CITY OF CHULA VISTA
DONATION ACCEPTANCE FORM
Firehouse Subs Public Safety Foundation
Name of donor:
Address: 12735 Gran Bay Pkwy #150 _ City: Jacksonville State: Fl Zip: 32258 Description of donation: Thermal Imaging Cameras
Donor estimate of current value: $39,421.24
Potential immediate or initial acquisition or installation cost, any on-going maintenance or N/a
replacement cost:
Intended use: 2 TICs added to FF and FFPM SCBA for situational awareness and enhanced safety.
Conditions of acceptance or donor designation: PR announcement of grant award.
Remarks:
City department receiving donation: Fire Department
APPROVED / DISAPPROVED
Date Department Head's Signature
Date City Manager's Signature
Date Submitted to Council Date Approved by Council
Date Mayor's Signature
Note: The City of Chula Vista cannot guarantee future funding for repair, maintenance, use or replacement of donated items.
CC: City Council, Finance Department, City Manager's Office Page 1 of 2