Check One: Donation Loan

Check One: Donation Loan

Donation Of PROPERTY FOREducational PURPOSES

** SEE REVERSE SIDE FOR INSTRUCTIONS **

COLLEGE / DIVISION / DATE
INITIATOR / PHONE

DONOR INFORMATION (See instructions on the reverse side.)

LEGAL NAME OF DONOR
ADDRESS / CITY / STATE / CA / ZIP
PERSON TO CONTACT / PHONE

DESCRIPTION – Please include quantities, and make/model/serial number, whenever appropriate. Describe each donation in full. Attach a separate sheet, if necessary.

EXPLAIN HOW ITEM(S) WILL BE UTILIZED IN THE EDUCATIONAL PROGRAM(Be specific)

ANSWER ALL QUESTIONS REGARDING THE ITEMS DESCRIBED ABOVE

Age of Item * / Years / Present Value*
Where is/are the item(s) presently located?
Is/Are the item(s) disconnected and ready to move?
Delivery or Pick-up date: / By whom?

* PER DECLARATION OF DONOR

EXPENSE TO THE DISTRICT / AMOUNT
Transportation to and from the College / 0
Installation and Building Modifications / 0
Secondary A & I (additional lighting, ventilation, et. al.) / 0
Utility connections required / 0
Repair and/or Modification Costs / 0
Estimated Annual Energy Costs / 0
Other:______
TOTAL EXPENSE TO THE DISTRICT / 0
Screened by the Director of College Facilities/ Manager of Information Technology
APPROVALS:
Vice President of Administrative Services
College President

01Mar 2010LACC1022.DOC

Donation Of property for Educational purposes

instructions

This form is to be used only for donations of equipment, supplies and monies for educational purposes. LOANS OF EQUIPMENT AND MATERIALS MUST BE DOCUMENTED SEPARATELY.

All donations must be approved by the College President, or designee, and must be submitted for ratification by the Board within sixty (60) days of acceptance.

DONATIONS OF MONIES

  1. Complete all relevant information on the front side of this form.
  2. Attach the check made payable (endorsed) to the Los Angeles Community College District.
  3. Attach an original Budget Transfer Authorization (BTA) form designating the account to which the monies are to be deposited.
  4. Send check and original Budget Transfer Authorization (BTA) form to the District Budget Office.
  5. Prepare Board item for acceptance of monies.

DONATIONS OF EQUIPMENT OR SUPPLIES

  1. Complete all items on the front of the form – enter N/A wherever information is not applicable.
  2. All donations of equipment require review and approval of the College President, Vice-President of Administration and when necessary Director of College Facilities/Information Technology prior to acceptance by the Board.

Send completed form directly to:
College Procurement Specialist with copies to the Vice President of Administrative Services______
______
______
______

The donation by includes the following items and or activities:

01Mar 2010LACC1022.DOC

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