1 Vandal resistant camera 94 several Various F 2 Two Way Radio 7 Icom several Various F 3 PBJCF Main Building 1 West Palm beach F 4 PBJCF All Dorm 1 West Palm beach F 5 Flag Pole 1 West Palm beach F 6 PBJCF Maintenance 1 Maintenance Shed (outside) F 7 Sofa with chase 20 All dorms F 8 ottoman 11 All dorms F 9 Washer 1 Unimac 1306002092 Intake F 10 Dryer 1 Unimac 1306002006 intake F 11 chair 1 FA Office F 12 Desk with Credenza 1 FA Office F 13 Phone 24 several Various F 14 2 drawer file storage 1 FA Office F 15 4 shelf bookcase 1 FA Office F 16 VCR 1 FA Office F 17 Monitor 2 FA Office F 18 Computer 2 FA Office F 19 Manager Chair 1 FA Office F 20 All in One Printer 1 FA Office F 21 Round Table 1 FA Office F 22 Refrigerator 1 FA Office F 23 chairs 2 Bus Mgr Office F 24 2 shelf bookcase 1 Bus Mgr Office F 25 5 shelf bookcase 1 Bus Mgr Office F 26 CPU monitor 1 Bus Mgr Office F 27 CPU 1 Bus Mgr Office F 28 Safe 1 Bus Mgr Office F 29 HP printer 1 Bus Mgr Office F 30 Mini Fridge 1 AFA Office F 31 chairs 1 AFA Office F 32 Desk 1 AFA Office F 33 4 shelf bookcase 1 AFA Office F 37 Manager Chair 1 AFA Office F 38 CPU monitor 1 AFA Office F 39 cpu 1 AFA Office F 40 HP printer 1 AFA Office F 41 chair 1 HR Office F 42 desk 1 HR Office F 43 Manager Chair 1 HR Office F 44 Filing Cabnets 3 HR Office F 45 Cabinet 1 HR Office F 46 2 drawer wood filing cabinet 1 HR Office F 47 4 shelf bookcase 1 HR Office F 48 printer 1 HR Office F 49 shredder 1 HR Office F 50 CPU monitor 1 HR Office F 51 CPU 1 HR Office F 52 CPU monitor 1 Training Office F 53 CPU 1 Training Office F 54 4 shelf bookcase 1 Training Office F 55 Filing Cabnets 1 Training Office F
56 Mgr chairs 7 Conf Room F 57 Conf Table 1 Conf Room F 58 chair 2 Case Mgr Sup Office F 59 4 shelf bookcase 1 Case Mgr Sup Office F 60 Filing Cabnets 1 Case Mgr Sup Office F 61 desk 1 Case Mgr Sup Office F 62 printer 1 Case Mgr Sup Office F 63 CPU monitor 1 Case Mgr Sup Office F 64 CPU 1 Case Mgr Sup Office F 65 4 shelf bookcase 1 Clinical Director office F 66 chair 1 Clinical Director office F 67 desk 1 Clinical Director office F 68 cpu desk 1 Clinical Director office F 69 printer 1 Clinical Director office F 70 CPU monitor 1 Clinical Director office F 71 cpu 1 Clinical Director office F 72 Mgr chairs 1 Clinical Director office F 73 Fax Machine 1 Case Mgr Sup Office F 74 Copier leased 1 Admin Commons F 75 14 set of 5 metal lockers 5 lobby area F 76 Refrigerator 1 Admin Commons F 77 coffee maker 1 Admin Commons F 78 microwave 1 Admin Commons F 79 lock boxes 4 Lobby Area F 80 Metal Detector 1 lobby area F 81 chairs 3 lobby area F 82 end tables 2 lobby area F 83 CCTV Monitor 1 Sub Control F 84 CPU 1 Sub Control F 85 CPU monitor 1 Sub Control F 86 chair 1 Sub Control F 87 Exam Table 1 Medical F 88 4 shelf metal rack 2 Medical F 89 Filing Cabnets 4 Medical F 90 medical med cart 1 Medical F 91 chair 3 Medical F 92 medical scale 1 Medical F 93 desk 3 Medical F 94 Large Refrig 1 Medical F 95 Small Refrig 1 Medical F 96 Shredder 1 Medical F 97 Stool 1 Medical F 98 Printer 2 Medical F 99 2 draw file cabinet 1 Medical F 100 CPU monitor 2 Medical F 101 CPU 2 Medical F 102 WheelChair 1 Medical F 103 Tool Cart with drawers 1 Maint Room F 104 Desk 1 Maint Room F 105 Mgr chairs 1 Maint Room F
106 Tool Bench 1 Maint Room F 107 CPU monitor 1 Maint Room F 108 CPU 1 Maint Room F 109 desk 1 Asst Clinical Dir F 110 chair 1 Asst Clinical Dir F 111 CPU monitor 1 Asst Clinical Dir F 112 CPU 1 Asst Clinical Dir F 113 printer 1 Asst Clinical Dir F 114 4 shelf bookcase 1 Asst Clinical Dir F 115 CPU 2 MHOS office phase II F 116 CPU monitor 2 MHOS office phase II F 117 printer 2 MHOS office phase II F 118 Filing Cabnets 1 MHOS office phase II F 119 desk 2 MHOS office phase II F 120 Mgr chairs 2 MHOS office phase II F 121 Folding chair 1 Case mgr office phase II F 122 chair 1 Case mgr office phase II F 123 CPU monitor 2 MHOS office phase I F 124 CPU 2 MHOS office phase I F 125 desk 2 MHOS office phase I F 126 Mgr chairs 2 MHOS office phase I F 127 chair 1 MHOS office phase I F 128 Filing Cabnets 1 MHOS office phase I F 129 TV 1 Alpha Dorm F 130 washer 1 Alpha Dorm F 131 dryer 1 Alpha Dorm F 132 table 1 Alpha Dorm F 133 tv 1 Bravo Dorm F 134 table 1 Bravo Dorm F 135 tv 1 charlie Dorm F 136 table 1 charlie Dorm F 137 cpu monitor 2 alpha case mgr/mhos office F 138 cpu 2 alpha case mgr/mhos office F 139 Mgr chairs 2 alpha case mgr/mhos office F 140 Filing Cabnets 1 alpha case mgr/mhos office F 141 desk 2 alpha case mgr/mhos office F 142 chair 1 alpha case mgr/mhos office F 143 4 shelf bookcase 1 alpha case mgr/mhos office F 144 4 shelf bookcase 1 bravo case mgr/mhos office F 145 CPU monitor 2 bravo case mgr/mhos office F 146 cpu 2 bravo case mgr/mhos office F 147 desk 2 bravo case mgr/mhos office F 148 Filing Cabnets 1 bravo case mgr/mhos office F 149 chair 1 bravo case mgr/mhos office F 150 printer 2 bravo case mgr/mhos office F 151 CPU monitor 1 master control phase I F 152 cpu 1 master control phase I F 153 printer 1 master control phase I F 154 CCTV Monitor 4 master control phase I F
155 Mgr chairs 1 master control phase I F 156 chair 2 master control phase I F 157 CCTV Monitor 4 master control phase II F 158 Mgr chairs 1 master control phase II F 159 chair 2 master control phase II F 160 TV 1 Delta Dorm F 161 Table 1 Delta Dorm F 162 Tv 1 echo dorm F 163 table 1 Echo dorm F 164 tv 1 Fox Dorm F 165 table 1 Fox Dorm F 166 CPU monitor 2 Echo case mgr/mhos office F 167 cpu 2 Echo case mgr/mhos office F 168 printer 2 Echo case mgr/mhos office F 169 Filing Cabnets 1 Echo case mgr/mhos office F 170 CPU monitor 2 fox case mgr/mhos office F 171 cpu 2 fox case mgr/mhos office F 172 printer 2 fox case mgr/mhos office F 173 Filing Cabnets 1 fox case mgr/mhos office F 174 desk 2 Echo case mgr/mhos office F 175 desk 2 fox case mgr/mhos office F 176 Mgr chairs 2 Echo case mgr/mhos office F 177 Mgr chairs 2 fox case mgr/mhos office F 178 chair 1 Echo case mgr/mhos office F 179 chair 1 fox case mgr/mhos office F 180 lrg tables 2 intake F 181 dishwasher 1 Kitchen F 182 toaster 1 kitchen F 183 steam Table 1 Kitchen F 184 slicers 2 kitchen F 185 oven/stove 1 kitchen F 186 commerical oven 1 kitchen F 187 ice machine 1 kitchen F 188 warming drawer 1 Kitchen F 189 mixer 1 kitchen F 190 food cart 1 kitchen F 191 walkin Cooler 1 kitchen F 192 walkin freezer 1 kitchen F 193 desk 2 Kitchen F 194 chair 2 kitchen F 195 back blower 1 Maint F 196 weed eater 1 maint F 197 hedge trimmer 1 maint F Total Provider s Name: Contract Manager s Name: Provider s Signature: Contract Manager s Signature: Date:
*E = Excellent, G = Good, F = Fair, P = Poor