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AMADOR COUNTY UNIFIED SCHOOL DISTRICT
Page \ of ---1l_ Amador County Unified School District /Amador County Office of Education
Request to Surplus
school site/Department: _____..~_.._.'-\t::f-~~""-------- Date Jj~ajf{
Item 1.0 . #and Inventory ~ticker Description of the Item Reason for Surplus Request Including: Brand, Model, Year Purchased
AMADOR COUNTY \ {o flfif Jfer Ob5oid~ USD
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-~r Uf}u5Jfe_ AMADOR COUNTY
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003893
AMADOR COUNTY I
\ USO
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AMADOR COUNTY USO
If lllllll lllll llllllllllllllllllll llllllll 003881
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•.. ~-AMADOR COUNTY I
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00491 2 -
' '-VJ J}\_.. Date: L /it J l? Administrator's Signature:
--------------------------------------------------------------------------------\ - r------------(:}---':'.:. __________________________________ J. _____ :.: _________ DISTRICT USE l Re<eived bySupe<intendent" Offi<e f){)c jj, ~ FEB
2 S Z01E
Superintendent's recommendation for value and disposal method:--------- - - --
RECEIVED Date: ____ _
Board Approval sent to site: _______________ Date: ---- -
Final Method of Disposal: ________ ________ ____ _
Responsible Employee's Signature:------------- Date: ____ _
8/2015
Page c9-- of~
·-Item l.D. # and Inventory Sticker Description of t he Item Reason for Surplus Request
Including: Brand, Model, Year Purchased
AMADOR COUNTY
{oN!fJfer Ob&oleJtj USO \ :
~ 1111111111111111111/ll llllllllll llllllll 003883
·~r Vflu5J/e_. - · - _... _ . ·- --..
AMAOOR coUNT'i ' \
\~'\'\~~,~~i\~~\\~i~ • \ ~ 003s91 -I I
AMADOR COUNTY- . \
\ USO • \
1111111111111111111111111111111111111111
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~~ 003866 .. - - -·---AMADOR COUNTY
'1 USO
lllllll lllll llllllllllllllllllllllllllll l 003865
_, - - --->--·
AMADOR COUNTY '· USO I ,-, 111111111111 11111 11111111111111111111111 003882
.. -... I) r'\ (\ (
Administrator's Signature: G~; ' b \,. ~ -0.-Date:
DISTRICT USE
Received by Superintendent's Office _____________ Date: ____ _
Superintendent's recommendation for value and disposal method:------------ -
Board Approval sent to site: ______ ________ __ Oate: -----
Final Method of Disposal: ____________________ _
Responsible Employee's Signature:-- -----------Date:-----
8/2015
Page _3_ of ( ~ Amador County Unified School District I Amador County Office of Education
Request to Surplus
School Site/Department: ---"--=+~"'-'ll-J-.....l........:"':::fz::!::_.:;...-------- Date JP (j f I~ Item 1.0. #and Inventory ~ticker
AMADOR COUNTY . ·-._.
.. 1111111 11111 1111~1~11!111 11111 11111111 · 1 003890
.. , -·
AMADOR COUNTY USO
~ 1111111111111111111111111111111111111111 003900
AMADOR couNiY USO
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AMADOR COUNTY USO
1111111111111111111111111111111111111111 003901
AMADOR COUNTY USO
~ I \\\Ill \\Ill\\\\\\\\\\\\\\\\\\\\ \I\\\\\\ 003884
C'll
DISTRICT USE
Description of the Item Including: Brand, Model, Year Purchased
Reason for Surplus Request
Ob5oldt/ V f} u5J /e_,
Received by Superintendent's Office _ _ _ ________ __ Date:-----
Superintendent's recommendation for value and disposal method:-------------
Board Approval sent to site: _______________ Date: ____ _
Final Method of Disposal: ____________________ _
Responsible Employee's Signature:------ ------- Date:-----
8/2015
Page Jl of Jl_
Item 1.0. #and Inventory ~ticker Description of the Item Reason for Surplus Request Including: Brand, Model, Year Purchased
AMADOR COUNTY {oN!fJer Ob5oleft/ USO
I llllll lllll lllll lllll lllll lllll llll llll 003870 ·~r V fl u6J f e__,, - ----.. ....
