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Item C28 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: March 20. 21. 2002 Bulk Item: YES XXX NO Division: Monroe County Department: Fixed Asset Surplus AGENDA ITEM WORDING: Approval to remove surplus equipment from inventory via deletion and disposal. ITEM BACKGROUND: See attached schedule PREVIOUS RELEVANT BOCC ACTION: N/A STAFF RECOMMENDATION: TOTAL COST: N/A BUDGETED: Yes_ No Cost to County: N/A REVENUE PRODUCING: Yes No AMOUNT PER MTH YEAR_ Checked ~~ ""mant F;n.." D;, '6(1/J A ,~./ ~ Division Director Approval: SANDRA CARLIL~~irector ))~~ Item Prepared By: Divina D. SDeer. DeDutv Clerk DOCUMENTATION: Included YES To Follow Not Required Agenda Item: ~ ~ DISPOSITION: Thnr"bv I""hmllrv? 1 ?OO? Board of County Commisioners March 20, 21, 2002 SCHEDULE OF SURPLUS ITEMS ITEM BACKGROUND AMOUNT BOCC ACTION Estimated Original Present County ID# Description Value Value need approval to- 1 0803-90 Computer damaged by lightning $2,294.00 $0.00 remove & dispose 2 0800-163 Postage Scale outdated-old-obsolete $1,020.00 $0.00 remove & dispose 3 0803-077 Computer damaged by lightning $1,797.00 $0.00 remove & dispose 4 0903-700 Airconditioner beyond econom ical repair $884.40 $0.00 remove & dispose 5 0940-410 Computer old-obsolete-no long er in use $2,460.00 $0.00 remove & dispose 6 2000-442 Microscope outdated-old-obsolete $1,117.00 $0.00 remove & dispose 7 2000-485 Sterilizer outdated-old-obsolete $1,570.78 $0.00 remove & dispose 8 2000-716 Okidate printer outdated-old-obsolete $871.76 $0.00 remove & dispose 9 2000-726 Cash register outdated-old-obsolete $899.10 $0.00 remove & dispose 10 2000-745 Computer outdated-old-obsolete $1,724.00 $0.00 remove & dispose 11 2000-747 Computer outdated-old-obsolete $1,724.00 $0.00 remove & dispose 12 2000-738 Computer outdated-old-obsolete $1,531.70 $0.00 remove & dispose 13 2000-748 Computer outdated-old-obsolete $6,659.00 $0.00 remove & dispose 14 2000-801 Computer outdated-old-obsolete $1,845.00 $0.00 remove & dispose 15 2000-842 Computer outdated-old-obsolete $1,693.00 $0.00 remove & dispose ~ 16 3000-125 Printer beyond econom ical repair $1,028.00 $0.00 remove & dispose i 17 3000-169 Computer old-obsolete-no long er in use $1,351.00 $0.00 remove & dispose 18 0201-190 Gateway Computer broken-outdated-obsolete $1,857.00 $0.00 remove & dispose , I 19 0201-167 Dell Computer broken-outdated-obsolete $2,001.00 $0.00 remove & dispose ! 