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CITY OF RIVERSIDE <br />Tax ID# 95-600-0769 <br />DONATION ACCEPTANCE FORM <br />Name of Donor: Riverside Food Hall <br />v -r3 2 0 w; J <br />Address: 191 W. 4th St. City: Pomona State: CA Zip: 91766 <br />Description of donation: $150 Sponsorship Check <br />Donor estimate of current value: $150.00 <br />Potential immediate or initial acquisition or installation cost, any on-going maintenance or <br />replacement cost: NA <br />Intended use: Sponsorship of the 52 things to do in Riverside -Deck of cards <br />Conditions of acceptance or donor designation: Business (Riverside Food Hall) will be included <br />in the deck <br />Remarks: No Goods or Services were provided by the City in exchange for the donation <br />City Department and City Representative receiving donation: Office of the Mavor-Kathv Young <br />Deposit Account Code: 0120000-374222 <br />Exp. Account Code: 0120000-453925 <br />APPROVED / DISAPPROVED <br />Date <br />me ead/E`hgcted 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 />cc: City Council, Finance Department, Receiving Department <br />