Donated Equipment Record

Project Title:     Nyssa Skate Park                                          Project #:                              

Donor:                                                                                      Phone #        

Address:                                                                                                                                   

The hourly rate for donated equipment used on a project shall not exceed its fair-rental value.   Records of in-kind contributions of equipment shall include schedules showing the hours and dates of use and the signature of the operator of the equipment.

Date

Description of
Equipment Used

Hourly Rate of
Donated Equipment
Number of
Hours Used


     


     


     


     


     


     


     


     


     


     

 


Signature of Person
Donating Equipment

Project Supervisor
Signature
Date




   



Total Value of Donation This Sheet $