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5 <br /> SAMPLE HAND RECEIPT ATTACHMENT F <br /> Subgrantee Organization: <br /> Address: <br /> Telephone#: <br /> hereby acknowledge receipt of the following equipment from Snohomish County Dept. of <br /> Emergency Management as part of the USDHS-ODP State Domestic Preparedness <br /> Equipment Program (CFDA #97.004-OJP) <br /> Extended <br /> Date Rec'd Description Model / Part # Serial # # of Units Qty Unit Price Price <br /> I understand that my agency is responsible for the licensing, maintenance, training, storage, proper inventory <br /> and use of the above listed equipment. If this equipment is lost, stolen, or deemed unusable it will not be <br /> -eplaced. <br /> Equipment valued at $5,000 or more have additional compliance requirements. Including but not limited to; <br /> detailed property records must be maintained, an inventory must be conducted by the subgrantee every two <br /> years on all federally purchased equipment valued at $5,000 or more, a control system to adequately maintain <br /> and safeguard the equipment must be established, and federal disposal requirements must be met. To be <br /> :onsistent with Agency policy, lower limits (below $5,000) may be established. (Common Rule (CFR_.32)) <br /> ne hold Snohomish Co. Dept. of Emergency Management, the Washington State Military Department and <br /> all its agents harmless for any and all damages that may result from the acceptance of this equipment. <br /> 4dditionally, I also understand that our agency must report this equipment in accordance with OMB Circulars A- <br /> 37 and are subject to audit under OMB A-133. <br /> Signed by: <br /> Date: <br /> Print Name /Title: <br /> 2b <br />