20 0202-315 Dell Computer broken-outdated-obsolete $2,343.00 $0.00 remove & dispose I 21 0201-084 Compaq Computer broken-outdated-obsolete $3,764.97 $0.00 remove & dispose 22 0202-248 UPS broken-outdated-obsolete $759.00 $0.00 remove & dispose 23 0202-286 UPS broken-outdated-obsolete $827.84 $0.00 remove & dispose 24 0202-324 Okidata Printer broken-outdated-obsolete $968.00 $0.00 remove & dispose 25 0202-353 Hi resolution monitor broken-outdated-obsolete $2,835.00 $0.00 remove & dispose I 26 0202-358 Hi resolution monitor broken-outdated-obsolete $2,835.00 $0.00 remove & dispose 27 0204-126 Printer broken-outdated-obsolete $1,800.00 $0.00 remove & dispose 28 0204-127 Controller broken-outdated-obsolete $1,425.00 $0.00 remove & dispose i 29 0204-132 Modem broken-outdated-obsolete $966.93 $0.00 remove & dispose ! 30 0201-080 Compaq Computer broken-outdated-obsolete $3,298.00 $0.00 remove & dispose 31 0201-111 IBM Computer broken-outdated-obsolete $3,095.00 $0.00 remove & dispose 32 0201-124 Hundai Computer broken-outdated-obsolete $1,499.00 $0.00 remove & dispose ! 33 0202-198 NEC Computer broken-outdated-obsolete $1,814.95 $0.00 remove & dispose I i 34 0202-206 Computer wi cash drawe broken-outdated-obsolete $2,177.50 $0.00 remove & dispose I 35 0202-288 Monitor broken-outdated-obsolete $2,512.00 $0.00 remove & dispose 36 0204-144 Linecard broken-outdated-obsolete $3,469.60 $0.00 remove & dispose 37 0204-164 Cabinet broken-outdated-obsolete $900.00 $0.00 remove & dispose I i 38 1801-134 HP Printer beyond econom ical repair $875.99 $0.00 remove & dispose i 39 0601-361 Smartwriter beyond econom ical repair $1,800.00 $0.00 remove & dispose 40 3300-133 Dell Computer beyond econom ical repair $1,981.00 $0.00 remove & dispose 41 0500-759 WYSE terminal beyond econom ical repair $890.00 $0.00 remove & dispose 42 0500-760 WYSE terminal beyond econom ical repair $890.00 $0.00 remove & dispose ! 43 0500-680 Mail Machine beyond econom ical repair $1,920.00 $0.00 remove & dispose ! 44 0500-678 Mail Scale beyond econom ical repair $2,014.00 $0.00 remove & dispose 45 0500-679 Mail Machine beyond econom ical repair $5,912.00 $0.00 remove & dispose I 0310612002 MONROE COUNTY INVENTORY DELETION REQUEST RECEIVED FES 05 2002 TO: DIVINA SPEER FROM: LISA CHERRY/JENNIFER Hll..L PROPERTY CLERK. FINANCE DEPT. PURCHASING & BUDGET (06001) DATE: JANUARY 30. 2002 .lL__ 'r. 0 7 ZOOZ .......~c;..... . ..J).~li"< 0803-90 /' <SElllAL . ................,......... .....--.---.........------.-......... ...~E....R.......... ::::::::+~:~+~~~::::::::;!j:~::: G3SMN DELL COMPUTER SYSTEM P6300 (*SYSlEM CRASHED) PITNEY BOWES POSTAGE SCALE DELL 446/MXE COMPUTER <1J~Pi . . ttlJJ,(:~l:n 912/98 ()lll(;il1'oi.AJj~lism. ~Jtf.sl!1N'J'Y.A.t..