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CITY OF RIVERSIDE <br />Tax ID# 95-600-0769 <br />DONATION ACCEPTANCE FORM <br />Name of Donor: Riverside Community Services Foundation <br />Address: 6927 Magnolia Ave City: Riverside State: CA Zip: 92506 <br />Description of donation: Donation for RAP Program <br />Donor estimate of current value: $700.66 <br />Potential immediate or initial acquisition or installation cost, any on-going maintenance or <br />replacement cost: <br />Intended use: RAP Programming <br />Conditions of acceptance or donor designation: To be used for RAP programming only. <br />Remarks: No Goods or Services were provided by the City in exchange for the donation <br />City Department and City Representative receiving donation: Jovan Fontenot <br />Deposit Account Code: _ deposit to account 9924300-374222 and increase expenditures <br />account 9924300-421040 in equal amount. <br />APPROVED/DISAPPROVED <br />111 10�� <br />Date D0artment Head/Elected Official Signature <br />Date <br />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 />