AMADOR COUNTY \ USO I
lllllllllllllllll lllllllllllllll\1111111 ~ \ I
. ' ~ 003878 -----
AMADOR COUNTY uso
• I /Jll/l//ll/ l/l/ll/ll/ll/l/ll//JJl//ll// I I
003886 I
AMADOR COUNTY " \ USO I
"' • I \\\Ill\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\ 003888
- - -
~- - ---... AMADOR CO UNTY I
USO
lllllll lllllllllllllllllllllllllllllllll ' 003871
,D} \L I
.. c D' UJoY- r Administrator's Signature:--------Date: ___ _
DISTRICT USE
Received by Superintendent's Office ________ _ _ _ __ Date: ___ _ _
Superintendent's recommendation for value and disposal method:-------------
Board Approval sent to site: _ _ _________ _ _ __ Date: _ ___ _
Final Method of Disposal : _______ ______ _______ _
Responsible Employee's Signature: _____________ Date:---- -
8/2015
Page s__ of ( J_ Amador County Unified School District/ Amador County Office of Education
Request to Surplus L { School Site/Department: Date: J -J (] I rq
I I
Item :.o. :i and Inventory ~ticker Description of the :tern Reason for Surplus Request
lnc!uding: Brand, W1odel, Year Purchased . .. . .... .
'>-
(ofa.1f~ Ob&olelt/ .MADOR COUNTY
USO
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003593 I . ..-')(fwe r Uriu5J/~ ~
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AMADOR COUNTY USO
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---· .. -----
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DOR COUNTY .,. USO ,
llll lllll\llllllllllllllllllllll 003966 "
AMA
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A MADOR CO UNTY ·- : .'\
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---- - -- - --AM ADOR COUNTY '
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j~~ -i;ninis~;ator's Signature: ( rr Date: ... ·-
DISTPh . '->~..:
Recei\.• ... ~'t Sup~rinte.,dent':.: Office _____________ Date: ____ _
Supcfr1 <:?n- !nt'!: r:? .::ommP . !ion for value and disposal method:---- ·---------
- --- ·-· ---·- -------- -----------Beard Approval t.e: - ----- - - _______ Date: _ ___ _
'1=inal Met hod of LJi:;posa l : ____ _
Rcspor. . ." 1; ie Employe ,, , Signature: _ ___ _ , ___ Date: ____ _
8/2015
Page L ofJL
Amador County Unified School District/ Amador County Office of Education
School Site/Department:
Requestto Surplus Date: [)_&a LJq I '
Item l.D. # and Inventory Sticker Description of the Item Reason for Surplus Request Including: Brand, Model, Year Purchased
AMADOR COUNTY h
{oN!fJfer Ob5ofefe/ · USO
1111111111111111111111111111111111111111 I
·~( Vf}u.5Jf~ 003875
.. AMADO.R COUNTY
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\ 003861 I I J - -- ------ -·--
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< \ AMADOR COUNTY USD
lllllll lllllllllllllllllllllllllllllllll ' I 003897
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AMADOR COUNTY \ USO
11\ll\\ l\\\\ \\I\\\\\\\ Ill\\ \\Ill \\\I 1111 003892 '•
. - . AMADOR CO UNTY
USD
lllllllllllllllll lllllllllllllllllllllll I 003895 - ,.... ,...,. (
......_ lJ )l~~ Administrator's Signature: r 7\ Date: "" .....
