HomeMy WebLinkAboutExhibit 24ATTACHMENT G
PROPERTY REPORTING FORM FOR DEP AGREEMENT NO. LP6 703
(Per Property With Grantee Assigned Property Control Numbers)
GRANTEE: List rum -expendable equipment/personal property' costing S 1,000 or more purchased under the above Agroandtt. Also list all upgrades` under this Agreement, costing S1,000 or more,
of property previously purchased under a DEP Agreement (identify the prefely upgraded and the applicable DEP Agreement on a separate sheet). Complete the serial nofcost, location/address and
property control number columns of this form. The Grantee shall establish a unique identifier for tracking all personal property pmclnseid uhder this Agreement and shall report the inventory of said
property, on an annual basis, to the Departinen s Grant Manager, by DEF Ajgreanent numberLtro later than January 31" for each yeas this Aignsement is in effect.
DESCRIPTION SERIAL NOJCOST" j LOCATION/ADDRESS
'Not including software, **Attach copy of invoice, bill of sale, or other doamtettation to support purchase.
GRANTEE ASSIGNED PROPERTY
CONTROL NUMBER
GRANTEE:
Grantee's Grant Manager:
BELOW FOR DEP USE ONLY
t Date:
DEP GRANT MANAGER:
DEP Grant Manager Signature:
Malatalrr this document with a copy of the invoices supporting the cost of each item identified above du your Agreement file. If the Agreement is a cost
reirnbursetneat Agreement, make rare to send invoices supporting the cost of the Items to Fth+aeee and Accounting for the processing of the Grantee's
invoice ter payment.
Date:
DFP EligANCE AND ACCi UNTDNJ0 No processing requited by Finanu & Accouairng as the Grantee is responsible for retaining ownaship of the equipment/property upon satisfactory completion of the Agreement.
DEP PROPERTY MANAGEMENT_: N4 pnteessiag sequined by the Property Management section as the Grantee will retain ownership of tla a tuipmattIpruperty won aniafactory completion of the Agreement.
DEP Agreement No. LP6703, Attachment G, Page 1 of 1