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a_ w: City Manager's Office - M-31 <br />�1: Cit of Santa Ana <br />y 20 Civic Center Plaza <br />���r �I Donation Request P.O. Box 1988 <br />t_�. Santa Ana, CA 92702 <br />— (714) 647-5200 <br />'Contact Information <br />,Name Ijohnathan R. Hernandez FItle rE.D 8� Founder <br />Pddres� s. <br />1714 N Raitt St <br />city, s�— tate, zip: <br />Santa Ana, CA, 92701 IPho� e: <br />657-261-1653 <br />Email <br />santanaunidos@gmail.com ',Fax: <br />9 Onization Information <br />Name: <br />Santa Ana Unidos <br />Tax -Exempt Status: Is your organization a non-profit or public lax -exempt organization as : Select One <br />defined under Section 501(c)(3) of the Internal Revenue Code? IZ Yes ❑ No <br />If No, you will only qualify for a credit for City -related costs for your request (i.e. permit fees, i f <br />lLLYes' <br />staff time, rental rates for facilities or equipment, etc.). Costs for City services vary and if 47-5211563 <br />approved, credit may or may not cover lull cost of requested City services. (rax ID M <br />Donation <br />—f <br />cityServicesservlees credit E <br />Requested: <br />ate Needed: <br />08-25-2018 <br />�Mayorlcauncilmember. <br />Sarmiento <br />Direct Payment Amount S 501 0 EventEvent pa pe 08-25-2018 <br />Event Tim e: <br />11:00 AM - 4:30 PM <br />�Roqucsted: <br />__ _ <br />120 W. 5th St, Santa Ana. CA. 92701 <br />Event Location: <br />7 <br />Address, City, State, Zip <br />The Roses In Concrete Education 8 Arts festival is bringing together musicans, <br />Description of students, educators and community to celebrate youth in power. <br />Event l Purpose: <br />This event directly challenges negative sterotypes that Minder youth from thriving <br />Community Benefit: within our city. Youth are able to perform art, music and poetry amongst some of <br />their favorite and most influential artists. <br />--- <br />Applicant Signature: �Dat� e: I U8-06-2018 <br />r <br />Mail: City Manager's Office -M-31 <br />Email: donationrequestQsanta-ana.arg <br />20 Civic Center Plaza <br />Fax: (714) 647.6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Donation Request 8: DR - <br />Relerence # on au.craeed uays Council Meeting Date: September 4, 2074 <br />t—Approved <br />_— <br />Eligibility Met: YES 1 NO YES Amount: $500 <br />City Manager Signature: Date: <br />Revised 01/05/2017 <br />29A-10 <br />