~ $2294.00/$0.00 0800-163 ./ A532000000 7/17/90 $1020.00/$0.00 0803-077 45915A3A55B4 5/10/95 $1797.00/$0.00 CHECK APPROPRIATE LINE BELOW: x APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOR BIDS. APPROVAL TO REMOVE FROM INVENTORY AND DISPOSE OF IT. APPROVAL TO ACCEPT HIGHEST BIDS ON SURPLUS PROPERTY. REASON FOR REOUEST: ITEMS ARE GONE. COMPUTERS CRASHED & WERE TAKEN BY TECHNICAL SERVICES AND NEW ONES WERE PURCHASED. POSTAGE SCALE ONLY WORKED WITH OLD SYSTEM. PREPARED BY; LISACllERRY _ . _ ~~Y30'2002 DIVISIONDIRECTORAPPROVAL~ _ ~~ PRINT NAME: JAMES t. RTS ~~ p" t-JT" ~ K E t-J ()e: {2. e." NA-lJ on: eJf \-.H c. A h ~ E: fl.v' I (, \:s ~: 0"':"""-. ,.......-T'l T"l"'\on.. T'\r'lrTorT"'lo " I^n TO: DIVINA SPEER PROPERTY CLERK FINANCE DEPT DATE: \ ~ b-S'.....02-- RECEIVED FEB 0 12001 MONROE COUNTY INVENTORY DELETION REQUEST FROM: PlAbll~, W Drt'/5 RECEIVED JAN 2 8 2002 M.C. 1.0. NUMBER 0903-700 J 1794B49673 Carrier AJC 11/02/1994 $884.40/$0 CHECK APPROPRIATE LINE BELOW: xxxxx APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOR BIDS APPROVAL TO REMOVE FROM INVENTORY AND DISPOSE OF IT. APPROVAL TO ACCEPT HIGHEST BIDS ON SURPLUS PROPERTY. REASON FOR REQUEST: BROKEN PREPARED BY: ~ 4- ."..j~ DIVISION DIRECTOR APPROVAL: ~ ~ PRINT NAME: Dent Pierce DATE: I / .I- ~- /0 A- I I "2-/1 [0<'- OMB FORM REVISED 11/99 ds MONROE COUNTY "COMPUTER RELATED EQUIPMENT" INVENTORY DELETION REQUEST RECEIVED rES 52002 TO: L>"V.,,,C\ S~ r PROPERTY CLERK. FINANCE DEPT. DATE: ~O~ FROM: _rna.("~ G:oJ.~ S ~..tppn J.,Str) ~ ~. ILL \ {EL ~: ,)? ,,[J[JZ M.C. I.D. NUMBER SERIAL NUMBER ASSET DESCRIPTION DATE ORIGINAL & EST. PURCHASED PRESENT VALUE 5'(~\~ Ue..\1 00 ~f}o ., \ l,l, a CHECK APPROPRIATE LINE BELOW: APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOR BIDS. ~ APPROVAL TO REMOVE FROM INVENTORY AND DISPOSE OF IT. APPROVAL TO ACCEPT HIGHEST BIDS ON SURPLUS PROPERTY. REASON FOR REQUEST: C) L iJ ~ 0 f1.> so L.EfT&' - f..J 0 L b h6(jfl, oJ a & ~ PREPARED BY: .AM"Cu~~~ DATE: OL nrvlSloN DIRECTOR APPROVAL, p._/,/te- ' I I PRINTN :~~Ml ~~ f2-cE Z ~t02- TECHNICAL SERVICES APPROVAL, ~-- PRINT NA ~ ~ t.. ~ f11 ,4...I...J OMB FORM REVISED 11/99 . I - I .....-.::::.I:::.I~...::::. I \l::j: 44At,"1 r Kul".l ~. I C/9/L-)t./"EL ~/'9.// ,U'.-<,/;r ~f'L~//qy<.8 '7'9~?.3 (3.,,-..,.y~ {?903- 700 - /;;/~ ft/..-d #,,4;7 pvA'..$ ~~.s,~ o~ tP# 7?"'~'7, /l~F ()?<> .b~ Ct?~/,~/L-. ~R.P) 7ed: .4~~ 7t/o7- QUERY ASSETS: 1.,._ PREVIOUS FIRST LAST F (I)NANCIAL EXIT VIEW NEXT QUERIED ASSET PENTAMATION -------------_____________________________________________ ASSET 1 OF 1 FOUND PROPRIETARY FUND (Y/N) ASSET ID - !IIII DEPARTMENT DATE ACQUIRED CATEGORY CODE DESCRIPTION GRANT FUNDING SOURCE LOCATION CODE VENDOR CONDITION INSURER ESTIMATED LIFE MANUFACTURER DEPRECIATE ASSET MODEL DEPREC LIFE .. . SERIAL NUMBER DEPREC COST CENTER CUSTODIAN DEPREC ACCOUNT LOCATION INVENTORY DATE REMARKS MAINTENANCE DATE LICENSE # RETIRED DATE TFER FROM/TO STATUS