ATTACHMENT A
an OF PASADENA MANUAL OF PERSONNEtl
SECTION 10 iriNANCi'M POdCIFS
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CITY OF PASADENA
DONATION / GIFT ACCEPTANCE FORM
Name of Donor: P/^S/lOr-r-VJ^ /\^^-\<-l^ ^^TTt e_(/_£^^-^ Aad,ess:3S7t1 E.KAl fiU. ^7 city: ft^^^ S^.^:C^LW27
Description of donation: Cr»«l STRUCT 10^ 0^ ^ F'IA/ f^^TT/^^_^(^£- m VI-CK^^Y \^^z\^
Donor estimate of current valuerr
Potential immediate or initial acquisition or installation cost, an on-going maintenance or replacement ^.S^tnML
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Intended use: ft^--V\i^ C^j^ 61 (Ac^ \S^{^e.^\
Conditions of acceptance or donor desienation: 1\JQUE-
Remarks: iNe^E-
City Department receiving donation/gift: P/i ^S , ^a^w-^MA Q i^vd ^ (^^V^<+( ^e^toe.
APPROVED / DISAPPROVED (Please circle)
Date
Date
Department Head Signature
City Manager Signature
Date
Date
Approved by City Council
Mayor Signature
Note: The City of Pasadena cannot guarantee future funding for repair, maintenance, us or replacement of donated items.
CC: City Council, Finance Department, City Clerk
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