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<br />Equipment Used by FNP <br />Cass <br /> <br />ISchedule BI <br /> <br />County/Site <br /> <br />Agency/Facility Name <br /> <br />E <br /> <br />t <br /> <br />D <br /> <br />E <br /> <br />:qUlpmen A .,. B = C x = <br /> Initial Useful Value Per % used Total <br /> Cost Life Year Life by FNP Value <br />Tables $320 5 $64 $64 <br />Screen $150 5 $30 $30 <br />TVNCR $750 3 $250 $250 <br />Software <br />Printer/s $5000 3 $1666 $1666 <br />Bookshelves $500 5 $100 $100 <br />Cubicle partitions <br />File Cabinetls $250 5 $50 $50 <br />Deskls $500 5 $100 $100 <br />Office Chair/s $200/1000 5 $501$200 $125 <br />Computer/s $6000 3 $2000 $1000 <br />Fax machine $500 3 $166 $166 <br />Multi-media projectors $3000 3 $1000 $1000 <br />Dioital camera <br />Overhead projector <br />Slide projector <br />Laminator $150 3 $50 $50 <br />Copier/s $13900 3 $4633 $4633 <br />Typewriter $300 3 $100 $100 <br />Stove/s $400 3 $133 $133 <br />Refrioerator/s $500 3 $166 $166 <br />F reezerls $200 3 $166 $66 <br />Microwave $300 3 $100 $100 <br />Phone Equipment $250 5 $50 $50 <br />Chalkboard/white board $200 5 $40 $40 <br />Other: (specify) $500 5 $100 $100 <br />Total Equipment Value $9989 <br />(Transfer total to Contributor <br />Support Form Value of <br />Equipment) <br /> <br />Signature: <br /> <br />~;", <br />':~"'!T' <br />\:~~r <br />'Cnair or Departm <br />~ <br /> <br /> <br />Revised 1/06 <br />