 633-3680, ext. 14100 Fax: {321) 633-3698

Date

Date

[

Kristine Rodriguez, MBA, CPPO, CPPB, Director

__ _,;_ ___ _;_.:___-==�------- �,--------------

Digitally signed by Kristine RodriguezDate: 2020.10.22 12:40:06 -04'00'

PROPERTY INVENTORY ATTESTATION

(Submit with your completed inventory to Property Control)

(Custodia11: You may use this form in lieu o/preparin.g a separate attest letter. You are not required to do botli.)

School/Dept. Name: Lockmar Elementary----------------------

School/Dept.#: 2111

Asset# Description 090009507 SOFTWARE, SUCCESSMAKER FULL CURR.

As Property Custodian, I hereby attest that the asset listed above is (select only ONE): (Select only ONE and complete the corresponding area below. Submit a separate attestation for each item.)

0 Missing/Unlocated:

When/where the item was last seen: Actions taken to locate the item:

Any other details regarding the disappearance of the asset:

0 Stolen (Police or incident report MUST be attached) Describe bow item was determined to be stolen:

Actions taken to locate the item/report the theft: _______________________ _

• Obsolete Software:

ls software still installed on a device at your site?

ls software still in use at your site?

OYes 0 Yes

9No

8No

Software is considered obsolete because: AGE

I request that this �tern be �tory.

')1f)Jcneva.J � Signature of Property Custodian (Principal, Director, or Above)

Nor IYJ ae L, HosteJler, Pr�·nc�pal Printed Name and Title

Rev. Aug 2017

Control use onl Current Book Value Life C cle

t-t- /g /zo Date r I

04/20/2012 7,200.00 0.00 3

01/07/2010 $7,500.00 0.00 5

PROPERTY INVENTORY ATTESTATION

(Submit with your completed inventory to Property Control)

(Custodian: You may use this form in lieu of preparing a separate attest letter. You are not required to do both.)

School/Dept. Name: Space Coast Jr/Sr High School School/Dept.#: 0302

Asset# Description

020045337 Milling Machine, Ye1i & Horiz

As Property Custodian, I hereby attest that the asset listed above is (select only ONE):

(Select only ONE and complete the corresponding area below. Submit a separate attestation for each item.)

e> Missing/Unlocated:

When/where the item was last seen: Room 701C

Actions taken to locate the item: Searched room 701 and campus. Emailed the missing asset list to the staff to have them

search their locations

Any other details regarding the disappearance of the asset: There was a classroom move and this item may have been

inadvertently DCR'd, however, we are unable to find documentation.

0 Stolen (Police or incident report MUST be attached)

Describe how item was determined to be stolen:

Actions taken to locate the item/report the theft:

0 Obsolete Software:

Is software still installed on a device at your site?

Is software still in use at your site?

Software is considered obsolete because:

l request that this item be removed from our inventory.

Sylvia Mijuskovic, Principal

Printed Name and Title

For Accountin Services, Property Control use only:

Rev. Aug 2017

OYes

0 Yes

ONo

ONo

Date

08/01/1991 $8,366.00 0.00 5

Bro~hlrd Public Schools 1 t' t i •. \ f 1 ' !:. ,li~I

.t ')(.' t ·· 1.(.3'l ·:nt'~1V ~ ~ :.: t .1 ·•./\.f' _, I : t -~ ' . ).A ~ • f. ..._. '

PROPERTY INVENTORY ATTESTATION

(Submit with your completed inventory to Property Control)

(Custodian: You may use this form in lieu of preparing a separate attest letter. You are not required to do both.)

School/Dept. Name: Space Coast Jr/Sr School/Dept.#: 0302

·-~~~-A-s-se_t_#~~~~---'-~~·-~-~~~~~~~~~---D-e-sc-r-ip_t.=io=n==================~-======1 _?20117048 LeBlanc Contra Bass Clarinet _ ___J As Property Custodian, I hereby attest that the asset listed above is (select only ONE):

(Select only ONE and complete the corresponding area below. Submit a separate attestation for each item.)

-0 Missing/Unlocated:

When/where the item was last seen: Building 3, Room 305

Actions taken to locate the item: Searched every area instruments are stored. E-mailed entire staff to look in their work locations

for the instrument. Cross-referenced instrument loan fom1s.

Any other details regarding the disappearance of the asset: Purchased in 2005.

-De~ctibe . hbw,,if~l1l ;w~s deterfuinedto be stolen:

!:'-!:'· ,.,,,;.;.;. : · .. ;.;•"• · ...... . .......... ·.:.:,;:

·' ~~-"">

:W:C:tioris t~~~P tQ:,I.d~atx the,ifom/report the theft:

-... • .... .': .. :·:· .. -.. .·, - ;::.: .: • .-::;,~·

r§: ~ottware ~t!J! ! in '~¢• .. a.t.xqµtsfte? S·Qftw~rej s p6Iisideredobi81efe becau5e:

. -I request that this item be removed from our inventory.

Sy lvia Mijuskovic I Principal

Printed Name and Title

Control use only:

OYe's

O.Yes

--

--- -

-

-

-

·- -----~ -ONo''

---------~-~;J.-/'j

Date

Current Book Value Life C cle-i

Rev. Aug 2017

09/19/2005 $6,945.00 0.00 5

08/27/2002 $ 5,141.00 0.00 3

08/27/2002 $5,336.00 0.00 3

10/04/2005 $ 20,240.60 0.00 7