. DISTRICT USE
Received by Superintendent's Office _____________ Date: ____ _
Superintendent's recommendation for value and disposal method:--- ------- ---
Board Approval sent to site: _____________ __ oate: _ ___ _
Final Method of Disposal: ____________________ _
Responsible Employee's Signature: ________ _ ____ Date:-----
8/2015
Page 1-of _\l,_ Amador County Unified School District/ Amador County Office of Education
Request to Surplus
School Site/Department i; J Of }~11115 - .;r: ft) Name of Person Completing Form: 13 tfj:f lJa.,.ta 0 Y\
oate: ___ d-/J_O / ___,___fq _ ~ '
Item l.D. #and Inventory ~ticker Description of the Item Reason for Surplus Request
Including: Brand, Model, Year Purchased
AMADOR COUNTY - : [o.ip<J~ OcJ.f J~./M 4 11;J lz__, lJSO
Ill/II/ 11111 Ill/Ill/I/ I/Ill/I/II I Ill I/I/ I
J (!WU 003970 .--
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. -AMADOR COUNTY \ USO
\lll\\\llll\lllll\\lllll\l\lll\\l\llllll 003584
- -- -·--~ ' AMADOR COUNTY '
USO
\\ll\\\ lllll llllllll\l\l\\llllllllll\lll 003965 -·
AMADOR CO UNTv USO
I/Ill/I I II/I I/Ill I/Ill I/I/Ill/II II/I/Ill 003968 ,_ '-on n I - .. - - --
. . , . C~1 ~r . Administrators Signature.------ --- Date. ___ _
DISTRICT USE
Received by Superintendent's Office ______________ Date: ____ _
Superintendent's recommendation for value and disposal method:--------------
Board Approval sent to site: ________________ Date: - ----
Final Method of Disposal: _____________________ _
Responsible Employee's Signature:--------------Date:------
8/2015
Page _R_ of _il__ Amador County Unified School District / Amador County Office of Education
Request to Surplus / I School Site/Department: lJ, (,1 ~- '10 ,) S - "J: µ ~ Date: d /JO, / q
I ("7 .
Name of Person Completing Form: __ ~~~!e~·~~-~~~~~~~~~~---------~ Item 1.0. #and Inventory ~ticker
Description of the Item Reason for Surplus Request
Including: Brand, Model, Year Purchased , AMADOR COUNTY
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AMADOR COUNTY . USO
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AMADOR COUNTY USO
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I AMADOR COUNTY \ USO ·
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'-DD~ ~~ 003942 - . - - .. ( f1'. I
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Administrator's Signature:--------Date: _ _ _ _
DISTRICT USE
Received by Superintendent's Office _____________ Date: ____ _
Superintendent's recommendation for value and disposal method:-------------
Board Approval sent to slte: _______________ Date: ____ _
Final Method of Disposal: ____________________ _
Responsible Employee's Signature:-------------Date:-----
8/2015
Page i_ of Q__ Amador County Unified School District/ Amador County Office of Education
Request to Surplus j I School Site/Department: -l""'=""~~j _ O-'-'--aJ_,_c v-=\ S:..___:L--L--_f/( --'-?) _ _ Date d-DM ilq
) Name of Person Completing Form: _________ _ ______ _ _ ____ _
Item 1.0. # and Inventory ~ticker
i ·· AM.ADO.A co"uNi'Y ··· USO
. I 1111111111111111111111111111111 Ill\ Ill\ . 003797
AMADOR CO\JNTY - .. USO • I
1111111 11111 11111 11111111111111111111111 003969
AMADOR COUNTY USO
1111111111111111111111111111111111111111 003941
Resource 6390
Asset Tag no03964 200712008
AMADOR COUN-TY USO
lllllllllllllllllllllllllllllllllJJJJlll 003796
DISTRICT USE
Description of the Item Including: Brand, Model, Year Purchased
Reason for Surplus Request
Received by Superintendent's Office _ _ _ ______ _______ Date:------
Superintendent's recommendation for value and disposal method:---------- - - ---
Board Approval sent to site: _ ___ _________ _____ Date: --- - --
Final Method of Disposal : _ _____ ______ _____________ _
Responsible Employee's Signature:------ ----- ----- Date: - --- - -
8/2015
Page _lLotJL
Item l.D. #and Inventory Sticker Description of the Item
Reason for Surplus Request Including: Brand, Model, Year Purchased
- - - - ··-·
Db5ofek/ AMADOR COUNTY ~~
{oN!fJfer USO
1111111 111!1!1111111111111111111 11111111 002883 ·~r U11u5J/e_, ..
