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t� * City of Santa Ana <br />' Donation Request <br />a w e <br />'Name: ___--!Frank Bejarana <br />lddresa: 11902 W. Chestnut Ave. <br />',city, state, zip, ISanta Ana, CA, 82703 Phone: <br />Email: Ifrank@kidworksoa.org IF= <br />Name: (KidWorks Community Development Corp. <br />ionization a non-pmtn or <br />of Oro internal Revenue + <br />City Manager's Offloo — M-31 <br />20 Civic Center Plaza <br />P.O. Box 1088 <br />Santa Ana, CA 02702 <br />('714) 847.5200 <br />ami Family Engagamcnt <br />as palect One: Q Yes❑ No <br />if No, you will only qualify for a credit for City -related costs for your request (i.e. permit fees, I I <br />istafftime, rental rates for facilities or equipment, etc.). Coats for City services vary and ff It Yea, x%4_3081569 <br />approved, credit may or may not cover full cost of requested City services. Rax ID #: <br />Services Credit <br />untRequested: <br />Needed: <br />Direct Payment Amount ---.`._ _.— <br />Regtaeatad. ;$500 IEventData: May 12, 2018 IEventTima i10:00AM-2:00PM <br />!Event Location: <br />!Address, City, State, Zip <br />(Description of <br />'Event l Purpose: <br />!Community Benefit: <br />"Applicant Signature:.._.... <br />850 W. Willits St. Santa Ana, CA 82703 <br />Cwnwo`MN,N �u�EY Fl.[9rcenpMPOS Murtygmro+tW,ttY4MC0wImNMNowfM.,NN!nnaW n.WM'm,an9alWkxbM <br />Mail: City Manager's Office—M-31 I Email donationrequest@santo-ana.org <br />20 Civic Cantor Plaza Fax: (714) 847.8954 <br />' P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Donation RequestDig. Council Nigerian ©ate:........ <br />!2e?2r�,cs g e+n afSaat&¢rstf UPVS .. <br />Eligibility Met: YES !Na Approved Amount: <br />City Manager Signature: <br />Revised 0 1/0 512 01 7 <br />EXHIBIT 14 <br />