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PED Federal Grant
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Equipment Over $5,000 Approval Form
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Equipment is defined as tangible, nonexpendable, personal property having a useful life of more than one year and an acquisition cost of $5,000 or more per unit. The acquisition cost for equipment is determined by the “net invoice price of the equipment, including the cost of any modifications, attachments, accessories, or auxiliary apparatus necessary to make it usable for the purpose for which it is acquired." To determine what constitutes a unit, each item must be independently useable for the purpose for which it was acquired.
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Grant Name
Title IV Part AFiscal Year
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District
School
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Submitter (for questions on the form)
Phone #
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#EquipmentFunctionObject #QuantityPer Item PriceTotals
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1 $ -
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2 $ -
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3 $ -
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4 $ -
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5 $ -
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6 $ -
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7 $ -
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8 $ -
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9 $ -
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TOTAL $ -
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INSTRUCTIONS:
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1.Please provide a brief narrative which describes how this equipment will support your grant. Equipment that is purchased or leased is:
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a.
Reasonable and necessary to effectively operate the program;
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b.
Existing equipment will not be sufficient and;
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c. The costs are reasonable and allocable (benefit the grant in proportion to the percentage of funds spent on the equipment).
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Additional information for Special Education:
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Equipment purchased for a specific student:
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1.
Equipment is identified in the student's IEP dated (IEP must be current):
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2.
Equipment
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will require upgrading or replacement before the student exits school.
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will not require upgrading or replacement before the student exits school.
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3.
If an upgrade or replacement is required, how will this be achieved, including funding?
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4.
How will the equipment be maintained?
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5.
For assistive technology equipment, technical assistance consultation was provided by:
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(agency or company familiar with assistive technology (AT) for persons with disabilities)
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6.
Describe the LEA's process for property management as required under 34 CFR SS 80.32:
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Equipment purchased for general special education student support:
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7.Equipment supports this number of students who receive special education services. Attach the list of student identifcation numbers this equipment will support.
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8.
Where will the equipment be located?
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9.
Will equipment require upgrading, maintenance or replacement?
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Yes
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No
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If Yes:
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a.
How will it be maintained?
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b.
How will this maintenance be funded?
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c.
What is the expected annual support cost?
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d.
What is the expected life cycle of this equipment?
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PED Approval
Date
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