Planning Pod - Event Management Software

PCS Facilities

Program Agreement

Please use the fields below to make a formal request for the commemorative program with the City of San Ramon. I understand that the commemorative element that I have selected above will not last forever. The City will maintain or replace, if necessary, the element for the term of ten (10) years. The City will determine the level of maintenance required and the type of care needed to reasonably maintain the donation. The City reserves the right to remove and/or relocate commemorative elements and their associated donation acknowledgments/memorial plaques, when they interfere with site safety, maintenance or construction activities or when the term of the commemorative agreement has expired.

Name of Person/Pet Honored (required)

Donor Information

Donor First Name (required)

Donor Last Name (required)

Email (required)

Address (required)

Phone Number (required)

Requested Location of Bench (required)

Private or Non-Profit Reques

Private

Non-Profit

Engraving Information – Please print (max. 35 characters including spaces per line)

Personalization

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Preferred Payment Method - A 2.88% convenience fee will be added per total credit card transaction. If cash or check is selected, please drop off payment within 3-5 business of the application completion. (required)

Check

Card

Cash

Name of Person/Pet Honored (required)

Select Item (required)

Existing tree or bench with bronze plaque at a City park approved location $1,800.00

Memorial Bench without a concrete slab at a City park approved location $3,350.00

Memorial bench with a concrete slab at a City park approved location $4,850.00

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