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CITY OF RIVERSIDE <br /> RFCEIVED <br /> Tax ID# 95-600-0769 SEP 2 6 2018 <br /> DONATION ACCEPTANCE FORM <br /> City of Riverside <br /> City Clerk's Office <br /> Name of Donor: Target <br /> Address: P.O. Box 1296 City: Minneapolis State: MN Zip: 55440-1296 <br /> Description of donation: Check donation for Shop With A Cop <br /> Donor estimate of current value: $2,000 <br /> Potential immediate or initial acquisition or installation cost, any on-going maintenance or <br /> replacement cost: No <br /> Intended use: The funds will be used for purchasing materials and supplies for Shop With A <br /> Cop. <br /> Conditions of acceptance or donor designation: The donation is made to the Riverside <br /> Police Department specifically for Shop With A Cop. <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 Department/Angela <br /> Ki g <br /> Deposit Account Code: 3125000 - 374222 <br /> APPROVED / DISAPPROVED <br /> 6 <br /> Date 1Depa ent Head/Ele ed Official 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 />
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