Home
Clerk
>
Donation Acceptance Forms
>
2019
>
HUB International (2)
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/15/2019 8:42:32 AM
Creation date
11/15/2019 8:42:29 AM
Metadata
Fields
Template:
General
General - Type
Agendas
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
Page 1 of 1
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
Show annotations
View images
CITY OF RIVERSIDE RECEIVED <br />Tax ID# 95-600-0769 NOV 15 2019 <br />DONATION ACCEPTANCE FORM <br />City of Riverside <br />Name of Donor: HUB International <br />City Clerk's Office <br />AddressPO Box 2158 <br />City: Riverside State: CA Zip: 92516 <br />Description of donation: Wellness Donation <br />Donor estimate of current value: $6,502.89 <br />Potential immediate or initial acquisition or installation cost, any on-going maintenance or <br />replacement cost: N/A <br />Intended use: Funds will be used to for Wellness Incentives <br />Conditions of acceptance or donor designation: Wellness Program <br />Remarks: No Goods or Services were provided by the City in exchange for the donation <br />City Department and City Representative receiving donation: Human Resources - Stephanie Holloman <br />Deposit Account Code: 2100001-453221 <br />APPROVED / DISAPPROVED <br />11/07/2019 <br />Date <br />Date <br />Date Submitted to Council <br />e"Head/ElecOfficial Signature <br />Chief Financia is Signature (if needed) <br />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 />
The URL can be used to link to this page
Your browser does not support the video tag.