ENTER Y IF ALL ARE CORRECT OR N TO REENTER MONROE COUNty -:P' "COMPUTER RELATED EQUIPMENT" INVENTORY DELETION REQUEST 200l. TO: DIVINA D. SPEER FROM: PROPERTY CLERK FINANCEHEebIVED FES 04 2002 DATE: ~~ 2000-442 I 283335 MICROSCOPE 03/13/1986 $1117.00/$0 2000-485 ./ N/A STERILIZER 10/01/1985 $1.570.78/$0 2000-716.f 901 B0054216 OKIDATA PRINTER 04/06/1989 $871.76/$0 2000-726 j 201769 CASH REGISTER 11/02/1989 $899.10/$0 2000-745 .f BXNLT DELL COMPUTER 10/27/1997 $1,724.00/$0 2000-747 / BXNLM DELL COMPUTER 10/27/1997 $1,724.00/$0 2000-738 I 2316570 GA TEWA Y COMPUTER 10/27/1997 $1,531.70/$0 2000-748 j BPRMQ DELL POWER EDGE COMPUTER 10/27/1997 $6,659.00/$0 2000-801 I B57D9 DELL COMPUTER 10/27/1997 $1,845.00/$0 2000-842 j 6Z32X DELL COMPUTER 10/27/1997 $1,693.00/$0 CHECK APPROPRIATE LINE BELOW: xxxxx APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOR BIDS APPROVAL TO REMOVE FROM INVENTORY AND DISPOSE OF IT. APPROVAL TO ACCEPT HIGHEST BIDS ON SURPLUS PROPERTY. REASON FOR REQUEST: NOT STATE STANDARD/OUTDATED OLD - OBSOLETE - NO LONGER IN USE PREPARED BY: ~?~ PRINT NAME: CHRISTOPH R SMIT~ ~~ DIVISION DIRECTOR APPROVAL: Q PRINT NME: ~ERFOR TECHNICAL SERVICES APPROVAL: PRINT NAME: N PERR N DATE: 1!3JIO~ )/'5 VOL OMB FORM REVISED 11/99 ds TO: DIVINA D. SPEER PROPE TY CLERK FINANCE DEPT DATE: - oJ- RECEIVED FEB 1 :t JOOZ MONROE COUNTY "COMPUTER RELATED EQUIPMENT" INVENTORY DELETION REQUEST FROM: ~ _, r~ ~; M.C. 1.0. NUMBER 3000-125 / 3128JG237C Printer OS/27/1992 $1,028.00/$0 3000-169 j 9R8BJ Comp~er 08/25/1997 $1,351.00/$0 CHECK APPROPRIATE LINE BELOW: APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOR BIDS XXXXXX APPROVAL TO REMOVE FROM INVENTORY AND DISPOSE OF IT. APPROVAL TO ACCEPT HIGHEST BIDS ON SURPLUS PROPERTY. REASON FOR REQUEST: 3000-125 BROKEN 2000-169 OUTDATED-OLD-OBSOLETE-NO LONGER IN USE DEPARTMENT DIRECTOR: (.a-t97~DA ~N~ PREPARED BY. TECHNICAL SERVICES APPROVAL: PRINT NAME: OMB FORM REVISED 11199 ds MONROE COUNTY IICOMPUTER RELATED EQUIPMENTII INVENTORY DELETION REQUEST TO: DIVINA D. SPEER FROM: PROPERTY CLERK FINANCE DEPT DATE: 1 0201-190./ 5721759 Gateway Computer 09/30/1996 $1,857.00/$0 2 0201-167.-' 4G8ZN Dell Computer 02/22/1995 $2,001.00/$0 3 0202-315", 3417122 Dell Computer 03/02/1994 $2,343.00/$0 4 0201-084' 4134HBF30105 Compaq Computer 03/30/1991 $3,764.97/$0 5 0202-248 v' W910520484 UPS 09/25/1991 $759.00/$0 6 0202-286./ B93070702263 UPS 09/01/1993 $827.84/$0 7 0202-324'/ 404A0027093 Okidata Printer 07/13/1994 $968.00/$0 8 0202-353 " DCA400041 Hi resolution monitor 02/07/1996 $2,835.00/$0 9 0202-358" DT A5058A0024 Hi resolution monitor 02/07/1996 $2,835.00/$0 10 0204-126 . 