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Property Control Record and Equipment Certification · 2021. 1. 19. · GCC – 200 Rev. 01/11/2021...

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  • GCC – 200 Rev. 01/11/2021

    Property Control Record and Equipment Certification

    The purpose of this form is to inventory all equipment purchased with federal funds during the life of the grant. All firearms must to be listed with Serial Numbers regardless of unit cost.

    Authorizing Agency: Implementing Agency: Project Name:

    Project Number: Project Director: E-mail Address:

    Equipment Information Item Description: Serial/other identification No.: Purchased Date: Vendor: Cost: Purchased by: Insurance Coverage: Assigned to: Equipment location: Equipment purpose:

    Item Description: Serial/other identification No.: Purchased Date: Vendor: Cost: Purchased by: Insurance Coverage: Assigned to: Equipment location: Equipment purpose:

    Item Description: Serial/other identification No.: Purchased Date: Vendor: Cost: Purchased by: Insurance Coverage: Assigned to: Equipment location: Equipment purpose:

    I, the undersigned certify that the equipment approved in the above referenced grant was purchased and installed in compliance with grant regulations and guidelines. The completed Property Control Record and equipment photos have been uploaded to GEMS along with applicable supporting documentation.

    ____________________________________________________________ Print Name

    ____________________________________________________________ ____________________ Signature Date

    Item Description: Serialother identification No: Purchased Date: Vendor: Cost: Purchased by: Insurance Coverage: Assigned to: Equipment location: Equipment purpose: Item Description_2: Serialother identification No_2: Purchased Date_2: Vendor_2: Cost_2: Purchased by_2: Insurance Coverage_2: Assigned to_2: Equipment location_2: Equipment purpose_2: Item Description_3: Serialother identification No_3: Purchased Date_3: Vendor_3: Cost_3: Purchased by_3: Insurance Coverage_3: Assigned to_3: Equipment location_3: Equipment purpose_3: Print Name: Date: Authorizing Agency: Implementing Agency: Project Name: Project Number: Project Director: Email Address:

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GCC – 200 Rev. 01/11/2021 Property Control Record and Equipment Certification The purpose of this form is to inventory all equipment purchased with federal funds during the life of the grant. All firearms must to be listed with Serial Numbers regardless of unit cost. Authorizing Agency: Implementing Agency: Project Name: Project Number: Project Director: E-mail Address: Equipment Information Item Description: Serial/other identification No.: Purchased Date: Vendor: Cost: Purchased by: Insurance Coverage: Assigned to: Equipment location: Equipment purpose: Item Description: Serial/other identification No.: Purchased Date: Vendor: Cost: Purchased by: Insurance Coverage: Assigned to: Equipment location: Equipment purpose: Item Description: Serial/other identification No.: Purchased Date: Vendor: Cost: Purchased by: Insurance Coverage: Assigned to: Equipment location: Equipment purpose: I, the undersigned certify that the equipment approved in the above referenced grant was purchased and installed in compliance with grant regulations and guidelines. The completed Property Control Record and equipment photos have been uploaded to GEMS along with applicable supporting documentation. ____________________________________________________________ Print Name ____________________________________________________________ ____________________ Signature Date
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