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CITY OF RIVERSIDE <br />Tax ID# 95-600-0769 <br />DONATION ACCEPTANCE FORM <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 National Night Out <br />Donor estimate of current value: $500 <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 National Night <br />Out. <br />Conditions of acceptance or donor designation: The donation is made to the Riverside <br />Police Department specifically for National Niaht Out. <br />Remarks: No Goods or Services were provided by the City in exchanae for the donation <br />City Department and City Representative receiving donation: Police Department / Angela <br />Kinq <br />Deposit Account Code: 3125000 - 425400 <br />APPROVED / DISAPPROVED <br />Date <br />Departme Head/Elected 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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