State of California State of by dandanhuanghuang

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									 State of California                                                                                                                           Page           of
 DEPARTMENT OF COMMUNITY SERVICES AND DEVELOPMENT
 CSBG CONTRACT
 CLOSE-OUT EQUIPMENT INVENTORY SCHEDULE
 CSD 715D (Rev. 02/12)


Contractor Name                                                                                            Contract Term                  Contract Number


                            List all equipment inventory items purchased with CSBG funds (current & previous contract years) which
                                                             have a useful life of more than one year.


         *Item Name                          Serial            Vehicle License Plate               Purchase                Purchase                    Condition
                                            Number             Number (if applicable)                Date                    Price             G=Good     F=Fair
       (e.g., laptop, van, etc.)
                                                                                                                                               P=Poor    I=Inoperative
                                                                                                                                               N=No Longer Needed




*Note: Vehicle Purchases – you must submit the invoice and proof of payment for all vehicle purchases.


Preparer's Name & Title (Please Print)                                                                   Date                         Contact Number

                                                                                                                                      (    )

                                                      IF MORE SPACE IS NEEDED, ATTACH ADDITIONAL COPIES.
                                             INSTRUCTIONS
                               CLOSE-OUT EQUIPMENT INVENTORY SCHEDULE
                                          CSD 715D (Rev. 02/12)


Contractor        Enter contractor name, contract term and contract number.
Information


Equipment to      List all equipment inventory items purchased with CSBG funds (current & previous contract
be included       years) which have a useful life of more than one year. See definition of equipment below:

                  Equipment:
                  An article of nonexpendable, tangible personal property having a useful life of more than
                  one year and an acquisition cost which equals or exceeds the lesser of the capitalization
                  level established by the non-profit organization for financial statement purposes, or $5,000.


Item Name         Provide a brief name of the equipment item (e.g., laptop, van, etc.).


*Vehicle          You must submit the invoice and proof of payment for all vehicle purchases.
Purchases:


Serial Number     Enter the equipment serial number.


Vehicle License   If Applicable: Enter the vehicle license plate number. Do Not enter the Vehicle
Plate Number      Identification Number (VIN #).


Purchase Date     Enter the date the equipment was purchased.


Purchase Price    Enter the price for the equipment purchased.


Condition         State the condition of the items purchased using the following categories:
                  G=Good       F=Fair
                  P=Poor       I=Inoperative
                  N=No longer needed).
Agency       Enter the following information:
Approval     Print the Preparer’s Name & Title, Date the form was completed and a Contact number.


Additional   If more space is needed, attach additional copies of the form to the close-out packet.
Pages

								
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