DONATION OF PROPERTY FOR EDUCATIONAL 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
PERSON TO CONTACT
CA
ZIP
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
01 Mar 2010
LACC1022.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_______________________
___________________________________
___________________________________
___________________________________
01 Mar 2010
LACC1022.DOC
DONATION OF PROPERTY FOR EDUCATIONAL PURPOSES
INSTRUCTIONS
The donation by
01 Mar 2010
includes the following items and or activities:
LACC1022.DOC