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City of Santa Ana f Donation Request 4h City Manager's Office - M-31 20 Civic Center Plaza P.O. Box 1988 Santa Ana, CA 92702 (714) 647.5200 Name: IWIlard Nieghborhood Task Force - account with Charitable Ventures of OC (501c(3) - CVOC 7anization a non-proet or of the Intemal Revenue i as ISelect One: I R1 Yes ❑ No will only qualify/ora credit for City -related costs for yourrequest (i.e. permit fees, If Yes, rentalretes forfacAiOes orequipment,eic.).Cesis for City services vary andif CVOC-20-8756660 credit may or may not cover full cost of requested City services. ax ID#: Name: Imarta Rodriguez Itle: Office Administrator ddresa: 1510 N. Parton Street city, state, zip: Santa Ana, CA 92706 hone: 714-542-6781 Email: marta@saintpeterlutheran.net Fax: City Manager Signature: Name: IWIlard Nieghborhood Task Force - account with Charitable Ventures of OC (501c(3) - CVOC 7anization a non-proet or of the Intemal Revenue i as ISelect One: I R1 Yes ❑ No will only qualify/ora credit for City -related costs for yourrequest (i.e. permit fees, If Yes, rentalretes forfacAiOes orequipment,eic.).Cesis for City services vary andif CVOC-20-8756660 credit may or may not cover full cost of requested City services. ax ID#: IMM -1 Mail: City Managers Office -M-31 Email: donationrequest@santaana.org 20 Civic Center Plaza Fax: (714) 647.6954 P.O. Box 1988 Santa Ana, CA 92702 City Services Credit F Date Needed: H/30/201 H Mayor/Councilmember. Yliegas Dunt Requested: Direct Payment Amount S � 500 Event Date: 9/13/ZO1 H Event Time: 1:00 pR1 (Requested: Event Location; St. Peter Evangelical Lutheran Church Addmss,crly State, ble 1510 N. Parton St. Santa Ana, CA 92706 City Manager Signature: announcement / ribbon cutting / celebration to kick off project for street topper Description of signage for the Willard community. Event l Purpose: The Willard neighborhood is located next toy Floral Park Washington Square both which have n street topper signage. With Willards proximity to downtown, having their own street topper signage would to downtown, g Community Benefit: bring a sense of ownership and pride to the Willard residents. It would also help advance the city's efforts In the "Love Where You Live" campaign and bring uniformity of style to this Santa Ananeighborhood. Applicant Signature: IMM -1 Mail: City Managers Office -M-31 Email: donationrequest@santaana.org 20 Civic Center Plaza Fax: (714) 647.6954 P.O. Box 1988 Santa Ana, CA 92702 Revised 01/05/2017 kt Donation Request #: Reference Aon all related DPVs DR - Council Meeting Date: September 18, 2018 Eligibility Met: YES / NO YES Approved Amount: $1,500 City Manager Signature: Date: Revised 01/05/2017 kt