Appendix D Member Constituency Office Assets Inventory Form

Appendix D – Member Constituency Office Assets Inventory Form

Constituency:
Member: / Phone:
Constituency Assistant: / Fax:
Address of Constituency Office:
Is the Member seeking re-election on May 9? / Yes: / No

Computer and Related Equipment

Item Description
For example: personal computer, monitor, laptop, iPad, tablet, printer, scanner, etc.
(add more lines if required) / Procurement Method
L = provided by Leg. Assembly
P = purchased by constit. office
D = donated to constit. office / Estimated Cost at time of purchase / Estimated Age / Estimated Present Value / Plan for Disposal
R = return to Leg. Assembly

Audio-Visual and other Electronic Equipment

Item Description
For example: television, stereo, video players, projectors, recording devices, cameras, etc
(add more lines if required) / Procurement Method
L = provided by Leg. Assembly
P = purchased by constit. office
D = donated to constit. office / Estimated Cost at time of purchase / Estimated Age / Estimated Present Value / Plan for Disposal
R = return to Leg. Assembly
T = transfer to incoming Member

Office Furniture – with an initial acquisition cost of $500 or more

Item Description
For example: seating – including couches, chairs(guest, steno, executive), desks, bookcases, tables, file cabinets, storage cabinets, etc. / Procurement Method
L = provided by Leg. Assembly
P = purchased by constit. office
D = donated to constit. office / Estimated
Cost / Estimated Age / Estimated Value / Plan for Disposal
DO = donation
DI = disposal
S = sell
T = transfer to incoming Member

Other Assets – with an initial acquisition cost of $500 or more

Item Description
For example: artwork, rugs, decorative accessories, kitchen appliances, fans, auxiliary heaters, vacuum system, donated items of value, etc. / Procurement Method
L = provided by Leg. Assembly
P = purchased by constit. office
D = donated to constit. office / Estimated
Cost / Estimated Age / Estimated Value / Plan for Disposal
DO = donation
DI = disposal
S = sell
T = transfer to incoming Member

Disclaimer:

I confirm thatall computer equipment and related devices have been returned to the Legislative Assembly as per the guidelines for disposition of constituency office assets (see Appendix 1).

I also confirm that all office furniture, equipment and other assets have been disposed of in accordance with the Legislative Assembly guidelines for disposition of constituency office assets (see Appendix 1).

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Member SignatureDate

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Member Name (please print)