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CITY OF RIVERSIDE RECEIVED <br /> Tax ID# 95-600-0769 AUG 3 0 Z018 <br /> DONATION ACCEPTANCE FORM <br /> City of Riverside <br /> Name of Donor: Flora "Penny" Marseilles City Clerk's Office <br /> Address: 514 Zapata City: Riverside State: Ca Zip: 92507 <br /> Description of donation: $5,500.00 Check (Check#1020 Dated 08-14-18) <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: <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. /Sgt. Angulo <br /> Deposit Account Code: 0000720 -225140 <br /> APPROVED / DISAPPROVED <br /> Date Department ead/Elected Offic al 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 />