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RECEIVE <br /> CITY OF RIVERSIDE <br /> Tax ID# 95-600-0769 OCT 0 5 201 <br /> DONATION ACCEPTANCE FORM <br /> City of Riverside <br /> City Clerk's Office <br /> Name of Donor: Riverside Temple Beth El <br /> Address: 2675 Central Avenue City: Riverside State: CA Zip: 92506 <br /> Description of donation: $100 Check (Check#2010 Dated 9/19/17) <br /> Donor estimate of current value: <br /> Potential immediate or initial acquisition or installation cost, any on-going maintenance or <br /> replacement cost: N/A <br /> Intended use: Donation to K9 Trust Fund <br /> Conditions of acceptance or donor designation: K9 Trust Fund <br /> Remarks: No Goods or Services were provided by the City in exchange for the donation <br /> City Department and City Representative receiving donation: Police Dept/ Sqt. Chad Milby <br /> / Sqt. Angulo for K9 Unit <br /> Deposit Account Code: 0000720 - 225140 <br /> APPROVED / DISAPPROVED <br /> Date partment Head/Elected ficial Signature <br /> Date Chief Financial Officer Signature (if needed) <br /> Date Submitted to Council Date Approved by Council (if needed) <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 />