-AMADOR CO UNTY
DeJ I L~pfot {)bsd(ek uso
flllll/ l//ll l/!ll l/lllll/l/ !1/ll//llll/! 004725 D ~ - )FA't7 rYf
41i itt~ pl(_{ '·
AMADOR COUNTY
01J5ofe_je USO
1111 111111111111111111 111111111111111111 L-c-pfof 004015
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l)ltf[ tap Okvlde lrf - ,... --
ul~ u AMADOR COUNTY
oJtvkk USO
I II/Ill I/Ill I/Ill/I/II II/I/ Ill/I/Ill I/II 004723 µ(t({() L .
I
--- -------------------------------------~~-:'.:'.'.'.~~'.~~'.-~'.~~-~'.~'.~'. ... ----~-~}. ______________ ~~-:~: __________________ ___ DISTRICT USE
Received by Superintendent's Office _____________ Date: ____ _
Superintendent's recommendation for value and disposal method:------------
Board Approval sent to site:. ______________ Date: ____ _
Final Method of Disposal: ___________________ _
Responsible Employee's Signature:--- --- --- ---Date:-----
8/ 2015
Item 1.0. #and Inventory ~ticker
DISTRICT USE
Description of the Item Including: Brand, Model, Year Purchased
Reason for Surplus Request
l \ ir \&\ I [
Received by Superintendent's Office _______________ Date:------
Superintendent's recommendation for value and disposal method:----- ----------
Board Approval sent to site: _________________ Date: ------
Final Method of Disposal: ______ _ ___________ ______ _
Responsible Employee's Signature: - - -------------Date: - -----
8/2015
Page
Amador County Unified School District I Amador County Office of Education
School Site/Department:
Item l.D. #and Inventory Sticker
DISTRICT USE
AMADOR CO UNTY uso
ll/l!ll //l/l/llll I/Ill/I/II l//ll//ll /I// 004722
Requestto Surplus Date ;} I JO!~ Description of the Item Reason for Surplus Request
Ob5oldt/ U1Ju.5J/~
( l
I I
Received by Superintendent's Office ____ _____ _ ______ ____ _ Date:---- - ---
Superintendent's recommendation for value and disposal method:------- --- - - - - - - - -----
Board Approval sent to site: _ _ _ _ _ _ _ _ _ _ _ _ _ ___ _ _______ Date:
Final Method of Disposal:------- - ---- --------- -------------
Responsible Employee's Signature:--- ----------- - ----- Date: - -------
8/ 2015
AMADOR COUNTY PUBLIC SCHOOLS Acknowledgment of Donation of Gift/Contribution to District
Date: 2/26/19 School Site I Department: Educational Services Name of person completing this form: Margaret Shoda Description of Gift I Contribution: 2019 Song Books of Amador & Calaveras Counties for all school sites No goods or services were provided by Amador County Public Schools in return for the contribution. Does the gift/contribution require Maintenance Department services for installation? D Yes ~No
If yes, Maintenance Department completes this section. Required materials for installation: __ Labor costs of installation: __ Total: ** Maintenance Director 's Signature:
Name of Donee/Contributor: _L_e_d_,,.g'---e_r _D_i___,spL_a_t_c_h __________ _ Mailing Address: _P_O_B_o_x_1_2_4_0 ______________ _ Town: Jackson Zip: 95642 Telephone No.: 209-223-8761
Have you acknowledged receipt of gift/contribution with a thank you letter? ~YesD No (If yes, please attach a copy of thank you letter.)
**Note: If maintenance and material costs for installation are unbudgeted or prohibitively high, the Superintendent may recommend Board rejection of the gift/contribution.
Form No. 49 (Rev. 3/2008)
February 27, 2019
Ledger Dispatch PO Box 1240 Jackson, CA 95642
Dear Mr. Mitchell,
Amador County Public Schools 217 Rex Avenue, Jackson, CA 95642
(209) 257-5353 ~FAX 257-5360
When Kat Everett contacted us to distribute the song books to our schools we were more than willing to accept this generous offer. The 2019 Song Books of Amador and Calaveras Counties were picked up and delivered to all of our schools for musicians, poets and any and all interested students this week.
We appreciate the Ledger Dispatch partnering with Amador County Public Schools by reaching out to our students and their families in support of the arts. We look forward to our partnership continuing for years to come!
Kind regards,
Y-~£21~ Donna Custodio Director of Student Services
DC/ms
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