NATIS HOUSE (DBA NEUTRAL GROUND) (2)

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sem•. City of Santa Ana Donation Request Contact Information City Manager's Office— M-31 20 01vic Center Plaza P.Q. Box 1988 Santa Ana, CA 92702 (714) 647.5200 Name: Nati Alvarado Executive Director r adreas: 1920 E. 17th Suite 202 Ity, state, zip: Santa Ana, Calif. 92705 phone: 714-267-7747 Email: nati@ngservices.org IF= 1 Name: I Natis House DBA Neutral Ground is your organization a non-profit or 501(c)(3) of the Internal Revenue i as Select One: I ® Yea ® No If No, you will only quality for a credit for City -related costs for your request (i.e. permit fees, If Yea, rtaNtime, rental rates for facilities or equipment, etc.). Costs for City services vary and if Ye 45-4041042 approved, credit may or may not cover full cost of requested City services. ax ID M: Direct Payment Amount 6-2 250.00 Event Date: 3-2018 vent TIme:12:00pm Council Meeting Date, Requested: Reference N on all related DPVs 1825 C Ivic Center Dr Santa Ana, Ca. 92706 Event Location: Approved Amount: Address, City, State, 7Jp City Manager Signature: Ouse provides mediation an Intervention services to ante Ana youth Description of Fandfarmilies in need. The funds fromthis sponsorship will go towards on-going Event/Purpose: cost and services through June 30, 2018, The community benefits from Natis House services an program y overcoming Community Benefit•. life challenges, learning workforce skills, completing educational opportunities. Applicant Signature: ata. 06-08-2018 Y ✓ -G Mail: City Manager's office — M-31 I Email: donationrequest@santo-ana.org 20 Civic Center Plaza Fax: (714) 647.6964 P.O. Bax 1988 Santa Ana, CA 92702 A Revised 01/0512017 Donation Request it: DR- Council Meeting Date, JUNE 19, 2018 Reference N on all related DPVs Eligibility Met: YES 1 NO YES Approved Amount: $250 City Manager Signature: Date: a. A Revised 01/0512017