Property and Equipment Activity Form
(PEA)
Please use this form when equipment location changes due to the following:
Equipment is being transferred to another department
Equipment is going to Surplus
Equipment is being transferred to the employees home
Complete the necessary fields for up to 6 assets, and click on the 'Submit' button below.
Asset #
Description
Model#
Serial#
Manufacturer
Biomed#
From
Unit# / Building / Room
To
Unit # / Building / Room
1
Condition:
No work/no repairs necessary
Repairs of 10% or less of acquisition cost
Repairs of 11-50-% of acquisition cost
Repairs of 51-75% of acquisition cost
Spare parts only
Scrap/no value
Activity:
Transfer to another Dept.
Go to Surplus
Transfer to Employees Home
2
Condition:
No work/no repairs necessary
Repairs of 10% or less of acquisition cost
Repairs of 11-50-% of acquisition cost
Repairs of 51-75% of acquisition cost
Spare parts only
Scrap/no value
Activity:
Transfer to another Dept.
Go to Surplus
Transfer to Employees Home
3
Condition:
No work/no repairs necessary
Repairs of 10% or less of acquisition cost
Repairs of 11-50-% of acquisition cost
Repairs of 51-75% of acquisition cost
Spare parts only
Scrap/no value
Activity:
Transfer to another Dept.
Go to Surplus
Transfer to Employees Home
4
Condition:
No work/no repairs necessary
Repairs of 10% or less of acquisition cost
Repairs of 11-50-% of acquisition cost
Repairs of 51-75% of acquisition cost
Spare parts only
Scrap/no value
Activity:
Transfer to another Dept.
Go to Surplus
Transfer to Employees Home
5
Condition:
No work/no repairs necessary
Repairs of 10% or less of acquisition cost
Repairs of 11-50-% of acquisition cost
Repairs of 51-75% of acquisition cost
Spare parts only
Scrap/no value
Activity:
Transfer to another Dept.
Go to Surplus
Transfer to Employees Home
6
Condition:
No work/no repairs necessary
Repairs of 10% or less of acquisition cost
Repairs of 11-50-% of acquisition cost
Repairs of 51-75% of acquisition cost
Spare parts only
Scrap/no value
Activity:
Transfer to another Dept.
Go to Surplus
Transfer to Employees Home
Initiating Department:
Name:
Email:
Site:
Medical University
Hospital Authority (MC)
Phone:
Pager/Cell:
Receiving
Department:
Name:
Email:
Phone:
Pager/Cell:
Special Instructions / Notes: