Donation Acceptance Forms
9/20/2017 4:41:07 PM
9/20/2017 4:40:49 PM
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CITY OF RIVERSIDE <br />Tax ID# 95- 600 -0769 <br />DONATION ACCEPTANCE FORM <br />Name of Donor: Yard House <br />Address: 3775 Tyler Street <br />4 <br />City: Riverside State: CA zip: 92503 <br />Description of donation: 40 gift cards to share with department personnel in <br />recognition of 9/11 anniversary. <br />Donor estimate of current value: $1,000 (each card $25) <br />Potential immediate or initial acquisition or installation cost, any on -going maintenance or <br />replacement cost: No <br />Intended use: For department personnel to use for business or personal use. <br />Conditions of acceptance or donor designation: <br />No conditions <br />Remarks: No Goods_ or Services were provided by the CitTin exchange for the donation <br />City Department and City Representative receiving donation: Fire /Michael Moore <br />Deposit Account Code: <br />Note: The City of Riverside cannot guarantee future funding for repair, maintenance, use or replacement <br />of donated items. <br />Original to City Clerk <br />cc: City Council, Finance Department, Receiving Department <br />
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