005972 Printer 12/12/1990 $1,800.00/$0 11 0204-127" 008003 Controller 12/12/1990 $1,425.00/$0 12 0204-132 / 2630275 Modem 03/18/1991 $966.93/$0 13 0201-080 / 411 HAN30059 Compaq Computer 07/16/1991 $3,298.00/$0 14 0201-111 ' 23A2704 IBM Computer 06/03/1992 $3,095.00/$0 15 0201-124 . 5XHA00800287 Hundai Computer 09/30/1992 $1 ,499.00/$0 16 0202-198 ' 8552016HS NEC Computer 08/23/1988 $1,814.95.00/$0 17 0202-206 / 90603179 Computer w/ cash drawer 09/30/1989 $2,177.50/$0 18 0202-288 . 320B1382 Monitor 09/01/1993 $2,512.00/$0 19 0204-144 .' NA Linecard 09/30/1991 $3,469.60/$0 20 0204-164 v NA Cabinet 09/08/1993 $900.00/$0 CHECK APPROPRIATE LINE BELOW: APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOR BIDS XXXXX APPROVAL TO REMOVE FROM INVENTORY AND DISPOSE OF IT. APPROVAL TO ACCEPT HIGHEST BIDS ON SURPLUS PROPERTY. J , I J REASON FOR REQUEST: #1 in Conf room hard drive dont work. Lance took it apart. #2,3,4 in conf rm outdated, surplused, bidders refused #5-20 @ the jail cell #1, 2, 3 equipment mostly broken-outdated-old-obsolete and no I nger in use. LIQ Lisa A ury PREPARED BY: ])~ \ Divina Speer DIVISION DIRECTOR APPROVAL: PRINT NAME: TECHNICAL SERVICES APPROVAL: PRINT NAME: OMB FORM REVISED 11/99 ds RECEIVED FEB 2 1 za02 MONROE COUNTY "COMPUTER RELATED EQUIPMENT" INVENTORY DELETION REQUEST TO: DIVINA D. SPEER FROM:~, ~~ PROPERTY CLERK FINANCE DEPTBECEIVED FEB 0 DATE:~-/G"-o;L 2 2002 1801-134/ USHB146834 HP Printer 09/30/1996 $875.99/$0 CHECK APPROPRIATE LINE BELOW: xxxxxx APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOR BIDS APPROVAL TO REMOVE FROM INVENTORY AND DISPOSE OF IT. APPROVAL TO ACCEPT HIGHEST BIDS ON SURPLUS PROPERTY. REASON FOR REQUEST: BROKEN am ate PREPARED BY: ' -----' DIVISION DIRECTOR APPROVAL: PRINT NAME: TECHNICAL SERVICES APPROVAL: PRINT NAME: OMB FORM REVISED 11/99 ds RECEl "" "I " " i ,,:" ~'~~_ ~.,{ .G d '/! l ~ i r MONROE COUNTY .~.- INVENTORY DELETION REQUEST TO: DIVINA SPEER PROPERTY CLERK FINANCE DEPT DATE: FROM: Holly Elomina ~~/nO-/ 0601-361 N/A Smartwriter 07/26/1996 $1,800.00/$0 CHECK APPROPRIATE LINE BELOW: APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOR BIDS APPROVAL TO REMOVE FROM INVENTORY AND DISPOSE OF IT. APPROVAL TO ACCEPT HIGHEST BIDS ON SURPLUS PROPERTY. REASON FOR REQUEST: Broken - Beyond economical repair xxxxx PREPARED BY: DATE: DIVISION DIRECTOR-APPROVAL: PRINT NAME: -LJu~J U)l~ Theresa Westerfield OMB FORM REVISED 11/99 ds 3- 6-02;10:58A1~;~O~JROE COUI':1'( MIS ; 305;::9551 05 ff I / ,..~ TO: DIVINA D. SPEER PROPERTY CLERK FINANC = DEPT DATE: MONROE COlJlNTY "COMI:>>UTER RELATED ~UIPMENT" INVENTORY DELETION REQUEST FROM:ifk~t ~;u , ,) i",;J6L: v/;bj) iJi4R ,IiI ; "XifiO'~ -'- < -".t_"'~"". 3300-133 E25QG Dell Computer 04/16/1998 $1,981.00/$0 .~. .~. . ,.' ,:f ~ ,;:: .