CITY OF FONTANA
DONATION ACCEPTANCE APR 0 3 2024
(For All Donations)
Name of Donor/Organization:
Bel-Air Swap-Meet, Inc. BY:_
Address:
17455 Valley Blvd, Bloomington, CA 92316
Contact Person, Title: Phone No.
Hae Park 909.875.3000
Type of Donation: (Check boxes)
Monetary Amount $ Receipt No.
$10,000.00 1002429.002
(Attach Copy of Receipt)
Goods/Services Estimated Value $ Description
Intended use of Donation:
Specific Description:
2024 Fontana Days Run Title Sponsor
General
Thank you/acknowledgement letter sent to Donor? (Required for ALL donations) X Attach copy of acknowledgement letter to this form.
G.E.T. Online Donation Tracking Form Has Been Completed. (Required for ALL donations with a value greater than $500.00) Received By: Date:
Kristina Torres 3/25/2024
copy otis from sento superior Mamas 04/12024
= = = FOR ADMINISTRATION USE ONLY = = =
City Council Agenda Date
Entered in Novus by: Date
This form must be filled out for all donations received regardless of value amount. This donation must be approved by City Council prior to any spending or use of the donation.
S:Community Services Special Events|Fontana Days Run|2024|Sponsorships|Donation Record forms|Donation Acceptance Bel Air.x/s\3/25/2024\11:32 AM City of Fontana
FONTANA COMMUNITY SERVICES DEPARTMENT
CALIFORNIA
March 25, 2024
Bel-Air Swap Meet, INC.
17455 Valley Blyd
Bloomington, CA 92316
Dear Bel-Air Swap Meet,
On behalf of the City of Fontana, Community Service Department, we would like to extend our sincere gratitude for your generous donation of $10,000 as a Title Sponsor for the 2024 Fontana Days Run. We are grateful for your continued support, as it is through generous donors such as that of your organization that allows the City to host such wonderful events.
With this donation, the City is able to obtain the necessary tools and equipment needed to host another successful event. Once again, thank you for your efforts in helping the City of Fontana improve this series of community events, as we strive to continue to meet the recreational needs of the citizens of Fontana.
We look forward to working with you in the future.
Sincerely,
Dameling
Diana Ambriz
Community Services Coordinator, Special Events
City of Fontana
City of Fontana
Community Services Department • 16860 Valencia Ave • Fontana, CA • 92335 Phone: 909.349.6900 • Fax: 909.349.6965
BEL-AIR SWAP-MEET, INC. OPERATING ACCOUNT LUYULL
Supplier: City of Fontana MAIN Customer#: Check#: 109024 Invoice Invoice Date Reference Invoice Amount Discount Amount Paid FONTANA DR 2024 02/22/2024 Title Sponsor -... $10,000.00 $10,000.00 •.
GL Acct: 11015 Check Date: 02/22/2024 Total: $10,000.00
FONTANA
Receipt #1002429.002
City of Fontana Receipt Date Mar 20, 2024
Email: [email protected] Fax: (909) 349-6911 Transaction Confirmation # 1002429.002 Phone: (909) 349-6900 Customer ID 23333
8353 Sierra Avenue Fontana, CA, 92335 Prepared By csanchez BEL-AIR SWAP-MEET, INC. OPERATING ACCOUNT
PO BOX 780
BLOOMINGTON, CA 92316
Bel-Air Swap-Meet, Inc. Operating Account
Phone: (909) 875-3000
17565 VALLEY BL, FONTANA, CA 92316
Subtotal $10,000.00
Revolving Half Marathon #0105.101.WS24 Activity Enrollment Location: CSD Administration, Facility: CSD Administration Office Charge item Unit QTY Unit fee Price
General Per Seat 1.00 $10,000.00 $10,000.00
Total Charges $10,000.00
Total Payments $10,000.00
Balance $0.00
Payment Summary
Payer: Bel-Air Swap-Meet, Inc. Operating Account ID: 23333 Home phone: (909) 875-3000 Billing address: PO Box 780, Bloomington, CA 92316
PAYMENT TYPE AMOUNT
Check #109024 $10,000.00
Waivers
Description Status Waiver due date
Registration Form: Release of Liability Waiver for Bel-Air Swap-Meet, Inc. Operating Account Signature:
I on behalf of myself or on behalf of my minor child, hereby waive in advance any and all actions or causes of action and claims for injury or property damage I may have, or which may hereafter accrue to the participant, his/her heirs of other successors as a result of my participation in any activity, or activities incidental thereto, (herinafter referred to as the "activity") sponsored by the City of Fontana. This is intended to release and hold harmless the City of Fontana and it's elected officials, officers, employees, contractors, and agents.
I understand that the participant must be in good health prior to participating in the activity. I understand that serious accidents occasionally occur to participants during such an activity, transportation, to or from such an activity, and during activities incidental to such an activity. Knowing these risks, I expressly assume those risks and agree that under no circumstances will I, or any of the participant's heirs or successors present any claim or action against the City of Fontana.
I also agree that the participant may be photographed and or filmed, and or agree to have the participant photographed and or filmed, and release the use of the photographs and or footage for publicity in City of Fontana publications and other public information materials.
I hereby represent that I understand and am familiar with the nature of the activities in which I (or my child) will participate in this recreation program. I personally read and understand this release.
Registration Form: Medical Release Waiver for Bel-Air
Swap-Meet, Inc. Operating Account Signature:
--
I do hereby give permission for any certified emergency professional or health care professional to administer any type of medical treatment he/she deems necessary to the participant in case of an emergency and in the event that I cannot be contacted.