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Automobile Club of Southern California
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CITY OF RIVERSIDE <br />DONATION ACCEPTANCE FORM <br />Name of Donor: SD+,•.+ne,,, <br />MAR 0 S 2021 <br />City of Riverside <br />Address: j1.5r vil Y City: C0��gS G,_State: CA Zip: 6)2-b', <br />Description of donation:. 0 U X h ie,-- lowki 66"Arl± �a _ <br />Donor estimate of current value: -4 1 ?.1 �2 , 0v <br />Potential immediate or initial acquisition or installation cost, any on-going maintenance or <br />replacement cost: 01(40',_24 moi, +r,-l��v�t r, � S �,v,f -krrn � 1 G , � v �� /if <br />Intended use: :L' Ars Lin , VV (7-M <br />Conditions of acceptance or donor designation <br />Remarks: N by-\ <br />City Department receiving donation: <br />APPROVED I DISAPPROVED <br />Date <br />Date <br />Date Submitted to Council <br />Department ad Signature <br />($2,500 or below) <br />Chief Financial Officer Signature <br />($2,501 to $25,000) <br />Date Approved by Council <br />(more than $25,000) <br />Note: The City of Riverside cannot guarantee future funding for repair, maintenance, use or replacement <br />of donated items. <br />cc: City Council, Finance Department, City Clerk <br />l <br />
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