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CITY OF RIVERSIDE ",'4118 M <br /> ED <br /> Tax ID# 95-600-0769 <br /> DONATION ACCEPTANCE FORM <br /> Ciy ':f dive side <br /> Name of Donor: Mayor's Office, City Hall, City of Riverside <br /> Address: 3900 Main Street City: Riverside State: CA Zip: 92506 <br /> Description of donation: 10 Laptop computers, 40 PCs with monitors, keyboards and cables <br /> Donor estimate of current value: $2,383.00 (see attached) <br /> Potential immediate or initial acquisition or installation cost, any on-going maintenance or <br /> replacement cost: Not applicable <br /> Intended use: For use in public libraries and schools in Riverside's sister city Cuautla <br /> (Mexico)—given as a gift to commemorate the 50th anniversary of the sister city relationship <br /> between Riverside and Cuautla <br /> Conditions of acceptance or donor designation: 50th anniversary gift from Riverside to Cuautla <br /> Remarks: No Goods or Services were provided by the City in exchange for the donation <br /> City Department and City Representative receiving donation: Mayor's Office <br /> Deposit Account Code: Not applicable <br /> APPROVED / DISAPPROVED4 <br /> March 29, 2018 � <br /> Date Department ea•1 Elected Officia' 'iature <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 />