EQUIPMENT UPDATE REPORT
Name of County here COUNTY
# of 911 CKTS TRUNKS:
Due: Jan. 2009
# PSAP POSITIONS: Phones / PBX System Mapping Hardware $ $ $ $ $ -
EQUIPMENT: Answering Equipment Brand/Model/Size/Vendor/Version: Original Purchase Date / Price $ Beginning FY08 Price (see application) $ FY08 Purchase Upgrade / Price: $ Replaces Item / Price: $ (Beg. Price + Upgrade - Replacement) Current Value: $ EQUIPMENT: Mapping Software Brand/Model/Size/Vendor/Version: Original Purchase Date / Price $ Beginning FY08 Price (see application) $ FY08 Purchase Upgrade / Price: $ Replaces Item / Price: $ (Beg. Price + Upgrade - Replacement) Current Value: $ EQUIPMENT: Call Detail Recorder Brand/Model/Size/Vendor/Version: Original Purchase Date / Price $ Beginning FY08 Price (see application) $ FY08 Purchase Upgrade / Price: $ Replaces Item / Price: $ (Beg. Price + Upgrade - Replacement) Current Value: $ EQUIPMENT: CAD Software Brand/Model/Size/Vendor/Version: Original Purchase Date / Price $ Beginning FY08 Price (see application) $ FY08 Purchase Upgrade / Price: $ Replaces Item / Price: $ (Beg. Price + Upgrade - Replacement) Current Value: $
(see application)
Current Value:
$ $ $ $
-
(see application)
Current Value:
UPS Batteries Date Replaced: Logging/Voice Recorder $ $ $ $ $ (see application)
UPS $ $ $ $ $ -
Current Value:
CAD Hardware $ $ $ $ $ -
(see application)
(see application)
Current Value:
Current Value:
Auxiliary Generator $ $ $ $ $ -
Clock Synchronizer $ $ $ $ $ -
(see application)
(see application)
Current Value:
Current Value:
TIME AUDIT / CERTIFICATION
DUE: Jan 2009
Name of County here As of: Name of County Coordinator: Title: *% of Time Performing 911 Coordinator Duties: Other duties: Name of MSAG Coordinator: Title: *% of Time Performing MSAG Coordinator Duties: Other duties: Name of Mapping Administrator: Title: *% of Time Performing Mapping Admin Duties: Other duties: date
0%
0%
0%
Names of Call Receivers:
*% of Time Performing Call Receiver Duties 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
Title
Other Duties
COMMENTS/NOTES:
* Average time
E911 7/14/08
SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
CAMP MURRAY, WASHINGTON 98430-5122
NEW FORM WILL REPLACE PREVIOUS FORMS NAME OF ORGANIZATION DATE SUBMITTED
Name of County here
PROJECT DESCRIPTION CONTRACT NUMBER
FY09 E911 County Contract
1. AUTHORIZING AUTHORITY SIGNATURE
E09 - _____
PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS SIGNATURE PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT (A-19) SIGNATURE PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
Please complete form with any new contract or any time personnel changes. Submit one original to State E911 Office