Laserfiche WebLink
Ot 4- - - -':). " -.10 e <br />CITY OF RIVERSIDE <br />Tax ID # 95-600-0769 <br />DONATION ACCEPTANCE FORM <br />T— <br />Name of Donor: Lpt%4�-VAT'0��w <br />Address: -ZILAk WeS* AoAN� City: L&--zl Py,es State: C.A- Zip:100%& <br />Description of donation: %=1 <br />;w 2at9 <br />Donor estimate of current value: S 12.1 <br />Potential immediate or initial acquisition or installation cost, any on-going maintenance or <br />replacement cost: <br />Intended user e % CLe.4 %a% <br />%%4 SkAMMcu- �WCSO ARA tkC= <br />Conditions of acceptance or donor designation: coMpcekA-oew\je RAoocA- <br />-Ao l.f�Q�`E �Oarrr+��1 <br />PP+ "t'1,� ANO � '�L�c 29l°l ,��u�ar"� De�a� O:ra In�,1 -iurC6 v xa2� ��D. <br />Remarks: No Goods or Services were provided by the City in exchange for the donation <br />City Department and City Representative receiving donation: <br />���s, ��c.�'�k�t�1a-�luhriy�,vice5 <br />��C�C� 1 �.� <br />0 1 <br />Deposit Account Code: <br />-- 2 T— / 9 <br />Date <br />Date <br />.Departrt HeadlIflected Official Signature <br />pr .u� <br />..t <br />'fficer <br />Chief Finanzer-6 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 />