~~; :,; 2; ..~L. . - J~. ~~ ()..l:"rv_'t' ~ .;~ ~ ~ fVv<'"t~ . \~~-..t _ _ ' . '......."]5 . tA. APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOH BIDS XXXXX APPROVAL TO REMC'VE FROM INVENTORY AND DISPOSE OF IT. APPROVAL TO ACCEPT HIGHEST BIDS ON SUFtPLUS PROPERTY. REASON FOR REQUEST: BROKEN I ---.J CHECK APPROPRIATE LINE BEL')W: PREPARED BY: ~M G~rJb Risk Manager (A, W~ \(..Q~ Pri" Mme: Mana Del RIO __ (~ Pri,' Name: W yne Robertson DIVISION DIRECTOR APPROVAL: ___~ ~ PRINT NAME: JAME ROBERTS TECHNICAL SERVICES APPROVAL: PRINT NAME: B FORM REVISEI) 11199 ds ~. 3 '='''-0 3- 6-02:10:S8^t/!;vlONROE COUi'-llv MIS ; 305:~9551 05 it 2/ 2 . 03/El6/20112 09: 19 3El5295366:J J I Vv K[LHA<:,E QERK FINANe PAGE Ell! Ell MONROE COUNTY "COMPUITER RELA'tED ECIUIPMENT" INVENTORY DELETION F~EQUEST TO: DIVINA D. SPEER PROPERTY CLERK FINANCE DE PT DATE: FpbTuary 21... 2001 FRON: . TAX COLLECTOF~ OFF! CE ~~lcD rm!i.llilllltl~WNf~l~j!~lmli~~IJmll!!mlliii"'~=, DIAn STATION -- 0';00-7'>9 E.. TF.R'MTNAt. VIRnNIA STATION 0500-760 WYSE TERMINAL DIA:U' STATION. , 0500-794 303LTOOIZ20 7 SCUTRE, Collection Svst; 9-10-1993 i .t8.m.. 0 $89Q.OO/$O $2044.00/$0 t CHECK APPROPRIATE LINE BE:lOW: APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOR BIDS ?5'!.'l' APPROVAL TO REMOVE FROM INVENTORY AND DISPOSE OF IT. APPROVAL TO ACCEPT H GHEST BIDS ON SURPLUS PROPERTY. REASON FOR REQUEST: ,J&.ABLE TO FIX. Tal COSTLY TO REP1,I:~J~URNED OUT. - -. ~:~~ PREPARED BY: _. ~ _Go.~....._:.':' . DATE:_&rcli.. DMSIDN DIRECTDR APPROVAL' ~ ~i~ PRINT"""",, ~~.dq"., ~.r: _ <..__ TECHNICAl SERVICES APPROVAL.; h_~ "- _ _ ~_ '. PRINT NAME: ,~~~ h eK"f"'1 ~ h _ 9,1, 2001 OIflB Jl"ORM REVISED 1 11DU cI. MONROE COUNTY INVENTORY DELETION REQUEST m~ 6,//edM.-M{7tJrlktltwllj \ ~Au J.5" ~ .-j} !--Ie-/tl/l/w e-?_ ., ". TO: FROM: PROPERTY CLERK, FINANCE DEPT. DATE: SERIAL ASSET NUMBER DESCRIPTION 4//oc-1-foR. /J ' Bow ~ s: /'loci",; .43 DO ~7(,~'),(~iJ) MJ4r'/ S'-Ale... /'t-S;t)filJ" p,(3(7~V~5 A-1 de DATE PURCHASED -5~J"o .5J~1/9;?) 7&;.. ?g /H4c~j /l1IJCtzf~ firlJ9 p (JONe ~ Hode.l Go DO 2 -S~~ 'SeUi 79lJD P. e:,Ot../E.s' Hade 3..;,ro Xt3!1 ~ $j1l/1p ~~ 1/U,/OO ()!Jt:{)- ~~ CHECK APPROPRIATE LINE BELOW: APPROVAL TO REMOVE FROM INVENTORY AND ADVERTISE FOR BIDS. APPROV AL TO REMOVE FROM INVENTORY AND DISPOSE OF IT. APPROV AL TO ACCEPT HIGHEST BIDS ON SURPLUS PROPERTY. REASON FOR REQUEST: (()'?.f)- p~ d7 /Iv~!etJ)~ - ~e~iJ8Jr 73~t'4.c];>~LilAJ/ Ft!J L Pe,pa..; /CZJ , r PREPAREDBY>~0 a~ < DATE: ED DIVISION DIRECTOR APPROVAL: ~' ~ / ZL-~ PRINT AME ..})/W~ ---.;;;, 'fub-Z OMU FORM REVISED 11/99 I- IStJ... TT II /oJ.-LU1.-' iF35"~ ' ORIGINAL & EST. PRESENT VALUE ItJ:J.J% UJJJ/, "0 59/:l,dJ. tN/ I'.,. ' , 1, <;i:' hOdsTLLI r